Every Kentucky county has a local group working on health issues, foundation finds in compiling Health Coalitions Directory

For the first time, the Foundation for a Healthy Kentucky has documented that every Kentucky county has a local group working on health issues.

All 120 counties are listed in the Kentucky Health Coalitions Directory, which includes 208 groups. Last year’s first-ever directory listed fewer than 150. "Whether they are called health coalitions, collectives, consortia, associations or networks, people are joining forces to work on health-related challenges," the foundation said in a news release. "The groups have differing levels of organization and are pursuing various goals. Some are increasing access to healthy food and physical activity; others are planning needed screenings and education for people at risk for serious health problems like cancer, diabetes and other chronic diseases; yet others are improving working conditions through smoke-free ordinances."

The foundation said it would periodically update the directory. “These are local residents working on solutions to health issues where they live, work and raise their families,” said Susan Zepeda, president and CEO of the foundation. “Their work spans a broad spectrum of issues that contain a common thread: to improve health in the community and our state. These groups represent local health change efforts.”

The directory is designed to raise awareness of local efforts and "foster collaboration, build local capacity, provide technical assistance to these groups and celebrate their successes," the foundation said. State and national coalitions, and international coalitions doing work that affects Kentucky, are included in the directory. To get a PDF of it, visit the foundation's newsroom at www.healthy-ky.org.

Here are tools and resources to help you understand how the health reform law impacts you, your family and your business

By Molly Burchett
Kentucky Health News

The rollout of the insurance-buying section of the Patient Protection Affordable Care Act started Oct. 1, and regardless of where you stand on the law, it's important to be informed about what will happen Jan. 1 when the law's major provisions are set to go into effect. To help you understand how the health law impacts you, your family or your business, the Foundation for a Healthy Kentucky has compiled a list of links to information about the health law.

The law, informally known as Obamacare, is a set of health care reforms signed into law by President Obama on March 23, 2010. The law includes insurance mandates and requires everyone to have health insurance or pay a penalty starting Jan. 1.  In addition to insurance mandates, both the establishment of online health-insurance exchanges and expansion of Medicaid are two essential elements of the law.

In June 2012, the Supreme Court upheld the health law in a 5-4 vote, saying its requirement that most Americans obtain insurance or pay a penalty was authorized by Congress’s power to levy taxes. The Internal Revenue Service will administer that provision of the law. The court ruling limited the law’s blanket expansion of Medicaid, which attempted to require all states to expand the program in order to receive federal funding, saying that each state could make its own decision.

The Kentucky Health Benefit Exchange, Kynect, was established in July 2012 and opened for enrollment Tuesday. Calling it “the single-most important decision in our lifetime for improving the health of Kentuckians,” Gov. Steve Beshear announced his decision to expand Medicaid in Kentucky in May. As a result of this decision, Medicaid has expanded to provide coverage to Kentuckians under 65 in households up to 138 percent of the federal poverty level—currently $15,856 for an individual or $32,499 for a family of four.

About 640,000 Kentuckians are uninsured, and 308,000 of them qualify for expanded Medicaid because their incomes are less than 138 percent of the federal poverty threshold. The remaining 332,000 Kentuckians must purchase private insurance through Kynect. Of those purchasing private plans, an estimated 83 percent will be eligible for at least some tax credit to do so, reports Kentucky Voices for Health, a group of health-reform advocates.

Currently, the federal government pays 71 percent of Medicaid costs, and the state covers 29 percent of the costs. Under Medicaid expansion, the federal government will cover 100 percent of the costs of the newly eligible people for the first three years. Starting in 2017, the federal government will cover 95 percent of the costs for this expanded population, and federal funding will phase down to 90 percent by 2020.

The Kentucky Voices for Health presentation, found here, gives more details about the overall purpose of the Affordable Care Act and its implementation in Kentucky. Get Covered Kentucky, a coalition spearheaded by Kentucky Voices for Health, compiled additional information about Medicaid expansion. Click here for these tools and resources.

Beshear says Medicaid expansion is the right choice for Kentucky, providing numerous reasons and county-level data to explain why not expanding the program would hurt both Kentucky’s health, which already ranks poorly in many health categories, and taxpayers’ bottom line. Click here to see the impact of health reform on your local community.

You may be eligible for coverage through Medicaid or tax subsidies to help you purchase private insurance. Go the the Kynect website to determine your eligibility for Medicaid coverage or private insurance subsidies and to enroll Medicaid, the Kentucky Children’s Health Insurance Program or private plans. "It’s easy to apply, with just one application to fill out. When you apply online, you get enrolled quickly. We also have insurance agents and Kynectors who will help you apply using computers," says the website. If you want to apply by mail or fax, click here for paper applications.

The law does not require small employers (businesses with 50 or fewer employees) to provide insurance coverage. If you own a small business with 25 or fewer employees, there may be significant tax credits available through Kynect to help cover the cost of insurance. Since the mandate to cover employees has been delayed for a year, businesses with more than 50 employees will not face penalties in 2014 for not providing health insurance, but they may face penalties starting in 2015.

