State Health Department gets diabetes prevention funding; will focus on prediabetes detection and lifestyle changes

The state Department for Public Health has been awarded a $134,380 federal grant to help reduce high rates of prediabetes and Type 2 diabetes in Kentucky.

“Diabetes is a tremendous public health concern that is both horrific for the individual, if unmanaged, and costly in terms of medications, various complications and long-term hospitalizations that are so often associated with the disease,” Audrey Haynes, secretary of the Cabinet for Health and Family Services, said in a press release.

In 2009, Kentucky's rate for diagnosed diabetes was the fourth highest in the nation at 11.4 percent of the population, compared to a national median of 8.3 percent. The rate means an estimated 366,000 adults in Kentucky have diabetes. An additional 266,000 Kentuckians are estimated to have prediabetes, according to the CFHS website.

Prediabetes often leads to Type 2 diabetes, the most common type, within a few years, but lifestyle changes promoted by the federal Diabetes Prevention Program can decrease the risk of developing diabetes by almost 60 percent, according to a recent study published in the Journal of Preventive Medicine.

“We must act now to begin reversing the devastating impact of diabetes on our state,” Haynes said. “We are excited to continue our work with the Diabetes Prevention Program to help more Kentuckians start making healthier lifestyle choices so they can avoid developing diabetes and lead longer, healthier lives.”

The DPP specifically targets individuals with prediabetes and works with them to reduce their risk of developing Type 2 diabetes. The risk factors for both are: being older than 45, being overweight or obese, physical inactivity, having a family history of diabetes, ever having gestational diabetes, high blood pressure, abnormal cholesterol, having a history of cardiovascular disease and being African-American, Hispanic/Latino, Native American, Asian American or Pacific Islander. Click here to take the diabetes risk test.

The federal Centers for Disease Control estimates that national efforts to prevent Type 2 diabetes could save $5.7 billion in health care costs by preventing 885,000 cases in the next 25 years. Kentucky will focus on three diabetes prevention strategies that involve raising awareness among health care providers to improve detection and treatment of prediabetes and encouraging both state/local government and business to add lifestyle change programs to the list of covered services under health plans, says the news release. (Read more about diabetes and prevention in Kentucky).

Health departments prepare for challenges posed by health-care reform law

No one really has a clue what changes from the health-care reform law will mean to Kentuckians and public health departments are preparing for the uncertainty, reports Kristy Cox of Business Lexington.

"The Affordable Care Act will have an impact on health departments.  It is going to put a whole lot more people out there on the street on health insurance" of one kind or another, Dr. Rice Leach, head of the Lexington-Fayette County Health Department, told Cox.

"I think how health departments are impacted is going to look a little different depending on what part of the state they're in," Rice said. "The United States has passed a law that creates an entitlement for 30 or 40 million people, and here in Lexington, for 10,000 or 20,000 more people to have health insurance. Now, who is going to take care of them?"

If the private sector can't handle the increased patient load, Leach said, the stress goes onto the health departments, meaning they may be expected to provide a broad "continuum" of care for acute medical needs, including doctors and laboratory services. Leach said he hopes other systems will step up to provide care so health departments can continue to focus on preventative services.

Many factors determine what health departments can and can't do as well as their ability to generate dollars. Leach called  the services mandates by state and federal governments as "mission critical activities," which include preventive health, communicable disease control, public health education, emergency response, sanitary code and restaurant inspection and public health policy, writes Cox. 

Despite the challenging economic environment created by budget cuts and managed-care non-payment issues, Kentucky health departments are trying to stay focused on their big-picture mission.  Some departments are writing grants and others, like the Lincoln Trail District Health Department, has sent nurses into school systems in attempt to increase revenue through expanded clinical services, Cox reports.

Foundation for a Healthy Kentucky looking for grant applications for programs that cut chronic disease risk for school-age kids

The Foundation for a Healthy Kentucky is looking for applications for grants that will fund innovative programs to reduce chronic disease risk for school-aged children. Because chronic disease occurs at higher rates in Kentucky than in surrounding areas, the foundation sees this new "Investing in Kentucky’s Future" initiative is seen as having particular urgency. It anticipates awarding grants to five to 10 communities statewide.

This five-year, $3 million program seeks to find ways to limit those diseases that decrease quality of life and increase the risk of early death. These include conditions like cancer, diabetes, heart disease, even substance abuse and some mental illness.

Susan Zepeda, CEO of the foundation, explains that the organization's "goal is to help communities make positive changes that will help children start and sustain healthy habits to last a lifetime. Whether the challenge is access to needed routine medical check-ups, safe places to play or nutritious foods, or caring adults to show ways to communicate and avoid risky behaviors, we want to help communities find new pathways to positive solutions.”

The deadline to submit a letter of intent to apply for grant funding is Nov. 16. Following a letter of intent, the foundation will invite applicants to submit a full proposal. The deadline for the receipt of the full proposal is Feb. 28, 2013. For a complete copy of the Request For Proposal, and additional information regarding grant opportunities through the Foundation for a Healthy Kentucky, visit www.healthy-ky.org or call (toll-free) 877-326-2583.

