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Saturday, February 9, 2013

Ky. Rural Health Association seeks entries in reporting contest

The Kentucky Rural Health Association invites nominations for its annual rural health reporting awards, which aim to encourage more and better coverage of Kentucky’s rural health-related issues by the state’s newspapers.

The contest has daily and non-daily divisions, each with two categories: series and single story. Each of the four winners gets a plaque and a $100 prize at KRHA's summer conference. Articles must originally have been published during the preceding fiscal year. Entries will be accepted from staff writers, editors, freelance writers and others affiliated with a Kentucky-based newspaper, and from KRHA members and community members at large on the writers’ or newspapers’ behalf. Each entry should include three copies of the article as it originally appeared in the newspaper. The awards will be based on relevance to rural health, quality of reporting, impact on health care policy and new insights generated by the reporting.

For entry information, contact Ernie L. Scott of the Kentucky Office of Rural Health at 750 Morton Blvd., Hazard KY 41701, or 606.439.3557 ext. 83689, or ernie.scott@uky.edu.
The Kentucky Rural Health Association invites nominations for its annual rural health reporting awards, which aim to encourage more and better coverage of Kentucky’s rural health-related issues by the state’s newspapers.

The contest has daily and non-daily divisions, each with two categories: series and single story. Each of the four winners gets a plaque and a $100 prize at KRHA's summer conference. Articles must originally have been published during the preceding fiscal year. Entries will be accepted from staff writers, editors, freelance writers and others affiliated with a Kentucky-based newspaper, and from KRHA members and community members at large on the writers’ or newspapers’ behalf. Each entry should include three copies of the article as it originally appeared in the newspaper. The awards will be based on relevance to rural health, quality of reporting, impact on health care policy and new insights generated by the reporting.

For entry information, contact Ernie L. Scott of the Kentucky Office of Rural Health at 750 Morton Blvd., Hazard KY 41701, or 606.439.3557 ext. 83689, or ernie.scott@uky.edu.
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About Dr Kevin Lau


Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.



About Dr Kevin Lau


Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.
Read More


Thursday, February 7, 2013

Statewide smoking ban close to House vote, Stumbo says

For the second straight year, the state House Health and Welfare Committee has approved a bill that would ban smoking in enclosed public places or workplaces. It is still unlikely to become law, but might get farther in the legislative process.

"The proposal has never been voted on by the full House, and it would probably have a rough road in the Republican-controlled Senate," Beth Musgrave reports for the Lexington Herald-Leader. "Senate President Robert Stivers, R-Manchester, said that the government shouldn't tell businesses they cannot regulate smoking on their own property." (Stivers' hometown does just that; it is one of 22 Kentucky jurisdictions with smoking bans.)

House Speaker Greg Stumbo told Musgrave that he supports the measure, House Bill 190, and that sponsors are close to getting the votes it needs to pass the full House. The House has 100 members, but a bill can pass with as few as 40 votes as long as enough members abstain and it has a plurality.

The bill passed the committee Wednesday by a vote of 11-0, with four Republicans abstaining: Reps. Tim Moore of Elizabethtown, Robert Benvenuti of Lexington, Ben Waide of Madisonville and Addia Wuchner of Burlington.

Rep. Julie Adams of Louisville, the bill's Republican sponsor, told Musgrave that 29 states have statewide smoking bans, 24 with bans like the bill would impose. "This is a mainstream issue," she said. "The Kentucky General Assembly is way behind the general public." (Read more)

Basketball star Derek Anderson will join Smoke-Free Kentucky for its annual lobbying day in Frankfort Thursday, Feb. 14. He said in a press release, “Kentucky has so much to be proud of.   We are known for our hoops and horses.  Unfortunately, we are also number 1 in the number of deaths from lung cancer.  This is unacceptable to me. I want to be a part of the movement to change that.”  He added, “I am a businessman.  Smoke-free workplaces make good economic sense.” (Read more)

Read more here: http://www.kentucky.com/2013/02/07/2507141/statewide-smoking-ban-clears-kentucky.html#storylink=cpy

Read more here: http://www.kentucky.com/2013/02/07/2507141/statewide-smoking-ban-clears-kentucky.html#storylink=cpy


Read more here: http://www.kentucky.com/2013/02/07/2507141/statewide-smoking-ban-clears-kentucky.html#storylink=cpy
For the second straight year, the state House Health and Welfare Committee has approved a bill that would ban smoking in enclosed public places or workplaces. It is still unlikely to become law, but might get farther in the legislative process.

