Community health centers get federal grants to hire employees to help you shop for health insurance coverage

Kentucky's online health insurance exchange, Kynect, opens Oct. 1, 2013, and most Kentuckians must have health insurance by January of next year or face tax penalties having it. To help you get health insurance if you don't have it, the federal government is giving 20 of the state's 21 health centers outreach and enrollment grants totaling $2.83 million.

The government estimates that the money will help 61,539 people learn about and enroll in new health insurance plans through the Kynect website, and that the health centers listed below will boost their local economies by hiring a total of 52 additional workers.

These recipients are among 1,159 health centers across the country getting a total of $150 million.

If you're a Kentuckian shopping for insurance, you can use the Kynect website to see if you qualify for payment assistance, special discounts or tax credits to help cover the cost of the insurance.  You may qualify for insurance programs like Medicaid or the Kentucky Children's Health Insurance Program, and the website can also be used to compare insurance plans.

As October draws nearer, there will be additional assistance for Kentuckians, such as people called "Kynectors" who can be reached by phone or online and help you gather more information about what type of coverage may be best for you and your family.  Check here for more information or here to read more about the federal grants.

Tips to keep children safe from the dangers of summer heat

While enjoying time with family on the boat, at church picnics, in the backyard or at the beach, be sure to keep kids safe during the summer heat.

Heat can trigger three major illnesses, says Dr. Eric Kirkendall of Cincinnati Children's Hospital Medical Center. “Heat stroke, heat exhaustion and heat cramps are reactions caused by exposure to high temperatures combined with high humidity.”

The most serious reaction is heatstroke, which is a life-threatening emergency that should be treated immediately by parents and then by medical professionals. Symptoms can include hot, flushed skin, high fevers (over 104° F), confusion, and even seizures.

If you notice signs of heatstroke, call 911 immediately, cool off the child as quickly as possible by sponging the entire body with cool water, elevate feet to counteract shock and have the child drink cool, not cold water, while waiting for Emergency Medical Services to arrive, said Kirkendall. Do the same if treating the child for heat exhaustion, although it is not necessary to call 911 or a physician unless symptoms continue.

Heat exhaustion is less severe, but also requires medical attention. Symptoms include lots of sweating, nausea, dizziness, fainting or weakness. Heat cramps occur mostly in the child's abdomen and legs, especially the calf or thigh muscles, but symptoms do not include a fever.

Parents can take many steps to keep children safe by keeping them hydrated with water, limiting their time outside during extremely hot weather and encouraging inside breaks when they do play outside, said Kirkendall. Click here for more information.

State health department asks Kentuckians to help improve the state's health by commenting on improvement plan by Aug. 1

Yes, Kentucky ranks first in smoking and cancer deaths, 10th in obesity and poorly in other health measurements, but Kentuckians can help improve the state's health status by giving their thoughts on how to do that.

The state Department for Public Health is seeking Kentucky residents' input for the state health improvement plan, which will help the DPH determine priorities for positive changes. Residents can fill out an online survey through Aug. 1; the survey can be accessed by clicking here.

"Now is the time to make a move in the right direction," said state Health Commissioner Dr. Stephanie Mayfield. "Too many Kentuckians are dying from issues that can be prevented. This will take public health, community partners, and the general public to weigh in on the best strategies to move in that direction. . . . The main objective of the state health improvement plan is to address these negative health indicators by developing a road map to transform Kentucky from a state that consistently reports poor health status to one that supports dynamic initiatives to help Kentuckians lead healthier lives."

Prescription drugs killing more women than ever; Kentucky ties for fifth for its high percentage of deaths

The ongoing national epidemic of addiction to prescription painkillers is spreading more quickly among women, and it is killing more women than ever before. Kentucky ties Utah for the fifth highest percentage of female deaths due to prescription-drug overdose (15.7 percent), says a new government report.

Opioids, or prescription painkillers, are the leading cause of drug-overdose deaths among women, accounting for 70 percent of overdoses. And, although men are more likely than women to die from drug overdose and Kentucky has the highest rate of male deaths in the country (25.9 percent), the percentage increase in the rate of overdose deaths from 1999 to 2010 was greater for women (151 percent) than for men (85 percent). During that period, there was a 415 percent overall increase in opioid painkiller-related deaths among women, compared with a 265 percent increase among men, says a Centers for Disease Control Vital Signs report released last week. (CDC graphics)

Since 2007, more women have died from drug overdoses than from motor-vehicle traffic injuries and about five times as many women died from prescription-painkiller overdoses in 2010 as in 1999. About 6,600 of those deaths occurred in 2010 alone, and prescription painkillers are reported to be involved in one of every 10 suicides among women, says the report.

Across the nation, about 18 women per day die from prescription drug overdose and every three minutes, a women goes to an emergency room for prescription-painkiller misuse or abuse, which is more likely to occur in women between the ages of 25 and 54. The report also says the rise of deaths from prescription drugs relates closely to increased prescribing of these drugs during the past decade.

States can take action against the dangers of prescription drug abuse by increasing access to substance abuse treatment while reducing barriers to getting such treatment, says the report. It is also important to educate health care providers about effective pain treatment options and to educate the public about the risks and benefits of taking prescription painkillers. Click here for a PDF factsheet from the CDC.

