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B
C
B
For
the
end
of
the
public
health
emergency,
this
is
a
welcome
time
for
all
of
us.
It's
certainly
a
welcome
time
for
the
Public
Health
Community.
That's
had
to
work
so
hard
during
the
pandemic,
so
most
of
our
federal
grants
have
run
their
course
and
or
the
federal
funding
that
we
receive.
So
you
look
at
cares
funding.
That's
long
done,
arpa
funding!
That's
long
done!
We
have
special
and
designated
funding
for
laboratory
for
Disaster
Response
for
Health
Equity
work.
Those
grants
were
supposed
to
end
most
of
them
at
the
end.
B
June
30th
2023
give
or
take
a
month,
and
they
were
extended
a
number
of
them
to
have
extended
spending
period
till
next
summer,
so
the
spending
plan
for
those
has
already
been
introduced
and
we're
really
largely
in
final
execution
and
wind
down
for
those
grants.
So
that's
what
the
first
bullet
mentions
up
there
at
the
top.
One
thing
you
might
notice
for
those
of
you
who
cross
over
when
you
do
the
budget
next
year,
this
last
year
is
the
final
year
getting
money
out.
B
So
this
would
be
the
last
year
that
public
health
budget
is
larger
than
what
it
might
normally
otherwise
be
for
fy24,
and
when
we
get
to
fy25
the
next
biennium
we're
going
to
recede
back
into
more
of
what
our
normal
footprint
would
be.
If
that
helps,
one
of
the
many
big
things
we've
done
is
provide
a
lot
of
testing
for
covid,
particularly
earlier
in
the
pandemic
and
throughout
almost
all.
B
Well,
actually,
all
of
the
regular
Laboratory
Testing
is
largely
gone
at
this
point,
except
for
our
ongoing
support
for
long-term
care
facilities
for
the
nursing
homes.
There's
about
300
or
so
of
them.
I
think
that
we
support
and
we
have
renewed
the
contract
for
one
more
year
and
that
will
run
through
June
30th
and
then
the
funding
will
exhaust,
and
that
will
be
the
last
year
that
we
do
that.
Support
for.
C
B
B
We
have
distributed
a
large
portion
of
the
tests,
we
have
on
hand
we're
continuing
to
try
to
distribute
the
ones
we
have
remaining.
Those
are
ones
that
the
federal
government
purchased
at
this
point
that
were
given
out
to
the
states,
and
then
we
have
a
small
amount
of
money
still
remaining
over
the
next
fiscal
year.
So
the
state
fiscal
year
24,
where
we'll
be
able
to
continue
to
provide
tests
for
the
health
departments,
and
then
they
can
use
those
within
their
communities
to
support
high
priority
areas.
B
The
correctional
facilities,
the
school
testing
support,
will
dissipate
and
that
that
won't
be
there
anymore.
We
we
found
that
there
were
a
number
of
schools
and
districts
this
year
who
were
interested,
but
there
were
quite
a
few
who
didn't
want
the
tests,
even
though
we
offer
them
repeatedly.
So
it's
just
run
its
course.
We're
getting
to
the
end
of
that
Journey.
Most
responsibilities
for
the
kova,
19
vaccines
and
Therapeutics
either
have
ended,
have
transitioned
or
are
transitioning
so
give
you
examples.
B
Remdess
severe
was
the
very
first
medication
that
was
approved
for
use
for
Cova,
that's
all
on
the
commercial
marketplace.
Now
it's
a
regular
medication,
fully
approved
and
and
it's
purchased
and
provided
at
the
discretion
of
Physicians
if
they
feel
it's
appropriate,
monoclonal
antibodies
that
got
a
lot
of
attention
during
parts
of
the
Pandemic
those
are
gone.
There
are
no
more
monoclonal
antibodies.
Every
time
the
virus
changed
substantially.
B
You
had
to
design
a
new
antibody
for
the
new
virus
and
there's
just
not
the
demand
for
it
at
this
point
in
the
combination
of
the
number
of
people
who
have
some
immune
protection
because
they've
been
infected
plus
the
number
of
people
who've
had
the
vaccination,
plus
the
the
large,
probably
majority
of
Americans
who've,
been
both
infected
and
vaccinated
that
in
the
changing
of
the
virus,
has
made
those
Therapeutics
no
longer
economically
needed
or
just
sustainable
or
needed.
The
oral
antiviral
medications
Pax
lovid.
B
You
see
that
commercial
on
commercials
and
TV-
that's
largely
commercialized
at
this
point,
but
the
federal
government
still
has
a
supply
of
that,
and
so
that's
available
still
at
no
charge
for
the
medication.
