Kentucky teens under 18 among least likely to drink alcohol, but binge drinking among them is nearly the national average

About 6 percent (709,000 of 12 million) of U.S. children aged 12 to 14 drank alcohol in 2009, and nearly half got their drinks from their own home, according to a study by the Substance Abuse and Mental Health Services Administration.

Because the data are new, they have not been broken down by state, SAMHSA spokesman Bradford Stone said. But the 2007-08 National Survey on Drug Use and Health, which was released in June 2010, showed Kentucky teens are among the least likely in the country to drink alcohol. Numbers showed about 13.8 percent Kentucky youth ages 12 to 17 had tried alcohol in the month they were surveyed. Census estimates indicate Kentucky has about 235,000 10- to 14-year-olds.

Kentucky ranks 10th lowest in percentage of youths who drink alcohol, the 2007-08 numbers showed. Most of the states with the lowest percentages were in the South, including Alabama, Georgia, Mississippi, South Carolina and Tennessee. The lowest percentage, 7.57, was in Utah; Rhode Island, at 20.7 percent, had the highest. Nationwide, the percentage was 15.3 percent.

Nearly 9 percent of 12- to 17-year-olds in Kentucky said they had binged on alcohol in the month they were surveyed, compared to 9.25 percent nationwide.

Research shows underage drinking can lead to future problems. "People who begin drinking alcohol before the age of 15 are six times more likely than those who start at age 21 and older to develop alcohol problems," said SAMHSA Administrator Pamela Hyde.

The National Survey on Drug Use and Health is an annual, countrywide survey involving in-person, at-home interviews with about 70,000 people 12 years of age and older. Each interviewee is randomly selected. Data pertaining to the use of alcohol, tobacco, illicit drugs and mental health is collected. The survey is funded by SAMHSA. Figures are subject to error margins depending on the size of a state and its sample in the survey.

Longtime legislator gets national award for helping mentally ill

State Rep. Jimmie Lee of Elizabethtown, left, today received the national Jacob K. Javits Award, an honor given to legislators who advocate for mental health services.

"It just blows my mind that someone from Kentucky wins, and it was me," Lee told Marty Finley of his hometown paper, The News-Enterprise.

Lee, who has served as a legislator since 1993, was chosen for the honor due to his efforts to expand services for the mentally ill. His efforts include helping to replace the Eastern State Hospital in Lexington, obtaining funding for community mental health centers, and helping to open a new crisis stabilization unit in Louisville.

Lee is the first Kentucky legislator to be chosen for the award. To recognize his achievements, the Kentucky General Assembly passed resolutions that made today Jimmie Lee Day. (Read more)

Sponsor of meds-for-meth bill now willing to accept compromise excluding gel capsules and liquids

Legislators wanting to pass a bill that would make the key component to make methamphetamine available only by prescription are now willing to make a concession that they would not accept last week.

House Speaker Greg Stumbo, D-Prestonsburg, said "supporters of the bill are considering excluding cold medicines in gel or liquid capsule form," the Lexington Herald-Leader's Beth Musgrave reports. It is more difficult to extract pseudoephedrine in cold medicines that come in gel or liquid capsule form, though it's unclear how much more difficult.

When Kentucky Health News first broached the idea to the bill's sponsor, Sen. Tom Jensen, R-London, last week, Jensen said he was not willing to make comprises on the bill, though it lacked the votes to pass the Senate. Now he seems to have had a change of heart. "If that would get it passed, we would certainly do it," said Jensen, right. "I have not talked to enough people yet who have said that would change their minds."

Democratic Rep. Linda Belcher of Shepherdsville, who has a similar bill in the House, said the change would help, because more legislators would vote for it because there would still be some cold medicines containing pseudoephedrine, which helps combat symptoms from allergies, on the market.

Drug industry lobbyists, however, rejected the compriomise. "According to the U.S. Drug Enforcement Administration, PSE (pseudoephedrine) in gel cap or liquid formations is 'readily extractible,' meaning it can still be used illegally to make meth," said Elizabeth Funderburk, a spokeswoman for the Consumer Healthcare Products Association.

