UNOFFICIAL COPY 24 RS BR 1039
Page 1 of 63
XXXX 2/26/2024 4:58 PM Jacketed
AN ACT relating to the protection of mothers and their children. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
SECTION 1. A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 3
IS CREATED TO READ AS FOLLOWS: 4
(1) As used in this section: 5
(a) "Exchange": 6
1. Means a governmental agency or nonprofit entity that makes qualified 7
health plans, as defined in 42 U.S.C. sec. 18021, as amended, 8
available to qualified individuals and qualified employers; and 9
2. Includes: 10
a. An exchange serving the individual market for qualified 11
individuals; and 12
b. A small business health options program serving the small group 13
market for qualified employers; and 14
(b) "Health benefit plan" has the same meaning as in KRS 304.17A-005, 15
except for purposes of this section the term includes: 16
1. Short-term limited-duration coverage; and 17
2. Student health insurance offered by a Kentucky-licensed insurer 18
under written contract with a university or college whose students it 19
proposes to insure. 20
(2) To the extent permitted by federal law: 21
(a) The following shall provide a special enrollment period to pregnant 22
individuals who are eligible for coverage: 23
1. Any insurer offering a health benefit plan; or 24
2. Any exchange operating in this state; 25
(b) Except as provided in paragraph (c) of this subsection, the insurer or 26
exchange shall allow the pregnant individual, and any individual who is 27 UNOFFICIAL COPY 24 RS BR 1039
Page 2 of 63
XXXX 2/26/2024 4:58 PM Jacketed
eligible for coverage because of a relationship to the pregnant individual, to 1
enroll for coverage under the plan or on the exchange at any time during 2
the pregnancy; 3
(c) If the insurer or exchange is required under federal law to limit the 4
enrollment period to a period that is less than the period provided in 5
paragraph (b) of this subsection: 6
1. The enrollment period shall not be less than the maximum period of 7
time permitted under the federal law; and 8
2. The enrollment period shall begin not earlier than the date that the 9
individual receives confirmation of the pregnancy from a medical 10
professional; 11
(d) The coverage required under this subsection shall begin no later than the 12
first day of the first calendar month in which a medical professional 13
determines that the pregnancy began, except that a pregnant individual may 14
direct coverage to begin on the first day of the month occurring after that 15
date but during the pregnancy; and 16
(e) If a directive under paragraph (d) of this subsection falls outside of the 17
pregnancy period, the coverage required under this subsection shall begin 18
no later than the first day of the last month that occurred during the 19
pregnancy. 20
(3) For group health plans and insurers offering group health insurance coverage in 21
Kentucky, the plan or insurer shall, at or before the time an individual is initially 22
offered the opportunity to enroll in the plan or coverage, provide the individual 23
with a notice of the special enrollment rights under this section. 24
(4) (a) Except as provided in Section 7 of this Act, nothing in this section shall be 25
construed to imply that the insured is not responsible for the payment of 26
premiums for each month during which coverage is provided. 27 UNOFFICIAL COPY 24 RS BR 1039
Page 3 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(b) For any coverage provided under this section, the original or first premium 1
shall become due and owing not earlier than thirty (30) days after the date 2
of enrollment. 3
Section 2. KRS 304.17A-145 is amended to read as follows: 4
(1) As used in this section, "health benefit plan" has the same meaning as in KRS 5
304.17A-005, except that for purposes of this section, the term includes: 6
(a) Short-term limited-duration coverage; and 7
(b) Student health insurance offered by a Kentucky-licensed insurer under 8
written contract with a university or college whose students it proposes to 9
insure. 10
(2) (a) A health benefit plan shall provide[issued or renewed on or after July 15, 11
1996, that provides] maternity coverage. 12
(b) The coverage required by this subsection includes coverage for:[shall 13
provide ] 14
1. All individuals covered under the plan, including dependents, 15
regardless of age; 16
2. Maternity care associated with pregnancy, childbirth, and postpartum 17
care; 18
3. Labor and delivery; 19
4. All breastfeeding services and supplies required under 42 U.S.C. sec. 20
300gg-13(a) and any related federal regulations, as amended; and 21
5. [Coverage for ]Except as provided in subsection (3) of this section, 22
inpatient care for a mother and her newly born[newly-born] child for a 23
minimum of: 24
a. Forty-eight (48) hours after vaginal delivery; or[ and a minimum 25
of ] 26
b. Ninety-six (96) hours after delivery by Cesarean section. 27 UNOFFICIAL COPY 24 RS BR 1039
Page 4 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(3)[(2)] The provisions of subsection (2)(b)5.[(1)] of this section shall not apply to a 1
health benefit plan if: 2
(a) The[ health benefit] plan authorizes an initial postpartum home visit which 3
would include the collection of an adequate sample for the hereditary and 4
metabolic newborn screening; and[ if ] 5
(b) The attending physician, with the consent of the mother of the newly 6
born[newly-born] child, authorizes a shorter length of stay[ than that required 7
of health benefit plans in subsection (1) of this section] upon the physician's 8
determination that the mother and newborn meet the criteria for medical 9
stability in the most current version of "Guidelines for Perinatal Care" 10
prepared by the American Academy of Pediatrics and the American College 11
of Obstetricians and Gynecologists. 12
Section 3. KRS 304.17A-220 is amended to read as follows: 13
(1) All group health plans and insurers offering group health insurance coverage in the 14
Commonwealth shall comply with Section 1 of this Act and the provisions of this 15
section. 16
(2) Subject to subsection (8) of this section, a group health plan, and a health insurance 17
insurer offering group health insurance coverage, may, with respect to a participant 18
or beneficiary, impose a pre-existing condition exclusion only if: 19
(a) The exclusion relates to a condition, whether physical or mental, regardless of 20
the cause of the condition, for which medical advice, diagnosis, care, or 21
treatment was recommended or received within the six (6) month period 22
ending on the enrollment date. For purposes of this paragraph: 23
1. Medical advice, diagnosis, care, or treatment is taken into account only 24
if it is recommended by, or received from, an individual licensed or 25
similarly authorized to provide such services under state law and 26
operating within the scope of practice authorized by state law; and 27 UNOFFICIAL COPY 24 RS BR 1039
Page 5 of 63
XXXX 2/26/2024 4:58 PM Jacketed
2. The six (6) month period ending on the enrollment date begins on the 1
six (6) month anniversary date preceding the enrollment date; 2
(b) The exclusion extends for a period of not more than twelve (12) months, or 3
eighteen (18) months in the case of a late enrollee, after the enrollment date; 4
(c) 1. The period of any pre-existing condition exclusion that would otherwise 5
apply to an individual is reduced by the number of days of creditable 6
coverage the individual has as of the enrollment date, as counted under 7
subsection (3) of this section; and 8
2. Except for ineligible individuals who apply for coverage in the 9
individual market, the period of any pre-existing condition exclusion 10
that would otherwise apply to an individual may be reduced by the 11
number of days of creditable coverage the individual has as of the 12
effective date of coverage under the policy; and 13
(d) A written notice of the pre-existing condition exclusion is provided to 14
participants under the plan, and the insurer cannot impose a pre-existing 15
condition exclusion with respect to a participant or a dependent of the 16
participant until such notice is provided. 17
(3) In reducing the pre-existing condition exclusion period that applies to an individual, 18
the amount of creditable coverage is determined by counting all the days on which 19
the individual has one (1) or more types of creditable coverage. For purposes of 20
counting creditable coverage: 21
(a) If on a particular day the individual has creditable coverage from more than 22
one (1) source, all the creditable coverage on that day is counted as one (1) 23
day; 24
(b) Any days in a waiting period for coverage are not creditable coverage; 25
(c) Days of creditable coverage that occur before a significant break in coverage 26
are not required to be counted; and 27 UNOFFICIAL COPY 24 RS BR 1039
Page 6 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(d) Days in a waiting period and days in an affiliation period are not taken into 1
account in determining whether a significant break in coverage has occurred. 2
(4) An insurer may determine the amount of creditable coverage in another manner 3
than established in subsection (3) of this section that is at least as favorable to the 4
individual as the method established in subsection (3) of this section. 5
(5) If an insurer receives creditable coverage information, the insurer shall make a 6
determination regarding the amount of the individual's creditable coverage and the 7
length of any pre-existing exclusion period that remains. A written notice of the 8
length of the pre-existing condition exclusion period that remains after offsetting 9
for prior creditable coverage shall be issued by the insurer. An insurer may not 10
impose any limit on the amount of time that an individual has to present a 11
certificate or evidence of creditable coverage. 12
(6) For purposes of this section: 13
(a) "Pre-existing condition exclusion" means, with respect to coverage, a 14
limitation or exclusion of benefits relating to a condition based on the fact that 15
the condition was present before the effective date of coverage, whether or not 16
any medical advice, diagnosis, care, or treatment was recommended or 17
received before that day. A pre-existing condition exclusion includes any 18
exclusion applicable to an individual as a result of information relating to an 19
individual's health status before the individual's effective date of coverage 20
under a health benefit plan; 21
(b) "Enrollment date" means, with respect to an individual covered under a group 22
health plan or health insurance coverage, the first day of coverage or, if there 23
is a waiting period, the first day of the waiting period. If an individual 24
receiving benefits under a group health plan changes benefit packages, or if 25
the employer changes its group health insurer, the individual's enrollment date 26
does not change; 27 UNOFFICIAL COPY 24 RS BR 1039
Page 7 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(c) "First day of coverage" means, in the case of an individual covered for 1
benefits under a group health plan, the first day of coverage under the plan 2
and, in the case of an individual covered by health insurance coverage in the 3
individual market, the first day of coverage under the policy or contract; 4
(d) "Late enrollee" means an individual whose enrollment in a plan is a late 5
enrollment; 6
(e) "Late enrollment" means enrollment of an individual under a group health 7
plan other than: 8
1. On the earliest date on which coverage can become effective for the 9
individual under the terms of the plan; or 10
2. Through special enrollment; 11
(f) "Significant break in coverage" means a period of sixty-three (63) consecutive 12
days during each of which an individual does not have any creditable 13
coverage; and 14
(g) "Waiting period" means the period that must pass before coverage for an 15
employee or dependent who is otherwise eligible to enroll under the terms of 16
a group health plan can become effective. If an employee or dependent enrolls 17
as a late enrollee or special enrollee, any period before such late or special 18
enrollment is not a waiting period. If an individual seeks coverage in the 19
individual market, a waiting period begins on the date the individual submits a 20
substantially complete application for coverage and ends on: 21
1. If the application results in coverage, the date coverage begins; or 22
2. If the application does not result in coverage, the date on which the 23
application is denied by the insurer or the date on which the offer of 24
coverage lapses. 25
(7) (a) 1. Except as otherwise provided under subsection (3) of this section, for 26
purposes of applying subsection (2)(c) of this section, a group health 27 UNOFFICIAL COPY 24 RS BR 1039
Page 8 of 63
XXXX 2/26/2024 4:58 PM Jacketed
plan, and a health insurance insurer offering group health insurance 1
coverage, shall count a period of creditable coverage without regard to 2
the specific benefits covered during the period. 3
2. A group health plan, or a health insurance insurer offering group health 4
insurance coverage, may elect to apply subsection (2)(c) of this section 5
based on coverage of benefits within each of several classes or 6
categories of benefits specified in federal regulations. This election shall 7
be made on a uniform basis for all participants and beneficiaries. Under 8
this election, a group health plan or insurer shall count a period of 9
creditable coverage with respect to any class or category of benefits if 10
any level of benefits is covered within this class or category. 11
3. In the case of an election with respect to a group health plan under 12
subparagraph 2. of this paragraph, whether or not health insurance 13
coverage is provided in connection with the plan, the plan shall: 14
a. Prominently state in any disclosure statements concerning the 15
plan, and state to each enrollee at the time of enrollment under the 16
plan, that the plan has made this election; and 17
b. Include in these statements a description of the effect of this 18
election. 19
(b) Periods of creditable coverage with respect to an individual shall be 20
established through presentation of certifications described in subsection (9) 21
of this section or in such other manner as may be specified in administrative 22
regulations. 23
(8) (a) Subject to paragraph (e) of this subsection, a group health plan, and a health 24
insurance insurer offering group health insurance coverage, may not impose 25
any pre-existing condition exclusion on a child who, within thirty (30) days 26
after birth, is covered under any creditable coverage. If a child is enrolled in a 27 UNOFFICIAL COPY 24 RS BR 1039
Page 9 of 63
XXXX 2/26/2024 4:58 PM Jacketed
