Health

J. Tyler Franklin

Earlier this year, first grader Cora Maddox stopped receiving Medicaid benefits that helped pay for treatment of her apraxia, a brain disorder that affects her speech and motor skills.

Cora’s mother, Angie Maddox, a web designer from Boone County, had to supplement what the family’s private insurance wouldn’t cover for her child’s tube feedings and therapy sessions — a total of $1,500 a month that had previously been paid for by Medicaid.

Cora was one of thousands of Kentuckians who lost services while the state transitioned to a new one-stop portal for welfare benefits called Benefind, which was designed by previous Gov. Steve Beshear’s administration and rolled out in the first months of Gov. Matt Bevin’s.

“All of Cora’s information from the old system never got transferred to the new system,” Maddox said during a legislative hearing on Monday. “Everything was gone.”

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The state says a 73-year-old Louisville man has died of West Nile virus.

Health and Family Services Cabinet spokeswoman Beth Fisher says it is Kentucky's first death from the virus reported this year.

The state Health Department says Jefferson County typically reports a few cases of the virus each year, mostly during late summer and early fall.

The Clark County Health Department in southern Indiana, across the Ohio River from Louisville, identified two samples of mosquitoes infected with the virus this week in Charlestown and Jeffersonville.

The cabinet advises wearing bug repellent and protective clothing outdoors and staying indoors at dawn, dusk and early evening when mosquitoes are most active.

The cabinet's website says symptoms of West Nile may include a slight fever or headache, possibly with skin rash and swollen lymph glands.

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The nation's opioid problem comes with staggering physical and emotional costs to patients and families. But the financial burden on the health system has been harder to peg.

A report set to be released Tuesday shows a more than thirteenfold increase in spending by health insurers in a four-year period on patients with a diagnosis of opioid dependence or abuse.

From 2011 to 2015, insurers' payments to hospitals, laboratories, treatment centers and other medical providers for these patients grew from $32 million to $446 million.

While the latest figure represents a small portion of the overall spending on medical care in the United States, the rapid rise is cause for concern, says Robin Gelburd, president of Fair Health, a nonprofit databank that provides cost information to the health industry and consumers.

"That really shows the stress on the health system and the impact on the individuals," said Gelburd.

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Kentucky educators will be trained this week on how to administer a heroin antidote.  The drug Naloxone, also known by the brand name Narcan, is being made available to high schools who voluntarily choose to participate. 

Bowling Green Superintendent Gary Fields says he still hasn’t decided if his district will stock Narcan, which can also reverse the effects of prescription drug overdoses.

"I think anytime we ask lay people who aren't health care professionals to administer medicine, that's always a scary moment, but if we feel like it's going to possibly save the life of a student down the road, then I think we're going to have to move in that direction," Fields told WKU Public Radio.

The south central Kentucky region has not seen the rise in heroin experienced by Lexington, Louisville, and northern Kentucky.

Opioid High: Students Face A Different Kind of Test

Sep 11, 2016
Aaron Payne | Ohio Valley ReSource

It’s not just about notebooks and pencil boxes anymore: the opioid epidemic means back-to-school supplies now include things like emergency overdose treatments and drug prevention plans.

Many schools in the Ohio Valley region are using random drug testing despite doubts from addiction treatment experts about whether the tests really work to deter abuse.

A Tragedy, Then Testing

A new testing program takes effect this year in Belpre, Ohio, where students have witnessed the consequences of opioid abuse first hand.

On a recent Friday night, the Belpre High School football team made the trip to face Trimble in the second week of high school football.

Among the team leaders are Logan Racy and Aric Ross, who are both in their senior seasons.

Southwings and Vivian Stockman

The prestigious National Academy of Sciences recently announced a comprehensive study on the health effects of the controversial coal mining practice known as mountaintop removal. For coalfield residents who have long questioned what impact the dust, blasting, chemicals and water contamination was having, the announcement comes as welcome news, if somewhat overdue.  

A decade of efforts to research the health effects of living near mountaintop removal mining have often run into industry opposition, political roadblocks, and bureaucratic delays. After decades of questions and concerns there is now reason to believe that answers are on the way.

Longstanding Concerns

Concerns about how surface mining affects the people of Appalachia are nearly as old as the practice itself. West Virginia first regulated surface mining in 1939, and statements of concern and protest have long been a part of the culture in the central Appalachian coalfields.

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A powerful drug that's normally used to tranquilize elephants is being blamed for a record spike in drug overdoses in the Midwest. Officials in Ohio have declared a public health emergency and the U.S. Drug Enforcement Administration says communities everywhere should be on alert for carfentanil.

The synthetic opioid is 100 times more potent than fentanyl, the prescription painkiller that led to the death earlier this year of the pop star Prince. Fentanyl itself can be up to 50 times more deadly than heroin.

In the past few years, traffickers in illegal drugs increasingly have substituted fentanyl for heroin and other opioids. Now carfentanil is being sold on American streets, either mixed with heroin or pressed into pills that look like prescription drugs. Many users don't realize that they're buying carfentanil. And that has deadly consequences.

"Instead of having four or five overdoses in a day, you're having these 20, 30, 40, maybe even 50 overdoses in a day," says Tom Synan, who directs the Hamilton County Heroin Coalition Task Force in Southwest Ohio. He's also the police chief in Newtown, Ohio.

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Drug abuse is a health crisis in Kentucky, and the state's top health professional says it will get a lot worse over the holiday weekend.

Kentucky Health Commissioner Dr. Hiram Polk says an Emergency Health Alert has gone out to first responders, hospitals and addiction counselors to mobilize for a rash of overdose cases.

