As we get ready to celebrate the Thanksgiving holiday and the time before the 2023 Regular Session narrows, my colleagues and I met in Frankfort this week for another productive round of interim meetings. The meetings we have held during this legislative interim have provided an opportunity to discuss and debate some of the issues we will consider this session.

This week’s discussions were informative and helpful, I thought you might appreciate a review and hope you will let me know if you have any questions or comments.

• Interim Joint Committee on Veterans, Military Affairs, and Public Protection: Legislators heard testimony regarding veteran’s affairs, radon-induced lung cancer, and elevator mechanic licensing.

The Executive Council of Veterans Service Organizations and the Kentucky Department for Veterans Affairs discussed possible pieces of legislation for the 2023 session. During a presentation on radon-induced lung cancer, lawmakers learned that radon exposure is the second leading cause of lung cancer, and officials are working to raise awareness and access to testing.

One of the state’s largest elevator repair companies also shared a proposal to help with labor shortages. They are asking legislators to consider making changes to the licensing process for elevator mechanics to take into consideration experience veterans gain while serving our nation.

• IJC on Health, Welfare, and Family Services: Committee members discussed pharmaceutical pricing and how pricing practices can often drive up the cost for patients. Committee members also continued their efforts to study how practices used by the companies who manage pharmacy benefits for health insurance providers may actually be increasing costs for insurers and patients. Some data shows that Pharmacy Benefit Managers (or PBMs for short) drive prescription drug costs down in the short term, but often lead to higher costs in the long term.

Members also heard concerns about the practice of white bagging — when pharmacies ship a patient’s medication directly to site of care, and then the staff there prepare and administer the drug. Some of the potential consequences for patients include delayed care for urgent treatment changes, difficulty in care coordination, and they may be charged co-pays for drugs nor received due to shipping errors. Some of the consequences for the hospitals include negative impact on overall medication-use system, it introduces multiple risk points, and can undermine electronic health record integrity.

• Benefits Cliff Task Force: Legislators discussed the recommendations and findings of the task force’s efforts to identify what can be done to help move Kentuckians into the workforce. Recommendations include directing the Cabinet for Health and Family Services to conduct a review of all public assistance programs and introducing a system that tiers benefits in order to slowly phase out benefits as a recipient’s income increases, rather than immediately terminating benefits following small income increases. The task force also found a need to enact legislation requiring CHFS to integrate user-friendly benefits cliff calculator tool.

• IJC on Tourism, Small Business, and Information Technology: Members discussed the role the Department of Parks plays in emergency responses. State parks were essential in our state’s response efforts in both Western and Eastern Kentucky as those regions faced natural disasters. They served as a community resource by providing lodging for the American Red Cross, utility crews, first responders, and displaced families.

As part of the state’s emergency response efforts, seven Kentucky State Parks were designated to provide emergency shelter and food services for individuals impacted by the tornado. The parks offered temporary housing to more than 800 individuals and 250 first responders.

The committee was also briefed about plans to commemorate the 250th anniversary of the settlement of Harrodsburg. The city was founded in 1774 and is the first permanent settlement west of the Allegheny Mountains. This celebration is an opportunity to not only celebrate a great moment in our state’s history, but also leverage the historic event to foster civic pride and support ongoing community initiatives and promote the future tourism and economic development opportunities.

• IJC on Licensing, Occupations, and Administrative Regulations: Legislators discussed a slew of issues, including residential military real-estate disclosures, and the professional licensure of non-resident citizens. Roughly 5 percent of the current population of Kentucky is made up of non-resident citizens, individuals from other nations who are here legally. Often in their home country, these individuals were professionals in trade industries that require skills that translate into Kentucky’s job market. However, many cannot pursue work in that trade because of current law. In addition to the licensure of non-resident citizens, the committee also discussed the need to include a residential real estate disclosure for homes that are located within a later determined circumference of a military base, such as Fort Knox or Fort Campbell.

The idea behind this stems from being a good steward to would-be buyers, to inform them of the conditions of their new home environment. Executive Branch Efficiency Task Force: Legislators took a deep dive into the Department of Parks and the Tourism, Arts, and Heritage Cabinet. The cabinet shared that federal Covid relief money allocated by the legislature has been vital. According to testimony, it will not only to help Kentucky’s tourism and travel industry recover from the pandemic but also help them expand and target different consumer segments moving forward.

The cabinet also highlighted a recent report that found that every $1 spent generated $66 in economic impact for the commonwealth last fiscal year. The Department of Parks discussed its first reorganization in more than 20 years and how the new system would benefit all parks and their employees while improving efficiency and accountability across the state.

