Judge rules University of Louisville's hospital is public and subject to Open Records Act; it may appeal

The University of Louisville's hospital is a public entity, a Jefferson Circuit Court judge has ruled in a lawsuit filed to get access to the university's deals with other health providers.

Judge Martin McDonald ruled yesterday in favor of The Courier-Journal, WHAS-TV and the American Civil Liberties Union, noting that the university makes or approves all appointments to University Hospital's board of directors. The university had argued that the board, and thus the hospital, was not a public agency under the state Open Records Act.

The hospital said it might appeal the ruling. McDonald gave it 30 days to give him the records being sought, along with arguments about why they should be exempt" under exceptions to the law, reports The C-J's Andrew Wolfson. "He gave the news organizations at the ACLU 20 days to respond to any claimed exemptions." The hospital has said revealing contracts would put it at a competitive disadvantage.

The suit began after the university refused to let the plaintiffs see records related to its proposed merger with Jewish Hospital & St. Mary's HealthCare and Lexington-based St. Joseph Health Care System. Gov. Steve Beshear vetoed the merger on grounds that a public hospital should not be bound by a religious organization's health-care policies. This month the hospital announced a new deal with KentuckyOne Health, which includes the faith-based entities, but said reproductive services would not be affected despite a policy of "respect" for Catholic health directives. (Read more)

U of L and KentuckyOne Health announce partnership that keeps women's health services intact at University Hospital

The University of Louisville and KentuckyOne Health have reached a partnership agreement that will leave the resolution of any "moral roadblocks" up to a higher authority. U of L President James Ramsey said the partnership will allow the hospital board to continue its control over the public entity, a principle that scuttled an earlier deal with Catholic Health Initiatives, which then formed KentuckyOne with Jewish Hospital. Gov. Steve Beshear signed on to the agreement, after killing the first one.

The goals of a public institution that provides all women's health services -- including reproductive and end-of-life care -- were not the same goals of those espoused by the Roman Catholic Church. The new agreement seems to have solved that issue by continuing to allow the hospital's pharmacy and Center for Women and Infants and to provide the same services as they did before, reports Laura Ungar of The Courier-Journal. The services will be provided by the same people as currently, the partners said. This includes all reproductive services.

The Archdiocese of Louisville said in a statement that it was not part of the negotiations but that there were no more “moral roadblocks” to its continued official recognition of KentuckyOne as a Catholic entity. The archdiocese said the partners involved “have committed to respecting one another’s traditions, missions, and values, including our own Ethical and Religious Directives for Catholic Health Care Services.” (Read more)

Health care is strong second to economy among concerns of Ky. registered voters; candidates compared on handling of issues

Health care ranks high among the concerns of Kentucky voters, according to the latest Kentucky Health Issues Poll taken for the Foundation for a Healthy Kentucky.

The poll, taken Sept. 20 through Oct. 14, asked registered voters to name the two most important issues in the Nov. 6 presidential election. The economy was mentioned by 65 percent; health care was second, with 42 percent. Foreign policy was a distant third, at 21 percent. The error margin on the sample of 1,160 voters is plus or minus 2.88 percentage points.

The poll did not ask voters whom they favored for president, but did ask which candidate they trusted to do a better job on certain issues. Romney, who is considered certain to win Kentucky, had a clear advantage on two issue areas, listed first:

• Dealing with the federal budget deficit: Romney 49%; Obama 36%

• Dealing with the economy and jobs: Romney 48%; Obama 36%

• Dealing with the future of the health reform law: Romney 45%; Obama 40%

• Addressing terrorism: Romney 43%; Obama 42%

• Dealing with the situation in Afghanistan: Romney 42%; Obama 40%

• Improving education: Obama 45%; Romney 40%

• Looking out for the best interests of women: Obama 42%; Romney 40%

• Making decisions about women's reproductive health choices and services: Obama 41%; Romney 38%

"This poll gives us a reliable snapshot of the issues most important to Kentucky voters as they decide who they will vote for on Nov. 6," said Dr. Susan Zepeda, president/CEO of the foundation. "Regardless of the outcomes of the election, our foundation believes it is essential for our elected officials to know what Kentuckians think about these issues." To download the full report by the Institute for Policy Research at the University of Cincinnati, click here.

Eastern Kentucky native wants to alert Appalachian women about their high rate of cervical cancer and how to prevent it

University of Kentucky physician and Pike County native Baretta Casey, right, has spent most of her career providing health care and education throughout the state, with a focus on Appalachian Kentucky. The health disparities between Eastern Kentucky and the rest of the state, especially high rates of cancer, are of "special concern" to Casey, reports Ann Blackford of UKNow.

