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“Quit Now Kentucky is currently offering eight (8) weeks of free Nicotine Replacement Therapy (NRT) to ALL callers who enroll in coaching between June 20, 2016 and August 15, 2016. This offer is coinciding with an increased amount of Public Service Announcements from the CDC's "TIPS From Former Smokers" public awareness campaign.

To enroll, Kentucky residents may call 1-800-Quit Now (1-800-784-8669). The quitline offers services in both English and Spanish from 7:00 A.M. – 1:00 A.M. EST Monday through Sunday.”

The Kentucky Department for Public Health (DPH) is challenging communities and organizations to join Step It Up, Kentucky!. This statewide campaign aims to improve the health of all Kentuckians by building the demand for walkable communities, making walking a priority.

Public health recommends getting 30 minutes of physical activity five days a week to improve health, which can easily be achieved by walking. People are more likely to make the decision to walk when they have places, programs and policies that provide opportunities and encouragement.

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“Getting people to move more starts with improving the places we live, learn, work and play,” said Elaine Russell, coordinator for the Obesity Prevention Program. “Communities can be built for people to be active in their everyday life. By providing safe, attractive and convenient places to walk, anybody can incorporate exercise into their daily routine.”

Recently, the U.S. Surgeon General launched Step It Up! A Call to Action to Promote Walking and Walkable Communities, which calls on Americans to increase walking by designing communities that encourage physical activity in order to address rising rates of chronic disease. Step It Up, Kentucky! demonstrates a state-level commitment to the Surgeon General’s call to action.

Step It Up! has already received numerous endorsements from businesses, organizations, individuals and state leaders, including Gov. Matt Bevin, who issued an official proclamation in support of Step It Up!

There are many things communities can do to support Step It Up, Kentucky!, including participating in walking programs, working with local coalitions to create spaces and opportunities for walking, or just spreading the message that Kentucky communities need to be redesigned as thriving places for everybody to be active and healthy.

Individuals and organizations can join Step It Up, Kentucky! by pledging their support and taking any of the small steps to promote walking in their communities:

· Organization Endorsement of Step It Up, Kentucky! CLICK HERE

· Individual Pledge to Step It Up, Kentucky! CLICK HERE

Over the past few years, the DPH Obesity Prevention and Healthy Communities Programs have provided competitive funding opportunities for 27 local communities to develop pedestrian plans. Through the Walkable Communities Committee, DPH has worked with the Kentucky Transportation Cabinet to establish free statewide trainings and provide technical assistance on designing walkable communities.

“The collaboration between Kentucky’s Public Health Department and Transportation Cabinet is transforming communities across the state,” said Ian Thomas, state and local program manager for America Walks, a nonprofit national organization that promotes walking and works to build walkable communities. “Their Walkable Communities Committee and training programs are a national model, which we hope to see replicated in other states.”

The Surgeon General’s call to action reinforces the importance of this work and encourages more communities to contribute to a statewide walking movement.

“Creating a culture that supports healthy lifestyles starts with building support at the local level,” said Dr. Connie White, acting commissioner for DPH. “All Kentuckians deserve safe, inviting places to be active. Step It Up, Kentucky! is the first step on a long journey to better community health.”

From adding sidewalks to developing parks and recreation sites, there are a number of things communities can do to become more walkable. Winchester, for example, created a mile-long circular path in the middle of the Central Kentucky city by simply mowing a stretch of undeveloped land. Rockcastle County, meanwhile, paved a one-mile path along a roadway in Mt. Vernon that is now used by walkers, runners and bikers. The path also served as the site for an eight-week walking challenge in the community.

For more information on Step It Up!, visit the Partnership for a Fit Kentucky’s website. If you are interested in reading more about obesity prevention, increasing access to physical activity, or what other communities are doing to encourage wellness, visit the Partnership for a Fit Kentucky’s blog.

From Cabinet for Health and Human Services Communications

Louisa United Methodist Church

Our neighbors are in need and we need your help to help them! Beginning today and going through Sunday evening we'll be collecting cleaning supplies for our friends in West Virginia who were affected by the recent floods. If you're coming to our Bible school this week or if you just want to make a donation please drop them off at our Church door and we'll take care of it. Here is a list of items needed at this time:

Brooms
Mops
Bleach
Trash bags
Gloves
Bottled water
Peanut butter and other non-perishable food items that do not require being heated up or cooked

PLEASE SHARE

Medicaid hearings in Bowling Green and Frankfort elicit nearly incessant criticism; third and final hearing in Hazard next Wed.

Supporters of the current Medicaid expansion sat on the front row of a packed hearing room in Frankfort.

