Louisville Circuit Judge Brian Edwards rejects Jewish women's religious challenge to Kentucky's near-total ban on abortions

By Sarah Ladd
Kentucky Lantern

Jefferson Circuit Judge Brian Edwards has ruled against a lawsuit by three Jewish women challenging Kentucky’s abortion ban on religious grounds.

Circuit Judge Brian Edwards

In a nine-page opinion issued Friday night, Edwards said the women do not have standing and that their concerns are “hypothetical.” Citing several earlier cases, the judge said the issue was not yet a concrete problem and lacked “ripeness.”

“Individuals cannot manufacture standing merely by inflicting harm on themselves based on their fears of hypothetical future harm that is not certainly impending,” Edwards wrote. Therefore, “Plaintiffs have failed to demonstrate the existence of a justiciable controversy as defined by generations of case law.”

The ruling came more than a month after the judge heard oral arguments, which heavily focused on in vitro fertilization (IVF) and the extent to which it overlaps with the state’s abortion ban.

One of the plaintiffs has nine frozen embryos that she’s paying thousands of dollars annually to preserve, just as Kentucky lawmakers are split on what protections exist for IVF in the state.

Jessica Kalb, Sarah Baron and Lisa Sobel are the
plaintiffs. (Kentucky Lantern photo by Sarah Ladd)

The women’s lawyers, Benjamin Potash and Aaron Kemper, argued that by banning most abortions, Kentucky had imposed and codified a religious viewpoint that conflicts with the Jewish belief that birth, not conception, is the beginning of life.

They also said the plaintiffs — Lisa Sobel, Jessica Kalb and Sarah Baron — feel Kentucky’s current laws around abortion inhibit their ability to grow their families.

Benjamin Potash, one of the lawyers for the plaintiffs, told the Lantern that the decision “makes numerous obvious errors,” such as basing part of the ruling on a reading of Roe v. Wade, which established a federal right to abortion but was overturned in 2022 by the U.S. Supreme Court.

Assistant Attorney General Lindsey Keiser defended the law on May 13 for the Attorney General Russell Coleman, who praised Friday’s decision “to uphold Kentucky law.”

“Most importantly, the court eliminates any notion that access to IVF services in our commonwealth is at risk,” Coleman said in a statement. “Today’s opinion is a welcome reassurance to the many Kentuckians seeking to become parents.”

Potash said the judge’s decision is “disappointing” and said “we look forward to review by higher courts.”

“After 13 months of waiting, we received a nine-page decision that we feel fails to comport with the law,” he said. “Our nation is waiting for a judiciary brave enough to do what the law and our traditions require.”

Read More

988 roll-out uneven, but Ky. appears to be doing 'pretty well;' last of 14 regional mental-health centers nearing certification for calls

By Melissa Patrick

Kentucky Health News

Even though the roll-out of the three-digit national suicide hotline remains a work in progress across the nation, Kentucky's roll-out over the past two years has gone "pretty well."

So says Steve Shannon, executive director of the Kentucky Association of Regional Programs for mental health. He said Kentucky's success has largely been because of a statewide 988 coalition and its subcommittees that work toward quality outcomes and toward having all of the state's 988 calls to be answered by people inside the state.

"We appreciate the partnership with the team at the Department for Behavioral Health, Developmental and Intellectual Disabilities," he said. "The call centers have worked very closely with them and it's been a great outcome for Kentuckians." 

The 988 line connects people experiencing a mental-health or substance-use crisis with a trained counselor. Shannon said 13 of the state's 14 community mental health centers act as call centers, and that the 14th center is in the process of getting certified to meet the national 988 call center standards, which will mean that eventually 988 calls in all 120 counties can be served by their regional cengter.   

"Our goal is 100% of Kentucky calls get answered by Kentucky," he said. 

Brice Mitchell, spokesman for the state Cabinet for Health and Family Services, also praised Kentucky's 988 roll-out, stating that the centers have used federal grants to increase workforce capacity by hiring staff and utilizing volunteers. 

"These efforts have ensured calls to 988 are most often answered at the local level, 84% in May," Mitchell said in an email. "Additionally, the current in-state answer rate of 25 seconds steadily remains faster than the national average of 36 seconds, and we know every second is critical when it comes to getting someone connected to help."

Asked about the 379 abandoned in-state calls that were reported in May, Mitchell said, "We are not able to determine why calls may be abandoned; one reason could be due to internet or cell phone instability." 

