March/April: Behavioral Health
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MEDICAL NEWS THE BUSINESS OF HEALTHCARE SERVING KENTUCKY AND SOUTHERN INDIANA $2.50 MARCH/APRIL 2021 News in Brief page 2 / People in Brief page 4 / Commentary page 18 Physician Spotlight Meet David Austin Hudson, MD, with RACIAL TRAUMA New Vista Community AND Mental Health THE Center Read more on page 5 HUDSON UK, partners break ground on new Coldstream Research Lab By Sally McMahon This training included didactic lectures, readings Read more on page 14 Steven Kniffley Jr., PsyD, is a on Black psychology, clinical psychologist who leads Spald- Steven Kniffley Jr.: My goals for Universal Medical ing University’s Collective Care Cen- Liberation psychology and the first year in- Supply offers ter – one of the nation’s only behavioral the assessment and treatment clude coordinating American made PPE health clinics to specialize in treating and implementing of racial trauma in various race-based trauma and stress. a university-wide Since 2018, he has served as associate racial and ethnic groups, and cultural climate as- director of Spalding’s Center for Behavior- sessment as well as viewing videos demonstrating al Health training clinic, of which the Col- developing a diver- lective Care Center is a specialty division. racial trauma assessment and sity, equity, justice, Kniffley’s area of expertise is re- and inclusion stra- therapy techniques.” search and clinical work with Black KNIFFLEY tegic plan. males. Specifically, his work focuses on Read more on page 16 understanding and developing culturally cifically, racial trauma can contribute MN: What is racial trauma? appropriate interventions for Black male to mental health difficulties related SK: Trauma that stems from the re- psychopathology as well as barriers to to poor concentration, flashbacks and sult of chronic experiences racism and dis- academic success for this population. nightmares, intrusive thoughts, re- crimination and contributes to a constant IN THIS ISSUE We talked to Kniffley recently about strict emotional expression, depression state of hypervigilance for racially based his work at the Collective Care Center, and anxiety. BEHAVIORAL slights and micro-assaults at the individu- the treatment protocol for the experi- Racial trauma can also contribute al, institutional and cultural levels. HEALTH ence of racial trauma and his goals in his to physical health difficulties such as new position of Chief Justice, Equity, hypertension, decreased immune sys- This month we take a closer look at MN: What are the challenges re- Diversity and Inclusion Officer. High- tem, chronic fatigue, insomnia, and mi- behavioral health in Kentucky. lated to the experience of racial trauma lights are below. graines. Lastly, the experience of racial found during your research and clini- Articles start on page 9. trauma can contribute to difficulties in cal experience? Medical News: What are your goals relationships due to feelings of hopeless- SK: Racial trauma can have a nega- for your first year as Chief Justice, Eq- ness, helplessness and frustration that tive impact on the physical and psycho- uity, Diversity and Inclusion Officer? contribute to isolation. logical health of persons of color. Spe- MN: Tell me about the racial trau- ma training recently conducted at Sev- en Counties Services. SK: I had the honor of supporting 130 Seven Counties Services Inc. cli- nicians learning and growing in racial trauma therapy. Over eight weeks, the Monroe, GA Monroe, clinicians completed a virtual self-paced Permit #15 Permit training on Racial Trauma Assessment PAID and Therapy. US Postage US Continued on page 8 PRSRT STD PRSRT PAGE 2 MEDICAL NEWS / MARCH-APRIL 2021 NEWS IN BRIEF Peer review privilege in Kentucky: A revolution in public policy By Ed Monarch Privilege Takes Shape and Kyle Virgin This grant of privilege was enacted, and is effective, in extending In 2005, the United States Con- gress passed the Patient Safety Quality statutory protections for nearly all information and process and Improvement Act, which is relevant communications arising from the retrospective review and to the extent that Congress enacted a patient safety initiative with broad peer evaluation of the competency of professional acts or conduct review privilege protections for those of healthcare personnel.” healthcare providers who participate in the program it created. Thus, Congress recognized and passed legislation to initiative is a prerequisite to the privi- tation and access to first-hand witness further the same public health priori- lege and, second, because the scope of testimony outside of the professional ties as KRS 311.377. the initiative may yet be interpreted to review function, KRS 311.377(3) and MONARCH VIRGIN In 2018, the Kentucky General