Bill to expand optometrists' scope of care, aided by political money, continues rapid progression through General Assembly

A bill that would considerably expand optometrists' scope of care cleared the House Licensing and Occupations Committee in an hour-long meeting this afternoon, the latest move in its speedy progression through the General Assembly.

Senate Bill 110 was introduced last week and was passed 33-3 by the full Senate last Friday. It passed through the House Licensing and Occupations Committee today by a 14-2 vote. It will likely be considered by the full House Friday, The Courier-Journal's Tom Loftus reports.

Loftus reported this morning that legislators have received more than $400,000 from optometrists' political action committee and its individual members, with 137 of Kentucky's 138 legislators and Gov. Steve Beshear receiving campaign money. The Kentucky Optometric Association, which employs 18 lobbyists, has given more than $327,000 alone in the past two years through its PAC. (Read more)

"In 2010, optometrists gave $249,273 to all political candidates, including local candidates," Beth Musgrave reports for the Lexington Herald-Leader. "Ophthalmologists, in comparison, gave only $575 in 2010, according to the Kentucky Registry of Election Finance." (Read more)

Both sides are running advertising campaigns, but the ophthalmologists and their fellow medical doctors seem to be behind in that competition, too. A radio ad from the Kentucky Medical Association this week urged listeners to call their senators, though the bill had already passed the Senate.

The bill, sponsored by Republican Sen. Robert Stivers of Manchester, left, extends the scope of care optometrists can provide, most notably allowing them to conduct some laser procedures usually performed by opthamologists. "These are considered minor, non-invasive laser procedures," Dr. Joe Ellis, a spokesman for the Kentucky Optometric Association, told Kentucky Health News. "They're most commonly performed when a person has cataract surgery. There is a membrane that clouds over and they would be allowed to remove that."

Nationwide, only optometrists in Oklahoma are allowed to perform this type of laser procedure, Ellis said. They have been permitted to do so since 1998.

The bill would also allow optometrists to "remove lumps and bumps around the eye," Ellis said, which is currently only permitted in Oklahoma, Louisiana, Tennessee and North Carolina. It would also allow optometrists to do what Ellis termed "routes of administration." "Like if a person had an inflammation around the eye, you can inject a steroid to reduce inflammation," he said, adding nine states allow optometrists to do that.

The proposal would also allow optometrists to prescribe certain drugs, and would let the state Board of Optometric Examiners define what procedures optometrists could legally perform. Supporters say it would make certain types of eye care more available in rural areas, which have few ophthalmologists.

Physicians take issue with the proposal, saying optometrists are not properly trained to perform the procedures. Critics are also suspicious over the speed with which the bill is moving. An editorial in the Herald-Leader today says, "We've long known that politicians are blinded by political money," the opinon piece says. "If this bill becomes law, some of their constituents could be, too." (Read more)

Foundation for a Healthy Kentucky awarded nearly $3 million in grants in 2010

The Foundation for a Healthy Kentucky awarded nearly $3 million to community organizations, schools, government agencies and institutions in 2010. The funds, awarded in 80 grants, will support programs and policy development for health improvement and access to health care.

The grants supported health advocacy initiatives; helped civic leaders identify and address key health concerns; supported the integration of mental health and medical services; helped communities get planning assistance and funding for federally-qualified health clinics; and helped four foundations address nutrition, physical activity and environment policy issues.

The largest sums went to Burkesville-based Cumberland Family Medical Center for the Kentucky Health Futures Initiative; Home of the Innocents to improve access to dental care; Montgomery County Health Department for the Gateway Rural Health Investment Network; and Saint Joseph Health System to deliver virtual care. Each of these four organizations received $250,000.

The Foundations spends earnings on a $45 million settlement that then-Attorney General Ben Chandler reached in 1999 with Anthem Inc. as a result of the company's conversion of the charitable assets of the old Blue Cross & Blue Shield of Kentucky. For the foundation's history and other background click here.

Panel OKs bill to ban children under 14 from tanning booths

A bill that would prevent children under the age of 14 from bronzing their skin at tanning booths cleared the House's Health and Welfare Committee Tuesday. House Bill 338 will now move to the full House for consideration.

The bill is sponsored by Henderson Democratic Rep. David Watkins, who is a physician. "This is simply trying to protect our children and trying to protect our young people," Watkins, right, told WTVQ-TV. "They are utilizing tanning booths to an excess amount and I think parents need to be aware of this."

The bill is backed by the Kentucky Medical Association and the American Cancer Society. If it passes, a parent or business that allows a child under 14 would not face any penalties, though the bill's sponsors would eventually like to see penalties added. (Read more)

Cost is one obstacle for bill that would require coroners to look into nursing home deaths

A bill that would require coroners to be called when someone dies in a nursing home may be in jeopardy. At issue is how to pay for it.

