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From YouTube: House Standing Committee on Licensing, Occupations, and Administrative Regulations (3-8-23)
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A
Find
a
seat
we'll
get
started,
I'm
officially
calling
this
meeting
the
house
standing
committee
on
licensing
and
occupations
and
administrative
regulations
to
order.
Please
silence
your
cell
phones
if
you're
interested
in
testifying,
please
use
the
sign-in
sheet.
Testimony
is
at
the
chair's
discretion
based
on
time
constraints
and
information
already
presented.
A
No
signs
or
any
props
are
available
in
the
committee
room
or
allowed
in
the
committee
room.
So
please
pay
attention
to
that
rule.
I
think
we're
all
good.
This
morning,
I'd
like
to
introduce
two
special
guests:
I've
got
Logan
shadowing
me
today
from
Boyle
County
FFA
vice
president,
so
welcome
to
LNO
the
best
committee
to
come
shadow
in
so
welcome,
and
then
a
big
shout
out
to
the
former
gentleman
from
Kenton
69
Mr,
Adam
Kanan,
former
chair
of
this
committee
is
here
today.
So
welcome
representative
caning
thanks
for
joining
us
this
morning,.
D
Representative
banto
here
representative
bratcher
representative
Callaway
declines
here,
representative
Dixon,
representative
Fister,
representative
Flannery,
representative
Gentry,
here,
representative
hevren,
representative
Heron,
here
representative
Huff,
here,
representative
Jackson,
representative
colcarney,
representative
Meredith,
representative
Moser,
representative
Palumbo,
here,
representative
Pratt,
representative
Smith,
representative
timony,
chairman
cook.
Here.
A
E
F
Representative
Al
Gentry
for
house
district
46.
E
E
There's
a
technical
correction
that
allows
Sports
wagering
at
simulcasting
facilities
and
the
12-month
in-person
registration
requirement
to
go
to
a
track
and
actually
register
your
account
in
person
was
removed
in
the
committee
substitute,
and
so
those
are
the
differences
in
the
committee
substitute
and
the
bill.
Do
we
have
a.
A
E
Of
you
have
heard
about
the
popularity
of
this
and
I'm
not
here
to
appeal
about
popularity
today,
I'm
here,
to
tell
you
about
taking
a
industry
that
exists
in
darkness
and
in
the
shadows
and
legitimizing
it
legalizing
it
and
regulating
it
to
protect
the
consumers
of
Kentucky.
E
It
can
also
be
through
a
offshore
website.
There
are
several
of
those
out
there
and
eighty
percent
of
the
people
that
take
part
in
wagering
through
those
offshore
websites
think
that
they
are
legal
sources
for
this,
but
they're.
Not
they
don't
understand
that
because
the
internet
does
not
bar
them
from
going
to
those
sites
and
placing
those
Wagers
having
accounts
with
those
companies.
E
The
bill
before
you
today
will
put
this
industry
in
a
legal
and
regulated
status
so
that
everyone
knows
what
what
the
what
the
framework
is,
what
the
regulation
is,
and
we
put
it
under
the
regulation
of
the
Kentucky
Horse
Racing
commission,
which
has
regulated
wagering
in
this
state
for
a
century
or
better.
They
have
a
track
record
of
managing
integrity
and
handling
wagering
in
a
proper
manner.
E
E
Looked
at
over
a
million
Geo
comply
checks
from
folks
in
Kentucky
who
tried
to
use
legal
Sports
wagering
in
Ohio
during
the
first
month
in
January,
I,
think
55
000,
roughly
unique
accounts
that
they
notated
in
those
Geo
comply
checks.
Last
Super,
Bowl
season,
it's
188
000
accounts
that
were
that
were
unique
accounts
that
were
picked
out
and
shown
to
be
from
Kentucky
residents
who
were
trying
to
bet
in
our
border
states.
Over
5
million
I
think
Geo
comply
checks
during
that
time
period.
E
This
is
not
a
huge
amount
of
money
for
the
state.
Let
me
be
clear:
it's
roughly
by
the
fiscal
note
about
23
million
dollars
annually
in
Revenue,
but
that's
23
million
dollars.
It's
either
not
being
given
to
any
government
right
now
or
being
given
to
one
of
our
border
states,
because
we
don't
expect
this
to
proliferate
in
a
huge
amount,
much
more
than
what
we're
already
seeing
in
the
wagering
space.
Already,
like
I,
said
a
billion
in
the
in
the
marketplace
of
illegal
betting.
E
Currently,
a
significant
portion
leaving
our
state
just
across
the
borders,
especially
in
in
along
the
Tennessee
line,
the
Ohio
border,
the
Indiana
border
and
the
total
projection
that
we
come
up
with
is
only
about
2.3
or
2.4
billion
dollars.
