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Showing posts from September, 2018

Panel at health policy forum cites alternatives to opioids for pain, and the need for a culture shift on the topic

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By Melissa Patrick Kentucky Health News Kentucky has a new law restricting painkiller prescriptions to three days for acute pain, but an anecdotal story from one of the state's leading doctors suggests that it has a ways to go: the child of a friend recently got wisdom teeth extracted and was given a 30-day supply of pain medicine. "They don't need that many. They may only need -- zero!" said Dr. Philip Chang, chief medical officer at UK HealthCare . "I don't know how well that [law] is followed, to be honest with you." Chang also discussed proven ways to reduce opioid use, and still relieve pain, during the "Alternatives to Opioids" panel at the Howard L. Bost Memorial Health Policy Forum held Sept. 24 in Lexington by the Foundation for a Healthy Kentucky . The meeting's theme was "Kentucky's Substance Use Epidemic: A Solutions Update." Comprehensive EAP photo The law , passed in 2017, limits painkillers to a three-day supply

Red Bird dental clinic fixes teeth of people in drug treatment, preparing them for work and cutting need for painkillers

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Dr. Bill Collins works on a patient. (Photo by Deborah Yetter) A dental clinic in southeastern Kentucky, with help from dental-school students, is pulling teeth and providing dentures for residents of drug-treatment centers "in hopes of building their self-confidence and putting them in a better position to get jobs," Deborah Yetter reports for the Louisville Courier Journal . "In a state that already suffers from high poverty and poor dental health, addiction is adding to the toll on teeth � and that is holding back some people in drug treatment programs," Yetter writes, quoting Dr. Bill Collins, dental director at the Red Bird Mission of the United Methodist Church : "People do well when they complete treatment. But when they smile and they have no teeth, it's hard for them to get employment. And if they can't find work, they go back to drug use." Students from the state's two dental schools are helping. "The Red Bird dental clinic sho

Share of uninsured Kentuckians in rural areas and small towns dropped to 13 percent from 40 percent after Medicaid expansion

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OPINION By Emily Beauregard Executive director, Kentucky Voices for Health Medicaid expansion has made an overwhelmingly positive impact on rural Kentucky. Our state was among the top three leaders in lowering our uninsured rate for low-income adults in rural areas and small towns. That rate dropped from 40 percent to 13 percent between 2008-09 and 2015-16, according to a new report from researchers at Georgetown University and the University of North Carolina . This may be the first time Kentucky has been a leader in anything other than cancer deaths and poor health outcomes. Compare the dramatic dip in uninsured to our neighbors in Tennessee, where the uninsured rate for low-income adults in rural communities is 35 percent, down just 6 percentage points from 2008-09. In Mississippi, it�s 35 percent, down about 5 percentage points. In Kentucky, we saw a 27-percentage-point improvement. What is Kentucky doing that our neighbors aren�t? It�s simple; our leaders agreed to expand Medicai

U.S. Medicaid boss defends work rules and other 'community engagement' requirements, says they will thwart dependency

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By Al Cross Kentucky Health News The director of the Centers for Medicare and Medicaid Services gave a spirited defense of work rules and other "community engagement" requirements in state Medicaid programs, such as the one Kentucky officials have proposed. Seema Verma "We are committed to this issue," Seema Verma said Sept. 27 at a meeting of insurers who manage care of Medicaid beneficiaries for state governments. She didn't mention that the plan has been blocked by a federal judge, who said federal officials didn't adequately consider the state's prediction that thousands would be dropped from the rolls for failure to follow the rules or report their income and activity. But she did address those concerns. "These policies are not blunt instruments," Verma said. "We�ve worked carefully to design important protections to ensure that states exempt individuals who have disabilities, are medically frail, serve as primary caregivers, or hav

Federal judge strikes down state law Bevin cited, requiring abortion clinics to have agreements for ambulance service

Kentucky abortion clinics do not need to have written agreements with an ambulance service and hospital for patient care in the event of an emergency, because such restrictions are unconstitutional, a federal judge ruled Friday. The ruling by U.S. District Judge Greg Stivers undercuts Gov. Matt Bevin's efforts to eliminate legal abortion in the state. Abortion providers argued Bevin "was using the law unfairly to try to shut down the state's only abortion clinic and block another from opening," reports Deborah Yetter of the Louisville Courier Journal . "The ruling involves a 1998 state law requiring abortion clinics to have so-called 'transfer' agreements with an ambulance service and hospital in the event of a medical emergency at the clinic, a provision opponents argued was unnecessary but one that lawyers for Bevin said is necessary for patient safety."

