SERVING KENTUCKY MEDICAL NEWS AND SOUTHERN INDIANA The business of healthcare
$2.50 October 2017
News in Brief page 2 | People in Brief page 4 | Event Calendar page 6
Corner Office LAWMAKERS Meet Daniel Fisher, partner and Health HEAR SOBERING Care Practice Chair with Bingham Greenebaum Doll in Louisville, Ky. who ACCOUNT OF joined the firm directly out of law school. OPIOID CRISIS Read more on page 5
Cabinet reaches agreement By Ben Keeton with Bluegrass.org to manage
MEDICAID OVERSIGHT AND ADVISORY COMMITTEE CO-CHAIR REP. KIMBERLY MOSER, R-TAYLOR MILL Hazelwood ICF At one Kentucky hospital, people The Cabinet for Health and are bringing in heroin and shooting up chair Rep. Addia Wuchner, R-Florence, “People do get better,” Ingram said. Family Services (CHFS) has with patients. said of the topics on the agenda that “People do recover, although for those reached an agreement That’s one example of the “very included prevention, treatment and people on the front lines, it doesn’t seem with Bluegrass.org – a desperate situation” the opioid-abuse criminal justice issues. that way.” Kentucky-based, non-profit organization – to crisis has created, Kentucky Chamber of Co-chair Rep. Kimberly Poore In what he described as a “rare bright assume management of Hazelwood, a state-owned Commerce President Dave Adkisson said Moser, R-Taylor Mill, said the point of spot, there were 70 million fewer dos- Intermediate Care Facility (ICF) for individuals with while testifying before a panel of state combining the two committees’ meetings age units of opioids prescribed last year intellectual and developmental disabilities. legislators in the Capitol Annex. was to show the complexity of the opioid- in Kentucky than in 2011. (That figure Read more on page 8 abuse crisis and need for a coordinated, doesn’t include buprenorphine, a semi- long-term strategy to tackle it. synthetic opioid that is used to treat opi- From the Archives It cuts across all demographics. “We know that everything we have oid addiction.) There are still about 300 The future of the VA Medical Center It touches everyone. We know heard about the opioid use disorder million dosage units of opioids being pre- problem, heroin problem, is real to many scribed in Kentucky. in Louisville it doesn’t matter where you families and our communities,” she said, “This whole problem is the Over the past 24 years, live. Addiction doesn’t care “and it cuts across all demographics. It overexposure of opioids to our country Medical News has had how smart you are, where touches everyone. We know it doesn’t and state,” Ingram said. “We are reducing the privilege of telling matter where you live. Addiction doesn’t that overexposure.” thousands of stories of you went to school or how care how smart you are, where you went advocacy efforts, new developments or healthcare House Bill 333 Will Help much money you make.” to school or how much money you make.” providers making a difference in the community. Office of Drug Control Policy He said the passage of House Bill Going forward, we are going to occasionally revisit — Co-chair Rep. executive director Van Ingram testified 333 earlier this year would further drive some of these stories to see how they impact Kimberly Poore Moser, that 1,404 Kentuckians died of a drug down the number of opioids prescribed. healthcare today. This month, we look back to 2008 It prevents doctors from prescribing and the discussions surrounding the location of the R-Taylor Mill overdose last year. He said the introduction of the synthetic opiate fentanyl into the more than a three-day supply of opioid new VA Medical Center. heroin supply was largely driving the painkillers, with some exceptions allowed. Read more on page 12 He was among more than 25 people death rate. In addition, fentanyl has been It also increased penalties for trafficking from across the country who testified about present in 53 percent of the drug overdoses in opioids and authorized the state Office the best policies to attack the crisis at a recorded in Kentucky so far, this year. of the Inspector General to investigate IN THIS ISSUE rare six-hour meeting of both the Interim Ingram said the Kentucky General trends in drug usage and trafficking. Joint Committee on Health and Welfare Assembly passed many measures in the Department for Medicaid Services and Family Services, and the Medicaid last five or six years to address opioid Medical Director Dr. Gil Liu testified on AGING CARE Oversight and Advisory Committee. the impact of opioid abuse disorder on abuse, but it takes time for the full impact This month we take a closer look at the business “Today is a snapshot,” meeting co- of those laws to be seen. Kentucky’s Medicaid program. At the beginning of 2014 Kentucky of aging in Kentucky, with a diverse set of articles spent about $56 million in Medicaid money covering topics such as the increasing popularity on behavioral health and substance abuse of the Music & Memory program for people treatment, he said. By the end of 2016, with Alzheimer’s disease. We also explore how Kentucky was spending about $117 million telemedicine is helping docs reach seniors in in Medicaid money on those treatments. remote areas of the state who are unable to travel
Rep. Danny Bentley, R-Russell, asked for an in-person appointment. Think house calls
Monroe, GA Monroe, what percent of people with substance are a thing of the past? Think again. Seniors are Permit #15 Permit abuse disorder have a behavioral health relying on in-home doctor visits more and more.
PAID disorder, outside of the drug issue. This and more starting on page 13
US Postage US “Well over half of the people,” Liu said. PRSRT STD PRSRT Continued on page 9 PAGE 2 MEDICAL NEWS • OCTOBER 2017
NEWS IN BRIEF
Highlands Health System UofL researcher receives NIH grant to merge with Appalachian to study periodontal disease
Regional Healthcare Huizhi Wang, MD, PhD, of the Department of Oral Immunology and Appalachian Regional Infectious Diseases at UofL, earned the five-year grant for the study from the Healthcare (ARH) and National Institute of Dental and Cra- Highlands Health System niofacial Research, part of the National announced they have en- Institutes of Health. tered into a Letter of Intent Periodontal disease, a chronic in- to merge the Prestonsburg- flammatory disease that affects the gum based Highlands Regional tissue and bone supporting the teeth, can WANG Medical Center and other have serious consequences for those who Highlands Health facilities Periodontal disease is a common suffer from it. If left untreated, it can lead to tooth loss. and services into the multi- struggle for many Americans, affecting half of U.S. adults over 30. Now, a re- Research also has shown peri- hospital ARH system. odontal disease is associated with other ARH and Highlands searcher at the University of Louisville ARH system. All other Highlands out- School of Dentistry is embarking on a chronic inflammatory diseases, and may hope to finalize the transaction by early patient services and facilities in Floyd, promising study of a potential way to be linked to cardiovascular disease, dia- next year after the completion of the due betes, rheumatoid arthritis and stomach Johnson, Martin and Magoffin counties help combat the disease after earning a diligence process. and colon cancer. are also included in the merger. nearly $2 million grant. Under the agreement, the 192-bed ARH offers a wide-range of prima- Highlands Regional Medical Center ry and specialty care services through its will operate under the new name, High- network of health facilities and partner- Behavioral health leaders create lands ARH Regional Medical Center, ships with other health systems. and will become the 12th hospital in the initiative to tackle addiction crisis In response to Louisville’s ongoing der the overarching concerns of access addiction crisis, a new initiative has been to treatment, prevention initiatives and Lourdes palliative care chaplain created that brings together thought healthy recovery, the TAG team has leaders from providers all over Louisville self-selected into smaller action groups wins award to form to form the Treatment Advisory to focus on specific goals. Group (TAG). The group was convened