Wednesday, July 17, 2024

As part of resetting its relationship with rural hospitals, UK will not build a new hospital at interstate junction in southeast Lexington

By Al Cross
Kentucky Health News

FRANKFORT, Ky. -- The University of Kentucky will not build a hospital in southeast Lexington because it wants to do what its network of rural hospital partners want: focus on its mission as a top-level care facility for the sickest patients, a UK vice president told a legislative subcommittee Wednesday.

Mark D. Birdwhistell (UK photo)
The proposed Hamburg-area hospital "was perceived as us stepping outside of our swim lane" by the university's clinical affiliates out in the state, Senior Vice President for Health and Public Policy Mark Birdwhistell told the Budget Review Subcommittee on Health and Family Services.

"We heard loud and clear, 'We want UK HealthCare to focus on taking care of the sickest of the sick. We don't want UK out doing primary care and secondary care.' . . . That was very eye-opening."

Birdwhistell reiterated, "The message we received loud and clear from our clinical affiliates was, 'When our folks get that sick, we want them to come to UK. We want them on campus. We don't them in a community hospital.'"

UK was in the planning process for a new hospital at the southern junction of Interstates 75 and 64, and had bought the property and done some initial work. Baptist Health is in the process of opening a new hospital on an adjacent site.

Instead of a hospital, UK will build a clinic with specialty services like the one it has built in a former department store in the Turfland Center in southwest Lexington, but larger, Birdwhistell said after the meeting: "Turfland plus."

He told the legislative subcommittee that the university will also build other clinics to serve its employees in Lexington and the Bluegrass region, many of whom are "having to get health care outside the system. . . . We feel like that is our obligation."

Birdwhistell spoke to the subcommittee in a new role, which he said will include centralizing the university's "government-relations activities across campus," including "building a better partnership with the General Assembly. I felt I was uniquely positioned to do that."
Previously, Birdwhistell was UK HealthCare's vice president for health system administration and chief of staff. He was secretary of the state Cabinet for Health and Family Services under Republican Gov. Ernie Fletcher, and helped Republican Gov. Matt Bevin propose changes to the federal-state Medicaid program, which he had run before becoming cabinet secretary. He appeared with Angela Dearinger, executive vice dean of the UK College of Medicine, who was briefly health secretary at the end of Bevin's term.

The General Assembly is firmly controlled by Republicans. In the recent legislative session, Birdwhistell was the university's point man in changing legislation that helped Pikeville Medical Center and some other rural trauma hospitals but in its original form would have reduced some of the extra Medcaid payments that UK gets for being a "safety net" hospital.

That relates to UK's recent takeover of other hospitals in Ashland and Morehead, which Birdwhistell discussed at Wednesday's legislative subcommittee meeting. Speaking of UK's absorption of King's Daughters Medical Center in Ashland, he said "Where we failed . . . is when you put that UK brand in front of that name, that brings with it an expectation of service, not predator," which he said was the perception of some.

"And so, we're readjusting a lot of the narratives to say, 'When you have UK in front of your name, you go to a partner and say, 'What can we do to help you be successful?' It's not 'What do we do to crush you?' And this is community health care. This is not our forte, so we've learned that lesson. . . . We can grow the workforce for those providers and not have to do it ourselves."

Birdwhistell said UK can also serve as a backstop for its rural partners, noting that UK doctors rearranged their schedules one weekend to keep open the neonatal intensive-care unit at Pikeville, which would have had to close temporarily due to employee vacations. "That's what we do," he said. "That's where we excel and that's where we need to get back to."

UK's latest acquisition is St. Claire Medical Center in Morehead, where it has run a satellite medical-school program for several years. The College of Medicine also has satellites in Bowling Green and Northern Kentucky, and Dearinger said it has seven residency programs in Bowling Green, the state's third largest city, and is starting residency programs in Ashland and Pikeville.

"We are trying to grow the number of doctors to stay in our state," Dearinger said, calling UK's Rural Physician Leadership Program "one of our crown jewels." She said it has produced 120 doctors, most of whom are practicing in Kentucky, "the vast majority" in rural parts of the state. Later, she said 42 percent of all recent medical-school graduates from UK have stayed in Kentucky, far above the 24% of "a few years ago."

Two Democratic legislators from Louisville, Sen. Karen Berg and Rep. Lisa Willner, asked Dearinger if UK has had fewer applicants for medical school or residencies due to restrictions on medical education, by which they meant the recent state law that bans abortions except in cases of threat to the woman's life or permanent damage to a life-sustaining organ.

Dearinger said "To be honest, we have not seen a decrease." She said she has heard anecdotal reports of students or graduates interested in obstetrics and gynecology going elsewhere, but "We are still inundated with OB applicants to do a residency at the University of Kentucky."

Another Louisville Democrat, Rep. Sarah Stalker, noted a May 16 Kentucky Health News story, from Kentucky Public Radio, that said 15% fewer U.S. medical-school graduates applied to Kentucky residency programs in the 2023-24 academic year, and there was a 23% decline in those for obstetrics and gynecology, according to the Association of American Medical Schools., which blamed the decline on the state's near-total abortion ban.

