KENTUCKY HEALTH NEWS
Events, trends, issues, ideas and independent journalism about health care and health in Kentucky, from the Institute for Rural Journalism at the University of Kentucky
Sunday, September 1, 2024
Kentucky Health News has moved to a new website. This site will no longer be updated.
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Sunday, August 11, 2024
13 of Kentucky's 71 rural inpatient hospitals at risk of closing, with six of them at immediate risk, a national policy center estimates
Center for Healthcare Quality and Payment Reform map |
Kentucky Health News
Thirteen of Kentucky's 71 rural inpatient hospitals are at risk of closing, and six of those are at immediate risk of closing, according to the latest analysis of Hospital Cost Reports by the Center for Healthcare Quality and Payment Reform, a policy center that says it works toward patient-centered, affordable health care.
Kentucky Cabinet for Economic Development table |
The original bill allows the Cabinet for Economic Development to provide loans to struggling hospitals to maintain or upgrade facilities; maintain or increase staff; or provide health services not currently available. The low-interest loans can run up to 20 years and are available to hospitals in counties with fewer than 50,000 people.
Kentucky maternal health roundtable explores ways to improve Kentucky maternal health; two stories from Kentucky Lantern
Centers for Disease Control and Prevention photo |
The roundtable discussion touched on several topics, including the Health Access Nurturing Developmental Services program, more commonly known as HANDS; praise for Rep. Kim Moser's, R-Taylor Mill, "Momnibus" bill that passed during the 2024 legislative session; and the need for a comprehensive approach toward improving the state's maternal mortality rates, including addressing social determinants of health, which includes things like transportation and housing, and the role that substance-use plays in such deaths.
Kentucky's maternal mortality rates are dismal, according to Ladd's reports. And, they are worse for women of color than white women.
"The 2023 March of Dimes report showed the state once again had high maternal mortality, which was worse for Black Kentuckians. The state has a maternal mortality rate of 38.4 deaths per 100,000 live births, higher than the national rate of 23.5 deaths per 100,000 live births," Ladd reports.
She adds, "A 2023 state report on maternal mortality also showed substance-use disorder contributed to nearly 60% of all maternal deaths. Most maternal deaths in Kentucky — 88% — are preventable, a report from the Cabinet for Health and Family Services said."
The links to the stories are below.
https://kentuckylantern.com/2024/08/09/a-kentucky-lantern-q-a-with-federal-health-
https://kentuckylantern.com/2024/08/08/roundtable-explores-ways-to-improve-kentucky-maternal-health/
Saturday, August 10, 2024
New study finds smoking and vaping dual use increases lung cancer risk; expert says it increases risk for other diseases too
Kentucky Health News
People who use electronic cigarettes and smoke traditional cigarettes are more likely to develop lung cancer than people who just smoke, according to a new study.
Centers for Disease Control and Prevention photo |
Amanda Bucher, director of tobacco policy research and outreach at the University of Kentucky College of Nursing, explained that because e-cigarettes contain a different mix of toxic chemicals than cigarettes do, including some new compounds that are formed when the chemicals are heated, people who are dual users are exposed to a broader range of toxins than they would be if they just used one device or the other.
- are 50 to 80 years old
- smoke or have quit smoking within the past 15 years
- have at least a 20-pack-year smoking history, which means a pack a day for 20 years or two packs a day for 10 years, and so on. A pack year is the number of packs smoked per day multiplied by the number of years the person smoked.
Grant applications open to nonprofits that work with substance-use disorder and mental health in underserved communities
Foundation for a Healthy Kentucky photo |
The second round of Foundation for a Healthy Kentucky grants to expand services and programming for substance use recovery and mental heath support in minoritized communities is open through Sept. 13.
- Use a trauma-informed and resilience-informed care approach to reduce premature death of BIPOC Kentuckians
- Provide culturally responsive, evidence-based prevention, mental health treatment and recovery support services to BIPOC Kentuckians
- Strengthen treatment and prevention infrastructure through collaborative projects centering BIPOC voices
Thursday, August 8, 2024
Annual health-policy forum Oct. 8 in Frankfort will focus on how a civic engagement approach can change health outcomes in Ky.
