Moving forward or running in place: Kentucky health care leaders discuss revenues a year and half after Kentucky’s Kynect and Medicaid expansion

Originally published in the September 2015 edition of The Lane Report

MOVING FORWARD

Over a year and half after the launch of Kynect, Kentucky’s lauded health insurance exchange program, and the Medicaid expansion program, the Commonwealth is among the nation’s leaders in reducing its population of uninsured residents. Across the board, Kentucky hospitals are providing more services to more people which, one naturally assumes, leads to improved revenues.

Mike Rust, CEO of the Kentucky Hospital Association (KHA), echoed this assumption to an extent. “Many of the state’s health care systems are experiencing an overall improvement in their financial positions” in the last 18 months, he said. A good deal of credit for this improvement goes to the insurance mandates in the Patient Protection and Affordable Care Act (ACA). Performance varies among institutions, but from a broad perspective, revenues are up and, in some cases, “by a significant margin,” he said.

There are, however, exceptions to this news, added Elizabeth Cobb, KHA Vice President of Health Policy and a member of the board of directors for the Kentucky Rural Health Association (KRHA). Some rural hospitals are still struggling to keep their doors open despite increased numbers of payers and a related reduction in uncompensated care, she said.

Nevertheless, from a broad perspective, Kentucky is well ahead of its neighbor states in realizing many of the ACA’s early goals. Audrey Tayse Haynes, Secretary of the Cabinet for Health and Family Services (CHFS), takes great pride in the numerous reports that show Kentucky leads its region, and the nation in some measures, in reducing the numbers of the uninsured.

A report published in the first quarter of 2015 by The Foundation for a Healthy Kentucky showed that the numbers of uninsured nationally dropped to about 12.9 percent of the population in December 2014. In that same time period, Kentucky’s uninsured stood at an estimated 9.8 percent, a 10.4 percentage point drop in the uninsured from 2013, according to a Gallup-Healthways survey.

There are many more encouraging statistics from the last year and half, Haynes said. According to CHFS estimates, improvements in the number of uninsured people in the Commonwealth have introduced approximately $2.2 billion new dollars into the health care industry, $1 billion of which has been shared among the state’s hospitals.

“That’s money going directly into the health care system, not to the recipients” she pointed out. The ACA’s influence is also credited to the creation of approximately 11,900 new jobs in professional health care and social work sectors, Haynes said.

But a year and half is still a very short period of time. While on the surface Kentucky hospitals are doing better financially, a finer-tuned analysis of hospital revenues reveal some cracks in the program. Most notable is the major shift in payer-mix engendered by the Medicaid expansion program, which paints a different and much more complex portrait of the financial health of Kentucky’s systems.

RUNNING IN PLACE

Sheila Currans, CEO of Harrison Memorial Hospital in Cynthiana, and Carl Herde, Chief Financial Officer for the Baptist Health System acknowledge that Kentucky’s efforts to reduce the ranks of the uninsured has made positive strides, but the rapid increase in the state’s Medicaid rolls pose a new set of challenges to hospitals across Kentucky.

“When it’s said that revenues are up, it’s a relative term,” Herde said. “We are seeing more patients, doing more services, and, certainly, our charges are up. But we are also experiencing a significant shift in our payer mix. If you are caring for the same or more patients, but not getting the same as you used to get for services, it creates an operational challenge.”

Medicaid Expansion grows faster than expected

A critical variable in assessing hospital revenues is its payer mix, Currans explained. In the simplest terms, the payer mix is the comparative ratio of patients with commercial insurance coverage, Medicaid/Medicare or other forms of government reimbursement, and those few who still self-pay.

“The payer mix in our service area [the Harrison County region] is naturally going to be different from what hospitals in Louisville, Paducah, or other Kentucky communities may see. Payer mix is directly associated with community’s specific demographics,” she continued.

Since the expansion, Currans and Herde noted a significant shift in their respective health systems’ payer mix.

“Though our [HMH’s] population is mostly Medicare/Medicaid, we used to have a higher percentage of commercial insurance than we’ve seen lately. There has been a clear shift in our payer mix to more Medicaid patients,” Currans said. Taking into consideration that Medicaid reimburses between 70 – 80 percent of charges, the anticipated cuts affect revenues even if total patient volume is up.

The KHA has noted an inverse relationship between the steep reduction in Kentucky’s uninsured in the last year and a half and the increase in Medicaid rolls, said Cobb. The difference, she noted, has a larger impact on rural hospitals whose Medicaid/Medicare patient populations are proportionately larger than those in urban hospitals. While hospitals may be seeing more patients and performing more services, “it’s important to remember that Medicaid doesn’t cover 100 percent of the costs of care,” she said.

With regard to Baptist Health’s holdings, Herde said that he was not seeing much difference between its rural and urban hospitals. As an administrator tasked with oversight of Baptist’s “bottom line,” there was a slightly better margin with commercial insurance than with Medicaid.

“For a small percentage of our insured patients, we had a margin that we now don’t have,” Herde said.

