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From YouTube: Administrative Regulation Review Subcommittee (9-12-23)
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B
A
A
With
corn
being
present,
the
subcommittee
is
duly
constituted
to
do
business
first.
I
need
an
approval
of
minutes.
Is
there
any?
Is
there
a
second
okay
without
objection
so
ordered?
Please
call
the
first
regulation.
B
C
A
B
A
C
32Kr10203046
and
50.
all
make
changes
for
consistency
with
electronic
filing
through
the
use
of
the
electronic
Finance
Management
System
and
the
registry
deleting
paper
forms
no
longer
used.
Additionally,
o30
changes
the
requirement
that
the
executive
Committees
of
political
parties,
with
less
than
10
000
in
their
campaign
fund
accounts
report
their
funds
to
the
registry
annually
instead
of
semi-annually
and
establishes
the
date
by
which
the
Committees
are
required
to
do
so.
The
staff
amendments
for
these
four
regulations
all
make
changes
to
comply
with
KRS
chapter
13A.
A
E
Which
I
mean
it
would
affect
any
the
only
other
party.
We
would
recognize
I'm,
not
sure.
If
there's
a
certain
part
you're
asking
about
the
only
other
party.
That's
we
recognize
as
a
Libertarian
party
as
a
as
a
as
a
group
that
can
have
executive
committees
also.
E
A
thousand
dollars,
no
a
lot
of
the
county
committees,
don't
have
over
ten
thousand
dollars,
and
this
is
this
is
brought
about
because
there
was
a
change
legislative
change
in
statute
last
session
that
that
put
this
into
play,
but
didn't
give
us
any
any
guidance.
This
is
just
how
to
administer
the
the
change
in
the
statute
from
the
2023
session.
A
Thank
you.
There
are
no
further
questions.
Many
of
the
members.
Thank
you.
Please
call
next
regulation.
I
A
K
A
N
A
A
K
A
Q
First
of
all,
I
appreciate
you
guys
being
here
today.
The
new
weight
classes
that
you
had
put
in
place
here
is
that
just
to
the
MMA
or
there's
additional
weight
classes
throughout.
O
That's
for
MMA
just
to
reflect
the
standardized
weight
classes,
making.
O
Q
Q
For
instance,
if
we
have
the
amateur
boxing
to
charge
at
the
door
for
an
event,
but
there's
some
type
of
prohibition
of
that
right
now,
because
they're
amateurs,
but
obviously
that's
how
you
would
raise
the
money
to
build
a
pay
for
the
event
is
that
is
that
something
you
guys
are
having
trouble
dealing
with
right
now,
as
it
relates
to
boxing
events,
especially
with
our
youth,
because
any
other
you
know
if
I
go
to
a
high
school
football
game.
Q
O
So,
yes,
that
that
is
something
that
we
have
been
dealing
with.
You
know
based
on
the
language,
in
our
statutes,
we
found
that
those
events
once
they
charge
admission
at
the
door.
They
fall
under
our
jurisdiction
and
we
don't
have
the
ability
to
license
amateur
boxers
or
anyone
under
18..
P
Q
A
O
I,
don't
know
sorry
I'm,
not
sure
who's.
The
records
that
we
found
were
I
believe
2008
I.
Don't
have
those
records
in
front
of
me
but
2006
or
2008
was
the
last.
So.
Q
A
Seeing
other
questions,
thank
you
all
for
coming.
Please
call
the
next.
B
A
I
This
regulation
is
being
amended
to
provide
the
board
and
mechanism
to
temporarily
suspend
a
class
one.
Two
three
six
or
seven
license
that
has
not
been
surrendered
by
an
agency
after
it
ceases
to
provide
continuous
service,
provide
the
board,
a
mechanism
to
issue
a
temporary
hardship
license
to
a
county
that
could
otherwise
be
left
without
a
class.
One
emergency
ambulance
service
require
class
one
agencies
to
schedule
a
minimum
of
one
staffed
ambulance
to
be
staged
in
the
agency's
geographic
service
area
and
allow
Health
Care
Facilities
to
request
that
any
licensed
agency
conduct
a
non-emergency
transport.
I
If
an
agency
license
for
a
specific
Geographic
service
area
is
unable
to
respond
to
the
non-emergency
calls
within
two
hours.
From
the
initial
time
the
call
was
received,
the
staff
suggested
Amendment
amends
various
sections
to
comply
with
the
drafting
requirements
of
krs-13a
and
make
technical
changes.
A
B
A
Thank
you
all.
There
are
no
amendments.
Are
there
any
questions
from
any
of
the
members
of
the
subcommittee?
A
I
just
had
one
question:
what
are
some
different
non-traditional
fishing
methods.
U
We
get
that
on
occasion
we
just
list
traditional
as
rod
and
reel
basically
or
hand
line,
but
non-traditional
would
be
hand
grabbing
where
you
stick
your
hand
in
hole
and
pull
out
a
catfish
limb
lining
Trot
lines,
anything
basically,
that's
a
legal
fishing
method.
That's
not
Broad
and
reel.
N
V
302
16010-1611
update
regulatory
requirements
for
amusement
rides
and
attractions
in
accordance
with
2022
House
Bill
273,
including
requirements
relating
to
business
registration
permits,
inspection
and
operation
safety
violations,
notice
of
occurrences
and
penalties.
