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From YouTube: Budget Review Subcommittee on Human Resources (11-16-21)
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A
View
subcommittee
on
human
service
21
so
hope
you
people
understand
you're
very
special,
that
you're
on
our
agenda
for
today.
So
we
look
forward
to
hearing
from
you.
Members
were
provided
with
zoom
length,
access,
medium
remotely
and
many
materials
were
put
online
earlier
this
week
and
made
available
for
downloading.
At
this
time.
We'll
have
the
secretary
call
the
roll
senator
members
you
need
to
indicate
whether
you're
present
in
person
remote
from
the
district
or
remote
from
office.
Thank
you.
A
Next,
we
have
approval
of
the
minutes
from
the
october
6th
meeting.
Do
I
hear
a
motion
for
a
second
all,
those
in
favor
say:
aye
opposed
vote.
No
minutes
are
approved.
Thank
you.
We
have
a
very
heavy
agenda
this
morning
in
this
meeting
will
always
precedes
our
appropriation
revenue
committee
meeting
at
one
o'clock,
so
we're
going
to
try
to
be
out
of
here
by
12
30,
give
folks
a
chance,
an
opportunity
for
lunch
before
we
go
into
that
one
o'clock
meeting.
A
So
to
that
end,
I'd
ask
our
presenters
if
you
would
to
limit
your
presentations
to
no
more
than
than
20
minutes
and
I'll
leave
us
a
few
minutes
for
our
questions
and
answers.
But
with
that
I
just
want
to
remind
those
participating
remotely.
Please
remember,
to
meet
your
microphones.
This
morning
we
have
a
presentation
from
mckenzie
longorium,
with
the
alzheimer's
association
regarding
the
status
of
services
for
individuals
with
convention
and
funding
for
those
services.
H
It's
becoming
a
little
too
routine,
I
think,
good
morning.
Everyone
I
also
will
be
much
shorter
than
20
minutes.
I
don't
think
I'll
need
that
much
time
today,
senator
meredith
chairman
meredith
members
of
the
committee-
thank
you
all
so
much
for
allowing
me
to
have
some
time
today
what
I'm
going
to
be
talking
about
today.
H
Most
of
you
already
heard
about
and
actually
voted
on
last
year,
it's
a
bill
that
I
worked
on
with
senator
alvarado,
the
senate
bill
74,
the
dementia
services
coordinator
position,
so
I
just
want
to
give
a
little
bit
of
background
or
refresher
on
what
that
bill
was
and
what
it
accomplished.
And
then
you
know
why
I'm
here
today
to
get
it
sort
of
to
the
next
step
in
the
process
that
we
are
hoping
for.
H
So
just
as
a
brief
reminder,
senate
bill
74
was
geared
towards
doing
some
revamping
and
fixing
up
of
an
office
that
has
been
in
existence
in
the
state
for
more
than
two
decades,
but
has
not
been
staffed
or
funded.
So
there
was
an
office
that
was
created
the
office
of
alzheimer's
disease
and
related
disorders.
It's
a
mouthful.
It
was
created
over
two
decades
ago
again,
as
I
stated,
and
there
was
a
corresponding
alzheimer's
disease
and
related
disorders,
council
or
just
ad
council,
which
is
much
easier.
H
So
while
that
was
great
good
intentions,
unfortunately,
the
office
remained
unfunded
and
without
staffing
for
the
entirety
of
this
time
period.
So
what
I
wanted
to
accomplish,
with
senator
alvarado,
was
doing
some
cleanup
on
that
office.
Changing
things
around
a
little
bit
articulating
some
better,
better
duties
about
what
we
wanted
this
office
and,
more
specifically,
an
individual
to
do
as
well
as
making
some
changes
to
the
makeup
of
the
council
and
putting
some
mandatory
updates
in
place
for
the
state
plan.
H
So
our
concept
was
to
create
an
office
of
dementia
services
and
within
that
to
have
one
person
sort
of
our
dementia
services
coordinators.
What
we
sort
of
call
this
position-
and
it
exists
in
11
other
states
at
this
point
too,
so
that
was
sort
of
our
background
for
how
we
approach
this
change
to
the
office.
So
again,
a
few
changes
to
the
office
changing
the
name
establishing
more
of
this
sort
of
staff
position.
H
Doing
some
changes
to
the
membership
of
the
council,
making
sure
that
we
had
some
more
representatives
from
the
long-term
care
industry.
We
noticed
that
there
were
some
absences
and
gaps
there,
as
well
as
some
a
need
from
some
more
caregiver
perspectives
and
some
consumer
advocacy
advocate
perspectives.
So
we
added
those
as
well
and
then
finally,
it
ensured
some
changes
to
the
state
plan.
H
But
without
staff.
Without
a
real
functioning
office,
it
has
really
fallen
on
the
shoulders
of
the
department
for
aging
and
independent
living,
and
specifically,
I
must
give
credit
to
marnie
mountjoy
over
at
dale,
for
she
has
really
been
keeping
the
state
plan
and
any
semblance
of
an
active
ad
council
alive,
in
addition
to
all
of
her
other
duties
that
she
does
over
at
dale.
H
So
that's
really
just
some
background
on
what
senate
bill
74
sought
to
achieve,
and
what
I
also
wanted
to
do
then
is
just
provide
a
little
bit
of
reasoning
behind
why
this
position
is
so
necessary
before
I
sort
of
make
my
case
for
why
it
needs
to
be
funded
indefinitely.
H
Realistically.
The
reason
this
position
is
so
needed
is
because,
as
with
many
states
in
kentucky,
it's
a
very
fragmented
system
of
care,
so
we
lack
a
lot
of
coordination
amongst
agencies
amongst
even
agencies,
and
then
you
know
public
sector,
consumer
advocacy
groups
that
provide
caregiving
services
like
us
and
aarp
our
aaa's.
H
It's
all
sort
of
very
scattered
the
the
lack
of
a
sort
of
point
person
in
state
government
to
oversee
dementia
services
and
supports
can
really
help
our
caregivers
of
which
there
are
about
200
000,
if
not
more
here
in
kentucky
alone,
it
can
really
help
these
individuals
navigate
the
care
process
better,
which
means
better
care
outcomes
for
individuals
living
with
the
disease,
roughly
80
000
kentuckians
that
currently
have
a
diagnosis
of
alzheimer's
or
dementia,
and
it
can
also
help
keep
these
individuals
in
their
home
and
communities
longer
rather
than
having
to
force
these
people
into
you
know
a
nursing
home
which,
of
course,
is
at
a
great
cost
to
the
state.
H
You
know
maybe
30
000
a
year,
if
not
more,
to
keep
those
individuals
in
a
facility
versus
keeping
them
home
and
safe
in
their
communities,
and
all
of
you,
as
members
of
health
of
welfare,
have
heard
this.
You
know
spiel
from
me
before,
so
without
a
person,
though,
to
really
help
coordinate
some
of
those
services
help
lay
people
navigate.
How
confusing
medicare
medicaid
is
what
state
programs
we
have
may
have
available
the
difference
between
their
private
insurance
and
qualifying
for
medicaid?
H
That's
working
on
those
recommendations
within
the
state
plan,
and
I
think
one
of
the
biggest
things
too
is
that
we're
potentially
missing
out
on
millions
of
dollars
that
are
out
there
floating
around
from
the
federal
government
and
those
come
in
the
form
of
grants.
Different
funding,
opportunities
that
are
specifically,
you
know
supposed
to
be
implemented
in
states
and
that
are
out
there
up
for
grabs
in
order
to
improve
alzheimer's
and
dementia
services
and
supports
infrastructure.
H
It's
just
really
not
feasible
to
try
and
bring
some
of
those
federal
dollars
into
the
state
and
just
as
an
example
of
this
is
just
again
one
out
of
11
states
now
that
are
in
the
process
of
implementing
this
virginia
established
their
dementia
services
coordinator
back
in
2015,
and
since
that
point
in
time
they
have
brought
in
over
five
million
dollars
into
the
state
to
improve
their
dementia
care
services.
H
So
a
lot
of
the
states
that
you
see
that
have
began
to
have
implemented
this
position,
they're
starting
to
get
some
of
these
federal
dollars
and
they're,
seeing
some
real
increases
in
their
quality
of
care
outcomes.
H
Just
to
note
a
few
of
them
would
include
again
virginia
georgia,
illinois
new
mexico
and
texas
currently
are
working
on
the
implementation
of
their
position
as
well.
So,
obviously
you
know
the
senate
bill.
74
passed.
We
had
unanimous
support.
It
was
fantastic,
very
grateful,
the
cabinet,
the
department
for
aging
and
independent
living.
They
have
been
able
to
fund
the
position.
We
have
hired
someone
jennifer
craig
she's,
fantastic
tons
of
experience
in
the
field,
exactly
the
type
of
person
that
we
want
to
have
in
this
role.
All
of
this
is
great.
H
The
department
has
received
a
grant
which
is
enabling
them
to
fund
this
position,
but
unfortunately,
likely
only
for
one
year,
maybe
with
pinching
some
pennies
and
stretching
some
dollars
for
two
years.
Obviously
a
year
on
the
job
isn't
really
enough
for
anyone
to
make
a
real
impact
or
difference.
I
mean
I've
been
here
three
and
a
half
years,
and
I
still
don't
know
what
I'm
doing
half
the
time.
H
So
I
don't
really
think
giving
someone
a
year
to
try
and
get
their
feet
wet
and
make
some
real
differences
in
this
space
is
enough
time
and,
of
course,
the
uncertainty
of
not
knowing
if
your
job
is
going
to
continue
is
troublesome
for
that
individual.
H
I
think,
in
a
situation
where
perhaps
this
was
a
position
that
is
temporary
in
nature,
so
perhaps
a
grant
using
grant
funding
to
bring
someone
in
to
maybe
study
some
specific
impacts
of
covid19
on
a
certain
population
right
that
you
can
understand
that
being
a
temporary
position
in
nature,
but
I
believe
to
really
see
the
full
benefits
of
this
position
to
invest
in
the
front
end
and
then
see
massive
economic
benefits
on
the
back
end
again,
everything
from
you
know
looking
at
our
services
in
the
state.
Where
are
there
gaps
in
services?
H
Maybe
where
our
service
is
duplicative,
so
maybe
where
we
could
save
money,
because
you
know
you
have
two
things
essentially
accomplishing
the
same
issue.
Maybe
departments
aren't
talking
to
enough
each
other
enough
about
what
services
we
even
have
available
for
individuals
with
this
disease
and
their
caregivers
there's
just
a
lot
of
benefits.
I
think
from
an
economic
standpoint
to
having
this
position
fully
funded
indefinitely.
H
So
it
is
for
that
reason
that
I
am
hoping
to
ask
that
this
position
be
included
in
the
cabinet's
budget
ongoing
so
that
we
know
that
this
position
is
secure
and
that
can
it
achieve
all
of
the
different
outcomes
that
we
hope
it
will
achieve,
and
I'm
sure
everyone
now
is
wondering,
of
course.
How
much
are
we
looking
at?
What's
the
request
with
the
combination
of
salary
and
benefits,
this
is
the
number
I
received
from
dale.
A
Excellent
job,
as
always
appreciate
it
and
a
couple
of
epiphanies
I've
had
during
this
interim
session
specific
to
appropriations.
Revenue
is
sometimes
we
don't
recognize
the
costs
associated
with
doing
nothing,
and
usually
it's
quite
substantial
and
the
other
being
that
a
lot
of
people
will
present
and
say
that
if
we
do
this,
we'll
save
this.
A
But
we
don't
do
a
good
job.
