2019

August

PUBLISHED BY LEGISLATIVE RESEARCH COMMISSION Volume 32, No. 5 LEGISLATURE.KY.GOV/LEGISLATION/PAGES/DEFAULT.ASPX Legislators Ag financing finds new hear how niche in KY, lawmakers told state landed by Rebecca Hanchett LRC Public Information airfreight hub FRANKFORT – Funding can hardly keep up with demand for a new niche of state- by Jim Hannah supported farm loans available in over 50 LRC Public Information Kentucky Appalachian counties. “They tell me they’re out of money again, HEBRON – Cincinnati/Northern Kentucky which is a really good thing,” Governor’s International Airport officials briefed a group Office of Agricultural Policy Executive of state legislators on July 19 on road improve- Director Warren Beeler told the Tobacco ments needed to support a $1.5 billion freight Settlement Agreement Fund Oversight hub Amazon is building at the airfield. Committee on Aug. 14 about the SOAR “While the predominance of package (Shaping Our Appalachian Region) Farm movement will be plane to plane, there is also Loans offered in Kentucky’s 54 Appalachian a need to expand road infrastructure,” airport Regional Commission (ARC) counties in CEO Candace McGraw said during the meeting partnership with London-based Kentucky of the Interim Joint Committee on Transporta- Highlands Investment Corporation. Rep. , R-Harrodsburg, comments on Kentucky’ tion. Beeler said nearly $1 million in state agricultural programs at the Aug. 14 meeting of the To- In response to a question from committee tobacco settlement money has been invested bacco Settlement Agreement Fund Oversight Commit- co-chair Sen. Ernie Harris, R-Prospect, Mc- in 141 of the four-year loans, each offered at a tee. Graw named a series of roads surrounding the maximum of $7,500 and 1-percent fixed rate soon as it comes back in we lend it out. One airport that need improving. She added that the of interest. hundred percent of the money goes to the 3 million-square-foot package sorting facility is About $750,000 in Kentucky Agricultural farmers.” projected to create 2,000 new jobs. Development Fund (KADF) money funneled Responding to questions about loan McGraw said Amazon officials told her into the SOAR loans has generated over $1 demand from Committee Co-Chair Rep. they selected the airport for the e-commerce million in loans to date, Kentucky Highlands , R-Pembroke, Hayes said there giant's first air hub because it had a great air- Program Director Michael Hayes told the are five or six applicants in queue who qualify field infrastructure that was well maintained, committee. He said the last round of loan for loans right now. highway infrastructure leading to it, a trained funds was received in April and completely Luckily, he said, more loan funding is aviation workforce and officials who moved at loaned out by June 30. making its way back into the program. the speed of business. “That $7,500 niche – there’s a pretty big demand out there for (that),” said Hayes. “As Continued on page 3 Continued on page 3

THE KENTUCKY GENERAL ASSEMBLY 1 Pension relief passed in special session by Rebecca Hanchett LRC Public Information

FRANKFORT—Five options for over 100 quasi-governmental agencies in Kentucky to get a handle on their rising pension costs have been passed by the Kentucky General Assem- bly in a five-day special session. The options found in House Bill 1 would allow the state’s approximately 118 quasi-gov- ernmental agencies—including local health de- partments, regional state-supported universi- ties and community colleges, domestic violence shelters and others –to keep their employees in the Kentucky Employees Retirement Systems (KERS) nonhazardous plan at increased costs, or move all or a portion of their employees to an alternative retirement program. Agen- cies that leave KERS would have to pay their unfunded liabilities, which are earned but yet-unfunded benefits, in either a lump sum or in installments over 30 years. Senate Minority Floor Leader Morgan McGarvey, D-Louisville, speaks on public pensions in committee during the July The bill was approved on a 27-11 vote in special session while Senate Minority Caucus Chair Johnny Ray Turner, D-Prestonsburg, listens. the Senate on July 24 after passing the House by a vote of 52-46 on July 22. HB 1 sponsor Rep. James Tipton, R-Tay- history,” McDaniel said. Employees now in the KERS nonhazardous lorsville, said during House floor debate on HB The cost of implementing HB 1 is project- defined-benefit plan who are moved to a new 1 that Kentucky’s quasi-governmental agencies ed to potentially be $58.5 million in fiscal year plan would retain their earned benefits, but provide essential services that are at financial 2021 and $110.5 million in fiscal year 2022, would not be eligible for a defined-benefit plan risk without passage of the legislation. He said according to a fiscal note attached to HB 1. In- under HB 1. the KERS nonhazardous plan currently has cluded in the cost is the rate freeze, the employ- Tipton credited a 2015 law allowing certain only 12.9 percent of the funds it needs to pay er cost to leave the KERS plan, and continued quasi-governmental employers in KERS and future benefits. state General Fund appropriations of around CERS to be voluntarily or involuntarily re- “And, while legally these quasi entities $50.2 million per year. moved from the state pension system as the have a legal obligation to pay … we understand HB 1 would work by extending the one- basis for HB 1. That legislation, 2015 HB 62 the difficulties they have and the problems that year freeze on employer retirement contribution sponsored by then-State Rep. , might arise without passage of legislation that rates for quasi-governmental agencies in the D-Greenville, requires employers to pay their might provide them some relief,” Tipton told KERS non-hazardous plan into fiscal year 2019- unfunded liabilities to the system by lump sum the House. 2020 while giving agencies the choice to remain or installment. Sen. Christian McDaniel, R-Taylor Mill, in the KERS plan or to voluntarily leave the plan Unlike the 2015 law, HB 1 would not im- who is chair of the Senate Appropriations & as of that date. Agencies would have between pact CERS and includes some other differences. Revenue Committee, also spoke in support of April 1, 2020 and May 1, 2020 to file a resolu- House State Government Committee Chair the bill. tion stating their intention to stop participating Jerry Miller, R-Louisville, told the House before “House Bill 1 addresses the issues con- in plan. it voted on the bill that HB 1 “gives options to fronting some of the agencies that provide crit- Agencies that choose to leave the KERS avoid layoffs, to avoid bankruptcies.” He chal- ical services on behalf of the commonwealth nonhazardous plan would be required to set lenged an assertion made by some opponents in every community in our state, be it regional up a new defined-contribution, 401(k)-type to HB 1 that the bill violates what is known as universities, public health departments, rape retirement plan for their employees and pay the “inviolable contract”— language in state crisis centers, mental health agencies. They their unfunded liabilities to KERS. Agencies law that many say guarantees public pension all provide services that are the foundation or that remain in KERS would have to pay the full benefits earned. safety net for so many in our society.” actuarial cost of that decision as determined Miller said officials with the Kentucky -Re “If we want to continue to have a great by system actuaries in accordance with HB 1. tirement Systems did not see HB 62 as a viola- university system, if we want to continue to Agencies could also allow current defined-ben- tion of the inviolable contract at the time of that have social service safety nets ... these are the efit employees hired before 2014 to remain in actions we must take at this particular time in KERS by paying the full actuarial cost. Continued on page 69

2 2019 Interim LEGISLATIVE RECORD foot maintenance hangar at the airport. When completed, that facility will employ 100 workers , with annual salaries starting at about $65,000. Airfreight The Cincinnati/Northern “We do not operate on local tax dollars,” from page 1 Kentucky International McGraw said. “We are actually a tax generator for the commonwealth.” Airport has supported more She said the airport gets its income from, “I say that to emphasize that investing in than $21 million in income among other things, airplane-landing fees, infrastructure now ... has a huge impact in the parking revenue and developing and leasing future,” McGraw said. “If we didn’t have those tax revenues for Kentucky industrial buildings on its campus. things, we would not have been able to close and more than $4 million for The airport supported more than $21 this deal.” million in income tax revenues for Kentucky This is not the first package hub at the Ohio, according to a and more than $4 million for Ohio, accord- airport. McGraw said the airport is also a global 2016 study. ing to a 2016 study by The Economic Centers super hub for DHL. at the University of Cincinnati and Northern "We are their primary location in the Kentucky University. Of the 14,000 people Americas," she said, adding that DHL employs employed on the airport’s campus, McGraw said 4,200 people and operates 96 daily flights at the A second smaller cargo facility is being 52 percent are Kentucky residents, 38 percent airport. It the international shipping conglom- built to handle FedEx packages. That shipping are Ohio residents and 10 percent are Indiana erate’s second-largest hub, eclipsed only by the company has two aircraft based out of the residents. company’s operations in Leipzig, Germany. Northern Kentucky airport. Sen. Gerald A. Neal, D-Louisville, asked Until construction is completed on the All the package-handling growth has made whether security protocols for working on the Amazon’s hub, the e-commerce company is the Northern Kentucky airport the eighth-larg- airport campus hampered hiring. McGraw said working out of DHL’s hub. DHL sorts its pack- est cargo facility in North America and fast- it was challenging to find employees who could ages at night while Amazon sorts its packages est-growing in the United States. McGraw said pass the required 10-year background check. during the day. the airport was “on the cusp” of becoming the She said prior drug convictions eliminate a large The first phase of the Amazon facility is seventh largest. The airport handled more than number of otherwise qualified candidates. expected to be completed in the third quarter of 1.2 million tons of cargo last year. McGraw said the airport was working with 2021. Construction will continue through 2030 McGraw said this has spurred the aircraft Kentucky schools to develop supply chain man- before the entire 450-acre Amazon hub will be maintenance and engineering company FEAM agement curriculums to foster interest in the fully operational. Aero to build a $19 million, 103,000-square- field and ease the labor shortage in the future.

Group diagnoses Tobacco, Alzheimer’s care in Kentucky from page 1

by Jim Hannah the task force was formed earlier this year to “The money’s coming back in. We’ve added LRC Public Information study whether the state has enough health care $275,000 in repayments. But there’s a pretty big workers, services and facilities to meet the demand for that small (loan),” said Hayes. FRANKFORT – One nursing home growing demand. Three other programs showcased by Beeler resident recounted nearly choking to death In response to questions from task force today were Kentucky State University’s $5,000 on dinner while her roommate desperately Co-chair Rep. Deanna Frazier, R-Madison, agricultural mini-grant program, the non-profit searched for someone to help. Another said Wells said Kentucky has no minimum staffing Kentucky Center for Agriculture and Rural it wasn’t uncommon to hear fellow residents law for long-term care. She said research Development (KCARD)—supported in part by calling out for help. And nearly every resident suggests that residents need 4.1 hours of direct grants supported through KADF—and a youth said there simply weren’t enough people in the care per day to “avoid negative outcomes.” program component of CAIP, or the County building. Frazier, who accompanied Wells on the Agricultural Investment Program, also under That’s what a long-term care ombudsman visit to the two nursing homes, said the findings KADF. said residents of two Kentucky nursing warranted serious thought by task force Beeler said “youth CAIP,” as he calls it, homes told her during recent visits to the members. streamlines a county’s ability to use its share facilities. Bluegrass District Long-Term Testifying alongside Wells was another of the state’s tobacco settlement money for Care Ombudsman Denise Wells reported nursing home residents’ advocate, Kentucky youth agricultural projects. Projects range her finding on Aug. 1 to the Alzheimer’s & Long-term Care Ombudsman Sherry Culp. She from entering a country ham at the state fair to Dementia Workforce Assessment Task Force. said that Kentucky could enhance the quality showing livestock, he said. With the number of Kentuckians living of care by advancing policies that encourage “So it’s working, it’s working,” said Beeler. with Alzheimer’s or dementia expected to people to become direct care workers, or DCWs “We continue to try and figure out how to make jump 17 percent to 86,000 people by 2025, Continued on page 69 this money new again.”

THE KENTUCKY GENERAL ASSEMBLY 3 2019 General Senate Assembly

Julie Raque Adams (36) Jimmy Higdon (14) Dan “Malano” Seum (38) 213 S Lyndon Lane 344 N Spalding 1107 Holly Ave Louisville, KY 40222 Lebanon, KY 40033 Fairdale, KY 40118 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 (Home) 270-692-6945 (Home) 502-749-2859 Ralph Alvarado (28) Paul Hornback (20) Brandon Smith (30) 3250 McClure Road 6102 Cropper Rd 124 Craig Street Winchester, KY 40391 Shelbyville, KY 40065 Hazard, KY 41702 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 Tom Buford (22) Stan Humphries (1) (Home) 606-436-4526 409 W Maple St 763 Sinking Fork Rd (Home FAX) 606-436-4526 Nicholasville, KY 40356 Cadiz, KY 42211 Robert Stivers II (25) (LRC) 502-564-8100 (LRC) 502-564-8100 207 Main St (LRC FAX) 502-564-2466 (Home) 270-522-0195 Manchester, KY 40962 (Home) 859-885-0606 Alice Forgy Kerr (12) (LRC) 502-564-8100 (Home FAX) 859-885-0606 3274 Gondola Dr (Home) 606-598-8575 Jared Carpenter (34) Lexington, KY 40513 (Work) 606-598-2322 PO Box 100 (LRC) 502-564-8100 (Work FAX) 606-598-2357 Berea, KY 40403 (Home) 859-223-3274 Damon Thayer (17) (LRC) 502-564-8100 Christian McDaniel (23) 702 Capital Ave. Danny Carroll (2) PO Box 15231 Annex Room 242 220 Cimarron Way Latonia, KY 41015 Frankfort, KY 40601 Paducah, KY 42001 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 Morgan McGarvey (19) (Home) 270-703-8025 2250 Winston Ave Reginald Thomas (13) Julian M. Carroll (7) Louisville, KY 40205 702 Capital Ave. 702 Capital Ave (LRC) 502-564-8100 Annex Room 255 Annex Room 255 (Home) 502-589-2780 Frankfort, KY 40601 Frankfort, KY 40601 (LRC) 502-564-8100 (LRC) 502-564-8100 Stephen Meredith (5) (LRC FAX) 502-564-0777 1424 Byrtle Grove Rd Johnny Ray Turner (29) Matt Castlen (8) Leitchfield, KY 42754 849 Crestwood Dr 702 Capital Ave (LRC) 502-564-8100 Prestonsburg, KY 41653 Annex Room 255 (LRC) 502-564-8100 Frankfort, KY 40601 Robby Mills (4) (Home) 606-889-6568 (LRC) 502-564-8100 702 Capital Avenue Robin L. Webb (18) Annex Room 255 102 S Hord St Perry B. Clark (37) Frankfort, KY 40601 Grayson, KY 41143 5716 New Cut Rd (LRC/Home) 502-564-8100 (LRC) 502-564-8100 Louisville, KY 40214 (Home) 606-474-5380 (LRC) 502-564-8100 Gerald A. Neal (33) Stephen West (27) 462 S 4th St 202 Vimont Ln C.B. Embry Jr. (6) Meidinger Twr, Ste. 1250 Paris, KY 40361 PO Box 1215 Louisville, KY 40202 (LRC) 502-564-8100 Morgantown, KY 42261 (LRC) 502-564-8100 Whitney Westerfield (3) (LRC) 502-564-8100 (Home) 502-776-1222 700 South Main Street (Home) 270-526-6237 (Work) 502-584-8500 PO Box 1107 (Work FAX) 502-584-1119 Hopkinsville, KY 42241 Rick Girdler (15) Dennis Parrett (10) (LRC) 502-564-8100 702 Capital Ave 731 Thomas Rd (Work) 270-885-7671 Annex Room 209 Elizabethtown, KY 42701 Frankfort, KY 40601 (LRC) 502-564-8100 Phillip Wheeler (31) (LRC) 502-564-8100 (Home) 270-765-4565 702 Capital Ave. David P. Givens (9) Albert Robinson (21) Annex Room 255 PO Box 12 1249 S Main St Frankfort, KY 40601 Greensburg, KY 42743 London, KY 40741 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 Denise Harper Angel (35) John Schickel (11) Mike Wilson (32) 2521 Ransdell Ave PO Box 991 702 Capital Ave. Louisville, KY 40204 Union, KY 41091 Annex Room 242 (LRC) 502-564-8100 (LRC) 502-564-8100 Frankfort, KY 40601 (Home) 502-452-9130 Wil Schroder (24) (LRC) 502-564-8100 Ernie Harris (26) 702 Capital Ave Max Wise (16) PO Box 1073 Annex Room 209 702 Capital Ave. Crestwood, KY 40014 Frankfort, KY 40601 Annex Room 229 (LRC) 502-564-8100 (LRC) 502-564-8100 Frankfort, KY 40601 (Home) 502-241-8307 (LRC) 502-564-8100 * Members of the Kentucky General Assembly may also be contacted by calling 502-564-8100.

4 2019 Interim LEGISLATIVE RECORD 2019 Kentucky General Assembly House

Rocky Adkins (99) (30) (46) PO Box 688 4012 Lambert Ave 8406 Cloverport Dr Sandy Hook, KY 41171 Louisville, KY 40218 Louisville, KY 40228 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 (Home) 606-738-4242 (Home) 502-454-4002 (Work) 606-928-0407 McKenzie Cantrell (38) Jim Glenn (13) (Work FAX) 606-929-5913 702 Capital Avenue 702 Capital Ave. (4) Annex Room 424A Annex Room 462A 2359 Brown Mines Rd Frankfort, KY 40601 Frankfort, KY 40601 Marion, KY 42064 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 John Bam Carney (51) (Home) 270-686-8760 (Home) 270-988-4171 PO Box 4064 Campbellsville, KY 42719 (LRC) 502-564-8100 (89) 2163 E Highway 30 Danny Bentley (98) (Home) 270-403-7980 East Bernstadt, KY 40729 702 Capital Avenue (LRC) 502-564-8100 Annex Room 367C (37) (LRC FAX) 502-564-5640 Frankfort KY 40601 PO Box 509 (Home) 606-305-1321 (LRC) 502-564-8100 Fairdale, KY 40118 Jr. (12) (LRC) 502-564-8100 714 N Broadway B2 John Blanton (92) (Work) 502-439-6175 Providence, KY 42450 702 Capital Avenue Myron Dossett (9) (LRC) 502-564-8100 Annex Room 329H 491 E Nashville St (Home) 270-667-7327 Frankfort, KY 40601 Pembroke, KY 42266 (Work FAX) 270-667-5111 (LRC) 502-564-8100 (LRC) 502-564-8100 Derrick Graham (57) (Home) 270-475-9503 157 Bellemeade Dr (32) Jim DuPlessis (25) Frankfort, KY 40601 702 Capital Ave. 702 Capital Ave (LRC) 502-564-8100 Annex Room 451E Annex Room 376 (Home) 502-223-1769 Frankfort, KY 40601 Frankfort, KY 40601 Joe Graviss (56) (LRC) 502-564-8100 (LRC) 502-564-8100 702 Capital Ave. Charles Booker (43) Larry Elkins (5) Annex Room 429J 702 Capital Ave. 702 Capital Ave. Frankfort, KY 40601 Annex Room 424C Annex Room 405D (LRC) 502-564-8100 Frankfort, KY 40601 Frankfort, KY 40601 (Work) 859-433-4392 (LRC) 502-564-8100 (LRC) 502-564-8100 David Hale (74) 11 Hales Ln Adam Bowling (87) Daniel Elliott (54) Wellington, KY 40387 PO Box 2928 PO Box 2082 (LRC) 502-564-8100 Middlesboro, KY 40965 Danville, KY 40423 (Home) 606-768-3474 (LRC) 502-564-8100 (LRC) 502-564-8100 Chris Harris (93) (Home) 859-332-4204 719 Forest Hills Rd Joseph M. Fischer (68) Forest Hills, KY 41527 Terri Branham Clark (100) 126 Dixie Place (LRC) 502-564-8100 702 Capital Ave. Ft Thomas, KY 41075 (Home) 606-237-0055 Annex Room 429B (LRC) 502-564-8100 Mark Hart (78) Frankfort, KY 40601 (Home) 859-781-6965 202 W 4th St (LRC) 502-564-8100 (Work) 513-794-6442 Falmouth, KY 41040 (Home) 606-232-0357 (75) (LRC) 502-564-8100 121 Arcadia Park (Home) 859-654-4278 Kevin D. Bratcher (29) Lexington, KY 40503 (94) 10215 Landwood Dr (LRC) 502-564-8100 20 Ohio St Louisville, KY 40291 (Home) 859-221-3107 Whitesburg, KY 41858 (LRC) 502-564-8100 (LRC) 502-564-8100 (Home) 502-231-3311 Deanna Frazier (81) (2) 702 Capital Ave. 438 Millers Chapel Rd R. Travis Brenda (71) Annex Room 405C Mayfield, KY 42066 702 Capital Ave. Frankfort, KY 40601 (LRC) 502-564-8100 Annex Room 316E (LRC) 502-564-8100 (Home) 270-705-7539 Frankfort, KY 40601 (Work) 270-247-2210 (LRC) 502-564-8100 (6) (Work FAX) 270-247-2304 702 Capital Ave. (3) Annex Room 413E Kathy Hinkle (96) 375 Stonegate Drive Frankfort, KY 40601 702 Capital Ave. Paducah, KY 42003 (LRC) 502-564-8100 Annex Room 424B (LRC) 502-564-8100 Frankfort, KY 40601 (Home) 270-331-0648 (84) (LRC) 502-564-8100 (Home FAX) 270-443-4526 277 Right Branch Spencer (83) Chavies, KY 41727 PO Box 985 George Brown Jr. (77) (LRC) 502-564-8100 Jamestown, KY 42629 424 E Fourth Street (Home) 606-233-5660 (LRC) 502-564-8100 Lexington, KY 40508 (Home) 270-343-2264 (LRC) 502-564-8100 (Work) 270-343-5588 (Home) 859-312-7513

THE KENTUCKY GENERAL ASSEMBLY 5 2019 Kentucky General Assembly

Cluster Howard (91) C. Ed Massey (66) (76) 476 Kings Ridge 702 Capital Ave. 10 Deepwood Dr Jackson, KY 41339 Annex Room 352B Lexington, KY 40505 (LRC) 502-564-8100 Frankfort, KY 40601 (LRC) 502-564-8100 (Home) 606-568-7660 (LRC) 502-564-8100 (Home) 859-299-2597 (16) Regina Huff (82) Bobby McCool (97) PO Box 397 179 Mountain St 702 Capital Ave. Elkton, KY 42220 Williamsburg, KY 40769- Annex Room 413C (LRC) 502-564-8100 (LRC) 502-564-8100 Frankfort, KY 40601 (Home) 270-265-3163 (Home) 606-549-3439 (LRC) 502-564-8100 (Home FAX) 270-265-3164 (62) Thomas Huff (49) Chad McCoy (50) 702 Capital Ave PO Box 1331 702 Capital Avenue Annex Room 351 Shepherdsville, KY 41065 Annex Room 370 Frankfort, KY 40601 (LRC) 502-564-8100 Frankfort, KY 40601 (LRC) 502-564-8100 (LRC) 502-564-8100 Joni L. Jenkins (44) (80) (15) 2010 O’Brien Ct PO Box 121 PO Box 411 Shively, KY 40216 Stanford, KY 40484 Greenville, KY 42345 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 (Home) 502-447-4324 (42) Dennis Keene (67) PO Box 757 (47) PO Box 273 1040 Johns Hill Rd Louisville, KY 40201 Bedford, KY 40006 Wilder, KY 41076 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 (Work) 502-741-7464 (Home) 502-255-3392 (Home) 859-441-5894 Michael Meredith (19) (Work) 502-255-3286 Kim King (55) PO Box 292 (Work FAX) 502-255-9911 250 Bright Leaf Dr Brownsville, KY 42210 Harrodsburg, KY 40330 (LRC) 502-564-8100 (31) (LRC) 502-564-8100 (Work) 270-597-6049 702 Capital Ave. (Home) 859-734-2173 Russ A. Meyer (39) Annex Room 451B Matthew Koch (72) 106 Lone Oak Drive Frankfort, KY 40601 702 Capital Ave. Nicholasville, KY 40356 (LRC) 502-564-8100 Annex Room 329E (LRC) 502-564-8100 Frankfort, KY 40601 Suzanne Miles (7) (24) (LRC) 502-564-8100 PO Box 21592 113 N Walters Ave (69) Owensboro, KY 42304 P.O. Box 8 170 Herrington Ct #12 (LRC) 502-564-8100 Hodgenville, KY 42748 Erlanger, KY 41018 (LRC) 502-564-8100 (LRC) 502-564-8100 Charles Miller (28) (Work) 270-358-0868 (Home) 859-653-5312 3608 Gateview Cir (23) Louisville, KY 40272 189 Blue Sky Dr (40) (LRC) 502-564-8100 Glasgow, KY 42141 702 Capital Ave. (Home) 502-937-7788 (LRC) 502-564-8100 Annex Room 429E (Home) 270-646-6821 Frankfort, KY 40601 Jerry T. Miller (36) Rob Rothenburger (58) (LRC) 502-564-8100 PO Box 36 811 Stapleton Rd Eastwood, KY 40018 Shelbyville, KY 40065 (45) (LRC) 502-564-8100 (LRC) 502-564-8100 PO Box 2090 (Home) 502-633-5832 Lexington, KY 40588 (20) (LRC) 502-564-8100 702 Capital Ave. (21) (Home) 859-252-2202 Annex Room 429A PO Box 336 (Home FAX) 859-259-2927 Frankfort, KY 40601 Tompkinsville, KY 42167 Derek Lewis (90) (LRC) 502-564-8100 (LRC) 502-564-8100 702 Capital Ave. Annex Room 413D Tim Moore (18) (1) Frankfort, KY 40601 417 Bates Rd 350 Peppers Mill Drive (LRC) 502-564-8100 Elizabethtown, KY 42701 Paducah, KY 42001 (Home) 606-594-0061 (LRC) 502-564-8100 (LRC) 502-564-8100 (Home FAX) 606-672-5526 (Home) 270-769-5878 (Work) 270-462-3156

Scott Lewis (14) (64) (60) PO Box 454 PO Box 143 12094 Jockey Club Dr Hartford, KY 42347 Independence, KY 41051 Union, KY 41091 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 (Home) 859-371-8840 (61) (33) (Home FAX) 859-371-4060 702 Capital Ave. 702 Capital Avenue Dean Schamore (10) Annex Room 413G Annex Room 416C 120 Ball Park Rd Frankfort, KY 40601 Frankfort, KY 40601 Hardinsburg, KY 40143 (LRC) 502-564-8100 (LRC) 502-564-8100 (LRC) 502-564-8100 (34) 2007 Tyler Ln (59) (41) Louisville, KY 40205 PO Box 8 702 Capital Ave (LRC) 502-564-8100 Prospect, KY 40059 Annex Room 432C (Home) 502-451-5032 (LRC) 502-564-8100 Frankfort, KY 40601 (Work) 502-645-2186 (LRC) 502-564-8100

6 2019 Interim LEGISLATIVE RECORD

2019 Kentucky LRC General Assembly Publications

Steve Sheldon (17) Tommy Turner (85) 2019 Price List 702 Capital Ave 175 Clifty Grove Church Annex Room 351B Somerset, KY 42501 Daily Record Pick up: $82.50 Frankfort, KY 40601 (LRC) 502-564-8100 (LRC) 502-564-8100 (Home) 606-274-5175 Daily Record Mailed: $82.50 (plus Ken Upchurch (52) John Sims Jr (70) PO Box 969 postage) 3177 Maysville Rd Monticello, KY 42633 Flemingsburg, KY 41041 (LRC) 502-564-8100 Friday Record Mailed: $30.25 (plus (LRC) 502-564-8100 (Home) 606-340-8490 (Home) 606-748-1839 postage) (26) PO Box 6605 Individual Record Pick up: $2.75 (48) Shepherdsville, KY 40165 702 Capital Ave (LRC) 502-564-8100 Individual Record Mailed: $2.75 (plus Annex Room 432A (Home) 502-543-8209 Frankfort, KY 40601 (LRC) 502-564-8100 postage) Susan Westrom (79) PO Box 22778 Diane St. Onge (63) Lexington, KY 40522 523 Kluemper Court (LRC) 502-564-8100 Bills Fort Wright KY 41011 (Work) 859-266-7581 (LRC) 502-564-8100 Complete Set of Bills and Resolutions (Home) 859-341-1231 Buddy Wheatley (65) 702 Capital Avenue (Pick up): $425 Cherlynn Stevenson (88) Annex Room 462A 702 Capital Ave Frankfort, KY 40601 Individual Bills Per Page: $.05 Annex Room 424G (LRC) 502-564-8100 Frankfort, KY 40601 (11) Amendments Per Page: $.05 (LRC) 502-564-8100 702 Capital Avenue III (86) Annex Room 451A Roll Call Votes: $.15 Per Page 545 KY 223 Frankfort, KY 40601 Flat Lick, KY 40935 (LRC) 502-564-8100 (LRC) 502-564-8100 (Work) 270-831-1087 Publications (Home) 606-542-5210 (35) (22) 702 Capital Avenue 1-10 copies: Free to general public; 1481 Jefferson School Road Annex Room 424D Scottsville, KY 42164 Frankfort, KY 40601 larger numbers of free copies are (LRC) 502-564-8100 (LRC) 502-564-8100 (Home) 270-622-5054 (Home) 502-599-7289 available to schools and state agencies Les Yates (73) Ashley Tackett Laferty (95) 702 Capital Avenue (Copies over preapproved limits require 702 Capital Ave Annex Room 351C Annex Room 432F Frankfort, KY 40601 agency approval) Frankfort, KY 40601 (LRC) 502-564-8100 (LRC) 502-564-8100 (27) 702 Capital Ave Administrative Regulations (2018) Annex Room 351D * Members of the Kentucky General Assembly may also be Frankfort, KY 40601 contacted by calling 502-564-8100. Bound Volumes: $235.25 (LRC) 502-564-8100 Administrative Register: $120.00 Walker Thomas (8) 2620 Cox Mill Road Volumes and Register: $355.25 Hopkinsville, KY 42240 (LRC) 502-564-8100 (Home) 270-889-8091 (Home FAX) 270-885-5335 Acts of the General Assembly (2018) James Tipton (53) 8151 Little Mount Rd Regular Sessions: $80.00 (2 Volumes) Taylorsville, KY 40071 (LRC) 502-564-8100 Special Sessions: Priced after printing

Journals House and Senate Complete Set, House Set, Senate Set: Priced after printing

(All prices subject to 6% Kentucky sales tax, and subject to change)

THE KENTUCKY GENERAL ASSEMBLY 7 Committee Meetings

Michele McCarthy and Marla Miller, Center for INTERIM JOINT COMMITTEE ON Behavioral Health; Olivia Spradlin, Kentucky HEALTH, WELFARE, AND FAMILY Coalition Against Domestic Violence; Jaclyn McGranahan, American Civil Liberties Union; SERVICES Rusty Cress, Dinsmore; Jade Flesch, United Way Index Minutes of the Third Meeting of the 2019 Interim of Greater Cincinnati; Angela Morris, Kentucky July 19, 2019 Administrative Office of the Courts; Kevin Call to Order and Roll Call Newton, Legislative Research Commission; A The third meeting of the Interim Joint Lisa Galloway and Kristan Mowder, Humana Administrative Regulation Review Subcommittee, Committee on Health, Welfare, and Family CareSource. 33 LRC Staff: DeeAnn Wenk, Ben Payne, Chris Agriculture, 16 Services was held on Friday, July 19, 2019, at 2:30 Alzheimer’s and Dementia Workforce Assessment p.m., at the Kenton County Detention Center, Joffrion, Becky Lancaster, Sean Meloney, Dana Task Force, 38, 54 3000 Decker Crane Lane, Covington, Kentucky. Simmons, and Gina Rigsby. Appropriations and Revenue, 14, 17, 29 Representative Kimberly Poore Moser, Co- Approval of the Minutes Chair, called the meeting to order at 2:35 p.m., A motion to approve the minutes of the June 3, 2019 meeting was made by Senator Alvarado, E and the secretary called the roll. Economic Development and Workforce Invest- Present were: seconded by Representative Gibbons Prunty, ment, 20 Members: Senator Ralph Alvarado, Co- and approved by voice vote. Chair; Representative Kimberly Poore Moser, Welcome and Overview of the Overdose G Co-Chair; Senators Danny Carroll, Morgan Prevention and Pre-Arrest Diversion Government Contract Review Committee, 42 McGarvey, and Max Wise; Representatives Project H Danny Bentley, Tina Bojanowski, Adam Jason Merrick, Director of Addiction Health, Welfare, and Family Services, 8 Bowling, Deanna Frazier, Robert Goforth, Scott Services Kenton County Detention Center Lewis, Melinda Gibbons Prunty, Josie Raymond, (KCDC), stated that the KCDC offers a J Steve Riley, Nancy Tate, and Lisa Willner. comprehensive biopsychosocial and spiritual Judiciary, 26 Guests: Jason Merrick, Director of treatment program for substance abuse disorders K Addiction Services Kenton County Detention (SUDs). KCDC utilizes medications that are Kentucky Career and Technical Education Task Center; Terry Carl, Jailer, Kenton County Jail; approved by the Federal Drug Administration Force, 52 Van Ingram, Executive Director, Office of Drug (FDA) to treatment opioid use disorder (OUD), Control Policy, Justice and Public Safety Cabinet; methamphetamine disorder, cocaine disorder, L and other drug disorders. Currently 150 of the Licensing, Occupations, and Administrative Reg- Carrie B. Oser, Ph.D., ; ulations, 25 Alecia Webb-Edgington, President and CEO, 800 inmates are in-house clients that are in Local Government,12 Life Learning Center; Matt Brown, Chief of Staff treatment. More people need help with OUPs, to the CEO, Addiction Recovery Care (ARC); but there is not enough bed space to provide M Jim Beiting, Chief Executive Officer, Transitions, treatment. As part of the Kentucky Opioid Medicaid Oversight and Advisory Committee, 29 Inc.; Michael E. Fletcher, MD, Anesthesiologist; Response Effort (KORE), the Department N Jennifer Shofner, Transitions, Inc.; Scott Majors, for Behavioral Health, Developmental and Natural Resources and Energy, 28 Ms. Keith Poynter, and Dan Martin, Kentucky Intellectual Disabilities (DBHDID) awarded a Board of Physical Therapy; Erin Swift, YMCA; grant to KCDC to establish or expand the Quick P Denise Govan and Tami Wilson, Life Learning Response Team (QRT) model in Kentucky. Funds Program Review and Investigations Committee, 50 are also received from the federal Department Public Assistance Reform Task Force, 64 Center; Shannon White, Centerstone Kentucky; Public Pension Oversight Board, 56, 58, 62 Amy Martin, Northern Kentucky Office of Drug of Justice. Public safety officials often find Public Water and Wastewater System Infrastruc- Control Policy; Chris Crumrine, University themselves on the front lines of responding to ture Task Force, 67 of Kentucky; Urooj Nasim, Kentucky Voices behavioral health crises but have few resources for Health; Lynne Saddler, District Director of available to address the needs of people with S serious behavioral health conditions. A Quick State Government, 18 Health, Northern Kentucky Health Department; Jonathan Borden, Office for Children with Special Response Team provides a way for public safety T Health Care Needs; Cassidy Lekan, Transitions, officials to work with behavioral health providers Tobacco Settlement Agreement Fund Oversight Inc.; Sarah John, Department of Corrections to serve individuals who have experienced an Committee, 49 Addiction Services; Ashley McCarty, Kentucky opioid-related overdose or complication (e.g., Tourism, Small Business, and Information Tech- blood-borne infection). QRTs can be composed nology, 21, 22 Chamber of Commerce; John Francis, Redwood; Katie Marks, Department for Behavioral Health, of emergency response personnel, medical Developmental and Intellectual Dias abilities; personnel, law enforcement officers, substance Michelle Lyndenberg, Interact for Health; Ashley abuse treatment providers, public health Graham, Department for Public Advocacy; providers, and peer support specialists. The goal

8 2019 Interim LEGISLATIVE RECORD of a QRT is to reduce the incidence of overdoses overdose deaths. A coordinator was hired to educate inmates and and overdose fatalities by increasing the number ODCP has partnered with the Kentucky their families about the Vivitrol® program. of people who receive Opioid Use Disorder Injury Prevention and Research Center (KIPRC), The biggest obstacle for someone to reoffend (OUD) services, including harm reduction and a program between the University of Kentucky is not having transportation to get to a residential treatment services. A QRT consists of a retired and the Kentucky Department for Public Health, or outpatient treatment program. The ODCP is first responder, social worker, and peer support to establish findhelpnowky.org to help someone working with the Transportation Cabinet and specialist that offers services to help prevent find an addiction treatment facility that is the Kentucky Department for Medicaid Services additional overdoses from occurring. The accepting new clients. Kentuckians struggling (DMS) to provide parolees with a SUD that QRT can leave a Narcan kit and resources with with a substance use disorder, either themselves has transportation issues will be able to receive the resident if they are willing to go through or within their families, can call 1-833-8KY- non-emergency transportation through the training at no cost to the resident. If the person HELP (1-833-859-4357) toll-free to speak with a 1115 waiver. The goal is to remove obstacles \ wants to seek help, the QRT can assess and refer specialist about treatment options and available for parolees to be successful in recovery and not that person at the time of the visit. Medication resources. The specialist will conduct a brief reenter the justice system. assistance treatment (MAT) for individuals with screening assessment in order to connect callers Through the KORE program, five parole an OUD is used to stabilize a person while in with the most relevant treatment services as officers were trained to become job specialists custody at KCDC, get them covered by health quickly as possible. Approximately 50 residential who work with employers to hire individuals insurance, and then transition them back into treatment programs accepts Medicaid. Barriers on parole. After a recommendation from the the community. A person released into the are being removed to help individuals receive Substance Abuse and Mental Health Services community receives money to help with living treatment as soon as possible instead of having Administration (SAMHSA), Kentucky doubled expenses for seven weeks in order to give that to wait weeks to get into a facility. the number of parole officers being trained to person time to find a good job that has a living SOAR (Supporting Others in Active become a job specialist. wage and benefits so they do not have to go back Recovery), focuses on relapse prevention, The Re-entry Division was created within into the same environment where they got into education, and reentry skills based on the the Kentucky Justice and Public Safety Cabinet trouble before. The biggest barrier to recovery for Therapeutic Community Model, a group-based, to establish consistent re-entry services for men and women is to go back into the same bad residential approach to treating substance abuse. everyone. In 2016, the Kentucky State Police environment. The University of Kentucky Center The evidence-based strategy seeks to reduce (KSP) started the Angel Initiative as a pro-active for Drug and Alcohol Research is conducting an recidivism and set the stage for long-term approach offering an alternative escape to those in-depth study of KCDC’s services and will be recovery before inmates return to communities. battling addiction. Under this initiative, anyone available on-line soon. Participants live together in a single dormitory battling addiction can come to any KSP post and In response to questions by Representative to provide a steady continuation of care as get help finding a treatment center. No questions Goforth, Mr. Merrick stated that through MAT, inmates complete their sentences along with asked. The Justice and Public Safety Cabinet KCDC offers FDA-approved medications to other programs and curriculum. The program partners with the Kentucky Injury Prevention stabilize someone who is addicted to opioids. is funded in part by a grant from the Kentucky and Research Center to conduct prescriber The MAT process at KCDC includes screening Office of Drug Control Policy made possible with training across the Commonwealth with a grant by clinicians for eligibility, assessment from opioid-response appropriations in the Kentucky provided by the Center for Disease Control and a medical team, and approval by the medical state budget. The SOAR program is currently Prevention (CDC). director. There are equal amounts of clients that available for up to 88 participants who have Kentucky’s Strategic Initiative for will either receive medication, receive Vivitrol or completed the DOC-approved substance abuse Transformational Employment (KYSITE) began receive buprenorphine. The treatment program program or graduated from Moral Reconation in April 2019 and phase one of this program will at KCDC is only for clients who are at high risk Therapy (MRT). Participants must also have last until June 30, 2020. This initiative will offer for morbidity associated with OUD. 60 days of clear conduct, meet the appropriate support to the business community by creating Addiction Treatment, Prevention Efforts, risk classifications, and maintain a job workforce driven solutions to help alleviate and Reentry Pilots in the Commonwealth assignment in the program. While living in the Kentucky’s addiction epidemic and increase Van Ingram, Executive Director, Office of SOAR dormitory, inmates can engage in other workforce participation. The initiative is a Drug Control Policy (ODCP), Justice and Public evidence-based programs to earn good time partnership between the Kentucky Chamber of Safety Cabinet, stated that from 2017 to 2018, credits. Participants have the opportunity to earn Commerce, the Cabinet for Health and Family Kentucky had a 15 percent drop in overdose at least 120 days good time credit by completing Services, and the ODCP. The Chamber of rates. Kentucky receives federal funds for the such programs as MRT Parenting, MRT Anger Commerce can help facilitate a meeting between Kentucky Opioid Response Effort (KORE) Management, Soft Skills Boot Camp, and New the Human Resources Department of a company to deal with the opioid epidemic. The ODCP Directions, which provide valuable skills that and a parolee. The Chamber of Commerce, purchases Narcan for law enforcement agencies. help support a successful transition back into the through the business community, matched a Local health departments conduct training community. Currently there are approximately $350,000 grant from the ODCP. and distributes Narcan in communities across 6,000 individuals in the SOAR program. With funds from the ODCP and KORE, a Kentucky. The Department for Behavioral Health, In March 2016, the Kentucky Department recovery job specialist has been hired in all 12 Developmental and Intellectual Disabilities of Corrections (DOC) began offering eligible career centers located throughout Kentucky to (DBHDID) works with Kentucky’s hospital DOC-based substance abuse program (SAP) help connect individuals in recovery from SUDs system to help pay for Narcan if a person does participants the opportunity to initiate Vivitrol, with a job. not have another payer source. Distribution of a long-acting (30-day) injectable medication- In response to questions by Representative Narcan and increased accessibility to treatment assisted treatment (MAT) for opioid use disorder Goforth, Mr. Ingram stated the 1-833-8KYHELP have been huge contributing factors in reducing and alcohol use disorder, prior to their release. hotline started in January 2018, but he would

THE KENTUCKY GENERAL ASSEMBLY 9 have to get information on the number of and HIV testing are part of the SEP. CDC reports who want to treat more clients. There will be incoming and outgoing calls and how many that individuals who are part of the SEP are five educational sessions for physicians interested individuals have received treatment by calling times more likely to enter treatment programs in helping individuals with opioid use disorder. the hotline. for a SUD and three times more likely to stop Senator Alvarado recommended Dr. Oser to In response to questions by Representative injecting drugs. The SEPs work. contact the Kentucky Board of Medical Licensure Willner, Mr. Ingram stated that there are University of Kentucky Center on Drug and the Kentucky Medical Association to find approximately 5,900 individuals in prison, a and Alcohol Research Opioid Grant and providers who would be willing to treat these halfway house, or in recovery. Approximately Helping to End Addiction Long-term (HEAL) patients. 40,000 individuals are on parole, and a large Grant In response to a question by Representative percentage are involved in an outpatient Carrie B. Oser, Ph.D., University of Bojanowski, Dr. Oser stated that the HCS looks treatment program. Kentucky, stated that two years ago, the National at aggregate level outcome data to look at the In response to questions by Representative Institutes of Health (NIH) launched the HEAL overdose rates within the counties. The study can Tate, Mr. Ingram stated that the largest driver initiative. The HEALing Communities Study see cost savings will be to help sustainability. of recidivism is not new crimes but failing a (HCS) is a partnership between the NIH, the Importance of Reentry Programs for requirement of probation and parole. There National Institute on Drug Abuse (NIDA), and Addiction Recovery are no statistics of recidivism for participants the Substance Abuse and Mental Health Services Alecia Webb-Edgington, President and in the programs offered to parolees. A number Administration (SAMHSA). The University CEO, Life Learning Center, stated that the center of programs are being funded for peer support of Kentucky was awarded $87 million grant is a non-profit entity located in Covington. There specialists who help individuals after being for the study. The project is being conducted is an education continuum that is built on five paroled. in partnership with numerous federal, state, pillars of life: physical, financial, emotional, In response to questions by Senator Danny community, public health, criminal justice, relational, and spiritual. There is also a care Carroll, Mr. Ingram stated that it is difficult to behavioral health, and health care partners. The continuum that has wrap-around services that award grants to faith-based treatment centers primary outcome of the HCS is to reduce opioid support the education continuum. The center because federal funds come with significant related overdose deaths by 40 percent over 3 addresses whatever is a barrier that holds an restrictions. On November 6, 2019, there will be years within 67 highly affected communities in individual back from continuing their journey a faith-based conference to help work through Kentucky, Massachusetts, New York, and Ohio. toward recovery and getting employment. The these issues and try to find a way around the Sixteen of the communities are in Kentucky. center does not take any public funding, so restrictions. The same Medicaid transportation NIDA and SAMHSA provides oversight to the the $1.2 million yearly budget is raised from providers will be used, and qualifications will Healing Communities Study Advisory Board. private industry and private individuals. All be established for receiving transportation The Cabinet for Health and Family Services the individuals that are served can get a job, the to appointments. If an individual is already and the Justice and Public Safety Cabinet has challenge is being able to keep the job because receiving Medicaid services, it will be the first partnered with the HCS. they do not have the support wrap-around payer of non-emergency medical transportation The HCS will test the impact of the services or the community support that is needed if it is to a medical appointment. Communities that Health (CTH) intervention to continue their recovery. In response to a question by Representative on opioid related overdose deaths. The CTH Once a challenge identified when working Moser, Mr. Merrick stated that 75 percent and 80 is working with 16 local Kentucky Agency for with individuals released from KCDC, they are percent of KCDC’s parolees do not re-enter jail. Substance Abuse Policy, KY ASAP (ASAP) transported to Life Learning Center where a risk More than 84 percent of its parolees do not use boards to develop and produce a comprehensive, assessment is conducted. Form I-9, Employment drugs illicitly when released. data-drive community response plan to deploy Eligibility Verification from the Department Syringe Exchange Program (SEP) evidence-based practices (EBPs) across multiple of Homeland Security, U.S. Citizenship and Lynne Saddler, District Director of Health, sectors to reduce opioid-related overdose deaths. Immigration Services, is used for verifying Northern Kentucky Health Department, stated There is a requirement that at least one-third of the identity and employment authorization of that harm reduction in regard to SUDs is about the counties be in rural areas. individuals hired for employment in the United trying to prevent death from overdoses and Three primary ways to reach the target States. All U.S. employers must ensure proper trying to prevent the spread of infectious diseases goal of reducing overdose related deaths are to completion of Form I-9 for each individual they that occur associated with injection drug use. improve opioid use disorder (OUD) cascade of hire for employment in the United States. The The syringe exchange programs (SEPs) operate care, expand overdose prevention, and reduce form lists the documents that establish both throughout Kentucky. Kentucky has been lauded opioid supply. Kentucky will use health care identity and employment authorization. KRS nationally for how aggressive it has been in getting navigator care teams comprised of a community 186.417(1) states that the Transportation Cabinet community support and approvals to be able to coordinator who will work with the KY ASAP shall issue to any felony offender, if the felony operate the SEPs. The CDC says research that has board, two prevention specialists, care navigator, offender is eligible, released from the Kentucky been conducted over the past 30 years shows that and jail care navigator. Department of Corrections or a Federal Bureau the SEPs reduce healthcare cost, prevent disease, In response to a question by Representative of Prisons facility located in Kentucky on home and save lives. SEPs in Northern Kentucky are Bowling, Dr. Oser stated that counties without incarceration, parole, completed service of operated at the Grant County Health Center, a suppressed data had to have greater than five sentence, shock probation, or pardon, a personal mobile units in Covington and Newport. Over overdose related deaths per 100,000 residents. identification card or, if the felony offender 1,800 individuals have been helped and 650 In response to questions by Senator is eligible, an operator’s license. An offender are repeat participants. Almost 2,000 doses of Alvarado, Dr. Oser stated that the study will who wishes to obtain a personal identification Narcan have been given in Northern Kentucky build upon telehealth services. There is a need to card or operator’s license shall provide proper that saved over 176 lives. Individuals can receive expand and increase the number of physicians documentation to comply with the provisions a Hepatitis A vaccination, Hepatitis C testing,

