Appeals court OKs plan that shields owners of Purdue Phrama from future lawsuits; they must give it up and donate billions

Purdue Pharma's headquarters in Stamford, Conn.
(Photo by Drew Angerer, Getty Images, via New York Times)

A federal appeals court has approved a settlement by Purdue Pharma, the maker of OxyContin, that protects its billionaire owners, the Sackler family, from future lawsuits. The Sacklers would give up the firm, which would take the new name Knoa, "with its profits being sent to a fund to prevent and treat addiction," reports Geoff Mulvihill of The Associated Press.

"Family members would also contribute $5.5 billion to $6 billion in cash over time, or about half of what the court found to be their collective fortune, much of it held offshore. At least $750 million of that money is to go to individual victims of the opioid crisis and their survivors. Payments are expected to range from about $3,500 to $48,000."

Tuesday’s decision by The U.S. 2nd Circuit Court of Appeals in New York also protects the family from lawsuits "over the toll of opioids, even though they did not file for bankruptcy," AP notes. "The court’s ruling reversed a 2021 ruling that found bankruptcy court judges did not have the authority to approve a settlement that would offer bankruptcy protections for those who have not filed for bankruptcy."

The deal "would end claims filed by thousands of state, local and Native American tribal governments and other entities," AP reports. "Sackler family members have been clear that without the protections, they won’t hold up their part of the deal. . . . Several states had withheld support for the plan, but after a new round of negotiations last year, all of them came on board."

The sole remaining objector was the Office of the Bankruptcy Trustee in the Justice Department, which "did not immediately say whether it would appeal Tuesday’s ruling to the U.S. Supreme Court, ask the Circuit Court to review its decision or accept the ruling as is," AP reports. "Even without an appeal, it could be months before the bankruptcy plan takes effect."

Invisible radon gas is the No. 2 cause of lung cancer in Kentucky but only 0.13% of houses in the state have been tested for it

Radon potential is measured in becquerels per cubic meter; a becquerel is one radioactive decay per second. Generally, the rate depends on the geology of a location and how much uranium and thorium are in the rocks, but levels in individual buildings vary depending on construction and exact location.

Three of every seven buildings in Kentucky have elevated levels of a colorless, odorless gas that is a significant cause of lung cancer, reports Bill Estep of the Lexington Herald-Leader. That rate of 42% is six times the national rate of 7%, according to the Kentucky Association of Radon Professionals.

But only 13 of every 10,000 houses in Kentucky have been tested for radon, says Ellen Hahn, a professor in the University of Kentucky nursing professor who runs BREATHE, which stands for Bridging Research Efforts and Advocacy Toward Healthier Environments.

Kentucky has the nation's highest age-adjusted rate of lung cancer, mainly because it has the nation's second-highest smoking rate, but some people who have never smoked or have little exposure to indoor tobacco smoke get lung cancer. Radon is the No. 2 cause of lung cancer, and a combination of radon and smoking create an even higher risk of the disease, Estep reports.

Lindi Campbell (Breath of Hope KY photo)

"Lindi Campbell, 58, was fit, active and had never smoked, but had to have two lobes of her right lung removed in December 2017 as a result of developing lung cancer. Campbell said she grew up in Lexington in a house where she was exposed to secondhand cigarette smoke and radon," Estep reports. "After she was diagnosed with cancer, she had her childhood home tested. The results showed a radon level that was the equivalent of smoking 40 cigarettes a day, she said."

Campbell is president of Breath of Hope KY, which tries to raise awareness about lung cancer, reduce stigma surrounding it, and raise money for research.

Radon is a product of the natural decay of uranium and thorium, another radioactive element. "As it breaks down, it releases radioactive particles that can be inhaled and damage lung tissue over time," Estep notes. Newer homes are more likely to have a buildup because are more tightly sealed.

Estep offers ways to take action to protect yourself: "Radon information is available through several sources, including BREATHE; the Kentucky Geological Survey; the Kentucky Radon Program; the U.S. Environmental Protection Agency; and the American Lung Association. Health officials also recommend testing your home."

“Everyone needs to test,” Hahn said. “There’s no risk-free level of radon.”

"Free test kits are available at many county health departments, and people can also request a kit through the Kentucky Radon Program," Estep reports. "People in Pulaski, Rowan, Logan and Christian counties can check out test kits at public libraries, with a valid library card, as part of an on-going study by BREATHE. People can also buy test kits at home-improvement stores or online. Companies that install systems to pull radon out of homes can also test for the gas."

And how much do those systems cost? "Tracy Howard said it cost $1,300 to have Alpha Radon Remediation install an exhaust system in the basement of her house in Stanford on May 24," Estep writes. "Howard got a free test kit from the local health department and the results showed a radon level of 4.2, just over the limit at which the EPA recommends installing a system to reduce the radon level. Howard, a nurse who works from home to do remote patient monitoring, shares the house with her husband and their daughter and 4-year-old grandson. She wanted to reduce their risk of exposure to the cancer-causing substance. To her, it was worth $1,300 to accomplish that."

“I know how dangerous it is,” Howard told Estep. “Consider the cost of installing the system vs. the cost of getting lung cancer later in life.”

Lt. Gov. Jacqueline Coleman announces $40 million in federal funds for Kentucky schools to provide mental-health services

Lt. Gov. Jacqueline Coleman (Image from Facebook)

Lt. Gov. Jacqueline Coleman announced $40 million in federal funding is coming to Kentucky schools to support and expand access to school-based mental health services, Tom Latek reports for Kentucky Today. 

Coleman said this is important because "Students are six times more likely to access mental-health services when they are offered in schools." 

Coleman was speaking May 30 in the Capitol rotunda, where she and and other advocates gave an update on the student mental-health initiative that she began nearly two years ago. 

Coleman said the plan is for regional educational cooperatives, comprising school districts, to give the money to "major universities" in their area to be used to recruit, train and educate mental health professionals for grade school children in each region, Munashe Kwangwari reports for WLKY.

"We are building the workforce while providing services to the kids who do not have access right now," Coleman said, adding that the issue remains important in Kentucky and across the rest of the nation. She pointed to several studies to back up this claim, Latek reports, quoting her at length:

“A Pew Research internet poll reported earlier this year, 40% of U.S. parents of children under 18 say they are extremely or very worried that their children may struggle with anxiety or depression, while 36% indicated they were somewhat worried about this," Coleman said. 

She also quoted from a 2021 Kentucky Incentives for Participation program survey: “Twenty-two percent of the students in grades 6, 8, 10, and 12, reported serious psychological distress in the past 30 days. In a 2021 Kentucky Youth Behavior Risk survey, 9.8% of Kentucky middle school students, and 9.5% of Kentucky high school students attempted suicide, over the previous 12 months.”

