Administrative Regulation Review Subcommittee

 

Minutes of the<MeetNo1> September Meeting

 

<MeetMDY1> September 11, 2001

 

The<MeetNo2> September meeting of the Administrative Regulation Review Subcommittee was held on<Day> Tuesday,<MeetMDY2> September 11, 2001, at<MeetTime> 10:00 AM, in<Room> Room 149 of the Capitol Annex. Representative John Arnold Jr., Chair, called the meeting to order, and the secretary called the roll.

 

Present were:

 

Members:<Members> Representative John Arnold Jr., Chair; Senators Marshall Long, Joey Pendleton, and Richard Roeding; Representatives Woody Allen, James Bruce, and Jimmie Lee.

 

Guests:John Steffen, Finance and Administration Cabinet; Jeff Harper, Jeff Mosley, Governor's Office of Agricultural Policy; Brian K. Bishop, Patricia T. Bausch, Kentucky Board of Emergency Medical Services; Mark Mangeot, Jack A. Wilson, Larry Dusak, Ronald Price, Lola Lyle, Bruce Scott, Hank List, Jay Wilkerson, Natural Resources and Environmental Protection Cabinet; Brian Logan, Brenda Priestley, Jack Damron, Department of Corrections; Charles E. Wilkinson, Hollie Spade, Susan Smith, Transportation Cabinet; Mary Ellen Wiederwohl, Education Professional Standards Board; Carrie Banahan, William J. Nold, Department of Insurance; Rena Elswick, Bernard J. Hettel, Kentucky Racing Commission; Michael S. Peck, Kenneth L. Meredith, Janet Hall, Department of Housing, Buildings and Construction; Wanda Fowler, Alex Beck, Pamela J. Murphy, Cabinet for Health Services; Barbara Wright, Mary Ann Burgess, Joyce Lea, Patti Smith-Glover, Rosanne Barkley, Karen Doyle, Shirley Eldridge, Marian Love, Stephanie Brammer-Barnes, Debbie Salleng, Cheryl Bentley, Mike Cheek, Cabinet for Families and Children; Dr. Kimberly Williams, Kentucky Telehealth Board; Charles Wolfe, Associated Press; Roger Irvin, Irvin Elevator; Dennis Morgan, Otis Elevator; David Powers, Powers Elevator Co.; Paul Case, Abell Elevator; Steve Bowlds, D-C Elevator; Linda Atlee, Thyssenkrupp Elevator; Wade Helm, Kentucky Conservation Committee; Joe Knoepfler; Roger Givens, Kentuckians for the Commonwealth; Pat W. Martin, CFA, KFTC; Ann Wilkerson, KFTC; Robert L. Wood, Kentucky Academy of Family Physicians; Jeanie Lemaster, Lennie House, Wiliam (Bill) Bausch, Lisa Hinkle, Stephanie Fightmaster, Nurses Registry; Richard Phillips, St. Claire Medical Center; Marie Alagia Cull, Karen Hinkle, Kentucky Home Health Association; Rosanne Nields, St. Elizabeth Medical Center.

 

LRC Staff:Dave Nicholas, Karen Smith, Susan Wunderlich, Donna Kemper, Edna Lowery, Ellen Steinberg, and Representative Steve Nunn.

 

The Subcommittee determined that the following administrative regulation did not comply with statutory requirements and was found deficient:

 

Natural Resources And Environmental Protection Cabinet: Department for Environmental Protection: Division of Water: Water Quality

 

401 KAR 5:074. KPDES permit conditions for beef, dairy, poultry, and swine concentrated animal feeding operations. Hank List, Deputy Secretary, and Bruce Scott represented the Cabinet.

 

In response to a question by Senator Roeding, Mr. List stated that this administrative regulation was not an emergency administrative regulation, but it was the fourth submission of the administrative regulation.

 

In response to a question by Senator Roeding, Mr. Scott stated that the Franklin Circuit Court lawsuit on the prior version of this administrative regulation was ongoing.

 

The Subcommittee unanimously approved a motion by Senator Roeding to find this administrative regulation deficient.

