Bankruptcy filing by mental-health agency is a loser for Kentucky, where such services can be scarce and little used

By Molly Burchett
Kentucky Health News

The decision of Seven Counties Services Inc. to file bankruptcy to avoid paying into the Kentucky Employee Retirement System has created a "no win" situation for the state, and the issue may add yet another obstacle for Kentuckians to get the mental health care they need.

Louisville-based Seven Counties is one of the state's largest mental-health agencies, serving more than 30,000 adults and children with mental-health services, alcohol and drug-abuse treatment, developmental-disabilities services and preventive programs, according to its website.

And while Kentucky's mental-health system has received an F grade for its funding, the state pension system needs agencies like Seven Counties to pay in more because the system is just 27 percent funded. "Employers will have to ante up around 38 percent of annual payroll, compared with the 23 percent now required," Mike Wynn notes in The Courier-Journal.

Kentucky's need for mental health services is much greater than the supply, and an estimated 1.7 million Kentuckians live in areas designated as a "mental health professional shortage area," which means almost 40 percent of Kentucky residents lack proper access to such professionals, says a report by the Kaiser Family Foundation. About 24 percent of residents' mental-health care needs are under-served, and this situation could be worsened by federal health reform, which will expand mental-health and substance-abuse treatment benefits to more Kentuckians without adding to the number of providers.

Bankruptcy for Seven Counties is a lose-lose proposition: It could close its doors in 2014 and stop providing services to 30,000 Kentuckians or, if the bankruptcy goes through, the state's retirement system wouldn't get anticipated agency payments into the system, reports Ryan Alessi of cn|2, a news service of the Time Warner and Insight cable-TV companies.

“The only two paths this can go is we could stay in KERS until we have given them our last nickel, which is a year (or) year-and-a-half from now … (and) we close the doors and go out of business and KERS gets no more money because we’re out of business,” Dr. Tony Zipple, president of Seven Counties, told Alessi.

In addition to funding problems for mental-health services, many people with mental-health issues don't seek treatment because of its stigma, said Sheila Schuster, executive director of the Kentucky Mental Health Coalition, in a recent opinion piece sent to Kentucky newspapers.  Shuster calls on elected leaders to increase funding of mental health services and highlights the prevalence of mental health illness.

"At least one-fourth of us will experience a behavioral health issues (mental illness or substance use disorder) in a given year," Schuster writes. That number, and the number of people needing treatment, will continue to grow, she says.

Schuster also writes about the societal impact of not treating mental illness: "Depression is rated as the #1 cause of disability in this country, and is a leading cause of absenteeism and decreased productivity in the work force." Because some people avoid treatment due to stigma, they may self-medicate with drugs or alcohol, and "the effects of stigma and failure to treat the whole person can have catastrophic results," she writes.

In addition to calling for more mental health funding, Schuster asks all Kentuckians to get educated about mental illness so that its stigma can be erased. Click here to read more from Schuster about mental health and resources for help. For a PDF of her op-ed, click here; for a text version, here.

By Molly Burchett
Kentucky Health News

The decision of Seven Counties Services Inc. to file bankruptcy to avoid paying into the Kentucky Employee Retirement System has created a "no win" situation for the state, and the issue may add yet another obstacle for Kentuckians to get the mental health care they need.

Louisville-based Seven Counties is one of the state's largest mental-health agencies, serving more than 30,000 adults and children with mental-health services, alcohol and drug-abuse treatment, developmental-disabilities services and preventive programs, according to its website.

And while Kentucky's mental-health system has received an F grade for its funding, the state pension system needs agencies like Seven Counties to pay in more because the system is just 27 percent funded. "Employers will have to ante up around 38 percent of annual payroll, compared with the 23 percent now required," Mike Wynn notes in The Courier-Journal.

Kentucky's need for mental health services is much greater than the supply, and an estimated 1.7 million Kentuckians live in areas designated as a "mental health professional shortage area," which means almost 40 percent of Kentucky residents lack proper access to such professionals, says a report by the Kaiser Family Foundation. About 24 percent of residents' mental-health care needs are under-served, and this situation could be worsened by federal health reform, which will expand mental-health and substance-abuse treatment benefits to more Kentuckians without adding to the number of providers.

Bankruptcy for Seven Counties is a lose-lose proposition: It could close its doors in 2014 and stop providing services to 30,000 Kentuckians or, if the bankruptcy goes through, the state's retirement system wouldn't get anticipated agency payments into the system, reports Ryan Alessi of cn|2, a news service of the Time Warner and Insight cable-TV companies.

“The only two paths this can go is we could stay in KERS until we have given them our last nickel, which is a year (or) year-and-a-half from now … (and) we close the doors and go out of business and KERS gets no more money because we’re out of business,” Dr. Tony Zipple, president of Seven Counties, told Alessi.

In addition to funding problems for mental-health services, many people with mental-health issues don't seek treatment because of its stigma, said Sheila Schuster, executive director of the Kentucky Mental Health Coalition, in a recent opinion piece sent to Kentucky newspapers.  Shuster calls on elected leaders to increase funding of mental health services and highlights the prevalence of mental health illness.