The CHFS publishes a weekly tally of the total numbers of Medicaid recipients as reported from the six Managed Care Organizations (MCOs) contracted to manage the program. The report on August 17 listed numbers at just over 1.27 million, or about 25 percent of the Commonwealth’s total population, said Secretary Haynes. That total number includes about 500,000 children under age 18 and the state’s population of people with permanent disabilities.

The expansion welcomed about 310,000 individuals during the first enrollment period. Counts have fluctuated since, Haynes continued, but the average has been around 400,000 or less. In addition, the state estimates that another 110,000 have enrolled in commercial health plans through Kynect. About 75 percent of those were among the uninsured, she said.

“When the state began enrolling people into medical coverage, the Medicaid numbers did exceed our initial expectations, but the numbers have been stable since,” Haynes commented. The area of the state with the highest enrollment in both Medicaid and commercial insurance is eastern Kentucky, which had been an area noted for having the highest number of uninsured, she said.

There is speculation that the influx of Medicaid patients may include low income individuals and families who had formerly been covered by commercial insurance through an employer. That migration away from insurance coverage to Medicaid further skews payer mixes toward the government program. While there has been no study to substantiate the claim, the shift in payer mix has led Currans and Herde to make the assumption that the phenomenon has occurred.

“It seems as though we’re seeing more Medicaid patients in our service areas than have been converted from the ranks of the uninsured,” Herde said.

Bad Debt

In a KHA report to the CHFS earlier in 2015, uncompensated care, or provided care for which no payment is received, showed a dramatic decline in rate through 2014. The influence of Kynect and Medicaid expansion is credited for reducing those charges that are usually left hanging on the balance sheet.

“The KHA’s mission is to work with hospitals and the state to ensure that Kentuckians get access to the care and coverage they need to be a healthier population,” Rust commented. To a significant extent, the direction health care has taken in the last year represent positive steps toward realizing that mission. Although uncompensated care has reached new lows, the incidence of bad debt to hospitals is actually on the rise.

The intent of the ACA is to make quality health care more affordable to a greater number of people, said Rust, but despite improvements, there still is an issue of under-insured individuals. These are people who opt for cheaper health insurance plans that also come with high deductibles. The issue is mainly concerned with families with lower incomes that are just above the level at which they would qualify for Medicaid.

“In general, there are two type of folks who buy high deductible insurance plans with cheaper premiums: Young people who imagine they’re in good health and don’t need expensive health coverage and those persons who simply can’t afford to pay the premiums of a high end insurance plan,” Herde said. “If that person or family can’t afford high premiums, then they’re not going to able to afford the high deductible either.”

Acknowledging that the rise in patient liability is a challenge to address, Secretary Haynes argued that the issue is not insurmountable and it’s better than what hospitals were enduring before.

“It’s a lot better for both the patient and hospital to try and work out a payment plan to cover a $5,000 deductible than writing off debts of over $100,000 in cases of injury or a catastrophic illness,” Haynes responded.

Rust agreed. “At least a portion of that debt is getting paid.”

But there are still individuals who have, for a variety of reasons, not yet signed on to an insurance plan or taken advantage of Medicaid eligibility.

“In any given month of the last two years, about 2-3 percent of our patients are still essentially self-pay,” Currans said. “We try to offer assistance to get them signed up through the exchange, but patients have to be proactive and ask for that help. So we still have a lingering problem with charges we write off because of our commitment and obligation to provide high quality care,” Currans said.

These are concerns with which Currans and Herde regularly deal when analyzing their respective organizations’ balance sheets. But they do it with the understanding that delivering and sustaining a high level of health care quality is their primary mission.

Changing Strategies for the future and controlling ER overuse

Nobody argues that the system is or ever will be perfect. Aside from the debate over the shift in payer mix, all agreed that there is still ground to cover in reducing the overuse of Emergency Rooms during off-hours.

Among the strategies being tested to address that issue include development of advance triage units to assess, prioritize, and treat critical cases; Baptist Health has opened several medical clinics and urgent treatment centers providing off-hour care to address non-emergent complaints; HMH is considering the same sort of clinic to open adjacent to its ER. The KentuckyOne Health System has introduced yet another potential solution called Anywhere Care which puts patients in touch with a physician or physician extender by video chat or phone for treatment of common ailments.

Looking toward the time when federal coverage of Medicaid costs is passed down to the state, everyone is adopting a wait and see attitude. For Currans and Herde, they expect that hospitals will, as always, be asked to maintain high levels quality care while managing further reductions in reimbursement.

Managing the demands of quality health care delivery will always requires major expenditures, Herde said. Baptist is currently financing multi-million dollar expansions and renovations of several facilities, implementing an updated computer networking system, keeping up with federal mandates on Electronic Health Records (EHRs), and changing its billing systems to ICD-10 coding which directly impacts hospital revenues. And that list doesn’t even include the purchase and maintenance of the latest clinical technology nor the salaries and benefits of staff and employed physicians.

“Looking to our future, and those of other healthcare systems in the state, there are a lot of headwinds,” he said.

“But this is part of our job as administrators – to manage expenses and make the best use of our revenues to maintain and improve high standards of quality healthcare delivery. I’m proud to be associated with an organization that does this job well,” Herde said. In the last two years, he said Baptist cut about $40 million on supplies, maintenance agreements, contracted services and other operations to run more efficiently.