Chief State Medical Examiner Tracey Corey estimates she would need three more doctors, more support staff and more equipment if even 10 percent of deaths needed investigation, the Lexington Herald-Leader's Valarie Honeycutt-Spears reports.

House Bill 69, sponsored by Rep. Tom Burch, D-Louisville, right, would require a nursing home or hospice staff member to alert a coroner about a death on the premises within 24 hours. If they, and they alone, suspect abuse, coroners would be required to inform law enforcement authorities or prosecutors. The aim is to determine if abuse or neglect might have occurred.

"But Burch said if Corey's financial concerns lead to the bill being sent to the committee making decisions about state spending, he think it 'means sudden death' for the legislation," Honeycutt-Spears reports.

Burch also said nursing home officials are balking at the bill's aim to increase the penalties for failing to report abuse or neglect. As of now, such a failure is considered a Class B misdemeanor, which carries a punishment of up to 90 days in jail and a $250 fine. The bill would change it to a Class A misdemeanor, which can result in up to 12 months in jail and a fine up to $500.

The bill would also mean long-term care facilities that fail to designate a staff member to report deaths to the coroner would be fined $200 a week. (Read more)

Drug czar coming to Kentucky to look at prescription pill abuse

The White House drug czar will visit Kentucky next week to investigate prescription pill abuse, a problem he called "heartbreaking." In a four-day tour, Gil Kerlikowske, President Obama's chief advisor on drug issues, will meet with law-enforcement officials, recovering addicts, drug-treatment workers, business leaders and politicians, Roger Alford of The Associated Press reports.

On Monday, U.S. Senate Republican Leader Mitch McConnell of Kentucky met with Kerlikowske, right, to discuss his visit. They discussed several of the state's drug issues, including prescription drug abuse, meth production and marijuana cultivation.

Kerlikowske's visit will focus on prescription pill abuse. Earlier this year, Kentucky's two largest newspapers published in-depth reports on the issue. In its series "Prescription for Tragedy," The Courier-Journal reported more Kentuckians die from prescription pill overdoses than car crashes. In its look at "pill mills," the Lexington Herald-Leader investigated how some counties are passing legislation to keep the faux medical clinics out of their areas.

Alford reports the problem drastically grew in 2000 upon the explosion in use of of OxyContin, which became known in Appalachia as the "Heroin of the Hills." When Kentucky started maintaining narcotic monitoring systems, drug traffickers went south to Florida, where there is no such system, to buy the drug. In one raid in South Florida in the early 2000s, authorities found more than 1,000 files from patients who lived in Eastern Kentucky, the Herald-Leader found. Most recently, Florida's Gov. Rick Scott proposed a budget that would leave a new prescription drug monitoring program unfunded. The chairman of the Health and Human Services Committee of the Florida House called the monitoring system "big brother."

Given the tight economy, Kerlikowske said it will be important to deal with the issue in "smart ways." "If we educate kids about the dangers of pills ... if we clean out medicine cabinets in a safe way, if we get physicians more information about how to recognize addiction and how to deal with this, and then we can crack down on doctor shopping and physicians who are over-prescribing, we have huge potential to really begin to bring this under control." (Read more)

Campbell County expected to repeal smoking ban

UPDATE, Feb. 17: The county Fiscal Court voted 3-1 to repeal the ban, Mike Rutledge of The Kentucky Enquirer reports.

A smoking ban in Campbell County may be repealed before it even takes effect. Campbell County commissioners will vote on the matter tomorrow.

The ordinance, which would ban smoking in workplaces and public places like bars and restaurants, originally passed in December, The Kentucky Post's Chris Reed reports. But with two new members on the four-member commission, both of whom have expressed their opposition to the ban, it may be overturned.

Opponents say a ban would hurt Newport bars and restaurants, citing studies that show businesses that go smoke free experience a 20 to 30 percent loss in revenue. Supporters are still fighting to keep the ban. "We're trying extremely hard to convince the commissioners to leave the ban in place, said Jenny Beene-Skuban, volunteer for Smoke-Free Northern Kentucky. (Read more)

New fitness program in Clay County designed to get kids moving

Every fourth- and fifth-grader in the Clay County schools will receive a pedometer as part of a new fitness program designed to combat childhood obesity.

"The goal is to motivate students to be more physically active in a county where one research project found that 47 percent of children were overweight or obese," the Lexington Herald-Leader's Bill Estep reports.

The program integrates physical activity in lesson planning in subjects like math and geography. "It does that through challenges to walk enough steps to get to Houston, for instance, with lessons about the geography or history of places along the route," Estep reports. "We want to see some changes," said Deann Allen, instructional supervisor for the school system.

