Call to Order and Roll Call
The December meeting of the Administrative Regulation Review Subcommittee was held on Monday, December 17, 2012, at 10:00 AM, in Room 149 of the Capitol Annex. Representative Johnny Bell, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Senator Joe Bowen, Co-Chair; Representative Johnny Bell, Co-Chair; Senators David Givens, Alice Forgy Kerr, and Joey Pendleton; Representatives Robert R. Damron, and Jimmie Lee.
Guests: Representatives Stan Lee and Jim Gooch; Travis Powell, Sarah Levy, Council on Postsecondary Education; Tamara Biggs, KY Teachers' Retirement System; DeVon Hankins, Greg Harkenrider, Doug Hendrix, Finance Cabinet; Gary Morris, Department of Revenue; Michael Burleson, Board of Pharmacy; Connie Calvert, William Reynolds, Board of Optometric Examiners; Adam K. Rich, Board of Dentistry; Nathan Goldman, Paula Schenk, Board of Nursing; Jim Grawe, Tom Underwood, Board of Podiatry; William H. Martin, Zeb Weese, Heritage Land Conservation Fund Board; Barbara Pauley, Energy and Environment Cabinet; Amber Arnett, Justice and Public Safety Cabinet; Amy Barker, Brenn Combs, James L. Erwin, LaDonna Thompson, Department of Corrections; Frank Goins, Department of Insurance; Randy White, Kentucky State Penitentiary; Ann DAngelo, Michael Neal, Matt Osborne, Transportation Cabinet; Kevin Brown, Terry Holliday, Amy Peabody, David Wickersham, Department of Education; Patty Dempsey, The Arc of Kentucky; Beth Harrison, Kentucky TASH; Lucy Heskins, D'Arcy Robb, Kentucky P & A, Commonwealth Council on Developmental Disabilities; Wayne Young, Kentucky Assoc. of School Administrators; Sarah Richardson, Patrick Shirley, KATLC/OVR; Russ Coy, D.J. Wasson, Blanche Minor, Cecilia Webber, Department of Insurance; Roger Banks, Dawn Bellis, William Swope, Housing, Building & Construction; Courtney Bourne, Ryan Halloran, Office of Occupations & Professions; Stephanie Brammer-Barnes, Stephanie Hold, Mary Reinle Begley, CHFS-OIG; Dr. Stephen Hall, Claudia Johnson, DBHDID, Div. of Intellectual Disabilities; Stuart Owen, Department of Medicaid Services; Tim Arnold, Department of Public Advocacy; Katie & Will Bentley, parents; Josh Crabtree, Children's Law Center; Allie Rigsby, KY Statewide Youth Council; Wilson Sears, KY Assoc. of School Superintendents; Deborah Spalding, P & A, Office of Learning (KDE); Shannon Stiglets, KY School Boards Assoc.; Paul Walsburger; Mike Waford, KY Center for Instructional Discipline; Brian Brezasky, Sarah S. Nicholson, KY Hospital Assoc.; Mary L. Chandler, John Daniels, Central KY Wellness Center; Terry Braunson, Wendell Foster's Campus for Developmental Disabilities; James Cheely, parent & president of The Arc of KY; William Dolan, Protection and Advocacy; Cathy Jo Edwards, Tina Jackson, self-advocates; Elizabeth Theisen-Jewell, Opportunity for Work & Learning; Harold L. Kleinert, Human Developmental Institute; Grant Logsdon, self-advocate; F. Patrick Reed, KACES; Sheila Schuster, KY Psychological Assoc.; Mark Scureman, for Elizabeth Scureman; Robert Smith, for Jennifer Smith; Ronald A. Spalding, Andrew Venetianer, R.E.A.C.H. of Louisville; Betsy Dunnigan, and Kevin Mudd, DBHDID.
LRC Staff: Dave Nicholas, Emily Caudill, Donna Little, Sarah Amburgey, Karen Howard, Betsy Cupp, and Laura Napier.
