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From YouTube: House Standing Committee on Health Services (8-9-23)
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C
E
D
A
I
am
here:
we
have
a
quorum
and
we'll
conduct
some
business.
Now
I'd
like
to
remind
everyone
to
just
silence
your
cell
phones,
I
just
did
mine,
so
we
don't
have
any
distractions
and
I
think
to
get
us
started
I'm
going
to
go
ahead
and
consider
all
of
the
regulations
that
we
have
before
us
today.
We
have
11
different
regulations.
Those
were
all
sent
to
committee
members
and
I
would
just
like
to
ask.
If
there
are
any
comments
or
questions
I
see,
hearing
none
see
none.
A
We
will
consider
those
administrative
regs
reviewed
the
first
bill
that
I
would
like
to
take
up
since
I
know
some
of
our
senate
members
are
here
and
are
between
various
meetings,
we're
going
to
go
ahead
and
bring
up
Senator,
Julie
Rocky
Adams
to
discuss
Senate,
Bill
37,
and
if
you
have
any
guests
with
you,
please
invite
them
to
the
table.
Introduce
yourself
for
the
record
and
just
please
proceed.
F
F
and
before
you
today,
and
thank
you,
madam
chair
before
you
today
is
Senate
Bill
37
and
let
me
tell
you
what
Senate
Bill
37
is
not
because
there's
been
a
lot
of
hairs.
Put
on
the
monster
here.
Senate
Bill
37
is
not
a
codification
of
a
regulation.
Senate
Bill
37
is
not
blowing
up.
The
Board
of
Pharmacy
Senate
Bill
37
is
has
evolved
since
the
beginning
of
session,
and
so
today's
version
that
is
before
you
is
a
result
of
broad
participation.
F
So
what
it
does
it
does
one
thing
it
establishes
the
membership
of
the
advisory
Council
to
the
Board
of
Pharmacy
to
allow
for
input
and
Broad
expertise
on
the
practice
of
Pharmacy
The
Advisory
Council
will
be
comprised
of
several
Pharmacy
Specialties
and
representatives
from
long-term
care
and
the
hospitals,
so
kind
of
the
Genesis
behind
this
bill
was
the
the
practice
of
Pharmacy
is
starting
to
evolve
in
the
state
of
Kentucky,
with
the
ups
and
Amazon
and
DHL,
and
all
of
these
new
entities,
we've
kind
of
broadened
our
practice
of
Pharmacy
in
this
state,
and
so
what
this
advisory
Council
will
do
is
lend
some
expertise
to
the
Board
of
Pharmacy
if
they
so
choose
to
draw
on
those
various
new
and
dynamic
aspects
of
a
pharmacy
economy
in
Kentucky
and
so
I'd
be
happy
to
entertain
any
questions.
A
Okay,
thank
you
so
much
Senator,
Adams
and
I've
had
loads
of
meetings
about
this
as
well,
and
I'm,
really
glad
that
you
came
to
a
resolution
and
and
I
think
it's
really
smart
to
have
input
from
all
of
those
stakeholders.
So.
F
G
You
know
they've
been
several
bills
come
out
of
the
Senate
this
year
and
my
first
suggestion,
maybe
is
how
to
interim
on
Pharmacy
I,
think
there's
about
five
or
six
in
the
Senate
I
know
at
least
three
in
the
house.
So
it
might
be
time
to
have
a
task
force
there.
But
I
would
like
to
thank
Senator,
Adams
and
well-educated
lady
who
I
like
went
to
some
major
universities
which
I
like
and
the
Kentucky
Farmers
Association,
and
the
Kentucky
Board
of
Pharmacy
for
working
together
to
create
SB
37.
G
It's
a
bill
that
makes
Kentucky
more
safe
and
improves
the
health
of
the
Commonwealth.
You
know,
that's
what's
in
her
heart
is
to
improve
the
Commonwealth.
When
we
let
bills
die
to
save
lives.
Whether
in
the
center
of
the
house,
then
we're
not
doing
our
job
so
I'm
a
yes
vote
and
I
hope
that
during
the
interim,
we
can
bring
all
these
Pharmacy
problems
to
a
head.
That.
A
Sounds
great.
Thank
you.
Thank
you.
That's
a
great
idea.
All
right.
Do
we
have
any
further
questions.
All
right
see
none
DJ,
please!
Oh!
We
do
need
a
second
all
right.
Thank
you.
Ryan.
Please,
take
the
role
representative.
C
C
D
D
A
A
A
H
Appreciate
the
opportunity
to
talk
about
this
Senate
during
resolution,
not
to
bore
you
but
I've,
been
in
healthcare
for
40
years
retired
in
2013
as
a
hospital
CEO
small
rural
hospital
for
30
years.