For example, the TAG Advoca- HERO, the Health Enhancement life. With as- in January by the Office of Addiction cy team is looking at issues where the Research Organization, has named sistance from Services, part of the Louisville Metro treatment community’s collective voice is Brent Easton, a palliative care chaplain Lourdes and Public Health & Wellness. needed. The TAG Sober Housing Task for Lourdes and Mercy Health, the re- Mercy Health’s Leadership from Centerstone, The Force is working on proper credential- Brook Hospitals, Volunteers of Amer- ing for Metro-area recovery residences to cipient of the inaugural Alliant Healthy well-being pro- ica, Our Lady of Peace, Jeffersontown protect the interests of recovering people, HERO Award. gram, he ad- Police, Renew Recovery, Landmark Re- the neighborhoods where housing is lo- The Alliant Healthy HERO Award justed his habits covery, Center for Behavioral Health, cated and the owners/providers of legiti- recognizes an individual whose partici- and rethought Morton Center, Greater Louisville mate recovery homes. The Single Point pation in a company-sponsored well- his definition Counseling Center, Beacon House and of Access team is working with Metro being program has inspired significant, of success. Over many more have come together to focus United Way to evaluate the possibility sustained improvements in health and the past three on solutions build strong relationships of having the phone number 211 be a overall well-being. years, Easton across providers, regardless of treatment simple, easy and complete way to connect Easton spent years losing and re- has lost 100 pounds and trimmed 13 philosophy or treatment approach. Un- with addiction services across the city. gaining weight before renewing his inches from his waist. commitment in 2014 to changing his UofL gastroenterology receives $4 Study finds many avoid end-of- million from NIH for liver research National Institute of Environmental life care planning Health Sciences (NIEHS), one of the National Institutes of Health, to explore Even though advance directives percent completed advance directive. Of the long-term effects of environmental have been promoted by health profes- those, 29 percent completed living wills, chemicals on the liver. sionals for nearly 50 years, only about a 33 percent filed healthcare proxies and With the NIEHS award, Cave third of U.S. adults have them, according 32 percent remained undefined, mean- plans to explore how any number of en- to a recent study. ing the type of advance directive wasn’t docrine disrupting chemicals contribute People with chronic illnesses were specified or was combined. to fatty liver disease. The flexible nature only slightly more likely than healthy People older than age 65 were signifi- CAVE of the award allows him to redirect the individuals to put their wishes down cantly more likely to complete any type of research over the course of the funding, on paper. advance directive than younger ones—46 UofL gastroenterologist Matthew and adapt the work in light of new leads. For the analysis, published in the percent of older people, versus 32 percent Cave, MD, believes that chemicals we Cave is one of eight environmental July issue of Health Affairs, researchers of those who were younger. But the dif- breathe, consume or come in contact health scientists receiving the new Rev- reviewed 150 studies published between ference between people who were healthy with in the environment may be con- olutionizing Innovative, Visionary En- 2011 and 2016 that looked at the pro- and those who were sick when they filled tributing to liver disease in as many as vironmental Health Research (RIVER) portion of adults who completed advance out the directive was much smaller—33 one in four people. He has been award- Outstanding Investigator Award from directives. Of nearly 800,000 people, 37 percent compared with 38 percent. ed $4.01 million over eight years by the the NIEHS. MEDICAL NEWS • OCTOBER 2017 PAGE 3
NEWS IN BRIEF
Kentucky Public Health sends nurses to help in Hurricane Irma recovery and federal officials coordinated the de- ployment. The team was in Florida for about two weeks. K e n t u c k y ’ s Nurse Strike Team consists of 10 reg- istered nurses and two administrative staff members from the Franklin County A Nurse Strike Team from Kentucky Health Department, helped Hurricane Irma victims in Florida the Louisville Metro Department of Pub- last month. It was the first time Kentucky lic Health and Wellness, the Northern has been asked to send a team of nurses to Kentucky Health Department and the Kentucky Department for Public Health. another state following a disaster. Kentucky They worked in a medical needs shelter in Department for Public Health (DPH), Orlando and were redeployed to other lo- within the Cabinet for Health and Family cations in Florida as needed. Services (CHFS), along with local, state Kosair Charities provides $1 million to UofL for children’s healthcare programs The University of Louisville has re- Child Neurology. ceived $1 million from Kosair Charities Through the years, Kosair has pro- to support four health-related programs vided more than $30 million in philan- designed to benefit children. thropic support to the university. The largest portion of funds will The Kosair Charities Division of Pe- support the Department of Pediatrics’ diatric Forensic Medicine is Kentucky’s Forensic Medicine team who work to only physical abuse and neglect assess- identify, evaluate, document and pre- ment program. The formal consultation vent child abuse and neglect. Other service provides medical expertise on the programs supported include the UofL diagnosis, documentation and follow-up Autism Center at Kosair Charities, of suspected cases of child physical abuse the Kosair Charities Pediatric Clini- and neglect. cal Research Unit and the Division of Norton Healthcare moves employees from downtown to East End 4 TOP 50 NATIONALLY Norton Healthcare Inc. has moved stitute for Nursing and Norton University RANKED PROGRAMS three departments from its downtown cam- were moved to the Plaza I building at 9500 pus to a major East End office building on Ormsby Station Road. The departments had Hurstbourne Parkway, north of Shelbyville outgrown their space at Norton’s downtown Cancer Care Road in Louisville, Kentucky. campus, at Broadway and Floyd Street. The human resources department, In- Diabetes & Endocrinology UK College of Pharmacy receives $5 Neurology & Neurosurgery million for malaria research Geriatrics Approximately $5 tucky College of Pharmacy, in partnership million in additional with Eisai Pharmaceuticals and Medicines funding from the Global for Malaria Venture (MMV), for ongoing Health Innovative Tech- malaria research. nology Fund (GHIT) This award from GHIT funds research has been awarded to the over two years with Dean Guy as the proj- lab of Dean Kip Guy at ect’s principal investigator. See how we’re making a difference at ukhealthcare.com the University of Ken- GUY News in Brief continued on page 18 PAGE 4 MEDICAL NEWS • OCTOBER 2017
PEOPLE IN BRIEF
Baptist Health Chris Roty, Kim Leake, Shiraaz Rahman, Jordan Brown, current president MD, was hired MD, was hired MD, will join of Baptist Health as an associate as a glaucoma Baptist Health La Grange, has medical director. cataract surgeon. Medical Group. been named interim president of Baptist Health Paducah.
ROTY LEAKE RAHMAN BROWN John-Kenyon ResCare
Neurologist John Lee Titsworth, Jessica Finch, Frank Guckes Cole, MD, has MD, PhD, OD, joined was hired as joined Baptist has joined as a medical vice president Health Floyd Baptist Health optometrist. of finance Spine Center. Medical Group for ResCare Neurosurgery. Workforce Services.
COLE TITSWORTH FINCH GUCKES Hosparus Health Roy Lowdenback Drew Lally, Kaylea Janel Shannon was named MD, was hired Lipps, OD, McCracken vice president as an associate was hired as a was hired as of Business medical director. resident medical vice president Development at optometrist. of Kentucky Baptist Health operations. Paducah.
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CORNER OFFICE
Meet Dan Fisher, partner and Health Care Practice Chair at Bingham Greenebaum Doll in Louisville, Ky.
