Kentucky Doc Summer 2015 | Seite 7

doc Summer 2015 • Kentucky lution, wells, sewage systems and inspections of food and health facilities fall. In the second are disaster preparedness and response, housing support and food assistance for families. In the third are included specific health screenings, vaccination programs, contagious infectious disease monitoring, family planning services and the HANDS program providing guidance and care for families with prenatal needs up to two year olds. New pressures on the community health system have included marked increases in HIV and Hepatitis C as evidenced in rural Indiana and attributed to shared needles in IV drug users. This was addressed in Kentucky with Senate Bill 192 funding needle exchange and now awaiting local approvals. As with much of medicine there has been a major shift in financing in public health. Mr. Lockard has noted 13 recent budget cuts and with the Affordable Care Act has seen further cuts in federal funds. To make up deficits local health taxes have been increased. Specific services are now being billed directly to Medicare, Medicaid, VA and to private insurances. Also more private and federal grants are being sought. 7