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A
Here
quorum
is
established
and
with
that
I
will
entertain
a
motion
to
approve
the
minutes
from
the
last
meeting.
So.
C
A
Motion
in
a
second
to
approve
the
meeting,
all
those
in
favor,
please
signify
saying
aye,
all
opposed,
nay,
motion
carries
and
minutes
are
adopted.
We're
going
to
go
ahead
and
jump
right
into.
We've
got
quite
a
bit
on
the
agenda
today,
so
we
will
go
ahead
with
the
department
of
aging
and
independent
living
and
secretary.
D
Thank
you,
sir.
Thank
you
chairman
eric
friedlander
secretary,
the
cabinet
for
health
and
family
services.
D
And
I
want
to
state
for
the
record
that
I
have
never
been
over
this
program
or
any
of
the
programs
within
the
department
for
aging
and
independent
living.
So
here's
one
what
I
want
to
say
and
I'll
turn
this
over
to
commissioner
eldridge
really
quickly.
There
was.
There
was
a
lot
of
adaptation
that
had
to
happen.
Meals,
senior
meals
had
to
be
adapted.
For
the
last
couple
of
years.
D
D
I
think,
good
changes
within
some
of
the
state,
funded
programs
and-
and
commissioner
will
talk
about
that,
some-
those
are
those
programs
like
personal
care
assistant
program,
heart
supported,
living
you'll,
hear
some
you've
probably
already
heard
some
about
that.
But
those
are
straight
general
fund
programs,
as
opposed
to
medicaid
programs
that
serve
folks
who
are
elderly
or
disabled,
and
so
with
that,
I'm
going
to
be
very
quick
and
turn
it
over
to
commissioner
eldridge.
E
E
So
our
mission
is
simple:
it
is
to
promote
the
welfare,
dignity
and
independence
of
older
adults.
Individuals
with
physical
disabilities
and
adults
in
need
of
a
guardian
kentucky
has
over
a
million
individuals,
age,
60
and
older.
The
secretary
keeps
no
secret
that
he
falls
into
that.
As
do
many
many
other
individuals.
E
So
what
does
kentucky
look
like
in
supporting
older
adults
and
individuals
with
disabilities
based
on
the
latest
data?
We
know
that
individuals
aged
55
and
older
is
expected
to
nearly
double
by
2040,
which
we
know
is
less
than
20
years
away
and
really
appreciate
the
work
that
has
gone
on
over
the
past
four
years
to
support
older
adults.
E
We
know
that
again,
there's
over
a
million
aging
individuals
in
kentucky
and
that
number
is
expected
to
grow.
We
are
one
of
the
fastest
aging
states
in
the
country
and
the
work
that
we
do
here
will
set
precedent
nationally
for
how
we
ensure
that
older
individuals
have
their
rights
met
in
the
community
of
their
choice.
We
also
know,
as
the
secretary
spoke
about
that
one
in
seven
kentuckians
experience:
food
insecurity
for
older
adults.
That
number
is
specifically
heightened,
and
so
through
governor
beshear's
budget
and
also
the
legislative
approved
budget.
E
Secure
that
is,
information
and
data
that
we
have
been
touted
in
kentucky
has
been
recognized
nationally
to
ensure
that
our
seniors
remain
food
and
food
secure,
and
we
have
also
eliminated
the
wait
list
for
seniors
and
we'll
talk
more
on
that
next
time
later
on
in
the
presentation
and
then
lastly
just
want
to
keep
in
mind
as
we
talk
about
our
an
aging
state
that,
as
of
now
23
and
a
statewide
level
of
kentuckians,
are
60
and
older,
we
do
know
in
our
rural
areas.
That
number
is
anywhere
between
28
to
30
percent.
E
E
So
what
other
populations
do
we
serve?
As
I've
spoken
to?
We
serve
older
adults,
individuals
with
disabilities,
that
goes
for
the
entire
age
gamut.
We
serve
individuals
with
dementia
and
also
adults
under
guardianship.
There
are
4
500
individuals
in
our
guardianship
that
are
court
appointed
to
us
when
the
individual
has
no
other
family,
member
or
community
person
that
is
able
to
willing
and
step
up
and
befriend
them
to
oversee
their
their
medical
decision-making
or
their
financial
decision-making,
and
then,
lastly,
again
we
support
caregivers.
E
We
all
know
that
without
caregivers
we
would
not
be
where
we
are
at.
We
all
at
some
point
in
time
have
had
supportive
caregivers,
whether
it's
our
parents,
our
pastors
in
our
community,
our
next
door
neighbors
and
anyone
in
between
within
our
department.
We
are
either
federally
funded
or
state
funded.
There
are
the
an
array
of
federally
funded
programs
through
the
older
americans
act.
It
is
the
long-term
care
ombudsman
program.
E
We
also,
as
we
had
spoke
to
earlier,
have
congregate
home,
delivered
meals.
We
talk
congregate,
those
are
meals
that
are
provided
in
your
local
senior
centers.
There
are
195
senior
centers
across
kentucky.
There
is
at
least
one
in
every
120
counties
and
then
the
home
delivered
meals.
There
are
individuals
who
are
not
able
to
get
out
of
their
home
and
we
ensure
that
their
nutritional,
their
nutritional
needs
are
met.
E
Additionally,
to
that,
if
individuals
participate
in
senior
centers,
they
have
opportunities
to
participate
in
health
promotion
and
disease
prevention.
I
was
recently
at
the
callaway
county
senior
center
out
in
murray
kentucky.
They
have
a
phenomenal
program
out
there.
I
know
a
lot
of
you
all
have
heard
about.
Pickleball
pickleball
is
a
hot
commodity
out
there.
It
is.
E
It
is
a
wonderful
program.
Also.
We
have
our
senior
community
service
employment
program.
This
allows
individuals
that
are
age,
60
and
older,
an
opportunity
to
get
back
into
the
workforce
in
the
event
they
have
retired
or
had
a
medical
need
come
up
that
has
prevented
them
from
getting
back
into
the
workforce.
We
ensure
that
they
are
able
to
return.
E
We
have
the
supportive
services.
This
is
ensuring
that
our
seniors
are
able
to
stay
in
their
home
through
home
modifications
through
lawn
care,
for
example,
if
their
roof
needs
to
be
repaired.
If
there's
a
hole
in
their
floor,
it's
as
simple
as
we
have
invested
a
lot
of
money
in
in
meals.
We
have
to
ensure
that
for
seniors
to
receive
those
meals
that
their
home
is
secure
and
they
are
living
in
a
stable
home.
E
Additionally,
through
the
older
americans
act,
we
provide
a
state
health
insurance
assistance
program.
This
is
a
prescription
savings
program
offered
to
older
adults
to
ensure
that
their
prescription
plan
provides
the
highest
cost
savings
and
lasty
last
year
through
open
enrollment.
We
hit
the
highest
number
in
cost
savings
that
we've
ever
hit
before,
thanks
to
in
part,
the
staff
with
the
department
for
aging,
independent
living
and
also
in
partnership
with
public
health,
and
then,
lastly,
there
is
the
national
family
caregiver
program.
E
We
know
that
dementia
is
is
on
the
rise
and
through
the
old
americans
act.
We
recognize
that
adult
children
supporting
their
parents
with
dementia
need
additional
assistance,
need
help
and
that's
what
this
program
is
geared
to
do.
In
addition
to
many
of
you
all
have
heard
about
the
grandparents
raising
grandchildren
program,
this
is
a
federal
program
to
ensure
that
grandparents
have
funding
available
to
them
to
support
the
grandchildren
when
they
are
court
appointed
to
take
over
there's
an
array
of
state
general
funded
programs
that
are
overseen
within
our
department
state
guardianship.
E
As
I
mentioned
earlier,
we
also
have
two
state
general
funded
programs
that
support
individuals
with
brain
injury.
We
have
the
traumatic
brain
injury
trust
fund,
as
well
as
the
behavioral
program.
The
behavioral
program
is
a
program
that
we
are
working
on,
increasing
its
outreach
and
services
to
to
serve
as
a
short-term
crisis
intervention
program
through
some
of
the
cmhcs.
E
We
currently
do
assisted
living
certification
in
the
social
model
for
assisted
living.
There
are
about
120,
assisted
living
communities
across
the
state.
There
is
an
increase
in
assisted
living
communities
out
in
western
kentucky
and
we
are
starting
to
see
there
is
a
increase
in
older
adults.
Moving
to
western
kentucky,
as
the
secretary
spoke
to
earlier,
we
have
the
personal
care
attendant
program.
It
ensures
that
individuals
with
severe
physical
disabilities,
meaning
the
loss,
the
functional
loss
of
two
or
more
limbs,
you
think
of
someone
who's,
had
a
spinal
cord
injury.
E
They
would
be
able
to
access
this
program
to
ensure
that
they're
able
to
live
independently.
We
have
the
heart
supported
living
program.
It's
a
program
honestly
that
is
near
and
dear
to
my
heart.
It
is
a
program
that
of
last
resort
to
ensure
that
individuals
are
able
to
receive
their
therapy
services
or
receive
adaptive
equipment.
E
E
The
home
care
program,
mimics
the
supportive
services
program
through
the
older
americans
act
and
ensures
that
older
adults
are
able
to
stay
in
their
home
through
home
modifications
and,
lastly,
the
family
caregiver
program.
This
program
is
specific
solely
to
grandparents
supporting
their
grandchildren
in
their
community.
E
So
those
are
the
different
programs
that
we
directly
either
oversee
or
through
contract
with
our
community
partners.
There
are
some
administrative
oversight
and
support
entities
that
we
we
oversee.
One
is
the
medicaid
home
and
community-based
waiver,
as
we
are
the
department
for
aging
and
independent
living.
D
E
E
In
addition
to
that,
we
also
oversee
all
participant
directed
services
for
all
medicaid
waivers.
There
are
six
medicaid
waivers
five
of
the
six
offer
a
pds
option
and
then
also
we
oversee
the
state
independent
living
council.