Dearinger said UK is still getting hundreds of "very good applicants, and we don't have any problems filling our residency programs and fellowship programs with very high-quality young physicians. We are prioritizing as much as we can, Kentucky students, so that they will stay" in the state.

Roll call: Most members of the subcommittee did not attend the late-morning meeting. The chairman, Sen. Donald Douglas of Nicholasville, a physician, noted that at the start of the meeting and made an unusually pointed comment: "I expect my colleagues in the General Assembly to show up."

Tuesday, July 16, 2024

UK is again the top Ky. hospital in U.S. News rankings, followed by St. Elizabeth in Northern Ky. and Baptist Health Louisville

By Melissa Patrick
Kentucky Health News
Three Kentucky hospitals, in the state's three largest metripolitan areas, have been named among the nation's "Best Regional Hospitals" in the annual ranking by the U.S. News & World Report magazine. 

The No. 1 hospital in Kentucky is again the University of Kentucky hospital, followed by St. Elizabeth Healthcare in Edgewood and Covington and Baptist Health Louisville.

To make the list, a hospital must offer a full range of services; rank nationally in one of 11 measured specialties, or have seven or more high-performing rankings for procedures and conditions; and have at least three more "high performing" than "below average" rankings for procedures and conditions. 

The report offers an overview of 121 Kentucky hospitals with a breakdown of each of the measured categories, according to the services a hospital provides. 

UK HealthCare, for the ninth straight year, ranks No. 1 in the state with its Albert B. Chandler Hospital.

In cancer care, UK's Markey Cancer Center moved up to No. 36 from No. 44 last year. Markey is Kentucky's only National Cancer Institute-designated cancer center, and one of 72 in the nation. 

“Together, these recognitions firmly establish Markey among the nation's top cancer centers, affirming that patients can access world-class cancer care right here in Kentucky,” Dr. Mark Evers, director of the cancer center, said in a news release

UK's hospital system also ranked nationally in two other adult specialties: ear, nose and throat and obstetrics and gynecology; and three children specialties: pediatric cardiology and heart surgery, orthopedics and urology.

Six UK HealthCare adult specialties – four more than the previous year’s rankings – also received the “high performing” designation: gastroenterology and gastrointestinal surgery, geriatrics, neurology and neurosurgery, orthopedics, pulmonology and lung surgery and urology. 

The system also was rated "high performing" for 14 procedures and conditions, including heart attack, heart-bypass surgery, heart failure, colon-cancer surgery, kidney failure, back surgery (spinal fusion), stroke, gynecological-cancer surgery, leukemia, lymphoma and myeloma, hip replacement, chronic obstructive pulmonary disease (COPD), lung-cancer surgery, pneumonia and prostate-cancer surgery. 

Chandler Hospital was also named Best Regional Hospital for Equitable Access, a new category that recognizes success in caring for patients in historically underserved communities. UK HealthCare was one of 98 medical centers nationwide and the only hospital in Kentucky to receive this recognition.

“We diligently examine our data and metrics to help us identify and quantify disparities that are unique to our underserved populations. That allows us to execute targeted strategies and solutions to address these issues. We are truly the university – and the hospital – for Kentucky," Tukea Talbert, who oversees health equity efforts at UK HealthCare, said in the release.

St Elizabeth's Edgewood and Covington hospitals ranked high performing in 15 procedures and conditions: leukemia, lymphoma and myeloma, colon-cancer surgery, lung-cancer surgery, prostate cancer surgery, abdominal aortic-aneurysm repair, heart attack, heart-bypass surgery, heart failure, kidney failure, stroke, maternity care (uncomplicated pregnancy), hip replacement, knee replacement, COPD and pneumonia.

This is the 11th time that Baptist Health Louisville has ranked No. 1 or tied for that ranking in Jefferson County. The hospital ranked high-performing in nine procedures and conditions: leukemia, lymphoma and myeloma, colon-cancer surgery, abdominal aortic-aneurysm repair, heart attack, aortic-valve surgery, heart-bypass surgery, hip replacement, knee replacement and COPD. The hospital ranked below average for diabetes. 

“We’re incredibly excited to be recognized by U.S. News and World Report for being number one in metro Louisville. It’s a recognition that comes as a culmination of a lot of work from the entire team at Baptist Health Louisville who strive every single day to ensure that the care that we provide is the highest quality and the safest it possibly can be,” Dr. Jonathan Velez, president of Baptist Health Louisville, said in a news release. 

The 35th annual rankings compared hospitals in 15 specialties and 20 common procedures and conditions. Data from the report came from the Centers for Medicare & Medicaid Services, the American Hospital Association and professional organizations. This year, the report also includes Medicare Advantage data in the rankings, including risk-adjusted mortality rates for its beneficiaries in 11 adult specialties.

Nationally, the report named the top 22 hospitals to the national "Honor Roll." The top hospitals were not ranked again this year, but were instead listed in alphabetical order. Regionally, 466 hospitals were recognized as "Best Regional Hospitals." Click here for a FAQ about how and why U.S. News ranks hospitals.

Study to help reduce risk of heart disease and diabetes, to be done via Zoom, is looking for participants in 16 Kentucky counties

Kentucky Health News map
By Gia Mudd-Martin
University of Kentucky

Heart disease and Type 2 diabetes are often preventable, but Kentucky has the nation’s ninth-highest rate of heart disease and the fifth highest rate of diabetes. Plus, many Kentuckians have pre-diabetes but don’t know they have it.