The
staff
suggested
Amendment
for
302
KR
16010,
amend
section
2
to
establish
that
a
permit
expires
at
the
end
of
the
calendar
year
and
I'm
in
section
4
to
clarify
submission
procedures
for
itineraries.
V
The
remainder
of
the
staff
suggested
amendments
I'm
in
various
sections
to
comply
with
KRS
chapter
13A,
302
Kar
33010,
establishes
requirements
and
procedures
for
grain
buying
by
dealers
or
warehouses,
including
licensure
fees.
The
staff
suggest
an
amendment
amend
Section
1
to
establish
application
and
renewal
procedure
I'm
in
section
four
and
five
to
clarify
deadlines
for
moving
grain
out
of
temporary
storage
and
amends
various
sections
in
the
material
Incorporated
by
reference
to
comply
with
KRS
chapter
13A.
A
Q
Just
looking
through
the
the
amusement
ride
and
the
attractions,
the
registration
application.
So
whenever
we
have
like
the
fairgrounds
and.
Q
You
know
you
have
all
the
different
rides
and
set
up,
and
if
you
hear
the
horror
story,
sometimes
you
get
some
injuries
they
pack
up
and
they
leave.
But
this
requirement
now
would
be
if,
if
me
as
a
personal
injury
lawyer,
I
find
someone
who
gets
injured
on
there.
Where
would
I
go
to
be
able
to
make
sure
that
each
individual
person
has
a
ride
set
up?
Has
that
that
insurance
in
place
to
make
sure
that
all
of
our
constituents
are
safe?
That
be
here.
Q
S
Yeah,
so
you
can
verify
it
before
you
get
on
it.
If
you,
if
you
see
it,
but
after
the
fact,
you
would
inquire
about
their
itinerary
that
was
filed
with
us
prior
to
operation,
which
would
list
not
only
the
vendor,
but
the
different
devices
that
were
used
that
day,
both.
Q
One
of
our
constituents
at
home
were
injured
on
one
of
these,
the
kind
of
I
warned
my
kids.
They
can't
ride
them
because
they're
Fly
by
Night
on
the
stationary,
but
right
now,
we've
set
in
place
to
protect
people.
So
all
they
would
do
now
is
contact
your
office
and
they
would
say
yes,
this
ride
is
registered
such
and
such
owned
by
this
person
has
an
insurance
policy
of
this
amount.
Yes,
sir,
let
them
know.
Thank
you.
Thank
you.
W
Q
B
A
B
C
900
KR
6080e
amends
to
add
a
ground
ambulance
provider
ceasing
to
provide
continuous
service
in
a
geographic
area
to
the
definition
of
emergency
circumstance
and
require
an
attestation
from
a
County
government
to
seek
a
temporary
class.
One
hardship
license
to
address
the
emergency
circumstance
without
an
ambulance
provider.
First,
obtaining
a
certificate
of
need.
A
A
Thank
you
all
for
coming.
There
are
no
amendments.
Are
there
any
questions
for
members
of
the
subcommittee?
Seeing
none.
Thank
you
for
coming
guys
we're
going
to
change
things
up.
There's
a
regulation
we'll
hold
the
Medicaid
to
the
end,
so
I
guess
the
next
one
we
have
is
apartment
for
community-based
services.
I
921-3020
is
being
amended
to
have
the
option
of
utilizing
a
standard,
medical
deduction
or
actual
monthly
medical
expenses.
When
determining
income
deductions
and
eligibility
for
SNAP
applicants
who
meet
the
established
definitions
for
elderly
or
disabled
921-3095
establishes
the
requirements
for
the
elderly
simplified
application
project.
The
staff
suggested
amendment
makes
various
technical
changes.
A
J
A
Next
on
the
agenda
are
the
Medicaid
regs,
commissioner,
if
it's
all
right
with
you
we'll
we
have
a
few
people
signed
up
to
testify,
let's
go
ahead
and
let
those
people
testify
first
and
then
we'll
get
into
the
the
rugged
cell.
So
up
first,
who
do
we
have
see.
B
A
I
will
ask,
since
we
do
have
several
people
speaking
today.
Just
keep
your
comments,
brief
I
know
last
session
or
last
meeting
we
had,
we
had
a
lot
of
people.
That
said
the
same
thing
again:
we
want
to
make
sure
everybody
gets
their
voice,
make
sure
their
voice
is
heard,
but
just
not
duplicate
testimony.
So
if
everybody
can
be
brief,
I
appreciate
it
towards
your
service.
Please
identify
yourself.
R
My
name
is
John
Bowman
I'm,
the
Kentucky
campaign
coordinator
for
dream.org
I'm,
here
to
speak
on
behalf
of
these.
These
regs
I
am
someone
that
has
used
the
Medicaid
services
before
for
here
effort
Dental
on
Vision
Services,
when
I
was
in
in
treatment
and
for
people
in
recovery.
These
things
are
are
huge.
R
It
gives
people
that
sense
of
self-worth,
and
you
know
if
we
want
people
to
be
productive
members
of
society,
then
we
need
to
back
them
with
these
services,
so
they
can
have
that
confidence
to
get
out
and
better
themselves
and
I'll
leave
it
at
that.
Thank
you.
Thank.
