'Fair Chance Academy' to help employers foster employment opportunities for people with substance-use disorders

The foundation of the Kentucky Chamber of Commerce is offering a three-day "Fair Chance Academy" to help employers foster employment opportunities for Kentuckians in recovery from substance use disorders who are ready to re-enter the workforce. 

“Employment is a critical component of long-term recovery, and the business community has an important role to play in helping individuals return to the workforce and reducing stigma around recovery in the workplace,” Morgan Kirk, director of the Kentucky Chamber Foundation’s Workforce Recovery Program, said in a news release. “We’re excited to begin offering this training to help employers transform lives, and we encourage businesses of all sizes and across all industries to apply.”

The Chamber will select 15 companies to participate in the inaugural Fair Chance Academy which will involve three, full-day training workshops at the Kentucky Chamber Headquarters in Frankfort on May 11, May 25 and June 8. Applications for the academy close on Friday, April 15. Click here to apply.   

Following the training, participants will spend three months implementing actionable steps within their companies to become fair chance employers, a practice that reduces many of the roadblocks that make it difficult for candidates in recovery or with a criminal conviction to get hired. 

"Certifying employers as ‘fair chance’ can provide stable employment for someone, which is a critical component of long-term recovery," Van Ingram, executive director of the Kentucky Office of Drug Control Policy, said in the release. "This can provide Kentuckians with the purpose and motivation they might need to stay in remission and get their lives back.”

Employers will also have the opportunity to participate in a discussion with Sam Quinones, author of “The Least of Us,” who has been nationally recognized for his writings on the opioid crisis.

The Fair Chance Academy is part of the foundation’s Transformational Employment Program, which launched last year. This program provides a bridge from recovery to employment by lessening the risk of employers who hire or retain people with substance-use disorder, if the employees sign up for treatment and complete it. To date, 55 Kentucky employers are signed up, which impacts more than 11,000 employees.

April is National Second Chance Month.

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Kentucky's Covid-19 metrics continue to drop, almost to last June's lows, but pandemic death toll has surpassed 15,000

In yellow counties on this adapted Centers for Disease Control and Prevention map, the CDC says residents who are immuno-compromised or at high risk for severe illness should talk to a health-care provider about "additional precautions, such as wearing masks or respirators indoors in public. If you live with or have social contact with someone at high risk for severe illness, consider testing yourself for infection before you get together and wearing a mask when indoors with them."

By Melissa Patrick
Kentucky Health News

The good news about the Covid-19 pandemic is that all metrics to measure the coronavirus in Kentucky continue to drop – including deaths, for the second week in a row. The bad news is that the addition of last week's Covid-19 deaths means that more than 15,000 Kentuckians have died from the disease.  

The state attributed 135 more deaths to Covid-19 last week, an average of 19.3 per day. That's down from 33.7 per day last week and approximately 40 a day recorded in each of the three weeks prior to that. The state's pandemic death toll is now 15,028. 

From last Monday through Sunday, the standard reporting week, the percentage of Kentuckians testing positive for the coronavirus dropped again, to 1.97%. The last time the state saw a positivity rate this low was in June 2021, just before the highly contagious Omicron variant hit. The low was 1.79%.

The state's weekly report showed 3,948 new cases of the virus during the week ended April 4, an average of 564 per day. The week before, the average was 790 per day. 

The state's seven-day infection rate fell to 4.13 daily cases per 100,000 residents. A few hotspots remain. Counties with rates more than double the statewide rate were Pike and Trimble, 8.4;  Cumberland. 8.6; Perry, 9.4; Wolfe, 12; Hickman, 13; Clinton, 23.8; Taylor, 24.9; and Anderson, 42.1. 

The New York Times ranks Kentucky's infection rate fourth among states, even though the number of cases has declined 46% in the last 14 days.

Of the week's new cases, nearly 24% were in people 18 and younger. 

