Poll finds parents overwhelmingly support more nutritious school food; USDA expected to issue new guidelines

Photo by Reuters' Lucy Nicholson

Chocolate bars, Cheetos and cheesy fries may soon be a thing of the past at public schools in America, and that's fine with parents, a new poll has found.

The survey found "most people agreed the chips, soda and candy bars students buy from vending machines or school stores in addition to breakfast and lunch are not nutritious, and they support a national standard for foods sold at schools," reports Susan Heavey for Reuters.

As it did for school lunch earlier this year, the U.S. Department of Agriculture is expected to release new guidelines for vending machines and à la carte sales by June, some experts say.

In Kentucky, schools are already not allowed to sell food that competes with the national school lunch and breakfast programs from the minute students arrive in the morning until 30 minutes after the last lunch period. Only water, 100 percent fruit juice, lowfat milk and any beverage that contains no more than 10 grams of sugar per serving are allowed to be sold in school vending machines, as per state mandate. There are no limits as to what food or drinks that can be sold in fundraisers.

The poll, conducted by advocacy group Kids' Safe and Healthful Foods Project, found 80 percent of the 1,010 adults surveyed said they would support nutritional standards that limit the calories, fat and sodium in such schools.

Students eat one-fifth to one-half of their daily diet at schools, and the Centers for Disease Control and Prevention report 20 percent of American children are obese, As of 2007 in Kentucky, more than 37 percent of children were either obese or overweight, a study by the National Conference of State Legislatures shows.

A study by the National Academy of Sciences reports that about $2.3 billion worth of snack food and drinks are sold each year in schools nationwide. As such, changes might be controversial. The new guidelines for school lunch met with resistance from lawmakers, who "locked limits to french fries and counted pizza as a vegetable because it contains tomato sauce," Heavey reports.  There are concerns industry lobbyists and members of Congress could dilute the USDA proposals. (Read more)

Rogers joins bill to link up states' prescription drug monitoring systems

Though a state bill aimed at quashing "pill mills" by proactively tracking drug prescriptions has so far failed to pass in the Kentucky General Assembly, Republican U.S. Rep. Hal Rogers of Eastern Kentucky's 5th District has joined a federal effort to allow state prescription drug tracking systems to share information. Though 48 states have such systems, there is no way for them to communicate with each other.

On Thursday, federal lawmakers introduced legislation "that would establish technical standards and security and encryption procedures to ease sharing information," James R. Carroll reports for The Courier-Journal.

"While my region of Southern and Eastern Kentucky became ground zero for the abuse of prescription drugs a decade ago, it is now wreaking havoc on communities small and large and cutting across socioeconomic and gender lines," Rogers said in a statement.

About 1,000 people in Kentucky died last year from prescription drug abuse, though the real number is suspected to be higher, due to under-reporting.

Missouri and New Hampshire are the only states that do not have, or don't have plans to set up, a drug-monitoring system that allows "doctors, pharmacists and law enforcement to share information that may identify abuse and misuse of pharmaceuticals," Carroll reports.

"It is high time we get these systems linked up to eliminate the interstate doctor-shopping which has been fueling the pill pipeline around our country," Rogers said.

The proposal would not create a new national database, but would also states to communicate with each other through data hubs already in place. The bill is expected to get the support of the White House administration, Carroll reports. (Read more)

Last week, Gov. Steve Beshear said Kentucky would sign an agreement to share and receive prescription drug dispensing data with at least 20 other states. "The blight of prescription drug abuse is tearing our families and communities apart, and we must use every tool available to attack this deadly scourge on our state," he said. "One of our key strategies is sharing information with surrounding states, so that we can not only cut off access to abusers, but also identify the problem prescribers." (Read more)

Sen. Rand Paul puts holds on federal synthetic drug bans

U.S. Sen. Rand Paul, left, has put a hold on several Senate bills aimed at banning chemicals used in synthetic drugs because he feels "enforcement of most drug laws can and should be local and state issues," said his spokeswoman Moira Bagley. The move has been criticized by other lawmakers, law enforcement and a woman from his home city whose daughter had a bad reaction to synthetic marijuana. (Photo by Matt Goins)

"When Ashley Stillwell, 19, bowed to peer pressure last August and smoked a substance called 7H, it quickly immobilized her," reports Bill Estep for the Lexington Herald-Leader. "Ashley's frightened friends poured water on her and shook her. When they couldn't rouse her, Ashley heard the others discuss dumping her body in the Barren River."

