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A
B
A
This
we
want
to
welcome
you
to
our
last
meeting
of
2022
of
the
tobacco
settlement
agreement
fund
oversight
committee
and,
as
we
begin,
I
would
like
to
take
a
moment
to
recognize
Senator
Dennis
Parrott.
This
will
be
his
last
meeting
serving
here
as
a
member
of
our
Senate
and
I.
Want
you
to
know
I
greatly.
D
You
know
any
anybody
that's
been
here,
you
know,
there's
there's
there's
good
and
bad,
but
it's
it's
still
a
it's.
It's
still
a
a
wonderful
Arena.
If
you
want
to
call
it
that
to
get
good
legislation
passed
and-
and
you
know
legislation
brings
this-
this
brought
forth
to
the
legislators
to
vote
on
and
and
discuss.
D
There's
been
a
lot
of
dialogue
and
all
those
meetings
and
this
and
it's
all
most
of
us
not
all
of
it.
Certainly,
but
it's
healthy
and
it's
you
know,
that's
what
government
government
works
and
and
I
think
here
in
Kentucky
I,
don't
know
about.
E
C
D
Up
there,
just
like
at
no
better
as
much
as
they
do
and
and
I
I'm
proud
to
be
have
been
a
part
of
this,
but
on
the
flip
side,
I'm
glad
I'm
done
and
my
wife
is
a
lot
happier
that
I'm
done
and
the
grandkids
and
and
I'm
certainly
look
looking.
You
know
more
forward
to
you
know,
add
more
time
with
the
grandkids
and
and
can
get
a
little
more
work
done
on
the
farm.
D
So
but
it's
been
a
it's
been
a
wonderful
thing
for
for
our
family,
even
our
grandkids
they'll
they'll
ask
questions
about
legislative
stuff.
You
know,
that's
that's
the
way
it
started
and
that's
and
I'm
proud
of
that
too.
But
but
I
certainly
I
appreciate
this
place.
A
Well,
you're,
appreciated
and
I
want
you
to
know.
I
think
everyone
needs
to
remember
this.
We
as
a
legislative
body
are
only
as
good
as
those
members
that
serve
in
this
legislative
body
and
Senator
parrot.
You
are
one
of
the
fine
ones
that
I've
had
the
opportunity
serving
with
and
you're
greatly
appreciated,
and
you
have
always
been
so
open
and
welcoming
to
me
during
the
when
we're
in
session.
So
you
are
appreciated
greatly
and
Senator
Webb.
Would
you
like
to
add.
F
I,
would
you
know
it's?
We
hate
we're
not
losing
Dennis,
because
we
know
where
his
farm
is
and
I
pass
by
there
all
the
time.
F
So,
but
you
know
to
have
his
knowledge
of
Agriculture
of
tobacco
settlement
dollars
and
thanks
he's
done
all
of
his
life
made
his
living
ad
and
and
the
network
that
he's
had
and
the
experiences
that
he's
had
in
the
industry
to
begin
with,
you
just
can't
find
that
every
day
and
then
to
to
be
losing
that,
at
a
time
when
the
challenges
are
so
great
with
Urban
Rural
and
federal
and
state
and
Global
AG
issues,
you
know
it.
F
He
is
so
but
from
our
family
to
theirs.
I
understand
the
you
know:
the
demands
it
is
on
the
family
and
and
how
happy
I've
talked
to
his
wife
a
lot
and-
and
you
know
she
seems
a
little
lighter
to
deal
with
now,
but
Dennis.
We
love
you
and
our
legislative
family
will
miss
you
here.
Yeah.
A
A
But
our
fa
I've
always
said
our
families
are
the
ones
who
really
pay
the
price
for
our
service
up
here.
Our
job
is
even
though
it's
hard
they
their
their
job
at
home,
is
a
lot
harder
when
we're
not
there.
So
we
greatly
appreciate
your
service.
Thank
you.
Okay.
Now
we'll
move
on.
We
like
to
ask
the
clerk
to
call
the
road.
Please.
D
E
A
Do
have
a
forum,
and
the
next
part
on
our
agenda
will
move
toward
approval
of
the
minutes
for
November
meeting.
Do
I
get
a
motion
please,
and
a
second.
D
A
Those
in
favor,
please
say:
aye,
not
opposed
minutes
passed
next,
we'll
move
on
we're
going
to
change
our
order
of
our
normal
business,
we're
going
to
ask
Dr
Mark
Evers.
A
If
he
will
please
come
to
the
table
and
we
have
Dr
Jason
Chesney,
who
I
believe
is
online
and
they're
going
to
speak
to
us
about
the
utilization
of
tobacco
settlement
dollars
for
cancer,
research
and
I.
Ask
you
to
make
sure
to
hit
your
microphone
and.
G
G
G
I
I
really
want
to
thank
everybody
for
for
having
me
here.
It's
always
great
honor
to
come
and
talk
about
the
market.
Cancer
center
and
I
really
appreciate
all
the
support
that
this
committee
and
the
legislature
has
has
given
to
us.
I
will
try
to
be
fairly
brief.
Our
mission
at
the
Marquis
Cancer
Center
is
to
reduce
the
cancer
burden,
with
a
focus
on
Kentucky
and
its
most
vulnerable
populations.
G
The
research
prevention
treatment,
education
and
Community
engagement,
I
I,
don't
need
to
tell
this
audience
about
Kentucky
challenges,
but
we
do
face
a
number
of
challenges
here.
In
Kentucky,
one
is
poverty
about
17
percent
of
our
population
in
Kentucky
live
in
poverty.
We
have
45
counties
of
the
120
that
are
considered
as
persistent
poverty
and
those
are
predominantly
in
Eastern
Kentucky.
G
Other
significant
challenges
that
we
Face
include
smoking,
obesity,
low
education
attainment
as
well
as
cancer
burden.
So
we've
made
a
lot
of
strides
I
think
over
the
last
decade,
but
unfortunately,
our
cancer
burden
is
still
severe.
We're
number
one
as
a
state
in
all
cancer
incidents.
We're
also
number
one
in
all
cancer
mortality
and
as
bad
as
that
is
in
in
the
state
itself.
