Health care reform will be costly to hospitals, Kentucky Hospital Association chief says

Many of Kentucky's 132 hospitals will lose money and be forced to merge because of the new health care law, says the president and CEO of the Kentucky Hospital Association.

Speaking to the Madisonville-Hopkins County Chamber of Commerce, Michael Rust, left, said one in three Kentucky hospitals is already losing money. Under the new law, reimbursement rates for Medicare are set to go down by 10 percent, which will further put the pinch on health-care facilities. "The proposed 10 percent reduction will cut jobs and wages by an estimated $5.3 million, reduce sales to businesses by $19.6 million and reduce state and local revenues by $1 million," Ron Sanders reports on iSurfHopkins.com.

Rust said the expanded coverage afforded by the law, known as the Patient Protection and Affordable Care Act, will cost Kentucky $1 trillion. Half of that will be financed by new taxes. The other half will be paid for through Medicare cuts, representing a $3.4 billion loss in Kentucky hospital revenue, Sanders reports. Hospitals are, in turn, "working to reduce costs through strategic affiliations or mergers or acquisitions," Sanders reports from Rust's speech. (Read more)

Kentucky Voices for Health Executive Director Jodi Mitchell told Kentucky Health News, "We know the law is not perfect and there are areas of concern that are valid. However, status quo is not an option given that we had a broken and costly health care system. We anticipate the reforms will continue to happen and there will be corrections and amendments to the law to improve upon it." Kentucky Voices for Health is a coalition of more than 100 organizations and individuals working to build a healthier Kentucky and does not have a formal stance on the new health care law, Mitchell said. "It is the law of the land and we are trying to provide objective information in regards to the valuable consumer protection provisions that are in the law."

Free clinic helps care for poor workers in horse racing industry

People who don't have health insurance but who work at Churchill Downs and elsewhere in the horse racing industry can get free care, thanks to the Kentucky Racing Health Services Center.

"The nonprofit, nurse-managed clinic started as a joint venture between the University of Louisville and the Kentucky Racing Health and Welfare Fund, a non-profit organization that gets its money from when people wager but do not cash their tickets," The Courier-Journal's Laura Ungar reports.

The clinic opened six years ago and helps about 2,500 patients a year. Most earn very low wages; stable-help and groom positions pay between $150 and $250 a week plus housing, equine-related employment service Equimax found.

To be treated, workers must be able to show a valid racing license and be employed in the horse industry. Many of the clinic's patients are Hispanics, who have a disproportionately high number of health issues compared to the rest of the population in part because language barriers can either keep them from getting care or understanding instruction. In Jefferson County, the number of Hispanics has increased — representing 4.4. percent of Jefferson County's population in the 2010 U.S. Census versus 1.8 percent in 2000. (Read more)

Teens are misinformed about risks of tanning beds, and are not being warned at salons

With swimsuit season just around the corner, the American Academy of Dermatology has found that more than 40 percent of people who tan have never heard from tanning salon employees about the dangers of tanning beds. This comes days after the Tanning Bed Cancer Control Act was introduced by U.S. Reps. Carolyn Maloney (D-N.Y.) and Charlie Dent (R-Pa.). It calls on the Food and Drug Administration to reclassify indoor tanning beds and require warning labels on the equipment about the dangers of ultraviolet light.

"Studies have found that UV radiation from indoor tanning beds increases a person's risk of developing melanoma by 75 percent," said dermatologist Dr. Ronald L. Moy, president of the dermatology academy. "Contributing to this problem is the fact that tanning bed facilities currently are not required to verbally warn patrons of the known health risks of ultraviolet radiation and, in some cases, they may be misleading the public by falsely promoting artificial UV light as safer than natural sunlight."

The report found tanning bed users from 14 to 17 are "more than twice as likely to think tanning beds are safer than the sun than older tanners age 18 to 22 ... and more than three times as likely to think that tanning beds do not cause skin cancer," the research-reporting service Newswise reports.

"The FDA currently ranks tanning beds as a Class I medical device, which provides a minimal level of regulation and oversight similar to bandages, tongue depressors, gauze and crutches," Moy said. "That is why it's important that the FDA change the classification of indoor tanning devices to reflect the significant health risks that they pose." (Read more)

Earlier this year in the Kentucky General Assembly, state Rep. David Watkins of Henderson introduced a bill that would prevent children under 14 from using tanning booths. The bill, which was backed by the Kentucky Medical Association and the American Cancer Society, cleared the House's Health and Welfare Committee but went no further.

Schools serving somewhat healthier lunches, but short on physical activity, national survey shows

The nation's middle and high schools are feeding students somewhat healthier lunches, but are falling short in providing physical activity to students, a report from the Robert Wood Johnson Foundation's Bridging the Gap program has found. And while soft drinks and sugary snacks are available in most schools, Kentucky is an exception.

The report, which analyzed the 2007-08 school year, found schools are offering fruits and vegetables most or every day, more whole grains and fewer helpings of french fries. However, there is still considerable progress to be made, the foundation says; pizza is available most every day, too, and students could buy sugar-sweetened drinks in vending machines, à la carte lines, store or snack bars at 71 percent of middle schools and 92 percent of high schools.

