Legislative

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Kentucky Legislative Session: The 2018 Kentucky Regular Legislative Session is a long session limited to 60 days that began on January 2. February 16 is the last day for new bill requests. February 26 is the last day for new House Bills and February 28 is the last day for new Senate Bills. The legislature will not meet during the Veto Period of March 29 through April 9. The final two days scheduled are April 12 and 13. The schedule may change.

Read How a Bill Becomes Law to learn how a bill goes through the Legislative process, including how it can be changed and passed without any public knowledge.

Bills of interest to EMS:

April 20, 2018

 

2018 KAPA FINAL LEGISLATIVE REPORT

 

SENATE BILLS

 

SB 142/FN (BR 1391)D. Carroll

     AN ACT relating to training for telecommunicators.
     Amend KRS 15.550 to require telecommunicators that provide dispatch for emergency medical conditions to be trained in high-quality telephone cardiopulmonary resuscitation (T-CPR).

PASSED

Apr 02, 2018 - signed by Governor (Acts, ch. 65)

 

SB 151 (BR 1644) - J. Bowen

     AN ACT relating to the local provision of wastewater services.
     Amend KRS 65.240, relating to interlocal agreements, KRS 74.407, relating to water districts, KRS 76.080, relating to metropolitan sewer districts, KRS 76.231, relating to joint sewer agencies, KRS 76.325, relating to sewer construction districts, and create a new section of KRS 220.010 to 220.540, relating to sanitation districts, to allow each agency or entity to contract with other entities to acquire wastewater facilities in connection with the acquisition, construction, operation, repair, or maintenance when the entity's facilities are outside of that particular agency's jurisdictional boundaries.

Amended to include Pension Reform language:

*My Thanks to “Howdy Kurtsinger” for his summarization of the bill!

Changes are as followers:

Kentucky Retirement Systems (KRS)

Includes the Kentucky Employees Retirement System (KERS), County Employees Retirement System (CERS), and the State Police Retirement System (SPRS)

·         Current KRS Retirees: No change

·         Current KRS Defined Benefit Members (Tier I/Tier II Members)

o  Members who began participating on or after July 1, 2003, but prior to September 1, 2008, shall contribute an additional 1% of pay to fund retiree health.  Same as Tier II/III. 

o  High 3/High 5 Final Compensation:  Must be compete 3 or 5 years for members retiring on or after January 1, 2019.

o  Sick Leave Service Credit: Sick leave is not limited for purposes of service credit in KRS in SB 151/PHS2. PHS2 provides current members cannot use sick leave service credit for purposes of retirement eligibility or to reduce applicable actuarial penalties for retirements occurring on or after July 1, 2023.  Note: SB 1/SCS1 had limited sick leave service credit to sick leave accrued as of December 31, 2018, and it couldn’t be used for retirement eligibility/reducing actuarial penalties for retirements occurring on or after January 1, 2019 (Tier III and after receive no sick leave service credit for acc. sick leave).

o  Comp. Time Paid At Retirement: Provides that lump-sum payments for compensatory time at retirement will not boost retirement benefits for non-hazardous Tier I members retiring after July 1, 2023 (Tier II and III already ineligible).

o  Modifies KERS/CERS/SPRS inviolable contracts to exclude legislative changes that become effective on or after July 1, 2018.

o  May opt to prospectively participate in the KERS 401(a) money purchase plan (past service not impacted) by 1/1/2021. 

o  For hazardous members, provides that the spouse shall supersede all designated beneficiaries in case of ensuring minimum line of duty death benefits are provided to the spouse and make provisions retroactive to deaths occurring on or after January 1, 2017.

·         Current KRS Cash Balance Members

o  Nonhazardous: Changes future interest credit on cash balance account balances so that contributing members will receive an annual interest credit of 85% of the plan’s 10-year net return (currently 4% return plus 75% of 5-year return above 4%). Former members not contributing will receive a 0% annual interest credit (currently 4%).

o  Nonhazardous: May opt to prospectively participate in the KERS 401(a) money purchase plan (past service not impacted) by 1/1/2021. 

o  Nonhazardous & Hazardous: Removes $5,000 Death Benefit paid after retirement for those members with 4+ years of service credit.

