Resources meet volunteers: Foundation for a Healthy Kentucky, Friedell Committee for Health System Transformation merge

By Melissa Patrick
Kentucky Health News

The Foundation for a Healthy Kentucky and the Friedell Committee for Health System Transformation have joined together and will function as one organization, a change that takes effect immediately.

In announcing the merger, the groups "emphasized the organizations' congruent missions and committed volunteers, and the value of speaking with a single, amplified voice to influence community and statewide health policy change," says the release.

Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky,
at Dec. 3 luncheon announcing a merger with the Friedell Committee.

The groups announced the union at a Dec. 3 luncheon to honor the late Dr. Gil Friedell, who founded the committee and was well-known for his mantra: "If the problem is in the community, the solution is in the community."

J.D. Miller, chairman of the Friedell Committee, citing the quote, said this philosophy was something they all agreed on.

"One of the things that is important to all of us is to be engaged in our communities . . . I think we all believe that and that we all understand that whatever we want to do in health and advocacy, it must be with community engagement," Miller said.

Bonnie Hackbarth, spokeswoman for the foundation, said after the luncheon that many committee members had already joined the foundation's Community Advisory Council. Its members advise the foundation's overall policy and strategic direction, and serve as liaisons to Kentucky communities.

"Potentially tripling the size of our council and adding Friedell Committee members' wealth of knowledge and expertise means reaching far deeper into Kentucky communities," LeChrista Finn, incoming chair of the advisory council, said in the release. She added that the new members will also help the foundation "better understand both the local issues and local solutions."

"This is one of the most engaged, dedicated groups of health advocates in our state," Miller said.

Richard Heine (Photo: Foundation for a
Healthy Kentucky)

Richard Heine, executive director of the Friedell Committee, said after the luncheon that he was "very pleased" with the merger.

"I think that what we bring is a lot of community presence and I think they are going to benefit particularly in the council to have our people, community level people," he said. "And we've done a lot of thinking about what needs to happen in terms of health care in the future, so I think we bring a lot of that with us when we come."

Asked what the foundation offered the committee, Heine said funding and resources.

The news release said the legacy of the Friedell Committee, especially in the areas of diabetes and obesity prevention, will continue through the foundation.

"The prevention of obesity and diabetes is among the work included in the foundation's 2019-2020 strategic plan, which we just approved," Mark Carter, chair of the foundation's board of directors, said in the release. "Our hope is to leverage Friedell Committee members' expertise in this area to better bring coordinated community-wide solutions to this increasingly serious societal health issue."

Miller said Friedell was aware of the potential merger before his death on Sept. 23.

"He was very much in support of joining together with the foundation, which was very important to us," Miller said. "We realized that as we joined, we could actually increase the impact of both organizations. And more than increasing the impact, we could learn from each other."

Jane Chiles, who was chair of the Friedell Committee for several years and is now chair of Kentucky One Health, said Friedell's legacy had come full circle, noting that he had been part of the vision for the foundation when it was "just a twinkle in the eye."

"The circle is complete," she said.

Foundation President and CEO Ben Chandler said, "We are so excited about this unification. It is something that's come full circle and I hope Dr. Friedell would be pleased. We want to continue making progress together and I think we can really, really attain great things."

Chandler announced that the Foundation's Healthy Kentucky Policy Champion of the Year award has been renamed the Gil Friedell Health Policy Champion award.

Kentucky loses a health champion who advocated for health equity and community-based solutions; Dr. Gil Friedell was 91

Dr. Gilbert "Gil" Friedell

By Melissa Patrick
Kentucky Health News

Dr. Gilbert Friedell, who was a fierce advocate for health equity and finding community-based solutions to the many health issues that plague Kentucky, died Sept. 23 at the age of 91.

His mantra,"If the problems are in the community, the solutions are in the community," was a drumbeat message that will continue to guide the efforts of many who knew him.

"It is difficult to imagine a more selfless man of medicine," said veteran journalist Al Smith.

Friedell was described in his obituary as an "avid student," attending Harvard College in 1943 at the age of 16 and graduating from the University of Minnesota Medical School in 1950. He then went on to receive his medical training in pathology in Boston and served as a physician in the Navy reserves for two plus years.

He was a medical faculty member at Harvard, Boston University, the University of Massachusetts and the University of Kentucky, where he became the first director of the Lucille Parker Markey Cancer Center in 1983, with a focus on cancer prevention.

He stepped down as the director in 1990 to run Markey Cancer Control Program, where he worked to convey breast-cancer information to the public and health professionals through the Kentucky Cancer Program, the Kentucky Cancer Registry and a regional information service for Kentucky, Tennessee and Arkansas -- all organizations that he helped to create. He retired from this position in 1998.

Friedell was an unwavering advocate for increasing health care access to Kentucky's underserved citizens, especially those who lived in Eastern Kentucky. To that end, he co-founded Kentucky Homeplace, a lay health-worker program funded by the Kentucky General Assembly that facilitates access to health-care services in 30 Eastern Kentucky counties.

Since 1994, the program has served over 161,968 people who have received access to more than 4.9 million services valued at $324.4 million, according to Fran Feltner, director of UK's Center for Excellence in Rural Health, where the program is based.

"Gil was a true friend and mentor," Feltner said. "He truly understood the community."

Feltner recalled how they testified to lawmakers in Washington and Frankfort about the value of community health workers and helped pass the national Patient Navigator Bill, which recognizes the need for improving access to care.

"His legacy will never be forgotten and his love for the community will live in my heart and in our work as we continue the lessons learned," Feltner said.

Friedell's legacy will also continue in the work of the Friedell Committee on Health System Transformation, which he founded. He asked that it not bear his name, but the other members unanimously overruled him. The committees' mission is "to improve the health of Kentuckians by promoting an effective, values-based health system, advocating for community action, and measuring the system's performance."

"Gil indeed touched each of us deeply," said Carolyn Dennis, executive director of the committee. "His determination for a just healthcare system that respects the inherent right of every individual to receive the best care possible was contagious; everyone associated with the Friedell Committee carries that same passion and sorrow in his passing. . . . He will be sorely missed but his legacy will live on by all who knew and loved him."

Dennis described Friedell as a "consummate gentleman," partial to wearing a "jaunty bow tie and beret," who was "tireless in his quest to engage leaders in every geographic corner of the state to improve the health of their communities."

Friedell was the recipient of numerous awards, authored more than 200 articles in medical publications, served on many state and national public-health committees, and co-authored The Great Diabetes Epidemic: A Manifesto for Control and Prevention that published in 2014.

"The very vibrant Big Sandy Diabetes Coalition . . . is a testament to Gil, who was really its founder with his periodic trips here to encourage us and educate us about the diabetes epidemic," said Prestonsburg lawyer John Rosenberg. "He infected us with the belief that the solution to better health care was in the community, and that took hold. He was a wonderful man, in his quiet way, a great leader and a great spirit!"

