Just-released figures show uninsured by county, age, income

People in Logan, Magoffin, Casey, Todd, Menifee, Adair, Monroe, Edmonson and McCreary counties are more likely to lack health insurance than residents of other Kentucky counties, according to the data just released from the Bureau of the Census. And children are least likely to be insured in Todd, Monroe, Lyon, Edmonson, Webster, Hickman, Logan, Trigg, Woodford and Breckinridge counties.

Example of interactive mapping shows data for Logan County, highest in percentage of uninsured

According to the Census Bureau's Small Area Health Insurance Estimates , 22.3 percent of Logan County residents had no health insurance in 2011. Because of small sample sizes in the poll, the error margin for each county's figure is plus or minus 2 percentage points, approximately. The figures are for people under 65, who do not qualify for Medicare. Other counties with 20 percent or more uninsured, in descending order, are Magoffin, Casey, Todd, Menifee, Adair, Monroe, Edmonson, McCreary, Lewis, Metcalfe, Clinton, Breckinridge, Cumberland, Rowan, Gallatin, Butler, Robertson and Graves.

The maps are especially topical because enrollment in the state health-insurance exchange begins Oct. 1. An interactive tool allows users to map and rank counties by various factors. A little clicking reveals that Todd County, on the western border of Logan, probably has the highest percentage of children without health insurance, 10.3 percent, plus or minus 2.5 percentage points. To show county data, limit the geography to Kentucky and check the Show Counties box.

The data are from 2011, the latest year available. The figures can also be sliced by income levels: less than 138 percent of the federal poverty line, the new eligibility threshold for Medicaid in Kentucky and other states that have expanded it under the federal health-reform law; and less than 400 percent of the poverty line, the threshold for subsidies for insurance policies that the insurance exchange will offer.

In its colorful Kynect costume, Obamacare hits the streets in Kentucky and attracts national news coverage

By Molly Burchett
Kentucky Health News

When the Patient Protection and Affordable Care Act takes effect Jan. 1, many Kentuckians may have signed up for the health coverage it mandates without ever associating it with its political label, Obamacare.

This could be a planned marketing strategy or just the result of the state's effort to provide health care coverage to uninsured Kentuckians, but there's no need to anxiously await for Obamacare's arrival in Kentucky; the state's part of the health-reform law has hit the airwaves with a commercial, and the streets with tote bags and flyers in hand. And national news coverage has followed.

Huffington Post’s Jason Cherkis spent a day at the Kentucky State Fair and the next day in Laurel County with workers from Kynect, the state’s online health-insurance marketplace, and while learning much about the Kynect outreach efforts, he reports little about Obamacare. That's because it's not being called Obamacare, a label Republicans devised and the White House eventually accepted.

At the reform law's core is the implementation of health-insurance exchanges and subsidies in each state, which is provided through Kynect in Kentucky, "but little or none of these operations will have the words 'Affordable Care Act,' much less 'Obamacare,' attached to them," writes Jonathan Bernstein of The American Prospect. 

The Kynect website, where Kentuckians can go to sign up for insurance coverage and determine their eligibility for it, doesn't mention the federal government, reports Kevin Drum of Mother Jones in an article titled "Here's Hoping That Obamacare Is Better Than That Appalling Obamacare."

The state site describes the long-awaited (for some) and highly controversial (for more) law: without referring to it directly: "Starting next year, most Americans will be required to have health insurance. By using Kynect, you may receive payment assistance, special discounts or tax credits to help cover the costs of coverage for you, your family or your employees,"it says.

Most Kentuckians probably don't know that the insurance exchange exists, let alone that the exchanges are part of Obamacare. In an August Kaiser Family Foundation health reform poll, only 22 percent of respondents nationwide said they’ve heard “a lot” or “some” about the state-by-state exchanges, which are set to begin selling policies and signing up people for expanded Medicaid on Oct. 1.

Half of those polled (51 percent) said they didn’t know enough about Obamacare to understand how it will affect them and their family, and the number was even higher (62 percent) among the uninsured, the reform law's target population.