There
are
various
centers
for
independent
living
across
the
state
to
support
individuals
with
disabilities.
E
E
E
It
is
a
statewide
council
that
works
with
various
other
cabinets
to
ensure
that
older
adults
that
they
do
not
that
they
prevent
elder
elder
abuse
through
community
partners
such
as
state
police,
such
as
long-term
care
associations,
are
also
part
of
that
as
well
and
then,
lastly,
brand
new
to
us
is
the
program
for
all
inclusive
care
for
the
elderly.
This
is
a
pace
program
that
we
just
started
in
september
of
this
year
enrolled
our
first
participant,
and
it
is
a
partnership
between
our
department
and
the
department
for
medicaid
services.
E
So,
as
you
can
see
through
all
of
that,
it
is,
there
is
a
lot
of
work
that
is,
that
is
done.
This
slide
is
very
important
and
really
truly
shows
where
we
are
you'll
see
in
fiscal
year,
2020
our
department
was
heavily
reliant
on
state
funds
to
the
tune
of
you
could
honestly
say
a
70-30
for
state
funds
throughout
the
next
four
years.
There
was
a
significant
transition
in
which
we
have
become
much
more
solely
reliant
on
federal
funding
than
state
funding.
E
E
Our
state
budget
was
around
70
million
dollars,
so
we
have
been
able
to
pull
down
additional
federal
funds
through
a
medicaid
match
to
support
state
guardianship.
In
addition
to
federal
grants
that
we
have
gone
after
to
support
individuals
to
live
independently
in
their
community,
you
will
notice
there
is
some
money
set
aside.
That
is
restricted.
E
So
what
does
our
department
look
like
in
order
to
move
forward
and
meet
our
mission
and
our
vision?
How
does
this
happen?
I
have
the
distinct
honor
to
work
alongside
over
250
kentuckians,
to
ensure
that
we
are
meeting
the
needs
of
the
state
you
will
notice,
specifically
within
the
division
of
guardianship.
That
number
has
increased
due
to
the
medicaid
match.
We've
been
able
to
bring
on
additional
additional
individuals
and
senator
meredith.
I
had
the
honor
of
testifying
in
front
of
you
last
year
on
guardianship
and
the
modernization
that
we
have.
E
We
have
done,
and
it
has
been
very
successful.
You'll
also
notice
for
the
division
of
finance
and
administration
67
staff
85
of
those
staff
members
are
specifically
to
support
the
fiduciary
and
benefits
of
the
4
500
guardianship.
Individuals,
if
you
think
of
the
mail
that
you
receive
your
taxes,
your
health
care
benefits
paying
any
bills.
Our
staff
manage
all
of
that
for
4,
500
individuals
and
the
other
130
oversee
the
medical
decisions
and
any
other
decisions
that
need
to
be
made
out
in
the
field.
E
We
do
have
six
staff
members.
In
the
commissioner's
office,
we
have
49
additional
staff
that
support
the
quality
living,
support,
aging
and
physical
disabilities,
and
then
also
we
have
our
newly
minted
office
of
dementia
services.
We
have
one
director
there
and
I
am
proud
to
say
that
office
has
been
a
true
success
and
it
will
turn
one
year
old
on
october
1st.
E
E
One
of
the
things
in
just
a
true
top
honor
is
in
the
beginning
of
january
of
2021.
Kentucky
was
one
of
the
first
states
to
ensure
that
homebound
individuals
had
access
to
a
coveted
vaccine
if
they
wanted
it.
We
implemented
the
shot
of
hope
at
home
through
a
partnership
with
our
department
and
the
department
of
public
health.
E
We
also
have
received
national
and
regional
recognition
for
working
with
health
occupation,
students
of
america.
These
are
high
school
students
that
want
to
go
into
the
healthcare
field
and
we
were
able
to
partner
them
with
our
senior
centers
through
a
private
public
partnership
with
a
local
bank
out
in
western
kentucky.
E
Deputy
commissioner
layla
williams
conducted
the
second
annual
senior
hunger
summit.
Virtually
we
will
have
a
third
senior
hunger
summit
on
november
2nd
of
this
year.
It
has
been
very
well
received
with
national
attendance,
and
we
also
have
had
national
speakers
as
well
and
have
been
recognized
for
the
work
that's
done
there.
E
E
What
we
do
know
for
certain
is
that
individuals
with
disabilities
want
the
choice
to
direct
their
own
care.
They
want
to
say,
when
someone
comes
into
their
home,
to
assist
them
with
getting
ready
or
to
assist
them
with
taking
them
out
to
a
job
or
out
to
a
bar
or
what
have
you
wherever
they
want
to
go.
What
we
all
know
is
that
we
all
want
that
choice
and
then,
lastly,
as
I
shared
with
you
all,
we
were
able
to
eliminate
waitlists
for
senior
meal
services.
E
E
E
So
our
goals
for
2022-
what
have
we
done
this
year
and
where
are
we
headed?
As
I
shared
with
you?
We
were
able
to
establish
and
implement
the
pace
program.
These
were
goals
that
I
had
the
honor
of
sharing
with
you
all
in
february
of
2022,
when
I
had
provided
the
budget
testimony,
those
that
have
check
marks
are
all
goals
that
have
been
implemented.
As
of
today,
we're
able
to
develop
and
implement
a
state
plan
on
aging
dashboard
to
track
our
goal.
Progress.
E
E
The
we
were
able
to
partner
with
the
kentucky
department
of
veterans
affairs
to
support
caregivers
of
veterans
and
our
department
was
recognized
at
the
veterans
affairs
conference
last
month
for
the
outstanding
partnership
that
we
have
been
able
to
provide
veterans.
We
are
grateful
for
veterans
and
their
service.
We
are
especially
grateful
to
support
their
caregivers
that
support
our
veterans
and
then,
lastly,
we
were
able
to
fully
implement
all
guardianship,
modernization,
positions
and
training.
E
We've
seen
a
decrease
in
turnover
in
guardianship,
in
addition
to
additional
money
coming
into
to
lower
caseloads
for
state
guardianship,
individual
state
guardianship,
staff,
you'll
notice,
the
one
area
that
doesn't
have
a
check
mark
is
a
grant
program
called
reap.
It
stands
for
remove,
reduce,
educate,
adjust,
accommodate
and
pace
it's
a
concussion
management
program
aimed
in
schools.
We
all
know
about
sports
injuries
in
schools.
We
are
all
aware
of
how
concussions
can
be
really
that
hidden
pandemic.
E
E
A
F
That's
that's
the
other
guy
he's
taller
younger,
better,
looking
smarter,
but
I
understand
the
confusion
first,
one
thank
you
for
your
presentation,
excellent
job.
You
really
have,
and
I
want
to
make
sure
that
you
understand
that
the
purpose
of
task
force
is
not
to
criticize
anyone's
work.
You've
done
exceptional
work.
There's
no
doubt
about
that,
but
I
think
we're
really
trying
to
identify
opportunities
to
increase
efficiencies,
make
sure
there's
no
redundancy
but
also
make
sure
there's
accountability
for
the
programs
that
we
have
in
place.
F
And
you
know
what
becomes
everybody's
responsibility
becomes
nobody's
responsibility.
So
that's
one
of
the
things
I
particularly
focus
on
but
glad
to
see
the
work
that
you've
done.
I
know
there's
going
to
be
several
questions
here,
but
I'd
like
to
start
with
the
guardianship
programs,
because
such.
E
F
And
I
appreciate
that
you're
undertaking
this
modernization
program,
but
what's
average
case
load
now
for
state
guardianship
workers?
Do
you
have
that
number.
E
E
E
In
addition
to
that,
the
quality
of
of
work
has
has
increased,
we've
been
able
to
hire
additional
positions.
I
think
I
spoke
to
the
property
and
asset
management
positions.
They
are
able
to
manage
all
of
the
properties
and
all
the
vehicles,
all
the
other
items
that
individuals
may
have
as
well
as
we
have
implemented
a
guardianship
floaters.
If
you
will
I'm
an
occupational
therapist,
I
come
from
a
medical
background
and
float.
Staff
are
invaluable
to
ensure
individuals
have
time
off
with
our
guardianship.
E
E
We
do
have
great
collaboration
with
aps
and
guardianship
and
we
have
we
are
able
to
ensure
that
before
aps
submits
the
case
over
to
us.
That
is
well
vetted
to
ensure
we
are
truly
the
program
of
last
resort
and
that
there
is
no
other
outstanding
family
available
to
take
on
this
individual.
Well,.
F
E
I
I
can
share
with
you.
The
scl
waiver
does
support
guardianship,
individuals,
there's
about
600
individuals
with
developmental
intellectual
disabilities
that
are
also
in
our
state
guardianship
that
are
enrolled
in
the
scl
waiver.
C
C
I
don't
have
a
lot
of
confidence
in
particularly
one,
but
it's
the
nursing
home
ombudsman
agency,
and
so
my
question
is
how
does
the
role
of
the
long-term
care
and
budget
program
differ
from
that
as
a
function
of
adult
protective
services
or
the
inspector
general
or
even
the
chfs
kind
of
ombudsman
office
that
they
have?
It
is.
How
is
that
different.
E
That's
a
great
question
senator
thank
you
for
that.
So
the
ombudsman
works
directly
with
the
individual.
They
go
out
to
the
facility
to
ensure
that
the
individuals
say
there's
the
complaint,
that
a
call
light
is
not
being
answered.
You
know
it's
been
over
an
hour,
and
so
the
resident
makes
that
concern
to
their
family
member,
the
family
member
reaches
out
to
the
ombudsman
agency.
It
is
a
direct
line
to
that
individual.
There
is
no
one
in
between
the
ombudsman
goes
out
and
sits
with
that
individual.
E
The
majority
actually
of
the
calls
that
come
into
the
ombudsman
are
around
call
lights,
there's
also
a
long-term
care
staff
that
have
a
direct
line
to
the
ombudsman
if
there
are,
if
their
needs,
aren't
being
met
as
well.