Kentucky Health News
What if the way to improving the health of Kentuckians is to create a culture where every person shares the same goal? That will be the focus of the Foundation for a Healthy Kentucky's 2024 Howard L. Bost Memorial Health Policy Forum, to be held at the Kentucky Historical Society, 100 West Broadway Street, Frankfort from 8:30 a.m. to 1 p.m. ET Oct. 8.
The forum, titled "Finding Common Ground on our Path to Better Health," will look at how to unite the state around a shared goal of addressing unmet health needs. The event is free, but reservations are required. To register, click here.
"Kentucky is consistently ranked as one of the unhealthier states in the country, despite the efforts by a dedicated few to improve the well-being of our communities," according to a news release for the event. "To make real progress, every single Kentuckian will need to play their part because we are stronger together."
Kentucky has been ranked among the bottom 10 states in health status since the America's Health Rankings began in 1990, except in 2008, when it ranked 39th. In 2023, Kentucky ranked No. 41.
The forum will host national and local experts who will talk about how to more authentically engage community members and find common ground on the path toward better health.
The sessions include:
- Enough, Time to Build: How Communities Can Forge a Civic Path Forward: Rich Harwood, president and founder of The Harwood Institute, will talk about that the way forward is a new civic path, not more divisive politics.
- Philanthropy + Democracy: Centering Humanity: Joy Ossei-Anto, managing director of Funder Engagement, Philanthropy for Active Civic Engagement will explore the role philanthropy can play in ensuring democracy is larger than politics and that humanity is centered.
- Moving from Ally to Advocate: A Call to Action: Colene Elridge, CEO of Be More Consulting, will delve into the critical journey from allyship to advocacy within healthcare policy.
Addiction Recovery Care says it’s cooperating with FBI investigation into possible fraud
Addiction Recovery Care, Kentucky’s largest provider of drug and alcohol treatment, has offices and other facilities in Louisa. (Kentucky Lantern photo by Matthew Mueller) |
Kentucky Lantern
Kentucky’s largest provider of addiction treatment services, Addiction Recovery Care, or ARC, is the subject of an FBI investigation into possible health care fraud, according to a July 30 post on a website of the federal agency’s Louisville office.
ARC, which is funded almost entirely through Kentucky’s Medicaid program, has not been charged with any crime but the agency is asking people with information to fill out an online form “if you believe you were victimized by ARC or have information relevant to this investigation.”
ARC, a for-profit company based in Louisa, and whose CEO and affiliates have emerged as prolific political donors in recent years, said in a statement from spokesman Kyle Collier that it is cooperating with the FBI.
“We have recently learned that there is a federal investigation into ARC,” the statement said. “As we all know, healthcare is one of the most highly regulated fields in the country, and addiction treatment is among the most highly scrutinized healthcare services. ARC is a trailblazer in the field of addiction services. We are confident in our program and in the services we offer. We, and our legal counsel, are cooperating fully in the investigation.”
Collier directed further inquiries to ARC’s chief legal officer, Jessica Burke, who provided a similar statement.
ARC has developed a reputation for aggressive expansion since it was launched by Tim Robinson, a Lawrence County lawyer who founded the company with a single halfway house for alcohol treatment in 2010. Fueled by the availability of new Medicaid funds for substance use disorder treatment since 2014 under the Affordable Care Act, ARC operates some 1,800 treatment beds in 24 counties and reaches hundreds more clients through outpatient services, the Kentucky Lantern reported in July.
Last year, ARC took in $130 million in Medicaid funds, the government health plan which gets most of its money from the federal government, making it by far the state’s largest provider of substance use services.
Robinson and his wife, Lelia, own ARC and some related entities which provide them with an annual income of $533,400, according to a 2022 tax filing of a related non-profit company, Odyssey Inc.
The company has been singled out for praise by politicians including Kentucky Gov. Andy Beshear, who spoke at an ARC ribbon cutting for a new ARC facility in March.
“With the help of organizations like ARC, we are working to build a safer, healthier commonwealth for our people,” Beshear said.
He also praised Robinson, ARC’s founder, in his State of the Commonwealth speech in January.
“With us today,” Beshear said, “is Tim Robinson, founder and CEO of ARC, an essential partner in our fight against addiction. … I’m proud to say we now have more treatment beds per capita than any other state in the country.”
From mid-2021 through the end of 2023 Robinson, his corporations and employees gave at least $252,500 to political committees supporting Beshear, according to reporter Tom Loftus’ analysis in the Kentucky Lantern of campaign finance records.