The uninsured and newly eligible Medicaid recipients, an estimated 600,000 Kentuckians, are also the target of Kynect's outreach efforts, although they may not be the ones receiving the tote bags at fairs and community events.

Furthermore, the Kaiser survey results show a vast majority of Americans don't know that the health law is actually a law; about 44 percent said they were “unaware” of the current status of the law, with 31 percent of that number  (14 percent of the total) saying they simply didn’t know if the Affordable Care Act was law or not.

This all suggests the possibility that, even as people start signing up for Obamacare in a few weeks, public opinion about the health law won't change, writes Sarah Kliff of The Washington Post. Thus, while public opinion of Obamacare leans to the negative, that may not keep some of its ostensible opponents from becoming users of it.

Kliff writes that the following three paragraphs written by Cherkis say everything you need to know about Obamacare:

Reina Diaz-Dempsey

A middle-aged man in a red golf shirt shuffles up to a small folding table with gold trim, in a booth adorned with a flotilla of helium balloons, where government workers at the Kentucky State Fair are hawking the virtues of Kynect, the state’s health benefit exchange established by Obamacare.
The man is impressed. “This beats Obamacare I hope,” he mutters to one of the workers.
“Do I burst his bubble?” wonders Reina Diaz-Dempsey, overseeing the operation. She doesn’t. If he signs up, it’s a win-win, whether he knows he’s been ensnared by Obamacare or not.

With millions of dollars from the federal government, the state conducted "market research that included holding a dozen focus groups in Louisville, Paducah and London, according to Gwenda Bond, assistant communications director with the Cabinet for Health and Family Services," Cherkis reports. The tote bags are popular, but Diaz-Dempsey doesn't hand one over until the would-be recipient hears her simple pitch, which does mention the law, but without its political label:
We are Kynect -- part of the new health care law.
Do you know anyone who doesn’t have health insurance?
You may qualify for Medicaid or a tax credit based on your income.

"The crush of people don't greet Diaz-Dempsey with tea party dogma or amateur constitutional scholarship," Cherkins writes. "No one is there to complain about the individual mandate or heckle about death panels. They have questions. They wonder if they could get coverage despite having a pre-existing medical condition, how much it will cost them. . . . Could they just enroll their child? They talk about their sons and daughters, neighbors going without health care, and ask about the subsidies. The vast majority are relieved to learn about the health exchange."

Erin Hoben

But the next day in London, in a heavily Republican area, Cherkis encountered many skeptics and outright opponents of Obamacare. He reports that Erin Hoben, an outreach worker with Kentucky Voices for Health, an association of pro-Obamacare groups, told him that a Hazard woman she had been working with "called her recently to tell her that the Tea Party had urged her not to enroll because the exchange wasn’t happening."

Democratic Gov. Steve Beshear, who expanded Medicaid and defended Obamacare in a speech to the fair's Kentucky Farm Bureau Country Ham Breakfast, told Cherkis, “Most people don’t really understand it yet. I do not find that most people have any kind of negative feeling about it. It’s just that most people don’t quite understand the act or what they’re supposed to do yet.”

But the feds like what Kentucky is doing, and the state's only Democratic congressman, John Yarmuth of Louisville, told Cherkis: “I know that the administration believes that Kentucky and Vermont are the two best exchanges that were created, that are models for the country. They’ve said that numerous times to the Democratic caucus.” (Read more)

So, as the Kynect website says, "It’s a new day for health-care coverage in Kentucky. Thanks to Kynect, the power to manage your own care is finally in your hands," regardless if you know it or not.

Click here to view a Kynect factsheet to learn more about the health-insurance exchange.

Kentucky nursing homes rank 40th in the nation in new survey; reformers ask governor to create special task force for action

Kentucky got a D grade and a rank of 40th among the states in a new national survey of nursing-home care, and reform advocates are calling on Gov. Steve Beshear and other policymakers to take corrective action.

The state ranks lowest in the Southeast, the lowest ranked region, in nursing home care quality; one in five Kentucky nursing homes were cited as having a severe deficiency, "indicating widespread abuse, neglect and mistreatment of residents," says the report of the survey, created by a Florida-based advocacy group Families for Better Care.

