Opinion: U of L Health should repay all its state loan, not just half

By Jim Waters
Bluegrass Institute for Public Policy Solutions

The University of Louisville Cardinals men’s basketball squad gave its fans a timely stocking stuffer Dec. 14 with the team’s first win of the season, beating the Western Kentucky Hilltoppers at the KFC Yum Center.

U of L’s health-care system should follow suit and offer taxpayers some Christmas joy by fully repaying the $35 million borrowed from the Commonwealth under the auspices of needing the money to purchase Kentucky One Health’s assets, including Jewish Hospital.

The money was neither needed nor used for these purchases.

In previous columns, we urged lawmakers to “invite the university to either pay for this project out of its already-flush-with-cash pockets or seek a loan from the private sector.”

Kentucky’s taxpayers “should be outraged that U of L lobbied heavily for this loan even though the university is flush with hundreds of millions in cash and is more than capable of making this acquisition without one red cent from Frankfort’s coffers,” we opined.

But taxpayers’ voices were drowned out by the Santa-sized claims of former U of L President Neeli Bendapudi, who doubled down on her assertions that the loan was “vital” to purchasing the additional facilities and that there was no other way for the university to absorb Kentucky One Health’s operating losses.

Documents obtained by the Bluegrass Institute Center for Open Government reveal that not only was U of L capable of acquiring the funds to make needed improvements to the previously faltering Kentucky One Health system without the government loan, but that the monies were used for a variety of capital purchases, including upgrades to the system’s emergency medical records platform, computer replacement/remediation and even a new roof at Jewish Hospital.

Such outlays can improve a hospital’s ability to provide quality care, but were they so “vital” that UofL needed a subsidized, partially forgivable taxpayer-backed loan from state government to purchase them?

“Partially forgivable”? This health-care giant is only required to pay back half the loan even though the enterprise reaped year-over-year total operating revenues of $2.2 billion while holding more than $1 billion worth of total assets during the most recent fiscal year, according to audited financial statements obtained by the Center for Open Government via the open-records law.

In their annual report to the Legislative Research Commission, officials indicated they anticipated paying back “the obligated portion of the loan” ($17.5 million) ahead of schedule.

Bluegrass Institute Visiting Policy Fellow Andrew McNeill instead urges the company to “meet this moment by respecting Kentucky’s working families and taxpayers who ponied up for what has proven to be an unnecessary loan” by going beyond what’s statutorily required and repaying the entire loan.

New U of L President Kim Schatzel, whose administration officially begins in February and who has extensive business and private sector experience, should appreciate what a welcome gift that would be for the Commonwealth. Perhaps she could help spread some needed holiday cheer by voicing her own support for full repayment.

McNeill wrote in a letter to Interim Joint Appropriations and Revenue Committee members that such a gesture “would make an immediate and positive impression with Kentucky’s taxpayers, especially those from outside of Jefferson County.”

Senate health bill expected Thur., McConnell says; could stretch Medicaid expansion but then cut program more than House bill

By Al Cross and Melissa Patrick
Kentucky Health News

Senate Republicans plan to make their repeal-and-replace-Obamacare bill public on Thursday, Majority Leader Mitch McConnell of Kentucky told reporters Tuesday.

The bill is likely to continue the Medicaid expansion, which serves 470,000 Kentuckians, longer than the bill passed by the House, but could make deeper cuts to Medicaid in the long run.

McConnell talked and gestured as Republican Policy Committee

Chair John Barrasso of Wyoming, left, and Conference Chair

John Thune of South Dakota listened, while Republican Whip John

Cornyn of Texas looked away. (Associated Press photo : J. Scott Applewhite)

McConnell's announcement indicated that the bill is being analyzed by the Congressional Budget Office, which would clear it for debate, votes and perhaps passage on the Senate floor next week, meeting McConnell's goal of action before the July 4 week recess that begins Friday, June 30.

"I expect to have a discussion draft on Thursday, and we will go to the bill once we get a CBO score, probably next week," McConnell told reporters. Asked how long the Senate will have to review the bill, McConnell said "plenty of time."

On the floor Monday, Minority Leader Chuck Schumer of New York asked McConnell if the Senate would have more than 10 hours to debate the bill and McConnell wouldn't answer the question, saying only, "We'll have ample opportunity to read and amend the bill."

Schumer and other Democrats have been shut out of negotiations in the bill, which Republicans can pass with no Democratic votes because they are invoking budget rules that preclude a filibuster and bypass the 60-vote requirement to pass legislation.

McConnell said of Democrats, "They've made it clear they are not interested in helping" repeal Obamacare. Republicans plan no committee hearings on the bill, and note that Democrats passed Obamacare with only their own votes.

"No transparency would have been added by having hearings in which Democrats would have offered endless single-payer-system amendments," McConnell said. "That is not what this Senate was sent here to do."

McConnell's office is writing the bill, Republican Sen. Bob Corker of Tennessee told The Washington Times Monday: “The leader is really writing this bill. You can say the Finance Committee is, you could say the Budget Committee is, you could say the Health Committee is — but the leader’s office is writing the bill. And what they’re trying to do is sort of try to attempt hit the sweet spot between those differences that exist, which are natural when you have people from different states. I haven’t seen what that is yet, and to my knowledge no one has seen that yet.”

The Times reports, "Republican negotiators are still fine-tuning how make tax credits in their plan generous enough for certain cohorts, including the needy and older Americans who aren’t yet eligible for Medicare. Yet Sen. Rand Paul, Kentucky Republican, suggested his colleagues want to dole out more taxpayer assistance than the 2010 law they’re trying to scrap."

“One of the key things when it comes out, when we get a copy, is: Are there more subsidies in our bill than Obamacare?” Paul said. “That, to me, really is a non-starter.”

That could depend on what Paul calls a "subsidy." The word generally refers to tax credits and cost sharing for private insurance policies, but could also be applied to the heavy financial support that the 2010 health-reform law gives to states' expansion of the Medicaid program.

McConnell has suggested phasing out the Medicaid expansion through 2023, instead of ending it in 2020, but The Hill reports that the Senate bill could make deeper cuts to Medicaid in the long run: "According to lobbyists and aides, the proposal would start out the growth rate for a new cap on Medicaid spending at the same levels as the House bill, but then drop to a lower growth rate that would cut spending more."

That risks losing the votes of Republican senators such as Rob Portman of Ohio and Dean Heller of Nevada, and McConnell has only two votes to spare. If the vote is 50 to 50, Vice President Mike Pence can break the tie in favor of the Republicans.