The issue of youth mental health is so prevalent that U.S. Surgeon General Vivek Murthy issued a public-health advisory in December 2021 that said there is an urgent need to address a mental-health crisis among the nation's youth. In may, he issued another advisory drawing attention to the dangers of social-media use to children's mental health. 

Coleman also noted that all three branches of state government have put forth initiatives to prioritize student mental health, including a three-day mental health summit held by the Kentucky Supreme Court this week, Latek reports. 

Coleman added, “Now is the time to act. It is incumbent upon all of us to work together on this critically important issue, the number one issue here and across the country. This isn’t about right or left, it’s about doing what’s right, to make sure no student gets left behind.”

The heat is on; here's how to keep your heart healthy in summer

By Dr. Vincent Sorrell

Chief of cardiology, UK HealthCare

Memorial Day marks the unofficial start to summer. From outdoor barbecues to lounging by the pool, summertime means more time spent outdoors with friends and family. But fun in the sun comes with risks.

Humans regulate heat through blood flow. A healthy heart dissipates heat by pushing blood toward the skin. We also shed heat through sweat. People with pre-existing heart conditions are especially at risk, as heat can put extra stress on the heart. According to the Centers for Disease Control and Prevention, more than 600 people die every year from preventable, heat-related illnesses. More than 65,000 are treated in the emergency room for heat stroke, heat exhaustion and dehydration.

It’s important to recognize the signs of heat exhaustion and heat stroke and what to do is someone is in danger. With heat exhaustion, look for signs such as heavy sweating, paleness, muscle cramps, fatigue, and dizziness or fainting. It can be treated by moving the person indoors and cooling them off with a cool cloth. If they don’t improve in an hour, seek medical help.

Heat stroke is more severe. Symptoms include high body temperature (above 103º F), skin that’s red and hot but not sweaty, rapid pulse, throbbing headache, and dizziness and confusion. Heat stroke is a medical emergency — call 911 right away if you see someone in distress.

Dehydration can begin within just a few hours of the onset of extreme heat. Signs of dehydration include fatigue, headache, muscle cramps, dizziness and dry mouth. Dehydration causes the heart to pump harder, which can put heart patients at further risk. Elderly patients in particular need to drink up, as they may not feel thirsty until they are dehydrated. Some patients may still not feel thirsty even after they become dehydrated.

Here are some ways you can stay safe in the sun:

Drink lots of water. Hydration helps the heart pump more easily and helps the muscles work more efficiently. The more you sweat, the more you need to replenish fluids. Skip the alcohol, coffee and tea as it can further dehydrate you. It’s important to keep drinking, even if you don’t feel thirsty.

Keep your cool. In excessively hot temperatures, stay indoors. If you must be outside, find a shady spot and use a fan or a damp towel to stay cool. At the peak of heat in the early afternoon, avoid being outside for prolonged periods of time. Wear loose, light-colored clothing as well as a hat.

Monitor medications. Due to the extra strain of heat, heart patients need to be diligent in keeping up their prescription regime.

Be smart when it comes to exercise. Exercise is important for long-term heart health. If you don’t have the option to take your work out indoors, stick to the early hours of the day. Take it easy — avoid excessive or intense effort in extreme heat.

Researchers develop a scoring system to identify long Covid; ongoing study at 85 sites needs more rural participants

Epigram.org.uk

Researchers have developed a method to determine whether someone is suffering from long Covid-19, defined as "post-acute sequelae Covid." Sequelae are conditions resulting from earlier disease or injury.

"This symptom-based PASC definition represents a first step for identifying PASC cases and serves as a launching point for further investigations," the reserachers report in the Journal of the American Medical Association. "Future analyses must consider the relationships among age, sex, race and ethnicity, social determinants of health, vaccination status after index date, co-morbidities, and pregnancy status during infection."

"Researchers identified symptoms that are the most distinctive to long Covid, including: fatigue, especially after exercise; brain fog; dizziness; gastrointestinal symptoms; heart palpitations; issues with sexual desire or capacity; loss of smell or taste; thirst; chronic cough; chest pain; and abnormal movements," reports Karen Weintraub of USA Today. "Each self-reported symptom is given a score and someone with a score of 12 or more 'is a person who very likely has long Covid,' said Dr. Leora Horwitz, who helped lead the research from the New York University Grossman School of Medicine. "It doesn't mean these symptoms are the most common, or the most severe, or the most burdensome, or the most important to people. It just means that these are the ones that help us identify people who have long-term consequences."

The researchers studied 9,764 adults at 85 hospitals, health centers, and community organizations in 33 states. "More than 20% of people who've had Covid score high enough six months after their infection to meet this working definition of long COVID, although one-third of them no longer meet the criteria at nine months," Weinraub reports.

The National Institutes of Health funded the research, which is continuing. "The study is still looking for participants who are Hispanic or who live in rural areas," Weintraub notes.

Legislators nix Beshear's 2nd regulation to expand Medicaid dental, vision and hearing services, but it'll remain in place for now

Kentucky Voices for Health graphic supports the expansion,
which legislators say they oppose on procedural grounds. 

By Melissa Patrick

Kentucky Health News

The legislature's Administrative Regulation Review Subcommittee voted May 9 to find Gov. Andy Beshear's new regulations to expand Medicaid's vision, dental and hearing services deficient, based largely on process. 

"This deficiency vote has nothing to do with the regulation itself," said Co-Chair Sen. Steve West, R-Paris. "As far as expanded dental services, I think every single person up here on this committee would be in support of expanded dental services. I don't think there's any question about that. But our job in this committee is to protect the legislative process and protect the legislative branch and our role in the process. I don't think we would be here if there was some level of effort from the cabinet to meet us halfway, to discuss it, to show up in our office and work through this thing together. But in my case personally, there has been none of that." 

Beshear, asked what the deficiency means for Kentucky adults who are receiving these new services under the regulation that was recently found deficient, said, "They're still in place, at least until the next legislative session." 

At his weekly news conference, Beshear also talked about how important these basic services are to getting Kentuckians back into the workforce.

"This is about helping people with very basic needs . . . being able to see, being able to hear, being able to get the dental appointment, because we lose millions of productive hours at work due to emergency dental procedures that could otherwise be prevented," he said. "So this is a no brainer when you look at the low costs versus the number of people we can get back into the workforce."

This is the second set of regulations aimed at expanding these Medicaid services to be found deficient by the subcommittee. 

The original set was also found deficient by the 2023 General Assembly in Senate Bill 65, thus ending the benefits. SB 65 also stated that the Cabinet for Health and Family Services was prohibited from promulgating any new regulations unless they were "substantially different" from the original one. 

Within two weeks of SB 65 becoming law, the health cabinet filed the new regulations to expand vision, dental and hearing services for people on Medicaid, with each of the regulations stating the reasons that they were "substantially different" from the original regulation. 

