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Louisa-Lawrence Co, KY

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Date: 10-19-2017

State coalition launched to improve health, reduce costs of smoking

Kentucky Press News Service

FRANKFORT - Determined to move Kentucky from its dismal rankings as the nation's worst state for cancer and the second-highest for smoking, more than 100 health, business and community leaders gathered in the Capitol Wednesday to launch the Coalition for a Smoke-Free Tomorrow.

The broad-based statewide alliance will support state and local policy changes to improve Kentucky's health by reducing tobacco use and protecting Kentuckians from secondhand smoke and other tobacco emissions, according to a news release.

Top on the list of those policy initiatives is increasing Kentucky's cigarette tax by at least $1 per pack. According to data compiled by Coalition founding partners American Cancer Society Cancer Action Network and Campaign for Tobacco-Free Kids, this would keep 23,200 youth from becoming adult smokers, lead 29,400 adult smokers to quit, prevent 14,800 of today's youth from dying prematurely, and result in 5,900 fewer smoking-affected pregnancies and births. 

"...Lawrence County Health Department is proud to be a member of Coalition for a Smoke-Free Tomorrow and supports initiatives to reduce tobacco use and exposure to secondhand smoke. Lawrence County Clear the Air Coalition was formed in 2007 to raise community awareness about the health risks associated with exposure to secondhand smoke and has been very successful as Three Rivers Medical Center, Lawrence County School District and many restaurants and businesses have adopted smoke-free policies. Still, nearly 25% of Lawrence County adults are smokers and 29% of moms smoked during their pregnancy. Lawrence County Health Department and Clear the Air Coalition continue to campaign for a county-wide smoke free ordinance. Need help quitting? Please call the health department at 606-638-9500 for information about tobacco cessation classes or visit"

Debbie Miller
Public Health Director
Lawrence County Health Department


According to the Coalition, illnesses related to tobacco use and secondhand smoke cost Kentucky nearly 9,000 lives and $1.92 billion in health care expenditures every year. Nearly $590 million of those annual costs are covered by Medicaid. The tax burden on every household to cover these costs is $1,168 annually. Smoking also costs Kentucky businesses an estimated $2.79 billion annually in lost productivity.

The proposed tobacco tax would raise $266 million in new state revenue, while also reducing Kentucky's health care expenditures and creating a healthier workforce, the partners said. Given Kentucky's current tax rate of 60 cents per pack, the 43rd lowest in the nation, the new rate still would fall below the national average of $1.71 per pack.

"We cannot let Kentucky continue to be the cancer capital of the nation," Ben Chandler, chair of the Coalition and CEO of the Foundation for a Healthy Kentucky, said on Wednesday. "Smoking-related cancer and other diseases are completely preventable, and we have the policy tools that both research and practical experience show will move the needle. The good news is that implementing these policies doesn't cost an arm and a leg; it just takes the will of Kentucky's policy leaders who want to improve the Commonwealth's health, quality of life, and ability to attract more jobs."

Coalition partners say they are in the campaign for the long haul to achieve a significant reduction in smoking and tobacco use in Kentucky. They initially will focus on:

Securing a $1-or-more-per-pack increase in the state cigarette tax, with parallel increases in the tax rates on other tobacco products.
Helping counties and cities enact comprehensive smoke-free ordinances covering all workplaces.

Educating the public and health care providers about cessation resources and ensuring effective implementation of a new law that requires insurance to pay for tobacco-cessation programs. 

At Wednesday's Coalition launch, partners said achieving the initial goals will reduce Kentucky's smoking rate significantly. Kentucky's adult rate, at 24.5 percent is the second highest in the nation (right behind West Virginia, at 24.8 percent), and 62 percent higher than the national average of 15.1 percent. Kentucky's high school youth rate of 16.9 percent is more than double the national average of 8 percent.

