How to create a successful fitness plan this spring

Photo from PeopleImages | iStock / Getty Images Plus

By Dr. Robert G. Hosey

University of Kentucky

Scientists have found that regular participation in aerobic exercise has been shown to decrease levels of stress, stabilize mood, improve sleep and improve self-esteem. Just five minutes of aerobic exercise can help alleviate and stimulate anti-anxiety effects. Here are some tips to create a successful fitness plan this year.

Preliminary checks: Before you start working up a sweat, schedule a visit to your doctor to gauge on your overall health. Discuss any aches, pains or limitations that might impact your plans to get active. Your doctor can also assess your cardiovascular health and help you understand how and when to increase your exercise intensity.

Make a plan: Exercise should be planned for a time in the day when you feel rested and have the most energy. If you are planning to exercise outside, avoid extreme temperatures (warmer than 85 degrees F or colder than 32 degrees F). Remember to dress appropriately for the weather and wear comfortable, supportive footwear. An indoor contingency plan for exercise can help you stay active even during spring showers.

Don’t forget to warm up and cool down: Aerobic exercise, such as walking or biking, is recommended for those getting started with a new routine. Your exercise session should start with a warm-up period of slow walking or low-resistance bicycling and end with a cool-down segment at similar intensity.

At the end of exercise, stretch the major muscle groups used by holding each stretch for 20-30 seconds. This can minimize injury and fatigue and increase flexibility.

Make it manageable: Begin your exercise routine with an amount of time that is manageable, something as short as a five-minute walk around the neighborhood. Once you’re comfortable exercising for that long, slowly increase the duration of your sessions.

Don’t push yourself too hard, either. You should be able to maintain a conversation at all times of exercise without experiencing breathlessness.

Hydrate, hydrate, hydrate: Drinking water is important, especially when you’re exercising more. Staying hydrated helps your muscles work more efficiently and helps your heart pump blood more easily. Make sure to drink plenty of water before you exercise — it’ll help your body perform at its best.

Buy a durable water bottle and carry it with you at work and when you run errands. Having a water bottle by your side will remind you to drink throughout the day.

Have fun: Exercise shouldn’t be a slog, so make sure you’re doing something that you enjoy and makes you feel good. A successful start of a new routine will keep you motivated to continue and progress.

Fitness trackers and fitness apps are additional options to stay engaged and monitor progress. Enlisting a companion for exercise will add an element of support and keep the activity enjoyable.

Robert Hursey, M.D., is physician with UK HealthCare Orthopaedic Surgery and Sports Medicine and professor of family and community medicine in the UK College of Medicine.

Bill would address health-care workforce shortage with public-private fund to help Kentuckians enter health-related professions

By Melissa Patrick
Kentucky Health News

In response to Kentucky's health-care workforce shortages, the legislature has sent Gov. Andy Beshear a bill to create a fund with private and public money to help more Kentuckians pursue health-related careers.

Rep. Ken Fleming

"This is a growing crisis that threatens not only to burden families and providers, but may jeopardize the very availability of critical health care services across the country," Rep. Ken Fleming, R-Louisville, said in presenting the bill to the House March 8. 

The need for health-care workers in Kentucky is well-documented. 

The Kentucky Hospital Association's 2022 Workforce Survey Report cited 13,423 total vacancies in Kentucky hospitals, including 5,391 for RNs and LPNs combined, or more than one in five nursing positions. Other top vacancies included respiratory therapists (17.7%), laboratory staff (14.2%), environmental services (13.7%) and social workers (13.7%).

The report says urban hospitals had larger vacancy rates than rural hospitals, at 18.3% and 13.8% respectively, but both rates are "unsustainable."

The Eastern Kentucky Healthcare Action Plan by Shaping Our Appalachian Region says the region’s turnover rates in vital health-care roles are statistically at or above the national turnover rate of 19.5%. In 2021 it was 24.6%. Further, it says healthcare jobs are responsible for 17.6% of Eastern Kentucky's economy, more than any other industry in the region, and that thousands of jobs remain unfilled.

