State's Medicaid program will be handled by managed care companies starting tomorrow

Update, Nov. 1: Kentucky Voices for Health, a coalition of more than 250 health care organizations, individuals and advocates, released its views on the move to managed care, which they said must be as much about improving the quality of health care as it is about saving money. "We want Medicaid managed care to be a positive move for both the fiscal health of Kentucky and the health of Kentuckians, so we must continually strive to ensure that all who are eligible have access to high-quality, affordable, effective health care regardless of poverty status or disability," said Dr. Rev. Marian McClure Taylor, KVH board member and executive director of the Kentucky Council of Churches.

The transition must also run smoothly, said Jody Mitchell, KVH executive director. "Our priority is ensuring that the 540,000 Medicaid members affected continue to receive the best health care possible, without interruption." (Read more)

About 560,000 Kentuckians on Medicaid will have a new way of getting health care starting tomorrow when the state switches to managed care.

So far, 68 acute-care hospitals, including some out-of-state facilities, have signed on to at least one of three of the managed care organizations chosen earlier this year by the state to run the program, reports Beth Musgrave of the Lexington Herald-Leader. Excluding the Louisville area, which has long been and will continue to be served by the Passport managed-care organization, there are 96 acute-care hospitals in Kentucky.

"A significant number of hospitals have signed in the last couple of weeks, and we anticipate that these numbers will continue to grow," said Jill Midkiff, spokeswoman for the Cabinet for Health and Family Services. The state had delayed the switch to managed care, which had been scheduled to begin Oct. 1, by one month to give providers time to sign contracts.

Gov. Steve Beshear said today the federal Centers for Medicaid and Medicare Services have approved the transition. "We have worked hard to make the transition as seamless as possible, and I appreciate the collaborative efforts that allowed us to reach this goal under aggressive deadlines."

Switching to managed care has been Beshear's answer to overcoming a Medicaid budget deficit. The program will be run by four managed care companies, which will be paid a predetermined per-patient, per-month amount regardless of what care is needed. Because they won't be paid using a fee-for-service model — believed to be more costly — and will try to streamline care, Beshear (right, photo by H-L's Pablo Alcala) said the move will save $1.3 billion in the next three years.

Delaying the move by another month could have cost the state $9.2 million in savings, Musgrave reports. (Read more)

Most beverage companies targeting kids, teens even more to sell sugary drinks, despite pledges; Pepsi an exception

A study analyzing the marketing practices for 600 products made by 14 companies found there is more advertising of sugary drinks to children, despite industry pledges to the contrary.

Child and teen exposure to TV ads for full-calorie soda doubled from 2008 to 2010. "This increase was driven by Coca-Cola and Dr. Pepper Snapple Group. Children were exposed to nearly twice as many TV ads for sugary drinks from these companies," the report by the Yale Rudd Center for Food Policy and Obesity reads. "In contrast, children were exposed to 22 percent fewer ads for PepsiCo sugary drink products." PepsiCo makes Mountain Dew, so sugary and popular among youth in Eastern Kentucky that dentists have identified a tooth-decay syndrome of "Mountain Dew mouth."

Coca-Cola, PepsiCo, Dr. Pepper Snapple Group and Kraft Foods produce two-thirds of the 900 products analyzed.

Coca-Cola accounted for three out of four brand appearances seen by children and teens. Nearly two-thirds of all full-calorie soda or energy drink ads on TV included sponsorship of an athlete, sports league or teams, or an event or cause.

In 2010, black children and Hispanic teens saw 80 to 90 percent more TV ads than white children. Marketing on Spanish-language TV is also growing. In 2010, Hispanic children and teens saw nearly twice the number of sugary drink and energy drink ads as in 2008.

The American Academy of Pediatrics says highly caffeinated energy drinks "have no place in the diet of children and adolescents." But in 2010, teenagers saw 18 percent more TV ads and heard nearly twice as many radio ads for energy drinks than adults did. (Read more)

Cyber predators have easier access to children because of phones, video games

Child predators have it easier than ever to entice their young victims, due to the ever-growing accessibility of the Internet. "It's a lot easier now than everybody has the Internet in their pocket," Lexington Police Detective David Flannery told Karla Ward of the Lexington Herald-Leader. "Every day that we think of a way to combat it, people are thinking of a way to get around us," Flannery said. "It changes every day, and you have to keep up with it."

Using the World Wide Web to lure children for sex acts has skyrocketed since 1998, when the National Center for Missing and Exploited Children received 707 reports of people trying to entice children via the Internet. In 2008, there were 8,787 reports.

"Computers and cell phones remain the primary means of communication, but game systems including Xbox 360, Nintendo DS and Wii also can be connected to the Internet, giving predators another way to gain access to children," Ward reports.

Though parents are becoming more aware, more education is needed, said Erin May Roth, an assistant U.S. attorney and the Project Safe Childhood coordinator for the Eastern District of Kentucky. "What they don't really think about is the fact that their kids are going to sleep with their phone," she said.

Flannery is the only police officer in Lexington assigned full-time to investigate Internet crimes against children. While he does not go into detail about his methods to track down predators, the concept involves pretending. "Anything that a kid can do, we can do," Flannery said.

Sometimes officers from several agencies and departments work together. The Kentucky State Police administers an Internet Crimes Against Children Task Force, the state attorney general's office has a similar unit, and, because cases can involve a number of jurisdictions, sometimes the Federal Bureau of Investigations, the U.S. Postal Service, the Secret Service and U.S. Immigrations and Customs Enforcement are involved.

Mother Frieda Curry, right, discovered her 14-year-old daughter was entangled with a 38-year-old man who initially pretended to be 16. She contacted the Richmond Police Department and found more than 40 text messages and 10,000 pages of messages and videos on the computer. "I was frantic," she said. "I was in the worst state I've ever been in." (Photo by H-L's David Perry)

But Curry, whose daughter is now in college, dealt with the problem and the predator was sentenced in U.S. District Court to 10 years in prison. Thinking about the crimes can be difficult, but "only by shining a light on the problem will we ever hope to find a solution for it," said Assistant Commonwealth's Attorney Lou Anna Red Corn. (Read more)

Brain-injured man disappeared when home staff wasn't looking

On the day of his disappearance, a resident of a personal-care home who was found dead four weeks later had not been checked on by staff for nearly three hours, reports Valarie Honeycutt Spears of the Lexington Herald-Leader, citing documents from a state investigation.