A team of at the University of Kentucky is leading a health study called “Heart of the Family” to help people learn to reduce their risk for these illnesses, and the team is inviting participants to join.

What do participants get?  
  • “Heart of the Family” participants receive eight one-on-one, personalized health education sessions based on their risk factors and health. The sessions are over Zoom — no travel required.
  • Free screenings to check health measurements such as blood pressure and cholesterol; these can be done in your home community (team members can come to you) or at an off-campus UK office
  • Gift card for participation
Who can join? You may be eligible to participate if you are:
  • At least 18 years old
  • Do not have heart disease or diabetes
  • Live in one of these Kentucky counties: Anderson, Bourbon, Boyle, Casey, Clark, Franklin, Garrard, Harrison, Jessamine, Lincoln, Madison, Marion, Mercer, Pulaski, Scott, Woodford
  • Have two or more of these risk factors: family history of heart disease or diabetes; personal history of gestational diabetes or polycystic ovarian syndrome; little or no exercise; unhealthy diet; high blood pressure; high cholesterol; elevated blood sugar; stress; depression; overweight; cigarette smoker
Some participants will be invited to have a friend or family member join with them as a “study buddy,” so make sure you have someone willing to participate with you. They can participate even if they have diabetes or heart disease. Study buddies will receive the same benefits listed above.

What is required of participants? Participants should be willing to complete eight virtual health-education sessions, share health information with the study team, and have blood drawn. All your information will be kept completely confidential, just like in regular medical care.

How can I get involved? If you’re interested in learning more or joining, contact Emily Cravens at or 859-218-6827. Learn more about participating in research at

Sunday, July 14, 2024

Cigarette tax collections in Ky. jumped, then dropped, after tax increases; state's smoking rate has also been on the decline

Kentucky Health News graph from state data
By Melissa Patrick
Kentucky Health News

Increasing state cigarette taxes has proven to be an effective policy to decrease smoking rates, and it appears that is also true in Kentucky.

Nearly 30 percent of Kentucky adults smoked in 2011, two years after the legislature had doubled the cigarette tax to 60 cents a pack. Following a 50-cent increase to $1.10 in 2018, the state's adult smoking rate fell to 17.4% in 2022, the last year for which a rate is available. 

Shannon Baker, the American Lung Association's advocacy director for Kentucky and Tennessee, said that while she could not point to something definitive to explain why Kentucky's smoking rate has been decreasing, as has also been the case in the nation, she could speak to the impact of raising cigarette taxes:

"When taxes increase, smoking rates decline. We should take advantage of that, for goodness sake, and increase the cigarette tax in Kentucky by at least $1 and then tax all other nicotine products at parity with the cigarette tax." 

After an initial boost in cigarette-tax revenue from the rate hikes in 2011 and 2018, revenue from the tax declined 24% from 2019 to 2024.

The legislature increased the tax to 30 cents from 3 cents in 2005, but smoking rates before 2011 should not be compared with those after that because of a change in survey methodology, says the Behavioral Risk Factior Surveillance System, a continuing federal-state poll of Americans' habits.

Baker stressed that its important to take advantage of all policies that are known to decrease smoking. Beyond raising taxes, she said it's important to fund the state tobacco-control program and enforce the law against underage sales, which she said would result in fewer youth becoming addicted to nicotine and growing up to be lifelong smokers, and all the health issues that come with that. 

The new report on state General Fund receipts for the fiscal year that ended June 30 showed a 1.5% increase in receipts from other tobacco products, such as electronic cigarettes or vapes.

Asked about the impact of vaping on decreasing smoking rates, Baker focused her comments on young people, who are more likely to vape than smoke.

"We really have to get a handle on this youth vaping problem," she said, noting that Kentucky is one of about 10 states that doesn't require tobacco retailers to be licensed. "We don't even know where all of these shops are in order to enforce the law against underage sales."

Baker added, "We really need a better method of enforcing the law against underage sales. And what that looks like is licensure and routine regular enforcement opportunities that result in significant penalties all the way up to license suspension and revocation, for scofflaws that routinely violate the law. We're not talking about any onerous policy on those who are compliant with the law. We're simply talking about those who violate the law and violate it routinely." 

The 2023 Youth Risk Behavior Survey found that 5.3% of Kentucky high-school students said they currently smoked cigarettes and 19.7% said they used electronic vapor products. Among middle schoolers, the 2.2% said they smoked cigarettes and 12.8% used a vapor product. "Current use" is considered having used a product on at least one day during the 30 days prior to the survey.

Asked if she thought the new law that bans retailers from selling unauthorized vapor products would be effective in decreasing youth vaping, as it has been touted to do, Baker said, "House Bill 11 turned into . . . an industry market-share grab and nothing more; it is not a protection for kids. What we saw was a bill passing that, in effect would, if it's upheld in court, remove certain products, primarily imported products, from the market shelves, which in and of itself is not a bad thing. But, it certainly doesn't protect kids who will just switch to the other products that remain on the shelves." 

The law has been challenged in court. If it holds up, it will go into effect January 2025.

