Kentucky leads nation in drug-fraud prosecutions and settlements

Kentucky leads the U.S. in pursuing pharmaceutical fraud, according to a report by the Washington, D.C.-based consumer group, Public Citizen. Since 1991, the state has pursued the most claims against pharmaceutical companies and reached more than 30 settlements. It pursued 17 single-state settlements, the most of any state.

The most common violation was overcharging Medicaid programs for services, mostly for drugs, Beth Musgrave of the Lexington Herald-Leader reports. The violations that netted the biggest penalties were for improper promotion of drugs. Attorney General Jack Conway oversees the Office of Medicaid Fraud and Abuse Control; his spokeswoman, Shelley Catherine Johnson, told Musgrave the agency has recovered or been awarded more than $265 million since Conway took office in January 2008. (Read more)

Pill-mill bill causing problems for patients who have long-term prescriptions: expensive drug-screening tests

In July, Kentucky started making long-time holders of certain controlled-substances prescriptions submit to urine tests to determine if they were actually taking the drugs, rather than selling them. Because insurance companies don't consider the tests medically necessary, patients often have to pay for them out of pocket. It can be expensive, reports John Cheves of the Lexington Herald-Leader, citing one couple that had to pay $533.

The tests are required under emergency regulations issued to implement House Bill 1, the "pill mill bill," and Gov. Steve Beshear has said he understands the financial burden the tests can bring on those who are not abusing prescriptions. Changes could happen in January when the emergency regulations expire and are replaced with permanent rules, Cheves reports. The Kentucky Medical Licensure Board is hearing complaints, and has extended a grace period for compliance for doctors until Nov. 1.

"But critics say they warned last spring that HB 1 — intended to crack down on the illicit sale of prescription drugs — would treat everyone like a potential felon, including doctors and patients engaged in legitimate medical care," Cheves reports. Much debate about the bill has revolved around its implication on doctors, with little attention paid to patients. Cheves reports that soon may change.

Under the law, doctors are required to get an initial urine test from patients who have long-term controlled substance prescriptions. They must also get random drug tests once a year for "low-risk" patients who are most unlikely to abuse drugs based on test results, and three times a year for "high risk" patients. The amount of people requiring drug tests is "likely to be in the tens of thousands," Cheves reports. (Read more)

Health reform's exchange won't attract many new insurers to Ky. because it's a small, sickly state, former Medicaid boss says

Kentucky is unlikely to attract many new insurance companies when it starts its Health Benefits Exchange a year from now, a former state Medicaid commissioner told Dawn Marie Yankeelov for a story in The Lane Report.

“Kentucky is not a big attractor,” said Elizabeth Ann Johnson, a lawyer with Stites and Harbison in Lexington office. “We are a small state for insurers, and we have a sicker population statistically – we see high Medicaid use. I would be surprised to see new players flood into the state.”

The exchange, required by the federal health-reform law, will be a "web-based marketplace that includes information necessary so Kentuckians can compare price and quality as they shop for health insurance," Yankeelov notes. "It also will assist employers in facilitating enrollment of their employees into health plans, enable individuals to receive insurance-premium tax credits and subsidies, and qualify small businesses for tax credits. . . . The average employer and employee in Kentucky will be able to find information on the exchange through a planned Navigators program, an outreach and education program that will be staffed by employees trained and certified to discuss the exchange."

University of Kentucky researchers have estimated that as many as 2.4 million Kentuckians may use the exchange. "The high end of this estimate includes approximately 1.4 million individuals currently receiving employer-sponsored insurance through their large employers," Yankeelov notes. Her story has other good background information on the law, the exchange and the problem of the uninsured, who make up about 15 percent of Kentucky's population. Read it here.

Health Benefit Exchange advisory board forms panels to help draft application Kentuckians will use to obtain health insurance

At its first meeting yesterday, the Kentucky Health Benefit Exchange Advisory Board created committees: Behavioral Health, Dental/Vision, Education/Outreach, Navigator/Agent, Qualified Health Plans and Small Business, reports Jodi Mitchell of Kentucky Voices for Health. (Illustration from The Lane Report)

Exchange officials urged the Navigator, Qualified Health Plans and Small Business committees to meet immediately to provide feedback for the draft of the insurance application that must be filed with the federal government by Nov. 16. The Navigator Committee will meet Thursday, Oct. 4 at 1:30 at the exchange offices at 12 Mill Creek Park, off Millville Road near Frankfort.

Anyone interested in serving on the committees is asked to email Carrie.Banahan@ky.gov as soon as possible.  Meetings of the committees will be posted on the Cabinet for Health and Family Services open-meetings site and will soon be available on a new exchange site. The next full meeting of the Advisory Board will be Oct. 25 at 1:30 p.m. at the exchange offices.

More information on state exchanges, which will serve as marketplaces for health insurance under the federal reform law, is available here.

Federal official and expert on integrating physical and behavioral health services will speak in Louisville Wednesday morning

The integration of physical health and behavioral health services, one of the hottest topics in health care, will be the topic of a Health Enterprises Network forum in Louisville Wednesday, Oct. 3.

The speaker will be Kathleen Reynolds, director of the federal Center for Integrated Health Solutions, vice president of health integration and wellness for the National Council for Community Behavioral Healthcare and author of Raising the Bar: Moving Toward the Integration of Healthcare. She will review the landscape of integration, discuss how it will affect Kentucky, and offer ideas on how health-care organizations can accomplish it.

The forum will be held from 8 to 9:15 a.m. Oct. 3 at the University of Louisville's Clinical and Translational Research Building, 505 S. Hancock Street. The registration fee for members of the Health Enterprises Network is $45; non-members $60; full-time students $10. For more information call 502.625.0179 or email Register@HealthEnterprisesNetwork.com.

Mayfield named state's top doctor, as head of health department

Dr. Stephanie Mayfield

Dr. Stephanie Mayfield has been appointed as the commissioner for the state Department for Public Health, making her the first woman and first African American to hold the position, which has typically been held by a physician. The appointment was made by Audrey Haynes, secretary of health and family services.

The department is the largest health-care provider in the state, with an annual budget this year of almost $400 million. It includes 59 county and district health departments, many of which are "financially struggling," notes Beth Musgrave of the Lexington Herald-Leader. "The health departments have seen their budgets cut in recent years, leading to some lay offs and furloughs." (Read more)

Mayfield has been director of Kentucky’s public health laboratory since 2005. According to the Cabinet for Health and Family Services, Mayfield and the state lab team have been instrumental in speeding up tuberculosis detection and in testing the state's newborns for a wide array of problems. In addition to overseeing the state lab, Mayfield has also served as a lecturer on rotation at the University of Kentucky School of Medicine’s Preventive and Occupational Medicine Residencies and the University of Louisville School of Medicine’s Department of Pathology.

Dr. Steve Davis, who as deputy commissioner has run the department for more than a year, tells Kentucky Health News that he will remain in the agency.

Obesity alert study: Portion size labels can be deliberately confusing and consumers are easily, even willingly, fooled

Yikes! According to the Centers for Disease Control and Prevention, the "large" soda you order today is about six times as large as the one you ordered 60 years ago. "Food sizes have become larger over time," says Aradhna Krishna, a University of Michigan marketing professor who has been looking into portion size and perception. "So, that same hamburger has become bigger, the french fries have become bigger, and again this is leading to obesity."