If
we
do
it
all
of
documenting
the
savings,
but
I
don't
think
that's
anybody's
fault.
It's
just
that
almost
every
service
that
we
provide
in
the
state,
I
think,
can
make
the
argument
that
they
are.
They
need
more
funding
and
when
they
realize
those
savings,
then
those
are
just
used
offset
the
shortage
of
funding
that
they
haven't
received.
A
So
we
never
really
see
that
full
benefit
of
those
savings,
but
that's
just
something
we
have
to
accept,
but
I
think
your
position
is
well
stated
and
I
appreciate
your
position
with
that-
will
open
this
up
for
a
question
and
we'll
go
with
those
presents
in
the
room
first
and
then
those
who
are
participating
remotely.
Please
use
the
chat
function.
The
staff
will
notify
us
of
your
question
start
with
the
representative
westrom.
I
I
Well,
thank
you
for
bringing
this
to
our
attention.
We
would
bear
responsibility
if
it
were
placed
in
a
budget
nor
removed,
but
it
was
never
placed
in
a
budget.
Please
don't
let
this
session
get
by
without
making
sure
by
yelling
at
us
that
we
we
need
to
make
absolutely
positively
certain
that
this
isn't.
F
We
were
you
know
every
session,
every
meeting,
and
this
was
during
two
interims
ago
right,
the
numbers
of
folks
faced
with
alzheimer's
and
dementia
and
how
that
number
is
growing
enormously
and
with
life
expectancies
increasing,
is
going
to
continue
and
continue
and
continue
to
grow
and
so
to
to
chair
meredith's
point.
You
know
the
costs
associated
with
doing
nothing
and
then
coupling
that
with
the
number
of
individuals
and
the
number
of
families
that
would
be
affected
by
doing
nothing,
it's
just
it's
very
sobering.
So
thank
you
so
much.
Thank
you.
E
Thank
you,
mr
chair.
Thank
you
as
always
for
bringing
this
information,
and
we've
worked
hard
to
make
sure
that
this
coordinator
position
is,
I
it's
been
in
the
cabinet
for
a
while.
It
hasn't
been
funded.
We
put
in
statute
last
year
to
to
ensure
that
this
position
is,
is
funded
or
is,
is
actually
implemented.
The
cabinet
assured
us
that
this
would
be
an
internal
kind
of
readjustment
and,
and
would
be
these
costs
could
be
absorbed
by
the
cabinet.
So
how
do
we
as
legislators,
because
we
don't
appropriate?
E
I
mean
we
appropriate
funds,
but
we
don't.
We
don't
have
line
item
kind
of
jurisdiction
over
what
the
cabinet
funds,
how
do
we
hold
their
feet
to
the
fire?
You
know
I
mean
it.
They
they
have.
It
looks
like
hired
someone
to
work
on
this
issue.
E
H
Well,
I
personally
wouldn't
like
to
see
it
funded
through
grants
again.
I
just
think
that
can
be
temporary
in
nature
and
I'm
just
using
that
as
yeah
sure
I
mean
I
think,
especially
with
the
hiring
of
jennifer
craig.
H
She
really
is
a
fantastic
individual
with
all
of
the
backgrounds
and
experience
that
we
want,
and
I
would
worry
you
know
without
securing
the
position
we
wouldn't
be
attracting
or
if
it's
and
in
any
way
it
could
be,
you
know,
impacted
by
a
grant
cycle
or
what
have
you
that
we
wouldn't
be
able
to
retain
her
or
attract?
H
You
know
the
type
of
individual
that
we
want
for
the
position.
I
make
no
qualms
about
being
a
budget
expert
or
an
appropriations
expert,
so
I
don't
necessarily
know
what
the
specific
answer
is
to
say.
H
E
A
Representative
mosher,
I
might
offer
that
giving
our
mutual
understanding
of
what
the
chemist's
commitment
was
supposed
to
be
and
I'm
not
challenging
them.
It's
just
to
get
it
verified
for
this
next
budget
cycle.
That
may
be
a
letter
from
from
you
senator
alvarado
and
representative
bentley,
and
I
saying
here's
our
understanding.
Can
you
can
you
verify
that
for
us,
if
not
we'll
have
to
make
it
a
appropriation
within
the
budget,
but
I
mean
that's
the
starting
point
just
to
make
sure
that
they
are
committed.
J
Thank
you.
Thank
you
just
piggybacking
on
on
that,
mr
chairman,
so
you
know
this
is
a
good
bill.
We
knew
it
was
important.
I
know
other
states
that
we've
talked
about
what
we're
trying
to
do
to
help
improve
diagnosis,
identifying
grants
developing
a
state
plan
for
the
state
when
it
comes
to
dementia,
and
this
is
what
other
states
have
done,
that
successfully
have
done
so
and
again,
just
what
trevor
and
moser
had
said,
we've
had
meetings
with
the
secretary
who
told
us
yeah.
This
is
important.
J
We
know
needs
to
be
done,
we're
going
to
find
a
way
to
fund.
This
is
what
he
assured
us.
So
there
are
pockets
of
money.
Mr,
mr
chairman,
things
that
I
I
don't
know
that
we
should
be
using
medicaid
dollars
for
that.
We
are
using
it
for
like
advertisements,
seven
million
dollars
worth
of
advertisements,
hot
air
balloons
in
louisville
cartoons
on
television.
J
You
know,
115
000
out
of
that
probably
won't
affect
a
couple
less
cartoons
on
tv.
They
can
use
a
fun
something
that
will
really
impact
people's
lives,
delivery,
better
care
for
years
to
come
more
than
a
few
advertising
dollars.
So
maybe
there's
a
way
of
putting
budget
language
and
saying
some
of
that
needs
to
be
diverted
towards
this
position
long
term.
I
think
that
might
be
a
good
way
to
do
it,
but
thank
you
very
much.
I
always
appreciate
your
testimony.
G
Thank
you
very
much
chair
chairman
meredith.
I
just
want
to
tell
mckenzie
thank
you
so
much
for
for
what
you're
doing
here,
the
old
adage
when,
when
you
don't
have
anybody
in
charge,
nothing's
going
to
get
done
and-
and
I
think
you
pointed
that
out
greatly-
I
think-
to
have
somebody
a
point
to
work
on
those
grants
and
to
stay
actively
involved.
I
notice
there's
a
number
of,
and
the
question
goes
to
this
point.
There's
a
number
of
you
know:
alzheimer's
facilities.
G
We
have
one
here
locally,
that
those
things
can
be
five
to
six
to
ten
thousand,
sometimes
a
month,
to
try
to
take
care
of
folks.
So
the
idea
that
you
would
be
working
towards
keeping
people
home
longer-
I
know
medicare
has
some
for
the
most
part
will
cover
a
big
part
of
being
at
home
for
home
health
and
and
some
of
that
skilled
work,
but
when
they
get
into
a
facility,
this
designated
alzheimer
the
support
doesn't
get
anywhere
near
the
cost
of
what
it.
G
So
so
I
love
what
you're
doing,
and
I
would
hope
that
what
jennifer
and
I'm
sure
she
is
will
will
bring
in
these
a
lot
of
these
private
facilities,
alzheimer's
facilities
across
the
state
and
bring
those
guys
to
the
plate
and
see
what
we
can
do
to
partner
up
with
those
guys.
Does
that
make
sense?
Maybe.
H
Yes,
absolutely
representative
sheldon,
and
I
think
just
also
to
your
point.
We
know
too
that
there
is
about.
I
think
this
is
the
right
figure,
428
million
in
our
fmap
funding
that
is
coming
to
improve
and
expand
our
home
and
community-based
services
in
this
state
and
reading
through
what
the
cabinet's
plan
was
or
our
department
for
medicaid
services.
H
I
think
it's
been
partially
approved
by
cms
reading
what
the
cabinet
has
in
plan
for
that
I
just
going
through.
That
saw
a
lot
of
opportunities
for
some
improvements
of
services,
some
training
of
caregivers-
and
I
you
know
having
a
person
in
state
government
too-
that
is
responsible
for
the
office
of
dementia
services
and
then
can
work
cross-functionally
with
dms
here
as
we're
adding
all
of
these
millions
of
dollars
from
our
fmap
funding.
A
Appreciate
your
presentation
on
this,
and
again
I
guess,
maybe
not
a
formal
recommendation,
but
go
back
to
centers,
alvarado
and
representative
moser
representative
bentley
that
possibly
the
next
step
for
us
is
to
write
a
letter
asking
the
cabinet
to
document
for
us
what
their
understanding
is
and
their
commitment
to
this
is,
and
if
not,
then
we
will
go
to
step
two.
I
think
which
would
be
a
a
line.
Item
appropriation
in
the
budget
so
appreciate
your
presentation
this
morning
and
look
forward
to
working
with
you.
H
J
Chairman,
if
I
might
I'll.
A
A
A
B
B
A
K
Proceed,
let
me
introduce
myself
again,
I'm
tom
miller,
I'm
the
ceo
for
uofl
health,
and
we
appreciate
the
opportunity
to
come
and
present
to
you
kind
of
our
second
year.
We
have
completed
our
second
year
of
operations
as,
u
of
l
health
this
past
week
and
and
I
think,
we're
proud
of
what
we
have
done.
We
serve
patients
in
all
120
counties
throughout
the
commonwealth.
K
We
have
12
000
associates
who
are
our
team
members
in
our
health
system,
and
that
includes
over
a
thousand
providers
in
our
health
system.
We're
kentucky's
only
dedicated
burn
center,
we're
one
of
only
two
level.
One
trauma
centers
in
the
state
of
kentucky
we're
one
of
two
organ
transplant
centers
throughout
the
state,
and
we
provided
care
to
over
1.5
million
patients
this
past
year.
K
If
you
go
to
page
two
on
our
slides,
what
you'll
see
is
that
we
have
about
250
locations
across
the
seven
county
area
around
the
louisville
community
and
we're
very
proud
of
that
ken.
This
is
working
now
you'll
go
to
the
second
page
and
we're
very
proud
that
we
service
a
broad
community,
both
locally
and
regionally
and
nationally.
K
You
know
one
of
the
criteria
that
was
asked
of
us
on
page
three.
If
you'll
go
forward,
was
focus
on
bringing
access
to
the
medically
underserved
areas
in
our
community
and
we
expanded
five
urgent
cares,
which
we
call
them
urgent
care
pluses
because
they're
urgent
care,
plus
primary
care
offices,
so
that
if
you
need
urgent
care,
you
can
receive
that.
But
if
you
want
a
term
relationship,
there
are
primary
care
doctors
there
we
recruited
143
doctors
last
year
to
our
health
system.
K
We
invested
50.
We
are
planning
on
investing
50
million
dollars,
not
including
kedfa
money
to
open
up
a
hospital
in
bullitt
county
bullitt
county
is
the
10th
largest
county
in
the
state
without
a
hospital,
and
it's
our
goal
to
open
up
that
hospital
and
begin
the
construction
online
later
this
year,
and
then
we've
invested
115
million
over
the
last
two
years
back
in
our
health
care
facilities.
So
we've
tried
to
meet
the
needs
of
the
underserved.
K
I
do
want
to
thank
you.
I
want
to
thank
you
for
expanding
access
through
telehealth
house
bill
140,
making
telehealth
medicine
regulation
changes
permanent
has
been
very
helpful
to
us.
We
were
doing
about
30
telehealth
visits
a
month
prior
to
covid
and
we're
doing,
on
average,
now
about
4
000
a
month
and
developing
telemedicine
access
opportunities
for
the
rural
healthcare
and
how
how
we
use
it
for
stroke
patients
in
these
in
rural
hospitals
who
these
hospitals
are
trying
to
determine
whether
they
need
more
advanced
levels
of
care.