Friedell's obituary said, "To those who knew him, Gil will be remembered for his wise personal and professional counsel, incisive questions, wit, infectious chuckle, poetic annual holiday letters and fondness for bow ties. Gil dedicated his life to transforming inequitable systems to make the world a better place."

Smith, a Friedell Committee member, said, "We remember him best when we do all we can for the good health of Kentucky."

Friedell is survived by Jan, his wife of 67 years, four of their five children, seven grandchildren, and one great-granddaughter. A memorial service will be held in Charleston, S.C. in the fall with details to follow. In lieu of flowers, donations may be made to the Gilbert H. Friedell Resident Scholar in Cancer Prevention and Control Fund, University of Kentucky, Markey Cancer Center, 800 Rose Street, Lexington KY 40536, to the attention of Elisha Maxson.

Bill Wagner, who headed group of health clinics for disadvantaged in Louisville, wins Gil Friedell Memorial Health Policy Award

Wagner, left, with Foundation President and CEO Chandler

William Wagner, retired CEO of Family Health Centers of Louisville, is the latest winner of the Foundation for a Healthy Kentucky's Gil Friedell Memorial Health Policy Award, for his work expanding access to care and coverage.

“Bill’s passion for bettering the health of Kentuckians is a perfect reflection of the spirit of the Gil Friedell Memorial Health Policy Award,” said Ben Chandler, the foundation's president and CEO. “Dr. Friedell was a passionate advocate for access to health care. Bill’s 40-year career is a testament to his commitment to serving others by expanding opportunities for health-care coverage and bringing medical care to underserved areas in rural and urban communities. He has made a profound impact on the health and wellness of countless Kentuckians.”

Wagner established primary-care centers focused on people who are low-income, homeless, immigrants and refugees, then expanded them to include dental, behavioral health, pharmacy services, health education, outreach and enrollment services.

He was influential in the evolution of Kentucky’s Medicaid program, helping develop the nonprofit Passport Health Plan for managed care of Medicaid patients and the Children’s Health Insurance Program, providing medical services for hundreds of thousands of children and adults in Kentucky.

He also helped shape the next generation of social workers and public-health professionals through his work with the Kent School of Social Work and the College of Public Health at the University of Louisville.

“It's an honor to receive the award,” Wagner said. “I accept it on behalf of all the health care providers who work so hard to provide medical care access in underserved areas of Kentucky – urban and rural. They’re the real heroes. I have great respect for them and working with them made my job so fulfilling.”

Wagner retired at the end of 2021, something he delayed due to the pandemic. During it, he worked with non-English-speaking communities to provide testing and education. When vaccines rolled out, Wagner was at the forefront, helping with logistics, outreach, and education, most notably with the homeless.

The Memorial Health Policy Award is named for Gil Friedell, first director of the Markey Cancer Center at the University of Kentucky and cofounder of the Kentucky Cancer Registry. He helped launch a nonprofit advocacy education organization in 2005 that later became the Friedell Committee for Health System Transformation. The Foundation created the award when it united with the Friedell Committee in 2018.

Wagner and Friedell worked in the mid-1990s to create a community partnership for breast and cervical cancer screening in Louisville’s West End, which had extremely high death rates from those diseases.

The foundation makes a $5,000 grant to a Kentucky nonprofit working to improve health policy in the commonwealth in honor of the Friedell Award winner. Wagner selected Kentucky Voices for Health, a nonpartisan coalition that amplifies the voices of individuals, families, and communities in the decisions that affect the health and well-being of all Kentuckians.

Wagner said he selected KVH because of his concern that many Kentuckians could lose the Medicaid coverage to which they gained access in the pandemic. “Having health-care coverage is key to having access to medical care and living a healthier life,” he said. “I’m concerned when the emergency measures for expanded Medicaid expire, we will have many folks who aren’t sure how to recertify or apply through Kynect. KVH can help fill those gaps.”

Wagner was selected from the foundation's 2021 Healthy Kentucky Champions, Kentuckians honored for making a difference in the health of their communities or the state. Nominations for the 2022 awards are due by May 20. For more information and to nominate someone, visit Healthy-KY.org.

Denise Hall awarded Gil Friedell Health Policy Award for her substance-use prevention efforts with youth in Trimble County

Left to right: Foundation for a Healthy Kentucky Board Chair Dr. Clifford Maesaka, Denise Hall, Foundation President and CEO Ben Chandler, and Council President Tim Marcum.

Denise Hall of Trimble County is this year's winner of the Foundation for a Healthy Kentucky's Gil Friedell Health Policy Award for her  substance-use prevention efforts among youth. 

“Drug addiction is something far too many Kentuckians have seen first-hand, and that’s why Denise Hall’s work is so critical,” said Ben Chandler, president and CEO of the foundation. “Her efforts to prevent future addictions and support the overall wellbeing of the youth of her community makes her the perfect person to receive the Friedell Award. At a time when so many young people are struggling with their mental health, Trimble County students can take comfort in knowing what a strong advocate they have on their side.”

Hall began working in the substance-use prevention field in 1998 at Seven Counties Services. In 2003, she became coordinator for the Trimble County Family Resource and Youth Services Center, an organization that connects students and their families to needed services, like utility assistance or clothes and food, as a way to remove nonacademic barriers to learning. 

While with the FRYSC, Hall wrote two Drug Free Communities grants and directed them. In 2017, she gave up her coordinator position to focus on the grant program, which is in its 10th and final year. 

Hall retired Oct. 1, with plans to assist local nonprofits and schools with grant writing and continue attending meetings of the Trimble CARES Coalition, of which she was managing director. CARES stands for Community Assessing Resources and Education on Substance misuse. 

Hall’s work also includes implementing a Drug Education Series and a Sources of Strength group at Trimble County Junior/Senior High School. She made tools such as drug-testing kits and medication-deactivation kits available to parents and she provided one-on-one education for students who violated school drug and alcohol policies. She was also crucial in getting vape detectors installed at the high school. She has written grants for a small kitchen that allows for life-skills lessons in a special-needs classroom and for a washer and dryer at TCJSHS, and was instrumental in finding money to build a new wheelchair ramp after the old one broke. 

“I am so honored to be chosen for this award,” Hall said. “So many wonderful people worked on these projects with me, and we so appreciate the amazing students of this community.”

The Memorial Health Policy Award is named for Gil Friedell, first director of the Markey Cancer Center at the University of Kentucky and cofounder of the Kentucky Cancer Registry. He helped launch a nonprofit advocacy education organization in 2005 that later became the Friedell Committee for Health System Transformation. The Foundation created the award when it united with the Friedell Committee in 2018.

The foundation makes a $5,000 grant to a Kentucky nonprofit working to improve health policy in the commonwealth in honor of the Friedell Award winner. Hall selected Trimble CARES Coalition, which works against the harmful effect of substance abuse and strives to ensure that all youth have support available to make positive, healthy choices.

Hall was selected from the foundation's 2022 Healthy Kentucky Champions, Kentuckians honored for making a difference in the health of their communities or the state. Click here to nominate someone for the 2023 class of Healthy Kentucky Champions. 

