Weekly newspaper's editorial advises readers to ignore 'irresponsible rhetoric' about Obamacare and find out the facts

The Sentinel-News, a twice-weekly newspaper in Shelbyville, reminded Kentuckians to pay close attention to the "irresponsible rhetoric" surrounding the launch of the Patient Protection and Affordable Care Act.

Since registration opened Oct. 1, "misinformation and carefully constructed lies" abound, the paper said in an editorial. It reflects on how many people have "fallen victim" to exaggerated individual experiences posted on social media and "even worse, the acceptance and delivery of similar items by otherwise responsible broadcast news outlets."

The editorial says there is great disagreement about the viability of the law and both sides of the political aisle are producing statistic and "experience"-based arguments to sway you to their way of thinking.  It goes on to say that the Better Business Bureau has issued an alert about scammers trying to capitalize on the process, and it is easy for consumers to be "had" in this environment. Fact-checking organizations have called some of the information propaganda. Tragically, the editorial says, "the 'information' being distributed to validate their arguments appears to be flimsy and desperate and without sound base."

The message of this editorial is: Consumers, do your homework and check your facts. It recommends a visit to the website of KIPDA, a Louisville-region planning agency that is helping people navigate the new system; checking the website of the state health-insurance marketplace, Kynect, to see what insurance will cost you and your family; calling an information hot line; analyzing all of your options ; and doing the math: Are the new health care options more or less expensive, more or less restrictive than another option you may have?

And finally, the editorial reminds us to be patient: "All parties (need to) let it roll out, evaluate how it works and then adjust the law to ensure that it meets the needs of most Americans and provides the intended health care." (Read more)

Students in Kentucky are invited to celebrate Farm to School Week in annual Farm to School Art Contest

Kentucky students are invited to participate in the third annual Farm to School Art Contest, which celebrates Farm to School Week.

Entries must be drawn on 8 1/2-by-11-inch white unlined paper and have the theme "Farm to School Lunch ... Across Kentucky" printed on them, with the student's name, address, grade and school listed on the back.  Students are encouraged to make the entries colorful since they may be reproduced.

Contest entries must be mailed by Nov. 15 to Kentucky Farm to School Program coordinator Tina Garland, 107 Corporate Dr., Frankfort KY 40601.

Winners will be announced in December.  Each county will select winners in elementary, middle school/junior high and high school.  Statewide winners will get $50 for first place, $30 for second and $20 for third. Rewards will also be given to the first, second and third place school food-service directors and his or her staff.

The goal of the Kentucky Department of Agriculture's Farm to School program is to bring high quality and fresh Kentucky Proud products to the school systems. At least 84 if Kentucky's 173 school districts are in the program, buying food from more than 80 producers, according to a  press release from the Kentucky Department of Education.

For more information about the Farm to School program, email Tina.Garland@ky.gov.

Free-for-all food program increases student participation, raises Ky. breakfast count by 25% with only 39% of districts participating

Kentucky schools participating in a program that provides free breakfast and lunch to all students in high-poverty schools have significantly increased student participation in school lunch and breakfast programs, Charles Edwards reports for Education Week.

Schools participating in the "community eligibility option" have increased student participation by 13 percent in the lunch program and 25 percent in the breakfast program during the first two years of its availability and eliminated significant administrative costs, according to the Washington-based Food Research Action Center and the Center on Budget and Policy Priorities.

Collectively, Illinois, Kentucky and Michigan achieved a 25 percent increase in breakfast participation over the first two years, Education Week reports.

Of the 174 school districts in Kentucky, 68 participate in the community eligibility option, Nancy Rodriguez of the Kentucky Department of Education told Kentucky Health News. That is 39 percent of the public school districts. One private school also participates.

The program allows high-poverty schools to serve all students free breakfasts and lunches without individually identifying children as eligible. Schools get about the same amount of reimbursement from the Department of Agriculture that they did under the existing system—but without the paperwork. The reimbursement is based on the total number of meals served.

The school nutrition director at Ballard County, a participant in the "community eligibility option," told Whitney Jones of WKMS-FM, Murray State's NPR station, that the district saves $500 per year per student eating both breakfast and lunch at school.