"It may be too late to rally support . . . if reports coming out of a meeting of Republican senators are accurate, Rob Garver and Eric Pianin of The Fiscal Times report. "Sen.John Thune of South Dakota and Majority Whip John Cornyn [of Texas] exited a meeting of the Senate GOP caucus Tuesday afternoon and told reporters that there is currently no consensus among members on what the final version of the bill ought to look like." The writers add, "McConnell is the shrewdest politician on Capitol Hill and it would be a serious mistake to underestimate his ability to pull victory from the jaws of defeat."

McConnell "stopped short of guaranteeing that the bill would get the 50 Republican votes it would need to pass it when he brings it to the floor," notes Tierney Sneed of Talking Points Memo. McConnell replied, “We are going to make every effort to pass the bill that dramatically changes the current health-care law.”

The House Freedom Caucus, an ardently conservative group generally aligned with Paul, sent McConnell a letter warning him not to make bill too moderate. McConnell told reporters that the bill will be "a profound, positive improvement over the status quo."

Meanwhile, some lobbying groups expressed frustration at the inability to meet with McConnell. “It is deeply disturbing,” Erika Sward, assistant vice president of the American Lung Association, told the Los Angeles Times. “Patients groups like ours need to make sure that our patients’ needs for healthcare will be met. … We can’t do that if we can’t see what is being proposed.”

"Major physician groups, hospitals, consumer advocates and organizations representing millions of patients with cancer, diabetes, heart disease and other serious illnesses have been pleading with Republican leaders for months to open up the process and listen to their concerns," report Noam Levey and Lisa Mascaro of the Times. "This week, a group of more than 15 patients' groups . . . asked McConnell’s office to meet with them next week, proposing any time between Friday and June 22.

"A representative from McConnell’s office told them staff schedules were too busy, according to representatives of several of the organizations. McConnell spokesman Don Stewart said the majority leader’s schedule is full. 'Numerous meetings are already booked well in advance,' he said."

A group of 120 lobbies for consumer and health-care providers wrote McConnell a letter asking for the preservation of Medicaid, and the American Hospital Association said the Medicaid cuts being considered would have "serious negative consequences for communities across America."

Mike Rust, president and CEO of the Kentucky Hospital Association, told Kentucky Health News that the group has long taken two consistent positions: "Keep the expansion and if they repeal it, restore the cuts to Medicare" reimbursements, which were made when Medicaid was expanded.

Don Ritchie, historian emeritus of the Senate, told the Times that the Senate had not taken such a partisan, secretive approach to major legislation since said not since the years before World War I. That's when "Senate Democrats, at the urging of President Woodrow Wilson, drew up major tariff reforms while shutting out Republicans. But when Democratic leaders tried that again when they had large majorities during the Great Depression, rank-and-file senators revolted. It hasn’t happened since, he said."

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Some Republican senators, including Rand Paul, don't like Mitch McConnell's strategy of drafting health bill in secret

Kentucky Health News

Senate Majority Leader Mitch McConnell continues to catch heat from Democrats, and dissatisfaction from some Republicans, about Senate Republicans' secret drafting of a repeal-and-replace-Obamacare bill that he wants passed by June 30.

At the congressional baseball game, McConnell and Schumer
gave their first joint interviews, as did House Speaker Paul Ryan
and House Minority Leader Nancy Pelosi. (AP photo by Alex Brandon)

Senate Democratic Leader Chuck Schumer of New York told the Kentuckian in a letter that they should convene a meeting of all 100 senators "on the topic of health care," which "affects every single American and one-sixth of our economy. We believe we all owe it to our constituents to pursue any bipartisan potential legislation because it profoundly impacts so many American lives."

Schumer told reporters, “They’re ashamed of the bill. If they liked the bill, they’d have brass bands marching down the middle of small-town America saying what a great bill it is. But they know it isn’t.”

McConnell spokesman David Popp "argued that the letter suggests Democrats are now open to the 'repeal' component of the 'repeal and replace' health care effort," CNN reports. "He alluded to Schumer's comments earlier this year in which he said Democrats will work with Republicans on repairing Obamacare as long as Republicans back off of the 'repeal' part of it."

Popp noted that Schumer's letter said Democrats would like to "discuss how to make health care more affordable and accessible." Popp said that was an admission that Obamacare is neither. "That admission is another positive step from a party that, until now, has been wedded to the unsustainable status quo and its consequences for families across the country," he told CNN, urging Democrats to "propose ideas."

Meanwhile, seven governors — four Democrats and three Republicans — wrote McConnell and Schumer, asking that senators in both parties be allowed to help draft the bill. McConnell has said he wouldn't involve Democrats in drafting because "They're not interested in doing anything that we're interested in doing," and hearings aren't needed because the issues are well known.

Republican grumbles

The lack of "a formal, open drafting session . . . has created an air of distrust and concern — on and off Capitol Hill, with Democrats but also with Republicans," report Thomas Kaplan and Robert Pear of The New York Times. "The secrecy surrounding the Senate measure to repeal and replace the Affordable Care Act is remarkable — at least for a health-care measure this consequential."

Sean Sullivan and Kelsey Snell of The Washington Post report, "Rank-and-file Republican senators are increasingly frustrated that McConnell and a small group of GOP aides are crafting a bill behind closed doors."

They quote Sen. Bob Corker, R-Tenn.: “I’ve said from day one, and I’ll say it again. The process is better if you do it in public, and that people get buy-in along the way and understand what’s going on. Obviously, that’s not the route that is being taken.”

The Times reports, "Mr. McConnell said there had been 'gazillions of hearings on this subject' over the years — a less-than-precise tabulation that offered little comfort to Democrats who want hearings held now, in this particular year, on the contents of this particular bill."

Corker is not the only Republican who wants to know more, and sooner. McConnell's Kentucky colleague, Rand Paul, asked reporters if they had a copy of the bill, and if so, whether he could have one. Paul is considered one of the Republicans least likely to support the bill, since he said the House version didn't go far enough. “My preference would be a more open process in committees, with hearings and people on both sides,” he told the Times.

Among Republican senators, "Few seem to have a clear, coherent picture of what will be in the legislation," the Times reports, quoting Ron Johnson of Wisconsin: “I come from a manufacturing background. I’ve solved a lot of problems. It starts with information. Seems like around here, the last step is getting information, which doesn’t seem to be necessarily the most effective process.”