Foundation for a Healthy Ky. adds 28 new members to its Community Advisory Council, most from Friedell Committee

The Foundation for a Healthy Kentucky has added 28 new members to its Community Advisory Council, bringing its total up to 49.

Of the new members, 27 were formerly members of the Friedell Committee for Health System Transformation, which united with the foundation in December.

The Community Advisory Council advises the foundation's board of directors on overall policy and strategic direction. Members also serve as liaisons with Kentucky communities, putting the council at the center of a strategy shared by both the foundation and the Friedell Committee to expand community engagement statewide.

LeChrista Finn, an associate professor at Kentucky State University in Frankfort, is the newly named chair of the council. The new vice chair is Tim Marcum, regional director of planning at Baptist Health in Louisville. Both have served on the council since 2014.

"Council members, new and existing, are among the most mission-minded health- and health-policy advocates in the Commonwealth of Kentucky," Finn said. "I am grateful that members of the Friedell Committee have stepped up, once again, to work toward a healthier Kentucky."

The 28 new council members are: Constance Alexander, Murray, writer, consultant, and civic journalist; Charlotte Beason, Louisville, retired executive director of the Kentucky Board of Nursing; Dennis Chaney, Bowling Green, Barren River District Health Department director; Tracey Clark, Hopkinsville, executive director of the Jennie Stuart Health Foundation; Danny Duncan Collum of Shelby County, a writer and professor at Kentucky State; Al Cross, Frankfort, journalist and University of Kentucky professor and director of its Institute for Rural Journalism and Community Issues, publisher of Kentucky Health News; Colette Crown, Lexington, former administrative coordinator for the Friedell Committee; Barbara Hadley-Smith, Frankfort, retired government and private sector communications executive; Ann Hagan-Grigsby, Louisville, chief executive officer of the Park DuValle Community Health Center, Inc.; Richard Heine, Lexington, former executive director of the Friedell Committee; the Rev. Nancy Jo Kemper, Lexington, retired executive director of the Kentucky Council of Churches; Rev. Terry Lester, London, retired pastor at First Baptist London; Sylvia Lovely, Lexington, president of, Sylvia Lovely & Associates and former executive director of the Kentucky League of Cities; Kathryn Mershon, Louisville, independent hospital and health care professional; Dr. J.D. Miller, Lexington; retired Appalachian Regional Healthcare executive; M. Raynor Mullins, Lexington, emeritus faculty, dental public health, University of Kentucky; Judy Myers, Lexington; faculty member at Indiana University Southeast School of Nursing; Mark Neikirk, Highland Heights, executive director of the Scripps Howard Center for Civic Engagement at Northern Kentucky University; Marty Newell, Whitesburg, chief operating officer, Center for Rural Strategies; John Rosenberg, Prestonsburg, director emeritus of Appalachian Research and Defense Fund of Kentucky and vice chair of the Kentucky Public Advocacy Commission; Sheila Schuster, Louisville, executive director of the Advocacy Action Network; Dr. Doug Scutchfield, Lexington, emeritus professor at UK College of Public Health; Rich Seckel, Lexington, executive director of the Kentucky Equal Justice Center; Susan Stokes, Louisville, owner Access Community Assistance and former state representative; Lisa Tobe, Louisville, executive director of Wildflower Consulting; Tom Walton, Louisville, executive in residence, University of Louisville School of Public Health and Information Sciences; Dr. Pat Withrow, Paducah, cardiologist and director of outreach at Baptist Health Paducah (the only new Council member who did not come from the Friedell Committee); Charlotte Whittaker, Hartford, president of AARP Kentucky and former executive director, Ohio County Senior Services.

These members join Finn, Marcum and the following existing Council members: Nancy Addington, Elizabethtown, retired director of the Area Agency on Aging at the Lincoln Trail Area Development District; Tracey R. Antle, Russell Springs, chief operating officer of Cumberland Family Medical Center; Angela Carman, Berea, assistant professor in the UK College of Public Health; Roger Crittenden, Frankfort, retired circuit and district court judge; Sandra Duverge, Louisville, Health Equity Program Manager at Passport Health Plan; Fran Feltner, Hazard, director of the UKCenter of Excellence in Rural Health; Deborah S. Fillman, Owensboro, retired director of the Green River District Health Department; Liz Durst Fowler, Lexington, president and CEO of Hospice of the Bluegrass; Amanda Goldman, Lexington, system director of quality and wellness for Catholic Health Initiatives and director of diabetes and nutrition care at KentuckyOne Health; Randy Gooch, Nicholasville, director of the Jessamine County Health Department; Laura Hancock Jones, Morganfield, dentist at Union County Family Dental; Michael Keck, Science Hill, vice president at Five Talents Financial Group; Keith Knapp, LaGrange, associate professor at Bellarmine University; Sherry Lanham, Beattyville, director of the Lee County Family Resource Center; Matthew Minier, Louisville, director of student success at the Southern Baptist Theological Seminary; Wynn Radford, Hopkinsville, retired insurance agent; Robert Slaton, Georgetown, health-care consultant; Melissa Slone, Hazard, research interdisciplinary director for the UK Center of Excellence in Rural Health ; and Johnny White, Russellville, organizational development manager at Constellium.

Diabetes is an epidemic and needs to be treated like one, with a public-health approach, Lexington policy experts say in new book

Diabetes is often called an epidemic, but is not treated as such. Two Lexington health policy experts argue in a new book that this has to change, Tom Eblen reports for the Lexington Herald-Leader.

The Great Diabetes Epidemic: A Manifesto for Control and Prevention was written by Dr. Gilbert Friedell, former director of the Markey Cancer Center at the University of Kentucky and founder of the Friedell Committee, a statewide health care policy organization; and Isaac Joyner, a public-health policy analyst who has worked on a variety of issues in Kentucky, Texas and the Carolinas. It outlines specific steps that people, communities and the government should take in its approach to diabetes, saying the solution is a "major public health response."

"If we continue to treat diabetes on a one-patient-at-a-time basis, we can't deal with an epidemic," Friedell told Eblen. "Unless you take a public health approach to an epidemic, it doesn't work."

Kentucky has seen a 158 percent increase in cases over the last 15 years, "outpacing every other state except Oklahoma," according to the Centers for Disease Control and Prevention. Eblen reports that most cases are Type 2 diabetes, which is related to obesity.

"A flu epidemic of such magnitude would create public alarm and swift official response," Eblen writes.

The authors say the first step in changing diabetes in America is widespread, routine screening. They cite Centers for Disease Control and Prevention estimates that more than one-fourth of the people who have diabetes don't know it because they have not been tested.

In Kentucky, that means that 370,000 Kentuckians know they have diabetes, but 137,000 more might have it and not know it, Eblen reports. Officials estimate 233,000 Kentuckians have pre-diabetes, meaning they are at immediate risk of developing the disease.

