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A
Good
morning
we're
going
to
start
the
meeting
this
morning
with
a
minute
or
so
of
self-reflection
on
for
representative
white
who's
at
uk
now
and
praying
for
his
family.
A
He
had
been
taken
to
the
hospital
here
in
frankfort
and
flown
to
uk
overnight
and
his
his
common
knowledge.
He
had
four
units
of
blood,
so
let's
take
a
moment
now
to
consider
him
if
you
would.
A
A
President
in
the
room
members,
you
will
need
to
indicate,
as
we
did,
where
you're
in
the
room
or
in
the
office,
so
now
we're
going
to
delay
the
minutes
to
see
if
we
get
a
quorum
later
on.
If
not,
we
will
defer
the
minutes
to
the
next
meeting.
A
Okay.
So
before
we
begin
with
presentations,
those
members
participating
remotely,
please
remember
to
meet
your
microphones.
We
have
a
full
agenda
this
morning
with
several
presenters.
This
morning.
First,
we
have
representatives
from
the
university
of
kentucky,
dr
francis
filtner
and
mr
ernie.
Scott
is
ernie
on
internet
who
will
be
providing
a
presentation
on
the
kentucky
office
of
rural
health.
A
C
All
right,
ernie,
scott
remotely
the
director
of
the
kentucky
office
of
rural
health
at
the
center
for
rural
health
and
hazard.
D
Okay,
thank
you
good
morning.
Everyone
thank
you
for
the
invitation
and
opportunity
to
share
information
from
the
uk
center
of
excellence
in
rural
health.
As
today,
we
will
provide
you
with
a
brief
overview
of
our
kentucky
office
of
rural
health,
and
we
will
highlight
the
kentucky
state
loan
repayment
program.
C
All
right,
perfect,
all
right,
so
the
the
state
office
of
rural
health
program
and
you
can
advance
to
the
next
slide
there
as
well,
was
established
by
health
and
human
services.
C
Hersa
back
in
1991,
all
50
states
have
a
designated
state
office
of
rural
health.
Some
are
located
in
state
government,
some
in
academic
settings
like
us
and
then
some
operate
specifically
as
their
own
non-profit
authorizing
legislation
provides
that
each
state
office
of
rural
health
must
conduct
a
series
of
projects
and
programs
number
one
establish
and
maintain
a
state
clearinghouse
for
collecting
and
disseminating
relative
relative
rural
information
on
rural
health
care
issues,
research
findings
and
innovative
approaches
to
the
delivery
of
health
care
in
rural
areas.
C
Here
in
kentucky,
as
dr
francis
feltner
alluded
to
the
uk
center
serves
as
the
designated
state
office
of
rural
health
or
the
kentucky
office
of
rural
health.
The
mission
of
the
corps
aligns
with
the
center
and
as
to
support
the
health
and
well-being
of
kentuckians
by
promoting
access
to
rural
health
services.
C
The
corps
has
the
kentucky
office
of
rural
health
or
known
as
the
corps
has
managed
and
provided
oversight
for
the
development
and
implementation
and
coordination
of
the
kentucky
state
loan
repayment
program.
Since
2003.,
we
are
funded
through
hearsay's
bureau
of
health
workforce
and
the
the
program
provides
cost-sharing
grants
to
states
to
operate
their
own
educational
loan.
Repayment
programs
for
primary
care
providers
working
in
health,
professional
shortage
areas
known
as
hipps's
within
our
states
at
the
national
level.
The
state
loan
repayment
program
was
originally
established
in
title
three
of
public
service
act
of
1987.
C
C
C
Providing
primary
care
services
at
an
eligible
site
in
the
state
participants
receive
tax-free
student
loan
repayment
in
exchange
for
those
two-year
service
commitments.
Loan
repayment
offered
through
the
k-slurp
is
based
on
a
50-50
match
for
every
federal
dollar
provided
by
casler.
Participants
must
have
a
dollar
for
dollar
match
from
a
sponsor
source
if
an
applicant's
employer
is
providing
and
serving
as
the
matching
source.
C
The
employer
must
agree
that
the
funds
will
not
be
used
as
a
salary
offset
and
when
agreeing
to
provide
the
matching
funds,
the
sponsor
may
not
add
additional
service
obligations
to
the
applicant.
As
you
can
see
on
this
slide,
k-slurp
allows
for
eligibility
to
include
the
following
health
professionals,
with
a
permanent
and
unrestricted
license
to
practice
independently
and
unsupervised
in
the
state
of
kentucky.
C
As
you
read
down
that
it
covers
the
gamut
from
mds,
do's,
dentists,
nurse
practitioners,
certified
nurse
midwives,
physician
assistants,
registered
dental
hygienist,
a
number
of
health
service
or
health
service,
psychologists
licensed
clinical
social
workers,
psychiatric
nurse
specialists
licensed
professional
counselors,
marriage,
family
therapists,
registered
nurses,
pharmacists
and,
most
recently,
that
we
added
the
alcohol
and
substance
abuse
counselors
to
the
list
next
slide.
Please
participants
are
awarded
funding
in
a
tiered
format
based
on
their
provider,
type
level
of
well-indebtedness
and
the
sponsor
commitment
level.
C
That's
based
on
the
federal
award
plus
the
sponsor
match:
physicians,
assistants,
nurse
practitioners,
midwives
and
many
of
the
behavioral
health
specialists
are
at
the
forty
thousand
dollar
range
and
then
registered
nurses,
hygienists
alcohol
substance,
abuse,
counselors
fall
in
at
the
twenty
thousand
dollar
range.
Now
it
should
note
that
there's
also
opportunities
for
12-month
extensions
beyond
the
initial
two
years.
C
C
The
other
factors
sites
must
implement
a
sliding
fee
discount
schedule
for
uninsured
patients
based
on
income
status
with
discounts
started
at
least
200
percent
federal
poverty
guidelines
and
a
nominal
rate
or
fee
available
to
patients
at
the
100
federal
poverty
guidelines.
They
must
have
a
written
or
posted
policy
that
patients
will
not
be
denied
services
through
the
inability
to
pay
and
they
must
accept
medicare
and
medicaid
next
slide,
please,
as
far
as
program
impact.
C
As
I
said,
171
primary
care
professionals
have
participated
in
the
program
since
2003
over
the
past
12
years.
We
have
partnered
in
with
eligible
sites
and
sponsors
in
48
of
our
counties
and
those
are
highlighted
on
the
map.
Below
due
to
time,
I
wasn't
able
to
pull
together
a
full
retention
count
for
the
purposes
of
this
presentation,
but
a
recent
study
of
70
individuals
that
had
signed
between
january
of
2017
to
january
of
2021.
C
C
Shortage
area,
we
are
currently
awarded
382
in
federal
funds
to
for
the
program
with
no
administrative
costs,
all
those
are
passed
directly
to
the
communities
and
in
recent
years
we've
been
successful
in
securing
a
dollar
for
dollar
match,
primarily
through
the
participants
employer
at
100
of
that
next
slide.
C
That
said,
we
receive
upwards
of
two
dozen
competitive
applications
each
year
that
we're
not
able
to
fund
due
to
the
amount
of
funding
that
we
have.
Many
small
practices
seem
to
often
be
unable
to
provide
the
dollar
for
dollar
match,
leaving
them
less
competitive
and
eligible
to
participate
in
our
program.
C
C
Of
course,
that's
going
to
be
based
on
other
how
many
states
actually
apply
for
the
program
to
be
able
to
expand
our
own
program
here
in
kentucky,
and
the
option
also
will
exist
over
the
next
four
years
to
decrease
or
eliminate
the
dollar
for
dollar
match
is
also
a
possibility.