"The proposal has never been voted on by the full House, and it would probably have a rough road in the Republican-controlled Senate," Beth Musgrave reports for the Lexington Herald-Leader. "Senate President Robert Stivers, R-Manchester, said that the government shouldn't tell businesses they cannot regulate smoking on their own property." (Stivers' hometown does just that; it is one of 22 Kentucky jurisdictions with smoking bans.)

House Speaker Greg Stumbo told Musgrave that he supports the measure, House Bill 190, and that sponsors are close to getting the votes it needs to pass the full House. The House has 100 members, but a bill can pass with as few as 40 votes as long as enough members abstain and it has a plurality.

The bill passed the committee Wednesday by a vote of 11-0, with four Republicans abstaining: Reps. Tim Moore of Elizabethtown, Robert Benvenuti of Lexington, Ben Waide of Madisonville and Addia Wuchner of Burlington.

Rep. Julie Adams of Louisville, the bill's Republican sponsor, told Musgrave that 29 states have statewide smoking bans, 24 with bans like the bill would impose. "This is a mainstream issue," she said. "The Kentucky General Assembly is way behind the general public." (Read more)

Basketball star Derek Anderson will join Smoke-Free Kentucky for its annual lobbying day in Frankfort Thursday, Feb. 14. He said in a press release, “Kentucky has so much to be proud of.   We are known for our hoops and horses.  Unfortunately, we are also number 1 in the number of deaths from lung cancer.  This is unacceptable to me. I want to be a part of the movement to change that.”  He added, “I am a businessman.  Smoke-free workplaces make good economic sense.” (Read more)

Read more here: http://www.kentucky.com/2013/02/07/2507141/statewide-smoking-ban-clears-kentucky.html#storylink=cpy

Read more here: http://www.kentucky.com/2013/02/07/2507141/statewide-smoking-ban-clears-kentucky.html#storylink=cpy


Read more here: http://www.kentucky.com/2013/02/07/2507141/statewide-smoking-ban-clears-kentucky.html#storylink=cpy
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Long term treatment with meloxicam in cats

Gowan RA, Baral RM, Lingard AE, et al. A retrospective analysis of the effects of meloxicam on the longevity of aged cats with and without overt chronic kidney disease. J Feline Med Surg. 2012; 14: 876-81.

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly prescribed pharmaceuticals for the treatment of pain and inflammation in humans, dogs, and horses. Meloxicam is metabolized primarily through the oxidative pathway rather than the glucuronidation pathway, an important factor in limiting toxicity in cats. The dependence of many NSAIDs on the glucuronidation pathway is part of the reason for the cat’s susceptibility to NSAID toxicity. Meloxicam is a COX-2 selective inhibitor with a COX-1/COX-2 ratio of inhibition of 2.7; thus, adverse effects of meloxicam are still of concern and primarily involve the gastrointestinal tract and kidneys due to the dependence of these organs on COX-1 for health. In the European Union, Switzerland, Australia, and New Zealand, meloxicam is licensed for long-term treatment of chronic pain in cats. In the United States, meloxicam has a black box label for avoiding its repeated use due to an increased risk of acute renal failure and death. This unacceptable risk has not been a concern in other countries, possibly due to better patient selection and the lower doses used. Regardless of licensed or extra-label use of meloxicam, previous studies have shown that it can be administered safely to aged cats with or without chronic kidney disease (CKD), at least at low therapeutic doses and provided they are clinically stable and monitored carefully.