The program is a venture between the system, Kosair Children's Hospital in Louisville and Manchester Memorial Hospital. Kosair is paying for the pedometers, expected to cost about $15,000. A similar program was started in Louisville last year. (Read more)

Survey shows 75 percent of Bullitt County residents favor smoking ban; measure to be considered tomorrow

A survey found 75 percent of 400 Bullitt County residents would support a smoking ban in businesses. The numbers were released a day before the Bullitt County Board of Health is set to consider the ban, The Courier-Journal's Emily Hagedorn reports.

"There were a lot of people who said Bullitt County wasn't ready (for a smoking ban)," said Health Department Director Swannie Jett. "I think we've gotten to the root of who wants change in Bullitt County."

The survey showed people who most supported the measure are between the ages 18 and 34 and over 65 and have college degrees.

Critics who oppose a ban weren't impressed. "No survey that's paid for by an interest group is worth anything," said Harlen Compson, spokesman for Bullitt County Choice.

A statewide survey released in January by activists in favor of a statewide smoking ban showed 59 percent of Kentucky voters favor a ban in public places. (Read more)

Kentucky companies adjust to new federal rules requiring accommodations for breast-feeding mothers

Rules in the federal health-care refom law are resulting in Kentucky companies making room and time for mothers breast-feeding their children, the Lexington Herald-Leader's Mary Meehan reports.

Louisville Metro Government and four Louisville hospitals have announced programs that encourage breast feeding. Thirteen government work sites in Louisville will add lactation stations funded by a $7.9 million federal grant. The University of Kentucky started providing a program for breast-feeding mothers in 2009.

"It's not easy being a working mom when you are trying to breast-feed," said mother Lauren Goodpaster, right (H-L photo by Mark Cornelison). "Just having the support, having people say that's a great thing you are doing, that was kind of a boost to keep me going on days when it is such a pain."

The rules, which took effect when the Patient Protection and Affordable Care Act was signed March 23, 2010, require employers to provide reasonable break time and a private, non-bathroom place for nursing mothers to express breast milk during the work day. For more information about the regulations, click here. The U.S. Department of Labor has not yet released specific accommodation requirements or penalties if companies don't comply.

As of now, accommodations can be anything from providing a clean room with a locked door to allowing a fast food worker time to pump breast milk while in her car, Meehan reports.

Studies show breast-fed children are sick less often than those given formula, resulting in mothers missing less work time to care for their kids. In Kentucky, just 59 percent of new mothers breast-feed, compared to 75 percent nationwide. (Read more)

As meds-for-meth bill languishes, some seek compromise, but bill's sponsor says proposals would render it ineffective

By Al Cross and Tara Kaprowy
Institute for Rural Journalism and Community Issues

As the bill to require prescriptions for three widely used decongestants remains short of votes to pass the Senate, there is talk of a compromise measure to thwart the use of the medicines for making methamphetamine. But the bill's sponsor says he is not open to the compromises he's heard.

"We want to go with something that works," said Sen. Tom Jensen, R-London. "What has worked is what they've done in Oregon and Mississippi. What they have done is make a controlled substance out of pseudoephedrine, ephedrine and phenylpropanolamine," and greatly reduced the number of meth labs.

Lobbyists for drug manufacturers are circulating alternative proposals, such as applying the prescription rule only to the estimated 5,500 people convicted of a drug-related crime. Another industry proposal would cut the annual non-prescription purchase limit by more than half, from 108 grams per year to 50.

Jensen dismissed those proposals, saying they would do nothing to curtail "smurfing," meth makers' use of people who are paid to buy ingredients. "Some of them are homeless, some of them are college kids, some of them come from poor backgrounds," Jensen said of the buyers. "They've got fake IDs, they've got GPS systems showing all the pharmacies in the area, and they'll hit them very quickly." He added, "Even trying to limit (per-month consumption) has created a whole other problem. We have a whole lot of people who are getting involved in criminal activity who probably don't even know it."

The current monitoring system keeps the decongestants behind the counter and requires buyers to register. Under federal law, individuals may not buy more than 9 grams of pseudoephedrine in a 30-day period.

Last week on the Jack Pattie Show on Lexington's WVLK-AM, Louisville drug officer Stanley Salyards said he would accept a bill that would require prescriptions only for pills containing the three decongestants, since making meth from gelcaps and liquid preparations is very difficult. Two other police officers on the program indicated agreement.

Jensen rejected that idea today, saying his Senate Bill 45 would apply to only 15 products, and "All the other cold and flu medicines are still out there."

A Senate committee approved the bill on a 6-4 bipartsan vote last week, but the full Senate has passed over it for more than a week, and Jensen acknowledged in today's interview that it lacks the votes to pass.

He said manufacturers of the 15 cold remedies "have spent a tremendous amount of money opposing it and getting a lot of misinformation out there ... We, unfortunately, don't have the funds to get out and make full-page ads and radio statements and TV commercials that say 'That's just not true.'" For example, the ads say the registration and tracking system is effective, but the law-enforcement officers on the radio show last week said it is not.

