Monday, January 31, 2011

As debt deepens and auditors arrive, Adair County hospital CEO resigns and is apparently escorted from the building

The CEO of Westlake Regional Hospital in Columbia "resigned Monday morning and was apparently escorted out of the hospital," reports the Adair County Community Voice. Rusty Tungate "and eight others turned in their resignations just one day before a consulting firm is scheduled to review the hospital's finances and operations."

Last week, the hospital's board hired Spectrum Health Partners LLC "to provide a complete review of the hospital’s operations and finances," beginning tomorrow, the Community Voice reports. Board Chairman James Evans told the newspaper that the firm will help find an interim administrator, probably by Wednesday.

"Evans would not elaborate on discussions with Tungate prior to his resignation," the Voice reports. "Tungate and the hospital renewed their contract in November. Tungate was serving as administrator to Westlake and has contracts with two other hospitals. His salary for services to Westlake was $195,000." (Read more)

UPDATE, Feb. 2: Tungate and other administrators are part of a team that also provides management for Jane Todd Crawford Memorial Hospital in Greensburg and Casey County Hospital in Liberty. Tungate will remain CEO of both hospitals, Larry Rowell reports in the Casey County News. Tungate told Rowell that the Adair County board was no longer willing to share management with the other hospitals, and that he is the longest-tenured hospital CEO in Kentucky. (Read more)

In a story in last week's Voice, Editor-Publisher Sharon Burton quoted Evans as saying, "We're losing $500,000 a year and we're deep in debt." The hospital recently borrowed $12.5 million. Adair County owns the hospital, and the board members are appointed by the county judge-executive with approval of the fiscal court. Judge-Executive Ann Melton referred to the consultants' work as a partial "audit."

Two bills would encourage, protect whistleblowers

Two proposed bills would serve to crack down on fraudulent health care claims and make it easier for employees to blow the whistle on illegal activity.

State Sen. Tom Jensen, R-London, (photo, right) has sponsored Senate Bill 11, which would increase damages and penalties against wrongdoers and prohibits retaliation against employees who assist in prosecution. It would also allow an employee who "works for a Medicaid provider or contractor to turn over evidence to prosecutors and receive a portion of the money recovered," The Lexington Herald-Leader's Beth Musgrave reports.

House Bill 4, sponsored by House Speaker Greg Stumbo, D-Prestonsburg, (photo, left) proposes similar action, likewise protecting whistleblowers and paying "some of the proceeds of the action being distributed to the person successfully bringing the action." The consequences as proposed in Stumbo's bill would be more widespread, however. "I want to see this used not just in (Medicaid), as the Senate is proposing, but anywhere fraud with state dollars is taking place," Stumbo said.

Almost two dozen states have their own false claims acts, including Tennessee and Indiana. Attorney General Jack Conway has expressed some concerns about the proposals. (Read more)

Effect of new health care law on premiums debatable

Neither President Barack Obama nor Republicans who oppose him are entirely accurate about whether or not the new health care law will lower premiums. Obama insists it will, Republicans say otherwise.

Politico found Obama's claims to be somewhat of a stretch. A new report showed middle-class families could save up to $2,300 in premiums, and small businesses could save up to $350 for each family. "But that's compared to what their premiums would have been without the law," reporter David Nather determined. "There are provisions that might help some people and businesses pay less for their premiums — just not everyone."

For example, only businesses with 10 or less full-time employees who earn wages of less $25,000 get the full 35 percent credit. Premiums may be "significantly lower" in high-risk pools for people with pre-existing conditions, "but they're still expensive," Nather reports.

Republican claims that premiums have already risen are not entirely true either. "There have been a series of premium increases by insurers across the country, but it's not always easy to tell what's really due to the law and what's not," Nather writes. Regarding its request to increase premiums by 56 percent for people who opt to buy insurance on their own, Blue Shield of California stated the increase has little to do with the new law. "These rates reflect trends that were building long before health reform," officials said.

"The bottom line is that the law's early provisions may be pushing some people's rates slightly higher, but they're probably not a big factor," Nather concludes. (Read more)

Jobs increasing in health services industry

Though Kentucky has been hit hard by the recession, certain industries, including health care, are hiring. State unemployment trends show educational and health services have grown 20.5 percent since 2001.

"With the population maturing — not just in Kentucky and in Fayette County but elsewhere — you're going to continue to see health care as a growing industry," said Ron Crouch, director of research and statistics for the state Office of Employment and Training.

The Lexington Herald-Leader's Scott Sloan reports all of Lexington's hospitals are expanding and large, flourishing companies like ACS and Pacific Pulmonary "are capitalizing on service related to health care."

Professional and business services also grew — up 15.2 percent between 2001 and the second quarter of 2010. Toyota has resumed hiring, Cincinnati-based grocery Kroger is growing and technology companies are creating more jobs. (Read more)

Health-related proposals target obesity, smoking; none are expected to pass this session

Though several health-related bills have been introduced in the Kentucky General Assembly, including ones that target smoking and obesity, legislators do not expect sweeping overhauls this year.

"I don't look for too much to change during this time," state Rep. Tom Burch, D-Louisville, told The Courier-Journal's Laura Ungar. The short session and the fact that it's not a budget year are apparently factors.

Perhaps the most discussed proposal, House Bill 193, would prohibit cigarette use in all enclosed public places and enclosed places of employment, including restaurants, bars and nightclubs. It also bans smoking within a "reasonable" distance outside of public places and work places.

State Rep. Addia Wuchner, R-Burlington, looks to target childhood obesity with a series of bills that would promote fitness and would measure children's body-mass indices, a height-weight ratio measurement. For more on her efforts, click here.

Making cold medication pseudoephedrine only available by prescription is another health-related proposal with proponents saying it would vastly curb the prevalence of methamphetamine labs in the state. Two similar bills have been proposed to this end, one by state Rep. Linda Belcher, D-Shepherdsville, another by state Sen. Tom Jensen, R-London. (Read more)

Skyrocketing prescription drug abuse is subject for examination by Kentucky's two biggest newspapers

The uphill battle against prescription drug abuse across the state was extensively explored in Kentucky's two largest newspapers this weekend.

In their series titled "Prescription for Tragedy," which continues today, The Courier-Journal's Laura Ungar and Emily Hagedorn examined the effects of drug addiction in Bell County, which has the highest number of drug-related deaths in the state. Yet, as prescription drug abuse continues to rise statewide, funding to fight addiction has been slashed and treatment can be difficult to get, Hagedorn and Ungar report. (C-J photo illustration)

The Lexington Herald-Leader looks at how some counties are fighting back by drawing up ordinances that ban "pill mills," pain management clinics that "churn out large amounts of prescriptions for pain and anti-anxiety pills," Bill Estep and Dori Hjalmarson report.

The C-J reports 978 Kentuckians died in 2009 from prescription drug overdoses, up from 403 in 2000. For more state- and nation-wide numbers, click here. Bell County is the hardest hit in the state, with about 54 prescription drug-related deaths per 100,000 people. The high death rate is attributed to several factors, including "few good jobs, little for young people to do and easy access to nearby states where prescriptions are easier to get," Ungar and Hagedorn report.

While the problem continues to grow, petty crimes, such as theft, have increased with it. Yet, the funds to fight the abuse have decreased in Bell County. That is the case statewide, with funding cut from the state Office of Drug Control Policy and Operation UNITE, which was formed to fight chronic drug abuse. Moreover, Kentucky's family and juvenile drug courts were eliminated last year to save money.

A few Eastern Kentucky counties are fighting back by passing ordinances that ban certain types of pain clinics from opening or continuing to operate, the Herald-Leader reports. Carter, Greenup, Knott and Morgan counties have already approved their bans. Residents of Johnson and Owsley counties are asking for more regulation.