Baker also wanted to make sure people know that the funds for the state's tobacco control program come from the Master Settlement Agreement with cigarette manufacturers, not from the cigarette tax.

"We need to increase funding for tobacco control because . . .  Kentucky has the highest lung-cancer incidence and mortality rates in the entire nation and most of that is due to our high smoking rate," Baler said. "So even though the smoking rate may be declining, it isn't gone. It isn't good, even."

Saturday, July 13, 2024

Kentucky is a national leader in lung-cancer screening, but still has a long way to go to get all eligible people screened

American Cancer Society photo illustration
By Melissa Patrick
Kentucky Health News

Kentucky ranks second among states for lung-cancer screening, but experts say many more Kentuckians need to be screened. Only 10.6% of those at high risk have received screening; the national rate is 4.5%.

A recent study led by American Cancer Society researchers, published in the Journal of the American Medical Association Internal Medicine, shows fewer than one in five eligible individuals in the United States were up-to-date with recommended lung-cancer screening. 

"This research does show an improvement over screening rates reported for previous years. But we clearly, still have a long way to go. We must push harder to move the needle in the right direction,” Dr. Priti Bandi, ACS's scientific director for risk factors and screening-surveillance research, said in a news release.

The U.S. Preventive Services Task Force and ACS recommend annual low-dose CT scans for lung-cancer screening for individuals who:
  • 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. 
Jennifer Redmond Knight, who serves as co-principal investigator for the lung-cancer screening project under the Kentucky Lung Cancer, Education, Awareness, Detection, Survivorship Collaborative, said one reasons lung-cancer screening remains low is because it is a relatively new cancer screening. The first recommendations for annual screenings were issued in 2013 and the eligibility for screenings expanded in 2021. 

"What that means is more people are now eligible for screening, which means the percentage of people who have been screened has gone down because there are more people eligible," Knight said. 

Another challenge is stigma, said Knight, who is also an assistant professor in the University of Kentucky's College of Public Health and a member of the UK Markey Cancer Center's Prevention and Control Research Program.

For years, Knight said people with a "significant smoking history" have felt shamed when their health-care providers ask them if they've quit smoking and they haven't, so when their provider encourages this new screening, there are often trust issues.

Knight said much work is being done in Kentucky to reduce stigma associated with lung cancer, largely through the Lung Cancer Screening Program the legislature created in 2022. Knight is on the program's advisory board.

"Kentucky is actually leading the way in many ways with quality lung-cancer screening and addressing the stigmas and helping lung-cancer screening programs throughout the state work in that space," Knight said.

She also talked about the value of early detection, which lets cancer be treated more effectively. Early screening is also important because it can often identify cancer before it spreads or causes symptoms. 

"We have hope now with lung cancer that we never had before," Knight said. "The story used to be if you get lung cancer, you're not going to make it very long. But now there's a story of hope that has to be changed. . . . So there's a lot of cultural shifts around this." 

The cancer society's research found that screening was much less common in persons without health insurance or a usual source of care, and in Southern states, which have the highest lung-cancer burden. Lung cancer is the leading cause of cancer deaths in Kentucky.

Most Kentuckians can pay for lung-cancer screenings through insurance or a program that offers low-cost screenings. Most Kentuckians have access to health insurance because the state expanded Medicaid in 2014, under the Patient Protection and Affordable Care Act, to include people making up to 138% of the federal poverty level. 

"If you meet the eligibility criteria, lung-cancer screening is covered by Medicare, Medicaid and most private insurance plans without cost-sharing. In rare instances where insurance coverage is unavailable, many programs including UK’s Lung Cancer Screening Program, offer screenings at a relatively low cost," Dr. Timothy Mullett of UK wrote in an article to debunk myths about such screenings.

The state Department for Public Health offers a service called Quit Now Kentucky to help Kentuckians of all ages quit smoking. To learn more go to, text QUITKY to 797979 or call 1-800-QUIT-NOW.

Friday, July 12, 2024

Lee Co. harm-reduction chief says 80% of clients are homeless

Jo Ann Fraley runs the harm-reduction program for
the Kentucky River District Health Department.
(Photos by Stu Johnson, WEKU)
By Stu Johnson, WEKU

Homelessness is a reality in virtually every section of Kentucky. Although often thought of as an urban challenge, rural Kentucky also finds the plight of the unhoused a pressing issue. Here's a glimpse of how one Appalachian community is addressing homelessness needs.

There is a gathering spot inside The Hub in downtown Beattyville. It’s the Lee County Health Department's harm-reduction center, where staff work to connect clients with care providers.

The director is Jo Ann Fraley, a social worker who’s worked in addiction and recovery. Fraley said about 80 percent of The Hub's clients live on the streets or are couch surfing, and many don’t realize their health status.

“Lot of them have blood-pressure issues and they don’t even know. A lot of them have diabetes and they don’t even know,” Fraley said. “So, those issues we need to address as quick as we can.”

Fraley said the focus is getting people hooked up with doctors and health providers, because “We can’t expect change if we don’t help with the changing process.”

“They’ve lost hope. They give up. They’ve burnt every bridge that they have with family. And so, they let themselves go and they just think nobody cares about them. And whenever someone goes somewhere and they’re not treated very nice, they don’t go back,” said Fraley.

