Anthem expands its rural health scholarship program at EKU

Anthem Blue Cross and Blue Shield's Kentucky Medicaid unit is expanding its rural scholarship program at Eastern Kentucky University "to grow the number of frontline workers in the eastern region of the state and increase access to care and improve health equity for those living in Kentucky’s rural areas," the company and the university said in a press release.

The fund of nearly $200,000 "will enable more students to provide care in underserved communities," the release said. "Anthem Medicaid launched the scholarship in August 2021, granting eight students the opportunity to pursue health education and eventually serve in Eastern Kentucky." This year’s scholarship recipients are Breanna Goble, a Johnson County native, and Sara Cornelison, a Madison County native.

In the Kentucky Hospital Association’s 2022 Workforce Survey Report, Kentucky hospitals reported more than 13,000 vacancies across 13 professional groups last year. "Nursing topped the list with 22% of all nursing positions unfilled, and another 14% of nurses near retirement," the release noted. 

Using his pardon power, Beshear lets people with certain certified health conditions possess up to 8 ounces of medical marijuana

Beshear displayed a map showing in green the adjoining states where medical cannabis is legal.

By Al Cross
Kentucky Health News

Kentuckians who meet a detailed set of requirements would be able to possess up to 8 ounces of marijuana for medical use starting Jan. 1, under an executive order Gov. Andy Beshear signed Tuesday.

The drug would have to be bought in a state where the sale of cannabis is legal, and the person would need the receipt and a certification from a health-care provider saying that they have at least one of 21 specific conditions, including cancer, epilepsy, Parkinson's disease, Crohn's disease, sickle-cell anemia, severe and chronic pain, post-traumatic stress disorder, fibromyalgia, glaucoma or a terminal illness.

Beshear's order is in the form of an advance, conditional pardon. He had not mentioned such a device in his seven months of public deliberation about the issue, which began when the state Senate again refused to hear a House-passed bill to legalize medical cannabis. Republicans control both chambers.

The highest-quality health care is a human right," the Democratic governor asserted. Noting that Kentucky has high rates of cancer and painkiller overdoses, he said "There's another way to manage the pain without the threat of addiction."

Beshear created a Medical Cannabis Advisory Committee that held several public hearings on the issue. It received more than 3,500 comments, 98.6% of which favored of legalizing medical cannabis, he said.

"Kentuckians are leaving this state to access medical cannabis," he said. "Some of them are leaving this state for good." The drug is legal in 37 states.

One commission member, Justice Secretary Kerry Harvey, said cannabis is "a treatment that's already available to the overwhelming majority of Americans but not Kentuckians," some of whom have declined to use the drug because they don't want to violate the law: "What an awful choice that must be."

Jared Bonvell, a veteran from Northern Kentucky, said his use of cannabis gave him "a change of life that is just absolutely astounding," allowing him to stop taking 13 medications.

Paducah contractor Craig Manley said in a video that nothing took away his pain except THC, the psychoactive ingredient in cannabis.

State and federal law define marijuana as containing Delta-9 THC. Products containing Delta-8 THC, a less potent form, are on the market legally. Beshear signed another order regulating Delta-8 THC and said it would provide the legal framework for regulating cannabis if the legislature legalizes it.

Beshear's cannabis order notes that 8 ounces is the most marijuana that can be possessed under Kentucky law without being a felony, and says the health-care provider's certification "shall not constitute a prescription for medical cannabis."

The order allows the cannabis to be possessed by a caregiver, defined as someone at least 21 and with "significant responsibility for managing the well-being of the individual on whose behalf the cannabis was purchased."

"Today's actions are not substitutes for much-needed legislation," Beshear said. "What we're trying to do is take a measured step to help those who are struggling."

State Rep. Jason Nemes, R-Louisville, who sponsored the unsuccessful bills, called Beshear's order an “unprecedented power grab” that “cannot stand,” WDRB reports, adding, "Nemes says he invites the governor to work with lawmakers to develop a legal medical marijuana program." Beshear said he would keep working to legalize medical cannabis with a law.

John Cheves of the Lexington Herald-Leader reports, "There may yet be legal challenges to Beshear’s actions. House and Senate leaders did not immediately respond to requests for comment Tuesday. But the office of Republican Attorney General Daniel Cameron, who often clashes with Beshear, said he’s studying the orders."