So
I
preface
my
presentation,
but
just
letting
you
know
I
think
I
know
a
little
bit
about
health
care.
H
But
what's
interesting
about
this
is
when
I
started
this
business
in
the
mid
70s,
we
had
Workforce
shortages
and
it's
never
been
adequately
addressed
and
as
we're
looking
at
this
new
problem,
I
just
see
the
same
old
ideas
being
regenerated,
and
you
know
there's
some
good
things
like
scholarship
assistance
and
in
exchange.
You
stay
for
a
couple
years
in
community,
but
it
doesn't
address
the
fundamental
problem
that
we
have,
particularly
in
rural
communities,
but
also
in
Urban
Healthcare
deserts
that
we
have.
H
H
Now
this
is
the
same
time,
but
we
have
a
Monumental
shift
in
our
payment
mechanism
for
Medicare,
where
we
went
from
cost-based
reimbursement,
which
we
refer
to
as
the
good
old
days
to
prospective
payment
system
which
put
providers
at
risk
and
I
realized
that
we
had
to
grow
our
Revenue
faster
than
the
reimbursement
cuts
that
were
going
to
come
so
got
heavily
involved
in
recruiting
Physicians
and
every
candidate
I
brought
in
without
exception.
One
of
the
first
questions
was:
what's
your
percentage
of
Medicaid?
H
H
H
But
the
issue
is:
there's
where's
the
money
going
to
come
from
the
money's
there.
When
we,
when
I
came
to
Senate
in
2017,
our
Medicaid
budget
was
10
billion
dollars
and
I
said,
then
it's
as
large
as
it
ever
should
be.
You
know,
by
improving
the
health
or
population
getting
people
back
to
engageful
employment,
there's
enough
money
for
everybody
truly
roll
it
forward.
For
this
biannual.
It's
a
15
billion
dollar
budget,
Medicaid
population
growing
from
1.4
million
to
1.7
it's
very
expensive.
H
What
I'm
suggesting
is
we
change
this
whole
dynamic
and
how
we
pay
for
Medicaid
and
I'm,
suggesting
that
that
we
have
the
department
of
Medicaid
developed
by
payment
methodology
based
on
the
deprivation
index
and
I'm
looking
at
representative
Frederick
Gordon,
because
we
had
the
attended
the
seminar
this
past
spring
on
this
very
subject.
You
know
this
is
an
index
that's
published
by
the
federal
government
that
looks
at
seven
different
areas.
A
G
Thank
you,
chair
lady
Senator,
Meredith
I'm,
fully
behind
you
on
this
being
from
a
rural
community.
I
understand
I've
been
on
a
hospital
board
for
over
nine
years,
and
this
is
something
we
got
to
do
for
Kentucky
to
get
us
out
on
the
bottom.
You
know
we
wrote
the
rural
hospital
bill.
We
have
several
people
over
half
dozen
on
that
already
and
I
think
belfon's
going
to
open
up
in
November
and
there's
a
bill
on
Pharmacy
access
and
nobody's
looked
at
similar
to
that.
G
A
You
you're
very
welcome
and
thank
you
senator
for
bringing
this
I
think
this
is
a
very
smart
way
to
get
creative
about
how
we
recruit
and
re
retain
our
health
care
workers
in
in
rural
parts
of
our
state.
A
H
H
J
I
D
D
A
Okay,
Senate
joint
resolution
54
passes
unanimously.
Congratulations
and
same
should
pass
on
the
house
floor.
I
think
it's
a
great
idea.
Thank.
A
K
The
first
part
of
the
legislation
has
to
do
with
definitions.
It
really
talks
about
what
the
physician
wellness
program
is,
and
it
makes
a
distinction
between
Career
fatigue
and
burnout,
that
is,
impairment
and
competency.
The
second
section
has
to
do
with
position
non-disclosure
rights.
It
goes
into
really
what
what
physician
has
a
right
to
disclose
or
has
an
obligation
to
disclose
and
what
they
have
the
right
to
not
have
disclosed
about
them.
K
Then
there
is
the
prohibition
of
discrimination
against
the
Physicians
who
participate
in
the
program.
It
really
limits
the
employers
adverse
actions
against
the
physician,
based
simply
on
their
participation
in
the
physician
wellness
program
and
then
finally,
the
physician's
obligation
to
continue
to
report
things
where
they
have
where
either
they
or
someone
they
know
in
this
particular
area
become
have
competence
issues.
My
hope
is
that
this
will
really
help
not
only
retain
physicians
in
the
Commonwealth
of
Kentucky,
but
bring
positions
to
the
Commonwealth
of
Kentucky.
