AN ACT relating to gender transition services.

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AN ACT relating to gender transition services. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
SECTION 1. A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 3
READ AS FOLLOWS: 4
(1) As used in this section: 5
(a) "Gender transition services": 6
1. Means surgical, medical, mental health, or pharmaceutical services 7
that are performed for the purpose of altering the appearance of an 8
individual's sex or validating or affirming an individual's perception 9
of the individual's sex, if that appearance or perception is inconsistent 10
with the individual's sex; 11
2. Includes but is not limited to the following surgical, medical, mental 12
health, and pharmaceutical services, if performed for the purposes 13
stated in subparagraph 1. of this paragraph: 14
a. Prescribing or administering any drug, including testosterone, 15
estrogen, or progesterone; 16
b. Performing any sterilizing surgery, including castration, 17
hysterectomy, oophorectomy, orchiectomy, penectomy, and 18
vasectomy; 19
c. Performing any surgery that artificially constructs tissue having 20
the appearance of genitalia differing f rom the individual's sex, 21
including metoidioplasty, phalloplasty, and vaginoplasty; 22
d. Removing any healthy or non diseased body part or tissue; and 23
e. Providing any counseling or therapy; and 24
3. Does not include surgical, medical, mental health, or pharma ceutical 25
services provided to an individual: 26
a. Born with a medically verifiable disorder of sex development, 27
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including external biological sex characteristics that are 1
irresolvably ambiguous; 2
b. Diagnosed with a disorder of sexual development, if a health 3
care provider has determined, through genetic or biochemical 4
testing, that the individual does not have a sex chromosome 5
structure, sex steroid hormone production, or sex steroid 6
hormone action that is normal for a biological male or biological 7
female; or 8
c. Needing treatment for an infection, injury, disease, or disorder 9
that has been caused or exacerbated by surgical, medical, mental 10
health, or pharmaceutical services performed for the purposes 11
stated in subparagraph 1. of this paragraph; 12
(b) "Health care provider" means any person, agency, clinic, or facility that is: 13
1. Engaged in the rendering of any surgical, medical, mental health, or 14
pharmaceutical services; and 15
2. Licensed, certified, or otherwise regulated in this state or subject to 16
regulation in this state; 17
(c) "Health plan" means any policy, certificate, contract, or plan that offers or 18
provides coverage in this state for surgical, medical, mental health, or 19
pharmaceutical services: 20
1. By direct payment, reimbursement, or otherwise; and 21
2. On a fully insured or self-insured basis or any combination thereof; 22
(d) "Sex" means the biological indication of male and female as evidenced by 23
sex chromosomes, naturally occurring sex hormones, gonads, and 24
nonambiguous internal and external genitalia present at birth; and 25
(e) "State or local government" means this state or any local government of 26
this state, including: 27
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1. Any agency, board, bureau, department, council, commission, 1
committee, government corporation, institution, legislative body, 2
authority, ho spital, clinic, political subdivision, instrumentality, or 3
other entity of this state; 4
2. Any city, county, charter county government, urban -county 5
government, consolidated local government, unified local government, 6
public school district, public institut ion of education, special district, 7
hospital district, or municipal corporation of this state; and 8
3. Any agency, board, bureau, department, council, commission, 9
committee, institution, legislative body, authority, hospital, clinic, 10
entity, or other instru mentality, of an entity referenced in 11
subparagraph 2. of this paragraph. 12
(2) A health care provider shall not: 13
(a) Render gender transition services to any individual in the course and scope 14
of employment by a state or local government; or 15
(b) Seek or acce pt payment or reimbursement for the rendering of gender 16
transition services to any individual from any of the following: 17
1. A state or local government, including: 18
a. A person contracted with a state or local government to provide 19
or administer a health plan; and 20
b. A health plan offered or sponsored by a state or local 21
government; or 22
2. A federal agency providing or administering Medicare benefits to or 23
on behalf of a Medicare beneficiary in this state, including a: 24
a. Person contracted with a federal agency to provide or administer 25
Medicare benefits in this state; and 26
b. Health plan that provides Medicare benefits that are publicly 27
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funded or subsidized. 1
(3) (a) State or local government funds shall not be directly or indirectly used, 2
granted, paid, or distributed to any entity, organization, or individual for the 3
provision or subsidy of any gender transition services. 4
(b) Paragraph (a) of this subsection includes but is not limited to a prohibition 5
on the use of: 6
1. Any state or local government property, facility, or building to provide 7
or subsidize any gender transition services; and 8
2. Federal funds by a state or local government to provide or subsidize 9
any gender transition services. 10
(4) (a) If a licensing, certifying, or other regulatory authority for a health care 11
provider finds, in accordance with the agency's disciplinary and hearin g 12
process, that a health care provider has violated this section, the authority 13
shall revoke the health care provider's licensure, certification, or other 14
authorization to provide services in this state. 15
(b) An intentional violation of this section by a pu blic servant shall be a 16
violation of KRS 522.030. 17
Section 2. KRS 15.241 is amended to read as follows: 18
(1) The Attorney General may seek injunctive relief as well as civil and criminal 19
penalties in courts of proper jurisdiction to prevent, penalize, and remedy violations 20