C
Other
notes
of
interest
24
of
the
current
43
state
states
that
have
state
loan
repayment
programs
currently
possess
a
state
appropriation
to
service.
The
match
which
we
do
not
have
here
in
kentucky
secured
state
appropriated
match,
would
allow
the
case
slurp
program
to
further
develop,
resulting
in
being
more
competitive
in
securing
additional
federal
funds
and
more
effectively
addressed
health
provider.
Workforce
shortages
in
rural
and
underserved
communities
all
across
the
commonwealth.
D
I
will
add
just
a
little
bit
to
his
presentation
without
the
powerpoint
here
that
the
center
did
start
this
program
in
2003,
and
we
have
done
a
really
good
job.
I
think
of
looking
at
all
of
our
opportunities
to
match
dollars
and
to
make
sure
that
the
people
that
need
the
state
loan
repayment
as
far
as
the
funds
will
go
and
allow
us
to
help
those
in
needed
areas.
A
You're
welcome
put
my
speaker
on.
Thank
you
for
your
presentation,
dr
filner
and
mr
scott.
The
director
are
there
any
questions
from
the
members
in
the
room
representative
used
to
be
frazier.
It's
you're,
gordon
now,
yeah
kim.
B
E
Had
considered
those
options
and
just
a
response.
D
E
Yes,
thank
you,
mr
chair,
thank
you
for
being
with
us
today
and
I
this
is
a
a
great
interest
of
mine
and
I
know
a
lot
of
my
colleagues
as
we
grapple
with
the
healthcare
worker
shortage.
So
I
have
a
couple
of
questions.
If
I
may,
how
are
the
practitioner
needs
identified
in
various
regions
throughout
throughout
the
state.
D
Okay,
also
by
hipsa
areas,
it
could
be
shortage
areas
or
it
could
be
a
special
population
like
where
there's
high
rates
of
disparities,
which
would
also
be
a
hipsa
as
well.
But
when
we
look
at
our
nurse
practitioners
that
have
participated
in
the
program,
they
it's
a
big
number.
It's
a
bigger
number
of
nurse
practitioners
that
have
participated
than
it
is
physicians
in
our
program.
D
E
I
agree
with
that,
so
you
noted
that
earlier
in
your
presentation
presentation
I
just
wanted
to
or
the
commissioner
I
wanted
to
clarify
that
the
practitioners
need
to
be
practicing
independently.
Did
I
hear
that
right.
D
They,
okay,
let
me
go
back
to
that
slide.
Most
nurse
practitioners
do
practice
independently.
However,
they
have
to
be
in
one
of
those
clinic
areas.
Let
me
see
if
I
can
go
back
to
the
slide
here.
If
I
can
make
that
happen
to
see
that
the
equipment
works
a
little
bit
different
than
mine
does
okay,
so.
D
C
It
was
more
than
likely
a
comment
of
mine
that
maybe
was
it
was
a
bit
a
bit
skewed.
Maybe
I
it's
just
saying
that
that
the
nurse
practitioners
are
totally
finished
with
their
their
their
programs,
their
academic
programs
and
they're
that
they're
totally
able
to
licensed
and
able
to
provide
care
independently,
so
that
they're
they're,
not
just
you,
know
more-
refers
to
the
physicians
that
it's
not
for
residents
per
se,
it's
for
those
that
are
actually
out
of
their
academic
programs.
Okay,.
E
B
E
D
There
is
not
a
state
appropriation
match
in
the
program
now
there
are
20
other
states,
23
other
states
that
do
have
a
state
match
that
that
is
working
well
with
their
group.
It
is
the
provider
or
the
practice
that
has
to
put
them
the
one-to-one
match.
E
D
F
Thank
you,
mr
chairman,
could
you
give
me
a
very
high
altitude
perspective,
in
particular
when
it
comes
to
eastern
part
of
the
state
when
it
comes
to
total
workforce
among
those
various
disciplines
in
terms
of
what's
totally
totally
needed
out
there.
D
D
There
is
a
huge
need
in
those
areas
and
most
of
the
rural
areas
are
hipses.
There
is
a
or
a
special
need
area
in
rule.
I
don't
know
if
that
answers
your
question.
F
And
I
I
and
I
appreciate
the
answer
honestly-
not
really
I'm
just
I'm
trying
if
there's
going
to
be
a
significant
effort
from
a
healthcare
workforce
initiative,
I'm
just
trying
to
get
a
little
a
little
perspective
on
what
the
gap
is.
We
know
participation
is
below
60
56,
whatever
it
is,
but
it's
way
below.
I
didn't
know
how
that
applies
to
to
the
middle,
not
the
middle,
well,
mental
health,
but
healthcare
profession
industry.
F
So
we
can
structure
either
things
when
it
comes
to
a
tax,
monetization
program
or
some
type
of
initiatives
for
these
different
practices,
private
or
public
and
folks.
So
I'm
trying
to
try
and
do
what
I'm
trying
to
think
through
that
process.
In
order
to
understand
what
that
gap
is
I
mean
it?
I
don't
know
it
could
be
at
40
percent
work
participation-
I
don't
know,
but
it
could
be
at
65.
C
F
B
D
C
You
know
again
that,
like
you
said
dr
feltner,
the
fairly
qualified
health
centers
have
definitely
increased
across,
not
not
only
in
eastern
kentucky,
but
across
the
state.
They
have
a
larger
prep
presence
than
even
10
years
ago.
Rural
health
clinics,
since
in
the
past,
10
years
since
I've
been
has
grown,
we
have
in
the
neighborhood
of
80
plus
rural
health
clinics
that
have
have
came
about
in
in
the
past
10
years.
Now.
What
should
be
noted
on
that?
C
Is
I'm
not
I'm
not
saying
that
there's
a
80
plus
rural
health
clinics
that
have
opened
there
have
been
that
many
practices
that
have
became
rural
health
clinics,
so
they
could
have
been
existing
rural
health
clinics
prior
to
transforming
into
a
rural
health
clinic.
They
could
have
been
a
private
practice
that
saw
the
benefit
in
becoming
a
certified
world
health
clinic.
D
And
to
get
those
to
get
those
federal
dollars
to
either
be
a
rural
health
clinic
or
a
federally
qualified
health
care
center,
they
have
to
do
that
sliding
fee
skill
that
we
talked
about
on
the
one
slide,
and
that
has
to
be
part
of
where
we
place
these
folks
as
well.
That
was
a
little
bit
back
to
your
question
representative
moser
there,
but
so
I
think,
as
mr
scott
has
said,
our
clinics
that
were
in
trouble
have
been
able
to
to
go
to
federally
qualified
health,
centers
or
rural
health
centers
to
continue
providing
services.
B
C
C
Are
right,
yeah,
so
a
federally
qualified
health
center
look
alike?
There's
not
a
huge
number
of
those
in
the
state.
I'm
aware
of
one,
maybe
two
at
this
time.
Those
received
a
lot
of
the
same
benefits
of
a
federally
qualified
health
center
from
the
federal
level,
but
they
don't
receive
actual
grant
funding
to
provide
the
cater.
C
So
they
they
still
benefit
from
some
of
the
like
the
340b
drug
prescription
program,
the
ftca
coverage
trying
to
think
of
some
of
the
others,
but
that
that's
sort
of
the
difference.
They
don't
receive
specific
federal
funding
to
operate,
to
provide
cater.