The donations to Democrat Beshear were a shift in the giving pattern for Robinson, a lifelong and loyal Republican. He also gave big to Beshear’s opponent in the 2019 governor’s race, Republican incumbent Gov. Matt Bevin.
The Lantern’s analysis shows that — including money contributed to Beshear committees — Robinson, his corporations and employees have made at least $570,000 in political contributions over the past decade as his for-profit company grew.
He also has donated to Kentucky Republican lawmakers, including some who wrote recent letters on ARC’s behalf, asking that rate cuts proposed to ARC and other addiction providers be suspended until further study.
The rate cuts of 15% to 20% proposed by three of the six private insurance companies that process state Medicaid claims became public recently at a legislative hearing. ARC and another provider told lawmakers that such cuts would devastate Kentucky’s efforts to turn the tide of addiction to drugs and alcohol.
“Kentucky has made significant strides in access to treatment,” Matt Brown, chief administrative officer for ARC, told a July 30 legislative committee. “With these cuts, it could completely set back addiction treatment in our state 20 years.”
Six national insurance companies known as managed care organizations, or MCOs, handle the majority of the state’s $16 billion a year Medicaid business. Under contracts with the state, they are paid a fixed rate per member to cover the cost of care.
Brown, the ARC official, told lawmakers this is no time to cut payments for addiction services, citing some indicators of success.
Brown noted that overdose deaths in Kentucky have declined for the past two years after years of rising. Kentucky also has the most treatment beds per resident, most of them through ARC, he said.
The state’s latest annual overdose report, released in June, shows a decrease in deaths to 1,984 from 2,200 the year before, a decline of 9.8%.
In a statement released after the hearing on the cuts, the Kentucky Association of Health Plans, which represents the MCOs, said its members “are proud to work collaboratively with quality, trustworthy providers of behavioral health and substance use disorder treatment” and access to those services is “top of mind” to ensure those in need receive care.
“Health plans strive for the best networks possible and are encouraged by the state to prioritize plan member outcomes and value-based care,” it said.
The FBI posting on the website seeking information on ARC does not provide further information about the nature of the investigation,
A spokeswoman did not immediately respond to a request for comment.
Friday, August 2, 2024
Lawmakers join Ky's largest addiction treatment provider to oppose Medicaid payment cuts; centers trying to negotiate cuts
Kentucky Lantern
The state’s largest provider of drug and alcohol treatment is warning that looming cuts in Medicaid reimbursement to some providers could damage efforts to curb addiction that has engulfed Kentucky — just as the state is showing improvements.
Matt Brown |
A handful of companies that provide substance use disorder treatment, including ARC, have been notified they face cuts of 15% to 20% from some private insurers that handle most Medicaid claims, Brown told the committee.
Brown noted that overdose deaths in Kentucky have declined for the past two years after years of rising. Kentucky also has the most treatment beds per resident, most of them through ARC, he said.
The state’s latest annual overdose report, released in June, shows a decrease in deaths to 1,984 from 2,200 the year before, a decline of 9.8%.
Brown was joined by Deron Bibb, chief financial officer for Stepworks, a recovery program based in Elizabethtown, and ARC executive John Wilson, also executive director of the Kentucky Association of Independent Recovery Organizations, speaking to the interim joint Health Services Committee about the cuts.
“This will likely result in higher overdose rates, higher recidivism, more crime and incarceration,” Bibb said. “We need to understand the full scope and impact of these cuts.”
The cuts have been announced by three of the six managed care organizations, or MCOs, private insurance companies that handle claims for most of the state’s $16 billion-a-year Medicaid program, Brown said.
Under their contracts with the state, the MCOs generally have authority to set rates they pay providers. The state pays MCOs a fixed amount per member to cover Medicaid costs.
One company also has begun notifying patients it will no longer cover addiction services at ARC effective Sept. 30, Brown said.
He did not identify the MCOs that have announced cuts and declined to do so after the hearing, saying ARC and other companies are still attempting to negotiate with them.
The Kentucky Association of Health Plans, which represents the MCOs, said in a statement released Thursday by spokesman Tyler Glick, that its members “are proud to work collaboratively with quality, trustworthy providers of behavioral health and substance use disorder treatment” and access to those services is “top of mind” to ensure those in need receive care.