Kentucky loses a health champion who advocated for health equity and community-based solutions; Dr. Gil Friedell was 91

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Dr. Gilbert "Gil" Friedell By Melissa Patrick Kentucky Health News Dr. Gilbert Friedell, who was a fierce advocate for health equity and finding community-based solutions to the many health issues that plague Kentucky, died Sept. 23 at the age of 91. His mantra,"If the problems are in the community, the solutions are in the community," was a drumbeat message that will continue to guide the efforts of many who knew him. "It is difficult to imagine a more selfless man of medicine," said veteran journalist Al Smith. Friedell was described in his obituary as an "avid student," attending Harvard College in 1943 at the age of 16 and graduating from the University of Minnesota Medical School in 1950. He then went on to receive his medical training in pathology in Boston and served as a physician in the Navy reserves for two plus years. He was a medical faculty member at Harvard,  Boston University , the University of Massachusetts and the University

Herald-Leader goes after understaffing at Ky. nursing homes

"At Sunrise Manor Nursing Home in Hodgenville, a frail woman spent a night in 2015 sitting precariously on her bathroom toilet, shouting uselessly for help, shivering with cold, because nobody remembered to return and assist her to bed. The nurse�s aide for that unit later told state inspectors that she had been overwhelmed trying to monitor 26 residents during the graveyard shift." That's the first paragraph of one of the stories from John Cheves of the Lexington Herald-Leader about understaffing at Kentucky nursing homes. It goes on: "At Stonecreek Health and Rehabilitation in Paducah that same year, harried nursing staff dealt with a resident screaming about excruciating pain from a neglected urinary catheter � he had an infection that soon would require emergency hospitalization � by removing his speaking valve, a plastic prosthesis in his throat, to render him mute. At Woodcrest Nursing and Rehabilitation Center in Elsemere this year, a resident told state ins

Congress agrees on bipartisan opioid package

Congress has agreed on a comprehensive package to address the opioid epidemic, which includes both law-enforcement and public-health measures. President Trump is expected to sign it. The 653-page bill has a provision to fight importation of fentanyl through the mail, one that allows more health-care providers to prescribe medication for opioid addiction, and another to make it easier for Medicaid recipients to get inpatient care for substance abuse over the next five years. �While there is more work to be done, this bipartisan legislation takes an important step forward and will save lives,� a group of Republican and Democratic committee leaders said in a statement. Opioid overdoses were responsible for nearly 50,000 U.S. deaths last year, 1,565 in Kentucky. One of the most expensive items in the new law is the partial removal of a decades-old federal rule that prevented states from using federal Medicaid dollars on inpatient addiction treatment facilities with more than 16 beds, calle

Panel acknowledges medical benefits of medical marijuana but also concerns, including potency of a possible 'Trojan horse'

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By Melissa Patrick Kentucky Health News Research shows conclusively that medical marijuana has some health benefits, but also comes with some adverse risks that would likely be exacerbated by the increasing potency of the plants, and some think a medical marijuana law in Kentucky would be a "Trojan horse" for recreational use. Meanwhile, teen vaping of high-potency marijuana products is increasing. And some wonder why Kentucky should follow states that have passed laws approving certain drugs, when that's the job of the U.S. Food and Drug Administration . Those were the some major messages Sept. 24 during a breakout session at the Foundation for a Healthy Kentucky 's Howard L. Bost Memorial Health Policy Forum, the theme of which was "Kentucky's Substance Use Epidemic: A Solutions Update." Ed Shemelya Ed Shemelya, a 30-year veteran of the Kentucky State Police and coordinator of the federal government's National Marijuana Initiative , said we need t