Thinking a lot about this, Krishna tried an experiment. She gave people cookies that were labeled either medium or large, and then measured how much they ate. "The catch? The cookies were identical in size, What happened? You guessed it," reports NPR's Helen Thompson and Shanikar Vedantam. "People ate more cookies when they were labeled 'medium.' Rather than trust what their stomachs were telling them, in other words, people went by the label." It gets worse: "(They) think they've not eaten as much," says Krishna.

The researcher said women have known all about this principle for awhile, because it's what's been happening with sizes of clothing. It's something called "vanity sizing."  "What used to be a size 8 in the 1950s has become a size 4 in the 1970s and a zero in 2006," Krishna said. It makes you feel better about yourself and your body image. The real question, she asks, is how much do we want to be lied to or, indeed, how much do we lie to ourselves? (Read more)

Tenn. study suggests rural residents have as much access to care as anyone, if they're insured and don't mind the drive

A health-care study in Tennessee, which started with the premise that people in rural areas have less access to care than urban dwellers, ended with a rather surprising conclusion: They don't. Not if they have health insurance. "When it comes to commercially insured patients, there’s little disparity in access to health care between residents of rural communities and urban areas in Tennessee," said Dr. Steven L. Counter, president of the BlueCross BlueShield of Tennessee Health Institute.

How can this be? The study found that almost half of rural residents pass up the hospitals closest to their homes to go to larger urban hospitals, even if the same services are available locally, writes Getahn Ward of The Tenneseean. "The conclusion we came to is that we’re living in a very mobile society, and the distance is not necessarily a determinant factor in whether people get care or not," said Coulter.

Because the survey did not include consumers, it's only a guess about why they chose to take the time and trouble to go to the big town, but experts says it's a combination of services not being available or a perception that they aren't, even if they are. This raises, again, age-old questions about the viability of rural hospitals, some of which often don’t have the money for capital-intensive technology and services. However, Coulter told the Tennessean that "a recent increase in alliances between rural hospitals and larger hospitals and urban health systems raises hopes that non-urban hospitals may be able to expand their menus of services."

Such partnerships between non-profits and for-profit chains are becoming more common, reports Ward, and some say those efforts will change the perception of those in far-flung regions that great medicine is being practiced close-by. This could be especially important, said Wes Littrell, chief strategy officer and president of Nashville-based Saint Thomas Health, in the new world of health reform. “We expect that when you get more into population management that you need to take care of the patient closer to home in the lower-cost setting,” he said. (Read more)

Kentucky doctor honored for her work in bolstering health and preventing deaths of babies born a few weeks early

A Kentucky neonatalogist was honored this week for giving the state "a role in catalyzing a national movement around healthier babies." Ruth Ann Shepherd, M.D., division director for maternal and child health in the Kentucky Department for Public Health, was presented the Association of State and Territorial Health Officials Presidential Meritorious Service Award and recognized as "an early pioneer in recognizing the critical public health problem of preterm births in Kentucky, and that the troubling trend was common to most states in the country."

According to New Public Health, an online publication of the Robert Wood Johnson Foundation,  Shepherd’s research "revealed that babies born at 37 or 38 weeks had far worse health outcomes than babies born at 39 or 40 weeks. With support from the leadership at the Kentucky Department of Health, and many other organizations who have since taken up the cause of helping to create conditions for healthier babies, many states are beginning to make strides in preventing early births."

Charles Kendall, chief of staff at the Kentucky Health Department, told the online magazine that the  prematurity rate for infants in Kentucky was exceptionally high, averaging at about 36 weeks at the time of birth.  "There was a corresponding infant death rate that was far exceeding the national average When she looked at the data, it occurred to her that many of those deaths could have been prevented.," he said. "Much of the prematurity rate had nothing to do with medical issues. The data were telling her that women who smoke are much more likely to deliver early and to have smaller babies. The size of the baby was really the predictor for the infant death rate."

 But what Shepard also understood, said Kendall, was that a lot of these births were actually planned for convenience. "That was one of the more startling pieces of information from the data. In many cases it was not a medical issue but a lack of education or convenience. She also brought the science from her work that showed that the fetal brain is still in critical stages of development in those early weeks, and that it’s not at its full capacity until 39 or 40 weeks. That was very compelling. She also said this is not just a Kentucky issue. This is going on everywhere." ( Read more

Kentucky has the nation's third highest rate of cardiac disease. Learn more, Sept. 29 is World Heart Day

September 29 is World Heart Day, and, according to the most recent edition of the United Health Foundation’s America’s Health Rankings, Kentucky has the third highest percentage of adults with cardiac disease. Arizona and West Virginia were the only states that ranked worse than Kentucky. It is the leading cause of death in the United States for both men and women.

According to the Heart Disease and Stroke Action Plan for the State report for 2011-2016, Kentucky women also have a higher heart disease age-adjusted death rate of 205 per 100,000 as compared to a national average of 176 per 100,000.  Further, 41 percent of adult women in Kentucky have high cholesterol, a leading indicator for the disease. To read the state action plan, go here. For more on World Heart Day and the World Heart Federation, go here.

Kentucky Parent Survey: We could do a lot better on school meals, we're very much in favor of more health education

Fewer than 10 percent of Kentucky
parents report that their child has ever
walked or biked to school.

When asked, only about one in four Kentucky parents describe the meals served at their child's schools or day care centers as being nutritious. Fewer than 10 percent report that their child have ever walked or biked to school. And an overwhelming majority want information about sexually transmitted infections, human anatomy, abstinence education, birth control methods and condom use taught in Kentucky's high schools.

These are just a few of the surprising results from the first Kentucky Parent Survey conducted by the Foundation for a Health Kentucky, a random telephone survey of 1,006 parents of children under 18. The survey assessed the views of parents, step-parents, grandparents, foster parents and other legal guardians of children in Kentucky. The term "school" was used broadly in the survey as included (2 percent of total surveyed), as well those in pre-school and day care. The study took on nutrition, physical activity and health education.

Eighty-eight percent of parents reported that it was "very important" that meals at schools meet a minimum standard for nutritional value. Only about 1 in 4 parents currently thought their schools were meeting that standard. Only 11 percent are concerned that their younger children are getting too many "celebration-related" treats at their school.

While parents in the state reported that a little more than half (52 percent) of school-age children took physical education classes, that class was not a daily occurrence but met between one and four times a week. Only about 1 in 3 students took a daily course in P.E. That leaves 14 percent without a planned daily class during the school year.

On the topic of health education, parents reported that half of school-age children in the state took health classes, but again not daily. According to the FHK, "The Kentucky Parent Survey included a series of questions about dating relationships and sexual health to determine support for covering those topics...
At the middle school level, more than 8 in 10 parents would favor teaching communication skills (99 percent), human anatomy (91 percent), abstinence education (85 percent), and information about HIV and sexually transmitted infections (84 percent). At the high school level, more than 8 in 10 would favor teaching communication skills (99 percent), information about HIV and sexually transmitted infections (97 percent), human anatomy (97 percent), abstinence education (94 percent), birth control methods (87 percent), and condom use (84 percent)."

Future reports in the FHV series will address access to safe and effective health care for children, children's health behaviors and family routines and the places where parents turn for information on raising healthy kids.

Walmart, Humana to give discount on healthier grocery choices like veggies, fruit, lean meat, skim milk, certain packaged goods

Starting Oct. 15, more than 1 million members of Humana Inc.'s Healthy Rewards program will start getting a 5 percent credit on about 1,300 healthy food items at all U.S. Walmart stores.  The credit can be used against future purchases at Walmart, which is the largest U.S. food retailer.

