Central Baptist takes over Russell County Hospital

Russell County Hospital in Russell Springs will be managed by Lexington's Central Baptist Hospital, at least for the next three years. The deal announced this week is the latest in a growing consolidation of rural hospitals with larger, urban facilities, expected to accelerate under federalhealth reform.

"The three-year agreement creates an opportunity to provide greater accessibility to a wider range of health services in Russell County, while exploring ways to reduce costs and maintain affordability of services," the hospitals said in a press release. "The management agreement will allow creation of a broader continuum of care, including enhanced alignment of physicians and hospital services."

Russell County Hospital has 25 beds and 170 employees. It is a critical-access hospital, meaning it limits admissions and patient stays in return for slightly higher reimbursements from Medicare and Medicaid. Chris McQueary, chairman of the hospital's board, said in the press release, “This strategic partnership will allow us to work more closely with a leading health care system to provide high levels of care in the most cost-effective way.”

Central Baptist named Robert Ramey the CEO of Russell County Hospital. He has worked at Central Baptist for 17 years, most recently as administrator of Baptist-Physicians’ Surgery Center, the release said.

Laurel County man talks about bout with West Nile; one of few diagnosed with disease in Kentucky

A Laurel County man has shared his story after contracting the West Nile Virus, which, though rare in Kentucky, has been more common nationwide this year than it has been since it was first discovered in 1999.

Kelly Curens spent three weeks at the University of Kentucky medical center, much of which was spent in an induced coma. He started feeling sick after a camping trip at Lake Cumberland, reports Phil Penderton for WKYT-TV. The illness started with a headache and graduated to feeling dizzy, which were symptoms to similar to ones he experienced a few years ago when he was diagnosed with a brain tumor. When he went to the emergency room at St. Joseph London hospital, he had a seizure. 

Curens was one of the first in Kentucky to be positively diagnosed with the virus, which has affected more than 1,100 people nationwide this year. About half of the cases have been in Texas. Four horses have been diagnosed with the disease in Kentucky since Aug. 2. Craig Carter, director of the UK Veterminary Diagnostic Lab, said Kentucky is "still in the high-risk part of the season for West Nile infection."

Curens has been treated and is feeling much better now. "From what I was told, I'm very lucky," he said. "My blood sugar and blood pressure has always been good. Had I not been healthy I probably wouldn't be here today."

The elderly, infants and babies at the most risk, said Marion Pennington, regional epidemiologist at the Cumberland Valley District Health Department.

To protect oneself from the West Nile Virus, officials advise to:
• Dispose of tin cans, plastic containers, ceramic pots and other containers that could collect water.
• Remove discarded tires from properties. They are the most common mosquito breeding grounds in the country.
• Drill holes in recycling containers.
• Drain gutters properly and clean gutters in the spring and fall.
• Turn over swimming pools and wheelbarrows when they aren't in use.
• Change the water in birdbaths on a regular basis.
• Clean and chlorinate swimming pools and hot tubs.
• Make sure screens on windows don't have holes in them.
• Wear long-sleeve shirts and long pants when outside in the early morning and late evening. (Read more)

At least 50 Kentuckians sick from salmonella, likely from cantaloupes; best to wash them with a diluted bleach solution

Photo by Richard North for Gristmill

Health officials have zeroed in on a farm in southwestern Indiana responsible for at least some of the cantaloupe that were contaminated with salmonella, an outbreak that has sickened at least 50 Kentuckians and 178 people nationwide. It has also been associated with the death of two Kentuckians.

There is disagreement between state and federal officials whether melons from the region are safe to eat, The Associated Press reports. The Food and Drug Administration says to discard any cantaloupes grown in the area that were bought on or after July 7. Amy Reel, Indiana Department of Health spokeswoman, says melons from other farms in the area are safe to eat.