K
If
you'll
go
forward
on
the
next
slide,
you
know
we
are
university
of
louisville
health
is
the
safety
net
health
care
provider
for
our
community
and
it's
hard
to
talk
about
the
last
two
years.
Without
talking
about
the
pandemic,
we
went
through
a
fourth
wave
of
cova
19,
which
had
a
significant
impact
on
our
hospitals.
We
had
as
high
in
august
of
162
patients
within
our
facility
that
were
covered.
K
K
We
partnered
with
churches
and
local
community
groups
to
make
sure
that
everybody
had
access
and
what
you
see
on
this
graph
in
the
circled
area.
This
is
the
west
louisville
community
and
you'll,
see
where
the
heavily
shaded
areas
that
people
receive
vaccinations,
and
that
was
a
focus
on
from
our
standpoint.
K
Our
facilities
were
running
all
summer
long
30
patients
above
our
bed
capacities.
We
were
holding
patients
in
our
ers
overnight
and
we
had
this
mentality
that
we
would
never
say.
No,
we
got
calls
from
almost
every
hospital
in
the
state
of
do.
You
have
availability
to
take
care
of
patients
because
they
were
full.
K
We
took
the
position,
we
will
never
say
no,
except
we
did
say
no
to
louisiana
and
to
arkansas
who
wanted
to
transfer
patients
to
us,
but
we
never
said
no
to
anybody
in
the
state
of
kentucky
who
needed
access,
and
I
just
have
to
say
the
term.
Healthcare
heroes
is
a
term
that
was
used
a
lot
last
year.
It
hasn't
been
much
use
this
year.
K
From
a
financial
standpoint,
you
will
see
the
first
eight
months
from
november
first
1st
through
june
20th
2020
and
the
21
and
from
information-
and
you
know
we
have
been
successful
financially.
The
first
year
is
an
eight
month
period,
but
it
also
shows
some
of
the
acquisition
of
the
assets
of
of
kentucky
one
that
we
had
to
put
on
our
books,
but
but
we,
our
net
income,
was
95
million
dollars.
Last
year.
K
We
took
care
of
almost
a
third
of
our
patients,
were
either
medicare
or
self-pay,
which
is
a
tremendous
number
for
for
our
hospitals,
our
fdes.
We
have
a
commitment
through
the
capital
loan
of
58.80.
We
rose
to
7
900
ftes
this
past
year.
A
lot
of
that
was
taking
on
services
that
were
outsourced
with
kentucky
one
and
bringing
those
back
to
louisville,
and
our
business
office
and
rit
functions
associated
with
it,
and
we
did
achieve
our
average
hourly
rate.
K
You'll
see
some
differences
associated
with
the
rates
from
year
to
year,
and
that's
because
of
additional
people
that
we've
added
on
in
our
business
office
functions
and
and
our
admissions
last
year
were
41
41
000
a
little
over
41
000,
and
so
it
was
a
successful
financial
year
for
us.
We
were
able
to
achieve
everything
we
outlined
that
we
would
do
in
in
this
acquisition.
As
you
know,
the
acquisition
was
initially
losing
50
million
dollars.
The
university
was
concerned
about
taking
on
the
responsibility
associated
with
it.
K
We
would
have
been
in
a
very
difficult
con
position
if
jewish
hospital
would
have
closed
down.
They
ran
as
high
as
320
patients.
This
summer-
and
there
was
no
place
in
our
city
to
take
care
of
those
patients
anywhere
else
at
that
hospital
closed
down,
and
so
I
want
to
thank
you
for
your
trust
in
us,
and
and
thank
you
for
the
commitment
that
we've
made
and
that
that
the
university
made
in
us
and
the
local
foundations
have
made
in
us
because
they
follow
through
with
their
words.
K
If
we
talk
about
the
kedf
alone,
just
to
remind
you,
it
was
a
35
million
dollar
loan
that
was
provided
to
us
17
and
a
half
million
of
that
would
have
to
be
paid
back
over
20
years
with
the
one
percent
interest
rate
and
the
first
payments
are
made
in
2024.,
we
used
the
35
million
dollars
we
outlined
in
our
annual
report
of
all
the
items
that
we
use
it
on.
K
We
use
it
to
reinvest
back
in
our
facilities
to
make
sure
that
we
have
the
opportunity
to
take
care
of
our
patients
as
we
look
forward
we're
focusing
on
new
growth,
supporting
rural
health
by
adding
60
beds
of
uofl
health
medical
center
south,
which
is
in
bullitt
county
building.
A
40-bed
rehab
hospital
which
we
broke
ground
on
yesterday,
with
a
partnership
with
kindred
plans,
are
underway
to
improve
uofl
health's
primary
teaching
site
we're
adding
additional
adult
psych
program
to
medical
to
mary
and
elizabeth
hospital.
K
This
past
year,
we've
really
focused
on
making
sure
that
our
hospitals
were
the
community
hospitals
for
our
community,
so
shelby
hospital,
which
at
one
point
in
time,
was
considered
a
band-aid
station,
and
I
don't
mean
that
negative
to
them,
but
more
patients
were
transferred
out
than
came
to
their
emergency
room.
We
focused
on
adding
a
six
bed
icu
and
recruiting
additional
specialist
in
that
community
and
when
we
took
them
over,
they
had
an
average
census
of
two.
K
Today
they
were
running
18
patients
in
their
hospital,
which
is
just
tremendous
and
their
surgeries
have
tripled,
and
we're
able
to
try
to
keep
those
people
in
that
community.
Mary
and
elizabeth.
We
added
a
24
7
stemi
program
for
the
interventional
cardiac
program:
brown
cancer
center.
We
expanded
to
two
additional
sites
to
take
academic
medicine
and
reach
out
more
into
the
community
associated
with
it.
We've
opened
additional
ors
and
trauma
volumes
have
hit
record
numbers
in
our
community.
K
Unfortunately,
a
lot
of
that
is
violence
in
the
community
and
and
where
the
hospital
would
take
care
of
all
those
patients
jewish
hospital.
We
opened
a
20-bed
general
psych
program
when
you
talk
about
alzheimer's.
This
is
part
of
the
area
that
we
believe
that
we
can
make
a
difference
on
jewish,
also
implanted
two
artificial
hearts,
which
was
another
world
first
for
jewish
hospital
and
from
a
quality
standpoint,
which
was
a
question
in
the
last
time.
One
of
our
hospitals
was
an
f.
K
You
know
we
continue
to
meet
and
exceed
all
the
conditions
of
the
kedful
loan
and
we've
sent
that
in
our
report
we've
used.
The
proceeds
alone
are
spelled
out
in
the
letter
that
we
have
and
we've
outlined
every
single
thing,
and
and
because
we
have
been
able
to
achieve
the
items
that
we've
had,
and
you
had
trust
in
us
we're
in
discussions
with
the
cabinet
to
amend
the
terms
of
the
loan
to
allow
for
accelerated
payments
back
and
with
that.
Thank
you
very
much
for
your
trust
in
us.
A
I
have
one
possibly
a
couple
looking
more
long-term,
I
have
to
admit
that
when
we
talk
about
medically
underserved
area,
I
really
didn't
envision
that
applying
almost
specifically
to
the
greater
metropolitan
area,
16
counties
within,
what's
considered
greater
louisville.
I
guess
I
have
a
more
of
a
global
vision.
A
Why
do
you
see
the
division
for
uofl
health
say
five
ten
years
from
now
and
the
reason
I
ask
it,
it's
it's
based
on
part
of
representative
bentley's,
comment,
sure
why
why
you
folks
are
really
showing
up
again
the
the
healthcare
delivery
system
within
that
16
county
area?
Well,
maybe
it's
less
next,
we,
I
guess
we
don't
count
indiana
specifically,
but
while
that's
being
bolstered
being
supported,
we
have
a
real
health
care
relations
throughout
the
rest
of
kentucky.
A
That's
struggling
mightily
and
I
would
hope
that
the
university
of
louisville
health's
vision
encompasses
more
than
just
that
immediate
geographic
area,
and
what
do
you
do
for
the
the
far
ends
of
the
state?
Or
do
you
see
that's
part
of
your
mission?
If
it's
not,
I
understand
that,
but
just
would
like
to
understand
what
the
future
looks
like.
K
I'll
try
to
identify
that
in
several
ways.
One
is
from
the
university
standpoint.
The
university
has
accelerated
programs
out
for
moving
family
practice
residencies
out
into
the
rural
communities,
and
so
I
think
they
have
three
of
those
programs
now
and
they're
reaching
out
to
do
more
of
those.
So
I
do
think
there's
the
opportunity,
because
the
number
one
I'm
a
real
hospital
ceo.
K
So
that's
what
I
did
for
the
last
five
years
and
the
number
one
issue
is
having
doctors
in
your
community
that
live
there
and
work
there
and
stay
there,
and
so
the
ability
to
build
primary
care
into
those
communities
with
doctors
and
teach
them
there
and
be
a
part
is
a
key,
and
the
university
is
committed
to
continuing
to
do.
Do
that
and
we're
reaching
out
every
day
to
try
to
do
that.
K
From
a
health
system
standpoint
we
have
reached
out
to
every
rural
hospital
within
80
miles
80
miles
of
us
to
try
to
see
how
we
can
help
them
and
is.
Is
that
purchasing
supplies
cheaper?
Is
it
being
able
to
get
to
get
on
our
managed
care
contracts,
so
they
get
paid
better?
Are
there
recruitment
needs
that
we
can
help
with
within
the
university
in
the
516
residents
that
we
have
I've
reached
out
and
we
continue
to
meet
with
those
hospitals.
K
Some
are
have
relationships
with
other
hospitals
in
the
state,
whether
it's
uk
or
chi
or
baptist.
Others
are
free
standing
and,
if
there's
an
opportunity
for
us
to
help
them,
we
are
reaching
out
right
now
today
and
have
been
doing
that
this
year
to
see
what
we
can
do
to
help
them
with
their
circumstances
and
whatever.
That
is
we'll
be
glad
to
do
that,
and
that's
our
that's
our
regional
approach.
K
You
know
we
have
taken
care
of
patients
in
every
county
in
the
commonwealth
this
year,
and
so
when
I
got
a
call
from
greg
kaiser
at
three
rivers
hospital
saying
I've
got
five
people
in
my
ear
and
I
don't
I
can't
take
care
of
them.
You
know
that's
a
hundred
and
some
odd
miles
away.
We
said
yes,
we'll
take
those
patients
and
help
you
out
in
every
case.
We
do
that
most
of
what
we're
out
there
doing
is
the
tertiary
care
and
the
high-end
care
of
those
patients.
K
They
want
to
keep
their
local
patients
as
much
as
they
can,
but
when
they
get
overwhelmed,
we
are
there
for
them,
and
so,
as
we
look
going
forward,
I
hope
we
further
have
what
I
would
call
affiliation
relationships
with
these
hospitals
if
they're
interested
and
nobody
we're
not
talking
about
buying
them,
we're
just
talking
about
assisting
and
helping
them
in
what
they
need,
and
if
I
can
do
that
and
help
them
be
successful
and
keep
their
patients
in
the
community.
We've
done
a
lot,
and
so
that's
what
we're
reaching
out
to.
A
A
A
My
new
bff
and
part
of
the
conversation
was
hey,
we're
glad
to
have
a
relationship
with
you,
but
if
you
help
us
keep
our
primary
care
and
secondary
care
patients
that
we're
capable
of
taking
care
of
that,
you
have
all
the
rest
and
almost
without
exception,
I
get
eyes
that
would
start
rolling
and
even
one
said
now.