 

The Subcommittee determined that the following administrative regulations, as amended by the promulgating agency and the Subcommittee, complied with statutory requirements:

 

Finance And Administration Cabinet: Kentucky Aquaculture Production System Grant Program

 

200 KAR 35:020. Disbursement of monies from the Kentucky Aquaculture Production System (KAPS) Grant Program for the construction of commercial aquaculture ponds. John Steffin, Assistant General Counsel, Finance and Administration Cabinet, Jeff Mosley, General Counsel, Governorís Office of Agricultural Policy, and Jeff Harper, Governorís Office of Agricultural Policy, represented the Cabinet.

 

In response to questions by Senator Roeding, Mr. Steffin stated that the funding for the grant program had not originated from tobacco settlement funds. The 2000 budget bill provided the funding to the Cabinet while also authorizing the Cabinet to reassign the funds to an appropriate state agency. The Cabinet had retained their authority to promulgate administrative regulations for the program, but had reassigned the distribution of the funds and administration of the program to the Governorís Office of Agricultural Policy.

 

In response to a question by Senator Roeding, Mr. Mosley stated that the Project Review Committee decided which grant applications receive funding. The Committee utilized a point and ranking system to determine the appropriate recipients.

 

In response to questions by Senator Roeding, Subcommittee staff stated that because of the Governorís Officeís questionable authority to promulgate the emergency administrative regulation that had initiated this Program, this companion ordinary administrative regulation from the Cabinet had replaced that emergency administrative regulation. The Cabinet had much clearer statutory authority to regulate this program.

 

This administrative regulation was amended as follows: (1) the RELATES TO and STATUTORY AUTHORITY paragraphs were amended to correct statutory citations; (2) Sections 2 through 9 were amended to comply with the drafting and format requirements of KRS Chapter 13A; (3) Section 2 was amended to establish region-specific minimum scoring standards for acceptable applications; and (4) Section 9 was amended to incorporate by reference the required application form.

 

Board of Emergency Medical Services

 

202 KAR 7:580 & E. Class I ground ambulance providers. Patricia Bausch, General Counsel, and Brian Bishop, Executive Director, represented the Board.

 

In response to a question by Senator Roeding, Ms. Bausch stated that all interested parties had reached an agreement regarding a hospital diversion plan for ambulance providers.

 

Representative Lee stated that he commended the Board for reaching a compromise on the diversion plan issue because it ensured that the affected parties resolved the issue rather than the Subcommittee.

 

This administrative regulation was amended as follows: (1) the STATUTORY AUTHORITY and NECESSITY, FUNCTION, AND CONFORMITY paragraphs and Section 3 were amended to correct statutory citations; (2) the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 1 through 13 were amended to comply with the drafting and format requirements of KRS Chapter 13A; (3) Section 9 was amended to clearly establish the medical director requirements; and (4) Section 4 was amended to establish hospital diversion plan requirements for ambulance providers.

 

Justice Cabinet: Department of Corrections: Office of the Secretary

 

501 KAR 6:999. Corrections secured policies and procedures. Jack Damron, Counsel, represented the Department.

 

Pursuant to KRS 61.810(1)(i) and (k), KRS 61.815(2), and KRS 197.025(6), the Subcommittee went into closed session to review this administrative regulation.

 

Transportation Cabinet: Department of Human Resources Management: Administration

 

600 KAR 1:045. Disciplinary and separation procedures. Hollie Spade, Office of General Counsel, and Charles Wilkinson, General Counsel, represented the Cabinet.

 

This administrative regulation was amended as follows: (1) the RELATES TO, STATUTORY AUTHORITY, and NECESSITY, FUNCTION, AND CONFORMITY paragraphs and Sections 1, 2, 4, and 6 were amended to correct statutory citations; and (2) the NECESSITY, FUNCTION, AND CONFORMITY paragraph, and Sections 2 through 8 were amended to comply with the drafting and format requirements of KRS Chapter 13A.

 

Department of Vehicle Regulation: Division of Motor Carriers

 

601 KAR 1:030. Hearings. This administrative regulation was amended as follows: (1) the RELATES TO, STATUTORY AUTHORITY, and NECESSITY, FUNCTION, AND CONFORMITY paragraphs and Sections 1, 2, 4, and 6 were amended to correct statutory citations; (2) Section 1 was amended to comply with the drafting and format requirements of KRS Chapter 13A; and (3) Sections 6, 7, 8, 10, 11, and 12 were amended to delete provisions superceded by KRS Chapter 13B, as required by KRS 13A.120(2)(e) and (i).