Walmart has taken note that "one of the biggest barriers to healthy nutrition is cost," Dr. John Agwunobi, president of health and wellness at Walmart, told Reuters. His company, he said, is trying an overall approach to improve the nutritional value of the food it sells. And because food accounts for more than half of Walmart's annual sales, and since it has tremendous clout in the U.S. market, the hope is that changes at its stores can influence other supermarket chains to do more about healthy eating.

Walmart products eligible for the credit include fresh fruits, vegetables, lean cuts of meat, skim milk, brown rice and packaged goods, the company told Reuters. The program works with a HumanaVitality card provided to members of Humana's rewards unit who receive points for meeting health goals. (Read more)

18 Kentucky hospitals cited as 'top performers' on accreditation board's annual list

Eighteen Kentucky hospitals have been included on the annual list of hospitals that have excelled at adhering to basic procedures for surgery and other treatment of common illnesses such as heart attacks, heart failure and pneumonia. The Joint Commission, the nation’s major hospital accreditation board, has released this year's list of 620 hospitals considered to be “top performers” for following recommended protocols at least 95 percent of the time. The top 18 percent of accredited hospitals make the list.

Among the Kentucky hospitals that qualified on all four measurements were Greenview Hospital in Bowling Green, Ephraim McDowell Regional Medical Center in Danville, St. Elizabeth Medical Center in both Florence and Fort Thomas, Central Baptist Hospital in Lexington.

Those qualifying in three categories were the Robley Rex Veterans Affairs Medical Center in Louisville (not in surgery) and the Appalachian Regional Hospitals in Harlan and Middlesboro (not in heart attack).

Qualifying in two categories were Twin Lakes Regional Medical Center in Leitchfield, Frankfort Regional Medical Center, the Hospital of Louisa and Jackson Hospital Corp., all for pneumonia and surgical care.

Recognized for pneumonia care were Parkway Regional Hospital in Fulton, Paul B. Hall Regional Medical Center in Paintsville, Logan Memorial Hospital in Russellville and the KentuckyOne Health Hospital in Martin.

Among behavioral-health hospitals, ranked on their in-patient psychiatric care, the Kentucky facilities on the list were the Universal Health Services facility in Bowling Green, the new Cumberland Hall Hospital in Hopkinsville.

According to Kaiser Health News, the Leapfrog Group, a nonprofit organization devoted to patient safety, aided in the rankings process, as did Consumer Reports. The Commission has its own metrics. It's worth noting that next month, Medicare will start using hospital quality rankings on its Hospital Compare website to set reimbursements. (Read more)

After two days with doctors at work, Herald-Leader columnist wonders about patients and future of health-care system

Tom Eblen

Tom Eblen, the Lexington Herald-Leader's local columnist and former editor, spent two days shadowing doctors last week and lived to tell about it. Part of the Lexington Medical Society's Mini-Internship Program, Eblen was given a close-up look at the working lives of physicians and the world in which they, well, operate. He found himself alongside an orthopedic surgeon replacing shoulders, doing fascinating retinal work with an caring opthalmologist, in an emergency room on a slow day and with a busy internal medicine specialist. He learned more than confirming he had probably made the correct career choice, he writes.

In the emergency room: "A middle-aged man with a history of heart trouble came in with chest pains. An elderly man came in suffering from dizziness. A young man came in with an infection from a mouth full of rotten teeth. Like more than one-quarter of all Kentuckians, the young man and several other people Wooster saw that day had no health insurance. What people forget when they debate the cost of universal coverage is that society already pays for treating uninsured people, often at high-cost emergency rooms. . . .

"As I shadowed these physicians, I kept thinking how much of their patients' pain and suffering could have been avoided if they had taken better care of themselves — if they had eaten better, gotten more exercise, and avoided cigarettes and substance abuse. I wondered how we will continue to manage not only our health care system, but our rising expectations. As people live longer and get sicker, we may need to focus more on quality of life rather than simply extending it at all costs." (Read more)

White children exposed to high levels of chemical BPA are five times more likely to be obese, study concludes

White children exposed to high levels of bisphenol A, better known as BPA, are five times more likely to be obese than children with low levels, according to a study published last week in the Journal of the American Medical Association. The study by the New York University School of Medicine is the first to link the chemical to obesity in children, which is especially prevalent in Kentucky.

Environment Health News reporter Brien Bienkowski reports that scientists found traces of BPA, which are used in some canned food and beverages, paper receipts and dental sealants, "are found in virtually every U.S. adult and child. In the study of body mass and BPA data from 2,838 youths aged 6 to 19, only white children were found to have significant increases in obesity prevalence as their BPA levels increased. Those with the highest concentrations in their urine were five times more likely to be obese than children with the lowest levels. Black children with higher BPA levels were 1.25 times more likely to be obese than those with lower levels, which the scientists said is not statistically significant. Hispanic children had the same rates of obesity at the highest and lowest levels."

Bienkowski reports that "representatives from the chemical industry said the study had too many weaknesses to prove any connection. Steven Hentges, from the American Chemistry Council's Polycarbonate/BPA Global Group, said that attempts 'to link our national obesity problem to minute exposures to chemicals found in common, everyday products are a distraction from the real efforts underway to address this important national health issue.' "

One study of preschoolers in North Carolina and Ohio found that 99 percent of BPA exposure was through food. But since the chemical is in many plastics and other products, this is difficult for scientists to pin down. “People are always told if you just stop eating or exercise more, you will lose weight. But there may be more to it … and I think there is,” said Retha Newbold, a visiting scientist at the National Institute of Environmental Health Sciences, who specializes in BPA and other endocrine-disrupting chemicals.  (Read more)

James Bruggers, environmental writer for The Courier-Journal, noted the report here.

Lexington lawyer writes booklet helping Kentucky businesses to break down health-care reform law

Margaret Levi, a lawyer with the Lexington firm of Wyatt, Tarrant & Combs, has authored a new publication, The Impact of Health Care Reform on Kentucky Employers. The 68-page booklet, published by the Kentucky Chamber of Commerce, is a readable summary of The Patient Protection and Affordable Care Act, writes Greg Kocher of the Lexington Herald-Leader.

The law that started taking effect in March 2010 has had more more interpretations and critics than it has pages -- that's 2,555, if you don't count the legal citation references that require reading included within it. "There's a lot of criticism of it from people who haven't read it, and I think you have to know it before you can criticize it," said Levi, a Danville native and resident, said of the law. "I'm not taking a political position one way or another. I am neutral and I tried very hard to remain neutral."

The most common misconception about the law "is that all health care is going to be free and people can get all the care they want," Levi told Kocher. 'So there are some unrealistic expectations on behalf of consumers."

Levi also noted some confusion about how different-sized businesses qualify for different exemptions under different provisions of the law.  She said that some employers are weighing the "pay or play" mandate that takes effect in 2014. Under that provision, writes Kocher, "employers with 50 or more employees must provide 'minimum essential' health plan coverage to their eligible employees or pay a penalty if an eligible employee obtains coverage through a state-sponsored health insurance exchange and qualifies for benefits subsidized by the government. An employer who offers no health coverage will be subject to a penalty equal to $2,000 a year per employee after the first 30 employees. "I think some employers are doing the math as to whether they pay the penalty or provide insurance for their employees," Levis said. "I saw a report that said 88 percent of employers are still going to provide the coverage."