"The results of this first-ever survey sadly represent real people, human beings being abused and neglected every day," writes Bernie Vonderheide, president of the Kentuckians for Nursing Home Reform, the lobby that spearheaded the call for action. A representative of the Kentucky Association of Healthcare Facilities, the lobby for for-profit nursing homes in the state, was unavailable for comment.

The survey analyzed eight federal measures gauging nursing home care, and the state's nursing homes scored below average in five of the eight categories. For example, only a third of Kentucky facilities reported health inspections above average. Click here for more information or to see survey results.

In the letter to the governor, Vonderheide requested the creation of a special task force to address the issues, which they say affect thousands of Kentuckians, many who cannot speak up for themselves: "It’s time to stop this growing crisis in our state before it gets so big that we cannot manage it."

Donor who helped Monroe schools take over, expand wellness center pledges more for improvements, upkeep, scholarships

The Monroe County Schools are getting a $1 million-plus donation for a family wellness center and scholarships for graduates of the county's only high school from businessman George Eagle Bushong of Bradenton, Fla., who grew up in a prominent Monroe County family.

George Bushong and daughter Isabelle

School Supt. Lewis Darrell Carter told Shelley Smith of the Glasgow Daily Times that Bushong had mentioned his intent to donate $50,000 a year for 10 years for the  Monroe County Family Wellness Center, and surprised him two weeks ago by adding an extra $55,000 for the next decade for various scholarships.

The schools took ownership in November 2011 of the center, "which was built on property owned by the school district," Smith reports. "Since then, Carter said the wellness center membership has gone up from 340 members to 1,200." The annual donations will pay for an indoor digital golf machine, a swimming scoreboard and maintenance of the George and Isabelle Bushong Foundation Aquatic Center, which Bushing helped build to hold swim meets and was named for his daughter.

Asst. Supt. Amy Thompson told Smith the wellness center is heavily used by student athletes for training, physical education classes and afterschool fitness classes. “It gives the kids something to do to include fitness in their lives,” she said. " Carter said he’s even seen families meet at the wellness center to work out together," Smith reports. "He said the funding to help support this facility will be great service to community. . . . To pay homage to Bushong’s generous donations, Carter said they will change the name of the wellness center to the George and Isabelle Bushong Foundation Monroe County Family Wellness Center."

Some parents complain about healthier school lunches, but USDA says it's on course to improve public health

A few school districts in other states are opting out of a federal-funded school lunch program that was touted by first lady Michelle Obama to provide healthier options to students, and some parents in Harlan County are complaining about the new menus. But the U.S. Department of Agriculture, which runs the National School Lunch Program, says the naysayers are in a small minority and the healthier fare will become more popular and improve public health.

That is backed up in a study forUSDA's Economic Research Service of 2005, showing that "Students in schools that offered greater quantities of fruits and vegetables consumed more of these foods by most measures." During the 2012-13 school year the lunch program increased servings of fruits, vegetables, whole grains and fat-free or low-fat milk, while setting standards for calorie content and reducing intakes of sodium and trans fat. Students are allowed to eat as much fruit and vegetables as they want. The full report can be read here. (USDA graphic)

Districts from Kentucky to Illinois to New York have complained that students aren't interested in the healthier foods, leading students to buy fewer school meals, which costs the school districts who rely on federal reimbursements. But the number of districts opting out could be minimal. The School Nutrition Association "found that 1 percent of 521 district nutrition directors surveyed over the summer planned to drop out of the program in the 2013-14 school year and about 3 percent were considering the move," Carolyn Thompson reports for The Associated Press. There were 31 million students in the program in 2011.

So many students and parents have complained in Harlan County that the school board held a special meeting to address the issues, Mark Bell reports for the Harlan Daily Enterprise. "Complaints ranged from not being fed enough to food received not being good enough. While fruits and vegetables are offered freely and students can take their fill of those, meats and carbohydrates will continue to be served in limited portions only, so students complain of not getting enough food."