West said in a news release, “What we are witnessing here from CHFS is an overt effort to ignore duly enacted legislation and, to make it worse. It is a poor administration of the Medicaid program and those it serves. We want to provide the highest-quality services to the most people we can, but this isn’t the appropriate way to achieve that goal. We can’t afford the current Medicaid program, so why would we expand services in an already unsustainable program? The regulation discussed today is irresponsible, strains the system, and picks winners and losers. Taxpayers and Kentucky residents deserve better.”

Officials from the state Department for Medicaid Services told the committee that the new regulations were in compliance with SB 65. Medicaid Commissioner Lisa Lee said the new regulations were "substantially different" because they added services and increase fees for a number of services in each category. 

Lee also called the expansion of these benefits a great "return on investment" because federal funds will cover $31 million of the $36 million total cost. The state's share is coming from savings that Medicaid achieved by moving to only one pharmacy benefit manager, the middleman between drug manufacturers and the managed-care organizations that deal with Medicaid beneficiaries. 

Several subcommittee members voiced concern that Kentucky’s Medicaid program does not adequately cover behavioral-health services, emergency medical services and other services, and that those programs should have been considered when deciding how this money is spent.  

"What we should be doing is having a holistic conversation about how do we appropriately raise rates to take care of our most vulnerable population, so that we don't just have one winner, that we can have a lot of different winners," said Sen. Julie Raque Adams, R-Louisville. 

The expanded services cover 900,000 adults on Medicaid. 

Rep. Daniel Grossberg, D-Louisville, noted that because of these expanded services, "We've gotten 60,000 Medicaid members who have received glasses who would not have otherwise received glasses, 932 dentists have received reimbursement for crowns on more than 5,600 individual members who would not have otherwise been reimbursed or received crowns. We have nearly 1,200 members who have received dentures who would not otherwise receive dentures. And providers have received over $11 million that would have not otherwise yet received." 

Just a few more days remain for Kentuckians to offer public comment about the new regulations. The cabinet is accepting written comments until May 31. Comments should be sent to Krista Quarles, policy analyst, Office of Legislative and Regulatory Affairs, 275 East Main Street 5 W-A, Frankfort KY 40621. Her phone number is 502-564-6746; her fax is 502-564-7091; and her email is CHFSregs@ky.gov.

Meanwhile, Kentucky Voices for Health is still collecting comments from anyone who would like to make a public comment on these regulations, as they have done before for other rules. KVH will submit the comments for anyone who fills out one of their comment forms.

New Kentucky website provides data, maps and charts on how the environment affects human health, county by county

The website's address is Healthtracking.ky.gov.

The state Department for Public Health has launched a new resource for tracking a variety of topics that affect health in Kentucky. 

The website Healthtracking.ky.gov not only includes information and data about how the environment affects human health in a number of ways, but also presents data in map, chart or table formats for subcategories in each topic area. 

For example, under the category of heart disease and stroke, the site also provides information about the age-adjusted rate of hospitalization for heart attacks in each county, the crude rate of hospitalizations for heart attack in each county, and the number of hospitalizations for heart attack in each county. 

Other topics include: air quality, asthma, birth defects, cancer, childhood lead poisoning, chronic obstructive pulmonary disease (COPD), carbon-monoxide poisoning, climate and weather, drinking water, heat-related illness, radon (a naturally occuring, cancer-causing gas) and reproductive and birth outcomes. 

Data on the new site comes from several counrse, including the Centers for Disease Control and Prevention, the Environmental Protection Agency, the Kentucky Cancer Registry, state and local Health Departments and many others. Data can be examined at a state or county level.

The site also offers online maps with information about local health departments, prescription assistance, social vulnerability, and community vulnerability to Covid-19. It is managed by the health department's Environmental Public Health Tracking Program.

Rep. Guthrie's bipartisan bill to increase access to breakthrough therapies for people on Medicaid advances out of committee

Rep. Brett Guthrie addresses the House Energy
and Commerce Committee May 24. (Screenshot) 

U.S. Rep. Brett Guthrie's bipartisan bill to help Medicaid patients access breakthrough therapies, including gene therapies, to treat and cure rare diseases was approved by the House Energy and Commerce Committee on Wednesday, May 24.

The bill would allow access to innovative treatments and cures by enabling states to voluntarily enter into value-based purchasing (VBP) agreements for drugs, which ties the cost of treatments to patients' clinical outcomes. 

The bill, H.R. 2666, has been dubbed the Medicaid VBPs for Patients Act, or MVP Act. It was one of 19 pieces of legislation considered by committee on May 24, many of them aimed at increasing transparency and competition in the health-care industry.

Guthrie, a Republican from Bowling Green who represents the Second Congressional District, chairs the committee's Health Subcommittee, which approved the bill May 17. He issued a statement saying:

“The Medicaid VBPs for Patients Act would help get life-saving treatments to the most vulnerable patients across the country. With the flexibility this legislation provides, states can make high-cost therapies and cures for rare diseases available without raising taxes or cutting other state programs. Value-based payments ensure states are not on the hook for paying a drug manufacturer for a high-cost treatment if it is not effective and can even save states money in the long-term in caring for a patient.”

Guthrie added, “I will continue pressing for this legislation that better aligns incentives in health care and helps people have a better life.”

The other sponsors of the bill are Democratic Reps Anna Eshoo of California and John Auchincloss of Massachusetts and Republican Reps. Mariannette Miller-Meeks of Iowa and Dr. John Joyce of Pennsylvania.

Surgeon general issues public-health advisory that warns about the dangers of social-media use to children's mental health

CNN image

By Melissa Patrick

Kentucky Health News

Concerns about the effects of social media on youth mental health prompted America's top public-health official to issue a rare public-health advisory that calls for a multifaceted approach to find ways to minimize the harm. 

"The bottom line is we do not have enough evidence to conclude that social media is sufficiently safe for our kids. In fact, there is increasing evidence that social media use during adolescence — a critical stage of brain development — is associated with harm to mental health and well-being. In light of the ongoing youth mental health crisis, it is no longer possible to ignore social media’s potential contribution to the pain that millions of children and families are experiencing," Surgeon General Vivek H. Murthy writes in an op-ed about the advisory for The Washington Post. 

Social media use among teens is pervasive, with 95 percent of U.S. teenagers using the platforms and more than one-third saying they use social media "almost constantly," the report says. And this isn't just a teenage phenomenon; nearly 40% of children 8 to 12 years old use social media. 

The advisory walks through the benefits and harms of social media for children. 

It says social media may benefit children by allowing them to connect easily with friends and family or those who share abilities interests and identities, and a space to express themselves and find support when they need it. 

But it also says social media use can result in reduced sleep among youth, and expose them to extreme, inappropriate content and online bullying. One study has found that youth who spend more than three hours a day on social media face double the risk of experiencing poor mental health, including symptoms of depression and anxiety. This is of great concern because on average, one survey found that eighth and 10th graders spend about three and a half hours a day on social media, says the report.