L
Hi,
my
name
is
Ann
Perkins
I'm,
the
executive
director
of
Safe
Harbor
of
Northeast
Kentucky
I'm,
a
domestic
violence
program
that
serves
the
fiveco
ad
District
Boyd
Greenup,
Carter,
Lawrence
and
Elliott
counties
I've
been
in
this
position
and
serving
families
for
over
35
years
and
I
can
tell
you,
without
a
shadow
of
a
doubt
that
Medicaid
services
for
our
families
have
been
the
most
empowering
and
performative
measures
that
we
can
give
to
our
clients
in
the
in
Kentucky.
You
know
we
have.
L
We've
had
the
highest
rates
of
families
removed
from
the
home
for
the
last
four
decades.
We
lead
the
nation
actually
per
capita
and
families
removed
from
the
home.
So
when
you
remove
families
and
children
from
each
other,
you've
created
a
system
with
no
support
system
so
places
like
Safe
Harbor.
There's
15
of
our
programs
across
the
state
of
Kentucky.
L
Some
of
us
or
most
of
us
are
the
only
support
system
for
these
families.
So
when
they
walk
into
our
program,
we
actually
provide
ways
for
them
to
get
into
Dental
Care
get
into
Primary,
Care,
Providers
and
every
kind
of
services
that
they
need
to
get
back
on
their
feet
and
get
back
to
being
a
productive
citizens.
L
Putting
people
to
work
is
what
our
agency
is
doing
and
the
only
way
that
a
person
is
going
to
leave
a
domestic
violence
relationship
is
knowing
that
they're
going
to
be
independent
and
can
make
it
on
their
own.
So
if
we
don't
wrap
our
arms
around
those
folks
who
need
us,
the
most
who
are
third
generation,
foster
care
with
no
support
system
whatsoever.
We're
not
going
to
have
the
kind
of
state
that
we
envision.
Everyone
in
this
room,
I
think
wants
to
be
number
one
in
jobs
number
one
in
education
number
one
in
health
care.
L
Your
money
will
never
be
better
spent
I
have
a
principle
and
holy
at
Holy
Family
in
Ashland,
who
is
a
former
client
of
Safe
Harbor
he's
identified
that
I
have
teachers,
I
have
superintendents
I
have
the
former
head
football
coach
at
Morehead,
State
University.
All
of
these
folks
are
former
victims
who
are
survivors
because
they
had
an
opportunity
in
one
of
our
programs
to
go
to,
and
they've
all
testified
to
that.
L
So,
yes,
we
are
talking
about
the
poorest
of
the
poor
with
Medicaid,
but
we're
also
talking
about
people
who
brought
themselves
through
with
a
support
system
that
you
all
can
help
provide
by
making
all
these
health
services
available
for
our
citizens.
We
talk
about
Economic
Development.
We
need
people
to
work
when
people
tell
me
that
that
these
folks
don't
want
to
work.
I
have
never
had
a
person
walk
into
my
program.
That
told
me
they
did
not
want
to
go
to
work.
I've
never
had
that.
L
L
A
One
second
Senator
Thayer.
T
Thank
you
and
I
certainly
appreciate
your
testimony,
but
I've
been
here
20
years
and
seems
like
all
we
do
is
add
more
people
to
the
Medicaid
roles.
If
this,
if
these
programs
are
working
so
well,
how
come
people
aren't
dropping
off
the
rolls
and
we
keep
adding
more
people
to
the
welfare
system
paid
for
by
the
hard-working
taxpayers
of
the
state
I'm.
L
Glad
you
asked
that
question.
One
way
that
that
happens
is
when
we
don't
have
the
concerted
effort
amongst
all
of
us
in
this
state
to
provide
that
support
system.
Then
that's
how
you're
going
to
perpetuate
or
keep
this
what
I
call
cycle
of
poverty
or
domestic
violence
or
addiction
going.
So
it's
not
going
to
happen
overnight
for
sure,
but
I
can
tell
you
and
I've
seen
it
because
I've
been
there
for
35
years,
when
I
walk
into
Walmart
and
when
I
walk
into
places
all
over.
My
community
and
people
tell
me
that
they
are.
L
They
have
bought
their
own
home,
that
they
are
in
a
job
that
is
totally
self-sustaining.
Then
that's
proof
in
the
pudding.
If
we're
going
to
break
the
cycle,
then
we've
got
to
do
the
whole
infrastructure
issue,
which
is
support
services
for
health
to
be
able
to
get
a
job.
That's
the
number
one
thing
we
do
is
get
people
back
on
their
feet:
to
be
able
to
get
a
job
go
to
school
and
make
a
difference.
L
So
I
totally
understand
what
you're
saying
Senator
thing:
I
I
totally
get
that
because
we
still
don't
have
that
wrap
around
component
for
those
most
vulnerable
citizens,
our
programs
at
zero
V,
which
is
our
new
name.
Kentucky
domestic
violence
coalition,
we're
probably
the
most
holistic
programs
that
we
have
in
the
state
that
actually
House
people
get
people
into
school,
get
get
them
educated
and
get
them
into
jobs.
When
you
have
holistic
programs,
then
that's
when
you're
going
to
be
able
to
turn
that
tide
on
these
families.
T
Everything
you
do
for
domestic
violence
in
this
Commonwealth
I
appreciate
those
efforts.