To some degree, the bans are put in place to send a message to doctors who are considering opening up shop in these areas. Carter County did not have any pain clinics when its ban was passed, but one businesses later shied away from opening in the county after learning about the law.

After crackdowns on pill mills in Kentucky in the early 2000s, Kentuckians traveled to Florida, which had no prescription-tracking system, to obtain pills and later sell them. In one raid in South Florida, Estep and Hjalmarson report authorities found more than 1,000 files from patients who lived in Eastern Kentucky.
And pain management clinics still flourish within the state as well. One Johnson County pain management clinic (right) "was so busy Friday — payday — that sheriff's deputies parked outside to spot traffic violations," Estep and Hjalmarson report.

This year, state Sen. Jimmy Higdon, R-Lebanon, has introduced Senate Bill 47, which would more strictly regulate the operation of pain clinics. (Read more)

To read more about The Courier Journal's series "A Prescription for Tragedy," view the following links:

Friday, January 28, 2011

18 percent of Kentucky nursing homes had 10 or more deficiencies in July-Sept.; 42 exceeded state average of six

State inspectors found 20 of Kentucky's nursing homes, 18 percent of the total, had 10 or more deficiencies during the third quarter of 2010. Kentucky nursing homes have an average of six deficiencies, according to Medicare's nursing-home comparison data. The report shows 42 of the 109 homes in the state had more than six deficiencies from July through September.

Kentuckians for Nursing Home Reform, a non-profit organization that advocates for nursing home residents, obtained the data through an open-records request to the Kentucky Cabinet for Health and Family Services.

Inspections assess a facility on the care of residents and how that care is administered; on how staff and residents interact; and on its environment. Certified nursing homes must meet more than 180 regulatory standards.

To see a list of the nursing homes with 10 or more deficiencies, the four nursing homes that had no deficiencies during the third quarter and to read more, go to our news releases page.

Thursday, January 27, 2011

Lobbying on bills to require prescriptions for meds like pseudoephedrine intensifies in Kentucky and West Virginia

The lobbying battle over meds and meth is ramping up in Kentucky and West Virginia, with business interests weighing in against it in Kentucky.

The Kentucky Chamber of Commerce issued a press release this afternoon saying legislation to require prescriptions for decongestants like pseudoephedrine "could do more harm than good." It quoted Chamber official Bryan Sunderland as saying, "It would negatively impact worker productivity and result in higher health care costs – to employees, private employers and state government.”

Former Lt. Gov. Steve Pence sides with the Chamber of Commerce, telling The Associated Press it would move "a law enforcement issue into the medical profession, where it can least be handled."

This morning, a spokesman for the Asthma and Allergy Foundation of America, funded mainly by drug manufacturers, spoke at length from 9 to 10 a.m. on WVLK-AM in Lexington, arguing that the proposed law would impose unncessary costs and inconvenience on people who now buy the drugs over the counter.

There was no counter-argument on WVLK's Jack Pattie Show, though the Kentucky Medical Association has endorsed the idea, but yesterday a national substance-abuse expert told West Virginia legislators that a prescription law in that state could drastically reduce the incidence of methamphetamine labs.

And, if Kentucky and West Virginia would both pass such laws, "It will wipe out meth labs throughout this region," Stanford University psychiatry professor Keith Humphreys told Mountain State lawmakers, The Charleston Gazette's Alison Knezevich reports.

Some West Virginia legislators plan to introduce pseudoephedrine legislation soon, Knezevich reports. On Jan. 4, Kentucky state Sen. Tom Jensen, R-London, filed a bill that would require a prescription for ephedrine, pseudoephedrine and phenylpropanolamine, all now sold over the counter.

Oregon and Mississippi are the only states that require a prescription to get pseudoephedrine. Meth-lab incidence has fallen dramatically in those states since they implemented the laws, U.S. Rep. Harold "Hal" Rogers of Somerset, whose district covers most of Eastern Kentucky, noted in a recent article for newspapers.

Humphries told the West Virginia lawmakers that an average meth-lab bust costs taxpayers about $300,000, including cost of arrest, prosecution, incarceration, cleanup and foster care for children in the home. (Read more)

Company to pay $2 million for doctoring Medicaid documents

The company that administers Medicaid for Jefferson and 15 other counties will pay more than $2 million in damages because it falsified documents to get a bonus.

AmeriHealth Mercy's altered data increased its score for the number of cervical cancer screenings its providers performed in 2009 and resulted in a bonus of $677,000. Attorney General Jack Conway said Wednesday that a whistleblower contacted his office nine months ago saying the company doctored reports that claimed the number of hysterectomies or Pap smears women had received.

AmeriHealth Mercy is the third-party administrator for Passport Health Plan, which manages Medicaid for about 165,000 members in Jefferson, Oldham, Trimble, Carroll, Henry, Shelby, Spencer, Bullitt, Nelson, Washington, Marion, Larue, Hardin, Grayson, Meade and Breckinridge counties. Passport manages the Medicaid program in those counties, while AmeriHealth processes the day-to-day claims as per a contact it holds with Passport. In a written statement, Passport said it may change its third-party administrator for some services.

In an agreement with Conway's office, AmeriHealth will pay $2,032,758, which represents triple the amount it received in bonus money. The state is entitled to triple damages in these types of fraud cases. Because they both fund the program, the money will be split between the federal and state governments, The Lexington-Herald Leader reports.

Passport has been scrutinized by State Auditor Crit Luallen, who found the company squandered funds on meals, travel, lobbying and other expenses. Luallen further determined two top officials with the company were guilty of conflicts of interest. While overseeing the contract with AmeriHealth, the officials were also paid as consultants for the company, The Courier-Journal reports. Since the audit, Passport has fired two executives and hired an interim chief executive.

To read coverage from The Courier-Journal, click here; the Lexington Herald-Leader, here.

Tuesday, January 25, 2011

Wal-Mart says it will make store-brand food healthier, cut prices for fruits and vegetables to encourage consumption

Wal-Mart has announced plans to drop its prices on fruit and vegetables and offer packaged foods with lower salt, fat and sugar contents. The company's efforts are the result of talks with First Lady Michelle Obama, whose main agenda is to fight childhood obesity by promoting heathy eating.

Sheryl Gay Stolberg of The New York Times reports Wal-Mart plans to lower sodium, trans fats and added sugars in foods that are packaged under the company's brand Great Value. The targeted foods will include rice, soup, canned beans, salad dressings and snack items like potato chips. The company also plans to encourage its major suppliers, including Kraft, to follow suit. The company has further pledged to lower costs in foods that incorporate whole grains.

Though officials acknowledged lowering fruit and vegetable prices will cut into the company's profits, they said they hope the loss will be offset by consumers buying more volume. The changes will be implemented over the next five years. (Read more)

Bowling Green commission gives final passage to smoking ban

The Bowling Green City Commission gave second reading and final passage last night to a smoking ban that will apply to all indoor public places except "nursing homes, exclusive tobacco retailers and private clubs where membership is required," Andrew Robinson reports for the Bowling Green Daily News.

As on first reading, the vote at the special meeting was 3-2 and was prefaced by complaints that the measure was being rushed through because Mayor Elaine Walker will become Kentucky secretary of state on Saturday. The commission is expected to name one of its own as interim mayor then appoint someone to fill that vacancy.

Walker said she had planned to put the ban on the commission agenda next month. Its sponsor, Commissioner Brian "Slim" Nash, said, “This has been an issue since it was first introduced to this community in 2007. I don’t believe that anyone’s opinion would change given another seven days on this issue, or given another seven months.” The ban will take effect in 90 days. (Read more)

Videos aim to educate policymakers about smoke-free laws

With a statewide smoking ban proposed in the legislature, which reconvenes next week, and local ordinances still being proposed and passed, the Kentucky Center for Smoke-Free Policy has produced eight video vignettes to help educate policy makers and leaders about communities that have gone smoke-free.