The Administrative Regulation Review Subcommittee met on Monday, December 17, 2012, and submits this report:
Administrative Regulations Reviewed by the Subcommittee:
COUNCIL ON POSTSECONDARY EDUCATION: Nonpublic Colleges
13 KAR 1:020. Private college licensing. Sarah Levy, director of licensing, and Travis Powell, general counsel, represented the council.
A motion was made and seconded to approve the following amendments: to amend Sections 1, 2, 3, 4, 6, 8, 10, 14, and 16 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
FINANCE AND ADMINISTRATION CABINET: Kentucky Teachers' Retirement System: General Rules
102 KAR 1:225. General compliance with federal tax laws. Tamela Biggs, staff attorney, represented the system.
A motion was made and seconded to approve the following amendments: (1) to amend the RELATES TO paragraph and Section 3 to correct citations; and (2) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Section 3 to make technical corrections. Without objection, and with agreement of the agency, the amendments were approved.
Department of Revenue: Office of Processing and Enforcement: Forms
103 KAR 3:060E. Kentucky Tax Amnesty Application. Doug Hendrix, staff attorney, and Gary Morris, policy advisor, represented the office.
GENERAL GOVERNMENT CABINET: Board of Pharmacy: Board
201 KAR 2:020 & E. Examination. Michael Burleson, executive director, represented the board.
In response to a question by Senator Givens, Mr. Burleson stated that these administrative regulations were primarily being amended for compliance with House Bill 1 from the 2012 Special Session of the General Assembly.
In response to a question by Representative Damron, Mr. Burleson stated that notification of these changes was sent to all licensees and that pharmacy schools were encouraged to notify graduating students so that those students could apply earlier in light of application processing changes. The board did not receive public comments during the public comment period.
201 KAR 2:030 & E. License transfer.
A motion was made and seconded to approve the following amendments: to amend Section 2 to make technical corrections. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 2:040. Registration of pharmacist interns.
In response to questions by Senator Givens, Mr. Burleson stated that the amendment to this administrative regulation was recommended by a working administrative regulation committee, and revised the credit hour requirements. He stated that, in special circumstances, an intern could receive up to 400 hours of credit based on approval of a research project, which included a required 500-word essay approved by the board president.
A motion was made and seconded to approve the following amendments: to amend Sections 3 and 8 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 2:050 & E. Licenses and permits; fees.
In response to questions by Senator Givens, Mr. Burleson stated that this administrative regulation was amended to comply with new statutory requirements. New fees were established regarding the data bank and home medical equipment. The application fees were annual, as required by the authorizing statute.
201 KAR 2:061 & E. Procedures followed by the Kentucky Board of Pharmacy in the investigation and hearing of complaints.
A motion was made and seconded to approve the following amendments: to amend Sections 5 and 6 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 2:205 & E. Pharmacist-in-charge.
201 KAR 2:350 & E. Home medical equipment service providers.
In response to a question by Senator Givens, Mr. Burleson stated that this administrative regulation was amended to comply with new statutory requirements.
A motion was made and seconded to approve the following amendments: to amend Sections 3, 4, and 5 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
Board of Optometric Examiners: Board
201 KAR 5:010 & E. Application for licensure; endorsement. Connie Calvert, executive director, and Dr. William Reynolds, president, represented the board.
A motion was made and seconded to approve the following amendments: to amend Sections 1 and 2 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 5:030 & E. Annual courses of study required.
201 KAR 5:130 & E. Controlled substances.
Board of Dentistry: Board
201 KAR 8:520. Fees and fines. Dr. Adam Rich, president, represented the board.
In response to questions by Representative Damron, Dr. Rich stated that the board received comments during the public comment period but most concerns were related to opposition to House Bill 1 from the 2012 Special Session of the General Assembly. Commenters stated concerns for dentists without computer and internet access to use the KASPER system and opposition to the initial physical examination required before prescribing drugs tracked by the KASPER system. The board was working to resolve all concerns.
In response to a question by Co-Chair Bowen, Dr. Rich stated that the board experienced noncompliance with some out-of-state dentists who failed to report violations in other states while maintaining Kentucky licensure. Dentists wishing to maintain Kentucky licensure were required to comply with the board’s requirements just as Kentucky-practicing dentists. The fine was an attention getter to make sure dentists were aware that compliance with reporting out-of-state violations was vital to maintaining Kentucky licensure.
