Wednesday, June 30, 2021

Baptist to share Madisonville hospital with Deaconess, which now also has hospitals in Henderson and Morganfield

Baptist Health Madisonville
Starting Sept. 1, the hospital in Madisonville will be jointly operated by Baptist Health, which has owned it for nine years, and Deaconess Health System Inc. of Evansville, which recently added two nearby Kentucky hospitals.

The joint operation will include physicians' offices and outpatient facilities in Madisonville, Powderly, Dawson Springs, Princeton and Hopkinsville. Deaconess operates seven hospitals in Southern Indiana and recently took over the former Methodist hospitals in Henderson and Morganfield.

The hospital will be called Baptist Health Deaconess Madisonville and get "initial capital investments of more than $50 million" in surgical suites, the emergency room and the cancer-care facility, a press release said.

“In selecting a new name, we wanted to strongly signal that both Kentucky’s largest health-care system and the Tri-State’s largest health-care provider are joining forces, bringing their expertise to further elevate the level of care provided to the community and bolster services through targeted investments,” Baptist Health CEO Gerard Colman said in the release.

Deaconess CEO Shawn McCoy said, “Baptist Health and Deaconess will pool resources and experiences to grow and expand the hospital’s primary-care, surgery, cardiac and cancer-care programs, ensuring that patients from Madisonville and surrounding communities can continue to access quality health care close to home.”

The firms had announced their plan for a joint operation, but had not announced details. Baptist Health bought the former Trover Health System in 2012, renaming it Baptist Health Madisonville. Deaconess began in the 1890s as part of a movement among certain Protestant denominations (mainly Lutheran and Methodist) to provide medical care. Its Kentucky facilities, as of July 1, are Deaconess Henderson Hospital and Deaconess Union County Hospital.

People in recovery, and people trying to help them, talk about it at Chamber's annual meeting designed to help employers help, too

By Jacqueline Pitts
The Bottom Line, Ky. Chamber of Commerce

Kentuckians who are in recovery from substance-use disorder, and people who are trying to help them, talked about their efforts Tuesday at an annual conference designed to encourage employers to help.

Employment, assistance, wrap-around services and trainings were just some of the items discussed at the Kentucky Chamber of Commerce’s third annual Recovery Conference in Lexington.

Ashley McCarty, the Chamber’s Workforce Recovery director, spoke about her own personal struggles with substance-use disorder and how she is now using her experience to help Kentucky companies fix their outdated personnel policies to allow for a fair chance and notice early warning signs.

McCarty, who is seven years in active recovery from opioid addiction, said she was among the top five pharmaceutical sales representatives in the country when she had a few surgeries for which she was prescribed opioids for pain. Everything began to fall apart as she developed a dependency on those medications, her performance plummeted, and she even attempted suicide.

Recovery, McCarty said, taught her she could change by being open and transparent, working to build others up, and working on herself and her own struggles.

Keeneland cook Krystal Grimes talked about her recovery.
(Photographs by Sawyer Coffey, Kentucky Chamber of Commerce)
Krystal Grimes, a line cook at Keeneland, is four years into her active recovery and shared her powerful story with the conference.

Grimes said that to understand her addiction, it is important to understand her childhood and the sexual abuse she suffered at the hands of family members at a very young age. She was turned away by adults like school counselors, and abusers told her it was her fault. She then tried to take her own life. When she woke up, her first feeling was sadness that the attempt had not worked, and while the abuse stopped at that point, her feelings did not, and she sought out ways to numb the pain.

As she got older, she married a man who also struggled with addiction and they had three children. She was prescribed an opioid after each Caesarean section that made her feel like “Super Mom,” and her tolerance grew. After many years of struggles, Krystal and her husband lost their children and their home and she thought she didn’t think she had anything else to lose. Then she found heroin, and things continued to get worse as she attempted to stop the pain.

Eventually, she started treatment with Suboxone and eventually began attending classes, where she met McCarty, who inspired her to use the medication correctly and start doing the work of recovery.

With Keeneland since 2014, Grimes said the company has seen her struggle, but continues to believe in her and provide stability, support, and much more which she said has been critical to her recovery.

Jason Roop, Director of the Technology Training Center at Campbellsville University, presented research showing that people with substance-use disorder are often goal-oriented, resilient, adaptable, and persistent. He studied characteristics of those in leadership roles who have struggled with addiction and found transformational, authentic leaders are making a powerful difference in the business community and many other sectors.

How employers can help employees

Isaiah House Treatment Centers President Mike Cox shared their goals for effective treatment, including meaningful employment. Cox said when a business gives an individual in recovery a second chance, a sense of loyalty is automatically created. Isaiah House has partnerships with multiple businesses willing to employ individuals in active recovery.

Ed Early of Isaiah House discussed the critical role of the employer in the recovery process. It begins with reducing stigma in the workplace, he said. Employers should treat those in recovery in the same manner as other staff members: be welcoming, provide education and training, understand how to reward and hold employees accountable, and know when to retain, terminate and advance employees.

“It’s all about the opportunities they are given and the support they are shown,” said Early.

Landmark Recovery National Business Development Manager Zachary Crouch talked about why individuals don't seek help from employers: “The real reason is stigma.” Crouch said the cost of not treating substance use and mental health is too expensive not to address, since each replacement of an employee costs them six to nine months’ salary. He encouraged businesses to seek ways to engage employees when they are struggling with substance abuse and mental health and to encourage vulnerability, diversity, and inclusion in the workplace.

Representatives of Goodwill Industries of Kentucky, which has developed second-chance policies through removing barriers to employment for individuals in recovery and/or leaving incarceration, talked about new efforts to help individuals overcome re-entry and recovery challenges. One project is a program in which participants can learn soft skills, financial literacy, digital literacy, communications skills, resume writing, mock interviews to address criminal history and gaps in resumes, health and nutrition, and much more. Learn more about the program here.

Heather Lowe, founder of Ditched the Drink, shared her
testimony as Susan Rider of Preventia Group listened.
More than 70% of people with addiction issues are working, said Heather Lowe, founder of Ditched the Drink. She said it is critical to have vulnerable conversations, know the signs of a substance-use disorder, and implement successful treatment options in the workplace.

Saying it's critical to treat alcohol the same as a drug to address its abuse, Lowe shared her testimony of heavily using alcohol in workplace settings, which moved to her abusing alcohol at home.

