Local governments mulling ways to use opioid settlement funds

KFF Health News graphic

By Zacharie Lamb
WKMS

More than a year after local governments across Kentucky began receiving shares of the legal  settlement with opioid manufacturers and distributors, several local leaders in far western Kentucky are still figuring out how best they can use those funds to tackle the opioid epidemic.

State governments across the country have been tasked with stewarding a portion of funds acquired through regional and national opioid settlements with companies including Johnson & Johnson, McKesson and CVS. The settlements stem from multiple nationwide lawsuits against the firms for their role in fueling the opioid epidemic.

According to the Centers for Disease Control and Prevention, around 75% of drug overdose deaths were connected with opioids in 2022. That accounts for the deaths of more than 81,000 Americans that year. Kentucky’s Justice and Public Safety Cabinet said in its 2022 Overdose Fatality Report that a little over 1,500 people who died from overdoses in the state were found to have fentanyl in their system.

State governments and localities are using the settlement funds to try to heal communities affected by the opioid crisis and prevent others from being affected.

Kentucky has secured around $900 million from the settlements. Those funds have been split into two pools, with half earmarked for a state commission and half divvied up among the state’s county and city governments. The state sent the first installments to local governments in December 2022. Payments are expected to continue until 2038, with no deadline for when funds must be spent.

Lauren Carr. opioid-settlement adviser for the Kentucky Association of Counties, helps county officials follow the best practices and reporting guidelines for the settlement funds.

“You can't take these funds and use it for a program that was already being funded. You can't take these funds and supplant. These funds are supposed to be to supplement,” Carr said. “Either integrate a new program or supplement the existing programs that you have – seeing where barriers are – and providing those services.”

(However, Morgain Patterson, director of municipal law with the Kentucky League of Cities, told Kentucky Health News that while some states prohibit opioid settlement dollars from being used to fund existing programs, called supplanting, Kentucky's statute does not, "so they could be used for current programs . . . as long as they relate back to opioid-use disorder or co-occurring substance-use disorder and mental health issues." For example, she said settlement money could be used to purchase Narcan, even if the city or county is already paying for it. That said, Johns Hopkins University has put together a document of principles it supports that says, 'Jurisdictions should use the funds to supplement rather than replace existing spending.' This document is posted on KACo's website.)

The law creating the state opioid commission has a list of 29 possible uses for the funds. Carr said the list provides pathways for localities but doesn’t expressly limit their use.

The Paducah Police Department is using some of the city’s settlement dollars to staff a new position focused on lowering recidivism for the people with substance-use disorder. Police Chief Brian Laird said hiring a deflection specialist has been a long-term goal for his department.

“We encounter folks regularly that are homeless, folks that have mental health issues, folks that have drug abuse issues,” Laird said. “Instead of the officers continuing to respond over and over to these folks, we have somebody that can follow up with these individuals and try to get them some help.”

Deflection is a relatively new philosophy in law enforcement that focuses on keeping individuals with substance-use disorder from entering or re-entering the court system by avoiding interactions with police. Laird said that he’s aware of other social-work positions in police departments in Kentucky but believes Paducah may be the first in the state to hire a deflection specialist.

The position will be paid partly by the department's budget, but most of the funding comes directly from settlement money. Applications for the position closed in April, and Laird hopes the specialist to be on board by August.

Other county and city governments in far western Kentucky are still trying to figure out how to spend their portion of settlement funds.

Murray officials formed a work group before the first payments were received to investigate possible uses of the funding. City Administrator Jim Osborne said the city is still working with the state Attorney General’s office, which oversees the opioid commission, but that no official plans have been made.

“The goal would be using the money to not necessarily just in one area of but could combine areas that are approved uses,” Osborne said. “I think the key is finding a happy medium of where best it would be used … something that's legal, transparent and would help the community.”

Similarly, Marshall County Judge-Executive Kevin Spraggs said he wants to make sure settlement funds are used in the most efficient way possible.

“We want to make sure wherever this money goes, ultimately, it's put to the best possible use,” Spraggs said. “We don't want to jump into something without doing a lot of research, and we'd like to do something with a proven track record, percentage wise, where the most people are being helped.”

