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Wednesday, 18 May 2016

Princess Health and House Republicans want to make it harder for schools to get free meals for all students; could affect more than 350 Ky. schools. Princessiccia

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Photo from npr.org
By Danielle Ray
Kentucky Health News

Kentucky school officials are concerned about a proposal by Republicans in the U.S. House that would make it harder for schools to offer free meals to all students using federal money.

The House is considering changes to the 2010 Hunger-Free Kids Act, now in its second year, which allows schools who serve a high-poverty population to offer free meals to every student.

Instead of collecting individual applications for free or reduced-price meals, the Community Eligibility Provision uses data that illustrates how many students in a given school may be "food-vulnerable": how many students live in households that receive government assistance, live in foster care, are homeless, and other similar criteria.

Under current CEP rules, schools with greater than 40 percent of students who qualify as food-vulnerable are eligible to offer free meals to all students. A bill approved May 18 by the House Education and Workforce Committee would raise the threshold to 60 percent, forcing schools between 40 and 59 percent range off the program.

"Proponents of community eligibility say it spares schools from paperwork and administrative burdens, and that it allows low-income children to eat free meals without the stigma or red tape of particpation in the free meal program, which is often a barrier for participation," Evie Blad reports for Education Week. "But Republicans on the committee said the provision is wasteful, potentially allowing children from higher-income families access to free meals."

The change could affect more than 350 Kentucky schools. Kentucky has 804 schools eligible to offer free meals under current CEP rules, according to the Center on Budget and Policy Priorities. Under the proposed bill, only 441 would qualify, according to the center.

More than 10,000 students at 17 public schools in Lexington alone would be affected, according to the Lexington Herald-Leader reported. More than 190,000 students statewide could be affected, the Herald-Leader said.

Nick Brake, superintendent of Owensboro schools, told Keith Lawrence of The Messenger-Inquirer that he is hopeful that his district will be spared cuts.

"I have been working with Congressman (Brett) Guthrie�s office on this issue," Brake said. "We are still looking at the overall numbers, but our district average is 63 percent, so it looks favorable that we will be able to continue to provide the benefit of this vital program in the future."

Muhlenberg County Supt. Randy McCarty told Lawrence he thought his district would still qualify. "Once a district goes CEP, it stays in place for four years," he said.

Hopkins County, which recently expanded its use of free meals to all public schools, faces uncertainty if the changes are passed.

"I have no idea if school districts will be grandfathered in, or how Congress will write everything, but I am afraid that if we don't jump on this now, we may not get this opportunity again," Michael Dodridge, food services director of Hopkins County schools, told Laura Buchanan of The Messenger in Madisonville. "I would hate to pass this up."

UPDATE, May 26: The Harlan Independent School Board voted to join the program, Joe Asher reports for the Harlan Daily Enterprise.

The proposed CEP changes are part of House Resolution 5003, the child nutrition reauthorization bill introduced by Indiana Republican Rep. Todd Rokita. For more information on the proposed changes, click here.

Tuesday, 17 May 2016

Princess Health and May 17th, 2016 Support Instead Of The Fork. Princessiccia

Princess Health and May 17th, 2016 Support Instead Of The Fork. Princessiccia

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May 17th, 2016 Support Instead Of The Fork

Last night was involved. Just as I was dropping into bed, I checked the radar and realized, I had work to do. Severe weather season means weather coverage at any time-night or day. Even when the weather isn't considered severe--as broadcasters in a state known for tornadoes, it's important to be a voice of calm, especially when a storm looks and feels dangerous, but isn't. This coverage translated to roughly two hours sleep. Not good for me.

I made it through the day by remaining in contact with support and staying focused on getting what I needed--while keeping an eye toward getting something else I needed--a nap! I did eventually grab a one hour nap--still not enough, so I'm making it a priority to go to bed much much earlier tonight. No weather coverage tonight, thank goodness!

Tonight is a great night to republish some thoughts on consistency. The following excerpt is from the September 23rd, 2014 archived blog post:

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The topic of consistency has come up a few times of late. Consistency is key, for sure. This road isn't about perfection. Striving for perfection is the quickest detour to disappointment. Consistency is the goal along this road. If we can be consistent, we can accomplish amazing things. But how do we remain consistent?

