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A
This
meeting
to
order
the
meeting
number
four
of
the
house
budget
review
subcommittee
on
health
and
family
services.
As
a
reminder,
remote
access
is
allowed
to
all
meetings
of
the
regular
session.
Members
were
provided
a
zoom
link
to
access
the
menu
remotely.
The
media
materials
were
put
online
earlier
made
available
for
downloading.
At
this
time,
we'll
have
secretary
call
the
roll
members.
You
will
need
to
indicate
whether
you're
in
person
or
remote
from
the
office.
B
A
Thank
you.
We
do
not
have
a
quorum
right.
Okay,
we'll
we'll
dispense
with
the
minutes
right
now
and
approve
them
later.
If
we,
if
we
get
a
quorum
so
before
we
begin
for
all
members
participating
remotely,
please
remember
to
mute
your
microphones.
We
do
have
a
full
agenda.
This
morning.
A
First
I'd
just
like
to
invite
the
commissioner
morris
and
deputy
commissioner
craig
craft,
the
department
of
behavioral
health,
developmental
and
intellectual
disabilities,
to
give
us
a
presentation
on
the
governor's
budget
recommendations
you
may
proceed
in
addition.
Introduce
yourselves
for
the
record.
You
may
proceed.
C
C
Thank
you,
madam
chair
and
committee
members
for
having
us
here
today.
The
next
slide
wanted
to
just
start
with
a
brief
overview
of
our
department.
C
We
are
responsible
for
the
administration
of
state
and
federally
funded
mental
health
substance
use
disorder,
developmental
and
intellectual
disability
programs
and
services
throughout
the
commonwealth,
we're
the
federally
designated
entity
by
samso
the
substance,
abuse
and
mental
health
service
administration,
as
both
the
state
mental
health
authority
and
substance
abuse
authority.
Our
mission
is
to
provide
leadership
and
partner
with
others
to
prevent
disability,
build
resilience
and
facilitate
recovery
for
those
we
serve
next
slide.
C
C
On
any
given
day,
nearly
800
individuals
are
served
in
the
department's
facilities
which
we
operate.
Ourselves
are
under
a
contract.
We
have
four
acute
care:
psychiatric
hospitals
that
serve
about
350
people
a
day,
one
forensic
hospital
in
lagrange
kentucky
the
kentucky
correctional
psychiatric
center.
Historically,
we
have
a
census
of
about
60
in
that
facility.
C
That's
been
down
significantly
due
to
some
staffing
challenges
that
we'll
touch
on
a
little
later
and
we
have
two
long-term
care:
nursing
home
facilities
that
serve
approximately
150
people
a
day,
four
intermediate
care
facilities
for
people
with
intellectual
disabilities.
C
We
also
have
three
specialty
clinics:
a
specialized
personal
care
home
and
three
residential
substance
use
programs.
Most
of
our
community-based
services
are
private,
provided
primarily
through
kentucky's
14
community
mental
health
centers,
the
cmhcs.
C
They
do
fantastic
work,
they're,
really
good
partners,
and
they
are
a
network
of
non-profit
organizations
collectively,
making
up
behavioral
health
public
safety
net.
Here
in
kentucky
for
individuals
requiring
mental
health,
substance
use
and
or
developmental
and
intellectual
disability
services,
the
centers
collectively
employ
more
than
7
500
people
and
serve
more
than
150
clients.
C
Each
year
services
include
crisis
services,
diversion
services
to
keep
folks
in
the
lowest
level
of
care
possible.
They
serve
adults
with
serious
mental
illness,
children
with
serious
emotional
disorders,
substance,
use,
prevention
and
treatment,
homelessness,
services
and
prevention.
As
a
state
authority.
We
also
partner
and
provide
funding
to
support
a
number
of
other
community-based
partners
that
are
not
reflected
here
next
line.
C
Its
mission
is
to
reduce
opioid
overdose
deaths
and
increase
access
to
high
quality,
equitable,
evidence-based
prevention,
treatment
and
recovery
support
services
across
the
commonwealth.
Core
also
provides
leadership
across
state
agencies
and
community
partners
to
ensure
a
comprehensive
response
that
maximizes
impact
and
minimizes
duplication
of
effort.
C
A
big
challenge
has
been
the
change
in
drug
supply
and
the
influx
of
the
highly
fatal
fentanyl
in
heroin,
as
well
as
stimulant
drugs
similar
to
other
populations.
We
serve
at
d
bid,
there's
been
a
loss
of
financial
security,
housing
stability,
human
connection
and
purpose
which
have
threatened
the
stability
of
those
in
recovery.
C
The
framework
of
core
reflects
our
departmental
values
of
providing
a
comprehensive
response,
including
preventing
initiation
and
misuse
to
resilience,
building
integrating
screening
to
intervene,
early,
assertive
outreach
and
engagement
to
increase
crisis
service
and
treatment,
access,
supporting
treatment,
retention
through
person-centered
care
and
supporting
long-term
recovery.
This
framework
provides
a
groundwork
for
a
recovery.
C
Oriented
system
of
care
corps
has
funded
over
246
programs
statewide
to
implement
this
response.
112
hospitals
have
committed
opioid
stewardship.
Our
peer
support,
specialist
workforce
has
grown
dramatically
in
2021
over
50
000
narcan
units
were
distributed
and
nearly
7
000
suspected
overdose
reversals
were
documented.
C
C
Our
goal
and
commitment
is
to
scale
up
and
sustain
these
programs
to
reach
more
kentuckians
impacted
by
the
opioid
crisis
and
underlying
behavioral
health
crisis,
and
with
that
I'm
going
to
turn
it
over
to
stephanie.
I
hope
can
go
the
next
slide
to
talk
a
little
more
specifically
about
the
budget.
Yes,
good
morning.
E
This
slide
shows
the
department's
budget
for
2022
by
programming
area,
the
largest
part
of
that
budget
55
273.4
million,
is
for
the
operation
of
the
department's
facilities.
39
191.6
million
provides
funding
for
our
community
behavioral
health
programs.
E
There's
a
breakdown
about
83.7
of
that's
for
mental
health
programs
and
close
to
108
million
for
substance
use
disorder
programs,
there's
five
percent
that
is
set
aside
for
community
programs
for
individuals
with
developmental
and
intellectual
disabilities
and
one
percent,
our
general
support
or
administrative
costs.
Next,
stop
please.
Sarah.
E
Let's
do
quick,
44,
215.2
million
are
agency
funds.
Those
are
primarily
receipts
that
we
get
from
medicaid
medicare
and
third-party
billers
for
the
operation
of
our
facilities.
E
E
I
won't
dwell
on
a
lot,
but
just
to
note
a
few
things
you
can
see
a
significant
reduction
of
general
fund
from
fiscal
year
20
to
fiscal
year
21,
and
that's
actually,
where
the
community
mental
health
centers
support
for
their
kentucky
employment
retirement
system
was
moved
from
the
department
to
personnel
cabinet
in
the
last
budget,
but
not
really
a
true
general
fund
reduction.
E
Our
agency
funds
are,
if
you'll
note,
there's
a
decrease
from
expenditures
in
2020
through
2021.
E
E
For
federal
funds,
there's
a
significant
increase
from
2020
to
2022..
That
increase
is
again
provider
for
private.
I'm
sorry
provided
relief
funds
for
the
facilities,
as
well
as
other
funds
for
our
community-based
programs
that
were
received
under
the
cares
act
and
the
american
rescue
plan
act.
So
you
can
see
those
will
decrease
going
out
in
the
outer
ears
and
then
our
tobacco
funds
are
used
for
substance,
use
disorder,
programs
for
pregnant
and
parenting
women,
and
also
for
rural
suicide
prevention
program.
C
Next
slide,
sarah,
thank
you.