The traditional way to determine eligibility for free or reduced breakfast and lunch required families to fill out a parent-income survey, which discouraged some from enrolling. The new eligibility option has been rolled out incrementally since it was authorized by Congress in 2010, and all eligible schools in the country may participate beginning in the 2014-15 school year.

Now, the percentage of a school's children who are already enrolled in other federal need-based program or are homeless, migrant, in Head Start or in foster care, determines the eligibility of the school, reports Edward. If a school has an enrollment of at least 40 percent of such directly certified children, it is eligible. Some districts combine all their schools to include those that are below 40 percent.

Participation in the program has exceeded the original expectations, with more than 2,200 schools signed up in the first seven states allowed to participate. The original projection estimated 300 schools would participate over 10 years, Education Week reports.

Every Kentucky county has a local group working on health issues, foundation finds in compiling Health Coalitions Directory

For the first time, the Foundation for a Healthy Kentucky has documented that every Kentucky county has a local group working on health issues.

All 120 counties are listed in the Kentucky Health Coalitions Directory, which includes 208 groups. Last year’s first-ever directory listed fewer than 150. "Whether they are called health coalitions, collectives, consortia, associations or networks, people are joining forces to work on health-related challenges," the foundation said in a news release. "The groups have differing levels of organization and are pursuing various goals. Some are increasing access to healthy food and physical activity; others are planning needed screenings and education for people at risk for serious health problems like cancer, diabetes and other chronic diseases; yet others are improving working conditions through smoke-free ordinances."

The foundation said it would periodically update the directory. “These are local residents working on solutions to health issues where they live, work and raise their families,” said Susan Zepeda, president and CEO of the foundation. “Their work spans a broad spectrum of issues that contain a common thread: to improve health in the community and our state. These groups represent local health change efforts.”

The directory is designed to raise awareness of local efforts and "foster collaboration, build local capacity, provide technical assistance to these groups and celebrate their successes," the foundation said. State and national coalitions, and international coalitions doing work that affects Kentucky, are included in the directory. To get a PDF of it, visit the foundation's newsroom at www.healthy-ky.org.

Ky.'s successful rollout of health-insurance exchange prompts New York Times to profile Beshear as 'a man on a mission'

A weekend article in The New York Times describes Gov. Steve Beshear as a man determined to prove that the health-reform law works, and says Kentucky stands out in many ways while the federal government is struggling to fix its health-insurance website. While comparisons are difficult, Trip Gabriel reports that Kentucky's health insurance marketplace is "one of the most successful" in the country.

Kentucky is the only Southern state to operate its own insurance exchange as well as to expand Medicaid coverage. "It is an anomaly on the polarized political map, and a test — in a red state that has elected to the Senate Mitch McConnell, the Republican leader, and Rand Paul, a tea-party favorite — of whether bitterness over the law will dissolve if people decide it effectively provides affordable health care," Gabriel writes.

Gov. Steven L. Beshear, right, with employees at Kynect 
headquarters. He has said Kentuckians do not have to 
like President Obama or him to like the new health care law.

President Obama said last week that Kentucky may have had the most successful exchange launch. As of last week, some 34,000 Kentuckians had begun applications on Kynect, and more than 11,000 had signed up for plans.

At the federal level, exchanges have been plagued by technical "glitches" and to date, the Obama administration has failed to release official enrollment numbers. The Republican National Committee said Monday it was sending a Freedom of Information Act request to the Centers for Medicare and Medicaid Services, seeking Obamacare enrollment numbers, reports Caroline May of The Daily Caller.

About half a million people have started applications on the federal exchanges, administration officials said Saturday. The figure is only a snapshot of applications, and since the administration isn’t planning to release until next month the number of people who have actually enrolled in a health plan, much is left unsaid, writes Joanne Kenen of Politico. For now, it can only be said that Kentucky may have the most successful roll-out, and the governor is determined to make success a certainty.

Beshear told the Times his decision to embrace the law was not political. “To me this was a moral decision,” he said. “We’ve got 640,000 Kentuckians who don’t have access to any kind of affordable health care. The last ranking I saw, we’re 44th out of 50 in health status. You take any chronic disease or condition — heart disease, cancer, smoking, obesity, you name it — and we’re either the worst or close to the worst.”