I
really
need
that
primary
care
as
well.
So
I
appreciate
you
saying
that
you
want
to
keep
those
those
patients
in
their
local
communities
and
I
think
that's
not.
A
It
certainly
improves
the
health
of
the
community,
but
also
the
financial
health
of
the
community,
and
what
concerns
me
most
at
this
present
point
of
time-
and
I
asked
this
question
in
our
last
medicaid
oversight
committee
meeting
and
it's
not
a
rhetorical
question:
why
would
anyone
choose
to
go
to
a
rural
community
to
practice
medicine
when
you
know
you're
going
to
make
25
to
30
less
than
the
urban
counterparts
with
a
sicker
population
and
more
non-compliant
population?
A
A
Is
it
worth
that
price
and
I
think
that's
the
big
challenge
we
have
ahead
of
it.
So
I
think
we
needed
some
serious
dialogue
about
this,
because
I
think
it
really
can
improve
the
health
of
our
state.
If
we
incentivize
people
to
go
to
rural
communities
and
and
stay
there,
you
know
a
lot
of
programs.
I
had
loan
forgiveness
as
well,
but
I
don't
think
that's
enough
this
day
and
time
to
keep
them
there
and
I
think,
maybe
my
small
hospital,
maybe
the
canary
in
the
in
the
coal
mine.
A
When
I
left
in
2013,
we
had
34
active
staff
physicians.
Today,
it's
less
than
16.,
and
I
don't
know
that
it's
getting
better
anytime
in
the
meantime
and
if
our
system
collapses,
which
I
think
there's
a
real
potential-
that
it
could,
you
folks
will
get
those
patients.
But
what
you're
going
to
get
is
an
overabundance
of
no
pay.
The
self-pay
in
the
medicaid,
which
can't
pay
the
bills-
and
that
was
part
of
jewish's
demise
to
begin
with.
K
Well-
and
I
would
give
you
examples
after
example-
but
I'll
use
cardiology
in
taylorsville
hospital,
they
can't
attract
a
full-time
cardiologist,
but
we
place
somebody
there
four
days
a
week
all
day
long
to
help
those
patients,
so
they
can
be
seen
in
that
hospital.
They
may
not
be
there
every
single
day
and
live
in
that
community,
but
if
we
can
help
patch
it
so
that
the
community
gets
the
need,
the
health
it
needs,
then
that's
great.
That's
where
we
can
make
a
difference.
A
C
Hello
guys,
thank
you
very
much.
I'm
sorry,
I'm
not
there
in
person
for
this
presentation.
I
wish
I
was
I
I
do
want
to
make
two
comments.
One.
I
think
that
uofl
has
just
done
an
amazing
job
over
the
pandemic,
responding
to
the
needs
of
the
community.
Here
I
have
never
been
prouder
of
the
uofl
health
care
system
than
I
am
at
this
point,
and
I
want
to
tell
you
I
will
be
very
honest
when
u
of
l
decided
to
take
over
jewish.
I
had
a
lot
a
lot
of
reservations.
C
You
know,
jewish,
I
don't
know
if
any
of
you
all
know
this,
but
my
father
was
chief
of
staff
at
jewish
hospital
years
and
years
and
years
ago.
I
grew
up
in
that
hospital.
I
loved
that
hospital,
but
it
was
losing
money
horribly
and
I
was
really
really
worried.
It
was
going
to
take
uofl
down
and
instead
I
think
that
uofl
has
done
an
absolutely
amazing
job
of
increasing
the
services
to
the
community
and
keeping
true
to
its
mission
senator
meredith.
C
I
think
that
one
of
the
things
that
that
we
can
look
forward
to
in
the
future
is,
as
we
train
more
and
more
of
our
own
local
physicians
here
from
kentucky
and
teach
them
what
opportunities
we
have
here
in
the
state
and
let
them
go
home
and
serve
their
communities
that
that
we
can
have
a
tremendous
impact
on
health
care
in
this
state.
I
just
want
to
say
thank
you
to
you
guys.
I
think
it
has
exceeded
my
expectations
far
beyond
anything,
I
could
have
imagined.
Thank
you.
E
Thank
you,
mr
chair,
and
thank
you
so
much
for
your
presentation.
I
just
want
to
applaud
all
of
you
at
uofl
for
the
work
that
you've
done,
in
keeping
your
promises
and
and
really
echoing
what
senator
berg
has
said.
I'd
like
to
kind
of
tag
onto
senator
meredith's
question
about
rural
health
and
really
what
your
plans
are
to
address
the
health
care
worker
shortage
you
touched
on
it.
E
We
have
some
programs
through
ahec
that
are
really
in
place
to
recruit
and
retain
healthcare
workers
and
and
really
the
hospital
systems
and
mcos
are,
are
really
the
the
entities
that
stand
to
benefit
from
you
know,
in
addition
to,
of
course,
all
of
us
in
bolstering
our
health
care
workers.
Do
you
have
a
plan?
I
would
really
like
to
see
some
sort
of
partnership,
even
a
p3
through
the
universities
and
the
mcos
to
better
fund
ahec
and
maybe
modernize
what
they're
being
what
they're
doing
right
now.
E
K
Let's
talk
about
the
healthcare
worker
shortage,
and
just
so
you
understand
where
we're
at
this
morning,
we
have
we're
about
500
nurses
short
from
what
we
need.
An
unfortunate
situation
which
causes
part
of
the
problems
are
many
of
our
nurses
are
deciding
to
be
travelers
and
go
work
in
other
parts
of
the
country
at
rates
four
or
five
times
what
we're
paying
locally.
K
They
don't
get
any
benefits
and
they
have
to
travel
away
from
their
home,
and
that
is
a
really
difficult
thing
and
we've
tried
to
increase
wages
to
be
more
competitive
to
what's
going
on,
but
the
best
way
we
can
do
this
is
through
the
schools
and
and
so
we're
supporting
the
university
in
regard
to
adding
additional
programs
so
that
we
can
bring
more
nurses.
K
In
I
mean
there
is
no
other
profession
that
you
can
leave
your
job
today
and
go
work
anywhere
in
this
country
tomorrow
than
being
a
nurse,
and
I
just
commend
them
for
that
work,
and
so
trying
to
expand.
The
schools
of
nursing
is
a
key
part
of
what
we're
focused
on
we've
also
and
even
if
they
doubled
their
size.
K
It's
not
going
to
fix
the
issue
in
this,
these
communities
for
years,
and
I
hate
saying
that,
but
I
think
that's
true:
we've
had
to
go
to
international
nurses
and-
and
we
have
hired
350
international
nurses
that
will
be
coming
over
the
next
few
quarters
into
louisville
in
order
to
try
to
meet
some
of
the
needs
and
so
anything
that
we
can
help
on
the
statewide
program.
K
Anything
we
can
do
with
the
schools
and
the
educational
processes
and
and
having
to
bring
people
in
from
throughout
other
countries
are
what
we're
having
to,
because
we
cannot
fix
this
problem
today.
I
can't
magically
open
up
and
train
train
people.
We
have
programs
that
we've
helped
establish
to
take
lpns,
to
make
marions
to
bring
retired
nurses
back.
We're
asking
our
staff,
though,
to
do
too
much
and
to
work
too
hard
and
that's
what
leads
to
burnout,
which
can
lead
to
some
of
these
problems.
A
G
Yes,
thank
you.
I
just
wanted
to
ask-
and
I
know
we've
talked
about
this
in
the
past,
but
I
I
wanted
to
remind
at
least
myself
when
it
comes
to
rural
health
care,
we're
we're.
Looking
to
you
know,
I
know,
there's
some
programs
within
medical
schools
that
encourage
graduates
to
go
practice
in
the
rural
settings
is
uofl
continuing
to
expand
that
or
involved
in
that
with
the
medical
school
and
and
believing
that
that
may
be
in
collaboration
with
the
ahec
concept.
Is
that
something
you
guys
are
doing.
K
It
is
something
the
school
is
doing.
I
believe,
they're
in
three
different
sites
in
rural
areas,
where
they're
doing
teaching
associated
with
it.
I
think
they
have
five
five
residents
out
there
in
some
of
these
sites.
Is
it
something
we
could
expand
more
we've
got
to
get
more
residency
programs
right
now.
As
you
know,
the
federal
government
has
capped
those
residency
programs
out
there
and
family
practice
is
in
great
need
of
expanding
those
programs.
That's.
G
Right
I
appreciate
that,
and
yet
I
I
do
remember
recall
that
being
an
issue
now
and
thank
you
so
much.
Thank
you
for
what
you've
done
here
with
this
money.
You've
made
believers
out
of
a
lot
of
people,
and
I
just
appreciate
it,
and
I
don't
even
think
we
were
supposed
to
start
measuring
a
lot
of
these
metrics
for
a
couple
years
and
looks
to
me
like
you.
You've
met
most
of
them
already,
so
we
we
appreciate
it
and
thanks
for
that
and
keep
reaching
out
in
our
rural
communities.
We
need
that.
I
I
just
wanted
to
say
that
I
remember
when
u
of
l
came
before
the
appropriations
and
revenue
committee-
and
that
was
a
huge
ask,
and
I
wasn't
convinced
that
there
would
be
this
type
of
success,
and
I
congratulate
you
on
that.
I
believe.
As
far
as
rural
healthcare,
I
worked
with
ahec,
recruiting
physicians
for
southeastern
and
our
our
med
students
are
graduating
and
they're
looking
for
a
thriving
community
where
they
can
be
safe
and
have
a
long-term
residency
for
their
families.
I
It's
very
very
difficult
to
change
a
community
overnight
if
we
could
just
find
some
way
to
magically
improve
the
lifestyle
and
the
opportunities
in
many
of
our
rural
areas
that
don't
have
a
tax
base
to
provide
any
luxuries,
and
until
we
get
down
to
that
level,
I
don't
know
how
we're
going
to
get
the
medical
personnel
that
we
need.
But
thank
you
for
what
you're
doing
and
thank
you
for
your
commit
commitment
and
understanding
the
needs
in
the
rural
areas.
F
Thank
you,
mr
chairman,
and
thank
you
for
your
report.
I'm
encouraged
by
the
the
progress
that
you're
making
I
just
want
to
echo
concerns.
I
love
my
rural
hospital
and
I
appreciate
your
attitude
of
saying
you
want
to
help
them
not
just
take
over
them.
Echo
the
ahec.
I
was
a
physical
therapy
student
who
went
through
ahex,
so
anything
you
can
do
in
those
healthcare
workers.
I
want
to
say
my
husband
is
one
of
the
faculty
at
the
owensboro
uofl,
owensboro
health
and
he's
enjoying
working
with
those
residents.
F
Anything
you
all
can
do
to
to
get
more.
Residencies
would
be
great.
I
also
wanted
to
say
thank
you.
My
brother
had
a
an
accident
coming
back
from
a
car,
a
truck
accident
coming
back
from
eminence
and
he
went
to
uofl
and
was
very
well
taken
care
of,
and
the
emr
my
husband
hates
the
mr,
but
the
emr
helped
his
primary
care.
Physician
in
shelbyville
know
what
was
going
on
with
him
and
help
with
continuity
of
care
once
he
was
done.
F
J
You,
mr
chairman,
appreciate
that
gentlemen.
Thank
you
for
your
presentation,
appreciate
all
the
information
good
work.
You
all
do
another
profession,
that's
a
high
demand
can
go
almost
anywhere.