group health plan or other creditable coverage within thirty (30) days after 1
birth and subsequently enrolls in another group health plan without a 2
significant break in coverage, the other group health plan may not impose any 3
pre-existing condition exclusion on the child. 4
(b) Subject to paragraph (e) of this subsection, a group health plan, and a health 5
insurance insurer offering group health insurance coverage, may not impose 6
any pre-existing condition exclusion on a child who is adopted or placed for 7
adoption before attaining eighteen (18) years of age and who, within thirty 8
(30) days after the adoption or placement for adoption, is covered under any 9
creditable coverage. If a child is enrolled in a group health plan or other 10
creditable coverage within thirty (30) days after adoption or placement for 11
adoption and subsequently enrolls in another group health plan without a 12
significant break in coverage, the other group health plan may not impose any 13
pre-existing condition exclusion on the child. This shall not apply to coverage 14
before the date of the adoption or placement for adoption. 15
(c) A group health plan may not impose any pre-existing condition exclusion 16
relating to pregnancy. 17
(d) A group health plan may not impose a pre-existing condition exclusion 18
relating to a condition based solely on genetic information. If an individual is 19
diagnosed with a condition, even if the condition relates to genetic 20
information, the insurer may impose a pre-existing condition exclusion with 21
respect to the condition, subject to other requirements of this section. 22
(e) Paragraphs (a) and (b) of this subsection shall no longer apply to an individual 23
after the end of the first sixty-three (63) day period during all of which the 24
individual was not covered under any creditable coverage. 25
(9) (a) 1. A group health plan, and a health insurance insurer offering group health 26
insurance coverage, shall provide a certificate of creditable coverage as 27 UNOFFICIAL COPY 24 RS BR 1039
Page 10 of 63
XXXX 2/26/2024 4:58 PM Jacketed
described in subparagraph 2. of this paragraph[subsection]. A 1
certificate of creditable coverage shall be provided, without charge, for 2
participants or dependents who are or were covered under a group health 3
plan upon the occurrence of any of the following events: 4
a. At the time an individual ceases to be covered under a health 5
benefit plan or otherwise becomes eligible under a COBRA 6
continuation provision; 7
b. In the case of an individual becoming covered under a COBRA 8
continuation provision, at the time the individual ceases to be 9
covered under the COBRA continuation provision; and 10
c. On request on behalf of an individual made not later than twenty-11
four (24) months after the date of cessation of the coverage 12
described in subdivision a. or b. of this subparagraph, whichever is 13
later. 14
The certificate of creditable coverage as described under subdivision a. 15
of this subparagraph may be provided, to the extent practicable, at a time 16
consistent with notices required under any applicable COBRA 17
continuation provision. 18
2. The certification described in this subparagraph is a written certification 19
of: 20
a. The period of creditable coverage of the individual under the 21
health benefit plan and the coverage, if any, under the COBRA 22
continuation provision; and 23
b. The waiting period, if any, and affiliation period, if applicable, 24
imposed with respect to the individual for any coverage under the 25
plan. 26
3. To the extent that medical care under a group health plan consists of 27 UNOFFICIAL COPY 24 RS BR 1039
Page 11 of 63
XXXX 2/26/2024 4:58 PM Jacketed
group health insurance coverage, the plan is deemed to have satisfied the 1
certification requirement under this paragraph if the health insurance 2
insurer offering the coverage provides for the certification in accordance 3
with this paragraph. 4
(b) In the case of an election described in subsection (7)(a)2. of this section by a 5
group health plan or health insurance insurer, if the plan or insurer enrolls an 6
individual for coverage under the plan and the individual provides a 7
certification of coverage of the individual under paragraph (a) of this 8
subsection: 9
1. Upon request of that plan or insurer, the entity that issued the 10
certification provided by the individual shall promptly disclose to the 11
requesting plan or insurer information on coverage of classes and 12
categories of health benefits available under the entity's plan or 13
coverage; and 14
2. The entity may charge the requesting plan or insurer for the reasonable 15
cost of disclosing this information. 16
(10) (a) A group health plan, and a health insurance insurer offering group health 17
insurance coverage in connection with a group health plan, shall permit an 18
employee who is eligible but not enrolled for coverage under the terms of the 19
plan, or a dependent of that employee if the dependent is eligible but not 20
enrolled for coverage under these terms, to enroll for coverage under the 21
terms of the plan if each of the following conditions is met: 22
1. The employee or dependent was covered under a group health plan or 23
had health insurance coverage at the time coverage was previously 24
offered to the employee or dependent; 25
2. The employee stated in writing at that time that coverage under a group 26
health plan or health insurance coverage was the reason for declining 27 UNOFFICIAL COPY 24 RS BR 1039
Page 12 of 63
XXXX 2/26/2024 4:58 PM Jacketed
enrollment, but only if the plan sponsor or insurer, if applicable, 1
required that statement at that time and provided the employee with 2
notice of the requirement, and the consequences of the requirement, at 3
that time; 4
3. The employee's or dependent's coverage described in subparagraph 1. of 5
this paragraph: 6
a. Was under a COBRA continuation provision and the coverage 7
under that provision was exhausted; or 8
b. Was not under such a provision and either the coverage was 9
terminated as a result of loss of eligibility for the coverage, 10
including as a result of legal separation, divorce, cessation of 11
dependent status, such as obtaining the maximum age to be 12
eligible as a dependent child, death of the employee, termination 13
of employment, reduction in the number of hours of employment, 14
employer contributions toward the coverage were terminated, a 15
situation in which an individual incurs a claim that would meet or 16
exceed a lifetime limit on all benefits, or a situation in which a 17
plan no longer offers any benefits to the class of similarly situated 18
individuals that includes the individual; or 19
c. Was offered through a health maintenance organization or other 20
arrangement in the group market that does not provide benefits to 21
individuals who no longer reside, live, or work in a service area 22
and, loss of coverage in the group market occurred because an 23
individual no longer resides, lives, or works in the service area, 24
whether or not within the choice of the individual, and no other 25
benefit package is available to the individual; and 26
4. An insurer shall allow an employee and dependent a period of at least 27 UNOFFICIAL COPY 24 RS BR 1039
Page 13 of 63
XXXX 2/26/2024 4:58 PM Jacketed
thirty (30) days after an event described in this paragraph has occurred 1
to request enrollment for the employee or the employee's dependent. 2
Coverage shall begin no later than the first day of the first calendar 3
month beginning after the date the insurer receives the request for 4
special enrollment. 5
(b) A dependent of a current employee, including the employee's spouse, and the 6
employee each are eligible for enrollment in the group health plan subject to 7
plan eligibility rules conditioning dependent enrollment on enrollment of the 8
employee if the requirements of paragraph (a) of this subsection are satisfied. 9
(c) 1. If: 10
a. A group health plan makes coverage available with respect to a 11
dependent of an individual; 12
b. The individual is a participant under the plan, or has met any 13
waiting period applicable to becoming a participant under the plan 14
and is eligible to be enrolled under the plan but for a failure to 15
enroll during a previous enrollment period; and 16
c. A person becomes such a dependent of the individual through 17
marriage, birth, or adoption or placement for adoption; 18
the group health plan shall provide for a dependent special enrollment 19
period described in subparagraph 2. of this paragraph during which the 20
person or, if not otherwise enrolled, the individual, may be enrolled 21
under the plan as a dependent of the individual, and in the case of the 22
birth or adoption of a child, the spouse of the individual may be enrolled 23
as a dependent of the individual if the spouse is otherwise eligible for 24
coverage. 25
2. A dependent special enrollment period under this subparagraph shall be 26
a period of at least thirty (30) days and shall begin on the later of: 27 UNOFFICIAL COPY 24 RS BR 1039
Page 14 of 63
XXXX 2/26/2024 4:58 PM Jacketed
a. The date dependent coverage is made available; or 1
b. The date of the marriage, birth, or adoption or placement for 2
adoption, as the case may be, described in subparagraph 1.c. of 3
this paragraph. 4
3. If an individual seeks to enroll a dependent during the first thirty (30) 5
days of the dependent special enrollment period, the coverage of the 6
dependent shall become effective: 7
a. In the case of marriage, not later than the first day of the first 8
month beginning after the date the completed request for 9
enrollment is received; 10
b. In the case of a dependent's birth, as of the date of the birth; or 11
c. In the case of a dependent's adoption or placement for adoption, 12
the date of the adoption or placement for adoption. 13
(d) At or before the time an employee is initially offered the opportunity to enroll 14
in a group health plan, the employer shall provide the employee with a notice 15
of special enrollment rights. 16
(11) (a) In the case of a group health plan that offers medical care through health 17
insurance coverage offered by a health maintenance organization, the plan 18
may provide for an affiliation period with respect to coverage through the 19
organization only if: 20
1. No pre-existing condition exclusion is imposed with respect to coverage 21
through the organization; 22
2. The period is applied uniformly without regard to any health status-23
related factors; and 24
3. The period does not exceed two (2) months, or three (3) months in the 25
case of a late enrollee. 26
(b) 1. For purposes of this section, the term "affiliation period" means a period 27 UNOFFICIAL COPY 24 RS BR 1039
Page 15 of 63
XXXX 2/26/2024 4:58 PM Jacketed
which, under the terms of the health insurance coverage offered by the 1
health maintenance organization, must expire before the health 2
insurance coverage becomes effective. The organization is not required 3
to provide health care services or benefits during this period and no 4
premium shall be charged to the participant or beneficiary for any 5
coverage during the period. 6
2. This period shall begin on the enrollment date. 7
3. An affiliation period under a plan shall run concurrently with any 8
waiting period under the plan. 9
(c) A health maintenance organization described in paragraph (a) of this 10
subsection may use alternative methods other than those described in that 11
paragraph to address adverse selection as approved by the commissioner. 12
Section 4. KRS 18A.225 (Effective January 1, 2025) is amended to read as 13
follows: 14
(1) (a) The term "employee" for purposes of this section means: 15
1. Any person, including an elected public official, who is regularly 16
employed by any department, office, board, agency, or branch of state 17
government; or by a public postsecondary educational institution; or by 18
any city, urban-county, charter county, county, or consolidated local 19
government, whose legislative body has opted to participate in the state-20
sponsored health insurance program pursuant to KRS 79.080; and who 21
is either a contributing member to any one (1) of the retirement systems 22
administered by the state, including but not limited to the Kentucky 23
Retirement Systems, County Employees Retirement System, Kentucky 24
Teachers' Retirement System, the Legislators' Retirement Plan, or the 25
Judicial Retirement Plan; or is receiving a contractual contribution from 26
the state toward a retirement plan; or, in the case of a public 27 UNOFFICIAL COPY 24 RS BR 1039
Page 16 of 63
XXXX 2/26/2024 4:58 PM Jacketed
postsecondary education institution, is an individual participating in an 1
optional retirement plan authorized by KRS 161.567; or is eligible to 2
participate in a retirement plan established by an employer who ceases 3
participating in the Kentucky Employees Retirement System pursuant to 4
KRS 61.522 whose employees participated in the health insurance plans 5
administered by the Personnel Cabinet prior to the employer's effective 6
cessation date in the Kentucky Employees Retirement System; 7
2. Any certified or classified employee of a local board of education or a 8
public charter school as defined in KRS 160.1590; 9
3. Any elected member of a local board of education; 10
4. Any person who is a present or future recipient of a retirement 11
allowance from the Kentucky Retirement Systems, County Employees 12
Retirement System, Kentucky Teachers' Retirement System, the 13
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 14
Kentucky Community and Technical College System's optional 15
retirement plan authorized by KRS 161.567, except that a person who is 16
receiving a retirement allowance and who is age sixty-five (65) or older 17
shall not be included, with the exception of persons covered under KRS 18
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 19
employed pursuant to subparagraph 1. of this paragraph; and 20
5. Any eligible dependents and beneficiaries of participating employees 21
and retirees who are entitled to participate in the state-sponsored health 22
insurance program; 23
(b) The term "health benefit plan" for the purposes of this section means a health 24
benefit plan as defined in KRS 304.17A-005; 25
(c) The term "insurer" for the purposes of this section means an insurer as defined 26
in KRS 304.17A-005; and 27 UNOFFICIAL COPY 24 RS BR 1039
Page 17 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(d) The term "managed care plan" for the purposes of this section means a 1
managed care plan as defined in KRS 304.17A-500. 2
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 3
recommendation of the secretary of the Personnel Cabinet, shall procure, in 4