Additionally, Falmouth Nursing Home did not have a policy to make sure residents were under constant supervision and "the facility failed to establish" one, investigators found.

Larry Joe Lee, right, was a ward of the state and had a brain injury stemming from a childhood accident. He was "schizophrenic, bipolar and diabetic," Spears writes. He disappeared from the nursing home Aug. 4. His body was found Sept. 3 near the Licking River by bow hunters. The cause of his death has not yet been determined.

Spears' calls to the  home were not returned. It has since submitted a plan of correction to the state, which includes professional development for staff and new policies to keep track of patients' whereabouts.

"Since Lee's death, advocates and state lawmakers have been questioning whether personal care homes are the appropriate plate for people with brain injuries," Spears reports. Republican Sen. Jimmy Higdon, who comes from Lee's hometown of Lebanon, said he is on a fact-finding mission to see what changes need to be made to prevent a similar occurrence from happening. (Read more)

Kentucky court hearing more than 100 cases about drug that caused heart arrhythmia

More than 100 lawsuits filed by people who say they or their family members were hurt by Darvon, Darvocet or other drugs that contain the ingredient propoxyphene have been heard in U.S. District Court of the Eastern District of Kentucky since August. So far, none of the cases originated in Kentucky, but stem from people living in other parts of the country.

The effort is the result of U.S. District Judge Danny Reeves being selected by a federal panel to handle all cases pertaining to the subject, reports Jennifer Hewlett of the Lexington Herald-Leader. "It's basically in the interest of judicial economy so that multiple judges aren't handling the same issue," said deputy U.S. District Clerk Susan Baker.

Last last year, the U.S. Food and Drug Administration asked Xanodyne Pharmaceuticals to withdraw Darvon and Darvocet from the market after receiving evidence propoxyphene can cause serious or fatal heart rhythm abnormalities. Now, thousands of suits are being filed by people who took the drug. "Our issue is people took a bad drug that hurt people and they want to have their day in court," said attorney Richard Schulte of Dayton, Ohio, whose firm is dealing with 2,000 cases or potential cases. "We're looking for justice for our clients. You're not supposed to die when you take a pill for mild pain." (Read more)

Giuliani backs P'Pool, citing attorney general candidate's opposition to health-care reform law

Republican Rudy Giuliani, former mayor of New York City and presidential candidate in 2007-08, has endorsed GOP nominee Todd P'Pool in the race for attorney general, citing the candidate's "eagerness to join the legal fight against President Barack Obama's health care overhaul," reports Bruce Schreiner of The Associated Press.

"You've got to elect Todd as your next attorney general because you want to put Kentucky on the side of those states that say 'enough' with how far left our government has gone ... on health care policy," Giuliani said at a rally.

Twenty-six states are "challenging the law's requirements that people buy health insurance or pay a penalty on their taxes" starting in 2014, Schreiner reports. All of the attorneys general in the case are Republicans, except those in Iowa, Nevada and Wyoming. (In some states, attorneys general are appointed.) The case is headed to the U.S. Supreme Court.

Conway, who is seeking a second term, has defended the basic approach of the law, bringing into coverage most of the uninsured who now use emergency rooms to get care, while saying parts of it need changing. Giuliani said, "Your attorney general has Kentucky in a position, by not opposing it, of supporting Obamacare." (Read more)

What would solve primary-care crisis, create jobs and help banks? Building community health centers, writer contends

The federal health-care reform law will mean a glut of new patients who will be newly insured and bog down the primary-care system. Thousands of construction workers are out of jobs as the economy remains stagnant. And the banking sector is still reluctant to lend. The answer to all three problems? Build more community health centers, writes Jeffrey Leonard in an opinion piece in The Washington Monthly. (Photo: Vista, Calif., Community Clinic)

"The way to meet the flood of new patients coming down the pike is to expand the nation's existing network of community health centers — nonprofit clinics that offer primary care to the medically under-served, often in rural areas or inner cities," writes Leonard, CEO of the Global Environment Fund and chairman of the magazine's board of directors. "But to get this done, there's no need to appropriate billions more in direct government spending. Rather, there is a way to lure skittish banks in lending private capital to finance a health-center construction boom in all 50 states, simply by tweaking the language of an existing federal lending program."

Though community health centers generally have difficulty raising their own funds to expand or build facilities, in part because they serve uninsured, low-income patients who can't donate to building projects, they are sound investments, Leonard contends, pointing out only "one or two" of the 1,200 community health centers in America today have ever defaulted on a loan.

Still, they have trouble getting loans from banks, even once they have been able to raise a chunk of funds, in large part because centers "in an economically distressed inner-city neighborhood serving a mixture of Medicaid patients and the uninsured, or one in a depressed heartland town where real estate prices are spiraling downward" are seen as a risk, Leonard explains.

Leonard suggests the centers be eligible for the Small Business Administration's 504 loan program, in which a small business asks a non-profit lender to issue "low-interest, fixed-rate, government-backed bonds to finance up to 40 percent of the project," Leonard writes. As of now, the loan program is only open to some for-profit businesses. But Congress could change that, thus opening up possibilities. Moreover, the loan program is "routine and efficient to process" and the "interest rates are among the lowest on the market," Leonard contends.

Another option would be for construction companies and real estate developers to put up the equity themselves, build the facilities and then rent them out to nonprofits "on a long-term lease or through various lease-to-own arrangements." "Indeed, hungry developers and construction firms would find any number of ways to get the hammers swinging," Leonard writes.

Overall, it's a win-win, Leonard argues."It's hard to imagine Congress appropriating any more direct spending to fuel the construction of health centers," he writes. "But there's no good reason why they shouldn't change a few words in a statute to achieve the same end. Not only would it quickly create much-needed jobs in the construction trades, it would also spark economic activity over the long run in some of the places in America that need it most." (Read more)

Boys should get HPV vaccine to keep from spreading virus

A federal committee has recommended that boys receive the human papilloma virus vaccine, already recommended for girls, to fight the sexually transmitted virus that is known to cause cervical cancer. The vaccine could also protect boys against genital warts and anal cancer.