of: 21
(a) KRS Chapter 216B regarding abortion facilities and the administrative 22
regulations promulgated in furtherance thereof; 23
(b) KRS 311.710 to 311.830 regarding abortions and the administrative 24
regulations promulgated in furtherance thereof;[ and] 25
(c) KRS Chapter 39A and any orders or directives issued thereunder relating to 26
elective medical procedures, including but not limited to abortions; and 27
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(d) KRS 311.372 and Section 1 of this Act regarding gender transition services. 1
(2) Nothing in this section shall limit or preclude such authority as the secretary of the 2
Cabinet for Health and Family Services has to seek the relief set forth in subsection 3
(1) of this section. 4
Section 3. KRS 156.496 is amended to read as follows: 5
(1) Family resource and youth services centers shall be designed to meet the needs of 6
children and their families by providing services to enhance a student's ability to 7
succeed in school. If resources are limited, students and families who are the most 8
economically disadvantaged shall receive priority status for receiving services. 9
(2) Family resource centers shall be located in or near each elementary school in the 10
Commonwealth in which twenty percent (20%) or more of the student body are 11
eligible for free or reduced -price school meals. Family resource centers shall 12
promote identification and coordination of existing resources and shall include but 13
not be limited to the following core components for each site: 14
(a) Full-time preschool child care for children two (2) and three (3) years of age; 15
(b) After-school child care for children ages four (4) through twelve (12), with 16
the child care being full -time during the summer and on other days when 17
school is not in session; 18
(c) Families in training, which shall consist of an integrated approach to home 19
visits, group meetings, and monitoring child development for new and 20
expectant parents; 21
(d) Family literacy services as described in KRS 158.360 or a similar pro gram 22
designed to provide opportunities for parents and children to learn together 23
and promote lifelong learning; and 24
(e) Health services or referrals to health services, or both. 25
(3) Youth se rvices centers shall be located in or near each school in the 26
Commonwealth, except elementary schools, in which twenty percent (20%) or more 27
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of the student body are eligible for free or reduced -price school meals. Youth 1
services centers shall promote ident ification and coordination of existing resources 2
and shall include but not be limited to the following core components for each site: 3
(a) Referrals to health and social services; 4
(b) Career exploration and development; 5
(c) Summer and part-time job development for high school students; 6
(d) Substance abuse education and counseling; and 7
(e) Family crisis and mental health counseling. 8
(4) A grant program is hereby established to provide financial assistance to eligible 9
school districts to establish or maintain family resource or youth services centers. 10
The Cabinet for Health and Family Services shall award grants pursuant to KRS 11
156.4977. Funding provided to the Cabinet for Health and Family Services for the 12
grant program and agency administrative costs shall in clude an increase that is 13
equal to or greater than the general fund growth factor provided in agency budget 14
instructions. 15
(5) A family resource or youth services center that receives funding for one (1) year or 16
more shall not be considered ineligible for f unding based solely on the percent of 17
the student body eligible for free or reduced -price school meals unless the percent 18
of the student body eligible for free or reduced -price school meals is below twenty 19
percent (20%) for five (5) consecutive years. 20
(6) A school district shall not operate a family resource center or a youth services 21
center that: 22
(a) Provides abortion counseling or gender transition services, as defined in 23
Section 1 of this Act; or 24
(b) Makes referrals to a health care facility for the purp ose of seeking an abortion 25
or gender transition services, as defined in Section 1 of this Act. 26
(7) A school district may accept monetary donations for the operation and maintenance 27
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of family resource and youth services centers. Any donations given to the s chool 1
district for the operation and maintenance of family resource and youth services 2
centers shall be used only for the operation and maintenance of family resource and 3
youth services centers, and for no other purpose. 4
Section 4. KRS 39A.180 is amended to read as follows: 5
(1) The political subdivisions of the state and other agencies designated or appointed by 6
the Governor may make, amend, and rescind orders and promulgate administrative 7
regulations necessary for disast er and emergency response purposes, and to 8
supplement the carrying out of the provisions of this chapter, if not inconsistent 9
with any orders or administrative regulations promulgated by the Governor or by 10
any state agency exercising a power delegated to it by the Governor. 11
(2) (a) All written orders and administrative regulations promulgated by the 12
Governor, the director, or by any political subdivision or other agency 13
authorized by KRS Chapters 39A to 39F to make orders and promulgate 14
administrative regulations, shall have the full force of law and, if promulgated 15
as administrative regulations, shall follow the requirements for promulgating 16
administrative regulations under KRS Chapter 13A. All written orders 17
authorized by KRS Chapters 39A to 39F shall be f iled with the Legislative 18
Research Commission. 19
(b) The Governor may suspend a statute by executive order when an emergency 20
is declared under this chapter if: 21
1. The statute is specifically enumerated by the Governor in the executive 22
order; and 23
2. The execu tive order specifying the suspension is approved by the 24
Attorney General in writing. 25
(c) A statute suspension authorized in paragraph (b) of this subsection shall only 26