In my opinion, it starts with narrowing our focus. Not once have I sat down with a calendar to try to figure out when I'll arrive at some predetermined number. I haven't even stated a particular goal weight, opting instead for a "healthy weight." Who knows what that will be? It doesn't matter how long it takes or when I'll get there because my focus is on today. My goal is to make it through this day with the integrity of my food plan intact and if it's an exercise day, that too. Today is the day. I'm not obsessing about how much time it will take. It will take however long it takes. If I focus on how long it will take to "arrive," I'm suggesting that my efforts will end at some point. And making my food and fitness a big priority in my life is something I do not plan on ending, ever. 

Keeping it simple is important in keeping us consistent. It's super easy to make this really difficult. You can quickly overwhelm yourself with a multitude of numbers, rules, self-imposed requirements and rock solid expectations. Keep it as simple as you need, to fit where you are. If you're planning on waking up tomorrow as a completely different person with completely different habits and behaviors--it could become very difficult, really fast.

I recommend setting a calorie budget or points budget, whatever you prefer, and making the limit you set, sacred. Sacrificing the integrity of this budget shouldn't be something taken lightly. Treat it with the highest importance level. Then, find an exercise of some sort that works for you and your body and do it. Worry less about content and more about maintaining the integrity of your budget and exercise schedule. As you progress and you become more comfortable, you can get fancy all you want!!

Allow your food to become a natural evolution of good choices. My choices today look very different than when I first started losing weight six years ago. I wouldn't categorize myself as a "clean eater," but I'm at least 80% clean and that's a big difference for me.  Had I tried eating like this on Day 1, September 15th, 2008, it likely wouldn't have gone very well.

And that brings me to the "joy factor." I believe we must enjoy what we're doing in order to maintain consistency. If we don't enjoy--and I mean truly enjoy what we're eating, how do we expect to keep doing it? I eat what I like and nothing I don't. This doesn't mean I'm not willing to try new things. It simply means if I don't like it, it will not be on my regular "foods I enjoy" list. 

Somewhere over the years, someone decided that losing weight had to be about eating things you choked down as a means to an end. And as soon as the weight loss goal was reached, you could go back to eating what you like. I say nonsense!! Why not eat what you like and enjoy from day 1? Then, if they're not the best for you, gradually and naturally improve your choices. But never sacrifice by eating things you can't stand!!

My first food question isn't "Will this help me lose weight?" My first question about any particular food is: "Do I enjoy eating this?" If the answer is yes, then the second question is, "Will this food help me lose weight as a regular part of my day to day selections?" If the answer to that question is "No," then like it or not, it goes. An automatic "no" for me is sugar. I enjoy eating deep fried egg rolls, fried anything, really, and plenty of other things that if consumed regularly, would have a negative effect on my efforts. The key is finding foods that give you a "yes" to both questions.

The same "joy factor" applies to exercise. Find what you enjoy! If all you can do is walk slowly for short distances, do that. But make it enjoyable. Listen to music, an audio book, or carry on a conversation with someone--whatever you got to do to make it fun and enjoyable. When you're ready to make it something more intense--again, make sure it's something you truly enjoy doing.

Narrow the focus to one day at a time, set your limits and maintain the integrity of your limits, enjoy what you're eating and love what you're choosing to do for exercise.

And a big one: Develop a support system that focuses on accountability. Don't remain all hush about your efforts--share it, tell your friends and family--make some declarations and ask for support from those you're confident will give it. Keep a MyFitnessPal food diary or something similar and make it accessible by the friends you accept.

And another big one: Write, write, write--how you're feeling, what you're doing, describe your challenges, write about what you plan on doing to overcome these challenges, and write about how determined you are to succeed once and for all. Get it out on paper, in your personal diary--or on a blog, on your facebook--somewhere, anywhere--just write for you and your own personal clarity. There is no right or wrong. It doesn't matter if you fancy yourself a good writer or not--that isn't the point. If the only person who understands what you're writing is you, mission accomplished.