The Advisory Committee on Immunization Practices released its recommendation Wednesday. It is the first time there has been a public push for boys to receive the vaccine, though it has been licensed for male use for the past two years.

Dr. Baretta Casey, director of Cervical Cancer-Free Kentucky, applauded the move. "To stem the spread of the HPV virus and the many problems it causes is the best thing," she said.

The vaccine is usually given at the age of 11 or 12 and is only effective if it is given before a person becomes sexually active. As many as 80 percent of men and women are infected with HPV during the course of their lives, but most do not develop symptoms or illness, the Centers for Disease Control and Prevention reports.

The vaccine has been met with reluctance by parents, some of whom fear it would encourage sexual activity. Last year, just 49 percent of adolescent girls nationwide had received at least the first of its three doses, and only a third had gotten all three. In Kentucky, only 25 percent of adolescent females had received the first dose, and fewer than 11 percent had received all three doses.

Casey attributed parents' hesitation to a fear that the vaccine is harmful, though research shows otherwise. "It's our hope that people understand that this is a vaccine that has been around for quite a while now," she said. "The effects of the immunization are similar to other vaccines that we currently give our children. And if I can give my child a vaccine that would prevent them from ever developing cancer, I'm for it." On average, 391 Kentucky women develop cervical cancer and 66 die.

The cost of the vaccine — about $110 for each of the three doses — is also believed to be a factor in the low vaccination numbers, though Casey said Medicaid covers it, as do major health insurance providers such as Blue Cross Blue Shield and Anthem. Though the numbers are low, Casey said she is seeing some boys being vaccinated in Kentucky "but it's not a widely done practice." (Read more)

PIkeville Medical Center agrees to pay $36,000 to settle claim that it improperly billed Medicare

Pikeville Medical Center has agreed to pay more than $36,000, but does not have to admit any wrongdoing, to settle a lawsuit that accused it of improperly billing Medicare.

The suit was brought by Dr. Michael Fletcher, director of the pain management clinic from May 2005 to July 2007. "The hospital used improper billing codes for the pain management clinic, which indicated services were provided in a private physician's office, rather than a clinic," reports Brett Barrouquere of The Associated Press.

Fletcher alleged the same was being done at the hospital's radiation oncology and medical oncology units and told hospital administration as much, but nothing was done. Fletcher will receive $7,228 as part of the settlement of the suit, filed under the federal False Claims Act. (Read more)

Jury tells nursing home to pay $1 million to former resident

A Fayette County jury has decided that Lexington's Cambridge Place Nursing Home will have to pay more than $1 million in damages to a former resident who fell and was found in an equipment storage room with broken bones in her face.

In January 2009, Irene Hendrix, who has Alzheimer's disease, was reportedly walking up and down a hall using a Merry Walker, which is a walker that has a seat. At some point, Hendrix, right, fell and was found with bleeding in her brain, a 4-centimeter cut on her forehead and the broken bones, the Lexington Herald-Leader's Valarie Honeycutt Spears reports. Hendrix's daughter and guardian filed a lawsuit against the facility later that year, alleging negligence.

After two hours of deliberation, the jury awarded Hendrix $1 million for physical pain, suffering and mental anguish. It also awarded Hendrix more than $27,000 for her medical bills. "A jury spoke today regarding the level of care they expect for their loved ones in nursing homes in Fayette County," plaintiff's lawyer Scott Owens said.

The Cabinet for Health and Family Services and the Office of the Kentucky Attorney General previously investigated Hendrix's case and a state adult-protection worker "determined that Hendrix was a victim of caretaker neglect and had been exposed to an extreme safety risk," Spears reports. "The protection worker told the attorney general's office that she thought Hendrix's injuries were the result of an accident." The attorney general's office closed the case in March 2009. (Read more)

Funds available for critical-access hospitals, rural health-care providers through new federal program

Critical-access hospitals, physician-owned organizations and rural health-care providers are now eligible for federal funds that will help them implement necessary infrastructure and information-technology systems, the U.S. Department of Health and Human Services announced last week. The goal of the program, called the Advanced Payment Model, is to encourage participation in accountable care, one of the cornerstones of the health-care reform law.

Eligible participants must be either accountable care organizations "that do not include any inpatients facilities and have less than $50 million in total annual revenue," or ACOs in which inpatient facilities are critical access hospitals and/or Medicare low-volume rural hospitals and have less than $80 million in annual revenue, reports Karen Cheung in Fierce Healthcare.

An accountable care organization is a network of physicians and hospitals that share the responsibility to care for a group of patients. The organization's payment is tied to achieving health-care quality goals and outcomes. While ACOs are being heavily promoted in the new health care system, they were recently likened to "unicorns" because "no one has ever seen one," said William Hazel, Virginia secretary for Health and Human Resources, at the 2011 Howard L. Bost Memorial Health Policy Forum in Somerset. (Read more)

Almost $675,000 awarded to five facilities to improve health services, reduce disparities

Grants totaling nearly $675,000 will go from the Social Innovation Fund through the Foundation for a Healthy Kentucky to help five Kentucky facilities improve access to health services, reduce health risks and disparities and prompt health equality in their respective communities. The recipients are:

• Meade Activity Center in Brandenburg — $250,000 for physical activity programs for children and families, including after-school and summer activities such as golf, tennis, swimming and trail hiking.

• King's Daughters Medical Center in Ashland — $124,548 for mobile health services to nearly 1,500 residents living in Elliott, Fleming, Floyd, Johnson, Lewis, Magoffin, Martin and Morgan counties.

• Oldham County Health Department in LaGrange — $100,000 for Hope Health Clinic for the uninsured. Will help about 1,200 residents each year living in Carroll, Henry, Oldham and Trimble counties.

• St. Elizabeth Healthcare in Edgewood — $100,000 for behavioral health consultations with mental health professionals for patients in Northern Kentucky who go to the emergency room to get mental health services.

• Norton Healthcare Centers for Prevention and Wellness in Louisville — $100,000 to reduce the risk of cardiovascular disease and increase access to care for 2,200 low-income and uninsured residents each year living in Louisville and metropolitan areas.

