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From YouTube: Senate Standing Committee on Health Services (3-8-23)
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A
So
Health
Services
committee
meeting
I
have
a
very
good
agenda
today
before
we
start
in
the
road
call.
Please
allow
me
to
recognize
our
newest
member
of
our
committee,
Senator
Chambers
Armstrong,
and
certainly
glad
to
have
you
as
part
of
our
team
here.
So
if
you
would
please
everybody
Welcome
Center.
A
A
C
You
Mr
chairman,
thank
you.
Honorable
members
of
the
health
committee
on
the
Senate
I,
truly
appreciate
the
opportunity
to
come
before
you
today.
I
am
representative
Brandon
Reed
I
represent
the
24th
house
district.
That's
green
heart
in
LaRue
counties.
I
do
have
a
distinguished
guest
with
me
today.
I
will
allow
her
at
this
time
to
introduce
herself
with
a
record.
C
Mr
chairman
members
of
the
committee,
HP
75,
is
aimed
at
improving
access
to
the
Quality
Health
care
for
each
and
every
Kentuckian,
as
well
as
serving
as
a
Lifeline
to
rural
hospitals
serving
communities
throughout
our
Commonwealth
with
HP
75.
Now
Grant
access
to
hospitals
to
be
reimbursed
for
outpatient
services,
hospitals
will
be
able
to
harness
Federal
resources
while
using
no
State
funds.
This
measure
simply
Builds
on
legislation
like
the
chairman
referred
to
earlier.
We
approved
back
in
2019
and
2021
with
House
Bill
183
and
provides
an
additional
opportunity
to
harness
Federal
resources.
C
D
Thank
you
so
much
again,
chairman
Meredith,
for
allowing
me
just
to
make
a
couple
brief
comments
about
the
need
for
this
bill.
It's
very
critical
to
support
our
hospitals,
because
our
hospitals,
as
I've
testified
in
front
of
your
Committee
in
the
past,
are
really
facing
skyrocketing
expenses
and
the
revenues
just
are
not
there
to
cover
that
and
I
wanted
just
to
let
everyone
know
that
today,
a
new
report
is
coming
out
by
Kaufman,
Hall
and
Kaufman.
Hall
is
a
national
management
consulting
firm.
D
They
do
National
reports
on
the
state
of
Hospital
finances,
and
so
we
contacted
them
and
asked
them
if
they
would
do
a
report
just
for
our
state,
and
so
that
is
what
is
being
released
today
and
I
just
wanted
to
let
everyone
know
that
report
is
echoing
what
we
have
been
saying
all
along
and
basically
the
report
founded
in
2022
Kentucky
hospitals
face
their
most
challenging
year.
Financially,
since
the
start
of
the
pandemic,
they
found
that
inflation
record
high
operating
costs
and
lower
patient
volumes
led
to
unprecedented
Financial
losses.
D
They
found
that
38
percent
of
the
state's
hospitals
are
at
risk
of
closure.
A
couple
of
the
other
highlights
operating
expenses
for
our
hospitals:
increased
4.2
billion
since
2019.
labor
expenses
increased
approximately
3
billion,
the
hospital
spent
1.2
billion
more
in
contract
labor
in
2022
than
they
did
in
2019
prior
to
the
pandemic.
D
We
can't
pass
those
costs
along,
and
so
the
result
is
that
Kentucky
hospitals
ended
2022
with
a
negative
operating
margin,
equal
equaling,
a
loss
of
more
than
a
quarter
billion
dollars,
and,
what's
really
important,
is
that
those
losses
occurred
despite
having
the
inpatient
atrip
program
and
so
had
we
not
had
the
inpatient
Atria
program
in
2020
two,
the
losses
would
have
been
much
greater.
In
fact,
according
to
this
study
that
would
have
exceeded
1.3
billion
dollars,
so
this
bill
is
very
critical.
D
C
A
Reid
always
appreciate
your
commitment
to
this
as
well
know
your
District
well
I
appreciate
your
commitment
to
it,
Nancy,
even
through
our
statistic
of
38
percent.
Could
you
give
me
that
number
again?
Yes,.