Another staff member at The Hub is Shawn Maynard, who was a user of oxycontin, pain pills, and then methamphetamine, along with alcohol. Maynard has been clean for six years and works with clients to address barriers. He said the homeless lifestyle itself creates health risks.

“When you’re homeless, your hygiene’s not gonna be good and that’s gonna create infection, staph infection,” said Maynard. “If you do get a cut and you’re not getting the proper wound care for it, it’s gonna get infected.”

Nathan Tipton
Nathan Tipton, a client of The Hub, said he’s been four months clean after struggling with drugs for years.

“I was on meth and drinking real bad and after my papa and mama died, it got worse and stayed out there in the woods for about four and half year; still homeless, but life makes a big difference when you got God on your side,” said Tipton.

Tipton said it’s different from before, he was stealing and robbing to get a fix.

The Lee County Health Department is part of the Kentucky River Health District. District Health Director Scott Lockard said he and Fraley brainstormed over The Hub concept, and said creating bonding relationships is important.

“We form that relationship. We show them that they can be treated with dignity. We establish trust and then when the timing is right and they’re ready for treatment, we can link them to treatment immediately,” said Lockard.

“Health is the foundation for everything. If you don’t have health, you can’t worry about education, you can’t worry about employment. You can’t worry about everything else.”

So, Lockard said that means linking up to a medical home and making sure the clients have a payer source, which for most is Medicaid. He said some don’t even realize they are eligible for the fedreal-state program that provides free medical care to lower-income people.

Lockard said the district is trying to to establish a similar program in Letcher County, and he envisions similar like services in all seven Kentucky River District counties, ideally in the next five years or so. Besides Lee and Letcher, the district also includes Knott, Perry, Leslie, Owsley and Wolfe counties.

Thursday, July 11, 2024

Breathitt, Lee, Jessamine and Nelson counties are certified as Recovery Ready Communities, totaling 14 in effort's 14 months

Kentucky Health News map
Gov. Andy Beshear presents Recovery Ready Community
certificate for Lee County to Scott Lockard and Jo Ann Fraley
of the Kentucky River District Health Department. (Photo by Al Cross) 
By Al Cross
Kentucky Health News

Four more Kentucky counties have been certified as Recovery Ready Communities, signaling that they have the services needed to help their residents recover from addiction. That brings the total to 14 out of 120; the program began 14 monhs ago. "We've got 106 to go," Gov. Andy Beshear said.

Breathitt, Jessamine, Lee and Nelson counties earned cetification by showing they are able to provide addiction treatment to their 123,000 residents, according to Beshear, who presented Lee County's certificate at a wide-ranging press conference Thursday.

Scott Lockard, public-health director for the seven-county Kentucky River Disrrict Health Department, accepted Lee County's certificate with Jo Ann Fraley, who runs the department's harm-reduction program, which includes a syringe exchange to prevent disease among intravenous drug users and steer them into treatment.

"The substance-use-disorder problem is the largest public-health issue that we are facing today in Eastern Kentucky and many parts of our commonwealth," Lockard said.

Noting another major topic of Beshear's press briefing, Lockard said, "These great economic-development announcements are fabulous, but each one of those factories need people to work in them. Second-chance employment is huge, and we have so many people who are being impacted by substance-use disorder, especially in our part of the state, in Eastern Kentucky."

Lee County's recovery program is based in The Hub, in the health department's annex. "Our motto at the Hub is 'We meet people where they are, but we do not leave them there,' because it's key that everyone who comes through our door is treated with respect and dignity."

Lockard said the program has gotten more 230 people into treatment, including three that morning. They were immediately transported to a treatment facility, Lockard said: "When they're ready, we need to get them in there right then."

When people leave residential treatment, The Hub offers them 11 support groups, links to second-chance employment and "a ministry that fills the soul," Lockard said. "You know, this emptiness left by drugs, we need to fill it with somethng else, and if we can get individuals back and show them that they have worth, that they have dignity, then we have the possibility to really help them to be gainful members of our society and fill some of these many jobs and just have a higher quality of life."
Lockard said substance use must be approached as a disease. "We cannot incarcerate our way out of this problem." He said The Hub includes a court diversion program for low-level drug offenders.

Immediately before the recovery discussion, Beshear and State Police Commissioner P.J. Burnett announced a statewide drug roundup of 206 suspects, mostly on trafficking charges. Burnett said another 50 suspects are still being sought.

To be certified as recovery-ready, a county must have peer-support services, mental-health treatment, addiction treatment, employment services and a stigma-free environment to encourage recovery. The program "encourages communities to provide transportation to and from employment services and job interviews, allowing Kentuckians to make positive changes in their lives while filling much-needed jobs and contributing to the commonwealth’s record-breaking economic growth," a news release from Beshear's office said. 

The release included statements from representatives of the other counties.

“This is a huge step in continuing to move Breathitt County forward in applying for grants that will improve the lives of every person in our county,” said Breathitt County Circuit Court Clerk James Elliot Turner II. “We need to provide every opportunity for each person in Breathitt County to fulfill their potential. This is a win for our people.”

Shauna O’Nan, Jessamine County Health Department harm reduction director, said “There is no set path of recovery, but after going through this certification process, we are confident, as a community, that we will be able to meet people where they are on that path.”