 

Department of Highways: Division of Multimodal Programs: Mass Transportation

 

603 KAR 7:090. Railroads. Ms. Spade stated that the President of the Kentucky Railroad Association wrote the Department a letter in support of this administrative regulation.

 

This administrative regulation was amended as follows: (1) the STATUTORY AUTHORITY paragraph was amended to correct statutory citations; and (2) Sections 1, 2, 3, and 5 were amended to comply with the drafting requirements of KRS Chapter 13A.

 

Education Professional Standards Board

 

704 KAR 20:120. Emergency certification and out-of-field teaching. Mary Ellen Wiederwohl represented the Board.

 

In response to questions by Senator Roeding, Ms. Wiederwohl stated that to comply with the requirements of KRS Chapter 334A, this administrative regulation required teachers of exceptional children with communication disorders (speech language pathologists) to have a master degree before they could receive emergency certification.

 

This administrative regulation was amended as follows: (1) the RELATES TO paragraph and Section 2 were amended to correct statutory citations; and (2) Section 2 was amended to delete superfluous language, as required by KRS 13A.222(4)(a).

 

704 KAR 20:165. Qualifications for professional school positions. This administrative regulation was amended as follows: Sections 1 and 24 were amended to comply with the drafting requirements of KRS Chapter 13A.

 

704 KAR 20:510. Probationary certificate for teachers of exceptional children. In response to questions by Senator Roeding, Ms. Wiederwohl stated that Kentucky had a critical shortage of special education teachers. To reduce that shortage, the Board amended this administrative regulation to provide more opportunities for potential exceptional children educators to receive the required training so that they could become certified. They could obtain the training at eleven educational cooperatives throughout the state.

 

This administrative regulation was amended as follows: (1) the NECESSITY, FUNCTION, AND CONFORMITY paragraph was amended to clearly state the necessity for and function served by this administrative regulation, as required by KRS 13A.220(3)(f); and (2) Sections 2 and 3 were amended to comply with the drafting requirements of KRS Chapter 13A.

 

Department of Insurance: Health Insurance Contracts

 

806 KAR 17:310. Prompt payment of claims reporting requirements. William Nold, counsel, and Carrie Banahan represented the Department. Nancy Galvagni, Kentucky Hospital Association, appeared in support of this administrative regulation as amended.

 

In response to a question by Representative Bruce, Ms. Banahan stated that this administrative regulation encouraged the prompt payment of insurance claims by insurance companies.

 

In response to questions by Chairman Arnold, Mr. Nold stated that this administrative regulation established a reporting system so that the Department could monitor the prompt payment of insurance claims. Chiropractors were protected under this administrative regulation and the prompt payment statutes. The Department already had established a separate complaint process to address specific acts of discrimination in the payment of claims. The Department had been considering whether there was an unneeded distinction in insurance reimbursement rates for chiropractors as opposed to other health care providers.

 

Ms. Galvagni stated that the Kentucky Hospital Association had reached an agreement with the Department regarding an amendment to the prompt payment reporting form that was incorporated by reference in this administrative regulation. She stated that requiring the insurance companies to provide more information on the prompt payment reporting forms would enable the Department to better monitor the insurance companiesí compliance with the prompt payment laws.

 

Without objection, this administrative regulation as amended was approved.

 

This administrative regulation was amended as follows: (1) the RELATES TO paragraph was amended to correct statutory citations; (2) the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 2 and 4 were amended to comply with the drafting and format requirements of KRS Chapter 13A; and (3) the prompt payment reporting forms were amended to require more information from the insurance companies regarding insurance claims received and paid.

 

Kentucky Racing Commission: Thoroughbred Racing

 

810 KAR 1:009. Jockeys and apprentices. Rena Elswick, Executive Secretary, and Bernard Hettel, Executive Director, represented the Commission.

 

In response to questions by Senator Roeding, Mr. Hettel stated that this administrative regulation increased the riding fees paid to jockeys by the horse owners so that Kentucky would have fees comparable to those in neighboring states. The Commission had not increased the jockey fees for sixteen years.

 

This administrative regulation was amended as follows: the Necessity, Function, and Conformity paragraph and Sections 1 through 16 were amended to comply with the drafting and format requirements of KRS Chapter 13A.

