Christian County Public Schools ban brought-in fast food as part of an effort to battle childhood obesity, a big problem in Ky.

Fast food is no longer a lunch option for students in Christian County Public Schools, Margarita Cambest reports for Kentucky New Era after the Board of Education voted to ban "commercially prepared, restaurant meals" Tuesday. Parents have been bringing fast-food meals to schools, even though 14 schools offer free meals under a federal program.

"Prepared foods must now be put in a non-identifiable container to pass the cafeteria doors—essentially meaning no logos," Cambest reports. "Takeout containers and bags must be discarded, and the food placed in a lunch box or brown bag if brought from home. Soda is out as well. The consumption of bottled or canned carbonated beverages during meal times is also forbidden."

Sandra McIntosh, the system's food-service director, "said the decision allows her to enforce a federal mandate that has been questioned by some local principals," Cambest reports. But then she notes that the federal school-lunch program "leaves the authority to control the sale of foods in direct competition with the national program with state and local agencies, according to the United States Department of Agriculture," which runs the program.

Changes in the program, which McIntosh said have made meals "more nutritional" by having "lower fat, more whole-grain and more dark green and red vegetables, have been unpopular with many students and parents.

A study by USDA's Economic Research Service in 2005 showed that "Students in schools that offered greater quantities of fruits and vegetables consumed more of these foods by most measures." And fast food has more calories. Research at the Yale Rudd Center for Food Policy and Obesity says on days that children eat fast food, they consume 126 additional calories and teens consume 310 more calories. The center says 33 percent of children and 41 percent of teens consume fast food daily.

Kentucky children rank third worst among the states for in obesity, with 37.1 percent of them considered either overweight or obese, according to the Child Policy Research Center.

Stanton Elementary School, closed almost three weeks because of bat infestation, is scheduled to reopen Wednesday

By Melissa Patrick
Kentucky Health News

Stanton Elementary in Powell County will reopen this week after being closed for almost three weeks because of a bat infestation, school officials said Monday.

"They are moving everything back into the building today," Arliss Crowe, secretary to the district's director of pupil personnel, told Kentucky Health News on Monday. "Students will be back in the school on Wednesday." Schools in the county were dismissed Monday and Tuesday while crews moved furniture serving students who were moved to alternate facilities.

The state Department for Public Health closed the school Nov. 14 after bats were reported frequently entering the building, county School Supt. Mike Tate told The Clay City Times. An animal-removal company found three to five bats initially and did not see any more after they began their work, he said.

The company completed its work last week and told the school system to monitor the building for a week and if no bats are sighted it "could be safe to move back in," Tate told the weekly newspaper.

Tate told the weekly newspaper that he met with state health officials Friday, Nov. 29, to determine what needed to happen next. "We want to be careful and not act too quickly," he said then. "We want to get back, but we want to make sure the school is safe." (Read more)

Ky., high in childhood obesity, fights it with better school meals, increased activity requirements and maybe help from Big Bird

By Melissa Patrick
Kentucky Health News

Kentucky children are some of the nation's fattest.

In 2011, the last year for which data are complete, Kentucky ranked sixth in the U.S. in the percentage of obese 2-to 4-year-olds from low-income families (15.5%), eighth for percentage of obese 10-17 year-olds (19.7%), and third in percentage of obese students in high school (16.5%), according to a project of the Trust for America's Health and the Robert Wood Johnson Foundation. (Read more

Kentucky has several programs in place to fight childhood obesity, such as improving food choices in schools with farm-to-school mini-grants and improved school nutritional guidelines. Efforts are also being made to increase the standard expectations of physical activity, according to the federal 

Centers for Disease Control and Prevention website.  

Laws that require Kentucky school districts to develop local wellness policies for grades K-5 that includes moderate to vigorous physical activity each day and encourages healthy choices among students are a step in the right direction toward decreasing childhood obesity. This legislation also requires assessment tools to measure each child's level of physical activity on an annual level, according to the National Association of State Boards of Education website. There is also a push to increase the activity requirements in child care facilities, according to the CDC website.

The frequency at which children eat fast food, and its nutritional value, are also challenges in decreasing childhood obesity. Kids and teens consume up to 300 calories more per trip to a fast-food or full service restaurant compared to days they eat at home, Ryan Jaslow reports for CBS News. (Read more)

Although fast-food restaurants have made some improvements with healthier sides and beverage choices in most children's meals, "there is room for improvement," researchers say in the "Fast Food Facts 2013" report, issued by Yale University's Rudd Center for Food Policy & Obesity.

The report examines how 18 major restaurant chains market their foods and beverages to children and teens, and analyzes the nutritional quality of the chains' food. Significant findings included: Less than 1 percent of all children's meal combinations at such restaurants met recommended nutrition standards; McDonald's spent 2.7 times as much to advertise its products as all fruit, vegetable, bottled water and milk advertisers combined; the total amount spent on all advertising by fast-food restaurants in 2012 was $4.6 billion; preschoolers viewed 2.8 fast-food ads per day in 2012; children 6 to 11 saw 3.2 such ads per day; and teens viewed 4.8. The researchers also found that fast-food restaurants continued to target black and Hispanic youth, populations at high risk for obesity and related diseases.