G
It's
even
worse
in
our
eastern
part
of
our
state
in
in
eastern
Appalachian
Kentucky,
where
we
have
cancer
races,
some
are
are
some
of
the
highest
in
the
U.S
at
the
Marquis
Cancer
Center,
we
have
focused
on
several
cancers
that
are
are
very
prevalent
in
our
state
and
are
also
in
the
top
five
that
we
rank
in
the
top
five
in
either
instance
of
mortality.
This
includes
long
colorectal,
head
and
neck
cervical,
as
well
as
melanoma.
We
also
have
a
number
of
risk
factors
that
we
consider
as
our
research
priorities.
G
G
So
I
just
want
to
briefly
talk
about
some
of
the
impact
that
the
state
funding
has
had
on
us
and
and
a
portion
of
the
tobacco
settlement.
Funds
went
toward
NCI
designation
to
help
us
achieve
that
status,
which
we
achieved
in
2013
and
I
have
to
say.
It's
been
an
amazing
Journey,
since
NCI
designation
with
the
number
of
patients
that
we've
seen
at
the
market
cancer
center
and
the
people
that
we've
been
able
to
touch
and
treat.
G
So,
just
a
just
a
little
bit,
because
it's
very
exciting
times
now
at
the
market,
Cancer
Center,
as
I
said,
we
initially
achieved
our
NCI
designation
in
2013.
every
five
years.
We
have
to
renew
our
application,
so
we
we
did
this
in
2018
and
with
this
renewal
that
we
just
submitted
in
October,
we
we
are
applying
for
comprehensive
status,
which
is
the
the
highest
Echelon
for
NCI
designated
Cancer
Centers.
G
So
we
have
our
site
visit
that
will
be
in
February,
with
with
a
number
of
NCI
experts
and
Specialists
who
will
be
visiting
us
at
that
time.
What
has
NCR
designation
meant
to
us?
Well,
first
of
all,
it's
it's
really
been
I.
Think
impactful.
In
terms
of
the
number
of
patients
that
we've
been
able
to
see.
We
have
a
number
of
affiliate
sites
throughout
Kentucky.
G
G
G
So
what
does
Comprehensive
Cancer
Center
status
means
when
I
talk
about
this
I
say
it's
taken
us
to
the
next
level.
It
means
that
we'll
achieve
more
funding
through
the
NCI,
which
really
equates
to
more
research,
more
cancer
screening,
more
prevention,
more
clinical
trials,
increased
straw,
patients,
more
Cutting,
Edge,
early
phase
clinical
trials
with
the
latest
Cancer
Treatments,
more
more
private
donations
Etc.
So
so
it
really
is
sort
of
taking
it
to
that
next
step.
So
to
speak.
G
I'll
briefly
talk
a
little
bit
about
some
of
the
things
going
on
at
the
market,
Kansas
Center
and
again
very
much
appreciate
the
support
provided
by
the
the
tobacco
settlement,
funds,
which
has
really
helped
jump
start
a
number
of
projects
that
are
now
sustained
through
more
Federal
funding,
as
well
as
funding
from
industry
sites
Etc.
So
I
just
want
to
talk
first
about
our
lung
cancer
screening
project.
So
some
of
this
work
was
started
with
tobacco
settlement
funds
and
I
have
to
say
I'm
really
proud
of
this
program.
G
This
is
led
by
Dr,
Tim
mullet,
and
basically
this
is
screening
those
kentuckians
who
are
at
most
risk
for
lung
cancer.
This
program
has
has
been
a
Statewide
program,
but
it's
achieved
success
beyond
my
wildest
expectations.
In
fact,
Kentucky
is
now
number
two
in
the
country
for
lung
cancer.
Screening
we're
just
behind
Massachusetts
and
just
think
about
that.
G
We
lead
all
of
the
Southern
States
in
in
lung
cancer
screenings
by
by
a
long
shot,
and
what
that
has
meant
is
that
we
have
seen
a
decrease
in
our
late
stage:
lung
cancer
rate
in
Kentucky
over
the
last
several
years.
It's
about
a
19
percent
drop,
it's
two
times
faster
decrease
in
Kentucky,
compared
to
the
U.S
as
a
whole
and
even
three
times
faster
in
Appalachian
Kentucky
compared
to
the
U.S.
In
addition,
we've
we've,
through
your
help,
have
had
a
number
of
policy
changes
which
have
further
helped
us
just
most
recently.
G
I
was
here
for
the
signing
in
July
of
the
Kentucky
lung
cancer
screening
program
that
was
created
by
by
you
all,
and
the
governor
I
also
want
to
just
say
that
colorectal
cancer
we're
we're,
also
have
very
high
rates
of
that
in
the
State
and
back
in
2000.
We
actually
ranked
49th
in
the
country
and
colorectal
cancer
screening
through
a
lot
of
efforts
on
a
lot
of
people's
parts
and
including
Dr
Tucker,
as
well
as
colleagues
at
the
University
of
Louisville
Brown
Cancer
Center.
G
G
We
also
have
a
cancer
moonshot
initiative
that
has
put
in
a
significant
amount
of
funds
to
help
us
with
some
counties
in
Eastern
Kentucky
that
still
have
very
high
cancer
rates
and
I
have
to
say
all
of
this
has
been
quite
significant,
because
what
we've
seen
is
a
30
percent
decrease
in
our
instance
of
colorectal
cancer,
as
well
as
a
34
percent
decrease
in
mortality.
In
fact,
Kentucky
is
no
longer
number
one
in
in
colorectal
cancer
incidents.
G
Sir,
we
have
a
number
of
programs
in
cervical
cancer
prevention
again
we're
high
in
this
particular
Cancer,
and
a
lot
of
this
is
due
to
human
papillomavirus
or
HPV.
So
there's
been
a
significant
amount
of
work
with
screening
for
cervical
cancer,
as
well
as
increasing
vaccinations
for
HPV
I
have
to
say
as
well
that
with
the
opioid
epidemic
we've
seen
surging
rates
of
hepatitis
c,
a
virus
in
the
state,
particularly
in
our
rural
Appalachian
population
and
hepatitis
C
viruses
is,
can
can
down
the
road
cause,
cause
liver
cancer.
G
So
we're
seeing
increased
rates
of
liver
cancer
in
the
state
that
I
I
think
probably
secondary
to
our
increased
rates
of
hepatitis
C,
but
through
a
really
unique
program.