So
we
want
to
talk
for
just
a
minute
about
initiatives
that
were
funded
in
both
house
bill
1
and
house
bill
285.
C
The
department
is
just
really
excited
about
the
many
initiatives
related
behavioral
health
that
were
included
in
both
of
these
bills
and
just
want
to
thank
you
and
express
our
gratitude
for
that
behavioral
health
is,
we
know,
really
been
highlighted
as
important
during
these
past
couple
of
years.
The
first
thing
is
the
cost
of
living
adjustments
to
our
employees,
as
we've
already
mentioned,
as
if
you've
heard
many
times
during
the
during
the
interim
staffing
shortages
have
been
pervasive
and
it's
been
very
difficult
to
staff
our
facilities.
C
So
this
is
going
to
make
a
big
difference.
Next
is
the
90-day
crisis
support
line
implementation,
as
you
likely
know,
in
july
of
this
year,
988
will
be
implemented
to
replace
the
national
suicide
prevention
lifeline
or
nspo,
making
it
easier
for
kentuckians
to
seek
services
when
they're
having
a
behavioral
health
crisis.
C
10
of
the
14
cmhcs
are
currently
nspl
certified
call
centers,
and
we
anticipate
that
13
of
the
14
will
be
fully
accredited
before
and
on
a
day
goes
live.
These
funds
will
allow
the
call
centers
to
respond
to
the
anticipated
increase
in
call
volume
when
it's
a
three-digit
number.
Those
it's
expected
we'll
get
a
lot
more
calls,
and
it's
going
to
allow
calls
from
kentuckians
to
be
answered
and
responded
to
by
kentuckians,
as
well
as
having
little
to
no
wait
times
for
response.
C
C
This
is
covatosian
for
staff
and
patients
of
our
facilities.
Again,
we
have
up
to
800
people
in
our
facilities
on
any
given
day
and
3
400
staff,
which
equates
to
about
5
to
6
000
tests
a
month.
These
funds
are
going
to
allow
the
department
to
comply
with
cms
cdc
and
the
office
of
the
inspector
general.
C
C
All
of
our
departments
buying
a
budget
request
since
that
time
have
contained
a
request
for
funding
for
tim's
law
and
we're
delighted
to
have,
for
the
first
time,
some
funding
available
for
that
in
2020,
the
department
applied
for
and
was
awarded
a
four-year
1
million
dollar
samsung
grant
to
pilot
assisted,
outpatient
treatment
or
aot
in
kentucky,
which
allowed
us
to
pilot
tim's
law.
C
C
Next
is
the
increased
slots
for
the
sel
and
michelle
p
wavers.
Although
this
is
a
medicaid
program,
our
department
does
provide
the
oversight
of
those
programs
which,
as
you
know,
are
critical
supports
for
individuals
with
intellectual
and
other
developmental
disabilities,
allowing
them
to
live
in
the
community
and
decrease
reliance
on
our
facilities.
C
Next
is
the
support
of
the
cmhcs
to
offset
the
cost
of
unfunded
liability
associated
with
their
participation
in
cars.
The
kentucky
employee
retirement
system,
as
previously
mentioned,
the
cmh
serve
over
150
000
individuals
every
year
whose
lives
are
impacted
by
mental
health,
substance
use
and
or
intellectual
and
developmental
disabilities.
So
this
is
this
is
really
important
and
we
thank
you.
C
Next
for
capital
budget,
we
were
pleased
to
see
funding
for
renovations
of
our
oakwood
icf
western
state
nursing
facility
and
a
substantial
maintenance
pool
the
department's
facilities
age.
C
Their
range
and
age
is
from
eastern
state
hospital,
which
was
open
in
2013
to
western
state
hospital,
which
was
built
in
1854
maintenance
pool
funding
is
critical
for
the
department
to
maintain
our
state-owned
facilities,
again:
four
hospitals,
two
nursing
homes,
four
icfs,
three
icf
homes,
three
clinics,
a
personal
care
home
and
two
sud
homes.
So
we
have
lots
of
real
estate
renovation
of
the
oakwood
and
western
state.
Nursing
facilities
in
particular
will
make
both
of
those
facilities
more
efficient
and
accessible
to
the
people
who
live
there
slide.
E
So
this
slide
includes
a
list
of
some
of
the
governor's
initiatives
that
were
not
funded
in
house
bill.
1.,
probably
most
critical
of
the
department
was
a
request
for
a
current
year
appropriation
for
restricted
funds
for
agency
funds.
E
The
appropriation
authority
will
allow
the
department
to
use
receipts
from
the
billings
of
the
facilities
for
operations
of
the
facilities.
As
the
commissioners
mentioned
a
couple
times,
staffing
for
the
facilities
has
been
an
extreme
struggle
over
the
past
two
years.
Direct
care
staff
for
our
facilities
in
2019
were
there
were
over
780,
full-time
and
part-time
employees
by
july
of
2021.
That
was
down
to
650.
E
as
an
example,
our
largest
facility
western
state
hospital
in
july
of
2020.
They
were
already
at
a
reduced
number
of
direct
care
staff
at
300.
by
june
of
2021.
That
number
had
decreased
to
246
and
in
august
two
months
later,
the
department
lost
28,
direct
care
and
nursing
staff,
and
they
were
only
out
able
to
hire
sex
that
month.
So
there's
just
many
other
examples
of
our
facility
struggling
and
as
a
result
of
that,
the
department
has
instituted
some
salary
initiatives
to
try
to
attract
and
retain
the
existing
staff
that
we
have.
E
E
So
with
those
salary
adjustments,
we
hope
that
will
lead
to
increased
staff,
so
we'll
have
the
cost
of
increased
staffing,
as
well
as
increased
costs
for
the
existing
staff
that
benefited
from
those.
So
this
appropriation
authority
again
will
allow
us
to
use
the
funds
that
we
generate
from
billings
to
cover
those
salary
initiatives
to
staff
the
facilities.
E
E
There
was
additional
funding
included
for
oakwood
generator
project.
There
is
a
an
existing
in
the
last
final
budget.
There
was
a
1.8
million
dollar
project
set
aside
for
the
to
replace
the
generators
which
are
45
years
old
at
the
facility
and
based
on
current
market
rates.
That
funding
will
not
be
sufficient
to
to
cover
the
of
that
project.
E
So
again,
house
bill
285,
included,
675
000
to
add
to
the
project
funding
for
that
and
then
again,
our
kentucky
correctional
psychiatric
center
is
on
the
grounds
of
luther
like
it
and
it's
in
a
facility
that
was
built
in
the
1980s,
and
I
think
the
governor's
budget
had
in
the
department
of
corrections
of
projects
set
aside.
That
would
allow
us
to
do
some
security
upgrades
there
window
and
roof
replacements
and
some
repairs
to
hvac
and
electrical
systems
as
well.
Some
other
repairs
and
improvements.
C
A
G
E
Tobacco
funds
are
typically
a
continuing
appropriation,
I'm
not
exactly
sure
when
tobacco
fans
overall
for
the
state
of
a
master
settlement
agreement
with
that
works,
but
for
the
department,
our
funds,
it's
a
continuing
appropriation.
So,
typically,
if
programs
don't
spend
those
they're
able
to
carry
them
forward
and
continue
to
offer
those
programs
the
following
year,.
G
C
So
tim's
law
named
for
tim
morton,
who
had
chronic
and
persistent
mental
illness
for
a
long
time.
His
mother
is
a
huge
advocate
and
part
of
nami
I've
known
her
for
many
years.
Tim's
law
is
it's
a
process
for
an
involuntary
outpatient
commitment,
so
somebody
can
be
committed
compelled
to
receive
outpatient
treatment
and
services
and
work
with
the
court.
Some
called
the
black
robe
effect.