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 5
from one (1) or more insurers authorized to do business in this state, a group 6
health benefit plan that may include but not be limited to health maintenance 7
organization (HMO), preferred provider organization (PPO), point of service 8
(POS), and exclusive provider organization (EPO) benefit plans 9
encompassing all or any class or classes of employees. With the exception of 10
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 11
all employers of any class of employees or former employees shall enter into 12
a contract with the Personnel Cabinet prior to including that group in the state 13
health insurance group. The contracts shall include but not be limited to 14
designating the entity responsible for filing any federal forms, adoption of 15
policies required for proper plan administration, acceptance of the contractual 16
provisions with health insurance carriers or third-party administrators, and 17
adoption of the payment and reimbursement methods necessary for efficient 18
administration of the health insurance program. Health insurance coverage 19
provided to state employees under this section shall, at a minimum, contain 20
the same benefits as provided under Kentucky Kare Standard as of January 1, 21
1994, and shall include a mail-order drug option as provided in subsection 22
(13) of this section. All employees and other persons for whom the health care 23
coverage is provided or made available shall annually be given an option to 24
elect health care coverage through a self-funded plan offered by the 25
Commonwealth or, if a self-funded plan is not available, from a list of 26
coverage options determined by the competitive bid process under the 27 UNOFFICIAL COPY 24 RS BR 1039
Page 18 of 63
XXXX 2/26/2024 4:58 PM Jacketed
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 1
during annual open enrollment. 2
(b) The policy or policies shall be approved by the commissioner of insurance 3
and may contain the provisions the commissioner of insurance approves, 4
whether or not otherwise permitted by the insurance laws. 5
(c) Any carrier bidding to offer health care coverage to employees shall agree to 6
provide coverage to all members of the state group, including active 7
employees and retirees and their eligible covered dependents and 8
beneficiaries, within the county or counties specified in its bid. Except as 9
provided in subsection (20) of this section, any carrier bidding to offer health 10
care coverage to employees shall also agree to rate all employees as a single 11
entity, except for those retirees whose former employers insure their active 12
employees outside the state-sponsored health insurance program and as 13
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 14
(d) Any carrier bidding to offer health care coverage to employees shall agree to 15
provide enrollment, claims, and utilization data to the Commonwealth in a 16
format specified by the Personnel Cabinet with the understanding that the data 17
shall be owned by the Commonwealth; to provide data in an electronic form 18
and within a time frame specified by the Personnel Cabinet; and to be subject 19
to penalties for noncompliance with data reporting requirements as specified 20
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 21
to protect the confidentiality of each individual employee; however, 22
confidentiality assertions shall not relieve a carrier from the requirement of 23
providing stipulated data to the Commonwealth. 24
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 25
for timely analysis of data received from carriers and, to the extent possible, 26
provide in the request-for-proposal specifics relating to data requirements, 27 UNOFFICIAL COPY 24 RS BR 1039
Page 19 of 63
XXXX 2/26/2024 4:58 PM Jacketed
electronic reporting, and penalties for noncompliance. The Commonwealth 1
shall own the enrollment, claims, and utilization data provided by each carrier 2
and shall develop methods to protect the confidentiality of the individual. The 3
Personnel Cabinet shall include in the October annual report submitted 4
pursuant to the provisions of KRS 18A.226 to the Governor, the General 5
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 6
financial stability of the program, which shall include but not be limited to 7
loss ratios, methods of risk adjustment, measurements of carrier quality of 8
service, prescription coverage and cost management, and statutorily required 9
mandates. If state self-insurance was available as a carrier option, the report 10
also shall provide a detailed financial analysis of the self-insurance fund 11
including but not limited to loss ratios, reserves, and reinsurance agreements. 12
(f) If any agency participating in the state-sponsored employee health insurance 13
program for its active employees terminates participation and there is a state 14
appropriation for the employer's contribution for active employees' health 15
insurance coverage, then neither the agency nor the employees shall receive 16
the state-funded contribution after termination from the state-sponsored 17
employee health insurance program. 18
(g) Any funds in flexible spending accounts that remain after all reimbursements 19
have been processed shall be transferred to the credit of the state-sponsored 20
health insurance plan's appropriation account. 21
(h) Each entity participating in the state-sponsored health insurance program shall 22
provide an amount at least equal to the state contribution rate for the employer 23
portion of the health insurance premium. For any participating entity that used 24
the state payroll system, the employer contribution amount shall be equal to 25
but not greater than the state contribution rate. 26
(3) The premiums may be paid by the policyholder: 27 UNOFFICIAL COPY 24 RS BR 1039
Page 20 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(a) Wholly from funds contributed by the employee, by payroll deduction or 1
otherwise; 2
(b) Wholly from funds contributed by any department, board, agency, public 3
postsecondary education institution, or branch of state, city, urban-county, 4
charter county, county, or consolidated local government; or 5
(c) Partly from each, except that any premium due for health care coverage or 6
dental coverage, if any, in excess of the premium amount contributed by any 7
department, board, agency, postsecondary education institution, or branch of 8
state, city, urban-county, charter county, county, or consolidated local 9
government for any other health care coverage shall be paid by the employee. 10
(4) If an employee moves his or her place of residence or employment out of the 11
service area of an insurer offering a managed health care plan, under which he or 12
she has elected coverage, into either the service area of another managed health care 13
plan or into an area of the Commonwealth not within a managed health care plan 14
service area, the employee shall be given an option, at the time of the move or 15
transfer, to change his or her coverage to another health benefit plan. 16
(5) No payment of premium by any department, board, agency, public postsecondary 17
educational institution, or branch of state, city, urban-county, charter county, 18
county, or consolidated local government shall constitute compensation to an 19
insured employee for the purposes of any statute fixing or limiting the 20
compensation of such an employee. Any premium or other expense incurred by any 21
department, board, agency, public postsecondary educational institution, or branch 22
of state, city, urban-county, charter county, county, or consolidated local 23
government shall be considered a proper cost of administration. 24
(6) The policy or policies may contain the provisions with respect to the class or classes 25
of employees covered, amounts of insurance or coverage for designated classes or 26
groups of employees, policy options, terms of eligibility, and continuation of 27 UNOFFICIAL COPY 24 RS BR 1039
Page 21 of 63
XXXX 2/26/2024 4:58 PM Jacketed
insurance or coverage after retirement. 1
(7) Group rates under this section shall be made available to the disabled child of an 2
employee regardless of the child's age if the entire premium for the disabled child's 3
coverage is paid by the state employee. A child shall be considered disabled if he or 4
she has been determined to be eligible for federal Social Security disability benefits. 5
(8) The health care contract or contracts for employees shall be entered into for a 6
period of not less than one (1) year. 7
(9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 8
State Health Insurance Subscribers to advise the secretary or the secretary's 9
designee regarding the state-sponsored health insurance program for employees. 10
The secretary shall appoint, from a list of names submitted by appointing 11
authorities, members representing school districts from each of the seven (7) 12
Supreme Court districts, members representing state government from each of the 13
seven (7) Supreme Court districts, two (2) members representing retirees under age 14
sixty-five (65), one (1) member representing local health departments, two (2) 15
members representing the Kentucky Teachers' Retirement System, and three (3) 16
members at large. The secretary shall also appoint two (2) members from a list of 17
five (5) names submitted by the Kentucky Education Association, two (2) members 18
from a list of five (5) names submitted by the largest state employee organization of 19
nonschool state employees, two (2) members from a list of five (5) names submitted 20
by the Kentucky Association of Counties, two (2) members from a list of five (5) 21
names submitted by the Kentucky League of Cities, and two (2) members from a 22
list of names consisting of five (5) names submitted by each state employee 23
organization that has two thousand (2,000) or more members on state payroll 24
deduction. The advisory committee shall be appointed in January of each year and 25
shall meet quarterly. 26
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 27 UNOFFICIAL COPY 24 RS BR 1039
Page 22 of 63
XXXX 2/26/2024 4:58 PM Jacketed
provided to employees pursuant to this section shall not provide coverage for 1
obtaining or performing an abortion, nor shall any state funds be used for the 2
purpose of obtaining or performing an abortion on behalf of employees or their 3
dependents. 4
(11) Interruption of an established treatment regime with maintenance drugs shall be 5
grounds for an insured to appeal a formulary change through the established appeal 6
procedures approved by the Department of Insurance, if the physician supervising 7
the treatment certifies that the change is not in the best interests of the patient. 8
(12) Any employee who is eligible for and elects to participate in the state health 9
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 10
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 11
state health insurance contribution toward health care coverage as a result of any 12
other employment for which there is a public employer contribution. This does not 13
preclude a retiree and an active employee spouse from using both contributions to 14
the extent needed for purchase of one (1) state sponsored health insurance policy 15
for that plan year. 16
(13) (a) The policies of health insurance coverage procured under subsection (2) of 17
this section shall include a mail-order drug option for maintenance drugs for 18
state employees. Maintenance drugs may be dispensed by mail order in 19
accordance with Kentucky law. 20
(b) A health insurer shall not discriminate against any retail pharmacy located 21
within the geographic coverage area of the health benefit plan and that meets 22
the terms and conditions for participation established by the insurer, including 23
price, dispensing fee, and copay requirements of a mail-order option. The 24
retail pharmacy shall not be required to dispense by mail. 25
(c) The mail-order option shall not permit the dispensing of a controlled 26
substance classified in Schedule II. 27 UNOFFICIAL COPY 24 RS BR 1039
Page 23 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(14) The policy or policies provided to state employees or their dependents pursuant to 1
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 2
aid-related services for insured individuals under eighteen (18) years of age, subject 3
to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36) months 4
pursuant to KRS 304.17A-132. 5
(15) Any policy provided to state employees or their dependents pursuant to this section 6
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 7
consistent with KRS 304.17A-142. 8
(16) Any policy provided to state employees or their dependents pursuant to this section 9
shall provide coverage for obtaining amino acid-based elemental formula pursuant 10
to KRS 304.17A-258. 11
(17) If a state employee's residence and place of employment are in the same county, 12
and if the hospital located within that county does not offer surgical services, 13
intensive care services, obstetrical services, level II neonatal services, diagnostic 14
cardiac catheterization services, and magnetic resonance imaging services, the 15
employee may select a plan available in a contiguous county that does provide 16
those services, and the state contribution for the plan shall be the amount available 17
in the county where the plan selected is located. 18
(18) If a state employee's residence and place of employment are each located in 19
counties in which the hospitals do not offer surgical services, intensive care 20
services, obstetrical services, level II neonatal services, diagnostic cardiac 21
catheterization services, and magnetic resonance imaging services, the employee 22
may select a plan available in a county contiguous to the county of residence that 23
does provide those services, and the state contribution for the plan shall be the 24
amount available in the county where the plan selected is located. 25
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 26
in the best interests of the state group to allow any carrier bidding to offer health 27 UNOFFICIAL COPY 24 RS BR 1039
Page 24 of 63
XXXX 2/26/2024 4:58 PM Jacketed
care coverage under this section to submit bids that may vary county by county or 1
by larger geographic areas. 2
(20) Notwithstanding any other provision of this section, the bid for proposals for health 3
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 4
the statewide rating structure provided in calendar year 2003 and a bid scenario that 5
allows for a regional rating structure that allows carriers to submit bids that may 6
vary by region for a given product offering as described in this subsection: 7