For Carr, addressing the opioid epidemic has two major components – prevention and harm reduction. She said that many localities focus on prevention, with programs like “Just Say No” to kepe people from becoming substance users in the first place. Harm reduction focuses on helping individuals who are already using drugs.

The list of 29 potential uses include programs for intervention, treatment and recovery services for substance users. The funds could also be used to educate the general public and provide training to health care providers, recovery specialists or law enforcement.

The list also includes things like drug take-back and disposal programs and expenss for naloxone, branded as Narcan, that can block opioid overdoses. Carr said that increasing accessibility to the medication and teaching the public about its use could help to prevent deaths.

“At the end of the day, a dead person doesn't recover,” Carr said. “We all can be first responders. Whether it's at a basketball game, at the library or at a Walmart, you never know when you may be a first responder, and so being prepared is something that will help save lives for individuals that are in active addiction right now.”

Medical-cannabis 'cleanup' bill passes House; critics disappointed more qualifying conditions not added and say it increases hurdles

By Melissa Patrick

Kentucky Health News

In what the sponsor calls a bill to "clean some things up," more restrictions are being added to the state's medical-marijuana law and provisions were added to allow local school districts to opt out.

State Rep. Jason Nemes

One of the key provisions in House Bill 829, sponsored by Rep. Jason Nemes, R-Middletown, would allow public and private schools to opt out of the program.

Public school boards are required to establish policies related to the use of medical cannabis no later than Dec. 1, 2024. The policies must either prohibit the use of medicinal cannabis on school property, or permit the use with several options for administration, as outlined in the bill. 

The measure would also allow local governments to apply a small local fee to compensate for any additional costs caused by the operation of cannabis businesses; prioritize Kentucky hemp businesses for state contracting; and clarify the powers that the state Cabinet for Health and Family Services has when it comes to inspection. 

It would also abolish the provisional license, which allows someone who makes an application for a license to sell medical marijuana to get the product while the application is pending. Nemes said this "put the cart before the horse."

When the House passed the bill 66-30 on March 12, it allowed the state to move the dates up for licensing, which would allow product to be obtained when the program starts Jan. 1, 2025. 

A floor amendment, filed at the request of the Kentucky League of Cities, was approved to allow cities to be able to opt out of the medical cannabis program before Jan. 1, 2025, even if a licensee had been approved before that date.

The committee substitute for the bill would require a patient to consult with a pharmacist annually to make sure the medical cannabis does not have a negative interaction with the patient's other prescriptions.

That  prompted several Democrats to object in the floor debate, saying the new requirement , with a potential cost of up to $40, imposes another hurdle in accessing medical cannabis.

"It seems like we're adding even more hurdles to make this medicine harder to receive, more expensive for folks to access. . . . I really wish we were back here today to make this medicine more accessible to the people of Kentucky who have been asking us to do this for years," said Rep. Rachel Roberts, D-Newport. 

Rep. Rachel Roarx, D-Louisville, said allowing public school districts to opt out "puts barriers in place" for students who benefit from medical cannabis for conditions such as epilepsy. 

Rep. Josh Bray, R-Mount Vernon, disagreed and supported the opt-out provision for schools, saying that he recognizes the need for this because some schools are concerned about the liability of administering a drug that is not authorized by the U.S. Food and Drug Administration.  

Rep. Cherlynn Stevenson, D-Lexington, said she was disappointed that the bill wouldn't expand the list of qualifying conditions that could be treated with medical cannabis, as was recommended by at "statutory advisory board of doctors and nurses appointed by the state licensing boards."

Stevenson said she hoped these conditions would be added in the Senate, where the bill has not been assigned to a committee.

Bills filed to let cities and counties regulate marketing and sale of tobacco products and vaping materials more strictly than state

By Melissa Patrick
Kentucky Health News

Lawmakers in both the House and Senate have filed bills to let cities and counties more strictly regulate marketing and sale of tobacco products, a power the legislature took from them nearly 25 years ago. 

