UNOFFICIAL COPY 22 RS BR 1600 Page 1 of 111 XXXX Jacketed AN ACT relating to emergency medical services. 1 Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2 Section 1. KRS 311A.010 is amended to read as follows: 3 As used in this chapter, unless the context otherwise requires: 4 (1) "Advanced emergency medical technician" or "AEMT" means a person certified by 5 the board under this chapter as an advanced emergency medical technician; 6 (2) "Advanced practice paramedic" or "APP" means a paramedic licensed by the board 7 under this chapter as a paramedic and certified by the board under this chapter in at 8 least one (1) emergency medical services subspecialty, including community 9 paramedic, critical care paramedic, wilderness paramedic, tactical paramedic, or 10 flight paramedic; 11 (3) "Ambulance" means a vehicle that[which] has been inspected and approved by the 12 cabinet[board], including a helicopter or fixed-wing aircraft, except vehicles or 13 aircraft operated by the United States government, that are specially designed, 14 constructed, or have been modified or equipped with the intent of using the same, 15 for the purpose of transporting any individual who is sick, injured, or otherwise 16 incapacitated who may require immediate stabilization or continued medical 17 response and intervention during transit or upon arrival at the patient's destination to 18 safeguard the patient's life or physical well-being; 19 (4) "Ambulance provider" means any individual or private or public organization, 20 except the United States government, who is licensed by the cabinet[board] to 21 provide medical services that may include transport at either basic life support level 22 or advanced life support level and who may have a vehicle or vehicles, including 23 ground vehicles, helicopters, or fixed-wing aircraft to provide such transportation. 24 An ambulance provider shall be licensed in accordance with the classification 25 system established pursuant to Section 16 of this Act[may be licensed as a Class I, 26 II, III, or IV ground ambulance provider, a Class VI medical first response provider, 27 UNOFFICIAL COPY 22 RS BR 1600 Page 2 of 111 XXXX Jacketed a Class VII air ambulance provider, or a Class VIII event medicine provider]; 1 (5) "Board" means the Kentucky Board of Emergency Medical Services; 2 (6) "Cabinet" means the Cabinet for Health and Family Services; 3 (7) "Community paramedic" or "CP" means an advanced practice paramedic certified 4 under this chapter as a CP; 5 [(7) "Emergency medical facility" means a hospital or any other institution licensed by 6 the Cabinet for Health and Family Services that furnishes emergency medical 7 services;] 8 (8) "Emergency medical responder" or "EMR" means a person certified under this 9 chapter as an EMR or EMR instructor; 10 (9) "Emergency medical services" or "EMS" means the services utilized in providing 11 care for the perceived individual need for immediate medical care to protect against 12 loss of life, or aggravation of physiological or psychological illness or injury; 13 (10) "Emergency medical services educator" or "EMS educator" means a person who is 14 certified and licensed by the board under this chapter as a Level I, II, or III EMS 15 educator to provide emergency medical services education and training with the 16 scope of practice established by the board through administrative regulations; 17 (11) "Emergency medical services field provider " or "EMS field provider" means an 18 individual who, under this chapter, is certified as an emergency medical 19 responder, emergency medical technician, or advanced emergency medical 20 technician, or is licensed as a paramedic; 21 (12) "Emergency Medical Services for Children Program" or "EMSC Program" means 22 the program established under this chapter; 23 (13)[(12)] "Emergency medical services medical director" means a physician licensed in 24 Kentucky [and certified by the board under this chapter ]who is employed by, under 25 contract to, or has volunteered to provide supervision for a paramedic or an 26 ambulance provider[service], or both; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 3 of 111 XXXX Jacketed (14)[(13)] "Emergency medical services personnel" means: 1 (a) Persons trained to provide emergency medical services and certified or 2 licensed by the board under this chapter as an AEMT, APP, EMR, EMR 3 instructor, EMT, EMT instructor, paramedic, or paramedic instructor; and 4 (b) Authorized emergency medical services medical directors and mobile 5 integrated healthcare program medical directors, whether on a paid or 6 volunteer basis; 7 (15)[(14)] "Emergency medical services system" means a coordinated system of health-8 care delivery that responds to the needs of acutely sick and injured adults and 9 children, and includes community education and prevention programs, mobile 10 integrated healthcare programs, centralized access and emergency medical dispatch, 11 communications networks, trained emergency medical services personnel, medical 12 first response, ground and air ambulance providers[services], trauma care systems, 13 mass casualty management, medical direction, and quality control and system 14 evaluation procedures; 15 [(15) "Emergency medical services training or educational institution" means any 16 organization licensed by the board under this chapter to provide emergency medical 17 services training or education or in-service training, other than a licensed ambulance 18 service which provides training, or in-service training in-house for its own 19 employees or volunteers;] 20 (16) "Emergency medical technician" or "EMT" means a person certified under this 21 chapter as an EMT or EMT instructor; 22 (17) "Executive director" means the executive director of the Kentucky Board of 23 Emergency Medical Services; 24 (18) "Medical care facility" means a hospital or any other facility that is licensed by 25 the Cabinet for Health and Family Services and that furnishes emergency 26 medical services; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 4 of 111 XXXX Jacketed (19) "Mobile integrated healthcare" or "MIH" means a program licensed by the cabinet 1 under Section 16 of this Act[board under this chapter] to provide services including 2 evaluation, advice, and medical care for the purpose of preventing or improving a 3 particular medical condition outside of a hospital setting to eligible patients who do 4 not require or request emergency medical transportation; 5 (20)[(19)] "Mobile integrated healthcare program medical director" or "MIH program 6 medical director" means a physician licensed in Kentucky and certified by the board 7 under this chapter who is employed by, under contract to, or has volunteered to 8 provide supervision for a licensed MIH program; 9 (21)[(20)] "Paramedic" means a person who is involved in the delivery of medical 10 services and is licensed under this chapter; 11 (22)[(21)] "Paramedic preceptor" means a licensed paramedic who supervises a 12 paramedic student during the field portion of the student's training; 13 (23)[(22)] "Pre-hospital[Prehospital] care" means the provision of emergency medical 14 services, mobile integrated healthcare, or transportation by trained and certified or 15 licensed emergency medical services personnel at the scene or while transporting 16 sick or injured persons to a hospital or other [emergency ]medical care facility;[ 17 and] 18 (24)[(23)] "Training institution" or "emergency medical services training institution" 19 means any organization licensed by the board under this chapter to provide 20 emergency medical services training or education or in-service training, other 21 than a licensed ambulance provider that provides training, or in-service training 22 in-house for its own employees or volunteers; and 23 (25) "Trauma" means a single or multisystem life-threatening or limb-threatening injury 24 requiring immediate medical or surgical intervention or treatment to prevent death 25 or permanent disability. 26 Section 2. KRS 311A.015 is amended to read as follows: 27 UNOFFICIAL COPY 22 RS BR 1600 Page 5 of 111 XXXX Jacketed (1) There is hereby created an independent agency of the state government to be 1 known as the Kentucky Board of Emergency Medical Services[ is created and shall 2 be attached to the Kentucky Community and Technical College System]. 3 (2) The board shall consist of [thirteen (13) members who are residents of Kentucky 4 appointed by the Governor in conjunction with recognized state emergency medical 5 services related organizations. Membership shall be made up of ]the following 6 members, who shall be residents of Kentucky: 7 (a) One (1) physician licensed in Kentucky who serves as the medical director 8 for an ambulance provider and is board-certified in emergency medicine, 9 appointed by the Governor from a list of three (3) physicians submitted by 10 the Kentucky Medical Association; 11 (b) One (1) physician licensed in Kentucky who is routinely involved in the 12 emergency care of ill or injured children appointed by the Governor from a 13 list of three (3) physicians submitted by the Kentucky Medical Association; 14 (c) One (1) local government representative appointed by the Governor from a 15 list of three (3) individuals submitted by the Kentucky League of Cities; 16 (d) One (1) local government representative appointed by the Governor from a 17 list of three (3) individuals submitted by the Kentucky Association of 18 Counties; 19 (e) One (1) licensed or certified emergency medical services field provider who 20 is primarily employed by a hospital-based health care facility appointed by 21 the Governor from a list of three (3) individuals submitted by the Kentucky 22 Hospital Association; 23 (f) One (1) licensed or certified emergency medical services representative 24 appointed by the Governor from a list of three (3) individuals submitted by 25 the Kentucky Ambulance Providers Association; 26 (g) One (1) licensed or certified emergency medical services representative 27 UNOFFICIAL COPY 22 RS BR 1600 Page 6 of 111 XXXX Jacketed appointed by the Governor from a list of three (3) individuals submitted by 1 the Kentucky Firefighters Association; 2 (h) One (1) hospital administrator appointed by the Governor from a list of 3 three (3) individuals submitted by the Kentucky Hospital Association; 4 (i) One (1) long-term care facility administrator appointed by the Governor 5 from a list of six (6) individuals that includes three (3) individuals submitted 6 by the Kentucky Association of Health Care Facilities/Kentucky Center for 7 Assisted Living and three (3) individuals submitted by LeadingAge 8 Kentucky; 9 (j) One (1) licensed emergency medical services educator appointed by the 10 Governor from a list of three (3) individuals submitted by Emergency 11 Medical Service Educators of Kentucky; 12 (k) One (1) licensed or certified behavioral health provider appointed by the 13 Governor from a list of three (3) nominees submitted by the Kentucky 14 Mental Health Coalition; 15 (l) One (1) licensed administrator of an air medical transportation provider 16 that is based in Kentucky appointed by the Governor; and 17 (m) The commissioner of the Department for Public Health in the Cabinet for 18 Health and Family Services or his or her designee[(a) One (1) emergency 19 medical technician who works for a government agency but is not serving in 20 an educational, management, or supervisory capacity; 21 (b) One (1) physician licensed in Kentucky serving as medical director of an 22 advanced life support ambulance service selected from a list of three (3) 23 physicians submitted by the Kentucky Medical Association; 24 (c) One (1) physician licensed in Kentucky who is routinely involved in the 25 emergency care of ill or injured children selected from a list of three (3) 26 physicians submitted by the Kentucky Medical Association; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 7 of 111 XXXX Jacketed (d) One (1) citizen having no involvement in the delivery of medical or 1 emergency services; 2 (e) One (1) certified emergency medical services educator; 3 (f) One (1) fire-service-based, licensed Class I ground ambulance service 4 administrator who is a certified emergency medical technician, an advanced 5 emergency medical technician, or a licensed paramedic; 6 (g) One (1) licensed air ambulance service administrator or paramedic for a 7 licensed air ambulance service headquartered in Kentucky; 8 (h) One (1) privately operated, licensed Class 1 ground ambulance service 9 administrator who is a certified emergency medical technician, an advanced 10 emergency medical technician, or a licensed paramedic; 11 (i) One (1) hospital administrator selected from a list of three (3) nominees 12 submitted by the Kentucky Hospital Association; 13 (j) One (1) advanced life support ambulance provider who is an advanced 14 emergency medical technician or a licensed paramedic, who works for a 15 government agency but is not serving in an educational, management, or 16 supervisory capacity; 17 (k) One (1) publicly operated Class I ground ambulance service administrator 18 who is a certified emergency medical technician, an advanced emergency 19 medical technician, or a licensed paramedic; 20 (l) One (1) mayor of a city that operates, either directly or through contract 21 services, a licensed Class I ground ambulance service; and 22 (m) One (1) county judge/executive from a county that operates, whether directly 23 or through contract services, a licensed Class I ground ambulance service]. 24 (3) [(a) ]Members shall serve for a term of four (4) years, may be reappointed, and 25 shall serve no more than two (2) consecutive terms. A member appointed to a 26 partial term vacancy exceeding two (2) years shall be deemed to have served a full 27 UNOFFICIAL COPY 22 RS BR 1600 Page 8 of 111 XXXX Jacketed term. A former member may be reappointed following an absence of at least one (1) 1 term. 2 [(b) Any person serving on the board in a position eliminated on June 27, 2019, 3 and whose term has not expired prior to the June 27, 2019, may continue to 4 serve in a voting, ex officio capacity until the expiration of his or her term.] 5 (4) The board shall: 6 (a) Meet at least six (6) times a year; and 7 (b) At the first meeting of the board after September 1 of each year, elect a chair 8 and vice chair by majority vote of the members present and set a schedule of 9 six (6) regular meetings for the next twelve (12) month period. 10 (5) The board shall adopt a quorum and rules of procedure by administrative regulation. 11 (6) (a) A member of the board who misses three (3) regular meetings in a twelve (12) 12 month period shall be deemed to have resigned from the board and his or her 13 position shall be deemed vacant. 14 (b) The failure of a board member to attend a special or emergency meeting shall 15 not result in any penalty. 16 (c) The Governor shall appoint a person with the same professional 17 qualifications[of the same class] to fill the vacancy within ninety (90) days. 18 (d) The person removed under this subsection shall not be reappointed to the 19 board for at least ten (10) years. 20 (7) Members of the board shall be entitled to reimbursement for actual and necessary 21 expenses when carrying out official duties of the board in accordance with state 22 administrative regulations relating to travel reimbursement. 23 (8) The board shall submit a report to the cabinet and the Legislative Research 24 Commission by September 1 of each year. The report shall include but not be 25 limited to: 26 (a) A detailed list of income and expenses of the board; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 9 of 111 XXXX Jacketed (b) A detailed summary of data collected on the number of complaints against 1 individuals certified or licensed by the board and emergency medical 2 services training institutions approved by the board, and the disposition of 3 those complaints; 4 (c) An accounting of all new administrative regulations and amendments to 5 administrative regulations promulgated by the board; and 6 (d) Recommendations for changes in administrative regulations, board policies, 7 and statutes[Annual reports and recommendations from the board shall be 8 sent by September 1 each year to the Governor, the president of the Kentucky 9 Community and Technical College System, and the General Assembly]. 10 Section 3. KRS 311A.020 is amended to read as follows: 11 (1) The board shall: 12 (a) Exercise all of the administrative functions of the state not regulated by the 13 Board of Medical Licensure or Cabinet for Health and Family Services in the 14 regulation of the emergency medical services system and the practice of 15 emergency medical services, and emergency medical services training 16 institutions, with the exception of employment of personnel as described in 17 subsections (5) and (6) of this section; 18 (b) Issue any licenses or certifications authorized by this chapter; 19 (c) Oversee the operations and establish the organizational structure of the Office 20 of the Kentucky Board of Emergency Medical Services, which is created and 21 shall be attached to the board for administrative purposes. The office shall be 22 headed by the executive director appointed under paragraph (d) of this 23 subsection and shall be responsible for: 24 1. Personnel and budget matters affecting the board; 25 2. Fiscal activities of the board, including grant writing and disbursement 26 of funds; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 10 of 111 XXXX Jacketed 3. Information technology, including the design and maintenance of 1 databases; 2 4. Certification and recertification of emergency medical responders; 3 5. Certification and recertification of emergency medical technicians and 4 advanced emergency medical technicians; 5 6. [Licensure and relicensure of ambulances, ambulance services, and 6 mobile integrated healthcare programs; 7 7. ]Licensure and relicensure of paramedics; 8 7.[8.] Certification and recertification of advanced practice paramedics; 9 8.[9.] Certification and recertification of EMS educators; 10 9.[10.] Investigation of and resolution of [quality ]complaints and ethics 11 issues pertaining to professional certifications and licenses; and 12 10.[11.] Other responsibilities that may be assigned to the executive 13 director by the board; 14 (d) Employ an executive director and deputy executive director and fix the 15 compensation. The executive director and deputy executive director shall 16 serve at the pleasure of the board, administer the day-to-day operations of the 17 Office of the Kentucky Board of Emergency Medical Services, and supervise 18 all directives of the board. The director and deputy executive director shall 19 possess a baccalaureate degree and shall have no less than five (5) years of 20 experience in public administration or in the administration of an emergency 21 medical services program; 22 (e) [Employ or contract with a physician licensed in Kentucky who is board 23 certified in emergency medicine and fix the compensation. The physician shall 24 serve at the pleasure of the board and as the medical advisor to the Kentucky 25 Board of Emergency Medical Services and the staff of the board; 26 (f) ]Employ or contract with an attorney licensed to practice law in Kentucky and 27 UNOFFICIAL COPY 22 RS BR 1600 Page 11 of 111 XXXX Jacketed fix the compensation. The attorney shall serve at the pleasure of the board and 1 have primary assignment to the board. The board and the attorney shall 2 implement and oversee regulatory processes and may consult with the 3 cabinet on ways to improve emergency medical services; 4 (f)[(g)] Employ personnel sufficient to carry out the statutory responsibilities of 5 the board in accordance with the following:[.] 6 1. Personnel assigned to investigate an emergency medical responder 7 program complaint or regulate the emergency medical responder 8 programs shall be certified emergency medical responders, emergency 9 medical technicians, advanced emergency medical technicians, or 10 licensed paramedics;[.] 11 2. Personnel assigned to investigate an emergency medical technician 12 program complaint or regulate the emergency medical technician 13 program shall be certified emergency medical technicians, advanced 14 emergency medical technicians, or paramedics;[.] 15 3. Personnel assigned to investigate an advanced emergency medical 16 technician program complaint or regulate the advanced emergency 17 medical technician program shall be certified advanced emergency 18 medical technicians or paramedics;[.] 19 4. Personnel assigned to investigate a paramedic program complaint or 20 regulate the paramedic program shall be licensed paramedics;[.] 21 5. A person who is employed by the board who is licensed or certified by 22 the board shall retain his or her license or certification if he or she meets 23 the in-service training requirements and pays the fees specified by 24 administrative regulation;[.] 25 6. A person who is employed by the board may instruct in emergency 26 medical subjects in which he or she is qualified, with the permission of 27 UNOFFICIAL COPY 22 RS BR 1600 Page 12 of 111 XXXX Jacketed the board. All instruction shall be rendered without remuneration other 1 than his or her state salary and the employee shall be considered as on 2 state duty when teaching; and[.] 3 7. A person who is employed by the board may render services for which 4 the person is qualified at a declared disaster or emergency or in a 5 situation where trained personnel are not available until those personnel 6 arrive to take over the patient, or where insufficient trained personnel are 7 available to handle a specific emergency medical incident. All aid shall 8 be rendered without remuneration other than the employee's state salary 9 and the employee shall be considered as on state duty when rendering 10 aid. In cases specified in this paragraph, the state medical advisor shall 11 serve as the emergency medical services medical director for the 12 employee; 13 (g)[(h)] Establish committees and subcommittees and the membership thereof. 14 Except for the executive committee members, who shall be members of the 15 board, members of committees and subcommittees do not need to be 16 members of the board but shall reflect the qualifications of the board 17 members. Members of any committee or subcommittee established by the 18 executive director shall be approved by the board; 19 (h)[(i)] In collaboration with the cabinet, enter into contracts, apply for grants 20 and federal funds, and disburse funds to local units of government as 21 approved by the General Assembly. All funds received by the board shall be 22 placed in a trust and agency account in the State Treasury subject to 23 expenditure by the board; 24 (i)[(j)] Administer the Emergency Medical Services for Children Program; and 25 (j)[(k)] Establish minimum curriculum and standards for emergency medical 26 services training. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 13 of 111 XXXX Jacketed (2) The board may utilize materials, services, or facilities as may be made available to it 1 by other state agencies or may contract for materials, services, or facilities. 2 (3) The board may delegate to the executive director, by written order, any function 3 specified in this chapter other than promulgation of an administrative regulation or 4 the establishment of a committee or subcommittee with members who are not 5 members of the board[specified in this chapter]. 6 (4) Except for securing funding for trauma centers, the board shall not serve as the lead 7 agency relating to the development or regulation of trauma systems, but shall be a 8 partner with other state agencies in the development, implementation, and oversight 9 of such systems. 10 (5) [(a) The Kentucky Community and Technical College System shall employ 11 personnel for the work of the board, and the personnel in the positions described in 12 this section and all other persons in administrative and professional positions shall 13 be transferred to the personnel system of the Kentucky Community and Technical 14 College System on July 12, 2006, in the appropriate classification to carry out the 15 mission of the board. All employees transferred under this paragraph shall have all 16 employment records and months of service credit transferred to the Kentucky 17 Community and Technical College System. Employees of the board transferred 18 under this paragraph who subsequently return to state employment under KRS 19 Chapter 18A shall have their employment records and months of service credit 20 under the Kentucky Community and Technical College System transferred back to 21 the KRS Chapter 18A personnel system, and the employment records and months of 22 service credit shall be used in calculations for all benefits under KRS Chapter 18A. 23 (b) New employees hired or contracted after July 12, 2006, shall be employed or 24 contracted by the Kentucky Community and Technical College System. 25 (6) ]The board shall appoint a personnel committee consisting of the chair of the board, 26 one (1) physician member of the board, and two (2) additional board members[one 27 UNOFFICIAL COPY 22 RS BR 1600 Page 14 of 111 XXXX Jacketed (1) ambulance service provider member of the board, one (1) additional member of 1 the board selected by the chair of the board, and one (1) representative of the 2 Kentucky Community and Technical College System administration. The personnel 3 committee shall conduct an annual job performance review of the executive 4 director, the medical advisor, and the board attorney that conforms with the 5 personnel standards of the Kentucky Community and Technical College System and 6 includes a recommendation for or against continued employment to be presented to 7 the personnel office of the Kentucky Community and Technical College System. 8 (7) All state general fund moneys appropriated to the board, all federal funds, all 9 moneys collected by the board, and all equipment owned by the board shall be 10 transferred to the Kentucky Community and Technical College System on July 1, 11 2006. 12 (8) The board shall develop a proposed biennial budget for all administrative and 13 operational functions and duties in conjunction with the Kentucky Community and 14 Technical College System budget submission process. The Kentucky Community 15 and Technical College System shall not make changes to the budget proposal 16 submitted by the board, but may submit written comments on the board's budget 17 proposal to the board and other agencies in the budget submission process]. 