A motion was made and seconded to approve the following amendments: (1) to amend the RELATES TO and STATUTORY AUTHORITY paragraphs to correct statutory citations; (2) to amend Section 4 to delete provisions that were duplicative of 201 KAR 8:540; and (3) to amend Sections 4 and 5 to comply with the drafting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 8:532 & E. Licensure of dentists.
A motion was made and seconded to approve the following amendments: (1) to amend the RELATES TO; STATUTORY AUTHORITY; and NECESSITY, FUNCTION, AND CONFORMITY paragraphs to correct statutory citations; and (2) to amend Sections 1, 2, 4 through 12, and 16 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 8:540 & E. Dental practices and prescription writing.
A motion was made and seconded to approve the following amendments: (1) to amend the RELATES TO and STATUTORY AUTHORITY paragraphs to correct statutory citations; and (2) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 1 through 6 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
Board of Nursing: Board
201 KAR 20:056 & E. Advanced practice registered nurse licensure, program requirements, recognition of a national certifying organization. Nathan Goldman, general counsel, and Paula Schenk, executive director, represented the board.
In response to questions by Representative Damron, Mr. Goldman stated that the board received a lot of positive feedback from licensees during the public comment period. The board worked closely with licensees to develop these administrative regulations.
Representative Damron thanked the board for working hard to write appropriate administrative regulations.
A motion was made and seconded to approve the following amendments: to amend Section 1 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 20:057 & E. Scope and standards of practice of advanced practice registered nurses.
In response to a question by Representative Damron, Mr. Goldman stated that the board worked closely with licensees to develop the discretionary language regarding drug screening.
A motion was made and seconded to approve the following amendments: (1) to amend Section 9(8) to clarify that a prescribing APRN may obtain a baseline drug screen if the APRN considers it clinically appropriate or if the APRN believes that it is appropriate to see if the patient is actually taking the controlled substance; (2) to amend Section 9(12) to delete provisions for noncompliance, which are not authorized by statute; and (3) to amend Section 9 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 20:161 & E. Investigation and disposition of complaints.
201 KAR 20:215 & E. Continuing competency requirements.
Board of Podiatry: Board
201 KAR 25:011 & E. Approved schools; examination application; fees. Jim Grawe, assistant attorney general, and Tom Underwood, executive director, represented the board.
In response to questions by Representative Damron, Mr. Grawe stated that all licensees were notified of the proposed changes to these administrative regulations. The board did not receive negative comments from licensees during the public comment period. Mr. Underwood stated that the board developed a practical approach to regulatory implementation of House Bill 1 from the 2012 Special Session of the General Assembly.
In response to a question by Senator Givens, Mr. Grawe stated that the list of drugs of concern was developed by experts for the specific area of podiatry, and the list differed somewhat from similar lists from other specific professions. Mr. Underwood stated that podiatrists have a narrower scope of practice than some other specific professions; therefore, the list of drugs differed somewhat.
A motion was made and seconded to approve the following amendments: to amend Sections 1 and 5 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 25:021 & E. Annual renewal of licenses, fees.
A motion was made and seconded to approve the following amendments: to amend Sections 1 and 3 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 25:031 & E. Continuing education.
201 KAR 25:051 & E. Procedure for complaints and hearings involving licensees: temporary suspension.
A motion was made and seconded to approve the following amendments: to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 1 through 4 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
201 KAR 25:090 & E. Prescribing and dispensing controlled substances.
A motion was made and seconded to approve the following amendments: to amend the Necessity, Function, and Conformity paragraph and Sections 1, 3, and 5 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
ENERGY AND ENVIRONMENT CABINET: Department for Natural Resources: Division of Technical and Administrative Support: General Administrative Procedures
418 KAR 1:010. Definitions for 418 KAR Chapter 1. William H. Martin, president, Kentucky Heritage Land Conservation Fund Board; Barbara Pauley, attorney; and Zeb Weese, biologist consultant, represented the division.