In Nelson County, "Collaboration and community involvement underlie Nelson County’s efforts to provide recovery resources to its citizens," the release said. Jessica Bickett, safe-communities specialist with the Lincoln Trail District Health Department, said “Nelson County has a strong network of community partners who are committed to supporting the recovery community.”

"These communities are stepping up to help fellow Kentuckians who are struggling with addiction," Beshear said. "We are grateful for, and we applaud, their good work."

To learn more about the program and to apply for certification as a Recovery Ready Community, click here.

Paths to treatment

If you or a loved one are struggling with addiction, connect to treatment by calling 833-8KY-HELP (833-859-4357). Information about treatment programs all across the commonwealth is available at

Information on how to obtain the life-saving drug naloxone, which is used to reverse an opioid overdose, can be found at that website as well as at and

Visit the State Police website to find a post where those suffering from addiction can be paired with a local officer who will assist with locating an appropriate treatment program through KSP’s Angel Initiative.

To find recovery housing, go to

Wednesday, July 10, 2024

31% of Kentucky women live more than half an hour from a hospital with a maternity unit; across the U.S., only 9.7% do

Map from 2023 March of Dimes report
By John McGary, WEKU

“Estill Medical. This is Madisyn. How may I help you?”

It’s a few minutes before lunch at Estill Medical Clinic, in Irvine. The practice is owned by nurse practitioner and Estill native Donna Isfort. It offers many services, but, like every other medical facility in the county, no obstetrician/gynecologist.

Isfort said, “Many, many of my patients at least have to travel anywhere from 30 minutes to 60, 70, minutes just to get to obstetrical care. There's just not any here. We have no nurse midwives. . . . I do family practice, so I do a lot of women's health at my clinic, but not prenatal care.

Estill County does have a hospital, but a spokesman for Mercy Health-Marcum and Wallace Hospital said it hasn't delivered babies since 1986, not counting unplanned births in the emergency room.

According to a 2023 report by the March of Dimes, women living in what some call “maternity care deserts” like Estill and several nearby counties must travel more than twice as far to get the care they need. Multiple studies conclude that greater distance puts women, expectant and otherwise, at greater risk.

The report says 31 percent of Kentucky women live more than 30 minutes form a birthing hospital; the national figure is 9.7%.

Isfort says she and her staff work closely with the Estill County Health Department to provide the help they can and out-of-county referrals for services they can’t provide.

Some think Kentucky’s maternity care deserts may spread. At a June 24 rally in Lexington to mark the two-year anniversary of the Supreme Court’s toppling of Roe v. Wade, second-year medical student Shriya Dodwani painted a bleak picture.

“The Accreditation Council for Graduate Medical Education requires that OB/GYN residents have access to abortion training,” Dodwani said. “This isn't about politics. It's about ensuring that we have the comprehensive skills needed to provide the best possible care for our patients. Without this training in Kentucky, we're left with no choice but to leave and pursue our education elsewhere.”

In a recent survey of students at Kentucky’s three medical universities, 62 percent of respondents said they’re considering finishing elsewhere because of the state’s near-total abortion ban.

A week later, University of Kentucky HealthCare officials unveiled a plan that could help some women in rural areas. The outreach division of UK Women’s Health OBGYN announced they’d add services at 19 new sites, several in Eastern Kentucky, and expand telehealth services.

Dr. Emily DeFranco is chair of UK’s Department of Obstetrics and Gynecology, said “We'll send a sonographer with an ultrasound machine to the site, and they'll perform the ultrasound and then virtually, by telemedicine, the physician who is in Lexington is able to view the images from the ultrasound, and then have a video conference with the patient on that site and counsel her about the findings.”

That sort of outreach could eliminate some of the long trips many women must make for routine care. Another program, funded in part by Medicaid and tobacco-settlement dollars, helps expectant and new mothers: HANDS, which stands for Health Access Nurturing Development Services. It’s available to all women during pregnancy through a child’s third birthday.

At the Estill County Health Department, Teresa Talbott is the ongoing home visitor, dropping in weekly with 15 to 20 families per year for the last 17 years.

“We're not coming in to look at your home. We're not coming, you know, to tell you what t“o do, Talbott said. “We're just coming in and giving you the information and helping you along with it.”

One woman she’s helping now is Whitney Bingham, who happens to be the health department’s Women, Infants and Children program coordinator. Talbott, who Bingham calls TT, is assisting her and her two-year-old son through challenges ranging from potty training to car-seat installations.

But Bingham says that when it’s time for her to leave for an OB-GYN visit, she makes the hour-long drive to Lexington.

The state Cabinet for Health and Family Services declined our request for an interview with the Department for Public Health’s director of women’s health.

Tuesday, July 9, 2024

This year, more than 3,700 calls from Kentucky to the 988 suicide-and-crisis lifeline have been routed to the Veterans Crisis Line

This story has been updated.

By Lisa Autry
WKU Public Radio

More than 16,000 Kentucky veterans struggling with their mental health have used the national 988 hotline since it launched two years ago.

The suicide and crisis lifeline doesn’t require callers to disclose personal information, but veterans' overall use can be tracked because callers can be directed to the Veterans Crisis Line. In Kentucky, more than 3,700 calls have been routed to the veterans line so far this year, according to the state Cabinet for Health and Family Services.