Sen. Julie Raque Adams, R-Louisville, filed Senate Bill 81 and Rep. Kim Moser, R-Taylor Mill, filed House Bill 147. The bills say "A city or county government may impose restrictions or requirements on the use, display, sale, and distribution of tobacco products or vapor products that are stricter than those imposed under state law." 

Coalition for a Smoke-Free Tomorrow illustration

Adams said at a news conference, "Our bills do not mandate that local communities pass tobacco control laws. Rather, the bills give communities the tools that they can use, if they so choose. Also, this measure does not take away any power from the state legislature in any way. If there comes a time that another proven statewide measure to improve health by reducing tobacco use is warranted and supported by my colleagues, the state would still have the right to do that."

Adams explained that the bill would allow local control of tobacco policies that was taken away in 1996 when cigarette manufacturers lobbied to pre-empt local control as a way to overturn existing local laws and prevent future community measures to reduce tobacco use. 

Moser said the law is needed to make Kentucky a healthier place, noting that nearly 9,000 Kentuckians die from a smoking-related disease each year; Kentucky has the second highest rate of chronic obstructive pulmonary disease, or COPD; and the highest cancer incidence and death rates in the nation, with one-third of the cancer cases tied directly to smoking.

"That means that more than one-third of the cancers in Kentucky can be prevented, " she said, adding later, "There's simply no reason that local communities that have the political will and the constituents support to adopt measures to limit the marketing and the sale of tobacco products in their community should be prohibited from doing so." 

Nearly 25 years after the pre-emption law was enacted in March 1996,  Kentucky continues to have nearly the highest adult smoking rate in the nation, at 24 percent, with rates as high as 49% in some areas. In 16 Kentucky counties, more than 30 percent of women smoke while pregnant. 

Meanwhile, electronic cigarettes are addicting a whole new generation of youth to nicotine, with one in four Kentucky high-school students and nearly one in six middle schoolers regularly using e-cigarettes. 

Hannah Abdon, a student at Randall Cooper High School in Union, spoke about the prevalence of e-cigarette and tobacco advertising is in her area. 

"While driving to my own high school, I pass four different stores that heavily advertised tobacco products in their store fronts," she said. "Most of these places are very close to my school. . . . Tobacco advertising is virtually everywhere I look. This is why we need special laws . . . so that my community and others in Kentucky can try new ways to prevent youth from vaping and other tobacco use. "  

Abigail Birman, a junior at McCracken County High School in Paducah, said without this law, it's useless for her to advocate for any local changes: "What is crazy is that I have not done any local advocacy work in my area because there is a state law that prohibits my local community from doing more to protect me and my friends from tobacco advertising."

Representing the business community, Betsy Clemons, executive director of the Hazard-Perry County Chamber of Commerce, expressed strong support for these bills. She talked about the importance of building a healthy workforce in Eastern Kentucky, which has some of the highest health disparities in the nation, to attract potential companies to locate or expand their operations in the region.

Clemons said smoking costs Kentucky businesses nearly $2.8 billion every single year in lost productivity and an additional $5,800 per year for every employee that smokes.

"We need more tools to help reduce tobacco use, improve our workforce, health, productivity and reduce our costs. We need the freedom to innovate and try things in our community that might not work elsewhere in Kentucky," she said. "That's what local control of tobacco marketing and sales is all about in it's the next logical step for Kentucky." 

Dr. Pat Withrow, a retired Paducah cardiologist and advocate for prevention of youth tobacco use, said limiting youth exposure to e-cigarette and tobacco advertising is a proven strategy to decrease teen use of the products. 

"We know that 90% of tobacco use starts before age 18," he said. "If local communities could reduce youth exposures to ads of vapes and other tobacco products, they could also reduce youth tobacco use."

The bills are supported by the Coalition for a Smoke-Free Tomorrow, comprising of more than 220 Kentucky businesses, health care providers, faith-based and health advocacy organizations.

Beshear asks mayors, county judge-executives to help enforce mask mandate; says he expects they will, 'even though it is hard'

Table from White House Coronavirus Task Force report; for a larger version, click on it.

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear announced 1,054 new cases of the novel coronavirus Tuesday, and said it signals another record-breaking week.

