Saturday, May 19, 2018

As hepatitis A outbreak continues in Kentucky, health officials say vaccine is best way to protect yourself; and wash those hands!

By Melissa Patrick
Kentucky Health News

Since state officials declared an outbreak of hepatitis A in November, Kentucky has had 577 confirmed cases of it. That's almost 30 times the state's average of about 20 cases a year, and five of those 577 people have died from the liver disease.

The most common prescription for preventing hepatitis is hand washing, but the absolute best way to avoid the highly contagious disease is vaccination, which requires two shots, six months apart.

The first dose provides more than 90 percent immunity, but getting both shots offers lifelong protection, Louisville health officials told Darcy Costello of the Louisville Courier Journal.

State health officials have advised anyone living in Jefferson, Bullitt, Hardin, Greenup, Carter and Boyd counties, where the outbreak has been concentrated, to get a vaccination.

Officials also advise shots for anyone at high risk for getting the disease, including people who use illegal drugs, people who are homeless or have unstable housing, men who have sex with men, people recently in jail or prison and people with underlying liver disease.

Boyd County residents have responded well to the call, Erin Crace, nurse supervisor at the Ashland-Boyd County Health Department, told Kentucky Health News in a telephone interview. She said the agency vaccinated more than 100 patients a day in mid-April, and the number has dwindled to about 10 to 15 per day.

The department has also reached out to food-service workers to get them vaccinated. As of May 15, six Boyd County food workers have been diagnosed with the disease, the Lexington Herald-Leader reports.

Hepatitis A is found in the feces of people with the disease and is most frequently transmitted by eating or drinking something that has been contaminated with fecal matter -- typically because the food or beverage has been handled by someone with the virus who hasn't properly washed their hands after going to the toilet or changing a diaper. It can also be spread when someone with the virus shares a cigarette, drink or towel, or through sex, drinking contaminated water, and illicit drug use.

So far, most of the state's cases have been among the homeless and drug users, according to the Kentucky Department for Public Health.

A person can get the hepatitis A vaccine in a number of places, including health departments, pharmacies and primary-care providers, but Crace recommends calling first to make sure they have the vaccine in stock before you go.

Because of rules for storing and handling the vaccine, which expires, many primary-care providers, especially in low-risk counties, don't always have the vaccine on hand, and pharmacies might be more likely to have it, Crace said.

She added that the supply of vaccines will also vary among health departments, but the health departments in Boyd, Carter and Greenup counties were well stocked.

Crace said the Ashland-Boyd County department is able to vaccinate children and most people with insurance as well as those who are uninsured or under-insured. It can also offer the vaccine for a cash price. It offers a walk-in clinic between 8 a.m. and 9 a.m., and appointments as available for the rest of the day. It is open Monday through Friday.

A new state regulation requires students to have had the two-dose hepatitis A vaccine by the first day of school, but Crace said the department hasn't vaccinated many children recently, because many of them have already received it; it is offered at 12 months of age and older.

The most common symptoms of hepatitis A are fatigue, low-grade fever, loss of appetite, joint pain, sudden nausea and vomiting, yellow eyes or skin, abdominal pain, pale stools and dark urine, according to the Centers for Disease Control and Prevention. A person with the virus is contagious for up to two weeks before showing symptoms. Symptoms usually last less than two months, but 10 percent to 15 percent of victims remain sick for up to six months.

Friday, May 18, 2018

Another report on the upsurge of methamphetamine in Kentucky, this time from an eastern county: Johnson

Methamphetamine image from Drug Enforcement Administration
While most of Kentucky's focus has been on finding ways to combat the state's heroin and prescription drug epidemic, another drug that had captured headlines just a few years ago is on the rise -- methamphetamine.

Meth use has long been mostly prevalent in Western Kentucky, but is moving east.

“We’re completely eat up with it around here,” Paintsville Police Chief Mike Roe told Aaron K. Nelson of The Paintsville Herald. “It’s an epidemic.”

Nelson reports that according to the Johnson County Judicial Center, meth production is on the decline in Johnson County, but possession and trafficking of the drug is on the rise.

"The numbers for first-offense meth possession started with a handful of charges in 2008. They slowed down in 2012, but have skyrocketed since, peaking with 80 charges in 2017," he writes. And as of early May, Nelson reports that there have already been 26 charges in the county.