The 100-acre Chamberlain Farms, 20 miles north of Evansville, seems to be at least one source of the outbreak. It stopped producing and distributing the melons Aug. 16. They sold cantaloupe to four grocery stores in Southwestern Indiana, as well as to wholesale purchasers in St. Louis; Owensboro, Ky.; Peru, Ill.; and Durant, Iowa. (Read more)

Salmonella is a bacterium that is found in the intestines of animals and is contracted from eating raw eggs or raw poultry or having those products touch other food. It can occasionally be found on produce, so the Kentucky Cabinet for Health and Family Services recommends washing all fruit and vegetables thoroughly and scrubbing the rinds of cantaloupes and other melons before cutting or slicing them. As Tim Wright, the acting health director in Anderson County, told The Anderson News,  "People use a clean knife and cut through the melon, and that can shove the salmonella right into its meat" if any remains on the rind. He recommends washing all melons in a solution of one cup of bleach to a gallon of water, because melon rinds get salmonella when rodents urinate on them.

Brushing teeth twice a day, two minutes at a time, is the way to prevent cavities, a new campaign advises

Kids should brush their teeth twice a day for two whole minutes at a time, a new public-service campaign urges. The “Kids’ Healthy Mouths” campaign includes TV spots, print ads, a website, social media messages and other materials, reports Jennifer LaRue Huget for The Washington Post.

Campaign materials point out that “dental decay is the most common chronic childhood disease.” More than 16 million children across the United States suffer from it. In Kentucky, nearly 35 percent of third-grade students had untreated tooth decay, the Centers for Disease Control and Prevention's State Oral Health Profile shows.

“The mouth is the gateway to a person’s overall health, and an unhealthy mouth can be linked to diabetes and even heart disease,” the campaign says. “In the U.S., oral disease causes kids to miss 51 million school hours and their parents to lose 25 million work hours annually. Additionally, oral disease disproportionately affects children from low-income families and these children have almost twice the number of decayed teeth that have not been treated by a dentist as compared to others in the general population.”

The campaign includes a YouTube video channel on which there are videos that are each 120 seconds long. The goal is for kids to watch the videos while they’re brushing.

Research has shown brushing two minutes at a time, twice a day, is the “optimal prevention brushing regimen,” because it “takes two minutes for the tooth enamel to uptake the fluoride” in toothpaste, said Maria Lopez Howell, consumer adviser for the American Dental Association. When enamel absorbs fluoride it makes the surface harder and more resistant to bacteria. Brushing for two minutes additionally removes plaque on teeth. (Read more)

West Nile outbreak light in Ky. but 'one of the largest' in nation

U.S. health officials reported Wednesday three times the usual number of West Nile cases for this time of year and one expert told the Associated Press it was “one of the largest” outbreaks since the virus appeared in this country in 1999.

So far, 1,118 illnesses have been reported, about half of them in Texas, according to the Centers for Disease Control and Prevention. Kentucky has reported few cases.

In an average year, fewer than 300 cases are reported by mid-August. There have also been 41 deaths this year. Most infections are usually reported in August and September, so it’s too early to say how bad this year will end up, CDC officials said. AP reports that West Nile virus peaked in 2002 and 2003, when severe illnesses reached nearly 3,000 and deaths surpassed 260.

 The best way to prevent West Nile disease, say experts, is to avoid mosquito bites. Insect repellents, screens on doors and windows and wearing long sleeves and pants are some of the recommended strategies. Also, empty standing water from buckets, kiddie pools and other places to discourage breeding. (Read more)

Medicare is a hot topic on the presidential campaign trail; federal agency says reform has saved seniors money

Republican presidential candidate Mitt Romney and running
mate Paul Ryan talk health care in New Hampshire. Photo
by Aram Boghosian for The Boston Globe.

The federal health reform law continues to be a major point of contention in the presidential campaign. Yesterday, Republican vice presidential candidate Paul Ryan said, "Medicare should not be a piggybank for Obamacare," while at a rally in New Hampshire yesterday and blasted President Obama "for using $716 billion in savings from Medicare and applying it to his health care law," reports Matt Viser for The Boston Globe.