"At least one-fourth of us will experience a behavioral health issues (mental illness or substance use disorder) in a given year," Schuster writes. That number, and the number of people needing treatment, will continue to grow, she says.

Schuster also writes about the societal impact of not treating mental illness: "Depression is rated as the #1 cause of disability in this country, and is a leading cause of absenteeism and decreased productivity in the work force." Because some people avoid treatment due to stigma, they may self-medicate with drugs or alcohol, and "the effects of stigma and failure to treat the whole person can have catastrophic results," she writes.

In addition to calling for more mental health funding, Schuster asks all Kentuckians to get educated about mental illness so that its stigma can be erased. Click here to read more from Schuster about mental health and resources for help. For a PDF of her op-ed, click here; for a text version, here.

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W. Va. plans private-public model to provide school breakfast, improve child health, fight obesity; could this approach help Ky.?

By Molly Burchett
Kentucky Health News

Breakfast has been said to be the most important meal of the day, and it can be important in fighting obesity. Policymakers in West Virginia are pushing for breakfast food programs in schools through public-private partnerships, and a new report says similar programs could save $41 billion in federal dollars long-term by preventing obesity. Does this make sense, and does it make sense for Kentucky?

Like West Virginia, Kentucky has a high obesity rate among middle and high school students but has many children who don't always get the food they need to live a healthy life. Kentucky ranks fourth highest in food insecurity among children because 23 percent of Kentucky's children do not always know where they will find their next meal, according to Feeding America’s "Map the Meal Gap" study. (Here's a link to its interactive map, where you can see food insecurity rates by county in order to find out more about your county. One example appears below; orange dots are headquarters of regional food banks.)

A recent bill passed by West Virginia lawmakers addresses the problems of food insecurity, obesity and education simultaneously and serves as the first example for a statewide public-private funding partnership to improve school meals programs, reports David Gutman of The Associated Press. The bill would also require every county to set up a fund to collect private food donations.

The bill aims to require every school to have breakfast food programs so no student goes without it because of costs, says Gutman. Poor nutrition and diet are sometimes issues of cost and income level since healthy foods can be more expensive than unhealthy ones. For example, a bag of 10 apples may costs $4.99, but a package of Little Debbie oatmeal creme pies could be $1.79. A medium-sized apple has 93 calories and less than 1 gram of fat while an oatmeal creme pie has 318 calories and 13 grams of fat.

What does this have to do with obesity? The research-based logic is that a healthy, daily breakfast improves diet and can replace sugary alternatives such as donuts. Eating a healthy breakfast also improves education by combating hunger and aiding concentration and has been found to be associated with overall health and mental functioning. Overall, these factors may work together to improve education and diet, reports Gutman.

Such a program could help Kentucky address the state's problems related to food insecurity, obesity and education, while generating long-term savings. Similar food programs that provide meals to low-income children could generate as much as $41 billion in long-term federal saving by preventing obesity, says a new report from the Campaign to End Obesity.

The report says that the S-CHIP childhood obesity demonstration project, which combines changes in preventive care with community and school efforts to reduce childhood obesity in low-income communities, could prevent a child from becoming obese, saving an estimated $41,500 for an average female and $30,600 for an average male Medicaid beneficiary, says the report.

Three other programs were highlighted as huge cost-savers because they would prevent obesity and related chronic conditions in the long run, which would reduce health care costs and increase wages, says the report. These include increasing obesity screenings by physicians, bringing the Diabetes Prevention Program to scale and covering certain weight loss drugs under Medicare Part D. Preventive health policies aimed at obesity prevention could significantly reduce government expenditures, could save tax dollars and could improve the overall health of Kentuckians.

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

By Molly Burchett
Kentucky Health News

Breakfast has been said to be the most important meal of the day, and it can be important in fighting obesity. Policymakers in West Virginia are pushing for breakfast food programs in schools through public-private partnerships, and a new report says similar programs could save $41 billion in federal dollars long-term by preventing obesity. Does this make sense, and does it make sense for Kentucky?

Like West Virginia, Kentucky has a high obesity rate among middle and high school students but has many children who don't always get the food they need to live a healthy life. Kentucky ranks fourth highest in food insecurity among children because 23 percent of Kentucky's children do not always know where they will find their next meal, according to Feeding America’s "Map the Meal Gap" study. (Here's a link to its interactive map, where you can see food insecurity rates by county in order to find out more about your county. One example appears below; orange dots are headquarters of regional food banks.)

A recent bill passed by West Virginia lawmakers addresses the problems of food insecurity, obesity and education simultaneously and serves as the first example for a statewide public-private funding partnership to improve school meals programs, reports David Gutman of The Associated Press. The bill would also require every county to set up a fund to collect private food donations.

The bill aims to require every school to have breakfast food programs so no student goes without it because of costs, says Gutman. Poor nutrition and diet are sometimes issues of cost and income level since healthy foods can be more expensive than unhealthy ones. For example, a bag of 10 apples may costs $4.99, but a package of Little Debbie oatmeal creme pies could be $1.79. A medium-sized apple has 93 calories and less than 1 gram of fat while an oatmeal creme pie has 318 calories and 13 grams of fat.