K
I
have
three
I
have
three
kids
all
who
are
Physicians
and
none
are
interested
in
practicing
in
the
Commonwealth
of
Kentucky.
We
have
to
do
something
to
help
recruit
our
good
providers
back
to
the
Commonwealth
and
with
that
I'm
going
to
turn
it
over
to
some
of
our
our
guests.
L
Thank
you,
Senator
Douglas.
Thank
you,
madam
chair
members
of
the
committee.
As
I
said,
I
am
Dr
Sean
Jones
I'm
practicing
another
laryngologist
in
Paducah
and
president
of
the
Kentucky
foundation
for
medical
care,
which
is
the
charitable
arm
of
the
Kentucky
Medical
Association
I'm.
Also
the
medical
director
for
provider
Wellness
for
Baptist
Health,
Medical
Group,
which
is
part
of
the
largest
not-for-profit
hospital
system
in
the
state.
L
It's
an
honor
to
speak
to
you
today
regarding
physician
wellness
and
our
strong
support
of
Senate
Bill
12..
According
to
the
agency
for
Health
Care
research
and
quality
burnout
is
a
long-term
stress
reaction
marked
by
emotional
exhaustion,
depersonalization
and
a
loss
of
sense
of
personal
accomplishment.
L
Physicians
and
other
health
care
workers
are
at
increased
risk
for
experiencing
burnout.
Due
to
the
demanding
nature
of
our
work,
research
has
confirmed
that
upon
matriculation
to
medical
school,
medical
students
are,
on
average,
more
emotionally
well
adjusted
than
their
age-matched
peers.
Yet
average
rates
for
c-suite
Corporate
America
burnout
hovers
in
the
32
to
34
percent
range.
Depending
on
the
study.
The
rates
for
Physicians
over
the
last
several
years
have
been
in
the
50
to
54
percent
range,
but
following
the
covet
pandemic,
the
AMA
has
recently
reported
a
63
percent
National
physician
burnout
rate.
L
A
We
have
a
motion
on
the
bill.
Do
we
have
a
second
okay?
We
have
a
second
I
know
that
the
Jones
traveled
all
the
way
from
Paducah
today
to
give
us
their
comments,
so
I'd
like
to
offer
Evelyn
an
opportunity
to
chime
in
if
you'd
like
or
if
you
have
anything
to
add
well.
M
I
respect
your
all's
time
fully.
I
just
think
it's
so
important
public
I
mean
mental
health
is
important
for
everyone
and
Physicians
are
not
not
lacking
in
that
need.
I
had
a
colleague
of
mine
several
years
ago,
who
had
battled
with
depression
for
years
and
did
not
seek
help
excellent
physician,
wonderful
patient
confidence,
because
he
was
worried
about
how
it
would
affect
his
efficacy
and
he
took
his
own
life,
and
this
Commonwealth
lost
an
incredible
position.
M
A
N
Thank
you,
chairman
Moser,
and
thank
you
for
being
here.
This
is
a
really
important
bill.
I
support
it
fully
as
a
licensed
psychologist,
I'm,
a
huge
proponent
of
people
getting
the
help
they
need
and
seeking
that
help
and
having
every
possible
barrier
removed.
I
am
curious,
though
about
are
there
repercussions
for
Physicians
who
were
seeking
treatment?
Are
they
are
they
currently
being
required
to
report
or
what
I
guess?
What
is
the?
What
precipitated
the
need
for
this
bill?
Aside
from
the
Mental
Health
crisis
and
the
burnout
which
we're
all
too
familiar
with,
but.
L
I
think
there
are
a
lot
of
stigma
or
Stigmata
associated
with
The
Physician
seeking
help,
just
because
of
the
perceived
nature
of
some
of
the
questions
that
you
have
to
answer.
When
you
make
applications
to
hospital
boards
or
even
insurance
companies,
they
will
ask
if
there's
ever
been
a
mental
health
issue.
N
Thank
you
for
for
that
response
and
I
think
it's
important
that
we
heard
you
unpack
that
and
that
we
make
that,
as
you
know,
public
as
possible,
that
there
shall
be
no
professional
barriers,
that
there
shall
be
no
professional
stigma
or
professional
repercussions
from
people
seeking
the
help
they
need.
So
so.
Thank
you
for
that.
Thank.
M
A
Thank
you,
representative
willner
and
next
representative
Bray.
O
L
The
the
three
that
were
listed
on
the
National
Academy
of
medicine's
website
were
and
I
think
we're
reiterated
in
the
kmas
that
were
physician
or
prior
authorization.
