Wednesday, 23 April 2014

Princess Health and Princess Health andBeshear says Kynect signups show importance of health-care reform to Kentucky's health; Republican foes keep attacking it.Princessiccia

By Al Cross
Kentucky Health News

Opponents of federal health reform kept up their drumbeat Tuesday as Gov. Steve Beshear announced the latest, but still not quite final, signup figures from Kynect, the state health-insurance exchange.

Kynect Executive Director Carrie Banahan listened to Beshear.
(Lexington Herald-Leader photo by Pablo Alcala)
Beshear held a news conference to announce that 413,410 Kentuckians enrolled for coverage via the exchange through April 11, when most enrollment in private insurance plans closed until Nov. 15. he said "A significant number" of paper enrollments are still being processed. Enrollment is open year-round for the Medicaid program and for people who experience a major event such as change of jobs or birth of a child.

So far, 68 percent of those who signed up for a private insurance policy through the exchange have paid their premiums, according to a state press release. About three-fourths of the policies are from the Kentucky Health Cooperative, a non-profit insurance company created under the Patient Protection and Affordable Care Act, known as Obamacare. The rest of the market was about equally divided between Humana Inc. and Anthem, the only for-profit company offering exchange policies statewide.

Beshear said state officials estimate that three-fourths of exchange enrollees did not have health insurance when they signed up, and Health and Family Services Secretary Audrey T. Haynes estimated that the number of uninsured Kentuckians has dropped to around 200,000, from an estimated 640,000. She said an unknown number of the uninsured obtained insurance outside the exchange.

About three-fourths of the exchange enrollees are in Medicaid, which Beshear expanded to cover people with household incomes up to 138 percent of the federal poverty threshold. The previous income limit was only 69 percent of poverty. The federal government will pay the entire cost of covering the newly eligible people through 2016, when the state will have to start picking up a small share, reaching a cap of 10 percent in 2020.

The federal government pays about 71 percent of benefits for previously eligible Medicaid recipients in Kentucky. Some who had been eligible but never enrolled signed up through the exchange; Haynes said she didn't know the number, but said she still feels good about the estimate of 17,000, made before the exchange opened Oct. 1.

Beshear reiterated his belief, based on a study by the international accounting firm PriceWaterhouseCoopers, that expansion of Medicaid will pay for itself by expanding the health-care industry and creating 17,000 jobs. Republicans in the General Assembly have expressed skepticism about that but have offered no countervailing information.

The leading Republican attacker has been U.S. Sen. Mitch McConnell, who sent Kentucky newspapers his latest column on the subject Monday, saying claims that the law has been successful are refuted by the experiences of those who had their policies canceled despite President Obama's promise that they could keep them, and have had to pay higher premiums and deductibles, "often for a plan that offers less access to hospitals and their favorite doctor."

McConnell called "shocking" the signup of inmates by jails and prisons, which he said could limit access to care because the demand for it may outstrip the supply of doctors, nurse practitioners and other health-care providers. Officials have said the signups save the state money by transferring costs to the federal government.

Asked about McConnell's criticism, Beshear said, "These critics continue, apparently, to sit in their own echo chambers and talk to each other, because when you get out and talk to these 413,000 people, they are very thankful that we have moved forward both in expanding the Medicaid program and in setting up our own health-benefits exchange." Haynes said the program has been "overwhelmingly successful by all measures."
Read more here: http://www.kentucky.com/2014/04/22/3207241/beshear-says-more-than-413000.html?sp=/99/322/&ihp=1#storylink=cpy

Tea party activist David Adams, who is appealing initial adverse rulings in two lawsuits he filed to challenge Beshear's actions, disputed the estimate that three-fourths of the exchange enrollees had been uninsured, "arguing that enrollment questions on the Kynect website prompted people to falsely claim that they lacked insurance when submitting applications," Mike Wynn reports for The Courier-Journal.

Beshear said the reform law is "a tool to improve people's health, to help those who are vulnerable to to remove lack of health coverage as the determining actor in a family's financial security." He said the nearly-final enrollment figure is "a milestone that shows just how important health-care reform is to our families and our future. . . . We're going to keep enrolling people until everybody in Kentucky who needs health coverage has health coverage."

Skeptics of the law say research has shown that enrollment in Medicaid doesn't improve enrollees' health, but defenders say that study didn't last long enough. Beshear said, "It'll probably take several years to see a change in our rankings, but you will see a change in our rankings over the next generation." He said the reform law's emphasis on prevention and wellness will give the state a healthier workforce that will attract more jobs.