Opponents of the bill say having to get prescriptions would increase costs for cold and allergy sufferers, and meth makers would simply cross state lines to get their supplies. The opponents are backed not only by heavy spending, but by the Kentucky Chamber of Commerce. The Chamber has suggested "banning all online retail sales, distribution and shipment of products containing ephedrine and/or pseudoephedrine from non-Kentucky licensed pharmacies to individuals in Kentucky."

Rep. David Floyd, R-Bardstown, filed a bill last week to make the pill forms of the three substances “legend” drugs, those that are "available through the determination of a pharmacist or by prescription," reports The Kentucky Standard of Bardstown. "It would not be classified as a controlled substance." The bill would also prohibit purchases of any of the three medicines by anyone under 18 without a prescription.

“While many of us are sympathetic to those who have been adversely affected by the meth trade in Kentucky, I don’t believe making pseudoephedrine only available via a doctor’s prescription will curtail the meth problem in our commonwealth,” Floyd said in a press release. “By placing more responsibility on pharmacists who already have a monitoring system for pseudoephedrine sales, we can gain better control on those who are purchasing the product to make meth while not punishing those who need pseudoephedrine for legitimate health purposes.”

Floyd's House Bill 376, which he said he wrote after consulting with Bardstown pharmacists, would allow pharmacists to dispense the drugs to "a person evidencing physical symptoms treatable by those products," according to the bill summary, and "would require pharmacists to ask a series of questions to those trying to purchase a pseudoephedrine product," the Standard reports. It would also require thrm to put the information into the state's electronic tracking system for prescriptions.

"Local pharmacist Leon Claywell already uses a screening system to determine why a customer is buying medicine containing pseudoephedrine, Floyd said. If he thinks it is not for a legitimate purpose, he refuses to sell it," the Standard reports.

Idaho study: Drug testing for state-aid recipients inefficient

As discussion continues among Kentucky lawmakers over whether public-assistance recipients should undergo mandatory drug testing, an Idaho study has concluded such an undertaking is not cost-effective.

"The costs of legal action alone during the first year could exceed the costs of the drug testing and treatment program," says the study, as reported by The Associated Press. "To fund the costs of the program, (Idaho) would need to either appropriate additional funding for a drug-testing program, or divert funds from current programs for the screening, testing and treatment activities."

The study was conducted by Idaho's Department of Health and Welfare. It found that testing for federal welfare programs like Medicaid and food stamps is forbidden. For child-care assistance and temporary cash assistance for families, programs that cover about 10,500 Idahoans, the study showed the "costs of testing and related treatment would wipe out prospective savings achieved by removing offenders."

On Jan. 7, state Rep. Lonnie Napier, R-Lancaster, filed House Bill 208, which would requie random drug and urine testing for any Kentucky resident over 17 who gets Medicaid, food stamps or welfare benefits. Those failing the test would lose their benefits until they passed drug testing at a later date. The cost of the proposal was unknown, though Napier, right, said there are more than 600,000 Kentucky adults on welfare, and a drug test costs about $30. Those numbers result in a $18 million price tag, plus the costs of expanding drug treatment programs.

The House's Health and Welfare Committee has had the bill since Feb. 1 and does not appear likely to approve it.

Missouri, Virginia and Nebraska legislators are considering similar proposals. New Mexico lawmakers are debating whether to test for drugs as a condition to receive unemployment benefits. Minnesota and Wisconsin test convicted felons who receive some form of public assistance. Arizona "requires about 12,500 people in one federal program to complete a drug-screening questionnaire, with some then undergoing drug screens," AP reports.

The proposals have not been met without controversy. In 1999, Michigan's effort to drug test members of needy families who received temporary federal assistance lasted just five weeks before it was ruled unconstitutional, AP reports. (Read more)

Red wine, dark chocolate make for heart-healthy Valentine's

Those seeking to stay heart healthy even on the most romantic day of the year won't have to look much farther than the wine rack, scientific research source Newswise reports. Experts from the Loyola University Health System have found red wines like Pinots and merlots all contain a healthy amount of catechins, which help improve "good" HDL cholesterol.

Dark chocolate with a 70 percent-plus cocoa content is likewise heart friendly, thanks to its resveratrol, which helps lower blood sugar. "You are not even choosing between the lesser of two evils, red wine and dark chocolate have positive components that are actually good for your heart," said Susan Ofria, clinical nutrition manager at Gottlieb Memorial Hospital.

In honor of National Heart-Healthy Month, which is being celebrated this month, Ofria also recommends eating: salmon or tuna; flax seeds; oatmeal; black or kidney beans; walnuts and almonds; and blueberries, cranberries, raspberries and strawberries. (Read more)