In 11-1 vote, Somerset passes comprehensive smoking ban

Lighting up in Somerset, once a big tobacco town, will no longer be allowed in all enclosed public places. The city council voted 11-1 Monday evening to pass a smoking-ban ordinance, reports Heather Tomlinson of the Commonwealth Journal. (C-J photo)

The ordinance includes restaurants, bingo halls, gaming facilities, nursing homes and any place of employment. "It's a public health safety issue," said councilor Jerry Girdler, who lost his well-known brother Eddie two weeks ago to throat and lung cancer. "The facts back up that smoking is harmful to the people around them."

The meeting attracted a crowd of more than 50, many of whom voiced their opinions. Business owner Teresa Singleton said, "I am really shocked at the fact that the City of Somerset is considering taking away the rights of businesses to make those decisions on whether we want our place of business to be smoking or non-smoking. For you to take that on your own, I think that's a major step in the wrong direction."

Local podiatrist Pamela Jensen-Stanley disagreed. "I believe the ban is necessary," she said. "I think it's time that Somerset moves up and gets with the program." (Read more)

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Recession has hit health departments hard: 23,000 jobs (15%) lost, core funding cut

Funding and job cuts as a result of the economic recession have weakened the impact public health departments have on their communities, says a series of articles published in the Journal of Public Health Management and Practice.

"Continued cuts to public health services will have an unsatisfactory impact on the health of individuals and the community," said Dr. Lloyd F. Novick, the journal's editor-in-chief. "There is a heightened vulnerability at the present time for adverse health outcomes. Above all, the realization of the vital need to maintain resources for our public health delivery system is imperative."

In 2009, 23,000 jobs in public health departments were eliminated, 15 percent of the total. By 2010, more than half the agencies had a cut in core funding. As they scramble to make do with their new bottom lines, more cuts are expected. "The current, alarming trend of diminishing resources, reduced workforce and impaired capacity to maintain public health programs pose major hurdles for local agencies, with consequences that will be felt well into the future," said Dr. Rachel Willard of the University of California.

To view an article on the impact of the 2008-2010 economic recession on local health departments, one on a local health department that is providing only essential services, and one on enhancing public health value in an era of declining resources, click here.

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In front-page editorial, rural weekly in Adair County demands that board members of county-owned hospital resign

In our experience, most weekly newspapers don't have editorial pages, much less editorials, so when one puts an editorial on the front page and also runs an editorial about the decision, and the work is well-written and well-argued, it's worth noting.

The Adair County Community Voice in Columbia, Ky., noted county government's bailout of the "collapsing" county-owned hospital; elected officials' request that they have "a say in any final decision to sell the hospital" and that "the hospital administration will try just as hard to keep the hospital independent as they will to sell it;" and some appointed board members' dislike of the requests.

"It seems like little to ask of someone who is $13 million in debt and asking you for $1.7 million," the editorial said, noting that one member said the board had been "a rubber stamp" for agents who secured the bonded debt. That admission "saves us the trouble of trying to prove that board members acted irresponsibly in overseeing the hospital’s business," the editorial said. "Now the question has to be, 'Why are they still on the board?'" It said the board not only "ran the hospital into the ground" but is "in control of a document that will show if any criminal activity took place," a forensic audit that gives board members "a personal stake in any damaging evidence that may come out."

In her explanatory editorial, Editor-Publisher Sharon Burton said she put the editorial out front because "We believe this is a critical time for our community, and we believe bad decisions will continue if the board is left as it is. We believe it’s our job to bring the issue to the forefront, and there is no better place to do that than on the front page of the Community Voice." The explanatory editorial also included useful background and perspective, including: "At small newspapers we don’t have the luxury of separating the people who cover the news from the people who write opinion pieces. Instead, we work hard to provide fair and unbiased coverage of local news. Then, we look at how that news impacts the people in our community and take a stand as needed on our editorial page."

Burton told us in an email that the editorial generated responses by phone, emails, Facebook messages "and of course being stopped at church and the grocery store," all of them positive except a letter from the daughter of a board member, which is running this week. The Community Voice doesn't put editorials or most news online, but PDFs of the pages with the editorials are available on the Institute for Rural Journalism and Community Issues website. The front page, with color, is 3.5 MB; the inside page is 682 KB.

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Hopkinsville newspaper endorses smoking ban

The Kentucky New Era newspaper in Hopkinsville said in a recent editorial that if the state legislature doesn't enact a smoking ban, the city should.

The General Assembly "should not squander the opportunity or delay action on a law that could protect everyone against the health risks associated with exposure to secondhand smoke," the editorial said. "Legislators should not disregard the overwhelming scientific evidence of the effects of secondhand smoke. . . . Opponents of a smoking ban argue that they want to protect the rights of smokers. We believe those rights to not extend to smoking in places where non-smokers work, shop and eat." (Read more)

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Johnson County focus of C-J series on docs, prescription abuse

The second day of The Courier-Journal's investigation into prescription drug abuse and the role of doctors looks at Johnson County, ranked 11th in the state for drug overdose deaths despite its small population of 24,000. It ranks second in such deaths per capita, right behind adjoining Floyd County, as shown on this C-J map of death rates by county. (Click on map for larger version.)

