McConnell: 'Completely unacceptable' for Biden to extend pandemic emergency but lift bar on asylum seekers at borders

McConnell and Biden in January 2017

Senate Majority Leader Mitch McConnell said Thursday that President Biden was being inconsistent and political by extending the pandemic public-health emergency for another 90 days, and the travel mask mandate for at least 15 days, while announcing that he will lift the pandemic restriction that allows the U.S. to turn away seekers of asylum at national borders.

“Democrats are ending the Covid emergency for illegal immigrants but extending it for American citizens," McConnell said in a press release. “Democrats are not basing their decisions on any smart strategy, coherent plan, or objective science. They pretend the pandemic justifies an endless freeze on student-loan payments despite the tightest job market in modern history, but not controlling who crosses our borders. They pretend that unelected public-health bureaucrats get to dictate economic policy and immigration policy, but they overruled the experts on the actually medical subject of booster-shot policies, causing multiple FDA scientists to resign in protest. When President Biden’s political advisers want to dictate policy, they do so freely, but when they want to duck accountability, they pretend they are powerless.

“This White House is using the pandemic as a pretext to shamelessly pick and choose liberal policies to advance. The effects will be functionally open borders while a state of emergency continues for Americans. Completely unacceptable.”

Bill Wagner, who headed group of health clinics for disadvantaged in Louisville, wins Gil Friedell Memorial Health Policy Award

Wagner, left, with Foundation President and CEO Chandler

William Wagner, retired CEO of Family Health Centers of Louisville, is the latest winner of the Foundation for a Healthy Kentucky's Gil Friedell Memorial Health Policy Award, for his work expanding access to care and coverage.

“Bill’s passion for bettering the health of Kentuckians is a perfect reflection of the spirit of the Gil Friedell Memorial Health Policy Award,” said Ben Chandler, the foundation's president and CEO. “Dr. Friedell was a passionate advocate for access to health care. Bill’s 40-year career is a testament to his commitment to serving others by expanding opportunities for health-care coverage and bringing medical care to underserved areas in rural and urban communities. He has made a profound impact on the health and wellness of countless Kentuckians.”

Wagner established primary-care centers focused on people who are low-income, homeless, immigrants and refugees, then expanded them to include dental, behavioral health, pharmacy services, health education, outreach and enrollment services.

He was influential in the evolution of Kentucky’s Medicaid program, helping develop the nonprofit Passport Health Plan for managed care of Medicaid patients and the Children’s Health Insurance Program, providing medical services for hundreds of thousands of children and adults in Kentucky.

He also helped shape the next generation of social workers and public-health professionals through his work with the Kent School of Social Work and the College of Public Health at the University of Louisville.

“It's an honor to receive the award,” Wagner said. “I accept it on behalf of all the health care providers who work so hard to provide medical care access in underserved areas of Kentucky – urban and rural. They’re the real heroes. I have great respect for them and working with them made my job so fulfilling.”

Wagner retired at the end of 2021, something he delayed due to the pandemic. During it, he worked with non-English-speaking communities to provide testing and education. When vaccines rolled out, Wagner was at the forefront, helping with logistics, outreach, and education, most notably with the homeless.

The Memorial Health Policy Award is named for Gil Friedell, first director of the Markey Cancer Center at the University of Kentucky and cofounder of the Kentucky Cancer Registry. He helped launch a nonprofit advocacy education organization in 2005 that later became the Friedell Committee for Health System Transformation. The Foundation created the award when it united with the Friedell Committee in 2018.

Wagner and Friedell worked in the mid-1990s to create a community partnership for breast and cervical cancer screening in Louisville’s West End, which had extremely high death rates from those diseases.

The foundation makes a $5,000 grant to a Kentucky nonprofit working to improve health policy in the commonwealth in honor of the Friedell Award winner. Wagner selected Kentucky Voices for Health, a nonpartisan coalition that amplifies the voices of individuals, families, and communities in the decisions that affect the health and well-being of all Kentuckians.

Wagner said he selected KVH because of his concern that many Kentuckians could lose the Medicaid coverage to which they gained access in the pandemic. “Having health-care coverage is key to having access to medical care and living a healthier life,” he said. “I’m concerned when the emergency measures for expanded Medicaid expire, we will have many folks who aren’t sure how to recertify or apply through Kynect. KVH can help fill those gaps.”

Wagner was selected from the foundation's 2021 Healthy Kentucky Champions, Kentuckians honored for making a difference in the health of their communities or the state. Nominations for the 2022 awards are due by May 20. For more information and to nominate someone, visit Healthy-KY.org.