Since May 2023, the state has seen a 40% increase in calls from Kentuckians to 988 and a 53% increase in the number of those calls that are answered in state. Additionally, there has been a 15% increase in Kentucky’s answer rate over the past two years, according to data provided by the the cabinet. 

The federal government provided about $1 billion to launch and implement the 988 Suicide & Crisis Lifeline, with the expectation that states would establish their own funding to operate the call centers, but Axios reports that the "efforts have been uneven . . .  leading to significantly lower response times in certain states." 988 launched in July 2022. 

Axios reports that only 10 states have added a surcharge to cell-phone bills to fund 988 services, though all states fund their general-emergency 911 services in this way, according to a report from Inseparable, a mental health advocacy group. Kentucky is not one of them. 

Kentucky's General Assembly has put money in the budget for the 988 call centers since the 2022 legislative session, but "At some point, a dedicated funding mechanism that allows to accommodate for growth and calls is really necessary," Shannon said. "The appropriation is good, but the concern is, as utilization increases, those costs will increase."  He added that there have been some "preliminary conversations" about this, and the goal is to have an "ongoing, dedicated funding stream, comparable to 911."

This year, Rep. Adam Bowling, R-Middlesboro, filed HB 740 to fund 988 with a fee on special license plates, gifts, grants, contributions, appropriations or other sources. It was never heard in committee.

Another challenge is that many people still don't know about 988. The Pew Charitable Trusts released a survey last year that showed only 13% of adults in the U.S. had heard of the 988 line.

A national 988 paid marketing campaign will launch this month and run through October to help address this issue. It will also likely increase the number of calls. 

Axios reports that going forward, "States and cities are also moving toward integrated 988 and 911 services, said Kaiser Family Foundation researcher Heather Saunders, who tracks policies around the hotline. Federal regulators are also looking to require that 988 calls are routed to a person's actual location, rather than their area code, to better connect them with nearby resources." 

Read More

Ben Chandler to retire as head of Foundation for a Healthy Kentucky; board names COO Allison Adams to succeed him

Ben Chandler and Allison Adams

Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky for the last eight years, announced Thursday that he would retire at year's end and be succeeded by Allison Adams, the philanthropy's chief operating officer.

“After a very thorough process, it was clear to everyone on the board that Allison was the perfect choice to be the organization’s next leader,” said Marianne Smith Edge, chair of the foundation's Board of Directors, said in a news release.

“We are excited to see what the future holds, and know the foundation will be in good hands. Allison’s experience, strategic skills, and dedication to disease prevention will be strong assets for the organization. The Board is grateful to Ben and all that he has done for the foundation over the last eight years. His vision to lead the organization into policy advocacy has resulted in many wins for the health of Kentuckians.” 

Chandler, who will turn 65 on Sept. 12, became head of the foundation in 2016, after heading the Kentucky Humanities Council. Before that he was state auditor, attorney general, the 2003 Democratic nominee for governor and U.S. representative from the Sixth Congressional District. As attorney general, he sued to recover the charitable assets of Kentucky Blue Cross Blue Shield when it was bought by Anthem Inc. The $45 million settlement was used to create the foundation in 2001. 

“It has been an incredible experience to lead the Foundation that I helped make possible during my time as an elected official,” said Chandler, of Versailles. “We have achieved things that many deemed impossible. While I am so proud of what we have accomplished these last eight years, I know there is still much to be done. I have the utmost confidence and trust in the organization’s future with Allison at helm.” 

Adams, of Maysville, was director of the Buffalo Trace District Health Department and president of the Kentucky Health Department Association, during which time she worked on legislation to transform Kentucky’s public-health system. A registered nurse, she joined the foundation in 2020 as vice president for public policy and was named chief operating Officer in January 2023.

“I am so honored and thrilled to have been chosen to take the reins of such a dedicated and respected organization,” Adams said. “It has been a privilege to work with Ben these past four years to address the unmet health needs of Kentuckians. Our state still faces many health challenges, and I will not waiver in my commitment to creating a commonwealth where every single person has what they need to live a healthy life.”

Under Chandler, the foundation became more active in lobbying state government, including the legislature. The news release said, "He was a strong advocate for the historic cigarette-tax increase passed by the state General Assembly in 2018, as well as the tobacco-free school campus bill in 2019 that resulted in a large increase of school districts covered by comprehensive tobacco-free campus policies. "

Read More

Supreme Court allows government efforts against controversial social-media posts, saying plaintiffs lack standing to sue

U.S. Supreme Court (Photo by Andrew Harnik, Getty Images)

By Mark Sherman

Associated Press

The Supreme Court on Wednesday sided with the Biden administration in a dispute with Republican-led states over how far the federal government can go to combat controversial social media posts on topics including Covid-19 and election security.

