Shallow Pool

Looking at the new Executive Director of the Kentucky Retirement Systems (KRS) a few more thoughts come to mind.

From the Frankfort State Journal:

Mike Burnside, the new executive director of the Kentucky Retirement Systems, plans to hit the ground running when he starts work on Jan. 3.

"I think there's going to be a steep learning curve," he told The State Journal.

Well I’ll give him this at least he's honest about being totally unqualified.

However, honesty seems to be absent in the KRS Board Chairman’s statement.

Randy Overstreet, chairman of the KRS board of trustees, said Burnside has the right experience to lead KRS. "His knowledge of the legislative process and established relationships with the legislature will be invaluable," Overstreet said. However, Burnside is an unknown quantity with local lawmakers. Rep. Derrick Graham, D-Frankfort; Rep. Carl Rollins, D-Midway; and Sen. Julian Carroll, D-Frankfort, all said they were unable to comment on the decision to hire him. None of them could ever recall meeting or talking to Burnside.

Since the decision to hire Burnside was unanimous, (over 3 other apparently more qualified candidates), this feels like a done deal. Mark Hebert asks the valid a valid question on his blog.

It's probably a fair question to ask Burnside if his votes, or lack of votes, had anything to do with his pursuit of the Kentucky Retirement System's top job, which is expected to pay more than $200,000.

All signs point to Bill Hanes not giving up power. The relatively low $157,000 compared to Hanes $235,000, puts Burnside in the same basic salary range as Chief Operating Officer Thielan, Chief Investment Officer Tosh, Chief Benefits Officer (and close personal friend) Geri Miller, and legal counsel Eric Wampler. All four of these owe their positions and allegiance to Hanes.

Hanes will most likely officially work for Robert Klausner or some other vendor for a six figure salary and KRS will pay significantly more to that vendor in fees. With Burnside one of five top officers, it will give the appearance of new leadership, while Hanes still calls the shots behind the scenes.

KRS justified paying Hudepohl this way from their press release.

Hudepohl recommended a well-qualified pool of four candidates from the national market and we are fortunate to have hired such an experienced ‘Kentuckian’ to lead the KRS organization,” Overstreet said. Overstreet said the Board is very pleased with Hudepohl’s management of the search. “The search for a new executive director was extensive and far-reaching, receiving applications from 17 states.”

If everyone else was less qualified than Burnside then the talent level in this pool was pretty shallow.

Moments of Introspection

Every person comes to those moments in life when you need to do a little introspection. There is nothing like a good public butt kicking to trigger that moment of introspection. I know Stan Lee kicked my butt when I ran against him and Jack Conway gave Stan the worst whipping, of any legitimate candidate (Jack Conway 612,689 to Stan Lee 399,603) in any race in the last general election.

So watching from the outside, I think Stan Lee might be having one of those introspective moments. So far Stan has prefiled one bill for the 2008 General Assembly.

BR 157 - Representative Stan Lee (12/13/07)
AN ACT relating to torture of a dog or cat. Amend KRS 525.135 relating to torture of a dog or cat to increase the penalty for a first offense to a Class D felony; provision to name the bill, "Romeo's Law."

Now, I know this is going to sound strange to those of you who have read this blog, but I agree with Stan on this one. Occasionally he gets one right.

Stan appears to be adopting a low profile for this session. I wonder if he is just licking his wounds and will reemerge spouting his right wing-nut philosophy or is this, the beginning of a more moderate Stan Lee. A more moderate Stan Lee might actually get elected to higher office.

Electronic Health Record Systems

How do you start to lower the costs of medical care?

If you have ever had to deal with any insurance company and a group of medical providers you know they have about 10 different forms for everything and they don’t really like talking to each other. So here is a simple concept let’s all speak the same language.

Everyone in the medical professions must use the same method of record keeping. This includes all doctors, hospitals, clinics, pharmacies, government agencies, universities, insurance companies and employers. Now to really work well this should be national, but let’s just talk about Kentucky.

