Pill-mill bill passes; attorney general won't get drug-monitoring system but narcotic-prescribing doctors will have to use it

House Speaker Greg Stumbo, center, walks
with House budget committee chair Rick
Rand and House Majority Floor Leader
Rocky Adkins. (Courier-Journal photo).

Legislators have sent Gov. Steve Beshear a bill to curb prescription drug abuse and crack down on rogue pain clinics, ending the special session of the General Assembly.

The final version left the state's prescription drug-monitoring system under the control of the Cabinet for Health and Family Services and the doctor-controlled Kentucky Board of Medical Licensure rather than move it to the attorney general's office, as the last version in the regular session would have. But in another significant change, it will require doctors and pharmacists who prescribe or dispense Schedule II and III drugs, such as oxycodone and morphine, to use the Kentucky All Schedule Prescription Electronic Reporting system. Only about 25 percent of Kentucky physicians now use KASPER.

Putting the drug-monitoring system in the hands of the attorney general was considered a linchpin of efforts to help law enforcement to proactively identify suspicious prescribers; law enforcement officers can access the database only if they have a case opened, and say they need the data to open cases. But the Kentucky Medical Association called giving law enforcement oversight of information with prescription-drug information a violation of personal privacy. "You are essentially legislating medical care," said Shawn Jones, president of the KMA.

Beshear, who repeatedly pressured legislators to pass a bill pertaining to the issue, issued a statement this evening expressing his delight. "Even though the prescription drug bill doesn't include every element we had hoped, it is an enormous bipartisan accomplishment, and it restores Kentucky as a leading state in innovative tactics in battling prescription drug abuse," he said. "The elements of the bill also help prevent Kentucky from becoming a source state for prescription pills.

House Speaker Greg Stumbo, who sponsored the bill, called its passage "a step forward" though he "would have preferred a stronger version." He told reporters that he did not feel this would be the last time lawmakers would be changing laws to fight the problem, and noted that Beshear could use his gubernatorial reorganization powers to change the administration of the system: "I think the governor, in the days ahead, will continue to take aggressive action on addressing this problem."

The measure will require pharmacists to submit information to KASPER within 24 hours of dispensing a narcotic and doctors must check the system before prescribing one to a new patient. They then would be required to check a KASPER report every three months during a patient's treatment.

As before, the measure will require most pain clinics be owned by at least one doctor; 33 of Kentucky's 77 pain clinics are owned by people with no medical background. Those who already own clinics and haven't had run-ins with the law will be "grandfathered" and be allowed to continue operating. "That really waters it down. A lot!!" Operation UNITE Director Karen Kelly said on Facebook.

Lawmakers also passed the transportation budget bill, which was the main reason why they were called in for a special session by Beshear. They reached an impasse last week when the Senate would not approve the budget, a move Beshear and Senate President David Williams blamed on each other.

There were suggestions that the road and drug issues, the only items that the legislature could consider under Beshear's call of the session, were related. "As the Senate receded on the amendment to put back $50 million of [road] money into Senate President David Williams' district, word went out that the House would compromise on the pill bill and let the Senate keep KASPER [where it is] as long as a funding change took place," Ryan Alessi reports for cn|2. "The Senate sprang into action amended the pill bill and leaders from the two chambers worked together to pass legislation before supper time."

Kentucky's pill mill fight makes headlines in Wall Street Journal

A man gets arrested at a pain clinic in Lexington.
Photo by Charles Bertram for the Lexington
Herald-Leader.

The Wall Street Journal has featured Kentucky's legislative battle over its pill-mill bill in today's paper, calling the state an "epicenter of abuse."

"Kentucky is ground zero of the effort to move prescription-drug monitoring programs out of the health-care arena into law enforcement," said Even Jenkins, executive director of the West Virginia State Medical Association, a physicians trade group, and a Democratic state senator.

"The Republican-controlled Senate is considering a vote as early as Friday on a bill that would restrict ownership of pain clinics to licensed physicians and give law enforcement easier access to the state's prescription-drug database," writes Timothy W. Martin.

But, he notes, there is strong opposition to the bill from the Kentucky Medical Association, which worries "giving law enforcement oversight of a database with prescription-drug information is a violation of personal privacy."

"You are essentially legislating medical care. We think doctors should write those regulations, not legislatures," said Shawn Jones, president of the KMA. He called the bill an "overreach."

"The struggle over the Kentucky bill highlights the complicated path policy makers and law enforcement are traversing nationwide in their attempts to fight abuse of prescription painkillers," Martin reports. "Unlike importers and dealers of illicit drugs such as cocaine, the supply chain for prescription drugs is made up largely of legitimate businesses and professionals."

Legislative pushes in Ohio, West Virginia, Florida and other states have been met with fierce opposition from physician and pharmacy trade groups, Martin writes.