18 Section 4. KRS 311A.025 is amended to read as follows: 19 (1) The board shall, subject to the provisions of this chapter, create levels of 20 certification or licensure, as appropriate for [individuals ]providing services under 21 this chapter. These may consist of but not be limited to: 22 (a) Emergency medical services educator, Level I, II, and III; 23 (b) Emergency medical responder; 24 (c) Emergency medical technician and advanced emergency medical technician; 25 (d) Paramedic, advanced practice paramedic, and paramedic preceptor; 26 (e) Emergency medical services medical director[ who supervises a person or 27 UNOFFICIAL COPY 22 RS BR 1600 Page 15 of 111 XXXX Jacketed organization licensed or certified by the board]; 1 (f) Mobile integrated healthcare program medical director who supervises an 2 MIH program licensed by the cabinet[board]; 3 (g) Emergency medical services[service] training institution; 4 (h) Emergency medical services[service] testing agency; 5 (i) [Ground ambulance service, including categories thereof; 6 (j) Air ambulance service; 7 (k)] Medical first response provider; 8 (j)[(l)] Emergency medical dispatcher, emergency medical dispatch instructor, 9 and emergency medical dispatch instructor trainer; 10 (k)[(m)] Emergency medical dispatch center or public safety answering point; 11 and 12 (l)[(n)] Any other entity authorized by this chapter. 13 (2) The board shall promulgate administrative regulations in accordance with KRS 14 Chapter 13A for any certification or license the board may create. The 15 administrative regulations shall, at a minimum, address: 16 (a) Requirements for students, if appropriate; 17 (b) Requirements for training; 18 (c) Eligibility for certification or licensure; and 19 (d) Renewal, recertification, and relicensure requirements. 20 (3) The board may authorize a physician licensed to practice in Kentucky to serve as an 21 emergency medical services medical director if that physician meets the 22 requirements specified by the board by administrative regulation. 23 Section 5. KRS 311A.035 is amended to read as follows: 24 The board shall[may] carry out the functions of this chapter and[, including but not 25 limited to]: 26 (1) Maintain[Establishing minimum data reporting requirements, including 27 UNOFFICIAL COPY 22 RS BR 1600 Page 16 of 111 XXXX Jacketed requirements specifically related to emergency medical services and trauma care of 1 children, for ambulance providers and collection and analysis of data related to the 2 provision of emergency medical services; 3 (2) Maintaining] the Emergency Medical Services for Children Program with federal 4 funds so designated plus any additional funds that may be appropriated by the 5 General Assembly, or any other funds that may become available to the board, 6 including gifts, grants, or other sources; and 7 (2) Apply for, receive, and dispose[(3) Developing a statewide plan for the 8 implementation of emergency medical services systems and trauma care systems 9 within the Commonwealth of Kentucky that specifically addresses the unique needs 10 of rural areas; 11 (4) Applying for, receiving, and disposing] of federal, state, or private funds by grant, 12 appropriation, donation, or otherwise for emergency medical services programs, 13 personnel, and equipment[; and 14 (5) Developing, monitoring, and encouraging other projects and programs that may be 15 of benefit to emergency medical services in the Commonwealth. 16 Nothing in this section shall be construed to change or alter the issuance of certificates of 17 need for emergency medical services providers]. 18 Section 6. KRS 311A.055 is amended to read as follows: 19 (1) In accordance with the provisions of KRS Chapter 13B, all discipline for which the 20 board is authorized to conduct investigations, hold hearings, and impose 21 punishments is delegated to the executive director, [state medical advisor, ]board 22 attorney, and hearing panels as provided herein. 23 (2) Any person may make a complaint to the executive director that a training 24 institution[an entity] licensed or certified by the board, emergency medical services 25 personnel, or any other person licensed or certified by the board has violated a 26 provision of this chapter, an administrative regulation promulgated pursuant to this 27 UNOFFICIAL COPY 22 RS BR 1600 Page 17 of 111 XXXX Jacketed chapter, protocol, practice standard, or order of the board. 1 (3) Each complaint shall: 2 (a) Be in writing and may be submitted electronically, by fax, or by mail; 3 (b) Identify specifically the person or training institution[organization] against 4 whom the complaint is made; 5 (c) Set forth the facts relating to the violation alleged and any other supporting 6 information that[which] may have a bearing on the matter; and 7 (d) Contain the name, address, telephone number, facsimile number, and e-mail 8 address, if available, of the complainant[; 9 (e) Be subscribed and sworn to as to the truth of the statements contained in the 10 complaint by the complainant; and 11 (f) Be notarized. 12 (4) A complaint which is unsigned shall not be acted upon by the executive director. A 13 complaint which is not subscribed and sworn in the manner specified in subsection 14 (3) of this section shall be returned to the complainant for completion]. 15 (4)[(5)] The executive director of the board may, on behalf of the board, based on 16 knowledge available to the office of the board, make a complaint against any person 17 or training institution[organization] regulated by the board in the same manner as 18 provided in subsection (3) of this section. 19 (5)[(6)] Upon receipt of a [properly completed ]complaint, the executive director shall 20 assign the complaint to a staff investigator who shall investigate the complaint and 21 shall make findings of fact and recommendations to the executive director who shall 22 then convene a preliminary inquiry board. 23 (6)[(7)] When the executive director assigns a complaint to a staff investigator, he or 24 she shall notify the person or training institution[organization] against whom the 25 complaint has been filed, the employer of the emergency services personnel against 26 whom the complaint has been filed, the emergency medical services medical 27 UNOFFICIAL COPY 22 RS BR 1600 Page 18 of 111 XXXX Jacketed director or mobile integrated healthcare program medical director for the 1 ambulance provider[organization against whom the complaint has been filed or] 2 that employs the emergency medical services personnel against whom the complaint 3 has been filed, and any other person or organization specified in this chapter. 4 (7)[(8)] The notification shall name the person or training institution[organization] 5 complained against, [the complainant, ]the violations alleged, and the facts 6 presented in the complaint and shall notify the person or training 7 institution[organization] complained against, the employer, and the emergency 8 medical services or the mobile integrated healthcare program medical director of: 9 (a) The fact that the complaint shall be answered, the steps for answering the 10 complaint, and the action to be taken if the complaint is not answered; 11 (b) The time frame and steps in the proceedings of a complaint; 12 (c) The rights of the parties, including the right to counsel; and 13 (d) The right to testify at any hearing. 14 (8)[(9)] Upon the failure of a license or certificate holder to respond to a written 15 accusation or to request a hearing within twenty (20) days after the sending of the 16 accusation, the accused shall be considered to have admitted the truth of the facts 17 and the circumstances in the allegation and appropriate discipline may be imposed. 18 (9)[(10)] The preliminary inquiry board shall consist of one (1) member of the board 19 selected by the chair, and two (2) persons representing the same category of 20 certification or licensure as the defendant who are not members of the board 21 appointed by the chairman of the board. 22 (10)[(11)] After reviewing the complaint and results of any investigation conducted on 23 behalf of the board, the preliminary inquiry board shall consider whether the 24 accusation is sufficient to remand the matter for a hearing as provided in this section 25 and KRS Chapter 13B. A majority vote of the members of the preliminary inquiry 26 board shall be necessary for action to either remand the matter for hearing or 27 UNOFFICIAL COPY 22 RS BR 1600 Page 19 of 111 XXXX Jacketed dismiss the complaint without hearing. 1 (11)[(12)] If the preliminary inquiry board dismisses the complaint, all parties notified 2 previously shall be notified of the action. If the preliminary inquiry board remands 3 the matter for a hearing, all parties notified previously shall be notified of the 4 action. 5 (12)[(13)] Each proceeding to consider the imposition of a penalty that[which] the board 6 is authorized to impose pursuant to this chapter shall be conducted in accordance 7 with KRS Chapter 13B. 8 (13)[(14)] A hearing panel for purposes of making a decision in any disciplinary matter 9 shall consist of one (1) physician who may be a member of the board or who meets 10 the qualifications of an emergency medical services medical director; one (1) person 11 from the category of persons or training institutions[organizations] of the same 12 class as the defendant; and the hearing officer, who shall not be involved in 13 emergency medical services. 14 (14)[(15)] The hearing officer may issue subpoenas to compel the attendance of 15 witnesses and the production of documents in the conduct of an investigation. The 16 subpoenas may be enforced by any Circuit Court for contempt. Any order or 17 subpoena of the court requiring the attendance and testimony of witnesses and the 18 production of documentary evidence may be enforced and shall be valid anywhere 19 in this state. 20 (15)[(16)] At all hearings the board attorney or, on request of the board, the Attorney 21 General of this state or one (1) of the assistant attorneys general designated shall 22 appear and represent the board. 23 (16)[(17)] The emergency medical services provider or related employer of a person 24 licensed or certified by the board and the emergency medical services medical 25 director of such a person who is the defendant in a hearing shall be parties to the 26 action and may appear and testify in the matter at any deposition or hearing on the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 20 of 111 XXXX Jacketed matter and may propose conclusions of law, findings of fact, and penalties to the 1 hearing panel. 2 (17)[(18)] To make a finding or recommend discipline, the two (2) members of the 3 hearing panel who are not the hearing officer shall agree on the finding or 4 discipline. In the event of a tie vote, the hearing officer shall cast the deciding vote. 5 (18)[(19)] The final order in any disciplinary proceeding shall be prepared by the 6 executive director and sent to all parties and to the cabinet in the manner prescribed 7 by law. 8 (19)[(20)] Any person or training institution[entity] aggrieved by a final order of the 9 board may appeal to the Franklin Circuit Court in accordance with the provisions of 10 KRS Chapter 13B. 11 (20)[(21)] The only discipline that the board may impose against an emergency medical 12 services medical director is denial, suspension or withdrawal of the board's approval 13 for that person to serve as an emergency medical services medical director. 14 (21)[(22)] If the executive director substantiates that sexual contact occurred between a 15 licensee or certificate holder and a patient while the patient was under the care of or 16 in a professional relationship with the licensee or certificate holder, the license or 17 certification may be revoked or suspended with mandatory treatment of the person 18 as prescribed by the executive director. The executive director may require the 19 licensee or certificate holder to pay a specified amount for mental health services 20 for the patient which are needed as a result of the sexual contact. 21 (22) Except as specified in this section, all board proceedings, including the complaint 22 and answer and other records relating to a disciplinary proceeding, shall be 23 confidential until a final determination is made by the board, except: 24 (a) The board may turn over to the Attorney General, the United States 25 Attorney, Commonwealth's attorney, or county attorney of the jurisdiction 26 in which the offense allegedly occurred, evidence that may be used in 27 UNOFFICIAL COPY 22 RS BR 1600 Page 21 of 111 XXXX Jacketed criminal proceedings; and 1 (b) If the complainant or alleged violator publicly discloses the existence of a 2 preliminary inquiry, the board may publicly confirm the existence of the 3 inquiry and, in its discretion, make public any documents that were issued 4 to either party. 5 Section 7. KRS 311A.060 is amended to read as follows: 6 (1) (a) If it is determined that a training institution[an entity] or a member of 7 emergency medical services personnel regulated, licensed, or certified by the 8 board has violated a statute, administrative regulation, protocol, or practice 9 standard relating to serving as a training institution[an entity] or a member of 10 emergency medical services personnel regulated by the board, the office of the 11 board may impose any of the sanctions provided in subsection (2) of this 12 section. Any party to the complaint shall have the right to propose findings of 13 fact and conclusions of law, and to recommend sanctions. 14 (b) For the purposes of this subsection, violation of [" ]a statute, administrative 15 regulation, protocol, or practice standard relating to serving as training 16 institution[an entity] regulated by the board, a paramedic, first responder, or 17 emergency medical technician["] shall include violation of KRS 304.39-215 18 and conduct that is subject to the penalties under KRS 304.99-060(4) or (5). 19 (2) The office of the board shall require an acceptable plan of correction and may use 20 any one (1) or more of the following sanctions when disciplining emergency 21 medical services personnel or any training institution[entity] regulated by the 22 board: 23 (a) Private reprimand that shall be shared with each of the paramedic's, 24 emergency medical responder's, advanced emergency medical technician's, or 25 emergency medical technician's emergency medical services or related 26 employer and medical director; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 22 of 111 XXXX Jacketed (b) Public reprimand; 1 (c) Fines of fifty dollars ($50) to five hundred dollars ($500) for a natural person 2 or fifty dollars ($50) to five thousand dollars ($5,000) for a training 3 institution[public agency or business entity]; 4 (d) Revocation of certification or licensure; 5 (e) Suspension of certification or licensure until a time certain; 6 (f) Suspension until a certain act or acts are performed; 7 (g) Limitation of practice permanently; 8 (h) Limitation of practice until a time certain; 9 (i) Limitation of practice until a certain act or acts are performed; 10 (j) Repassing a portion of the paramedic, emergency medical responder, 11 advanced emergency medical technician, or emergency medical technician 12 examination; 13 (k) Probation for a specified time; or 14 (l) If it is found that the person who is licensed or certified by the board has been 15 convicted of, pled guilty to, or entered an Alford plea to a felony offense, the 16 license or certification shall be revoked. 17 (3) The filing of criminal charges or a criminal conviction for violation of the 18 provisions of this chapter or the administrative regulations promulgated thereunder 19 shall not preclude the office of the board from instituting or imposing board 20 disciplinary action authorized by this chapter against any person or training 21 institution[organization] violating this chapter or the administrative regulations 22 promulgated thereunder. 23 (4) The institution or imposition of disciplinary action by the office of the board against 24 any person or training institution[organization] violating the provisions of this 25 chapter or the administrative regulations promulgated thereunder shall not preclude 26 the filing of criminal charges against or a criminal conviction of any person or 27 UNOFFICIAL COPY 22 RS BR 1600 Page 23 of 111 XXXX Jacketed training institution[organization] for violation of the provisions of this chapter or 1 the administrative regulations promulgated thereunder. 2 Section 8. KRS 311A.070 is amended to read as follows: 3 (1) When a complaint is filed against an [ambulance service, ]emergency medical 4 services field provider, or a training[an emergency medical services educational] 5 institution or an employee or volunteer thereof, or when the office of the board is 6 contemplating action against an [ambulance service, ]emergency medical services 7 field provider, or a training[emergency medical services educational] institution or 8 an employee or volunteer thereof, written notice of the complaint or proposed action 9 shall be sent to: 10 (a) The county judge/executive, in the event of an emergency medical services 11 field provider employed by the county or a training institution operated by 12 the county[a county-operated ambulance service, emergency medical services 13 provider, or educational institution]; 14 (b) The mayor, in the event of an emergency medical services field provider 15 employed by the city or a training institution operated by the city[a city-16 operated ambulance service, emergency medical services provider, or 17 educational institution]; 18 (c) The mayor, in the event of an emergency medical services field provider 19 employed by the urban-county government or a training institution operated 20 by the urban-county government[government-operated ambulance service, 21 emergency medical services provider, or educational institution]; 22 (d) The chairman of the fire protection district, in the event of an emergency 23 medical services field provider employed by the fire protection district or a 24 training institution operated by the fire protection district[a fire district-25 operated ambulance service, emergency medical services provider, or 26 educational institution]; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 24 of 111 XXXX Jacketed (e) The head of the public agency, in the event of an emergency medical services 1 field provider employed by the public agency or a training institution 2 operated by the public agency[ambulance service, emergency medical 3 services provider, or educational institution operated by a public agency] other 4 than specified in paragraphs (a) to (d) of this subsection; 5 (f) The president, chancellor, or other officer in charge of a training institution 6 in the event of an emergency medical services field provider employed by the 7 institution or a training institution operated by the president, chancellor, or 8 other officer[an educational institution operated, in the event of an ambulance 9 service or educational institution]; 10 (g) The chief operating officer or president of a nonprofit corporation, corporation 11 for profit, limited liability company, or other business entity, in the event of an 12 emergency medical services field provider employed by the business entity or 13 a training[ambulance service, emergency medical services provider, or 14 educational] institution operated by the business entity; and 15 (h) Both the [ambulance service, ]emergency medical services field provider and 16 training[, or educational] institution officials specified in this subsection and 17 the officials of any public agency contracting for services. 18 (2) The notice specified in this section shall be in addition to any notice provided to any 19 other person or organization. 20 Section 9. KRS 311A.075 is amended to read as follows: 21 (1) The chair of the board, or his or her designee, in writing, may determine that 22 immediate temporary suspension of a license or certification of a [natural ]person 23 against whom disciplinary action or an investigation is pending is necessary in order 24 to protect the public. If the defendant is employed by an emergency medical 25 services provider, the input of the employer's emergency medical services medical 26 director or mobile integrated healthcare program medical director may be sought 27 UNOFFICIAL COPY 22 RS BR 1600 Page 25 of 111 XXXX Jacketed with regard to the matter. [In the event of an action against an organization, the 1 determination that an immediate temporary suspension is necessary in order to 2 protect the public shall be made by the chair of the board, or his or her designee, in 3 writing. ]When [this action may be ]necessary to protect the public, the executive 4 director, in writing, shall issue an emergency order suspending the licensee or 5 certificate holder. Upon appeal of an emergency order, an emergency hearing shall 6 be conducted in accordance with KRS 13B.125. 7 (2) No board member shall be disqualified from serving on a disciplinary action 8 hearing panel for the reason that he or she has previously sat on a preliminary 9 inquiry panel hearing of the same licensee or certification holder. 10 (3) Disciplinary actions in which a license or certification has been temporarily 11 suspended and a hearing shall be held in accordance with KRS 13B.125 within 12 ninety (90) days unless the defendant requests an extension of time. 13 (4) The order of immediate temporary suspension shall remain in effect until either 14 retracted or superseded by final disciplinary action by the office of the board. In 15 cases where disciplinary action is imposed, the office of the board may additionally 16 order that the temporary suspension continue in effect until the later expiration of 17 time permitted for appeal or termination of the appellate process. 18 Section 10. KRS 311A.130 is amended to read as follows: 19 (1) The conduct of proper in-service training, including but not limited to in-house in-20 service training, in accordance with the standards specified by this chapter, 21 administrative regulations, and the standards of relevant United States Department 22 of Transportation curricula shall be that of the provider of the in-service training. 23 (2) If in-service training is conducted by an ambulance provider[service], emergency 24 medical services provider, or training[educational] institution, the organization, the 25 instructor, and its medical director share responsibility for the provision of training 26 that[which] meets or exceeds the requirements of subsection (1) of this section. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 26 of 111 XXXX Jacketed (3) Persons and organizations providing in-service training for any emergency medical 1 services personnel shall keep the records required by the board or cabinet by 2 administrative regulation and shall make them available to a representative of the 3 board or cabinet upon request. 4 (4) Failure to keep a record required by the board or cabinet by administrative 5 regulation or required to be kept by statute, falsifying a record, or grossly 6 negligently maintaining a record required to be kept by administrative regulation or 7 statute shall be subject to action by the office of the board or cabinet. 8 (5) Providing in-service training not meeting or exceeding the requirements specified in 9 subsections (1) and (2) of this section shall be subject to action of the office of the 10 board or cabinet. 11 (6) Penalties specified in this section shall be in addition to any action that[which] the 12 board or cabinet may be permitted to take against the license or certification of any 13 person or organization. 14 (7) The board may refuse to recognize any in-service training not conducted in 15 accordance with the provisions of this chapter, United States Department of 16 Transportation curricula, or administrative regulations promulgated pursuant to this 17 chapter. If the board determines that in-service training will not be accepted, the 18 denial of credit shall be extended to all persons who completed that specific in-19 service training. 20 Section 11. KRS 311A.170 is amended to read as follows: 21 (1) Subject to the provisions of this section, a paramedic may perform any procedure: 22 (a) Specified in the most recent curriculum of the United States Department of 23 Transportation training course for paramedics; and 24 (b) Any additional procedure specified by the board by administrative regulation. 25 (2) When there is a change in the United States Department of Transportation 26 curriculum for paramedics, or the board approves an additional skill or procedure by 27 UNOFFICIAL COPY 22 RS BR 1600 Page 27 of 111 XXXX Jacketed administrative regulation, or the cabinet approves a protocol differing from the 1 curriculum or administrative regulations, no person who was not trained under that 2 curriculum, [or ]administrative regulation, or protocol shall perform any activity or 3 procedure in the new curriculum, administrative regulation, or protocol unless the 4 person has been trained according to the new curriculum, administrative regulation, 5 or protocol and demonstrates competency in the new knowledge or skill. 6 Competency in a new skill shall be demonstrated through a return demonstration to 7 a competent evaluator. If the board adopts the new procedure or skill, the board 8 shall promulgate an administrative regulation specifying the new procedure, training 9 requirements, examination requirements, and a time period during which the 10 paramedic shall successfully complete the material or lose his or her license as a 11 paramedic. 12 (3) The board shall promulgate administrative regulations in accordance with KRS 13 Chapter 13A establishing the educational requirements, testing requirements, 14 credentialing, and licensure requirements of advanced practice paramedics. 15 Advanced practice paramedics shall validate competency as prescribed in 16 administrative regulations and be identified as one (1) or more of the following 17 certification levels of advanced practice paramedic: 18 (a) Certified community paramedic; 19 (b) Certified critical care paramedic; 20 (c) Certified flight paramedic; 21 (d) Certified tactical paramedic; or 22 (e) Certified wilderness paramedic. 23 (4) A paramedic may draw blood samples from a criminal defendant upon the request 24 of a peace officer and the consent of the defendant, or without the consent of the 25 defendant upon receipt of a court order requiring the procedure, if the paramedic is 26 authorized to do so by his or her employer. The authorization shall be in writing and 27 UNOFFICIAL COPY 22 RS BR 1600 Page 28 of 111 XXXX Jacketed may be by general written policy of the employer and the [service's ]medical 1 director. The paramedic who drew the blood sample shall deliver the sample to the 2 peace officer or other person specified by the court in a court order and shall testify 3 in court with regard thereto upon service of a proper subpoena. 