(a) The regional rating bid scenario shall not include a request for bid on a 8
statewide option; 9
(b) The Personnel Cabinet shall divide the state into geographical regions which 10
shall be the same as the partnership regions designated by the Department for 11
Medicaid Services for purposes of the Kentucky Health Care Partnership 12
Program established pursuant to 907 KAR 1:705; 13
(c) The request for proposal shall require a carrier's bid to include every county 14
within the region or regions for which the bid is submitted and include but not 15
be restricted to a preferred provider organization (PPO) option; 16
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 17
carrier all of the counties included in its bid within the region. If the Personnel 18
Cabinet deems the bids submitted in accordance with this subsection to be in 19
the best interests of state employees in a region, the cabinet may award the 20
contract for that region to no more than two (2) carriers; and 21
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 22
other requirements or criteria in the request for proposal. 23
(21) Any fully insured health benefit plan or self-insured plan issued or renewed on or 24
after July 12, 2006, to public employees pursuant to this section which provides 25
coverage for services rendered by a physician or osteopath duly licensed under KRS 26
Chapter 311 that are within the scope of practice of an optometrist duly licensed 27 UNOFFICIAL COPY 24 RS BR 1039
Page 25 of 63
XXXX 2/26/2024 4:58 PM Jacketed
under the provisions of KRS Chapter 320 shall provide the same payment of 1
coverage to optometrists as allowed for those services rendered by physicians or 2
osteopaths. 3
(22) Any fully insured health benefit plan or self-insured plan issued or renewed to 4
public employees pursuant to this section shall comply with: 5
(a) KRS 304.12-237; 6
(b) KRS 304.17A-270 and 304.17A-525; 7
(c) KRS 304.17A-600 to 304.17A-633; 8
(d) KRS 205.593; 9
(e) KRS 304.17A-700 to 304.17A-730; 10
(f) KRS 304.14-135; 11
(g) KRS 304.17A-580 and 304.17A-641; 12
(h) KRS 304.99-123; 13
(i) KRS 304.17A-138; 14
(j) KRS 304.17A-148; 15
(k) KRS 304.17A-163 and 304.17A-1631; 16
(l) KRS 304.17A-265; 17
(m) KRS 304.17A-261; 18
(n) KRS 304.17A-262;[ and] 19
(o) Section 1 of this Act; 20
(p)_ Section 2 of this Act; and 21
(q) Administrative regulations promulgated pursuant to statutes listed in this 22
subsection. 23
Section 5. KRS 164.2871 (Effective January 1, 2025) is amended to read as 24
follows: 25
(1) The governing board of each state postsecondary educational institution is 26
authorized to purchase liability insurance for the protection of the individual 27 UNOFFICIAL COPY 24 RS BR 1039
Page 26 of 63
XXXX 2/26/2024 4:58 PM Jacketed
members of the governing board, faculty, and staff of such institutions from liability 1
for acts and omissions committed in the course and scope of the individual's 2
employment or service. Each institution may purchase the type and amount of 3
liability coverage deemed to best serve the interest of such institution. 4
(2) All retirement annuity allowances accrued or accruing to any employee of a state 5
postsecondary educational institution through a retirement program sponsored by 6
the state postsecondary educational institution are hereby exempt from any state, 7
county, or municipal tax, and shall not be subject to execution, attachment, 8
garnishment, or any other process whatsoever, nor shall any assignment thereof be 9
enforceable in any court,[.] except retirement benefits accrued or accruing to any 10
employee of a state postsecondary educational institution through a retirement 11
program sponsored by the state postsecondary educational institution on or after 12
January 1, 1998, shall be subject to the tax imposed by KRS 141.020, to the extent 13
provided in KRS 141.010 and 141.0215. 14
(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for 15
members of governing boards, faculty and staff of institutions of higher education 16
in this state shall not be construed to be a waiver of sovereign immunity or any 17
other immunity or privilege. 18
(4) The governing board of each state postsecondary education institution is authorized 19
to provide a self-insured employer group health plan to its employees, which plan 20
shall: 21
(a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and 22
(b) Except as provided in subsection (5) of this section, be exempt from 23
conformity with Subtitle 17A of KRS Chapter 304. 24
(5) A self-insured employer group health plan provided by the governing board of a 25
state postsecondary education institution to its employees shall comply with: 26
(a) KRS 304.17A-163 and 304.17A-1631; 27 UNOFFICIAL COPY 24 RS BR 1039
Page 27 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(b) KRS 304.17A-265; 1
(c) KRS 304.17A-261;[ and] 2
(d) KRS 304.17A-262; 3
(e) Section 1 of this Act; and 4
(f) Section 2 of this Act. 5
Section 6. KRS 194A.099 is amended to read as follows: 6
(1) The Division of Health Benefit Exchange within the Office of Data Analytics shall 7
administer the provisions of the Patient Protection and Affordable Care Act of 8
2010, Pub. L. No. 111-148. 9
(2) The Division of Health Benefit Exchange shall: 10
(a) Facilitate enrollment in health coverage and the purchase and sale of qualified 11
health plans in the individual market; 12
(b) Facilitate the ability of eligible individuals to receive premium tax credits and 13
cost-sharing reductions and enable eligible small businesses to receive tax 14
credits, in compliance with all applicable federal and state laws and 15
regulations; 16
(c) Oversee the consumer assistance programs of navigators, in-person assisters, 17
certified application counselors, and insurance agents as appropriate; 18
(d) At a minimum, carry out the functions and responsibilities required pursuant 19
to 42 U.S.C. sec. 18031 to implement and comply with federal regulations in 20
accordance with 42 U.S.C. sec. 18041;[ and] 21
(e) Regularly consult with stakeholders in accordance with 45 C.F.R. sec. 22
155.130; and 23
(f) Comply with Section 1 of this Act. 24
(3) The Office of Data Analytics: 25
(a) May enter into contracts and other agreements with appropriate entities, 26
including but not limited to federal, state, and local agencies, as permitted 27 UNOFFICIAL COPY 24 RS BR 1039
Page 28 of 63
XXXX 2/26/2024 4:58 PM Jacketed
under 45 C.F.R. sec. 155.110, to the extent necessary to carry out the duties 1
and responsibilities of the office if[, provided that] the agreements incorporate 2
adequate protections with respect to the confidentiality of any information to 3
be shared;[.] 4
(b)[(4)] [The office ]Shall pursue all available federal funding for the further 5
development and operation of the Division of Health Benefit Exchange;[.] 6
(c)[(5)] [The Office of Health Data and Analytics ]Shall promulgate 7
administrative regulations in accordance with KRS Chapter 13A to implement 8
this section; and[.] 9
(d)[(6)] [The office ]Shall not establish procedures and rules that conflict with or 10
prevent the application of the Patient Protection and Affordable Care Act of 11
2010, Pub. L. No. 111-148. 12
SECTION 7. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 13
READ AS FOLLOWS: 14
(1) As used in this section: 15
(a) "Eligible individual" means a woman who is: 16
1. Pregnant as a result of a sexual assault that has been established by: 17
a. An examination by a sexual assault nurse examiner as defined 18
in KRS 314.011 or examination at a sexual assault examination 19
facility as defined in KRS 216B.015 and reported as required in 20
Section 20 of this Act; or 21
b. The filing of a criminal complaint with a law enforcement 22
agency alleging conduct described in KRS 510.040, 510.050, or 23
510.060 within three (3) months of the sexual assault; and 24
2. Eligible for coverage under a health benefit plan or on any exchange; 25
(b) "Exchange": 26
1. Means a governmental agency or nonprofit entity that makes qualified 27 UNOFFICIAL COPY 24 RS BR 1039
Page 29 of 63
XXXX 2/26/2024 4:58 PM Jacketed
health plans, as defined in 42 U.S.C. sec. 18021, as amended, 1
available to qualified individuals and qualified employers; and 2
2. Includes: 3
a. An exchange serving the individual market for qualified 4
individuals; and 5
b. A small business health options program serving the small group 6
market for qualified employers; and 7
(c) "Health benefit plan" has the same meaning as in KRS 304.17A-005, 8
except that for purposes this section, the term includes: 9
1. Short-term limited-duration coverage; and 10
2. Student health insurance offered by a Kentucky-licensed insurer 11
under written contract with a university or college whose students it 12
proposes to insure. 13
(2) To the extent funding is available, premiums for coverage under a health benefit 14
plan or on any exchange shall not be charged to an eligible individual, and all 15
premiums, copayments, or coinsurance amounts shall be administered and paid 16
through the Division of Health Benefit Exchange within the Office of Data 17
Analytics. 18
Section 8. KRS 205.522 is amended to read as follows: 19
(1) With respect to the administration and provision of Medicaid benefits pursuant to 20
this chapter, the Department for Medicaid Services,[ and] any managed care 21
organization contracted to provide Medicaid benefits pursuant to this chapter, and 22
the state's medical assistance program shall be subject to, and comply with, the 23
following, as applicable:[provisions of ] 24
(a) KRS 304.17A-163;[, ] 25
(b) KRS 304.17A-1631;[, ] 26
(c) KRS 304.17A-167;[, ] 27 UNOFFICIAL COPY 24 RS BR 1039
Page 30 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(d) KRS 304.17A-235;[, ] 1
(e) KRS 304.17A-257;[, ] 2
(f) KRS 304.17A-259;[, ] 3
(g) KRS 304.17A-263;[, ] 4
(h) KRS 304.17A-515;[, ] 5
(i) KRS 304.17A-580;[, ] 6
(j) KRS 304.17A-600, 304.17A-603, and 304.17A-607;[, and ] 7
(k) KRS 304.17A-740 to 304.17A-743; and [, as applicable] 8
(l) Section 2 of this Act. 9
(2) A managed care organization contracted to provide Medicaid benefits pursuant to 10
this chapter shall comply with the reporting requirements of KRS 304.17A-732. 11
Section 9. KRS 205.592 is amended to read as follows: 12
(1) Except as provided in subsection (2) of this section, pregnant women, new mothers 13
up to twelve (12) months postpartum, and children up to age one (1) shall be 14
eligible for participation in the Kentucky Medical Assistance Program if: 15
(a)[(1)] They have family income up to but not exceeding one hundred and 16
eighty-five percent (185%) of the nonfarm income official poverty guidelines 17
as promulgated by the Department of Health and Human Services of the 18
United States as revised annually; and 19
(b)[(2)] They are otherwise eligible for the program. 20
(2) The percentage established in subsection (1)(a) of this section may be increased 21
to the extent: 22
(a) Permitted under federal law; and 23
(b) Funding is available. 24
Section 10. KRS 205.6485 is amended to read as follows: 25
(1) As used in this section, "KCHIP" means the Kentucky Children's Health 26
Insurance Program. 27 UNOFFICIAL COPY 24 RS BR 1039
Page 31 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(2) The Cabinet for Health and Family Services shall: 1
(a) Prepare a state child health plan, known as KCHIP, meeting the requirements 2
of Title XXI of the Federal Social Security Act, for submission to the 3
Secretary of the United States Department of Health and Human Services 4
within such time as will permit the state to receive the maximum amounts of 5
federal matching funds available under Title XXI; and[. The cabinet shall, ] 6
(b) By administrative regulation promulgated in accordance with KRS Chapter 7
13A, establish the following: 8
1.[(a)] The eligibility criteria for children covered by KCHIP, which 9
shall include a provision that[the Kentucky Children's Health Insurance 10
Program. However,] no person eligible for services under Title XIX of 11
the Social Security Act, 42 U.S.C. secs. 1396 to 1396v, as amended, 12
shall be eligible for services under KCHIP,[the Kentucky Children's 13
Health Insurance Program] except to the extent that Title XIX coverage 14
is expanded by KRS 205.6481 to 205.6495 and KRS 304.17A-340; 15
2.[(b)] The schedule of benefits to be covered by KCHIP[the Kentucky 16
Children's Health Insurance Program], which shall:[ include preventive 17
services, vision services including glasses, and dental services including 18
at least sealants, extractions, and fillings, and which shall] 19
a. Be at least equivalent to one (1) of the following: 20
i.[1.] The standard Blue Cross/Blue Shield preferred provider 21
option under the Federal Employees Health Benefit Plan 22
established by 5 U.S.C. sec. 8903(1); 23
ii.[2.] A mid-range health benefit coverage plan that is offered and 24
generally available to state employees; or 25
iii.[3.] Health insurance coverage offered by a health 26
maintenance organization that has the largest insured 27 UNOFFICIAL COPY 24 RS BR 1039
Page 32 of 63
XXXX 2/26/2024 4:58 PM Jacketed
commercial, non-Medicaid enrollment of covered lives in the 1
state; and 2
b. Comply with subsection (6) of this section; 3
3.[(c)] The premium contribution per family for[of] health insurance 4
coverage available under the KCHIP, which[Kentucky Children's 5
Health Insurance Program with provisions for the payment of premium 6
contributions by families of children eligible for coverage by the 7
program based upon a sliding scale relating to family income. Premium 8
contributions] shall be based: 9
a. On a six (6) month period; and 10
b. Upon a sliding scale relating to family income not to exceed: 11
i.[1.] Ten dollars ($10), to be paid by a family with income 12
between one hundred percent (100%) to one hundred thirty-13
three percent (133%) of the federal poverty level; 14
ii.[2.] Twenty dollars ($20), to be paid by a family with income 15
between one hundred thirty-four percent (134%) to one 16
hundred forty-nine percent (149%) of the federal poverty 17
level; and 18
iii.[3.] One hundred twenty dollars ($120), to be paid by a 19
family with income between one hundred fifty percent 20
(150%) to two hundred percent (200%) of the federal 21
poverty level, and which may be made on a partial payment 22
plan of twenty dollars ($20) per month or sixty dollars ($60) 23
per quarter; 24
4.[(d)] There shall be no copayments for services provided under 25
KCHIP[the Kentucky Children's Health Insurance Program]; and 26
5.[(e)] a. The criteria for health services providers and insurers 27 UNOFFICIAL COPY 24 RS BR 1039
Page 33 of 63
XXXX 2/26/2024 4:58 PM Jacketed
wishing to contract with the Commonwealth to provide[ the 1
children's health insurance] coverage under KCHIP. 2
