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From YouTube: Senate Standing Committee on Health Services (2-22-23)
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A
B
You
have
a
guest,
yes
thank
you.
Mr
chairman
I
have
our
fantastic
judge,
exec
Jerry
Summers
here
since
he's
taken
office,
the
county
has
just
expanded
and
gotten
out
of
debt
done
a
fantastic
job.
Thank
you.
A
Glad
to
have
you
this
morning,
he
always
speaks
glowingly
about
you.
That
way,
so
just
don't
think
it's
a
committee
meeting,
but
anyone
else,
if
not
we'll
jump
right
into
the
agenda,
we're
going
to
change
the
order
of
this
a
little
bit
because
we
have
some
bills
I
think
we
get
through
very
quickly
and
we'll
save
Senate
Bill
37
for
the
last,
because
I
think
it'll
pay
the
most
time
consuming
and
constraints
we're
working
under.
So
with
that
excuse
me
I
always
get
a
hold
of
myself.
We
need
to
have
roll
call.
A
Present
we
do
have
a
quorum,
and
now
we
have
Senator
Carroll
here
so
add
him
to
the
to
the
list
soon
about
90
is
Center
Higdon
here.
A
F
G
A
Senator
I
know
she
will
knock
a
home
run
to
today.
So
if
you
have
any
questions,
make
sure
they're
softball
questions.
Okay,.
A
E
So
this
is
just
SB.
110
is
a
cleanup
bill
from
sb10
from
last
session
in
regards
to
the
board
of
nursing,
just
a
few
Corrections
with
kr13
to
make
those
congruent
and
the
committee
sub
is
actually
a
change
to
the
nurse
the
number
of
nurse
Educators
that
would
be
on
the
board
and
it
previously
stated
six
having
trouble
filling
six.
They
decided
to
change
that
to
no
less
than
three
members
and
no
greater
than
six,
and
she
can
explain
that
if,
if
you
need
any
questions,
have
any
questions.
I
C
A
A
We'll
do
11
next
next
bill
on
the
agenda.
We're
going
to
hear
is
sending
Bill
111
in
this.
The
primary
sponsor
is
Senator
Amanda,
Mays
Bledsoe,
another
rookie.
A
K
A
J
You,
chairman
and
members
of
the
committee,
the
committee
to
the
substitute
Bill
to
Senate
Bill
111,
allows
Kentucky's
large
Independent
Health
Department's
flexibility
in
hiring
a
health
commissioner
by
changing
the
current
requirement.
The
health
commissioner
be
a
physician.
This
legislation
allows
other
highly
qualified
public
health
professionals
who
have
earned
a
minimum
of
a
master's
degree
in
public
health
or
related
field
and
who
have
at
least
five
years
of
manageable
experience
in
a
health
department
to
serve
in
that
role
like
the
Chief
Executive
Officer
of
a
hospital.
J
Do
not
these
large
Health
departments
have
experienced
difficulties
in
hiring
physicians
in
recent
years,
and
this
request
needs
to
change
next
I'm,
going
to
turn
it
over
to
let
Ms
Mooney
talk
about
the
public
health
things,
and
also
we
have
several
members
of
the
local
Health
departments
here
with
us
today
who
also
like
to
we're
great
for
their
first.
Their
support.
K
Thank
you
Senator,
and
thank
you
to
the
Health
Services
committee
for
considering
this
important
bill
again.
I'm
Jennifer
Mooney
at
Northern,
Kentucky
Health
Department,
the
Northern
Kentucky
independent
District
of
Health,
has
operated
under
the
ability
to
employ
a
non-physician
for
about
20
years.
This
has
allowed
for
the
district
to
attract
and
hire
Leaders
with
public
health
experience
from
a
wider
pool
of
candidates
to
benefit
the
agency.
This
has
been
a
very
successful
model
for
our
health
department
and
Community.
K
Local
Health
departments
provide
a
large
and
varying
range
of
services
and
programs
today
that
are
significantly
different
than
they
were
decades
ago.