This study builds on previous work of Gunew et al. and Gowan et al. and further examines the effect of long-term meloxicam administration on renal function in cats with and without pre-existing CKD by providing long-term survival data. A total of 82 cats were enrolled in the study of which 47 had CKD and 35 did not have evidence of overt CKD. Treatment with meloxicam did not appear to decrease longevity in cats with pre-existing CKD, as survival times (median 1608 days) were not reduced when compared with previously published data. Quality of life is a major concern for cat owners, in particular with regard to chronic painful conditions. In conclusion, these authors recommend that meloxicam should be considered as part of a therapeutic regimen in cats with chronic painful conditions, with or without overt stable CKD. [GO]

See also:
Sparkes AH, Heiene R, Lascelles BDX, et al. ISFM and AAFP consensus guidelines: Long-term use of NSAIDs in cats. J Feline Med Surg. 2010; 12: 521-38.

Gowan RA, Lingard AE, Johnston L, Stansen W, Brown SA and Malik R. Retrospective case-control study of the effects of long-term dosing with meloxicam on renal function in aged cats with degenerative joint disease. J Feline Med Surg. 2011; 13: 752-61. 

Related blog articles:
Meloxicam for feline arthritis (June 2008)
Cats and arthritis (2009)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Gowan RA, Baral RM, Lingard AE, et al. A retrospective analysis of the effects of meloxicam on the longevity of aged cats with and without overt chronic kidney disease. J Feline Med Surg. 2012; 14: 876-81.

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly prescribed pharmaceuticals for the treatment of pain and inflammation in humans, dogs, and horses. Meloxicam is metabolized primarily through the oxidative pathway rather than the glucuronidation pathway, an important factor in limiting toxicity in cats. The dependence of many NSAIDs on the glucuronidation pathway is part of the reason for the cat’s susceptibility to NSAID toxicity. Meloxicam is a COX-2 selective inhibitor with a COX-1/COX-2 ratio of inhibition of 2.7; thus, adverse effects of meloxicam are still of concern and primarily involve the gastrointestinal tract and kidneys due to the dependence of these organs on COX-1 for health. In the European Union, Switzerland, Australia, and New Zealand, meloxicam is licensed for long-term treatment of chronic pain in cats. In the United States, meloxicam has a black box label for avoiding its repeated use due to an increased risk of acute renal failure and death. This unacceptable risk has not been a concern in other countries, possibly due to better patient selection and the lower doses used. Regardless of licensed or extra-label use of meloxicam, previous studies have shown that it can be administered safely to aged cats with or without chronic kidney disease (CKD), at least at low therapeutic doses and provided they are clinically stable and monitored carefully.



This study builds on previous work of Gunew et al. and Gowan et al. and further examines the effect of long-term meloxicam administration on renal function in cats with and without pre-existing CKD by providing long-term survival data. A total of 82 cats were enrolled in the study of which 47 had CKD and 35 did not have evidence of overt CKD. Treatment with meloxicam did not appear to decrease longevity in cats with pre-existing CKD, as survival times (median 1608 days) were not reduced when compared with previously published data. Quality of life is a major concern for cat owners, in particular with regard to chronic painful conditions. In conclusion, these authors recommend that meloxicam should be considered as part of a therapeutic regimen in cats with chronic painful conditions, with or without overt stable CKD. [GO]

See also:
Sparkes AH, Heiene R, Lascelles BDX, et al. ISFM and AAFP consensus guidelines: Long-term use of NSAIDs in cats. J Feline Med Surg. 2010; 12: 521-38.

Gowan RA, Lingard AE, Johnston L, Stansen W, Brown SA and Malik R. Retrospective case-control study of the effects of long-term dosing with meloxicam on renal function in aged cats with degenerative joint disease. J Feline Med Surg. 2011; 13: 752-61. 

