2017 Interim LEGISLATIVE Volume 30, No. 4 July 2017 * Read online at www.lrc.ky.gov/legislation.htm RECORD Cities seek local revenue options, lawmakers told by Rebecca Hanchett Government on June 28. LRC Public Information Kentucky is one of only a handful of states that does not give cities or counties authority to FRANKFORT—It took around $150 mil- level a local option sales tax, although proposals lion to revitalize Owensboro’s waterfront, says have been considered in recent legislative ses- the city’s mayor Tom Watson. But paying for the sions. project under the city’s existing tax structure “We think we have as much understanding wasn’t easy. as anybody of what our community can toler- No new city revenue stream was available for ate, of what they’d be interested in,” Watson told the project at the start, said Watson, pushing the the committee. “I’m not a tax-and-spend guy, I city seek other funding sources including some promise you … and this is just an option. We’d federal funds. Having more local tax options— like to have some control and some say in what including the option to levy a restaurant tax, happens.” which Owensboro cannot levy under current Joining Watson before the committee was Rep. Ken Fleming, R-Louisville, speaks during Kentucky law—would help cities like his build Kentucky League of Cities (KLC) President and the June Interim Joint Committee on Local their infrastructure and be more competitive, Sadieville Mayor Claude Christensen, who said Government meeting. he told the Interim Joint Committee on Local Continued on page 2 From telehealth to midwifery: Health issues studied by Jim Hannah The practice of incorporating new commu- tients with chronic diseases. LRC Public Information nication technologies when treating patients, Thornbury said he is president of the Ken- broadly known as telemedicine or telehealth tucky Academy of Family Physicians, a group FRANKFORT – Using video calling services care, is already being used in Kentucky to treat that supports the legislative intent of the pro- like FaceTime or Skype can be good for your routine problems like urinary tract infections, posed bill. health – but not for the physician’s bottom line. sore throats and rashes. Rep. Steve Riley, R-Glasgow, who sponsored That’s according to testimony giving during Thornbury said the proposed legislation similar legislation during the last session, said the July 17 meeting of the Interim Joint Com- would encourage the expansion health benefit the proposed measure would also ease the physi- mittee on Health and Welfare and Family Ser- plan coverage of telehealth care for the treatment cian shortage in the state. vices. of chronic diseases such as diabetes, autoim- “I think we all know we have difficulty getting “It’s about payment parity,” said Dr. William mune disorders and asthma. He said Kentucky’s in to see our doctor,” he said. “I know that many C. Thornbury Jr., who testified in support of pro- doctors need to get reimbursed for the same as of you have gone to the doctor and in many cases posed legislation that would allow Kentucky’s office visits for the strategic planners in the large had to wait two hours for a visit. You are busy physicians to get reimbursed the same amount health care systems to invest in telehealth care people. We are all busy people. We have a lot of for video appointments as they command for technology while maintaining the brick-and- office visits. mortar offices that are still necessary to serve pa- Continued on page 2 THE KENTUCKY GENERAL ASSEMBLY 1 other midwives have basically been pushed un- derground with the medical community com- Health, plicit in turning a blind eye.” The “Hospital Peer Review” proposal would from page 1 limit the public’s access to hospital peer reviews in medical malpractice suits. Sen. Ralph Alvara- people in those situations. Those long visits do, R-Winchester, said the bill is necessary to make it very difficult to see a doctor in a timely allow doctors to offer honest criticism of each manner.” other in a private setting without worrying that Rep. Mary Lou Marzian, D-Louisville, said their words later could be used as evidence in a telehealth care might not help residents from courtroom. the poorest rural counties where the physician Sen. Stephen Meredith, R-Leitchfield, spoke shortage is most acute. in support of the proposed legislation. “What do we do about folks in Kentucky in “I think you really have to look at the intent of really rural areas without access to broadband?” peer review,” he said. “It is to improve the quality she said. “How do we address those issues?” of care rendered to a community, not to provide The committee also discussed these proposed fodder for litigation.” bills: Lawyer Liz Shepherd, president of the Ken- tucky