Legislators expected to ban products containing addictive, powerful ingredient marketed as 'bath salts'

Kentucky is one of an increasing number of states proposing an emergency ban on products marketed as "bath salts," which can cause paranoia, hallucinations and even violent behavior.

The product, which is sold legally in stores and online under names like Cloud Nine, Red Dove, Blue Silk, Zoom and Ivory Wave, contains the ingredient methylenedioxypyrovalerone, commonly known as MDPV. The drug, which is also in products labeled as plant food, has been compared to cocaine and methamphetamine because of its addictive nature, the Lexington Herald-Leader's Beth Musgrave reports.

State Sen. Walter Blevins, D-Morehead, left, sponsored Senate Bill 129, and state Rep. John Tilley, D-Hopkinsville, right, sponsored House Bill 121, both of which ban methylenedioxypyrovalerone. Their bills simply refer to the drug with the street name "dove," and, in an emergency capacity, ban possession, trafficking or manufacture of MDPV and two related chemicals. The emergency ban is expected to pass.

Musgrave reported in December more than 100 cases of MDPV overdose were reported to poison centers in the last quarter of 2010, more than 75 percent of which were in Louisiana and Kentucky. The Louisiana Poison Center has been studying the abuse of the drug, which is most commonly snorted, but can be injected, smoked and eaten. Nationwide, the center has received 360 calls about the drug this year, Director Mark Ryan said. Earlier this month, White House drug czar Gil Kerilikowske issued a warning against abusing the product. Emergency bans have been issued in Louisiana, North Dakota and Florida, and legislative bans are also pending in Hawaii and Mississippi. (Read more)

Two bills aim to establish registry for abusers of adults

Identical bills have been filed in the House and Senate to establish a state registry of people who have abused or neglected adults.

Senate Bill 38, sponsored by Sen. Julie Denton, R-Louisville, left, and House Bill 101, filed by Rep. Ruth Ann Palumbo, D-Lexington, right, have advance in their respective committees.

The Courier-Journal's Deborah Yetter, who wrote a series of stories that examined elder abuse in December, reports that advocates including the Council on Developmental Disabilities are working to advance the bill. Council officials feel "a registry would help protect disabled or elderly adults by giving potential employers a place to check the backgrounds of people they hire to provide personal care at home such as housekeeping or bathing or grooming," Yetter reports.

Some state officials have expressed concerns about the cost of such a registry. (Read more)

Senate quickly passes bill to allow optometrists to perform minor surgical procedures; ophthalmologists say that would be risky

"The Senate approved a bill Friday to allow optometrists to perform some surgical procedures on the eye and eyelid, brushing aside warnings from medical doctors who said optometrists are not qualified and could harm surgical patients," John Cheves reports for the Lexington Herald-Leader. Supporters of the bill said it would improve eye services in rural areas.

Prospects for Senate Bill 110 in the House are uncertain, but it passed the Senate 33-3 and optometrists have long been major financiers of legislators' campaigns. They have given almost $740,000 to state candidates since the Registry of Election Finance began keeping computerized records in 1997, and have won several legislative battles against ophthalmologists, medical doctors who specialize in eye matters.

The bill was filed Monday night and approved by the Senate Licensing and Occupations Committee the next day. "After ophthalmologists started calling, the Senate granted them a brief hearing Friday morning to air their complaints, although it did not stop the Senate vote," Cheves reports. Sen. Julie Denton, R-Louisville, chair of the Health and Welfare Committee, called the process a "kangaroo court" and said, "Just because we have a squeaky wheel doesn't mean we have to oil it immediately."

If the bill becomes law, optometrists could "remove lumps and bumps and use lasers to treat a few specified conditions, although they could not perform Lasik corrective surgery or any other procedure requiring general anesthesia," Cheves reports. "Optometrists told the committee that about two-thirds of Kentucky's counties don't have an ophthalmologist, especially in rural areas. . . . Oklahoma passed a similar law in 1998 with no serious problems, they added."