10 2019 Interim LEGISLATIVE RECORD literacy, parenting, anger management, setting of this section. Currently, individuals are for treatment by the managed care organizations boundaries, overcoming codependency, and worried that the release letter from a facility (MCOs) can be a barrier to treatment once spirituality. ARC’s innovative “Crisis to Career” will no longer satisfy the requirement of KRS someone has been released from a detention approach combines world-class SUD treatment 186.417(2)(d). KRS 17.180(3) states that the facility. with vocational training to bring an almost Commonwealth shall provide and maintain in In response to questions by Representative unheard of level of success to those that complete every detention center the automated fingerprint Willner, Mr. Beiting stated that Transitions has the entire 12-month program. identification system equipment and programs established a mobile assessment team that goes ARC was chosen by the United States required by the Department of Kentucky State to detention facilities in Kenton, Boone, and Department for Health and Human Services Police through administrative regulation. If a Campbell counties. Assessing an individual to become one of the first programs in the parolee cannot get an identification card upon once they are released from a facility might be nation to be a part of the Building Evidence release, that individual will face a huge barrier too late to help them receive needed services. and Employment Strategies (BEES) study. The to employment. Another issue that needs to be Ms. Webb-Edgington stated that Life Learning three-year study will follow clients through the addressed by the General Assembly are the lack Center comes to the facility in advance of an vocational training piece of the program and of accreditation for sober living housing facilities. individual’s release to go through the enrollment follow up with them after graduation. Across the Matt Brown, Chief of Staff to the CEO, process for its program. Life Learning Center country, prison populations are steadily declining, Addiction Recovery Care (ARC), stated that is in a pilot program with the Kenton County but over the past three years, Kentucky’s has the Office of Drug Control Policy’s annual Commonwealth Attorney’s office to allow risen. During the current fiscal year, Kentucky’s report stated that for the first time since 2013, individuals to come to the center to do their Department of Corrections potentially could there was a statewide drop in overdose deaths. work probation and parole. Once an individual spend $628 million on its prison population. Fatal overdose rates dropped nearly 15 percent completes the program and gets a job and remain ARC’s Court Concierge Programs allows peer between 2017 and 2018. The drop has been employed, they will divert from the criminal support specialists to be in a courtroom and on credited to education, treatment programs, and justice system. call for the judge, jailer, and sheriff’s office to other harm reduction initiatives. ARC operates a Representative Frazier stated that it would assist those that have entered into the criminal network of residential and outpatient treatment be helpful to have a jail concierge. justice system to enter treatment at the time of centers at 34 locations located in 12 counties. The In response to questions by Representative arrest or from jail. In ARC’s first pilot program full continuum of care at these locations include Tate, Mr. Brown and Mr. Beiting both stated in Letcher County, 82 men and women were able withdrawal management, crisis stabilization, that 85 percent of their programs are funded by to enter treatment rather than continue in jail residential treatment, sober living, outpatient Medicaid, and 15 percent is private insurance, saving the county money. services, and vocational training. Treatment for private pay, and KORE funding for individuals The recently published report by the federal substance use disorder (SUD) requires a holistic who do not have Medicaid. Drug Enforcement Administration (DEA) shows approach that treats the entire person. ARC’s Medication Assisted Treatment (MAT) that Kentucky has been hit incredibly hard by program combines the best practices of medical A.Overview the opioid epidemic. No community, workplace, care, clinical services, spirituality, and vocational Michael E. Fletcher, MD, Chief Medical or family has remained untouched by this training. Officer, Addiction Recovery Care (ARC), stated epidemic. It is imperative that we find a solution ARC’s medical services are overseen by a that MAT has been around for 20 years. ARC to the growing incarceration and recidivism board-certified Addictionologist. The clinical prescribes medications in conjunction with rates. Addressing SUD as a disease instead of a program consists of licensed clinicians and behavioral health and case management on an criminal problem will stop recidivism and allow peer support specialists utilizing national best outpatient basis. Via telemedicine, patients can those with a SUD to step out of the cycle of practices including Hazelden Betty Ford’s COR- be evaluated and started on therapy. Medical addiction and incarceration. In addition to saving 12 program. Targeted case managers provide therapies for HIV have substantially improved tremendous amounts of money, individual lives wrap-around services and identifying and since the early 1990s and the cure rate is high. in our communities, workplaces, and families walking the client through removing barriers to House Bill 1, AN ACT relating to controlled can be saved. recovery. Vocational training opportunities allow substances and making an appropriation therefor, Jim Beiting, Chief Executive Officer, a client to discover a purpose for their life and from the 2012 Extraordinary Session was a Transitions, Inc., stated Transitions is a non- the opportunity for meaningful employment. good bill, but there were allot of unintentional profit that has been in business since 1969. ARC also has a facility dedicated to SUD negative consequences. Physicians should feel Transitions has offered long-term quality drug treatment for pregnant and postpartum women comfortable writing MAT prescriptions. and alcohol treatment. Transitions renovated a at Karen’s Place Maternity Center at any point B.MAT in the Justice System 180-bed residential facility in Northern Kentucky during her pregnancy. She can stay at the Jason Merrick, Director of Addiction with immediate access to care. Whether a facility facility through delivery and up to six months Services, Kenton County Detention Center, is hospital-based or community-based program postpartum along with her child. Clients can learn stated that experiencing drug withdrawal is one like Transitions, up to 60 percent of referrals to be mothers while also learning how to become of the most horrific experience in someone’s life. for treatment come from the criminal justice and remain sober. ARC’s proprietary “Invitation The criminal justice system deals with the most system. Drug and alcohol addiction and SUD to Destiny” curriculum is an all-inclusive life severe cases of SUD. The answer to help treat is a legitimate biopsychosocial medical disease. skills program designed to dismantle a client’s these men and women with opioid use disorder The staff at Transitions is trained to administer barriers to recovery. The curriculum teaches with medication assisted care immediately upon Narcan. Sometimes when an individual is clients how to be successful in areas of exercise admittance. The individuals are engaged in incarcerated, Medicaid services are stopped, and nutrition, self-esteem, building identity, their treatment and are grateful for the services and it is hard to restart the services after they safe and stable housing, furthering education, received. KCDC has been award funds through are released. The 1115 waiver allows more vocational training, home economics, financial KORE the state, and SAMHSA. At two weeks individuals to receive treatment. Authorization THE KENTUCKY GENERAL ASSEMBLY 11 KAR 50:110, which contains Grade A milk into an individual’s buprenorphine treatment, and milk products standards; 902 KAR 50:110 Senators Robby Mills, Albert Robinson, and they are given a time released suboxone injection – incorporates materials related to permit Damon Thayer; Representatives Jeffery Donohue, over the course of 30 days then again 30 days later requirements and sanitary standards for Grade Larry Elkins, Joe Graviss, Kim King, Adam for another shot. KCDC is funded to provide the A milk producers, processors, handlers and Koenig, Jerry T. Miller, and Rob Rothenburger. first three injections while the individual is in distributors, Grade A dry and condensed milk, Guests: Speaker David Osborne, Speaker custody, and then transition them to community Grade A dry and condensed whey, and the Pro Tem David Meade, and Majority Floor providers. The oral dosage is cheaper than the fabrication of single-service containers and Leader, Bam Carney, Kentucky House of injectables, because KCDC is not allowed to bill Representatives; Senator John Schickel, 11th closures for milk and milk products; 911 KAR th Medicaid. There is a need to look at the barrier 1:020 – establishes minimum monthly payments Senate District; Representative Ed Massey, 66 for individuals that need medical care but are for cost of treatment and care, commensurate House District; Kristin Baldwin, Northern not covered while in the custody of the criminal with ability to pay, procedures for the preparation Kentucky Chamber of Commerce; Boone County justice system. After individuals re-enter and transmittal of patient statement of accounts, Judge/Executive Gary Moore; Campbell County society, they need to be supported and there receipt of payments, clinic participation fess, Judge/Executive Steve Pendery; Burlington Fire is funding for the after care programs. It costs services provided by contracted providers, Protection District Chief Jeff Barlow; Point approximately $23,000 per year per inmate for authorizations of payment, procedures for failure Pleasant Fire Protection District Assistant Chief incarceration. There needs to be services to help to provide payments, provisions for discharge, Eric Seibel; Doug Bivins, BlueStart US, Hebron, stop recidivism. Individuals need a job to give criteria for reapplication, as well as a process Kentucky; Michael Poynter and Bob Andrew, them resources and confidence and help them for reconsideration of an adverse decision; 911 Kentucky Board of Emergency Medical Services; not reoffend and divert back into substance use. KAR 1:060 – establishes requirements relating Chief Gregg Bayer and Chief Cathy Rigney, In response to a question by Senator to the Office of Children with Special Health Kentucky Association of Fire Chiefs; Dan Ison, Alvarado, Mr. Fletcher stated that MAT is not Care Needs Medical Staff; and 911 KAR 1:071 Shelby County; Ron Wolf, Associated General a cure for everyone. Abstinence and forced – repeals 911 KAR 1:070 and 911 KAR 1:080. Contractors of Kentucky; Bryanna Carroll, withdrawal does not work. Mr. Merrick stated The provisions contained in 911 KAR 1070 are Kentucky League of Cities; and Gay Dwyer, that the answer to MAT lies in more increased to be updated pursuant to KRS Chapter 13A and Kentucky Retail Federation. supervision and education. Eliminating contained in separate administrative regulations LRC Staff: Mark Mitchell, John Ryan, Joe someone’s medication should not be used as a in this chapter. The provisions of 911 KAR 1:080 Pinczewski-Lee, Daniel Carter, and Cheryl punishment. refer to a program no longer operated by the Walters. In response to questions by Representative Office for Children with Special Health Care Ms. Kristin Baldwin, Vice President of Public Bentley, Mr. Merrick stated that mismarketing Needs. Affairs and Communications with the Northern from Indivior was due to the claim it was safer The Cabinet for Health and Family Kentucky Chamber of Commerce, welcomed the because it has Naloxone in it. That is not an attack Services requested deferral of 911 KAR 1:010 committees and told members about the events on the reputable active ingredient in Suboxone – establishes application forms used for clinical planned for them in conjunction with Northern which is Buprenorphine. Mr. Fletcher stated that programs, procedures for application and Kentucky United. he was not familiar with this particular case. reapplication, eligibility criteria, assignment of Welcome and Discussion of Local Issues In response to questions by Representative pay category, and processes used to determine Boone County Judge/Executive Gary Moore Goforth, Senator Alvarado stated that Suboxone initial and continuing eligibility for services, also welcomed the committees to Northern is prescribed more than Vivitrol because it is as well as a process for reconsideration of an Kentucky. He told the members that daytime cheaper and covered by the MCOs. Injectables are adverse decision. population has doubled in Boone County. The higher and more difficult to get prior authorized Adjournment Visitor’s Bureau, TANK, and Sanitation District and covered by insurance. Mr. Merrick stated that There being no further business, the meeting #1 are collectively working together. If Northern Vivitrol does not treat the severe SUD specific to was adjourned at 4:48 p.m. Kentucky is given the tools, it can fend for itself. opioids as well as Buprenorphine (Suboxone). Campbell County Judge/Executive Steve Buprenorphine will reduce the desire and keep Pendery told the committees that Northern a person engaged in recovery or treatment for a INTERIM JOINT COMMITTEE ON Kentucky is working for prosperity. There are longer period of time. Vivitrol can treat a mild or LOCAL GOVERNMENT 37 cities within three counties of Northern moderate SUD successfully for opioids. Minutes of the 2nd Meeting Kentucky. Eighty percent of the jobs within the of the 2019 Interim Consideration of Referred Administrative July 19, 2019 region are in Boone County. Regulations In conclusion, Judge Moore mentioned the Call to Order and Roll Call The following administrative regulations Amazon hub that is going to be built in Boone The second meeting of the Interim Joint were placed on the agenda for consideration: County. Committee on Local Government was held on 201 KAR 22:135 – establishes the fees required Discussion of Consolidation of Local Friday, July 19, 2019, at 3:00 PM, at the Ferguson to apply for a credential by application, Emergency Services Community Center of the Boone County reinstatement, or renewal; 902 KAR 20:111 – Chief Jeff Barlow, with the Burlington Fire Historic Courthouse in Burlington, Kentucky. establishes standards for medically managed Protection District, discussed Fire/EMS/Rescue The Committee met jointly with the Interim intensive inpatient withdrawal management Governance Reform. The Boone Emergency Joint Committee on State Government. Senator provided by a chemical dependency treatment Services of Tomorrow Comprehensive Study Wil Schroder, Chair, called the meeting to order, program or hospital; 902 KAR 50:101 – repeals and Recommendations was initiated in October and the secretary called the roll. 902 KAR 50:100 as the sanitation rating methods 2017, and released in October 2018. The study Present were: of Grade A milk producers, processors, and included three separate analyses: (1) retaining Members: Senator Wil Schroder, Co-Chair; handlers are incorporated by reference in 902 independence, (2) full consolidation, and (3) Representative Michael Meredith, Co-Chair;

12 2019 Interim LEGISLATIVE RECORD to continue to provide their own services. There semi-consolidation by enhancing cooperative should be clear accountability of the governing annually; and patients 50 years and older account agreements. board—majority elected on general November for 68 percent of all EMS incidents. Governance reform legislation for fire ballot, and there should be diversified revenue There are four disciplines of training: (1) agencies is needed because tax reforms reduce and taxing authority. Legislation for the new Emergency Medical Responder (EMR) which revenues essential to providing fire/EMS/rescue entity needs to: (1) protect existing retirement requires 50 hours of training and provides services; economic growth and development structures; inclusion provides no greater, and basic immediate lifesaving interventions; (2) create service demands before revenues are no less, retirement system benefit status for Emergency Medical Technician (EMT) which realized; there can be an unequal cost share for employees; (2) protect existing health plan requires 150 hours of training and provides basic services; and decreasing volunteers and labor coverages already in place to allow continuation stabilization and safe transportation of patients; shortages create operational costs that exceed of existing health insurance coverage; no state (3) Advanced Emergency Medical Technician prior legislative funding models. health insurance mandate; and (3) provide that (AEMT) requires 400 hours of training and The author of the study recognizes that the taxation beyond any established caps be required provides basic and advanced stabilization and legislature seeks direct public accountability to present to voters for a direct ballot decision. safe transportation of patients; and (4) Paramedic of service boards; seeks taxpayer protections; Accountability stemming from the legislation which requires 2,000 hours of training and November ballot elections for governance; would be through requiring: (1) existing elected provides advanced care for critical and emergent represents taxpayer interests for essential services boards passing a majority decision to opt-in patients. with timely delivery; and wants to ensure that to a consolidated emergency service district; Since 2011, there has been a certification service boundaries are consistent with ballot (2) voters directly elect majority of the board and licensure pass rate improvements of 14 precinct boundaries for general elections to be governing a consolidated emergency service percent for EMTs and has improved 28 percent possible. The public needs to have a strong and district; and (3) voters directly voting to approve for paramedics. direct voice in the level of service expectations or deny any taxation beyond existing limits. There are five agency organization types: for their local community. Voters decide the Mr. Doug Bivins, Chief Operating Officer for hospital, governmental/non-fire, community/ amount taxpayers in that locale are willing to pay BlueStar US, gave the committees background on non-profit, fire department, and private/non- for emergency services. BlueStar, which is located in Hebron, Kentucky. hospital. The number of providers has increased Assistant Chief Eric Seibel, with the Point BlueStar is one of the largest and fastest growing but they are having challenges in staffing them. Pleasant Fire Protection District, discussed solutions-based distributors in the world. Point Splitting in certification training levels, EMR current challenges to fire/EMS/rescue.Pleasant Fire Protection District cooperated with and EMT providers have decreased lately, while Volunteers, labor pools, revenue authority Mr. Bivins in explaining their fiscal obligations AEMT and EMTP providers have increased. and sources, and grants/alternative funding is and were good stewards of the district’s tax funds. The concerns of KBEMS include: staffing; decreasing, disappearing, or limited. Residential/ Senator Thayer said he was interested in growing industry; expanding roles, which include commercial growth and sprawl, run volume, seeing details of the fire districts’ proposal. There critical care, flight paramedic, community, service demands/expectations, personnel costs, should be accountability and transparency from wilderness, tactical and emergency paramedics; CERS contribution rates, and operational costs furthering education; and salaries. Responses st the boards. It is an inefficient way to fund the fire are increasing. Problems in the 21 century districts. He likes the idea of consolidation and to the concerns include researching alternative include operating well beyond expectations direct November elections but does not want training delivery methods, which include of original charter and changing the mission accelerated training, distance learning, and th new bureaucracies to be created. and responsibility of the fire district. The 20 Representative Miller stated that he agreed scheduling around work; increasing marketing century structure is not working anymore. There with Senator Thayer and applauds the fire and public relations; Education Committee is a misunderstanding of how KRS Chapter districts’ idea of consolidation. In response to Accreditation Workgroup identifying best 75 Fire District Board members are elected, a a question from Representative Miller, Chief practices; regulator revisions to address issues misunderstanding of board members’ authority Barlow replied that not all fire districts charge brought to the Board by stakeholders; and and responsibility, and there is limited revenue the 20 cents maximum for fire service. Most fire leadership. authority. districts charge 17 to 20 cents with the smallest Chief Gregg Bayer, President of the Kentucky The anticipated benefits of consolidation being 12.2 cents. Association of Fire Chiefs (KAFC), told the include combining administrative functions and In response to another question from committee that fire chiefs are dedicated to ease eliminating redundant administrative efforts, Representative Miller, Chief Siebel said the the burden on EMS, in particular regarding creating a diverse specialized-skill career path Boone County response time is 12 to 15 minutes. recruitment, retention and also training. Training for personnel that is currently unsustainable; The response time should be within five minutes. time is an issue. The KAFC is looking at on-line recruiting and retaining improvements by Discussion of Fire Department Hiring learning and workforce development programs. growing workforce strengths; strengthening of Candidates having EMT and Paramedic He referred members to written remarks from mid-level officers and management; expanding Certification Chief Wayne Briscoe of the City of Frankfort, and strengthening specialized divisions and Mr. Michael Poynter, Executive Director which were included in the committee members’ services; reducing and eliminating redundant of the Kentucky Board of Emergency Medical folders. capital; and increasing purchasing power. Services (KBEMS), gave the committees the Chief Cathy Rigney, with the Winchester Chief Barlow told the committee that fire following statistics: there are 13,379 certified or Fire Department and KAFC, stated that she districts are asking for the creation of a new licensed providers; 220 licensed EMS agencies; agreed with Chief Bayer. The KAFC would like entity, whereby the existing Chapter 75 Fire 1,147 ground ambulances; 72 helicopter different options on the front end to get boots on Districts or other organizations can opt to ambulances; five fixed wing ambulances; 885,307 the ground. remain independent entities as they currently EMS incidents in 2018 (2,426 per day); one out Regarding higher education requirements, exist and municipalities and counties can opt of every five citizens are in contact with EMS Representative Meredith commented that THE KENTUCKY GENERAL ASSEMBLY 13 he feels a precedent is being set that is cost Girdler, Stan Humphries, Alice Forgy Kerr, school, and funding for students with limited prohibitive and would like to steer away from Morgan McGarvey, Stephen Meredith, Gerald English proficiency (LEP). Mr. Ritter stated that the requirement of higher education. In years A. Neal, Dennis Parrett, Robin L. Webb, Stephen $214 million has been appropriated for pupil past, Kentucky did not require national registry West, and Phillip Wheeler; Representatives Lynn transportation through SEEK in each of the last recognition. He wanted the KBEMS’ thoughts Bechler, Danny Bentley, Myron Dossett, Joseph several budgets. The most recent calculation for about the national test. M. Fischer, Kelly Flood, Jim Glenn, David Hale, districts’ transportation costs totaled about $376 Mr. Bob Andrew, Director of Education Mark Hart, Angie Hatton, Dennis Keene, Russ million. with the KBEMS, told Representative Meredith A. Meyer, Jason Nemes, Ruth Ann Palumbo, Districts that have increased local revenue that the Kentucky Revised Statutes establishes Melinda Gibbons Prunty, Brandon Reed, Steve to a level known as ‘tier one’ may receive standards. He discussed the history of the various Riley, John Sims Jr, Wilson Stone, James Tipton, additional funding through the budget. About elements in the scope of practice and the use of and Susan Westrom. $160 to $170 million each year is given to tier the National Registry Exam and the rationale Guests: Robin Kinney, Associate one districts. Local revenue and effort are a big behind its use. Commissioner, Office of Finance and Operations, part of SEEK. Districts are required to levy a Representative Meredith commented that Department of Education; Chay Ritter, Branch minimum equivalent tax rate of 30 cents per $100 Kentucky needs to focus on practicing in the Manager, Funding and Reporting Branch, of assessed property. All of the school districts field instead of taking a test. Division of District Support, Office of Finance combined generate about two-and-a-half billion Representative Rothenburger commented and Operations, Department of Education; dollars in tax revenues. that his biggest concern is EMT training classes David Eager, Executive Director, Kentucky Mr. Ritter stated that ‘nickels’ are nickel- do not seem to be offered anymore in the rural Retirement Systems; and Perry Nutt, Staff equivalent taxes that help districts dedicate funds areas. The Kentucky Fire Commission was Economist, Legislative Research Commission. to facilities renovation and new construction. looking at making money available for EMT LRC Staff: Jennifer Hays, Cynthia Brown, Each district is required to have the Facilities training. Katy Jenkins, and Chase O’Dell Support Program of Kentucky (FSPK). The Mr. Michael Kurtsinger, with the Kentucky Approval of Minutes equalization formula for nickels is formula driven Fire Commission, told Representative A motion was made by Representative Reed, and impacted by local property assessment and Rothenburger that there is money in the budget seconded by Representative Gibbons Prunty, to statewide equalization level. for EMT training but could not commit at this approve the minutes of the June 4, 2019 meeting. In response to a question from Senator time. The minutes were approved by voice vote. McDaniel, Mr. Ritter stated that ‘local effort’ is Chief Bayer commented that it has become Education Funding determined based on assessed value. In response more burdensome to provide training programs. Robin Kinney, Associate Commissioner, to another question, Ms. Kinney confirmed that, There needs to be more training but it is so cost Office of Finance and Operations, Department if a local county has a poor collection percentage, prohibitive right now. of Education, and Chay Ritter, Branch Manager, that factor will be one of the biggest determinants In response to a question from Representative Funding and Reporting Branch, Division in large fluctuations of funding for the county’s Tipton, Mr. Poynter stated that ten high schools of District Support, Office of Finance and schools. offer EMT training. Mr. Andrew added that 13 Operations, Department of Education, discussed In response to a question from high schools offer paramedic training programs. the Support Education Excellence in Kentucky Representative Stone, Mr. Ritter and Ms. Kinney The KBEMS is trying to get more. Satellite (SEEK) formula. stated that the 2019-2020 budget was the first programs are available and held offsite. Robin Kinney testified that, in 1985, 66 budget that included language stating that Senator Schroder announced that the next poor property districts formed together to unexpended SEEK funds would be allocated meetings of the two committees would be held challenge the overall educational system in for pupil transportation. In response to another on August 22nd at the Kentucky State Fair. Kentucky. As a result, the system was declared question, Mr. Ritter and Ms. Kinney confirmed There being no further business, the meeting unconstitutional pursuant to Section 183 of the that the General Assembly would need to include was adjourned at 4:30 p.m. Kentucky Constitution. The decision resulted that language in the next budget for unexpended in the Kentucky General Assembly enacting SEEK funds to continue be allocated for pupil INTERIM JOINT COMMITTEE the Kentucky Education Reform Act (KERA) transportation. Representative Stone expressed ON APPROPRIATIONS AND in 1990, which included the SEEK funding his hope that the legislature would find a way to mechanism. The SEEK funding formula has not help with transportation costs. REVENUE Minutes of the 2nd Meeting changed much in 30 years. KRS 157.350 sets In response to a question from Senator Kerr, of the 2019 Interim forth Seek eligibility requirements. Ms. Kinney stated that Jefferson County has over July 9, 2019 SEEK is an allocation formula used to 100 languages spoken in its schools. In response Call to Order and Roll Call disperse funds to school districts. Once a district to another question from Senator Kerr, Ms. The 2nd meeting of the Interim Joint receives the funds, the funds can be utilized by Kinney stated that she would provide Senator Committee on Appropriations and Revenue the district to make it as efficient and effective as Kerr with a list of the category five schools. was held on Tuesday, July 9, 2019, at 1:00 PM, possible. In response to a question from Representative in Room 149 of the Capitol Annex. Senator Mr. Ritter testified that the first input into Sims, Mr. Ritter and Ms. Kinney testified that the Christian McDaniel, Chair, called the meeting to the SEEK formula is the Aggregate Average Daily SEEK per pupil rate has been at $4,000 only during order, and the secretary called the roll. Attendance (AADA); which each district reports the current biennium. In response to another Present were: to KDE. The statewide AADA is about 593,000. question from Representative Sims, Ms. Kinney Members: Senator Christian McDaniel, Other inputs into the formula include funding stated that school districts are using federal funds Co-Chair; Representative Steven Rudy, Co- for free lunch for at-risk children, funding for various expenditures within the educational Chair; Senators Tom Buford, Matt Castlen, Rick for children with disabilities, home hospital system. In response to another question, she (H/H) for students unable to physically attend said that different school districts have different

14 2019 Interim LEGISLATIVE RECORD financial needs based upon the population, Retirement System (KERS) plan and the State Kentucky Teachers’ Retirement System (KTRS) enrollment, and debt of the district. In response Police Retirement System (SPRS) plan for Fiscal was still using stock assumptions. to a final question from Representative Sims, Mr. Years 2021 and 2022. The new rates will go into In response to a question from Representative Ritter stated that the SEEK formula accounts for effect June 1, 2020. The assumptions will also Hatton, Mr. Eager said that from KRS’ standpoint, property wealth within districts. A school district determine contribution rates for the County it would be irresponsible to fund the system less with high property wealth receives less from the Employees Retirement System (CERS) for Fiscal than the actuary recommends. The solution to state because of the ‘local effort.’ A district with Year 2021. city funding problems is not to cut pensions. A low property wealth and local effort will receive Mr. Eager stated that KRS went many years big adjustment in the assumptions made was more state assistance. relying on assumptions that were outdated. necessary because small adjustments had not In response to a question from When KRS adjusted the interest assumptions been made over time. Representative Dossett, Mr. Ritter stated that in 2017, that action drove the contribution In response to a question from Senator there is no guarantee that the state will match rate from 49 percent to 83 percent. It had to be Wheeler, Mr. Eager testified that there is very the recallable nickel if it is passed by a district. done because the system was underfunded and little liability associated with the tier three cash- Rather, it depends upon the language in each underestimated for a long time. hybrid plan, because it has been in place for five biennium budget bill. Mr. Eager highlighted changes to the years. If the state continues to fund at the full In response to a question from Senator assumptions made by KRS. KRS added two years Actuarially Required Contribution (ARC), the McDaniel, Ms. Kinney stated that each county to the assumed life expectancy of members. contribution rate for a new person coming into must have a school district, but that she was Turnover varies between systems, with KERS KRS will be 3.05 percent in 2043. Tier three will not aware of guidelines regarding how many non-hazardous having higher turnover, and have a positive impact. schools must be in a district. In response to CERS non-hazardous having lower turnover. In response to a question from Representative another question from Senator McDaniel, Mr. KRS also made investment earning assumptions Tipton, Mr. Eager stated that the funded ratio for Ritter testified that KDE has field staff who visit 1.25 to 1.50 percent lower than previously CERS non-hazardous was higher 10 years ago. In districts throughout the year. KDE has an audit assumed, depending on the system. response to another question from Representative process to check a district’s attendance records KRS is projecting what the life expectancy Tipton, Mr. Eager said that incorrect assumptions and other records. will be for members who will be retiring for the in the past were a big contributor to the funded In response to a question from Senator Neal, next 40 years, and that there will be a higher cost ratio of CERS consistently decreasing over time, Ms. Kinney stated that the SEEK formula does associated with it. Previous experience studies even when employers were paying 100 percent not include a process by which to determine used the national mortality tables, but that KRS of the recommended contribution rate. KRS was whether a viable level of student service delivery will now determine mortality based on its own in a negative cash flow for 15 years. In response is being maintained in the state. membership. People in the KRS live longer than to another question, Mr. Eager testified that In response to a question from Representative the national average. Starting in 2020, the life KRS non-hazardous payroll growth will be -10 Rudy, Mr. Ritter testified that less than 10 school expectancy assumption for males age 65 will percent this year. Representative Tipton stated districts are levying an occupational tax. The increase from 19 years to 21. The assumption that at some point there will be an economic district occupational tax is levied on taxpayers for females age 65 will increase from 22 years downturn that puts stressors on investment who live and work in the district. to almost 24. The state will have to pay more returns; continuing to say that it is important to Kentucky Retirement Systems money in benefits because people are staying in have accurate assumption rates. Mr. Eager stated David Eager, Executive Director, Kentucky the system longer. that KRS needs to amend the system to rely less Retirement Systems (KRS), discussed actuarial Due to the new assumptions, employer on contributions based on payroll growth. assumptions for KRS. contribution rates and requirements are In response to a question from Senator Mr. Eager testified that the actuary’s job recommended to rise. The recommended Buford, Mr. Eager said that last year, KRS is to come up with the appropriate amount of contribution rate for KERS non-hazardous will was ‘shorted’ $132 million because quasi- money that the state, cities, and counties should rise four percent, resulting in $59 million more governmental agencies were allowed to pay a 49 contribute to fund retirements. Actuaries know needed to fund that system. The contribution percent contribution rate, and the state did not the age of each systems’ members, how much requirement for KERS hazardous will increase appropriate the difference. It will cost KRS $121 money each member earns, how much service by four million dollars. The rate will increase by million next year. In response to another question each member has, the gender of each member, 3 and a half percent for CERS non-hazardous, from Senator Buford, Mr. Eager testified that he and each member’s occupation. Actuaries do not requiring $86 million more. The CERS knows of three bills being considered related to know how much money that investments will hazardous contribution rate is recommended to quasi agencies, with the net-present cost of them earn, how long members are going to live, when increase from 46.5 percent to 57.6 percent. The totaling $800 million. Senator Buford stated that members are going to retire, how long members contribution rate for SPRS is recommended to if the legislature allows quasi agencies to have the will stay in a job, or if members will become increase 13 percent. The new recommendations lesser contribution rate, it could result in $1.5 disabled. modestly lower the funded status of each billion to the negative side of the bottom line An experience study of KRS is statutorily retirement system. over 20 years. required every five years. The experience In response to a question from Senator In response to a question from Senator study for the five-year period ending June 30, McDaniel, Mr. Eager stated that life expectancy McDaniel, Mr. Eager stated that after September 2018, was conducted by the actuary, Gabriel, is ascending. The KRS board deferred to the 1, it will be much more expensive to buy time. In Roeder, Smith & Company (GRS). The KRS actuary’s forecast as it relates to life expectancy. response to a follow-up from Senator McDaniel, Board agreed with and approved the actuarial KRS needs to ask for funding that matches the Mr. Eager said that a person conventionally assumptions recommended by GRS as a result level ‘prescribed’ by the actuary. In response retiring will not see a change in benefits due to of the study. The assumptions will determine to another question from Senator McDaniel, changes in actuarial assumptions. It may affect contribution rates for the Kentucky Employees Mr. Eager testified that he did not know if the reduced benefits for early retirement. THE KENTUCKY GENERAL ASSEMBLY 15 In response to a question from Representative fund dollars. Capitol Annex. Representative Richard Heath, Nemes, Mr. Eager said that the difference From 2000 to 2014, MSA appropriations Chair, called the meeting to order, and the between the contribution rate quasi agencies pay, closely followed the statutory distribution secretary called the roll. and what the agencies would pay at the full rate, formula. Starting in Fiscal Year 2015, the approach Present were: will be $121 million next year. Representative was changed. For tobacco appropriations, Members: Representative Richard Heath, Nemes questioned why the actuarial analysis on the debt service is first taken off the top, with Co-Chair; Senators Stan Humphries, Robby the proposed quasi agency pension bill did not distributions then being made to the three funds. Mills, Dennis Parrett, Robin L. Webb, Stephen take into account what taxpayers would have to Mr. Nutt stated that the current budget West, and Whitney Westerfield; Representatives pay if the legislature did nothing. Mr. Eager stated predicts $118.1 million in MSA receipts for Fiscal Myron Dossett, Larry Elkins, Kelly Flood, that the actuarial analysis provided information Year 2020. Mr. Nutt reviewed the various areas Joe Graviss, Chris Harris, Mark Hart, Kim for the costs of the five options for quasi agencies receiving general fund tobacco appropriations King, Matthew Koch, Brandon Reed, Rob within the proposed bill. for Fiscal Year 2020. For Fiscal Year 2020, the Rothenburger, Steven Rudy, Dean Schamore, In response to a question from Senator ADF will receive $42,636,600 in appropriations, John Sims Jr, Wilson Stone, Nancy Tate, Walker West, Mr. Eager testified that the funded ratio with the ECDF receiving $27,930,800, and the Thomas, James Tipton, and Les Yates. for KERS non-hazardous is 12.9 percent, and HCIF receiving $17,391,400. Guests: Amanda Robertson, Beginning that it is likely decrease. In response to another In response to a question from Senator Farmer Regional Coordinator, USDA -Farm question, he stated that KERS has positive cash Buford, Mr. Nutt stated that there have been a few Service Agency; Tamara Sandberg, Executive flow for the first time in 15 years. If things do not years in which there was a deficit in the general Director, Feeding Kentucky and Michael change, the asset and liability levels will grow. fund receipts, while also a surplus in the tobacco Halligan, CEO, God’s Pantry Food Bank. In response to a question from Representative receipts. The unanticipated tobacco receipts have LRC Staff: Stefan Kasacavage, Kelly Meyers, Mr. Eager testified that he did not know sometimes lapsed back into the general fund Ludwig, Nathan Smith, and Susan Spoonamore, whether the administration has discussed ways to help in a deficit situation. In response to a Committee Assistant. to create new revenue or increase revenue. statement from Senator Buford, Mr. Nutt stated Beginning Farmer Program Tobacco Settlement Funds that while there may have been money taken out Ms. Amanda Robertson, Beginning Farmer Perry Nutt, Staff Economist, Legislative of Kentucky Access in the past, it was not general Regional Coordinator, Farm Service Agency, Research Commission, discussed tobacco fund tobacco money. said the United States Department of Agriculture settlement funds. Representative Stone stated that the (USDA) was reorganized. The Beginning Farmer Mr. Nutt testified that Kentucky signed the MSA was the result of a settlement between Program operates under Farm Production and Master Settlement Agreement (MSA) in 1998. tobacco companies and state attorney generals, Conservation Division and includes the Farm Under the terms of the contract, Kentucky with approximately 40 states agreeing to the Service Agency, Natural Resource Conservation receives a payment each April from cigarette settlement. States receive funds from the Service, Risk Management Agency, and a new manufacturers that have signed the MSA. On agreement based on the amount of tobacco sales program known as the Business Center. average, over the past 20 years, Kentucky has in the state. Kentucky has spent the funds it Ms. Robertson said that qualifications for received about $111 million each year under the receives from the MSA well. The MSA has had a beginning farmer participant is solely based MSA. many positive effects. on the years that an individual operated a farm. In the 2000 Regular Session, House Bill Senator Webb stated that Kentucky is an It includes veterans, women, and minorities. 583 created the Tobacco Settlement Agreement international model as it relates to the handling A beginning farmer is an individual who has Fund (TSAF), which divided all MSA payments of MSA funds. not operated a farm for more than ten years. into three funds. The Agricultural Development Correspondence Received An individual seeking farm ownership must Fund (ADF) receives 50 percent of the moneys, Senator McDaniel reviewed the not have operated a farm for more than ten the Early Childhood Development Fund correspondence received from Jenny Bannister, years and does not own real estate that exceeds (ECDF) receives 25 percent, and the Health Care Deputy Director, Office of Budget Review (LRC). thirty percent of the average acreage in the Improvement Fund (HCIF) receives 25 percent. county where the property is located. She stated In the same year, House Bill 611 created the ADF List of Reports Received Since June, 2019 the USDA supports veterans by focusing on and specified that MSA money distributed to the Senator McDaniel reviewed the list of employment, education and entrepreneurship. ADF would be divided into two accounts; with reports received by the committee since June, The USDA is committed to supporting diversity 65 percent of funds going to the state account, 2019. and inclusion in agriculture. Approximately one and 35 percent going to the county account. In Adjournment million women work the land in the United the 2000 Regular Session, House Bill 706 created With no further business before the States. According to a 2017 census from 2012 the ECDF. In the same session, House Bill 517 committee, the meeting was adjourned at 2:28 to 2017, Kentucky’s number of female farmers created the HCIF and specified that MSA money p.m. increased by 37 percent. Youth programs are distributed to the fund was to be allocated to available including a youth loan program. Youth three areas; 70 percent of funds are to go to the INTERIM JOINT COMMITTEE ON from the ages of 10 through 20 can receive up to Kentucky Access Insurance Program, 20 percent AGRICULTURE $5,000 if they are enrolled in Future Farmers of of funds are to go to the Lung Cancer Research Minutes of the 1st Meeting America (FFA) and 4-H. Program, and 10 percent of funds are to go to of the 2019 Interim Ms. Robertson explained that the Farm substance abuse treatment for minors. July 8, 2019 Service Agency (FSA) benefits farmers and Mr. Nutt testified that tobacco dollars do not Call to Order and Roll Call beginning farmers with farm loan programs, lapse to the general fund at the end of the fiscal The 1st meeting of the Interim Joint storage facilities programs, disaster programs, year, rather they can carry forward. Tobacco Committee on Agriculture was held on Monday, cost share programs and crop insurance. dollars are tracked separately from other general July 8, 2019, at 10:00 AM, in Room 154 of the Beginning farmers identified as socially

16 2019 Interim LEGISLATIVE RECORD disadvantaged, limited resources, veteran God’s Pantry Food Bank, spoke on the fight Kentucky Kids Eat Coalition, which supports farmers, female, or minority can qualify for against hunger. the efforts to feed the hungry. Mr. Halligan said waivers of administration fees. Mr. Halligan stated that medical expenses, that God’s Pantry Food Bank and the agencies Ms. Robertson explained that the USDA job loss, or other unexpected events can supported are under the same guidelines as any has direct operating loans with a loan limit contribute to persons being chronically hungry other food distribution entity. of $400,000; microloans with a $50,000 loan or hungry for a short period of time. There are Representative Schamore suggested limit, and direct farm ownership loans with a approximately 600,000 people at risk of hunger that the Kentucky Cattlemen’s Association $600,000 loan limit. Other farm loan programs in the state. Nearly 200,000 or roughly 18 consider donating a culled cow for processing include guaranteed loans, youth loans, and percent of children are hungry. Magoffin, Clay, and distribution through God’s Pantry and loans targeting minority and women farmers. Elliot, Robertson and Breathitt counties have Feeding Kentucky. Ms. Sandberg said that Beginning farmers are encouraged to visit the highest child food insecurity rates. Magoffin Feeding Kentucky has funding from Agriculture the Natural Resources Conservation Services County has the highest rate with 31 percent of Workforce Development Association to help pay (NRCS) to help create a Conservation Plan and hungry children year-round. Another group of for the processing fee. to visit the Risk Management Agency (RMA) people to be concerned about are those who near In response to Senator West, Ms. Sandberg for crop insurance. She said the National retirement age. Kentucky adults between the said there are different reasons for the disconnect Agricultural Statistics Service (NASS) provides ages of 50 to 59, have the worst food insecurity between the Supplemental Nutrition Assistance timely, accurate and useful statistics to United rate in the nation at 18.6 percent. Program (SNAP) and hunger. The SNAP States agriculture through reports and surveys. Feeding Kentucky has seven food banks program has helped to keep Americans from In 2017, there were 674,940 beginning farmers, that cover the entire Commonwealth. Feeding starving on the street, but there are hungry an increase of 20 percent from 2016. Another Kentucky partners with food pantries, soup people in Kentucky who do not qualify for program within USDA is Rural Development. kitchens, and shelters to provide resources for federal programs. Mr. Halligan explained that The Rural Development program helps to access to food. Over 50,000 people a week are the SNAP program is enormous. SNAP provides improve the economy and quality of life in rural served meals which equates to 64 million meals 12 meals for every meal at a Food Bank. The America by focusing on purchasing or building a year. The Farms to Food Banks program SNAP program is one of the least fraudulent homes in rural areas. The Agricultural Marketing represents ten percent of the produce volume. programs in the country. Service (AMS) helps to create marketing In 2018, God’s Pantry Food Bank’s distribution In response to Representative Harris, Mr. opportunities: farmers market promotion, of produce was 13.6 million pounds. Halligan said that one of the biggest challenges local food promotion and cost-share programs Ms. Sandberg stated the Farms to Food in the summer for kids is how to replace meals for organic certification. The USDA is also Banks program initially focused on fresh produce that they lose when they are on free and reduced committed to supporting the Farm to School but now includes any agricultural product. The price lunch during the school year. The federal Program. With agriculture changing, USDA primary goals are to feed and provide nutritional statutes require congregate feeding which means saw a need for developing an Urban Agriculture meals to hungry Kentuckians, support farmers that a child needs to go to a site for supervision Toolkit to help establish neighborhood gardens, by increasing their cash flow, and reducing during the meal. In rural counties like Pike hydroponic and aquaculture operations, rooftop waste. She said that in 2018, the Farms to Food County, it does not work well. Federal legislation gardening, and seasonal high tunnel programs. Banks program was able to access approximately is being considered to be able to use an EBT card Ms. Robertson said there are 64 county offices three million pounds of produce which provided to purchase food for children in the summer. with 16 farm loan teams. over five million supplemental meals. For the In response to Representative Tipton, Ms. In response to Representative Tipton, Ms. first time in several years, the Farms to Food Sandberg stated that Hunters for the Hungry Robertson stated that beginning farmers can Banks program was unable to distribute in all is a great program. The Kentucky Beef Council come from a background of no farming or was 120 counties. The program experienced a budget supports hunger relief by selling t-shirts as raised on a farm and want to re-enter farming reduction by $100,000 due to lack of funding by a fundraiser and the proceeds help Feeding on a small scale. She said there is still a program the General Assembly. Ms. Sandberg stated that Kentucky to purchase beef from Kentucky which helps to connect beginning farmers to 350 farmers, from 64 counties, participated in farmers. Funding is a key issue for purchasing or retiring farmers. the program last year with an average payment donating a product. A grant from the Kentucky In response to Representative Thomas, of $1,500 per farmer. A processing pilot program Department’s Hunger Initiative, founded by Ms. Robertson stated that growing crops in will begin this year in hopes of extending the Farm Credit Mid-America, enabled the purchase container crates and remodeling older buildings fresh produce season. Farms to Food Banks of 200 freezers for food pantries, but more cold to produce hydroponic vegetables is becoming will partner with the University of Kentucky storage capacity is needed. more common. at nine food pantry sites throughout the state There being no further business, the meeting In response to Senator Humphries, Ms. to teach meal preparation. She said that the was adjourned. Robertson said that FSA officials visit with Kentucky Kids Eat program targets child hunger military veterans. Individuals stationed at by connecting kids to healthy food 365 days INTERIM JOINT COMMITTEE Fort Campbell have a significant interest in a year. Another program is the Kentucky Fruit ON APPROPRIATIONS AND agriculture and those stationed at Fort Knox and Vegetable Incentive Program which creates REVENUE make up a smaller group. The Kentucky a financial incentive for summer food service Budget Review Subcommittee on Human Department of Agriculture also has programs sponsors to include Kentucky-grown fruits and Resources for veterans and they reach out to work with vegetables in the summer meals they serve. Minutes of the 2nd Meeting interested individuals too. In response to Representative Rothenburger, of the 2019 Interim Update on Feeding Kentucky Programs Ms. Sandberg stated that Feeding Kentucky does July 9, 2019 Tamara Sandberg, Executive Director, not get funding from the Kentucky Department Call to Order and Roll Call Feeding Kentucky and Michael Halligan, CEO, of Public Health, although it is a member of the The 2nd meeting of the Budget Review THE KENTUCKY GENERAL ASSEMBLY 17 Subcommittee on Human Resources of the Department for Behavioral Health, is no oversight at the current time. Dr. Brenzel Interim Joint Committee on Appropriations and Developmental and Intellectual Disabilities stated that since many of the services are paid for Revenue was held on Tuesday, July 9, 2019, at Dr. Brenzel and Deputy Commissioner by MCOs, those organizations have to justify on 10:00 AM, in Room 129 of the Capitol Annex. Craycraft gave an overview of the department a day to day basis the necessity of that service. Senator Matt Castlen, Chair, called the meeting and funding for substance abuse disorders. There being no further business before the to order, and the secretary called the roll. In response to questions by Representative subcommittee, the meeting was adjourned at Present were: Westrom, Dr. Brenzel stated that there have been 11:03 PM. Members: Senator Matt Castlen, Co-Chair; around 150 contracts granted to the community Representative Danny Bentley, Co-Chair; from federal funds to help treat substance abuse INTERIM JOINT COMMITTEE ON Senators Christian McDaniel, Morgan McGarvey, disorders. There are some specific expectations STATE GOVERNMENT and Stephen Meredith; Representatives Melinda on data collection and the responsibility for Minutes of the 1st Meeting Gibbons Prunty and Susan Westrom. those community programs to collect that data of the 2019 Interim Guests: Stephanie Bates, Deputy with the goal of service provision is written into July 19, 2019 Commissioner, Department for Medicaid the contracts. The administrative regulations Call to Order and Roll Call Services, Cabinet for Health and Family Services are under revision regarding the qualifications The first meeting of the Interim Joint (CHFS); Ann Hollen, Senior Behavioral Health for staff working at the treatment facilities Committee on State Government was held on Policy Advisor, Department for Medicaid which varies by facility and which program Friday, July 19, 2019, at 3:00 PM, at the Ferguson Services, CHFS; Allen J. Brenzel, M.D., M.B.A., licensure is being utilized. Dr. Marks stated Community Center of the Boone County Medical Director, Department for Behavioral that all KORE funded programs are Alcohol Historic Courthouse in Burlington, Kentucky. Health, Developmental and Intellectual and Other Drug Treatment/Behavioral Health The Committee met jointly with the Interim Disabilities (BHDID), CHFS; Stephanie Service Organization (AODE/BHSO) licensed Joint Committee on Local Government. Senator Craycraft, Deputy Commissioner, BHDID, facilities. Dr. Brenzel stated that the Cabinet’s Wil Schroder, Chair, called the meeting to order, CHFS; and Katherine Marks, Ph.D., Kentucky goal is treatment on demand, and the Cabinet is and the secretary called the roll. Opioid Response Effort (KORE) Project Director, close to meeting that goal as long as it continues Present were: BHDID, CHFS. to increase awareness of what services are Members: Senator Wil Schroder, Co- LRC Staff: Miriam Fordham, Kevin Newton, available. There has been a dramatic expansion Chair; Representative Jerry T. Miller, Co-Chair; and Jay Jacobs. in the number of providers, the size of those Senators Robby Mills, Albert Robinson, and Funding for Substance Use Disorder providers, and the number of individuals that Damon Thayer; Representatives McKenzie Treatment and Prevention Services can be treated. Cantrell, Jeffery Donohue, Larry Elkins, Joseph Department for Medicaid Services In response to questions by Senator M. Fischer, Joe Graviss, Richard Heath, Reginald Deputy Commissioner Bates and Ms. Meredith, Deputy Commissioner Craycraft Meeks, Patti Minter, Jason Nemes, Attica Scott, Hollen, discussed the Section 1115 Substance Use stated that the $20 million SAPT block grant James Tipton, and Les Yates. Disorder Demonstration being implemented by requires the Cabinet to maintain a certain level Guests: Speaker David Osborne, Speaker the Department for Medicaid Services (DMS). of general fund in order to retain those funds. Pro Tem David Meade, and Majority Floor In response to questions by Senator CHFS will be requesting an appropriation Leader, Bam Carney, Kentucky House of Meredith, Ms. Hollen stated that methadone is increase of around $30 million to be able to use Representatives; Senator John Schickel, 11th now covered as a key component of treatment the federal funds it will be receiving. Senate District; Representative Ed Massey, 66th of Opioid Use Disorder (OUD), and there In response to questions by Representative House District; Kristin Baldwin, Northern is coverage across the Commonwealth with Prunty, Dr. Brenzel stated that the hospitals are Kentucky Chamber of Commerce; Boone County 191 residential treatment providers. Deputy now required by the Joint Commission to track Judge/Executive Gary Moore; Campbell County Commissioner Bates stated that all five of the each provider, how much opiates each provider Judge/Executive Steve Pendery; Burlington Fire Medicaid Managed Care Organizations (MCOs) prescribes, and then try to identify which Protection District Chief Jeff Barlow; Point do serve the foster care population which also provider is an outlier. The Kentucky Hospital Pleasant Fire Protection District Assistant Chief includes adoption subsidy children. Association’s (KHA) statewide initiative has Eric Seibel; Doug Bivins, BlueStart US, Hebron, Deputy Commissioner Bates stated that the an advisory board that is working with all the Kentucky; Michael Poynter and Bob Andrew, foster care population is not vulnerable if one of hospitals, and the advisory board’s job will be Kentucky Board of Emergency Medical Services; the MCOs drops out, CHFS would fall back on to train and monitor across those health care Chief Gregg Bayer and Chief Cathy Rigney, the other MCOs and the details for handling that organizations. KHA is working with residents Kentucky Association of Fire Chiefs; Dan Ison, situation are written in the MCO contracts which and funding training for the recognition of Shelby County; Ron Wolf, Associated General are posted to the Finance Cabinet’s website. opiate use disorder and the risk factors to the Contractors of Kentucky; Bryanna Carroll, In response to questions by Representative University of Pikeville, University of Louisville, Kentucky League of Cities; and Gay Dwyer, Bentley, Ms. Hollen stated that withdrawal and the University of Kentucky medical centers Kentucky Retail Federation. management was covered prior to July 1, and trying to influence as many individuals in LRC Staff: Mark Mitchell, John Ryan, Joe 2019, and has been expanded in the DMS medical schools to have the training introduced Pinczewski-Lee, Daniel Carter, and Cheryl implementation plan to cover all four levels of into the curriculum. Dr. Brenzel stated that most Walters. withdrawal management. of the housing that the commonwealth funds are Ms. Kristin Baldwin, Vice President of Public Approval of Minutes provided by agencies as part of the continuum. Affairs and Communications with the Northern Senator Meredith moved that the minutes Dr. Marks stated that there is a section of Kentucky Chamber of Commerce, welcomed the from the June 4, 2019, meeting be approved, the recovery housing that is not operated by any committees and told members about the events motion was seconded by Representative Bentley of the treatment or recovery community. This planned for them in conjunction with Northern and all were in favor. housing consists of standalone houses, and there Kentucky United.

