Seven Ky. communities get grants to reduce risks for chronic diseases among children and 'Invest in Kentucky's Future'

Seven diverse Kentucky communities are getting money to reduce the risk of chronic disease among Kentucky's youth. The initial grants announced Thursday are part of the Foundation for a Healthy Kentucky's new Investing in Kentucky’s Future initiative, a five-year, $3 million program.

“The health of our next generation is at stake,” said Susan Zepeda, CEO and president of the foundation. “Our goal is to help communities make positive changes in policies and service access that will help our children grow into healthy, productive adults. Regardless of the challenges, we want to help communities find new pathways to positive solutions.”

Community groups will use their initial grants to collect and analyze local health data. That analysis will guide development of innovative strategies for effective, sustainable measures to improve children's health. Those communities chosen for the initiative are:

• Clinton County School District, Albany: initial grant of $27,755 for the Clinton County Healthy Hometown Coalition. “We are thrilled that our community was chosen to participate in this important initiative,” Asst. Supt. Paula Little said. “The members of the Healthy Hometown Coalition are committed to helping children grow up in a physical, social, and cultural environment that supports good health habits. With help from the foundation, we can develop our capacity to make a lasting, positive change in our community.”

• Fitness for Life Around Grant County, Williamstown: initial grant of $21,643 for FFLAG and the Northern Kentucky Health Department. “We are pleased and excited to be given the opportunity to work with the Foundation for a Healthy Kentucky,” FFLAG Chairman Jeff Walters said. “We are a small group that has been working on improving the health of our community and we believe we’ve had a positive impact thus far. This grant will accelerate the process and the work that’s been started.”

• Foundation for Appalachian Kentucky, Hazard: initial grant of $32,558 for Perry County Wellness Coalition. “We’ve been working for several years to improve the menu and encourage better eating habits in and out of school,” said Linda Campbell, nutrition director at Perry County Schools. “It’s not as easy as changing a menu or just buying whole wheat bread. We’re changing a culture, and that’s not a simple thing. Working together, as a community, we can really start to make a difference. This grant from the Foundation for a Healthy Kentucky allows us to take the next steps toward helping our kids to become healthier.”

• Green River Area Development District, Owensboro: initial grant of $40,483 for Partnership for a Healthy McLean County. “The Partnership for a Healthy McLean County realizes the impact community organizations, schools, work sites and health care have on the health of families,” said Jiten Shah, executive director of the district. "Obesity is a major factor for many chronic diseases which can begin in childhood and continue into adulthood. "

• Kentucky Heart Foundation Inc., Ashland: initial grant of $19,245 for Healthy Kids, Healthy Communities in Ashland. “Investing in Kentucky’s Future is a perfect fit for the work of the Healthy Kids Coalition and gives us the opportunity to continue to work on policy, system and environmental changes to improve the health of children in Boyd and Greenup counties,” said Laura Patrick, coordinator of Healthy Kids, Healthy communities. “We know that this approach will help sustain change for years to come and what is great about it is that it is sustainable.”

• Kentucky River Community Care, Inc., Jackson: initial grant of $34,156. “This foundation grant will help Breathitt County plan more opportunities for youth and families to participate in healthy lifestyle activities,” said Bridget Turner, KRCC director of clinical services. “We need to develop a strategic plan to specifically address the many barriers that face our children and threaten their future. Education, prevention, behavioral health, physical health, nutrition, employment, substance abuse are a few of the issues that we are trying to deal with in our county.”

• Louisville Metro Department of Public Health and Wellness: initial grant of $34,160. “If we are ever going to realize a healthier future for our citizens, we must improve the health of our young people,” said Dr. LaQuandra Nesbitt, director of the department. “These funds from the Foundation for a Healthy Kentucky will facilitate a coordinated, systemic approach to overcome the health barriers that many of our youth face. The grant will allow us to formulate policies and strategies to improve health that are based on accurate data with buy-in from stakeholders across the community.”

Reducing chronic diseases to improve Kentuckians' health
 
Chronic diseases such as cancer, diabetes and heart disease, are those that last over time, decrease quality of life, increase the risk of early death and occur at higher rates in Kentucky than in surrounding states; substance abuse and some mental illnesses are also chronic diseases.