There needs to be a mandated uniform electronic health record system (EHR) in Kentucky. The biggest single, and currently growing, EHR system is used by the Veteran’s Administration. This works.

What is the up side?

The actual benefits can be summarized as follows:

EHR Systems

• It is estimated that over 5 years, EHR benefits will be $86,400 per provider and the benefits will be accrued by several stakeholders such as physician practices, ancillary services, pharmacies and most importantly patients
• Ohio State University Health System reduced the time for getting medication to patients by 65 percent from 5.28 hours to 1.51 hours. They also reduced Radiology turnaround from 7.37 hours to 4.21 hours
• Maimonides Medical Center reported 30.4 percent reduction in average length of stay from 7.26 to 5.05 days. They also realized organizational efficiencies by preventing duplicate ancillary tests
• Heritage Behavioral Health experienced 70 percent reduction in cost of clinical documentation with EHR
• University of Illinois at Chicago Medical Center gained significant benefits in reallocation of nursing time from manual documentation to direct care - estimated to be $1.2 million

e-Prescriptions

• Many errors occur because of handwritten prescriptions that can be easily misunderstood and can result in adverse drug events or complications. More than 3 billion prescriptions are written annually and according to an eHI report, medication errors account for 1 out 131 ambulatory care deaths and many deaths in acute care are also attributed to medication error.
• Studies indicate that the national savings from universal adoption could be as high as $27 billion annually

Computerized Provider Order Entry (CPOE)

• The Center for Information Technology Leadership (CITL) estimates that implementing advanced ambulatory CPOE systems would eliminate over 2 million drug events per year; avoid nearly 13 million physician visits, 190,000 admissions and over 130,000 life-threatening adverse drug events per year and save $44 billion per year.
• Brigham and Women's Hospital in Boston reported 55 percent reduction in serious medication errors and 17 percent reduction in preventable Adverse Drug Events (ADE) - average cost of an ADE was $2,595, resulting in projected savings of $480,000 per year. They estimated net savings from $5 million to $10 million per year.
• Maimonides Medical Center in New York realized 55 percent decrease in medication discrepancies and 58 percent reduction in problem medication orders. They also eliminated pharmacy transcription errors.
• Children's Hospital of Pittsburg has eradicated handwriting transcription errors completely and cut harmful medication errors by 75 percent.
  
  Will this be easy to do?
  
  No, there will be a lot of foot dragging, complaining, ego problems from the medical profession and actual computer glitches that would slow the implementation of such a system. But the real impediments to do this are greedy health providers and their lobbyists and the severe lack of a spine in most of our state legislators.

Saw Dust and Art Supplies

According to the Herald Leader the piggy bank in Frankfort is empty.

Gov. Steve Beshear issued a dire warning Thursday about the state's budget; saying Kentucky's "financial house is in serious disarray."

"Merely saying that information still coming to us is alarming would be an understatement," Beshear said in a statement.

While you have to blame Ernie Fletcher with a large part of this problem, a major contributing factor to the bank being empty has been the legislature’s inability to structure a comprehensive revenue package. They seem to be contented to handing out tax breaks, like a break on selling saw dust (how has the Commonwealth survived without that).

There are also those that adopt the Chicken Little approach and sign the no new tax pledge. A list of these brave legislators is at the bottom of this post.

Here is some of the current proposed tax break legislation for the next session.

BR 498 - Representative Joseph M. Fischer (12/13/07)
AN ACT relating to sales and use tax on delivery charges. Amend KRS 139.050 to exempt delivery charges from sales and use tax; EFFECTIVE August 1, 2008.

BR 142 - Representative Jim Glenn (11/29/07)
AN ACT relating to sales and use tax holidays and declaring an emergency. Create a new section of KRS Chapter 139 to provide a sales tax holiday for the first week in August each year to exempt school supplies, school art supplies, and clothing with a sales price of less than $100 per item; EFFECTIVE May 1, 2008

BR 461 - Representative Tommy Thompson (12/14/07)
AN ACT relating to sales and use tax. Amend KRS 139.495 to exempt sales by churches for charitable fundraising events from sales and use taxes; amend 139.496 to comply; EFFECTIVE August 1, 2008.