Republicans are making Obamacare the centerpiece of their campaigns for the Nov. 6 elections, but Beshear told The Washington Post in January that by Election Day the law will be a net plus for Democrats. Asked yesterday if he would recommend to Democrats in the legislature that they use the reform law in their campaigns, he said candidates will have to make their own decisions, but "The Affordable Care Act, some next November, is going to be looked at a lot differently than it was looked at last November," when the national rollout was very troubled.

"The 80 percent of Americans and Kentuckians whom the Affordable Care Act will not affect at all are gonna know that it's not gonna affect them, so it's not gonna be a big issue for them one way or the other," Beshear said, and the 20 percent who are affected "like what they're getting. . . . I would say to those who think they're gonna make this the crowning issue and defeat somebody on it, have at it, because I don't think they're gonna get to first base by next November."

Reminded that Republicans use the law's nickname to run against a president who is unpopular in Kentucky, and asked when the tipping point in public opinion might come, Beshear suggested that he will find a way to gain political advantage.

"Whether you see a big change in the polling numbers when you use the phrase Obamacare or not, I don't think is gonna be all that relevant come next November, because people out here in Kentucky are gonna hear a lot about Kynect and the Affordable Care Act and the successes that we've had," he said. "I think you are seeing the polling now, when you talk about Kynect and what is going on in Kentucky, that people are very favorably disposed to it."

Democrat Elisabeth Jensen, running for Congress in the 6th District, has run a radio ad embracing "Kentucky Kynect" and said, "It polled well." (Read more)

Monday, 21 April 2014

Princess Health and Princess Health andBerea students' second health fair tackles touchy topics.Princessiccia

Della Walters tries to walk straight while wearing "drunk goggles" at
the Berea health fair. (Richmond Register photo by Crystal Wylie)
Student-run health fairs are becoming more popular across Kentucky, and some of them are touching on touchy topics. At their second health fair recently, for middle- and high-school students, Berea Community High School health students "handled more mature issues" than at their first, for elementary-school students. reports Crystal Wylie of The Richmond Register.

"Although students had their pick of topics ranging from sexually transmitted diseases, drunk driving, smoking, mental health, sugary drinks, learning disabilities and fitness," health teacher Cathy Jones said some students wanted to include 'sexting,' sexually oriented text messages. She allowed their presentation to pair the topic with cyber-bullying; students asked their classmates to sign a pledge against doing both.

�It�s a hot topic and something teenagers encounter,� Jones told Wylie. �They thought it was important to cover.� Jones said she plans to hold a fair twice a year. Meanwhile, Eastern Kentucky University professor Laurie Larkin and her public-health students conducted a health fair at Clark-Moores Middle School, Wylie reports. (Read more)
Princess Health and Princess Health andGeneral Assembly's failure to pass heroin bill incites wrath, calls for local action and a special session.Princessiccia

Princess Health and Princess Health andGeneral Assembly's failure to pass heroin bill incites wrath, calls for local action and a special session.Princessiccia

In the final hours of the 2014 legislative session, the House failed to pass Senate Bill 5, which would have helped combat heroin abuse. Some heroin-recovery advocates and community leaders are outraged, and now people are searching for local solutions to the problem while waiting for the General Assembly to act.

Senate Bill 5 would have allowed prosecutors to charge drug traffickers with homicide if someone died from an overdose of drugs sold by a trafficker, and allocated savings from a 2011 prison reform to fund drug-treatment programs. It would have permitted first responders and addicts' family members to give naloxone, a life-saving drug, to someone who overdosed. Amendments to the bill would have begun an program for addicts to exchange used needles for new ones, decreasing the prevalence of hepatitis C and HIV, and making Zohydro, a powerful painkiller, illegal�until it is changed into a tamper-resistant variety, Scott Wartman and Terry DeMio write for The Kentucky Enquirer.

"During a meeting in Campbell County Thursday night, many who are involved in heroin treatments predicted that a delay in passing the bill will result in more deaths and heartache throughout the commonwealth�and specifically in Northern Kentucky, which has been the most affected area by the deadly drug," Don Weber reports for cn|2's "Pure Politics." 

Charlotte Wethington, who works as a recovery advocate at the residential treatment center the Grateful Life Center, lost her son Chad 12 years ago because of an overdose. "I've been fighting this battle for well over a decade, and it is long overdue, past overdue, that we address the heroin epidemic," Wethington said, Weber writes. Dr. Mike Kalfas, a Northern Kentucky physician who treats heroin addicts, says Senate Bill 5 could have stopped what he says might be HIV or Hepatitis C epidemics in the near future. "Everywhere else there's been an IV drug problem, over time, the drug problem builds, then the Hepatitis C problem builds, and not far behind them is HIV," he said.

