Statement by Susan G. Zepeda, president of the Foundation for a Healthy Kentucky, on recent legislation regarding federal nutrition standards -- June 3, 2014

As Kentucky students break for summer vacation, some look ahead to summer camp and family trips, while others wonder where their next good meal will come from. School districts and nonprofits struggle to find ways to assure Kentucky’s lowest income families can offer their children nutritious food during the summer.

So, it is ironic to read that Congress – our elected representatives – is battling to reduce or delay the nutrition standards recently enacted. Yes, to reduce them, through a proposed waiver of the nutrition standards enacted in 2010.

This, while Kentucky school districts have stepped up to the plate to answer Kentucky requests for healthier meals – taking advantage of farm-to-school opportunities, experimenting with edible schoolyard programs, and introducing children to fresh fruits and vegetables they may never before have seen or tasted.

This, while the Foundation for a Healthy Kentucky’s polling data tell us adults want healthier foods in the schools. Our most recent Parent Poll showed that 88% of parents believe it is important that the meals served in their child’s school or daycare meet a minimum standard for nutritional value.

Despite the importance parents placed on nutritious meals, fewer than 1 in 4 described the meals at their children’s school or daycare as “very nutritious.” And the 2014 Kentucky Health Issues Poll – which reaches adults throughout the commonwealth – affirms this view is broadly held. When asked specifically about the recently adopted USDA school nutrition standards, more than three-quarters of adults (78%) favored the new USDA standards for meals served to students. 

In KHI polls since 2009, adults see childhood obesity as a problem – about half as a serious problem, another third as a problem, but perhaps not as serious. In Kentucky, the Data Resource Center for Child and Adolescent Health showed that in 2011-2012, 35.7% of Kentucky children were considered overweight or obese.

Sadly, children living in poverty are at higher risk of obesity, since their diet is less likely to include the nourishing fruits, vegetables and protein they need, and more likely to be heavy on sugar, fats and salt.

Kentucky was a leader in removing junk food from school vending machines. We are known nationally for innovative efforts (such as the Lexington-based “Better Bites” program) to offer healthy foods at parks and recreational sites not known for their nutritious offerings. “Healthy in a Hurry”-style efforts to transform local corner markets in cities and smaller towns, to offer fresh seasonal produce, and the growth of local farmers markets underscore our desire to grapple with the challenges of obesity in our schools and communities.

The reason for the waiver – to accommodate schools struggling to make needed dietary changes – might be more compelling if the major voice for the waiver, as USA Today noted in its May 29 editorial, was not the School Nutrition Association, a trade group of school food officials backed by such food companies as Coca-Cola, Domino’s Pizza and PepsiCo. Interestingly, USA Today also noted 19 of the association’s former presidents have called on Congress to reject the waiver. We add our voice to this call.

About the Foundation for a Healthy Kentucky: The Foundation is a non-profit philanthropic organization that invests in communities and informs health policy through grant making, research and education. Since 2001, the Foundation has invested more than $24 million in health policy research and demonstration (pilot project) grants. The Foundation is committed to improving access to care, reducing health risks and disparities and promoting health equity.

Statement by President Barack Obama on the Fourth Anniversary of the Patient Protection and Affordable Care Act, March 23, 2014

Since I signed the Affordable Care Act into law, the share of Americans with insurance is up, and the growth of health care costs is down, to its slowest rate in fifty years – two of the most promising developments for our middle class and our fiscal future in a long time.

More Americans with insurance have gained new benefits and protections – the 100 million Americans who’ve gained the right to free preventive care like mammograms and contraception, the eight million seniors who’ve saved thousands of dollars on their prescription drugs, and the untold number of families who won’t be driven into bankruptcy by out-of-pocket costs, because this law prevents insurers from placing dollar limits on the care you can receive.

More Americans without insurance have gained coverage.  Over the past four years, over three million young Americans have been able to stay on their family plans.  And over the past five and a half months alone, more than five million Americans have signed up to buy private health insurance plans on – plans that can no longer discriminate against preexisting conditions or charge you more just because you’re a woman or a cancer survivor – and millions more have enrolled in Medicaid.

It is these numbers, and the stories behind each one of them, that will ultimately determine the fate of this law.  It is the measurable outcomes – in savings for families and businesses, healthier kids with better performance in schools, seniors with more money to spend because they’re paying less for their medicine, and young entrepreneurs who’ll have the freedom to try new jobs or chase that new idea – that will ultimately offer more security and peace of mind to more Americans who work hard to get ahead.

