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Kentucky shows deep drop in uninsured adults under federal health law

Gov. Steve Beshear delivers his 2014 State of the Commonwealth speech on Jan. 7, 2014, in Frankfort. Photo by Mark Cornelison | StaffBy Jack Brammer
jbrammer@herald-leader.com

The percentage of adults without health insurance in Kentucky has dropped to less than 12 percent, the second largest decline among the states since the federal Affordable Care Act took effect in January, a new poll shows.

Kentucky’s uninsured rate dropped from 20.4 percent last year to 11.9 percent halfway through 2014, a decline of 8.5 percentage points, according to a Gallup Poll released this week.

Only Arkansas saw a larger decline.

“From day one, Kentuckians swarmed our exchange, kynect, eager to gain health insurance coverage, some for the very first time in their lives,” Gov. Steve Beshear said in a statement Wednesday touting the new poll. “To see this steep decline in the uninsured rate in such a short period of time reaffirms that kynect is working and we made the right decision for the health and well-being of our citizens.”

President Barack Obama and others have hailed kynect as a national model since it was launched Oct. 1.

At the close of open enrollment on April 15, more than 413,000 Kentuckians had enrolled in health care coverage through kynect. The majority received Medicaid, the government-funded insurance program for the poor and disabled, but more than 82,000 purchased a private insurance plan. Of those, the state said 74 percent qualified for some level of financial assistance to help with their premium costs.

Surveys of kynect enrollees revealed that about 75 percent of applicants who signed up during the initial open enrollment period reported they did not have health insurance prior to signing up for coverage through kynect.

As of July 31, more than 521,000 Kentuckians had enrolled in health care coverage through kynect, Beshear said.

Individuals who qualify for Medicaid may visit kynect to enroll in coverage at any time. Only those individuals who experience a qualifying event, such as the loss of employer-sponsored health insurance coverage, may purchase a private health insurance plan outside of the open enrollment period.

The next open enrollment period begins Nov. 15, for coverage effective Jan. 1.

Gallup’s poll is the first nationwide survey of the uninsured in all 50 states and the District of Columbia. Results were based on telephone interviews with a random sample of more than 178,000 adult Americans.

Lawmakers strike deal on state budget, but Rupp Arena out of luck

State Sen. Robert Stivers, R-Manchester

By John Cheves
Jcheves@herald-leader.com

FRANKFORT — Top Kentucky lawmakers emerged from a closed room about 5:30 a.m. Sunday to announce they had reached a deal on a $20.3 billion, two-year state budget that does not provide major money for a proposed renovation of Rupp Arena.

“I think it’s responsible. It makes a pretty significant and strong statement toward education,” Senate President Robert Stivers, R-Manchester, told reporters after the conclusion of an 18-hour negotiating session between House and Senate leaders.

One high-profile casualty was the $65 million in bonds Gov. Steve Beshear proposed in January for the renovation of Rupp Arena and the attached convention center in Lexington. Instead, the state budget will include “a small sum,” to be matched with local funds, so Lexington can move ahead with more planning, engineering and programming on the project, Stivers said.

If Lexington publicly produces a formal financing plan for the Rupp Arena renovation and a signed lease agreement with the University of Kentucky, which uses the venue for its men’s basketball games, then it can return for more money in the 2015 legislative session, Stivers said.

“There are mechanisms in place for it to go forward,” Stivers said.

greg-stumbo-3Some lawmakers on the budget conference committee said they were unimpressed by a personal appeal Lexington Mayor Jim Gray made for Rupp Arena funding on Saturday. Gray said UK has not yet signed a future lease deal for the arena, and he said he could not publicly disclose the proposed terms of UK’s next lease or his own plan to pay for the renovation project.

State Rep. Kelly Flood, D-Lexington, said she believes Gray did the best he could Saturday fielding queries from lawmakers.

“There are some very good questions about the plan that right now the mayor simply cannot answer,” Flood said Sunday afternoon. “I sense right now that the Senate really does want to keep the project moving forward, but they want more assurances about how the financing would work. If he (Gray) can come back, even in our next session (in 2015), having rolled out a formal financial plan, there could be some more help then. I don’t think it would have to wait until our next budget in 2016.”

Gray had not seen details of the budget agreement as of early Sunday afternoon, said spokeswoman Susan Straub.

“We need to see it and make sure we understand it before we comment on it,” Straub said.