"Seeing and hearing first-hand experiences working with smoke-free laws will help educate other communities who are working towards clean indoor air for the workers and patrons in their communities," said Ellen Hahn, director of the center at the University of Kentucky. "Everyone deserves to breathe clean air."

The video vignettes feature officials from Floyd County, Clark County, Glasgow, Bardstown (right) and Radcliff. The vignettes were produced by UK College of Nursing faculty, students and staff. To view the videos, click here.

McConnell says Senate will vote on repeal of health reform law

Senate Republican Leader Mitch McConnell said on Fox News Sunday that the Senate would somehow vote on whether or not to repeal the health-reform law.

McConnell's Democratic counterpart, Majority Leader Harry Reid, has declared the House-passed repeal bill "dead on arrival" in the Senate, but Senate rules provide several ways that the issue could be put to a vote.

McConnell called the new law "the single worst piece of legislation" passed while he has been a senator. He said if the Senate does not vote for repeal, opponents will attempt to dismantle the law item by item. (Read more from The Associated Press)

Bowling Green schools buy local foods, reap rewards from state

Bowling Green Independent Schools are working with the Kentucky Department of Agriculture and nearby farms and purveyors to offer locally grown food in their cafeterias, Jenna Mink of the Bowling Green Daily News reports.

This year, the district has bought locally-grown watermelons, strawberries, peaches and apples. "They're in the process of getting three types of lettuce and tomatoes," Mink reports.

The school district is also participating in the Kentucky Restaurant Rewards Program, which allows buyers of locally grown produce to get receive cash-back rewards from the state agriculture department. Bowling Green schools reportedly received a check for $1,800 for three months of food.

Students are being exposed to local foods, as well as to fruits and vegetables in general, in other ways. Through a pilot project with the Department of Agriculture, students from Bowling Green as well as Scott County are taking field trips to local orchards.

Two area elementary schools are also part of the federally-funded Fresh Fruit and Vegetable Program, in which grant funds help buy fresh fruit and vegetables for the students. Teachers hand out the produce as a snack three to four times a week. (Read more)

Monday, January 24, 2011

Williams says he supports a statewide smoking ban

State Senate President David Williams expressed firm support for the proposed statewide smoking ban at the Kentucky Press Association's forum for gubernatorial candidates in Louisville Friday.

"Secondhand smoke is full of carcinogens, it's a health hazard to workers ... and it ought to be stopped, and now's the time to stop it," said Williams (standing in Courier-Journal photo). Williams endorsed a ban when Democratic Gov. Steve Beshear proposed increasing cigarette taxes in 2008, but some saw that as political gamesmanship while Williams sorted out his position on the tax; he eventually supported a bill raising tobacco and alcohol taxes. The issue arose when forum moderator Al Cross (seated in photo) asked candidates what they would do to improve Kentucky's poor health status and followed up by asking their positions on a smoking ban.

Williams is running in the Republican gubernatorial primary against businessman Phil Moffett, who said the scientific findings about the health effects of secondhand smoke have been "overblown." He and independent candidate Gatewood Galbraith both said property owners shoould retain the right to decide smoking policies. For C-J political writer Joe Gerth's story on the forum, click here. For a live-blog account from Kenny Colston of cn|2 Politics, go here.

Poor conditions found at Letcher County personal-care home

State inspectors found pitiable conditions when they visited Golden Years Rest Home, right, in Letcher County in December, the Lexington Herald-Leader's Beth Musgrave and Valarie Honeycutt-Spears report.

Kool-Aid dripping on insulin bottles, expired medications and a hallway smelling of urine and feces were among the conditions found at the personal-care home in December. Inspectors also learned the home's 35 residents could only bathe every other day because of a lack of linens, and there was no milk because the bill hadn't been paid in a month.

"Quite frankly, if children were living in the same conditions that are found at some, but not all, personal care homes, we would never tolerate it," Marsha Hockensmith, state director of protection and advocacy, told the Herald-Leader. The sub-standard conditions found at Golden Years are the latest to be discovered in personal-care homes in the state. (Read more)

Federal grant will help build assisted-living and hospice facility in Maysville

Gov. Steve Beshear presented a $800,000 community development block grant (federal money administered by the states) for the construction of a Maysville assisted-living facility and hospice inpatient facility Friday, The Ledger Independent reports.

The Hospice of Hope projects will include 32 apartment-style units in the assisted-living facility, and eight units for hospice care. The $7- to $8-million project is slated for construction this spring.

At the check presentation, Beshear said Kentuckians are finding ways to improve health care-related services, despite tough economic times. Beshear spoke of his administration's efforts to increase enrollment in KCHIP, a free or low cost health insurance program for children, and the efforts to secure $62 million for the Kentucky Prescription Assistance Program. (Read more)

Legislator wants to make hospitals, health care facilities report infections acquired by patients under their care

In the face of strong opposition from Kentucky hospitals, a Democratic legislator has filed a bill that would require all health-care facilities to report the incidence of infections acquired by patients while under their care, the Lexington Herald-Leader's Beth Musgrave reports.

"The cost of hospital-acquired infections to Kentucky's health care system is estimated to be $392 to $462 million each year," state Sen. Denise Harper Angel, left, said, calling the sum "staggering." The Louisville legislator also wants to require all health facilities to implement infection-prevention programs.

Nancy Galvagni, senior vice president of the Kentucky Hospital Association, said the federal government already requires that hospital-acquired infections be reported. "There is no need for a new state mandate which would only add additional, unneeded costs on Kentucky's hospitals and state government," she said.

Infections commonly acquired at health facilities include "urinary tract infections caused by catheters, pneumonia caused by ventilators and surgical wound infections," Musgrave reports. Some report as many as 1,400 people die in Kentucky each year from hospital-acquired infections (which hospitals prefer to call "healthcare-associated infections," keeping the acronym but spreading the blame).

Senate Bill 72 would require that health care facilities report their infection data to the Cabinet for Health and Family Services by July 1, 2012. (Read more)

Friday, January 21, 2011

Hybrid operating room, with both surgery and imaging, part of UK Chandler Hospital's $800 million expansion

A distinguishing feature of the $800 million expansion to the University of Kentucky's Chandler Hospital will be a hybrid operating room.

The 1,000-square-foot room, with a price tag of $3.2 million, allows physicians to perform surgeries as well as patient imaging and catheterization, thus giving it the "hybrid" label. The imaging is performed with help of a robotic arm, enabling doctors to get needed information without moving patients, the Lexington Herald-Leader's Mary Meehan reports. The room will allow surgeons to perform common heart procedures, such as the insertion of stents, as well as complex surgeries.

Dr. Bernard Boulanger, UK HealthCare surgical medical director, told Meehan the hybrid room will be used "every day, most of the day."

To test the efficiency of the room's design, a to-scale model was built out of Styrofoam in which doctors, nurses and technicians simulated procedures. The renovation, which is in its second phase, will also add eight standard operating rooms to the facility, each of which will cost $1 million. (Read more)

Thursday, January 20, 2011

As expected, Beshear asks legislature to move $100 million from next year's Medicaid budget to make up this year's shortfall

Gov. Steve Beshear, left, is urging the legislature to pass legislation that would rectify a $100 million shortfall in the 2011 Medicaid budget. If it doesn't, Beshear said payments for health care providers who treat Medicaid patients would decrease by 30 percent, the Lexington Herald-Leader's Jack Brammer reports.

"With thousands of of Kentuckians joining the program every month, its passage is critical to ensuring vulnerable Kentuckians get the services they need, and that health care providers do not see unnecessary drastic reductions in reimbursement payments," Beshear said in a press release issued yesterday.