These
days
are
physicians,
as
we
know,
so,
not
only
just
nurses
we're
starting
to
see
the
same
situation,
a
lot
of
burnout,
a
lot
of
reasons
for
burnout,
part
of
its
workload,
although
workload's
always
been
heavy
in
medicine
emr,
which
is
supposed
to
be
a
promise
of
making
things
more
efficient,
has
not
been
that
it's
been
more
burdensome.
I
know
it's
here
to
stay.
J
I
know
that's
how
we're
trying
we
think
we're
tracking
information.
There's
an
interoperability
problem,
that's
a
whole
another
discussion
for
another
time
that
needs
to
be
worked
on
and
we're
hearing
a
lot
of
things
about
residency
programs,
preceptor
tax
credits
for
res.
You
know
rural
physicians
or
nurses,
who
are
wanting
to
bring
in
medical
students
or
nursing
students
to
experience
rural
medicine
in
rural
areas.
We've
proposed
a
lot
of
those
bills
in
the
past
for
that
to
fund
residency
positions.
J
Our
trauma
network,
we
hear
from
our
hospitals
all
the
time
the
lack
of
funding
I'll
be
filing
a
bill
this
year,
very
similar
to
the
super
speeder
bill
that
we
saw
in
georgia
has
passed.
People
that
exceed
20
miles
over
the
speed
limit
has
collected
a
lot
of
money
there,
sadly
enough
in
georgia,
but
to
use
those
funds
particularly
to
fund
these
kinds
of
programs
and
to
defund
trauma
networks,
residency
positions
in
our
rural
communities,
preceptor
tax
credits,
acute
brain
injury
slots
for
a
waiver
which
are
very
expensive.
J
You
all
know
if
you're
close
to
frasier
hospital,
90
000
per
slot,
hoping
I
hope
it
doesn't
generate
enough
revenue
to
cover
those,
but
I
suspect
it
will
and
to
use
some
of
those
for
those
purposes.
I
do
have
two
questions
for
you.
First,
I'm
glad
that
you're
using
international
system,
I've
advocated
for
that
for
a
long
time,
a
lot
of
nurses
in
the
philippines
south
of
our
border,
who
are
very
good
at
what
they
do
well
trained.
J
Who
would
love
to
come
to
the
united
states
to
earn
the
kind
of
money
that
we're
paying
nurses?
Even
what
we've
been
used
to
paying
them
in
the
past,
because
it's
eight
times
what
they're
making
back
home
and
they're
very
qualified
people?
So
I'm
glad
to
hear
you
using
that.
But
two
questions.
Do
you
think,
first
of
all
have
you
you
think
that
the
nurses
that
we've
lost
to
agency
nursing,
who
are
now
doing
travel,
often
are
signing
two
three-year
contracts?
J
Do
you
think
you've
lost
them
for
a
while?
Was
the
window
of
opportunity
past
us
to
get
them
back
and,
secondly,
liability
issues
which
I
know
is
still
a
factor
for
recruiting
doctors,
recruiting
nurses
to
practice
in
the
state
you
all
right
against
the
indiana
border?
Could
you
comment
on
how
much
that
impacts
you
and
the
cost
that
it
impacts
your
hospital.
B
I
think
on
the
nursing
issue,
I
think
we've
lost
some
people
out
of
the
workforce.
I
mean,
I
think
the
the
last
two
years
have
been
difficult
for
those
who
are
at
the
front
lines
and
we're
starting
to
see
the
the
results
of
burnout
on
that.
B
K
Have
the
opportunity
to
bring
them
back
at
that
point
in
time,
so
we
keep
in
communication
with
them,
but
we're
not
we're
not
losing
them
forever.
I
don't
believe.
B
And
I
think
there
are
two
things:
there's
there's
you
know
we
work
you
know,
especially
within
the
the
metro
area,
with
a
finite
number
of
resources
when
you're
and
it's
not
just
nurses,
it's
rehab,
it's
respiratory
therapists,
it's
all
those
allied
health
plus
plus
nursing
and
physicians,
it's
a
finite
number
and
to
really
move
this
needle.
I
think
that
the
pipeline
has
to
be
bigger
to
get
more
of
the
graduates
out
and
into
practice,
and-
and
I
think
that's
we
want
to
see
something
move.
That's
when
that's
going
to
happen.
J
J
You
wind
up
and
I'm
a
case
in
point
right,
I'm
a
california
kid
came
to
kentucky
got
kentucky
fight
once
I
got
here,
fell
in
love
with
the
state
and
I've
stuck
around,
and
here
I
am
doing
what
I'm
doing
now
and
I'm
still
practicing.
So
we
need
to
attract
more
folks
because
once
they
come
here,
they
get
some
roots
down.
They
like
it.
They
build
their
connections,
they
stick
around
for
that
long
term
and
some
of
the
things
that
we're
talking
about
are
things
so
that's
good
to
hear.
J
I
mean
we've
been
advocating
during
a
special
session
that
just
passed
for
funding.
We
didn't
get
a
response
from
the
governor's
office
on
that.
If
there's
still
an
opportunity
to
get
them
back,
that's
something
we
need
to
look
at
to
help
bolster
for
recruitment
and
retention
of
that
staff
and
if
you
could
comment
on
liability
and
how
much
of
a
factor
that
is
for
you.
Let
me.
K
Address
residency
for
a
second:
we,
our
health
system,
agreed
to
expand
and
pay
for
the
20
additional
residency
slots
this
year
and
that's
just
to
come
out
on
our
part
to
try
to
reach
out
further.
But
that
needs
to
be
addressed
and
there's
discussion
that
will
be
addressed.
K
I
think,
on
the
library
standpoint
we
have
a
self-funded
captive
ourselves
and
so
we've
been
able
to
to
manage
within
our
captive
and
and
been
successful,
not
seeing
huge
swings,
although
the
the
systems
are
hardening
up
again
in
so
many
different
areas,
but
it's
not
at
a
critical
point
today,
but
it
is
hardening
up
to
get
insurance
and
particularly
to
get
reinsurance
associated
with
it,
but
the
the
years
of
10
years
ago
we're
not
seeing
just
yet
anything
could
happen.
I
think
we're
somewhat
fortunate.
K
F
Thank
you
very
much,
mr
chairman,
and
I
want
to
add
my
thanks
and
appreciation
to
you
for
this
presentation
and
for
really
the
incredible
work
that
you're
doing
and
as
a
member
of
the
jefferson
county
delegation,
I've
had
an
opportunity
to
get
some
updates
along
the
way
about
the
really
amazing
work
you're
doing
to
address
underserved
populations,
and
I
know
you
just
briefly
touched
on
it
today
and
I
don't
know
if
you've
offered
those
updates
to
other
members
of
the
committee
who
maybe
you
know,
represent
other
areas.
F
But
I
was
so
impressed
by
that
information
and
I
think
it
really
is
relevant
for
other
members
of
the
committee,
and
I
just
wanted
to
recommend
that
you
make
those
updates
available
for
anyone
who
might
be
interested.
But
my
colleagues
know
that
those
updates
are
something
that
you
have
offered.
So
thank
you
so
much.
I.
A
Want
to
finish
with
follow
up
on
representative
westrom's
comments
and
appreciate
her
experience
and
trying
to
recruit
people
to
underserved
areas.
It
is
a
challenge
and
I
think
the
biggest
problem
we
have
in
kentucky-
and
this
may
sound
kind
of
rhetorical-
don't
mean
it
as
such,
but
is
poverty,
and
if
we
would
make
the
same
commitment
to
addressing
the
issues
of
poverty
in
kentucky
that
we've
made
to
tackling
covid,
I
think
we
could
truly
turn
this
around
for
the
state
of
kentucky.
A
I
know
a
lot
of
memphis
is
the
last
general
assembly
on
the
west
end
of
louisville,
and
certainly
that
is
appropriate,
but
there's
even
more
critical
areas
of
poverty
throughout
the
state,
just
not
in
the
eastern
kentucky
or
extreme
western
throughout
the
state,
even
with
their
own
district,
and
we
truly
need
to
make
a
commitment
to
address
that
if
kentucky.
A
If
we
have
a
single
county
that
fails
and
we
have
failed
as
an
institution-
and
I
hope,
as
we
go
in
this
budget
cycle-
that
we
can
be
bold
in
what
we
need
to
do.
I
think
we
all
recognize
in
these
budget
review
committees
that
we
have
a
revenue
shortage
and
it
needs
to
to
be
addressed.
I'm
not
suggesting
of
raising
taxes
on
anyone,
but
I
am
suggesting
having
a
fair
tax
code,
because
I
remind
everyone
here
that
we
have
exempted
50
of
the
income
in
kentucky's
generated
from
taxation
and
that's
not
fair.
A
A
I
know
that
dr
benapi
is
particularly
proud
of
the
fact
that
you've
done
that
to
artificial
heart
transplants
and
I
think
that's
that's
great,
for
not
just
louisville
but
for
kentucky
puts
us
on
the
map
and
I
don't
know
why
kentucky
can't
be
the
center
of
medical
excellence
for
the
united
states.
If
we're
voting
our
efforts,
but
again
it
requires
efforts
on
everyone's
part
and
a
commitment
for
this
entire
state.
So
appreciate
you
being
here
today
and
we
look
forward
to
talking
to
you
in
the
future.
Thank
you.
A
Next
presentation
is
from
folks
from
bowling
green.
A
If
you
would,
after
we
get
your
slides
up
and
running,
identify
yourself
the
record
and
feel
free
to
proceed.
Thank
you.
A
Folks,
part
of
our
technical
problem
is
your
video,
that's
embedded
within
your
presentation.
It's
a
little
bit
of
challenge
to
do
that.
Having
seen
it
previously,
I
think
it
certainly
has
value
to
our
medicaid
oversight
committee
meeting.
But
can
we
respectfully
ask
not
to
do
that
portion
of
presentation,
certainly,
certainly,
and
in
fact
please
push
a
button
after
green
light.
M
Thank
you.
In
fact,
you
all
should
have
the
powerpoint
presentation
in
your
packets.
Would
you
like
for
us
to
work
from
that?
You
pushed.
A
M
We
can
use
let's.
A
M
All
right
good
afternoon,
I'm
dr
mary,
lloyd,
moore,
executive
director
of
the
suzanne
vitale
clinical
education
complex
in
bowling
green,
and
this
is
mr
david
wheeler
executive
director
of
our
life
works
at
wku
program
and
david
has
over
25
years
of
experience
with
life
skills
incorporated
where
he
worked
with
state
general
fund
dollars
throughout
his
tenure
there,
and
as
well
as
the
michelle
p
waiver
for
13
years.
M
We
also
have
mr
john
kelly
to
my
right,
your
left,
who
is
founder
of
the
kelly
autism
program
and
parent
of
an
adult
daughter
with
with
autism,
and
it
is
our
extreme
pleasure
to
be
here
with
you
all
today,
chairman
meredith.
Thank
you
for
the
opportunity
and
members
of
the
committee.
Thank
you
for
the
opportunity
to
be
here
with
you.
M
We're
here
to
talk
about
our
life
works
at
wku
program,
as
well
as
to
sound
an
alarm
about
an
unaddressed
problem
for
the
commonwealth
of
kentucky,
as
well
as
to
offer
a
cost
savings
solution
for
that
problem.
Some
of
you
all
have
heard
this
information,
and-
and
we
are
most
grateful
to
have
the
opportunity
to
present
this
information
about
our
lifeworks
program.
M
It's
it's
a
program
that
is
designed
to
help
those
autistic
individuals
who
have
the
ability
to
move
to
independent
living
and
become
contributing
members
of
our
society
and
our
life
works
program
is
a
model
replicable
program
for
the
entire
state
of
commonwealth
and
say
the
entire
state
of
kentucky
as
and
and
beyond,
and
david
now
is
going
to
tell
us
about
the
lifeworks
at
wku
program
we'll
skip
the
video.