Senate Bill 45 would make ephedrine, pseudoephedrine and phenylproppanolamine available only by prescription. It is similar to legislation that has passed in Oregon and Mississippi, where there has reportedly been a radical drop in the incidence of meth labs. The bill has been repeatedly passed over since being approved 6-4 by the Senate Judiciary Committee. (Read more)

Humana reinvents itself again, to adapt to U.S. health-care reform

Humana, Kentucky's largest corporation, says it is reinventing itself in the wake of the federal health reform law, focusing on becoming a "well-being" company rather than just a provider of health insurance.

Of the notable changes, the Louisville-based corporation that started life almost 50 years ago as a nursing-home company, then ran hospitals, is now back in the business of providing medical care directly, The Courier-Journal's Patrick Howington reports. That change is due to the $790 million purchase of Concentra, which operates occupational and urgent-care clinics (photo of Dr. J. Shawn Standridge and Danny Murphy by C-J's Michael Hayman). Humana Chairman and CEO Michael McCallister said similar purchases in fields like home health and information technology are expected.

Humana is also involved with development of products such as fitness games that can be played online and a water bottle that tells its owner when it's time to rehydrate. The company is also planning to market diabetic supplies to consumers, and is selling research to health-care companies about the effectiveness of certain drugs. "It's a significant change in our strategy," McCallister said.

Part of the change is due to the new health law, which will mean a $136 billion federal cutback in Medicare Advantage, a supplemental coverage program. Humana is the program's second-largest provider with 1.9 million members, and half its revenue comes from the program.

Though Humana laid off 750 Louisville workers early last year, analysts predict the company will weather the changes. Though Medicare Advantage cuts will likely mean there will be a predicted 5 million fewer seniors enrolled in the plan by 2019, other, smaller providers will likely stop offering it. Humana will be there to pick up those lost customers, analysts contend. (Read more)

Smoking ban up for discussion, not a vote, in Jessamine County Tuesday; bars would be exempt, unlike in Fayette

UPDATE, Feb. 27: "Each branch of government will have the option of adopting or rejecting the ordinance as it stands. Each body will essentially adopt the same ordinance but has freedom in the way it’s enforced within each jurisdiction," Laura Butler of The Jessamine Journal reports.

Elected officials in Jessamine County will meet tomorrow to discuss a smoking ban that could come to a vote later this year. The proposed ordinance would prohibit smoking inside and near the entrance of most enclosed places and workplaces, including restaurants, outdoor stadiums and arenas, but bars would be exempt.

So would a cigar bar (photo by Matt Goins) in the Brannon Crossing development near the border with Fayette County, which has an ordinance banning smoking in bars. The Lexington Herald-Leader's Greg Kocher reports that smoking would be allowed in private homes, unless they are used for child care, adult day care or health care. It would also be allowed in hotel and motel rooms that are designated for smoking; in tobacco stores; in private clubs; and at private functions.

Members of the Smoke-Free Jessamine County Coalition are disappointed by the exceptions. "They've changed a stronger ordinance to exclude certain words and phrases to make it a weaker ordinance," coalition member Susanna Moberly said. "We're very upset with that as a coalition."

"We're not going to put anybody out of business," countered Terry Meckstroth, a Jessamine County Fiscal Court magistrate. "I think the committee felt, 'Let's get something that everybody can live with right now.'" Tomorrow's meeting involves the fiscal court and the city councils of Nicholasville and Wilmore. (Read more)

Three Ky. physicians and one nurse practitioner investigated for high numbers of prescriptions for antipsychotic drugs

State and federal officials are investigating three Kentucky doctors and one nurse practitioner because of the unusually high amounts of antipsychotic drug prescriptions they write for Medicaid patients.

In 2008 and 2009, the four wrote the most prescriptions in the state for Abilify, Geodon, Seroquel, Zyprexa and risperidone, antipsychotic drugs that can cost up to $10 a pill, The Courier-Journal's Laura Ungar reports.

Somerset psychiatrist Dr. Zev Zusman wrote 6,556 prescriptions in 2008 and 2009, resulting in $2.2 million in Medicaid charges.

Mount Sterling's Dr. Samuel Welch, left, wrote 5,881 prescriptions, costing taxpayers $1.9 million.

Deborah Bradford, an Owensboro-based nurse practitioner and psychologist, wrote 4,279 prescriptions, at a cost of $1.2 million.