Virus cases plummet in last 2 days; Beshear says will be 'really hard' to keep at 120/day; aims to get all black Kentuckians insured

Kentucky Health News chart shows the two-week trend is still up, but less steeply than last week.

As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Al Cross and Melissa Patrick
Kentucky Health News

Gov. Andy Beshear reported Monday a marked drop in new coronavirus cases, reversing a nine-day trend of elevated case numbers.

He also announced what he said would be the first step to eliminate the health inequality among African Americans that has been "laid bare" by the pandemic, an effort to get every black Kentuckian covered by health insurance.

Beshear said only 70 new cases of the virus were reported in Kentucky on Sunday, and just 120 on Monday, with only one death each day. Sunday's number of cases was the lowest reported since Sunday, April 27, when 71 cases were reported. Sunday numbers are often lower due to limited reporting.

The two-day report followed a four-day period that had an average of 292 cases per day, which was part of a nine-day stretch with an average of 244. The increases drove up the estimated transmission rate of the virus in the state to seventh highest in the nation, by one measure.

Beshear said Kentuckians' increased number of contacts as their economy continues to reopen "is creating more cases. Now, those cases are still in a certain range that is manageable, but we will have to be watching as that continues. We still don't have enough data from the last several days to have a full conclusion."

Asked if he still feels comfortable with his strategy for reopening the state's economy, Beshear said, "I do. We are very carefully monitoring this. . . . Remember, when we had a two-week decline, it took us almost a week after that to truly see it."

He added, "I do worry that some aren't taking it a seriously as we should.  . . . We know that distance and masking work, and if people are unwilling to do those things, it makes it less safe."

Asked if he has decided that the state will have to live with a certain number of new daily cases for then foreseeable future, Beshear said it would be "really hard" to keep the number under 120 "in the near future, and as long as we are taking care of people, as long as we are protecting the long-term-care facilities, which we really need to, as long as we're ensuring there's not an outbreak like [one at a state prison], then we've got an opportunity to reopen our economy while dealing with this virus."

Among the new cases Sunday and Monday, 61 were in Louisville Metro and 48 were in Lexington. The state has had 11,476 people with the virus, 3,359 of whom have recovered and 472 of whom have died.

Noting that African Americans have accounted for 16.4 percent of the deaths, Beshear said, "Inequality here has resulted in death, and it's our job to do something about it. Let's make sure everybody has the means to see a doctor."

He said the one thing he can do immediately to address health inequality is “an effort to cover 100 percent of our individuals in our black and African American communities. Everybody. We’re going to be putting dollars behind it, we’re going to have a multifaceted campaign to do it.”

He offered few details, but suggested that the effort would look like the one that the administration of his father, Steve Beshear, conducted to sign up people for Medicaid and subsidized health insurance after expanding it under the Patient Protection and Affordable Care Act. "The blueprints are out there on how to do it," he said. "There are multiple groups out there that have done this at different times."

About 5.8% of black Kentuckians had no health insurance in 2018, according to the Census Bureau's American Community Survey. The statewide figure was 5.6%.

Beshear said two other areas for effort in the future will be quality and access. "You shouldn't have to take multiple buses to see a doctor," he said.

In other covid-19 news Monday:

Read more here: https://www.kentucky.com/news/politics-government/article243373171.html#storylink=cpy