C
Sometimes
people
will
be
more
compliant
if
there's
a
judge
in
a
court
involved,
and
that
would
be
before
they
really
meet
the
criteria
to
be
involuntarily
hospitalized,
which
of
course,
is
you
know
difficult
for
people
to
be
away
from
their
family
and
away
from
home
and
in
some
of
those
responsibilities.
So
it's
it's.
It's
we've
piloted
there.
Not
a
lot
of
people
have
gone
through
it.
Yet
because
it's
been
pretty
new,
but
it's
we've
had
you
know
a
few
of
those
cases
have
been
quite
successful
so
and
it's
it's.
C
G
Answer
your
question:
yeah
it
does.
I
I
have
a
question
about
the
condition
of
the
state
facilities.
I've
been
here
for
24
years
now,
and
it's
always
been
a
nightmare.
How
bad
is
it
still
and
and
what
are
your
hopes
for
full
recovery
for
these
facilities
as.
C
Our
kentucky.
Correctional
psychiatric
center
needs
a
lot
of
repairs
to
make
sure
that
it's
secure
and
then
our
western
state
hospital,
which
was
again
built
in
1854,
is
really
really
difficult
to
maintain
and
to
keep
contemporary
and
updated.
But
we
struggle
a
lot
in
in
our
ics
to
oakwood
and
outwood.
The
cottages
need
pretty
frequent
repairs.
E
Yeah,
I
would
just
say:
we've
been
pretty
fortunate:
the
department
has
received
replacement
facilities
for
central
icf,
which
is
now
bingham,
gardens,
glasgow,
nursing
facility
and
eastern
state
hospital
all
been
replaced,
so
we've
been
fortunate
there
and
again,
the
also
recently
we've
had
funding
for
the
updating
of
the
cottages
at
oakwood.
E
G
C
We
have
about
800
people
in
on
any
given
day
in
all
those
facilities
that
census
is
down
quite
a
bit
from
say
a
decade
ago.
I
think
we
were
looking
just
this
morning
at
census
from
2009
there's
a
lot
of
factors,
one
we
our
census
is
down
in
our
acute
psychiatric
hustles,
because
there's
there
is
so
much
more
programming
for
substance
use
disorder.
Now
that
people
don't
have
to
go
to
psychiatric
hospitals
for
that
type
of
service.
C
Our
census
is
down
in
our
icfs
because
we
we're
under
a
consent
decree
with
the
department
of
justice
in
the
early
2000s,
and
there
was
a
continued
push
to
to
get
people
services
in
the
community.
People
with
intellectual
and
developmental
disabilities.
C
Again
census
is
down
at
kcpc
right
now.
It
was
down
because
we
were
not
able
to
keep
all
the
units
open
due
to
the
maintenance
needs,
and
now
it's
down
because
of
critical
staffing
shortages.
We
we
need
more
beds
there.
We
just
have
to
work.
We've
got
lots
of
initiatives
underway,
trying
some
creative
things,
things
we've
never
thought
about
before
to
try
to
increase
staffing,
and
I
think
I
think
the
waitlist
went
down
for
the
first
time
last
week.
C
So
we're
hoping
that's
a
new
trend
but
yeah
about
800
people
a
day.
G
Wow
one
more
question
just
for
levity:
the
building
that
was
built
in
1854
has
anybody
ever
reported
any
ghosts
in
that
building?
I
don't
know.
E
Not
officially,
but
the
former
facility
director
was
there
did
speak
of
the
reports
of
ghost
as
well.
So,
okay,
it's
a
it,
is
a
beautiful
old
building.
So
if
you're
ever
in
hopkinsville-
and
you
have
a
chance
to
go
past
it,
they
considering
the
age
of
it
and
limits
on
funding
in
the
past
for
maintenance,
they've
done
an
excellent
job,
taking
care
of
it.
A
Okay,
sorry,
representative,
fraser
gordon
sure,
oh
okay,
okay,
I
have
a
few
questions.
I'll
try
to
do
them
quickly.
I
I
want
to
give
you
kudos
on
the
core
work.
I
think
that's
great,
you
said
there
was
an
increase.
Has
that
when
did
that
increase
start
seeing
increase
in
the
fentanyl
coming
in,
though.
C
Well,
I
think
we've
seen
an
uptick
in
that
for
for
quite
a
while,
but
the
increase
in
overdoses.
Really.
I
think
that
data
just
started
to
trend
up
in
the
past
year
is
that
right
because
we've
been
seeing
a
decline,
but
again
our
as
a
society.
We've
had
a
lot
of
new
stressors
over
the
past
couple
of
years
and
that's
it's
been
a
national
trend,
so
we
try
to
stay
in
touch
with.
You
know
our
partners
across
the
nation
and
we
know
we're
doing
a
lot
of
good
work.
We
just
need
to.
A
C
A
It
okay,
thank
you
and
then
on
slide
five
you're
talking
about
the
residential
does
that
include
the
the
contracts
with
the
nonprofits
and
the
like
the
children's
alliance
facilities.
Does
that
include
them
so.
E
For
our
residential
piece,
that's
our
state-owned
facilities
and
the
contracts
that
will
be
included
in
those
would
be
university
of
kentucky
for
operation
of
eastern
state
hospital,
new
vista
for
the
operation
of
many
of
the
icfs
and
rest
care.
Our
community
piece,
our
community
partners,
will
be
in
that
community,
behavioral
health
portion
and.
C
If
you
will
look
at
slide,
I
think
it
is
three
we
on
that
map.
You'll
see
our
facilities
yeah
there
they
are,
we
all
those
stars
are
where
facilities
are
and
then
they're
color-coded.
So
the
red
stars
are
our
acute
hospitals
in
our,
including
our
forensic
hospital.
The
light
blue
are
our
nursing
homes.
The
dark
blue
stars
are
the
icfs.
A
Reason
I
asked
a
question:
is
I'm
hearing
from
some
of
those
folks
that
have
state
contracts
that
are
sorely
underfunded
as
well?
So
that's
why
I
was
asking
if
that
was
included
in
the
residential,
because
that's
that's
who's
talked
to
me.
So
apparently
you're.
This
is
just
the
st
your
state,
the
state-owned
facilities
correct
the.
A
E
A
Okay,
so
that's
why
it's
five?
Yes,
okay!
Okay,
thank
you
for
that
and
then,
let's
see
on
the
expansion
of
tim's
lawn
on
section
eight
you
didn't
mention.
I
know
it's
supposed
to
go
to
the
west
river
valley.
I
didn't
hear
you
mention
penny
roll
in
millenberg
county.
Is
it
included
in
that
as
well
or
any
rules
included?
Okay,
yes,
ma'am?
Okay!
I
didn't
hear
you
mention
it,
so
I
just
wanted
to
ask
and
then
my
final
question
on
slide.
A
Nine
we'd
love
to
give
more
money
if
it's
available,
but
if
not
do
you
all
ever
get
to
do
private
public
partnerships?
I
know
we
did
that
at
lake
malone
state
park
for
a
new
dock
there
were
private
public
partnerships.
Can
you
ever
do
that
for
some
of
the
needs
financial
needs
that
you
have
in
some
of
these
facilities.
A
I'm
just
thinking
there
might
be
businesses
in
a
community
that
might
be,
you
know
supportive
and
might
be
willing
to
help
match
or
something
like
that,
but
just
just
a
thought
on
that
front
and
I
have
actually
been
to
oakwood
and
hazelwood.
When
I
did
my
physical
therapy
rotations
in
school,
we
went,
we
went
to
those
facilities.
A
G
Those
were
great
questions,
madam
chair.
I
just
want
to
ask
you
to
pass
on
our
deep
appreciation
to
all
of
the
staff
and
people
that
work
at
these
facilities.
G
We
can't
meet
them,
but
we
couldn't
survive
without
them.
Thank
you
so
much
and
pass
that
on.
Please.