"More research is needed to fully understand the impact of social media," says the 19-page advisory, titled "Social Media and Youth Mental Health." Current evidence "indicates that while social media may have benefits for some children and adolescents, there are ample indicators that social media can also have a profound risk of harm to the mental health and well-being of children and adolescents."

The advisory lays out steps that policymakers, technology companies, researchers, families and young people can take to make social media safer for youth. Following are some of the suggestions for various interests. 

Policymakers are encouraged to strengthen safety protections for children interacting with social media platforms and to develop age-appropriate health and safety standards. They are also called on to require higher safety standards of data privacy for children. 

Technology companies are urged to create safety standards for social media that protect youth from exposure to harmful content and online harassment. They are encouraged to limit features that manipulate youth into excessive and unhealthy use of social media. The report also calls on them to be transparent and to share their assessment findings and data with independent researchers. 

Families are asked to model responsible social-media behavior and to create a family media plan. It also asks families to create tech-free zones that encourage other activities. 

Youth are reminded that they can reach out for help if they are negatively affected by social media and to be cautious about what they share.

The American Psychological Association recently issued a health advisory on social-media use in adolescence that included 10 research-based recommendations.

Ky. Hospital Assn. hands out annual quality awards to hospitals

The Kentucky Hospital Association recently gave Kentucky hospitals its annual Quality Awards, honoring them for their leadership, innovation in quality, safety and commitment to patient care. The recipients were: 

• Bluegrass Community Hospital in Versailles and Deaconess Union County Hospital in Morganfield - critical access hospitals 
• Rockcastle Regional Hospital in Mount Vernon - hospitals with fewer than 100 beds
• Ephraim McDowell Regional Medical Center in Danville and St. Claire Regional Medical Center in Morehead - hospitals with 100 to -250 beds
• St. Joseph Hospital, Lexington, and Owensboro Health Regional Hospital - hospitals with more than 250 beds
• The Brook Hospital-KMI, Louisville - psychiatric hospitals
• Continuing Care Hospital, Lexington - physical rehabilitation or long-term acute care hospital 
• St. Elizabeth Healthcare of Northern Kentucky - system project
• U of L Health, Louisville - KHA Quality-Centered Health System Award, a new one for the association

"These hospitals and systems demonstrated not only a dedication to patient safety, but their persistence in going above and beyond what is expected for providing quality care," a KHA news release said.

Hospital group honors health-care leaders at annual convention

By Melissa Patrick

Kentucky Health News

Larry Gray of Baptist Health Louisville and Carl Herde of the Kentucky Hospital Association were awarded the KHA's Distinguished Service Award at the association's 94th annual convention in Lexington May 17. 

The award, considered the association's highest honor, is given to individuals who have given untiring and exceptional service to their hospital, community, the state and KHA, according to a news release. 

Larry Gray accepts Distinguished Service Award
from KHA President Nancy Galvagni (Photo provided)

Gray is president of Baptist Health Louisville and has served in the Baptist Health system for more than 35 years. A hospital news release in February said he plans to retire this year.

The KHA release notes that Gray led the hospital through the Covid-19 pandemic and that Louisville Business First named him a Healthcare Hero for his extensive Covid-19 vaccine outreach and his leadership abilities. 

Prior to his role at the Louisville hospital, Gray served as the director of pastoral care in 1988, the vice president for System Support and Administrative Services at Baptist Health Lexington and president of Baptist Health Corbin. 

Carle Herde accepts Distinguished Service
Award from Nancy Galvagni (Photo provided)

Herde, vice-president of financial policy at KHA, also received the Distinguished Service Award. 

Herde started at Touche Ross & Co., the predecessor firm of Deloitte & Touche in Louisville. He joined Baptist Health in 1984 as a controller and eventually served as the chief financial officer and vice president during his 23 years with the system. He also served on multiple boards throughout his career. After retiring, Herde joined the KHA in 2016.  

During his time at the association, Herde led the charge to secure funding for Kentucky’s hospitals with the Hospital Rate Improvement Program. A KHA release said the program has helped keeping hospitals open during a financially difficult time.

KHA gave the late Thomas "Tommy" Elliott of LOuisville its Health Care Governance Leadership award, for individuals who make a positive and sustainable impact on the quality of care in their communities through their work as governing-board members. Elliott was killed in the mass shooting at Old National Bank in Louisville on April 10.

The KHA release says Elliott was committed to providing health equity for the people of Kentucky while serving on the boards of Baptist Health Louisville, the Baptist Health System and the Greater Louisville Foundation from 2008 to 2022. He also served on several charitable organizations’ boards.

In dedicating memorial, Beshear says he intended it partly as a response to those who discounted the pandemic for political ends

Elder Mario Webb and the New Covenant Gospel Choir of Lexington sang at the dedication of the state's Covid-19 memorial on the state Capitol grounds Wednesday. A sign-language interpreter stood at the lectern and Gov. Andy Beshear sat to her right. (Photo by Al Cross, Kentucky Health News)

By Al Cross
Kentucky Health News

As he dedicated the state's memorial to Kentucky's 18,600-plus Covid-19 victims Wednesday, Gov. Andy Beshear said it was intended partly as a response to those who diminished the pandemic for political reasons.  

"I wanted everyone who's lost someone to this virus to know that their loved one was important, and that they are missed, and that we in Kentucky will not bow to politics, we will recognize the loss that we have been through; we will recognize the sacrifices that were made, and we will provide a place, a safe place, for everyone to be able to come to grieve, to remember, and hopefully to process it in a way that helps them move forward."

Asked afterward what he meant by not bowing to politics, the Democratic governor said "We're gonna honor those that we lost, we're gonna honor those that sacrificed. Just because talking about something is difficult ... that doesn't mean you don't do the right thing." Asked what "politics" would have him do otherwise, he said, "Not talk about Covid anymore.'

The state's Republican leaders, none of whom were at the event on the state Capitol grounds, have been talking about Covid as part of their campaign to unseat Beshear in the Nov. 7 election. He was asked what he would say to their arguments that his emergency measures lasted too long and were too strong.

"We lost 18,600 Kentuckians, and we would have lost a lot more. Tell that to the folks here who lost their loved ones," he said. "It diminishes the sacrifices made by so many, whether that's health-care workers, all the way to our kids that understood the sacrifice they were making. And to them, it was easy; it meant if somebody's relative would still be alive because of their actions, they were willing to do it."

In his dedication speech to the crowd of about 150, Beshear said health-care workers showed "more courage than most of us would have imagined," working with insufficient personal protective equipment early in the pandemic. "As more disease then we could ever imagine swept through the doors, they kept showing up" at hospitals, nursing homes and clinics.

At the time, it was thought that as many as 10 percent of those exposed to the virus would die from it, said Dr. Jason Smith, chief medical officer of UofL Health. "Yet we never had a problem getting people to come and take care of people who were affected." He said the privately funded memorial should be not just for those who were lost, "but for what we can be."