In Paintsville, Johnson's county seat, three doctors have been convicted in the past 10 years of prescribing narcotics illegally. The epidemic prompted the county Fiscal Court to try to pass an ordinance that would have outlawed clinics that were "dealing largely in cash; drawing significant numbers of patients from other counties; generating at least half of their revenue from prescribing narcotics; dispensing disproportionate amount of prescriptions, compared with other medical services; and not being affiliated with a nearby hospital," R.G. Dunlop reports. Attorney General Jack Conway's office ruled the county did not have the authority to pass such a ban.

Dunlop relays the stories of the Paintsville doctors with shocking prescribing practices and also speaks to the mayor, who called the problem "an epidemic." "What we end up doing is arresting all these 'victims' ... and the doctors who create the problem continue to practice." The C-J site also includes this video of Dunlop and photographer Scott Utterback's encounter with Aaron Cantrell, a co-owner of a clinic that is pictured today and will be the focus of more coverage tomorrow. (Read more)

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Corbin City Commission enacts smoking ban

The Corbin City Commission passed an ordinance this week to ban smoking in all enclosed public areas and enclosed public buildings. The ordinance will also require smokers to remain at least 25 feet from building entrances. Areas subject to the ban include bingo parlors, restaurants except for outdoor seating, and motels and hotels, "which may not offer more than 20 percent of rooms as smoking," Dean Manning of The News Journal reported. "Once the ordinance is advertised, it will become law," Becky Kilian of The Times-Tribune reports.

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McCracken County to consider banning new kind of synthetic pot

In response to several teenagers overdosing on it, officials in McCracken County are considering banning chemicals that are being sold as synthetic marijuana.

"Death is a realistic side effect when using this stuff," said Jamey Locke, emergency director for Mercy Regional Hospital.

Between July 10 and Aug. 21, 17 people — 13 of them teenagers — were taken to hospitals by ambulance after having smoked synthetic marijuana. "In almost every case they ended up in ICU," McCracken County Sheriff Jon Hayden said.

An ordinance will be introduced Nov. 14 at a Fiscal Court meeting. It would outlaw the sale or possession of the new synthetic marijuana. Although Kentucky has previously banned certain types of synthetic marijuana, "It appears manufacturers have changed the chemical composition to meet that requirement," The Associated Press reports. (Read more)

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Bullitt County health board will appeal judge's ruling against smoking ban, with financial help from Clark County

The Bullitt County Board of Health will appeal a local judge's ruling that it lacks the authority to impose a smoking ban, and it will get some help from the board in Clark County, one of four where bans have been enacted by health boards instead of county fiscal courts.

The $5,000 will come not from tax dollars, but from "money received from the University of Kentucky for consulting services provided by Health Department Director Scott Lockard," Rachel Parsons of The Winchester Sun reports. UK "contracted with the Clark County Health Department so Lockard could work with the university and other local public health directors on smoke-free issues."

If the Bullitt County ruling is upheld, the decision could invalidate regulations enacted by health departments in Clark, Madison, Woodford and Hopkins counties. At the Court of Appeals, “If they uphold the lower court’s ruling, then we will have an injunction against our ruling until it goes to the Supreme Court, so we will suspend the enforcement of it until we get a final determination,” Lockard said. “We fully anticipate that the ruling will be in favor of the boards of health, because this is just a very narrow interpretation.” (Read more)

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Lexington council turns to wellness center to cut insurance costs

Following a national trend to improve employee health so companies can cut health-insurance costs, the Lexington-Fayette Urban County Council agreed Tuesday to set up a wellness center for city employees.

The center will "be voluntary and free for employees, retirees and dependents covered by the city's health insurance plan," reports Beverly Fortune of the Lexington Herald-Leader. Acute and primary care, chronic-disease management and preventive screenings will be among the services provided at the center, the location of which has not yet been chosen. It is estimated to cost $1.3 million.

Chattanooga opened a similar center in 2006. Its health insurance costs were increasing about 20 percent annually, with health benefits costing the city $16 million that year. Today, the city is saving about $5 million a year, said Madeline Green, director of risk management and incentives for the city. (Read more)

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Bullitt judge strikes down health board's smoking ban; could lead to decision with statewide impact, if appealed

A Bullitt County judge has extinguished a countywide smoking ban that was supposed to go into effect Monday, saying the county health board overstepped its authority. The ruling could lead to a decision with statewide impact, determining whether county health boards have such power; a judge in another county approved a ban there and the ruling was not appealed.

Circuit Judge Rodney Burress called the ban void and unlawful, Charlie White of The Courier-Journal reports. "This court does not believe that type of 'Big Brother' conduct was anticipated by the Kentucky state legislature in its grant of power and authority to boards of health," Burress wrote.

"It's a win for business and a win for choice in Bullitt County," said Harlen Compton, one of the founders of Bullitt County Choice, a group of area business owners and residents.

The ban would have prohibited smoking in bars, restaurants and all public places. But even before the Bullitt County Board of Health passed the ban, the county's eight cities and its Fiscal Court sued the board, White reports.