“We are experiencing an escalation, our third major escalation in this covid crisis, and it is significant,” Beshear said at his daily briefing. “Last week we had 6,126 positive cases and we are on pace to have more than that this week.”

Beshear again reminded Kentuckians that higher case counts result in more deaths, noting that the state can expect 104 more deaths from last week's cases because its mortality rate for the disease is 1.7%. "That shows you how quickly the number of people that we lose can accelerate," he said. 

The share of Kentuckians testing positive for the virus in the past seven days was 4.69%, still short of the 5% danger zone. Beshear cautioned that this rate could "be impacted really quickly if we keep having this many positive tests."

Beshear didn't announce any new restrictions to stem the escalation, instead reiterating that it's up to Kentuckians to step up and do their part. 

“We must act. . . . It's not about new steps, but we will take them if we have to. We saw with the last escalation that we have the power to stop it if we simply do what we know works and that is wearing a mask, engaging in social distancing,” he said. “And if we are honest with ourselves, we know that fewer people are wearing masks right now than they were” when he mandated masks in July. (He renewed the order Tuesday.)

Beshear said Monday that he would step up enforcement of the mandate and ask county judge-executives and mayors to help. He said Tuesday that he had talked with them, and they can make a "huge difference."

"Our expectation is that they will step up, even though it is hard, and begin pushing and pushing and pushing people the right way." Earlier, he said, "We as leaders need to make sure that if we go to a retail establishment and people aren't wearing masks, that we say something to that establishment." He said retailers should not accept money from people not wearing masks.

Asked about President Trump's actions since being released from the hospital with covid-19, which include downplaying the virus on social media and removing his mask in front of cameras, Beshear said the president has an "opportunity for true leadership" by setting life-saving examples for infected people, including wearing a mask when they are around others.

Beshear didn't mention Trump's false tweet about the flu, but Health Commissioner Steven Stack said most Kentuckians understand that the flu killed 22,000 Americans last season, while covid-19 has already killed nearly 220,000.

Twitter added to Trump's tweet a note saying it violates the platform's rules about spreading misleading and potentially harmful information related to covid-19. Facebook removed a similar post.

Stack, a physician, also pointed to a new Centers for Disease Control and Prevention study showing that Arizona saw a 151% increase in cases after it lifted its stay-at-home orders and largely opened its economy. The spike caused the state to increase its mitigation efforts, including mask mandates, closing bars and gyms and reducing restaurant capacity to 50%. The report says these actions resulted in a 75% decrease in cases. "We know what works," Stack said. 

Beshear pointed to the latest guidance from the White House Coronavirus Task Force report, which says "Masks must be worn indoors in all public settings and group gathering sizes should be limited." 

The report, covering Sept. 26 to Sunday, Oct. 2, puts 75 of the state's 120 counties into one of the danger zones, up from 56 the previous week. 

The number of counties in the red zone increased from 14 to 26; the orange zone number dropped from 22 to 20; and the yellow zone number rose from 20 to 29. The report says 62% of the state's counties have moderate or high levels of community transmission of the virus. 

Statewide, the report puts Kentucky in the red zone for cases, ranking it 16th in the country. It places the state in the yellow zone for the share of residents testing positive, ranking it 10th. 

Communities in the White House red zone have weekly positive-test rates higher than 10% and more than one new case per 1,000 residents. Those in the recently added orange zone have 0.51 to 1 new cases per 1,000, and a weekly positive-test rate of 8 to 10%, or one of those two conditions and one condition qualifying as being in the red zone. Yellow-zone communities have new cases between 0.1 and 0.5 case per 1,000 and a positive-test rate of 5% to 8% -- or one of those, with the other in the a higher zone.

White House Coronavirus Task Force maps; for a larger image, click on it.

Beshear said the report largely lines up with the state's incidence-rate map, which has 21 red counties today. Red counties on the state map have at least 25 cases per 100,000 people in the last seven days. 

Beshear announced four more deaths from covid-19, bringing the state's death toll to 1,218: an 89-year-old man from Christian County; two women, 69 and 78, from Jefferson County; and an 85-year-old man from Henderson County.

