Kentucky 2023 2023 Regular Session

Kentucky House Bill HB470 Introduced / Bill

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AN ACT relating to the protection of children. 1 
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2 
SECTION 1.   A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 3 
READ AS FOLLOWS: 4 
As used in Sections 1 to 5 of this Act: 5 
(1) "Cross-sex hormones" means testosterone, estrogen, or other androgens given to 6 
a person in amounts that are larger or more potent than would normally occur 7 
naturally in a healthy person of the same age and sex; 8 
(2) "Gender" means the psychological, behavioral, social, and cultural aspects of 9 
being a person whose sex is male or female; 10 
(3) "Gender-affirming care" includes treatments by health care providers and 11 
mental health care providers that support a gender transition; 12 
(4) "Gender reassignment surgery" means any service that seeks to surgically alter 13 
or remove physical or anatomical characteristics or features that are typical for a 14 
person’s sex in order to instill or create physiological or anatomical 15 
characteristics that resemble a different sex, including but not limited to genital 16 
or nongenital gender reassignment surgery performed for the purpose of 17 
assisting a person with a gender transition; 18 
(5) "Gender transition" means the process in which a person goes from identifying 19 
with and living as a gender that corresponds to his or her sex to identifying with 20 
and living as a different gender and may involve social, legal, or physical 21 
changes; 22 
(6) (a) "Gender transition services" means any service provided or performed by a 23 
health care provider or mental health care provider for the purpose of 24 
assisting a person with a gender transition. Gender transition services 25 
include but are not limited to: 26 
1. Social transition services by health care providers and mental health 27  UNOFFICIAL COPY  	23 RS BR 134 
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care providers; 1 
2. Inpatient and outpatient hospital services; 2 
3. Prescribing or dispensing puberty-blocking drugs; 3 
4. Prescribing or dispensing cross-sex hormones; 4 
5. Genital gender reassignment surgery; and 5 
6. Nongenital gender reassignment surgery. 6 
(b) "Gender transition services" do not include: 7 
1. Services to persons born with a medically verifiable disorder of sex 8 
development, including a person with external sex characteristics that 9 
are irresolvably ambiguous, such as those born with forty-six (46) XX 10 
chromosomes with virilization, forty-six (46) XY chromosomes with 11 
undervirilization, or having both ovarian and testicular tissue; 12 
2. Services provided to a person diagnosed by a physician after genetic or 13 
biochemical testing as having a disorder of sexual development caused 14 
by an abnormal sex chromosome structure, sex steroid production, or 15 
sex steroid hormone action; 16 
3. The acute and chronic treatment of any infection, injury, disease, or 17 
disorder that has been caused by or exacerbated by the performance of 18 
a gender transition service, whether or not the gender transition 19 
service was performed in accordance with state and federal law or 20 
whether or not funding for the gender transition procedure is 21 
permissible under Sections 1 to 5, 6, and 9 of this Act; or 22 
4. Services of a mental health care provider that do not include gender-23 
affirming care for a person under the age of eighteen (18) years; 24 
(7) "Genital gender reassignment surgery" means a medical procedure performed 25 
for the purpose of assisting a person with a gender transition, including but not 26 
limited to surgical services such as: 27  UNOFFICIAL COPY  	23 RS BR 134 
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(a) Surgeries that sterilize, including castration, vasectomy, hysterectomy, 1 
oophorectomy, orchiectomy, and penectomy; and 2 
(b) Surgeries that artificially construct tissue with the appearance of genitalia 3 
that differs from the individual’s sex, including metoidioplasty, phalloplasty, 4 
and vaginoplasty; 5 
(8) "Health care provider" means a: 6 
(a) Health facility or service required to be licensed under KRS Chapter 216B; 7 
(b) Massage therapist or community health worker licensed or credentialed 8 
under KRS Chapter 309; 9 
(c) Physician, osteopath, or podiatrist licensed under KRS Chapter 311; 10 
(d) Physician assistant regulated under KRS Chapter 311; 11 
(e) Chiropractor licensed under KRS Chapter 312; 12 
(f) Dentist licensed under KRS Chapter 313; 13 
(g) Advanced practice registered nurse (APRN), licensed practical nurse (LPN), 14 
or registered nurse (RN) licensed under KRS Chapter 314; 15 
(h) Pharmacist and all sites or persons that are required to obtain a license, 16 
certificate, or permit from the Board of Pharmacy under KRS Chapter 315; 17 
(i) Optometrist licensed under KRS Chapter 320; 18 
(j) Pharmaceutical companies; manufacturers and distributors of puberty-19 
blocking drugs or cross-sex hormones as defined in this section; or any 20 
other person or entity that dispenses, prescribes, or distributes such puberty-21 
blocking drugs or cross-sex hormones via courier, delivery, or mail service 22 
for use by a person in the Commonwealth under the age of eighteen (18) 23 
years; and 24 
(k) Any other health care practitioners as determined by any division of state 25 
government by administrative regulations promulgated in accordance with 26 
KRS Chapter 13A; 27  UNOFFICIAL COPY  	23 RS BR 134 
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(9) "Mental health care provider" means: 1 
(a) School counselor or school-based mental health services provider as defined 2 
in KRS 158.4416 or credentialled under KRS Chapter 158; 3 
(b) Employees of the Kentucky Department of Education, Kentucky Board of 4 
Education, or local boards of education who meet the certification 5 
requirements to be a social worker, psychologist, or mental health counselor 6 
as established, or which may be established, by the Kentucky Board of 7 
Education and/or the Education Professional Standards Board under KRS 8 
Chapter 156, 157, 158, 159, 160, 161, 162, or 163; 9 
(c) Alcohol and drug counselor or art therapist licensed or credentialed under 10 
KRS Chapter 309; 11 
(d) Psychiatrist licensed under KRS Chapter 311; 12 
(e) Psychologist, psychological practitioner, psychologist with autonomous 13 
functioning, or psychological associate licensed or certified under KRS 14 
Chapter 319; 15 
(f) Pastoral counselor licensed under KRS Chapter 335; 16 
(g) Social worker or clinical social worker licensed or certified under KRS 17 
Chapter 335; 18 
(h) Marriage and family therapist or marriage and family therapist associate as 19 
licensed or credentialed under KRS Chapter 335; 20 
(i) Professional clinical counselor or professional clinical counselor associate 21 
licensed under KRS Chapter 335; and 22 
(j) Any other mental health care practitioners as determined by any division of 23 
state government by administrative regulations promulgated in accordance 24 
with KRS Chapter 13A; 25 
(10) "Nongenital gender reassignment surgery" means medical services performed 26 
for the purpose of assisting a person with a gender transition, including but not 27  UNOFFICIAL COPY  	23 RS BR 134 
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limited to augmentation mammoplasty, subcutaneous mastectomy, liposuction, 1 
lipofilling, thyroid cartilage reduction, gluteal augmentation, pectoral implants, 2 
hair reconstruction, or various aesthetic services; 3 
(11) "Puberty-blocking drugs" means gonadotropin-releasing hormone analogues or 4 
other synthetic drugs used to stop luteinizing hormone and follicle stimulating 5 
hormone secretion, synthetic antiandrogen drugs used to block the androgen 6 
receptor, or any other drug used to delay or suppress pubertal development in 7 
persons under the age of eighteen (18) years for the purpose of assisting those 8 
persons with a gender transition; 9 