D
The
regular
federally
qualified
health
care
centers
receive
that
federal
dollars
to
to
get
their
clinic's
function.
Their
paper
providers
pay
for
things
that
keep
that
going
in
order
to
provide
services
for
the
folks
that
they
serve
and
they
have
to
keep
that
sliding
fee
skill
and
ernie,
since
they
don't
receive
the
federal
dollars.
That
was
a
question
that
I
had
on
their
grant.
They
still
have
to
have
the
sliding
fee
scale
in
order
to
participate,
so
it
is
a
look-alike.
A
Yes,
ma'am
remotely
representative
wilner,
dr
wilner.
B
Thank
you,
mr
chairman,
and
thank
you
for
the
in
the
overview
of
this
program.
I
know
quite
a
few
psychologists
who
came
to
kentucky
to
get
their
loans
paid
off
through
this
program
and
have
stayed
here
in
the
states.
So
I
know
it's
it's
very
important,
I'm
wondering
just
about
like
specialties
and
I'm
thinking
specifically
of
geriatricians,
and
we
know
that.
B
There's
such
a
need
for
that
in
the
rural
areas
everywhere
really,
but
I'm
wondering
if
you
do
anything
to
recruit
specifically
for
those
specialties
or
to
try
to
open
up
more
slots
in
specialty
areas
where
there's
a
particular
need.
D
C
Dr
filner,
that
that
is
correct.
The
mds
does
nurse
cracks
that
it's
either
family
practice
or
pediatric
or
gerontology
is,
is
how
that
it's
laid
out.
Yeah.
A
A
There
is
an
area
in
northeastern
kentucky,
southeastern
kentucky
and
southwestern
kentucky,
which
are
open,
and
I
know
because
I'm
from
greenham
county
there's
a
need
in
all
three
of
those
places
in
kentucky.
Do
you
ever
advertise
or
go
there
to
recruit
people?
I
mean
when
I
was
in
college.
I
went
to
private
enterprise
and
they
paid
for
two
years
of
my
college.
I
had
to
work
for
them
for
four
years,
which
is
similar
programs,
but
do
you
ever
put
on
a
career
program
or
anything
like
that
to
get
people
there.
D
Yes,
I
will
start
first
and
then
let
ernie
kick
in
there,
but
we
do
go
across
the
state
to
talk
about
what
resources
we
have
at
the
center
state.
Loan
repayment
is
one
of
them
that
we
do.
We
attend
conferences
where
physicians
and
providers
pharmacists,
where
nurse
practitioners
attend
those
conferences
and
set
up
a
table
and
and
recruit
from
that
area
to
let
them
know
what's
going
on,
so
we
advertise
in
the
paper
when
it
comes
time
for
there's
a
cycle
that
it
hits
so
every
way
that
we
can
possibly
get
it
out.
D
C
Sure
so,
as
dr
filtner
mentioned,
I
mean
we.
We
try
to
try
to
think
of
every
way
that
we
can
to
to
to
to
get
the
word
out.
We
also
serve
as
the
national
health
service
corps
point
of
contact
here
in
this
state
through
a
pro
program
from
the
cabinet
there.
So
so
we
sort
of
package
those
programs,
together
between
national
health
service
corps
and
the
state
loan
repayment
program,
and
really
try
to
push
that
availability
out
across
the
state.
C
There's
just
some
areas
that
just
haven't
taken
taking
us
up
on
the
offer.
I
guess
maybe
they
have
their
own
individual
recruitment
retention
programs
within
their
own
facilities,
but
but
just
those
that
that
that
do
take
us
up
and
find
value
you
can
guarantee
that
their
their
applicants
are
going
to
be
in
the
pot
there.
Every
every
september
we
open
a
30-day
application
window
and
and
and
it's
it's
well
received
from
across
the
state.
I.
D
A
D
Tell
you
how
long
it
takes
you
to
get
from
one
end
to
the
other
or
up
and
down,
but
we
try
our
best
to
reach
everyone
possible,
including
going
to
the
schools
before
they
graduate
to
the
classes
to
let
them
know
about
the
state
loan
repayment
and
as
far
as
a
service
corps
we
have
both
of
those.
So
it
really
gives
us
an
opportunity
to
help
a
person
figure
out
where
they
best
get
services
from
at
the
best
opportunity
for
them
to
get
out
of
their
state
loans.
E
Thank
you
for
indulging
me,
mr
chair,
and
I
I
really
appreciate
this
great
overview,
because
I
think
that
you
know
we
really
needed
to
understand
your
program
and
and
really
what
you
do
and
so
now
that
we
do
do
we
have
needs,
do
we
do
we
have
a
number
of
slots
that
we
actually
need
to
fill
across
kentucky
and
do
we
know
what
that
state
appropriation
would
be
need
to.
D
Be
we
do
know
that
we
turned
down
24
people
last
year,
yeah
in
the
program
and
for
their
matches,
whether
they,
if
they
were
a
physician,
their
match,
would
have
been
forty
thousand
dollars
to
forty
thousand
dollars.
There's
not
many
of
the
smaller
clinics
around
kentucky
that
can
afford
to
do
that.
Match.
E
D
We
do
know
we
do
know
that,
okay,
if,
if,
if
you
do
the
math
between
200
000,
for
an
example-
and
you
had
40
000
for
a
nurse
practitioner-
I'm
sorry
a
physician
or
20
000
for
a
nurse
practitioner,
you
can
do
the
math.
How
many
people.
E
D
E
Okay,
yeah:
those
are
some
good
good
points
and
one
more
quickly
do
you
have
any
sort
of
affiliation
or
partnership
with
ahack.
E
E
Right,
yeah,
I
think
that
you
know
we
could.
We
could
do
a
lot
to
strengthen
those
relationships
and
really
reach
kids
in
high
school
and
and
look
at
creating
with
ahex.
Some
really
good
programs
too.
B
D
E
Absolutely
yeah,
I
think
there
are
all
sorts
of
entry-level
certifications
that
we
could
introduce
high
school
students
to
to
to
improve
our
healthcare
pathways
career
pathways
and.
F
Real
quick:
do
you
all
accept
the
programs
except
private
funds.
A
And
again,
thank
you
for
all
url's
presentations,
of
course,
being
from
rural
kentucky,
it's
very
important
to
me
to
get
health
care
there,
where
I'm
located
now
we're
overwhelmed
at
the
hospitals.
It
says
I
get
three
calls
at
least
amendment
a
week
that
people
have
delayed
their
procedures
and
I
wouldn't
cause
a
cova
we're
just
overwhelmed.
D
A
We
have
a
quorum
now,
so
next,
let's
have
the
approval
of
the
minutes
from
the
january
19th
meeting.
Do
I
hear
a
motion?
A
Now,
at
this
time
we
have
secretary
freelander
and
mr
eric
lowery
from
the
cabinet
to
give
us
an
overview
of
what's
included
in
the
governor's
budget
recommendations.
Would
you
and
they're
all
on
virtual
internet?
Okay?
Would
you
all
please
identify
yourselves
for
the
record
and
again
members
hold
your
questions
till
after
the
presentation
please
and
keep
it
around
20
minutes.
If
you
can.
G
G
First,
chairman
bentley,
thank
you
for
allowing
us
to
come
and
talk
to
you
today
and
I,
I
hope,
fran's
still
in
the
room,
because
she
has
made
a
tremendous
difference
over
her
career
out
of
the
center
for
for
health
excellence
for
for
health
care
across
rural
kentucky
and
if
she's
still
there.