Jim Ford, vice president of business education for the Kentucky Chamber, told Kocher that the booklet "basically says here are the rules, here's what it means, here's what implementation means. We're leaving politics at the door. Here's what you need to know." (Read more) For information on buying the booklet, go here.

Life spans of the least educated are shrinking; steepest decline among white women, biggest gap among white men

Here's some bad news for states like Kentucky, which are overwhelmingly white and have large shares of the population that did not graduate from high school: A new study "that looks separately at Americans lacking a high school diploma found disturbingly sharp drops in life expectancy for whites," and four previous studies support that case, reports Sabrina Tavernise of The New York Times.

"The reasons for the decline remain unclear," writes Tavernise, "but researchers offered possible explanations, including a spike in prescription-drug overdoses among young whites, higher rates of smoking among less-educated white women, rising obesity, and a steady increase in the number of the least-educated Americans who lack health insurance."

Dr. S. Jay Olshansky

White women without high-school diplomas are at particular risk, said S. Jay Olshansky, a public health professor at the University of Illinois at Chicago and the lead investigator on the study, published last month in Health Affairs. They lost a whopping five years of life expectancy between 1990 and 2008, he said.

That's big. To understand just how big: The average life expectancy for white women without a high-school diploma was 73.5 years, compared with 83.9 years for white women with a college degree or more. For white men, the gap was even bigger: 67.5 years for the least educated white men compared with 80.4 for those with a college degree or better.

The slump is now the subject of an inquiry by the National Academy of Sciences. “There’s this enormous issue of why,” said David Cutler, an economics professor at Harvard University. “It’s very puzzling and we don’t have a great explanation.” And it is yet another sign of distress in one of the country’s most vulnerable groups during a period when major social changes are transforming life for less educated whites. (Read more)

Government says health-reform law to save average Kentuckian with Medicare coverage $5,000 through 2022

The U.S. Department of Health and Human Services says the Patient Protection and Affordable Care Act will likely save the average person with traditional Medicare coverage $5,000 from 2010 to 2022, and people with Medicare who have high prescription drug costs will save more than $18,000 over the same period, based on the agency's estimates.

The department also announced that seniors and people with disabilities in Kentucky have already saved $85.5 million on prescription drugs since the law was enacted. Nationwide, the report states that over 5.5 million people have saved nearly $4.5 billion on prescription drugs since the law was enacted. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year.

Study estimates that secondhand smoke kills 42,000 Americans a year, and 900 of those are babies

More bad news for smokers and those who love them: A report out this week in the American Journal of Public Health says secondhand smoke is accountable for 42,000 deaths of non-smokers each year in the U.S., including nearly 900 infants. Kentucky likely has more than its share of those deaths because the percentage of Kentuckians who smoke is the nation's highest.

The study at the University of California, San Francisco notes that those annual deaths represent nearly 600,000 years of potential life lost and $6.6 billion in lost productivity, amounting to $158,000 per death.

The study by Wendy Max a professor of health economics at the UCSF School of Nursing, involved the first use of a biomarker to gauge the physical and economic impacts of cigarette smoke, and revealed that secondhand smoke exposure disproportionately affects African Americans, especially their infants. 

Doctor complaints about bill aimed at reducing prescription drug abuse largely based on misconceptions, health officials say

State health officials say doctors' complaints about House Bill 1, which cracks down on pill mills and doctors who supply the illegal prescription pill trade, result from misunderstandings and misconceptions about the law's language and intent, Mike Wynn of The Courier-Journal reports. Doctors say the bill's regulations are excessive and restrict their ability to write common prescriptions.

Assistant deputy inspector general Stephanie Hold, of the Cabinet for Health and Family Services, said doctors have at least 19 misconceptions about the state's drug tracking system, Kentucky All Schedule Prescription Electronic Reporting, and said checking KASPER before writing prescriptions "should not impede them in any way," Wynn reports. Mike Rodman, director of the Kentucky Board of Medical Licensure, said there's nothing in the law that prevents doctors from prescribing controlled substances. He said many doctors have for years practiced prescription standards similar to those in the bill, but feel uncomfortable with them being written as law.

The co-chair of the state oversight committee, Democratic Rep. John Tilley, said there are some legitimate concerns about the bill "that need discussion after we can distill what is fact and what is myth," but lawmakers could likely address all of them without changing the statute. (Read more)

Republicans reject governor's executive order creating health benefits exchange; move is only symbolic for now

Republican legislators voted yesterday against Gov. Steve Beshear's executive order creating the Kentucky Health Benefits Exchange, required by federal health reform. Sen. David Givens of Greensburg offered a motion to the legislative Health and Welfare Committee that said Beshear doesn't have authority to create new agencies, but only to rearrange existing agencies with the legislature's approval, Nick Storm of cn|2 Pure Politics reports.

Democrats at the meeting were caught off guard and ultimately walked out after raising objections, Storm reports. They claimed Beshear was following federal law, and said the legislature should consider the matter when it reconvenes in January. Legislators hoped they would get answers from the Cabinet for Health and Family Services about costs and operations of the exchange, which they didn't get at their meeting last month.

The exchange will match up the uninsured with private health insurance companies, and is designed to serve those who make too much to qualify for Medicaid but don't have employer-sponsored insurance. After Democrats left the meeting, Republicans voted to report the committee's findings to the Legislative Research Commission and the governor. The vote remains symbolic unless it is cited in a lawsuit challenging the exchange, which now seems likely. (Read more)

UK study will try to stem high-risk, health-damaging risks in drug-using rural women in Appalachian Kentucky

Researchers at the University of Kentucky have embarked on a five-year study that aims to lower behavioral risks of HIV/AIDS and hepatitis C among disadvantaged, rural women in Appalachian Kentucky. With the help of a $2.7 million grant from the National Institute on Drug Abuse, investigators will examine the effectiveness of a brief intervention in reducing high-risk behaviors, including sexual practices and use of injected drugs.

Michele Staton-Tindall, right, associate professor in the College of Social Work, is the principal investigator. "Our intervention will focus on an individualized plan for enhancing each woman's motivation to reduce risk behaviors and to utilize existing health services," Staton-Tindall said. "The long-term goal of this study is to increase access to health and behavioral-health services in order to improve the quality of health for high-risk rural women."

According to co-investigator Jennifer Havens, HIV is not a high risk for Appalachian drug users, but hepatitis C is. Caused by a virus that attacks the liver, it is the leading cause of liver cancer in the United States. Currently, more Americans die each year from diseases related to hepatitis-C infection than from HIV-related causes, according to data from the Centers for Disease Control and Prevention. Like HIV, hepatitis C is spread through contact with contaminated blood, often through the use of needles shared by intravenous drug users.

Report: Two-thirds of Kentuckians obese by 2030 if trends continue; cost to nation's future unquestionably high

Nearly two-thirds of adults in Kentucky will be obese by 2030 if rates continue to climb as they are now, an analysis reported Tuesday. The level of obesity, defined as being roughly 30 or more pounds overweight, is projected to reach 60.1 percent in Kentucky in 2030, up from 30.4 percent in 2011, according to an analysis commissioned by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation. Nancy Hellmich and Laura Ungar of The Courier-Journal in Louisville report that if states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020, and double again by 2030. Medical costs associated with treating preventable obesity-related diseases could increase by up to $66 billion per year by 2030, and the loss in economic productivity could be as high as $580 billion annually. (Read more)

The joint report also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index (BMI) of their residents by just 5 percent by 2030. Doing so would spare millions of Americans serious health problems, and the country could save billions of dollars in health spending. See the interactive map showing how much improvement could be made if that small change were made here.