Bet
in
our
program
in
Kentucky
have
the
annual
handles
for
several
of
the
states
around
us.
If
anybody
wants
to
know
those
I
have
tons
of
data
that
I
could
provide
to
you
today,
but
I
just
want
you
to
understand
that
this
is
not
a
product.
That's
not
already
happening
in
the
marketplace.
E
F
Thank
you,
representative
Meredith,
and
he
kind
of
stolen,
my
thunder.
He
hit
the
hammer
right
on
the
on
the
nail
there
with
access
to
this
type
of
activity
already
exists
it
that
accesses
is
either
in
an
illegal
fashion,
through
private
bookies
or
through
offshore
counts.
F
The
Kentucky
residents
are
participating
in
the
activity
already
they're
doing
it
legally
or
simply
going
across
the
border
and
spending
their
discretional
dollars
there.
This
will
tax
and
regulate
and
make
it
legal
significantly
reduce
illegal
participation,
this
type
of
activity
and
will
also
help
us
pay
down
our
pension
liabilities,
because
that's
where
the
the
funds
will
be
going
to
I
would
love
to
have
your
support.
Thank
you.
E
And
I'll
close
with
and
much
like
previous
versions
and
representative
Gentry
alluded
to
it.
The
funds
go
into
the
wagering
Administration
fund
to
start
with,
they
will
pay
for
the
regulatory
cut.
The
increased
regulatory
cost,
the
racing
commission
for
regulating
Sports
wagering,
the
leftover
funds
after
the
increased
regulation
cost
is
paid,
will
go
to
the
permanent
pension
fund,
unlike
other
proposals
that
you've
seen
on
this
bill
in
the
past.
For
those
of
you
all
that
have
been
here,
this
bill
does
not
include
online
poker
or
daily
fantasy.
A
H
Thank
you
Mr,
chairman
representative.
These,
let
me
make
sure
I
have
a
pictures
right
on
the
how
this
is
going
to
operate.
H
There'll
be
a
licensed
fee
and
that'll
be
rfp'd
out
for
companies
that
want
to
come
into
the
state,
such
as
FanDuel
or
and
if
I
miss
speak.
Some
of
these
I
don't
know
them
all,
but
is
that
how
it's
set
up
won't.
E
Be
particular
an
RFP
representative
Smith
the
superior
license
as
I
said.
Any
track
licensed
track
in
Kentucky
can
apply
for
a
license.
Okay,
that's
the
superior
license.
It's
a
five
hundred
thousand
dollar
upfront
licensing
fee
with
a
fifty
thousand
dollar
annual
renewal
fee,
the
other
companies,
the
DraftKings,
the
fanduels.
The
platforms
that
you're
talking
about
would
also
have
to
be
licensed,
but
they
would
then
have
to
contract
within
one
of
those
three
available
contracts
with
each
track
to
be
able
to
operate.
E
H
So
make
sure
again
that
I've
got
this
Vision
to
write
at
our
horse
tracks,
we're
going
to
they're
going
to
develop
a
room
such
as,
let's
say,
I've
been
in
Vegas
and
they
had
booking
there.
They
have
the
games
all
up
on
the
screens
and
so
it'll
be
similar
to
that
type
of
an
atmosphere.
It
won't
be
that
you
have
to
go
and
and
pick
up
papers
to
fill
out
to
I
mean
you
know
like
a
book
to
that
they
will
be
allowing
this
type
of
betting
at
the
facility
with
live.
E
H
And
final,
so,
could
you
tell
me
then
I
know
a
lot
of
numbers
are
hypothetical
on
what's
taken
out
of
the
state
and
what's
bit
today
and
the
black,
what
we
call
Black
Market,
where
it's
not
regulated,
can
you
say
that
it's
across
the
whole
state,
or
is
it
centered
around
the
bordering
states
that
they
have
this
issue
like?
Is
it
a
Louisville
issue
or
Northern
Kentucky,
because
you,
a
lot
of
things
I
read,
was
that
they
had
to
go
across
the
border
to
to
bet
on
the
Super
Bowl?
H
You
know
we've
seen
a
lot
of
publicity
on
that.
Can
we
say
that
it's
widespread
from
one
end
to
the
east,
to
the
West
I.
E
Would
say
it's
pretty
widespread
now,
if
you
look
at
and
Geo
comply
has
provided
us
they're,
one
of
the
Geo
fencing
companies
that
that
provide
services
to
the
providers
to
make
sure
that
the
folks
are
betting
within
the
jurisdiction,
where
they're
legally
able
to
do
that.
They
have
provided
us
with
a
heat
map
that
I
can
show
you
after
the
meeting
representative
Smith
that
what
it
shows
is
obviously
in
those
border
regions.