Swannie Jett, the county's health director, said health officials were "very disappointed" and will decide in the coming weeks if they will appeal the decision.

Burress wrote that Bullitt County residents "are entitled to be governed by their elected representatives and should not be subjected to additional laws enacted by an administrative agency without an express grant of authority."

The health board passed the ban under Kentucky Revised Statute 212.230, which says health boards "shall" adopt, implement and enforce regulations necessary to protect public health. Opponents said such a far-reaching regulation as a smoking ban can only be legally passed by city councils or fiscal courts, White reports.

However, the Bullitt County board is not the first in Kentucky to enact such a ban. Health boards in Woodford, Hopkins, Madison and Clark counties have done likewise. The move in Hopkins County did result in a legal battle, but the judge sided with the health department. (Read more)

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Judge to decide if health board's smoking ban will stand in Bullitt County, as one did in Hopkins County

Whether the Bullitt County Board of Health had the authority to pass a countywide smoking ban is in the hands of Bullitt Circuit Judge Rodney Burress, who heard from the board and representatives of the Fiscal Court objecting to the move Thursday.

In March, the Board of Health passed a ban that would prohibit smoking in bars, restaurants and all public places, including some that are outside. It was supposed to go into effect in September.

But attorneys representing the Bullitt Fiscal Court said the health board has "overstepped its authority by enacting a policy that should have been handed down by a legislative body, such as a city council or Fiscal Court," The Courier-Journal's Charlie White reports.

Margaret Miller, who is helping to represent the board of health, cited the Kentucky statute, which gives boards of health the authority to adopt, implement and enforce regulations to protect people's health.

The Bullitt County Board of Health is not the first in Kentucky to enact such a ban. Health boards in Woodford, Hopkins, Madison and Clark counties did likewise. The move in Hopkins County did result in a legal battle, but the judge sided with the health department and the ruling was not appealed. (Read more)

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Cities' efforts to combat obesity get state, national attention

The efforts of two Kentucky cities to slim down made news this week. On Monday, The New York Times ran a story about Louisville's programs to encourage healthy eating and physical activity in an attempt to combat obesity. On Tuesday, the Lexington Herald-Leader ran a short story about the move to healthier snacks at two public pools. (Eric Crawford, sports columnist for The Courier-Journal, notes in a blog post, partly about his own weight issues, that Men’s Health magazine says Lexington ranks No. 25 in fatness nationally, while Louisville is No. 51.)

The Times story describes Louisville's eight-year effort to combat obesity by establishing bike lanes, creating pocket parks, and making sidewalks wider and safer. The effort involves multiple city agencies and grants from the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention. The results are hard to measure, sort of like a new dieter on a scale, reporter Stephanie Strom writes: "Successes on one front are countered by setbacks on another, and signs that the needle has moved overall are slight and mostly anecdotal."

Former Louisville Mayor Jerry Abramson, who started the initiative, told Strom that the impetus to reduce the city's obesity rate was economic. “For businesses, a healthy work force is more productive and less costly, so it became a competitiveness issue,” he said. “Every city was offering tax incentives, every city was offering real estate deals but not every city had the weight problem we do.”

The Herald-Leader article focuses on menu changes at two park pools' snack stands. The new menus include options like fresh fruit, grilled chicken, and yogurt. The change is a joint effort of the city Parks Department and the Tweens Nutrition and Fitness Coalition in Lexington to encourage healthier eating. As Coalition Chairman Anita Courtney told the Herald-Leader, "Concession stands are like pantries for kids in the summer. What they are stocked with is what they'll eat."

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Bowling Green American Legion post tests smoking ban, is fined

An American Legion post in Bowling Green has been fined $25 for violating the city's no-smoking ordinance. The Bowling Green Code Enforcement Board decided unanimously Tuesday to uphold the citation that Post 23 received April 28 after two plainclothed police officers went into the facility during bingo night and found people smoking inside, Justin Story of the Bowling Green Daily News reports.

Officers Tammy Britt and Rebecca Robins testified they bought two sheets of bingo cards and a soda at the facility. They said they were not asked at any point if they were members of the Post. The city's smoking ordinance "defines private organizations as establishments that are exempt from federal income taxes, are not profit-oriented, maintain a selective membership that operates the organization and does not sell food, drinks, entertainment or lodging to anyone who is not a member or a member's guest," Story reports.

More members started to smoke after Jim Manley, the Post's chief finance officer, told the crowd they were free to do so. "He said that if a citation were issued it would be to (the post) and not the individual, and after that more people started smoking," Britt said. The citation indicates the facility violated three provisions of the ordinance: allowing smoking in a building/enclosed area; failure to remove ashtrays; and failure of owner or person in control to ensure compliance.

Malcolm Cherry, an officer of Post 23, "said that he wanted it to be cited by allowing smoking during charitable gaming on April 28 in an effort to prove it was exempt," Story reports. "Our whole intention was for the officers to be there and have the citation issue to us personally," Cherry said. City Attorney Gene Harmon argued the post does not meet all the criteria to be considered a private club, in part because it sells bingo cards and refreshments during bingo night. The board agreed. (Read more)

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