be in effect while the emergency executive order is in effect. 27
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(d) Any existing administ rative regulation that conflicts with a written order 1
issued under this chapter shall be amended, withdrawn, or repealed in 2
accordance with KRS Chapter 13A to conform with the written order. 3
(e) When a written order ends, any administrative regulation prom ulgated under 4
the authority of this section shall: 5
1. Become void; and 6
2. Be withdrawn, amended, or repealed in accordance with KRS Chapter 7
13A. 8
(3) Notwithstanding subsection (2) of this section, the Governor shall not suspend any 9
laws in KRS Chapters 39A to 39F, Chapter 13A, 446.350, 527.020, 311.372, 10
Section 1 of this Act, 311.710 to 311.820, or any other statutes related to abortion 11
or gender transition services, as defined in Section 1 of this Act. 12
(4) The law enforcement authorities of the state and o f its counties, urban -counties, 13
charter counties, and cities shall enforce the written orders and administrative 14
regulations issued pursuant to KRS Chapters 39A to 39F. 15
Section 5. KRS 205.5365 is amended to read as follows: 16
(1) As used in this section, "gender transition services" has the same meaning as in 17
Section 1 of this Act. 18
(2) Notwithstanding any provision of law to the contrary and unless required under 19
federal law, the Department for Medicaid Services ,[ and] any managed care 20
organization with whom the department contracts for the delivery of Medicaid 21
services, and the state's medical assistance program are hereby prohibited from 22
expending any Medicaid funds on , or provid ing benefits or coverage for, gender 23
transition services, including but not limited to[ any of the following]: 24
(a)[(1)] Cross-sex hormones when prescribed or administered primarily or solely 25
for the treatment of gender dysphoria; and 26
(b)[(2)] Gender reassignment surgery to alter or remove physical or anatomical 27
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characteristics or features that are typical for and characteristic of a person's 1
biological sex. 2
SECTION 6. A NEW SECTION OF KRS 205.6481 TO 205.6495 IS 3
CREATED TO READ AS FOLLOWS: 4
(1) As used in this section: 5
(a) "Gender transition services" has the same meaning as in Section 1 of this 6
Act; and 7
(b) "KCHIP" means: 8
1. The state child health plan known as the Kentucky Children's Health 9
Insurance Program; or 10
2. Any plan submitted for federal approval of a children's health 11
insurance program for Kentucky under Title XXI of the Federal 12
Social Security Act. 13
(2) KCHIP shall not reimburse or provide benefits or cover age for gender transition 14
services. 15
SECTION 7. A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 16
IS CREATED TO READ AS FOLLOWS: 17
(1) As used in this section, the following have the same meaning as in Section 1 of 18
this Act: 19
(a) "Gender transition services"; 20
(b) "Health plan"; and 21
(c) "State or local government." 22
(2) All of the following shall not reimburse or provide benefits or coverage for 23
gender transition services: 24
(a) A health plan offered or sponsored by a state or local government; and 25
(b) A health plan, including Medicare supplement insurance, that provides 26
Medicare benefits that are publicly funded or subsidized. 27
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Section 8. KRS 18A.225 is amended to read as follows: 1
(1) (a) The term "employee" for purposes of this section means: 2
1. Any person, including an elected public official, who is regularly 3
employed by any department, office, board, agency, or branch of state 4
government; or by a public postsecondary educational institution; o r by 5
any city, urban -county, charter county, county, or consolidated local 6
government, whose legislative body has opted to participate in the state -7
sponsored health insurance program pursuant to KRS 79.080; and who 8
is either a contributing member to any on e (1) of the retirement systems 9
administered by the state, including but not limited to the Kentucky 10
Retirement Systems, County Employees Retirement System, Kentucky 11
Teachers' Retirement System, the Legislators' Retirement Plan, or the 12
Judicial Retirement Plan; or is receiving a contractual contribution from 13
the state toward a retirement plan; or, in the case of a public 14
postsecondary education institution, is an individual participating in an 15
optional retirement plan authorized by KRS 161.567; or is eligib le to 16
participate in a retirement plan established by an employer who ceases 17
participating in the Kentucky Employees Retirement System pursuant to 18
KRS 61.522 whose employees participated in the health insurance plans 19
administered by the Personnel Cabinet p rior to the employer's effective 20
cessation date in the Kentucky Employees Retirement System; 21
2. Any certified or classified employee of a local board of education or a 22
public charter school as defined in KRS 160.1590; 23
3. Any elected member of a local board of education; 24
4. Any person who is a present or future recipient of a reti rement 25
allowance from the Kentucky Retirement Systems, County Employees 26
Retirement System, Kentucky Teachers' Retirement System, the 27
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Legislators' Retirement Plan, the Judicial Retirement Plan, or the 1
Kentucky Community and Technical College System's option al 2
retirement plan authorized by KRS 161.567, except that a person who is 3
receiving a retirement allowance and who is age sixty -five (65) or older 4
shall not be included, with the exception of persons covered under KRS 5
61.702(2)(b)3. and 78.5536(2)(b)3., un less he or she is actively 6
employed pursuant to subparagraph 1. of this paragraph; and 7
5. Any eligible dependents and beneficiaries of participating employees 8
and retirees who are entitled to participate in the state -sponsored health 9
insurance program; 10
(b) The term "health benefit plan" for the purposes of this section means a health 11
benefit plan as defined in KRS 304.17A-005; 12
(c) The term "insurer" for the purposes of this section means an insurer as defined 13
in KRS 304.17A-005; and 14