Jennifer
Havens
at
the
Markey
Cancer
Center
is
working
with
folks
around
the
state.
There's
a
project
now
to
provide
free
medication
through
a
collaboration
with
the
NCI,
as
well
as
the
other
NIH
institutes
and
Gilead
Sciences.
G
That's
providing
about
50
million
dollars
worth
of
free
medication
to
treat
Perry
County,
that's
one
of
the
highest
counties
in
Kentucky
for
for
hcv
infections
and
and
what
Dr
Havens
is
has
noted
that,
with
the
almost
400
patients
that
have
been
treated
thus
far,
she
has
seen
a
93
percent
sustained
virologic
response,
which
means
that
93
percent
of
these
patients
are
cured
of
their
hcv.
So
again
we
we
see
this
as
a
really
wonderful
project.
G
It's
it's
helping
folks
and
it's
one
of
the
first
Trials
of
its
kind,
that
is
utilizing
funds
from
NCI
and
other
NIH
institutes
as
as
well
as
Gilead
Sciences
to
to
Really
provide
that
medication.
Another
thing
that
we've
been
working
on,
the
the
citizens
of
Martin,
County
and
Eastern
Kentucky
were
quite
concerned
about
their
water
supply.
They
had
a
major
spill
of
about
300
million
gallons
of
coal,
slurry
into
their
water
supply
and
so
through,
with
our
help,
and
also
help
from
from
from
NIH
sources
and
and
grants.
G
Dr,
unrein
and
Hoover
worked
with
citizens
in
Martin,
County
and
also
Letcher
County
to
test
their
water
supply
and
also
work
with
the
engineers
in.
In
that,
in
those
two
counties
to
actually
clean
up
the
water
supply,
this
is
another
example
again.
I'll
try
to
be
brief,
but
I'm,
just
so
proud
of
this
example
as
well.
G
So
the
education
attainment
in
Appalachian
Kentucky
is
much
much
lower
than
it
is
in
the
rest
of
the
U.S,
with
most
of
most
of
the
the
population
achieving
a
high
school
education
attainment
at
best,
but
but
not
many
going
on
to
college
or
at
least
a
lower
percentage
than
the
U.S.
But
we
have
a
program.
That's
called
action:
it's
to
train
Appalachian
students
in
cancer,
they're
trained,
they're
mentored.
G
They
understand
cancer
professions,
and
this
is
really
geared
toward
Appalachian
students
undergraduate
and
high
school
students
and
of
the
60
of
the
56
undergraduate
students
from
Appalachia
that
have
gone
through
this
program.
We
now
have
25
that
have
been
accepted
to
medical
school
or
going
to
medical
school,
three
that
are
in
pharmacy
school
one.
That's
a
graduate
school
three
and
Master's
programs,
so
just
again,
something
that
has
achieved
Excellence
beyond
my
wildest
expectations.
These
students
have
now
published
two
books,
actually
their
essays
of
basically
their
experiences
with
family
friends.
G
With
cancer
and
just
just
a
moving
portrayal
of
their
lives,
you
know
what
they
face
with
with
cancer
in
their
community.
So
again,
I'm
really
proud
of
this,
because
what
I'm
hoping
is
that
some
of
these
kids,
who
are
going
to
medical
school
now
will
come
back
to
Kentucky,
particularly
in
Eastern
Kentucky,
to
practice
and
with
that
knowledge
of
cancer,
and
what's
going
on
in
their
Community,
will
be
outstanding
Physicians
for
their
for
for
their
communities.
G
G
G
A
A
No,
you
were
hand
us
over
to
Dr
Chesney.
If
he's
available
there.
H
So
can
you
hear
me:
we've
got
you
yeah,
fantastic
and
I
apologize
that
I'm
not
there.
It's
only
a
50
minute
drive
and
I
was
only
given
a
zoom
invite.
H
So
that's
why
I'm
not
and
I've
enjoyed
sitting
next
to
Dr,
Evers
and
hearing
his
talk
over
the
years
and
I
have
to
say
something
that
I'm
proud
about
is
the
fact
that
he
and
I
have
worked
together
to
have
a
joint
meeting
every
two
months
between
the
University
of
Kentucky
Marquis
cancer
center
and
the
brown
Cancer
Center
at
the
University
of
Louisville,
where
we
go
through
the
clinical
trials
that
we
have
at
each
of
the
institutions
and
educate
the
medical
oncologists
and
surgical
oncologists
and
radiation
oncologists
about
the
availability
of
clinical
trials,
and
none
of
that
would
happen
without
the
support
that
we
get
from
the
tobacco
Master
settlement
funds.
H
I
am
going
to
attempt
to
share
my
screen
and
I'll.
Ask
if
someone
can.
Let
me
know
if
I
have
shared
my
screen.
A
C
C
H
Okay
well
you've.
This
group
has
seen
this
slide
before,
but
I
I
want
to
reiterate
an
important
fact,
which
is
that
cancer
is
not
going
away.
In
fact,
the
epidemiologists
have
stated
that
that
we
will
see
about
a
50
increase
in
individuals
suffering
from
cancer
by
2040..
We
believe
it's
going
to
be
much
higher
than
that,
mostly
because
of
the
new
treatments
we
have
that
are,
are
trans
translating
into
long
life
spans
for
patients,
particularly
the
immunotherapies
and
the
good
news.
H
Even
though
cancer
incidence
is
up
and
expect
it
to
be
up
and
number
of
people
suffering
from
cancer
is
going
to
be
up,
the
good
news
is
that
mortality
is
dropping
significantly
and
and
Dr
Evers
mentioned
that
the
reduction
in
stage
four
lung
adenocarcinoma
that
we're
experiencing
right
now,
that's
due
to
immunotherapies
and
their
effectiveness,
and
you
can
see
on
this.
This
slide.
H
I
I
hope
that
the
the
male
and
female
mortality
rates
are
dropping
significantly
now
and
and
what
we're
going
to
see
over
the
next
five
years
is
a
is
a
dramatic
drop
as
a
result
of
these
new
Therapies.