(12) "Public funds" means any money, regardless of the original source of the money, 10 
of: 11 
(a) The Commonwealth of Kentucky, and any department, agency, or 12 
instrumentality thereof; 13 
(b) Any county, city, or local school district, special district, and any 14 
department, agency, or instrumentality thereof; and 15 
(c) Any other political subdivision of the Commonwealth, and any department, 16 
agency, or instrumentality thereof; 17 
(13) "Sex" means the biological state of being male or female based on a person's 18 
chromosomes, in the absence of any of the medically verifiable disorders 19 
described in subsection (6)(b) of this section; and 20 
(14) "Social transition services" means any gender-affirming care, encouragement, 21 
affirmation, or advocacy for gender transition, including but not limited to 22 
affirming the person’s name change, pronoun adoption, dress and grooming, and 23 
sex-role specific behaviors that vary from those behaviors typically associated 24 
with the person’s sex. 25 
SECTION 2.   A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 26 
READ AS FOLLOWS: 27  UNOFFICIAL COPY  	23 RS BR 134 
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(1) The provision of one (1) or more gender transition services to a person under the 1 
age of eighteen (18) years by a health care provider or mental health care 2 
provider is unethical and unprofessional conduct that establishes the provider is 3 
unfit to perform the duties and discharge the responsibilities of his or her position 4 
or occupation. 5 
(2) All licensing or certifying agencies for health care providers or mental health 6 
care providers, in accordance with each agency's disciplinary and hearing 7 
process, shall: 8 
(a) Investigate any report that a provider it licenses or certifies has provided 9 
gender transition services to a person under the age of eighteen (18) years; 10 
and 11 
(b) Revoke the provider’s licensure or certification if a report made under this 12 
subsection is confirmed. 13 
(3) A state, county, city, local government, local school district, special district, or any 14 
department, agency, or instrumentality thereof, in accordance with each entity's 15 
disciplinary and hearing process, shall: 16 
(a) Investigate any report that a publicly funded health care provider or mental 17 
health care provider has rendered gender transition services to a person 18 
under the age of eighteen (18) years; and 19 
(b) Terminate the public funding of a health care provider or mental health 20 
care provider if a report made under this subsection is confirmed. 21 
(4) A state, county, city, local government, local school district, special district, or any 22 
department, agency, instrumentality thereof, shall terminate public funding for a 23 
health care provider or mental health care provider if the provider’s licensure or 24 
certification is revoked under subsection (2) of this section. 25 
(5) This section shall constitute a complete defense to any and all claims, demands, 26 
damages, actions, state judicial or administrative proceedings, or professional 27  UNOFFICIAL COPY  	23 RS BR 134 
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licensing or disciplinary proceedings based on the refusal by a health care 1 
provider or mental health care provider to provide gender transition services to a 2 
person under the age of eighteen (18) years. 3 
(6) A health care provider who provides gender transition services to any person 4 
under the age of eighteen (18) years shall report the provided services to the Vital 5 
Statistics Branch. A health care provider who fails to report the provided services 6 
to the Vital Statistics Branch within thirty (30) days of providing the services shall 7 
be guilty of a: 8 
(a) Class B misdemeanor for the first offense; 9 
(b)  Class A misdemeanor for the second offense; and 10 
(c) Class D felony for each subsequent offense. 11 
SECTION 3.   A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 12 
READ AS FOLLOWS: 13 
(1) Notwithstanding any other provision of the law to the contrary, including KRS 14 
214.185, health care providers and mental health care providers that engage in 15 
the following activities shall be jointly and severally liable for all damages and 16 
costs sustained by reason thereof: 17 
(a) Providing gender transition services for a person under the age of eighteen 18 
(18) years; 19 
(b) Dispensing, prescribing, or distributing any puberty-blocking drugs or 20 
cross-sex hormones for the purpose of assisting a person under the age of 21 
eighteen (18) years with gender transitioning; or 22 
(c) Aiding or assisting in the provision of gender transition services for a 23 
person under the age of eighteen (18) years, except to the extent allowable 24 
under the First Amendment to the United States Constitution and the 25 
Constitution of Kentucky. 26 
(2) This section shall constitute a complete defense to any and all claims, demands, 27  UNOFFICIAL COPY  	23 RS BR 134 
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damages, actions, state judicial or administrative proceedings, or professional 1 
licensing or disciplinary proceedings based on the refusal by a health care 2 
provider or mental health care provider to provide gender transition services to a 3 
person under the age of eighteen (18) years. 4 
(3) Notwithstanding any other provision of the law to the contrary, including KRS 5 
214.185, if any act in subsection (1) of this section results in personal injury, an 6 
action may be brought by the person's parent or guardian before the person 7 
attains the age of eighteen (18) years and may be brought by the person within 8 
thirty (30) years after attaining the age of eighteen (18) years, except that: 9 
(a) If, at the time the person attains the age of eighteen (18) years, he or she is 10 
under other legal disability, the limitation period shall not begin to run until 11 
the removal of the disability; and 12 
(b) If, during any period of time, the person is subject to threats, intimidation, 13 
manipulation, fraudulent concealment, or fraud perpetrated by the health 14 
care provider who prescribed or otherwise provided gender transition 15 
services or by any person acting in the interest of the health care provider, 16 
the limitation period shall not run during this time period. 17 
(4) The right of action for personal injury under this section shall not cease or die 18 
with the person injuring or injured. An action may be brought or revived under 19 
this section by the personal representative or against the personal representative, 20 
heir, or devisee. 21 
(5) In an action brought under this section: 22 
(a) If the plaintiff prevails, he or she shall be entitled to reasonable costs and 23 
attorney's fees; 24 
(b) Compensatory damages may be awardable, including but not limited to: 25 
1. Pain and suffering; 26 
2. Loss of reputation; 27  UNOFFICIAL COPY  	23 RS BR 134 
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3. Loss of income; 1 
4. Loss of consortium between spouses; 2 
5. Loss of consortium between parent and child; and 3 
6. Loss of enjoyment of life, including the expectation or experience of 4 
biological parenthood; and 5 
(c) Injunctive, declaratory, punitive, and any other appropriate relief may be 6 
awarded. 7 
(6) Notwithstanding any other provision of law to the contrary, an action under this 8 
section may be commenced and relief may be granted in a judicial proceeding 9 
without regard to whether anyone commencing the action has sought or 10 
exhausted available contractual or administrative remedies. 11 
(7) Nothing in this section shall be construed as precluding legal action under any 12 
other applicable statute. 13 
(8) Qualified official immunity to suit and from liability are waived to the extent of 14 
liability created by this section. 15 
SECTION 4.   A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 16 
READ AS FOLLOWS: 17 
(1) Public funds shall not be directly or indirectly used, granted, paid, or distributed 18 