The report also features a series of joint policy recommendations from TFAH and RWJF, including full implementation of the Healthy, Hunger-Free Kids Act, protection of the federal health reform law's Prevention and Public Health Fund, and inclusion of additional physical education and activity components in the Elementary and Secondary Education Act. To download the full report, go here. 

Some strategies for seniors as Kentucky observes Fall Prevention Awareness Day Saturday, Sept. 22

Kentucky has joined 45 other states in proclaiming Saturday, Sept. 22 as Fall Prevention Awareness Day. In 2011, fall-related injuries among the elderly in the Bluegrass were associated with $266 million in hospital charges, according to Julie Lasslo, Kentucky Safe Aging Coalition coordinator at the Kentucky Injury Prevention and Research Center.

"Falls come at an immeasurable impact on the quality of life for many seniors," Lasslo writes in the Lexington Herald-Leader, noting that the Centers for Disease Control and Prevention estimate that one-third of Americans are hospitalized due to falls. She says such falls are not an inherent part of the aging process and some simple strategies can prevent them:

# Engage in a physical activity regime that includes balance, strength training, and flexibility.
# Consult with a health professional about getting a falls risk assessment.
# Have medications periodically reviewed.
# Get an annual eye exam.
# Store frequently used items at waist level.
# Remove clutter from stairwells, hallways and walking paths.
# Install and use handrails in stairwells and bathrooms.
# Remove throw rugs.
# Place double-sided tape under area rugs and loose carpet.
# Keep your home well-lit and consider using a night light.

For more information, go to Nofalls.org.

Governor names board to guide creation of insurance exchange

Gov. Steve Beshear today appointed the board to make recommendations for the state health-insurance marketplace required by federal health reform.

The Health Benefit Exchange Advisory Board, originally planned to include 11 members, was expanded to 19. Beshear explained in a news release, “We need the insight and experience of a variety of Kentuckians to ensure that the exchange not only meets the requirements of the law, but also meets the needs of Kentuckians who will be looking for affordable health insurance.”

"The Health Benefit Exchange will facilitate the purchase and sale of health plans in the individual market; assist small employers in facilitating the enrollment of their employees in health plans; provide one-stop shopping by helping individuals enroll in health plans Medicaid and KCHIP; enable individuals to receive premium tax credits and premium subsidies; and qualify small businesses for tax credits," the release said.

Three public officials will serve as ex-officio representatives, including Insurance Commissioner Sharon Clark, whom Beshear named chair of the board. The other ex-officio members are Medicaid Commissioner Lawrence Kissner and Stephen R. Hall, commissioner of the Department for Behavioral Health and Developmental and Intellectual Disabilities. The other appointees represent various private interests and "will serve for staggered term limits of two or three years as designated by the governor, to ensure the board maintains an experienced membership," the release said.

Consumer advocates or representatives are represented by:
• David Allgood of Louisville, director of advocacy at the Center for Accessible Living.
• Andrea Bennett of Louisville, deputy director of Kentucky Youth Advocates.
• Tihisha Rawlins of Louisville, associate state director of AARP.

Providers based in health-care facilities are represented by:
• Ruth Brinkley of Louisville, president of KentuckyOne Health.
• Julie Paxton of Prestonsburg, an attorney for Mountain Comprehensive Care Center.
• Ed Erway of Lexington, chief revenue officer at  University of Kentucky Healthcare.
• Donna Ghobadi of Lexington, vice president of revenue cycle at Central Baptist Hospital.
Providers not based in health-care facilities are represented by:
• Connie Hauser of Barbourville, a physical therapist.
• John Thompson of Lexington, a dentist.
• Dr. Michael Huang of Lexington, a general internal medicine physician at Kentucky Clinic South, part of UK Healthcare.

Insurers are represented by:
• Deborah Moessner of Louisville, president and general manager at Anthem Blue Cross & Blue Shield.
• Jeff Bringardner of Louisville, president of Humana Inc. Kentucky.
• Carl Felix of Frankfort, chief operating officer at Bluegrass Family Health.

Other representatives are:
• Marcus Woodward of Ashland, a Democratic activist and health-insurance broker, representing insurance agents.
• Gabriela Alcalde of Louisville, a health policy officer at the Foundation for a Healthy Kentucky, representing individual purchasers of health benefit plans.
• Joe Ellis of Benton, an optometrist, representing small employers.

Volunteer emergency medical squads becoming less numerous

Belfry Fire and EMS responds to an accident.
(Rachel Dove-Baldwin, Williamson Daily News)

Volunteer emergency medical service squads appear to be dying out around the nation as rural populations change and EMS evolves, and Kentucky is no exception.

Volunteer squads have long been the sole emergency responders in many rural areas, reports Candi Helseth of the health-oriented Rural Assistance Center, but according to a 2010 study, "Rural Volunteer EMS: Reports from the Field," 69 percent of 49 local EMS directors in 23 states reported problems recruiting and retaining volunteers.

The North Carolina Rural Health Research and Policy Analysis Center study reported three main reasons for loss of EMS volunteers: high numbers of retirees or elderly in rural areas are unlikely to have physical strength required for EMS, many working-age individuals leave rural areas to find jobs elsewhere, and volunteers have too many obligations to cover weekends. Almost three-quarters of the all-volunteer EMS agencies hosted fundraising events to get necessary funding, requiring further time commitments. (Read more)

Volunteer fire departments have reported similar problems, but volunteer firefighters are called out less often and often receive stipends for attending meetings and training, said Michael Poynter, executive director of the Kentucky Board of Emergency Medical Services. He told Kentucky Health News that that state is part of the national trend away from volunteer EMTs, but still has 17 services that are fully volunteer and 35 that use a mixture of paid EMTs and volunteers. Kentucky has more than 250 licensed emergency medical services.

Former health secretary is CEO of Kentucky Health Cooperative, a new type of insurance firm created by health reform

Former health and family services secretary Janie Miller, who resigned in February, has become chief executive of the Kentucky Health Cooperative, a new type of health-insurance organization established by the federal health-care reform law.

The Patient Protection and Affordable Care Act requires the cooperatives to be "directed by their customers and designed to offer people and small businesses affordable health insurance options," Tom Loftus explains for The Courier-Journal, noting that the co-op got a $59 million loan from the U.S. Department of Health and Human Services in June. The co-op "is sponsored by a coalition of business leaders, health providers and community organizations," Loftus reports.

The co-op declined to reveal Miller's salary. She was state insurance commissioner from 2001 to 2003, when Republican Gov. Ernie Fletcher was elected. When Democrat Steve Beshear became governor in December 2007, he named Miller secretary of the Cabinet for Health and Family Services. She is a naive of McCreary County.

Miller said in a news release, “The co-op will be governed and run by its members and will provide individuals and small businesses a viable alternative for quality, affordable health insurancec coverage. Unlike traditional insurance, however, any profits earned by the co-op must be used to improve benefits or lower premiums.” The C-J story is here.