BR 114 - Representative Tanya Pullin, Representative Eddie Ballard, Representative Sheldon E. Baugh, Representative Larry Belcher, Representative Larry Clark, Representative Leslie Combs, Representative Jim DeCesare, Representative C. B. Embry Jr, Representative Tim Firkins, Representative Melvin B. Henley, Representative Tom McKee, Representative Charles Miller, Representative Russ Mobley, Representative Fred Nesler, Representative Steve Riggs, Representative Carl Rollins II, Representative Sal Santoro, Representative Charles Siler, Representative Dottie Sims, Representative Tommy Thompson, Representative Robin L. Webb, Representative Ron Weston, Representative Addia Wuchner, Representative Brent Yonts (08/24/07)
AN ACT relating to income tax credits for small businesses. Create new sections of KRS Chapters 141 and 154 and amend KRS 141.0205 to establish a small business tax credit.

BR 876 - Representative Mike Denham (11/30/07)
AN ACT relating to sales and use tax. Amend KRS 139.480 to exempt straw, wood shavings, and sawdust from the sales and use tax when used in agricultural or equine pursuits; EFFECTIVE August 1, 2008.

BR 466 - Representative Robert R. Damron (12/10/07)
AN ACT relating to sales and use tax holidays and declaring an emergency. Create a new section of KRS Chapter 139 to exempt the sale or purchase of clothing with a sales price of less than one hundred fifty dollars ($150) per item, computers and computer supplies with a sales price of less than one thousand five hundred dollars ($1,500) per item, and school supplies; define terms; outline procedures; amend KRS 139.210, 139.220, and l39.340 to allow retailers to absorb the tax on other items sold during the sales tax holiday and advertise accordingly; EMERGENCY; EFFECTIVE MAY 1, 2008.

There is one bill on taxes that I do like. The bill comes from Jim DeCesare, once again proving that even a blind and sometimes bigoted hog finds an acorn.

BR 393 - Representative Jim DeCesare (12/05/07)
AN ACT relating to accounting for the expenditure of state funds. Create new sections of KRS Chapter 42 to require the Finance and Administration Cabinet to create a searchable Web site to provide certain information on the expenditure of state funds; provide that the new sections shall be known as the "Taxpayer Transparency Act of 2008."

Of the bill listed above, guess which one has the least chance of passing.

No new tax pledge signers as of Thursday, September 13, 2007, 2:28 PM from Americans for Tax Reform.

16 Senators of 38 (42%)
Walter Blevins (S-27)
Charlie Borders (S-18)
Tom Buford (S-22)
Julie Rose Denton (S-36)
Carroll Gibson (S-5)
Brett Guthrie (S-32)
Ernie Harris (S-26)
Dan Kelly (S-14)
Vernie McGaha (S-15)
Richard Roeding (S-11)
Richard Sanders (S-9)
Katie Kratz Stine (S-24)
Robert Stivers (S-25)
Gary Tapp (S-20)
Elizabeth Tori (S-10)
Jack Westwood (S-23)
27 House members of 100 (27%)
Royce Adams (H-61)
Sheldon Baugh (H-16)
Kevin Bratcher (H-29)
James Comer (H-53)
Tim Couch (H-90)
Ron Crimm (H-33)
Robert Damron (H-39)
Jim DeCesare (H-21) - Taxpayer Protection Caucus Chair
Bob DeWeese (H-48)
C.B. Embry, Jr. (H-17)
Joseph Fischer (H-68)
Danny Ford (H-80)
Jim Gooch (H-12)
W. Keith Hall (H-93)
Melvin B. Henley (H-5)
Jimmy Higdon (H-24)
Jeff Hoover (H-83)
Thomas Kerr (H-64)
Stan Lee (H-45)
Russ Mobley (H-51)
Brad Montell (H-58)
Lonnie Napier (H-36)
Marie Rader (H-89)
James Stewart III (H-86)
Tommy Turner (H-85)
Ken Upchurch (H-52)
John Vincent (H-100)