Republican rationale

The Post reports, "Senate leaders argued that they are keeping a tight grip on emerging bill language a secret because they are writing several different policy options for each section of the bill. They worry that sharing any one piece out of context could give a distorted impression of what the final bill will include."

The Times says, "It is not unusual for lawmakers to draft major legislation in private, but they usually refine, debate and amend it in open committee sessions. The House bill to repeal the Affordable Care Act did not receive a hearing where outside experts could have testified, but lawmakers dissected its contents and were able to propose changes at three stages: in the Ways and Means, Energy and Commerce, and Budget Committees. Senate Republican leaders evidently think their back-room approach gives them the best chance to devise a health care bill that can squeak through the Senate, given their narrow majority and the policy differences in their conference."

Fifty-two senators are Republicans, allowing defection by only two to let a bill pass with the tie-breaking vote of Vice President Mike Pence. McConnell plans to bring the bill to a vote by June 30, the last day before a week-long recess, the Post reports. If it passes, a House-Senate conference committee would be named to work out the differences.

"The largest, most enduring clash within the Senate is over the future of Medicaid," the Post notes. "Republican senators are at odds over how much and how quickly to pare back federal spending on the program, which expanded under Obamacare and added millions of Americans to the rolls of the federally insured." It added 470,000 Kentuckians.

Does McConnell really want to pass a bill?

Jennifer Rubin, a conservative columnist for the Post, wonders whether McConnell really wants to pass a bill: "There are two possibilities here: First, McConnell has some magic formula for getting the votes of all but one senator (if Paul is indeed a “no” vote ) in a conference that includes far-right ideological twins Sens. Ted Cruz (R-Tex.) and Mike Lee (R-Utah) and moderates such as Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska), who among other things object to rolling back Medicaid or blocking Planned Parenthood funding. If such a formula exists, McConnell would have to think he can garner support in lightning speed, hold off uniform Democratic objections and ignore concerns from outside groups (doctors, hospitals, insurers). I suppose anything is possible, but such a process would be unique in Senate history.

"The other possibility is that McConnell knows this is impossible. He has set an entirely artificial deadline that cannot be met precisely because he knows health-care reform won’t happen. He wants to wipe the slate clean and move on to other issues such as tax reform and the budget — before those issues become untenable. He is experienced enough to know that this administration and the dysfunctional House are entirely capable of careening toward a government shutdown in the fall. Therefore, the sooner Congress can turn to these items, the better."

The Times notes, "While much of the Affordable Care Act was written in the open, some important provisions were hashed out in private, just before the Senate vote, by Senator Harry Reid, the Nevada Democrat who was then the majority leader. Republicans complained bitterly at the time, and Democrats threw those complaints back at them this week. 'This massive piece of legislation that seeks to restructure one-sixth of our economy is being written behind closed doors, without input from anyone, in an effort to jam it past not only the Senate but the American people,' Mr. McConnell said in December 2009, using words that could be spoken by any Democrat today."

McConnell says he doesn't know how he will get votes to repeal and replace Obamacare; his Republican colleagues turn gloomy

Mitch McConnell (Reuters photo by Joshua Roberts)

"U.S. Senate Majority Leader Mitch McConnell said on Wednesday he does not yet know how Republicans will amass the votes needed to pass legislation now being crafted to dismantle Obamacare," Reuters reports. "He declined to discuss what provisions he might want to see in the bill or provide a timetable for producing even a draft to show to rank-and-file Republican senators and gauge their support."

McConnell needs 50 votes plus the tie-breaking vote of Vice President Mike Pence, and "I don't know how we get to 50 at the moment," he told the wire service. "But that's the goal. And exactly what the composition of that (bill) is, I'm not going to speculate about because it serves no purpose."

Republicans hold 52 Senate seats, but some moderates are firmly opposed to the proposed American Health Care Act passed by the House, and some conservatives, including Kentucky Sen. Rand Paul, think the bill wouldn't repeal enough of the 2010 Patient Protection and Affordable Care Act. "The Republican leader compared the effort to solving a Rubik's Cube," Reuters reports.

"Republican senators quickly distanced themselves from a House-passed Obamacare repeal-and-replacement bill after a new analysis of the legislation was released on Wednesday," The Hill reports. "The American Health Care Act would result in 23 million more uninsured Americans over a decade, according to the Congressional Budget Office analysis. The CBO also found that in states that would let insurers charge sick people more, some could be priced out of being able to afford insurance."

McConnell said in a Senate floor speech that the CBO score repeats "things we already know, like that fewer people will buy a product they don't want when the government stops forcing them to," but is a step that will allow the Senate to proceed with its own bill. Still, "It makes everything harder," Sen. Dean Heller, R-Nev., told Politico.

"Senators reported that they’ve made little progress on the party’s most intractable problems this week, such as how to scale back Obamacare's Medicaid expansion and overall Medicaid spending," which are highly important to Kentucky, report Politico's Burgess Everett and Jennifer Haberkorn. "Frustrations are rising and confidence is diminishing. . . . A feeling of pessimism is settling over Senate Republicans."

Republican senators reported being surprised by McConnell’s Wednesday statement, Politico reports: "Though aides said McConnell was restating the challenge of passing a bill in a sharply divided conference, senators said they also did not take the calculating majority leader’s words as a vote of confidence."

“He doesn’t do much that’s not purposeful. So is he sending a message here of: ‘Don’t anybody think this is likely to happen?’” an unnamed Republican senator told Politico. “If I had to bet my house, I’d bet we don’t get it done.”

McConnell recently warned senators and leadership staffers deliberating privately on the issue that he would bar staff members from the meetings if leaks from the conversations continued. Budget Committee Chair Mike Enzi of Wyoming, who is starting to draft the bill, told Roll Call that the number of leaks “seems normal,” but added, “If every idea was voiced out there, then there would be opposition to every idea before it gets finalized.”

McConnell originally named 12 Republican senators to work with him on the bill, but after he was criticized for not naming any women to the work group, he said any Republican could take part in the discussions. "Despite that, Republican leadership has faced criticism for the manner in which the legislation is being crafted," Roll Call's Joe Williams and Erin Mershon reported. "Several members say the bill is not expected to go through formal committee process."

Or through any Democratic senators. McConnell told Reuters that said health care and taxes remain the top priorities for Republicans, and "added that he will not reach out to the minority Democrats on either one because differences between the two parties are too stark," Reuters reports. He said, "They're not interested in doing what we're interested in doing."