KET talks with experts on heart disease and health reform tonight

Some nationally recognized heart specialists will speak directly to Kentuckians about heart disease tonight on the season premiere of Health Three60 on KET. Cardiovascular disease, the leading cause of death in the United States -- and, perhaps surprisingly, in women -- will get a thorough examination. The show will take on the history of the disease, what women should know about the disease and what the future looks like for all of us. Host Renee Shaw will explore the history of cardiac surgery and the development of the artificial heart with Dr. Laman Gray, Jr. cardiovascular surgeon and medical director at the Cardiovascular Innovation Institute. Gray will also discuss how the death rate from heart disease has decreased even as the increase has gone up.

Guests will also include Dr. Joey Maggard, executive director of the Central Kentucky Chapter of the American Heart Association; Dr. Melissa Walton-Shirley, cardiologist with Cardiology Associates in Glasgow; Mark Rucker, recipient of the American Heart Association Lifestyle Change Award; Dr. Paula Hollingsworth, cardiologist at Central Baptist Hospital in Lexington; and, James B. Hoving, Ph.D., division chief of cardiosvascula therapeutics at the Cardiovascular Innovation Institute. Health Three60 airs at 9 p.m. EDT.

Immediately preceding Health Three60, on this week's edition of Kentucky Tonight, host Bill Goodman and guests will discuss health care and health care reform.  Scheduled guests include State Sen. Tom Buford, R-Nicholasville, chair of the Senate Banking and Insurance Committee; State Rep. Mary Lou Marzian, D-Louisville, vice chair of the House Budget Review Subcommittee on Human Resources; Dr. Ralph Alvarado, a Winchester internist and pediatrician; and Dr. Barbara Casper, an internist and University of Louisville professor of medicine. Kentucky Tonight airs at 8 EDT.

New state web portal eases non-emergency reporting of child and adult abuse and neglect

The state Department for Community Based Services has launched a web-based portal for reporting child and adult abuse and neglect in non-emergency situations. According to DCBS Commissioner Teresa James, the new system should enhance the current intake system, especially for those situations that do not require an immediate response from the department's staff.

Law enforcement and judicial officials, medical professionals, educators, child and senior caregivers and other advocates have been using the program since July, giving feedback to DCBS staff to help refine the system for the general public. According to the Cabinet for Health and Family Services press release, "Users of the portal are required to enter an email contact and will receive an immediate, automated response that their online report has been made. Centralized intake staff will review reports as they are submitted. Users will receive a response message within 48 hours only if their report has not been accepted because it doesn’t meet criteria for investigation. Reports that are accepted do not generate a follow-up email message. The reporting portal has several mandatory input fields so that intake staff can get adequate information about the incident, the alleged victim, the alleged perpetrator and any safety issues in order to screen reports effectively."

The site, https://prd.chfs.ky.gov/ReportAbuse/home.aspx, will be monitored from 8 a.m. to 4:30 p.m. ET Monday through Friday. Reports will not be reviewed during evenings, weekends or state holidays.

If situations arise during these times indicating a child or adult is at risk of immediate harm, these should be reported to 911, local law enforcement or 877-KY SAFE1. Calls are anonymous. If the report meets the criteria for abuse, an investigation is conducted within 24 hours in most cases or, if the child is suspected to be in immediate danger, they are conducted within the hour. Callers should try to know the child's name, approximate age, address, parents' names and location of the child when the call is made. They should also have names and phone numbers of other people who have information about the suspected abuse.

 

Suit alleging unnecessary procedures at London hospital is the 31st by plaintiff's attorney in past year

More than 300 former heart patients at the Saint Joseph London hospital have sued it, its cardiologists and agencies involved with its operation and billing services, alleging the patients were subjected to unnecessary medical procedures.

"The lawsuit was filed by Louisville attorney Hans Poppe, who has previously filed similar lawsuits," 30 in the past year, Nita Johnson reports for The Sentinel-Echo of London. "This last lawsuit is a compilation of 339 cases that Poppe has had investigated."

Claims in a lawsuit state only one side of a case. A hospital spokesman said, "We are aware of the lawsuits and take the allegations seriously, but we cannot comment any further on pending litigation." (Read more)

CNN's fact-checking of 'Medicare's impending bankruptcy' shows the program is not likely to go under soon, or ever

That giant whooshing sound you just heard may have been the sound of millions of baby boomers letting out of sigh of relief. That's because CNN.com did some much needed fact checking on the often-cited and often-fretted about claim of Medicare’s “impending” bankruptcy. What they found is was startling -- and in a good way, for a change.

Trudy Lieberman, writing in the Columbia Journalism Review, notes that the Democrats used the B word at their convention, claiming that if Republicans repealed the Affordable Care Act and thus its efforts to prolong the Medicare Hospital Trust Fund, "Medicare could go broke in 2016.” Republicans, when asked to respond to the charge, promptly B-worded back, saying “Medicare will go bankrupt in 2024." Lieberman reports that CNN then "did some old-fashioned reporting, read some financial reports, and found sources that could really give the financial skinny on Medicare. And it didn’t go for that 'mostly true' or 'partly misleading' stuff that some other fact checking pieces resort to, which can confuse readers more than it enlightens them.

"First, CNN reported, as CJR has urged news outlets to do, that only one part of Medicare is in potential trouble—the Hospital Trust Fund, which is financed by payroll taxes. The other parts of Medicare, including Part B, which finances doctor visits, lab tests, and outpatient services, 'are adequately financed for now,' Medicare trustees have said. Jonathan Oberlander, a health policy expert at the University of North Carolina, told CNN that repealing the health reform law “would in fact worsen Medicare’s financial condition,” but even so, he added, “Medicare is not going bankrupt. Medicare would still have most of the necessary funds to pay those expenses and other parts of the program would be unaffected. Medicare won’t go bankrupt in the literal sense in 2016 or 2024 or 2064 -- or ever.

The Centers for Medicare and Medicaid Services noted this year, "In practice, Congress has never allowed a Medicare trust fund to exhaust its assets." (Read more)

Volunteer State becoming Salad State? CDC report shows Tennessee is getting less obese, leaving U.S.'s top 10

It can be done. A determined state can move the needle on its obesity numbers. Heidi Hall of The Tennessean reports that widespread efforts to change Tennesseans’ diet and exercise habits mean that the state’s percentage of obese residents have dropped for two consecutive years – something that hasn’t happened in more than a decade. "A new report from the Centers for Disease Control and Prevention moves Tennessee out of the top 10 most obese states for the first time since 1999 – it’s now ranked 15th – and," Hall notes, "is prompting cautious optimism in leaders charged with slimming down the state." (Associated Press photo)

The question, writes Hall, is what pellets of the state's shotgun approach are working. In a state that added bike lanes and sidewalks, altered its school lunches, and added fresh produce to convenience stores, where should credit go? “I think the biggest success is that we increased awareness around the issue,” said Ted Cornelius, the Tennessee Obesity Task Force’s co-chair. “We have the capacity to analyze barriers people face -- cost, access to healthy food and places to be active -- and we keep bringing those up to leaders in communities.”

The percentage of Tennesseans considered obese peaked at 32.9 percent in 2009 and dropped to 29.2 percent last year. Rural areas lead the drop, moving from 70.7 percent overweight in 2009 to 64.7 percent last year, but Schlundt said it may not be time to celebrate just yet. Rural residents took a similar jump upward from 2005-06, and both could be anomalies because the CDC surveyed fewer rural residents. (Read more)

Study finds 'the link between cholesterol and cancer is clear'

University of Rochester Medical Center scientists have verified a link between cholesterol and cancer with new genetic evidence, raising the possibility that cholesterol medications such as statin drugs could be used for cancer prevention or to augment existing cancer treatment.