Fleming's House Bill 200 aims to address this shortage by creating the Kentucky Health Care Workforce Investment Fund. It would use public and private money to increase scholarship opportunities.

Fleming told the House that this "innovative and creative" approach "puts a jetpack on the health-care training pipeline." 

The fund will be administered by the Council on Postsecondary Education, with 65% of it to be used for educational scholarships and 35% to be used to incentivize universities and training programs. 

Money from the fund can be used for a wide range of certified and licensed health-care professions, including nurses, mental-health professionals and emergency medical professionals, to name a few. 

The bill says the money can be used to "improve racial and ethnic diversity within a specific designated healthcare credential."

Legislature passes bill aimed at preventing doctors' burnout by saying they don't have to report seeking mental-health treatment

Photo from Getty Images via Kentucky Lantern

By Sarah Ladd
Kentucky Lantern

A bill aimed at preventing burnout among physicians has cleared both chambers of the General Assembly. Senate Bill 12 unanimously cleared the Senate in late February and the House on Monday.

The legislation would protect Kentucky doctors who seek mental-health help from wellness programs by stating they do not need to report their participation in such a program and can't be dismissed for not reporting it. It does not mean that physicians don’t need to report conditions that have the potential to hinder their judgment, the Lantern previously reported.

Doctors who testified in committee in favor of the bill said burnout among doctors can lead to lower patient satisfaction, low morale, high turnover, increased rates of substance abuse and even suicide.

The bill's primary sponsor, Sen. Donald Douglas, R-Nicholasville, is a physician. He has testified that being able to access private help for stress “without fear of retaliation” is “imperative” for Kentucky’s doctors.

Rep. Killian Timoney, R-Nicholasville, in presentoing the bill to the House, sid it would “have a significant impact for Kentucky physicians.”

“Like many professions over the last few years,” Timoney said, “physicians have seen significant increases in work-related stress both due to the Covid-19 pandemic and the overall demanding nature of their work.”

He said SB 12 will help address this by encouraging doctors to get mental health help when they need it — and promising them confidentiality when they do so.

There was no discussion before a unanimous and bipartisan House vote. The bill now heads to Gov. Andy Beshear’s desk for a signature or veto.

Beshear gets bill to regulate Delta-8 tetrahydrocannabinol

Centers for Disease Control and Prevention photo

By Melissa Patrick

Kentucky Health News

In response to a court decision that deemed products containing Delta-8 tetrahydrocannabinol to be legal, a bill to regulate products with the substance has passed both houses of the General Assembly without dissent and has gone to Gov. Andy Beshear for final action. 

“The Kentucky hemp program is a staple for our agricultural community, but the selling and usage of unregulated THC is a danger to every Kentuckian who may use it,” Rep. Rebecca Raymer, R-Morgantown, the bill's sponsor, said in a news release. “These products have no standards for production. If someone were to purchase Delta-8, they have no way of determining if it is safe. This measure will both protect our consumers and enhance the industry.”

According to WebMD, Delta-8 THC is a naturally occurring chemical compound called a cannabinoid that's found in small traces in hemp and marijuana plants. Its chemical structure is similar to that of Delta-9 THC, the main psychoactive compound found in marijuana. Delta-8 causes a milder high than Delta-9. It can generally be purchased anywhere that sells CDB products, including gas stations, convenience stores and vape shops. 

House Bill 544, sponsored by Raymer, directs the Cabinet for Health and Family Services to begin the process of regulating Delta-8 THC and any other hemp-derived substances by Aug. 1. 

The bill also makes it illegal for people under 21 to purchase Delta-8 THC products, requires retailers to keep the products behind a counter, and sets guidelines for labeling. It establishes a testing and approval process that products must clear before they can be sold or distributed in the state.

"These are just our recommendations of what we think should be included in it, and I think the hemp industry would like to be at the table to come up with the final recommendations of maybe what the testing and the thresholds would look like," Raymer told a House committee March 9.