In the Midwest lately, including Kentucky, Indiana and Ohio, heroin on the streets is being cut and sold with Fentanyl.   

Fentanyl is the deadly drug that killed rock legend Prince, and is far more potent than heroin.

Hospitals and EMS are stocking up on the overdose-reversal drug naloxone. 

In just two days in Louisville, there were 28 overdoses, and Dr. Polk predicts much more over the weekend.

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Kentucky has the fifth highest obesity rate in the nation.

The commonwealth also has the dubious distinction of being only one of two states that saw an increase in obesity levels between 2014 and last year.

The figures come from a new report by the Trust for America’s Health and the Robert Wood Johnson Foundation.

Read the Full Report Here

The latest data show that 34.6 percent of Kentucky’s adults were obese in 2015. Kentucky had the third-highest rate of obese whites, and the fifth-most African-Americans who were obese.

Only Kentucky and Kansas saw an increased rate of adult obesity. Four states saw a decrease, and the rest were stable.

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Elizabeth Boccieri has been using meth and oxycontin in the past few days, ever since she heard about extra-strength laced heroin that’s been making its way south from Ohio to Louisville.

Law enforcement officials are worried that heroin laced with poison finally reached Louisville this week. Twenty-eight people have been hospitalized with suspected heroin overdoses in Louisville in the past three days, according to local hospitals. One died on Wednesday.

And while it will take weeks to for officials to determine whether the heroin is laced through toxicology testing, it’s what’s on virtually everyone’s mind who encounters the drug in some way.

“My mom is, like, begging me to not use heroin,” the 29-year-old Boccieri said. “There’s bad stuff going around. And so I’m trying to stay away from it.”

Two weeks ago, Boccieri ended her fifth stint in jail this year for heroin-related charges, she said. For 49 days, she detoxed from heroin and other drugs. But after doing hard drugs for almost half of her 29 years, the habit has become her life. She is back to living on friends couches and doing drugs.

24 Heroin Overdoses Reported in One Day in Louisville

Aug 31, 2016
Flickr/Creative Commons/Dimitris Kalogeropoylos

Public health officials in Louisville are warning of a spike in heroin overdoses in the city.

According to WDRB-TV, officials at Norton Hospital say there were at least 24 confirmed overdose cases in Louisville on Tuesday.

Dr. Robert Couch, an emergency physician at Norton, said at a news conference that he saw eight overdose patients within five hours.

He calls it a "public health emergency," saying the heroin on the street seems to be unusually potent. He says patients taking what would usually be a small amount are losing consciousness.

Couch says larger doses of naloxone, a widely available overdose antidote that many first responders carry, are needed to reverse the drug's effect.

The announcement comes after recent overdose spikes in communities in the neighboring states of Indiana, Ohio and West Virginia.

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Multiracial people in Kentucky are 30 percent more likely to have asthma, according to a new report from the Foundation for a Healthy Kentucky and the University of Kentucky released on Tuesday.

And multiracial “and other” race Kentuckians were more likely to report poor mental health than white or black Kentuckians, according to the report.

Those and other findings show stark disparities across health outcomes for non-white Kentuckians. They come from 11,000 phone surveys with people of all races between 2011 and 2013. The “other” category includes American Indians, Hawaiians and those with unspecified races.

The findings are from before Kentucky expanded Medicaid to include childless adults and people making up to 138 percent of the poverty limit ($11,880).

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Indiana’s health commissioner has declared a public health emergency in Southern Indiana’s Clark County that allows local officials to start a needle exchange to curb the spread of hepatitis C and HIV.

Commissioner Dr. Jerome Adams declared the emergency Monday, making the county the sixth in Indiana to win permission for a needle-exchange following an HIV outbreak in Southern Indiana linked to intravenous drug use. The five others are Fayette, Madison, Monroe, Scott and Wayne counties.

Clark County spent eight months trying to work out problems with its initial needle-exchange application. The county submitted a second application after ending talks with the Los Angeles-based AIDS Healthcare Foundation to pay for the program.

County health Commissioner Kevin Burke said state health officials didn’t support how that foundation would have funded the program.

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Treatment for life-threatening allergic reactions is about to get a little cheaper.

Mylan, the maker of the EpiPen, said Monday that it will launch a generic version of the device for half the price of the brand-name product.

The company says the generic will hit the market in a few weeks and cost $300 for a two-pack. That's less than half the price of a two-pack of brand-name EpiPens, which are available at Target pharmacies for about $630, according to GoodRX.

The move by Mylan comes in response to mounting pressure from consumers and Congress to lower the drug's price. In less than 10 years, the price for a two-pack of injectors has risen from about $100 to more than $600.

"This helps Mylan with its public relations battle against criticism for sharp price increases on the EpiPen," says Larry Levitt, a health policy analyst at the Kaiser Family Foundation. "The introduction of a lower-priced generic version may keep competitors out of the market."

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For at least the next seven months, give or take, there’s no need to worry that the proposed changes to expanded Medicaid benefits will affect your coverage.

Seven months is the average time it takes for the federal government to negotiate with a state over changes to Medicaid. And even then, some of the changes likely won’t happen.

On Wednesday, Gov. Matt Bevin submitted those proposed changes via what’s called a “Medicaid demonstration waiver” to the U.S. Department of Health and Human Services.

The Affordable Care Act was originally designed to extend Medicaid to residents in all 50 states who earn below 138 percent of the federal poverty limit, or $16,394 in 2016. But the Supreme Court famously struck down that provision.

Most states expanded Medicaid as the ACA plan set out several years ago. But a handful of states, now including Kentucky, have applied for waivers to change what the federal government intended for expansion.

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