to any entity, organization, or individual that provides gender transition services 19 
to persons under the age of eighteen (18) years. 20 
(2) Gender transition services shall not be provided to persons under the age of 21 
eighteen (18) years by a health care provider or mental health care provider 22 
owned, operated, or employed, directly or indirectly, by the state, county, city, 23 
local government, local school district, special district, or any department, 24 
agency, or employee or instrumentality thereof. 25 
SECTION 5.   A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 26 
READ AS FOLLOWS: 27  UNOFFICIAL COPY  	23 RS BR 134 
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(1) The Attorney General may bring an action to enforce compliance with Sections 2, 1 
3, 4, 6, 7, 9, 11, 12, 13, 14 or subsection (23) of Section 8 of this Act. 2 
(2) Nothing in Sections 2, 3, 4, 6, 7, 9, 11, 12, 13, 14 or subsection (23) of Section 8 3 
of this Act shall deny, impair, or otherwise affect any right or authority of the 4 
Attorney General, the Commonwealth of Kentucky, or any agency, officer, or 5 
employee of the state, acting under any law other than this section, to institute or 6 
intervene in any proceeding. 7 
(3) No health care provider or mental health care provider owned, operated, or 8 
employed, directly or indirectly, by the state, county, city, local government, local 9 
school district, special district, or instrumentality thereof, shall intervene in a 10 
legal proceeding brought to challenge Sections 2, 3, 4, 6, 7, 9, 11, 12, 13, 14 or 11 
subsection (23) of Section 8 of this Act. 12 
SECTION 6.   A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO 13 
READ AS FOLLOWS: 14 
The Department for Medicaid Services and any managed care organization contracted 15 
to provide Medicaid or Kentucky Children's Health Insurance Program benefits 16 
pursuant to this chapter shall not reimburse or provide benefits or coverage for gender 17 
transition services as defined in Section 1 of this Act for persons under the age of 18 
eighteen (18) years. 19 
SECTION 7.   A NEW SECTION OF SUBTITLE 12 OF KRS CHAPTER 304 20 
IS CREATED TO READ AS FOLLOWS: 21 
(1) As used in this section: 22 
(a) "Gender transition services" has the same meaning as in Section 1 of this 23 
Act; and 24 
(b) "Insurer" includes any nongovernmental self-insurer, self-insured plan, 25 
self-insured group, or other entity that reimburses or provides benefits or 26 
coverage for health care services. 27  UNOFFICIAL COPY  	23 RS BR 134 
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(2) To the extent permitted under federal law: 1 
(a) If an insurer elects to reimburse or provide benefits or coverage for gender 2 
transition services for persons under the age of eighteen (18) years, the 3 
insurer shall: 4 
1. Be jointly and severally liable for damages sustained as a result of the 5 
gender transition services, notwithstanding any other provision of law 6 
to the contrary, including KRS 214.185; and 7 
2. Not require an insured or any other party to submit to arbitration a 8 
claim under subparagraph 1. of this paragraph. 9 
(b) Any contractual arbitration clause contained in a policy, plan, certificate, or 10 
contract that is in violation of this subsection shall be void and 11 
unenforceable. 12 
(3) Notwithstanding any other provision of the law to the contrary, including KRS 13 
214.185, and to the extent permitted under federal law, if any act in subsection (2) 14 
of this section results in personal injury, an action may be brought in the same 15 
manner as the cause of action authorized in subsections (3) to (7) of Section 3 of 16 
this Act. 17 
Section 8.   KRS 18A.225 is amended to read as follows: 18 
(1) (a) The term "employee" for purposes of this section means: 19 
1. Any person, including an elected public official, who is regularly 20 
employed by any department, office, board, agency, or branch of state 21 
government; or by a public postsecondary educational institution; or by 22 
any city, urban-county, charter county, county, or consolidated local 23 
government, whose legislative body has opted to participate in the state-24 
sponsored health insurance program pursuant to KRS 79.080; and who 25 
is either a contributing member to any one (1) of the retirement systems 26 
administered by the state, including but not limited to the Kentucky 27  UNOFFICIAL COPY  	23 RS BR 134 
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Retirement Systems, County Employees Retirement System, Kentucky 1 
Teachers' Retirement System, the Legislators' Retirement Plan, or the 2 
Judicial Retirement Plan; or is receiving a contractual contribution from 3 
the state toward a retirement plan; or, in the case of a public 4 
postsecondary education institution, is an individual participating in an 5 
optional retirement plan authorized by KRS 161.567; or is eligible to 6 
participate in a retirement plan established by an employer who ceases 7 
participating in the Kentucky Employees Retirement System pursuant to 8 
KRS 61.522 whose employees participated in the health insurance plans 9 
administered by the Personnel Cabinet prior to the employer's effective 10 
cessation date in the Kentucky Employees Retirement System; 11 
2. Any certified or classified employee of a local board of education or a 12 
public charter school as defined in KRS 160.1590; 13 
3. Any elected member of a local board of education; 14 
4. Any person who is a present or future recipient of a retirement 15 
allowance from the Kentucky Retirement Systems, County Employees 16 
Retirement System, Kentucky Teachers' Retirement System, the 17 
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 18 
Kentucky Community and Technical College System's optional 19 
retirement plan authorized by KRS 161.567, except that a person who is 20 
receiving a retirement allowance and who is age sixty-five (65) or older 21 
shall not be included, with the exception of persons covered under KRS 22 
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 23 
employed pursuant to subparagraph 1. of this paragraph; and 24 
5. Any eligible dependents and beneficiaries of participating employees 25 
and retirees who are entitled to participate in the state-sponsored health 26 
insurance program; 27  UNOFFICIAL COPY  	23 RS BR 134 
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(b) The term "health benefit plan" for the purposes of this section means a health 1 
benefit plan as defined in KRS 304.17A-005; 2 
(c) The term "insurer" for the purposes of this section means an insurer as defined 3 
in KRS 304.17A-005; and 4 
(d) The term "managed care plan" for the purposes of this section means a 5 
managed care plan as defined in KRS 304.17A-500. 6 
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 7 
recommendation of the secretary of the Personnel Cabinet, shall procure, in 8 
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 9 
from one (1) or more insurers authorized to do business in this state, a group 10 
health benefit plan that may include but not be limited to health maintenance 11 
organization (HMO), preferred provider organization (PPO), point of service 12 
(POS), and exclusive provider organization (EPO) benefit plans 13 
encompassing all or any class or classes of employees. With the exception of 14 
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 15 
all employers of any class of employees or former employees shall enter into 16 
a contract with the Personnel Cabinet prior to including that group in the state 17 
health insurance group. The contracts shall include but not be limited to 18 
designating the entity responsible for filing any federal forms, adoption of 19 
policies required for proper plan administration, acceptance of the contractual 20 
provisions with health insurance carriers or third-party administrators, and 21 
adoption of the payment and reimbursement methods necessary for efficient 22 
administration of the health insurance program. Health insurance coverage 23 