E
Folks
are
more
apt
to
try
to
place
a
bet
on
their
phone
because
they
may
not
realize
that
they
have
to
actually
cross
the
river
across
the
state
border
to
do
it.
In
fact,
I
will
tell
you
I've
heard
from
some
folks
in
Louisville
who
know
the
exact
spot
on
River
Road
that
they
can
go
to
where
they
can
bounce
off
an
Indiana
cell
phone
tower
and
they
can
place
the
BET
without
crossing
the
river
and
paying
the
toll.
H
And
the
reason
for
it,
Mr
chairman,
is
because
my
vote
today
is
going
to
be
for
regulating
it's
not
to
promote
a
business
one
way
or
the
other,
but
I
don't
believe
we
need
anything
out
there.
That's
non-regulated,
I,
don't
care
if
it's
alcohol
gaming,
whatever
and
I've,
stayed
consistent
on
that
message.
So
I
just
want
to
make
sure
that
I
understand
that
the
the
problems
across
the
whole
state
is
not
just
a
border
issue.
It.
E
A
I
Good
morning,
chairman
members
of
the
committee
I'm
David
walls,
executive,
director
of
The
Family
Foundation.
We
are
a
Christian
public
policy
organization
that
stands
for
Kentucky
families
and
the
biblical
values
that
make
them
strong,
really
appreciate
the
opportunity
to
be
here
this
morning
and
just
Express.
A
few
concerns
about
House
Bill
551,
the
family,
foundation's
opposition
to
the
expansion
of
predatory
gambling
is,
is
well
known
to
this
committee
and
its
members.
But
an
issue
of
such
magnitude
and
importance
requires
that
we
once
again
lay
out
our
concerns.
I
Predatory
gambling,
especially
in
the
expansive
form
that
is
being
considered
here
in
House
Bill
551
is
not
a
victim
victimless
form
of
entertainment
or
competition.
It
is
a
form
of
financial
fraud
that
sees
the
government
partner
with
wealthy
gambling
interest
to
the
harm
of
its
own
citizens.
This
is
a
simple
truth
and
a
harsh
reality.
This
type
of
predatory
gambling
is
designed
to
prey
on
human
weakness,
with
the
government
colluding
with
gambling
interest
to
exploit
our
fellow
kentuckians.
I
Online
sports
betting
puts
casinos
in
the
pockets
of
millions
of
people
and
has
led
some
states
to
already
report
a
tripling
of
rates
in
gambling
addiction
in
Magno.
Make
no
mistake,
despite
any
attempts
to
protect
children
from
this
highly
addictive
form
of
gambling.
Commercialized
sports
betting
harms
children
and
radically
changes
the
way
that
they
perceive
Sports.
The
high
frequency
of
deceptive
ads
by
Sports
gambling
operators
serves
to
normalize
gambling
for
children,
leading
kids
to
believe
that
gambling
is
Central
to
playing
and
watching
sports
Studies
have
indicated
that
children,
no
matter
what
steps
are
taken.
I
They
will
gain
access
to
sports
gambling
apps
on
their
phones
and
devices
in
states
where
sports
betting
is
legal
and
when
a
younger,
the
younger,
a
child
starts
gambling,
the
more
likely
it
is
that
they
will
become
a
habitual
and
problem
gamer.
I
Finally,
I
would
just
urge
this
committee
and
all
the
members
to
consider
for
a
moment
is
the
further
expansion
of
predatory
gambling
really
good
policy.
In
a
time
when
addictions
of
all
kind
are
on
the
rise.
Is
it
a
good
time
when
high
inflation,
gas
prices
and
other
costs
are
making
family
budgets
even
tighter
and
if
a
multi-billion
dollar
fund,
a
new
government
program
for
problem
gaming,
which
has
been
proposed
in
other
legislation,
is
needed
to
attempt
to
undo
some
of
the
harms
of
this
expansion
of
gambling?
I
Wouldn't
kentuckians
be
better
off
without
it
I
believe.
So,
one
of
the
main
purposes
of
government
is
to
seek
the
welfare
of
its
citizens
not
to
exploit
those
who
are
vulnerable.
Government-Sponsored
gambling
is,
by
its
very
nature,
bad
government
and
bad
policy.
I
urge
you
and
the
members
of
this
committee
to
oppose
this
expansion
of
gambling
and
the
harm
that
it
will
cause
Kentucky
again,
thank
you
for
the
opportunity
to
be
here.
A
J
J
Gene
Cole
with
the
Kentucky
league
on
alcohol,
gambling
problems
and
substance,
use
disorder
and
Kentucky
ethics
League.
As
Mr
walls
said,
gambling
is
a
predatory
industry,
even
though
they
try
to
frame
it
as
not.