State Supreme Court hears arguments in abortion case

Protesters were audible inside the court chamber, reports Alex
Acquisto of the Lexington Herald-Leader, who took the photo. 

By Al Cross
Kentucky Health News

The Supreme Court of Kentucky heard oral arguments Tuesday in a case that will ultimately, but not immediately, decide the constitutional framework for abortion laws in Kentucky.

The immediate issue before the seven justices is whether to reinstate a Jefferson Circuit Court judge's injunction blocking two laws that ban almost all abortions in the state. Reinstatement would allow the state's two abortion clinics, both in Louisville, to resume performing the procedure.

The ultimate issue, which will almost certainly be decided by a court with two new justices elected last week, is whether the state constitution's sweeping language about liberty, equality, religious freedom and self-determination creates a right to abortion.

The court has found in earlier cases that the language establishes a right to privacy, the source of constitutional protection of abortion rights in other states, and the right asserted by the clinics on behalf of their would-be patients. The lower-court injunction looked favorably on those arguments.

Clinic attorney Heather Gatnarek, an employee of the American Civil Liberties Union of Kentucky, said the central question for the Supreme Court is: “At what point in pregnancy does the state’s interest in protecting fetal life become compelling enough to outweigh an individual’s rights to make their own determinations about their bodies and their pregnancies?”

The arguments suggested that the court could reinstate the injunction in a limited way, perhaps making exceptions for abortions in cases of rape or incest. That was an option mentioned by state Solicitor General Matthew Kuhn, representing Attorney General Daniel Cameron.

In presenting his broader case, Kuhn pointed to the lack of any reference to abortion in the constitution and argued, “There is not a shred of evidence . . . that suggests our constitution implicitly protects abortion,” thus leaving the issue to the legislature.

Justice Lisa Hughes of Louisville     noted that when the constitution was written in 1891, women could not vote, hold public office or, unless orphaned, own property. “Women were not considered,” she said, so “Is that not, then, something the court can consider when deciding a 2022 issue following a ballot initiative when the people voted no?”

Hughes was referring to the referendum a week earlier in which voters defeated, by 4.7 percentage points, an amendment that would have added to the constitution language saying that it was not to be construed as creating a right to abortion or funding of abortion. The court delayed arguments until after the vote, since passage of the amendment would have made the case moot.

Kuhn said, as Cameron had in a brief, that the court should not consider the referendum except as an example of how divisive the issue is, and thus should be left up to legislators, not courts.

If that was the case, asked Justice Michelle Keller, why did the legislature think "it so important to put that initiative on the ballot?"

Keller surely knew the answer to her question. The amendment was sponsored by state Rep. Joseph Fischer, whom she defeated in a widely watched race for the court's Northern Kentucky seat.

Fischer also sponsored the "trigger law" that took effect this summer when the U.S. Supreme Court overturned its Roe v. Wade decision, which had established a constitutional right to abortion for more than 49 years. The law essentially bans abortion except in cases of threats to the woman's life.

Also at issue in the case is a 2019 law that bans abortion if a fetal heartbeat can be detected, which can occur as early as the fifth week of pregnancy. An earlier law with a 15-week ban is not part of the case.

Gatnarek cited a brief filed by doctors' groups that said the laws create risks and “unacceptable barriers” to the care of patients.

Keller, noting that her first career was as a nurse, said "This exception for the life of the mother does not allow the mother to make any of her own decisions. The decision is left up to whatever physician is on call when the life-threatening emergency arises. And if there's a man bleeding out in the ER, he has all the self-determination in the world, and most women do too unless they're in a state of pregnancy. And then suddenly, there is no self-determination."

Justice Laurance VanMeter of Lexington, a possible swing vote, asked Gatnarek whether the General Assembly, not courts, should say where the interests of fetal life outweigh individual rights: "Isn't that ultimately the role of the legislature?"

Gatnarek replied, "It is the role of the legislature to legislate, but they must do so within the confines of what this court tells them is constitutionally permissible."

The arguments may be viewed on the KET website.