But hospitals are motivated by greater things than just revenues, Rust said. They’re first priority is providing even higher standards of quality health care than today.

“We’re seeing hospitals changing their care settings to be more proactive around wellness,” Cobb observed. Rust added that small and large hospitals are also getting benefits from partnering even closer with health departments to reduce re-admissions through follow-ups.

Haynes acknowledges that there are challenges ahead, but that the direction that Kentucky health care has taken in the last year and half amount to more positives than negatives for the patient and the provider. “Hospitals are using this time to analyze their service delivery and business models to take advantage of ACA’s emphasis on improving population health rather than reactively treating illness,” Haynes said.

Furthermore, she believes that the program is capable of sustaining itself in the long run. Furthermore, staying the course in long term will have eventually result in a healthier Kentucky population and an active economic engine moving the Commonwealth’s health care enterprises forward.

“I think the CHFS is playing an important part in fostering the type of market competition among the state’s health systems that promote invention and innovation,” she said. “By expanding coverage, we are creating a buyer’s market and introducing more transparency in health care delivery.”

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Faced with teen’s disappointment, parents shocked to discover they don’t give a damn

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Faced with his son’s bitter disappointment Sunday night at having to wait one more day to get the latest Samsung at the T-Mobile shop, Dan Miller, 45, expected to feel a sense of impotence and self-recrimination for leaving his wallet at home.

What a surprise, then, when Dan discovered he really didn’t give a damn.

In fact, Dan found the tantrum his son, Darry, threw in the parking lot rather hilarious.

“I had no idea Darry could be that funny,” Miller chortled. “In hindsight, the timing could not have been better. The smart phone box was in his hand when I told him I’d forgotten my wallet. His face turned this shade of cherry red. With his blonde hair, his head looked like a big zit. And then he handed the box back to the clerk and started this shallow panting, almost like an asthmatic wheeze. It was just darling.”

In the parking lot, Darry apparently took it to a whole new level. He jammed his hands in his pockets and muttered something unintelligible under his breath. When his father asked “Ah honey, what’s a’matter?” in an intentionally patronizing tone, Darry snapped. He accused his father of leaving his wallet at home on purpose!

“It was so precious the way he said it. I knew right then I had to escalate this,” Miller commented. “I told him not to worry. We could stop at the Quick-E Mart and pick up a $10 Go-Phone.”

“I DON’T WANT A GO PHONE!” Darry screamed.

‘Idoughwannagophone!” Dan mocked, at which point Darry stamped his left foot, declared he never gets what he wants and his father doesn’t care. Sources close to the incident suggest Darry was right.

“In all my seven months, I’ve never seen anyone react like that,” said Sheila Reynolds, a service rep at T-Mobile who witnessed events from inside the store. “Just watching from the window, I could tell – Mr. Miller really didn’t give a fuck.”

Other witnesses confirmed Reynolds’ account.

“I was concerned at first. Then I saw it was that rude little shit, Darry Miller,” explained May Edwards, 74. “It’s hard to give a damn when it’s a kid like that. But Dan was amazing. The fuck that he didn’t give – it was infectious. It wasn’t long before we were in tears.”

Edwards, joining in, suggested Darry might be happier with cans on a string.

“Darry bolted to the car to sulk after that,” said Miller with an arm over his new friend’s shoulder.

The only thing that worried Dan was how Darry’s mother, Tonya, would take the news. After all, “it takes two to make an irredeemable putz,” he observed.

In a phone interview, Tonya admitted that her knee jerk reaction was to blame Dan for leaving his wallet. But seconds later, she realized she didn’t give a damn either. “All this time, I thought the point of buying your kids things was just to make others jealous. Who would have thought that raising such a selfish prick could be so entertaining? People say we throw the best parties these days.”

Several families in the community acknowledged that the Millers’ dinner parties are the place to be each weekend with Darry’s fits of anger a popular entertainment. The tirade at his 16th birthday party, when the Millers reneged on their promise of a car, is considered legendary.

When asked if this experience would change the way the Millers raise their four younger children, Dan was emphatic.

“Hell no. Where’d be the fun in that?!”

Easter weekend in Cynthiana is strange and surreal

Easter weekend in Cynthiana is strange and surreal

Until this past weekend, I would never have associated the Easter holiday with the strange and surreal. But if it keeps up the same pattern as last weekend, Halloween will be hard pressed to remain my favorite holiday.
Friday morning, I was driving on the Bourbon County side of Headquarters Road. It was obvious even then that the rain was going to cause flash flooding at least.
Water was already standing inches deep in pools along the roadsides and the natural drainage off the hillsides resembled nothing less than old creek beds.
In the meantime, I was getting thoroughly irritated by the two-ton truck tailgating me because, apparently, I wasn’t driving fast enough through deep, standing waters.
Thinking it would be a good idea to get some pictures for this week’s paper, I saw a potential image of creek water running through a barn along the side of the road. Though it was at the height of the pouring rain, I pulled into a nearby driveway, grabbed my camera and went to the side of the road.