4 (5) A paramedic shall be permitted to render services only under the supervision of a 5 certified emergency medical services medical director, certified mobile integrated 6 healthcare program medical director, or under the direct supervision of an 7 emergency department medical director. 8 (6) A paramedic holding board certification as a community paramedic may provide 9 mobile integrated healthcare services only as an employee of a mobile integrated 10 healthcare program holding a Class V mobile integrated healthcare license in 11 affiliation with a Class I ground ambulance provider. 12 (7) Any provision of this chapter other than this section relating to the requirement for 13 additional training, requirement for skill examination, or approval of standing 14 orders, protocols, or medical procedures to the contrary notwithstanding, a 15 paramedic may be employed by a hospital to work as a licensed paramedic in the 16 emergency department of the hospital subject to the following conditions: 17 (a) The hospital in collaboration with the medical staff shall provide operating 18 procedures and policies under which the paramedic shall operate consistent 19 with the paramedic's scope of practice; 20 (b) A paramedic shall provide patient care services under the orders of a 21 physician, physician assistant, advanced practice registered nurse, or as 22 delegated by a registered nurse; 23 (c) Subject to the provisions relating to the scope of practice of a paramedic, a 24 hospital may require a paramedic to take additional training on any subject or 25 skill that[which] the paramedic may be required to perform in that[a] hospital 26 and demonstrate competency in the skill or subject to a competent evaluator; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 29 of 111 XXXX Jacketed and 1 (d) The paramedic does not violate the provisions of KRS 311A.175 or any other 2 statute or administrative regulation relating to a paramedic. 3 No provision of this section shall prevent a paramedic from being employed in any 4 other section of the hospital where the paramedic's job duties do not require 5 certification or licensure by the board and do not otherwise constitute the unlawful 6 practice of medicine. 7 (8) Except as provided in subsection (2) of this section, nothing in this section shall 8 prevent an employer from exercising reasonable fiscal control over the costs of 9 providing medical services to its citizens nor prevent the employer from exercising 10 any reasonable control over paramedics providing care on behalf of the licensed 11 entity. 12 Section 12. KRS 311A.175 is amended to read as follows: 13 (1) No certified emergency medical responder shall perform any act or procedure 14 that[which] exceeds the scope of practice of an emergency medical responder as 15 specified in this chapter and in administrative regulations promulgated by the board. 16 (2) No emergency medical technician shall perform any act or procedure that[which] 17 exceeds the scope of practice of an emergency medical technician as specified in 18 this chapter and in administrative regulations promulgated by the board. 19 (3) No advanced emergency medical technician shall perform any act or procedure 20 that[which] exceeds the scope of practice of an advanced emergency medical 21 technician as specified in this chapter and in administrative regulations promulgated 22 by the board. 23 (4) No paramedic shall perform any act or procedure that[which] exceeds the scope of 24 practice of a paramedic as specified in this chapter, administrative regulations 25 promulgated by the board, or protocol, standing order, or other document approved 26 by the cabinet[board]. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 30 of 111 XXXX Jacketed (5) A certified emergency responder, emergency medical technician, advanced 1 emergency medical technician, or licensed paramedic is presumed to know the 2 standards of practice for his or her level of certification or licensure. 3 (6) It is the legal duty of an emergency medical responder, emergency medical 4 technician, advanced emergency medical technician, or paramedic to refuse to 5 perform any act or procedure that[which] is beyond the scope of practice for his or 6 her level of certification or licensure regardless of whether that act or procedure is 7 ordered by a physician, physician assistant, medical director, advanced practice 8 registered nurse, registered nurse, or supervisor. 9 (7) No employer or organization for which an emergency medical responder, 10 emergency medical technician, advanced emergency medical technician, or 11 paramedic has volunteered shall reprimand, discipline, or dismiss an emergency 12 medical responder, emergency medical technician, advanced emergency medical 13 technician, or paramedic who has refused to perform an act or procedure 14 that[which] the emergency medical responder, emergency medical technician, 15 advanced emergency medical technician, or paramedic knows is in violation of the 16 provisions of this section. Violation of this section by an employer or by an 17 organization for which an emergency medical responder, emergency medical 18 technician, advanced emergency medical technician, or paramedic has volunteered 19 shall be grounds for a legal action for wrongful discipline or wrongful discharge, as 20 appropriate. 21 (8) The provisions of this section shall not apply to an order to perform an act or 22 procedure: 23 (a) For which a license or certification by the board is not required and which 24 otherwise do not constitute the unlawful practice of medicine; or 25 (b) For which no license or certification is required and does not involve medical 26 care or treatment; or 27 UNOFFICIAL COPY 22 RS BR 1600 Page 31 of 111 XXXX Jacketed (c) For which a license or certification issued by an agency other than the board is 1 required and the emergency medical responder, emergency medical 2 technician, advanced emergency medical technician, or paramedic holds such 3 a license or certification. 4 SECTION 13. A NEW SECTION OF KRS CHAPTER 216B IS CREATED 5 TO READ AS FOLLOWS: 6 As used in Sections 13 to 20 of this Act: 7 (1) "Ambulance" has the same meaning as in Section 1 of this Act; 8 (2) "Ambulance provider" has the same meaning as in Section 1 of this Act; and 9 (3) "Emergency medical services field provider" or "EMS field provider" means an 10 individual who, under KRS Chapter 311A, is certified as an emergency medical 11 responder, emergency medical technician, or advanced emergency medical 12 technician, or is licensed as a paramedic. 13 SECTION 14. A NEW SECTION OF KRS CHAPTER 216B IS CREATED 14 TO READ AS FOLLOWS: 15 (1) The cabinet shall carry out the functions of this chapter and shall: 16 (a) License and regulate ambulance providers; 17 (b) Inspect ambulance providers; 18 (c) Conduct investigations on complaints and handle disciplinary action 19 relating to ambulance providers; 20 (d) Prescribe, collect, and enforce emergency medical services data reporting 21 requirements, including as required by subsection (3) of this section, and 22 participate in the National Emergency Medical Services Information 23 System; 24 (e) Review medical protocols as required by subsection (2) of this section and 25 Section 19 of this Act; and 26 (f) Promulgate administrative regulations necessary to implement Sections 13 27 UNOFFICIAL COPY 22 RS BR 1600 Page 32 of 111 XXXX Jacketed to 20 of this Act. 1 (2) The cabinet shall employ or contract with a licensed physician residing in 2 Kentucky who is board-certified in emergency medicine and fix the 3 compensation. The physician shall serve as the medical advisor to the cabinet and 4 review and approve or deny medical protocols submitted by ambulance providers 5 as provided by Section 19 of this Act. 6 (3) The cabinet shall: 7 (a) Establish minimum data reporting requirements, including but not limited 8 to requirements specifically related to emergency medical services, trauma 9 care for children, ambulance providers, and medical first responders; 10 (b) Establish a central repository in the cabinet for all data required to be 11 reported under paragraph (a) of this subsection; 12 (c) Analyze the data required to be reported under paragraph (a) of this 13 subsection to make recommendations for improving emergency services or 14 to take advantage of grant opportunities as required by paragraph (e) of this 15 subsection or by Section 5 of this Act; 16 (d) Apply for, receive, and dispose of federal, state, or private funds by grant, 17 appropriation, donation, or otherwise for emergency medical services 18 programs, personnel, and equipment; and 19 (e) Develop, monitor, and encourage other projects and programs that may be 20 of benefit to emergency medical services in the Commonwealth. 21 (4) The cabinet may consult with the Kentucky Board of Emergency Medical 22 Services as necessary to implement subsection (3) of this section. 23 (5) The cabinet may establish an advisory committee to make recommendations 24 regarding the implementation of Sections 13 to 20 of this Act and to improve 25 emergency medical services. 26 SECTION 15. A NEW SECTION OF KRS CHAPTER 216B IS CREATED 27 UNOFFICIAL COPY 22 RS BR 1600 Page 33 of 111 XXXX Jacketed TO READ AS FOLLOWS: 1 (1) No person who is not a licensed ambulance provider, or whose license to do so 2 has been suspended, revoked, or denied, shall operate an ambulance service. 3 (2) Notwithstanding any other statute to the contrary, nothing in Sections 13 to 20 of 4 this Act shall change or alter the way in which 911 service or response areas are 5 defined or operated. An ambulance provider that holds a license to operate a 911 6 ambulance service shall comply with the current process established at the local 7 level for 911 dispatch calls and service areas. 8 (3) (a) Except as provided by paragraph (b) of this subsection, an ambulance 9 provider shall be licensed by the cabinet as required by Sections 13 to 20 of 10 this Act. 11 (b) A license to operate an ambulance agency issued by the Kentucky Board of 12 Emergency Medical Services that was in effect on the day prior to the 13 effective date of this Act shall expire on December 31, 2022, unless the 14 ambulance provider renews that license in accordance with the 15 requirements established by the cabinet. 16 (4) The cabinet may promulgate administrative regulations to enforce the provisions 17 of this section. 18 Section 16. KRS 311A.030 is repealed, reenacted as a new section of KRS 19 Chapter 216B, and amended to read as follows: 20 (1) The cabinet[board] shall promulgate administrative regulations in accordance with 21 KRS Chapter 13A to carry out the functions of Sections 13 to 20 of this Act[this 22 chapter], including but not limited to [: 23 (1) ]licensing, inspecting, and regulating of ambulance providers[ services], mobile 24 integrated healthcare programs, and medical first [-]response providers. The 25 administrative regulations shall address specific requirements for: 26 (a) Class I Ground ambulance providers, which provide basic life support or 27 UNOFFICIAL COPY 22 RS BR 1600 Page 34 of 111 XXXX Jacketed advanced life support services to all patients for emergencies or scheduled 1 ambulance transportation that[which] is medically necessary; 2 (b) Class II Ground ambulance providers, which provide only basic life support 3 services but do not provide initial response to the general population with 4 medical emergencies and which are limited to providing scheduled ambulance 5 transportation that[which] is medically necessary; 6 (c) Class III Ground ambulance providers, which provide mobile intensive care 7 services at or above the level of advanced life support to patients with critical 8 illnesses or injuries who must be transported between hospitals in vehicles 9 with specialized equipment as an extension of hospital-level care; 10 (d) Class IV Ground ambulance providers, which provide basic life support or 11 advanced life support services and transportation for restricted locations such 12 as industrial sites and other sites that do not provide services outside a 13 designated site; 14 (e) Class V Mobile integrated healthcare programs, which do not transport 15 patients as a function of the program and which must be operated by or in 16 affiliation with a Class I ambulance provider that provides emergency medical 17 response in the geographic area; 18 (f) Class VI medical first response providers, which provide basic or advanced 19 life support services, but do not transport patients; 20 (g) Class VII air ambulance providers, which provide basic or advanced life 21 support services; and 22 (h) Class VIII event medicine providers, which provide basic or advanced life 23 support services, but do not transport patients.[; and] 24 (2) The cabinet may promulgate administrative regulations in accordance with KRS 25 Chapter 13A, to amend, add to, or eliminate the categories of ambulance 26 providers listed under subsection (1) of this section. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 35 of 111 XXXX Jacketed (3) The cabinet shall promulgate administrative regulations in accordance with KRS 1 Chapter 13A to: 2 (a) Define and apply levels of emergent care response for all ambulance 3 providers regulated under Sections 13 to 20 of this Act; 4 (b) Establish a procedure for receiving, investigating, and resolving complaints 5 about ambulance providers and employees thereof; 6 (c) Develop a process to review and either approve or disapprove protocols for 7 ambulance providers; 8 (d) Establish a process for licensed ambulance providers to amend their 9 designated service areas, including the service areas for which a certificate 10 of need was issued prior to the effective date of this Act; 11 (e) Require applicants for ambulance provider licensure to specify the 12 geographic service area to be served by the applicant; and 13 (f) Establish the following minimum requirements: 14 1. Unless required by the United States Centers for Medicare and 15 Medicaid Services, an ambulance shall not be needed to transport a 16 patient to a hospital's own helipad or to a necessary service, including 17 but not limited to mobile imaging, located on or adjacent to the 18 hospital campus; and 19 2. Ambulance providers shall not discriminate in the transport of 20 patients, regardless of whether the patient is seeking physical health 21 treatment or behavioral health treatment[Licensing, inspecting, and 22 regulating of emergency medical services training institutions. 23 Nothing in this section shall be construed to change or alter the issuance of certificates of 24 need for emergency medical services providers]. 25 Section 17. KRS 311A.032 is repealed, reenacted as a new section of KRS 26 Chapter 216B, and amended to read as follows: 27 UNOFFICIAL COPY 22 RS BR 1600 Page 36 of 111 XXXX Jacketed (1) Each licensed ambulance provider[, as defined in KRS 311A.010,] shall: 1 (a) Post in a conspicuous area of the main office, any satellite location, and on the 2 company Web site, if the company hosts or otherwise maintains a Web site 3 itself or through contract with another party, a comprehensive fee schedule of 4 all services provided that is consistent with the Healthcare Common 5 Procedure Coding System (HCPCS). The fee schedule shall: 6 1. Clearly identify fees for services including base rates, mileage, 7 disposable supply fees, and any other potential fees for services 8 provided; and 9 2. Be documented in understandable language with sufficient explanation 10 to allow consumers to draw meaningful comparisons of fees among 11 licensed ambulance providers; 12 (b) Provide a copy of this fee schedule to a beneficiary at the time of service upon 13 request; 14 (c) Update fee schedules within fifteen (15) calendar days of any modification; 15 and 16 (d) Submit a report of an initial ambulance provider fee schedule and any 17 subsequent modifications to the cabinet[Kentucky Board of Emergency 18 Medical Services]. The report shall be subject to open records requests under 19 KRS 61.870 to 61.884. 20 (2) The cabinet may[Kentucky Board of Emergency Medical Services shall]: 21 (a) Assess a licensed ambulance provider a monetary penalty of one hundred fifty 22 dollars ($150) per occurrence for failure to post or update a modified fee 23 schedule as required under subsection (1) of this section; and 24 (b) Issue a statement of violation[ consistent with administrative regulations 25 promulgated by the Kentucky Board of Emergency Medical Services]. 26 (3) The cabinet[Kentucky Board of Emergency Medical Services] shall promulgate 27 UNOFFICIAL COPY 22 RS BR 1600 Page 37 of 111 XXXX Jacketed administrative regulations in accordance with KRS Chapter 13A to implement [the 1 provisions of ]this section. 2 Section 18. KRS 311A.155 is repealed, reenacted as a new section of KRS 3 Chapter 216B, and amended to read as follows: 4 (1) There shall be an emergency medical services grant program to provide funding to 5 each county for the direct operation of emergency medical services, including but 6 not limited to purchase or lease of ambulances or equipment. Funds available shall 7 not be used to fund personnel or consultant salaries. 8 (2) Funds appropriated to or received by the emergency medical services grant program 9 shall be placed in a trust and agency account in the State Treasury and shall not 10 lapse. 11 (3) The cabinet[board] shall administer the emergency medical services grant program 12 and may promulgate administrative regulations in accordance with KRS Chapter 13 13A, which shall include but not be limited to funding criteria necessary for its 14 implementation and operation. 15 (4) Twenty percent (20%) of the funds received each fiscal year for the grant program 16 may be withheld from general distribution and shall be distributed for emergency 17 purposes only. 18 (5) Grants may be made each fiscal year to each county fiscal court determined to be 19 eligible by the cabinet[board] for distribution to public ambulance 20 providers[services] operated by or for the county. A county may keep funds 21 appropriated to them for a period of two (2) years, if desired, for expenditure for 22 authorized purposes. At the end of two (2) years from the date of the receipt of the 23 grant, the county shall return any funds remaining unexpended to the emergency 24 medical services grant fund. Each expenditure made by the fiscal court from grant 25 funds provided to the county shall be documented, with appropriate receipts or other 26 documents, and a copy of each receipt or other document shall be provided to the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 38 of 111 XXXX Jacketed cabinet[board] to verify that the expenditure was proper. The cabinet[board] shall 1 require reimbursement to the emergency medical services fund by the county, with 2 interest at a rate of twenty percent (20%) annually, for any funds expended for an 3 unauthorized purpose. If the county fails or refuses to reimburse the fund, the 4 cabinet[board] shall notify the Attorney General, who shall seek appropriate civil 5 and criminal remedies. 6 (6) The cabinet[board] shall, annually, by January 1, promulgate administrative 7 regulations in accordance with KRS Chapter 13A specifying items of equipment 8 and other authorized expenditures for the upcoming fiscal year. No funds shall be 9 provided to the county until after the start of the fiscal year. 10 (7) The cabinet[board] may, in the event of a documented situation that[which] the 11 cabinet[board] considers to be an emergency and beyond the ability of the county to 12 pay, provide emergency funding to the fiscal court for an ambulance or authorized 13 equipment that[which] has been damaged or destroyed. Normal replacement of an 14 ambulance or equipment shall not be considered an emergency. The amount of 15 funding that may be provided by the cabinet[board] shall not exceed ten thousand 16 dollars ($10,000). Only one (1) emergency funding request shall be granted for any 17 county in each fiscal year. The amount of the emergency grant to the county shall be 18 deducted from the county's grant for the next fiscal year. 19 Section 19. KRS 311A.180 is repealed, reenacted as a new section of KRS 20 Chapter 216B, and amended to read as follows: 21 (1) Each emergency medical services medical director for an ambulance 22 provider[service], or other emergency medical services provider, shall submit: 23 (a) His or her protocols, including the pre-hospital care protocols related to the 24 assessment, treatment, and transport of stroke patients; 25 (b) His or her standing orders; and 26 (c) Similar medical control documents to the cabinet[board] for approval prior to 27 UNOFFICIAL COPY 22 RS BR 1600 Page 39 of 111 XXXX Jacketed placing the document in use. 1 (2) The medical advisor for the cabinet[board] shall review each document submitted 2 to ascertain if it is in accordance with accepted standards of medical care and in 3 accordance with the provisions of this chapter and administrative regulations 4 promulgated thereunder. If the protocol, standing order, or other medical control 5 document clearly violates the accepted standards of medical care, this chapter, or an 6 administrative regulation, the medical advisor shall notify the emergency medical 7 services medical director of the exact violation and recommend a correction thereof. 8 (3) Following review of protocol, standing order, and medical control documents and 9 giving the emergency medical services medical director who submitted the 10 documents an opportunity to review the medical advisor's comments, the medical 11 advisor shall submit the documents together with his or her comments to the 12 cabinet[board] for approval or disapproval. 13 (4) The cabinet[board] shall approve, disapprove, or approve with modifications 14 protocol, standing order, and medical control documents submitted by the 15 emergency medical services medical director[ at its next regular or special meeting 16 following the submission of the documents. 17 (5) If a protocol, standing order, or other medical control document is disapproved by 18 the board, the emergency medical services medical director who submitted it may 19 appeal the decision to the Franklin Circuit Court. If the decision of the board is 20 appealed to the Franklin Circuit Court, the board shall bear the burden of proving 21 that the protocol, standing order, or other medical control document violates the 22 accepted standards of medical care, or an administrative regulation]. 23 (5)[(6)] The cabinet[board] shall, by administrative regulation, specify a schedule for 24 submission and prompt review and decision making with regard to protocols, 25 standing orders, and medical control documents submitted to the cabinet[board]. A 26 medical protocol, standing order, or medical control document submitted to the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 40 of 111 XXXX Jacketed cabinet by a medical director who is board-certified in emergency medical 1 services shall be deemed approved forty-five (45) days following the date of 2 submission unless the cabinet provides written notice prior to that date that the 3 protocol, standing order, or other document is disapproved or requires 4 modification. 5 Section 20. KRS 311A.190 is repealed, reenacted as a new section of KRS 6 Chapter 216B, and amended to read as follows: 7 (1) Each licensed ambulance provider, mobile integrated healthcare program, and 8 medical first response provider as defined in this chapter shall collect and provide to 9 the cabinet[board] patient care record data and information required by the 10 cabinet[board by this chapter and administrative regulation]. 11 (2) The cabinet shall promulgate administrative regulations in accordance with KRS 12 Chapter 13A to establish requirements governing: 13 (a) Patient records and run reports to be collected and maintained by each 14 licensed ambulance provider, mobile integrated healthcare program, or 15 medical first response provider; 16 (b) Submission of the information from those records and run reports to the 17 cabinet; and 18 (c) Personnel recordkeeping requirements. 19 (3) The cabinet[board] shall develop a patient care record form for the use of each class 20 of ambulance provider, mobile integrated healthcare program, and medical first 21 response provider containing the data required in subsections (1) and 22 (2)[subsection (1)] of this section. An ambulance provider, mobile integrated 23 healthcare program, or medical first response provider may utilize any patient care 24 record form it chooses in lieu of or in addition to the cabinet[board] developed 25 patient care record form. However, the data captured on the patient care record form 26 utilized by the ambulance [service ]provider, mobile integrated healthcare program, 27 UNOFFICIAL COPY 22 RS BR 1600 Page 41 of 111 XXXX Jacketed or medical first response provider shall include at least the[that] data that[which] is 1 required by the administrative regulations promulgated pursuant to subsections (1) 2 and (2)[subsection (1)] of this section. 3 (4)[(3)] An ambulance provider, mobile integrated healthcare program, or medical 4 first response provider shall report the required patient care record data [as 5 prescribed through administrative regulations promulgated by the board ]by 6 transmitting the required data and information to the cabinet[board] in an electronic 7 format. If the cabinet[board] requires the use of a specific electronic format, the 8 cabinet[it] shall provide a copy of the file layout requirements, in either written or 9 electronic format, to the licensed ambulance provider or medical first response 10 provider at no charge. 11 (5)[(4)] In collaboration with the board, the cabinet shall[The board may] publish a 12 comprehensive annual report reflecting the data collected, injury and illness data, 13 treatment utilized, and other information deemed important by the cabinet[board]. 14 The annual report shall not include patient identifying information or any other 15 information identifying a natural person. A copy of the comprehensive annual 16 report, if issued, shall be forwarded to the Governor and the General Assembly. 17 (6)[(5)] Ambulance provider, mobile integrated healthcare program and medical first 18 response provider patient care records and the information transmitted electronically 19 to the cabinet[board] shall be confidential and in compliance with HIPAA privacy 20 rules referenced in 45 C.F.R. pt. 164. No person shall make an unauthorized 21 release of information on an ambulance provider, mobile integrated healthcare 22 program, or medical first response provider patient care record. Only the patient or 23 the patient's parent or legal guardian if the patient is a minor, or the patient's legal 24 guardian or person with proper power of attorney if the patient is under legal 25 disability as being incompetent or mentally ill, or a court of competent jurisdiction 26 may authorize the release of information on a patient's care record or the inspection 27 UNOFFICIAL COPY 22 RS BR 1600 Page 42 of 111 XXXX Jacketed or copying of the patient care record. Any authorization for the release of 1 information or for inspection or copying of a patient care record shall be in writing. 