“Health plans strive for the best networks possible and are encouraged by the state to prioritize plan member outcomes and value-based care,” it said.
Sen. Stephen Meredith, R-Leitchfield and co-chairman of the health committee, said Tuesday the lawmakers likely would seek more testimony on the subject, including from the MCOs.
“I know there’s two sides to every story,” he said.
Wilson said the recovery organization he represents wants to make sure lawmakers are aware of the situation and already has asked them to voice concerns.
“There’s going to be real world consequences and I think it’s important to let legislators know what’s taking place,” he said.
Some defenders benefitted from owner’s largesse
Several lawmakers have signed letters urging that the MCOs suspend any cuts to substance use treatment until the General Assembly can further review the matter. They include some in key leadership positions and some who have benefited from campaign donations from ARC founder and owner Tim Robinson and his employees.
ARC, a for-profit company based in Louisa, has emerged as the state’s largest and fastest growing provider of addiction services, financed largely by Medicaid, the government health plan with the majority of funds from the federal government. Growth took off after 2014 when substance use treatment was included in the Medicaid expansion authorized by the Affordable Care Act.
The Lantern reported the company took in about $130 million last year in Medicaid funds and was by far the largest recipient of the about $1.2 billion the state spent on substance use treatment.
The company and Robinson also have become among Kentucky’s major political donors with more than $500,000 in contributions over the last decade — with funds divided among Republican causes and those of Gov. Andy Beshear, a Democrat, the Lantern reported earlier this month, citing campaign finance and other public records.
Sen. Phillip Wheeler, R-Pikeville, who has received $19,900 in contributions from Robinson, his wife Lelia and ARC employees since 2016, on July 9 sent a letter to Kentucky Medicaid Commissioner Lisa Lee urging the cuts for addiction services be suspended “until the legislature fully understands the reasons behind them.”
“Kentucky has made great progress in tackling the addiction crisis that has touched so many of our constituents, neighbors, colleagues, friends and family members,” Wheeler said.
Cutting reimbursement now “could negatively affect some of our most vulnerable citizens and prevent us from seeing these positive trends continue,” his letter said.
A similar letter addressed to “to whom it may concern” was signed by Rep. Patrick Flannery, R-Olive Hill, who has received about $17,000 in campaign contributions from Robinson and ARC employees.
Another letter was signed jointly by Senate President Robert Stivers, R-Manchester, House Speaker David Osborne, R- Prospect, Rep. Kimberly Moser, R-Taylor Mill and Meredith. Moser and Meredith are co-chairs of the joint Health Services Committee which heard from ARC and other treatment officials Tuesday.
Republican supermajorities control the Kentucky House and Senate.
Robinson has given $10,000 to the Kentucky House Republican Caucus, and $15,000 to the Kentucky Senate Republican Caucus in the last four years.
Robinson also has given other contributions to campaigns of Republican state legislators in the past decade including $4,100 to Moser and $2,000 to Osborne.
From 2021 through 2023, ARC companies and employees gave about $252,000 to a political committee supporting Beshear, whom Robinson, a Republican, has said he admires and would like to see run for president.
Bibb, Stepworks’ chief financial officer, gave $500 to Flannery in December 2023 and $2,500 to the Kentucky House Republican Caucus in October 2022, according to Kentucky Registry of Election Finance records.
Not asking for more money, just no cuts, says company official
Brown said that one concern of the MCOs is the cost of treatment, in particular long-term treatment for addiction.
ARC understands concerns about costs, but experience shows people with addiction benefit the most from long-term services, Brown told the committee.
“It is not just about surviving from their addiction but thriving in their communities,” he said. “Long-term treatment is vital.”
Without quality treatment, costs to the state will rise elsewhere, Bibb said.
“These costs will not go away,” Bibb said. “They simply will shift back to the emergency room, the judicial system, foster care, homelessness.”
ARC is willing to work with the MCOs and the state to ensure it is using money efficiently and effectively, Brown said after the hearing.
“Everybody’s got to be good stewards,” he said. “We’re committed to helping provide a solution.”
Brown and Wilson said representatives of treatment providers plan to meet with MCOs and state officials in coming weeks to try to resolve their differences.
“We’re not asking for more money,” Brown said. “We’re asking for no cuts.”
Wheeler, in an interview, said he appreciates the support of Robinson, a longtime friend since college together at the University of Kentucky, but that’s not why he sent the letter.