Public
Health
departments
deal
much
less
with
medical
patient
care
and
more
with
the
social
determinants
of
Health,
for
instance,
factors
that
may
affect
how
health
care
is
accessed.
Today's
Public
Health
also
focuses
a
great
deal
on
environmental
conditions,
exposure
risk
to
the
communities
at
large,
which
obviously
affect
individuals,
while
a
medical
doctor
with
Public
Health
Training
can
provide
leadership
at
leadership
at
the
local
level.
K
So
too
can
professionals
with
related
degrees
and
years
of
experience
in
public
health.
Nky
health
uses
a
model
of
Contracting
with
a
medical
physician
to
serve
as
the
medical
director.
This
person
provides
reviews
and
approvals
for
medical
protocols
and
practices
as
needed
provides
limited
medical
services,
for
example
our
TB
tuberculosis,
patient
care,
and
also
serves
as
a
consultant
on
various
services
or
program
topics.
This
is
shown
to
be
a
tried
and
true
model
for
many
years
for
us,
a
high
performing
local
Health
Department
celebrating
its
10th
year
of
Public
Health
accreditation.
G
And
I
will
just
add
to
their
testimony
here
that
the
of
the
61
Health
departments
across
the
Commonwealth,
all
the
other
health
departments
too,
outside
of
Lexington
and
Louisville
employee
models.
Similar
to
this,
we
used
to
have
health
officers
MDS
at
Health
departments
across
the
state,
but
as
the
the
focus
of
Health
departments
has
changed,
we
have
now
gone
to
Public,
Health
directors
with
varying
other
degrees
and
we
all
contract
with
an
MD
for
that
medical
oversight
to
work
under
those
auspices.
I
D
I
Foreign,
thank
you.
Would
you
please
introduce
yourself
to
to
the
committee
and
the
people
in
the
room
and
we'll
proceed.
I
Before
you
before,
we
get
started
I'm
sorry,
we.
I
Second
motion
by
by
Senator
Adamson,
you
got
him.
Okay,
we
have
a
motion
on
we.
We
have.
We
have
a
sub
for
Senate,
Bill
43,
all
those
in
favor
say
aye,
all
those
opposed,
nay,
okay,.
A
H
A
Appreciate
that
so
Sid
Centerville
43
is
a
simple
little
bit
over
here
that
a
lot
in
Frankfurt,
but
this
one
truly
is
it
deals
with
Central
caregivers,
and
many
of
you
will
remember
that
we
passed
Senate
Bill
100
back
in
the
2022
session
to
establish
rights,
to
designate
an
essential
caregiver
to
Residents
in
person
at
long-term
care
facilities,
hospitals
and
our
State
Mental
Hospitals
and
required
our
cabinet
for
have
health,
Family
Services,
probably
regulate
regulations
to
accommodate
that
what
I've
asked
in
this
bill
is
to
kind
of
broaden
the
scope
of
that,
because
obviously
our
Healthcare
delivery
system
covers
much
more
than
that.
A
So
you
have
facilities,
outpatient
services.
So
that's-
and
this
is
what
this
bill
does
to
expand,
both
of
that
not
just
address
a
code
of
pandemic,
but
anytime
we
have
this
type
of
Health
crisis
that
we
could
still
have
essential
caregivers
to
assist
in
the
the
care
and
treatment
of
their
family
members,
which
is
the
case
in
most
sensible,
but
additionally
again
extend
that
privilege
to
other
health
care
facilities
that
are
not
within
this
current
bill.
I
C
A
I
Thank
you,
Senator
Meredith.
We
have
eight
to
zero.
I
know
that
that
surprises
me
a
little
bit,
but
I
really
appreciate
you
being
here
this
morning.
I
appreciate
your
presentation:
Senate
Bill
43,
as
amended
by
proposed
Senate
substitute
one
has
passed
with
favorable
expression.
Thank.