Kentucky Hemp Association President Katie Moyer and Commonwealth Extracts CEO John Taylor endorsed the bill at the same committee meeting.

Taylor said, "Every valid actor wants these types of regulations. It gets rid of the bad actors that make it hard to compete. It costs a lot of money to do the right thing, and when we have people making things in bathrooms and basements and barns it really makes it very hard to compete on a legitimate level." 

The Senate changed the bill to say that if a Kentucky producer is shipping a Delta-8 THC product to a state with testing requirements, the producer can defer to that state's requirements, but if shipping to a state with no testing requirements, they should abide by Kentucky's regulations. The House agreed.

Gov. Andy Beshear is expected to sign the bill. He issued an executive order in November 2022 directing the health cabinet to regulate Delta-8 THC following the court ruling in Boone County last year. His order was coupled with one using his pardon power to allow people with certain medical conditions and a doctor's certificate to possess up to 8 ounces of cannabis bought legally in another state.

George Rawlings, who founded industry that recovers health-care costs from patients who get settlements or judgments, dies at 77

George Rawlings

George Rawlings, who made a fortune by starting an industry that recovers health-care providers' costs of caring for patients who later get settlements or verdicts for injuries from accidents and defective products, died Thursday of the blood cancer multiple myeloma. He was 77.

"His foundation’s tax records show he and his company gave away millions to both sectarian charities and evangelical causes, including youth camps in 13 underdeveloped countries and to the late Rev. Jerry Falwell’s Liberty University, where the divinity school is named for the Rawlings family," reports Andrew Wolfson of the Courier Journal. "He also gave generously to local causes, including $1 million to Baptist Hospital in La Grange and $100,000 apiece to the city of La Grange and Oldham County, when both were experiencing budget troubles."

In a 2018 profile, Wolfson described Rawlings as “probably the richest Kentuckian you never heard of.” His company, the Rawlings Group, is based in LaGrange and employs 1,600 people. Its customers pay it 20 percent of the amount recovered in a process known as subrogation. "Critics have called the subrogation practice cruel because severely injured people can lose most or even all of a settlement — money they counted on to defray lost wages or to compensate for pain and suffering," Wolfson writes. "Rawlings has said the recoveries his firm made reduced health-insurance costs."

Vast majority of Kentucky continues to have low risk of Covid-19

Centers for Disease Control and Prevention maps, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

All but 10 of Kentucky's 120 counties have a low risk of Covid-19 infection on the latest federal risk map, and Menifee County is the only one considered to have a high risk.

The Centers for Disease Control and Prevention risk map, which considers both new cases and Covid-19 hospital numbers, shows Menifee as the only high-risk county, in orange. Counties with a medium risk of transmission are in yellow, and those with a low risk are in green.

Counties with medium risk are Harrison and Robertson; Elliott, Morgan and Rowan (the latter two border Menifee); and Clay, Knox, Laurel and Whitley.

In high-risk counties, the CDC continues to recommend that you wear a well-fitting, high-quality mask in public indoor spaces, and if you are at high risk of getting very sick, consider avoiding non-essential indoor activities in public where you could be exposed.

If you live in a medium or high-risk county, the CDC advises those who are at high risk of getting very sick to wear a well-fitting mask when indoors and in public and to consider getting tested before having social contact with someone at high risk for getting very sick and consider wearing a mask when indoors when you are with them.

In the last seven days, The New York Times ranks Kentucky's new-case rate 13th among the states, with a 41% drop in cases in the last two weeks. The Times has Menifee County's rate at 6.6 per 10,000 residents and the state's rate at 0.9 per 10,000 (or 9 per 100,000).

To enlarge any image, click on it; to download, right-click.

The CDC also provides a community transmission level map, largely used by researchers and health-care facilities, that shows the level of virus in each county, at one of four levels. The map shows six counties with low levels of transmission and 62 with a medium level; the rest have either substantial or high risk.

Former state health commissioner Stephanie Mayfield Gibson is the new board chair of the Trust for America's Health

Dr. Stephanie Mayfield Gibson

Dr. Stephanie Mayfield Gibson, who was state health commissioner in 2012-15, is the new board chair of the Trust for America's Health, which defines itself as "a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority."