Hospitals reported 240 patients with Covid-19, less than a third of the 782 reported a month ago; 36 of them were in intensive care and 18 were on mechanical ventilation. Five of the state's hospital regions are using at least 80% of their intensive-care beds, but very few of their patients have Covid-19. Overall, 53% of beds were in use, 77% of ICU beds were, and only 22% of ventilators were.

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Recent genetic and medical study of 371,000 in United Kingdom concludes that no amount of alcohol is good for your heart

WebMD photo

By Melissa Patrick
Kentucky Health News

Although observational studies have indicated that moderate alcohol consumption is good for your heart, a new genetic and medical study of 371,000 people in the United Kingdom determined that any level of alcohol consumption is linked with a higher risks of heart disease – and the more you drink, the greater the risk. 

Not only does the study suggest that alcohol can lead to cardiovascular disease, there are "unequal and exponential increases in risk at greater levels of intake," the researchers conclude. They said that "should be accounted for in health recommendations around the habitual consumption of alcohol." 

The study, published in JAMA Network Open, found that the risk of cardiovascular disease is "relatively modest" for those who consume up to seven drinks per week, but that risk increases exponentially with more alcohol. 

The researchers question whether an average consumption of two drinks per day should be considered low-risk behavior and emphasize the need for "aggressive efforts to reduce alcohol intake among heavy drinkers." 

The researchers define light alcohol consumption as up to eight drinks per week; moderate consumption as 8 to 15 per week; heavy consumption as 15 to 24; and abusive consumption as more than 24 drinks per week.

While this study found that moderate drinkers have less heart disease than heavy drinkers or those who abstain, it suggested another cause for that: Those with light to moderate alcohol consumption also had healthier overall lifestyles, such as smoking less or not at all, exercising more, and eating healthier. 

"The reported cardioprotective effects of light to moderate alcohol consumption may be the product of confounding lifestyle factors," says the report.

The study looked at the connection between genes that are linked to alcohol consumption and cardiovascular disease for more than 371,000 people who participate in the U.K. Biobank, a large-scale biomedical database that allows researchers to study participants' genes and their relationship to health. Their average age was 57 and they reported consuming an average of 9.2 drinks per week. 

Understanding your alcohol intake can help assess how alcohol may affect your health, Dr. Danielle Anderson, an addiction medicine specialist with UK HealthCare, said in a recent article titled, "When One More Drink Can be Dangerous to Your Health." 

Assessing alcohol intake starts with counting the number of “standard drinks” you have in a week, Anderson writes. A “standard drink” is a 12-ounce beer containing 5% alcohol, a 5-ounce glass of wine, or 1.5 ounces of liquor containing 40 percent alcohol (80 proof). 

The federal government's Dietary Guidelines for Americans recommend that men of legal drinking age either abstain or limit intake to two drinks or less in a day, and that women abstain or limit intake to one drink or less in per day. The guidelines say drinking less is better for health than drinking more. 

The National Institute on Alcohol Abuse on Alcoholism defines binge drinking as consuming five drinks for men or four drinks for women on the same day within a couple hours. 

If you have alcohol-use disorder, the current medical term for was once called alcoholism, treatments are available that include medications, therapy and involvement in mutual support programs such as Alcoholics Anonymous or the Supportive Medication And Recovery Treatment (SMART), Anderson notes. 

Anderson, an assistant professor in the UK Department of Psychiatry, advises, "Talk to your provider about your health conditions and medications prior to using alcohol. If you are drinking above the recommended amounts of alcohol, talk with your provider about your concerns."

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Lexington's health department starts National Public Health Week by honoring two 'public health heroes'

UK Professor Sharon Walsh

University of Kentucky Professor Sharon Walsh and Lexington Fire Battalion Chief Marc Bramlage have been named the Dr. Rice C. Leach Public Health Heroes for 2022 by the Lexington-Fayette County Health Department.

The award, announced Monday at the start of National Public Heath Week, is given annually to those who have demonstrated their dedication to improving the health of Lexington residents. It is named for the late Rice C. Leach, who was commissioner of health for Lexington and the state and spent more than 50 years as a public-health physician.