Susan Rider of Preventia Group said studies show businesses that have adopted organizational change around alcohol often report improvements in morale and productivity, and a decrease in absenteeism, accidents, downtime, turnover, and theft. Also, various options for substance use disorder treatment can help lead to reduced health care costs for businesses

As employers heard about the ways addressing substance use disorder in the workplace can save them money, the Kentucky Career Center highlighted its services that can help. Learn more about programs like the Work Opportunity Tax Credit, the Kentucky Unemployment Tax Credit, Federal Bonding Programs, and Kentucky Essentials Skills Training by visiting or by emailing

HEALing Communities Study, other efforts

Dr. Sharon Walsh of the University of Kentucky reported on the HEALing (Helping End Addiction Long Term) Communities Study, a four-year, $87 million effort, funded by the largest federal grant UK ever received, to reduce opioid overdose deaths in 16 Kentucky counties.

Walsh said many "silos" separate medical care, behavioral health and recovery housing, which can make it difficult for people to find what they need. To address this, the study is evaluating the impact of various interventions, including education and distribution of naloxone; effective delivery of medication for substance use disorder; and safer opioid prescribing and distribution.

Walsh pointed to the rise of illicit fentanyl from China in U.S. markets as a reason that naloxone training and distribution, and a focus on medically-assisted treatment for substance-use disorder, remain critical to helping Kentuckians reach recovery.

RECON Kentucky, a consortium for recovery in Kentucky, announced its first inductees into the Kentucky Recovery Hall of Fame. U.S. Rep. Hal Rogers of Somerset and Jay Davidson, founder of The Healing Place, were honored for their work to solve the state’s struggles with substance-use disorder.

Van Ingram, executive director of the Kentucky Office of Drug Control Policy, stressed that Kentucky’s struggle with substance-use disorder must be addressed at the community, person-to-person level. He highlighted areas of success the state has seen in recent years including his office’s partnership with the Chamber’s Workforce Recovery initiative, which is training more than 5,000 Kentucky business leaders on the importance of being a recovery-friendly workplace.

While Kentucky is doing many things right, Ingram said, there is bad news as well. His office will soon release a report showing a 40 percent increase in overdose deaths, much of which can be attributed to a rise in the use of fentanyl. To get Kentucky back on track, Ingram said Kentucky must re-evaluate all efforts to ensure the state is saving as many lives as possible.

Senate Republican Leader Mitch McConnell said efforts the federal level to combat substance-use disorder have broad, bipartisan support in Congress. He emphasized the importance of people getting back to work, especially those struggling with substance use disorder, and said the continuation of additional unemployment benefits is an obstacle to that.

The Bottom Line is a news service of the Kentucky Chamber of Commerce. This story was independently edited and published by Kentucky Health News.

Tuesday, June 29, 2021

The pandemic isn't over: Virus activity in Kentucky is picking up as the more contagious Delta variant spreads across the country

Kentucky Health News graph, based on initial, unadjusted daily case reports

UPDATE, June 30: The state reported 351 new cases of the coronavirus in Kentucky Wednesday, raising the seven-day rolling average by 20, to 188 per day. That's the largest daily increase in more than two months, except on June 8, when hundreds of delayed cases were reported. The positive-test rate also increased, to 1.92%.

By Al Cross
Kentucky Health News

After three weeks of pretty steady decline, coronavirus activity in Kentucky is picking up a little.

The state reported 244 new cases of the virus Tuesday, the most in almost two weeks, and that raised the seven-day rolling average to 168 cases per day. Except two days when the average rose by one case, it had declined every day for three weeks.

The share of Kentuckians testing positive for the virus is also increasing slightly. Over the last seven days, it has been 1.88 percent; that 7-day figure has risen the last four days, after bottoming at 1.79% last Friday.

Health experts have voiced concern that vaccinations are slowing as a more contagious variant of the virus is spreading and is expected to become dominant in the United States. “The delta variant is currently the greatest threat in the U.S. to our attempt to eliminate Covid-19,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

In Kentucky in the last seven days, an average of 10,235 people per day have been vaccinated for the virus. That's well below the approximately 18,000 in mid-May and far below the 40,000 in mid-April. Of the state's eligible population, those 12 and older, 58% have received at least one dose of a vaccine. Among the total population, it's 49.4%, and the fully vaccinated share is 43.4%.

The Delta variant has hospitalized many younger people in rural areas of some other states, including Missouri. Hospitalizations for Covid-19 ticked up in Kentucky on Tuesday, reaching 176 after a year-long low of 169 the day before. Daily Covid-19 hospitalizations dropped below 400 in mid-May, below 300 in early June and below 200 about a week ago.

The state's seven-day infection rate rose Monday and Tuesday, the first two-day increase in just over two weeks. The rate is now 3.28 per 100,000 residents; counties with rates more than double the state rate are Caldwell, 15.7; Elliott, 15.2; Gallatin, 14.5; Hopkins, 13.4; Webster, 12.1; Wolfe, 12; Anderson, 11.3; Pike, 10.1; Logan, 9; Perry, 8.9; Graves, 8.8; Bracken, 8.6; Owen, 7.9; Nicholas, 7.9; Greenup, 7.7; Simpson, 7.7; Mason, 7.5; and Bell, 6.6.

The state reported five Covid-19 deaths Tuesday, the most in two weeks, for a total of 7,217. The 7-day and 14-day death averages are both 3.3 per day; the latter average is the lowest in many months. Deaths are the most lagging indicator of a pandemic.

Monday, June 28, 2021

McConnell keeps promoting shots as daily vaccinations in Ky. fluctuate around 10,000; first sweepstakes drawing is Friday

McConnell in Louisville on Monday
(Photo by Yasmine Yumaa, WFPL)
Senate Minority Leader Mitch McConnell, on a tour of Kentucky during a Senate recess, continued to promote vaccination against the coronavirus.

“I was a polio victim when I was a kid,” McConnell said Monday. “It took 70 years to develop a polio vaccine, two of them, that worked. Our country, as a result of the CARES Act and the $50 billion we put into Operation Warp Speed, developed not one, not two, but three highly effective vaccines in less than a year.”

Those efforts that produced a “modern medical miracle” will be useless if people don’t get vaccinated, McConnell said at a press conference in Louisville.

Asked what he would say to vaccine skeptics, a majority of whom are Republican white men like him, McConnell replied simply, “Take it.”

The state is offering three $1 million prizes to vaccinated adults and 15 postsecondary-education scholarships to vaccinated youth 12-17 to encourage shots. The deadline for the first drawings, which will be held Friday, is 11:59 p.m. Wednesday. For details, go to

Daily numbers of coronavirus vaccinations in Kentucky have increased the last four days, after a decline that took the seven-day average below 10,000. Monday, it stood provisionally at 10,540, subject to adjustment, according to Centers for Disease Control and Prevention data processed by The Washington Post (for the interactive version of the chart, click here):

Washington Post chart, adapted by Ky. Health News; click on it to enlarge. Interactive version here.

Ky. OSHA complaints rose 45% in 2020, partly due to pandemic; issues are likely to linger as workplaces try to get back to normal

Courier Journal graph, adapted by Kentucky Health News

Kentucky workers filed 45 percent more occupational safety and health complaints in 2020 than in 2019, but only 8 percent of them have been investigated, reports Matt Mencarini of the Courier Journal.

