Princess Health and Three Kentucky health departments in first group up for national accreditation; requires local health assessment, improvement plan.Princessiccia

Princess Health and Three Kentucky health departments in first group up for national accreditation; requires local health assessment, improvement plan.Princessiccia

Cabinet for Health and Family Services county health boards county health departments health departments health policy public health

Gusty 14:41 Add Comment

By Molly Burchett
Kentucky Health News

Three Kentucky health departments are among the first in the nation to be considered for national accreditation, a process that could help improve patient care and put the agencies in closer touch with their communities' needs.

The national Public Health Accreditation Board will make its first accreditation decisions next week. Among the first group being considered are the Franklin County Health Department, the Three Rivers District Health Department in Carroll, Gallatin, Owen and Pendleton counties, and the Northern Kentucky Independent District Health Department, in Boone, Grant, Kenton and Campbell counties.

The decision will be a historic one, and this is an exciting time for the board and Kentucky, said board Chair Dr. Douglas Scutchfield, professor of health services research and policy at the University of Kentucky College of Public Health.

The accreditation program was launched in September 2011 after a seven-year development process aimed at advancing quality and performance and value in the departments, and their accountability to stakeholders, Scutchfield said.

Departments are assessed by rigorous standards tested in 30 diverse health departments across the country to ensure essential public health services are provided in the community, according to the board's website. Two of the 12 "domains" of the standards deal with administration and governance. In Kentucky, state law makes county health boards responsible for the health of the county. Counties served by district health departments still have county boards.

Accreditation can help a board and department identify opportunities to improve performance and management, and to improve relationships with the community, since the process requires a community health assessment, a community improvement plan and a strategic plan to address the need of the community, said Scutchfield.

The process, often called "Mobilizing for Action through Planning and Partnerships," can help boards and departments be better prepared to proactively respond to emerging and re-emerging health challenges. For a PDF of Franklin County's MAPP document, click here.

The accrediting board has received 108 applications from health departments around the nation: 13 state health departments, 94 local health departments and one tribal agency. In addition to the three Kentucky agencies being considered in the first group, the other Kentucky departments that have applied for accreditation and are awaiting site visits are Lexington-Fayette County, Barren River District, Madison County and Christian County, Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services, said in an email.

The accreditation process encourages departments to move away from the "silo" model to collaborate with community programs. In Christian County, it has changed the way department employees view their jobs, because they have to continuously reflect on their methods and brainstorm for ways to improve, Health Department Director Mark Pyle told Nick Tabor of the Kentucky New Era.

"Accreditation will likely open new revenue streams," Tabor writes. "But in a way, the process matters more than the status designation."

Midkiff said, "In addition to benefiting from the process itself, our federal and state resources in public health are increasingly shrinking, we are being asked to do more with less. And there is a need for transparency within agencies."

Midkiff said accreditation "may make the agency more competitive for grants in the future. We are actually seeing quality improvement and performance management requirements being written in many federal grants now, so it is being expected at the national level."

Although accreditation is completely voluntary, it is being encouraged for local health departments by the state Department for Public Health, which is in the process of applying for its own accreditation in 2014. Midkiff said the department just completed its state health assessment, which is now being reviewed, and is beginning to assemble partners to write a state health improvement plan, which should take about a year.

Kentucky Health News is an independent service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Poll finds four out of five Kentuckians are comfortable seeing a nurse practitioner or physician assistant for routine care.Princessiccia

Princess Health and Poll finds four out of five Kentuckians are comfortable seeing a nurse practitioner or physician assistant for routine care.Princessiccia

dental care dental health Foundation for a Healthy Kentucky nurse practitioners physician assistants poll

Gusty 14:06 Add Comment

New poll figures indicate the majority of Kentuckians are comfortable seeing a nurse practitioner, physician assistant or mid-level clinician for their routine care, especially if they have been treated by such clinicians. The findings come as the General Assembly considers a bill that would allow physician assistants to practice more independently.

In the Kentucky Health Issues poll last fall, 79 percent of Kentucky adults said they would be comfortable seeing a nurse practitioner for routine health care, and half of those people said they would be very comfortable. Eighty-one percent said they would be comfortable seeing a physician assistant for routine health care, and 42 percent of those respondents said they would be very comfortable.

Reported comfort was higher among people who had received care from a nurse practitioner or physician assistant in the past year; 86 percent of those people said they would be comfortable seeing an NP again for routine care. Eighty-eight percent of those who had received care from a PA in the past year said they would be comfortable doing that again.