Walsh is the principal investigator on UK's largest grant ever, an $87 million study to determine how to reduce opioid overdose deaths in Kentucky and create a national model. It involves Jefferson, Fayette, Franklin, Kenton, Campbell, Mason, Greenup, Boyd, Carter, Bourbon, Clark, Madison, Jessamine, Boyle, Knox and Floyd counties.

Walsh and her team have established partnerships with behavioral-health and criminal-justice agencies to implement an integrated set of evidence-based practices to combat the opioid epidemic, including communication campaigns, expanding capacity to medication-assisted treatment for opioid-use disorder, providing overdose education and distributing 4,600 units of naloxone, a drug that reverses overdoses. 

“I’m honored to receive the award created in memory of Rice C. Leach, a true public health hero committed to improving the health and well-being of Lexingtonians and all Kentuckians,” Walsh said in a news release. “Kentucky was one of the first and is among the states hardest hit by the nation’s opioid crisis. Combating this epidemic must happen in the communities where affected people live.”

Chief Marc Bramlage (Photo by Frank Handshoe)

Bramlage received the award for supporting the health department's Covid-19 vaccination clinics. "it is an honor to be awarded for doing a job you love," he said. He and Walsh will be recognized at the April 11 Board of Health meeting and at the April 14 Urban County Council meeting. 

UK's College of Public Health has organized daily events this week to celebrate Public Health Week, including a panel discussion at 6 p.m. Thursday, April 7, to discuss health equity and social determinants of health. Click here to register. 

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Domestic-violence survivor triumphs, one step at a time, at UK

University of Kentucky video; for captions, click on play, then click the CC icon on the bottom line. If using a mobile device, click on the "thought bubble" in the same area.

April Ballentine uses new equipment to walk.
(University of Kentucky photo by Mark Cornelison)

By Allison Perry
and Steve Shaffer
University of Kentucky
   
   “Deep breaths, April. Deep breaths.”
   April Ballentine nods, steeling herself. As she sits inside the lab of the University of Kentucky’s Sports Medicine Research Institute, her anticipation stirs up an incredible amount of pure nervousness.
   This is the day the Lexington native has been waiting for, working for – for weeks, months, even years.
   A crowd has gathered to witness this moment, including April’s friends and family, UK faculty, and physical therapy students from the UK College of Health Sciences.
   With great trepidation, she shifts her body into position, channeling her mindfulness to conquer this new task. Then, she is asked the million-dollar question.   
   “You ready?”
   April looks up at the physical therapist in front of her, unflinching. “Yes.”
   Today, the 51-year-old will stand and walk for the first time in more than eight years.

•

   In August 2013, April was out with friends at a happy hour when an ex-boyfriend showed up, gun in hand. As he raised it toward her face, she blocked his first shot. But in the chaos, she blacked out and fell to the ground. He then unloaded the chamber on her in front of more than 50 witnesses.
   At some point, April woke up, covered in a white sheet. Her ears were ringing, and all she could utter was one phrase, over and over. “I’ve got to get up.”
   She then heard a voice gently reply, telling her to lie still, followed by sirens. She couldn’t breathe. Then, everything went black again.
   When April woke up for the second time, she was at UK's Albert B. Chandler Hospital. She had survived five gunshots at close range. A trauma team led Dr. Andrew Bernard, the trauma medical director, had stopped the bleeding, saving her life.
   Because she was hooked up to a respirator, April’s medical team gave her a dry-erase board to communicate.
   “I wrote my daughter’s name with a question mark, and they said she was fine,” April said. “Then they asked me if there was anything they could get for me. And I said I was hungry as hell.”
   That fighting spirit kept April going during her stint in the ICU – a time she calls “one of the greatest challenges I’ve had to go through in my life.” After several weeks of intensive care, she was discharged to Cardinal Hill Rehabilitation Hospital.
   “That’s when I learned I was paralyzed,” April said. “I had never heard that word before – or if I did, it just never registered because I was so highly medicated.”
   At Cardinal Hill, April began working with a team of therapists led by physical medicine and rehabilitation physician Sara Salles. She had to learn how to live with her new normal: paralyzed from the chest down due to a T4 spinal-cord injury.
   “Dr. Salles explained everything to me,” April said. “And I said, ‘OK.’ I never asked why. I never cried about it. The pain was more overbearing than anything else I could have imagined because it was constant. [It’s] something I never want anyone to experience.”
   April spent 90 days at the facility. She’d heard of companies that made robotic exoskeletons, which allowed users to stand up and walk again with bracing and support from the upper body. Occasionally during her therapy, April would try to stand, holding herself with her arms.
   It was far harder than she had expected.
   “It was so difficult,” she said. “I recall trying to push myself up, and it almost seemed impossible. That dream was shot really easily. I had to learn that I had to live for today and not tomorrow. Because I lived for walking, I couldn’t live in the moment.”