b. [However, ]The cabinet shall provide, in any contracting process 3
for coverage of[the] preventive services[health insurance 4
program], the opportunity for a public health department to bid on 5
preventive health services to eligible children within the public 6
health department's service area. A public health department shall 7
not be disqualified from bidding because the department does not 8
currently offer all the services required by[ paragraph (b) of] this 9
section[subsection]. The criteria shall be set forth in administrative 10
regulations under KRS Chapter 13A and shall maximize 11
competition among the providers and insurers. The[ Cabinet for] 12
Finance and Administration Cabinet shall provide oversight over 13
contracting policies and procedures to assure that the number of 14
applicants for contracts is maximized. 15
(3)[(2)] Within twelve (12) months of federal approval of the state's Title XXI child 16
health plan, the Cabinet for Health and Family Services shall assure that a KCHIP 17
program is available to all eligible children in all regions of the state. If necessary, 18
in order to meet this assurance, the cabinet shall institute its own program. 19
(4)[(3)] KCHIP recipients shall have direct access without a referral from any 20
gatekeeper primary care provider to dentists for covered primary dental services 21
and to optometrists and ophthalmologists for covered primary eye and vision 22
services. 23
(5)[(4)] KCHIP[The Kentucky Children's Health Insurance Plan] shall comply with 24
KRS 304.17A-163 and 304.17A-1631. 25
(6) The schedule of benefits required under subsection (2)(b)2. of this section shall 26
include: 27 UNOFFICIAL COPY 24 RS BR 1039
Page 34 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(a) Preventive services; 1
(b) Vision services, including glasses; 2
(c) Dental services, including sealants, extractions, and fillings; and 3
(d) The coverage required under Section 2 of this Act. 4
Section 11. KRS 164.2847 is amended to read as follows: 5
(1) Tuition and mandatory student fees for any undergraduate or graduate program of 6
any Kentucky public postsecondary institution, including all four (4) year 7
universities and colleges and institutions of the Kentucky Community and 8
Technical College System, shall be waived for a Kentucky foster or adopted child 9
who is a full-time or part-time student if the student meets all entrance requirements 10
and maintains academic eligibility while enrolled at the postsecondary institution, 11
and if: 12
(a) The student's family receives state-funded adoption assistance under KRS 13
199.555; 14
(b) The student is currently committed to the Cabinet for Health and Family 15
Services under KRS 610.010(5) and placed in a family foster home or is 16
placed in accordance with KRS 605.090(3); 17
(c) The student is in an independent living program and the placement is funded 18
by the Cabinet for Health and Family Services; 19
(d) The student who is an adopted child was in the permanent legal custody of 20
and placed for adoption by the Cabinet for Health and Family Services. A 21
student who meets the eligibility criteria of this paragraph and lives outside of 22
Kentucky at the time of application to a Kentucky postsecondary institution 23
may apply for the waiver up to the amount of tuition for a Kentucky resident; 24
or 25
(e) The Cabinet for Health and Family Services was the student's legal custodian 26
on his or her eighteenth birthday. 27 UNOFFICIAL COPY 24 RS BR 1039
Page 35 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(2) Tuition and mandatory student fees for any undergraduate program of any 1
Kentucky public postsecondary institution, including all four (4) year universities 2
and colleges and institutions of the Kentucky Community and Technical College 3
System, shall be waived for a Department of Juvenile Justice foster child who is a 4
full-time or part-time student if the student meets all entrance requirements and 5
maintains academic eligibility while enrolled at the postsecondary institution and 6
obtains a recommendation for participation from an official from the Department of 7
Juvenile Justice, and if: 8
(a) The student has not been sentenced to the Department of Juvenile Justice 9
under KRS Chapter 640; 10
(b) The student has been committed to the Department of Juvenile Justice for a 11
period of at least twelve (12) months; 12
(c) The student is in an independent living program and placement is funded by 13
the Department of Juvenile Justice; 14
(d) The parental rights of the student's biological parents have been terminated; or 15
(e) The student was committed to the Cabinet for Health and Family Services 16
prior to a commitment to the Department of Juvenile Justice. 17
(3) Tuition and mandatory fees for any undergraduate or graduate program of any 18
Kentucky postsecondary institution, including all four (4) year universities and 19
colleges and institutions of the Kentucky Community and Technical College 20
System, shall be waived for a child conceived and born as a result of sexual 21
assault as defined in Section 13 of this Act who is a full-time or part-time student 22
if the student meets all entrance requirements and maintains academic eligibility 23
while enrolled in the postsecondary institution. 24
(4)[(3)] Upon request of the postsecondary institution, the: 25
(a) Cabinet for Health and Family Services shall confirm the eligibility status 26
under subsection (1) of this section of the student seeking to participate in 27 UNOFFICIAL COPY 24 RS BR 1039
Page 36 of 63
XXXX 2/26/2024 4:58 PM Jacketed
the waiver program;[and the ] 1
(b) Department of Juvenile Justice shall confirm the eligibility status and 2
recommendations under subsection (2) of this section of the student seeking to 3
participate in the waiver program; and 4
(c) Department of Kentucky State Police shall confirm the eligibility status 5
under subsection (3) of this section of the student seeking to participate in 6
the waiver program. 7
Release of this information shall not constitute a breach of confidentiality required 8
by KRS 199.570, 610.320, or 620.050. 9
(5)[(4)] The student shall complete the Free Application for Federal Student Aid to 10
determine the level of need and eligibility for state and federal financial aid 11
programs. If the sum of the tuition waiver plus other student financial assistance, 12
except loans and the work study program under 42 U.S.C. secs. 2751-2756b, from 13
all sources exceeds the student's total cost of attendance, as defined in 20 U.S.C. 14
sec. 1087ll, the tuition waiver shall be reduced by the amount exceeding the total 15
cost of attendance. 16
(6)[(5)] Except when extended in accordance with subsection (7)[(6)] of this section, 17
the student shall be eligible for the tuition waiver: 18
(a) For entrance to the institution for a period of no more than four (4) years after 19
the date of graduation from high school or obtaining a high school 20
equivalency diploma; and 21
(b) For one hundred fifty (150) consecutive or nonconsecutive credit hours 22
earned, after first admittance to any Kentucky institution if satisfactory 23
progress is achieved or maintained up to age twenty-eight (28). 24
(7)[(6)] The expiration of a student's eligibility under subsection (6)[(5)](a) of this 25
section shall be extended by the number of academic terms the institution 26
determines the student was unable to enroll for or complete due to serving: 27 UNOFFICIAL COPY 24 RS BR 1039
Page 37 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(a) On active duty status in the United States Armed Forces; 1
(b) As an officer in the Commissioned Corps of the United States Public Health 2
Service; or 3
(c) On active service in the Peace Corps Act or the Americorps. 4
The original age limitation under subsection (6)[(5)](b) of this section shall be 5
extended by the total number of years during which the student was on active duty 6
status. The number of months served on active duty status shall be rounded up to 7
the next higher year to determine the maximum length of eligibility extension 8
allowed. 9
(8)[(7)] The Council on Postsecondary Education shall report nonidentifying data on 10
graduation rates of students participating in the tuition waiver program by 11
November 30 each year to the Legislative Research Commission. 12
(9)[(8)] Nothing in this section shall be construed to: 13
(a) Guarantee acceptance of or entrance into any postsecondary institution for a 14
foster or adopted child, or a child under subsection (3) of this section; 15
(b) Limit the participation of a foster or adopted student, or a student under 16
subsection (3) of this section, in any other program of financial assistance for 17
postsecondary education; 18
(c) Require any postsecondary institution to waive costs or fees relating to room 19
and board; or 20
(d) Restrict any postsecondary institution, the Department of Juvenile Justice, or 21
the Cabinet for Health and Family Services from accessing other sources of 22
financial assistance, except loans, that may be available to a foster or adopted 23
student, or a student under subsection (3) of this section. 24
Section 12. KRS 164.2849 is amended to read as follows: 25
(1) The General Assembly of the Commonwealth of Kentucky finds and declares that it 26
is in the best interests of the Commonwealth to encourage and support adults to 27 UNOFFICIAL COPY 24 RS BR 1039
Page 38 of 63
XXXX 2/26/2024 4:58 PM Jacketed
adopt and provide foster care for children in the custody of the state and under 1
other specified circumstances. 2
(2) The General Assembly further finds and declares that it is in the best interests of 3
the Commonwealth to protect the unborn and to support the birth of a child 4
conceived as a result of sexual assault established by the filing of a criminal 5
complaint by the victim with a law enforcement agency alleging conduct 6
described in KRS 510.040, 510.050, or 510.060 within three (3) months of the 7
assault, or by an examination by a sexual assault nurse examiner as defined in 8
KRS 314.011 or examination at a sexual assault examination facility as defined 9
in KRS 216B.015 and reported to law enforcement as required under Section 20 10
of this Act. 11
(3) The General Assembly recognizes that a child whose care, custody, and control has 12
been assumed by the Commonwealth as evidenced by termination of the rights of 13
the biological parents and adoption from state custody or a custodial commitment to 14
the Cabinet for Health and Family Services or the Department of Juvenile Justice is 15
a special ward of the state and faces particular challenges in pursuing higher 16
education. 17
(4) The General Assembly recognizes that a child who was conceived and delivered 18
as a result of sexual assault also faces particular challenges in pursuing higher 19
education. 20
(5) Because it is the intent of the General Assembly to support adoption, foster 21
parenting, protection of the unborn, and educational advancement, the purpose of 22
KRS 164.2847 is to provide postsecondary education advancement opportunity for 23
foster and adopted children who are or were wards of the state, or for children who 24
were conceived and born as a result of sexual assault as described in subsection 25
(2) of this section. 26
Section 13. KRS 199.011 is amended to read as follows: 27 UNOFFICIAL COPY 24 RS BR 1039
Page 39 of 63
XXXX 2/26/2024 4:58 PM Jacketed
As used in this chapter, unless the context otherwise requires: 1
(1) "Adoption worker" means an employee of the cabinet so designated by the 2
secretary for health and family services, a social worker employed by a county or 3
city who has been approved by the cabinet to handle, under its supervision, 4
adoption placement services to children, or a social worker employed by or under 5
contract to a child-placing adoption agency; 6
(2) "Adult adopted person" means any adopted person who is twenty-one (21) years of 7
age or older; 8
(3) "Cabinet" means the Cabinet for Health and Family Services; 9
(4) "Child" means any person who has not reached his eighteenth birthday; 10
(5) "Child conceived and born as a result of sexual assault" means any child 11
conceived and delivered as a result of sexual assault established by an 12
examination by a sexual assault nurse examiner as defined in KRS 314.011 or 13
examination at a sexual assault examination facility as defined in KRS 216B.015 14
and reported as required in Section 20 of this Act, or the filing of a criminal 15
complaint by the victim with a law enforcement agency alleging conduct 16
described in KRS 510.040, 510.050, or 510.060 within three (3) months of the 17
assault; 18
(6) "Child-caring facility" means any institution or group home, including institutions 19
and group homes that are publicly operated, providing residential care on a twenty-20
four (24) hour basis to children, not related by blood, adoption, or marriage to the 21
person maintaining the facility, other than an institution or group home certified by 22
an appropriate agency as operated primarily for educational or medical purposes, or 23
a residential program operated or contracted by the Department of Juvenile Justice 24
that maintains accreditation, or obtains accreditation within two (2) years of 25
opening from a nationally recognized accrediting organization; 26
(7)[(6)] "Child-placing agency" means any agency licensed by the cabinet, which 27 UNOFFICIAL COPY 24 RS BR 1039
Page 40 of 63
XXXX 2/26/2024 4:58 PM Jacketed
supervises the placement of children in foster family homes or child-caring 1
facilities, or which places children for adoption; 2
(8)[(7)] "Department" means the Department for Community Based Services; 3
(9)[(8)] "Family rehabilitation home" means a child-caring facility for appropriate 4
families and comprising not more than twelve (12) children and two (2) staff 5
persons; 6
(10)[(9)] "Fictive kin" means an individual who is not related by birth, adoption, or 7
marriage to a child, but who has an emotionally significant relationship with the 8
child, or an emotionally significant relationship with a biological parent, siblings, or 9
half-siblings of the child in the case of a child from birth to twelve (12) months of 10
age, prior to placement; 11
(11)[(10)] "Foster family home" means a private home in which children are placed for 12
foster family care under supervision of the cabinet or of a licensed child-placing 13
agency; 14
(12)[(11)] "Group home" means a homelike facility, excluding Department of Juvenile 15
Justice-operated or -contracted facilities, for not more than eight (8) foster children, 16
not adjacent to or part of an institutional campus, operated by a sponsoring agency 17
for children who may participate in community activities and use community 18
resources; 19