Medical News: disabled individuals in our community. ing, providing feedback and lending a hand How’d you end up Louisville is home. FAST FACTS wherever necessary. working at Bing- As for working at BGD, I have had un- ham Greenebaum expected, but positive, opportunities to Hometown: Lima, Ohio MN: What’s one piece of advice you re- Doll? work with a diverse client base across vari- Family: Wife, one member most clearly? ous industries. The national reach of our daughter, two sons DF: My father would often give two- Dan Fisher: I practice allows me to interact with lead- Hobbies: Pickleball, pieces of advice that are related: “Don’t came to Bingham ers of businesses and industries across the ever give up.” and “With change comes op- Greenebaum Doll United States. biking, golf, reading portunity. You have to be able to adapt and (BGD) directly out Currently Reading: Red Notice: change to be successful in life.” FISHER of law school. BGD MN: What are some particularly suc- A True Story of High Finance, offered me the prospect of joining a prolific cessful initiatives that you are most Murder, and One Man’s Fight MN: What do you consider your great- tax and corporate practice. While the job proud of? for Justice By Bill Browder est achievement at BGD? required me to move to Louisville, a city I DF: Outside of work, I am particularly Words to live by: “Having DF: It is hard to state a single, great- knew very little about, I immediately saw proud of what I accomplished as the presi- Light, We Pass It On To Others” est achievement in my career. For me, the that the city and BGD were welcoming and dent of The Council on Developmental (Wittenberg University) greatest achievement has been my contin- offered to my wife, Laura, and me a won- Disabilities, Inc. I was able to lead a capi- ued ability to adapt my skills in order to rep- derful opportunity to pursue and advance tal campaign that gave the organization the resent companies across multiple, highly- our career goals and raise our family. opportunity to develop a new office build- MN: Tell me about your management regulated industries, such as the healthcare ing that was fully handicap accessible and style. industry. However, I also take great pride MN: How’s it different than you highly visible to the community. DF: I would say I am a collaborative in the opportunity my position gives me to expected? At Bingham Greenebaum Doll, I am leader. I have the unique privilege of lead- help others succeed. Whether it be helping DF: BGD and the City of Louisville have proud of the continuing expansion and ing a highly intelligent, driven and dynamic to mentor a colleague or helping structure a both exceeded my expectations. I love the growth of our Health Care Practice Group. group of attorneys. As such, I find it is my transaction for the future success of a busi- community and the environment it provides The opportunity to bring together attorneys job to empower them and help them fur- ness, I get a great deal of reward from seeing for nurturing my family, and have been able across practice groups to serve the dynamic ther develop their skills and passions. I try my work positively impact others. to be very active civically, including work and ever-changing industry of healthcare has to lead by example and be engaged in the with charities that serve developmentally- been an engaging and rewarding process. projects my team is working on: delegat-
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EVENT CALENDAR
Substance Use Disorder Education Evening of Entrepreneurship with Frederique Dame
Oct. Time: 11 a.m. to 4 p.m. Oct. Time: 7:30 p.m. 3 Location: University of Pikeville, 147 Sycamore St., 4 Location: Kentucky Derby Museum, 704 Central Ave., Health Professions Education Building, 7th Floor, Louisville, Ky. 40208 Pikeville, Ky. 41501 Info: Celebrate Louisville’s progress on building a Info: This event will bring together local, state and national sustainable, innovative community for entrepreneurs. Keynote from Frederique Dame, investor and product developer (Uber, Yahoo!, subject matter experts to discuss the prevention and treatment of Photobucket, Smugmug). Visit the web site at greaterlouisville.com substance use disorder. Speakers will discuss putting evidence based for more information. guidelines into practice in a rural setting and provide resources and tools to assist current and future providers in Appalachia help Healthcare Transformation Survival Seminars turn the tide on the substance use disorder epidemic. Register at conta.cc/2hROicV. Find more information at soar-ky. Oct. Time: 9:30 a.m. to 3 p.m. 5 Location: Ashland Community College, The Rocky org/providereducation. Adkins Pavilion, 902 Technology Dr., Grayson, Ky. 41143 Info: An in-depth look at the Medicare Access and CHIP Medicare Risk Adjustment & Documentation Guidance webinar Reauthorization Act (MACRA) legislation and the Quality Time: 1 to 2 p.m. Payment Program. Visit the web site at kentuckyrec.com for Oct. more information. 4 Info: A webinar designed to help ensure providers understand the basics of Medicare Risk Adjustment and Lexington Medical Society & KMA 10th District Dinner Meeting the importance of proper medical record documentation and coding. Visit the web site at kypca.net for more information. Oct. Time: 6 p.m. social; 6:30 p.m. dinner; 7:15 p.m. program 10 Location: Hilary J. Boone Center, University of Kentucky, 500 Rose Street, Lexington, Ky. 40508 HAVE AN EVENT FOR OUR PRINT OR Info: Guest speaker is Dale Toney, MD, KMA Board Chair and ENEWS CALENDAR? 10 District Trustee. Register at lexingtondoctors.org. Email [email protected].
Corporate Government Affairs Healthcare Regulation Real Estate Litigation Medical Malpractice Intellectual Property
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We all work together for a healthier Kentucky.
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16pass7773v1_10x12.25.indd 1 12/2/16 9:56 AM PAGE 8 MEDICAL NEWS • OCTOBER 2017
NEWS
Cabinet reaches agreement with Bluegrass.org to manage Hazelwood ICF
By Ben Keeton Disabilities, a part of CHFS. considered medically fragile. “As we work to deliver a person- Facility leadership has undergone The Kentucky Cabinet for Health The residents are happy, healthy centered model emphasizing a myriad of changes over the years, and Family Services (CHFS) has reached and safe and I think that will be independence, we determined it is in the particularly since 2010. The facility also an agreement with Bluegrass.org – a strengthened with Bluegrass.” best interest of all involved to partner currently utilizes more than 10 different Kentucky-based, non-profit organization with Bluegrass.org – a proven leader in vendors to provide adequate staff. – to assume management of Hazelwood, — Donna Ball, president the field – to manage Hazelwood. As BHDID and Bluegrass.org emphasize a state-owned Intermediate Care Facility of Concerned Families always, residents and family members are this transition is designed to bring about (ICF) for individuals with intellectual our top priority and we are working to stability and unification for the facility. and developmental disabilities (IDD). of Hazelwood ensure this transition will be seamless.” “At Bluegrass.org our mission is to The agreement includes Hazewood assist individuals to live meaningful and Successful Model ICF, the Hazelwood specialty clinic, and balanced lives. Since three community homes. The transition follows the successful 2006, Bluegrass has “Hazelwood plays an invaluable role model Bluegrass.org has achieved with served the residents of in Kentucky’s healthcare infrastructure operation of Somerset-based Oakwood, Oakwood in Somerset and has served to meet the needs of the largest of Kentucky’s four state- with care 24 hours a countless individuals, family members, owned ICFs. day, seven days a week and staff over many decades. Just as “Bluegrass has a proven record BEATRICE ensuring each resident healthcare standards have progressed, so of managing the transition and receives services have best practices in the management operations of a state- created by an interdisciplinary team. of intermediate care facilities,” said run intermediate care Residents participate in more than 30 Wendy Morris, commissioner for the facility,” said CHFS enrichment classes, take part in Special Department for Behavioral Health, Secretary Vickie Yates Olympics, community events and have an Developmental and Intellectual Brown Glisson. “The opportunity to work in a garden center expertise and stability and tea room operated by Oakwood. We GLISSON this arrangement provides are looking forward to providing the will solidify services and same high-level of care and support for insure consistent quality of care to this the residents and families at Hazelwood,” vulnerable population.” said Paul Beatrice, CEO at Bluegrass.org. Under the terms, Bluegrass.org will assume responsibility for the complete staffing, management and We are committed to helping administration of the facility, like the arrangement between the Cabinet our state employees understand Flexible practice opportunities and Bluegrass.org for the operation their employment options of Oakwood. and make fully informed for physicians. Following a meeting with Cabinet and Bluegrass representatives, the decisions about their future.” president of the Hazelwood family — Sec. Vickie Yates The Family Health Centers are dedicated to providing group, which advocates for Hazelwood primary and preventive health care to all, regardless of residents, endorsed the transition. Brown Glisson ability to pay. We serve the working poor, the uninsured, “We’re excited and enthusiastic about working with Bluegrass,” said New Opportunities those experiencing homelessness, refugees from all over Donna Ball, president of Concerned State employees at Hazelwood the world, and anyone in need of affordable, Families of Hazelwood. “The residents in good standing will be offered a job high quality health care. are happy, healthy and safe and I think with Bluegrass, with at least comparable that will be strengthened with Bluegrass. salary and benefits. CHFS and It seems like they are really positive and Bluegrass.org human resources’ staff To learn more about opportunities in any of our seven caring. We are looking forward to some members are available on the Hazelwood positive changes.” campus to inform employees about the Louisville Metro locations, please contact: benefits package and answer questions. [email protected] ǀ 502-772-8574 Continuous Change Representatives from CHFS’ human www.fhclouisville.org fhclouisville Hazelwood ICF has an average daily resources will help those with merit status who wish to consider a transfer to census of 80 residents with an additional 24 residents residing in three community a vacant cabinet position. “We are committed to helping Certified by The Joint Commission for homes. Hazelwood and the community homes provide services on a 24-hour our state employees understand their employment options and make fully ambulatory care, labs and as a Patient basis, seven days a week. The residents informed decisions about their future,” Centered Medical Home (PCMH). have intellectual and developmental concluded Sec. Glisson. disabilities, with the majority also being REP. MARY LOU MARZIAN, D-LOUISVILLE (RIGHT), AND REP. JONI JENKINS, D-SHIVELY.