D
D
A
I
remember
even
before
covet
I
think
the
average
profit
margin
for
particular
hospitals
less
than
one
half
of
one
percent,
and
if
it
hadn't
been
for
HB,
183
I'm
sure
that
number
would
have
been
even
greater
but
I
think
from
a
lot
of
the
facilities
that
that
was
going
to
be
Saving,
Grace
for
them
and
I
heard
from
a
lot
of
hospitals
that
they
were
thrilled.
A
What
do
you
see
coming
next?
What.
A
F
D
A
Aye
bill
passow
with
Southern
unanimous
of
consent,
we'll
proceed
them
for
with
favorable
expression,
and
you
know
I
would
ask
for
a
consent
on
this
one.
But
folks,
I
really
would
like
to
be
able
to
speak
about
this
on
the
senate
floor,
because
I
think
we
need
to
make
people
aware
that
to
how
critical
the
situation
is
and
I
Envision
that
when
we
come
back
in
2024,
we'll
need
to
try
to
examine
other
measures
that
could
address
the
situation
but
appreciate
you
being
here
this
morning
and
thank.
A
A
E
E
H
E
All
right,
thank
you.
I
appreciate
the
opportunity
to
be
before
you
today
and
thanks
to
the
committee
for
hearing
this
bill,
this
house
bill
180,
is
about
getting
the
right
treatment
to
the
right
patient
at
the
right
time.
It
saves
precious
time,
it
saves
health
care
costs
and
it
saves
lives.
So
what
you
know
the
problem
is
that
most
of
us
have
been
touched
by
cancer.
E
We
we
all
have
loved
ones
or
we
know
someone
who
has
had
devastating
side
effects
of
their
chemotherapy,
the
perhaps
a
treatment
that
didn't
work
right
away
and
they've
gone
through
cycle
after
cycle
of
trial
and
error
and
what
house
bill
180
does
it
simply
requires
health
benefit
plans
to
cover
biomarker
testing,
which
is
ordered
by
their
physician
and
will
provide
the
the
correct
diagnosis:
well,
a
health
care
provider
who
has
treated
a
patient
and
diagnosed
their
cancer.
E
What
this
does
is
targets
their
biomarker
identifies
the
patient's
biomarker
and
will
will
identify
Precision
treatment
for
their
cancer.
There's
current
currently
limited
and
disparate
access
to
this
biomarker
testing
because
of
a
lack
of
insurance
coverage
for
everyone,
but
especially
in
the
minority
and
poor
and
Rural
populations.
The
fiscal
impact
study
returned
saying
that
this
is
not
expected
to
materially
increase
premiums
or
the
cost
of
Health
Care
in
the
Commonwealth
oftentimes.
E
E
I
think
at
this
point,
I
will
just
hand
it
over
to
my
my
guest,
maybe
Dr
kalesser.
If
you
can
tell
us
a
little
bit
about
the
background
of
biomarker
testing
and
and
exactly
what
it
does,
I
think.
It's
I
think
it's
a
great
education
for
all
of
us.
H
I
have
some
brief
remarks
and
a
few
slides,
I'd,
like
to
start
out
by
letting
you
know
about
the
difference
between
somatic
and
inherited
somatic,
is
something
that
is
only
in
the
cancer
where
inheritance
is
going
to
be
passed
down
from
children
down
to
your
children.
Approximately
90
of
cancers
are
caused
by
somatic
mutations
and
another
10
percent
are
caused
by
these
inherited
mutations,
and
it's
very
critically
important
that
we
are
able
to
understand
what
these
mutations
are,
because
it
help
us
helps
us
select
the
correct
treatment
for
patients
as
well
as
prevents
adverse
effects.
H
I'd
like
to
next
show
you
how
far
we've
come
since
we've
known
about
biomarkers,
for
those
of
you
who
are
not
used
to
looking
at
these
survival
curves
every
day.
100
means
a
hundred
percent
of
the
patients
are
still
alive
and
40
means
a
time,
and
so
looking
at
the
at
the
left
panel
in
2002,
the
median
survival
for
with
for
patients
diagnosed
with
non-small
cell
lung
cancer
was
eight
months,
and
it
didn't
matter
what
treatment
you
use.
They
all
turned
out
to
be
about
the
same
now,
jumping
ahead.
