News

New Law will improve access to birthing centers

Fri, 6 Jun 2025 16:39:00 GMT

Kentucky midwives say new state law will improve access to birthing centers

Appalachia + Mid-South Newsroom | By Sylvia Goodman

Published June 5, 2025 at 6:00 AM EDT

https://www.lpm.org/news/2025-06-05/kentucky-midwives-say-new-state-law-will-improve-access-to-birthing-centers

After years of advocacy, freestanding birth centers will soon be easier to open in Kentucky, as activists say many women go to neighboring Tennessee and Indiana for childbirth.

Shannon Long, a certified midwife with a doctorate in nursing, has thought about opening her own freestanding birth center for years. After working in hospitals for more than two decades, Long said she wanted to get away from policy-driven care.

“There's a population of people out there that don't feel comfortable delivering at home, and they really don't want to deliver in a hospital, so the birth center is a good fix for those people,” Long said.

Long, who lives in Danville, imagines a house with a living room and kitchen, where each patient has their own bedroom. She said she would want her birth center to have its own backyard and have an open feeling, even if it's close to the city.

“Just kind of make it look like home,” Long said.

Kentucky doesn’t have any birth centers that aren’t attached to hospitals, at least not yet.

Though birth centers are legal in the state, midwives and providers have struggled to open them because of certificate of need laws that require new facilities to prove there’s a need for that service in the area. The laws have made it difficult to open birth centers within reach of hospitals.

Now, thanks to a Kentucky law passed this year and set to go into effect later this month, birth centers with for beds or less in Kentucky will be exempt from the certificate of need process. While it likely won't be some time until any centers can open as the state creates regulations, it’s something midwives like Long have been fighting for for years.

Mary Kathryn DeLodder, who volunteers with the Kentucky Birth Coalition, said she’s been working on a legislative fix to the birth center dilemma since 2020, when Middletown GOP Rep. Jason Nemes first proposed exempting the centers from the arduous certificate of need process. DeLodder says it was a natural progression for the group, which previously saw success pushing for a certified professional midwife designation.

“It's just kind of a natural progression that we took on as the next step to continue to expand birth options,” DeLodder said. “To have another place where midwives can practice in an out-of-hospital setting in Kentucky, because not everybody wants a home birth, not everybody wants a hospital birth, and there's nearly no middle ground.”

Crossing State Lines

DeLodder said it took a long time to compromise enough with rural hospitals concerned about their solvency and obstetricians worried about patient safety. But DeLodder said patients are already leaving the state to access the care that they want. In Louisville, some families opt to head for the Tree of Life Family Birth Center in Jeffersonville, Indiana, instead of delivering in Kentucky. Meanwhile Kentuckians living near the Tennessee border sometimes choose to cross rather than give birth in the state, DeLodder said.

“It's not fun to travel in a car when you're in labor, for anybody who's ever done that, trying to get to the hospital,” DeLodder said. “We want those families to not have to go that far to be able to stay in Kentucky, be close to home, not have to then travel two hours back home, if that's the case, once they've got a newborn with them.”

Not only has the prohibition meant patients crossing state lines, but providers too. Jenny Fardink, and her business partner Christy Peterson are licensed midwives in both Tennessee and Kentucky. They own Clarksville Midwifery and are hoping to open their own birth center just over the Tennessee border in fall this year. Fardink said she just had to pull the trigger and begin finalizing her own birth center plans after waiting years for Kentucky laws to change.

“We were hoping the last two years that it was going to pass in Kentucky, and then we would have opened in Kentucky,” Fardink said.

She said many of her clients are based in Kentucky and she otherwise appreciates the laws surrounding midwifery in Kentucky, but right before the state legislature moved to change the certificate of need laws to exempt birth centers, Fardink and Peterson got approval from Tennessee to open their own clinic.

“We thought it was going to pass last year, and we've been planning birth centers for so long that it's kind of like you have a plan in place, you know what you need to do, and you just start moving,” Fardink said.

Fardink said she knows hospitals were concerned that birth centers would take away their clientele, but she said many of her patients would have gone to great lengths to receive midwifery care or might opt for a home birth instead. She’s had patients calling from well outside her one hour radius, seeking a non-hospital option.

“We try really hard to accommodate people and come up with creative ways for people to be a little bit closer, so that we all feel safe,” Fardink said. “Sometimes people will deliver at a friend's house or relatives house, if they can.”

Ensuring safety

When bills to make birth centers easier to open first began appearing in the legislature years ago, some medical providers in the state were concerned about how it would affect patient care and their own revenues. Cory Meadows, the deputy executive vice president of the Kentucky Medical Association, said they are now “neutral” on the birth center portion of the bill, and believe that the ultimate version has enough safeguards to ensure patient health.

The birth center provisions were part of a larger bill that drew great scrutiny from medical providers by the end of the session. Toward the end of the session, legislators slotted in provisions to update the state’s abortion ban. That new piece of the bill got a lot of attention, but the original provisions on birth centers survived.

House Bill 90 in its final form requires centers to get accreditation from the Commission for the Accreditation of Birth Centers and medical malpractice insurance. It also requires centers to be within 30 miles of a hospital and have a transfer agreement in place with one of the nearby hospitals. The center also needs to have a licensed doctor on staff as a medical director, largely in an advisory role.

“The bill lays out a number of requirements for birthing centers. Now, the devil is always in the details,” Meadows said. “We do remain interested and will remain engaged in monitoring whatever regulations are released, and if necessary, will comment.”

While HB 90 laid out several rules and safety precautions, it also left a lot up to the state to create more regulations, giving the Cabinet for Health and Family Services until December 1 to update its rules. Meadows said he is particularly watching regulations around a potential loophole in the bill that allows centers to avoid a transfer agreement if they can submit “evidence of a failure by a hospital” to enter a patient transfer agreement.

DeLodder with the Kentucky Birth Coalition said regulations on things like insurance and facility requirements could make or break the viability of centers in the state.

“We haven't had any birth centers open in Kentucky since the mid 1980s so the regulations that exist around birth centers haven't been really substantially updated since that time,” DeLodder said. “So for somebody who really wants to open a birth center, they need to know what all the rules are going to be before they start to pursue that, so they can make sure that they have everything in place.”