Oklahoma's law is the only one like it in the U.S., according to a commenter on the story, identified as "uk1234." Noting the bill language that would give the state Board of Optometric Examiners "sole authority to determine what constitutes the practice of optometry," the commenter wrote, "The fox will be in charge of the hen house." But a commenter named "taxus" replied, "If the training is adequate (long enough to be proficient) and the practitioner trainee is certified by a panel of peers in the licensing body, then it could prove to be a good idea for folks the 2/3 of the counties where these particular procedures are not now available." (Read more)

State's Tobacco Quit Line is now available to users aged 15-17

The state Tobacco Quit Line will now offer counseling services to Kentuckians aged 15 to 17 to help them give up cigarettes or other tobacco products. The line had been available only to people 18 and older.

Public Health Commissioner William Hacker, a pediatrician by trade, said “Studies show that people have more success quitting smoking when they have access to resources like counseling and peer support. We hope this change will encourage young people who are interested in quitting to take action and start leading healthier, tobacco-free lives.”

Data from the 2010 Kentucky Youth Tobacco Survey show that almost 25 percent of the state's high-school students are smokers and almost 70 percent of teenage smokers want to quit. Although the prevalence of smoking among youth has declined in the past few years, the smoking prevalence among teenagers and young adults is higher than among other adult populations.

“Addressing the prevalence of teen smoking in Kentucky is a critical issue because statistics show that more than 80 percent of adult smokers became regular smokers before age 18,” said Irene Centers, coordinator OF the tobacco prevention and cessation program in the Department of Public Health. “It’s imperative that we not only prevent young people from ever using cigarettes and tobacco products, but also that we offer assistance to help them give up tobacco.”

Kentucky’s Tobacco Quit Line is a free, telephone-based tobacco cessation service that offers:
· One-on-one proactive counseling for tobacco users who are ready to quit.
· Support for people who want to stop smoking or using other tobacco products.
· Information on tobacco dependence for health care professionals.
· Information about local resources to help tobacco users quit.

Callers to the line speak with coaches trained to assist them with quitting. Coaches have a minimum of a bachelor’s degree or equivalent and are trained in behavioral modification and motivational interviewing. Services are available in English and Spanish at the time of the call. Counseling in other languages is available free through a third-party translation service. For the deaf or hard of hearing, TDY/TDD is available at (800) 969-1393. If employers want to help their employees quit, information is available through the Quit Line and local health departments. Group sessions and cessation materials can be made available at the worksite.

Beshear backs bills to protect seniors from abuse but doesn't endorse minimum staffing for nursing homes

Gov. Steve Beshear today endorsed a package of previously introduced bills that he said would give the elderly and other adults more protection against abuse and exploitation, but it did not include a bill to set minimum staffing standards for nursing homes, the major measure sought by reformers. The legislation would:

• Prevent people who abuse or neglect vulnerable or elderly adults from benefiting from their deaths (House Bill 52)
• Keep a person convicted of felony abuse or exploitation of an adult from serving as that victim's guardian, executor or power of attorney (HB 54)
• Make it easier and more efficient for adults and seniors needing a guardian when more than one state is involved. (HB 164)
• Require annual criminal background checks of staff at personal care agencies, a step beyond the pre-hiring check. (Senate Bill 23)
• Require criminal background checks for all employees of nursing homes and assisted living homes, including custodians and food service workers (SB44)
• Create an adult abuse registry (HB101 and SB 38)

Beshear noted that last year he implemented recommendations from a Cabinet for Health and Family Services report investigation of nursing home neglect and abuse and said “This legislation further strengthens safety standards and will make a significant difference in the lives of Kentucky’s elderly citizens and the people who care for them.” Beshear recently received the Better Life Government Involvement Award from the main nursing-home lobby, the Kentucky Association of Health Care Facilities.

Bernie Vonderheide of Kentuckians for Nursing Home Reform told Kentucky Health News, "We think Gov. Beshear is to be applauded for reacting decisively to reports by advocates and the media of abuse and neglect of our state's senior citizens. We hope he will continue giving his attention to these serious matters. For example, he should also support legislation before the General Assembly that would set minimum staffing standards for nursing homes, one of the big causes of abuse and neglect among our seniors."