Mayfield Gibson, who lives in Memphis, is a board-certified anatomic and clinical pathologist. In 2012, Democratic Gov. Steve Beshear named her the first African American and first woman public-health commissioner in Kentucky. She had been director of laboratory services in the Cabinet for Health and Family Services. 

When Republican Gov. Matt Bevin took office, Mayfield Gibson became senior vice president and chief medical officer for population health at KentuckyOne Health, which operated several Catholic hospitals and Louisville's Jewish Hospital. She was associate chief of staff and staff pathologist at the Department of Veterans Affairs Medical Center in Louisville.

In 2020-22, Mayfield Gibson was director of Covid-19 response for Resolve to Save Lives, founded by Dr. Thomas Frieden, former director of the Centers for Disease Control and Prevention. It provided guidance and technical support to local and state health departments, other partners and federal agencies.

Bill to address postpartum depression and other maternal mental-health problems has passed and awaits the governor's action

By Melissa Patrick

Kentucky Health News

A bill to ensure greater access to information and resources for mental-health care before and after the birth of a child passed without dissent in both houses of the General Assembly and has gone to Gov. Andy Beshear.

Sen. Shelley Funke Frommeyer

"Kentucky, sadly, has one of the worst maternal mortality rates in the country," the bill's sponsor, Sen. Shelley Funke Frommeyer, R-Alexandria, told the Senate Families & Children Committee in February.  "And we're looking to get upstream of that. We really want to work towards a solution." 

Senate Bill 135 calls on the state Cabinet for Health and Family Services to create written information on perinatal mental-health disorders, including postpartum depression, and make it available on its website. It also requires the cabinet to provide access to online clinical assessment tools to help providers detect the symptoms of perinatal mental-health disorders. 

The cabinet is also charged with creating a panel of maternal- and infant-health experts to explore the issue of perinatal mental-health disorders, including prevention, treatment and gaps in service.  The panel is required to report its findings to the Interim Joint Committee on Health, Welfare and Family Services and the Advisory Council for Medicaid Services on or before Nov. 1 of each year. 

"This bill is simple, but the impact will be wide reaching and could mean the difference between life and death for some Kentucky mothers," said Rep. Stephanie Dietz, R-Edgewood, who carried the bill in the House.

Amendment for pediatric recovery centers

A House floor amendment that included language from House Bill 436 was added to the bill and agreed to in the Senate. It directs the cabinet to submit a state plan amendment application by Nov. 1, 2023 to the federal Centers for Medicare and Medicaid Services to provide medical assistance "to the fullest extent permitted under federal law" for inpatient and outpatient services provided by a residential pediatric recovery center. 

Rep. Matt Lockett, R-Nicholasville, sponsor of HB 436 and the amendment, told the House that there is a great need for these centers because they care for babies with neonatal abstinence syndrome, noting that Kentucky has 15 babies born with NAS per 1,000 births. 

"These centers provide a unique non-hospital holistic approach that saves taxpayer dollars by avoiding expensive hospital stays and unnecessary foster care placements," said "They provide high quality inpatient medical care in a home like setting for babies born exposed to addictive substances."

Ernie Scott of Letcher County dies of rare brain aneurysm at 46; had been director of the State Office of Rural Health since 2013

Ernie Lee Scott

Funeral services were held Friday for Ernie Scott, who was director of the State Office of Rural Health in the University of Kentucky Center of Excellence in Rural Health. He did Sunday, March 12, at his home in Partridge, in Letcher County. He was 46.

The cause of death was a "random and rare" aneurysm in the brain, Coroner Perry Fowler told The Mountain Eagle of Whitesburg.

Scott started his career as a radiology technologist, earned a bachelor’s degree in health care administration at Midway College, was director of planning and special projects for Mountain Comprehensive Health Corp. in Whitesburg, and became director of the Office of Rural Health in 2013.