O
O
O
Standalone
physician,
clinics
anymore,
you
know
in
my
hometown,
I've
I
grew
up
with
you
know
four
or
five
independent
doctors
and
now
they've
all
Fallen
under
the
hospital
umbrella
because
they
have
to,
and
so
as
we
look
at
improving
access
to
care
all
across
Kentucky,
not
just
rural
Kentucky.
We
have
to
look
at
each
one
of
these
things
and
when
it
comes
time
to
to
recruit
physicians
in
you
know
each
one
of
these
is
important
and
at
some
point
we
have
to
look
at
our
liability
atmosphere.
Thank
you
all.
K
Yeah,
thank
you,
chairman
Moser
representative
Ray
you're,
exactly
right.
For,
for
my
time
in
medicine,
I've
been
in
private
practice,
I've
had
a
ball.
I
always
tell
people,
I
have
really
thoroughly
enjoyed
medicine,
but
these
areas
have
really
really
been
a
headache
and
they
really
have
affected
my
ability
to
offer
the
type
of
care
that
I've
wanted
to
offer
to
my
patients.
L
L
The
data
we
have
at
within
the
hospital
system
for
which
I
work,
the
burnout
rates
are,
are
fairly
equivalent.
G
J
Thank
you
chair
lady
Senator,
appreciate
you
bringing
this
to
us,
we're
always
looking
to
the
doctors
to
take
care
of
us,
but
we
never
looked
to
the
looked
at
how
we're
going
to
take
care
of
the
doctor.
So
I
think
this
is
a
first
step.
C
P
Thank
you
and
I
Echo
the
sentiments
of
Representative
Bray
and
looking
at
these
things
going
forward.
I
myself
was
not
a
doctor,
but
I
worked
a
level
one
Trauma
Center
at
the
University
of
Kentucky
hospital
for
many
years
and
carrying
that
trauma
beeper
into
the
ER
and
getting
all
the
calls
from
cracked
chests
and
car
wrecks
homicides
and
the
weight
of
the
things
that
I
had
to
carry
along
with
all
the
other
Health
Care
Professionals.
That
worked
in
the
trauma
center
still
haunt
me
to
this
day.
P
So
I
know
that
many
doctors
they
they
go
into
a
lot
more
of
those
taking
care
of
patient
type
things.
But
you
look
at
the
Whole
Health
Care
field
and
those
type
of
situations
they
there.
There
needs
to
be
some
even
this
expanded
even
more
past
physicians
at
some
point
so,
but
thank
you
so
much.
This
is
a
great
first
step
and
for
all
my
colleagues
in
the
medical
care
field,
you
know
I
think
this
is
something
that
we
maybe
can
expand
down
the
road.
Thank
you.
D
D
D
A
Yes,
okay,
Senate
Bill
12
passes
unanimously.
Favorable
expression
same
should
pass
on
the
house
floor.
Congratulations!
Thank
you
very
much
for
your
work.
Thank.
Q
R
E
Thank
you,
committee
Senate,
Bill
71
is
a
simple
life-saving
measure
bill.
It's
aimed
at
facilitating
responsible
organ
donation
throughout
Kentucky
motion.
A
Okay,
we
have
a
motion
in
a
second.
Do
we
have
any
questions
or
comments
from
the
committee.
E
Yes,
so
the
the
bill
basically
allows
two
additional
classes
of
individuals
who
can
make
a
decision
to
donate
for
someone
who
did
not
prior
to
their
injury
or
illness,
and
it
also
makes
various
clarifications
to
KRS
311.1925.
I
About
I
but
I
just
want
to
say
something
because
I
don't
want
to
be
painted
ever
in
the
light
that
I'm
not
for
organ
donation
and
I,
don't
know
if
processes
need
Revisited
or
or
what,
but
when
you're
suddenly
facing
the
worst
thing
that
you
could
ever
think
could
happen
to
you,
you
don't
need
a
sales
call
and
I
don't
need
a
sales
pitch.
The
way
that
the
opportunity
is
presented
needs
to
be
Revisited.
Thank
you.
D
A
A
A
And
I
think:
do
you
have
some
guests?
Yes,
so
if
I
think
it
is
Katie
Moyer
coming
to
the
table
and
okay,
all
right,
if
you
all
can
make
your
way
to
the
table,
just
introduce
yourselves
for
the
record
and
please
proceed.
S
A
R
Okay,
so
the
committee
sub,
really
it
it
changes.
One
thing
from
our
first
version
that
we
had,
which
is
it's
going
to
remove
the
percentage
of
0.3
to
the
concentration
of
Delta,
a
that's
allowable
and
I'll.
Just
talk
about
the
bill,
so
this
is
basically
going
to
look
to
set
up
regulations
for
Delta
eight
as
of
right
now,
there's
not
really
any
there's
no
age
limit.
This
is
going
to
make
it
where
it
is
illegal
to
purchase
under
the
age
of
21..