 

810 KAR 1:011. Pari-mutuel wagering. This administrative regulation was amended as follows: (1) the RELATES TO paragraph and Section 4 were amended to correct statutory citations; and (2) the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 1 through 8 and 10 through 13 were amended to comply with the drafting and format requirements of KRS Chapter 13A.

 

Harness Racing

 

811 KAR 1:125. Pari-mutuel rules. This administrative regulation was amended as follows: (1) the RELATES TO and STATUTORY AUTHORITY paragraphs and Section 12 were amended to correct statutory citations; (2) the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 1 through 15 were amended to comply with the drafting and format requirements of KRS Chapter 13A; and (3) a new Section 16 was created to incorporate by reference the required tax form.

 

811 KAR 1:215. Kentucky Standardbred Development Fund. In response to questions by Senator Roeding, Mr. Hettel stated that this administrative regulation would encourage standardbred breeding and racing in Kentucky by clarifying the rules for standardbred racing and establishing supplemental purses for the races. No fees were increased in this administrative regulation.

 

This administrative regulation was amended as follows: (1) the RELATES TO and STATUTORY AUTHORITY paragraphs were amended to correct statutory citations; and (2) the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 2, 3, 4, 6, 7, 14 through 18, 20, 21, 26, 28, 29, 33, and 34 were amended to comply with the drafting and format requirements of KRS Chapter 13A.

 

Cabinet For Families And Children: Department of Community Based Services: Child Support

 

921 KAR 1:380. Child Support Program application and interstate process. Karen Doyle, Rosanne Barkley, and Patty Smith-Glover represented the Department.

 

This administrative regulation was amended as follows: the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 1, 2, 3, 4, 5, 7, and 9 were amended to: (1) comply with the drafting and format requirements of KRS Chapter 13A; and (2) specify when the material incorporated by reference was required.

 

K-TAP, Kentucky Works, Welfare to Work, State Supplementation

 

921 KAR 2:006. Technical requirements for the Kentucky Transitional Assistance Program (K-TAP). Joyce Lea represented the Department.

 

This administrative regulation was amended as follows: Sections 1, 2, 4, 5 through 13, 15, 16, 19, and 24 were amended to comply with the drafting and format requirements of KRS Chapter 13A.

 

Protection and Permanency: Child Welfare

 

922 KAR 1:400. Supportive services. Stephanie Brammer-Barnes represented the Department.

 

In response to questions from Senator Roeding, Ms. Brammer-Barnes stated that this administrative regulation established safety net services for individuals who were no longer eligible to receive K-TAP funding because they had exceeded the 60 month time limit. It authorized periodic payments for emergency situations such as maintaining employment or housing, preserving a family unit, or keeping a child out of danger.

 

This administrative regulation was amended as follows: (1) the RELATES TO paragraph and Section 1(2) were amended to correct statutory citations; (2) Sections 1 and 3 through 10 were amended to comply with the drafting and format requirements of KRS Chapter 13A; and (3) Section 5(3) was amended to clearly establish the time period for which a family qualifies for safety net funds.

 

Day Care

 

922 KAR 2:160. Child care assistance program. Mike Cheek, Director, and Stephanie Brammer-Barnes represented the Department.

 

In response to questions by Senator Roeding, Mr. Cheek stated that because the child care assistance program eligibility criteria increased from 160% to 165% of the federal poverty level, this year the Department would serve an additional 1800 children. To determine which counties qualified as urban and rural for co-payment amounts, the Department used a metropolitan statistical area survey, the federal statistical model, performed by Murray State University. This administrative regulation established a recoupment provision to enable the Department to recover funds from any recipient whom the Department overpaid.

 

This administrative regulation was amended as follows: (1) Section 1 was amended to clearly establish definitions; and (2) Sections 2, 3, 4, 6, 7, and 8 were amended to comply with the drafting and format requirements of KRS Chapter 13A.

 

922 KAR 2:180. Requirements for unregulated provider registration in the child care assistance program. In response to questions by Representative Bruce, Ms. Brammer-Barnes stated that this administrative regulation defined an unregulated provider as one who cared for no more than three unrelated children in his or her home, with one of the children being served by the child care subsidy program. It required unregulated providers to comply with heightened minimal health and safety standards, implementing House Bill 706.