In 2014 Scott received the Emerging Leader Award from the National Organization of State Offices of Rural Health, and in 2020 he won the Kentucky Rural Health Association's Dan Martin Award for lifetime contributions to rural health. Last year, the office was one of three organizations in the nation to receive a three-year, nearly $900,000 grant from the federal Office of Rural Health Policy to improve access to health care for veterans living in rural Kentucky and to improve coordination of veterans' care.

Scott is survived by his wife, Tiffany Bullock Scott, and their daughter, Addyson Grace Scott. The couple owned and operated the General Store at Pine Mountain Crossing on US 119 and ran a hospital gift shop. Other survivors include his mother, Iris Jean Scott; siblings Howard Wayne Scott (Renee) and Sherry Scott Geiger (David); and many nieces and nephews.

"To know Ernie was to love him," his obituary says. "He quickly became a friend to all he met. He always greeted folks with a smile and often a big hug. He was a planner, a goal setter, and achiever. He loved his family, friends, church, and his community. He poured his heart and soul into Letcher County (specifically Cumberland River) and made huge impacts in many other rural communities."

His funeral was at Lewis Creek Pentecostal Church, along the Poor Fork of the Cumberland River in Partridge, with burial in the D.L. Creech Cemetery four and a half miles downstream, at Cumberland. Tri-City Funeral Home was in charge. Memorial donations may be made to a health-care scholarship fund in Scott’s name at Commercial Bank, 1701 E. Main St., Cumberland KY 40823.

Medical cannabis bill passes Senate, awaits House vote March 30

By Melissa Patrick
Kentucky Health News

A bill that would make medical marijuana legal for some in Kentucky has passed the state Senate for the first time and awaits a vote in the House, which has passed two similar bills in previous legislative sessions.

Sen. Stephen West

"It is time for Kentucky to join the other 37 states in the United States that allow medical marijuana as an option for their citizens," said Sen. Stephen West, R-Paris, in presenting his bill to the Senate, adding later, "It is understood that this is a very complex issue and if passed, will be a work in progress." 

Senate Bill 47 passed late Thursday night on a 26-11 vote. The House gave the bill its first of three required readings the same night, which will allow enough time for it to pass out of the House when the lawmakers return March 29 and 30.

Last year, after a House-passed bill again got no hearing in the Senate, Gov. Andy Beshear used his pardon power to allow people with 21 specified medical conditions and a doctor's certificate to possess up to eight ounces of marijuana bought legally in another state. (Illinois is the only adjoining state where nonresidents can legally buy cannabis.) Beshear signaled Thursday that he would sign the bill.

West, who said he has worked on such legislation for about five or six years, told the Senate, “This is one of those issues where you take out the ledger and you list the pros and cons. It’s a long list on both sides, but for me personally, the pros outweigh the cons.”

The 124-page bill would not allow medical marijuana to be smoked, require users to be 18 or older or be a caretaker for a child, limit supply, and not take effect until Jan. 1, 2025.

The medical marijuana would be allowed for certain "qualifying medical conditions," including all cancers regardless of the stage; chronic, severe, intractable or debilitating pain; epilepsy or any other tractable seizure disorder; multiple sclerosis, muscle spasms or spasticity; chronic nausea or cyclical vomiting syndrome that has proven resistant to other conventional medical treatments; post-traumatic stress disorder; and any other medical condition or disease for which the new Kentucky Center for Cannabis Research at the University of Kentucky determines would benefit from medicinal marijuana.

West and other lawmakers praised the advocacy of Eric and Michelle Crawford, a quadriplegic who has long searched for another option to manage his pain. They also praised the ongoing work of advocate Jamie Montalvo, who suffers from multiple sclerosis, toward getting this bill passed. 

 Sen. Phillip Wheeler, R-Pikeville, said the Crawfords and Montalvo don't want to break the law: "These are people that are willing to work hard and make sacrifices to comply with the law. What they are looking for is a pathway forward to make sure that people can get a safe product." 