In the last 30 years, cancer rates have gone down 20 percent nationwide, but have risen in areas of Kentucky, according to a January 2017 study. Kentucky also has some of the highest rates of heart disease and stroke mortality, both tied to smoking, said Coalition partner American Heart Association/American Stroke Association. 

"Health outcomes are complicated by tobacco use, especially for newborns whose mothers were exposed to tobacco smoke while pregnant," said cardiologist Dr. Pat Withrow, director of outreach for Baptist Health Paducah. "These babies are more likely to suffer respiratory infections, ear infections, asthma, and sudden infant death syndrome (SIDS). We must enact policies proven to help these moms quit smoking and reduce their exposure to secondhand smoke - it's critical to their infants' early and life-long health."

The Campaign for Tobacco-Free Kids, another Coalition partner, said 2,900 Kentucky youth start smoking every year. 

"Big Tobacco needs replacement smokers, and they target teens," said Jacob Steward, a sophomore at Bourbon County High School. "Making cigarettes more expensive by increasing the tax will prevent teens from starting to smoke. Teens who smoke don't have a lot of money and they will quit smoking while their addiction to nicotine is young. The $1 tobacco tax increase will keep more than 23,000 Kentucky youth from becoming adult smokers. This is a BIG WIN on many levels." Steward is a member of the Students Making A Community Change (SMACC) group working to prevent teen tobacco use and protecting workers from secondhand smoke.

The tax increase and comprehensive smoke-free laws at the city and county levels are pro-business, Dave Adkisson, president and CEO of the Kentucky Chamber of Commerce, said. "The costs of smoking to employers - in extra health care costs and reduced productivity - add up to more than $5,800 per smoking employee each year. That's why an overwhelming majority of Kentucky Chamber of Commerce members support these measures."

"With the task of tax reform looming before the General Assembly in 2018, Governor Bevin has emphasized that all ideas and concepts 'will be on the table,'" said Sen. Ralph Alvarado. "This charge provides a great opportunity to examine all the potential impacts and benefits that a Smoke-Free Tomorrow plan can have on the financial and physical health of our Commonwealth."

The Coalition for a Smoke-Free Tomorrow has launched a website,, which compiles information about the campaign and tobacco-use reduction policies and programs, as well as a monthly newsletter. Leaders of companies and organizations who would like to join the Coalition can do so on the website. For more information, contact Angela Koch, This email address is being protected from spambots. You need JavaScript enabled to view it., 502-326-2583.


Date: 10-18-2017

State working out how to pay relatives who provide foster care under recent court decision

FRANKFORT, Ky. — Kentucky's top human services official said Tuesday that the state will comply with a court order to pay relatives who provide free foster care the same as they do licensed foster families.

The court decision comes as a growing number of relatives, many of them grandparents, are caring for children removed from homes because of abuse or neglect and say the extra costs have caused them to burn through retirement savings and raise the children in poverty.The court decision comes as a growing number of relatives, many of them grandparents, are caring for children removed from homes because of abuse or neglect and say the extra costs have caused them to burn through retirement savings and raise the children in poverty.

But Vickie Yates Brown Glisson, secretary of the Cabinet for Health and Family Services, said the cabinet is still analyzing how to apply the court decision.

"Our legal team is studying it," she said in a brief interview.

The court decision comes as a growing number of relatives, many of them grandparents, are caring for children removed from homes because of abuse or neglect and say the extra costs have caused them to burn through retirement savings and raise the children in poverty.

Some have reported losing homes or facing bankruptcy.

Officials say the state's drug epidemic has helped fuel an all-time high of about 8,500 children in state care because of abuse or neglect.

Meanwhile, the lawyer who won the foster payment case and an independent children's advocacy agency say they are getting inundated with calls from anxious relatives who are desperate for financial help and want to know if they are eligible under last week's court decision.

"People are out there, they are suffering," said Richard Dawahare, the Lexington lawyer who won the case on behalf of a great-aunt caring for two young boys who was denied foster payments.