H
At
Brown
Cancer
Center,
well,
we
we,
like
at
the
Marquee,
have
sub-specialty
oncologists,
so
we
have
doctors
who
focus
on
breast
cancer
and
doctors
who
just
focus
on
lung
cancer
Etc,
and
then
we
have
clinical
trials
and
and
cancer
education
programs
that
you'll
hear
about,
and
Outreach
programs
going
out
into
the
community
Through
the
Kentucky
cancer
program
and
then,
of
course,
translational
cancer
research,
which
a
large
part
of
the
funding
we
get
from
the
state
through
the
tobacco
Master
settlement
program,
goes
towards
our
basic
research
programs
to
try
to
end
cancer
once
and
for
all.
H
One
of
the
most
important
things
that
our
patients
experience
here
is
the
the
access
to
multi-disciplinary
cancer
clinics.
These
are
cancer
clinics
that
are,
you
know
that
are
that
emphasize
one
type
of
cancer
have
radiation,
oncologists,
surgical,
oncologists,
medical
oncologists,
who
focus
on
that
type
of
cancer
and
work
together
towards
the
common
goal
of
making
sure
their
patients
live
into
their
90s
instead
of
dying
early
of
cancer
and
the
impact
of
having
a
50
year
old,
very
successful,
individual,
very
productive,
individual
raising
a
family
pass
from
cancer
cannot
be
overstated.
H
Many
think
of
us,
as
as
the
Louisville
cancer
center,
but
we're
not
the
Louisville
Cancer
Center.
We
have
patients
who
actually
come
from
every
County
in
Kentucky
to
to
Louisville
to
get
treated
and,
and
so
the
last
time
I
gave
this
talk.
I
I
showed
the
actual
numbers
and
I
will
admit
that
several
of
the
counties
just
have
one
or
two
patients
that
are
distant.
H
Pike,
Pikeville,
Pike
County
actually
had
six
last
year,
but
but
you
can
see
on
this
slide
that
in
Jefferson
County
we
had
6
500
newly
diagnosed
cancer
patients.
You
can
basically
multiply
that
times,
10
for
the
number
of
patients
under
our
care.
If
you
look
at
all
the
other
counties
in
Kentucky,
it
was
just
over
five
thousand
so
about
50.
H
000
were
treated
here
for
cancer
and
and
the
funding
that
we
get
makes
the
the
cancer
registry,
the
nurse
Navigators,
the
social
workers,
the
financial
counselors,
all
those
folks
who
are
involved
in
trying
to
make
sure
that
patients
get
the
best
care
have
access
to
the
best
clinical
trials.
I
get
it
no
matter
where
they
live
in
Kentucky
and
I.
I
need
to
mention
three
names:
It
Centers
me
personally,
I
think
it'll
Center,
everyone
who's
listening
to
me
right
now.
H
This
is
Owen
McMasters,
who
was
11
when
he
had
a
sore
throat
and
it
was
pretty
bad
and
his
dad
Kelly
brought
him
to
the
hospital
with
with
it
and
and
his
white
count
turned
out
to
be
quite
high
and
it
turned
out.
He
had
acute
lymphoblastic
leukemia
Kelly
McMasters
is
the
chair
of
surgery.
H
Here,
Dr
Evers
knows
him
well:
Owen
underwent
an
bone
marrow
transplant
and
and
and
did
well
for
about
four
years,
but
then
recurred
and
and
passed
away
when
he
was
only
16
years
old
and
and
he's
why
I
come
to
work
every
day.
H
We
cannot
accept
having
children
die
of
cancer
in
the
United
States
anymore,
Steve
Tompkins
Steve
had
melanoma
when
he
was
52
Steve
graduated
from
Trinity,
which
is
a
local
Catholic,
High
School
here
and
went
on
to
play
baseball
at
the
uofl,
and
then
he
coached-
and
he
really
you
know
that
was
his
claim
to
fame
coaching
at
Trinity
and
was
loved
by
the
community
and
and
went
on
multiple
clinical
trials
over
10
years
and
ultimately
passed
from
his
his
melanoma.
H
Not
too
long
ago
after
receiving
several
of
our
cellular
therapies,
and
then
this
is
Laura
McGregor
Laura
was
Laura
was
diagnosed
in
2007.
You
know
the
in
the
the
point
of
including
her
is
is
to
just
State
the
fact
that
cancer
affects
the
whole
lifespan
and
Laura
was
only
30
and
she
was
pregnant
with
her
second
son
and
found
it.
H
She
decided
she
was
not
going
to
let
cancer
stop
her
and
her
life,
and
so
she
founded
hope
scars,
which
is
now
a
national
Foundation
based
here
out
of
Louisville,
who
and
and
what
hope
scarves
does
is
it
passes
scarves
to
cancer
cancer
patients,
mostly
female
cancer
patients,
with
the
stories
of
the
individual
who
held
this
the
scarf
before
it
was
passed
on
and
Laura,
unfortunately,
died
was
diagnosed
with
stage
four
best
tech
melanoma
in
January
of
14
passed
away
this
January,
so
your
funding
is
helping
us
end.
H
What
we
are
seeing
in
these,
these
young
and
middle-aged
adults
in
Kentucky.
One
of
the
key
initiatives
that
has
been
supported
by
your
funding
has
been
the
cellular,
immunotherapy
program.
You've
heard
about
this
program
before
the
tumor
infiltrating
lymphocyte
program
or
tills
for
short
I
I.
We
have
now
become
the
top
till
Center
in
the
country.
H
Md
Anderson,
Cancer
Center
in
Houston
Texas
is
sending
us
patients.
The
National
Cancer
Institute
in
Bethesda
is
sending
us
patients.
The
University
of
Michigan
is
sending
us
patients
and
so
on
and
so
on,
and
it's
because
of
the
funding
that
we're
getting
that's
supporting
the
great
research
that's
happening
at
the
University
of
Louisville.
The
therapy
is
pretty
complicated.
H
It
involves
a
surgeon
like
Dr
Evers,
taking
out
a
tumor
and
then
Cellular
immunologists
in
the
lab,
isolating
the
immune
cells
from
the
tumor
and
expanding
them
literally
a
billion
fold,
and
then
we
reinfuse
those
cells
into
the
patient
after
we
deplete
their
own
immune
system
and
then
follow
it
with
a
growth
factor.
So
it
involves
three
to
four
weeks
in
in
a
bone
marrow
transplant
unit.