"The link between cholesterol and cancer is clear," senior study author Hartmut Land said, "but it's premature to say that [cholesterol-lowering drugs] are the answer." Still, The Times of India reports that the data gathered by the research team at the James P. Wilmot Cancer Center at URMC "supports several recent population-based studies that suggest individuals who take cholesterol-lowering drugs may have a reduced risk of cancer, and, conversely that individuals with the highest levels of cholesterol seem to have an elevated risk of cancer." 

Millions of Americans take cholesterol-lowering drugs prescribed by physicians. The drugs work by blocking the action of key enzymes in the liver, which synthesizes cholesterol. The Times story explains that "clinical trials also are evaluating statins as a tool against cancer, and some previous studies suggest that when used in combination with chemotherapy, statins might make chemotherapy more effective by sensitizing certain cancer cells to chemotherapy-induced cell death. Land, however, urges caution and further study. Doctors do not know the appropriate statin dose for cancer prevention or treatment of cancer-related conditions. Side effects cannot be ignored either, and little research has distinguished between the responses among people who take statins."

See the study in the online journal Cell Reports by clicking here. 

Is there a correlation between food-stamp use and obesity? Some say yes, and that corporations are getting fat in the process

"Who's getting fat off food stamps?" asks ABC News' Alan Farnham, reporting that a record number of Americans -- 46.7 million, or nearly 1 in 7 -- now uses the benefit, known as the Supplemental Nutrition Assistance Program. It cost $72 billion last year, up from $30 billion four years earlier. Budget hawks have targeted the program's swollen size and cost, helping prevent passage of a new Farm Bill. Now Farnham reports, "There are those who say SNAP is making two different constituencies fat -- big corporations and the poor -- the first, figuratively; the second, literally."

In Kentucky -- with its extraordinarily high rate of obesity and, as of June 2012, its 406,689 households on food stamps -- the correlation between those two bears close scrutiny.  Many health advocates who are concerned about Americans' increasing obesity argue that "food stamp purchases should be disallowed for items high in salt or fat or sugar," Farnham notes. Consumer watchdog groups such as Eat Drink Politics similarly argue that food and beverage makers are making a mint from SNAP, and are spending equal portions to oppose legislation antithetical to their interests.

Hard numbers about what the program buys are hard to come by, says the report, in part because the U. S. Department of Agriculture either doesn't have or does not release certain crucial data: "It lacks the legal authority, for example, to require retailers to report what products SNAP participants are purchasing. It knows the dollar value of transactions, but not whether the customer bought Cheesy Puffs or broccoli."

As for the increasing obesity of the poor, data on that problem are readily available, but food stamps' complicity in it is the subject of much debate. Julian Alston, professor of agricultural and resource economics at the University of California, Davis, has studied the question in depth. Alston and his co-authors conclude that food stamp participants are more likely than non-participants to be overweight or obese. Farnham writes that "they don't say food stamps are making them fat. The authors then go on to analyze whether the exclusion of certain food items from program eligibility might make participants healthier." (Read more)

In wake of pill-mill regulation fight, Beshear has chance to craft a medical licensing board more to his liking

Gov. Steve Beshear

Gov. Steve Beshear is in a position to reshape a state medical board that has played a central and controversial role in recent efforts to crack down on prescription drug abuse. Mike Wynn of The Courier-Journal  reports that the terms of three members of the Kentucky Medical Licensure Board expired Aug. 31, and two other members’ terms await action after ending last year.

The licensure board drew criticism in 2011 "for not taking more aggressive action against so-called pill mills and corrupt doctors who supply Kentucky’s drug epidemic," Wynn writes. "The medical industry also has criticized the board in recent months for writing what doctors view as overly complex and excessive prescription regulations under HB 1, a landmark bill from the 2012 General Assembly that takes aim at abuse of drugs."

Beshear spokeswoman Kerri Richardson said the appointments are under review but did not indicate how the governor might proceed other than noting that he will consider qualifications and recommendations. Current board members serve until Beshear makes any new appointments. (Read more)

Baptist Health, formerly Baptist Healthcare System Inc., acquires Richmond hospital; could become largest health group in Ky.

Pattie A. Clay Regional Medical Center

The nonprofit formerly known as Baptist Healthcare System Inc. is moving closer to becoming the largest health care organization in Kentucky, with last week's acquisition of the Pattie A. Clay Regional Medical Center in Richmond, reports Ed Green of Business First. No money changed hands, notes Green, since Baptist Healthcare assumed ownership of the nonprofit medical center.

The company also announced a system-wide rebranding effort designed to bring all of its facilities under a new brand name: Baptist Health. The goal, said Andy Sears, vice president of planning and system development for the nonprofit organization, is to broaden its reach across the state. System-wide, Baptist Health has more than 1,900 licensed acute-care beds and served 93,892 inpatients and 1.8 million outpatients in 2011.

More bad news about childhood obesity: Study finds it can change some kids' brains and damage their mental 'flexibility'

It's not news that Kentucky is lagging in child fitness. In fact, the Truth for America's Health "F as in Fat" report found that the state has the third highest childhood obesity rate in the country. This is bad news, alright, and it's about to get worse. Dr. Claire McCarthy writes in The Boston Globe that a new study in the current issue of Pediatrics and shows that obesity can hurt kids' brains.

"Researchers looked at 49 adolescents with metabolic syndrome. Metabolic syndrome, a consequence of obesity, is the triad of insulin resistance (pre-diabetes or diabetes), high blood pressure and high blood lipids," McCarthy writes. "The researchers compared the adolescents with 62 adolescents who had the same socioeconomic background but didn't have metabolic syndrome. The kids with metabolic syndrome had more trouble with arithmetic, spelling, attention and mental 'flexibility' than the ones who didn't have metabolic syndrome. Even more frightening, the researchers saw actual changes in their brains, in the hippocampus (which plays a crucial role in memory) and the white matter (which passes messages through the brain). It was only a small study, and not all kids with obesity have metabolic syndrome. But this study is alarming -- especially since we don't know if losing weight can make the brain go back to normal."

In her column tagged "MD Mama," McCarthy goes on: "Given that brains are still developing in adolescence, it's very possible that the changes could be permanent. What else do we need before we take the problem of childhood obesity really seriously?" (Read more) To read the study in Pedatrics, go here.

17 percent of Kentuckians lack food security; beef council to help on local level with donations to food banks

More than 750,000 people in Kentucky, 17 percent of those living in the commonwealth, do not always know where they will find their next meal, according to Feeding America’s Map the Meal Gap study. Among Kentucky's children, the number of those experiencing food insecurity is an astonishing 23 percent.

Here's a link to the Map the Meal Gap interactive map. To see Kentucky's hunger index by Congressional district, go here.

The Lane Report notes this has prompted state Agriculture Commissioner James Comer to declare September as Farmers and Food Banks Fighting Hunger Month in Kentucky. “Programs such as Farm to Food Banks are ones that aid Kentucky farmers by furnishing them with another outlet to sell their commodities while at the same time providing food for the hungry," said Comer.