• IJC on Local Government: Members heard from the Kentucky Association of Counties (KACO) regarding its legislative agenda for the upcoming session. The association praised lawmakers for the legislature's significant investments in counties and other local governments over the last few budget cycles — from broadband and infrastructure projects to county clerks' offices and the jail fund.

KACO's top priority remains equalization and modernization of county revenue alternatives, such as additional local tax options, to meet the needs of each county, especially with the inevitable end of COVID relief funding. The association also expressed that county jails are the number one budget issue for counties. County jails house state prisoners, and officials have raised concerns about low reimbursement rates for years.

In 2021, the average number of days spent in custody was much higher than in previous years, leading to a budget shortfall in counties and residents having to pick up the tab. The state budget included a considerable increase in the daily reimbursement, but there is still a great deal of ground to make up before the rate is where it needs to be. IJC on State Government: Committee members heard testimony from the Kentucky State Police (KSP) on their recruitment and retention efforts. KSP shared that they are severely dealing with the lack of manpower, mounted by many factors, from low pay to negative public sentiment around the profession.

The commissioner of State Police praised the General Assembly’s recent investments and how they have helped get more troopers on the road. Thanks to the legislature providing $15,000 pay raises across the board, KSP reports the number of sworn troopers swelled by nearly 200, applications have doubled in the past seven weeks, and the most recent recruitment section is the largest in history.

Officials also warned that fentanyl is more dangerous than ever for Kentuckians. This year, 42 percent of KSP’s lab submissions contain some trace of fentanyl, a number that pales compared to a decade ago when only 15 requests contained the drug. The commissioner shared that nearly 70 percent of overdoses last year were attributed to fentanyl as well.

Lawmakers additionally pressed the Kentucky Department of Criminal Justice Training (DOCJT) on juvenile detention centers. This comes on the cusp of two recent riots that erupted at juvenile detention facilities in recent months.

• Public Pension Oversight Board: Lawmakers received an actuarial valuation update from all three Kentucky retirement systems. Each shared that despite the recent poor investment market, those declines were muted because of gains made in the previous fiscal year and the General Assembly meeting and exceeding our pension obligations. Funding ratios also continue to be higher in spite of these market pressures. The Kentucky Public Pensions Authority revealed they will see a significant gain for all insurance funds due to Medicare premiums decreasing significantly from 2022 to 2023. This will improve the funded status of the insurance funds and lower the required contribution effort across all funds.

With the legislature paying off the previously awarded benefits, the Teachers' Retirement System reported the state contributed 140 percent of the actuarially determined employer contribution for FY 2022, and the state's contribution to pension would have increased by about $60 million without the amortized payments. Finally, the Judicial Form Retirement System shared that all plans remain fully funded, but ratios did decline as expected this fiscal year.

• Emergency Medical Services Task Force: Members reviewed the recommendations and findings made this interim. Recommendations from the task force include recommendations on the topics of certificate of need and licensing, reimbursement for services, training and education, workforce recruitment and retention, behavioral health patient transport, and data collection and analysis. Throughout the task force, the task force heard from areas of EMS who would be directly affected by its findings and recommendations.

Compiling the work of the task force was a hands-on effort not only by legislators, but also by members of the EMS community.

• Commission on Race and Access to Opportunity: Legislators and commission members began discussing the role of doulas in maternal health. Doulas are trained professionals who support women through child birth. Maternal health is a crisis in the United States, with the United States outranking all other developed countries in maternal mortality. Research has shown that women who have had doulas had lower risk of having an underweight baby, lower risk for post birth depression, and have a lower risk of having a C-section.

Next, the committee heard from Repr. Herron on the office of public health potentially opening a new office of gun violence protection. The aims of the office would be similar to that of the office on drug policy, which would be to collect geographic data on gun violence to best address the issue.

The committee also heard details about access to healthcare from Fulton County. Compared to neighboring counties, Fulton consistently ranks among the lowest of the state in terms of healthcare. In order to address this, the director of Fulton Independent Schools suggests access is an issue and suggested new healthcare facilities are needed.

Last, the committee heard from the Kentucky Center for Statistics. Overall, Kentucky is becoming more racially diverse with more students graduating university.

As always, I can be reached on my mobile at (502) 639-7079 or through the toll-free message line in Frankfort at 1-800-372-7181. Feel free to contact me via email at James.Tipton@lrc.ky.gov. If you would like more information, please visit the legislature’s website at legislature.ky.gov.