AMA president, a Kentuckian, says doctors have a duty to make sure patients know about new health-insurance exchanges

Despite the mixed messages from many physicians about the Patient Protection and Affordable Care Act, Dr. Arvis Hoven, an internal-medicine and infectious-disease specialist in Lexington and the new president of the American Medical Association, said the physicians' lobby will do whatever is within its power to promote "Obamacare."

"Our job as physicians will continue to be to get our patients the type of care they need at the right time, at the right place, with the right provider," Hoven told Sarah Kliff of The Washington Post in an interview conducted for C-SPAN’s "Newsmakers." Transparency and communication with patients are important in making sure patients know about health- insurance exchanges, and the AMA can help the American public get the type of care they need and deserve, she said.

Although the law is polarizing and some AMA members don't support it, Hoven said the physician's responsibility is to the patient. "Some supported, some did not support it, but at the end of the day the American Medical Association and its policy body, the House of Delegates, came together in support of the Affordable Care Act."

It is a physician's duty to communicate elements of the law, such as the exchanges, to the patient and his or her family, Hoven told Kliff. As millions of people get added to the health insurance system, "Our job will be to teach them how to use health care insurance, how to get prevention and wellness care on the front end, how to be healthy and stay healthy."

Amid concerns over doctor shortages and the expansion of Medicaid, Hoven said she thinks there will be enough doctors, but it is important for them to emphasize team-based, physician-led care, utilizing all providers at their highest level of training. This will certainly be crucial for the Kentucky health system, since the state needed many more doctors and other medical professionals even before the Medicaid expansion, said a recent review by Deloitte Consulting.

Physicians and communities must work together to make sure there are enough health professionals, Hoven said: "This is work not only physicians need to be involved in, but communities need to be involved in, and we’re going to have to work together both publicly and privately to get this to happen." Click here to watch the entire interview.

Kissner, six Medicaid directors from other states picked for national institute

State Medicaid Commissioner Lawrence Kissner is one of seven state program directors to participate in the year-long Medicaid Leadership Institute, which Gov. Steve Beshear said will help Kissner's ability to deliver high-quality, cost-effective health care services to Kentuckians.

The Medicaid Leadership Institute was developed in 2005 to enhance strategic thinking and leadership skills among Medicaid directors, and it is managed by the Center for Health Care Strategies and funded by the Robert Wood Johnson Foundation.

The institute is directed by Carolyn Ingram, the center's senior vice president and a former New Mexico Medicaid director. Ingram said in a news release, “Each of these seven Medicaid directors is essentially the CEO of one of the largest health insurers in his or her state. . . . Commissioner Kissner and the other Medicaid directors chosen bring a diverse array of experiences to the Institute and will spur each other to take full advantage of opportunities to transform the nation’s health care safety net.”  Click here to read more or here for more information about the Medicaid Leadership Institute.

Kissner was named commissioner of the Department for Medicaid Services in June 2012.  He is a graduate of the University of Notre Dame with a bachelor’s in business administration and has nearly 30 years of experience in the private insurance industry.  He most recently served as president and CEO of Magnolia Health Plan in Jackson, Miss. He was president of UnitedHealthcare of Kentucky from 2004 to 2006, according to the department's website. 

Kentucky Spirit leaves the state; cabinet assigns company's clients to other Medicaid managed-care firms

By Molly Burchett
Kentucky Health News

About 125,000 Medicaid patients in Kentucky have a new insurance company, with Saturday's departure of Kentucky Spirit from the state.

The state Cabinet for Health and Family Services reassigned Kentucky Spirit's clients to Coventry Cares or WellCare, and sent letters to the clients last week notifying them of the reassignment. They will have 90 days to change companies if they are not satisfied with their new one.

The letters were conditional, because the state was still in a legal battle trying to keep the company in the state for two more months. Cabinet officials told Beth Musgrave of the Lexington Herald-Leader that Kentucky Spirit stopped serving Kentucky clients shortly after midnight Saturday, and that the cabinet will file a lawsuit seeking damages because Kentucky Spirit breached its three-year contract that began in 2011. "If successful, the state could win millions of dollars from Kentucky Spirit, a subsidiary of St. Louis-based Centene Corp.," Musgrave notes. The company alleges that it lost money because the state gave it incomplete information.

"We are staffed up and as prepared as we can be," said Michael Murphy, CEO of CoventryCares, in an interview with Kentucky Health News Wednesday. He said the company is planning to take on about 67,000 new members from Kentucky Spirit, and will cover them according to our existing contract with the state.

One of the biggest challenges will be coordinating transition efforts with pharmacies, because the state was unable to give Coventry the Centene data until the company actually left Kentucky, said Murphy. "We expect there to be a fair amount of confusion and chaos, he said, but CoventryCares is automatically authorizing a 3-day supply of medications while the systems get updated with new member information."

Cabinet spokeswoman Jill Midkiff said, "While we are disappointed that Kentucky Spirit has defaulted on its contract with the state and abandoned its members, both Coventry Cares and WellCare have agreed to work closely with the cabinet, providers and members to make this transition as smooth as possible."