Nelson adds that first-offense manufacturing of methamphetamine peaked in 2013 and 2014, with 20 cases each year, compared to just one case in 2016, one in 2017, and zero so far in 2018. But at the same time, trafficking of the drug has increased, reporting that "first-offense trafficking meth cases in 2017 were the highest on record," with those numbers having been tied or exceeded already in 2018.

“A few years ago, you had manufacturing here. A lot of shake-and-bake,” Roe told Nelson, referring to the relatively easy — and dangerous — method for making low-quality methamphetamine in small, portable labs. “Now, it’s coming in from Detroit, Louisville, Huntington … everywhere.”

Beth Warren of the Louisville Courier Journal has reported a similar meth surge in Louisville, and Dave Thompson of The Paducah Sun has reported that methamphetamine is now the "drug of choice" in Western Kentucky and Southern Illinois.

"Meth-related deaths in Kentucky more than tripled from 2013 to 2016, when 252 people died, according to the Kentucky Injury Prevention and Research Center. More than a third of those deaths were in Jefferson County," Warren wrote. "Police across Kentucky intercepted more than triple the amount of meth last year than they did in 2013, according to a recent state police report. Nearly 11,000 drug seizures submitted to the state crime lab last year were meth — more than heroin, cocaine and fentanyl combined."

“I would say trafficking is our top priority,” Roe said. “Busting these dealers.”

Bevin names Adam Meier, who as his deputy staff chief oversaw Medicaid change, to head Cabinet for Health and Family Services

Adam Meier (picture provided
to the Cincinnati Enquirer) 
Gov. Matt Bevin has appointed Adam Meier secretary of the Cabinet for Health and Family Services, the state's largest cabinet, with more than 7,000 employees and an annual budget of more than $12 billion.

Meier, a lawyer from Fort Thomas, was Bevin's deputy chief of staff for policy, and in that position was responsible for overseeing the new Medicaid plan, called Kentucky HEALTH (for "Helping to Engage and Achieve Long Term Health"), authorized by a federal waiver.

“For much of the past two years, he has been focused on health-care policy in Kentucky, and his empathy for people, combined with his legal background and working knowledge of human services programs at the state and federal level, make him an ideal choice to lead this important cabinet," Bevin said in a news release.

Bevin also named Kristi Putnam as a deputy secretary for the health cabinet. Most recently, Putnam, has served as the program manager for Kentucky HEALTH.

The new Medicaid plan adds new rules for many in the program, including a deductible account, which is like a health savings account; a rewards account that allows beneficiaries to earn credits for dental and vision care, which were once basic benefits; reporting requirements and penalties; and new premiums and co-payments.

The controversial "community engagement" requirements that require beneficiaries to work, volunteer or attend school or job training at least 80 hours a month will be phased in for most counties over the next year. These requirements will largely affect "able-bodied" adults without dependents who have gained Medicaid coverage through the 2014 expansion to people in households with incomes up to 138 percent of the federal poverty level.

Medicaid covers about 1.4 million Kentuckians, nearly 500,000 through the expansion.

“With the innovative changes coming with the Kentucky HEALTH waiver and the increased financial resources and legislative support for improving Kentucky’s child welfare, foster care, and adoption systems, I am honored and humbled at the responsibility Gov. Bevin has entrusted me with to lead the cabinet at this pivotal time," Meier said in the news release.

Meier succeeds Vickie Yates Brown Glisson, who left the office at the end of January to run against Democratic Rep. John Yarmuth in Louisville's 3rd Congressional District. The acting secretary has been Scott Brinkman, secretary of the Governor's Executive Cabinet.

Thursday, May 17, 2018

New law to encourage safe disposal of unused painkillers takes effect in July; similar initiatives across state are already in motion

A new law to encourage the safe disposal of unused painkillers, and to make it easier to do so properly will take effect in mid-July.

Sen. Alice Forgy Kerr
Senate Bill 6, sponsored by Sen. Alice Forgy Kerr, R-Lexington, passed with overwhelming bipartisan support, with only one senator, Sen.Wil Schroder, R-Wilder, voting against the final version. Gov. Matt Bevin allowed the bill to become law without his signature.

The new law will require pharmacists to tell customers how to safely dispose of unused opioids and other controlled substances, and either provide or offer to sell them a product designed to neutralize drugs for disposal -- or provide on-site disposal.