MEDICAL NEWS • OCTOBER 2017 PAGE 9
COVER STORY
Continued from cover Lawmakers hear sobering account of opioid crisis
Adkisson, meanwhile, said the impact of the opioid crisis on Kentucky’s KENTUCKY LAUNCHES NEW health was staggering. “Less obvious, however, is the toll that STRATEGY FOR OPIOID ABUSE is taken on the state’s economic growth Kentucky Opioid Response Effort (KORE), which is being funded with and development,” he said. “In Kentucky, the opioid crisis has contributed to a low $10.5 million in federal dollars, is a comprehensive targeted response workforce-participation rate. to Kentucky’s opioid crisis by expanding access to a full continuum “At a time when job openings and of high quality, evidence-based opioid prevention, treatment, investment in Kentucky are reaching recovery, and harm reduction services and supports in high-risk record highs, we must provide the geographic regions of the state. KORE has three primary targets: REP. MARY LOU MARZIAN, D-LOUISVILLE (RIGHT), healthy productive workforce needed to AND REP. JONI JENKINS, D-SHIVELY. grow the economy.” 1. Prevention 2. Treatment 3. Harm Reduction most effective evidence-based intervention,” Rep. Mary Lou Marzian, D-Louisville, Brenzel said. asked how the state could fund the mental The Kentucky Department for Behavioral Health, Developmental Wuchner said the grant money couldn’t health, treatment and prevention programs and Intellectual Disabilities (KDBHDID) has hired a project director, come fast enough. needed after the governor recently Dr. Katie Marks from UK, for the Kentucky Opioid Response Effort grant. “Opioid addiction is a ravenous beast proposed cuts of 17 percent for most state More on this in the education issue coming in November. because its increasing tolerance requires agencies in the current fiscal year to make individuals to take higher doses to stave off up for an expected budget shortfall. withdrawal and addiction spiral can happen Department for Behavioral Health, coming,” he said. “That is something I for opioid overdose victims, pregnant and quickly,” she said. “It fractures families, Developmental and Intellectual don’t often say. We have received funding parenting women, individuals re-entering lives, communities and futures. It fills our Disabilities Medical Director Dr. Allen J. from the legislature, the governor’s society upon release from criminal justice headlines daily. It fills our courtrooms, our Brenzel said grant money is helping to pay budget and we have received a significant settings and adolescents and young adults at jails, our hospital ERs, our NICUs (neonatal for programs to tackle the opioid crisis. number of grants.” risk of addiction. intensive care unit). It fills our court dockets, “The good news ... is that resources are Kentucky was recently awarded a $10.5 “Now, what is very critical, is that we use million federal grant to help on programs those dollars, and guide those dollars to the and it fills our morgues.”
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KENTUCKY . INDIANA . GEORGIA . TENNESSEE . VIRGINIA PAGE 10 MEDICAL NEWS • OCTOBER 2017
THE 2017 MEDI STAR THE AWARDS: AWARDS The A.O. Sullivan Award for Excellence in Education Presented to organization that takes CELEBRATING THE 2017 creative approaches to developing and implementing programs, which enhance MEDISTAR HONOREES the level of knowledge, education and TUESDAY, career opportunity in healthcare. The Bingham Greenebaum Doll OCTOBER 24, 2017 Leadership in Healthcare Award Presented to a progressive and 4:30 • Registration entrepreneurial individual who is not afraid to take risks and whose job & Cocktail Reception performance is considered exemplary 5:30 • Award Ceremony by providers, patients and peers. The Centerstone Healthcare The Muhammad Ali Center Advocacy Award Louisville, Kentucky Presented to an individual or organization that has worked to raise awareness of health challenges in our Purchase tickets online at region and worked to affect change. medistarawards.com The Bluegrass Care Navigators Aging Care Award SPONSORED BY: Presented to an organization that has advanced the level of care for the senior community through innovative methods resulting in reduced costs and improved quality of life.
The Kentucky Life Sciences Council Healthcare Innovation Award Presented to an organization that has developed a new procedure, device, service, program or treatment that improves the delivery of care.
The Dickinson Wright Nurse of the Year Award Presented to a nurse who has gone above and beyond their normal responsibilities to improve best practices and contribute to patient education.
The Physician of the Year Award Presented to a physician who has shown outstanding leadership and vision and has contributed to their workplace leaving a lasting legacy.
SAME EXPERTS. NEW NAME.
Hospice of the Bluegrass is now
Bluegrass Care Navigators. Hospice care continues to be a focus, yet we now guide and provide expert care long before life’s final months. More ways to care.