The increase could have had causes other than the pandemic, since the volume of complaints can be cyclical, the state Labor Cabinet told Mencarini. But he cites examples, such as a November complaint against the Kroger Distribution Center in Louisville, alleging that employees had Covid-19 and managers were not informing others about it.

The state's low investigation is actually above the national average, Mencarini reports. "Across the U.S., complaint investigations decreased dramatically during the pandemic," he writes. "Critics for years have derided weak worker safety laws and enforcement, decrying dwindling budgets and staffs in worker safety agencies. The pandemic only exacerbated the problem, they say."

Bill Londrigan, executive director of the state AFL-CIO, told Mencarini, "There needs to be some sort of recognition that even though the rates of transmission and death from Covid have decreased due to the increase in the vaccination rates, that certainly it is not in the rearview mirror. Protections should still be in place."

"Many of the complaints lodged in 2021 suggested the national polarization around masks extended to the workplace," Mencarini reports. "As Covid rates drop and more people return to workplaces, new challenges are arising." Londrigan told him that some workplaces shouldn't abandon mask-wearing, though "no one really likes it."

Sunday, June 27, 2021

Salmonella outbreaks in backyard poultry sicken Kentuckians

Centers for Disease Control and Prevention chart, adapted by Kentucky Health News
Chickens are common in Kentucky backyards.
(Getty Images photo via CDC)
At least 17 people in Kentucky have become sick in an outbreak of Salmonella bacteria linked to backyard poultry, according to the Centers for Disease Control and Prevention.

"One in three sick people is a child younger than 5 years," the CDC warned Thursday. "Don’t let young children touch chicks, ducklings, or other backyard poultry."

The outbreaks have affected almost 500 people and caused more than 100 hospitalizations in 46 states; Kentucky's case numbers are higher than average for the nation.

Poultry can carry salmonella "even if they look healthy and clean," the CDC said. "These germs can easily spread to anything in the areas where the poultry live and roam. You can get sick from touching your backyard poultry or anything in their environment and then touching your mouth or food."

The CDC said owners of backyard poultry should:
  • Wash your hands
    • Always wash your hands with soap and water immediately after touching backyard poultry, their eggs, or anything in the area where they live and roam.
    • Use hand sanitizer if soap and water are not readily available. Consider having hand sanitizer at your coop.
  • Be safe around backyard flocks
    • Don’t kiss or snuggle backyard poultry, and don’t eat or drink around them. This can spread Salmonella germs to your mouth and make you sick.
    • Keep your backyard flock and supplies you use to care for them (like feed containers and shoes you wear in the coop) outside of the house. You should also clean the supplies outside the house.
  • Supervise kids around flocks
    • Always supervise children around backyard poultry and make sure they wash their hands properly afterward.
    • Don’t let children younger than 5 years touch chicks, ducklings, or other backyard poultry. Young children are more likely to get sick from germs like Salmonella.
  • Handle eggs safely
    • Collect eggs often. Eggs that sit in the nest can become dirty or break.
    • Throw away cracked eggs. Germs on the shell can more easily enter the egg through a cracked shell.
    • Rub off dirt on eggs with fine sandpaper, a brush, or a cloth. Don’t wash them because colder water can pull germs into the egg.
    • Refrigerate eggs to keep them fresh and slow the growth of germs.
    • Cook eggs until both the yolk and white are firm, and cook egg dishes to an internal temperature of 160°F to kill all germs.

Call your health-care provider right away if you have any of these severe symptoms:

  • Diarrhea and a fever higher than 102°F
  • Diarrhea for more than three days that is not improving
  • Bloody diarrhea
  • So much vomiting that you cannot keep liquids down
  • Signs of dehydration, such as:
    • Not urinating much
    • Dry mouth and throat
    • Feeling dizzy when standing up

Louisville-based columnist for Washington Post includes Beshear and two other governors among list of heroes of the pandemic

Govs. Andy Beshear, Mike DeWine (Ohio) and Jay Inslee (Wash.)
By Perry Bacon
The Washington Post

I was relieved in 2019 when voters in Kentucky, where I live, rejected giving then-incumbent Gov. Matt Bevin (R) a second term. Unlike Bevin, who spent his time in office on Trump-like attacks on the press, judiciary, teachers and other institutions, his opponent Andy Beshear was at least a small d-democrat. My worry was that Beshear was also a big-D Democrat — the kind of blah, status-quo figure the party often churns out, who isn’t particularly good at politics or governing. After all, the main reason he won was that people in Kentucky disliked Bevin and had good memories of Steve Beshear, the former governor and Andy’s dad.

I was totally wrong about Andy Beshear. As Covid-19 struck, the usually mild-mannered governor was aggressive early, emphatically emphasizing the dangers of the virus in ways that helped get people in the state to take it seriously sooner than we might have otherwise. He issued a stay-at-home order and required business closures before many other states did — a bold move, considering the Republicans who hold most of the power in this bright-red state wanted to take their cues from President Donald Trump. In his almost-daily news conferences, Beshear was reassuring and optimistic about how the state could limit sickness and fatalities if we all followed public health guidance. It was a moment of real leadership — and it saved lives.

Beshear, of course, isn’t the only person who rose to the occasion. So here is my list of some of the people who provided outstanding service to the country during the worst stages of the pandemic. I consulted with journalists, government officials, policy experts and others, but these are solely my choices. It no doubt leaves out many who did important work. I also do not mean to minimize the failures of government and society more broadly that could have prevented more death and suffering. Nor do I want to suggest that the fight is over — deaths from Covid-19 are way down, but 370 died of the virus Wednesday.

A lot of governors were consistently supportive of mask-wearing and other policies advocated by health experts to stop the spread of the virus. And the nation’s governors as a group deserve a lot of credit for managing what my colleague Max Boot has rightly described as one of the most important achievements of U.S. governance — of American adults getting coronavirus vaccines over the past six months.

But it was easier to take aggressive steps if you were a governor (Democrat or Republican) in a blue state. In Ohio, Mike DeWine (R), like Beshear, had to navigate around a lot of conservatives mimicking Trump’s dismissive attitude toward the virus. DeWine’s innovative move to start a lottery to encourage people to take the vaccines became a model for other states and the federal government. Under Jay Inslee (D), Washington was the first state with a major covid-19 outbreak, but the worst of it was stamped out fairly quickly thanks to the leadership of Inslee and other key figures there.