R
It's
going
to
have
to
be
behind
the
counter
product
labeling
and
then
set
up
guidelines
for
batch
testing,
and
this
is
asking
the
cabinet
to
come
up
with
these
regulations
by
August
of
this
year.
These
are
just
our
recommendations
of
what
we
think
should
be
included
in
it,
and
I
think
the
hemp
industry
would
like
to
be
at
the
table
to
come
up
with
the
final
recommendations
of
maybe
what
the
testing
and
the
thresholds
would
look
like
and
I
like
Katie
can
speak
to
that.
If
you
would
like
to.
S
Yes,
so,
as
we
all
know,
you
know
the
the
Kentucky
hemp
industry
has
had
a
lot
of
hurdles
and
obstacles
and
and
I
always
like
to
say
that
we've
never
taken
a
step
backwards
in
this
industry.
We've
always
been
moving
forward.
Sometimes
our
our
footsteps
don't
land
exactly
where
we
want
them
to.
S
But
this
is
a
situation
where
this
is
something
that
we
have
wanted
and
advocated
for
for
for
four
years
and
last
session,
we
had
an
opportunity
to
meet
with
several
members
here
of
the
panel
and
when
we
met
with
chair
Moser
about
this,
just
briefly
in
the
hallway
to
advocate
for
regulations
that
would
put
some
common
sense
rules
on
the
sale
and-
and
you
know
the
production
of
Delta
eight
products,
and
so
what
we
have
in
the
industry
right
now
is
we
have
sort
of
a
wild
west
situation.
It's
a
gray
area.
S
But
it's
coming
from
who
knows
where
we're
not
surely
getting
it
from
Kentucky
producers
who
are
growing
it
here
and
who
we
can
go
visit
their
store
their
facility
and
make
sure
it's
clean
and
make
sure
they
know
who
they're
getting
their
materials
from
and
and
make
sure
that
there's
no
residual
solvents
left
in
the
products
and
that
the
finished
product
what
people
end
up
consuming
in
the
very
end,
is
safe
and
effective
and
simple
with
clean,
healthy
ingredients
and
I.
Think
that's
what
we
all
really
want.
S
We,
we
look
at
the
all
the
variety
of
cannabinoids
in
the
plant
they're
coming
from
the
plant,
the
the
hemp
industry
supports
hemp,
derived
cannabinoids
and
stop.
We.
We
love
hemp.
Cannabis
naturally
occurring
derivatives
of
cannabis,
but
we're
not
cool
with
synthetics
these
crazy
things,
solvents
residual
things
that
are
floating
around
in
in
materials
that
we
we
don't
have
any
regulations
for.
So
we
support
this
bill.
This
is
a
good
thing.
I
would
like
to
support
it
publicly
and
and
help
push
it
through
the
rest
of
the
the
process.
S
I'd
also
I'd
like
to
introduce
John
Taylor
if
I
may
John
is
from
Commonwealth
extracts,
which
is
one
of
the
largest
cannabinoid
producers
in
Kentucky,
so
we're
we're
being
represented
from
one
of
the
best
and
who
has
been
involved
in
this
since
2014,
like
myself,.
T
Ma'am
again,
my
name
is
John
Taylor
I'm,
the
founder
and
CEO
of
Commonwealth
extracts
and
I'm,
not
going
to
waste
the
committee's
time,
I'm
just
going
to
applaud
representative
Raymer
and
thank
her
for
her
time
and
her
concern.
This
morning
we
went
in
and
she
said
we
were
going
to
have
a
bad
meeting
and
I
couldn't
have
been
happier
we're
all
in
support
of
regulations.
Every
valid
actor
wants
these
types
of
regulations.
It
gets
rid
of
the
Bad
actors
that
make
it
hard
to
compete.
T
It
costs
a
lot
of
money
to
do
the
right
thing
and
when
we
have
people
making
things
in
bathrooms
and
basements
and
barns,
it
really
makes
it
hard
to
compete
on
a
legitimate
level.
So
again,
I
applaud
the
regulations
and
I
couldn't
be
happier
to
be
here
and
have
time
to
meet
with
representative
okay.
A
G
G
Third
class
of
drugs
controlled
by
the
pharmacists
in
the
country,
whether
it
be
something
like
a
loture
zone
for
ringworm
that
they
could
diagnose,
really
easy
or
all
the
THC
products
that
are
out
there
OTC.
So
that's
my
recommendation.
If
we
do
this
thing
in
the
summer
is
in
Kentucky
to
lead
the
way
and
have
a
third
class
of
drugs
and
settle
all
these
problems.
That
we
have
second
question:
I
have
is
a
concentration
when
they
pull
this.
