As meds-for-meth bill dies, backer asks colleagues to find solution

The bill that would have required prescriptions for three popular decongestants used to make methamphetamine "was buried today, but not without a eulogy and a promise to resurrect it," Renee Shaw reported for Kentucky Educational Television.

KET's coverage was highlighted by parts of a floor speech from the bill's sponsor, Sen. Tom Jensen, R-London, who challenged his colleagues to come up with a solution to the meds-for-meth problem. "We're waiting for something very terrible to happen by not acting on this," he said. Holding out the prospects of wrecks, fires, explosions and other accidents meth makers could cause, he warned, "A tragedy's gonna happen here and then we're all really gonna feel bad."

Shaw noted that lobbies opposing the bill had creating "polarizing publicity" with radio and full-page newspaper advertising. A Senate committee approved the bill on a bipartisan 6-4 vote early last month but the measure never attracted enough support to gain a vote in the full Senate.

"If my solution is not the answer, figure out a way," Jensen pleaded. In another floor speech, Sen. Joey Pendleton, D-Hopkinsville, thanked Jensen for his work and said, "We have a tremendous problem here . . . I'm like him. Tell us what we need to do."

Three Florida women put pressure on Sunshine State's "pill mills," legislators, governor

As Kentucky officials ask Florida legislators to crack down on pill mills, three Florida women have started a grassroots effort to spread awareness about the problem. Nurse Renee Doyle, respiratory therapist Joy Saghy and nurse Janet Colbert, all of whom have experienced the effects of prescription-drug addiction first-hand, have formed STOPP Now — Stop the Organized Pill Pushers Now, The Miami Herald's Audra D.S. Burch reports.

To spread awareness, Saghy, Colbert and Doyle host rallies at pain clinics. Their goal is to have oxycodone banned, except when treating advanced cancer, and to support the establishment of a tracking database. About 50 people generally show up at the rallies. Next week, they will go to Tallahassee to meet with senators about the issue. "We will tell them that these pills are destroying our community," Colbert said.

In February, Attorney General Pam Bondi introduced proposals that would cut down on the problem, one of which would be to establish a database that tracks prescription sales. But Florida Gov. Rick Scott is firmly against such a database, saying it is costly and infringes on privacy.

Each day, about seven people die by overdosing on prescription pills, Burch reports. In the first half of 2010, Florida doctors prescribed nine times more oxycodone than the rest of the entire country.

While the problem is reportedly great in Florida, the drugs find their way to Kentucky, through traffickers who travel to Florida to "doctor shop" to gain prescriptions for pain medications at each stop. They then return to Kentucky, which does have a tracking database, to sell the pills they're collected. (Read more)

UK loses branding for high-quality nursing care

The University of Kentucky hospital has lost magnet status, a designation given to facilities that offer high-quality nursing care, the Lexington Herald-Leader's Mary Meehan reports.

The recent review says UK, which advertised the designation by flying its flag (H-L photo by Charles Bertram), did not have a "structure for supporting a culture of patient safety." Nurses did not meet the grade when it came to "friendliness/courtesy," "promptness/response to call," and "attention to special/personal needs." Their attitudes toward requests also were apparently lacking.

Dr. Richard Lofgren, chief clinical officer for UKHealthcare, downplayed the loss. "It is a recognition from a professional society," he said. "You can get recognition from a whole lot of professional societies." But other hospital officials say "the designation means so much to them that they make meeting the expensive and time-consuming application process part of the job responsibilities of employees," Meehan reports.

Kentucky facilities that have magnet status include: Baptist East Hospital in Louisville; Central Baptist Hospital in Lexington; Frankfort Regional Medical Center in Frankfort; Kosair Children's Hospital in Louisville; and St. Elizabeth Healthcare in Northern Kentucky.

Kentucky's state health plan receives $30 million from federal health reform to offset costs of covering early retirees

Kentucky's state employee health plan received nearly $30 million from a federal program established under the new health care law meant to help pay for early retiree benefits. Nationwide, $535 million in health benefit costs have been reimbursed through the Early Retiree Reinsurance Program, says a press release from Health and Human Secretary Kathleen Sebelius.

The program was set up to keep employee-sponsored health plans "providing coverage to retirees who are 55 or older but not yet eligible for Medicare," The Courier-Journal's Patrick Howington reports. Most employers have stopped doing so. In 1988, two of three employers provided health coverage to their retirees. In 2009, only one in three did. The funds will help keep premium increases from rising too sharply, Kentucky Personnel Secretary Tim Longmeyer said.