$35 cap on seniors' monthly insulin costs isn't reflected in online 'plan finder' that is used by Medicare members to choose a plan

Screenshot of Medicare plan finder; for the web page, click here.

By Susan Jaffe
Kaiser Health News

A big cut in prescription drug prices for some Medicare beneficiaries kicks in next year, but finding those savings isn’t easy.

Congress approved in August a $35 cap on what seniors will pay for insulin as part of the Inflation Reduction Act, along with free vaccines and other Medicare improvements. But the change came too late to add to the Medicare plan finder, the online tool that helps beneficiaries sort through dozens of drug and medical plans for the best bargain.

Officials say the problem affects only 2023 plans.

To fix anticipated enrollment mistakes, Medicare officials will give beneficiaries who use insulin a chance to switch plans next year. They can make one change after Dec. 8 and throughout 2023 through a special enrollment period for “exceptional circumstances.” Typically, people are locked in for an entire year.

The Centers for Medicare & Medicaid Services provided initial details of the opportunity in a document distributed to the State Health Insurance Assistance Program, or SHIP, which assists Medicare enrollees in every state. Although Medicare did not publicize the document, beneficiaries can get more information by contacting their local SHIP office. CMS officials would not answer questions about whether the ability to change plans will be granted automatically.

State counselors and contractors such as regional Aging and Independent Living councils "are advising Medicare beneficiaries as they call in that while the cost is currently not reflective, they will see a decrease in their insulin costs effective January 2023," Kentucky health cabinet spokeswoman Susan Dunlap said. "A handout was created and shared with all SHIP counselors to educate the public on this."

In some cases, a special enrollment period can be avoided, said Janet Stellmon, SHIP director in Montana. If the plan charges more than a $35 copayment for a member’s insulin, a SHIP counselor can ask the plan to correct the mistake, said Stellmon, who helped one beneficiary save $565 a month on insulin: “Plans usually try to make it right quickly.”

Medicare patients spent $1 billion in 2020 on insulin products — four times the amount in 2007, with some paying as much as $116 a month out-of-pocket, KFF has found. Americans paid an average of five to 10 times as much for insulin in 2018 than in other countries, according to a recent study. About 3.3 million people with Medicare rely on one or more insulin products to control blood sugar levels.

The $35 copay for injectable insulin products takes effect Jan. 1, and July 1 for patients who use an insulin pump.

When beneficiaries who use insulin now check the plan finder, the price could show up as thousands of dollars a year instead of the maximum $420 stipulated by law. An inaccurate price could also distort the costs of other drugs, which depend on what coverage phase patients reach. For example, once both the plan and the patient spend a total of $4,660 for all drugs next year, the member pays no more than 25% of the cost for non-insulin drugs.

It’s extremely difficult for consumers to evaluate policy options without the plan finder. One plan might have the lowest price for one drug but not another. Or a plan might have the lowest premium but higher drug prices. Or a preferred pharmacy in one plan may be excluded in another.

The finder does display a warning: “This new $35 cap may not be reflected when you compare plans. You should talk to someone for help comparing plans.” It points readers to the Medicare help line — 800-633-4227 — or a counselor with SHIP.

It doesn’t mention the option of changing plans after the Dec. 7 enrollment deadline, but both SHIP counselors and representatives answering the Medicare help line rely on the same flawed plan finder.

Drug plans do not have to cover all injectable insulins, said Tatiana Fassieux, an education and training specialist at California Health Advocates. “It’s all about the formulary,” she added, referring to the list of drugs covered by a plan.

Kentucky had many fewer new cases of Covid-19 last week, but more serious cases, and it still ranks eighth among the states

New York Times map, adapted by Ky. Health News; for interactive version with data, click here.

By Al Cross
Kentucky Health News

For every eight cases of Covid-19 that were reported in Kentucky in the first week of November, only five cases were reported last week. But the weekly rate of new cases remains high, eighth among the states.

The state Department for Public Health reported 3,570 new cases last week, or 510 per day. Those figures were 37.5 percent less than the previous week.

The weekly new-case incidence rate was 10.8 per 100,000 residents, down from 12.98. Counties with rates more than double the statewide rate were Elliott, 28.5; McLean, 27.9; Mercer, 24.4.8; and Trimble, 21.9.