Is
it
pool
with
ethanol,
the
THC
I.
T
T
Love
that
again,
regulation
is
good
for
our
industry.
We
need
oversight
and
we
need
some
support
from
our
cabinets
to
be
able
to
ensure
safety.
As
far
as
the
type
of
extraction
I
use,
carbon
dioxide,
carbon
dioxide,
you
can't
extract
with
ethanol
or
hydrocarbons
fluorons
a
lot
of
different
compounds.
Not
everything
is
safe
and
then
you
deal
with
volatility
in
a
manufacturing
process.
So.
G
T
R
P
I
just
learned,
as
of
yesterday
through
you
and
maybe
it'd,
be
good
for
the
committee
to
know
where
the
Delta
8,
9,
10
11
comes
from,
and
what
constitutes
those
number
ranges.
T
In
chemistry,
the
position
of
the
Delta
refers
to
where
the
double
bond
is
and
the
difference
between
Delta,
a
Delta,
9
and
Delta
10
is
the
position
of
the
double
bond
in
the
molecule
they're,
very
similar,
in
fact,
they're
almost
identical,
except
for
that.
The
two
ways
to
get
the
compounds
is
either
through
chromatography
and
a
process
called
separation,
which
is
where
you
take
a
naturally
occurring
molecule
and
you
separate
it
based
on
specific
gravity
or
molecular
density,
different
things
and
then
there's
conversion,
which
is
a
cheaper
way
to
do
it.
T
T
T
Sir,
that's
an
acetate,
that's
a
non-naturally
occurring
compound.
That's
been
synthesized
through
conversion,
so
delta,
T,
Delta,
9,
thcp
and
thco
or
non-naturally
occurring
compounds
that
can
be
formulated
in
a
laboratory.
This
is
kind
of
the
outer
parameter
of
what
we
call
naturally
occurring
I.
Don't
personally
support
those
compounds
because
Mother
Nature
had
it
right
and
if
we're
just
separating
a
molecule,
it's
not
the
same
as
synthetically,
creating
one
just
one
more
question.
A
Further
questions
we
do
have
Mr
Mark
Cowden
here
with
us
who
would
like
to
speak
in
opposition.
So
if
you
could
just
make
room
for
him
or
maybe
just
exit
the
table
and
be
ready
to
come
back
up
after
he
presents.
U
U
U
Okay.
So
if,
if
you
put
a
cap
on
it,
you're
you're
going
to
be
faced
with
an
illicit
market
and
that
intern
could
restart
the
War
on
Drugs.
U
V
I'd
like
to
just
comment
on
the
bill,
I'm
so
happy
to
see
the
Kentucky
hemp
Association
at
the
table.
V
You
know
hemp
is
a
a
crop
with
several
end
uses
and
it
was
thought
to
Once
be
a
replacement
for
tobacco,
although
it
faces
many
difficult
obstacles,
so
I'm
glad
to
see
that
we've
got
a
committee
sub.
That
will
help
the
Kentucky
hemp,
Association
and
Farmers
across
Kentucky
to
continue
thriving
I'm,
very
hopeful
that
the
cabinet
will
develop
a
reasonable
policy
to
satisfy
our
Farmers
so
that
we
can
continue
to
push
this
crop
forward.
Thank
you.
A
Thank
you
very
much
representative,
Rayburn
and
and
we'll
watch
that
process
as
well
and
make
sure
that
everyone
understands
when
the
public
comment
period
is
and
that
all
all
stakeholders
are
involved
and
I
know.
Miss
Moyer
will
be
on
top
of
that.
So
absolutely.
S
And
if
it's
okay,
if
I,
respond
to
that
I,
just
want
to
thank
you
for
that
comment,
and
you
know
we,
we
pulled
out
some
documentation
from
the
kda's
website
this
morning
and
started
printing
it
out,
and
you
know,
we're
looking
at
last
year
was
87
percent
of
Kentucky's
hemp
industry,
which
is
revolving
around
cannabinoids,
whether
it's
in
farming
it
processing
it.
So
that
is
a
huge
chunk
of
the
hemp
industry
that
we
are
here
to
represent
today
and
there's
so
much
more
to
it.
A
Okay,
well,
thank
you.
So
much
I
think
it's
a
it's.
A
good
bill
see
no
further
questions.
Dj,
please
take
the
role
oops.
We
need
a
motion
on
the
sub
and
we
need
to
to
adopt
the
sub
all
in
favor
aye
any
opposed.
Okay.
Now
we
need
a
motion
on
the
bill.