In embracing the law, Beshear decided not to seek approval from the General Assembly for the exchange or the expansion of Medicaid, moves that brought a lawsuit and a circuit-court ruling supporting him. The state Supreme Court has been asked to hear the case, brought by tea-party activist David Adams of Nicholasville. Beshear said in a recent op-ed piece in the Times, "To those more worried about political power than Kentucky’s families, I say, 'Get over it.'"

“Steve Beshear is a man on a mission,” Al Cross, the director of the University of Kentucky's Institute for Rural Journalism and Community Issues, publisher of Kentucky Health News, told Gabriel. “He no longer has to worry about politics.” Beshear, who is in his second term, cannot seek re-election in 2015.

While many Kentuckians are concerned about Obamacare's effect on their health insurance or the state budget, Beshear blamed the law’s unpopularity on Republicans who were "demonizing" it. "You don’t have to like the president; you don’t have to like me," he told Gabriel. "Because this isn’t about him, and it’s not about me. It’s about you, your family and your children. So do yourself a favor. Find what you can get for yourself. You’re going to like what you find."

Resigned heart surgeon wins settlement from UK, which plans to upgrade program he left but won't say why it was suspended

Dr. Mark Plunkett

The University of Kentucky will pay Dr. Mark Plunkett more than $1 million as part of a settlement after Plunkett's pediatric cardiothoracic surgery program at UK was suspended for reasons still unclear.

The agreement with the heart surgeon comes after UK Healthcare was accused of hiding information about both the pediatric heart surgery program's suspension and about its surgery-related deaths. Statistics were released regarding the program's mortality rates, but reasons for its suspension remain unclear.

UK's settlement agreement with Plunkett, which the Lexington Herald-Leader obtained under Kentucky's Open Records Act, says he will receive salary supplements over two years to make up the possible difference between his former UK salary of $700,000 and future annual earnings. He is required to make efforts to find employment.

Plunkett will receive at least $1.05 million but no more than a total of $1.75 million, reports Linda Blackford of the Herald-Leader. In addition to this larger payment, if he is unemployed, as he now is, UK will pay him $350,000 a year between May 1, 2015 and April, 30, 2017. The settlement also calls for Plunkett's agreement not to speak to the news media.

Read more here: http://www.kentucky.com/2013/10/17/2881676/university-of-kentucky-to-pay.html#storylink=cPlunkett's agreement not to speak to the media,

Plunkett came to UK in 2007 from the UCLA Medical Center and was the chief cardiothoracic surgeon before the pediatric program was suspended. In July of this year, Plunkett accepted a new job at the University of Florida, which was scheduled to begin Sept. 1. However, UF officials recently says it was in their "best interests" to for them to part ways.

After suspending the pediatric cardiothoracic surgery program, Blackford writes, "UK waged a legal battle to keep the mortality rates for Plunkett's program secret. But after CNN ran a lengthy story on the topic in August and identified two babies who died, UK voluntarily released the mortality rates." She also says UK officials declined to comment on the settlement, except to say it would be paid out of clinical revenues, not state revenues.

UK Executive Vice President for Health Affairs Dr. Michael Karpf convened a task force and charged it with providing recommendations regarding the future of the program. The nearly 30-member taskforce released a report Friday that outlined a series of steps that will be taken in the coming months to re-open it, says a UK news release.

The more than 100-page report assesses the program and offers recommendations to re-institute it without providing specific details about why it was suspended in the first place. Click here for more information.

After an initial fight, UK did release mortality statistics for pediatric heart surgery program in August. The mortality rates at UK averaged 5.8 percent, ranging from 5.2 percent to 7.1 from 2010 to 2012. UK said the numbers were comparable to the national average of 5.3 percent for programs of similar size, reports WKYT-TV.

UK officials remain positive about the program's outlook. "Our current patient care ranking of 12th among the nation’s university health systems is a reflection of the dedication and skill of our nurses, doctors and staff, as well as, their unrelenting pursuit of improvement," Karpf said. "That's the kind of commitment we will bring to re-instituting this program as well."

Meanwhile, UK's Chandler Medical Center was named a "rising star" among academic health-care facilities.