(d) The term "managed ca re plan" for the purposes of this section means a 15
managed care plan as defined in KRS 304.17A-500. 16
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 17
recommendation of the secretary of the Personnel Cabinet, shall procure, in 18
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 19
from one (1) or more insurers authorized to do business in this state, a group 20
health benefit plan that may include but not be limited to health maintenance 21
organization (HMO), preferred provide r organization (PPO), point of service 22
(POS), and exclusive provider organization (EPO) benefit plans 23
encompassing all or any class or classes of employees. With the exception of 24
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 25
all employers of any class of employees or former employees shall enter into 26
a contract with the Personnel Cabinet prior to including that group in the state 27
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health insurance group. The contracts shall include but not be limited to 1
designating the entity respon sible for filing any federal forms, adoption of 2
policies required for proper plan administration, acceptance of the contractual 3
provisions with health insurance carriers or third -party administrators, and 4
adoption of the payment and reimbursement methods n ecessary for efficient 5
administration of the health insurance program. Health insurance coverage 6
provided to state employees under this section shall, at a minimum, contain 7
the same benefits as provided under Kentucky Kare Standard as of January 1, 8
1994, a nd shall include a mail -order drug option as provided in subsection 9
(13) of this section. All employees and other persons for whom the health care 10
coverage is provided or made available shall annually be given an option to 11
elect health care coverage throug h a self -funded plan offered by the 12
Commonwealth or, if a self -funded plan is not available, from a list of 13
coverage options determined by the competitive bid process under the 14
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 15
during annual open enrollment. 16
(b) The policy or policies shall be approved by the commissioner of insurance 17
and may contain the provisions the commissioner of insurance approves, 18
whether or not otherwise permitted by the insurance laws. 19
(c) Any carrier bidding to off er health care coverage to employees shall agree to 20
provide coverage to all members of the state group, including active 21
employees and retirees and their eligible covered dependents and 22
beneficiaries, within the county or counties specified in its bid. Exc ept as 23
provided in subsection (20) of this section, any carrier bidding to offer health 24
care coverage to employees shall also agree to rate all employees as a single 25
entity, except for those retirees whose former employers insure their active 26
employees out side the state -sponsored health insurance program and as 27
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otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 1
(d) Any carrier bidding to offer health care coverage to employees shall agree to 2
provide enrollment, claims, and utilization data to the Commonwealth in a 3
format specified by the Personnel Cabinet with the understanding that the data 4
shall be owned by the Commonwealth; to provide data in an electronic form 5
and within a time frame specified by the Personnel Cabinet; and to be subject 6
to penalties for noncompliance with data reporting requirements as specified 7
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 8
to protect the confidentiality of each individual employee; however, 9
confidentiality assertions shall no t relieve a carrier from the requirement of 10
providing stipulated data to the Commonwealth. 11
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 12
for timely analysis of data received from carriers and, to the extent possible, 13
provide in the request -for-proposal specifics relating to data requirements, 14
electronic reporting, and penalties for noncompliance. The Commonwealth 15
shall own the enrollment, claims, and utilization data provided by each carrier 16
and shall develop methods to p rotect the confidentiality of the individual. The 17
Personnel Cabinet shall include in the October annual report submitted 18
pursuant to the provisions of KRS 18A.226 to the Governor, the General 19
Assembly, and the Chief Justice of the Supreme Court, an analysi s of the 20
financial stability of the program, which shall include but not be limited to 21
loss ratios, methods of risk adjustment, measurements of carrier quality of 22
service, prescription coverage and cost management, and statutorily required 23
mandates. If sta te self-insurance was available as a carrier option, the report 24
also shall provide a detailed financial analysis of the self -insurance fund 25
including but not limited to loss ratios, reserves, and reinsurance agreements. 26
(f) If any agency participating in t he state-sponsored employee health insurance 27
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program for its active employees terminates participation and there is a state 1
appropriation for the employer's contribution for active employees' health 2
insurance coverage, then neither the agency nor the emplo yees shall receive 3
the state -funded contribution after termination from the state -sponsored 4
employee health insurance program. 5
(g) Any funds in flexible spending accounts that remain after all reimbursements 6
have been processed shall be transferred to the credit of the state -sponsored 7
health insurance plan's appropriation account. 8
(h) Each entity participating in the state-sponsored health insurance program shall 9
provide an amount at least equal to the state contribution rate for the employer 10
portion of the health insurance premium. For any participating entity that used 11
the state payroll system, the employer contribution amount shall be equal to 12
but not greater than the state contribution rate. 13
(3) The premiums may be paid by the policyholder: 14
(a) Wholly fr om funds contributed by the employee, by payroll deduction or 15
otherwise; 16
(b) Wholly from funds contributed by any department, board, agency, public 17