I
just
wanted
to
know
I
say
thank
you,
so
we
can
go
to
the
next
slide.
G
The
cabinet
for
health
and
family
services,
as
you
all
know,
is,
is
big
and
anytime.
I
go
to
other
states
and
talk
about
the
scope
of
the
cabinet
and
the
programs
that
we
have
we're
really
the
envy
of
a
lot
of
other
states,
because
under
the
cabinet
we
have
so
many
different
programs
that
impact
sort
of
that
community
health
and
human
service
side
of
it
we're
able
to
collaborate
in
ways
that
other
states
just
aren't
able
to
do
they
they
talk
about
that.
They
they
end
up
fighting
more
than
collaborating.
G
So
so
I
I
know
there
are
always
discussions
about.
You
know
is
the
cabinet
too
big
and
all
of
that,
but
I
will
tell
you
having
been
here
when
it
was
split
and
and
and
when
it's
together,
my
own
personal
opinion
is
the
scope
of
the
cabinet
really
helps
work
with
making
sure
that
we're
doing
things
in
a
coordinated
manner
as
as
as
much
as
possible
next
slide.
So
this
this
next
slide.
G
So
this
kind
of
gives
you
some
of
the
scope
of
the
cabinet.
You
see
that
six
thousand
six
hundred
employees
that's
down
close
to
a
thousand
employees
since
the
last
time
we
presented-
and
that
has
to
do
with
everything
some
of
what
you
talked
about
earlier-
the
challenges
of
the
pandemic.
You
know
we
have
a
whole
different
relationship
to
work
than
than
we
had.
G
You
know
the
challenges
of
of
social
workers
and
and
and
making
sure
that
we
have
adequate
pay
and
that
that
really
it's
not
just
social
workers,
it
does
indeed
go
across
the
cabinet
so
with
all
of
that,
and
and
I'd
be
remiss
to
say
during
a
pandemic
right
when
public
health
and
dr
stack
and
the
governor
have
been
leading
us
through
a
lot
of
this,
you
know
where
we've
been
able
to
provide
supports
for
for
long-term
care
and
schools
and
testing,
and
all
of
that
those
are.
G
These
are
things
that
we've
been
able
to
do,
even
through
that
1.6
million
kentuckians
receiving
their
health
coverage
through
medicaid,
almost
700
000
children
enrolled
in
medicaid.
So
so
our
impact
on
children's
health
being
so
tremendous
30
over
32
000
providers,
including
the
folks
you
just
heard
fqs
and
rural
health
clinics.
G
Where
would
we
be
without
that
kind
of
support
for
our
health
care
system
and
health
care
structure,
the
hospitals
bill,
we
passed
and
collaborate
you
all
passed
and,
and
we,
in
collaboration
with
the
hospital
association,
the
hospital
reinsurance
program
hospitals
this
past
this
last
year,
received
a
billion
more
dollars
than
they
would
have
without
that
legislation.
But
and
as
you
say,
the
hospitals
have
been
challenged
and
stretched
as
all
of
healthcare
has,
but
but
where
would
we
be
without
that?
G
In
addition,
you
know:
you'll
you'll
see
the
snap
benefits
when
you
look
at
the
children
in
foster
care
that
number's
actually
down.
You
know
whether
that's
about
numbers
or
reporting.
You
know.
G
It
takes
a
couple
years
to
make
sure
we
know
we
have
a
trend,
as
opposed
to
just
a
point
in
time,
so
we'll
keep
an
eye
on
that,
but
I
think
it
it
does
speak
to
representative
mead,
really
helping
with
with
prevention
and
and
that's
really
trying
to
make
a
a
an
investment
that
way,
and
we
need
to
continue
to
do
that
over
9000
grocers
who
work
with
us
in
in
in
the
snap
program
and
with
wic
program
again,
you
know
we
we
talk
about
these
programs
in
terms
of
their
impact
on
individual
health
and
nutrition.
G
Very
important,
but
also
we
need
to
think
about
these
programs
is
you
know,
grocers
are
a
very
small
margin
business
and
and
where
would
they
be
without
that
kind
of
funding
that
goes
into
their
programs?
We
have
some
county
by
county
impact
statements
that
that
I
think
we've
shared
with
you
and
we'll
continue
to
share
our
our
community
mental
health
centers.
The
tremendous
challenge
that
we've
had
in
terms
of
behavioral
health.
G
We
know
we're
gonna,
see
that
going
forward
the
tremendous
challenge
we
have
with
substance
use
disorders,
there's
no
question
that
the
pandemic.
C
G
Uncertainty
and
the
economic
uncertainty,
even
though,
even
though
we're
doing
very
well
in
in
terms
of
the
economy
but
coming
out
of
this,
the
isolation
and
the
uncertainty.
This
absolutely
adds
to
to
the
stresses
that
we
all
feel
I
can
raise
my
hand
on
that
right,
I'm
I'm
I'm
tired
and-
and
we
all
are
and
it's
we
know
that
we
have
to
have
those
kinds
of
supports
in
our
communities.
It's
just
it's
just
critical
for
us
as
well
as
that,
even
not
on
this
list
is
the
support.
G
We've
been
able
to
provide
child
care,
how
important
child
care
is
across
the
commonwealth.
We've
all
come
to
see
that
how
important
that
is
to
supporting
our
workforce
and
and
the
and
huge
investments
we've
been
able
to
make
in
child
care
to
keep
places
open.
You
know
it's
always
a
challenge.
We
have
agreements
and
disagreements,
but
in
the
end
the
important
thing
is
that
we
we
keep
our
centers
open.
G
So
on
this
next
slide
is
the
22
budget
for
the
cabinet
80
of
its
medicaid.
The
the
vast
majority
is
medicaid
that
that
blue
one,
the
larger
blue
one,
that's
dcbs.
You
can
see
that
the
interesting
thing
the
interesting
thing
about
this
slide,
I
think,
is
formally
behavioral.
Health
was
the
next
largest
department
after
medicaid
and
dcbs,
but
with
all
the
coveted
funding
with
all
that
the
activity
on
on
the
pandemic.
G
Actually
public
health
is
now
a
little
bit
larger
than
behavioral
health
and
and
appropriately.
So
a
lot
of
those
federal
funds
that
are
coming
in
are
flowing
through
the
department
of
public
health.
Some
of
the
upper
funds
that
you
all
appropriated
for
public
health
really
to
keep
schools
and
testing
long-term
care
testing
going
through
this
year,
are
really
important
investments
in
in
how
we
take
care
of
folks
and
how
we
continue
to
mitigate
some
of
the
impacts
of
the
pandemic.
But
it's
just.
G
G
So
our
fund
sources
are
basically
the
same.
Probably
two
years
ago,
when
we
presented
to
you,
we
were
just
over
70
in
terms
of
federal
funds.
You
know,
even
with
all
the
additional
federal
funds
that
puts
us
up
to
73
percent,
but
but
by
and
large,
the
funding
source
for
the
cabinet,
even
though
we're
a
big
cabinet-
and
we
we
take
a
a
pretty
good
source
of
general
funds
to
support
the
vast
majority.
G
Most
of
those
general
funds
are
matched
to
medicaid.
That's
a
four
to
one
match
or
through
dcbs
kind
of
our
worst
match
rate
is:
is
50
50.,
so
so
those
investments
in
this
cabinet-
and
I
do
think
of
them
as
investments
and
investments,
the
general
assembly-
makes-
are
investments
that
actually
immediately
pay
a
dividend
for
for
kentucky
and
kentucky's
economy.