Long, who worked as an obstetric nurse for 22 years before turning to midwifery, said she knows what the standard of care is in hospitals. She said that hospital policies don’t work for all women — rules requiring women remain lying down for labor or must be hooked up to monitoring machines and have an IV placed.

“There's people that's going to deliver in the hospital period because they want an epidural and you have all the access to emergency C-sections,” Long said. “But there's still such a need for people who don't want the hospital setting, that would desire a more natural setting, more peaceful, not so rushed.”

Long, who is currently working toward certification as a nurse midwife, said the new certification would allow her to deliver in a hospital. She knows how to screen for complications that could mean a more dangerous delivery.

She encourages her clients to go through standard testing, but tries not to be “pushy.” Long hopes being more understanding and taking the time to explain the evidence and research behind different procedures will help improve outcomes among communities that typically forgo testing or are distrustful of the medical establishment.

“I think that's why most people deliver in the home setting, because they don't want the pressure of what is required at the hospital,” Long said.

Long said she also hopes any facility she opens will be able to address maternal care deserts in the state – especially in her region in central Kentucky. While Casey and Russell counties to the south both have a hospital, neither of those hospitals have dedicated maternity units.

“That's the most important thing about the birthing center is it will provide another avenue of safety to improve our outcomes,” Long said. “A lot of people who live in rural areas, they acknowledge that if they deliver at home, it'll be a good hour … before they could get to a hospital. So the birthing center mitigates that for them.”

State government and politics reporting is supported in part by the Corporation for Public Broadcasting.

This story was produced by the Appalachia + Mid-South Newsroom, a collaboration between West Virginia Public Broadcasting, WPLN and WUOT in Tennessee, LPM, WEKU, WKMS and WKU in Kentucky and NPR.

Donate now to Aid E Ky Flood Relief

Sun, 31 Jul 2022 02:52:00 GMT

Aid Flood Relief in Eastern Kentucky

KANPNM will turn your donations into the supplies needed to assist people and clean-up efforts in the flood ravaged areas of Eastern Kentucky.
 
Impassible roads, lingering high water and damage to communications infrastructure is making it difficult to communicate with people inside the flooded areas. News reports quote Governor Beshear as saying that rescue crews have made more than 1,200 rescues from helicopters and boats. Weather forecasts predict more rain is expected in the coming days.
KANPNM members live in many of the affected counties and work at affected clinics, health departments and hospitals. It is easy to imagine APRNs and their health care colleagues staying at work to care for those rescued from the flood while the rain falls and their own homes are in danger.
Join our efforts to make sure these communities have the supplies they need to address the many needs and challenges of the coming days.
 
HOW YOU CAN HELP
Your donation using one of these KANPNM links will raise money that the Association will use to purchase and deliver the items that will assist in care and clean-up efforts. Thank you for your generous support!

                                                            DONATE $10 

                                                            DONATE $25 

                                                            DONATE $50 
 
                                                            DONATE $100 
 
News Reports of the Flood Event, Additional Rainfall expected
Gov. Beshear: Death Toll from Eastern Kentucky Floods Rises as Search and Rescue Efforts Continue 
Death toll hits 16 in Kentucky floods; victims include 4 young siblings    
Appalachian flooding deaths set to climb; more rain forecast 
Missing Persons
Kentucky State Police is responding and actively searching for missing people.
If you wish to report a missing loved one in the counties of Breathitt, Perry, Knott, Letcher or Leslie counties, contact Post 13 Hazard at 606-435-6069.                        
If you wish to report a missing loved one in the counties of Magoffin, Johnson, Martin, Floyd, or Pike counties, contact Post 9 Pikeville at 606-433-7711.
If you wish to report a missing loved one in the counties of Jackson, Owsley, or Lee counties, contact Post 7 Richmond at 859-623-2404.
If you wish to report a missing loved one in the counties of Wolfe or Morgan counties, contact Post 8 Morehead at 606-784-4127.
If you wish to report a missing loved one in Harlan County, contact Post 10 Harlan at 606-573-3131.
Please note phone lines are extremely busy right now. It may take a while to get through.
A command staging area has been established at the Hazard Armory for emergency personnel only. The public should not travel to the affected areas until emergency personnel gives the all-clear.

DONATE $10	DONATE $25
DONATE $50	DONATE $100

Ky Nursing Leadership Highlighted in Media

Fri, 26 Mar 2021 01:34:07 GMT

Kentucky Nursing Leadership During Pandemic, USA

Contributors: Dr Janie Heath, Dean of the University of Kentucky College of Nursing, Warwick Professor of Nursing & President of the Kentucky Nurses Action Coalition; Dr Ruth Carrico, Professor of Medicine, University of Louisville Division of Infectious Disease & Immediate Past President of the Kentucky Nurses Association;

Contributors: Dr Janie Heath, Dean of the University of Kentucky College of Nursing, Warwick Professor of Nursing & President of the Kentucky Nurses Action Coalition;
Dr Ruth Carrico, Professor of Medicine, University of Louisville Division of Infectious Disease & Immediate Past President of the Kentucky Nurses Association;
and Delanor Manson, Chief Executive Officer, Kentucky Nurses Association, Kentucky Nurses Action Coalition, and Kentucky Nurses Foundation

On the occasion of World Leadership Day on 20 March, ICN brings you a story of strong nursing leaders who – like so many others around the world – are fighting on the frontlines of the battle against the COVID-19 pandemic and providing quality nursing education to the next generation of nurses.

When the World Health Organization declared 2020 as “The Year of the Nurse and Midwife,” no one imagined it would look like this. That declaration will be in our hearts forever as nurses throughout the world continue to march through the COVID-19 pandemic storm.

Just like Florence Nightingale, mother of modern nursing, and Mary Jane Seacole, British-Jamaican nurse and businesswoman, did in the Crimean war, nurses today are sacrificing to put others above themselves. From 9/11 to Ebola to Hurricane Sandy— nurses in the USA have met each challenge with courage and compassion. The COVID-19 crisis has not been any different and, in Kentucky, a nursing collaborative was established to shepherd the commonwealth, its citizens, nurses and students through the crisis.

Efforts have been around the clock, regardless if serving on the frontlines of care delivery, conducting virtual research experiences, providing innovative telehealth alternatives or converting educational environments to online learning. Over 80,000 nurses have been supported by the Kentucky Nurses Association (KNA) to help maintain safety and wellness.