Cancer is prevalent in her Casey's own family, and this is why she "has taken on the challenge of helping reduce cancer rates in Kentucky, especially cervical cancer and other Human papillomavirus cancers," Blackford reports. Cervical cancer rates are highest in rural and Appalachian Kentucky. According to the Kentucky Cancer Registry from 2005 to 2009, the cervical cancer rate in the region was 9.85 per 100,000 people. The state rate was 8.6. The average of deaths per year in the region from cervical cancer was 258.

"We have the tools to change these high rates and make a real difference in people's lives," Casey said. "I feel the best thing I can do for the people of Eastern Kentucky is to educate about prevention and screening of cervical cancer." Casey became the director of the Cervical Cancer-free Kentucky Initiative at UK's College of Public Health's Rural Cancer Prevention Center in 2010. Through this position, she makes connections with county health departments, community organizations and health advocacy groups that provide education and funding for cervical cancer prevention projects.

"Casey is passionate about educating people on the importance of vaccinating their children against HPV," Blackford writes. She said she wants people to look past the controversy of vaccinating their children and realize the importance of the vaccine. "The vaccine given for the appropriate reason can save a life," Casey said. (Read more)

The Courier-Journal, continuing to explore Louisville hospital merger, says many more questions still need answering

The proposed merger of the University of Louisville hospital with Jewish Hospital & St. Mary’s Healthcare and with St. Joseph Health System of Lexington, which follows the teachings of the Roman Catholic Church, continues to draw heavy attention from The Courier-Journal. Sunday's newspaper had a long column by editorial writer Pam Platt, and an editorial that online was packaged with a video discussion among the editorial board and U of L President James Ramsey, David Laird of Jewish and St. Mary’s, Dr. Daniel Varga of St. Joseph and James Taylor, CEO of University Hospital.

"On many levels, the merger . . . is appealing," the editorial began, saying the new system would be broader and more efficient and secure the three Louisville hospitals as they compete with Baptist Hospital-East and Norton Healthcare, which recently announced an affiliation arrangement with the University of Kentucky" hospital. "Two significant issues continue to make the merger problematic, however." In addition to the issues of reproductive care, the editorial wonders whether advances in medical science that conflict with Catholic teaching could cause the merger to "unwind," as hospital officials put it, and what the ramifications of that would be. (Read more)

In her column, Platt, right, focused on the merger's impact on women, saying it remains unclear. For example, "The partners say transportation will be provided for pregnant women wanting tubal ligations, as well as for their infants. But what will be the process for them accessing that? What are the details? . . . Many of us need more answers to additional questions . . . before we know if this merger is the answer not only for the business end of things, but for all the people who depend on the hospitals for their care." The merger needs state approval to proceed. (Read more)

Baptist Hospital East would allow U of L docs to perform tubal ligations there after merger with Catholic system

Since the merger between Jewish Hospital, University Medical Center and Saint Joseph Health Systems will prevent female patients from getting their tubes tied there — because St. Joseph is owned by a Catholic-based parent company — Baptist Hospital East will provide a facility where University of Louisville doctors can perform the procedure.

"This will ensure our ability to provide reproductive services for our patients after the merger occurs," said Dr. David Dunn, U of L executive vice president for health affairs, addressing perhaps the largest single concern about the merger. University Hospital CEO James Taylor called it a "very small" compromise. "We compromised only a location, not a population."

Through a $15 million fund "that will be set aside from the assets of University Hospital and given to U of L for that purpose once the merger closes," uninsured women will be able to have tubal ligations at Baptist, whether they're being done after giving birth via C-section or vaginally, reports Patrick Howington of The Courier-Journal. They can also be done even if the procedure is unrelated to childbirth. University of Hospital performed 301 tubal ligations last year.

University Hospital has historically provided care for indigent patients who cannot afford to get care elsewhere. Because these patients are not wealthy enough to choose which hospital they go to, they have no choice but to adhere to Catholic directives. Though the issue of female sterilization has been addressed, there is still the issue of how end-of-life care will be handled at University Hospital. That includes how living wills and the removal of a feeding tube will be dealt with.

The merger, which would create Kentucky's largest health-care system, still needs the approval of Gov. Steve Beshear and the Catholic Church. "We have a public institution with a public mission that has been supported by the public dollars and public leadership for many years," said state auditor Crit Luallen. "And we have to look at how a merger with a religious organization changes the public's access and the public's protection." (Read more)