H
H
Let's
take
a
little
dive
into
what
we
are
seeing
more
commonly
in
Kentucky
what
this,
what
this
slide
is
showing
you
is
that
the
rate
of
testing
is
low.
There
are
a
variety
of
reasons
for
that,
including
the
lack
of
insurance
coverage
and
patients
who
are
unable
to
access
this
treatment
have
poorer
survival.
The
other
thing
that
we
know
is
that
if
you
are
living
in
Appalachia
or
you
have
Medicare
Medicaid
Insurance,
you
are
also
less
likely
to
receive
this
testing.
H
G
G
G
G
You
know
by
five
years,
so
I've
have
less
side
effects,
less
less
severe
heart
and
hard
side
effects.
I
exercise
six
days
a
week,
I
have
three
kids,
I
run
them
everywhere,
and
I
live
a
pretty
normal,
healthy
life
for
someone
with
stage
four
metastatic
cancer
without
biomarker
testing.
G
Obviously
we
heard
from
Dr
collesser
my
outcomes
would
have
been
much
less
I
feel
this
bill
is
extremely
important,
not
just
for
people
like
me
that
are
educated
and
have
access
to
this
testing,
but
all
all
kentuckians,
no
matter
their
age,
their
race
or
their
economic
status,
because
it
is
life-changing
and
life-saving
for.
For
many
of
us.
E
F
Sure
I
could
say
a
few
brief
comments
based
on
my
experience.
I've
been
in
family
medicine
for
36
years
now,
and
I've
seen
a
lot
of
patients
with
cancer
and
dealt
with
them
and
their
families,
and
it's
always
been
a
very
difficult
conversation.
That
conversation
has
gotten
a
lot
easier
over
the
last
10
years
or
so.
We've
made
tremendous
progress
with
all
types
of
cancer
and
a
lot
of
that
progress
has
been
based
on
biomarker
testing,
either
through
liquid
biopsies,
which
are
blood
tests
or
through
tissue
biopsies.
F
F
It
moves
quickly
through
the
stages
and
unfortunately,
it's
often
not
found
until
it's
late
in
the
course
of
the
disease,
we're
going
after
it
now
through
our
lung
cancer
screening
program
or
finding
it
early
and
making
a
big
difference
for
the
state
of
Kentucky
and
for
our
country,
but
even
when
we
find
cancer
in
the
late
stages
stage,
three
and
stage
four.
The
message
is
very
different
now
than
it
was
just
10
to
15
years
ago
we
have
patients
now
that
are
living,
5,
10
15,
20
years
with
stage
3
and
stage
four
lung
cancer.
F
When
I
was
in
practice
just
10
or
15
years
ago,
when
we
saw
a
patient
that
had
stage
three
or
four
lung
cancer,
we
felt
that
it
was
unlikely
that
they
would
be
alive
a
year
later.
50
percent
of
the
people
that
present
with
stage
four
lung
cancer
or
with
any
type
of
lung
cancer,
do
not
survive
more
than
a
year
with
the
Advent
of
biomarker
testing
and
targeted
therapy
through
Precision
medicine
and
through
immunotherapy.
F
We
are
making
a
big
difference,
and
the
family
of
lung
cancer
survivors
is
growing
in
numbers,
their
voices
are
getting
louder
and
stronger
and
I
and
many
others
stand
with
them
and
feel
that
this
type
of
progress
should
be
available
for
all,
and
not
just
for
some
and
that's
what
this
bill
is
about.
Thank
you.
E
Thank
you,
Dr,
gieske
and
I'll.
Just
close
with
this
is
a
standard
of
care.
It's
just
not
being
covered
by
insurance
companies.
This
is
really
cutting
edge
treatment
that
Kentucky
needs
to
get
on
board
with.
We
are
number
one
in
the
nation
for
lung
cancer
and
we
have
to
change
that.
So
that's
what
this
does
and
I
would
appreciate
your
support.
A
I
And
thank
you
and
Leah
thank
God.
Those
three
kiddos
are
blessed.
Is
this
treatment
also
commensurate
with
the
patient's
commitment
to
their
own
recovery
or
or
their
own?