2 (7)[(6)] An ambulance provider or medical first response provider that collects patient 3 data through electronic means shall have the means of providing a patient care 4 record or summary report that includes all required data elements to the medical 5 care facility. A copy of the medical first response patient care record or summary 6 report of the patient care record and patient information shall be made available to 7 the ambulance provider[service] that transports the patient. A copy of the 8 ambulance transportation and medical[run] report forms[form] shall be made 9 available to any medical care facility to which a patient is transported and shall be 10 included in the patient's medical record by that facility. If a patient is not transported 11 to a medical facility, the copy of the patient care record that is to be given to the 12 transporting ambulance provider or medical care facility shall be given to the patient 13 or to the patient's parent or legal guardian upon request. If the ambulance provider, 14 medical facility, patient, or patient's legal guardian refuses delivery of their patient 15 care record or is unavailable to receive the form, that copy of the patient care record 16 shall be returned to the medical first response provider or ambulance provider and 17 destroyed. 18 (8)[(7)] All ambulance providers[services] and mobile integrated healthcare programs 19 shall be required to keep adequate reports and records to be maintained at the 20 ambulance base headquarters and to be available for periodic review as deemed 21 necessary by the cabinet[board]. Required records and reports are as follows: 22 (a) Employee records, including a resume of each employee's training and 23 experience and evidence of current certification or licensure; and 24 (b) Health records of all personnel including records of all illnesses or accidents 25 occurring while on duty. 26 (9)[(8)] Data and records generated and kept by the board, the cabinet, or their[its] 27 UNOFFICIAL COPY 22 RS BR 1600 Page 43 of 111 XXXX Jacketed contractors regarding the evaluation of emergency medical care, mobile integrated 1 healthcare programs, and trauma care in the Commonwealth, including the 2 identities of patients, emergency medical services personnel, ambulance providers, 3 medical first-response providers, and emergency medical facilities, shall be 4 confidential, shall not be subject to disclosure under KRS 61.805 to 61.850 or KRS 5 61.870 to 61.884, shall not be admissible in court for any purpose, and shall not be 6 subject to discovery. However, nothing in this section shall limit the discoverability 7 or admissibility of patient medical records regularly and ordinarily kept in the 8 course of a patient's treatment that otherwise would be admissible or discoverable. 9 Section 21. KRS 216B.020 is amended to read as follows: 10 (1) The provisions of this chapter that relate to the issuance of a certificate of need shall 11 not apply to ambulance services, abortion facilities as defined in KRS 216B.015; 12 any hospital which does not charge its patients for hospital services and does not 13 seek or accept Medicare, Medicaid, or other financial support from the federal 14 government or any state government; assisted living residences; family care homes; 15 state veterans' nursing homes; services provided on a contractual basis in a rural 16 primary-care hospital as provided under KRS 216.380; community mental health 17 centers for services as defined in KRS Chapter 210; primary care centers; rural 18 health clinics; private duty nursing services operating as nursing pools; group 19 homes; licensed residential crisis stabilization units; licensed free-standing 20 residential substance use disorder treatment programs with sixteen (16) or fewer 21 beds, but not including Levels I and II psychiatric residential treatment facilities or 22 licensed psychiatric inpatient beds; outpatient behavioral health treatment, but not 23 including partial hospitalization programs; end stage renal disease dialysis facilities, 24 freestanding or hospital based; swing beds; special clinics, including but not limited 25 to wellness, weight loss, family planning, disability determination, speech and 26 hearing, counseling, pulmonary care, and other clinics which only provide 27 UNOFFICIAL COPY 22 RS BR 1600 Page 44 of 111 XXXX Jacketed diagnostic services with equipment not exceeding the major medical equipment cost 1 threshold and for which there are no review criteria in the state health plan; 2 nonclinically related expenditures; nursing home beds that shall be exclusively 3 limited to on-campus residents of a certified continuing care retirement community; 4 home health services provided by a continuing care retirement community to its on-5 campus residents; the relocation of hospital administrative or outpatient services 6 into medical office buildings which are on or contiguous to the premises of the 7 hospital; the relocation of acute care beds which occur among acute care hospitals 8 under common ownership and which are located in the same area development 9 district so long as there is no substantial change in services and the relocation does 10 not result in the establishment of a new service at the receiving hospital for which a 11 certificate of need is required; the redistribution of beds by licensure classification 12 within an acute care hospital so long as the redistribution does not increase the total 13 licensed bed capacity of the hospital; residential hospice facilities established by 14 licensed hospice programs; or the following health services provided on site in an 15 existing health facility when the cost is less than six hundred thousand dollars 16 ($600,000) and the services are in place by December 30, 1991: psychiatric care 17 where chemical dependency services are provided, level one (1) and level two (2) of 18 neonatal care, cardiac catheterization, and open heart surgery where cardiac 19 catheterization services are in place as of July 15, 1990. [The provisions of this 20 section shall not apply to nursing homes, personal care homes, intermediate care 21 facilities, and family care homes; or nonconforming ambulance services as defined 22 by administrative regulation. ]These listed facilities or services shall be subject to 23 licensure, when applicable. 24 (2) Nothing in this chapter shall be construed to authorize the licensure, supervision, 25 regulation, or control in any manner of: 26 (a) Private offices and clinics of physicians, dentists, and other practitioners of 27 UNOFFICIAL COPY 22 RS BR 1600 Page 45 of 111 XXXX Jacketed the healing arts, except any physician's office that meets the criteria set forth 1 in KRS 216B.015(5) or that meets the definition of an ambulatory surgical 2 center as set out in KRS 216B.015; 3 (b) Office buildings built by or on behalf of a health facility for the exclusive use 4 of physicians, dentists, and other practitioners of the healing arts; unless the 5 physician's office meets the criteria set forth in KRS 216B.015(5), or unless 6 the physician's office is also an abortion facility as defined in KRS 216B.015, 7 except no capital expenditure or expenses relating to any such building shall 8 be chargeable to or reimbursable as a cost for providing inpatient services 9 offered by a health facility; 10 (c) Outpatient health facilities or health services that: 11 1. Do not provide services or hold patients in the facility after midnight; 12 and 13 2. Are exempt from certificate of need and licensure under subsection (3) 14 of this section; 15 (d) Dispensaries and first-aid stations located within business or industrial 16 establishments maintained solely for the use of employees, if the facility does 17 not contain inpatient or resident beds for patients or employees who generally 18 remain in the facility for more than twenty-four (24) hours; 19 (e) Establishments, such as motels, hotels, and boarding houses, which provide 20 domiciliary and auxiliary commercial services, but do not provide any health 21 related services and boarding houses which are operated by persons 22 contracting with the United States Department of Veterans Affairs for 23 boarding services; 24 (f) The remedial care or treatment of residents or patients in any home or 25 institution conducted only for those who rely solely upon treatment by prayer 26 or spiritual means in accordance with the creed or tenets of any recognized 27 UNOFFICIAL COPY 22 RS BR 1600 Page 46 of 111 XXXX Jacketed church or religious denomination and recognized by that church or 1 denomination; and 2 (g) On-duty police and fire department personnel assisting in emergency 3 situations by providing first aid or transportation when regular emergency 4 units licensed to provide first aid or transportation are unable to arrive at the 5 scene of an emergency situation within a reasonable time. 6 (3) The following outpatient categories of care shall be exempt from certificate of need 7 and licensure on July 14, 2018: 8 (a) Primary care centers; 9 (b) Special health clinics, unless the clinic provides pain management services 10 and is located off the campus of the hospital that has majority ownership 11 interest; 12 (c) Specialized medical technology services, unless providing a State Health Plan 13 service; 14 (d) Retail-based health clinics and ambulatory care clinics that provide 15 nonemergency, noninvasive treatment of patients; 16 (e) Ambulatory care clinics treating minor illnesses and injuries; 17 (f) Mobile health services, unless providing a service in the State Health Plan; 18 (g) Rehabilitation agencies; 19 (h) Rural health clinics; and 20 (i) Off-campus, hospital-acquired physician practices. 21 (4) The exemptions established by subsections (2) and (3) of this section shall not apply 22 to the following categories of care: 23 (a) An ambulatory surgical center as defined by KRS 216B.015(4); 24 (b) A health facility or health service that provides one (1) of the following types 25 of services: 26 1. Cardiac catheterization; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 47 of 111 XXXX Jacketed 2. Megavoltage radiation therapy; 1 3. Adult day health care; 2 4. Behavioral health services; 3 5. Chronic renal dialysis; 4 6. Birthing services; or 5 7. Emergency services above the level of treatment for minor illnesses or 6 injuries; 7 (c) A pain management facility as defined by KRS 218A.175(1); 8 (d) An abortion facility that requires licensure pursuant to KRS 216B.0431; or 9 (e) A health facility or health service that requests an expenditure that exceeds the 10 major medical expenditure minimum. 11 (5) An existing facility licensed as an intermediate care or nursing home shall notify the 12 cabinet of its intent to change to a nursing facility as defined in Public Law 100-13 203. A certificate of need shall not be required for conversion of an intermediate 14 care or nursing home to the nursing facility licensure category. 15 (6) [Ambulance services owned and operated by a city government, which propose to 16 provide services in coterminous cities outside of the ambulance service's designated 17 geographic service area, shall not be required to obtain a certificate of need if the 18 governing body of the city in which the ambulance services are to be provided 19 enters into an agreement with the ambulance service to provide services in the city. 20 (7) ]Notwithstanding any other provision of law, a continuing care retirement 21 community's nursing home beds shall not be certified as Medicaid eligible unless a 22 certificate of need has been issued authorizing applications for Medicaid 23 certification. The provisions of subsection (5) of this section notwithstanding, a 24 continuing care retirement community shall not change the level of care licensure 25 status of its beds without first obtaining a certificate of need. 26 Section 22. KRS 216B.095 is amended to read as follows: 27 UNOFFICIAL COPY 22 RS BR 1600 Page 48 of 111 XXXX Jacketed (1) An applicant may waive the procedures for formal review of an application for a 1 certificate of need and request a nonsubstantive review as provided below. The 2 cabinet may grant or deny nonsubstantive review status within ten (10) days of the 3 date the application is deemed completed and shall give notice to all affected 4 persons of the decision to conduct a nonsubstantive review. Any affected person 5 other than the applicant may request a hearing by filing a request with the cabinet 6 within ten (10) days of the notice to conduct a nonsubstantive review. As 7 applicable, hearings shall be conducted as provided in KRS 216B.085. Based solely 8 upon the record established with regard to the matter, the cabinet shall approve or 9 deny a certificate of need on all projects assigned nonsubstantive review status 10 within thirty-five (35) days of the determination of nonsubstantive review status. If 11 the application is denied nonsubstantive review status, it shall automatically be 12 placed in the formal review process. 13 (2) If a certificate of need is denied following a nonsubstantive review, the applicant 14 may request that the application be placed in the next cycle of the formal review 15 process. Nothing in this subsection shall require an applicant to pursue a formal 16 review before obtaining judicial review pursuant to KRS 216B.115. 17 (3) The cabinet may grant nonsubstantive review status to an application for a 18 certificate of need which is required: 19 (a) To change the location of a proposed health facility; 20 (b) To replace or relocate a licensed health facility, if there is no substantial 21 change in health services or substantial change in bed capacity; 22 (c) To replace or repair worn equipment if the worn equipment has been used by 23 the applicant in a health facility for five (5) years or more; 24 (d) For cost escalations; or 25 (e) [To establish an industrial ambulance service; or 26 (f) ]In other circumstances the cabinet by administrative regulation may 27 UNOFFICIAL COPY 22 RS BR 1600 Page 49 of 111 XXXX Jacketed prescribe. 1 (4) Notwithstanding any other provision to the contrary in this chapter, the cabinet may 2 approve a certificate of need for a project required for the purposes set out in 3 paragraphs (a) to (e)[(f)] of subsection (3) of this section, unless it finds the facility 4 or service with respect to which the capital expenditure is proposed to be made is 5 not required; or to the extent the facility or services contemplated by the proposed 6 capital expenditure is addressed in the state health plan, the cabinet finds that the 7 capital expenditure is not consistent with the state health plan. 8 (5) The decision of the cabinet approving or denying a certificate of need pursuant to 9 this section shall be final for purposes of judicial appeal, unless the applicant 10 requests the application be placed in the formal review process. An approved 11 certificate shall be issued thirty (30) days after notice of the cabinet's decision, 12 unless a judicial appeal is taken and issuance is enjoined by the court. 13 (6) Notwithstanding any other provision of law, the cabinet shall not grant 14 nonsubstantive review status to a certificate of need application that indicates an 15 intent to apply for Medicaid certification of nursing home beds within a continuing 16 care retirement community established under KRS 216B.015, 216B.020, 216B.330, 17 and 216B.332. 18 (7) Notwithstanding any provision of state law or the state health plan promulgated by 19 administrative regulation in accordance with KRS 216B.040, the cabinet shall grant 20 nonsubstantive review for a certificate of need proposal to establish an ambulatory 21 surgical center if the applicant complies with the following: 22 (a) The applicant is an ambulatory surgical center that was organized and in 23 operation as the private office of a physician or physician group prior to 24 October 1, 2006; 25 (b) 1. The cabinet's general counsel has submitted a letter to the Accreditation 26 Association for Ambulatory Health Care advising that the cabinet does 27 UNOFFICIAL COPY 22 RS BR 1600 Page 50 of 111 XXXX Jacketed not object to the applicant's parent company applying for and obtaining 1 Medicare certification; or 2 2. The applicant is an ambulatory surgical center that has received from the 3 cabinet a favorable advisory opinion dated June 14, 2005, confirming 4 that the applicant would be exempt from the certificate of need or 5 licensure requirement; 6 (c) The applicant's ambulatory surgical center has been inspected and accredited 7 by the Accreditation Association for Ambulatory Health Care since December 8 31, 2006, and has maintained accreditation with that organization consistently 9 since that time; and 10 (d) The applicant was a party to litigation concerning the ambulatory surgical 11 center and physician office issue and, prior to July 12, 2012, obtained a Court 12 of Appeals ruling in its favor. 13 Section 23. KRS 42.738 is amended to read as follows: 14 (1) The executive director shall establish and implement a statewide public safety 15 interoperability plan. This plan shall include the development of required 16 architecture and standards that will insure that new or upgraded Commonwealth 17 public safety communications systems will interoperate. The Kentucky Wireless 18 Interoperability Executive Committee shall be responsible for the evaluation and 19 recommendation of all wireless communications architecture, standards, and 20 strategies. The executive director shall provide direction, stewardship, leadership, 21 and general oversight of information technology and information resources. The 22 executive director shall report by September 15 annually to the Interim Joint 23 Committee on Seniors, Veterans, Military Affairs, and Public Protection and the 24 Interim Joint Committee on State Government on progress and activity by agencies 25 of the Commonwealth to comply with standards to achieve public safety 26 communications interoperability. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 51 of 111 XXXX Jacketed (2) The Kentucky Wireless Interoperability Executive Committee shall serve as the 1 advisory body for all wireless communications strategies presented by agencies of 2 the Commonwealth and local governments. All state agencies in the 3 Commonwealth shall present all project plans for primary wireless public safety 4 voice or data communications systems for review and recommendation by the 5 committee, and the committee shall forward the plans to the executive director for 6 final approval. Local government entities shall present project plans for primary 7 wireless public safety voice or data communications systems for review and 8 recommendation by the Kentucky Wireless Interoperability Executive Committee. 9 (3) The committee shall develop funding and support plans that provide for the 10 maintenance of and technological upgrades to the public safety shared 11 infrastructure, and shall make recommendations to the executive director, the 12 Governor's Office for Policy and Management, and the General Assembly. 13 (4) The executive director shall examine the project plans for primary wireless public 14 safety voice or data communications systems of state agencies as required by 15 subsection (2) of this section, and shall determine whether they meet the required 16 architecture and standards for primary wireless public safety voice or data 17 communications systems. 18 (5) The Kentucky Wireless Interoperability Executive Committee shall consist of the 19 following members[twenty (20) members as follows]: 20 (a) A person knowledgeable in the field of wireless communications appointed by 21 the executive director who shall serve as chair; 22 (b) The executive director of the Office of Infrastructure Services, 23 Commonwealth Office of Technology; 24 (c) The executive director of Kentucky Educational Television, or the executive 25 director's designee; 26 (d) The information technology lead of the Transportation Cabinet; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 52 of 111 XXXX Jacketed (e) The information technology lead of the Justice and Public Safety Cabinet; 1 (f) The information technology lead of the Department of Kentucky State Police; 2 (g) The commissioner of the Department of Fish and Wildlife Resources, or the 3 commissioner's designee; 4 (h) The information technology lead of the Energy and Environment Cabinet; 5 (i) The director of the Division of Emergency Management, Department of 6 Military Affairs; 7 (j) The executive director of the Kentucky Office of Homeland Security; 8 (k) The information technology lead of the Department for Public Health, Cabinet 9 for Health and Family Services; 10 (l) A representative from an institution of postsecondary education appointed by 11 the Governor from a list of three (3) names submitted by the president of the 12 Council on Postsecondary Education; 13 (m) The executive director of the Center for Rural Development, or the executive 14 director's designee; 15 (n) A representative from a municipal government to be appointed by the 16 Governor from a list of three (3) names submitted by the Kentucky League of 17 Cities; 18 (o) A representative from a county government to be appointed by the Governor 19 from a list of three (3) names submitted by the Kentucky Association of 20 Counties; 21 (p) A representative from a municipal police department to be appointed by the 22 Governor from a list of three (3) names submitted by the Kentucky 23 Association of Chiefs of Police; 24 (q) A representative from a local fire department to be appointed by the Governor 25 from a list of three (3) names submitted by the Kentucky Association of Fire 26 Chiefs; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 53 of 111 XXXX Jacketed (r) A representative from a county sheriff's department to be appointed by the 1 Governor from a list of three (3) names submitted by the Kentucky Sheriffs' 2 Association; 3 (s) A representative from a local Emergency Medical Services agency to be 4 appointed by the Governor from a list of three (3) names submitted by the 5 Kentucky Board of Emergency Medical Services;[ and] 6 (t) A representative from a local ambulance provider to be appointed by the 7 Governor from a list of three (3) names submitted by the Cabinet for Health 8 and Family Services; and 9 (u) A representative from a local 911 dispatch center to be appointed by the 10 Governor from a list of three (3) names submitted by the Kentucky Chapter of 11 the National Emergency Number Association/Association of Public Safety 12 Communications Officials. 13 (6) Appointed members of the committee shall serve for a two (2) year term. Members 14 who serve by virtue of an office shall serve on the committee while they hold that 15 office. 16 (7) The committee shall meet quarterly, or as often as necessary for the conduct of its 17 business. A majority of the members shall constitute a quorum for the transaction of 18 business. Members' designees shall have voting privileges at committee meetings. 19 (8) The committee shall be attached to the Commonwealth Office of Technology for 20 administrative purposes only. Members shall not be paid and shall not be 21 reimbursed for travel expenses. 22 (9) The Public Safety Working Group is hereby created for the primary purpose of 23 fostering cooperation, planning, and development of the public safety frequency 24 spectrum as regulated by the Federal Communications Commission, including the 25 700 MHz public safety band. The group shall endeavor to bring about a seamless, 26 coordinated, and integrated public safety communications network for the safe, 27 UNOFFICIAL COPY 22 RS BR 1600 Page 54 of 111 XXXX Jacketed effective, and efficient protection of life and property. The Public Safety Working 1 Group membership and other working group memberships deemed necessary shall 2 be appointed by the chair of the Kentucky Wireless Interoperability Executive 3 Committee. 4 (10) The committee may establish additional working groups as determined by the 5 committee. 6 Section 24. KRS 65.7623 is amended to read as follows: 7 (1) There is hereby created the Kentucky 911 Services Board, the "board," consisting of 8 seven (7) members as follows: 9 (a) The executive director of the Office of Homeland Security; 10 (b) The secretary of the Public Protection Cabinet; 11 (c) One (1) elected city official of a city government appointed by the Kentucky 12 League of Cities; 13 (d) One (1) elected county official of a county government appointed by the 14 Kentucky Association of Counties; 15 (e) One (1) director of a certified PSAP operated by a local government entity or 16 a consolidated group of local government entities who previously served on 17 the 911 Services Advisory Council and is not an elected official, to be 18 appointed jointly by the Kentucky Association of Public-Safety 19 Communications Officials and the Kentucky Emergency Number Association; 20 (f) One (1) member representative of a county or city government appointed by 21 the Governor from a list of three (3) names submitted by the Kentucky League 22 of Cities or Kentucky Association of Counties. The Kentucky League of Cities 23 and the Kentucky Association of Counties shall alternate in providing a list of 24 names to the Governor every two (2) years, and the selected member 25 representative shall serve for a two (2) year term and may be an elected city or 26 county official; and 27 UNOFFICIAL COPY 22 RS BR 1600 Page 55 of 111 XXXX Jacketed (g) One (1) member appointed by the Governor who shall be employed by or 1 representative of the interest of CMRS providers. The member representing 2 the interests of CMRS providers shall serve for a two (2) year term, and shall 3 alternate between representing a Tier I provider and a Tier III provider. 4 (2) The executive director of the Office of Homeland Security and secretary of the 5 Public Protection Cabinet shall serve by virtue of their offices. The members 6 appointed under subsection (1)(c) to (e) of this section shall be appointed for a term 7 of four (4) years and until their successors are appointed and qualified. Members 8 appointed under subsection (1)(f) and (g) of this section shall serve for a term of 9 two (2) years. Members appointed under subsection (1)(c) to (g) of this section may 10 only serve as long as the appointee holds the office or position he or she held at the 11 time of his or her appointment. Any vacancy on the board shall be filled in the same 12 manner as the original appointment and shall be for the remainder of the unexpired 13 term. 14 (3) No member of the board shall be held to be a public officer by reason of 15 membership on the board. The elected city and county officials appointed under 16 subsection (1) of this section shall each serve on the board in an ex officio voting 17 capacity by virtue of their respective elected offices as long as they continue to 18 occupy their local elected positions during their term as a board member. Their 19 duties as members of the board shall be an extension of their duties as local elected 20 officials and their service on the board shall not constitute the holding of a separate 21 and distinct public office apart from their respective local elected positions. 