Paducah-based Dr. Duncan Darnell, a child and adolescent psychiatrist, wrote 3,536 prescriptions, costing $1.1 million.

Welch and Darnell defended their practices. Welch, the medical director of Pathways Inc., said he sees about 20 patients a day in a 10-county area. "The biggest chunk of what I do is see patients for medications," he said, adding that other psychologists provide talk therapy.

Darnell, the medical director at Four Rivers Behavioral Health, said he prescribes for more than 1,000 of his own patients, as well as sometimes prescribing for patients cared for by another psychiatrist and a nurse practitioner. "The folks I end up seeing are often very mentally ill," he told Ungar. "For me, medicines are used as a last resort."

Tracking the prescription levels is part of "a federal review into concerns about over-prescribing, waste and health care fraud in an era of tight government budgets," Ungar reports. Sen. Chuck Grassley, R-Iowa, is leading the review, and has asked every state to list the top 10 prescribers for certain medications. (Read more)

Kentucky's rates of leisure-time physical activity are among the lowest in the nation; Carter and Pike counties may be the worst

In three-fourths of Kentucky's counties, more than 30 percent of adults say they get no physical activity in their leisure time, according to new survey data from the Centers for Disease Control and Prevention. The statewide average is 30.1 percent. The problem is largely an Appalachian one; four Eastern Kentucky counties may have the highest percentage of physically inactive adults in the country.

CDC's telephone surveys indicate that 42.8 percent of adults in Pike and Carter counties were physically inactive in 2006-08. The only county with a higher figure, 43 percent, was McDowell County, West Virginia, which nearly borders Pike County. Magoffin and McCreary counties, also in Appalachia, rank fourth and fifth. The statewide rate for Kentucky is 30 percent; Kentucky Health Facts has this listing of county rates.


County figures are subject to error margins depending on the size of a county and its sample in the survey. Error margins are usually expressed in terms of a 95 percent confidence level, meaning that in 19 of 20 cases if the entire population were surveyed, the result would be within the error margin. For example, in Carter County, there's a 19 in 20 chance that the figure is between 36.3 and 50.4 percent. A less strict test is standard deviation, which gives the likely result if the data are distributed like the famous "bell curve." In Carter County, the standard deviation is 3.6 percentage points for each figure, meaning there's about a two-out-of-three chance that between 39.2 and 46.4 percent of adults in Carter County are physically inactive -- in any case, very high.

Because Pike County is larger and produces a larger sample for the survey, the error margin there is smaller, with a standard deviation of 2.6 percentage points. At the 95 percent confidence level, Pike County's physical-inactivity figure is between 37.9 and 48.2 percent. At the standard deviation it is between 40.2 and 45.4 percent -- again, very high in any case.

Magoffin County, with a likely rate of 42.2 percent, has a standard deviation of plus or minus 4.9 percentage points and a range of 33.4 to 52.7. McCreary County, at 41.6 percent, has a standard deviation of plus or minus 4.6 percentage points and a range of 33.4 to 51.2 percent.

Colors indicate level of inactivity for each county; legend below (click map for larger image)

FOR NATIONAL MAP

Fayette County was the only Kentucky county below the 2006-08 national rate of 25.4 percent, with a rate of 25.3 percent, plus or minus a standard deviation of 1.8 percentage points. It was followed by Calloway (25.5, plus or minus 2.7 points), Oldham (27.2, plus or minus 3.3), Henderson (27.5 percent, plus or minus 2.5) and Jefferson (27.6 percent, plus or minus 1.1).

Light blue/green: 21.1 to 26 percent
Medium blue: 26.1 to 31.1 percent
Dark blue 31.2 percent and above

Activity rates were higher in the northwestern quadrant of the state, in the Louisville and Evansville metropolitan areas. More than 30 percent of adults in Eastern and Southern Kentucky were physically inactive, making Kentucky adults as a whole some of the least physically active in the country. Physical inactivity rates were 29.2 percent or higher for more than 70 percent of the counties in Alabama, Kentucky, Louisiana, Mississippi, Oklahoma and Tennessee. Mississippi had the highest percentage of counties whose adults fell in the lowest of four levels measured, followed by Tennessee.