Gray also has asked lawmakers to let Lexington raise its hotel and motel tax from 6 percent to 8.5 percent, which would yield about $3.5 million a year for the $328 million reinvention of Rupp. That proposal, which is not part of the state budget, appears to face an uphill battle in the Senate during the final days of this year’s legislative session.

House and Senate leaders, who spent the night cloistered in a committee room of the Capitol Annex, reached a consenusus on hundreds of differences in their proposed budgets. Most were relatively minor, but some involved huge sums of money or made significant changes to state policy, including:

Court refuses to block Kentucky Spirit from ending Medicaid contract on Friday

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — A Kentucky Court of Appeals judge refused on Monday to stop Kentucky Spirit, a Medicaid managed care company with more than 124,000 clients in the state, from pulling out of Kentucky on Friday.

Chief Court of Appeals Judge Glenn E. Acree ruled that the Cabinet for Health and Family Services had ample time to prepare for Kentucky Spirit’s departure from the Medicaid market and should not need an additional two months to transition Kentucky Spirit’s members to two other Medicaid managed care companies.

Acree wrote that the cabinet also could try to extend Kentucky Spirit’s contract if it wanted the company to remain in Kentucky through Aug. 31. A lower court had repeatedly warned the cabinet to begin to plan for Kentucky Spirit’s departure on July 5 and the cabinet failed to do so, Acree said.

Kentucky Spirit told the state in October that it was going to end its contract on July 5, a year before it was set to expire. Kentucky Spirit said it was losing too much money in Kentucky.

In May, Franklin Circuit Court Judge Thomas Wingate ruled that if Kentucky Spirit pulls out of the state on Friday it would be in breach of contract and liable for damages, possibly in the millions of dollars.
Kentucky Spirit appealed Wingate’s decision, but that appeal is still pending.

The cabinet, which oversees Medicaid, filed an emergency motion asking the court to order Kentucky Spirit to remain in Kentucky until at least Aug. 31.

Judge: State must explain why it removed info from child abuse case files

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — The state will have to show at a hearing in the next two months why it removed information from social worker case files about children who have been killed or nearly killed as a result of abuse and neglect.

Franklin Circuit Court Judge Phillip Shepherd said after an almost one-hour court hearing Monday that he expects the hearing to be set in the next 60 days. At the hearing, Cabinet for Health and Family Services officials will have to explain why they removed the names of parents, grandparents and other key information from more than 140 case files.

What information can be removed from the case files is at issue in a long-running legal battle between the cabinet and the state’s two largest newspapers. The newspapers asked for all case files of children who have been killed or nearly killed as a result of abuse and neglect in 2009 and 2010.

Shepherd has ruled twice in the past two years that when a child is killed or nearly killed the records can be reviewed by the public and are subject to the Open Records Act. Social worker files on abused and neglected children typically are not open to public inspection.

Commissioner of state health agency replaced abruptly

By Beth Musgrave — bmusgrave@herald-leader.com

The leader of the state department that oversees services for Kentuckians with mental illness and intellectual disabilities was abruptly replaced on Thursday.

Officials with the Cabinet for Health and Family Services declined to elaborate on the departure of Stephen Hall, who was named commissioner of the Department for Behavioral Health, Developmental and Intellectual Disabilities in 2009.

Hall, whose position was a political appointment, could not be reached for comment on Thursday.

Jill Midkiff, a spokeswoman for the cabinet, said Thursday afternoon that “there has been no final personal action” regarding Hall, but cabinet Secretary Audrey Tayse Haynes met with Hall’s staff Thursday morning to announce that Betsy Dunnigan, deputy commissioner of the department, will serve as acting commissioner.

Haynes thanked Hall in a memo about the change to the department’s 3,000 employees.

“We certainly wish Dr. Hall well with his future opportunities and appreciate his services to the department, our consumers and the people of Kentucky,” Haynes wrote.

Dunnigan has been with the cabinet for nearly 20 years, according to the memo. She was first appointed acting deputy commissioner in 2006 and was named deputy commissioner in 2009.

Judge rules Kentucky Spirit can’t pull out of Medicaid contract a year early

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — A Franklin Circuit judge ruled Friday that Kentucky Spirit, a Medicaid managed care company that last year served more than 125,000 Kentucky patients, cannot terminate its contract with the state on July 1.

The company — which employs 200 people in Lexington — could face fines if it pulls out of the state before its three-year contract is complete in July 2014, according to the decision by Judge Thomas Wingate.

In a 13-page order released Friday, Wingate ruled that the subsidiary of Centene Corp. could not terminate its contract on July 1, a year before it is set to expire.