•

   In October 2015, April was speaking about her experience at a church to raise awareness for Domestic Violence Awareness Month. Fayette County Sheriff Kathy Witt heard her story and approached April with a proposition.
   “She said, ‘I want you on my team’,” April said. “She’s been a great advocate for domestic violence awareness for a very long time.”
   April began working with the sheriff’s office, first as a volunteer, then as an employee. She now serves as a victim advocate intake specialist in Amanda’s Center, a 24-hour point of contact for victims of domestic violence located in the Fayette District Courthouse. In this role, she helps ensure victims have access to the resources and help they need.
   April describes the work as “a calling” that has helped her heal, process and understand her own trauma.
   “I understand what it’s like to be a victim, and I understand what it’s like to be afraid and to not be afraid,” she said. “And I believe that I’m a good resource to help someone escape, or to help them understand the extreme behavioral issues they’re experiencing.”
   April also began volunteering at Cardinal Hill, playing a mock “patient” for physical-therapy students to learn how to work with people who have spinal-cord injuries.
   “[I want to show] that for anyone with a spinal-cord injury, life is possible and life can be good,” she said. “And I make it fun, too. I think my personality fits because I break the ice, make them laugh, and say the unexpected.”
   Several years ago, she was contacted by ReWalk Robotics, a company that makes bionic devices to help people with spinal cord injuries. ReWalk’s exoskeleton has been available since 2014 and was the first such device to be cleared for market in the U.S. by the Food and Drug Administration. The company was looking for an opportunity to start a program in Lexington. April passed their information on to her contacts at Cardinal Hill, not really expecting to hear anything further.
   But that contact lit a spark in her. She decided to start focusing on her physical fitness.
   “I started thinking, ‘OK, I’ve got to take better care of myself,’” April said. “And then Covid hits. I said, ‘I’m not going to sit here and do nothing.’”
   April sought out a trainer and got to work, noting playfully that one of her goals was to develop “Angela Bassett arms.” Over the past two years, she’s lost 180 pounds and developed incredible upper-body and core strength. Although April’s spinal-cord injury is at her T4 vertebra – around chest height – she still has some sensation and strength in her core, which helps her do things that many others with her same injury classification can’t do.
   Last August, April began to build strength in another way.
   She bought her own house, regaining the independence she lost that traumatic day in August 2013.
   “Taking on my health and being able to live independently with such a high injury level made me dream,” she said, “and recognize, and remember that I can do anything.”

•

   Denise O’Dell is relatively new to UK, having joined the College of Health Sciences as an associate professor last summer. As a physical therapist, she specializes in working with patients who have neurological impairments, including brain and spinal cord injuries. O’Dell teaches students in UK’s Doctor of Physical Therapy program and works with patients in the Kentucky Neuroscience Institute’s ALS Multidisciplinary Clinic.

   O’Dell took a group of UK students to Cardinal Hill last fall, where April was volunteering again as a mock patient. In addition to the physical therapy techniques students will perform, O’Dell says she often reminds them how important it is to listen to their patients during therapy.
   And listening to April’s story, O’Dell and her students were impressed.