• Since Thursday, 69 more residents and 34 employees at Kentucky long-term-care facilities have tested positive for the virus, making respective totals of 1,453 and 673. Six more resident deaths have been confirmed, for a total of 289; three employees have died of covid-19. Eleven more facilities have been added since Thursday to the list of those with at least one case.
• Health Secretary Eric Friedlander said no cases have been found in 22 percent of the 129 facilities where the state has completed testing of all residents and employees. He said about half the population has been tested, and at least half of the facilities will have been fully tested by the end of the week.
• Friedlander showed figures from a federal study showing that the national rates cases among of nursing-home resident and employees is almost double Kentucky's rate, and the rate of resident deaths is more than double. "Kentucky has done a good job, a very good job" protecting residents, he said. However, the federal agency "allows nursing homes to report only those covid-19 cases and deaths that occurred on or after May 1 – weeks after the pandemic began sweeping through nursing homes," reports Bob Seagall of WTHR in Indianapolis.
• State inspection records indicate that most Kentucky nursing homes were prepared for the pandemic after it began, Bailey Loosemore reports for the Louisville Courier Journal. "At least 154 of the state's 285 licensed nursing homes have received covid-19-focused infection-control inspections since late March, including eight facilities that have reported some of the highest numbers of cases." Only two "were cited for infection-related deficiencies," both "not properly wearing a mask." Two others received citations unrelated to the pandemic. Most covid-19 deaths in Kentucky have been of nursing-home residents.
• Asked about the recent coronavirus outbreak at Clays Mill Road Baptist Church in Jessamine County, Beshear said it should teach churches and other facilities that they "truly ready and that we take the guidance seriously" before reopening. "You ought to be asking them to wear masks, and you ought to be leading with it. You gotta make sure that you have the cleaning, that people are spaced out, that you don't just give lip service to these guidelines. . . . Put your credibility behind it."
• Lexington is going through a third round of increases in new daily coronavirus cases, but not because 10 nights of protests have spread the virus, public-health officials told the Lexington Herald-Leader. It is spreading “rapidly” in the city, local health-department spokesman Kevin Hall said, but “Based on our case investigations, the protests are not contributing to the rise in cases we’ve seen this week and the couple weeks prior.” Symptoms can appear two to 14 days after infection.
• Much of the increase is among Lexington's Hispanic and African-immigrant populations, the Herald-Leader's Beth Musgrave reports: "Approximately 17 percent of the 847 people who have tested positive for covid-19 are Hispanic, according to the Lexington-Fayette County Health Department figures. Fayette County’s population is 7% Hispanic."
• The thousands of jail inmates released to keep them from getting infected had a re-arrest rate identical to the 4.6 percent rate for jail inmates released during the same period last year, Chief Justice John Minton told a legislative committee, the Herald-Leader reports.
• Americans experienced more depression and loneliness during the early covid-19 pandemic, but those who were able to maintain frequent in-person social and sexual connections had better mental health outcomes, according to an Indiana University study. “This data reaffirms our understanding of the importance of human connection for mental health and well-being,” said the lead author, Molly Rosenberg. “It also suggests that these kinds of connections are not easily recreated with remote technology where direct touch is not possible.” The researchers don't say limits on contacts should be lifted, but call for an increase in mental-health services and better ways for interpersonal connection. 
• The state Department of Corrections says 105 of 982 inmates at the Green River Correctional Complex in Central City have not been retested for the coronavirus, almost a week after the deadline to do so, Jared Bennett reports for WFPL. Inmates have told loved ones that the facility ran out of test and do not know when more will arrive, but the department did not respond to a follow-up question about this, Bennett reports. After a spike in cases, the entire complex was tested for the virus, resulting in 363 inmates and 51 staff testing positive for the virus. The department reports that 192 inmates and 42 staff have since recovered, and three have died from it.
• A study in BMJ Open Diabetes and Research Care found that high blood sugar levels at the time of hospital admission is a good predictor of that a covid-19 patient will become critically ill or die.
• The New York Times tracks infection rates in each U.S. county over time. Here's a screenshot of the 20 counties with the most cases on its Kentucky chart as of 11 a.m. Monday:

Grayson County newspapers introduce health department's new public health director, who says he's going after human trafficking

Grayson County Public Health Director Joshua Embry
(Photo by Matt Lasley, Grayson County News-Gazette)

By Al Cross
Kentucky Health News

LEITCHFIELD, Ky. – Health departments in Kentucky usually operate in the background, or under the radar of local news organizations, unless a health issue arises. But their work is important, so they deserve more regular attention, and both weekly newspapers in Grayson County did that when it got a new public health director.

Some residents of the west-central Kentucky county may have been startled when they read a headline in the Grayson County News-Gazette saying that Joshua Embry was going to "address human trafficking." He told reporter Matt Lasley, "Based on our clinic services, we know for a fact it is happening in our community. . . It's definitely happening in small, rural towns."

"According to Embry, human trafficking is not solely related to sex, it also includes human labor, and can be drug-related as well," Lasley reports. "In many instances, people are brought into the country and forced to provide unpaid labor to work off a debt to the person who brought them here."

Also, "Underage children can be victims of human trafficking without ever leaving their homes, by being deceived into sharing explicit images of themselves with people online. These images are then widespread, which falls under the umbrella of human trafficking, health department officials say."

January is Human Trafficking Awareness Month, and Embry "is beginning an awareness campaign aimed at educating the community on the issue and how to address it and report it," Lasley writes.

The front-page story in the county's other weekly, The Record, briefly mentioned human trafficking and was more general, reminding readers of the health department's wide range of services and responsibilities, which include "grief counseling services for families who've lost a child."