D
D
Q
I'd
like
to
explain
my
vote
as
well:
I
just
want
to
thank
representative
Raymer
for
this,
as
well
as
for
the
committee
substitute
that
I
was
very
concerned
before
that
was
done
and
I
know
that
you
worked
really
hard
up
through
this
morning
early
this
morning,
working
hard
to
make
this
bill
right,
so
I
appreciate
it.
I
think
it's
going
to
be
great
for
all
of
Kentucky.
So
thank
you.
A
A
A
A
What
we
have
is
a
committee
Amendment
and
we
will
after
we
adopt
the
committee
Amendment.
We
will
roll
that
into
a
committee,
stop
to
make
it
easier
on
the
on
the
house
floor.
So
I
think
what
I'll
have
to
do
is
go
ahead
and
present
your
part
of
the
bill
and
then
we'll
we'll
present.
The
committee
Amendment
okay.
W
X
X
In
2017,
my
husband
and
I
received
a
call,
as
foster
parents,
to
meet
a
beautiful
baby
girl
born
dependent
on
both
cocaine
and
Silva.
Excuse
me
suboxone.
She
was
the
last
one
of
the
five
children
from
the
same
birth
parents
all
to
be
born
drug
exposed
and
adopted
through
our
State
foster
care
system.
With
a
lot
of
research,
questions,
connections,
personal
advocacy,
tears
and
prayers.
This
proud
mama
now
has
a
beautiful
and
thriving
sassy
and
Brilliant
six-year-old
girl.
X
We're
ready
to
share
our
story
and
help
us
help
support
our
state
in
caring
for
these
newborns
and
their
families.
Right
now,
every
19
minutes
a
drug
exposed
newborn
is
born
in
the
United
States
every
19
minutes,
Kentucky's
Nas
rate
remains
far
above
the
national
average
and
in
2020
there
were
993
recorded
cases
of
babies
with
signs
and
symptoms
of
Nas.
X
This
nonprofit
will
be
a
pediatric
residential
recovery
facility
for
these
drug
exposed
newborns
will
be
a
non-judgmental
family-centered
secured
facility
providing
services
in
an
in-home-like
setting
and
will
be
open,
24
hours,
seven
days
a
week
around
the
clock
Staffing
to
meet
the
needs
of
these
babies
and
families.
We
have
two
goals:
we're
dedicated
to
two
goals:
inpatient
Medical
Care
a
facility
will
provide
with
withdrawal
services
to
the
infants
with
nas
in
an
intimate
Homelink
setting,
surrounded
by
medical
staff
and
specially
trained
volunteers.
X
Newborns
will
have
access
to
and
be
introduced
to
therapeutic
treatments,
holistic
care
along
with
their
medical
care,
and
will
also
provide
child
welfare
care,
substance,
abuse
care
and
family
preservation
care.
The
second
goal
is
family
advocacy,
will
work
beside
and
serve
beside
our
local
adult
substance,
abuse
recovery
homes,
to
strengthen
family
advocacy
resources
and
provide
a
bonding
environment
between
both
parent
and
child.
X
We
encourage
birth
parents
straight
from
delivery
to
enter
into
treatment,
while
in
treatment
birth
parents
will
have
the
ability
to
bond
with
newborn
on
site,
have
hands
Hands-On
training
with
our
staff,
parenting
classes
and
a
pathway
to
support
and
resources
to
include,
but
not
limit
us
to
things
like
prenatal
programs,
plan
of
Safe,
Care,
postnatal,
follow-up,
housing
assistance
and
more
pediatric
residential
recovery
facilities
are
a
relatively
New
Concept
to
the
United
States.
However,
there
are
a
handful
in
operation
already
and
they're
having
big
successes.
X
Bridget's
path
is
a
newborn
facility
in
Kettering
Ohio.
Not
only
have
they
paved
the
path
for
others
to
be
created,
but
they
even
helped
create
and
implement
the
crib
act
with
our
federal
government
in
2021
Ohio
reported
1526
babies
being
treated
for
Nas.
This
was
the
total
cost
of
132
million
476
366
Medicaid
dollars.
This
was
the
length
of
stay,
adding
up
to
a
total
of
20
922
days
in
the
hospitals,
breaking
this
cost
down
to
six
thousand
three
hundred
and
thirty
one
dollars
per
baby
per
day
of
our
Medicaid
funding
compared
to
Bridget's
path.
X
Funding
at
one
thousand
four
hundred
and
eighty
dollars
per
day
per
baby
with
the
exceptional
Medical
Care
and
the
astronomical
Savings
in
Medicaid
funding.
They
still
have
one
overall
goal
and
that's
to
Simply
keep
families
together
because
of
their
services
and
resources.
Over
the
past
five
years,
85
percent
of
their
newborns
went
home
with
their
families
and
avoided
foster
care
placements
and
with
their
follow-up
protocols
in
place.