About 48 states have legislation requiring prescription drug-monitoring programs. That's up by 16 from 10 years ago, but restrictions for who can access the data varies by state, Martin reports. Kentucky law enforcement has complained it cannot access the data in time to single out problem prescribers, which is the reason House Bill 1 would transfer the tracking system from the Cabinet for Health and Family Services to the attorney general's office.

"The data is all there — it's just under a rug," said Attorney General Jack Conway, saying law enforcement cannot know now who are the highest prescribers in the state. Having access to the database would solve that problem, he said. (Read more)

Hospitals get antsy about leasing space to fast-food chains

McDonald's has space in the Cleveland Clinic. (AP photo)

While the U.S. Department of Agriculture decides what to suggest about junk food in schools, hospitals are likewise at a crossroads, with many administrators feeling conflicted about housing fast-food chains in their facilities.

At Truman Medical Center in Kansas City, the cafeteria features low-fat meals, on the other side of a wall from a McDonald's. CEO John Bluford said the golden arches send "an inconsistent message" to patients, staff and community because of the unhealthy offerings, but Truman agreed to a 25-year contract with the chain in 1992 "at a time when the financial benefit of having a stable food-service client in the hospital outweighed any potential health concerns," reports Elana Gordon for NPR.

Getting out of these contracts can be tricky. The Cleveland Clinic tried to end its agreement with McDonald's 10 years ago, but the restaurant remains in operation. "We're just going to live with it," said Bill Barum, director of hospitality and retail services. "When the contract ends, we'll have the opportunity to reexamine the space."

Of the 14,000 McDonald's in the country, there are 27 in hospitals, and officials say the restaurant's menu can be tailored to health-conscious diners.

Some hospitals have five fast-food outlets, a survey by the Physicians Committee for Responsible Medicine found. The report's top five "worst hospital environments" housed at least one fast-food restaurant. "In this day and age, you would think a hospital might be proud enough, if not shamed enough, to cut or end these contracts with fast-food outlets," said Susan Levin, a dietitian with PCRM.

But while some hospitals are looking to end fast-food contracts, some are signing them, including the Texas Medical Center's St. Luke's Episcopal Hospital and the Medical University of South Carolina University Hospital, where Chick-fil-A is  open for business. (Read more)

Poll finds parents overwhelmingly support more nutritious school food; USDA expected to issue new guidelines

Photo by Reuters' Lucy Nicholson

Chocolate bars, Cheetos and cheesy fries may soon be a thing of the past at public schools in America, and that's fine with parents, a new poll has found.

The survey found "most people agreed the chips, soda and candy bars students buy from vending machines or school stores in addition to breakfast and lunch are not nutritious, and they support a national standard for foods sold at schools," reports Susan Heavey for Reuters.

As it did for school lunch earlier this year, the U.S. Department of Agriculture is expected to release new guidelines for vending machines and à la carte sales by June, some experts say.

In Kentucky, schools are already not allowed to sell food that competes with the national school lunch and breakfast programs from the minute students arrive in the morning until 30 minutes after the last lunch period. Only water, 100 percent fruit juice, lowfat milk and any beverage that contains no more than 10 grams of sugar per serving are allowed to be sold in school vending machines, as per state mandate. There are no limits as to what food or drinks that can be sold in fundraisers.

The poll, conducted by advocacy group Kids' Safe and Healthful Foods Project, found 80 percent of the 1,010 adults surveyed said they would support nutritional standards that limit the calories, fat and sodium in such schools.

Students eat one-fifth to one-half of their daily diet at schools, and the Centers for Disease Control and Prevention report 20 percent of American children are obese, As of 2007 in Kentucky, more than 37 percent of children were either obese or overweight, a study by the National Conference of State Legislatures shows.

A study by the National Academy of Sciences reports that about $2.3 billion worth of snack food and drinks are sold each year in schools nationwide. As such, changes might be controversial. The new guidelines for school lunch met with resistance from lawmakers, who "locked limits to french fries and counted pizza as a vegetable because it contains tomato sauce," Heavey reports.  There are concerns industry lobbyists and members of Congress could dilute the USDA proposals. (Read more)

Do Not be Judgmental Too Fast

Do not be judgmental Too Fast is a a favorable story of a father with four of his children, the article about not judging too fast you should read because it contains a lot of meaning.

A man has 4 children to teach them not to judge things too quickly. The father gave them questions bergilirian out and noticed a lot of pear trees.

The first child to go out in the rainy season, the second son went out in the spring, the third son went out in the summer and four children to go out in the fall. When they all had to return home, the father called them to tell what is already viewed by each of them.

The first child said that "the tree was ugly, bent and spinning"
The second child did not so he said that "the tree was covered with green buds and buds promising"
The third son disagreed, saying "it's like paradise tree with fragrant flowers that smell and look beautiful"
Last child did not agree with his older brother he said "the tree falling fruit full of ripe fruit of life"

Their father said they were all right because they saw that the tree of life in just one season, she told her children that they can not judge a tree / person with only one season (tree)

The essence of all the fun, excitement and love that only comes from life can be measured at the end of the season when the season ended. If you give up during the winter season, you will lose a promising semimu, lose your summer is beautiful and full of life in gugurmu season.