I've
been
supportive
of
funding
those
efforts,
but
when
it
comes
to
Medicaid,
there's
no
work,
there's
no
work
requirement
and
all
I'm
saying
is
all
we
do-
is
keep
adding
more
and
more
people
to
the
Medicaid
roles
that
the
taxpayers
continue
to
support
So
before
anybody
else
comes
up
here
and
wants
to
give
us
the
same
speech
that
you
gave
us
today
just
know
that
there's
a
little
bit
of
skepticism
coming
from
me.
L
There
I
cannot
even
tell
you
a
handful
of
people,
I
house,
150
people
a
day
in
my
program.
I
have
emergency,
I
have
60
beds,
I
have
30
beds
in
transitional.
I
have
34
one
two
three
bedroom
apartments:
I
can't
tell
you,
but
a
handful
of
our
Medicaid
recipients
that
don't
have
a
part-time
job.
If
they
get
a
full-time
job,
they
lose
everything
and
that's
how
we've
set
the
system
up
and
that's
how
it
works.
But
almost
I
would
say
70
of
all
my
Medicaid
people
work
part-time.
That
are
able
to
thank.
A
F
Z
Is
something
that
we're
hoping
to
decrease
the
incidence
of
just
out
of
curiosity
I
just
wanted
to
know
if
you
were
familiar
with
the
Office
of
Vocational
Rehabilitation
work
with
them
for.
Z
L
L
T
One
more
comment
again:
I
appreciate
the
work
you're
doing,
but
I
think
you
know
we're
talking
about
two
different
things
here:
the
great
work
you
do
for
domestic
violence,
victims
I
mean
that
is
that
is
a
calling
and
I
appreciate
it.
But
there's
a
separate
issue
here
of
continuing
to
throw
more
and
more
money
into
Medicaid.
T
Into
the
workforce,
but
when
I
continue
to
see
these
stories
about
these
18
to
34
year
old
white
men,
who'd
rather
sit
home
on
their
couch
with
their
Netflix
remote
and
their
doordash.
It
really
aggravates
me
that
they're
living
on
the
taxpayers
money
when
they
are
able-bodied
and
should
be
out
there
working
because
there
are
jobs
out
there
waiting
for
them.
That's
the
you
got
to
give
a
speech
today
and
so
did
I.
Thank
you.
Mr
chairman
yeah,.
Q
X
Q
D
Q
One
of
and
I
completely
agree
with
Senator
there
as
far
as
able-bodied
people
unwilling
to
participate,
I
think
it's
almost
a
theft
and
it's
something
we
have
to
deal
with.
Q
But
one
way
we
do
make
sure
that
we
increase
participation
in
the
workforce
which
we
have
not
enough
of
in
Kentucky,
is
making
sure
they
have
those
basic
necessities
like
Vision,
like
Dental,
like
hearing,
and
that's
what
we're
here
today
for
right
to
make
sure
that
expansion,
so
that
people
can
be
back
in
the
workforce,
because
the
failure
to
do
so
in
Kentucky
has
led
us
to
be
very
far
behind
the
rest
of
the
country.
And
we
talk
about
the
cycle.
Q
So
we
want
to
make
sure
that
we
have
ready,
enable
Workforce
and
hope
God
willing
at
that
point.
But
I
do
understand
that
if
someone-
if
they
have
horrific,
Dental
issues,
if
they
have
bad
hearing
those,
then
sometimes
we
do
know
from
statistics
that
does
affect
participation.
So
we
have
to
look
at
statistics
and
we
work
that
and
we
got
to
be
smarter
about
it.
So,
while
I
do
share
some
strong
feelings
that
someone
who's
able-bodied
and
just
just
lazy,
unwilling
I
don't
want
to
reward
that
conduct.
But
I
do
think.
Q
L
I
agree:
I
have
one
quick
story:
I
just
had
a
a
stage,
three
lung
cancer
survivor
who
could
not
access
her
chemotherapy
because
she
had
abscessed
teeth
and
it
took
almost
two
months
for
her
to
find
a
way
to
get
that
Dental
Care
taken
care
of,
and
it
was
because
I
had
a
a
dentist
who
my
own
personal
dentist,
who
I
called
and
asked
if
he
would
take
care
of
her.
L
L
Those
doctors
deserve
a
decent
reimbursement
for
the
work
that
they
do
and
that's
one
important
reason
for
this
regulation
to
be
effective.
We've
got
to
have
decent
reimbursements
for
those
folks.
He
did
it
for
us.
I
I
gave
him
five
hundred
dollars
to
do
that
for
her,
so
that
she
could
start
her
chemotherapy.
She's
done
great.
She
called
me
up
and
she
paid
back
the
money
that
that
was
that
Safe
Harbor
gave
her
so
that
I
could
pay
it
forward
to
the
next
person
she's.
L
AA
Good
afternoon,
some
of
you
thought
I
had
retired,
but
not
yet
I'm,
Dr,
Sheila,
Schuster
I'm,
a
licensed
psychologist
and
executive
director
of
the
Kentucky
mental
health
Coalition,
which
is
80
plus
organizations
of
consumers,
family
members
providers
and
Advocates.
Thank
you
for
this
opportunity
before
addressing
each
of
the
regs
I.
Just
want
to
remind
you
all
that
our
physical
health
and
our
mental
and
emotional
health
are
inextricably
woven
together.
AA
Think
of
the
last
time
that
you
had
a
physical
illness
or
ailment
of
some
kind
and
recollect
what
your
emotional
or
mental
state
was.
While
you
were
dealing
with
that,
and
the
same
is
true
in
reverse.