22 (4) The executive director of the Office of Homeland Security shall serve as chair and 23 preside over meetings of the board, which shall be conducted at least four (4) times 24 each year. In the absence of the executive director of the Office of Homeland 25 Security, the board may be chaired by any other member of the board selected by 26 the remaining members. The board shall be subject to the provisions of the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 56 of 111 XXXX Jacketed Kentucky Open Meetings Act, KRS 61.805 to 61.850. The board shall establish a 1 regular meeting schedule for each calendar year. The board shall hold at least two 2 (2) meetings per calendar year in congressional districts other than the one in which 3 Frankfort is located, and shall rotate its traveling meeting locations among the 4 congressional districts before holding another traveling meeting in the same 5 congressional district. A majority of the members appointed to the board shall 6 constitute a quorum. 7 (5) In addition to the administrator appointed by the executive director of the Office of 8 Homeland Security under KRS 65.7625, the Office of Homeland Security shall 9 provide staff services, office space, and other resources necessary to conduct its 10 affairs. The board shall be attached to the Office of Homeland Security for 11 administrative purposes but shall operate as an independent entity within state 12 government. 13 (6) The board members shall serve without compensation but shall be reimbursed in 14 accordance with KRS 45.101 for expenses incurred in connection with their official 15 duties as members of the board. 16 (7) All administrative costs and expenses incurred in the operation of the board, 17 including payments under subsections (5) and (6) of this section and KRS 65.7625, 18 shall be paid as reimbursement to the Office of Homeland Security from that 19 portion of the CMRS fund that is authorized under KRS 65.7631(2) to be used by 20 the board for administrative purposes. Expenses for personnel, equipment, or 21 facilities that serve multiple functions or purposes shall be prorated. Only those 22 costs for services directly involved in the coordination and administration of duties 23 related to the CMRS emergency telecommunications function shall be eligible for 24 payment using the funds provided in KRS 65.7631(2). 25 (8) Prior to June 1 of each year, the Office of Homeland Security shall submit a budget 26 detailing all projected administrative and operational expenses for the subsequent 27 UNOFFICIAL COPY 22 RS BR 1600 Page 57 of 111 XXXX Jacketed fiscal year to be used by the board in establishing the board's budget for the 1 upcoming fiscal year. 2 (9) The board shall be advised by a permanent advisory council with members 3 appointed by the executive director of the Office of Homeland Security. The 4 members of the advisory council shall represent the interests of the 911 community 5 and shall, at a minimum, include a representative from each of the following 6 organizations: 7 (a) 1. The Department of Kentucky State Police; 8 2. The Kentucky Sheriffs' Association; 9 3. The Kentucky Association of Chiefs of Police; 10 4. The Kentucky Fire Chiefs Association; 11 5. The Kentucky Ambulance Providers Association; 12 6. The Kentucky League of Cities; 13 7. The Kentucky Association of Counties; 14 8. The Department of Criminal Justice Training;[ and] 15 9. The Kentucky Board of Emergency Medical Services; and 16 10. The Cabinet for Health and Family Services; 17 (b) The Kentucky Association of Public-Safety Communications Officials and the 18 Kentucky Emergency Number Association, each appointed by the executive 19 director of the Office of Homeland Security from a list of three (3) names 20 submitted by both organizations; and 21 (c) Any other members selected by the executive director who are familiar with 22 PSAPs, public finances, shared governmental services, emergency 23 management, community crisis response preparation, or the interests of 911 24 service stakeholders. 25 Section 25. KRS 75A.020 is amended to read as follows: 26 (1) A new consolidated emergency services district may be formed by one (1) of the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 58 of 111 XXXX Jacketed following processes: 1 (a) The board of: 2 1. Any two (2) or more fire protection districts established under KRS 3 Chapter 75 or 273, any special district whose services are subject to the 4 licensure provisions of KRS Chapter 216B[311A], or any rescue squads 5 established under KRS Chapter 39F; or 6 2. Any fire protection districts established under KRS Chapter 75 or 273, 7 any special district whose services are subject to the licensure provisions 8 of KRS Chapter 216B[311A], or any rescue squads established under 9 KRS Chapter 39F that have merged within the five (5) years prior to the 10 adoption of this section that would have been eligible to consolidate 11 under the provisions of this section; 12 3. May adopt resolutions agreeing to the formation of a consolidated 13 emergency services district and requesting the creation of a consolidated 14 emergency services district. The governing bodies shall notify the 15 county fiscal court, consolidated local government, charter county 16 government, or unified local government with jurisdiction over the 17 proposed district and request the formation of a consolidated emergency 18 services district; or 19 (b) The board of any two (2) or more consolidated emergency service districts 20 established under this chapter may adopt resolutions agreeing to the merger of 21 consolidated emergency services districts and requesting the creation of a new 22 consolidated emergency services district. The governing bodies shall notify 23 the county fiscal court, consolidated local government, charter county 24 government, or unified local government with jurisdiction over the proposed 25 district and request the formation of a new consolidated emergency services 26 district. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 59 of 111 XXXX Jacketed (2) (a) Any county fiscal court, consolidated local government, charter county 1 government, or unified local government, upon receipt of a request from two 2 (2) or more fire protection districts, special districts whose services are subject 3 to the licensure provisions of KRS Chapter 216B[311A], or rescue squads 4 established under KRS Chapter 39F, may create a consolidated emergency 5 services district in their jurisdiction by adoption of an ordinance approving the 6 establishment of a consolidated emergency services district and authorizing 7 any relevant fire protection district to join if its governing authority has 8 approved it to join the consolidated district. 9 (b) The ordinance shall describe the boundaries by metes and bounds and name 10 for the consolidated district. No consolidated emergency services district shall 11 take effect less than sixty (60) days from completing the required elements 12 outlined in this section. 13 (c) The county fiscal court, consolidated local government, charter county 14 government, or unified local government clerk shall notify all planning 15 commissions, cities, and area development districts within whose jurisdiction 16 the approved service area is located and any state agencies required by law to 17 be notified of the proposal for the creation of the taxing district within thirty 18 (30) days from adoption of the ordinance authorizing creation of the district. 19 (d) The creation of a consolidated emergency services taxing district shall be of 20 legal effect only after adoption of an ordinance creating the taxing district and 21 after a certified copy of the ordinance creating the taxing district is filed with 22 the county clerk. 23 (e) Any aggrieved person may bring an action in the Circuit Court having 24 jurisdiction of that county to contest the decision of the county fiscal court or 25 legislative body of the county to establish a consolidated emergency services 26 district or to protest the inclusion of any county, consolidated local 27 UNOFFICIAL COPY 22 RS BR 1600 Page 60 of 111 XXXX Jacketed government, charter county government, unified local government, fire 1 protection district or volunteer fire department district established pursuant to 2 KRS Chapter 75 or 273, any special district whose services are subject to the 3 licensure provisions of KRS Chapter 216B[311A], or any rescue squad 4 established pursuant to KRS Chapter 39F within a consolidated emergency 5 services district. 6 (3) (a) If the governing body of any fire protection district established under KRS 7 Chapter 75 or 273, any special district whose services are subject to the 8 licensure provisions of KRS Chapter 216B[311A], or any rescue squad 9 established under KRS Chapter 39F desires to have its district become part of 10 an established consolidated emergency services district after the creation of 11 the district, it shall by motion so record its desire in the minutes of the board, 12 in the case of any fire protection district, any emergency medical services 13 special district, or any rescue squad. The board shall convey this request to the 14 consolidated emergency service district's board. Within sixty (60) days of 15 receiving the request the consolidated emergency service district's board shall 16 vote upon this request. The approval shall be certified to the clerk of the 17 county, consolidated local government, charter county government, or unified 18 local government in the jurisdiction in which the consolidated district is 19 located. 20 (b) The approval of the addition of a district to the consolidated emergency 21 services district shall become effective upon the adoption of an ordinance 22 amending the ordinance creating the consolidated emergency services district 23 by the county fiscal court, consolidated local government, charter county 24 government, or unified local government and authorizing the inclusion of the 25 petitioning fire protection district. The amended ordinance shall identify the 26 boundaries by metes and bounds of the amended consolidated emergency 27 UNOFFICIAL COPY 22 RS BR 1600 Page 61 of 111 XXXX Jacketed services district. 1 Section 26. KRS 75A.050 is amended to read as follows: 2 (1) (a) Upon the creation of a district, the trustees of a district are authorized to 3 provide fire services, emergency medical services subject to KRS Chapter 4 216B or 311A, or rescue services pursuant to KRS Chapter 39F, as provided 5 in paragraph (c) of this subsection, and to levy a tax upon the property in the 6 district. 7 (b) The property taxed shall be subject to county tax, and the tax levied by the 8 board upon creation of the district shall be approved by the county fiscal court, 9 consolidated local government, charter county government, or unified local 10 government having jurisdiction over the district at the time of passage of the 11 ordinance creating the district. The tax shall not exceed ten cents ($0.10) per 12 one hundred dollars ($100) of valuation as assessed for county taxes, for the 13 purpose of defraying the expenses for the provision of fire services or rescue 14 services. The rate set in this subsection shall apply, notwithstanding the 15 provisions of KRS 132.023. 16 (c) The district that establishes and operates an emergency ambulance service and 17 is the primary service provider in the district may levy a tax upon the property 18 in the district. The tax to be levied shall be proposed by the board, shall be 19 approved by the county fiscal court, consolidated local government, charter 20 county government, or unified local government having jurisdiction over the 21 district and the tax shall not exceed twenty cents ($0.20) per one hundred 22 dollars ($100) of valuation as assessed for county taxes, for the purpose of 23 defraying the expenses of the provision of fire services, emergency medical 24 services, or rescue service, or to make contracts for fire protection for the 25 districts as provided in KRS 75.050. The rate set in this subsection shall 26 apply, notwithstanding KRS 132.023. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 62 of 111 XXXX Jacketed (d) 1. Any increase of the total tax levy beyond the rate initially approved by 1 the board and authorized by the county fiscal court, consolidated local 2 government, charter county government, or unified local government 3 shall be subject to KRS 132.023. Any increase in excess of the annual 4 compensating rate for the consolidated emergency services district shall 5 require the approval of the county fiscal court, consolidated local 6 government, charter county government, or unified local government 7 having jurisdiction over the district. If at any time an election resulting 8 from a recall petition pursuant to KRS 132.017 is required, the question 9 shall be presented to all voters in every precinct for which any part of the 10 precinct is served by the district subject to the recall petition. 11 2. If two (2) or more established consolidated emergency services merge to 12 create a new consolidated emergency services district, as authorized in 13 this chapter, the initial tax to be levied, as proposed by the board, shall 14 be approved by the county fiscal court, consolidated local government, 15 charter county government, or unified local government having 16 jurisdiction over the district, and the initial tax levied shall not exceed 17 the highest tax rate currently levied by one (1) of the merging districts. 18 Any increase to the initial tax rate shall be subject to KRS 132.023. Any 19 increase in excess of the annual compensating rate for the consolidated 20 emergency services district shall require the approval of the county fiscal 21 court, consolidated local government, charter county government, or 22 unified local government having jurisdiction over the district. If at any 23 time an election resulting from a recall petition pursuant to KRS 24 132.017 is required, the question shall be presented to all voters in every 25 precinct for which any part of the district serves. 26 (2) The property valuation administrator of the county in which the district is created, 27 UNOFFICIAL COPY 22 RS BR 1600 Page 63 of 111 XXXX Jacketed with the cooperation of the board, shall note on the tax rolls the taxpayers and 1 valuation of the property subject to such assessment. The county clerk shall 2 compute the tax on the regular state and county tax bills in such manner as may be 3 directed by regulation of the Department of Revenue. 4 (3) These taxes shall be subject to the same delinquency date, discounts, penalties, and 5 interest as are applied to the collection of ad valorem taxes and shall be collected by 6 the sheriff of the county involved and accounted for to the treasurer of the district. 7 The sheriff shall be entitled to a fee of the amount collected by him. The fiscal court 8 shall, in the ordinance set forth in subsection (2) of this section and in consultation 9 with the sheriff and the consolidated emergency services district, set a collection fee 10 for the sheriff in an amount not to exceed four and one-fourth percent (4.25%). 11 Section 27. KRS 75A.090 is amended to read as follows: 12 (1) The district may, through the board, make and enter into contracts with any other 13 fire protection district, fire prevention district, municipal corporation, volunteer fire 14 department, volunteer fire prevention unit, volunteer fire protection unit, any special 15 district whose services are subject to the licensure provisions of KRS Chapter 16 216B[311A], or any rescue squads established under KRS Chapter 39F, either 17 within the same county or within an adjoining county in an area adjacent to the 18 boundary line between the counties, for the furnishing or receiving of emergency 19 services for all property within the confines of the area included in and covered by 20 the contract or contracts, where these emergency services are not otherwise 21 provided by some division of government or governmental agency. 22 (2) The personnel acting in their official capacities and equipment of a contracting 23 party, in going to and returning from an emergency, or in answering and responding 24 to a false alarm or call, and while endeavoring to provide emergency services within 25 the area covered by the contract, shall be deemed and is declared to be engaged in 26 the exercise of a governmental function. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 64 of 111 XXXX Jacketed Section 28. KRS 75A.120 is amended to read as follows: 1 (1) As used in this section, unless the context requires otherwise: 2 (a) "Board" means the board of trustees a consolidated emergency services 3 district organized under this chapter; 4 (b) "Chairman" means the chairman of the board of a consolidated emergency 5 services district organized under this chapter; 6 (c) "Chief" means the chief of the consolidated emergency services district 7 organized under this chapter; 8 (d) "Consolidated emergency services district" means districts organized under 9 this chapter; 10 (e) "Dismissal" means the discharge of an employee by lawful authority; 11 (f) "Employees" means all persons employed, and paid wages, salary, or other 12 compensation for emergency services performed, by the board of trustees of a 13 consolidated emergency services district organized under this chapter. The 14 term "employees" does not include any individual who is a volunteer as 15 defined in paragraph (n) of this subsection. 16 (g) "Member" shall include the chief and all officers; all providers of emergency 17 services, including volunteer, paid, regular, and all employees, or special 18 firefighters; of a consolidated emergency services district organized under this 19 chapter; 20 (h) "Paid emergency service worker" means all personnel who are employees of 21 the consolidated emergency services district organized under this chapter 22 involved in the provision of emergency medical services subject to the 23 licensure provisions of KRS Chapter 216B[311A] or the provision of rescue 24 services pursuant to KRS Chapter 39F; 25 (i) "Paid firefighters" means all firefighters who are employees of the 26 consolidated emergency services district organized under this chapter; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 65 of 111 XXXX Jacketed (j) "Regular firefighters" means all firefighters who are members of a 1 consolidated emergency services district organized under this chapter, except 2 for special firefighters appointed by the chairman of the board of trustees 3 pursuant to KRS 75.110; 4 (k) "Salary" and "wages" mean any compensation received by an employee by 5 reason of his employment for services performed for a consolidated 6 emergency services district organized under this chapter; 7 (l) "Suspension" means the separation of an employee from the service for a 8 temporary or fixed period of time, by his appointing authority, as a 9 disciplinary measure; 10 (m) "Trustees" means the board of trustees of a consolidated emergency services 11 district organized under this chapter; and 12 (n) "Volunteer" means any person who is a member of a consolidated emergency 13 services district organized under this chapter who volunteers to provide 14 services for the district, if the individual receives no salary, wages, or other 15 compensation for services performed, or if the individual is paid expenses, 16 reasonable benefits, or a nominal fee to perform the services for which the 17 individual volunteered, and the services are not the same type of services 18 which the individual is employed to perform for the consolidated emergency 19 services district organized under this chapter. 20 (2) (a) The chairman may, if in his or her discretion there is a case of need, appoint 21 special firefighters to do special duties at any place within the limits of the 22 consolidated emergency services district, on terms he or she deems proper. 23 (b) These special firefighters shall be governed by rules as the board may provide, 24 and be given the powers the board may provide, including the powers 25 enumerated in KRS 75.160 in the discretion of the board; if rules are not 26 provided they shall be deemed to have the powers and duties of regular 27 UNOFFICIAL COPY 22 RS BR 1600 Page 66 of 111 XXXX Jacketed firefighters. 1 (3) (a) Except as provided in subsection (4) of this section no member or employee 2 of a consolidated emergency services district shall be reprimanded, dismissed, 3 suspended, or reduced in grade or pay for any reason except inefficiency, 4 misconduct, insubordination, or violation of law or of the rules adopted by the 5 board the district, and only after charges are preferred and a hearing conducted 6 as provided in this section. 7 (b) Any person may file charges against a member or employee of the district by 8 filing them with the secretary of the board and by delivering or mailing the 9 charges to the principal offices of the district. The secretary shall immediately 10 communicate the charges to the board by mailing or delivering a copy of the 11 charges to each member of the board within seven (7) days of receipt of the 12 charges at the principal fire house. The chairman shall, after conducting or 13 having conducted any inquiry or investigation which may be necessary, 14 determine if probable cause appears. The chairman shall prefer charges to the 15 board against any member or employee, against whom probable cause exists, 16 of conduct justifying the dismissal or punishment of the member or employee. 17 If probable cause does not exist, the chairman shall dismiss the charges. All 18 charges shall be written and shall set out clearly the charges made. The person 19 filing the charges may withdraw them at any time before the conclusion of the 20 hearing. The charges may then be dismissed. 21 (c) Charges preferred by the chairman shall be heard by either the full board or a 22 committee consisting of at least three (3) members of the board appointed by 23 the chairman. At the hearing all charges shall be considered, and the trial shall 24 be confined to matters related to the issues presented. Within forty-five (45) 25 days after the charges have been preferred by the chairman to the board, that 26 body, or a committee consisting of at least three (3) members of the board 27 UNOFFICIAL COPY 22 RS BR 1600 Page 67 of 111 XXXX Jacketed appointed by the chairman, shall proceed to hear the charges. At least ten (10) 1 days before the hearing the member or employee accused shall be served 2 personally or by registered mail with a copy of the charges and a statement of 3 the day, place, and hour at which the hearing of the charges will begin. The 4 person accused may, in writing, waive the service of charges and demand trial 5 within thirty (30) days after the charges are preferred to the board. 6 (d) The board of the district may summon and compel attendance of witnesses at 7 hearings by subpoena issued by the secretary of that body and served upon the 8 witnesses by any officer authorized to serve court subpoenas. If any witness 9 fails to appear in response to a summons, or refuses to testify concerning any 10 matter on which he may lawfully be interrogated, any District Judge, on 11 application of the board, may compel obedience by proceedings for contempt, 12 as in the case of disobedience of a subpoena issued from the District Court. 13 The member or employee accused may have subpoenaed any witnesses he or 14 she may desire, upon furnishing their names to the secretary of the board. The 15 written records of the charges, the hearing, if held, and any other actions or 16 decisions of the board on the charges shall be kept as an open public record 17 and maintained as required by KRS Chapter 61. 18 (e) When the board or the chief of the district has probable cause to believe a 19 member or employee of a district has been guilty of conduct justifying 20 dismissal or punishment, the board or the chief may suspend the member or 21 employee from duty or from both pay and duty, pending trial, and the member 22 or employee shall not be placed on duty, or allowed pay, until the charges are 23 heard. If the member is suspended, there shall be no continuances granted 24 without the consent of the member or employee accused. If the member 25 suspended is a paid firefighter or an employee, the hearing on the charges 26 shall be conducted within fourteen (14) days after the charges have been 27 UNOFFICIAL COPY 22 RS BR 1600 Page 68 of 111 XXXX Jacketed preferred by the chairman of the board. 1 (f) The board of the district shall fix the punishment of a member or employee of 2 the district found guilty, by a reprimand, suspension for any length of time not 3 to exceed six (6) months, by reducing the grade if the accused is an officer, or 4 by combining any two (2) or more of those punishments, or by dismissal as a 5 member or employee of the district. 6 (4) (a) Any member or employee of the district found guilty by the board of the 7 district of any charge, as provided by KRS 75.130, may appeal to the Circuit 8 Court of the county in which the district is located, but the enforcement of the 9 judgment of the district shall not be suspended pending appeal. The notice of 10 the appeal shall be filed not later than thirty (30) days after the date the board 11 of the district makes its determination on the charge. 12 (b) Upon request of the accused, the secretary of the board shall file a certified 13 copy of the charges and the judgment of the board in the Circuit Court. Upon 14 the transcript being filed, the case shall be docketed in the Circuit Court and 15 tried as an original action. 16 (c) If the secretary of the board fails to certify the transcript to the Circuit Court 17 within thirty (30) days after the request is made, the party aggrieved may file 18 an affidavit in the Circuit Court setting out as fully as possible the charges 19 made, the time of the hearing, and the judgment of the board, together with a 20 statement that demand for transcript was made upon the secretary of the board 21 more than thirty (30) days before the filing of the affidavit. Upon the filing of 22 the affidavit in the Circuit Court, the case shall be docketed and the Circuit 23 Court may compel the filing of the transcript by the secretary of the board by 24 entering the proper mandatory order, and by fine and imprisonment for 25 contempt. The appeal shall have precedence over other business, and be 26 determined speedily. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 69 of 111 XXXX Jacketed (d) An appeal will lie from the judgment of the Circuit Court to the Court of 1 Appeals as in other cases. 2 (5) (a) No person shall be appointed a member of the district on account of any 3 political service, contribution, sentiment, or affiliation. No member shall be 4 dismissed, suspended, or reduced in grade or pay for any political opinion. 5 (b) Members and employees of the district, while off duty and out of uniform, 6 shall be entitled to: 7 1. Place political bumper stickers on their privately owned vehicles; 8 2. Wear political buttons; 9 3. Contribute money to political parties, political candidates, and political 10 groups of their choice; 11 4. Work at the polls on election days; 12 5. Aid in the registration or purgation of voters; 13 6. Become members of political groups; and 14 7. Hold office in political groups and carry out the mandates of that group. 15 (6) (a) The chief in the district shall attend all sessions of the board, except executive 16 sessions, and shall execute all the orders of the board. Whenever "chief" is 17 used in this chapter, it shall include the assistant chief when the chief is not on 18 duty. 19 (b) The regular members of the district, except volunteer members, shall have the 20 same powers of arrest as now given by law to sheriffs of this Commonwealth 21 and they are hereby expressly declared conservators of the public peace whose 22 duties, in addition to their other prescribed duties, are to conserve the peace, 23 enforce all laws and preserve order, and they shall have and are hereby 24 expressly given the same right and the same power to arrest, search, and seize 25 as is now given by law to sheriffs of this Commonwealth, and they shall be at 26 all times subject to the orders of the county judge/executive in which the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 70 of 111 XXXX Jacketed district lies while enforcing this section. Provided, however, that members of 1 these fire departments shall not have the power to serve subpoenas, 2 summonses, and notices in civil cases and they shall receive no fees for 3 performing any of the duties prescribed in this section as pertains to powers of 4 law enforcement. The members shall constitute a law enforcement agency in 5 addition to the patrol and investigation functions of the sheriff and his 6 deputies under KRS 75.150 to 75.170. 7 (7) (a) Each member of the district shall, before entering upon the discharge of his or 8 her various duties, take an oath before the county judge/executive of the 9 county or a notary public, to faithfully discharge his duties, and the oath shall 10 be subscribed by the person taking it and filed in the minute book kept by the 11 secretary of the board. 12 (b) Each member of the district shall give such bond as the board may designate 13 and with a surety as required by the board conditioned upon faithful 14 performance of the member's duties. 15 (8) (a) The chief, assistant chief, or highest officer present at the fires answered by 16 his or department shall investigate their causes. He or she may examine 17 witnesses, compel the testimony of witnesses, administer oaths, compel 18 production of evidence, and make arrests as provided in KRS 75.160. He or 19 she may enter any building at all reasonable times for the purpose of 20 examining the building if, in his or her opinion the building is in danger of 21 fire. He shall report his or her findings, when requested, to the board, 22 Kentucky Inspection Bureau, and state fire marshal. 23 (b) The chief of the district shall direct and control the operation of the district 24 and the control of the members in the discharge of their duties. He or she, and 25 members of the district, shall have access to and the use of all cisterns, 26 fireplugs, the waters of the waterworks of private persons and cisterns of 27 UNOFFICIAL COPY 22 RS BR 1600 Page 71 of 111 XXXX Jacketed private persons for the purpose of extinguishing fires and shall have the power 1 to examine these water supplies at all reasonable times to see that they are in 2 condition for use in case of fire. The chief shall have control of all hoses, 3 buildings, engines, and other emergency equipment provided for the district 4 under direction of the board, or those authorized by the board to exercise this 5 direction, and shall perform such other duties prescribed by the board not 6 inconsistent with law. Upon application within ten (10) days to the board, any 7 owner of property where water is used for firefighting or the provision of 8 other emergency services shall be reimbursed in a reasonable amount by the 9 board for water used. 10 (9) The secretary of the board shall keep a minute book, appropriately bound and 11 marked, in which the minutes of each meeting of the board shall be kept, together 12 with all resolutions, tax levies, and other important material the board may 13 designate. A copy of all material required to be kept by the secretary shall be kept 14 on file in the office of the clerk of the county containing the district. The public 15 shall have the right to inspect the book and its contents at all times. 16 (10) (a) The board may, in its discretion, employ or retain a regularly licensed attorney 17 to advise them on all matters pertaining to their duties and shall have the 18 discretion to delegate this authority to the attorney. This attorney shall attend 19 all meetings of the board, except executive sessions when the board does not 20 desire his or her presence, whenever the board shall request him or her to 21 attend and shall advise the board on all legal matters on which he or she is 22 requested to give advice. 23 (b) In addition to the attorney provided for in this subsection, the county attorney 24 in the county in which the district lies shall advise and represent the board in 25 all matters and on the occasions chosen by the board whenever the board so 26 requests. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 72 of 111 XXXX Jacketed (c) The board may fix the salary or compensation of the attorney provided for in 1 subsection (1) of this section, in their discretion. 2 (11) With respect to audits and financial reports, the board of the district shall follow the 3 procedures of KRS 65.065. 4 Section 29. KRS 95A.020 is amended to read as follows: 5 (1) As used in this section, "chief fire officer" means an individual who plays an 6 essential role in the administrative structure of his or her fire department. 7 (2) There is hereby created the Kentucky Fire Commission, hereinafter called 8 "commission," which shall be attached to the Kentucky Community and Technical 9 College System for administrative purposes only. 10 (3) (a) The commission shall include male, female, and racial minority 11 representation. 12 (b) No more than three (3) appointed members shall reside in the same 13 congressional district. 14 (4) The commission shall be composed of fourteen (14) members, residents of the State 15 of Kentucky, and appointed by the Governor. These members should be persons 16 well qualified by experience or education in the field of fire protection or related 17 fields. 18 (5) The membership of the commission shall include: 19 (a) One (1) member of a fire department formed under KRS Chapter 75 or 273 20 who is: 21 1. Not a chief fire officer; 22 2. Not a career employee of any department other than the one from which 23 he or she is nominated; and 24 3. Selected from a list of at least three (3) names submitted by the 25 Kentucky Firefighters Association; 26 (b) One (1) member of a volunteer fire department who is: 27 UNOFFICIAL COPY 22 RS BR 1600 Page 73 of 111 XXXX Jacketed 1. Not a chief fire officer; 1 2. Not a career employee of any fire department other than the one from 2 which he or she is nominated; and 3 3. Selected from a list of at least three (3) names submitted by the 4 Kentucky Firefighters Association; 5 (c) One (1) member of a fire department formed under KRS Chapter 95 selected 6 from a list of at list three (3) names submitted by the Kentucky Professional 7 Firefighters; 8 (d) One (1) chief fire officer of a paid fire department selected from a list of at 9 least three (3) names submitted by the Kentucky Association of Fire Chiefs; 10 (e) One (1) licensed physician with experience in emergency medicine; 11 (f) A chief fire officer of a volunteer fire department who is not a career member 12 of any other department, selected from a list of at least three (3) names 13 submitted by the Kentucky Association of Fire Chiefs; 14 (g) One (1) member of a fire department formed under KRS Chapter 67 or 75, or 15 a fire department in a county containing an urban county government created 16 pursuant to KRS Chapter 67A, who is selected from a list of at least three (3) 17 names submitted by the Kentucky Professional Firefighters; 18 (h) The director of Homeland Security or his or her designee; 19 (i) One (1) mayor or other officer of a Kentucky city providing fire services 20 under KRS Chapter 95 selected from a list of at least three (3) names 21 submitted by the Kentucky League of Cities; 22 (j) One (1) county judge/executive or other officer of a Kentucky county selected 23 from a list of at least three (3) names submitted by the Kentucky Association 24 of Counties; 25 (k) One (1) representative of a Kentucky building, industry, or safety association; 26 (l) One (1) representative of the general public who is not an employee of any 27 UNOFFICIAL COPY 22 RS BR 1600 Page 74 of 111 XXXX Jacketed government or governmental agency; 1 (m) The state fire marshal or his or her designee; and 2 (n) One (1) officer of a fire-based ambulance provider[emergency medical 3 service] selected from a list of at least three (3) names submitted by the 4 Cabinet for Health and Family[executive director of the Kentucky Board of 5 Emergency Medical] Services. 6 (6) The vice president of administrative services of the Kentucky Community and 7 Technical College System, president of the Kentucky Firefighters Association, 8 president of the Kentucky Professional Firefighters, and president of the Kentucky 9 Association of Fire Chiefs, or their designees, shall serve as nonvoting ex officio 10 members of the commission. 11 (7) The members of the commission who are firefighters shall possess a minimum of 12 five (5) years of fire service experience and shall be certified with the following: 13 (a) One hundred fifty (150) hours of training for volunteer firefighters; or 14 (b) Four hundred (400) hours of training for professional firefighters. 15 (8) The Kentucky Firefighters Association, Kentucky Professional Firefighters, 16 Kentucky Association of Fire Chiefs, Cabinet for Health and Family 17 Services[Kentucky Board of Emergency Medical Services Association], Kentucky 18 League of Cities, and Kentucky Association of Counties shall submit their lists of 19 nominees by November 15 of each year as vacancies occur. 20 (9) The Governor shall appoint members of the commission to staggered terms not to 21 exceed four (4) years. However, initial appointments shall be appointed as follows: 22 (a) Four (4) members shall serve for two (2) year terms ending November 30, 23 2021; 24 (b) Five (5) members shall serve three (3) year terms ending November 30, 2022; 25 and 26 (c) Five (5) members shall serve four (4) year terms ending November 30, 2023. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 75 of 111 XXXX Jacketed (10) After the expiration of the initial appointments, appointive members shall be 1 appointed for a term of four (4) years. Any member chosen by the Governor to fill a 2 vacancy created otherwise than by expiration of term shall be appointed for the 3 unexpired term of the member he or she is chosen to succeed. 4 (11) When vacancies occur other than by expiration of term and nominations are 5 required, the Governor may request a new list or select an appointee from a 6 previously submitted list. Appointive members shall not serve more than two (2) 7 consecutive four (4) year terms. 8 (12) A majority of the voting members appointed to the commission shall constitute a 9 quorum. The commission shall: 10 (a) Meet at least four (4) times per year upon call of the chair, or upon the written 11 request of any five (5) members; and 12 (b) Annually elect a chair, vice chair, and secretary in accordance with KRS 13 95A.030. 14 (13) A member of the commission who misses three (3) regular meetings, without the 15 approval of the chairman, in one (1) year shall be deemed to have resigned from the 16 commission and his or her position shall be deemed to be vacant. As used in this 17 subsection, a "year" begins when the first meeting is missed and ends three hundred 18 sixty-five (365) days later or when the third meeting is missed, whichever occurs 19 first. The Governor shall appoint a similarly qualified person to fill the vacancy 20 within ninety (90) days of the vacancy occurring. The failure of a commission 21 member to attend a special or emergency meeting shall not result in any penalty. A 22 person removed under this subsection shall not be reappointed to the commission 23 for at least ten (10) years after removal. 24 (14) Members of the commission shall receive no compensation for their services but 25 shall be allowed their actual and necessary expenses incurred in the performance of 26 their functions. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 76 of 111 XXXX Jacketed Section 30. KRS 142.301 is amended to read as follows: 1 As used in KRS 142.301 to 142.363: 2 (1) "Ground ambulance provider" means a Class I, II, or III ground ambulance provider 3 described in Section 16 of this Act[KRS 311A.030]; 4 (2) "Assessment" means the Medicaid ambulance service provider assessment 5 established in KRS 142.318; 6 (3) "Department" means the Department of Revenue; 7 (4) "Charitable provider" means any provider which does not charge its patients for 8 health-care items or services, and which does not seek or accept Medicare, 9 Medicaid, or other financial support from the federal government or any state 10 government. The collaboration with public hospitals, agencies, or other providers in 11 the delivery of patient care; affiliation with public institutions to provide health-care 12 education; or the pursuit of research in cooperation with public institutions or 13 agencies shall not be considered as the receipt of government support by a 14 charitable provider; 15 (5) "Dispensing" means to deliver one (1) or more doses of a prescription drug in a 16 suitable container, appropriately labeled for subsequent administration or use by a 17 patient or other individual entitled to receive the prescription drug; 18 (6) "Entity" means any firm, partnership, joint venture, association, corporation, 19 company, joint stock association, trust, business trust, syndicate, cooperative, or 20 other group or combination acting as a unit; 21 (7) "Gross revenues" means the total amount received in money or otherwise by a 22 provider for the provision of health-care items or services in Kentucky, less the 23 following: 24 (a) Amounts received by any provider as an employee or independent contractor 25 from another provider for the provision of health-care items or services if: 26 1. The employing or contracting provider receives revenue attributable to 27 UNOFFICIAL COPY 22 RS BR 1600 Page 77 of 111 XXXX Jacketed health-care items or services provided by the employee or independent 1 contractor receiving payment; and 2 2. The employing or contracting provider is subject to the tax imposed by 3 KRS 142.303, 142.307, 142.309, 142.311, 142.314, 142.315, 142.316, 4 142.361, or 142.363 on the receipt of that revenue; 5 (b) Amounts received as a grant or donation by any provider from federal, state, 6 or local government or from an organization recognized as exempt from 7 federal income taxation under Section 501(c)(3) of the Internal Revenue Code 8 for: 9 1. Research; or 10 2. Administrative or operating costs associated with the implementation 11 and operation of an experimental program; 12 (c) Salaries or wages received by an individual provider as an employee of a 13 charitable provider, the federal government, or any state or local governmental 14 entity; 15 (d) Salaries or wages received by an individual provider as an employee of a 16 public university for the provision of services at a student health facility; and 17 (e) Amounts received by an HMO on a fixed, prepayment basis as premium 18 payments; 19 (8) "Health-care items or services" means: 20 (a) Inpatient hospital services; 21 (b) Outpatient hospital services; 22 (c) Nursing-facility services; 23 (d) Services of intermediate-care facilities for individuals with intellectual 24 disabilities; 25 (e) Physicians' services provided prior to July 1, 1999; 26 (f) Licensed home-health-care-agency services; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 78 of 111 XXXX Jacketed (g) Outpatient prescription drugs; 1 (h) HMO services; 2 (i) Regional community services for mental health and individuals with 3 intellectual disabilities; 4 (j) Psychiatric residential treatment facility services; 5 (k) Medicaid managed care organization services; and 6 (l) Supports for community living waiver program services; 7 (9) "Health-maintenance organization" or "HMO" means an organization established 8 and operated pursuant to the provisions of Subtitle 38 of KRS Chapter 304; 9 (10) "Hospital" means an acute-care, rehabilitation, or psychiatric hospital licensed 10 under KRS Chapter 216B; 11 (11) "Hospital services" means all inpatient and outpatient services provided by a 12 hospital. "Hospital services" does not include services provided by a noncontracted, 13 university-operated hospital, or any freestanding psychiatric hospital, if necessary 14 waivers are obtained by the Cabinet for Human Resources, Cabinet for Health 15 Services, or Cabinet for Health and Family Services from the Health Care Financing 16 Administration or Centers for Medicare and Medicaid Services, or hospitals 17 operated by the federal government; 18 (12) "Health and family services secretary" means the secretary of the Cabinet for Health 19 and Family Services or that person's authorized representative; 20 (13) "Inpatient hospital services," "outpatient hospital services," "intermediate-care-21 facility services for individuals with intellectual disabilities," "physician services," 22 "licensed home-health-care-agency services," and "outpatient prescription drugs" 23 have the same meaning as set forth in regulations promulgated by the Secretary of 24 the Department of Health and Human Services and codified at 42 C.F.R. pt. 440, as 25 in effect on December 31, 1993; 26 (14) "Medicaid" means the state program of medical assistance as administered by the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 79 of 111 XXXX Jacketed Cabinet for Health and Family Services in compliance with 42 U.S.C. sec. 1396; 1 (15) "Nursing-facility services" means services provided by a licensed skilled-care 2 facility, nursing facility, nursing home, or intermediate-care facility, excluding 3 services provided by intermediate-care facilities for individuals with intellectual 4 disabilities and services provided through licensed personal care beds; 5 (16) "Person" means any individual, firm, partnership, joint venture, association, 6 corporation, company, joint stock association, estate, trust, business trust, receiver, 7 trustee, syndicate, cooperative, assignee, governmental unit or agency, or any other 8 group or combination acting as a unit and the legal successor thereof; 9 (17) "Provider" means any person receiving gross revenues for the provision of health-10 care items or services in Kentucky, excluding any facility operated by the federal 11 government; 12 (18) "Commissioner" means the commissioner of the Department of Revenue or that 13 person's authorized representative; 14 (19) "Total bed capacity" means the combination of licensed nursing home beds, 15 licensed nursing facility beds, and licensed intermediate-care facility beds; 16 (20) "Regional community services programs for mental health and individuals with an 17 intellectual disability" means programs created under the provisions of KRS 18 210.370 to 210.480; 19 (21) "Psychiatric residential treatment facility" has the same meaning as provided in 20 KRS 216B.450; and 21 (22) "Supports for Community Living Waiver Program" has the same meaning as 22 provided in KRS 205.6317. 23 Section 31. KRS 189.910 is amended to read as follows: 24 (1) As used in KRS 189.920 to 189.950, "emergency vehicle" means any vehicle used 25 for emergency purposes by: 26 (a) The Department of Kentucky State Police; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 80 of 111 XXXX Jacketed (b) A public police department; 1 (c) The Department of Corrections; 2 (d) A sheriff's office; 3 (e) A rescue squad; 4 (f) An emergency management agency if it is a publicly owned vehicle; 5 (g) A licensed[An] ambulance provider[service], mobile integrated healthcare 6 program, or medical first response provider[ licensed by the Kentucky Board 7 of Emergency Medical Services], for any vehicle used to respond to 8 emergencies or to transport a patient with a critical medical condition; 9 (h) Any vehicle commandeered by a police officer; 10 (i) Any vehicle with the emergency lights required under KRS 189.920 used by a 11 paid or volunteer fireman or paid or volunteer ambulance personnel, or a paid 12 or local emergency management director while responding to an emergency or 13 to a location where an emergency vehicle is on emergency call; 14 (j) An elected coroner granted permission to equip a publicly or privately owned 15 motor vehicle with lights and siren pursuant to KRS 189.920; 16 (k) A deputy coroner granted permission to equip a publicly or privately owned 17 motor vehicle with lights and siren pursuant to KRS 189.920; or 18 (l) A conservation officer of the Kentucky Department of Fish and Wildlife 19 Resources. 20 (2) As used in KRS 189.920 to 189.950, "public safety vehicle" means public utility 21 repair vehicle; wreckers; state, county, or municipal service vehicles and 22 equipment; highway equipment which performs work that requires stopping and 23 standing or moving at slow speeds within the traveled portions of highways; and 24 vehicles which are escorting wide-load or slow-moving trailers or trucks. 25 Section 32. KRS 205.5602 is amended to read as follows: 26 (1) For purposes of this section and KRS 205.5601 and 205.5603: 27 UNOFFICIAL COPY 22 RS BR 1600 Page 81 of 111 XXXX Jacketed (a) "Ground ambulance provider" means a Class I, II, or III ground ambulance 1 provider described in Section 16 of this Act[KRS 311A.030]; 2 (b) "Assessment" means the Medicaid ambulance service provider assessment 3 imposed in KRS 142.318; 4 (c) "Cabinet" means the Cabinet for Health and Family["Board" means the 5 Kentucky Board of Emergency Medical] Services; 6 (d) "Commissioner" means the commissioner of the Department for Medicaid 7 Services; and 8 (e) "Department" means the Department for Medicaid Services. 9 (2) The department shall: 10 (a) Promulgate administrative regulations to establish the standards and 11 procedures necessary to implement the provisions of this section and KRS 12 205.5601 and 205.5603; 13 (b) Calculate an assessment on emergency ground transport collections pursuant 14 to subsection (3) of this section; 15 (c) Administer assessment proceeds according to subsection (6) of this section; 16 (d) Apply uniformly to all assessed ground ambulance providers any annual 17 changes to the assessment rate according to the process described in 18 subsection (3) of this section; and 19 (e) Evaluate current ground ambulance provider reimbursement rates paid by 20 managed care organizations and require increases consistent with: 21 1. KRS 205.5601 and this section; 22 2. Current fee-for-service reimbursement rates; and 23 3. An adequate network of ambulance service providers. 24 (3) (a) The assessment due from a ground ambulance provider on emergency ground 25 transport collections shall be not less than one-half of one percent (0.5%) 26 lower than the maximum limit for a provider assessment as approved by the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 82 of 111 XXXX Jacketed Centers for Medicare and Medicaid Services. 1 (b) For illustrative purposes only, if the maximum limit for a provider assessment 2 as approved by the Centers for Medicare and Medicaid Services is six percent 3 (6%) of the emergency revenues collected by the ground ambulance provider, 4 the minimum taxable limit under this section would be five and one-half 5 percent (5.5%) of the emergency revenues collected. 6 (4) The assessment shall not generate more than the maximum amount as approved by 7 the Centers for Medicare and Medicaid Services. 8 (5) (a) 1. Within ninety (90) days after July 15, 2020, the commissioner shall 9 determine whether a state plan amendment or an amendment to any 10 Kentucky federal Medicaid waiver is required to implement this section. 11 2. If the commissioner determines that a state plan amendment or an 12 amendment to a Kentucky federal waiver is necessary, the commissioner 13 is authorized to seek any necessary state plan or waiver amendment, and 14 the assessment shall not take effect until the state plan or waiver 15 amendment is approved. 16 (b) The assessment shall not be implemented until the first day of the calendar 17 quarter after the Department for Medicaid Services receives notice of federal 18 matching funds approval from the Centers for Medicare and Medicaid 19 Services and has notified the Department of Revenue of that approval. 20 (c) The commissioner shall implement this section to the extent that it is not 21 inconsistent with the state Medicaid plan or any Kentucky federal Medicaid 22 waivers. 23 (d) Payments to ground ambulance providers shall begin within ninety (90) days 24 of the later of the approval of federal matching funds, the state plan, or waiver 25 amendment. The first monthly assessment payment shall be due sixty (60) 26 days after the implementation of the enhanced fee schedule. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 83 of 111 XXXX Jacketed (6) The assessment shall be administered as follows: 1 (a) An annual amount of two hundred thousand dollars ($200,000) shall be 2 returned to the department to offset the Medicaid administration expenses; 3 (b) The remaining portion of the assessment shall: 4 1. Be utilized to increase the rates paid by a managed care organization for 5 emergency ambulance services up to the amount paid by the fee-for-6 service Medicaid program for emergency ambulance services; or 7 2. Be paid as supplemental payments to ground ambulance providers in a 8 proportional amount according to the total Medicaid ambulance 9 transports; and 10 (c) If any funds are remaining after the department's duties have been completed 11 under paragraph (b) of this subsection, the remaining funds shall be utilized by 12 the department to increase non-emergency medical transport rates. 