DO NOT ALLOW SUFFERING IN ONE SEASON IN SEASON DESTROY OTHER HAPPINESS, DO NOT JUDGE ON THE HARD FOR ONE SEASON, THE DURATION SULITMU skip diligently AND THE DURATION OF A BETTER WILL COME A TIME LATER.

Silly Jokes

"If you fail today, do not ever give up. Repeat your failure to keep your boss to give up."

"Do not do mistakes like ass. So tomorrow morning when you are late for work .... so do not you be late (again) on his return".

"Success can be achieved because of the business ...
Because the business there will ...
Because there is a willingness to create goals ² ...
² goal came from a dream ...
Because there are dreams Sleep ...
So ...
If you want to succeed let us sleep ... "

"If you run out of venture capital for your business activity, continued to deposit your capital even if not paid off" short-Mario-

"Nobody who works hard in this world. Work Light Heavy Whatever It Feels When Not Done"

"When Overcome Financial Difficulties .... Do not ever give up .... knock your head is a stone walled or it will be out money ..."

Our job is not to succeed. Our job is to try even though you know you will never succeed. Because the DID's only owned Dora the Explorer ...
WORKS! WORKS! WORKS! Hooray!

Few people have the characters do not envy when you see his success. Take care not to the extinct species. Let us preserve!

If you have not find jobs that match your talents, whatever bakatilah your current job. If necessary, register yourself in Indonesia's Got Talent. You will perform, although not as bright as a gifted talent. Good luck.

If you have not been able to reach No. 1 on your business .. Missiles fired at the person in front of you.

When you fail to achieve your dream, never stop to keep trying until finally there was no power to give it a try

When you have failed in carrying out the mission of your business, be patient for a while ... because you will respawn in the next 4 seconds and can continue misssion your card ... GO! GO! GO!

"If you born poor, do not be sad. Please contact the hospital where you were born. Who knew you mixed up"

"Your generation will be more advanced, when it rarely watch my movies and the like"

Secrets of Women Who Love Bite Lip Below

Secrets of Women Who Love Bite Lip Below is a picture or a bit of explanation about the criteria for the type of woman biting her lips, but not all covered her mouth, only the bottom of it.

Biting her lower lip, wet, or slightly memanyunkan lips, indeed often do women. But, did you understand its meaning, but feel passionately and stimulated by his style. Well, now, learn the secret and, come on, conquered! Lip biting behavior is very often carried out by several women at all.

But you should begin to notice the behavior of this one, especially if you seek him was like doing it. Here we tell the secrets of personality and behavior of women who like biting her lip. Do not tell anyone, okay?

If on the sidelines of your conversation with him, and then all of a sudden with a timid accent he's biting his lower lip as if he were geregetan, or lips and suck it out in a wet state, it means he's a brave teaser. Very brave! There was no hesitation or the slightest sense of shame to tease and entice you. They are not afraid to bite his lip in public many times, in addition, they are also adept at showing various facial expressions to get the attention of his interlocutor.

This type of woman who's "hot", easy to heat. But, it is difficult to conquer this woman, for he is also the type of man the conqueror. Only, if you are able to make him feel "neglected", including with all the tricks that lip bite, maybe he'll entangled. On the bright side, this woman had a high passion and total submission. So, it's useless if you have patience to deal with?

Or, when the he wanted to apologize or ask for help you, along with innocent eyes, he's definitely going to bite her lips to get more attention and sympathy from you. Note only. With that bite, he looked once ketidaberdayaan.

This type of women are shy, nervous, and rikuhan. Women are also the type of helper and not tegaan. Only, his character often weak and disloyal. Especially if she is aware of the "innocence" that provoke pity, and will be able to use it. Therefore, facing this type of woman, must put "padlock" dead lock!

There's also the kind of woman who often continue to wet his lips, just a hissing snake. Hat-care, although this type of woman is very exciting, but there is trickery in his heart. Irritable, unstable, insecure, and jealous. Menghaki very strong character in this type of woman. Indeed, these women desire high cenderunt and easily satisfied. However, the psychological side which often childishly very tiring.

Finally, the woman who bites his lips as he looked down, blushing. In fact, sometimes, without anything else often biting lip tip, especially if you're thinking. Different expressions on his face sometimes make you smile. Therefore, women like this do not be afraid or hesitant to express his admiration for you. But, if he was upset and angry, not half-hearted, harsh words can come out of his mouth. And if that happens, just let sit for 1 to 2 days. That way he will understand if you do not like and do not tolerate such behavior and attitudes that.

So, if you're like a woman like this, do not be afraid and hesitate to tease. Luluhkan the heart of this charmer. The trick is easy, kulum a wine, and move into the mouth when you kiss them. Then rub and touch sensitive parts of the body-style course with a dopingi and erotic. Surely he's going to melt under a second!