Rather he’s concerned about the impact of cuts of up to 20% on ARC’s services, which he said have helped many people in the region including a brother who benefited from its treatment program.
Also, he said, ARC is a major employer in the area where jobs have been scarce and also trains its clients for jobs.
EMS staffing shortages are at crisis level, says Kentucky EMS board chair
Centers for Disease Control and Prevention photo |
Kentucky Health News
Kentucky's Emergency Medical Services are facing severe staffing shortages, with low pay, "abysmal" reimbursement rates and high turnover identified as the key reasons for the problem.
"We lose more paramedics every year than we gain, unfortunately. . . . We're hemorrhaging providers, we're losing more paramedics than we can replace," Kentucky Board of Emergency Medical Services Chairman John Holder told lawmakers at the July 30 Interim Joint Committee on Health Services.
Holder said Kentucky has an attrition rate of 21%, which means two out of 10 of their emergency medical technicians, commonly known as EMTs, will not return or certify again next year. Further, he said only 40% of their EMTs work with an EMS service.
"That means that less than half of those who are certified are actually going to work on an ambulance and treat members of their community," he said.
Holder said that even with new rules that allow only one paramedic per service, regardless of the size of the service, some EMS services can't even manage that level of staffing
“We're receiving regular calls from EMS services who are saying gentlemen were having to self-report that we cannot meet the staffing requirement as set by regulation, which means they don't have enough paramedics to staff their ambulances,” Holder said. “It truly is a crisis. I mean, we have services that are going to shut down if we can't find a solution to this problem.”EMS staffing challenges have been ongoing, while the need for services increase. According to Holder's presentation, there were "31,006 more requests for ambulance transport annually than five years previous."
First Federally Qualified Health Clinic residency program opens in Kentucky, with hopes of bringing more rural doctors to state
Kentucky Health News
Dr. Tyler Elam |
"I think there is a greater . . . mutual benefit for having the learners present in an FQHC," he said. "It helps us close care gaps for the indigent, while also being able to train new physicians."
Study finds blood test diagnosed Alzheimer's disease 90% of the time; early diagnosis is crucial with new medications available
2024 Alzheimer's disease facts and figures special report graphic |
Kentucky Health News
Tuesday, July 30, 2024
State judge dismisses constitutional challenge to anti-vaping law
Kentucky State Capitol Building |
Kentucky Lantern
Franklin Circuit Judge Thomas Wingate has dismissed a lawsuit challenging the constitutionality of a 2024 law banning the sale of some vaping products.
Wingate sided with the lawsuit’s defendants — Allyson Taylor, commissioner of the state Department of Alcoholic Beverage Control, and Secretary of State Michael Adams — who filed a motion to dismiss. The law designates the ABC as its enforcement agency.
The Kentucky Smoke Free Association, which represents vape retailers, had argued that the law was too broad and arbitrary to be constitutional because it is titled “An act relating to nicotine products” but also mentions “other substances.” The state constitution says a law cannot relate to more than one subject.
In his opinion, Wingate said the law doesn’t violate the state constitution.
The law’s title “more than furnishes a clue to its contents and provides a general idea of the bill’s contents,” he wrote.
The law’s “reference to ‘other substances’ is not used in a manner outside of the context of the bill, but rather to logically indicate what is unauthorized,” Wingate wrote.
The lawsuit centers on House Bill 11, which passed during the 2024 legislative session and is scheduled to take effect Jan. 1. Its backers said it will curb underage vaping by limiting sales to “authorized products” or those that have “a safe harbor certification” based on their status with the U.S. Food and Drug Administration.
Opponents have said it will hurt small businesses and favor big companies, and could drive youth to traditional cigarettes.
Altria, the parent company of tobacco giant Philip Morris, lobbied for the bill and is pushing similar bills in other states. Altria, which has moved aggressively into e-cigarette sales, markets multiple vaping products that have FDA approval.
“The sale of nicotine and vapor products are highly regulated in every state, and the court will not question the specific reasons for the General Assembly’s decision to regulate and limit the sale of nicotine and vapor products to only products approved by the FDA or granted a safe-harbor certification by the FDA,” Wingate wrote in a Monday opinion. “The regulation of these products directly relates to the health and safety of the commonwealth’s citizens, the power of which is vested by the Kentucky Constitution in the General Assembly.”