Last month, after her first wellness visit under her new insurance plan, a woman from Colorado shared with me what that peace of mind meant to her. “After using my new insurance for the first time, you probably heard my sigh of relief from the White House,” she wrote.  “I felt like a human being again.  I felt that I had value.”

This is what’s at stake any time anyone, out of some outdated obsession, pledges to repeal or undermine the Affordable Care Act.  And that’s why my administration will spend the fifth year of this law and beyond working to implement and improve on it. 

If you’re an American who wants to get covered – or if you know someone who should – it’s now last call for 2014.  March 31st is the deadline to get covered this year.  So check out or call 1-800-318-2596 to see what new choices are available to you, and get covered today.

Commonwealth of Kentucky
Office of the Governor

Kerri Richardson

Terry Sebastian

Governor Beshear Signs SB 198
Measure Addresses Professional Standards for Diabetes Education

LEXINGTON, Ky. (June 22, 2012) - Governor Steve Beshear today held a ceremonial signing of Senate Bill 198 that addressed some oversights in a law establishing licensure requirements for diabetes educators in Kentucky.

The legislation was designed to improve consumer protection, raise professional standards within the field of diabetes management and care and increase access to care.

Kentucky is the first state to require diabetes educators to be licensed, a move viewed as a step forward in the ongoing efforts to combat the country’s diabetes epidemic. Amendments to the original law, however, were necessary to ensure that the practice of diabetes education is protected under Kentucky law.

“Through this innovative legislation, we are raising professional standards for diabetes management and care,” Gov. Beshear said. “For years, our certified diabetes educators have worked diligently to assist patients with diabetes. By adding the licensure requirement, we are taking an important step forward in terms of recognition for the diabetes educator.”

SB 198 is modeled after the law that applies to dietitians and nutritionists. Specifically, it addresses the practice of licensed diabetes educators and the penalty for practicing diabetes education without a license.

Building on the original law that established licensure, the language in SB 198 allows for a clear definition of scope of practice for the qualified diabetes educator; helps establish the minimum quality standards for providing the service; and offers more protection for the patient with diabetes and the provider of diabetes education services. 

Under the amended law, penalties and violations are Class A misdemeanors, as is the case with the dietitians and nutritionists.

“This is truly a step forward in the field of diabetes management and care,” said Dr. Steve Davis, acting commissioner of the Kentucky Department for Public Health. “Not only are we raising professional standards and heightening recognition for those working in the field, we are improving standards for patients, as well. Ultimately, this will lead to better care and management of the disease.”

“Kentucky has made strong moves for action on diabetes, increasing the impact of talented, dedicated people, along with our systems without additional spending. The nation is moving to copy the new Kentucky models,” said Sen. Alice Forgy Kerr, of Lexington.

“Once again, Kentucky is a national leader in diabetes solutions,” said Rep. Ruth Ann Palumbo, of Lexington.  “The House and Senate have been completely united to make sure families facing diabetes have as much public support as possible.”

Professionals seeking licensure in Kentucky will apply to a board comprised of five people representing various stakeholders in the field of diabetes management. Additional continuing education, licensure fees and practicing standards will be required to maintain a diabetes educator license.

Diabetes educators are highly skilled professionals integral to the multidisciplinary diabetes care team. They counsel patients on how to incorporate healthy eating and physical activity into their life. They also help patients understand how their medications work, teach them how to monitor their blood glucose to avoid the risk of complications, and give them the ability to problem solve and adjust emotionally to diabetes.


Follow Governor Beshear on Twitter @Govstevebeshear, read the Governor’s personal notes on his blog at, and view his video commentaries at



Kentucky Hospital Association
Elizabeth Cobb
Vice President, Health Policy
2501 Nelson Miller Parkway
Louisville, KY 40223

100 Kentucky Hospitals join the Kentucky Hospital Association’s new quality improvement program

Louisville, KY (May 11, 2012) — One-hundred Kentucky hospitals have joined the Kentucky Hospital Association (KHA) in an effort to improve patient care and reduce health care costs in the commonwealth. The hospitals’ goal is to reduce preventable readmissions and hospital acquired conditions (HACs) and to prevent unnecessary, early, elective deliveries. 

KHA has been awarded a contract, in partnership with The Health Research & Educational Trust (HRET), an affiliate of the American Hospital Association (AHA), by the Centers for Medicare and Medicaid Services (CMS) to support the Partnership for Patients (PfP) campaign.  PfP is a national initiative launched earlier this year by the U.S. Department of Health and Human Services. 

Through the PfP, KHA has established a hospital engagement network (K-HEN) to help hospitals identify ways to improve patient safety and share learning among hospitals across the state. The PfPs’ goal for this two-year project is to reduce preventable hospital readmissions that occur within 30 days of discharge by 20 percent and HACs by 40 percent (compared to 2010) by the end of 2013.

