Hope is high for a House floor vote and passage of a statewide smoking ban, but the Senate remains doubtful

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. -- A bill to ban smoking in public places and places of employment is headed to the House floor yet again, and its sponsor says it will finally get a vote. But its chances in the Senate remain doubtful.

Rep. Susan Westrom

"I feel very confident that we will get a floor vote," Rep. Susan Westrom, D-Lexington, five-year sponsor of the legislation, said after Thursday's committee meeting. "I am shooting for next Wednesday."

House Bill 145 passed the Health and Welfare Committee 11-4, with all Democrats and two Republicans on the panel for it and four Republicans opposed.

Westrom said the bill is not a smoking ban, but simply asks smokers to step 15 feet outside to smoke. She said, this is "not a huge sacrifice, but the benefits are so incredible."

The bill also requires those smoking electronic cigarettes and hookahs to step outside, which could cause a "battle," Westrom said.

The legislation got to the House floor last year, but didn't get a vote, and has never gotten out of committee in the Senate. Polling shows a clear majority of Kentuckians support banning smoking in indoor public places, but almost 30 percent of Kentuckians smoke, tops in the nation. The state also is No. 1 in lung cancer and deaths from it.

Two Republican senators, pediatrician Ralph Alvarado of Winchester and lawyer Julie Raque Adams of Louisville, chair of the Senate Health and Welfare Committee, sat with Westrom and Rep. David Watkins, D-Henderson, a retired physician, before the committee.

Alvarado gave an impassioned reading of his op-ed that was in the same day's Lexington Herald-Leader to the committee. "Smoking is killing Kentucky, literally and fiscally," he said.

He said an estimated 950 Kentuckians die every year because of secondhand smoke; exposure to it costs Kentucky more than $128 million every year; children exposed to secondhand smoke suffer from repeated ear infections, bronchitis, pneumonia and asthma; and secondhand smoke is a proven cause of heart disease, cancer and stroke in non-smoking adults.

By passing the bill, "The General Assembly can save more lives with this legislation than I can throughout my entire medical career," Alvarado said. Democratic Gov. Steve Beshear supports it.

Adams, who will be sponsoring the legislation in the Senate, told the committee, "We need to see a vote on the floor. We need to talk to our senators. We need to keep up the advocacy because Kentuckians deserve better."

Senate Republican Floor Leader Leader Damon Thayer told Jack Brammer of the Herald-Leader that there is "not much sentiment" for the bill in the Senate: "Let the free market work this out."

Republican Bob DeWeese, a doctor from Louisville, voted for the bill. He said the title of representative was fleeting, but "I'm a doctor for life."

Newly elected Rep. George Brown Jr., D-Lexington, noted that he voted against the smoking ban in Lexington many years ago. "Since that time, I've had an awakening and I understand that the collective rights of citizens are much more important than those of individuals."

Rep. Robert Benvenuti III, R-Lexington, said "liberty interests have to be balanced" between the rights of smokers to smoke in the workplace versus the rights of others to be healthier.

Newly elected Rep. Phil Moffett, R-Louisville, said "I support it at the local level and that is where is should reside," and asked Westrom why the legislature shouldn't just make tobacco illegal "if it is that devastating."

Westrom suggested Moffett ask the Kentucky Farm Bureau Federation about that. She said in December that Farm Bureau has been the main obstacle to the bill.

About 5,000 farmers in Kentucky grow tobacco, a greatly reduced number from the days of the federal tobacco program, which ended 10 years ago. Farm Bureau spokesman Dan Smaldone said in December that the organization continues to oppose the legislation because it invades the private-property rights of business owners.

Asked why a farm organization cares about that, Smaldone wrote in an email, "KFB's membership supports policy for rural issues that fall outside of the agriculture industry, including educational and economic issues that impact their local communities. The organization has policy on the issue because its membership determined it was important to take a position on it."

As for the local approach, Westrom said after the meeting that too many local communities have not taken the initiative to pass smoking bans.

About one-third of Kentuckians are covered by strong local smoke-free laws, with 24 communities with smoke-free laws that cover all workplaces and enclosed public places, according to the Smoke-Free Kentucky Coalition website.

Westrom, Alvarado and committee Chair Tom Burch, D-Louisville, said they thought the bill would pass the House, but none were sure about the Senate. Westrom noted that Senate President Robert Stivers, R-Manchester, has been vocal against the bill.

"The wonderful thing about Sen. Stivers is that he understands how important the cancer research center is at the University of Kentucky," Westrom said, noting Stivers' call to reopen the 2014-16 state budget to authorize the project: "If we are going to invest that amount of money for a cancer research center, the best thing we can do . . . is make sure the entire state is setting the example of a smoke-free state."

Smoke-Free Kentucky Chair Amy Barkley said, "If the House passes it and puts the ball in their court . . . I'm just going to be optimistic that they will listen to their voters. We know that 66 percent of the voters support a statewide smoke-free law and that crosses all parties and regions of the state." That is the figure in the latest Kentucky Health Issues Poll; a Bluegrass Poll put the figure at 57 percent.