So,
whereas
with
oig,
it's
an
investigation
under
their
view
with
the
ombudsman,
it
is
they
have
to
respond
within
a
certain
period
of
time
to
that
individual
to
ensure
that
their
voice
is
being
met
and
the
ombudsman
truly
serves
as
a
media
between
the
individual
and
the
facility.
C
Yeah,
I
don't,
I
don't
know,
that's
what
happens
and
that's
what's
supposed
to
happen.
That
is
what
happens
in
real
practice.
I
mean
I
do
nothing
but
long-term
care.
There's
a
lot
of
gotcha
stuff
from
the
ombudsman
agency
from
the
people
that
they
train.
When
there's
been
problems,
I've
reached
out
and
it's
more
of
a
you
know.
What
do
you
want
us
to
do
about
it
kind
of
thing?
When
I
ask
what
can
be
done
about
the
ombudsman
agency,
when
I've
contacted
members
within
our
own
cabinet,
they
say
nothing.
C
It's
federally
required
it's
a
federal
program,
we're
just
a
pass-through,
so
I
know
we
have
oversight,
but
there
is
really
no
oversight
over
the
ombudsman
programs.
That's
why
I'm
wondering
is
it
any
different
from
what
oig
does
what
it's
from
from
the
you
know
from
the
the
chfs's
ombudsman
office,
all
that
just
different,
if
it's
a
different
thing,
because
I
don't
know
that
we
provide
any
oversight.
C
It's
there,
it's
structured
money
comes
from
the
federal
government
gets
passed
through,
but
if
they
don't
do
a
good
job,
if
they're
not
following
their
proper
policies,
how
do
we
file
a
complaint
for
those
who
are
overseeing
it's
got
to
go
through.
Congress
is
my
understanding
and
most
of
the
time
they
just
set
that
up
and
said
here
they
can
handle
the
issues
that
we
get
called
about.
We
don't
want
anything
done
and
it's
an
organization
that
claims
to
be
understaffed
and
claims
that
they
want
more
responsibility.
C
So
when
we
had
an
assisted
living
build,
we
went
oversight
of
that
too.
Even
though
we
don't
have
enough
personnel
to
handle
our
current
long-term
issues,
which
is
a
concern
for
me.
So
when
they
don't
have
enough
staff
but
they're
asking
for
more
work
and
then
complaint,
they
don't
have
enough
staff
to
handle
the
work
and
are
asking
for
more
work.
It
just
doesn't
make
any
sense.
So
I'm
just
curious
in
terms
of
that.
C
A
couple
other
questions,
if
I
can,
mr
chairman,
so
I
was
looking
through
a
lot
of
the
different
programs
you've
got
here.
How
does
how
does
your
department
promote
health
and
disease
prevention
differently
than
the
department
for
public
health.
E
So
we
actually
serve
as
a
collaboration
within
that
the
under
the
federal
program
we
have
to
provide
evidence-based
education
and
the
programs
that
were
provided
are
geared
towards
60
and
older.
One
of
the
programs
that
has
actually
been
very
successful
has
been
a
it's
a
program
called
bingo
size.
It
implements
exercise
and
bingo
together,
and
it
was
actually
founded
in
western
kentucky
through
western
kentucky
university
and
is
a
worldwide
renowned
program
specific
to
that.
E
That
is
a
program
that
is
through
the
older
americans
act
and
has
to
be
overseen
by
the
state
unit
on
aging
director,
which
is
the
individual
that
is
assigned
to
oversee
all
other
americans
act.
Programs
federally
there.
It
does
not
allow
for
delineation.
Of
you
know,
title
3d,
which
is
the
health
disease,
and
prevention
program,
cannot
be
separated
out
to
public
health.
Whereas
this,
you
know
title
program
can
be
moved
here
and
and
so
forth.
They
all
have
to
be
housed
together.
C
So
it
couldn't
be
under
the
department
of
public
health,
I
mean
under
a
different,
you
could
you're
saying
this.
Federally
was
not
allowed
correct.
Okay,
also
notice
that
your
department
administers
a
state
health
insurance
assistance
program.
So
how
is
this
program
different
from
the
role
of
connectors
assisters
within
the
health
benefit
exchange?
E
That
that's
a
great
question
this
program,
specifically
that
we
operate,
is
another
one
that
is
through
the
older
americans
act.
It
is
through
to
ensure
that
older
adults
have
a
direct
line
to
review
their
in
part
through
the
old
americans
act,
but
it
is
a
direct
line
to
ensure
that
older
adults
have
a
direct
line
to
review
their
to
review
their
prescriptions.
E
So
it
is
one
in
which
we
contract
with
the
department
for
public
health
because
we
have
access
to
and
we
support
so
many
individuals
that
are
aging
and
that
we
know
we
have
that
expertise.
We're
also
able
to
connect
them
with
no
pun,
intended
with
older
adult
services
to
support
them
through
social
services
such
as
the
home
repair
and
home
modification.
D
D
So
this
is
a
constituent
issue
right
whenever
I
have
somebody
that
has
questions
about
medicare
and
and
those
kinds
of
things
I
I
refer
them
to
a
ship's
line
in
aging
and
independent
living,
because
you
know
medicare
is
complicated
and
what
what
those
coordinations
of
benefits
pieces
are
and-
and
actually
I
wouldn't
refer
them
to
a
connector.
I
refer
to
dale.
D
It's
so
specific,
I'd
worry
about
it
because
medicare
is
all
those
rules
can
get
really
they
have
their
own
set
of
rules
and
it
just.
I
would
worry
about
mashing
it
together
with
connectors,
but
it
does
come
again.
It's
a
federal
funding
issue
as
well,
but
it's
just
it's
also,
then
a
really
training
and
really
specific
program
around
really
how
you,
how
you
maximize
your
medicare
and
your
prescription
direct
benefit
and.
E
Senator
if
I
may
propose
that
if
we
were
to
flip
that
and
ensure
that
our
our
ship
directors
and
our
ship
staff,
they
could
be
trained
to
be
connectors
as
well.
There
are
many
adult
children
that
call
on
behalf
of
their
loved
one
and
trying
to
figure
out
what
does
medicare
mean
for
mom,
and
we
could
also,
if
they're
speaking
with
a
connector.
That's
also
ship
trained,
ensure
that
hey,
you
know,
while
I'll
have
you
on
the
phone,
do
you
have
insurance?
Do
you
have
the
benefits
you
need
for
yourself.
C
One
more
question
to
chairman:
if
I
could
also
I
know,
we've
heard
testimony
about
a
lot
of
our
medicaid
waivers
that
are
administered
through
the
cabinet.
We've
heard
testimony
from
the
secretary
from
dms
also
that
all
of
them
went
through
there,
but
here
you've
got
also
again
two
of
the
waivers,
which
are
the
heart,
supported
living
program
and
the
brain,
injury
waiver
and
trust
fund.
C
Is
it
necessary
for
these
programs
to
be
in
your
department,
or
should
they
be
directly
issued
by
medicaid
or
the
department
of
behavioral
health
and
intellectual
disabilities?
Would
it
be
put
under
there
because
a
lot
of
the
other
waivers
are
handled
through
that?
So
that's
what
another
curiosity
there
too.
E
So,
just
just
for
clarification,
the
the
programs,
the
heart
support,
living
in
brain
injury.
Those
are
state-funded
programs
they're,
not
medicaid,
waiver
programs.
There
are
some
similarities
to
brain
injury.
The
brain
injury
trust
fund
is,
in
addition
to
the
waiver.
So
if
there's
certain
items
that
an
individual
isn't
meeting
under
the
brain
injury
waiver,
they
could
meet
through
the
brain
injury
trust
fund
same
with
the
heart.
If
they
have
maximized
out
all
of
their
waiver
services,
they
could
do
that.
So
there
would
be
that
there
is
that
similar
service.
D
D
You
have
two
state-funded
brain
injury
programs,
the
the
regular
tbi
program
and
the
behavioral,
and
so
they
can
work
together
and
often
work
together,
but
they're
like
four
separate
programs
depending
upon
where,
where
somebody
is
and
the
length
of
the
onset
of
the
traumatic
brain
injury
as
well
as
then
there's
some
things
that
that
medicaid
can't
pay
for
that,
you
can
get
or
somebody
maybe
is
not
eligible
more
rare,
but
that
the
state-funded
programs
can
pay
for
that.
D
D
I
will
tell
you
different
cabinet
secretaries:
it's
gone
back
and
forth
where
medicaid's
running
at
all,
to
where,
like
dale,
has
run
it
all
or
they
move
the
dale
person
into
medicaid.
There
have
been
all
sorts
of
configurations.
D
I
can't
tell
you
what's
right:
each
one
has
a
strength
and
a
weakness.
My
preference
is
to
have
the
programmatic
folks
working
on
the
programmatic
side
and
and
medicaid
who
should
have
the
fiscal
responsibility
working
on
that?
That's
that's
the
philosophy
I'm
working
under
it.
Like
I
say
it,
it
is
I've
seen
every
configuration
just.
D
C
C
F
Just
a
brief
one:
it's
I
guess
goes
back
to
philosophy
and
you-
and
I
talked
about
this
a
little
bit
because
I
would
really
like
to
see
the
presence
of
the
department
of
public
health
be
elevated.
I
think
their
importance
really
has
been
emphasized
during
this
covid
situation,
but
one
of
the
things
we've
had
a
lot
of
discussions
about
particular
alvaro
knives
is
who's
responsible
for
the
health
of
the
state
and
I
think
we've
kind
of
delegated
that
to
the
mcos
and
they
haven't
done
a
very
good
job.
F
So
I
would
hope
that
we'd
have
and
one
central
agency
that
we
can
say
you're
going
to
improve
the
health
of
the
the
state
and
we're
going
to
hold
you
accountable
for
it.
But
I
see
problem
programs
such
as
this
concussion
management
program
implementation,
great
program,
but
is
that?
Should
that
be
a
public
health
function?.