18 2019 Interim LEGISLATIVE RECORD Welcome and Discussion of Local Issues include operating well beyond expectations direct November elections but does not want Boone County Judge/Executive Gary Moore of original charter and changing the mission new bureaucracies to be created. also welcomed the committees to Northern and responsibility of the fire district. The th20 Representative Miller stated that he agreed Kentucky. He told the members that daytime century structure is not working anymore. There with Senator Thayer and applauds the fire population has doubled in Boone County. The is a misunderstanding of how KRS Chapter districts’ idea of consolidation. In response to Visitor’s Bureau, TANK, and Sanitation District 75 Fire District Board members are elected, a a question from Representative Miller, Chief #1 are collectively working together. If Northern misunderstanding of board members’ authority Barlow replied that not all fire districts charge Kentucky is given the tools, it can fend for itself. and responsibility, and there is limited revenue the 20 cents maximum for fire service. Most fire Campbell County Judge/Executive Steve authority. districts charge 17 to 20 cents with the smallest Pendery told the committees that Northern The anticipated benefits of consolidation being 12.2 cents. Kentucky is working for prosperity. There are include combining administrative functions and In response to another question from 37 cities within three counties of Northern eliminating redundant administrative efforts, Representative Miller, Chief Siebel said the Kentucky. Eighty percent of the jobs within the creating a diverse specialized-skill career path Boone County response time is 12 to 15 minutes. region are in Boone County. for personnel that is currently unsustainable; The response time should be within five minutes. In conclusion, Judge Moore mentioned the recruiting and retaining improvements by Discussion of Fire Department Hiring Amazon hub that is going to be built in Boone growing workforce strengths; strengthening of Candidates having EMT and Paramedic County. mid-level officers and management; expanding Certification Discussion of Consolidation of Local and strengthening specialized divisions and Mr. Michael Poynter, Executive Director Emergency Services services; reducing and eliminating redundant of the Kentucky Board of Emergency Medical Chief Jeff Barlow, with the Burlington Fire capital; and increasing purchasing power. Services (KBEMS), gave the committees the Protection District, discussed Fire/EMS/Rescue Chief Barlow told the committee that fire following statistics: there are 13,379 certified or Governance Reform. The Boone Emergency districts are asking for the creation of a new licensed providers; 220 licensed EMS agencies; Services of Tomorrow Comprehensive Study entity, whereby the existing Chapter 75 Fire 1,147 ground ambulances; 72 helicopter and Recommendations was initiated in October Districts or other organizations can opt to ambulances; five fixed wing ambulances; 885,307 2017, and released in October 2018. The study remain independent entities as they currently EMS incidents in 2018 (2,426 per day); one out included three separate analyses: (1) retaining exist and municipalities and counties can opt of every five citizens are in contact with EMS independence, (2) full consolidation, and (3) to continue to provide their own services. There annually; and patients 50 years and older account semi-consolidation by enhancing cooperative should be clear accountability of the governing for 68 percent of all EMS incidents. agreements. board—majority elected on general November There are four disciplines of training: (1) Governance reform legislation for fire ballot, and there should be diversified revenue Emergency Medical Responder (EMR) which agencies is needed because tax reforms reduce and taxing authority. Legislation for the new requires 50 hours of training and provides revenues essential to providing fire/EMS/rescue entity needs to: (1) protect existing retirement basic immediate lifesaving interventions; (2) services; economic growth and development structures; inclusion provides no greater, and Emergency Medical Technician (EMT) which create service demands before revenues are no less, retirement system benefit status for requires 150 hours of training and provides basic realized; there can be an unequal cost share for employees; (2) protect existing health plan stabilization and safe transportation of patients; services; and decreasing volunteers and labor coverages already in place to allow continuation (3) Advanced Emergency Medical Technician shortages create operational costs that exceed of existing health insurance coverage; no state (AEMT) requires 400 hours of training and prior legislative funding models. health insurance mandate; and (3) provide that provides basic and advanced stabilization and The author of the study recognizes that the taxation beyond any established caps be required safe transportation of patients; and (4) Paramedic legislature seeks direct public accountability to present to voters for a direct ballot decision. which requires 2,000 hours of training and of service boards; seeks taxpayer protections; Accountability stemming from the legislation provides advanced care for critical and emergent November ballot elections for governance; would be through requiring: (1) existing elected patients. represents taxpayer interests for essential services boards passing a majority decision to opt-in Since 2011, there has been a certification with timely delivery; and wants to ensure that to a consolidated emergency service district; and licensure pass rate improvements of 14 service boundaries are consistent with ballot (2) voters directly elect majority of the board percent for EMTs and has improved 28 percent precinct boundaries for general elections to be governing a consolidated emergency service for paramedics. possible. The public needs to have a strong and district; and (3) voters directly voting to approve There are five agency organization types: direct voice in the level of service expectations or deny any taxation beyond existing limits. hospital, governmental/non-fire, community/ for their local community. Voters decide the Mr. Doug Bivins, Chief Operating Officer for non-profit, fire department, and private/non- amount taxpayers in that locale are willing to pay BlueStar US, gave the committees background on hospital. The number of providers has increased for emergency services. BlueStar, which is located in Hebron, Kentucky. but they are having challenges in staffing them. Assistant Chief Eric Seibel, with the Point BlueStar is one of the largest and fastest growing Splitting in certification training levels, EMR Pleasant Fire Protection District, discussed solutions-based distributors in the world. Point and EMT providers have decreased lately, while current challenges to fire/EMS/rescue.Pleasant Fire Protection District cooperated with AEMT and EMTP providers have increased. Volunteers, labor pools, revenue authority Mr. Bivins in explaining their fiscal obligations The concerns of KBEMS include: staffing; and sources, and grants/alternative funding is and were good stewards of the district’s tax funds. growing industry; expanding roles, which include decreasing, disappearing, or limited. Residential/ Senator Thayer said he was interested in critical care, flight paramedic, community, commercial growth and sprawl, run volume, seeing details of the fire districts’ proposal. There wilderness, tactical and emergency paramedics; service demands/expectations, personnel costs, should be accountability and transparency from furthering education; and salaries. Responses CERS contribution rates, and operational costs the boards. It is an inefficient way to fund the fire to the concerns include researching alternative are increasing. Problems in the 21st century districts. He likes the idea of consolidation and training delivery methods, which include THE KENTUCKY GENERAL ASSEMBLY 19 accelerated training, distance learning, and Senator Schroder announced that the next pharmaceutical formulary: formulating its own scheduling around work; increasing marketing meetings of the two committees would be held formulary, adopting another state’s formulary, and public relations; Education Committee on August 22nd at the Kentucky State Fair. or choosing one of the two existing commercial Accreditation Workgroup identifying best There being no further business, the meeting formularies which are the Official Disability practices; regulator revisions to address issues was adjourned at 4:30 p.m. Guidelines (ODG) or the American College brought to the Board by stakeholders; and of Occupational and Environmental Medicine leadership. INTERIM JOINT COMMITTEE ON (ACOEM) Guidelines. The ODG formulary is Chief Gregg Bayer, President of the Kentucky ECONOMIC DEVELOPMENT AND the most widely used and has been adopted by Association of Fire Chiefs (KAFC), told the surrounding states. Tennessee and Texas were two WORKFORCE INVESTMENT committee that fire chiefs are dedicated to ease Minutes of the 2nd Meeting states that the Department examined. Answering the burden on EMS, in particular regarding of the 2019 Interim a follow up question, the Commissioner said recruitment, retention and also training. Training July 11, 2019 that one of Texas’s challenges has been getting time is an issue. The KAFC is looking at on-line Call to Order and Roll Call physicians to abide by the formulary as it applies learning and workforce development programs. The 2nd meeting of the Interim Joint to legacy injury claims. He said that within the He referred members to written remarks from Committee on Economic Development and regulation are specific phase out dates that will Chief Wayne Briscoe of the City of Frankfort, Workforce Investment was held on Thursday, allow the medical community to adjust to the which were included in the committee members’ July 11, 2019, at 1:00 PM, in Room 154 of the new formulary. Physicians may prescribe outside folders. Capitol Annex. Representative Russell Webber, of the formulary in certain circumstances if it is Chief Cathy Rigney, with the Winchester Chair, called the meeting to order, and the proven to be necessary. Fire Department and KAFC, stated that she secretary called the roll. Replying to Representative Lynn Bechler, agreed with Chief Bayer. The KAFC would like Present were: Commissioner Swisher explained that utilization different options on the front end to get boots on Members: Senator Danny Carroll, Co- review physicians are selected by the carrier, and the ground. Chair; Representative Russell Webber, Co-Chair; a utilization review process has to be provided Regarding higher education requirements, Senators Perry B. Clark, Rick Girdler, Denise per regulation. The Department does not have Representative Meredith commented that Harper Angel, Ernie Harris, Alice Forgy Kerr, Wil a role in choosing a utilization physician. The he feels a precedent is being set that is cost Schroder, Reginald Thomas, Mike Wilson, and Commissioner explained that an aggrieved party prohibitive and would like to steer away from Max Wise; Representatives Lynn Bechler, John has the option to file a medical dispute with the the requirement of higher education. In years Blanton, Charles Booker, McKenzie Cantrell, Department. past, Kentucky did not require national registry Daniel Elliott, Chris Freeland, Al Gentry, Kathy Answering a question from Representative recognition. He wanted the KBEMS’ thoughts Hinkle, Thomas Huff, Nima Kulkarni, Savannah John Blanton regarding one of his constituents, about the national test. Maddox, Jason Petrie, Ashley Tackett Laferty, the Commissioner said that this regulation Mr. Bob Andrew, Director of Education and Buddy Wheatley. would not help his constituent who had with the KBEMS, told Representative Meredith Guests: Robert Swisher, Commissioner, medications denied and had to request a review that state law establishes standards. He discussed Department of Workers’ Claims; Dale Hamblin, of that decision, but the formulary will make it the history of the various elements in the scope Counsel, Department of Workers’ Claims; less likely for medications to be denied. of practice and the use of the National Registry Mike Nemes, Deputy Secretary, Education and Addressing Co-Chair Danny Carroll, Exam and the rationale behind its use. Workforce Development Cabinet; Lana Gordon, Commissioner Swisher said that the formulary Representative Meredith commented that Commissioner, Department of Workforce is standardized and all physicians are required Kentucky needs to focus on practicing in the Investment; Charles Aull, Public Policy Manager, to follow it. Statutorily, the Commissioner of field instead of taking a test. Greater Louisville Inc. (GLI). the Department has the power to amend the Representative Rothenburger commented LRC Staff: Carla Montgomery, Andrew formulary. Per this administrative regulation, that his biggest concern is EMT training classes Manno, Chip Smith, Candice Messer, and Sasche the Commissioner is required to review the do not seem to be offered anymore in the rural Allen. formulary annually. areas. The Kentucky Fire Commission was Approval of Minutes Responding to Representative Ashley looking at making money available for EMT A motion to approve the minutes of the June Tackett Laferty, Commissioner Swisher clarified training. 06, 2019 meeting was made by that the formulary is a binary system in which Mr. Michael Kurtsinger, with the Kentucky Senator Danny Carroll, seconded by Senator each medication has either a Y or N status. A Fire Commission, told Representative Rick Girdler, and approved by voice vote. Y status medication can be prescribed without Rothenburger that there is money in the budget Consideration of Referred Administrative a utilization review and without the necessity for EMT training but could not commit at this Regulation of preauthorization. An N status medication time. 803 KAR 025:270 & E – Pharmaceutical indicates that the prescribing physician needs Chief Bayer commented that it has become formulary. “The purpose of the formulary is to provide more information to the carrier. If more burdensome to provide training programs. to facilitate the safe and appropriate use of a medication is denied, then the prescribing There needs to be more training but it is so cost prescription drugs in the treatment of work- physician can find an alternative that has similar prohibitive right now. related injury and occupational disease.” therapeutic characteristics. In response to a question from Representative Commissioner Robert Swisher and Dale Hamblin Tipton, Mr. Poynter stated that ten high schools were present to explain the administrative 2019 Regular Session House Bills 333 and offer EMT training. Mr. Andrew added that 13 regulation and answer questions. 391 high schools offer paramedic training programs. Responding to a question from Representative The need for these two bills is driven by The KBEMS is trying to get more. Satellite Al Gentry, Commissioner Swisher stated that the talent attraction and retention stemming from programs are available and held offsite. Department had three choices when choosing a the struggle to meet workforce demand. There

20 2019 Interim LEGISLATIVE RECORD are currently 134,800 job openings in the and offers apprenticeships concentrated in Secretary speculated that finance and budget state but only 26,220 active job seekers. The STEM fields such as radiography, nursing, and issues could be a factor of why HB 391 says “Not job demand by 2022 will be 415,041. About telehealth technician. more than 2,500 of the 10,000 employees shall be 25 percent of graduates from Kentucky post- Unemployment Insurance qualified employees in recovery.” secondary institutions are employed in the state Commissioner Gordon gave an overview Replying to Representative Nima Kulkarni, three years after graduation, and additionally, of the modernization and progress of the Mr. Aull said immigrants are important to over the last five years the Commonwealth’s Unemployment Insurance Program. A bill workforce development and population growth. average net migration has been approximately impacting the Service Capacity Upgrade Although GLI makes efforts to ensure employers 1,500 people per year. The proposed legislation Fund (SCUF) was effective July 1, 2018 and and employees who are immigrants feel will offer tax credits as an incentive to employees is intended to upgrade technology through welcomed in the Louisville area, immigration and employers. HB 333, or the Highly Skilled the acquisition of new software and increase reform has to occur on the federal level and is Employee Tax Credit, is for individuals who service delivery capacity by the Unemployment an ongoing issue. Addressing another question, either stay in Kentucky or relocate to Kentucky Insurance Division. There is a $60 million Deputy Secretary Nemes said he would follow up to fill a job in a high demand industry sector. collection cap over the course of a maximum with Representative Kulkarni regarding federal These sectors include manufacturing; healthcare; of five years with a projected $10 million to $12 funds collected as a result of the 1998 American business and information technology; million to be collected each year from calendar Competitiveness in the Workplace Act. construction; and transportation, distribution, years 2019 to 2023. In the first quarter of 2019, and logistics. The credit would be $1,500 per the Unemployment Insurance Trust Fund Senator Reginald Thomas expressed applicant with a total approval cap of $3 million balance was $506.6 million, the unemployment concerns about HB 333 and HB 391 due to a a year. HB 391, or the Earn and Learn Tax contributions from employers was $44.5 million, loss of funds for the state and the bills are too Credit, is for employers who pay the educational and the benefits to claimants was $82.1 million. similar to the existing Work Ready Scholarship expenses of employees in high demand industry The current maximum weekly benefit is $552, Program. areas. There would be a credit of up to 25 percent which is greater than the national average of Replying to Senator Max Wise, Deputy for employee educational costs, and companies $344. The state’s maximum weeks of eligibility Secretary Nemes said there may be some overlap would be eligible for $1,500 per employee per is 26 compared to the national average of 24.1 in the Work Ready Scholarship Program and year with an approval cap of 10,000 employees while the average benefit duration is 18.4 weeks what is proposed in HB 333 and HB 391 but per year. Deputy Secretary Nemes explained that compared to the national average of 15.4. The changes can be made during the Interim and HB 391 also includes a portion that addresses claim duration and maximum benefit amount before the 2020 Regular Session. training to qualified employees in recovery. Mr. are challenges for the Department as well as After Representative Jason Petrie expressed Aull, of GLI, said that he believes these two tax aging technology, re-employment activities, and concerns about the target audience of the credits can incentivize companies to develop the success of connecting suitable work with proposed legislation, Deputy Secretary Nemes their own training and educational programs, the Commonwealth’s workforce. The Deputy stated that parts of the legislation should read attract employees from other states, and keep Secretary added that unemployment offices are “skilled” instead of highly skilled to avoid established employees and their families in the being converted to career centers to better serve confusion with low skill, medium skill, and Commonwealth. Legislation such as HB 333 and not only the unemployed but also those currently high skill. Representative Petrie also expressed 391 may help the Commonwealth to compete employed who want additional training to concerns about what income levels would with other states in the region. further their careers. benefit most from the tax credit and said he was Registered Apprenticeship Program In response to Co-Chair Danny Carroll, not convinced it would help those from another Registered apprenticeship provides Deputy Secretary Nemes said that HB 333 and state. employers with a highly skilled and qualified HB 391 do have similarities to the Work Ready Co-Chair Russell Webber announced that workforce that is critical for the state’s economic Scholarship Program, but the proposed bills the next meeting will be on August 22, 2019 at growth and ability to compete on an international are tax credits for individuals and employers in the Kentucky State Fair. scale. Over $1.5 million in federal funding was the five high demand sectors. Co-Chair Carroll There being no further business, the meeting allotted to the state to expand apprenticeship expressed concern that these bills may be a was adjourned at 2:41 p.m. initiatives which includes 251 registered duplication of existing programs and would be programs, nine competency based programs, costly to the state. Answering another question, and 3,391 registered apprentices. New programs Deputy Secretary Nemes stated he is not aware INTERIM JOINT COMMITTEE have been added within the five high demand of any plans to propose legislation to address ON TOURISM, SMALL sectors including a registered nurse program; unemployment insurance for smaller businesses an information technology program involving that cannot afford to buy into the state’s BUSINESS, AND INFORMATION coding and programming; and programs in unemployment insurance system. TECHNOLOGY civil service within various state agencies such Addressing Representative McKenzie Subcommittee on Economic Development, Small Business, and Information Technology as the Cabinet for Health and Family Services, Cantrell, Deputy Secretary Nemes agreed Minutes of the 1st Meeting Transportation, Commonwealth Office ofthat it would be beneficial for the two bills of the 2019 Interim Technology, and the Department of Veterans to be passed together. Answering a follow up July 19, 2019 Affairs. Deputy Secretary Nemes also discussed question, the Deputy Secretary confirmed that Call to Order and Roll Call the K-Tech Program which is intended to the high demand industry sectors are ones that The 1st meeting of the Subcommittee on equip students with recognized post-secondary have already been established by the Workforce Economic Development, Small Business, and credentials and STEM skills. It was launched Innovation Board but the Board meets regularly Information Technology of the Interim Joint with a $627,000 grant for students enrolled in and can recommend changes as needed. Committee on Tourism, Small Business, and Hazard Independent and Perry County School Addressing another question, the Deputy Information Technology was held on Friday, THE KENTUCKY GENERAL ASSEMBLY 21 July 19, 2019, at 1:00 PM, at the CVG Centre in total labor income. in Erlanger, Kentucky. Representative Diane St. In January 2017 Amazon announced that INTERIM JOINT COMMITTEE Onge, Chair, called the meeting to order, and the its new air cargo hub will be located at CVG. secretary called the roll. This represents a $1.5 billion investment and ON TOURISM, SMALL Present were: is projected to create 2,000 jobs at its initial BUSINESS, AND INFORMATION Members: Senator Danny Carroll, Co- opening. The Amazon Prime Air hub will be over TECHNOLOGY Chair; Representative Diane St. Onge, Co- 900 acres and include a three million square foot Minutes of the 2nd Meeting Chair; Senators Ernie Harris, Wil Schroder, and sorting facility, a loading dock, and ramp space of the 2019 Interim July 11, 2019 Reginald Thomas; Representatives Lynn Bechler, for 100 planes. Until construction of phase one Call to Order and Roll Call George Brown Jr, Chris Freeland, Jim Glenn, Jim is complete in the third quarter of 2021, Amazon The 2nd meeting of the Interim Joint Gooch Jr., Richard Heath, Josie Raymond, Bart has partnered with DHL to utilize its existing Committee on Tourism, Small Business, and Rowland, Maria Sorolis, Cherlynn Stevenson, space for package sorting. Groundbreaking for Information Technology was held on Thursday, Nancy Tate, and Les Yates. the major project took place May 2019. July 11, 2019, at 3:00 PM, in Room 154 of the Guests: Kristen Baldwin, Vice President of Creating a hub of innovation has been a Capitol Annex. Representative Tommy Turner, Public Affairs and Communications, Northern top priority for the airport. CVG is presently Chair, called the meeting to order, and the Kentucky Chamber of Commerce; and Brian engaging startups, integrating universities secretary called the roll. Cobb, Chief Innovation Officer, CVG Centre. through research and development, partnering Present were: LRC Staff: Andrew Manno, Chip Smith, with established companies, and navigating Members: Senator Danny Carroll, Co- Candice Messer, and Sasche Allen. positive regulatory change. Partnerships with Chair; Representative Tommy Turner, Co-Chair; Northern Kentucky Chamber of startups and universities such as University of Senators Rick Girdler, Ernie Harris, Wil Schroder, Commerce Introduction Louisville, University of Kentucky, and Northern Reginald Thomas, Mike Wilson, and Max Wise; Kristen Baldwin, the Vice President of Public Kentucky University have been utilized to Representatives Lynn Bechler, Terri Branham Affairs and Communications for the Northern improve and explore logistics, cyber security, Clark, George Brown Jr, Jeffery Donohue, Chris Kentucky Chamber, welcomed members to application development, work health and safety, Freeland, Chris Fugate, Jim Glenn, Robert Northern Kentucky. She said that although the and weather applications. CVG is currently Goforth, Jim Gooch Jr., David Hale, Richard area only makes up 10 percent of the state’s working on automated kiosks for passenger Heath, Cluster Howard, Kim King, Bobby population, it accounts for 20 percent of state check in that will maximize efficiency and lower McCool, Michael Meredith, Charles Miller, Ruth tourism. Mrs. Baldwin also explained that there costs. Self-navigating Segways that could be Ann Palumbo, Josie Raymond, Brandon Reed, is a need for infrastructure funding to continue used by those with limited mobility are being Maria Sorolis, Cherlynn Stevenson, Ashley to make improvements in the area. developed. Lastly, CVG is working to develop Tackett Laferty, Nancy Tate, and Les Yates. Cincinnati/Northern Kentucky wearable technology for individuals with vision Guests: Victor Slone, Martin County International Airport: 2019 CVG Update disabilities. Magistrate; Chris Musgrave, Interim Executive The CVG Airport encompasses 7,700 acres, Answering a question from Representative Director, Kentucky Mountain Regional which is larger in land area than the city of Jim Glenn who mentioned the airport in Recreation Authority; Jerry Stacy, President, Florence, and have runways that are positioned Singapore that has become a tourist attraction, Kentucky Mountain Regional Recreation in a way to lessen noise for the surrounding Mr. Cobb said that CVG’s main focus is to Authority; Matt Wireman, Treasurer, Kentucky area. In June 2019, CVG set a new all-time local concentrate on consumers and to offer multiple Mountain Regional Recreation Authority; passenger record of 426,246 passengers served. carrier options. Frank Jemley, Chief of Staff, Tourism, Arts, and According to U.S. Department of Transportation Responding to Co-Chair Danny Carroll, Heritage Cabinet; John Cox, Communications rankings, CVG’s $346 average airfare is the Mr. Cobb stated that partnerships with regional Director, Tourism, Arts, and Heritage Cabinet; lowest in the region, and it is the only airport airports have been created when a plane may Laura Prewitt, Executive Director, Kentucky in the region lower than the national average of require maintenance when it has landed at Horse Park; Kim Baker, President and CEO, $353. In June 2019, Frontier Airlines announced another regional airport or cases when inclement Kentucky Center for the Performing Arts; Rich new nonstop routes from CVG in the fall of weather is a factor. Storm, Commissioner, Department of Fish and 2019 to include Fort Lauderdale, Miami, New Addressing Co-Chair St. Onge, Mr. Cobb Wildlife; Karen Waldrop, Deputy Commissioner, Orleans, and Sarasota-Bradenton. The airport is explained that the General Assembly can assist Department of Fish and Wildlife; Kevin Kelly, a regional jobs hub with more than 70 employers CVG by formulating solutions to connect those Public Information Officer, Department of Fish on campus and more than 31,000 total jobs looking for employment with the actual job and Wildlife, and Brian Clark, Chief of Staff, supported. Employees are 52 percent Kentucky opportunities. Department of Fish and Wildlife. residents, 38 percent Ohio residents, and 10 There being no further business, the LRC Staff: Carla Montgomery, Andrew percent Indiana and other state residents. CVG meeting was adjourned. Manno, Chip Smith, Candice Messer, and Sasche has an annual economic impact of $4.4 billion, Allen. and the total passenger volume has grown 38 Approval of Minutes percent since 2015. Air service growth has been A motion to approve the minutes of the June driving down airfares and therefore contributing 06, 2019 meeting was made by to increased passenger volume. Every year since Representative Chris Fugate, seconded by 2016 CVG has supported more than $21 million Senator Wil Schroder, and approved by voice in income tax revenues for the Commonwealth vote. and more than $4 million for Ohio. Furthermore, Rails to Trails the airport supports more than $625 million in Representative Chris Fugate and members direct labor income and more than $1.3 billion

22 2019 Interim LEGISLATIVE RECORD of the Kentucky Mountain Regional Recreation draw in more visitors, create jobs, and add new Representative Cherlynn Stevenson Authority gave an update of the program. money into the economy. commended the idea of creating a trail system Representative Fugate said he and members of In response to Representative Bobby because it can add to the economy through the Authority have looked to the Hatfield and McCool, Representative Chris Fugate said adventure tourism in the eastern part of the McCoy Trail System in West Virginia as an that the trail system in West Virginia had been state. She said that tourism revenue is often not example for the Kentucky Mountain Regional funded through permit sales and support from capitalized on in the Commonwealth. Recreation Authority. Last year the Hatfield and the state legislature, but it will take time to start Responding to a question from McCoy Trail System generated $2.1 million in selling permits for the trail system in Eastern Representative Terri Branham Clark, permit fees and had 51,000 visitors, 85 percent Kentucky. The trails in the various counties have Representative Fugate confirmed that it is of which came from outside a 100 mile radius of to be connected and marked. In addition, land planned for all trails in the 35 counties listed in the trail system. Representative Fugate detailed agreements have to be established with property statute to be connected, including her district of other statistics of West Virginia’s trail system and owners. Once those steps are taken, permits Boyd County. said that the development of Eastern Kentucky’s can begin to be sold to the trails. Mr. Musgrave Replying to Representative Robert Goforth, trail system could create major tourism and added that West Virginia generates substantial Mr. Musgraves said that he does not have a economic development opportunities. He stated revenue from paraphilia sales from the Hatfield complete list of contact information for all that he hopes in the 2020 Regular Session the and McCoy Trail System. Answering another 35 county representatives to send meeting General Assembly can appropriate funds for question, Mr. Musgraves said the Authority notifications to yet, which highlights the need for the Authority, including hiring a permanent was set up to be a non-taxing special purpose a full time executive director. executive director. governmental entity. Representative Ashley Tackett Laferty made Interim Executive Director Chris Musgrave Replying to Representative Lynn Bechler, remarks about the development of the trail said that in May of 2019 the Authority had a Representative Fugate stated that $1 million over system and the possible economic opportunities foundational meeting to establish the board the two year budget cycle would be requested it can create for the distressed counties of members and have had two other meetings. Mr. from the state General Assembly in the coming Eastern Kentucky which could create other Musgraves has accomplished everything thus Regular Session to get the trail system off the adventure tourism activities, restaurants, shops, far as a volunteer but cannot continue on as the ground. Representative Fugate said that the and supporting businesses. permanent executive director. He was recently goal is to connect all of the trails legally with Tourism, Arts, and Heritage Cabinet appointed as the Chief of Staff for the Department permission from land owners. He said eventually Frank Jemely, Chief of Staff for the Cabinet, of Local Government which will be a conflict the Authority would like to connect the trails of stated that information requested at a previous of interest. With a full time executive director, Eastern Kentucky to the Hatfield and McCoy meeting regarding the return on investment of the Authority will be able to move forward Trail System in West Virginia and the Spearhead a $150 million proposal for renovations to state with finalizing arrangements with existing Trails in Virginia to create a three state system. parks had been dispersed to members. He said trails, setting up accounts with the Finance and Answering a question from Representative that by August 1, 2019 members of the General Administration Cabinet, obtaining insurance, David Hale, Representative Fugate confirmed Assembly would be provided with a list of among other things. The Authority would like to that there are 35 counties in the Authority, completed, planned, and current projects of the be a self-sustaining entity that operates without and it has a board that includes nine county Department of Parks. interference from the General Assembly. Thus representatives which is either a county judge Kentucky Horse Park far, all counties involved have verbally agreed executive or a designee. Those nine board The Executive Director of the Kentucky to contribute $5,000 initially for the hiring of an member seats will be rotated each year, going Horse Park, Laura Prewitt, gave an overview of the executive director. At the Authority’s last board in alphabetical order of the county. In addition, economic impact of the park, new events at the meeting it was decided it would form a 501(c)(3) the board includes the Secretary of the Tourism, park, and future events. A 2016 analysis showed to seek private funding. Mr. Musgraves pointed Arts, and Heritage Cabinet; the Commissioner that the park has an annual economic impact of out that the way the legislation was written, of the Department of Local Government; the over $130 million to the Commonwealth. That there are many other recreational opportunities Commissioner of the Department of Fish and impact is attributed to the park’s events, tourists, possible besides ATV trails such as bicycle trails, Wildlife; a nonvoting state Representative; and and campgrounds. The park holds over 200 horse trails, blue water trails, and historic and a nonvoting state Senator. Co-Chair Tommy equine and non-equine events each year, with six cultural sites. Turner added that some county fiscal courts new events being added in 2019. Those events The President of the Authority, Jerry in the eastern part of the state requested to included the first park owned horse show, The Stacy said that the economic impact in West be included in the legislation that were not Kentucky Horse Park Spring Opener. The park Virginia from the trail system was $23 million. originally involved. has hosted almost 20,000 horses this year, which The creation of that type of economic impact means the people working with and coming to would be extremely beneficial after the loss of Addressing a question from Representative see those horses are spending money in Central coal mining jobs in the region. The trail system Michael Meredith, Representative Fugate Kentucky at hotels, restaurants, shops and other will begin to generate revenue along with the explained that West Virginia’s state legislature local businesses. creation of other entrepreneurial and investment gave $1 million for liability insurance and its Although the park has added several new opportunities. All 35 counties involved with the Authority purchased an additional $9 million of revenue streams, the staff has been focused on Authority have pledged to find funds in their coverage, but the Authority assumes all liability some international events such as the German budgets to help assist with the endeavor. Matt and all private land owners receive sovereign based Equitana that will be held at the Park in Wireman, said that recreational opportunities immunity. Representative Meredith pointed out 2020. The three day event is expected to bring at are imperative to the distressed counties in the recent federal court rulings that may have least 30,000 to the Park some of which will stay at Eastern Kentucky. Establishing the trail system some effect on waiver systems for places that the park’s campground. The park’s campgrounds and other supporting businesses will help to charge a fee to use their facilities. welcome an average of 40,000 campers a year THE KENTUCKY GENERAL ASSEMBLY 23 that come from all 50 states, but Kentucky and national audiences while driving tourism Wildlife Service would dedicate personnel residents account for 44 percent of reservations. dollars to the area. Ms. Baker reiterated that and equipment to the state to combat the carp In addition, group tours and horseback riding no state tax dollars were used to build the Old infestation, specifically deploying its unified have become a renewed focus which has showed Forester’s Paristown Hall. She closed by giving method which is a combination of sound and a 10 percent increase in revenue. Ms. Prewitt an overview of the Kentucky Center Governor’s specialized netting. closed by detailing an online ticket solution that School for the Arts (GSA), which has been Chronic wasting disease (CWD) was also will allow visitors to purchase daily, annual, and hosted over the years at Bellarmine University, discussed which is a neurological disease that parking passes online beginning in early August Centre College, Transylvania University, and effects deer, moose, and elk. It is a contagious 2019. University of Kentucky. GSA has 98 percent of its prion disease that causes deterioration of Kentucky Center for the Performing Arts students attend college with 92 percent receiving the brain and causes the animals to become The President and CEO, Kim Baker, a scholarship averaging $20,000. emaciated, lose their fear of humans, react outlined the history, operation, and an Department of Fish and Wildlife erratically, and can eventually be fatal. CWD has upcoming venue opening of the Center. In Department leadership gave overviews and not been found in the Kentucky but has been 1980 the General Assembly and Governor updates. The Department uses various platforms found is six out of seven of the surrounding John Y. Brown developed a plan to build the to relay information to the public including states. Due to the proximity of known cases in $33.5 million Center through a public private Kentucky Afield Television, which is the longest other states, forward planning is being utilized partnership in which the state would provide continuously-running outdoors television show through the department’s communication team. partial funding, a foundation would provide in the country, Facebook, Twitter, and YouTube. Community forums have been held in the partial funding, and a portion of the Louisville Although Kentucky Afield Television draws western, eastern, and northern parts of the state transient room tax would also fund the operation 250,000 viewers each month, the most growth to give information about how to prevent CWD of the Center. It was established as a 501(c)(3) has been with YouTube page which receives from crossing into the Commonwealth. to promote the growth and development of 12 million views a year. The Department has Boater safety is currently being focused on, the arts while serving as a catalyst for tourism created 25 information videos this year that have specifically the use of alcohol and wearing life and talent attraction. The board of directors garnered 350,000 Facebook views. Available on jackets which are the top two factors in causes are appointed by the governor and the center is its website are statewide news releases, meeting of boat fatalities. Public service announcement administratively attached to the Tourism, Arts, agendas, video archives of committee and videos have been created by the Department and Heritage Cabinet. The Kentucky Center for commission meeting, and quarterly financial and posted on social media to bring awareness the Arts Corp was also created, in conjunction reports. Another communication medium to boating safety. Kentucky law requires each with the Finance and Administration Cabinet, that has been expanded is GovDelivery, which occupant of a boat to have a life jacket. Boating to supervise construction of the center and is a communication tool that will allow the safety educational videos are available on the provide all management functions for facility Department to engage customers and staff by department’s website, and a boating safety or any other property acquired or leased. The email. coordinator was recently hired. Department center is not included in the state’s personnel or Some of this information dispersed to Chief of Staff Brian Clark thanked members for pension systems and is considered a component citizens includes details regarding the Asian carp the passage of HB 248 during the 2019 Regular unit of the Commonwealth. Sources of funds crisis that the state is currently facing. Black, Session that gives conservation officers added for the fiscal year 2020 budget included two bighead, and silver carp have been infesting the authority to make boating under the influence percent from the Governor’s School for the lakes and rivers for the past several years. One arrests based on probable cause. Arts state appropriation, one percent from a solution has been the creation of a bio-acoustical Commissioner Rich Storm closed by state maintenance pool, 19 percent from the fish fence that will be installed by the end of 2019 detailing the department’s summer camp Louisville transient room tax, 10 percent from at Lake Barkley. These fences will use bubble program. More than 250,000 people have taken contributed income, and 68 percent through fences and a sound deterrent to prevent the fish part in the summer camp programs over the center operations. The budget in 1983 was $3 from continuing to travel any further. This effort years. There will be 4500 kids ranging in ages million and the budget for fiscal year 2020 is is a collaboration with the U.S. Fish and Wildlife of 10 to 13 to attend during the summer 2019. approximately $25 million. Service, the Unites States Geological Survey, the The campers will learn about nature, archery, Tennessee Wildlife Resources Agency, and the boating, outdoor survival, firearm safety, fishing, The Kentucky Center for the Arts Corp has United States Army Corps of Engineers through and swimming. At the close of camp, the children a family of venues that included the Kentucky a three year research grant. The Department also can obtain completion patches and their hunter Center, the Brown Theater on Broadway, and recently began contracting with commercial education card. The program staffs a director, the Old Forester’s Paristown Hall. The Kentucky fishermen to remove carp around the Louisville educators, superintendents, and maintenance Center houses Whitney Hall, Bomhard Theater, area through a $400,000 grant from the U.S. workers and has 8 air-conditioned cabins per and MeX Theater. The Brown Theater was Fish and Wildlife Service. Nine commercial camp that hold 25 to 30 campers. The yearly purchased by the center in 2018 and the Old fishermen are already under contract and in a budget of the program is $1 million which is Forester’s Paristown Hall opens to the public one day pulled out 8,000 pounds of fish from the about $300 per camper. July 23, 2019. Old Forester’s Paristown Hall Ohio River. The Department has also partnered Representative Ruth Ann Palumbo thanked is a 2,000 person standing room and part of a with the Kentucky Fish Center to help combat Ms. Prewitt for what the Kentucky Horse Park larger $32 million development project that is the massive number of carp. The Kentucky Fish has done in for the economy in her district. receiving tourism tax incentives. The venue is Center is a private business whose goal is remove Replying to a question from Co-Chair financed through private donations and a private five million pounds of carp from waterways by Tommy Turner, Commissioner Rich Storm stated commercial loan which will be maintained by the the end of 2019. Deputy Commissioner Karen that historically CWD has been transmitted Kentucky Center for the Arts Foundation. It will Waldrop highlighted a press release that had from both wild herds and commercial farms. attract national music artists with local, regional, just been issued which said the U.S. Fish and He said the zones of cases are hard to track

24 2019 Interim LEGISLATIVE RECORD because of the unpredictability of tracking the August 22, 2019 at the Kentucky State Fair. industry helps tie the area into the culture of animals. Three cases in surrounding states are There being no further business, the meeting the rest of the state. New Riff is five years old within 100 hundred miles of the state lines. The was adjourned at 4:52 p.m. and has invested $22 million in two campuses. Commissioner explained that it can take over a Another campus with new rick houses is in the year before a case is discovered. Commissioner INTERIM JOINT COMMITTEE ON planning stage. Later this summer, the distillery Storm said it may be time revisit commercial LICENSING, OCCUPATIONS, AND will add three additional fermenters, creating a deer farm legislation, and the department has 50 percent increase in production capability. ADMINISTRATIVE REGULATIONS planned to put together another deer working Minutes of the 1st Meeting Because of the economic investment and group to combat CWD. of the 2019 Interim additional tourism, during the last six years Responding to Representative Charles July 19, 2019 the attitude has changed toward the industry. Miller, Deputy Commissioner Karen Waldrop Call to Order and Roll Call However, the industry does need continued explained that dock permits are usually obtained The 1st meeting of the Interim Joint reduction of red tape and regulatory reform. through the department but there are certain Committee on Licensing, Occupations, and The Supreme Court in Tennessee will clarify the cases when they would be obtained from United Administrative Regulations was held on Friday, issue of commerce clause versus the right for States Army Corps of Engineers depending on July 19, 2019, at 10:30 AM, at Chas Seligman states to sell alcohol. This is important for the the location of the dock. Distributing Company, 10885 Clydesdale Court, smaller business to be able to ship to other states. Representative Chris Fugate expressed Walton, KY. Senator John Schickel, Chair, called Also, the ability to sell single bottles to tourists in his gratitude to the commissioner and the the meeting to order, and the secretary called the distillery gift shops will benefit the business. department for the success of the summer camp roll. Jack Wells said the craft industry appreciated program in Perry County. Present were: everything that the legislature has done over Addressing Representative Michael Members: Senator John Schickel, Co-Chair; the past few years regarding regulations. Boone Meredith, Commissioner Rich Storm said the Representative Adam Koenig, Co-Chair; Senators County Distilling Company is only four years Department is fully supportive of double fencing Tom Buford, Christian McDaniel, Damon old and is a much smaller operation than New of deer farms in an effort to prevent CWD. Thayer, and Reginald Thomas; Representatives Riff Distillery. Tourism has become a big part Answering a question from Co-Chair Matthew Koch, Nima Kulkarni, C. Ed Massey, of their revenue stream. The brown sign on the Tommy Turner, Deputy Commissioner Karen Chad McCoy, Jerry T. Miller, Kimberly Poore interstate has increased visitors 150 percent. Waldrop said because prions have been found Moser, Phillip Pratt, Diane St. Onge, and Buddy With e-commerce, alcohol needs to ship across in urine this can be a way to transmit CWD. Wheatley. state lines. Protect the shipping companies is Some states have banned urine unless in the Guests: Kristen Meadors Baldwin, currently the biggest problem. synthetic form. Responding to another question, Northern Kentucky Chamber of Commerce; The federal government placed a temporary Commissioner Rich Storm said the economic Jennifer Doering, Chas. Seligman Distributing reduction in the tax on proof gallons for craft impact of deer hunting industry in the state is Company; Bryan Alvey, Kentucky Distillers distilleries from $13.50 a proof gallon to $2.70 $550 million. Association, Jack Wells, and Josh Quinn, a proof gallon. This has an effect on their Replying to Representative David Hale, Boone County Distillery, Ken Lewis, New Riff business and what they are able to reinvest in Deputy Commissioner Karen Waldrop said that Distillery; Dan and Peggy Montgomery, Verona their operations. A tax break for craft distilleries there are over 20 full time commercial fishermen Vineyard Winery; Jessie Brewer, Boone County would be helpful. in total working on the Asian carp issue but Commissioner. Josh Quinn, Boone County Distillery, said more are needed. Answering another question, LRC Staff: Tom Hewlett, Bryce Amburgey, New Riff Distilling, Boone County Distillery and she said that the market is there for the carp that Jasmine Williams, Melissa McQueen, Lisa other small distilleries in the area are united and are being harvested. Commissioner Rich Storm Moore, and Susan Cunningham consider themselves to be colleagues. said there has been interest from the lobster bait Minutes Bryan Alvey, Kentucky Distillers Association industry. The minutes from December 10, 2018, (KDA), said the Northern Kentucky region is Representative Kim King spoke of her meeting were approved without objection. having a significant impact on the bourbon personal experience with the Department’s Welcome industry. As of 2018 the industry employed over summer camp program. Kristin Meadors Baldwin, with the Northern 20,000 people with a payroll of $1 billion dollars, Co-Chair Danny Carroll expressed his Kentucky Chamber of Commerce, welcomed and $2 billion dollars in capital investment. appreciation of the Department’s summer camp members to Northern Kentucky. She said that KDA partners with many other industries in the programs and thanked the Commissioner and passage of sports gaming could have a 20 percent state to bring in tourism. Visitors who come to Department on behalf of his constituents for increase in state tourism. Kentucky to visit a horse farm also want to visit a their work on the carp crisis. Chas Seligman Distributing Company distillery or a winery. The Bourbon Trail and the Representative Lynn Bechler stated that Jennifer Doering, Chas Seligman Bourbon Trail Craft Tour had over 1.4 million there have been a lot of entrepreneurial efforts Distributing Company, and her family welcomed visitors in 2018. made in his district and surrounding areas to the committee. She thanked the committee and HB 400 opened the door for shipping. The deal with the Asian carp including carp concrete. the General Assembly for passing legislation Tennessee Supreme Court decision will also Co-Chair Tommy Turner announced that makes the alcoholic beverage industry more have a positive impact. The KDA is letting other that will be a Subcommittee on Economic responsible. states know that we are open for business. The Development, Small Business, and Information Kentucky Distillers Association UPS is working with software companies to have Technology meeting on July 19, 2019 in Ken Lewis, New Riff Distilling, said the interstate shipping become a reality. Northern Kentucky, and the next meeting of the bourbon industry is increasingly important to The bourbon industry is the highest taxed full Interim Joint Committee on Tourism, Small Northern Kentucky. Northern Kentucky is often industry in the state with 60 percent of the Business, and Information Technology will be on seen as a suburb of Cincinnati. The bourbon revenue from every bottle going to taxes. It is THE KENTUCKY GENERAL ASSEMBLY 25 hoped that the federal tax extension that Mr. and 15 part-time employees working in the is a civil matter, their office is not able to be of Wells mentioned will become permanent. winery and restaurant. The winery has partnered assistance in recovering money the owner is out In response to a question from Representative with Walton-Verona High School FFA program for repairs. Koenig, Mr. Lewis said New Riff competed in the funding events and working with students, BR 94 will help landlords screen future San Francisco International Spirits competition, educating them about the wine industry and rental residents in order to protect their property considered the most prestigious in the world. how farming is important to this industry. investments. By reducing damage, and thus New Riff submitted five entries and all five won Partnering with other industries is reducing the cost of repairs, investors will double gold. important to grow tourism in the state. Therefore have more capital to invest in other projects. In response to a question from Senator the winery is now licensed to sell bourbon and Additionally, the new screening tool will improve Thayer, Mr. Alvey said there are a lack of beer. They have also added food sales to enhance neighborhoods and communities. reciprocal states and helpful language in other the experience. In response to a question from Senator states shipping laws. In Hawaii, if a resident Facebook is a primary mode of advertisement Thayer, Mr. Brewer said that with this new tool wants to ship a bottle of spirits to their home for the winery with 9,800 followers on their page. there would be a way to track damage left by a from another state they must have a retail Forty-five percent of the winery’s revenue comes tenant that would be reflected on the background license. Common carriers do not have the from customers from Indiana and Ohio. check allowing the landlord to rent to a better luxury of time to check for a license. Alaska, on Another consideration for the winery is quality tenant. the other hand, is wide open, as is D.C. IMX is growing their customer base, and becoming Senator Schickel said that there would be a a software company that KDA and UPS have known as the place people go for a consistent tour of the distributor warehouse showcasing all been working with regarding compliance. There experience. It is important to cultivate a team aspects of the business. are also discussions regarding new legislation. that partners with local high schools and two year There being no further business, the meeting Finally, the in-person piece of HB 400 could be colleges to develop individuals who want to work was adjourned at 11:36 AM. considered unconstitutional. There have been no in food service, farming, and manufacturing. law suites challenging it so far; however, that is This ensures quality in the products that they a factor. sell as well as great customer service and the In response to a question from Senator hospitality that Kentucky is known for. With INTERIM JOINT COMMITTEE ON Thomas, Mr. Alvey agreed that because of the today’s interest in “farm to table” restaurants, JUDICIARY Tennessee Distillers v. Total Wine case other the winery gets requests to deliver wine to those Minutes of the 2nd Meeting states will see an opportunity to begin online restaurants. However, this can be cost prohibitive of the 2019 Interim sales. Kentucky currently ranks 11th in distilleries with the current distribution model. Automation July 12, 2019 in the United States, even though Kentucky still of the licensing processes would be less time Call to Order and Roll Call produces 95 percent of the worlds bourbon. consuming. The 2nd meeting of the Interim Joint In response to a question from Senator Schickel commended the Committee on Judiciary was held on Friday, Representative Miller, Mr. Alvey said common Montgomery’s for all the hard work that they July 12, 2019, at 10:00 AM, in Room 154 of the carriers choosing to ship and laws in other states have put into their winery, adding that it is a Capitol Annex. Senator Whitney Westerfield, loosening restrictions will make shipping to beautiful place to visit. Chair, called the meeting to order, and the other states easier. When parity is realized it will In response to a question from Senator secretary called the roll. be easier to ship out of state. Thomas, Mr. Montgomery said this is a tougher Present were: In response to a question from climate for growing grapes with a lot of heat and Members: Senator Whitney Westerfield, Representative Kulkarni, Mr. Alvey said there is humidity. The American varietals Chambourcin, Co-Chair; Representative Jason Petrie, Co- a detailed breakdown of where tourists visit and Norton, Vidal all make good wines. The winery Chair; Senators Danny Carroll, Alice Forgy Kerr, spend their money. Seventy percent are from also grows traditional French Vinifera, Cabernet Gerald A. Neal, Wil Schroder, Dan “Malano” either out of state or out of the country. These are Franc, Petite Verdot, Riesling and Chardonnay, Seum, Robin L. Webb, Stephen West, and Phillip affluent visitors who spend money in the area. also, a German varietal called Dornfelder. Wheeler; Representatives John Blanton, Charles This is good for wineries, distillers, restaurants Kentucky does not have a signature varietal, a Booker, Kevin D. Bratcher, McKenzie Cantrell, and hotels. grape that we are known for, but the industry Daniel Elliott, Chris Harris, Joni L. Jenkins, Economic Benefits of Small Farm Wineries is working to develop such a grape. Once a Stan Lee, Derek Lewis, Savannah Maddox, C. Dan and Peggy Montgomery, Verona grapevine is established in this climate it will Ed Massey, Patti Minter, Jason Nemes, Brandon Vineyard Winery, noted that their winery do well. Legislatively the industry could use Reed, and Maria Sorolis was small in comparison to the other alcohol help with distribution to small local restaurants Guests: Senator Wil Schroder, Ted industries in Kentucky. The winery was that want to carry local wine but cannot find a Sandmann, Jasmine Heiss, Mike Shea, Tom established in 2005, planting 2,500 vines on the distributor who will sell one case at a time. Underwood, Gay Williams, Ed and Karen Hyde, farm in Verona. In addition to the grapes, fruit BR 94 AN ACT relating to Criminal Matthew Henderson, Gabrielle Summe, and trees and chestnut trees were planted. Currently Damage to Rental Property Senator Robby Mills Verona Vineyard Winery has a capacity of Jesse Brewer, Boone County Commissioner, LRC Staff: Alice Lyon, Chandani Kemper, 15,000 bottles, or 3,000 gallons in comparison to said that not all tenants treat rental property with Dale Hardy, Matt Trebelhorn, Raleigh Dixon, other wineries in Kentucky who are producing respect. There have been instances of damage and Yvonne Beghtol. hundreds of thousands of gallons. The winery to kitchen cabinets, intentional cigarette burns Dissemination of Personally Identifying has won awards for every vintage released since in carpets, broken windows and leaving trash Information About Minors 2008. Revenue has grown between 30 and 50 behind for the property owner to clean up. This Ted Sandmann, father of Nicholas percent for the last eight years. type of damage is costly to the property owner. Sandmann, said that, on June 18, 2019, Nicholas Currently there are four full-time employees A county attorney has advised that, because it attended the March for Life in Washington, DC

26 2019 Interim LEGISLATIVE RECORD with other students from Covington Catholic presented statistics on jail incarceration in Some counties see building large jails to High School. Video from that day of Nicholas Kentucky. “In Our Backyards” is focused on hold state prisoners as a revenue solution for standing face-to-face with a Native American shrinking jail populations in rural communities, the county, but the Vera Institute has identified man who was chanting and beating a drum was which bear the heaviest burdens of mass two major risks with that approach: when posted online. That video became “viral” by being incarceration while major urban areas reduce having more beds eliminates a physical limit on shared widely across social media platforms and their use of jails. pretrial detention, pretrial detention rates grow, resulted in threats of violence against students, Vera’s analysis of the data collected by the and local taxpayers must pay for the cost of an parents, and the school. U.S. Bureau of Justice Statistics, the Kentucky expanded jail if DOC decides to stop using the Senator Schroder testified that he would Department of Corrections (DOC), and beds. For example, after the Breckinridge County be filing “anti-doxing” legislation, similar to individual counties identified the drivers of jail jail expanded in the early 2000s to hold more SB 240 from 2019, to protect minors from the incarceration: high rates of pretrial detention, convicted state inmates, the pretrial population types of threats Nicholas Sandmann faced. SB the prevalence of drug related charges, and the increased 450 percent between 2000 and 2015. 240 criminalized the online dissemination of use of local jails to hold people for the state and In response to Representative Bratcher, personally identifying information about a federal prison systems. Ms. Heiss said that drug charges underlie most minor when done with the intent to intimidate, Regarding pretrial detention, the Vera criminal charges, and giving judges more tools abuse, threaten, harass, or frighten a minor, and Institute seeks to support accused people in the to address that could improve public safety when it creates a reasonable fear of physical community before trial, rather than holding outcomes. injury to the minor. Sentencing begins at a Class people who cannot afford monetary bail prior to In response to Senator Wheeler, Ms. Heiss A misdemeanor. If physical injury is involved, trial. Between 2000 and 2015, pretrial detention said connecting offenders with substance abuse it is a Class C felony. If the minor or minor’s in Kentucky grew at nearly twice the national programs before trial would benefit everyone, but household members suffer monetary losses, rate, with most of the growth in counties with the methods of coercing people into treatment there are additional graduated criminal penalties. fewer than 30,000 residents. should be individually tailored. Chairman Westerfield stated that, while The Vera Institute has documented lasting In response to Representative Minter, Ms. the legislature cannot keep adding new crimes, negative impacts. A 2013 study of Kentucky’s Heiss responded that bail reform is a critical first he supported this legislation because being in pretrial practices found that people who were step in narrowing pre-entry detention. the age of the internet brings new conduct and held for all of the pretrial period were more In response to Senator West, Ms. Heiss requires new boundaries. likely to be re-arrested on new charges following stated that available beds are often quickly filled. In response to Senator Wheeler, Senator disposition of their case than those released before When beds are not available, authorities must Schroder said he will amend the bill to include trial. As few as 2 days in pretrial detention were find alternatives. An unintended consequence all high school students, regardless of age. associated with an increased likelihood of a new of having more facilities built is the increase of In response to Representative Cantrell, arrest, and the longer people were held, the more pretrial detention. Senator Schroder could not recall Utah’s exact likely to be re-arrested. The negative impacts of In response to Senator West, Ms. Heiss said anti-doxing penalties. pretrial detention are most pronounced for those reasonable bail should be individually set for In response to questions from Representative classified as low risk, charged with lower-level each person, lowering the number of those held Nemes regarding criminal penalties being offenses, or held on low monetary bail amounts. in detention. contingent upon the acts of another person, Families are also impacted; a 2002 national study In response to Representative Booker, Ms. Senator Schroder stated that if someone makes found that two-thirds of the women held in jail Heiss will share Vera Institute materials on the identifying information available, then that because they could not afford monetary bail disproportionate racial and ethnic impacts in person participated in the crime by giving others amount were also the mothers of children under incarceration. Nationally the gap between black the tools to make contact. the age of 18. and white incarcerations is closing in urban In response to Representative Jenkins, In the United States, 68 percent of the areas, but not rural areas. Senator Schroder advised that merely posting jail population has a substance use disorder. In response to Representative Massey, Ms. online alone would not qualify as a crime; there Research has shown that community-based drug Heiss stated that the Vera Institute is working to would also have to be a reasonable fear of injury treatment is more effective than incarceration, understand federal funding and investing it in and the necessary intent. Existing bullying laws and produces long-term savings from reduced community based substance abuse prevention would not cover doxing. crime and the reduced cost of incarceration. Also, and treatment programs is a key to serving more In response to Senator Harris, Senator recently incarcerated people are significantly people. Schroder said holding a person from another more likely to die of an overdose because a In response to Senator Schroder, Ms. state accountable under a Kentucky statute is person’s tolerance for drugs has lessened while Heiss stated that the Vera Institute relies on done in other areas of law. incarcerated. the Bureau of Justice Statistics for their date, Approval of the minutes of the June 7, Kentucky is one of only a few states that relies and the last comprehensive study was in 2015. 2019 meeting on contracts with local jails to confine people Regarding the concern for women in jails, Ms. Representative Petrie made a motion to sentenced to a state prison term. Nearly half of Heiss will share a Vera report called Overlooked. approve the minutes, which was seconded by state inmates are held in Kentucky’s 76 county Tennessee passed legislation enabling judges Representative Massey and approved by voice jail facilities, led by Fulton, Simpson, Webster, to consider alternatives to incarceration for vote. Larue, Todd, and Casey counties. In August 2018 primary caregivers of children, recognizing that County Jail Populations and Trends in approximately 90 percent of Kentucky’s jails were separating caregivers from their children puts Incarceration operating above capacity. A 2006 State Auditor’s the children at a higher risk of incarceration. Jasmine Heiss, Campaign Director for report on Kentucky jails found that housing state In response to Representative Blanton, Ms. “In Our Backyards” with the Vera Institute of inmates exacerbated overcrowding in county Heiss stated that looking at the front end of the Justice, and Mike Shea of Government Strategies jails. causes of these criminal behaviors is what drives THE KENTUCKY GENERAL ASSEMBLY 27 the Vera Institute. under federal law. Family Support; Jessica Hinkle, Branch Manager, In response to Senator Neal, Ms. Heiss Disposition of Decedent’s Body Division of Family Support; Roger McCann, will share materials on racial and ethnic Senator Mills presented BR 201, and said he Executive Director, Community Action demographics in jail populations. was also speaking on behalf of Representatives Kentucky; John Burke, Principal, Inez Power; Perfecting Vehicle Liens Miles and Wiederstein. After a murder in DB Kazee, Principal and Counsel, Inez Power; Tom Underwood, with the Rotunda Group, Henderson last year, the husband of the deceased and Lee Bazzle, Project Director, Inez Power. introduced Gay Williams, President of the was charged. While awaiting trial in the local jail, LRC Staff: Stefan Kasacavage, Janine Coy- Kentucky Automobile Dealers Association. the husband was called by the coroner regarding Geeslin, Tanya Monsanto, Silas Montgomery, Ms. Williams introduced Ed and Karen Hyde, the disposal his wife’s remains. This was because and Rachel Hartley. owners of Legacy Nissan. under KRS 367.93117, unless another person Presentation and Public Hearing on the Mr. Hyde explained that when a customer is designated, the decedent’s surviving spouse Low Income Home Energy Assistance Program acquires a loan to purchase a vehicle, the dealer controls the disposition. BR 201 amends (LIHEAP) Block Grant Application – Federal has to perfect a lien on that collateral to protect current law to exempt any survivors who have Fiscal Year 2020 the bank, and the lien is filed in the county in been arrested or charged with an offense which Douglas Beard provided an overview of which the customer resides. Sometimes the resulted in the death of the decedent. the Department for Community Based Services county in which the customer resides is not the In response to Senator Webb, Senator (DCBS), which is the largest organizational county shown on their driver’s license. In the Mills explained that the bill does not require unit within the Cabinet for Health and Family event of bankruptcy, the trustee can deem the a conviction because of the length of time Services (CHFS) with a budget of over $1 billion. lien invalid because it was not filed in the correct involved. If the person charged is later acquitted, The Low Income Home Energy Assistance county of residence, requiring the dealer to pay the person could relocate the remains. Program (LIHEAP) is funded by a federal block off the loan. Chairman Westerfield said that a statement grant received by DCBS on behalf of Kentucky. Chairman Petrie suggested changing the from Ms. Amye Bensenhaver, retired Assistant LIHEAP provides assistance to low-income definition of a perfected lien to “recorded in the Attorney General and currently with the households that pay a high proportion of income county in which the debtor/owner lies resident Kentucky Open Government Coalition, for home energy. DCBS anticipates Kentucky’s or in an adjoining county.” regarding Senator D. Carroll’s bill from the 2019 award will be $57.8 million for 2020. Less than Gabrielle Summe, President of the Kenton Session on redacting personal information from 10 percent is used for administrative costs. County Clerks Association, testified that there public records is in members’ folders for review. DCBS maintains a contractual arrangement are approximately 15 statutes regarding the Chairman Westerfield reminded members with Community Action Kentucky, Inc. (CAK) perfection of liens. If clerks make a mistake in of the August 23, 2019 IJC meeting, and invited and the Kentucky Housing Corporation (KHC) filing the lien, then they are responsible for members to attend Fancy Farm the first weekend to provide support, training, and monitoring. paying off the loan. in August. CAK and KHC have an arrangement with Matthew Henderson, with the Kentucky There being no further business, the meeting Kentucky’s Community Action Network that Transportation Cabinet, said the Cabinet would was adjourned at 11:47 am. makes LIHEAP benefits available in all counties. like more legal certainty for all stakeholders There are 23 community action agencies regarding the status of the lien. Improvements in INTERIM JOINT COMMITTEE that together cover all Kentucky counties. Each the database at Transportation may create new ON NATURAL RESOURCES AND agency allows local control, so specific needs options. Centralized lien recording is the most can be met. CAK utilizes a continuous process ENERGY expansive option. Mr. Henderson noted that Minutes of the 2nd Meeting for quality improvement, including review of the county of residence will not be included on of the 2019 Interim policy and procedure, committee structure, federally-compliant REAL ID driver’s licenses. July 9, 2019 data collection analysis, use of technology, and In response to Senator West, Ms. Summe Call to Order and Roll Call training and technical assistance. said the Transportation Cabinet has an online The 2nd meeting of the Interim Joint In response to a question from Representative search engine called OVIS, in which one can Committee on Natural Resources and Energy Gibbons Prunty, Mr. Beard stated lessees can enter the VIN number to see if liens are filed and was held on Tuesday, July 9, 2019, at 3:00 PM, benefit from LIHEAP. in which counties, but the lien statement itself in Room 154 of the Capitol Annex. Senator In response to a question from Representative is not available. Each county clerk determines Brandon Smith, Chair, called the meeting to Blanton, Mr. Beard stated in order to avoid a whether to provide lien access online. order, and the secretary called the roll. reconnection fee, applicants should apply for In response to Representative Cantrell, Ms. Present were: LIHEAP before their electricity is disconnected. Summe said she participated in an unreported Members: Senator Brandon Smith, Co- The LIHEAP block grant findings of fact federal bankruptcy case, In re Godsey, in 2012. Chair; Representative Jim Gooch Jr., Co-Chair; were approved by unanimous voice vote. The decision interpreted Kentucky statutes Senators Jared Carpenter, Matt Castlen, C.B. Inez Power as requiring underlying documents to be Embry Jr., Robby Mills, Reginald Thomas, Lee Bazzle stated Inez Power is an innovative completely error free, otherwise a lien could Johnny Ray Turner, Robin L. Webb, Whitney energy from waste system utilizing a gasification not be perfected. The Kenton County Clerk’s Westerfield, and Phillip Wheeler; Representatives process that was developed in Inez, Kentucky. office has had to payoff car loans involved in John Blanton, Charles Booker, Randy Bridges, The objective is to avoid landfill use by converting bankruptcy cases due to misspelled information, Myron Dossett, Jim DuPlessis, Daniel Elliott, municipal solid waste into energy. Since 2000, the wrong county listed, and other errors. Chris Fugate, Angie Hatton, Cluster Howard, coal production and options for long-term waste Chairman Petrie added that if the legislature Dennis Keene, Derek Lewis, Melinda Gibbons disposal are on a rapid decline. redefined what perfection is in Kentucky, the Prunty, Josie Raymond, Cherlynn Stevenson, In 1990, there were over 6,000 landfills federal courts would utilize that definition. Until and Rob Wiederstein. and 144 waste-to-energy incinerators. In 2015, then, any imperfection will invalidate a lien Guests: Douglas Beard, Director, Division of the number of landfills had decreased to 1,738,