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I noticed the Nicholas County school bus coming down the road. It’s the one that transports students to the Harrison Area Technology Center every morning.
I did not notice the pool — NOTE: not a puddle! — of water right in front of me. The school bus’ front tire sent a tsunami shooting high above my head.
It was like standing in front of a firing squad. I saw the wall of water coming and there was nothing I could do except take it, shrug, and get my picture.
Later on, as I’m drying off while covering heroin arrests at the Sheriff’s department, I listened with bemusement to a phone exchange between Sheriff Shain Stephens and family members of an accused drug trafficker who were apparently attempting to dictate the terms of their son’s surrender….

“Let me get this straight,” said Stephens. “You’re going to tell him to give himself up ….. To me? ….. Where.”

There was a slight pause.

“The intersection to Shadynook Road? No? Oh, you want me to come down Shadynook a few miles. ….. Alone. … No other cops…….

“How about this, you get your son and drive him here to the station and we won’t add running from police to our charges. ….. I am listening. …. Yes he did run from police …. Those are your demands?! ….  How about this, he comes in now or we find him later…. Yes we will. ….. I promise we will ….. Because he’s a heroin dealer!”

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Listening to that negotiation go its expected direction — Nowhere — I forgot all about my experience with the roadside tsunami until Saturday morning at The Frankie Taylor Community Easter Egg Hunt at Ingles Field.
One thing I have learned about kids — when they’re excited about an event, like, say, an Easter egg hunt, they’re as coiled to spring as an Olympic sprinter in the starting block.
Despite being an un-spring-like morning with slightly frigid temperatures, the intense anticipation of hundreds of children surrounding the different Easter egg hunt fields at the stadium generated its own kind of heat.
By 11 a.m., the scheduled start time for the hunt, the kids were looking for any sign, any excuse, to pounce on those eggs.
I saw Leroy Conner walking out to the center of the field with every good intention of arranging an exciting, but orderly, start to the Easter egg hunt.

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Lacking a sound system or a bullhorn, Conner raised his arm for attention and that was enough to prove a basic law of physics: Kinetic energy, once released, cannot be stopped.
Once the first few kids launched themselves into the field, the only thing Mr. Conner could do was stand still and let the inevitable tide of children run by him.
I understood a little about how he felt.
But let me tell you, the Kentucky Derby bills itself as the fastest two minutes in sports. Pah! I say.
The Derby has nothing on the Frankie Taylor Easter Egg Hunt. That field of 10,000 eggs was picked clean in less than 60 seconds.
If only there was a way to apply this method to cleaning their room, I heard more than one parent say.
Afterward, on what became a cloudless and warm spring day with deep blue skies, I took pictures of rising flood waters in the west end of town.

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After all that, the spectacle of Kentucky losing to Wisconsin, painful as it was, barely registered as a footnote for such a strange series of Easter weekend events.

Recovering her wild rainbow

Recovering her wild rainbow

Kristin “Rainbow Dash” Grenier to hike 2,650 mile west coast trail

After months spent recovering from an extended bout with Lyme disease, Kristin “Rainbow Dash” Grenier has decided she needs to get out of the house and take a nice, long walk — of about 2,650 miles.
Grenier will spend the next four to five months hiking the Pacific Crest Trail (PCT). For those who are not familiar with the PCT, it is the west coast’s answer to the Appalachian Trail.

Rainbow Dash seated at her favorite perch on the Appalachian Trail. Photo courtesy of Kristin Grenier.
Rainbow Dash seated at her favorite perch on the Appalachian Trail.
Photo courtesy of Kristin Grenier.

The trail begins in the town of Campo on the border between Mexico and California and ends eight miles across the Canadian border at Manning Park.
It covers the entire length of California, Oregon and Washington and features about every kind of natural landscape imaginable.
The PCT skirts the western edge of the Mojave desert, then runs across the peaks of the Sierra Nevada mountain range. In Washington and Oregon, the path meanders around Crater Lake National Park and runs the Cascade range which contains some of the highest and most famous mountain peaks and active volcanoes in the United States, Grenier said.
While the features of this spectacular wilderness trail are enticing, few experienced hikers have completed the entire PCT. A few years ago it was estimated that more people had been to the top of Mount Everest than had traversed the PCT, she said.
“It has grown a lot in popularity in the last two years thanks to the book ‘Wild: From Lost to Found on the Pacific Crest Trail’  by author Cheryl Strayed, so that statistic is probably not true anymore. But there will still be plenty of sections where people, and cell phone signals, will be scarce,” she said.

Grenier has embarked on this ambitious journey in part to raise awareness of Lyme disease and to raise money in support of the International Lyme and Associated Diseases Society (ILADS). The society supports Lyme disease research and its appropriate treatment.
But the hike is also a highly personal one for the young scientist whose life and passions were sidelined for months due to a case of Lyme disease that went misdiagnosed for nearly 10 months.

