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.

Kentucky among states selected to study, address expensive problem of 'superusers' of emergency rooms

Kentucky is one of a few states teaming up with the National Governors Association to address the expensive problem of uninsured or Medicaid-covered "superusers" who over-use hospital emergency rooms or other costly health services instead of lower-cost alternatives like primary care.

“I’m proud Kentucky has been chosen to participate in this important program,” Gov. Steve Beshear said in a news release. “Across the nation, an understanding has been growing that we must focus our efforts on providing the best in coordinated care, helping to direct individuals who may be using more expensive, less effective services to more cost-efficient preventive services that provide better health outcomes in the long run. It’s by achieving these outcomes that we will build a healthier future for Kentucky.”

Kentucky, Alaska, Colorado, Kentucky, New Mexico, Puerto Rico and West Virginia will participate in a policy academy designed to help them create systems for these "superusers", enabling state officials to confront rising Medicaid expenditures while improving quality of care and health, says an NGA release.

These "superusers," sometimes called "super-utilizers" or "frequent flyers," often go to a hospital or emergency room for recurring health issues that can be treated more effectively and less expensively in other ways. Kentucky Medicaid spent more than $219 million on emergency-room use in 2012, and 4,400 Medicaid recipients used ERs 10 or more times during that year, says Beshear's release.

“There’s a handful of people who drive most of our spending,” Dan Crippen, the executive director of the governors’ association, told Kelsey Miller of Kaiser Health News. While the median ER visit cost $615 in 2009, an office-based visit with a physician cost $361, according to the federal Medical Expenditure Panel Survey.

“Kentucky has too long lagged behind in health rankings, and now is the time for us to begin truly moving the needle in the right direction,” said Cabinet for Health and Family Services Secretary Audrey Tayse Haynes. “By participating in this national effort, we can learn what has worked for other states and share Kentucky’s experiences as well.”

State leaders will first meet as a group with consultants from various health-care sectors, then officials will spend 18 months implementing the plans in their communities, says Miller. Funding for the effort is provided by the Robert Wood Johnson Foundation and the Atlantic Philanthropies.

Kentuckians support goals of reform law, foundation head says

While politicians say President Obama's health-care reform is not popular in Kentucky, polls show that nine out of 10 adult Kentuckians favor its goals, the president of the Foundation for a Healthy Kentucky noted after the law passed its final court test.

"Thursday's Supreme Court decision affirms the constitutionality of the Affordable Care law and moves the United States and Kentucky children and adults one step closer to assured access to affordable insurance and care," Susan Zepeda said. "Our Kentucky Health Issues Poll found that regardless of their views on the Affordable Care law, the vast majority . . . of Kentuckians believe that all Americans should have access to affordable, quality health care." She said Kentuckians "expressed strong support for key provisions of the law already in effect: tax breaks for small employers, no co-pay on key preventive services, access to insurance for children with pre-existing health problems."


Looking forward, "Kentucky leaders need to be sure our residents are aware of the provisions of this law," Zepeda said. "As individuals and as a state, we need to take advantage of opportunities and resources the law makes available, even as we continue to work to improve access to quality care throughout Kentucky. The Foundation stands committed to addressing the unmet health care needs of Kentuckians, informing health policy and investing in communities, to increase access to care, decrease health disparities, and advance health equity in the Commonwealth." (Read more)

U of L profs get $6.3 million to continue spinal cord research

Susan Harkema, a University of Louisville professor, talks
about epidural spinal stimulation. Courier-Journal photo.

Two University of Louisville professors have received a $6.3 million grant to continue their work helping paralyzed patients restore movement by using electrical stimulation.

The grant was awarded to Susan Harkema and Dr. Jonathan Hodes from the Leona M. and Harry B. Helmsley Charitable Trust.

Last year, they received much acclaim when they published a study in the journal The Lancet "showing that the use of continual, direct, electrical stimulation of a patient's lower spinal cord using technology designed for pain relief can allow a person using a wheelchair to stand and bear weight," reports Laura Ungar for The Courier-Journal.

With these new grant funds, Harkema said they will "be able to built a stimulator that will allow the individual to take advantage of these advances in their homes and communities."

One of the initial case studies involved Rob Summers, a former baseball player from Oregon who was paralyzed below the chest after a car accident. After the therapy, he was able to get to a standing position and stand as long as four minutes. "He was also able to take steps with help and move his toes, ankles, knees and hips." Harkema said he continues to improve.