The New York Times, which calculates the rates differently, says the statewide rate is 16 per 100,000 and the top counties are Leslie, 65; Cumberland, 45; Russell, 41; Simpson, 39; McCreary, Green and Knott, 38; Johnson, 36; Metcalfe and Muhlenberg, 35; Powell, 34; and Nelson, 33. It ranks Kentucky eighth among the states.

The share of Kentuckians testing positive for the coronavirus in reported tests also declined, to 7.29% last week from 8.31% the week before, the state said. The figures do not include at-home tests.

The number of Kentucky hospital patients with the virus fell last week, but the number in serious condition rose. As of midnight Sunday, there were 310 Covid-19 patients, down from 332 the previous week; 42 were in intensive care, up from 40; and 19 were on mechanical ventilation, up from 13.

Hospitals are also reporting many cases of the flu and respiratory syncytial virus (RSV), which is hardest on infants and seniors. Flu cases in the state are more than doubling each week, and if current trends continue next week, new flu cases will outnumber new Covid-19 cases. 

The state said it confirmed 47 Covid-19 deaths last week, up from 41 the week before. The state's pandemic death toll stands at 17,410.

Time for pharmacy-benefit managers to 'share the savings' in prescription-drug costs, crusaders against diabetes write

OPINION By George Huntley and Stewart Perry

George Huntley of Indianapolis is CEO of the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition. He has lived with Type 1 Diabetes for 39 years. Lexington insurance agent Stewart Perry is a lifelong patient advocate living with Type 2 diabetes and a founding member of the Diabetes Leadership Council.

American health-care innovation has saved countless lives. Whether it’s a new vaccine to prevent serious illness, or a breakthrough treatment to help someone manage a previously debilitating chronic disease, we owe a lot to those researchers and scientists in white lab coats.

But what if they toiled away in the lab to make that new medicine and no one could access or afford it? And what if the reason was because some unknown middleman was dictating the cost and skimming vast sums of money off the top to pad their bottom line?

While we’d like to think that no one would stand for such a thing, this is unfortunately what happens every day in our modern health-care system.

It should be a lot simpler. Scientists develop a medicine, physicians determine when to prescribe it, pharmacists dispense it, and a patient takes it to manage their health. But somehow it became commonplace for an insurance company to dictate which medicines a patient can take—and for a pharmacy benefit manager, or PBM, to determine how much they pay for it. And we’re supposed to believe they do this to help businesses and individuals save money.

Because of these unfair practices, tens of millions of Americans struggle at the pharmacy counter. And with worsening inflation on all the other necessities of life, this situation is only getting worse. In fact, the Kaiser Family Foundation found that 30 percent of patients don't take their prescriptions as prescribed due to cost—and instead, choose to cut pills, skip doses or not fill prescriptions at all.

If you’re still not convinced, consider this: in recent years, the net prices of drugs—the list price, minus rebates and other discounts and reductions—have been going down. This should translate to lower costs for patients, but we’re seeing the opposite. Patients are spending more on prescription medications, even though PBMs and insurers are hauling in more savings.

Not surprisingly, PBMs and insurers are working hard to protect the complex web they’ve created to snare as much money as possible and increase their profits. But legislators at the state and federal levels are continuing to fight on patients’ behalf—and thanks to their efforts, we’re moving in the right direction.

In 2020, the Kentucky General Assembly passed groundbreaking legislation to rein in PBMs’ involvement in the state’s Medicaid program by creating a single drug formulary, managed by one PBM. Cutting out multiple unnecessary PBMs is expected to save taxpayers hundreds of millions of dollars a year, while ensuring patients can more easily access the medications they need to manage their health.

Of course, additional work remains to ensure patients are not bearing the brunt of PBMs’ unfair practices. That’s why a large and growing group of patient advocates and health-care providers are encouraging legislators to focus on patients over PBM profits—and are calling for legislation that would require middlemen to share manufacturer rebates directly with patients at the point of sale.

PBMs and insurers negotiate with drug manufacturers to get lower prices on prescription medicines. In theory, these savings should be passed along to patients to reduce their out-of-pocket costs. In reality, the system allows PBMs and insurers—massive, billion-dollar corporations—to keep the rebates, while continuing to charge patients higher prices for their medications.