The
manifestations
of
depression
or
anxiety
or
mental
confusion
are
often
experienced
in
changes
in
our
bodily
functions
in
a
disrupted
sense
of
physical
well-being.
Sometimes
it's
difficult
to
know
which
came
first
and
what's
exacerbating
the
other.
It's
why
we
preach
the
necessity
for
integrated
or
whole
person
care
so
that
both
physical
and
mental
health
can
be
addressed.
AA
So
I'd
like
to
call
your
attention
to
the
mental
health
benefits
of
these
physical
health
services,
so
we
think
about
eyes
and
ears
and
teeth,
and
we
think
of
those
as
physical,
but
each
one
of
these
has
tremendous
Mental
effects
if
they
are
not
treated
having
the
ability-
and
this
is
about
hearing
having
the
ability
to
hear,
alarms,
audio
directions
and
warnings.
Sirens
and
other
Communications
is
associated
with
safety
in
times
of
emergency
or
when
a
crick
responds
to
a
verbal
command
or
information
is
needed.
AA
AA
If
you
know
anyone
who
has
a
hearing
loss,
they
will
tell
you
the
number.
One
thing
is:
how
isolated
that
condition?
Is
it
constantly
interferes
with
the
individual's
ability
to
communicate
with
others
to
be
functional
in
social
situations,
whether
in
the
family,
the
community
or
in
school
or
work
settings?
Hence,
there's
a
strong
link
between
hearing
loss
and
a
likelihood
to
develop
or
exacerbate
mental
health
conditions
such
as
anxiety
and
depression.
AA
We
know
that
hearing
loss
is
often
associated
with
early
onset
dementia
in
adults,
a
condition
which
is
very
costly
to
both
the
member
and
their
family
in
terms
of
memory,
loss
and
socialization
difficulties,
but
also
very
costly
to
the
Commonwealth
of
of
Kentucky,
undiagnosed
and
untreated
hearing
loss
has
long-term
effects
on
health
leading
to
higher
health
care
costs.
People
with
hearing
loss
have
over
a
10-year
period
of
47
percent,
increased
rate
of
hospitalization
and
then
on
the
dental
side.
AA
Look
if
they
have
teeth
or
the
need
to
hide
chronic
halitosis,
which
is
the
result
of
dental
decay.
One
self-esteem
is
highly
correlated
with
the
way
in
which
one
sees
oneself
or
how
we
perceive
others.
Seeing
us
impacting
the
sense
of
being
accepted
and
belonging
or
not.
One
concerning
aspect
of
untreated
dental
pain
is
the
prescribing
of
opioids
in
the
ER,
when
an
individual
with
dental
pain
is
seen
there.
AA
To
read
and
follow
prescription
directions
or
other
health
care
information
on
the
mental
health
side,
it
is
crucial
for
them
to
be
as
contributing
members
of
society
or
to
see
themselves
in
a
favorable
way.
We're
talking
about
Workforce
Readiness
here
folks
and
there's
been
a
lot
of
talk
about
that.
AA
She
was
scheduled
to
speak,
but
had
a
conflict
in
fact,
is
at
a
conference
to
talk
about
what
she
calls
the
the
mouth
brain
connection,
the
connection
between
dental
problems
and
cognitive
functioning.
She
wants
to
remind
us
that
she
has
a
letter
from
her
organization
supporting
these
regulations
and
wants
to
remind
us
that
of
the
link
again
between
hearing
dental
vision
and
the
development
of
dementia,
dementia
and
Alzheimer's
are
the
third
leading
most
expensive
diseases
that
we
have
in
the
United
States.
AA
So
in
closing,
I
just
want
to
remind
you
all
that
if
we
want
our
Medicaid
members
to
have
all
that
they
need
both
physically
and
mentally,
so
that
they
can
be
fully
contributing
members
of
society
that
we
need
to
see
a
continuance
of
these
excellent
benefits
and
I'm
happy
to
answer
any
questions,
except
what
I'm
going
to
retire.
AA
T
AA
T
Sheila
I
want
to
bring
up
a
point
about
some
of
the
earlier
testimony
chairman
Mosher,
just
texted
me
a
really
good
point
that
I
want
to
put
on
the
record
that
this
General
Assembly
under
current
majority
leadership,
is
dealing
with
the
benefits
Cliff
situation
to
deal
with
people
losing
benefits
because
of
full-time
employment
and
chairman
Mosher
wanted
to
remind
the
committee
that
we
are
using
a
benefit,
Cliff
modeling
tool
to
stare
step
folks
off
their
benefits
versus
an
Abrupt
Cliff,
which
will
allow
them
a
raise
or
better
job
without
fear
of
losing
assistance.
T
So
I
wanted
to
get
that
on
the
record
and
also
I
was
speaking
with
representative
Frazier
Gordon.
Who
knows
a
lot
more
about
this
topic
than
I
do,
and
she
pointed
out
that
we
do
fund
Vocational,
Rehabilitation
programs
that
have
a
work
requirement
and
that
there
are
a
lot
of
programs
out
there
that
we
can
fund
with
a
work
require
requirement
that
helps
people
get
a
leg
up
a
hand
up
rather
than
a
permanent
handout.
On
behalf
of
the
taxpayers.
Anything
like
that
that
helps
people
get
back
into
the
full-time
Workforce.
