Beshear says current state of Ky. law on abortion is 'the most extremist in the nation' because of no rape or incest exceptions

Beshear talks about abortion. (Screenshot from Facebook)

By Al Cross
Kentucky Health News

The current state of Kentucky's law on abortion is "the most extremist in the nation" because it is bans almost all abortions with no exceptions for cases of rape or incest, Gov. Andy Beshear said Thursday.

At his regular weekly press conference, Beshear was asked for his reaction to the defeat Tuesday in Kansas of a constitutional amendment similar to one on the Nov. 8 ballot in Kentucky, which would negate a preliminary court ruling that two state abortion laws probably violate the state constitution's privacy and religious-freedom provisions.

The temporary injunction, issued by Jefferson Circuit Judge Mitch Perry in a lawsuit by the state's two abortion clinics, has been blocked by state Court of Appeals Judge Larry Thompson of Pikeville pending the court's consideration of an appeal and a request to toss the case to the state Supreme Court.

That makes abortion illegal in Kentucky, except to save the woman's life or prevent permanent damage to a life-sustaining organ, under a "trigger law" the General Assembly wrote to take effect if the U.S. Supreme Court overturned its 1973 Roe v. Wade decision for abortion rights, which it did on June 24. 

"I believe that most Kentuckians view the current state of reproductive health in Kentucky as extremist," Beshear said. "I believe people should go thinking about that constitutional amendment with regards to the trigger law. . . . If that constitutional amendment passes, it will make the trigger constitutional, if it is not" under Perry's ruling.

"The trigger law is, I think, the most extremist in the nation," Beshear said. "It means that rape victims have no options. It means that victims of incest have no options. . . . They deserve options. I think the vast majority of Kentuckians agree the current state that we're under right now is extremist, and I don't think most people out there like extremism."

Beshear generally favors abortion rights, but not late-term abortions. He did not give a reaction to the Kansas referendum, in which voters defeated by 3 to 2 a constitutional amendment that would have negated a Kansas Supreme Court decision that said the state constitution creates a right to abortion.

The amendment on Kentucky's ballot would likewise negate Perry's ruling or any appellate-court ruling upholding it.

Beshear also did not respond to a question about The New York Times' state-by-state estimates of the likely outcome in similar referenda in each state, which predicted that the proposed amendment would be defeated, by a vote of 53 to 47 percent. Here's an adapted version of the Times map with its estimates; for a larger version, click on it.

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Advocates in recovery call for safe drug-use sites, less strict criminal laws, funding from national opioid settlement

Amanda Hall

Kungu Njuguna

By Amanda Hall and Kungu Njuguna
    
The rural-urban divide is an issue that has a considerable impact on the politics and policies of Kentucky. Though there may be differences in communities across the commonwealth, we still have numerous similarities that unite us. We share many of the same joys and hopes for our communities, and unfortunately, we also share some of the same obstacles and difficulties.

One issue that transcends county lines is the overdose epidemic. Kentucky is second in the nation for rates of overdose deaths. Fatal drug overdoses rose nearly 15% in Kentucky last year, surpassing 2,000 deaths. Black overdose deaths continue to trend upward, with Black Kentuckians now representing 10.26% of fatal overdoses despite comprising only 8.6% of the population.

For years, the reaction to drug use has been to incarcerate and reincarcerate. Our jails and prisons continue to burst at the seams with people who need treatment and resources, not incarceration. We now know that further criminalizing drug use has negative public health effects, such as driving drug use underground, increasing the likelihood that people will engage in less safe practices such as sharing needles, and decreasing the likelihood to seek necessary medical attention.

In addition, multiple studies have shown that sending people who used drugs to jail or prison leads to higher rates of mortality, and that the leading cause of death for people formerly incarcerated during the period immediately after release from prison is drug overdose. People who are incarcerated for drug use often live with the life-long consequence of a criminal record, which bars them from employment, housing, education and other essential opportunities. Incarceration due to substance use disorder separates families. The children of incarcerated parents are much more likely to be incarcerated or develop substance-use disorder.

Kentucky Senate Bill 90, enacted this year, aims to divert those with substance-use disorder to treatment and is a great first step. However, we must do more.

First, we need to shift to harm-reduction models for people who use drugs. This should include strengthening Kentucky’s Good Samaritan law, increasing syringe-exchange sites across the state, making Fentanyl test strips and naloxone more readily available, and creating sites for overdose prevention and safe consumption.