What does this have to do with obesity? The research-based logic is that a healthy, daily breakfast improves diet and can replace sugary alternatives such as donuts. Eating a healthy breakfast also improves education by combating hunger and aiding concentration and has been found to be associated with overall health and mental functioning. Overall, these factors may work together to improve education and diet, reports Gutman.

Such a program could help Kentucky address the state's problems related to food insecurity, obesity and education, while generating long-term savings. Similar food programs that provide meals to low-income children could generate as much as $41 billion in long-term federal saving by preventing obesity, says a new report from the Campaign to End Obesity.

The report says that the S-CHIP childhood obesity demonstration project, which combines changes in preventive care with community and school efforts to reduce childhood obesity in low-income communities, could prevent a child from becoming obese, saving an estimated $41,500 for an average female and $30,600 for an average male Medicaid beneficiary, says the report.

Three other programs were highlighted as huge cost-savers because they would prevent obesity and related chronic conditions in the long run, which would reduce health care costs and increase wages, says the report. These include increasing obesity screenings by physicians, bringing the Diabetes Prevention Program to scale and covering certain weight loss drugs under Medicare Part D. Preventive health policies aimed at obesity prevention could significantly reduce government expenditures, could save tax dollars and could improve the overall health of Kentuckians.

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

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Parents should talk to children about alcohol; study shows teens do listen

Two recent studies highlight how important it is for parent to talk with their teens about the risks of alcohol use, which leads to more than 4,500 deaths nationwide every year.

In the first study, Mothers Against Drunk Driving found that fewer than a third of alcohol-related deaths among 15- to 20-year-olds are caused by drinking and driving. About 32 percent of the drinking-related deaths involved traffic crashes, while 68 percent involved incidents such as murder (30 percent), suicide (14 percent), alcohol poisoning (9 percent) and other causes (15 percent), MADD says in a press release.

"These data show that taking away the keys truly does not take away all of the risks when it comes to underage drinking," MADD national president Jan Withers said. "MADD hopes this information will inspire parents to have ongoing conversations with their kids about the dangers of drinking alcohol before age 21, especially since we know that a majority of kids say their parents are the biggest influence on their decisions about alcohol."

Another study says parents can help reduce children's excessive drinking in college by talking with them about the potential dangers of excessive drinking before they set foot on campus, and it turns out that children really do listen to their parents about drinking, says the study by Rob Turrisi of Penn State. Discussing drinking in any way before teens go to campus, including why some teens drink while others don't, as well as the potential dangers of excessive drinking, can help.

Having this type of conversation with teens about the reality of underage drinking and its risks, such as alcoholism and alcohol poisoning, and can reduce the odds that light drinkers will escalate into excessive drinkers, says the study. It can also increase the likelihood that already heavy-drinking teens cut down on their drinking or even stop completely.

The National Institute on Alcohol Abuse and Alcoholism also urges parents to talk with their children about alcohol. Click here for more information about doing this or to read about the risks of alcohol use and other prevention strategies.

Two recent studies highlight how important it is for parent to talk with their teens about the risks of alcohol use, which leads to more than 4,500 deaths nationwide every year.

In the first study, Mothers Against Drunk Driving found that fewer than a third of alcohol-related deaths among 15- to 20-year-olds are caused by drinking and driving. About 32 percent of the drinking-related deaths involved traffic crashes, while 68 percent involved incidents such as murder (30 percent), suicide (14 percent), alcohol poisoning (9 percent) and other causes (15 percent), MADD says in a press release.

"These data show that taking away the keys truly does not take away all of the risks when it comes to underage drinking," MADD national president Jan Withers said. "MADD hopes this information will inspire parents to have ongoing conversations with their kids about the dangers of drinking alcohol before age 21, especially since we know that a majority of kids say their parents are the biggest influence on their decisions about alcohol."

Another study says parents can help reduce children's excessive drinking in college by talking with them about the potential dangers of excessive drinking before they set foot on campus, and it turns out that children really do listen to their parents about drinking, says the study by Rob Turrisi of Penn State. Discussing drinking in any way before teens go to campus, including why some teens drink while others don't, as well as the potential dangers of excessive drinking, can help.

Having this type of conversation with teens about the reality of underage drinking and its risks, such as alcoholism and alcohol poisoning, and can reduce the odds that light drinkers will escalate into excessive drinkers, says the study. It can also increase the likelihood that already heavy-drinking teens cut down on their drinking or even stop completely.

The National Institute on Alcohol Abuse and Alcoholism also urges parents to talk with their children about alcohol. Click here for more information about doing this or to read about the risks of alcohol use and other prevention strategies.

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Beshear vetoes prompt-pay bill but takes several steps to address problems in Medicaid; he and Haynes say it's working

Gov. Steve Beshear has vetoed the bill designed to make Medicaid managed-care firms pay health-care providers more quickly, but is taking administrative steps to address the issue.

Beshear said he agreed with the intent of House Bill 5 but it might have interfered with the contractual relationship between the state and the four managed-care companies. The bill would have subjected that relationship to the state Department of Insurance's review and investigation process for private-insurance payment complaints. 