Kentucky’s children are at greater risk than most for chronic diseases, including high rates of obesity and smoking. When children grow up, they are at an increased risk for heart disease, cancer or stroke, and Kentucky is above the national average in deaths from these diseases.

The Investing in Kentucky's Future initiative will help Kentucky communities confront this cycle of problems. The foundation is encouraging local leaders to identify how best to engage the community in order to have the biggest impact.

“This is the first step in our multi-year approach, which will lead to implementation of permanent solutions for healthier communities,” said Zepeda. “We believe that by working together on the local level, civic leaders with vision can develop innovative strategies to improve the health of our children.”

More than 50 interested organizations responded to the foundation’s request for proposals in October last year, and 22 were invited to submit a full proposal. The foundation’s board of directors approved funding for seven as part of the initiative. Click here to read more about the foundation.

Study shows talking with college students about binge drinking makes them think about it

College students who hear warnings about binge drinking from family or friends are more likely to be concerned about their own alcohol use, compared to those who don't hear this advice, a new study indicates.

The study found that students who were not distressed about their binge drinking had not heard concern expressed to them about their alcohol consumption.

“On the other hand, when a friend or family member expressed concerns to a student about her or his excessive drinking, it can help the student reflect on their alcohol consumption and begin to take steps to reduce it,” said lead researcher Jeffrey Hayes, professor of counseling psychology in Penn State's College of Education, in a news release.

Despite the negative consequences of binge drinking, about 80 percent of college students drink alcohol, and about half of those who drink engage in binge drinking, says the National Institute on Alcohol Abuse and Alcoholism. Hayes said more than half of college students who sought counseling reported drinking alcohol at a level considered to be “hazardous” by the World Health Organization.

As a psychologist, Hayes often hears about the negative effects of binge drinking on students' academic performance and emotional and physical well-being. "I am aware of and concerned about the ingrained culture of binge drinking among adolescents," he said in the release.

Results of this study can help inform professionals who work with college students to encourage student engagement through outreach programs, and it also raises awareness for family and friends of those who may abuse alcohol, said Hayes. (Read more)

U.S. News gives Kosair Children's Hospital a national ranking; 11 other Kentucky hospitals make 'high-performing' list

Each year, U.S. News and World Report publishes its "Best Hospitals" guide for people seeking a high level of specialty care. The only Kentucky hospital to be nationally ranked in the report for 2014 is Kosair Children's Hospital in Louisville. It received national rank in these areas of specialty care: heart, lung, neurology, cancer, orthopedics and urology.

While no Kentucky hospitals were nationally ranked in adult specialty categories, 11 Kentucky hospitals made the cut for meeting standards of strong performance within the state:
     1. St. Elizabeth Edgewood - 11 high-performing specialties
     2. Baptist Health Louisville - 10 high-performing specialties
     2. University of Kentucky Albert B. Chandler Hospital - 10
         high-performing specialities
     4. Baptist Health Lexington - 9 high-performing specialties
     5. Jewish Hospital in Louisville - 7 high-performing specialties
     6. Norton Hospital in Louisville  - 5 high-performing specialties
     7. University of Louisville Hospital - 2 high-performing specialties
     8. King’s Daughters Medical Center in Ashland - 1 high-performing specialty
     8. St. Elizabeth Florence - 1 high-performing specialty
     8. St. Elizabeth Fort Thomas- 1 high- performing specialty
     8. St. Joseph East- 1 high-performing specialty

To read more about specialty rankings for each hospital, click here for an article in The Lane Report or here for the U.S. News report.

Kentucky among states selected to study, address expensive problem of 'superusers' of emergency rooms

Kentucky is one of a few states teaming up with the National Governors Association to address the expensive problem of uninsured or Medicaid-covered "superusers" who over-use hospital emergency rooms or other costly health services instead of lower-cost alternatives like primary care.

“I’m proud Kentucky has been chosen to participate in this important program,” Gov. Steve Beshear said in a news release. “Across the nation, an understanding has been growing that we must focus our efforts on providing the best in coordinated care, helping to direct individuals who may be using more expensive, less effective services to more cost-efficient preventive services that provide better health outcomes in the long run. It’s by achieving these outcomes that we will build a healthier future for Kentucky.”