Other nursing organisations, the Kentucky Organization of Nurse Leaders and the Kentucky Board of Nursing, stepped up too. Every day, they advocated for nurses’ safety and protection as they faced supply chain shortages of Personal Protective Equipment (PPE), infectious patient surges and new evidence on COVID-19 treatment and containment.

Academic nurse leaders throughout Kentucky also stepped up to support students’ success notwithstanding tremendous pressures with state budget cuts. Faculty found creative solutions to help students’ complete required clinical hours despite many healthcare facilities limiting student access. In Kentucky alone, 3,000 undergraduate nursing students graduated by the end of 2020.

In addition to everything Kentucky nurse leaders did, they remembered nurses are human too. They recognised “emotional” PPE (e-PPE) was critically needed to address the mental health tsunami that nurses faced personally and for their patients, families and communities. Perhaps that is the single most important impact they made as, sadly, nurse suicide rates are now higher than in the general population in the United States and we cannot afford to lose one more life to suicide in the nursing workforce.

Kentucky nurses felt the stress of their circumstances, on the job and at home. In the middle of one crisis after another, they provided comfort and care to patients as well as their own families and friends—some of whom faced hardships due to lack of childcare, job loss, active COVID symptoms, and a divided country.

Generous Kentuckians donated time and money for statewide distribution of PPE, including masks and hand sanitizers, and e-PPE, including the KNA Apricot Ribbon and Sign Campaign. Over 1000 ribbons and 600 thank you signs were distributed and prominently placed throughout Kentucky’s 120 counties. Nurses were publicly recognised for their tireless dedication for care delivery during the pandemic.

The color of apricot was chosen for the ribbon campaign because it is the “academic color for nursing” and the orange palette represents “warmth, optimism and hope”. The ribbons wrapped around trees, lamp posts, and other landmarks to lift the spirits of frontline providers.

Dr Camille Burnett helped launch a statewide public letter-writing campaign called Heart-2-Heart, a partnership between the University of Kentucky Colleges of Nursing and Agriculture, Food and Environment. The, now a national initiative, included a network of young members of Kentucky’s 4-H Youth Development Program of Fayette County, encouraging them to make cards, draw pictures and write letters supporting healthcare workers in COVID-19 hotspots. To date, over 3000 nurses in Kentucky have received Heart-2-Heart cards.

Building multiple platforms for widespread distribution Heart-2-Heart campaign such as social media, educational conferences and academic environments, Kentucky nurse leaders continue to dedicate resources to advance e-PPE efforts. Crisis management research has repeatedly demonstrated that adversity, such as a pandemic, in the middle of racial unrest and a presidential election does not have to hold us back from reaching our greatest potential. Collectively, the Kentucky nursing community has stayed resilient and strong though challenging times. By working together, staying connected and communicating intentional strategies, such as below, they have emerged stronger and healthier.

Staying focused on what we can control – stopping COVID-19 single handedly is out of our hands but you can control how you react to the challenges by following CDC recommendations for handwashing, social distancing and disinfecting surfaces.
Taking time to breathe and reflect – thinking about how our new world with COVID-19 brings opportunities for creative adjustments and family connections by returning to simpler times in our lives with walking outdoors, eating dinners together and playing board games.
Practicing gratitude – finding something positive every day and being grateful for simple things like beautiful days of sunshine or spending more time with pets is vital to health and mental wellness.
Taking care of ourselves – prioritizing “me time” in the middle of a crisis is challenging but critical if you are going to come out healthy on the other side. You must get adequate sleep, exercise and eat healthy so you can take better care of others and your communities. Kentucky nurses—along with thousands of health care professionals and service industry workers—are keeping their state and nation afloat right now.

Kentucky nurse leaders are grateful for the relentless efforts of so many to continue building a culture of health and strengthening the nursing workforce during unprecedented times. #TogetherKY #KYNursingStrong

For questions about the Heart-2-Heart campaign or for information on how to get involved, contact heart2heart@uky.edu

What's this about a subsidiary?

Thu, 21 Sep 2017 16:27:42 GMT

By: Danny Albertson, Beth Partin, Cathy Waits, Ellen Thomson, Judi Kuric, Carol Darwin, Leila Faucette

The Kentucky Coalition of Nurse Practitioners & Nurse-Midwives is a tax-exempt organization under IRS Code Section 501(c)(3). The Coalition was formed in 1988 to, among other things, provide education to Kentucky APRNs, and to improve access to care and health in Kentucky. In 2013, we began having conversations about whether certain of the Coalition’s activities might be better conducted out of a new organization. It seemed to us that some of the activities were also the type that can be conducted by a classic trade association (exempt under Section 501(c)(6). Using such an organization would allow us to carry out or expand certain activities that are better suited to an association.

During our annual general membership meeting, last April, an announcement was made about this new organization. We wanted to take some space in this newsletter to give you some background on the subject. For the Q&A below we’re calling the subsidiary the “Association” and our existing, parent organization the “Coalition.” While we refer to the Association as a “subsidiary,” it is not one in the traditional sense, since control is not maintained via stock ownership, but rather via board appointment.

Q. What exactly is occurring?
A. The Coalition is in the process of forming a new Kentucky nonprofit corporation, which will apply for exempt status under Section 501(c)(6) of the Code. The activities of the Coalition and the Association will be separate activities, but the two organizations will be tightly connected by virtue of the fact that the Coalition will appoint (and can remove) the board of directors of the Association.

Q. Why is the Coalition going to the trouble and expense of forming a subsidiary organization?
A. So that it can conduct certain activities, in type or magnitude, that a Section 501(c)(3) cannot, and to expand the reach and strength of the Coalition. This will help with our effort to move toward Full Practice Authority for the APRNs of Kentucky. The Coalition leadership, in fact the entire board of directors, is committed to putting all necessary resources toward this initiative.

Q. What does this subsidiary have to do with our legislative goals?
A. Section 501(c)(6) organizations do not have the limits on lobbying that Section 501(c)(3) organizations do. It is also the better vehicle for promoting the APRN profession and increasing its visibility in the Commonwealth. Unlike the Coalition, the Association will also be permitted to engage in political activities.

Q. Are there other considerations?
A. Yes, the Association has the potential to offer health insurance for purchase by its members and the Association can also work for more discounted relationships with vendors. These activities are off-limits to the Coalition.