"That language would have resulted in excessive costs for state government and taxpayers due to the expansion of the review process beyond the current parameters used for private insurance," Beshear's office said in a press release.

Instead, Beshear ordered the department to take over responsibility for review of prompt-payment complaints from the Department for Medicaid Services. "If improper payment practices are discovered, DOI can impose sanctions," the release said. He also ordered the department to audit each of the managed-care firms operating statewide – Wellcare, Coventry Cares, and Kentucky Spirit – at their cost.

Meanwhile, the firms have agreed to meet with every hospital they have under contract to reconcile outstanding accounts.  "This effort will begin immediately and continue until every hospital’s accounts receivable has been reconciled," the release said.  "The results will . . . be made public, in order to provide transparency and accountability." The firms have  agreed to meet with any other provider who wants a meeting.

Also, the Cabinet for Health and Family Services will hold eight regional forums for providers, managed-care firms, and Insurance Department representatives to discuss concerns and how to improve the system. Part of this effort will focus on "emergency room management that meets community needs without an ER operating as a de facto primary-care office," the release said. "A key component of controlling costs and improving health in a healthcare system is to provide the right treatment in the most cost-effective setting."

CHFS Secretary Audrey Tayse Haynes said the switch to managed care, made in November 2011, is working. “We are already seeing a tremendous increase in the use of preventive services, which improve health-care outcomes, while also reducing the enormous costs for treating chronic health conditions” such as diabetes-related amputations, she said.

Beshear said his plan would solve "lingering implementation problems" with managed care "while preserving the significant improvements in patient care and health care cost savings."

"Getting our people healthy and keeping them that way is not just good health policy, it’s good economics," Beshear said. "That’s why we will never return to the old fee-for-service system.  This is a significant cultural shift in medical care that has already happened across the country in both the private insurance market and in the Medicaid system."

Gov. Steve Beshear has vetoed the bill designed to make Medicaid managed-care firms pay health-care providers more quickly, but is taking administrative steps to address the issue.

Beshear said he agreed with the intent of House Bill 5 but it might have interfered with the contractual relationship between the state and the four managed-care companies. The bill would have subjected that relationship to the state Department of Insurance's review and investigation process for private-insurance payment complaints. 

"That language would have resulted in excessive costs for state government and taxpayers due to the expansion of the review process beyond the current parameters used for private insurance," Beshear's office said in a press release.

Instead, Beshear ordered the department to take over responsibility for review of prompt-payment complaints from the Department for Medicaid Services. "If improper payment practices are discovered, DOI can impose sanctions," the release said. He also ordered the department to audit each of the managed-care firms operating statewide – Wellcare, Coventry Cares, and Kentucky Spirit – at their cost.

Meanwhile, the firms have agreed to meet with every hospital they have under contract to reconcile outstanding accounts.  "This effort will begin immediately and continue until every hospital’s accounts receivable has been reconciled," the release said.  "The results will . . . be made public, in order to provide transparency and accountability." The firms have  agreed to meet with any other provider who wants a meeting.

Also, the Cabinet for Health and Family Services will hold eight regional forums for providers, managed-care firms, and Insurance Department representatives to discuss concerns and how to improve the system. Part of this effort will focus on "emergency room management that meets community needs without an ER operating as a de facto primary-care office," the release said. "A key component of controlling costs and improving health in a healthcare system is to provide the right treatment in the most cost-effective setting."

CHFS Secretary Audrey Tayse Haynes said the switch to managed care, made in November 2011, is working. “We are already seeing a tremendous increase in the use of preventive services, which improve health-care outcomes, while also reducing the enormous costs for treating chronic health conditions” such as diabetes-related amputations, she said.

Beshear said his plan would solve "lingering implementation problems" with managed care "while preserving the significant improvements in patient care and health care cost savings."

"Getting our people healthy and keeping them that way is not just good health policy, it’s good economics," Beshear said. "That’s why we will never return to the old fee-for-service system.  This is a significant cultural shift in medical care that has already happened across the country in both the private insurance market and in the Medicaid system."

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State Health Department gets diabetes prevention funding; will focus on prediabetes detection and lifestyle changes

The state Department for Public Health has been awarded a $134,380 federal grant to help reduce high rates of prediabetes and Type 2 diabetes in Kentucky.

“Diabetes is a tremendous public health concern that is both horrific for the individual, if unmanaged, and costly in terms of medications, various complications and long-term hospitalizations that are so often associated with the disease,” Audrey Haynes, secretary of the Cabinet for Health and Family Services, said in a press release.

In 2009, Kentucky's rate for diagnosed diabetes was the fourth highest in the nation at 11.4 percent of the population, compared to a national median of 8.3 percent. The rate means an estimated 366,000 adults in Kentucky have diabetes. An additional 266,000 Kentuckians are estimated to have prediabetes, according to the CFHS website.

Prediabetes often leads to Type 2 diabetes, the most common type, within a few years, but lifestyle changes promoted by the federal Diabetes Prevention Program can decrease the risk of developing diabetes by almost 60 percent, according to a recent study published in the Journal of Preventive Medicine.