K-HEN will provide resources and expertise to build on evidence from research and pilot projects, as well as best practices, learning networks and other resources to address ten targeted areas:
1.       Adverse drug events (ADE)
2.       Catheter-associated urinary tract infections (CAUTI)
3.       Central line-associated blood stream infections (CLABSI)
4.       Injuries from falls and immobility
5.       Obstetrical adverse events
6.       Pressure ulcers
7.       Surgical site infections
8.       Venous thromboembolism (VTE) or deep vein clots
9.       Ventilator-associated pneumonia (VAP)
10.   Preventable readmissions

“Kentucky’s hospitals continue to demonstrate a strong commitment to improve patient safety and quality of care.  KHA is very pleased that almost 80 percent of Kentucky’s hospitals are participating in K-HEN.  There are nearly 2,000 hospitals participating nationwide, working with their state hospital associations in partnership with HRET, in 33 states. Out of the hospital associations involved, Kentucky has one of the highest participation rates with 100 of the state’s 131 hospitals signed up,” said Michael T. Rust, KHA president. “Our state’s participation in the hospital engagement network is the latest example of our ongoing effort to make care safer for our patients.”

“The commitment to patient safety and quality by hospitals across Kentucky has resulted in lives saved, fewer complications and reduced costs,” said Mark J. Neff, chair of the KHA Board of Trustees and president and CEO of St. Claire Regional Medical Center in Morehead. “Participation in the K-HEN will do even more to improve care for our patients.”

Kentucky hospitals participating in the K-HEN include:

1.       Baptist Hospital East
2.       Baptist Hospital Northeast
3.       Baptist Regional Medical Center
4.       Breckinridge Memorial Hospital
5.       Caldwell Medical Center
6.       Cardinal Hill Rehabilitation Hospital
7.       Carroll County Memorial Hospital
8.       Casey County Hospital
9.       Caverna Memorial Hospital
10.    Central Baptist Hospital
11.    Clinton County Hospital
12.    Commonwealth Regional Specialty Hospital
13.    Continuing Care Hospital
14.    Crittenden County Hospital
15.    Cumberland County Hospital
16.    Cumberland Hall Behavioral Health Services
17.    Flaget Memorial Hospital
18.    Fleming County Hospital
19.    Frankfort Regional Medical Center
20.    Frazier Rehab Institute
21.    Gateway Rehabilitation Hospital
22.    Greenview Regional Hospital
23.    Hardin Memorial Hospital
24.    Harlan ARH Hospital
25.    Harrison Memorial Hospital
26.    Hazard ARH Regional Medical Center
27.    HealthSouth Lakeview Rehabilitation Hospital
28.    HealthSouth Northern Kentucky Rehabilitation Hospital
29.    Highlands Regional Medical Center
30.    Jane Todd Crawford Hospital
31.    Jennie Stuart Medical Center
32.    Jewish Hospital
33.    Jewish Hospital-Shelbyville
34.    Kentucky River Medical Center
35.    Kindred Hospital-Louisville
36.    King's Daughters Medical Center
37.    Knox County Hospital
38.    Kosair Children's Hospital
39.    Lincoln Trail Behavioral Health System
40.    Livingston Hospital and Healthcare Services
41.    Marshall County Hospital
42.    Mary Breckinridge ARH Hospital
43.    McDowell ARH Hospital
44.    Methodist Hospital
45.    Methodist Hospital Union County
46.    Middlesboro ARH Hospital
47.    Monroe County Medical Center
48.    Morgan County ARH Hospital
49.    Muhlenberg Community Hospital
50.    Murray-Calloway County Hospital
51.    New Horizons Health Systems, Inc.
52.    Nicholas County Hospital
53.    NorthKey Community Care
54.    Norton Audubon Hospital
55.    Norton Brownsboro Hospital
56.    Norton Hospital
57.    Norton Suburban Hospital
58.    Oak Tree Hospital
59.    Ohio County Hospital
60.    Our Lady of Peace Hospital
61.    Parkway Regional Hospital
62.    Pattie A. Clay Regional Medical Center
63.    Paul B. Hall Regional Medical Center
64.    Pikeville Medical Center
65.    Pineville Community Hospital
66.    River Valley Behavioral Health Hospital
67.    Robley Rex VA Medical Center
68.    Rockcastle Regional Hospital and Respiratory Care Center
69.    Russell County Hospital
70.    Saint Joseph Berea
71.    Saint Joseph East
72.    Saint Joseph Hospital
73.    Saint Joseph London
74.    Saint Joseph Martin
75.    Saint Joseph Mount Sterling
76.    Southern Kentucky  Rehabilitation Hospital
77.    St. Claire Regional Medical Center
78.    St. Elizabeth Edgewood
79.    St. Elizabeth Florence
80.    St. Elizabeth Fort Thomas
81.    St. Elizabeth Grant
82.    Sts. Mary & Elizabeth Hospital
83.    T. J. Samson Community Hospital
84.    Taylor Regional Hospital
85.    The Brook Hospital-Dupont
86.    The Brook Hospital-KMI
87.    The James B. Haggin Memorial Hospital
88.    The Medical Center at Bowling Green
89.    The Medical Center at Franklin
90.    The Medical Center at Scottsville
91.    The Ridge Behavioral Health System
92.    Three Rivers Medical Center
93.    Trigg County Hospital
94.    Trover Health System
95.    Twin Lakes Regional Medical Center
96.    Wayne County Hospital
97.    Western Baptist Hospital
98.    Westlake Regional Hospital
99.    Whitesburg ARH Hospital
100.Williamson ARH Hospital