Nationwide, more than 5 million Americans live with some type of paralysis, and more than 1.3 million have spinal-cord injuries. (Read more)

Nearly 1 in 3 Kentuckians say they know a friend or relative who has struggled with prescription-pill abuse, poll finds

Almost one in three Kentuckians say they have a friend or relative that has had problems stemming from prescription drug abuse, the Kentucky Health Issues Poll has found.

In Eastern Kentucky, 43.2 percent of respondents said "yes" when asked if a family member or friend had had problems because they had abused pain pills. In the Lexington area, it was 39.4 percent. Western Kentucky had the lowest number at 19.7 percent. Statewide, it was 31.9 percent.

"Although other studies have shown that Kentucky has among the highest levels of prescription-drug abuse in the nation, the latest survey helps illustrate how pervasive the issue has become in the state," reports Bill Estep of the Lexington Herald-Leader.

The survey, which polled 1,614 people, found that people ages 18 to 29 were more likely to have a friend or relative who had had a problem with pill abuse — 43.8 percent compared to 29.7 percent of people ages 46 to 64.

"Other findings include that 54.5 percent of those polled in Kentucky said they'd been prescribed a pain reliever such as OxyContin, Vicodin or Percocet in the past five years," Estep reports. "The rate in Appalachia was the lowest in the state, at 46.4 percent. That might reflect that there are fewer medical providers in that part of the state, and that fewer people have insurance."

The survey also asked respondents if they had ever used a prescription drug that was not prescribed to them. In that case, just 5.5 percent said yes, but nearly twice as many 18-to-29-year-olds answered yes. "These findings underscore the impact misuse of prescription pain medications is having in Kentucky and the importance of work by prescribers and policymakers to assure that these drugs aren't used inappropriately," said Susan Zepeda, chief executive officer of the Foundation for a Healthy Kentucky, which helped fund the survey.

The poll was also funded by The Health Foundation of Greater Cincinnati. It was conducted Sept. 27 to Oct. 27 by the Institute for Policy Research at the University of Cincinnati. A random sample of adults across Kentucky were interviewed, including 1,313 landline interviews and 308 cell-phone interviews. For more from the Foundation for a Healthy Kentucky, click here. (Read more)

Jobs, economy top priorities for Kentuckians, poll finds; cost of health care, overall health also important

When asked what should be the state's priorities in the next year, more than nine in 10 Kentuckians responded that job creation should be at the top of the list. Heath concerns ranked slightly lower.

The 2011 Kentucky Health Issues Poll, which released the first of its series of findings Tuesday, asked more than 1,600 people, "How important is it to you that the governor and the Kentucky legislature work on each of the following issues in the next year?" Job creation ranked first, with 93 percent.

The vast majority of Kentuckians felt it was also important for policymakers to work on:

• improving Kentucky's economy (91 percent)

• improving K-12 public education (86 percent)

• reducing the cost of health care (85 percent)

• improving the health of Kentuckians (83 percent)

• reducing crime in Kentucky (83 percent)

Other priorities included making government more transparent (67 percent), improving roads and highways (66 percent) and reducing taxes (60 percent).

Regardless of political party, Kentuckians agreed on the relative importance of these policy priorities.

"We understand the challenges our elected officials face in working to meet Kentucky's needs in these difficult economic times," said Susan Zepeda, CEO of the Foundation for a Healthy Kentucky, which helped fund the poll. "We think the Kentucky Health Issues Poll provides valuable insight into the views of the public to help with the hard choices ahead."

In the coming months, the poll will reveal views on statewide smoke-free legislation, prescription-painkiller misuse and gun safety. The poll, which is also funded by The Health Foundation of Greater Cincinnati, was conducted Sept. 27 to Oct. 27 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,621 adults across Kentucky were interviewed, including 1,313 landline interviews and 308 cell phone interviews. In 95 of 100 cases, estimates will be accurate to plus or minus 2.5 percent.

Kentucky Youth Advocates gets $100,000 to push for income-tax policies aimed at helping the poor improve their health

Kentucky Youth Advocates is one of 12 coalitions nationwide to receive a "Roadmaps to Health" grant from the Robert Wood Johnson Foundation. The non-profit children's advocacy organization will receive $100,000 for two years to build statewide support for tax policies that would help low-income families keep more of their income to pay for doctor visits, healthier diets and weight-loss or smoking-cessation services.