“We must act now to begin reversing the devastating impact of diabetes on our state,” Haynes said. “We are excited to continue our work with the Diabetes Prevention Program to help more Kentuckians start making healthier lifestyle choices so they can avoid developing diabetes and lead longer, healthier lives.”

The DPP specifically targets individuals with prediabetes and works with them to reduce their risk of developing Type 2 diabetes. The risk factors for both are: being older than 45, being overweight or obese, physical inactivity, having a family history of diabetes, ever having gestational diabetes, high blood pressure, abnormal cholesterol, having a history of cardiovascular disease and being African-American, Hispanic/Latino, Native American, Asian American or Pacific Islander. Click here to take the diabetes risk test.

The federal Centers for Disease Control estimates that national efforts to prevent Type 2 diabetes could save $5.7 billion in health care costs by preventing 885,000 cases in the next 25 years. Kentucky will focus on three diabetes prevention strategies that involve raising awareness among health care providers to improve detection and treatment of prediabetes and encouraging both state/local government and business to add lifestyle change programs to the list of covered services under health plans, says the news release. (Read more about diabetes and prevention in Kentucky).

The state Department for Public Health has been awarded a $134,380 federal grant to help reduce high rates of prediabetes and Type 2 diabetes in Kentucky.

“Diabetes is a tremendous public health concern that is both horrific for the individual, if unmanaged, and costly in terms of medications, various complications and long-term hospitalizations that are so often associated with the disease,” Audrey Haynes, secretary of the Cabinet for Health and Family Services, said in a press release.

In 2009, Kentucky's rate for diagnosed diabetes was the fourth highest in the nation at 11.4 percent of the population, compared to a national median of 8.3 percent. The rate means an estimated 366,000 adults in Kentucky have diabetes. An additional 266,000 Kentuckians are estimated to have prediabetes, according to the CFHS website.

Prediabetes often leads to Type 2 diabetes, the most common type, within a few years, but lifestyle changes promoted by the federal Diabetes Prevention Program can decrease the risk of developing diabetes by almost 60 percent, according to a recent study published in the Journal of Preventive Medicine.

“We must act now to begin reversing the devastating impact of diabetes on our state,” Haynes said. “We are excited to continue our work with the Diabetes Prevention Program to help more Kentuckians start making healthier lifestyle choices so they can avoid developing diabetes and lead longer, healthier lives.”

The DPP specifically targets individuals with prediabetes and works with them to reduce their risk of developing Type 2 diabetes. The risk factors for both are: being older than 45, being overweight or obese, physical inactivity, having a family history of diabetes, ever having gestational diabetes, high blood pressure, abnormal cholesterol, having a history of cardiovascular disease and being African-American, Hispanic/Latino, Native American, Asian American or Pacific Islander. Click here to take the diabetes risk test.

The federal Centers for Disease Control estimates that national efforts to prevent Type 2 diabetes could save $5.7 billion in health care costs by preventing 885,000 cases in the next 25 years. Kentucky will focus on three diabetes prevention strategies that involve raising awareness among health care providers to improve detection and treatment of prediabetes and encouraging both state/local government and business to add lifestyle change programs to the list of covered services under health plans, says the news release. (Read more about diabetes and prevention in Kentucky).

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'Incredible Colon' to march across the state in Colon Cancer Awareness Month; more than a dozen stops scheduled

A special tour throughout the state of the Incredible Colon — an inflatable model of a human colon, large enough for visitors to walk through it — will promote education about risks and preventive measures of colon cancer during March, National Colon Cancer Awareness Month.

Colon cancer is the second leading cause of cancer mortality in Kentucky and nationwide, and it affects men and women of all ethnicities. Kentuckians have a higher than average risk of colon cancer due to higher rates of obesity, diets high in fat, and lack of regular exercise.

As many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly, according to the federal Centers for Disease Control and Prevention. Screenings detect any abnormalities or early signs of cancer, like polyps in the colon, and when detected early, polyps can be easily removed during a colonoscopy before they develop into cancer. When colon cancer is found early and treated, the five-year relative survival rate is 90 percent, underscoring the need for preventive health exams.

However, only 63 percent of Kentuckians who should have screening tests have had them, according to Kentucky data from the federal Behavioral Risk Factor Surveillance System, an ongoing national survey.

The colon tour is a coordinated promotion by the Kentucky Cancer Program, local cancer councils and the Kentucky Colon Cancer Prevention Project. It is free and open to the public and will take place in 13 Kentucky communities March 4-28:

• March 4: Fleming County Hospital, Flemingsburg (10:30 a.m. - 2:30 p.m.)
• March 5: Walmart, Manchester (Noon - 4 p.m.)
• March 6: Hazard ARH Medical Mall, Hazard (10 a.m. - 3 p.m.)
• March 7: Rowan County Chamber of Commerce, Morehead (members
  only, 9:30 a.m. - 3 p.m.)
• March 8: Frankfort Regional Hospital, Frankfort (9 a.m. - 4 p.m.)
• March 19: Lexmark, Lexington, (Employees only, 8:30 a.m. - 2 p.m.)
• March 20: Lawrence County High School, Louisa (8 a.m. - 5 p.m.)
• March 21: Lady of Bellefonte Health Center, Grayson (10 a.m. - 2 p.m.)
• March 23: Phillip Sharp Middle School, Butler (8-11 a.m. )
• March 25: Town Center Mall, Ashland (10 a.m. - 3 p.m.)
• March 26: Walmart, Georgetown (3-6 p.m.)
• March 27: Adron Doran University Center, Morehead (9:30 a.m. - 3 p.m.)
• March 28: Walmart, Somerset (10 a.m. - 2 p.m.)