The 2010-2012 budget assumed the state would receive $100 million more from the federal government than it actually got. Beshear is asking the legislature to reallocate $166.5 million from "next year's Medicaid budget to the current year. To make up the resulting shortfall in fiscal year 2012, Beshear said the state would expand the use of private contractors to provide Medicaid services," Brammer reports.

Senate President David Williams objected to the governor's proposal. Williams, who is running for governor this year, said Beshear has yet to cut $125.5 million in Medicaid costs, which he promised he would do last year. (Read more)

Kentucky gets an 'F' for how it handles food-borne illnesses

Kentucky is one of 13 states to receive an "F" for the way it handles food-borne illnesses, the Lexington Herald-Leader's Mary Meehan reports.

The Center for Science in the Public Interest report looked at data from the Centers for Disease and Prevention from 1998 to 2007. Ironically, the report gave the highest letter grades to the states that had the highest incidences of food-borne illness. "Those states are the most likely to have robust detection and reporting systems," the CSPI concluded.

"States that aggressively investigate outbreaks and report them to CDC can help nail down the foods that are responsible for making people sick," said CSPI Food Safety Director Caroline Smith DeWaal. "But when states aren't detecting outbreaks, interviewing victims, identifying suspect food sources, or connecting with federal officials, outbreaks can grow larger and more frequent."

During the period of study, Kentucky only reported 25 outbreaks, resulting in 193 people getting ill. Of those outbreaks, 75 percent involved 26 to 50 people, Meehan reports.

Dr. William Hacker, commissioner of the Kentucky Department for Public Health, said sizable changes have been made in the past five years, including hiring 18 epidemiologists to help prevent and study outbreaks. "I believe the report doesn't actively reflect what is happening in Kentucky," he said.

Seven states, including Florida, Hawaii, Maryland, Minnesota, Oregon, Washington and Wyoming, were given "A" grades. Kentucky, Arizona, Arkansas, Louisiana, Mississippi, Missouri, Nebraska, New Mexico, Oklahoma, South Carolina, Texas and West Virginia all received failing grades. The study noted the states with the lowest grades are in climates "conducive to pathogen growth." (Read more)

For a fact sheet on new legislation that addresses gaps in outbreak reporting, click here.

Kentucky one of six states to join Cervical Cancer-Free America

Kentucky is one of six states that has joined the Cervical Cancer-Free America initiative, led by the University of North Carolina at Chapel Hill. The announcement was made today as the country observes National Cervical Cancer Awareness Month.

As part of the initiative, members are encouraging public health officials to form coalitions to increase vaccination rates for girls ages 10 to 18 and encourage cervical cancer screening with the Pap test or, when appropriate, the human papillomavirus (HPV) test.

Kentucky ranks fifth nationwide in the number of new cervical cancer cases each year. "Each week, four to five women are diagnosed and, regrettably, at least one woman dies of the disease in Kentucky," reports Dr. Robert Hilgers, founder of the Kentucky Cervical Cancer Coalition.

HPV causes almost all cervical cancers, Hilgers said. There are no symptoms when first infected, but precancerous changes can take place at the cellular level. Precancerous changes can lead to cancer that involves the bladder, intestines, lungs and brain. "Patients usually do not have problems until the cancer becomes symptomatic or advanced and difficult to cure," Hilgers writes.

"The goal of eliminating cervical cancer is a lofty one, but eminently achievable," said Jennifer S. Smith, associate professor of epidemiology at UNC-Chapel Hill and director of CCFA. "(Our initiative) is working to make this vision a reality by driving state and local prevention programs, and ensuring that successful strategies are shared among states."

Every year, more than 12,000 U.S. women are diagnosed with cervical cancer, American Cancer Society numbers show. Of those, 4,000 die. CCFA's new website features fact sheets, brochures and multimedia and online resources. (Read more)

Retail medical clinics are faster and cheaper, but they can cause problems for patient care, doctors say

Medical clinics located in retail establishments such as Walgreens and Walmart are becoming increasingly popular, The Courier-Journal's Laura Ungar reports.

Researching and consulting firm Merchant Medicine lists 40 retail clinics in Kentucky and anticipates more to open in 2011.

The clinics are generally operated by nurse practitioners and are in grocery, drug and department stores. Visits are generally faster and cheaper than going to a traditional doctor's office. A 2009 Annals of Internal Medicine study noted a typical visit costs an average of $110, compared to $166 in a doctor's office, $156 in an urgent care center and $570 in an emergency room, Ungar reports.

But some doctors take issue with the clinics, saying physicians provide better care and are more qualified to detect serious medical problems. "There might be something that presents as a minor complaint but is in fact the tip of the iceberg," said Dr. Gordon R. Tobin, president of the Kentucky Medical Association. "Physicians have the gold standard in education and training." (Read more)

Essay contest for grad/undergrad students, topic: 'Obamacare' is hosting its annual essay contest, with this year's essay topic President Obama's Patient Protection and Affordable Care Act, which the U.S. House voted yesterday to repeal.

The competition is open to all undergraduate and graduate students, with first place receiving $1,500 and second place $750. Graduate and undergraduate students will be judged separately.

In the essay, students should imagine they've just been hired as a health aide to a member of Congress of their choice. That member asks the student to summarize what the next steps on health reform should be in 1,000 words or less. The recommendations should be explained and justified and major challenges should be identified and addressed.

Submissions are due Feb. 28. (Read more)

Wednesday, January 19, 2011

Faith-based alliances may be exempt from health-insurance mandate; Kentucky court case part of national question

Though the health-refom law requires all Americans to be enrolled in a health-insurance plan by 2014, Christians can be exempt if they pool their risk. Such is the message being spread by Samaritan Ministries and Christian Care Ministry.

Melissa Maynard of Stateline, a nonpartisan news service of the Pew Center on the States, reports the new law "does in fact contain language exempting faith-based groups from the requirement." That's because these ministries fall under the umbrella of "health care sharing ministries," in which members pool their money and their risk to help each other cover their medical expenses.

Christian Care Ministry is hoping to target 11 million Americans "it estimates profess Christian faith and are not covered by an employer's insurance plan," Maynard reports. Currently, only 100,000 households nationwide are members of health care sharing ministries.

However, states have a major role to play in implementing the law, and last fall, the Kentucky Supreme Court ruled Christian Care Ministry should be considered a regulated insurance plan since its members pool their risk. The group says it believes an agreement can be reached with the state, Maynard reports.

The issue will be debated in Arizona, Georgia, Indiana, Maine, Montana, North Carolina and South Carolina this year, in part because conservative legislators are eager to sidestep implementation of the health reform law. (Read more)

Bowling Green commission votes 3-2 for smoking ban

After more than three years of discussion, the Bowling Green City Commission passed the first reading of a smoking ban Tuesday in a 3-2 vote.

The ban would ban smoking in "most indoor businesses in the city," reports Andrew Robinson of the Bowling Green Daily News. A second reading will be voted on at a special meeting Monday. If the measure passes, it will take effect 90 days after the vote.

Commissioner Brian "Slim" Nash said last week he wanted to get the ban passed before a new mayor (and possibly a new commissioner) takes office. Mayor Elaine Walker voted for the ban; she will soon become Kentukcy secretary of state, having been appointed by Gov. Steve Beshear to replace Trey Grayson, who resigned. The commission may choose one of its own members to replace Walker, opening up a commission seat for another appointment.

The vote was preceded by "lively debate," Robinson writes, with some citizens displeased by the proposal. "All you're trying to do is ram this down my throat, Commissioner Nash, and I don't like it," James Ackzien said.