provided to state employees under this section shall, at a minimum, contain 24 
the same benefits as provided under Kentucky Kare Standard as of January 1, 25 
1994, and shall include a mail-order drug option as provided in subsection 26 
(13) of this section. All employees and other persons for whom the health care 27  UNOFFICIAL COPY  	23 RS BR 134 
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coverage is provided or made available shall annually be given an option to 1 
elect health care coverage through a self-funded plan offered by the 2 
Commonwealth or, if a self-funded plan is not available, from a list of 3 
coverage options determined by the competitive bid process under the 4 
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 5 
during annual open enrollment. 6 
(b) The policy or policies shall be approved by the commissioner of insurance 7 
and may contain the provisions the commissioner of insurance approves, 8 
whether or not otherwise permitted by the insurance laws. 9 
(c) Any carrier bidding to offer health care coverage to employees shall agree to 10 
provide coverage to all members of the state group, including active 11 
employees and retirees and their eligible covered dependents and 12 
beneficiaries, within the county or counties specified in its bid. Except as 13 
provided in subsection (20) of this section, any carrier bidding to offer health 14 
care coverage to employees shall also agree to rate all employees as a single 15 
entity, except for those retirees whose former employers insure their active 16 
employees outside the state-sponsored health insurance program and as 17 
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 18 
(d) Any carrier bidding to offer health care coverage to employees shall agree to 19 
provide enrollment, claims, and utilization data to the Commonwealth in a 20 
format specified by the Personnel Cabinet with the understanding that the data 21 
shall be owned by the Commonwealth; to provide data in an electronic form 22 
and within a time frame specified by the Personnel Cabinet; and to be subject 23 
to penalties for noncompliance with data reporting requirements as specified 24 
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 25 
to protect the confidentiality of each individual employee; however, 26 
confidentiality assertions shall not relieve a carrier from the requirement of 27  UNOFFICIAL COPY  	23 RS BR 134 
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providing stipulated data to the Commonwealth. 1 
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 2 
for timely analysis of data received from carriers and, to the extent possible, 3 
provide in the request-for-proposal specifics relating to data requirements, 4 
electronic reporting, and penalties for noncompliance. The Commonwealth 5 
shall own the enrollment, claims, and utilization data provided by each carrier 6 
and shall develop methods to protect the confidentiality of the individual. The 7 
Personnel Cabinet shall include in the October annual report submitted 8 
pursuant to the provisions of KRS 18A.226 to the Governor, the General 9 
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 10 
financial stability of the program, which shall include but not be limited to 11 
loss ratios, methods of risk adjustment, measurements of carrier quality of 12 
service, prescription coverage and cost management, and statutorily required 13 
mandates. If state self-insurance was available as a carrier option, the report 14 
also shall provide a detailed financial analysis of the self-insurance fund 15 
including but not limited to loss ratios, reserves, and reinsurance agreements. 16 
(f) If any agency participating in the state-sponsored employee health insurance 17 
program for its active employees terminates participation and there is a state 18 
appropriation for the employer's contribution for active employees' health 19 
insurance coverage, then neither the agency nor the employees shall receive 20 
the state-funded contribution after termination from the state-sponsored 21 
employee health insurance program. 22 
(g) Any funds in flexible spending accounts that remain after all reimbursements 23 
have been processed shall be transferred to the credit of the state-sponsored 24 
health insurance plan's appropriation account. 25 
(h) Each entity participating in the state-sponsored health insurance program shall 26 
provide an amount at least equal to the state contribution rate for the employer 27  UNOFFICIAL COPY  	23 RS BR 134 
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portion of the health insurance premium. For any participating entity that used 1 
the state payroll system, the employer contribution amount shall be equal to 2 
but not greater than the state contribution rate. 3 
(3) The premiums may be paid by the policyholder: 4 
(a) Wholly from funds contributed by the employee, by payroll deduction or 5 
otherwise; 6 
(b) Wholly from funds contributed by any department, board, agency, public 7 
postsecondary education institution, or branch of state, city, urban-county, 8 
charter county, county, or consolidated local government; or 9 
(c) Partly from each, except that any premium due for health care coverage or 10 
dental coverage, if any, in excess of the premium amount contributed by any 11 
department, board, agency, postsecondary education institution, or branch of 12 
state, city, urban-county, charter county, county, or consolidated local 13 
government for any other health care coverage shall be paid by the employee. 14 
(4) If an employee moves his or her place of residence or employment out of the 15 
service area of an insurer offering a managed health care plan, under which he or 16 
she has elected coverage, into either the service area of another managed health care 17 
plan or into an area of the Commonwealth not within a managed health care plan 18 
service area, the employee shall be given an option, at the time of the move or 19 
transfer, to change his or her coverage to another health benefit plan. 20 
(5) No payment of premium by any department, board, agency, public postsecondary 21 
educational institution, or branch of state, city, urban-county, charter county, 22 
county, or consolidated local government shall constitute compensation to an 23 
insured employee for the purposes of any statute fixing or limiting the 24 
compensation of such an employee. Any premium or other expense incurred by any 25 
department, board, agency, public postsecondary educational institution, or branch 26 
of state, city, urban-county, charter county, county, or consolidated local 27  UNOFFICIAL COPY  	23 RS BR 134 
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government shall be considered a proper cost of administration. 1 
(6) The policy or policies may contain the provisions with respect to the class or classes 2 
of employees covered, amounts of insurance or coverage for designated classes or 3 
groups of employees, policy options, terms of eligibility, and continuation of 4 
insurance or coverage after retirement. 5 
(7) Group rates under this section shall be made available to the disabled child of an 6 
employee regardless of the child's age if the entire premium for the disabled child's 7 
coverage is paid by the state employee. A child shall be considered disabled if he or 8 
she has been determined to be eligible for federal Social Security disability benefits. 9 
(8) The health care contract or contracts for employees shall be entered into for a 10 
period of not less than one (1) year. 11 
(9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 12 
State Health Insurance Subscribers to advise the secretary or the secretary's 13 
designee regarding the state-sponsored health insurance program for employees. 14 
The secretary shall appoint, from a list of names submitted by appointing 15 
authorities, members representing school districts from each of the seven (7) 16 
Supreme Court districts, members representing state government from each of the 17 