Related blog articles:
Meloxicam for feline arthritis (June 2008)
Cats and arthritis (2009)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Read More


Richard III, scoliosis and me

Seeing Richard III's skeleton, I felt a shiver of empathic pain. Scoliosis twisted both our spines

By 


UK - King Richard III Discovery
The remains of King Richard III, found beneath a Leicester car park. Photograph: University of Leicester/Corbis
The discovery of the bones of Richard III, lying quietly under a Leicester city council car park for 500-odd years, is historically fascinating and imaginatively compelling. But, inspecting the newspaper photograph of those meticulously laid-out, gingery and desiccated human remains, I am startled by another sensation: that of raw, physical connection. Because Richard and I share not only our height – a surprisingly tall five foot eight – but also our skeletal deformity: scoliosis. Though his was far more pronounced (and therefore disabling) than mine, still, just like him, my adult life has been dogged by an "S" curvature of the spine.
I was in my late teens, an energetic ballet and swimming type, when one day without warning my back went into spasm and I found myself crunched over in agony. I think I saw a chiropractor and that was that. Except that over the next few years, it only took one wrong move – sneezing, laughing, reaching for a drink of water – and I'd be suddenly skewed, immobile and in pain for days.
At 28, I had a baby. Then – rather quickly – another, and another. By the time the smallest was a few months old, I rarely had a day when I could move freely and without pain. Life went on – I still went to work – but I was a different person, rarely upright, never far from a bag of frozen peas, entertaining my children from the bed or the floor.
Finally, I had an MRI scan. The consultant grabbed a plastic spinal column off his desk and, with one vicious twist, bent it out of shape. "This is you," he said, demonstrating how my "mild to moderate" scoliosis was wearing out my vertebrae. I swallowed and asked him if swimming might help. He shrugged: "Not a lot. You'll find you get progressively more immobile as you get older." I was 31 years old. I sat in the hospital car park and cried.
In fact, I was lucky. An insightful friend insisted I try Pilates and today, after more than 20 years of twice-weekly classes, my scoliosis is hugely less pronounced – mild rather than moderate – and my fear of immobility mostly laid to rest. On a bad day, one shoulder and one hip will be noticeably higher than the other, and I'll ache a bit (all right, a lot). But I stretch every day – every hour if I have to – and at 52, I rather like that I'm now comparatively supple for my age.
And though over the years my scoliosis has frightened, exhausted and (frankly) enraged me, I now wouldn't want to be without it. It's taught me patience and – in constructive and unexpected ways – about pain. It's taught me to observe myself with curiosity and kindness, rather than tension and terror. More than anything, though, it's taken me on this wild, uncompromising journey through my body, and shown me how to relish the light, unthinking joy of movement. The truth is, I don't mind being like this. My deformity has become my friend.
Still, looking at what's left of the poor Plantagenet king, I find it hard to view that ancient, twisted snake of vertebrae without a shiver of empathic pain. Our bones are everything, the very core of us. They carry us through life – far more viscerally individual than those other pumping organs we can scarcely visualise. And because they (literally) create the shape and poise of us, even long-dead ones seem to contain clues of the living people we once were.
I know enough about living with scoliosis to understand that a curve like his would have informed and warped every moment of the day. He would have woken stiff and skewed, only to have to negotiate his way through a day of disability and paralysing spasm. Poor man. It touches me deeply to see his deformity – his and mine – lying there visible and exposed and still somehow pungent, when everything else has been rinsed by time and decay.




Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.
Seeing Richard III's skeleton, I felt a shiver of empathic pain. Scoliosis twisted both our spines

By 


UK - King Richard III Discovery
The remains of King Richard III, found beneath a Leicester car park. Photograph: University of Leicester/Corbis
The discovery of the bones of Richard III, lying quietly under a Leicester city council car park for 500-odd years, is historically fascinating and imaginatively compelling. But, inspecting the newspaper photograph of those meticulously laid-out, gingery and desiccated human remains, I am startled by another sensation: that of raw, physical connection. Because Richard and I share not only our height – a surprisingly tall five foot eight – but also our skeletal deformity: scoliosis. Though his was far more pronounced (and therefore disabling) than mine, still, just like him, my adult life has been dogged by an "S" curvature of the spine.
I was in my late teens, an energetic ballet and swimming type, when one day without warning my back went into spasm and I found myself crunched over in agony. I think I saw a chiropractor and that was that. Except that over the next few years, it only took one wrong move – sneezing, laughing, reaching for a drink of water – and I'd be suddenly skewed, immobile and in pain for days.
At 28, I had a baby. Then – rather quickly – another, and another. By the time the smallest was a few months old, I rarely had a day when I could move freely and without pain. Life went on – I still went to work – but I was a different person, rarely upright, never far from a bag of frozen peas, entertaining my children from the bed or the floor.
Finally, I had an MRI scan. The consultant grabbed a plastic spinal column off his desk and, with one vicious twist, bent it out of shape. "This is you," he said, demonstrating how my "mild to moderate" scoliosis was wearing out my vertebrae. I swallowed and asked him if swimming might help. He shrugged: "Not a lot. You'll find you get progressively more immobile as you get older." I was 31 years old. I sat in the hospital car park and cried.
In fact, I was lucky. An insightful friend insisted I try Pilates and today, after more than 20 years of twice-weekly classes, my scoliosis is hugely less pronounced – mild rather than moderate – and my fear of immobility mostly laid to rest. On a bad day, one shoulder and one hip will be noticeably higher than the other, and I'll ache a bit (all right, a lot). But I stretch every day – every hour if I have to – and at 52, I rather like that I'm now comparatively supple for my age.
And though over the years my scoliosis has frightened, exhausted and (frankly) enraged me, I now wouldn't want to be without it. It's taught me patience and – in constructive and unexpected ways – about pain. It's taught me to observe myself with curiosity and kindness, rather than tension and terror. More than anything, though, it's taken me on this wild, uncompromising journey through my body, and shown me how to relish the light, unthinking joy of movement. The truth is, I don't mind being like this. My deformity has become my friend.
Still, looking at what's left of the poor Plantagenet king, I find it hard to view that ancient, twisted snake of vertebrae without a shiver of empathic pain. Our bones are everything, the very core of us. They carry us through life – far more viscerally individual than those other pumping organs we can scarcely visualise. And because they (literally) create the shape and poise of us, even long-dead ones seem to contain clues of the living people we once were.
I know enough about living with scoliosis to understand that a curve like his would have informed and warped every moment of the day. He would have woken stiff and skewed, only to have to negotiate his way through a day of disability and paralysing spasm. Poor man. It touches me deeply to see his deformity – his and mine – lying there visible and exposed and still somehow pungent, when everything else has been rinsed by time and decay.




Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.
Read More


Wednesday, February 6, 2013

Beshear calls for action to improve state's health, but says only that 'It's time for us to begin looking seriously' at a smoking ban

By Al Cross
Kentucky Health News

His priorities were education and tax reform, but Gov. Steve Beshear mentioned several health issues in his State of the Commonwealth speech tonight to a joint session of the General Assembly.

Beshear called for action to correct the state's "fundamental weaknesses," including "a population whose health ranks among the worst in the nation." Near the end of his speech, he said, "We need to continue improving the health of our people," but after about a minute of discussing tobacco and smoking he stopped short of endorsing a statewide ban on smoking in the workplace. (KET photo)

"It's time for us to begin looking seriously at doing this on a statewide level," he said to some applause, after noting that nearly half of Kentuckians live in jurisdictions where smoking is legally restricted, that the state has the highest or next-to-highest smoking rate overall and among teens and pregnant women, and that "Our smoking-related mortality rate is the worst in the nation. . . . Our addiction hurts productivity, jacks up health care costs and kills our people."