28 2019 Interim LEGISLATIVE RECORD and the number of waste-to-energy incinerators Cabinet; Michael J. Nemes, Deputy Secretary, Department of Education (KDE) discussed decreased to 75. Transportation costs for waste Education and Workforce Development Cabinet; secondary career and technical education. KDE’s have increased due to larger landfills and regional Lana Gordon, Commissioner, Department of presentation included information on career landfill locations. Workforce Investment; Dr. Wayne D. Lewis, centers and funding needs. In 2018, China imposed strict recycling Jr., Commissioner, Kentucky Department In response to a question from import guidelines, and as a result the recycled of Education; David Horseman, Associate Representative Scott, Mr. Horseman said exports from the United States have decreased. Commissioner, Office of Career and Technical teachers are recruited through postings and Many communities have ceased recycling Education and Student Transition; Dr. Aaron word of mouth. Commissioner Lewis said that programs until other outlets are identified. Thompson, President, Council on Postsecondary the University of Louisville is a major partner for Inez Power employs a patented gasification Education; Dr. Jay Box, President, Kentucky the New Teacher Institute. Mr. Horseman stated process to convert municipal solid waste to usable Community and Technical College System. that professional development funding comes synthesis gas that can be turned into valuable LRC Staff: Chuck Truesdell, Jennifer from Perkins funds and federal funds. commercial products. The gasification process Krieger, Seth Dawson, and Amie Elam. Council on Postsecondary Education generates more energy with less emissions than Education and Workforce Development Representatives from the Council on current incineration solutions. The process Cabinet Postsecondary Education (CPE) discussed creates zero waste and 100 percent of the by- Representatives from the Education and workforce education and readiness. CPE’s products have a beneficial reuse. Workforce Development Cabinet discussed presentation included information on awarded In response to a question from Senator career and technical education. The cabinet’s credentials and workforce solutions. Webb, Mr. Kazee stated the gasification process presentation focused on high demand jobs and In response to a question from Representative has no harmful environmental impact. the Work Ready Initiative. Flood, Dr. Box said CPE is working with hospitals In response to a question from In response to a question from Representative to fill in funding gaps until the legislature is able Representative Booker, Mr. Bazzle stated Bojanowkski, Secretary Ramsey said that the to find more long-term solutions. building a gasification facility near a landfill Education and Workforce Development Cabinet In response to a question from Representative would decrease transportation costs. plans to aggressively pursue the number of Glenn, Dr. Box said that, to fill instructor roles, In response to a question from Senator workers with disabilities that are being placed in hospital nurses would need to be adjunct faculty. Thomas, Mr. Burke stated a new gasification jobs. Deputy Secretary Nemes said that his staff He said that many nurses would have shared facility would cost approximately $80 million. will send the exact percentage of workers with appointments between a hospital and a clinical In response to a question from Representative disabilities who are not placed to committee site. DuPlessis, Mr. Bazzle stated the gasification members. In response to a question from Representative process is self-sustaining; however, it does use In response to a question from McCool, Dr. Box said pending legislation, natural gas or diesel to begin the process. Representative Scott, Deputy Secretary Nemes if passed, will allow short-term federal Pell There being no further business, the meeting said that registered apprenticeship programs use funding to be used for certificate programs. He was adjourned. a worker’s competency to accelerate program said that short-term certificate programs allow completion. individuals to get into the workforce sooner than In response to a question from a traditional program. Representative Howard, Secretary Ramsey said In response to a question from INTERIM JOINT COMMITTEE the cabinet will provide data to the committee Representative Howard, Dr. Thompson said ON APPROPRIATIONS AND regarding the wages of the 138,000 job openings general education needs to be revamped to in Kentucky. Representative Howard also focus on employability skills. Dr. Box said the REVENUE Budget Review Subcommittee on Education requested information on the reasoning behind legislature needs to reinvest in higher education Minutes of the 1st Meeting the number of openings. to prevent losing valuable faculty at Kentucky’s of the 2019 Interim In response to a question from colleges and universities. July 9, 2019 Representative Fischer, Secretary Ramsey said There being no further business to come Call to Order and Roll Call that the Work Ready Scholarship program helps before the committee, the meeting was adjourned The first meeting of the Budget Review to provide tuition-free training to students. He at 12:06 p.m. Subcommittee on Education of the Interim Joint said that the community and technical colleges Committee on Appropriations and Revenue was will play a bigger role in reducing the amount MEDICAID OVERSIGHT AND held on Tuesday, July 9, 2019, at 10:00 AM, in of debt students accumulate before entering the ADVISORY COMMITTEE Room 154 of the Capitol Annex. Representative workforce. Minutes Steve Riley, Chair, called the meeting to order, In response to a question from Representative July 8, 2019 and the secretary called the roll. Flood, Deputy Secretary Nemes said that the Call to Order and Roll Call Present were: registered apprenticeship program is expanding The Medicaid Oversight and Advisory Members: Representatives James Tipton, into information technology, healthcare, and Committee meeting was held on Monday, July Co-Chair, and Steve Riley, Co-Chair; Senators education. 8, 2019, at 1:00 PM, in Room 171 of the Capitol C.B. Embry Jr., Stan Humphries, and Mike In response to a question from Annex. Senator Stephen Meredith, Chair, called Wilson; Representatives Tina Bojanowski, Representative Tipton, Deputy Secretary Nemes the meeting to order, and the secretary called the Randy Bridges, Joseph M. Fischer, Kelly Flood, said the cabinet will provide the committee with roll. Jim Glenn, David Hale, Cluster Howard, Regina a more detailed breakdown of the Work Ready Present were: Huff, Bobby McCool, and Attica Scott. scholarship recipients. Members: Senator Stephen Meredith, Co- Guests: Derrick K. Ramsey, Secretary, Kentucky Department of Education Chair; Representative Daniel Elliott, Co-Chair; Education and Workforce Development Representatives from the Kentucky Senators Ralph Alvarado, Danny Carroll, Jimmy THE KENTUCKY GENERAL ASSEMBLY 29 Higdon, and Morgan McGarvey; Representatives for Medicaid Services (DMS) to directly healthcare dollars lost to spread pricing. Ohio Jim Gooch Jr., Melinda Gibbons Prunty, Steve administer pharmacy benefits, commonlyhas implemented pass-through contracts and Sheldon, and Lisa Willner. referred to as a carve-out. The carve-out is is seeing increased reimbursements but still Guests: Carol Steckel, Commissioner, Jessin the most transparent, fair, and predictable not enough to cover the cost of doing business. Joseph, Pharmacy Director, Department for method for pharmacy reimbursement. The Data reported to the federal government does Medicaid Services, Cabinet for Health and Family House amended SB 5 to remove the carve- not include spread pricing. In July of 2017, West Services; Don Kupper, President, Kentucky out provisions and added transparency, data Virginia implemented a Medicaid carve-out Pharmacists Association; Trevor Ray, PharmD, collection requirements, and other pharmacy plan. A West Virginia study showed a savings of Independent Pharmacist, Owner, Midway reimbursement restrictions. SB 5 provisions $54 million. Prior to the carve-out, West Virginia Pharmacy; Betsy Johnson, President, Executive include requiring the PBMs to submit pharmacy paid $66.8 million in administrative expenses Director, Wayne Johnson, Vice President of reimbursement data to DMS and giving DMS the to the MCOs for pharmacy benefits. After Reimbursement, Kentucky Association of authority to review and approve reimbursement the carve-out, West Virginia’s administrative Health Care Facilities, Kentucky Center for rates over or under five percent 30 days before a expenses dropped to $9.9 million. Assisted Living; Melanie Claypool, Director, change is said to take effect. SB 5 permits DMS The new request for proposal (RFP) Provider Network, Passport Health Plan; Shawna to set, create, or approve the PBM established for the MCOs’ contracts contains positive Dellecave, Director, Family Advocacy and the pharmacy reimbursement rates and to require improvements such as mandating pass-through Arts, The Council on Development Disabilities; the PBMs to comply with all state and federal contracts, prohibiting post-adjudication fees, and Erin Davis, Executive Director, The Prince laws. including effective rate contracts, and an Care Group. The dispensing fee to pharmacies has increased dispensing fee. Suggested additional LRC Staff: DeeAnn Wenk, CSA, Dana increased by two dollars. Data analysis was improvements to ensure greater transparency Simmons, Sean Meloney, and Becky Lancaster. conducted by DMS that resulted in transparency would be to prohibit national contracts and Approval of Minutes recommendations, methodology changes, to require each MCO to contract with each A motion to approve the minutes of the June and increased accountability for the MCOs pharmacy without the bundling of other 3, 2019 meeting was made by Representative and PBMs. DMS has acted to stop the reduced contracts. DMS could set the reimbursement Sheldon, seconded by Senator Alvarado, and reimbursements on high-frequency dispensed rates for all MCO plans and mandate that the approved by voice vote. drugs. Community pharmacies have developed MCOs hire a transparent PBM or mandate that Independent Pharmacy Reimbursements a more positive working relationship with DMS. DMS directly administer pharmacy benefits. Don Kupper, President, Kentucky However, there are still MCO reimbursement Independent pharmacies would also like to see Pharmacists Association (KPhA), stated that issues with spread pricing, lack of transparency an increase in the dispensing fees to adequately along with the American Pharmacy Services in pharmacy reimbursement data, lack of reimburse the pharmacies for the services Corporation, the KPhA represents more than regulation implementing the SB 5 provisions, provided. Pharmacies will continue to work with 6,000 pharmacists. The KPhA works to ensure PBMs utilizing the effective rate contracting Medicaid to implement its full authority to set, fair, adequate, and transparent pharmacy practices, specialty pharmacies, mail order create and approve reimbursement rates. reimbursements for Kentucky pharmacies. The pharmacies, national contracts, accountability, In response to questions and comments passage and implementation of the 2018 SB 5 and fees. A Kentucky Medicaid data report from Senator Higdon, Mr. Ray stated that along with a two dollar dispensing fee increase concluded that $209 million was paid to PBMs DMS could mandate that the MCOs have an were important steps for Kentucky pharmacies. by MCOs that was not paid to pharmacies over individual contract with pharmacies and not a Trevor Ray, PharmD, Independent the past two years. bundled national contract. DMS is working with Pharmacist, Owner, Midway Pharmacy, stated The use of effective rate contracting the independent pharmacies to figure out how to that the National Average Drug Acquisition Cost will continue to add to the disruption of be proactive and gain more control of the PBMs (NADAC) is a federally developed survey of transparency. Pharmacies are unsure of how in the proposed MCO contracts. community pharmacies to determine the average much will be paid at the end of the year due to In response to questions and comments acquisition cost for outpatient prescriptions post adjudication fees, recoupments, effective from Senator Alvarado, Mr. Ray stated that drugs dispensed in Medicaid. The NADAC is a rate adjustments, claims processing fees, and there are some collusion issues that could arise component in reimbursement methodology in other fees charged by the PBMs to pharmacies if pharmacy groups under different ownerships the Kentucky Medicaid fee-for-service program. that lower the overall pharmacy reimbursement. decided to share pricing information. Pharmacy The Centers for Medicare and Medicaid Services Independent pharmacies are seeing retail claims services administration organizations (PSAOs) (CMS) recommends a professional dispensing fee that follow the NADAC methodology with a may have the ability to leverage and negotiate between $9 and $13 based on acquisition costs. small $.30 to $.50 cent dispense fee instead of the the PBMs’ contracts. However, there is not much Effective rate contracting is a pharmacy benefit recommended $9 to $13. The PBMs frequently leverage because the PBMs are so much larger manager (PBM) reimbursement methodology mandate that patients receive specialty drug than any of the pharmacies, even the ones in a where pharmacists are guaranteed a certain prescriptions from specialty pharmacies that are PSAO. Small and rural independent pharmacies reimbursement level on a group of drugs that are owned by the PBM and likewise with mail-order do not have the ability to negotiate and leverage dispensed over a period of time. Spread pricing prescriptions. MCO contracts. At times the MCOs are not is the difference between the amount paid by the The PBMs are not direct contractors with aware that the PBM has made changes until health insurance plan to the PBM and what the the state and it can be difficult for regulators notice is given by the pharmacies. Pharmacies PBM reimburses pharmacies. to hold the PBMs accountable for its actions. are not given a reason or explanation as to why a In June of 2017, pharmacies saw dramatic The large number of fees the PBMs charge reimbursement has been changed. Once an appeal drops in reimbursements from the Medicaid pharmacies continue to be disruptive to the has been filed with the Department of Insurance Managed Care Organizations (MCOs). SB 5 overall reimbursement rate. Six states, including by a pharmacy regarding a reimbursement, the originally would have required the Department Kentucky, reported more than $865 million reimbursement will be increased in many cases

30 2019 Interim LEGISLATIVE RECORD but it is an arduous process. Mr. Kupper stated Kentucky statute specific to SB 5 in the RFP. The with all pharmacists, MCOs, and PBMs while that many patients in the eastern and rural part reporting requirements would be contractual. being mindful of the impact on the community of the state would not have any other way to DMS would require a report of the spread. DMS pharmacists. receive medications if not through Kentucky modified the requirements to reinforce that In response to questions and comments from Medicaid. the MCOs would have to align coverage, prior Senator Meredith, Commissioner Steckel stated In response to questions and comments authorization criteria, and processes to those of that the anticipated shortfall of $200 million did from Representative Gibbons Prunty, Mr. Ray DMS. The pharmacy rebate language was added not occur within Kentucky Medicaid. Kentucky stated that independent pharmacies do not have to the RFP to ensure MCOs comply. DMS put in Medicaid is close to having a level budget a reasonable explanation as to why there are so the RFP that the PBMs must use a pass-through because there has been a significant decrease in many fees paid to the PBMs by the pharmacies. model for payments to the pharmacies. DMS the number of eligibles. The primary provision Many of the fees are added for participation in removed the MCOs’ and PBMs’ ability to charge of SB 5 was the five percent rate increase or a network. At times the recoupment retroactive hidden fees such as retroactive take-backs from decrease that has been implemented and is being fees are not seen until six months after the the pharmacies, generic effectiveness rates, and monitored by DMS. DMS is seeing an evolution prescription has been filled. The additional fees the direct and indirect remuneration fees. DMS of the issues. The next issue to be addressed is the have gone up 45,000 percent in the last six years. removed the previous barriers to receiving both post adjudification adjustments. DMS will not be In response to questions and comments from the summary and claim-level detailed pharmacy able to see results in that area until the new MCO Representative Sheldon, Mr. Ray stated that cash reports from the MCOs and PBMs. contracts become effective on July 1, 2020. prescriptions are the only type of prescriptions SB 5 requires any changes greater than five In response to questions and comments where a total amount paid is known at the point percent in the aggregate or at the point of sale to from Senator Higdon, Commissioner Steckel of sell. Cash prescriptions are less than 10 percent be reported to DMS. DMS has been developing stated that in regards to the MCOs contract of a pharmacy’s business. the maximum allowable cost (MAC) rate change update, DMS has disclosed all the information In response to questions and comments from monitoring process. The MAC changes daily and that is permitted. Questions regarding the RFP Senator Carroll, Mr. Ray stated that the MCOs a goal of DMS is to have an automated system. should be directed to the Cabinet of Finance and would know what the process is for dropping a DMS uses an algorithm, along with NADAC, Administration. The new MCO contracts will medication from a formulary prescription list. wholesale acquisition cost (WAC), and average begin on July 1, 2020. Many times the provider will need to complete wholesale price (AWP), to justify the reasoning In response to questions and comments a long process to receive a prior authorization behind the change in the rate of a prescription. from Senator Alvarado, Commissioner Steckel for the medication. Independent pharmacies DMS is working with vendors to monitor drug stated that the West Virginia program was very will continue to work with DMS and legislators price changes at the national level for approvals different from the Kentucky program. West to receive fair payment for the products and and denials of the rate changes. Virginia had a carve-out, a single PDL, and the services provided to patients. Carol Steckel, Commissioner, Department organization of its program was different. West In response to questions and comments for Medicaid Services, Cabinet for Health and Virginia has approximately half the number from Senator Meredith, Mr. Ray stated that there Family Services, stated that DMS is working of people on Medicaid as Kentucky. DMS is are many hospitals as contract entities that are on replicating the West Virginia study with replicating the West Virginia data with Kentucky sponsors of the 340B drug pricing program with Kentucky data. DMS hopes that by the fall of Medicaid numbers so there is a more accurate rural and chain pharmacies. There are also rural 2019, it will be able to share data regarding what comparison. DMS is pulling data in regards to health clinics that are involved with the 340B the impact would be if a carve-out was done or expected profitability of the insurance companies drug pricing program. not. DMS has control over the PBMs and will and to verify if the money is returned to the Implementation of 2018 RS Senate Bill 5 build that power in the new contracts. DMS held MCOs as part of the medical loss ratio (MLR). Jessin Joseph, Pharmacy Director, the MCOs accountable to obtain data regarding In 2016, DMS started the MLR. It is DMS’ intent Department for Medicaid Services, Cabinet for PBMs. DMS is meeting with representatives to evaluate and adjust the MLR back to 2016 to Health and Family Services, stated that DMS from the independent and chain pharmacies to reflect any errors in calculating the MLR given has been monitoring the pricing spread through hear about the current issues and concerns. DMS the PBMs’ rates. May of 2019. As part of SB 5, all MCOs and is working to create a level and fair playing field Long-Term Care Facilities Status Report PBMs are required to give the cumulative spread for the independent pharmacies. Betsy Johnson, President, Executive to DMS on the fifteenth of the month. At 12.92 Mr. Joseph stated that all MCOs are Director, Kentucky Association of Health percent, the spread has stayed the same as it was required to utilize a pharmacy and therapeutic Care Facilities (KAHCF), Kentucky Center for at the end of 2018. WellCare does not have a (P&T) committee similar to the fee-for-service Assisted Living (KCAL), stated that KAHCF spread because the contractual model that they population. As new drugs come to the market, is the primary association that represents have is an administrative fee model or a pass- DMS asks the P&T committee to evaluate the propriety and nonproprietary nursing facility through model, which is based off a flat fee per drug. The recommendations from the P&T providers, personal care homes, and assisted member, per month or per claim depending on committee often align with what the MCOs living communities across Kentucky. In regards the contract. The other four MCOs’ spread is have on the preferred drug list (PDL). For best to long-term care, only skilled nursing facilities what is charged to DMS compared to what is efficiency, DMS would prefer a state mandated, receive Medicaid reimbursement. Assisted living reimbursed to pharmacies. In other states, the single PDL that all MCOs would abide by to relieve providers and personal care providers do not spread averages around 8 to 15 percent. the burdens from providers. DMS is working on receive Medicaid reimbursement for services Many changes were made to the new RFP for uniform policies which will help the MCOs and provided. Nursing facility providers serve the MCOs’ contracts that came from discussions PBMs to administer care. Commissioner Steckel approximately 31,000 residents and account for with independent pharmacists and organizations stated that DMS is working hard to prevent 57,470 direct and indirect jobs statewide. There to better understand what is happening at a unintended consequences. DMS may appear to is at least one nursing facility in all of the 120 ground level of business. DMS referenced the be slow to respond but DMS is working closely counties in Kentucky. Medicaid recipients make THE KENTUCKY GENERAL ASSEMBLY 31 up almost 70 percent of residents in skilled current cost and reimbursement environment in or has a bad health survey, it takes approximately nursing facilities in Kentucky. The impact of Kentucky is critical. three years to get the star rating back up. nursing facilities is shown in terms of jobs, In response to questions and comments Kentucky’s average for short stay readmissions income, economic activity, and tax revenue from Senator Meredith, Ms. Johnson stated that was better than the national average but in other contributed to the state. Long-term care the federal law allows up to a six percent provider areas, such as quality, Kentucky is in the middle providers support an estimated $5.13 billion of tax for skilled nursing facilities however there is of the national average. Kentucky is an out lier the state’s economic activity. a state statute that caps that provider tax at 4.2 in the immediate jeopardy category. Kentucky is Wayne Johnson, Vice President of percent. Skilled nursing facilities would pay number two in the nation in regards to litigation. Reimbursement, Kentucky Association of Health the provider tax up front then be matched with In response to questions and comments Care Facilities, Kentucky Center for Assisted federal dollars. There would not be any general from Senator McGarvey, Ms. Johnson stated Living, stated that nursing facility providers have fund dollars required for the skilled nursing that KAHCF hoped to collect data regarding faced unprecedented general and professional facilities across Kentucky to see approximately the medical review panel legislation but it was liability costs in the past due to predatory trial $20 million in additional reimbursements. Mr. not possible due to the Kentucky Supreme attorney practices and the litigation environment Johnson stated that as of last year, Kentucky has Court decision. KAHCF will be watching the in Kentucky. Obtaining a qualified workforce an 87 percent occupancy bed rate. Traditionally, implementation of the certificate of merit bill has gotten more difficult for nursing facility Kentucky has a higher occupancy rate than other passed in the 2019 Regular Session. The KAHCF providers. The current low unemployment surrounding states. will work closely with the Kentucky Justice rates, lack of workers, and the competition in In response to questions and comments Association. The KAHCF will review what is other health care fields have driven up wages from Senator Carroll, Ms. Johnson stated that working for other states in regards to tort reform. significantly. The nursing facility acuity rate in in regards to quality, there has not been much The KAHCF hopes to address the way that Kentucky remains high as providers care for improvement however, Kentucky is above the nursing facilities are targeted and the amount the most fragile citizens. A 2018 AON Report national average on short-term readmissions to of records requests that are put on the facilities highlights Kentucky as one of the worst states hospitals. In regards to the survey environment, by trial attorneys. The KAHCF is not seeking to in need of medical malpractice reform and is Kentucky nursing facilities are the most sited in limit legitimate, rightful settlements or litigation lagging in tort reform. the nation for immediate jeopardies and fined due to egregious behavior of providers. Between 2010 and 2030 Kentucky’s the most in civil money penalties. There is $33 Provider Tax for Long-Term Care population over age 65 will increase by 72 percent million in a civil fund that is not being put back Carol Steckel, Commissioner, Department and this will increase the demand for Certified into the economy or resident care. The chair of for Medicaid Services, Cabinet for Health and Nursing Assistants (CNAs), Licensed Practical KAHCF has created a data workforce committee Family Services, stated that DMS will work with Nurse (LPNs), and Registered Nurses (RNs). to review data to understand why Kentucky is the long-term care industry on increasing the Statewide RNs, LPNs, and nurse aide wage costs falling short with immediate jeopardies being provider tax to provide more of a federal match. have steadily increased over the past 10 years. issued against providers. If a skilled nursing DMS does want to review the data regarding Although providers received a full inflationary facility is cited with an immediate jeopardy the providers that do not take Medicaid or providers increase this year, Medicaid increases have not nursing facility is no longer able to train nurse that have a large private pay population and the kept pace with these and other staff increases. aides in the facility causing workforce issues. impact of raising the provider tax in the private Nursing facility providers in Kentucky have Mr. Johnson stated that in Kentucky the average market. DMS wants to maximize resources for higher levels of staff when compared to fine is nearly $100,000 per facility. The national all providers. surrounding states. Kentucky continues to give average is approximately $90,000. In response to questions and comments from the direct care needed to provide quality within In response to questions and comments Senator Meredith, Commissioner Steckel stated the state. Since 2010, Medicaid and total patient from Representative Gooch, Ms. Johnson stated that DMS would review using intergovernmental acuity has risen dramatically. that the provider tax would be on the licensed transfers for rural and county hospitals. DMS is Long-term care facilities are reimbursed by skilled facility beds. Federal law requires that all in the process of getting approval for graduate Kentucky’s Medicaid Program through a price- like providers are taxed the same if participating medical education and indirect medical based system implemented by DMS in 2000. The in the provider tax system. The provider tax education programs with the University of urban and rural prices are adjusted quarterly system would benefit the majority of the skilled Kentucky and the University of Louisville. The for acuity and annually by an inflationary nursing facilities in Kentucky. Mr. Johnson stated universities would benefit from the programs but adjustment determined by DMS. In theory, the that the provider tax is based on non-Medicare would also provide funding to 14 other hospitals price-based system allows DMS to accurately days rather than a per bed tax. The provider in Kentucky that also have graduate medical predict nursing facility costs. Although DMS will tax change proposed to DMS is an incremental education programs. DMS is meeting once a increase provider rates by the full inflationary provider tax. week with the Kentucky Hospital Association increase effective July 1, 2019, providers have In response to questions and comments (KHA) regarding the implementation of House only been paid one-tenth of one percent inflation from Senator Alvarado, Ms. Johnson stated that Bill 320 which is a hospital assessment. DMS is for the past five years. Due to the inflationary nursing facilities staff turnover rate is a significant looking at the market as a whole to maximize rates paid over the past five years, KAHCF issue. The KAHCF has a human resources resources for all providers. proposed a provider tax increase to fund an committee within the association to assist Adjournment inflationary increase. Last year’s proposal would providers in dealing with workforce issues. CMS There being no further business, the meeting have increased taxes by $.93 per non-Medicare changed the criteria for the star rating system for was adjourned at 3:04 PM. day, providing a net of $17.8 million in revenue nursing facilities. The health inspections provide to nursing facility providers. KAHCF, KCAL, the most weight on the star rating that deal with and providers have tried to offer solutions the requirements of participation set by CMS. If to problems presented to the profession. The a nursing facility receives an immediate jeopardy

32 2019 Interim LEGISLATIVE RECORD ADMINISTRATIVE REGULATION A motion was made and seconded to amend the NECESSITY, FUNCTION, AND REVIEW SUBCOMMITTEE approve the following amendments: (1) to amend CONFORMITY paragraph and Sections Minutes of the July Meeting Sections 2 and 4 to delete outdated language; and 1 through 3 to comply with the drafting July 10, 2019 (2) to amend Sections 1 through 4 and material requirements of KRS Chapter 13A. Without Call to Order and Roll Call incorporated by reference to comply with the objection, and with agreement of the agency, the The July meeting of the Administrative drafting and formatting requirements of KRS amendments were approved. Regulation Review Subcommittee was held on Chapter 13A. Without objection, and with 201 KAR 2:090. Reference material and Wednesday, July 10, 2019, at 10:00 AM, in Room agreement of the agency, the amendments were prescription equipment. 149 of the Capitol Annex. Representative David approved. A motion was made and seconded to Hale, Chair, called the meeting to order, and the 9 KAR 1:040 & E. Executive agency lobbyist, approve the following amendments: to amend the secretary called the roll. employer or executive agency lobbyist, and real STATUTORY AUTHORITY and NECESSITY, Present were: party in interest registration and expenditure FUNCTION, AND CONFORMITY paragraphs Members: Senator Stephen West, Co- statements; financial transactions andand Section 1 to comply with the drafting Chair; Representative David Hale, Co-Chair; termination forms; and enforcement. requirements of KRS Chapter 13A. Without Senators Perry B. Clark and Alice Forgy Kerr; A motion was made and seconded to approve objection, and with agreement of the agency, the Representatives Deanna Frazier, Mary Lou the following amendments: to amend the TITLE amendments were approved. Marzian, and Tommy Turner. and Sections 1, 2, and 4 through 6 to comply 201 KAR 2:100. Security and control of Guests: Kathryn Gabhart, Executive Branch with the drafting and formatting requirements of drugs and prescriptions. Ethics Commission; Rosemary Holbrook, KRS Chapter 13A. Without objection, and with A motion was made and seconded to Alaina Myers, Personnel Cabinet; Todd Renner, agreement of the agency, the amendments were approve the following amendments: (1) to Department of Revenue; Anthony Gray, Larry approved. amend the NECESSITY, FUNCTION, AND Hadley, Board of Pharmacy; Marc Manley, PERSONNEL CABINET: Personnel CONFORMITY paragraph and Sections Kenneth Urlarge , Board of Licensure for Long Cabinet, Classified 1 through 4 to comply with the drafting Term Administrators; Cindy Castle, Carson 101 KAR 2:180. Employee performance requirements of KRS Chapter 13A; and (2) Kerr, Board of Ophthalmic Dispensers; Nathan evaluation system. Rosemary Holbrook, general to amend Section 2 to change “personal Goldman, Board of Nursing; Tony Cotto, Board counsel, and Alaina Myers, deputy commissioner supervision” to “supervision” for consistency of Podiatry; Rick Hessig, Board of Private of human resources, represented the cabinet. with KRS 329.010(27). Without objection, and Investigators; Mike Denney, Michelle Sullivan, A motion was made and seconded with agreement of the agency, the amendments Kentucky Lottery , Phillip Dietz, John Wood, to approve the following amendments: to were approved. Board of Emergency Medical Services; Steven amend the NECESSITY, FUNCTION, AND 201 KAR 2:116. Substitution of drugs, Fields, Chris Garland, John Hast, Karen Waldrop, CONFORMITY paragraph and Sections 1 and biologics and biosimilar products. Department of Fish and Wildlife Resources; 5 to comply with the drafting requirements of A motion was made and seconded Clint Quarles, Department of Agriculture; KRS Chapter 13A. Without objection, and with to approve the following amendments: to Bert Gibbons, Michael Mullins, John Small, agreement of the agency, the amendments were amend the NECESSITY, FUNCTION, AND Department for Natural Resources; Patrick approved. CONFORMITY paragraph and Sections 1 and O’Connor, Leah Spears, Eric Stone, Department 101 KAR 2:190. Employee performance 2 to comply with the drafting and formatting of Insurance; Ben Bellamy, Gwen Pinson, management system. requirements of KRS Chapter 13A. Without Karen Wilson, Public Service Commission; A motion was made and seconded objection, and with agreement of the agency, the Heather Becker, H.E. Corder, Ronald Kirby, to approve the following amendments: to amendments were approved. Board of Auctioneers; Erica Brakefield, Jan amend the NECESSITY, FUNCTION, AND 201 KAR 2:225. Special limited pharmacy Bright, Julie Brooks, Jessica Davenport, CONFORMITY paragraph to comply with the permit – medical gas. Andy Waters, Department for Public Health; drafting requirements of KRS Chapter 13A. A motion was made and seconded Stephanie Brammer-Barnes, Allen Brenzel, Without objection, and with agreement of the to approve the following amendments: to Kara Daniel, Department for Behavioral Health, agency, the amendments were approved. amend the NECESSITY, FUNCTION, AND Developmental and Intellectual Disabilities; FINANCE AND ADMINISTRATION CONFORMITY paragraph and Sections 1 Erika Bauford, Sarah Cooper, Bryan Hubbard, CABINET: Department of Revenue: Income through 5 to comply with the drafting and Department for Community Based Services; Tax; General Administration formatting requirements of KRS Chapter 13A. Curt Duff, James Morris, and David Sinclair. 103 KAR 15:061. Repeal of 103 KAR Without objection, and with agreement of the LRC Staff: Sarah Amburgey, Stacy Auterson, 15:060. Todd Renner, executive director, Office agency, the amendments were approved. Emily Caudill, Betsy Cupp, Ange Darnell, Emily of Tax Policy and Regulation, represented the 201 KAR 2:240. Special limited pharmacy Harkenrider, Karen Howard, and Carrie Klaber. department. permit – charitable. The Administrative Regulation Review Income Tax; Individual In response to questions by Representative Subcommittee met on Wednesday, July 10, 2019, 103 KAR 17:121. Repeal of 103 KAR 17:120. Marzian, Mr. Hadley stated that special limited and submits this report: BOARDS AND COMMISSIONS: Board of pharmacy permits for charities included, Administrative Regulations Reviewed by Pharmacy for example, free clinics with a pharmacy the Subcommittee: 201 KAR 2:010. Schools approved by the component. The permit was renewed yearly, FINANCE AND ADMINISTRATION board. Anthony Gray, general counsel, and and charity events were held at various intervals CABINET: Executive Branch Ethics Commission Larry Hadley, executive director, represented the during the year. 9 KAR 1:010 & E. Statement of financial board. A motion was made and seconded disclosure. Katie Gabhart, executive director, A motion was made and seconded to approve the following amendments: to represented the commission. to approve the following amendments: to amend the NECESSITY, FUNCTION, AND THE KENTUCKY GENERAL ASSEMBLY 33 CONFORMITY paragraph and Sections 2 In response to a question by Representative RELATES TO paragraph and Sections 2 and 3 through 4 to comply with the drafting and Marzian, Mr. Kerr stated that comments during to comply with the drafting requirements of KRS formatting requirements of KRS Chapter 13A. the public comment period related primarily Chapter 13A; and (2) to amend Section 5 to: (a) Without objection, and with agreement of the to the addition of the ABO-NCLE practical add an exception for admittance to a long-term agency, the amendments were approved. examination. care facility licensed under KRS Chapter 216B; 201 KAR 2:270. Expungement. A motion was made and seconded to and (b) delete the reference to KRS 218A.205. A motion was made and seconded to approve approve the following amendments: (1) to Without objection, and with agreement of the the following amendments: to amend Section amend Sections 1, 4, 5, and 8 to comply with agency, the amendments were approved. 2 to comply with the drafting requirements of the drafting requirements of KRS Chapter 13A; Board of Private Investigators KRS Chapter 13A. Without objection, and with (2) to update the Application for Ophthalmic 201 KAR 41:020. Application for licensure. agreement of the agency, the amendments were Dispenser or Apprentice License for consistency Rick Hessig, chair, and Marc Manley, board approved. with this administrative regulation in referring counsel, represented the board. 201 KAR 2:340. Special limited pharmacy to the required examinations; and (3) to amend 201 KAR 41:030. Examination. permit – clinical practice. Section 2 to clarify that an applicant shall: (a) A motion was made and seconded to approve A motion was made and seconded to approve pass both the ABO Basic Examination and the the following amendment: to amend Section 1 to the following amendments: to amend Sections 1 NCLE Basic Examination; and (b) pass either delete language, “at least twice annually,” which through 3 and 5 to comply with the drafting and the NCSORB National Practical Examination, or was duplicative of the language established in formatting requirements of KRS Chapter 13A. both the ABO Practical and the NCLE practical KRS 329A.025(2)(c). Without objection, and Without objection, and with agreement of the examination. Without objection, and with with agreement of the agency, the amendment agency, the amendments were approved. agreement of the agency, the amendments were was approved. Board of Licensure for Long-Term Care approved. 201 KAR 41:040. Fees. Administrators 201 KAR 13:050. Apprentices. A motion was made and seconded to 201 KAR 6:030. Temporary permits. Marc 201 KAR 13:055. Continuing education approve the following amendments: to amend the Manley, board counsel, and Kenneth Urlage, requirements. RELATES TO and STATUTORY AUTHORITY board vice chair, represented the board. In response to a question by Representative paragraphs and Sections 1, 6, 9, and 10 to comply A motion was made and seconded to Marzian, Mr. Kerr stated that continuing with the drafting requirements of KRS Chapter approve the following amendments: to amend the education changes primarily included clarifying 13A. Without objection, and with agreement of RELATES TO and STATUTORY AUTHORITY the definition for “in-person contact hours.” the agency, the amendments were approved. paragraphs and Sections 1 through 3 to comply A motion was made and seconded 201 KAR 41:060. Renewal and reinstatement with the drafting requirements of KRS Chapter to approve the following amendments: to procedures. 13A. Without objection, and with agreement of amend the NECESSITY, FUNCTION, AND 201 KAR 41:065. Inactive status. the agency, the amendments were approved. CONFORMITY paragraph and Sections 6 A motion was made and seconded to 201 KAR 6:040. Renewal, reinstatement, through 11 to comply with the drafting and approve the following amendments: to amend and reactivation of license. formatting requirements of KRS Chapter 13A. Section 1 to: (1) require the written request to In response to a question by Representative Without objection, and with agreement of the the board for inactive licensure status to be prior Marzian, Mr. Manley stated that provisions agency, the amendments were approved. to the time of renewal; and (2) comply with the regarding disciplinary action information sharing 201 KAR 13:060. Military service; drafting requirements of KRS Chapter 13A. were precipitated by a specific incident in which reciprocity; endorsement. Without objection, and with agreement of the a licensee who was the subject of a complaint A motion was made and seconded to agency, the amendments were approved. left Kentucky and allowed Kentucky licensure to approve the following amendments: to amend 201 KAR 41:070. Continuing professional expire. When the licensee applied for licensure Sections 2 and 3 to comply with the drafting and education requirements. in another state, the board was unable to share formatting requirements of KRS Chapter 13A. A motion was made and seconded to pertinent information with that state because Without objection, and with agreement of the approve the following amendments: (1) to final action on the complaint or adjudication on agency, the amendments were approved. amend the NECESSITY, FUNCTION, AND the merits had not proceeded. Changes to this Board of Nursing CONFORMITY paragraph and Sections 3 administrative regulation allowed a record of a 201 KAR 20:370. Applications for licensure. through 7, 10, and 11 to comply with the complaint to be shared if another state requested Nathan Goldman, general counsel, represented drafting and formatting requirements of KRS the information. There was reciprocity in that the board. Chapter 13A; and (2) to amend Section 10 to: (a) Kentucky could also request similar information A motion was made and seconded to approve clarify waiver provisions; and (b) include undue from other states. the following amendment: to amend Section hardship or similar extenuating circumstances A motion was made and seconded to 1 to comply with the drafting requirements of that precludes the licensee’s completion of the approve the following amendments: to amend KRS Chapter 13A. Without objection, and with requirements. Without objection, and with the STATUTORY AUTHORITY paragraph agreement of the agency, the amendment was agreement of the agency, the amendments were and Section 4 to comply with the drafting approved. approved. requirements of KRS Chapter 13A. Without 201 KAR 20:506. Nurse licensure compact. 201 KAR 41:080. Complaint procedure. objection, and with agreement of the agency, the Board of Podiatry A motion was made and seconded to amendments were approved. 201 KAR 25:090. Prescribing and dispensing approve the following amendments: to amend Board of Ophthalmic Dispensers controlled substances. Tony Cotto, executive Sections 1 and 2 to comply with the drafting and 201 KAR 13:040. Licensing. Cindy advisor, represented the board. formatting requirements of KRS Chapter 13A. Castle, chair, and Carson Kerr, board counsel, A motion was made and seconded to approve Without objection, and with agreement of the represented the board. the following amendments: (1) to amend the agency, the amendments were approved.

34 2019 Interim LEGISLATIVE RECORD KENTUCKY LOTTERY CORPORATION requirements of KRS Chapter 13A; and (2) to 1 to comply with the drafting requirements of 202 KAR 3:010. Code of ethics. Mike amend Section 3 to reduce from $600 to $500, KRS Chapter 13A. Without objection, and with Denney, assistant general counsel, and Michele the re-inspection fee for wooden roller coasters. agreement of the agency, the amendments were Sullivan, vice president of human resources, Without objection, and with the agreement of approved. represented the corporation. the agency, the amendments were approved. Regulation and Inspection; Tobacco Sales KENTUCKY COMMUNITY AND 302 KAR 16:040. Correction of safety 302 KAR 78:021. Repeal of 302 KAR 78:020. TECHNICAL COLLEGE SYSTEM: Board of violations and right to re-inspection. Animal Control Officers Emergency Medical Services A motion was made and seconded to approve 302 KAR 101:010. Training requirements 202 KAR 7:560. Ground vehicle staff. Philip the following amendments: to amend the TITLE for Kentucky Animal Control Officers. Dietz, chair; Michael Poynter, executive director; and Section 1 to comply with the drafting and A motion was made and seconded to and John Wood, attorney, represented the board. formatting requirements of KRS Chapter 13A. approve the following amendments: to amend A motion was made and seconded to Without objection, and with agreement of the the TITLE; the NECESSITY, FUNCTION, approve the following amendments: to amend agency, the amendments were approved. AND CONFORMITY paragraph; and Section Section 1 to comply with the drafting and 302 KAR 16:070. Reports of injuries 1 to comply with the drafting requirements of formatting requirements of KRS Chapter 13A. involving amusement rides and amusement KRS Chapter 13A. Without objection, and with Without objection, and with agreement of the attractions. agreement of the agency, the amendments were agency, the amendments were approved. 302 KAR 16:091. Rides and attractions not approved. TOURISM, ARTS, AND HERITAGE included in the definition of amusement ride or ENERGY AND ENVIRONMENT CABINET: Department of Fish and Wildlife attraction. CABINET: Department for Natural Resources: Resources: Game 302 KAR 16:101. Operate amusement ride Division of Mine Safety: Mining Safety Standards 301 KAR 2:221. Waterfowl seasons and or device defined. 805 KAR 3:110. Employees’ personal limits. Steven Fields, staff attorney; Chris 302 KAR 16:111. Violations, civil penalties, protection. Bert Gibbons, assistant director; Garland, acting director, Wildlife Division; John revocations, and suspensions of business Michael Mullins, regulation coordinator; and Hast, bear program coordinator; and Karen identification number. John Small, commissioner, represented the Waldrop, deputy commissioner, represented the In response to a question by Co-Chair division. department. Hale, Mr. Quarles stated that changing from A motion was made and seconded 301 KAR 2:222. Waterfowl hunting eighteen (18) to sixteen (16), the operator age to approve the following amendments: to requirements on public land. threshold that would constitute a violation, was amend the NECESSITY, FUNCTION, AND 301 KAR 2:300. Black bear seasons and for consistency with commensurate statutory CONFORMITY paragraph and Section 1 to requirements. changes. comply with the drafting requirements of KRS In response to a question by Representative A motion was made and seconded to Chapter 13A. Without objection, and with Marzian, Ms. Waldrop stated that the male quota approve the following amendments: to amend agreement of the agency, the amendments were had been removed for bears. Reporting for the the TITLE; the NECESSITY, FUNCTION, AND approved. purposes of quota tracking was conducted via CONFORMITY paragraph; and Sections 1 and PUBLIC PROTECTION CABINET: call-in after 9 p.m. This administrative regulation 3 to comply with the drafting and formatting Department of Insurance: Insurance Fraud also adjusted bear zones. requirements of KRS Chapter 13A. Without 806 KAR 47:010. Fraud prevention. Patrick In response to questions by Co-Chair Hale, objection, and with agreement of the agency, the O’Connor, deputy commissioner; Leah Spears, Ms. Waldrop stated that the quota tracking amendments were approved. executive advisor; and Eric Stone, investigator system was updated daily. Mr. Hast stated that 302 KAR 16:121. Inflatable rides or supervisor, represented the department. Kentucky was nearly reaching the quotas. Ms. attractions. A motion was made and seconded to Waldrop stated that the department expected In response to questions by Co-Chair Hale, approve the following amendments: to amend bear harvesting to increase. Mr. Quarles stated that private inflatable rides or Sections 1, 4, 5, and 7 and material incorporated GENERAL GOVERNMENT CABINET: attractions, such as those for school functions, by reference to comply with the drafting and Department of Agriculture: Division of were regulated and inspected at least once unless formatting requirements of KRS Chapter 13A. Regulation and Inspection: Amusement Rides a problem occurred, which would result in re- Without objection, and with agreement of the 302 KAR 16:010. Business identification inspection. The device was inflated and anchored agency, the amendments were approved. number required. Clint Quarles, attorney, to the ground for the purposes of inspection. The 806 KAR 47:021. Repeal of 806 KAR 47:020 represented the division. serial numbers of the inflatables were recorded, and 806 KAR 47:030. A motion was made and seconded to and the blower units received the inspection seal. ENERGY AND ENVIRONMENT approve the following amendments: to amend A motion was made and seconded to CABINET: Public Service Commission: Utilities the TITLE; the NECESSITY, FUNCTION, approve the following amendments: to amend 807 KAR 005:056. Fuel adjustment clause. AND CONFORMITY paragraph; and Sections the TITLE; the NECESSITY, FUNCTION, Ben Bellamy, staff attorney; Gwen Pinson, 1 through 5 to comply with the drafting and AND CONFORMITY paragraph; and Sections executive director; and Karen Wilson, executive formatting requirements of KRS Chapter 13A. 3 through 5 to comply with the drafting advisor, represented the commission. David Without objection, and with agreement of the requirements of KRS Chapter 13A. Sinclair, vice president, Energy Supply and agency, the amendments were approved. 302 KAR 16:131. Maintenance and repair of Analysis, represented LG&E and KU Energy in 302 KAR 16:020. Inspection and operation amusement ride or attractions. opposition to this administrative regulation. of amusement rides or amusement attractions. A motion was made and seconded to In response to questions by Co-Chair A motion was made and seconded to approve the following amendments: to amend West, Ms. Pinson stated that the Public Service approve the following amendments: (1) to amend the TITLE; the NECESSITY, FUNCTION, Commission (PSC) was in the process of Sections 2 and 3 to comply with the drafting AND CONFORMITY paragraph; and Section reviewing all of its administrative regulations THE KENTUCKY GENERAL ASSEMBLY 35 as part of the Red Tape Reduction Initiative. know if out-of-state coal providers were already 902 KAR 4:030. Newborn screening This administrative regulation was initially “padding” prices. It seemed unlikely that program. Jan Bright, branch manager; Julie promulgated in 1982 and was a priority for Kentucky coal producers would “pad” prices Brooks, regulation coordinator; and Andrew amendment as a result of House Resolution 144 because it would be in their interests to submit Waters, assistant division director, represented from the 2019 Regular Session of the General competitive bids. While PSC had not done an the department. Assembly, which urged PSC to consider all costs, independent economic analysis, the Economic 902 KAR 4:035. Cost reimbursement for including fossil fuel-related economic impacts for Development Cabinet had data regarding job specialized food products. the purposes of analyzing coal purchases. Among and wage impacts. PSC hoped that any increased State and Local Confinement Facilities other changes, the major shift was to Section costs would be offset by rate-payer base increases 902 KAR 9:010. Environmental health. Erica 3(5), which was revised to exempt coal severance resulting from economic growth. Brakefield, section supervisor; Jessica Davenport, taxes in determining the reasonableness of fuel Co-Chairs West and Hale stated that this program evaluator; and Julie Brooks, regulation costs. This administrative regulation also made was a very important administrative regulation. coordinator, represented the department. hearings discretionary, rather than mandatory, in Cost containment for consumers was important, A motion was made and seconded to approve order to limit costs from unnecessary hearings. as was economic growth. the following amendments: (1) to amend Section If the attorney general wished to have a hearing A motion was made and seconded to 1 to add the definition for “tempered water”; and or if the public requested a hearing or a hearing approve the following amendments: (1) to (2) to amend the NECESSITY, FUNCTION, was in the public interest, the hearing would be amend the RELATES TO; STATUTORY AND CONFORMITY paragraph and Sections 1, held. Additionally, the public was always able to AUTHORITY; and NECESSITY, FUNCTION, 2, 12, 14, 16, and 17 to comply with the drafting submit comments pertaining to an ongoing PSC AND CONFORMITY paragraphs and Sections requirements of KRS Chapter 13A. Without case. 1 through 3 to comply with the drafting and objection, and with agreement of the agency, the In response to a question by Co-Chair formatting requirements of KRS Chapter 13A; amendments were approved. Hale, Mr. Sinclair stated that nonprofit regulated (2) to amend Section 1 to clarify that standards Food and Cosmetics utilities were only authorized to recover actual for suspension of rate schedules shall be based 902 KAR 45:120. Inspection and permit fuel costs. In 2018, LG&E and KU Energy on the severity and history of nonconformity; fees for recreational vehicle communities, purchased approximately sixty (60) percent of and (3) to amend Section 3 to: (a) clarify that youth camps, and private water supplies. Erica coal used to generate electricity from Kentucky standards for suspension of fuel adjustment Brakefield, section supervisor; Jessica Davenport, coal producers. The proposed revision to the clauses shall be based on the severity and history program evaluator; and Julie Brooks, regulation fuel adjustment clause would change how PSC of unreasonable fuel charges; and (b) delete coordinator, represented the department. reviewed fuel procurement decisions from being language that could have been interpreted as Department for Behavioral Health, based on the actual full price paid to the price limiting the scope of coal severance taxes. Developmental and Intellectual Disabilities: less any coal severance tax. Customers would still Without objection, and with agreement of the Division of Behavioral Health: Substance Abuse pay the full cost of fuel, including coal severance agency, the amendments were approved. 908 KAR 1:341. Repeal of 908 KAR 001:340. tax; therefore, the proposed administrative PUBLIC PROTECTION CABINET: Real Stephanie Brammer – Barnes, regulation regulation might cause higher consumer costs. Estate Authority: Kentucky Board of Auctioneers coordinator; Dr. Allen Brenzel, medical director; The extra cost amount was uncertain; however, 831 KAR 1:010. Licensing fees and and Kara Daniel, division director, represented estimates could be between ten (10) and twenty applications. Heather Becker, general counsel; the division. (20) million dollars annually, depending on how H. E. Corder, executive director; and Ron Kirby, In response to a question by Co-Chair West, coal bidding strategies changed. The proposed board member, represented the board. Ms. Daniel stated that the changes represented administrative regulation could be challenged A motion was made and seconded to in these administrative regulations stemmed on constitutional grounds, which could result in approve the following amendments: (1) to from the cabinet’s efforts to implement House lengthy and costly litigation, further increasing amend Sections 1, 2, 4, 5, and 8 to comply with Bill 124 from the 2018 Regular Session of the costs for consumers. The potential benefits to the drafting and formatting requirements of General Assembly, which required the cabinet to coal producers, employees, and communities KRS Chapter 13A; and (2) to amend Section 8 perform a comprehensive review of standards for were not quantified and might be greater or less to incorporate by reference the License Renewal substance abuse treatment facilities statewide. The than increased costs to consumers. Form. Without objection, and with agreement of department worked with Medicaid, the cabinet’s In response to questions by Co-Chair Hale, the agency, the amendments were approved. Office of Inspector General, and the Office of Ms. Pinson stated that the cost impact was 831 KAR 1:020. Standards of conduct and Drug Control Policy to develop these revised expected to be minimal. Estimates from Mr. complaints. standards. These changes updated requirements, Sinclair were calculated based on an unlikely, 831 KAR 1:030. Education requirements. streamlined licensure, incorporated national worst-case scenario. One (1) commenter A motion was made and seconded to standards, and made revisions for the purposes during the public comment period stated that approve the following amendments: (1) to of improving quality of patient care. the economic benefits of the possible increase amend Section 3 to clarify that proof of a high 908 KAR 1:370. Licensing procedures, fees, outweighed the risks. There could be a consumer school diploma or equivalent is required, unless and general requirements for nonhospital-based cost increase, but it was expected to be very waived pursuant to KRS 330.060(1)(b); and (2) alcohol and other drug treatment entities. minimal, such as seventy-five (75) cents per year. to amend Sections 3, 4, and 6 to comply with A motion was made and seconded to Numerous utilities submitted public comments the drafting requirements of KRS Chapter 13A. approve the following amendments: (1) to during the public comment period. Without objection, and with agreement of the amend Section 3 to make conforming changes In response to questions by Co-Chair West, agency, the amendments were approved. stemming from a deletion made in the Amended Ms. Pinson stated that worst-case estimates CABINET FOR HEALTH AND FAMILY After Comments version that removed differing were based on an overall four and five tenths SERVICES: Department for Public Health: survey requirements between accredited and (4.5) percent coal cost increase. PSC did not Maternal and Child Health non-accredited AODEs; and (2) to amend