   “I could see the drive that she has to give back to society, to better herself, to stay engaged,” O’Dell said. “Given my background and having worked with a lot of individuals with spinal cord injury, I saw sparks there that I hadn’t seen in others for quite some time.”

   Encouraged by April’s overall strength, O’Dell asked if she’d ever stood up. April had been medically cleared via bone-density screenings for standing – with support – in her power chair, but she had never tried to stand another way. O’Dell brought her to a set of parallel bars.
   “Denise was like, ‘We’re going to do something different’,” April said. “She said, ‘I’m going to have you stand using these parallel bars.’ And I just kind of looked at her and said OK. I’m open to it.”
   With O’Dell supporting her legs, April grabbed the bars and pushed up into a standing position.
   “She literally just popped up into standing,” O’Dell said. “The first time she was up for two or three minutes. That’s pretty unheard of for someone who hasn’t done it for so long.”
   Shortly after, April asked to stand again.
   “Even though we were out of time, we did it again,” O’Dell said. “The students were like, ‘We’ll stay.’ They could see that this was a better learning moment than I think they had expected.”
   In a previous job, O’Dell had been part of a team that helped evaluate and train patients following spinal cord injury, including evaluations for standing and use of exoskeletons. Based on her experience – and what she had just witnessed – she thought April could be an ideal candidate. She made some calls to her colleagues at UK HealthCare and the College of Health Sciences and contacted ReWalk to come up with a plan for April to trial an exoskeleton device.
   “Next thing I knew, I had a phone call with a date,” April said. “So here we are.”

•

   Back in the Sports Medicine Research Institute lab, April’s big moment is here. She’s officially “trialing” the exoskeleton, which will help the ReWalk team determine if she’s an eligible candidate to begin training with the device. From the crowd, a voice calls out: “Use those Angela Bassett arms!”
   April smiles and offers a correction: “These are April Ballentine arms.”
   She swings a set of forearm crutches back, tilts forward, and prepares to use her considerable upper body strength. The exoskeleton beeps and whirs. Guided by therapists from ReWalk, April pushes into the crutches and powers up to a full standing position. Now, she’s standing taller than the therapist in front of her.
   Her audience cheers.
   From there, the team takes April through some of the basic movements she will need to master: holding a neutral standing position, shifting her weight laterally, pivoting, and finally, walking. The machine will move her legs for her, but she will use the forearm crutches to support, balance and guide her body as she moves.
   When it’s time to walk, the therapists clear a path in the room and tell April she’ll be walking toward a man in a blue suit – Bernard, the UK trauma surgeon, who stopped by to show his support. Seeing him, her eyes fill with tears.
   April’s first few steps are big, lurching. The team stops to recalibrate the machine to her gait. Her trainer, David Asbury, comes to stand by her side and coach her through the walk. She grins.
   “Hey, I’m taller than you!” she exclaims to Asbury, and everyone laughs.
   With the machine recalibrated, she tries again. This time, she takes off, walking across the room, only stopping when she reaches a curve that requires a pivot. Sitting down to rest, she’s overcome with emotion as her friends and family hug and congratulate her.
   “I’m just overwhelmed right now,” she says, voice shaking. “It’s been eight and a half years.”