Did
you
want
to
skip
it
from
up
there,
because
I
think
if
I
click
it,
it
goes
immediately.
M
N
N
This
program
on
behalf
of
not
just
us,
but
for
the
families
and
and
the
individuals
that
we
get
calls
from
weekly
who've
been
waiting
for
something
like
this,
and
so
our
program
is
a
24
month,
transition
academy
program
where
young
adults
with
autism
can
come
and
and
obtain
the
skills
necessary
to
gain
and
and
maintain
gainful
employment
and
achieve
independent
living
and
learn
the
skills
necessary
to
maintain
lifelong
meaningful
relationships
and
so
and
we're
proud
to
be
kentucky's
only
living
learning
community
for
young
adults
with
autism
and
so
and
you'll
see
on
this
next
slide
a
participant
profile.
N
A
typical
participant
at
life
works
is
someone
as
a
young
man
or
a
young
woman
with
ages
21
to
30,
who
has
autism.
We
have
an
individual
now
who
also
has
cerebral
palsy.
We
have
a
young
lady
enrolled,
that's
coming
next
year,
who's
from
the
louisville
area,
who
also
has
cerebral
palsy
and
and
autism
intelligence
levels
range
from
low
average
to
well
above
average,
and
their
socioeconomic
and
educational
backgrounds
are
varied.
N
N
Just
less
than
100
feet
is
a
small,
intimate
housing
complex
consisting
of
three
different
apartment
buildings,
and
it's
it's
it's
it's
it's
a
perfect
setup
for
having
organic
environment
for
being
able
to
have
people
learn
in
the
classroom,
setting
and
then
also
in
their
apartments
and
then
in
the
community,
and
so
that's
what
we
work
on
all
day
every
day,
and
so
they
they
come
to
life
works
with
skills
already
to
some
respect.
N
N
They
have
been,
they
have
varying
backgrounds
and
education
levels,
but
something
they
all
have
in
common
as
referenced
on
the
slide
is
a
failure
to
launch
it's.
It's
young
people
who
have
left
high
school
and
some
have
left
college.
One
has
even
left
graduate
school
returned
home
with
their
families
and
gotten
stuck,
and
so
there's
just
been
a
real
failure
to
launch.
They
have
they're
at
home
unemployed
with
little
or
no
relationships.
Their
skills
have
regressed
and
self-confidence,
and
sense
of
direction
are
non-existent.
N
That's:
okay.
Sorry,
that's
all
right!
We
have
10
critical
outcomes
that
we
focus
on
there.
Two
of
the
most
important
to
me
or
to
us
is
employment
and
independent
living,
that's
critical
to
them
and
critical
to
us,
and
so
all
the
others
outcomes
are
are
important
too.
N
But
that's
our
primary
goals
is
to
help
them
obtain
employment
and
learn
to
live
to
achieve
independent
living,
and
so
they
all
have
individualized
plans
and
those
plans
change
over
time,
but
they're
they
all
tie
back
to
those
outcomes,
and
so
we
require
and
support
individuals
to
participate
in
community
service
learning,
volunteerism
and
employment.
We
have
partnered
with
area
businesses
and
industries
to
help
boost
the
ongoing
workforce
development
initiatives
across
the
state.
N
N
They
have
a
small
break
during
the
holidays,
but
they're
there
every
day
and
participating
in
class
on-site
training
and
and
going
to
work
and
also
service,
learning
volunteering
so,
and
then
lastly,
I'll
mention
that
we
have
the
opportunity
for
folks
in
our
region
or
within
driving
distance,
who
would
like
to
participate
in
classes
but
not
live
in
the
program
or
not
participate
in
the
full
program,
and
so
we
call
we
refer
to
that
as
the
bridge
program
and
people
commute
in
for
that.
So
thank
you.
Thank
you,
dr
moore.
M
That
is,
for
your
information.
10
000,
more
people
than
in
the
entire
city
of
covington
kentucky
and
10
000
less
than
the
city
of
owensboro
just
put
that
number.
In
into
perspective,
the
lifetime
costs
for
individuals
with
autism
is
3.5
to
5
million
dollars
over
a
lifetime,
and
families
who
have
children
diagnosed
with
autism
earn
30
percent
less
than
other
families.
Due
to
the
additional
responsibilities
that
are
involved
in
caring
for
their
autistic
children.
L
M
I'll
try
to
push
this
again,
but
I'll
move
on
there
will
be
thank
you.
There
will
be
500
000,
autistic
individuals
aging
into
adulthood
in
the
next
10
years,
but
of
that
number
85
percent
of
college
graduates
with
autism
are
underemployed
or
unemployed,
and
that's
compared
to
a
national
unemployment
rate
of
4.5
percent,
and
we
we
know
that
a
contributing
factor
to
this
statistic
is
the
lack
of
training
in
job
readiness
and
life
skills,
which
is
what
we
offer
at
our
life
works
program.
M
The
average
cost
of
home
and
community-based
waiver
services
in
kentucky
in
2019
was
49
000
a
year.
But,
as
you
all
well
know,
there
is
a
waiting
list
for
these
services
so
to
the
next
slide.
If
we're
able
thank
you
we're
in
a
state
of
crisis
in
terms
of
support
for
autistic
adults-
and
we
are
here
to
sound
the
alarm
once
again
by
age,
22,
publicly
funded
education
and
services
cease
to
be
available
as
families
reach.
M
M
We
are
indeed
in
a
state
of
crisis,
but
we
have
a
solution
and
a
solution
that
we
think
is
cost
effective
for
the
commonwealth
of
kentucky.
The
tuition
of
lifeworks
of
our
life
works
program
is
fifty
thousand
dollars
a
year.
These
costs
are
for
operational
expenses.
Only
the
facility
has
been
paid
for
by
the
most
generous
support
from
mr
bill
gatton
and
mr
gary
watkins.
So
we've
got
the
facility
personnel
expenses
are
985
752
dollars
per
year
for
eighteen
staff.
M
Our
capacity
for
the
transition
academy
is
28
participants
with
the
actual
cost
per
participant
being
forty
nine
thousand
five
hundred
and
fifty
five
dollars
and
then,
as
you
heard
previously,
will
hur.
We
will
serve
individuals
in
our
bridge
program.
Additionally,
so,
as
you
can
see,
there's
there's
no
wiggle
room
in
the
budget.
The
tuition
of
fifty
thousand
dollars
is
absolutely
necessary
for
the
supports
these
individuals
receive.
M
There
are
very
few
programs
of
this
nature
in
the
united
states
and
there
are
no
programs
of
this
nature
in
kentucky
or
in
our
immediate
vicinity
and,
as
you
can
see
in
the
slide,
our
tuition
of
fifty
thousand
dollars
is
the
lowest
available
from
the
the
sample
of
these
programs
that
I've
provided
for
you
there's
a
range
of
ninety
four
thousand
per
year
in
chapel
haven
west
in
tucson
to
fifty
seven
thousand
dollars
a
year
at
29
acres
in
in
dallas
and
we'll
move
on
to
the
next
slide.
M
The
cost
of
funding
a
participant
for
two
years
is
a
hundred
thousand
dollars
minus
the
state
income
tax
from
successful
participants,
which
is
a
week
we
thirty,
they
earn
thirty
six
thousand
dollars
a
year
times
five
percent
tax
rate
times
a
forty
two
year
work
life,
which
is
seventy
five
thousand
six
hundred
dollars
minus
ten
percent
to
account
for
the
ten
percent,
who
will
not
work
for
a
total
of
sixty
eight
thousand
forty
dollars,
the
total
cost
becomes
a
hundred
thousand
dollars
less
the
reduction
in
cost
of
sixty
eight
thousand
forty
dollars
for
a
total
of
thirty
one
thousand
nine
hundred
and
sixty
dollar
net
cost
to
the
state
of
funding,
one
participant.
M
On
the
other
hand,
as
you
were
stating
earlier,
the
lifetime
cost
of
not
funding
a
participant
is
two
million
four
hundred
dollars.
I
mean
two
million
four
hundred
thousand
dollars
and
we
arrive
at
that
number
by
multiplying
the
average
sixty-year
lifespan
past
age,
six
at
past
age,
eighteen
by
forty
thousand
dollars
the
cost
per
year
for
public
support.
M
M
The
cost
of
savings
per
class
of
28
participants,
which
is,
as
I
mentioned
previously,
as
our
capacity
is
49
million
505
thousand
one
hundred
and
twenty
dollars,
with
the
total
savings
for
for
three
two
year:
budget
periods
being
148
million
five
hundred
and
fifteen
thousand
three
hundred
and
sixty
dollars,
and
this
this
equals
a
savings
per
net.
Dollar
spent
for
life,
works,
participant
of
and
56.32
cents,
so
the
the
dollar
spent
on
them
will
end
up
saving
in
the
long
run
over
time.
M
And
our
next
slide
the
support
provided
by
a
three
by
three
two
year.
Budget
periods
will
allow
us
to
put
in
place
our
plan
for
sustainability.
M
M
We're
also
hopeful
to
create,
with,
of
course,
your
help
and
approval
and
autism
waiver
for
such
services
in
the
con
in
the
commonwealth.
I
know
you've
heard
of
of
autism
waivers
before
and
and
I'm
talking
about,
the
the
cost
for
individuals
in
in
the
life
works
program,
but
we
need
time
time
and
to
work
out
the
details
of
this
program,
and
I'm
not
here
to
talk
about
that
specifically
today,
so
to
the
next
slide
in
your
packets
or
on
the
screen.
M
M
We
need
a
line-item
budget
of
2.8
million
of
2
million
800
000
over
three
budget
periods
to
provide
for
the
life
works
program.
This
dollar
amount
will
provide
in
and
only
for
three
with
that,
we're
not
looking
for
in
perpetuity
just
for
three.
This
dollar
amount
will
provide
a
runway
for
84
individuals
in
the
transition
program,
in
addition
to
100
plus
participants
in
the
bridge
program
there
at
lifeworks
to
be
productive
members
of
society
and
potentially
save
the
commonwealth,
1
million
768
000
40
over
their
individual
lifetimes.
M
M
We
everyone
here
in
this
room
has
the
opportunity
and
I
believe,
more
importantly,
the
the
the
responsibility
to
provide
assistance
for
for
this
growing
segment
of
our
population
to
become
more
self-sufficient,
but
the
fifth,
the
the
tuition
of
fifty
thousand
dollars
is,
is
too
steep
for
most
families
to
afford
without
our
help.
M
Whenever
you
you
would
come
or
whenever
you're
in
the
area,
we
would
love
to
show
you
what
what
we
have
and
again
chairman
mayor
to
thank
you
and
all
of
you
thank
you
for
the
opportunity
to
be
here
today
to
to
talk
about
our
life
works
program
and
to
to
enlist
your
help
in
providing
these
services
for
our
fellow
kentuckians.
Thank
you.
Thank
you.
Excellent.
A
Presentation,
the
third
time
I've
heard
it
gets
better
every
time
and
makes
me
more
committed
to
it,
and
my
initial
interest
in
this
is
because
it
serves
a
population
that,
I
think
truly
is
forgotten.
A
If
they
can't
launch
appropriately,
then
where
do
they
go
and
it
becomes
a
burden,
financial
burden
to
society,
and
I
was
truly
impressed
that
they're
not
asking
for
an
ongoing
appropriation,
it's
a
one-time
appropriation
to
to
launch
this
program
and
make
it
self-sustaining,
and
it
does
fall
in
that
category
that
it
costs
a
whole
lot
more
to
do
nothing
than
to
make
this
appropriation.