Beshear said "It's hard not to think about how far we've come and about how we never take certain things for granted again; just being able to hug your fellow human beings, being able to go to a restaurant with your family, making those memories, 'cause Covid reminds us that life is fleeting and short'; you can lose someone in an instant. And I believe we as a people are not just more united, despite everything out there, based on what we have been through; but I think we are more grateful for all of the moments that we have."

Rabbi at dedication of pandemic memorial says 'Denial can never cure disease, and ... distortions can never change facts'

Rabbi David Wirtschafter

Wednesday's dedication of the state's pandemic memorial closed with a prayer from Rabbi David Wirtschafter of Lexington's Temple Adath Israel, who first read his adaptation of Archibald MacLeish's poem "The Young Dead Soliders Do Not Speak," written about World War I. MacLeish had the soldiers say, "We leave you our deaths. Give them their meaning. Wirtschafter said sculptor Amanda Matthews' work "challenges us to answer the question: 'What will these Covid deaths mean?' Whether they are for a new hope, or for nothing, is tragically not up to those who died, but it is up to us." Then he read his adaptation of MacLeish's work:

"The casualties of Covid do not speak.
Nevertheless, they are heard in the still houses. Who has not heard them?
They have a silence the speaks for them at night, and when the clock counts.
They say, 'We were your fellow Kentuckians, your neighbors, your countrymen, your co-workers, your family, your friends. We have died. Remember us.
They say, 'We weren't allowed to finish our lives. Covid finished them.
They say, 'We lost our lives, but who will bear witness to those who were lost?'
They say, 'Our deaths are not ours, they are yours. They will mean what you make them.'
They say, 'Whether our lives and our deaths will lead to real change and a new hope, or for nothing, we cannot say. It is you who must say this.'
They say, 'We leave you our deaths, Give them their meaning. We were your fellow Kentuckians, your neighbors, your countrymen, your friends, your co-workers, your family. 'We have died,' they say. 'Remember us.' "

In his closing prayer, Wirtschafter asked God to "guide our deeply divided state in the sacred cause of reclaiming our sense of common humanity. Teach us to overcome the anger, fear, hatred and recklessness that all too often made the hospitalizations and deaths higher than they had to be. Remind us that denial can never cure disease, and that distortions can never change facts."

Pandemic memorial at Capitol to be dedicated Wednesday

The memorial is pictured on Monday, after the final sod had been laid and watered. The Capitol steps are in the background on the right. (Kentucky Health News photo by Al Cross; click on it to enlarge)

The state's permanent memorial to Kentucky vicims of the Covid-19 pandemic will be dedicated at 2 p.m. Wednesday on the grounds of the state Capitol.

The memorial – titled “United We Stand. Divided We Fall,” after the state motto – was designed and sculpted by Kentucky native Amanda Matthews, artist and chief executive officer of Lexington's Prometheus Foundry.

“This phenomenal new memorial honors the 18,653 Kentuckians lost during this once-a-century pandemic,” Gov. Andy Beshear said in a press release. “It will stand in a place of prominence in the Capitol Monument Park for generations to come so that they might learn about the great challenges we faced and how Kentuckians came together during this crisis.”

Matthews said her work "captures the ideals and visual symbols of our state motto and seal in three-dimensional form. Most important to the concept are the diverse people of Kentucky and their fear and grief during the time of Covid, yet their strength and hope for better days."

The memorial's center is encircled by green lights, symbolizing empathy and compassion for the Kentuckians lost throughout the pandemic; white lights shine through the night until sunrise.

The memorial has several semi-abstract human figures
of varying sizes. (Commonwealth of Kentucky photo)

The human figures in the memorial each have a small bell in a cutout where the heart would be. Matthews told the Lexington Herald-Leader, "When you grieve deeply it affects your whole body, but ut really, truly, affects your heart space and I wanted to show that emptiness."

The dedication will begin with the chiming of bells by Kandie Adkinson, a longtime employee in the secretary of state’s office, recalling Beshear's request early in the pandemic that Kentuckians ring bells at 10 a.m. each day "so that those who were feeling alone would know we were with them," the release says. For months, each weekday at 10 a.m. in the Capitol rotunda, Adkinson rang her father’s bell 120 times to honor those lost in each county. 

The memorial's final design was selected by an advisory panel of health-care workers, Covid-19 survivors, and family members and loved ones of victims.

“The Covid-19 Memorial is a beautiful way to honor all those we loved dearly,” panel member Jacqueline Woodward said. “It will ensure future generations remember the dedicated Kentuckians we lost during this tragic pandemic that impacted so many lives. May the memorial be another means to bring comfort and peace to those who lost a loved one. I feel truly blessed to be a part of this project.”

Woodward will speak at the dedication, along with Dr. Jason Smith, chief medical officer at UofL Health, who will talk about the impact of Covid-19 in the state and the memorial’s creation.

“This memorial honors the thousands of Kentuckians we lost throughout the pandemic,” Smith said in the release. “It also represents the strength of our commonwealth and our citizens to join together, support each other and persevere. The pandemic revealed many heroes. In particular, it shines a light on the incredible work of our health-care workers, who put themselves on the front line to protect and heal our community. This memorial is a symbol of hope and stands as a reminder that our work towards keeping our state safe is not done.”

Beshear will speak about the two main legacies of the pandemic in Kentucky, the release said, quoting him in advance: “One is loss. In a little more than three years, this evil virus caused the deaths of more than 1.1 million Americans, including more than 18,600 Kentuckians. But this memorial also reflects a second legacy of Covid, and that’s the unity and coming together that saved tens of thousands of lives and ultimately allowed us to end the pandemic. We, as Kentuckians, answered the call in times of tragedy and lived out our faith and values: living for one another, loving our neighbors as ourselves and being the Good Samaritans helping those in need.”

The release said "the primary donors" to the memorial fund were most of the state's leading hospital systems: Norton Healthcare, Baptist Health, St. Elizabeth Healthcare, King’s Daughters Health System, UofL Health, University of Kentucky and Pikeville Medical Center. It concludes, "Numerous private donations rounded out the funding and no tax dollars were used."

U.S. Department of Agriculture gives Grace Community Health, a nonprofit, a $1 million grant to build a new clinic in Pineville

The U.S. Department of Agriculture's Rural Development program is giving $1 million to help build a medical clinic in Pineville for Covid-19 testing, treatment and vaccines, as well as integrated medical, dental, and behavioral health services.

"The pandemic created a delay in health care, and there is currently a surge in cases," USDA said in announcing the grant to Grace Community Health. It said delayed preventive health visits caused increases in uncontrolled diabetes, stress, anxiety, depression, suicide rates, and substance-use disorders.

Grace Community Health is a nonprofit organization with clinic locations in six southeastern Kentucky counties.