Not allowing Democrats to help draft the bill "will leave McConnell, a conservative 75-year-old Kentuckian with a reputation as a dealmaker, a narrow path to win passage of these ambitious goals, which are also at the head of Republican President Donald Trump's policy agenda," Reuters notes.

"McConnell also said he has not asked the White House for input as the Senate devises its own health care legislation after the Republican-led House of Representatives passed its version on May 4, but may do so in the future," Reuters reports. "I told the president there would be a point at which we might well want him and the vice president to be helpful," McConnell said, adding that Trump and Pence could help with "whipping" up support for a bill.

They might also be needed to get votes for any compromise bill that emerges from a House-Senate conference committee -- if the Senate passes a bill.

Wrapping up the week, Mary Agnes Carey asked Kaiser Health News colleague Julie Rovner, "Why do you think Mitch McConnell would send such a public signal that he’s having a problem getting to 50 votes?" Rovner replied, "I really don’t know. I thought it was kind of curious. One of the things that it might be is that he wants to, you know, light a fire under his caucus, who are having all this disagreement, saying you know this whole thing could, you know, just dissolve if you don’t actually start coming to the table and compromising. Why else do you think he might do it?"

Carey said, "Well, you talk about how the calendar is working against him if he wants to get to tax reform. We’re at Memorial Day, and typically tax reform takes a lot of work, a heavy lift, maybe he just wants to move onto that. Rovner asked, "So basically abandon the whole health reform idea?" Carey acknowledged, "I mean, it sounds a little nutty. And obviously it’s a campaign promise they’ve all made. But also, as we’ve seen, there are problems in the marketplace. You do see insurers leaving over uncertainty. Perhaps they want to let that play out. I’m not sure."

"Neither am I," Rovner replied. For their conversation, click here.

Attorney general, stiffed again by UK's refusal to let it examine heart-clinic records, says university violated Open Records Act

Attorney General Andy Beshear has ruled that the University of Kentucky violated the state Open Records Act by not giving the Lexington Herald-Leader records about a Hazard heart clinic that proved to be a financial debacle.

"The Herald-Leader asked UK for a copy of a presentation made May 2 to the UK Board of Trustees by lawyer David Douglass regarding the Appalachian Heart Center in Hazard," the newspaper's John Cheves reports. "The newspaper also asked for records showing money paid to Douglass’ law firm and for copies of audits of the cardiology practice, which separated from UK after questions were raised about its billing."

UK gave the paper on a few documents, "citing five separate legal exemptions under the records law, including executive privilege, attorney-client privilege and the confidentiality required by the federal Health Insurance Portability and Accountability Act," Cheves writes. The paper appealed to Beshear's office, which asked to examine the records in camera, or confidentially, but the university refused, as it has in a string of cases.

“Given that UK refused to provide any of the disputed records for in camera review, we can only find that UK failed to meet its burden to establish any of its claims of exemptions,” Assistant Attorney General James wrote in his decision, signed by Beshear and issued Wednesday. “We are not prepared to accept, without independent confirmation, that all of the responsive documents are shielded from public inspection.”

James dismissed all the exemptions cited by UK. "Regarding the patient confidentiality required by HIPAA, James said, UK can redact identifying information about patients from documents that contain them, but it cannot use that law to justify withholding all records related to a medical facility," Cheves reports.

Attorney general's opinions in open-records matters are decisions that have the force of law unless overturned by a court. UK seems likely to do so in this case; it has more than one such lawsuit pending.

UK appeals attorney-general rulings that say doctors' foundation and compensation committee are public agencies

The University of Kentucky has appealed to Fayette Circuit Court two attorney general's rulings that the foundation that bills for and pays UK doctors and the UK HealthCare Compensation Planning Committee are public agencies subject to the state open-records law. Attorney-general decisions in open-government matters have the force of law unless overturned in court.

Lachin Hatemi (Herald-Leader photo by Patrick Mitchell)

Both lawsuits name as a defendant Lachin Hatemi, a former UK medical student who requested records of the committee and the Kentucky Medical Services Foundation, and Attorney General Andy Beshear.  He and his predecessor, Jack Conway, ruled that the committee and the foundation are public agencies because UK faculty members run them. "The foundation contends in multiple lawsuits that it is a private entity that doesn’t have to allow the public to inspect its records," notes Linda Blackford of the Lexington Herald-Leader.

"Hatemi’s requests included the names of students who received college scholarships from the foundation, numerous financial records and the foundation’s financial relationships with private businesses," Blackford reports. He also requested minutes of the Compensation Planning Committee, which is "made up of faculty and department chairs," Blackford reports. "UK has argued that because the committee provides advice, not policy, it’s not a public entity. The foundation’s lawyers characterized Hatemi’s requests as 'an attempt to disrupt KMSF operations and harass and intimidate KMSF employees and officers for whom he has previously expressed contempt,' the documents say. However, neither the foundation nor UK asked for any specific action against Hatemi." Beshear's March 2016 opinion said the foundation’s lawyers had not presented “clear and convincing evidence” that Hatemi’s requests were unreasonable or made to harass.

Blackford notes, "The foundation has made headlines in the past year because of its links to a controversial UK surgeon who lost his privileges to work in UK hospitals in August. Paul Kearney alleged that UK administrators decided to pursue the revocation only after he started asking questions about how the foundation was spending money. Hatemi is one of Kearney’s former students."

UK pays big to settle a health-care debacle but keeps almost all details under wraps; Herald-Leader says trustees should worry

"The University of Kentucky has spent more than $5 million in the last year to fix federal billing issues involving a Hazard cardiology practice it acquired three years ago, but UK officials have declined to provide documents detailing problems that led to the payments," including an audit of the Appalachian Heart Center that UK calls "preliminary" though the issue has been resolved, Linda Blackford reports for the Lexington Herald-Leader.

Most of the money went to Medicare and Medicaid, but $1 million went to a Washington lawyer whose billing records the university largely refused to release, citing attorney-client privilege. The university's trustees were told about the matter at a dinner meeting, which the Herald-Leader said it didn't cover because the agenda for the meeting did not include the matter. UK says no minutes were taken at the meeting, normally a social event that precedes formal meetings the next day.

The Herald-Leader said it would file an appeal with the attorney general, whose decisions in open-records and open-meetings matters have the force of law unless a court rules to the contrary. “We have strong concerns about the overall lack of transparency by the university in this case,” Editor Peter Baniak said. “Records about the issues involving this clinic should be public, as should the information presented and discussion that took place in an open meeting of the board of trustees.”