"You have to find cases early, which means you have to screen people who seem well," Friedell said. "The symptoms of diabetes come on maybe 10 years after the disease starts. But nobody knows they have the disease. We're wasting 10 years that we could be doing something good for people."

Current recommendations for diabetes screening is for people with high blood pressure, or anyone older than 45. The authors say everyone older than 20 should be screened. They say this has to be viewed as a societal problem, not an individual one, Eblen reports.

The authors call for increased government and community funding and efforts toward proven diabetes prevention programs and for insurance companies to revise the way they reimburse for diabetes saying, " the longterm payoff would be huge" with these changes. Most importantly, they also call for increased public awareness and urgency.

"There has to be a sense of urgency, and there is no sense of urgency about diabetes," Friedell told Eblen. "We need to do something to get the public involved, and the public has to feel that it's important."

Friedell and Joyner will speak about the book and sign copies at 5 p.m. Friday, Nov. 14, which is World Diabetes Day, at The Morris Book Shop, 882 East High Street. They also are scheduled to testify Nov. 18 in Washington to the Congressional Caucus on Diabetes.

Schuster wins top health policy advocacy award for more than 40 years of work in mental health; calls for an end to stigma around it

By Melissa Patrick
Kentucky Health News

Sheila Schuster, who has spent more than four decades advocating for those with mental illness and other disabilities, and worked to increase access to health care across Kentucky, was named the first Gil Friedell Health Policy Champion to a standing ovation by an audience from all over Kentucky.

Left to right: Mark Carter, Sheila Schuster, Ben Chandler, LeChrista Finn

The Foundation for a Healthy Kentucky award was presented at the organization's annual policy forum in Lexington Sept. 23, exactly one year after the death of Friedell, who was a fierce advocate for health equity and finding community-based solutions to the many health issues that plague Kentucky.

"This award is a tremendous honor. I treasure it even more because it is named for Gil Friedell, a mentor, friend and role model," Schuster said with great emotion. "Gil's legacy of health advocacy inspires me every day to do all I can to improve the lives of my fellow Kentuckians."

Schuster, a psychologist and mental-health advocate, selected Mental Health America of Kentucky to get the $5,000 cash grant that came with the award. She said she chose MHA because it was the oldest mental-health advocacy organization in the state and because it had partnered with her organization, the Kentucky Mental Health Coalition, on numerous policy initiatives.

Ben Chandler, president and CEO of the foundation, said in a news release, "Sheila is passionate about improving mental health, she is passionate about ensuring access to health care, and she is passionate about going about her work in a way that garners both respect and results."

Schuster was chosen from this year's 10 Healthy Kentucky Policy Champion recipients, Kentucky individuals or organizations recognized by the foundation for their engagement in improving the health of people in their communities and/or the entire state through policy change.

Sheila Schuster accepts Friedell award

In addition to leading the Advocacy Action Network, an umbrella organization that includes groups addressing health care, mental health, social justice and disability issues, Schuster also chairs Kentucky Voices for Health, a coalition to improve Kentucky's health, and leads the Kentucky Mental Health Coalition, which comprises more than 80 organizations. She chairs the Behavioral Health Technical Advisory Committee of Kentucky's Medicaid program. She has also held numerous leadership positions, including president and executive director, with the Kentucky Psychological Association.

"I love the policy work that I've done over the past 40 plus years," she said. "And to get an award for doing it is like icing on the cake."

And not to let an opportunity pass, Schuster spoke about the challenges of stigma when it comes to mental health and encouraged the 360 people in the room to do their part to reduce it.

"And while I have the mic, I'd like to close by urging each of you to do whatever you can to reduce the stigma that envelops mental illness, making it so difficult for our people to seek the help they need and to feel OK about it," she said.

"Stigma causes us to fear and isolate individuals with mental illness, to unfairly blame them for mass shootings when they are 10 times more likely to the the victim of violence than to be its perpetrator. Think about your language, examine your attitudes and do something positive to support those who are struggling with mental health issues. Never underestimate what a kind gesture, an understanding word or a listening ear can do to tear down that stigma."

Report says hospitals could fund improvements in Ky.'s health

A focus on population health, prevention and wellness is how Kentucky will become a healthier state, and one source for funding these efforts is hospitals, because most nonprofit hospitals are required to invest back into their communities, according to a recent report from the Friedell Committee for Health System Transformation.

“Right now, in Kentucky, most of the money that is spent in health is for healthcare and services,” Dr. Richard Heine, executive director of the Friedell Committee and author of the report, said in a news release. “Very little money is available to address population health and wellness, which would lead to healthier people.”

The report, "Hospital Community Benefits and the Health of Kentucky," says that while many Kentucky nonprofit hospitals are already partnering with local health departments to create a community health needs assessment and addressing community needs, there is room for more collaboration between community leaders and their local hospitals to find ways to use these funds toward improving their communities health.

Figure 1 has 2009 national data. Figure 2 has 2011-12 Kentucky data. (Friedell Committee graphic)

Almost 10 percent of the annual $9 billion operating budgets of Kentucky's non-profit hospitals, or $877 million, goes toward community benefits.

More than 80 percent of that is used to cover bad debts or care that wasn't reimbursed. Only 5 percent goes to "community health improvement services and community benefit operations," according to the report.

The report ponders that there might be more dollars available for community needs and improvement of population health because the expansion of Medicaid has reduced the amount of uncompensated care.

"With some portion of the more than $877 million in community benefit funds available, Kentucky nonprofit hospitals are in a position to stimulate significant changes in the reach and efficacy of preventive health programs, health policy, and with collaboration and cooperation of the people they serve, much progress can be expected," the report says.

“This partnership can be powerful and important in creating positive change,” Heine said in the release. “These funds present a possible means to finance community health initiatives, which typically do not have a designated funding source.”

Governor's focus on health deserves another round of applause, Friedell Committee for Health officer writes in op-ed piece

Gov. Steve Beshear's focus on health in his State of the Commonwealth speech should be applauded, given the poor state of Kentucky's health, an officer of the Friedell Committee for Health System Transformation writes in an op-ed piece made available to Kentucky newspapers.

"Gov. Beshear has been frank with us about the health deficiencies that we know exist but pretend do not," Jane Chiles writes. "Within a day of his speech, he  announced a $1.7 million federal grant to go after the leading uglies – obesity, diabetes, stroke, heart disease and high blood pressure – to 'support our goal of improving our dismal health statistics.'"

"What to do about the uglies?" Chiles asks. "The Friedell Committee for Health has been convening health professionals and laymen over the past year to ask that question. The solutions will require resources and time. We need a commitment in Frankfort. But we also need a community commitment.

"Here’s the good news: We have an existing infrastructure for a state and community collaboration. We have a health department in each of our 120 counties. Their mission, guided by state statute and a state Department for Public Health, has been transformed in recent years. They still combat communicable diseases, provide health screenings and services and protect us with restaurant and other inspections. But the best of our health departments have also taken on the enormous task of keeping communities healthy by influencing the social, environmental and economic conditions affecting population health. We need more of that."