13 (7) Each ground ambulance provider shall report to the cabinet[board], at the time and 14 in the manner required by the cabinet[board], ground emergency revenue collected 15 to accomplish the purposes of this section and KRS 205.5603. 16 (8) (a) No more than one hundred eighty (180) days after the end of each calendar 17 year, the cabinet[board] shall compile[submit to the cabinet transport] data for 18 all ground ambulance providers licensed in Kentucky. 19 (b) The data required by paragraph (a) of this subsection shall, at a minimum, 20 include the number of emergency ground transports completed during the 21 previous calendar year and the emergency revenue collected. 22 Section 33. KRS 211.494 is amended to read as follows: 23 (1) A comprehensive statewide trauma care program shall be established within the 24 Department for Public Health. The statewide trauma care program shall consist of, 25 at a minimum, a statewide trauma care director and a state trauma registrar funded 26 through available federal funds or, to the extent that funds are available, by the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 84 of 111 XXXX Jacketed trauma care system fund established in KRS 211.496. The department may contract 1 with outside entities to perform these functions. 2 (2) The statewide trauma care system shall address, at a minimum, the following goals: 3 (a) To reduce or prevent death and disability from trauma without regard to the 4 patient's insurance coverage or ability to pay for services; 5 (b) To provide optimal care for trauma victims by utilization of best practices 6 protocols and guidelines; 7 (c) To minimize the economic impact of lost wages and productivity for trauma 8 patients; and 9 (d) To contain costs of trauma care. 10 (3) (a) The Department for Public Health shall establish an advisory committee to 11 assist in the development, implementation, and continuation of its duties. 12 (b) The advisory committee shall consist of eighteen (18) members to be 13 appointed by the secretary of the Cabinet for Health and Family Services and 14 shall be composed of representatives from the following agencies and 15 organizations: 16 1. The Department for Public Health; 17 2. The Kentucky Board of Medical Licensure; 18 3. The Kentucky Board of Nursing; 19 4. The Kentucky Board of Emergency Medical Services; 20 5. The Kentucky Medical Association; 21 6. The Kentucky Hospital Association; 22 7. The Kentucky Committee on Trauma of the American College of 23 Surgeons; 24 8. One (1) representative from each verified Level I trauma center; 25 9. One (1) hospital representative from a Level II verified trauma center, 26 one (1) hospital representative from a Level III verified trauma center, 27 UNOFFICIAL COPY 22 RS BR 1600 Page 85 of 111 XXXX Jacketed and one (1) hospital representative from a Level IV verified trauma 1 center. The Kentucky Hospital Association shall submit 2 recommendations to the secretary for each of the three (3) members 3 appointed under this subdivision; 4 10. The Kentucky Chapter of the American College of Emergency 5 Physicians; 6 11. The Kentucky Chapter of the Emergency Nurses Association; 7 12. The Kentucky Transportation Cabinet; 8 13. Two (2) members at large, one (1) of whom shall be a health care 9 consumer; 10 14. One (1) representative with extensive experience in injury prevention 11 programs; and 12 15. One (1) representative with pediatric trauma experience. 13 (c) Members of the advisory committee shall serve for a period of four (4) years 14 and shall serve until a successor is appointed, except that initial terms shall be 15 staggered and one-third (1/3) of the members shall be appointed to four (4) 16 year terms, one-third (1/3) of the members shall be appointed to three (3) year 17 terms, and one-third (1/3) of the members shall be appointed for two (2) year 18 terms. 19 (d) The advisory committee shall meet at least on a quarterly basis. The 20 committee shall elect a chair, a vice chair, and a secretary from among its 21 members and adopt rules of governance at the first meeting in each fiscal year. 22 The first meeting of the advisory committee shall occur before September 30, 23 2008. 24 (e) Appointed members shall serve without compensation but may receive 25 reimbursement for actual and necessary expenses relating to the duties of the 26 advisory committee in accordance with state regulations relating to travel 27 UNOFFICIAL COPY 22 RS BR 1600 Page 86 of 111 XXXX Jacketed reimbursement. 1 (f) Expenses associated with the advisory committee shall be paid by the trauma 2 care system fund established in KRS 211.496, to the extent funds are 3 available. 4 (4) The statewide trauma care director and the advisory committee shall develop and 5 implement a statewide trauma care system, integrated with the public health system 6 for injury prevention, that recognizes levels of care for the appropriate delivery of a 7 full range of medical services to all trauma patients in the Commonwealth. The 8 statewide trauma care system shall include but is not limited to: 9 (a) Development and implementation of trauma prevention and education 10 initiatives; 11 (b) Facilitation of appropriate education and continuing education about trauma 12 care and procedures for physicians, nurses, and emergency medical services 13 personnel; 14 (c) Development and statewide distribution of guidelines and protocols for the 15 care and treatment of trauma victims that include the needs of special 16 populations and are fully integrated with all available resources, including but 17 not limited to emergency medical services, physicians, nurses, and hospitals; 18 (d) Voluntary hospital trauma center verification through the American College of 19 Surgeons or the Department for Public Health; 20 (e) Local and regional triage and transport protocols for use by [the Kentucky 21 Board of Emergency Medical Services, ]emergency medical services 22 providers[,] and emergency rooms; and 23 (f) Continuing quality assurance and peer review programs. 24 (5) The Department for Public Health or the statewide trauma care director and the 25 advisory committee established in this section shall coordinate activities related to 26 the care of trauma patients with other state agencies and boards that are directly or 27 UNOFFICIAL COPY 22 RS BR 1600 Page 87 of 111 XXXX Jacketed indirectly involved with care of injured persons. Upon request of the Department for 1 Public Health or the statewide trauma care director, other state agencies and boards 2 shall assist and facilitate the development and implementation of a statewide trauma 3 care system. 4 (6) Data obtained through a trauma registry or other data collected pursuant to KRS 5 211.490 to 211.496 shall be confidential and for use solely by the Department for 6 Public Health, the statewide trauma care director, the advisory committee, and 7 persons or public or private entities that participate in data collection for the trauma 8 registry. Personal identifying information that is collected for use in the trauma 9 registry shall not be subject to discovery or introduction into evidence in any civil 10 action. 11 (7) The statewide trauma care director shall report information on the status of the 12 development and implementation of the statewide trauma system upon request. 13 (8) The Department for Public Health may promulgate administrative regulations in 14 accordance with KRS Chapter 13A to implement this section. 15 Section 34. KRS 316.165 is amended to read as follows: 16 (1) Any person employed by a full-service funeral establishment or an embalming 17 service establishment, except a common carrier engaged in interstate commerce, the 18 Commonwealth and its agencies, or an ambulance[emergency medical services] 19 provider duly certified or licensed pursuant to KRS Chapter 216B[311A], who 20 wants to engage in the business of surface transportation or removal of dead human 21 bodies in the Commonwealth, shall apply for and may be granted a permit from the 22 board. 23 (2) Surface transportation and removal services shall not include: 24 (a) The arrangement or conduction of funerals; 25 (b) The provision for the care or preparation, including embalming, of dead 26 human bodies; or 27 UNOFFICIAL COPY 22 RS BR 1600 Page 88 of 111 XXXX Jacketed (c) The sale or provision of funeral-related goods and services; 1 without also the issuance of a funeral service establishment license or an embalming 2 service establishment license. 3 (3) The board shall promulgate administrative regulations related to the processes and 4 procedures for the permitting of persons to provide surface transportation and 5 removal services of dead human bodies. 6 Section 35. KRS 405.075 is amended to read as follows: 7 (1) As used in this section: 8 (a) "Newborn infant" means an infant who is medically determined to be less than 9 thirty (30) days old; 10 (b) "Newborn safety device" means a device: 11 1. Designed to permit a parent to anonymously place a newborn infant in 12 the device with the intent to leave the newborn and for an emergency 13 medical services provider to remove the newborn from the device and 14 take custody of the newborn infant; 15 2. Installed with an adequate dual alarm system connected to the physical 16 location where the device is physically installed. The dual alarm system 17 shall be: 18 a. Tested at least one (1) time per month to ensure the alarm system 19 is in working order; and 20 b. Visually checked at least two (2) times per day to ensure the alarm 21 system is in working order; 22 3. Approved by and physically located inside a participating staffed police 23 station, staffed fire station, or staffed hospital that: 24 a. Is licensed or otherwise legally operating in this state; and 25 b. Is staffed continuously on a twenty-four (24) hour basis every day 26 by a licensed emergency medical services provider; and 27 UNOFFICIAL COPY 22 RS BR 1600 Page 89 of 111 XXXX Jacketed 4. Located in an area that is conspicuous and visible to police station, fire 1 station, or hospital staff; and 2 (c) "Participating place of worship" means a recognized place of religious 3 worship that has voluntarily agreed to perform the duty granted in this section 4 and display signage prominently on its premises regarding its participation in 5 this section and its operating hours during which staff will be present. 6 (2) A parent shall have the right to remain anonymous, shall not be pursued, and shall 7 not be considered to have abandoned or endangered a newborn infant under KRS 8 Chapters 508 and 530 if the parent: 9 (a) Places a newborn infant: 10 1. With an emergency medical services provider; 11 2. At a staffed police station, fire station, or hospital; 12 3. At a participating place of worship; or 13 4. Inside a newborn safety device that meets the requirements of subsection 14 (1) of this section; and 15 (b) Expresses no intent to return for the newborn infant. 16 (3) (a) Any emergency medical services provider, police officer, or firefighter who 17 accepts physical custody of a newborn infant, or who physically retrieves a 18 newborn infant from a newborn safety device that meets the requirements of 19 subsection (1) of this section, in accordance with this section shall 20 immediately arrange for the infant to be taken to the nearest hospital 21 emergency room and shall have implied consent to any and all appropriate 22 medical treatment. 23 (b) Any staff member at a participating place of worship who accepts physical 24 custody of a newborn infant in accordance with this section shall immediately 25 contact the 911 emergency telephone service as set forth in KRS 65.750 to 26 65.760, wireless enhanced 911 system as set forth in KRS 65.7621 to 65.7643, 27 UNOFFICIAL COPY 22 RS BR 1600 Page 90 of 111 XXXX Jacketed or ambulance provider[emergency medical services] as set forth in KRS 1 Chapter 216B[311A] for transportation to the nearest hospital emergency 2 room. 3 (4) By placing a newborn infant in the manner described in this section, the parent: 4 (a) Waives the right to notification required by subsequent court proceedings 5 conducted under KRS Chapter 620 until such time as a claim of parental 6 rights is made; and 7 (b) Waives legal standing to make a claim of action against any person who 8 accepts physical custody of the newborn infant. 9 (5) A staffed police station, fire station, hospital, emergency medical facility, or 10 participating place of worship may post a sign easily seen by the public stating that: 11 "This facility is a safe and legal place to surrender a newborn infant who is less than 12 30 days old. A parent who places a newborn infant at this facility and expresses no 13 intent to return for the infant shall have the right to remain anonymous and not be 14 pursued and shall not be considered to have abandoned or endangered their 15 newborn infant under KRS Chapters 508 and 530." 16 (6) Actions taken by an emergency medical services provider, police officer, firefighter, 17 or staff member at a participating place of worship in conformity with the duty 18 granted in this section shall be immune from criminal or civil liability. Nothing in 19 this subsection shall limit liability for negligence. 20 (7) The provisions of subsection (2) of this section shall not apply when indicators of 21 child physical abuse or child neglect are present. 22 (8) KRS 211.951, 216B.190, 405.075, 620.350, and 620.355 shall be known as "The 23 Representative Thomas J. Burch Safe Infants Act." 24 SECTION 36. A NEW SECTION OF KRS CHAPTER 311A IS CREATED 25 TO READ AS FOLLOWS: 26 (1) Except for personnel under subsection (2) of this section, personnel employed by 27 UNOFFICIAL COPY 22 RS BR 1600 Page 91 of 111 XXXX Jacketed the Kentucky Board of Emergency Medical Services under the Kentucky 1 Community and Technical College System shall be transferred to the Kentucky 2 Board of Emergency Medical Services in the KRS Chapter 18A personnel system 3 along with the funding associated with those employees. 4 (2) (a) Personnel employed by the Kentucky Board of Emergency Medical Services 5 under the Kentucky Community and Technical College System who 6 participate in a defined contribution plan that meets requirements of 26 7 U.S.C. sec. 403(b), for employees of the Kentucky Community and 8 Technical College System, may choose to remain in their present 9 employment and be assigned to the board to continue providing these 10 services or become an employee of the board under the KRS Chapter 18A 11 personnel system. 12 (b) Employees shall make their choice within thirty (30) days following the 13 effective date of this Act and shall have access to counseling by 14 representatives of the KRS Chapter 18A personnel system, the Kentucky 15 Community and Technical College System, and applicable retirement 16 systems concerning the effect the choice of employment would have on the 17 employee. If an employee does not make a choice within thirty (30) days 18 following the effective date of this Act, that employee shall be deemed to 19 have chosen to exercise the option to become an employee of the board 20 under the KRS Chapter 18A personnel system. 21 (3) Employees transferred pursuant to subsections (1) and (2) of this section shall 22 retain: 23 (a) Their salaries and leave time balances accumulated as of the transfer date; 24 (b) For purposes of determining leave time accumulation, the date of initial 25 employment with a state agency or a postsecondary educational institution, 26 whichever is earlier; and 27 UNOFFICIAL COPY 22 RS BR 1600 Page 92 of 111 XXXX Jacketed (c) For purposes of calculating retirement and retiree health benefits and 1 contributions, the earlier of the date of initial participation or membership 2 date, in: 3 1. A state-administered retirement system if the employee has 4 participated or is participating in the Kentucky Employees Retirement 5 System; or 6 2. A defined contribution plan that meets requirements of 26 U.S.C. sec. 7 403(b), for employees of the Kentucky Community and Technical 8 College System. 9 Nothing in this paragraph shall be construed to provide additional service 10 credit for the employee prior to the transfer date other than what has been 11 credited to the appropriate retirement system. 12 (4) (a) All existing state general fund moneys appropriated to the board, all federal 13 funds, all moneys collected by the board, all equipment owned by the board, 14 instructional supplies, equipment, funds, and records of the Kentucky 15 Community and Technical College System associated with the Kentucky 16 Board of Emergency Medical Services that are not related to the collection 17 of emergency medical services data and the licensure and inspection of 18 ambulance providers, shall be transferred to the Kentucky Board of 19 Emergency Medical Services in the KRS Chapter 18A personnel system 20 along with all financial and management oversight responsibility and 21 liability. 22 (b) All instructional supplies, equipment, funds, and records of the Kentucky 23 Community and Technical College System associated with the Kentucky 24 Board of Emergency Medical Services related to the collection of emergency 25 medical services data and the licensure and inspection of ambulance 26 providers shall be transferred to the Cabinet for Health and Family 27 UNOFFICIAL COPY 22 RS BR 1600 Page 93 of 111 XXXX Jacketed Services. 1 Section 37. KRS 61.510 is amended to read as follows: 2 As used in KRS 61.510 to 61.705, unless the context otherwise requires: 3 (1) "System" means the Kentucky Employees Retirement System created by KRS 4 61.510 to 61.705; 5 (2) "Board" means the board of trustees of the system as provided in KRS 61.645; 6 (3) "Department" means any state department or board or agency participating in the 7 system in accordance with appropriate executive order, as provided in KRS 61.520. 8 For purposes of KRS 61.510 to 61.705, the members, officers, and employees of the 9 General Assembly and any other body, entity, or instrumentality designated by 10 executive order by the Governor, shall be deemed to be a department, 11 notwithstanding whether said body, entity, or instrumentality is an integral part of 12 state government; 13 (4) "Examiner" means the medical examiners as provided in KRS 61.665; 14 (5) "Employee" means the members, officers, and employees of the General Assembly 15 and every regular full-time, appointed or elective officer or employee of a 16 participating department, including the Department of Military Affairs. The term 17 does not include persons engaged as independent contractors, seasonal, emergency, 18 temporary, interim, and part-time workers. In case of any doubt, the board shall 19 determine if a person is an employee within the meaning of KRS 61.510 to 61.705; 20 (6) "Employer" means a department or any authority of a department having the power 21 to appoint or select an employee in the department, including the Senate and the 22 House of Representatives, or any other entity, the employees of which are eligible 23 for membership in the system pursuant to KRS 61.525; 24 (7) "State" means the Commonwealth of Kentucky; 25 (8) "Member" means any employee who is included in the membership of the system or 26 any former employee whose membership has not been terminated under KRS 27 UNOFFICIAL COPY 22 RS BR 1600 Page 94 of 111 XXXX Jacketed 61.535; 1 (9) "Service" means the total of current service and prior service as defined in this 2 section; 3 (10) "Current service" means the number of years and months of employment as an 4 employee, on and after July 1, 1956, except that for members, officers, and 5 employees of the General Assembly this date shall be January 1, 1960, for which 6 creditable compensation is paid and employee contributions deducted, except as 7 otherwise provided, and each member, officer, and employee of the General 8 Assembly shall be credited with a month of current service for each month he 9 serves in the position; 10 (11) "Prior service" means the number of years and completed months, expressed as a 11 fraction of a year, of employment as an employee, prior to July 1, 1956, for which 12 creditable compensation was paid; except that for members, officers, and employees 13 of the General Assembly, this date shall be January 1, 1960. An employee shall be 14 credited with one (1) month of prior service only in those months he received 15 compensation for at least one hundred (100) hours of work; provided, however, that 16 each member, officer, and employee of the General Assembly shall be credited with 17 a month of prior service for each month he served in the position prior to January 1, 18 1960. Twelve (12) months of current service in the system are required to validate 19 prior service; 20 (12) "Accumulated contributions" at any time means the sum of all amounts deducted 21 from the compensation of a member and credited to his individual account in the 22 members' account, including employee contributions picked up after August 1, 23 1982, pursuant to KRS 61.560(4), together with interest credited, on such amounts 24 and any other amounts the member shall have contributed thereto, including interest 25 credited thereon. For members who begin participating on or after September 1, 26 2008, "accumulated contributions" shall not include employee contributions that are 27 UNOFFICIAL COPY 22 RS BR 1600 Page 95 of 111 XXXX Jacketed deposited into accounts established pursuant to 26 U.S.C. sec. 401(h) within the 1 funds established in KRS 16.510 and 61.515, as prescribed by KRS 61.702(3)(b); 2 (13) "Creditable compensation": 3 (a) Means all salary, wages, tips to the extent the tips are reported for income tax 4 purposes, and fees, including payments for compensatory time, paid to the 5 employee as a result of services performed for the employer or for time during 6 which the member is on paid leave, which are includable on the member's 7 federal form W-2 wage and tax statement under the heading "wages, tips, 8 other compensation," including employee contributions picked up after 9 August 1, 1982, pursuant to KRS 61.560(4). For members of the General 10 Assembly, it shall mean all amounts which are includable on the member's 11 federal form W-2 wage and tax statement under the heading "wages, tips, 12 other compensation," including employee contributions picked up after 13 August 1, 1982, pursuant to KRS 6.505(4) or 61.560(4); 14 (b) Includes: 15 1. Lump-sum bonuses, severance pay, or employer-provided payments for 16 purchase of service credit, which shall be averaged over the employee's 17 total service with the system in which it is recorded if it is equal to or 18 greater than one thousand dollars ($1,000); 19 2. Cases where compensation includes maintenance and other perquisites, 20 but the board shall fix the value of that part of the compensation not paid 21 in money; 22 3. Lump-sum payments for creditable compensation paid as a result of an 23 order of a court of competent jurisdiction, the Personnel Board, or the 24 Commission on Human Rights, or for any creditable compensation paid 25 in anticipation of settlement of an action before a court of competent 26 jurisdiction, the Personnel Board, or the Commission on Human Rights, 27 UNOFFICIAL COPY 22 RS BR 1600 Page 96 of 111 XXXX Jacketed including notices of violations of state or federal wage and hour statutes 1 or violations of state or federal discrimination statutes, which shall be 2 credited to the fiscal year during which the wages were earned or should 3 have been paid by the employer. This subparagraph shall also include 4 lump-sum payments for reinstated wages pursuant to KRS 61.569, 5 which shall be credited to the period during which the wages were 6 earned or should have been paid by the employer; 7 4. Amounts which are not includable in the member's gross income by 8 virtue of the member having taken a voluntary salary reduction provided 9 for under applicable provisions of the Internal Revenue Code; and 10 5. Elective amounts for qualified transportation fringes paid or made 11 available on or after January 1, 2001, for calendar years on or after 12 January 1, 2001, that are not includable in the gross income of the 13 employee by reason of 26 U.S.C. sec. 132(f)(4); and 14 (c) Excludes: 15 1. Living allowances, expense reimbursements, lump-sum payments for 16 accrued vacation leave, and other items determined by the board; 17 2. For employees who begin participating on or after September 1, 2008, 18 lump-sum payments for compensatory time; 19 3. For employees who begin participating on or after August 1, 2016, 20 nominal fees paid for services as a volunteer; and 21 4. Any salary or wages paid to an employee for services as a Kentucky 22 State Police school resource officer as defined by KRS 158.441; 23 (14) "Final compensation" of a member means: 24 (a) For a member who begins participating before September 1, 2008, who is 25 employed in a nonhazardous position, the creditable compensation of the 26 member during the five (5) fiscal years he or she was paid at the highest 27 UNOFFICIAL COPY 22 RS BR 1600 Page 97 of 111 XXXX Jacketed average monthly rate divided by the number of months of service credit during 1 that five (5) year period multiplied by twelve (12). The five (5) years may be 2 fractional and need not be consecutive. If the number of months of service 3 credit during the five (5) year period is less than forty-eight (48), one (1) or 4 more additional fiscal years shall be used; 5 (b) For a member who is employed in a nonhazardous position, whose effective 6 retirement date is between August 1, 2001, and January 1, 2009, and whose 7 total service credit is at least twenty-seven (27) years and whose age and years 8 of service total at least seventy-five (75), final compensation means the 9 creditable compensation of the member during the three (3) fiscal years the 10 member was paid at the highest average monthly rate divided by the number 11 of months of service credit during that three (3) years period multiplied by 12 twelve (12). The three (3) years may be fractional and need not be 13 consecutive. If the number of months of service credit during the three (3) 14 year period is less than twenty-four (24), one (1) or more additional fiscal 15 years shall be used. Notwithstanding the provision of KRS 61.565, the 16 funding for this paragraph shall be provided from existing funds of the 17 retirement allowance; 18 (c) For a member who begins participating before September 1, 2008, who is 19 employed in a hazardous position, as provided in KRS 61.592, the