Public health leaders: With the federal government often both downplaying the virus and taking a hands-off approach when Trump was in office, city and state public health directors had to make hard and politically fraught decisions. That led to intense criticism of these officials, including threats of violence, and a wave of resignations or outright ousters. But these local officials took actions that saved lives during the heat of the pandemic. It would be impossible here to list every standout official, but I will single out Ohio’s Amy Acton, Santa Clara County’s (Calif.) Sara Cody, Michigan’s Joneigh Khaldun, the Cherokee Nation’s Lisa Pivec and Maine’s Nirav Shah for their exemplary work fighting the pandemic in their communities and states.

Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases: The doctor hasn’t been perfect — he made some comments that turned out to be inaccurate and at times prioritized placating Trump over candor with the public. That said, when Trump was in office, Fauci seemed to be the top U.S. official taking the pandemic seriously. That was an extremely important role. It’s hard to imagine all of the mask-wearing, closures and other mitigation efforts that happened before Biden became president without Fauci repeatedly delivering a message that was essentially: “Ignore what the Leader of the Free World says, and take this virus really seriously."

Adam Silver: On the night of March 11, 2020, Trump announced a 30-day ban on people from Europe traveling to the United States to stop the spread of the virus. But in my view, what really convinced Americans that Covid-19 was a super-serious threat was the National Basketball Association deciding that same night to suspend its season. Sports are one of America’s most influential institutions. So when league commissioner Adam Silver was seen to take the virus more seriously than even most elected officials, it had a huge impact, forcing a national conversation and resulting in cancellations and closures across a number of sectors.

President Biden and Ron Klain: Biden entered office with exactly the right approach — making covid-19 the highest priority of his administration. Klain, the White House chief of staff who also managed the U.S. government’s response to Ebola during the Obama administration, has led the implementation of that approach, both communicating that strategy in a calm and reassuring manner and executing it.

Vaccine scientists: Having vaccines rolled out so quickly was a critical success and a huge credit to the scientists and companies who worked on them, both those working in government agencies such as the National Institutes of Health and at companies such as Johnson & Johnson, Moderna and Pfizer. Barney Graham and Kizzmekia Corbett of NIH were among the key figures in the vaccine development process.

Health-care workers: More than 3,600 health-care workers died of Covid-19 over the past year, according to an analysis done by The Guardian and Kaiser Health News. That is significantly larger than the number of U.S. military deaths — about 2,300 — in Afghanistan since 2001. This was a kind of war, and health-care workers were our front-line troops, risking their lives for us all.

The American people: Millions of Americans stayed home for much of the past year, wore masks, supervised online schooling for their children, stopped seeing friends and family, and took newly developed vaccines. We needed leaders such as Beshear and Fauci, but we also needed Americans to become health leaders in their individual circles. America’s covid-19 year was terrible in so many ways. But it also showed that there are a multitude of great leaders among us.

Saturday, June 26, 2021

Six of the state's 61 health departments are losing their directors; pandemic made some of them delay or advance their departure

By Melissa Patrick
Kentucky Health News

Nearly 10 percent of the state's health departments are losing their directors, with five retiring and one resigning. And the 61 district and county health departments are losing other staff due to fatigue and stress of the pandemic.

Some of the directors who are leaving say it's due in part to the pandemic; others say it made them stay an extra year. "Many of us did not want to leave during the height of the Covid response," said Dr. Kraig Humbaugh, commissioner of the Lexington-Fayette County Health Department.

Sara Jo Best, president of the Kentucky Health Departments Association, said the pandemic has caused exhaustion, stress and depression among many public-health employees and has likely contributed to retirements.

"The health-department employees were either loved or hated at various times throughout this pandemic," Best said. "So it wasn't uncommon for us to get threatening phone calls, for us to have terrible encounters with individuals. People thought we were doing too much or they thought we weren't doing enough. There were a lot of things that got politicized that should not have. So you know, not only did they work long hours, gave up weekends, gave up holidays, didn't see their families, but on top of that, sometimes they were subject to a lot of verbal abuse and sometimes physical threats."

Best said she didn't know the number of retirements. The state Department for Public Health declined to provide the number of employees or the names of the directors who are retiring without an open-records request. Best provided the names of directors who are leaving by Aug. 1, the most popular date for state workers; some are already gone, due to accumulated vacation and sick time.

Besides Humbaugh, the retiring directors are Lake Cumberland District Health Department Executive Director Shawn Crabtree; Northern Kentucky Health Department District Director of Health Dr. Lynne Saddler; Graves County Health Department Director Noel Coplen; and Ashland-Boyd County Health Department Public Health Director Maria Hardy.

Kayla Bebout, public health director at the Christian County Health Department, is resigning, effective July 16. 

Kayla Bebout
Bebout, who has been in public health for 14 years and director since 2017, said the pandemic was not the only reason she was leaving, but it played a role in her decision. Bebout said she is moving to a job outside public health and hopes to come back eventually. 

"I feel the personal need to step away mentally, spiritually, physically for little bit, and to get refreshed," she said. "I have intentions of hopefully coming back to public health, but at this moment, I've got to do what is best for me, personally and professionally and that is to step away for just a little bit." 

The state has 61 district and county health departments, with most counties as part of a district.

Coplen, of Graves County, has worked in the state system for 34 years, 28 with the health department, said he had decided to not leave during the height of the pandemic. "I just felt like I owed it to my community and my staff that was working so hard, all of our public-health partners," he said, adding that he is leaving now because "It was time for me to retire."   

Shawn Crabtree
Lake Cumberland's Crabtree, who has 30 years invested in the state retirement system, 20 as district health director, said likewise.

"Actually, Covid prompted me to stay," he said. "I was gonna retire last August. But, you know, my board and my community and my staff have always been good to me and they're important to me, and I saw this pandemic being . . . the thing that I've been training for, for the last 19, 20 years. And I really didn't want to walk out and leave the people that's been good to me. And, you know, it was an overwhelming experience. So to think about handing that off to someone who may or may not have had . . . any kind of background or expertise, I just, I didn't feel like it was the right thing to do."

Crabtree said he was leaving because it makes financial sense to do so. "There just comes a time when you're in the retirement system, that financially it doesn't make sense to continue to work at the job," he said. State employees 57 or older can retire with full benefits when their age and years of service equal 87.

Hardy, of Ashland, said in a text reply to a voice mail that she has planned for three years to retire on July 31 of this year.

Dr. Lynne Saddler
Northern Kentucky's Saddler, who has worked in public health for 30 years, 11 in Northern Kentucky, acknowledged that the pandemic has been hard on her and her staff. She said that in January, she realized that the "stars aligned" and it became evident that for a number of reasons it was time for her to retire -- one reason being it's time for the department to do its community health assessment and reset priorities.

"I felt like it really should be done under new leadership, the person who's going to carry the health department forward to its next chapter should be the one at the helm going through these planning processes," she said. "And so it was a good stopping spot for me and it was good for the agency." 

Humbaugh was senior deputy commissioner of the state health department before becoming commissioner of Lexington's department in 2016. He said he would be seeking other opportunities.