Sen. Stephen Meredith, R-Leitchfield, said it was important to show those who are suffering from  debilitating diseases  "just a little bit of mercy" and that was why he voted yes.   

“Will this be abused by some folks?  It certainly will," he said. "But again, if we can benefit just one person, one child, I think it’s worthwhile."

Only Republicans voted against the bill: Gary Boswell of Owensboro, Danny Carroll of Benton, Donald Douglas of Nicholasville, Rick Girdler of Somerset, President Pro Tem David Givens of Greensburg, Chris McDaniel of Ryland Heights, Robby Mills of Henderson, John Schickel of Union, President Robert Stivers of Manchester, Mike Wilson of Bowling Green, and Max Wise of Campbellsville. 

Marijuana is a "scourge of the earth," Boswell said. "I urge my colleagues to vote no. If you are going to violate federal law, at least tighten up the bill to include only the critically ill." 

Douglas, a physician, said, “With the different growing techniques and the increased concentration of these chemical compounds, I’m not really convinced that this drug is safe. But we do have some research going on out there, and I really want to thank the University of Kentucky. I hope we have some other institutions doing research who will give us good information.”

Bill to ban gender-affirming care for youth passes after advocates scramble and maneuver to quash bipartisan Senate changes

By Melissa Patrick
Kentucky Health News

A revised bill with language to ban gender-affirming care for Kentucky's transgender youth moved quickly through both houses of the General Assembly Thursday and is on Gov. Andy Beshear's desk.

Even if the Democratic governor vetoes the bill, as is expected, the supermajority of Republicans in the legislature can override the veto when they return on March 29 and 30. 

Changes made to Senate Bill 150, sponsored by Sen. Max Wise, R-Campbellsville, were approved in a hastily called meeting of the House Education Committee, which approved it 16-5 with Republican Rep. Killian Timoney of Nicholasville voting "no" with the four Democrats on the committee.

Soon after, the amended bill passed the House 75-22, despite more than two hours of Democrats speaking against it.

SB 150 moved quickly to the Senate for concurrence with the House changes. It passed 30-7 to shouts and obscenities yelled from the gallery at legislators. Sen. Danny Carroll of Benton was the only Republican to vote against the bill and Sen. Robin Webb of Grayson, was the only Democrat for it.

The night before, Carroll had narrowly succeeded in watering down a House bill that would limit gender-affirming care, but after his floor amendment passed 19-17 the Senate laid HB 470 on the clerk's desk and Wise worked with the House to put most of the original bill into SB 150.

The amended version of SB 150 prohibits gender-affirming medical care for trans youth, including gender-affirming surgery or puberty-blocking hormones. It allows health-care providers to de-transition youth who are already taking such hormones, which would require them to taper them off of the drugs. It also provides exemptions for youth who have a diagnosed sexual-development disorder. 

Providers who violate the law would have their licenses revoked, and youth who claim injury as a result of gender-affirming care could fule suit to recover damages until they turn 30 years old or within three years from the time they discovery the injury. The normal deadline for a lawsuit is one year.

SB 150 also includes its original provisions to prohibit schools from requiring teachers to use a trans student's preferred pronouns and requires schools to notify parents about any content related to sexuality. It also added content from HB 177, which does not allow any sex education to children in grades five and below and bans all students from receiving instruction that explores "gender identity, gender expression or sexual orientation."

Carroll speaks on SB 150. (Legislative Research Comm. photo) 

Carroll's revised bill likewise prohibited surgical medical treatments for trans youth, but unlike allowed some nonsurgical medical-treatment options. His change was supported by all seven Democratic senators and 12 of the 31 Republicans. Seven of them voted the other way when Wise's bill came back from the House. It passed 30-7.

Republicans who voted with Carroll on his amendment but against him on the SB 150 were Jared Carpenter of Berea, Matthew Deneen of Elizabethtown, President Pro Tem David Givens of Greensburg, Jason Howell of Murray, Amanda Mays Bledsoe of Lexington, Chris McDamiel of Ryland Heights, Stephen Meredith of Leitchfield, Mike Nemes of Louisville, Brandon Smith of Hazard, Brandon Storm of London and Whitney Westrefield of Fruit Hill (Christian County). 