E
So
to
that
I
can
share
with
you
specifically,
we
do
have
representatives
of
public
health
on
that.
Whether
a
program
is
housed
within
a
certain
department
or
not.
There
are
dale
representatives
that
are
engaged
in
public
health
programs.
There
are
public
health
representatives
engaged
in
dale
programs.
E
F
B
E
B
And
I
think
we've
touched
on
this,
but
have
you
been
able
to
identify
any
gaps
in
coverage
for
individuals
with
these
separations
of
programming
and
financial
responsibilities?
B
It
seems
to
me
that
I
heard
about
a
an
issue,
and
maybe
this
is
not
specific
to
dale
but
coverage
for
behavioral
issues
versus
psychiatric
issues,
and
I
I
just
use
that,
as
an
example
of
you
know,
there's
a
breakdown
in
in
coverage.
Have
you
seen
that.
E
That
is
a
great
question
representative.
If
I
were
able
to
speak
to
it,
it
would
be
within
within
guardianship.
With
regards
specific
to
those
coverage
areas.
The
one
thing
that
I
I
can
share
with
you
is
that
we
have
a
great.
We
have
a
great
team
at
dale
and
we
have
really
expanded.
E
Our
ability
to
collaborate
with
mcos
actually
had
an
opportunity
to
meet
with
a
medicare
provider
as
well,
but
really
looking
to
see
what
community
options
are
out
there
and
ensure
that
our
staff
are
as
knowledgeable
as
possible
to
ensure
that
there
are
not
those
coverage,
there's
gaps
and
that,
if
there
are,
we
know
who
to
contact
through
the
secretary's
leadership,
he
has
really
ensured
that
there
are
no
barriers.
D
I
I
would
add
some
of
those
gaps
have
to
do
with
available
trained
healthcare
personnel.
F
F
D
Of
folks
that
provide
and
are
trained
in
that
there
there
are
centers
at
uofl
and
uk.
I
don't
know
if
there's
really
anyone
else
that
you'd
point
out,
but
it's
not
it's
not
statewide
and
it
is.
It
is
a
a
need
that
is
growing
and
will
be
growing.
The
other
piece
that
I
think-
and
I
said
this
I
think
my
first
day
of
testimony,
the
other
challenge
is
housing
right.
D
D
Our
waiver
programs
are
the
only
programs
that
pay
for
smaller
site
housing
and
that's
it,
and
so
I
think
we
we
do.
D
Challenges
in
housing
are:
are
there
certainly,
there
are
some
more
assisted
living
opening
up
in
western
kentucky
they're
expensive,
if
you're
fortunate
enough
to
have
long-term
care
insurance.
That
can
help,
but
I
think
that's
a
that's
a
real
challenge
to
us
to
to
get
that
kind
of
coverage.
The
other
place
where
we
hear
about.
D
I
don't
know
if
it's
gaps
but
frustrations,
sometimes
from
from
hospitals
who
are
looking
at
for
individuals
where
they
don't
have
a
placement,
and
they
don't
have
somebody
who
can
make
decision,
because
somebody
maybe
doesn't
have
decision
making
capabilities
at
that
point.
How
do
we?
How
do
we
and
we've
had
some
discussions
with
with
kha,
but
how?
How
do
we
do
that
without
overburdening
our
system
right?
D
But
then
how
do
we
work
with
the
providers
when
there's
somebody
doesn't
have
decisional
capacity
and
and
and
what's
that
process,
because
it's
a
court
process
and
it
takes
a
while
and
that's?
I
know
that
that's
a
frustration
in
in
the
provider
community
as
well.
Those
are
the
major
ones.
I
think
I.
E
Will
just
add
to
that
as
a
secretary
talking
able
to
to
take
a
minute,
there
is
a
revolving
door
if
you
will,
with
our
corrections,
facilities
with
individuals
with
serious
mental
illness
being
released
back
out
to
the
street
before
a
private
or
public
guardian
is
notified,
and
then
they
have
gone
a
wall.
E
D
I
think
that
and
and
secretary
harvey
would
tell
you
that
he
has
folks
who
are
in
correctional
facilities,
who
are
aging
no
longer
a
threat
right,
they're,
just
they're
they're,
probably
getting
close
to
end
of
life.
D
How
how
how
we
work
with
those
populations
is
a
challenge
and
we
don't
have
great
locations
right
if
you're
a
nursing
facility,
you
don't
necessarily
want
to-
and
this
is
I
mean
it's
legitimate-
I'm
not
criticizing
anybody,
but
if
you're
a
nursing
facility,
you
have
somebody
that
has
a
criminal
background,
you're
not
going
to
necessarily
welcome
him
in
right.
So
they
have
challenges
as
well
in
terms
of
thinking
about
placement.
So
those
are
all
challenges
within.
D
I
think
the
gaps
but
challenges
within
that
kind
of
side
of
the
system,
particularly
when
it
comes
to
folks
who
are
aging.
B
So
thank
you
for
bringing
up
the
housing
issue
and
certainly
the
older
aging
population
in
in
jail-
and
you
know
are-
are
there
areas
where
you
think
this
population
would
be
better
served
in
the
department
of
justice
or
is
I
I
mean
it's
all
kind
of
still?
It's
all
still
a
health
care
issue,
and
so
housing
becomes
really
challenging.
B
You
know,
and-
and
I
don't
want
to
underestimate
your
ability
to
to
handle
this,
but
you
know
it
seems
that
we
need
some
strong
partnerships
in
these
areas.
Is
that.
D
Happening
it
is
we're
we're
beginning
that
work.
This
has
been
an
issue
I
think
for
20
years.
As
far
as
I
know
so,
we've
begun
some
discussions.
There
are
no.
There
are
no
easy
answers,
we're
still
waiting,
for
instance,
on
our
11
15
waiver,
about
substance
use
and
folks
coming
out
of
facilities
and
whether
medicaid
cms
will
approve
that
kind
of
transition.
D
Time
right,
I
was
at
a
conference
last
week
and
the
cms
folks
said:
well,
yes,
they're
really
really
really
thinking
about
it
now,
so
I'm
I'm
slightly
hopeful,
but
it's
been
two
years
since
we've
had
that
waiver
in
so
that
that
piece
and
it's
the
funding
piece
that
I
think
is
really
tricky.
B
B
E
It
is,
it
is
open
to
anyone
in
federally.
There
is
an
age
requirement
at
the
state
level.
We
have
removed
that
age
requirement.
We
recognize
that
individuals
become
grandparents
at
any
age
and
that
if
they
have
court
custody
over
the
custody
of
their
grandchild,
it's
it's
inclusive
of
all
individuals,
so
all
abilities
all
all
children.
B
Okay,
thank
you.
I
have
one
more
question
and
the
other
question
with
the
increase,
or
we
know
that
we're
going
to
have
a
large
number
of
kentuckians
aging
has
there
been
any
type
of
projections
about
the
workforce
and
employment
and
what
we
need
to
be
doing
to
prepare
to
care
care
for
this
population
in
the
years
to
come,
and
if
so,
what
does
that
look
like?
And
how
are
we
partnering
with
our
education
folks
to
make
sure
that
we
have
that
base
that.
E
Is
that
is
a
great
question,
so
a
perfect
example
of
that
is
the
partnership
that
we
are
doing
with
the
health
occupation,
students
of
america.
We
are
working
with
high
schools,
so
working
with
high
school
students.
I
know
a
lot
of
my
peers
in
other
states
are
working
at
the
college
level,
which
is
great,
but
we
also
know
a
lot
of
individuals
at
the
high
school
level
are
deciding
where
they
want
to
go.
So
we
are
starting
early
on
and
ensuring
that
individuals
are
familiar
with
with
aging
and
that
it
is
a
very
honorable
profession.
E
It's
it's.
There
is
no
better
job
than
to
give
back
to
people
that
have
come
and
served
their
their
time,
so
we're
working
with
high
schools
with
high
school
students
that
are
interested
in
going
to
the
healthcare
field.
We
have
a
partnership
right
now
with
the
university
of
kentucky
and
in
offering
up,
through
virtual
classes,
a
mentorship
program
to
educate
them
on
what
the
programs
that
we
offer
in
addition
to
that
work
with
the
secretary's
office
through
a
certified
nursing
cna
program
to
ensure
that
we
are
getting
more
cnas
in
and
then
also.
E
In
addition
to
that,
through
our
office
of
dementia
services,
we
are
just
starting
early
on
to
look
at
geriatricians.
We
know
that
pediatrics
is
a
great,
a
great
field
and
I
was
a
pediatric
occupational
therapist.
I
love
working
with
kids
and
again
it's
needing
that
love
and
that
compassion
for
our
older
adults.
I
have
worked
in
in
both
fields.
It's
a
true
honor,
and
so
it
is
making
sure
that
college
students
and
high
school
students
understand
geriatrics
and
want
to
have
that
drive
to
be
able
to
give
back,
especially
to
geriatric
psychology.
E
Yes,
we
can
work
and
look
to
see
what
we
have
within
the
cabinet.
I'm
sure
that
we
have
that
and
if
not,
we
can
work
with
the
cabinet
of
education
and
workforce
to
get
that
to
you,
but
we
can.
We
can
definitely
do
that.
Okay,
thank
you.
Thank
you.
F
E
To
provide
meals
to
seniors
yes,
so
that
program
is
another
one.
It
falls
into
the
older
americans
act.
So
it's
the
state
unit
on
aging
was
allocated
when
the
department
for
aging
independent
living
was
established.
Our
department
was
actually
a
branch
under
dcbs
and
it
was
developed
as
its
own
separate
standalone
department.
Meals,
specifically,
as
we
know,
are
delivered
in
the
home
to
individuals
and
along
with
the
supportive
services.
So
it's
ensuring
that
we
have
that
full
separate
independent
living
department
to
support
older
adults.
D
I
was
there
when
they
started
the
department
independent
living.
You
know
I
was
not
over
it
and
it
was
that
under
dcbs
the
focus
was
really
aps
in.