"I know that there are several people that are leaving, but some of us actually kind of stayed on . . . because this was so important," he said. "I told our board last winter that I [thought] we'd have more control over Covid this summer, so it would be a good time for me to transition away."

He stressed that while the state has made great progress against Covid-19, it's important to remember it is not over yet, and the mental health needs of public-health employees should continue to be addressed. 

Mental health, public health and the pandemic

Challenges of fatigue, stress, depression and post-traumatic stress disorder among public-health workers have been widely reported during the pandemic.

A recently released Centers for Disease Control and Prevention survey of more than 26,000 public-health workers found that 53% reported symptoms of at least one mental-health condition in the past two weeks, including PTSD (37%), depression (32%), anxiety (30%), or ideas of suicide (8.4%). Symptoms were more prevalent in those who were not able to take time off or worked more more than 40 hours a week. 

In response to many of these concerns, Best said the state health department has surveyed its employees and provided some mental-health training, and local departments have done internal assessments and offered supports. 

"We hired a group to come in and do sessions with our staff," said Best, who is the public health director at the Lincoln Trail District Health Department. 

Crabtree, of Lake Cumberland, reiterated some of what Best said about the stress of the pandemic, saying his staff never knew when they picked up the phone if it would be in support or in opposition of their work. "That's a grind," he said. 

He said one way his agency handled the stress is to give staff opportunities to take some time off if they were feeling burnt out or overwhelmed, even when it was not convenient to do so.

Dr. Kraig Humbaugh
Humbaugh said the Lexington department has "recharge moments," encouraging employees to take breaks and do any number of given activities, like yoga or working on a puzzle. In addition, he said employees have access to an employee-assistance program.

Saddler, from Northern Kentucky, said her agency also works on supporting employees' mental health, first and foremost by talking about it, and making sure everyone knows they have a comprehensive and  confidential employee-assistance program. 

"There are times in our lives, all of us, including me, when you need to have that person, that objective person to talk to and work through things and that there's no shame in it and that it's something to take advantage of because it is so beneficial," she said. 

Saddler added that it's important to know that "we are all forever changed personally and professionally by this pandemic," and that she tries to convey to her staff that "we need to be kinder and gentler to ourselves and we need to be kinder and gentler to each other moving forward."

State Health Commissioner Steven Stack told Jack Brammer of the Lexington Herald-Leader that he knew there always has been public criticism of government, but dissent from sound medical advice took “an emotional toll” on him as he and Gov. Andy Beshear tried to save lives.

“What kept me going?” Stack asked himself. “A lot of people out there who I think and hope saw someone who cared.”

Thursday, June 24, 2021

'Functionally 100%' of new coronavirus cases this month have been among the unvaccinated; back-to-work incentive offered

Washington Post chart, adapted by Kentucky Health News; for a larger version, click on it.

By Al Cross
Kentucky Health News

Making what they called the best argument for vaccination against the coronavirus, Gov. Andy Beshear and his health commissioner said Thursday that only 0.08 percent of recent virus cases in Kentucky are in people who have received at least one dose of a Covid-19 vaccine.

At his weekly press conference, Beshear also announced a back-to-work incentive for Kentuckians getting extra unemployment benefits due to the pandemic, and a $763 million allocation of federal pandemic relief funds to child-care centers. Here are the details:

Vaccinations: Health Commissioner Steven Stack said 99.92% of the state's virus cases in the last four weeks, six out of 7,290, were in unvaccinated people. "That is functionally a hundred percent," he said. During the same period, unvaccinated people were 99 percent of those people hospitalized for Covid-19, and 93 percent of the deaths from the disease.

But only 49% of Kentucky's population has had at least one dose of vaccine, and just 42.5% are fully vaccinated, figures similar to states where the Delta variant of the virus is causing more hospitalizations.

"We've got to continue to talk about the vaccines," Beshear said. "The Delta variant's out there, and the threat is very real." He said the 99% figures presented by Stack "ought to be some of the best evidence for everybody who's qualified going out and getting vaccinated."

Stack said the variant, which originated in India and is expected to become dominant in the U.S., is more contagious than others, but only slightly more resistant to vaccines, which are 88% effective against death or severe disease from the variant.

"If you get vaccinated, you have essentially got a 90-percent-plus reduction in your risk for death and serious disease and going in the hospital," Stack said. "The new Delta variant is dangerous; it's more dangerous for younger people than the previous versions. We're gonna see more younger people get hurt. . . . Your risk is incredibly reduced if you get vaccinated." 

Stack noted that new coronavirus cases in Kentucky have declined for seven weeks in a row, much as new cases around the world have dropped for eight straight weeks, and said, "This is the result of vaccination, hands down, pure and simple. Vaccines did this."
State Dept. for Public Health graph, adapted by Ky. Health News; for a larger version, click on it.
Stack noted that the first of three drawings in the state's lottery-style sweepstakes for vaccinated people will be held next week, with the entry deadline Wednesday night. He said 472,938 adults had entered for a chance at $1 million, and 26,636 youth, ages 12-17, had entered for a full postsecondary-education scholarship, five of which will be awarded in each drawing.

He said those numbers create "way better odds" than the state lottery, and he hopes they inspire people to get a shot. "I hope, though, they're even more inspired by the fact that 100 percent of the people getting sick now in Kentucky are ones who are not vaccinated."

Vaccinations are lagging again; the seven-day average is below 10,000 a day. Beshear said signups for the drawings indicate that they have spurred vaccination, but it's hard if not impossible to tell how much. He said Ohio saw a boost when its drawings were announced, and when its first drawing was held.

Asked what the state might do about the possibility of the virus spreading from a free J.D. Shelburne concert Saturday in Spencer County, which has the state's second-lowest vaccination rate, Beshear said he was unaware of the event, but said the county's vaccinations may be under-reported due to ZIP code areas crossing county lines. Stack agreed, but said that even without the anomaly, the county would still have one of the lower vaccination rates.

Unemployment benefits: After weeks of requests from businesses and demands from Republicans, the Democratic governor said the state would give $1,500 each to the first 15,000 Kentuckians who are getting extra unemployment benefits of $300 a week and go back to work for four weeks. Critics have said the federally funded payments, which will expire Sept. 30, are keeping people from going back to work at a time when employers are having difficulty finding workers.

The governor said he has discussed the issue daily with business people, who he said have always thought a back-to-work payment would do more to get people back in the labor force than ending the payments, which some Republican governors have done. "This is meant to be surgical," he said. Details are at

Beshear said the program will cost $22.5 million, which will come from funds the state has yet to spend from the Coronavirus Aid, Relief, and Economic Security (CARES) Act that Congress passed in bipartisan votes last year. He said the parameters were chosen to get one-fourth of those receiving the extra benefit back onto payrolls, and to equal five weeks of the extra benefit, which "gets you real close" to Sept. 30. He said he could still end the benefits before that date, based on his monitoring of the situation and the experience of other states.