creditable 20 compensation of the member during the three (3) fiscal years he or she was 21 paid at the highest average monthly rate divided by the number of months of 22 service credit during that three (3) year period multiplied by twelve (12). The 23 three (3) years may be fractional and need not be consecutive. If the number of 24 months of service credit during the three (3) year period is less than twenty-25 four (24), one (1) or more additional fiscal years shall be used; 26 (d) For a member who begins participating on or after September 1, 2008, but 27 UNOFFICIAL COPY 22 RS BR 1600 Page 98 of 111 XXXX Jacketed prior to January 1, 2014, who is employed in a nonhazardous position, the 1 creditable compensation of the member during the five (5) complete fiscal 2 years immediately preceding retirement divided by five (5). Each fiscal year 3 used to determine final compensation must contain twelve (12) months of 4 service credit. If the member does not have five (5) complete fiscal years that 5 each contain twelve (12) months of service credit, then one (1) or more 6 additional fiscal years, which may contain less than twelve (12) months of 7 service credit, shall be added until the number of months in the final 8 compensation calculation is at least sixty (60) months; or 9 (e) For a member who begins participating on or after September 1, 2008, but 10 prior to January 1, 2014, who is employed in a hazardous position as provided 11 in KRS 61.592, the creditable compensation of the member during the three 12 (3) complete fiscal years he or she was paid at the highest average monthly 13 rate divided by three (3). Each fiscal year used to determine final 14 compensation must contain twelve (12) months of service credit. If the 15 member does not have three (3) complete fiscal years that each contain twelve 16 (12) months of service credit, then one (1) or more additional fiscal years, 17 which may contain less than twelve (12) months of service credit, shall be 18 added until the number of months in the final compensation calculation is at 19 least thirty-six (36) months; 20 (15) "Final rate of pay" means the actual rate upon which earnings of an employee were 21 calculated during the twelve (12) month period immediately preceding the 22 member's effective retirement date, including employee contributions picked up 23 after August 1, 1982, pursuant to KRS 61.560(4). The rate shall be certified to the 24 system by the employer and the following equivalents shall be used to convert the 25 rate to an annual rate: two thousand eighty (2,080) hours for eight (8) hour 26 workdays, nineteen hundred fifty (1,950) hours for seven and one-half (7-1/2) hour 27 UNOFFICIAL COPY 22 RS BR 1600 Page 99 of 111 XXXX Jacketed workdays, two hundred sixty (260) days, fifty-two (52) weeks, twelve (12) months, 1 one (1) year; 2 (16) "Retirement allowance" means the retirement payments to which a member is 3 entitled; 4 (17) "Actuarial equivalent" means a benefit of equal value when computed upon the 5 basis of the actuarial tables that are adopted by the board. In cases of disability 6 retirement, the options authorized by KRS 61.635 shall be computed by adding ten 7 (10) years to the age of the member, unless the member has chosen the Social 8 Security adjustment option as provided for in KRS 61.635(8), in which case the 9 member's actual age shall be used. For members who began participating in the 10 system prior to January 1, 2014, no disability retirement option shall be less than the 11 same option computed under early retirement; 12 (18) "Normal retirement date" means the sixty-fifth birthday of a member, unless 13 otherwise provided in KRS 61.510 to 61.705; 14 (19) "Fiscal year" of the system means the twelve (12) months from July 1 through the 15 following June 30, which shall also be the plan year. The "fiscal year" shall be the 16 limitation year used to determine contribution and benefit limits as established by 17 26 U.S.C. sec. 415; 18 (20) "Officers and employees of the General Assembly" means the occupants of those 19 positions enumerated in KRS 6.150. The term shall also apply to assistants who 20 were employed by the General Assembly for at least one (1) regular legislative 21 session prior to July 13, 2004, who elect to participate in the retirement system, and 22 who serve for at least six (6) regular legislative sessions. Assistants hired after July 23 13, 2004, shall be designated as interim employees; 24 (21) "Regular full-time positions," as used in subsection (5) of this section, shall mean 25 all positions that average one hundred (100) or more hours per month determined by 26 using the number of months actually worked within a calendar or fiscal year, 27 UNOFFICIAL COPY 22 RS BR 1600 Page 100 of 111 XXXX Jacketed including all positions except: 1 (a) Seasonal positions, which although temporary in duration, are positions which 2 coincide in duration with a particular season or seasons of the year and which 3 may recur regularly from year to year, the period of time shall not exceed nine 4 (9) months; 5 (b) Emergency positions which are positions which do not exceed thirty (30) 6 working days and are nonrenewable; 7 (c) Temporary positions which are positions of employment with a participating 8 department for a period of time not to exceed nine (9) months and are 9 nonrenewable; 10 (d) Part-time positions which are positions which may be permanent in duration, 11 but which require less than a calendar or fiscal year average of one hundred 12 (100) hours of work per month, determined by using the number of months 13 actually worked within a calendar or fiscal year, in the performance of duty; 14 and 15 (e) Interim positions which are positions established for a one-time or recurring 16 need not to exceed nine (9) months; 17 (22) "Vested" for purposes of determining eligibility for purchasing service credit under 18 KRS 61.552 means the employee has at least forty-eight (48) months of service if 19 age sixty-five (65) or older or at least sixty (60) months of service if under the age 20 of sixty-five (65). For purposes of this subsection, "service" means service in the 21 systems administered by the Kentucky Retirement Systems and County Employees 22 Retirement System; 23 (23) "Parted employer" means a department, portion of a department, board, or agency, 24 such as Outwood Hospital and School, which previously participated in the system, 25 but due to lease or other contractual arrangement is now operated by a publicly held 26 corporation or other similar organization, and therefore is no longer participating in 27 UNOFFICIAL COPY 22 RS BR 1600 Page 101 of 111 XXXX Jacketed the system. The term "parted employer" shall not include a department, board, or 1 agency that ceased participation in the system pursuant to KRS 61.522; 2 (24) "Retired member" means any former member receiving a retirement allowance or 3 any former member who has filed the necessary documents for retirement benefits 4 and is no longer contributing to the retirement system; 5 (25) "Current rate of pay" means the member's actual hourly, daily, weekly, biweekly, 6 monthly, or yearly rate of pay converted to an annual rate as defined in final rate of 7 pay. The rate shall be certified by the employer; 8 (26) "Beneficiary" means the person or persons or estate or trust or trustee designated by 9 the member in accordance with KRS 61.542 or 61.705 to receive any available 10 benefits in the event of the member's death. As used in KRS 61.702, "beneficiary" 11 does not mean an estate, trust, or trustee; 12 (27) "Recipient" means the retired member or the person or persons designated as 13 beneficiary by the member and drawing a retirement allowance as a result of the 14 member's death or a dependent child drawing a retirement allowance. An alternate 15 payee of a qualified domestic relations order shall not be considered a recipient, 16 except for purposes of KRS 61.623; 17 (28) "Level percentage of payroll amortization method" means a method of determining 18 the annual amortization payment on the unfunded actuarial accrued liability as 19 expressed as a percentage of payroll over a set period of years but that may be 20 converted to a dollar value for purposes of KRS 61.565(1)(d). Under this method, 21 the percentage of payroll shall be projected to remain constant for all years 22 remaining in the set period of time and the unfunded actuarially accrued liability 23 shall be projected to be fully amortized at the conclusion of the set period of years; 24 (29) "Increment" means twelve (12) months of service credit which are purchased. The 25 twelve (12) months need not be consecutive. The final increment may be less than 26 twelve (12) months; 27 UNOFFICIAL COPY 22 RS BR 1600 Page 102 of 111 XXXX Jacketed (30) "Person" means a natural person; 1 (31) "Retirement office" means the Kentucky Public Pensions Authority's office building 2 in Frankfort, unless otherwise designated by the Kentucky Public Pensions 3 Authority; 4 (32) "Last day of paid employment" means the last date employer and employee 5 contributions are required to be reported in accordance with KRS 16.543, 61.543, or 6 78.615 to the retirement office in order for the employee to receive current service 7 credit for the month. Last day of paid employment does not mean a date the 8 employee receives payment for accrued leave, whether by lump sum or otherwise, if 9 that date occurs twenty-four (24) or more months after previous contributions; 10 (33) "Objective medical evidence" means reports of examinations or treatments; medical 11 signs which are anatomical, physiological, or psychological abnormalities that can 12 be observed; psychiatric signs which are medically demonstrable phenomena 13 indicating specific abnormalities of behavior, affect, thought, memory, orientation, 14 or contact with reality; or laboratory findings which are anatomical, physiological, 15 or psychological phenomena that can be shown by medically acceptable laboratory 16 diagnostic techniques, including but not limited to chemical tests, 17 electrocardiograms, electroencephalograms, X-rays, and psychological tests; 18 (34) "Participating" means an employee is currently earning service credit in the system 19 as provided in KRS 61.543; 20 (35) "Month" means a calendar month; 21 (36) "Membership date" means: 22 (a) The date upon which the member began participating in the system as 23 provided in KRS 61.543; or 24 (b) For a member electing to participate in the system pursuant to KRS 25 196.167(4) or subsection (2) of Section 36 of this Act who has not previously 26 participated in the system or the Kentucky Teachers' Retirement System, the 27 UNOFFICIAL COPY 22 RS BR 1600 Page 103 of 111 XXXX Jacketed date the member began participating in a defined contribution plan that meets 1 the requirements of 26 U.S.C. sec. 403(b); 2 (37) "Participant" means a member, as defined by subsection (8) of this section, or a 3 retired member, as defined by subsection (24) of this section; 4 (38) "Qualified domestic relations order" means any judgment, decree, or order, 5 including approval of a property settlement agreement, that: 6 (a) Is issued by a court or administrative agency; and 7 (b) Relates to the provision of child support, alimony payments, or marital 8 property rights to an alternate payee; 9 (39) "Alternate payee" means a spouse, former spouse, child, or other dependent of a 10 participant, who is designated to be paid retirement benefits in a qualified domestic 11 relations order; 12 (40) "Accumulated employer credit" mean the employer pay credit deposited to the 13 member's account and interest credited on such amounts as provided by KRS 14 16.583 and 61.597; 15 (41) "Accumulated account balance" means: 16 (a) For members who began participating in the system prior to January 1, 2014, 17 the member's accumulated contributions; or 18 (b) For members who began participating in the system on or after January 1, 19 2014, in the hybrid cash balance plan as provided by KRS 16.583 and 61.597, 20 the combined sum of the member's accumulated contributions and the 21 member's accumulated employer credit; 22 (42) "Volunteer" means an individual who: 23 (a) Freely and without pressure or coercion performs hours of service for an 24 employer participating in one (1) of the systems administered by Kentucky 25 Retirement Systems without receipt of compensation for services rendered, 26 except for reimbursement of actual expenses, payment of a nominal fee to 27 UNOFFICIAL COPY 22 RS BR 1600 Page 104 of 111 XXXX Jacketed offset the costs of performing the voluntary services, or both; and 1 (b) If a retired member, does not become an employee, leased employee, or 2 independent contractor of the employer for which he or she is performing 3 volunteer services for a period of at least twelve (12) months following the 4 retired member's most recent retirement date; 5 (43) "Nominal fee" means compensation earned for services as a volunteer that does not 6 exceed five hundred dollars ($500) per month. Compensation earned for services as 7 a volunteer from more than one (1) participating employer during a month shall be 8 aggregated to determine whether the compensation exceeds the five hundred dollars 9 ($500) per month maximum provided by this subsection; 10 (44) "Nonhazardous position" means a position that does not meet the requirements of 11 KRS 61.592 or has not been approved by the board as a hazardous position; 12 (45) "Monthly average pay" means: 13 (a) In the case of a member who dies as a direct result of an act in line of duty as 14 defined in KRS 16.505 or who dies as a result of a duty-related injury as 15 defined in KRS 61.621, the higher of the member's monthly final rate of pay 16 or the average monthly creditable compensation earned by the deceased 17 member during his or her last twelve (12) months of employment; or 18 (b) In the case where a member becomes totally and permanently disabled as a 19 direct result of an act in line of duty as defined in KRS 16.505 or becomes 20 disabled as a result of a duty-related injury as defined in KRS 61.621 and is 21 eligible for the benefits provided by KRS 61.621(5)(a), the higher of the 22 member's monthly final rate of pay or the average monthly creditable 23 compensation earned by the disabled member during his or her last twelve 24 (12) months of employment prior to the date the act in line of duty or duty-25 related injury occurred; 26 (46) "Authority" means the Kentucky Public Pensions Authority as provided by KRS 27 UNOFFICIAL COPY 22 RS BR 1600 Page 105 of 111 XXXX Jacketed 61.505; and 1 (47) "Executive director" means the executive director of the Kentucky Public Pensions 2 Authority. 3 Section 38. KRS 205.590 is amended to read as follows: 4 (1) The following technical advisory committees shall be established for the purpose of 5 acting in an advisory capacity to the Advisory Council for Medical Assistance with 6 respect to the administration of the medical assistance program and in performing 7 the function of peer review: 8 (a) A Technical Advisory Committee on Physician Services consisting of five (5) 9 physicians appointed by the council of the Kentucky State Medical 10 Association; 11 (b) A Technical Advisory Committee on Hospital Care consisting of five (5) 12 hospital administrators appointed by the board of trustees of the Kentucky 13 Hospital Association; 14 (c) A Technical Advisory Committee on Dental Care consisting of five (5) 15 dentists appointed by the Kentucky Dental Association; 16 (d) A Technical Advisory Committee on Nursing Service consisting of five (5) 17 nurses appointed by the board of directors of the Kentucky State Association 18 of Registered Nurses; 19 (e) A Technical Advisory Committee on Nursing Home Care consisting of six (6) 20 members of which five (5) members shall be appointed by the Kentucky 21 Association of Health Care Facilities, and one (1) member shall be appointed 22 by the Kentucky Association of Nonprofit Homes and Services for the Aging, 23 Inc.; 24 (f) A Technical Advisory Committee on Optometric Care consisting of five (5) 25 members appointed by the Kentucky Optometric Association; 26 (g) A Technical Advisory Committee on Podiatric Care consisting of five (5) 27 UNOFFICIAL COPY 22 RS BR 1600 Page 106 of 111 XXXX Jacketed podiatrists appointed by the Kentucky Podiatry Association; 1 (h) A Technical Advisory Committee on Primary Care consisting of five (5) 2 primary care providers, two (2) of whom shall represent licensed health 3 maintenance organizations, appointed by the Governor, until such time as an 4 association of primary care providers is established, whereafter the association 5 shall appoint the members; 6 (i) A Technical Advisory Committee on Home Health Care consisting of five (5) 7 members appointed by the board of directors of the Kentucky Home Health 8 Association; 9 (j) A Technical Advisory Committee on Consumer Rights and Client Needs 10 consisting of seven (7) members, with one (1) member to be appointed by 11 each of the following organizations: the American Association of Retired 12 Persons Kentucky, the Family Resource Youth Services Coalition of 13 Kentucky, the Kentucky Association of Community Health Workers, the 14 Kentucky Legal Services Corporation, the Arc of Kentucky, the Department 15 of Public Advocacy, and the National Association of Social Workers-16 Kentucky Chapter; 17 (k) A Technical Advisory Committee on Behavioral Health consisting of seven 18 (7) members, with one (1) member to be appointed by each of the following 19 organizations: the Kentucky Mental Health Coalition, the Kentucky 20 Association of Regional Programs, the National Alliance on Mental Illness 21 (NAMI) Kentucky, a statewide mental health consumer organization, the 22 People Advocating Recovery (PAR), the Brain Injury Association of America-23 Kentucky Chapter, and the Kentucky Brain Injury Alliance; 24 (l) A Technical Advisory Committee on Children's Health consisting of ten (10) 25 members, with one (1) member to be appointed by each of the following 26 organizations: the Kentucky Chapter of the American Academy of Pediatrics, 27 UNOFFICIAL COPY 22 RS BR 1600 Page 107 of 111 XXXX Jacketed the Kentucky PTA, the Kentucky Psychological Association, the Kentucky 1 School Nurses Association, the Kentucky Association for Early Childhood 2 Education, the Family Resource and Youth Services Coalition of Kentucky, 3 the Kentucky Youth Advocates, the Kentucky Association of Hospice and 4 Palliative Care, a parent of a child enrolled in Medicaid or the Kentucky 5 Children's Health Insurance Program appointed by the Kentucky Head Start 6 Association, and a pediatric dentist appointed by the Kentucky Dental 7 Association; 8 (m) A Technical Advisory Committee on Intellectual and Developmental 9 Disabilities consisting of nine (9) members, one (1) of whom shall be a 10 consumer who participates in a nonresidential community Medicaid waiver 11 program, one (1) of whom shall be a consumer who participates in a 12 residential community Medicaid waiver program, one (1) of whom shall be a 13 consumer representative of a family member who participates in a community 14 Medicaid waiver program, and one (1) of whom shall be a consumer 15 representative of a family member who resides in an ICF/ID facility that 16 accepts Medicaid payments, all of whom shall be appointed by the Governor; 17 one (1) member shall be appointed by the Arc of Kentucky; one (1) member 18 shall be appointed by the Commonwealth Council on Developmental 19 Disabilities; one (1) member shall be appointed by the Kentucky Association 20 of Homes and Services for the Aging; and two (2) members shall be appointed 21 by the Kentucky Association of Private Providers, one (1) of whom shall be a 22 nonprofit provider and one (1) of whom shall be a for-profit provider; 23 (n) A Technical Advisory Committee on Therapy Services consisting of six (6) 24 members, two (2) of whom shall be occupational therapists and shall be 25 appointed by the Kentucky Occupational Therapists Association, two (2) of 26 whom shall be physical therapists and shall be appointed by the Kentucky 27 UNOFFICIAL COPY 22 RS BR 1600 Page 108 of 111 XXXX Jacketed Physical Therapy Association, and two (2) of whom shall be speech therapists 1 and shall be appointed by the Kentucky Speech-Language-Hearing 2 Association; 3 (o) A Technical Advisory Committee on Pharmacy consisting of seven (7) 4 members, two (2) of whom shall be Kentucky licensed pharmacists who own 5 fewer than ten (10) pharmacies in the Commonwealth and shall be appointed 6 by the Kentucky Independent Pharmacy Alliance, two (2) of whom shall be 7 Kentucky licensed pharmacists and shall be appointed by the Kentucky 8 Pharmacy Association, and one (1) member to be appointed by each of the 9 following organizations: the Kentucky Hospital Association, the Kentucky 10 Primary Care Association, and the National Association of Chain Drug Stores; 11 [and] 12 (p) A Technical Advisory Committee on Persons Returning to Society from 13 Incarceration consisting of twelve (12) members of whom: 14 1. One (1) shall be appointed by each of the following organizations: the 15 Kentucky Jailers Association, the Kentucky Medical Association, the 16 Kentucky Association of Nurse Practitioners and Nurse-Midwives, 17 Community Action of Kentucky, the Homeless and Housing Coalition 18 of Kentucky, the Kentucky Office of Drug Control Policy, a Kentucky 19 civil legal aid program, the Kentucky Department of Corrections, the 20 Kentucky Department of Public Advocacy, the Kentucky Association of 21 Regional Programs, and the Kentucky Administrative Office of the 22 Courts; and 23 2. One (1) formerly incarcerated individual who is a current or former 24 Medicaid recipient shall be appointed by Mental Health America of 25 Kentucky; and 26 (q) A Technical Advisory Committee on Emergency Medical Services 27 UNOFFICIAL COPY 22 RS BR 1600 Page 109 of 111 XXXX Jacketed consisting of seven (7) members of whom one (1) shall represent the air 1 medical industry and shall be appointed by the Kentucky Chapter of the 2 Association of Air Medical Services; one (1) shall be appointed by the 3 Kentucky Board of Emergency Medical Services; two (2) shall represent the 4 emergency medical services billing industry and shall be members of and 5 appointed by the Kentucky Ambulance Providers Association; and three (3) 6 shall represent ground ambulance providers and shall be appointed by the 7 Kentucky Ambulance Providers Association. All members appointed to this 8 committee shall represent emergency medical services providers that 9 operate in Kentucky and shall have experience in interpreting, 10 implementing, or ensuring compliance with Medicaid regulations. 11 (2) The members of the technical advisory committees shall serve until their successors 12 are appointed and qualified. 13 (3) Each appointive member of a committee shall serve without compensation but shall 14 be entitled to reimbursement for actual and necessary expenses in carrying out their 15 duties with reimbursement for expenses being made in accordance with state 16 regulations relating to travel reimbursement. 17 Section 39. The following KRS sections are repealed: 18 211.9523 Abolition of category of nonemergency health transportation provider -- 19 Conversion to disabled persons carrier or Class II ground ambulance provider. 20 311A.080 Persons prohibited from operating ambulance service or first response 21 program -- Penalties. 22 Section 40. Each member of the Kentucky Board of Emergency Medical 23 Services established in Section 2 of this Act shall hold office for a term of four years and 24 until their successors are appointed, except that the members appointed to fill the first 25 vacancy occurring for a term beginning on the effective date of this Act, shall be as 26 follows: Two members shall be appointed for one year, two for two years, four for three 27 UNOFFICIAL COPY 22 RS BR 1600 Page 110 of 111 XXXX Jacketed years, and four for four years, and the respective terms of the first members shall be 1 designated by the Governor at the time of their appointments. Upon the expiration of the 2 respective terms of the members first appointed, the term of each successor shall be for 3 four years and until his or her successor is appointed. 4 Section 41. Any person serving on the Kentucky Board of Emergency Medical 5 Services in a position eliminated on the effective date of this Act whose term has not 6 expired prior to the effective date of this Act may continue to serve in a nonvoting ex 7 officio capacity until the expiration of his or her term. 8 Section 42. The affairs of the Kentucky Board of Emergency Medical Services 9 relating to the licensure of ambulance providers and the collection of data and run reports 10 for those ambulance providers shall be concluded, and any records, files, and documents 11 associated with those activities of the Kentucky Board of Emergency Medical Services 12 shall be transferred to the Cabinet for Health and Family Services. Any records, files, 13 documents, equipment, supporting budgets, and any and all unexpended funds associated 14 with those activities of the Kentucky Board of Emergency Medical Services shall be 15 transferred to the Cabinet for Health and Family Services. All advisory opinions, 16 decisions, and actions promulgated, made, or taken by the Kentucky Board of Emergency 17 Medical Services relating to those activities that have not been repealed or rescinded shall 18 continue in effect after the effective date of this Act unless the Cabinet for Health and 19 Family Services issues an advisory opinion, decision, or action to repeal, rescind, or 20 amend the prior action. 21 Section 43. (1) In accordance with KRS 13A.312, each administrative 22 regulation related to the licensing of ambulances and ambulance providers and to data 23 collection promulgated by the Kentucky Board of Emergency Medical Services prior to 24 the effective date of this Act shall remain in effect as it exists until the Cabinet for Health 25 and Family Services amends or repeals the administrative regulation pursuant to KRS 26 Chapter 13A. 27 UNOFFICIAL COPY 22 RS BR 1600 Page 111 of 111 XXXX Jacketed (2) The Cabinet for Health and Family Services shall review the existing 1 administrative regulations related to the licensing of ambulances and ambulance 2 providers and data promulgated by the Kentucky Board of Emergency Medical Services 3 and shall promulgate emergency and ordinary administrative regulations needed to 4 effectuate any amendments or repeals based on that review. 5 (3) The Cabinet for Health and Family Services and the Kentucky Board of 6 Emergency Medical Services are authorized to promulgate any administrative regulations 7 needed to implement this Act as emergency administrative regulations, accompanied by 8 ordinary administrative regulations. 9