In Spencer County, there were no complaints about the food, just a price increase of 10 cents for lunches, to $2.30 ($2.45 at the high school) that school officials attributed to the 2010 federal law. District Director of Operations and Transportation Brett Beaverson wrote in a school-board agenda item, "The logic behind the mandated increase is to eventually equal the difference between the reimbursement rate ($2.86) and the full-pay lunch price." Malloy Bilger reports for the Magnet, "Beaverson said failing to pass the increase would make it appear that the federal government was subsidizing full-pay lunches." (Read more)

Overall, schools are getting healthier, according to a report released Monday by the Centers for Disease Control and Prevention. Since 2006, "the percentage of districts that required schools to prohibit offering junk food in vending machines increased from 29.8 percent to 43.4 percent . . . and the percentage of districts with food procurement contracts that addressed nutritional standards for foods that can be purchased separately from the school breakfast or lunch increased from 55.1 percent to 73.5 percent." states the CDC. "Between 2000 and 2012, the percentage of districts that made information available to families on the nutrition and caloric content of foods available to students increased from 35.3 percent to 52.7 percent." (Read more)

Obamacare hearing highlights employers' worry and uncertainty; Yarmuth says repeal and defunding bids block needed changes

Three of Kentucky's congressmen agreement at a field hearing in Lexington Tuesday that the Patient Protection and Affordable Care Act needs changing, but had no a consensus on how it should be fixed.


From left, U.S. Reps. John Yarmuth, D-3rd District; Andy Barr, R-6th District; and Brett
Guthrie, R-2nd District, listen to Rep. Phil Roe, R-Tennessee, who chaired the hearing.

Business leaders at the hearing also called for a fix, saying the law creates challenges for employees, workers and the economy.

Republican Reps. Brett Guthrie of Bowling Green and Andy Barr of Lexington said the law should be repealed. Democratic Congressman John Yarmuth of Louisville said efforts to change the law are hindered by efforts to repeal or defund it, reports Ryan Alessi of cn|2's "Pure Politics."

Yarmuth supports changes to the law's definition of a full-time employee as one that averages 30 hours of work a week, which he says has led to unintended consequences. Many of the 130 hearing attendees also expressed concern about the 30-hour employees, Alessi reports.

The law includes a mandate that companies 50 or more full-time employees must provide those workers with health insurance or pay a $2,000 penalty per employee. Although this mandate has been delayed a year by the Obama administration, the employee mandate and complex regulations of the law has created "massive uncertainty" for U.S. employers, said Barr.

Several business owners complained about the looming mandate and uncertainty as well as the harmful financial consequences of Obamacare at the hearing, which was held by the U.S. House's Subcommittee on Health, Employment, Labor and Pension. Six of the eight speakers were Republicans expressing opposition to the law.

"What we know is what the administration is now admitting — that this massive piece of legislation is unworkable,” said Barr, who also said that the law should be permanently delayed, reports Alessi.

A majority of Americans (57 percent) disapprove of "defunding" Obamacare as a way to stop the law from being implemented, says an August poll from the Kaiser Family Foundation.  Almost 70 percent of respondents said defunding would be "using the budget process to stop a law is not the way our government should work."

Long-time Lexington restaurant owner Joe Bologna said he is concerned that Obamacare will impact people's ability to eat out.  To prepare for this and rising health costs faced by the business, he has reduced his staff from 54 to 47 and is closed on Mondays, reports Jack Brammer of the Lexington Herald-Leader. Other business people shared similar stories about the law's negative consequences.

On the other hand, Carrie Banahan, executive director of the Kentucky Health Benefits Exchange, the state's online insurance marketplace, said the law will improve Kentucky's health. There were many supporters of the law at the hearing, and some even hissed at critics of the law, reports Alessi.

“If we could get a bipartisan agreement to actually work on tweaks legislatively, I think we could dramatically improve the law and eliminate a lot of uncertainty,” said Yarmuth. Click here to read more about testimonies form the hearing or to watch cn|2 videos.

Kentucky expands list of permanent locations for safe disposal of unneeded or expired prescription medications

Gov. Steve Beshear announced today that Kentucky now has 149 permanent prescription drug disposal locations in 97 counties where Kentuckians can safely dispose of unused or expired medications in order to help curb the state's prescription drug abuse problem.