Chiles asks, "Why bother? Isn’t health an individual thing? You want to smoke? Smoke. You want to supersize your soda? It’s a free country. But here’s the thing: Improved population health links directly to improved education and vice versa. Likewise, for economic vitality. If we want a prosperous, smarter Kentucky ready to compete with the world, we need a healthy Kentucky." (Read more)

CEO of Pikeville Medical Center wins 2023 Gil Friedell Memorial Health Policy Award from the Foundation for a Healthy Kentucky

Donovan Blackburn

By Melissa Patrick
Kentucky Health News

Donovan Blackburn, CEO of Pikeville Medical Center, is the latest winner of the Foundation for a Healthy Kentucky's Gil Friedell Memorial Health Policy Award for his work in changing the landscape of health care in Eastern Kentucky. 

“Donovan Blackburn has been a visionary for Eastern Kentucky and has helped bring the type of high-quality care to the region that its residents have long deserved,” Ben Chandler, president and CEO of the foundation, said in a news release. “A chance for a healthy life shouldn’t be determined by the area of Kentucky in which you live, and Donovan’s work is making the commonwealth a more equitable place to access healthcare.”

Gary Dryden of Louisville, chair of the foundation's Community Advisory Council, noted that the expansion of health-care options in Appalachia facilitated by Blackburn's hospital has provided care that residents previously had to travel hours to larger cities to obtain. 

"Because of his vison," Dryden said Wednesday, "thousands of Kentuckians have access to resources needed to sustain a healthy life." 

Blackburn’s ability to foster consensus through collaboration has helped secure millions in investment in healthcare delivery, the release said.

Under his leadership, in 2020, PMC opened its Appalachian Valley Autism Center.  In 2021, the Mettu Children’s Hospital opened, allowing clinicians to partner with specialists in cardiology, endocrinology, and pulmonology at the University of Kentucky Children’s Hospital. In 2022, a satellite center in Floyd County opened, enabling the Autism Center to provide services to children from Pikeville and Prestonsburg.

PMC also opened its Heart and Vascular Institute of Eastern Kentucky, the result of a $35.2 million capital investment. The new space includes a new cardiac rehabilitation department, 29 exam rooms and three state-of-the-art interventional cardiac catheterization labs. 

“I am deeply honored and humbled and honored," Blackburn said about receiving the award. "I recognize and realize what this award stands for and I wear it as such also as a badge of honor, not for myself, but for the 3,100 employees that I have the opportunity to lead from the back. . . . And so on behalf of our organization, I'm very proud to accept this award."

Donovan Blackburn accepts a $5,000 donation to the non-profit of his choice, Appalachian Valley Autism Center from Ben Chandler, and Gary Dryden. (Foundation for a Healthy Kentucky photo). 

Blackburn also expressed his gratitude for the $5,000 donation to the non-profit of his choice.  Blackburn selected the Autism Center, which provides applied-behavior-analysis therapy to children between the ages of 2 and 12 on the autism spectrum. 

Blackburn explained that his granddaughter, Ava, who is now 6, was the inspiration for the center because she was born with sensory disorder and is on the spectrum. His wife, Debbie Blackford, is the executive director of the center, which is called the AVA Center. 

"We sincerely appreciate not only the award, acknowledging the work that we've done throughout Eastern Kentucky, but also for the generosity and the gift for the AVA Center that is changing so many kids lives in the region as well," he said. 

According to the news release, the center supports 90 children and is projected to double that by the end of 2024.

The winner of the Gil Friedell Memorial Health Policy Award is chosen from recipients of a Healthy Kentucky Champions Award, which recognizes Kentuckians who are working to improve the health of their community and the commonwealth. This year, there was a record number of nominees. Click here to read more about each of them.

The other 2023 Healthy Kentucky Champions are: 

• Dr. Muhammad Babar – Doctors for Healthy Communities, Louisville
• Shelly Baer – Emerald Therapy Center of Murray
• Mark Birdwhistell – UK HealthCare
• Lacretia Dye – Western Kentucky University
• Donald Frazier – UK Science Outreach Center
• Ellen Hahn - UK Kentucky Center for Smoke-free Policy
• Jeremy Harrell – Veteran’s Club of Louisville
• Susan Jones – Western Kentucky University
• Dr. Whitney Jones – Colon Cancer Prevention Project
• Dr. Karl Lange – Mission Health Lexington
• Katherine Marks – Commissioner, state Department of Behavioral Health, Developmental and Intellectual Disabilities
• Rhondell Miller – Hotel Inc. of Bowling Green
• Jerry Ugrin – Lewis County Primary Care Center

Draft plan for a statewide campaign for better health gets endorsement, much talk at Friedell Committee annual meeting

By Al Cross
Kentucky Health News

A statewide committee of volunteers is on target with its plan for a campaign to make Kentucky a healthier state, an expert in state and local health told the committee Monday.

“You guys are absolutely on the right track,” Julie Willems Van Dijk of the University of Wisconsin told the Friedell Committee for Health System Transformation at its annual meeting in Lexington.

The committee is developing a campaign that would involve many partners around the state, including health-care providers, education and business leaders, state and local health officials, and other groups and individuals interested in improving Kentucky’s poor health. The draft campaign’s working motto is “healthier, wealthier and wiser,” reflecting how education, health and economic development are related.

“Your three-legged stool of health, industry and education fits solidly within the model we’re talking about,” said Van Dijk, deputy director of the County Health Rankings and Roadmaps Program funded by the Robert Wood Johnson Foundation.

Dr. Lee T. Todd Jr.

Kentucky’s health rankings – we’re first in smoking, cancer deaths and preventable hospitalizations – prompted Dr. Lee T. Todd Jr. to dub such statistics “the Kentucky uglies” when he was president of the University of Kentucky. Now part of the group developing the campaign, he told the committee in a keynote speech Sunday night, “Those are things we need to remember and repeat.”

Noting the low life expectancy in many Kentucky counties, and the wide range of life expectancy among Louisville neighborhoods, Todd asked, “Why can’t people get excited about that, or disappointed, or just mad about it?”

Kentucky ranks 44^th among the states in health, and “The bottom line is, it hurts us economically,” Audrey Haynes, secretary of the state Cabinet for Health and Family Services, told the committee Monday.

Todd noted how San Antonio reduced its obesity rate after losing a prospective employer that cited how fat the city’s sixth-graders were. He said local communities should “get mad about something and decide you’re going to change something. . . . We have just got to stop tolerating ill health.”

As examples, he cited Grant County’s successful effort to improve its health ranking, the Hopkins County oral-health program that reduced premature births, and Clark County’s effort – now funded by a small extra tax – to varnish students’ teeth to prevent cavities.

“Why can’t we get this stuff to roll across this state and make a big difference?” Todd asked. He suggested that one reason has been a shortage of leadership and courage, as demonstrated by the political dominance of traditional industries with health implications, such as coal and tobacco.