T
It's
not
only
good
for
society,
it's
good
for
them
as
a
person,
because
there
is
no
better
program
than
an
able-bodied
person
having
a
well-paying
job,
because
there
is
integrity
in
every
kind
of
work,
every
profession,
every
career,
every
job.
There
is
integrity
in
that
there
is
honor
in
that
and
there's
nothing
better,
in
my
view,
other
than
a
stable
family
life
that
helps
people
feel
like
they
are
making
a
solid
concert
abusion
to
society,
as
well
as
leading
to
better
self-esteem
outcomes.
So
thank
you
for
letting
me
give
another
speech.
Mr
chairman.
M
My
name
is
Alicia
Watley
I'm,
with
Kentucky
youth
advocates
in
the
Kentucky
oral
health
Coalition
good
to
see
you
all
again.
Thank
you,
chair
Lewis,
for
the
time
today
so
I'm
here
on
behalf
of
the
Kentucky
oral
health
Coalition,
which
is
a
network
of
folks
around
the
state
who
are
just
looking
to
make
oral
health
better
in
Kentucky
I
want
to
First
just
Echo
the
sentiments
that
you
all
have
heard
for
several
months
now.
I'm
not
gonna,
sit
here
and
kind
of
re-educate
on
why
oral
health
is
important.
M
We've
all
heard
that
several
folks
have
talked
about
that.
So
I,
don't
want
to
repeat
that
message,
but
I
do
want
to
talk
a
little
bit
about
some
important
details
that
we
think
need
to
be
looked
at
as
we
move
forward
to
find
a
permanent
path
for
benefits
for
adults
in
Kentucky
on
dental
care,
so
the
first
of
that
is
continuity
of
care.
This
is
a
concept,
that's
been
brought
up
for
several
months
and
it
is
still
really
important
to
the
more
than
one
million
kentuckians
who
are
on
the
Medicaid
Program.
M
So
we
were
really
encouraged
to
see
you
all.
Look
at
this
with
Senate
Bill
65
and
ensuring
that
those
who
were
in
active
treatment
plans
at
the
time
were
able
to
continue
that
even
after
those
regulations
were
ascended,
but
we
still
have
hundreds
of
kentuckians
that
are
in
active
treatment
plants
now,
with
the
current
emergency
regulations
that
are
in
place
and
any
action
taken
to
rescind
those
regulations
could
jeopardize
their
ability
to
receive
that
care.
M
So
we
are
asking
that
you
consider
that
reality
When
approaching
a
more
permanent
solution
to
oral
health,
and
this
has
also
impacted
Medicaid
providers
that
are
providing
this
dental
care
for
folks,
we've
seen
many
providers
who
have
come
to
us
and
said
that
they
are
hesitant
or
are
refusing
to
offer
the
expanded
Services
because
of
the
uncertainty
around
the
permanency
of
those
benefits
and
the
impact
that
might
have
on
their
offices
as
well.
The
second
part
of
this
is
the
reimbursement
rates
for
providers.
We've
all
talked
about
this
as
well
and
I
know.
M
A
lot
of
the
members
of
this
committee
are
well
aware
of
the
deficiencies
in
the
current
fee
schedule,
especially
prior
to
the
increase
that
happened
this
year,
but
also
the
deficiencies
that
continue
in
the
current
fee
schedule.
Many
Medicaid
providers
in
Kentucky
that
offer
Dental
Care
are
operating
at
a
loss
to
be
able
to
do
that
and
provide
to
the
vulnerable
members
of
their
communities.
A
lot
of
others
choose
not
to
absorb
that
loss
in
order
to
provide
that
care.
M
The
rate
increases
that
were
seeing
earlier
this
year
were
welcomed
by
providers,
of
course,
across
the
state,
but
they
simply
were
not
enough.
I
am
not
a
dental
provider,
so
I'm
not
going
to
pretend
to
know
what
it
takes
to
perform
a
root
canal
or
make
a
set
of
Dentures
for
for
a
patient,
but
I
do
know
that
dentists
have
come
to
us
at
the
Coalition,
with
concerns
about
being
able
to
continue
to
offer
services
at
the
current
rates.
We
also
would
urge
this
committee
to
continue
talking
to
Providers
I
know.
A
AB
Hi
I'm
Melvin,
yo
I'm,
actually,
the
chair
of
the
Department
of
overall
health
science
at
the
University
of
Kentucky
College
of
Dentistry,
so
I
oversee
many
of
the
Dental
Specialty
divisions
at
the
college
includes
Public
Health,
Dentistry,
Orthodontics,
Pediatric,
Dentistry
oral
pathology,
adult
Hospital,
Dentistry,
Oral,
Facial,
Pain
and
oral
maxillofacial
surgery.
This
is
pretty
much
most
of
the
Specialties
that
we
have
in
dentistry.
AB
I
am
in
an
oromaxofacial
surgeon,
that's
Fellowship,
trained
and
head
and
neck
surgery,
so
I
have
degrees
in
both
Dentistry
and
Medicine.
A
large
portion
of
my
practice
is
devoted
to
the
treatment
of
oral
cancer.
So
when
the
expansion
of
dental
Medicaid
happened,
I
was
extremely
excited
about
it,
because
now
it
covers
the
fabrication
of
prosthesis
that
can
cover
the
deformities
that
oral
cancer
patients
have
and
from
its
Associated
treatments.