Kerr told Kentucky Health News in March that shifting to a mindset of immediately getting rid of any unused pain medications will require a "cultural shift," much like when we had to learn to put our seat-belts on: "It took us a while."

The law adds to several other efforts to decrease the misuse of prescription drugs in the state, Michon Lindstrom reports for Spectrum News.

In August, Attorney General Andy Beshear announced creation of a pilot program called the Kentucky Opioid Disposal Program to provide drug deactivation pouches to people living in Floyd, Henderson, McCracken and Perry counties -- four that have struggled with opioid addiction.

And in March, he announced a partnership with CVS Health to launch a new medication-disposal program that involved the placement of in-store disposal units in nine of the company's 24-hour pharmacies. Click here for a list of the CVS locations with medication deposit boxes.

While announcing the CVS partnership, Lindstrom reported that Beshear said most heroin addiction begins with an addiction to opioids.

“That’s pretty profound,” said Beshear. “What that tells us is that 80 percent of people using heroin right now didn’t go out and actively make the decision to buy a street level drug until they were already actively addicted. For 70 percent of the people out there abusing prescription pills, they aren’t their pills, they are from a friend or family member. It tells us that the most dangerous place in each and everyone of our homes, the most likely place to cause addiction in our kids and our grandkids, is the medicine cabinet.”

Reps. Addia Wuchner, R-Florence, and Kim Moser, R-Taylor Mill, also introduced an initiative called the Spring Clean Northern Kentucky in March 2017 that brought safe drug disposal pouches to more than 30 locations in Boone, Kenton and Campbell Counties.

While presenting the initiative, Lindstrom reports that Wuchner and Moser stressed the importance of removing un-used drugs from the house to prevent others from misusing the medication and forming an addiction.

“These are potentially dangerous, they are dangerous when they are used and abused and the fact that we have medications that are still unused in our medicine cabinets, especially opioids we are at risk for a neighbor, for a visiting child, for a visiting young person, for our own children to get their hands on those medications.” said Wucher.

“It is important to reduce the supply of controlled substances, especially on the street, and that does start with getting them out of the medicine cabinets and really educating our families about exactly what it is they can do,” said Moser.

Sunday, May 13, 2018

UK gets contract that will let it expand to rural Kentucky a program to get or keep pregnant women off opioids

Women with opioid-dependence problems during and after pregnancy will get more help from the University of Kentucky through a $4.9 million contract from the Patient-Centered Outcomes Research Institute, created by the Patient Protection and Affordable Care Act of 2010.

The contract will boost the Perinatal Assistance and Treatment Home (PATHways) program, now based in Lexington, which helps pregnant women with medication, peer support and health services to reduce the number of babies born with an opioid addiction. After delivery, they get peer counseling and health services.

The program has been successful. "Between 2014 and spring 2017, more than 150 women received treatment through PATHways. Of those, 77 percent were admitted to labor and delivery without any illicit drugs in their systems," Linda Blackford reports for the Lexington Herald-Leader. "Women who participate in the pilot will be required to find a local physician to prescribe medication assisted therapy, and the program will help them find this support if they don't already have it."

Blackford notes, "Kentucky has one of the highest rates in the nation of babies born with neonatal abstinence syndrome, a rate that has climbed from 46 babies in 2001 to 1,115 in 2016, according to hospital discharge data collected annually by the Kentucky Cabinet for Health and Family Services."

Read more here:

The contract will fund a study in which one group of rural women will attend pregnancy and parenting support and education groups led by a trained nurse and a peer support specialist every other week. The other group will have meetings via telemedicine with specialists in high-risk pregnancy, addiction care, pediatrics or substance counseling. "The goal is for women to receive enhanced substance abuse care in their home communities, which is especially important to patients living in rural areas," a UK press release said.

The program was developed by the UK medical college's Department of Obstetrics and Gynecology and Department of Psychiatry, and the College of Nursing.

Friday, May 11, 2018

Medicaid work requirements to begin in Northern Kentucky this summer, with all but eight counties to be involved by Dec. 1

Kentucky's new work requirements for "able-bodied" Medicaid recipients will be phased in slowly, with the three main Northern Kentucky counties leading the way. Campbell County will be the first to instigate the new "community engagement" requirements on July 1, followed by Boone County on Aug. 1 and Kenton County on Sept. 1.