C
We
will
you
know,
I
will
say
in
case
you
don't
know,
one
of
our
facilities
is
in
dawson
springs
and
we
had
a
lot
of
staff
there
who,
in
addition
to
everything
else,
lost
their
homes,
and
we
were
fortunate
to
be
able
to
provide
housing
for
some
of
our
staff
on
the
campus
there.
So
our
facilities,
their
staff,
are
they're
like
family,
so
we
will
certainly
pass
that
on
and
we
very
much
appreciate
that.
A
And
echo
that
from
the
whole
committee,
thank
you
very
much.
Thank
you.
Thank
you.
Next
we
have
dr
commissioner
stack
and
mr
tuggle
to
provide
a
presentation
on
the
budget
recommendations
for
the
department
of
public
health.
Just
please
identify
yourselves
for
the
record
record
and
then
you
may
proceed.
We
will
transition
out
with
them.
H
Thank
you
who
is
my
slides,
carrie,
I
say
right.
Thank
you.
Sarah
next
slide,
please
so
good
afternoon
is
good
morning
good
morning.
Maybe
it's
wishful
thinking
so
good
morning.
I'm
pleased
to
be
here
today
to
speak
about
the
department
for
public
health
budget,
so
I
have
with
me
budget
director,
mike
tuggle
from
the
department
for
public
health
and
myself,
along
with
the
others
from
the
cabinet
behind
me.
H
So
next
slide,
please,
the
department
for
public
health,
I
realize,
has
received
a
lot
of
attention
in
recent
years
for
its
engagement
and
activity
on
covet
19,
but
the
department
for
public
health
does
much
more
than
just
kobe
19
and
in
fact
it
will
return
at
some
future
point
in
time
to
not
doing
cobit,
19,
probably
and
mostly
doing
these
other
things.
H
Just
some
examples
of
our
programs
in
the
prevention
bucket
hands
and
first
steps
which
are
early
childhood
programs
geared
towards
reducing
adverse
childhood
events
and
setting
people
off
to
a
good
start
at
the
beginning
of
life,
immunizations,
which
are
obviously
important
for
a
variety
of
preventable
diseases
and
newborn
screening
and
I'll.
Come
back
to
that.
H
On
my
last
slide,
the
department
for
public
health
provides
all
of
the
55
mandated
newborn
screening
tests
for
all
approximately
53
000
live
births
in
the
state
of
kentucky
on
an
annual
basis,
so
that
obviously,
is
an
incredibly
important
service
and
a
service
that
is
not
provided
anywhere
else
or
by
any
other
lab
within
the
commonwealth
of
kentucky.
In
terms
of
protection,
we
do
environmental
inspections.
Of
course,
a
number
of
agencies
and
other
parts
of
government
do
various
inspections.
H
We
have
a
disaster
preparedness
area
that
works
on
things
like
the
health
function
when
we
have
the
tornadoes
go
through
western
kentucky
when
we
have
flooding
in
eastern
kentucky
and
then
of
course,
covet
they've
played
an
enduring
role
throughout
the
covet
response:
disease
surveillance.
Again
we
talk
about
covet
a
lot
but
there's
all
sorts
of
other
diseases,
sexually
transmitted
infections,
tuberculosis,
hepatitis,
hiv,
aids
and
a
variety
of
other
conditions,
including
the
avian
flu
issue.
H
If
that
changes,
harm
reduction,
mobile
harm
reduction
has
to
do
with
addressing
the
opioid
epidemic
and
helping
to
mitigate
the
harms
caused
by
that
horrible
affliction
and
then
for
promotion
to
talk
about
food
nutrition
services
and
the
women
at
the
children's
program
and
other
things,
such
as
smoking,
cessation,
diabetes
prevention,
prescription
assistance
and
any
number
of
other
areas
where
we
try
to
promote
good
health
and
help
people
adopt
behaviors
that
make
that
possible
next
slide.
Please.
H
This
is
a
budget
slide.
That's
going
to
show
you
two
years
of
historical
data
for
actual
spending,
the
current
fiscal
year,
22
budgeted
spending
plan
and
then
also
the
upcoming
biennium
in
the
governor's
proposed
budget
in
fiscal
year,
23
and
24..
The
only
thing
I
want
to
draw
your
attention
to
on
this.
Our
department
is
typically
about
360
million
dollars,
give
or
take.
H
It
has
expanded
substantially
because
of
federal
cova
dollars
that
have
come
through
the
department,
and
you
notice
that
at
the
bottom,
in
the
total
lines,
we've
gone
from
about
360
million
up
to
600
million
for
fiscal
year,
21
to
770
million
approximately
for
fiscal
year
22,
and
that
the
largest
year
would
be
potentially
next
year
in
fiscal
year
23,
and
then
it
would
begin
the
de-escalation
in
years
forward,
and
I
would
imagine
we
would
return
to
a
more
traditional
type
of
budget
in
years
ahead.
Next
slide,
please.
H
So
this
shows
all
the
revenues
of
the
funding
sources
for
the
department
for
public
health.
Almost
80
percent
of
our
funds
are
federal
funds,
and
this
is
again
a
good
way
to
look
at
this.
Typically,
we
have
just
under
200
million
dollars
in
federal
funds.
We
have
about
600
million,
so
it's
been
about
a
tripling
of
our
federal
funding.
The
other
funding
sources
are
generally
similar
to
or
consistent
with
previous
experience.
H
Next
slide,
please
so
this
slide
will
show
you
the
expenditures.
This
is
again
for
the
current
fiscal
year,
22.,
the
largest
proportion
53
percent,
goes
in
grants,
loans
and
benefits.
So
this
is
supporting
local
health
departments
and
supporting
other
partners
and
the
work
that
they
do.
Personnel
costs,
of
course,
like
most
of
our
agencies,
our
people
are
one
of
our
most
valuable
assets,
and
so,
of
course,
there's
costs
both
directly
employed
and
contracted
services
included
there
and
then
there's
a
small
sliver
at
four
percent
for
actual
operating
costs.
H
That
would
be
for
things
like
technology
and
information
services,
support
materials
to
support
the
laboratory
and
its
work
and
other
concrete
operating
expenses
next
slide,
please
I
have
this
for
the
revenue
side
and
in
a
minute
we'll
get
to
the
expenditure
side.
The
the
single
thing
I
want
to
show
here
really
is:
this
is
for
the
proposed
biennial
budget
fiscal
year,
23,
followed
by
24..
H
The
debt
service
is
a
new
item
and
I'll
touch
on
that
on
my
final
slide.
That
is
for
a
proposed
capital
spending
project
for
a
modernization
of
our
public
health
lab.
Currently,
dph
doesn't
have
debt
to
service,
but
should
that
be
approved,
we
would
have
the
budget
would
include
in
the
governor's
budget,
the
money
necessary
to
maintain
that
bond
funded
project
next
slide,
please.
H
So
these
slides
are
intended
to
show
where
the
house
proposed
budget,
the
governor's
budget
are
perhaps
similar
or
differ
a
little
bit.
Let
me
first
say
here
as
I
go
into
this
final
major
section
of
my
presentation.
I
want
to
thank
both
the
governor
and
thank
the
legislature
through
its
house
budget.
Both
of
these
budgets
provide
very
important
and
essential
support
for
public
health
across
the
state,
both
through
the
state
department
for
public
health
and
also
our
invaluable
local
health
department
partners,
upon
whom
we
all
rely
to
provide
these
important
services
in
these
areas.
H
All
three
of
these,
both
the
house
and
the
governor,
have
recommended
funding
to
address
these
three
essential
elements.
So,
first
of
all,
I
think
we
all
know
our
state
employees
have
not
had
a
cost
of
living
increase
for
far
too
long.