Researchers called for fast-food restaurants to stop marketing unhealthy foods to children and teens, saying "Research shows that exposure to food marketing messages increases children’s obesity risk." (Read more

On the marketing front, "Sesame Street" characters have joined the Produce Marketing Association to help market fresh fruits and vegetables to children, according to a press release from the Robert Wood Johnson Foundation.

"Marketing healthy products with the same skill and vigor typically used for less healthy options could make a major difference in shaping children's food preferences," Dr. Risa Lavizzo-Mourey, the foundation's president and CEO. "I have a vision of children pestering their parents for pears and begging for broccoli."

Some schools let kids with live head lice stay; policy change has some Kentucky parents scratching their heads

By Molly Burchett
Kentucky Health News

School districts across the country are adopting policies that say students diagnosed with live head lice or nits (louse eggs) can remain in school and parents don't need to be alerted when their child comes in contact with lice. Others schools say they will keep strict lice policies and will continue to alert parents about lice infestations. What's the policy at your child's school?

The American Pediatric Association, the Harvard School of Public Health and the National Association of School Nurses recommend that schools discontinue "no-nits" policies, taking the position that students should not be excluded from school due to suspected head lice or due to nits only. The Kentucky Department of Education and the Kentucky School Board Association also support this recommendation.

The organizations say "no-nit" policies that require a child to be free of nits before they can return to schools should be discontinued because nits are very unlikely to hatch and become crawling lice, nits are cemented to hair shafts and are unlikely to be transferred to another person, and the burden of absenteeism to the students and communities isn't doesn't outweigh the risks of head lice.

This policy shift is designed to help keep children from missing class and to shield children with lice from embarrassment, but these more lenient policies are bugging some parents, reports Jennifer Kerr of The Associated Press.

One school in Paducah says its strict policy about alerting parents if their child gets lice won't change anytime soon, reports Mychaela Brunen of WPSD-TV.

Vicki Brantner has been a school nurse at McNabb Elementary School in Paducah for six years and says the school's strict lice policy is here to stay. "When we have somebody that has head lice, we have a step-by-step procedure that we give to them to take home, it's not only washing the hair, but you have to clean your environment," Brantner told Brunen.

"We have a no-nit policy which means not only can they be here if they have the actual bug, but all the eggs removed also," said Brantner. She said parents with elementary school-aged kids should check their child's hair for lice once a week.

Marcey Davis, a mother of five, said she appreciates getting notices about lice infestations from McNabb Elementary. "It keeps me informed as a parent, as to what's going on in their classrooms and the school," she told Buren. "Parents need to stay on top of in order to keep a lice-free school, at the risk of embarrassing my child, I would rather know about it."

The head louse is a parasitic insect that can be found on the head, eyebrows, and eyelashes of people, and the CDC estimates that 6 million to 12 million infestations occur each year between schoolchildren between the ages of 3 and 11. It is much more common for schoolchildren to get lice because schools bring large numbers of children together where they are in close contact with each other, reports Mike Potter of the University of Kentucky College of Agriculture.

Here are some tips from the CDC that can be used to prevent and control the spread of lice:

• Avoid head-to-head (hair-to-hair) contact during play and other activities at home, school, and elsewhere (sports activities, playground, slumber parties, camp). 
• Do not share clothing such as hats, scarves, coats, sports uniforms, hair ribbons, or barrettes.
• Do not share combs, brushes, or towels. Disinfest combs and brushes used by an infested person by soaking them in hot water (at least 130°F) for 5–10 minutes. 
• Do not lie on beds, couches, pillows, carpets, or stuffed animals that have recently been in contact with an infested person.

Obamacare's employer mandate poses challenges for schools

While Kentucky public-school employees get their health insurance through the state’s self-funded program and don't have to worry too much about how federal health reform may affect them, their employers do, Madelynn Coldiron points out in the November issue of the Kentucky School Board Advocate.

“School districts probably thought that they were not involved in the ACA or it was not a hot-button issue for them, but it really is,” Shannon Stiglitz, a lobbyist for the Kentucky School Boards Association, which publishes the Advocate, told Coldiron. “They do have roles and responsibilities under the Affordable Care Act and they need to be aware of them or costly penalties could be incurred.”

The law will require employers with 50 or more employees working 30 hours or more a week or 130 hours a month to cover them or pay a fine starting Jan. 1, 2015.  Almost all Kentucky school districts have at least that many employees, said Susan Barkley, assistant director of the state Department of Education's Division of District Support, which created an ACA implementation guide for school districts.

The law means that districts may have to make some employment changes, or changes to employment policies. What’s very complicated for schools is documenting actual time worked for people in positions like substitute teachers, paraprofessional coaches and part-time employees, Barkley told Coldiron. And, Stiglitz said, districts must be careful because if a school district worker who is eligible for coverage instead purchases a health plan from the state’s marketplace, the district faces a big fine.

To control costs, local boards can amend policies to limit the number of hours or days that “variable hour employees” like substitute teachers or coaches may work, Bass said. Or, substitutes who turn down assignments after they've worked enough hours to qualify for health insurance may be terminated. News reports across the country have detailed school systems' plans to cut some substitute teachers and college adjunct professors as a result of the health law's mandates.