When,
when
I
hear
that
you're
working
out
six
days
a
week,
is
patient
compliance
going
to
also
be
a
factor
in
whether
this
biomarker
testing
is
effective
for
one
patient,
if
they're
non-compliant
versus
Leah's
commitment
to
be
very
committed
to
your
own
health
and
Improvement
and
I,
don't
know
that
that's
a
question
for
you
Leah.
It
might
be
more
of
a
question
for
our
oncologist.
F
Yeah
I
can
I
mean
I
could
certainly
add
to
that
patient
compliance
is
very
important.
As
we
know,
cancer
has
many
etiologies
and
factors
in
both
the
diagnosis
and
the
response
to
treatment.
Anyone
that
exercises
eats
well
and
takes
care
of
themselves
is
going
to
be
much
more
likely
to
do
better
with
their
cancer
treatment
if
they
quit
smoking,
for
example,
reduce
drinking
reduce
weight.
G
And
I
would
say
too
the
targeted
therapy
that
I'm
on
typically
has
a
Effectiveness
for
two
to
three
years.
I've
been
on
it
a
little
bit
over
three
years.
When
my
it's
not
a
matter
of.
If
my
cancer
will
progress,
it
is
when
it
when
will
it
progress,
I
will
have
to
have
biomarker
testing
re-performed
to
see
if
I
have
any
new
genetic
mutations.
G
That
would
qualify
me
for
additional
targeted
therapies
that
could
be
either
added
to
the
one
that
I'm
currently
on
or
added
with
traditional
chemo,
in
order
to
prolong
my
life
even
longer.
So
for
those
of
us
that
are
stage
four
that
you're
never
going
to
be
truly
cured
stable
is
what
we
hope
for,
or
no
evidence
of
disease.
Then
we
need
this
biomarker
testing
to
be
able
to
receive
the
next
best
treatment
line
of
treatment.
As
we
go
down
our
journey
of
this
cancer
diagnosis.
I
And
this
is
me
trying
to
learn
a
little
better,
the
legislative
process
as
well,
that
if
we
we
were
talking
just
before
you
about
the
affordability
of
costs
and
such
but
sometimes
I,
wonder
whether
we're
spending
dollars
on
a
path
that
a
person's
not
even
committed
to
being
on
that
path.
But
yet
they've
been
placed
on
that
path
because
their
insurance
might
cover
it,
but
they
haven't
necessarily
been
committed
to
that
path
of
health
or
Improvement
or
or
treatment.
I
E
Improvement
like
yeah
and
I
I
think
I
understand
your
question.
You
know
when,
when
a
patient
is
diagnosed
with
cancer,
I
think
it's
It's
Our
obligation
to
offer
the
best
treatment
and
part
of
that
is
in
doing
this
testing.
We
can't
require
that
a
patient
comply
with
their
treatment.
Certainly,
cancer
patients
are
worn
out
by
the
end
of
some
of
their
treatment.
My
mom
was
that
way
after
three
years
she
said
I've
had
enough.
E
So
so
you
know,
while
we
can
only
offer
the
treatment,
we
can't
require
compliance
and
I
I,
don't
think
that
we
can
separate
out
who
will
be
compliant
and
who
isn't
and
offer
treatment
only
to
people
who
would
be
compliant.
E
I
think
that
if
a
patient
is
diagnosed
with
this
serious
disease
and
they
are
going
to
through
the
steps
of
getting
biomarker
testing,
they're
likely
going
to
be
very
worried
about
their
situation
and
they
are
going
to
do
everything
they
can
to
be
compliant.
So
you
know,
I
I
know
that
there
are
reasons
why
we
think
that
patients
aren't
being
compliant.
Maybe
they're.
You
know
having
a
hard
time
quitting
smoking
in
Leah's
case.
G
Non-Targeted
therapies
do
give
you
less
harsh
side
effects,
so
I
physically
feel
good,
whereas
I've
met
other
patients
who
are
on
traditional
chemo
and
they
are
so
sick.
They
couldn't
work
out
if
they
wanted
to.
Whereas
since
I've
been
given
this
gift
of
feeling
semi-normal,
then
I
can
take
advantage
of
that
to
help
myself
as
best
I
can,
whereas
someone
who's
on
traditional
therapies
may
not
have
that
luxury
because
they
physically
their
bodies,
just
can't
do
it
I
think
that's
an
excellent
point.
I
mean.