The poll also inquired about a proposed new �mid-level� profession: advanced dental hygiene practitioners. These practitioners would provide routine dental care, including diagnostic and preventive services such as filling cavities. Although advanced dental hygiene practitioners cannot currently be licensed to practice in Kentucky, polling data indicated 73 percent of Kentucky adults would be comfortable with such a practitioner providing routine dental care.

"As providers move to create a system of care that includes a range of skill sets and training in its care teams, new strategies emerge that hold promise to increase access to affordable care � not just in urban centers but also in rural and underserved communities,� said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which sponsored the poll. �The data suggest that the public is very receptive to health care services from different types of clinicians.�

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points. (Read more)

Princess Health and Bill to shield nursing homes from lawsuits clears Senate along party lines; not looking healthy in House despite TV, radio ads.Princessiccia

Princess Health and Bill to shield nursing homes from lawsuits clears Senate along party lines; not looking healthy in House despite TV, radio ads.Princessiccia

advertising health journalism health policy legislation legislature lobbying long-term care newspapers nursing homes politics state government; General Assembly tort reform

Gusty 13:52 Add Comment

Last week the state Senate approved on party lines a bill that would make lawsuits against nursing homes go through a review panel first. Republicans supported the bill and Democrats voted against it in a 23-12 vote that marked the clearest partisan split in the Senate in this year's legislative session.

Senate Bill 9 would create medical review panels of three physicians and an attorney moderator to hear complaints against long-term care facilities and vote on whether the suit had enough merit to go to court.  The bill's sponsor, Senate Health and Welfare Chairwoman Julie Denton, R-Louisville, declind to answer an opposign senator's questions about the bill. She said in introducing it that the panel would be advisory but its opinion would be admissible in court and would curb such lawsuits, reports Jack Brammer of the Lexington Herald-Leader.

Bills like this have failed in years past and could have diverse implications for Kentucky communities and nursing homes. At least one Kentucky newspaper looked around and found that lawsuits are one reason Extendicare Health Services Inc. shed management responsibilities last year for all 21 of its facilities in Kentucky, reports Nick Tabor of the Kentucky New Era in Hopkinsville.

Without Extendicare management in Western Kentucky, the volume of nursing-home lawsuits in the region appears to be shrinking, Tabor reports. In recent years, nearly all the Christian County cases that have been closed were dismissed through settlements, not by judges declaring them unfounded. This suggests the bill would minimally affect the county, writes Tabor. Other Kentucky communities may be affected differently; judges differ from circuit to circuit.

Although the bill passed the Senate, it appears to be on its deathbed in the House. Rep. Tom Burch, D-Louisville, who chairs the House Health and Welfare Committee, joked about its prospects to Tabor: �I can�t make any predictions about the bill this time, but I�ve called in three priests to have the last rites ready.� If nursing homes received this new layer of protection, he said, hospitals and day-care centers would want it too.

A similar bill died in Burch's committee last year; this version is being supported by television and radio commercials urging viewers and listeners to call their legislators in support. When Extendicare announced last spring it was transferring management of all its Kentucky facilities to a Texas company, it cited Kentucky�s �worsening litigation environment� and said tort reform seemed unlikely here.

Bernie Vonderheide, director of Kentuckians for Nursing Home Reform, said most so-called �frivolous� lawsuits would cease if the state imposed minimum staffing requirements on nursing homes, his group's main legislative goal. (Read more)

Princess Health and Medically unnecessary procedures are part of culture of disability in Eastern Kentucky, professor writes.Princessiccia

Princess Health and Medically unnecessary procedures are part of culture of disability in Eastern Kentucky, professor writes.Princessiccia

disabilities health policy heart disease hospitals rural health

Gusty 06:05 Add Comment

St. Joseph London Hospital is taking heat over accusations of performing medically unnecessary cardiac catheterizations and other invasive cardiac procedures, and a look at the health data by a Kentucky physician suggests that the phenomenon is broader and reflects cultural problem in Eastern Kentucky.

An examination of health data by Dr. Peter Hasselbacher, a retired internist and professor emeritus at the University of Louisville, confirmed that St. Joseph London performed a large number of invasive heart procedures for such a relatively small, rural hospital.  Many patients have sued the hospital, alleging unnecessary procedures, notes a story in The Courier-Journal.  And when the hospital came under federal supervision, the frequency of its most commonly performed stent-angioplasty procedure dropped by 37 percent, Hasselbacher reports on his Kentucky Health Policy Institute blog.