Most of that amount was taken from reductions to Medicare Advantage, a category of Medicare plans that are run by private insurance companies. The idea behind the program "was that competition among the private insurers would reduce costs," reports Politifact.com, a Tampa Bay Times project that fact-checks statements on public policy. "But in recent years the plans have actually cost more than traditional Medicare. So the health-care law scales back the payments to private insurers."

Ryan has proposed his own fix, a voucher program for Medicare, which Obama sharply criticized Saturday: "Now you think they'd avoid talking about Medicare, considering both of them have proposed to voucherize the Medicare system," he said. "They want seniors to get a voucher to buy their own insurance, which would force seniors to pay an additional $6,400 for their health care."

Meanwhile, the Centers for Medicare and Medicaid Services released a press release detailing how much the Patient Protection and Affordable Care Act has saved seniors. Kentucky seniors and those with disabilities have saved $78.4 million on prescription drugs since 2010. In 2012, seniors in Kentucky saved an average of $579 because of the Patient Protection and Affordable Care Act. The law covers the prescription drug coverage gap known as the "donut hole."

In the first seven months of 2012, 477,235 Kentuckians with Medicare also got at least one preventive service for free because of a provision in the law, a CMS reports.

"The health care law has saved people with Medicare over $4.1 billion on prescription drugs, and given millions access to cancer screenings, mammograms and other preventive services for free," said Kathleen Sebelius, secretary for the Department of Health and Human Services. "Medicare is stronger thanks to the health care law, saving people money and offering new benefits at no cost to seniors."

Aetna buying Coventry, which manages some Medicaid care

Aetna will buy Coventry Health Care for about $5.6 billion as the third-largest health insurance company poises itself for more Medicare and Medicaid patients under the federal health-care reform law.

Coventry Cares is one of four managed care organizations that supervise care for Kentucky's Medicaid patients. But since being put in place last November, the company reports it has been beleaguered by shortfalls and has threatened to end many contracts with hospitals.

"It's a deal that almost had to happen," said thomas Carroll, a Stifel Nicolaus & Co. analyst in Baltimore. "For Aetna to really compete effectively amongst the other large national managed care companies, they have to do more in terms of gaining market share in the commercial business as well as getting a bigger foothold in Medicare and Medicaid, which are the growth areas in managed care over the next decade."

The health care law "seeks to add as many as 17 million patients under Medicaid, the insurance program for the poor, while individuals states have increasingly turned to insurers to help them manage existing programs at lower costs," reports the Bloomberg News. "Medicare managed-care plans are among the fastest-growing products for health insurers as Americans age." (Read more)

Several hundred, including Sens. McConnell and Paul, attend tea-party rally to express displeasure about health reform law

By Tara Kaprowy
Kentucky Health News

Hundreds of tea-party activists showed up at a midday rally at the state Capitol to protest the Patient Protection and Affordable Care Act and Kentucky's involvement in its implementation. Both are issues in the Nov. 6 elections. (Photo by Pablo Alcala, Lexington Herald-Leader)

In a rare appearance at a tea-party event, U.S. Senate Republican Leader Mitch McConnell encouraging those in the crowd "to make Barack Obama a one-term president."

Sen. Rand Paul, who was elected in large measure on his tea-party identity, repeated his riposte to the 5-4 court decision upholding the law: "Just because a couple of people on the Supreme Court declares something to be 'constitutional' does not make it so," he said. "I still think the whole damn thing is unconstitutional."

Scott Wartman of The Cincinnati Enquirer estimated that 300 to  500 people attended the event, which was organized by the Louisville Tea Party. Some who attended came in support of the health care law and carried placards expressing their sentiments. "The rally also drew dozens of counter-protesters who favor Obama and the health care act," Jack Brammer reported for the Lexington Herald-Leader.