Their
reports
show
that
those
families
are
still
thriving.
X
Phoenix
graces
are
non-profit,
but,
along
with
other
pediatric
recovery
facilities
in
the
future,
we
need
the
crib
act
implemented
in
Kentucky.
This
will
support
the
transformational
impacts
we
will
see
and
create
in
our
community.
It
will
save
millions
of
Medicaid
dollars
and,
while
we're
at
it,
I'd
really
like
to
get
those
Nas
numbers
down
in
Kentucky.
A
Okay,
thank
you,
I
I'm,
going
to
stop
you
because
we
have
a
motion
in
a
second,
but
we
do
have
a
committee
amendment
that
we
will
add
to
this
bill
and
I'll.
Explain
it
here
in
a
second
and
I.
Just
want
to
thank
you
for
bringing
this
I
think
this.
The
treatment
for
our
Nas
babies
and
their
families
is
a
brilliant
plan.
I'd
love
to
get
those
babies
out
of
the
NICU.
A
That
was
my
field
for
18
years,
so
I
know
what
that's
like
and
I
know
how
expensive
it
can
be,
and
so
anything
we
can
do
to
to
get
our
Medicaid
numbers
down
and
get
our
our
families
healthy
is
is
exactly
what
we
should
be
doing.
So
thank
you
very
much
for
your
presentation.
You're
welcome
to
stay
there.
A
I
would
like
to
go
ahead
and
present
the
amendment
that
we
decided
that,
since
this
is
a
Medicaid
issue,
we
wanted
to
go
ahead
and
address
with
the
anticipation
of
Senate
Bill
65
coming
over
and
the
rollback
of
the
Medicaid
expansion
for
the
dental
vision
and
hearing
services.
We
identified
a
potential
problem.
This
amendment
fixes
the
problem
for
any
health
care
provider
who
has
entered
into
a
contract
during
the
expansion
of
services.
We
want
to
make
sure
that
they
receive
reimbursement,
and
all
of
that
will
be
addressed
prior
to
June
30th
of
this
year.
A
That
should
take
care
of
anyone
who
has
entered
into
a
contract
and
still
put
some
guard
rails
around
the
Medicaid
expansion.
While
we
work
out
how
to
best
address
our
dental
vision
and
hearing
services
for
our
Medicaid
recipient,
so
that
is
what
this
amendment
does.
I
am
happy
to
ask
answer
any
questions.
A
Okay,
we
have
a
motion
on
the
amendment.
Second,
all
right,
I'm,
sorry,
okay,
feel
free
to
go
ahead.
Thank
you.
Thank.
Y
You
chairwoman
and
thank
you
Brett
blockett,
for
your
work
on
this
bill.
I'm
excited
to
see
it
move
forward.
My
question
is
about
the
amendment
I
just
want
to
clarify,
since
this
is
fresh
to
my
eyes.
The
amendment
relates
to
all
Medicaid
services
and
not
just
Medicaid
services
relating
to
neonatal
abstinence
syndrome.
Is
that
right?
It.
A
The
amendment
relates
to
dental
vision
and
hearing,
because
and
and
I'll
explain
why
this
is
suddenly
thrust
upon
us.
We
just
yesterday
passed
Senate,
Bill,
65
out
of
committee,
and
so
last
night
late
last
night
I
worked
with
my
friends
from
Kentucky
voices
for
health
and
we
they
brought
this
to
my
attention
and
we
worked
for
a
long
time
last
night
and
this
morning
on
getting
this
language
together.
So
I
apologize
for
it
for
the
lateness,
but
we
wanted
to
make
sure
that
we
corrected
this
before
it
was
too
late.
N
My
question
is
about
the
bill
itself
and
not
the
amendment.
That's
perfectly
fine.
Thank
you.
We
just
heard
a
bill
that
talked
about
certification
for
Recovery
centers
for
adults.
Would
these
pediatric
recovery
centers
be
subject
to
some
sort
of
certification
or
medical
oversight?
Or
can
anybody
open
up?
You
know
Bob's
Clinic
of
residential
pediatric
recovery.
X
A
C
D
Q
A
B
A
A
Okay,
thank
you
and
then
the
last
well,
the
the
motion
carries
the
house
house
bill
436,
as
amended
by
the
committee
Amendment
now
house
committee
sub
passes
with
unanimous,
oh
no
I'm,
sorry,
18,
yes,
and
one
pass
favorable
expression
so
same
should
pass
on
the
house.
Now
we
need
to
adopt
the
title.
Amendment
may
I
have
a
motion
to
adopt
the
title.
Amendment.
A
A
Of
your
work
and
and
your
amenability
to
this
amendment,
so
thank
you.