In a recent speech to the Veterans of Foreign Wars state convention in Bowling Green, Gov. Andy Beshear urged veterans to seek help.

“We see an epidemic of suicide among our veterans and even our active service members that is unacceptable," Beshear said. "It’s important we have all of the services to make that individual whole at the ready.”

Since the 988 line was launched in July 2022, more than 80,000 calls have been received from residents of Kentucky.

The line connects those in distress to trained counselors 24 hours a day, via calls, chats or text messages. Thirteen of Kentucky's 14 regional mental health centers serve as call centers, and the 14th is in the process of becoming nationally certified. That means 988 calls in all 120 counties can be served by a local center instead of the call being answered out of state.

Calls from all 120 counties are routed initially to an in-state center. If they're not answered within 90 seconds, the calls roll over to an out-of-state backup center.

Since May 2023, the state has seen a 40% increase in calls from Kentuckians to 988 and a 53% increase in the number of those calls that are answered in-state.

"The centers work continuously to recruit, train, and retain compassionate local individuals dedicated to helping fellow Kentuckians in crisis," said Brice Mitchell, a spokesman for the state Cabinet for Health and Family Services. "Using federal grant funding, the centers have increased the workforce capacity through hiring staff and utilizing volunteers."

In May, 84% percent of calls in May were answered at the local level, according to to CHFS. The current in-state answer time of 23 seconds remains faster than the national average of 36 seconds.

Brooke A. Flinders, a double graduate of Frontier Nursing University, will become its next president on Aug. 1

Brooke Flinders
Kentucky Health News

Brooke A. Flinders, who earned her advanced degrees from Frontier Nursing University, has been named the next president of the Versailles institution. 

Flinders has extensive experience as an advanced practice nurse, educator, and college administrator. She will leave her position as a nursing professor and associate provost at Miami University in Ohio and become president of FNU on Aug. 1. She holds a Master of Science in Nursing and a Doctor of Nursing Practice degree from FNU. 

“We are thrilled that Dr. Flinders has accepted the offer to become the next president of Frontier Nursing University,” said FNU Board Chair Michael Carter.  “Dr. Flinders’ wealth of experience as an educator, practitioner, and administrator will be a tremendous asset to our students and to our faculty and staff who support them. We are extremely excited about the future of Frontier under Dr. Flinders’ leadership.”

Flinders will succeed Susan E. Stone, who was with the university for more than 30 years, the last 23 as president. Stone will be president emeritus and chair of midwifery and nursing on FNU's board.

Flinders obtained her Associate Degree of Science in Nursing (1994) and Bachelor of Science in Nursing (2003) degrees from Miami. In addition to acute care and community-based care experience as a registered nurse and full-scope practice as a certified nurse-midwife, Flinders has been a nurse educator, nursing department chair, and associate dean.

“I am proud and honored to accept the position of president of Frontier Nursing University,”  Flinders said. “My connection to Frontier extends nearly two full decades, and I am so proud to be one of its more than 9,000 graduates. . . .  I believe wholeheartedly in Frontier’s mission to provide accessible nurse-midwifery and nurse practitioner education that integrates the principles of diversity, equity, and inclusion, and I am excited to carry it forward.”

Flinders received the 2021 Distinguished Alumni Award from Miami's nurisng department, and in recognition of their service efforts during the Covid- pandemic, she and each of her nursing colleagues received the President’s Service Medallion. Flinders became a fellow of the American College of Nurse-Midwives in 2021, as a recognition of her demonstrated leadership, clinical excellence, scholarship, and professional achievement.

“As a proud graduate of Frontier School of Midwifery and Family Nursing and Frontier Nursing University, I am eager to build upon the amazingly strong foundation that already exists,” Flinders said. “Health-care provider shortages and the maternal mortality crisis plague our country. Frontier has a long history of finding unique solutions to complex problems, and we will continue to be a leader in identifying and implementing solutions by producing highly prepared nurse-midwives and nurse practitioners who have answered the call to serve.”

FNU was founded in 1939 as the Frontier Graduate School of Midwifery by the Frontier Nursing Service, a group of nurses and nurse-midwives who have served rural areas of Kentucky since 1925. Formerly located in Hyden, FNU completed its transition to Versailles in 2022 and is "one of the largest not for profit universities in the United States for advanced nursing and midwifery education, its website says.

Monday, July 8, 2024

Coleman reappoints two members to state opioid commission

By Melissa Patrick
Kentucky Health News

Attorney General Russell Coleman has reappointed two members to the state opioid commission, thus not changing the balance of votes on the issue of syringe-exchange programs, which he says he opposes.

Those members are Jason Roop, an assistant professor of business and theology at Campbellsville University, who represents victims of the opioid crisis, and Van Ingram, who works for Gov. Andy Beshear as executive director of the Kentucky Office of Drug Control Policy and fills a slot representing the drug treatment and prevention community. Each of their terms expires in 2026. 

The Kentucky Opioid Abatement Advisory Commission has nine voting and two non-voting members. The legislature created the commission in 2021 to distribute the state's portion of the $900 million in settlements with opioid manufacturers and distributors, with half of the money going to the state and the other half going to local governments. 