McCreary and Wayne counties win Health Policy Champion award from Foundation for a Healthy Ky. for being 'bright spots'

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Foundation for a Healthy Kentucky CEO Ben Chandler announced the award as nominees listened. By Al Cross Kentucky Health News Wayne and McCreary counties won the first overall Health Policy Champion award presented by the Foundation for a Healthy Kentucky , for being "bright spots" of progress on health issues in Appalachian Kentucky. "We have a tie," Foundation President and CEO Ben Chandler said as he announced the award at the foundation's annual Howard L. Bost Memorial Health Policy Forum in Lexington on Monday. The adjoining counties on the Tennessee border were two of eight nominees for the award, which spotlights "those folks who are advocating the policy changes that will make Kentucky healthier," Chandler said. The $5,000 award was divided equally between the McCreary County Health Coalition and the Wayne County Health Council . "They show us there' s always somewhere to start when it comes to working to improve health," Chandle

Appalachian health researchers discuss work, with three sessions on drugs, and are urged to engage more closely with communities

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By Melissa Patrick Kentucky Health News A big step toward improving health in Appalachia would be closer relationships between residents of the region and researchers -- who often drop in, gather data and leave. That's what researchers were told last week as they gathered in Lexington to talk about their work in Appalachia, ranging from opioid disposal programs to air and water quality. Joyce Bells-Berry of the Mayo Clinic, keynote at the Appalachian Translational Research Network Summit Joyce Bells-Berry of the  Mayo Clinic  said at the eighth annual Appalachian Translational Research Network Summit that it was time for Appalachian researchers to stop "helicopter" research and truly engage with communities in the region. "Community engagement allows us to get to the why so that we can answer our research questions in a way that is pivotal for changing the lives of those around us, in a way that builds partnerships and mutual respect, while taking into consideration

65 kids a day are abused or neglected in Ky., third in nation; officials urge safe sleep practices, care about who provides care

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By Melissa Patrick Kentucky Health News FRANKFORT, Ky. � When it comes to keeping babies safe, three of the most important things are safe sleep practices, recognizing that bruising in non-mobile infants is not normal, and choosing an appropriate caregiver. So said members of the state's Child Fatality and Near Fatality External Review Panel , who told legislators at the Sept. 19 joint health committee meeting that three-fourths of cases they reviewed in 2017 were "potentially preventable." They lawmakers also heard the executive director of Prevent Child Abuse Kentucky say the state ranked No. 3 for "child maltreatment" in 2016 . Jill Seyfred added that 23,827 Kentucky children were confirmed victims of child abuse or neglect in 2017, about 65 a day. The ABCs � and D � of safe sleep Dr. Jaime Pittenger, a review-panel member and the president of Prevent Child Abuse Kentucky, told the committee that 39 percent of the deaths the panel reviewed in 2017 involved s

Lexington has 100+ restaurants on probation for health violations; hepatitis A raises concern, but no cases have been related to food

Amid a nearly statewide outbreak of hepatitis A, the Lexington-Fayette County Health Department is monitoring more than 100 restaurants that it has placed on probation for violation of public-health standards, Janet Patton reports for the Lexington Herald-Leader . "Spoiled food. Soiled equipment. Dirty floors, dirty walls. Live roaches and flies inside kitchens. Dead ducks hanging outside. Lexington�s restaurant inspectors have seen it all," Patton writes. "Since 2015, they�ve compiled a list of restaurants and other food service providers to target for heightened scrutiny." The cleanliness of restaurants has taken on fresh importance since the hepatitis A outbreak started in about a year ago. The Lexington health department recently recommended that everyone in Fayette County be vaccinated against the liver disease because some food service workers had tested positive for the virus. No Kentucky cases of the disease have been attributed to food service. A restaur

Deal to sell Jewish Hospital may be falling apart, raising the possibility that it might be closed, with big ramifications