Todd said the committee needs to find “a market driver” like the state Supreme Court ruling that forced education reform in 1990 or the Russians’ launch of the first man-made satellite in 1957, which prompted national reform of science and math education.

He said the federal health-reform law could provide that spark, because it will bring many people into the health-care system and provide free preventive services. He suggested a targeted effort, such as getting the newly enrolled to check their A1C hemoglobin (a rough measure of blood sugar and an indicator of diabetes), and predicted the tests would show many of them “are diabetic but didn’t know about it.”

While the statewide campaign can focus on certain things, Todd said, it “can’t be viewed as outsiders” giving direction to local communities. He said the effort must be led by people in local communities, focusing on their local health problems. Willems said the committee could set strategic priorities from which communities could select.

As the committee met Monday, Todd and Committee Chair Jane Chiles of Lexington said the campaign needs grant money and a staff. “This subject is too important for us to nickel-and-dime it,” he said.

As Chiles adjourned the meeting, she said of the proposal, “This is a winning concept, a winning strategy.”

For a PDF copy of the committee’s draft proposal, click here.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky. Al Cross is director of the Institute and a member of the Friedell Committee.

Seven Healthy Kentucky Champions named by Foundation for a Healthy Kentucky; finalists for Friedell Award to be given Oct. 17

The Foundation for a Healthy Kentucky has announced its 2022 class of Healthy Kentucky Champions. The awards recognize individuals dedicated to improving the health of Kentuckians at a community level or state level; they are finalists for a statewide award to be announced in October.

“These seven Healthy Kentucky Champions are an inspiration to all working to better the health of our state,” said Ben Chandler, president and CEO of the foundation. “We owe them much gratitude for their dedication to addressing some of the health challenges Kentuckians face. The commonwealth is better because of these Healthy Kentucky Champions.”

The seven Healthy Kentucky Champions are nominees for the 2022 Gil Friedell Memorial Health Policy Champion Award, which comes with a $5,000 grant from the foundation to a Kentucky-based nonprofit of the winner’s choice. This year’s Friedell Award winner will be announced at the Howard L. Bost Memorial Health Policy Forum Oct. 17. The forum will focus upstream the social determinants of health on the connection between educational opportunities and health outcomes of Kentuckians. To learn more and register for this free, virtual event, click here.

The Healthy Kentucky Champions are Dr. Patricia Bautista-Cervera of Louisville, Eric Crawford of Maysville, Terry Gehrke of Louisville, Denise Hall of Trimble County, Michelle Howell of Scottsville, Dr. Patrick Kitzman of the University of Kentucky and Mark Thomas of Todd County.

Dr. Patricia Bautista-Cervera

Dr. Patricia Bautista-Cervera is a pediatrician and pediatric allergist at the La Casita Center, an organization dedicated to enhancing the well-being of Louisville’s Latinx and immigrant community. As health empowerment coordinator, Bautista-Cervera works to promote health through workshops, informational videos, one-on-one communications, and other various means. During the COVID-19 pandemic, she delivered important information to the Spanish-speaking community through the online video series, “Consejos de Salud con la Dra. Paty.” She also was instrumental in developing virtual forums with stores and restaurants to educate the Hispanic community about the virus and promote preventive measures and vaccination. In 2020 she supported 994 Covid-19-positive patients, offering medical guidance and, through an empowering model, connecting them to LCC’s wrap-around services and other resources in the community.

Eric Crawford

Eric Crawford, a Maysville native, joined Kentuckians for Medicinal Marijuana in 2013. Crawford’s education in the endocannabinoid system and cannabis, as well as his experience as a quadriplegic, has fueled his passion for advocating for the legalization of medical marijuana in Kentucky. He has been involved in crafting legislation and has testified at the state Capitol about how cannabis improves his quality of life. He is a member of the Governor’s Medical Cannabis Advisory Committee and has also traveled the state with Kentuckians for Medicinal Marijuana for more than 50 medical cannabis educational seminars. Crawford remains active in the Maysville community by serving on the Lions Club and volunteering at a nursing home. He is a Finis Davis Fellowship recipient through the Kentucky Lions Eye Center and a past member of Kentucky Partners in Policymaking through the Commonwealth Council for Developmental Disabilities.

Terry Gehrke

Terry Gehrke has been in the fitness-wellness industry for more than 30 years. She founded Balanced Wellness LLC in 1999 in Jefferson County and still leads the organization as president and wellness consultant/health educator. Gehrke joined the Kentucky Diabetes Network in 2019 as executive director and has guided the organization to promote better health for Kentuckians at-risk for and living with diabetes. She leads KDN’s symposium committee each year to offer the largest professional education opportunity for diabetes training in the state, the Kentucky Diabetes Symposium. Gehrke’s background includes teaching in the University of Louisville Health and Sport Sciences Department and working with Southeast Christian Church’s Sports & Fitness Ministry. Gehrke is a member of several organizations including the National Wellness Institute, the National Physical Activity Society, and Exercise is Medicine.

Denise Hall

Denise Hall of Trimble County began working in the substance use prevention field in 1998 at Seven Counties Services. In 2003, she became coordinator for Trimble County Family Resource and Youth Services Center before writing two Drug Free Communities grants and directing them. The DFC grant is now in its 10th and final year. Hall’s work includes implementing a Drug Education Series in Trimble County and a Sources of Strength group at Trimble County Junior/Senior High School. She administers a survey to middle and high schoolers to understand the needs for substance-misuse prevention. Hall was crucial in getting vape detectors installed at the high school and is managing director of the Trimble CARES Coalition.

Michelle Howell

Michelle Howell co-owns Need More Acres Farm in Scottsville with her husband Nathan. She has an agriculture degree from Western Kentucky University and previously worked for University of Kentucky Cooperative Extension assisting tobacco farmers as they transitioned to fruit and vegetable production. She collaborates with local and state partners to increase equitable opportunities for farmers. Howell has also been involved in writing grants worth more than $2.4 million to benefit food access, women’s life courses, and urban-rural development. Need More Acres co-founded the Community Farmers Market in Bowling Green, which piloted several Supplemental Nutrition Assistance Program incentives. CFM was essential to growing Kentucky Double Dollars into a statewide program and CFM is one of the organization's pilots of the Fresh Rx MOMs program for expecting mothers on Medicaid. Both programs help under-resourced Kentuckians access fresh, healthy food from farmers markets. Additionally, Howell partners with UK, WKU and Kentucky State University for interactive professional development on diversity and inclusion.

Patrick Kitzman

Dr. Patrick Kitzman is a professor in the University of Kentucky Department of Physical Therapy. He’s also founding director of the Kentucky Appalachian Rural Rehabilitation Network, a team that develops strategies to reduce disability and improve the quality of life for individuals with neurological impairments living in underserved rural Appalachian counties. Kitzman and his team established projects CARAT and CARAT-TOP. In CARAT (Coordinating and Assisting the Reuse of Assistive Technology) students learn to refurbish used medical equipment and donate it to those in need in the community. CARAT-TOP (Coordinating and Assisting the Reuse of Assistive Technology- Together One Priority) is a training program created through a partnership with the UK Center of Excellence in Rural Health. It brings together community members and high-school students of all abilities to learn new skills to help individuals and communities affected by disability.