Kentucky's state plan includes about 45,000 retirees and some spouses or dependents. Only state plans in California, New Jersey and Georgia received more funds. Two undisclosed Kentucky health plans received about $123,000 in funding. More than 30 Kentucky health-plan sponsors have been approved to participate. Sponsors can "only apply to recoup claims for retirees whose health costs exceed $15,000," Howington reports. (Read more)

States can't reveal drug costs because federal law makes them secret; Montana governor blames drug lobby, Ky. contractor

When Montana journalists asked Gov. Brian Schweitzer to reveal the prices the state pays for drugs in government health care programs, he said he wanted to tell them, but had to refuse because federal law keeps the information secret because Congress is "bought and paid for" by drug manufacturers. "Congress has created a system so that even the states, which buy tens of millions of dollars worth of these drugs, have no idea what we pay on a per-unit basis," said Schweitzer, a conservative Democrat with a maverick streak.

"Actually, Schweitzer does know what the state pays — but, before acquiring the information last summer, had to have his chief counsel sign a written agreement not to disclose it publicly," Mike Dennison of the Billings Gazette reports. "Schweitzer said the drug industry wants to keep secret the rebates it gives to states buying drugs for public programs, because it doesn't want regular retail customers to know how much more they're paying for drugs."

Schweitzer obtained the information last summer when he was trying to compare what the federal-state Medicaid program for the poor and disabled was paying for drugs compared to the cost in Canada. Montana news outlets argued that the state open-records law requires him to release "documents in his possession that list public money paid out or received by the state," Dennison reports. But the governor's chief legal counsel "said federal law bars disclosure of the information requested by the news organizations, and that federal law pre-empts Montana's open-records laws."

Also, "Magellan Medicaid Services, the Virginia-based contractor that negotiates additional drug rebates for the state Medicaid program, also claimed that the rebate information is a trade secret protected from public disclosure," Dennison reports. MMS, which works for several states including Kentucky, said revealing the information would hamper its ability to compete with other companies doing the work." It seems to us that if all such information from all states were released, that wouldn't be a problem.

Almost all nursing homes have employees with criminal past, estimated 5% of employees; background-check bill seems dead

A new federal report says 92 percent of nursing homes employ someone with a criminal record. Most states require such facilities to check the backgrounds of applicants for employment, but the standards vary and some, such as Kentucky, do not check the backgrounds of those not involved in patient care, and a bill to extend that to them appears dead in the General Assembly.

"About 5 percent of nursing home workers—or one out of every 20—had at least one conviction, according to the report, which took a random sample of 260 nursing homes certified by Medicare and ran FBI background checks on their workers," reports Marian Wang of ProPublica, the nonprofit investigative news agency.

“The current system of background checks is haphazard, inconsistent and full of gaping holes in many states,” Sen. Herb Kohl, D-Wis., chairman of the Senate Aging Committee, told The New York Times. “Predators can easily evade detection during the hiring process, securing jobs that allow them to assault, abuse and steal from defenseless elders.” The lack of national standards allows people convicted in one state to work in another—a more significant factor in states like Kentucky, which border several other states and have population centers on the borders.

Judge issues permanent injunction barring Medi-Share, a Christian health-coverage plan, from operating in Kentucky

After a legal battle that lasted almost nine years, the Christian health-coverage plan Medi-Share will be prohibited from operating in Kentucky, Franklin Circuit Judge Thomas Wingate decided today.

The state Department of Insurance and the Office of the Attorney General first sued Medi-Share in June 2002, saying the group was an unauthorized insurer. The Florida-based group claimed it was a "sharing program," and so exempt from state regulation. In August 2010, the Kentucky Supreme Court ruled Medi-Share was insurance and "was not exempt from state regulation under the religious publication statute," says a press release from the Public Protection Cabinet.

"Medi-Share members affirm a statement of Christian beliefs and pledge to follow a code that includes no tobacco or illegal drugs, no sex outside of marriage, and no abuse of alcohol or legal medications. Every month, they pay a fixed 'share' to cover the medical expenses of members in need. The cost usually is less than private insurance, but it’s not tax deductible. Members use a network of medical providers," Ricardo Alonso-Zaldivar of The Associated Press reports.