36 2019 Interim LEGISLATIVE RECORD Section 18 to clarify a provision concerning the agency’s mailing address; and (2) require provisions. the biopsychosocial assessment. Without form completion and submission within ten (10) JUSTICE AND PUBLIC SAFETY objection, and with agreement of the agency, the days. Without objection, and with agreement of CABINET: Asset Forfeiture amendments were approved. the agency, the amendments were approved. 500 KAR 9:011. Repeal of 500 KAR 9:010, 908 KAR 1:372. Licensure of residential The following administrative regulations 500 KAR 9:020, 500 KAR 9:030, and 500 KAR alcohol and other drug treatment entities. were deferred or removed from the July 10, 2019, 9:040. A motion was made and seconded to approve subcommittee agenda: Motorcycle Safety Education Commission: the following amendments: (1) to amend Section STATE BOARD OF ELECTIONS: Forms Motorcycle Safety 3 to state that the food requirements apply only and Procedures 500 KAR 15:010 & E. Motorcycle safety to a facility that prepares meals on-site for a 31 KAR 4:120. Additional and emergency education program. client and do not apply to a facility where clients precinct officers. TRANSPORTATION CABINET: prepare their own meals on-site or are otherwise FINANCE AND ADMINISTRATION Department of Vehicle Regulation: Division of responsible for their meals; (2) to amend Section CABINET: Department of Revenue: Income Driver Licensing: Administration 5 to specify that a residential transitional living Tax; General Administration 601 KAR 2:030 & E. Ignition interlock. program shall ensure that each client participates 103 KAR 15:050. Filing dates and extensions. PUBLIC PROTECTION CABINET: for a minimum of five (5) hours per week Office of Financial Management: State Department of Insurance: Agents, Consultants, in counseling and planned clinical program Investment Commission Solicitors, and Adjustors activities, with counseling comprising at least 200 KAR 14:201. Repeal of 200 KAR 14:200. 806 KAR 9:001. Prelicensing courses of two (2) hours; and (3) to amend Section 8 to: (a) BOARDS AND COMMISSIONS: Board of study. require all residential AODE programs to have Pharmacy 806 KAR 9:020. False or deceptive names, at least one (1) shower or tub per fifteen (15) 201 KAR 2:095. Pharmacist interns. titles, prohibited. clients; and (b) to make a technical correction. 201 KAR 2:165. Transfer of prescription 806 KAR 9:030. Adjuster licensing Without objection, and with agreement of the information. restrictions. agency, the amendments were approved. 201 KAR 2:310. Compounding for Agents, Consultants, Solicitors, and Substance Abuse a veterinarian’s office or institutionalAdjustors 908 KAR 1:374. Licensure of nonhospital- administration for veterinary use. 806 KAR 9:061. Repeal of 806 KAR 9:060. based outpatient alcohol and other drug Board of Dentistry 806 KAR 9:070. Examinations. treatment entities. 201 KAR 8:581. Charity dental practices. 806 KAR 9:110. Agent’s rights after contract A motion was made and seconded to approve Board of Social Work termination. the following amendments: (1) to amend the 201 KAR 23:150. Complaint procedure, 806 KAR 9:190. Disclosure requirements RELATES TO and STATUTORY AUTHORITY disciplinary action, and reconsideration. for financial institutions authorized to engage in paragraphs and Sections 1 through 8 to comply ENERGY AND ENVIRONMENT insurance agency activities. with the drafting and formatting requirements CABINET: Department for Environmental 806 KAR 9:200. Volume of insurance agent of KRS Chapter 13A; (2) to amend Section 7 Protection: Division of Water: Water Quality exchange of business. to establish waiver criteria; and (3) to amend 401 KAR 5:010. Operation of wastewater 806 KAR 9:310. Life settlement licenses. Section 4 to clarify that if clients prepare their systems by certified operators. 806 KAR 9:321. Repeal of 806 KAR 9:320. own meals on-site or are otherwise responsible Water Quality Certification 806 KAR 9:341. Repeal of 806 KAR 9:341. for their meals, a food service permit shall not be 401 KAR 8:030. Water treatment plant and 806 KAR 9:350. Recognition of financial required. Without objection, and with agreement water distribution system classification and planning certification and designation for receipt of the agency, the amendments were approved. staffing. of fees and commissions. Department for Income Support: Division 401 KAR 8:050. Drinking water program Life Insurance and Annuity Contracts of Child Support Enforcement: Family Support fees. 806 KAR 15:081. Repeal of 806 KAR 15:080. 921 KAR 1:380. Child support enforcement Certified Operators LABOR CABINET: Department of program application and intergovernmental 401 KAR 11:001. Definitions for 401 KAR Financial Institutions: Administration process. Bryan Hubbard, commissioner, Chapter 11. 808 KAR 1:180. Use of special restricted represented the division. 401 KAR 11:030. Wastewater treatment and funds. A motion was made and seconded to approve collection system operators; classification and CABINET FOR HEALTH AND FAMILY the following amendments: to amend Section 2 qualifications. SERVICES: Division of Epidemiology and to comply with the formatting requirements of 401 KAR 11:040. Water treatment and Health Planning: Communicable Diseases KRS Chapter 13A. Without objection, and with distribution system operators; classification and 902 KAR 2:070. Rabies control. agreement of the agency, the amendments were qualifications. Public Accommodations approved. 401 KAR 11:050. Operator and training 902 KAR 7:010. Hotel and motel code. Department for Community Based Services: provider certification. Division of Public Health Protection and Child Welfare 401 KAR 11:060. Operator and training Safety: Mobile Homes and Recreational Vehicles 922 KAR 1:510. Authorization for disclosure provider certification fees. Parks; Facilities Standards of protection and permanency records. Erika Department for Natural Resources: 902 KAR 15:010. Manufactured and mobile Bauford, section supervisor, and Sarah Cooper, Division of Mine Permits: Bond and Insurance homes. staff assistant, represented the department. Requirements Office of Inspector General: Division of A motion was made and seconded to approve 405 KAR 10:001. Definitions for 405 KAR Healthcare: Health Services and Facilities the following amendments: to amend Section 4 Chapter 10. 902 KAR 20:036. Operation and services; to revise the authorization form to: (1) include 405 KAR 10:015. General bonding personal care homes. THE KENTUCKY GENERAL ASSEMBLY 37 Food and Cosmetics introduce themselves and give their agency name, Alzheimer’s Program Development and 902 KAR 45:065. Tattooing. area of expertise, and issues that may pertain to Implementation line item in the state budget but Food and Cosmetics the charge of the task force. Each member gave no increases have occurred. 902 KAR 45:070. Body piercing and ear a brief overview of their backgrounds and how Utilize the AD council and stakeholder piercing. they could be of service to this task force. community to revise the current definition, 902 KAR 45:075. Tanning facilities. Charge and Duties of the Task Force eligibility, and service requirements for the Department of Medicaid Services: Division The Legislative Research Commission provision of respite care. Kentucky provides of Policy and Operations: Medicaid Services authorized the Alzheimer’s and Dementia Task respite care through Title III-E. Ad Districts 907 KAR 1:604 & E. Recipient cost-sharing. Force by memorandum and set forth the charge (AAAs) can provide respite care, but funding Department for Aging and Independent and duties. The charge is to study health care limitations and or prioritization play a big part in Living: Division of Guardianship: Guardianship workforce needs and the long-term care services funding allocation. Most caregivers are unaware 910 KAR 2:020. Referral process for adult and supports infrastructure, including long-term of the availability of respite care. guardianship. care facilities used to provide care to individuals Maintain a system of care coordinators and Department for Aging and Independent diagnosed with Alzheimer’s or dementia. The benefit counselors in each of the 15 AAAs. There Living: Division of Guardianship: Guardianship task must submit findings and strategies to LRC is no system in place. 910 KAR 2:040. Service provisions for adult by November 29, 2019. Develop incentives beyond tax incentives for guardianship. The duties include assessing the health care caregivers. There is no tax incentive for caregivers Department for Community Based Services: workforce to identify current or anticipated and no measures beyond tax incentives. Division of Protection and Permanency: Child workforce shortages and possible steps to Support legislation for a caregiver tax Welfare ameliorate any shortages, evaluating the credit for people who provide in-home care for 922 KAR 1:310 & E. Standards for child- effectiveness of current initiatives to develop, dependent relatives who have little to no income placing agencies. recruit, and retain highly skilled direct and have been diagnosed with Alzheimer’s or Child Welfare care workers, geriatricians, gerontologists, related dementia. Although attempted, no such 922 KAR 1:350 & E. Requirements for public neurologists, and other professionals involved legislation has been passed. child welfare agency foster parents, adoptive in providing care and treatment to individuals Develop a demonstration to test the parents, and respite care providers. diagnosed with Alzheimer’s or dementia, feasibility and cost-effectiveness of adult day care 922 KAR 1:470. Central registry. evaluating the current state of long-term clients receiving services in other long-term care 922 KAR 1:495 & E. Training requirements care services and supports infrastructure and settings traditionally considered institutional for foster parents, adoptive parents, and respite providing recommendations for improvement, in order to expand access to accommodate care providers for children in the custody of the and examining existing workforce training anticipated growth in demand. Many adult day cabinet. initiatives and making recommendations to services, especially social models, have been The subcommittee adjourned at 11:10 improve career mobility and retention among cut due to funding issues as federal funding a.m. The date, time, and room for the August health care workers, including continuing moved to the medical model. There has been no subcommittee are pending. education requirements and the current demonstration or pilot program of traditionally credentialing process. institutional services for the purpose of ALZHEIMER’S AND DEMENTIA State of Long-Term Care Services and expanding Home- and Community-Based WORKFORCE ASSESSMENT TASK Supports Infrastructure Services (HCBS) care. Mackenzie Longoria, Director of Public The second recommendation was to monitor FORCE Minutes of the 1st Meeting Policy, Greater Kentucky and Southern Indiana a statewide data collection system by collecting of the 2019 Interim Chapter of the Alzheimer’s Association, and monitoring, at minimum, the following: July 2, 2019 discussed long-term care services and the The prevalence of dementia-related diseases Call to Order and Roll Call supports infrastructure. across the commonwealth. In 2012, 2015, and The 1st meeting of the Alzheimer’s and In 2007, SJR 6 directed the Office on 2016, the association applied to be included in Dementia Workforce Assessment Task Force was Alzheimer’s Disease and Related Disorders the Centers for Disease Control and Prevention’s held on Tuesday, July 2, 2019, at 10:00 AM, in (AD Office) and the Alzheimer’s Disease and (CDC) Behavioral Risk Factor Surveillance Room 131 of the Capitol Annex. Senator Robby Related Disorders Advisory Council (AD Survey (BRFSS). In 2016, it was funded in part Mills, Chair, called the meeting to order, and the Council) to assess the current and future impact with help from DAIL and currently represents secretary called the roll. of Alzheimer’s disease on Kentuckians and state the most up-to-date statistics. BRFSS cognitive Present were: systems, programs, and services. This assessment model collects demographic, geographic, and Members: Senator Robby Mills, Co-Chair; was updated in 2017 with new and revised socioeconomic data related to cognitive decline. Representative Deanna Frazier, Co-Chair; recommendations. There is also a caregiver module which focuses Senators Stephen Meredith and Reginald Several of the recommendations address the on collecting data regarding caregivers’ personal Thomas; Representative Lisa Willner; Bill AD Office, which as of June 2019, exists in name health and greatest care needs. This is the most Cooper, Buddy Hoskinson, Mackenzie Longoria, only and is not funded or staffed. important piece of data that can be collected to Devon McFadden, Andrea Renfrow, Mary The association is realistic about costs and is ensure accurate information about individuals Romelfanger, and Phillip Travis. willing to work with the Department for Aging in Kentucky experiencing cognitive decline and Guest: Steven Davis, Inspector General. and Independent Living (DAIL) to serve as the their caregivers. However, the association was LRC Staff: Dana Simmons and Jennifer de facto AD Office. unable to be included in the upcoming 2019 Luttrell. The first recommendation was to: BRFSS module due to lack of funding. The cost for Introduction of Members Increase and improve support for family including the six necessary questions is $30,000, Senator Mills asked each member to caregivers by requesting an increase in the which now rests solely on the association.

38 2019 Interim LEGISLATIVE RECORD The prevalence of dementia-related diseases a person with a health problem or disability; guidelines, HCBS care, hospice care, and by county. BRFSS, nor any other data system, relationship between the caregiver and the care chronic care management). Efforts to integrate captures this information. recipient; health problem or disability of the care mental health care are slowly being addressed The prevalence of early-onset dementia recipient; if the caregiver assists with household within hospital systems, but disparity between and related diseases across the commonwealth. tasks; if the caregiver assists with personal tasks; levels of care causes disruptions and confusion BRFSS, nor any other data system, captures this average hours of caregiving provided per week; with disease management strategies and care information. length of time as a caregiver; type of assistance planning. The prevalence of inpatient geriatric most needed by the caregiver that they do not The fifth recommendation was to enhance psychiatry beds. BRFSS, nor any other data receive (question included for years 2015–2018); state policies and procedures to provide system, captures this information. if the care recipient has Alzheimer’s disease or additional support to ensure the health, safety, The availability of geriatric services and another dementia in addition to another health and welfare of individuals with Alzheimer’s specialists. Kentucky is behind in the availability problem or disability (question added in 2019); disease and related dementia by: of such services and specialists. The American and the percentage of adults aged 18 years or Utilizing the AD Council to evaluate state Geriatrics Society estimates that an additional older who are not caregivers who expect to be regulations on home care, adult day, and home 23,750 geriatricians should be trained by 2030 caregivers in the next two years. health, to assure they are “dementia friendly.” in order to meet the demands of an aging U.S. The third recommendation was to establish When time provides, the council attempts to population, however, as of 2017, there are state protocol on appropriate interface and evaluate said regulations, but are limited by time currently only 6,910 certified geriatricians choices for individuals with Alzheimer’s and and funding constraints. practicing nationwide, and it is estimated that the their families by requiring the AD Council to Monitoring and giving recommendations United States has approximately half the number utilize a protocol detailing how to interface that address persons with dementia ability to of certified geriatricians that it currently needs. with individuals with Alzheimer’s and related remain in their current living environment despite Researchers also estimate that the United States dementias and their families. The protocol a change in their condition (i.e.: challenging will need 19 percent more neurologists by 2025 should include appropriate placement care behaviors or other disease symptoms) that under in order to meet the increasing demand. In 2017 options based on the stages of Alzheimer’s and existing regulations might otherwise promote Kentucky was identified as one of the twenty related dementias. DAIL provides resources for their move to a different level of care. This protocol states that were deemed “neurology deserts” due case managers and serves as a resource for family should ensure that the provider can adequately to a projected shortage of neurologists, combined members. Department for Medicaid Servies demonstrate that the person’s care needs can be with an expected rapid rise in Alzheimer’s disease (DMS) through the Division of Community safely and effectively met without the disruption and other dementias. Alternatives (DCA) has a manual for HCBS of moving. The association is actively working The availability of assessment services for providers and case managers and is working on this issue through participation in the 1915(c) Alzheimer’s and related dementias. Assessment on improving the ways in which they can be waiver redesign and with recommendations for services for Alzheimer’s and related dementias a resource for families, through the 1915(c) training and case management for individuals depend largely on an individual’s Point Of Care waiver redesign. The Alzheimer’s Association is with Alzheimer’s or related dementias utilizing (POC) and/or information available at their local working on a request for an Alzheimer’s specific HCBS. health department or AAA. While 82 percent of 1915c waiver. The association has given public Supporting a pilot demonstration project seniors say it is important to have their thinking comments with recommendations as it relates to to address the problem of facility discharges of and memory checked, only 16 percent say they case managers and care planning. However, there residents exhibiting challenging behaviors. There receive regular cognitive assessments. There is a is no singular official “handbook” or “protocol” is no such pilot program in place. Currently, Medicare billing code for care planning but since for interfacing with individuals with Alzheimer’s there is a 22 percent hospital readmission rate its implementation in 2017, less than one percent and their families. for dementia patients. of doctors utilize the code, partly because of the The fourth recommendation was to Reviewing the current Kentucky Medicaid low reimbursement rate. Congressman Guthrie explore options to increase insurance coverage programs to ensure “dementia friendly” has introduced a second version of this code for individuals with Alzheimer’s and related approaches and policies, and identify challenges called I-HOPE at the federal level that providers dementias by: to admission and eligibility requirements. The can use for care planning. Cognitive assessment Supporting and protecting Medicaid association is actively working on this issue is covered by the Medicare annual wellness visit, eligibility and Alzheimer’s specific waivers for through participation in the 1915(c) waiver but most seniors are unaware of the benefit individuals with early-onset Alzheimer’s disease. redesign and with recommendations for training and therefore do not ask for it. Kentucky does Kentucky uses the federal Medicaid financial and case management for individuals with collect information through Software Asset eligibility requirements for HCBS and sets the Alzheimer’s or related dementias utilizing HCBS, Management (SAM), a statewide data system on functional eligibility requirements as: (1) are as well as the financial and functional eligibility services provided by AAAs, but currently lists elderly or have a physical disability and (2) meet requirements. that information pertaining to Alzheimer’s and the Level of Care defined by KAR 1:022 and Supporting and encouraging the evolution dementia under a “Disability” title. would be admitted to a nursing facility if no have and application of best practice for persons The number and location (county) of waiver services. This has the potential to prevent with dementia living in personal care homes Kentuckians who are currently providing care in individuals with early onset to qualify for HCBS and assisted living facilities. With Personal their home to a family member. The association services. Care Homes (PCs) being licensed by the Office does not collect data related to the number and Advocating for integrated systems of of the Inspector General (OIG) and Assisted location of Kentuckians providing care to a healthcare and support that support mental Living Facilities (ASLs) being certified by family member in their home. BRFSS collects health parity and are effective for individuals DAIL, there is a disparity in the education and data related to the percentage of adults 18 years with Alzheimer’s disease and their families training requirements, as well as policies, rules or older who self-report as being a caregiver to (e.g.: disease management strategies, practice and or regulations regarding best practices THE KENTUCKY GENERAL ASSEMBLY 39 for individuals with Alzheimer’s or related nursing care, routine personal and healthcare for whom it is prescribed and; dementias in those settings. needs, meals, and to be part of daily activities. opening the medication container The goals and recommendations of the Attendant Care - Help with tasks a person or dosage package, but not handling or state plan to address Alzheimer’s align with the cannot do on his or her own due to being aged removing the medication. association’s overall policy goals and priorities or because of a physical disability. This For certification, an ASL must complete to increase public awareness, build a dementia- service includes help with bathing, dressing, the DAIL application; provide a copy of a blank capable workforce, increase access to home- and grooming, light housework, laundry, and meal lease agreement; a copy of written material used community-based services, and enhance the planning and preparation to market the proposed ASL, including material quality of care in residential settings. Environmental and Minor Home that markets offered special programming The Kentucky statistics include the number Adaptation - Changes to a person’s home that (ex: Alzheimer’s and dementia care), staffing of Kentuckians living with Alzheimer’s or related ensure their health, safety, and welfare, increase or training; a floor plan; and a nonrefundable dementia, from 73,000 to 86,000 by 2025. This independence and allow them to continue to live application fee of $40 per unit (plus additional is an increase of nearly 17 percent over the next at home. fees depending on the size of the facility). The six years. Alzheimer’s and related dementias Home Delivered Meals. certification process is annual and absent a were responsible for 1,765 deaths in 2017. The Non-Specialized and Specialized Respite formal complaint against the facility, the state number of caregivers in Kentucky - 273,000 → Care - Provides a short term break for a person’s does not conduct any oversight and monitoring 300,000 by 2025 with 311 million total hours primary, unpaid caregiver. of the quality of care in the facility. of unpaid care is valued at $3.9 million with A person may qualify for HCBS / 1915(c) Personal Care Homes (PCs) are licensed as $197 million in higher healthcare costs for if they are elderly or have a physical disability; LTC facilities by the OIG. Services in a PC may caregivers. Costs associated with caring for the meet nursing facility level of care as defined in be reimbursed from the state general fund but disease include $23,703/per capita Medicare Kentucky Administrative Regulation 907 KAR there is no reimbursement for Medicaid services. spending, $778 million in Medicaid costs for 1:022 and would be admitted to a nursing facility Clients may be ambulatory or mobile non- people with dementia, 20.6 percent increase if the person did not have waiver services; and ambulatory and whose care needs do not exceed expected from 2019 to 2025, and 22.2 percent meet the federal financial qualifications for the PC’s capability (i.e.: residents must be able to hospital readmission rate for dementia patients. Medicaid. KRS 205.520(3) authorizes CHFS manage most of their ADLs). PCs in Kentucky The 2016 BRFSS data says that in Kentucky, one to comply with any requirement that may be means an establishment located in a permanent in eight of those aged 45 and over report they imposed, or opportunity presented, by federal building, which has resident beds. Services that are experiencing confusion or memory loss law to qualify for federal Medicaid funds. HCBS can be performed in PCs include continuous that is happening more often or is getting worse compliance with federal law is monitored by supervision; basic health/health-related (“subjective cognitive decline”); 55.9 percent say DAIL, via CHFS, DMS, and DCA. HCBS includes services (supervision of self-administration of it has created “functional difficulties;” more than Alzheimer’s respite care and Alzheimer’s/Adult medications, storage and control of medications, half have not discussed these problems with a Day Care. when necessary); personal care services; and healthcare professional; 90.4 percent of those Assisted Living Facilities (ASLs) must be social/recreational activities. For complete reporting cognitive decline are also managing certified initially and annually by DAIL and are details of the licensure process, see 902 KAR another chronic condition (i.e.: diabetes, considered private business entities (910 KAR 20:008. heart disease, COPD, etc.); nearly one in four 1:240). As such, no public funding is available Nursing Facilities (NFs) are licensed by Kentuckians are caregivers who provide at least for services provided in this setting (i.e.: no OIG and are legally responsible for the facility 20 hours per week of unpaid care. Medicaid reimbursement). Clients must be and compliance with all federal, state, and local In Kentucky, the two entities that are ambulatory or mobile non-ambulatory and not laws and regulations pertaining to the operation responsible for licensure and/or certification a danger to self or others. ASLs in Kentucky of the facility. NFs are often the final stop on of long-term care (LTC) facilities through means a number of living units on the same site, the continuum of care. NFs “shall care for its the Cabinet for Health and Family Services operated as one business entity and certified to residents in a manner and in an environment (CHFS) are DAIL, which includes Home-And- provide services for five or more adults. Services that promotes maintenance or enhancement Community-Based-Services (HCBS) with Adult that can be performed in ASLs include Assistance of each resident’s quality of life” (902 KAR Day and Respite Care also under CHFS/DAIL, with Activities of Daily Living (ADLs) and 20:300). Before admission to an NF, the facility by way of DMS and the DCA and the OIG, Instrumental Activities of Daily Living (IADLs) “shall make a comprehensive assessment of the Division of Healthcare. Assisted Living Facilities such as housekeeping, scheduled daily activities, resident’s needs, which describes the resident’s (ASL) are certified by DAIL. Personal Care (PC) and assistance with self-administration of capacity to perform daily life functions and Homes and Nursing Homes/Facilities (NF) are medication as directed in KRS 194A.705(1) significant impairments in functional capacity” licensed by OIG. (d): “Assistance with self-administration of (902 KAR 20:300). Kentucky has administrative HCB services are authorized through the medication in accordance with (ibid), which, for regulations for “nursing facilities” (902 KAR 1915(c) Medicaid Waiver Program: “A Kentucky medications not preset in a medication organizer 20:300) but also “nursing homes” (902 KAR Medicaid program established pursuant to and or single dose unit container as described in KRS 20:048). in accordance with 42 U.S.C. 1396n(c).” This 194A.700(3)(a), may include but shall not exceed Nursing homes are defined as waiver program provides Medicaid-paid services the following staff actions if the client requests “establishments with permanent facilities that and supports to the elderly or to adults and assistance: include inpatient beds” and “services provided children with physical disabilities to help them providing the client with a may include medical services and continuous to live at home rather than in an institutional medication reminder; nursing services. Patients in a nursing home setting. Services include: reading the medication label to facility require inpatient care but do not currently Adult Day Health Care - A place the client and confirming that the require inpatient hospital services” (902 KAR for persons 21 and older to receive skilled medication is being taken by the client 20:048).

40 2019 Interim LEGISLATIVE RECORD Nursing facilities are defined as “a nursing assigned duties: Alzheimer’s disease and other out orientation and in-service requirements. facility licensed pursuant to this reg and 902 types of dementia and the aging process. Staff Orientation program - the facility shall conduct KAR 20:008 (which relates to license procedures and management shall receive annual in-service an orientation program for all new employees to and fee schedules). education applicable to their assigned duties that include review of all facility policies (that relate 902 KAR 20:048: “(b) When the patient’s address no fewer than four of the topics listed to the duties of their respective jobs), services, condition exceeds the scope of services of the above. and emergency and disaster procedures. In- facility, the patient, upon physician’s orders The ASL must maintain a description of service training - all employees shall receive (except in cases of emergency), shall be any dementia-specific training that is provided, in-service training and ongoing education to transferred promptly to a hospital or a skilled including, at a minimum, the content, the correspond with the duties of their respective nursing facility, or services shall be contracted number of offered and required hours, the jobs. All nursing personnel shall receive in- for from another community resource.” schedule, and the staff who are required to service or continuing education programs at Program staff at a certified adult-day center complete the training. least quarterly. shall include trained and experienced staff who According to 902 KAR 20:036(8), each Because NFs take Medicaid, there are federal shall be present each day of operation and at facility must have an administrator who is training and education requirements. least two staff members at the adult-day center responsible for the facility’s operation and who 42 CFR 483.95 – Training requirements: “A at times when there is more than one client in must delegate such responsibility in his/her facility must develop, implement and maintain an attendance. Staffing ratios shall be one staff to absence, and one attendant shall be awake and effective training program for all new and existing one client; two staff if two to 10 clients; three on duty on each floor in the facility at all times. staff; individuals providing services under staff if 11 to 15 clients; one staff member for each According to 902 KAR 20:036(8), all a contractual arrangement; and volunteers, five additional clients over 15; one staff member employees shall receive in-service training to consistent with their expected roles. A facility certified in CPR; and a director that meets the correspond with the duties of their respective must determine the amount and types of qualifications laid out in 910 KAR 1:160 (9)(a)1. jobs. Shall include but not be limited to one to training necessary based on a facility assessment Prior to assuming duties, paid and volunteer three hours of policies/services/procedures; four as specified at § 483.70(e). Training topics must personnel shall receive a minimum of six hours hours of reporting cases of adult abuse, neglect, include but are not limited to communication; of orientation including program objectives; or exploitation; five hours of methods of assisting resident’s rights and facility responsibilities; policies and procedures; health, sanitation, patients to achieve maximum abilities in ADLs; and abuse, neglect, and exploitation. In emergency procedures; client confidentiality; six hours of methods for proper application of addition to the freedom from abuse, neglect, and personnel policies. physical restraints; and nine hours of the aging and exploitation requirements in § 483.12, Within three months of employment, staff process training. facilities must also provide training to their staff shall be provided a minimum of 34 hours of According to 902 KAR 20:036(g), the that, at a minimum, educates staff on activities basic training that includes one hour of the number of personnel required shall be based that constitute abuse, neglect, exploitation, aging process; seven hours of recognizing and on the number of patients, amount and kind of and misappropriation of resident property as reporting suspected adult abuse neglect or PC, and the supervision and program needed to set forth at § 483.12; procedures for reporting exploitation; nine hours of dementia training, meet the needs of residents. incidents of abuse, neglect, exploitation, including causes and manifestations of dementia Only 902 KAR 20:048 (Nursing Homes) or the misappropriation of resident and managing a client with dementia; 10 hours lays out staffing requirements. The facility shall property; dementia management and of crisis intervention with a combative client; have adequate personnel to meet the needs of resident abuse prevention; required in-service and 11 hours of effects of dementia on the the patients on a 24-hour basis. The number and training for nurse aides. In-service training must caregiver. Staff shall receive a minimum of eight classification of personnel required shall be based be sufficient to ensure the continuing competence hours of annual training to review and update on the number of patients and the amount and of nurse aides, but must be no less than 12 hours knowledge and skills. HCBS providers must also kind of personal care, nursing care, supervision, per year and include dementia management ensure compliance with federal Medicaid laws and program needed to meet the needs of the training and resident abuse prevention training. and training. patients as determined by medical orders and There is a KRS provision, 216.595, that sets According to KRS 194A. 717, staffing in by services required by this administrative out requirements for “assisted living facilities an assisted-living community shall be sufficient regulation. When the staff to patient ratio does and long-term care facilities claiming to provide in number and qualification to meet the 24- not meet the needs of the patients, the Division special care for person’s with Alzheimer’s disease hour scheduled needs of each client pursuant for Licensing and Regulation shall determine or other brain disorders.” (1) (a) Any assisted- to the lease agreement and functional needs and inform the administrator in writing how living community as defined by KRS 194A.700 assessment; one awake staff member shall be on many additional personnel are to be added and of or long-term care facility as defined in KRS site at all times; an assisted-living community what job classification and shall give the basis for 216.535 that claims to provide special care for shall have a designated manager who is at least this determination. A responsible staff member persons with a medical diagnosis of Alzheimer’s 21 years of age, has at least a high school diploma shall be on duty and awake at all times to assure disease or other brain disorders shall maintain or GED and has demonstrated management prompt, appropriate action in cases of injury, a written and current manual that contains the or administrative ability to maintain the daily illness, fire, or other emergencies. Volunteers information specified in subsection (2) of this operations; and no employee who has an active shall not be counted to make up minimum section. This manual shall be maintained in the communicable disease. staffing requirements. The facility shall have a office of the community’s or facility’s director According to KRS 194A.719: In-service director of nursing service who is a registered and shall be made available for inspection upon Education for Staff and Management, ASL nurse and who works full time during the day, request of any person. The community or facility staff and management shall receive orientation and who devotes full time to the nursing service shall make a copy of any program or service education (within 90 days of hire) on the of the facility. information contained in the manual for a following topics as applicable to the employee’s 902 KAR 20:048 (Nursing Homes) also lays person who requests information. THE KENTUCKY GENERAL ASSEMBLY 41 The community or facility shall maintain Ombudsman, there are only two nursing facilities 1997 which are NF certified so two licenses are and update written information on the following: in Kentucky that operate under these statutes. needed to be renewed every year. It was allowed (a) The assisted-living community’s or In response to a question from Representative to participate in the Title 18/Medicaid program long-term care facility’s mission or philosophy Thomas about the lack of data and the possibility so now both state and federal governments are statement concerning the needs of residents with of partnering with universities to collect data, involved. Most facilities are duly certified. Alzheimer’s disease or other brain disorders; Ms. Longoria said the association has considered Mr. Hoskinson added that he believes there (b) The process and criteria the assisted- partnering with the universities to solicit funds is not a consistent number of hours for continuing living community or long-term care facility for the 2020 BRFS by giving a gift that could be education. CNAs actually have more required uses to determine placement into services for split between the University of Kentucky and the hours of training. He would like the task force to persons with Alzheimer’s disease or other brain University of Louisville to make up the gap in look at the consistency of continuing education disorders; funding. It’s not a guarantee and it’s not in their across the state. (c) The process and criteria the assisted- charge to provide funding for data collection Senator Mills asked Mr. Davis, Inspector living community or long-term care facility uses because the universities do research. It would General, CHFS, to speak. Mr. Davis gave a brief to transfer or discharge persons from special have to be in the form of a major gift. overview of his background and the history, services for Alzheimer’s or other brain disorders; In response to a question from Ms. certification rules, reimbursement structure, and (d) The supervision provided for residents Romelfanger, Ms. Longoria replied that the obstacles of ASLs, NFs, and PCs. with a medical diagnosis of Alzheimer’s disease association’s region nine, which includes Senator Mills told the members the meeting or other brain disorders; Kentucky, Indiana, and Illinois, has also reached dates for the rest of the interim and asked them (e) The family’s role in care; out to the development staff and medical schools to come up with experts to testify before the task (f) The process for assessing, planning, at both of the universities concerning a major force during the next five meetings. implementing, and evaluating the plan of care gift. Adjournment for persons with Alzheimer’s disease or other Senator Meredith stated that data collection There being no further business, the meeting brain disorders; is important, but that the main focus of the task was adjourned at 11:45 a.m. (g) A description of any special care services force should be access to care, accessing care, for persons with Alzheimer’s disease or other and funding of care. He also added that he would GOVERNMENT CONTRACT brain disorders; like to hear from the caregivers and what their REVIEW COMMITTEE (h) Any costs associated with specialized obstacles are and what would make their lives Committee Minutes services for Alzheimer’s disease or other brain better. July 11, 2019 disorders; and In response to a question from Representative Call to Order and Roll Call (i) A description of dementia or other brain Frazier about the statistic from the 2016 BRFSS The Government Contract Review disorder-specific staff training that is provided, data that says one in eight of those aged 45 and Committee met on Thursday, July 11, 2019, at including but not limited to the content of the over report they are experiencing confusion or 10:00 AM, in Room 131 of the Capitol Annex. training, the number of offered and required memory loss, Ms. Longoria said that she thought Representative Stan Lee, Chair, called the hours of training, the schedule for training, it was broken down by gender but that she would meeting to order, and the secretary called the and the staff who are required to complete the have to get back with that information. She roll. training. added that women are two-thirds more likely, Present were: KRS 216B.072 provides the training/ African-American women are two-thirds more Members: Senator Stephen Meredith, Co- education requirements for these facilities. A likely, and Hispanic women are one half more Chair; Representative Stan Lee, Co-Chair; long-term care facility as defined in KRS 216.535, likely to develop the disease. Senators Julian M. Carroll, Paul Hornback, except for a personal care home (note: there are In response to a question from and Phillip Wheeler; Representatives Charles Alzheimer’s personal care facilities all over the Representative Willner concerning receiving Booker, Chris Fugate, and Mark Hart. state, yet no specific statutes), that advertises to information about how other states are handling Guests: Brian Mefford, Jessica Burke, Jay provide special care for persons with a medical these issues, Ms. Longoria said that Barry Lewis, Huber, Stacy Woodrum, Heather Wagers, Ethan diagnosis of Alzheimer’s disease or other related Director of Programming, and others at the Witt, Brian Wilcox, Toby Smith, Jessica Hinkle, disorders or maintains an identifiable unit for the national office would know more and that she Sara Beth Gregory, Timothy Gutman, Charles treatment of persons with a medical diagnosis of would find out and get back to the task force with Harman, Krista Hall, Jason Rainey, Jordan Alzheimer’s disease or other related disorders that information. Smith, Beth Ward, Craig Collins, Bart Hardin, shall provide training to all staff members in the Ms. Romelfanger pointed out that there is Stephanie Bates, Natalie Kelly, Hillarye Dailey, care and handling of Alzheimer’s disease or other a diagnostic code that many care providers are Mary Scollay, Marc Guifoil, Shawn Chapman, related disorders as follows at least eight hours not aware of and do not use. She added that Jennifer Scutchfield, Jarrod Derring, Luke of orientation related to Alzheimer’s disease or another focus of the data collection should be Morgan, Tim Wiard, Daniel Schulman, and other related disorders to include the following: a knowledge base of caregivers in a professional Rich Storm, Damon Preston, Brian Rogers, and (a) Facility policies; setting. Ms. Longoria added that Congressman Melanie Foote. (b) Etiology and treatment; Guthrie has continued to push this issue and Hal LRC Staff: Kim Eisner, Jarrod Schmidt, and (c) Disease stages; (d) Behavior management; Rogers has signed on as a cosponsor. Kim Smith. and Mr. Travis added that Wellington Parc A motion was made by Senator Meredith to (e) Residents’ rights; and accepted Title 19/Medicare money which approve Minutes of the June 2019, meeting of the (2) Annual continuing education of at least defines it as skilled care. It started in 1992 as an committee. Representative Fugate seconded the five (5) hours related to Alzheimer’s disease or Alzheimer’s facility that did not accept Medicare motion, which passed without objection. other related disorders. or Medicaid as a private pay only facility of 60 According to the State Long-Term Care beds. Twenty private rooms were added in JUNE DEFERRED ITEMS:

42 2019 Interim LEGISLATIVE RECORD DEPARTMENT FOR PUBLIC Contract Amendment List, with exception DEPARTMENT FOR ENVIRONMENTAL ADVOCACY of those items selected for further review by PROTECTION Jeffrey Sherr, 1900004346. Damon Preston, members of the committee. Representative Hart EEMS, Inc. (Environmental Engineering & Brian Rogers, and Melanie Foote discussed the seconded the motion, which passed without Measurement Services, Inc.), 1900004445. contract with the committee. A motion was objection. made by Representative Booker to consider the DEPARTMENT FOR FAMILY RESOURCE contract as reviewed. Senator Meredith seconded A motion was made by Senator Meredith CENTERS & VOLUNTEER SERVICES the motion, which passed without objection. to consider as reviewed the Memoranda of Northern Kentucky Cooperative for Agreement List, with exception of those items Educational Services, Inc., 1900004679. ECONOMIC DEVELOPMENT – OFFICE selected for further review by members of the OF THE SECRETARY committee. Representative Hart seconded the DEPARTMENT FOR LOCAL Commonwealth Center for motion, which passed without objection. GOVERNMENT Commercialization, Inc., 1900004227. Brian ICF, Inc., LLC, 1900003843; Roy William Mefford and Jessica Burke discussed the contract A motion was made by Senator Meredith Brothers, 1900004220-1. with the committee. A motion was made by to consider as reviewed the Memoranda of Agreement Amendment List, with exception DEPARTMENT FOR PUBLIC HEALTH Representative Hart to consider the contract Bluegrass.Org, 1900003972; Multi, as reviewed. Representative Fugate seconded of those items selected for further review by members of the committee. Representative Hart 1900004001; Multi, 1900004002; Multi, the motion, which passed with Representative 1900004003; Multi, 1900004005; Multi, Booker voting no. seconded the motion, which passed without objection. 1900004006; Kentucky Cancerlink, Inc., JUSTICE – OFFICE OF THE SECRETARY 1900004009; Big Sandy Health Care, Inc., Motorcycle Safety Foundation, 1900003762; A motion was made by Senator Meredith 1900004010; Pennyroyal Healthcare Services, Total Control Training, 1900003763. Jay Huber, to consider as reviewed the Correction List. 1900004011; Ohio County Hospital Corporation, Stacy Woodrum, and Heather Wagers discussed Representative Hart seconded the motion, which 1900004012; Go-Hire Employment and the contracts with the committee. A motion passed without objection. Development, Inc., 1900004071; Livingston was made by Senator Meredith to disapprove Hospital Health Care, 1900004168; Cancer the contracts. Representative Hart seconded the Survivors Against Radon, Inc., 1900004173; motion which failed, with Senator Hornback, THE FOLLOWING PERSONAL Multi, 1900004358. SERVICE CONTRACTS WERE REVIEWED Senator Wheeler, Representative Booker, and DEPARTMENT FOR WORKFORCE WITHOUT OBJECTION: Representative Hart voting no. A motion was INVESTMENT made by Senator Wheeler to reconsider. Senator American Institutes for Research, ATTORNEY GENERAL Meredith seconded the motion, which passed 1900004373; Greater Louisville Workforce Tichenor and Associates, 1900004513; with Senator Hornback voting no. A motion Development Board, Inc., 1900004378; Tichenor and Associates, 1900004514. was made by Senator Meredith to disapprove University of Kentucky Research Foundation, the contracts. Representative Hart seconded the BEHAVIORAL HEALTH, 1900004412; University of Kentucky Research motion, which passed with Senator Hornback DEVELOPMENTAL & INTELLECTUAL Foundation, 1900004868; Options Unlimited, and Representative Booker voting no. DISABILITIES Inc., 1900004890. University of Pikeville, 1900004704; The DEFERRED ITEMS: DEPARTMENT OF CORRECTIONS Change Companies, 1900004720. KENTUCKY RETIREMENT SYSTEMS American Correctional Association, Vertosoft, LLC, 2020-0010. A motion was BOARD OF MEDICAL LICENSURE 1900003554; Dunn Law, PLLC, 1900004947. Kentucky Physicians Health Foundation, made by Representative Fugate to defer the DEPARTMENT OF EDUCATION 1900003730. contract to the August 2019 meeting of the University of Kentucky Research committee. Representative Lee seconded the CHFS - OFFICE OF THE SECRETARY Foundation, 1900003641; University of motion, which passed. Susan Gormley Tipton, 1900003969. Kentucky Research Foundation, 1900003644; WESTERN KENTUCKY UNIVERSITY University of Kentucky Research Foundation, COUNCIL ON POSTSECONDARY Tennessee Equine Hospital North, 192010. 1900003727; University of Kentucky Research EDUCATION A motion was made by Representative Fugate to Foundation, 1900003757; University of Blue & County, LLC, 1900003724; Texas defer the contract to the August 2019 meeting of Louisville Research Foundation, 1900003782; Instruments, Inc., 1900004073; University of the committee. Representative Lee seconded the Kentucky Special Parent Involvement Network, Kentucky Research Foundation, 1900004325; motion, which passed. Inc., 1900003832; VSA Kentucky, 1900003842; Eprep, Inc., 1900004416; University of Kentucky Kentucky Educational Development A motion was made by Senator Meredith Research Foundation, 1900004808. Corporation, 1900004082; Kentucky Educational to consider as reviewed the Personal Service Development Corporation, 1900004088; DEPARTMENT FOR COMMUNITY Contract List, with exception of those items Kentucky Educational Development BASED SERVICES selected for further review by members of the Corporation, 1900004090; Kentucky Valley Community Action Kentucky, Inc., committee. Representative Hart seconded the Education, 1900004094; Kentucky Educational 1900003964; Multi, 1900004189; Central motion, which passed without objection. Development Corporation, 1900004099; Kentucky CAC, Inc., 1900004344. Kentucky Educational Development A motion was made by Senator Meredith Corporation, 1900004103; Kentucky Valley to consider as reviewed the Personal Service Education, 1900004110; Kentucky Educational THE KENTUCKY GENERAL ASSEMBLY 43 Development Corporation, 1900004124; EASTERN KENTUCKY UNIVERSITY KENTUCKY STATE UNIVERSITY Northern Kentucky Cooperative for Educational Mary Ronetta Brown, 20-188; Diane Renee Dr. Marshall Grigsby, 20-25. Services, Inc., 1900004147; University of Yates, 20-189; Tolene Pitts, 20-190; Patricia Kentucky Research Foundation, 1900004148; Works, 20-191; Diane Johnson, 20-195; Allen KY RIVER AUTHORITY University of Kentucky Research Foundation, Real Estate Services, LLC, 20-247; Mountain University of Kentucky Research 1900004181; Assessment Solutions Group, View Veterinary Services, PLLC, 20-254. Foundation, 1900003993. 1900004200; Kentucky Educational Development KY TEACHERS RETIREMENT SYSTEM Corporation, 1900004204; Kentucky Valley FACILITIES & SUPPORT SERVICES Stantec Consulting Services, Inc., AC Advanced Cleaning Services, LLC, 2020- Education, 1900004205; University of Louisville 0001; SouthEast Printing and Mailing, 2020- Research Foundation, 1900004208; University 1900004505; Wood Environment & Infrastructure Solutions, Inc., 1900005000. 0002; Ice Miller, LLP, 2020-0005; Williams and of Kentucky Research Foundation, 1900004209; Jensen, PLLC, 2020-0007; Mulloy Borland, LLC, University of Kentucky Research Foundation, HORSE RACING COMMISSION 2020-0008; Stoll Kennon Ogden, PLLC, 2020- 1900004231; University of Kentucky Research Racing Medication and Testing Consortium, 0009; Vertosoft, LLC, 2020-0010; Cavanaugh Foundation, 1900004287; Kentucky School Inc., 1900003802. MacDonald, LLC, 2020-003. Board Association Educational Foundation, Inc., 1900004296; Human Resources Research KENTUCKY COMMUNICATIONS MOREHEAD STATE UNIVERSITY Organization, 1900004339; Caveon, LLC, NETWORK AUTHORITY Sturgill, Turner, Barker & Moloney, PLLC, 1900004357; University of Kentucky Research Public Resources Advisory Group, Inc., 20-001; Sturgill, Turner, Barker & Moloney, Foundation, 1900004403; Panorama Education, 1900004389; Bofa Securities, Inc., 1900004397; PLLC, 20-002; Sign Language Network of KY, Inc., 1900004431; University of Kentucky Morgan Stanley & Company, LLC, 1900004398. Inc., 20-003; VITAC Corporation, 20-004; Research Foundation, 1900004707; University Robinson Kirlew & Associates, 20-005; Dean of Kentucky Research Foundation, 1900004717; KENTUCKY EMPLOYERS MUTUAL Dorton Allen Ford, PLLC, 20-006; The Segal Kentucky School Board Association Educational INSURANCE Company, 20-007. Foundation, Inc., 1900004735; Kentucky Valley Ascential Care Partners, LLC, 20-ACP-001; Education, 1900004889. US-Reports, Inc. d/b/a Afirm, 20-AFM-001; MURRAY STATE UNIVERSITY Arcadia Settlements Group, Inc., 20-ASG-001; Capitol Solutions, LLC, 010-20; The Segal DEPARTMENT OF HIGHWAYS Bluegrass ChemDry, 20-BGC-001; Multi, 20- Company (Eastern States), Inc., 012-20; Greg Burgess and Niple, Inc., 1900004794; CLD-001; Conning, Inc., 20-CON-001; Dinsmore T. Taylor & Associates, 013-20; Deaf and Hard Integrated Engineering, 1900004849; AECOM & Shohl, LLP, 20-DAS-001; Dean, Dorton, Allen, of Hearing Interpreter, Referral & Advocacy Technical Services, Inc., 1900004872; QK4, Inc., Ford, PLLC, 20-DDF-001; Furniture Solutions Services, LLC, 014-20; Trifecta Real Estate 1900004873; Michael Baker International, Inc., for the Workplace, Inc., 20-FSW-001; Gallagher Services, 015-20; Sloan Appraisal & Realty 1900004874; QK4, Inc., 1900004878; American Benefit Services, 20-GBS-001; GENEX Services, Services, 016-20; Murphy Napier & Company, Engineers, Inc., 1900004968; H. W. Lochner, LLC, 20-GEN-001; Groom Law Group, 20-GLG- 017-20. Inc., 1900004969; J.M. Crawford & Associates, 001; Hanna Resource Group, 20-HRG-001; ISO Inc., 1900004970. Claims Partners, Inc., 20-ISO-001; Lexington NORTHERN KENTUCKY UNIVERSITY Financial Center, 20-LFC-001; MCF Advisors, Patricia Bills, 2020-100. DEPARTMENT OF MILITARY AFFAIRS LLC, 20-MCF-001; Milliman, Inc., 20-MIL- Tetra Tech, Inc., 1900004885. OFFICE OF HEALTH DATA AND 001; McCready & Keene, Inc., A OneAmerica ANALYTICS DEPARTMENT OF VETERANS AFFAIRS Company, 20-MKI-001; McCarthy Strategic Multi, 1900003614; Kentucky Health Med Care Pharmacy, LLC, 1900004785. Solutions, 20-MSS-001; TEKSystems, Inc., 20- Departments Association, Inc., 1900003995. TEK-001; TowerHunter, Inc., 20-THI-001; DEPARTMENT OF WORKERS’ CLAIMS Underwriters Safety & Claims, 20-USC-001. OFFICE OF INSPECTOR GENERAL Blue & County LLC, 1900004328. Pioneer Network In Culture Change, KENTUCKY ENVIRONMENTAL 1900004203. EARLY CHILDHOOD DEVELOPMENT EDUCATION COUNCIL Child Care Council of Kentucky, 1900004352; Kentucky Association for Environmental STATE TREASURER Metro United Way, Inc., 1900004360; Ohio Education, 1900004608. Mattingly Center, Inc., 1900004218. Valley Educational Cooperative, 1900004361; United Way of the Bluegrass, 1900004686; Care KENTUCKY HIGHER EDUCATION TRANSPORTATION - OFFICE OF THE for Children, Inc., 1900004687; Foundation STUDENT LOAN CORPORATION SECRETARY for Appalachian Kentucky, Inc., 1900004691; Hawkins Delafield & Wood, LLP, 19-007. Cole and Moore PSC, 1900003971; Embry Merritt Shaffar Womack, PLLC, 1900004018; Community Action Lexington Fayette, KENTUCKY LOTTERY CORPORATION 1900004695; Western Kentucky University, Ferreri Law Group, PLLC, 1900004019; Fogle MCM CPA’s and Advisors, 20-16-011; Keller Walker, 1900004020; Fox Wood and 1900004696; Northeast Kentucky Community Valenti Hanley, PLLC, 20-16-024-2; Ellipse Action Agency, 1900004697; Center for Rural Estill, 1900004021; Fulton Devlin & Powers, Solutions, LLC, 20-17-016; Kizan Technologies LLC, 1900004022; Gerner & Kearns County Development, 1900004698; United Way of LLC, 20-19-069. Paducah-McCracken County, 1900004701; PSC, 1900004023; Gess Mattingly and Western Kentucky University, 1900004702; Zero KENTUCKY RETIREMENT SYSTEMS Atchison, 1900004024; Goldberg Simpson, To Three National Center for Infants Toddlers Dean Dorton Allen Ford, PLLC, 1900004000. LLC, 1900004025; Goodrum & Downs, & Family, 1900004705; Ghazvini Consulting PLLC, 1900004026; Jones & Walters, PLLC, Services, 1900004847. KENTUCKY STATE POLICE 1900004027; Kerrick Bachert PSC, 1900004028; McBrayer, PLLC, 1900004340. Logan & Gaines, PLLC, 1900004029; McMurry

44 2019 Interim LEGISLATIVE RECORD and Livingston, 1900004030; Morgan & DEPARTMENT FOR COMMUNITY 1900002128. Pottinger, P.S.C., 1900004032; Patrick Law Firm, BASED SERVICES 1900004033; Pohl and Aubrey PSC, 1900004034; Public Consulting Group, Inc., 1800001649. MILITARY AFFAIRS COMMISSION Reed Weitkamp Schell and Vice, 1900004035; Sarah Nicole Gossett, 1900000248-1; Russell Robert L Roark, PLLC, 1900004036; Sturgill, DEPARTMENT FOR INCOME SUPPORT R. Watts, 1900000276-1. Turner, Barker & Moloney, PLLC, 1900004037; Dr. William Underwood, 1900000483; Malissa J. Mollett, 1900001951. MURRAY STATE UNIVERSITY Tooms Dunaway & Webster, 1900004038; McClain DeWees, PLLC, 014-19; Peck, Wallace Boggs, PLLC, 1900004039; Crown Title, DEPARTMENT FOR PUBLIC HEALTH Shaffer & Williams, a division of Dinsmore & LLC, 1900004041; Alicia A. Sneed, 1900004042; Multi, 1700002138; Multi, 1700002723. Shohl, LLC, 018-14; ERS Group, 100-18. Bertram Cox & Miller, LLP, 1900004043; Daniels Law Office PSC, 1900004044; Embry Merritt DEPARTMENT OF HIGHWAYS NORTHERN KENTUCKY UNIVERSITY Shaffar Womack, PLLC, 1900004045; Fox Wood WMB, Inc., 0700003516-1; Dlz Kentucky, SHP Leading Design, 2019-114; Omni and Estill, 1900004046; Gerner & Kearns County Inc., 0700003516-1; HMB Professional Architects, 2019-115; Moody Nolan, Inc., 2019- PSC, 1900004047; Gess Mattingly and Atchison, Engineers, Inc., 1300000186; EA Partners, 124. 1900004048; Greg Taylor, 1900004049; Hoffman PLC, 1300002466; HMB Professional & Barnes, 1900004050; Kerrick Bachert PSC, Engineers, Inc., 1500002143; Bureau Veritas TRANSPORTATION - OFFICE OF THE 1900004051; the Law Office of Kim Hunt Price, Company, 1700000588; Integrated Engineering, SECRETARY PLLC, 1900004053; Legacy Title Company, LLC, 1700002776; Aecom Technical Services, Inc., Benson Group, LLC, 1900002528; Reed 1900004054; Logan & Gaines, PLLC, 1900004055; 1800000306; QK4, Inc., 1800000321; Palmer Weitkamp Schell and Vice, 1900004035. McMurry and Livingston, 1900004056; Tooms Engineering County, 1900002860; Haworth UNIVERSITY OF KENTUCKY Dunaway & Webster, 1900004057; Wallace Meyer Boleyn, Inc., C-99005159. Murphy Group Architects, A181140; CMTA, Boggs, PLLC, 1900004058. DEPARTMENT OF INSURANCE Inc., K19-106; Blue & Company, LLC, K19-160; UNIVERSITY OF KENTUCKY Heather Quinn, LLC, 1900003925. Marshall Medical Management, LLC, K19-195; Witt Kieffer, K20-107; Results Marketing Benson Law Offices, K19-196; Commonwealth & Design, Inc. d/b/a Ethos, K20-109; Horn and DEPARTMENT OF JUVENILE JUSTICE Anesthesia, PSC, K19-202; NEPCON, LLC, Associates in Rehabilitation, K20-110; Susan Keith Hardison, 1800002061. K19-231. Burton, DMD, K20-111; Danny Corales MD, DEPARTMENT OF MILITARY AFFAIRS UNIVERSITY OF LOUISVILLE K20-112; NAMI Lexington (KY), Inc., K20-113; Public Private Solutions Group, 1900001602. McCarthy Strategic Solutions, 19-019. Smith Management Group, K20-114; Trinity Consultants, K20-115; Rockcastle Hospital and DEPARTMENT OF VETERANS AFFAIRS WESTERN KENTUCKY UNIVERSITY Respiratory Care Center, Inc., K20-116; St. Claire Multi, 1800001970; Multi, 1900000323. Huron Consulting Services, LLC, 181929; Regional Medical Center, K20-117; Oak Ridge Ann Huttner Coaching, Inc. d/b/a Oak Treek Associated Universities, Inc., K20-118. EASTERN KENTUCKY UNIVERSITY Leadership Coaching, 181938; Multi, 182014; Sturgill, Turner, Barker & Moloney, PLLC, Multi, 182014; Multi, 182014; Multi, 182020. UNIVERSITY OF LOUISVILLE 20-074; CMTA, Inc., 20-096; Elise Russell, 20- JRA, Inc., 20-004. 123. WESTERN KENTUCKY UNIVERSITY FACILITIES & SUPPORT SERVICES THE FOLLOWING MEMORANDA Sodexo Management Inc., 192009; Mactec Engineering & Consulting, OF AGREEMENTS WERE REVIEWED Employers Risk Services A Division of Houchens 1000002150; HMB Professional Engineers, WITHOUT OBJECTION: Insurance Group, 192011; Grenzebach Glier & Inc., 1200002582; Third Rock Consultants, Associates, 192012. LLC, 1200003126; Sherman Carter Barnhart, ATTORNEY GENERAL 1400001413; Hafer Associates, 1500001053; Family Nurturing Center of Kentucky, Omni Architects, 1500001238; Ensafe, Inc., 1900004606. 1600002252; K. Norman Berry Associates, THE FOLLOWING PERSONAL SERVICE BEHAVIORAL HEALTH, 1800000098. AMENDMENTS WERE REVIEWED DEVELOPMENTAL & INTELLECTUAL WITHOUT OBJECTION: JUSTICE - OFFICE OF THE SECRETARY DISABILITIES Balance Dynamics Motorcycle Training Eastern Kentucky University, 1900003968; BOARD OF MEDICAL LICENSURE Center, Inc., 1900001592. Pathways, Inc., 1900004169; Pennyroyal Regional Multi, 1900000777; Multi, 1900000777. Mental Health Mental Retardation Board, KENTUCKY EDUCATIONAL CHFS - DEPARTMENT FOR AGING AND 1900004176; Communicare, Inc., 1900004178; TELEVISION INDEPENDENT LIVING Centerstone of Kentucky, Inc., 1900004187; Michelle L. Grant, 1900000169. Neurobehavioral Resources Ltd, Lifeskills, Inc., 1900004193; Comprehend, Inc., 1900004202; Mountain Comprehensive Care 1900000437. KENTUCKY LOTTERY CORPORATION Center, 1900004217; Lake Cumberland Mental IGT Global Solutions Corporation f/k/a CHFS - OFFICE OF THE SECRETARY Health Mental Retardation Board, 1900004222; GTECH Corporation, 19-15-001; SeNet Thomas J. Hellmann Attorney-At-Law Bluegrassorg, 1900004235; Kentucky River International Corporation, 19-18-032. PLLC, 1900002243. Community Care, Inc., 1900004241; University KENTUCKY RETIREMENT SYSTEMS of Kentucky, 1900004407; University of Ice Miller, 1900000705; Morris James, LLP, Kentucky, 1900004539.