In other covid-19 news Tuesday:

• Counties with 10 or more new cases were Jefferson, 190; Fayette, 185; Christian, 31; Daviess, 28; Laurel, Madison and Whitley, 24 each; Henderson, 22; Pike and Warren, 21 each; Scott, 20; Calloway and Knox, 17 each; Bullitt, 14; Carter and Shelby, 13 each; Franklin, Lincoln, Nelson and Rockcastle, 12 each; Boone, Johnson, Morgan and Pulaski, 11 each; and Allen and Clark, 10 each. 

• Beshear announced 592 people were hospitalized with covid-19 in Kentucky on Tuesday, with 150 of them in intensive care and 93 of those on ventilators. 

• Beshear announced 23 more residents and 30 more staff in long-term care facilities have tested positive, with 12 more resident deaths, for a total of 721 deaths, including five staff. The daily report shows 713 active resident cases and 465 active staff cases. 

• The daily K-12 student report shows 40 more students and 14 more employees have tested positive, with 807 active student cases and 401 active employee cases. Beshear said 15 more schools were added to the list of those with at least one case.

• The daily college and university report shows 108 more students and two more staff have tested positive for the virus, with 1,164 active student cases and 23 active staff and faculty cases. 

• Of today's new cases, 144 were children 18 and younger. Of those, 21 were 5 and under and the youngest was 3 months old, according to the news release.

• 
  Beshear showed pictures of a quilt on display in the Capitol Rotunda, made by over 100 Kentucky mask-makers from scraps left over from masks. He said the quilt is symbolic of a time when Kentuckians came together to do what was needed to help one another stay safe. "They took their own time to protect their fellow human being, not just by wearing one, but by making them," he said.
  

• The Superhero Mask Project, formed in Kentucky, started out making masks for health-care workers and first responders across the nation, but now provides them to Kentucky children in low-income families, WDRB reports. So far, the group has given out 10,000 masks, with 4,000 of them going to children.

• “Top White House officials are blocking strict new federal guidelines for the emergency release of a coronavirus vaccine, objecting to a provision that would almost certainly guarantee that no vaccine could be authorized before the election on Nov. 3,” The New York Times reports. “The Food and Drug Administration is seeking other avenues to ensure that vaccines meet the guidelines. That includes sharing the standards, perhaps as soon as this week, with an outside advisory committee of experts that is supposed to meet publicly before any vaccine is authorized for emergency use. The hope is that the committee will enforce the guidelines, regardless of the White House’s reaction.”

• The federal government's response to the pandemic “has already been the costliest economic relief effort in modern history," The Washington Post reports. “At $4 trillion, the assortment of grants, loans and tax breaks exceeded the cost of the Afghanistan war. More than half, or $2.3 trillion, went to businesses, which in many ways were not required to show they were impacted by the pandemic or keep workers employed. … At $884 billion, roughly one-fifth of the relief money went to help workers and families. … Only 16% of the money was allotted to fighting the health crisis.”

• The Commission on Presidential Debates has approved the use of a Plexiglas barrier between the two vice-presidential candidates Wednesday, but health experts say such a barrier is not enough to stop aerosol transmission of covid-19. “Those barriers really don’t do anything,” John Lednicky, an aerobiologist at the University of Florida, told Business Insider. When the candidates speak, they’ll expel aerosols or smaller particles that “can hang suspended in the air for minutes to hours,” according to the publication.

• The CDC made a long-awaited update of guidance, saying the virus in small droplets and particles that can linger in the air for minutes to hours "may be able to infect people who are further than 6 feet away from the person who is infected or after that person has left the space." Evidence to support this has been found within enclosed spaces that had inadequate ventilation and where infected people are breathing heavily, for example while singing or exercising, says the CDC. NPR reports on the new guidance. 

• More than 30,000 people across Louisville may have been exposed to the coronavirus since the pandemic began in March, with infections much higher in West Louisville compared to other neighborhoods, Grace Schneider reports for the Louisville Courier Journal. In its latest round of testing, the University of Louisville Co-Immunity Project tested more than 2,000 volunteers in Jefferson County and confirmed that the extent of virus has been vastly underestimated there, by about half. The research found an infection rate of 10 to 12% in West Louisville, a heavily Black area, but only 2-4% in other parts of the county.