• Extra Care – personalized home care • Transitional Care – help with hospital to home • Palliative Care – pain and symptom relief • Hospice Care – for life’s final months
• Grief Care – support during grief
To discuss the care that’s right for you or your loved one, call 855.492.0812 or learn more at bgcarenav.org
©2017 Bluegrass Care Navigators Bluegrass Care Navigators complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. MEDICAL NEWS • OCTOBER 2017 PAGE 11
2017 MEDISTAR AWARDS
Kentucky Health Inscope Medical
Career Center — The Inscope Direct and Video laryngoscopes both integrate controllable suction in a — Responds to needs in the healthcare novel, proprietary manner that overcomes workforce and has partnered with the challenges experienced by previous employers and community organizations attempts to develop a suction laryngoscope. on such programs as an Acute Care Nurse Aide training program and a Hispanic — The Inscope Direct and Video laryngoscopes Job Fair for immigrants and refugees. reduce patient risks and clinician training requirements while improving patient — The KHCC is a place where employers can outcomes in emergent intubations. The A.O. Sullivan join forces – collaboratively rather than The Kentucky competitively—to promote healthcare careers. — The Inscope laryngoscopes’ low price Award for Life Sciences For job seekers, the KHCC demystifies point meets cost requirements for routine Excellence in healthcare occupations for new job seekers, Council Healthcare intubation environments (pre-surgery), Education expanding the diversity of applicants. Innovation Award while also providing greater protection from unexpectedly difficult intubations — Since January 2016, 268 individuals than currently available laryngoscopes. who accessed services at the KHCC were placed into healthcare jobs at an average wage of $18.02 per hour. Mark Carter Passport Health Plan Robert Edwards UK HealthCare — Announced in April that Passport would be purchasing a 20-acre site along West Broadway that will be developed into a — Serving for the Kentucky Cabinet for Health and Well-Being Campus, anchored Health & Family Services (CHFS), Rob by a new headquarters for Passport. advocated for better healthcare for Kentuckians and ensured that efforts — Presence will allow engagement with were made to see this through. many members from a holistic approach and may be the largest investment in — Rob also serves as the lead for the The Bingham West Louisville in over 50 years. Government Affairs and Policy Team Greenebaum Doll The Centerstone where he advocates on behalf of UK Leadership in — The West Louisville project shows young Healthcare HealthCare and its patients including Healthcare Award leaders what’s possible if they defy the underserved populations it serves. convention and take calculated risks. Advocacy Award — During the 2017 legislative session, Rob spent time in Frankfort advocating for House Bill 333, related to opioid addiction Elizabeth Edghill and Schedule II drug prescriptions. Family Health Centers
— Managing Refugee and Immigrant Services Signature HealthCARE at Family Health Centers allows Liz to advocate for some of the newest and — Signature has embraced new to the most vulnerable neighbors – ensuring healthcare marketplace technology, they have the language access and care VirtueSense, allowing physical therapists coordination resources they need. to pinpoint metrics down to the centimeter and better empowering — Developed the FHC’s most recent health patients during rehabilitation. The Dickinson literacy initiative, “Know Your Healthcare,” Wright Nurse of a community health education class. Topics — Person-directed care is a culture and include being part of your healthcare the Year Award mindset that everyone embraces team; levels of care – the right place at to provide better clinical outcomes the right time; health insurance basics; The Bluegrass and quality of life initiatives. and a changing healthcare system. Care Navigators — A person-centered care approach results Convinced FHC’s leadership to approve a new Aging Care Award — in better medication management Community Health Worker (CHW) position and decreased hospitalizations. earlier this year, then wrote and received the AKHCAN CHW Workforce Development Incentive grant to start the program. Ralph Alvarado, MD, State Senator
Serves in the Kentucky General Assembly as a State Senator and is also a practicing physician. Ralph has championed various pieces of medical legislation watching them become law, such as: — 2016 Senate Bill 17: Protects current physician licensing process in Kentucky. — 2017 Senate Bill 4: Establishment of medical review panels to screen out frivolous medical lawsuits in Kentucky. First true advancement of medical tort reform in Kentucky in 20 years. — 2016 Senate Bill 20: Establishes an appeals process for all providers The Physician of participating in Medicaid with Managed Care Organizations. the Year Award PAGE 12 MEDICAL NEWS • OCTOBER 2017
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M edical News has a rich history of presenting news and information about the business of healthcare in From the Kentucky and Southern Indiana. Over the past 24 years, our staff has had the privilege of telling thousands of stories of advocacy efforts, new developments or healthcare providers making a difference in the community. Going forward, we will occasionally revisit some of these stories to see how they impact healthcare today. Archives Below is a story that ran in the October 2008 issue, discussing the location of the new VA Medical Center. Today, a location has been selected, but ground has not been broken and there is still much discussion in the community on the most appropriate location for the medical center. October 2008 Ben Keeton, Publisher
The future of the VA Medical Center in Louisville By Zach Everson Iroquois Hill Post 6182 who served in the Army The U.S. Department of Veterans in Vietnam, most veter- Affairs is going to build a new Louis- ans want the new hospi- ville VA Medical Center. The question, tal to be built at the Zorn however, is where. Avenue site and are upset According to Bob Morey, facility about a possible downtown planner at the VA, the locations be- location. ing considered are the Zorn Avenue “It’s almost unani- site that is home to the current hos- mous,” he said. And Mo- pital a downtown spot near the Uni- rey agrees that anecdotally versity of Louisville’s Health Sciences most vets are in favor of Center, which has 50 faculty members the new VA being built at employed by the VA (it also funds the Zorn Avenue location. some of the university’s faculty re- Murphy cited parking search and 100 of its 600 resident po- shortages and traffic con- sitions) a green field site where there gestion as two reasons why has not been any previous construc- many vets would prefer the tion and, therefore, has less chance Zorn Avenue site. But the for pre-existing environmental issues. South End resident views the hospital’s move to be Many Options near the University Louis- wherever this hospital ends up being,” We’re advocating for a Cook said. The best answer as to which of ville as a done deal. downtown hospital, not for “Having said that, we feel very those options is best, however, depends We feel very strongly that we strongly that we can deliver even better all veterans’ functions to on which of the main stakeholders—the can deliver even better care care to the veterans if the hospital is be downtown.” local VA, the veterans and the Univer- located downtown.” sity of Louisville—you talk to. to the veterans if the hospital — Dr. Larry Cook “We are not advocating anything The Louisville VA Medical Center is located downtown. We other than veterans having their own does not have an official position on Along with the mayor’s office, the are not advocating anything freestanding autonomous hospital the new hospital’s location, according university has helped the VA and its built,” Cook said. “That’s different than to Judy Williams, a public affairs offi- other than veterans having consultants identify sites on the health sharing certain support functions,” he cer there. The site of the new hospital, their own freestanding sciences campus that it thinks would said, citing services ranging from the as well as the timing of that announce- make for a suitable location. autonomous hospital.” emergency room to laundry. ment, will be determined at the VA’s “We’re advocating for a downtown Among the benefits Cook gave for headquarters in Washington, D.C. — Executive Vice President for hospital, not for all veterans’ functions a downtown location would be veteran’s “There hasn’t been a decision ren- Health Affairs at the University to be downtown,” Cook said, suggest- ability to access to an additional 400 dered yet,” said Williams. of Louisville, Dr. Larry Cook ing that inpatient care be handled at university faculty members at any given In support of the site-selection pro- the new hospital with outpatient ser- time and the proximity to its cancer and cess, the VA completed a phone survey vices, administration and maybe a “They’re going to put it downtown heart programs. of 4,000 patients at its medical center nursing center housed at the Zorn Av- so they can ship you across the street,” “We have conditions today for in July. Williams and Morey said those enue location. Murphy said. “And that’s the point which we routinely have to move vet- results have been forwarded to Veterans “There are 400,000 outpatient vis- of being downtown, which is under- erans downtown. And if you just take Affairs Secretary Eric Shinseki’s office, its rendered through the current VA standable.” one disease like stroke, time saved is but they will not be made public until hospital system. There are about 5,000 Executive Vice President for Health brain saved.” he has reviewed them. annual hospital admissions,” Cook said. Affairs at the University of Louisville, Considering the other medical fa- They hope he will be briefed later “It’s not going to be that big a deal Dr. Larry Cook, also thinks that veter- cilities downtown, Cook said that area in October with representatives from that often for the average veteran.” ans would be better served with a down- has the greatest concentration of medi- the local VA in attendance. town facility. cal services in Kentucky. “It’s highly But while the VA is not yet willing “We recognize that ultimately this likely that specialized services that the to share the veterans’ opinions, many PRINT TO WEB: is going to be a VA decision. And we’re veterans need could then be provided vets have no qualms voicing them. Read the article in full going to have our same programs and more proximately, more conveniently at at medicalnews.md. According to Larry Murphy, com- our same commitment to the veterans those other hospitals.” mander of the Veterans of Foreign Wars MEDICAL NEWS • OCTOBER 2017 PAGE 13