•

   For patients with a spinal cord injury, a ReWalk exoskeleton isn’t just about the chance to walk again. The mobility it offers comes with a number of health benefits that can improve the patient’s overall quality of life – better circulation, muscle spasticity, bowel and bladder function, and even nerve pain.
   “The opportunity to stand and walk is multifaceted,” O’Dell said. “Physiologically, being upright, your gastrointestinal system works better. Your heart, your lungs work better. An individual such as April will rate their quality of life higher from a participation and health standpoint.”
   But April still has more work ahead of her.
   Although insurance will cover the cost of training with the device, it does not cover the cost of the device itself for non-veterans. ReWalk continues to pursue insurance coverage opportunities, but for now, April will need to cover the cost of her own exoskeleton.
   To help fundraise for the device, April is working through a nonprofit organization called I GOT LEGS, which set up a donation page for her. Once she has her down payment, she can begin working with ReWalk-trained physical therapists to become proficient with the exoskeleton, a process that usually takes 20-30 sessions.
   She isn’t deterred by the cost. Where there’s a will, there’s a way, and April Ballentine always finds a way.
   “Throughout the last nine years, there have been people saying, ‘You can’t do this, you can’t do that’ – whatever,” April said. “I’m going to prove you wrong every time.”
   Besides, she has another ambitious goal to meet. In November, April’s daughter is getting married. And she’s determined to walk her daughter down the aisle.
   It’s that determination that makes her such a light and role model for the community, said Bernard. Despite her tragedy, she has persevered.
   “She was a victim, but she’s not a victim anymore,” Bernard said, adding that her situation “was minutes of crisis, and then it’s a lifetime of potential impact.”
   When she woke up under that sheet in 2013, April had only one thought in her mind: I’ve got to get up. Eight and a half years later, she’s done it. And she’s hungry to do it again.
   She just needed that little extra push – one that came in the form of a chance meeting with someone who saw her potential and had the right experience to make it happen.
   Denise “is pretty phenomenal,” April said. “Recently, I told her, thank you for seeing my ability instead of my disability. If it wasn’t for her, I would not be here today.”

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CDC lists only six Ky. counties – Harrison, Robertson, Clay, Knox, Laurel and Whitley – as those where masks might be needed

National Geographic map, adapted by Kentucky Health News; to enlarge, click on it.

The latest Centers for Disease Control and Prevention map of risk posed by the coronavirus has every county at low risk except Harrison, Robertson, Clay, Knox, Laurel and Whitley. In those counties, residents who are immuno-compromised or at high risk for severe illness should talk to a health-care provider about "additional precautions, such as wearing masks or respirators indoors in public. If you live with or have social contact with someone at high risk for severe illness, consider testing yourself for infection before you get together and wearing a mask when indoors with them," the CDC says.

The ratings are based on new coronavirus cases, Covid-19 hospitalizations and the percentage of staffed inpatient beds occupied by Covid patients. Kentucky remains one of the higher-risk states, according to the CDC's national map. Its rate of new cases over the last two weeks is third among the states, behind Alaska and Vermont and virtually tied with Colorado, according to The New York Times.

Here's a series of maps from National Geographic showing the progress of the pandemic in the nation since last June, when the highly contagious Omicron variant began to take hold (click on it to enlarge):

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Latest bill to aid independent pharmacies stalls in Senate after running into one of the session's heaviest lobbying campaigns

By Melissa Patrick
Kentucky Health News

FRANKFORT – The latest bill to help independent pharmacies compete with pharmacy benefit managers, sailed out of the House with overwhelming support but came to a resounding halt in the Senate. No one is saying why, but the PBMs mounted one of the session's heaviest lobbying campaigns.

PBMs determine what drugs are offered in insurance plans, where and how a patient gets their drugs, how much is paid for the drug, and how much the pharmacist gets. The leading PBM in Kentucky is CVS Caremark, a sister company to one of the nation's largest pharmacy chains.

House Bill 457 passed the House 88-3 on March 21, with 56 sponsors. The next day it went to the Senate Appropriations and Revenue Committee, not a usual location for such a bill, and never got a hearing. It has had none of its regularly required three daily readings, and only two legislative days remain. 

Key parts of the bill would ensure that patients could pick their pharmacy, instead of being required to use one affiliated with the PBM; increase transparency between insurers and PBMs; and ban PBMs from retroactively denying a pharmacy claim after adjudication, commonly referred to as "clawing back."

Rep. Steve Sheldon, R-Bowling Green

Republican Rep. Steve Sheldon of Bowling Green, the bill's prime sponsor, said he was surprised that it didn't move in the Senate after getting such overwhelming support in the House. He said he couldn't say why leaders of the Senate's Republican majority had not supported it, but did say that many big companies opposed it. 