"The Social Innovation Fund grant recipients are committed to meeting specific health care challenges in their communities, thereby promoting lasting change in Kentucky's rural and urban communities," said Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky. "These five grants are part of a $12 million total investment in initiatives to address Kentucky's health challenges through the Social Innovation Fund and required matching grants." (Read more)

Beshear may need to support meds-for-meth bill for it to pass, Conway says

Passage of a "meds-for-meth" bill next year could depend on how a re-elected Gov. Steve Beshear feels about the issue, on which he has not taken a position, Attorney General Jack Conway told Ryan Alessi on CN|2's "Pure Politics."

Conway is a supporter of such a bill, which would make pseudoephedrine, a key ingredient in the manufacture of methamphetamine, available only by prescription. Alessi noted that the Democratic governor has remained ambivalent about the issue and asked the Democratic attorney general, "Does the governor need to come out in order to get something like that passed?"

"This is an issue ... that just grabbed me, right here."

Conway replied, "He may need to. He may need to, and I know he's studying the issue." Bringing his hand to his chest, Conway continued, "This is an issue, Ryan, that just grabbed me, right here," adding that he had been wrongly blamed during his U.S. Senate race last year for an increase in meth labs during his term."We have seen an explosion of meth labs in this state for two reasons," he said. "One, it's still very easy to get your hands on pseudoephedrine, and . . . you now can do it in a mobile fashion ... called a shake-and-bake lab." He said U.S. Rep. Hal Rogers, R-Somerset, begged him to support the bill partly because investigators for the UNITE anti-drug program Rogers started are having to shift from prescription drugs to meth.

Conway said he would be open to changing his position if drug companies and other opponents of the bill can come up with a way to control "smurfing," the use of surrogates to circumvent the electronic system that tracks pseudoephedrine purchases but is not even used by most pharmacies.

His Republican opponent, Hopkins County Attorney Todd P'Pool, opposes the bill and says meth manufacture should be controlled by tightening "the law to bar convicted drug dealers from being able to buy cold medicine with pseudoephedrine and cracking down on the amount someone can buy per month," Alessi reports. (Read more, view interview with Conway)

Twice as many kids are killed on roads and streets on Halloween as on any other day, but many parents fail to discuss safety

Only one-third of parents talk to their children each year about how to stay safe on Halloween, a study released by the Safe Kids Fayette County Program has found, even though on average, twice as many child pedestrians are killed during the holiday than on any other other day of the year. (Photo by zirconicusso)

"Given children's limited attention spans, repeated and consistent messages about safe behaviors are key to preventing injuries," said Sherri Hannan, a nurse and coordinator of Safe Kids Fayette County. "By following the basic safety tips provided by Safe Kids, Halloween can be a fun and safe night for children of all ages."

Of the 935 parents surveyed, most said they had talked to their kids at some point about Halloween safety but don't make it an annual conversation. The study also showed 40 percent of parents allow their children to use one or more unsafe items on Halloween, such as a mask, loose-fitting clothing and/or a sharp object.

The study found that 12 percent of children 5 or younger are allowed to trick-or-treat without an adult. "It is alarming to hear that children ages 5 years and younger are trick-or-treating without adult supervision," Hannan said. "If they are old enough and mature enough to trick-or-treat without an adult, parents should make sure children go out in groups and stick to a predetermined route with good lighting."

To keep children safe, Safe Kids recommends:
• Children under 12 should trick-or-treat and cross streets with an adult.
• Children and parents should always walk on sidewalks or paths. In the absence of those, they should walk facing traffic as far to the left as possible.
• Parents and children should cross at corners, using traffic signals and crosswalks.
• Costumes and trick-or-treat bags should be decorated with reflective tape or stickers.
• Parents should check treats for signs of tampering before children are allowed to eat them. Candy should be thrown away if the wrapped is faded, torn or unwrapped.
• Drivers should slow down and be especially alert in neighborhoods.
• Drivers should anticipate heavy traffic and turn on their headlights early in the day.
• Drivers should reduce distractions while driving and pay attention to the road.

Halloween treats can be healthy, and trick-or-treaters with diabetes can still be part of the fun

It wouldn't be Halloween without candy and chocolate in pillowcases and paper sacks. But with childhood obesity and diabetes rates looking as scary as the ax murderers and zombies knocking at the door, parents may consider handing out something other than the usual calorie-packed treats this year.

Courtney Cairns Pastor of The Associated Press suggests five non-candy foods "that won't get your house egged," including pretzel packs, single-serving bags of Goldfish snack crackers, freeze-dried fruit, snack-size microwave popcorn bags and squeezable applesauce. (AP photo) She also suggests handing out items that aren't food related at all, including stickers, temporary tattoos, crayons, bubbles and Play-Doh.

Still, eating a bit of candy on Halloween is tradition — and one still going strong. The National Retail Federation reported Americans spent nearly $1.8 billion on Halloween candy in 2010, spending an average of $20.29 per person.

Though one in four children are diabetic, they needn't skip tradition entirely, research-reporting service Newswise reports. "They can enjoy Halloween and enjoy some of the sweets the holiday offers — within reason," said Dr. Kenneth McCormick, pediatric endocrinologist and senior scientist at the Comprehensive Diabetes Center at the University of Alabama at Birmingham.

McCormick said kids can opt to count their carbohydrate calories; exchange candy for other treats; or save their candy for dessert. By counting carbs, a child pays attention to how much they are consuming and "take, for example, one unit of insulin for every 15 to 20 grams of carbohydrates," Newswise reports. "This is an easy option for kids on an insulin pump because they can just dial in an extra dose of insulin to compensate for what they are about to eat," McCormick said.