So
that's
why
we
presented
this
three
times.
I
appreciate
the
presentation
yet
again
question
from
representative
wilner.
F
M
Here
well,
as
you
well
know,
we
we
have
to
start
somewhere
and
we
have
started
with
our
life
works
program
and
in
in
the
creation
of
of
a
replicable
model.
We
are
hopeful
that
other
communities
who
are
so
inclined
in
in
the
commonwealth
would
be
able
to
look
to
our
roadmap
to
our
blueprint
to
our
instructions.
You
know,
we've
we've,
I
I
won't
say
we
can
relegate
it
to
a
cookbook,
but
close.
M
It
is
a
systemic
problem
and
it's
not
one
that
is
just
in
bowling
green
or
any
of
our
hometown
communities
and
that's
why
the
the
opportunities
that
we
have
at
lifeworks
are
so
critical,
because
we
have
we
have
a
blueprint
and,
and
so
to
me,
that
would
be
the
beginning
of
an
answer
to
your
question
and
again
and
beyond
that
we
all
need
to
link
arms
and
recognize
the
problem
and
and
make
the
commitment
to
do
something
to
support
our
our
brothers
and
sisters
on
the
spectrum.
M
D
Thank
you,
mr
chairman,
and
I
have
a
couple
questions
and
I
appreciate
you.
All's
presentation
there.
There
are
other
providers
throughout
the
state
that
do
provide
services
to
to
this
age
group
on
the
spectrum,
the
waiver
providers,
and
they
do
very
similar
types
things
as
far
as
life
skills
and
employment
programs.
The
organization
I
run,
we
have
individuals
that
are
on
the
spectrum
that
we
do
that
with.
We
also
have
employment.
So
this
is
an
issue
statewide
and
the
employment
part
of
what
we
do
through
ovr
and
michelle
p
it.
D
It
is
part
of
a
larger
problem
in
the
in
the
disabled
population,
in
that
these
programs
cannot
sustain
themselves
at
all
they're,
not
financially
viable.
We
lose,
I
think,
to
this
point
in
the
fiscal
year
which
started
in
in
september.
I
think
we're
already
maybe
thirty
thousand
dollars
in
the
hole
with
this
program.
So
this
is
a
larger
issue
and
there
are
programs
throughout
the
state
that
maybe
not
specific
to
autism,
but
do
support
that
population,
probably
not
to
the
level
of
expertise
that
you
all
do,
and
that's
you
know
so
there
there
are.
D
These
services
are
available.
We
could,
at
a
probably
a
lesser
expense
focus
on
some
of
these
centers
and
getting
training
to
be
able
to
help
that
population
to
bring
more
in
and-
and
we
also
have
many
in
the
disabled
population
that
are
getting
no
services
right
now,
and
you
know,
I
think,
that's
that's
part
of
a
larger
problem
and
just
on
questions.
How
many
do
you
all
have
in
your
bridge
program
right
now.
I
D
M
Our
capacity
is
is
for
28
individuals
for
our
transition
program
and
the
request
is
specifically
to
to
launch
that
and
and
get
us
to
capacity,
but
there
would
be.
We
have
10
individuals
in
the
bridge
program
right
now,
but
we've
got
the
capacity
as
we
grow.
We
I'll
digress
just
a
moment.
If
you
will,
we
we've
planned
the
program.
We've
we've
secured
the
building,
we've
secured
the
the
staff
and
we
were
ready
to
go
in
the
midst
of
the
pandemic.
The
pandemic
came.
We
had
folks
that
had
signed
up.
M
We
we
started
last
year.
We
have
11
folks
in
our
program
now
our
transition
program,
our
capacity,
is
28,
so
we're
building.
We
have
10
in
our
bridge
program
right
now
and
and
we've
got
much
larger
capacity
as
we
build
our
our
staff.
Now
is
three
almost
four,
so
I
want
you
to
understand
that
we
are
building
to
capacity
with
our
numbers
and
david.
You
probably
want
to
add
something
to
that,
but
I
wanted
to
jump.
N
In
no,
I
think
you
covered
it
and
to
the
point
you
made
something
that
I've
noticed
or
experienced
in
my
time
here
at
wku
at
the
the
lifeworks
program.
N
Is
that,
like
the
michelle
p
waiver
and
some
of
the
other
services
that
are
out
there
now
are
really
for
individuals
with
a
lower
iq?
N
And
so
a
lot
of
these
individuals
have
a
higher
iq,
intellectually,
but
just
really
fall
between
the
cracks
in
other
areas,
and
so,
while
some
may
qualify
for
the
michelle
p
waiver,
which,
like
you
were
pointing
out
rates,
are
very
low
and
we
we
could.
You
know
that
could
be
certainly
a
source
of
revenue
for
us
and
we're
in
the
enrollment
process.
For
that
right
now
we
have
a
lot
of
people
who
who,
who
really
don't
qualify
for
other
services
because
of
their
iq
stand
so.
M
It
will
be
specific
to
those
who
who
cannot
afford,
so
if
it
would
a
sliding
scale.
If,
if
someone
comes
in
and
can't
afford
it,
then
we
certainly
wouldn't
they
would
be,
they
would
pay
the
full
tuition.
But
if
we've
got
someone
who
can't
afford
it.
D
And-
and
please
don't
give
me,
I
appreciate
what
you
all
are
doing.
Our
organization
is
in
the
early
stages
of
opening
an
autism
center
more
for
pediatric.
D
So
I
I
very
much
appreciate
what
you
all
are
doing,
and
I
I
wish
that
you
know
I
wish
there
was
more
of
a
balance
on
the
services
throughout
the
state
and,
and
it
is
a
struggle
and
my
daughter's
boyfriend
is
on
the
spectrum.
D
So
we
you
know,
we
we
have
that
relationship
and
and
he
he
works,
but
there
are
there
really
aren't
services
in
that
area
for
that
age
group
in
our
area
that
to
help
him
get
to
a
different
level,
and
so
I
think
the
model
that
you
all
are
you
all
have
is
great.
I
think
we
could
also
expand
some
existing
providers
to
make
them
more
expertise
to
be
able
to
increase
the
services
available
in
the
state.
M
We
do
have
the
opportunity
for
for
this
segment
of
individuals
who
have
the
capacity
are
not
living
to
potential
at
home,
on
their
parents
sofa
and
with
with,
as
you
know,
yeah.
M
Our
thinking
is
that
we
are
going
to
be
able
to
to
build
our
sustainability
program
that
I
described
and
with
the
infusion
of
the
the
three
year,
the
three
two
year
budget
terms
that
whatever
is
not
used,
we
will
put
an
endowment
and
and
be
able
to
to
leave
that
there
to
to
assist
those
in
the
future
coming
through.
Okay,
so.
O
John,
I'm
not
sure
yep
there.
It
is
it's
on
this
program,
as
the
others
have
been
a
a
very
close
collaboration
with
the
community
fundraising
in
the
community.
In
the
course
of
this
program,
based
on
the
success
we
had
with
previous
programs,
we
wanted
to
make
sure
that
we
had
the
resources
available
to
be
able
to
produce
the
facility
staffing
to
get
us
going.
There
was
an
ongoing
effort
to
build
endowment
as
we
speak
to
support
the
scholarships
long
term.
We
feel
we
will
get
there.
O
That's
why
we're
asking
for
a
limited
term
request
relative
to
funding.
It's
bridging,
if
you
like,
playing
on
the
words
that
we
have
with
the
program
to
be
able
to
get
to
that
point
of
sale
of
self-sustainability
relative
to
working
with
the
community
combination
of
resources
coming
from
program
participants
along
with
work
within
the
community.
O
As
was
talked
earlier,
we
are
spending
as
a
as
a
nation,
more
time
and
resources
focusing
on
the
younger
group
as
they're
maturing
working
through
the
process.
The
problem
is,
they
don't
have
a
light
at
the
end
of
the
tunnel
in
a
lot
of
cases
that
they're
finding
more
resources
earlier
as
they
get
older,
there
are
fewer
and
fewer
resources.
O
That's
what
has
been
driving
the
lifeworks
program
to
give
that
opportunity
to
be
able
to
say
as
they
age
through
that
process
use.
Other
resources
in
the
community.
Here
is
a
vehicle
that
is
very
intensive
and,
as
david
said,
very
focused
on
not
just
the
social
skills,
but
very
much
on
the
job
skills
job
coaching,
the
relationship
there.
A
major
portion
of
the
timing
behind
this
program
is
making
sure
that
we're
getting
an
individual,
not
just
in
a
job,
but
in
a
future
occupation.
O
We
haven't
succeeded
if
we've
just
basically
gone
through
a
program
great
you
can
live
in
an
apartment
building
by
yourself
or
in
a
community
with
others
and
go
out
and
find
a
job
if
we
don't
connect
them
to
an
opportunity
where
they
have
skills,
likes
desires
and
capability,
we
haven't
done
our
job.
That's
why
we're
working
the
program
that
we
have?
That's
why
it's
as
intensive
as
it
is.
O
That
could
be
a
much
larger
number
and
when
we
talk
in
terms
of
how
we
could
coordinate
all
of
them
within
a
business
community,
it's
a
function
of
being
able
to
have
the
resources
to
be
able
to
support
that
growing
piece
of
basically
that
day
program,
if
you
like,
where
they
have,
by
and
large
the
social
skills,
but
do
not
have
the
the
ability
to
be
able
to
focus
on
on
developing
a
career.
That's
the
primary
focus
of
the
of
the
bridge
program,
and
that
is
very
replicable.
O
A
Folks,
I
hate
to
cut
this
off,
but
we're
running
severely
behind
still
have
another
presentation
we
need
to
hear.
But
if
there's
any
follow
follow-up
questions,
I'd
ask
that
our
committee
members
follow
up
with
with
these
folks,
and
we
can
give
you
that
contact
information
but
appreciate
to
again
your
presentation.
A
L
All
right,
thank
you
so
much
for
having
us
today.
We
are
so
excited
to
be
here,
we'll
go
ahead
and
start
with
the
first
slide.
L
L
And
fortunately,
different
organizations,
including
community
farm
alliance,
have
stepped
up
to
the
plate
in
doing
just
that.
With
farmers,
market
nutrition
programs
or
more
specifically,
kentucky
double
dollars
which
allows
people
who
utilize
snap
to
double
their
money
that
they
spend
on
local
fruits
and
vegetables
in
farmer's
markets
and
some
select
retail
stores.
L
L
L
Next
slide,
please,
and
when
we
look
at
the
benefits
and
the
impact
programs
like
kentucky
double
dollars,
have
we
can
see
why
it
is
so
important
that
they
flourish?
A
2021
spur
report
showed
us
that
broad
expansions
of
healthy
food
incentives
would
provide
powerful
returns
on
investments,
for
families
for
grocers
and
for
farmers,
as
well
as,
more
broadly
among
state
economies.
L
L
Next
slide,
please
so
with
farmers
market
nutrition
programs,
whether
it's
kentucky
double
dollars,
fresh
rx
for
moms
or
the
senior
voucher
program.
There
have
been
real
life
changes
made,
especially
for
the
farmers
of
this
state,
and
luckily
today
we
have
two
farmers
with
us
who
have
been
impacted
by
accepting
these
incentive
types
of
programs
at
their
farmers
markets
and
local
iga
grocery
stores.
So
I'd
like
to
pass
it
off
to
ms
carissa
arnold.
P
Hello,
thank
you
for
the
opportunity
to
speak
today.
I
think,
as
chairman
meredith
spoke
earlier,
about
addressing
poverty
in
kentucky.