“The effects of prescription drug abuse are devastating to our families and our communities,” Beshear said in a news release. “Medications, once they are no longer needed for their prescribed purposes, should be disposed of properly to reduce their risk of being diverted and abused . . . "

Counties with permanent disposal boxes are shown on the map below in green. The boxes are monitored to ensure safe drug disposal and are located in law enforcement buildings. There are two pending locations, one in Ohio County and one in Franklin County, as shown in light blue. The 23 counties in white do not have permanent disposal locations.

“One in five of our Kentucky teens has abused prescription medication for an off-label purpose, and that abuse is starting in the home when children have access to their parents’ unused or expired pain medications,” Attorney General Jack Conway said in the news release.

The disposal boxes are funded by Kentucky Agency for Substance Abuse Policy, Operation Unite, Kentucky League of Cities and state and local law enforcement agencies, says the release.  Click here for a complete listing of locations and hours of operation.

State insurance exchange call center gets 422 calls in first week; Herald-Leader story lists common questions and answers

http://www.kentucky.com/2013/08/22/2780783/ky-call-center-shares-answers.html

UK, with magnet of National Cancer Institute designation, attracts 4 researchers and their $17 million in funding from U of L

"A month after the University of Kentucky announced it is home to the state’s first National Cancer Institute-designated cancer center, an internationally recognized research team studying the role metabolism plays in cancer is leaving the University of Louisville for its chief in-state rival," Laura Ungar reports for The Courier-Journal. "The four researchers . . . will bring with them more than $17 million in federal funding over five years."

UK officials told Ungar they didn't recruit the researchers, and a U of L official said the school made "a significant counter-offer." But one of the researchers told Ungar that UK offered new equipment, new laboratory space and an opportunity to work with a wider group of collaborators.

"One area the scientists have been researching is lung cancer, which strikes and kills Kentuckians at the nation’s highest rate," Ungar writes. "Their work includes a newly funded project from the National Cancer Institute on biochemistry in lung cancer." (Read more)

National magazine looks at drug companies' efforts to stop anti-methamphetamine bills, especially in Kentucky

In a strong piece of investigative reporting for Mother Jones magazine, largely about Kentucky, freelancer Jonah Engle delves into the history of how making methamphetamine became a simple task via over-the-counter cold medications, and how drug makers have warded off most state laws intended to make the decongestant pseudoephedrine more difficult to purchase. (Photo by Stacy Kranitz: Cleaning up a meth lab found on school property in London.)

Engle's well-rounded story examines the issue from the viewpoints of politics, law enforcement, drug users and the effects of their habits on their children, while looking at how small-town life -- especially in Kentucky, where meth-related cleanup and law enforcement cost the state $30 million in 2009 -- has been hit hard by the drug. When a bill in 2011 to require a prescription for pseudoephedrine, a Washington-based group representing the makers and distributors of over-the-counter medicines and dietary supplements, reportedly spent more than $303,000 in three weeks, with most of the money spent on "robocalls," or automated telephone messages. The bill failed, but in 2012 the legislature passed a law with a tighter limit on the amount of pseudoephedrine anyone can buy in a month, after a strong radio advertising campaign by the Consumer Healthcare Products Association. The drug is kept behind counters so purchases can be tracked but does not require a prescription.

Engle tells a tragic story of meth in many states, ever since 2007, when the process called "shake-and-bake" or "one-pot" method, became commonplace. "The number of clandestine meth sites discovered by police has increased 63 percent nationwide," Engel writes. "As law enforcement agencies scramble to clean up and dispose of toxic labs, prosecute cooks, and find foster homes for their children, they are waging two battles: one against destitute, strung-out addicts, the other against some of the world's wealthiest and most politically connected drug manufacturers. In the past several years, lawmakers in 25 states have sought to make pseudoephedrine—the one irreplaceable ingredient in a shake-and-bake lab—a prescription drug. In all but two—Oregon and Mississippi—they have failed as the industry has deployed all-star lobbying teams and campaign-trail tactics such as robocalls and advertising blitzes."