 

This administrative regulation was amended as follows: (1) the RELATES TO, STATUTORY AUTHORITY, and NECESSITY, FUNCTION, AND CONFORMITY paragraphs were amended to correct statutory citations; (2) the NECESSITY, FUNCTION, AND CONFORMITY paragraph was amended to conform to the language of the enabling statute, pursuant to KRS 13A.220; (3) Section 1(1) was amended to clearly establish that the Cabinet is not required to register a prospective provider, but rather to consider for registration; (3) Section 1(7) was amended to establish the content of the Cabinet's letter approving or denying an applicant's request; (4) Sections 1 to 3 were amended to comply with the drafting and format requirements of KRS Chapter 13A; and (5) Section 6 was amended to comply with KRS 13A.2251(1)(a) regarding incorporation of forms.

 

The Subcommittee determined that the following administrative regulations complied with statutory authority:

 

Governor's Office: Kentucky Aquaculture Production System Grant Program

 

10 KAR 4:020E. Disbursement of monies from the Kentucky Aquaculture Production System (KAPS) Grant Program for the construction of commercial aquaculture ponds. Jeff Mosley, General Counsel, and Jeff Harper represented the Office.

 

Department of Housing, Buildings and Construction: Elevator Safety

 

815 KAR 4:010. Annual inspection of passenger elevators. Janet Hall, General Counsel, Kenneth Meredith, Deputy Commissioner, and Michael Peck, Chief Elevator Inspector, represented the Department.

 

The Subcommittee and the promulgating administrative agencies agreed to defer consideration of the following administrative regulations to the next meeting of the Subcommittee:

 

Governor's Office: Early Childhood Development Authority

 

10 KAR 6:010E. Duties of the Early Childhood Development Authority.

 

Secretary Of State: Implementation of Revised Article 9

 

30 KAR 5:010E. Definitions for 30 KAR Chapter 5.

 

30 KAR 5:020E. General provisions.

 

30 KAR 5:030E. Acceptance and refusal of records.

 

30 KAR 5:040E. UCC Information Management System.

 

30 KAR 5:050E. Filing and data entry procedures.

 

30 KAR 5:060E. Search requests and reports.

 

Kentucky Employees' Retirement System: General Rules

 

105 KAR 1:310E. Duty-related death and disability.

 

Board of Medical Licensure

 

201 KAR 9:016. Restrictions on use of amphetamine and amphetamine-like anorectic controlled substances.

 

Board of Speech-Language Pathology and Audiology

 

201 KAR 17:030. License fees and requirements for inactive status.

 

Board of Nursing

 

201 KAR 20:070E. Licensure by examination.

 

201 KAR 20:110E. Licensure by endorsement.

 

201 KAR 20:470E. Dialysis technician credentialing requirements and training program standards.

 

Board of Licensure and Certification for Dietitians and Nutritionists

 

201 KAR 33:015. Application; approved programs.

 

201 KAR 33:050. Complaint procedure.

 

201 KAR 33:060. Supervision requirements.

 

Commercial Mobile Radio Service Emergency Telecommunications Board

 

202 KAR 6:070E. PSAP Workload Fund disbursement.

 

Board of Emergency Medical Services

 

202 KAR 7:130 & E. Procedure for immediate temporary suspension of license or certification against which disciplinary actin or investigation is pending.

 

Department Of Agriculture: Organic Agricultural Product Certification

 

302 KAR 40:010. Standard organic agricultural product requirements.

 

Justice Cabinet: Department of Criminal Justice Training: Kentucky Law Enforcement Council

 

503 KAR 1:150E. Department of Criminal Justice Training - Kentucky Police Corps basic training: graduation requirements; records. This administrative regulation was deferred because there was not a representative of the Department present at the Subcommittee meeting pursuant to KRS 13A.290(4).

 

General Training Provision

 

503 KAR 3:060E. Department of Criminal Justice Training - Kentucky Police Corps basic training course cadet conduct requirements; procedures and penalties. This administrative regulation was deferred because there was not a representative of the Department present at the Subcommittee meeting pursuant to KRS 13A.290(4).

 

Transportation Cabinet: Department of Vehicle Regulation: Division of Motor Carriers

 

601 KAR 1:018. Special overweight or overdimensional permits. Hollie Spade, Office of General Counsel, Charles Wilkinson, General Counsel, and Mary Morris represented the Cabinet.