seven (7) Supreme Court districts, two (2) members representing retirees under age 18 
sixty-five (65), one (1) member representing local health departments, two (2) 19 
members representing the Kentucky Teachers' Retirement System, and three (3) 20 
members at large. The secretary shall also appoint two (2) members from a list of 21 
five (5) names submitted by the Kentucky Education Association, two (2) members 22 
from a list of five (5) names submitted by the largest state employee organization of 23 
nonschool state employees, two (2) members from a list of five (5) names submitted 24 
by the Kentucky Association of Counties, two (2) members from a list of five (5) 25 
names submitted by the Kentucky League of Cities, and two (2) members from a 26 
list of names consisting of five (5) names submitted by each state employee 27  UNOFFICIAL COPY  	23 RS BR 134 
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organization that has two thousand (2,000) or more members on state payroll 1 
deduction. The advisory committee shall be appointed in January of each year and 2 
shall meet quarterly. 3 
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 4 
provided to employees pursuant to this section shall not provide coverage for 5 
obtaining or performing an abortion, nor shall any state funds be used for the 6 
purpose of obtaining or performing an abortion on behalf of employees or their 7 
dependents. 8 
(11) Interruption of an established treatment regime with maintenance drugs shall be 9 
grounds for an insured to appeal a formulary change through the established appeal 10 
procedures approved by the Department of Insurance, if the physician supervising 11 
the treatment certifies that the change is not in the best interests of the patient. 12 
(12) Any employee who is eligible for and elects to participate in the state health 13 
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 14 
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 15 
state health insurance contribution toward health care coverage as a result of any 16 
other employment for which there is a public employer contribution. This does not 17 
preclude a retiree and an active employee spouse from using both contributions to 18 
the extent needed for purchase of one (1) state sponsored health insurance policy 19 
for that plan year. 20 
(13) (a) The policies of health insurance coverage procured under subsection (2) of 21 
this section shall include a mail-order drug option for maintenance drugs for 22 
state employees. Maintenance drugs may be dispensed by mail order in 23 
accordance with Kentucky law. 24 
(b) A health insurer shall not discriminate against any retail pharmacy located 25 
within the geographic coverage area of the health benefit plan and that meets 26 
the terms and conditions for participation established by the insurer, including 27  UNOFFICIAL COPY  	23 RS BR 134 
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price, dispensing fee, and copay requirements of a mail-order option. The 1 
retail pharmacy shall not be required to dispense by mail. 2 
(c) The mail-order option shall not permit the dispensing of a controlled 3 
substance classified in Schedule II. 4 
(14) The policy or policies provided to state employees or their dependents pursuant to 5 
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 6 
aid-related services for insured individuals under eighteen (18) years of age, subject 7 
to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36) months 8 
pursuant to KRS 304.17A-132. 9 
(15) Any policy provided to state employees or their dependents pursuant to this section 10 
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 11 
consistent with KRS 304.17A-142. 12 
(16) Any policy provided to state employees or their dependents pursuant to this section 13 
shall provide coverage for obtaining amino acid-based elemental formula pursuant 14 
to KRS 304.17A-258. 15 
(17) If a state employee's residence and place of employment are in the same county, 16 
and if the hospital located within that county does not offer surgical services, 17 
intensive care services, obstetrical services, level II neonatal services, diagnostic 18 
cardiac catheterization services, and magnetic resonance imaging services, the 19 
employee may select a plan available in a contiguous county that does provide 20 
those services, and the state contribution for the plan shall be the amount available 21 
in the county where the plan selected is located. 22 
(18) If a state employee's residence and place of employment are each located in 23 
counties in which the hospitals do not offer surgical services, intensive care 24 
services, obstetrical services, level II neonatal services, diagnostic cardiac 25 
catheterization services, and magnetic resonance imaging services, the employee 26 
may select a plan available in a county contiguous to the county of residence that 27  UNOFFICIAL COPY  	23 RS BR 134 
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does provide those services, and the state contribution for the plan shall be the 1 
amount available in the county where the plan selected is located. 2 
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 3 
in the best interests of the state group to allow any carrier bidding to offer health 4 
care coverage under this section to submit bids that may vary county by county or 5 
by larger geographic areas. 6 
(20) Notwithstanding any other provision of this section, the bid for proposals for health 7 
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 8 
the statewide rating structure provided in calendar year 2003 and a bid scenario that 9 
allows for a regional rating structure that allows carriers to submit bids that may 10 
vary by region for a given product offering as described in this subsection: 11 
(a) The regional rating bid scenario shall not include a request for bid on a 12 
statewide option; 13 
(b) The Personnel Cabinet shall divide the state into geographical regions which 14 
shall be the same as the partnership regions designated by the Department for 15 
Medicaid Services for purposes of the Kentucky Health Care Partnership 16 
Program established pursuant to 907 KAR 1:705; 17 
(c) The request for proposal shall require a carrier's bid to include every county 18 
within the region or regions for which the bid is submitted and include but not 19 
be restricted to a preferred provider organization (PPO) option; 20 
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 21 
carrier all of the counties included in its bid within the region. If the Personnel 22 
Cabinet deems the bids submitted in accordance with this subsection to be in 23 
the best interests of state employees in a region, the cabinet may award the 24 
contract for that region to no more than two (2) carriers; and 25 
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 26 
other requirements or criteria in the request for proposal. 27  UNOFFICIAL COPY  	23 RS BR 134 
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(21) Any fully insured health benefit plan or self-insured plan issued or renewed on or 1 
after July 12, 2006, to public employees pursuant to this section which provides 2 
coverage for services rendered by a physician or osteopath duly licensed under KRS 3 
Chapter 311 that are within the scope of practice of an optometrist duly licensed 4 
under the provisions of KRS Chapter 320 shall provide the same payment of 5 
coverage to optometrists as allowed for those services rendered by physicians or 6 
osteopaths. 7 
(22) Any fully insured health benefit plan or self-insured plan issued or renewed to 8 
public employees pursuant to this section shall comply with: 9 
(a) KRS 304.12-237; 10 
(b) KRS 304.17A-270 and 304.17A-525; 11 
(c) KRS 304.17A-600 to 304.17A-633; 12 
(d) KRS 205.593; 13 
(e) KRS 304.17A-700 to 304.17A-730; 14 
(f) KRS 304.14-135; 15 
(g) KRS 304.17A-580 and 304.17A-641; 16 
(h) KRS 304.99-123; 17 
(i) KRS 304.17A-138; 18 
(j) KRS 304.17A-148; 19 
(k) KRS 304.17A-163 and 304.17A-1631; and 20 
(l) Administrative regulations promulgated pursuant to statutes listed in this 21 