Consistency brings results. If the results aren't to your liking, change the elements of your consistent efforts until you find the balance you desire.
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That was a fun little trip back to a year and a half ago. An additional thought:

Here's the thing-- If we give ourselves this simplified approach, it allows mental space to face the bigger issues of emotional and stress eating. I can't count the number of times in past weight loss attempts where I made the basics bigger than I could handle--and then, at the slightest bend emotionally or in my stress level, I'd release the plan completely. I was looking for some kind of magic emotional and stress pattern of stability. Instead, I eventually realized stress and emotions are a part of life--so instead of hoping and praying for a pattern of stability long enough for me to succeed--I realized how I needed to learn ways of changing my pattern of perspective.

This is where the benefits of accountability and support have the best chance of changing things. Reaching for support instead of the fork can give us life changing shifts in perspective.

I'm hitting the pillow softly, with gratitude, confidence and certainty. I maintained the integrity of my maintenance calorie budget, I remained abstinent from refined sugar and I exceeded my daily water goal. And in the face of a challenging schedule over the last 24 hours, I increased my awareness--understanding how I might not make the best choices under these conditions--so I brought in additional support to help carry me through to a wonderful finish. This kind of day--in all its challenges, feels amazing once I'm on the pillow and giving thanks for having made it through. I'm grateful.  

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Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Effects of new vaping regulations won't be felt immediately; American and British researchers have differing views of e-cigs. Princessiccia

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By Danielle Ray
Kentucky Health News

A long time coming, the U.S. Food and Drug Administration released new regulations this month for all tobacco products, including electronic cigarettes, vape pens, hookahs, dissolvables, and pipes. But the effects might not be felt for as long as two years.

Photo: excusemyvapes.com
The regulations require health warnings on packages and advertisements and ban sales to minors. Other regulations include reporting ingredients to the FDA, requiring photo identification to buy, banning free samples and banning the labeling of products as moderate, with words such as "light" or "mild,"

The FDA called the regulations a milestone in consumer protection. It believes the new rules will help prevent misleading claims by manufacturers moving forward and allow for review of new products not yet on the market. The agency already regulated traditional cigarettes, smokeless tobacco, and roll-your-own tobacco prior to the decision.

The new rules will take effect in stages. The ban on sales to minors begins Aug. 8, but according to Phil Galewitz of The Washington Post, the ban will primarily affect Michigan and Pennsylvania, as the other 48 states already ban sales of e-cigarettes to minors. Warning labels will take effect May 2018. The labels will read: �WARNING: This product contains nicotine. Nicotine is an addictive chemical.�

Don't expect changes overnight. Manufacturers have two years to submit products for review and another year for the agency to perform evaluations.

Why did the FDA take on vaping? For one thing, because the market has so far been unregulated, the ingredients in vaping liquid are largely a mystery. However, a 2015 Harvard University study found several dangerous chemicals present in these liquids. The chemicals can destroy tiny passageways in lungs, leading to scar tissue buildup and eventually respiratory disease, according to the study.

For another thing, adolescents and teenagers are vaping at unprecedented rates. More than 3 million middle and high school students used e-cigarettes in 2015, up more than 500,000 from the year before, according to the FDA.

E-cigarettes have been the most commonly used tobacco products among youth for two consecutive years. Sixteen percent of high schoolers and about 5 percent of middle schoolers were vapers of e-cigarettes in 2015, according to the FDA. More than 80 percent of them cited appealing flavors, which include "gummy bear" and "cotton candy," as their primary reason for use.

The science is still out on whether the harmful qualities of vaping negate any potential benefits. Some studies have found e-cigarettes to be less harmful than traditional cigarettes. For example, a 2015 Public Health England review concluded that e-cigarettes are about 95 percent less harmful than traditional cigarettes.

"E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm," said Professor Kevin Fenton, director of health and well-being at PHE, said in a news release. "The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting."

As noted in the Harvard study, e-cigarettes are not harmless. The question remains if vaping can be a tool to help current smokers quit, if they lure in kids who otherwise would not become smokers or if it's a little of both.

According to the British study, there is no evidence that vaping attracts non-smokers. Fewer than 1 percent of either adults or young people who have never smoked are becoming regular e-cigarette users, the study noted.

As for fears that vaping leads to traditional smoking, Linda Bauld, a cancer prevention expert at Cancer Research United Kingdom, said in a news release that those claims are unfounded.

"Fears that e-cigarettes have made smoking seem normal again or even led to people taking up tobacco smoking are not so far being realized," Bauld said. "In fact, the overall evidence points to e-cigarettes actually helping people to give up smoking tobacco."