H
We're
now
testing
it
in
melanoma,
long
head
and
neck
cervical
cancer,
we're
hoping
for
FDA
approval
soon
for
the
melanoma
patients,
and
this
is
just
a
a
dramatic
example.
In
my
opinion,
we
just
published
this
I
think
a
week
or
two
ago,
each
one
of
these
little
bars
or
columns
on
the
on
this
waterfall
plot
are
an
individual
patients.
Tumor
Mass
and
anything
that
goes
up
is
the
tumor
grew
in
in
that
individually.
H
So
this
was
a
treatment
that
turned
out
to
be
very
effective
and
very
durable,
and
we
thus
have
patients
coming
from
across
Kentucky
and
the
country
to
receive
it,
and
the
durability
shown
here
in
what's
called
a
swimmer's
plot,
with
the
ongoing
patients
having
a
response
with
little
triangles
at
the
end
of
the
the
column
and
and
I
have
an
example
of
a
patient.
I
wish
it
was
from
Kentucky,
but
she
agreed
to
have
her
name
splattered
all
over
the
Internet.
H
So
we
included
her
her
name's
Val
snap
Val
was
in
her
early
70s
I
think
she
was
73
specifically
and
she
was
told
by
MD
Anderson
that
she
was
too
old
to
receive
this
therapy,
and
she
called
up
here
and
I
talked
with
her
and
she
passed
all
the
screening
tests,
including
the
Cardiac
and
Pulmonary
tests
that
we
do
and
after
receiving
the
treatment
she
had
a
complete
response
and
she's
out
I
think
two
to
three
years
now
living
a
normal
lifespan,
which
is
what
we're
all
about,
and
a
famous
quote
that
Val
gave
to
one
of
our
University
magazines
was
I,
look
out
over
the
farm
and
it's
so
beautiful.
H
I
think
how
blessed
I
am
to
be
able
to
hear
that
be
here
to
see
this
and
how
many
people
have
been
told
they
wouldn't
be
here
for
long
and
have
not
had
the
chance.
I
have
had
and
Val
is
alive
and
well.
I
I
love
this
picture,
because
every
time
I
do
a
Telehealth
with
her
because
she
lives
in
Nashville.
Now
that
dog
gets
in
front
of
her
face
and
I
can't
see
her,
but
she
she
she's
alive
and
well,
like
so
many
other
of
our
patients,
and
none
of
this
would
happen.
H
This
is
another
patient
who
who
agreed
to
have
her
name,
release,
Jan,
Phillips
and,
and
she
had
cervical
cancer,
which
is
terminal.
There's
no
FDA
approved
options
once
it's
stage
four.
She
received
the
cell
therapy
here
in
Louisville
from
Knoxville,
Kentucky,
I'm,
sorry,
Knoxville,
Tennessee,
and
then
this
lady
is
from
the
south
end
of
Louisville
Adrian,
Adrian
Baker
and
she
had
lung
cancer.
It
was
it
progressed
after
she
received
all
the
FDA
approved
options
and
she's
now,
I
think
about
a
year
and
a
half
out
with
no
evidence
of
disease.
H
So
the
the
funding
that
we
get
from
the
tobacco
Master
settlement
agreement
is
literally
saving
lives.
We
would
not
be
able
to
be
doing
these
Cell
Therapy
programs
here,
if
it
weren't
for
that
funding-
and
this
is
just
this-
is
just
a
slide.
It's
it's
a
little
bit
outdated,
but
it
shows
where
all
the
patients
are
coming
from
just
demonstrating
that
they're
coming
from.
H
Basically
the
eastern
half
of
the
state
of
the
country,
obviously
in
Kentucky
we're
seeing
the
majority
of
the
patients
I
didn't
include
that
on
on
this
slide,
but
this
funding
isn't
just
for
cancer
research.
It's
for
cancer
screenings
and
Dr
Evers
I
went
through
in
some
detail
the
success
that
Kentucky
has
experienced
as
a
result
of
the
initiative
with
colonoscopies.
H
We
we
believe
that
another
key
area
of
concern
is:
is
lung
cancer
were
the
number
one
state
because
the
tobacco
smoking?
We
have
a
abysmal
rate
of
lung
cancer
screen
like
the
rest
of
the
country,
it's
less
than
10
percent
of
eligible
smokers.
It's
in
that
compares
to
mammography
and
colonoscopy,
which
is
60
to
70
percent
of
those
eligible.
So
we've
worked
pretty
hard
to
improve
lung
cancer
screening.
Just
like
UK
and
Marquee
has.
H
We
did
see
a
significant
drop,
unfortunately,
during
the
pandemic,
as
this
slide
shows
in
20
and
21,
but
I'm
pretty
proud
that
this
was
year
to
date.
So
we're
this
isn't
the
actual
number
1646,
but
year
to
date,
about
a
week
ago,
we
had
beat
our
2019
numbers,
and
this
screening
involves
a
five
second
low-dose
chess
CT,
no
IV
contrast.
The
patient
gets
in
the
hardest
part
about
getting.
H
The
screen
is
making
it
to
the
to
the
image
Imaging
Center
to
get
it
done,
but
I
can't
tell
you
how
many
patients
we've
detected
with
early
stage
lung
cancer
that
can
be
cured
with
a
surgeon's,
a
scalpel
alone,
which
is
which
translates
which
will
translate
into
further
reductions
in
the
lung
cancer
death
rate
in
Kentucky
that
Dr
Evers
already
brought
up
I.
We
also
do
basic
research
here
that
I
haven't
brought
up
yet
and
and
I'm
very
proud
of
this.
This
scientist,
his
name's
Junior,
he
was
trained
here.
H
He
did
his
postdoc
here.
He
went
to
Yale
University
for
his
first
faculty
job
and
then
came
back
here
for
his
next
one,
and
now
he's
the
director
of
our
cancer
and
Immunology
program
and
he's
the
chief
of
the
division
of
immune
therapy,
the
department
of
surgery
he
has
four
two
million
plus
dollar
Ro
ones.
He
routinely
publishes
Cutting
Edge
research
in
the
top
journals,
including
this
one.