postsecondary education institution, or branch of state, city, urban -county, 18
charter county, county, or consolidated local government; or 19
(c) Partly from each, except that any premium due for health care coverage or 20
dental coverage, if any, in excess of the premium amount contributed by any 21
department, board, agency, postsecondary education institution, or branc h of 22
state, city, urban -county, charter county, county, or consolidated local 23
government for any other health care coverage shall be paid by the employee. 24
(4) If an employee moves his or her place of residence or employment out of the 25
service area of an in surer offering a managed health care plan, under which he or 26
she has elected coverage, into either the service area of another managed health care 27
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plan or into an area of the Commonwealth not within a managed health care plan 1
service area, the employee sha ll be given an option, at the time of the move or 2
transfer, to change his or her coverage to another health benefit plan. 3
(5) No payment of premium by any department, board, agency, public postsecondary 4
educational institution, or branch of state, city, ur ban-county, charter county, 5
county, or consolidated local government shall constitute compensation to an 6
insured employee for the purposes of any statute fixing or limiting the 7
compensation of such an employee. Any premium or other expense incurred by any 8
department, board, agency, public postsecondary educational institution, or branch 9
of state, city, urban -county, charter county, county, or consolidated local 10
government shall be considered a proper cost of administration. 11
(6) The policy or policies may contain the provisions with respect to the class or classes 12
of employees covered, amounts of insurance or coverage for designated classes or 13
groups of employees, policy options, terms of eligibility, and continuation of 14
insurance or coverage after retirement. 15
(7) Group rates under this section shall be made available to the disabled child of an 16
employee regardless of the child's age if the entire premium for the disabled child's 17
coverage is paid by the state employee. A child shall be considered disabled if h e or 18
she has been determined to be eligible for federal Social Security disability benefits. 19
(8) The health care contract or contracts for employees shall be entered into for a 20
period of not less than one (1) year. 21
(9) The secretary shall appoint thirty -two (32) persons to an Advisory Committee of 22
State Health Insurance Subscribers to advise the secretary or the secretary's 23
designee regarding the state -sponsored health insurance program for employees. 24
The secretary shall appoint, from a list of names submit ted by appointing 25
authorities, members representing school districts from each of the seven (7) 26
Supreme Court districts, members representing state government from each of the 27
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seven (7) Supreme Court districts, two (2) members representing retirees under a ge 1
sixty-five (65), one (1) member representing local health departments, two (2) 2
members representing the Kentucky Teachers' Retirement System, and three (3) 3
members at large. The secretary shall also appoint two (2) members from a list of 4
five (5) names submitted by the Kentucky Education Association, two (2) members 5
from a list of five (5) names submitted by the largest state employee organization of 6
nonschool state employees, two (2) members from a list of five (5) names submitted 7
by the Kentucky Associ ation of Counties, two (2) members from a list of five (5) 8
names submitted by the Kentucky League of Cities, and two (2) members from a 9
list of names consisting of five (5) names submitted by each state employee 10
organization that has two thousand (2,000) o r more members on state payroll 11
deduction. The advisory committee shall be appointed in January of each year and 12
shall meet quarterly. 13
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 14
provided to employees pursuant to this section shall not provide coverage for 15
obtaining or performing an abortion, nor shall any state funds be used for the 16
purpose of obtaining or performing an abortion on behalf of employees or their 17
dependents. 18
(11) Interruption of an established treat ment regime with maintenance drugs shall be 19
grounds for an insured to appeal a formulary change through the established appeal 20
procedures approved by the Department of Insurance, if the physician supervising 21
the treatment certifies that the change is not in the best interests of the patient. 22
(12) Any employee who is eligible for and elects to participate in the state health 23
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 24
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 25
state health insurance contribution toward health care coverage as a result of any 26
other employment for which there is a public employer contribution. This does not 27
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preclude a retiree and an active employee spouse from using both contributions to 1
the extent needed for purchase of one (1) state sponsored health insurance policy 2
for that plan year. 3
(13) (a) The policies of health insurance coverage procured under subsection (2) of 4
this section shall include a mail -order drug option for maintenance drugs for 5
state employees. Maintenance drugs may be dispensed by mail order in 6
accordance with Kentucky law. 7
(b) A health insurer shall not discriminate against any retail pharmacy located 8
within the geographic coverage area of the health benefit plan and that meets 9
the terms and conditions for participation established by the insurer, including 10
price, dispensing fee , and copay requirements of a mail -order option. The 11
retail pharmacy shall not be required to dispense by mail. 12
(c) The mail -order option shall not permit the dispensing of a controlled 13
substance classified in Schedule II. 14
(14) The policy or policies provi ded to state employees or their dependents pursuant to 15
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 16