Guthrie agrees to work on nursing shortage with Democrat on his subcommittee, saying it may be the biggest issue in health care

Rep. Brett Guthrie

U.S. Rep. Brett Guthrie, R-Bowling Green, in his role as chair of the major health subcommittee in the House, pledged last week to work with a rising Delaware Democrat to address the nation's nursing shortage.

At the Wednesday, May 17, meeting of the health subcommittee of the House Energy and Commerce Committee, Rep. Lisa Blunt Rochester of Delaware withdrew her legislation that would set up a national nursing-workforce center and state-based nursing workforce centers.

Rep. Lisa Blunt Rochester

Blunt Rochester's legislation "had been on the agenda for the subcommittee’s April legislative hearing, as was much of the legislation passed by the subcommittee on Wednesday, but it was not included in the markup. Blunt Rochester ultimately pulled her amendment to include it in the wide-ranging bill the subcommittee passed but urged Guthrie to include it in the next markup," reports Michelle Stein of Inside Health Policy. "Guthrie said the nursing workforce shortage is one of the most pressing issues in health care and agreed to work with Blunt Rochester on legislation."

Guthrie said, “One of the biggest issues we have, the biggest maybe in health care, is the nursing shortage. And we definitely need to work together to move forward on that and try to figure out how we can get through this. And so we're certainly willing to work with you.”

Earlier, Blunt Rochester said, “I believe we need a strategy to not only centralize the study and the development of nursing workforce practice and policy, but we also need to better support local entities in addressing state-specific nursing workforce challenges.”

The American Association of Colleges for Nursing has "said nursing school enrollment is not growing fast enough to meet the projected demand for RNs and APRNs," Stein notes. "Nursing homes have warned the administration must take into account nursing shortages when putting together its expected nursing home minimum staffing ratios."

Blunt Rochester is expected to run for the Senate next year, following Monday's announcement by Sen. Tom Carper, D-Del., that he will retire.

Ky. kids still aren't as immunized as they were before pandemic; pertussis threat rises; cancer-preventing vaccine rates still low

Slide shown by state epidemiologist at Immunization Summit shows Kentucky's rate of vaccination against childhood diseases is lower than all bordering states. (For a larger version, click on it.)

By Melissa Patrick
Kentucky Health News

The Immunize Kentucky Coalition's Immunization Summit, held May 10 in Lexington, opened with a warning that Kentucky's children fell behind on their immunizations during the pandemic and still haven't caught up. 

State Epidemiologist Kathleen Winter
(Photos by Melissa Patrick)

Citing 2021-22 school immunization data, State Epidemiologist Kathleen Winter said Kentucky is behind all its bordering states in routine childhood vaccination rates and is well below the national average. 

The greatest concern right now is kindergartners, she said, because their measles-mumps-rubella vaccination rate has dropped in the last two school years. (MMR rates among seventh and 11th-graders remained about the same, but that's no surprise, since two doses of the vaccine are recommended before a child turns 6.) 

"We really need to focus on this particular age group that maybe has missed vaccines . . . because of the pandemic," Winter said. 

Winter said Kentucky's kindergarten two-dose MMR rate of 86.5% ranks in the bottom five states nationally. The national rate is 93.5%. The National Immunization Survey by the Centers for Disease Control and Prevention, which runs behind school data, shows that Kentucky's decline in immunization is similar to a national decline.

Regular well-child visits help parents and health-care providers keep children current on immunizations. Winter said one study found that 41% of Kentucky parents of children 12 and younger reported their child had missed a well-child visit during the pandemic. This rate was even higher among Hispanics (48%). 

"We're getting back on track with routine visits now, but we still have not caught up for where we had this big decline during the pandemic months," Winter said. 

Winter said there are "dramatic differences" in immunization rates between those who have private health insurance, publicly paid insurance, and those who are uninsured.

The National Immunization Survey for the recommended seven-vaccine series for children under 2 shows that 78% of children with private insurance had received all of them, but only 64.3% of those on Medicaid had received all of them, and only 45.2% of uninsured children had. 

"There's some real work to be done with these vulnerable populations, not just here in Kentucky, but nationwide," Winter said.

Pertussis concerns

Since 2018, fewer Kentucky children have received the DTap or Tdap vaccines, which protect against tetanus, diphtheria and pertussis (whooping cough). Rates among kindergarteners and 11th graders have been "pretty stable," but there has been a steady decline among seventh graders since 2018, with rates between 80% and 85%, Winter said.

The United States has a spike in pertussis about every five years, Winter said, noting there was a "major epidemic" in 2012 and "We are well positioned to have another one." 

She added, "We are concerned about this in particular because we have had outbreaks of pertussis reported this year; several counties have already noticed outbreaks. . . . So this is the time we really need to focus on getting kids vaccinated for pertussis."

Cancer-prevention vaccine rates are low

 

According to the CDC, human papillomavirus (HPV) is a very common virus that can cause cancer -- and the HPV vaccine can prevent more than 90% of cancers caused by it, including cervical cancer. But only 57% of Kentucky teens have taken it. 

"Kentucky is another state that really needs to be worried about HPV," Winter said. "We have some of the highest rates of cervical cancer here in Kentucky."

Even more concerning, said Winter, is that fewer than half Kentucky females are up-to-date on HPV vaccines and two-thirds of them haven't gotten a single dose of the vaccine, which is given in either a two or a three-dose series, depending on age. Kentucky ranks 37th among the states for this measure. 

HPV can also cause cancers of the vagina, vulva, penis, anus, rectum, throat and the back of the tongue. The CDC reports that each year, about 47,199 new cases of cancer are found in parts of the body where HPV is often found. Of those, about 37,300 of them are caused by HPV.

Covid-19 vaccines still available and free

Winter noted that the end of the national public-health emergency for Covid-19 means that getting Kentuckians vaccinated against the disease has become normalized.

And because the now single-dose bivalent vaccine is recommended for everyone 6 months and older, Winter said it needs to be considered a routine childhood vaccination. 

"We have to routinize it in every way possible, routinize it for our conversations with parents and for routine childhood visits, getting it incorporated fully into the childhood schedule," she said. 

That's not being done yet, the data shows.

"When we look specifically at children, 94% of those under the age of 5 have never been vaccinated against Covid and 74% of children in the 5- to 11-year age group have never been vaccinated," Winter said. "So we are still not making this routine for children. It's not being offered and provided in the settings that it  needs to be offered and provided." 

Winter also stressed that Covid-19 vaccines are still readily available and free, even though the commercialization of the vaccine is expected to come in late summer or fall. 

"This is why we need to work now to get this routinized as much as we can into clinics and settings where people are routinely getting vaccinated," she said. 

She added that the latest guidance is for people 65 and older to get an additional booster and that guidance for everyone else is likely coming. 

Vaccinations work

Winter said the measles exposure that thousands of people had in February at the spontaneous revival at Asbury University in Wilmore turned out to be a public-health success story.