"School districts are facing vexing financial and operational questions about how they will comply with the Affordable Care Act, which some administrators say is forcing them to choose between absorbing the hefty costs of health coverage for currently uninsured employees or cutting back on those workers' hours," reports Sean Cavanagh of Education Week.

Next week the federal House Committee on Education and the Workforce will hold a hearing to learn more about how the health law is affecting schools. Meanwhile, districts are waiting for additional Internal Revenue Service guidelines regarding substitute teachers and short-term employees.

For more information about the health law's impact on Kentucky's school districts, click here to view the education department’s ACA guide.

School nurses are an unfunded mandate for schools, which are picking up more of their cost as health department budgets shrink

Marion County nurse Renee Schooling helps
Levi Hardin, a Marion County first grader with
diabetes, check his blood sugar. (Lebanon
Enterprise Photo by Stevie Lowery)

Kentucky school nurses are stretched thin across the districts they serve and the budgets to pay for  them are stretched even thinner, because of budget cuts in the state Department of Public Health.

School districts are picking up the load, but often not all of it, because of their own financial challenges. "Basically it's one of the many unfunded mandates," Editor Stevie Lowery writes for The Lebanon Enterprise.

Lowery reports that the Marion County Schools currently share the cost of nurses with the Lincoln Trail District Health Department, with the schools paying 58 percent, or $161,000 a yera, and the department paying 42 percent, $116,000.

In some counties, schools are bearing the entire cost, which in some cases has reduced the availability of nurses, but Thursday night, the Christian County school board voted to hire another nurse, giving it one at every school, Editor Eli Pace reports for the Kentucky New Era in Hopkinsville.

Marion County Supt. Taylora Schlosser told Lowery that while her district values the services nurses provide, she and the school board will need to keep evaluating who pays for that service. The district plans to compare the cost of its contract with the health department and the cost of hiring its own nurses, with a commitment to not allow the level of service to change, Lowery reports.

“We will always have school nurses because we are going to take care of our kids,” Schlosser told Lowery. “How we pay for school nurses might change.”

In Kentucky, if a student requires medical care in order to attend school, state law requires school districts to provide the care.  Districts may hire nurses, contract with the health department, or use the medical supervision and delegation of medical tasks to district staff by local medical professionals, Lowery reports.

School nurses take care of students and staff who are injured or not feeling well, care for students with special medical or dietary needs, administer medications, conduct screenings, give flu shots, provide nutrition and wellness education, certify and give immunizations, and train staff in CPR, first aid and emergency administration of medication, Lowery reports.

“We’re not just boo-boos and Band-Aids,” Keown told Lowery. "Our main goal is to keep kids in school and keep them healthy so they can get a better education. Healthy kids make healthy students.” (Read more)

In Christian County, nurses have been called on almost 13,000 times this year, nurse coordinator Megan Kidd reported to the school board Thursday night. She said many students in the district don't have primary-care physicians and are told by their parents to see the school nurse, Pace reports.

"Kidd said 11 out of the district’s 15 schools have at least one diabetic student who depends on insulin," Pace writes. "In addition to insulin injections, other common reasons for trips to the nurse include allergic reactions requiring EpiPens and asthma attacks. Seizures also seem to be on the rise, Kidd said.

"But even though most of the visits were related to fairly common issues, Kidd told a story of a school nurse who once saw a student starting to show signs of leukemia. The nurse didn’t diagnose the child with cancer — that’s something a school nurse would be not allowed to do anyway, Kidd said — but the nurse pushed the child’s parents to go to the doctor, and the child did in fact turn out to have cancer." (Read more; subscription required)

Free-for-all food program increases student participation, raises Ky. breakfast count by 25% with only 39% of districts participating

Kentucky schools participating in a program that provides free breakfast and lunch to all students in high-poverty schools have significantly increased student participation in school lunch and breakfast programs, Charles Edwards reports for Education Week.

Schools participating in the "community eligibility option" have increased student participation by 13 percent in the lunch program and 25 percent in the breakfast program during the first two years of its availability and eliminated significant administrative costs, according to the Washington-based Food Research Action Center and the Center on Budget and Policy Priorities.

Collectively, Illinois, Kentucky and Michigan achieved a 25 percent increase in breakfast participation over the first two years, Education Week reports.

Of the 174 school districts in Kentucky, 68 participate in the community eligibility option, Nancy Rodriguez of the Kentucky Department of Education told Kentucky Health News. That is 39 percent of the public school districts. One private school also participates.

The program allows high-poverty schools to serve all students free breakfasts and lunches without individually identifying children as eligible. Schools get about the same amount of reimbursement from the Department of Agriculture that they did under the existing system—but without the paperwork. The reimbursement is based on the total number of meals served.

The school nutrition director at Ballard County, a participant in the "community eligibility option," told Whitney Jones of WKMS-FM, Murray State's NPR station, that the district saves $500 per year per student eating both breakfast and lunch at school.

The traditional way to determine eligibility for free or reduced breakfast and lunch required families to fill out a parent-income survey, which discouraged some from enrolling. The new eligibility option has been rolled out incrementally since it was authorized by Congress in 2010, and all eligible schools in the country may participate beginning in the 2014-15 school year.