So
it
was
more
of
a
not
enforcement,
but
you
know
it
the
adult
protective
services.
It
was
more
in
protection.
It
was
more
on
that
side
of
the
house
and
it
was
decided
at
that
point
in
time
to
to
move
it
to
give
that
focus
on
aging
right
and
disabilities.
Primarily,
there
was
nobody
that
had
that
singular
focus.
D
The
disabilities
piece
actually
came
out
of
behavioral
health,
so
they
kind
of
merge
two
pieces
together
to
make
to
make
aging
and
independent
living
so
that
that
it's
an
explanation
of
why
it
came
to
be
and
and
where
it
is,
and
and
as
the
recipient
of
the
aging
funds
right.
That's
that's
why
these
programs
cluster
in
this
department.
A
I
have
one
one
follow-up
question
of
that.
You
mentioned
a
couple
of
times
that
it's
mandated
by
the
federal
government.
Is
the
programs
mandated
or
is
the
department
mandated
because
there's
a
big
difference
there.
E
So
it
is
the
the
federal
rule
states
for
the
older
americans
act
that
each
state
should
have
a
state
unit
on
aging
director,
one
person
that
oversees
the
programs
and
then
it's
all
the
the
federal
programs.
So,
yes
representative,
you
could
move
all
of
this
to
dcbs
to
public
health.
Yes,
but
you
cannot
split
off
the
various
programs.
A
Thank
you.
The
reason
I
we
ask
these
questions
is
because
over
the
past
couple
of
months,
as
we've
heard
this
testimony
from
the
outside
looking
in,
there
appears
to
be
a
lot
of
redundancy
in
some
of
these
things,
and
so,
as
we
look
at
it
as
senator
meredith
mentioned,
could
some
of
these
things
fall
under
dcbs?
A
Could
some
fall
under
the
department
for
public
health
in
several
of
the
programs,
as
I
look
through
the
slide
said
in
collaboration
with
say,
medicaid
or
another
department,
so
that
that
makes
us
wonder,
can
those
fall
directly
under
those
departments?
Then,
if
that's
the
case,
so
that's
why
we
asked
some
of
these
questions
and
that's
the
purpose
of
this
task
force
is
to
look
at
streamlining
the
agencies
and
combining
some
of
these
programs
and
and
making
the
departments
more
efficient
as
we
move
forward.
So
we
appreciate
your
all's
testimony
and
appreciate
your
answers.
G
D
And,
unlike
the
previous
department,
I
I
was
over
this
for
a
little
bit
so
also
steve
and
stacy
have
a
depth
of
experience.
D
Steve
has
been
over
this
department
before
he
actually
was
over
this
group
when
it
was
actually
with
dcbs,
particularly
the
child
support
enforcement
side
and
has
a
lot
of
experience
working
with
county
attorneys,
and
that's
why
I'm
glad
he's
here.
So
he
I
don't
have
to
necessarily
they're
a
complex
group.
As
you
all
know,
and
and
steve
has
worked
with
him
so
long.
I
think
I
think,
there's
a
level
of
trust.
That's
built
there.
D
Stacy
has
really
worked
her
way
up
through
the
ranks
of
disability,
determination,
office
and
has
been
over
than
this
office
previously,
and
I
will
tell
you
that
the
folks
at
social
security
administration
have
a
tremendous
amount
of
respect
for
her,
so
I
felt
very
fortunate
when
they
they
agreed
to
to
come
and
work
work
with
us
this
time
within
the
cabinet.
So
with
that
and
trying
to
inflate
cheryl's
egos
we'll
turn
it.
G
D
G
Thank
you,
mr
secretary.
Thank
you
chairmans
meredith
and
mead
good
afternoon.
G
G
Our
mission
in
the
department
is
to
ensure
vital
income
supports,
are
provided
to
enhance
the
well-being
of
kentucky's
families.
Child
support,
enforcement's
mission
to
ensure
kentucky's
children
are
financially
supported
by
both
parents
and
disability
determination,
services
mission
to
determine
the
medical
eligibility
for
residents
of
the
commonwealth,
who
apply
for
social
security
and
social
security
income.
Ssi
disability
benefits
from
the
federal
government.
G
This
is
a
breakdown
of
our
our
budget
for
disability.
They
composed
41
percent
of
the
total
department
budget
at
nearly
54
million
dollars
and
for
child
support,
composes,
40
or
59
percent
of
the
total
overall
budget,
or
at
77.5
million
dollars
of
the
pie,
so
to
speak.
G
G
G
So
the
legislature
does
obviously,
through
our
state
constitution,
have
to
authorize
expenditure
any
dollar,
whether
it's
state
or
federal,
so
in
federal
fiscal
year,
and
both
programs
run
off
federal
fiscal
years.
So
in
disability,
for
federal
fiscal
year,
dds
closed
200
have
roughly
281
full-time
equivalent
staff
and
we're
continually
hiring.
If
you
have
anybody
that
has
a
bachelor's
degree,
we'd
be
interested
in
talking
to
them.
G
We
were
blessed
that
the
social
security
administration
gave
us
additional
hiring
authority.
So
in
claims
closed,
initial
claims,
processed
43
might
as
well
say.
44
000,
reconsideration
claims
process
was
13.4,
000,
continuing
disability
review
claims
process,
nearly
10
000
other
claims
process
3294,
with
a
total
of
nearly
71
000
claims
processed.
G
Their
funding
is
a
blended
state
and
federal
fund
match,
so
66
of
the
child
support
program
is
reimbursed
by
the
federal
government,
and
this
is
different
from
the
disability
program
in
that
child
support
spends
state
dollars
and
they're
reimbursed
by
the
federal
government.
So
it's
not
a
direct
relationship
financially
with
the
federal
government.
So
that's
the
major
difference
between
the
two
programs.
G
Non-Judicial
functions
that
we
have
are
we
commonly
call
administrative
functions,
are
obtaining
financial
institution
information,
dna
testing,
obviously,
in
paternity
cases,
in
hospital
paternity
establishment,
where
we
work
with
hospitals
to
establish
a
paternity
wage
assignments,
personal
property
and
assets,
liens
and
levies,
tax
refund
unemployment,
benefits
offsetting
and,
lastly,
license,
revocation-
and
we
also
through
judicial
processes
through
the
county
attorneys,
do
that
local
service
delivery
through
the
court
system.
G
Child
support
enforcement
received
approximately
46
million,
including
approximately
7.5
million
in
incentive
monies
based
on
federal
fiscal
year
2020.,
so
the
federal
government
runs
a
year
behind
so
that
they
can
audit
the
data
in
the
following
fiscal
year.
So
these
funds
are
granted
annually
and
they're
federal
funds
counted
in
state
fiscal
year.
21.
G
G
G
Federal
fiscal
year,
21
disbursements
this-
that
was
385
million,
eighty
881
thousand
two
hundred
and
thirty
five
dollars
of
that
total.
As
you
can
see,
the
majority
of
which
goes
to
families
and
children,
total
disbursements
was
347
million,
250
dollars,
two
hundred
fifty
thousand
seven
hundred
and
eight
dollars
and
total
disbursements
to
tanf
to
offset
the
dollar
spent
in
the
tanf
program.
G
G
So
from
the
left-
and
I
know
this
is
very
small
print
and
my
eyesight
isn't
as
good
as
it
used
to
be,
and
I
apologize
for
that.
The
child
support
enforcement
program
is
on
the
far
right
and
shows
the
different
branches
we
have
within
that
division.
G
We
have
lilly
pattison
with
us
today
as
well
she's
the
division
director
of
that
program
to
the
far
right.
You
have
the
division
of
disability,
determination,
services.
We
have
heather
boggs
here.
The
division
director
provides
operational
support
as
well
as
joanne
wells.
I
had
a
senior
moment
there
for
a
second
who
is
one
of
the
assistant
directors
there
that
handles
case
processing
so
and
in
the
middle,
where
our
reorganization
was
focused.
The
highlighted
area
was
the
creation
of
the
division
of
fiscal
management.
G
G
To
create,
let
me
go
to
the
next
slide,
getting
ahead
of
myself.
So
what
does
this
do?
For
us?
It
provides
fiscal
oversight
for
both
department
divisions
in
an
independent
way,
provides
increased
oversight,
financial
fidelity
efficiency
and
proper
development
and
adherence
to
consistent
cabinet-wide
policies
and
provides
for
cross
training
and
cross
assistance
between
branches,
resulting
in
cost
savings,
preparedness
and
staff.
Attrition.
G
So,
within
this
area
we
have
our
budget
person
for
the
department.
We
also
will
one
of
the
priorities
for
this
division
is
the
bringing
on
staff
for
our
program.
Integrity
section
are
our
two
big
ones
we're
going
to
be
focused
on.
We
have
our
fiscal
facilities,
people
as
well
in
this
division.
G
Again,
you
know,
ch,
both
divisions
needs
are
different
in
disability.
The
need
is
in
frankfurt
and
in
louisville,
where
we
also
have
an
office
and
child
supported
statewide.
G
It's
through
our
state
employees
out
there,
as
well
as
our
our
county
attorneys.
So
those
needs
are
much
different,
so
putting
them
together
made
sense,
we're
hoping
to
have
a
new
division
director
very
soon,
and
so
as
soon
as
they're
on
board.
We'll
move
forward
in
you
know
getting
down
in
the
weeds
into
hiring
staff.
Some
staff
were
already
in
existence
in
disability
and
child
support
that
have
been,
as
the
personnel
folks
say,
crosstalk
crosswalked
to
this
division.
C
Thank
you,
mr
chairman.
I've
got
a
lot
of
questions,
commissioner,
and
it's
going
to
be
somewhat
critical
of
your
leadership
and
how
this
this
organization
how
things
have
been
going.
So
I'm
going
to
preface
it
with
that.
I
think
this
is
a
department
that
could
be
split
in
the
attorney
general's
office
and
dcbs.
Frankly,
I
don't
know
that
it
needs
to
be
where
it's
at
currently.