Those numbers are lower in Kentucky due to a state mandate enacted in 2005. That law prohibits students from beign served anything but water, 100 percent fruit juice, low-fat milk or beverages that have fewer than 10 grams of sugar per serving during the school day. It also prohibits anything but those types of drinks from being available in school vending machines during the school day.

In the 2008 national survey, principals said 1 in 4 middle-school students ate breakfast at school and nearly 3 in 4 ate lunch there. But among high-school students, only 18 percent eating school breakfast and 60 percent school lunch. In schools with higher percentages of students eligible for free and reduced lunch, "both breakfast and lunch consumption were significantly greater, indicating that school meals were an especially important source of nutrition for students in low socioeconomic status schools," the report reads.

Physical education was required for a part of the school year for 83 percent of middle-school students, but only 35 percent of high-school students. Only 10 to 13 percent of high-school students and 21 to 24 percent of middle-school students participated in intramural sports and physical activity clubs in 2008. Only a fourth of middle-school students and 14 percent of high-school students biked or walked to school in 2008.

The study is based on surveys that were mailed back from principals, food-service managers and other staff. In 2007, 222 middle schools and 224 high schools responded. In 2008, 265 middle schools and 262 high schools participated in the survey. The response rate from schools was 76 percent in 2007, 77 percent in 2008. The conclusions come in time for the implementation of the Healthy, Hunger-Free Kids Act of 2010. (Read more)

Legislators need to help cities tackle pill abuse, mayor says

Winchester's mayor is displeased with the Kentucky attorney general's recent finding that local governments do not have the right to ban pain clinics within their borders. "The opinion carries no legal authority, but it does represent a major roadblock for local governments," Ed Burtner writes. "It highlights the fact that local officials are limited to a reactive role in addressing the problems associated with prescription drugs abuse. That's unacceptable."

The Kentucky League of Cities supported three bills this year that would have regulated "pill mills," notes Burtner, who is on the league's executive board. None made it out of committee. "City officials throughout the state are committed to working with legislators, the Kentucky Medical Association and other interested parties to develop legislation that tackles prescription drug abuse head-on," Burtner wrote.

According to the Kentucky Office of Drug Control Policy, the abuse of prescription pain relievers in Kentucky is second only to marijuana. Prescription drug-related offenses increased by more than 13 percent in 2008. (Read more)

Adair hospital board broke meetings law, attorney general finds

Adair County Hospital's board of directors was wrong to hold a closed-session discussion about the future of an interim CEO because the discussion was about his retention, not posible discipline or dismissal, the Kentucky attorney general's office found. It also concluded the hospital board did not have sufficient cause to discuss a report by Spectrum Health Partners in private.

Adair County Community Voice Publisher Sharon Barton submitted a written complaint to the board chairman March 30 alleging the violations. To remedy the matter, she asked for a copy of the PowerPoint presentation that had been viewed during the meeting as well as any minutes, notes, records and any other documents that had been reviewed.

The board replied that it was "clearly entitled to discuss this issue in executive session" because it was a personnel issue and so exempt from public discussion.

Assistant Attorney General Amye Bensenhaver disagreed, saying the personnel exemption applies only to discussions that might lead to the appointment, discipline or dismissal of an employee, member or student. "This exception shall not be interpreted to permit discussion of general personnel matters in secret," she wrote. "The board acknowledges that the closed session discussion focused on securing the continued employment of the interim CEO and not on reviewing the comparative qualifications of competing applicants for the purpose of identifying the best qualified applicant to fill a vacant position. Although the potential for reputational damage exists where several individuals apply for a position and some must be eliminated based on their lesser qualifications, such potential does not exist where the discussion relates to the continued employment of a current employee."

Bensenhaver also said the board should not have discussed the Spectrum report in closed session. The board was obligated to give notice "in regular open meeting ... of the general nature of the business to be discussed in closed session," she wrote. In correspondence, the board said that the report "contained information on specific individuals that might lead to discipline or dismissal" or might lead to litigation. "Even with this additional information, we believe the board's ... compliance fell short of the statutory requirements," Bensenhaver wrote.

Ambulance providers raising fees to deal with rising costs

Ambulance services are being forced to raise their fees in order to pay the bills, USA Today's Greg Latshaw reports. "Ambulance providers nationwide are coping with rising costs, decreased support from local government, low Medicare reimbursement rates and a jump in the number of uninsured Americans," Stephen Williamson, president of the American Ambulance Association, told Latshaw.

Medicare reimbursement rates were between 6 and 17 percent below cost, a 2007 report by the Government Accountability Office showed. Since, that gap has grown even wider. Moreover, in the past 18 to 24 months, far more people are using ambulance services who don't have health insurance. "We're having to raise the rate on everyone else because of the people who don't have insurance," said Steve Weigland, director of servicing for the International Association of EMTs and Paramedics. (Read more)