A motion was made and seconded to approve the following amendments: (1) to amend the RELATES TO and STATUTORY AUTHORITY paragraphs to delete irrelevant citations; and (2) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Section 1 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
418 KAR 1:020. Administrative procedures of the board.
418 KAR 1:031. Repeal of 418 KAR 1:030.
418 KAR 1:040. Grant applications.
A motion was made and seconded to approve the following amendments: (1) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph to correct statutory citations; (2) to amend Section 1 to specify required forms; and (3) to amend Sections 1, 2, and 4 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
418 KAR 1:050. Procedures for acquisition of land.
A motion was made and seconded to approve the following amendments: (1) to amend the RELATES TO paragraph to add relevant citations; and (2) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Section 6 to comply with the drafting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
418 KAR 1:060. Management.
A motion was made and seconded to approve the following amendments: (1) to amend Sections 2, 3, 10, and 14 to specify the required forms; and (2) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 10 and 14 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
418 KAR 1:070. Remedies.
A motion was made and seconded to approve the following amendments: (1) to amend Sections 1 and 2 to clarify provisions; and (2) to amend Sections 1, 2, and 3 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
JUSTICE AND PUBLIC SAFETY CABINET: Department of Corrections: Office of the Secretary
501 KAR 6:020. Corrections policies and procedures. Amber Arnett, staff attorney, and Amy Barker, assistant general counsel, represented the department.
A motion was made and seconded to approve the following amendments: to amend Section 1 and the material incorporated by reference to clarify provisions and to comply with the drafting requirements of KRS Chapter 13A. Without objection, and with the agreement of the agency, the amendments were approved.
Capital Punishment
501 KAR 16:290. Preliminary and post-execution procedures concerning condemned person. Amber Arnett, staff attorney, and Amy Barker, assistant general counsel, represented the department. Tim Arnold, Post-trial Division Director, Department of Public Advocacy, appeared in opposition to these administrative regulations.
Mr. Arnold stated that the Department of Public Advocacy (DPA) was opposed to these administrative regulations because a specific provision for the location and communication availability of defense counsel was omitted. Mr. Arnold reviewed some past executions and noted at least one (1) instance in which an execution was conducted without defense counsel availability and communication access. It was important during an execution for the defense counsel of the condemned person to have access to the condemned person and to communication in case of events such as a last minute stay of execution or reconsideration in the case of a voluntary execution. DPA recommended amending these administrative regulations to include these provisions.
In response to a question by Co-Chair Bell, Mr. Arnold stated that it was appropriate to put provisions for the availability and communication access for the condemned person’s defense counsel into these administrative regulations because these administrative regulations not only provided requirements for execution drugs, but also established execution procedures. Because these administrative regulations were silent regarding defense counsel availability and communication access, requirements could be interpreted as allowing or prohibiting defense counsel availability and communication access. Ms. Barker stated that the Department of Corrections omitted these provisions because the department needed flexibility regarding where the defense counsel should be located and what office supplies would be available.
Senator Pendleton stated that he was opposed to the death penalty by lethal injection. It was a difficult issue, but he was opposed to capital punishment, which prohibited the offender from being forced to confront his or her actions and the result on society. Additionally, in some cases, there were reports after an execution of evidence such as DNA evidence that later exonerated the executed person. Senator Pendleton requested to be recorded as voting in opposition to these administrative regulations.
Co-Chair Bowen suggested that this amendment seemed ancillary to these administrative regulations and should be inserted into a different administrative regulation by a simple amendment.
In response to a question by Representative Lee, Ms. Barker stated that the condemned person’s defense counsel should be provided with a nearby location and access to communication based on internal policy. It was unlikely that a warden would refuse access and communication. Mr. Arnold stated that case law provided some assurances, but such a serious matter as an execution required specific provisions.
In response to a question by Representative Damron, Ms. Barker stated that the issue of the condemned person’s defense counsel availability and communication access was addressed in the Statement of Consideration but that the Department of Corrections opted not to amend these administrative regulations in response to those public comments.