C
My
first
question
is
what
percent
of
child
support
cases
are
currently
and
up
to
date
in
kentucky
right
now
I
mean
I
know
I
know
I
think
secretary
freelander
had
given
us
recent
testimony.
In
july
we
were
about
56,
I
think
was
56.35
percent
of
the
total
amount
of
current
child
support
has
been
collected.
So
I'm
curious
if
you
know
what
that's
that's,
accurate,
yeah.
G
That's
roughly
correct
does.
C
So,
commission,
I
asked
you
that
question
when
you
came
before
this
committee
or
one
of
these
committees
before
I
asked
you
that
very
question
several
months
ago,
and
you
said
I
can
get
that
for
you,
and
here
are
several
months
later.
That's
why
I'm
asking
you
again
hoping
you'll
be
prepared,
knowing
that
I
was
on
this
committee
that
should
be
off
the
tip
of
your
tongue.
I
would
imagine,
if
you're
in
charge
of
oversight
of
this.
G
It
is
1.4
billion
dollars,
1.4.
G
Support
and
as
I
said
in
that
last
committee
meeting,
you
know
those
don't
start
those
cases
don't
start
with
us
generally,
a
lot
of
times,
families
separate
that
go
their
own
ways.
G
They
get
orders
privately
for
child
support,
the
non-custodial
parent
gets
behind
twenty
thousand
dollars
plus,
and
then
they
come
into
our
system
and
those
marriages
are
added
into
our
total
marriage.
C
C
I
can't
imagine
if
1.4
billion,
or
even
half
of
that
was
injected
back
into
the
system,
how
many,
how
much
less
dependence
would
be
on
public
support
for
those
children
if
they
were
properly
supported,
child
support,
enforcement's
implemented
by
county
attorneys,
as
you
mentioned
across
the
country.
Clark
county,
I
think,
is
number
one.
Our
attorney's
done
a
tremendous
job
there.
How
does
your
department
handle
the
political
nature
of
managing
the
performance
of
local
elected
officials
across
kentucky.
G
G
G
They
at
one
time
had
nearly
200
staff
in
their
child
support
program
and
they
had
dropped
to
105
staff
and
through
no
fault
of
theirs,
trying
to
hire
it.
Just
was
difficult,
so
we've
put
more
money
in
their
contract
this
year
and
they
have
had
some
set
success,
hiring
and
we're
working
closely
with
them
meeting
periodically
going
over
their
hiring
numbers
working
on
their
performance
measures,
helping
them
train
and
also
you
know,
working
with
them
and
providing
any
direct
assistance.
We
can.
C
I
think
I've
got
my
statistics
show
that
there's
more
than
3
400
people
in
jefferson
county,
who
owe
at
least
3
000
each
in
child
support
right
now,
there's
more
than
89
million
dollars
in
missing
child
support
payments
in
jefferson,
county
alone.
From
what
I've
my
research
does
your
department
approve
pay
increases
for
county
officials
who
administer
your
child
support
enforcement
program?
Yes,
sir,
what's
your
criteria
for
reviewing
and
awarding
salary
increases
for
a
lot
of
these
folks?
Is
there
any
connection
with
program
performance,
as
you
just
listed.
G
C
Yeah,
that's
a
concern
and
that
may
be
why
we're
1.4
billion
dollars
in
the
hole
on
this.
Have
you
approved
salary
increases
for
child
support
employees
in
jefferson
county
since
2019.
C
We've
got
the
director
of
jefferson
county
child
support
is
diane,
fleming
was
hired
in
2017,
her
initial
salary
was
thousand
nineteen
dollars
and
twenty
cents
current
salary
was
thing
was
a
hundred
and
twenty
thousand,
and
you
got
also
got
another
raise
now
at
a
hundred
and
thirty
thousand
six
hundred
and
three
dollars
and
twenty
cents
with
numbers
like
this
and
bad
performance
like
this.
Doubling
of
that
individual
salary
are
any
of
your
executive
staff.
Family
members
related
to
the
governor
by
any
chance.
G
He
was
doing
our
federal
tax,
offset
security.
C
Okay
and
I've
also
heard
you
have
a
big
salary
increase
in
that
role
as
well.
Are
you
also
aware
of
I
think
of
auditor
harmon's
2019
report.
C
C
I
know
you've
done
a
reorganization,
I'm
not
sure,
if
that's
as
a
result
of
this
audit
and
all
the
things
that
were
mentioned
in
there,
but
that
was
all
basically
in
stuff
that
was
done
under
your
leadership
before
so.
Sometimes
when
we
look
at
reorganization,
we
start
seeing
that
there's
people
that
are
related
to
other
members
of
government
salaries
that
are
double
people
that
don't
do
a
good
job
in
performing
their
jobs.
C
That's
a
concern
for
me
that
the
structure
we've
got
isn't
working
for
that,
mr
chairman,
so
I
thank
you
for
your
indulgence,
but
I
think
a
lot
of
times.
We
need
to
start
taking
a
look
at
having
to
restructure
this
and
put
it
under
different
locations
where
this
can
be
done
well,
because
I
think
it
can
be
run
well,
but
in
the
meantime
we've
got
1.4
billion
dollars,
backed
up
in
a
rearranges
for
child
support.
C
When
I
asked
that
question
to
have
to
rely
on
staff,
that's
your
main
duty,
that's
what
you
said
as
to
who
you
are
here
major
concern,
and
I'm
concerned
that
you're
back
in
this
position
again,
because
I
don't
think
we,
I
think
we
had
a
bad
audit
before
and
we're
back
at
it
and
we're
in
this
kind
of
situation.
F
It's
a
unique
department
obviously
has
some
challenges,
but
I'm
curious
because
of
the
political
nature
of
this
working
with
county
attorneys
throughout
the
state,
I
guess
most
notably
jefferson
county,
since
they
seem
to
be
the
most
deficient
at
this
point.
What
kind
of
leverage
do
you
have
with
those
folks
to
to
do
the
job
better.
G
Budgetary
is
is,
for
the
most
part
and
on
the
political
net
we
don't
look
at
politics.
We
just
look
at
what
the
job
is.
The
service
delivery.
F
Well,
I
appreciate
that,
but,
as
senator
alvarado
noted,
you
know
over
60
of
the
outstanding
child
support
payments
in
jefferson
county.
I
certainly
note
that
they've
had
a
shortage
of
staff
and
you
tried
to
address
that,
but
if
we're
not
still
not
getting
results
from
from
jefferson
county,
what's
the
next
step.
G
Well,
my
philosophy
is
to
work
closely
with
them
and
that's
what
we're
doing
right
now
we
initiated
a
meeting
to
talk
about
hiring
staff.
That
was
the
first
thing
to
address
and
so
we're
making
progress
there.
We
also
are
doing
their
training
for
the
most
part
and
we
have
staff
actually
helping
with
some
of
the
workload
until
it
can
get
staffed
up.
G
So
the
next
step
is
the
once
they
get
staffed
up
is
to
work
with
them
closely
on
a
performance
improvement
plan
so
to
ensure
that
they
move
upward
in
their
performance
of
the
program.
F
G
G
We
have
team
meetings
with
the
select
group
of
county
attorneys
monthly,
and
so
we
hear
from
them
know
what
their
issues
are
and
hear
from
jefferson
county
as
well,
and
you
know
that's
why
we,
you
know
we
heard
regularly
about
their
hiring
challenges
there
and
why
they
were
struggling
with
their
performance.
F
G
F
G
Well,
I
would
would
like
for
them
to
have
an
opportunity
now
to
get
staffed
up
and
then
start
proving
their
performance
so
a
year
from
now
we'll
reevaluate
that
and
see
how
they're
doing.
F
Well,
I
think
it
goes
back
to
the
political
nature
of
this
relationship,
and
I
I
don't
see
that
it's
not
an
indictment
to
use.
Just
you
really
don't
have
the
leverage
to
to
make
these
people
do
what
they're
supposed
to
do
unless
you
can
interject
some
competition
into
this,
and
that's
privatization
of
this
possibly
so
I
think
that's
gonna
be
looked
at
seriously.
It's
a
lot
of
money,
a
lot
of
kids
living
in
poverty
that
shouldn't
be
living
in
poverty,
so
is
that
something
you
have
taken
a
hard
look
at!
Is
privatization
of
this.
G
G
F
Contracts,
you
can
fire
them.
You
know
it's
hard
to
fire
a
county
attorney,
and
that
goes
back
to
political
nature.
This
thing-
and
I
don't
blame
you
for
that,
but
I
I
can't
blame
you
for
the
lack
of
results.
You
know
what's
the
trigger
point
for
any
county,
where
we
say
you
guys
can't
do
it
we're
going
to
give
it
to
somebody
else.
What's
the
trigger
point.
G
It's
the
lack
of
progress
on
on
their
performance
and.
G
Well,
jefferson,
county
a
year.
G
G
Yes,
they're
they're
put
they're
public.
We
just
we
publicized
that.
Lastly,
let's
see
in
july,
yes,.
G
D
The
other
trigger
that
I've
seen
in
this
program
is
really
the
waste
fraud
and
abuse
angle
on
it.
When
county
attorneys-
and
you
know,
we've
seen
several
who've
gotten
into
trouble
and
even
been
investigated
by
law
enforcement,
then
those
those
contracts
go
to
other
counties
and
that's
the
other,
that's
the
time.
Those
are
the
times
that
I've
seen
the
contracts
move
from
one
really
one
county
to
another,
where,
where
a
different
county
will
oversee
another
county's
child
support
enforcement,
I
think
you
have
a
couple
of
those
examples.
Currently,
yes,
sir.
A
G
We
we
have
different
thresholds
for
dip
where
a
county
lies
in
the
their
performance,
so
the
counties
in
the
upper
tier
have
a
less
percentage
requirement
to
increase
versus
those
at
the
lower
lower
tier.
G
A
Okay
and
then
one
last
question
is
what
states
are
privatizing,
their
collections.