A
L
L
Thank
you,
state
senator
Jimmy
Higdon
and
you
have
a
committee
said:
I
do
have
a
committee
sub
Mr
chairman
motion,
sir.
L
L
It's
still
in
your
word
simply
says
any
treatment
center
or
program
license
as
a
chemical
dependency
treatment
service
shall
provide
transportation
services
to
the
resident
who
wish
to
voluntarily
leave
the
treatment
program.
If,
after
expressing
the
tent
to
voluntary
leave,
the
treatment
center
informs
a
family
member
guardian
or
emergency
contact
of
the
resident's
desire
to
leave.
L
Also
Mr
chairman,
the
bill
says
the
facility
and
Law
Enforcement
Officers
shall
not
drop
those
voluntary
leaving
the
facility
at
any
location
other
than
a
public
local
public
transportation
location
or
to
meet
a
at
a
location
where
a
driver
of
a
rides
ride,
sharing
service
will
pick
them
up
or
at
the
resident's
home
and
also
Mr
chairman
prior
to
a
resident
being
admitted
to
a
facility.
The
facility
shall
conduct
a
search
for
any
outstanding
warrants.
L
L
L
There's
you
know
had
several
reports
of
walkaways
in
at
some
of
the
treatment
centers
in
my
district
and
and
they
just
kind
of
end
up
in
town
or
at
people's
homes
and
and
with
somebody
else
having
to
deal
with
the
issue
of
those
folks
not
have
any
place
to
go
after
after
leaving
the
the
center.
You
know
they
can
leave
anytime
they're,
not
there
they're,
not
court
ordered
to
be
there
they're
there
voluntarily,
so
they
can
leave
anytime.
So
we
just
if
they
decide
to
leave.
M
L
H
I
Thank
you,
Mr
chairman
Senator
Higgins.
This
is
a
wonderful
bill
previously
before
redistricting
I
had
some
of
these
facilities
in
in
my
district,
and
that
was
a
concern
that
many
many
people
shared
that
is
this
is
the
it's
actually
voluntary
there
are
voluntary
facilities
is
what
is
what
we're
looking
at
they're,
not
necessarily
all
court
ordered
and
and
people
were
leaving
their
facilities
at
all
hours
of
the
night,
and
they
were
wandering
the
streets,
and
many
of
the
people
in
the
community
shared
with
me.
I
B
A
L
A
M
M
There
you
are
welcome
and
I
also
see
Dr,
Sean
and
Evelyn
Jones
in
the
back,
welcome
to
you
all
and
and
Dr
Sean
Jones
welcome
home.
Sir
thank.
A
D
N
N
We'll
make
sure
I
apologize,
Trent
blacketer
licensed
pharmacist
in
the
state
of
Kentucky
worked
for
synchrony
Pharmacy
based
out
of
Louisville
Kentucky.
H
A
D
Okay,
thank
you.
Mr
chairman
Senate
bill
37..
So
you
know
we
talk
about
modernization
in
Kentucky
but,
as
the
chairman
knows,
as
well
as
I
do
anytime
anything
new
is
proposed,
it
does
become
a
heavy
lift.
People
are
generally
averse
to
change
and
Pharmacy
is
one
area
that
has
evolved
into
a
really
Dynamic
economy
in
Kentucky,
and
it's
very
important
that
all
perspectives
and
ideas
are
considered
when
creating
new
public
policy.
D
D
This
would
have
had
a
dramatic
impact
on
the
practice
of
Pharmacy
across
the
state
of
Kentucky,
and
so
during
the
regulatory
process.
There
was
a
lot
of
angst
and
communication.
The
Board
of
Pharmacy
ended
up
pulling
that
Reg
back
so
37
was
the
Genesis
of
37
was
just
to
keep
things
the
way
they
have
been
for
the
last
15
years.
So
it
was
just
a
codification
of
the
current
regulation
now
also
attached
to
37
was
through.
D
The
sub
was
my
original
Senate
Bill
95,
which
was
the
board
reorganization
for
the
Board
of
Pharmacy,
and
so
where
we
got
on
the
board.