Q. As a member of the Coalition, why should I support this decision to form the Association?
A. Because it strengthens Coalition through its common mission with the Association and allows the “system” to move into new areas.

Q. But I don’t want another membership. Must I participate with the Association?
A. We understand! The way this will work is that, by virtue of being a member of the Coalition, one will automatically be a member of the Association. There will be a single dues statement, with an allocation of dues set out on the statement. Your check will be made out to one organization, and that organization will transfer the other organization’s allocatable amount to that organization. In addition, there will be one website login.

Q. When is all this happening?
A. The plan, approved by the Coalition’s board of directors, is to roll out the Association’s proverbial red carpet shortly after January 1, 2018.

If you have other questions we didn’t cover here, please feel free to contact Danny Albertson at vice.president@kcnpnm.org ro join the Virtual Town Hall Meeting on Wed., October 4th at 7:00 PM Eastern/6:00 PM Central.

Join by video from PC, Mac, Linux, iOS or Android:
https://zoom.us/j/835393327

Or iPhone one-tap :
US: +16699006833,,835393327#

Or Telephone：
US: +1 669 900 6833 Meeting ID: 835 393 327

All members are encouraged to attend!

Senate Bill 7: A Collaborative Success using the Nursing Model

Mon, 14 Apr 2014 19:47:43 GMT

Senate Bill 7: A Collaborative Success using the Nursing Model

You see no byline here. This story cannot be told with one voice. And, just like advanced practice nursing takes the wide view – not of disease, but of the health of the patient, health of the family, and health of the community – this is the story of the community we lovingly call “The Coalition”.

As a community, not taking credit for something we have done causes us to become invisible. You could say invisibility is a consequence of this humility. Yet, where facial details are unclear there’s a strong backbone and flexible spirit. Collective strength is revealed when individuals come together as a greater whole, a collaborative coalition.

The passage and signing of SB7, ending the career-long requirement for the CAPA-NS in Kentucky is our story, our success. If you had a part in it, you know it. If you made just one call to the message line in the past five years, you had a part. If all you did was keep your dues current, you had a part. If you haven’t been a member or haven’t been participating, this is a warm invitation to become an active part of a growing solution to the complex issue of health care. No matter who you are and no matter what your level of interest or involvement, if you’re an APRN practicing in Kentucky we want your commitment to be a part of us.

To some our legislative success may seem like no big deal. Being able to shred the CAPA-NS after four years doesn’t affect many of us or how we will practice. But, the wider view needs to include what didn’t happen. SB 7 was a compromise agreement. Think back to the last two legislative sessions when our colleagues in medicine sought legislation which threatened advanced practice nursing with direct supervision by physicians and regulation - not by our own professional board - but by the board of medical licensure. These defensive successes were a lot like that of the Seattle Seahawks in the Super Bowl. When their strong, steady defense shut down what everyone thought to be the Goliath of scoring machine offenses. Defensive football isn’t as glamorous as those long passes drilled into the end zone. Like football, defensive success in legislative battles aren’t nearly as fun to celebrate. But, in the case of SB 7, people, we have played excellent defense, with a deep, bench. A deep bench, 2200 strong!

Please wait until you get a definitive date from us before you burn or otherwise mutilate your CAPA-NS! We will be in close communication with KBN and inform KCNPNM membership of the new procedures as they unfold.

It’s a long walk to Frankfort by yourself. Join us and together we can increase access to health care across Kentucky. Become a member at www.kcnpnm.org

Health Dept: 2 more flu deaths reported in NKY, including child

Wed, 8 May 2013 19:03:43 GMT

April 19, 2013 (FOX-19) The Northern Kentucky Health Department says two additional deaths have been reported as a result of the influenza virus.

That brings the total number of flu deaths in the region this year to eight, with the most recent being a Campbell County man and a child.

Recent flu activity in Northern Kentucky shows that the spread of the virus may be slowing down, but is still proving serious for some.

A total of 40 cases were reported for the week ending April 13, compared to 78 the previous week.

Through April 13, 2013, a total of 3,428 cases of flu have been reported in Northern Kentucky. This makes the 2012-2013 season the highest ever.

Kentucky Health Benefits Exchange Call Center Will Create 100 Jobs

Wed, 8 May 2013 19:01:07 GMT

April 19, 2013 (WTVQ-DT) Governor Steve Beshear announced Friday that Xerox will create 100 new jobs by creating a Kentucky-based call center for people looking for health insurance information through the Kentucky Health Benefit Exchange.

Workers will offer information to callers about available health care coverage offered through the Exchange which is part of the Affordable Care Act.

The call center will open August 1st, just ahead of this fall's launch of the Health Benefit Exchange which is an online marketplace where people can search and compare health insurance plans from different companies.

Governor Beshear said he wants people looking for affordable health plans to "have access to real people who can help them answer questions."

Xerox will establish call centers in Frankfort, Lexington, and London with the potential for other locations around the state creating more than 100 new, full-time jobs.

Federal funding from the Affordable Care Act will support the startup, staffing and training of the call center through 2014.

You can find more information about the Kentucky Health Benefits Exchange here.

CRE: Mandatory reporting of 'superbug' soughtCRE: Mandatory reporting of 'superbug' sought

Wed, 24 Apr 2013 20:09:34 GMT

April 12, 2013 (The Courier-Journal) A state legislator from Louisville and the leader of a national watchdog group are calling for a new rule that hospitals report all CRE "superbug” cases to the state — a measure they say would better control the potentially deadly bacteria.

After reading a story in The Courier-Journal last month about the rise in CRE locally, state Rep. Tom Burch, D-Louisville, sent a letter to Gov. Steve Beshear seeking support for mandatory reporting of CRE bacteria, and he plans to introduce a bill on the subject in next year’s General Assembly.

Poll Shows Health Care Costs are a Burden for Many Kentuckians

Wed, 24 Apr 2013 20:06:47 GMT

April 11, 2013 (WEKU 88.9) A recent statewide survey shows health-care costs are a burden for many Kentuckians, especially for those who are poor and don't have insurance and put off getting care they need because they can't afford it. More than 60 percent of Kentucky adults in the poll said high costs forced them or a family member living in their home to delay getting care in the past year. Not surprisingly, almost 90 percent of uninsured respondents reported going completely without care in the past year.