After that, large groups of counties are to be rolled into the program each month until the last scheduled counties are added Dec. 1.

Whitley, Knox, Bell, Clay, Leslie, Harlan, Perry and Letcher counties will be exempt from the community engagement requirements until December 2019, apparently because that area is part of a pilot project to help people in the Supplemental Nutrition Assistance Program (formerly called food stamps) find jobs.

Medicaid's new "community engagement" requirements are part of an overhaul of the program, part of which will require "able bodied" Kentuckians to participate in an approved community engagement or work activity 80 hours a month, and document their hours monthly, to keep their Medicaid coverage. Officials call the program PATH, for Partnering to Advance Training and Health.

The rest of the Medicaid benefit changes will start July 1 for all counties, according to the health cabinet. Those are the deductible account, which is like a health-savings account; the My Rewards account, which allows a person to earn credits for dental and vision care; the reporting and lock-out requirements; and the premium and co-payment requirements, etc.

A county-by-county spreadsheet of enrollment in Medicaid, as of January 2018, is at

Kristi Putnam, program manager for the changes in Medicaid, told attendees of a recent stakeholder forum in Frankfort, “Volunteering, care giving, job training, enrolling in classes and working are all qualifying activities," Darla Carter of Insider Louisville reports.

The changes will largely affect "able-bodied" Kentuckians without dependents who have gained Medicaid coverage through the 2014 expansion to people in households with incomes up to 138 percent of the federal poverty level.

Pregnant women, those who are deemed medically frail, primary caregivers of a dependent, full-time students, former foster youth up to age 26 and the chronically homeless will be exempt from the requirements.

Kentuckians who qualify for the program will get a notice in the mail about the community engagement requirements, as well as the address of a Kentucky Career Center to aid them.

“We’ve been partnering with our library system,” Putnam said. “We’ve been working with our federally qualified health care centers to find other locations and other places where career coaches can go and actually provide services, so job assessments, job placement services, connection to training and education programs, so this is intended to not be a you have to come to the career center. It’s very much intended to be a we will come to where you are.”

Putnam added that the slow rollout is designed to help the state troubleshot and allow for weekly meetings to discuss any issues that arise, Carter reports.

The state recently rejected a request by a consumer advocacy group that has voiced concerns about the changes, Kentucky Voices for Health, to create a stakeholders advisory council to help with the implementation of the program, Carter reports. (KVH has created two "explainers" about the changes, one in two pages, and a more detailed version in four pages.)

WFPL, a public radio station in Louisville, has also created an interactive tool called "Kentucky Medicaid Waiver Calculator," to help Medicaid enrollees and others figure out how it will affect the, based on family size, income and other factors. The state does not support its use.

Instead, the Cabinet for Health and Family Services has opted to continue with its current approach, which includes holding forums and sending beneficiaries notices in the mail, Carter writes.

The next forum is scheduled for June 7 at 1 p.m. at the Kentucky Career Center, 1324 Madison Ave. in Covington.

In addition, the state offers its own overview that includes answers to frequently asked questions; it is online at

The state also offers a website,, where Medicaid beneficiaries can go to report and check in on their benefits, track their monthly program requirements and earn or spend their rewards from their My Rewards account.

The changes are being challenged in federal court in Washington by 16 Kentuckians on Medicaid who say the waiver approved by the Trump administration violates several federal laws. They also argue that the waiver risks the health care of tens of thousands of low-income families.

The administration of Gov. Matt Bevin has estimated that in five years, the Medicaid rolls would have 95,000 fewer people with the changes than without them, partly because of non-compliance. The program covers about 1.4 million Kentuckians.

Thursday, May 10, 2018

Rural Health Journalism Workshop in North Carolina June 8; deadline to apply for travel stipend is May 23

The Association of Health Care Journalists is hosting a free one-day workshop on covering health on June 8 in Research Triangle Park, N.C.

The conference is free for AHCJ members, but registration is required by May 25. Members who need financial assistance should apply for one of the limited travel stipends by the May 23 deadline.

The keynote speaker will be Hannah Koch, a research and technical assistance associate for mental health at the Western Interstate Commission for Higher Education. Koch is tentatively scheduld to discuss key behavioral health issues in rural communities.