A
newbie
like
me,
who's
only
been
here
for
two
years,
not
such
a
big
deal
for
all
of
these
other
dedicated
employees
who
have
been
here
working
so
hard
and
certainly
through
covet
above
and
beyond.
H
This
is
essential
and
really
critical
to
our
ability
to
recruit
and
retain
a
highly
talented
and
committed
workforce
and
to
reward
them
appropriately
for
the
important
services
they
provide.
So
thank
you
both
to
the
house
and
the
governor.
Of
course,
there
are
differences
in
the
approaches
here
and
I'll
leave
that
to
others
to
navigate,
but
we
obviously
are
supportive
of
recognizing
the
workforce.
H
The
other
two
items
are
also
very
important
predominantly
to
support
the
local
health
department,
so
in
2020,
just
before
the
pandemic
hit
in
a
wonderfully
collaborative
effort.
That
involved
democrats,
republicans,
the
house,
the
senate,
local
government
state
government,
a
wonderfully
collaborative
partnership-
and
I
see
representative
mosher
here
on
my
screen-
thank
you
to
representative
mosher
and
to
senator
alvarado
for
their
work
on
this
and
the
others
who
worked
along
with
us.
But
we
recognized
an
incredible
crisis
with
the
local
health
departments,
where
more
than
half
of
the
counties
would
be
bankrupt.
H
Over
the
next
two
year
period,
this
is
what
I
was
thought
would
be
my
primary
focus
when
I
took
this
job
two
years
ago
and
then
kova
delta
curveball
to
all
of
us.
This
funding,
though,
did
not
get
through
so
when
they
passed
house
bill
129
in
2020.
H
The
session
was
interrupted
because
of
covid
and
the
funding
mechanism
didn't
get
addressed.
Thank
you
to
the
house
and
to
the
governor
for
putting
in
place
the
funding
necessary
to
enact
this
important
transformation
and
make
sure
we
have
a
supportable
sustainable
public
health
system
for
the
people
of
kentucky,
and
these
are
the
funds
that
are
necessary.
H
So
thank
you
and
then
in
2021,
in
the
regular
session,
the
legislature
passed
house
bill
8
and
that
placed
certain
additional
obligations
for
pension
liabilities
on
contracted
workforce,
that
the
local
health
departments
and
the
state
department
for
public
health
rely
upon.
This
provides
the
funding,
that's
necessary
to
implement
and
make
that
house
building
doable,
and
so
thank
you
very
much,
and
this
will
largely
support
the
local
health
departments
in
the
work
they
do
next
slide.
Please.
H
This
is
the
first
area
where
there
is
a
material
or
substantive
difference
between
the
house
and
the
governor's
budget.
The
governor
has
recommended
just
shy
of
180
million
dollars
from
the
american
rescue
plan.
The
arpa
state
fiscal
recovery
funds
in
order
to
support
ongoing
coveted
mitigation
activities,
so
kovitt
will
not
be
with
us
indefinitely.
H
Additionally,
the
governor
has
proposed
an
additional
one
and
a
quarter
million
dollars
in
added
resources
for
the
pediatric
cancer
research
trust
fund.
This
is
in
addition
to
the
funding
that
is
already
provided
and
again,
I
would
commend
this
to
you.
I
think
we
can
all
appreciate
the
incredible
distress
finding
out
that
your
child
has
a
cancer
diagnosis,
places
on
families
and
the
child
him
or
herself,
and
how
it's
important
for
us
to
support
these
initiatives.
H
The
next
two
items
are
included
in
both
the
house
and
the
governor's
budget,
so
the
20
2.5
million,
rather
of
general
fund
dollars
to
support
the
area
health,
education
centers,
would
help
to
support
community
partners
who
are
working
on
improving
the
health
care
workforce
pipeline.
I
know
this
is
a
topic
that
has
been
widely
discussed
both
by
the
governor
and
by
the
legislature,
and
so
thank
you.
This
is
in
both
budgets
at
present
and
then
the
final
one
is
not
actually
money
asked
of
you.
It's
an
appropriation
requested
of
you
and
it's
in
both
budgets.
H
H
H
I
want
to
just
give
you
a
little
bit
of
insight
about
what
goes
on
there.
So
we
have
a
high
complexity,
clinical
reference
laboratory
and
select
agent
facility,
and
by
select
agent
I
mean
we
handle
the
bioterrorism
specimen.
So
if
anthrax
or
white
powder
shows
up
in
an
envelope
somewhere,
it
is
that
lab
that
analyzes,
it
is
a
biosafety
level
3
facility.
There
is
no
other
biosafety
level
3
facility
in
the
commonwealth
of
kentucky.
H
The
building
is
over
30
years
old,
the
laboratory
science
and
the
machines
have
evolved.
Remarkably,
it's
almost,
but
not
quite
like
going
from
the
middle
ages
into
the
star
trek
era.
These
machines
generate
an
incredible
amount
of
heat.
They
require
incredibly
precise
environmental
conditions
for
temperature
and
humidity,
and
this
physical
plant,
this
building,
in
which
the
lab
operates,
cannot
maintain
those
conditions
and
it
places
us
in
regular
peril
of
failure
of
machines,
loss
of
necessary
accreditation
in
order
to
provide
these
services
for
services,
for
which
there
is
no
in-state
backup.
H
Some
of
the
other
problems
in
the
building.
Some
of
the
initial
equipment
in
the
building
the
autoclaves
would
sterilize
equipment.
The
water
purifiers,
the
chillers,
the
big
refrigerators
that
store
important
chemicals
and
other
materials
are
all
original,
install
end
of
life
and
break
down
on
a
recurring
basis.
There's
also
extensive
deferred
maintenance
with
recurrent
water
leaks
from
the
roof,
which
run
the
risk
of
dripping
onto
multi-million
dollar
analyzers,
causing
them,
obviously
to
get
upset
and
irritable
and
not
function
properly
and
a
potential
economic
loss
to
the
the
commonwealth.
H
There
are
a
number
of
other
issues,
but
the
services
we
provide
I've
already
mentioned
53
000
live
bursts
about
every
year
newborn
screening.
There
is
no
other
lab
in
the
state
that
provides
that
service.
Every
newborn
has
specimens
sent
there.
If
we
didn't
have
that
lab,
we
would
have
to
send
it
at
a
substantial
added
expense
to
an
out-of-state
lab
to
and
pay
another
vendor
to.
Do
it
same
thing
for
the
biosafety
level,
three
lab
animal
necropsy
lab.
We
do
the
rabies
testing
and
you
have
to
study
the
brain
of
a
deceased.
H
H
H
We
did
a
feasibility
study
that
we
got
a
vendor
for
late
last
summer.
We
expedited
that
through
the
fall,
we
got
the
study
report
in
december,
and
this
got
in
in
time
for
the
budget
materials
it
may
not
have
been
known
or
available
to
the
house
when
they
worked
on
their
version
of
the
budget.
I
would
just
urge
and
commend
you
to
please
consider,
including
this.
It
would
be
a
five-year
project
which
means,
in
all
intents
and
purposes
it
would
be
six
years
before
someone
has
it.
H
I
would
love
to
watch
a
future
commissioner,
celebrate
the
cutting
of
the
ribbon
and
know
that
the
commonwealth
of
kentucky
will
move
out
of
a
then
nearly
40
year
old
building
that
has
served
its
purpose
well,
but
at
this
point
simply
cannot
continue
to
support
the
commonwealth
for
these
critical
services
because
it
needs
to
be
replaced
with
a
more
modern
facility
next
slide
and
now.
Madam
chair,
I
offer
myself
and
mr
tuggle
up
to
you
for
any
questions
that
you
may
have.
A
G
H
Representative
westrom,
I
think
one
I
can't,
because
my
my
duration
is
two
years
that
maybe
others
behind
me
could
comment.