Through the lens of harm reduction, we must also revise Kentucky’s harsh drug-sentencing laws. First, we need to treat drug possession as a misdemeanor as opposed to a felony and ensure people have access to treatment for their addiction. Second, Kentucky’s persistent-felony-offender law increases long sentences and does not allow an outlet for people to deal with their drug use from a public-health perspective. Removing language pertaining to drug crimes from the law can help ensure that more people are not subjected to these long sentences. Third, we need to ensure that the tens of thousands of people who are on community supervision have access to treatment resources as opposed to incarceration when they commit technical violations.

The resources to fund this new future are at our disposal. As a result of the national opioid settlement, Kentucky is set to receive $478 million. All these funds must be spent on substance-use-disorder treatment and prevention. We challenge those charged with distributing this money to fund novel approaches that truly address the overdose crisis in our state. Throughout the commonwealth, there are a multitude of grassroots organizations that are providing ground-level services to those suffering in active addiction. Funding these community-based, harm reduction organizations is paramount if Kentucky seeks to stem the tide of fatal overdoses.

As a rural Kentuckian and an urban Kentuckian affected by the overdose epidemic, we ask that all join for a better future for our fellow Kentuckians suffering with substance use disorder.

Amanda Hall of Louisa is Justice Campaign director for Dream Corps. Kungu Njuguna of Louisville is policy strategist for the American Civil Liberties Union of Kentucky. Both are in long-term recovery.

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Abortion-rights supporters encouraged by Kansas voters' rejection of anti-abortion measure similar to one on Kentucky's Nov. 8 ballot

By Al Cross

Kentucky Health News

Voters in a Kansas referendum Tuesday maintained a right to abortion in the state constitution, encouraging opponents of a broad anti-abortion amendment on Kentucky's Nov. 8 ballot.

The Kansas measure would have nullified a 2019 court decision that said the state's constitution guaranteed a right to abortion. Voters rejected it by 61% to 39% in unofficial returns.

The Kentucky ballot has a proposed constitutional amendment designed to thwart a similar decision that could stem from a lawsuit that is moving through Kentucky courts. It would say that the Kentucky Constitution does not create a right to abortion or government funding of it.

Democratic Gov. Andy Beshear has come out against the amendment, noting that it includes no exceptions for rape or incest. Beshear generally favors abortion rights, but the rape and incest exceptions are popular.

Kansas state Rep. Stephanie Clayton and other abortion-rights
supporters were surprised. (Photo: Danielle Kurtzleben, NPR)

The lopsided Kansas vote was a surprise, and was welcomed by abortion-rights supporters such as Laphonza Butler, president of EMILY’s List, which supports female candidates who support the right. 

“Make no mistake, abortion is on the ballot across the country in November, and voters will be holding Republicans accountable for their efforts to strip us of our rights — the success of blocking this anti-abortion ballot initiative is proof of that,” Butler said.

The Kansas City Star reports, "The movement against the amendment succeeded in turning a wide swath of no voters out, despite the amendment’s placement on a primary ballot many assumed would favor Republicans. They were able to keep margins in rural counties smaller than anticipated."

Kansas voters may have been confused by their oddly worded amendment, and voters unsure about a proposal are more likely to reject it.

The Kentucky measure is more straightforward. It was put on the ballot by the state legislature, through a bill sponsored by Republican Rep. Joseph Fischer, who is challenging Justice Michelle Keller, a registered independent, in an officially nonpartisan race for Northern Kentucky's state Supreme Court seat.

The state Supreme Court is already dealing with procedural issues in a lawsuit that could prompt it to render a decision like the high court in Kansas. It involves two state laws, one that bans abortion after six weeks and the "trigger law" written to ban almost all abortions if the U.S. Supreme Court overturned its 1973 Roe v. Wade decision, which it did June 24.

Jefferson Circuit Judge Mitch Perry largely accepted the legal arguments of Kentucky's two abortion clinics, both in Louisville, that the laws violate rights to privacy and religious freedom implicitly created by the state constitution.

Perry issued an injunction blocking enforcement of the laws, but Republican Attorney General Daniel Cameron got Court of Appeals Judge Larry Thompson of Pikeville to block Perry's order pending the appeals court's consideration of the case, beginning with a motion to send it straight to the state Supreme Court. That made abortion illegal in Kentucky, at least temporarily, except when needed to save the life of the woman or prevent a serious, permanent disability to a life-sustaining organ. 