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Back to the future New old way of caring for homebound has arisen with growth of the home-based primary care practice. By Ellen Thomson Interdisciplinary teams are It is estimated that the number of people in the United States over the age vital to provide the skill set of 65 will double by the year 2050. This needed to manage the complex will seriously impact the nation finan- cially. 25 percent of Medicare spending care issues of the chronically now occurs in the last year of life, and ill, homebound patient. 38 percent of Medicare beneficiaries spend a portion of their final year of life in a nursing home. There will be ciary. These practices are truly specialty an increasing need for retirement plans practices. The providers are experts in to finance retirees for a longer period the management of chronic disease, pal- as well. liative and end of life care, and through The need for healthcare providers the interdisciplinary makeup of many, trained to manage chronic illnesses has behavioral healthcare. grown as the population ages. This care A recent study listed the attributes must be focused on reducing the burden that make home based primary care of chronic disease through quality im- successful. Interdisciplinary teams are provement and cost reduction. vital to provide the skill set needed to care community has operated in a more changing the way they compensate manage the complex care issues of the More Isn’t Better is better mode, rather than an under- healthcare providers from a fee for ser- chronically ill, homebound patient. Traditionally, the American health- standing of what works. Medicare is vice process to a quality based program A barrier that needs to be over- in recognition of these needs. This come, however, is the availability (and change is impacting providers across remuneration) of behavioral health ser- the board. vices. There is a lot of work currently A survey conducted in 2011 of the being done to establish integrated care Medicare population found that 5.6 per- (behavioral and medical) into primary cent of community dwelling Medicare care, so more to come on that. recipients (as opposed to facility–long YOUR LEXINGTON term care–dwelling) were completely or Time Investment mostly homebound. Traditionally, these This type of team work also re- people suffer from a greater number of quires extensive care coordination, and LAW FIRM FOR chronic illnesses, often exacerbated by the visits typically take longer than a isolation, poverty and a loss of coordi- routine office visit (plus travel time), so nated and continuous healthcare. consideration needs to be made for this time investment. A large part of the fi- HEALTHCARE. nancial savings found in the project was This is an advertisement. Services may be provided by others. A new old way of caring for attributed to the avoidance of unneces- sary ER/hospital visits. This means the these homebound individuals, team must be ready and able to make For more information about our rm, our healthcare and their special needs, has acute visits when the need arises. Fi- nally, a team well versed in palliative practice, and how we can beneet you, please contact one of our arisen with the growth of the nationally-recognized healthcare lawyers in Kentucky. or end of life care should support most home-based primary people’s wishes to die at home. care practice. The future for home-based primary Kerry B. Harvey care will depend upon establishing the 859.899.8739 | [email protected] program as a Medicare benefit, avail- Andrew L. Sparks able to all Medicare beneficiaries. 859.899.8734 | [email protected] A New Old Way Also, it can be argued that this care 300 West Vine Street, Suite 1700 | Lexington, KY 40507 A new old way of caring for these is a specialty in itself, and training pro- homebound individuals, and their spe- grams can be developed for providers cial needs, has arisen with the growth in all disciplines who are interested in of the home-based primary care prac- providing this type of care. DickinsonWrightpllc tice. These practices, studied through a House calls can take us back to the Medicare demonstration project known future of healthcare, providing the kind as Independence at Home, were found of care patients want, in the setting they to provide the triple aim of healthcare want it, at a higher quality and lower – improving health, improving patient cost than is currently available to most. ARIZONA FLORIDA KENTUCKY MICHIGAN NEVADA OHIO TENNESSEE experience and reducing costs. — Ellen Thomson is director of Clinical TEXAS WASHINGTON DC TORONTO | DICKINSONWRIGHT.COM In fact, the first year of the project Quality at MD2U in Louisville, Kentucky. showed a saving of $3,070 per benefi- PAGE 14 MEDICAL NEWS • OCTOBER 2017
AGING CARE
The power of telehealth Telehealth program brings expert aging care into even the smallest of rural communities in Kentucky.
By Laura Dawahare Telemedicine was conceived as a way ADVANCING DISCOVERIES FOR AGE-RELATED DISEASE to extend scarce clinical resources from the academic medical center to rural In 1985, the University of Kentucky Sanders-Brown Center on Aging (SBCoA) was among the first 10 Alzheimer’s Disease Centers funded by the National Institutes of Health, and has been continuously funded communities in a cost-effective manner ever since. and has been used successfully for more than 20 medicine specialties at the Uni- Research participation is essential to advancing knowledge of diseases and identifying potential treatments. Sanders-Brown sponsors numerous studies that explore age-related brain disorders and versity of Kentucky. The Sanders-Brown promote healthy aging. program allows doctors at participating facilities to easily arrange consultations There are participation opportunities for people with Alzheimer’s or other dementias, and for people at risk for those diseases but without symptoms. Healthy volunteers are always needed. Participation is open to with world-renowned experts in Al- persons of all genders, racial backgrounds, and ethnicities. Current Sanders-Brown studies are investigating a range treatment and prevention approaches, including The trusting supplements for brain health, impacts of medication, exercise, and new medications related to Alzheimer’s relationship disease and cognitive impairment. between a patient A full list of studies open for enrollment is available at goo.gl/UQkuN1. with dementia and their she could persuade her mother-in-law to doctor is the foundation for an entire care — Laura Dawahare is the senior hometown doctor come to Morehead for an appointment, team that incorporates the resources at the public relations specialist at the Univer- JICHA is the foundation so she contacted Kentucky TeleCare’s Sanders-Brown Center on Aging.” sity of Kentucky. director Rob Sprang to see about the for an entire care team that possibility of using the telehealth incorporates the resources at the equipment. The virtual appointment was Sanders-Brown Center on Aging.” awkward for both until Jicha – known for his rapport with patients – broke the ice, — Greg Jicha, MD, UK Sanders- saying, “Wow, you look like a movie star Brown Center on Aging on the TV!” Jicha cared for her for over a decade. Jicha recognized immediately that tele- zheimer’s and memory disorders, add- medicine was an effective way to deliver ing the latest expertise to a patient’s expert care to patients outside of Lex- care team without having to travel too ington, and the program became a fix- far from home to be seen. ture on the telehealth schedule. “State-of-the-art memory evalua- This scene takes place several times tions should not be available only to the a month, as physicians affiliated with people able to make a trip to Lexington,” the Sanders-Brown Center on Aging said Jicha, who notes that people with use telemedicine to work with health- memory disorders are sometimes anxious Because an Ounce of Prevention… care professionals and patients regularly about traveling or being in unfamiliar at more than a dozen healthcare facili- In the always complex world of health care and health insurance law, places, which can make the trip fright- ties around the state, and even more Bingham Greenebaum Doll LLP is uniquely equipped to assist health care ening for the patient and trying for the upon request. companies, practices and providers with strategic initiatives, daily operations loved ones who accompany them. and regulatory matters. We continually monitor emerging market trends, new
“Taking advantage of internet tech- technologies, and the changing laws that impact all phases of your health care nologies to bring expert care into even State-of-the-art memory business. Find out how BGD can help your business stay healthy by calling the smallest of rural communities is a evaluations should not be 800.436.3644, or visiting BGDlegal.com. blessing for many families across Ken- tucky who simply cannot bring a loved available only to the people able one with dementia to Lexington.” to make a trip to Lexington.” Local Need — Greg Jicha, MD, UK Sanders- The Sanders-Brown/Kentucky Brown Center on Aging TeleCare clinical outreach program be- gan in 2005, when a patient from Olive THIS IS AN ADVERTISEMENT Hill needed to be seen but refused to “Optimizing care for a person with Louisville Lexington Cincinnati Indianapolis Jasper Evansville BGDlegal.com travel to Lexington for her appointment. memory loss requires teamwork,” said Ji- The patient’s daughter-in-law, a cha. “The trusting relationship between a nurse at St. Claire hospital, was certain patient with dementia and their hometown MEDICAL NEWS • OCTOBER 2017 PAGE 15
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Bending the cost curve Advanced Illness Care reduces costs through integrated care, without reducing the quality of care.