NEWS RELEASE from Cabinet for Health and Family Services May 3, 2012

Kentucky continues planning for state health benefit exchange
If upheld, Governor will create exchange by executive order 

FRANKFORT, Ky. (May 3, 2012)—Governor Steve Beshear today outlined the state’s ongoing efforts to prepare for the possible implementation of key provisions of the federal Affordable Care Act (ACA). The case regarding the validity of the ACA remains pending before the United States Supreme Court, and a decision is anticipated in late June.

If upheld, the state has only through the end of this year to demonstrate its readiness to run a health insurance exchange, or the responsibility will default to the federal government. Several interest groups representing employers, health care advocates, and citizens, including the Kentucky Hospital Association, the Kentucky Chamber of Commerce, Kentucky Voices for Health, and Anthem Blue Cross Blue Shield have expressed that the Commonwealth should not allow the federal government to operate the exchange for Kentucky.

Therefore, if the law is upheld by the Supreme Court, Governor Beshear announced today that he will issue an executive order to establish a Kentucky health benefit exchange. “While no one can predict what the Supreme Court will ultimately decide, it is imperative that the state prepare for any decision,” said Gov. Beshear. “The steps we have taken to date, and the planning process we are putting in place helps ensure the state is able and ready to follow the law, if upheld, and also guarantees we don’t have the federal government running our insurance market.”

The health benefit exchange, a requirement of the ACA, will facilitate the purchase and sale of health plans in the individual market, assist small employers in facilitating the enrollment of their employees in health plans, provide one-stop shopping by helping individuals enroll in health plans, Medicaid and KCHIP, enable individuals to receive premium tax credits and premium subsidies, and qualify small businesses for tax credits. Officials from CHFS and the Kentucky Department of Insurance will meet with insurers, providers, agents, consumers, employers and advocates in the coming weeks to solicit input on the development of a Kentucky exchange.

“The Commonwealth believes it is best positioned to operate an exchange for the full benefit of Kentuckians,” said CHFS Secretary Audrey Tayse Haynes. “Kentucky understands the unique regional and economic needs of our citizens, as well as the health insurance needs of small businesses. We have existing working relationships with insurers, agents, advocates, health care providers and other business partners. By establishing a state-operated exchange, we can also better ensure coordination and integration of eligibility determinations and enrollment with the Medicaid program.”

In February, Kentucky received a $57.8 million grant from the U.S. Department of Health and Human Services (HHS) to continue planning for and implementation of programs and systems required by ACA. These efforts include building an end-to-end eligibility and enrollment system to serve both Medicaid and exchange participants. The grant funds, along with a $50 million project in the recently enacted budget (HB 265), provide funding toward meeting the Medicaid eligibility requirements under the ACA. The most significant functionality requirements for health insurance affordability programs involve the Medicaid Program and relate to the expansion of eligible people and the associated simplified eligibility rules. Other requirements include easy, online access, real-time eligibility determinations, and enrollment for most Medicaid or KCHIP applicants, and the necessary interfaces with the Health Benefit Exchange. The grant will fund a significant portion of the state’s requirements with 100 percent federal funds, with the remainder of the requirements funded at a 90/10, federal-state matching rate.

Kentucky previously received two federal health insurance exchange planning grants totaling $8.6 million. These grants provided the necessary resources to conduct the research and planning needed to build a better health insurance marketplace and determine how exchanges would be operated. To learn more about the Affordable Care Act please visit