It
is
because
you
see
on
TV
all
these
ads
for
absent
are
being
proposed
in
this
legislation
such
as
DraftKings,
FanDuel,
Caesars
and
any
of
the
others.
There's
always
ads,
saying:
hey,
Place,
50
bet
with
us
and
we'll
give
you
another
200..
J
J
Even
though
they're
this
geofencing,
as
was
pointed
out,
there's
places
here
in
Kentucky,
can
be
hit.
Even
cell
phones
are
vulnerable
yeah.
You
can
put
a
thing
on
there
saying.
Are
you
over?
You
have
to
be
over
21
or
over
18.,
and
if
anybody
can
read
and
wants
to
play
some
bad,
they
can
push
the
yes
button
certifying
they're
over
18
or
21.,
no
matter
how
old
they
actually
are.
J
I've
heard
stories
of
how
underage
people
in
other
states,
Place
Wagers
through
through
the
phone
one
maxed
out
his
mother's
credit
cards
in
about
a
month's
time
play
some
bets.
Mother
had
no
clue
until
bill
came
or
others
of
where
I
think
this
was
on
an
Apple
device,
I'm,
not
sure,
because
it's
something
I've
never
heard
of,
but
supposedly
with
Apple
devices,
they
can
mirror
a
dad
had
his
phone
and
it's
child
had
a
phone,
but
it
was
mirror
of
his
dads
and
through
that
mirror
the
child
was
able
to
place
bets
in
Wagers.
A
All
right,
thank
you,
Mr
Cole,
thank
you
for
testifying.
Now,
I
have
a
few
more
that
are
signed
up
to
speak
in
favor
of
this
bill,
but
we
do
have
a
motion
and
a
second
on
the
table,
so
I'll
leave
it
up
to
if
they
need
to
come
forward.
They
can
but
representative
Meredith
representative
Ginger.
If
you're
good,
we'll
go
ahead
and
vote
Madam
clerk,
please
call
the
roll
representative.
B
B
L
F
M
A
A
A
G
A
We
do
we,
we
have
a
motion
in
a
second
who
did
the
motion
come
from
Kim
I
didn't
know
if
it
came
out
of
the
sky.
I
didn't
know.
H
N
O
Thank
you,
Mr
chair.
Could
you
just
tell
us
briefly
what
the
agreed
upon
languages.
G
Sure
do
you
want
me
to
go
through
that
or
do
I
want
to
go
through
it?
Okay,
actually,
I
have
a
handy
dandy
little
sheet
right
here.
Okay,
in
section
one
of
the
bill,
it
spells
out
the
requirements
to
be
met
in
the
collaborative
agreement
for
prescriptive
Authority
for
controlled
substance,
substances
for
aprns
and
the
collaborating
physician.
G
The
2023
Bill
requires
a
standardized
capacity
as
form
be
developed
by
a
committee
of
two
aprns
and
two
Physicians
within
60
days
of
the
bill
becoming
law
within
90
days.
The
Kentucky
Board
of
Nursing
is
required
to
promulgate
a
regulation
incorporating
the
standardized
Kappa
CS
form,
and
once
the
regulation
is
in
place,
every
Kappa
CS
agreement
will
utilize
the
same
standard
form.
G
Kentucky
Board
of
Nursing
will
notify
the
Kentucky
Board
of
medical
licensure
when
a
Kappa
CS
has
been
entered
and
the
Kentucky
Board
of
Nursing
will
notify
the
Kentucky
Board
of
medical
licensure.
When
a
Kappa
CS
has
been
rescinded
and
will
furnish
a
copy
of
that
notification,
the
Kappa
CS
will
have
these
requirements,
which
are
to
be
recorded
on
the
agreement
form.
The
current
one-year
moratorium
on
Controlled
Substances,
prescribed
by
newly
licensed
aprns,
will
be
eliminated.
The
Kappa
CS
meeting
requirements
between
the
APRN
and
the
collaborating
physician
are
spelled
out
in
statute.
G
Aprns
Who
currently
have
a
Kappa
CS,
but
have
not
completed
four
years,
can
complete
the
four-year
period
pursuant
to
the
capacity
as
terms
already
in
place
and
then
submit
requests
for
exemption
to
the
Kentucky
Board
of
Nursing.
Aprns
wishing
to
practice
in
the
state
through
licensure
endorsement
are
exempt
from
Kappa
CS
requirements.
G
With
a
Kentucky
physician,
the
Kentucky
Board
of
Nursing
shall
conduct
random
audits
of
the
prescribing
practices
of
aprns
through
a
review
of
Casper
and
shall
take
disciplinary
action
under
krs-314091.
If
a
violation
has
occurred.
Section
2
of
the
bill
establishes
the
controlled
substance
prescribing
Council
there.
G
In
90
days
to
the
council,
recommendations
and
explanation
of
their
response.