aid-related services for insured individuals under eighteen (18) years of age, subject 17
to a cap of one thousand fou r hundred dollars ($1,400) every thirty -six (36) months 18
pursuant to KRS 304.17A-132. 19
(15) Any policy provided to state employees or their dependents pursuant to this section 20
shall provide coverage for the diagnosis and treatment of autism spectrum disorder s 21
consistent with KRS 304.17A-142. 22
(16) Any policy provided to state employees or their dependents pursuant to this section 23
shall provide coverage for obtaining amino acid -based elemental formula pursuant 24
to KRS 304.17A-258. 25
(17) If a state employee's resi dence and place of employment are in the same county, 26
and if the hospital located within that county does not offer surgical services, 27
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intensive care services, obstetrical services, level II neonatal services, diagnostic 1
cardiac catheterization services, a nd magnetic resonance imaging services, the 2
employee may select a plan available in a contiguous county that does provide 3
those services, and the state contribution for the plan shall be the amount available 4
in the county where the plan selected is located. 5
(18) If a state employee's residence and place of employment are each located in 6
counties in which the hospitals do not offer surgical services, intensive care 7
services, obstetrical services, level II neonatal services, diagnostic cardiac 8
catheterization services, and magnetic resonance imaging services, the employee 9
may select a plan available in a county contiguous to the county of residence that 10
does provide those services, and the state contribution for the plan shall be the 11
amount available in the county where the plan selected is located. 12
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 13
in the best interests of the state group to allow any carrier bidding to offer health 14
care coverage under this section to submi t bids that may vary county by county or 15
by larger geographic areas. 16
(20) Notwithstanding any other provision of this section, the bid for proposals for health 17
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 18
the statewide rating structure provided in calendar year 2003 and a bid scenario that 19
allows for a regional rating structure that allows carriers to submit bids that may 20
vary by region for a given product offering as described in this subsection: 21
(a) The regional rat ing bid scenario shall not include a request for bid on a 22
statewide option; 23
(b) The Personnel Cabinet shall divide the state into geographical regions which 24
shall be the same as the partnership regions designated by the Department for 25
Medicaid Services for purposes of the Kentucky Health Care Partnership 26
Program established pursuant to 907 KAR 1:705; 27
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(c) The request for proposal shall require a carrier's bid to include every county 1
within the region or regions for which the bid is submitted and include but not 2
be restricted to a preferred provider organization (PPO) option; 3
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 4
carrier all of the counties included in its bid within the region. If the Personnel 5
Cabinet deems the bid s submitted in accordance with this subsection to be in 6
the best interests of state employees in a region, the cabinet may award the 7
contract for that region to no more than two (2) carriers; and 8
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 9
other requirements or criteria in the request for proposal. 10
(21) Any fully insured health benefit plan or self -insured plan issued or renewed on or 11
after July 12, 2006, to public employees pursuant to this section which provides 12
coverage for services rendered by a physician or osteopath duly licensed under KRS 13
Chapter 311 that are within the scope of practice of an optometrist duly licensed 14
under the provisions of KRS Chapter 320 shall provide the same payment of 15
coverage to optometri sts as allowed for those services rendered by physicians or 16
osteopaths. 17
(22) Any fully insured health benefit plan or self -insured plan issued or renewed to 18
public employees pursuant to this section shall comply with: 19
(a) KRS 304.12-237; 20
(b) KRS 304.17A-270 and 304.17A-525; 21
(c) KRS 304.17A-600 to 304.17A-633; 22
(d) KRS 205.593; 23
(e) KRS 304.17A-700 to 304.17A-730; 24
(f) KRS 304.14-135; 25
(g) KRS 304.17A-580 and 304.17A-641; 26
(h) KRS 304.99-123; 27
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(i) KRS 304.17A-138; 1
(j) KRS 304.17A-148; 2
(k) KRS 304.17A-163 and 304.17A-1631; 3
(l) KRS 304.17A-265; 4
(m) KRS 304.17A-261; 5
(n) KRS 304.17A-262; 6
(o) KRS 304.17A-145; 7
(p) KRS 304.17A-129; 8
(q) KRS 304.17A-133; 9
(r) KRS 304.17A-264; and 10
(s) Administrative regulations promulgated pursuant to statutes listed in this 11
subsection. 12
(23) (a) Any fully insured health benefit plan or self-insured plan issued or renewed to 13
public employees pursuant to this section shall provide a special enrollment 14
period to pregnant women who are eligible for coverage in accordance w ith 15
the requirements set forth in KRS 304.17-182. 16
(b) The Department of Employee Insurance shall, at or before the time a public 17
employee is initially offered the opportunity to enroll in the plan or coverage, 18
provide the employee a notice of the special e nrollment rights under this 19
subsection. 20
(24) (a) As used in this subsection, "gender transition services" has the same 21
meaning as in Section 1 of this Act. 22
(b) Any fully insured health benefit plan or self -insured plan issued or renewed 23
to public employees pursuant to this section shall not reimburse or provide 24
benefits or coverage for gender transition services. 25
(c) State or local government funds shall not be used to provide or subsidize 26
gender transition services to public employees or their dependents. 27
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Section 9. KRS 164.2871 is amended to read as follows: 1
(1) The governing board of each state postsecondary educational institution is 2
authorized to purchase liability insurance for the protection of the individual 3