C
B
G
Social
security
administration,
yes,
sir,
they
they
have
regulations
and
they
also
assign
you
know
workloads
working
closely
with
with
the
social
security
administration.
It's
actually
well
documented
and
they
follow
our
progress
throughout
the
year.
B
B
D
The
the
social
security,
the
disability,
social
security,
that's
the
disability,
determinations
the
the
unique
nature
there
is
that
we're
direct
contractors
to
social
security
as
a
matter
of
fact,
what
the
the
classification
of
employees
in
in
social
in
dss
our
fftl
employees,
as
opposed
to
like
regular
state
employees,
and
it
really
has
to
do
with
the
nature
that
we're
direct
contractors
with
social
security,
so
they
set
standards
for
us
in
terms
of
the
number
of
cases
we
clear,
they
line
us
up
against
other
states
in
the
southeast,
because
that's
where
we
are
is
region
four,
I
remember
some
of
that
stuff,
and
so
we
we're
ranked
pretty
well.
D
G
The
child
support
is
funded
through
the
agency
for
children
and
families,
office
of
child
support
enforcement.
So
no
they
do
not
arrearage
issues
nationally
is
a
major
problem.
It's
not
just
in
kentucky
it
doesn't.
We
don't
want
to
minimize
that
it's
just
the
nature
of
how
collections
and
rearranges
come
into
our
our
system,
but
they
do
provide
for
incentive
monies.
I
think
I
I
mentioned
in
one
of
the
slides.
G
The
incentive
monies
are
based
off
our
performance,
and
last
year
we
were
paid
seven
and
a
half
million
dollars
in
incentive
monies
based
on
our
performance.
A
A
D
D
I
promise
to
go
fast,
so
the
it's
we
call
it
gaps
the
general
administration
program.
It's
kind
of
the
secretary's
office
is
the
way
to
think
of
it.
These
are
the
these
are
the
all
the
offices
that
are
associated
with
the
secretary's
office
I'll
try
to
go
through
fairly
quickly.
Oh
look
at
me.
You
can
see
these
different
pieces,
they're,
they're,
they're
things
that
you
know
hrit
our
financial
branch.
D
Sarah
cooper
over
our
office
of
legislative
and
regulatory
affairs
ombudsmen
folks
are
often
in
touch
with
our
ombudsman
program,
our
public
affairs.
So
that's
our
communications
group,
legal
services.
You
see
all
this
and
probably
the
bigger
one
in
terms
of
external
impact,
is
our
office
of
the
inspector
general.
D
When
you
look
at
how
our
fund
sources
are
split,
we're
mostly
federal,
but
it's
because
of
the
way
we
do-
and
that
goes
back
to
my
original
testimony-
around
cost
allocation,
so
we
cost
allocate
the
costs
of
the
secretary's
office
across
our
federal
program.
So
we
we,
as
I
say,
maximize
what
we
can
in
terms
of
our
our
federal
reimbursement
for
our
programs,
legal
services.
D
I
think
that's
obvious
and
they've
been
very
busy.
I
think
I'm
the
most
sued
secretary
ever
in
the
history
of
the
cabinet.
I
continue
to
build
on
my
record
office
of
public
affairs.
So
again
this
is
communications,
and
but
that's
internal
and
external.
We
we
susan
dunlap,
believes
that
leads
that
I'm
sorry
west
duke
leads
the
office
of
legal
affairs,
and
so
susan
has
a
an
expertise
in
internal
communication,
and
I've
tried
to
be
really
intentional
about
that.
D
So
I
have
a
podcast,
but
it's
it's
really
targeted
internal,
so
that
folks
can
get
to
know
other
people
in
the
cabinet.
I
try
to
do
across
departments
and
then
I
do
some
videos
I
hate
looking
at
them,
so
those
are
all
the
kinds
of
things
that
we
do
and
and
about
80
million.
Well,
I
guess
they
said
285,
but
I
mean
it's.
We
get
median
inquiries
all
the
time.
Ombudsman.
This
is
really
an
interesting
program
and
I'll
try
to
do
this
fast
administrative
hearings
has
been.
Is
there?
D
So
all
of
those
13b
hearings
that
folks
have
to
go
through
when
when
they
go
through
our
processes
and
like,
are
they
snap
disqualifications
or
any
of
our
programs
where
they
maybe
weren't
eligible
for
something
or
get
kicked
out
of
a
program?
They
go
through
the
office
of
administrative
hearings.
Occasionally
a
licensure
hearing
will
come
through
here.
D
Certificate
of
need
hearings
come
through
here,
so
it's
it's
a
pretty
big
group
of
folks,
and
so
that
was
added
most
recently
to
the
ombudsman's
office,
because
a
lot
of
that
then,
is
you're
dealing
with
the
public
and
you're
dealing
with
providers
and
you're
dealing
with
individuals.
So
that's
that's
a
big
piece
of
it.
Then
the
citizens
who
call
in
that's
again
it
can
come
from
the
general
assembly.
We
funnel
everything
through
our
ombudsman's
office
because
they
have
a
nice
tracking
system.
D
So
we
can
follow
through,
like
it's
like
canary
in
the
coal
mine
a
little
bit
when
we
start
seeing
complaints
go
up
in
a
specific
area.
It
kind
of
lets
us
know
what's
happening
and
then
the
program
performance
is
the
group
that
really
overlooks
kind
of
dcbs.
D
It's
an
independent
look
at
dcbs,
it'll
review
cases,
it'll
review,
timeliness
of
cases
and
they
usually
have
an
annual
report
for
you
all
about
what
their
review
of
dcbs
is.
A
lot
of
folks
then
come
out
of
dcbs
and
go
into
this,
so
it
helps
with
quality
control
and
and
it's
a
pretty
big
job.
The
ombudsman
is
lisa
lee
williams,
so
we
have
two
lisa
lees
but
lisa.
Lee
williams
is
the
ombudsman
here,
administrative
services,
astrid
masterson.
D
This
is
facilities,
management,
accounting,
procurement
contracts,
senator
meredith.
You
are
probably
on
a
first
name
basis
with
astrid,
and
so
this
is
everything
this
is
like
small
but
mighty
because
they
handle
everything
on
the
procurement
and
contracting
side
for
the
cabinet
for
health
and
family
services.
They
also
work.
They
have
facilities,
so
they're
not
finances
facilities
right,
but
we
have
folks
who
who
help
us
with
our
facilities.
I
invite
you
all
over
to
the
cabinet
for
health
and
family
services.
D
Anytime,
specifically,
I
think
when
we're
when
we
get
to
the
point
where
we're
redoing
our
escalators,
I
want
you
all
to
be
there
and
feel
sorry
for
me.
Our
application
technology
services-
that
is,
then
our
these-
are
the
folks
that
help
us
with
our
eligibility
systems.
It
really
is
kind
of
rit
folks,
rit
maintenance,
they're,
not
cot,
but
they
do
all
our
it
projects.
So.
D
Give
an
example:
so
all
of
the
eligibility
systems
all
of
the
connect
stuff,
if
you
saw
lots
of
things
on
how
we
back
up
our
data
and
present
it
to
the
public.
This
is
the
group
that
does
a
lot
of
that.
It's
heavily
contractors
attracting
state
employees
for
the
salaries
that
we
can
can
give
is
a
challenge.
So
this
is
a
heavy
contractor
group.
This
office
jennifer
harp
is
the
person
who's
in
charge
of
this
office
of
data
analytics.
This
was
one
of
the
things
that
was
changed
in
the
reorganization
that
you
all
passed.
D
This
was
called
the
office
of
health
data
analytics,
but
really
what
we
were
looking
at
and
we
brought
it
in
more
tight
to
the
secretary's
office.
D
So
we
that
group
is
one
that
we're
we're
continuing
to
evolve.
When
I
came
into
the
cabinet
oats,
there
was
something
called
oats
and
it
had
both
this
function
and
the
it
function.
The
previous
administration
split
it
office
of
health
data
analytics
and
the
the
it
function.
When
I
came
in,
I
was
sold
a
great
idea.
D
We
need
to
have
data
analytics
and
health
data
analytics.
We
should
be
looking
at
our
data.
We
should
be
using
our
data,
but
the
how
it
ended
up
functioning
was
there
wasn't
good
definition
between
what
one
group
did
and
what
the
other
group
did.
So
this
is
helping
us
make
that
definition.
So
you
know
I
wish
I
could
give
a
better.
So
here's
an
example:
somebody
wants
to
query
our
eligibility
systems
if
it
was
just
a
simple
query:
they'd
go
to
the
technology
side
and
get
it
pretty
fast.
D
If
it
was
like
how
how
do
two
systems
work
together,
they
were
going
through
data
analytics,
but
if
they
felt
like
they
could
get
it
quicker.
Some
other
way,
they'd
go
another
way.
So
we've
really
been
working
on
how
to
structure
this.
It's
still
a
work
in
progress,
but
it's
something
that
we
are
working
on,
and
this
is
the
group
that
works
with
the
universities,
so
there's
called
the
state
university
partnership.
It's
where
medicaid
helps
fund
some
research
on
the
part
of
universities.
D
Again,
this
is
starting
previous
administration,
great
idea,
and
so
we
work
with
the
universities
on
what
they're,
what
they're
called
their
state
university
projects
they're
their
research
projects.
What
I've
started
to
try
to
do
is
it
was
always
the
universities
would
propose
to
us-
and
now
this
this
year,
for
the
first
time
about
six
months
ago,
we
came
up
with
a
list
of
hey
help.
Us
study
some
things.
So
it's
a
back
and
forth
we're
still
right
in
the
middle
of
the
process.
D
D
Finance
and
budget
you've
seen
eric
lowry
sitting
next
to
me
he
is
the
one
that
really
helped
set
up
how
we
fund
the
secretary's
office.
I
called
him
a
genius
before
and
his
staff
have
not
stopped
giving
him
grief
because
of
that,
but
I
didn't
say
if
it
was
a
g
or
j
so,
but
he
is
he's
a
he's
he's.
You
know
it's.