Now, the percentage of a school's children who are already enrolled in other federal need-based program or are homeless, migrant, in Head Start or in foster care, determines the eligibility of the school, reports Edward. If a school has an enrollment of at least 40 percent of such directly certified children, it is eligible. Some districts combine all their schools to include those that are below 40 percent.

Participation in the program has exceeded the original expectations, with more than 2,200 schools signed up in the first seven states allowed to participate. The original projection estimated 300 schools would participate over 10 years, Education Week reports.

Schools and students are still getting used to lunches that are healthier but not as suited to their tastes

School lunches look and taste different than they did before new federal nutrition standards kicked in, and that has caused more food to end up in garbage cans and more students to bring a lunch from home, according to an article from the October issue of Kentucky School Advocate, a magazine published by the Kentucky School Boards Association.

"We're serving more and it's going in the garbage," Estill County school food service director Belinda Puckett told KSBA reporter Madelynn Coldiron. "The (students) have to take a fruit or a vegetable and it's going in the garbage."

Others think that with time, students will adapt to the new menu, which has more whole grains, fruits and vegetables, and fewer calories and sweets.

"It really is the same food, just a little different presentation," said the state Department of Education's Valerie Crouch, who provides technical assistance and training to food service directors, told Coldiron.

The biggest challenge, Marshall County school food service director Beth Cunningham said, "is the speed at which we have had to adopt this. . . . Kids don't like change."

The timetable for transition to the new menus was short, so kids had to adjust quickly, Sabrina Jewell of Henderson, president of the Kentucky School Nutrition Association. She said food suppliers hadn't perfected offerings that would meet the guidelines, but the products have since improved, Coldiron reports.

Many schools have seen a decline in the number of students eating school meals, with some districts dropping as much as 10 percent to 20 percent, according to Jewell.  This translates into a loss of federal reimbursement dollars for those meals not purchased, Coldiron notes.

Smaller districts are affected more deeply by fewer lunches being purchased, because any small change makes a big difference in a small budget.

The state surveyed food service directors to determine the reason for the drop in participation, but the survey had too many variables to pinpoint a single factor, Crouch told Coldiron. Two variables were an increase in the cost of lunch in some districts, and an increase in the number of schools joining a federal program that provides free meals to all students regardless of income.

Budget challenges add yet another dimension to the new federal nutrition guidelines, Coldiron reports. "Fresh produce costs more than canned or frozen," said Jewell, whose Henderson County bill for produce doubled last year.

Another concern is that the students are still going home hungry.

"We have a 68 percent free and reduced lunch rate," said Puckett, of Estill County. She told Coldiron that parents are complaining about children coming home hungry. "I think they need to come look at these kids who aren't eating and they're not getting enough to eat like what they used to."

Plans are in place this year to make new recipes and food displays to encourage kids to eat, Jewell said.  Students who reject school meals are either bringing their lunch from home or not eating at all, and neither is a good outcome, Jewell told Coldiron.

"We don't get to police their lunchboxes," she said. "It's whatever is sitting on the shelf: high carbs, high fat, low nutritional value." (Read more)

Fewer teens report using tobacco and abusing prescription drugs, but some attribute latter trend to increase in heroin use

By Melissa Patrick and Melissa Landon
Kentucky Health News

Fewer Kentucky teenagers said last year that they used prescription drugs without a doctor's direction, or tobacco, than in the last such survey. But some addiction experts worry that prescription-drug abuse has dropped since 2010 because young people are using heroin instead.

According to a state survey of young people in 88 percent of Kentucky's school districts, their improper use of prescription drugs has declined steadily since 2004, with the greatest decrease between 2010 and 2012.

In 2012, prescription-drug abuse among high-school seniors dropped almost a third, to 9 percent from 13.1 percent in 2010. Among sophomores, it dropped to 7.6 from 11.3 percent; among eighth graders, to 2.9 from 5.3 percent; and among sixth graders, to 0.7 from 1.8 percent.

Some feel there's a disconcerting reason for the decline in prescription-drug abuse. "My concern is the unintended consequence is that people have switched to heroin," Karyn Hascal, president of The Healing Place recovery program in Louisville, told Laura Ungar of The Courier-Journal. "The problem is addiction, not the drug of the day." Hascal said The Healing Place has seen addicts who started out using other types of drugs but eventually turned to heroin as a cheaper option.

Although the survey didn't measure heroin use among teens, it asked if any of their four best friends had used illegal drugs in the past year. The results showed a continued slow decline, to 12.2 percent and 15 percent, respectively, among high-school sophomores and seniors.

"Over the past four years we have significantly stepped our efforts to address prescription-drug abuse," Connie Smith, manager of the Substance Abuse Prevention Branch of the state Division of Behavioral Health, said in a news release. "All of our regional prevention centers have been working very hard with their local coalitions to plan and implement effective programs to reduce illegal use of prescription drugs among youth."