Ky. poll finds 40% delay health care because of cost

Tue, 16 Apr 2013 16:06:05 GMT

April 10, 2013 (Cincinnati.com) Results of a 2012 Kentucky Health Issues Poll show that a majority of people in the state consider health care costs a financial burden and 40 percent have delayed medical procedures because of the expense.

Of those, a higher number of people said deductibles are more of a drain than insurance premiums or copays.

The 2012 Kentucky Health Issues Poll was funded by the Health Foundation of Greater Cincinnati.

Jennifer Chubinski, director of community research for the Health Foundation, said the survey demonstrates some of the consequences of a shift in the business model for health care.

"The question about what creates the greatest financial burden has never been asked by us before,” Chubinski said. "It shows that not only are health insurance costs increasing, but so is the burden carried by employees.”

Nurses want bigger role in medical care

Mon, 8 Apr 2013 18:09:45 GMT

April 4, 2013 (The Body: The Complete HIV/AIDS Resource) According to the Kentucky Health Issues Poll (KHIP), only 32 percent of Kentucky adults ages 18 to 64 report that their medical provider has discussed HIV testing with them, despite CDC recommendations for routine HIV screening. The poll indicated that doctors are most likely to talk about HIV testing with "younger, lower-income, and African-American adults." Forty percent of African-American respondents stated that a medical provider had discussed HIV testing with them, compared to 30 percent of white respondents. Only 23 percent of adults ages 46 to 64 reported their medical providers had talked with them about HIV testing. KHIP results also indicated that 40 percent of Kentucky adults have never been tested for HIV.

Will Kentucky expand Medicaid, and if so, how?

Thu, 4 Apr 2013 17:59:49 GMT

March 29, 2013 (The Morehead News) Kentucky is one of the last states to decide whether to Medicaid under federal health reform, and now that the General Assembly has gone home, Democratic Gov. Steve Beshear can turn his attention to the many questions that linger.

Some Republican legislators think he will expand the program, but they worry about the cost when the state would have to start helping cover the new expenses, beginning in 2017.

Republican Gov. Bill Haslam of Tennessee decided Wednesday that he will not pursue Medicaid expansion, saying that it could put hospitals in financial jeopardy by giving them more patients on which they lose money, reports Michelle Kaske of Bloomberg. If he is right and the same logic applies to Kentucky, Medicaid expansion in the state could harm the rural hospitals and providers -- some of whom are already squeezed by the issues with the new managed-care system.

Along with Kentucky, 10 other states are undecided about Medicaid expansion: Alaska, Indiana, Kansas, Nebraska, New York, Oregon, Utah, Virginia, West Virginia and Wyoming.

Study suggesting that coal is a cause of health problems in E. Ky.

Thu, 4 Apr 2013 17:14:55 GMT

March 21, 2013 (Kentucky Health News) A heated debate centers on new research showing that residents in Floyd County, where coal is stripped from the tops of mountains and ridges, report more health problems than those in two nearby communities without such mines, Elliott and Rowan.

The study, published in the online Journal of Rural Health, is the latest by Dr. Michael Hendryx of West Virginia University to suggest that residents of mining areas have poorer health conditions and experience more serious illness. It is available to readers of Kentucky Health News by clicking here.

New health ranking of counties places Oldham at top for second straight year; some counties had big

Mon, 25 Mar 2013 19:26:21 GMT

March 21, 2013 (Kentucky Health News) A new report of the national county health rankings shows several Kentucky counties have improved in the last two years while others have gotten significantly worse.

For the second year in a row, Oldham County ranked best in health outcomes, and Floyd County ranked worst this year, but the statistical differences among closely ranked counties are so small that they are subject to error margins. The rankings recognize that by placing the counties into quartiles, or fourths, of the state's 120 counties.

Legislature eases physician assistant rules; nurse practitioners' prescription power, Medicaid promp

Mon, 25 Mar 2013 19:12:28 GMT

March 19, 2013 (Kentucky Health News) The Kentucky General Assembly has joined other states in easing the restrictions on physician assistants’ medical practice, but has held up a similar move for advanced registered nurse practitioners. Both issues relate to the shortage of medical practitioners in many Kentucky counties, and the quality of medical care.

Health rankings reveal Perry as second unhealthiest county

Thu, 21 Mar 2013 16:43:33 GMT

March 20, 2013 (Hazard Herald)

This year’s "County Health Rankings” have been released, and once again Perry County ranks as one of the least healthy counties in the state.

Out of 120 counties, Perry has taken the 119th spot with Floyd County beating it out for the least healthy county in Kentucky. This is the fourth year the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute have conducted this report, which ranks the overall health of nearly every county in all 50 states. Since the first rankings were released in 2010, Perry has consistently ranked among the state’s top 5 unhealthiest counties.

Website makes reporting suspected child, adult abuse easier

Tue, 11 Sep 2012 12:26:30 GMT

State Launches New Abuse and Neglect Reporting Portal

Website makes reporting suspected child, adult abuse easier

FRANKFORT, Ky. (Sept. 10, 2012) – The Kentucky Department for Community Based Services (DCBS) has launched a new web-based abuse/neglect reporting portal that will modernize and enhance the current intake system.

The online Kentucky Child/Adult Protective Services Reporting System makes it convenient, confidential and secure to report non-emergency situations that do not require an immediate response from DCBS staff.

DCBS, part of the Kentucky Cabinet for Health and Family Services (CHFS), is the state’s primary agency for child and adult protection.

DCBS Commissioner Teresa James said the system was created to better protect Kentucky’s children and vulnerable adults.

"The safety of Kentucky’s children, adults and seniors depends on a shared responsibility,” James said. "We launched this website so concerned members of the public can more easily report suspected abuse and neglect and so that child and adult welfare investigators and law enforcement officials can better do their jobs.”

The website can be accessed at https://prd.chfs.ky.gov/ReportAbuse/home.aspx, and will be monitored from 8 a.m. to 4:30 p.m. EDT, Monday through Friday. Website reports will not be reviewed during evenings, weekends or state holidays. If situations arise during these times indicating a child or adult is at risk of immediate harm, these should be reported to 911, local law enforcement or (877) KY SAFE1.

The website is accessible by any computer or smartphone.

James said the ease and immediacy of the portal should make the reporting system more efficient.