Public opinion will make the difference this year, Westrom said. "Some portions of the state are more that 74 percent approval; 70 percent of the people who used to smoke are in favor of this; and an average of 60 percent of those in rural areas are in favor of smoke-free."

Regan Hunt, executive director of Kentucky Voices for Health, named national Consumer Health Advocate of the Year

Regan Hunt

Regan Hunt, the executive director of Kentucky Voices for Health, has been named Consumer Health Advocate of the Year by Families USA, which calls itself "the national organization for health-care consumers." KVH is a group of organizations and individuals working to improve health and coverage for Kentuckians, and was organized in response to the federal health-reform law. It includes groups that lobby, but it does not lobby.

The award is given to individuals who have made exceptional contributions in the effort to help our nation's health care consumers. Hunt received the award to "recognize and honor her leadership in the expansion of Medicaid in Kentucky, her efforts to bolster health coverage under the Affordable Care Act and her steadfast commitment to building a healthier Kentucky," Nicole Nash reports in a KVH press release.

"Regan is a one-of-a-kind advocate who led the way on Medicaid expansion and health coverage enrollment in the Bluegrass State," Ron Pollack, executive director of Families USA, said. "Thanks to Regan's tireless efforts, thousands of Kentuckians have access to health care. The diverse coalition she has mobilized will continue to benefit Kentucky residents for years to come." (Read more)

Foundation for a Healthy Kentucky lists 2014 grants

The Foundation for a Healthy Kentucky has provided more than $1.3 million in 2014 for community programs, polling and policy initiatives to not only advise policymakers but also advocate for better health and health care across the state.

"Our strategies to address the unmet health care needs of Kentuckians are built on investment at the local and state levels," Susan Zepeda, president and CEO of the foundation, said in a news release.

The foundation said it donated $125,000 to Kentucky Voices for Health, a coalition of lobbying groups that support health reform; $50,000 to Kentucky Youth Advocates, an organization dedicated to the improvement of public policies that influence the lives of children and families and $60,000 to the University of Cincinnati for the 2013 Kentucky Health Issues Poll.

As part of a 2012-17 strategic plan to help school-aged children grow up to be healthier than their parents, the foundation provided three grantees money to set in motion the business plans they developed. Recipients included: Clinton County School District ($158,361), Fitness for Life Around Grant County ($182,033) and Louisville Metro Department of Public Health and Wellness ($161,850). The foundation also funds a multi-year study of Kentucky's transition to managed-vcare Medicaid.

The foundation matched a $3 million federal investment to begin nurse-managed clinics, telemedicine, mobile health services, care navigation and and an activities center. These projects "have improved the quality of life for more than 20,000 Kentuckians and provided training for more than 250 providers," according to the release.

To support the improvement of health literacy in Kentucky, the foundation invested $100,000 in health programming on KET, and $25,000 with the Institute for Rural Journalism and Community Issues at the University of Kentucky , mainly for the publication of Kentucky Health News.

Chain restaurants, theaters, amusement parks and grocery delis must post calorie counts in a year, to fight obesity

McDonald's already posts calorie content on its menus

In an effort to combat the country's obesity epidemic, the Food and Drug Administration issued final regulations Tuesday that will require chains with 20 or more restaurants, movie theaters and pizza parlors to post calorie counts on menus.

"The rules will have broad implications for public health," Sabrina Tavernise and Stephanie Strom report for The New York Times. "As much as a third of the calories that Americans consume come from outside the home, and many health experts believe that increasingly large portion sizes and unhealthy ingredients have been significant contributors to obesity in the United States."

“This is one of the most important public health nutrition policies ever to be passed nationally,” Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, told the authors. “Right now, you are totally guessing at what you are getting. This rule will change that.”

The numbers "could be a pretty big wake-up call," writes Jason Millman of The Washington Post. "The FDA rules are more comprehensive than expected, given the strong industry pushback since the menu labeling provision was included in the 2010 health-care law." The FDA proposed a rule in 2011, but heavy lobbying has delayed its finalization.

"Do people eat healthier when they can see calorie counts?" Milliman asks. "The evidence so far seems mixed. The impact seems to be greater when the calorie count is much higher than what consumers expect. What does seem clear from past studies is that people really are terrible judges of how many calories they consume when they dine out [and] are especially bad judges of the calorie content of the least healthy foods commonly found of restaurant menus."

The rules also cover food in vending machines, amusement parks, alcohol if it is on the menu or a menu board, and some prepared foods in supermarkets. Chain restaurants are defined as food establishments with 20 or more outlets.

The policy will take effect a year from now, "and seems likely to face legal and political challenges from some parts of the food industry, including grocery and convenience stores that sell prepared foods for takeout," the Times reports.

The National Grocers Association told the paper, “Grocery stores are not chain restaurants, which is why Congress did not initially include them in the law. We are disappointed that the FDA's final rules will capture grocery stores, and impose such a large and costly regulatory burden on our members.”

Daren Bakst, a research fellow in agricultural policy at the conservative Heritage Foundation, told the authors that the FDA interpreted the law too broadly. “If Congress wanted to cover any establishment that sells prepared foods, they would have said that,” he said. “No reasonable person is about to confuse a grocery store, convenience store or movie theater with a restaurant.” But retiring Democratic Sen. Tom Harkin of Iowa, who helped create the labeling requirement, said the rule “closely mirrors congressional intent.”