State House Speaker David Osborne said the incentive is “extremely insulting to those who have worked throughout this pandemic. It defies logic that they would choose to do so as long as the additional federal payments are available. . . . The fact there are more than a hundred thousand available jobs, many of which already offer starting bonuses, should serve as plenty of incentive without a one-time payment.”

Child care: The money for child care will come from the American Rescue Plan Act, passed with only Democratic votes. A state press release said $470 million will go to "sustainability payments" to child-care providers and $293 million will be used to increase provider payments, improve payment policies, raise wages for early-childhood educators and family child-care homes; and increase "the number of quality child care options for under-served populations."

Cabinet for Health and Family Services Secretary Eric Friedlander said the state will leave the pandemic with more small family providers of child care than it had going in, "so it is possible to work together to get a better spot. . . . I am so happy, and the child-care providers are so happy, that we now understand how important they are. They are vital to all of us getting back to work."

Families can apply for assistance at Information is also available at local offices of the Department for Community Based Services, where applications are also accepted.

Daily numbers: All major measures of the pandemic in Kentucky continued to decline Thursday. The state reported 204 new cases of the virus, lowering the seven-day rolling average by 7, to 174. The share of Kentuckians testing positive over the last seven days is 1.85%, the lowest on record, and the daily new-case rate over the last seven days is 3.22 per 100,000 residents.

Counties with rates more than double the statewide rate are Bracken, 20.6; Caldwell, 17.9; Hopkins, 16; Webster, 13.2; Graves, 10; Anderson, 9.4; Letcher, 8.6; Simpson, 8.5; Gallatin, 8.1; Morgan, 7.5; Carter, 7.5; Leslie, 7.2; Casey, 7.1; Greenup, 6.9; and Pike, 6.7.

The state recorded four Covid-19 deaths Thursday, bringing Kentucky's toll to 7,200. Deaths have been in single digits for the last 13 days, and no more than four have been reported for the last nine days. Deaths are averaging 3.14 per day over the last seven says and 4.43 a day over the last 14 days. The state has stopped listing individual deaths.

Wednesday, June 23, 2021

Agriculture Secretary Tom Vilsack talks at Rural Health Journalism Workshop about boosting federal nutrition programs

Secretary Tom Vilsack
By Melissa Patrick
Kentucky Health News

The Department of Agriculture is making sure children have enough to eat this summer, updating temporary food-assistance programs and evaluating federal formulas for food assistance, Agriculture Secretary Tom Vilsack told a rural health journalism workshop Wednesday.

Vilsack said he hopes the one-year Summer Food Service Program, also called the Summer Electronic Benefit Transfer Program, put in place because of the pandemic, will be continued permanently through the Biden administration's $1.8 trillion American Families Plan pending in Congress.

"We know these nutrition programs do make a difference in terms of health and educational outcomes," said the former Iowa governor in his second stint as secretary. "And so it's important for us to look at ways in which we can fill the gap between the 180 days of the school year and the summer months." 

$45 billion in the plan would also extend what is called community eligibility, which determines whether a school district is qualified for free and reduced lunch, Vilsack said. During the pandemic, all schools have had access to free meals. 

He said that for the first time in 45 years, USDA is looking at the calculations used to determine benefits in the Supplemental Nutrition Assistance Program, formerly known as food stamps, because "There are significant gaps and barriers to accessing full and complete food security."

Kentucky had 603,105 people enrolled in SNAP, or 13.5% of the state's population, in May, according to the Kentucky Center for Economic Policy SNAP data tracker.

USDA graphic; for a larger version, click on it.

A USDA study issued the same day, Barriers that Constrain the Adequacy of Supplemental Nutrition Assistance Program Allotments, found that nearly nine out of 10 SNAP participants face barriers to providing their households a healthy diet for a full month.

The most common barrier, faced by 61% of households, was the cost of heathy food. Other barriers included a lack of time to prepare meals made from scratch (30%), the need for transportation to the grocery (19%) and no storage for fresh or cooked foods (14%), a USDA press release said.

Vilsack also spoke to the importance of continuing things that worked during the pandemic, such as the food-box program, encouraging producers to donate food, and ensuring that food banks have appropriate infrastructure to store their goods. USDA recently committed $1 billion toward this effort. 

Vilsack noted at the workshop, sponsored by the Association of Health Care Journalists, that Congress will make the decisions on such changes and the "onus is on us" to make the case for them. 

"We know from studies that SNAP does reduce poverty. We know that it does improve health outcomes. We know that it reduces obesity rates among children of low income families. We know that it provides a better opportunity for these youngsters to be better learners, which results in higher graduation rates," he said. "So I think there's a return on investment that we need to remind Congress about so that as they look at the additional costs associated with these nutrition assistance programs, they understand we're getting significant benefit in reduced healthcare costs over time, in better educational outcomes and better employment opportunities for these youngsters." He added that SNAP benefits farmers and local rural economies.

Vilsack also hit on several other topics at the workshop, including issues around climate change, rural hospitals, and meat industry safety standards.

Tuesday, June 22, 2021

Risks of vaccines are very small, but one in four Kentucky adults think those risks outweigh the benefits of getting vaccinated

Foundation for a Healthy Kentucky poll, Feb. 11-March 12, 2021; error margin +/-3.5 percentage points
By Melissa Patrick
Kentucky Health News

One in four Kentucky adults told pollsters last winter that the benefits of vaccines for adults are outweighed by the risks of taking them. That poses an obstacle to getting the state protected from stronger variants of the coronavirus, and raising the risks that other diseases may spread.

The poll was taken for the Foundation for Healthy Kentucky Feb. 11 through March 12, when vaccines for the virus were becoming widely available. It did not ask about those vaccines, but about vaccines generally.

Sixty-nine percent of adults said the benefits of vaccines for adults outweigh the risks of vaccine side effects, while 26% said the risks outweigh the benefits. On vaccines for children, 77% said the benefits outweigh the risks while 18% said the risks outweigh the benefits.

"I think this is a big issue, because it's been pretty clearly proved by science across the board that vaccines are not only safe, but are crucial to the health and well-being of our citizens and our society," Foundation President and CEO Ben Chandler told reporters Tuesday.

"What we've got, essentially, is a quarter of the entire population here in Kentucky who, I would interpret, believes that the vaccines, all vaccines, are essentially dangerous, and they're concerned about taking them. . . . So we got some educating to do." 

The poll indicated that most Kentuckians have plenty of information about the pros and cons of vaccines. When asked if they had heard about the advantages and disadvantages of vaccines for both adults and children, 84% for adults and 80% for children said they had heard either a "great deal" or a "fair amount" of information on the topic.