Next
slide,
please,
when
we
talk
about
the
general
fund
again
medicaid
in
the
cabinet
is
about
70
of
the
general
fund.
G
Again,
that
really
has
to
do
with
the
match
rate
in
medicaid,
particularly
on
the
benefit
side,
the
next
being
community-based
services,
which
comes
in
around
20
and
and
then
the
rest
is
what
what's
made
up
from
the
cabinet.
Again,
you
see
public
health
and
behavioral
health.
Really,
when
you
look
at
general
fund,
then
that
starts
to
look
like
what
I
would
have
normally
presented
to
you
in
terms
of
in
terms
of
the
size
of
the
departments
next
slide.
G
So
how
are
funds
spent?
Well,
the
vast
majority
are
grants,
loans
and
benefits.
What
that
means,
and
and
again
the
vast
majority
of
the
grants,
loads
and
benefits-
are
paid
out
to
health
care
providers
are
paid
out
to
grocers
or
paid
out
to
child
care
providers.
That's
where
the
vast
majority
of
the
cabinet
and
how
the
vast
majority
of
the
cabinet
funds
are
spent
that
that's
just
that's,
absolutely
correct.
G
G
So
this
is
the
part
where
I
get
to
say.
Thank
you.
I
get
to
say
thank
you
to
the
governor
and
I
get
to
say
and,
and
I
get
to
say
thank
you
to
you
all
for
the
house
budget.
This
is
an
odd.
This
is
odd
right.
This
is
really
never
happened
before,
where
somebody's
testifying
in
front
of
you
with
a
budget,
that's
already
passed,
so
we
know
a
lot
of
the
things
that
are
in
there
and
so.
G
Just
want
to
say
it's:
this
is
a
good
budget,
it's
a
good
budget
and
and-
and
we
are
greatly
appreciative-
we
are
going
to
be
able
to
do
things
that
that
we've
been
wanting
to
do
for
years,
and
actually
what
I
want
to
highlight
first,
is
is
where
there's
agreement
in
in
in
the
budget
right,
where
the
the
vast
majority
of
agreement
that
we
have
between
the
house
budgets,
that's
passed
and
the
governor's
budget
that
he
as
he
presented
it.
So
all
these
pieces
are
critically
important.
G
I
think
representative
moser,
I
I
I
struggle
not
to
call
you
chairman
moser.
I
talked
about
the
area
health,
education,
centers
and
really
bring
back
the
funding
to
these
centers,
because
they're
so
important
and
getting
kids
interested
in
health
care
really
trying
to
reach
out
in
terms
of
really
equitable
representation
across
the
commonwealth.
For
those
centers,
the
importance
of
the
988
implementation
is
is
just
critical
for
for
everything
that
that
that
we
want
to
do.
G
We
were,
as,
as
I
pointed
out,
we're
concerned
about
the
behavioral
health
responses
that
we're
going
to
need
to
have
in
the
coming
years,
senior
meals
we
provided
over
three
million
senior
meals
this
year
way
above
what
we've
ever
been
able
to
do
and,
and
the
funding
for
that
is
is-
is
really
critically
important,
and
I
already
addressed
some
of
the
prevention
services
and
and
some
of
the
other
rates
next
slide
and
then
right.
G
We
talked
about
the
child
care
increase
and
all
the
support
we've
been
we've
been
supplying
there
on
the
good
work
that
our
our
partners
in
the
rape
crisis
center
child
advocacy,
center
domestic
violence,
all
of
our
partners.
There
who've
done
so
many
important
things,
the
biggest
thing
being
the
medicaid
benefits
growth.
I
think
that,
in
terms
of
the
investment
of
dollars,
I
think
that's
well
spent
and
really
supports
our
healthcare
system.
G
I
cannot
emphasize
that
enough
and
and
making
sure
that
we
have
t
systems
that
are
that
are
up
to
date.
These
are
all
critically
important
pieces.
Now.
What
you
hear
is
on
the
10
f
map
reinvestment,
and
there
are
some
pieces
within
that
when
medicaid
presents
that
there
there's
some
there'll
be
some
challenges
there,
but
but
basically,
how
we're
investing
that
money
to
support
our
community-based
providers
for
the
scl
and
shell
p
and
and
traumatic
brain
injury
program.
G
G
It
is
a
tremendous
challenge
and
also
then
talking
about
things
like
the
basic
health
plan
house
joint
resolution
57,
because
this
really
helps
address
some
of
the
benefits
cliff
there
and-
and
you
know,
we
we
have
less
of
a
benefits
cliff
there
than
than
some
other
states,
but
and
and
as
we
talked
about
child
care
is
really
the
place
where
the
benefits
click.
This
eclipse
is
the
greatest,
but
we
need
to
continue
to
do
that
so
next
slide.
G
So
there
are
some
things
that
aren't
in-house.
No
one-
and
this
is
the
other
ones
weren't
in
any
particular
order,
but
this
one
is
the
public
health
lab
replacement.
I
want
to
just
stop
for
a
second
on
that
that
lab
is
20
to
30
years
old.
It's
an
old
lab.
Those
of
you
in
healthcare
know
the
difference
between
equipment
that
we
use
30
years
ago,
and
today
I
mean
just
think
of
your
cell
phones.
It's
it's
night
and
day
and
by
the
time
we
get
this
up
get
this
built.
G
I
mean
you're,
looking
at
35
40
year
old
equipment.
This
is
this
is
critical
for
us
and
we've
seen
how
not
investing
in
a
public
health
infrastructure,
it's
dangerous
and
and
the
public
health
lab
does
many
things.
A
lot
of
the
big
funding
came
through
homeland
security
and
back
when,
after
9
11,
the
the
lab
tests
were
for
white
powder,
the
the
lab
does
all
the
newborn
screening,
which
is
so
very
important.
G
The
lab
does
test
for
rabies
and
all
sorts
of
things,
and
we
don't
even
think
about
all
that
they
do
with
food
and
water
testing
and
all
sorts
of
things
that
that
really
only
the
public
health
lab
does
as
well
as
validating
other
labs.
I
cannot
stress
to
you
how
important
making
that
investment
would
be.
The
behavioral
health
restricted
fund
increase
really
goes
to
our
facilities.
G
If
you
look
at
the
historical
agency
funding
for
those-
and
you
again,
you'll
get
more
of
this
in
their
presentation
and
it
looks
like
a
pretty
sizable
increase
and
and
it's
a
good
size
increase,
but
that's
because
we
we're
we
are
hurting
so
badly
for
personnel
across
our
facility
system
again,
just
like
all
other
facilities
across
the
commonwealth.
We
are
experiencing
that
as
well,
then,
within
the
bounds
of
a
state
personnel
system
and
contract
system.
So
it
is
it's
a
tremendous
challenge.
G
There
are
some
ask
for
coping
mitigation
funds
again
so
that
we
could
continue
the
school
testing
and
long-term
care
testing.
That
sp
would
be
where
the
lion's
share
of
that
would
be,
and-
and
I
I
I
think-
well,
I
love
that
we
hopefully
won't
have
to
do
that.
I
would
love
to
tell
you
that,
but
we
just
we
just
don't
know
at
this
point,
and
so
I
think
that
that's
a
pretty
important
piece
and
then
you
know
the
pediatric
research
trust
fund.
G
Again,
you
know
you
heard
the
governor
talk
about
david
turner,
jr,
a
young,
not
a
young
man,
very
young,
nine
year
old,
who
who
died
of
brain
cancer
and
the
importance
of
of
investing
in
in
this
trust
fund.