An unvaccinated Jessamine County resident who attended the revival in Februrary had Kentucky's third reported case of measles in three months, but Winter said there has not been one secondary measles case from that exposure. She noted that the person with measles wore a surgical-type mask at "a lot" of the events.

"The reality is, most people are immune to measles," Winter said. "Most people are fully vaccinated or had measles as a child. So we do not have this crisis of a population-level issue. What we have are targeted individuals and ages where we need to get back on track. So, this is where we need to focus."

To register for this event, click here.

Even with this public-health victory, Winter cautioned that without a high level of population immunity, the potential for a super-spreading event would remain. 

Organizers of the summit hope it will be an annual event. Amber Malott, chair of the Immunize Kentucky Coalition, which is part of the Kentucky Rural Health Association, said its mission is to "create equitable access to vaccinations across the commonwealth." As part of that mission, she said they will hold free pediatric immunization symposiums in Morehead June 20 and Owensboro June 29.

Legislative task forces will examine Cabinet for Health and Family Services and certificate-of-need process for health-care facilities

The Kentucky General Assembly has created joint House-Senate committees to study specific topics, including the Cabinet for Health and Family Services and the state's certificate-of-need process for health-care facilities.

Sen. Steve Meredith

Rep. David Meade

The Kentucky Health and Human Services Delivery System Task Force was created by this year's Senate Bill 48, sponsored by Sen. Steve Meredith, R-Leitchfield, to study the health cabinet's structure and operations, and its administration of programs, policies, and procedures, and determine "if or how services may be delivered more effectively and efficiently," a legislative press release said. It will also examine Kentucky's "benefits cliff" and continue the work of an earlier task force on that subject. Meredith and House Speaker Pro Tem David Meade, R-Stanford, will co-chair the committee. Other members are:

• Senate Republican Caucus Chair Julie Raque Adams, Louisville
• Sen. Shelley Funke Frommeyer, R-Alexandria
• Sen. Denise Harper Angel, D-Lousville
• Sen. Amanda Mays Bledsoe
• Rep. Samara Heavrin, R-Leitchfield
• Rep. Kimberly Poore Moser, R-Taylor Mill
• Rep. Amy Neighbors, R-Edmonton
• Rep. Sarah Stalker, D-Louisville

Rep. Russell Webber

Sen. Donald Douglas

The Certificate of Need Task Force was created by Senate Concurrent Resolution 165, sponsored by Sen. Gex Williams, R-Verona, and HCR 85, sponsored by Rep. Marianne Proctor, R-Union. It will review Kentucky's CON program, including related laws and the state health plan; review the need to maintain or modify CON for each covered health service; and make recomendations. The co-chairs are Sen. Donald Douglas, R-Nicholasville, and Rep. Russell Webber, R-Shepherdsville. The other members are:

• Sen. Karen Berg, D-Louisville
• Senate President Pro Tem David P. Givens, R-Greensburg
• Sen. Steve Meredith, R-Leitchfield
• Sen. John Schickel, R-Union
• Rep. Lindsey Burke, D-Lexington
• Rep. Daniel Elliott, R-Danville
• Rep. Marianne Proctor, R-Union
• Rep. Susan Witten, R-Louisville

Each task force has 10 members, appointed by the presiding officers of each chamber. Reflecting the partisan makeup of the legislature, each has four Republican senators and four Republican House members, and one Democratic senator and one Democratic House member. The committees also include the Task Force on School and Campus Security, a Task Force on Local Government Annexation; the Lottery Trust Fund Task Force, to evaluate the performance of its scholarships and grant programs; the Multimodal Freight Transportation System Improvement Task Force, to study freight and air terminals and ports; and the Jail and Corrections Reform Task Force, which may recommend realignment and closure of correctional facilities.

The task forces are to make recommendations by Dec. 4, in time for the next scheduled legislative session, which will begin Jan. 2, 2024. Task-force meetings will be live-streamed via the Legislative Research Commission's LRC YouTube channel and on KET.org/legislature. Archived footage of meetings can be accessed via KET.org/legislature/archives and on the YouTube channel. The LRC Legislative Calendar has meeting schedules and other information.

Meet some of the Kentuckians answering the new 988 crisis line: they're first responders driven by empathy

Sunshine Randolph, an engagement specialist for New Vista in Lexington, answers calls to the 988 suicide prevention line. (Kentucky Lantern photo by Carter Skaggs)

This story discusses suicide. If you or someone you know is contemplating suicide, please call or text the National Suicide Prevention Lifeline at 988.

By Sarah Ladd
Kentucky Lantern

When Sunshine Randolph was an undergraduate student, her stepfather died by suicide.

“It really does kind of rock your world,” she said of the experience, which drew her to work in suicide prevention. “I know what it can do to a family.”

Randolph now answers 988, the suicide prevention lifeline in Kentucky, for the Lexington-based New Vista. She draws on her personal experience to help people get through some of their most challenging moments.

“We kind of have these backgrounds in psychology,” said Randolph, whose bachelor's degree is in psychology. “We maybe are more familiar with (mental health) – but experiencing it is something a little different.”

Still, she tries to empathize while not projecting her own experiences on others. “No one death by suicide or or suicidal ideation is the same,” she said.

Calls and texts to the crisis hotline rose after 988 launched in July 2022, replacing a 10-digit number. Experts said the simplification of the lifeline would save more lives.

Gov. Andy Beshear said in January that overall, the state saw a 26% increase in calls to 988 in the second half of 2022, with fewer calls dropped as well.

There were 708 more communications in August that year — the month after the launch — than in June, state data shows.

There were 646 crisis text messages from Kentuckians from January and June of 2022, the Lantern previously reported. Then, after 988 launched, that jumped to 2,286 crisis messages — an increase of 254%.

In February, 727 texts and 634 calls came in, according to a Cabinet for Health and Family Services report. In the past year, there was a 30% increase in Kentucky-based calls overall.

People who answer the line said that since the launch of 988, calls have expanded beyond suicidality. Sometimes, people are calling 988 just to talk and de-stress at the end of the day or middle of the night.

Roughly 138 Kentuckians answer the crisis line at Kentucky’s 13 participating call centers.

In March, there were 112 full-time and 26 part-time employees answering 988, according to estimates from Kentucky’s chapter of Mental Health of America.

Those Kentuckians spend their shifts saving lives behind the scenes. They also, sometimes, just listen.

Marcie Timmerman, the executive director for MHAKY, said the folks who answer 988, which was first proposed in 2019, are “first responders.”

“They’re really the first people who can respond to a mental health crisis,” Timmerman said. “They’re really crucial to the system.”

Driven by empathy

Randolph isn’t alone in pulling from personal experiences to help others who call or text 988.

Her colleague, Abby King, grew up hearing her mother advocate for mental health. That’s because before she was born, her grandmother died by suicide.