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The debt crisis that sick Kentuckians can’t avoid: bills for health care. State is 11th in medical debtors, but average debt is low.

Kaiser Health News chart, adapted by Kentucky Health News

By Elisabeth Rosenthal

Kaiser Health News

President Joe Biden’s campaign promise to cancel student debt for the first $10,000 owed on federal college loans has raised debate about the fairness of such lending programs. While just over half of Americans surveyed in a June poll supported forgiving that much debt incurred for higher education, 82% said that making college more affordable was their preferred approach.

But little public attention has been focused on what is — statistically, at least — a bigger, broader debt crisis in our country: An estimated 100 million people in the U.S., or 41% of all adults, have health-care debt, compared with 42 million who have student debt.

Kentucky ranks high in percentage of residents having medical debt in the collection process, at 18.1%, which is 11th among the states, but the average debt is one of the lower, $520.

The millions under the weight of medical debt deserve help, both because medical debt is a uniquely unfair form of predatory lending and because of its devastating ripple effects on American families.

Unlike college tuition or other kinds of debt, outlays for medical treatments are generally not something we can consider in advance and decide — yes or no — to take on. They are thrust upon us by illness, accident, and bad luck. Medical treatment generally has no predictable upfront price and there is no cap on what we might owe. And, given our health system’s prices, the amount can be more than the value of the family home if incurred for a hospital stay.

When it was time for my kids to choose a college, I knew in advance almost exactly what it would cost. We could decide which of the different tuitions was “worth it.” We made a plan to pay the amount using bank accounts, money saved in college savings plans, some financial aid, a student job, and some money loaned by a grandparent. (Yes, we had enough resources to make a financially considered choice.)

Think about how different educational debts are from those incurred in health care. In one case, profiled by KHN, the parents of twins, who were born at 30 weeks, faced out-of-pocket bills of about $80,000 stemming from charges in neonatal intensive care and other care that insurance didn’t cover. In another case, a couple ended up owing $250,000 when one spouse went to the emergency room with an intestinal obstruction that required multiple surgeries. They had to declare bankruptcy and lost their home. Even smaller bills lead to trashed credit ratings, cashing in retirement accounts, and taking on second jobs; in surveys, half of adults in the U.S. say they don’t have the cash to pay an unexpected $500 medical bill.

In “taking on” medical debt, patients sign only the sort of vague financial agreement that has become ubiquitous in American health care: “I agree to pay for charges my insurance doesn’t cover,” presented on the stack of forms to sign on arrival at an emergency room or a doctor’s office. But no one can fully consider options or say “no” to care while in pain or medical distress or even properly agree to pay an unknown amount.

Student debt causes hardships because it hits people who’ve just started careers, with salaries at the bottom of the pay scale, forcing them to delay life choices, like purchasing a home or starting a family. But medical debt often comes with all that plus medical woes: In a KFF poll, 1 in 7 people with health care debt said they’d been denied care by a provider because of unpaid bills. Sometimes a bill for as little as a few hundred dollars can turn into a collections nightmare.

Already, the federal government is stepping in to assist student loan borrowers. It has paused student debt payments during the pandemic, and the Biden administration has announced that it would forgive student debt for tens of thousands of public sector workers. Late last year, the Department of Education announced that it would no longer contract with outside debt collectors but would instead deal with loan defaults and potential defaults itself to better “support borrowers.”

Medical debt collection has typically been outsourced to aggressive private agents and the for-profit medical debt collection industry; there are few guardrails. Recently, consumer credit reporting agencies have said they will no longer put small medical debts on credit reports and remove medical debts that have been paid. For many people, that will take years. Some 18% of Americans with health care debt said they never expect to be able to pay off their debt.

The irony here is that medical debt is sometimes discharged in bulk by charities, like RIP Medical Debt and church groups, which will pay pennies on the dollar to make patients’ outstanding medical debt disappear. The absurdity of this fix was shown when the comedian John Oliver, in a late-night stunt, cleared $15 million of Americans’ debt after buying it for $60,000.

But medical debt isn’t a joke and now harms a broad swath of Americans. The government could act in the short term to relieve this uniquely American form of suffering by buying the debts for a modest price. And then, it needs to tackle the underlying cause: a health care system that denies millions of people adequate care while still being the most expensive in the world.