I
think
that
that's
that's
really
important,
so
these
are
just
sort
of
some
of
the
pieces
that
are
that
are
a
little
bit
different,
but
I
just
wanted
to
highlight
those.
In
particular,
you
know
my
mother
had
a
kind
of
an
alzheimer's
dementia
mix.
G
You
know
that's
not
a
lot
of
funding,
but
but
you
know
it
just
it's
just
personally
important
so
anyway,
I'm
trying
to
do
this
very
quickly.
I
hope
I
made
my
20
minutes
and
happy
for
the
next
slide
and
happy
to
take
any
questions.
F
Thank
you,
mr
chairman.
Mr
secretary,
I
know
you
got
a
monumental
task
in
front
of
you
to
try
to
juggle
so
many
departments
in
such
a
good
sized
budget.
It's
not
an
easy
process
to
go
through
and
in
terms
of
trying
to
do
the
right
thing.
F
The
best
way
you
can,
you
know,
given
a
lot
of
things
that
go
on,
goes
on
with
that,
and
also
I
want
to
express
my
appreciation
for
your
participation
and
insight
and
thoughts
and
guidance
on
working
with
the
chairman
chairwoman,
mosher
and
I
on
the
ambulance
issue,
which
hopefully
we'll
get
something
going
here
sooner
rather
than
later.
So
I
want
to
express
my
appreciation
for
your
mr
secretary.
F
I
wanted
to
drill
down
to
to
a
particular
program
and
I
believe
it's
sort
of
highlighted
on
your
slide
number,
eight
in
regards
to
tim's
law,
pilot
expansion
and
before
I
say
that,
thank
you
and
I
and
appreciate
you
highlighting
the
frisky.
They
came
in
at
at
a
lower
amount
than
what
the
house
bill
did
in
terms
of
putting
more
money
into
that
program,
which
I
think
is
very
viable
and
important.
F
So
I
appreciate
working
with
us
and
and
toward
in
that
regards,
but
I
want
to
talk
to
you
about
the
tim's
law.
I
I
know
there
was
a
million
dollar
a
year
to
go
into
this
particular
program
to
expand
it
as
an
additional
five
hundred
thousand
dollars.
That's
going
to
go
in
this
and
the
budget.
F
I
believe
it's
in
the
house
bill,
one
as
well
as
the
governor's
budget,
I
asked
we
had
the
department
come
in
here,
behavioral
health
department,
and
I
asked
them
some
questions
in
regards
to
what
we
can
do
to
to
help
expand
that
more
because
with
house
bill
127,
which
passes
the
past
this
chamber
and
it's
in
the
sitting
in
the
senate,
we
we're
looking
to
explain
that
from
what
I
understand
from
the
samsung
grant
to
around
17
1800
people
that
would
qualify
for
this
program
that
are
not
currently
in
there.
F
So
looking
at
that
and
the
grant
is
a
hundred
thousand
dollars
that
is
is
is
felt
when
it
comes
to
keeping
these
individuals
out
of
of
our
these
individuals
are
being
where
we
there's
a
hundred
thousand
dollars,
that's
being
that's
being
affected
for
these
people
that
continue
on
this
particular
process,
but
the
tim's
law
helps
curtail
that
by
going
through
a
court
order.
F
As
you
know,
with
that
thought
in
mind,
there
is,
there
is
a
push
and
I'm
trying
to
get
the
anr
working
with
the
anr
folks
to
expand
that
to
have
it
across
all
regions
and
throwing
spaghetti
into
wallets
around
four
and
a
half
million
dollars
this
year.
Nine
million
dollars
next
year,
but
if
we
can
try
to
curtail
that
cost,
not
only
from
the
re
not
not
only
to
reduce
re-hospitalization,
but
also
look
at
saving
money
for
clinical
clinicians
to
show
up
for
law
enforcement,
get
involved.
F
That
could
be
significant
money
that
could
be
saved.
And
if
you
look
at
17
1800,
that's
170,
180
million
dollars,
that's
being
felt
in
terms
of
trying
to
deal
with
all
that.
I
want
to
get
your
thoughts
on
trying
to
help
secure
additional
money
in
order
to
expand
the
the
expand
this
program
to
at
least
go
through
half
the
community
services,
and
then
next
I
guess
the
second
half
of
the
fiscal.
F
The
budget
go
throughout
the
throughout
the
state
and
doing
that,
because
I
tell
you
it's
not
only
we'll
be
saving
a
lot
of
money,
particularly
when
you're
looking
at
the
budget
of
oh
I'm
trying
to
figure
101.9
billion
dollars.
That's
if
I
read
that
right.
So
if
you
can
save
a
hundred
million
dollars,
we
can
reallocate
that
to
other
programs
in
doing
that,
and
I
want
to
get
your
thoughts
about
that
approaching
in
terms
of
trying
to
expand
the
program
and
save
money,
but
also,
more
importantly,
quality
care.
G
Thank
you,
representative
fleming.
First,
I
appreciate,
and
yours
and
representative
moser's
interest
in
really
some
of
the
the
ems
challenges
across
the
state.
So
I
just
want
to
say
thank
you
for
that.
Also,
I
want
to
say
thank
you
I
I
long
time
ago
and
you
guys
know
I've
been
over
most
of
the
programs
in
this
cabinet.
G
I
was
over
family
resources
and
youth
services
centers
and
their
fantastic
programs,
and
you
know
it's
kind
of
a
little
known
piece
about
how
important
they've
been
in
some
of
the
tornado
response
in
western
kentucky
and
how
they've
stepped
up
to
do
exactly
what
they
were
designed
to
do,
which
is
assist
with
the
community
so
I'll
leave
it
there
in
terms
of
tim's
law.
This
is
the
full
request
that
we
received
from
the
department
for
behavioral
health.
G
They
were
wanting
to
make
sure
that
what
they
were
doing
was
followed
quality
measures.
They
could
really
focus
on
making
sure,
as
they
expanded
that
they
that
they
did
it
in,
as
as
as
planful
and
as
true
to
to,
I
think
the
concept
of
tim's
law
as
they
possibly
could.
G
Of
course
we
will
do
whatever
you
all
ask
us
to
do,
but
just
know
that
this
actually
you
know
this
came
from
the
department
of
behavioral
health
and
that
expansion
was
the
full
amount
that
they
asked
for,
and
I
I'm
sure
they'll
be
able
to
talk
a
little
bit
more
in
depth
with
you
when
they
come
to
testify.
F
And
I
appreciate
that,
mr
secretary,
just
we,
we
did
talk
to
them
and
they
came
in
and
I'll
be
quite
honest
with
you.
I
really
didn't
get
a
very
good
satisfaction,
satisfactory
response
from
them.
In
fact,
I
think
in
looking
at
past
court
cases,
particularly
whistleblower,
there
was
an
effort
to
keep
that
that
program.
F
I
guess
off
the
radar
stream
in
terms
of
effort
as
well
as
funding,
and
that
really
concerned
me
and
I'm
going
back
a
couple
years,
and
I
want
to
I'm
concerned
that
there's
more
like
a
mentality
there
that
not
be
not
to
push
this
forward
because
the
evidence
is
there
because
I've.
I
know.
F
Several
people
have
been
benefited
from
this-
that
they're
they
are
not
going
back
to
the
hospitals
because
they're
going
through
this
program
and
be
and
being
supported
by
the
community,
as
well
as
a
court
system
to
get
them
in
a
better
position.