They
may
request
information
from
licensure
boards
regarding
their
investigation
and
enforcement
procedures.
They
will
submit
annual
reports
to
the
governor
and
the
lrc
recapping,
the
above
items,
with
the
first
report
due
on
December
31st
2024,
and
they
may
also
make
policy
recommendations
to
legislative
and
executive
branches
to
improve
prescribing
and
enforcement
practices.
However,
the
council
cannot
make
policy
recommendations
regarding
scope
of
practice
of
providers
and
then
the
council
does
not
have
a
sunset
clause.
O
Yeah,
thank
you.
I
really
appreciate
all
of
the
work
that's
gone
into
this
I
know
it's
been
years
in
the
making
trying
to
come
to
an
agreement
and
I'm
very
happy
to
see
the
prescribing
Council.
That's
something
that
We've
we've
worked
on.
I
I
think
I
even
filed
a
bill
a
couple
of
years
ago
to
strengthen
the
collaborative
agreement
and
that's
exactly
what
this
does
so
I
am
happy
about
that.
I,
like
the
reporting.
O
Is
there
any
comment
on
liability
protection
or
liability,
insurance
requirements
or
I
didn't
see
anything
about
liability.
K
Thank
you,
chairman,
and,
very
briefly,
thank
you
for
bringing
this
before
before
us.
You
know
I
I
initially
had
some
concerns.
Obviously
you
know
our
the
war
on
opiates
is
something
that
is,
that
is
very
concerning
to
everybody
and-
and
you
know
it's
it's
very.
It's
still
a
daunting
task.
K
I
believe
that
the
provisions
that
you
all
have
put
in
place
are
very
strong,
I
think
the
safeguards
are
there,
I
think
the
guard
rails.
Are
there
I
think
the
limits
that
you
put
on
prescriptions
are
there
where
they
need
to
be
and
I
also
have.
I,
also
believe
that
Casper
is
a
very
effective
method.
K
My
sister
is
a
doctor
and
she
talks
about
her
reporting
that
she
gets
from
Casper
about
you
know
any
anomalies
in
her
in
her
prescriptive
ability.
So
I
believe
that
Casper
is
a
very,
very
strong
tool
in
this
and
I'll
be
voting
yes
today,
but
I
just
wanted
to
to.
Let
you
all
know
that,
for
me
it
was
not
an
easy
guess.
It
was
a.
It
was
a
process,
but
I
believe
that
you
all
have
done
the
right
things
with
this
and
I
think
that
this
is
going
to
be
very
successful
Kentucky.
Thank
you.
B
I'd
like
to
explain
my
vote,
you
know
thank
you.
I
look
back
through
the
years.
This
has
been
going
on
for
a
long
time
and
I
look
back
at
Wendy
Fletcher.
She
was
down
here
for
years
and
I
want
to
thank
her
and
Jill
York
back
there
and
you
Senator
Adams
for
keeping
the
keeping
the
flag
flying
for
this
and
I'm
glad.
We've
come
to
an
agreement,
I
vote,
Yes.
F
M
Yes
quickly
explain
my
vote.
Yes
ma'am
I
just
want
to
take
the
time
to
thank
Senator,
Julie
Rocky
Adams
for
her
leadership
on
this
issue.
I
know
it's
been
a
big
lift,
and
this
is
something
that,
when
I'm
home
in
my
district
in
the
18th
District,
a
lot
of
aprns
are
talking
to
me
about.
So
thank
you
for
your
strong
leadership.
I
P
Like
to
explain
my
yes
thank
you
so
much
Senator
Adams
for
working
so
hard
on
this
compromise
that
will
expand.
Health
Care
in
Kentucky,
appreciate
it
and
I'm
a
yes
vote.
A
B
K
Thank
you,
chairman.
Okay,
Senator
Bledsoe.
On
page
two
of
your
bill,
you
reference
further
defined
in
28c
Fr,
section
20.3,
Part
D.
Could
you
elaborate
a
little
bit
on
the
impact
of
that
on
this
bill?
I.
L
F
E
A
O
I
just
want
to
thank
you
for
making
it
easier
for
cosmetologists
to
practice
across
state
lines.
This
is
an
interstate
compact
for
anyone
who
is
watching
and
doesn't
know
what
the
bill
does.
So.
Thank
you.
P
A
P
D
D
A
Q
Okay,
thank
you
so
much
chairman
I'm
here
joined
with
several
guests,
and
we
are
here
as
well
as
people
in
the
audience
from
the
Kentucky
Medical
Association,
the
Kentucky
speech,
language
hearing
Association
and
the
hearing
aid
Association
of
Kentucky
and
we're
here
to
talk
about
58..