members of the governing board, faculty, and staff of such institutions from liability 4
for acts and omissions committed in the course and scope of the individual's 5
employment or service. Each institution may purchase the type and amount of 6
liability coverage deemed to best serve the interest of such institution. 7
(2) All retirement annuity allowances accrued or accruing to any employee of a state 8
postsecondary educational institution through a retirement program sponsored by 9
the state postsecondary educational ins titution are hereby exempt from any state, 10
county, or municipal tax, and shall not be subject to execution, attachment, 11
garnishment, or any other process whatsoever, nor shall any assignment thereof be 12
enforceable in any court. Except retirement benefits a ccrued or accruing to any 13
employee of a state postsecondary educational institution through a retirement 14
program sponsored by the state postsecondary educational institution on or after 15
January 1, 1998, shall be subject to the tax imposed by KRS 141.020, t o the extent 16
provided in KRS 141.010 and 141.0215. 17
(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for 18
members of governing boards, faculty and staff of institutions of higher education 19
in this state shall not be construed to be a waiver of sovereign immunity or any 20
other immunity or privilege. 21
(4) The governing board of each state postsecondary education institution is authorized 22
to provide a self -insured employer group health plan to its employees, which plan 23
shall: 24
(a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and 25
(b) Except as provided in subsection (5) of this section, be exempt from 26
conformity with Subtitle 17A of KRS Chapter 304. 27
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(5) A self-insured employer group health plan provided by the governing board of a 1
state postsecondary education institution to its employees shall comply with: 2
(a) KRS 304.17A-129; 3
(b) KRS 304.17A-133; 4
(c) KRS 304.17A-145; 5
(d) KRS 304.17A-163 and 304.17A-1631; 6
(e) KRS 304.17A-261; 7
(f) KRS 304.17A-262; 8
(g) KRS 304.17A-264; and 9
(h) KRS 304.17A-265. 10
(6) (a) A self-insured employer group health plan provided by the governing board of 11
a state postsecondary education institution to its employees shall provide a 12
special enrollment period to pregnant women who are eligible for coverage in 13
accordance with the requirements set forth in KRS 304.17-182. 14
(b) The governing board of a state postsecondary education institution shall, at or 15
before the time an employee is initially offered the opportunity to enroll in the 16
plan or coverage, provide the employee a notice of the special enrollment 17
rights under this subsection. 18
(7) (a) As used in this subsection, "gender transition services" has the same 19
meaning as in Section 1 of this Act. 20
(b) A self-insured employer group health plan provided by the governing board 21
of a state postsecondary education institution to its employees shall not 22
reimburse or provide benefits or coverage for gender transition services. 23
(c) State or local government funds shall not be used to provide or su bsidize 24
gender transition services to state postsecondary education institution 25
employees or their dependents. 26
Section 10. KRS 304.17C-125 is amended to read as follows: 27
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The following shall apply to limited health servic e benefit plans, including any limited 1
health service contract, as defined in KRS 304.38A-010: 2
(1) KRS 304.17A-129; 3
(2) KRS 304.17A-262;[ and] 4
(3) KRS 304.17A-591 to 304.17A-599; and 5
(4) Section 7 of this Act. 6
Section 11. KRS 605.110 is amended to read as follows: 7
(1) (a) Any child committed to or in the custody of the cabinet or the Department of 8
Juvenile Justice who is not placed in a location where smoking cessation 9
services are provided may participate in smoking cessation services offered by 10
local health departments or their contracted agents at no cost. 11
(b) Unless provided otherwise, when any child committed to or in the custody of 12
the Department of Juvenile Justice or the cabinet requires medical or surgical 13
care or treatment, the Department of Juvenile Justice or the cabinet may 14
provide the same or arrange for the furnishing thereof by other public or 15
private agencies, and may give consent to the medical or surgical treatment. 16
For this purpose, the services and faci lities of local health officers and 17
departments shall be made available, at a cost not to exceed the Medicaid 18
reimbursement rate, to the Department of Juvenile Justice or the cabinet, and 19
as far as practicable, any publicly owned hospital shall provide hos pitalization 20
without charge for any such child who is a resident of the political subdivision 21
by which the hospital is owned or operated. This section does not authorize 22
nor shall permission be granted for abortion ,[ or] sterilization, or gender 23
transition services, as defined in Section 1 of this Act. 24
(2) Any child placed in a foster home by an agency duly authorized in KRS Chapter 25
620 to place a child in a foster home shall receive a complete medical, visual, and 26
dental examination by a professional autho rized by the Kentucky Revised Statutes 27
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to conduct such examinations. Arrangements for a child placed in a foster home to 1
receive such examinations shall be made within two (2) weeks of his placement in a 2
foster home and not less than every twelve (12) months thereafter. 3
(3) Children maintained in any of the facilities and programs operated or contracted by 4
the Department of Juvenile Justice or the cabinet shall, so far as possible, receive a 5
common school education. 6
(a) The Kentucky Educational Collaborativ e for State Agency Children shall be 7
established to serve children in facilities and programs operated or contracted 8
by the Department of Juvenile Justice or the Cabinet for Health and Family 9
Services, residential, day treatment, clinical, and group home p rograms. All 10
policies and procedures necessary to educate state agency children shall be 11