Foundation matches Social Innovation Fund money to create grants for improving health services in seven Kentucky counties

The Foundation for a Healthy Kentucky today announced four equal Social Innovation Fund grants totaling $1 million to improve access to health services, reduce health risks and disparities, and promote health equity in Jefferson, McCreary, Wolfe, Powell, Montgomery, Bath and Menifee counties. The projects are expected to serve nearly 9,000 people in the next year.

Home of the Innocents in Louisville will establish a dental clinic at the newly opened interdisciplinary Hockensmith Pediatric Assessment Center. The program will provide dental services to children in state care, children with special health care needs, and other children and families served by the Home and its partner agencies.

St. Joseph Health System, based in Lexington, will establish primary care clinics in Powell and Wolfe counties, both rural and low-income. These satellite clinics will be staffed by nurse practitioners and will utilize telemedicine to collaborate with physicians and specialists at a central location.

Cumberland Family Medical Center, based in Burkesville, will establish a nurse-managed health center and rural training program for nurse practitioners and physician assistants. Funds will be used to expand the scope of services provided in McCreary County to include x-ray and utilize health IT to connect with other CFMC sites. This will be the county's first x-ray, reducing travel for local residents who previously had to travel ouside the county for x-ray services.

The Montgomery County Health Department in Mount Sterling will establish a health education and navigation program to serve a low-income population in Montgomery, Bath and Menifee counties. Four full-time health navigators will be employed to serve the community by assessing individual needs and linking patients with services.

Each $250,000 grtant includes $125,000 from the Foundation for a Healthy Kentucky. As an endowed public charity, the foundation was able to provide the matching funds that were required to secure the Social Innovation Fund award for Kentucky. Learn more about the grants here.

Monthly magazine for children in K-3 promotes healthy lifestyles

Every Kentucky student in kindergarten to third grades is getting a free subscription to Fit4Fun, a reader that, through entertaining means, encourages children to lead healthy lifestyles.

The publication is a joint effort of Wordsworth Publishing Group and the Kentucky Children's Health & Fitness Fund. Though an agreement with the state Department of Education, it is distributed to all 797 public elementary schools and kindergartens in the state.

"We believe every child can grow up happy, healthy and productive," said Jan Winter, founder and president of Wordsworth. "We want children to learn to make all kinds of smart decisions, and we partner with parents and schools to make sure they get consistent messages." The publication is supported by donations and sponsorships.

Each issue, which has 32 to 40 pages, features content that encourages imagination, playing, learning and growing. The playing component focuses on "fitness for life" and the growing component teaches children about nutrition and food awareness. Topics covered include dental health, science and technology careers, bike safety, diversity, scientific method, Kentucky history and facts and responsible media consumption.

The online version is free and the website features a teacher's guide with plans to help with instruction.

Bill filed to keep guns from those judged to be mentally ill

Keeping guns out of the hands of the mentally ill is the aim of House Bill 308, which was filed last week by Rep. Bob Damron, D-Nicholasville.

"We want only the right folks to be able to buy a firearm," said Damron, right. "That does not include the mentally ill. I think most gun owners would stand behind that." Damron is an ally of the National Rifle Association.

The bill covers a loophole in state law. Though the federal Brady Handgun Violence Prevention Act of 1993 requires background checks when someone buys a gun and prohibits the sale of guns to people "adjudicated as a mental defective or who has been committed to a mental institution," Kentucky does not require courts to give their mental health records to the FBI, The Lexington Herald-Leader's John Cheves reports. Since 1998, Kentucky has only submitted four records.

Damron's proposal would require state courts to inform the Kentucky State Police when someone is adjudged mentally incompetent or sent to a mental institution. The KSP would then notify the FBI, which in turn would add the names to the National Instant Criminal Background Check System. The names would only be those of mentally ill people who have been documented by the courts. Those who voluntarily commit themselves to a mental institution or who are treated for mental health issues would be protected by privacy laws.