Five workshops will cover a variety of topics, including "What reporters should know about rural residents and rural health," featuring Alan Morgan, chief executive officer of the National Rural Health Association and Dr. Jeffrey Heck, president and chief executive officer of the Mountain Area Health Education Center.

Another workshop, "Will your local hospital survive?" will include George Pink, deputy director of the North Carolina Rural Health Research Program and Dana Weston, president of the University of North Carolina Rockingham Health Center.

"Addressing rural health workforce hurdles" will be a workshop with Mark Holmes, director of the North Carolina Rural Health Research and Policy Analysis Center and the director of the Cecil G. Sheps Center for Health Services Research, and Dr. Robert Bashford, associate dean for the Office of Rural Initiatives at the University of North Carolina School of Medicine.

The "Rural opioid crisis: Access to treatment and harm reduction" workshop will include Regina LaBelle, visiting fellow, Duke-Margolis Center for Health Policy and a former chief of staff in the White House Office of National Drug Control Policy, and Donald McDonald, executive director of the Addiction Professionals of North Carolina.

Wrapping up the day will be a workshop titled, "Can telemedicine transform health care in rural communities?" featuring Latoya Thomas, policy director for the American Telemedicine Association.

To register for the workshop, click here. To request a travel stipend click here, or send an e-mail to membership coordinator Tina England:

Wednesday, May 9, 2018

Polk maintains he quit for health reasons, denies knowing he had been placed on 'special leave' amid allegation of drinking on job

By Melissa Patrick
Kentucky Health News

Former state health commissioner Hiram Polk told Kentucky Health News at the end of April that he left his position in September "strictly" over a disagreement with "middle management" over lack of funding for an early-childhood anti-drug program that he had championed, and because of his health.

But records in the internationally renowned surgeon's state personnel file show he had been placed on "special leave" to allow the Cabinet for Health and Family Services time to "investigate allegations of misconduct; i.e., the consumption and possession of alcohol during work hours while on Cabinet premises."

Dr. Hiram Polk
Polk denied knowledge of such an investigation and said "I did not know" that the special-leave notice had been placed in his file.

Asked if the charge was true or not, Polk said, "You are the first person I heard from about it. I have no knowledge of either possession or use."

He also said, "I am not aware now or then" that he had been accused of drinking on the job. Later, he said he had never seen his personnel file, and "It never occurred to me to do so."

Noting that the documents indicated that the leave notice was hand-delivered to him, he said he remembered Deputy Secretary Tim Feeley delivering a letter and suggesting "I ought to take this leave," but "I don't remember what was in the letter or anything else. . . . I told you as much about this as I know and you are talking from a document about me that I have never seen."

Doug Hogan, a spokesman for the cabinet, confirmed in an e-mail that the "special investigation leave action" was hand-delivered to Polk.

Hogan was asked about the timeline of documents in the file. He said Polk's resignation letter was dated Sunday, Sept. 17, but was not transmitted to the cabinet until after he had worked Sept. 18 and part of Sept. 19 -- the date of the  "special leave" notification letter was delivered.

Polk said it was his decision to resign. "I resigned because I was having medical trouble and had been told that I ought to have a pacemaker for a very slow heartbeat and that is not a minor thing in somebody my age," he said. He is 82.

Asked if there was anything else he wanted to say, Polk said he wanted to clarify that his disagreements with the cabinet had to do with "middle management" and had nothing to do with former Secretary Vickie Yates Brown Glisson, who resigned from her position in late January to run for Congress in Louisville.

In the earlier interview, Polk said, “The middle management people were essentially Vickie Glisson, and she's middle management – the whole thing is. So she did not agree with the expenditure of the money.” Glisson declined to comment.

Hepatitis A cases continue to spread across state; proper hand-washing and a vaccine are best ways to prevent it

New cases of hepatitis A, a highly contagious liver disease, continue to be reported in Kentucky, with 43 new cases and one death being reported between April 22 and April 28, according to the Kentucky Department for Public Health.

Since August, the health department has reported 448 cases and four deaths. The state averages about 20 cases a year.

Of the 448 cases, 11 have been in Hardin County, and four each in Nelson and Meade counties, department spokesman Donny Gill told Jeff D'Alessio of The News-Enterprise in Elizabethtown.