By a 6-3 vote, the justices threw out lower-court rulings that favored Louisiana, Missouri and other parties in their claims that officials in the Democratic administration leaned on social-media platforms to unconstitutionally squelch conservative points of view.

Justice Amy Coney Barrett wrote for the court that the states and other parties did not have the legal right, or standing, to sue. Justices Samuel Alito, Neil Gorsuch and Clarence Thomas dissented.

The decision should not affect typical social media users or their posts.

The case is among several before the court this term that affect social media companies in the context of free speech. Earlier cases over state laws and the one that was decided Wednesday are variations on the same theme, complaints that the platforms are censoring conservative viewpoints.

The states had argued that White House communications staffers, the surgeon general, the FBI and the U.S. cybersecurity agency are among those who applied “unrelenting pressure” to coerce changes in online content on social media platforms.

The justices appeared broadly skeptical of those claims during arguments in March and several worried that common interactions between government officials and the platforms could be affected by a ruling for the states.

The Biden administration underscored those concerns when it noted that the government would lose its ability to communicate with the social media companies about antisemitic and anti-Muslim posts, as well as on issues of national security, public health and election integrity.

White House press secretary Karine Jean-Pierre said the court reached the right outcome because “it helps ensure the Biden Administration can continue our important work with technology companies to protect the safety and security of the American people, after years of extreme and unfounded Republican attacks on public officials who engaged in critical work to keep Americans safe.”

Louisiana Attorney General Liz Murrill said the decision “gives a free pass to the federal government to threaten tech platforms into censorship and suppression of speech that is indisputably protected by the First Amendment. The majority waves off the worst government coercion scheme in history.”

The justices did not weigh in on the substance of the states’ claims or the administration’s response in their decision Wednesday.

“We begin — and end — with standing,” Barrett wrote. “At this stage, neither the individual nor the state plaintiffs have established standing to seek an injunction against any defendant. We therefore lack jurisdiction to reach the merits of the dispute.”

In dissent, Alito wrote that the states amply demonstrated their right to sue. “For months, high-ranking government officials placed unrelenting pressure on Facebook to suppress Americans’ free speech. Because the court unjustifiably refuses to address this serious threat to the First Amendment, I respectfully dissent.”

Nina Jankowicz was named in the original lawsuit after being appointed in 2022 to lead a new board in the Department of Homeland Security to tackle disinformation. The board was dissolved within weeks, amid conspiracy theories and criticism from Republicans and conservative activists who saw the effort as a political tool to regulate free speech.

Jankowicz, an expert in disinformation, said the Supreme Court had done what she had expected, but she said the damage from the lawsuit is not easily fixed.

“Unfortunately, there is an entire class of people that now believes the government, in coordination with independent researchers, is censoring some part of the American population,” she said. “I don’t think that’s going to go away anytime soon.”

The decision comes as many social media companies have removed guardrails against hate and disinformation. The platform X, owned by Elon Musk, has restored the accounts of conspiracy theorists and extremists who were previously banned. It also has gutted teams that once fought misinformation on the platform, leaving the community of users to moderate itself.

Meta, which owns Facebook and Instagram, no longer emphasizes news and political content on its platforms after facing years of accusations that it mishandles misinformation and contributes to political polarization.

The decision means that the Food and Drug Administration "can continue coordinating directly with social-media platforms," reports Jessica Karins of Inside Health Policy.

"The justices said the plaintiffs lacked standing to sue because they could not show the removal of their social-media content or bans on their accounts were undertaken as the result of government pressure. Rather, the removal was the result of an independent decision-making process that considered government feedback — even if strongly worded — as one of many factors."

The dissenters argued "that the government undertook a major campaign of censorship and that the majority is allowing a significant restriction on free speech to remain in place," Karins reports.

The decision "says the plaintiffs’ allegations of injury depend on actions taken by the social-media platforms, but instead of suing the platforms, the plaintiffs sought to enjoin government agencies and officials from communicating with platforms on misinformation," Karins notes. "Barrett wrote that this contradicts the principle that courts cannot redress injury caused by a third party not before the court."

In friend-of-the-court briefs, the American Academy of Pediatrics, the American Medical Association, the American Academy of Family Physicians and other health organizations "emphasized the government’s compelling interest in fighting misinformation about vaccination, since many of the social media posts at issue were about Covid-19 vaccines," Karins reports.