The federally funded survey measures use of drugs, tobacco and inhalants; mental health; school safety issues; and gambling. The division said 153 of the 174 school districts at the time took part, with 122,718 students participating. The survey also measures concerns such as school safety issues and gambling. The report said that almost every other area studied had lower numbers in 2012 than in 2008

The survey asked several questions about tobacco. Among high-school seniors, 25.6 percent reported smoking in the previous 30 days, down from 29.4 percent in 2010. Among sophomores, smoking dropped to 18 percent from 21.7 percent; among eighth graders, to 8.7 from 10.7; and among sixth graders, to 2 percent from 2.5 percent in 2010.

Use of smokeless tobacco by high-school students declined in 2012, after rising in each survey from 2006 to 2010. Among seniors, it fell to 15.7 percent from 17.5 percent in 2010; among sophomores, it dropped to 13.4 percent from 15.9 percent. Among younger students, an eight-year decline continued, but at a sharper rate since 2010.

Marijuana use among high-schoolers declined slightly after increasing in 2008 and 2010. The survey also showed a steady decrease in the risk that teenagers associate with occasional use of marijuana. For the full report, click here.

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.

Donor who helped Monroe schools take over, expand wellness center pledges more for improvements, upkeep, scholarships

The Monroe County Schools are getting a $1 million-plus donation for a family wellness center and scholarships for graduates of the county's only high school from businessman George Eagle Bushong of Bradenton, Fla., who grew up in a prominent Monroe County family.

George Bushong and daughter Isabelle

School Supt. Lewis Darrell Carter told Shelley Smith of the Glasgow Daily Times that Bushong had mentioned his intent to donate $50,000 a year for 10 years for the  Monroe County Family Wellness Center, and surprised him two weeks ago by adding an extra $55,000 for the next decade for various scholarships.

The schools took ownership in November 2011 of the center, "which was built on property owned by the school district," Smith reports. "Since then, Carter said the wellness center membership has gone up from 340 members to 1,200." The annual donations will pay for an indoor digital golf machine, a swimming scoreboard and maintenance of the George and Isabelle Bushong Foundation Aquatic Center, which Bushing helped build to hold swim meets and was named for his daughter.

Asst. Supt. Amy Thompson told Smith the wellness center is heavily used by student athletes for training, physical education classes and afterschool fitness classes. “It gives the kids something to do to include fitness in their lives,” she said. " Carter said he’s even seen families meet at the wellness center to work out together," Smith reports. "He said the funding to help support this facility will be great service to community. . . . To pay homage to Bushong’s generous donations, Carter said they will change the name of the wellness center to the George and Isabelle Bushong Foundation Monroe County Family Wellness Center."

Some parents complain about healthier school lunches, but USDA says it's on course to improve public health

A few school districts in other states are opting out of a federal-funded school lunch program that was touted by first lady Michelle Obama to provide healthier options to students, and some parents in Harlan County are complaining about the new menus. But the U.S. Department of Agriculture, which runs the National School Lunch Program, says the naysayers are in a small minority and the healthier fare will become more popular and improve public health.

That is backed up in a study forUSDA's Economic Research Service of 2005, showing that "Students in schools that offered greater quantities of fruits and vegetables consumed more of these foods by most measures." During the 2012-13 school year the lunch program increased servings of fruits, vegetables, whole grains and fat-free or low-fat milk, while setting standards for calorie content and reducing intakes of sodium and trans fat. Students are allowed to eat as much fruit and vegetables as they want. The full report can be read here. (USDA graphic)

Districts from Kentucky to Illinois to New York have complained that students aren't interested in the healthier foods, leading students to buy fewer school meals, which costs the school districts who rely on federal reimbursements. But the number of districts opting out could be minimal. The School Nutrition Association "found that 1 percent of 521 district nutrition directors surveyed over the summer planned to drop out of the program in the 2013-14 school year and about 3 percent were considering the move," Carolyn Thompson reports for The Associated Press. There were 31 million students in the program in 2011.

So many students and parents have complained in Harlan County that the school board held a special meeting to address the issues, Mark Bell reports for the Harlan Daily Enterprise. "Complaints ranged from not being fed enough to food received not being good enough. While fruits and vegetables are offered freely and students can take their fill of those, meats and carbohydrates will continue to be served in limited portions only, so students complain of not getting enough food."

In Spencer County, there were no complaints about the food, just a price increase of 10 cents for lunches, to $2.30 ($2.45 at the high school) that school officials attributed to the 2010 federal law. District Director of Operations and Transportation Brett Beaverson wrote in a school-board agenda item, "The logic behind the mandated increase is to eventually equal the difference between the reimbursement rate ($2.86) and the full-pay lunch price." Malloy Bilger reports for the Magnet, "Beaverson said failing to pass the increase would make it appear that the federal government was subsidizing full-pay lunches." (Read more)

Overall, schools are getting healthier, according to a report released Monday by the Centers for Disease Control and Prevention. Since 2006, "the percentage of districts that required schools to prohibit offering junk food in vending machines increased from 29.8 percent to 43.4 percent . . . and the percentage of districts with food procurement contracts that addressed nutritional standards for foods that can be purchased separately from the school breakfast or lunch increased from 55.1 percent to 73.5 percent." states the CDC. "Between 2000 and 2012, the percentage of districts that made information available to families on the nutrition and caloric content of foods available to students increased from 35.3 percent to 52.7 percent." (Read more)

LaRue County High School collaborates with university and nursing home to offer nurse-aide training course

Fifteen students at LaRue County High School have signed up for a new nurse's aide class offered in coordination with Campbellsville University and a local nursing home through which students will earn a nurse certification. The class is being subsidized by the county school district.