Because the bill didn't pass, communities are looking for local solutions, even if resources are limited. Dr. Bonnie Hedrick of the Northern Kentucky Agency for Drug Abuse reported that her organization is not only working on needle cleanup projects but also encouraging local doctors to prescribe the antidote to those who are addicted, Rae Hodge of The Associated Press reports. "Northern Kentucky Drug Strike Force director Bill Mark said that unless Gov. Steve Beshear calls the legislature into a special session to consider the bill, his organization has few tools to fight the state's growing heroin problem."

Beshear hasn't decided whether to call a session. "He argued that every session produces worthy bills that die, and 'it's too early to determine if a special session on any topic is prudent or needed,'" Beshear said, Mike Wynn writes for The Courier-Journal. Republican Senate President Robert Stivers has urged Beshear to call a session. He said, "This isn't political. This is about real people; this is about real problems; this is about real people losing their lives."

Sunday, 20 April 2014

Princess Health and Princess Health andCEO of Somerset hospital, rated by Consumer Reports as clearly the least safe in Kentucky, is resigning.Princessiccia

Mark Brenzel (Photo via Somerset Commonwealth Journal)
The CEO of the Kentucky hospital with by far the lowest safety rating from Consumer Reports magazine is resigning. Lake Cumberland Regional Hospital is one of 61 owned in 20 states by LifePoint Hospitals of Brentwood, Tenn.

In an April 14 message to the hospital staff, Mark Brenzel wrote, �A few weeks ago, I informed Scott Raplee, President of LifePoint�s Central Group, about my decision to step down  . . . I have struggled managing some health problems since last year that have required me to limit some activities including work hours. While these lifestyle changes have been helpful, they have made it difficult for me to keep up with the demands of this job.�

Brenzel concluded, �I have greatly enjoyed the last four years and am glad to be ending my hospital management career where it began in 1976 when I first visited LCRH [soon after it opened]. We have made great progress in improving patient care and implementing new strategies that will help LCRH be successful in the new healthcare reform environment. My wife and I are planning to stay in the community for the long term and look forward to supporting LCRH in any way that we can.�

Raplee told the Somerset Commonwealth Journal that LifePoint is doing national search to find a replacement for Brenzel, who will remain as CEO during the search. �We are discussing the possibility of Mark taking a new role with LCRH once the new CEO is hired,� Raplee said in a press release.

Thursday, 17 April 2014

Princess Health and Princess Health andHigh school students in Bourbon County campaign for indoor smoking ban, also against teenagers' use of e-cigarettes.Princessiccia

From left: LaShana Harney, Tyler Boyle
and Jessica Jones
(
Cori� Bowen photo)
By Cori� Bowen
Kentucky Health News

A group of young people in a Bluegrass county with a strong tobacco tradition is trying to make the county's indoors smoke-free.

Students Making a Change in our Community started at Bourbon County High School in the late 1990s and was revamped in 2013 by several students and Cyndi Steele of the Bourbon County Health Department. SMACC members said they felt it was time for the voices of youth to be heard again on smoking issues.

�Our main idea is to try to establish a smoke-free ordinance in Bourbon County,� senior Lashana Harney said.

The group has been busy this year collaborating with other youth in Paris at events such as the 2013 National Kick Butts Day � a youth rally against tobacco use and secondhand smoke � as well as attending a recent Kentucky Supreme Court hearing on an anti-smoking ordinance enacted by the Bullitt County Board of Health.

�It was interesting to be at an actual case,� Harney said. �It could go either way with this case.�

Jessica Jones, a junior, said that while SMACC targets adults, it also educates and trains elementary students on how to say no to tobacco, and about the harms of smoking. �We�ve been traveling and training fifth-graders,� she said.

SMACC members are working towards a school regulation against electronic cigarettes, which they think are deceptive. They don�t believe their peers realize the harmful effects associated with them.

�E-cigarettes are becoming more popular than traditional cigarettes,� junior Tyler Boyle said. ��The best way to get to youth is other youth.�

The Kentucky Tobacco Policy Research Program lists chemicals in e-cigarettes that can have negative effects on health including acetone (nail polish remover) and formaldehyde. The legislature recently banned sales of e-cigarettes to people under 18.

Harney, Jones and Boyle say they have seen a decrease in their parents� smoking since each student has become an anti-smoking advocate.