·         KRS Hazardous New Hires: Member benefits the same except removes the $5,000 Death Benefit paid after retirement for those members with 4+ years of service credit.

·         KRS Nonhazardous New Members:

o  Establishes optional, Tier IV 401(a) Money Purchase Plan (defined contribution plan). Members must opt into 401(a) plan, in lieu of cash balance plan, within 90 days of employment.  PHS 2 to SB 151: At the request of the systems, the PHS2 changes when this optional plan becomes available to July 1, 2019 (from January 1, 2019 in SB 1 SCS1).

o  401(a) benefit will be based upon an account balance of employee contributions (5% of pay), employer contribution (4% of pay), and investment returns. 

o  KRS board may allow investment options within KRS investment pool, contract with outside entity, or through Kentucky Deferred Compensation (KDC).

o  Member can retire under same provisions as nonhazardous cash balance participants and annuitize their account balance.

o  Members eligible for disability/death before retirement/retiree health benefit similar to cash balance plan members.

o  Removes $5,000 Death Benefit paid after retirement for those members with 4+ years of service credit.

·      Funding Provisions

o  Requires level dollar financing of unfunded liabilities over closed 30-year amortization period, using 5-year smoothed asset valuation method for all KRS systems. Amortization period reset in 2019 valuation.

o  Contribution on or after July 1, 2020 shall be set as dollar amount and prorated to each employer based on share of actual payroll in FY15-FY17 (i.e. each employer will have different employer rate).  SB 151/PHS2 provides that executive branch agencies in KERS will be one collective rate instead of separate rates for various Cabinets/departments in state government. 

·      Retired/Reemployed Provisions (for retirees who retire on or after 1/1/2019):

o  Non-Hazardous:  3 month break required or retirement voided.

o   If 3 month break is observed, member can work part-time, continue to receive pension benefit, but no second account is created.

o   If 12 month break is observed, member can work full-time, continue to receive pension benefit, but no second account is created.  If member works in full-time position after 3 month break, pension is suspended until 12 months after retirement date.

o   Employer makes normal cost contribution for any reemployed retiree.

o  Hazardous Members/Certified peace officers:  1 month break required or retirement voided.  If 1 month break is observed, member can return to work in part-time or full-time capacity, continue to receive pension benefit, but no second account is created.  Employer makes normal cost contribution for any reemployed retiree.

o  A retiree of another state-adm. retirement system who retires on or after 1/1/2019, shall not be eligible to earn a second retirement account in KRS. 

·     Conflict of Interest Provisions - No member of GA, public servant, trustee or employee of KRS board shall have any interest in the business of KRS while employed/serving AND for five (5) years following employment/service.

PASSED

Apr 10, 2018 - signed by Governor (Acts, ch. 107)

 

HOUSE BILLS

 

HB 61/CI/FN (BR 372)G. WatkinsL. BrownD. MayfieldC. McCoyC. MorganB. ReedR. Rothenburger

     AN ACT relating to criminal attempted murder.
     Amend KRS 439.3401 to make criminal attempt to commit murder of a peace officer or a firefighter an offense for which at least 85 percent of the sentence must be served before probation or parole.

AMENDMENTS

HB 61 (As Introduced)

     HFA1( R. Rothenburger ) - Amend to include emergency medical personnel in protections for police officers and firefighters.

     Jan 11, 2018 - 2nd reading, to Rules; recommitted to Appropriations & Revenue (H)
     Jan 16, 2018 - floor amendment (1) filed

Died in the House

 

HB 135/HM (BR 916) J. GreerJ. RichardsS. Westrom

 

    AN ACT relating to emergency air ambulance coverage.
     Amend KRS 304.17A-005 to define balance bill and insured; create a new section of subtitle 17A of KRS Chapter 304 to define registered air ambulance service provider, to prohibit a health benefit plan from using an allowed amount for air ambulance services under certain conditions, to determine when an air ambulance transport is medically necessary, to require assumption of charges by the insurer under certain conditions, to require notification to the air ambulance service of assumption by the insurer, prohibit the air ambulance provider from certain actions following receipt of notification, to establish payment requirements for the insurer, to establish the Independent Dispute Resolution program for disputed air ambulance service charges within the Department of Insurance, to require reporting by registered air ambulance service providers and the department, to set requirements for registration in the program, to set requirements to be an independent reviewer for the program, and to establish procedures for the Independent Dispute Resolution program; and amend KRS 304.17A-096, 304.17A-430, 304.17B-001, 304.17B-015, 304.17B-033, 304.17C-010, 304.18-114, 304.38A-010, and 304.39-241 to conform.
     Jan 04, 2018 - introduced in House
     Jan 08, 2018 - to Banking & Insurance (H)