As
you
may
know,
from
the
presentation
held
during
the
interim
in
2017
president
Trump
signed
into
law
the
bipartisan
over-the-counter
hearing,
aid
act
as
part
of
the
FDA
reauthorization
after
feedback
from
industry
providers
and
patients
in
2022.
Q
L
M
R
R
N
A
A
S
Thank
you
for
keeping
everything
on
track
today,
right
on
schedule.
What
you
have
before
you
oh,
can
we
can
we
please
adopt
the
sub
Mr
chairman.
A
C
S
You
Mr
chairman
Mr
Lewis
and
myself.
We
are.
We
are
your
chairs
of
the
administrative
regs
Committee
in
Frankfort
this.
What
I'm,
getting
ready
to
say,
is
mainly
for
any
new
members
that
are
on
the
committee.
The
administrative
regs
committee
works,
unlike
any
other
Committee
in
Frankfurt,
so
we
take
a
look
at
all
the
regulations
flowing
from
the
administration,
all
those
flow
through
our
committee
and
we
make
sure
that
they
meet
meet
the
requirements
necessary
and
in
that
process.
S
If,
if
we
don't
like
a
reg
or
if
it
doesn't
meet
the
requirements
of
13A,
we
cannot
strike
down
that
Reg.
We
can
only
find
it
deficient
or
ask
the
administration
to
defer,
and
so,
if
we
do,
if
we
don't
like
the
reg
and
we
find
it
deficient,
that
means
we
don't
like
it,
but
it
still
can
move
forward.
The
governor
can
just
proceed
on
as
if,
if
nothing's
wrong
with
the
wreck,
and
so
what
we
started
doing
about
three
years
ago,
is
at
the
end
of
each
session.
S
S
We
have
a
list
of
the
regs
that
were
found
efficient
for
you
and
I'm,
going
to
let
Coach
here
Lewis
talk
about
that
a
little
bit,
but
this
this
bill
is
more
about
the
process
than
it
is
about
the
actual
regulations,
and
it
puts
put
some
teeth
into
the
work
of
the
administrative
regs
committee
and
just
to
give
you
some
context,
it's
not
like
we're
stopping
the
administration
from
from
doing
their
work.
S
We
reviewed
over
500
regulations
and,
in
all
that
time
we
found
three
sets
of
regs
deficient,
so
so
Governor
beshear
most
of
his
agenda,
470
other
sets
of
regulations
were
allowed
to
move
through
the
process,
and
so
that's
what
the
bill
does
and
then
now
turn
it
over
to
coach
air
Lewis.
T
Thank
you.
So
we
have
a
few
different
ones.
One
of
the
first
ones
that
I
came
into
in
January
was
Medicaid
expansion.
The
regs
took
funds
that
we
had
from
savings
from
our
PBM
bill
in
2020
that
Max
wise
carried
These
funds,
expanded
medicaid
access
for
hearing
vision
and
audio
hearing
vision
and
dental
the
the
agency.
The
cabinet
does
not
have
that
authority
to
appropriate
funds.
We
do
Let's
see.
We
also
had
Board
of
Pharmacy
authorized
protocols
that
we
had
yesterday
reg
dealed
with
medications
that
pharmacists
made
dispense
without
a
prescription.
T
Amendment
strikes
the
individual
conditions
and
adds
more
generalized
language
about
what
pharmacists
are
allowed
to
dispense,
essentially
giving
them
more
discretion.
We
wanted
it
to
be
each.
You
know
an
individual
list
and
one
before
that
I
was
here,
was
employer,
employee
contracts
and
what
pretty
much
it
controls
and
restricts
who
works
as
an
independent
contractor
within
Kentucky.
The
rag
ignores
multiple
long-held
tests
to
determine
whether
a
worker
qualifies
as
an
independent
contractor.
These
are
the
regs.
We
found
deficient,
be
happy
to
answer
any
questions.
A
K
K
Of
the
deal
that
the
dental,
the
dental
piece.
K
I
I'm
just
I'm
just
kind
of
I'm,
not
really
asking
a
question,
I'm
kind
of
more
making
a
statement
about
this.
You
know
I
I'm,
a
firm
believer
that
you
know,
dental
health
is
one
of
those
ones.
It's
really
really
important
to
the
overall
life
expectancy
of
humans.
I
mean
it's
one
of
those
key
indicators
and
Kentucky
definitely
has
been
chasing
the
pack.
You
know
in
that
particular
category
and
I
think
about
all
of
our
overall
health
outcomes
and
the
quality
of
life
that
we
want.
K
Our
you
know,
fellow
kentuckians,
to
live
to
lead.
The
problem
is,
is
that
the
policy
wasn't
followed
correctly
in
order
to
provide
them
the
coverage.
So
that's
where
I'm
torn
personally
with
this
today
and
I
I
would
look
that
you
know
we
moving
forward.