The foundation resource page includes additional resources to help you understand health reform efforts at the federal level, including those from the Kaiser Family Foundation, which includes a subsidy calculator, the Robert Wood Johnson Foundation and a fact page from the U.S. Department of Health and Human Services. In addition, a foundation report outlines how the health law creates opportunities to address public health issues, decrease health disparities and reform care delivery.

KET will show how annual county health rankings are stirring competition to improve health, community by community

The rankings are in quartiles, or fourths of the 120 counties

Kentuckians love the competition among their basketball and football teams. But what if that same spirit of competition was transferred to health? To help encourage such competition, and thus improve health county by county, the University of Wisconsin Population Health Institute produces county health rankings each year, in partnership with the Robert Wood Johnson Foundation.

The next edition of KET's "Health Three60," Tuesday at 9 p.m. ET, with Renee Shaw, looks at three communities that are taking those health statistics seriously and making positive changes. A health coalition drives change in Grant County, which moved from 89th to 60th in the rankings in three years. In Hardin County and some surrounding communities, a grassroots drive leads to a smoking ban. And new trails in Rockcastle County encourage healthy lifestyles, as well as economic development. The series is funded in part by the Foundation for a Healthy Kentucky. (Read more)

National Childhood Obesity Awareness Month: Policy changes underway in Ky. to lower its very high childhood obesity rate

September is National Childhood Obesity Awareness Month, and a number of policy changes are underway to combat the increasing trend of overweight children in America and Kentucky, where one in three kids are on their way to developing Type 2 diabetes.

Kentucky suffers from one of the highest childhood obesity rates in the country, tying Mississippi for the highest percentage of youth in grades 9 to 12 that are obese (18 percent). It has the third highest percentage of children ages 10 to 17 who are obese (21 percent), compared to 16.4 percent nationally, says a report by Kentucky's Task Force on Childhood Obesity.

The state's efforts to lower childhood obesity rates include two important studies for the Cabinet for Health and Family Services – "Shaping Kentucky’s Future: Policies to Reduce Obesity" and "Unbridled Health: A Plan for Coordinated Chronic Disease Prevention and Health Promotion." These reports contain policy recommendations for work communities, corporations, schools and the state itself to help Kentuckians eat healthy and exercise, The Foundation for a Healthy Kentucky says in a news release.

“Lowering childhood obesity rates is a positive lever for overall health change, reduced risk of chronic disease and an improved quality of life," said Susan Zepeda, president of the foundation. "Foundation polling and recent news reports signal growing awareness among Kentuckians of the importance of and the need for lowering our obesity rates."

Nationally, the recent report "F as in Fat: How Obesity Threatens America’s Future 2013" provides recommendations that could improve health in Kentucky and across the country with funding and effective implementation, including:
 · All food in schools must be healthy
 · Kids should have opportunities to be physically active on a regular basis
 · Restaurants should post calorie information on menus
 · Only healthy products should be marketed to children
 · Transportation plans should encourage walking and biking
 · Everyone should be able to purchase healthy, affordable foods close to home

“Here at home, Kentucky will host the Southern Obesity Summit in 2014 and several organizations are hard at work to advance health policies that support sound nutrition and active living at work, at school and in our communities,” said Zepeda. “These efforts create opportunities to discuss strategy and create more awareness of the compelling need to reduce childhood obesity rates in the commonwealth.”

Statewide forum on community efforts to promote children's health will be held in Northern Kentucky Monday, Sept. 16

"The goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort," veteran Kentucky broadcaster Greg Stotelmyer reports for Public News Service.

Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, main sponsor of the forum, told Stotlemyer that its title, "Communities Connecting for Healthier Kids," sends the message that everyone has a role to play in improving health, “whether it's fast food outlets that are offering healthy alternatives, whether it's state parks that are offering healthy kid friendly meals made with local produce, whether it's employers who gently encourage employees to use the steps.”

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., who will be a headline speaker at the forum, told Stotlemyer it takes leadership and vision to grow community health. “The faith community, the schools, the neighborhoods you know, all have something at stake here,” he said. “And by working together for community health, everyone benefits.” Cohen said a study in which his organization was involved found that for every $1 spent on community prevention of health problems, $6 could be saved. (Read more or listen)

Other speakers include David Jones Jr., member of the Jefferson County school board and former chairman of the Humana Inc. board of directors; and Daniel Hatcher, healthy out-of-school time adviser at the Alliance for a Healthier Generation. The conference is the latest of the foundation's annual Howard L. Bost Memorial Health Policy Forums, and is free to the public. For more information, click here. For a conference agenda, go here. To register, here.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpufThe goal is simple, the challenge difficult – how to ensure that the current generation of children in Kentucky grows up healthier than their parents. 