The gap in the law, which exists in many states, went under a national microscope when Seung-Hui Cho killed 32 people and himself on the Virginia Tech campus in 2007. More than a year before the shooting, a judge had deemed Cho dangerously mentally ill following a stalking incident. When Jared Loughner killed six people and injured many others, including U.S. Rep. Gabrielle Giffords, in Tucson, Ariz., the gap again gained national attention. However, Loughner is not known to have been a patient in an institution, so it is not clear if his mental health issues were documented. (Read more)

More Kentucky children are insured under KCHIP, Medicaid; groups commend effort, ask for improvements

In the two years since the national Children's Health Insurance Program was reauthorized, about 51,700 children have been enrolled in Kentucky CHIP and Medicaid. Three advocacy groups -- Covering Kentucky Kids and Families, Kentucky Youth Advocates and Kentucky Voices for Health -- commended that effort and asked for greater efficiency in KCHIP.

"The number of uninsured children in Kentucky has dropped despite the loss of jobs and employer-sponsored coverage in our state," the three groups said in a statement Feb. 3. They asked that KCHIP be made more efficient by "allowing continuous eligibility, matching application information with existing databases, and developing web-based applications."

In Kentucky, kids up to age 19, with family incomes up to 200 percent of the federal poverty level, are eligible for KCHIP. That equates to an annual earnings of $44,000 for a family of four. (Read more)

Systems that track pseudoephedrine sales do not necessarily curb meth making, experiences of Ky. and other states show

Systems that track the sale of the key ingredient used to make methamphetamine have not decreased the manufacture of the highly addictive drug, according to an analysis by The Associated Press.

The analysis shows meth-related activity has risen by 65 percent in Kentucky since sales have been tracked. Kentucky is one of only three states nationwide that electronically monitors pseudoephedrine and ephedrine sales. Arkansas and Oklahoma also track their sales, and also had more meth-related incidents than the rest of the country — up by 34 percent in Arkansas and 164 percent in Oklahoma.

The tracking systems record the buyer's name during the purchase of the cold medications that contain pseudoephedrine. The system also limits how much of the drug can be bought at one time at one location. If a customer has already met the limit for the month, the pharmacist is immediately notified.

Supporters say the tracking systems make it easier for authorities to investigate meth-related crime, but critics say the systems promote "smurfing," in which "meth producers recruit friends, acquaintances, strangers and even their own children to buy pills," AP reports. "It's almost like a sub-criminal culture," said Drug Enforcement Administration agent Gary Boggs told the news service. "You'll see them with a GPS unit set up in a van with a list of every single pharmacy or retail outlet. They'll spend the entire week going store to store and buy to the limit."

Daviess County Sheriff Keith Cain, a leading meth expert in Kentucky, defended the tracking systems. "One reason these numbers have gone up is because of law enforcement's ability to track and locate the people producing meth," he said. "If we pull the plug on electronic tracking, we lose the ability to see where these labs are at."

Despite the controversy, several other states are either implementing or considering the implementation of tracking systems. The move is cost effective and the pharmaceutical industry is is full support of it. "That is far cheaper than one alternative — making the medication available only by prescription," AP reports. (Read more)

Governor undecided on meds-for-meth bill, says time hasn't come for state smoking ban, but may back nursing-home legislation

By Al Cross
Institute for Rural Journalism and Community Issues

Gov. Steve Beshear says he hasn't made up his mind about the bill that would require prescriptions for decongestants used to make methamphetamine, but he sounds skeptical. And he doesn't think Kentucky is ready for a statewide smoking ban, but he might endorse legislation to better protect residents of nursing homes.

Beshear addressed the three health issues under questioning from Bill Bryant of Lexington's WKYT-TV on the latest "Kentucky Newsmakers," broadcast today. To watch the broadcast, click here.

"I'm personally conflicted" about the meds-for-meth bill, Beshear said, but his more specific remarks indicated skepticism. He said people in law enforcement are "pushing very hard" for the bill, and noted that such a law greatly reduced the number of meth labs in Oregon, and might do the same in Mississippi, but he suggested the numbers might go back up.

"They’ll just go across the state line and get it across the counter," he said of meth makers, adding that the problem needs a national solution, perhaps like Kentucky's registration-and-reporting system for sales of pseudoephedrine and other decongestants. "You're going to have to have a system that applies in every state," he said. "I'm concerned about the millions of people who need to go buy cold medicine."