H
This
is
nature
Immunology,
one
of
the
top
journals
currently
related
to
cancer,
Immunology
and-
and
the
pictures
you
see,
are
pictures
of
of
Mouse
lungs
on
at
the
top
under
PBS.
It
says
you
know,
that's
the
the
placebo
and
you
can
see
all
the
black
that's
melanoma,
that
has
spread
from
a
primary
melanoma,
and
then
he
has
a
new
treatment
that,
based
on
an
old
idea,
called
beta
gluclan.
That
is
essentially
prevented.
H
Most
of
that
spread
that
he's
moving
into
a
clinical
trial
with
our
clinical
trialis,
and
he
wanted
me
to
show
you
all
this,
this
new
technology
that
can
really
focus
in
on
individual
immune
cells,
which
really
does
translate
into
us
being
able
to
figure
out
exactly
how
the
immune
system
sees
cancer
cells
and
try
to
egg
the
immune
system
on,
so
that
it
can
actually
take
care
of
cancer
in
all
patients.
H
Dr
Evers
brought
up
education
and
how
important
that
was
to
him.
Likewise,
it
is
for
me,
we
are
all
getting
older
and
if
Kentucky
doesn't
train
the
next
generation
of
cancer
doctors
and
researchers,
then
there's
going
to
be
a
problem
pretty
soon,
and
so
we
we
use
a
portion
of
the
funding
related
to
cancer
research,
to
support
the
the
training
of
graduate
students
and
postdoctoral
fellows
who
focus
on
cancer
research
as
well
as
medical
oncologists,
surgical
oncologists
and
radiation
oncologists.
H
As
does
Marquee
and
I
I
put
together,
this
pie
chart
for
you
to
to
see
my
research
budget
for
the
brown
cancer
center
and
the
the
big
piece
is
is
is:
is
extramurally
funded
peer-reviewed
grants?
So
it's
sponsored
research
essentially
that
most
of
which
comes
from
the
NIH.
H
But
a
lot
comes
from
the
Leukemia
Lymphoma
Society,
the
American,
Cancer
Society
other
foundations,
and
you
can
see
that
that's
the
the
majority
of
our
funding,
but
we
would
not
be
able
to
bring
66
million
dollars
in
research
funding
into
the
state
of
Kentucky
if
it
weren't
for
the
key
other
sources
of
revenue
that
are
listed
here
and
the
the
two
million
is
donations
they're
low
right
now
that
I
won't
I
won't
sugarcoat.
H
That
they're
they're
we're
on
the
low
end
of
donations
for
philanthropy
right
now,
uofl,
health
and
and
the
school
of
medicine
supports
us
with
five
million
dollars
in
in
healthcare
Revenue.
A
big
Pharma
I
supports
us
with
just
over
a
million,
but
the
tobacco
Master
settlement
agreement
with
the
3.4
million
dollars
that
money
translates
into
infrastructure
that
enables
us
to
do
the
research
that
will
ultimately
lead
to
cures
in
cancer
and
leads
to
extramural
funding
from
federal
federal
grants
as
well
as
foundations,
and
that's
a
key
point.
H
So
this
is
my
last
slide
your
funding.
We
would
not
be
successful
without
this
funding.
We
would
be
more
successful
if
we
got
more
funding
to
tell
the
truth,
but
this
funding
translates
into
us
being
able
to
to
reduce
the
cancer
death
rate
through
our
multi
multi-disciplinary
cancer,
subspecialty
programs
through
Innovative
laboratory
research
in
our
clinical
trials
through
cancer
screening
and
then,
of
course,
educating
the
next
generation
of
cancer
doctors
and
researchers
in
Kentucky.
H
B
Sorry,
I'm
out
of
practice
on
committees
here
for
a
second,
the
holidays.
Thank
you
for
your
presentation.
There
was
one
chart
early
on
on
the
cancer
death
rates
and
and
them
dropping,
which
is
all
really
really
encouraging.
But
when
I
look
at
this,
the
female
incidence
rates
are
still
they're
ticking
up
overall
over
time
and
I'm
wondering
if
you
can
give
us
any
insight
into
why
you
think
the
female
rates
may
be
ticking
up
on
the
overall
in
the
male
incidents
are
ticking
down.
H
So
I
personally
I,
we
don't
know
for
sure,
but
personally
I
believe
it's
it's
a
combination
of
better
early
detection.
Women
tend
to
do
a
better
job
with
their
health
than
men,
so
we're
we're
detecting
cancer
earlier
in
them
and
number
two:
the
Aging
population.
There's
no
question
well,
a
common
question
that
I
receive
is
okay,
the
cancer
death
rate
so
that
we
usually
Express
those
numbers
in
a
percentage
of
the
population
right.
H
So
it's
the
number
of
deaths
per
hundred
thousand,
but
as
the
population
ages,
the
number
one
risk
factor
for
cancer
is
age.
So,
as
as
we
see
the
bubble
from
the
baby
boomer
population,
we
are
seeing
currently
a
bubble
from
in
in
cancer
patients.
So
I
I
think
it's
it's
a
combination
of
those
two
issues.
H
A
Dr
Chaney,
we
miss
you
being
here
making
our
presentation
in
person.
We
appreciate
you,
though
doing
it
there
online
Dr
Evers.
We
appreciate
it
all
the
members
here
I
think
you
know
that
we
lost
our
co-chair
just
a
short
period
of
time,
and
we
do
you've
got
our
strong
support
of
what
you
do
right
there.
Thank.
A
Once
again
want
to
thank
you
both
for
being
here.
Thank
you.
Okay.
Now,
next
we'll
have
the
reports
from
our
AG
development
board
and
we'll
ask
Brian
Lacefield
he's
executive
director
of
the
Kentucky
office,
AG
policy
and
Bill
McCloskey,
the
deputy
executive
director.
If
they'll,
please
come
up
introduce
themselves
and
do
your
presentation,
please,
foreign.
I
Good
afternoon,
chairman
committee,
members
good
to
say
afternoon
been
in
the
habit
of
visiting
with
you
all
in
the
morning,
but
it's
it's
great
to
be
back
for
our
our
final
meeting
of
the
the
calendar
year
and
an
extra
week
in
between
since
last.
Normally
we're
here.