approved by the Kentucky Board of Education. All duties, responsibilities, 12
rights, and privileges specifically imposed on or granted to the local education 13
administration units shall be imposed on or granted to the Department of 14
Juvenile Justice or the Cabinet for Health and Family Services and contracted 15
agencies with regard to educating agency children. Classrooms for the 16
Kentucky Educational Collaborative for State A gency Children shall be 17
within or near the facilities and programs operated or contracted by the 18
Department of Juvenile Justice or the cabinet. The Kentucky Department of 19
Education, the Department of Juvenile Justice, and the Cabinet for Health and 20
Family Services, Department for Community Based Services, shall develop a 21
biennial plan regarding the educational needs and provisions of educational 22
programs, with emphasis on the coordination of all treatment services and 23
funds available to provide for the educ ation of state agency children. The 24
biennial plan shall include strategies to assure that teacher preparation 25
programs include content related to working with state agency children and 26
that adequate professional development opportunities for better meeting the 27
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needs of these students are available for teachers and schools. 1
(b) Teachers and other staff shall be hired on contract through a local school 2
district or if a local school district is not willing to participate, teachers may 3
be hired by the Kentucky Educational Collaborative for State Agency 4
Children or a contract may be entered into with a private provider of 5
educational services. All certified educational staff hired by the Kentucky 6
Educational Collaborative for State Agency Children shall be member s of the 7
Kentucky Teachers' Retirement System. 8
(c) Beginning July 1, 1993, the Kentucky Education Collaborative for State 9
Agency Children shall be financed through: 10
1. The amount generated by state agency children under the Support 11
Education Excellence in Kentucky program as provided in KRS 157.360 12
for the guaranteed base and adjustments for the number of at -risk 13
students, exceptional students, and transportation costs; 14
2. A per -pupil distribution of professional development funds with the 15
collaborative serving as a consortium for state agency children; 16
3. A per-pupil distribution of technology funds in accordance with the state 17
education technology plan pursuant to KRS 156.670 and the formula for 18
the distribution of funds to local school districts; 19
4. A per-pupil distribution of textbook funds pursuant to K RS 157.100 and 20
157.190; 21
5. The funding for school services for state agency children authorized by 22
KRS 158.135; and 23
6. Other grants and entitlements, including federal funds, identified in the 24
implementation plan developed pursuant to paragraph (f) of this 25
subsection for the education of Kentucky's children. 26
(d) The commissioner of Juvenile Justice and the secretary of the Cabinet for 27
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Health and Family Services shall promulgate administrative regulations, 1
pursuant to KRS Chapter 13A, with the assistance of the Kentucky 2
Department of Education and upon recommendation of the Kentucky Board 3
of Education regarding the governance, curriculum, and other topics 4
necessary to educate state agency children. The regulations shall: 5
1. Provide for the development and imp lementation of interagency 6
agreements that: 7
a. Define the financial responsibility of each state and local agency 8
for providing services to state agency children; 9
b. Establish procedures for resolving interagency disputes among 10
agencies that are parties to the agreements; and 11
2. Provide procedures for the implementation of the Kentucky statutes 12
regarding school -based decision making, student outcomes, 13
accountability, assessment, rewards and sanctions, technology, staff 14
development, salaries, and the develop ment of coordinated individual 15
treatment, education, and transition plans to ensure compliance with 16
present education and treatment laws and regulations specific to the 17
needs of children in the programs of the Cabinet for Health and Family 18
Services. 19
(e) When the placement of a state agency child is changed so that the state agency 20
child must transfer from one school or educational facility to a different 21
school or educational facility, the school or educational facility that the state 22
agency child is leavin g shall, within two (2) days of the state agency child 23
leaving, prepare an educational passport for the child, which shall be 24
delivered to the cabinet or the Department of Juvenile Justice. The cabinet or 25
the Department of Juvenile Justice shall, within tw o (2) days of enrolling a 26
state agency child in a new school or educational facility, present the 27
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educational passport to the receiving school or educational facility. 1
(f) The commissioner of Juvenile Justice and the secretary of the Cabinet for 2
Health and Family Services and the commissioner of the state Department of 3
Education shall initiate development of a plan for implementation of the 4
Kentucky Educational Collaborative for State Agency Children. 5
Section 12. The Gene ral Assembly finds that it would not be in the interest of 6
public health or welfare to use or receive public funds, or for public entities to offer or 7
sponsor health plans that provide benefits or coverage, for gender transition services due 8
to the substantial risks and known harmful effects of those services, including irreversible 9
physical alterations and, in some cases, sterility and lifelong sexual dysfunction. 10
Section 13. If any provision of this Act, or this Act's a pplication to any person 11
or circumstance, is held invalid, the invalidity shall not affect other provisions or 12
applications of the Act, which shall be given effect without the invalid provision or 13
application, and to this end the provisions and applications of this Act are severable. 14
Section 14. Sections 7 to 10 of this Act apply to health plans issued or renewed 15
on or after the effective date of this Act. 16