The school board agreed on June 17 to pay $300 per student.  Although students accepted into the program will be expected to cover the remaining $200 of the course fee, grants are available to help them, and upon completion of the course, students will receive a certificate stating that they have completed some medical training, says Denise Skaggs, instructional supervisor for the school system.

"The course is titled as an SRNA (State Registered Nurse Aide) program; where students will learn skills involving senior personal care, mobility assistance, checking vitals (i.e. heart rate, blood pressure etc.) and minor medical equipment use and care," says Rebecca Roscoe of the LaRue County Herald-News.

Classes will be coordinated by Campbellsville University and held at the Brockman Center in Hodgenville and at the Sunrise Manor nursing home, where the course's required 16 clinical hours will take place, reports Roscoe. The hands-on clinical experience will be a great benefit, Skaggs said.

The idea for the course came from a survey in which 45 students expressed interest in a nursing program due to their interest in pursuing a medical career, Roscoe reports. Administrators talked to Taylor County school officials, who have implemented a similar program, to gain insight about launching their own program.  Thirty students applied and 15 students have been accepted by a review committee.

“I’m glad to see us offer something specific for our students that will help them achieve success in their future career,” Skaggs told Roscoe. “I think the program is a great addition because it speaks to our community … and now that we know the services that are available for us we want to take advantage of programs offered to benefit and increase our students success.” The program serves as a model for other public high schools to do the same.

Covington schools show 'Fitness Rocks' by lowering body mass, lifting the bars of nutrition, wellness and academic achievement

Sparks are flying in Covington Independent Schools. The schools' Fitness Rocks program, which combines fitness and wellness activities in an after-school program four or five days a week to create a healthier community for students, is the reported cause of fire.

The district's after-school student activities are based on the SPARK (Sports, Play and Active Recreation for Kids) curriculum for out-of-school-time, and the district reports great success since the program launched three years ago.

Since then, students' body mass has shrunk 4 percent, and there has been a 6 percent increase in the number of students who engage in at least an hour of daily physical activity and the number of students eating fruits two or more times a day, and vegetables three or more times a day, reports Julie Wohlleb of the Kentucky School Boards Association.

Students in Fitness Rocks also saw a greater increase in their math and science MAP (Measure of Academic Progress) scores than students not participating. “It’s been demonstrated how students who are active 60 minutes or more a day have increased academic success,” Haggard told Wohlleb.  

The program is also being used for professional development for physical education teachers, and "The SPARK curriculum has been really helpful in giving our fitness coaches and PE teachers ways to get all kids engaged no matter their skill level,” Haggard told Wohlleb.

The district started Fitness Rocks three years ago at each of its seven schools through a Carol M. White Physical Education grant from the U. S. Department of Education. The program encourages a range of activities to keep students active, from playing flag football to video games, and so far, 55 percent of elementary students and 19 percent of high school students across the district have participated in the program this year.

In addition to after-school activities, Fitness Rocks provides healthy snacks and sponsors family nights at every school that focus on fitness, wellness and nutrition, and program coordinators are witnessing changes in health behaviors across the district. “We’ve been really working hard, especially this year, at finding a sustainability model because it has been so impactful for the community and parents and students alike; they just love it,” Haggard said. (Read more)

Judge orders Medicaid managed-care firm to pay for school health services, including $8 million in claims; appeal possible

Medicaid managed care company Kentucky Spirit must cover preventive care services provided by local health departments in schools, a judge has ruled.

Circuit Judge Phillip Shepherd of Frankfort said the company must pay $8 million for the services already provided by school nurses, which would be only .07 percent of its estimated profit for 2013, according to the updated earnings report of Centene Corp. of St. Louis, the parent company for Kentucky Spirit. The company is the only one of the five managed care organizations in Kentucky  that had disputed the coverage of school health services.

Kentucky Spirit stopped providing coverage for school health services last summer, saying its state contract didn't require payment for such services,but Shepherd noted that the state reimbursed health departments for school services before it transitioned to managed care, reports Tom Loftus of The Courier-Journal. “Kentucky Spirit is not free to disregard this longstanding interpretation of Medicaid eligibility and unilaterally re-interpret these to the detriment of local health departments,” Shepherd wrote.

Health departments and school districts will now find some relief because many school nurse programs were threatened by cutbacks and closings as a result of Kentucky Spirits failure to pay for services. “It’s great news because there have been dozens of districts that have had to either say they are going to cut back on nurses, or that they are going to close clinics, or that they are going to dip into their reserves to try to cover the additional costs,” Kentucky School Boards Association spokesman Brad Hughes told Loftus.

Gov. Steve Beshear said Kentucky Spirit had “sought a loophole” in its contract to avoid paying for school health services covered by Medicaid, writes Loftus. Centene released a statement later Tuesday saying that the company is reviewing options and considering an appeal.