I
I
was
looking
back
over
the
calendar
happening
at
the
office
of
AG
policy
and
after
our
meeting
on
the
10th,
we
we
had
our
second
of
the
stakeholder
meetings
that
the
commissioner
has
put
together
with
with
stakeholders
involving
the
large
and
food
animal
veterinarians
and
the
the
shortage
that
we
see
across
the
state,
especially
in
our
Rural
and
underserved
communities,
and
had
this
meeting
in
conjunction
with
the
North
American
Livestock
Show
over
in
in
Louisville,
and
we
had
between
50
and
60
folks.
There.
At
that.
I
That
meeting
again
continuing
to
address
the
the
issues
and
looking
at
what
what
can
be
done
about
this
I
was
able
to
to
speak
and
outline
the
new
program
that
we
have
launched
at
the
office
of
AG
policy
with
a
grant
program.
In
addition
to
our
pre-existing
program
for
low
interest,
subordinate
loans
for
any
practices
that
are
wanting
to
to
establish
a
large
animal
practice
by
into
an
existing
practice
or
by
any
equipment
that
is
specific
to
large
and
food
animal
veterinary
medicine.
I
From
this,
these
two
meetings
were
establishing
a
working
group,
a
vested
stakeholders.
That
will
continue
to
look
for
other
other
ways
that
we
can
continue
to
address.
This
we'll
add,
as
an
aside
that
bill
and
I
did
have
first
conversation
with
with
the
practicing
veterinarian
for
both
the
same
practice,
looking
at
one,
adding
in
a
new
practicing
veterinarian
becoming
a
partner
and
then
expanding
their
operation.
So
hopefully
that
will
translate
into
an
application
and
then
can
present
that
to
you,
after
it
is,
it
is
approved
and
funded.
I
We
had
the
following
week:
was
our
joint
act,
finance
and
AG
development
board?
Meeting
I
spoke
about
the
agenda
that
last
time
I
was
visiting
with
you,
so
I
will
spare
you
a
recap
of
every
stop
we
made,
but
it
was
the
first.
I
It
was
a
two-day
event
and
the
first
day
was
spent
visiting
numerous
projects
that
were
funded
by
both
AG
development
dollars
and
with
ag
finance
and
had
our
joint
meeting
the
following
down
on
Friday
there
in
one
of
our
farmers
markets
that
was
funded
with
with
State
and
County
funds
there
in
downtown
Somerset
bill
and
I
had
a
chance
to
to
go
and
impact
our
future
generation
of
AG
leaders,
as
we
spoke
to
the
University
of
Kentucky's
AG
marketing
class,
and
that
group
of
students
got
got
more
AG
policy
than
they
probably
were
were
expecting
that
day.
I
But
we
had
a
great
chance
doing
that
in
that
class
was
for
Dr
will
Snell,
who
we
all
often
get
to
come
and
speak
to
our
our
committee
meetings,
and
it
was
a
great
experience
and
every
time
I
do
that.
I
get
excited
about
about
the
future.
We
had
had
several
that
actually
were
had
participated
or
their
families
had
into
some
of
our
our
county
level.
Programs
with
the
cape
and
the
yate
program.
The
Farm
Bureau
annual
meeting
was
the
last
few
days
of
November.
I
First
few
days
of
December
back
in
in
Louisville,
we
were
back
chairman
back
to
what
it
looked
like
prior
to
pandemic.
I
There
were
over
2
000
registered
for
this
event
and
was
was
a
great
great
chance
to
see
folks
from
literally
across
the
state,
all
at
one
place,
and
one
highlight
that
I've
always
enjoyed
at
that
meeting
is
the
UK
AG
econ
Outlook,
where
the
AG
economists
are
giving
both
a
a
look
back
at
the
previous
year
and
a
look
ahead
at
what's,
projections
for
the
upcoming
year
and
I
think
a
real
highlight
and
what
I
wanted
to
share
with
this
committee
was
Dr
Snell
and
his
Outlook
has
projected
the
2022
AG
receipts
for
Kentucky
will
exceed
eight
billion
dollars.
I
This
will
be
the
first
time
we've
crossed
that
threshold
and
Senator
Webb.
You
go
back
into
the
days
where
we
were
established.
We
were
at
Agri
seats
of
three
and
a
half
billion,
and
we
were
looking
towards.
Can
we
get
to
that
5
billion
and
egg
receipts?
At
that
time?
Tobacco
was
accounting
for
25
percent
of
those
AG
receipts.
I
Tobacco
is
now
less
than
three
percent
of
these
accuracy,
so
for
the
I
think,
that's
a
great
time
to
pause
and
and
recognize
the
work
and
and
the
commitment
that
the
the
general
assembly
has
done,
and
specifically
this
oversight
committee
on
on
Guiding
this
throughout
every
Administration,
on
the
the
use
of
these
funds
for
for
Kentucky
farmers
and
seeing
the
mission
accomplished
that
we
have
Diversified
Kentucky
Agriculture
and
we
have
grown
our
AG
receipts
and
as
we
close
out
this
calendar
year,
I'm
just
kind
of
reflective
and
very
thankful
of
everything
that
is
has
gone
on.
I
Senator
Parrott.
It
was
great
to
be
able
to
to
recognize
you
for
your
your
service
today,
I
think,
back
to
the
first
time
you
and
I
met
was
when
you,
you
joined
several
of
your
colleagues
that
were
all
the
the
the
representatives
and
senators
from
from
Agriculture,
and
you
spoke
I
think
about
12
years
ago.
I
You
were
in
session
and
I
was
part
of
the
Kentucky
AG
leadership
class,
a
class
that
is
funded
by
by
these
funds
and
was
going
through
that
and
we
we
were
able
to
set
and
and
visit
and
talk
about
about
these
funds
and
other
things
moving
through
the
the
general
assembly
at
the
time
and
I
I
credit.
I
My
experience
in
that
program
I
would
not
have
had
the
opportunity
to
to
serve
in
the
last
position
with
the
Farm
Service
Agency
or
for
sure
this
position
here
and
and
think
about
all
the
the
other
interactions
we
had
through
the
AG,
Business
Association
of
Kentucky
and
other
other
are
groups
and
what
you've
done
so
I
I.
Thank
you
for
your
your
service
to
to
Kentucky,
specifically
to
Agriculture
and
and
to
these
funds
so
best
of
wishes
and
your
your
next
Endeavor
I'm.