“Share the savings” legislation would put an end to this unfair practice—and could save Americans living with chronic diseases hundreds or even thousands of dollars per year. That’s more money in the pockets of Kentuckians where it belongs.

PBMs and insurers defending the status quo argue that premiums will rise sharply if these rebates are shared with patients. And they also falsely claim that it will increase the costs for our businesses as well. But actuarial studies show that's not true, including a 2022 study from Milliman that projects an increase in premiums of less than 1 percent—and that's not even counting the savings from reduced hospitalizations that would result from patients taking their medications as prescribed.

The truth is that patients can't afford not to share in these rebates. And that’s why it’s time for PBMs to start sharing the savings.

State has fewer spots at facilities that care for children with emotional or psychiatric needs, threatening family breakups

Kentucky has "a shrinking number of spots at facilities that care for children, most in foster care. Financial strain is exacerbated by unprecedented staff shortages, including therapists, that leave facilities unable to operate at full capacity," Deborah Yetter reports in her last story for the Louisville Courier Journal. She retired Friday.

"Everybody has an empty bed or empty cottage but they can't fill it," Michelle Sanborn, president of Children's Alliance, told Yetter. The group represents private agencies, many nonprofit or faith-based, that provide care for children with emotional or psychiatric needs. "Now with this workforce crisis, and increased need for therapeutic services, it's really hitting a crisis point," Sanborn said.

Cheryl and Jacob White (Cheryl White via CJ)

Yetter's object example is Jacob White, 13, of Frankfort, who has cycled through foster homes, residential treatment centers and psychiatric hospitals for four years "as state social service workers sought treatment for his autism, psychiatric issues and sometimes, aggressive or violent behavior," she reports. "The state says it is unable to find any place to accept Jacob and is seeking to move him from Peace Hospital, a Louisville psychiatric facility, to a Florida treatment center."

Jacob's mother, Cheryl White, is fighting the move in court, saying that if the state can't find a place for him in Kentucky, it should let him come home. "If they succeed in taking him to Florida, I don't know how to get him back," White, a single mother who relinquished custody of Jacob to the state in 2018, told Yetter. "They're going to make it so I can't even visit my son."

White, who works at a Frankfort store, told Yetter that she visits Jacob weekly but can't afford flights and a Florida hotel, "and doesn't trust her 15-year-old Toyota with 275,000 miles to make the trip," Yetter reports. "The matter is scheduled to go before a Family Court judge in December." A court-appointed special advocate for the child has recommended against sending him to Florida.

But in Kentucky, Sanborn told a legislative committee last month, Yetter reports, "administrative demands, stress and better-paying jobs elsewhere have caused workers to leave in droves, with employee turnover at a record 81 percent. . . . She said some private facilities the state depends on are at the brink of closing."

Flu off to fast start in Kentucky, as cases keep more than doubling each week; flu, Covid-19 and RSV threaten a 'triple-demic'

State Dept. for Public Health map, adapted by Ky. Health News; county figures are online here.

Last week's cases will
be reported on Friday.

By Al Cross
Kentucky Health News

Influenza is spreading quickly in Kentucky, raising the threat of a "triple-demic" of flu, Covid-19 and respiratory syncytial virus (RSV).

The state Department for Public Health's most recent report says 2,082 flu cases were confirmed during the week that ended Nov. 5. That was 140 percent more the the previous week, and case numbers the week before were more than triple the previous week. All told, 3,342 cases have been confirmed, and that does not include at-home tests.

Most of the cases have been in Kentuckians 20 and younger. Many school districts have closed schools or moved to nontraditional instruction for a few days.

Kentucky Department for Public Health graphs

Last Monday, 25 of the 171 public districts did; the following day was Election Day, when most were scheduled to be closed anyway for voting.

"More than 100,000 Kentucky students have been sent home this month, and health professionals are warning more closures are likely, saying there is a strong possibility of a "tripledemic" this winter," reports Krista Johnson of the Louisville Courier Journal. "For the past two years, safety measures related to Covid-19 have kept influenza and RSV case numbers low, but hospitalizations due to these viruses are increasing."

The state has confirmed one death from the flu, in an adult.