THE KENTUCKY GENERAL ASSEMBLY 45 CHFS - DEPARTMENT FOR AGING AND 1900004786. 1900004100; Jefferson County Board of INDEPENDENT LIVING Education, 1900004104; Spencer County Board Multi, 1900004391; Multi, 1900004491. DEPARTMENT OF CORRECTIONS of Education, 1900004105; Montgomery County Henderson County, 1900000424-1. Board of Education, 1900004106; Campbell DEPARTMENT FOR COMMUNITY DEPARTMENT OF CRIMINAL JUSTICE County Board of Education, 1900004107; BASED SERVICES Campbell County Board of Education, Kentucky Housing Corporation, TRAINING Eastern Kentucky University, 1900004297. 1900004108; Owensboro Independent School 1900003852; Audubon Area Community District, 1900004109; Jefferson County Board of Services, 1900004341; Big Sandy Area DEPARTMENT OF EDUCATION Education, 1900004111; Christian County Board Development District, 1900004342; Greater Bullitt County Board of Education, of Education, 1900004112; Hopkins County Louisville Workforce Development Board, 1900003550; Campbell County Board of Board of Education, 1900004113; Oldham Inc., 1900004347; Northern Kentucky Area Education, 1900003552; Fulton County Board of County Board of Education, 1900004114; Development District, 1900004349; Eastern Education, 1900003553; Marion County Board Montgomery County Board of Education, Kentucky University, 1900004478. of Education, 1900003555; Russell Independent 1900004115; Jefferson County Board of DEPARTMENT FOR ENVIRONMENTAL School District, 1900003557; Meade County Education, 1900004116; Trigg County Board of PROTECTION Board of Education, 1900003559; Mason County Education, 1900004117; Estill County Board of Copperhead Environmental Consulting, Board of Education, 1900003560; Scott County Education, 1900004118; Jefferson County Board Inc., 1900004097; Botanica, Inc., 1900004375; Board of Education, 1900003783; Clark County of Education, 1900004120; Hardin County Board United States Department of the Interior, Board of Education, 1900003784; Jefferson of Education, 1900004129; Jefferson County 1900004417; US Department of Agriculture, County Board of Education, 1900003790; Ohio Board of Education, 1900004130; Scott County 1900004877. Valley Educational Cooperative, 1900003819; Board of Education, 1900004131; Science Hill Eastern Kentucky University, 1900003820; Independent School District, 1900004132; DEPARTMENT FOR FAMILY RESOURCE Northern Kentucky University, 1900003841; Owen County Board of Education, 1900004133; CENTERS & VOLUNTEER SERVICES Kentucky Valley Education, 1900003846; Utah Clark County Board of Education, 1900004136; Multi, 1900004399; Multi, 1900004437; State University, 1900003851; Ashland Board of Fayette County Board of Education, 1900004137; Multi, 1900004439; Multi, 1900004440; Education, 1900003853; Calloway County Board Madison County Board of Education, Multi, 1900004448; Multi, 1900004489; of Education, 1900003870; Campbell County 1900004139; Scott County Board of Education, Multi, 1900004504; Multi, 1900004506; Board of Education, 1900003871; Elliott County 1900004140; Anderson County Board of Multi, 1900004507; Multi, 1900004522; Multi, Board of Education, 1900003886; Floyd County Education, 1900004142; Bath County Board of 1900004536; Eastern Kentucky University, Board of Education, 1900003890; Hart County Education, 1900004145; Fayette County Board of 1900004680. Board of Education, 1900003902; Jefferson Education, 1900004149; Jefferson County Board County Board of Education, 1900003907; of Education, 1900004150; Woodford County DEPARTMENT FOR LOCAL McCracken County Board of Education, Board of Education, 1900004151; Hopkins GOVERNMENT 1900003930; Nelson County Board of County Board of Education, 1900004152; City of Hindman, 1900003660; City of Education, 1900003940; Newport Independent Scott County Board of Education, 1900004153; Somerset, 1900003703; Harlan County Fiscal School District, 1900003941; Shelby County Jefferson County Board of Education, Court, 1900004188; Southern Water and Board of Education, 1900003953; Woodford 1900004155; Frankfort Independent School Sewer, 1900004386; Lyon County Industrial County Board of Education, 1900003955; District, 1900004156; Jefferson County Board Development Authority, 1900004618; Graves Wolfe County Board of Education, 1900003962; of Education, 1900004157; Estill County Board County Fiscal Court, 1900004692; Lawrence Northern Kentucky University, 1900003984; of Education, 1900004158; Hopkins County County Fiscal Court, 1900004740; Harlan CHS Department for Public Health Food Safety Board of Education, 1900004159; Corbin County Fiscal Court, 1900004741; Owen Branch, 1900003996; Bell County Board of Independent School District, 1900004160; County, 1900004743; Knott County Fiscal Education, 1900004072; Fleming County Board Knox County Board of Education, 1900004161; Court, 1900004753; Henderson County Fiscal of Education, 1900004074; Pulaski County Board Boyd County Board of Education, 1900004162; Court, 1900004756; Pike County Fiscal Court, of Education, 1900004076; Jefferson County Newport Independent School District, 1900004791; Owsley County, 1900004863; Board of Education, 1900004077; Knox County 1900004163; Shelby County Board of Education, Owsley County, 1900004866; McCreary County Board of Education, 1900004078; Jefferson 1900004164; Adair County Board of Education, Fiscal Court, 1900004952. County Board of Education, 1900004079; 1900004167; Fayette County Board of Education, DEPARTMENT FOR MEDICAID Henderson County Board of Education, 1900004184; Garrard County Board of SERVICES 1900004080; Leslie County Board of Education, Education, 1900004186; Allen County Board of University of Kentucky, 1900003801. 1900004081; Corbin Independent School Education, 1900004197; Spencer County Board District, 1900004083; Carter County Board of of Education, 1900004213; Kentucky Valley DEPARTMENT FOR WORKFORCE Education, 1900004084; Leslie County Board of Education, 1900004223; Kentucky Community INVESTMENT Education, 1900004086; Scott County Board of and Technical College System, 1900004232; Eastern Kentucky Cep, Inc., 1900004384; Education, 1900004087; Glasgow Independent Bellevue Independent School District, Kentucky Community and Technical College School District, 1900004092; Scott County Board 1900004236; Berea Independent Board of System, 1900004415; Hazard Community and of Education, 1900004093; Madison County Education, 1900004237; Breathitt County Board Technical College, 1900004435. Board of Education, 1900004095; Green County of Education, 1900004240; Carter County Board Board of Education, 1900004096; Jefferson of Education, 1900004242; Casey County Board DEPARTMENT OF AGRICULTURE County Board of Education, 1900004098; of Education, 1900004244; Christian County Kentucky Association of Food Banks, Inc., Madison County Board of Education, Board of Education, 1900004245; Clark County

46 2019 Interim LEGISLATIVE RECORD Board of Education, 1900004246; Clinton County Kentucky University, 1900004992. THE FOLLOWING MEMORANDA Board of Education, 1900004247; Crittenden OF AGREEMENT AMENDMENTS WERE County Board of Education, 1900004248; DEPARTMENT OF JUVENILE JUSTICE REVIEWED WITHOUT OBJECTION: Cumberland County Board of Education, Kentucky Department of Education, 1900004249; Danville Independent School 1900003817; Louisville Jefferson County Metro ADMINISTRATIVE OFFICE OF THE District, 1900004250; Fayette County Board of Government, 1900004880. COURTS Education, 1900004251; Floyd County Board DEPARTMENT OF MILITARY AFFAIRS National Center for State Courts, of Education, 1900004252; Fulton Independent Western Kentucky Food Service, 1900002072. Board of Education, 1900004253; Garrard 1900003966-1; Oldham County Fiscal Court, BEHAVIORAL HEALTH, County Board of Education, 1900004254; 1900004372; City of Madisonville, 1900004746. Glasgow Independent School District, DEVELOPMENTAL & INTELLECTUAL 1900004255; Harlan County Board of Education, DEPARTMENT OF REVENUE DISABILITIES 1900004256; Hart County Board of Education, Multistate Tax Commission, 1900004345. Centerstone of Kentucky, Inc., 1800000550; 1900004257; Jackson County Board of Education, NAMI Lexington Kentucky, Inc., 1800001999; 1900004258; Larue County Board of Education, DEPARTMENT OF WORKPLACE Chestnut Health Systems, Inc., 1800002030; 1900004259; Livingston County Board of STANDARDS Bluegrass.org, 1900001648; Kenton County Education, 1900004261; Martin County Board of Department for Public Health, 1900004333. Fiscal Court, 1900002798; Voices of Hope - Lexington, Inc., 1900002799. Education, 1900004268; Menifee County Board EARLY CHILDHOOD DEVELOPMENT of Education, 1900004269; Metcalfe County Kenton County Public Library, 1900004343. COUNCIL ON POSTSECONDARY Board of Education, 1900004270; Eastern EDUCATION Kentucky University, 1900004271; Middlesboro ECON DEV - OFFICE OF THE Kentucky Department of Education, Independent School District, 1900004272; SECRETARY 1900002352; National Center for Higher Monroe County Board of Education, Shaping Our Appalachian Region, Inc., Education Management Systems, Inc., 1900004273; Owensboro Independent School 1900004379. 1900003026. District, 1900004274; Owsley County Board of Education, 1900004275; Paris Independent JUSTICE - OFFICE OF THE SECRETARY DEPARTMENT FOR COMMUNITY School District, 1900004276; Russell County Kentucky Department of Corrections, BASED SERVICES Board of Education, 1900004277; Russellville 1900004876. University of Kentucky Research Independent School District, 1900004278; KENTUCKY DEPARTMENT OF PARKS Foundation, 1800001650. Southgate Independent School District, Breaks Interstate Parks Commission, 1900004279; Warren County Board of Education, DEPARTMENT FOR INCOME SUPPORT 1900004134; Eastern Kentucky University, State of Mississippi, 1800001783. 1900004280; Washington County Board of 1900004414. Education, 1900004281; Wayne County Board DEPARTMENT FOR LOCAL of Education, 1900004282; Webster County KY RIVER AUTHORITY GOVERNMENT Board of Education, 1900004283; Whitley United States Department of the Interior, University of Kentucky Research Foundation, County Board of Education, 1900004284; 1900003991. 1900002297; Bell County, 1900002404; Perry Williamstown Board of Education, 1900004285; County Fiscal Court, 1900003310. Wolfe County Board of Education, 1900004286; OFFICE OF INSPECTOR GENERAL University of Kentucky Collaborative Center University of Kentucky Research DEPARTMENT FOR MEDICAID for Literacy Development, 1900004293; Murray Foundation, 1900002938-1. SERVICES State University, 1900004295; Murray State PUB PROTECTION - OFFICE OF THE University of Kentucky Research University, 1900004310; Eastern Kentucky SECRETARY Foundation, 1900002797. University, 1900004316; Meade County Board Kentucky Labor Cabinet, 1900004359. of Education, 1900004387; Ohio County Board DEPARTMENT FOR NATURAL of Education, 1900004402; Office of Employer STATE TREASURER RESOURCES and Apprenticeship Services, 1900004524; Center for Accessible Living, 1900003339. Multi, 1800000233. Walton-Verona Independent School District, DEPARTMENT FOR PUBLIC HEALTH 1900004683; Kentucky Community and TRANSPORTATION - OFFICE OF THE SECRETARY University of Kentucky Research Technical College System, 1900004796; Barren Foundation, 1800001733; University of Kentucky County Board of Education, 1900004869; Kentucky Community and Technical College System, 1900004060; Federal Highway Research Foundation, 1900003173; Justice Danville Independent School District, Cabinet, 1900003253. 1900004879; Johnson County Board of Administration National Highway Institute, Education, 1900004886; Jefferson County Board 1900004061. DEPARTMENT FOR WORKFORCE of Education, 1900004888; Eastern Kentucky UNIVERSITY OF KENTUCKY INVESTMENT University, 1900004895; Fayette County Board of Southeast Community & Technical College, Kentucky Transportation Cabinet, Education, 1900004917; Jefferson County Board 001-20; Gateway Community Technical College, 1900000040. of Education, 1900004937; Pike County Board 002-20; Morehead State University, 003-20. of Education, 1900004941; Berea Independent DEPARTMENT OF AGRICULTURE Board of Education, 1900004956; Shelby County Multi, 1900003210; Multi, 1900003211; Board of Education, 1900004960; Shelby County Northern Kentucky Area Development District, Board of Education, 1900004962; Western 1900003662; Feeding America, Kentucky’s THE KENTUCKY GENERAL ASSEMBLY 47 Heartland, 1900003664; Gods Pantry Food Bank, DEPARTMENT FOR COMMUNITY UNIVERSITY OF KENTUCKY Inc., 1900003666; Purchase Area Development BASED SERVICES Kaufman, Hall & Associates, LLC, K20- District, Inc., 1900003667; Dare To Care, Inc., Jobs for Kentucky’s Graduates, 1900004436. 106; Davis Moore Capital, LLC, K20-108. Craig 1900003668. Toby Smith and Jessica Hinkle discussed the Collins and Bart Hardin discussed the contracts contract with the committee. A motion was with the committee. A motion was made by DEPARTMENT OF CORRECTIONS made by Senator Meredith to defer the contract Representative Hart to consider the contracts Montgomery County, 1900000485. to the August 2019 meeting of the committee. as reviewed. Senator Hornback seconded the DEPARTMENT OF EDUCATION Senator Hornback seconded the motion, which motion, which passed with Senator Wheeler and Murray State University, 1900001135; passed. Senator Meredith voting no. Kentucky Department of Agriculture, DEPARTMENT OF EDUCATION 1900001181; Indiana University, 1900002028; Leading Educators, Inc., 1900004174. THE FOLLOWING PERSONAL SERVICE University of Louisville Research Foundation, Charles Harman and Krista Hall discussed the AMENDMENTS WERE SELECTED FOR 1900002720. contract with the committee. A motion was FURTHER REVIEW: DEPARTMENT OF JUVENILE JUSTICE made by Representative Booker to consider the contract as reviewed. Senator Carroll seconded Community Resources for Justice Crime BOARD OF ELECTIONS the motion, which passed. and Justice Institute, 1900000329. McBrayer McGinnis Leslie & Kirkland, PLLC, 1900002068. Jennifer Scutchfield, Jarrod DEPARTMENT OF MILITARY AFFAIRS EASTERN KENTUCKY UNIVERSITY Derring, and Luke Morgan discussed the Fort Knox Community Schools Food Multi, 20-197; Multi, 20-198; Multi, 20-199; contract with the committee. A motion was made Service, 1900001278; Eminence Independent Multi, 20-200; Multi, 20-201; Multi, 20-202; Multi, by Senator Wheeler to consider the contract as Board of Education, 1900001518. 20-203; Multi, 20-204; Multi, 20-205; Multi, 20- 206; Multi, 20-207; Multi, 20-208. Ethan Witt reviewed. Senator Carroll seconded the motion, DEPARTMENT OF TRAVEL and Brian Wilcox discussed the contracts with which passed. Multi, 1900002850. the committee. A motion was made by Senator DEPARTMENT FOR MEDICAID Meredith to consider the contracts as reviewed. SERVICES JUSTICE - OFFICE OF THE SECRETARY Senator Hornback seconded the motion, which Island Peer Review Organization, Kentucky Medical Services Foundation, passed. Inc., 1900001837. Inc., 1800002210; Myers and Stauffer, LLC, ECON DEV - OFFICE OF THE 1900002320. Stephanie Bates and Natalie Kelly KENTUCKY LOTTERY CORPORATION SECRETARY discussed the contracts with the committee. Finance & Administration Cabinet, 19-001. University of Louisville Research A motion was made by Senator Meredith to consider the contracts as reviewed. Senator MILITARY AFFAIRS COMMISSION Foundation, 1900004370; Awesome Center Carroll seconded the motion, which passed. Kentucky Science and Technology for Entrepreneurship, Inc., 1900004380; Northern Kentucky University Foundation, Corporation, 1900000653. DEPARTMENT OF CORRECTIONS Inc., 1900004381. Brian Mefford, Jason Rainey, Mid America Health, Inc., 1900001785; OFFICE OF INSPECTOR GENERAL and Jessica Burke discussed the contracts with Diamond Drugs, Inc., 1900001789. Hillarye Trilogy Health Services, 1700001314; the committee. A motion was made by Senator Dailey and Stacy Woodrum discussed the University of Kentucky Research Foundation, Meredith to consider the contracts as reviewed. contracts with the committee. A motion was 1900002938. Senator Carroll seconded the motion, which made by Senator Carroll to consider the contracts passed. TRANSPORTATION - OFFICE OF THE as reviewed. Senator Wheeler seconded the SECRETARY HORSE RACING COMMISSION motion, which passed. University of Louisville Research Racing Surfaces Testing Laboratory, UNIVERSITY OF KENTUCKY Foundation, 1900000897. 1900003800. Mary Scollay, March Guifoil, and Whitecap Health Advisors, LLC, K19-199. Shawn Chapman discussed the contract with Craig Collins and Bart Hardin discussed the the committee. A motion was made by Senator contract with the committee. A motion was made Carroll to consider the contract as reviewed. THE FOLLOWING PERSONAL by Senator Hornback to consider the contract Representative Hart seconded the motion, which SERVICE CONTRACTS WERE SELECTED as reviewed. Representative Hart seconded the passed with Senator Hornback, Senator Wheeler, FOR FURTHER REVIEW: motion, which passed with Senator Meredith and Representative Fugate voting no. voting no. AUDITOR OF PUBLIC ACCOUNTS MURRAY STATE UNIVERSITY Harding Shymanski and Company, Multi, 001-20; Multi, 002-20; Multi, 003- 1900003983. Sara Beth Gregory and Timothy 20; Multi, 004-20; Multi, 005-20; Multi, 006- THE FOLLOWING PERSONAL SERVICE Gutman discussed the contract with the 20; Multi, 007-20; Multi, 008-20; Multi, 009- CONTRACT FOR $10K AND UNDER WERE committee. A motion was made by Senator 20. Jordan Smith and Beth Ward discussed SELECTED FOR FURTHER REVIEW: Carroll to consider the contract as reviewed. the contracts with the committee. A motion Representative Booker seconded the motion, was made by Senator Meredith to consider KENTUCKY FISH AND WILDLIFE which passed. the contracts as reviewed. Senator Hornback RESOURCES seconded the motion, which passed. Blue & Company, LLC, 1900004221. Tim Wiard, Daniel Schulman, and Rich Storm discussed the contract with the committee.

48 2019 Interim LEGISLATIVE RECORD A motion was made by Senator Hornback to District requested an amendment Cattlemen’s Association’s (KCA) long range plan consider the contract as reviewed. Representative to CAIP. The board recommended that will be implemented from 2020 to 2025. Hart seconded the motion, which passed. approval, which did not affect the Kentucky has the second most cattle per program total. square mile behind Missouri. The KCA has a There being no further business, the meeting Spencer County Conservation strong emphasis on education, because beef adjourned at 1:30 PM. District requested an amendment farmers own the cattle. to CAIP. The board recommended approval, which did not affect the All of the cattle in Kentucky are eventually TOBACCO SETTLEMENT program total. transported out of state, but there are strict AGREEMENT FUND OVERSIGHT Trigg County Soil Conservation regulations on transportation. Most of the beef COMMITTEE District requested an additional $73,713 packing plants are in the western United States Minutes in Trigg County funds for CAIP. The so cattle must be transported, but the KCA July 3, 2019 board recommended approval, which would like all cattle to stay in Kentucky. Call to Order and Roll Call would bring the program total to The KCA believes the solution is to feed The 4th meeting of the Tobacco Settlement $134,063. cattle locally, utilize byproducts of the distillery Agreement Fund Oversight Committee was The projects discussed included: industry as high quality feed, build a beef held on Wednesday, July 3, 2019, at 10:00 AM, Christian Fellowship was approved processing plant within the region, and develop in Room 129 of the Capitol Annex. Senator C.B. for up to $17,045 in Marshall County a beef and forage innovation center. Embry Jr., Chair, called the meeting to order, and funds for the construction of a school Kentucky Beef Network the secretary called the roll. greenhouse. Becky Thompson stated the goal of the Present were: Metcalfe County Extension District Kentucky Beef Network (KBN) is to move the Members: Senator C.B. Embry Jr., Co- Board was approved for up to $190,000 marketed product away from a commodity and Chair; Representative Myron Dossett, Co-Chair; in state funds and $10,000 in Metcalfe closer to a recognized value-added product in Senator Dennis Parrett; Representatives Kim County funds to construct a farmers demand by retailers. KBN uses proven, modern King, Brandon Reed, and Dean Schamore. market and to enclose the pavilion. production practices for master cattlemen and Guests: Warren Beeler, Executive Director, The Metcalfe County 4-H Council master grazer classes, which have increased the Governor’s Office of Agricultural Policy (GOAP); was approved for $1,350 in Metcalfe total pounds of beef produced. Bill McCloskey, Deputy Executive Director, County funds to purchase 18 hams for The Kentucky Beef Quality and Care GOAP; Dave Maples, Executive Vice President, meat production education. Assurance Program aims to raise awareness of Kentucky Cattlemen’s Association; Becky Pendleton County Extension practices that ensure proper cattle handling and Thompson, Director, Kentucky Beef Network District Foundation was approved for welfare to keep producers safe while continuing (KBN); and Cary King, Chairman, KBN. $90,000 in state funds and $10,000 to provide healthy beef to consumers. The LRC Staff: Nathan Smith, Tanya Monsanto, in Pendleton County funds for the Beef Efficiency Conference invites nationally Kelly Ludwig, and Rachel Hartley. construction of a permanent open-air recognized speakers to challenge attendees on Governor’s Office of Agricultural Policy farmers market pavilion structure. where efficiencies can be found on the farm. Report Christian County Agricultural The Integrated Reproductive Management Warren Beeler testified about the allocation Extension Foundation was approved Program was implemented in 2015 and has of funds by county since the inception of the for up to $250,000 in Christian County spread throughout Kentucky. The focus of the Kentucky Agricultural Development Fund. funds for the construction of an program is to narrow the calving window so Bill McCloskey described the Agricultural exposition facility. there are more pounds weaned. The result is a Development Board’s projects for June under the Wise Meat Packing was approved 24 percent revenue increase when marketing the program. Mr. McCloskey highlighted programs for up to $50,248 in multiple county calves. including the County Agricultural Investment funds to purchase equipment. The Certified Pre-Conditioned for Health Program (CAIP), Deceased Farm Animal Western Kentucky State Fair was program provides marketing opportunities for Removal, Next Generation Farmer, Youth approved for up to $60,975 in multiple calf farmers and adds value to the calves through Agriculture Incentives Program, and the On- county funds to upgrade the fairground pre-conditioning and weaning for 45 days. Farm Energy Program. facilities. The KBN operates the Eden Shale Farm in The requested program amendments Kentucky State Fair Board was partnership with the University of Kentucky, discussed included: approved for up to $1,500,000 in state and it has been used as a learning center and Owen County Farm Bureau funds to reconstruct the Freedom Hall demonstration farm since 2012. requested an additional $325,000 in make-up ring and to conduct a traffic Beef Solutions is a program to process local Owen County funds for CAIP. The board engineering study. beef for distribution through Kroger. Over 900 recommended approval, which would McLean County 4-H Council was cattle have been processed, and 426,220 pounds bring the program total to $330,500. approved for up to $7,680 in McLean have been packaged since 2018. Graves County Agricultural County funds to purchase small animal In response to a question from Development Fund requested holding pens. Representative Schamore, Ms. Thompson stated an additional $63,520 in Graves Bluegrass Organic Hemp was there is an enrollment process for farmers to County funds for CAIP. The board denied due to the board’s policy on purchase cattle. There is currently a six month recommended approval, which would hemp. waiting period. bring the program total to $113,883. Kentucky Cattlemen’s Association In response to a question from Simpson County Conservation Dave Maples testified about the Kentucky Representative Dossett, Ms. Thompson stated THE KENTUCKY GENERAL ASSEMBLY 49 the challenges to build larger facilities for cattle provide the panel with enough time to review all screened out. DCBS’ position is that more calls are land availability and the topography in cases from the previous fiscal year. should be screened out, which it argues would Kentucky. Mr. Maples stated a network of small Under its governing statute, the panel is be workable with a proposed full differential barns would have the same effect. required to destroy copies of case files and has response system that would enable DCBS to There being no further business, the meeting been regularly destroying paper copies. Case files provide different services based on the assessed was adjourned. stored in the electronic information system are level of risk. nearing the end of the 5-year retention period. Substance abuse is another frequent PROGRAM REVIEW AND Recommendation 2 is that the panel should subject of the panel’s recommendations. INVESTIGATIONS COMMITTEE establish a policy for the destruction of electronic Examples are recommendations related to Minutes documents. neonatal abstinence syndrome and medication July 12, 2019 Ms. Ortkiese said the panel is concerned assisted treatment. The panel’s most frequent Call to Order and Roll Call that it is not reviewing all child fatalities and recommendation pertaining to substance abuse The Program Review and Investigations near fatalities that occur within the state. The is full implementation of family drug courts Committee met on Friday, July 12, 2019, at panel receives its cases primarily from DCBS. throughout the state. Kentucky previously had 10:00 AM, in Room 131 of the Capitol Annex. The Department for Public Health also forwards family drug courts, but funding for the program Representative Rob Rothenburger, Chair, called cases to the panel, including from its local ended in 2008. Jefferson County has made efforts the meeting to order, and the secretary called the child fatality review teams that are under the to reinstate its family drug court and in 2018 roll. jurisdiction of coroners. Not all localities have opened the Jefferson Family Recovery Center Present were: review teams, many existing teams may not have with funding from a nonprofit. Members: Senator Danny Carroll, Co-Chair; a quality review process, and some are new. The The panel’s recommendations have Representative Rob Rothenburger, Co-Chair; department is working to assist local teams on frequently centered on using medical providers Senators Tom Buford, Perry B. Clark, Reginald the review process. to educate parents on safe sleep practices and Thomas, Stephen West, Whitney Westerfield, Nationally, child fatality review cases are abusive head trauma. The Kentucky Hospital and Phillip Wheeler; Representatives Lynn underreported. States have differing statutes for Association and Prevent Child Abuse Kentucky Bechler, Chris Fugate, Al Gentry, Ruth Ann reporting cases and information to state review recently developed a video on safe sleep and Palumbo, and Walker Thomas. panels. Depending on the state and the agency, abusive head trauma that is being distributed to Guests: Judge Roger Crittenden, Chair, agencies may be mandated to report to the birthing centers in the state. Child Fatality and Near Fatality External Review panel or may be allowed to provide information Ms. Ortkiese said the panel twice Panel. Elisha Mahoney, Executive Staff Advisor, to panel if requested. The Kentucky panel has recommended open court proceedings for Justice and Public Safety Cabinet. Elizabeth expressed concern about the number of Sudden dependency, neglect, and abuse proceedings. Caywood, Deputy Commissioner; Lesa Dennis, Unexplained Death of Infants (SUDI) cases that In 2016, the General Assembly authorized an Chief of Staff; Christa Bell, Director, Division have not been referred to the panel for its review. open court pilot project, which began in 2018. of Protection and Permanency; Melanie Taylor, Ms. Ortkiese summarized two statistics for The Administrative Office of Courts issued a Assistant Director, Division of Protection and Kentucky and other states for the period 2008 to 3-month status report that identified positives Permanency; Laura Begin, Staff Assistant; 2017. In Kentucky, there were 2.10 fatalities per and negatives of the pilot and recommended Department for Community Based Services. 100,000 children, nearly identical to the national further study. LRC Staff: Greg Hager, Committee Staff rate of 2.21. In Kentucky, 0.13 percent of reports The panel’s recommendations on law Administrator; Chris Hall; Van Knowles; Jean of child abuse involved a fatality, which was enforcement relate to processing of child death Ann Myatt; Sarah Ortkiese; Jeremy Skinner; lower than the national rate of 0.23 percent. She scenes and drug testing of caregivers. The panel William Spears; Shane Stevens; Susannah Stitzer; showed comparisons of key characteristics of the wants law enforcement to treat every child Joel Thomas; Tanner Rife, Graduate Fellow; and Kentucky panel to panels in five selected states. fatality or near fatality under the premise that the Christy Young, Committee Assistant. Ms. Stitzer summarized the child may have been a victim of neglect or abuse. Minutes for June 7, 2019 recommendations the panel made from 2014 to The Department for Criminal Justice Training Upon motion by Representative Fugate and 2018 in seven categories: DCBS, substance abuse, has provided child death scene training for law second by Representative Thomas, minutes for courts, medical providers, law enforcement, enforcement and has requests for additional the June 7, 2019 meeting were approved by voice coroners, and general. The panel has made training. vote without objection. several recommendations regarding DCBS, most The panel’s recommendations involving Staff Report:Kentucky Child Fatality And related to increased funding for the department coroners relate to their role in child death Near Fatality External Review Panel, 2018 or the department’s protocols and internal review investigations. According to the panel, coroners’ Update processes. DCBS is implementing significant involvement varies by county. Child death Ms. Stitzer said the panel is compliant changes initiated by state and federal legislation notifications have increased, which the panel with statutory requirements except that its and its new model for internal review of errors, partly attributes to the use of pocket cards that are annual report was not published on December the Culture of Safety. Eventually, Program Review on scene guides. Use of the Sudden Unexplained 1, 2018. As the deadline approached, a number staff and the panel will be better able to determine Infant Death Form has increased, but often is of cases for review had yet to be received from how the changes relate to recommendations incomplete according to the panel. the Department for Community Based Services of the panel. The panel recommended DCBS General recommendations relate to (DCBS). The panel decided to delay the annual review its protocols for screening out cases. The the education and awareness of child abuse report until February 1, 2019. Recommendation panel reviewed 27 cases from FY 2017 that were and neglect. The General Assembly has 1 of the Program Review report is that the initially screened out by DCBS. The number of enacted three statutes dealing with the panel’s General Assembly may wish to change the due screened out cases has increased significantly; recommendations. The statutes cover education, date of the panel’s annual report to February 1 to nearly one half of referrals to DCBS in 2017 were training, and background check requests by

50 2019 Interim LEGISLATIVE RECORD parents on their children’s caregivers. report and it is not always clear to whom a panel’s for open courts is because it gives the public Ms. Ortkiese said that the panel’s recommendation should be addressed. greater confidence in the judicial system. recommendations are in its annual reports. It is Judge Crittenden reiterated that the In response to a question from Senator not always apparent whether a recommendation Department for Public Health suspected abuse Thomas about the common themes in near is being made and the wording of some or neglect in only the 10 SUDI cases that were fatality cases, Judge Crittenden cited substance recommendations is unclear. Recommendation referred to the panel. The panel has reviewed abuse, especially opioids, as the most common 3 of the Program Review report is that more than 600 cases in its history. Near fatalities theme. It is often a factor in head trauma caused recommendations in the panel’s annual reports are severe injuries, in some cases life altering, such by caregivers and neglect of care. He also cited should be easily identifiable and clearly stated. as a brain injury. The panel disagrees with DCBS family violence and young parents as themes. Representative Palumbo asked how SIDS about screening out. Cases in which children are Senator Carroll, commenting on the delay [Sudden Infant Death Syndrome] cases are under 4, the referral is from a professional, or in records getting to the panel, said that integrity related to SUDI cases. Ms. Ortkiese said that there have been previous referrals for the child of the criminal investigation is paramount, so SIDS cases are included in SUDI cases. should not be screened out. it must be thorough. He said the intake process In response to Representative Palumbo’s Representative Rothenburger asked about used to be local and is now done via regional call question about why only 10 of 88 SUDI cases the typical scenario of when there is a call to centers. He has not always been pleased with the were reviewed by the panel, Ms. Ortkiese said emergency medical services for a child that response when he has made a report. that only 10 were referred to the panel. DCBS appears to involve abuse. Judge Crittenden Judge Crittenden said that DCBS could and panel officials could possibly explain further. said that once the child is at the hospital, respond to the call center issue. A law enforcement staff should make a report to DCBS and law representative is on the panel. The panel In response to Representative Palumbo’s enforcement immediately. There should be a may receive the report while criminal justice request for clarification of the 27 panel cases that joint investigation. If abuse is found, DCBS proceedings are taking place. The relationship were screened out, Ms. Stitzer said that DCBS should take action to determine whether the between the cabinet and law enforcement is uses specified criteria to determine whether child should be removed from or returned to the good. further investigation of a referral is warranted. If home. After the investigation, the DCBS report In response to Senator Carroll’s question, the determination is no, the referral is screened is uploaded to the panel for its review. Ms. Dennis said that calls go to a centralized out. DCBS does not investigate further but keeps In response to a question from Representative regional system. There is no plan to return to a record of the referral. Rothenburger, Judge Crittenden said that the local intake. Calls are managed within the central In response to a question from Senator panel reviews cases from the previous fiscal office for consistency. Central office staff in Wheeler about national underreporting of child year. Contract analysts review case materials and Frankfort review a sample of screened-out calls. fatalities, Ms. Ortkiese said that staff did not have prepare summaries. Panel members also have There is a plan to record calls to better assess the access to data to indicate what the percentage access to original case materials. intake process. The system will allow supervisors would be for Kentucky. Representative Rothenburger asked, given to join intake calls when needed. the delay in reviewing cases, about the mission of In response to Senator Carroll’s questions, Representative Bechler said that he is the panel. Judge Crittenden said that the purpose Ms. Dennis said that there is a set process for skeptical of estimates such as this that are widely of the panel is to make recommendations related taking a call. Intake decision criteria are in accepted. He asked whether KRS 199.466 or any to system breakdowns to prevent future fatalities statute, regulation, and standards of practice and other statute requires that a background check and near fatalities. should be applied consistently across regions. on an individual caring for a child be completed In response to a question from Intake workers are trained to identify families after a parent or guardian requests it. Ms. Stitzer Representative Palumbo, Judge Crittenden said who could use additional services and to refer responded yes; the cabinet provides the results that the 27 fatality and near fatality cases that the them to community resources to prevent future of the check to the individual who requested it. panel reviewed in FY 2017 that were screened out problems. Ms. Caywood described this as a Judge Crittenden introduced Ms. Mahoney should not have been. Representative Palumbo differential response system. Ms. Bell said that and gave a response to the Program Review staff suggested that the committee look further into the preference is to have experienced intake report. Regarding its Recommendation 1, he said screening out. workers, but this is not always possible. The call that as of November 2018, the panel still had 60 In response to a question from Senator centers are adopting a safety model. cases from FY 2017 to review. The designated Wheeler about the delay in getting cases, Judge In response to Senator Carroll’s question as recipients of the panel’s annual report were Crittenden said that he cannot say why it takes to whether DCBS is comfortable with regional notified that it would be published on February 10 months to do an investigation. Sometimes a call centers as the best approach, Ms. Bell 1, 2019. The panel will not provide an incomplete criminal case is ongoing. The delay in uploading said that the regional approach is better for report even if the due date is not changed in cases to the panel’s file sharing system is because consistency across the state and allows for more statute. of a lack of staff. central guidance and the use of more experienced Regarding Recommendation 2, the panel In response to questions from Senator West, staff. There is a need for a better balance with has now established a policy for destruction Judge Crittenden said that reports are retained identifying community resources. of electronic documents. The Commonwealth 5 years, which is a requirement in statute or Senator Clark made a motion to adopt the of Technology will delete documents with regulation. Paper materials are destroyed soon staff report; Representative Palumbo seconded. identifying information. The panel will maintain the after the panel meeting at which they are The report Kentucky Child Fatality And Near general data. reviewed. The panel’s reports are not used in Fatality External Review Panel, 2018 Update was Regarding Recommendation 3, he said criminal justice proceedings and the panel is adopted by roll call vote. that he understands the concern with how not subject to open records requirements. The Update: Implementation of HB 1, recommendations are presented in the panel’s cabinet and law enforcement maintain their own Response to Recommendations in 2018 reports. There is time pressure to produce the records. One of the reasons the panel has asked Program Review Foster Care Report THE KENTUCKY GENERAL ASSEMBLY 51 Ms. Caywood summarized provisions of HB upload a case will get shorter with a new system the top five industry sectors, and 15 percent are 1, enacted in the 2018 regular session. As part of and a full staff of four in the fatality unit. Ms. connected to the top support occupations within the child welfare transformation process, there Taylor said that she hopes to reduce the time of the industries. were workgroups within DCBS as the legislation the process by 2 months. Frequent acronyms associated with CTE was being considered. The process incorporates Senator Carroll said that he is concerned include Area Technology Center (ATC), consideration of recommendations in the 2018 that the panel can review a case in an open Locally-Operated Center (CTC), and Local Program Review foster care report. The three meeting in which there is an ongoing criminal Area Vocational Education Center (LAVEC). main goals of child welfare transformation are investigation. Ms. Caywood said that this is the KDE governs 53 state-operated ATCs; CTCs to safely reduce the number of children entering way the statute sets up the panel. She said no are locally-operated and governed by a school foster care, improve timeliness to appropriate identifying information is presented at panel district; and each LAVEC, which is either permanency, and reduce caseloads. There have meetings. Senator Carroll said that someone a CTC or a part of a high school facility, is been 81 planning sessions as of May 1, 2019. might be able to figure out such information district-governed and receives supplemental Ms. Bell described implementation of HB anyway. state funding. Student enrollment for grades 9 1 by DCBS and trends in the number of foster Representative Rothenburger said that care through 12 at secondary CTE systems include 53 care homes and adoptions. She also covered should also be taken in regard to open meetings state-operated ATCs serving 22,392 students; 42 the status of two recommendations from the and privacy provisions of HIPAA [Health LAVECs serving 31,365 students; and 220 other Program Review foster care report. DCBS Insurance Portability and Accountability Act of CTE program locations serving 95,665 students. is addressing Recommendation. 1.4 that the 1996]. KDE provides annual renewable contractual department should use existing data to calculate The meeting was adjourned at 10:06 AM. partnerships for principals and teachers. a more accurate “percent of need met” figure in Some ATCs house additional teachers, special its recruitment report. Each region now develops KENTUCKY CAREER AND education staff, and counselors. a targeted diligent recruitment plan that reflects TECHNICAL EDUCATION TASK KDEs three central offices in the Division of its children in care. DCBS also considers how Technical Schools and Continuous Improvement FORCE many children have to be placed outside a Minutes of the 2nd Meeting provide leadership and support to all 53 state- region to meet a child’s needs. She said that of the 2019 Interim operated ATCs in the areas of budget and DCBS has implemented Recommendation 1.5 July 10, 2019 finance, procurement, supervision of principals, that the department should indicate disruptive, Call to Order and Roll Call professional learning, and technical assistance. neutral, and positive reasons for placement The 2nd meeting of the Kentucky Career Funding based on enrollments goes back to the changes in its reports. The data are used to and Technical Education Task Force was held on district in which the ATC resides and is used develop performance-based measures that are Wednesday, July 10, 2019, at 10:00 a.m. in Room for building maintenance, upgrades, and small included in agreements with private child-care 129 of the Capitol Annex. Representative Bobby equipment purchases. providers and child-placing agencies. A video on McCool, Chair, called the meeting to order, and The majority of counties have access to ATC recruitment of foster care parents was shown. Ms. the secretary called the roll. or CTC facilities into which multiple high schools Dennis summarized the implementation of the Present were: feed, based on geography and transportation for HB 1 provision related to reporting of caseloads. Members: Senator Mike Wilson, Co-Chair; students. She described the trend, mostly upward, in the Representative Bobby McCool, Co-Chair; In response to a question from Senator number of children in custody of the cabinet. Senators Jimmy Higdon and Johnny Ray Turner; Wilson relating to prior testimony from Ms. Begin said that HB 1 required the creation Representatives Kevin D. Bratcher, C. Ed Massey, Commissioner Lewis, Mr. Horseman said student of a study group of public and private child and Reginald Meeks; and Steven Thomas. transportation can be an issue due to the costs welfare leaders, stakeholders, and advocates to Guests: Sabrina Cummins, OEA. of busing students, gas, and drivers. Through make recommendations on performance-based LRC Staff: Jo Carole Ellis, Lauren Busch, funding in the recently created New Skills for contracting for licensed child-caring facilities Seth Dawson, Chuck Truesdell, and Christal Youth (NSFY) grant, the concept of regionalizing and child-placing agencies and the feasibility of White. classes allows students to receive academic privatizing all foster care services. The group’s Approval of Minutes from June 18, 2019 instruction at the technology facility, eliminating report on performance-based contracting, which On a motion by Senator Wilson and a the need for transportation. In response to a includes 20 recommendations, was submitted second by Representative Meeks, the minutes of follow-up question, Mr. Horseman said KDE, in November 2018. The group’s report on the June 18, 2019, meeting were adopted by voice in an advisory capacity, envisions combining privatization, which has four recommendations, vote. resources among districts, business, industry, was submitted in June 2019. and interested parties to enter into interlocal Ms. Caywood summarized the federal Family Kentucky Department of Education agreements and work together to provide access First Prevention Services Act of 2018. Kentucky David Horseman, Associate Commissioner, as funds becomes available. Senator Wilson will be one of the first states to implement its and Leslie Slaughter, Executive Advisor, Office requested written recommendations from KDE provisions. She concluded by saying that DCBS of Career and Technical Education and Student to enable the legislature to establish policy will focus on biological families in its priorities Transition (CTEST), Kentucky Department of regarding CTE. for the 2020 legislative session. Education (KDE), gave an overview on the state’s Senator Higdon said while business and In response to questions from Representative career and technical education system. industry are willing to be part of the solution for Bechler, Ms. Bell said that it has taken 4 to 5 Mr. Horseman said 67 percent of high technology centers to meet business and industry months to upload a case to the system used by school students are enrolled in at least one career demands, progress is slow due to funding and the the panel because of the old system involving and technical education (CTE) course in a career lack of local control. Mr. Horseman said state- regions sending photocopied documents to pathway. Eighty-five percent of program area operated centers are 100 percent funded by KDE, the central office for further work. The time to enrollments are connected to occupations within and the funding is proportionately divided based