In an editorial, the newspaper attacked UK officials' secrecy about the case and other health-care issues, such as appealing an AG's decision that that the Kentucky Medical Services Foundation isn't a public agency. "Their imaginative legal arguments and bizarrely incomplete responses to requests for information by the Office of the Attorney General, this newspaper and a private individual should embarrass and trouble the trustees," it said, noting that a UK official said the university paid back "more than what was required."

"Who pays an attorney $1 million to settle a dispute by paying more than was owed?" the editorial asked. "If this were a one-off we might think that UK HealthCare and KMSF, which handles billing for UK physicians, are just muddling around to avoid admitting their deal went bad. But it’s only the latest in a series of stories that indicate a pattern of secretiveness in UK’s vast health-care empire."

Medicare ratings for nursing homes rely heavily on self-reported data; recent inspection data are available elsewhere

Next time you look at Medicare's ratings for nursing homes, be aware that most of the information used to make the ranking is based on self-reported data and is not verified by the government.

Consumers and investors make critical decisions based on these misleading "gold standards" that are doled out by Medicare, Katie Thomas reports for The New York Times.

"Only one of the three criteria used to determine the star ratings - the results of the annual health inspections — relies on assessments from independent reviewers," Thomas writes. "The other measures — staff levels and quality statistics — are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value."

ProPublica, the nonprofit, investigative journalism enterprise, offers a program, Nursing Home Inspect, that allows consumers to search and analyze the details of recent nursing home inspections, featuring tools the federal government's Nursing Home Compare doesn't have, including the ability to search using any keywords and the ability to sort results based on the severity of the violation and by state. (Read more)

The Medicare ratings also do not account for fines and other enforcement actions by state, rather than federal, authorities,Thomas reports, or complaints filed by consumers with state agencies.

Starting this year, Medicare will use this same type of rating system not only in nursing homes, but also in hospitals, dialysis centers and home-health-care agencies, Thomas writes. And federal officials told Thomas that "while the rating system can be improved — and that they are working to make it better — it gives nursing homes incentives to get better." They cite the homes' reduced use of physical restraints, and fewer reports of bedsores, as examples of improvement.

But current and former nursing home employees, lawyers and advocacy groups say some nursing homes have "learned how to game the rating system," Thomas writes. Nursing home ratings have risen steadily since the program began, she notes. "In 2009, when the program began, 37 percent of them received four- or five-star ratings. By 2013, nearly half did."

The Times analysis also shows that even if a nursing home has a history of poor care, it self-reports better. "Of more than 50 nursing homes on a federal watch list for quality, nearly two-thirds hold four- or five-star ratings for their staff levels and quality statistics," Thomas writes. These same homes received one or two stars for the health inspection, which is conducted by state workers.

“These are among the very worst facilities, and yet they are self-reporting data that gives them very high staffing and very high quality measures,” Toby S. Edelman, a senior policy lawyer with the Center for Medicare Advocacy,told Thomas. “It seems implausible.”

Courier-Journal editorial says Beshear must set Cabinet for Health and Family Services right on child-abuse records

The Courier-Journal published a remarkable editorial Sunday excoriating the Cabinet for Health and Family Services for the high level of secrecy in which it has enveloped cases of children who were killed or nearly killed while its caseworkers were supposed to see that they were protected from harm. Last week a judge ordered the cabinet to pay nearly $1 million in civil penalties and attorneys' fees to the newspapers that have been seeking the records. Rather than excerpt the editorial, we publish it in full, along with photographs of the officials it holds responsible. For larger versions, click on the images.

Herald-Leader blasts UK for secrecy surrounding children's heart program and its efforts to rebuild it despite nearby competition

The Lexington Herald-Leader blasted the University of Kentucky in an editorial Sunday for "stonewalling questions about the decision to halt pediatric cardiothoracic surgeries and the mysterious sidelining of Dr. Mark Plunkett, the high-profile surgeon UK hired in 2007 to rebuild that program."

Mark Plunkett

The editorial says UK officials implied that "all would be clear" after their examination of the children's heart program, but "nothing is clear" after they issued a 100-page report that "offers no explanation about what went wrong. In fact, Plunkett's name never appears in the report."

But the report does acknowledge two challenges in rebuilding the program: "There are several excellent congenital heart centers in close proximity" to Lexington, and "In some cases we must regain the trust of our referring providers." Dr. Michael Karpf, UK's vice president for health, has been publicly appealing for referrals of all types from hospitals and physicians in Western Kentucky, where UK competes with Vanderbilt University.

Michael Karpf

"After two unsuccessful, no doubt very expensive, efforts to build this program, UK wants to try again," the editorial says. "And it wants to regain trust of referring physicians and families with very sick, very young children despite the fact that it has consistently undermined trust by refusing to answer legitimate questions. UK has in fact agreed to pay a lot of money to avoid a public discussion of what went wrong," keeping Plunkett on the payroll, then paying him $1.5 million for "a vow of silence on both sides."

The editorial concludes, "It is aggravating that UK, a public land-grant institution in a very sick state, is intent on carving out a specialized, expensive health-care niche that's already filled when there are so many needs that are not being met. It is also deeply disturbing that UK's energy and treasure are aimed at maintaining a shroud of secrecy over this program. We still don't know much about what happened in Plunkett's operating rooms but it is clear that UK botched this opportunity to regain the public's trust." (Read more)

Asked to reply, UK spokesman Jay Blanton said, "First, our job is to make sure that Kentuckians have access to the most complex health care. Kentuckians should not have to go outside Kentucky to have access to such high-quality, complex care. . . . If we didn’t have such a program, Kentuckians – particularly those in Eastern Kentucky – will have to leave the state for critically important pediatric care. Moreover, part of the requirements of having a Level 1 trauma center and service for this region is to have an appropriate presence in this critical area of children’s care.

"Second, we’ve been totally forthright. Our standards and expectations – for both transparency and quality – are evidenced by, among other things, our ranking just this month of 12th out of 118 academic medical centers for quality, by University Health Consortium. UHC provides an objective, impartial analysis across a range of quality measures. You don’t rank 12th in the country if you are not putting forward, in a transparent fashion, your numbers and outcomes across an array of metrics and quality measurements."