In close vote, Louisville sets content rules for children's menus, citing child obesity; critics say law invades parental responsibility

A food-service business in Louisville will be allowed to offer a children's menu only if it includes certain types of healthy items, under an ordinance passed by 13 Democrats on the Metro Council over "vocal bipartisan objections" from 11 other members, Phillip M. Bailey reports for the Courier Journal. "The proposal touched a nerve with many residents and council members who said such choices should be left up to parents."

Supporters said the ordinance is needed to fight an epidemic of child obesity and is the first in the United States to set food and drink standards for children's menus. The American Heart Association, which spearheaded the proposal, said about 12 cities, mostly in California, have adopted similar rules, Bailey reports. Mayor Greg Fischer said he plans to sign the measure into law.

The ordinance will require food service businesses "to provide a non-fried fruit or vegetables, a whole grain product or a lean protein or one 2-ounce serving of nuts, seeds, dry beans, peas or one egg," Bailey reports. "The restaurant must make available either a water, sparkling water, flavored water with no added natural or artificial sweeteners or milk product." Violation carries a fine of up to $100.

"Many of the council members who voted against the idea said they support the goals but that it shouldn't be the city's job to tell people how to eat," Bailey writes.

"Here we go again, this is a government overreach. We continue to tell parents what they need to do with their children," said Councilwoman Mary Woolridge, D-3rd District, one of three Democrats who joined eight Republicans in voting against it.

"Several Democrats who voted for the measure also expressed doubts that it would achieve its goals," Bailey reports. Councilwoman Vicki Aubrey Welch, Blackwell's co-sponsor, said it would address the local childhood obesity epidemic.

"Nearly 25 percent of Louisville sixth-graders and 18 percent of kindergartners are obese, according to the Louisville health department," Bailey writes. "Health advocates point out that one out of three children in the United States eat fast food and thus have a higher caloric intake that can result in a poor diet, obesity and diabetes."

Paducah expands smoking ban to e-cigs, private workplaces

Paducah has expanded the anti-smoking ordinance that it first passed in 2006.

The city commission voted 4 to 1 on Tuesday, April 10 to apply the ban to electronic cigarettes and private places of employment, making it comprehensive. “This is based on evidence that these types of ordinances make an impact on the smoking rates," Mayor Brandi Harless said.

"This amended ordinance also prohibits smoking in municipal and school-owned outdoor sports arenas and amphitheaters, public or private owned outdoor playgrounds, shelters, swimming pools, and spray-grounds, and municipally-owned outdoor public parks, playgrounds, trails, shelters, swimming pools, and spray-grounds," reports James Long of KFVS-TV in Cape Girardeau, Mo. "Smoking now is prohibited in city-owned vehicles, and each city vehicle is required to have one no-smoking sign."

The smoke-free ordinance still exempts private vehicles, retail tobacco stores, government and higher-education workplaces designated under KRS 61.165, private organizations or clubs, and private dwellings (unless used as a child-care facility), adult day-care centers, assisted-living facilities, hotel or motel guest rooms, screened gazebos, and the golf course at the city's Paxton Park, Long reports. It also exempts health-care facilities, which usually ban smoking on their own.

Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, praised the commission's action: "The comprehensive law now protects residents from secondhand smoke in all public spaces and workplaces and covers e-cigarettes as well as traditional cigarettes. This policy ensures that all who live, work and visit in Paducah can enjoy their right to breathe air that is free of tobacco smoke and related emissions. Studies show that comprehensive smoke-free laws decrease hospital admissions for emphysema and ER visits for asthma, reduce heart attacks and strokes, prompt more smokers to quit, and discourage youth from starting to smoke. These laws also benefit business by reducing health care, cleaning and maintenance costs and improving working productivity."

Needle exchanges slowly spread as locals conclude they're better than HIV and hepatitis outbreaks, injuries from discarded syringes

Needle exchanges may be difficult for some people to accept, but they are better than outbreaks of hepatitis and HIV or accidental injury from discarded needles, officials in Kentucky counties that have established the exchanges told Bill Estep of the Lexington Herald-Leader.