Prior
to
this
now,
patients
that
have
breast
cancer
can
have
mastectomies
and
have
reconstructions
easily
and
paid
for
by
Medicaid.
AB
Patients
on
outside,
on
the
dental
side
never
had
that.
But
with
this
expansion
and
dental
Medicaid,
it
has
brought
that
to
us
and
we
were
extremely
happy
to
have
that,
but
not
only
that
those
services
covered.
You
know
the
additional
services
that
are
covered
by
Dental
Medicare
expansion
is
actually
very
exciting
because
we
think
it
can
do
a
lot
for
us
as
providers
of
dentistry
in
Kentucky.
AB
So
even
with
this
expansion
of
dental
Medicaid
services
in
Kentucky,
we
still
have
a
shortage
of
dentists
outside
of
the
Louisville
Covington
and
Lexington
areas,
and
as
a
greater
shortage
of
even
greater
stories
of
dental
providers
that
accept
Dental
Medicaid,
so
the
UK
College
of
Dentistry.
We
feel
that
this
shortage
of
Medicaid
dental
provides.
We
really
feel
the
shortage
of
Medicaid
dental
provides
in
rural
Kentucky
firsthand.
You
know,
along
with
the
University
of
Louisville,
we
are
the
safety
net
providers
for
dentistry
in
the
state.
AB
They
often
travel
many
hours
just
to
have
simple
procedures,
such
as
teeth
extractions,
which
could
have
been
completed
in
the
community
if
they
were
providers.
This
actually
places
an
undue
burden
on
our
practice,
as
it
increases
the
wait
time
for
patients
that
require
more
complicated
procedures
that
only
an
academic
institution
can
provide
one
of
the
main
reasons
that
extraction
rates
are
so
high
in
Kentucky
is
due
to
the
lack
of
dental
care
access
for
Delta
Medicaid.
AB
Not
only
do
high
rates
of
extractions
result
from
that,
one
can
also
develop
life-threatening
head
and
neck
infections
from
carious
teeth.
Multiple
patients
are
transferred
on
a
weekly
basis
with
threatening
head
and
neck
infections
secondary
to
bad
teeth.
Many
of
these
patients
are
even
airlifted
from
rural
hospitals
and
these
patients,
when
they
arrive,
required
multiple
trips
to
the
operating
room
and
lengthy
hospital
stays
costing
us
an
undue,
but
a
financial
burden
on
the
medical
Medicaid
side,
but
the
amount
of
money
it
costs,
and
but
the
issue
is
the
majority
of
these.
AB
Patients
have
had
Medicaid
insurances
and
they
had
hard
time
getting
into
a
dentist
just
for
early
treatment
of
their
bad
teeth.
A
simple
filling
or
root
canal
could
have
could
have
alleviated
that
long,
Hospital
stay
and
life-threatening
infection,
so
another
disease,
that's
near
and
dear
close
and
close
to
my
heart
is
or
cancer.
This
could
actually
be
increa.
This
could
be
reduced
with
increased
access
to
dental
care.
Kentucky
is
second
in
the
nation,
in
the
prevalence
of
Oren
for
oral
pharyngeal
cancers
in
the
country.
AB
Mom
thinks
I
want
to
highlight
is
that
oral
cancer
is
a
dental
disease.
The
majority
of
these
cancers
are
diagnosed
by
the
dental
Community
when
these
cancers
are
diagnosed
late.
Not
only
do
the
patients
do
poorly
in
prognosis,
the
cost
to
treat
these
patients
also
increase
significantly
early
stage.
Cancers
can
be
treated
with
what
we
call
single
modal
therapy,
such
as
surgery
or
radiation
alone,
but
when
a
cancer
is
in
the
later
stages,
as
many
of
the
cancers
I
treat
are,
multimodal
therapy
is
required.
AB
AB
So
there
is
no
quick
fix
to
the
lack
of
dental
providers
in
rural
Kentucky
with
the
expansion
of
dental
Medicaid
services.
It
is
definitely
a
good
start.
Every
year
about,
180
dentists
are
graduated
between
the
University
of
Louisville
and
University
of
Kentucky.
Dental
schools
I'm
not
sure
if
there's
a
true
shortage
in
terms
of
the
number
of
dentists
in
Kentucky,
but
geographically
in
many
of
the
rural
areas,
there's
a
major
shortage.
AB
Many
of
these
new
grads
are
from
these
high
Medicaid
rural
areas,
we're
hoping
that,
with
the
expansion
of
services,
some
of
these
graduates
will
be
amenable
to
returning
home.
Opening
a
dental
office
they'll
be
able
to
provide
the
same
breadth
of
Medicaid
covered
Services
instead
of
a
commercial
insurance.
AB
An
example
alone
is
actually
I
have
an
oramaxofacial
surgery,
resin
graduating
in
June
of
2024,
and
she
has
already
committed
to
work
in
a
rural
County.
Servicing
a
majority
of
Medicaid
population-
and
this
I
like
to
say,
is
probably
due
to
the
Medicaid
expansion
Dental
medication.
Actually
I
could
say
that
it's
definitely
due
to
the
dental
Medicaid
expansion.
AB
An
additional
point
I
like
to
bring
up
is
that
when
dental
offices
are
open
in
communities,
not
only
do
they
bring
Health
Care
to
the
community,
they
also
bring
jobs
and
put
money
back
into
these
economically
depressed
communities.