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Petition drive from parents asks UK Healthcare to release mortality rates for cardiothoracic surgeries on children

More than 250 people have signed a petition asking the University of Kentucky hospital "to make public the mortality rates for pediatric cardiothoracic surgery patients from 2010, 2011 and 2012," Linda Blackford reports for the Lexington Herald-Leader. "All pediatric cardiothoracic surgeries were suspended at UK last fall amid an internal review." UK spokesman Jay Blanton said Monday the investigation is not complete.

"In May, the state attorney general's office issued an opinion that said UK must release mortality rates and other data about the cardiothoracic surgery program to WUKY, the university-owned radio station," Blackford reports. "UK has acknowledged that it calculated mortality rates for the program as part of its investigation, but has refused to release them, citing patient confidentiality laws." The Herald-Leader also requested the information under the Kentucky Open Records Act.

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The three-year span includes the tenure of ardiothoracic surgeon Dr. Mark Plunkett, who no longer works at UK. Jennifer Allen, whose one-year-old daughter died after having three surgeries performed by Dr. Plunkett, wrote on the petition, "We deserve to know this information, we CAN understand and comprehend this information. It is our right to know and the right of the public!" Allen's daughter suffered from hypoplastic left heart syndrome, where the left side of the heart is underdeveloped and can't pump blood properly. Allen told Blackford she finds it "very suspicious" that UK won't release the information. UK says there were so few surgeries at times that patients' identities could be deduced.

Tabitha Rainey, whose son survived cardiothoracic surgery at UK, before being moved to another hospital, started the petition after being interviewed by CNN, which reported on the issue over the weekend and updated its story today with news of the petition. She said she doesn't accept UK's response that publicly releasing mortality rates would somehow harm patient confidentiality, telling Blackford, "There are no names and no dates, just the data on how many have passed on." (Read more)

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Chief of cardiothoracic surgery and pediatric heart program at UK, suspended from surgeries, takes job in Florida

Dr. Mark Plunkett, the chief University of Kentucky cardiothoracic surgeon whose surgery program was suspended last year for unspecified reasons, has accepted a new job a the University of Florida.

The internal review of UK HealthCare's pediatric cardiothoractic program is ongoing and should be completed in the next few weeks, Michael Karpf, UK's executive vice president for health affairs, told Linda Blackford of the Lexington Herald-Leader.

In December, Brenna Angel, reporter for university radio station WUKY, identified Plunkett as the surgeon at the center of the program review. At the time, Plunkett was on a leave of absence but remained on staff with a $700,000 salary, Angel reported. WUKY requested data under the Kentucky Open Records Act about Plunkett's most recent surgery and his patient mortality rate, but UK denied such requests. Attorney General Jack Conway ruled that UK must release the mortality rates and other data, but UK Has appealed to Fayette Circuit Court, citing privacy rules in the federal Health Insurance Portability and Accountability Act, even though Conway said HIPAA doesn't preempt the Open Records Act, as Angel reported. Angel has since left the station for Lexington city government but the station and the Herald-Leader are defending the appeal.

In addition to being chief of UK's Division of Cardiothoracic Surgery, Plunkett was director of its pediatric cardiac program and a co-director of UK's Gill Heart Institute, says his UK biography. He came to UK in 2007 from the UCLA medical center, where he worked with Karpf. His resignation is effective Aug. 14, UK officials told Blackford.

Attorney general says UK should hand over records on children's heart surgeries, which have been suspended pending review

Attorney General Jack Conway has ruled that the University of Kentucky hospital violated the state Open Records Act by refusing to give a reporter for the university-owned radio station records relating to the work of the chief of cardiothoracic surgery, who has stopped doing surgery on children. UK refused to let Conway's staff examine the records to evaluate UK's claimed need for confidentiality.

After inquiries by Brenna Angel of WUKY, "UK announced that the hospital had stopped performing pediatric cardiothoracic surgeries pending an internal review," John Cheves writes for the Lexington Herald-Leader. Angel reports that she sought records on Dr. Mark Plunkett, left, who was also director of the pediatric and congenital heart program: "the date of Plunkett’s last surgery, the mortality rate of pediatric heart surgery cases, and documentation related to the program’s review." She sought no patient-specific information.

UK denied her request, citing the federal Health Insurance Portability and Accountability Act and arguing that release of the information could lead to the identification of one or more patients because Plunkett was doing so few surgeries on children. It also cited HIPAA in refusing to let Conway's staff review the records. Conway rejected that argument, noting that HIPAA does not supersede state laws and even make allowances for them.

Because it deals with the Open Records Act, Conway's decision has the force of law. UK can appeal the decision to circuit court within 30 days of March 27, the date of the decision. "UK spokesman Jay Blanton says officials are considering whether to file an appeal," Angel reports. The decision was publicly released Monday, the same day UK held a press conference about "the progress UK Healthcare has made in cardiology," she notes. "Yet the pediatric cardiothoracic surgery program remains under review, and patients from Central and Eastern Kentucky are being referred to hospitals out of state. Dr. Mark Plunkett remains on staff."

When Angel asked Dr. Michael Karpf, UK's executive vice president for health affairs, to comment, he replied, “We’ll have something to say about that in a little while.” Cheves notes, "UK recruited Plunkett, a noted surgeon at the University of California at Los Angeles, in 2007 to strengthen its pediatric heart program. He makes $700,000 a year, one of the highest salaries at UK." (Read more)

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Judge rules University of Louisville's hospital is public and subject to Open Records Act; it may appeal

The University of Louisville's hospital is a public entity, a Jefferson Circuit Court judge has ruled in a lawsuit filed to get access to the university's deals with other health providers.

Judge Martin McDonald ruled yesterday in favor of The Courier-Journal, WHAS-TV and the American Civil Liberties Union, noting that the university makes or approves all appointments to University Hospital's board of directors. The university had argued that the board, and thus the hospital, was not a public agency under the state Open Records Act.

The hospital said it might appeal the ruling. McDonald gave it 30 days to give him the records being sought, along with arguments about why they should be exempt" under exceptions to the law, reports The C-J's Andrew Wolfson. "He gave the news organizations at the ACLU 20 days to respond to any claimed exemptions." The hospital has said revealing contracts would put it at a competitive disadvantage.