Attendees are invited to dress in blue, the color of colon cancer awareness, and there will be door prizes, giveaways (while supplies last), refreshments and educational information about colon cancer screening, prevention and early detection. (Read more)

A special tour throughout the state of the Incredible Colon — an inflatable model of a human colon, large enough for visitors to walk through it — will promote education about risks and preventive measures of colon cancer during March, National Colon Cancer Awareness Month.

Colon cancer is the second leading cause of cancer mortality in Kentucky and nationwide, and it affects men and women of all ethnicities. Kentuckians have a higher than average risk of colon cancer due to higher rates of obesity, diets high in fat, and lack of regular exercise.

As many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly, according to the federal Centers for Disease Control and Prevention. Screenings detect any abnormalities or early signs of cancer, like polyps in the colon, and when detected early, polyps can be easily removed during a colonoscopy before they develop into cancer. When colon cancer is found early and treated, the five-year relative survival rate is 90 percent, underscoring the need for preventive health exams.

However, only 63 percent of Kentuckians who should have screening tests have had them, according to Kentucky data from the federal Behavioral Risk Factor Surveillance System, an ongoing national survey.

The colon tour is a coordinated promotion by the Kentucky Cancer Program, local cancer councils and the Kentucky Colon Cancer Prevention Project. It is free and open to the public and will take place in 13 Kentucky communities March 4-28:

• March 4: Fleming County Hospital, Flemingsburg (10:30 a.m. - 2:30 p.m.)
• March 5: Walmart, Manchester (Noon - 4 p.m.)
• March 6: Hazard ARH Medical Mall, Hazard (10 a.m. - 3 p.m.)
• March 7: Rowan County Chamber of Commerce, Morehead (members
  only, 9:30 a.m. - 3 p.m.)
• March 8: Frankfort Regional Hospital, Frankfort (9 a.m. - 4 p.m.)
• March 19: Lexmark, Lexington, (Employees only, 8:30 a.m. - 2 p.m.)
• March 20: Lawrence County High School, Louisa (8 a.m. - 5 p.m.)
• March 21: Lady of Bellefonte Health Center, Grayson (10 a.m. - 2 p.m.)
• March 23: Phillip Sharp Middle School, Butler (8-11 a.m. )
• March 25: Town Center Mall, Ashland (10 a.m. - 3 p.m.)
• March 26: Walmart, Georgetown (3-6 p.m.)
• March 27: Adron Doran University Center, Morehead (9:30 a.m. - 3 p.m.)
• March 28: Walmart, Somerset (10 a.m. - 2 p.m.)

Attendees are invited to dress in blue, the color of colon cancer awareness, and there will be door prizes, giveaways (while supplies last), refreshments and educational information about colon cancer screening, prevention and early detection. (Read more)

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Tips to help avoid a preventable return trip to the hospital

Patients too often leave the hospital without knowing how to care for themselves, leading to a preventable return. Here are tips to improve your chances of a successful recovery at home:

Be sure you understand your illness, and the care you received in the hospital.

Ask if you will require help at home. Can you bathe yourself? Climb stairs? Will you need bandages changed or shots? If so, do you have a caregiver to help, or will you need to arrange a visiting nurse?

Repeat back your care instructions to those who give them, to be sure you understand them.

Ask for a written discharge plan that lists your medical conditions, your treatments, and the plan for your ongoing care.

Get a list of all medications, how to use them, and what to do if you experience side effects. Be sure to ask whether to continue medications you were taking before this hospitalization.

Ask what symptoms suggest you’re getting worse and what to do if that happens, especially at night or during the weekend.

What follow-up appointments will you need and when? Ask if your hospital will make the appointments for you, and send your records.

Do you have transportation home, to follow-up appointments, and to the drugstore?

If you have a regular physician, make sure the hospital sends a report of your hospital stay.

If you are uninsured or will have difficulty affording prescriptions, a hospital discharge planner or social worker may be able to link you to community resources that can help.

Get a name and number to call if questions about your hospitalization or discharge arise.

Sources: The Associated Press; Dr. Eric Coleman, University of Colorado; Robert Wood Johnson Foundation; Journal of the American Medical Association.

Patients too often leave the hospital without knowing how to care for themselves, leading to a preventable return. Here are tips to improve your chances of a successful recovery at home:

Be sure you understand your illness, and the care you received in the hospital.

Ask if you will require help at home. Can you bathe yourself? Climb stairs? Will you need bandages changed or shots? If so, do you have a caregiver to help, or will you need to arrange a visiting nurse?

Repeat back your care instructions to those who give them, to be sure you understand them.