Attitudes toward vaping have been much more favorable overall in the UK. Public health officials there seem more willing to accept e-cigarettes as a safer alternative and even a stop smoking tool than do U.S. officials.

For more background information on the FDA's new regulations, click here.

Monday, 16 May 2016

Princess Health and May 16th, 2016 Every Day. Princessiccia

Princess Health and May 16th, 2016 Every Day. Princessiccia

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May 16th, 2016 Every Day

Keeping a blog post short isn't always easy for me. Every day there's something I experience or something I'm reminded of--and these things, when they pertain to what this blog is all about, stimulate thoughts and ideas--and I'm a communicator, I want to share it right here, right now! But I often need to reel it in, be patient--be calm and get more rest!

Today had a rough start followed by an unexplained stomach ache midday that sent me home about an hour early. It was clearly something at lunch, I'm just not sure--everything was fresh. That's a wonderful benefit of eating the way I eat--it's much easier to key into direct food/body connections.

I felt much better by evening time--just in time for my Monday night support group conference call. I enjoyed a fantastic dinner--and had some fun with the tweets, too.

I maintained the integrity of my maintenance calorie budget, I remained abstinent from refined sugar, I exceeded my daily water goal and I made time for a great workout.

The day was rough in some ways and quite solid/smooth in others. How's that for balance?

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Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Health-care consumers get little help resolving complaints, columnist says, citing some horrific examples. Princessiccia

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By Trudy Lieberman
Rural Health News Service

Who protects consumers of health care?

Two recent emails from readers got me thinking about that question. I don�t mean consumers in their role as patients whose medical well-being is looked after by state medical boards and health departments that police doctors and hospitals. Those organizations don�t always do a perfect job protecting patients from harm, but at least they are in place.

But who protects patients when things go wrong on health care�s financial side? What happens when you receive a bill you didn�t expect and can�t afford to pay? What happens when insurers send unintelligible explanations of benefits you can�t understand? What about questionable loan arrangements to avoid medical bankruptcy? Consumers of health care are pretty much on their own.

From the 1960s though the 1980s when people complained, they got action from consumer organizations, government and even businesses that set up departments to handle complaints. That consumer movement is now but a flicker.

�We don�t have as many public-interest minded regulators, and officials who try to grab these issues by the horns and deal with them,� says Chuck Bell, director of programs for Consumers Union.

The emails I received show that although it�s an uphill battle to get redress, fighting back as an individual can get attention and may ultimately lead to better protections for everyone.

John Rutledge, a retiree, got snared in Medicare�s three-day rule by a hospital near his hometown Wheaton, Ill. At the end of March he took his wife, who was having breathing problems, to the hospital where she was held for three nights of �observation.� Patients must be in a hospital for three days as an in-patient before they are entitled to Medicare benefits for 100 days of skilled nursing home care, as I noted in a recent column.

Thousands of families have been caught when hospitals decide their loved ones are admitted for �observation,� a tactic that allows them to avoid repaying Medicare if government auditors find patients should not have been classified as �in-patients.� Playing the �observational� game is worth millions to hospitals but costs families tens of thousands of dollars when someone doesn�t qualify for Medicare-covered skilled nursing care.

Rutledge knew about the three-day rule. Both his doctor and a pulmonologist at the same medical practice recommended an in-patient stay, and Rutledge refused to sign a hospital document saying his wife was admitted for observation. Still, the hospital prevailed, claiming a consultant made the decision to keep her for �observation.�

Rutledge was stuck with a bill that, so far, totals over $15,000 for the skilled nursing care his wife did need. He said he had been a �significant donor� to the hospital foundation, and �I have told the foundation that what I spend as a result of �observation� will come out of what I planned to give them, starting with the annual gift.�

The second email came from Kathryn Green, a college history professor who lives in Greenwood, Miss. Green is fighting an air-ambulance company, which transported her late husband to a Jackson hospital after he suffered a fatal fall in their home. This �nightmare,� as she calls it, is a bill from the transport company that claims it�s outside her insurance network, and says she owes them $50,950.

�I am 63 and will have a devastated retirement if this is upheld,� Green told me.