“It’s still steadily progressing upward and that’s not what we want,’’ Gill said. “Just a trace amount and you can come in contact with it. It’s a strong virus that lives outside of your body for a long time.’’

Hepatitis A is found in the feces of people with the disease and is most frequently transmitted by eating or drinking something that has been contaminated with fecal matter -- typically because the food or beverage has been handled by someone with the virus that hasn't properly washed their hands after going to the toilet. It is also spread by drinking contaminated water, sex, and illicit drug use. The Mayo Clinic notes that it does not spread through sneezing or coughing.

“It can get on surfaces and you never know if it’s there or not,” Gill told D'Alessio. “The contact doesn’t have to be person-to-person.”

For example, the Louisville Metro Health Department writes in a tweet:  "Hep. is spread when someone with the virus shares a cigarette, drink, joint, towel, sex with you."

The most common symptoms of hepatitis A are fatigue, low-grade fever, loss of appetite, joint pain, sudden nausea and vomiting, yellow eyes or skin, abdominal pain, pale stools and dark urine, according to the Centers for Disease Control and Prevention. A person with the virus is contagious for up to two weeks before showing symptoms.

D'Alessio reports that of the 11 people in Hardin County with the disease, none have been identified as restaurant workers. To date, a food transmitter has not been identified in any Kentucky outbreaks.

Most of the state's cases so far have been among the state's homeless and drug users, says the DPH website.

Louisville's health department also posted a tweet that says an employee of Texas Roadhouse at 13321 Shelbyville Road had been diagnosed with hepatitis A and that anyone who ate there between April 11 and April 25 should monitor for symptoms through June 14 as they may have been exposed to the virus.

On May 8, WSAZ-TV reported that an employee who handled food at the Dairy Queen on 13th Street in Ashland was diagnosed with hepatitis A.

"The investigation found that the risk of restaurant patrons becoming infected is very low," health officials stated in a press release. "Dairy Queen is working with the health department to prevent any new cases from arising in the community as a result of this case."

"This makes the fifth food worker in Boyd County diagnosed with the disease this year during this multistate outbreak," reports the station in Huntington, W.Va.

The CDC notes that hepatitis A is very hard to kill, and can live outside the body. It recommends hand washing with soap and water after using the bathroom or changing diapers, and before preparing or eating food, are the best ways to prevent an infection. A vaccine for the disease is also available.

The state health department has recommended hepatitis A vaccination for everyone in Jefferson, Bullitt, Hardin, Greenup, Carter and Boyd counties.

Owenton convenience store pulls synthetic urine used to pass drug tests after issue is raised by police chief and local paper

Following inquiries by the local newspaper and police chief, an Owenton convenience store has stopped selling "controversial items such as U-Pass, a brand of synthetic urine that can allegedly be used to pass a drug test," reports Molly Haines of the Owenton News-Herald.

The Owenton Marathon Station, also known as Cowboys, "began selling items like U-Pass and synthetic cannabinoids, an alternative to marijuana, earlier this year," Haines reports. "When local residents began noticing the items, they took to Facebook to express their concerns, with one post garnering nearly 170 comments and more than 100 shares on the social media website."

Police Chief Terry Gentry raised the issue with the City Council on April 17, and three days later the News-Herald interviewed store owner Dash Patel, who "said he was unaware of any discussion of the products on social media," Haines reports. "Additionally, Patel said concerned customers or Gentry had not approached him."

But the next day, "Gentry visited the store and Patel assured him the items would be removed from the business," Haines reports.

Gentry told Haines the items are “perfectly legal,” but she notes that "the health effects of using synthetic cannabinoids can be unpredictable and harmful — even life-threatening — according to the Centers for Disease Control and Prevention."

Meanwhile, the Owen County Drug Prevention Coalition wrote store manager Kishan Patel, asking her to no longer sell U-Pass because it encourages drug use.

Patel told the coalition in an email May 1, “At the time when we brought these products in our inventory (by customer demand), we were not aware of how these products would affect the community. One of our goals has always been helping our community grow.”

Tuesday, May 8, 2018

Law allowing petition for involuntary drug and alcohol treatment was passed in 2004, but is seldom used; big problem is cost

Information about Casey's Law can be found at
A law that allows families and others to file a petition to request involuntary, court-ordered drug treatment for their loved ones has been "slow to catch on around the state, even though the number of overdose deaths continues to rise," Miranda Combs reports for Lexington's WKYT-TV.