Kim Lindgren, who presented a petition with almost 1,700 signatures supporting a smoke-free law, saw things differently. "While I get the rights of smokers," Lindgren said, she argued that she should be able to sit in a restaurant without the "overwhelming smell of smoke coming from the smoking section." (Read more)

Congressman weighs in on state issue, supporting prescription rule for cold medicines used to make methamphetamine

Republican U.S. Rep. Hal Rogers of Kentucky's 5th District is backing state legislation that would require a prescription for the sale of medicines like pseudoephedrine, a key ingredient in the manufacture of methamphetamine. The congressman, right, sent out a column to every newspaper in the state last week expressing his support.

"We can't ignore the potential for this legislation to nearly eliminate meth labs in Kentucky, as reports are showing it has already done in Oregon and Mississippi," Rogers wrote.

A Rogers ally, state Sen. Tom Jensen, R-London, filed the bill Jan. 4. It would require a prescription for ephedrine, pseudoephedrine and phenylpropanolamine, which are now sold over the counter. It would also prohibit a practitioner from dispensing more than 9 grams of the medicines to a user within a 30-day period.

Roger Alford of The Associated Press reports Republicans and Democrats alike support the bill, but industry groups like the Consumer Healthcare Products Association strongly oppose it and have been running large newsppaer ads against it. (Read more)

Tuesday, January 18, 2011

Vaccine against measles, mumps and rubella doesn't cause autism, so get your children immunized, UK doctor says

A University of Kentucky psychiatrist is encouraging parents to get their children vaccinated for measles, mumps and rubella (MMR) now that scientists have found no connection between the vaccine and autism. "I really want the word out there that vaccines do not cause autism," Dr. Paul Glaser, right, told the Lexington Herald-Leader's Mary Meehan.

Glaser's message comes after the British Medical Journal published a report debunking Dr. Andrew Wakefield's 12-year-old assertion of a link between vaccinations and autism. Investigators found that Wakefield "misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study," Meehan reports. Wakefield's assertions led to a substantial decrease in the number of children who got the MMR shot. In the United Kingdom, vaccination rates decreased to below 80 percent from 92 percent.

The first dose of the MMR vaccine is generally given to children when they are toddlers. The second dose is administered before children start kindergarten. (Read more)

White House officials blast effort to repeal health-care reform

As House Republicans planned to pass a bill tomorrow that would repeal last year's Affordable Care Act for health care and health insurance, officials of a freshly business-friendly Obama administration said today that repeal makes "bad business sense."

Small Business Administration Administrator Karen Mills and Rebecca Blank, acting deputy secretary of commerce, hosted a conference call with journalists today to discuss the effects of repealing the act. The newly Republican House is expected to vote in favor of repeal, but Senate Majority Leader Harry Reid has said it will be "dead on arrival" in the Democratic-majority Senate.

Republicans have repeatedly called the health care reform "job-killing," an assertion that the nonpartisan accountability service has judged to be inaccurate. Administration officials argued likewise today, in the call with Kentucky Health News and other news outlets.

"The Affordable Care Act really supports our nation's entrepreneurs and entrepreneurial spirit," Mills said. Repealing the law would take away tax credits — a 35 percent deduction for business owners that pay 50 percent of their employees' coverage. In 2013, that credit jumps to 50 percent. Repeal would also "stifle innovation" by creating "job lock," Mills said, which happens when people stay in a job they no longer want for fear of losing their health insurance.

The act provides coverage for dependent children until they turn 26 and does not allow discrimination against enrollees who have pre-existing conditions. Mills said more than 100 million people have pre-existing conditions nationwide.

Repeal would also "add $1 trillion to the federal deficit," Mills said. Republicans dispute that.

Since 2009, Mills said the number of small businesses that are offering health insurance coverage to their employees has increased — by 9 percent in businesses with less than 200 employees and 13 percent in businesses with less than 10 employees.

Mills stressed there is "no mandate, no requirement" penalizing small business owners with less than 50 workers who don't offer health insurance.

Blank spoke of the "simply unsustainable" rising costs of health care before the act took effect, saying in 1960 less than 1 percent of the payroll was spent on health care. By the mid-2000s, that number had jumped to 10 percent. "That's a runaway cost train that had absolutely no mechanism to put on the brakes," she said.

Blank added widening insurance coverage is "designed to move toward a system in which doctors and insurers are rewarded for the quality of care, rather than just the quantity." The act, Blank said, will "rein in costs," "improve American global competition" and "spur job growth."

New program aims to get more physicians practicing in rural Ky.

A new program in Morehead aims to get more physicians practicing in rural areas and improve access to health care.

The Rural Physician Leadership Program is the result of a partnership between the University of Kentucky College of Medicine, St. Claire Regional Medical Center and Morehead State University. UK and the RPLP work together to identify and recruit students interested in rural medicine. "We approach potential students when they're in college, sometimes even in high school," Dr. Anthony Weaver, assistant dean for RPLP, told The Morehead News.

Students accepted in the program spend their first two years of college at UK taking basic science courses. They also are part of groups in which rural and community medicine is discussed. In their third year, they go to Morehead to work with physicians in clinics, nursing homes and hospitals, mainly St. Claire. In the fourth year they are exposed to specialties such as internal medicine, neurology and gynecology. Students also have rotations in family medicine.

The program also has a business component, teaching students how to pinpoint and work with community organizations.

"There is no other program quite like this one, where the collaboration between a medical school, a teaching hospital and a regional university has been so carefully planned as to create opportunities to improve patient care in rural areas," Weaver told the News. (Read more)

Monday, January 17, 2011

Health reform will be difficult to implement, as faceoff between insurers and state official showed

Huffington Post contributor Don McNay, right, of Richmond, writes that states will adopt health-care reform "kicking and screaming," as shown by the Kentucky insurance commissioner's recent face-off with insurance companies over children's health coverage.

Under the reform act's mandate, insurance companies that offer "child only" policies "cannot deny coverage to a child due to any preexisting condition present in that child," McNay notes. In response, when the provision took effect Sept. 23, 2010, insurance companies stopped offering that type of policy in Kentucky.

State Insurance Commissioner Sharon Clark conducted a hearing on the matter Oct. 13, 2010 and determined that "insurance companies are very concerned about suddenly getting a number of 'bad risks' that they had not planning for in their pricing," McNay reports to his international audience. Clark also determined that if insurance companies stopped offering "child only" policies, the Kentucky Access program for the uninsured would be overwhelmed with new enrollees.

As a result, Clark "ordered all insurers selling individual health insurance policies in Kentucky to offer an annual enrollment each January for children under age 19," McNay notes. "It took strong action by the Kentucky insurance commissioner to get this first part of health reform implemented for a very small part of the population. It's a small battle in a small state for a small set of the population, but a big glimpse of how implementing health care reform nationwide is going to go." (Read more)

Kentucky doctors' offices are the least digitized in the country; increase expected nationwide

Kentucky has the lowest percentage of doctors' offices who have adopted electronic health record systems, says a survey released by the Office of the National Coordinator for Health Information Technology.

Just 38.1 percent of Kentucky health clinics are digitized, compared to 51 percent nationwide. Louisiana (39.1 percent) and Florida (39.4 percent) were second and third lowest, respectively. Minnesota tops the list, with 80.2 percent of its offices paperless, followed by Massachusetts (77.3 percent) and Wisconsin (75.4 percent). The survey data were compiled by the National Center for Health Statistics.

Those numbers are expected to grow nationwide. Hospitals and physicians can now register for the Medicare and Medicaid EHR incentive programs, which give federal funds to facilities that have adopted EHRs. Kentucky physicians and hospitals are among the first nationwide to be eligible to receive incentives from both programs. University of Kentucky HealthCare and Central Baptist Hospital in Lexington were the first hospital systems in the country to receive funds — which totaled $4.1 million — from the incentive programs. Another 25 Kentucky providers have started the application process.

