Interim Joint Committee on Agriculture


Subcommittee on Rural Issues


Minutes of the<MeetNo1> 1st Meeting

of the 2013 Interim


<MeetMDY1> October 9, 2013


Call to Order and Roll Call

The<MeetNo2> 1st meeting of the Subcommittee on Rural Issues of the Interim Joint Committee on Agriculture was held on<Day> Wednesday,<MeetMDY2> October 9, 2013, at<MeetTime> 10:00 AM, in<Room> Room 131 of the Capitol Annex. Representative Mike Denham, Chair, called the meeting to order, and the secretary called the roll.


Present were:


Members:<Members> Senator Stan Humphries, Co-Chair; Representative Mike Denham, Co-Chair; Senators David P. Givens, and Paul Hornback; Representatives C.B. Embry Jr., Derrick Graham, James Kay, Tom McKee, Terry Mills, and Bart Rowland.


Guests:  Kristen Branscum, Kentucky Department of Agriculture; Timothy Bickel, TeleHealth Director, University of Louisville Physicians, Kentucky TeleHealth Network; Dr. Kerri Remmel, Chair of the Neurology Department, University of Louisville; Joe Grossman, President and CEO, Appalachian Regional Healthcare; Dr. Susan Smyth, Chair of the Cardiology Department, University of Kentucky, and Mark Birdwhistell, Executive Vice President, University of Kentucky.


LRC Staff:  Tanya Monsanto, Stefan Kasacavage, Kelly Ludwig, and Susan Spoonamore, Committee Assistant.


Impact of the Kentucky Proud Program on Rural Kentucky

Ms. Kristen Branscum, Executive Director of Marketing, Kentucky Department of Agriculture, discussed the impact of the Kentucky Proud Program on rural Kentucky. Ms. Branscum stated Kentucky Proud is the state's official marketing brand for agricultural products grown, raised, processed, or manufactured in Kentucky. The program’s name has been changed to “Kentucky Proud Keeps Kentucky Growing.”


Ms. Branscum stated that Kentucky Proud products are now offered through the Kentucky State Parks at the Capitol Annex Cafeteria on Wednesdays. The Homegrown by Heroes program, which was launched in January 2013, provides consumers another venue to purchase local farm products from veteran farmers. The Udderly Kentucky program is an effort to keep Kentucky dairy farmers in business. Udderly Kentucky milk is purchased from Kentucky dairy farmers and processed by Prairie Farms, a Kentucky milk processor, and can be found in Wal-Mart stores in southeastern Kentucky. A seven cent premium goes into a fund and is distributed to Kentucky dairy farmers each quarter. Approximately 105 dairy farmers participate, and has each received $10,000 to $20,000 in premiums so far for 2013.


In response to Representative Denham, Ms. Branscum stated that a list of Homegrown Heroes is on the Kentucky Department of Agriculture's website.


In response to Representative Mills, Ms. Branscum stated that she would provide him a list of Udderly Kentucky milk producers in his district.


In response to Senator Givens’ question dealing with price differentials, Ms. Branscum said that the department remains transparent and nonexclusive. The department does not have a revenue stream to maintain the program. It uses Kentucky Proud funds obtained from the Agriculture Development Board and uses existing staff to assist with the Udderly Kentucky milk program.


TeleHealth and TeleMedicine and the Impact on Rural Kentucky

Mr. Timothy Bickel, TeleHealth Director, Kentucky TeleHealth Network,   University of Louisville, and Dr. Kerri Remmel, Chair of Neurology, University of Louisville, discussed the TeleHealth and TeleMedicine program and its impact on rural Kentucky. Mr. Bickel stated the University of Louisville and University of Kentucky were designated primary TeleHealth Centers when the TeleHealth Network was established. St. Claire Hospital in Morehead, Kentucky and Baptist Health Hospital in Madisonville, Kentucky were designated as regional training centers. The program connects with more than 200 sites and has the ability to connect with every public school in Kentucky. The program allows rural patients the opportunity to remain in their home area and at local hospitals while receiving care from specialists in Louisville or Lexington.


The TeleHealth program’s technology allows a specialist to be at a patient's bedside in a remote area within 15 minutes. TeleHealth eliminates travel time for the patient and specialist, and the patient receives care more quickly with this method of treatment. TeleHealth allows rural patients easier access to more doctors and specialists, resulting in better outcomes and healthier Kentuckians. Prior to the program, counties without a neurologist had to be transferred to another hospital. As a result of TeleHealth and TeleMedicine, only 10 percent of the cases are sent to other hospitals. This keeps patients in the local community and local hospital, thereby decreasing transportation costs and additional costs for patients' families.


In response to Representative Denham, Dr. Remmel stated the biggest challenge to collaboration is the lack of resources. Dr. Remmel said the focus is on sharing resources and building collaboration and relationships among healthcare officials.


In response to Senator Humphries, Mr. Bickel stated a request must be made to the TeleHealth Board to be approved as a TeleHealth member. A facility must have proper equipment to be approved. Mr. Bickel stated that there is staff to assist hospitals with determining the type of equipment needed in order to participate in TeleHealth and TeleMedicine. There are no fees required for membership. The Trover facility in Madisonville is a major educational partner, providing Madisonville doctors, patients, and students with educational seminars and trainings.


In response to Senator Givens, Mr. Bickel and Dr. Remmel stated it is a doctor's decision whether to utilize technology to make a patient diagnosis. Currently, the technology is primarily used to follow up and monitor a patient's case.


University of Kentucky Healthcare and Appalachian Regional Healthcare, Heart Center Partnership in eastern Kentucky

Mr. Joe Grossman, President and CEO, Appalachian Regional Healthcare, Dr. Susan Smyth, Chair of the Cardiology Department and Director of the Gill Heart Institute, University of Kentucky, and Mr. Mark Birdwhistell, Executive Vice President, University of Kentucky discussed the University of Kentucky Healthcare and Appalachian Regional Healthcare, Heart Center Partnership.


Mr. Grossman stated the partnership began as an effort to keep patients and family close to home. Appalachian Regional Healthcare needed a partner to help in expanding services and assist with doctor and staff coverage and decided to partner with the University of Kentucky. Dr. Smyth stated Kentucky has higher heart disease and heart attack rates than most other states. Some patients are denied coverage if they do not use in-state services and specialists. The partnership improves the quality of care that a patient receives. Doctors participating in the partnership are considered University of Kentucky staff. Doctors are able to interact with University of Kentucky doctors on a daily basis, utilize university seminars, participate in educational discussions about certain cases or patients, and access additional training and educational opportunities. Many rural doctors utilize TeleHealth to take advantage of the educational opportunities.


Mr. Birdwhistell also stated the expansion allows all doctors to be in one system. All patient files are in one system so that all doctors can access patient files more quickly to see what tests and examinations have been conducted by another doctor. Patients receive better care because of the partnership. Local doctors can access patient files to see what care has been done by university specialists and perform follow up care in the patient's local community.


In response to Representative Denham, Dr. Smyth said there is a need to educate Kentuckians--especially children--about the risks of heart disease and heart attack. There is a need to teach children CPR and the importance of living a healthy lifestyle. Additional funds are needed for research and education. Dr. Smyth indicated the partnership is trying to implement a standard of care across the Commonwealth.


The meeting adjourned at 12:00 p.m.