Also
very
thankful
for.
For
my
colleagues.
I
I've
got
at
the
Kentucky
office
of
AG
policy.
We
have
got
a
tremendous
team,
all
fully
staffed
right
now
and
hoping
we
can
roll
through
2023
the
the
same
way,
but
thankful
for
what
they're
able
to
do
to
help
get
these
funds
and
and
delivered
our
our
partners
with
with
UK
and
Kentucky
State
Extension,
our
different
administrating
entities
that
we
partner
with
and
the
county
funds,
but
but
specifically
want
to
thank
the
general
assembly
for
for
22
years
of
directing
these
funds
for
for
the
work
they've
done.
I
Seeing
the
the
presentation
before
was
very
inspiring
to
see
the
the
work
coming
on
from
the
medical
community
and
then
to
see
what
is
able
to
be
accomplished
in
our
agriculture
Community
as
well,
it
it
is
inspiring
and
so
I.
Thank
you,
your
colleagues,
for
the
continued
support
of
these
funds
throughout
thankful.
I
Just
it's!
It's
really,
as
I've
been
able
to
be
working
in
this
now
for
two
years
directly.
It's
it's
very
impressive
to
see
that
we've
been
able
to
continue
this
work
for
as
long
as
we've
had
now
talking
about
things
in
a
in
a
in
a
calendar
year
ending
well,
we
we
all
have
our
fiscal
years.
I
We
know
how
we
operate
and
delivered
to
you
and
all
of
your
colleagues
this
week
should
have
been
a
copy
of
our
annual
summary
that
came
out,
and
this
is
the
second
one
now
that
we've
done
in
conjunction
with
the
Kentucky
Department
of
Agriculture.
I
Now
that
we're
part
of
that
organization
and
give
a
a
tremendous
shout
out
to
the
comms
team
at
the
KDA
for
their
work,
putting
this
together
but
I'm
very
excited
about
the
what
we
were
able
to
Showcase
and
in
all
of
our
different
County
and
Statewide
projects
that
we're
doing
from
the
grant
side,
as
well
as
a
recap
of
all
of
our
our
loans
that
we've
done
and
if
anybody
has
theirs
with
you
or,
if
not
look
when
you
get
back
to
your
office,
you've
got
to
go
to
page
10.
I
I
think
this
has
the
best
Easter
egg
in
it
as
as
chairman.
I
This
is
in
your
county
here,
a
poultry
producer
up
in
Northern,
Christian
County,
and
he
is
holding
a
copy
in
his
hand
of
last
year's
annual
summary,
as
he
has
photographed
for
his
picture
in
this
year's
annual
summary
I
know
that
I
was
I
was
standing
there
Bill
handed
him
a
picture
or
handed
him
a
one
of
his
annual
summaries,
and
we
were
able
to
get
his
picture
for
an
energy
project,
but
we
have
got
the
staff
already
listing
out
projects
that
they
have
worked
on
this
past
year.
I
That
we
want
to
see
highlighted
in
in
the
future
year
and
I
would
be
remiss
if
I
didn't
compliment
both
of
our
interns
that
we
had
this
Summer.
That
I
brought
a
couple
of
the
oversight
committees
because
they
did
a
live
share
of
the
writing
on
on
this,
as
well
as
jessalyn
Watson.
Our
communication
director
that
we
have
at
the
office
fact
policy.
I
The
last
thing
I
want
to
mention
is
a
recap
of
our
loans
that
we
had
as
I
continue
to
share
with
you
each
time
I
come
we're,
seeing
a
increase
in
in
activity
with
Kentucky
AG
Finance.
As
you
all
are
aware,
our
loans
have
a
fixed
interest
rate
and
we
don't
have
to
worry
what
the
10-year
treasury
is
doing.
Our
rate
since
Inception
have
been
loaned
out
at
two
two
percent
and
we
allow
all
of
our
participating
lenders
to
add
75
basis
points
or
three
quarters
of
a
percent
on
top
for
servicing
fee.
I
So
the
fixed
rate
to
all
of
our
borrowers
that
are
utilizing.
This
program
is
2.75
largely
below
the
market
rate
and
and
and
significantly
so
as
rates
continue
to
move
and
we're
seeing
a
lot
of
our
other
long-term
rates
on
the
other
part
of
the
loans
in
the
the
eights
to
nine
percent.
So
we're
seeing
what
had
been
about
a
million
and
new
obligations
each
month
approved
were
up
over
2
million
and
this
this
past
year
or
this
past
month
for
the
November
loans.
I
We
had
one
under
our
infrastructure
program,
one
under
AG
processing
and
the
the
others
were
beginning
farmer,
programs
representing
beef,
grain
and
poultry
2.2
million
of
AG
Finance,
but
we're
able
to
leverage
that
for
for
nearly
8
million
in
in
total
capital
investment
that
we
saw
and
I'll
give
you
a
little
spoiler
for
for
next
month.
We
had
another
two
million
that
was
approved,
but
this
time
we're
we're.
A
smaller
percentage
of
the
overall
was
close
to
16
million.
I
So
the
use
of
these
funds
are
really
there
to
keep
the
capital
moving
to
get
our
partnering
lenders,
whether
they're
there
are
Community,
Banks
or
AG
credits,
or
you
see
in
this
case
metco
from
from
Jefferson
County
there.
One
of
our
government
lending
institutions
are
able
to
to
leverage
our
funds,
taking
that
subordinate
position,
the
lower
interest
rate
and
then
getting
their
their
funds
out
and
I.
I
Think
you'll
can
see,
continue,
increase
in
and
and
for
sure
the
next
year
and
we're
forecasting
that
with
our
cash
needs
inside
and
I
will
pause
there
and
let
bill
go
through
the
the
projects
that
were
funded
and
then
we'll
be
happy
to
take
any
questions.
You
have.
J
All
right,
I'll,
move
on
to
page
two,
give
you
an
update
on
AG
development,
board
approvals
of
projects
and
programs
designed
to
help
our
our
farmers
in
Kentucky
transition
away
from
tobacco
into
other
Enterprises.
So
if
you
look
on
page
two,
you
can
see
there
was
four
applications
approved
for
the
cape
program.
County
Agri.