The flu is getting off to a faster start than usual. The percentage of clinic visits resulting in reports of influenza-like illnesses is higher than it has been in any of the last four years, according to a health department graph.

ILI means influenza-like illnesses; MMWR is the CDC's Morbidity and Mortality Weekly Report 

Had trouble with a health-insurance claim? An appeal? National, nonprofit newsroom ProPublica wants you to help its reporting

Photo illustration from ProPublica

ProPublica, the national, nonprofit, investigative newsroom, wants Americans to help it report why health insurance claims are denied, what the consequences are for patients, and how the appeal process works. It says it has heard from hundreds of people about the obstacles they have faced when denied health care.

"Take Alyssa Miller, a hospital-based nurse," ProPublica reports. "When she was 16, she was diagnosed with cancer and had to undergo radiation treatment. Given her now-increased cancer risk, her oncologist said she’d have to get a mammogram by 25. But when she went to get the procedure, Miller’s insurer denied her claim because, per its policy, it only covers mammograms when patients are 40 or older. She fought back with an appeal backed by a note from her doctor. That was denied, too."

Miller told ProPublica, “I was just really frustrated and confused by the whole appeals process. I feel like I’m supposed to know how this works being a health care provider. I almost gave up.”

Miller was able to get her mammogram covered by asking her employer’s human-resources office to get involved, ProPublica reports, "but she is among just a small percentage of people who appeal these denials. . . . Even insurance company employees, doctors and nurses have to battle insurers for coverage for themselves and their family members."

ProPublica said it has heard from "more than 100 people who work in health care or insurance and have had difficulty getting care covered, including:

• A doctor whose son has a speech disorder but had to stop speech therapy because insurance would not cover it.
• A nurse practitioner with long COVID whose treatments are being denied by insurance.
• An ophthalmologist whose uncle had a detached retina, which can cause blindness without treatment. The insurer denied the surgery because it concluded the procedure was not emergent.

Now we are hoping to hear from more people who can help us understand what is happening on the inside as these decisions are made. If you or someone you know works in health insurance, please fill out this form." If not, use the link in the first paragraph of this story.

Federal government signals that President Biden will extend the public-health emergency for Covid-19 beyond Jan. 12

Photo illustration by Dado Ruvic, Reuters

The U.S. Department for Health and Human Services "on Friday signaled it will extend the Covid-19 public health emergency beyond Jan. 12," the scheduled date for its expiration, Inside Health Policy reports.

"Health and Human Services Secretary Secretary Xavier Becerra has promised to give stakeholders 60 days notice before lifting the emergency declaration so they can prepare for a return to normal operations," reports Spencer Kimball of CNBC. "In October, HHS extended the public health emergency until Jan. 11. HHS did not provide a 60-day notice on Friday, which was the deadline to alert states and health-care providers if the federal government planned to lift the declaration on Jan. 11."

Becerra told reporters in October that how the U.S. fares against Covid-19 this fall and winter will help determine whether the emergency needs to be renewed again, Kimball notes. "Public health officials are expecting another Covid surge this winter as people gather more indoors where the virus spreads easier. The future also remains uncertain as more immune evasive Omicron subvariants become dominant in the U.S."

The HHS move will "draw praise from key health care-stakeholders who recently urged the administration to maintain the PHE and related policies through the winter to help address a potential Covid surge and to grant states more time prepare for the Medicaid redetermination process slated to re-start once the emergency ends," IHP reports.

National Rural Health Day is Nov. 17; Kentucky Rural Health Association's annual conference is Nov. 16 and 17 in Somerset

By Melissa Patrick
Kentucky Health News

Thursday, Nov. 17 is 12th annual National Rural Health Day, a day set aside to generate an increased awareness of rural-health related issues. 

"National Rural Health Day is an opportunity to celebrate the “power of rural.” We use this day to highlight the unique health care challenges that rural people face. Then, we show how our programs and policies, and the efforts of our partners and stakeholders, help address and reduce health care disparities in rural communities," the Health Resources & Services Administration says on its website.

The event is sponsored by the National Organization of State Offices of Rural Health, which will host a special web event on Nov. 17 at 2 p.m. EST titled "Collaboration Carpool: Conversations with Mission-Minded Rural Stakeholders." The event will include representatives from the United States Department of Agriculture, broadband, philanthropy, public health, and rural health clinics and community centers. Go to powerofrural.org/featured-events/ for more information and to register.  