As the number of St. Joseph London procedures dropped sharply, there was a more dramatic increase in catheterizations and angioplasties statewide. From 2010 to 2011, the number of the most commonly reported angioplasties in Kentucky increased from 12,803 to 22,688, a 77 percent increase, reports Hasselbracher.

This map showing how many people living in each of Kentucky�s counties underwent a percutaneous transluminal coronary angioplasty (PTCA) in 2010. This is the most common invasive cardiac procedure in Kentucky and is used to prevent and treat heart attacks.

In this map, the darker the shade of blue, the greater percentage of people living in that county had an angioplasty in 2010. The differences among the counties is staggering. It ranges from a low of 42 people per 100,000 in a single year, all the way up to 1,700 per 100,000 � a 40-fold difference. In the counties with the highest rates, between 1 percent  and 2 percent of the county's population underwent the procedure in a single year.

These rates are based on where people live, rather than where they go to the hospital, and the counties with the highest rates are in Appalachia. Hasselbacher calls Eastern Kentucky is "an angioplasty factory" and says the phenomenon can't be be fully explained by the simple fact that people in the region are sicker than those in the rest of the state; he offers another explanation.

"It is my belief that a major, perhaps even the major segment of the economy of Eastern Kentucky revolves around the getting of disability and the keeping of disability" and its government benefits, Hasselbacher writes. "As other industries such as coal and tobacco have faded in importance, the pursuit of disability, medically justified and not, has drained away resources from medical services into an ersatz unemployment and social support program."

Hasselbacher, left, says he doesn't wish to imply that the people of Eastern Kentucky are morally distinguishable from the rest of us, or that their health-care professionals are any less professional. He acknowledges that the region has had an uphill struggle for many years, and it is easy for providers to fall into the trap of wanting to do everything and anything to help patients.

"A culture has evolved in which being sick or just having a diagnosis of being sick is a gateway to economic security for people and professionals alike," Hasselbacher writes. "Some patients, doctors, hospitals, and lawyers wittingly or unwittingly support that process. Doing medially unnecessary diagnostic testing and treatment is part of that culture. It is also good for business." (Read more)   

Princess Health and How To Beat Those Bingo Wings?. Princessiccia

Princess Health and How To Beat Those Bingo Wings?. Princessiccia

Gusty 14:13 Add Comment

Bingo wings - who doesn't hate them? Most women would agree that the dangling fat underneath the upper arms is quite disturbing. Therefore, they don't feel confident to wear sleeveless tops or dresses, and they don't feel confident in general about how they look. The good news is that they can beat the bingo wings with the right exercises.

Why do we get bingo wings?

Bingo wings are basically excessive fat accumulated on the upper arms. Fat accumulates because the food we take in provides more energy than the energy we use. Besides belly, hips and thighs, arms are perfect spots for storing the excessive fat. So the fact of having bingo wings is a sign of being overweight.

Fighting bingo wings - Step 1.

The right exercise to start fighting bingo wings is cardiovascular (aerobic type) exercise, to use  up more energy, to burn fat. There are many choices: jogging, swimming, biking, dancing, speed walking, aerobics, Zumba� Fitness. Doing one of these exercises regularly, at least thirty minutes four times a week can help reduce body fat all over the body, including upper arms.

Fighting bingo wings - Step 2.

Besides, doing toning exercises for the arm area can speed up the result. Working with own body weight is one of the best choices, also being very easy to do the exercises in the comfort of your own home.

Back press or chair dip - The chair is behind your back, then you place your hand palms down on the chair with your arms straight and the legs in front of you as wide as your shoulder. Lower your body until your elbow is bent at a 90 degree angle and then push yourself back up.

Push ups (easy or difficult version) - You might hate push ups, but once you see the results they will become your best friend. You might want to start with the easy version, which places the knees instead of the feet on the floor so that you don�t feel much pressure when lowering your body to the floor.

These two exercises done in repetitions will make you get the best results.

It is important to remember that doing toning exercises only will not get rid of the flabby underarms. Cardiovascular exercise (outlined above) is unavoidable to get the results you want.

During our ZUMBA� classes, there are many steps when serious arm moves are added. Beside the cardiovascular and fat burning benefit of a ZUMBA� fitness class, you can tone up your arms, if you keep your upper arm muscles tight while doing the arm moves. You will feel the difference!

Good bye, bingo wings! - Hello, gorgeous sleeveless dress!