Kentucky, Alaska, Colorado, Kentucky, New Mexico, Puerto Rico and West Virginia will participate in a policy academy designed to help them create systems for these "superusers", enabling state officials to confront rising Medicaid expenditures while improving quality of care and health, says an NGA release.

These "superusers," sometimes called "super-utilizers" or "frequent flyers," often go to a hospital or emergency room for recurring health issues that can be treated more effectively and less expensively in other ways. Kentucky Medicaid spent more than $219 million on emergency-room use in 2012, and 4,400 Medicaid recipients used ERs 10 or more times during that year, says Beshear's release.

“There’s a handful of people who drive most of our spending,” Dan Crippen, the executive director of the governors’ association, told Kelsey Miller of Kaiser Health News. While the median ER visit cost $615 in 2009, an office-based visit with a physician cost $361, according to the federal Medical Expenditure Panel Survey.

“Kentucky has too long lagged behind in health rankings, and now is the time for us to begin truly moving the needle in the right direction,” said Cabinet for Health and Family Services Secretary Audrey Tayse Haynes. “By participating in this national effort, we can learn what has worked for other states and share Kentucky’s experiences as well.”

State leaders will first meet as a group with consultants from various health-care sectors, then officials will spend 18 months implementing the plans in their communities, says Miller. Funding for the effort is provided by the Robert Wood Johnson Foundation and the Atlantic Philanthropies.

Online health-insurance exchange will differ in several ways from those in other states; scheduled to go online Oct. 1

Kentucky is one of 17 states setting up its own online health-insurance exchange under the Patient Protection and Affordable Care Act. A new report provides a limited update about the process, and reminds us that Kentucky doesn't have a long-term plan to pay for the Kentucky Health Benefits Exchange, branded Kynect and scheduled to go online Oct.1.

The state is writing regulations to govern the operations of the exchange, and "developing IT systems that house and execute the eligibility determination rules for exchange coverage, federal premium tax credits and cost-sharing subsidies, Medicaid, and the Children’s Health Insurance program" says the Georgetown University report, prepared for the Commonwealth Fund, which calls itself "a private foundation that aims to promote a high-performing health care system."

Most states are involving their legislatures in decisions about exchanges, says the report. This is not the case in Kentucky, perhaps because Republicans control the state Senate. Tea party activist David Adams has filed suit, challenging the legality of Gov. Steve Beshear's decision to implement the exchange without legislative approval. So far, a judge has denied the governor's request to dismiss it.

Even the exchanges with their own rulemaking authority like Kentucky have worked with the legislatures for other decisions, "such as the exchange's long-term financing mechanisms," says the report. The federal funding Kentucky is using to establish the exchange will be gone by 2015, but as of May 31, Kentucky and seven other states had no plans for a long-term revenue source.  Other states have either assessed insurers offering coverage on the exchanges or they are assessing taxes to cover the cost, says the report. Kentucky officials have indicated they will use assessments, but some Republicans have said that would be a tax, which only the General Assembly can impose.

The report also highlights the various approaches states have taken to toward selection of exchange plans. Kentucky is called a "market organizer," meaning that it "manages plan choices through limits on the number or type of plans that an insurer can offer but does not selectively contract with insurers," says the report. As required by the health-reform law, the Kentucky exchange will require participating insurers to offer at least "silver" and "gold" plans, and it is also requiring them to offer catastrophic coverage outside the metal-labeled tiers (which could have included "bronze").

Kentucky opted for no more than four plans per metal tier. Officials say limiting the number of plans will help consumers avoid being overwhelmed while giving insurers flexibility. Although the employer mandate to provide health insurance was delayed until 2015, Kentucky's exchange is still expected to offer multiple tiers through multiple insurers for employers to buy insurance, says the report.

On the advice of a 19-member board Beshear appointed to oversee the exchange, Executive Director Carrie Banahan has decided to not require plans to display quality metrics, as 10 other states plan to do, the report says. The board is chaired by Sharon Clark, commissioner of the Kentucky Department of Insurance.