A free one-day conference coming up in Erlanger will attempt to draw engaged civic leaders into that effort.

Larry Cohen, executive director of the Prevention Institute in Oakland, Calif., will be a headliner at the forum.

He says it takes leadership and vision to grow community health.

"The faith community, the schools, the neighborhoods you know, all have something at stake here,” he explains. “And by working together for community health, everyone benefits."

Cohen says a study his organization was involved in found that, for every dollar spent on community prevention of health problems, six dollars could be saved.

The conference takes place September 16 and is free to attend. Register online, on the Foundation for a Healthy Kentucky website.

Susan Zepada, president and CEO of the Foundation for a Healthy Kentucky, says it's hard work to change behaviors and it isn't a top-down effort – everyone has a role to play. Thus, the forum's title – "Communities Connecting for Healthier Kids."

"Whether it's fast food outlets that are offering healthy alternatives,” Zepada says. “Whether it's state parks that are offering healthy kid friendly meals made with local produce. Whether it's employers who gently encourage employees to use the steps."

Zepada adds some Kentuckians' habits around eating, smoking, drinking and exercise have long contributed to the chronic health problems faced by the state.

Cohen says community health is also a good financial investment for business.

"We've seen businesses right now spend $73 billion on preventable, chronic diseases and I underline 'preventable,'" he says.
- See more at: http://www.publicnewsservice.org/2013-09-05/health-issues/can-ky-raise-a-healthier-next-generation/a34165-1#sthash.IOtVDcVD.dpuf

Seven Ky. communities get grants to reduce risks for chronic diseases among children and 'Invest in Kentucky's Future'

Seven diverse Kentucky communities are getting money to reduce the risk of chronic disease among Kentucky's youth. The initial grants announced Thursday are part of the Foundation for a Healthy Kentucky's new Investing in Kentucky’s Future initiative, a five-year, $3 million program.

“The health of our next generation is at stake,” said Susan Zepeda, CEO and president of the foundation. “Our goal is to help communities make positive changes in policies and service access that will help our children grow into healthy, productive adults. Regardless of the challenges, we want to help communities find new pathways to positive solutions.”

Community groups will use their initial grants to collect and analyze local health data. That analysis will guide development of innovative strategies for effective, sustainable measures to improve children's health. Those communities chosen for the initiative are:

• Clinton County School District, Albany: initial grant of $27,755 for the Clinton County Healthy Hometown Coalition. “We are thrilled that our community was chosen to participate in this important initiative,” Asst. Supt. Paula Little said. “The members of the Healthy Hometown Coalition are committed to helping children grow up in a physical, social, and cultural environment that supports good health habits. With help from the foundation, we can develop our capacity to make a lasting, positive change in our community.”

• Fitness for Life Around Grant County, Williamstown: initial grant of $21,643 for FFLAG and the Northern Kentucky Health Department. “We are pleased and excited to be given the opportunity to work with the Foundation for a Healthy Kentucky,” FFLAG Chairman Jeff Walters said. “We are a small group that has been working on improving the health of our community and we believe we’ve had a positive impact thus far. This grant will accelerate the process and the work that’s been started.”

• Foundation for Appalachian Kentucky, Hazard: initial grant of $32,558 for Perry County Wellness Coalition. “We’ve been working for several years to improve the menu and encourage better eating habits in and out of school,” said Linda Campbell, nutrition director at Perry County Schools. “It’s not as easy as changing a menu or just buying whole wheat bread. We’re changing a culture, and that’s not a simple thing. Working together, as a community, we can really start to make a difference. This grant from the Foundation for a Healthy Kentucky allows us to take the next steps toward helping our kids to become healthier.”

• Green River Area Development District, Owensboro: initial grant of $40,483 for Partnership for a Healthy McLean County. “The Partnership for a Healthy McLean County realizes the impact community organizations, schools, work sites and health care have on the health of families,” said Jiten Shah, executive director of the district. "Obesity is a major factor for many chronic diseases which can begin in childhood and continue into adulthood. "

• Kentucky Heart Foundation Inc., Ashland: initial grant of $19,245 for Healthy Kids, Healthy Communities in Ashland. “Investing in Kentucky’s Future is a perfect fit for the work of the Healthy Kids Coalition and gives us the opportunity to continue to work on policy, system and environmental changes to improve the health of children in Boyd and Greenup counties,” said Laura Patrick, coordinator of Healthy Kids, Healthy communities. “We know that this approach will help sustain change for years to come and what is great about it is that it is sustainable.”

• Kentucky River Community Care, Inc., Jackson: initial grant of $34,156. “This foundation grant will help Breathitt County plan more opportunities for youth and families to participate in healthy lifestyle activities,” said Bridget Turner, KRCC director of clinical services. “We need to develop a strategic plan to specifically address the many barriers that face our children and threaten their future. Education, prevention, behavioral health, physical health, nutrition, employment, substance abuse are a few of the issues that we are trying to deal with in our county.”