52 2019 Interim LEGISLATIVE RECORD on program enrollment. On a follow-up question prioritized occupational and program areas comprehensive and intentional approach to the regarding the funding amount, Representative based on state and regional industry needs; and integration of academics and CTE. McCool said detailed financial aspects will be explore CTE performance funding. In response Representative McCool’s addressed in a future meeting. The vision for the NSFY grant is a question, Mr. Horseman said an accreditation In response to a question by Representative regionalized governance and delivery of CTEs approval process is necessary through the Meeks, Mr. Horseman said each special needs through accelerated career academies. The Southern Association of Colleges and Schools student in every building receives a specialized academies are employer-led through regional (SACS) for CTE programs offered through Individualized Education Plan (IEP) regardless workforce areas with cross-institutional colleges. of the absence of a special education teacher involvement and encompass career pathways Responding to Representative Bratcher’s in the building and regardless of the student’s with seamless transitions from secondary to question, Ms. Slaughter said most CTE classes specific needs. postsecondary education. They are aligned to are half-day programs where students spend Responding to a question by Senator the state’s and region’s most in-demand careers, the remainder of the day in another school, Higdon, Mr. Horseman said the majority of involve shared resources and funding among depending on proximity and geography. The funds for ATCs come from the General Fund all partners, and provide valuable industry grant is intended to convert a technology and SEEK money does not follow students to certifications and credentials recognized by center into a model that provides a true, all-day ATCs. business and industry. technical high school. For areas with greater In response to a question from Kentucky, selected as one of 25 states distances, the use of virtual technology and Representative Massey, Mr. Horseman said receiving a $100,000 planning grant, utilized skyping will help eliminate gaps relating to funding is best utilized through business and the funds to study labor market information, academic courses. Responding to a follow-up industry partnering with schools and districts. do needs assessment work, and identify question from Representative Bratcher, Mr. Combining resources will allow more students to priorities. Kentucky was also approved for Phase Horseman said ATC principals serve under follow a specific career pathway. Mr. Horseman 2 funding, a $2 million grant awarded over a KDE; however, the district is reimbursed if a said students attending ATCs and coming from three-year period. Kentucky has used the grant district employee works at an ATC. The expense private schools within the region may pay tuition to address issues identified in the two reports of and expertise required to operate machinery but details have not yet been finalized. by encouraging the development of a more and special equipment in technology centers is Ms. Slaughter has been instrumental in the regionalized approach, similar to the iLEAD not feasible or affordable in every high school. implementation of the NSFY grant, which is or Ignite Academies, by incentivizing school In response to Representative Bratcher’s considered the most transformational piece of districts to work together and share resources. question, Mr. Horseman expressed concern about work for CTE in the last three to five years. The As a result, three cohorts of regional the hazards associated with certain industries as critical first steps are creating greater efficiency, academies have been created. The idea is to it relates to students. Certified welding inspectors improving the delivery system, and expanding create accelerated, all-day academies that observe, approve, and recommend a student to access for more students. can address various CTE issues such as local companies. Other students have extensive Prior to 2012, the 53 state-operated ATCs transportation expenses and the need for wrap- training and gain transferrable skills that lead were governed and housed within the Education around support services. The academies work to careers with companies willing to provide and Workforce Development Cabinet before with local workforce investment boards and more in-depth training. Relating to a follow- being moved to KDE. The transition to having the state workforce investment board to create up question, Mr. Horseman said the benefit all CTE housed under KDE has created more employer-led processes so that the academies are of all-day academies allow academic teachers efficiency by streamlining practices and allowing designed to support the most in-demand state to work side-by-side with technical teachers; support of all 173 school districts and state- and regional occupations. allow students more classroom time, access, operated centers in a more cohesive, unified The grant is designed to tailor and personalize and opportunity; and eliminate time and money manner. Ms. Slaughter said the reorganization career pathways for students to ensure work- spent on transportation. Ms. Slaughter said the adds a more comprehensive approach for cross- based learning opportunities and to incentivize all-day model is designed to be a technical high institutional alignment and collaboration. districts who are ready and willing to dissolve school inclusive of all graduation requirements Ms. Slaughter mentioned the 2014 CTE district lines and build a regionalized approach and learning of concepts and standards in Study issued by the Southern Regional Education for the benefit of students more efficiently. The industry and practice. Students respond well to Board. The first recommendation from the grant has enabled partnerships to grow and the more contextual approach. report was to commission a more in-depth study evolve and has created interlocal agreements that Responding to a question from Senator of the CTE funding. share resources and commitments on sustaining Higdon, Ms. Slaughter said the academies The funding report, prepared by Thomas P. and moving forward. Partnerships with industry for Marion, Nelson, Larue, and Bardstown Miller & Associates and titled First Things First, A leaders and employers in each region help design Independent are in the early phases of the Funding of Analysis of Kentucky’s CTE Systems, pathways and identify skills, knowledge, and planning grant after forming a partnership included the following recommendations: base competencies students must have. This provides to build two all-day regional academies. The funding for CTE on state goals and business and the opportunity to pilot CTE innovation at a Launch Point Academies of Marion and industry needs; convene a committee to explore grassroots level and help solidify future structure Nelson Counties include some overlapping ways of funding CTCs and ATCs equally; and funding needs. and some different programs. The academies provide adequate funding for CTE programs to Most recently, a 2018 Executive Order will be implemented during the fall of 2019 accomplish state priorities; create a proactive, changed the Office of Career and Technical and each site has a three- to five-year timeline intentional process of funding large equipment Education to CTEST. The change moved student for implementation. In response to a follow-up purchases and maintaining and/or upgrading transition areas such as high school graduation question, Mr. Horseman said KDE’s priority is to current equipment; allow a locally-operated requirements, dual credit, and advanced provide opportunities and careers for students per-pupil funding formula weight tied to state- placement with CTE, which has enabled a more through a viable, statewide-unified system, THE KENTUCKY GENERAL ASSEMBLY 53 incentivize districts, share resources, and add ALZHEIMER’S AND DEMENTIA percent of nursing facility residents, 41.9 percent programs as funds become available. Senator WORKFORCE ASSESSMENT TASK of residential care community residents, and 30.9 Higdon said regional needs are best determined FORCE percent of adult day service center participants through local control of a specific area due to the Minutes of the 2nd Meeting received care for Alzheimer’s or dementia. In unique needs among regions. Mr. Horseman said of the 2019 Interim 2015, 44.5 percent of hospice patients and 32.3 provisions for interlocal agreements will ensure August 1, 2019 percent of home health agency patients received the remaining 120 school districts not served Call to Order and Roll Call care for Alzheimer’s or dementia. There has been by the 53 centers are included. He explained the The 2nd meeting of the Alzheimer’s and a dramatic increase in alternatives to nursing governance board will allow input from various Dementia Workforce Assessment Task Force was facility care in the residential care community businesses and industries of feeder districts and held on Thursday, August 1, 2019, at 10:00 AM, in setting due to the increasing costs of nursing through technical support and resources from Room 131 of the Capitol Annex. Representative facility care. Differing reimbursement structures KDE. He believes working together will garner Deanna Frazier, Chair, called the meeting to depending on the level of care, avoidance of a the best results. order, and the secretary called the roll. nursing facility label, effective marketing with a Senator Wilson said incentives, as outlined Present were: controlled message by residential care providers, in 2017 Senate Bill 1, are geared toward schools Members: Representative Deanna Frazier, a flexible market with no certificate of need, receiving more credit for accountability scores Co-Chair; Senators Stephen Meredith and significantly reduced regulatory burdens, the in high demand industries; however, it is Reginald Thomas; Representatives Danny Bentley perception of greater resident independence, and not a requirement. He said Bowling Green’s and Lisa Willner; Melissa Aguilar, Bill Cooper, a change in assisted living statutory definition in ATC placement of 100 percent of its students Sherry Culp, Steven Davis, Buddy Hoskinson, 2000, all contributed to the rise of the residential has been the result of business and industry Mackenzie Longoria, Andrea Renfrow, Mary care. There have been significant differences in buy-ins through the donation of machinery, Romelfanger, and Kelly Upchurch. the approach nationwide for assisted living and money, and supplies amounting to an excess Guests: Steven D. Davis, Inspector General, other residential care settings. Most states define of $500,000. He said while partnerships with Office of the Inspector General, Cabinet for assisted living as a health care model, rather than companies are important, access to multiple Health and Family Services; Sherry Culp, a social model. CTE credentials, programs, and certifications are State Long-Term Care Ombudsman, Nursing Effective on July 14, 2000, the Kentucky equally necessary. Senator Wilson is concerned Home Ombudsman Agency of the Bluegrass, legislature amended the assisted living law additional dual credit requirements, especially and Denise Wells, District Long-Term Care by replacing voluntary certification with for students with special needs, may create a Ombudsman, Nursing Home Ombudsman mandatory certification, developing additional burden on districts. Mr. Horseman said KDE Agency of the Bluegrass. standards, and moving away from a purely social wants to provide adequate information to ensure LRC Staff: Dana L. Simmons, Lead Staff, model to a quasi-medical model. The current legislators can make the best informed decisions and Becky Lancaster. law still prohibits delivery of health services; for students. Seven or eight options for graduation Approval of Minutes however, some assisted living facilities have requirements can be weighed to determine the A motion to approve the minutes of the July dedicated dementia units. Some facilities offer best course of action to take for being in a career 2, 2019 meeting was made by Senator Meredith, assistance with medication administration, or college pathway. Student personalization will seconded by Mary Romelfanger, and approved Activities of Daily Living (ADL), Instrumental benefit students in particular areas of study, and by voice vote. Activities of Daily Living (IADL), and provide modifications may be necessary in the future Evaluation of Current State of Long-Term nearly continuous supervision. Assisted living for the development of specific career pathways. Care Services facilities no longer have the appearance of a KDE desires to be realistic in terms of advancing Steven D. Davis, Inspector General, Office purely social model. The course of illness is students to be prepared for life’s next step. Senator of the Inspector General, Cabinet for Health and such that Alzheimer’s and dementia clients will Wilson said equal access to multiple programs is Family Services (CHFS), stated that there are eventually need supervision, ADL assistance, important for higher graduation rates. different areas in which long-term care (LTC) and other supports due to the decline in Representative McCool announced that the is provided to individuals with Alzheimer’s and cognition. Kentucky law does not fully embrace annual CTE summer program will be held July Dementia. LTC typically starts at home with the the provision of healthcare in an assisted living 23-26 in Louisville at the Galt House and invited assistance of family or an informal caregiver. facility; although, many states do. Some states all members to attend. The next level of LTC consists of a home health have moved past the purely private pay model The next meeting of the CTE Task Force will agency and private nursing services, including to include covered services but not room and be Wednesday, August 21, 2019, at 10 a.m. in provider types that do not provide skilled board. Kentucky is one of three states that do Room 129 of the Capitol Annex. nursing, which assist individuals in their homes not provide any Medicaid funding for residential There being no further business before the or other residential settings,. A residential care care. committee, the meeting was adjourned at 11:45 community will generally provide assistance Mr. Davis stated that Kentucky’s assisted a.m. with supervision and limited supports. The next living standards do not adequately address the level is a nursing facility or a skilled nursing need for residential care for individuals who facility that provides intermediate care such as require limited health care supports but do an Alzheimer’s focused nursing home. The final not need high intensity nursing care, have an level of LTC is a hospice provider. Medicare unstable medical condition, or require skilled covers all hospice costs except room and board. care. Kentucky should modernize its residential Kentucky Medicaid covers room, board, and community standards to enable individuals who other services. enter care with nearly full cognition to age in Mr. Davis stated that the National Center place in a setting that meets their non-skilled for Health Statistics confirmed that in 2016, 47.8 needs. The focus should be on the continuum

54 2019 Interim LEGISLATIVE RECORD of care and should enable a resident to avoid living under one tier and allowing patients to A patient must be referred out of the facility to discharge until clinically unstable or in need of stay in one place to create a better continuum have a medical service provided to the patient. high intensity nursing services. An option for of care on the lower level. The workforce issue It is the responsibility of the facility to advise change would be to combine current concepts in in a nursing facility differs from personal care all clients and family members when there is a personal care homes and assisted living to create and assisted living because there are not many limit of care for a patient. The only medical care a single congregate care model that is tiered and heavy care clients in those homes. The crisis that can be provided in assisted living is ADL, focused on the provider’s ability to manage care is with the workforce in the nursing facilities IADL, and assisting with medication. However, as the client ages in place. that have a multitude of complex care patients. staff cannot leave a patient that is in distress that Another option of care would be the With challenging standards and regulations, needs assistance or redirection. Under the law, extended congregate care model that could nurse aides do difficult work for low pay. CHFS the patient should be given a discharged notice. include a continued stay with exceptions to would like to create supports and infrastructures With Alzheimer’s and dementia, a client may admissions criteria. The newly-designed assisted outside of the nursing facility that will serve as temporarily fall out of cognition or lose a range living provider type would share similarities resources for the nurse aides. of motion but be able to come back. However, with the existing assisted living and personal In response to questions and comments from providers cannot provide assistance with that care home models but also include the provision Melissa Aguilar, Mr. Davis stated that capacity issue. of housing, meals, and one or more personal care is difficult to change at the nursing facility level Buddy Hoskinson, Quality Assurance services. Admission criteria would still require due to the certificate of need laws in place. It is and Accountability Director, Department for the resident to perform ADL with supervision difficult to move or create new bed capacity in Aging and Independent Living (DAIL), Cabinet if needed, be able to transfer with assistance if LTC. New facilities that cater to memory care are for Health and Family Services, provided the needed, be capable of taking medication unless being built in Kentucky. He stated that making committee with a fact sheet regarding the the facility employs a trained nurse, not be lower level care more appealing to providers direct care workforce initiative from the Iowa bedridden, not be a danger, and not have any would increase capacity. There are more services Department of Public Health. He stated that it special needs that cannot be met by the facility. that provide care, for example, adult day health would be beneficial for Kentucky to create and There would need to be statutory and regulatory programs, home health care, and private duty provide a similar fact sheet. adjustments to have these changes implemented. nursing services. However, there are laws that Sherry Culp, State Long-Term Care In response to questions and comments impact the ability of some providers. There is a Ombudsman, Nursing Home Ombudsman from Mary Romelfanger, Mr. Davis stated that critical issue with the workforce in the nursing Agency of the Bluegrass, stated that a LTC the Cabinet for Health and Family Services facilities. ombudsman is a resident advocate for quality of needs to boost telehealth programs. Telehealth is In response to questions and comments care and quality of life of residents in LTC. The a great opportunity to fill some of the gaps for from Senator Thomas, Mr. Davis stated that ombudsman provisions in the Older Americans care. There is an initiative for the Department for regulations for personal care homes do not Act (OAA) include investigating and resolving Public Health and other areas to revitalize and mention Alzheimer’s or dementia and do not complaints, providing information to residents, modernize the telehealth concept. Telehealth account for the condition of decline. Once a families, and staff, and advocating for systemic could help in the limited mental health model patient is in decline, a personal care home may changes to improve residents’ care and quality of to assist clients with mental health issues that not be the best place for that patient. Assisted life. In financial fiscal year (FFY) 2018, Kentucky’s reside in personal care homes. The clinical living, which is not the health care model, does ombudsmen investigated 6,025 complaints of and psychiatric care are so different that the recognize special units that could be used for which 27 percent were complaints about care. populations are not usually mixed unless there Alzheimer’s and dementia, or hospice clients. Complaints about staff represented 15 percent are no other resources. There are potential problems because when units of the complaints. Many facilities do not want In response to questions and comments are locked down by regulations. Patients do not to admit people that may become medicaid from Senator Meredith, Mr. Davis stated that have the ability to self-exit in case of emergency eligible because the patients are entering without Kentucky does need another level of care and when the patient is a danger to themselves. It a payment source. needs to more clearly define the scope of services becomes an unworkable solution for the patient. She stated that 50 percent of patients in that are offered in the other levels of care. Mr. If assisted living was more of a model with a LTC in Kentucky have Alzheimer’s or a memory Davis suggested reviewing the level of care below care continuum, it would be possible to create disorder. The Alzheimer’s Association states the nursing facility level. He stated that there is a facility that could focus solely on Alzheimer’s that nationwide 70 percent of people with an infrastructure in place but redefining and and dementia patients. In the admission Alzheimer’s or dementia have behaviors that tiering the levels of care could be reviewed before standards, there are protections built around are difficult to manage such as hitting, spitting, the next legislative session. The lower level assisted living that state a patient could not be wandering, and cursing. Denise Wells, District revision could be handled in a short amount a resident if they were bedridden unless it is a Long-Term Care Ombudsman, Nursing Home of time. Every level of care in LTC is exceeding temporary condition. Senator Meredith stated Ombudsman Agency of the Bluegrass, stated or needing to exceed the scope of care that is in that 14 days is a medical-necessity definition that ombudsmen have a responsibility to act as place. CHFS has been reviewing Florida’s model used for reimbursement. the residents’ voices. In 2018, care was the most of LTC for approximately a year and a half with In response to questions and comments widely cited complaint from residents. Failure to limited staff. CHFS may want to create new from Mackenzie Longoria, Mr. Davis stated respond to requests for assistance represented standards according to the Florida model. that in 2000, the authorization for units used eight percent of all complaints. The shortage of In response to questions and comments for Alzheimer’s and dementia patients were staff in a facility represented three percent of the from Representative Wilner, Mr. Davis stated layered into a social model and created an complaints. Residents expressed that the nurse that Florida is a good model to review that has a inconsistency. A facility can be an Alzheimer’s, aides did not have enough training to provide four tiered program. CHFS could start the effort and dementia unit, but staff are prohibited from adequate care. by putting personal care homes and assisted providing any medical services to that patient. Ms. Culp stated that PHI is a company that THE KENTUCKY GENERAL ASSEMBLY 55 works to ensure quality care for older adults other workers who work in LTC. Retirement Systems (KRS) began his comments and people with disabilities by creating quality In response to comments and questions by commending the legislature for the additional jobs for direct care workers. A 2018 PHI report from Representatives Frazier, Ms. Wells stated funding received and pointed out that KRS stated that one in four Americans will be age 65 that in Kentucky there is not a minimum staffing had received an additional $185 million in and older in 2060 and more than half will need law for LTC. Research has been done to suggest contributions during the recently completed long-term care at some point. The Alzheimer’s that residents need 4.1 hours of direct care per 2018 fiscal year. In addition, with the passage Association declares that state officials can day to avoid negative outcomes. The Centers for of HB 200 and an employer contribution rate help the Alzheimer’s crisis by increasing public Medicare & Medicaid Services (CMS) website of 83 percent for the Kentucky Employees awareness for early detection and diagnosis, lists the average number of hours of direct care Retirement System (KERS) nonhazardous plan, increasing access to home and community-based that each nursing home provides to patients daily the plan anticipates a positive cash flow of $300 services, building a dementia-capable workforce, and in Kentucky the average is approximately 3.9 million without considering investment returns. and enhancing the quality of care in residential hours per day. However, Mr. Eager noted the significant settings. Direct care workers assist older adults In response to comments and questions increase in rates did come with some negative and people with disabilities with daily tasks, from Melissa Aguilar, Ms. Culp stated that impact, most notably relating to quasi-state such as dressing, bathing, and eating. Direct she does not work with programs that certify (quasi) agencies that could not afford to either care workers include personal care aides, home individuals to work specifically with patients remain or exit the plan. He indicated KRS health aides, and nursing assistants. Nursing that have Alzheimer’s and dementia. staff had investigated many options and were assistants also perform clinical tasks, such as Adjournment proposing three to the Public Pension Oversight blood pressure readings and assistance with There being no further business, the meeting Board (PPOB) for consideration. range-of-motion exercises. She stated that nurse was adjourned at 12:00 PM. With regards to employer participation, Mr. aides have some of the highest rates of injuries Eager provided some background and reviewed on the job. previous legislative enactments relating to the Ms. Culp stated that it does not matter what matter. He noted that HB 62, which was passed laws and regulations are in place, if the care is PUBLIC PENSION OVERSIGHT in 2015, initially created the process by which from a for-profit or a not-for-profit organization, BOARD certain agencies could cease participation and if the amount of money being paid is from an Minutes leave KRS. The process according to HB 62, individual or paid by Medicaid, the experience December 17, 2018 which could take up to 18 months, started with of the older adult patient is determined by his Call to Order and Roll Call an application, a cash deposit to cover needed or her interactions with the direct care worker. The 9th meeting of the Public Pension actuarial analysis, and initial approval by the Nursing home residents throughout the country Oversight Board was held on Monday, December KRS board. Next, an actuarial valuation was explained that the most important elements 17, 2018, at 1:00 PM, in Room 154 of the Capitol conducted using the assumed rate of return, a of quality in their day-to-day lives were the Annex. Senator Joe Bowen, Chair, called the cost was determined, the agency made a decision accessibility, attitude, and training of the direct meeting to order, and the secretary called the to leave or stay, and the agency could pay the cost care worker. The direct care workforce totaled 4.3 roll. as a lump sum or in installments over a 20-year million workers in 2017. The home care worker Present were: period. In 2017, HB 351 adjusted the process is among the fastest growing occupations and Members: Senator Joe Bowen, Co-Chair; by establishing a benchmark for the actuarially have added one million jobs between 2016 and Representative Jerry T. Miller, Co-Chair; Senators assumed interest rate used to calculate the 2017, more than any other single occupation. Jimmy Higdon, Christian McDaniel, Gerald cost estimate and by removing the installment However, wages for home care workers have A. Neal, Dennis Parrett, and Wil Schroder; payment option for agencies. In 2018, HB 362 remained stagnant in the last decade. One in four Representatives Ken Fleming, DJ Johnson, James froze the contribution rate for quasi agency direct care workers is an immigrant, totaling one Kay, , and Russell Webber; J. employers in KERS nonhazardous at 49.47 million workers nationwide. Immigrants are a Michael Brown, John Chilton, Timothy Fyffe, percent for FY 2019 (versus 83.43 percent for valuable part of the direct care workforce. Men Mike Harmon, James M. “Mac” Jefferson, and every other employers) and also created a phase- make up roughly half of the United States labor Sharon Mattingly. in period for employers of the County Employees force yet only 14 percent work in LTC. Other Legislators Attending: Representatives Retirement System (CERS) plan. Mr. Eager also Direct care workers are a key segment Derrick Graham and Jim DuPlessis. discussed a 2018 legislative proposal that did of the eldercare workforce and would benefit Guests: David Eager, Executive Director, not become law that would have offered quasi from improved geriatrics training. In May, and Katherine Rupinen, General Counsel, agencies a 40-year interest-free installment plan the Geriatrics Workforce Improvement Act Division of Advocacy, Kentucky Retirement for paying the costs to cease participation. was introduced in the United States Senate, Systems; and Danny White, Gabriel, Roeder, Mr. Eager discussed the first of three key paving the way for strengthening the health Smith & Company. aspects to the KERS nonhazardous funding care sector’s ability to support older Americans. LRC Staff: Jennifer Black Hans, Bo Cracraft, problem. First, he noted that contributions The United States House of Representatives and Angela Rhodes. are based on a percent of payroll calculation, passed the Educating Medical Professionals and Approval of Minutes which has led agencies to outsource, not replace Optimizing Workforce Efficiency and Readiness Representative Fleming moved that the departing employees, and have retirements that (EMPOWER) Act which would continue funding minutes of the November 26, 2018 meeting be exceed new hires. As payroll has declined, so for geriatric workforce enhancement programs approved. Representative Johnson seconded the have contributions received, which then leads that are based in home and community-based motion, and the minutes were approved without to a higher contribution rate and more incentive settings and nursing homes. There should be objection. for employers to look for ways around paying more employment support, peer to peer support, Agency Participation Issues the increasing contribution rate. Danny White, and effective supervision for nurse aides and David Eager, Executive Director, Kentucky Gabriel, Roeder, Smith & Company, the KRS

56 2019 Interim LEGISLATIVE RECORD consulting actuary, reviewed recommended and Mr. Eager continued the discussion by In response to a question from Representative actual budgeted contribution rates from 1993 defining and providing a list of the 118 quasi- Fleming regarding an analysis or assessment of through 2019 for the plan, noting that, during governmental entities participating in KERS. He value, Mr. Eager indicated that KRS was not in this period of rising rates, the active member noted they are not defined by statute, but generally, a position to assess the value or impact of the populations had declined significantly. Mr. represent services created by government, tend underlying quasi agencies. White indicated that, in a situation like this, to maintain separate legal status, and often are In response to questions from Mr. Harmon, where rates are climbing, but covered payroll is governed by board members who are appointed Mr. White indicated that, for administrative declining, using a percent of payroll mechanism by government officials. He stated that depending purposes, the fixed contribution rate would apply to collect contributions is not adequate. Mr. on how these entities are defined, there could be to each agency. Effectively, that fixed rate would White recommended the legislature enact a up to 600 quasi agencies in KERS and CERS, then be used to calculate a dollar amount due. A fixed-dollar allocation and stated that a similar including health departments, mental health portion of the dollar amount invoiced would be provision had been included in SB 151. units, universities, housing authorities, advocacy used to pay the normal cost for active employees, Second, Mr. White stated that another key centers, and other agencies. while the remainder would be applied to the to the KERS nonhazardous funding problem Mr. Eager and Mr. White offered three employers outstanding UAL. was the fact that a majority of the unfunded recommended options for addressing the Mr. White noted that option 2 would actuarial liability (UAL) covered retiree benefit participation issues facing the quasi employers. represent a policy decision for the quasi agencies payments. He reviewed the unfunded liability Mr. Eager indicated that staff had considered to pay less, thus a disadvantage is that additional of both the total KERS nonhazardous fund all options and tried to be creative, but in the funding would be required. Using the current and the smaller group of quasi agencies, where end, the recommended options were fairly rate of 49 percent that quasi agencies are paying, retiree benefits accounted for 69 percent and 59 straightforward. the total shortfall is approximately $132 million, percent of the UAL, respectively. He stated that Option 1 would require quasi-governmental which could be made up through future budgets the smaller group of quasi agencies accounted agencies to resume paying the actuarially or higher contribution rates for the remaining for approximately 20 percent of the total KERS determined contribution rate (currently 83.43 employers. Mr. White referenced a slide which nonhazardous UAL. Mr. White and Mr. Eager percent) after the one year reprieve given in FY provided detail to the estimate of $132 million in both emphasized this was related to current 2019. The advantage of this option would be contributions. retiree payments, which presents a dilemma the that all employers are paying the same rate, but In response to questions from Senator state cannot legislate its way out of. Mr. White disadvantages include potential bankruptcies McDaniel, Mr. White stated that other agencies reviewed a chart of active versus retired members and the state losing services provided by quasi or the general fund would have to make up the dating back to 2010, which showed the declining agencies. Mr. White stated that this option would difference if quasi agencies continue to pay just active membership base referenced earlier in the likely result in less total contributions received 49 percent converted to a fixed dollar payment. meeting. compared to having all the quasi agencies paying Option 3 would keep the contribution rate Third, Mr. White stated the KERS funding 49.47 percent, given the likelihood of bankruptcy for quasi-government agencies at a reduced rate problem is putting pressure on quasi agencies that or cessation. (currently 49.47 in FY 2019), but also require a cannot afford to pay the higher contribution rates Option 2 would keep the contribution rate “soft freeze” of benefits. Mr. White commented and are being faced with the option of bankruptcy. for quasi-government agencies at a separate, that this option would be subject to future Mr. White noted two major problems that are lower rate (currently 49.47 in FY 2019), while litigation, and there could be workforce and caused by bankruptcy. First, contributions paid also converting the contribution required for financial implications as well. He noted that by the employer and employees of the agency amortizing the unfunded liability to a fixed dollar some might argue this option represents a shared are lost. Secondly, the unfunded liability that is payment rather than a percent of payroll. Many solution, which asks Tier 1 and 2 members to associated with the agency must be covered by agencies have indicated this option would allow sacrifice some benefits, but it is still a better the remaining employers, which then further them to continue operating, while converting option for members than having their employer drives up future contribution rates. Mr. White the amortization to a fixed dollar would remove filling bankruptcy or ceasing to participate. provided an example of Seven County Services the risk associated with a declining payroll. In response to questions from Mr. Harmon, as an employer that exited the plan through In response to a question from Senator Mr. White stated Tier 1 and 2 members would bankruptcy. Bowen, Mr. White stated that once a policy not lose any current benefits accrued under this Mr. Eager focused the discussion on quasi- was established, and a lower contribution rate option, but would then be transitioned to Tier state agencies and the dilemma they are facing. determined, the rate established would be used 3 for future service. He noted this could trigger Many quasi agencies had told KRS they could to calculate the dollar amount owed by each one of the potential disadvantages, where Tier not afford the 83.43 percent contribution rates, quasi agency. The employers would be invoiced 1 employees decide to just go ahead and retire. but also could not afford cessation as outlined by for dollar contributions rather than as a percent If employers decided to not replace retiring HB 351. Mr. Eager stated that the state wants the of their payroll. members, not only would less contributions be services of these quasi agencies to continue, and In response to a question from Representative received, but there could be workforce issues. most agencies would like to remain in KRS. Miller regarding amortization periods, Mr. Mr. Eager reviewed two recommendations White stated that option 2 did not include any that had been approved by the KRS Board of In response to a question from Senator change to the length of the amortization period. Trustees. First, the board recommended that Bowen regarding new agencies joining KERS, However, some of those decisions would be current provisions of HB 62 and HB 351 not Ms. Rupinen, General Counsel, Division of determined by policy. A policy of charging a be altered. Secondly, the board recommended Advocacy, KRS stated she is not aware of any fixed rate would make the amortization period adopting the option 2 approach to addressing the moratorium restricting new agency participation, irrelevant as employers would pay that same rate, quasi agency participation issue. He stated that but very few are seeking to join given the cost of expressed in total dollars, until the fund is 100 none of the options were optimal, but option 2 contribution rates. percent funded. results in the least amount of risk of bankruptcy THE KENTUCKY GENERAL ASSEMBLY 57 and payroll decline. willing to pay benefit contributions on contract is Monday, January 28, 2019. Senator Bowen recognized and welcomed workers that are not receiving the benefits, Mr. Representative Jim DuPlessis, who will serve as White stated that a partial amount could be PUBLIC PENSION OVERSIGHT the new Co-Chair of the PPOB in 2019. collected for the unfunded liability. BOARD In response to a question from Representative Recommendations Minutes DuPlessis with regards to requiring employers to Senator Bowen reviewed the 2018 PPOB June 24, 2019 pay contributions on outsourced workers, Mrs. recommendations. The recommendations Call to Order and Roll Call Rupinen indicated that the option had been included: The 5th meeting of the Public Pension discussed in years past, and she believed that PPOB staff should research and present Oversight Board was held on Monday, June 24, KRS would not be opposed to it. information to the board regarding the level of 2019, at 1:00 PM, in Room 154 of the Capitol Mr. White added that KRS does not compensation paid to retirement system board Annex. Representative Jim DuPlessis, Chair, currently know how many agencies are using members in Kentucky and nationwide. called the meeting to order, and the secretary contract employees. He indicated that requiring The PPOB should study issues regarding called the roll. contributions for contract employees could be an mandates for system asset managers to abide by Present were: option if payroll could be identified to make sure the CFA Code of Conduct and whether the SEC Members: Representative Jim DuPlessis, those employers were faithfully making those Code of Ethics should be used as an alternative Co-Chair; Senators Christian McDaniel, Dennis contributions. Mr. White also added that it was mandate. Parrett, and Wil Schroder; Representatives Joe his understanding that, in some cases, employers Legislation should be enacted, similar to Graviss, Jerry T. Miller, Phillip Pratt, Russell are reducing head count through other sources, provisions included in BR 11 that has been Webber, and Buddy Wheatley; John Chilton, such as technology, and not utilizing contract prefilled for the 2019 Regular Session, to allow Timothy Fyffe, Mike Harmon, and James M. employees. Mr. Eager added that KRS would KRS to conduct electronic trustee elections, “Mac” Jefferson. like to do a follow-up with a more thorough to synchronize CERS trustee elections to Guests: David Eager, Executive Director, and examination. save administrative costs, and to make other David Harris, Chairman, Investment Committee, In response to a question from housekeeping changes recommended by KRS. Kentucky Retirement Systems Board of Trustees, Representative DuPlessis regarding how option Legislation should be enacted, similar to Danny White, GRS Retirement Consulting; 2 would work for an employer looking to the provisions included in BR 202 that has been Beau Barnes, Deputy Executive Secretary and add employees, Mr. White explained that the prefilled for the 2019 Regular Session, to void the General Counsel, Teachers’ Retirement System; normal cost component would act as a variable retirement of an elected official who following and Donna Early, Executive Director, Kentucky rate and would be paid for each employee. The retirement returns to the same office within 12 Judicial Form Retirement System and AC dollar amount that would serve to pay down the months. Donahue, Trustee for Judicial Form Retirement unfunded liability would then be shared across Legislation should be enacted to convert the System; Bryan Sunderland, Deputy Chief of Staff all employees. So, employers who wanted to add funding formula of the KRS systems so that each and Legislative Director, Office of the Governor employees would not have to pay the full rate on agency pays a set dollar amount. and John Chilton, State Budget Director. every new employee, just the normal cost for that The General Assembly should consider LRC Staff: Brad Gross, Jennifer Black Hans, additional employee. auto-enrolling future public employees into Bo Cracraft, and Angela Rhodes. In response to questions from Mr. Chilton, Kentucky Deferred Compensation with a 1 Approval of Minutes Mr. White agreed that options 1 and 2 would percent employee contribution. Senator Parrett moved that the minutes impact employer funding, while option 3 did The General Assembly should enact of the May 20, 2019 meeting be approved. consider a change in benefits for active Tier 1 legislation to address funding/participation Representative Miller seconded the motion, and and 2 members moving into Tier 3 on a going concerns of quasi-governmental employers. the minutes were approved without objection. forward basis. In response to follow up questions Representative Johnson moved that Investment and Cash Flow Quarterly regarding how option 2 might work for other the 2018 Recommendations be approved. Update – Kentucky Retirement Systems plans, such as CERS and the Teachers’ Retirement Representative Miller seconded the motion, and David Eager, Kentucky Retirement Systems System, Mr. White noted that the CERS plan was the recommendations were approved without (KRS) providing a summary of investment not funded with general fund appropriations objection. J. Michael Brown abstained. performance, as of March 31, 2019, for each of and creating a situation where some employers Representative Simpson moved that the the pension and insurance plans across the fiscal paid less than others could create some real draft PPOB 2018 Annual Report be approved year to date, 3-, 5-, 10-, and 20-year time frames. inequality, since the difference would have to be subject to the addition of the recommendations Mr. Eager pointed out that most of the plans had paid by the rest of the employers. So, in the case just approved and any technical edits needed. performed near their respective benchmarks of CERS, it is more paramount that the rate be Representative Johnson seconded the motion, and that staff expected the fiscal year returns the same across all employers. and the draft PPOB 2018 Annual Report was to be approximately 5.5 percent depending on Representative Kay made a comment approved without objection. the specific plan. He cautioned that KRS may regarding Representative DuPlessis’ earlier Senator Bowen recognized with resolutions experience a more difficult period going forward, question about outsourcing, and noted that he the legislators leaving PPOB. Those mentioned as the Federal Reserve (Fed) is expected to ease had previously filed a bill addressing the matter were Representative Fleming, Representative Kay, rates, which benefit equity markets and hurt and does believe there are a lot of state jobs and Representative Simpson. Senator Higdon fixed income assets. Given KRS has less equity that are being contracted in order to avoid the recognized Senator Bowen with a resolution and more fixed income than most peers, it could pension costs, which is not helping the unfunded along with comments from Representative prove to be difficult period for plans. problem. Miller. Mr. Eager discussed cash flow for the In response to a question from Senator With no further business, the meeting was first nine months of FY19 as compared to the Bowen regarding how many employers would be adjourned. The next regularly scheduled meeting same time period in FY18. He began with the

58 2019 Interim LEGISLATIVE RECORD Kentucky Employees Retirement System (KERS) approaches. assumptions, Mr. White stated that contribution nonhazardous pension plan. He pointed out In response to questions from Senator rates were estimated to increase about 4 percent that a lower total of member contributions was McDaniel with regards to adjusting the assumed due to the changes. In response to a follow-up due to a continued decline in payroll, while the rate of return in light of recent increased question regarding how KRS retirees were living significant increase in employer contributions contributions and future expectations in the longer than the average citizen, Mr. White stated was the result of the new and higher rates. equity markets, Mr. Harris responded that that demographics and characteristics of KRS Overall, he noted that KERS was experiencing there is a temptation to use the current scenario members likely drove that experience, pointing a positive net cash flow for the first time in 15- and market expectations to revise return out education, lifestyle, and life choices as 16 years. For the County Employees Retirement assumptions, but this would be a challenge given examples. System (CERS) nonhazardous plan, cash flow the funding ratios of KERS and a need for more Representative DuPlessis commented was very similar to the prior year and assets were risky assets to reach a higher assumption. He that looking at average life expectancy is a bit effectively flat. He noted payroll had declined noted that the increase in employer contributions misleading due to the fact that national averages slightly and stated employer contributions were was making a significant impact, but indicated include younger populations as compared to increasing as the higher rates are being phased- that trend would have to continue for a few more a KRS population of retirees. He noted that in over the next couple of years. Moving to years before the board would feel comfortable actuaries have found that if someone lives past insurance, Mr. Eager stated that net cash flow adjusting assumptions. In a follow up question the age of 45 or so, the life expectancy is going had improved, however, lower investment gains from Senator McDaniel regarding the recent to be higher than the overall 79-81 average. had impacted the change in assets for a few plans. changes to the mortality assumptions, Mr. White Mr. White stated that GRS looks at the retiree responded that GRS had recommended an population starting at age 65. In response to questions from Representative updated mortality assumption that was based In response to a question from Representative Miller regarding what the plans expected funding specifically on actual KRS retiree experience, DuPlessis regarding how actual experience ratio might be for the upcoming June 30, 2019 which also included an improvement scale into might impact next year’s contribution rates, Mr. actuarial valuations, Mr. White responded that the future. Eager stated that KRS expects returns to be very he expected the KERS nonhazardous fund to In response to a question from Representative close to assumptions, maybe slightly less for remain near its current 13 percent funded status. Miller regarding how to determine and pay the the plans with a 6.25 percent assumption, but He noted that recent assumption changes would unfunded liability portion of the plan, Mr. Eager that contribution rates should not be impacted likely increase the unfunded liability from the stated there are two different calculations. First, significantly due to investment performance. He prior year, but the increased contributions and the unfunded liability payment due must be did note that the new mortality assumptions will asset gain would serve to offset. For the CERS calculated and in this step a plan has to decide be incorporated in this valuation, so there will be nonhazardous plan, Mr. White estimated the whether to use a level percent of pay or level dollar an increase in rates due to those changes. funding ratio would likely dip a bit as a result of the method. Second, once you have the payment assumption changes and the fact that employers amount determined, a plan must determine if Investment and Cash Flow Quarterly are phasing into the higher contribution rates. the employers want to make that payment based Update – Teachers’ Retirement System Overall, across the board, a slight decline should on their percent of the plans total payroll or by Beau Barnes, Teachers’ Retirement Systems be expected due to the new assumptions. their share of the total unfunded liability. (TRS), began his presentation discussing the In response to a question from Representative In response to questions from Representative pension investment performance as of March Wheatley regarding the CERS nonhazardous Graviss regarding if the portfolio might look to 31, 2019. He discussed the benchmarks and pension fund’s cash flow, Mr. Eager confirmed add more of the safer equity assets given the Fed’s gross and net returns for the quarter, fiscal-year- that the change in net position for CERS expected policy decision and outlook for those to-date, 1-, 3-, 5-, 10-, and 20-year trailing time nonhazardous went from $350.8 million in FY18 assets, Mr. Eager responded that ultimately that periods. He stated that the 30-year compounded to $1.2 million in FY19. would be a decision of the investment committee, gross return is 8.27 percent. In response to a question from but that the target allocations do include a range Mr. Barnes next reviewed cash flow for the Representative Graviss regarding any incentives where staff and the committee can have some pension fund through the first three quarters of for employers to decrease payroll, both Mr. flexibility. Representative Graviss expressed FY19 and FY18. He pointed out cash inflows, Eager and Mr. White both stated they were not some concern that assets were not allocated outflows, and the total net plan assets across aware of incentives, but given that pension costs conservative enough to protect the fund. In both time periods. are tied to total payroll, one way an employer response to a follow-up question regarding how In response to a question from can manage that cost is to manage payroll. In a long the actuary’s project out liabilities, Mr. Representative DuPlessis regarding member and follow up question from Representative Graviss White responded that cash flows are generally employer contributions, Mr. Barnes confirmed regarding an alternative plan of allocating the projected out over a 90-year period, while the that members contribute 9.105 percent from liability proposed by KRS, Mr. Eager stated that liability projection covers approximately 30-35 their pay towards the pension fund, while staff believed allocating the liability cost separate years. the state’s (employer) total contributions of from a percent of payroll method would serve In response to a question from Senator $799,599,000 was the 13.1 percent statutory rate as disincentive for employers from shedding Schroder with regards to when mortality plus an additional amount needed to pay the full payroll. assumptions have changed, Mr. White stated the unfunded liability, which totals approximately Representative DuPlessis stated that assumptions were last changed during the 2013 29 percent. follow-up information had been provided to Experience Study, and he noted that a member’s In response to a question from Representative each member in their packets regarding the assumed life expectancy was 2 years longer than DuPlessis regarding net cash flow, Mr. Barnes alternate plan outlined in May, which provided in the past. agreed that the pension fund experienced a a comparison of estimated contributions for In response to a question from Representative negative cash flow of approximately $250 million each individual quasi-employer under the two Wheatley regarding the changes in mortality before investment gains or losses. Mr. Barnes THE KENTUCKY GENERAL ASSEMBLY 59 noted the additional contributions appropriated DuPlessis regarding how actual experience might which was two full months prior to the end of the along with recent portfolio rebalancing tactics impact next year’s contribution rates, Mr. Barnes fiscal year. He stated that multiple briefings and make the negative cash flow manageable. stated he doubted TRS would have 3.5 percent meetings had been held with both stakeholders In response to a question from Senator for FY19, although TRS is experiencing positive and legislators. He noted that a copy of the bill, McDaniel with regards to the impact of fully payroll growth. He indicated there could be summaries, side-by-sides, the actuarial analysis, funding the contribution rate, Mr. Barnes stated some increase due to experience and stated that and other explanatory material was provided that the additional funds received from the the budget request that TRS makes will reflect a to these interested parties, along with multiple General Assembly and Governor has not only payroll growth that is less than anticipated. endorsement letters from quasi-governmental allowed TRS to fully implement their funding Investment and Cash Flow Quarterly employers and KRS. Mr. Sunderland stated that plan, but has also served as a game changer for Update - Judicial Form Retirement System his office worked with KRS and had taken input investments. Donna Early, Judicial Form Retirement from a number of legislators throughout the Mr. Barnes continued with an update on System (JFRS), joined by A.C. Donohue, Trustee, process. cash flow for the medical fund cash as of March began her presentation with the performance Mr. Sunderland outlined the difficult 31 of FY19 and FY18. He discussed cash inflows, overview for the defined benefit and hybrid challenge of trying to balance the needs of quasi- outflows, and the total net plan assets across both cash balance plans for both the Judicial (JRP) governmental employers, their employees, as time periods. and Legislators’ (LRP) Retirement Plans. She well as the retirement system. He noted that each Lastly, Mr. Barnes discussed the recently presented charts for each plan with information quasi-governmental entity faces different needs, completed spring trustee elections and stated on the total portfolio, total portfolio net of fees, financial conditions, and underlying employee that 13,637 members voted, which was an total equity, total fixed income, and cash and demographics. He stated that some wish to stay increase of approximately 1,000 members from equivalents. in the system, while some wish to exit the system. the previous year. The cost per ballot was 56 Next, Ms. Early presented the statement of Some are willing to pay by installments, while cents. Mr. Barnes stated that with the helpful changes in net position for both JRP and LRP. others wish to pay by lump sum. Others wish to guidance of Representative Miller, TRS initiated She discussed the cash inflows, cash outflows, allow current employees to stay in the system. In for the first time electronic voting through the and net plan assets for FY19 and FY18. short, Mr. Sunderland commented that one size TRS member portal so members could vote in an In response to a question from does not fit all. encrypted manner. Representative DuPlessis, Ms. Early stated that Next, Mr. Sunderland reviewed past In response to questions from Representative the $1.6 million reduction in the cash inflow legislation relating to cessation of participation Wheatley regarding funding levels, Mr. Barnes employer contributions for the LRP for FY 2018- from the retirement system. He referenced HB stated that the pension fund as of June 30, 2019, 2019 was due to the appropriations being taken 62, which was passed in 2015 and signed by was 57.7 percent funded, and the medical fund out in the current budget. Ms. Early noted that then Governor Beshear, as the proposal that was 36.3 percent funded. In response to a follow the lack of appropriations will have an impact in set the framework and allowed participating up question, Mr. Barnes stated that the TRS the future. employers to exit the plan. In 2017, the General health care fund is better funded when compared In response to a question from Senator Assembly returned to pass HB 351, which to other states, of which many are pay-as-you-go Parrett, Ms. Early provided the approximate made some changes relating to the process for plans. number of members in each of the four plans payment of the actuarial cost to exit the system Representative Graviss inquired whether administered by JFRS: the LRP defined benefit (lump sum only), but maintained an employer’s KRS could provide a 30-year return for KERS. plan, the LRP hybrid plan, the JRP defined benefit ability to exit the system. Mr. Sunderland then Representative DuPlessis requested Mr. Eager plan, and the JRP hybrid plan. She explained that explained the conflict between the General email the 30-year return information to the for the LRP, the plans total membership does not Assembly’s support for and Governor Bevin’s members. total 138, since some legislators participate in strong objection to HB 362, which would have Representative Graviss commented that it is other systems (i.e. KERS, TRS). She said that she allowed universities, community colleges, noticeable that TRS is earning higher yields, has would provide exact membership numbers as a health departments, and other entities to cease more money invested in safe equities, and less follow up after the meeting. participating in the retirement systems during a money in private equities and alternatives than Representative Miller commented that defined window, provided the ceasing employers KRS. He expressed his concern as to why KRS’ he was a strong proponent of not funding the paid the actuarial costs of cessation through investment committee was not investing more legislative plan because he thought it looked equal installments with zero interest over a 30 like TRS. Representative DuPlessis responded horrible that the Legislators’ Retirement Plan is year period. that Mr. Eager had testified during previous funded so well compared to the KERS plan. Ms. Moving to the current proposal, Mr. meetings that KRS would take more risk if their Early commented that in defense of the funded Sunderland outlined that BR 9, which is now BR unfunded liability was closer to that of TRS or if status, it has been a result of the remarkable 19, provides for a one year cost relief to allow the plan had more assets. investments. She also noted that legislators have quasi-governmental employers to determine In response to a question from Senator never contributed more than what the statutory which solution is best for their individual Schroder with regards to TRS mortality rates, formula provided. Mr. Donahue added he situation. If the employers decide to remain in Mr. Barnes stated the assumptions were changed believes it is important to continue funding what the system, they have one year to financially during their Experience Study four years ago. is required to keep the funds fluid. prepare. If the employers decide to opt-out, they The next study will begin next year. Discussion of BR 9/BR 19 (Draft Proposal) can with a lump-sum option, installments that In response to a question from Representative Bryan Sunderland, Office of the Governor, are phased-in for affordability, and they can Miller with regards to payroll growth, Mr. started his presentation with a few opening decide to move all employees to a new plan or Barnes stated that the board currently utilizes an remarks and reviewed a timeline of how the plan leave Tier 1 and Tier 2 employees in the current assumption of 3.5 percent. was developed. Mr. Sunderland stated that BR 9 system. Mr. Sunderland stated that no employer In response to a question from Representative was made available to the public on May 1, 2019, would be forced out of the pension system.

60 2019 Interim LEGISLATIVE RECORD All remain in KERS nonhazardous unless the the same rates of return, but that employers who General Assembly gave a one-year reprieve employer takes action to exit. Each employer will chose the hard freeze would fully exit the plan on the increased rate, which resulted in $132 have one year to plan and budget and will receive after 30 years of installments regardless if they left million not going into the system. Mr. Chilton all financial information prior to having to make behind a liability or not. However, if employers noted that the proposal provides another year a decision. He noted that no employer could choose the soft freeze option, their full liability of reprieve and gives time for all stakeholders to elect to opt-out prior to April 1, 2020, which falls would have to be paid and their initial starting process the financial information and get a clear after the General Assembly’s next budget session rate would be increased to ensure payment was understanding of the true financial situation for where additional decisions regarding financing fulfilled over the 30-year period. each employer. Mr. Chilton stated that this plan may be made. Mr. Sunderland discussed the desire to adds some additional options for affordability As a result of discussions between the provide a proposal with multiple options that and also pointed out that there are subsidies Governor’s staff and legislators, Mr. Sunderland could be tailored to meet each employer’s specific that may be provided in the future. He stated explained that a few changes to the original BR 9 needs. He pointed out the various options, which that in the current budget there is almost $50 proposal had been made and referenced a letter included employers staying in the plan, choosing million of subsidies going to these organizations from the Governor that had been sent on June to exit with one of two lump sum options, or to enhance their ability to make these payments. 5th outlining four primary changes: (1) replacing utilizing one of the installment options. Lastly, Mr. Chilton stated that all the groups that Section 7 with a non-severability clause; (2) Mr. Sunderland reviewed three financial represent the organizations that will be benefited adding language that would require the pledge projections provided by GRS Consulting. have supported this measure. of assets in case of default; (3) adding language First, he reviewed a distribution of each quasi- Representative Graviss commented that he that would stop any additional accrual of employer and the percent of the actuarial cost and the minority caucus had been working on future benefits/service credit for employees still they would finance under the hard freeze option. two alternative options that he had requested participating in KERS, if an employer failed to He noted that 54 out of the 113 employers would to have added to the agenda and presented. pay; and (4) adding specific language to ensure fully pay their liability over the 30 year period, Representative DuPlessis responded that given the 2020 General Assembly had the opportunity while the remaining employers would leave the Governor was the only individual who could to revisit the issue addressed by the Act and behind a portion of their full cost. Secondly, he call a special session, the chair had decided to correcting of the indemnification clause. The reviewed a distribution of the initial installment focus the current meeting on allowing members resulting draft is BR 19. rate that would be required for employers to hear the Governor’s proposal. Representative Mr. Sunderland discussed the process choosing the soft freeze installment option. DuPlessis noted that he and Rep. Graviss had employers who make the decision to exit would Under this option, each employer would have to been working offline and had shared some ideas follow and noted they could do so either by paying fully pay the cost over 30 years and he noted that and commented that the Governor’s proposal their full actuarially accrued cost by lump sum only 28 out of the 113 employers would do so would still give legislators three months to pass or installment payments. If the employer chose with a starting rate of 49.47 percent. He pointed their own legislation. to completely exit and all employees moved to out that 12 of the remaining 85 employers would In response to questions from Representative a new plan, described as a hard freeze, and the see their starting rate increase to 70-75 percent Graviss regarding the addition of a non- employer decided to pay by lump sum payment, in order to fully meet their obligation over 30 severability clause, Mr. Sunderland stated the the actuarially accrued cost payment would years. Third and last, Mr. Sunderland discussed a proposal was a comprehensive solution, and be based on a 4.5 percent rate of return. If the summary of the financial impact of the two lump Section 7 of the bill draft ensures that all the employer choose a soft freeze, by leaving Tier 1 sum and two installment options. He noted that provisions remain together. In response to a and Tier 2 employees in KERS, the cost payment the hard freeze option resulted in more relief as follow-up question regarding the need for only would be based on a 3.5 percent rate of return employers were being priced at a higher discount 51 votes to pass, Mr. Sunderland stated that as to account for the additional risk to KERS. All rate relative to the soft freeze option. a result of the emergency clause included in the employers choosing the lump sum option would Mr. Sunderland closed his presentation by bill, a total of 51 votes are required. He expressed a have until June 30, 2021, to make full payment pointing out what the plan does and does not do. belief that the proposal was not an appropriations and would incur an annual 5.25 percent interest The plan does not force any employer out of the bill, but stated that prior appropriations bills had on pension costs and 6.25 percent interest on pension system, and it does not take away any been passed with less than 60 votes. health costs until the sum was fully paid. earned benefits or change any benefit structure. In response to a question from Representative For employers choosing to exit and pay He emphasized it does not affect other plans, and Wheatley in regards to whether the CERS would in installments, Mr. Sunderland reviewed the it does not prevent the 2020 General Assembly be impacted, Mr. Sunderland expressed a belief options. First, employers choosing to pay their from making changes or making supplemental that the bill was narrowly crafted for the quasi- full actuarially accrued liability in installments appropriations to any quasi-governmental governmental groups and regional universities. over 30 years or less and opting for a complete entity. Instead, he stated the plan does provide In response to a follow-up question regarding exit of all employees would use a 3.5 percent rate immediate relief and time for employers to specific language included in the draft, Mr. of return, while a soft freeze option where legacy prepare and decide a course of action. The Sunderland suggested that the provisions had employees remained in the system would result plan does provide future options and allows been included in previous legislation in 2015, but in a 3.0 percent rate. Employer installments employers to do what is best for their employees. agreed that staff would look into this language would be calculated as the higher of the The plan balances the need for services and the again. In addition to a follow-up question employer’s FY19 contribution or its 60 month need to pay for the benefits promised, and it regarding what type of plan employers who had average payroll multiplied by 49.47 percent, plus provides time for the 2020 General Assembly to exited were using, Mr. Sunderland stated he was a 1.5 percent annual increase for 30 years or until make adjustments or make appropriations. not aware of any employers who were utilizing a fully paid. Second, for those ceasing entities who Mr. Chilton commented that the financial defined benefit plan. would not fully pay off their liability in 30 years, situation quasi-governmental entities are Mr. Sunderland stated the cost would assume facing is severe and was recognized when the In response to questions from Senator THE KENTUCKY GENERAL ASSEMBLY 61 McDaniel regarding the differences between provision was necessary to protect the pension fully funded both the pension and medical plans BR 9 and BR 19, Mr. Sunderland stated that the system. Lastly, in response to Representative since he has been with TRS, which allows TRS only changes were the ones he had identified Graviss regarding the contribution rate for quasi- to invest more freely, it takes care of cash flow during the presentation. In response to a follow- governmental employers who remain in KERS, needs, and allows the system to be maintained in up question regarding employee-based lawsuits Mr. Sunderland stated their ARC would increase a more proper fashion. and the pending Seven Counties withdrawal to the full 84 percent with an expected increase In response to a question from Senator from KRS, Mr. Sunderland stated that he is not of 4 to 5 percent as a result of recent mortality Higdon, Mr. Harbin stated the only issue he aware of any lawsuits regarding a breach of the assumption changes. foresees in the upcoming year is moving the inviolable contract, but added that the Seven With no further business, the meeting was assumptions, which TRS will be looking at this Counties situation is exactly what the Governor’s adjourned. year. TRS will look at both the payroll growth office is trying to prevent. Senator McDaniel and the assumed rate of return, which is looked further commented that the pension plan is a PUBLIC PENSION OVERSIGHT at every five years. He discussed a study by multiemployer plan, and each of these quasi- BOARD the National Association of State Retirement governmental employers opted in KERS via Minutes of the 2nd Meeting Administrators (NASRA). an executive order. He stated that if an entity of the 2019 Interim Representative Miller commented that the offers a benefit, it needs to be able to pay for that March 25, 2019 most recent NASRA study showed a downward benefit and, if not, the liability cannot be thrown Call to Order and Roll Call trend on assumed rates and for the median it is back on to the Commonwealth, which also has The 2nd meeting of the Public Pension 7.25 percent and the average is 7.27 percent. Mr. obligations to its employees. Oversight Board was held on Monday, March Miller also mentioned that payroll growth over In response to a question from Representative 25, 2019, at 1:00 PM, in Room 154 of the Capitol the last 10 years has been 1.7 percent. Mr. Harbin Miller regarding how many counties had maxed Annex. Senator Jimmy Higdon, Chair, called the confirmed that TRS is still using 3.5 percent. out their local tax rates, Mr. Chilton stated that meeting to order, and the secretary called the In response to questions from Representative he is unsure but said he would provide a list of roll. DuPlessis, Mr. Harbin stated that the assumptions those who could raise their local tax. Present were: should not be changed too often due to asset In response to a question from Members: Senator Jimmy Higdon, Co- allocations being based on those assumptions. Representative Graviss regarding the inviolable Chair; Representative Jim DuPlessis, Co-Chair; He also stated that TRS does change the asset contract, Mr. Chilton stated the proposal does Senators Dennis Parrett, Wil Schroder, and Mike allocation on an annual basis so the investments not impact any current or accrued benefits, but Wilson; Representatives Joe Graviss, Jerry T. are not impacted by the actuarial assumptions. only affects benefits on a go-forward basis. Mr. Miller, Phillip Pratt, Russell Webber, and Buddy Answering a follow up question, Mr. Harbin Sunderland added that he would refer to the May Wheatley; J. Michael Brown, John Chilton, stated that the TRS board and staff has been 8, 2019 legal memorandum that was forwarded Timothy Fyffe, Mike Harmon, and Sharon stable and excellent, with low turnover and some to all members of the General Assembly. Mattingly. of the lowest administrative costs in the nation In response to a question from Representative Other Legislators Attending: Representative with good long term investment performance. Wheatley regarding the inviolable contract, Mr. Derrick Graham. He stated that TRS has two investment experts Sunderland stated that, while he was not an Guests: Gary Harbin, Executive Secretary, serving on the board and regularly consults other attorney, it was his understanding the contract was Teachers’ Retirement System; Brad Gross, investment professionals. Mr. Harbin stated that between the Commonwealth and the individual Jennifer Black Hans, and Bo Cracraft LRC Staff. the makeup of the board is totally subject to the employee. He added that the question is whether LRC Staff: Brad Gross, Jennifer Black Hans, control of the General Assembly. or not the contract guarantees benefits not yet Bo Cracraft, and Angela Rhodes. In response to questions from Representative earned or guarantees that an employee has the Approval of Minutes Graviss, Mr. Harbin stated the assumptions ability to earn benefits in the future. In a follow- Representative Pratt moved that the minutes will be reviewed in 2020. He confirmed that up question regarding whether any liability with of the February 25, 2019 meeting be approved. assumptions are reviewed every five years and regards to inviolable contract challenges would Senator Parrett seconded the motion, and the independent actuarial audits conducted every transfer to the employer exiting, Mr. Sunderland minutes were approved without objection. ten years. In response to a follow up question stated that was how he understands the bill, but Senator Higdon invited Gary Harbin, regarding the timing of the assumptions study noted again he was not an attorney. Executive Secretary, Teachers’ Retirement after the 2020 budget session, Mr. Harbin stated In response to a question from System (TRS), to introduce himself to the newest the adjustments to assumptions are long-term Representative Graviss as to whether an actuarial members of the Public Pension Oversight and intended to address the needs of the system analysis had been conducted, Mr. Sunderland Board. Mr. Harbin stated that he is a CPA and for the next 30 years. He also stated that there and Mr. White stated that an analysis had been has been with the TRS for the past 20 years. He is nothing that would prevent the Governor provided on BR 9, and the changes discussed thanked the board and the General Assembly or General Assembly from providing more during the presentation would not have a for the legislation that passed this session and funding for TRS. Representative Graviss asked material impact on the analysis. In response to stated that TRS should be able to get back into if TRS could supply the General Assembly with follow-up questions regarding the requirement private equity with the passing of Representative projections beyond one year of what the costs for collateral, Mr. Sunderland noted that in a Miller’s bill. Mr. Harbin stated that private and participants would look like under the bill that tries to make the best out of a tough equity is an asset class that returned 19 percent current assumptions. situation that language is difficult and not net of fees in 2018, and it will allow TRS with In response to a question from Senator necessarily great. He stated that some quasi- an allocation of 7 percent to keep pace with Higdon, Mr. Harbin stated the minimal payment governmental entities have expressed some other pension plans that have an allocation of 15 for the 2020 budget is already known because it concern about that provision of the bill draft, but percent in comparison. Mr. Harbin stated that, was based on the 2017 review, which gives the that some legislators believe that this particular most importantly, this is the first budget that has legislators plenty of notice to know if additional