Ask for a written discharge plan that lists your medical conditions, your treatments, and the plan for your ongoing care.

Get a list of all medications, how to use them, and what to do if you experience side effects. Be sure to ask whether to continue medications you were taking before this hospitalization.

Ask what symptoms suggest you’re getting worse and what to do if that happens, especially at night or during the weekend.

What follow-up appointments will you need and when? Ask if your hospital will make the appointments for you, and send your records.

Do you have transportation home, to follow-up appointments, and to the drugstore?

If you have a regular physician, make sure the hospital sends a report of your hospital stay.

If you are uninsured or will have difficulty affording prescriptions, a hospital discharge planner or social worker may be able to link you to community resources that can help.

Get a name and number to call if questions about your hospitalization or discharge arise.

Sources: The Associated Press; Dr. Eric Coleman, University of Colorado; Robert Wood Johnson Foundation; Journal of the American Medical Association.

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It's not too late to get your flu shot, and getting it could not only help yourself and your family but your neighbors

It's not too late to get your flu shot, even though the flu has hit earlier and more broadly than usual, experts say.

It generally takes about two weeks for a flu vaccine to be most effective, said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention. Getting the shot in mid-January might seem too late, but it's "better late than never," he said during a teleconference Friday.

The CDC says the flu has been widespread in Kentucky for more than five weeks, far more than last year. "Most of the country is seeing a lot of flu, and this may continue for several weeks," Frieden said. "We don't know if we are over the peak."

Getting a flu shot can protect your neighbors, too. The protection afforded by the current vaccine is an important tool in protecting the health of the general public. The flu can be serious, especially in senior citizens, those with other chronic health problems and children. This season's outbreak has led to the deaths of 20 children as of Friday.

The CDC has found that the current flu vaccine is 62 percent effective, meaning if you get vaccinated, "You are 62 percent less likely to get the flu," writes Mary Meehan of the Lexington Herald-Leader.

It is also important that people with flu symptoms seek treatment. Anti-virals such as Tamiflu can be effective in reducing the most serious symptoms, Frieden said. "If you get flu-like symptoms, it can really help you avoid serious illness, hospitalization or even death," he said.

Meehan's story includes advice for dealing with children and tips about how to avoid getting the flu. To read it, click here.

UPDATE: In response to the flu, the University of Kentucky today limited visitation at its hospitals: None will be under 18 or have any flu-like symptoms, and only two will be allowed in a patient’s room at a time. Visitors may be issued masks or other protective clothing, and other restrictions may be imposed in special care units such as women’s and children’s units, critical care and oncology units. "Compassionate visitation exceptions will be made on a case-by-case basis," a UK release said.

It's not too late to get your flu shot, even though the flu has hit earlier and more broadly than usual, experts say.

It generally takes about two weeks for a flu vaccine to be most effective, said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention. Getting the shot in mid-January might seem too late, but it's "better late than never," he said during a teleconference Friday.

The CDC says the flu has been widespread in Kentucky for more than five weeks, far more than last year. "Most of the country is seeing a lot of flu, and this may continue for several weeks," Frieden said. "We don't know if we are over the peak."

Getting a flu shot can protect your neighbors, too. The protection afforded by the current vaccine is an important tool in protecting the health of the general public. The flu can be serious, especially in senior citizens, those with other chronic health problems and children. This season's outbreak has led to the deaths of 20 children as of Friday.

The CDC has found that the current flu vaccine is 62 percent effective, meaning if you get vaccinated, "You are 62 percent less likely to get the flu," writes Mary Meehan of the Lexington Herald-Leader.

It is also important that people with flu symptoms seek treatment. Anti-virals such as Tamiflu can be effective in reducing the most serious symptoms, Frieden said. "If you get flu-like symptoms, it can really help you avoid serious illness, hospitalization or even death," he said.

Meehan's story includes advice for dealing with children and tips about how to avoid getting the flu. To read it, click here.

UPDATE: In response to the flu, the University of Kentucky today limited visitation at its hospitals: None will be under 18 or have any flu-like symptoms, and only two will be allowed in a patient’s room at a time. Visitors may be issued masks or other protective clothing, and other restrictions may be imposed in special care units such as women’s and children’s units, critical care and oncology units. "Compassionate visitation exceptions will be made on a case-by-case basis," a UK release said.

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Wellness programs looking good as business investments

Businesses should like these numbers a lot: Invest $1, get $3 back. That's the latest math on the return on employee wellness programs and experts are saying that may just be the start for the financial returns they can expect from targeted prevention efforts. Mark Green of The Lane Report writes that no less of an expert than Dr. William Frist of Nashville -- doctor, policy specialist, former U.S. Senate majority leader and venture capitalist -- has said: “No question in my mind, if we are to invest a dollar to have the greatest value in terms of outcome and results, we should put that dollar in prevention and wellness."