• Louisville Metro Department of Public Health and Wellness: initial grant of $34,160. “If we are ever going to realize a healthier future for our citizens, we must improve the health of our young people,” said Dr. LaQuandra Nesbitt, director of the department. “These funds from the Foundation for a Healthy Kentucky will facilitate a coordinated, systemic approach to overcome the health barriers that many of our youth face. The grant will allow us to formulate policies and strategies to improve health that are based on accurate data with buy-in from stakeholders across the community.”

Reducing chronic diseases to improve Kentuckians' health
 
Chronic diseases such as cancer, diabetes and heart disease, are those that last over time, decrease quality of life, increase the risk of early death and occur at higher rates in Kentucky than in surrounding states; substance abuse and some mental illnesses are also chronic diseases.

Kentucky’s children are at greater risk than most for chronic diseases, including high rates of obesity and smoking. When children grow up, they are at an increased risk for heart disease, cancer or stroke, and Kentucky is above the national average in deaths from these diseases.

The Investing in Kentucky's Future initiative will help Kentucky communities confront this cycle of problems. The foundation is encouraging local leaders to identify how best to engage the community in order to have the biggest impact.

“This is the first step in our multi-year approach, which will lead to implementation of permanent solutions for healthier communities,” said Zepeda. “We believe that by working together on the local level, civic leaders with vision can develop innovative strategies to improve the health of our children.”

More than 50 interested organizations responded to the foundation’s request for proposals in October last year, and 22 were invited to submit a full proposal. The foundation’s board of directors approved funding for seven as part of the initiative. Click here to read more about the foundation.

Kentucky expands Medicaid reimbursement for telehealth services, but lets managed-care firms keep authority over fees

By Molly Burchett
Kentucky Health News

Recent changes in Kentucky's telehealth regulations are making it easier for providers around the state and country to deliver health-care services to Medicaid patients, thus improving access to specialty care for many patients in Kentucky's rural areas. But the amount of their reimbursement can still be determined by Medicaid managed-care companies.

Patients in rural Kentucky sometimes need the care of a specialist not in their home community, and programs like the University of Kentucky’s telehealth program and the statewide Kentucky TeleHealth Network use videoconference tools to bring these physicians to the patients.

Kentucky has been among the leading states for driving reimbursement of telehealth services. As of July 2012, it was one of the 13 states requiring some level of private insurance coverage of telehealth. It is also one of the 15 states that requires reimbursement from Medicaid for some services, which are mostly mental-health and specialty services.

The new regulation expands the types of services eligible for Medicaid reimbursement. While the Kentucky TeleHealth Network has been operating since 2000, the old regulations limited the use of this type of technology, Rob Sprang, director of Kentucky TeleCare and chair of the state's Telehealth Board, told Greg Stotelmyer of Public News Service. "The previous regulations were very restrictive on who could see a patient on television, what services they could deliver on TV, and where those services could be delivered," he said.

The new rules lift restrictions on both the type and number of services covered by Medicaid. A much longer list of providers can be reimbursed for telehealth services, "including people like social workers, speech language pathologists, physical therapists, occupational therapists, a very broad group of providers outside of just physicians," said Sprang.

The regulation also includes certain services provided by a physician, psychiatrist, nurse practitioner, psychologist, dietitian and certified nutritionist. To provide telehealth services in Kentucky, a provider has to be approved for membership in the Kentucky Telehealth Network.

Reimbursement is technically the same as the amount paid for face-to-face services, but the regulation says managed-care firms are not required to reimburse those amounts. Thus, the role that telehealth will play in Kentucky could depend on how much the companies and the state decide to pay for it.

Still, the Foundation for a Healthy Kentucky has endorsed these changes to telehealth coverage and reimbursement, saying "it has the potential to help make quality specialty health services more accessible throughout Kentucky," reports Stotelmyer.

Telehealth will play a big role in health reform, said Sprang. "It's not rocket science," he told Stotelmyer. "You know, if you look at where providers are located today, there are no nephrologists, no kidney doctors, in most of our small communities. There are no child psychiatrists, there are no psychiatrists. There's so many medical specialties that are not available in our rural communities."

A recent report by Deloitte Consulting recommends increasing reimbursement for telehealth to address the state's doctor shortage problem, and that reimbursement needs to include primary care. "Given the potential benefits of using technologies such as telehealth to reach rural areas, where Medicaid populations can be large, the lack of Medicaid reimbursement for primary care could be a barrier to the overall effectiveness of Kentucky’s current and future investments in telehealth," says the report, which was released before the new regulations were issued.

Working with a local, regional or state health coalition? A simple step can help make healthy changes in Kentucky

The Foundation for a Healthy Kentucky is asking you to help update last year's Kentucky Health Coalitions Directory, a list of local groups working to better Kentucky's health, so that additional coalitions can be identified and groups can work together toward their shared goal of bettering the state.

