Cabinet files appeal to prevent releasing full child abuse records; Beshear backs decision

On the day the state was supposed to release unadulterated records on deaths and near deaths from child abuse, under a court order, it filed an appeal to stop the process. And though Gov. Steve Beshear had ordered the Cabinet for Health and Family Services to release the records, yesterday he sided with its officials, saying in an op-ed piece sent to Kentucky newspapers he did not "think the judge's order was protective enough" of informants who often want to remain secret, such as relatives, health-care providers, teachers and law-enforcement officials. (Getty Images photo)

“You teach in a small community and suspect a student is being abused,” Beshear wrote. “Can you come forward without the newspaper naming you as the accuser?" Jon Fleischaker, attorney for The Courier-Journal and the Kentucky Press Association, said Beshear was “fear-mongering,” and noted that Shepherd’s order to release records applies only in cases in which children were killed or nearly killed from abuse or neglect, following a state law designed to hold the cabinet accountable for its child protective services.

Beshear wrote, “The cabinet has been accused of 'operating under a veil of secrecy' in a supposed attempt to protect inept workers and a poorly designed system. But this is not about shielding the system from scrutiny. We understand the need to be more transparent than in years past.” In December, the cabinet handed over 353 pages of records, but the names of at least eight children who died from abuse or neglect had been redacted, along with all the names of children who had been seriously injured, as well as much other information. The Courier-Journal, the Lexington Herald-Leader and the Todd County Standard had sued the cabinet for refusing to release the records. Twice before, Franklin Circuit Judge Phillip Shepherd ordered the cabinet to turn them over. Last week, Shepherd fined the agency $16,000 for its secretive treatment and delays. He also found the cabinet should pay more than $57,000 in legal fees for the newspapers. (Read more)

Yesterday, the cabinet filed its motion with the state Court of Appeals and "asked the court to block Shepherd's Jan. 19 order to release records, starting today, with limited redactions," reports the C-J's Deborah Yetter. In the meantime, the cabinet released about 90 internal reviews of child deaths and serious injuries incurred by abuse but with deletions it feels is necessary "to protect the best interests of the state's child welfare system," its motion read. (Read more)

Home-health industry is the latest to complain about late payments since state switched to managed-care Medicaid

Kentucky's new Medicaid managed-care system is three months late in making payments to home-health agencies, officials told the House Health and Welfare Committee Thursday.

Nurses Registry and Home Health has outstanding claims of $300,000 to $400,000, Jeannie Lemaster, chief compliance officer, told lawmakers. "Kip Bowmar, executive director of the Kentucky Home Health Association, said only 8 percent of the claims from the approximately 150 home-health agencies have been paid since the switch to managed care Nov. 1," reports Beth Musgrave of the Lexington Herald-Leader.

"If these problems don't get corrected, there is a likelihood that some agencies could go out of business," Bowmar said.

Therapists who work with abused, neglected and at-risk children have likewise told lawmakers of back payments. Independent pharmacists have said "reimbursement rates are much lower than they were under traditional Medicaid, which means they are having to lay off employees," Musgrave reports.

In November, Kentucky made the switch to managed care for its 500,000 Medicaid recipients outside the Louisville region. The move is expected to save the state more than $1 billion in the next three years. Three companies, Coventry Cares, Wellcare of Kentucky and Kentucky Spirit, broker the care and are paid on a per-patient, per-month rate.

Lemaster said most of her agency's problems are with Coventry, which has denied 82 percent of their claims. "Lemaster said that because there are differences in the managed care companies and what is being approved for payments, there are inequities in the Medicaid system," Musgrave reports. "Some people are receiving services and others aren't."

Jill Midkiff, spokeswoman for the Cabinet for Health and Family Services, said problems related to the changeover are being ironed out. "The primary focus of the Medicaid program staff is and continues to be the prompt resolution of any issues that arise as we ease the transition of providers to managed care," she said. (Read more)

Lawmakers hear testimony about state's pill mill problem, discuss whether to put all prescription-drug issues into one bill

With a raid on a pain clinic in Paintsville making headlines yesterday morning, state legislators heard from community leaders and officials telling them to pass legislation to curb the proliferation of pill mills.

Lois Windhorst, best known as a leader of Mothers Against Drunk Driving, told the Senate Judiciary Committee about a family member she lost to prescription-drug abuse. "It just progressively got worse," she said. "She carried a big bag of pills with her wherever she went."

On the legislative agenda is Senate Bill 42, which "would require licenses for pain management clinics and doctors to own them," notes Greg Hall of The Courier-Journal. There are 77 pain clinics in the state, 33 of which are owned by people who have no medical background.

No vote was taken on the bill. Its sponsor, Sen. Jimmy Higdon, R-Lebanon, said he will revise it based on yesterday's testimony.

Sen. Ray Jones, D-Pikeville, argued for a more all-inclusive bill, which would include the premise of Higdon's bill; ban cash payment at clinics, as proposed in House Bill 251; and require doctors and pharmacists to use the state's electronic drug monitoring system known as KASPER, a bill that Attorney General Jack Conway and others are expected to push once it is filed.

Jones "also said filling prescriptions from out of state should be required to check with registries in those states to guard against duplicate prescriptions," Hall reports.

Committee Chairman Tom Jensen, R-London, said there is much support to deal with the issue of prescription-drug abuse in this legislative session. Nearly 1,000 Kentuckians die each year due to prescription drug overdoses. (Read more)

Meds-for-meth bill could lead to overcrowding at doctors' office, Hopkinsville hospital official says

Making pseudoephedrine available only by prescription has led to fears of packed waiting rooms in doctors' offices, Dennis O'Neil writes for Hopkinsville's Kentucky New Era. (Photo of Sudafed pills by WebMD.com)

"It could lead to some overcrowding of primary care facilities that are already overcrowded," said James Goss, director of marking and community relations for Jennie Stuart Medical Center.

This session, three bills have been introduced to deal with pseudoephedrine, the key ingredient to make meth. House Bill 80 would prohibit anyone convicted with a meth-related charge from getting the drug without a prescription. The other two bills would prohibit anyone from getting the drug without a prescription, with the exception of pills in gel cap form.

Goss said he is worried a new law would inconvenience patients. "On its face, the bill seems well intended to protect the health and well being of the community," he said. "We are sympathetic to the pocketbook and convenience issues of our patients." (Read more)

State auditor will examine University Hospital's indigent-care trust

After the Jefferson County attorney said the fund lacked oversight, state Auditor Adam Edelen said he will audit and review the indigent-care trust in Louisville through which $32 million tax dollars flow. (Courier-Journal photo by John Rott)

The audit will determine "whether there are adequate resources to treat indigents in the Louisville area," reports Patrick Howington of The Courier-Journal. The issue came up recently when University Hospital, the recipient of the funds, tried to merge with two other hospital systems.

Earlier this month, County Attorney Mike O'Connell said the trust's board, which is appointed by the University of Louisville, "had not met in more than two years," Howington writes. The next day, U of L President James Ramsey asked Edelen to look into the trust's financial records.

Edelen spokeswoman Stephenie Steitzer said the lack of board meetings raises the question of "whether there is a proper and effective governance structure in place."

The trust receives $25 million each year from the state and $7 million from Louisville Metro Government. University Hospital uses those funds to treat poor, uninsured patients. Last year, the trust only paid for "about one-third of the facilities' charity care last year, which cost $88 million and involved more than 63,000 cases," Howington reports. (Read more)