It's
an
18
billion
dollar
budget
you've
got
to
have
some
pretty
strong
skills
to
be
able
to
to
handle
that
piece
office
of
legislative
and
regulatory
affairs.
D
Sarah
cooper
is
acting
there
for
us
and
those
are
the
folks
you
deal
with
right.
That's
who
you
deal
with
when
with
legislation,
questions
legislative
questions
it
comes
to
this
group
and
and
that's
who
normally
answers
your
questions
and
shepherds
or
would
send
these
like
these
powerpoints
to
you
all
that
comes
to
our
office
of
legislative
and
regulatory
affairs.
They
also
handle
regulations,
and
so
it's
it's
it's
also.
D
If
you're
on
the
regs
committee,
you
see
them
all
the
time
and
somehow
they
keep
us
straight
in
presentations
to
you
all
hr.
We
just
had
a
retirement
teresa
straw,
michelle
barnes
is,
is
over
hr
again.
This
is
this
is
everything
this
is
every
employee
in
the
cabinet,
and
I
always
like
to
say
it.
D
Is
you
never
know
what
you're
gonna
get
from
one
day
to
a
next
personnel
is
always
probably
one
hr
is
probably
one
of
the
more
challenging
things
within
any
organization
and
then
the
office
of
inspector
general.
I
think
you
all
know
them
well
they're,
the
folks
that
do
the
surveying
of
all
health
care
child
care,
some
of
what's
going
on
in
assisted
living,
is,
is
as
as
commissioner
eldridge
presented.
D
We
are
based
on
legislation
working
out
where
that
that
line
is
between
assisted
living,
health
and
assisted
living,
social,
and
it's
it's
we're
trying
to
work
with
organizations
on
that,
and
they
also
have
the
the
care
system,
which
is
a
fingerprint
system.
It's
a
really
good
system.
It
does.
It
will
tell
you
if
then
somebody
has
subsequently
been
arrested.
D
Also
casper
is
there
in
the
inspector
general's
office
as
well
as
certificate.
Indeed
sits
there
now.
So
it's
it's
got
a
lot
of
different
pieces.
We
also
under
the
reorganization,
moved
our
kentucky
health
information
exchange.
K.
High
is
also
now
under
the
inspector
general's
office,
moved
it
there
because
they
had
casper,
and
so
it
it.
It
made
sense
to
me
to
to
kind
of
align
those
programs.
How
was
that.
A
I
got
a
couple
of
questions
for
you,
mr
secretary,
you
had
that
slide
just
a
second
ago
on
your
human
resources
department.
How
does
that
different
from
the
personnel
cabinets.
D
Okay,
so,
like
the
facilities
group,
it
relates,
like
our
facilities.
Groups
relates
to
finance
facilities.
Group.
Our
hr
office
relates
to
personnel
cabinet,
so
there's
so
many
actions
within
the
cabinet
for
health
and
family
services.
D
We
have
a
group
that
that
helps
coordinate
that,
in
collaboration
with
the
personnel
cabinet,
you
know
disciplinary
actions,
hiring
actions.
D
Those
are
things
that
we
work
together
with
a
personnel
cabinet
on,
but
it's
important
for
us
to
have
a
group
dedicated
within
the
cabinet,
because
we
have
about
six
thousand
employees,
and
that
would
just
I
think,
it's
important
for
us
to
have
this
group
and
they
relate
to
the
personnel
cabinet,
but
but
they
perform
some
of
the
functions
to
get
folks
ready
for
hiring
and
all
those
kinds
of
things
just
like.
I
said
disciplinary
action
and
all
sorts
of
things
payroll
processing
right.
We
do
that.
A
The
reason
I
ask
that
is
because
I
know
that
hiring
state
employees
can
be
it's
it's
cumbersome,
sometimes
with
the
the
rigs
and
and
the
rules
that
we
have,
especially
with
the
merit
system,
so
is.
Is
that
hindering
your
hiring
ability
in
any
way,
especially
having
those
two
entities,
the
personal
cabinet,
plus
your
human
resources?
Because
I
understand
right
now-
we're
hiring
some
temporary
social
workers
and
things
like
that.
We're
hiring
them
under
the
state
while
they
apply
to
become
state
workers.
D
I
think
that's
a
good
question.
We've
had
to
really
re-examine
our
processes
within
the
cabinet,
because
then
each
individual
department,
like
dcbs,
has
folks
who
are
responsible
for
for
helping
them
move
through
the
process,
and
then
it's
it's
the
same
thing
at
our
level.
So
it's.
How
do
we
make
sure
that
we
are
as
efficient
as
possible
within
that
structure?
D
I
I
think
we've
made
some
improvements.
As
you
mentioned,
we
do
some
temporary
hiring
to
make
sure
we
can
bring
people
on
more
quickly
than
really
some
of
the
regular
state
hiring
process.
I
I
think
you
know
the
things
we
ask
for
like
backgrounds
checks,
you
know
the
making
sure
that
we're
vetting
is
somebody
qualified
for
a
position,
we're
just
those
kinds
of
communications.
I
think
we're
working
on
streamlining
can
always
improve
processes.
D
A
D
I
have
asked
the
former
director
there
to
really
focus
strictly
on
implementation
within
the
cabinet
and
and
because
I
felt
like
we
needed
somebody,
one
person
who
was
devoted
exclusively
to
that,
because
there's
budget
implementation,
there's
legislative
implementation
and
making
sure
we
have
the
regs
right.
D
A
And
I
understand
that:
that's
that's
good
information.
Do
they.
We
we've
seen
in
the
past,
not
just
this
administration,
but
administrations
have
passed
where
it's
taken
years
to
get
legislation
implemented
that
the
general
assembly
has
passed
and
if
you've
heard
me
over
the
past
couple
meetings,
this
is
one
of
my
pet
peeves.
I
guess
you'd
say
is
that
implementation
doesn't
always
follow,
especially
as
quickly
as
as
we
have
intended
in
the
past.
A
We've
got
examples
out
there
right
now
that
that
have
not
been
implemented,
and
that's
concerning
I've
heard
the
governor
a
couple
of
times
say
that
we
don't
have
to
implement
it
because
they
didn't
put
the
money
in
the
budget,
but
there's
been
times
in
the
past.
The
money
has
not
been
put
in
the
budget
and
it
usually
when
that
happens.
It
is
the
intent
of
the
general
assembly
that
it
comes
out
of
the
current
budget.
That
is
there.
A
We
don't
always
have
to
earmark
money
and
put
it
forward
for
it
to
be
implemented,
and
that's
that's
going
to
be
our
opinion.
That's
how
we
operate.
That's
how
we
continue
to
operate
going
forward,
so
I
would.
I
would
hope
that
the
governor
would
go
ahead
and
implement
the
laws
that
this
general
assembly
has
passed
with
our
intent
and
a
lot
of
times
as
we
speak
of
intent.
A
We
hear
that
a
lot
of
times,
folks
saying
well
what
was
the
legislature's
intent,
but
you
know
I've
never
had
anybody
ever
come
and
ask
us
what
our
intent
was
when
they're
trying
to
implement
these
things.
So
I
would
just
add
that,
as
kind
of
a
side
note
there
and
then
my
final
question
is
switching
gears
a
little
bit
to
the
office
ombudsman.
I
don't
think
you
had
this
in
your
in
in
there
but
complaints.
A
D
It's
usually
by
phone,
so
in
terms
of
one-on-one
meeting
somebody
in
the
public.
That
is
not
necessarily
their
role.
It's
it's
more!
It's
more
electronic
communication.
A
Okay,
the
reason
I
asked
that
yeah
we
received
an
email
that
the
content-
the
email-
is
not
pertinent
to
this
committee,
but
there
was
one
thing
that
I
pulled
out
of
that
it
said
in
it.
It
said
the
office
ombudsman
does
not
see
people
for
me
in
just
my
thinking.
It's
a
little
concerning
because
the
office
of
ombudsman
is
where
the
general
public
should
be
able
to
go
to
talk
about
their
issues,
the
issues
they
have
with
the
cabinet
or
a
department
or
whatever
it
may
be.
A
A
D
A
That's
all
I
have
senator
alvarado
thank.
C
You,
mr
chairman
office
for
children
with
special
healthcare
needs.
I
thought
that
was
part
of.
Am
I
wrong?
Either
I'd
seen
an
organizational
chart
or
something
before
that
was
under
the
secretary's
office
or
not
or
if
it's
not
affiliated
there.
D
C
D
D
More
closely,
they
have
been
actually
under
public
health
before
and
and
then
independent,
so
they're
more
aligned
as
a
as
a
separate
office,
and
they,
like,
I
say,
they're
more
closely.
Aligned
with
public
health.
C
Okay,
well,
that's
what
I
my
questions:
we're
going
to
go
to
that
effectively
to
say
you
know:
can
we
hire,
I
think
the
university
of
kentucky's
offered.
I
know
when
I
was
in
training.
That's
who
did
a
lot
of
the
clinics
for
that,
but
wasn't
sure
if
that's
a
contracted
thing
or
if
that's
part
of
your
office
or
not,
but
if
it
isn't,
then
maybe
it's
something
I
need
to
ask
and
the
thought
was
to
maybe
look
at
having
them
be
aligned
with
public
health
as
well.
C
D
And
I'll
you
know,
I'm
sure,
ivy
alexander,
is
the
person
who's
over
that
they
mostly
contract
through
universities
for
a
lot
of
what
they
do.
There
are
some
pieces
that
they
go
to
private
physicians
and
and
contract
with
with
individuals,
they're
they're
you're,
not
asking
about
the
office.
The
sorry.
C
A
Seeing
them
thank
you,
mr
secretary.
We
appreciate
your
time.
As
always,
let's
see
our
next
meeting
will
be
october.
The
19th
at
three
o'clock
we'll
be
in
this
room.
Is
there
any
further
business
to
come
before
the
committee?
If
not,
is
there
a
motion
to
adjourn
second
and
without
objection?
We
are
adjourned.