subsection. 22 
(23) A fully insured health benefit plan or self-insured plan issued or renewed to 23 
public employees pursuant to this section shall not reimburse or provide benefits 24 
or coverage for gender transition services as defined in Section 1 of this Act for 25 
persons under the age of eighteen (18) years. 26 
Section 9.   KRS 454.210 is amended to read as follows: 27  UNOFFICIAL COPY  	23 RS BR 134 
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(1) As used in this section, "person" includes an individual, his or her executor, 1 
administrator, or other personal representative, or a corporation, partnership, 2 
association, or any other legal or commercial entity, who is a nonresident of this 3 
Commonwealth. 4 
(2) (a) A court may exercise personal jurisdiction over a person who acts directly or 5 
by an agent, as to a claim arising from the person's: 6 
1. Transacting any business in this Commonwealth; 7 
2. Contracting to supply services or goods in this Commonwealth; 8 
3. Causing tortious injury by an act or omission in this Commonwealth; 9 
4. Causing tortious injury in this Commonwealth by an act or omission 10 
outside this Commonwealth if he or she regularly does or solicits 11 
business, or engages in any other persistent course of conduct, or derives 12 
substantial revenue from goods used or consumed or services rendered 13 
in this Commonwealth, provided that the tortious injury occurring in this 14 
Commonwealth arises out of the doing or soliciting of business or a 15 
persistent course of conduct or derivation of substantial revenue within 16 
the Commonwealth; 17 
5. Causing injury in this Commonwealth to any person by breach of 18 
warranty expressly or impliedly made in the sale of goods outside this 19 
Commonwealth when the seller knew such person would use, consume, 20 
or be affected by, the goods in this Commonwealth, if he or she also 21 
regularly does or solicits business, or engages in any other persistent 22 
course of conduct, or derives substantial revenue from goods used or 23 
consumed or services rendered in this Commonwealth; 24 
6. Having an interest in, using, or possessing real property in this 25 
Commonwealth, providing the claim arises from the interest in, use of, 26 
or possession of the real property, provided, however, that such in 27  UNOFFICIAL COPY  	23 RS BR 134 
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personam jurisdiction shall not be imposed on a nonresident who did not 1 
himself or herself voluntarily institute the relationship, and did not 2 
knowingly perform, or fail to perform, the act or acts upon which 3 
jurisdiction is predicated; 4 
7. Contracting to insure any person, property, or risk located within this 5 
Commonwealth at the time of contracting; 6 
8. Committing sexual intercourse in this state which intercourse causes the 7 
birth of a child when: 8 
a. The father or mother or both are domiciled in this state; 9 
b. There is a repeated pattern of intercourse between the father and 10 
mother in this state; or 11 
c. Said intercourse is a tort or a crime in this state;[ or] 12 
9. Making a telephone solicitation, as defined in KRS 367.46951, or a 13 
charitable solicitation as defined in KRS 367.650 via 14 
telecommunication, into the Commonwealth; or 15 
10. Engaging in any of the following activities as a health care provider or 16 
mental health care provider, as defined in Section 1 of this Act; 17 
a. Providing gender transition services as defined in Section 1 of 18 
this Act for a person under the age of eighteen (18) years who 19 
resides in the Commonwealth before and after receiving the 20 
services and at the time the action is brought; 21 
b. Dispensing, prescribing, or distributing any puberty-blocking 22 
drugs or cross-sex hormones as defined in Section 1 of this Act, 23 
for the purpose of assisting with the gender transitioning of a 24 
person under the age of eighteen (18) years who resides in the 25 
Commonwealth before and after receiving the services and at the 26 
time the action is brought; or 27  UNOFFICIAL COPY  	23 RS BR 134 
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c. Aiding or assisting in the provision of gender transition services 1 
as defined in Section 1 of this Act for a person under the age of 2 
eighteen (18) years who resides in the Commonwealth before 3 
and after receiving the services and at the time the action is 4 
brought. 5 
(b) When jurisdiction over a person is based solely upon this section, only a claim 6 
arising from acts enumerated in this section may be asserted against him or 7 
her. 8 
(3) (a) When personal jurisdiction is authorized by this section, service of process 9 
may be made: 10 
1. In any manner authorized by the Kentucky Rules of Civil Procedure; 11 
2. On such person, or any agent of such person, in any county in this 12 
Commonwealth, where he or she may be found; or 13 
3. On the Secretary of State who, for this purpose, shall be deemed to be 14 
the statutory agent of the[such] person. 15 
(b) The clerk of the court in which the action is brought shall issue a summons 16 
against the defendant named in the complaint. The clerk shall execute the 17 
summons either by: 18 
1. Sending by certified mail two (2) true copies to the Secretary of State 19 
and shall also mail with the summons two (2) attested copies of 20 
plaintiff's complaint; or 21 
2. Transmitting an electronically attested copy of the complaint and 22 
summons to the Secretary of State via the Kentucky Court of Justice 23 
electronic filing system. 24 
(c) The Secretary of State shall, within seven (7) days of receipt thereof in his or 25 
her office, mail a copy of the summons and complaint to the defendant at the 26 
address given in the complaint. The letter shall be posted by certified mail, 27  UNOFFICIAL COPY  	23 RS BR 134 
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return receipt requested, and shall bear the return address of the Secretary of 1 
State. The clerk shall make the usual return to the court, and in addition the 2 
Secretary of State shall make a return to the court showing that the acts 3 
contemplated by this statute have been performed, and shall attach to his or 4 
her return the registry receipt, if any. Summons shall be deemed to be served 5 
on the return of the Secretary of State and the action shall proceed as provided 6 
in the Rules of Civil Procedure. 7 
(d) The clerk mailing the summons to the Secretary of State shall mail to him or 8 
her, at the same time, a fee of ten dollars ($10), which shall be taxed as costs 9 
in the action. The fee for a summons transmitted electronically pursuant to 10 
this subsection shall be transmitted to the Secretary of State on a periodic 11 
basis. 12 
(4) When the exercise of personal jurisdiction is authorized by this section, any action 13 
or suit may be brought in the county wherein the plaintiff resides or where the cause 14 
of action or any part thereof arose. 15 
(5) A court of this Commonwealth may exercise jurisdiction on any other basis 16 
authorized in the Kentucky Revised Statutes or by the Rules of Civil Procedure, 17 
notwithstanding this section. 18 
Section 10.   KRS 141.039 is amended to read as follows: 19 
In the case of corporations: 20 
(1) Gross income shall be calculated by adjusting federal gross income as defined in 21 
Section 61 of the Internal Revenue Code as follows: 22 
(a) Exclude income that is exempt from state taxation by the Kentucky 23 
Constitution and the Constitution and statutory laws of the United States; 24 
(b) Exclude all dividend income; 25 
(c) Include interest income derived from obligations of sister states and political 26 
subdivisions thereof; 27  UNOFFICIAL COPY  	23 RS BR 134 
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(d) Exclude fifty percent (50%) of gross income derived from any disposal of 1 
coal covered by Section 631(c) of the Internal Revenue Code if the 2 
corporation does not claim any deduction for percentage depletion, or for 3 