Reorganization
is
that
we
agreed
to
establish
that
is
already
in
reg
regulation
and
advisory
Council.
So
we
took
that
board
makeup,
which
would
have
increased
the
expertise
for
the
Board
of
Pharmacy
and
we
transferred
that
expertise
into
an
advisory
Council
so
and
because
of
Technology
pressures.
D
Yesterday,
we
weren't
able
to
finalize
where
we
were
on
this
compromise
bill,
so
I
need
to
impress
upon
the
committee
that
negotiations
are
still
ongoing
and
I've
had
very
positive
Communications
with
people.
Even
this
morning,
in
my
office
we
had
the
pharmacists
Association
in
the
health
care,
the
independence
in
my
office,
to
talk
about
options
as
we
go
forward.
But,
as
you
know,
it's
a
30-day
session.
So
time
is
of
the
essence,
and
so
in
order
to
keep
this
moving.
I
hope
that
we
can
pass
this
bill
out
of
committee
today.
D
Knowing
that
the
commitment
is
there
I
believe
from
all
sides
to
continue
this
conversation
so
that
when
we
do
bring
it
to
the
floor,
it's
something
that
we
can
be
proud
of
and
it
moves
the
ball
forward
on
increasing
a
level
of
expertise.
That
I
think
is
badly
needed
and
also
increasing
that
conversation
on
how,
when
we
make
regulations
how
it
affects
different
practices
of
Pharmacy
across
the
state
of
Kentucky
and
so
I,
don't
know
if
my
guest
would
like
to
share
a
little
bit
of
perspective.
H
The
Kentucky
Board
of
Pharmacy
has
a
critical
role
in
ensuring
patient
health,
but
I've
learned
that
the
board
has
repeatedly
restricted
Pharmacy
practices
that
are
commonly
allowed
in
other
states
and
taking
such
a
heavy
ended
handed
approach.
The
board
inhibits
economic
development
in
this
industry.
H
H
N
So
again,
I'm
with
synchrony
Pharmacy
we're
a
licensed
Long-Term
Care
Pharmacy
in
the
state
of
Kentucky
as
well
as
other
states.
We
provide
services
to
Residents
in
skilled
nursing,
Assisted,
Living,
Personal,
Care,
Independent,
Living,
nursing
home
communities.
As
a
company,
we
have
eight
Pharmacy
locations
which
serve
residents
of
these
facilities
in
20
States.
That's
involved
obtaining
a
a
number
of
out-of-state
Pharmacy
permits
for
those
locations
to
serve
those
patients
and
not
only
the
states
we
operate
in,
but
also
the
states
that
we
have
out-of-state
permits
in
So.
N
Currently,
our
company
has
two
resident
pharmacies
in
Kentucky.
We
also
have
two
out-of-state
pharmacies
that
have
out-of-state
permits
in
the
state
of
Kentucky.
We
maintain
those
in
the
primarily
in
the
event
that
we
have
business.
Continuity
needs
in
the
state
of
Kentucky
so
that
we
can
continue
to
provide
care
for
those
long-term
care
residents.
The
two
out
of
state
locations,
one's
in
Nashville,
Tennessee,
the
other
in
Indianapolis
Indiana.
We
believe
that
the
addition
of
the
board
proposed
regulation,
which
Senator
Adams
has
mentioned,
has
been
pulled,
but
just
want
to
State.
N
You
know
the
potential
harm
that
this
could
cause
any
that
states.
Any
person
who
engages
in
the
practice
of
the
profession
of
Pharmacy
for
a
Kentucky
resident
shall
hold
an
active
Kentucky
pharmacist
license,
creates
an
unnecessary
burden.
Currently,
the
out-of-state
pharmacies
are
required
to
have
a
pharmacist
in
charge
that
is
licensed
in
the
state
of
Kentucky,
as
well
as
they
take
responsibility
for
the
care
that's
provided
to
Residents
in
the
state
of
Kentucky.