Interest in EHR systems, which are believed to improve the quality of health care and patient outcomes, is growing nationwide. A survey by the American Hospital Association found that 81 percent of the nation's hospitals plan to take advantage of the incentive programs. NCHS numbers showed 41 percent of office-based physicians are planning to do the same. (Read more)

The changeover is expected to create a substantial surge in EHR software technology. World Market Media reports the market for electronic health record software is expected to reach $3.8 billion by 2015. (Read more)

Private information of Owensboro-area patients found on Web

The private information of thousands of people who visited the Green River District Health Department has been mistakenly available for perusal online since October.

Owensboro's Messenger-Inquirer found 9,986 names and personal information, including birth dates and Social Security numbers, of Daviess County residents last week after receiving a tip by Mickey Franzman, who stumbled on the information while doing a Google search on one of her relatives. The information included a database of health department clients.

The problem was fixed immediately by Intregranetics after the company was informed of it. "The information that was out there from the health department, it was nothing they did," President Michael Hobson told reporter James Mayse. "It was my responsibility ... It wasn't anything done intentionally."

Debbie Fillman, health department director, said Thursday that steps were in place to inform people who could have been affected. (Read more)

Health advocacy organizations reluctant to acknowledge grant money from drug companies, study finds

A study by the American Journal of Public Health shows not-for-profit groups like the American Diabetes Association get grant money from drug companies but don't necessarily acknowledge it.

Marian Wang of ProPublica, the nonprofit investigative news service, highlighted the results of the study, which examined 160-plus health advocacy organizations that got funding in 2007 from Eli Lilly & Co., a global pharmaceutical company.

The report found that, as a whole, "25 percent of health advocacy organizations acknowledged Lilly funding anywhere on their Web site. Eighteen percent acknowledged Lilly in their 2007 annual report, 1 percent acknowledged Lilly on a corporate sponsors page, and 10 percent acknowledged Lilly as the sponsor" of a grant event reported in the Lilly Grant Registry. (Read more)

State legislator wants to mandate drug testing for recipients of Medicaid, food stamps and other entitlements

A Republican legislator wants to make recipients of government entitlement programs, including Medicaid, take random drug tests in order to keep getting help.

House Bill 208, which proposes the drug screening, was introduced Jan. 7 by state Rep. Lonnie Napier, R-Lancaster, left. "I'm not a hard-hearted guy," he told the Lexington Herald-Leader's Jack Brammer. "I believe there is a need for public assistance for those who need it, but I understand some are using these funds to buy drugs."

Napier said he wants the Kentucky Cabinet for Health and Family Services to do random drug and urine testing for any Kentucky resident over the age of 17 who gets Medicaid, food stamps or welfare benefits. Those failing the test would lose their benefits until they passed drug testing at a later date.

The cost of the proposal is unknown. Napier said there are more than 600,000 Kentucky adults on welfare, and a drug test costs about $30, resulting in a $18 million price tag, plus the likely larger cost of expanding drug treatment programs -- a point made by conservative WHAS Radio talk-show host Mandy Connell in opposing the bill this morning.
Sheila Schuster, who helps advocate for disabled Kentuckians, said the bill "fans the flames of people who misunderstand the plight of those who receive assistance and would put more negative connotation on them." (Read more)

Wednesday, January 12, 2011

Fort Campbell soldier who went AWOL, and says his Kentucky PTSD treatment was inadequate, is set to return to Afghanistan

A Fort Campbell-based soldier who went absent without leave because of alleged post-traumatic stress disorder will return to finish his tour in Afghanistan.

"My family doesn't want me to go, but I am not disobeying a command order," Spc. Jeff Hanks, 30, told Kristin M. Hall of The Associated Press. Hanks, right, said his mental health issues date back to a 2008 deployment in Iraq. Last year, he spent six months in Afghanistan, during which he sustained a concussion when a mortar landed near him. Since turning himself in on Nov. 11, 2010, he said he has been treated for nightmares and headaches and was told to get counseling when re-deployed. Hanks told the AP he does not feel his PTSD has been treated adequately.

Hanks, a married father from North Carolina, said he will likely serve another four months in the country to complete his one-year tour. He has committed to serve in the Army another two and a half years. A Fort Campbell spokeswoman told the AP that Hanks is scheduled to re-deploy in the coming days. (Read more)

Hanks was deployed overseas in May 2010 and did not return after a mid-tour leave in October, reports Jake Lowary of The Leaf-Chronicle in Clarksville, Tenn. After turning himself in on Veterans Day, the Army opted to send Hanks for treatment at a facility in Hopkinsville, Ky., rather than send him back to Afghanistan. (Read more)

UK scientists discover a clue to treating diseases like 'mad cow'

University of Kentucky scientists may be a step closer to finding a way to treat diseases related to prion proteins, including bovine spongiform encephalitis, or mad-cow disease. They've learned that plasminogen, a protein used to bust blood clots in the body, increases the speed at which prion diseases progress.

"Since prion diseases can lay undetected for decades, delaying the ability of the disease-associated prion protein to replicate by targeting the cofactor of the process could be a monumental implication for treatment," said Chongsuk Ryou, right, senior author of the study.

Prion diseases are rare, fatal diseases characterized by oddly-shaped protein molecules in the brain. Besides mad-cow, they include Creutzfeldt-Jakob disease in humans; scrapie in sheep; and chronic wasting disease in deer and elk, UK's news source UKNow reports. The study was published by the Federation of American Societies of Experimental Biology in the December issue of The FASEB Journal.

Scientists used test tube reactions to multiply disease-associated proteins, UKNow reports. The reactions were done with and without plasminogen present. "By showing how prions hijack our own clot-busting machinery, this work points to a new target for anti-prion therapy," said Dr. Gerald Weissman, editor-in-chief of the journal. (Read more)

Kentucky gets 'F' for tobacco control, but expansion of cessation programs in Medicaid should raise grade

As a proposed statewide smoking ban continues to be debated, Kentucky and Indiana have received dismal grades from the American Lung Association's recently released State of Tobacco Control 2009 report. But it's 2011, and parts of the report are already out of date.

Kentucky received an "F" in all four assessed categories, including tobacco prevention and spending; smoke-free air; cigarette taxes; and cessation coverage. On the latter point, the state Medicaid program only provided coverage for smoking-cessation medication in 16 of 120 counties, but Gov. Steve Beshear announced in October 2010 that all Kentucky Medicaid patients are now eligible for nicotine- replacement therapy (NRT) products and tobacco-cessation medications. Under the program, the recipient is assessed by a physician, nurse practitioner or physician assistant. The recipient then chooses a smoking program in which to enroll and NRT or stop-smoking medications will be prescribed by the provider as needed. For more information about the program, click here.

Comprehensive smoking bans in Louisville, Lexington, Frankfort and other communities were commended in the report. For a report from Louisville's WDRB-TV, click here.

Tuesday, January 11, 2011

General revenues up, cigarette tax revenues down as tax is up

New numbers show revenues to Kentucky's General Fund, which pays for most state services besides roads, increased 5.4 percent since July 1, but money from the state's cigarette tax declined by 3.9 percent, perhaps in part because higher tobacco taxes have prompted some people to quit smoking.

Roger Alford of The Associated Press reports cigarette tax revenues dropped to $135 million, from $141 million in 2009. Gov. Steve Beshear acknowledged that cigarette tax revenue would decline when he pushed a 30-cent-per-pack increase in the tax two years ago. "Beshear said raising the cigarette tax would result in fewer smokers, which would translate into healthier Kentuckians and lower health care costs," Alford reports. (Read more)

Number of U.S. adults treated for diabetes more than doubled in a decade; it's a big problem in Kentucky

Diabetes, a bigger problem in Kentucky than in most states, is exploding nationally. The number of U.S. adults treated for the disease more than doubled between 1996 and 2007, the federal Agency for Healthcare Research and Quality has estimated. About 19 million adults said they had been treated for the disease in 2007, up from 9 million in 1996, AHRQ reports. And the figures don't include perhaps millions of pre-diabetics who haven't been treated or even diagnosed.