"Reporting suspected abuse and neglect is the right instinct, and it is the law in Kentucky,” James said. "With this new tool, we are giving people another direct method to contact our intake staff. If you see something of concern -- don’t wait, make the report.”

Professional partners like law enforcement and judicial officials, medical professionals, educators, child and senior caregivers and other advocates have been using the program since July. Users have given feedback to DCBS staff to help refine the system for the general public.

Users of the portal are required to enter an email contact and will receive an immediate, automated response that their online report has been made. Centralized intake staff will review reports as they are submitted. Users will receive a response message within 48 hours only if their report has not been accepted because it doesn’t meet criteria for investigation. Reports that are accepted do not generate a follow-up email message.

The reporting portal has several mandatory input fields so that intake staff can get adequate information about the incident, the alleged victim, the alleged perpetrator and any safety issues in order to screen reports effectively. Users who cannot complete information in all the required fields should call the toll-free reporting hot line: (877) KY SAFE1 or (877) 597-2331.

Learn more about recognizing the signs of child and elder abuse at http://chfs.ky.gov/dcbs/dpp/.

Cantaloupes Connected to Statewide Salmonellosis Outbreak

Fri, 17 Aug 2012 17:11:42 GMT

Cantaloupes Connected to Statewide Salmonellosis Outbreak

Public Advised to Avoid Eating Melons Grown in Southwestern Indiana

FRANKFORT, KY (Aug. 17, 2012) - The Department for Public Health (DPH) today reported that cantaloupes tested in the state public health laboratory carry the same strain of Salmonella associated with a statewide outbreak that health officials say is still ongoing.

The salmonellosis outbreak, which has sickened at least 50 Kentuckians and been associated with two deaths, began in early July. Through an epidemiological investigation and confirmatory lab testing, Kentucky public health officials determined that cantaloupes, which evidence indicates were grown in southwestern Indiana but purchased in Kentucky, carried the same strain of Salmonella determined to be the cause of an ongoing outbreak of infection. Salmonellosis cases caused by the outbreak strain have also been reported in other states. In addition, investigation is also continuing into other clusters of salmonella cases in Kentucky, which may be linked to cantaloupe or watermelon consumption.

"Foodborne illness is a serious threat to public health. Consumers are advised to avoid eating cantaloupes from southwestern Indiana, especially if they are at heightened risk for complications from salmonella infection,” said acting Public Health Commissioner Steve Davis, M.D. "In addition, healthcare providers are encouraged to be mindful of patients who may have symptoms consistent with salmonellosis and report all cases to the local health department.”

The U.S. Centers for Disease Control and Prevention is collaborating with public health officials in affected states and the U.S. Food and Drug Administration (FDA) to investigate the ongoing outbreak, including tracing the source of the affected melons and shipments of melons that may have been contaminated. A likely source of the outbreak is cantaloupes grown in southwestern Indiana region and distributed to stores in Kentucky. No Kentucky-grown cantaloupes have been associated with this outbreak.

Salmonella infections are relatively common, generally resulting in diarrhea, fever and abdominal cramps 12–72 hours after infection. Infection is most often diagnosed by culture of a stool sample. The illness usually lasts 4-7 days. Although most people recover without treatment, severe infections may occur, especially in young infants, the elderly and those with weakened immune systems.

Salmonella is a bacterium that can be found in the intestines of animals. Salmonellosis is often contracted from eating raw eggs or raw poultry or having those products touch other items that are then eaten (such as using the same cutting board for raw chicken and produce). Salmonella can also be found on the skin of reptiles and other animals. Handwashing should always be encouraged after playing with pets, especially in young children. Salmonella can occasionally be found on contaminated produce items, so all produce should be thoroughly washed and scrubbed before eating. In general, the FDA recommends thoroughly washing and scrubbing the rinds of all cantaloupes and melons prior to cutting and slicing, and to keep sliced melons refrigerated prior to eating.

If you believe you have experienced symptoms of salmonellosis, consult your healthcare provider. If you have a question, you may contact your local health department or the Kentucky department for Public Health’s Food Safety Branch at (502) 564-7181.

More information about Salmonella can be found at http://www.cdc.gov/salmonella

Your APRN license will be voided if certification lapses

Tue, 15 May 2012 20:31:52 GMT

Message to All APRNs from the Kentucky Board of Nursing

May 2012

An important change was made to the Kentucky nursing laws that affect all APRNs. Specifically, 201 KAR 20:056, Section 7 (2) (b) was modified as follows: "An APRN whose certification or recertification lapses prior to the expiration of the APRN license and who does not provide evidence of current certification or recertification after a request by the board shall have the APRN license voided….”

Effective July 1, 2012, if an APRN does not send KBN validation of current certification before the national certification expires and the APRN license is current, KBN will invalidate the APRN license the day following the expiration date of the certification. This action is not considered to be disciplinary action. It is, however, in keeping with the board’s mission of protecting the public, by assuring that all APRNs who hold a current license have continued to meet the competency requirements for advanced practice.

If the license is voided, the APRN may request a hearing by submitting the request in writing to the board. If the action is upheld by the board or is not challenged, The APRN may seek reinstatement of the license by meeting all of the requirements set forth in Section 6 of 201 KAR 20:056.

An APRN may not practice in the advanced role when the APRN license and/or the national certification have expired. To do so is a violation of nursing law and subjects the APRN to disciplinary action.

You will find the full version of the regulation at: http://www.lrc.state.ky.us/kar/201/020/056.htm

If you want to ensure everything is in order:

1. Visit https://secure.kentucky.gov/kbn/bulkvalidation/basic.aspx

2. Scroll down to the section titled Search by name.

3. Enter your name then click search. (You may also search by APRN license number)

4. On the search results, check the box next to your name on the APRN line.

5. Click Validate Selected

The following page will display the status of your license along with your national certifying body and certification expiration date. You’ll also see whether or not you’ve notified KBN of a CAPA-CS.

If you see that the certification date listed on KBN’s web site is out of date, send a copy of your current certification card, before July 1, by mail to:

Kentucky Board of Nursing

ATTN: Ruby King

312 Whittington Parkway, Suite 300

Louisville, KY 40222-5172

or email: Ruby.King@ky.gov

Certifying bodies are NOT required to notify the board of nursing of lapsed certifications. Every month KBNauditsfor certifications which will expire within the month of the audit and sends an email notification to those nurses.There is no second notice sent and there is no grace period.