The teen recovered after she was taken to the hospital, but her mother Amy, of Bowling Green, is frustrated by Paul's move to block the legislation. Three Senate measures passed committee last summer, and the House voted 371-98 in December to approve a ban on synthetic drug chemicals. Senate rules allow one member to place a hold on a bill. "That doesn't mean it can't be voted on, but it slows the process and raises some hurdles," Estep reports.

Bagley said Paul is concerned about banning the substances before research can be done on them. Sen. Charles Grassley, an Iowan Republican who sponsored one of the bills, said reclassifying the chemicals as controlled substances would not prevent research from being conducted. "We cannot let the will of just one senator obstruct the will of many," Grassley said.

One in nine high-school seniors had used a substance known as K2 or Spice in the past year, the National Institute on Drug Abuse reported in December. That makes synthetic marijuana the second most-abused drug in that age group. Calls to poison-control centers about synthetic drugs have risen from 3,200 in 2010 to 13,000 last year, Estep reports.

White House drug chief Gil Kerlikowske said his office is "urging the Senate to pass that legislation." (Read more)

Board suspends license of doctor at raided Lexington pain clinic

DEA agent enters building housing clinic
(Herald-Leader photo by Charles Bertram)

Read more here: http://www.kentucky.com/2012/02/16/2071374/board-suspends-medical-license.html#storylink=cpy

The Kentucky Board of Medical Licensure imposed an emergency suspension yesterday on the license of the doctor at a Lexington pain clinic that was raided by the Drug Enforcement Administration on Wednesday.

Dr. Najam Azmat "had little formal training in pain management or primary care, yet he was paid $7,500 a week to write prescriptions for powerful narcotic painkillers" at Lexington Algiatry, a pain clinic on Alexandria Drive, the Lexington Herald-Leader reports, drawing on board documents. The board's order said, "Azmat organized his practice at the Lexington Algiatry Clinic to maximize fraud and abuse, and it appears to be intentional."

The board "acted on an investigation that's been going on for some time," President Preston Nunnelley told the Herald-Leader. Azmat referred the newspaper to his lawyer, Fox DeMoisey of Louisville, who said he could not respond because he had not seen the board's allegations or the DEA's search warrant. "He intends to defend the matter vigorously," DeMoisey told the paper.

Azmat told a board investigator that he was employed by Warren Gold of Tampa, Fla., who owns Lexington Algiatry, for $7,500 a week. Valarie Honeycutt Spears and Josh Kegley of the Herald-Leader report, "Gold provided him with an apartment in Lexington, and Azmat traveled between Lexington and Georgia, where his family lives, organizing his work schedule around his flight schedule, the documents said." (Read more)

UPDATE, Feb. 18: A representative of the clinic "filed to do business under a new name," Kegley reports.

His latest story has more background on Gold, left, who pleaded no contest in Tampa to operating a pain clinic without a license, which at the time (2010) was required only by a local ordinance. His probation ended Dec. 23. He does not have a medical license in Florida or Kentucky, Kegley reports.

Read more here: http://www.kentucky.com/2012/02/16/2071374/board-suspends-medical-license.html#storylink=cpy

Read more here: http://www.kentucky.com/2012/02/16/2071374/board-suspends-medical-license.html#storylink=cpy

Read more here: http://www.kentucky.com/2012/02/16/2071374/board-suspends-medical-license.html#storyli

Judge continues to block graphic images on cigarette packs

Getting graphic labels on cigarette packages continues to be an uphill battle for the Obama administration, as a skeptical judge sided with cigarette makers who say "they can't be forced to spread the government's anti-smoking advocacy with 'massive shocking, gruesome warnings' on products they legally sell," reports The Associated Press.