Kaiser Health News is a national newsroom that produces in-depth journalism about health issues. Along with Polling and Policy Analysis, KHN is one of the three major operating programs at the Kaiser Family Foundation, an endowed nonprofit organization providing information on health issues.

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State report shows fewer new cases of coronavirus, but The New York Times ranks Kentucky's new-case rate first among the states

New York Times map, adapted by Kentucky Health News; for a larger version, click on it.

By Al Cross
Kentucky Health News

After a six-week surge, the daily average of new coronavirus cases in Kentucky fell 7.7 percent last week, according to the latest weekly report from the state Department for Public Health, released Monday. 

However, The New York Times reported that in the last seven days, Kentucky's rate of new cases has been higher than any other state, 2,634 per day, and has risen 29% over the last two weeks.

The state's report said Kentucky recorded 14,654 new cases in the Monday-Sunday reporting period, an average of 2,093 per day, by the state's count. The previous week, the state's average was 2,269.

Health-department officials have said the state's numbers run lower than the Times count because they reflect the removal of duplicate test results.

Of the new cases on the state report, 18% were among Kentuckians 18 and younger. With the start of school approaching, health officials are urging parents to get their children vaccinated against Covid-19.

Ky. Health News graph, from state data; click on it to enlarge.

The state report showed Covid-19 hospital numbers increased slightly, but deaths were down.

The number of Kentucky hospital patients with Covid-19 ticked up Sunday, to 602, four more than a week earlier. There were 89 Covid-19 patients in intensive care, up five; the number on mechanical ventilation remained at 33.

The state attributed 45 more deaths to Covid-19 during the week, down from 59 the week before. The pandemic death toll in Kentucky stands at 16,397.

The incidence rate of new cases in the state declined slightly, to 40.52 per 100,000 residents. The state report said the counties with the highest rates were Perry, 104 per 100,000; Robertson, 102; Letcher, 98; Bath, 83; Leslie, 77; Elliott, 74; Knott, 72; Cumberland, 71; Owsley, 71; and Greenup, 70.

According to the Times, the top counties were Perry, 145 per 100,000; Clinton, 140; Adair, 127; Knott 124; Floyd, 113; Letcher, 109; Powell, 104; Union, 102; Boyd, 102; Green, 98; and Harrison, 98.

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In flood cleanup, here's how to stay safe and healthy

Disaster cleanup workers take breaks and keep hydrated
when temperatures are high, as is forecast this week.

Floods can kill, but so can the cleanup, if you aren't careful, says Anna Goodman Hoover, an assistant professor in the University of Kentucky College of Public Health.

"As people try to re-enter flood-damaged properties, the risk of serious injury and even death is high," Hoover told Kentucky Health News. She shares a package of "vetted materials from various agencies and environmental/disaster organizations that provide safety information for re-entering, cleaning up, etc."

The college's Department of Epidemiology and Environmental Health has created a web page with a wide range of resources for people to stay safe and healthy in flooding. Here are selected examples from Hoover's package of how to protect yourself.

• Wash your hands often to avoid exposure to harmful substances.

• Use hand sanitizers frequently.

• Exercise good housekeeping.

• Only drink from proven potable water sources.

• Be careful walking over and handling debris that is covered with water, to avoid risk of slips, trips and falls.

• Remain current with tetanus vaccination (within the past 10 years).

• If exposed to stagnant water, wash and sanitize immediately.
• If injured by sharp or jagged materials, immediately clean out all open wounds with soap and clean water. If a wound gets red, swells, or oozes, seek immediate medical attention.

• Consider steel toe/shank footwear if available and use durable gloves for handling debris.

• Watch for exposed power lines.

• Use hearing protection for noisy environments.

• Use appropriate breathing apparatus to avoid inhaling dust containing asbestos, silica and other lung-damaging substances.

• Avoid sunburn by limiting exposure, using protective eyewear and using sunscreen and lip balm.

To avoid heat stress:

• Drink plenty of fluids, sports drinks if available.

• Monitor yourself and coworkers, use the buddy system.

• Block out direct sun or other heat sources.

• Use cooling fans and/or air conditioning, and rest regularly.

• Wear lightweight, light-colored, loose-fitting clothes.

• Avoid alcohol, caffeinated drinks, or heavy meals.

