Kentucky editorial roundup
Recent editorials from Kentucky newspapers:
The Courier-Journal on controlling Suboxone prescriptions:
There’s no mistaking Kentuckian’s heroin and opioid addiction is a public health crisis. There are not enough spots in urban detox and inpatient treatment centers. It’s worse in rural areas.
One hope for addicts seeking sobriety is treatment that combines Suboxone, to help the deadly craving for heroin and opioids, and counseling. It’s called MAT - medication-assisted treatment. If taken correctly, it can save lives.
Sounds good, but the Courier-Journal’s Laura Ungar found that rogue doctors and clinics are exploiting loopholes in regulations to turn a quick dollar at the expense of suffering addicts looking for help and a road to recovery.
Suboxone is an opioid that also includes Naloxone, an ingredient to curb substance abuse. But it can still be abused and often is. Stringent oversight is necessary. Without that, opioid drugs are back on the streets in the hands of addicts.
Kentucky smartly created detailed regulations two years ago to guide the treatment using Suboxone.
Yet, we are experiencing déjà vu. Kentucky struggled with regulations to control the unscrupulous doctors recklessly prescribing pain pills years ago. Finally, in 2012, legislation passed attempting to tackle. This year, even tighter controls were passed further limiting prescription access to pain medication.
Kentucky is at risk of relapsing into a similar dark time without aggressive action to close loopholes for managing and regulating Suboxone-based treatment programs.
Officials must tighten the regulations while keeping treatment accessible. Legislation may be necessary.
To begin, Kentucky must take the following actions:
Better define the necessary counseling that makes MAT effective along with required drug screenings with clear protocols for patients who fail tests.
Since counseling is critical, and addicts are sometimes unpredictable, create financial incentives through “bundling” of Medicaid payments for doctors and counselors providing treatment at a single location. This also makes it good for the patient to receive both facets of the treatment at a single location.
At the same time, aggressively work to prosecute doctors who break the law. It is not enough for the Kentucky Board of Medical Licensure to suspend or revoke licenses.
Significantly increase the training requirements for doctors to be certified to prescribe these medications.
There are doctors that are doing it right. Take, for example, Dr. Molly Rutherford, a Crestwood addiction specialist and president of the Kentucky Society of Addiction Medicine. She keeps a close eye on her Suboxone patients, requiring them to have “behavioral health contracts,” which, among other things, mandate counseling as often as twice a week.
And there’s The Morton Center in Louisville which writes short-term prescriptions for patients who must undergo various drug screens and requires them to attend therapy sessions four days a week.
Monitoring and counseling are critical when caring for addicts. The leaders in Frankfort must consider legislation for licensing Suboxone programs, increasing inspections and oversight. Rep. Rocky Adkins proposed such legislation this year. It failed.
Kentucky can’t experience déjà vu.
The Daily Independent on Kentucky’s Gold Shovel awards:
Kentucky’s receipt of a 2017 Gold Shovel award from Area Development magazine was cause for a little bragging by Gov. Matt Bevin. The award recognizes the commonwealth’s success last year in attracting corporate investments that create jobs and grow the economy.
The honor, a first for Kentucky, follows the recent announcement that, in only five months of 2017, the state shattered its all-time, full-year record for corporate investment.
“This Gold Shovel award brings additional national attention to the fact Kentucky is a serious economic development contender, both in our recent achievements and for what we have in the pipeline,” Gov. Bevin said. “We’re making changes to improve Kentucky’s business climate by cutting red tape, revolutionizing our workforce development and building our reputation internationally as a top choice for engineering and manufacturing projects, tech investment and service-related businesses.”
The annual Shovel Awards by Area Development, a leading trade publication, recognize state economic development agencies that drive significant job creation through innovative policies, infrastructure improvements, processes and promotions that attract new employers and investments in new and expanded facilities. Area Development invited each of the 50 states to submit information about its top-10 job creation and investment projects initiated in 2016.
Based on the number of high-value-added jobs per capita, amount of investment, number of new facilities and industry diversity of the 10 submitted projects, Kentucky qualified for the Gold Shovel award among states with populations between 3 and 5 million.