Combs reports that from December 2017 through April 2018, Rowan County attorneys filed 19 petitions under Casey's Law -- but before that, they had never used the law to involuntary order drug treatment. The law has been around since 2004.

"The law is for involuntary treatment," Combs writes. "This means a friend, co-worker or family member can file a petition requesting a judge order them to drug treatment. If the user doesn't follow appointments and court dates, a warrant can be issued for their arrest."

Assistant Rowan County Attorney Ashley Adkins, who coordinates the Casey's Law petitions, told Combs that after studying the law she quickly realized that the main barrier for family members to use the law is the expense, which she said costs about about $500 to execute.

"A lot of these families spent money in the past for their loved ones to go to rehab," Adkins says, "They've given them money to help support them so they don't have anything when they come to us. So we realized, if we want to make this work for everyone, there has to be funding available."

To help defray this cost, Adkins told Combs that the county had received a $20,000 grant through Pathways, an addiction resource center, that covers the full cost for families and friends to file a petition under Casey's law, and is also used to help fund the county's syringe-exchange program and efforts aimed at preventing drug abuse.

"The success of the county's way of operating has put Adkins on the road, teaching other counties how to successfully navigate Casey's Law," Combs writes.

"A lot of counties have had some confusion about how it works, or who pays for it," Adkins said. "You run into a lot of roadblocks that you learn along the way. So a lot of counties are just now starting to take advantage of Casey's Law."

Brad Stacy of The Morehead News wrote about a local effort organized by Adkins to educate their community about Casey's Law in January.

He reported that the Rowan County Agency for Substance Abuse Policy board and the county attorney's office held two free Casey's Law trainings in January, including how to manage the legal processes.

The class was led by Charlotte Wethington, who was instrumental in getting the law passed after losing her son Casey to a heroin overdose in 2001. She has since dedicated herself to advocating for Casey's law, which is officially called the "Mathew Casey Wethington Act for Substance Abuse Intervention."

In March, Beth Warren of the Louisville Courier Journal wrote a detailed article showing families and others how to invoke Casey's Law in Louisville. Warren notes a webpage with a step-by-step guide and video on to file a petition in Louisville, which links to another statewide resource: She noted that 60 petitions were filed in Louisville in 2017, compared to 27 in 2016.

Warren also notes that parents and others who need added support with Casey's law can ask to join the closed Casey's Law group on Facebook, which has over 1,500 members.

In February, Sam Knef of the Tristate Homepage wrote about a Henderson woman who was forced into rehab through Casey's Law, but not before her family met some roadblocks from a local attorney.

Taylor Willoughby, who was addicted to drugs and ordered into treatment through Casey's law, told Knef, "If they hadn't forced it on me, I don't think I would be alive today."

But her mother, Teresia Johnston, told Knef that when she initially called a local attorney, he "kind of laughed me off, said it doesn't work unless they put themselves in rehab," and called the law "a joke."

However, the Henderson County attorney disagreed and told Knef that Casey's law is an effective way to get people into treatment before they get arrested.

“Court ordered treatment is just effective or more effective as that treatment that somebody decides to go in themselves,” Steve Gold said. “So I’m a believer.”

Knef also notes that the cost of court fees and treatment are huge deterrents to the law, but adds that there are many state-funded centers that offer court-ordered rehab for free.

Ky.'s oldest working dentist, 97, dies; may have been U.S.'s oldest

Dr. J.M. Stephenson
Julius Middleton Stephenson, who was Kentucky's oldest working dentist, and may have been the oldest in the nation, died May 5 in Bowling Green. He practiced in the Cumberland River town of Burkesville, population 1,500.

Stephenson worked in his office as recently as March. He was a fixture at the state high school basketball tournament well into his 90s, and was secretary-treasurer of the South Central Kentucky Dental Society for 40 years. His son and daughter, who survive, are both dentists.

His funeral service will be held at 2 p.m. Wednesday at Burkesville First United Methodist Church with burial in Burkesville Cemetery with military honors. Flowers are welcome, but donations are encouraged to Lindsey Wilson College in Columbia.

Full disclosure: In his youth, the writer of this post was a patient of Dr. Stephenson.