 

In response to questions by Senator Roeding, Ms. Spade stated that mobile homes differed from manufactured homes because they were defined by statute as having smaller dimensions than manufactured homes.

 

In response to questions by Senator Roeding, Ms. Morris stated that a mobile home was able to be transported on its own axles while a manufactured home must be hauled on a tractor trailer.

 

In response to questions by Senator Pendleton and Representative Bruce, Ms. Spade stated that by statute, bails of hay were defined as divisible loads which may only be transported individually. This administrative regulation did not address the issue of divisible load transportation. A prior emergency executive order permitted the transportation of two bails of hay at a time, but it was no longer in effect. The Cabinet would be willing to work with the Subcommittee to address the issue in future administrative regulations or legislation, but they would oppose an amendment to this administrative regulation to address it. They did not have statutory authority to include it in this administrative regulation.

 

Senator Pendleton made a motion to defer consideration of this administrative regulation. Without objection, this administrative regulation was deferred.

 

Education, Arts, And Humanities Cabinet: Kentucky Board of Education: Department of Education: Office of District Support Services: School Administration and Finance

 

702 KAR 3:246. School council allocation formula: KETS District Administrative System Chart of Accounts.

 

Office of Learning Programs Development: Office of Instruction

 

704 KAR 3:500E. Professional Development Leadership and Mentor Fund.

 

Department of Libraries and Archives: Libraries

 

725 KAR 2:015E. Services and facilities for public libraries.

 

Labor Cabinet: Department of Workplace Standards: Division of Occupational Safety and Health Compliance: Occupational Safety and Health

 

803 KAR 2:320E. Air contaminants.

 

Department of Insurance: Authorization of Insurers and General Requirements

 

806 KAR 3:210E. Privacy of consumer financial information.

 

806 KAR 3:220E. Privacy of health information.

 

Health Insurance Contracts

 

806 KAR 17:180E. Standard health benefit plan and comparison format.

 

Public Service Commission: Utilities

 

807 KAR 5:080. Procedural and filing requirements and safeguards concerning nonregulated activities of utilities or utility affiliates.

 

Cabinet For Health Services: Department for Public Health: Health Services and Facilities

 

902 KAR 20:370 (& E). Operations and services; private duty nursing agencies. Pamela Murphy, State Inspector General, Lloyd Parish, Director, Inspector Generalís Office, and Alex Reese represented the Cabinet. Lisa Hinkle, Nurses Registry, appeared in opposition to this administrative regulation.

 

In response to a question by Senator Roeding, Ms. Murphy stated that this administrative regulation applied to private duty nursing agencies and not home health agencies. Private duty nursing agencies were defined as agencies that provided nursing services for a continuous block of time. They did not provide physical or occupational therapy and they were not recognized by Medicaid or Medicare. In contrast, home health agencies were defined as agencies that provided intermittent nursing services along with physical and occupational therapy. They were recognized by Medicaid and Medicare. Because a Certificate of Need was issued for private duty nursing agencies, the Cabinet was required to license and regulate them.

 

Ms. Murphy further stated that the Cabinet had met with interested parties and they had reached an agreement about which services may be provided by private duty nursing agencies. However, they had not reached an agreement about the amount of time that private duty nursing agencies may provide those services. As the Inspector General, she questioned whether she had the authority to arbitrarily establish a specific amount of time.

 

In response to questions by Chairman Arnold, Ms. Murphy stated that other existing administrative regulations regulated home health agencies.

 

In response to questions by Senator Roeding, Mr. Parrish stated that this administrative regulation required the private duty nursing agency and not the individual nurse to pay the $134 licensure fee.

 

Ms. Hinkle requested that the Subcommittee defer consideration of this administrative regulation until all interested parties had agreed how to define the permissible services for private duty nursing agencies. As currently drafted, the administrative regulation insufficiently distinguished between permissible services for private duty nursing agencies and for home health agencies. It allowed private duty nursing agencies to provide home health services but did not require them to serve Medicaid or Medicare patients, like home health agencies were required to do by their governing administrative regulations. Consequently, private duty nursing agencies would be able to contract for the private insurance patients leaving home health agencies serving only Medicaid and Medicare patients. That imbalance in their patient rosters would prevent home health agencies from sharing the cost burden of providing services to Medicaid and Medicare patients.