You
may
have
to
pay
the
pharmacy
fee
to
have
a
dispense
but
available
at
no
charge
for
medication
for
many
people,
but
that
will
all
be
commercial
here
very
very
shortly,
as
supplies
run
out
and
as
far
as
the
vaccines.
The
federal
government
has
the
most
current
bivalent
vaccine
and
still
has
supply
of
that.
B
So
you
can
still
go
get
your
bivalent
vaccine
at
no
charge
right
now
for
the
vaccine
itself
and
again
now
that
the
emergency
has
ended,
you
may
have
to
pay
a
pharmacy
administration
fee
which
your
insurance
company
would
typically
cover.
This
fall,
if
there's
a
new
or
revised
vaccine,
that'll
all
be
the
commercial
marketplace
with
very
scant
exception.
B
So
really,
all
of
this
has
been
mainstreamed
into
the
regular
Health
Care
system
for
the
most
part,
and
what
tail
part
has
not
been
is
in
the
process
of
transitioning
and
then
another
huge
task
that
we
did
very
early
in
the
pandemic
and
throughout
the
peak
parts
of
the
pandemics,
was
data,
collection
and
Analysis,
and
that
has
also
largely
normalized
into
routine
approaches
that
we
use
for
other
diseases
so
that
we
every
year
provide
a
flu
report
during
flu
season.
We
don't
typically
provide
an
RSV
report.
B
We
have
provided
really
substantial
analysis
in
public
reporting
for
the
covet
pandemic,
but
now,
if
you
go
to
the
website
like
has
happened
in
States
all
over
the
country
that
has
largely
Consolidated
to
very
few
data
points,
because
the
hospitals
just
aren't
being
overburdened
by
covet
right
now,
so
it's
no
longer
necessary
and
the
data
is
not
actionable
in
the
way
that
it
was
earlier
in
the
pandemic.
So
it's
not
over
covid
still
exists.
Covet
is
still
out
there.
B
Unobligated
funds
are
going
to
be
taken
back
to
the
treasury,
and
so
we
have
to
see
how
they
Define
obligated,
whether
it's
when
they
assign
it
to
us
when
what
we
spent
it
or
when
we
have
it
budgeted
in
that
nobody
knows
the
answer
to
and
the
president
just
signed
that
into
law
yesterday,
I
think
and
so
we'll
find
out
in
the
weeks
ahead.
What
the
implications
of
that
are
and
do
our
best
to
adapt,
and
so
that's
all
I
have.
A
A
My
eye
right
look
to
me
to
be
too
small
to
be
a
huge
take
back
from
the
states,
but
again
I,
don't
know
what
unobligated
means.
I
mean.
I
know
what
the
word
means,
but
I
don't
know
what
it
means
in
federal
speak,
so
we're
still
monitoring
what
that
impact
is
going
to
be,
and
we
think
we
might
know
but
I
we
don't
know,
and
it's
it
is
it's
a
profound
difference
not
only
for
public
health
but
for
the
Department
of
community-based
Services,
which
you'll
hear
from
next.
B
C
I
think
there's
tremendous
potential
for
them,
particularly
in
in
the
area
of
improving
the
health
or
population,
but
that's
not
a
responsibility.
We've
necessarily
delegated
them
as
a
priority.
I
think
it
could
be
should
be,
but
you've
already
acknowledged
that
we're
probably
going
to
see
a
contraction
in
our
labor
force.
Within
Public,
Health
Department-
can
that
be
mitigated
to
some
degree
by
again
expanding
the
Rose
responsibility
of
Public
Health.
C
B
Urge
the
legislature,
you
still
have
you've,
done
a
great
job
and
you
still
have
important
work
to
do
in
the
next
Pioneer
session
for
the
the
next
biennial
budget.
The
public
health
transformation
dollars
you've
given
in
this
funding
period
have
been
really
really
important
to
helping
to
sustain
Public
Health
transformation
going
forward
so
remember
in
2020,
House
Bill
129
passed
and
that
structurally
changed
how
funding
would
be
done
for
public
health
departments.
But
the
funding
didn't
come
because
the
session
got
cut
short.
B
But
then
all
this
coveted
money
came
in
so
it
largely
kept
everything
afloat,
but
we
kept
everything
afloat
because
the
entire
Public
Health
System
really
focused
on
one
problem.
Then
the
legislature
came
through
and
appropriated
money,
17
or
so
million
one
year,
19
or
so
million
another
year
to
help
support
the
local
Health
departments
to
do
corn
foundational
Public,
Health
Services,
as
well
as
the
local
Health
priorities
that
are
part
of
the
transformation
effort,
so
that
work
is
well
underway.