But they may not be getting the right information, Chandler said: "We've got a problem with the internet, with the dissemination of information throughout the society." He encouraged Kentuckians to seek information from their health-care providers and the Centers for Disease Control and Prevention, which he called "the best source that we've got." 

Asked if he thought the poll findings about vaccines in general were driven by discussions about the coronavirus vaccines, Chandler said that's possible. "But the health concerns go beyond Covid," he said. "If the vaccine controversies that have taken place cause people to not get their regular vaccines in the years ahead, we are going to be dealing with some serious health problems across the board here in Kentucky, and probably across the country." 

Washington Post charts, adapted by KHN; click on them to enlarge.
Chandler spoke out as vaccine uptake in the state is waning again, and public-health officials continue to work to get 70% of the state's population vaccinated, the level needed to reach herd immunity.

The latest CDC figures, as reported by The Washington Post, say Kentucky's seven-day average is 12,207 per day, down from an average of 18,369 on June 18. The latest daily figure, subject to revision, was 5,347. 

The CDC says more than 2.1 million Kentuckians have received at least one dose of a vaccine. That's 48.4% of the state's population; 42.3% are fully vaccinated. Full-vaccination rates range from 19% in Spencer County to 58% in Franklin County. 

Polls on vaccines have found major differences among political parties. In the foundation's poll, 82% of Democrats said the benefits of vaccines outweigh the potential risk for adults; that was true of 68% of independents and 59% of Republicans. 

When asked about children's vaccines, the results were closer, with 82% of Democrats, 80% of independents and 73% of Republicans saying the benefits of vaccines outweigh the potential risks.  

Chandler, a former Democratic attorney general and congressman, summed up polling on the issue: "People in rural Kentucky, people with lower educational levels, white men, typically Republicans, are more hesitant and more concerned about the efficacy, not only of the Covid vaccine, but of all vaccines."

The foundation's annual health policy forum, to be held Sept. 20, will focus on vaccines. 

The poll, conducted by the Institute for Policy Research at the University of Cincinnati,  included more than 800 adults who were contacted by both landline and cellphones. Its margin of error is plus or minus 3.5 percentage points for each result.

Monday, June 21, 2021

Ky. is reporting fewer than 200 new coronavirus cases per day, and the share of residents testing positive has fallen below 2%

State Dept. for Public Health map, adapted by Ky. Health News; click on it to enlarge.
By Al Cross
Kentucky Health News

Leading indicators of the pandemic in Kentucky have passed more milestones on a steady downward trend, but new daily vaccinations against the coronavirus are also declining, after a two-week rise.

The seven-day rolling average of new coronavirus cases dropped below 200 Saturday for the first time in almost a year, and stands at 196. At the height of the pandemic, in early January, the figure was over 4,000 a day.

The share of Kentuckians testing positive for the virus in the last seven days fell below 2 percent Saturday, to 1.98%. It grew to 2.01% Sunday but fell Monday to 1.95%, the lowest on record. At its height, on Jan. 10, it was 12.45%.

The state no longer issues daily reports on weekends, catching up on Mondays.

The rate of daily new cases over the last seven days continued its recent decline, falling to 3.4 per 100,000 residents. Counties with rates double or more the statewide rate were Bracken, 20.6; Webster, 18.8; Hopkins, 16; Elliott, 15.2; Graves, 11.5; Perry, 10.5; Whitley, 9.1; Breathitt, 9; Carter. 8; Letcher, 8; Owen, 7.9; Simpson, 7.7; Greenup, 7.3; Fleming, 6.9; and Robertson, 6.8.

For the last two days, Kentucky hospitals have reported 202 Covid-19 patients, the fewest since early in the pandemic; the earliest state report of hospitalizations, on April 28, 2020, said there were at least 320.

The number of Covid-19 patients in intensive care has been falling for four weeks, and is now 48, with 28 on a ventilator, says the state's daily report.

Deaths have also declined, and are averaging 3.9 per day for the last seven days and 6.2 per day for the last 14 days. The state's Covid-19 death toll stands at 7,190.

Vaccinations against the virus have generally declined in the last few days, after generally rising for almost two weeks. The latest Centers for Disease Control and Prevention figures, as reported by The Washington Post, say Kentucky's seven-day average is 12,899 per day, down from an average of 18,369 on June 18. The latest figure is subject to revision.

Washington Post chart, adapted by Ky. Health News; click here for the interactive version.

Kentucky still ranks 37th in well-being of children in latest Kids Count Data Book, but isn't progressing as much as other states

By Melissa Patrick
Kentucky Health News

The annual Kids Count Data Book on children's well-being, released June 21 by the Annie E. Casey Foundation and Kentucky Youth Advocates, again ranks Kentucky 37th in the nation for the overall well-being of its children. 

The latest data are for 2019, and are largely compared with data from 2010. The report rates children's overall well-being through 16 indicators in four major domains: health, economic security, education and family and community. 

Overall, Kentucky saw improvement in 11 of the 16 indicators, did worse in three of them and stayed the same on one. One measure did not show a comparison. 

“Though the commonwealth made progress on a number of indicators of child well-being between 2010 and 2019, rankings show we are not making progress as quickly as other states – and that progress is in jeopardy unless federal and state policymakers act boldly to sustain the beginnings of pandemic recovery efforts,” Terry Brooks, executive director of Kentucky Youth Advocates, said in a news release. 

Nearly one in four Kentuckians are children. Here's a look at each domain.

Charts from Kids Count Data Book; to enlarge any one of them, click on it.
Kentucky's health ranking improved this year, to 35th. Last year's report ranked Kentucky 42nd after changing one of the domain's indicators to measure childhood obesity instead of youth alcohol and drug abuse. The last report to use the original indicator was in 2019, when the state ranked 25th for health. 

The report says 37 percent of Kentucky's children were either overweight or obese in 2018-19, the same as in 2016-17. The national rate is 31%. Kentucky has the highest childhood obesity rate in the nation. 

Kentucky continues to have a low rate of children without health insurance, 4%. The national average is 6%. The news release reports that about  45,000 Kentucky children remain uninsured.

Another indicator of children's health is the rate of babies born weighing less than 5.5 pounds. That is 8.7% in Kentucky, where it has hovered for years. 

Kentucky ranked 30th in the report's Education domain, down from 27th last year. 

The best news in this category is that 91% of Kentucky high-school students graduate on time. 

The bad news is that the share of preschool-age children not in preschool increased to 60% in 2017-19, from 57% in 2009-11. And the share of fourth-graders not proficient in reading inched up to 65% in 2019, from 64% in 2009. 

And though the share of eighth graders who are not proficient in mathematics improved to 71% in 2019, from 73% in 2009, that still means only 29% of the state's eighth graders are proficient in math. 