The board and Banahan have gone against the grain on some other decisions. Most states are deferring to existing rules governing insurance agents; Kentucky is the only state requiring all agents to represent at least two insurers participating in the exchange.

In June, the state Cabinet for Health and Family Services issued a request for "Kynectors" to help Kentuckians shop for health insurance on the exchange. These employees and volunteers will help individuals and small businesses in determine their health-plan needs and help them choose plans to meet those needs, the cabinet said. To view the solicitation for Kynectors, click here.

The state is currently looking for exchange "kynectors"

Information for the report was gathered from minutes of the board.  Click here for a list of board members and here to view board meeting materials. Minutes of the May meeting will be posted after the board's next meeting on July 15, Midkiff said.

Dr. Hernandez, dead at 84, remembered as public-health leader, especially for women

Funeral services were held Tuesday, July 16, for Dr. Calixto “Carlos” Hernandez, a Cuban refugee who was a leader in Kentucky's public-health system and commissioner of the state health department from 1984 to 1992. He died Saturday, July 13, at the age of 84, of abdominal cancer.

Hernandez' s obituary said he was to have been the "head of all health resources" for Fidel Castro until he saw in 1957 that Castro's revolution would not be what he thought it would be. "The revolution turned out to be the biggest, bitterest disappointment of his life,” his widow, Jacqueline Hernandez, told Kevin Wheatley of The State Journal in Frankfort.

After an internship and residency in Louisville, he ran the Hardin County Health Department, became an American citizen, earned a master’s degree in public health from the University of California, Berkley, and joined the state health department. He was named its commissioner by Gov. Martha Layne Collins and kept the job under Gov. Wallace Wilkinson.

Wheatley reports, "Among his proudest achievements was a program providing mammograms to disadvantaged women, his wife said. Dudley Conner, who worked as a division director . . . said Carlos Hernandez was interested in women’s health initiatives and also launched programs focused on cervical cancer, preventive medicine and children’s immunizations, to name a few." Conner said, "He was very compassionate, kind-hearted, would help you do anything that needed to be done. He always was concerned about people and their public health."

Hernandez never fully retired, working as a medical consultant on Social Security disability cases, his widow told Wheatley. He is also survived by a daughter, Elena Hernandez Page; a son, Carlos Hernandez; and four grandchildren. (Read more)

Community-based solutions to childhood obesity show signs of progress elsewhere; will Kentucky pick up on them?

By Molly Burchett
Kentucky Health News

For decades, researchers reported with alarm the increasing trend of overweight children in America, with one in three kids on the way to developing Type 2 diabetes. Across the country, action has been taken to address this problematic trend, and now some preliminary, scattered results indicate that obesity rates have plateaued or dropped in some areas. Is Kentucky part of this success, and if not, will it learn from it?

The first set of positive signs came last year, with falling child obesity rates in New York City and Philadelphia, reports Lydia DePillis of The Washington Post. And, a recent Robert Wood Johnson Foundation brief shows similar progress in states with a large rural population as well:

• Mississippi posted a decrease from 43.9 percent of kids being overweight and obese in 2005 to 40.9 percent in 2011, three years after passage of the Mississippi Healthy Students Act. 
• In North Carolina, Vance and Granville counties saw significant declines after implementing healthy living programs based on the Centers for Disease Control’s community guide.
• Kids in Kearney, Neb., in grades one through five saw a 13.5 percent decline in obesity rates between 2005 and 2011.
• West Virginia fifth graders posted a 8.6 reduction in obesity rates over a six-year period.

Overall, progress was made through community-based solutions, including changes to make healthy foods available in schools while eliminating fried foods and working to integrate physical activity into people's daily lives while educating them about the importance of doing that, says the brief.

Kentucky, which suffers from one of the highest childhood obesity rates in the country, could learn from these successful programs. The state ties Mississippi for the highest percentage of youth in grades 9 to 12 that are obese (18 percent) and has the third highest percentage of children ages 10 to 17 who are obese (21 percent), compared to 16.4 percent nationally, says a report by Kentucky's Task Force on Childhood Obesity.