The suit began after the university refused to let the plaintiffs see records related to its proposed merger with Jewish Hospital & St. Mary's HealthCare and Lexington-based St. Joseph Health Care System. Gov. Steve Beshear vetoed the merger on grounds that a public hospital should not be bound by a religious organization's health-care policies. This month the hospital announced a new deal with KentuckyOne Health, which includes the faith-based entities, but said reproductive services would not be affected despite a policy of "respect" for Catholic health directives. (Read more)

Six of 41 child-abuse fatalities show improper follow-up by Cabinet for Health and Family Services, Herald-Leader analysis finds

The way child-abuse deaths are reviewed in Kentucky continues to be problematic. Looking at the 41 child fatalities in 2009 and 2010, Lexington Herald-Leader reporters Beth Musgrave and Bill Estep found at least six cases in which the Cabinet for Health and Family Services "did not do an internal review even though there were previous reports involving the family before the child died."

State law requires the cabinet to conduct such a review when a child dies or nearly dies because of abuse or neglect and the cabinet had prior involvement with the family.

That didn't happen in the case of 2-year-old Derek Cooper, whose father placed his hands over the crying boy's mouth "until the child was silent," a state report said. Cooper's father, Brandon Fraley, had had contact with the cabinet when he was a child himself, and in 2006 there was an allegation of domestic violence against him, Musgrave and Estep report. Cabinet spokeswoman Jill Midkiff said the cabinet doesn't do internal reviews when the contact with the cabinet occurred when the alleged abuser was a child, but Midkiff "provided no explanation about why the 2006 domestic violence investigation of Fraley didn't trigger an internal review," the newspaper reports.

The analysis also showed vast differences in the way internal reviews are conducted in different parts of the state. "Some of the reviews appeared to be thorough, but in others, child-protection workers produced only one-page reports with little detail on what happened to the children and no assessment of potential improvements," Musgrave and Estep report.

"The cabinet for so long has hidden everything it could," said state Rep. Susan Westrom, D-Lexington, who tried earlier this year to pass a bill that would create an external child-fatality review panel. Gov. Steve Beshear has issued an order to create such a panel, whose members will review cases and make recommendations. The panel will not have cabinet staff as members.

Westrom's bill got hung up partly over the cabinet's attempt to impose further restrictions on the sort of information it is required to make public. The newspaper's analysis the result of a long fight the Herald-Leader and The Courier-Journal have waged to make the child-abuse documentation available to the public. C-J lawyer Jon Fleischaker said on KET yesterday that the cabinet continues to redact more information that it should, in an effort to protect its own interests. The fight continues in the appellate courts. (Read more)

Beshear to have outside panel review cases of children killed or life-threatened by abuse

An independent panel of experts will review cases of children who have been killed or severely hurt by child abuse or neglect, Gov. Steve Beshear announced Monday. The panel will have 17 members and be based in the Justice and Public Safety Cabinet. Its aim will be to assess if the state's child-protection workers did all they could to protect children who died as a result of abuse. It will also determine causes of death.

The Cabinet for Health and Family Services "released thousands of pages of documents Monday that detail the state's involvement with dozens of children who were killed or nearly killed as a result of abuse of neglect," reports Beth Musgrave for the Lexington Herald-Leader. "Still, the cabinet continues to withhold some case files and has redacted large portions of others."

The release is the result of a lengthy court battle between the cabinet and the state's two largest newspapers, the Herald-Leader and The Courier-Journal. The newspapers argued documents pertaining to these cases were subject to open record laws and Franklin Circuit Court Judge Phillip Shepherd agreed. The cabinet released 76 of about 140 files, but with key information omitted. In February, Shepherd ruled the cabinet had 90 days to hand over remaining case files, fined the cabinet $16,000 for withholding the records and ordered it to pay $57,000 in attorney fees for the newspapers.

The cabinet appealed the ruling in the Court of Appeals, but on July 9, the court sided with the newspapers, refusing to allow the documents from being withheld. More than 40 similarily-redacted cases were released yesterday but the cabinet filed an appeal with the Kentucky Supreme Court. "We disagree on how much personal information about the children and private individuals included in caseworker files should be made public," Cabinet Secretary Audrey Haynes said.

Also yesterday, Beshear issued an order to create the panel, which will meet four times a year and will issue an annual report that details issues it finds. "When a child dies or is critically injured because of abuse or neglect, we must carefully review the practices of all government entitites involved to make sure that our system performed as it was supposed to — and if not, that review allows us to take disciplinary action," Beshear said.

Panel members will include law enforcement, prosecutors and medical experts, Musgrave reports. While the meetings will be open to the public, the records consulted during them will not be subject to open records laws. (Read more)

This is Child Abuse Awareness Month; tips for prevention

April is child abuse awareness month, and the state Cabinet for Health and Family Services is reminding Kentuckians that it's the law to report suspected child abuse or neglect.

"Protecting our children should be everyone's number one priority, and during the month of April, we are raising awareness about the warning signs of child abuse and how to report it," Gov. Steve Beshear said. "The cabinet works year round to educate our families and investigate every aspect of abuse. Together, we can make Kentucky a safer place for all our children."

To report child abuse, Kentuckians should call 800-KYSAFE1. Calls are anonymous. If the report meets the criteria for abuse, an investigation is conducted within 24 hours in most cases or, if the child is suspected to be in immediate danger, they are conducted within the hour.

Callers should try to know the child's name, approximate age, address, parents' names and location of the child when the call is made. They should also have names and phone numbers of other people who have information about the suspected abuse.

The ultimate goal is to reunite families when circumstances improve. "We want children to return home to a stronger, safer family," said Jim Grace, assistant director of the Department for Community Based Services' Division of Protection and Permanency.

The cabinet's handling of child abuse investigations and its reluctance to release records pertaining to child abuse deaths and near deaths has been a hot-button issue in the past year. The Courier-Journal and Lexington Herald-Leader both sued the cabinet for refusing to turn over records and a judge twice ruled the cabinet was wrong not to do so. Since, it has released hundreds of pages of records, but has chosen to redact, or omit, some of the information therein. In January, Beshear acknowledged the cabinet had been accused of "operating under a veil of secrecy in a supposed attempt to protect inept workers and a poorly designed system."  Legislators have since heard hours of arguments about the issue, and a bill that would create an external panel to review child abuse cases involving fatalities and near-fatalities, while imposing more secrecy, is one of the few measures that could pass the General Assembly when it re-convenes for one day next Thursday to end its legislative session.