Died in Committee

 

HB 147/FN (BR 399)M. HartP. PrattD. BentleyJ. CarneyJ. GreerD. HorlanderM. PruntyB. ReedS. Riley

     AN ACT relating to seizure disorders in schools.
     Amend KRS 159.832 to apply defined terms through KRS 158.838 and define "seizure action plan"; amend KRS 158.838 to include any medication prescribed to treat seizure disorder symptoms; require seizure disorder trainings to comply with Epilepsy Foundation of America guidelines; require parent or guardian of student diagnosed with a seizure disorder to collaborate with school personnel to create a seizure action plan; require the Kentucky Board of Education to promulgate administrative regulations regarding contents and development of seizure action plans; create a new section of KRS Chapter 158 to require every public school to provide a seizure education program; require Kentucky Board of Education to promulgate administrative regulations for development and implementation of the seizure education program; amend KRS 158.070 to require a minimum of one hour of self-study review of seizure disorder materials annually for all principals, guidance counselors, and teachers; provide that the Act may be cited as the Lindsey Crunk Act.

AMENDMENTS

HB 147 (As Introduced)

     HFA1( R. Nelson ) - Require public charter schools to provide seizure education program.

     HFA2( S. Overly ) - Require public charter schools to provide seizure education program.
     
HFA3( M. Hart ) - Amend to move new language in Section 4 from KRS 158.070(b) to KRS 156.095; reduce self-study requirement from every year to every other year; change the short title to "the Lindsey Crunk Act."
     
SCS1 - Amend KRS 158.838 to remove the proposed requirement for seizure disorder trainings to comply with Epilepsy Foundation of America guidelines; require parent or guardian of student diagnosed with a seizure disorder to collaborate with school personnel to implement a seizure action plan; require the Kentucky Board of Education to promulgate administrative regulations regarding the implementation of seizure action plans rather than the contents; remove the proposed requirement that every public school provide a seizure education program; amend KRS 158.070 to require a minimum of one hour of self-study review of seizure disorder materials for all new teachers, guidance counselors, and principals hired after July 1, 2019; require all current principals, guidance counselors, and teachers to complete one hour of self-study review of seizure disorder materials by July 1, 2019; and provide that the Act may be cited as the Lyndsey Crunk Act.

PASSED

April 13, 2018 - signed by Governor (Acts, ch. 153)

 

HB 176 (BR 1023)R. RothenburgerJ. MillerB. ReedR. WebberS. Westrom


     AN ACT relating to fee disclosures by licensed ambulance providers.
     Create a new section of KRS Chapter 311A to require ambulance providers to post fee schedules and provide them to beneficiaries; require the Kentucky Board of Emergency Medical Services to assess a fee of $150 for failure to post a fee schedule and modifications to the fee schedule; require the board to promulgate administrative regulations to implement the requirements.

AMENDMENTS

HB 176 (As Introduced)

     HCA1( R. Rothenburger ) - Amend to require that the fee schedule be provided upon request.
     
HFA1( M. Meredith ) - Require licensed ambulance provider companies to post fees on their Web site only when the companies maintain a Web site.

    Jan 10, 2018 - introduced in House

PASSED

Apr 10, 2018 - signed by Governor (Acts, ch. 79)

 

HB 181 (BR 1066)A. ScottG. Brown JrJ. JenkinsM. MarzianR. MeeksD. OwensR. Palumbo


     AN ACT relating to hate crimes. 
     Amend KRS 532.031 to remove language relating to an offense committed as a result of a hate crime because of the individual's actual or perceived employment as a city, county, state, or federal peace officer, member of an organized fire department, or emergency medical services personnel; remove language defining "emergency medical services personnel."