The 12 grantees were selected from more than 300 initial applicants. "Kentucky Youth Advocates has long been a proponent of improving economic policies for families, and promoting child health throughout the state," said Tara Grieshop-Goodwin, deputy director of the coalition. "We know income can impact health, and we are excited to ahve the opportunity to combine our economic well-being efforts with our health work and look forward to fostering partnerships between advocates from both disciplines throughout the state." (Read more)

Merger would give Jewish and St. Mary's $83 million for their assets, which would have to be used for charitable causes

If the much-debated merger between Saint Joseph Health System, University Hospital and Jewish Hospital & St. Mary's HealthCare overcomes legal obstacles, it could result in a $83 million payment for Jewish and St. Mary's assets that would have to be used for charitable purposes, according to law.

The money could be used for medical causes, research and to pay for historical support for the Jewish community in Louisville. The sum would make it one of the largest philanthropic funds in the city. "That would enable parent Jewish Hospital HealthCare Services to keep supporting those causes even after effectively losing control of Jewish & St. Mary's and its roughly $1 billion a year in revenue once the merger becomes final," reports Patrick Howington of The Courier-Journal.

Stu Silberman, president and CEO of Jewish Community of Louisville, said the fund "certainly means we'll be able to continue developing new and vibrant programming to support Jewish families, Jewish seniors in need, provide Jewish education." The Jewish population in Louisville is about 8,300.

News of the money came from a financial report by Catholic Health Initiatives, which owns Saint Joseph Health System. The report also suggested the hospital merger could become final as early as Dec. 31, seven months earlier than expected. (Read more)

Almost $675,000 awarded to five facilities to improve health services, reduce disparities

Grants totaling nearly $675,000 will go from the Social Innovation Fund through the Foundation for a Healthy Kentucky to help five Kentucky facilities improve access to health services, reduce health risks and disparities and prompt health equality in their respective communities. The recipients are:

• Meade Activity Center in Brandenburg — $250,000 for physical activity programs for children and families, including after-school and summer activities such as golf, tennis, swimming and trail hiking.

• King's Daughters Medical Center in Ashland — $124,548 for mobile health services to nearly 1,500 residents living in Elliott, Fleming, Floyd, Johnson, Lewis, Magoffin, Martin and Morgan counties.

• Oldham County Health Department in LaGrange — $100,000 for Hope Health Clinic for the uninsured. Will help about 1,200 residents each year living in Carroll, Henry, Oldham and Trimble counties.

• St. Elizabeth Healthcare in Edgewood — $100,000 for behavioral health consultations with mental health professionals for patients in Northern Kentucky who go to the emergency room to get mental health services.

• Norton Healthcare Centers for Prevention and Wellness in Louisville — $100,000 to reduce the risk of cardiovascular disease and increase access to care for 2,200 low-income and uninsured residents each year living in Louisville and metropolitan areas.

"The Social Innovation Fund grant recipients are committed to meeting specific health care challenges in their communities, thereby promoting lasting change in Kentucky's rural and urban communities," said Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky. "These five grants are part of a $12 million total investment in initiatives to address Kentucky's health challenges through the Social Innovation Fund and required matching grants." (Read more)

Funds awarded to educate East End Lexingtonians about food, health

Getting community elders to talk to youth about gardening and cooking is one of the missions to be accomplished in Lexington's East End neighborhood from a $52,000 grant.

The funds will create a virtual center where community members can go to learn about food and health. "Our goal is to improve decision making about food through information," said Steve Austin, vice president of the Blue Grass Community Foundation, which was awarded the money by the John S. and James L. Knight Foundation.

"Residents will have the opportunity to talk about what they need to make better food choices," the Lexington Herald-Leader reports. "A digital food information center will then be created so people can go online and learn about all things related to food." Printed information will also be available.

Adults and children living in the neighborhood will interview older members of the community about gardening, food preparation, cooking methods and entrepreneurship. "If we succeed here, we can do it across the city," Austin said. "We can transform Lexington, no matter where people live, to make better decisions about food." (Read more)

Foundation for a Healthy Kentucky receives $1 million grant in addition to $2 million already being used for matching grants

A federal agency has given the Foundation for a Healthy Kentucky $1 million, on top of an earlier $2 million, to make matching grants aimed at addressing the state's health challenges. The money comes from the Corporation for National and Community Services, which supports service and volunteering though grants and programs like AmeriCorps and Senior Corps.

The funds have "given us the opportunity to test innovative approaches that promote lasting change where the need is most critical," Foundation CEO and President Susan Zepeda said. "The continuation funding allows us to have an even greater impact in communities as we discover new information about how to address Kentucky's health challenges."