Economic well-being
: Kentucky ranks 40th in economic well-being, with all four indicators showing improvement since 2010. 

The percentage of Kentucky children in poverty dropped to 22% in 2019, from 26% in 2010; children whose parents lack secure employment dropped to 31% from 37%; and teens who are not in school and not working dropped to 8% from 11%. 

Also, the percentage of children living in households with a high housing cost burden dropped to 23% in 2019 from 32% in 2010.  A high housing-cost household is defined as one where more than 30% of monthly household pre-tax income is spent on housing-related expenses, including rent, mortgage payments, taxes and insurance.

Family and Community
: Kentucky ranked 43rd in the family and community domain, down from 41st in last year's report. 

Kentucky improved in three family-and-community indicators, including children living in high-poverty areas (15%), children living in families where the household head lacks a high school diploma (11%) and teen births.

The number of teen births in Kentucky continues to drop. In 2019, there were 25 births per 1,000 females aged 15-19. In 2010, that number was 46 per 1,000. The national average is 17 per 1,000. 

The percentage of children living in single-parent homes increased to 36% in 2019, from 35% in 2010. 

Impacts of the pandemic

"We cannot talk about child well-being in any meaningful way in this moment — or address the considerable challenges America’s children and families now face — without discussing the effects of the coronavirus," Lisa M. Hamilton, president and CEO of The Annie E. Casey Foundation, writes in the foreword to the report. 

To capture the impact of the last year, the Data Book takes a look at information collected in the Household Pulse Survey, which the report says was conducted in multiple waves since the onset of the pandemic by the Census Bureau and is the only source of robust national and state data related to the pandemic. 

“The supplemental pandemic-era survey data highlighted in the Data Book gives us a clearer picture of how families are faring today, including the disproportionate impact the pandemic has had on families of color," said Brooks. 

Key findings about Kentucky children in the supplemental report include: 
  • In 2020, one in five (20%) Kentucky adults with children in their household had little or no confidence in their ability to make their next rent or mortgage payment, with the highest rates experienced by Black families (40%) and Latinx families (30%). By March 2021, the statewide rate was at 15%, suggesting the beginnings of a recovery. 
  • 15% of Kentucky households with children reported sometimes or often not having enough food to eat throughout 2020 – a family stressor that hit Black households (26%) and a combination of smaller racial groups (American Indian, Alaska Native, Pacific Islander, Native Hawaiian and those of more than one race) the hardest (29%). This statistic only slightly improved overall in March 2021 to 13%.
  • More than one in four (26%) Kentucky adults living in households with children felt down, depressed, or hopeless in 2020, with only slight improvement (22%) by March 2021.
Brooks, of Kentucky Youth Advocates, said, “The commonwealth can and will bounce back from the ripple effects of the pandemic, and a key component of that is ensuring kids and families have the resources to meet basic needs and overcome daily challenges.”

Brooks praised the state's leaders for supporting children during the pandemic, by supporting child care, using federal funds to address the pervasive "digital divide," and ensuring schoolchildren have access to food while learning at home through the pandemic EBT program. 

KYA wants Congress to make the expansion of the child tax credit permanent, and wants Kentucky to enact its own refundable earned-income tax credit; to focus on increasing access to high-quality child care; to use federal funds to improve school-based mental-health supports for students; to expand school-based nutrition programs; to allow state employees 12 weeks of paid family leave after the birth or adoption of a child; and to double down on efforts to support families involved in the child welfare system. 

The Kids Count Data Center provides current and trend data for child well-being indicators related to each of the four domains in the report, at both a state and county level. It also offers a feature to create customized tables, maps, bar charts and graphs.

Sunday, June 20, 2021

Temporary Medicaid ending; special marketplace enrollment period ends Aug. 15; premium-free COBRA ends in September

Families USA graphic; for a larger version, click on it.
By Melissa Patrick
Kentucky Health News

Kentuckians have about two more months to buy reduced-cost health insurance on the federal marketplace under the special enrollment period. The deadline to sign up on is Aug. 15. 

The Biden administration reopened the marketplace in mid-February under the American Rescue Plan Act, for people who needed coverage during the pandemic, and later extended the deadline to Aug. 15. 

The special enrollment is open to both new and existing customers, including the thousands of Kentuckians who qualified for temporary Medicaid coverage during the pandemic through the state's "presumptive eligibility" program. The PE program will end for some of them on June 30.

"Kentuckians who will be losing their PE coverage at the end of this month, should contact a kynector to learn more about regular Medicaid and Marketplace options," Kentucky Voices for Health said June 15. 

KVH said Kentuckians who have been enrolled in PE coverage since January will be disenrolled on June 30. Those who enrolled after January may have a different end of coverage date.  

The special enrollment period includes provisions that make the plans more affordable, including enhanced premium subsidies, also known as tax credits, to help offset the cost of insurance. It also makes more people eligible for the subsidies, limits costs to no more than 8.5% of income, down from nearly 10%, and eliminates repayments that may be required when people reconcile their tax return with the tax credit they received. 

“Four of five enrollees will be able to find a plan for $10 or less per month after premium tax credits, and over half will be able to find a Silver plan with a zero-dollar premium," Carrie Banahan, deputy secretary of the state Cabinet for Health and Family Services, said in a news release. 

Silver plans have the the second-lowest costs and are the benchmarks used to calculate the tax credits. They are the most common choice of marketplace shoppers, said Banahan.

State officials said premiums will decrease on average by $50 per person per month, or by $85 per policy per month, although the savings will vary per individual. 

Through the end of May, just over 10,000 Kentuckians signed up for health insurance during the special enrollment period, according to a federal report

That's an increase in enrollment from the same period in 2020 and 2019, when 5,550 and 5,789 signed up, respectively. Open enrollment is usually in effect only six weeks at the end of a year, except for those who experience a "qualifying life event," like getting married or losing a job.

Nationwide, more than 1.2 million people have signed up. 

New premium-free COBRA options until September

If you had health insurance through your job until you lost hours or lost employment, you and your family may qualify for health coverage through premium-free COBRA (which stands for the Consolidated Omnibus Budget Reconciliation Act of 1985, which instituted the provision). 

The American Rescue Plan also requires the federal government to pay 100% of COBRA insurance premiums for eligible employees who lose their jobs (and for their covered relatives) through September, allowing them to stay on their company-sponsored health plans.

Families USA offers a fact sheet that answers a variety of questions about eligibility, enrollment process and other topics. It also features a list of local, state and national resources. 

Families USA also warns consumers that COBRA is only available through their former employer or health plan, and not through a website. 

President Biden has proposed in his American Families Plan to make some of these pandemic changes permanent, including the premium tax credits, expanded coverage to those who earn 400% and above the federal poverty level, and the 8.5% household income cap on the monthly amount a person would pay for their policy.