All Kentucky APRNs should send a copy of their recertification card to KBN as soon as they receive it or upon KBN’s request.

President Grants Disaster Declaration Requested by Gov. Beshear

Wed, 7 Mar 2012 13:34:01 GMT

Governor Steve Beshear was notified tonight that President Barack Obama has authorized assistance for residents of seven Kentucky counties that suffered significant damage as a result of Friday’s tornadoes and severe storms.

The President's action makes federal funding available to affected individuals in the counties of Johnson, Kenton, Laurel, Lawrence, Menifee, Morgan, and Pendleton. Damage surveys are continuing in other areas, and more counties and additional forms of assistance may be designated after the assessments are fully completed.

"Kentucky families were hit hard by the devastation caused by these storms and tornadoes, and recovery will be a long process,” said Gov. Beshear. "I am grateful that our request has been granted, and I appreciate the swiftness of the White House’s response.”

Gov. Beshear declared a statewide emergency on Friday evening, as storms were still rolling across the Commonwealth. He asked President Obama for an expedited declaration on Sunday.

Assistance for individuals can include grants for temporary housing and home repairs, low-cost loans to cover uninsured property losses, and other programs to help individuals and business owners recover from the effects of the disaster.

Residents and business owners who sustained losses in the designated counties can begin applying for assistance tomorrow by registering online at www.DisasterAssistance.gov or by calling 1-800-621-FEMA (3362) or 1-800-462-7585 (TTY) for the hearing and speech impaired. The toll-free telephone numbers will operate from 7 a.m. to 10 p.m. (local time) seven days a week until further notice. Recovery centers will also be set up in affected areas to assist those residents in person.

Deadly storms and tornadoes assaulted Kentucky on Friday, causing 23 deaths and more than 300 injuries. The Governor has deployed nearly 400 National Guard troops to assist with security, traffic control and other needs in affected counties. Local emergency officials and National Guard troops have completed search and rescue efforts in all our affected counties, and local emergency management teams are turning their attention to damage assessments.

Gov. Beshear implemented executive orders to protect consumers from price gouging and to allow residents in affected areas to get emergency refills of prescriptions, excluding controlled substances. He also directed the temporary suspension of restrictions on certain motor carriers and utility vehicles delivering disaster relief supplies.

Managed Care Implementation Delayed to Nov. 1st.

Mon, 19 Sep 2011 23:02:00 GMT

Medicaid Managed Care Implementation Extended until Nov. 1

Cabinet officials will manage Medicaid program to balance budget by the end of the fiscal year

FRANKFORT, Ky. (Sept. 19, 2011) — Cabinet for Health and Family Services (CHFS) Secretary Janie Miller today announced that the implementation date for Medicaid Managed Care, targeted for Oct. 1, 2011, will be extended one month, an option provided in the contracts with managed care organizations. The Cabinet has granted the extension in response to a request from the Kentucky Hospital Association (KHA), which has assured the Cabinet that a one-month extension to Nov. 1, 2011 will allow hospitals adequate time to sign contracts and prepare for implementation.

Discussions have been ongoing with hospital representatives over the last 2 ½ months about the expansion of managed care to Medicaid recipients in the 104 counties not covered by Passport. The short time frame for managed care implementation has been the primary concern expressed by the hospitals.

"We have made great progress in Medicaid Managed Care since we first announced the contract awards in July,” Secretary Miller said. "Thousands of providers have signed up with the managed care organizations and successful readiness reviews have been conducted, but we still need the hospitals to sign contracts before we can implement managed care across the commonwealth. The hospitals have told us they need one more month to prepare and this complies with their request.”

In July, Governor Steve Beshear announced that Kentucky had awarded four contracts to managed care organizations (MCOs) to provide health care services to Medicaid recipients statewide. Three of those contracts are with new vendors. Coventry Cares of Kentucky, Kentucky Spirit Health Plan and WellCare of Kentucky will serve more than 560,000 recipients across the state that live outside the 16-county region served by Passport, which provides managed care to 170,000 Medicaid recipients.

The managed care strategy emphasizes a holistic approach to health care, which can be particularly effective in helping coordinate the care delivery needs of individuals with a variety of health issues and multiple health care providers. The goal of the contracts will be to improve health care outcomes, particularly as it relates to diabetes control, coronary artery disease, colon cancer, cervical cancer, behavioral health, prenatal care and oral health. The contracts also place a high priority on reducing inappropriate use of services, such as unnecessary ER visits; improving care coordination, especially for individuals with chronic illnesses; promoting wellness and healthier lifestyles; and lowering the overall cost of health care.

Earlier this month, CHFS received approval from the Centers for Medicaid and Medicare Services (CMS) to operate a Medicaid managed care organization waiver program. The waiver allows Kentucky to implement a mandatory managed care program for virtually all Medicaid recipients in the state outside of the Passport region, which operates under a separate CMS waiver.

The expansion of Medicaid managed care to cover the entire state required federal approval from CMS, which the state received on Sept. 8, 2011. The move to statewide managed health care will save taxpayers $375 million in General Funds and $1.3 billion in all funds over the course of the new, three-year contracts.

The one-month extension will not have a significant effect on the managed care program savings for this fiscal year. The Department for Medicaid Services will manage the impact within the overall Medicaid program budget.

"The Medicaid program is made up of many moving parts, so handling a one-month deferral in savings is very manageable,” said Acting Medicaid Commissioner Neville Wise. "The contracts with MCOs included the provision for an extension to Nov. 1, so the department is fully prepared to manage the short-term, reduced savings.”

For more information on becoming a Medicaid provider visit the KCNPNM MCO information page.

Medicaid Managed Care Call Center

Fri, 26 Aug 2011 19:35:21 GMT

The Department for Medicaid Services Medicaid Managed Care call center will be open on Saturday and Sunday (Aug 27-28) from 9:00am-5:00pm EST. The call center will be available to answer questions from members and providers.