In response to a question by Co-Chair Bell, Ms. Barker stated that hundreds of public comments were received during the public comment period. Ms. Arnett stated that the Department of Corrections needed flexibility regarding the mechanics of access for the condemned person’s defense counsel. She noted that the condemned person had the option to choose his or her defense counsel to be the execution witness; therefore, the defense counsel would be accessible during the execution.
In response to a question by Co-Chair Bowen, Ms. Arnett stated that other states used the one (1) drug execution system. Sometimes access to the one (1) drug was difficult; however, Kentucky opted for the one (1) drug system because that system was not cruel and unusual. If the one (1) drug was unavailable, Kentucky had a two (2) drug backup system. There was not usually an availability problem regarding the two (2) drug system.
501 KAR 16:310. Pre-execution medical actions.
501 KAR 16:330. Lethal injection protocols.
TRANSPORTATION CABINET: Department of Vehicle Regulation: Division of Driver Licensing: Driver Improvement
601 KAR 13:110. Driver education programs. Ann D’Angelo, assistant general counsel; Michael Neal, administrative branch manager; and Matt Osborne, advisor, represented the division.
In response to a question by Co-Chair Bowen, Ms. D’Angelo stated that the vendor was established through a bid process authorized by KRS Chapter 45A.
A motion was made and seconded to approve the following amendments: (1) to amend the RELATES TO paragraph to add a statutory citation; and (2) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph, and Sections 1, 4, and 5 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
EDUCATION AND WORKFORCE DEVELOPMENT CABINET: Board of Education: Department of Education: Office of Learning Support Services
704 KAR 7:160. Use of restraint and seclusion in public schools. Kevin Brown, associate commissioner and general counsel; Amy Peabody, assistant general counsel; and David Wickersham, assistant general counsel, represented the department. Katie Bentley and William Bentley, citizens; Josh Crabtree, representative, Children’s Law Center; Patty Dempsy, representative, the Arc of Kentucky; Beth Harrison, co-chair, representative, Kentucky TASH; Lucy Heskins, staff attorney, Kentucky Protection and Advocacy; Allie Rigsby, youth leader, Kentucky Statewide Youth Council; D’Arcy Robb, public policy advisor, Kentucky Protection and Advocacy and the Commonwealth Council on Developmental Disabilities; Wilson Sears, executive director, Kentucky Association of School Superintendents; Deborah Spalding, assistant professor, Campbellsville University, and retired director of special education, Marion County; Shannon Stiglets, director, Kentucky School Boards Association; and Wayne Young, executive director, Kentucky Association of School Administrators, appeared in support of this administrative regulation. Representative Jim Gooch, Jr., Kentucky legislator, and Paul Walsburger, parent of a son with disabilities, appeared in opposition to this administrative regulation.
Ms. Dempsy stated that families were concerned about the restraint and seclusion issue. The Arc of Kentucky supported this administrative regulation.
Mr. Crabtree stated that the Children’s Law Center supported this administrative regulation. He recounted examples of inappropriate application of restraint and seclusion, including a child repeatedly locked in a closet for over six (6) weeks, an autistic child who had cloth placed in his mouth to keep him quiet, and a six (6) year old who was locked in a closet unsupervised for long enough to remove dry wall and knock his teeth out. He stated that this administrative regulation would be helpful in preventing those situations from occurring again.
Ms. Bentley, speaking for herself and her son, Will, recounted an incident in which her son, as a preschooler, was locked in a closet and restrained without her knowledge. He was nonverbal at the time and could not notify his parent of what had occurred. He was traumatized by the experience and wanted the Subcommittee to be aware that his teacher had harmed him.
Ms. Harrison stated that Kentucky TASH supported this administrative regulation to protect the vulnerable student.