Beshear called for improving prenatal care and newborn screening, and for minor improvements in last year's bill to fight prescription drug abuse. He said the bill has caused a precipitous drop in abuse of prescription painkillers. "Kentucky at one time had the sixth highest rate in the nation, but . . . we improved 24 spots," he said. "Nearly half of the state's known pain management clinics have closed rather than submit to new rules that protect patients." He said use of the Kentucky All Schedule Prescription Electronic Reporting system "has increased nearly seven-fold . . . and prescriptions for some of the most abused drugs have dropped up to 14 percent from a year ago."

However, the problem of babies becoming addicted to drugs in their addicted mothers' wombs has skyrocketed in the last decade or so, Beshear said: "In 2000, reports showed 29 babies in Kentucky born addicted to drugs. But in 2011, there were 730 babies – more than 25 times as many. And that figure is thought to be under-reported." He did not say how he wants to improve screening.

Beshear did not mention perhaps the biggest health policy question facing the commonwealth, whether to use federal subsidies to expand the Medicaid program to people in households earning up to 138 percent of the federal poverty threshold. Now the program covers people in households earning up to 70 percent of the poverty line. The federal government would pay all the cost of the additional enrollees through 2016, when the state would start picking up part of the tab, up to 20 percent in 2020.

Some Republicans say the state can't afford the expansion, while some Democrats say it would be a good long-term investment in the state's health and economy. Beshear has said he wants to do it if the commonwealth can afford it, and expects to get cost estimates around the end of March -- about the time the legislature must adjourn.

For a PDF of the speech text, click here. For an audio recording, go here. For video from KET, here.
By Al Cross
Kentucky Health News

His priorities were education and tax reform, but Gov. Steve Beshear mentioned several health issues in his State of the Commonwealth speech tonight to a joint session of the General Assembly.

Beshear called for action to correct the state's "fundamental weaknesses," including "a population whose health ranks among the worst in the nation." Near the end of his speech, he said, "We need to continue improving the health of our people," but after about a minute of discussing tobacco and smoking he stopped short of endorsing a statewide ban on smoking in the workplace. (KET photo)

"It's time for us to begin looking seriously at doing this on a statewide level," he said to some applause, after noting that nearly half of Kentuckians live in jurisdictions where smoking is legally restricted, that the state has the highest or next-to-highest smoking rate overall and among teens and pregnant women, and that "Our smoking-related mortality rate is the worst in the nation. . . . Our addiction hurts productivity, jacks up health care costs and kills our people."

Beshear called for improving prenatal care and newborn screening, and for minor improvements in last year's bill to fight prescription drug abuse. He said the bill has caused a precipitous drop in abuse of prescription painkillers. "Kentucky at one time had the sixth highest rate in the nation, but . . . we improved 24 spots," he said. "Nearly half of the state's known pain management clinics have closed rather than submit to new rules that protect patients." He said use of the Kentucky All Schedule Prescription Electronic Reporting system "has increased nearly seven-fold . . . and prescriptions for some of the most abused drugs have dropped up to 14 percent from a year ago."

However, the problem of babies becoming addicted to drugs in their addicted mothers' wombs has skyrocketed in the last decade or so, Beshear said: "In 2000, reports showed 29 babies in Kentucky born addicted to drugs. But in 2011, there were 730 babies – more than 25 times as many. And that figure is thought to be under-reported." He did not say how he wants to improve screening.

Beshear did not mention perhaps the biggest health policy question facing the commonwealth, whether to use federal subsidies to expand the Medicaid program to people in households earning up to 138 percent of the federal poverty threshold. Now the program covers people in households earning up to 70 percent of the poverty line. The federal government would pay all the cost of the additional enrollees through 2016, when the state would start picking up part of the tab, up to 20 percent in 2020.

Some Republicans say the state can't afford the expansion, while some Democrats say it would be a good long-term investment in the state's health and economy. Beshear has said he wants to do it if the commonwealth can afford it, and expects to get cost estimates around the end of March -- about the time the legislature must adjourn.