U of L profs get $6.3 million to continue spinal cord research

Susan Harkema, a University of Louisville professor, talks
about epidural spinal stimulation. Courier-Journal photo.

Two University of Louisville professors have received a $6.3 million grant to continue their work helping paralyzed patients restore movement by using electrical stimulation.

The grant was awarded to Susan Harkema and Dr. Jonathan Hodes from the Leona M. and Harry B. Helmsley Charitable Trust.

Last year, they received much acclaim when they published a study in the journal The Lancet "showing that the use of continual, direct, electrical stimulation of a patient's lower spinal cord using technology designed for pain relief can allow a person using a wheelchair to stand and bear weight," reports Laura Ungar for The Courier-Journal.

With these new grant funds, Harkema said they will "be able to built a stimulator that will allow the individual to take advantage of these advances in their homes and communities."

One of the initial case studies involved Rob Summers, a former baseball player from Oregon who was paralyzed below the chest after a car accident. After the therapy, he was able to get to a standing position and stand as long as four minutes. "He was also able to take steps with help and move his toes, ankles, knees and hips." Harkema said he continues to improve.

Nationwide, more than 5 million Americans live with some type of paralysis, and more than 1.3 million have spinal-cord injuries. (Read more)

Foundation for a Healthy Kentucky awarded nearly $3 million in grants in 2010

The Foundation for a Healthy Kentucky awarded nearly $3 million to community organizations, schools, government agencies and institutions in 2010. The funds, awarded in 80 grants, will support programs and policy development for health improvement and access to health care.

The grants supported health advocacy initiatives; helped civic leaders identify and address key health concerns; supported the integration of mental health and medical services; helped communities get planning assistance and funding for federally-qualified health clinics; and helped four foundations address nutrition, physical activity and environment policy issues.

The largest sums went to Burkesville-based Cumberland Family Medical Center for the Kentucky Health Futures Initiative; Home of the Innocents to improve access to dental care; Montgomery County Health Department for the Gateway Rural Health Investment Network; and Saint Joseph Health System to deliver virtual care. Each of these four organizations received $250,000.

The Foundations spends earnings on a $45 million settlement that then-Attorney General Ben Chandler reached in 1999 with Anthem Inc. as a result of the company's conversion of the charitable assets of the old Blue Cross & Blue Shield of Kentucky. For the foundation's history and other background click here.

Foundation matches Social Innovation Fund money to create grants for improving health services in seven Kentucky counties

The Foundation for a Healthy Kentucky today announced four equal Social Innovation Fund grants totaling $1 million to improve access to health services, reduce health risks and disparities, and promote health equity in Jefferson, McCreary, Wolfe, Powell, Montgomery, Bath and Menifee counties. The projects are expected to serve nearly 9,000 people in the next year.

Home of the Innocents in Louisville will establish a dental clinic at the newly opened interdisciplinary Hockensmith Pediatric Assessment Center. The program will provide dental services to children in state care, children with special health care needs, and other children and families served by the Home and its partner agencies.

St. Joseph Health System, based in Lexington, will establish primary care clinics in Powell and Wolfe counties, both rural and low-income. These satellite clinics will be staffed by nurse practitioners and will utilize telemedicine to collaborate with physicians and specialists at a central location.

Cumberland Family Medical Center, based in Burkesville, will establish a nurse-managed health center and rural training program for nurse practitioners and physician assistants. Funds will be used to expand the scope of services provided in McCreary County to include x-ray and utilize health IT to connect with other CFMC sites. This will be the county's first x-ray, reducing travel for local residents who previously had to travel ouside the county for x-ray services.

The Montgomery County Health Department in Mount Sterling will establish a health education and navigation program to serve a low-income population in Montgomery, Bath and Menifee counties. Four full-time health navigators will be employed to serve the community by assessing individual needs and linking patients with services.

Each $250,000 grtant includes $125,000 from the Foundation for a Healthy Kentucky. As an endowed public charity, the foundation was able to provide the matching funds that were required to secure the Social Innovation Fund award for Kentucky. Learn more about the grants here.

Musical reminder fights bed sores in nursing homes

Ten Kentucky nursing homes are using music to cue health care workers when patients with bed sores need to be moved.

Laura Ungar of The Courier-Journal reports that a burst of music comes through the facilities' loudspeakers every two hours, prompting health workers to stop what they're doing and move patients unable to move themselves. Ambulatory patients also use the music as a reminder to change their positions.

The 10 participating nursing homes are owned by Signature HealthCare and are in Augusta, Bedford, Beattyville, Lexington, Louisville and Prestonsburg.

"Repositioning people is not something new; what's new is the prompt," said Pam Larimore-Skinner, director of nursing at Signature HealthCare of Trimble County. "I think it makes people more conscious of the two hours because time can get away from you."

The experiment is funded by a $300,000 grant given to the University of Cincinnati College of Nursing from the Robert Wood Johnson Foundation. The study is to analyze if the audio reminders can reduce the number of bed sores, which damage skin and can lead to serious infection. So far, nursing home employees have noted improvement. (Read more)