Blue Cross & Blue Shield of Mississippi, the administrator for her insurance carrier the State and School Employees� Health Insurance Plan, paid $7,192 of the $58,142 the transport company billed. Blue Cross has told Green that she should be held harmless and should not be charged for the �balance after payment of the Allowable Charge has been made directly to that provider.�

Green is raising a ruckus and has taken her case to state and national media, members of Congress, the state attorney general, and the Mississippi Health Advocacy Program. The company has told her it will begin collection efforts.

In both cases there�s a legislative solution. The three-day rule can be fixed by counting all the time a patient spends in the hospital whether they�re classified as an �in� or as an �observational� patient. The ambulance problem can be fixed by changing the 1978 airline deregulation law that prevents states from interfering with fares, services, and routes. But money and politics block the federal changes that would help people like Rutledge and Green.

�It�s like playing a game of health-insurance roulette,� Bell says. �Your coverage exposes you to these gaps that have been normalized. It�s become the way of doing business.� A resurgent consumer movement could change all that.

What consumer problems have you had with balance billing? Write to trudy.lieberman@gmail.com.
Princess Health and Kentucky Center for Economic Policy report warns about impact of Bevin's proposed Medicaid changes. Princessiccia

Princess Health and Kentucky Center for Economic Policy report warns about impact of Bevin's proposed Medicaid changes. Princessiccia

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By Danielle Ray
Kentucky Health News

A research group with a liberal outlook warned Monday that Republican Gov. Matt Bevin should be careful in changing the state Medicaid program.

The Kentucky Center for Economic Policy said the state�s expansion of Medicaid eligibility under Democratic Gov. Steve Beshear has increased health screenings and job growth in health care.

Tobacco counseling and interventions increased 169 percent from 2013 to 2014, the first year of the expansion, the report noted. Influenza vaccinations went up 143 percent and breast cancer screenings increased 111 percent, it noted.

In addition, Medicaid expansion brought Kentucky health-care providers nearly $3 billion through mid-2015 and resulted in a 4.6 percent job growth in the health-care sector from 2014 to 2016, according to the report.

�No matter how you look at Medicaid expansion in Kentucky, it�s clear it has had a positive effect on access to health care that will improve our state�s economy and quality of life,� Jason Bailey, executive director of KCEP, said in a news release.

However, Bevin says the state can�t afford to have more than a fourth of its population on Medicaid and is seeking a waiver from the federal government to make changes in the program, such as �skin in the game� for beneficiaries: co-payments, deductibles or health savings accounts, as used in a year-old experiment in Indiana, which he has cited as an example.

The KCEP reports says the Medicaid waiver Bevin is seeking could result in additional costs to recipients and benefit changes. Arkansas was the first state to design a Medicaid expansion using such a waiver. So far, five other states have implemented similar waiver-based programs.

Waiver programs differ from standard Medicaid expansion in that they utilize some or all of the following: health savings accounts, a cost-sharing account to be used for health care expenses; lockouts, periods in which recipients who have been dis-enrolled for failure to pay premiums are barred from re-enrolling; and premium assistance, the use of Medicaid funds to buy private insurance plans.

These waivers are designed to grant states the freedom to enact experimental programs within Medicaid, so long as the programs continue to reflect the overall goal of Medicaid, increasing coverage of low-income individuals and improving overall health care, as well as efficiency and stability of health care programs that serve that population.

The Foundation for a Healthy Kentucky, which convened a meeting of Medicaid stakeholders last week, is holding off on making judgments of the proposed waiver program. �We believe that diverse input is essential to sustaining these gains, and to continue improving our health care system and health outcomes in Kentucky,� said Susan Zepeda, president of the foundation.

Zepeda said research the foundation has funded has shown a greater decrease in the number of Kentuckians who lack health insurance than any other state, which she attributes largely to Medicaid expansion adding about 400,000 Kentuckians to the rolls.

More than 1.4 million Kentuckians are enrolled in Medicaid, 39 percent of whom are children. Nearly 32 percent are enrolled under the expansion: childless adults in households that earn less than 138 percent of the federal poverty line, currently $33,000 for a family of four.

The KCEP report also asserts that Kentucky�s Medicaid benefits are on par with those of other states, specifically that 12 out of 13 of Kentucky�s optional benefits are also covered in at least 40 other states and territories. Kentucky Medicaid only covers services that are deemed medically necessary.