Parents can "trade the child a gift, money or low-carb snack for their candy," McCormick suggested. "We have been advising parents to do this for many, many years, and it is a solution that continues to work." Diabetic kids can also avoid problems if they eat their Halloween treats after they have eaten dinner. "By incorporating a sugary treat into meal time, when a child would normally get a dose of insulin, it eliminates the need for adding doses to their regimen," McCormick said. (Read more)

The Halloween candy face-off: Real Simple magazine tries to answer which candy is healthier

A nutritional analysis by Real Simple magazine pitted favorite Halloween treats against one another to see which are healthier. While neither winner is necessarily good for you, the competition offers one way to choose the lesser of two evils. (Photo by Lucas Allen)

Snickers candy bars are a better choice than Reese's Peanut Butter Cups, Kate Rope reports for Real Simple. Snickers "contains less fat, less saturated fat, and 10 fewer calories per two pieces," said Cynthia Sass, coauthor of "The Ultimate Diet Log."

Peanut M&M's or Skittles? Skittles are lower in calorie count, but M&M's will make you feel full longer.

Selecting Kit Kat over Twix will "save you 20 calories and rack up less saturated fat and sodium," Sass said, though it's a toss-up between Candy Corn and Tootsie Rolls.

What about Butterfinger or York Peppermint Patties? "Butterfingers boast 200 calories, 8 grams of fat, and 100 milligrams of sodium," Rope reports. "Meanwhile, three mini York patties pack 150 calories, 3 grams of fat, and 15 milligrams of sodium."

Jolly Rancher beat out Starburst, though not because there is a significant difference in calorie count, but because Jolly Ranchers take longer to suck and you're not as likely to eat several in a row.

Ther survey found for SweeTarts over Smarties; Milky Way over PayDay; Almond Joy over Mounds; Bubble Yum ove rTootsie Pop; and the classic caramel apple vs. candy apple. (Read more)

Tips for staying safe this Halloween include avoiding decorative contact lenses

Though ghouls and goblins willbe out in full force, there will be other, unexpected dangers lurking on Halloween, some before kids even leave the house.

Though glowing, oddly-colored eyes might seem like the ultimate spooky touch to kids' costumes, officials with the Kentucky Optometric Association, along with the Food and Drug Administration, warn against using decorative, non-corrective contact lenses that are sold without a prescription from an eye doctor. (FDA photo)

"Consumers who purchase lenses without a prescription or without consultation from an eye doctor put themselves at risk of serious bacterial infection, or even significant damage to the eye's ability to function, with the potential for irreversible sight loss," said Lisa Sanford Howard, an optometrist in Middlesboro. Risks involve conjunctivitis (pink eye), swelling, allergic reaction and corneal abrasion due to a poor lens fit.

In considering costumes, parents should make sure their children can see well through masks and walk without tripping on their costume, Kentucky State Police advise. While they're on the street, children should carry a flashlight or have reflective tape on their costumes to make them more visible.

"On Halloween evening, we're placing our children in probably some of the most dangerous traffic situations you could imagine," said KSP Lt. David Jude. "Our children are outside after dark, they walk along and cross unfamiliar streets, and they often wear dark colors, which are difficult for motorists to see."

When children get home with their haul, they should not eat treats until they have been checked by an adult. Parents should discard unwrapped or suspicious candy.

The U.S. Census Bureau estimates 41 million kids between ages 5 and 14 will go trick-or-treating this year.

Clinic in Greenup will offer free ovarian cancer screenings for Northeast Ky. women

Women in Northeastern Kentucky will be able to receive free ovarian cancer screenings thanks to funding that will set up a clinic in Greenup County.

The clinic is intended for women in Lewis, Carter, Elliott, Greenup and Boyd counties, as well as two counties in Ohio, but "certainly anyone who arrives at the clinic who meets the requirements will be eligible for screening," said Parry Barrows, spokeswoman for Gov. Steve Beshear's office. Eligible women must be age 50 and older or over the age of 25 who have a family history of ovarian cancer.

The clinic will be an expansion of a program that has been in place in Lexington since 1987. As of September, more than 200,000 screenings have been performed on more than 37,000 Kentucky women as part of the program.

To build the clinic, which will be located in the Greenup County Health Department, a $200,000 Appalachian Regional Commission grant will be combined with $45,000 from UK. The health department will contribute $66,600.

"Funding will go toward purchasing required equipment and furnishings, as well as provide program operations for up to 3 years," saysa press release from Beshear's office. "UK will train local ultrasound technicians to facilitate the scans and the UK Markey Cancer Center will read the scans and deliver patient reports."

"Establishing this satellite clinic ... will help save lives by giving women in northeast Kentucky and southern Ohio better access to free ovarian cancer screenings," said Chris Crum, director of the Greenup County Health Department. (Read more)

Rosalynn Carter Fellowships help journalists report about mental health; applications due April 16

The Carter Center Mental Health Program is providing six Rosalynn Carter Fellowships for journalists to report on a selected mental-health or mental-illness topic for one year. The center overseen by former president Jimmy Carter says its intention is to increase accuracy in reporting about these issues and decrease the prevalence of incorrect and stereotypical information.

Applicants must have at least three years of professional experience in print or electronic journalism. If selected, they will be required to attend orientation and presentation meetings at the beginning and end of the fellowship year. They will also be awarded a $10,000 stipend, but will not be required to leave their current job.

Those wishing to participate must submit a completed application by April 16, 2012. Awards will be announced July 13, 2012. For more information and the application packet, click here.

UK expert available for interviews today on National Mammography Day

A University of Kentucky expert is available for interviews this afternoon to discuss the importance of mammograms. The opportunity is in honor of National Mammography Day, which is today.

Dr. Margaret Szabunio, associate medical director for the UK Markey Cancer Center's Comprehensive Breast Care Center and division chief of women's radiology for UK HealthCare, is available for interviews from 11:30 a.m. to 1 p.m. and 2:45 to 4:30 p.m.

National Mammography Day is part of national Breast Cancer Awareness Month. The purpose of the day is to encourage women to get or make an appointment for a mammogram, which can sometimes detect a tumor up to three years before it can be felt.

A mammogram is an X-ray of the breast tissue. For every 1,000 women screened, about 80 will be called back for more evaluation. Of those, 15 will be recommended for a biopsy, and about one third of those women will be diagnosed with breast cancer.

To set up an interview, contact Allison Perry at 859-323-2399 or allisonperry@uky.edu or Teri Timmons at 859-323-2406 or teri.timmons@uky.edu. (Read more)

Statewide smoking ban bill will be filed again; gubernatorial candidates say it's not necessary at this point

For the second year, a bill that would ban smoking in all public places statewide will be filed and considered by the General Assembly. State Rep. Susan Westrom, left, who proposed a ban last year, outlined her plan Wednesday.