     Jan 11, 2018 - introduced in House
     Jan 17, 2018 - to Judiciary (H)

Died in Committee

 

HB 185 / AA/FN (BR 1005)J. BlantonL. BelcherK. BratcherL. BrownM. CantrellJ. CarneyT. CouchJ. DonohueK. Fleming K. FloodC. FugateA. GentryJ. Gooch Jr.D. HaleM. HartR. HeathR. HuffK. ImesJ. JenkinsK. KingS. LeeR. MeyerJ. MillerR. MillsC. MorganK. MoserR. NelsonJ. NemesD. OsborneR. PalumboP. PrattM. PruntyB. ReedJ. RichardsR. RothenburgerS. SantoroD. SchamoreJ. ShellJ. Sims JrD. St. OngeJ. Stewart IIIW. ThomasJ. TiptonR. WebberS. WestromA. WuchnerJ. York

     AN ACT relating to death-in-line-of-duty benefits and declaring an emergency.
     Amend KRS 16.505 to include in the definition of "dependent child," solely as it applies to a member who dies as a direct result of an act in line of duty or a duty-related injury, a disabled child of any age; define "monthly average pay" to mean the higher of a member's final rate of pay or average monthly creditable compensation earned during the deceased member's last 12 months of employment; amend KRS 16.601 and 61.621 to increase minimum act in line of duty or duty-related death benefits payable to the surviving spouse of a member of any of the systems administered by the Kentucky Retirement Systems from 25% to 75% of the deceased member's monthly average pay and, if there is no surviving spouse, to the dependent children at the rate of 50% for one dependent child, 65% for two dependent children, and 75% for three or more dependent children; amend KRS 61.510 to define "monthly average pay"; amend KRS 61.542 to provide that the surviving spouse shall supersede all previously designated beneficiaries in the case of line-of-duty death benefits payable from the systems administered by the Kentucky Retirement Systems unless the member files a valid beneficiary designation form after marriage to his or her spouse; amend KRS 61.702 to ensure full and timely hospital and medical insurance benefits for the spouse and dependents of a member who died as a direct result of an act in line of duty or duty-related injury; amend KRS 78.510 to define "monthly average pay"; provide that an
eligible surviving spouse of a member who died as a result of an act line of duty or duty-related injury prior to the effective date of the Act shall receive the increased line of duty or duty-related death benefits; provide that a surviving spouse of a hazardous duty member who died as a result of an act in line of duty on or after January 1, 2017, who was ineligible for the minimum monthly death benefits because he or she was not named beneficiary shall be eligible for the benefits provided by this Act; EMERGENCY.

AMENDMENTS

HB 185 (As Introduced)

     HCS1/AA - Retain original provisions except to amend KRS 16.601 and 61.621 to provide that the monthly payments to a surviving spouse of a system member who dies in the line of duty shall be reduced upon remarriage; amend KRS 61.702 to make technical amendments; EMERGENCY.
     
HFA1( J. Blanton ) - Amend to provide that payments to the surviving spouse shall be reduced to 25% of pay upon remarriage.
     
SFA1( R. Jones II ) - Provide that Act may be cited as the Officer Scotty Hamilton and Officer Nick Rodman Memorial Act of 2018.
     
SFA2( M. McGarvey ) - Retain original provisions, except to clarify that a disabled dependent child for purposes of line of duty benefits shall not be subject to benefit limitations based upon age.

PASSED

Apr 13, 2018 - signed by Governor (Acts, ch. 153)

 