The FDA offered some concessions to grocers, convenience stores, pizza chains and vending-machine owners. For example, pizzerias can define their serving sizes and list calories by the slice, and vending machine owners have been given an extra year to comply.

Smoking-ban supporters on 'Road to a Healthier Kentucky Tour' next week to rally support for the 2015 legislative session

The Smoke-Free Kentucky Coalition is kicking off its 2015 campaign to rally support for comprehensive, statewide smoke-free laws on its "Road to a Healthier Kentucky" Tour, from Monday, July 28 to Saturday, August 2.

The tour plans to make at least 10 media appearances across the state on its way to its final stop at the annual Fancy Farm Picnic in Graves County. The coalition says its goal is to get Kentuckians active and engaged in supporting smoke-free policy as the campaign gears up for the next legislative session. The message: "It's time to take a stand for better health by making Kentucky a smoke-free state."

The coalition says 24 other states have comprehensive, statewide smoke-free laws that cover all indoor workplaces and public places, including bars and restaurants. State Rep. Susan Westrom, D-Lexington, has introduced such legislation during the last four legislative sessions but it has not gotten a floor vote in the full House. Last year's bill apparently died because legislators feared backlash in an election year.

Almost 30 percent of Kentuckians still smoke, more than any other state in the nation, but a poll last fall showed 65 percent of Kentuckians favored a smoke-free workplace law, and 90 percent of Kentucky Chamber of Commerce members support such a law.

“2015 is the year we are finally going to pass a smoke-free law and protect everyone’s right to breathe clean air in Kentucky,” said Amy Barkley, chair of the coalition. “We know Kentuckians support going smoke-free, and we’re touring the state to call attention to those supporters.”

Here's the tour schedule:
Monday, July 28: King's Daughters Medical Center, 2201 Lexington Ave, Ashland, noon.
Tuesday, July 29: Appalachian Regional Healthcare, 110 Medical Center Dr., Hazard, 11 a.m.; Manchester City Hall, 123 Town Square, 3 p.m.
Wednesday, July 30: Markey Cancer Center, 800 Rose St., Lexington, 11 a.m.; Norton Cancer Institute, 676 S. Floyd Street, Louisville, 3 p.m.
Thursday, July 31: Big Dawg Country Radio, 101 E. Main St., Campbellsville, 11 a.m.; Fountain Square Park, Bowling Green, 2 p.m.
Friday, Aug. 1: Smothers Park, 199 West Veterans Blvd., Owensboro, 10 a.m.; Baptist Health (formerly Trover Clinic), 900 Hospital Dr. Madisonville, 12:30 p.m.; Baptist Health Paducah, 2501 Kentucky Ave., 3:30 p.m.
Saturday, August 2: Fancy Farm Picnic, St. Jerome Church, Fancy Farm, 10 a.m. to 4 p.m.

Barkley says she can be reached at 502-777-8148 or abarkley@tobaccofreekids.org to inquire about additional stops. For more information visit www.smokefreekentucky.org or contact Betsy Janes, 502-797-0638 or betsyjanes@ymail.com.

The coalition includes the American Cancer Society Cancer Action Network, the American Lung Association, the American Heart Association, the Campaign for Tobacco-Free Kids and other local health, businesses and community partners.

Nursing-home industry cited as example of how campaign-funding lobbying interests get what they want from General Assembly

Lobbying groups' political action committees gave almost 40 percent of the money that the campaign committees of the legislature's party caucuses received in the last 18 months, Tom Loftus reports for The Courier-Journal.

"Much of the remaining 60 percent came in contributions from officers of corporations and associations representing highway contractors, nursing homes, coal companies, payday lenders and other interests with an active lobbying presence in the state capital," Loftus writes. "The Senate Republican Caucus got at least $26,000 from about 30 owners or employees of Kentucky nursing homes."

"It's a part of the equation where we can't compete," Bernie Vonderheide, president and founder of Kentuckians for Nursing Home Reform, told Loftus. "The only tool we have to compete with that is to try to make our case to the public and hope." For several sessions of the legislature, the group has lobbied for staffing requirements at nursing homes, to no avail.

The winner of that lobbying battle is the Kentucky Association of Health Care Facilities, which has a generic name but is in fact the main lobby for nursing-home owners. KAHCF President Betsy Johnson sent Loftus this statement: "We support candidates who have consistently supported Kentucky's excellent caregivers, and in particular some of our most pressing issues including medical liability reform."

Loftus reports, "The General Assembly's two top leaders, who have been leading fundraising drives for their caucuses for the past month, say there's no problem." He quotes Senate President Robert Stivers, R-Manchester: "Contributions do not influence policy. ... It's the policy that influences contributions."

House Speaker Greg Stumbo, D-Prestonsburg, told Loftus, "We tell them when we have our fundraisers that this doesn't guarantee anything except that we will promise we will listen to your problems and we'll try to be honest with you." (Read more)