But
I
think
one
of
the
challenges
I
would
imagine
always
is
the
case
that
we
we
have
a
large
physical
plant
across
the
state
that
supports
many
agencies
and
it's
always
a
difficulty.
You
have
to
prioritize
and
make
choices
about
where
we
do
or
don't
invest.
H
I
I
would
just
say
there
is
a
lot
of
deferred
maintenance
across
a
wide
variety
of
state
buildings
and
a
real
need
to
make
use
of
this
moment
in
time
to
invest
in
some
of
this
critical
infrastructure
so
that
the
commonwealth
is
on
a
solid
footing
going
going
forward.
But
as
far
as
historical
perspective,
I'm
sorry
I
don't.
I
don't
have
that-
to
provide.
G
B
Thank
you
chair,
lady
doctor,
for
this
new
40
year
old
building.
What
is
the
estimate
on
providing
that?
How
much
money
would
you
probably
need.
H
Yes,
sir,
so
the
the
vendor
there's
a
feasibility
study.
I
believe
we've
sent
that
over
to
sherman
petrie
just
recently,
it's
135
million
dollars
bond
funded.
So
this
is
not
an
ask
for
general
funds
now.
This
is
bond
funded
over
an
extended
period
of
time,
which
would
be
appropriate
for
a
project
like
this,
and
that
would
enable
us
to
provide
the
extra
physical
space
needed
to
accommodate
the
machines
to
expand
into
some
of
the
other
services.
B
A
You
you
too
now
that
we
have
a
quorum.
Can
we
approve
the
minutes.
A
A
Good
morning,
yes
introduce
yourselves
for
the
record
and
you
may
proceed
okay.
D
Okay,
and
so
thank
you
for
having
us
today
to
talk
about
our
department,
so
our
department
is
divided
into
two
divisions.
Sarah,
you
can
go
to
the
next
slide,
the
division
for
family
resource
and
new
services
centers,
and
also
serve
kentucky,
which
is
our
americorps
programs,
and
so
one
thing
I
just
want
to
note
on
that
slide.
That
has
the
amount
for
frisk
is
that
chris
also
receives
funding.
That's
allocated
to
the
department
of
education
in
the
amount
of
48.8
million
dollars.
D
So
I
may
remind
you
have
that
as
we
go
through
this
presentation
so
that
you
get
a
piece
of
the
whole
picture
and
the
way
that
our
funding
is
divided
illustrates
the
collaboration
and
the
whole
child
approach
that
frisk
embodies
when
it
comes
to
removing
barriers
to
learning
for
children
next
slide.
D
So
the
governor's
recommended
budget
there
is
an
increase
for
family
resource
and
youth
services.
Centers,
and
you
know,
any
increase
that
is
received
is
primarily
going
to
be
used
for
increasing
the
amount
that
schools
received
in
operation
of
their
frisk
next
slide.
D
And
this
this
pie
chart
would
look
differently
if
the
additional
funds
from
education
were
included.
So
if
that
additional
almost
50
million
was
included,
it
would
actually
drive
the
personnel
on
operating
costs
down.
So
around
97
of
the
funds
received
by
our
department
does
go
out
to
schools
and
communities.
D
Next
slide,
so
just
a
bit
about
family
resource
and
youth
services
centers,
we
do
have
frisks
in
our
168
of
our
school
districts.
We
have
100
874
centers
serving
over
1200
schools,
so
we
do
have
centers
that
serve
more
than
one
school
very
few
serve
at
three
schools,
and
then
our
schools
receive
between
33
and
83
thousand
dollars
to
operate
a
center,
and
those
funds
are
based
on
the
free
lunch
eligibility
account
in
those
schools.
D
And
you
know
we
do
have
schools
that
whether
allocation
does
not
cover
the
full
cost
of
their
frisk
and
we
do
work
with
those
districts
as
we
can.
We
have
some
schools
that
are
able
to
add
additional
funds
to
keep
their
center
open
for
the
240
day
requirement,
and
if
not,
then
we
do
what
we
can
to
work
with
those
districts
to
keep
centers
open
for
as
long
as
possible
next
slide.
D
So
a
few
highlights
I
wanted
to
share,
and
these
are
all
regarding
the
2020
2021
school
year,
our
local
frisk
reported
receiving
over
17
million
in
cash
and
income
donations
from
their
community.
So
that's
times
good
services,
and
this
does
not
include
because
it
is
for
last
school
year.
This
does
not
include
the
donations
received
for
the
recent
tornado
response
in
western
kentucky.
D
Our
family
resource
and
new
services
center
coordinators
were
out
in
our
communities
working
alongside
our
emergency
professionals
and
other
school
leaders
knocking
on
doors
checking
on
their
families,
receiving
coordinating
allocating
donations,
and
this
is
something
that
we're
going
to
continue
to
do
for
as
long
as
is
needed
in
that
part
of
the
state.
Our
first
also
coordinated,
almost
300
000
volunteer
hours
during
this
past
school
year
and
then
our
home
visits.
You
know
in
a
given
year
we
do
around
20
000
home
visits
and
that's
a
typical
typical
year.
D
So
in
the
2020
2021
school
year
we
did
almost
four
times
as
many
home
visits,
and
this
was
important
because
a
lot
of
our
students,
if
not
all
of
them,
were
learning
virtually
for
all
or
part
of
that
time,
and
we
know,
based
on
our
impact
reports,
that
this
was
just
a
critical
service
for
a
lot
of
our
families
and
then
the
last
bullet.
D
There
refers
to
our
frisk
impact
report,
so
our
family
resource
and
youth
services
center
coordinators
actually
track
and
send
in
impact
reports
related
to
some
of
their
services,
and
a
lot
of
that
is
focused
in
the
kind
of
the
tier
two
level
small
group
program,
students
that
have
been
identified
using
the
early
warning
tool,
persistence,
graduation
tool
or
other
data,
and
they
target
services
for
those
students.
You
have
in
your
packet,
a
one
pager
that
has
our
has
some
highlights
from
the
2021
report.
D
It
has
a
qr
code,
and
so
I
encourage
you
to
take
a
look
at
that.
It's
organized
by
subject
matter.
So,
if
you're
interested
in
things
that
are
strictly
academic
or
attendance
or
grandparents
support
social,
emotional
learning,
you
can
find
a
report
that
speaks
to
that
and
then
we
also
have
reports
that
are
organized
by
a
location.
So,
if
you're
looking
for
something
in
your
district,
we
can
find
one
for
you
as
well,
if
it's
not
on
the
page
that
you
received
next
slide.
D
So
this
graph
just
shows
the
adaptation
of
services
during
the
pandemic,
and
I've
already
spoke
to
the
the
home
visits.
That's
the
blue
line.
You
can
see
the
increase
there,
but
I
wanted
to
also
illustrate
our
telephone
email
text.
D
You
know
first
does
support
groups
for
parents
and
grandparents
and
we
transitioned
those
to
virtual
support
groups,
and
we
found
that
our
parent
support
groups,
actually
the
participation
increased
during
the
pandemic
when
we
went
virtual,
but
that
did
not
remain
true
for
our
grandparents
support
groups,
and
so
you
know
due
to
a
portion
of
those
85
000
home
visits,
we
were
able
to
connect
with
relatives
or
grandparents
that
are
caring
for
their
grandchildren,
get
them
more
comfortable
with
things
like
zoom
or
google
meets
or
facebook,
and
and
hold
our
support
groups,
and
we
actually
saw
our
grandparents
support
group
participation
increase
after
that
initial
dip
down.
D
So
this
is
an
example
of
one
of
our
impact
reports.
This
was
a
program
that
was
developed
to
fight
against
summer
slide,
and
so
not
only
did
overwhelming
majority
of
the
kids
that
participated
in
this
program
increase
in
their
attendance
and
in
their
graduation
score,
but
they
also
increase
their
math
and
reading
score
as
well.