Likewise,
each
Board
of
Pharmacy
in
a
non-resident
State
requires
the
pharmacist
to
hold
an
active
pharmacist.
N
License
requires
all
pharmacists
to
hold
an
active
pharmacist
license
in
their
resident
state,
which
Other
Board
of
pharmacies
regulate
so
requiring
each
Board
of
Pharma
requiring
each
pharmacist
to
engage
Us
in
the
practice
of
Pharmacy
for
a
Kentucky
resident
could
certainly
result
in
delays
of
therapy
for
Kentucky
residents.
The
regulations
counterproductive
to
the
goal
of
promoting,
preserving
and
protecting
the
health,
safety
and
Welfare
of
residents
in
Kentucky.
No
other
state
or
Commonwealth
in
the
nation
has
this
strict
of
a
requirement
for
the
provision
of
Pharmacy
Services
by
an
out-of-state
licensed
Pharmacy.
N
So
we
highly
recommend
that
the
Commonwealth
of
Kentucky
follow
the
same
process
that
works
in
other
states
as
well
as
non-resident
out-of-state
pharmacies
and
not
require
every
pharmacist
to
obtain
a
non-resident
pharmacist
license
again.
It
creates
an
administrative
hurdle
for
out-of-state
pharmacies
in
their
attempt
to
provide
safe
and
reliable
care
to
Residents
in
the
state
of
Kentucky.
I
also
want
to
make
comment
just
on
another
issue.
That's
been
brought
up
within
this,
and
that
is
around
the
additional
use
of
the
nabp
verify
program.
N
We,
you
know,
as
a
company,
we
don't
have
issue
with
the
nabp
verify
program.
That's
been
proposed.
The
issue
is:
there's
a
been
proposed:
a
250
dollar
additional
application
fee
beyond
the
50
cost
of
that
nabp
verify
program
by
the
board,
that's
higher
than
what
a
pharmacist
must
pay
to
maintain
their
licensure
in
their
residence
state
in
40,
States
Across,
the
Nation
just
to
get
a
be
able
to
get
verified
in
the
state
of
Kentucky.
So
again,
we
need
to
make
sure
we're
not
placing
additional
burden
on
those
pharmacists.
N
N
I
A
A
O
F
Chris,
my
name
is
Chris
Harlem.
The
executive
director
of
the
Kentucky
Board
of
Pharmacy
and
joining
me
is,
is
also
Bill
cover
with
the
National
Association
of
boards
of
Pharmacy,
so
I
just
want
to
first
thank
thank
the
committee
thank
chairman
Meredith
for
the
opportunity
to
to
speak
today
on
behalf
of
the
Kentucky
Board
of
Pharmacy
today
regarding
Senate
bill
37..
F
F
F
Kentucky
patients
must
be
protected,
and
let
me
also
just
just
add
for
a
moment
that
dispensing
of
a
prescription
really
is
a
complex
process
that
involves
really
much
more
than
placing
pills
in
a
bottle.
Dispensing
includes
performing
functions
such
as
a
drug
utilization
review,
interpreting
clinical
data
performing
therapeutic
interventions,
patient
counseling.
F
Additionally,
pharmacists
perform
activities
such
as
compounding
such
as
non-sterile
or
sterile,
sometimes
high-risk,
sterile
compounding,
which
includes
making
medications
that
are
injected
to
the
bloodstream,
and
these
are
all
errors.
These
are
all
areas
in
which
errors
can
certainly
be
be
had
and,
and
next
I
really
just
want
to
talk
a
little
bit
about
the
foundation
of
our
of
our
jurisdiction.
F
F
F
In
fact
this
is
this-
is
our
responsibility
in
protecting
the
citizens
of
the
Commonwealth
through
appropriate
oversight,
while
allowing
these
new
advances
and
processes
and
Technology
I
also
want
to
emphasize
that
many
of
these
current
models
are
not
necessarily
new.
In
fact,
many
of
these
models
already
fall
under
our
current
law
and
pharmacists
already
required
licensure
by
us.