This isn't the only payment Centene is trying to avoid. A ruling is expected soon in a lawsuit the company filed against the state last year seeking to end its contract a year early, saying the state rushed to privatize Medicaid in 2011 and provided incorrect cost information to the bidders, causing the firm to lose about $120 million.

Appalachian Regional Healthcare, the largest health-care system in Eastern Kentucky, filed suit in April of this year against Kentucky Spirit for $5.9 million in unpaid claims. This suit is still pending, and was filed just before Centene raised its full-year forecast for premium and service revenue to $10.1 billion to $10.4 billion, Reuters reports.

New website for after-school programs promotes 'Drink Right, Move More and Snack Smart' to fight childhood obesity

To combat the country's childhood obesity epidemic, ChildObesity180, a new initiative from Tufts University, has launched Healthy Kids Hub, a website with resources for out-of-school-time programs, encouraging kids to develop and adopt three universal nutrition and physical activity principles: "Drink Right, Move More and Snack Smart."

The Hub offers free activity, nutrition and equipment support to volunteers, coaches and leaders in out-of-school-time programs, which serve tens of millions of children and have been identified as a promising area for obesity prevention efforts, the site says.

In Kentucky, almost 18 percent of middle-school-age children and 16 percent of elementary-age kids are obese, says a recent report from the University of Kentucky's College of Public Health.

Research shows that foods and beverages, as well as opportunities for physical activity, vary greatly in out-of-school programs, so the Hub promotes greater consistency in such programs and provides resources to help children follow healthy habits while out of school.

The website was launched at the National Afterschool Association convention in Indianapolis last week, according to a release. Visitors to the website can complete a brief survey to get resources tailored to their specific needs. Click here for the website.

School nurses start getting scarcer, due to Medicaid problems

By Molly Burchett
Kentucky Health News

Students in many Kentucky counties will find it harder to see a school nurse due to changes in the state Medicaid program and lack of payment from managed-care companies.

Takirah Sleet, 7, and school nurse Michelle Marra looked at Takirah's
lunch tray to calculate her insulin dosage at Lansdowne Elementary
in Lexington. (Lexington Herald-Leader photo by Pablo Alcala)

In Crittenden County schools, budget woes have forced the Pennyrile District Health Department to request additional money from the school district to keep its school health clinics fully-staffed and open, reports Jason Travis of The Crittenden Press. Allison Beshear, director of the health department, told Travis one reason from the budget crunch is a lack of payment from Kentucky Spirit, which owes the health department $266,000.

Without additional money from the school district, Beshear says, the health department cannot maintain the current level of service at school clinics through the end of the school year.  Proposals have been made to offer services to the district that entail reducing clerical staff without reducing the number of nurses; but in order to do so, trained school staff would have to handle daily medication distribution and help to answer the phones for the clinic.

"Kentucky Spirit has filed two appeals with the Cabinet of Health Services and the Finance Cabinet in which it claims to not be financially responsible for healthcare given in school clinics," reports Drew Adams of WKMS-FM in Murray reports in a story about similar problems in Hopkins County.

Other school districts facing similar problems include those of Bell, Clark and Pike counties. Eleven school health clinics in Bell County could be shut down by the end of this school year, reports WBIR-TV of Knoxville. In Clark County, a lawsuit between the state and Kentucky Spirit has put a halt to reimbursement for health services provided in county schools, reports Rachel Gilliam of The Winchester Sun.

Last month, the Pike County Board of Health filed a lawsuit against Kentucky Spirit because the managed-care firm has stopped reimbursing the Board of Health for school-nurse programs, reports Jordan Vilines of WYMT-TV in Hazard. The money has to be reimbursed in order to provide school nurses.

“I think having someone in the school to ensure that our children are healthy is imperative for the quality of life of our kids, especially in a very rural area," Pike Judge-Executive Wayne T. Rutherford told Vilines.  He said that without reimbursement, school nurses could lose their jobs, which would leave hundreds of kids without immediate medical care.

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 Health Kentucky.

One S.C. county serves as incubator for state's efforts to battle weight problems, with some good results

PE teacher Sharon Williams, right,
leads morning exercises before
classes start at Bells Elementary.
(The State photo by Tim Dominick)

With nearly two-thirds of South Carolina deemed overweight or worse, lucky Colleton County got picked to be a test case for doing better. That is, for improving its chances to beat the state's already overwhelming rates of diabetes, heart disease and stroke and for helping to lower the state's $1.2 billion dollar medical bill. Lucky, because in 2010, the county was awarded almost a half million Eat Smart Move More grant by the BlueCross BlueShield of South Carolina Foundation to see if it could promote health eating and more physical exercise countywide. Joey Hollerman of The State newspaper in Columbia, S.C., reports that "the results have been striking," though he notes that changing obesity numbers is "like turning an aircraft carrier, it's a slow process." Mostly, he's talking about attitude and perseverance.

How does the county-wide program work on a daily basis? First, of course, you have to have buy-in, which this county did. Hollerman explains that now when children arrive at Bells Elementary School in the county seat of Walterboro, "they go straight to the gym and walk laps before heading to classrooms. Worshipers at Power of Faith Delivery Ministry harvest collards as well as souls, and fried chicken is discouraged at church dinners. The local farmers market has a sparkling new home and a system set up to accept cards from the Supplemental Nutrition Assistance Program." The Let’s Go, Eat Smart program and exercise programs are posted in schools, workplaces, grocery stores and churches.