Kentucky Spirit was one of three managed care companies hired by the state in November 2011 to manage care for more than 540,000 people in the state-federal health care program for the poor, disabled and elderly.

Kentucky Spirit announced in October that it was losing too much money in Kentucky and would terminate its contract early. The company alleged in a lawsuit that state officials provided bad data to the three managed care companies before the contract was bid, causing large cost overruns.

Kentucky Spirit must pay health departments $7.9 million

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — Kentucky’s 59 health departments won a legal victory Tuesday over one of the state’s Medicaid managed care providers, which could mean $7.9 million for the cash-strapped agencies.

Franklin Circuit Judge Phillip Shepherd ruled Tuesday that Kentucky Spirit must pay the health departments for treatments provided by school nurses. The state Cabinet for Health and Family Services says the payments in question total $7.9 million.

“It’s good news for health departments,” said Dr. Rice Leach, Commissioner of Health for the Lexington-Fayette County Health Department. “The work we and others did was done with the expectation of receiving compensation, and this moves us closer to that result.”

The amount each health department is owed was not readily available on Tuesday.

Kentucky Spirit could appeal Shepherd’s decision, which would delay payment.

Grandparents urge state to reconsider cuts to child care assistance programs

By Beth Musgrave — bmusgrave@herald-leader.com

FRANKFORT — Grandparents pleaded with state officials Tuesday to reverse a freeze on new applications for a program that provides $300 in monthly assistance to relatives who take custody of abused and neglected children.

Among those testifying at a public hearing Tuesday was Sandra Flynn of Lexington, who has been caring for five grandchildren — including a set of twins who were born addicted to drugs — for two years. Flynn said she relies on the $300 check per child and a little less than $300 in food stamps to provide for her family of seven.

“I had to quit my job to take care of them,” said Flynn, a former nurse. “Why couldn’t they cut from somewhere else?”

Flynn and other grandparents who already receive so-called kinship care money will continue to collect payments, but child advocates warned that fewer relatives will have enough money to care for abused children in the future. That means more kids might end up in foster care, which would cost the state more money.

Earlier this year, the Cabinet for Health and Family Services announced a series of cutbacks aimed at plugging an $86.6 million hole in its budget for the fiscal year that starts July 1.

Judge rules cabinet has 30 days to comply with Open Records law

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — A Franklin Circuit Court judge has given the state 30 days to tell the state’s two largest newspapers why it redacted and took out information from more than 140 case files of children who have been killed or nearly killed from abuse or neglect.

Franklin Circuit Court Judge Philip Shepherd also ordered Cabinet for Health and Family Services Secretary Audrey Tayse Haynes to appoint a high-level staffer to oversee the cabinet’s compliance with his order.

Shepherd’s decision on Thursday came after a nearly two-hour hearing in Franklin Circuit Court on the status of the case that has taken almost three years to litigate.

Shepherd said that he would like Haynes to appoint someone by June 10 to oversee the cabinet’s compliance with the Open Records Act. Shepherd also said that he hopes the cabinet will provide detailed explanations of why information was removed by June 10 but gave the cabinet some leeway in case it takes longer given the number of case files involved. The newspapers are asking for the case files of children who have been killed or nearly killed from abuse and neglect in 2009 and 2010.

Senate approves panel to review child abuse deaths; final passage likely

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — A bill that would establish an independent review panel in Kentucky to examine deaths and critical injuries from child abuse or neglect appears poised to become law.

Late Thursday night, the Senate passed House Bill 290, which would create a 20-person external review panel of experts to examine child abuse deaths and make recommendations on how to improve the state’s child-protection system.

The House approved HB 290 last month, but the Senate made changes to the bill to increase transparency and improve oversight. The measure now goes back to the House, where it is expected to be given final approval. Gov. Steve Beshear could then veto the bill, sign it into law or let it become law without his signature.

Beshear created a similar independent panel by executive order in July after newspaper stories highlighted shortcomings in the child-protection system. For the panel to continue, it needs legislative approval.

The panel has met twice since July but has been given censored copies of social worker case files. HB 290 would let the panel see uncensored case files from the Cabinet for Health and Family Services and would allow it to ask for information from other agencies, such as the Kentucky State Police.

The panel — which consists of prosecutors, social workers, police and other advocates — will be housed in the Justice and Public Safety Cabinet but the legislature’s Investigations and Program Review Committee will have some oversight of the panel.