"People hear 'health department' and they automatically think STD tests" for sexually transmitted diseases, Embry told The Record's Rebecca Morris. "I want to be able to educate the community on all the programs we have. A lot of people just don't understand the great resource the health department is."

Embry, 32, began work last month after almost seven years at Breckinridge Health, which operates Breckinridge Memorial Hospital in Hardinsburg. After a brief teaching career, he started as an emergency-room admittance clerk and ended as coordinator of compliance, emergency preparedness and safety. He told Morris that health care is a "field you definitely have to be called to."

One could say that about the weekly newspaper business, too. I was editor of the News-Gazette (and general manager of a predecessor, The Leitchfield Gazette) before the Louisville Courier Journal hired me away in 1978. One of my successors as editor, Jenny Searcy, started The Record a few years later.

Grayson may be the only county in the U.S. with weekly newspapers operated by competing chains, which usually don't buy papers with less than $1 million in annual revenue, and certainly not in competitive markets. But Landmark Community Newspapers of Shelbyville bought The Record to give advertisers in its Elizabethtown daily, The News-Enterprise, an opportunity to buy combination ads. It ran a circulation campaign, managed by Searcy, that won it the local circulation lead and thus the public-notice ads. The News-Gazette went through several owners and is now owned by Paxton Media Group of Paducah, which bought in a 2017 package deal with two other nearby papers and moved it from twice-weekly to weekly publication. The county of 27,000 also has an AM-FM radio station with an active news department, WMTL-WKHG in Leitchfield, a town of about 7,000.

Rule expanding definition of 'public charge' criteria to Medicaid draws fire from hospitals and advocates for immigrant families

Acting Citizenship and Immigration Director Ken Cuccinelli
announced the final rule at a White House press conference.

Adult immigrants would find it harder to remain in the United States if they signed up for Medicaid benefits, under a rule that the Department of Homeland Security finalized Aug. 12.

The rule brought "outcry from stakeholders across the health-care industry who say the policy will drive up the number of uninsured patients and increase the cost of uncompensated care," reports James Romoser of Inside Health Policy. "Immigration advocates and the California attorney general have already indicated they intend to sue to stop the so-called public-charge rule, which is scheduled to take effect Oct. 15."

The rule "is in some respects not as harsh as the proposed rule released last fall," Romoser writes. "The administration backed off its proposal to penalize immigrants who receive Medicare Part D low-income subsidies, and it also decided not to penalize immigrants who receive Medicaid while they are pregnant or under the age of 21."

Still, six major hospital lobbies said in a joint statement, “This rule could undermine access to care for legal immigrants by discouraging the use of critical public programs like Medicaid. We are concerned that this could lead to delays in care that would negatively impact the health of the communities we serve. We ask the administration to withdraw this harmful rule.” The statement came from the American Hospital Association, America’s Essential Hospitals, the Association of American Medical Colleges, the Catholic Health Association of the United States, the Children’s Hospital Association and the Federation of American Hospitals.

"The Trump administration said the rule will better enforce provisions in immigration law meant to deny permanent legal residency to any immigrant likely to become a 'public charge,' a term used for people who depend on government assistance," Romoser reports. The term has been used as a criterion since Congress passed the first immigration law in 1882.

However, the term has historically "focused on cash welfare programs, Romoser notes. "The new rule broadly expands the definition to include food stamps, housing vouchers and Medicaid. Under the rule, even a short stint on Medicaid could doom an immigrant’s chance to remain in the country legally, immigration advocates say."

Sara Rosenbaum writes for The Commonwealth Fund, "Whereas before only nursing home care counted toward public-charge status, now a host of services, from preventive care to treatment of chronic conditions like diabetes, could render someone a public charge after 12 months."

Kaiser Family Foundation chart; click on it for a larger version

Other critics fear a chilling effect on immigrants with U.S.-born children, who are citizens. "Enrolling their children in Medicaid is not supposed to trigger any penalties," Romoser reports, "but widespread fear about the rule is already causing many immigrant families to avoid seeking Medicaid or any other government assistance even for children who are U.S. citizens, stakeholders say."

"Researchers at the Georgetown University Center for Children and Families said in a May report that fears in the immigrant community contributed to a 2.2% decline in children enrolled in Medicaid and CHIP last year," Romoser notes. "In an analysis of the proposed rule, the Kaiser Family Foundation estimated that between 2.1 million and 4.9 million Medicaid and CHIP enrollees living in a household with a noncitizen would disenroll from the insurance programs."