Read More

Rural Tennessee hospitals near Kentucky border remain closed as the Volunteer State keeps spurning expansion of Medicaid

Jellico Medical Center is defunct. (KFF News photo by Taylor Sisk)

By Taylor Sisk
KFF Health NewsJELLICO, Tenn. — In March 2021, this town of about 2,000 on the Kentucky border in the shadow of Pine Mountain lost its hospital. It's in Campbell County, which ranks 90th of Tennessee’s 95 counties in health outcomes and has a poverty rate almost double the national average, so losing its health care cornerstone sent ripple effects through the region.

“That hospital was not only the health-care lifeline to this community,” said Tawnya Brock, a health-care quality manager and a Jellico resident. “Economically and socially, it was the center of the community.”

Since 2010, 149 rural U.S. hospitals have closed or stopped in-patient care, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. Tennessee has had the second-most closures of any state, with 15, and the most closures per person. Texas has the most, with 25. Neither state has expanded Medicaid under the Patient Protection and Affordable Care Act, as has Kentucky, where only four hospitals have closed.

Jellico Medical Center was a 54-bed, acute-care facility. When it closed, some 300 jobs went with it. Restaurants and other small businesses in Jellico also have gone under, said Brock, who is a member of the Rural Health Association of Tennessee’s legislative committee. And the town must contend with the empty husk of a hospital.

Dozens of small communities are grappling with what to do with hospitals that have closed. Sheps Center researchers have found that while a closure negatively affects the local economy, those effects can be softened if the building is converted to another type of health care facility.

In Jellico, the town owns the old hospital building, and Mayor Sandy Terry said it is in decent condition. But the last operator, Boa Vida Healthcare of Indiana, holds the license to operate a medical facility there and has yet to announce its plans for the building, leaving Jellico in limbo. Terry said local officials are talking with health-care providers that have expressed interest in reopening the hospital. That’s their preferred option. Jellico does not have a Plan B.

“We’re just in hopes that maybe someone will take it over,” Terry said. Meanwhile, the nearest emergency rooms are a half-hour drive away in LaFollette, Tenn., and in Corbin, Ky.

MapQuest map, adapted by Kentucky Health News

An hour and a half away in Fentress County, the building that once housed Jamestown Regional Medical Center has been empty since June 2019, when Florida-based Rennova Health — which also previously operated Jellico Medical Center — locked it up.

County Executive Jimmy Johnson said Rennova’s exit from Jamestown was so abrupt that “the beds were all made up perfectly” and IV stands and wheelchairs sat in the halls. About 150 jobs evaporated when the center closed.

Rennova still owed Fentress County $207,000 in taxes, Johnson said, and in April the property was put up for auction. A local business owner purchased it for $220,000. But Rennova was granted a year to reacquire the building for what it owed in back taxes, plus interest, and did so within a few days.

Abandoned hospital buildings dot the map in Middle and East Tennessee. In West Tennessee, some shuttered hospitals have found new life.

The closing of McKenzie Regional Hospital in 2018 was a blow to the local economy. But Baptist Memorial Health Care, which operates a hospital in nearby Huntingdon, bought the assets — including the building, land, equipment, and ambulance service — and subsequently donated the building to the town of McKenzie.

Cachengo, a technology company, ultimately took over the space. Because of hospitals’ electrical infrastructure, the site was a perfect fit for a business like his, said Ash Young, Cachengo’s chief executive. Young said Cachengo is now looking into repurposing abandoned hospitals across the country.

Jill Holland, McKenzie’s former mayor and a local-government and special-projects coordinator for the Southwest Tennessee Development District, believes the town can become a technology hub. “It’s opening a lot of doors of opportunity for the youth in the community,” she said.

But in Jamestown, the vacant hospital is “deteriorating,” said Johnson, the county executive. “It could have been used to save lives.” Rennova did not respond to a request for comment.

The University of Tennessee Medical Center opened a freestanding emergency room elsewhere in Jamestown, sparing residents a half-hour drive to the closest ER. Johnson believes the old hospital building could serve the community as housing for those who are homeless or as a facility to treat substance use disorder.

Brock, the health-care quality manager, thinks things will get better in Jellico, but the community has had its hopes dashed more than once.

Brock believes a freestanding emergency room could be a viable solution. She urges her community to be responsive to “a new day” in rural health in America, one in which a hospital must focus on its community’s most urgent needs and be realistic about what that hospital can provide.

“Maybe it is just the emergency room, a sustainable emergency room, where you could hold patients for a period of time and then transfer them,” Brock said. “And then you build upon that.”