Mark Thomas

Mark Thomas, Todd County Schools superintendent, was instrumental in establishing the AXIS Program: Centering All Services in the district. In partnership with the Todd County Health Department, the program addresses students’ social and emotional well-being through mental-health case management. The program also assists with basic needs such as nutrition, clothing, toiletries, housing, transportation, and treatment for substance use disorder. Thomas played a crucial role in gaining needed buy-in of the program from staff and the community. Through his support, the program is expanding services to include parenting classes, prenatal classes, and mental health awareness programs for students and staff. Thomas began his career in Shelby County in 1996 as a middle school teacher. He has served in a number of school and district administrative roles across Kentucky before starting his current position in 2020.

Employee of convenience-store chain named Ky. Healthy Policy Champion for helping prevent tobacco sales to underage buyers

Albert Gray

Albert Gray of Five Star Food Marts has been named a Healthy Kentucky Policy Champion for his contributions to preventing the sale of tobacco products to underage consumers of the convenience stores.

The award is given by the Foundation for a Healthy Kentucky gives the award to recognize Kentucky individuals and organizations engaged in improving the health of people in their communities and/or the state through policy change.

Gray, now retired, was a human-resources and operations assistant at Five Star, which is based in Bardstown.

"Albert was an integral part of enacting a policy that required all FiveStar employees to receive training each year through the online Kentucky Tobacco Retail Underage Sales Training (TRUST) Program," Steve Cambron, director of the program that enforces age restrictions on tobacco-product sales, said in his nomination of Gray for the award.

Gray served on the TRUST advisory council to ensure that the training content was effective, made a Five Star store available for training videos, and has been a voluntary consultant to the program. "Thanks to his enthusiastic support, the TRUST program has been successful in reaching over 6,500 retail staff throughout the state," Cambron said.

Five Star has maintained a 97.6 percent compliance rate for tobacco inspections by the Food and Drug Administration, according to Koleen Slusher, director of the behavioral health in the state Cabinet for Health and Family Services. She said Gray "continues to share his expertise with our staff to guide their outreach to other tobacco retailers," and "has made a lasting contribution to our efforts to reduce underage youth access to tobacco and nicotine products and the harmful consequences associated with them."

Gray said, "I know one thing to be true of all addictions: Prevention is the absolute first line of defense."

Gray, of LaRue County, is now eligible for the Gil Friedell Health Policy Champion award, which comes with a $5,000 grant from the foundation to a Kentucky-based nonprofit of the winner's choice. The winner of the Friedell award will be announced later this month.

Nominations for the Healthy Kentucky Policy Champion Award are accepted at any time. See details on the foundation's website.

Authors of The Great Diabetes Epidemic appearing in half-hour show several times on KET channels this week

Dr. Gilbert Friedell and J. Isaac Joyner, co-authors of The Great Diabetes Epidemic: A Manifesto for Control and Prevention, discuss the topic with Dr. Wayne Tuckson in a half-hour "Kentucky Health" program airing on KET and its other channels this week.

"If you know diabetes, you know medicine," Tuckson says in introducing the show, "because diabetes affects everything, from the eyes, to the vascular system, to our extremities. Unfortunately, the incidence of diabetes is increasing, and diabetes is affecting people at a younger and younger age."

In their book, Friedell and Joyner recommend four steps to control the diabetes epidemic: "First, acknowledge that there is an epidemic, and deal with it as a public health problem, with community as well as individual action. . . . Second, our communities must take responsibility for diabetes and pre-diabetes in their populations," partly with "broad-based Community Diabetes Control and Prevention Councils representing all segments of the population in every county. . . . Third, the community and the Kentucky Department for Public Health need more precise information about the magnitude and extent of the epidemic. We therefore advocate universal screening of all residents over the age of 45 in doctors’ offices and in community screening locations. . . . Fourth, in order to prevent as many people with pre-diabetes as possible from developing diabetes, there should be numerous, available, affordable organized prevention programs in accessible community sites."

Here is the broadcast schedule for the program, in order of appearance:

KETKY: Monday, Jan. 4, at 6:30 a.m. ET

KET: Tuesday, Jan. 5, at 5 a.m. ET

KETKY: Jan. 5 at 7:30 p.m. ET

KETKY: Wednesday, Jan. 6, at 8:30 a.m. ET

KET2: Jan. 6 at 7 p.m. ET

KETKY: Thursday, Jan. 7, at 1:30 p.m. ET

KET2: Friday, Jan. 8, at 7:30 a.m. ET

KETKY: Saturday, Jan. 9, at 6 a.m. ET

Health commissioner leaves political correctness at the door, talks about getting governor to back anti-smoking measures

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. - State health officials didn't shy away from saying that smoking was one of Kentucky's top health issues at a recent meeting about population health, and Health Commissioner Hiram Polk went so far as to say they need to find a way to get Gov. Matt Bevin, who says smoking bans are a local issue, to adjust his policy.

Dr. Hiram Polk

"We've got to find some kind of landmark we can use there that would be acceptable to the governor and get through the legislature," Polk told the Friedell Committee for Health Oct. 25 in Frankfort.

Polk called smoking a "political issue" and said solutions include higher cigarette taxes and enforcement of smoke-free areas. He also said he has been talking to Ben Chandler, the new director of the Foundation for a Healthy Kentucky, about ways to get the governor to adjust his stance on this issue.

"It is really rare for somebody in this position to say publicly that 'I want to try to change the governor's mind'," Al Cross, director of the Institute for Rural Journalism and Community Issues, publisher of Kentucky Health News and Friedell Committee member, told the group as he summarized the day. Cross said the 80-year-old Polk, a noted surgeon, is a "guy who speaks his mind."

Tim Feeley, deputy secretary of the Cabinet for Health and Family Services, noted that Kentucky has some of the highest smoking rates in the nation, along with obesity, cancer and opioid abuse. He called for more smoking and nutrition education.

Drug issues

Polk said since taking office his "time has been overwhelmed with the issues of IV drug abuse." And that after attending many meetings on the topic, "There are no good ideas about what to do with drug addiction."

He said the cabinet is working on three opioid initiatives: one that centers around a "healthy living" early childhood educational program, which he hopes to have set up in at least five school districts by fall 2017; a program to increase access to medication-assisted treatments; and beginning this week, a program involving the state's mobile pharmacy, which will travel around the state upon invitation and share educational literature, pass out free Narcan (naloxone), accept outdated drugs and operate a one-for-one syringe exchange.

There was some question about the state's requirement that syringe exchanges be one for one. Feeley said, "As of right now, Governor Bevin has endorsed the needle exchange on a local-option basis. He has also stated that he is in favor of a one-for-one needle exchange. . . . We want to do a needle exchange that encourages the individuals to come in and to get into treatment. . . . Some of the thought is that a one-to-one exchange is the best way to do that."