So
if
that's
a
small
snippet
of
what's
going
on
to
the
1700,
we're
looking
at
significant
savings
but
also,
as
I
said,
before,
a
significant
effort
in
terms
of
quality
care.
G
Certainly
again,
thank
you.
I
think
we,
we
really
started
this
program,
even
though
it
had
been
the
delayed
start
just
just
now
and
well
last
year,
but
it
it.
It
is
a
good
program.
You
won't
hear
me
argue
that
at
all,
as
well
as
then,
the
mobile
crisis
just
kind
of
across
the
way
these
are.
These
are
things
that
we
have
to
do
to
get
upstream.
So
I
know
that
that
I
think
that
this
is
a
good
program.
B
Yes,
thank
you,
mr
chairman,
and
thank
you
secretary
friedlander
for
the
presentation.
First
of
all,
I
just
want
to
put
several
exclamation
points
behind
what
rep
fleming
said.
B
You
know,
I
think
a
lot
of
us
are
feeling
that
the
incremental
rollout
is
not
what's
needed
when
this
program
has
been
so
effective
in
40,
plus
other
states,
and
so
far
it's
been.
You
know
a
little
bit
effective
here
and
only
a
little
bit
because
we're
only
doing
it
a
little
bit.
B
So
I
I
really
hope
that
we
can
get
the
funding
in
place
and
and
get
that
sped
up,
because
it's
such
a
drain
on
resources
and,
as
rep
fleming
said,
it's
such
a
quality
of
life
issue
not
only
for
the
folks
with
severe
mental
illness
but
for
their
family
members,
for
the
people
who
care
about
them
and
and
really
for
communities
broadly
because
we
know
how
it
contributes
to
homelessness
and
a
whole
host
of
other
issues.
So
so
thank
you
for
your
response
and
you're
you're
nodding
on
that.
B
I
I
did
want
to
just
get
back
to
the
funding
initiatives
that
are
not
supported
in
the
budget
we
passed
and
you
touched
on
the
office
of
dementia
services
and,
like
you,
I
have
a
family
history,
my
father
in
my
case,
so
it's
personal
to
me
as
well,
but-
and
thank
you
for
for
sharing
that,
but
I
think
it's
more
than
personal,
and
I
wonder
if
maybe
you
could
expand
a
little
bit
on
why
we
really
need
this
office
to
be
funded.
B
G
So
this
office
has
been
on
the
books
for
a
while
and,
and
so
we
actually
through
a
grant,
started
funding
it.
I
think
this
last
year
and
already
well.
Well,
let
me
let
me
back
up
one.
We
have
an
aging
population.
G
We
know
that
we
are
going
to
see
more
alzheimer's
and
dementia
across
our
population
as
our
population
ages-
and
this
is
this-
is
a
tremendous
tremendous
stress
on
families,
on
communities
and
and
being
able
to
be.
When
I
was
working
with
this
city,
we
wanted
to
become
an
age-friendly
city
in
a
an
alzheimer's
and
dementia
friendly
city.
G
These
are
all
things
that
I
think
we
can
do
as
communities
and
individuals
that
don't
cost
a
lot
of
money,
but
they
need
somebody
to
to
lead,
and
we
have
good
partners
on.
You
know
in
communities
and-
and
I
just
think,
focusing
attention
on
what
we
know
is
going
to
be.
I
think
I've
heard
it
referred
to
as
the
great
tsunami.
G
These
issues
are
going
to
become
more
important
for
us
as
a
commonwealth
moving
forward.
So
I
think
that
that's
it's
it's
one
of
those
things
that
I
think
is
a
a
really
important
issue
for
us
to
at
least
start
to
get
our
hands
around.
A
very
similar
thing
happened
with
the
office
of
autism
right
it
took
us
a
while
to
get
get
an
office
going,
get
it
funded
and-
and
I
think
now
it's
doing
really
good
things
and
important
things.
B
B
Million
okay,
okay,
thank
you
so
much
and
I
hope
we
will
see
that
appropriation
added
into
this
budget
process
thanks
so
much.
A
C
A
Thank
you,
representative
sheldon.
You
have
a
question
just
a
quick.
H
Comment:
secretary
friedlander,
I
just
want
to
say
during
a
tough
tough
time
in
this
country
and
in
kentucky
for
the
last
couple
of
years
you
have
stood
absolutely
tall
when
I
think
others
have
maybe
faltered.
You
have
been
there
that
cabinet's
been
there.
You've
been
asked
to
implement
a
number
of
new
programs
federal,
as
well
as
things
that
we've
passed
in
this
body,
and
I
was
fortunate
enough
to
work
with
you
on
several
of
them,
whether
it
be
public
health
transformation
or
medicaid
prescription
program.
G
Thank
you.
You
know
senate
bill,
50
and
and
your
work
on
that
with
pbms
and
moving
us
to
a
single
pbm
in
medicaid.
Again,
I
know
I'm
using
initials
and
I
apologize,
but
your
work
on
that
senator.
Why
doesn't
work
on
that?
We're
we're
really
looked
at
as
a
model
for
the
country.
No
one
else
has
done
what
we've
done
around
that
single
pdm
and
I
think
it's
been
much
better
for
pharmacists
and
much
better
for
the
state
for
us
to
do
that.
So
I
I
want
to
thank
you
for
your
partnership.
A
A
H
H
We'd
like
to
thank
you
for
inviting
us
today
to
talk
about
the
general
administration
program,
support
budget
next
slide.
Please.
H
Overall,
the
office
is
divided
into
two
segments:
two
service
areas,
the
first
being
the
administrative
support
budget
and
the
second
being
the
office
of
inspector
general
next
slide.
H
Our
mission
is
in
each
of
these
offices
is
to
take
the
administrative
burden
off
of
our
service
departments
so
that
they
don't
get
bogged
down
with
those
types
of
things
and
they
can
focus
on
what
they
do,
which
is
serving
the
citizens
of
the
commonwealth.
They
do
a
fabulous
job.
We
handle
everything
from
hr
to
finance,
to
technology,
to
legal
services,
just
to
name
a
few
next
slide.
Please
the
budget
for
the
department.
H
This
fiscal
year
is
182
million
dollars
that
breaks
out
to
147
million
for
the
administrative
support
budget
unit
and
34
million
for
the
inspector
general's
office.
Next
slide,
please
to
break
the
budget
down
further.
The
administrative
support
budget
of
148
million
dollars
is
roughly
34
personnel
for
this
year,
19
operating
at
47
for
grants,
loans
and
benefits.
H
I
would
like
to
point
out
that
this
47
for
grants,
loans
and
benefits
the
69
million
dollars
is
the
dollars
that
were
appropriated
by
the
general
assembly
in
the
special
session
last
fall
under
senate
bill
3
for
covet
testing
and
mitigation.
These
are
one-time
dollars
that
will
only
be
in
this
fiscal
year.
H
If
those
dollars
were
not
included
in
the
budget,
then
this
chart
would
look
more
like
65
personnel
and
35
operating
next
slide.
Please,
the
inspector
general's
office
is
more
concentrated
in
personnel
cost,
with
87
percent
of
their
charges.
Speaking
to
personnel
and
13
to
operating
next
slide,
please
to
look
at
the
overall
department
budget
by
fund
the
the
state
funds
are
10.2
million
dollars.
H
H
The
recommended
budget
included
two
initiatives
funded
above
our
base
level
of
funding.
The
first
would
be
special
olympics,
a
very
worthy
organization
and
our
base
funding.
We
already
had
fifty
thousand
dollars
in
each
fiscal
year
dedicated
to
special
olympics,
so
this
appropriation
would
bring
the
annual
recurring
dollars
for
special
olympics
to
150
000.