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If one can pardon the cliche, the PCT is representative of Grenier’s determination to “get back in the saddle” after Lyme disease knocked her from it.
Grenier discovered a love for trail hiking around 2010 while she was living and working up in New Hampshire. As a researcher and Americorps volunteer stationed in the remote New England wilderness, there was not much to do with her free time except join friends for hiking excursions up and down the White Mountains.
Since getting hooked on trail hiking, she has adopted a trail name, Rainbow Dash, and embarked on ever more ambitious hikes. In 2012, before being sidelined with Lyme Disease, she took several months to travel the length of the Appalachian Trail.
Ironically, she believes it was during a brief section hike in Pennsylvania, apart from her full trail hike, that she was bitten by the tick that infected her with Lyme disease.
She didn’t realize it at the time. The only thing she knew is that she just started to exhibit a number of generalized symptoms of an illness that wouldn’t go away. The most prominent side effect was an alarming lack of energy. She suffered from arthritic muscle aches and general body soreness. However, providers were diagnosing other illnesses unrelated to Lyme disease and the treatments were doing no good.
“I didn’t have the textbook symptoms of the disease. I knew I’d been bitten by a tick, but there wasn’t the ‘tell-tale’ red bulls-eye rash that followed,” Grenier said.
She didn’t respond to treatments and her condition grew steadily worse. At her lowest times, Kristin suffered “brain fog” where she became forgetful and erratic in her behavior. She would lose anywhere from 14 – 20 hours of her life at a time.
“I didn’t understand at all what was going on with me,” she said. “I was just scared.”
A fact that she learned after she was correctly diagnosed is that “Lyme is known as the ‘great imitator.’”
According to the ILADS web site, a patient with Lyme might wind up being tested for anything from Lupus to MS to Fibromyalgia. Hundreds of symptoms have been attributed to Lyme disease.
Ticks that carry the disease are mostly deer ticks and incidence rates for Lyme disease are higher in the New England area and around the north central section of the United States around Minnesota and Wisconsin.
But there are risks of contracting the disease in Kentucky and throughout most of the United States, she said.
Grenier’s condition was finally diagnosed in Cynthiana by Dr. Greg Cooper and Crista Crowdy, PA, of Family Care Associates. When tests came back positive for Lyme, she was treated with two months of antibiotic therapy last year and another two months of antibiotics this year.
Thankfully, she has finally begun responding to the treatment. After spending such a long time with the illness, though, Grenier suffers setbacks from time to time.
Even now, she has moments where the bacterial infection asserts itself, Grenier said.
But rather than scaring her from the wilderness, the disease is likely to discover that it has a new enemy in Grenier.
Not only has she planned to return to her love of hiking, but she is using this excursion to gather sponsors and raise money to combat the disease.
She has so far raised over $1,500 in pledges and is open to accept more.
Many of her sponsors are pledging just a penny a mile for an overall contribution of $26.50. But every one of those pennies adds up, she said.
In a touching coda to her travel, Kristin was contacted by a Vermont woman who shared Grenier’s love of wilderness trail hiking. At 30-years-old, the woman contracted Lyme disease and went undiagnosed for 30 years, Grenier said.
When she finally got the treatment she needed, time had got past her. Lyme disease had robbed this woman of something she dearly loved.
If it is at all possible, Grenier said that the woman hopes to join her for the final leg of the journey into Canada.
“I hope that comes to pass,” Grenier said with earnest. “It would be so important.”
Awareness of Lyme disease got a celebrity boost recently from the revelations of pop singer Avril Lavigne, who was recently diagnosed and treated for the disease last year.
That has been a boost to Grenier’s cause and drawn focus to her goal to walk the PCT. She will be keeping regular updates of her progress on Facebook  and on her blog: livinghighonlife.com.
She will be glad to accept further pledges of support throughout the summer. While keeping up with her progress, don’t look for Kristin Grenier. Look for her trail name: Rainbow Dash.

Get with it and move on: A desegregation story

Before Bonita Watson agreed to be interviewed about her memories of leaving the all-black Banneker School for Cynthiana High School in 1957, she issued a blanket disclaimer.
<div class="source">Josh Shepherd</div><div class="image-desc">Bonita Watson</div><div class="buy-pic"><a href="http://web2.lcni5.com/cgi-bin/c2newbuyphoto.cgi?pub=081&amp;orig=bonita_watson_2703.jpg" target="_new">Buy this photo</a></div>

“It’s been over 50 years since I was in high school. I’m getting on toward 70 now. If I get anything wrong, you just keep that in mind,” she said, smiling and settling into a low seat at the Charles Feix Annex, the temporary home of the Cynthiana-Harrison County Public Library in Kentucky.

She came bearing a program for the only Banneker School reunion ever held. It was in 1988 and she was one of its organizers.

She also brought along her keepsake history of the Cynthiana High School. She leafed through the pages to her graduation year in 1959. In her lifetime, Watson has been witness to the closure of two high schools, both of which are clearly very dear to her heart.

In the spring of 1957, Watson was a freshman at the Banneker School. In the fall, she enrolled as a sophomore at Cynthiana High School just off of Bridge Street overlooking downtown.

She was among the first generation of black students in Harrison County to be integrated with the city school. At the same time, of course, the black county students began attending Harrison County High School.

Over 50 years removed from the event, a discussion of school desegregation naturally conjures up images of the civil rights movement, of protests and resistance and racial violence.

Watson admits to feeling apprehensive in those first few weeks at Cynthiana High School, but there weren’t marches and police lines in Harrison County. It was just kids walking to school.