By Al Cross
Kentucky Health News

Supporters were few and far between at the first two public hearings on Gov. Matt Bevin's plan for changes in the Medicaid program.

In Bowling Green on Tuesday and in Frankfort on Wednesday, critics of the plan said it would put too many obstacles between the poor and health care. A third and final hearing will be held in Hazard next Wednesday.

"What you're proposing to do here is more cumbersome than average folks find the insurance process now," said A.J. Jones of Louisville, identifying himself as a former Medicaid enrollee now on private insurance. He said in Frankfort that fiscal responsibility, a stated reason for the plan, is "important, but not when you're talking about people's health."

The plan would require enrollees to pay premiums of $1 to $15 a month, based on income. It would also require able-bodied adults without jobs to take job training or counseling, or do community service for nonprofit organizations.

Miranda Brown of Lexington, who helps the poor navigate the health-insurance system, said a homeless person she helped get on Medicaid told her that she would probably drop out of the program if she had to pay premiums.

Bevin and other Republicans say Medicaid enrollees need to have "skin in the game," but Harriet Seiler of Louisville said, "It's a concept that will scrape a pound of flesh from Kentuckians. . . . The sick, the poor and the unemployed are not naughty children who need to be incentivized, scolded or humiliated."

K.J. Owens of Louisville won applause from the overflow crowd in Frankfort when he said the plan "seems motivated by the concern that poor people are defective morally . . . that poor people just aren't trying hard enough. The people on Medicaid are in no more need of moral guidance than the governor and the people on the governor's staff."

Emotions peaked when Molly Shaw of Louisvile-based Parents for Social Justice predicted, "More people will be sick and more people will die. This waiver will kill people."

The plan is a request to the federal government for a waiver of normal Medicaid rules. Asked afterward to reply to Shaw's comment, Health Secretary Vickie Glisson said, "We're trying to maintain the expansion."

Bevin has said if federal officials don't approve his plan, he would end the expansion of Medicaid under federal health reform by his predecessor, Democrat Steve Beshear, that added to the rolls more than 400,000 Kentuckians earning up to 138 percent of the federal poverty level.

Emily Parento, who was Beshear's chief health-policy adviser, predicted that federal officials would not approve the work-oriented requirements or the plan's increase in premiums for enrollees between 100 and 138 percent of the poverty line. "This amounts to a penalty for poverty," she said, adding that the plan has "minimal detail" on the projected cost savings, other than reduced enrollment.

The only unequivocal endorsements of the whole plan, other than written statements from Republican legislators, came from the Kentucky Hospital Association and the state's largest hospital system, Baptist Health. KHA official Nancy Galvagni said the plan improves on those in other states "by using more carrots than sticks" to influence enrollees' behavior, and "does inject some personal responsibility into the system."

In Bowling Green, Diane Amos said her elderly mother couldn't afford premiums. (Daily News photo by Miranda Pederson)In Bowling Green, "A few speakers expressed support for smoking cessation programs or a pilot substance abuse treatment plan included in the proposal. But most of the about 20 people who spoke appeared passionately opposed to the changes, with comments that prompted frequent applause from the about 60 people at the hearing," reports Deborah Yetter of The Courier-Journal.

"Cara Stewart, a legal-aid lawyer who represents people on Medicaid, said Bevin’s application for a waiver conflicts with the federal government’s requirements for waivers," Yetter reports. "The goal generally, she said, is to enhance or expand coverage." Stewart said, “I don’t see anywhere in here where we’re increasing coverage I only see cuts in service and taking away access to care.”

The Frankfort hearing was part of a meeting of the state advisory council for Medicaid, chaired by nurse practitioner Elizabeth Partin of Columbia. She was among the speakers who questioned the removal of annual vision and dental exams from regular Medicaid coverage. "That's how you catch problems before they become huge problems," she said. Given the small cost, "It's not gonna break the bank either way, and it may help improve people's health."

The issue was also big in Bowling Green. “We’re No. 1 in toothlessness; so we’re not going to provide dental care for those who need it the most?” asked Chris Keyser, executive director of Fairview Community Health Center.

Franklin optometrist Steve Compton said optometrists often are the first to identify other health problems, such as high blood pressure or diabetes, during a routine eye exam. In Frankfort, Richmond optometrist Matt Burchett said optometrists discovered 15 percent of diabetics insured by United Health.

Under the plan, enrollees could earn coverage for vision and dental exams, as well as non-prescription drugs and gym-membership subsidies, by enrolling in job training, volunteer work or health-related classes.

Speakers at both hearings questioned the proposed six-month suspension of enrollment for failure to pay premiums. "It seems rather harsh," said council member Barry Whaley of Louisville, executive director of Community Employment Inc.