Bryant noted that law-enforcement officials say most pseudoephedrine sold in Kentucky goes to make meth, and asked Beshear if those officials had convinced him of the need for a prescription law. "I haven’t heard that statistic," Beshear said, reiterating his indecision. "It’s tough one because there isn’t any easy answer to it."

The meds-for-meth bill is one of the legislature's major issues, with drug manufacturers finacing heavy advertising campaigns against it but major political figures in Appalachian Kentucky weighing in for it. On Thursday, the bill pased a Senate committee on a bipartsan 6-4 vote after competing testimony from 5th District U.S. Rep. Hal Rogers and Pat Davis, the wife of 4th District Rep. Geoff Davis, all Republicans.

The bill's supporters also include House Speaker Greg Stumbo, the legislature's top Democrat, and Senate President David Williams, the top Republican, who is seeking his party's nomination for governor in the May 17 primary election.

Williams also favors a statewide smoking ban. Beshear, who is unopposed for the Democratic nomination, said Kentucky isn't ready for such a law, but will be once local bans become more prevalent: "Once you start getting experience with it, I think your business community becomes more comfortable with it … and people enjoy it."

The governor said momentum for a statewide ban "is building, but I don’t think we're at the point where everybody in the state is ready to go in that direction." He said his administration took a step against smoking by making cessation programs eligible for Medicaid.

Asked about a Stumbo proposal to ban smoking in cars with children, Beshear called it "an interesting concept" that deserves discussion but said the idea is "probably in the same situation" as a general ban, which has been offered as a bill by Rep. Susan Westrom, D-Lexington.

Williams' opponents in the Republican primary, Jefferson County Clerk Bobbie Holsclaw and Louisville businessman Phil Moffett, oppose a statewide smoking ban. Holsclaw favors local bans, but Moffett said at a recent Kentucky Press Association forum that the dangers of secondhand smoke have been "overblown."

Bryant asked Beshear if he plans to endorse a package of nursing-home legislation. "I’m talking to legislators who have some good ideas on how we can increase the protections to our elderly," the governor said. "We’ve got to do even better. The restrictive part is, we have no money … but that shouldn’t stop us and should not be an excuse for not doing some of the non-monetary things we can do to protect our elderly."

Beshear was not asked about specifics of the package, but for years Kentuckians for Nursing Home Reform and other advocates have lobbied for minimum staffing requirements at nursing homes. The long-term care industry, one of the more influential in Frankfort, has beaten back those efforts, arguing that homes need more flexibility and state inspections ensure proper care.

Nearly $45,000 awarded to three projects that help combat childhood obesity

Nearly $45,000 from the Blue Grass Community Foundation and Foundation for a Healthy Kentucky is being invested in three projects that target childhood obesity. The recipients are Seedleaf and East 7th Street Center ($19,998); the YMCA of Central Kentucky ($15,000); and the Girl Scouts of Kentucky's Wilderness Road ($10,000).

The S.E.E.D.S. Project will get 12- and 13-year-old students growing and selling fresh fruits and vegetables in the Williams Wells Brown neighborhood in Lexington, which is otherwise short on available fresh produce. The goal is to teach the students about healthy eating, as well as educate them about social entrepreneurship. The project runs from March to November.

YMCA of Central Kentucky, which has three locations in Lexington, will use its funding to launch "Take 10," a school-based physical activity program designed for kindergarten to fifth-grade students. The goal of the program is to integrate 10 minutes of physical activity with academic exercises. The program will be piloted in Picadome Elementary in Fayette County and Southside Elementary in Woodford County. Eventually, the Y hopes to expand the program in all 14 schools where it has an after-school program.

The Girl Scouts funds will be used to engage 100 girls from low-economic backgrounds to participate in health and wellness activities. The girls will train for the Thin Mint Sprint 5K, which is in May.

This is the second time the Blue Grass Community Foundation and the Foundation for a Healthy Kentucky have partnered to invest in community projects. "These three projects offer exciting examples of ways communities can help overcome childhood obesity by creating environments that support healthy eating and active living," said Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky. (Read more)