“Suicide” and “mental health” were “vocabulary words that I knew from a very, very young age,” the Bowling Green woman said. “So I think that that may have just made me more compassionate and understanding to the world at a really young age.”

King never got to meet her grandmother, but said she’s always had compassion for her, which she tries to extend to people who call the line.

That’s also made her anxious on some calls. “I know that suicide is real and does happen,” she said. “No one’s immune to it.”

It’s also difficult, once a call is over, to let go. Many times, King and Randolph said, they don’t know what happened with a caller once they hang up.

“I definitely think to myself, ‘how did this turn out?’” Randolph said. “You have to have hope and faith in the system … but yeah, I think about certain or really impactful, emotional calls all the time.”

The most important thing when taking a 988 call or text is to make sure the person reaching out is safe and feels heard, answerers say.

“The number-one priority is making sure they’re safe in that moment,” said Randolph.

Responders will balance listening to a caller vent while doing a risk assessment to see if the caller has hurt themself or plans to, if they have a suicide plan, and more.

“We have processes and protocols, like the risk assessment and then safety planning,” King explained. “But really, it’s just that natural human interaction that makes the call successful.”

Once the caller is safe and hangs up, responders may need to decompress and process what they’ve just heard.

King keeps her workspace calm, she said, for that reason. She may have essential oils or incense out or keep a virtual fireplace crackling on her TV.

Sometimes, decompressing is as simple as walking outside and feeling cool air on her cheeks.

“It can be as simple as taking a step outside, letting my dogs out,” Randolph added. “Touch the grass so to speak. Just making sure I’m reminding myself that I’m doing good work is really important. And a good face mask never hurt anyone after shift.”

 

Holliss Williamson at River Valley Behavioral Health
in Owensboro (Photo by Arden Barnes via Kentucky Lantern)

Holliss Williamson, a triage specialist in River Valley Behavioral Health in Owensboro, said she turns to her coworkers for support after especially difficult calls.

Her team of eight fills in for each other when one needs a mental health day or to just walk away from the desk for a while. They each know the toll crisis response can take on a person.

“We take secondary traumatic stress, vicarious trauma and burnout very seriously,” said her coworker Gerrimy Keiffer, a social worker at River Valley. “Working a crisis line is incredibly stressful because, in some cases, you don’t know if that person actually got help or if they got better when that phone call ends.”

River Valley crisis workers also have access to an app called Heroes Health, which lets them track their mental health and access resources.

King said she compartmentalizes her feelings while on calls.

“While I’m on the call, my main priority is to make sure that they’re safe. And that’s the perspective I try to keep to keep me calm throughout the call, even if I’m … even relating to some of the pain that they’re talking about,” she said. “It’s just reminding myself that I’m currently in a safe environment, and they’re not. So I have to make sure to provide that safety.”

A self-care action plan can also help when dealing with a lot of trauma. That can include asking:

• What brings me joy?
• What helps me reset?
• Am I getting tense?
• Am I having trouble breathing?

The effect of Covid-19 and anti-LGBTQ laws

The Covid-19 pandemic, Keiffer said, has “caused a lot of stress and unsurety” among the community, resulting in more calls to crisis lines.

“Combine that with loss of jobs for many, unstable employment, unstable economic environment that we’re entering right now, as well as a lot of the political and cultural strife we’re experiencing,” he said. “Within the last few months, we’ve also seen an uptick in individuals experiencing issues related to gender identity and LGBT concerns.”

He pointed to legislation targeting transgender Kentuckians as being a stressor for many.

River Valley has also seen an uptick in calls from youth, particularly those re-entering a public school setting after learning at home for so long because of the pandemic.

The Centers for Disease Control and Prevention reported in February that more young girls are feeling depressed.

Almost 60% of teenage girls “felt persistently sad or hopeless in 2021,” the CDC said. About 30% of teenage boys felt that way. Teens in the LGBTQ+ community suffered “ongoing and extreme distress.”

The CDC also reported that about 1 in 3 teen girls seriously considered attempting suicide in 2021.

“Add on the stressors that normally would be experienced as a youth like bullying, the anxiety of tests and just your own interpersonal issues, and then we throw on top of that the emotional triggers that you deal with that are exclusive to living during a pandemic, and that kind of unsurety,” Keiffer said. “It’s very difficult for kids, especially because that ability to emotionally regulate hasn’t fully formed. It is absolutely a concern.”

 
Will the police get involved if I call 988?

Several folks who answer 988 in Kentucky said police would be involved only as a last resort. For example, police may be called if a person admits to having a weapon and wanting to harm others.

Keeping everyone safe can be a balancing act.

“We don’t want to criminalize mental health,” Keiffer said. “If (people are) experiencing a mental health challenge, I want them to feel secure and safe to reach out for help.”

“Involving law enforcement immediately makes that person feel more stressed out,” Keiffer explained. “Having a police officer knock at your door when you’re having, for many, the worst moment in their life … we want to avoid that if we can.”

No wrong door

People who answer 988 aren’t just there to save lives. They provide an anonymous listening ear for people who just need to vent or maybe don’t have a support system.

“You can’t get to the saving,” Randolph explained, “without first listening to the client.”

They’re also focused on getting everyday resources to people in need. They may help a caller find food banks or places that can help with rent or housing. Lacking transportation or internet access, too, can lead to suicidal ideation. For teenagers, it’s often an issue of parents not supporting them or listening to them.

At River Valley in Owensboro, staff can direct callers to gambler’s addiction help, a sexual assault support line and more.

Basically, there is “no wrong door,” Keiffer said.

“I think of 988 as suicide prevention, but also a helping line,” Randolph said. “If you call me I might be able to connect you with several different things all at once or give you resources and advice on where to get those things.”

‘Please don’t prank-call 988’

Several 988 responders said they get prank calls, often from kids.

“I kind of just laugh a little bit,” King said, “because it comes from a place of: ‘I’m happy that these resources are available now.’”

Still, experts say mental health should be taken seriously.

“Mental health is not something we joke about,” said Timmerman, of Kentucky’s chapter of Mental Health of America.

So: “Please don’t prank-call 988.”

In the 2024 legislative session — a budget year — Kentucky’s chapter of Mental Health of America and the American Foundation for Suicide Prevention will be asking the General Assembly to allocate general fund dollars to 988.

“We need to fund” 988, Timmerman said, “as equally as we do 911.”

Just start with hello

Beyond funding, crisis workers say they need more awareness of the 988 number and education surrounding stigma.

“We’ve taken callers who were leery about even calling in,” Williamson said. “even some callers will hang up because … there’s a stigma … or they just don’t feel comfortable and never had to address their issues in that way.”

Some also recommended embedding social workers with police so when they do have to respond, trained mental health professionals are on hand.

Keiffer said if you don’t know where to start when calling 988, just start with hello. And: “If you don’t feel comfortable calling right away, that’s okay,” he said. “But do try again.”