Ms. Heskins stated that Kentucky Protection and Advocacy supported this administrative regulation. In 2009, U.S. Education Secretary Ernie Duncan reported on the abuse and misuse of restraint and seclusion in schools. There were over 100 reports of this abuse in Kentucky. This administrative regulation did not prohibit the breaking up of altercations, but specified when restraint and seclusions were appropriate. This administrative regulation prohibited the use of supine restraints and prone restraints. These restraints were implicated in some deaths. This administrative regulation required that families be informed if staff performed restraint or seclusion on the student. It also required training for all school staff, with additional training for the core response team.
Ms. Robb stated that Kentucky Protection and Advocacy and the Commonwealth Council on Developmental Disabilities supported this administrative regulation. There were “real-world” examples of maintaining a stable learning environment while still reducing restraint and seclusion.
Ms. Spalding stated that, prior to this administrative regulation, there was a lack of specific procedures for restraint and seclusion. Trainers and leaders were needed with parental involvement to maintain good results.
Mr. Rigsby stated that the Kentucky Statewide Youth Council supported this administrative regulation, which empowered teachers. Each school determined a leader to monitor the use of restraint and seclusion. As a child, Mr. Rigsby was secluded for three weeks in a broom closet during school hours for refusing to complete math work. His parents were not notified. This administrative regulation reduced restraint and seclusion and required family notification.
Mr. Walsburger, parent of a son with disabilities, stated that his son was restrained and secluded at five (5) years old. The child was traumatized and angered, which led to worse behavior. His son was secluded as a flight risk for refusing to come back to the classroom from recess, even though the child was in a full leg cast. At times when restraint and seclusion were removed, his son did better in school. Likewise, his son’s behavior worsened when restraint and seclusion were reinstituted. His son is in seventh grade now and is an A student. Restraint and seclusion should not be used under any circumstances.
Mr. Young stated that school administrators recognized the need for and supported this administrative regulation.
Mr. Sears stated that agreement had been reached to ensure safe schools for Kentucky children.
Ms. Stiglets, director stated that agreement had been reached on this administrative regulation. She thanked the department for working to reach consensus.
In response to a question by Senator Givens, Mr. Young stated that requirements pertaining to when restraint or seclusion is contraindicated were specific enough for the present. If more specificity was needed in the future, that could be amended once more information was known. Currently, the provision was intended to prevent third party intervention. Senator Givens encouraged the department to add specificity when enough information was available.
Representative Gooch noted that he was not a member of the Administrative Regulation Review Subcommittee and that his remarks did not necessarily reflect on those of this Subcommittee. He stated that bad behavior from students or even from adults who abuse restraint and seclusion methods was unacceptable. Classifying some students who are “exempt” from behavioral standards may be the result of Section 3 of this administrative regulation. It was inappropriate to teach children that they are entitled to different behavior standards. Representative Gooch believed this administrative regulation was going in a bad direction and may be a disservice to child development. Mr. Sears stated that this administrative regulation supported positive reinforcement and dealing with behaviors in ways other than restraint and seclusion whenever possible.
Co-Chair Bell stated that seclusion was a terrible practice. There had been some accidental deaths nationwide due to unsupervised seclusion. Isolation had a negative psychological and sociological effect. Co-Chair Bell encouraged the department to move away from seclusion as a means of behavior modification and classroom order maintenance. If seclusion was used, it needed to be well supervised. Mr. Sears stated that there had been a few instances of extreme seclusion, but most of its use was a mild form, such as a student sitting in a cloakroom for a few minutes if talking too much and causing a disruption in the classroom. This administrative regulation required that the use of seclusion be supervised.
In response to a statement by Co-Chair Bell, Ms. Stiglet stated that this administrative regulation required use of the lease extreme use of restraint or seclusion to modify behavior. This administrative regulation also required parental notification and supervision in cases of seclusion. Additionally, the seclusion area had to have all dangerous items removed.
Representative Lee stated that seclusion was a useful method of behavior modification. For example, an area with calm lighting may adjust a student’s mood.
Senator Pendleton stated that superintendents in his district appreciated the compromises and work the department did to get this administrative regulation properly amended.