Those companies' heavy lobbying efforts appear to have worked. 

The Pharmaceutical Care Management Association, PBMs' trade group, was one of the state's top 10 lobbying spenders in the first two months of the legislative session, spending $38,369 to get their messages to lawmakers, according to reports they filed with the Kentucky Legislative Ethics Commission.

That ranked the PCMA ninth in spending, and it seems likely to end the session at a higher rank, because it spent thousands of dollars from March 21 to April 1 on television commercials asking viewers to contact their legislators and ask them to vote against HB 457, saying it would raise drug prices.

Sheldon fought back on his Facebook page March 28, pleading with senators to consider the bill.

"I would appreciate the Senate looking at HB 457," he said. "We are down to 2-3 days … I realize bills that inject millions back into Kentucky and allow our seniors patient choice are not as glamorous as the status quo, but please take a real close look at this. Don’t let your Kentucky dollars get mandated by PBMs out of state while our seniors wait by the mailbox for their medicine !! Don’t believe the lies, propaganda and rhetoric. It’s not TOO late." 

Lobbying groups' spending reports for March are due April 15.

CVS Health reported spending $21,528 through February. In a statement dated March 21, it said, "House Bill 457 will only increase the costs of prescription drugs in Kentucky, making it more difficult for Kentuckians to access affordable medications. Dozens of Kentucky employers are opposed to this bill because it does not help control the cost of prescription drugs and hurts their employees. We urge the Senate to reject HB 457. We should protect consumers from increased health care costs, and lawmakers should focus on the high prices set by big drug companies."

The Kentucky Association of Health Plans, the lobby for the state's health insurers, reported spending $11,316, and the Kentucky Association of Health Underwriters reported $5,000. Both groups spoke against the bill in a House committee. 

Individual insurance companies, which have a wide range of interests, also opposed the bill. Anthem Inc. and its affiliates reported spending $35,597 on lobbying in the first two months, ranking 11th; United Healthcare reported spending $14,000.

Senate Appropriations and Revenue Committee Chair Sen. Chris McDaniel, R-Ryland Heights, did not respond to several e-mails from Kentucky Health News asking why he did not give the bill a hearting. 

Angela Billings, spokeswoman for the Senate majority, said in an e-mail that she had reached out to McDaniel with the question and that it would have to be "tabled" until the General Assembly returns April 13 to reconsider bills and budget lines vetoed by Gov. Andy Beshear.

"I daresay that he was extraordinarily busy with the budget and could not get to many bills worthy of hearing," Billings said. 

Sen. Max Wise, R-Campbellsville, who has been instrumental in getting PBM-control bills passed in prior legislative sessions, said he didn't know why this one hadn't moved in the Senate, but said in a text message, "I do support the concept and the language of HB 457." Asked if it was discussed in Republican senators' private caucus, he said, "Policy discussions stay within the caucus."

Kentucky lawmakers have been working on PBM issues for years, most recently passing 2020 Senate Bill 50 to make the state hire a single PBM to manage Kentucky Medicaid's prescription-drug business of more than $1 billion a year. A 2019 state analysis found PBMs made $123 million through spread pricing.

During the bill's House hearing, Sheldon, a pharmacist and businessman who is not seeking re-election, said it had taken three years of collaboration to produce, with upwards of 20 organizations supporting it.

Lobbying groups must list the bills on which they are lobbying, but not whether they are for or against them. Other than those above, those that listed HB 457, and their total expenses between Jan. 1 and Feb. 28, were: American Pharmacy Services Corp., $550; Appalachian Regional Healthcare, $10,209; Chewy Inc., $10,000; EPIC Pharmacies (buying group for independent pharmacies), $7,416; Ford Motor Co., $17,500; GE Appliances, $5,000; St. Elizabeth Healthcare of Northern Kentucky, 16,358; and University of Louisville Health, $6,000.

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