limit the scope of the materials includ- (4) protect the peer review privilege ed within the peer review privilege. protections of KRS 311.377(2) from a Peer review information and com- Assembly amended KRS 311.377 sub- The material that is privileged un- due process challenge under Section 14 munications are privileged in Ken- stantially, and the long history of prior der the 2018 enactment extends its pro- of the Kentucky Constitution. tucky, but only through a relatively Kentucky peer review decisions no lon- tections to “the proceedings, records, Through the current enactment of recent enactment, and after a compli- ger apply to the language of this statute. opinions, conclusions and recommen- KRS 311.377, the General Assembly cated legal history. KRS 311.377 grants In its current form, the statute extends dations of any committee, board, com- has effectively and thoroughly protected broad privilege protections to peer re- privilege and confidentiality protec- mission, medical staff, professional the documents and discussions involved view proceedings and documentation tions to “any civil action in any court, standards review organization, or oth- in a retrospective review of healthcare in medical malpractice cases. including but not limited to medical er entity” that performs a designated events for those providers that engage As effective on July 14, 2018, this malpractice actions, actions arising out professional review function. KRS in a quality improvement initiative. Fi- statute extended privilege and confiden- of review of credentials or retrospec- 311.377(3) specifically excludes “any nally, Kentucky healthcare providers are tiality protections to, “the proceedings, tive review and evaluation as referred evidence, document, or record which empowered to engage in a privileged records, opinions, conclusions and rec- to in subsection (1) of this section, and is subject to discovery independently and confidential investigation and dis- ommendations of any committee, board, actions by an applicant for or grantee of the proceedings” of the peer review cussion of healthcare events. commission, medical staff, professional of staff privileges.” Thus, the statutory entity. Like its federal analog, this sec- — Ed Monarch is a Member in Mc- standards review organization or other privilege protections of KRS 311.377 tion is intended to exclude from the Brayer PLLC’s Louisville office. Kyle entity” engaged in performing a desig- now specifically extend to medical privilege patient care records, billing Virgin is a Member in McBrayer PLLC ‘s nated professional review function. malpractice actions and actions for fa- records, discharge records, and other Lexington office. This grant of privilege was en- cility negligence in the credentialing of original patient records that do not re- acted, and is effective, in extending healthcare providers. sult from a retrospective review of pa- statutory protections for nearly all in- To read about the tient care. formation and process communications Sturdy Foundation Similarly, KRS 311.377(4) makes long history of arising from the retrospective review The protections of KRS 311.377 clear that KRS 311.377(2) includes Kentucky law that denied and evaluation of the competency of are limited to a “person or entity that peer review communications, and only privilege protections professional acts or conduct of health- attests to participating in a patient peer review communications, by ex- to healthcare peer care personnel. The 2018 amendments safety and quality improvement initia- cluding from the privilege any provider legislatively overrule a long history of review proceedings tive, including the program established communications or statements that are Kentucky law that denied privilege visit medicalnews.md. by the Patient Safety Quality and Im- made outside of the designated pro- protections to healthcare peer review provement Act.” fessional review function described in proceedings. This is an important caveat for two Section (2). Thus, by specifically ex- reasons: first, participation in such an cluding original patient care documen- Mental health and addiction about ensuring disorders are often treated differently compliance with than other health conditions by insurers, coverage bill passes existing law,” Sen. but there is no healthcare without mental Ralph Alvarado, health care,” Alvarado said. “When R-Winchester, said there is a disparity in treatment, it causes The General Assembly passed Act of 2008. That federal law generally before the Senate harm. Many people go without treatment legislation to make sure health insurance requires insurers to cover care for mental passed HB 50 by for years with disparities worsening by plans offered in Kentucky comply with a health and addiction just like physical a 36-0 vote.