U.S. District Judge Richard Leon of Washington, D.C., has already decided that the cigarette makers will probably succeed in their lawsuit, because he has ordered the government to not enforce the requirement that the labels appear on cigarette packages next year.

The labels, approved by the Food and Drug Administration, "included color images of a man exhaling cigarette smoke through a tracheotomy hole in his throat; a plume of cigarette smoke enveloping an infant receiving a mother's kiss; a pair of diseased lungs next to a pair of healthy lungs; a diseased mouth afflicted with what appears to be cancerous lesions; a man breathing into an oxygen mask," among others, AP reports.

Leon has indicated he thinks the labels go overboard in their efforts to convey the dangers of cigarettes. He has ruled they are too large; they were intended to cover the top half of packs. "It sounds like they are headed to a place," he said Wednesday, "where you have to watch a 10-minute video before you can even buy a pack of cigarettes." (Read more)

Health insurance exchange benefits will be decided at the state level; Kentucky can now proceed to set up its exchange

For months, Kentucky officials have said the state cannot move forward with setting up a health-insurance exchange under the new federal health law because there weren't enough details about which benefits they had to offer. On Friday, the Obama administration answered that question when it "let states, rather than the federal government, define which medical benefits insurance companies will have to offer consumers starting in 2014," reports Noam L. Levey of the Los Angeles Times. "This is significantly more state-flexible and friendly than many would have expected," Alan Weil, head of the National Academy for State Health Policy, told Levey.

The law says that by 2014, each state must offer an insurance exchange, an online insurance marketplace in which people can choose from a variety of plans from companies like Anthem or Bluecross/Blueshield and then, for the most part, be given federal subsidies to help pay their premiums. About 30 million individuals and employees of small businesses are expected to use the exchanges. The plans in an exchange must cover a basic set of benefits, including hospitalizations, emergency care, newborn and maternity care and pediatric services, but until now the federal government could have decided how generous the benefits had to be.

"Under the guidance issued Friday, state leaders can define their own set of benefits by using an existing major health plan in their state as a benchmark," Levey reports. "That means that some states may require insurers to cover services such as chiropractic therapy and in vitro fertilization, while others may not."

It's this variability between states that worries some. "In passing a good deal of the decision-making to states, the administration has guaranteed that Americans will continue to face a patchwork of state regulations that make coverage uneven and inefficient," report Gardiner Harris, Reed Abelson and Robert Pear in a news analysis for The New York Times.

Some consumer advocates also worry the move will allow states to make benefits too meager. Timothy Jost, a law professor at Washington and Lee University, said the policies "could restrict, for example, the number of covered visits a pregnant woman could make to her obstetrician or which prescription drugs to pay for."

However, by passing the responsibility on to the states, "President Obama will most likely make his plan for health care reform more politically palatable," the Times reporters write. "States will be allowed to set benefits at levels similar to what they are now, making coverage not much more expensive than it is today."

While some Republican state officials were happy with the decision, saying it makes it easier for states to comply with the law, others opposed to the law were critical. "All they're trying to do is avoid making tough calls before the election," said Ed Haislmaier, a senior research fellow at the Heritage Foundation. (Read more)

Writer weighs in on morning-after pill decision in provocative way, looking at both sides but ultimately saying it protects girls

Freelancer Mariam Williams writes a provocative piece in The Courier-Journal about a federal official's recent rejection of a proposal to allow girls 16 and under to obtain the morning-after pill without a prescription.

Williams speaks to girls who fall in this age group and highlights the advantages and disadvantages of the decision, which was made last week by Health and Human Services Secretary Kathleen Sebelius, despite a recommendation to the contrary by the U.S. Food and Drug Administration.

"Her decision will come at a cost to me and every other adult woman of child-bearing age," Williams writes. "It will set a precedent for every time someone wants to ignore science and embrace an ideology that not everyone else believes. Her actions will tell them that's OK, and when a pharmacist denies a grown woman's request for the morning-after pill, or when people who believe a fertilized egg is a person can't give any scientific reason for the laws they want to pass, they'll point to Kathleen Sebelius.