A motion was made and seconded to approve the following amendments: (1) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph to clearly state the necessity for and function served by this administrative regulation, as required by KRS 13A.220, including to state that this administrative regulation does not prohibit the lawful exercise of law enforcement duties by sworn law enforcement officers; (2) to amend Sections 1 through 7 to comply with the drafting and formatting requirements of KRS Chapter 13A; (3) to amend Sections 1, 3, and 4 to delete all instances of the modifier, “serious,” in the phrase “imminent danger of physical harm to self or others”; and (4) to amend Section 3 to: (a) clarify that physical restraint may be used to protect property as permitted pursuant to KRS Chapter 503; and (b) specify that school personnel shall not impose physical restraint on a student if it is known that physical restraint is contraindicated based on the student’s disability, health care needs, or medical or psychiatric condition. Without objection, and with agreement of the agency, the amendments were approved.
Kentucky Assistive Technology Loan Corporation: Corporation
789 KAR 1:010. General eligibility criteria for assistive technology loans. Sarah Richardson, administrative specialist, and Patrick Shirley, administrative specialist, represented the corporation.
A motion was made and seconded to approve the following amendments: (1) to amend the RELATES TO paragraph to add relevant citations; (2) to amend Section 1 to delete an unnecessary definition; (3) to amend Section 3 to clarify provisions; and (4) to amend Sections 3, 4, 5, 6, and 8 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
PUBLIC PROTECTION CABINET: Department of Insurance: Property and Casualty Division: Kinds of Insurance; Limits of Risk; Reinsurance
806 KAR 5:051. Repeal of 806 KAR 5:050. DJ Wasson, administrative coordinator, represented the division.
Financial Standards and Examination Division: Investments
806 KAR 7:110. Derivative instruments.
A motion was made and seconded to approve the following amendments: (1) to amend the RELATES TO paragraph to add citations; (2) to amend Section 1 to cite to statutory definitions, as required by KRS 13A.222(4)(d); and (3) to amend Sections 2, 3, and 5 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
Department of Housing, Buildings and Construction: Division of HVAC: Heating, Ventilation, and Air Conditioning Licensing Requirements
815 KAR 8:060. Requirements for approval of continuing education courses and providers. Dawn Bellis, general counsel, represented the division.
A motion was made and seconded to approve the following amendments: (1) to amend Sections 1, 2, and 5 to clarify provisions; and (2) to amend the RELATES TO paragraph and Sections 1, 2, 3, and 6 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
Office of Occupations and Professions: Secondary Metals Recyclers
830 KAR 1:010. Forms for Application, Certificate of Registration and Fees. Courtney Bourne, executive director, and Ryan Halloran, assistant attorney general, represented the office.
In response to a question by Co-Chair Bowen, Mr. Halloran stated that the office did not receive comments during the public comment period. The office worked with industry representatives to develop this administrative regulation. Industry seemed supportive of this administrative regulation.
A motion was made and seconded to approve the following amendments: (1) to amend Section 1 to specify that the application fee is $100; (2) to amend the RELATES TO paragraph to include additional relevant citations; and (3) to amend the TITLE; the NECESSITY, FUNCTION, AND CONFORMITY paragraph; Sections 1 and 2; and the material incorporated by reference to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
CABINET FOR HEALTH AND FAMILY SERVICES: Department for Medicaid Services: Division of Community Alternatives: Medicaid Services
907 KAR 1:145. Supports for community living services for an individual with an intellectual or developmental disability. Dr. Stephen Hall, commissioner; Claudia Johnson, division director; and Stuart Owen, regulation coordinator, represented the department. Tina Jackson, advocate; Dr. Harold Kleinert, director, Human Development Institute; F. Patrick Reed, CEO, KACES; Robert Smith, advocate; and Andrew Venetianer, representative, R.E.A.C.H. of Louisville, appeared in support of these administrative regulations. Terry Braunson, CEO, Wendell Foster’s Campus for Developmental Disabilities; James Cheely, parent and president, the Arc of Kentucky; William Dolan, attorney, Kentucky Protection and Advocacy; Cathy Jo Edwards, advocate; Grant Logsdon, advocate; Sheila Schuster, licensed psychologist, Kentucky Psychological Association; and Mark Scureman, parent, appeared in opposition to these administrative regulations.