KET program to feature citizens who work in three programs to improve the health of Kentucky children

The next episode of  KET's "Health Three60" series will be a program that features citizens who have made a difference in the health of Kentucky children. "Champions for Children's Health" premieres Monday, Oct. 21 at 9 p.m. Eastern Time. It is available online at www.ket.org.

Featured will be guest from HANDS (Health Access Nurturing Development Services), a  home-visitation program for new and expectant parents; Better Bites, of Lexington, whose goal is to transform the snacking culture to reduce childhood obesity; and Doctors and Lawyers for Kids, a Louisville group that helps families with legal issues, such as housing, custody and immigration, that may impact children’s health.

HANDS is a well-regarded, statewide program that works toward healthy pregnancies and births, healthy child growth and development, safe homes and self-sufficient families.  Referred participants begin the process with a home visit that determines the needs and concerns a family might have about pregnancy or a baby's first year.  Families then receive information and learn about resources available in the community to help them and based on the needs of the family, some will receive continued home visits.  This program is available not only to first-time Kentucky moms and/or dads, but also to expectant parents. The premise of the program is that early family intervention improves the well-being of the entire community.

Lexington TV reporter was moved to donate a kidney to a still-unknown stranger and hopes her story will encourage others

Lexington television reporter Leigh Searcy donated one of her kidneys to an unknown stranger and explained it to her 5-year-old  daughter and 6-year-old son this way: "It's like having two cookies and sharing one with someone who doesn't have one," reports Valarie Honeycutt Spears of the Lexington Herald-Leader.

Searcy, a fixture on WLEX-TV, told Spears that she had not considered donating a kidney until she reported a story about the family of a man who needed a kidney. What inspired her about this family was that it reminded her of her own: young, with two children. The man followed a regimented kidney dialysis schedule and strict diet that dictated his daily routine, but what he really needed was a kidney.

"It's hard to explain," Searcy told Spears. "But I left that home thinking, 'I'm going to get tested to see if I'm a match for him.'" She was not a match for that man, but he eventually got one as a result of her story, and she continued with further testing to see if she would match with someone else who needed a kidney.

Eventually, she was found to be a match for a would-be recipient. Searcy still does not know who the recipient was, but told Spears it was a woman "whom I'm told is doing very well and I'm happy for her." Searcy's surgery took place Aug. 29 and the recipient, who was in the same hospital, received the kidney almost immediately, reports Spears.

Searcy, told University of Kentucky Chandler Hospital officials that she would like to meet the recipient if the woman is willing but understands if it never takes place, Spears reports. "If I don't, I just hope my kidney is doing its job for her ... I just really hope it continues to work for her,'' Searcy said.

Stephen Strup, the James F. Glenn Professor and chief of urology in UK's College of Medicine, told Spears that it's unusual for someone to donate a kidney without having some knowledge of the recipient.
He said Searcy went into the donation with "eyes wide open and really thought about it and felt like it was something she was called to do," he said.

"I was healthy, had healthy children and most importantly, had no family history of kidney problems. Why not help someone if I can? It was a very matter-of-fact decision for me," she told Spears. "I considered the risks. My father pointed out more than once the fact I have two young kids; what if something happened?" Strup, the physician, told Spears, "Life with one kidney is really no different than life with two."

Searcy's husband, Versailles policeman Heath Dotson, told Spears that he decided that it was his wife's decision. "From the beginning, I didn't try to talk her out of it," he said. "I was very proud of her."

Lynne Polly, a donor coordinator at the hospital, told Spears that about 365 people are waiting to get a kidney there. "This year there were about 20 living donors  and 70 deceased donors," Spears writes. "Of the living donors in 2013, only Searcy and one other donor did not know the recipient."
Searcy told Spears the surgery had not affected her lifestyle, and that she is not aware of the missing kidney. A month of the surgery, she was running again, back to her normal routine and had no diet restrictions.

She told Spears that she agreed to share her story with the Herald-Leader because she wants others to consider becoming living donors. "The more people realize how far transplants have come," Searcy said, "the more people will be open to getting tested." (Read moreore)

Want to help? Contact Lynne Polly at (859) 323-5737 or lynne.polly@uky.edu. For more information about being a living donor, visit UKhealthcare.uky.edu/trans.