HB 279 (BR 1181)R. RothenburgerM. HartC. McCoyP. PrattJ. Sims Jr

     AN ACT relating to emergency medical services.
    Amend KRS 311A.010 to define "advanced emergency medical technician" and "emergency medical responder, " and update other definitions; amend KRS 311A.015 to change "first responder" to "emergency medical responder"; amend KRS 311A.020 to change "first responder" to "emergency medical responder"; add certification of advanced emergency medical technicians; amend KRS 311A.025 to change "first responder" to "emergency medical responder"; amend KRS 311A.030 to update licensing categories; amend KRS 311A.050 to change "first responder" to "emergency medical responder"; add advanced emergency medical technicians; amend KRS 311A.055 to change "first responder" to "emergency medical responder"; add advanced emergency medical technicians; amend KRS 311A.060 change "first responder" to "emergency medical responder"; add advanced emergency medical technicians; amend KRS 311A.065 to update psychological or physical evaluation requirements; amend KRS 311A.075 to update board membership; amend KRS 311A.095 to change "first responder" to "emergency medical responder"; add advanced emergency medical
technicians; add electronic mail application requirements; delete outdated transition language; amend KRS 311A.105 to add electronic mailing requirements; amend KRS 311A.120 to change "first responder" to "emergency medical responder"; add advanced emergency medical technicians and paramedics; amend KRS 311A.125 to delete contiuing competency documentation requirement; amend KRS 311A.130 to change "first responder" to "emergency medical responder"; add advanced emergency medical technicians; amend KRS 311A.140 to clarify certification and licensure requirements; change "first responder" to "emergency medical responder"; add advanced emergency medical technicians; amend KRS 311A.190 to change "run form" to "patient care record"; create new section of KRS Chapter 311A to set requirements for advanced emergency medical technicians; amend KRS 95A.262,189.910, and 311.550 to conform; repeal KRS 311A.110, 311A.115, and 311A.127.

     Jan 31, 2018 - introduced in House
     Feb 16, 2018 - 3rd reading, passed 84-0

Died in the Senate Committee

 

  HB 361 (BR 594) T. Moore

     AN ACT relating to reorganization.
     Amend KRS 65.7623 to adjust the membership of the Kentucky 911 Services Board; establish terms of service on board; provide for an administrative relationship with the Office of Homeland Security; amend KRS 65.7625 to delineate the financial responsibilities of the board and the Office of Homeland Security; confirm Executive Order 2017-298.
     Feb 13, 2018 - introduced in House
     Feb 15, 2018 - to Veterans, Military Affairs, and Public Protection (H)

Died in Committee

 

HB 424 (BR 1766)J. CarneyD. Osborne

     AN ACT relating to the Kentucky 911 Services Board.
     Amend KRS 65.7623 to reconstitute the Kentucky 911 Services Board; establish means and terms of service on board; provide for an administrative relationship with the Office of Homeland Security; exempt the board from the provisions of KRS 12.028; amend KRS 65.7625 to delineate the financial responsibilities of the board and the Office of Homeland Security.

AMENDMENTS

HB 424 (As Introduced)

     HCS1 - Retain original provisions, except adjust board membership of the Kentucky 911 Services Board under KRS 65.7623 to seven; remove the commissioner of the Department for Local Government and the director of the Division of Emergency management; one elected city official appointed by KLC, one elected county official appointed by KACo; one director of a PSAP, one representative rotating between city and county officials, and one member representing CMRS providers, all appointed by the Governor; establish terms of service on the board depending on member; establish an advisory council; specify that only those costs associated directly with the administration of CMRS related duties shall be eligible for payment from funds under KRS 65.7631(2); amend KRS 65.7631 to increase the non-obligated CMRS fund balance from $2,000,000 to $3,000,000 before it is distributed to eligible PSAPs.
     
HFA1( J. Carney ) - Amend membership of the board to reflect that the director of a certified PSAP shall be jointly appointed by the Kentucky Association of Public-Safety Communications Officials and the Kentucky Emergency Number Association; amend membership of the advisory council to reflect that the representatives to the Kentucky Association of Public-Safety Communications Officials and the Kentucky Emergency Number Association be chosen by the executive director of the Office of Homeland Security from a list of three names submitted by each organization.

Mar 29, 2018 - 3rd reading, passed 36-1; received in House; enrolled, signed by Speaker of the House; enrolled, signed by President of the Senate; delivered to Governor

PASSED

Apr 10, 2018 - signed by Governor (Acts, ch. 138)

 

 HB 428 (BR 288) K. MoserA. WuchnerJ. Gooch Jr.J. NemesD. St. Onge


     AN ACT relating to opioid overdose.
     Create a new section of KRS Chapter 222 to provide for an opioid assessment detention at an appropriate medical facility when a person has had an opioid overdose and been treated with naloxone or another opioid overdose intervention 

AMENDMENTS

HB 428 (As Introduced)

HCS1/FN - Create a new section of KRS Chapter 222 to provide for an immediate detention at an appropriate medical facility within particular service areas when a person has had an opioid overdose and been treated with naloxone or another opioid overdose intervention drug.

