The Richmond Register


October 7, 2012

Health board moves to stop the bleeding

RICHMOND — The  Madison County Health Department, especially the three-county home-health agency it operates, continues to be whipsawed by rising costs and declining reimbursements from Medicare and Medicaid.

MEPCO, which provides a variety of in-home health services in Madison, Estill and Powell counties, has finally had to resort to involuntary layoffs. Seven employees were told last week they they will be losing their jobs this month.

Despite cutting expenses substantially, including staff reduction through attrition, MEPCO’s income has kept falling at an even faster rate.

Fortunately, the health board socked money away during the good years. It has a reserve of more than $7 million to carrying it through the lean years, although most of that money was set aside for capital projects.

You don’t have to be a health care professional to know that bleeding must be staunched if a patient is to survive. Health department management, backed by the board, has taken that approach which MEPCO, which which was continuing to bleed money.

However, there is only so much that a local health board can do about rising costs and falling income from state and federal programs. As health board members noted last week, if recent trends continue, even its sizable surplus will last only a few years

Unlike private providers, MEPCO may not refuse service to patients who cannot guarantee payment. Also, unlike their private competitors, MEPCO is told what it must pay for state health insurance and retirement for its employees. Instead of fully funding the employee benefit programs it put in place, the General Assembly continues to push more of those costs onto local agencies. And, patients in financial need will suffer for it.

At both the state and national levels, we must decide how health care is to be provided and paid for. At the national level, the debate is confusing and unproductive. The way candidates from the two major parties portray their own plans and that of their opponents is baffling. That was evident in last week’s presidential debate. Until we can agree on what the facts are, especially the costs, we won’t resolve anything.

There are three contested legislative races in Madison County this year, and among the questions we intent to press in our interviews with candidates will be their plans for public health programs and the state retirement system.


While they may add to the excitement and theater of politics, I don’t think hecklers, especially those who ambush their targets, add much to political discourse.

On Friday, an ambush heckler disrupted the opening of the Madison County’s Democratic Party headquarters at the conclusion of U.S. Rep. Ben Chandler’s remarks. As he appeared to video Chandler, a young man in a booming voice asked why the congressman had refused to debate his Republican opponent. Although a few in the crowd heckled the intruder, Chandler and most others ignored him.

The congressman’s colorful grandfather, Happy Chandler, was both the perpetrator and recipient of some ambush heckling during his political career.

When Happy Chandler, then governor, challenged incumbent Sen. Alben Barkely in the 1938 Democratic primary, President Franklin Roosevelt came to Kentucky to campaign for Barkley. Chandler exercised his right as governor to welcome the president upon his arrival and then remained an unwelcome guest of the entourage.

Nearly 20 years later, when Chandler again sought the governor’s chair, he told young voters to “Be like your pappy and vote for Happy.”

After Chandler was accused of taking part in an illegal duck hunt on a friend’s land, a supporter of Chandler’s primary opponent had his son put on a duck costume and run through a venue where Chandler was speaking and yell, “Happy shot my pappy.”

Such stories are good for a few laughs, but they are don’t contribute to serious political discourse or help solve problems.

Text Only
  • 06.29 CrystalFarewell.jpg Starting over at Head Start

    All I ever wanted to be was a journalist. Having worked on my high school and college newspapers, I knew it was the career for me.
    I love talking to people, listening to their stories, being creative every day and experiencing new things. But as you know, news happens outside the hours of 9 to 5, and my job here at the Register rarely stayed within that time frame.

    June 29, 2014 2 Photos

  • Ike Adams They don’t make strawberries as they did back in the old days

    I’m not inclined to go through my archives at the moment, but it almost feels like the column I’m about to write has almost become an annual thing over the years.
    At least I know for sure that that this is not the first time that memories of picking strawberries there on Blair Branch on hot days in June has triggered this keyboard about this time of year.
    I grew up on a little subsistence, hillside farm deep in the mountains of eastern Kentucky, among the coalfields near the Virginia line.

    June 26, 2014 1 Photo

  • Ike Adams Baby boomers have let technology rob their grandchildren of the joys of youth

    When I was growing up, it was not uncommon to see fathers and sons along creek banks fishing together or in the woods hunting squirrels or pitching horse shoes or even shooting marbles late in the afternoon in the cool hours before dark.
    Dads were teaching kids to play the games they grew up with. Little girls, learned from mothers,how to skip rope, play with jacks or play hopscotch.

    June 12, 2014 1 Photo

  • Ronnie-Ellis.jpg No Lincoln or Douglas in this debate

    Remember the famous slap-down in the 1988 vice presidential debate when Republican Dan Quayle compared his youth and limited government experience to those of John Kennedy’s when Kennedy ran for president?
    His Democratic opponent, Texas Sen. Lloyd Bentsen, acidly replied: “I knew Jack Kennedy. Jack Kennedy was a friend of mine. Senator, you’re no Jack Kennedy.”