B
Right
now,
I
would
say
covet
has
obviously
been
disruptive
for
all
of
us,
I
mean
that's
undeniable
I
mean
there's
no
one
in
the
planet
really
who
hasn't
been
touched
by
this?
Probably,
but
it
wasn't
all
bad
for
public
health.
It
was
horribly
stressful
and
it
burned
people
out
and
of
course,
there
was
division
within
Society
about
perspectives
about.
B
It
should
be
Kentucky
public
health
and
behind
the
scenes
we
work
together.
The
public
health
transformation
dollars,
along
with
our
efforts
to
continue
to
transform
Public
Health,
will
help
and
it
is
helping
now
the
local
Health
departments
to
be
more
solidified
more
stable.
We
did
rate
increases
for
the
salaries
for
the
state
health
for
the
public
health
workers
in
the
State
Health
System,
the
last
three
months
of
last
year
that
people
haven't
seen
in
a
very
long
time
and
we've
got
stories
about
people
who
thought
they
would
lose
their
house.
B
People
who
were
worried,
their
husband
was
going
to
die
or
their
spouse
because
they
had
a
terminal
illness
that
they
wouldn't
be
able
to
support
themselves
after
they
they
passed
on.
People
had
been
in
public
health,
15
20
or
more
years,
and
not
seeing
those
kind
of
salary
increases
that
they
now
have
a
wage.
B
That
makes
it
possible
to
continue
to
do
that
and
be
sustainable
and
it's
helping
recruitment,
because
you
know
when
you
can
make
15
an
hour
to
work
in
a
fast
food
service
industry,
and
you
were
going
to
get
paid
eleven
dollars
to
work
at
the
health
department.
It
made
more
sense
to
go
work
in
the
service
industry.
Economically
for
families,
so
we
are
much
more
stable,
I
I'm,
absolutely
confident
that
Kentucky
public
health
is
better
at
at
this
stage
than
it
was
three
plus
years
ago.
B
They
will
be
hesitant
to
invest
in
judiciously
and
again.
I
don't
want
anyone
to
build
a
cliff
financed
Workforce.
We
don't
want
to
have
to
ever
go
back
and
do
reductions
in
Force
if
the
revenue
goes
away,
but
there
is
a
need
to
judiciously
invest
in
some
expansion
in
selected
places.
They'll
watch
very
carefully
and
see
if
the
continued
support
for
public
health
transformation
continues
in
the
next
biennium,
which
will
help
to
make
that
possible.
But
I
think
you
should
feel
very
proud
and
I
I
hope.
B
You'll
take
a
moment
when
you
have
a
chance
to
thank
the
public
health
directors
that
are
in
your
jurisdictions
in
your
districts,
they
really
are
leaders
in
their
communities
and
have
done
a
wonderful
job
and
weak
dialogue
and
communicate
so
much
better
than
we
did
before.
Plus
I
know.
This
is
a
long
answer,
Mr
chair,
but
we
have
done
other
things
that
have
been
good.
B
We
onboarded
hundreds
and
hundreds
of
additional
labs
and
Decay
High
the
Kentucky
Health
Information
exchange
that
now
electronically
report,
their
Laboratory
test
results
for
reportable
diseases
and
and
some
of
them
and
More
in
an
ongoing
basis,
doing
electronic
case
reporting,
which
is
when
they
have
to
report
clinical
data
for
folks
who
have
reportable
diseases.
This
is
where
the
electronic
health
records
help
to
save
time
for
clinicians,
who
are
burned
out
themselves
and
overworked,
but
also
for
public
health
to
get
more
quickly
more
accurately
more
efficiently
that
data.
B
We
have
a
warehouse
that
now
has
gowns
and
gloves
and
masks
in
in
new
ventilators
and
resources
we
did
not
have,
and
those
can
help
for
floods
and
tornadoes
and
Ice
storms
and
windstorms,
not
just
for
Global
pandemics.
We
also
have
invested
in
oh
what
I'd
like
there's
there's
at
least
two
other
things.
I
was
going
to
share.
Oh
some
of
our
disease
management
teams.
We
hope
this
fall
will
have
a
new
respiratory
disease
dashboard.
B
So,
instead
of
just
doing
influenza,
we
can
look
at
influenza
covet
RSV
to
try
to
give
a
more
useful
view
of
the
impact
of
respiratory
illnesses
in
the
fall
and
winter
and
and
stuff
that
the
public
can
actually
see
on
a
website
and
actually
use
if
they,
if
they
choose
to
do
that.
So
we
are
better
and
we
are
stronger,
but
I
agree
with
you
Senator.