In its effort to increase awareness about child abuse, the cabinet offered strategies for parents to prevent abuse, including:

• never discipling a child when a parent's anger is out of control

• never leaving a child unattended, especially in a car

• learning the signs of physical abuse, nothing bruises, cuts, burns or other injuries a child can't explain

• teaching children the difference between "good touches," "bad touches" and "confusing touches"

• listening to a child when he or she doesn't want to go with something

• noting a change in a child's behavior or attitude

• teaching children what if he or she gets lost

• teaching children the correct name for private body parts

• being alert for talk that indicates premature sexual understanding

• paying attention when someone shows an unusual interest in a child

• making sure a child's school or daycare will only release him or her to a designated person
(Read more)

Judge rails against state's handling of child-abuse records, Beshear's defense of cabinet

The judge who handled the case of 9-year-old Amy Dye, who was beaten to death last year by her adoptive brother, sent an op-ed piece to several newspapers criticizing Gov. Steve Beshear's move to back the Cabinet for Health and Family Services in its battle to prevent full disclosure of child-abuse death records.

"The publicity surrounding recent tragic deaths of children in Kentucky, and the now public shenanigans of the cabinet — caught lying about what it knew and when it knew it — have triggered a rare public anger," writes Circuit Judge Tyler Gill, left. "Openness should always be the rule where government is involved."

The Lexington Herald-Leader and The Courier-Journal sued the cabinet last year to obtain records about children who died from abuse or neglect. Though Franklin Circuit Judge Phillip Shepherd ruled in three cases that files should be released, the cabinet long refused to do so. "Shepherd said that in cases of children killed or badly hurt, the public has a legitimate, overriding interest in access to information that could show how the cabinet performed its job of protecting children," reports Bill Estep for the Herald-Leader.

In an order issued Jan. 19, Shepherd ruled the cabinet could omit very limited information, including the names of children who are hurt but don't die and the names of people, such as teachers, who report suspected abuse. The cabinet has appealed, saying it should be allowed to redact more information than that. Since Shepherd's ruling, the cabinet has released the internal reviews of 85 cases in which children were hurt or died in 2009 and 2010, along with extensive case files — though it has redacted information it sees fit on all of the documents.

Gill rails against the cabinet's appeal. "Do not be misled," he writes. "The cabinet's appeal of the Franklin Circuit Court ruling is not a high-minded effort to protect the privacy of persons who report child abuse. It is to protect the cabinet."

Kerri Richardson, spokeswoman for Beshear, said Gill is wrong about the cabinet's motivations. If it meant to protect itself, it would not have released hundreds of pages of records. "The cabinet is not just protecting those who report child abuse," she told Estep. "The cabinet is trying to protect innocent victims of abuse or neglect and the innocent families of victims of abuse or neglect."

But, given his handling of Amy Dye's case, Gill sees it differently. "The people of Todd County are painfully aware of the likelihood that a multitude of reports of suspected abuse were made by teachers and school officials about Amy Dye in the years before her death, several of which may have been mishandled or misplaced. I seriously doubt any of those who made reports would have allowed fear for their personal safety to keep them from speaking out. Their fear was for Amy," he writes. (Read more)

Health and family cabinet continues to withhold more information in copies of child abuse records than judge allowed

The state Cabinet for Health and Family Services released three more death and near-death cases involving child abuse or neglect Friday under court order, but continued to withhold critical information. It has appealed the order.

The 2009 cases involve two babies who died from suffocation while the parents were impaired. A third case involves a 2-year-old girl from Lawrence County, who was injured after she was reportedly kicked in the head by a horse while unsupervised.

The cabinet "continues to withhold, or redact, far more information" than was allowed under the Jan. 19 order of Franklin Circuit Judge Phillip Shepherd, reports Deborah Yetter of The Courier-Journal. Shepherd said the cabinet could withhold the names of children seriously injured by abuse or neglect, names of private citizens who report suspected abuse, the names of minor siblings in the home and the names of minor perpetrators.

But the cabinet is withholding more information than that. "For example, in the case of the girl injured by the horse, the cabinet deleted the name and relationship of the adult who was watching her, even though the adult is named and identified as her grandfather in a separate internal review of the case," Yetter reports. "The cabinet also withheld juvenile and family court records in that case and the names of all adults involved." The girl recovered from the skull fracture sustained by the horse.

Gavin Villarreal never woke up after he was found with a plastic bag over his head in his crib, possibly placed over the 5-month-old's head by other young children in the home. His parents both tested positive for drugs on the day of his death and were convicted. In the third case, a month-old baby died after his father apparently rolled over him in his sleep. Both parents admitted they had been drinking and used marijuana before they went to bed. (Read more)

Cabinet files appeal to prevent releasing full child abuse records; Beshear backs decision

On the day the state was supposed to release unadulterated records on deaths and near deaths from child abuse, under a court order, it filed an appeal to stop the process. And though Gov. Steve Beshear had ordered the Cabinet for Health and Family Services to release the records, yesterday he sided with its officials, saying in an op-ed piece sent to Kentucky newspapers he did not "think the judge's order was protective enough" of informants who often want to remain secret, such as relatives, health-care providers, teachers and law-enforcement officials. (Getty Images photo)

“You teach in a small community and suspect a student is being abused,” Beshear wrote. “Can you come forward without the newspaper naming you as the accuser?" Jon Fleischaker, attorney for The Courier-Journal and the Kentucky Press Association, said Beshear was “fear-mongering,” and noted that Shepherd’s order to release records applies only in cases in which children were killed or nearly killed from abuse or neglect, following a state law designed to hold the cabinet accountable for its child protective services.

Beshear wrote, “The cabinet has been accused of 'operating under a veil of secrecy' in a supposed attempt to protect inept workers and a poorly designed system. But this is not about shielding the system from scrutiny. We understand the need to be more transparent than in years past.” In December, the cabinet handed over 353 pages of records, but the names of at least eight children who died from abuse or neglect had been redacted, along with all the names of children who had been seriously injured, as well as much other information. The Courier-Journal, the Lexington Herald-Leader and the Todd County Standard had sued the cabinet for refusing to release the records. Twice before, Franklin Circuit Judge Phillip Shepherd ordered the cabinet to turn them over. Last week, Shepherd fined the agency $16,000 for its secretive treatment and delays. He also found the cabinet should pay more than $57,000 in legal fees for the newspapers. (Read more)

Yesterday, the cabinet filed its motion with the state Court of Appeals and "asked the court to block Shepherd's Jan. 19 order to release records, starting today, with limited redactions," reports the C-J's Deborah Yetter. In the meantime, the cabinet released about 90 internal reviews of child deaths and serious injuries incurred by abuse but with deletions it feels is necessary "to protect the best interests of the state's child welfare system," its motion read. (Read more)