“I was leaving what I knew. Of course I was nervous. It was a new school with a lot of people I didn’t know very well,” Watson said.

But she also pointed out that she was a teenager in a small Kentucky town. Watson’s concerns were teenager concerns. She was only vaguely aware of the “big picture” politics that surrounded the issue of school desegregation.

The most significant thing she knew was that she would no longer be going to Banneker School. If she was going to go to school — and her parents didn’t give her much choice in that matter, Watson joked — she would be walking across town and up Bridge Street hill to Cynthiana High School.

But this is where the narrative departs from the typical images one has of desegregation. As many point out who also experienced the closure of the Banneker School and the subsequent integration of the Harrison County and Cynthiana schools, there wasn’t much in the way of resistance or protest at the local level.

“One thing that helped is that Cynthiana is a small town. We all knew each other,” Watson said.

However, Watson wasn’t naive either.

“Sports had a lot to do with speeding up integration around here. Banneker School had a lot of good athletes,” Watson said. “Football and basketball was a big key.”

She points to pictures of Sammy Custard, Kenny Page, Baldwin David and Donald Holland in the two classes ahead of her. “They were some of the athletes,” she said, then added in a softer tone. “Most of them are gone now.”

But when thinking about the significant difference between Banneker School and Cynthiana High, Watson touches on something a bit unexpected.

The Banneker School catered to all grades – elementary, middle and high school. The school was not composed just of students from the west side of Cynthiana and in sections of Harrison County. Kids from Pendleton County attended the Banneker School as well.

“You have to remember that there weren’t that many schools for the black population,” she said. “When my father [Jesse Watson] went to school, he couldn’t even graduate in Harrison County. He had to get up early every morning and drive to Western High School in Bourbon County.”

But for her, the Banneker School was just a natural extension of her immediate neighborhood.

Most of her teachers were also her neighbors and fellow church members. And in those days, she said, their authority did not end when the Banneker school bell rang at the end of the day. Nor did it end just because you were no longer a student in their class, she said.

Watson hesitates about naming just one teacher, because they were all good and had an influence on her life. But the first teacher to come to mind was Miss J.T. Gaddie.

Miss J.T. taught grades 1 – 3 and in addition to lessons in reading and math, she had expectations that kids learned manners and what they could say and what they couldn’t say.

If kids smarted off or misbehaved, the parents were called to talk about the problem.

“Anyone who knew her will tell you, it didn’t matter if it was in class or in public Miss J. T. would correct you if you were doing wrong,” Watson laughed. “That was true of a lot of teachers, but especially her. But you know, we could use a few more Miss J.T.s in the world today.”

Watson also mentioned Mary Bryant, the home economics teacher who taught everyday life skills to their kids. And Mary Ann Adams, who may be one of the last living members of the Banneker School faculty.

Having kids from every class in the same school was a bit different from going to Cynthiana High where it was just the older kids.

But even though there was a change in school, the sense of community and of belonging continued.

Even now, she identifies herself closely with the Cynthiana High class of 1959.

“We have always been a tight class. We have reunion events every year,” she said.

When studying the history of school integration in Kentucky and the rest of the country, it is easy to appreciate just how big a change it was and the upheaval that came in areas of the country as a result.

But it was something a bit different for Watson, at least, who was right in the middle of it.

“I’m sure that there was some planning behind the scenes and there were people who were scared about what might happen,” Watson said. “But speaking for me, it was just something I had to go right on and just do.  No one asked us. We just had to get with it and move on.”

Nobody calls Kentucky Christians wimps … least of all New Jersey.

I was confused last week when the Letter to the Editor below arrived at the Cynthiana Democrat. It was critical of our Kentucky legislators and admonished Kentucky Christians for not reacting at the state’s refusal to grant tax incentives to a development group that wanted to only hire professed Christians at their tourist site.

To the editor:

Where are the Christians? How come they are sitting by watching the Kentucky legislators renege on their rebate incentive program offered by the state’s tourism office with Answers in Genesis’ theme park, the Ark Encounter.
If AIG doesn’t get thrown out of this agreement with Kentucky, then they are required to hire atheists and all sorts of non-Christians to work at their theme park. That’s like hiring an atheist as your head pastor.
What’s wrong with you Christians in Kentucky? That wouldn’t even fly in New Jersey. There would be a flood of people in the streets before we would let that happen. AIG wouldn’t be able to give the Gospel at the Ark theme park  either.
What’s wrong with your Kentucky legislators? Don’t you know that AIG is a Christian organization? What do they expect?
You Kentucky Christians are looking like wimps. Stand up for yourselves. Get out there and demand that your legislators do what’s right instead of bowing to pressure by atheist groups outside your state.
We here at the Creation Science Hall of Fame are hoping that we could construct our building somewhere between the Ark Encounter and the Creation Museum. Just think of the revenue these projects will bring to the state of Kentucky. Your gas stations, lodging, stores and restaurants would be booming  with tourists.
Get with it, Kentucky. Do what is right and don’t be afraid  to give an answer for your beliefs in our Lord.