Obviously
we
can't
make
any
Appropriations.
We
can't
do
anything
at
this
late
date.
However,
I
think
that
we
do
need
to
look
at
seeing
what
we
can
do
to
to
maintain
those
coverages
moving
forward.
K
A
S
My
name
is
Chairman,
there's
a
path
forward
for
the
cabinet
on
this.
These
regs
there's
some
gamesmanship
that
gets
played,
and
this
is
part
of
part
of
a
process
that
they
chose
to
move
forward.
Without
the
legislative
input
and
everybody
I
spoke
to
in
the
community,
the
dental
community
and
others,
they
they
would
say,
first
expand
our
rates,
then
expand
coverage.
S
They
went
ahead
and
expanded
coverage
didn't
expand
the
rates.
Having
said
all
that,
if
we
find
this
reg,
we
found
the
reg
deficient
and
if
we
find
it
null
and
void,
there's
still
a
path
forward
for
them
after
session
is
over.
They
can
our
committee
meets
every
month.
They
can
file
a
new
emergency
reg
and
make
the
changes
we've
been
in
consultation
with
them,
there's
a
way
for
them
to
get
it
done
if
they
choose
to,
especially
on
rates.
This
just
mainly
talked
about
the
expansion.
T
Yes,
representative,
there's
nothing
prohibiting
them
from
coming
out
with
a
different
fee
schedule.
It's
probably
been
over
20
years
since
it's
been
raised.
It
definitely
needs
to
be
looked
at,
but
this
is
not
the
way
to
do
it.
We
need
to
go
through
the
proper
channels.
We
need
to
go
through
us
because
we
appropriate
funds.
R
S
So
this
this
regular,
the
regulation
that
we
found
efficient
had
nothing
to
do
with
the
fee
schedule.
The
fee
schedule
stayed
stayed
the
same.
This
just
expanded
the
coverage
to
it
to
an
adult
population,
and
so
they
took
the
38
million
dollars
in
savings
from
the
PBM
bill,
which
was
Senator
wise's
Bill
a
few
years
ago,
and
they
went
rather
than
getting
legislative
input
on
how
to
spend
the
38
million.
They
just
went
ahead
and
expanded
the
Medicaid
population
and
spent
the
38
million.
S
We
felt
that
the
legislature
should
have
a
little
input
on
what
happens
there.
So
this
the
drug
we
found
efficient,
has
nothing
to
do
with
the
rates
they're
still
free
to
discuss
that
with
dentists
and
Audiology
others,
and
and
increase
those
rates
on
their
own.
They
can
be
back
in
our
our
committee
next
month
and
do
an
emergency
wreck
and
do
that.
That's
that's
their
discretion,
so
nothing
in
here
prevents
them
from
doing
that.
R
A
O
Thank
you
Mr
chair
and
thank
you
for
bringing
this
forward.
I
think
it
allows
us
to
have
a
robust
discussion
about
the
process
and
and
really
what's
going
on.
I
have
the
same
concerns
about
Dental
Care
I
know
that
this
doesn't
really
preclude
the
cabinet
from
moving
ahead
on
things
like
reimbursement
rates.
They
they
have
done
this
in
within
certain
categories
of
Dentistry.
O
There
are
some
services
that
Medicaid
covers
that
I
I
think
this
filled
the
gap
on
again
I,
don't
know
that
the
cabinet
can't
go
ahead
and
and
make
those
changes
anyway,
but
things
like
paying
for
fillings
versus
a
tooth
extraction,
things
that
you
know
are
very
common
sense.
So
you
know
we
need
to
make
sure
that
we're
we're
allowing
for
those
kinds
of
Common
Sense
changes
and
then
for
services
that
are
currently
underway.
When
this
expansion
happened
and
I
I
think
some
dental
services
were
kind
of
rolled
out
are.
O
Is
there
anything
to
protect
those
Services?
You
know
so
that
they
don't
just
fall
flat.
T
They
could
do
that
at
any
time.
So
one
of
the
issues
is
they
were
waiting
on
CMS
approval
and
they
didn't
get
that,
and
so
they
told
the
mcos
to
go
ahead
and
go
ahead
with
this
expansion
and-
and
there
was
just
a
lot
of
well
honestly-
lack
of
communication
between
the
providers
and
the
cabinet
going
forward.
I
mean
I.
Think
you
make
a
great
point,
I
think
when
you
look
at
preventative
care,
I
think
that's
a
huge
part
of
this
and
it's
it's
a
conversation.
T
S
Frankly,
that's
part
of
the
problem:
there's
a
lack
of
communication.