Wingate signed a permanent injunction against Medi-Share, prohibiting the group and any successor program from operating in the state unless it obtains appropriate documentation or actually qualifies as a "sharing program." Medi-Share members in Kentucky should immediately try to find health insurance elsewhere.

Board for nursing-home administrators wants a law to let it issue secret admonitions; bill is in jeopardy

A bill that was introduced late and got a fast start, but has hit speed bumps and maybe a roadblock, would allow the Kentucky Board of Licensure for Nursing Home Administrators to admonish them in secret without the action being "considered a disciplinary action against the licensee."

The chairman of the board committee that recommended the bill said the alternative already exists, though not in law, and "would only be used for situations that were not serious enough to warrant action against an administrator's license," reports Valarie Honeycutt Spears of the Lexington Herald-Leader.

House Bill 414, which would make several other changes, was introduced Feb. 9 by Rep. Tom Burch, D-Louisville. On Feb. 14, he posted the bill for consideration by the Health and Welfare Committee, which he chairs, and got the House to waive the rule that bills be posted for three days before being considered. The next day, the committee approved the bill 14-0 and put it on the consent calendar, which is used to pass non-controverial bills without debate. It was posted for passage Feb. 18, but was removed from the consent calendar that day and has languished on the regular calendar since.

On. Feb. 22, Rep. Tim Moore, R-Elizabethtown, filed an amendment to the bill that could doom it. His is one of several measures that would require abortion clinics to give women face-to-face counseling and offer them an opportunity to see an ultrasound image of their unborn child. Because of that, "Burch said this week he did not think the bill would continue to move," Sepears reports. However, the contents of the bill could be revived as an amendment to another one.

Spears, who has done much reporting about problems in nursing homes, notes that the board minutes from Februrary 2010 referred to 29 complaints, one was from 2006 and the rest were from 2007 through 2010. Among the cases was a nursing home administrator who did not contact authorities when aides abused a resident, an administrator criminally charged with stealing prescription drugs and an administrator sentenced to 10 years in prison for theft and exploiting an adult. The bill does not specify what kind of infractions would result in private criticisms." (Read more)

Kentucky is 'ground zero' in the war on drugs, Rogers says

A Kentucky congressman called "ground zero" in the war against drugs Wednesday as officials gathered in London for the regional meeting of the UNITE Coalition. In attendance was director of the White House Office of National Drug Control Policy, Gil Kerlikowke, right, who has been touring the state to investigate prescription drug abuse.

U.S. Rep. Harold "Hal" Rogers, R-5th District, was the keynote speaker, The Sentinel-Echo's Nita Johnson reports. "Our back yards have been become battlegrounds," Rogers said. "Just last week, five pharmacies in the area were robbed. Our overdose rate is twice as high as the rest of the country."

Rogers, left, repeated expressed his dismay over Florida Gov. Rick Scott's proposal to cancel his state's prescription-drug monitoring program, which has yet to really start. The lack of a monitoring system allows drug dealers to "doctor shop," obtaining prescriptions for drugs they sell in Kentucky. "There are drive-through pain clinics in Florida and 98 percent of the top 100 pain killers is oxycodone," Rogers said. "Last year, Florida alone issued 19 million units of oxycodone. This is an urgent crisis for the people I represent."

Rogers credited UNITE coalitions for fighting against the problem. "Adversity is being harnessed into hope," he said. "UNITE is reshaping future generations."

At a roundtable discussion before the gathering, Kerlikowske spoke of his goals. "I'm here to listen," he said. "The drug problem really impacts so much of our country ... It cuts across all of the social lines, all of the racial lines." (Read more)

Meds-for-meth bill backer has last-ditch change to exempt liquids and gelcaps, which police expert calls inefficient feedstocks

Jensen

Hoping to gain the few votes he needs, the sponsor of the bill that would require prescriptions for three popular decongestants said today that he will draft an amendment to exclude liquids and gelatin capsules from the bill, but doubts it will push the measure into law.

"I'm having one drafted to see if it would make a difference" to senators who might be wavering, said Sen. Tom Jensen, R-London. "But even if it passes in the Senate, the likelihood of it passing in the House before the end of the session would be very low. We're running very short on time." Only nine days remain in the session, and two of those are supposed to be reserved for consideration of any vetoes by the governor.