The results are based on data collected by the CDC's Behavioral Risk Factor Surveillance System, which is an ongoing telephone survey. People were listed as physically inactive if they answered "no" to this question: "During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening or walking for exercise?" Three years of data are used to compute each year's results. (Read more)

Lack of physical activity is a risk factor for developing obesity and Type 2 diabetes. CDC numbers show the proportion of U.S. adults who are obese was 33.9 percent in 2007-2008. Obesity-related medical costs were as high as $147 billion in 2008. The average annual medical costs for an obese person are $1,429 more than for someone who weighs a normal amount. In 2010, 25.6 million people had diabetes. Kentucky's obesity and diabetes rates are among the highest in the nation.


OBESITY RATES
Orange: 26.3 to 29.7 percent
Red: Above 29.8 percent

DIAGNOSED DIABETES
Orange: 8.5 to 10.1 percent
Red: Above 10.1 percent



Kentucky politicians of both parties object to Florida governor's plan to stop pill-monitoring program before it starts

The new Florida governor's plan to scuttle a yet-to-start program to monitor painkiller prescriptions "has sparked an uproar in Appalachian states that say they are deluged with illegally bought pills from South Florida," Arian Campo-Flores reports for The Wall Street Journal. The strongest objections come from Kentucky.

"The tracking system would include a centralized database to help identify buyers who are accumulating large numbers of pills and the doctors who are overprescribing them. In his recently released budget proposal, however, [Gov. Rick] Scott [CFNews13 photo] recommended repealing the 2009 law directing the state to set up the system," the Journal reports. "Scott has raised concerns about the database's effectiveness and its possible intrusion on patient privacy. Pointing to a $3.6 billion budget deficit for the coming fiscal year, he also worries that the state would end up paying for a program that lawmakers designed to be funded by federal grants and private donations. Most drug-monitoring programs in other states rely on both federal and state funds."

Scott's move has prompted expressions of disappointment from some of his fellow Republicans in Florida and strong objections from politicians of both parties in Kentucky and West Virginia, hotbeds of for abuse painkillers such as oxycodone. "It seems Gov. Scott wants Florida to become the oxy-tourism capital of the world," Kentucky Lt. Gov. Daniel Mongiardo, a Democrat from Hazard, told the Journal. (Read more)

Republican 5th District U.S. Rep. Hal Rogers of Somerset, the new chairman of the House Appropriations Committee, sent Scott a sharp letter on Feb. 17 expressing alarm and dismay. "Now is not the time to back down from this life or death challenge," Rogers wrote, calling Scott's move "equal to firing firefighters while your house is ablaze; it neither makes sense nor addresses an urgent crisis. Governor, your state, more than any other, must take this crisis seriously. . . . Your state's participation is paramount to the success of our nation in fighting this problem, helping addicts get treatment and prosecuting pushers." (Lexington Herald-Leader photo by David Perry)

Rogers dismissed concerns about privacy, saying Florida's program, like those in other states, has strict regulations governing access to the data. Noting his new position, "I can certainly appreciate the fiscal pressures with which you are confronted in balancing a tight state budget. However, this is a matter which warrants sacrifices elsewhere." For a story from the Herald-Leader's Bill Estep, click here.

Optometrists, ophthalmologists debate bill on TV after its passage

The bill to let optometrists perform some procedures now done legally only by ophthalmologists has passed both houses and is on the governor's desk, but members of both professions are debating its effects on television.

Leaders of the Kentucky Optometric Association and the Kentucky Academy of Eye Physicians appeared on cn|2's "Pure Politics" with Ryan Alessi on Insight cable Friday night, and are scheduled to appear on KET's "Kentucky Tonight" with Bill Goodman Monday at 8 p.m. EST.

Ben Gaddie of Louisville, president-elect of the optometrists' group, told Alessi that while the bill was passed only 11 days after it was filed, becoming the year's first to go to Gov. Steve Beshear, “We weren’t intentionally hiding anything … There are no secrets in Frankfort.”

Woodford VanMeter of Lexington, president of the ophthalmologists' group, "took issue with the ophthalmologists receiving limited time to raise their objections during committee hearings on the bill," cn|2 reports. (Click arrow to start video)

Abortion bills die in House Health and Welfare Committee

Four bills that would have made it more difficult to have an abortion in Kentucky won't make it past the House Health and Welfare Committee.