The $3 million is being matched by the foundation, and the $6 million in grants will be matched by the recipients, resulting in a $12 million impact. The foundation announced in February grants totaling $1 million for projects that will serve almost 9,000 Kentuckians in one year. The four grant recipients were Home of the Innocents in Louisville; St. Joseph Health System in Lexington; Cumberland Family Medical Center in Burkesville; and Montgomery County Health Department in Mt. Sterling. A fifth grant was awarded to Meade Activity Center in Brandenburg in June. Each organization received $250,000. (Read more)

Workshop Aug. 4-5 will help health groups with policy, programs

A two-day workshop intended to help health coalitions and organizations make progress at the policy level and implement evidence-based programs will begin Aug. 4.

On the first day, speaker Monte Roulier of Community Initiatives will speak about the art and science of building health and whole communities. On the second day, speakers from the Centers for Disease Control and Prevention will demonstrate how to use The Community Guide, a free resource that offers guidance on what programs and policies are evidence-based for obesity, mental health, asthma, tobacco, substance abuse, violence and other health issues.

The workshop is part of the "Health for a Change: Ignite — Unite — Act" series, a program of the Foundation for a Healthy Kentucky. It starts at 10 a.m. Aug. 4 and ends at 4 p.m. Aug. 5. at the Hurstbourne Place Office Building in Louisville. To register, click here.

Cities' efforts to combat obesity get state, national attention

The efforts of two Kentucky cities to slim down made news this week. On Monday, The New York Times ran a story about Louisville's programs to encourage healthy eating and physical activity in an attempt to combat obesity. On Tuesday, the Lexington Herald-Leader ran a short story about the move to healthier snacks at two public pools. (Eric Crawford, sports columnist for The Courier-Journal, notes in a blog post, partly about his own weight issues, that Men’s Health magazine says Lexington ranks No. 25 in fatness nationally, while Louisville is No. 51.)

The Times story describes Louisville's eight-year effort to combat obesity by establishing bike lanes, creating pocket parks, and making sidewalks wider and safer. The effort involves multiple city agencies and grants from the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention. The results are hard to measure, sort of like a new dieter on a scale, reporter Stephanie Strom writes: "Successes on one front are countered by setbacks on another, and signs that the needle has moved overall are slight and mostly anecdotal."

Former Louisville Mayor Jerry Abramson, who started the initiative, told Strom that the impetus to reduce the city's obesity rate was economic. “For businesses, a healthy work force is more productive and less costly, so it became a competitiveness issue,” he said. “Every city was offering tax incentives, every city was offering real estate deals but not every city had the weight problem we do.”

The Herald-Leader article focuses on menu changes at two park pools' snack stands. The new menus include options like fresh fruit, grilled chicken, and yogurt. The change is a joint effort of the city Parks Department and the Tweens Nutrition and Fitness Coalition in Lexington to encourage healthier eating. As Coalition Chairman Anita Courtney told the Herald-Leader, "Concession stands are like pantries for kids in the summer. What they are stocked with is what they'll eat."

Most Ky. communities not friendly to walkers, joggers, cyclists

Few Kentuckians live in walkable communities, according to the latest Kentucky Health Issues Poll for the Foundation for a Healthy Kentucky. Only 32 percent of Kentucky adults said there are a number of destinations within an easy walking distance from their home, and only 47 percent said they live in communities with sidewalks or shoulders on streets that allow for safe walking, jogging or biking.

"Walkable communities aren’t just safe for walkers, but cyclists, joggers and those engaging in other forms of recreation as well," the foundation said in a news release. It noted that the results varied regionally, with 60 percent of Northern Kentucky residents and 63 percent in the Lexington area saying they have safe places for walkers, joggers and and cyclists. Eastern Kentucky reported the least access, with 28 percent. Louisville and Western Kentucky fell in the middle at 49 percent and 47 percent, respectively.

“The good news is that we’re seeing more local governments finding innovative ways to support healthier lifestyles with small policy changes, like re-striping a country road to provide clear paths for walkers and bikers,” said Dr. Susan Zepeda, CEO of the foundation. “While we’re not surprised by the results, the foundation is concerned about the lack of walkable communities, considering the obesity epidemic we’re facing in Kentucky.”

According to Walk Score, a website dedicated to promoting walkable neighborhoods, communities that provide more safe walking options have healthier residents, less pollution and higher property values than more sprawling areas. Residents of walkable communities have places to go within an easy distance of their home, and can often make quick trips or run errands without using a car or public transportation.

The poll, conducted annually by the Institute for Policy Research at the University of Cincinnati, is jointly funded by the foundation and The Health Foundation of Greater Cincinnati. Its statewide sample of 1,677 results in a maximum margin of error of plus or minus 2.4 percentage points; regional samples are smaller and have higher error margins, around 5 percentage points. The foundation is the principal funder of Kentucky Health News.