Nick Lally, Chairman,
Board of Directors
Creation Science Hall of Fame
Tranquility, NJ

Thank God for you, Nick Lally, Chair of the Board of Directors of the Creation Science Hall of Fame in Tranquility, New Jersey, for showing me the tough, no-nonsense side of my brother New Jersey Christians.

For those readers who are not aware, the Answers in Genesis (AIG) group, which is responsible for the Creation Museum in Erlanger, Kentucky, is breaking ground on a new tourist attraction, the ARK project, which will be a representation of Noah’s Ark. The ARK project will be a little closer in design to a Disney-influenced amusement park. However, the installation, located about 10 miles south of the museum in neighboring Grant County, will also be an extension of the world view represented by the Creation Museum. The organization also has developed a hiring practice of asking potential employees to not only be Christian, but also to accept their cosmological view of the beginnings of our Universe to the rejection of rival theories of evolution and other heresies.

Now, I was aware of the decision by the Kentucky Tourism, Arts and Heritage Cabinet to turn down a tax rebate application from the Answers in Genesis (AIG) group for their multi-million dollar ARK project in Grant County because the organization was using discriminatory hiring practices and it was espousing ideas that ran counter to the separation of state and church.

I was also aware of the highly coordinated outcry and protests from AIG when their application was denied.
One wonders how much AIG spent on the billboard advertising alone. I find it quite an odd reaction from a group so concerned about losing money when the cabinet’s decision just cost them an estimated $18 million in tax incentive money, according to the news coverage from the Courier Journal.

But this letter wasn’t from the AIG.
It was from the Creation Science Hall of Fame?
Who are these guys?

Well, I haven’t had much time to do any deep digging on the group. But it wasn’t hard to come up with one fact that sheds light on the keen interest the Hall of Fame had in AIG qualifying for a tourism cabinet tax incentive.
The following is from their website: www.creationsciencehalloffame.org.
“We will build the Hall of Fame as a brick-and-mortar structure in northern Kentucky, between Answers in Genesis’ Creation Museum and the new Ark Encounter park.
We also expect all creationists to support this project collectively and with neither bias nor regard to politics or past disagreements.”
Such erudition on the website is quite a contrast from the tone of the letter from the Hall of Fame’s board of directors’ chair.
In response to the reasonable expectation that qualifying for state tax incentives require non-discriminatory hiring practices, Lally writes, “…They [AIG] are required to hire atheists and all sorts of non-Christians to work at their theme park….What’s wrong with you Christians in Kentucky? That wouldn’t even fly in New Jersey … You Kentucky Christians are looking like wimps…”
Lally’s tone sounds, to my ear at least, like some ridiculously cheesy New Jersey goombah stereotype — which is not helped by the fact that New Jersey’s governor is none other than good old fence-riding Chris Christie.
Of course, Lally is attempting to raise the hackles of a particular brand of Kentucky Christian: those that subscribe to the organization’s purported philosophy and world view.
Since this is also a non-profit company that’s looking to piggy-back their planned tourist attraction onto AIG’s Northern Kentucky Creation Science wonderland, I am naturally skeptical of the purity of their faith.
But that’s the journalist in me.
As the letter is addressed to Kentucky Christians in general, and since I consider myself an ardent member of that group, I am moved to respond to Mr. Lally’s challenge.
It should be noted, however, that I do not entirely subscribe to the world view that the Creation Science Museum champions.
Nor am I much bothered by it either.
My faith is based on being raised from infancy in the United Methodist Church, on a critical study of the Bible’s Old and New Testament teaching (NIV and King James versions, mostly) and a personal relationship that I have developed with Jesus Christ and God.
It has nothing to do with anyone else’s relationship with the Almighty and it certainly doesn’t extend toward helping a private developer earn millions in tax incentives while engaging in practices that run counter to state and federal laws regarding discrimination.
Why worry about hiring atheists anyway?
If the Christian mandate is to win new souls to Christ, would not the act of exposing doubters to the tenets of our faith not increase the likelihood of a conversion?
It’s been known to happen in my neck of the woods, Mr. Lally.
Personally, I think the greater act of a wimp is one who prefers preaching to the choir than to the unconverted. I won’t even mention profiting from it and claiming income tax exemptions based on religious grounds.

Or maybe I just did.
This Kentucky Christian does not fear atheists and I have serious doubts that they’re likely to take over the world any time soon. Although, with the major Abraham-based religions at each other’s throats almost constantly, they could probably win the globe by attrition alone.
But with regard to the point of view expressed in the letter last week, I have but one concern. It has been my experience that the act of demonizing a group of people in order to get a tax break is, in itself, the act of a demon.

Signing to the Angels: Artist’s first book is memoir of foster child born blind and deaf

Signing to the Angels: Artist’s first book is memoir of foster child born blind and deaf

When foster parents accept the challenge of caring for a child born blind and deaf, they hope to change that child’s life for the better. They don’t realize, or even expect, that the child has something vital to teach them and others with whom the child comes in contact.

Shelly was just such a child. 

Shelly and Claire signing
Claire Muller signing with her foster daughter, Shelly. With her daughter being blind and deaf from infancy, the two spent a great deal of time in direct physical contact with each other to communicate. Shelly is the subject of Muller’s first published book, “Signing to the Angels.”