Ken Cuccinelli, acting director of U.S. Citizenship and Immigration Services, said at a White House announcement, “President Trump’s administration is re-enforcing the ideal of self-sufficiency and personal responsibility, ensuring that immigrants are able to support themselves and become successful in America.”

Louisville doctor has possible cure for rare brain disease of Iranian woman, who gets visa after CJ story

UPDATE, Aug. 13: "U.S. officials in Armenia granted Marzieh Taheri, 61, the exemption on Monday, just hours after her son sent them links to the Courier Journal's initial article about her plight and subsequent coverage by other media," the CJ reports.

A Louisville doctor has found what may be the first treatment to repair a rare, debilitating brain condition that can eventually lead to death, and has said he would treat a 61-year-old woman from rural Iran who needs it, but she's from a country that's on the U.S. travel restriction list and her visa application is jumping through hoops, Caitlin McGlade reports for the Louisville Courier Journal.

Marzieh Taheri and son Mehran Jafari
 (Photo provided to Courier Journal)

Marzieh Teheri suffers from a condition called radiation necrosis, which developed after she received treatment for a tumor on her ear about three years ago. McGlade reports that the tumor is gone, but because of a condition that affects 10 percent of patients who get radiation therapy on their heads, brain tissue has died, which has "distorted her brain." Until recently, there has been no hope of a cure.

But that changed after Dr. Shervin Dashti, a neurosurgeon at Norton Healthcare, recently found what may be the first treatment to repair the brain indefinitely without any side effects, McGlade reports.

Dashti told McGlade that it's like half of Taheri's brain is "on fire." He has offered to treat her at the Norton Neuroscience Institute, but won't be able to until the U.S. government approves her visa.

The Trump administration set travel restrictions on people from Iran, North Korea, Venezuela, Libya, Syria, Somalia and Yemen that were upheld in June by the U.S. Supreme Court. The administration says the restrictions are needed to be able to properly vet people from these countries trying to enter the U.S.

McGlade reports that on a case-by-case basis, "People traveling to the U.S. from these countries may get waivers if they can show that denying the visa application would cause them 'undue hardship,' that they are not a threat to the United States, and that their visit would be in the U.S. national interest, according to a September 2017 White House proclamation."

The State Department "asked Taheri to list every country she traveled to in the past 15 years, detailing where she stayed, specific locations visited, how she paid for it and length of visit.The office also asked for previous passport numbers; names and birth dates of all immediate relatives; a list of her addresses for the past 15 years; all phone numbers, email addresses, social media accounts, including messaging apps; and her job history. Her daughters compiled and sent a mountain of documents."

Taheri told McGlade that she is optimistic she'll get a waiver, since the proclamation cites urgent medical care as grounds for eligibility. However, McGlade reports that critics call the restrictions discriminatory because most of the countries on the list are Muslim-majority, and Trump said he wanted to ban Muslims during his campaign.

Dissenting Supreme Court Justice Stephen Breyer has also questioned the waiver program's legitimacy, "citing the small number of waivers granted, lack of transparency and a sworn affidavit from a former consular officer who called the process "window dressing,"" McGlade reports.

A lawsuit has also been filed this year by dozens of people impacted by the ban asserting that the "government is denying or stalling virtually all waiver grants and hasn't given consular officials discretion to grant them," McGlade writes.

McGlade writes that the agencies have yet to file formal responses, but a State Department website disputes that claim. It notes that 1,246 visa applicants have been cleared for waivers as of July 31, 2018.

McGlade reports that the State Department won't say how many of the current visa applicants are from the affected countries, but a June letter to Sen. Chris Van Hollen, D-Maryland, said they had approved waivers for just 2 percent of applicants from Muslim-majority countries in the ban.

"Out of 27,129 applicants who could possibly get a waiver, only 579 had been cleared as of April 30," she reports.

Taheri applied for her visa in June. Dashti told McGlade that everyday Taheri gets weaker, and that she is "circling the drain."

"It is agony to place my faith in a process that I know might be fraudulent, but I have no choice," wrote her son, Mehran Jafari, who now lives in Georgia. "My mother’s life could be saved by 30 minutes of surgery, and I must do everything in my power to get her to Louisville."

He added, "I don't know how my 60-year-old mom who was in the United States three years ago can pose a national security threat. If someone like my mom can pose a threat . . . how safe do Americans feel now? If a 60-year-old kind-of disabled woman can jeopardize your safety . . . this is just not America."