“These are local residents working on solutions to health issues in their cities and towns,” said Susan Zepeda, CEO and president of the foundation. “These groups have differing levels of organization and are pursuing various goals. The Coalitions Directory is a resource for them and allows them to connect with other groups working to make their community a healthier place to live, work, and play.”

Now, across the state's 120 counties, there are 143 coalitions with varying health interests: some are increasing access to healthy food and physical activity, others focus on education about risk-factors for serious health problems like diabetes and other chronic diseases and others are improving working conditions through smoke-free ordinances.

All groups are working to positively change Kentucky's health, and an updated directory will help the foundation raise awareness of the coalitions' local efforts, foster collaboration, build local capacity and provide assistance to groups. Follow this link to submit new or revised information to the Coalitions Directory.

Foundation for a Healthy Kentucky seeks nominations for its board of directors and Community Advisory Committee

The Foundation for a Healthy Kentucky is accepting nominations for qualified persons to join its board of directors and Community Advisory Committee.

The 15 directors are responsible for preserving the foundation’s endowment and upholding its charitable mission of addressing the unmet health care needs of Kentuckians. Nominations are being accepted for three seats, including one to be selected by the directors and one by the governor.

The third seat will represent Supreme Court District 6: Bath, Boone, Bracken, Campbell, Carroll, Fleming, Gallatin, Grant, Harrison, Henry, Kenton, Lewis, Mason, Nicholas, Oldham, Owen, Pendleton, Robertson, Shelby, Spencer and Trimble counties. This director will be chosen by a Community Advisory Committee subcommittee, comprising five members who help run organizations addressing the unmet health care needs of Kentuckians.

The foundation is also accepting Community Advisory Committee nominations in anticipation of electing two new committee members. The 31 members provide advice and recommendations to the board, serve as community liaisons, serve on foundation committees, take part in the annual policy forum and appoint or nominate directors.

Please complete the nomination form and attach a resume or bio. Self-nominations are allowed.  The deadline for receipt of nominations is July 15. Mail to Mary Jo Dike, Foundation for a Healthy Kentucky, 1640 Lyndon Farm Court, Suite 100, Louisville, KY 40223, or email to mdike@healthy-ky.org. For more information call 502-326-2583 (toll-free 1-877-326-2584).

Poll shows strong support for medical marijuana in Kentucky

A statewide poll has found that 78 percent of Kentucky adults support the use of marijuana for medicinal purposes if recommended by their doctor, while only 26 percent of favor it for recreational purposes.

There were no significant differences in the poll results among the regions of the state on the medical-marijuana question, but on the recreational-use question, the Louisville area and Northern Kentucky were more likely to favor it, at about 37 percent. For geographic and demographic breakdowns of the poll results, click here.

Nationally, 17 states and the District of Columbia allow medical marijuana, and three states have recently legalized it for recreational use.

“Our Kentucky Health Issues Poll is designed to be informative to Kentucky policymakers,” said Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll. “Over the past several years, bills dealing with legalization of marijuana have been filed in the Kentucky General Assembly. This research gives policymakers a snapshot of Kentuckians’ views on this issue and should be helpful as lawmakers consider issues for the 2014 legislative session.”

For years, Sen. Perry Clark, D-Louisville, has introduced bills in the Kentucky Senate aimed to legalize medical marijuana. Although the bills, referred to as The Gatewood Galbraith Medical Marijuana Memorial Act, gained media coverage in the 2012 and 2013 legislative sessions, they have not received a committee hearing and have not passed.

The poll was funded by the foundation and the Health Foundation of Greater Cincinnati and was conducted last year from Sept. 20 to Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones, and the poll has a margin of error of plus or minus 2.5 percentage points.

Poll shows more than half of Ky. adults have no dental insurance and many go without essential dental care

Routine dental care is essential to overall health, but a new poll shows 1.7 million Kentucky adults do not have dental insurance. That is more than times the number of people who will be at Churchill Downs for the Kentucky Derby, notes the Foundation for a Healthy Kentucky, which co-sponsored the poll.

The poll also showed that many Kentucky adults are going without the dental care they need. While the poll found that few owe money for dental bills, only 61 percent said they visited a dentist or dental clinic within the past year. The national figure is 70 percent.

“Oral health is essential to overall health,” said Dr. Susan Zepeda, president and CEO of the foundation. “Yet, our research indicates a majority of Kentuckians do not have dental coverage, so it is not surprising that a large number of adults do not have a personal dentist or oral health provider.”

Poor oral health or oral pain can lead to poor nutrition and can reduce someone's quality of life by making it difficult to sleep, work or interact with others, and having dental insurance is an important factor in determining whether someone is getting the dental care they need.  More than 50 percent of poll respondents indicated not having dental insurance of any kind, and almost half of that group said they skipped getting dental care or check-ups in the past year due to its cost.