"But I believe you and girls younger than you are worth the danger her decision put all of us in. She did this to protect you where the adults in your life have failed you, to push you to talk to an adult if you're having sex or if you've been sexually assaulted so that you can get the information you need to be as safe as possible. So I hope you take your behavior seriously. We women do." (Read more)

Federal cuts, financial instability and competition leave many rural hospitals fearing the future

Many rural hospitals could be forced to close because of cuts to the Critical Access Program and the fact that, according to the National Rural Health Association, , 41 percent of critical-care hospitals are losing money, reports Jenny Gold of Kaiser Health News. This would be devastating to many rural communities, with a great impact felt by low-income and elderly residents. "A small hospital is often one of the biggest employers in a rural town, and closures 'can have an outsized economic impact,'" Eric Zimmerman, a health care lawyer and Washington lobbyist, told Gold.

More than 1,300 U.S. hospitals and nearly one in four acute-care facilities are designated as "critical access," giving them slightly higher Medicare and Medicaid reimbursements in return for limits on care they can provide. Many such hospitals like Hood Memorial, about an hour outside New Orleans, are dealing with uninsured patients, inability to collect payments from patients, and fewer funds from federal and state agencies, Gold reports. Many of these hospitals "tend to provide lower quality care" and are "less financially efficient than other facilities, according to a 2010 study published in the Journal of Health Politics, Policy and Law. Hood, for example, had $700,000 in losses last year despite the higher reimbursements. "It's a lot of variables, and all of them right now are working against us," CEO Hoppie Jones told Gold.

To prevent closures of rural hospitals and ensure "Americans in in isolated areas would still have access to health care," the federal government started the critical access program in 1997. To qualify, hospitals had to have 25 or fewer beds and be at least 35 miles away from another facility. However, states could waive the distance requirement, and many did, leaving hospitals like Hood with at least four other competing hospitals "within a 26 mile radius," Gold reports.

Federal judge rules proposed warning labels on cigarettes are too biased, blocks them from appearing on packs

The graphic warning labels that were going to start appearing on cigarette packages in the fall of 2012 have gotten hung up in court, with a federal judge ruling Monday they "impinge on the tobacco companies' right to free speech," reports James R. Carroll of The Courier-Journal.

District Judge Richard Leon's ruling will prevent the labels from being used until tobacco companies resolve a lawsuit against the federal government regarding the issue, something that could end up in the Supreme Court and take years. Leon said the five tobacco companies involved in the lawsuit "have demonstrated a substantial likelihood that they will prevail on the merits of their position."

Leon said the labels do not objectively warn about the risks of smoking and that tobacco companies "will suffer irreparable harm" if a ruling is not made on the label's constitutionality.

The labels, which were released by the Food and Drug Administration this summer, show graphic images of rotting teeth, a man with a zipper-like scar down the length of his chest and a man with smoke coming out of a tracheotomy tube. It is the first time in 25 years warning labels on cigarette packages have been altered, a move that was made possible when the FDA was given the authority to regulate tobacco products as part of a 2009 law.

FDA's aim is to "reduce the number of smokers by 213,000 by 2013 and save between $221 million and $630 million every year over the next 20 years," Rob Stein of the Washington Post reported in June.

Leon wrote that the images cause an emotional response that provokes "the viewer to quit, or never to start smoking: an objective wholly apart from disseminating purely factual and uncontroversial information. Thus, while the line between the constitutionally permissible dissemination of factual information and the impermissible expropriation of a company's advertising space for government advocacy can be frustratingly blurry here — where these emotion-provoking images are coupled with text extolling consumers to call the phone number '1-800-QUIT' — the line seems quite clear."

Matthew Myers, president of the Campaign for Tobacco-Free Kids, called Leon's ruling wrong. "If allowed to stand, this ruling would make it impossible to implement any effective warning labels," he said. An FDA spokesman said the agency is reviewing the ruling and had no immediate comment. More than 40 countries have pictorial health warnings on their cigarettes packages, including Canada. (Read more)