 

Representative Lee stated that he supported a deferral for this administrative regulation so that the interested parties could resolve this issue instead of the Subcommittee.

 

Ms. Murphy stated that the Cabinet agreed to defer consideration of this administrative regulation. Without objection, this administrative regulation was deferred.

 

In response to questions by Representative Lee, Ms. Murphy stated that the Cabinet for Families and Children, and not the Inspector Generalís Office, promulgated the administrative regulations that required three types of background checks on child day care employees. To more timely perform those checks, the Cabinet for Families and Children had increased the number of staff completing those checks. Additionally, Ms. Stephanie Brammer-Barnes, Cabinet for Families and Children, stated that to quicken the background check process, the Cabinet would be amending the day care administrative regulations to require the checks for new employees only and to eliminate the third type of required background check, the nurses aide abuse registry check.

 

In response to a question from Chairman Arnold, Mr. Reese stated that the Cabinet would be promulgating an administrative regulation establishing a home health aide abuse registry to prevent any aide that had a substantiated allegation of abuse, neglect, or misappropriation of property to continue to work in home health agencies.

 

Department for Medicaid Services: Services

 

907 KAR 1:013E. Payments for hospital inpatient services.

 

907 KAR 1:015E. Payments for hospital outpatient services.

 

907 KAR 1:025E. Payment for services provided by an intermediate care facility for the mentally retarded and developmentally disabled, a dually-licensed pediatric facility, an institution for mental diseases, a nursing facility with an all-inclusive rate unit.

 

907 KAR 1:031E. Payments for home health services.

 

907 KAR 1:038E. Hearing and Vision Program services.

 

907 KAR 1:065E. Payments for price-based nursing facility services.

 

907 KAR 1:072E. Payments for homecare waiver services.

 

907 KAR 1:092E. Payments for personal care assistance waiver services.

 

907 KAR 1:155E. Payments for supports for community living services for an individual with mental retardation or a developmental disability.

 

907 KAR 1:170E. Payments for home and community based waiver services.

 

907 KAR 1:360E. Preventive and remedial public health services provided through interagency agreement.

 

907 KAR 1:626E. Reimbursement of dental services.

 

Payment and Services

 

907 KAR 3:010E. Reimbursement for physicians' services.

 

907 KAR 3:100E. Payments for acquired brain injury services.

 

907 KAR 3:170E. Telehealth services and reimbursement. Wanda Fowler, represented the Department. Representative Stephen Nunn, Dr. Kimberly Williams, Chairperson, Kentucky Telehealth Board, and Primary Care Physician, St. Claire Medical Center, and Mr. Richard Phillips, St. Claire Medical Center, appeared in response to this administrative regulation.

 

Representative Nunn stated that Kentuckians had a critical lack of access to primary care physicians and medical specialists throughout the state. 105 Kentucky counties had been federally designated as medically under-served areas.

 

Dr. Williams stated that the Kentucky Telehealth Boardís mission was to provide adequate telehealth service across the state. In furtherance of that mission, the Board had reached a consensus with Medicaid about reimbursement for the medical specialty care provided by telehealth services. However, they had not reached an agreement regarding payment for primary care provided by telehealth services. Because primary care services were a vital part of the telehealth network, they also should be reimbursed under Medicaid.

 

Representative Nunn stated that he hoped Medicaid would seize this opportunity to pay for primary care telehealth services so that Kentucky citizens could receive a better quality of health care than they were currently.

 

In response to questions by Senator Roeding, Representative Nunn stated that the Board would continue its efforts to provide telehealth services statewide so that all Kentuckians would have reasonable access to it, including those in Northern Kentucky.

 

In response to a question by Senator Roeding, Mr. Phillips stated that the St. Claire Medical Center performed an average of 200 to 250 primary care telehealth consultations per year.

 

Without objection, this administrative regulation was deferred.

 

Cabinet For Families And Children: Department of Community Based Services: Family Support: Food Stamp Program

 

921 KAR 3:020E. Financial requirements.

 

921 KAR 3:025E. Technical requirements.

 

Protection and Permanency: Child Welfare

 

922 KAR 1:450E. Tuition waiver for foster and adopted children.

 

The Subcommittee adjourned at 11:45 a.m. until October 9, 2001, at 10 a.m. in Room 149 of the Capitol Annex.