Her life made such a profound impact on her permanent foster parents, Claire and Tom Muller, that she inspired the publication of Claire Muller’s first book, “Signing to the Angels.”

The book, released last month by Dancing With Bear Publishing, is a personal memoir of Shelly’s life as a member of the Muller family.

In 2009, at age 23, Shelly’s body finally succumbed to the complications of her medical condition, Muller said. 

“Signing with the Angels” chronicles the two decades in which her adopted daughter grew up. In that time, Muller said, Shelly’s mere existence demonstrated what it means to live a life “fully in the moment,” taking joy in the “pure value” of her life’s experience interacting with the world.

She entered the lives of Claire and Tom Muller when she was nearly 3 years old.

The Muller’s are experienced foster parents. They have often made their home a haven for children and teens who are surviving and coping with life’s worst abuses.

The family are glad to provide a shelter for these kids until they can be placed in stable homes with families that will, hopefully, help them build a life beyond a nightmare existence.

But in addition to offering foster services for children who are physically healthy, the Mullers have also taken in foster children who are medically fragile. 

The children cope with a range of birth defects from Down’s Syndrome to heart problems to developmental disabilities like “Microcephaly,” Claire Muller explains in the book’s first chapter.

Once in awhile, the Muller’s  adopt them as a permanent part of their home, she said.

“We hear about these children and the challenges they have to face. It’s natural to wonder how God in all his infinite power could allow such things to happen,” Muller said. “Then along comes a child like Shelly and you realize that God blessed this Earth with her and others like her.”

 Shelly was born blind at the Children’s Hospital in Columbus, Ohio, the result of a birth defect in her digestive system. 

“Shelly’s gut was unable to absorb the calories and nutrients. Food and drink passed through her with very little of the nutrition absorbed,” Muller said.

The easiest way to explain Shelly’s blindness is that her body expended so much effort compensating for the defect while in the womb that the child was born without a developed optic nerve, Muller explained. 

But that was just the beginning of Shelly’s medical problems. She also developed a respiratory ailment that forced doctors into a treatment with the unfortunate side effect of stealing the child’s hearing.

“The doctors had no choice. To keep her breathing, they had to use medicine that took her hearing,” Muller said.

The result is that Shelly lacked the sense of sight and hearing from a very early age.

“In terms of being blind and deaf, Shelly was like Helen Keller. She never had a chance to experience the world in the way most children did,” Muller said. “But Shelly also had continuing problems being able to digest food. She was never able to eat and drink normally.”

The Mullers were contacted by a social worker when Shelly was just past 2 years old. The couple agreed to be Shelly’s foster parents. It was not long afterward that the Mullers adopted Shelly permanently.

“I am blessed to have a husband who never questions the children we foster parent. We both simply accepted Shelly in with our other kids,” Muller said.

From the beginning, it was clear that despite her physical ailments Shelly was intelligent and capable of learning, Muller said.

They brought in specialists to teach Shelly sign language and an “intervener” who taught the child the skills blind and deaf people need to orient themselves to place and successfully move about. They teach cane skills and how to navigate a room without sight or hearing, she said.

“One thing I learned is that there are great job opportunities for people to work with blind and deaf persons. It is a unique specialty and a rare field. There is a demand for the skills and the specialists get paid well for their services,” Muller commented.

But as Shelly grew, Claire became fascinated with how her adopted daughter interacted with the world. Being blind and deaf all her life, she did not develop the ordinary fears that most children learn growing up.

“She would explore in the yard, enjoying the warmth of the sun and feeling everything around her. If there was a snake nearby, Shelly wouldn’t react because she wouldn’t be aware of it. And even if she were aware, if it brushed by her, Shelly would be delighted by the sensation,” Muller said.

She and Shelly made frequent flights on a small plane to Columbus to visit specialists. Shelly loved the take-off and she was delighted if there was turbulence, Muller said.

“Shelly loved the sensory experience of the plane’s movement. She had no concern about what these sensations might mean.  Watching her, it made me begin to look differently at the world,” Muller said.

This lesson was not something Shelly only taught to her adopted mother. Her family, and others who came to know Shelly, often observed the pure joy the child took from the simple act of living in this world.

It was not always that way. Shelly’s condition gave her moments of sickness and sadness, Muller said. Her doctors wrestled with the complex challenges that her birth defect presented throughout her life. Shelly pushed them professionally. Eventually, however, the problems became insurmountable, Muller said.

The book, however, is not a tragedy. It is spiritual and meant to be as uplifting as Shelly was to her family and friends, Muller said.

“Signing to the Angels” is a celebration of a person’s life that was far too brief, but managed to be full of a grace one often associates with angels, Muller said.

“Signing to the Angels” is available direct from Dancing with Bear publishing at www.dancingwithbearpublishing.com. It can also be bought through most of the usual book selling websites such as Amazon and Barnes and Noble.

Muller_bookcover

All proceeds from the sale of the book  will support Valley of Baca Missionary Retreat, an organization the Mullers founded to assist Christian missionaries on their visits to the United States.

 For more information on this service, visit www.valleyofbaca.org.