(13)[(12)] "Institution" means a child-caring facility providing care or maintenance for 20
nine (9) or more children; 21
(14)[(13)] "Placement services" means those social services customarily provided by a 22
licensed child-placing or a public agency, which are necessary for the arrangement 23
and placement of children in foster family homes, child-placing facilities, or 24
adoptive homes. Placement services are provided through a licensed child-placing 25
or a public agency for children who cannot be cared for by their biological parents 26
and who need and can benefit from new and permanent family ties established 27 UNOFFICIAL COPY 24 RS BR 1039
Page 41 of 63
XXXX 2/26/2024 4:58 PM Jacketed
through legal adoption. Licensed child-placing agencies and public agencies have a 1
responsibility to act in the best interests of children, biological parents, and adoptive 2
parents by providing social services to all the parties involved in an adoption; 3
(15)[(14)] "Rap back system" means a system that enables an authorized entity to 4
receive ongoing status notifications of any criminal history from the Department of 5
Kentucky State Police or the Federal Bureau of Investigation reported on an 6
individual whose fingerprints are registered in the system, upon approval and 7
implementation of the system; 8
(16)[(15)] "Reasonable and prudent parent standard" has the same meaning as in 42 9
U.S.C. sec. 675(10); 10
(17)[(16)] "Secretary" means the secretary for health and family services; and 11
(18)[(17)] "Voluntary and informed consent" means that at the time of the execution of 12
the consent, the consenting person was fully informed of the legal effect of the 13
consent, that the consenting person was not given or promised anything of value 14
except those expenses allowable under KRS 199.590(6), that the consenting person 15
was not coerced in any way to execute the consent, and that the consent was 16
voluntarily and knowingly given. If at the time of the execution of the consent the 17
consenting person was represented by independent legal counsel, there shall be a 18
presumption that the consent was voluntary and informed. The consent shall be in 19
writing, signed and sworn to by the consenting person, and include the following: 20
(a) Date, time, and place of the execution of the consent; 21
(b) Name of the child, if any, to be adopted, and the date and place of the child's 22
birth; 23
(c) Consenting person's relationship to the child; 24
(d) Identity of the proposed adoptive parents or a statement that the consenting 25
person does not desire to know the identification of the proposed adoptive 26
parents; 27 UNOFFICIAL COPY 24 RS BR 1039
Page 42 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(e) 1. A statement that the consenting person understands that the consent will 1
be final and irrevocable under this paragraph unless withdrawn under 2
this paragraph. 3
2. If placement approval by the secretary is required, the voluntary and 4
informed consent shall become final and irrevocable seventy-two (72) 5
hours after the execution of the voluntary and informed consent. This 6
consent may be withdrawn only by written notification sent to the 7
proposed adoptive parent or the attorney for the proposed adoptive 8
parent on or before the expiration of the seventy-two (72) hours by 9
certified or registered mail and also by first-class mail. 10
3. If placement approval by the secretary is not required, the voluntary and 11
informed consent shall become final and irrevocable seventy-two (72) 12
hours after the execution of the voluntary and informed consent. This 13
consent may be withdrawn only by written notification sent to the 14
proposed adoptive parent or the attorney for the proposed adoptive 15
parent on or before the expiration of the seventy-two (72) hours by 16
certified or registered mail and also by first-class mail; 17
(f) Disposition of the child if the adoption is not adjudged; 18
(g) A statement that the consenting person has received a completed and signed 19
copy of the consent at the time of the execution of the consent; 20
(h) Name and address of the person who prepared the consent, name and address 21
of the person who reviewed and explained the consent to the consenting 22
person, and a verified statement from the consenting person that the consent 23
has been reviewed with and fully explained to the consenting person; and 24
(i) Total amount of the consenting person's legal fees, if any, for any purpose 25
related to the execution of the consent and the source of payment of the legal 26
fees. 27 UNOFFICIAL COPY 24 RS BR 1039
Page 43 of 63
XXXX 2/26/2024 4:58 PM Jacketed
Section 14. KRS 199.473 is amended to read as follows: 1
(1) All persons other than a child-placing agency or institution, the department, or 2
persons excepted by KRS 199.470(4) who wish to place or receive a child shall 3
make written application to the secretary for permission to place or receive a child. 4
(2) Prior to the approval of an application to place or receive a child, the fee required 5
pursuant to subsection (13) of this section shall be paid and a home study shall be 6
completed. The purpose of the home study shall be to review the background of the 7
applicant and determine the suitability of the applicant to receive a child, taking into 8
account at all times the best interest of the child for whom application to receive has 9
been made. 10
(3) (a) The home study shall be made in accordance with administrative regulations 11
promulgated by the cabinet in accordance with KRS Chapter 13A. 12
(b) The cabinet shall conduct the home study for an applicant whose total gross 13
income is equal to or less than two hundred fifty percent (250%) of the federal 14
poverty level guidelines issued each year by the federal government, unless 15
the applicant submits a written request for the home study to be conducted by 16
a licensed child-placing agency or institution. Upon request, the cabinet shall 17
make information available to an applicant who does not meet the 18
requirements of this paragraph to assist the applicant in obtaining a home 19
study from a licensed child-placing agency approved to provide adoption 20
services. 21
(c) A licensed child-placing agency approved to provide adoption services shall 22
conduct the home study for an applicant whose gross total income is more 23
than two hundred fifty percent (250%) of the federal poverty level guidelines 24
issued each year by the federal government. 25
(d) Calculation of family size for this subsection shall include each child 26
requested to be adopted. 27 UNOFFICIAL COPY 24 RS BR 1039
Page 44 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(e) The portion of the home study pertaining to the home and family background 1
shall be valid for one (1) year following the date of its completion by an 2
adoption worker. 3
(4) The adoption worker making the home study shall make a finding in writing 4
recommending either that the application be granted or that the application be 5
denied. The recommendation of the adoption worker shall then be reviewed by the 6
secretary. 7
(5) Based on the report and recommendation of the adoption worker making the home 8
study, the secretary shall grant or refuse permission for the applicant to place or 9
receive a child as early as practicable, but, in any case, the decision shall be made 10
within sixty (60) days after the receipt of the application. In reaching a decision, the 11
secretary shall be guided by the ability of the persons wishing to receive the child to 12
give the child a suitable home, and shall at all times consider the best interest of the 13
child from a financial, medical, psychological, and psychiatric standpoint. 14
(6) If the application is refused, the secretary shall in general terms furnish in writing 15
the reasons for his or her refusal. 16
(7) Any person who seeks temporary custody of a child prior to the secretary's ruling 17
on an application for adoption shall file a petition seeking temporary custody, with 18
a notice of intent to adopt, with the Circuit Court that will have jurisdiction of the 19
adoption proceedings. The clerk of the court shall send a notice of the filing of the 20
petition to the cabinet. A hearing on the petition shall occur no later than seventy-21
two (72) hours after the filing of the petition, excluding weekends and holidays. 22
Proceedings under this subsection shall be incorporated into the court's adoption 23
file. If the adoption is not finalized within six (6) months of the filing of the petition 24
and notice of intent, the court shall conduct a hearing on the status and custody of 25
the child. 26
(8) Upon a finding by the Circuit Court that the child should be placed prior to the 27 UNOFFICIAL COPY 24 RS BR 1039
Page 45 of 63
XXXX 2/26/2024 4:58 PM Jacketed
secretary's ruling on the application, the Circuit Court may grant the applicant 1
temporary custody of the child pending the decision of the secretary. Temporary 2
custody shall not be granted to an applicant unless a background check, including 3
but not limited to a criminal records check by the Justice and Public Safety Cabinet 4
or the Administrative Office of the Courts and a background check of child abuse 5
and neglect records maintained by the cabinet, has been submitted to and reviewed 6
by the court. The background check required for temporary custody shall be part of 7
the home study required under subsection (2) of this section. If the application is 8
denied by the secretary, the temporary custody order shall be set aside and, upon 9
motion of the cabinet or of the child's parent or parents, the Circuit Court may order 10
the child returned to the biological parent or parents or the child's custody may be 11
awarded to the cabinet, another licensed child-placing agency, or other individuals 12
deemed appropriate by the court. This section shall not be deemed to permit the 13
completion of any adoption proceeding without the approval of the secretary and 14
compliance with KRS 615.030, if required. 15
(9) In any case where the cabinet refuses to approve the placement of a child for 16
adoption when requested by the parent or parents of the child, or refuses the request 17
of any person or persons that a child be placed with that person or those persons for 18
adoption, the decision of the secretary in so refusing shall be final unless within ten 19
(10) days after notice of refusal, the biological or proposed adopting parent or 20
parents shall appeal to the Circuit Court of the county in which the adoption is 21
proposed. No placement shall be disapproved on the basis of the religious, ethnic, 22
racial, or interfaith background of the adoptive applicant, if the placement is made 23
with the consent of the parent. 24
(10) The cabinet may refuse to approve the placement of a child for adoption if the 25
child's custodial parent is unwilling for the child to be placed for adoption with the 26
proposed adoptive family. The cabinet may approve or deny the placement, in spite 27 UNOFFICIAL COPY 24 RS BR 1039
Page 46 of 63
XXXX 2/26/2024 4:58 PM Jacketed
of the fact that the custodial parent or parents are unwilling to be interviewed by the 1
cabinet or other approving entity, or if, after diligent efforts have been made, the 2
adoption worker is unable to locate or interview the custodial parent or parents. The 3
cabinet shall be made a party defendant to the appeal. In the hearing of an appeal, 4
the court shall review the findings of the secretary and shall determine if the 5
secretary has acted arbitrarily, unlawfully, or in a manner that constitutes an abuse 6
of discretion. 7
(11) If a child who does not fall within the exception provided for in KRS 199.470(4) is 8
placed or received in a home without the court's review of the background check 9
required under this section or the permission of the secretary for health and family 10
services, or if permission to receive a child has been denied, a representative of the 11
cabinet shall notify in writing or may petition the juvenile session of District Court 12
of the county in which the child is found setting out the facts concerning the child. 13
When the petition has been filed, the court shall take jurisdiction of the child and 14
shall provide for it as it would provide for a dependent, neglected, or abused child 15
under KRS Chapter 620, except that the child may not be placed in the home of the 16
applicants who are to receive the child unless permission to do so is granted by the 17
secretary or the action is ordered by a Kentucky court of competent jurisdiction. 18
(12) When either the custodial parent or parents of the child to be placed or the persons 19
wishing to receive the child reside out-of-state, the requirement of KRS 615.030, 20
Interstate Compact on the Placement of Children, shall be met before the cabinet 21
gives approval for the child's placement. 22
(13) The secretary of the Cabinet for Health and Family Services shall be paid a 23
nonrefundable fee of two hundred dollars ($200) upon the filing of the written 24
application for permission to place or receive a child. Payment shall be made by 25
certified or cashier's check only. All funds collected under this section shall be 26
deposited in a restricted account, which is hereby created, for the purpose of 27 UNOFFICIAL COPY 24 RS BR 1039
Page 47 of 63
XXXX 2/26/2024 4:58 PM Jacketed
subsidizing an adoptive parent for suitable care of a special-needs child as 1
authorized in KRS 199.555. The fee required under this subsection shall not be 2
required for an application to place or receive a child that was conceived and 3
born as a result of sexual assault. 4
(14) Nothing in this statute shall be construed to limit the authority of the cabinet or a 5
child-placing institution or agency to determine the proper disposition of a child 6
committed to it by the juvenile session of District Court or the Circuit Court, prior 7
to the filing of an application to place or receive. 8
Section 15. KRS 199.502 is amended to read as follows: 9
(1) Notwithstanding the provisions of KRS 199.500(1), an adoption may be granted 10
without the consent of the biological living parents of a child if it is pleaded and 11
proved as part of the adoption proceeding that any of the following conditions exist 12
with respect to the child: 13
(a) That the parent has abandoned the child for a period of not less than ninety 14
(90) days; 15
(b) That the parent had inflicted or allowed to be inflicted upon the child, by other 16
than accidental means, serious physical injury; 17
(c) That the parent has continuously or repeatedly inflicted or allowed to be 18
inflicted upon the child, by other than accidental means, physical injury or 19
emotional harm; 20
(d) That the parent has been convicted of: 21