You
know
whenever
we
lift
up
the
lowest
of
our
citizens,
we
make
the
commonwealth
better
for
all
of
us.
P
I
have
been
a
farmer
for
only
four
years
previous
to
that
I
managed
a
multi-million
dollar
research
project
at
the
university
of
kentucky
in
the
college
of
agriculture
and
entomology,
I
have
managed
a
local
restaurant
in
lexington
that
was
very
much
innovative
in
the
70s
alfalfa
being
farm
to
table
and
being
one
of
the
first
restaurants
to
buy
from
local
farmers,
and
I
I
got
to
make
those
relationships
you
know.
P
Even
before
I
became
a
farmer
with
farmers
coming
to
the
restaurant
foragers
here
we
are,
you
know
what
what
can
you,
but
so
becoming?
I
feel
like
I've
had
a
four
year
field
study
so
far
you
know
we
began
the
market
garden
and
when
the
opportunity
came
up
to
what
we
were
asked,
if
we
wanted
to
accept
the
senior
nutrition
vouchers
and
also
the
wic,
it
was
a
no-brainer.
For
me,
I
am
a
true
kentuckian,
a
coal
miner's
daughter
and
if
you
all
remember
in
the
80s,
the
coal
industry
took
quite
a
downturn.
P
I
remember
us
getting
food
stamps
to
help
us
during
that
time
that
my
father
was
unemployed
until
he
could,
you
know,
find
employment,
and
you
know
it
didn't
last
long,
you
know,
but
it
had
it
bridged
that
gap.
You
know-
and
I
think
that
that's
what
it
does
for
a
lot
of
kentuckians
fast
forward
at
22
years
old.
P
I
found
myself
leaving
a
marriage
that
was
unfortunately
not
a
good
one
and
I
had
to
leave
des
moines
iowa
and
come
back
to
kentucky,
and
I
found
myself
in
a
position
where
I
also
needed
assistance
raising
a
daughter
by
myself.
P
I
also
was
a
wic
and
snap
recipient
and
now
being
so
fortunate
to
be
on
the
other
side
of
that
table
and
being
able
to
provide
the
very
best
fruits
and
vegetables.
You
know
for
the
commonwealth
for
people
who
would
not
otherwise
be
able
to
afford
you
know
to
buy
those
things,
because
in
the
last
50
years
our
grocery
store
vegetables
have
lost
their
nutritional
value
and
it
is
through
local
farms
that
you
will
get
nutritionally
dense
food.
P
P
Q
Thank
you
so
much
today
for
staying
around
through
the
lunch
hour
to
listen
to
us
talk.
I
really
do
appreciate
it
before
I
go
into
my
spiel.
I
just
got
to
say
I
take.
I
took
off
from
work
today
to
come
here
to
give
this
presentation,
and
not
many
times
mr
bentley
you're,
going
to
hear
that
politicians
enlighten
someone.
Q
Q
Give
you
a
small
history
of
myself.
Why
I'm
involved
with
this
program
and
why?
I
think
it's
so
important
for
the
state
of
kentucky,
not
just
eastern
kentucky,
but
the
state
of
kentucky
when
you're
looking
at
I'm?
Also
back
when
I
was
in
grade
school,
I
was
a
recipient
of
the
food
stamps
back
then
the
little
paper
things
you
pull
off.
That
type
of
thing.
I
remember
that.
Q
Well,
I
overcame
that.
My
family
overcame
that
through
farming
through
eastern
kentucky
through
the
college
years
of
my
college
years,
I'm
I'm
going.
This
is
I'm
setting
the
stage,
but
he's
got
a
point
at
the
end.
Okay,
but,
like
I
said
I
grew
up
on
a
family
farm
in
southeast
kentucky
real
kentucky,
mr
bentley,
to
where
poverty
is
fairly
high.
Q
Q
That's
all
this
is,
and
it
goes
back
to
mr
meredith
was
saying
I
mean
we've
got
to
do
something.
You
know
we
I'm
not
saying
we've
not
done
anything
in
the
state
of
kentucky.
You've
done
a
lot
of
things
in
the
state
of
kentucky
to
help
the
poverty
in
kentucky,
but
we've
got
a
long
way
to
go
and
from
my
experiences
I've
had
with
these
stores
and
producing
produce
for
35
years
and
farming
for
35
years.
Q
I
think
we've
got
an
avenue
here.
That's
got
me
excited
and
let
me
give
you
a
history.
Like
I
said,
I
grew
up
on
a
family
farm,
beef
cattle
tobacco
through
the
coal
industry
in
eastern
kentucky
man.
How
many
more
locks
am
I
going
to
have
to
take?
We
went
through
the
code.
We
went
through
the
tobacco
downturn.
Q
You
know
it's
tough,
it's
tough,
but
I've
got
to
give
eastern
kentucky
credit
in
my
little
county
of
owsley
county.
It's
one
of
the
most.
It's
the
best
count
in
the
state
for
high-speed
internet
with
some
of
the
things
that
they've
done.
They've
offset
tobacco
income
with
telework
system,
there's
some
bright
lights
out
there
and
you
guys
have
helped
with
all
of
them,
but
we're
right
now
talking
to
you
today
to
how
we
can
further
that
progression
and
move
us
forward.
Q
The
next
20
years,
but,
like
I
said,
like
I
said,
I
grew
up
on
a
family
farm,
went
through
the
college
years
and
all
that
type
of
thing
grew.
Tobacco
started
vegetables.
When
I
was
in
high
school,
you
know
all
the
time
looking
for
a
part-time
job,
that
type
of
thing
when
you've
got
tobacco
crops
out
there
you're
looking
for
supplemental
income
to
supplement
your
job
you're
trying
to
get
your
tobacco
crop
in
you're
trying
to
get
it
sold
that
type
of
thing
so
where's
the
income.
Coming
from.
Q
So
I
watched
a
lot
of
people
and
started
growing
a
few
vegetables.
No
one
in
the
county,
I
don't
think,
was
really
growing
vegetables
at
the
time.
So
I
diversified
at
an
early
age,
but
we're
going
to
see
how
that's
going
to
play
an
important
part
here
in
just
a
second,
but
I
sold
a
grocery
store,
sold
roasted
sold
off
the
farm
that
type
of
thing.
So
that's
my
involvement
at
an
early
age
for
the
last
35
years.
I
know
I'm
telling
my
age,
I'm
52,
but
I
mean
we're
getting
there
but
it.
Q
But
it's
got
a
point,
and
just
a
few
years
ago,
through
all
of
my
endeavors,
I
started
to
give
up
on
farming
after
the
dealing
with
some
save
a
lot
of
stores,
I'm
not
going
to
save
a
lot
stores
at
all.
That's
not
what
I'm
getting
at
here.
It's
just
the
marketing
channels
of
how
to
get
into
some
of
these
stores
to
have
your
product.
Q
Q
What
happened
started
order
started
going
down
to
very
few
numbers.
I
get
on
the
phone
and
call
well
they've
sort
of
said
we
can't
buy
from
outside
vendors
like
walmart's
all
the
other
ones.
It
is
what
it
that's
nothing
negative
on
save
a
lot.
That's
just
their
system
went
through
that
lost
30
000
produce
in
the
field,
bad
taste
about
one
under
it's
sort
of
like
the
coal
industry
in
the
tobacco
again,
in
a
way
honestly
and
you've
got
to
realize
vegetable
production
is
different
than
soybeans
corn.
You
take
cattle,
beef
cattle.
Q
We've
done
all
that
you
don't
get
a
check
when
you
go
to
the
market.
You
are
your
market.
You
got
to
develop
your
market.
We've
got
to
somehow
sustain
this
in
different
ways:
quality
relationships
that
type
of
things,
that's
what
we've
got
to
create,
but
but
where
I'm
going
with
that
through
all
those
years
and
experiences
I
had,
I
got
a
call
one
year
ago,
two
years
ago,
whatever
it
was
from
the
lady
said,
will
you
be
interested
in
supplying
some
of
your
produce
through
some
of
their
local
grocery
stores?
Igas?
Q
That
type
of
thing
in
eastern
kentucky?
I
don't
know
here
we
go
again.
You
know
I
did
I
wanted
and
we
had
went
through
the
whole
story.
She
knew
the
whole
story.
It
was
what
it
was.
She
said.
This
is
different,
explain
to
me
how
those
different
she
talked
to
me
about
the
double
dollars
program
that
we
test
piloted
last
year
through
the
three
of
those
stores.
Q
I've
done
some
research
on
the
iga
institutions.
They
can
purchase
outside
their
chain
that
type
of
thing
outside
vendors
may
have
a
chance.
Then
she
explained
to
me
about
the
double
dollars.
Well,
that
was
that
was
meeting
two
requirements
that
was
meeting
moving
more
produce
and
feeding
an
underserved
audience.
Q
This
may
have
a
chance,
so
the
gambler
that
farmers
are.
What
do
we
do
so
here
we
go
again.
So
yes,
I'm
in
and
when
we
were
in,
we
were
in
it's
one
of
those
things
and
long
story
short,
very
successful,
very
successful,
and
it's
due
to
the
double
dollars
program,
getting
me
into
those
stores
being
more
sustainable.
The
store
owners
talk
to
them
on
the
way
here
they
in
trouble.
Q
Q
Q
Q
Q
Q
This
program
has
ability,
10
years,
20
years,
that
you
can
hang
your
head
on
what
if
we
have
this
program
in
the
state
of
kentucky
and
all
the
stores,
just
the
iga
stores,
just
all
the
stores,
that's
hypothetical,
but
it's
possible
it's
possible.
We
can
move
that
50
mark
senator
meredith,
maybe
to
40,
maybe
a
35.
Q
A
And
that's
certainly
what
interested
me
and
bring
this
to
this
committee
and
I'm
sorry
we're
going
to
lose
about
our
entire
community
in
about
two
minutes.
But
kimmy
and
I've
had
several
conversations
about
this.
Our
original
intent
was
maybe
we
could
use
tobacco
settlement
funds,
but
understand
that
kentucky
department
of
agriculture
is
not
interested
in
doing
that.
They've
got
other
commitments,
so
we've
talked
about
other
funding
sources.
A
One
is
an
appropriation
through
the
budget,
those
of
us
connected
with
healthcare
even
remotely,
and
one
of
the
things
we
talked
about
is
why
not
asked
our
mcos
to
step
up.
The
ask
is
going
to
be:
is
it
500
600
000
around
that
around
500
600
000?
If
we
ask
each
of
the
mcos
contribute
a
hundred
thousand,
which
should
reap
them
benefits
because
it
can
improve
the
health
of
population
in?
So
that's
one
opportunity
again.
A
I
hate
to
cut
this
off,
but
I
know
you're
asking
so
six
hundred
thousand
we'll
look
at
different
funding
sources,
but
this
may
be
one
of
the
things
that
we'll
have
to
be
a
little
bit
innovative
on,
but
if
we
don't
get
it
this
round,
I
can
assure
you
that
we'll
be
back
in
in
two
years
and
do
it
again,
but
I'm
not
saying
we
can't
do
it.
A
We
won't
do
it,
but
I
think
we
need
to
look
at
some
innovative
ways
to
fund
this
because
again
it's
a
dollar,
a
dollar
match
for
federal
government,
and
we
need
to
do
this.
So
I
appreciate
that
appreciate,
y'all's
presentation.
Sorry,
I
didn't
give
you
more
time
and
just
not
a
very
good
committee
chair
and
I
I
get
fallen
behind
and
steph
looks
at
me
and
they
make
me
upside
the
head
but
great
job.
You
really
did.
I
appreciate
you
being
here
and
thank.