expenditures attributable to the making and administering of the contract 4 
under which such disposition occurs or to the preservation of the economic 5 
interests retained under such contract; 6 
(e) Include the amount calculated under KRS 141.205; 7 
(f) Ignore the provisions of Section 281 of the Internal Revenue Code in 8 
computing gross income; 9 
(g) Include the amount of deprecation deduction calculated under 26 U.S.C. sec. 10 
167 or 168; and 11 
(h) Allow the same treatment allowed under Pub. L. No. 116-260, secs. 276 and 12 
278, related to the tax treatment of forgiven covered loans, deductions 13 
attributable to those loans, and tax attributes associated with those loans for 14 
taxable years ending on or after March 27, 2020, but before January 1, 2022; 15 
and 16 
(2) Net income shall be calculated by: 17 
(a) Subtracting from gross income: 18 
1.[(a)] The deduction for depreciation allowed by KRS 141.0101; 19 
2.[(b)] Any amount paid for vouchers or similar instruments that provide 20 
health insurance coverage to employees or their families; 21 
3.[(c)] All the deductions from gross income allowed corporations by 22 
Chapter 1 of the Internal Revenue Code, as modified by KRS 141.0101, 23 
except: 24 
a.[1.] Any deduction for a state tax which is computed, in whole or in 25 
part, by reference to gross or net income and which is paid or 26 
accrued to any state of the United States, the District of Columbia, 27  UNOFFICIAL COPY  	23 RS BR 134 
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the Commonwealth of Puerto Rico, any territory or possession of 1 
the United States, or to any foreign country or political subdivision 2 
thereof; 3 
b.[2.] The deductions contained in Sections 243, 245, and 247 of the 4 
Internal Revenue Code; 5 
c.[3.] The provisions of Section 281 of the Internal Revenue Code shall 6 
be ignored in computing net income; 7 
d.[4.] Any deduction directly or indirectly allocable to income which is 8 
either exempt from taxation or otherwise not taxed under the 9 
provisions of this chapter, except for deductions allowed under 10 
Pub. L. No. 116-260, secs. 276 and 278, related to the tax 11 
treatment of forgiven covered loans and deductions attributable to 12 
those loans for taxable years ending on or after March 27, 2020, 13 
but before January 1, 2022, and nothing in this chapter shall be 14 
construed to permit the same item to be deducted more than once; 15 
e.[5.] Any deduction for amounts paid to any club, organization, or 16 
establishment which has been determined by the courts or an 17 
agency established by the General Assembly and charged with 18 
enforcing the civil rights laws of the Commonwealth, not to afford 19 
full and equal membership and full and equal enjoyment of its 20 
goods, services, facilities, privileges, advantages, or 21 
accommodations to any person because of race, color, religion, 22 
national origin, or sex, except nothing shall be construed to deny a 23 
deduction for amounts paid to any religious or denominational 24 
club, group, or establishment, or any organization operated solely 25 
for charitable or educational purposes which restricts membership 26 
to persons of the same religion or denomination in order to 27  UNOFFICIAL COPY  	23 RS BR 134 
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promote the religious principles for which it is established and 1 
maintained; 2 
f.[6.] Any deduction prohibited by KRS 141.205; and 3 
g.[7.] Any dividends-paid deduction of any captive real estate 4 
investment trust;[ and] 5 
4. a.[(d) 1.] A deferred tax deduction in an amount computed in 6 
accordance with this subparagraph[paragraph]. 7 
b.[2.] For purposes of this subparagraph[paragraph]: 8 
i.[a.] "Net deferred tax asset" means that deferred tax assets 9 
exceed the deferred tax liabilities of the combined group, as 10 
computed in accordance with accounting principles generally 11 
accepted in the United States of America; and 12 
ii.[b.] "Net deferred tax liability" means deferred tax liabilities that 13 
exceed the deferred tax assets of a combined group as 14 
defined in KRS 141.202, as computed in accordance with 15 
accounting principles generally accepted in the United States 16 
of America. 17 
c.[3.] Only publicly traded companies, including affiliated corporations 18 
participating in the filing of a publicly traded company's financial 19 
statements prepared in accordance with accounting principles 20 
generally accepted in the United States of America, as of January 21 
1, 2019, shall be eligible for this deduction. 22 
d.[4.] If the provisions of KRS 141.202 result in an aggregate increase to 23 
the member's net deferred tax liability, an aggregate decrease to 24 
the member's net deferred tax asset, or an aggregate change from a 25 
net deferred tax asset to a net deferred tax liability, the combined 26 
group shall be entitled to a deduction, as determined in this 27  UNOFFICIAL COPY  	23 RS BR 134 
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paragraph. 1 
e. [5.] For ten (10) years beginning with the combined group's first 2 
taxable year beginning on or after January 1, 2024, a combined 3 
group shall be entitled to a deduction from the combined group's 4 
entire net income equal to one-tenth (1/10) of the amount 5 
necessary to offset the increase in the net deferred tax liability, 6 
decrease in the net deferred tax asset, or aggregate change from a 7 
net deferred tax asset to a net deferred tax liability. The increase in 8 
the net deferred tax liability, decrease in the net deferred tax asset, 9 
or the aggregate change from a net deferred tax asset to a net 10 
deferred tax liability shall be computed based on the change that 11 
would result from the imposition of the combined reporting 12 
requirement under KRS 141.202, but for the deduction provided 13 
under this subparagraph[paragraph] as of June 27, 2019. 14 
f.[6.] The deferred tax impact determined in subdivision 15 
e.[subparagraph 5.] of this subparagraph[paragraph] shall be 16 
converted to the annual deferred tax deduction amount, as follows: 17 
i.[a.] The deferred tax impact determined in subparagraph 5. of 18 
this paragraph shall be divided by the tax rate determined 19 
under KRS 141.040; 20 
ii.[b.] The resulting amount shall be further divided by the 21 
apportionment factor determined by KRS 141.120 or 22 
141.121 that was used by the combined group in the 23 
calculation of the deferred tax assets and deferred tax 24 
liabilities as described in subdivision e.[subparagraph 5.] of 25 
this subparagraph[paragraph]; and 26 
iii[c.] The resulting amount represents the total net deferred tax 27  UNOFFICIAL COPY  	23 RS BR 134 
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deduction available over the ten (10) year period as 1 
described in subparagraph 5. of this paragraph. 2 
g.[7.] The deduction calculated under this subdivision[paragraph] shall 3 
not be adjusted as a result of any events happening subsequent to 4 
the calculation, including but not limited to any disposition or 5 
abandonment of assets. The deduction shall be calculated without 6 
regard to the federal tax effect and shall not alter the tax basis of 7 
any asset. If the deduction under this section is greater than the 8 
combined group's entire Kentucky net income, any excess 9 
deduction shall be carried forward and applied as a deduction to 10 
the combined group's entire net income in future taxable years 11 
until fully utilized. 12 
h.[8.] Any combined group intending to claim a deduction under this 13 
subdivision[paragraph] shall file a statement with the department on or 14 
before July 1, 2019. The statement shall specify the total amount of the 15 
deduction which the combined group claims on the form, including 16 
calculations and other information supporting the total amounts of the 17 
deduction as required by the department. No deduction shall be allowed 18 
under this subdivision[paragraph] for any taxable year, except to the 19 
extent claimed on the timely filed statement in accordance with this 20 