• Seek medical attention for symptoms of: extremely high body temperature (above 103°F); red, hot, and dry skin (without sweating); rapid, strong pulse; throbbing headache, dizziness or nausea.

• Take shelter in shaded areas and loosen or remove excess protective clothing if feasible.

To avoid traumatic stress:

• Pace yourself and take frequent rest breaks.

• Watch out for each other and identify nearby hazards.

• Be conscious of those around you. Exhausted responders or stressed responders may put themselves and others at risk.

• Maintain as normal a schedule as possible; regular eating and sleeping are crucial.

• Whenever possible, take breaks away from the work area.

• Recognize and accept what you cannot change—the chain of command, organizational structure, waiting, equipment failures, etc.

To avoid eye injury:

• Use safety glasses with side shields; a retainer strap is suggested.

• Consider safety goggles for protection from fine dust particles; can be used over regular prescription glasses.

• Any worker using a welding torch for cutting must have special eye wear to protect against welding flash, which causes severe burns to the eyes and surrounding tissue.

• Use only protective eyewear that has an ANSI Z87 mark on the lenses or frames.

Avoid the hazards of floodwaters:

• There are usually elevated levels of contamination associated with raw sewage and other hazardous substances in floodwaters.

• Minimize human contact with flood water.

• Wear waders and waterproof gloves.

• If skin comes into contact with floodwater, wash thoroughly with soap and water.

• Keep all open cuts or sores as clean as possible.

• Use antibiotic ointment such as Neosporin.

• Stay alert for flash flooding.

• Floodwater may contain chemicals, diesel fuel, gasoline, motor oil, chlorine, liquid oxygen, medical waste, corrosives and industrial and household products in all sizes and quantities.

Watch your work environment:

• Do not enter a structure that shows indication of being unsafe such as walls with large cracks, shifting, or partial collapse.

• Determine if any hazardous substances have been anywhere on the property including pipes and tanks.

• Don’t walk on surfaces you aren’t sure are stable.

• Use other ways to get to work surfaces, such as bucket trucks.

• Erect scaffolding on stable surfaces and anchor it to stable structures.

• Wear protective equipment provided, including safety shoes with slip resistant soles.

• Use fall protection with lifelines tied off to suitable anchorage points, including bucket trucks, whenever possible.

• After flooding, the water creates the perfect environment for mold to grow in homes and other buildings. Exposure to mold can cause wheezing and severe nasal, eye and skin irritation.

At home:

• Reconnect with family, spiritual, and community supports.

• Do not make any big life decisions.

• Spend time with others or alone doing the things you enjoy to refresh and recharge yourself.

• Be aware that you may feel particularly fearful for your family. This is normal and will pass in time.

• Remember that “getting back to normal” takes time.

 • Be aware that recovery is not a straight path but a matter of two steps forward and one back. You will make progress.

• You need to support your family and recognize that you are not going through this along.

• Avoid overuse of drugs or alcohol. 
• Identify and throw away food that may not be safe to eat: Food that may have come in contact with flood or storm water; food that has an unusual odor, color, or texture; meat, poultry, fish, eggs and leftovers that have been above 40 degrees F for two hours or more; food containers with screw-caps, snap-lids, crimped caps (soda pop bottles), twist caps, flip tops, snap-open, and home canned items; these cannot be disinfected if they have been in contact with floodwater

• If power is out, keep the refrigerator and freezer doors closed as much as possible
• Add block ice or dry ice to your refrigerator if the electricity is expected to be off longer than four hours.

• Wear heavy gloves when handling ice
Employers: Federal law "requires employers to provide a safe and healthful workplace free of recognized hazards and to follow Occupational Safety and Health Act standards. Employers' responsibilities also include providing training, medical examinations and record keeping. For more information, go to www.osha.govor call 1-800-321-OSHA(6742).

Employees should "follow the employer's safety and health rules and wear or use all required gear and equipment, and follow safe work practices for your job, as directed by your employer." Report hazardous conditions to a supervisor, and to the state OSHA agency, if employers do not eliminate them.

The above information originated with the Federal Emergency Management Agency, the National Institute of Environmental Health Sciences, the National Institute of Occupational Safety and Health, the Occupational Safety and Health Administration, the Centers for Disease Control and Prevention and the U.S. Army Corps of Engineers.

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Annual policy forum will focus on role of education in health

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