Geraldine Gambale, editor of Area Development, noted Kentucky’s economic growth is broad-based and cited new projects in a wide range of sectors.
Kentucky previously received Silver Shovel awards in 2007 and 2011 through 2016.
This year’s corporate investments in Kentucky — at nearly $5.8 billion — already topped the 2015 record of $5.1 billion. Those investments also put Kentucky on pace this year to create the most new jobs in a decade. To date in 2017, more than 9,500 new jobs have been announced. The numbers for both jobs and investment are increasing daily.
Among those investments is the announcement by Braidy Industries that it will build a $1.3 billion aluminum plant in South Shore. That means unlike most previous years, this corner of Kentucky has not been left out of economic growth the rest of the state has enjoyed.
Some may dismiss Gov. Bevin’s comments about the Gold Shovel award as bragging, but the late Dizzy Dean once said when talking about his baseball achievements that if it’s factual, it’s not bragging. The facts back up Gov. Bevin’s words.
Lexington Herald-Leader on tax reform:
Since Gov. Matt Bevin is so pumped about vocational training to solve Kentucky’s ills, he might start by studying his own chosen line of work as it has played out in Kansas.
Last week, Kansas’ Republican legislature, rejecting Republican Gov. Sam Brownback’s four-year “experiment” in cutting taxes to spur growth, overrode his veto and raised taxes.
There are some lessons there for fellow Republican Bevin who said, also last week, he’ll call a special legislative session after Aug. 15 to overhaul Kentucky’s tax system.
Although details are few, Bevin has promised to cut taxes, tighten up loopholes and enjoy the show as Kentucky’s economy takes off.
That’s kind of what Brownback promised in Kansas. But the insurrection last week arose, Forbes magazine explained succinctly, from “four years of below-average growth, deepening budget deficits and steep spending reductions.”
Kansas, like Kentucky, must have a balanced budget. So when revenue tanks and the rainy-day fund is emptied the only option is cut, cut, cut. The cuts were so deep in Kansas that the state supreme court found the legislature had violated its constitutional obligation to adequately fund education and ordered an increase.
But there are some serious differences between Kansas and Kentucky.
When Kansas began its experiment. the state treasury boasted a surplus of just over $700 million and had just enacted measures to shore up public pensions, which were 56 percent funded.
In Kentucky, the budget director just predicted a $113-million shortfall this year and public pensions are only 16 percent funded, with a projected $18.1 billion shortfall. And Kentuckians have already lived through almost a decade of deep cuts that have resulted in higher tuition (including a new round of hikes also announced last week), fewer services and neglected infrastructure.
There is no margin for error in Kentucky.
Bevin has said, and we agree, that tax reform must produce more revenue. From the letter he sent legislators telling them about the upcoming special session, it appears he plans on recouping revenue lost to tax cuts through tightening up tax loopholes and exemptions. Here again, no argument. Currently Kentucky gives away more in hundreds of tax forgiveness programs than it actually collects.
But tightening loopholes is much easier said than done: the political reality is that every tax giveaway wound up in the code because a well-heeled someone wanted it there — and will likely fight to keep it.
As for exemptions, like tax breaks, they’re a great way to make political friends. Bevin, like so many before him, has been eager to give huge breaks to a host of businesses. He also restored the incentives for the Ark Encounter, a Noah’s Ark-themed tourist attraction in Grant County. The Herald-Leader’s Linda Blackford recently reported on the lackluster economic impact the giveaways have had there.
Not everyone got a tax break in Kansas. Although the wealthiest one percent saved about $24,600 a year on average, the Institute on Taxation and Economic Policy figured that the poorest fifth of the population paid about $200 a year more in taxes, thanks to fewer deductions and a sales-tax increase.
So, here’s the danger, the on-the-job lesson Bevin should study. Kentucky’s razor-thin budget does not have room for magical thinking, for ideological experiments. If he goes into this special session with solid plans for business tax cuts without an equally firm, mathematically solid commitment to make up the difference, and more, by cleaning up thousands of breaks and exemptions, Kentucky and its people will suffer.