The Kentucky General Assembly has not enacted legislation regarding healthy eating and physical activity like many other states, notes a National Conference of State Legislatures report, but established a task force that made various recommendations to the legislature in September for strategies that address the problem of childhood obesity and that encourage better nutrition and increased physical activity among Kentucky children.

Some of the task force's recommendations include: requiring schools to improve nutritional content of school food, including promoting the use of school gardens, adopting a statewide standard for physical activity initiatives and nutrition education in schools and encouraging physical activity through a coordinated school health program. To view that report, click here.

Kentucky has no requirements for physical activity in schools. About 65 percent of Kentucky's youth did not attend physical-education classes in 2010, and 80 percent did not attend such classes five days per week, says a 2011 Center for Disease Control and Prevention survey.

However, the state does have several programs to promote physical activity or healthy eating. They includes the Farm to School program, which has been adopted by 1,243 schools and 174 school districts and is a collaborative effort between federal and state agencies to bring local agricultural products to schools and to educate students about local food production, says the report.

Using the success of other state programs and existing Kentucky programs as a guide, Kentuckians and "the members of the Task Force on Childhood Obesity are encouraged to continue their advocacy efforts to address Kentucky’s health crisis in ways that have the greatest likelihood of preventing and reversing chronic diseases associated with childhood obesity," says the report.

Kids' excessive salty snacks are linked to obesity, high blood pressure; new limits on school vending items may help

As new research shows that America's child-obesity epidemic is linked to eating too many salty snacks,  new federal regulations could ensure that vending-machine snacks in Kentucky's schools are healthier and lower in sodium.

Spurred by children eating too much salt and being too fat, "blood pressure in America's kids and teens has gone sky-high," creating a young generation at risk for serious health problems, including heart disease, stroke, reports Brian Alexander of NBC News.

“Kids eat far too much sodium,” the study's co-author, Dr. Stephen Daniels told NBC. “And they aren’t adding it at the table, and their parents aren’t putting it into food; they’re getting it through processed foods.” The research, published Monday in the journal Hypertension, links this rising blood pressure to children's increasing bod- mass index and sodium intake.

The "Smart Snacks in Schools" nutrition standards, announced last month by the Department of Agriculture, require any food sold in public schools to meet calorie, fat, sugar and sodium limits. The changes shouldn't be very significant for Kentucky students because the state already prohibits vending machine sales during the school day. And, a few existing state regulations, like fat content, are tougher than the federal changes and will remain in place, Sue Bartenfield, nutrition program manager for the Kentucky Department of Education, told Stu Johnson of the Kentucky Public Radio bureau in Frankfort. The new federal limits on calories and sodium are tighter, and the federal law will also keep vending machines shut down for a half-hour after school, Bartenfield told Johnson.

Kentucky picks up on federal Medicaid funding for inmates, which will expand when health reform takes full effect

Medicaid now covers care for inmates outside
prisons and jails, and health reform will extend
coverage to most former prisoners upon release.

By Molly Burchett
Kentucky Health News

Kentucky has missed out on millions of dollars from the federal government by not having it help pay for institutional health care of prison inmates outside prisons and jails. When the Affordable Care Act takes full effect Jan. 1, most Kentucky inmates will be eligible for expanded Medicaid coverage of hospitalizations and nursing-home stays, and the state is planning to have the feds pay almost all the cost. That should have benefits beyond saving state and local tax money.

Only a dozen states have taken advantage of the 16-year-old option to stick the federal government with 50 to 84 percent of such costs, and Kentucky is not among them, reports Christine Vestal of Stateline. The option stems from a 1997 ruling by the Department of Health and Human Services that Medicaid could cover care for Medicaid-eligible inmates who leave correctional facilities for at least 24 hours for treatment in qualified hospitals or nursing homes.

State and local governments have legal obligations to provide adequate health care to prisoners; those tapping the federal funds (Arkansas, California, Colorado, Delaware, Louisiana, Michigan, Mississippi, Nebraska, North Carolina, Oklahoma, Pennsylvania and Washington), and some scattered local governments use Medicaid to pay for hospital and nursing-home care for those prisoners qualifying for Medicaid, reports Vestal.