Whether or not someone has a normal source of care is also an important factor in determining health care outcomes because those with a personal dentist or doctor are more likely to seek care. Almost 40 percent of poll respondents, however, said they do not have a personal dentist or oral health provider, and almost 80 percent of those respondents said its been more than five years since they last visited a dentist or dental clinic.

The poll was funded by the foundation and the Health Foundation of Greater Cincinnati. The poll was conducted last year from Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones, and the poll has a margin of error of plus or minus 2.5 points.

Kentuckians tell pollsters they are concerned about air quality, but don't seem to put their concern into action

A recent poll shows that more than half of Kentucky adults, especially women, are concerned about air quality in their community, but only 48 percent say they change their behavior when an air quality alert is issued.

Perhaps they have never heard of an air quality alert, which is issued by a local or state air-pollution authority to protect the public's health from air pollution. The U.S. Environmental Protection Agency monitors air quality and uses an Air Quality Index to warn the public when the amount of particle pollution or ozone in the air may harm their health.

When pollution gets to a level of concern, alerts or action days are issued in participating areas, which in Kentucky are Louisville, Lexington and the Mammoth Cave area (primarily Edmonson County). This could explain why almost 30 percent of poll respondents from Louisville said they were very concerned about air quality in their community, and only 13 percent of respondents from Appalachia indicated this level of concern.

Almost 60 percent of Appalachians said they are not concerned at all about the air quality in their community, compared to 26 percent of Louisville respondents that aren't at all concerned. Few Eastern Kentucky counties are part of an air-quality monitoring program. In addition to the areas monitoring for alerts or action days, 37 Kentucky counties (colored in the map) participate in the monitoring program. Click here to compare counties.

Counties covered by an air-quality monitoring program are colored.

The poll indicated that just 20 percent of Kentucky adults said they change or limit their activities a lot when air quality alerts are issued, and about 30 percent said they change their behavior a little.  Respondents from the Louisville region were most likely to change or limit their activities, while those in the Lexington area were the most likely to not change or limit their behavior at all. 

When air quality is at an unhealthy level, people can protect themselves by limiting outdoor activities or avoiding heavy exertion.  These protective measures are even more important for those sensitive to air pollution, such as people with heart or lung disease, the elderly and children.

“The quality of our air impacts all of us, but is particularly important for sensitive groups, such as children with asthma. When an air quality alert is issued, we can protect ourselves and our families by avoiding heavy exertion and limiting outdoor activities,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll. “We can also do our part to limit emissions and protect our neighbors by turning off our car’s engine while we are waiting.” 

Almost 30 percent of Kentucky adults and 40 percent of Western Kentucky adults said they never turn their car’s engine off when waiting in their car and not moving, as in a traffic jam, train crossing or drive-through. Including those who never turn off their cars, more 60 percent said they wait at least four minutes before turning off their car’s engine when waiting in the car and not moving. Experts recommend turning off a waiting car’s engine after just ten seconds in order to save gas and limit emissions.

The poll was funded by the foundation and the Health Foundation of Greater Cincinnati and was conducted last year from Sept. 20 to Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones and the poll has a margin of error of plus or minus 2.5 percentage points.

Most Kentucky adults don't know that drug overdose is the leading cause of death in the state, but those in the east do

Drug overdoses, driven largely by prescription drug abuse, overtook motor vehicle accidents as the leading cause of unintentional deaths in Kentucky back in 2010 and remain the state's leading cause of death. From 2000 to 2010, the number of drug-overdose deaths in Kentucky rose a staggering 296 percent, highlighting the state's drug abuse epidemic that now kills more than 1,000 Kentuckians a year. But a recent poll suggests many Kentuckians are not fully aware of the state's drug problem.

In an effort to gauge awareness of the problem, the Kentucky Health Issues Poll asked Kentucky adults whether traffic accidents, falls, firearms or unintentional drug overdoses resulted in the highest dumber of deaths in the state each year. Only 44 percent of Kentucky adults correctly indicated that drug overdose is the leading cause of unintentional Kentucky deaths; 43 percent incorrectly identified traffic accidents as the leading cause.

Respondents from Eastern Kentucky, where the problem is most prevalent  were more likely to correctly identify it as the leading cause of death, at 69 percent. However, only 29 percent of Louisville-area respondents did.

“Experts have reported significant prescription pain reliever abuse in eastern Kentucky,” said Susan Zepeda, presient of the Foundation for a Healthy Kentucky, which co-sponsored the poll.  “It is no surprise that the Kentuckians most aware of this issue are those who are living in this region.  Awareness is the first step towards curbing this trend – it is up to all of us to get involved and take action to reduce the toll of this health crisis.”

The poll was conducted for the foundation and The Health Foundation of Greater Cincinnati from Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by land line and cell telephones, and the poll's margin of error is plus or minus 2.5 percentage points.

Poll shows Kentucky health-care providers often fail to discuss HIV testing with patients

A new poll suggests that most Kentucky health-care providers follow guidelines for discussing HIV screening with their patients, despite the the importance of early treatment to prevent its progression to AIDS.