The
cabinet
should
have
been
in
front
of
the
Health
and
Welfare
committee
discussing
this
with
us,
come
to
some
type
of
an
agreement
and
if
they
would
have
had
that
agreement
ahead
of
time,
there
probably
wouldn't
have
been
any
problem
in
our
committee
whatsoever
on
moving
this
forward.
O
F
Thank
you,
Mr
chair,
my
question's
simple
will
passing
this
bill
result
in
the
reduction
of
dental
hearing
or
vision
coverage
for
Medicaid
recipients
in
any
way.
T
T
You
could
say
temporarily:
go
ahead,
I
think
it's
an
opportunity
to
have
a
bigger
discussion,
though
again
dentists
aren't
accepting
these
rates
right
now
you
can
span
coverage,
doesn't
matter
they're,
not
accepting
it
and
that's
from
the
dentist
I
thought
to.
If
you
look
at
the
rates
on
the
Optometry
side,
it's
about
30
percent,
less
than
what
you
get
from
a
commercial
plan
or
a
Medicare
Plan.
T
We
definitely
need
to
look
at
this
issue
and
and
increase
coverage,
because
what
you
have
is
Healthcare
Healthcare
deserts
right
now,
but
even
the
cabinet
I
don't
know
if
they
really
talk
to
the
providers
on
this
whole
issue.
So
I
mean
it's
something.
We
really
need
to
look
into
and
dive
into
and
increase
and
work
on.
But
this
is
not
the
way
forward.
S
Representative
Gentry
I'd
like
to
comment
make
one
for
their
comment.
This
we
didn't
make
this
decision.
We
didn't
walk
into
the
committee
one
day
and
just
make
this
decision
off
the
cuff.
So
this
this
was
after
a
series
of
meetings
where
the
the
cabinet
wasn't
from
the
committee.
We
would
ask
them
to
defer,
fix
it
change
it
come
back
to
us
with
a
solution.
S
We
gave
him
multiple
opportunities
to
to
negotiate
and
work
work
through
it,
and
so
I
just
want
to
let
you
know
it
wasn't
after
it
wasn't
just
an
off
the
cuff
decision.
It
was
after
a
series
of
months
of
in
the
in
the
committee,
so.
P
L
F
Explain
my
vote.
Please.
Yes,
sir
I'm
a
no
today
and
it's
it's
for
the
kentuckians
with
disabilities
in
the
state
that
are
they're
on
Medicaid
that
have
needed
access
to
dental
hearing
and
vision
services
for
many
years
and
anything
that
that
try
to
stuff
has
get
in
the
way
of
moving
forward,
regardless
of
what
the
rate
structure
is
I'm
going
to
be
against
them.
Thank
you.
N
N
N
Impacts
some
of
the
most
from
over
here
sorry,
some
of
the
most
vulnerable
people
in
our
Commonwealth
and
in
my
district,
certainly
and
I-
want
to
fully
kind
of
understand
all
of
the
discussions
that
you
all
have
had
in
your
committee,
so
I'll
be
reaching
out
to
you
for
further
discussion,
but
I'm
a
pass
today.
Thank
you,
representative.
H
My
vote
Mr
chairman,
yes,
sir.
It's
a
yes
but
and
I
appreciate
this
conversation
because
this
seems
to
be
the
most
talked
about.
Amongst
my
providers
is
the
mandates
that
come
down
without
proper
pay,
proper
reimbursement
and,
as
you've
stated,
representative
Lewis.
This
is
a
major
issue
in
Eastern
Kentucky
on
finding
providers
to
see
our
Medicaid
patients.
So
thank
you
for
looking
into
it.
I'd
like
for
you
to
look
into
the
managed
care
too
on
the
issues
there,
because
again,
that's
a
roadblock.
So
anything
you
can
help
us
on
that.
K
Explain
my
yes
vote,
Yes,
sir.
Thank
you
all
for
bringing
this
forward.
You
all
answered
my
questions
and
made
me
feel
at
ease
with
my
yes
vote
today.
Thank
you,
and
you
also
have
kind
of
inspired
me
to
take
a
look
at
this
and
to
see
what
we
can
do
to
make
sure
that
we're
taking
care
of
our
our
fellow
kentuckians
in
the
Commonwealth,
because
we
need
to
and
I
think
that
the
current
system
is
definitely
lacking.
Thank
you.
A
A
E
Chairman
cook
could
I
please
register
a
yes
vote
on
Senate
bills,
57
58
and
94.
Please.
A
M
I
really
apologize.
I
was
a
few
minutes.
Late
I
would
like
to
welcome
my
guest
today,
William
Huffman.
He
is
going
to
be
my
page
for
the
day,
so
he's
gonna
be
hanging
out
and
see
what
it's
like
to
be
a
legislator.
So
please
make
him
feel
welcome
if
you
are,
if
you
see
him
today.
Thank
you
chairman.
Oh
good,.