Kentucky has mostly been paying for such care out of the state's General Fund rather than utilizing its ability to spread the cost via Medicaid. For most states and localities, not bothering to seek Medicaid reimbursement for prisoners is an omission "that deprives them of millions of dollars in potential federal reimbursement," writes Vestal.

Fourteen years after the ruling, in September 2011, Kentucky's Cabinet for Health and Services began picking up on the deal, and Medicaid paid for the first hospital stay for a Kentucky prisoner. "Since then, improvements have been made in the processing and coordination with the State Department of Corrections," said Jill Midkiff, the cabinet's director of communications.

Expanded Medicaid makes most inmates eligible

Ever since the 1997 ruling, it has made fiscal sense to get inmates who needed outside medical attention enrolled in Medicaid, which has historically been used for inmates who are pregnant or disabled. Midkiff said Kentucky's program has mostly covered pregnant inmates.  “But in 2014 it really becomes a no-brainer,” Aaron Edwards, a legislative analyst in California who helped get the state’s program started, told Vestal.

That’s when the major elements of the Affordable Care Act take effect, and Medicaid expands in Kentucky to cover individuals at 138 percent of the poverty line -- now $15,856 for an individual or $32,499 for a family of four. Most prisoners will then qualify for Medicaid, said Midkiff. "As a result, all state prisoners requiring a hospital stay who meet requirements for Medicaid eligibility should be covered," she said.

The federal government will pay all the cost of newly eligible Medicaid patients from 2014 to 2017, when Kentucky will increasingly pick up part of the tab, rising to 10 percent by 2020. One of the big changes involves the process to enroll Medicaid eligible inmates, which wasn't standardized before, and the Kentucky Health Benefits Exchange will make that process easier.

The state has projected General Fund cost savings from Medicaid coverage of inmates at $7 million to $8.4 million a year. Local governments will save money, too; the cabinet says it is working to ensure Medicaid enrollment is part of a standardized processes for jails around the state. For county-specific data about Medicaid expansion, click here for information prepared by the cabinet, which includes information about the benefit for county jails.

Prisoners' enrollment in Medicaid impacts the community in other ways. The health law requires coverage of behavioral health services, such as substance-abuse treatment and mental-health services. Upon release from prison, most inmates will have Medicaid coverage and access to these services, and studies have shown that access to services like substance abuse and mental health treatment reduces an inmate’s chances for recidivism, reports Mary Flynn of the California Health Report.

Most prisoners don't have health insurance upon release from prison, and studies show they do not receive treatment for chronic conditions but use expensive emergency rooms instead of primary-care doctors. Now, most will be covered by Medicaid and will have access to preventive services, reports Michael Ollove of Stateline.

Rushed transition to managed care is cautionary tale for other states, especially those with large rural populations

Since Kentucky's abrupt change to a Medicaid managed-care system in 2011, problems have been widespread among patients and providers, highlighting the dangers for other states, and especially rural ones, about a rushed transition to this model without sufficient preparation or oversight. Such problems could spread as Kentucky and some other states expand Medicaid under Obamacare.

“The Kentucky case is a harbinger of what can happen when states don’t allow enough time and devote sufficient resources to strengthen the Medicaid agency’s oversight capacity and systems — or develop strong contracts and care-monitoring systems from scratch if they haven’t contracted with managed care plans before,” Debra Lipson, a senior researcher at Mathematica Policy Research, told Jenni Bergal of Kaiser Health News, writing for The Washington Post.

Kaden Stone and mother, Angelina Alcott (Photo by Julie Bergal)

Patients in Kentucky's managed-care system complain of being denied treatment or having to drive long distances to find doctor's within their plans network. That's especially true of people in rural areas, such as Darlene VanHoeve in southeastern Kentucky, Bergal writes. VanHoeve has a son who needs treatment for autism at a center an hour away, but managed-care firm WellCare of Kentucky wouldn't pay for these services despite a physician's order, saying the center wasn’t in its network. In Greensburg, 8-year-old Kaden Stone loves playing baseball and riding his bike, but as a result of congenital bowel problems that have required dozens of surgeries and procedures, he needs PediaSure, his mother told Bergal. Yet, managed-care firm Coventry Cares stopped paying for it last fall, saying it was not “medically necessary.”