So.
D
To
highlight
we're
really
really
proud
of
these
reports,
and
I
just
wanted
to
to
highlight
our
work
in
this
area.
You
know
our
family
resource
youth
services,
centers
have
done
a
great
job
in
thinking
more
about
outcomes
and
making
sure
to
share
these
outcomes
with
their
school
board,
with
their
site-based
council
with
their
advisory
councils
with
their
administrators
with
their
legislators,
and
so
I
just
wanted
to
make
sure
I
highlighted
those
the
next
slide,
and
I
believe
this
is
my
last
slide.
So
this
slide
gives
a
historical
perspective
on
for
on
three
things.
D
So
the
blue
line
is
our
free
lunch
count.
So
you
can
see
we
had
a
steady
increase
from
about
fiscal
year,
eight
up
until
about
16,
and
then
we
kind
of
leveled
off
and
dipped
down
a
bit
in
f
by
22..
D
The
orange
line
is
the
frisk
per
student
amount,
so
the
way
that
frisk
funds
get
to
schools
is
that
we
we
take
our
overall
allocation
divide,
that
by
the
free
lunch
numbers
and
we
get
a
per
student
amount
and
then
funds
are
allocated
to
schools
based
on
their
free
lunch
account.
D
So,
for
example,
in
fy
22,
if
you
had
180
students
in
your
school
that
were
free
lunch
eligible,
you
would
get
183.86
per
student,
which
would
get
you
to
a
little
over
33
000
for
running
that
center
for
the
entire
year,
and
then
the
boxes
indicate
the
number
of
centers.
So
we
held
pretty
steady
for
years
we
lost
a
couple
of
centers
due
to
school,
closings
and
consolidations.
D
Those
were
basically
the
only
reason
we've
ever
closed.
A
center
is
because
the
the
schools
shifted,
and
you
can
see
that
really
in
the
last
several
years
from
fya
all
the
way
to
22
we've
opened
58
new
centers.
D
Our
per
student
amount
has
increased
somewhat
from
170
to
183,
which
meant
more
dollars
went
to
those
individual
schools,
but
our
our
centers
have
expanded
and
that
those
58
centers
cover
around
50
000
kids.
So
those
were
50
000
kids
in
our
state
that
were
in
schools
that
were
eligible
for
family
resource
centers.
So
eligibility
is
20,
free
lunch,
so
those
schools
they
were
in
eligible
schools,
but
did
not
have
those
services.
D
So
now
those
students,
those
50
000
students,
do
have
access
to
a
family
resource
or
youth
services
center
and
that's
how
we
get
to
874
centers.
So
you
know
any
increase
that
we
receive
through
through
our
the
budget.
We
will
be
using
to
focus
on
that
per
student
amount,
because
you
can
see
we're
we're
always
off
from
getting
to
where
we
were
back
in
fiscal
year.
Eight
when
we
were
sitting
around
210
dollars
per
student
next
slide.
I
Okay
and
on
for
surf
kentucky
surf
kentucky
is,
of
course,
the
state
service
commission
for
americorps
in
kentucky,
the
state
service
commission
is
what's
required
by
the
federal
agency
in
order
for
kentucky
to
receive
americorps
funding
and
the
budget
that
we
have.
The
americorps
program
brings
in
10.3
million
dollars
in
federal
funds.
I
That
is
cash
from
the
fed
that
goes
out
to
local
communities
for
the
25
current
americorps
programs
that
we
have,
in
addition
to
the
to
the
money
that
comes
from
the
federal
government
for
the
participants
of
the
programs,
which
we
call
members,
there's
4.6
million
dollars
that
they
will
receive
for
completing
their
service
in
the
americorps
program
and
that's
4.6
million
dollars
if
they
are
available
to
them
to
use
for
their
continuing
education.
I
In
addition
to
that,
as
you
are
aware,
most
federal
grants
require
match
in
americorps
case,
the
match
is
actually
provided
by
those
programs
that
want
to
participate.
I
It's
been
more
than
doubled,
138
increase
in
the
size
and
number
of
the
program
since
2015,
when
there
were
just
12
programs
in
kentucky
the
programs
that
we
have
the
participants,
they
are
going
to
be
not-for-profit
agencies
or
local
school
systems,
higher
education.
I
They
are
the
ones
that
propose
the
programs
and
manage
those
and
they
engage
their
citizens
and
it's
for
the
purposes
of
addressing
their
and
solving
their
own
local
problems.
The
program
focus
in
kentucky,
predominantly
it
is
education
based.
They
are
about
tutoring
and
mentoring
at
risk,
youth
and
just
basically
doing
whatever
they
can
within
their
local
communities
to
to
make
their
students
successful.
I
I
Not
only
do
the
members
participate
in
service
which,
if
you
value
what
the
members
provide
in
service,
that
that
would
be
over
20
million
dollars
if
they,
if
they
were
to
be
paid
a
standard
wage,
but
they
also
leverage
those
those
same
members,
leverage
volunteerism
in
their
community
and
that's
getting
the
citizens
involved
in
and
that's
estimated
to
be
an
additional
million
dollars
in
value
from
that
volunteerism
service.
I
Next
slide,
please
now.
This
is
our
map
of
programs
in
kentucky
and
just
to
talk
a
little
bit
about
about
what
you're,
seeing
here
on
this
map,
the
bottom
portion
of
the
page
or
those
symbols
or
icons.
I
They
represent
the
different
programs
that
we
have
so
for
each
of
those
programs-
and
these
are
the
programs
with
with
members
for
every
county
where
there
is
where
there
are
members
serving
the
icons
for
that
program
appear
in
that
county.
I
So,
for
example,
just
looking
at
grant
county
that
has
with
the
the
graduation
cap,
that
is
kentucky
college
coaches,
which
is
a
program
operated
out
of
northern
kentucky
university
as
it's
as
its
fiscal
agent,
and
they
do
whatever
they
can
to
help
kids
be
successful
in
getting
into
college,
making
it
through
their
first
college
experiences
in,
but
including
just
helping,
kids,
be
sure
and
sign
up
for
the
fafsa
again
looking
at
any
of
the
counties,
you
can
see
what
programs
are
there.
I
It
tends
to
be
centered
in
a
lot
in
eastern
kentucky
and
around
the
cities,
which
is
probably
most
representative
of
where
our
first
programs,
our
first
americorps
programs,
originated
and
then
also
there
were
a
lot
that
were
associated
with
southeast
because
they
focus
a
lot
on
the
poverty
within
appalachian
counties
and
programs
that
are
very
specific
to
the
southeastern
counties.
A
A
A
J
A
Okay
and
then,
let's
see.
A
A
I
just
want
to
make
a
comment
on
when
you
were
talking
about
the
the
increase
in
uptick
for
parents
doing
virtual
during
the
covid
and
decrease
with
grandparents.
Grandparents,
probably
don't
have
the
technology
skills,
but
I
know
that
I
used
to
do
home
health,
physical
therapy,
and
I
know
going
in
the
home.
You
know
having
that
connection
with
parents,
especially
if
you
have
parents
of
kids
with
disabilities,
it's
difficult
to
get
them,
get
them
together
or
get
them
out.
A
So
you're
always
contact
with
with
the
families,
and
in
this
way
you
can
be
creative
moving
forward
and
you
use
what
you've
learned.
That
could
be
a
positive
that
came
out
of
covid
to
have
those
greater
connections
with
families,
and
then
I
just
just
the
impact
reports,
the
math
increase
in
reading
and
the
scores
just
kudos
on
that
the
increase
is
going
to
be
evident,
hopefully
in
the
future,
with
the
success
of
the
kids
and
then
I
just
slide.
My
final
question
on
slide
11.
How
do
you
decide
with
this.
A
I
Icon,
so
actually,
these
are.