1. A felony that involved the infliction of serious physical injury to a child 22
named in the present adoption proceeding; or 23
2. Any conduct prohibited as any degree of rape, sexual abuse, or sexual 24
misconduct under KRS Chapter 510 that resulted in the birth of the 25
child named in the present adoption proceeding; 26
(e) That the parent, for a period of not less than six (6) months, has continuously 27 UNOFFICIAL COPY 24 RS BR 1039
Page 48 of 63
XXXX 2/26/2024 4:58 PM Jacketed
or repeatedly failed or refused to provide or has been substantially incapable 1
of providing essential parental care and protection for the child, and that there 2
is no reasonable expectation of improvement in parental care and protection, 3
considering the age of the child; 4
(f) That the parent has caused or allowed the child to be sexually abused or 5
exploited; 6
(g) That the parent, for reasons other than poverty alone, has continuously or 7
repeatedly failed to provide or is incapable of providing essential food, 8
clothing, shelter, medical care, or education reasonably necessary and 9
available for the child's well-being and that there is no reasonable expectation 10
of significant improvement in the parent's conduct in the immediately 11
foreseeable future, considering the age of the child; 12
(h) That: 13
1. The parent's parental rights to another child have been involuntarily 14
terminated; 15
2. The child named in the present adoption proceeding was born 16
subsequent to or during the pendency of the previous termination; and 17
3. The condition or factor which was the basis for the previous termination 18
finding has not been corrected; 19
(i) That the parent has been convicted in a criminal proceeding of having caused 20
or contributed to the death of another child as a result of physical or sexual 21
abuse or neglect; or 22
(j) That the parent is a putative father, as defined in KRS 199.503, who fails to 23
register as the minor's putative father with the putative father registry 24
established under KRS 199.503 or the court finds, after proper service of 25
notice and hearing, that: 26
1. The putative father is not the father of the minor; 27 UNOFFICIAL COPY 24 RS BR 1039
Page 49 of 63
XXXX 2/26/2024 4:58 PM Jacketed
2. The putative father has willfully abandoned or willfully failed to care for 1
and support the minor; or 2
3. The putative father has willfully abandoned the mother of the minor 3
during her pregnancy and up to the time of her surrender of the minor, 4
or the minor's placement in the home of the petitioner, whichever occurs 5
first. 6
(2) Upon the conclusion of proof and argument of counsel, the Circuit Court shall enter 7
findings of fact, conclusions of law, and a decision either: 8
(a) Granting the adoption without the biological parent's consent; or 9
(b) Dismissing the adoption petition, and stating whether the child shall be 10
returned to the biological parent or the child's custody granted to the state, 11
another agency, or the petitioner. 12
(3) A biological living parent has the right to legal representation in an adoption 13
wherein he or she does not consent. The Circuit Court shall determine if a 14
biological living parent is indigent and, therefore, entitled to counsel pursuant to 15
KRS Chapter 31. If the Circuit Court so finds, the Circuit Court shall inform the 16
indigent parent; and, upon request, if it appears reasonably necessary in the interest 17
of justice, the Circuit Court shall appoint an attorney to represent the biological 18
living parent pursuant to KRS Chapter 31 to be provided or paid for by: 19
(a) The petitioner, a fee to be set by the court and not to exceed five hundred 20
dollars ($500);[ or] 21
(b) Except as provided in paragraph (c) of this subsection, the Finance and 22
Administration Cabinet if the petitioner is a blood relative or fictive kin as 23
established in KRS 199.470(4)(a), a fee to be set by the court and not to 24
exceed five hundred dollars ($500); and 25
(c) A biological living parent described in subsection (1)(d) of this section shall 26
not be eligible for any payment under this subsection related to legal 27 UNOFFICIAL COPY 24 RS BR 1039
Page 50 of 63
XXXX 2/26/2024 4:58 PM Jacketed
representation. 1
SECTION 16. A NEW SECTION OF KRS CHAPTER 199 IS CREATED TO 2
READ AS FOLLOWS: 3
(1) As used in this section, "nonrecurring adoption expenses" means those expenses 4
which are incurred in the legal adoption of a child conceived and born as a result 5
of sexual assault for which parents are ultimately responsible which include 6
reasonable and necessary adoption fees, court costs, attorney fees, and other 7
expenses which are directly related to the adoption of a child conceived and born 8
as a result of sexual assault and which are not incurred in violation of state or 9
federal law. 10
(2) Any person who meets the requirements of KRS 199.470 and who seeks to adopt a 11
child conceived and born as a result of sexual assault that is placed for adoption 12
by the cabinet, by an agency licensed by the cabinet, or with written approval by 13
the secretary of the cabinet, may receive the payment of nonrecurring adoption 14
expenses from state funds. 15
(3) Any agreement for the payments of state funds under this section shall be made 16
prior to the adoption of the child. 17
(4) The payments shall be out of funds appropriated to the cabinet and shall not 18
exceed the limit established by the secretary for health and family services in KRS 19
199.555. 20
(5) The cabinet shall establish criteria to be followed for payments under this section 21
and shall promulgate the criteria by administrative regulation in accordance with 22
KRS Chapter 13A. 23
Section 17. KRS 199.894 is amended to read as follows: 24
As used in KRS 199.892 to 199.896, unless the context otherwise requires: 25
(1) "Cabinet" means the Cabinet for Health and Family Services; 26
(2) "Secretary" means secretary for health and family services; 27 UNOFFICIAL COPY 24 RS BR 1039
Page 51 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(3) "Child Care and Development Fund" has the same meaning as in 45 C.F.R. sec. 1
98.2; 2
(4) "Child Care Assistance Program" means the child care subsidy program 3
established in Section 18 of this Act; 4
(5) "Child-care center" means any child-care center that provides full- or part-time 5
care, day or night, to four (4) or more children in a nonresidential setting who are 6
not the children, grandchildren, nieces, nephews, or children in legal custody of the 7
operator. "Child-care center" shall not include any child-care facility operated by a 8
religious organization while religious services are being conducted, or a youth 9
development agency. For the purposes of this section, "youth development agency" 10
means a program with tax-exempt status under 26 U.S.C. sec. 501(c)(3), which 11
operates continuously throughout the year as an outside-school-hours center for 12
youth who are six (6) years of age or older, and for which there are no fee or 13
scheduled-care arrangements with the parent or guardian of the youth served; 14
(6)[(4)] "Department" means the Department for Community Based Services; and 15
(7)[(5)] "Family child-care home" means a private home that is the primary residence 16
of an individual who provides full or part-time care day or night for six (6) or fewer 17
children who are not the children, siblings, stepchildren, grandchildren, nieces, 18
nephews, or children in legal custody of the provider. 19
SECTION 18. A NEW SECTION OF KRS 199.892 TO 199.8 996 IS 20
CREATED TO READ AS FOLLOWS: 21
(1) The Child Care Assistance Program is hereby established within the cabinet. 22
Except as may be prohibited by federal law, the Child Care Assistance Program 23
shall utilize federal Child Care and Development Fund block grant funds to 24
provide an eligible program participant with financial support to find and afford 25
quality child care. 26
(2) An eligible program participant shall be eligible for child care assistance for a 27 UNOFFICIAL COPY 24 RS BR 1039
Page 52 of 63
XXXX 2/26/2024 4:58 PM Jacketed
child under subsection (1) of this section from birth to the age of one (1) year. 1
(3) In administering the Child Care Assistance Program, the cabinet shall: 2
(a) Establish a minimum reimbursement rate for participating child care 3
providers which shall not be less than eighty-five percent (85%) of the local 4
market rate for child care providers; and 5
(b) Prohibit participating child care providers from charging overages to 6
eligible program participants. 7
(4) For purposes of this section, "eligible program participant" means an individual 8
who conceived and delivered the child as a result of sexual assault established by 9
an examination by a sexual assault nurse examiner as defined in KRS 314.011 or 10
examination at a sexual assault examination facility as defined in KRS 216B.015, 11
and reported as required in Section 20 of this Act, or the filing of a criminal 12
complaint by the individual with a law enforcement agency alleging conduct 13
described in KRS 510.040, 510.050, or 510.060 within three (3) months of the 14
assault. 15
(5) The cabinet may promulgate regulations in accordance with KRS Chapter 13A 16
necessary to carry out the provisions of this section. 17
SECTION 19. A NEW SECTION OF KRS CHAPTER 211 IS CREATED TO 18
READ AS FOLLOWS: 19
(1) The Cabinet for Health and Family Services shall develop, produce, and 20
disseminate written materials providing information on benefits and programs 21
available to a victim of sexual assault that has been reported as required in 22
Sections 7, 12, and 20 of this Act who has conceived a child as a result of the 23
sexual assault, and benefits and programs available to a child conceived and born 24
as a result of sexual assault and how to access those benefits. 25
(2) The cabinet may consult or contract with nonprofit organizations to develop and 26
produce the materials required by this section and shall make the materials 27 UNOFFICIAL COPY 24 RS BR 1039
Page 53 of 63
XXXX 2/26/2024 4:58 PM Jacketed
available on its website and in print form for distribution to victims. 1
Section 20. KRS 216B.400 is amended to read as follows: 2
(1) Where a person has been determined to be in need of emergency care by any person 3
with admitting authority, no such person shall be denied admission by reason only 4
of his or her inability to pay for services to be rendered by the hospital. 5
(2) Every hospital of this state which offers emergency services shall provide that a 6
physician, a sexual assault nurse examiner, who shall be a registered nurse licensed 7
in the Commonwealth and credentialed by the Kentucky Board of Nursing as 8
provided under KRS 314.142, or another qualified medical professional, as defined 9
by administrative regulation promulgated by the Justice and Public Safety Cabinet 10
in consultation with the Sexual Assault Response Team Advisory Committee as 11
defined in KRS 403.707, is available on call twenty-four (24) hours each day for the 12
examinations of persons seeking treatment as victims of sexual offenses as defined 13
by KRS 510.040, 510.050, 510.060, 510.070, 510.080, 510.090, 510.110, 510.120, 14
510.130, 510.140, 530.020, 530.064(1)(a), and 531.310. 15
(3) An examination provided in accordance with this section of a victim of a sexual 16
offense may be performed in a sexual assault examination facility as defined in 17
KRS 216B.015. An examination under this section shall apply only to an 18
examination of a victim. 19
(4) The physician, sexual assault nurse examiner, or other qualified medical 20
professional, acting under a statewide medical forensic protocol which shall be 21
developed by the Justice and Public Safety Cabinet in consultation with the Sexual 22
Assault Response Team Advisory Committee as defined in KRS 403.707, and 23
promulgated by the secretary of justice and public safety pursuant to KRS Chapter 24
13A shall, upon the request of any peace officer or prosecuting attorney, and with 25
the consent of the victim, or upon the request of the victim, examine such person 26
for the purposes of providing basic medical care relating to the incident and 27 UNOFFICIAL COPY 24 RS BR 1039
Page 54 of 63
XXXX 2/26/2024 4:58 PM Jacketed
gathering samples that may be used as physical evidence. This examination shall 1
include but not be limited to: 2
(a) Basic treatment and sample gathering services; and 3
(b) Laboratory tests, as appropriate. 4
(5) (a) Each victim shall be informed of available services for treatment of sexually 5
transmitted infections, pregnancy, and other medical and psychiatric 6
problems. Pregnancy counseling shall not include abortion counseling or 7
referral information; and 8
(b) Each victim shall be informed of available counseling services that can be 9
provided by sexual assault counseling specialists. 10
(6) Each victim shall be informed of available crisis intervention or other mental health 11
services provided by regional rape crisis centers providing services to victims of 12
sexual assault. 13
(7) Each victim shall be informed of other services and benefits that may be available 14
to: 15
(a) Victims of sexual assault relating to any pregnancy resulting from the 16
sexual assault; and 17
(b) Any child conceived and born as a result of the sexual assault. 18
(8)[(7)] Notwithstanding any other provision of law, a minor may consent to 19
examination under this section. This consent is not subject to disaffirmance because 20
of minority, and consent of the parents or guardians of the minor is not required for 21
the examination. 22
(9)[(8)] (a) The examinations provided in accordance with this section shall be paid 23
for by the Crime Victims Compensation Board at a rate to be determined by 24
the administrative regulation promulgated by the board after consultation with 25
the Sexual Assault Response Team Advisory Committee as defined in KRS 26
403.707. 27 UNOFFICIAL COPY 24 RS BR 1039
Page 55 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(b) Upon receipt of a completed claim form supplied by the board and an 1
itemized billing for a forensic sexual assault examination or related services 2
that are within the scope of practice of the respective provider and were 3
performed no more than twelve (12) months prior to submission of the form, 4
the board shall reimburse the hospital or sexual assault examination facility, 5
pharmacist, health department, physician, sexual assault nurse examiner, or 6
other qualified medical professional as provided in administrative regulations 7
promulgated by the board pursuant to KRS Chapter 13A. Reimbursement 8
shall be made to an out-of-state nurse who is credentialed in the other state to 9
provide sexual assault examinations, an out-of-state hospital, or an out-of-10