One reason for the rally was to influence legislators to fight the implementation of the state health insurance exchange that Democratic Gov. Steve Beshear has created under the law. Before the rally, the Bluegrass Institute for Public Policy Solutions encouraged participants to ask their legislators what will happen to cost of the state-run health exchange if a huge number of Kentucky players decide not to offer health insurance to their employees.

The Bowling Green-based group also questioned the cost of expanding the Medicaid program to 138 percent the federal poverty level, which is up to individual states under the Supreme Court decision.

McConnell called the law the worst piece in modern times and the "single biggest step in the direction of Europeanizing America, because if the government ever gets its clutches on all the health care of all 306 million Americans, which it will have if Obamacare stands, the government controls the most important concern all of us in the end have — our own health and the health of our family handed over to a centralized government."

McConnell said repealing the law would be top on the agenda if Republicans win a majority of the U.S. Senate in November. But as he alluded earlier, Obama would need to be defeated to prevent a presidential veto of repeal legislation.

Debra Harper of Louisville told the Herald-Leader she suffered a mild stroke last February due to a congenital heart problem, and welcomes the law. “Our president finally gave this nation a blueprint for health care,” she said. “It’s like a blueprint for a house. There may be some changes you want in it, but it’s a sound structure, and people who want to discard all of it are being cruel.”

Kentucky Health News is a service of the University of Kentucky's Institute for Rural Journalism and Community Issues, with support from the Foundation for a Healthy Kentucky.

Most Medicaid recipients can switch their managed care company from now through Oct. 19

Medicaid recipients in 104 counties who want to change who provides their managed care will have an opportunity to do so during open enrollment now through Oct. 19.

Letters are being sent out by the Kentucky Department of Medicaid Services to inform recipients about the open enrollment option. These recipients can choose from three companies: Coventry Cares, Kentucky Spirit Health Plan and WellCare of Kentucky. There is no cost to switch coverage. Those who want to keep their current coverage do not need to take action.

Recipients who want more information about their coverage options and provider networks can reach their managed care organization by phone. The numbers are:

• Coventry Cares: 855-300-5528

• Kentucky Spirit Health Plan: 866-643-3153

• WellCare of Kentucky: 877-389-9457

The open enrollment does not apply to people who live in the region of the state covered by Passport Health Plan, which includes Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble and Washington counties.

All changes will take effect Nov. 1. Once enrolled, the member will have 90 days to change to a different MCO, but after that period will have to wait until the next open enrollment period. (Read more)

Some doctors find law to fight pill mills confusing and overreaching, and some say they will stop writing prescriptions

Dr. Kathy Nieder, with patient charts
(C-J photo by Michael Clevenger)

Dr. Ralph Alvarado’s medical practice in Winchester has prescribed controlled substances to 1,800 patients in Central Kentucky over the past three years. But he and other doctors in the practice decided to put down their pens four weeks ago. That’s because, Mike Wynn of The Courier-Journal reports, "The standards imposed under a new Kentucky law designed to crack down on prescription drug abuse are so strict and complex that he would go bankrupt in a month -- or worse -- if he were to continue prescribing controlled substances."

Alvarado, who has made two unsuccessful campaigns for the state Senate, told Wynn, "I’m not going to be threatened with jail time or criminal charges and lose my career." He said he would refer patients to specialists to get pain-pill prescriptions.

Proponents argue that the new prescribing standards in House Bill 1, passed by the 2012 General Assembly "in hopes of combating an epidemic of drug abuse that kills nearly 1,000 Kentuckians each year were intended only to root out pill mills and crooked doctors and should not hamper legitimate physicians or prevent patients from receiving needed drugs," Wynn writes. However, "Some doctors contend the legislation is excessive, confusing and time-consuming, and across Kentucky, many have been seeking advice from attorneys about following the law, and warning patients about potential cutbacks to common drugs for pain, anxiety and other conditions. Some doctors are even talking about leaving the state. . . . Others say they have sent patients home in tears or in pain because they lack the time and resources to comply with the law."