HRSA says its theme is "Advancing Behavioral Health Equity in Rural Communities" and will be hosting four webinars to bring attention to this issue. Click here for more details. Here are a list of dates and topics: 

• Monday, Nov. 14: Mindfulness Based Stress Mitigation in the Workplace (Registration required)
• Tuesday, Nov. 15:  Hidden in Plain Sight: Understanding the Impact of Intimate Partner Violence and Human Trafficking in Rural communities
• Wednesday, Nov. 16: Federal Office of Rural Health Policy Grantee Stories about how they have advanced behavioral equity in their communities 
• Thursday, Nov. 17: Health and Human Services Leadership Panel, discussing HHS programs and initiatives that advance rural behavioral health equity. 

In Kentucky, 1.8 million people, or 40.6% of the population, live in rural areas, according to the Rural Health Information Hub. It shows, using HRSA data, that every county in Kentucky is considered a Health Professional Shortage Area for mental health. 

That said, all Kentuckians who are experiencing a mental-health crisis can call the state's new, confidential 988 suicide and crisis hotline. It is available 24 hours a day, seven days a week. Kentuckians who call 988 will be routed to the closest regional call center according to their area code and the phone exchange. In addition, callers are asked if they are a farmer or a member of a farming family as part of a data gathering effort to better understand the increasing mental health crisis of farmers. 

A spokesperson from The Kentucky Rural Health Association said they have been highlighting rural healthcare providers through its social media as a way to celebrate National Rural Health Day. The association will also be hosting its annual conference in Somerset on Nov. 16 and Nov. 17. Click here to register and to see the full agenda. 

26 Ky. counties moved from low risk to medium risk for Covid-19 last week as flu and RSV cases remained high across the state

Centers for Disease Control and Prevention map

By Melissa Patrick
Kentucky Health News

While only three Kentucky counties were considered to be at high risk of Covid-19 transmission last week, 26 of them moved out of the low-risk category and into the medium-risk category this week. Meanwhile, influenza and RSV cases remain high. 

RSV stands for respiratory syncytial virus, a common virus that usually causes mild, cold-like symptoms. And while most people recover in a week or two, it can be serious for infants and older adults.

At his weekly news conference, Gov. Andy Beshear urged Kentuckians to get their flu and Covid-19 vaccinations and boosters, especially as we head into the holidays where multi-generational groups gather indoors. He also encouraged people to pull out their masks if they are at high risk of severe illness.

"If you're susceptible as an adult, if you have some of those conditions where RSV or the flu or Covid can make you really sick, consider wearing that mask in public, especially when you are indoors," he said. 

The Centers for Disease Control and Prevention risk map, which looks at both cases and hospital data to determine risk, shows Knott, Pike and Letcher counties at high risk of Covid-19 transmission. Letcher County was the only high-risk county on the prior week's high-risk map. 

The map shows 46 Kentucky counties at medium risk, shown in yellow, and 71 counties at low risk, shown in green. High-risk counties are shown in orange.

In high-risk counties, the CDC continues to recommend that you wear a well-fitting mask in public indoor spaces, and if you are at high risk of getting very sick, consider avoiding non-essential indoor activities in public where you could be exposed.

If you live in a medium or high-risk county, the CDC advises those who are at high risk of getting very sick to wear a well-fitting mask when indoors and in public and to consider getting tested before having social contact with someone at high risk for getting very sick and consider wearing a mask when indoors when you are with them.

Centers for Disease Control and Prevention map

The CDC also has a transmission-level map that shows the level of virus spread in each county, at one of four levels. The map shows two Kentucky counties at low levels of transmission (Fulton and Robertson), 16 counties at moderate levels of transmission and the rest have either substantial or high levels of transmission. This data is largely used by researchers and health-care facilities.

State health officials have encouraged Kentuckians to use the other CDC map to guide their preventive measures.

The New York Times ranks Kentucky's infection rate ninth among the states, with a 19% increase in cases in the last two weeks.

Beshear said state data indicate that Covid-19 is on a plateau in Kentucky, with a little up and down movement each week in both new cases and the positive-test rate.