Newswise, a news service about research, reports the AHRQ numbers also show:
• Costs for outpatient care doubled nationwide from about $5 billion to about $10 billion.
• Total prescription costs jumped from $4 billion to $19 billion. Patients paid an average of $1,048 for prescription meds in 2007, compared to $495 in 1996. (Read more)

Kentucky's trends are also alarming. In 2009, Kentucky was ranked fourth highest in the nation in prevalence of diabetes. A fact sheet from the state Diabetes Prevention and Control Program shows 8 percent of Kentuckians aged 35 to 44 were diagnosed with the disease. In 2000, less than 2 percent in the same age category had it. Prevalence is also increasing in seniors. In 2000, 14 percent of seniors 65 and older had diabetes. In 2009, 22 percent did.

The impacts of the disease are significant, the fact sheet indicates. In 2007, diabetes accounted for about 18 percent of hospitalizations in Kentucky, or almost 120,000 hospitalizations.

Why is diabetes increasing? Officials with the state diabetes program blame high obesity rates (30 percent of Kentucky adults), low rates of physical activity (30 percent of are considered inactive), and large shares of the population with high blood pressure (38.5 percent) and high cholesterol (30 percent).

The federal Centers for Disease Control also assess the ramifications of the disease. For a county-by-county estimate of diabetes diagnoses, go here.

Adair County Community Voice newspaper, local health department sponsor Community Health Challenge

Residents of Adair County should be getting more fit in the new year, thanks to community-wide competition sponsored by the local health department and one of the Columbia newspapers.

The Adair County Community Voice and the Lake Cumberland-Adair County Health Department are promoting the Adair County Community Health Challenge, in which teams of two or more get daily points for drinking water, eating vegetables and exercising. The Community Voice ran this photo illustration on its front page last week; from left are Jelaine Harlow and Destiny Burton of the health department and Sharon Burton and Christy Marr of the Voice.

The competition operates on the honor system. Each participant puts $5 into a pot, and the team with the most points takes home the winnings. The challenge will begin Jan. 24 and last for eight weeks. Team rankings will be published in the Community Voice each week. The goal of the competition is to achieve "total health." (Read more)

Monday, January 10, 2011

Rural teens more likely to abuse prescription meds; Operation UNITE launches 'Accidental Dealer' to guard medicine cabinets

A University of Kentucky study has shown rural teenagers in Kentucky are 26 percent more likely to abuse prescription drugs than those living in urban areas, the Lexington Herald-Leader's Mary Meehan reports. The study concludes 13 percent of teenagers living in rural areas have said they used prescription drugs recreationally. Only 10 percent of urban youths have tried them.

Dr. Jennifer Havens, right, spearheaded the study. She is a professor of epidemiology at UK's Department of Behavioral Science in the College of Medicine. "This is one of the first studies to show that hard data," she said.
Karen Kelly, director of Operation UNITE, a federally funded anti-drug program for Eastern Kentucky, said she was pleased to have the data. "We were excited when we heard about those numbers," she said. "A lot of times in small communities, people don't think there is anything to be concerned about."

The study looked at data from 17,872 participants ages 12 to 17 in the 2008 National Survey on Drug Use and Health. It showed teens are getting pills from medicine cabinets in their home, which has prompted UNITE to launch "Don't Be an Accidental Drug Dealer. The program, which Meehan reports started in Knox, Clay and Wolfe counties last week, will inform communities about prescription drug abuse through town hall-style meetings and public service announcements. (Read more)

The program has also started in Breathitt County, with a training meeting last Thursday to make volunteers and key personnel "aware about keeping the lid locked on prescription and over-the-counter medications," Jeff Noble reports for the Jackson Times-Voice. "For some that attended, the session was more than just basic information – it was an eye-opener that mirrored their concerns," Noble writes, citing a statement from Kelly: “In Eastern Kentucky, the average age of first-time drug abuse is 11 years old, so this is a particularly critical issue.” Karen Bunn, chair of the Breathitt UNITE Coalition, told Noble that the program needs volunteers to work. (Read more)

Dental tech firm wins $10,000 and free office in Kentucky Highlands' statewide business competition

A Louisville-based company, Inven, will receive $10,000 and free office space for a year to develop dental health technology. Inven won first place in a statewide business competition hosted by the Business Innovation & Growth Center at Kentucky Highlands Investment Corp. in London.

Inven will develop a tool used in root canals that saves time and poses a lower risk to patients.
The company's founders, Alex Frommeyer, Dan Dykes and Alex Curry, are graduates of the University of Louisville's J.B. Speed School of Engineering.

Second place went to Awesome Touch of Lexington, whose founders have created optical touch screen technology. Old Kentucky Logs of Corbin earned third place for its concrete logs made to look hand-hewn. Health reform does not 'kill jobs'; GOP disagrees

In their report released last week, Republicans in the U.S. House said the new health reform law will be "job-killing," but has concluded that is not necessarily the case.

The Republican report, released Jan. 6 and entitled "Obamacare: A Budget-Busting, Job-Killing Health Care Law," cites a study predicting 1.6 million lost jobs, but "fails to mention that the study refers to a hypothetical employer mandate that is not part of the new law," FactCheck reports. It says the report also fails to mention that the same study predicts a gain of 890,000 jobs in hospitals, doctors' offices and insurance companies.

"There's little doubt that the new law will likely lead to somewhat fewer low-wage jobs," FactCheck reports. "That's mainly because of the law's requirement that, generally, firms with more than 50 workers pay a penalty if they fail to provide health coverage for their workers." John Sheils of The Lewin Group said that loss would be between 150,000 and 300,000 jobs. But that loss would be partly offset by job growth in the health-care industry, says FactCheck, a service of the University of Pennsylvania's Anneneberg Public Policy Center. (Read more)

However, Republicans like U.S. Rep. Ed Whitfield of Kentucky's First District, right, say the new health law will have fiscal and economic consequences. Their reports says it "contains a number of provisions that will eliminate jobs, reduce hours and wages, and limit future job creation." It further contends that studies show it will "cost taxpayers more than originally estimated and may exacerbate the nation's dire fiscal condition."

Whitfield said in a statement on Jan. 7, "We must repeal the job-killing Obamacare health bill and enact solutions that lead to quality care without costing much needed jobs or placing onerous burdens on America's small business owners." Whitfield is the new chairman of the Energy and Environment Subcommittee of the House Energy and Commerce Committee.

Flu is now widespread in Kentucky

Flu activity is now widespread in Kentucky, WKYT-TV reports.

"It has just reached the category of widespread," Kentucky Health Commissioner Dr. William Hacker told the Lexington station. "It can be a problem until April or May. So I still recommend a flu vaccine for those who have not had one." (Read more)

Friday, January 7, 2011

Local ordinances have set the stage for statewide smoking-ban legislation, advocates say; poll shows a clear majority support it

By Tara Kaprowy
Kentucky Health News

Though advocates of anti-smoking laws don't believe a statewide smoking ban will pass in the General Assembly this year, they see public support for it and have come to the conclusion that it's time to get the discussion started.

"This will get the ball rolling at the state level," said Dr. Ellen Hahn, left, a nursing professor at the University of Kentucky and director of the Kentucky Tobacco Policy Research Program. "We know the best comprehensive laws won't happen overnight. We really need to start somewhere."

On Wednesday, state Rep. Susan Westrom, D-Lexington, filed House Bill 193, which would prohibit cigarette use in all enclosed public places and enclosed places of employment, including restaurants and bars. It also bans smoking within a "reasonable" distance outside of public places and work places.