Westrom's proposal, which she presented to the Interim Joint Committee on Health and Welfare, would ban smoking in all indoor workplaces, restaurants, bars and other public places in Kentucky.

Last week, gubernatorial candidates Democrat Steve Beshear, Republican David Williams and independent Gatewood Galbraith all said they did not feel a statewide smoking ban was necessary at this time and that bans should be handled at the local level. That's a change for Williams, who had endorsed a ban. He said he believed the General Assembly would ultimately decide the issue, but for now "the local approach seems to be working" and a governor shouldn't "intervene." Beshear said that as local bans proliferate, there will be enough support for a statewide ban.

But David Adkisson, president and CEO of the Kentucky Chamber of Commerce, spoke to the committee in favor of a ban. "The attitude in Kentucky is changing toward smoking and the health effects can no longer be ignored," he said. "The business community now sees the effects of both smoking and secondhand smoke on our workforces in terms of absenteeism and lost productivity. ... Smoking is not only killing us, it is bankrupting us — both in terms of costs to business and cost of government."

"The momentum at the local level has created a growing demand for a statewide smoke-free law," added Amy Barkley, chair of the Smoke-Free Kentucky Campaign. "We know from experience here in Kentucky and across the nation that smoke-free laws are good for health, good for business, and essential to protecting citizens and workers form the proven hazards of secondhand smoke."

Last year's bill never got a committee hearing, but advocates said hopes were never high that it would pass. They said the time was right to introduce the idea to the General Assembly and educate legislators about the importance of a comprehensive law that would protect all employees, including restaurant and nightclub workers, from second-hand smoke. "Here's what's important: We don't want to settle for a half-baked law," Barkley said. (Read more)

U of L, Frazier get $2.2 million for spinal treatment, research

The Frazier Rehab Institute and the University of Louisville have received $2.2 million for spinal cord research and treatment. The grant, awarded by the U.S. Department of Education, is one of 14 awarded in the country.

The funds will be used to operate the Frazier Rehab and Neuroscience Spinal Cord Injury Model System, which will advance rehabilitative care to people with spinal cord injuries and "be the center of new research in which findings are rapidly translated into clinical and rehabilitation practice," a U of L press release reads.

The model system will serve Kentucky, Indiana, Ohio and Tennessee, and the funds will be used over a five-year period. Goals of the program will be to provide integrated, multidisciplinary rehabilitation care for people with spinal cord injuries; conduct research; and enroll at least 30 patients per year into the model system database, information that will be shared with the other 13 model system centers that will be established around the country.

Daniel E. Graves, who is an associate professor of physical medicine and rehabilitation at the Baylor College of Medicine and the Texas Institute of Rehabilitation and Research in Houston, will come to U of L to lead the undertaking. "The model system is a basic framework for building a research network that can capitalize on the expertise of our current faculty," said Graves, right. "It also will enable us to draw in more scientists to work with us, ultimately bettering the lives of people with spinal cord injury." (Read more)

Parents, children should discuss HPV vaccine, study indicates

A study at Ohio State University found that college-aged women who have talked to their mothers about the human papillomavirus are more likely to get the vaccine that prevents it, Brandy Reeves, right, a certified sexuality educator and health education coordinator at the University of Kentucky, writes in the Lexington Herald-Leader.

HPV is known to cause cancer, including cervical cancer, oral cancer, vulvar cancer, anal cancer and penile cancer.

There are two vaccines for HPV approved by the Food and Drug Administration: Gardasil and Cervarix. "Because men can carry HPV and transmit it sexually to their partners, the FDA has approved the use of Gardasil in both genders, from ages 9 to 26," Reeves writes. "Parents who are nervous about bringing up the topic can focus on how the vaccine is safe and effective, and that it prevents cancer." (Read more)

Conway supports, P'Pool opposes meds-for-meth law; Conway defends decsion not to join lawsuits about federal health reform

In a debate where most of the sparks flew over often-specious questions about conflicts of interest, one of the biggest substantive disagreements between the candidates for attorney general Monday night was about whether to require a prescription for the cold medicine used to make methamphetamine. They also debated President Obama's health-care reform law.

Democratic Attorney General Jack Conway. left, said he supports such a law, which failed in this year's General Assembly, while Hopkins County Attorney Todd P'Pool, right, said he opposes it. The candidates were interviewed by Bill Goodman on KET's "Kentucky Tonight" as part of a series of debates between statewide candidates in the Nov. 8 election.

Republican P'Pool, the first to respond to Goodman's question, said he opposes making pseudoephedrine a scheduled drug because "I think it creates a burden for law-abiding citizens. . . . Let's don’t put a burden on soccer moms." He said he would support "a lifetime ban," which he did not explain, "for anyone convicted of a meth crime."

Conway said his position in favor of scheduling "is not the most politically popular position," but said he responded to a plea from "my friend Hal Rogers," the Republican congressman from Somerset who is a leading advocate. "I know it's not popular with some soccer moms," Conway said, and "I know it's inconvenient" to require a prescription, "but when you see a kid in a burn unit that’s gone through a meth lab it tears your heart." He said children at present at 80 percent of meth labs.

Conway said he is open to changing his position if opponents can show him how to prevent "smurfing," the use of surrogates to avoid the recordkeeping of pseudoephedrine purchases. He said many drug stories do not use the online recordkeeping system. He added that Oregon and Mississippi had "dramatic declines" in the number of meth labs after they scheduled pseudoephedrine.

P'Pool began the debate by sharply criticizing Conway's decision not to join lawsuits by Republican attorneys general challenging the constitutionality of the federal health-reform law: "He's absent form the fight against Obamacare … because he supports Barack Obama and his re-election." Conway replied, "I'm not gonna take some of the valuable resourecs of the office of the attorney general and put 'em on a lawsuit on health care when it’s an issue that’s gonna get decided anyway." He said some attorneys general are supporting the law in court, and "I didn’t join them either because I wanted to focus on Kentucky first."