Among them is Vicki Dever, a Shepherdsville grandmother raising six grandchildren, ranging in age from seven months to 13 years. She said the children suffer from the lack of financial help.

"They are not punishing the grandparents. They are punishing the children and it's not their fault," she said.

Terry Brooks, executive director of Kentucky Youth Advocates, said his organization has received dozens of calls since the federal court decision became final Oct. 10. One grandmother drove from another county to his office seeking information in person only to find she didn't qualify, he said.

"We have been inundated with questions," he said, speaking at Tuesday's meeting of the House Working Group on Adoption. "Sadly, the majority of folks we've talked to aren't eligible."

Brooks said even some state social workers with the Department for Community Based Services have called youth advocates seeking information about the court decision.

Glisson said the cabinet soon will send information to its DCBS offices across the state to help them with such questions.

"I want to make sure our DCBS offices know what this case means," she said.

Meanwhile, Dawhare said he is urging people who think they might qualify to contact their social workers to let them know of their interest.

"I'd make my voice heard, in a nice way," he said.

Brooks said his organization has put together a list of questions and answers about the court ruling on its website,

The court ruling from the 6th U.S. Circuit Court of Appeals became final after the U.S. Supreme Court refused to hear an appeal by the cabinet of its decision earlier this year that the state must pay relatives who provide temporary foster care for children. 

But the order does not require foster payments to relatives who obtain permanent custody or adopt children.

For that reason, Brooks said it's increasingly urgent that the state find some way to restore Kinship Care, a program to provide financial assistance to relatives who take custody of children. 

The state closed the program to new applicants in 2013 because of a budget shortfall.

The program provides $300 per month per child compared to foster care payments that start at about $25 a day per child or about $750 per month.

Dever, the Shepherdsville grandmother, said she and her husband are not eligible for foster payments for five of the children because they have permanent custody. And they are seeking permanent custody of the sixth child, an infant, she said.

The Devers get Kinship Care payments for three of the children they took in before the state froze the program but even those payments are in jeopardy because the state claims she missed a deadline to file paperwork. Dever said she has appealed and continues to get Kinship Care payments but cabinet officials told her if she loses the appeal, she will have to repay the money.

Even with Kinship Care payments of $900 per month, Dever, 58, who is disabled from a heart condition, said she and her husband, 73, a retired farmer, are barely scraping by.

Recently, she said, she couldn't come up with $20 two of the children needed to attend a school program that required a $10 donation per student. The school said it would accept a lesser donation and the children's great-grandparents provided each child with $1 so they could attend.

Dever said she and her husband never considered letting the kids go into foster care. She said the couple has taken the children in at various times after they were born to her daughter, who was involved with drugs; most recently, they brought the infant home from the hospital.

"They said we could put them in foster care," she said. "We just couldn’t do that. After we took the first one how can you take one and not another. What would you say to them later in life?"

About 70,000 Kentucky children are now in the care of relatives, said Shannon Moody, with the youth advocates organization, addressing the House adoption panel Tuesday.

Of those, about 12,000 have been removed from homes because of abuse or neglect and about 5,788 are covered by Kinship Care, Moody said.

About 1,300 children are in "relative foster care," where relatives are licensed foster care providers and are paid the state's daily rate. But families sometimes get conflicting information about becoming licensed foster parents.

Some grandparents have told the Courier-Journal state workers told them they can't become licensed foster parents in order to get payments for grandchildren. Others have said workers told them there's no guarantee the state would place the children with them once they obtained such a license.

"That information has been really inconsistent in the past," Tara Grieshop-Goodwin, with youth advocates, told the adoption panel.

Cabinet officials said they are working to standardize such information.

By Deborah Yetter
The Courier-Journal

October 12, 2017

TRMC CEO Greg Kiser and Willis Fletcher TRMC CEO Greg Kiser and Willis Fletcher

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