Don't hesitate, get the 2 in 1 benefit of our ZUMBA� classes, CLICK HERE to book your place!

Princess Health and Herald-Leader says state running out of time to fix Medicaid managed care, with decision on expansion looming.Princessiccia

Princess Health and Herald-Leader says state running out of time to fix Medicaid managed care, with decision on expansion looming.Princessiccia

health care access health care costs health reform managed care Medicaid newspapers state government state government; General Assembly

Gusty 10:45 Add Comment

A recent editorial in the Lexington Herald-Leader called for swift legislative action to fix the problems of Medicaid managed care. Timely action is even more necessary since the state is considering expanding the program, some critics have said.

Fifteen months ago the administration of Gov. Steve Beshear made a quick transition to managed care that privatized Medicaid for 550,000 poor, elderly and disabled people and was projected to save Kentucky $375 million in three years.  If the state expands Medicaid, that number of covered individuals could grow to more than 1 million � or roughly a quarter of all Kentuckians.

Although Medicaid is encouraging preventive care, such as more well-child visits and diabetes testing, providers haven't been paid for some of their services. The state recently granted the managed care companies a seven percent rate increase, and the companies have said they're losing money here and one is pulling out in July. But at the end of the first eight months of managed care Medicaid, the state had paid $500 million more to the companies than the companies had paid to providers.

"The delay and denial of payments are creating financial crises for providers and pharmacies and forcing small hospitals to lay off employees, deplete reserves and default on bonds," the editorial said. "This is creating a massive transfer of wealth from Kentucky medical practices and hospitals to for-profit companies based in other states. . . . For patients, the companies are putting up barriers to care that would be illegal in the private sector. The new burdens that have been placed on vulnerable Kentuckians and their medical providers threaten to unravel not just the safety net but, in some places, the whole health care system."

The editorial called on the General Assembly to pass legislation to curb abuses such as "the stiffing of hospitals that provide emergency care as required by federal law. . . . House Bill 299 and Senate Bill 178 would also curb the false economy of severely limiting in-patient mental-health care for children while referring them to nonexistent out-patient care."

The legislation would also require Medicaid managed care companies to:

• Meet the same provider network standards, including distance to hospitals and obstetrical care, as other insurers operating under Kentucky law.
• Decide claims based on nationally recognized clinical standards and provide specific reasons for denials so providers would know what's allowable.
• Participate in an appeals process for denied claims.

Appalachian Regional Healthcare wants to sue the U.S. Department of Health and Human Services and others, alleging that the new system is out of compliance with federal law.

"The feds shouldn't have to be dragged in," the editorial says. "The federal government covers roughly 70 percent of Kentucky�s $6 billion Medicaid program. Expanding Medicaid to include more low-income people is a linchpin of federal health care reform," and Beshear has said that he wants to expand Medicaid if the state can afford it. "Kentucky can't wait much longer to get Medicaid right." (Read more)

Princess Health and Beshear endorses statewide smoking ban as bill moves to the House floor; Williamsburg adopts its own ban.Princessiccia

Princess Health and Beshear endorses statewide smoking ban as bill moves to the House floor; Williamsburg adopts its own ban.Princessiccia

General Assembly governor health rankings legislation legislature local government smoking smoking ban state government tobacco tobacco prevention

Gusty 11:52 Add Comment

Gov. Steve Beshear endorsed a statewide smoking ban yesterday at a Frankfort rally to push the bill that would enact the ban.

"Beshear, who later acknowledged that he smoked in college but quit soon afterwards, said Kentucky ranks No. 1 in the nation in smoking and lung cancer," reports Jack Brammer of the Lexington Herald-Leader.

Noting that Kentucky leads the nation in smoking, Beshear said, "Our addiction hurts productivity, jacks up health care costs and literally kills our people. Yet we've never instituted a statewide law to protect Kentuckians from secondhand smoke." Noting that over one-third of Kentuckians live in jurisdictions with smoking bans, he said, "It's time that we extend that protection to all Kentuckians. . . . Years from now, people will wonder why we waited so long."

Republican Rep. Julie Raque Adams  of Louisville, a co-sponsor of the bill, noted at the rally that Williamsburg this week became the 23rd Kentucky locality to adopt a smoking ban.

The statewide measure, House Bill 190, was posted for passage in the House today but is not expected to be called for a vote unless supporters show Speaker Greg Stumbo that they have the votes to pass it.

Read more here: http://www.kentucky.com/2013/02/14/2517025/former-kentucky-basketball-star.html#storylink=cpy