Bevin's deputy chief of staff, Adam Meier, noted that suspended enrollees could re-enroll sooner by paying premiums and taking a health-literacy or financial-literacy course. "We want to mirror commercial insurance coverage," he said, "to teach people how to be engaged in their health insurance plan."

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky. 

JUNE 26, 2016

There's a vaccine for young people that prevents cancer, but most of them don't get it because most doctors fail to recommend it

By Melissa Patrick
Kentucky Health News

The human papilloma virus vaccination is proven to prevent cervical cancer and genital warts, but many pediatricians and family doctors still don't strongly recommend it, and they need to do better.

That was the main message at an HPV conference in Lexington June 21, where more than 100 people, mostly health-care providers, came to learn about the cancer-causing virus and the under-utilized vaccine that prevents it.

Dr. Alix Casler, medical director of pediatrics at Orlando Health Physician Associates in Florida, stressed the importance of teaching everyone in a health-care organization about why HPV vaccinations are so important.

"Every year that we fail to reach our goal, there are thousands of children who are going to go on to develop cancer," Casler said. "It is one of the most lifesaving things we do," but because it isn't mandatory and the diseases that it causes aren't ones pediatricians deal with, it often falls to the bottom of providers' priorities, she said.

Studies show that a "clear recommendation" from a physician is the most important factor in whether children get the HPV vaccine. Casler noted that a 2013 survey found that 80 percent of mothers who received a same-day recommendation had their son or daughter vaccinated that day.

The three-dose HPV vaccine was approved by the federal government 10 years ago and is recommended for 11- and 12-year-old boys and girls.

Kentucky falls in the bottom 10 states for HPV vaccinations, with 37.5 percent of its girls and 13.2 percent of its boys aged 13 to 17 vaccinated as of 2014. Nationwide, fewer than half of girls and only one-fifth of boys are getting immunized, and vaccination coverage did not increase substantially from 2011 to 2014.

HPV is spreading. About 79 million people in the United States are infected with it, and about 14 million more become infected each year. It is estimated that half of these new infections occur in people 15 to 24 years old.

Though most HPV infections will clear up on their own, the most persistent strains of the virus are directly linked to 27,000 new cancers a year. About 30 women per day in the U.S. are diagnosed with cervical cancer caused by HPV, and every year, there are about 324,000 new cases of genital warts caused by the virus.

Lois Ramondetta, a gynecologic oncologist at MD Anderson Cancer Center in Houston, who is on a mission to educate health-care providers about the vaccine, told clinicians in southern Texas, “If you are not recommending the vaccine, you are not doing your job. It’s the equivalent of having patients in their 50s and not recommending a colonoscopy — and then having them come back with cancer.” So reports Laurie McGinley for The Washington Post.

HPV infections cause more than 90 percent of anal and cervical cancers and 70 percent of vaginal, vulvar, penile and middle throat cancers, and two of the HPV strains are associated with more than 90 percent of anal and genital warts.

HPV is most commonly transmitted through sexual intercourse, but it can also be transmitted through any skin-to-skin contact, including genital contact of any kind or simply kissing.

Doctors and parents alike have struggled with the idea of giving young children a vaccine for a sexually transmitted disease. And some parents hesitate because they say the vaccine encourages sexual promiscuity, though research says otherwise.

Caslir said that just like putting on a seat belt to protect yourself before you turn on the engine, the most effective time to vaccinate for the cancer causing HPV virus is prior to exposure. In addition, it is important to vaccinate pre-teens early because they have the best immune response to the vaccine and are more likely to keep coming in for annual visits.

Dr. Daron G. Ferris, a speaker at the conference who works at the Georgia Cancer Center in Augusta, said that a mother of a 21-year-old woman with cervical cancer caused by HPV asked him, "So you mean if my daughter had received the Gardasil shots, she probably would not be having this surgery today?" and that he told her, "Yes. She would not have been there if she had been vaccinated."

Kirk Forbes, whose daughter Kristen died at the age of 23 from cervical cancer caused by a high risk strain of HPV, told the story of his daughter's battle. He and his wife have founded the Kristen Forbes EVE Foundation, whose mission is to eradicate cervical cancer and significantly reduce HPV infection rates. One of the foundation's efforts is a nationally acclaimed documentary that profiles five women, including Kristen, called "Someone You Love: The HPV Epidemic."

"We have the means to stop 90 percent of cervical cancers and who know how many versions of oral cancer, anal cancer, penile cancer... and could literally wipe out genital warts," Forbes said."We've got all the tools we need, now we've got to go out and get the job done."

Posted by Melissa Patrick at 9:08 PM

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.