By Gwen Cooper MEASURE HOSPARUS HEALTH AIC NATIONAL AVERAGE/ BENCHMARK
With the repeal, replace or repair of Percent Patients the ACA as a top conversation among 78 percent < age 60= 30 percent with completed > age 60= 50 percent legislators, regulators, providers, payers Advance Directive and consumers, the opportunity to dis- rupt the fragmented healthcare system is ER Visits Avoided 30 — now. This can be accomplished through Estimated ER Cost the adoption of innovative, sound pro- $36,000 $1,200/visit average in 2015 Avoidance grams that bend the cost curve and pro- vide increased value to both providers and $180,000- (6) stays of 3 days 1 in 5 ER visits results users of the system. Healthcare systems Estimated Inpatient at cost per stay of $30,000 in hospitalization worldwide are facing macro-scale changes Cost Avoidance *Likely to be higher in (CDC), $30,000/ stay involving advanced illness and end-of-life this population (per Healthcare.gov) care that could affect both the quality of care and quality of life for patients and Patient/Family their caregivers. Overall 4.9 (Very satisfied) 1-5 scale Satisfaction
One piece of legislation to watch focus of palliative care and provides spe- AIC programs have programs have needy patients, further documenting that and support is the recently cialized medical care for patients with been shown to improve the quality of improved quality of life through coordi- introduced Patient Choice serious illness. AIC is provided by an in- care and to reduce costs. Coordinated nated care will lower costs and improve terdisciplinary team of professionals who care that is aligned with patient and quality of life, thus improving value. and Quality Care Act. The Act have expertise in symptom management, family preferences, like the services of- Healthcare experts across the con- enhances existing Medicare advance care planning, care coordination, fered through advanced illness care pro- tinuum of care realize the importance coverage for end-of-life services and the development of individualized grams, produces a positive outcome for of supporting individuals and families to help ensure that the care care plans that align with patients’ goals patients and providers. living with advanced illness, and key and values. Although the current reimbursement federal legislation that will change the a patient receives aligns with The goal of palliative care is to pro- structure provides minimal to no cover- trajectory of healthcare reimbursement their values and choices. vide the best possible quality of life for age of home-based advanced illness care, is on the horizon. patients and their families. The most fa- healthcare is evolving in multiple ways The number of Americans over the miliar type of palliative care is hospice with focused initiatives and payment age of 65 is set to grow to 89 million by care, which is specialized palliative care structures tied to quality and cost of care. While Americans live longer, 2050. While Americans live longer, over for patients with an expected prognosis of This shift in value based care prompted over 70 percent of people 55 70 percent of people 55 and older and 85 six months or less, but palliative care also Hosparus Health to pilot an AIC program and older and 85 percent of percent of those 65 and above are living extends further upstream into the care of to help the sickest and most vulnerable pa- with at least one chronic illness. Medical patients who are not eligible for hospice, tients and their families. The goals are sim- those 65 and above are living spending for this population in the last either because of treatment preferences or ple, to illustrate the value of the program with at least one chronic illness. year of life is estimated at $80,000 per a prognosis greater than six months. through patient and family testimonies of person. High-need, high-utilizers of the The original Medicare benefit for their improved quality of life, document cost savings to the healthcare system, and One piece of legislation to watch and use our voice to pass key legislation that will support is the recently introduced Patient lead to an eventual advanced illness care Choice and Quality Care Act of 2017. The Medicare benefit. Act enhances existing Medicare cover- From 2015-2016 Hosparus Health led age for end-of-life services to help ensure an AIC pilot program involving twenty- that the care a patient receives aligns Palliative Care two patient participants. The pilot was with their values and choices, beginning conducted in collaboration with, and the conversation towards a more robust system account for the five percent of pa- hospice was envisioned as a reimburse- partially funded by, a commercial health Medicare benefit that includes advanced tients that spend 50 percent of the annual ment mechanism primarily to care for insurance provider. The outcomes in the illness care. healthcare expenditures. This important people with advanced cancer, key ele- table above are telling. — Gwen Cooper is Chief Marketing Of- group provides a great opportunity to ments of the benefit are not optimal This small pilot inspired Hosparus ficer at Hosparus Health in Louisville, Ky. reduce costs for this population through for the care of people with other dis- Health to allocate significant financial integrated care, without reducing the eases where a prognosis is longer than resources to expand the pilot as a pri- quality of care. six months such as Chronic Obstructive vate pay model in 22 Kentucky counties. PRINT TO WEB: Advanced Illness Care Pulmonary Disease, Congestive Heart Additionally, we continue to work with To learn more, view the Act Failure, Alzheimer’s disease and other commercial insurance companies to pilot summary on the Congress.gov Advanced Illness Care (AIC) is a web site at goo.gl/5Eds3g. neurological diseases. our program with their costliest and most PAGE 16 MEDICAL NEWS • OCTOBER 2017
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Music and memory Playlists created in the Music & Memory program have power beyond prescriptions.
By Sally McMahon to say during visits. But with a playlist your mother loves, families can be in The Music & Memory program, the moment, rather than in worry. created by Long Island social worker For our employees, the playlists Dan Cohen in 2006, helps provide remind them of commonalities with iPods loaded with personalized the elders they care for. Music crosses playlists to people suffering from generational and cultural boundaries in Alzheimer’s and dementia across the unexpected ways. country. The hope is that the music can trigger memories. MN: Which residents use the program? AM: Currently, 44 Signature We use it as HealthCARE locations are Music a proactive & Memory certified and two more resource and locations are in the process to certification. The nonprofit Music sometimes an & Memory focuses primarily on alternative to elders living with dementia, and at medicine.” Signature we have found success with the program benefitting different MCALLISTER populations of elders, beyond those
— Angie McAllister, Signature with dementia. Music reminds our elders with HealthCARE’s director of Alzheimer’s of past memories and Cultural Transformation throughout the week. However, people creating a playlist individualized for an emotions. Music can also transform an with Alzheimer’s may not be able to elder. Each elder usually has a favorite elder’s outlook. If an elder is isolated Cohen got the idea for the program appreciate the music in a group setting. singer, a song that brings memories of or the staff sees they are not engaging in 2006 after he heard a story on the They may not be able to understand a particular time in life, and a lyric that socially with others, music has the ubiquity of iPods, did some research or distinguish different sounds in their is his/her anthem. power to change their day. We’ve and decided that they were a poorly environment. The noise might lead to We use it as a proactive resource had elders who weren’t responding to utilized resource in nursing home care. increased agitation and confusion. Or, anything, and they started responding
He did a trial run at a local nursing they may not like the style of music to music. home, sitting with a few residents to being played. What has been surprising is how get to know them and their musical How Music & Memory program the Music & Memory program MN: How do you measure success? distinguishes itself from general music AM: The Music & Memory tastes, creating play lists based on their is an incredible bonding tool for discussions. programming is in the selection of the program is measured at the level of It was an instant and definitive hit music. Music is selected specifically for families and our employees.” each certified Signature location. We know we have been successful when with the residents. They were talking each resident, based on their preferences. — Angie McAllister, Signature and communicating in different Brain research of people with dementia an elder is engaged in the moment. ways. They were less agitated, more has shown that even when someone is no HealthCARE’s director of There’s no better measurement than cooperative, more attentive, more longer able to communicate verbally, he Cultural Transformation observing an elder smile or move to engaged, in less pain and more or she will still respond favorably to their the beat of the music. favorite music. articulate. It was also an instant hit and sometimes an alternative to Music & Memory programs are MN: Give an example of someone with the staff, increasing morale. medicine. If an elder has dementia popping up all around the state of who has benefited from the program. The program started getting or is feeling down that day, their Kentucky. We spoke with Angie AM: When we first launched national recognition via a film called individualized playlist can be used McAllister, Signature’s Director of the Music & Memory program Alive Inside, which introduced viewers almost as a personalized, perfectly Cultural Transformation, about the at Prestonsburg Health and to his organization and provided a clip tuned dose of medicine. program. Below are the highlights. Rehabilitation Center, one elder, with the story of Henry, a 94-year-old named Billy, was cognitively aware, but who responded to the music provided MN: What surprised you about Medical News: How do you isolated. Billy was instantly moved and by Cohen’s organization in a startling the program? integrate the Music & Memory brightened with his playlist. The staff and affecting way. AM: What has been surprising is program into the day? saw an inner peace in him that wasn’t how the Music & Memory program is Local Efforts Angie McAllister: Once our teams there before. Now, he has taken on the an incredible bonding tool for families are trained in the Music & Memory role of choir director in the facility. Long term care facilities have long and our employees. When your mother program, the nurses and CNAs take realized the benefit of music, often has Alzheimer’s and she may not know the lead in integrating the program into scheduling a variety of music programs your name, families struggle with what daily life for our elders. The first step is MEDICAL NEWS • OCTOBER 2017 PAGE 17
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Not your father’s senior living facility Aging communities cater to new and changing expectations.