So how, if the numbers aren't clear yet, how to measure if it's working? Well, only one fried chicken basket showed up at a recent church supper and the member who brought it ended up apologizing for her breach. On the day the reporter visited only the elementary school only one child in the entire first grade tried to slip through without selecting a fruit or vegetable. He was sent back and grabbed a plastic container of grapes from the Go (instead of the Slow or Whoa) food options, Hollerman reports. There are also anecdotes galore, including those of children, once on insulin, who are now fine without it.

South Carolin's BlueCross BlueShield recently awarded another grant to Eat Smart Move More, in part to continue the work in Colleton County but also to for expand it to other communities. (Read more)

Report: 110,000 Ky. youth 16 to 24 aren't in school or employed; state's rate of 'disconnected youth' exceeds U.S. average

Almost 110,000 teens and young adults in Kentucky are not enrolled in school and are not employed, even part-time, according to a new Kids Count report from the Annie E. Casey Foundation.  Nationwide, the number reaches nearly 6.5 million. In Kentucky between 2000 and 2011 the number of 16-19 year-olds not in school and not employed rose by 3 percent, but the number of idle young adults ages 20-24 climbed by a whopping 88 percent. Both rates exceed the national rate. (Getty Images)

The Kids Count report, "Youth and Work: Restoring Teen and Young Adult Connections to Opportunity," termed these 16- to 24-year-olds "disconnected." It found that they face many obstacles on their path to securing a stable financial future. For starters, many haven't finished high school and are competing with older Americans for the few entry-level jobs. In addition, they lack skills for higher-paying jobs. Many are poor and have attended under-performing schools. The report explains that, as such, this group can present a significant cost to taxpayers. (Read more) View the report here.

Task force recommends changes to protect safety and health of middle school students who play interscholastic sports

The boys of North Marshall Middle
School of Benton, Ky., after winning
a Christmas tournament last year.

Beth Musgrave of the Lexington Herald-Leader reports that the state Task Force on Interscholastic Athletics at the Middle School Level announced its preliminary recommendations this week to address concerns about young athletes' health and safety. It seems that middle school sports in Kentucky have never had the advantage of being governed by a unified code of rules and policies like their counterpart in high school sports. This has led to a confusing mish-mash of guidelines that the legislature is setting out to get right in the coming year.

Preliminary task force recommendations include requiring all middle school teams to follow high school rules on physical exams, medical coverage, concussions and practicing during extreme heat, and requiring the tracking of injuries and incidents for all sports. The task force also suggested that the Kentucky Board of Education look to create a single governing body, like the Kentucky High School Athletics Association that governs high school sports, to oversee all middle-school sports. Wilson Sears, executive director of the Kentucky Association of School Superintendents and a task force member, told Musgrave that the recommendations represent "real progress." (Read more)

Kentucky Parent Survey: We could do a lot better on school meals, we're very much in favor of more health education

Fewer than 10 percent of Kentucky
parents report that their child has ever
walked or biked to school.

When asked, only about one in four Kentucky parents describe the meals served at their child's schools or day care centers as being nutritious. Fewer than 10 percent report that their child have ever walked or biked to school. And an overwhelming majority want information about sexually transmitted infections, human anatomy, abstinence education, birth control methods and condom use taught in Kentucky's high schools.

These are just a few of the surprising results from the first Kentucky Parent Survey conducted by the Foundation for a Health Kentucky, a random telephone survey of 1,006 parents of children under 18. The survey assessed the views of parents, step-parents, grandparents, foster parents and other legal guardians of children in Kentucky. The term "school" was used broadly in the survey as included (2 percent of total surveyed), as well those in pre-school and day care. The study took on nutrition, physical activity and health education.

Eighty-eight percent of parents reported that it was "very important" that meals at schools meet a minimum standard for nutritional value. Only about 1 in 4 parents currently thought their schools were meeting that standard. Only 11 percent are concerned that their younger children are getting too many "celebration-related" treats at their school.

While parents in the state reported that a little more than half (52 percent) of school-age children took physical education classes, that class was not a daily occurrence but met between one and four times a week. Only about 1 in 3 students took a daily course in P.E. That leaves 14 percent without a planned daily class during the school year.

On the topic of health education, parents reported that half of school-age children in the state took health classes, but again not daily. According to the FHK, "The Kentucky Parent Survey included a series of questions about dating relationships and sexual health to determine support for covering those topics...
At the middle school level, more than 8 in 10 parents would favor teaching communication skills (99 percent), human anatomy (91 percent), abstinence education (85 percent), and information about HIV and sexually transmitted infections (84 percent). At the high school level, more than 8 in 10 would favor teaching communication skills (99 percent), information about HIV and sexually transmitted infections (97 percent), human anatomy (97 percent), abstinence education (94 percent), birth control methods (87 percent), and condom use (84 percent)."

Future reports in the FHV series will address access to safe and effective health care for children, children's health behaviors and family routines and the places where parents turn for information on raising healthy kids.