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KentuckyOne Health photo The future of Louisville's Jewish Hospital is in doubt. Its owner, KentuckyOne Health , "continues to lose money after months of negotiating to sell it and other local facilities to a hedge fund, according to a doctor who has written about the local health care industry." So reports the Louisville Courier Journal , which interviewed Dr. Peter Hasselbacher, a retired University of Louisville medical professor. "I would not be surprised for Jewish Hospital to close its doors within a matter of months," he said. "I wish the best for them, but I think the odds are stacked against them." "Hasselbacher's concerns are shared by five other doctors and five current KentuckyOne staff members in a variety of roles, as well as a former administrator with knowledge of the negotiations," the CJ's Grace Schneider and Morgan Watkins report. "They shared information with the Courier Journal on the condition of anonymity

Addict who writes column for Appalachian papers publishes book

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Phillip Lee, a recovering drug addict who writes a column for newspapers in Appalachian Kentucky and Tennessee, has published a book, The Journey of an Addict . "Through overdoses and many hospitalizations, through nursing homes and rehabilitation centers, through drug treatment programs and prisons, I survived through it all only by the grace of my higher power," Lee writes on Amazon . "This book is part of a complete dedication in my life to helping others reach recovery. Not being easy at all, I tell how it's the hardest thing I've ever done in life. I tell you about the personal rewards of recovery. The freedom and calm that is gained is second best to nothing. Looking back on some of the insane and dangerous situations, I can even laugh at some of the stories now." Lee began writing a column for the weekly Clinton County News in his hometown of Albany in May 2017. For a while it bore the name of the book as well as the title "An Addict's Co

National Medicaid boss defends work and 'community engagement' rules as measures to thwart dependence

By Al Cross Kentucky Health News The director of the Center for Medicare and Medicaid Services gave a spirited defense of work requirements like Kentucky has proposed for its Medicaid program, saying "We are committed to this issue." Seema Verma spoke  Thursday to a conference of insurers who managed care for state Medicaid programs. She did not mention that a federal judge has blocked the Kentucky plan, which is being re-evaluated by her agency, but addressed fears that the "community engagement" and reporting requirements would lead to loss of coverage for thousands of Kentuckians. "These policies are not blunt instruments," Verma said. "We�ve worked carefully to design important protections to ensure that states exempt individuals who have disabilities, are medically frail, serve as primary caregivers, or have an acute medical condition that prevent them from successfully meeting the requirement." Kentucky's plan would require "able-

FDA goes to war against teenagers' 'epidemic' use of electronic cigarettes, says another generation is at risk of nicotine addiction

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By Melissa Patrick Kentucky Health News The U.S. Food and Drug Administration is launching a new anti-vaping campaign aimed at teens. The campaign, "The Real Cost," will target nearly 10.7 million students through hard-hitting advertising on digital and social media sites that are popular among teens, like You Tube and Instagram, and by placing ads at least 10,000 high-school bathrooms. The ads will educate teens on the risk of nicotine addiction and the dangerous chemicals in the products; an estimated 80 percent of them don't see a great risk of harm from regular use of e-cigs, according to the latest "Monitoring the Future" survey, which tracks substance use by students in 12th, 10th and 8th grades. In 2017, more than 2 million youth were current users of e-cigarettes. Kentucky's high-school students use traditional cigarettes and e-cigarettes at about the same rate, 14 percent, according to the 2017 Youth Risk Behavior Survey. However, the same report

To defend against another flu epidemic in Kentucky: 'Get the shot. Consult your doc. Stop the spread," campaign says

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Nurse practitioner Sara Wellman gives Ben Chandler his shot; Health Commissioner Jeffrey Howard looks on. (Photo by Al Cross) By Al Cross Kentucky Health News Influenza killed 325 people in Kentucky last flu season, when only 40 percent of Kentuckians got a flu shot. The state's doctors, health agencies and the Foundation for a Healthy Kentucky aim to keep such things from happening this season. The foundation, the Cabinet for Health and Family Services and the Kentucky Medical Association staged an event in the state Capitol rotunda Tuesday to urge Kentuckians to get a flu shot on Wednesday, Sept. 26 or at least by the end of October. Flu cases have already been reported, and "Last year was one of the worst years ever for the flu," which can be at lot worse than an inconvenience, said KMA President Bruce Scott said. He said he can't understand why some people still think you can get the flu from a flu shot, because "The virus is not live." He called it &q