Westerfield said his yes vote was "reluctant." He said SB 150 was better than HB 470 largely because it allows doctors to talk freely with their patients about their medical concerns without fear of liability.  

Carroll, explaining his no vote, said, "We know that most kids that are struggling with gender dysphoria decide to stay the gender that they are. It's a phase that they go through, [and for] some it's not. What would it hurt to allow doctors to have access to these puberty blockers to give these kids time to work through the issues that they face? Why can't we trust our doctors, as we do for every other issue, to guide us through these things?"

Sen. Karen Berg, D-Louisville, whose trans son Henry died by suicide in December, said of SB 150, "This is absolutely willful hate for a small group of people that are the weakest and most vulnerable among us."

During the House floor debate, Rep. Chad Aull, D-Lexington, reminded the lawmakers that nearly half of LGBTQ individuals have seriously considered suicide and that percentage is much higher with transgender children. "If this legislation causes one child in Kentucky to consider or to take their own live, this is a wrong piece of legislation," he said.

Terry Brooks, executive director of Kentucky Youth Advocates, issued a statement calling the speedy passage of SB 150 "parliamentary shenanigans" and that the genesis of the measure "springs from a national agenda of fearmongering."   

"Passage of SB 150, even with the amendment, means that kids lose access to much needed health and mental health supports. It means that families lose vital rights. And it means that Frankfort Republicans – save the courageous Representatives Banta, Dietz, Moser, and Timoney and Senator Carroll, who refused to vote in support of the measure – lose their long-held core governing identity. That is a lose-lose-lose trifecta for us all," he said. 

Senate Majority Floor Leader Sen. Damon Thayer, R-Georgetown, who voted for the bill, said SB 150's anti-trans provisions were modeled after a law in South Dakota. 

Rep. Kim Moser, R-Taylor Mill, while explaining her "pass" vote said, "I'm concerned that it doesn't comment enough on the mental-health treatment. . . . I really would like to see that we are allowing for mental-health treatment, watchful waiting and making sure that we're supporting the families who are going through this issue. I'm passing today because we want to protect children on all sides of this issue." Moser is chair of the House Health Services Committee.

Tamarra Wieder, state director for Planned Parenthood Alliance Advocates, voiced her disappointment: "SB 150 is deliberately designed to create a culture war across this commonwealth. It has nothing to do with parental rights. It has nothing to do with caring for kids. What it does is go against the guidance of every major medical association in this state. It replaces our physicians with politicians and places our trans kids' lives on the line." 

Transgender bill awaits a vote in the Senate after an unusual bipartisan vote waters it down; outcome remains uncertain

UPDATE, 6:50 p.m. March 16: The Senate agreed to the changes made to Senate Bill 150 and passed it on a vote of 30-7. It now goes to Gov. Andy Beshear's desk for his consideration. 

UPDATE, 4:44 p.m. March 16: The House passed Senate Bill 150 with an amendment that included some of the provisions of  House Bill 470 on a vote of  75-22  It now goes to the Senate for concurrence or non-concurrence. 

UPDATE, 1:55 p.m. March 16: A House committee approved a substitute Senate Bill 150 that keeps some of the House-passed provisions of House Bill 470. If passed by the House the revised SB 150 could become the vehicle for House-Senate negotiations later today. The Lexington Herald-Leader has a story.

By Melissa Patrick
Kentucky Health News

The state Senate voted 19-17 Wednesday night to water down a House bill that would limit gender-affirming medical care for Kentucky's minors, but a vote on the revised version was delayed until Thursday. 

Sen. Danny Carroll

House Bill 447, sponsored by Rep. Jennifer Decker, R-Waddy (Shelby County), was called up for a vote with five floor amendments proposed. All but Floor Amendment 2, submitted by Sen. Danny Carroll, R-Benton, were withdrawn.