"Patients who have never been a problem are bound up in all of this," Greg Hood, Kentucky chapter governor of the American College of Physicians, told Wynn. "There are so many unintended consequences." Hood's group and the Kentucky Medical Association are trying to determine how many clinics are declining to write prescriptions, but neither is advocating that approach. According to state offices of the Drug Enforcement Administration, only three in-state doctors have voluntarily surrendered their DEA registration — required for prescribing controlled substances — in recent weeks for reasons related to the new law. Still, the Greater Louisville Medical Society held a meeting with about 200 members recently in which attorneys tried to explain the law’s details. Doctors cited nearly two dozen areas of concern stemming from what they call vague and ambiguous legal language, the group reported. (Read more)

New tool allows analysis of nursing-home deficiencies across the country; Kentucky seems to rank high in serious problems

Reporters now have a tool at their fingertips that will allow them to find nursing home problems in facilities across Kentucky, which appears to ranks high in serious problems.(iStock photo)

The tool was launched this week by ProPublica, a nonprofit, investigative news group, and allows "anyone to easily search and analyze the details of recent nursing home inspections, most completed since January 2011," report Charles Ornstein and Lena Groeger.

The tool has features that the federal government's Nursing Home Compare doesn't have, including the ability to search using any keyword. Results can also be sorted according to the severity of the violation and by state.

About 1.5 million people still live in nursing homes nationwide, though more seniors are living at home or in assisted-living facilities. The reports show there were almost 118,000 deficiencies cited against 14,565 homes. According to the Centers for Medicare and Medicaid Services, the average number of deficiencies for a nursing home inspected in the U.S. is eight and the average in Kentucky is seven.

ProPublica's analysis shows Kentucky ranked fourth nationwide for the most "K" and "L" deficiencies, considered the most serious kind. The state had 45 in the analysis, as did South Carolina. Texas had the most in the country by far, however, with 183. 

While ProPublica does rank the states, nursing home industry officials say "inspectors in different regions of the country have different thresholds for issuing a citation, and that could unfairly make one state's homes appear worse than another's," Ornstein and Groeger report. (Read more)

First cases of flu reported in Kentucky; not swine-related

By Tara Kaprowy
Kentucky Health News

Kentucky has its first confirmed cases of flu for the year, and officials are urging residents to get their vaccinations. (WYMT-TV photo)

The Department for Public Health reports six confirmed cases in Boyd County of the H3N2 strain, which is included in this year's flu vaccine. No cases of flu that contain genetic material from swine flu have been reported in Kentucky this year.

Kristy Bolen, senior epidemiologist at the Ashland-Boyd County Health Department, said both children and adults have been affected. "We do know that when kids go back to school, we tend to see more influenza," she said.

The reports of swine flu in Ohio and Indiana have prompted physicians to test for flu more than they normally would this time of year, Bolen told Kentucky Health News. "Being right on the border with Ohio, our local providers and local community members are more aware," she said. "It doesn't necessarily mean it will be a bad flu season."

The best way to protect against getting the flu is to get a vaccine, which should be done annually. The vaccine is recommended for anyone over 6 months of of age and is especially recommended for:
• Children age 6 months to 19 years
• Pregnant women
• People 50 years old or older
• People with any chronic health problems
• People who live in nursing homes or other long-term care facilities
• Health care workers
• Caregivers of people who have high risk for complications from the flu
• Out-of-home caregivers of people who live with children less than 6 months old.

"Getting the flu can be debilitating and sometimes life-threatening, so it's extremely important to take simple preventive steps to avoid i," said Dr. Steve Davis, acting commissioner for the DPH. "You should also follow the advice your mother gave you to prevent flu and other illnesses that tend to circulate at this time of year — wash your hands frequently, cover your mouth when you cough or sneeze, and stay home when you're sick." (Read more)

For more information about the flu, click here.

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