Cross said the administration's stance seems to be that only exchanges funded by state grants will have to be a one-for-one exchange. He said this strategy might work to appease the legislators who don't understand that this is a public health program designed to prevent the spread of HIV and hepatitis C. "We'll find out during the General Assembly," he said.

Polk also pointed out the increased health disparities among the state's African American population and those living in the Appalachian region, though he emphasized the problems in Appalachia.

"The situation in Appalachia is just appalling," he said. "I think again, Appalachia is more discriminated against than African Americans. If you look at anything. It needs the most help for everything."

Cross said that while Polk "is not politically correct," this is "largely a good thing" because public officials often "don't say what they believe to be fact and try to avoid confrontation. Hiram Polk is not conflict-averse, and we should be thankful for that."

And as for finding health solutions, Polk boldly reminded those in the room that many health decisions are selfishly motivated.

"We've got conflicting and selfish interests of people all over health care, many of which are represented in this room," he said. The perfect example of this, he said, is the pharmaceutical industry, which successfully lobbied to protect its "massive profits" under the Patient Protection and Affordable Care Act. He also said that the "larcenous nature" of this industry is sure to demand "$1,000 for every single treatment" of the newly developed medication assisted treatment drugs, which the state hopes to promote.

Cross said drug makers argue that their profits finance cutting-edge drug research, but also comprise a powerful lobby that knows how to influence the political system. He said the Kentucky Farm Bureau Federation is likewise a powerful lobby, "which I believe is the primary device by which Kentucky's tobacco heritage remains in control of tobacco policy in this state. . . . If you can change Farm Bureau, you can change the game."

Medicaid boss speaks

Medicaid Commissioner Steve Miller briefly reviewed the governor's proposals for the program and said the cost of the current plan is not sustainable. He said the plan "may not be all the answers . . . [but] what we have been doing, and the way we have been doing it, needs to change." After the meeting, Miller told Cross that state and federal officials have entered into negotiations about it.

Miller told the committee his agency is working to hold Medicaid managed-care organizations accountable to their contracts, but said they haven't changed their behaviors.

Providers still struggle with MCOs paying them on a timely basis, if at all. They also struggle with the administrative burden of dealing with five different MCOs. Scott Lockard, public health director in Clark County, asked if the state had considered contracting with only one MCO. Miller said the state wasn't ready to go that far, but averred, "We don't need to have five. I think we need to have more than two."

Raynor Mullins, professor emeritus at the University of Kentucky College of Dentistry, said it is clearly understood that Kentucky's financial woes are "substantial" and  asked, "When are we going to get serious and start to talk about tax reform?"

Miller said he would leave tax policy to others, but added, "The revenue stream as it exist today is not adequate enough to cover the Medicaid expenditures and other things that need to be done. . . . It is not sustainable as we are doing it today."

Friedell Committee will consider what it will take for Kentucky to become a healthier state at meeting Sunday and Monday

What will it take for Kentucky to become a healthier state? That will be the question at the fall meeting of the Friedell Committee for Health System Transformation, at the Marriott Griffin Gate in Lexington Sunday, Nov. 10 and Monday, Nov. 11. Participants will examine how the committee can work with communities and individuals to create a Kentucky that is “healthier, wealthier, and wiser,” a possible motto for a campaign the committee is considering.

“We have learned that building a healthier Kentucky will depend largely on what we do beyond the health-care system,” said Richard Heine, executive director of the committee. ”Efforts to promote good health must take place in the environment where people live, work, and play. For Kentuckians to be healthier, we must address the factors behind the problem of poor health, such as lack of education, poverty, poor nutrition, lack of employment, violence, transportation, and housing.”

Topics at the meeting include the state Health Benefit Exchange, managed-care Medicaid, the state’s financial situation, successful local policy changes, and the prevention and control of Kentucky’s major health challenge: diabetes.

Lee Todd, former president of the University of Kentucky, will be the keynote speaker Sunday evening and will introduce components of the committee’s campaign for a healthier Kentucky, now being formulated. Monday’s morning sessions will focus on public health, with discussions of county health rankings, public health partnerships with communities, and opportunities for progress in the health of Kentucky. Afternoon sessions will look at education partnerships and Kentucky’s workforce.

This meeting is funded in part by a grant from the Foundation for a Healthy Kentucky. For a copy f the full agenda, click here. For more on the committee, click here.

Work on successful lawsuit against changes in Medicaid earns Rich Seckel the Gil Friedell Healthy Policy Champion award

Rich Seckel

UPDATE, Dec. 21: Seckel was named the Gil Friedell Health Policy Champion award, which comes with a $5,000 grant to a Kentucky-based nonprofit of his choice. (The original version of this story was published Dec. 13.)

The point man in a lawsuit that blocked changes to Kentucky's Medicaid program has been honored for his work by the Foundation for a Healthy Kentucky.

Rich Seckel, director of the Kentucky Equal Justice Center, which helps legal-service programs in the state, was named a Healthy Kentucky Policy Champion "for his work to protect health care coverage gains for persons living on low incomes in Kentucky," the foundation said in a news release.

The foundation gives the award to Kentucky individuals and organizations who help improve the health of people in their communities and/or the state through policy change.

Under Seckel 's direction, the KEJC filed a lawsuit that kept then-Gov. Matt Bevin from implementing a federal waiver that would have added work requirements, premiums and administrative penalties to Medicaid.

The waiver application said the state's Medicaid rolls would have 95,000 fewer people five years after implementation than they would have without it, much of it from noncompliance with the new rules.

Seckel was nominated by Louisville psychologist and mental-health advocate Sheila A. Schuster, who was one of 2019's Healthy Policy Champions.

"Rich is the absolute epitome of the excellent health policy advocate," Schuster said. "He has offered his considerable policy expertise, outstanding writing skills, incisive analysis and strategic thinking, and his utmost generosity in sharing his time and talents (and that of his staff) to nearly every significant health policy initiative that has happened in Kentucky over the past thirty years."

Jane Perkins, legal director of the National Health Law Program, which worked with Seckel on the lawsuit, said, "Through Rich’s passionate and organized work with a team of legal advocates, KEJC has provided effective advocacy, consumer assistance and empowerment, policy change, and education around social-justice and health issues."

Seckel is a member of the foundation's Community Advisory Council, and was instrumental in the creation of the foundation, leading a coalition effort to use the $45 million in charitable assets of Kentucky Blue Cross and Blue Shield when it merged with Anthem Inc. The money provides the endowment for the foundation's work.

At KEJC since 1979, Seckel often advocates on poverty-law issues before state agencies and the legislature. Before earning a master's in social work from West Virginia University, he was a volunteer boycott organizer for the United Farm Workers.

Nominations for the Healthy Kentucky Policy Champion Award are accepted at any time. See details on the foundation's website.