For a PDF of the speech text, click here. For an audio recording, go here. For video from KET, here.
Read More


Physician assistants and some doctors urge lawmakers to pass bill that could ease provider shortage in rural Kentucky

Doctors and more than 150 physician-assistant students urged lawmakers Tuesday to pass a bill they stated involves dropping only one requirement in the law and could ease a physician shortage in Kentucky, reports Ryan Nick of cn|2's "Pure Politics."

Passage of Senate Bill 43 would repeal a law that allows physician assistants to treat patients only when a supervising physician is on site for the first 18 months after their certification. If passed, PAs would still be supervised but would be permitted to perform services in a location separate from the supervising physician, as long as that physician can be reached by phone at all times.

No other state requires PAs to have 18 months of on-site supervision. Colorado, the state with the next-longest mandate, requires supervision only for the first 1,000 hours after certification.

The bill's supporters say the burdensome supervision requirement has led to 55 out of Kentucky's 120 counties being medically underserved and has encouraged many PAs to practice in other states, reports Storm. They also say this rule needlessly complicates patient care, especially in rural areas where doctors are stretched thin, reports Melinda Beck of The Wall Street Journal.

The bill's sponsor, Sen. Tom Buford, R-Nicholasville, told Kentucky Health News that he expects the Kentucky Medical Association to seek some changes in the bill, but also expects it to pass because Senate Republican leaders, hospitals and universities support it. "We're educating these PAs at a lot of state expense just to work in other states," he said. House Speaker Greg Stumbo, D-Prestonsburg, told Storm he sees no reason why the bill shouldn't pass. Sen. Julie Denton, R-Louisville, chair of the Senate Health and Welfare Committee, told KHN that she supports the bill.

PAs are expected to be in even greater demand when the health-care reform law brings hundreds of thousands of Kentuckians into the health-insurance system. Beck notes the state is expected to face a greater shortage of physicians, particularly in primary care and rural areas. Buford said, "We're going to provide all this health care for everybody, and there's nobody to go see." For more from cn|2, including video interviews, click here.
Doctors and more than 150 physician-assistant students urged lawmakers Tuesday to pass a bill they stated involves dropping only one requirement in the law and could ease a physician shortage in Kentucky, reports Ryan Nick of cn|2's "Pure Politics."

Passage of Senate Bill 43 would repeal a law that allows physician assistants to treat patients only when a supervising physician is on site for the first 18 months after their certification. If passed, PAs would still be supervised but would be permitted to perform services in a location separate from the supervising physician, as long as that physician can be reached by phone at all times.

No other state requires PAs to have 18 months of on-site supervision. Colorado, the state with the next-longest mandate, requires supervision only for the first 1,000 hours after certification.

The bill's supporters say the burdensome supervision requirement has led to 55 out of Kentucky's 120 counties being medically underserved and has encouraged many PAs to practice in other states, reports Storm. They also say this rule needlessly complicates patient care, especially in rural areas where doctors are stretched thin, reports Melinda Beck of The Wall Street Journal.

The bill's sponsor, Sen. Tom Buford, R-Nicholasville, told Kentucky Health News that he expects the Kentucky Medical Association to seek some changes in the bill, but also expects it to pass because Senate Republican leaders, hospitals and universities support it. "We're educating these PAs at a lot of state expense just to work in other states," he said. House Speaker Greg Stumbo, D-Prestonsburg, told Storm he sees no reason why the bill shouldn't pass. Sen. Julie Denton, R-Louisville, chair of the Senate Health and Welfare Committee, told KHN that she supports the bill.

PAs are expected to be in even greater demand when the health-care reform law brings hundreds of thousands of Kentuckians into the health-insurance system. Beck notes the state is expected to face a greater shortage of physicians, particularly in primary care and rural areas. Buford said, "We're going to provide all this health care for everybody, and there's nobody to go see." For more from cn|2, including video interviews, click here.
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