Although the Centers for Disease Control and Prevention recommends routine HIV screenings for most patients, just 32 percent of Kentucky adults aged 18 to 64 report discussing HIV testing with their medical provider, according to the Kentucky Health Issues Poll.

About 40 percent of Kentucky adults reported they had never been tested for HIV. It’s estimated that 4,500 Kentuckians are living with HIV infection and it is estimated nationally that one in five people who have HIV do not know they do.

“It made headlines earlier this month when a little girl - the second person in history - was cured of HIV. As exciting as this development was, for most people, HIV remains a life-long condition that must be managed through medication to keep it from progressing to AIDS. The CDC’s recommendations are meant to improve the overall population health by detecting HIV so treatment can begin,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll.

“It appears that Kentucky providers are either not adhering to the routine screening recommendations or not communicating this message clearly to patients,” she said.

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points

Survey suggests Great Recession has harmed the health of Kentuckians

A recent poll shows continuation of a trend threatening Kentucky's overall health: as the number of Kentuckians living in poverty goes up, the percentage of adults who report their health as excellent or very good goes down.

Just over four in 10 Kentucky adults in the latest Kentucky Health Issues Poll described their health as excellent or good. In 2008, almost half used those descriptions.

People with higher incomes have consistently reported better health since the poll began tracking the health status of Kentucky adults 2008. Since research has shown a strong link between higher income and better health, the Great Recession and the resulting increases in unemployment, underemployment and poverty appear to be harming the overall health of Kentucky’s population.

In the accompanying graph, showing responses by income categories, FPL stands for federal poverty level, which in 2011 was a yearly household income of $22,350. Among the categories, 58 percent in the highest category said their health is excellent or good, but only 25 percent of those living in poverty used those descriptions.

Although the health status for each income category has remained fairly constant, the poll reflects federal data that show more people living in poverty. More than 33 percent in the latest poll were earning less than the federal poverty level; in 2008, that was only 19 percent. The polls, which used self-reporting of income and survey methods that differ from federal methods, showed much higher poverty rates than federal data.

“We know there is a direct relationship between income and good health, and these data reflect that,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, a sponsor of the poll. “While changes in our health-care delivery system may provide more health-care opportunities for low-income Kentuckians, these results show how vital a strong economy, and jobs that pay well, are to our population’s health.”

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points.

Foundation for a Healthy Kentucky gives UK $1 million for endowed co-chairs in rural health policy

Tyrone "Ty" Borders in the University of Kentucky College of Public Health's Department of Health Services Management, and Brady Reynolds in the UK College of Medicine's Department of Behavioral Science, have been named the Foundation for a Healthy Kentucky endowed co-chairs in rural health policy.

A $1 million gift from the foundation to the College of Medicine was matched by the state Research Challenge Trust Fund, better known as "Bucks for Brains." The gift has the goal of enriching Kentucky's research capabilities in regards to rural health issues and rural health policy.

Reynolds earned doctoral and master's degrees in life-span developmental psychology from West Virginia University. He also holds a master's degree in general/experimental psychology and a bachelor's degree (magna cum laude and with distinction) from James Madison University. His research has focused on nicotine use by adolescents, drug use, gambling and other addictive behaviors. In recent years Reynolds has begun research to promote smoking cessation among pregnant smokers in rural Appalachia.

Borders earned doctoral and master's degrees in health administration, as well as a master's degree in epidemiology from the University of Iowa, and a bachelor's degree in psychology from the University of Kansas. His research focuses on the conduct and analysis of population-based studies to identify subgroups of persons at risk for poor health and problems obtaining health services, with an emphasis on rural populations.

“Drs. Reynolds and Borders have skills in intervention research and rural health policy expertise that can help the University remain at the forefront of rural health policy work in today’s rapidly changing healthcare environment,” said Susan Zepeda, president and CEO of the foundation.

The mission of the foundation is to addresses the unmet health care needs of Kentuckians. Mission objectives are advanced through two initiative areas: promoting responsive health policy and a new children’s initiative named “Investing in Kentucky’s Future.” Foundation work aims to improve access to health care, reduce risks and disparities, promote health equity and healthy lifestyles. Since 2001, over $22 million has been invested in health policy research and demonstration grant projects across Kentucky

Poll finds four out of five Kentuckians are comfortable seeing a nurse practitioner or physician assistant for routine care

New poll figures indicate the majority of Kentuckians are comfortable seeing a nurse practitioner, physician assistant or mid-level clinician for their routine care, especially if they have been treated by such clinicians. The findings come as the General Assembly considers a bill that would allow physician assistants to practice more independently.

In the Kentucky Health Issues poll last fall, 79 percent of Kentucky adults said they would be comfortable seeing a nurse practitioner for routine health care, and half of those people said they would be very comfortable. Eighty-one percent said they would be comfortable seeing a physician assistant for routine health care, and 42 percent of those respondents said they would be very comfortable.