The Farms to Food Banks program allows the Kentucky Association of Food Banks to buy surplus and second-grade produce for distribution free of charge through the food banks' network. In honor of Farmers and Food Banks Fighting Hunger Month, the Kentucky Beef Council announced the launch of  Beef Counts KY, a program that will supply nutrient-rich beef for people facing hunger in Kentucky. Farmers will have the option of donating cash or donating proceeds from the sale of beef animals to the program. Fourteen livestock markets across the state are participating and will forward proceeds from donated beef animals to the program. “Each donated animal or the cash equivalent provides roughly 1,600 servings of high-quality nutrient-rich beef protein. This is a local solution to local hunger," said Chuck Crutcher, chairman of the KBC and Hardin County beef farmer. 

Eastern Kentucky native wants to alert Appalachian women about their high rate of cervical cancer and how to prevent it

University of Kentucky physician and Pike County native Baretta Casey, right, has spent most of her career providing health care and education throughout the state, with a focus on Appalachian Kentucky. The health disparities between Eastern Kentucky and the rest of the state, especially high rates of cancer, are of "special concern" to Casey, reports Ann Blackford of UKNow.

Cancer is prevalent in her Casey's own family, and this is why she "has taken on the challenge of helping reduce cancer rates in Kentucky, especially cervical cancer and other Human papillomavirus cancers," Blackford reports. Cervical cancer rates are highest in rural and Appalachian Kentucky. According to the Kentucky Cancer Registry from 2005 to 2009, the cervical cancer rate in the region was 9.85 per 100,000 people. The state rate was 8.6. The average of deaths per year in the region from cervical cancer was 258.

"We have the tools to change these high rates and make a real difference in people's lives," Casey said. "I feel the best thing I can do for the people of Eastern Kentucky is to educate about prevention and screening of cervical cancer." Casey became the director of the Cervical Cancer-free Kentucky Initiative at UK's College of Public Health's Rural Cancer Prevention Center in 2010. Through this position, she makes connections with county health departments, community organizations and health advocacy groups that provide education and funding for cervical cancer prevention projects.

"Casey is passionate about educating people on the importance of vaccinating their children against HPV," Blackford writes. She said she wants people to look past the controversy of vaccinating their children and realize the importance of the vaccine. "The vaccine given for the appropriate reason can save a life," Casey said. (Read more)

UK nanotechnology study shows promise for more effective cancer treatment compared to chemotherapy

Dr. Peixuan Guo, one of the three top
nanobiotechnology experts in the world

A new study by University of Kentucky researchers shows promise for developing ultrastable RNA nanoparticles that may help treat cancer and viral infections by regulating cell function and binding to cancers without harming surrounding tissue. The study, published in Nano Today, was carried out in the laboratory of Peixuan Guo, the William S. Farish Endowed Chair in Nanobiotechnology at the UK Markey Cancer Center, in collaboration with Dr. Mark Evers, director of the UK Markey Cancer Center.

 "A major problem with cancer treatments is the ability to more directly and specifically deliver anti-cancer drugs to cancer metastases," Evers said. "Using the nanotechnology approach that Peixuan Guo and his group have devised may allow us to more effectively treat cancer metastasis with fewer side effects compared to current chemotherapy." To read more about the study, read the University of Kentucky press release here. To read study in Nano Today, go here.

St. Joseph hospitals lay off 40 employees in Lexington

KentuckyOne Health announced Wednesday it would be laying off 40 employees at its St. Joseph Hospital and St. Joseph East locations in Lexington, Scott Sloan of the Herald-Leader reports. The move comes less than a year after 36 employees were laid off at the St. Joseph hospital on South Broadway and four at St. Joseph East on Richmond Road.

KentuckyOne Health was formed earlier this year to operate St. Joseph Health Systems and Jewish Hospital and St. Mary's HealthCare. Spokeswoman Barbara Mackovic said the decision was made because of "challenges in the healthcare industry," Sloan reports. "Like most other systems, KentuckyOne Health continually monitors our patient volumes and adjusts staffing to meet those needs," Mackovic said. "When we have growth in certain areas, we increase our staffing needs. "Unfortunately, when we see a decrease in patient demand, we must also adjust our staff accordingly." (Read more)

State health department says 381 cases of whooping cough puts disease at epidemic levels

The state Department of Public Health says whooping cough is now at epidemic levels. Department officials told Amanda Stephenson of WTVQ-TV in Lexington that 381 cases of the virus have been confirmed so far in 2012.  The Lexington-Fayette County Health Department is reporting 50 cases so far this year. That's double the 26 cases they'd seen in the previous five years. Estill County health officials have seen a quadrupling of cases since July. (Read more)

Mary Meehan of the Lexington Herald-Leader reports that Three Rivers District Health Department in Owenton, which serves Owen, Carroll, Gallatin and Pendleton counties, will offer shots at fall festivals in the district to stave off the spread of the disease. After 86 cases were confirmed in the area, the Northern Kentucky Health Department, which serves Boone, Campbell, Grant and Kenton counties, is offering vaccines for $4.

The Fayette County department isn't planning special clinics at this time, so people who are worried about the illness should contact their family physicians. Some pharmacies, such as Walgreens, are offering the shots in their stores. There is an adequate supply of vaccine for children and adults, said Beth Fisher, a spokesperson for the state Cabinet for Health and Family Services.

For more information on pertussis, and its symptoms, go to the CDC website.

'Cigarette 6' smoked by Hopkinsville paper's editorial

First came the Jackson Five, then the Chicago Seven. Now, straight from Hopkinsville's city council, come the Cigarette Six. So dubbed by the editorial board of the Kentucky New Era, the Six were met with by a incredulous headline on an editorial that addressed the group's attempt to circumvent a drive for an anti-smoking ordinance in most indoor public places: " 'Cigarette 6' on council must think we're stupid."

The editorial takes direct aim on the six members' apparent lack of interest in protecting citizens from secondhand smoke and their approach to a smoking ban that isn't one: a do-it-yourself sort of ban "that requires businesses to declare whether they will be a smoking or a smoke-free establishment." As if that is not what businesses are today without such a pronouncement. The New Era called the Six's stance "an embarrassment to the city." Read the complete New Era editorial here.

Because the 6-5 vote came with a smoking-ban proponent absent, and in the council's committee of the whole, where Mayor Dan Kemp, another proponent, cannot break ties, the council could still vote 7-6 in favor of the originally proposed smoking ban. For a report on the last council meeting, click here.

The editorial comes in the wake of a recent report by the statewide Friedell Committee for Health System Transformation that called for county health boards to "assume responsibility for educating their population about improving their health status," be "highly visible and proactive," and play a leading role "in developing healthy community coalitions and partnerships," and the Christian County health director's vow to take his board in that direction. An item on that report is here.

Video explains health reform and new insurance coverage

The folks at Henry J. Kaiser Family Foundation has done us all a tremendous favor: They've made health reform law kinda easy. And kinda brief. In their new video "Health Reform Hits Main Street," they've wrestled the topic down to a 9-minute short, animated movie that should -- if anyone can -- "explain the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014."

The press that comes with the video promises that you'll learn "more about how the health reform law will affect the health insurance coverage options for individuals, families and businesses with the interactive feature 'Illustrating Health Reform: How Health Insurance Coverage Will Work'."  Whether you actually learn that, we figure, is up to you. But with the help of narrator Cokie Roberts, they have given it a good try. 

Watch the video by clicking on this website, where a link will take you to the video. It's also available in Spanish.