B
What
we
need
to
see
now
is:
can
we
have
a
stronger
public
health
system,
help
to
improve
and
strengthen
the
health
of
the
public,
and
that
is
the
mission
of
both
the
department
and
the
cabinet
is
to
have
healthier
people
and
healthier
communities.
So
everybody
can
reach
their
full
human
potential
and
we're
committed
to
doing
that.
But
we
had
a
lot
of
rebuilding
to
do
and
I
think,
despite
and
because
of
covid,
the
Kentucky
public
health
system
is
better
off
today
than
it
was
a
few
years
ago.
C
Thank
you
I'm
curious
as
to
what
happens
with
the
next
communicable
disease
outbreak,
whatever
it
might
be,
or
we
we
have
to
admit,
we
were
kind
of
reactionary
because
nobody
knew.
What
we
were
dealing
with
is.
Is
that
an
kind
of
an
indictment
of
this
system
because
we're
dealing
with
communicable
diseases
does
it
have
to
be
so
coveted
specific?
Should
we
have
processes
in
place
that
regards
to
what
it
is
if
it's
covered
29
that
we're
better
prepared
next
time
than
we
were
this
time
so
do
have?
B
Covid
was
unprecedented
in
our
any
of
our
living
history,
because
all
of
humanity
had
no
immune
exposure
to
it.
It
was
a
brand
new
disease
that
we
had
nothing
prepared
for
it.
So
we
had
no
testing,
no
treatments,
no
vaccines,
nothing
so
that
that's
what
made
that
so
seismically
different.
If
we
were
to
have
a
hepatitis
outbreak-
or
you
know,
we
actually
have
unfortunately
increasing
syphilis,
we
have
multi-drug
resistant
gonorrhea.
We
have.
We
have
yeast
infections
that
are
alarmingly
dangerous
and
difficult
to
treat
and
hit
vulnerable
folks
in
institutionalized
settings.
B
Those
those
are
really
really
serious
problems
that
require
antimicrobial
stewardship,
the
pharmaceutical
industry
to
develop
new
and
better
drugs
that
respond
to
the
situation,
but
I
think
for
those
I
think
we
have
a
better,
a
more
strengthened
network.
If
we
had
another
brand
new
infection
that
all
of
humanity
had
never
seen
again,
I
hope
we
would
do
better,
but
I
I
would
just
say
what
really
was
difficult.
Then
was
not
just
the
lack
of
knowledge.
B
It
was
just
we
we
many
of
us
look
at
the
world
and
we
just
see
it
differently
and
it
was
so.
It
becomes
divisive
if
not
in
the
beginning,
like
in
the
first
few
months,
but
very
quickly
thereafter,
because
the
types
of
actions
that
had
to
be
taken
were
so
substantial
because
the
risk
was
so
substantial,
so
I
think
as
a
society.
We
we
just
have
to
continue
to
continue
to
try
to
do
the
best
we
can
to
recognize
what
are
those
moments
that
really
rise
above
the
typical
differences
of
you
to
like
this?
B
Really
this
really
threatens
us
all.
It
places
a
real.
You
know
real
danger
to
so
many
people
that
that's
why
things
are
done
differently.
I
I
wish
I
could
say
we're
going
to
do
better
if
that
were
to
happen
again,
but
I
think
human
I
study
history
Humanities
and
has
been
Humanity
for
a
very,
very
long
time
and
all
I
can
say,
is
I
think
in
Kentucky,
where
we
still
have
differences
of
opinion,
I
travel
all
over
the
state
and
I
I,
just
I'll
be
guilty.
B
Some
nice
woman
with
her
two
middle
school
kids
that
I
feel
like
I,
should
say.
Thank
you,
which
I
thought
was
very
courteous
and
I
said
now,
I'm
embarrassed
because
look
at
the
example
I'm
setting
as
the
health
commissioner,
but
it's
all
I
had
time
for
before
I
came
over
here
so
but
the
point
I
would
say
is
as
I
travel
around
the
state
people
say.
Thank
you
all
all
over
the
place
and
people
say
thank
you
regardless
of
party
and
even
identify
party
and
I.
Don't
think
that
means
they
agreed
with
everything.
B
I,
don't
think
that
for
one
minute,
I
think
they
recognized
God
that
really
looked
terrible.
It
was
terrible
and-
and
thanks
for
at
least
trying
and
so
I
think.
If
we
continue
to
find.
Where
can
we
cooperate
on
things?
I
think
we
would
do
better
Senator,
but
I
also
am
saying
one
about
it.
It'll
continue
to
be
a
challenge
because
humanity
is
just
humidity.