    June 7, 2014 1 Photo

  • Ronnie-Ellis.jpg Senate campaign already in full bloom

    Any hope for a respite in the U.S. Senate campaign following Tuesday’s primary disappeared immediately.
    Mitch McConnell and Alison Lundergan Grimes came out swinging in victory speeches which sounded like campaign kickoffs.
    McConnell commended Matt Bevin on “a tough (primary) race” and appealed to Bevin supporters to unite behind his re-election bid. That will be hard for Bevin and those who backed him.

    May 24, 2014 1 Photo

  • Jim Waters.JPG ‘Taxpayer-eaters’ meet ‘self-serving politician-eaters’

    What some candidates could gain in this year’s election – beyond just winning office – is a stark reminder of how wrong political leaders were when declaring last year they had adequately addressed Kentucky’s public-pension crisis.
    Instead, legislators with serious courage deficiencies failed to agree on reforms beyond what they believe are “politically feasible.”

    May 16, 2014 1 Photo

  • Ike Adams Step Out, Step up for Diabetes Association

    Six weeks ago when I wrote here announcing the 2014 Edition of Team TKO’s American Diabetes Association, Step Out Walk Team, several dozen of you readers sent generous donations to sponsor grandson Tyler Kane Ochs (TKO) and me in the walk that takes place, rain or shine, in the mud or not, at Keeneland on the morning of May 31.
    Another several dozen of you either called, emailed or dropped a card in regular mail and asked that I remind you again “after the holidays” (Easter and Mother’s Day).

    May 16, 2014 1 Photo

  • Ronnie-Ellis.jpg Hitting the campaign trail

    The most watched race in the country ? the battle for the U.S. Senate seat now held by Republican Mitch McConnell ? has so far produced a bevy of charges and not much substance.
    We haven’t seen that much of McConnell or his likely Democratic opponent Alison Lundergan Grimes out on the campaign trail.
    McConnell’s primary opponent Matt Bevin has been much more active and visible, but his performance hasn’t enhanced his chances.

    May 11, 2014 1 Photo

  • The case of the scary black cat

    If Margie didn’t believe that black cats were the harbinger of bad luck, she certainly believed it when a black cat brushed against her leg while she was leaning over a large trash can burning garbage one late afternoon.
    Startled by the sudden appearance of the feline, Margie opened her mouth wide and let out a blood-curdling scream that could have awakened Count Dracula himself.

    May 10, 2014

  • Ike Adams Basking in the spring sunshine

    If you had asked me, as recently as two weeks ago, to make a list of things I expected to see on the first Monday in May of 2014, two of the things that I actually did see would not have been on the list, even if you’d required that it contain at least 500 items.
    I’d have been a bit skeptical about Ralph’s purple asparagus and his gorgeous snowball bush, both of which came through most admirably. And I would have had my doubts about the poppies that have been in our back yard for several generations and the bearded German Iris that Jeanette Todd gave us more than two decades ago. It faithfully stuns us there at the corner of the front porch every spring, but there they were, basking in absolute glory as the sun set Monday afternoon.

    May 8, 2014 1 Photo

AP Video
Arizona Prison Chief: Execution Wasn't Botched Calif. Police Investigate Peacock Shooting Death Raw: Protesters, Soldiers Clash in West Bank Police: Doctor Who Shot Gunman 'Saved Lives' 'Modern Family' Star on Gay Athletes Coming Out MN Twins Debut Beer Vending Machine DA: Pa. Doctor Fired Back at Hospital Gunman Raw: Iowa Police Dash Cam Shows Wild Chase Obama Seeks Limits on US Company Mergers Abroad Large Family to Share NJ Lottery Winnings U.S. Flights to Israel Resume After Ban Lifted Official: Air Algerie Flight 'probably Crashed' TSA Administrator on Politics and Flight Bans Raw: National Guard Helps Battle WA Wildfires Raw: Ukraine's Donetsk Residents Flee Senators Push to End Hamas Threat in Cease-Fire A Young Victim's Premonition, Hug Before MH17 Raw: Deadly Storm Hits Virginia Campground Death Penalty Expert: 'This is a Turning Point' Raw: MH17 Victim's Bodies Arrive in Netherlands
Hyperlocal Search
Premier Guide
Find a business

Walking Fingers
Maps, Menus, Store hours, Coupons, and more...
Premier Guide

What county fair attraction do you like most?

Amusement rides
Beauty pageants
Flora Hall craft exhibits
Horse shows
Livestock, poultry shows
Truck, tractor pulls
Mud, dirt races
Gospel sing
I like them all
     View Results