So
this
expansion
not
only
helps
the
People's
Health
Care
wise,
but
can
also
help
the
communities
economically.
Thank
you.
A
Dr,
Bill
Collins
says
hello.
Thank
you
all
right
with
that
being
said,
Madam
Secretary
will
you
go
ahead
and
get
into
the
regulation
itself
and,
and
commissioner
a
few
and
you
come
forward.
C
907
KR
1025
amends
to
address
duly
licensed
pediatric
facilities
with
the
amendment
and
federal
approval
of
estate
plan
Amendment.
So
it
will
be
possible
for
individuals
who
turn
21
years
of
age
while
in
a
duly
licensed
pediatric
facility
to
remain
in
the
care
of
that
facility
and
to
comply
with
Keras
chapter
13A.
The
staff
Amendment
amidst
various
sections
to
comply
with
Karis
chapter
13A.
K
907-1632
amends
Kentucky,
Medicaid
vision
program
Provisions
to
make
technical
Corrections,
including
for
consistency
with
907-3005
Implement.
A
state
plan
amendment
that
allows
for
adults
to
receive
Vision
Services,
clarify
cost
saving
requirements
in
order
for
providers
to
deliver
services
on
a
non-medicade
basis,
clarify
vision,
service
limits
require
that
a
higher
quality
of
frames,
lenses
and
lens
enhancements
be
available,
clarify
that
contact
lenses
are
covered
and
available,
including
daily
lenses,
and
update
the
vision
fee
schedule.
K
The
amended
after
Commons
version
amend
section
4
to
clarify
the
referenced
warranty
is
the
manufacturer's,
warranty
and
amend
Section
5
to
clarify
that
daily
contact
lenses
are
disposable
lenses.
The
staff
suggested
amendments
amend
various
sections
to
comply
with
KRS
chapter
13.
A
the
proposed
agency
Amendment
for
907-1126
amends
section.
6
pertaining
to
diagnostic
service
service
covers
limitations
to
remove
from
the
list
of
services
that
shall
not
be
covered
in
conjunction
with
a
comprehensive
oral
evaluation,
a
limited
oral
evaluation
for
trauma-related
injuries
and
delete
limitations
on
specific
situations
regarding
limited
oral
evaluations.
A
Thank
you
all
for
coming
today.
I
feel
like
very
familiar
with
each
other
now,
but
please
introduce
yourself
for
the
record.
Yes
good
afternoon.
Hi
I'm
Wesley
Duke
I'm,
the
general
counsel
at
the
cabinet.
A
And
Jonathan
Scott
Rec
coordinator
again,
thank
you
all
for
coming
today
and
I
appreciate
your
Indulgence
I
wanted
to
make
sure
all
the
speakers
got
to
speak
and,
and
everybody
you
know,
could
share
their
views.
There
are
staff
amendments.
Is
there
a
motion
for
the
staff
amendments?
A
T
H
Q
F
Recommendations
from
our
Dental
technical
advisory
committee,
we
found
that
one
provision
in
our
reg
was
a
little
bit
more
stringent
than
it
should
have
been
and
So.
Based
on
their
recommendations.
We
removed
some
of
those
limitations
to
allow
those
services
to
be
provided
without
those
barriers
to
care.
AC
I'd
just
like
to
say
one
thing:
I
spoke
quite
a
bit
at
the
last
meeting
in
the
opposition
of
therefore,
but
I
still
want
to
stress
my
feelings
that
expanded
Services
cost
additional
money.
It
is
an
expenditure,
and
this
is
not.
This
is
not
the
proper
committee
to
be
doing
that
in
it
should
be
under
a
r
and
as
Senator
Dame
Thayer
suggested
earlier.
We
are
working
on
proper
ways
to
address
this
through
the
Cliff's
benefit
task
force
through
work
procedures
and
other
items.
AC
So
you
know
that's
just
try
to
explain
where
we
stand
here.
I
don't
have
any
problem,
helping
people
with
medical
needs,
but
I
do
have
a
problem
when
there
is
a
a
proper
way
to
do
things
and
an
improper
way
to
do
it.
These
regs
have
been
found
deficient
in
the
past
they've
brought
on
immediately
after
the
last
session
and
I
feel
like
this
is
more
of
a
loophole
or
political
move
than
it
is
to
addressing
the
real
issues
and
doing
it
in
a
proper
manner.
Thank
you,
Mr
chair.
A
A
That
being
said,
you
know
last
week
yourself,
commissioner,
and
secretary
Freelander
jumped
on
the
call
with
myself
and
Senator
West
and
really
do
appreciate
you
reaching
out,
and
you
know,
with
that
commitment
of
I
know
we
talked
about
speaking
with
Appropriations
and
revenue
members
and
then
also
members
on
the
health
committee
as
well
and
I.
Think
that
goes
a
long
way
into
working
this
out.
I
know
other
members
are
working
on
solutions
for
session,
but
that
being
said,
there's
many
members
here
that
wanted
to
find
this
regulation
deficient.
A
But
you
know
because
of
the
communication
that
we
are
having
and
going
forward.
We
believe
this
regulation
belongs
in
the
health
committee,
so
we
will
not
be
calling
that
making
that
motion
today.
B
That
concludes
our
agenda
for
this
month.
Our
next
meeting
is
currently
scheduled
for
Tuesday
October
10th
at
1
pm.