62 2019 Interim LEGISLATIVE RECORD funding is required. 2008, which had to be addressed by state law. participation in the Kentucky Employees Representative Miller commented on Specifically, state law clarified what constitutes Retirement System (KERS) by universities and assumptions, saying that by using a 3.5 percent a prearranged agreement between the retired quasi-governmental entities by a date certain. payroll assumption when for the last 10 years reemployed member and the same participating Both versions also extend the freeze on the it was actually 1.7 percent, and by using a 7.5 employer from which the member retired. Under employer contribution rate for those quasi-state percent assumed rate of return when the national this scenario, there is the potential for a voiding agencies in KERS already receiving the lowered average is 7.25 percent and trending downward, of the retirement benefits, meaning that it is as rate in fiscal year 2018-2019. The reduced rate is not TRS is doing a disservice to its members. if the employee never retired, and the employee would be maintained at 49.47 percent of pay in He also said that the General Assembly should will be required to pay back the retirement fiscal year 2019-2020. accept the responsibility for the real shortfall by benefits that were paid. In response to a question from Representative legislating level dollar funding. Mr. Harbin stated Mr. Gross reviewed bills that have passed in Wheatley, Mr. Gross stated that the quasi- he would also support level dollar funding if it regards to KRS retired reemployed provisions. governmental entities participating in TRS are was possible, and that TRS would take additional HB 55 creates a legal assumption as to statutory. When the CERS was created, quasi- money if the budget would allow it. prearranged agreements and specifies the voiding governmental entities participated as a voluntary In response to questions from Representative of retirement for an elected official which retires opt in system, but once in, it had to remain in. Wheatley, Mr. Harbin explained that state law from KRS and is re-elected to the same office For KERS, the Governor issues Executive Orders provides that the actuary sets the assumptions, within 12 months of retiring. HB 381 relates to often at the request of the entity to participate and the board shall approve the assumptions retired reemployed police officers at universities. and, more recently, final approval is with the established by the actuary. During the process to It creates an exemption for the universities so it KRS board of trustees. set the assumptions every five years, the board is not required to pay the employer contribution In response to a question from has discussions with and receives input from the for pension and retiree health on certain officers Representative DuPlessis regarding the Senate’s actuaries. In response to a follow up question, reemployed to specific positions that are limited version of HB 358, Mr. Gross stated that, if a Mr. Harbin stated that the payroll growth over in number. quasi-governmental employer were to opt back the last 30 years averaged above 4 percent. Senator Higdon commented that at some in to KERS, the employer would have to pay In response to a question from Representative point the issue needs to be revisited regarding 83.43 percent of pay within the next budget cycle Pratt, Mr. Harbin stated that TRS uses actuaries employers of retired officers not paying the full absent future action by the legislature. that are independent, professional actuary firms, rate. He explained that the systems should still In response to questions from Representative just like the CPA firms used for the audit. recoup the normal cost. Graviss, Mr. Gross confirmed with Dave Eager Legislative Update Mr. Gross continued with HB 419 relating that approximately 9,000 employees in KERS Brad Gross and Jennifer Black Hans, LRC to the process for retired reemployed members could be impacted by HB 358. In response Staff, presented the 2019 legislative update. Mr. and their employers to comply with KRS to follow up questions, Mr. Gross stated that Gross stated that most of the bills that have verification regarding prearranged agreements policy issues do exist regarding the absence of passed to date specifically deal with issues of or employment as an independent contractor. an installment period and specifics regarding retired reemployed members of the Kentucky The bill provides that there is no prearranged what enforcement mechanisms KRS would Retirement Systems (KRS). The presentation agreement if the reemployment occurs 12 have to ensure timely and continued payments. featured bills passed, bills for possible months or later from the date of the retirement. Representative Graviss commented that these concurrence, bills introduced of note, and all HB 419 should contribute to reducing paperwork questions concerning the bill could leave KRS pension bills introduced in the Senate and House. between the parties and KRS. and the remaining participating employees Mr. Gross started with some background In response to a question from Representative holding the bag for the nonpayment. history on retired reemployed members under Miller, Mr. Gross confirmed that HB 381 did not In response to a question from Representative state law. He stated that, in a 2008 special session, change current state law as it applied to retirees Miller, Mr. Gross stated that, under current law, if the General Assembly passed HB 1, which made which retain to their local elected positions, for an agency has voluntary cessation, its employees significant changes to breaks in employment and which it does not earn retirement after it retires stop participating as of a date certain and the how things are impacted when somebody retires from a participating agency in KRS. employer ceasing participation pays the actuarial and comes back to work at KRS. Specifically, Ms. Hans reviewed bills passed regarding bill as determined by the KRS actuary. if a retiree at KRS is reemployed on or after KRS and TRS housekeeping and the ethical In response to a question from Ms. September 1, 2008, there is no second retirement requirements for investment managers. HB 80 Mattingly, Mr. Gross stated that under current account. Also, the employee does not have to relates to KRS housekeeping and permits KRS cessation provisions, whatever an employee contribute to the systems because he or she is not to use electronic ballots for trustee elections accrued to cessation date is still in the system. earning a benefit. However, HB 1 required the and synchronizes the elections for the two Under some of the proposals related to HB employer to continue making the contribution County Employees Retirement System (CERS) 358, some employees could elect to continue on behalf of the reemployed member and at the trustees. HB 489 relates to KRS and TRS ethical participating in KERS. established rate in order to help pay down the requirements for investment managers and Senator Higdon commented that, if an unfunded liability. In the case of retiree health adopts additional conflict of interest provisions. employer ceases participating in the system, the care, which was provided to retired reemployed Mr. Gross reviewed SB 107 that passed and employee can take another state job and pick up members by the retirement systems, state provides for the automatic enrollment of state their retirement where it left off. law provided that, if that retiree took health employees in a 401(k) plan administered by the Mr. Gross discussed in summary fashion SB insurance coverage through the systems, the Deferred Compensation Authority. 41, which passed the House with a House floor employer was still required to reimburse the Mr. Gross discussed HB 358, which had amendment extending the rate reduction for system for the cost of that member’s health care. passed both chambers with different versions. quasi-governmental entities, and SB 162, relating There were also some federal issues in or around HB 358 relates generally to the cessation of to school resource and security officers. Finally, THE KENTUCKY GENERAL ASSEMBLY 63 Mr. Gross noted bills that are still pending: HB that will never pay the full actuarial cost over In response to a question from 504 relating to TRS pension reform, HB 505, installments with no specific end period; and Representative Graviss, Mr. Cracraft stated that which includes level dollar funding for TRS, that with at 13 percent funded level, KRS should he had not personally run the numbers at 5.50, and HB 525, proposing to change the TRS board not be the bank for the unsecured installment 5.75, and 6 percent for KERS nonhazardous, composition. On that, Mr. Gross concluded loans. but that this information could be found in the staff’s legislative update presentation. In response to a question from Representative sensitivity analyses conducted as part of the David Eager, Executive Director, KRS, was Graviss, Mr. Eager stated that KRS’ position has actuarial valuations for both TRS and KRS. He asked to join staff to answer some questions from not changed that KRS is financially neutral other noted that comparing assumptions at this level the board members. than the $121 million for the one year delay. The require the analysis of an actuary. In response to an earlier question from perception is that the universities are in a more Mr. Cracraft continued with his presentation Representative Graviss regarding HB 358, Mr. stable position with the ability to raise revenue showing recent changes with asset allocation for Eager stated that KRS is internally analyzing through tuition and other sources. all systems. He stated that TRS did sell equity whether it could garnish funds that might Biennial Investment Review assets during the third quarter. otherwise go to agencies from the state through Bo Cracraft, LRC Staff, provided a semi- Under investment return assumptions, the general fund. Mr. Eager stated it was his belief annual investment review. He started with asset Mr. Cracraft stated that NASRA conducts an that KRS can intercept those funds. Mr. Eager allocation, generally, and explained, that how a annual survey that shows change in median and also stated that universities continue to outsource plan chooses its investments, drives 90 percent of average public pension plan investment return positions and reduce their contribution rates, returns. Mr. Cracraft gave a brief description of assumptions. The updated chart shows that the but the liability for KRS does not go down and the traditional and alternative asset classes with median has now dropped to 7.25 percent. is also absorbed. the average peer percentages. He then reviewed In response to a question from Representative Graviss stated that there were the market performance of the components Representative DuPlessis, Mr. Cracraft stated still outstanding questions regarding HB 358, of those asset classes and did a comparison that if the Federal Reserve raises interest rates, particularly relating to the inviolable contract between 2017 versus 2018. Next, he provided a the investment market returns should also rise, issues for employees that are questionable if review of the current allocations of the systems’ but on the flip side there will be an impact as a an entity opts out. Later during the meeting, asset classes detailing the percentages under result of inflation growth. With no additional Mr. Gross explained the history of the original each asset class for each of the systems. He noted questions, he concluded his presentation. cessation statute, 2015 RS HB 62, and that the that public equity returns were low and private With no further business, the meeting was systems opined that it did not violate the contract. equity returns were the strongest performing adjourned. The next regularly scheduled meeting However, an agency interpretation of legislation asset class. is Monday, April 22, 2019. does not prevent a party from pursuing litigation. Mr. Cracraft discussed investments for each At the request of Representative Graviss, of the pension plans for the fiscal year to date, 1-, PUBLIC ASSISTANCE REFORM Mr. Eager said that KRS could provide more 3-, 5-, 10-, and 20-year rate of return percentages. TASK FORCE specific data regarding the employees that could He also compared the plans’ performance to the Minutes be impacted by HB 358. He also advised that peer groups’ median returns for the 1-, 3-, 5-, July 8, 2019 there is about a $3 billion liability from quasi- and 10-year snapshots. Call to Order and Roll Call governmental entities opting out with roughly Mr. Cracraft cautioned that it is difficult The 1st meeting of the Public Assistance one-third of it being for universities, one-third to grade performance within a single time Reform Task Force was held on Monday, July for public health, and one-third for mental snapshot. As an example, Mr. Cracraft discussed 8, 2019, at 3:00 PM, in Room 131 of the Capitol health. specific performance as compared with a one Annex. Representative David Meade, Chair, In response to follow up question from month difference. He stated that December 2018 called the meeting to order, and the secretary Representative Graviss, Mr. Eager stated that was one of the worst Decembers on record. On called the roll. the actuarial analysis on cash flow assumes that December 24, 2018, the S&P 500 fell by almost Present were: every agency would opt out. Under the lump sum 3 percent, and it has never fallen more than 1 Members: Senator Stan Humphries, Co- option, KRS would receive a substantial amount percent on that particular day. He stated that Chair; Representative David Meade, Co-Chair; of money in the third year. Under the installment January 2019 performance came back strong Senators Whitney Westerfield and Max Wise; option, there is no cost flow projection at this and was up approximately 8 percent. Mr. Representatives Nima Kulkarni and Russell time. Cracraft provided a chart that shows changes Webber; Elizabeth Caywood and Bill Wagner. In response to a question from Senator from one month to the next for the systems. He Guests: Anne-Tyler Morgan, Member, Higdon concerning a quasi-governmental entity explained this is why the actuarial and valuation McBrayer, PLLC; James Ziliak, Ph.D., Gatton opting out of the current system (Tier 1 & Tier professionals smooth the returns to obtain a Endowed Chair in Microeconomics and 2), he asked if it would be an advantage to KRS more accurate performance review. Director, Center for Poverty Research, University if the entity created a new retirement system in In response to a question from of Kentucky; Douglas Beard, Director, Cabinet Tier 3. Mr. Eager stated he was not sure of the Representative DuPlessis, Mr. Cracraft stated for Health and Family Services; and Laura Begin, legal aspect, but that there has been discussion he was not aware of any studies regarding Liaison, Cabinet for Health and Family Services. that the entity could work with the deferred whether the Kentucky systems could benefit by LRC Staff: Chris Joffrion (lead staff), Ben compensation system to set up plans. investing in the state park systems, such as how Payne, Sean Meloney, Becky Lancaster, Kate Mr. Eager commented on other aspects of the teachers’ retirement in Alabama built and Talley, and Christy Young. the bill, including that the installment payments developed the Robert Trent Jones golf courses that are driven by a contribution rate based on both within and out of the state. He noted that Charges and Duties of the Task Force the 2019/2020 valuation will be harmful to KRS; Alabama is an outlier with these investments and Representative Meade stated that the charge that the actuaries suggest that there are agencies even had ownership of an airline at one time. and duties of the Public Assistance Reform

64 2019 Interim LEGISLATIVE RECORD Task Force shall be to specifically examine the of relatives. TANF funds can also be used to (FFY) 2016 Kentucky spent over $9.6 billion on effectiveness of establishing work and community promote job preparation, to prevent or reduce Medicaid services. The task force could consider engagement requirements for Supplemental the occurrence of out-of-wedlock pregnancies, creating a community engagement program for Nutrition Assistance Program (SNAP) and and to encourage the formation and maintenance the Medicaid population that would require Medicaid beneficiaries and to recommended of two-parent families. employment, volunteer hours, or education and protocol for implementation. The task force shall According to the most recent fiscal year job training. also examine the effectiveness of a substance report provided by the U.S. Department of In response to questions from Senator abuse screening program for applicants and Health and Human Services (HHS), 64 percent Westerfield, Ms. Morgan stated that she would recipients of public assistance who have a felony of this funding is spent on basic assistance, 11 provide the task force with information on the or misdemeanor history of substance abuse and percent on work training and education, 14 status of litigation regarding substance abuse examine the effectiveness of requiring all welfare percent on child care, 5.4 percent on program testing at a later date, and Elizabeth Caywood, benefit cards to include photo identification. management, 3.9 percent on work supports and Deputy Commissioner of the Department for The task force will research and submit its support services, and 1.8 percent on fatherhood Community Based Services, stated that she findings and recommendations to the Legislative and two-parent family programs. Kentucky would provide information on the amount of Research Commission in November. is one of only two states that has devoted the SNAP benefits distributed in Kentucky. Introduction of Task Force Members majority of its TANF funds to basic assistance In response to a question from Dr. Wagner, Each member of the task force introduce in this fiscal year. Ms. Morgan asked the task Ms. Morgan stated that she did not recall if themselves. Representative Meade stated that force to study the shortcomings associated with substance abuse screening requirements in HB 3 the task force would hear testimony from many current TANF funding allocations and how would apply to all 3 programs, but she will look qualified individuals to help gather as much data allocations could be improved. She suggested into that. as possible. that the task force consider recommending 25 In response to questions from Need for Public Assistance Reform percent of the program funds for education Representative Kulkarni, Ms. Morgan stated Anne-Tyler Morgan, member, McBrayer and training programs and work programs that that the recommended redistribution of TANF PLLC, stated that although assistance is help families have long-term, sustainable jobs, funds did not include efforts to prevent or sometimes needed by families, the goal is to 25 percent for work and supportive services reduce out-of-wedlock pregnancies and that become self-sufficient, but that some families such as transportation or childcare, 25 percent under the redistribution model, funds allocated or individuals may need assistance for a longer for childcare needed to help low-income for childcare and child welfare could be used to period of time. parents establish and maintain employment, Kinship Care payments. 15 percent for basic assistance, 10 percent In response to a question from Ms. In the United States, the current welfare for short-term assistance, and 5 percent for Caywood, Ms. Morgan stated that TANF funds system is comprised of approximately 100 program maintenance. These recommendations, allocated for basic assistance did include child different federal programs. While the system does according to Ms. Morgan, are consistent with welfare activities. Ms. Caywood said that she give assistance to individuals who are currently Federal Law and with the comprehensive five would provide additional information on SNAP in need, it does not offer them any training year TANF reauthorization bill that was recently error rates in surrounding states and that the for the future, and eligibility rules require that approved by the U.S. House Ways and Means U.S. Department of Agriculture (USDA), Food recipients not have any assets in order to receive Committee. and Nutrition Service (FNS) has repeatedly benefits. Recipients are also penalized through Ms. Morgan stated that in 2016, Kentucky’s informed DCBS that substance use screening high effective marginal tax rates which makes it share of administrative cost to support the SNAP is not permissible in the SNAP program. She very difficult to get ahead because as recipients program exceeded $60 million. In the same fiscal recommended that DCBS be allowed flexibility in improve their financial status, the benefits are year, there were 408 positive post-certification how it manages TANF funds, and she stated that lessened or taken away. Changes need to be investigations which lead to $2.3 million in SNAP DCBS could testify to how funds are currently made to help recipients receive the help they benefits fraud discovered by the Department for distributed. Ms. Caywood also cautioned against need while improving their financial situation. Community Based Services (DCBS). In 2017, the penalties and punitive action against parents Federal rules and requirements limit what can SNAP error rates nationwide exceeded 6 percent. stated that it is important to be mindful of the be changed or reformed in Kentucky. What can The photo ID recommendations found in HB impacts on children. be done is to reform administration. 3, and discussed how concerning the photo ID In response to a question from Senator Ms. Morgan discussed three programs only one state, Massachusetts, currently uses Humphries, Ms. Morgan stated that TANF that were addressed in HB 3 from the 2019 the photo ID system. The program has cost funds in Kentucky are allocated to the four basic Regular Session are Temporary Assistance Massachusetts a great deal of money and has assistance categories in very different quantities for Needy Families (TANF), Supplemental several drawbacks. One drawback, using a photo than in most other states. She said that it may be Nutrition Assistance Program (SNAP), and the ID will limit which family member can purchase necessary to examine these allocations. Kentucky Medicaid Program. TANF was created food for the family. Requiring a photo ID also The Effects of Public Assistance Reform through the Personal Responsibility and Work does not resolve benefit trafficking or secondary James Ziliak, Ph.D., Gatton Endowed Chair Opportunity Reconciliation Act of 1996. She market fraud concerns. in Microeconomics and Director of the Center for stated that the challenges with TANF include Ms. Morgan stated that 21 percent of Poverty Research at the University of Kentucky, that some individuals remain in the program Kentuckians, or about 1 of every 6 adults, testified on public assistance participation rates. for long periods of time or they return to the receive Medicaid benefits. ApproximatelyDr. Ziliak stated that in 2000 approximately program due to recurring financial difficulties. 462,000 Kentucky adults (with income up to 138 2 percent of Kentuckians received benefits Federal law states that TANF funds can provide percent of the federal poverty level, regardless through TANF and that by 2018 that number had assistance to needy families so that children may of medical condition) receive services through dropped to less than 1 percent, or roughly 40,000 be cared for in their own homes or the homes the Medicaid expansion. In federal fiscal year people. The strong economy and reforms of the THE KENTUCKY GENERAL ASSEMBLY 65 1990’s lead to a reduction in TANF participation In response to a question from Senator food preparation in the home, as well as seeds and an increase in employment among single Westerfield, Dr. Ziliak stated that he was not that can be used to grow food, are eligible to be mothers. He also stated that the up take rates, or familiar with the exact modification that purchased using SNAP benefits. Restricted items the percent of eligible individuals who receive Kentucky has made concerning TANF and include alcohol, tobacco, live animals, vitamin benefits, has declined. Under Assistance for SNAP participation by convicted drug felons. supplements, prepared foods, cleaning products, Families with Dependent Care (AFDC), the Ms. Caywood stated that according to KRS personal hygiene items, pet food, and other non- predecessor to TANF, 70 to 75 percent of eligible 205.2005, any public assistance recipient under food items. Because the EBT cards are used to individuals received aid. Under TANF about 20 Title IV of the federal Social Security Act and transfer a variety of cash assistance benefits, the percent of eligible individuals receive aid. any food stamp program recipient who has been cards can be used to purchase items not permitted On the topic of SNAP, Dr. Ziliak testified convicted of a drug felony after August 22, 1996 by SNAP and that the EBT card system deducts that the majority of the administrative costs shall remain eligible for benefits if the recipient funds from appropriate accounts based on what covered by the state of Kentucky go toward the has been assessed as chemically dependent and is being purchased. Cash assistance program payment of participating vendors. Nationally, is participating in, or has successfully completed, benefits, such as those received through KTAP, 250,000 outlets accept SNAP benefits, including a chemical dependency treatment or is pregnant. can be used for rent or mortgage payments, to over 4,500 in Kentucky. SNAP participation rates In response to questions from Senator pay utility bills, or to purchase items such as in Kentucky are higher than the national average. Humphries, Dr. Ziliak explained that SNAP was diapers and person hygiene products. EBT cards In 2018, Kentuckians received $850 million in established based on the economy food plan of cannot be used to make any purchase as liquor federal SNAP benefits. Research indicates that 1964 and has only been updated about once every stores, gambling facilities, or in adult-oriented every dollar of SNAP benefits generates $1.50 in decade since. SNAP is updated to respond to entertainment facilities. economic activity, or $1.27 billion for Kentucky food price inflation. The economy food plan was According to Mr. Beard, in May of 2019 in 2018. Households that receive SNAP benefits designed for emergency use only during natural approximately 529,000 individuals living in spend 20 percent less on healthcare than low disasters and was intended to be a temporary 238,000 households in Kentucky received SNAP income households that do not receive SNAP plan. The food preparation cost is understated benefits and approximately 14,000 households benefits. by between 20 percent and 50 percent for single- which were home to 27,000 children received Dr. Ziliak testified that children are by far the mother families suggesting that SNAP benefits KTAP cash assistance benefits via EBT cards. largest group served by the Medicaid program, are inadequate for some families. The average monthly SNAP benefit was $251 but more Medicaid funds are spent on nursing Mr. Wagner reflected on Dr. Ziliak’s per household, 100 percent of which is federally homes and disabled elders than children. testimony quoting his statement, “if the goal funded. The average monthly KTAP benefit Dr. Ziliak stated that states that allocate is to reduce participation in TANF, SNAP and was approximately $217 per household. The funding for training experience longer term Medicaid among Kentuckians.” Mr. Wagner eligibility rules for KTAP are more restrictive gains from public assistance recipients than asked the chair to explain the goal of the task than SNAP; the income guidelines are lower and those states that attempt to push people into force and how to measure the effectiveness of there must be children under the age of 18 living work through work or community engagement any changes to the public assistance programs. in the home. requirements. Rescinding the Able-Bodied In response to Mr. Wagner’s question, Chairman Mr. Beard testified that EBT card fraud Adult Without Dependent (ABAWD) waiver has Meade stated that the purpose of the task force is committed by clients, retailers, and case led to declines in SNAP participation, but that is information gathering, to get all sides of the workers. Client perpetrated fraud included there is little evidence that rescinding the waiver issue at hand, to try to decipher data, and at the trafficking or trading cards for cash, double has increased job participation rates. end to come up with some recommendations. participation which occurs when recipients On the subject of substance abuse screening, He compared this task force to the Child Welfare receive benefits from multiple states, unreported Dr. Ziliak testified that federal laws prohibit House Work Group that was formed in 2017. household members or unreported income, and participation in TANF and SNAP by convicted inappropriate purchases. Retailer perpetrated drug felons, but states do have the option to Electronic Benefit Transfer (EBT) fraud includes giving cash back on SNAP modify or remove those prohibitions. Kentucky, Laura Begin, a liaison from the Cabinet for purchases, stealing card information, and along with about half of all states, modifies the Health and Family Services, testified that DCBS allowing households to purchase on credit. Case ban. He stated that evidence from various states uses electronic benefit transfer (EBT) cards workers commit fraud by issuing cards or benefits has shown that the administrative costs of drug to administer SNAP, Kentucky Transitional to themselves or to ineligible family or friends. testing outweighs the potential benefits and that Assistance Program (KTAP), and Kinship Care He explained that in an effort to prevent and substance use is not related to participation in benefits. The Kentucky Works Program and detect fraudulent behavior, the cabinet monitors public assistance programs or the length of time the Work Incentive (WIN Reimbursements) multiple replacement card requests, excessive an individual receives benefits. program may also utilize EBT cards in active card swipes which refers to the same card being Dr. Ziliak testified that because USDA status in Kentucky and explained the process used to make multiple large purchases in a single guidelines for SNAP require that benefits be for using an EBT card. A benefit recipient, an day, and out-of-state activity. The cabinet also redeemable by any member of the household that authorized representative, or family member utilizes secret shoppers and relies on public tips receives benefits, including photo identification in the household that receives benefits are to combat fraud. Mr. Beard stated that in May on benefit cards is not recommended as this permitted to use the EBT card with a 4-digit PIN of 2019, 192 cases of potential fraudulent activity could prevent the use of benefits by some which is required for any transaction. were identified. For the reporting period in July household members. Current SNAP error rates Mr. Douglas Beard, Director of Division to September 2018 a total of 184 individuals were are near an all-time low, and requiring cards to of Family Support in the Cabinet for Health disqualified from SNAP for trafficking benefits, contain photo identification will likely increase and Family Services, discussed restrictions and and for the period of October to December 2018, administrative costs and create problems for limits on the items that can be purchased using 230 individuals were disqualified for trafficking. vendors and benefit recipients. SNAP benefits. Food items that can be used for Combined, trafficking disqualifications from the

66 2019 Interim LEGISLATIVE RECORD second half of 2018 accounted for approximately products, but there are situations in which “Mom force is it to bring in more revenue, because $450,000 in fraud claims. and Pop” stores may skew how those items are if that is the case, then look at the corporate Mr. Beard explained that while federal identified. welfare. She also asked that the task force hear regulations permit the inclusion of photo In response to questions from Representative from constituents on these issues. identification on EBT cards, under no Kulkarni, Mr. Beard stated that feminine hygiene Reverend Don Gillette, Executive Director, circumstances can the inclusion of photo products would be included under TANF funds, Kentucky Council of Churches, stated that the identification impact a household’s eligibility and that the funds were of cash value, so there drug testing and photo identification would or ability to use the card to purchase allowed would be little restriction, including for internet create higher administrative costs, and cause items. Many recipients have authorized and other utilities. food insecurity, reduce health coverage and care, representatives who also must be allowed to Public Comments cause bankruptcies, and negative spillovers. He use the cards to make permitted purchases. For Tracey Pully of the Family Resource Youth stated the system needs to be reformed for the these reasons, there are many situations in which Services Center for Fulton Independent Schools better. He requested that the task force listen to photo identification may not work well. In the stated that she was surprised and unhappy to constituents. one state that includes photo identification on hear Ms. Morgan make the statement that the With no further business the meeting was EBT cards (Massachusetts), he stated that 75 only way to end poverty is to move people into adjourned at 5:29 PM. percent of benefit recipients are exempted from the workforce. She stated that the vast majority the photo identification requirements and that of the parents she works with in Fulton, where PUBLIC WATER AND overall the program has not been proven to half of the children are living in poverty, are WASTEWATER SYSTEM be beneficial. Maine previously implemented employed. She stated she was disturbed to hear INFRASTRUCTURE TASK FORCE a photo identification requirement, but after that only 1 percent of public assistance funding Minutes of the 1st Meeting 3 years, the state ended the program citing in Kentucky is lost to fraud but about 40 percent of the 2019 Interim high administrative costs and no return on of this meeting was about fraud. July 24, 2019 investment. Oklahoma attempted to implement Charlotte Goddard, a teacher, stated she Call to Order and Roll Call a photo identification program only to determine agreed with a lot of what Ms. Pully said. She was The 1st meeting of the Public Water and that any potential benefits would not justify the put off by remarks that have been made such as Wastewater System Infrastructure Task Force was administrative costs and burden. As alternatives whether people are productive or not. She asked held on Wednesday, July 24, 2019, at 1:00 PM, in to requiring photo identification on EBT cards, what the criteria was to determine the level of Room 154 of the Capitol Annex. Representative he discussed the possibility of connecting public productivity or unproductivity. She stated that Jim Gooch Jr., Chair, called the meeting to order, assistance benefits to state issued driver’s licenses sometimes by reforming these programs, it can and the secretary called the roll. or combining all public assistance benefits be detrimental to the families. Ms. Goddard Present were: including Medicaid benefits on a single card. asked that stigmas and stereotypes be put aside Members: Senator Phillip Wheeler, Co- In response to questions from Senator and start listening to evidence and research. Ms. Chair; Representative Jim Gooch Jr., Co-Chair; Westerfield, Mr. Beard stated in some cases of Goddard stated that if she could show the task Senator Robin L. Webb; Representatives Derek benefit fraud, the individual remains eligible force a picture of a bed one of the children in her Lewis and Ashley Tackett Laferty; Michael but that benefits are captured by the state for community is sleeping in, they would be appalled Burress, David Farrar, Mike Gardner, Peter restitution. Benefit interception of this sort and said that we should not be demonizing the Goodmann, Gary Larimore, Donna McNeil, and typically lasts for about 12 months. He also poor. Brian Traugott. explained that in some fraud cases there are Megan Meyer, Chair, Pennyroyal Indivisible Guests: Charles Snavely, Secretary, Energy hearings to explore the recipients’ intentions in Western Kentucky, stated that in Kentucky, 46 and Environment Cabinet, R. Bruce Scott, Deputy prior to any criminal proceedings. percent of SNAP recipients are children, up to Secretary, Energy and Environment Cabinet and In response to a question from Senator 62 percent of recipients are disabled and elderly, Peter Goodmann, Director, Division of Water, Wise, Mr. Beard stated that anyone with the and 36 percent are the working poor, so only Energy and Environment Cabinet. PIN number could make a purchase and it about 4 percent of people receiving these benefits LRC Staff: Stefan Kasacavage, Janine may not necessarily be healthy. Itemized data are not in some way turning in applications or Coy-Geeslin, Tanya Monsanto, and Susan is not provided from the vendor so it’s hard to proving that they are at least looking for work Spoonamore, Committee Assistant. know what products are purchased. He stated opportunities. She asked the task force to provide Kentucky’s Water Infrastructure Needs that Farmer’s Markets were now accepting more jobs that pay more than $10 an hour. She R. Bruce Scott, Deputy Secretary, Energy EBT cards, and suggested that the task force stated that the cost of living is too high to live on and Environment Cabinet (EEC) and Peter to explore FNS incentive programs for more $10 an hour and that the last time you could live Goodmann, Director, Division of Water, EEC nutritious purchases. Ms. Caywood added that in a 2-bedroom apartment for $10 an hour was explained Kentucky’s Water Infrastructure – some areas do not have access to fresh produce 1976. She asked the task force to look at reform Status and Needs. Mr. Goodmann stated that or fresh items. She also discussed the SNAP through a lens of how you can invest in your the focus of the information would include Nutrition Education Program that is available people and not how you can divest people from infrastructure for wastewater and drinking to communities which provides training on how assistance. water. About 95 percent of Kentuckians receive to best utilize the benefits, purchasing in-season Amanda Groves, representing Kentuckians public water. The regional consolidation produce, gardening, and making economical for the Commonwealth, Western Kentucky of systems is ongoing in order to relieve and nutritious meals. chapter, stated that every citizen in Kentucky in unsustainable situations. The consolidations In response to a question from Senator entitled to good education, quality healthcare, come with old infrastructure where maintenance Wise, Mr. Beard stated that the technology exists and quality fair economic justice and economic and investment has been deferred and sufficient to reject the purchase of alcohol and tobacco policies. She asked if the purpose of the task planning for the future has not been done. Since 1996, more than 145 small wastewater THE KENTUCKY GENERAL ASSEMBLY 67 treatment plants (WWTPs) have been taken or even zero interest loans; inadequate technical Mr. Gary Larimore, Executive Director, off-line. There are 800 wastewater systems capacity to sufficiently operate the system(s), Kentucky Rural Water Association (KRWA), across the state that are in operation today and difficulty finding entities willing to assume the stated that the association can do rate studies, at approximately 180 of those have been identified responsibility of managing a substandard or no charge, to help systems find the best option as priority candidates for regionalization. Most poorly operating system, and inadequate fee rate for raising rates. Mr. Larimore announced are located in small communities that are remote structures in place to be sustainable. A lot of utility that KRWA had just started an apprenticeship to regional facilities. Mr. Scott explained that models were constructed under the presumption program, certified by the Education and HB 513 was in response to a privately owned that there would be more usage and fee rates. Workforce Development Cabinet. The program system in Bullitt County that collapsed. The With more efficient use of water, consumption would be available to existing employees, bill allowed better regulatory oversight of small has declined. Previously, communities relied graduating high school students, and college private WWTPs and allowed sanitation districts, upon coal severance dollars and other federal students. It is a two-year program requiring water districts, etc. to own and operate systems dollars that have since gone away. 4,000 hours. outside their jurisdictions with voluntary Mr. Goodmann said that targeted investment In response to Senator Wheeler, Mr. Scott agreement. Mr. Goodmann stated that Kentucky was needed for critical water infrastructure stated that Martin County received a grant from had been successful at regionalization, but it was where funding options are limited in challenged the Abandoned Mine Land Grant Program. Ms. important to invest and maintain the assets that communities. Developing community McNeil said there were more loan funds available had been built. The average age of wastewater partnerships and public and private partnerships other than grant funds. Rural Development has plants is thirty-six years old, with 18,000 miles to help make financing infrastructure more a loan grant program. Most grants required a of sewer lines, and more than 4000 sewage lift available, and affordable, and leveraging of match that could be matched with other grants or stations. Mr. Goodmann said that according existing sources of funding are both key. One loans. KIA has four different loan programs, two to the United States Environmental Protection area of concern is receivership. The court recently of them are state and the other two are federal. Agency (USEPA) 2014 Clean Watershed Needs rejected a request for receivership to take over She said she would provide the committee Survey, Kentucky would need to invest $6.343 a system while raw sewage was running down with information on funding sources and the billion for its wastewater infrastructure. homeowners’ backyards. He suggested targeted availability of the grants or loans for the different Mr. Goodmann stated that Kentucky uses investment in counties that are struggling. infrastructures purposes. an estimated 136 billion gallons of potable water Mr. Scott said that approximately $6 million Mr. Goodmann said that there is a lot of each year, about 75 percent of which is used by had been given to Martin County but they are money available for disasters through the Federal residential households. The average per capita still not prepared to spend it. The EEC offered Emergency Management Agency (FEMA). He usage is typically less than 75 gallons per day or Martin County $7.5 million in loans with nearly state that Kentucky leaves millions of dollars on 27,000 gallons per year. More than 95 percent zero interest, but the loans were rejected because the table each year. of households and businesses are served by a they could not afford the loan. In response to Senator Wheeler, Ms. McNeil public water system. The vast majority of entities Mr. Scott explained that there was a lack of explained that KIA has a Fund B program for and individuals are paying something for their technical, managerial and financial capacity for drinking water, wastewater, and infrastructure water usage via an existing billing system and some systems. Some systems are understaffed funding. She explained that KIA also had several using a variety of usage fee rate structures. with certified operators. Some systems need other financing options to help challenged There are 213 water treatment plants with an better cost accounting and financial oversight. communities with infrastructure. average age of 38 years, approximately 64,000 He stated that investing in infrastructure would In response to Representative Tackett miles of distribution lines (average age of 40 provide better economic growth and protect Lafferty, Mr. Larimore said that the KRWA plus years), approximately 1,800 water storage Kentucky’s public health. He said that for every reviews what the revenue needs are for a tanks (average age of 28 years), and more than $3 million invested in water infrastructure, 15 community and then makes a rate structuring 1,000 pumping stations, which are old. Terrain, jobs were created. recommendation. If a case is before the Public depths, and stream crossings present a challenge Senator Webb requested that the list of the Service Commission (PSC), then the PSC can for distribution lines. According to USEPA’s 180 entities which have been identified as priority make an interim rate based on the information 2015 Needs Survey, Kentucky will need $8.232 candidates for regionalization be provided to the provided at that time. It could be a flat rate in billion for drinking water infrastructure through committee along with their priority and status. order to generate revenue quickly until new 2035. The American Society of Civil Engineers’ She said it would also be good to talk about meters are installed for accurate reading for (ASCE) 2017 Infrastructure Report Card gave the dual jurisdiction between federal and state commercial users. The PSC could then phase-in Kentucky a Grade D. entities. new rates based on recommendations. Mr. Scott said that, without investment, In response to Senator Webb, Mr. Scott Charles Snavely, Secretary, Energy and Kentucky would experience failure of systems, stated that EEC’s staffing for inspections was Environment Cabinet suggested that in addition which would be detrimental to the environment good, but the cabinet was still not able to inspect to addressing funding issues, the committee and quality of life in addition to losing economic every system annually. should also address oversight and management growth opportunities. There are funding options In response to Representative Lewis, Mr. of the systems. through the federal government, and state, local, Scott stated that the EEC had no money to help Ms. McNeil said that most of the utilities and private entities. As an example, he said that the water systems. There are federal funding who do a good job have properly funded the Kentucky Infrastructure Agency (KIA) has options available through several federal agencies replacement reserve accounts. She said that KIA money for loans. such as the Kentucky Infrastructure Authority requires a replacement reserve account to be in Mr. Scott said that not all systems were (KIA) and sometimes through state, local and place for the life of a loan. One reason utilities do taking advantage of the available funding private funds. Mr. Goodmann said changes are not want loans is the requirement of audits. She options. The smaller, more vulnerable systems being made to the qualifications for a certified said she thought EEC had authority to regulate had insufficient borrowing capacity to obtain low operator in order to speed up the process. against improper operation and maintenance of

68 2019 Interim LEGISLATIVE RECORD utilities. Mr. Goodmann stated that there is some language in the construction permit. He said that Kentucky was in the minority of states that Special session, did not have drinking water operational permits, from page 2 which might be the topic of future discussions. Mike Gardner, Water/Sewer Systems Manager, Bowling Green Municipal Utilities, said that a lot of problems for the systems was bill’s passage in 2015. singular goal of enacting a retroactive one-year lack of local leadership and working on measures “What’s the difference between 2015 and freeze on employer contribution rates for qua- to fill the funding gap. now? Ask yourselves that,” Miller told the si-governmental agencies and regional state uni- There being no further business, the meeting House. “We have to take action… It’s time to versities and colleges to serve as what she called was adjourned. take action to solve things.” “insurance” in case other legislation considered House Minority Caucus Chair Derrick this special session hits a roadblock. Graham, D-Frankfort, who voted against HB Both Graviss and Hatton were among 1, said 2015 HB 62 was a response to a federal those in the House voting against HB 1. Among bankruptcy ruling in the case of Seven Counties those voting against the bill in the Senate was Services, a Louisville-based community mental Minority Floor Leader Sen. Morgan McGarvey, health center that was allowed to withdraw from D-Louisville. the state pension system after the agency filed “We didn’t want to come in here and just bankruptcy. gavel out. In fact, we wanted to come in here Floor amendments proposed to the bill in and take the time to pass a bill that wouldn’t both the House and Senate were defeated before generate the type of debate we saw today and the final votes on the bill were taken in both instead have more unanimous, broad support chambers. because we do care about our workers. We do Rep. Joe Graviss, D-Versailles, who filed care about our institutions. We care about their HB 2 as an alternative bill this special session, jobs and the stability of the entire system,” Mc- said his bill—defeated by a vote of the House Garvey said on the Senate floor. State Government Committee—was more The special session was not unexpected. actuarially sound. He also challenged a non- Gov. indicated that he would call a severability clause in HB 1 requiring that the special session on quasi-governmental pension legislation be voided if any of provision in the reform when he vetoed 2019 HB 358, legislation bill is found unconstitutional or unenforceable. passed in the final hours of the 2019 Regular He called the clause “throwing the baby out Session to address the quasi-governmental with the bath water.” pension crunch. Also proposed but voted down in commit- The legislation included an emergency tee was HB 3, sponsored by Rep. Angie Hat- clause, which means the new law went into Alzheimer’s, ton, D-Whitesburg. Hatton’s proposal had the effect when the governor signed it on July 24. from page 3 for short. Those are people who assist older decade, according to information provided to community standards to enable individuals who adults and people with disabilities with daily the task force. It was $10.66 in 2007 and $11.30 enter care with nearly full cognition to age in tasks, such as dressing, bathing and eating. in 2017. Culp said nursing assistants are more place … ,” he said. “The focus should be on the “No matter what laws and regulations than three times likely to experience injuries on continuum of care and should enable a resident are in place, no matter if the care is from a the job than the typical U.S. workers. to avoid discharge until clinically unstable or in for-profit or not-for-profit organization, no Culp said her office investigated 6,025 need of high-intensity nursing services.” matter the amount of money being paid by the complaints last fiscal year. Twenty-seven percent Sen. Stephen Meredith, R-Leitchfield, individual or by the state’s Medicaid program – of the complaints were about care while 15 asked for specific suggestions on how Kentucky the experience of the older adult is determined percent of the complaints were about staffing. could modernize its standards. Davis said the by his or her interactions with the DCW,” Culp Steve Davis, inspector general for the Cabinet had been reviewing Florida’s model said. “Nursing home residents throughout Cabinet for Health and Family Services, testified for long-term care for more than a year and the country explain that the most important from the regulator’s point of view on Kentucky that Kentucky may want to adopt aspects of the elements of quality in their day-to-day lives long-term care supports for Alzheimer's and sunshine state’s standards. were the accessibility and attitude of the DCW. dementia. He said Kentucky’s assisted living Davis said Florida’s model does allow A good long-term care experience is dependent standards do not adequately address the need residents to more easily stay in one place. on having enough DCWs who are well trained for residential care for individuals who require The Kentucky task force must report and have a positive attitude.” limited health care support but do not need its findings and recommendations to the Adjusted for inflation, wages for home high-intensity nursing care. Legislative Research Commission of the General care workers have remained stagnant in the last “Kentucky should modernize its residential Assembly by Nov. 29.

THE KENTUCKY GENERAL ASSEMBLY 69 Scott Oldham 17 Bourbon 26 27

Shelby 23 36 28 33 19 Woodford 11 13 Campbell 7 22 35 20 Boone Kenton 37 12 Clark 24 14 17 38 34 10 Spencer Jessamine 7

Bullitt Gallatin Hardin Madison Grant Pendleton

Jefferson Co. Detail Fayette Co. Detail Northern KY Detail

23 Boone KentonCampbell 11

Gallatin 24 17 Pendleton Bracken Districts Carroll Grant Trimble Mason Greenup Lewis Senate Plan (SH001A02) became law (KRS 5.101 - 5.138) August 23, 2013, with enactment of House Bill 1. Owen Robertson 27 20 18 Henry Harrison Oldham 7 Fleming Boyd 26 Nicholas Carter Scott Franklin Shelby Bourbon Rowan Jefferson Bath Elliott Woodford Lawrence Spencer Fayette Montgomery Anderson 31 Bullitt Clark Meade Menifee 38 28 Morgan Hancock Jessamine Johnson Powell Martin Henderson Mercer Breckinridge Nelson Washington Wolfe Daviess Hardin 22 Madison Magoffin Estill Union 8 Boyle Garrard 34 4 10 14 Lee Floyd McLean Larue Marion Breathitt Pike Webster 21 Ohio Grayson Lincoln 30 5 Jackson Owsley Knott Crittenden 6 Ta yl or Rockcastle Perry Hopkins Casey 29 Livingston Hart Green 25 Muhlenberg Butler Edmonson 15 Clay Caldwell Laurel Leslie Letcher Ballard Pulaski McCracken Adair 2 Lyon Warren Russell Barren Metcalfe Marshall Christian 32 Knox Carlisle 16 Harlan To dd Logan 9 Trigg Wayne Graves 3 Cumberland Allen Whitley Bell Simpson Clinton McCreary Hickman 1 Monroe Calloway Fulton

Produced by the Legislative Research Commission Geographic Information Systems Office, Room 26 Capitol Annex, Frankfort, KY, 40601, 502-564-8100, [email protected]

70 2019 Interim LEGISLATIVE RECORD Scott 59 Oldham

Bourbon 48 72 66 63 65 Shelby 62 43 33 67 41 32 77 34 58 76 69 42 56 40 35 36 64 31 Woodford Campbell 30 75 Boone Kenton 44 45 79 68 46 Clark 29 60 28 37 88 73 38 55 61 49 53 39 Jessamine 47 Spencer 78 26 71 Bullitt Gallatin 70 Pendleton Hardin Madison Grant

Jefferson Co. Detail Fayette Co. Detail Northern KY Detail

Boone KentonCampbell

Gallatin 61 Pendleton Bracken Kentucky House Districts Carroll Grant 98 Trimble 78 Mason Greenup Lewis House Plan (HH001M01) became law (KRS 5.201 - 5.300) August 23, 2013, with enactment of House Bill 1. 47 Owen Robertson 70 Henry Harrison 99 59 Boyd Oldham 62 Fleming Nicholas Carter 100 Scott 72 Franklin 96 Shelby Bourbon Rowan Jefferson 57 Bath Elliott 58 Lawrence Woodford Spencer Fayette Montgomery Anderson 56 Clark Meade Bullitt 53 74 Menifee 97 13 Morgan Hancock 27 26 49 Jessamine Johnson 11 55 Powell Martin Henderson Breckinridge Nelson Mercer 39 73 Washington Wolfe 7 Hardin 81 Magoffin 10 50 Estill Union Daviess 18 Madison 95 25 Boyle Garrard 93 Lee Floyd Webster McLean 14 Larue Marion 71 Breathitt Pike 89 Ohio Grayson Lincoln Owsley 91 92 Crittenden 12 Jackson 54 80 Knott 4 Ta yl or Rockcastle Hopkins 24 Casey Perry Hart Livingston Green 90 Muhlenberg Butler Edmonson 94 Clay 3 Caldwell 51 Laurel 84 15 17 19 Leslie Letcher Ballard Adair Pulaski McCracken 9 21 85 1 Lyon Warren Metcalfe Russell Marshall 16 Barren 86 Christian 83 Knox Carlisle Harlan 6 Logan 23 52 Trigg To dd 8 Wayne 87 Graves Cumberland 82 Simpson Allen McCreary Bell Hickman 2 5 22 Monroe Clinton Whitley Calloway Fulton 20

Produced by the Legislative Research Commission Geographic Information Systems Office, Room 26 Capitol Annex, Frankfort, KY, 40601, 502-564-8100, [email protected]

THE KENTUCKY GENERAL ASSEMBLY 71 2019 Interim LEGISLATIVE Robert Stivers David Osborne SENATE PRESIDENT SPEAKER OF THE HOUSE RECORD David P. Givens David Meade Published monthly by the Jay D. Hartz PRESIDENT PRO TEMPORE SPEAKER PRO TEMPORE Legislative Research Com- Director Damon Thayer John Bam Carney mission, the Interim Record Legislative Research MAJORITY FLOOR LEADER MAJORITY FLOOR LEADER is designed to inform the Commission Morgan McGarvey MINORITY FLOOR LEADER MINORITY FLOOR LEADER citizens of Kentucky of the Robert Jenkins between-sessions work of the Deputy Director for Julie Raque Adams Suzanne Miles General Assembly. Committee and Staff MAJORITY CAUCUS CHAIR MAJORITY CAUCUS CHAIR Paper subscriptions are free Coordination Johnny Ray Turner Derrick Graham upon request. Contact the LRC MINORITY CAUCUS CHAIR MINORITY CAUCUS CHAIR Public Information Office, Rob Weber Mike Wilson Chad McCoy Public Information MAJORITY WHIP MAJORITY WHIP Capitol Annex, Frankfort KY, Officer 40601 at 502-564-8100, ext. 307 Dennis Parrett Joni L. Jenkins to subscribe. Joe Cox MINORITY WHIP MINORITY WHIP Publications and Printing TheInterim Record can also Officer The Kentucky Legislative Research Commission is a 16-member committee of the majority and minority leadership of be read online at legislature. Rebecca Mullins the Kentucky Senate and House of Representatives. Under Chapter 7 of the Kentucky Revised Statutes, the LRC constitutes ky.gov/Legislation/Pages/de- Hanchett the administrative office for the General Assembly. Its director serves as chief administrative officer of the Legislature when fault.aspx. If you have a paper Editor, Typography and it isn’t in session. subscription and would like to Design The Commission and its staff, by law and by practice, perform numerous fact-finding and service functions for members end your subscription and read of the Legislature, employing professional, clerical and other employees required when the General Assembly is in session the Interim Record online only, Public Information Staff: and during the interim period between sessions. These employees, in turn, assist committees and individual legislators please contact the LRC Public Stephanie Newberg in preparing legislation. Other services include conducting studies and investigations, organizing and staffing committee Information Office at 502-564- Jeff Fossett meetings and public hearings, maintaining official legislative records and other reference materials, providing information Steve Gatewood 8100, ext. 307. Stories and about the Legislature to the public, compiling and publishing administrative regulations, administering a legislative intern Bruce Phillips program, conducting orientation programs for new legislators, and publishing a daily index and summary of legislative photographs may be reprinted Bud Kraft actions during sessions. without permission, although Keith Krey credit is appreciated. Jim Hannah The LRC is also responsible for statute revision, publishing and distributing the Acts and Journals following sessions, Susan Kennedy and for maintaining furnishings, equipment and supplies for the Legislature. It also functions as Kentucky’s Commission on Printed with state funds Interstate Cooperation in carrying out the program of the Council of State Governments as it relates to Kentucky.

2019 Interim Change Service Requested Pre Sorted Standard U.S. Postage LEGISLATIVE PAID Kentucky General Assembly RECORD Frankfort, Kentucky 700 Capital Avenue Permit Number 308 Frankfort, Kentucky 40601

72 2019 Interim LEGISLATIVE RECORD