state physician if the sexual assault occurred in Kentucky. 11
(c) Independent investigation by the Crime Victims Compensation Board shall 12
not be required for payment of claims under this section; however, the board 13
may require additional documentation or proof that the forensic medical 14
examination was performed. 15
(10)[(9)] No charge shall be made to the victim for sexual assault examinations by the 16
hospital, the sexual assault examination facility, the physician, the pharmacist, the 17
health department, the sexual assault nurse examiner, other qualified medical 18
professional, the victim's insurance carrier, or the Commonwealth. 19
(11)[(10)] (a) 1. Each victim shall have the right to determine whether a report or 20
other notification shall be made to law enforcement, except where 21
reporting of abuse and neglect of a child or a vulnerable adult is 22
required, as set forth in KRS 209.030 and 620.030. 23
2. Each victim shall be advised that if a report is not made to law 24
enforcement within three (3) months of the sexual assault, the victim 25
shall not be eligible for those benefits that are specifically designated 26
for a victim of sexual assault that conceives a child as a result of the 27 UNOFFICIAL COPY 24 RS BR 1039
Page 56 of 63
XXXX 2/26/2024 4:58 PM Jacketed
sexual assault or for the child conceived and born as a result of the 1
sexual assault. 2
3. No victim shall be denied an examination because the victim chooses 3
not to file a police report, cooperate with law enforcement, or otherwise 4
participate in the criminal justice system. 5
(b) If the victim chooses to report to law enforcement, the hospital shall notify 6
law enforcement within twenty-four (24) hours. 7
(c) 1. All samples collected during an exam where the victim has chosen not 8
to immediately report to law enforcement shall be stored, released, and 9
destroyed, if appropriate, in accordance with an administrative 10
regulation promulgated by the Justice and Public Safety Cabinet in 11
consultation with the Sexual Assault Response Team Advisory 12
Committee as defined in KRS 403.707. 13
2. Facilities collecting samples pursuant to this section may provide the 14
required secure storage, sample destruction, and related activities, or 15
may enter into agreements with other agencies qualified to do so, 16
pursuant to administrative regulation. 17
3. All samples collected pursuant to this section shall be stored for at least 18
one (1) year from the date of collection in accordance with the 19
administrative regulation promulgated pursuant to this subsection. 20
4. Notwithstanding KRS 524.140, samples collected during exams where 21
the victim chose not to report immediately or file a report within one (1) 22
year after collection may be destroyed as set forth in accordance with 23
the administrative regulation promulgated pursuant to this subsection. 24
The victim shall be informed of this process at the time of the 25
examination. No hospital, sexual assault examination facility, or 26
designated storage facility shall be liable for destruction of samples after 27 UNOFFICIAL COPY 24 RS BR 1039
Page 57 of 63
XXXX 2/26/2024 4:58 PM Jacketed
the required storage period has expired. 1
SECTION 21. A NEW SECTION OF KRS CHAPTER 49 IS CREATED TO 2
READ AS FOLLOWS: 3
(1) A child conceived and born as a result of sexual assault is a victim of criminally 4
injurious conduct as defined in KRS 49.280 and shall be eligible for awards 5
pursuant to KRS 49.270 to 49.490. 6
(2) As used in this section, "child conceived and born as a result of sexual assault" 7
has the same meaning as in Section 13 of this Act. 8
Section 22. KRS 49.310 is amended to read as follows: 9
(1) Except as provided in subsections (2) and (3) of this section and Section 21 of this 10
Act, the following persons shall be eligible for awards pursuant to KRS 49.270 to 11
49.490: 12
(a) A victim of criminally injurious conduct; 13
(b) A surviving spouse, parent, or child of a victim of criminally injurious 14
conduct who died as a direct result of such conduct; 15
(c) Any other person dependent for his principal support upon a victim of 16
criminally injurious conduct who died as a direct result of such crime; and 17
(d) Any person who is legally responsible for the medical expenses or funeral 18
expenses of a victim. 19
(2) No victim or dependent shall be denied compensation solely because he or she is a 20
relative of the offender or was living with the offender as a family or household 21
member at the time of the injury or death. However, the Crime Victims 22
Compensation Board may award compensation to a victim or dependent who is a 23
relative, family, or household member of the offender only if the board can 24
reasonably determine the offender will not receive significant economic benefit or 25
unjust enrichment from the compensation. 26
(3) No compensation of any kind shall be awarded when injury occurred while the 27 UNOFFICIAL COPY 24 RS BR 1039
Page 58 of 63
XXXX 2/26/2024 4:58 PM Jacketed
victim was confined in any state, county, urban-county, or city jail, prison, or other 1
correctional facility, or any state institution maintained and operated by the Cabinet 2
for Health and Family Services. 3
Section 23. KRS 625.090 is amended to read as follows: 4
(1) The Circuit Court may involuntarily terminate all parental rights of a parent of a 5
named child, if the Circuit Court finds from the pleadings and by clear and 6
convincing evidence that: 7
(a) 1. The child has been adjudged to be an abused or neglected child, as 8
defined in KRS 600.020(1), by a court of competent jurisdiction; 9
2. The child is found to be an abused or neglected child, as defined in KRS 10
600.020(1), by the Circuit Court in this proceeding; 11
3. The child is found to have been diagnosed with neonatal abstinence 12
syndrome at the time of birth, unless his or her birth mother: 13
a. Was prescribed and properly using medication for a legitimate 14
medical condition as directed by a health care practitioner that may 15
have led to the neonatal abstinence syndrome; 16
b. Is currently, or within ninety (90) days after the birth, enrolled in 17
and maintaining substantial compliance with both a substance 18
abuse treatment or recovery program and a regimen of prenatal 19
care or postnatal care as recommended by her health care 20
practitioner throughout the remaining term of her pregnancy or the 21
appropriate time after her pregnancy; or 22
c. In the absence of a prescription for the treatment of a legitimate 23
medical condition, agrees, prior to discharge from the hospital, to 24
participate in a court-ordered assessment by a drug treatment 25
provider and the assigning of a certified peer support specialist for 26
referral to appropriate treatment, and agrees to participate in 27 UNOFFICIAL COPY 24 RS BR 1039
Page 59 of 63
XXXX 2/26/2024 4:58 PM Jacketed
treatment which shall commence within ninety (90) days after the 1
birth; or 2
4. a. The parent has been convicted of a criminal charge relating to the 3
physical or sexual abuse or neglect of any child and that physical 4
or sexual abuse, neglect, or emotional injury to the child named in 5
the present termination action is likely to occur if the parental 6
rights are not terminated; or 7
b. The parent has entered a guilty plea or been convicted of any 8
conduct prohibited as any degree of rape, sexual abuse, or 9
sexual misconduct under KRS Chapter 510, and the criminal act 10
upon which the plea or conviction is based resulted in the birth 11
of the child; 12
(b) 1. The Cabinet for Health and Family Services has filed a petition with the 13
court pursuant to KRS 620.180 or 625.050; or 14
2. A child-placing agency licensed by the cabinet, any county or 15
Commonwealth's attorney, or a parent has filed a petition with the court 16
under KRS 625.050; and 17
(c) Termination would be in the best interest of the child. 18
(2) No termination of parental rights shall be ordered unless the Circuit Court also finds 19
by clear and convincing evidence the existence of one (1) or more of the following 20
grounds: 21
(a) That the parent has abandoned the child for a period of not less than ninety 22
(90) days; 23
(b) That the parent has inflicted or allowed to be inflicted upon the child, by other 24
than accidental means, serious physical injury; 25
(c) That the parent has continuously or repeatedly inflicted or allowed to be 26
inflicted upon the child, by other than accidental means, physical injury or 27 UNOFFICIAL COPY 24 RS BR 1039
Page 60 of 63
XXXX 2/26/2024 4:58 PM Jacketed
emotional harm; 1
(d) That the parent has been convicted of: 2
1. A felony that involved the infliction of serious physical injury to any 3
child; or 4
2. Any conduct prohibited as any degree of rape, sexual abuse, or sexual 5
misconduct under KRS Chapter 510 that resulted in the birth of the 6
child; 7
(e) That the parent, for a period of not less than six (6) months, has continuously 8
or repeatedly failed or refused to provide or has been substantially incapable 9
of providing essential parental care and protection for the child and that there 10
is no reasonable expectation of improvement in parental care and protection, 11
considering the age of the child; 12
(f) That the parent has caused or allowed the child to be sexually abused or 13
exploited; 14
(g) That the parent, for reasons other than poverty alone, has continuously or 15
repeatedly failed to provide or is incapable of providing essential food, 16
clothing, shelter, medical care, or education reasonably necessary and 17
available for the child's well-being and that there is no reasonable expectation 18
of significant improvement in the parent's conduct in the immediately 19
foreseeable future, considering the age of the child; 20
(h) That: 21
1. The parent's parental rights to another child have been involuntarily 22
terminated; 23
2. The child named in the present termination action was born subsequent 24
to or during the pendency of the previous termination; and 25
3. The conditions or factors which were the basis for the previous 26
termination finding have not been corrected; 27 UNOFFICIAL COPY 24 RS BR 1039
Page 61 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(i) That the parent has been convicted in a criminal proceeding of having caused 1
or contributed to the death of another child as a result of physical or sexual 2
abuse or neglect; 3
(j) That the child has been in foster care under the responsibility of the cabinet 4
for fifteen (15) cumulative months out of forty-eight (48) months preceding 5
the filing of the petition to terminate parental rights; or 6
(k) That the child has been removed from the biological or legal parents more 7
than two (2) times in a twenty-four (24) month period by the cabinet or a 8
court. 9
(3) In determining the best interest of the child and the existence of a ground for 10
termination, the Circuit Court shall consider the following factors: 11
(a) Whether the parent is a mentally ill person[Mental illness] as defined by 12
KRS 202A.011(9), or an individual with an intellectual disability as defined 13
by KRS 202B.010(9)[ of the parent] as certified by a qualified mental health 14
professional, which renders the parent consistently unable to care for the 15
immediate and ongoing physical or psychological needs of the child for 16
extended periods of time; 17
(b) Acts of abuse or neglect as defined in KRS 600.020(1) toward any child in the 18
family; 19
(c) If the child has been placed with the cabinet, whether the cabinet has, prior to 20
the filing of the petition made reasonable efforts as defined in KRS 620.020 to 21
reunite the child with the parents unless one or more of the circumstances 22
enumerated in KRS 610.127 for not requiring reasonable efforts have been 23
substantiated in a written finding by the District Court; 24
(d) The efforts and adjustments the parent has made in his circumstances, 25
conduct, or conditions to make it in the child's best interest to return him to 26
his home within a reasonable period of time, considering the age of the child; 27 UNOFFICIAL COPY 24 RS BR 1039
Page 62 of 63
XXXX 2/26/2024 4:58 PM Jacketed
(e) The physical, emotional, and mental health of the child and the prospects for 1
the improvement of the child's welfare if termination is ordered; and 2
(f) The payment or the failure to pay a reasonable portion of substitute physical 3
care and maintenance if financially able to do so. 4
(4) If the child has been placed with the cabinet, the parent may present testimony 5
concerning the reunification services offered by the cabinet and whether additional 6
services would be likely to bring about lasting parental adjustment enabling a return 7
of the child to the parent. 8
(5) If the parent proves by a preponderance of the evidence that the child will not 9
continue to be an abused or neglected child as defined in KRS 600.020(1) if 10
returned to the parent the court in its discretion may determine not to terminate 11
parental rights. 12
(6) Upon the conclusion of proof and argument of counsel, the Circuit Court shall enter 13
findings of fact, conclusions of law, and a decision as to each parent-respondent 14
within thirty (30) days either: 15
(a) Terminating the right of the parent; or 16
(b) Dismissing the petition and stating whether the child shall be returned to the 17
parent or shall remain in the custody of the state. 18
Section 24. If the state would, or would likely, be required to make payments to 19
defray the cost of any requirement under Section 1 or 2 of this Act, as provided under 42 20
U.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as amended, then the Department of 21
Insurance shall, within 90 days of the effective date of this section, apply for a waiver 22
under 42 U.S.C. sec. 18052, as amended, or any other applicable federal law of all or any 23
of the cost defrayal requirements. 24
Section 25. If the Cabinet for Health and Family Services determines that a 25
waiver or other authorization from a federal agency is necessary to implement Section 6, 26
8, 9, or 10 of this Act for any reason, including the loss of federal funds, the cabinet shall, 27 UNOFFICIAL COPY 24 RS BR 1039
Page 63 of 63
XXXX 2/26/2024 4:58 PM Jacketed
within 90 days of the effective date of this section, request the waiver or authorization, 1
and may only delay implementation of those provisions for which a waiver or 2
authorization was deemed necessary until the waiver or authorization is granted. 3
Section 26. Sections 1 to 7 of this Act apply to plans issued or renewed on or 4
after January 1, 2025. 5
Section 27. Sections 1, 2, 3, 4, 5, 6, 7, and 26 of this Act take effect on January 6
1, 2025. 7
Section 28. This Act may be cited as the Love Them Both Act. 8