subdivision[paragraph]: and 21 
(b) Adding to gross income any deduction directly or indirectly related to the 22 
provision of gender transition services as defined in Section 1 of this Act for 23 
a person under the age of eighteen (18) years. 24 
SECTION 11.   A NEW SECTION OF KRS CHAPTER 158 IS CREATED TO 25 
READ AS FOLLOWS: 26 
(1) Notwithstanding any law to the contrary, including KRS 214.185, no public 27  UNOFFICIAL COPY  	23 RS BR 134 
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school counselor, school-based mental health services provider, or other public 1 
employee shall aid or assist in the provision of gender transition services as 2 
defined in Section 1 of this Act for a person under the age of eighteen (18) years, 3 
including but not limited to encouraging or making a recommendation to a 4 
person under the age of eighteen (18) years to consider or to obtain gender 5 
transition services, except to the extent allowable under the First Amendment to 6 
the United States Constitution and the Constitution of Kentucky. 7 
(2) Notwithstanding any other provision of the law to the contrary, including KRS 8 
214.185, if any employee identified in subsection (1) of this section provides a 9 
gender transition service to a person under the age of eighteen (18) years that 10 
results in personal injury, that employee shall be jointly and severally liable for 11 
damages sustained as a result of the gender transition services. 12 
(3) Notwithstanding any other provision of the law to the contrary, including KRS 13 
214.185, if any employee identified in subsection (1) of this section provides a 14 
gender transition service to a person under the age of eighteen (18) years that 15 
results in personal injury, an action may be brought in the same manner as the 16 
cause of action authorized in subsections (3) to (8) of Section 3 of this Act. 17 
(4) A schools shall notify each parent or guardian of a student who is a person under 18 
the age of eighteen (18) years if: 19 
(a) The student significantly changes his or her gender expression; 20 
(b) The student expresses an inconsistency between his or her sex and his or 21 
her perceived gender or perceived sex; or 22 
(c) The student expresses a desire to be referred to by a name, pronoun, or 23 
other identifier inconsistent with his or her sex. 24 
(5) A school shall withhold from a parent or guardian the notification required 25 
under subsection (4) of this section if: 26 
(a) A school health care provider or mental health provider, in good faith and 27  UNOFFICIAL COPY  	23 RS BR 134 
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with reasonable cause, determines that the student is a victim of physical, 1 
sexual, or substance abuse by that parent; 2 
(b) The school health care provider or mental health provider reports that 3 
parent’s abuse as required under KRS 620.030(2); and 4 
(c) Obtaining that parent’s consent would place the student at risk of further 5 
abuse by that parent. 6 
(6) Nothing in subsection (5) of this section shall relieve a school from making the 7 
required notification to the student’s other parent or guardian. 8 
Section 12.   KRS 213.121 is amended to read as follows: 9 
(1) A certificate or report registered under this chapter may be amended only in 10 
accordance with this section and administrative regulations adopted by the cabinet 11 
to protect the integrity and accuracy of vital records. 12 
(2) A certificate or report that is amended under this section shall be marked 13 
"amended," except as otherwise provided in this section. The date of amendment 14 
and a summary description of the evidence submitted in support of the amendment 15 
shall be endorsed on or made a part of the record. The cabinet shall prescribe by 16 
administrative regulation the conditions under which additions or minor corrections 17 
may be made to certificates or records within one (1) year after the date of the event 18 
without the certificate or record being marked "amended." 19 
(3) Upon written request of both parents and receipts of a sworn acknowledgment of 20 
paternity signed by both parents of a child born to an unmarried woman, the state 21 
registrar shall amend the certificate of birth to show the paternity, if paternity is not 22 
already shown on the certificate of birth. The certificate shall not be marked 23 
"amended." 24 
(4) Upon receipt of a certified copy of an order of a court changing the name of a 25 
person born in the Commonwealth and upon request of the person or the person's 26 
parents, guardian, or legal representative, the state registrar shall amend the 27  UNOFFICIAL COPY  	23 RS BR 134 
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certificate of birth to show the new name. 1 
(5) Upon receipt of a sworn statement by a licensed physician indicating that the 2 
gender of an individual born in the Commonwealth has been changed by surgical 3 
procedure and a certified copy of an order of a court of competent jurisdiction 4 
changing that individual's name, the certificate of birth of the individual shall be 5 
amended as prescribed by regulation to reflect the change. 6 
(6) Notwithstanding subsections (4) and (5) of this section, a certificate or report 7 
registered under this chapter shall not be amended if the purpose is to assist a 8 
person under the age of eighteen (18) years with a gender transition as defined in 9 
Section 1 of this Act. 10 
Section 13.   KRS 401.020 is amended to read as follows: 11 
(1) Both parents, provided both are living, or one (1) parent if one (1) is deceased, or if 12 
no parent is living, the guardian, may have the name of a child under the age of 13 
eighteen (18) changed by the District Court, or if the Family Court or Circuit Court 14 
has a case before it involving the family, the Family Court of a county with a 15 
Family Court, or the Circuit Court of a county without a Family Court of the county 16 
in which the child resides. However, if one (1) parent refuses or is unavailable to 17 
execute the petition, proper notice of filing the petition shall be served in 18 
accordance with the Rules of Civil Procedure. If the child resides on a United States 19 
Army post, military reservation, or fort, his or her name may be changed by the 20 
District Court, or the Family Court of a county with a Family Court, or the Circuit 21 
Court of a county without a Family Court of any county adjacent thereto. 22 
(2) A name change under subsection (1) of this section shall not be approved by any 23 
court if the court finds that the purpose of the requested name change is to assist 24 
a person under the age of eighteen (18) years with a gender transition as defined 25 
in Section 1 of this Act. 26 
SECTION 14.   A NEW SECTION OF KRS CHAPTER 600 IS CREATED TO 27  UNOFFICIAL COPY  	23 RS BR 134 
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READ AS FOLLOWS: 1 
(1) Any classification of the sex of any person under the age of eighteen (18) years 2 
under KRS Chapters 600 to 645 shall be the person's sex as defined in Section 1 3 
of this Act. 4 
(2) The Department of Juvenile Justice shall not classify the sex of any detained 5 
person under the age of eighteen (18) years to be a sex that is inconsistent with 6 
his or her sex as defined in Section 1 of this Act. 7 
Section 15.    If any provision of this Act or the application thereof to any person 8 
or circumstance is held invalid, the invalidity shall not affect the other provisions or 9 
applications of the Act that can be given effect without the invalid provision or 10 
application, and to this end the provisions of this Act are severable. 11 
Section 16.   This Act may be cited as the Do No Harm Act. 12 
Section 17.   This Act takes effect January 1, 2024, so that persons under the age 13 
of 18 years in the Commonwealth currently using puberty-blocking drugs or cross-sex 14 
hormones have time for appropriate medication tapering and discontinuation under the 15 
care of their health care providers or mental health care providers. 16