House Bill 390 and House Bill 215 would have prohibited a woman from having abortion after 20 weeks of pregnancy except in emergency cases; House Bill 374 would have required that a woman wanting an abortion meet with a doctor in person; and House Bill 243 "would have stopped a minor from another state from petitioning a court to receive an abortion if she does not have the permission of a parent," the Lexington Herald Leader's Beth Musgrave reports.

Republican Rep. David Floyd of Bardstown, left, sponsored three of the bills, but did not attend the meeting. "He had three bills, and he didn't have the guts to show up to defend his bills," committee chairman Tom Burch, D-Louisville.

Floyd said the bills should be considered by the Judiciary Committee, not the Health and Welfare, committee. "They devise the committee specifically to kill any pro-life bill," Floyd said of the health committee. The panel includes 10 Democrats and six Republicans. They voted along party lines. (Read more)

No vote taken on bill for drug tests for recipients of public aid

Despite motions to do so Thursday, the House Health and Welfare Committee did not vote on a bill that would require Kentuckians who receive public assistance to submit to random drug testing. The bill did not receive a vote because there is no money to pay for the drug testing and rehabilitation that would be required, said committee chairman Tom Burch, D-Louisville.

Maysville native Ruth Chamblin spoke at the meeting, saying her 12-month-old great-niece might still be alive if such a bill had been made law, the Lexington Herald-Leader's Beth Musgrave reports. Chamblin's great-niece died after she was allegedly beaten by her niece's then-boyfriend. Fearing investigation, Chamblin's niece neglected to take her daughter to the doctor for four days after the alleged attack, and the baby consequently died. The family was on public assistance at the time, and the boyfriend was reportedly a drug abuser.

House Bill 208, sponsored by Republican Rep. Lonnie Napier of Lancaster, right, would require random drug testing for people who receive Medicaid, food stamps and other kinds of public assistance. Those who test positive on the drug screening would have 60 days to get treatment. They would continue to receive public assistance in the meantime, but if they repeatedly failed more tests their assistance would be cut off. The reasoning behind the bill is to stop people from selling food stamps to buy drugs, Napier said.

Napier said the drug testing would cost about $1.5 million a year. One Idaho study has concluded drug testing for state-aid recipients is inefficient. (Read more)

Optometrists' well-financed bill is first to clear General Assembly

The bill that would significantly increase the care optometrists can provide passed the House Friday morning by a 81-14 vote. The bill, which now heads to Gov. Steve Beshear's desk, is the first this session to clear both houses of the General Assembly, The Courier-Journal's Tom Loftus reports.

Since it was filed Feb. 7, Senate Bill 110 has been cause for controversy, in part because of its speedy passage. It passed the full Senate last week, passed the House Licensing and Occupations Committee Wednesday and was voted on by the full House this morning. Loftus notes that optometrists have made more than $400,000 in campaign contributions to legislators and Gov. Steve Beshear in the past two years.

The bill allows optometrists, who do not attend medical school, to perform more types of procedures, most notably one that uses a laser to fix complications that can arise from cataract surgery. Only optometrists in Oklahoma are likewise allowed to use lasers while treating their patients; in every other state, only ophthalmologists -- medical doctors trained to perform eye surgeries --  can. The bill also allows optometrists to prescribe certain drugs and lets the state Board of Optometric Examiners define what procedures optometrists can legally perform.

On Thursday, ophthalmologists voiced their displeasure, saying they believe rules were broken in passing the bill. The bill should have been heard by the Health and Welfare committees, not the licensing committees, they say. "We hope that someone in the House (which now has the bill) will appeal for this to be corrected and ... sent to the proper committee so that the facts can be heard," said Woodford Van Meter, president of the Kentucky Academy of Eye Physicians and Surgeons.

House Speaker Greg Stumbo and Senate Majority Floor Leader Robert Stivers, the bill's sponsor, disagreed, saying the bill affects the licensing of optometrists. Ophthalmologists note the Senate and House rules say the health committees have "general jurisdiction" over "matters pertaining to ... optometrists." (Read more)