Reported comfort was higher among people who had received care from a nurse practitioner or physician assistant in the past year; 86 percent of those people said they would be comfortable seeing an NP again for routine care. Eighty-eight percent of those who had received care from a PA in the past year said they would be comfortable doing that again.

The poll also inquired about a proposed new “mid-level” profession: advanced dental hygiene practitioners. These practitioners would provide routine dental care, including diagnostic and preventive services such as filling cavities. Although advanced dental hygiene practitioners cannot currently be licensed to practice in Kentucky, polling data indicated 73 percent of Kentucky adults would be comfortable with such a practitioner providing routine dental care.

"As providers move to create a system of care that includes a range of skill sets and training in its care teams, new strategies emerge that hold promise to increase access to affordable care – not just in urban centers but also in rural and underserved communities,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which sponsored the poll. “The data suggest that the public is very receptive to health care services from different types of clinicians.”

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points. (Read more)

28% of Ky. adults 18-64 say they lack health coverage; 41% lacked it sometime in last year; employer coverage down since '08

Nearly three in 10 working-age adults in Kentucky are not covered by any form of health insurance, and the number who get health insurance from their employer, or their spouse’s employer, has plummeted since 2008, the first year of the Great Recession, according to the latest Kentucky Health Issues Poll. The decline accelerated in the last year, and was accompanied by a big jump in the percentage on public insurance.

The poll, taken Sept. 20 through Oct. 14, found that 28 percent of adults aged 18 to 64 said they had no health insurance at the time they were interviewed, and 41 percent said they had been uninsured at some point in the previous year.

The survey found that 37 percent get their insurance from an employer or spouse’s employer, well below the 55 percent figure in a similar poll in 2008. Conversely, 27 percent are now covered by some form of public insurance, way up from the 10 percent in 2008.

Medicaid in Kentucky covers households with incomes up to 70 percent of the federal poverty threshold; 43 percent of working-age adults living at or below that level reported being uninsured last fall. Among those with incomes more than double the poverty level for their size household, 15 percent said they were uninsured.

The poll was conducted for the Foundation for a Healthy Kentucky and the Health Foundation of Greater Cincinnati by the Institute for Policy Research at the University of Cincinnati. Pollsters contacted a random sample of 1,680 adults throughout Kentucky by telephone, including landlines and cell phones. The poll questioned only working-age adults about insurance because 98 percent of seniors have some form of health coverage. The poll has a margin of error of plus or minus 2.5 percentage points.

Ky. parents strongly favor increasing school dropout age, a step that could make future high-school students healthier

A statewide poll has found that Kentucky parents overwhelmingly favor increasing the state’s school dropout age, and doing so might help future high-school students' health, according to the Foundation for a Healthy Kentucky, which sponsored the poll.   

After being told the legislature may raise the dropout age to 18 from 16, 85 percent of Kentucky parents said they favor the move, and 77 percent of parents said they strongly favored it.

Besides their homes, school is where children spend most of their time, and the overall health and well-being of students affect their ability to learn.  Healthy kids learn better and students’ academic achievement in turn affects their ability to be healthy and stay well in the future.

“People may not realize that education is a health issue, but research tells us that completing high school is directly related to our health status in later life,” said Dr. Susan Zepeda, President and CEO of the foundation. “Increasing the dropout age is one strategy aimed at improving the graduation rate in the state. We hope this polling data will encourage a deeper conversation among parents, education experts and policy makers to explore this and other strategies to help our children succeed at school and lead a more healthy life.”

The dropout-age question was part of the Kentucky Parent Survey, which provided a snapshot of parental views on a number of issues involving health care, school and home life. It surveyed parents, step-parents, grandparents, foster parents or other legal guardians of children in Kentucky.

The poll was conducted in July and August 2012 by the Center for Survey Research at the University of Virginia.  More than 1,000 parents and guardians of children under 18 from throughout the state were interviewed by telephone, including landlines and cell phones.  The survey's margin of error is plus or minus 3 percentage points. 

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

Molly Burchett is new chief writer for Kentucky Health News

Kentucky Health News welcomes a new reporter, writer and blogger: Molly Burchett, a master's student in health communication at the University of Kentucky.

Burchett graduated from Transylvania University in 2009 where she studied business and communication.  She was president of the Student Government Association and a yearbook editor.  Her jobs before UK included development director for a Lexington medical practice. She started her master's program in August 2012 and is focused on raising awareness about community health issues in ways that can encourage positive changes in health behavior.

She is from Prestonsburg, where her father and mother are the lead physician and manager of Prestonsburg Primary Care. She is a graduate of Prestonsburg High School. At KHN she follows Tara Kaprowy and Amy Wilson, who have both returned to freelance journalism.

Kentucky Health News is funded by the Foundation for a Healthy Kentucky but is independently reported and edited by UK's Institute for Rural Journalism and Community Issues.