Justice Association, testified against the The “Midwifery Legislation in the Com- Rep. Mary Lou Marzian, D-Louisville, comments monwealth” proposal would certify practicing proposed legislation. on telehealth care during the July meeting of the midwives who are not registered nurses. Rep. “This proposed legislation protects a special Interim Joint Committee on Health and Welfare Addia Wuchner, R-Florence, said the measure class of people – hospitals and nursing homes and Family Services. would create a certified professional midwives – from the truth,” she said. “The proposed leg- council under the Kentucky Board of Nursing. islation would shield the facts from what really Keith Johnson, a certified public accountant The measure would require midwives to follow occurred from family members.” in Elizabethtown who has multiple sclerosis, tes- public health reporting laws concerning diseases Alvarado responded to Shepherd by pointing tified that a tax credit in the current fiscal envi- and vital statistics in addition to make midwifery out that 49 other states extend a legal privilege to ronment might not be popular but a limitation illegal, in most instances, for those who are not medical peer review so that someone who sues could be placed on the dollar amount any one licensed. a doctor cannot subpoena statements made by person receives or the state gives out in any given May Kathryn DeLodder of the Kentucky colleagues during the review process. year. Home Birth Coalition testified that there are – at “What we are proposing in this bill is very “There are ways to manage the costs,” he said. the most – four registered nurse midwives who similar to lots of other states in the country Wuchner, who chaired the meeting, said all are attending home births in Kentucky. She said where lawyers seem to do very well in discover- the issues discussed had been brought up in pri- the other about 85 registered nurse midwives ing information you claim is going to be hidden or sessions, but legislators couldn’t come to a practice exclusively in hospitals. by this legislation,” Alvarado said. consensus on how best to act. “That leaves the majority of Kentucky’s 700 The “Livable Home Tax Credit Program” “This is the time to work out the issues during annual home births in the purview of other mid- proposal would provide a tax break for people the interim and bring light on them and see what wives,” DeLodder said of the midwives that the with multiple sclerosis who need to modify their we need to get cleared up,” she said. “We are in proposed legislation seeks to regulate. “These houses with such things as wheelchair ramps and the process of doing exactly what we need to do walk-in showers. during this interim process.” Cities, from page 1 his response to local tax reform is “yes, please.” mentioned the 2014 General Assembly changed “I can’t levy an occupational tax in Sadieville. With only 332 residents, Sadieville doesn’t have the way cities are classified under state law, with By statute, I’m prohibited from doing that,” said much tax revenue. And it’s not alone: Most of all cities now falling under two classifications – Christensen. “So we’re limited.” Kentucky’s cities, or 52 percent, have fewer than first-class (Louisville) and Home Rule (all other Christensen said he wants to partner with the 1,000 residents, said Christensen. cities)—instead of the previous six. The change General Assembly as both a small-town mayor Another issue raised was city-county reve- removed what KLC has called the “restrictions and KLC President to level and improve the local nue-sharing. Watson said he would like to see and red tape” of the old classification system to tax structure. more on that front, although Committee Co- help all cities while safeguarding certain privileg- “So if your question today for me, at least, chair Rep. Michael Meredith, R-Brownsville, es the old system gave smaller cities. is what we need in small towns, we need you cautioned against General Assembly involve- “It’s an economy of scale,” said Bowen. to trust us. We have adding machines and cal- ment in such situations. Still, Watson and Christensen see room for culators, we have smart people, we have capable “I think it’s a city-by-city, county-by-coun- improvement. Owensboro is still prohibited people to manage money,” said Christensen. “We ty kind of situation that probably we don’t, as a from levying a restaurant tax. Only cities clas- need flexibility.” General Assembly, need to step into because it is sified as fourth or fifth class cities as of January Meredith reassured the mayors that provid- really a case-by-case basis,” said Meredith. 2014 can do that. And Sadieville, a former sixth- ing more local flexibility is part of discussions at Committee Co-chair Sen.