H
The
other
thing
that
was
included
under
the
department
was
the
maintenance
pool.
This
was
included
in
the
capital
project
section
of
the
budget.
The
maintenance
pool
dollars
are
the
dollars
that
we
use
to
support
the
maintenance
and
repairs
of
our
behavioral
health
facilities
located
throughout
the
state.
H
The
amount
of
maintenance
full
dollars
in
this
recommended
budget
was
significantly
larger
than
what
we
have
had
in
prior
bienniums.
So
we
are
pretty
excited
about
all
the
good
we
can
do
in
maintaining
our
facilities
and
addressing
life
safety
code
issues
and
things
of
that
nature
next
slide,
please,
in
the
interest
of
time,
I'm
not
going
to
read
through
these
next
two
slides,
but
I
always
like
to
point
out
the
the
hard
work
of
all
the
offices
that
are
under
administrative
support.
H
They
are
largely
unrecognized
and
forgotten
about
and
and
our
staff
do,
a
fabulous
job
and
handle
large
volumes
of
things
such
as
human
resource
for
over
6,
400
employees
or
10
000
travel
vouchers
a
year,
they're
processed
there's,
a
hundred
it
systems
and
modules
that
are
are
overseen
by
our
technology
staff.
H
Next
slide,
please,
our
our
legal
services
represents
a
cabinet
about
2700
cases.
This.
That
floored
me
is
that
the
office
of
ombudsman
administrator
review
processed
almost
89
000
contacts,
resolving
service
complaints,
appeals
program,
audit
reviews,
things
of
that
nature,
but
these
are
just
some
of
the
stats
to
highlight
the
hard
work
that
our
staff
has
done,
and
we
are
extremely
thankful
for
it.
H
I
I
We
are
also
responsible
for
prevention,
detection
and
investigation,
fraud,
abuse
and
waste
mismanagement
and
misconduct
by
the
cabinet's
clients,
employees,
medical
providers,
vendors
contractors
and
subcontractors,
and
we
also
conduct
special
investigations
into
matters
related
to
the
cabinet
or
its
programs,
as
as,
as
requested
by
the
cabinet
secretary
commissioners
or
other
office.
Heads
next
slide,
please.
I
So
the
programs
housed
within
the
office
of
the
inspector
general
are
health
care,
licensing,
child
care,
licensing
audits
and
investigations,
casper,
which
is
our
kentucky
pdpm
and
cares
voluntary
fingerprint
program
and
our
certificate
in
need
program
as
well.
Next
slide,
please,
all
right
out
of
our
office.
I
I
We
enforce
the
kentucky
kentucky
controlled
substance
act
through
casper
and
administer
the
certificate
of
need
program
in
order
to
prevent
unnecessary
proliferation
or
duplication
of
health
care
services
within
the
commonwealth.
Next
slide,
please.
I
Wait
and
and
lastly,
we
administer
the
casper,
which
is
our
kentucky
l
scripps,
prescription
electronic
reporting
program.
Casper
currently
has
28
a
little
over
28,
a
thousand
master
account
holders
and
a
little
over
13
000
delegate
users.
I
We
provide
an
average
of
153
000
reports
per
weekday,
and
this
also
includes
a
reverse
casper,
where
we
can
look
at
prescriber
report
cards
and
we're
working
on
additionally
a
modernization
on
top
of
what
we
can
do
with
interstate
data
sharing,
currently
direct
messaging
and
we're
been
very
proactive
working
with
our
healthcare
organizations
to
mitigate
additional
use
of
opioids
within
our
commonwealth
and
with
that
I'll,
just
open
it
up
for
questions.
I
think
the
next
slide
is
just
questions.
G
And
if
I
might
add
for
inspector
general
mather,
there
isn't
a
commissioner
in
the
cabinet
that
hasn't
taken
on
extra
duties
during
covet.
This
is
true
for
the
inspector
general
as
well.
G
He
has
coordinated
our
response
in
long-term
care
collaborated
with
walgreens
and
cvs
to
make
sure
of
how
all
of
the
vaccination
and
testing
and
things
were
rolled
out
in
our
long-term
care
side,
always
in
communication
with
with
the
long-term
care
associations,
also
been
working
with
between
health
care
providers
and
our
national
guard
and
our
strike
teams
and
coordinating
that
piece
and
all
of
this,
along
with
some
other
folks
and
other
folks
who
helped.
G
But
but
we've
asked
adam
to
do
a
lot
extra
and
I
will
say
there
probably
isn't
a
commissioner
that
we
haven't
done
that
with,
but
adam
has
really
stepped
up
in
in
many
many
ways.
So
when
I
started
to
talk
about
yeah,
we
do
all
these
things,
plus
plus
the
extra
plus
what
we
were
doing
through
kobit.
I
just
wanted
to
give
you
that,
as
as
an
example
of
his
importance,
also
to
the
cabinet's
response,
so
with
that
I'll
sit
back.
Thank
you
secretary.
H
For
inspector
general
mather,
I
hope
everything's
well
with
you
today.
Yes,.
C
H
Yeah,
it's
good
to
see
you.
I
just
want
to
also
say
kind
of
echo
secretary
friedlander,
because
you
know
I
called
you
several
times
concerning
different
issues
that
that
fell
in
your
venue
and
a
purview.
I
guess-
and
you
always
very
responsive
and
easy
to
work
with,
and
we
were
able
to
work
through
a
lot
of
things
that
could
have
been
a
real
headache.
Probably
still
is
for
you
in
some
ways,
but
but
you
you
made
it
easy
on
me.
So
thank
you
so
much
for
the
work
you
do.
D
A
A
I
I
you
know
some
people
how
to
articulate
this,
but
it
seems
like
if
we
put
another
drug
into
the
legal
status
in
kentucky
they're
asking
casper
to
record
it
also
have
you
all
thought
about
what
the
cost
of
that
might
be?
A
I
We
have
I
I
don't
have
a
cost
analysis.
We've
discussed
casper
as
being
one
of
multiple
options.
Potentially
that
could
be
used.
So
I
don't
necessarily-
and
I
apologize
chairperson
bentley-
I
don't
have
a
a
dollar
figure
on
what
that
cost
would
be
yeah.
G
And
chairman
bentley,
I
I
don't
either,
but
we
have
looked
at
it
in
our
public
health
department
and
it
really
is
kind
of
the
difference
between
trying
to
build
a
new
system
and
whether
we
can
add
to
an
existing
system.
I
think
it
would
be
better
if
we
could
add,
but
it's
just
whether
we
can
or
not.
A
Yeah
I
understand
that
casper
has
controlled
substance
only
as
being
part
of
it
and
this
product
that
they're
in
that
bill
is
not
a
controlled
substance,
unless
it
would
be
a
schedule
one.
So
that
was
the
reason
I
was
asking
that
okay.
Thank
you.
A
Thank
you
all
for
your
participation
in
your
presentation
and
thank
you
for
all
for
the
good
work
you've
done
for
the
last
couple
years
through
the
crisis.
I
appreciate
you
very
much.
Thank
you.
Thank
you
before
we
adjourn
members.
Please
note
that
we're
scheduled
to
meet
next
week,
wednesday
february,
the
9th
and
we'll
have
a
discussion
on
aging
and
independent
living
office
for
children,
with
special
health
care
needs
and
medicaid
february.
The
16th
will
be
based
upon
community-based
services,
public
health,
family
resource
centers
and
volunteer
services
and
february.