Frist, reports Green, "is a strong advocate of wellness -- as a business practice to adopt and a business sector to be in. Individual doctors, hospitals and the entire healthcare industry need to get involved, he said." Frist broke down for Green what factors most determine how long someone lives: “The numbers break down 30 percent genetic, 5 percent environmental, 15 percent socioeconomic, which is surprising to a lot of people, and then 40 percent behavioral: wellness, prevention. And then what is left (10 percent) is who your doctor is, what hospital you go to, what your emergency room is.” Those numbers  are important to Frist because to impact longevity healthcare spending over time, he said, resources should be on the 40-percent sector: behavior, wellness and prevention. Think smoking programs, weight loss, exercise, nutrition, seatbelt use. (Read more)

Businesses should like these numbers a lot: Invest $1, get $3 back. That's the latest math on the return on employee wellness programs and experts are saying that may just be the start for the financial returns they can expect from targeted prevention efforts. Mark Green of The Lane Report writes that no less of an expert than Dr. William Frist of Nashville -- doctor, policy specialist, former U.S. Senate majority leader and venture capitalist -- has said: “No question in my mind, if we are to invest a dollar to have the greatest value in terms of outcome and results, we should put that dollar in prevention and wellness."

Frist, reports Green, "is a strong advocate of wellness -- as a business practice to adopt and a business sector to be in. Individual doctors, hospitals and the entire healthcare industry need to get involved, he said." Frist broke down for Green what factors most determine how long someone lives: “The numbers break down 30 percent genetic, 5 percent environmental, 15 percent socioeconomic, which is surprising to a lot of people, and then 40 percent behavioral: wellness, prevention. And then what is left (10 percent) is who your doctor is, what hospital you go to, what your emergency room is.” Those numbers  are important to Frist because to impact longevity healthcare spending over time, he said, resources should be on the 40-percent sector: behavior, wellness and prevention. Think smoking programs, weight loss, exercise, nutrition, seatbelt use. (Read more)

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Government says health-reform law to save average Kentuckian with Medicare coverage $5,000 through 2022

The U.S. Department of Health and Human Services says the Patient Protection and Affordable Care Act will likely save the average person with traditional Medicare coverage $5,000 from 2010 to 2022, and people with Medicare who have high prescription drug costs will save more than $18,000 over the same period, based on the agency's estimates.

The department also announced that seniors and people with disabilities in Kentucky have already saved $85.5 million on prescription drugs since the law was enacted. Nationwide, the report states that over 5.5 million people have saved nearly $4.5 billion on prescription drugs since the law was enacted. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year.

The U.S. Department of Health and Human Services says the Patient Protection and Affordable Care Act will likely save the average person with traditional Medicare coverage $5,000 from 2010 to 2022, and people with Medicare who have high prescription drug costs will save more than $18,000 over the same period, based on the agency's estimates.

The department also announced that seniors and people with disabilities in Kentucky have already saved $85.5 million on prescription drugs since the law was enacted. Nationwide, the report states that over 5.5 million people have saved nearly $4.5 billion on prescription drugs since the law was enacted. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year.

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Almost half of Americans did not receive routine preventive care before 2010, study finds

Los Angeles Times graphic by Mel Melcon

Though preventive medicine is considered a cornerstone in improving health, nearly half of Americans did not receive routine preventive care before 2010, a report by the Centers for Disease Control and Preventionhas found.

The findings show “there are large disparities by demographics, geography, and health care coverage and access” when it comes to receiving preventive clinical services, said CDC Director Dr. Thomas Frieden.

The analysis looked at “how many people with vascular heart disease were prescribed aspirin or antiplatelet therapy to prevent heart disease (just 46 percent) and how many adults with hypertension had their blood pressure under control (just 43 percent). Only 28 percent of adults between 18 and 64 had received the seasonal influenza vaccine. Only 7.6 percent of tobacco users were prescribed tobacco cessation medication,” reports Eryn Brown for the Los Angeles Times.

When it came to cholesterol testing the results were more positive, with 70 percent of men and women considered at risk receiving screening in the last five years. Preventive care to manage diabetes was also more readily accessible.

The goal of the study was to establish a baseline of preventive care before the implementation of the Affordable Care Act, which “gave 54 million Americans at least one new free preventive service through private health insurance plans,” Brown reports. (Read more)

Los Angeles Times graphic by Mel Melcon

Though preventive medicine is considered a cornerstone in improving health, nearly half of Americans did not receive routine preventive care before 2010, a report by the Centers for Disease Control and Preventionhas found.

The findings show “there are large disparities by demographics, geography, and health care coverage and access” when it comes to receiving preventive clinical services, said CDC Director Dr. Thomas Frieden.

The analysis looked at “how many people with vascular heart disease were prescribed aspirin or antiplatelet therapy to prevent heart disease (just 46 percent) and how many adults with hypertension had their blood pressure under control (just 43 percent). Only 28 percent of adults between 18 and 64 had received the seasonal influenza vaccine. Only 7.6 percent of tobacco users were prescribed tobacco cessation medication,” reports Eryn Brown for the Los Angeles Times.

When it came to cholesterol testing the results were more positive, with 70 percent of men and women considered at risk receiving screening in the last five years. Preventive care to manage diabetes was also more readily accessible.

The goal of the study was to establish a baseline of preventive care before the implementation of the Affordable Care Act, which “gave 54 million Americans at least one new free preventive service through private health insurance plans,” Brown reports. (Read more)

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