Call Center: (855) 446-1245

http://medicaidmc.ky.gov

KASPER Reports now contain Ohio Data

Mon, 15 Aug 2011 21:40:31 GMT

Kentucky, Ohio to Share Drug Data through Interstate Prescription Monitoring Program

Pilot Project Allows Users to Access Data from Both States

FRANKFORT, KY (Aug. 8, 2011) – Governor Steve Beshear announced today that Kentucky and Ohio are automatically exchanging prescription medication data, following this week’s launch of the electronic Prescription Monitoring Information Exchange (PMIX). The announcement marks a highly anticipated milestone for prescription drug monitoring programs (PDMPs) and ongoing work to fulfill a need to share data across state lines.

The PMIX program is a partnership between the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system and the Ohio Automated Rx Reporting System (OARRS).

"I have long advocated for multi-state cooperation in fighting this scourge of prescription drug abuse, because no state is an island,” said Gov. Beshear. "I have personally spoken with Ohio Gov. John Kasich about the importance of partnership on this issue, and I am very pleased to launch this shared program today. I have no doubt that improved monitoring across state lines will help to save lives.”

Kentucky’s Cabinet for Health and Family Services oversees KASPER, which is considered a national model for prescription drug monitoring.

"While KASPER provides an effective tool for health care providers and law enforcement officers in the fight against prescription drug abuse and diversion, interstate data sharing among prescription drug monitoring programs is needed to enhance the effectiveness of the programs as tools to improve public health and safety,” said Health and Family Services Cabinet Secretary Janie Miller. "Prescription drug abuse is a public health epidemic and it simply isn’t enough to monitor drugs dispensed only in our state. Having the ability to report data from other states will dramatically strengthen our ability to monitor and detect abuse.”

The goal of PMIX is to help states implement a cost effective technology solution to facilitate interstate prescription drug monitoring data sharing. The program utilizes a centralized PMIX Hub server to facilitate data sharing.

Under the pilot program, authorized users in Kentucky and Ohio can securely access live PDMP data from both states’ prescription monitoring systems utilizing the PMIX Hub server. For example, a physician in Kentucky will be able to request a KASPER patient report and stipulate that they need Ohio data included on the report. The resulting KASPER report will include any prescription records that the Ohio PDMP provides for the patient as well as the KASPER prescription records, and will identify in which state each prescription was dispensed.

"We are extremely pleased with the success of the PMIX pilot and hope to expand this program to other states,” said CHFS Inspector General Mary Begley. "Sadly, prescription drug abuse continues to increase and we’re now seeing more deaths from overdoses than fatal car accidents. The reality is people are not obtaining these drugs only in Kentucky and we need tools that provide broader understanding of where and when drugs are being obtained.”

Doctor shopping (also called provider shopping) is the term used to describe acquiring controlled pharmaceutical substances by deception. Doctor shoppers often seek controlled substances from multiple providers and cover increasingly large territories to obtain the drugs.

"The effectiveness of KASPER and other state PDMPs would increase significantly if the available data included all controlled substance prescriptions for a patient regardless of the state in which they were dispensed,” said Dave Hopkins, who coordinates the KASPER program. "In fact, our KASPER users overwhelmingly agree that the ability to access information from other states would dramatically increase the effectiveness of the system.”

Several states, including Kentucky, currently allow a prescriber, dispenser, or law enforcement officer from another state to register and obtain access to their PDMP. However, due to the effort required to establish and maintain separate accounts with each state and review multiple reports and formats, only a limited number of practitioners and law enforcement officers have done so.

"We think the PMIX pilot will facilitate efforts to share prescription drug monitoring program data among all states,” added Hopkins.

The PMIX project is sponsored by the U.S. Bureau of Justice Assistance (BJA) with project management provided by the IJIS Institute.

Return to play after concussion

Mon, 15 Aug 2011 21:34:57 GMT

APRNs are not allowed to release an athlete to return to play after the diagnosis of a concussion. These guidelines per KHSAA were revised in June 2010 by the sports commissioner Julian Tackett.

http://www.khsaa.org/sportsmedicine/concussion/

Ky Dept. of Medicaid Services - PCP Letter of Intent

Wed, 20 Jul 2011 13:50:59 GMT

Auto Assignment and PCP Enrollment– The Department of Medicait plans to do the auto assignment of current recipients to one of the three Medicaid managed care organizations (MCOs) on August 18th. However, the MCOs have set internal deadlines of July 25th for physicians to sign letters of intent for initial listing in their network which will be used for the auto assignment process.

DMS clarified that specialist physicians are not prohibited from serving as a PCP, since some patients (ie., elderly, cancer patients) may be seeing a specialist as their primary care physician. Specialists desiring to serve as a PCP should submit letters of intent to that effect. PCPs are required to have admitting privileges at a hospital or formal referral agreement with a provider possessing admitting privileges, and agrees to provide 24/7 primary health care services to individuals. The MCO RFP also defined a PCP as including physician assistants, advanced practice registered nurse or a Rural Health Center. Letter from Dept of Medicaid

If you want to continue providing Primary Care Services to Medicaid Patients outside of the Passport Region, you will need to notify the managed care organizations of your interest in becoming a provider in their network!

There are three (3) Managed Care Organizations (MCOs) with whom the Cabinet has signed contracts to provide Medicaid services in a managed care environment are looking for Primary Care Providers with whom to contract. They are Centene – which is doing business in Kentucky as Kentucky Spirit Health Plans, Coventry Health Plan, and WellCare. After October 1, 2011 you will no longer to be able to provide Medicaid healthcare on a fee-for-service basis; you will need to be in a provider network with an MCO contract.

These 3 MCOs are authorized to provide Medicaid services in all counties of Kentucky with the exception of those for whom Passport has provided services over the past 10 years (Jefferson, Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble and Washington counties. Passport will continue to provide services in these counties.

If you are a primary care provider for Medicaid patients outside the Passport Region, complete the registration process for all three MCOs. (Visit our MCO page)

The MCOs have been asked by the KY Cabinet for Health & Family Services to provide the names of Primary Care Providers by the first of August. If you are interested in pursuing a contract, the MCOs will need to hear from you by July 25^th, if possible.

You do not need to have a negotiated contract by that date, but you do need to let the MCOs know that you are interested in being a primary care provider in their network. We understand that all families receiving Medicaid services will be automatically assigned to one of the three MCOs. One factor in making this assignment will be the primary care provider…hence, the importance of maintaining your status as a Medicaid provider by having a contract – if possible – with each of the three MCOs so that you can be in their provider network!