     HFA1( K. Moser ) - Amend to add psychiatric hospital to appropriate facility; add that admission may be ordered under KRS 202A.011; require release within 72 hours unless detained under law or for further treatment; require the Department for Behavioral Health, Developmental and Intellectual Disabilities to collect data; require appropriate facilities, qualified health professionals, and alcohol and drug peer support specialist to report data; add assessment and medically necessary treatment to Medicaid coverage; change coverage to the Medicaid Program and Medicaid managed care organizations.Feb 21, 2018 - introduced in House Mar 20, 2018 - 3rd reading, passed 92-3 with Committee Substitute and floor amendment (1)

Mar 21, 2018 - received in Senate; taken from Committee on Committees (S); 1st reading; to Health & Welfare (S)

Died in Committee

 

MEDICARE

 

Congress Extends Ambulance Add-Ons, Cuts ESRD, (End-Stage Renal Disease) Transport Reimbursement, and Requires Cost Data Collection

Ambulance Add-on Payments

Congress passed a five-year extension of the following Medicare add-on payments:

  • 2% increase for transports originating in urban areas
  • 3%  increase for transports originating in rural areas
  • 22.6% increase for transports originating in super-rural areas

The continuation of these add-ons is retroactive to January 1, 2018, meaning ambulance services will be reimbursed by Medicare with the add-on amounts on all claims with dates of service on or after January 1, 2018, , just as they were from July 1, 2008 through December 31, 2017.  Hopefully CMS will issue guidance concerning how contractors will handle claims that were already processed after the add-ons expired at the end of 2017, but have now been retroactively reinstated. 

The BBA extends the so-called add-on payments for a full five years – they will now expire on December 31, 2022.

Additional Reduction in Medicare ESRD Transport Payments

Congress said that to pay for the 5-year add-on extension, it is once again reducing reimbursement (calling it an “offset”) for transports of non-emergency ESRD patients by an additional 13%.  Congress had previously reduced Medicare reimbursement for non-emergency transports of ESRD beneficiaries by 10% beginning on October 1, 2013.  Under this Bill, the reduction for these transports will increase by 13%, bringing the total reduction for non-emergency ESRD transports to 23% beginning on October 1, 2018. 

Ambulance Cost Data System

Finally, HHS is required to develop a “data collection system” (which may include use of a cost survey) to collect cost, revenue, utilization, and other information from ground ambulance providers and suppliers. (This measure does not apply to air ambulance services). HHS will collect cost information on:

·        Whether reported costs actually relate to ambulance payment rates;

·         The utilization of capital equipment and ambulance capacity; and

 Different types of ground ambulance services furnished in different geographic locations.

By December 31, 2019, HHS is to identify a “representative sample” of ground ambulance services to submit cost data. The sample must be representative of the different types of ground ambulance services (e.g., emergency, non-emergency, governmental) from a mixture of urban, rural, and low population density areas.  No specific information is contained in the BBA about the size of the sample, or the specific details of the cost reporting system as the law gives the Secretary of HHS broad discretion is developing the data collection system.   

Before 2024, ground ambulance services may not be selected to submit a cost report in two consecutive years.  After 2024, HHS shall require ground ambulance services to submit cost data “as HHS determines” – but not less than once every three years.  (The initial measure passed by the House of Representatives would have required all ambulance services to submit cost reporting data at the outset).  

The good news here is that the BBA requires the Medicare Payment Advisory Commission – by March 15, 2023 - to assess and complete a report on the data collected, adequacy of payments to ground ambulance services, and the geographic variations in costs of providing ambulance service.  The report must also contain an analysis of the burden on ambulance services associated with the data collection system, and a recommendation as to whether the data collection system should continue or if it should be revised.   

The Penalty: If an ambulance service fails to report required cost data when requested, HHS shall reduce Medicare payments to that service by 10% for one year. There is a “hardship exception” to the penalty  if HHS determines an “event of significant hardship” interfered with the ability for a ground ambulance service to submit a cost report in a timely manner.

Joe Prewitt, Legislative Committee