Hospitals and doctors have continuously voiced complaints about denied or delayed payments from managed care companies. Kentucky health officials admit there have been problems related to the speedy switch to managed care in 2011, writes Bergal, but they insist that claims are now being paid promptly. They also insist that providers meet with managed-care companies to claim outstanding payments and that care quality has improved in the state.

Advocates for the mentally ill argue that the care system for them has deteriorated, saying plans have denied patients' long-standing prescriptions, forcing some community mental health centers to limit or cancel programs, says Bergal. “The whole thing has been a mess,” Sheila Schuster, executive director of the Kentucky Mental Health Coalition, told Bergal.

As Medicaid rolls expand, those already in the program could be shut out of some of the key preventive services included in the new health law, says a recent study published in Health Affairs.

States that have phased in managed care more slowly have been more successful, so Kentucky's story is a cautionary tale for other states. “It was a significant challenge,” Michael Murphy, chief executive of Aetna-owned Coventry Cares, told Bergal. “Obviously, we learned a few lessons in Kentucky.” Perhaps this tale will keep other states from having to learn lessons too.

Eye exams are now required for children ages 3 to 6 when first starting public school or preschool

Add eye exams to your back-to-school checklist, because state law now requires children aged 3 through 6 who are entering a public school or preschool program for the first time to have a vision exam.

“Studies show that vision problems are a major factor in limiting children’s abilities to learn and succeed,” said Dr. Tonia Batts, a Mayfield optometrist, said in a news release from the Kentucky Optometric Association. “Having children’s eyes examined is one of the most important things parents can do to support their children’s education and good health. . . . Many problems may not be obvious to them or their children’s teachers.”

Early diagnosis and treatment can prevent loss of sight from amblyopia, which most people call "lazy eye." Half of amblyopia cases are not diagnosed until after age 5, when it is difficult to correct, Batts said. Amblyopia the leading cause of vision loss in people under age 40, more than injuries or any other disease, but if detected early, is 100 percent treatable.

Batts said an eye examination is particularly important if your child loses place while reading; avoids close work; tends to rub his or her eyes; complains of frequent headaches; squints to use only one eye or consistently performs below academic potential.

Eye exams are covered by many private insurance plans, Medicaid and the Kentucky Children's Health Insurance Plan. Private programs may also help families with eye exam expenses. The Kentucky Vision Project, sponsored by the Kentucky Optometric Association, has donated millions of dollars in vision care, says the group's news release. Sight for Students and the Lions Club have other programs that can help. To find an optometrist in your area, click here.

LaRue County High School collaborates with university and nursing home to offer nurse-aide training course

Fifteen students at LaRue County High School have signed up for a new nurse's aide class offered in coordination with Campbellsville University and a local nursing home through which students will earn a nurse certification. The class is being subsidized by the county school district.

The school board agreed on June 17 to pay $300 per student.  Although students accepted into the program will be expected to cover the remaining $200 of the course fee, grants are available to help them, and upon completion of the course, students will receive a certificate stating that they have completed some medical training, says Denise Skaggs, instructional supervisor for the school system.

"The course is titled as an SRNA (State Registered Nurse Aide) program; where students will learn skills involving senior personal care, mobility assistance, checking vitals (i.e. heart rate, blood pressure etc.) and minor medical equipment use and care," says Rebecca Roscoe of the LaRue County Herald-News.

Classes will be coordinated by Campbellsville University and held at the Brockman Center in Hodgenville and at the Sunrise Manor nursing home, where the course's required 16 clinical hours will take place, reports Roscoe. The hands-on clinical experience will be a great benefit, Skaggs said.

The idea for the course came from a survey in which 45 students expressed interest in a nursing program due to their interest in pursuing a medical career, Roscoe reports. Administrators talked to Taylor County school officials, who have implemented a similar program, to gain insight about launching their own program.  Thirty students applied and 15 students have been accepted by a review committee.

“I’m glad to see us offer something specific for our students that will help them achieve success in their future career,” Skaggs told Roscoe. “I think the program is a great addition because it speaks to our community … and now that we know the services that are available for us we want to take advantage of programs offered to benefit and increase our students success.” The program serves as a model for other public high schools to do the same.