As Goodman pressed the point, P'Pool said, "It’s really not about health care; it's about the proper role of the federal government." He said Kentucky could join the case with the stroke of a pen, but "My opponent has not been bashful in his support of Barack Obama and that’s why he’s on the sidelines."

Conway replied that the lawsuit "might undo some of the underpinning" of Social Security and Medicare laws. "This is not a perfect bill; some things need to be fixed in health-care reform," he said, but he implicitly defended the bill's requirement to buy health insurance: "It costs Americans on average $46 billion a year to cover the uninsured," he said. "They’re going to the emergency room to get their care … They’re already in the market. This is about being more efficient."

Click here for a story on the debate by Deborah Yetter of The Courier-Journal. Video of the debate is posted online here.

Directory listing 2,500 substance-abuse treatment resources in Kentucky released; every county has at least one facility

There are 2,500 resources for substance abuse treatment in Kentucky, with at least one in each county, research at the University of Kentucky has found.

"In addition to the 345 state-certified substance abuse treatment providers listed in the directory, the peer- and faith-based resources it includes can be just as important for getting someone back on the road to recovery," said Van Ingram, executive director of the Kentucky Office for Drug Control Policy.

The 2011 Kentucky Substance Abuse Treatment Provider Directory is available online by clicking here and can also be obtained by sending an e-mail to michael.childress@uky.edu. The directory is the result of a collaborative effort between Foundation for Healthy Kentucky, which funded the project, the University of Kentucky's College of Communications and Information Studies and UK's Center for Business and Economic Research.

Nationwide, 23.5 million Americans 12 and up needed treatment for drugs or alcohol abuse in 2009, according to the Substance Abuse and Mental Health Services Administration. About 8 percent of 12+ Kentuckians used illicit drugs and 21 percent were binge alcohol drinkers in the past month, SAMHSA reports. On one day in March 2009, there were more than 19,000 people in Kentucky's substance abuse treatment facilities for either drug or alcohol abuse or both, the 2009 National Survey of Substance Abuse Treatment Services showed. (Read more)

Former official: DEA failed to slow prescription drug abuse epidemic by not limiting production

At a time when Oxycontin abuse was rapidly increasing, the Drug Enforcement Agency had the power to slow production of the drug and perhaps stave off what is now a prescription drug abuse epidemic in rural areas across the country, reports Guy Taylor of Salon. However, the agency allowed production of Oxycodone, the non-generic form of Oxycontin, to increase by 1,200 percent over a decade.

After the Food and Drug Administration approves a drug for production and sale, a section of the DEA known as the Office of Diversion Control decides how much of a drug can be manufactured. By law, the makers of Oxycodone and its generic forms have to present a quota approval application to Diversion Control. The office decides whether the amount requested can be manufactured. With the help of statistics provided by a former head of Diversion Control, Gene Haislip, Taylor discovered that in 1997 when Purdue Pharma first introduced Oxycontin, it was allowed to make 8.3 tons. This year, the DEA approved the manufacture of 105 tons.

Haislip tells Taylor DEA approved the increase in production in the face of a growing drug abuse epidemic, showing a "serious lack of accountability and oversight." Says Haislip: "The DEA is the lone federal agency with the power to decide how much of the drug gets made and put out there; it alone has had all the responsibility to do something about this problem." He told Taylor the agency should have learned from two examples in the 1970s and 1980s, when Diversion Control reduced quota requests for pill-based amphetamines and Methaqualone, the main ingredient in Quaaludes. When the quotas were reduced, illicit use of those drugs significantly decreased.

Asked why the agency allowed the production quota of Oxycodone to increase so much, DEA supervisory special agent Gary Boggs told Taylor the agency is required to set quotas at a level that "ensures an uninterrupted supply for the legitimate medical and scientific research needs of the United States, and that those needs are always changing as the population grows and as medical science finds different needs for products." He said there are patients who need the drug for medical purposes and the agency cannot limit their access because of those who abuse it.

Taylor opines: "The fact is that the U.S. government has adopted a position on prescription painkillers that differs from its policy toward other controlled substances such as cocaine, heroin and marijuana: Unlike those drugs, the DEA says limiting the supply of the prescription painkillers will not reduce abuse." He reports the agency's lack of oversight in the production of Oxycodone is "perplexing" to state and local governments now battling prescription pill abuse crises in their areas. Ohio Department of Alcohol and Drug Addiction Services director Orman Hall told Taylor the "the loss of life and the carnage associated" with prescription drug abuse could have been prevented had the DEA limited the production of Oxycodone. (Read more)

New Florida laws helping stem flow of pills, but loopholes remain and trade is shifting to other states

Though pill mills continue to be a big problem in Florida, where lax laws have fueled Kentucky's prescription pill trade, there is evidence that the tides are slowly turning in the Sunshine State. "Registered pain clinics in Florida have dropped from 930 last year to 736 now as the state begin to crack down," reports Laura Ungar of The Courier-Journal in the second installment of a special report on prescription drug abuse. (C-J photo by Kylene Lloyd: Broward County Detective Brann Redl)

A Florida law that took effect in July increases penalties for physicians who over-prescribe, tightens rules for prescriptions and pain-treatment regimens, and decreases the amount of time dispensers have to report the sale of prescription drugs into an electronic monitoring system that started Sept. 1.

The worry now is pill mill operators may just move to surrounding states. Georgia has seen a surge in clinics. "Each community outside of Atlanta is seeing an increased problem," said John Horn, first assistant U.S. attorney in Georgia, which has no electronic prescription-drug monitoring program. Some Kentucky addicts are heading to Ohio, Tennessee or West Virginia to get their pills, though now an interstate task force is helping to curb those efforts. (Read more)

There is also fear that the new law in Florida contains loopholes. "For example, board-certified pain specialists, such as anesthesiologists and surgeons, are exempt from pain-clinic registration and inspections," Ungar reports. The law also "doesn't require drug testing for patients."

But there are efforts on the national level by the U.S. Drug Enforcement Agency to stem the problem. Operation Pill Nation, launched in 2010, resulted in the DEA and other agencies making 340 undercover buys from more than 60 doctors working in more than 40 clinics in the first nine months of the operation. "The first arrests came in late February, when 22 people were picked up in one day," Ungar reports. A Florida strike force that started in March resulted in 937 arrests, including 17 doctors, and the confiscation of more than 250,000 pills.

