Legislative panel talks about health care with UK Board of Trustees at annual retreat
By Melissa Patrick
Kentucky Health News
The University of Kentucky hosted a legislative panel on Oct. 16 focused on health care to kick off the 2024 Board of Trustees annual retreat.
While welcoming the panel, UK Board Chair Britt Brockman said UK has a vital role to play when it comes to advancing the health of the state through education, healthcare, research and service. Still, he said, the university believes that even more can be done through partnership with the legislature.
“We want to support your efforts to make our commonwealth all that it can be — a healthier state, stronger communities, a vibrant and vital economy,” he said. “We are your partners here, excited to engage with you and hear more from you about how we can work together to advance the health of our state.”
The panel discussion, led by Mark Birdwhistell, UK HealthCare senior vice president for health and public policy, touched on several health topics, most related to the state’s health care workforce shortage, especially in rural Kentucky.
Health care workforce
Birdwhistell asked Rep. Kim Moser, R-Taylor Mill, chair of the House Health Services Committee, about Kentucky’s workforce shortage, noting that he had heard her say at a committee meeting that almost a third of Kentucky’s physicians are eligible for retirement, with a projected 3,000 shortfall by 2030.
Moser said the legislature has been working on this issue, pointing to the expansion of a loan forgiveness program through the Kentucky Office of Rural Health and House Bill 200, passed in 2023, that establishes a public-private partnership to give students health care scholarships.
To address the mental health workforce shortage, Moser said she has worked on bringing a program called “Train New Trainers” out of the University of California, Irvine to Kentucky. She said this program establishes a fellowship for primary care physicians to improve their mental health and substance use disorder training and that the Cabinet for Health and Family Services and the Primary Care Association are working to implement this year-long program.
“I really think that this is an area that UK could help us expand the training for our primary care physicians . . . especially in our rural areas, where we do not have psychiatrists and psychologists who really assist with that issue,” she said.
Moser also stressed that Kentucky needs more graduate medical education slots and that it is important to figure out how to keep those students in Kentucky.
“In 2023, 42% of UK College of Medicine graduates stayed in Kentucky to start their medical career as residents. That was a historic increase, with only 25-30% of graduates staying in the state from 2017-2018,” Kendall Staton reports for the Lexington Herald-Leader in a broader story about UK’s Board of Trustees meeting.
Role of education
Sen. Amanda Mays Bledsoe, R-Lexington, vice chair of the Senate Appropriations & Revenue Committee, talked about the importance of the new $380 million health education building on UK’s campus, paid for through funding that was authorized by the Kentucky General Assembly.
She said the building has had a direct impact on the increases seen in the enrollment of physicians, nurses, public health students and health sciences students.
“That’s a significant investment in the workforce pipeline, which is critical if we’re going to fill the jobs that we’re going to have in education and healthcare, our top two sectors,” she said.
Rural workforce issues
Sen. Donald Douglas, R-Nicholasville, vice chair of the Senate Health Services Committee, said nearly all of the state’s counties are considered health care deserts and that while 40% of the state’s population live in rural areas, only 17% of the state’s primary care physicians work in rural areas. He encouraged UK to partner with private practice physicians who want to work in rural areas.
Sen. Stephen Meredith, R-Leitchfield, chair of the Senate Health Services Committee and a former hospital administrator, talked about how he recruited new physicians to his hospital in the early 80s by creating a medical foundation, which allowed the hospital to guarantee them a competitive salary. “The hospital had to subsidize the practice,” he said.
“I ask this question constantly at Family Services and of our MCOs, ‘Why would anyone choose to go to a rural community knowing you’re going to make 25 to 30 percent less” than your urban counterparts?” he asked. “Until we address that basic issue, we’re not going to be successful.”
Senate Majority Caucus Chair Julie Raque Adams, R-Louisville, talked about the role of Senate Bill 280 when it comes to helping rural hospitals, especially in Eastern Kentucky.
SB 280 allows certain rural hospitals that get at least 35% of their revenue from Medicaid to get the same enhanced Medicaid reimbursement as UK and the University of Louisville. In other words, it allows qualifying hospitals to get paid higher Medicaid rates.
“What does that do for rural healthcare? . . . It allows them to expand their programming. It allows them to expand their specialty care. It allows them to expand their telehealth services. It allows them to expand their trauma units,” said Adams.
Health isn’t just about health care
Rep. Samara Heavrin, R-Leitchfield, chair of the House Families and Children Committee, talked about how things like the lack of childcare, foster care, domestic violence and substance use disorder impact Kentucky’s workforce.
“There’s great opportunity within the health care system to be able to partner on these issues, because if we don’t figure out how to fix these issues, we’re gonna have a lot bigger problems down the line,” she said.
Substance use disorder and mental health
Birdwhistell asked the panel about what needs to be done differently when it comes to substance use disorder and mental health treatment.
Adams called for more wrap-around services for people coming out of a recovery program to “support them in their sobriety and perpetuity.”
Heavrin called on more attention being paid to childhood trauma and adverse childhood experiences, to finding out what the cause is for these conditions.
Douglas said it is important to look at all of the current treatment models and their outcomes and use the models that show long-term success. He also talked about the importance of “responsibility and accountability.”
Meredith said poverty is the root cause of these problems and until we “lift our citizens out of poverty, we’re going to continue struggling with this area. We’ll never get it resolved.”
Moser called for breaking down the “bureaucratic barriers” that get in the way of people getting care, like prior authorization and Kentucky’s prescribing policies for drugs for addiction treatment like Suboxone and buprenorphine that are not in line with federal laws.
Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.