F
We
currently
license
over
5500
non-resident
pharmacists
today,
in
which
4
500
of
those
are
not
serving
as
a
pharmacist
in
charge.
47
of
the
pharmacists
licensed
are
non-resident.
Let
me
repeat
that,
because
that's
that's
an
important
Point
47
of
the
pharmacists
we
licensed
today
are
non-resident
pharmacist.
This
Senate
Bill
37
is
what
would
change
the
status
quo.
F
To
address
why
this
may
seem
to
be
a
new
requirement,
we
now
know
and
realize
that
there
is
a
misunderstanding.
Our
current
laws
are
clear
and
we
are
adapting
our
roles
to
the
advances
and
practice
today.
In
other
words,
these
these
so-called
new
rules
were
brought
about
by
new
Arrangements,
not
currently
addressed
in
our
regulations.
F
The
board
has
demonstrated
support
for
these
new
advances
and
Technology.
The
board
must
maintain
the
jurisdiction
to
ensure
the
safety
of
the
Kentucky
citizen.
This
is
why
we
are
so
concerned
with
Senate
bill
37.
without
jurisdiction.
We
cannot
effectively
protect
the
people
of
the
Commonwealth
and
pharmacist
and
violation
of
Pharmacy
law
or
Bad
actors.
F
Next,
let
me
let
me
address
the
assumption
that
under
Senate
Bill
37
that
the
public
will
be
fully
protected
because
the
board
licenses
the
pharmacy
and
the
pharmacist
in
charge.
This
is
not
true.
Liability
does
not
automatically
transfer
from
the
actions
of
the
pharmacist
to
the
pharmacy
or
the
pharmacist
in
charge.
F
F
F
The
notion
that
we
should
issue
an
emergency
order
of
suspension
on
a
pharmacy
permit
or
a
pharmacist
in
charge
for
this
individual
pharmacist
is
Extreme
and
it
puts
the
people
of
Kentucky
at
risk.
If
we
issue
an
emergency
order
of
suspension
on
either
the
pharmacy
or
the
pic
the
pharmacy
in
charge,
the
shipment
of
medications
to
Kentucky
would
have
to
cease
creating
a
significant
access
issue
for
our
citizens.
F
F
F
That
is
our
charge
and
Mission
Senate
Bill
37
provides
no
such
assurances
and
I
want
to
be
clear.
I
want
to
emphasize
that
we
are
treating
the
non-resident
pharmacies
and
pharmacists
with
the
same
standards
as
our
end-state
pharmacist
and
pharmacies,
because
both
are
servicing
the
citizens
of
the
Commonwealth.
F
I
would
also
like
to
address
the
next
concern
with
Senegal
37
that
is
related
to
controlled
substances
under
krs-218a,
which
is
Kentucky's,
controlled
substance.
Act
pharmacists
must
be
licensed
by
Kentucky
in
order
to
have
the
authority
to
dispense
control
substances
into
the
state.
Remember
that
pharmacist
dispense,
not
pharmacies
without
a
license
from
us.
Pharmacists
would
be
prohibited
from
dispensing
control
substances
into
Kentucky,
while
Senate
Bill
37
May
remove
the
board
of
Pharmacy's
regulatory
authority
to
license
non-resident
pharmacists,
krs-218a
mandates
licensure
if
dispensing
Controlled
Substances
to
residents
of
the
Commonwealth.
F
Further
218a.202
requires
that
pharmacists
obtain
a
Casper
account
without
a
license.
The
Kentucky
Board
of
Pharmacy
will
have
no
mechanism
to
enforce
compliance,
I
I,
wanna,
I
wanna
End
by
by
talking
about
the
meeting
with
with
stakeholders,
so
the
board
of
pharmacies,
general
counsel
and
I
met
with
with
a
group
of
Pharmacy
stakeholders
and
the
lobbying
firm,
the
Rotunda
group
we
met
in
August
to
discuss
concerns
of
non-resident
licensure.