There is also evidence that state drug monitoring systems work because they are a "major deterrent to doctor-shopping and a main reason Kentuckians go to Florida for drugs," Ungar reports.(Read more)

Despite new laws, Florida still fuels 'pill pipeline' to Kentucky

If you thought Florida's recent moves to stop the "pill pipeline" to Kentucky have worked, think again. "Cash-only clinics continue to operate throughout the Sunshine State, with doctors indiscriminately doling out prescriptions for such drugs as oxycodone and Xanax, often after little more than a cursory physical examination or a glance at an old MRI scan," Laura Ungar of The Courier-Journal reports from Fort Lauderdale. (C-J photo by Kylene Lloyd: Florida addict Bree Saghy shoots up crushed oxycodone, for which she has a prescription)

Florida has "new laws that forbid felons from owning clinics, strengthen penalties for doctors who over-prescribe painkillers and tighten rules for prescriptions and pain-treatment regimens," Ungar writes for the Louisville newspaper. "But anti-drug activists and officials worry they don’t go far enough, that pain-clinic operators, for example, will continue to charge hundreds of dollars in fees to customers or send them to associated pharmacies that may give the clinics a share of the profits — and Kentucky will keep paying the price. Local law enforcement and drug-policy officials estimate that 60 percent of Kentucky’s illicit pills come from Florida. . . . Police in Hazard, Ky., say there are neighborhoods in that Appalachian city where nearly every other household includes an addict or a dealer, and Deputy Chief Joseph Engle lays the blame squarely on Florida’s pain clinics, calling the doctors who allegedly fuel the trade 'murderers.'"

And the pills continue to be easy to get. The first step is usually to get an MRI, which gives the doctor an excuse to write a prescription. "Some bring old scans, try to pass off other people's as their own or get new ones at Florida imaging centers that sometimes have referral arrangements with clinics," Ungar reports. One recovering addict said he paid $500 to get an MRI and gave it to a doctor in Boca Raton. "You go down there, and they act so professional. But you are both knowing that nothing's wrong with you," he said.

The result has had a big effect on the Appalachian region of Kentucky. Dr. John Robert Morgan, who has worked in several Eastern Kentucky hospitals, spoke of one overdose patient "who came in with a bottle containing more than 200 oxycodone pills prescribed by an obstetrician/gynecologist in Miami. However, the patient was a man," Ungar reports.

The C-J devotes most of its Sunday front page and four inside pages to the issue. To read it and view videos online, click here. UPDATE, Oct. 17: A second installment takes most of the front plus two pages inside; there's also an interactive map and video narrative from Ungar; click here for the whole series.

Ex-boss of defunct Jenkins personal-care home accepts federal plea deal; he and relatives still face state charges

"The former administrator of a Letcher County personal-care home that was recently shut down by the state pleaded guilty Thursday in federal court to a charge that he took thousands of dollars from residents," Valarie Honeycutt Spears reports for the Lexington Herald-Leader.

James F. "Chum" Tackett of Jenkins accepted a prison sentence of two years and two days in prison, and agreed to repay $113,547 that he admitted embezzeling from the federal benefits of residents at the Golden Years Nursing Home. He still faces state charges, including felony theft. His daughter has been charged with failure to make required disposition of property, in relation to the home, and his grandson, who succeeded him as administrator, has been charged with bribing a witness and other felonies. (Read more) 

Republican leader and former U of L trustee says university made poor argument that hospital isn't public

The University of Louisville made a “terribly flawed argument” when it claimed that University Hospital was not a public entity, former U of L Trustee Bill Stone told cable channel cn|2's "Pure Politics" program yesterday. "That argument has been central as university leaders try to finalize a merger with two private hospital groups, Jewish Hospital and Catholic Health Initiatives," Ryan Alessi notes.

Stone, a former Jefferson County Republican chairman, said he agreed with Democratic Attorney General Jack Conway's ruling in an open-records case that the hospital is a public entity, and “I don’t know of any lawyer of merit who wouldn’t agree with Jack Conway’s assessment. That has been the weakness in U of L’s selling point. The University of Louisville Hospital is part of the university.”

Alessi reports, "Stone said the university should be highlighting the positives of the merger." Stone told him, “I think this merger can be sold to the public on the basis of how much it will mean to this community economically, what it will mean from a prestige point of view, where it will be an incubator for Nobel Prize-winning scientists.” For the story and video, click here; for the video only, on the image above.

Nurse practitioners endorse new plan to fight prescription drug abuse, ask to be on board that will recommend standards

UPDATE, Oct. 14: Gov. Steve Beshear's executive order did not create a slot for advance-practice registered nurses on the advisory council, which will have representatives appointed by Beshear and nominated by the Kentucky Board of Medical Licensure, the Kentucky Board of Dentistry, the Kentucky Board of Nursing and the Kentucky Board of Pharmacists. "The medical licensure boards will send the governor a list of nominees for the slots on the advisory council, and the governor will name the full council within the next few weeks," a release from Beshear's office said.

The Kentucky Coalition of Nurse Practitioners and Nurse Midwives is endorsing the plan announced Thursday by state officials to fight prescription drug abuse, but asking that advance-practice registered nurses (APRNs) who prescribe controlled substances be added to the advisory board that will set standards for over-prescribing.

“We believe that the addition of APRNs who are prescribing controlled substances for different populations will be very helpful . . . in creating guidelines for generally accepted practices,” Julianne Ewen, president of the 2,049-member coalition, said in the release, available here.

Advance practice registered nurses may prescribe controlled substances within certain limits. Wendy Fletcher, past president of the coalition, noted that APRNs make up 9.9 percent of all prescribers in Kentucky but prescribe only 3.7 percent of controlled-substance prescriptions in the state and “have demonstrated that they are responsible prescribers.”

While fewer than a third of Kentucky doctors use the Kentucky All Schedule Prescription Electronic Reporting database, "APRNs who prescribe controlled substances have eagerly made use of the KASPER tracking system," the release said. The coalition wants the legislature to require that all APRNs who have a Drug Enforcement Agency number register for a KASPER account.