Physicians say they dislike regulations on use of electronic health records, but they don't want to go back to paper records

Doctors say use of electronic health records is one factor contributing to physician dissatisfaction because it interferes with patient care, says a new study.

Surveyed physicians blame EHRs for reduced quality of care, saying that their daily interaction with "clunky" EHR systems contributes to their dissatisfaction, which is closely linked with their ability to provide quality care, reports Chris Kaiser of MedPage Today. The results were published in a study by the RAND Corp. and commissioned by the American Medical Association.

Physicians said the cumulative burden of rules and regulations affecting clinical practice, including “meaningful-use” rules for EHRs, also detracted from professional satisfaction, says the report brief. These rules were created by the federal Centers for Medicare & Medicaid Services; providers must certify that they are “meaningfully using” their EHRs by meeting established thresholds in order to qualify for the program's financial incentives. If providers accepting Medicare do not qualify by 2015, their Medicare payments will be reduced by 1 percent each year, says HealthIT.gov.

Despite their dissatisfaction with the regulations, physicians said they approved of the concept of EHRs, saying that their use has numerous benefits, including being able to remotely access patient information and improving in-practice communication, says the report. Only 20 percent of physicians said that practices should return to paper documentation.

“Physicians believe in the benefits of electronic health records, and most do not want to go back to paper charts,” said Dr. Mark Friedberg, a natural scientist at the RAND Corporation, in a news release. “But at the same time, they report that electronic systems are deeply problematic in several ways. Physicians are frustrated by systems that force them to do clerical work or distract them from paying close attention to their patients.”

The problem is that many EHR programs aren't user-friendly. This problem should be addressed, says the report, to ease physician workflow and free up time for the physician to spend with the patient. Here are some of the complaints physicians had about EHRs:

Time-consuming data entry 

User interfaces that do not match clinical workflow 

Interference with face-to-face patient care 

Information overload 

Lack of health information exchange between EHRs 

EHRs are expensive, threatening practice finances

Understanding physicians' professional satisfaction is important because better patient care is a potential "downstream" benefit of satisfaction. The researchers said knowing reasons for dissatisfaction can lead to targeted interventions to address the issues,says the news release.

"Aside from viewing better patient care as a potential consequence of better physician professional satisfaction, it may be useful to think of physician dissatisfaction, when it is caused by perceived quality problems, as an indicator of potential delivery system dysfunction," says the report.

Smokers shouldn't get Medicaid or Medicare, says freshman Republican lawmaker who grows tobacco

State Rep. Jonathan Shell of Lancaster, a young Republican who grows tobacco, is against a statewide smoking ban. No surprise there, but how about this: He also says people who use tobacco should't be able to get Medicaid benefits.

“As I don’t think we have should have a smoking ban, I also think if you’re going to be smoking, you should have to sign a waiver that you will not get onto Medicaid or Medicare ... so the taxpayers [don't] have to end up forking over those dollars because you made the wrong decision to smoke and put those carcinogens into your body,” Shell told Ryan Alessi on cn|2's "Pure Politics."

Shell, who is in his first term in the House, sponsored legislation this year to require drug testing for anyone who applies for government benefits such as Medicaid or food stamps, which he said "should be a last resort." His predecessor, Republican Lonnie Napier of Lancaster, was a leading advocate of such legislation.

Most of Alessi's five-and-a-half minute interview with Shell dealt with the workings of the tobacco industry. He said the free market will determine when he switches from growing tobacco to another crop, and he is already raising vegetables and flowers. He said his free-market and indiviphilosophy makes him oppose a smoking ban.

Free webcast for journalists TODAY at 2 p.m. ET will explore rural use of health-insurance exchanges

If you lack health insurance, you're more likely to live in a rural area. Put another way, if you're rural, you're more likely to lack health insurance. Nearly one in five uninsured Americans live in rural areas, while only a sixth of the U.S. population does. For those reasons, the federal health-reform law is especially important to rural areas, but "In the launch of health insurance exchanges across the country, one issue that has not been explored much is how the marketplaces will affect rural Americans," says the Association of Health Care Journalists. So, AHCJ is holding a webcast at 2 p.m. ET Thursday to explore how rural Americans will use the health-insurance exchanges that opened Oct. 1.