The
americorps
programs
are
based
from
proposals
from
groups
or
organizations
that
want
to
sponsor
a
program.
So
it
is
completely
up
to
those
groups
how
how
many
counties
or
that
they
would
be
successful
in
so
you
know
we
are
it's
not
that
we
are
that
we
decide
which
counties
that
we
would
operate
in.
It's
it's
awarding
a
program
to
an
organization
that
will
be
the
determining
factor.
I
A
Okay-
and
the
reason
I
ask
is
I
I
see
college
coaches-
I
represent
the
15th
district
and
I
see
icons
in
hopkins
and
muhlenberg
and
I
with
the
nude
redistricting,
I'm
now
going
to
represent
butler
and
there
was
nothing
there.
So
that's
why
I
was
asking
the
questions
so
right,
how,
if
butler
county,
if
there
would
there
need
to
be
a
group
in
butler
that
would
request
that
or
how
does
that
work.
I
It
can
so
programs
and,
of
course
this
represents
where
the
members
are
serving
so
there
might
be
members
in
the
county.
Even
though
there's
not
an
official
office,
the,
for
example,
a
team
is
centered
in
barron
county
and
they
have.
They
have
engaged
a
lot
of
the
schools
here
out
to
the
far
west.
So,
for
example,
there's
there
is
a
frisk
program
who
could
potentially
put
a
member
into
your
county
through
that
program
or
through
a
team
or
through
some
of
the
other
programs
that
expand
beyond
just
a
single
county.
I
A
B
A
And
is
this
yeah
again,
last
but
not
least,
an
update
on
social
workers,
a
staffing
report,
commissioner,
if
you
could
come
to
the
table,
introduce
yourself
for
the
record
and
proceed.
A
Commissioner
y'all
introduce
yourselves
for
the
record
and
proceed.
Please
thank
you
for
being
here.
J
J
J
You
have
asked
for
a
historical
data
document
which
we
sent
to
you.
That's,
hopefully
you
have
a
chance
to
review
and
we
can
answer
questions
regarding
that.
As
you
would
see,
we
really
fell
off
the
cliff
here
between
20
and
21,
like
many
other
folks
we're
struggling
with
staffing.
J
However,
without
staff,
we
cannot
do
the
mandate
that
we
have.
We
have
the
lowest
staffing
that
we've
had
in
our
agency.
In
10
years,
we
have
taken
some
measures,
such
as
really
do
salary
adjustments
for
entry
level
positions.
J
We
have
created
videos
and
pr
campaigns
for
recruitment
with
workers
with
lived
experience
to
do
the
recruiting,
and
we
have
created
an
intimate
process
with
the
help
of
hr
to
be
able
to
hire
staff
while
they
are
on
the
roster
and
be
able
to
take
on
cases
while
a
hr
goes
through
the
paper
process,
so
that
hopefully
caseloads
can
go
back
to
being
more
reduced
and
we
can
go
ahead
and
include
folks.
So
we
are
available
for
any
questions
that
you
have
about
our
staffing
issues.
J
A
If
you
could
go
into
further
depth
on
the
validity
of
the
data
and
then
the
quarterly
report
I
know
chair
petri
is
waiting
on
the
data
for
the
budget.
So
if,
if
you
could
report
on
that,
let's
see
the
next
reporting
period
is
january,
1st
of
march
31st
and
the
due
date
is
suggested
of
april
15th.
A
He
needs
those
in
a
timely
fashion.
So
if
you
could
just
further
elaborate
on
the
validity
of
the
data,
that
would
be
much
appreciated.
So.
J
The
assumption
was
that
was
sent
to
you
prior
to
the
document
that
you
all
asked
for.
You
asked
for
a
10-year
data
spreadsheet,
which
we
sent
to
you
all.
A
F
Sure-
and
we
do
apologize
for
any
confusion
that
may
have
occurred
with
that.
We
do
provide
a
legislative
caseload
report
and
that
is
done
quarterly.
So
I
think
maybe
there.
If
there
was
some
confusion,
whether
there
is
the
quarterly
caseload
report,
that's
required
or
if
there's
additional
additional
documentation
need,
but
we'll
be
definitely
ensuring
that
that
comes
over
in
a
timely
manner.
Both
the
legislative,
the
legislative
case,
loan
report
and
our
historical
data
going
forward.
A
Can
you
just
if
you
don't
care,
because
I
was,
I
was
a
little
bit
trying
to
get
myself
organized
here.
Can
you
explain
the
chart
a
little
more,
but
now
that
I
have
it
in
front
of
me,
I
was
looking
for
a
slide
powerpoint
that
didn't
exist
and
it
was
just
the
charts.
Okay,
if
you
don't
care.
J
I
appreciate
it.
We
felt
that
we
were
here
to
answer
questions
about
the
document
that
you
asked
for,
which
is
what
we
send
the
historical
data
from
2010,
not
to
make
a
presentation
on
staffing.
A
J
F
So
when
you're,
looking
at
looking
at
the
chart,
the
first
section,
the
the
chart,
looks
at
the
number
of
social
workers
and
clinician
positions
that
we
have
within
the
department.
So
you
can
see
you
know
each
year
what
those
totals
look
like
and
then,
like
the
commissioner
shared
we've,
seen
a
significant
change
in
the
last
quarter
of
2021
into
2022,
with
a
significant
decrease
in
our
in
our
staffing
and
and
those
are
the
positions
that
are
on
the
front
line,
doing
the
direct
services
and
with
with
families
and
then
the
bottom.
F
You
know
you
can
see
the
total
line
across
there.
The
worker
ones
are
our
entry-level
positions
and
worker
twos.
They
have
a
year
or
two
experience
and
then
our
clinicians
are
our
more
tenured
and
experienced
staff.
So
you
can
see
that
the
staffing
numbers
each
of
those
categories
and
how
they've
changed
over
the
years
and
the
total.
And
then
in
the
next
section
you
see
the
other
social
work
positions.
F
These
are
our
social
service
specialists
and
our
family
services
office
supervisors,
those
that
are
providing
supervision,
yes,
so
providing
supervision
to
our
frontline
staff
and
and
support
through
that
specialist
roles
in
different
ways
and
then
the
the
final
column,
the
the
chart.
You
see
the
total
positions
again
for
each
year
and
then
at
the
very
bottom.
We
have
a
another
subsection
of
that
and
you
see
in
the
green,
our
caseload,
cps
and
aps
caseload
carrying
positions.
F
These
are
the
the
workers
that
are
again
our
frontline
staff
who,
from
that
total
from
the
total
above
that,
are
you
know,
social
service,
clinicians
workers
and
clinician,
physicians,
that
are
carrying
carrying
cases
or
working
with
families
and
providing
direct
services.
F
And
then
again
you
see
that
the
total
case
slow
carrying
positions
and
then
the
the
difference
between
our
caseload
carrying
and
our
total
number
of
social
work
positions
is
our
non-caseload
carrying
positions
and
that
that's
the
next
line
at
261
for
2022.
And
then
you
see
our
vacancies
at
the
bottom.
A
Okay
and
I'm
gonna
show
my
ignorance
here,
but
can
you
just
give
me
the
acronym
for
cps
and
aps,
I'm
sorry,
child
protective
services
and
adult
protective
services?
Okay,
okay,
that
makes
sense
yeah.
I
should
have
already
known
that,
but
anyway,
thank
you.
We
talk
in
acronyms
a
lot.
Sorry.
A
Okay,
mr
chairman,
has
just
returned:
do
you
have
any
questions
for
the
commissioner.
B
Yeah
on
I'm
sorry,
yes,
charlie
on
the.
B
Let's
see
yes
on
the
social
workers
there,
when
is
the
next
time
you
report
this
report
that
you
have
here
say
end
of
sy
ffy
june.
When
will
the
next
one
be.