Senate Bill 45 would make pseudoephedrine, a key component in methamphetamine, available only by prescription. It would also apply to two other decongestants used in many cold medicines. A Senate committee approved the bill weeks ago but the full Senate has not voted on it because it lacks the votes to pass. Jensen said he thinks he is about two votes short.

Pseudoephedrine is more difficult to extract in gel or liquid forms, and less efficient in meth making, says Sgt. Stanley Salyards of the Louisville Metro Police and supervisor of its Clandestine Lab Team. "We've never seen a meth lab in Kentucky use gel caps or liquids," he said, "And it's much harder to do. I think it would definitely be worth it to get this bill passed."

The drug industry, which is still running a heavy advertising campaign against the bill, opposed the compromise when it was suggested several days ago. A spokeswoman for the Consumer Healthcare Products Association, citing information from the U.S. Drug Enforcement Administration, said pseudoephedrine is still easily extractible from gelcaps or liquids.

Salyards said the chemical can be extracted from liquids and gelcaps, but "You lose almost 60 percent of the pseudoephedrine when you're extracting it," and half the remainder is lost when the actual lab is cooking off. "It takes a heck of a lot more," he said. "Right now, you can dump [pills] in there and you're good to go."

He acknowledged that meth makers could adapt to the use of liquids and gelcaps, but "If it becomes a problem, we go back and deal with it then."

Beshear signs first bill of session; optometrists will benefit

Gov. Steve Beshear has signed legislation that will significantly increase the scope of care optometrists can provide, making it the first bill to become law in this session of the General Assembly.

"Access to quality health care is a critical issue for families across the commonwealth," he said in a press release. "After careful consideration, along with meetings with many interested parties, today I signed Senate Bill 110 to give Kentuckians greater access to necessary eye care."

The bill made an unusually speedy passage through the General Assembly after being filed Feb. 7. The Courier-Journal reported earlier this month optometrists have given a total of $400,000 in campaign contributions to legislators, the only exception being one who is a physician. Beshear's re-election campaign has also received optometrists' money.

The law will allow 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 opthalmologists can. The law also allows optometrists to prescribe certain drugs and lets the state Board of Optometric Examiners define what procedures optometrists can legally perform.

"In order to ensure the highest degree of oversight, I will be meeting with the Board of Optometric Examiners to make sure that providers of these services undergo extensive training," Beshear said. "I believe this new law will mean more Kentuckians can get the eye care they need." Optometrists practice in 106 counties in Kentucky. Two-thirds of the state's counties do not have an ophtalmologist, and supporters of the bill sais it will make eye care more accessible and affordable in rural areas.

Ky. officials ramp up criticism of plan to cancel Florida drug monitoring; U.S. drug czar says Fla. governor may lack facts

Kentucky officials continue to rail against Florida Gov. Rick Scott's proposal to cancel his state's prescription-drug monitoring program, a move they argue would keep the pipeline open for Kentucky dealers who head to the Sunshine State to get drugs.

"The callousness of this governor is absolutely incredible, with the number of people who are dying," said Frank Rapier, director of the Appalachia High Intensity Drug Trafficking Area program.

Democratic Gov. Steve Beshear and Republican U.S. Rep. Hal Rogers have written Scott expressing their displeasure. Kentucky "may have to take legal action," Lt. Gov. Dan Mongiardo, who lacks legal authority to do so for the state, told The Courier-Journal's Emily Hagedorn. "Rick Scott is trying to legalize prescription drugs on the street," Mongiardo said. "The last thing we need is an open spigot to illegal drugs."

Because Florida is one of few states without a drug-monitoring program, traffickers can to go from doctor to doctor, getting prescriptions for drugs at each stop. More people died from prescription drug abuse in Kentucky than traffic accidents, The C-J reported in a recent investigation. Scott has said the monitoring program is an invasion of privacy, is costly and may not be effective.

The issue was discussed in London Wednesday while R. Gil Kerlikowske, director of the White House Office National Drug Control Policy, made a stop there. Kerlikowske (right, C-J photo) is in Kentucky to investigate the prescription drug abuse in the state. "I am certainly giving (Scott) the benefit of the doubt that his decision comes from a lack of knowledge," he told Hagedorn. "So many people in his own state are dying, and others are dying, too." (Read more)

Yesterday, "Narcotics agents across South Florida descended on more than a dozen pain clinics," report Scott Hiaasen and David Ovalle of The Miami Herald. They call it "the most dramatic effort yet to curb the region’s booming business of illegal prescription narcotics." (Read more)