The panelists will be Al Cross, director of the Institute for Rural Journalism and Community Issues, which publishes Kentucky Health News and The Rural Blog; Alan Morgan, CEO of the National Rural Health Association; and Jim Doyle, who covers the business of health care for the St. Louis Post-Dispatch. AHCJ health-insurance topic leader Joseph Burns will serve as moderator.

Viewers of the one-hour webcast will be able to ask questions after the panelists' initial presentations. Registration is not required for the free webcast; a link to it will appear on this AHCJ web page shortly before the webcast begins.

Nationwide, eyes on are Ky.'s implementation and debate about Obamacare, and thousands of Kentuckians are signing up for it

By Molly Burchett
Kentucky Health News

The good, the bad and the ugly about health reform in Kentucky are showing up on national news as the state's two Republican senators stand vehemently against Obamacare and the state's Democratic governor ardently roots for it. Meanwhile, state officials say their health-insurance website, which is working much better than the federal site, is getting much more traffic than they expected.

The Republican senators from Kentucky, Rand Paul and Minority Leader Mitch McConnell, declared last week that their constituents didn’t want any part of the Affordable Care Act. “Obamacare might sell in New York, but Kentuckians aren’t buying it,” McConnell and Paul wrote in a column sent to newspapers.

This came after Democratic Gov. Steve Beshear, who decided to build the insurance exchange without asking for approval from the politically divided General Assembly, wrote a New York Times op-ed in support of the reform law. He jabbed at “naysayers” who “pour time, money and energy into overturning or defunding the Affordable Care Act.”

The problem for McConnell and Paul is that Kentuckians are buying into Obamacare, writes John Tozzi of Bloomberg Businessweek. "In fact, the Kentucky exchange has, so far, enrolled more patients than any other." Kentuckians are enrolling in droves, at a rate of more than 1,000 people per day, and Beshear has become more pointed in his criticism of McConnell and Paul.

“Our state’s U.S. senators are simply ignoring the facts when they continue to insist that ‘no one’ in Kentucky wants the Affordable Care Act,” Beshear told MSNBC.

Carrie Banahan, executive director of Kynect, the state's insurance exchange, told Jane Timm of MSNBC that enrollements are far beyond state officials' expectations. “We had thought that maybe we might receive a couple of hundred applications during the month of October. We had no idea it would be thousands of applications.”

Kynect's Carrie Banahan (left) and Gov. Steve Beshear

There were concerns that people in rural areas might not get the word about the program or have difficulty signing up because they lack Internet access, but Teresa Fleming, chief financial officer of Mountain Comprehensive Health in Eastern Kentucky, told Timm her lobbies had been flooded with people signing up for the plans. Her primary-care facilities were among the numerous Kentucky clinics that received part of $2.83 million in federal money for Kynect outreach and enrollment iniatives.“The response has shocked us,” Fleming said, “We think it’s due to a lot of word of mouth."

Kentucky's success is getting much national attention. Beshear discussed it with MSNBC’s Chris Matthews and keynoted a meeting in Washington. President Obama praised Beshear’s implementation during a private meeting with House Democrats Wednesday, said Rep. John Yarmuth, D-Louisville, who was at the meeting.

“The president said (the Affordable Care Act) got really good rollouts in some places you wouldn’t expect it, and he said the place that has done best is Kentucky,” Yarmuth told James R. Carroll of The Courier-Journal. He said Obama noted the irony that McConnell and Paul have been two of Obamacare's most vocal critics.

Republican efforts to defund or delay Obamacare led to the shutdown of the federal government, which has proven highly unpopular. It may have also improved public opinion of the law; an NBC/Wall Street Journal poll last week found a 7-percentage-point increase in its popularity. The survey also found the Republican Party registering its worst approval ratings in the poll's history, with just 24 percent having a favorable opinion of the GOP, and 21 percent viewing the Tea Party favorably.

"There is little question that the GOP is bearing the brunt of blame in the standoff over re-opening the government and the debate over the debt ceiling as 53 percent of the public now places the blame on Congressional Republicans compared to 31 percent who view President Obama as being the guilty party," Rick Ungar of Forbes reports.