KCEP noted that Medicaid is a partnership in which the federal government funds a minimum of half of traditional Medicaid spending in each state, with poorer states receiving a larger federal match. In Kentucky, the federal share is about 70 percent. For people covered by the expansion, the federal government is paying the full cost through this year, but the state will pay 5 percent in 2017, rising in annual steps to the law�s limit of 10 percent in 2020.


The full KCEP report is at http://kypolicy.org.

Sunday, 15 May 2016

Princess Health and May 15th, 2016 Epiphany Day Anniversary. Princessiccia

Princess Health and May 15th, 2016 Epiphany Day Anniversary. Princessiccia

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May 15th, 2016 Epiphany Day Anniversary

From my "Epiphany Day" post on May 15th, 2014:

I'm a great person worthy of love regardless of my size and appearance. I have my mind, sense of humor, talents, a big heart, loads of compassion for others and so very much more. And none of it is diminished with weight gain or increased with weight loss. 

I am me, always.

And my journey will continue toward a healthier weight because I want to live, I want to move easier, I want to experience the freedom a healthy body weight provides. Regardless of how this journey goes, I believe I just discovered one of my greatest personal freedoms of all.

From this blog on May 19th, 2014:

If we tether our identity, self-worth, definition of success and happiness to anything that naturally fluctuates or can change dramatically, then we're in for a roller coaster ride of emotional unrest.

I've always attached my self-worth to my weight. Well, until now of course. I've often talked about potential and not living up to potential. But here's the thing: Potential is tied directly to the constant qualities within us and if our focus is on the pursuit of happiness in every direction except within, then those qualities aren't allowed to flourish, to grow--to give life to the potential within us all.

This whole thing makes me want to take the best care I can. I've never felt more determined to return to a healthy weight. It's what I need physically. What I need emotionally isn't affected by weight loss. And making that distinction provides a nice inner calm, a peace.


The question to determine these inner qualities needing attention and love is: What are the qualities in me that remain regardless of my weight, regardless of my financial situation, regardless of my relationship status, regardless of my professional success--what about me stays the same when all of these other things can and do change?  My heart, soul, sense of humor, natural compassion for others, likes and dislikes, pride in parenting, artistic talents, selflessness, humility, etc. Have you made your list?  And when these constants are cared for and loved, watered, so to speak--they grow, they flourish--and they give us what we need to experience emotional freedom, the freedom and ability to claim our happiness come what may.
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Today was my two anniversary of "Epiphany Day."

I no longer base my self-worth and identity on anything that fluctuates. Gaining weight never made me a worse person and losing weight never made me a better person. The deep inner qualities that are the very foundation of me, didn't change. Those inner qualities were ignored for far too long because I was constantly distracted by the natural fluctuation of things outside of myself--and I made those things the source of my self-worth and identity. I abruptly stopped doing that on May 15th, 2014.

In the two years since "Epiphany Day," I've successfully lost the relapse/regain weight--plus some, I'm doing well in maintenance mode, I started doing stand-up again--just because it's in me and I must--no other reason, I started doing speaking engagements again, I have more support interactions and I freely envision/dream of what I want to do and where I want to go. I've been happy in the face of challenges, I've been calm amid stress and I've truly embraced ME on levels I didn't know existed. And now I know, regardless of the ups and downs of life--I can always be happy. And I can genuinely feel good about me. And with this, I know--I will be okay.

I picked up my grandson this afternoon. We shopped for him a pair of shoes--and pretty much destroyed the kids section of a local shoe store. I offered to help reorganize and the offer was politely declined. With every new pair he tried, he sprinted up and down the aisle until we found one pair that was the fastest. It was so much fun!

After our shoe adventure, we made our way to Stillwater for a belated Mother's Day dinner with mom.

It was a beautiful evening--and really, just a wonderful day.

Today-- I maintained the integrity of my maintenance calorie budget, I remained abstinent from refined sugar, I participated in several support exchanges and I exceeded my daily water goal. That's a solid day. I'll aim for another, tomorrow.

I'll let the Tweets take it the rest of the way...

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Thank you for reading and your continued support,
Strength,
Sean
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