The money is provided in installments and so far, the state has awarded 110 grants worth more than $55 million for treatment, prevention and recovery.

Attorney General Russell Coleman
Coleman's opposition to syringe exchanges was revealed when Chris Evans, the commission's executive director and a Coleman employee, passed on a vote approving a grant for the Boyle County Agency for Substance Abuse Prevention because it included help for a syringe exchange. 

In passing, Evans said Coleman doesn't support the exchanges. Coleman, a Republican who was elected in November, later said that was especially the case for programs that are not limited to one-for-one exchanges. His spokesman said Coleman would not base commission appointments on the issue.

As of February, 41 Kentucky counties had syringe-exchange programs that operate under a one-to-one rule and 24 counties have needs-based exchanges, according to the state Department for Public Health. It estimates that the overall return rate of syringes is 85% to 90%. 

Syringe exchanges are supported by research. The Centers for Disease Control and Prevention says injection drug users who have access to exchanges are five times more likely to get treatment than those who don’t. Another study says the exchanges do not encourage drug use or increase the frequency of drug use among current users.

Exchanges were authorized by the state's 2015 anti-heroin law, in an effort to thwart the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users. 

They also work to reduce overdose deaths by distributing naloxone; reduce medical harms such as skin, blood stream, and heart valve infections that severely injure substance users and incur large health care costs for society; and connect substance users to treatment and recovery supports in order to achieve sustained abstinence.

Patricia Freeman, a University of Kentucky pharmacy professor, has also been reappointed to the commission – by UK as a representative of the HEALing Communities study team, which is working on reducing drug-overdose deaths. Her term will expire in 2026. 

Two new non-voting members have also been appointed. State Rep. Chris Fugate, R-Chavies (Perry County), was appointed by House Speaker David Osborne to replace retiring Rep. Danny Bentley, R-Russell. Karen Kelly, chief of staff to U.S. Rep. Hal Rogers, R-5th District, was appointed by Senate President Robert Stivers to replace Carlos Cameron. 

Other members of the commission are Republican state Treasurer Mark Metcalf, who also passed on the Boyle County vote; Cabinet for Health and Family Services Secretary Eric Friedlander, who works for Beshear; Von Purdy, a vice president of Simmons College in Louisville, representing citizens at large; Darren "Foot" Allen, a retired state trooper, representing law enforcement; and Karen Butcher, representing citizens at large.

Cardiologists moving to positron emission tomography (PET) scans to diagnose heart diease, rather than SPECT scans

Image by Artemis Diana, iStock/Getty Images Plus
By Dr. Talal Alnabelsi
University of Kentucky

When it comes to diagnostic imaging of your heart – such as MRI, CT, SPECT, or PET – it can be overwhelming to know what kind of scan is right for you. What is your doctor looking for, and what exactly does the imaging show?

Imaging is vital in assessing and treating coronary artery disease (CAD), a condition in which plaque gradually builds up in the blood vessels. Over time, as the plaque accumulates, the blood vessels become narrower, reducing the blood supply to the heart muscle, which in turn could lead to symptoms such as chest pain or shortness of breath or a heart attack.

Risk factors for CAD are high cholesterol, high blood pressure, family history of heart disease, diabetes, smoking and obesity. It’s important for cardiologists to have a clear image of the heart to determine the extent of the plaque buildup or whether the plaque is causing any blockage in order to develop an effective treatment and prevention protocol.

Traditionally, cardiologists have relied on a type of imaging called single photon emission computed tomography (SPECT) to diagnose coronary artery disease and the extent of blockage in your heart. This involves the injection of a radioactive tracer into the veins while a special camera picks up the traces of the tracer, photographing it as it moves through the heart. The photographs are assembled into a three-dimensional image, showing areas of tissue damage and reduced blood flow.

There is a new movement among cardiologists to use positron emission tomography, or PET scans, to assess coronary artery disease. Although the procedure for a PET scan is similar to SPECT – both involve photographing radioactive tracers as they move through the heart – PET scans are more accurate and have a better image quality than SPECT.

Other benefits of PET scan for cardiac imaging include:
  • Overall scan time is shorter than for SPECT imaging, vital for patients who may find it difficult to be in the enclosed space of the imaging machine for a prolonged period
  • Allows assessment of not just the blood flow, but how well the heart muscle itself pumps blood
  • The ability to determine your coronary-artery calcium score
  • Can diagnose patients who continue to have chest pain despite no obvious blockage on cardiac catheterization or heart CT (microvascular disease)
  • Lower dose of radiation, beneficial to patients who have to go undergo frequent imaging
  • Image and assess patients who are suspected to have other conditions, such as cardiac sarcoidosis or endocarditis, scarring in the heart muscle or an infection from an implantable device such as a pacemaker.
Beyond heart disease, cardiac PET scans can image patients who have other suspected conditions including cardiac sarcoidosis or infections of implanted devices (pacemakers/defibrillators) or prosthetic heart valves.

While PET scans are not as widely available as SPECT, they give cardiologists a more complete picture of your heart’s health, reducing the need for alternative imaging tests or unnecessary invasive procedures. If your local health-care facility does not offer PET imaging, ask your cardiologist for a referral.

Talal Alnabelsi, M.D., is a cardiologist at UK HealthCare’s Gill Heart & Vascular Institute.