Carroll's wide-ranging amendment got the votes of 12 of the 31 Republican senators and all seven of the chanber's Democats. The Republican majority generally does not advance bills that are not supported by most Republican senators.

Senate President Robert Stivers, who voted against the bill, told the Lexington Herald-Leader that he couldn't predict what the Senate would do on the issue. “I think there was a lack of knowledge as to what all the amendments in the subject matter meant,” he said. “This is not the easiest of subject-matter topics.”

Like Decker's bill, Carroll's measure still prohibits surgical medical treatments for trans youth. However, it would allow some nonsurgical medical treatment options with the consent of the child's parent or legal guardian.

In order to qualify for the nonsurgical medical treatment, the child must have a medical diagnosis of gender dysphoria and the treatment must be provided by a licensed physician who is appropriately trained and experienced in providing it. It also calls for the child to be under the care of a clinical psychologist or psychiatrist. 

The revised bill defines which reversable puberty-blocking drugs are allowed and says treatment shall not include cross-sex hormones, like testosterone or estrogen, in amounts that are larger or more potent that would naturally be found in a healthy person of the same age and sex.  

It says all care must meet evidence-based medical standards for treatment of children with gender dysphoria and include mental-health services that address a  person's sex or gender but don't promote gender transition. 

Carroll's amendment removed the original bill's provisions that would have blocked a transgender youth from legally changing their name or birth certificate. It kept in place language from two bills that were added in a Senate committee: Teachers would not be required to use a student's preferred pronouns, and parents would gain more say about sex education and discussions about sexual orientation in schools would be prohibited. 

Besides Stivers, others voting against the amendment were Republican Sens. Gary Boswell of Owensboro, Donald Douglas of Nicholasville; Shelley Funke Frommeyer of Alexandria; Rick Girdler of Somerset; Jimmy Higdon of Lebanon, Robby Mills of Henderson, John Schickel of Union, Adrienne Southworth of Lawrenceburg, Damon Thayer of Georgetown; Lindsey Tichenor of Smithfield; Johnnie Turner of Harlan; Stephen West of Paris; Phillip Wheeler of Pikeville; Gex Williams pf Verona; Mike Wilson of Bowling Green, and Max Wise of Campbellsville. 

If the Senate passes the amended bill on Thursday, that will give the chambers a few hours to work out their differences and send the bill to the governor's desk ahead of the veto period. Democratic Gov. Andy Beshear is expected to veto the bill if he gets it. The supermajority of Republicans could easily override a veto, but only if the bill gains final passage on Thursday.

Even before the latest overhaul of the bill made in the Senate, the bill had already undergone several changes. 

The bill that passed out of the House on a 75-22 vote would have banned any treatment that supported gender transition for Kentucky's minors, including puberty-blocking hormones and gender re-assignment surgery. It also included a 30-year window for lawsuits against health-care providers who provided any gender-affirming care to minors, among other things. Changes from the original bill that were made in committee removed mental health care providers from the list  of providers who couldn't treat youth seeking gender affirming care.

The Senate Families and Children Committee added more changes to the bill March 14, including the addition of Senate Bill 150, sponsored by Sen. Max Wise, R-Campbellsville, which prohibits schools from requiring teachers to use a trans student's preferred pronouns and requires schools to notify parents about any content related to sexuality. It also included content from HB 177, sponsored by Rep. Shane Baker, R-Somerset, which does not allow any sex education to children in grades five and below and bans all students from receiving instruction that explores "gender identity, gender expression or sexual orientation." These changes remained in Carroll's amended version of the bill. 

The amended bill passed out of the committee 6-3. Carroll and fellow Republicans Whitney Westerfield of Fruit Hill (Christian County), Julie Raque Adams of Louisville voted "yes" but called for significant changes in the final version.

“I’m extremely uncomfortable putting myself in the place where a doctor should be. I don't have the training. I don't have the knowledge to make decisions,” said Carroll. “However, I feel a complete obligation to protect our kids. I too don't like the bill. I hate the tone of the bill. I think we could have accomplished what we needed to accomplish without going so far."