She added, “There are options out there.”

KFF Health News, part of the Kaiser Family Foundation, is a national nonprofit newsroom producing in-depth journalism about health issues.

Read More

Health department director says she has work to do, to educate Attorney General Coleman about syringe exchanges

Dr. Crystal Miller with state
Health Commissioner Stack

Kentucky Health News

The director of a district health department with a syringe exchange has voiced disappointment to her local newspaper over Attorney General Russell Coleman's opposition to the exchanges.

Dr. Crystal Miller, director of the Wedco Health District, which serves Scott, Harrison and Nicholas counties, told the Georgetown News-Graphic that syringe-exchange programs are misunderstood.

“It is unfortunate that our attorney general doesn’t support syringe service programs,” Miller told the newspaper. “We have work to do to educate him on grasping a full understanding of what this program entails.”

Noting Coleman's statements to Kentucky Health News, Miller said, “This program is designed around the very things he’s supportive of, prevention and treatment. We work closely with community partners to create a system that no matter where someone enters, we know how to link them to an agency that can assist. Substance abuse is a problem in our society that we will never enforce our way out of, and successful mitigation requires all hands-on deck. Syringe service programs are a framework for that in our community.”

The News-Graphic notes, "Approval for such a program, here, was difficult and strongly opposed by the Scott County Fiscal Court several times until a magistrate who once opposed such a program became aware of a situation involving someone he knew and reversed his opposition."

Miller said, “At surface level, syringe service programs can be misconceived. This program provides an entry point to many resources for people who use drugs and allows us to promote recovery. Through this program alone, we have referred people to treatment for drug use, linked them to care and resources within the community to help them make better, healthier choices.

"We have success stories of people recovering in every SSP program across Kentucky. However, one of the biggest successes within this program is the amount of hepatitis C and HIV that we have been able to detect and treat within our communities. Without this program, we would not have identified communicable diseases that are killing people and costing taxpayers large amount of money. Just within the Wedco District, through our SSP program, we have saved taxpayers $1.3 million in early identification/treatment of Hepatitis C. We are effective at prevention and treatment and the data proves it."

As for Coleman's concern that syringe exchanges promote drug use, Miller said, “I can assure you that not one participant has ever reached our doors and decided to start using drugs because we are providing clean syringes. We prevent the spread of disease, focus on reducing as many barriers as possible and being a resource to helping people make better decisions and recover, all while saving taxpayers money. I hope that we can work more closely with our AG to help him understand and support the impact that this program has in communities.”

More than half of Kentucky's counties have syringe exchanges.

Read More

Cervical-cancer screening declined in pandemic, UK study finds

A Pap test (Photo by Rabizo, iStock/Getty Images Plus)

By Elizabeth Chapin

University of Kentucky

New research at the University of Kentucky reveals concerning declines in cervical cancer screening rates among women in the U.S. during the Covid-19 pandemic, especially in rural areas.

The study, led by UK Markey Cancer Center researcher Ty Borders, analyzed nationally representative survey data from the National Cancer Institute to examine Pap test screening rates before and during the pandemic. A Pap test (or Pap smear) is a screening method that can detect cervical cancer or cell changes that may lead to cervical cancer, allowing for early detection and treatment.

The analysis showed that the odds of a woman receiving a Pap test in the past year were 30% lower in 2022 compared to 2019, before the pandemic began.
research published in JAMA Network Open 

The substantial decline is concerning, given that cervical cancer is largely preventable with regular screening and early intervention says Borders, a professor in the UK College of Nursing and director of the Rural and Underserved Health Research Center.

The study also found increased disparities in screening rates between rural and urban women. In 2022, only 48.6% of rural women reported receiving a Pap test in the past year, compared to 64% of urban women.

Women from rural areas have historically had higher rates of cervical cancer incidence and mortality, so a widening urban-rural gap in screening during the pandemic is particularly troubling, Borders says.

“The findings point to a need to expand access to cervical cancer screenings among all women, but especially those residing in rural areas, to prevent a possible uptick in future cervical cancer incidence and mortality,” said Borders.

Disruptions to health care services during Covid-19 lockdowns likely contributed to the declines in screening, as many clinics temporarily suspended or scaled back routine procedures like Pap tests.

Based on the results, health care providers may want to consider extra measures to ensure patients are up to date with recommended screenings, including expanding the availability of appointments for cervical cancer screenings and reminding patients of screening due dates.

The research was published in JAMA Network Open, a publication of the American Medical Association. 

Read More