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January 17, 2018

 Kentucky has been hit hard by the opioid epidemic, but the state is trying to fight it with innovative efforts to gather more specific data about overdose deaths. The Kentucky Injury Prevention and Research Center, a partnership between the state Department for Public Health and the University of Kentucky College of Public Health, built a "drug-overdose fatality surveillance system" that combines information sources like death-certificate information, post-mortem toxicology analysis, and victims' prescription history to get a better picture of which drugs are killing people and under what circumstances.

"The efforts that KIPRC and the state have made to improve this data have led to crucial findings, including that Kentucky’s crisis isn’t one crisis, but many," Kathryn Casteel reports for FiveThirtyEight. "Different parts of the state are afflicted with different drugs. Northern Kentucky, for example, has a high prevalence of heroin and fentanyl — a synthetic opioid that is more deadly than heroin and other types of opioids — while in the eastern part of the state, prescription opioids are still the main concern.

KIPRC chart; click on the image to enlarge it.

"We’re not doing this for the sake of research," Svetla Slavova, a biostatistician with KIPRC, told Casteel. "We provide actionable data for policymaking, treatment and prevention. We’re trying to be responsive and provide data that will help make these decisions." Because of KIPRC's research, Van Ingram, the executive director of the Kentucky Office of Drug Control Policy, said he was able to push legislation increasing the availability of the anti-overdose drug naloxone.

One of KIPRC's biggest efforts is to make death-certificate information more uniform across the state, because "even the smallest differences in language can leave overdose deaths uncounted," Casteel reports. Sarah Hargrove, a data management analyst for KIPRC and former autopsy technician for the state, is spearheading the effort. It's tough going, since some coroners in the state's 120 counties, many of them small, have limited resources and funding, and many have little medical experience.

But KIPRC is making headway. "Researchers were able to determine the specific drugs that were involved in 97 percent of drug overdose fatalities in 2016; that’s compared with 82 percent using death certificates alone," Casteel reports. The also used the surveillance system "to find which drugs were most commonly involved in deaths linked to a combination of substances, as well as which drugs were involved in overdose deaths among people of different age groups and genders."

Written by Heather Chapman - Posted at 1/17/2018 12:04:00 PM

@LAZ

 

January 13, 2018

Federal Approval Puts Kentuckians on a Path to Better Health


FRANKFORT, Ky. (Jan. 12, 2018) – Gov. Matt Bevin today announced that the federal Centers for Medicare and Medicaid Services (CMS) has approved the Commonwealth’s Section 1115 Medicaid waiver known as Kentucky HEALTH. The acronym HEALTH stands for “Helping to Engage and Achieve Long Term Health.”

Kentucky’s new program will improve the health of its participants, strengthen Medicaid’s long-term fiscal sustainability, and promote personal responsibility for health and well-being. Kentucky HEALTH introduces innovative delivery system reforms for the treatment of substance abuse, and a first-ever community engagement initiative for Kentucky HEALTH members designed to improve their health and strengthen Kentucky’s workforce.

“With federal approval of our Medicaid waiver, Kentucky will lead the nation in constructive changes to Medicaid," said Gov. Bevin. “This marks the first significant change to a federal entitlement program in more than 20 years. The result will be a transformational improvement in the overall health of our people and will provide a model for other states to follow.

“Kentucky HEALTH is specifically tailored with the unique needs of Kentuckians in mind. It will apply innovative approaches to improving our health, stability and quality of life. I want to publicly thank Cabinet for Health and Family Services Secretary Vickie Yates Brown Glisson, Education and Workforce Development Cabinet Secretary Hal Heiner, and the countless dedicated state employees who worked tirelessly to develop and secure approval for a program that will positively change Kentucky’s health narrative for generations to come."

CMS Deputy Administrator and Director for the Center for Medicaid and CHIP Services Brian Neale applauded Kentucky’s efforts.

“Today’s approval is the result of the hard work of Governor Bevin and his team and serves as a testament to Kentucky’s ongoing commitment to improving the lives of its Medicaid beneficiaries,” said Neale. “We look forward to reviewing the outcomes from Kentucky’s thoughtfully-crafted, groundbreaking demonstration, which will undoubtedly aid Medicaid reform efforts across our nation.”

The goal of this new program is to offer each member the ability to customize a path based on individual needs that will lead to better health, engagement in their communities, improved employability, and success through long-term independence.

“Kentucky HEALTH is a comprehensive, transformative plan empowering individuals to improve their health and well-being while ensuring Medicaid’s long term financial sustainability,” said Sec. Glisson. “Kentucky HEALTH also provides the opportunity for multiple cabinets within state government to coordinate and strengthen efforts to improve the quality of life for Kentuckians.”

“This program will put Kentucky on the national forefront of blending workforce and health programs that will ultimately put citizens in need on a path to better health and financial stability,” said Sec. Heiner. “We look forward to welcoming eligible Kentucky HEALTH members to our Kentucky Career Centers, and helping them gain the skills necessary to fill the hundreds of thousands of good-paying jobs that are available in the Commonwealth right now.”

Gov. Bevin unveiled the demonstration waiver known as Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) on June 22, 2016. Since then, the Commonwealth has incorporated valuable feedback from consumers, providers, advocates and other stakeholders in developing the program. Additionally, Gov. Bevin has consistently said since submitting the 1115 application that these are the terms under which Kentucky is able to maintain expanded Medicaid. Accordingly, Gov. Bevin has signed an executive order directing the Commissioner of Medicaid to take necessary actions to terminate Kentucky’s Medicaid expansion in the event that a court decision prohibits one or more of the components of the Section 1115 waiver from being implemented.

Kentucky HEALTH is an innovative approach that will put Kentuckians on a path to better health, and is key to ensuring the long-term viability of the Medicaid program. In addition, Kentucky HEALTH will ensure availability of Medicaid resources to our most vulnerable citizens by saving an initial estimated $2 billion dollars (federal and state) over the waiver demonstration period, allowing these funds to be focused on those most in need and other critical areas. Additional program information will be shared in the coming weeks. In the meantime, more details can be found at www.KentuckyHEALTH.ky.gov.

 

January 12, 2018

Lawrence County Extension Service is hosting "Cooking Through The Calendar," a monthly cooking class that includes instruction and participation in preparing a seasonal recipe. The class will also include information on better living through nutrition.