With Steele�s guidance, SMACC plans to keep educating and making its presence known in the community. Members will launch a group-written and directed YouTube video at the end of April that addresses secondhand smoke, titled, �It Could Be You.�

Steele said the road to banning smoking in public places for Bourbon County has been a work in progress for a long time: �I knew 20 years ago that when I chose to do this � it would be my career.� Now she has more help.

Wednesday, 16 April 2014

Princess Health and Princess Health andPoll: most Kentuckians support tobacco-free campuses, school nutrition standards and student physical activity requirements.Princessiccia

Kentuckians overwhelmingly support several school policies than can influence student health but are not all embraced by Kentucky schools, according to the latest Kentucky Health Issues Poll, taken in October and November.

The poll showed that 84 percent of Kentuckians�and 72 percent of smokers�support tobacco-free campus policies, which have been adopted by only about a third of Kentucky school districts. The survey also found that 72 percent strongly favor the tobacco-free policies, while 12 percent said they favored it somewhat.

The survey found that 57 percent of Kentucky adults strongly supported, and 21 percent somewhat supported, the U.S. Department of Agriculture's new standards for school nutrition, which reduced salt and saturated fat, increased offerings of whole-grain foods, fruit and vegetables, and put stricter controls on calories and portion size.

Because the U.S. Department of Health and Human Services recommends that young people exercise for 60 minutes per day, KHIP's survey asked Kentucky adults if they think Kentucky schools should offer 30 minutes of physical activity per day for students. It found that 88 percent strongly agreed and 9 percent somewhat agreed with the policy. Physical activity is an important topic for Kentucky because 18 percent of Kentucky children are obese, according to the Kaiser Family Foundation.
Democrats were more likely to be supportive of tobacco-free campuses and the new school menus, but there was no partisan difference on physical activity. "Poll findings show that support for the health of our children cuts across party lines," said Susan Zepeda, President/CEO of the Foundation for a Healthy Kentucky, which sponsors the poll with Interact for Health of Cincinnati. It is conducted by researchers at the University of Cincinnati.
Princess Health and Princess Health andUK's advanced ventricular-assist device program for heart patients saves and improves lives.Princessiccia

Princess Health and Princess Health andUK's advanced ventricular-assist device program for heart patients saves and improves lives.Princessiccia

Two years ago, John Doty was diagnosed with walking pneumonia, and though antibiotics originally helped, the pneumonia came back with a vengeance, and he went to see a cardiologist. He found out his heart was severely weakened with an ejection fraction of less than 10 percent. "The ejection fraction is a measure of how effectively the heart can pump blood volume into the body, and in a healthy heart, that number falls between 50-65 percent," Allison Perry writes for the University of Kentucky, where Doty received a left ventricular assist device (LVAD) because his heart was so weak.

UK Chandler Hospital is Lexington's only hospital, and one of two in the state, that can perform emergency VAD procedures. "When Mr. Doty was transferred to UK, he was very sick, on a ventilator and requiring two medications to support his blood pressure," said Dr. Navin Rajagopala, a heart failure cardiologist at the UK Gill Heart Institute. "He was going into kidney and liver failure. It was clear that he needed an assist device as soon as possible before the damage to his body was irreversible."

VADs partially take the place of the function of a failing heart. They're more often used for the left ventricle, but some patients need the device for the right ventricle or even two devices to help both ventricles (BiVAD). Because VADs can help the heart rest and heal, some patients receive them after a heart attack or a surgery. People suffering from congestive heart failure might need a VAD for the rest of their lives.

A viral infection damaged Andy Baker's heart, and though he originally resisted the idea of a VAD, now he says he's "happy to keep the device and has no interest in getting a heart transplant," Perry writes. "I had mixed feelings about it," Baker said about getting the VAD, "but it's given me life again."

VAD treatment can save money for the both the patient and the hospital and allow at-home recovery. VADs can allow people to return to their normal lives, participating in many of the same activities they did previously. in about 5 to 10 percent of cases, the VAD even helps the heart to heal to the point that the device can be removed. That was the situation for Doty, whose device was removed 16 weeks after he got it. "I almost feel like I never had it," Doty said. "It wasn't that great of an imposition, considering that it was keeping you alive."

UK performs about 20 to 30 VAD procedures per year, and recently received its third straight biannual Certificate of Distinction from The Joint Commission, the leading accreditor of U.S. health-care organizations. That "shows just what an outstanding job our physicians, nurses and support staff are doing when it comes to treating patients who require these assist devices," said Dr. Maya Guglin, director of UK's Mechanical Assisted Circulation Program. (Read more)