By: Janet Lively and Jim Schaefer Interpretations of nature through interior or architectural design offer a A significant evolution in the desires, unique, memorable touch to any senior preferences and economics surrounding living environment. Incorporating na- this market has occurred since we started ture in this way has shown to positively in this industry. Older facilities typically affect residents by reducing stress, im- boasted modest interiors and the basics; proving cognitive performance, emo- they were designed and constructed to tions and mood. accommodate the culture and ethos of a Integrated Technology depression-era population. Increasingly, older adults are inte- With the next generation, commu- grating technology into their daily lives; nities must provide amenities and so- in fact, they are becoming the fastest- phisticated interiors or they risk losing growing demographic on social media. market share. Enhancing residents’ daily They are becoming, tech savvy. As a living throughout the aging continuum, result, communities are incorporating in a setting like they have in indepen- USB connections and charging stations dent living, has become the objective. into millwork and Wi-Fi throughout, as However, a competing owner prior- well as creating keyless room entry. ity is operational cost savings and long- These additions often negate the need term adaptability. Fortunately, some of for a community business center. In some this can be delivered through efficient cases, residents receive tablets as a move- design, innovative finishes and infra- in perk. Therefore, connection accommo- structure technologies, such as LED and dations are not only necessary; they are a data connectivity. desirable feature beyond tablets. Amenities and Aesthetics
Architects and interior designers are incorporating open spaces that encour- However, a competing age social interaction and are conducive owner priority is operational to a variety of activities. Formerly, ac- cost savings and long-term tivity rooms were dispersed through- SAME EXPERTS. out a community. Designs now feature adaptability, some of which modifiable common areas which flexibly can be delivered through respond to diversified activities. NEW NAME. Today’s residents’ preferences are efficient design, innovative revolutionizing fundamental designs finishes and infrastructure Hospice of the Bluegrass is now related to daily services, such as dining. technologies, such as LED Bluegrass Care Navigators. They seek interactive dining experi- Hospice care continues to be a focus, yet we now guide ences, not just a room in which to eat a and data connectivity. and provide expert care long before life’s final months. meal. Communities have responded by Wellness featuring multiple spaces and styles of Many communities are adding resort- dining, including flexible hours like a caliber spas and fitness rooms, as their More ways to care. restaurant, and private family dining for residents are seeking a mind, body and • Extra Care – personalized home care special occasions. soul interaction on-site. Some are creating Similarly, in traditional senior liv- • Transitional Care – help with hospital to home spaces for cooking demonstrations, fitness • Palliative Care – pain and symptom relief ing models, the residents and the outside classes and equipment personalized for se- community were separate. Now, devel- niors, yoga and wellness spas. • Hospice Care – for life’s final months opers are inviting the local community Rehab has experienced tremendous • Grief Care – support during grief in by positioning community offerings transformation as well, primarily insti- as public services, making them easily gated by wealth, expectations and private To discuss the care that’s right for you or your loved one, accessible; some even encourage rooms pay. After surgery, many baby boomers call 855.492.0812 or learn more at bgcarenav.org be available for community events. choose to utilize short-term rehab ser- Outside businesses, such as upscale sa- vices at senior living communities. lons or rehabilitation services, are integrat- — Janet Lively is vice president of Mar- ed into communities. These professionals ©2017 Bluegrass Care Navigators keting and Business Development and Jim Bluegrass Care Navigators complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. can operate their businesses independently, Schaefer is the business development executive not by the senior living community. at Schaefer General Contracting. PAGE 18 MEDICAL NEWS • OCTOBER 2017
NEWS IN BRIEF
Continued from page 3 Michael Karpf honored for leadership at UK HealthCare
University of also fostering partnerships with leading Kentucky and UK regional health providers across the state HealthCare em- to extend care to those who need it most. ployees gathered Since being recruited to UK in 2003 to honor the ca- from UCLA, Karpf has developed ad- reer and leadership vanced subspecialty care programs compa- of UK Executive rable to those available at the nation’s very Vice President for best referral, research-intensive academic Health Affairs Dr. medical centers. This has been achieved in KARPF Michael Karpf great part through the recruitment of out- as he prepared to standing physicians and built tertiary and complete his last week in the role he has quaternary programs which have grown held for the past 14 years. dramatically both in volume and quality. Dr. Mark Newman began his post as Karpf plans to transition to a part- the new EVPHA beginning Sept. 18. time faculty position working on health Under Karpf’s leadership, UK has service and health policy issues and Tom Haselden invested close to $2 billion for faculty re- plans to stay involved in the Arts in [email protected] cruitment, program development, technol- Healthcare program. www.ezoutlook.com 800-219-1721 ext. 103 ogy acquisition as well as facilities, while Central Ky. physicians battle opioid abuse
Nine Central Kentucky physicians Leadership Institute (KPLI). took a leadership role during the Ken- This new physician leadership pro- tucky Medical Association (KMA) an- gram provides a small group of physi- nual meeting in Louisville. cians with intensive training on subjects This year’s meeting was designed to related to personal leadership, business foster ways of breaking down barriers leadership and advocacy leadership. to good healthcare, especially barriers The first class of 10 physicians in- that exist to address the issue of opioid cluded six from the Central Kentucky abuse. To help break down those bar- area. James Borders, MD; Mamata Ma- riers, physicians from around the state jmundar, MD; Danesh Mazloomdoost, were engaged in not only education, but MD; and John Patterson, MD, all of also provided feedback to policymakers Lexington completed the KMA’s KPLI from state and local government. program, along with Latonia Sweet,
COMPASSIONATE ADDICTION TREATMENT The KMA did this in a variety of MD of Winchester and Tuyen Tran, ways. One was to bring in noted author MD, of Versailles. Sam Quinones, whose book, Dream- In addition to the KMA’s KPLI If you or a loved one is struggling with land, documents the history of opioid program, however, the association has substance use we can help. The Bluegrass abuse over the past 30 years. had an active “Community Connector” Schwartz Center is a residential program KMA adopted Quinones’ mes- program for many years that highlights with individualized treatment plans, using sage by highlighting and training in- physicians who have been leaders in both dividual physicians who can make a their local communities and in medicine. evidence-based methods to ensure the difference in their communities. One They must also complete a public best possible. program recently instituted by the health or public education service element. KMA was the Kentucky Physician
Our mission is to help individuals and
families take control and lead happy, healthy lives. Local biotech firm gets grant to combat heart disease
Louisville-based biotech company pany study the effects of a proprietary FOR SUPPO R T AND APPOINT M E N T S Exscien has secured a $3.7 million grant protein on heart disease. Exscien leaders with which it hopes to get closer to de- plan to eventually license the protein to veloping treatments for heart failure. pharmaceutical companies, which could The three-year federal research commercialize drugs to treat progressive grant from the National Heart, Lung heart failure, a condition that affects and Blood Institute will help the com- more than 20 million people worldwide. MEDICAL NEWS • OCTOBER 2017 PAGE 19
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