Hahn, who has been reluctant to support a statewide ban, said Westrom's move is timely. Dozens of organizations now publicly support "smoke-free" laws, and 29 communities have enacted local smoke-free ordinances. "We're getting more ready every day because local leadership has shown the way," Hahn said. For a list of the communities and more details, click here.

As of now, 32 percent of Kentuckians are covered by smoke-free laws, and those numbers are growing, thanks, in part, to Campbell County's recent ordinance (though a new Fiscal Court is moving to repeal it before it takes effect). "I think the movement in Northern Kentucky has helped," Hahn said. "That's kind of the last urban area anywhere. Bans have also gone into effect in Bardstown and Glasgow. We've had some key places in the state if you look at the map. We're starting to fill in some areas."'

Hahn is the leading advocate for smoke-free ordinances in the state, but has long been reluctant to push for a statewide ban. "My hesitation was that we would end up with something bad, a law that would tie the hands of local government," she said. "And we didn't want something that was carved up with loopholes."

But the tide has turned, Hahn said. "I've said all along everyone deserves protection, everywhere. I don't think we'll ever see local ordinances in every locale in the state. In some ways, it's got to start some time and we're on first base. It's a process."

Jim Waters of the Bluegrass Institute for Public Policy Solutions, a free-market think tank in Bowling Green, replied to the developments this way: "Ironically, state politicians who loathe interference from Washington seem want to impose Frankfort's will on local communities. Some local communities like Bowling Green have had their own hard-fought, emotional battles over the smoking-ban issue. It would be outrageous for Frankfort now to come swooping in and possibly override their decisions."

Waters has branded Hahn "the smoking nanny" and debated her in a series of "Sorting Through the Smoke" seminars for journalists held by Kentucky Youth Advocates and the Institute for Rural Journalism and Community Issues, another UK-based center that publishes Kentucky Health News. For video of one encounter they had, in Danville, click here.

Hahn said it takes an average of two and a half to five years for Kentucky communities to pass smoke-free ordinances. As for enacting statewide bans, "It really varies across the country," she said, adding that she's willing to wait. "We don't want them to do something until they're ready," she said. "It's going to take a while for state legislators to study the science. They haven't done it before. We haven't asked them to do it."

What's important, Hahn said, is to wait until legislators are ready to pass a comprehensive law, not one subject to exemptions such as private clubs or nightclubs. Amy Barkley, a director for the Campaign for Tobacco-Free Kids, agreed. "Here's what's important: We don't want to settle for a half-baked law," Barkley said. "This is not an area that can be compromised."

Exemptions to the law lead to complications, Barkley said. "First, they mean that certain employees are not protected," she said. "If the intent of the bill is to protect people, why are some people more important than others?" Second, laws with exceptions are more difficult to enforce. "With a comprehensive law, everyone knows if you're indoors you can't smoke," Barkley said. "These things are very self-enforcing the more clear, concise and comprehensive they are."

Thirdly, exemptions can result in legal challenges," Barkley said, citing an example in Louisville when its smoking ordinance exempted Churchill Downs from being subject to it. "There was a lawsuit over that and the ordinance could not be put into effect while it was pending," she said.

Ultimately, both Hahn and Barkley are willing to bide their time. They both stressed the importance for local governments to continue their smoke-free efforts in the meantime. "These local officials shouldn't wait," Hahn said.

Poll shows clear support for statewide ban

A poll released Thursday by supporters of a statewide ban shows that a majority of Kentucky adults favor it, that opinions on both sides are strong, and that local communities should have the option of passing additional restrictions on smoking in public places and workplaces.

The telephone survey was taken Dec. 12-14 by Public Opinion Strategies, a well-regarded national firm that gave Kentucky Health News its questionnaire and the number of adults it called in each county. The poll asked, "Would you favor or oppose a state law in Kentucky that would prohibit smoking in most public places, including workplaces, public buildings, offices, restaurants and bars?" Then they were asked if they felt strongly about their opinion or were "just somewhat" in favor or opposed.

The results: 44 percent said they strongly favored such a law, while 15 percent said they were somewhat in favor of it, for a total of 59 percent. The opposition totaled 39 percent: 14 percent said they were somewhat opposed to the law, and the strongly opposed were 25 percent, the same percentage of adult Kentuckians who said they smoke. The strong opinions on both sides totaled 69 percent, a very high figure. The margin of error for the poll of 500 adults was plus or minus 4.38 percentage points for each figure, so a clear majority favors a statewide smoking ban.

Among smokers, 31 percent said they favored the law and 68 percent opposed it. Among the three-fourths of Kentuckians who don't smoke, the figures were virtually a mirror image: 69 percent in favor, 29 percent opposed. (The figures for smokers come from an interview by Kentucky Health News with Glen Bolger, a partner in the Arlington, Va.-based polling firm.)

Statistically, the poll found no difference among Democrats, Republicans, independents and tea-party supporters, with 55 to 60 percent identifying with each label saying they support a statewide ban.

While both leading candidates for governor, Democratic Gov. Steve Beshear and Republican state Senate President David Williams, have said they favor a statewide ban, neither has emphasized it, and there is skepticism among state legislators that it would be a deciding issue for voters. However, the poll found that 34 percent of voters said they would be "much more likely" to vote for a candidate for state office who supports the law, and 21 percent said they would be "somewhat more likely" to do so, for a total of 55 percent. On the other side, a total of 36 percent said they would be less likely to vote for a supporter of the law (20 percent much more likely and 16 percent somewhat). Only 6 percent said the candidate's position would make no difference.

The question initially described two alternative, unnamed candidates in terms of positions on the issue and asked, "For which of these candidates would you vote?" Even 31 percent of smokers said they would be more likely to vote for a candidate who supports a statewide ban.

Then the survey asked which is more important, the rights of smokers and of restaurant and bar owners, or the rights of employees and customers to breathe clean air in such establishments. (The alternatives were rotated, as were those on other questions.) A majority said employees' and customers' rights were more important, 53 percent much more so and 15 percent only somewhat. The poll did not differentiate between the rights of smokers and business owners or those of employees and customers.

Waters said, "Just because a majority of people in some poll say they want more government nanny-ism doesn't make it the right, or constitutional, action to take. The last time I checked, restaurant and bar owners' constitutionally protected private property rights are not subject to polling. In fact, the constitution exists for the express purpose of protecting those rights from some popular movement such as that being pushed by Kentucky's health nannies who want to deny Kentuckians their individual liberty to make their own decisions regarding smoking, eating and other lifestyle choices."

The main medical reason for smoking bans is research showing that second-hand smoke causes cancer and other diseases, and Kentuckians seem to accept those findings. Almost half, 48 percent, said exposure to second-hand smoke is a serious health hazard, while 28 percent said the hazard is moderate, 17 percent said it is minor, 5 percent said it is not a health hazard at all and 2 percent declined to say.

Many smokers acknowledged their risky behavior; 24 percent said second-hand smoke is a serious health hazard, while 35 percent said the hazard is moderate and 28 percent said it is minor. Only 10 percent said it is not a health hazard.

The poll found that regardless of what happens at the state level, 76 percent of Kentucky adults think local communities "should continue to have the option of passing additional restrictions on smoking in public places and workplaces." Fifty percent strongly agreed with the statement, and 26 percent agreed somewhat. Most of the 22 percent who disagreed did so strongly, again revealing the depth of feeling about the issue.

Waters said the Bluegrass Institute favors local control. "Even though we vehemently disagreed with the smoking bans implemented by Louisville, Lexington and other communities," he said, "we would be absolutely opposed to Frankfort overriding those local communities' decisions."

The poll also illustrated the precipitous decline of tobacco as a political force in Kentucky since repeal of the federal quota and price-support program in 2004. Only 6 percent of respondents said they grow tobacco or own land on which it is grown. For the poll questionnaire and results, click here.