In Oregon, the number of meth labs found by police dropped 96 percent since the bill was passed, while in Mississippi the number dropped 74 percent, Engle writes. "Children are no longer being pulled from homes with meth labs, and police officers have been freed up to pursue leads instead of cleaning up labs and chasing smurfers. In 2008, Oregon experienced the largest drop in violent-crime rates in the country. By 2009, property crime rates fell to their lowest in 43 years. That year, overall crime in Oregon reached a 40-year low. The state's Criminal Justice Commission credited the pseudoephedrine prescription bill, along with declining meth use, as key factors."

"Everywhere else, industry has prevailed," Engle reports. "Many states have very limited laws on what lobbyists must report, and they don't monitor spending on robocalls or ads. But news reports and my interviews with legislators in Southeastern and Midwestern states where meth labs are most concentrated—and where CHPA had the biggest fight on its hands—show that the pharmaceutical industry deployed a mix of robocalls, print and radio ads, as well as a Facebook page and a website, stopmethnotmeds.com. These states include Alabama, Kansas, Missouri, North Carolina, Oklahoma, and Tennessee." (Read more)

Laurel True, longtime advocate for health, education and human services, dies suddenly at 80

Laurel W. True, who continued his public service for health and other causes long after leaving state government, died suddenly Saturday at his home near Waddy in Shelby County. He was 80.

"For the past five decades, Mr. True worked tirelessly to improve the health and welfare of Kentuckians," The Courier-Journal said in an editorial. In the 1970s True was the first secretary of the old Cabinet for Human Resources and executive director of Kentucky Health Systems Agency-West, a state health-planning organization, and was an assistant superintendent of public instruction. Earlier, he helped start Medicaid in Kentucky and the conversion of United Mine Workers hospitals into Appalachian Regional Hospitals.

In retirement he continued as an advocate for health, education and human services as a member of the National Policy Council of AARP, vice chairman of the board of Seven Counties Services, secretary of Kentucky Voices for Health, a member of the Friedell Committee for Health System Transformation and as a trustee of Georgetown College, his alma mater. Under the aegis of the Freidell Committee in 2009, True conducted a study of the Kentucky Children's Health Insurance Program in Anderson County, which helped lead to policy changes designed to ease and encourage enrollment in KCHIP.

“He was a wonderful champion all of his life,” Sheila Schuster, a longtime mental health advocate, told The Courier-Journal. “He was never boastful or self-serving.”

Visitation will be from 3 to 8 p.m. Tuesday and 9 to 10 a.m. Wednesday at Immanuel Baptist Church in Frankfort, where True was a deacon and Sunday School teacher. The funeral will follow at 10 a.m., with internment in Frankfort Cemetery and arrangements by LeCompte-Johnson-Taylor Funeral Home. Donations are suggested to the Infant Resource Center at Immanuel Baptist Church, 1075 Collins Lane, Frankfort KY 40601. (Read more)

Agreement will move at least 600 from personal-care homes to community mental health facilities

At least 600 people now in personal-care homes will be moved to community-based settings under "an agreement that advocates say will systematically change the way community mental health services are delivered in Kentucky, improving the lives of hundreds of people with mental illnesses and disabilities," Beth Musgrave reports for the Lexington Herald-Leader.

Stories by the Herald-Leader and investigations by Protection and Advocacy, a state agency for the disabled and mentally ill, "found that personal care homes often are an ill-equipped last resort for people with complex problems such as substance abuse, mental illness or a mental disability," Musgrave writes. "Past problems at personal care homes have included criminal arrests of operators for stealing money from residents, lack of food, poor medical care and deaths" when residents walked away from homes in Letcher and Pendleton counties.

The state Cabinet for Health and Family Services estimates that the changes will cost $19 million over the next three years, and it said the money would come from the budget for housing people in mental hospitals. "Under the agreement, people can use their state supplement of $520 a month for services that will keep them out of a personal care home. Under the current system, a person can receive the supplement only if they live in a personal care home," Musgrave writes. "That change will affect anyone who is eligible for personal care home services, not just the 600 people who will get additional services under the agreement." The cabinet will have until October 2014 to move the first 100 personal-care-home residents. (Read more)

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Read more here: http://www.kentucky.com/2013/08/16/2769986/kentucky-agrees-to-offer-more.html#storylink=cpy