"Programs allowing intravenous drug users to exchange dirty syringes for clean ones are spreading in Kentucky as communities confront growing heroin abuse and concerns over the potential for disease outbreaks caused by addicts sharing needles," Estep reports. "So far, health departments and local governments in 13 counties have approved needle exchanges, and 11 are in operation, according to the state Cabinet for Health and Family Services and local officials."

Kentucky leads the nation in hepatitis C cases and has 54 of the 220 counties that the federal Centers for Disease Control and Prevention considers most at risk for HIV or hepatitis outbreaks from shared needles, based on "statistics such as numbers of overdose deaths, per capita income, unemployment and sales of painkillers," Estep notes. "Kentucky had 18 counties that the CDC calculated to be more vulnerable than Scott County, Indiana, to a disease outbreak among IV drug users, with Wolfe County considered at greatest risk in the nation."

A version of this map appeared on Kentucky Health News May 5. This one adds needle-exchange sites.

Some local officials "said they’ve faced concerns that giving needles to drug users enables or condones illegal drug activity, or will make the local drug problem worse," Estep reports. Republican Judge-Executive Mike Malone of Carter County "said he shared those concerns when officials from the health department brought up the idea. Malone said he changed his mind because of the potential for the program to head off disease and get addicts into treatment.

“It’s not about enabling them to take drugs. It’s about stopping the spread of disease,” Malone said. “The more you learn about it, the more you’ll understand it’s the right thing to do.”

Estep reports, "Health officials said they understand some people don’t like the idea of providing drug users with needles at public expense, but they argue the potential cost to taxpayers of not doing so is far worse."

Needle exchanges are operated by local health departments with approval of the county health board, the fiscal court and the city where the exchange is located, under a law passed by the 2015 General Assembly.

UPDATE, July 22: "Clark County’s needle exchange opened a week ago with one client." Fred Petke reports for The Winchester Sun. "Local officials are good with that." Clark County Health Department director Scott Lockard told Petke in an email, “Some of the health departments had their exchanges open several weeks before having their first client.”

Grant will fund Lexington signs, maps to encourage walking

A $182,000 grant will fund a pilot project in Lexington to encourage citizens to walk more, by erecting way-finding signs for pedestrians and updating walking maps.

The new Walk Lexington program will also feature signs that tell people how easy it is to get from one spot to another such as "It's only two minutes to the library." The signs are used to help people realize that walking is often faster than driving.

The grant is from the John S. and James L. Knight Foundation, which awards grants to programs in cities where the Knight brothers once owned newspapers, including the Lexington Herald-Leader.

A Herald-Leader report on the grant indicted that the recipient is the NoLi Community Development Corp., a nonprofit trying to make the North Limestone corridor a more livable place, through the Blue Grass Community Foundation, which announced it.

Hopkinsville mayor breaks tie to pass citywide smoking ban

After a six months of public debate, private wrangling and at least one serious local editorial page flaying, the Hopkinsville City Council narrowly passed a citywide smoking ban Tuesday night. The original ordinance that came before the council at its meeting was more of a smoking regulation than a ban because it required businesses to decide whether they would allow smoking at their establishments, and post that publicly. But once the ordinance came up for discussion, reports Carla Jimenez of the Kentucky New Era, council members opted for an all-or-nothing vote. “If we’re really, truly concerned about the health of people, then it should be everybody,” said Ward 8 Councilwoman Marby Schlegel. The exemptions to a full smoking ban vote were then removed. That vote resulted in a 6-6 tie, which was broken by Mayor Dan Kemp.

“It’s progress,” Kemp told Jimenez after the meeting. He said Hopkinsville now has a smoke-free ordinance similar to Owensboro, Bowling Green, Madisonville, Henderson, Oak Grove and  Paducah. Ward 4 Councilman Ward Henson disagreed.  "I think we took away rights from private business owners, which is something I totally disagree with, but I’m just glad to see the smoking thing out of the way.” The ordinance still has to pass on second reading before it becomes law. (Read more)

The excoriating editorial (see above) can be read here.