Representative Lee stated that the cabinet had put an incredible amount of work into the SCL administrative regulations. The administrative regulations were based on a waiver from the Centers for Medicare and Medicaid Services. The changes showed the importance of supportive employment supports and workshops and were developed in the best interest of recipients.
Dr. Kleinert presented a brief PowerPoint presentation regarding the National Core Indicators Data for Kentucky. The survey data demonstrated that Kentucky performed well in client safety; however, Kentucky needed to improve in other areas, such as community engagement, physical activity, and access to employment. He stated that the waiver helped fund jobs for lasting employment. The waiver did not provide community inclusion but helped to connect clients to access so that the client could develop community ties individually.
Mr. Reed stated that KACES was initially opposed to these administrative regulations; however, the division worked with stakeholders to improve requirements and avoid negative unintended consequences. The division added specificity to vague requirements, and KACES was satisfied with the amended versions of these administrative regulations.
Ms. Jackson stated that the Council for Developmental Disabilities supported these administrative regulations. The waiver offered new services and opportunities for enhanced community inclusion. The council was comfortable with the day training changes, and the reimbursement rate was commensurate with other states.
Mr. Smith stated that he appeared as an advocate for his daughter with disabilities. He noted that the division was helpful in working with stakeholders and followed up on everything the division agreed to amend. He appreciated that the option to remain in an institution was not deleted, and his daughter and his family had a good quality of life that would not exist without this program.
Mr. Venetianer stated that he represented R.E.A.C.H. of Louisville, Kaleidoscope Adult Health Services, and was part of the Arc of Kentucky tag team. Mr. Venetianer was concerned about what would happen to adult day programs and other programs. He was worried that other programs would lose funding to fund new programs authorized by these administrative regulations. Representative Lee stated that adult day programs were important and would continue to be funded. These administrative regulations were to provide new programs in addition to, not in lieu of, existing programs. Mr. Venetianer stated that he was satisfied with the proposal in light of the answers to his questions.
Dr. Schuster stated that the Kentucky Psychological Association was not opposed to these administrative regulations; however, she was concerned that psychological services were being singled out and drastically cut. These services were being cut at a point when the client was preparing for the stressors associated with entering employment and community living. Rates were being cut twenty-four (24) percent, which was in addition to the fact that travel and other time was not being reimbursed.
Ms. Logsdon assisted her son with his testimony. Mr. Logsdon stated that he had disabilities but lived in his own apartment. He did not go to an adult day program. He was in the process of building his own home, which would be completely disability accessible. Mr. Logsdon applauded the efforts to expand community access; however, he was concerned about the definition of eligible clients. He preferred that the definition be expanded to include developmental disabilities, independent of intellectual disabilities. SCL waiver clients lived in a perpetual state of anxiety regarding ongoing qualification for services. If a client unexpectedly no longer qualified, for example due to testing at or above a seventy (70) IQ, family members often had to cease employment to care for the individual. He asked what would happen if the caregiver died. Ms. Johnson responded that the definition had not changed. Level of care services should not change unless a client’s qualification changed.
Mr. Braunson stated that he supported ninety-nine (99) percent of the provisions in these administrative regulations; however, he did have some specific concerns. The concerns were not financial but ethical in nature. He disagreed with “conflict-free case management.” Long-term relationships existed with clients and administrators beyond just relationships with the case managers. Clients may be harmed, and these administrative regulations were not necessarily the best practices. Options, intended to be expanded, may actually be reduced. Mr. Braunson stated his belief that the division had “overinterpreted” federal guidelines and definitions. These administrative regulations failed to produce professional case managers and ignored the rights of individuals with disabilities. Co-Chair Bowen stated that the division’s response to the issues pertaining to case management was that the same individuals who deliver services could not also be the ones to review and evaluate services. Ms. Johnson stated that the division had developed training for case managers.
Mr. Dolan stated that it was difficult to defend and appeal an SCL waiver denial because these administrative regulations provided for too much interpretation on the part of the division. The division was equipped with expansive resources if an SCL waiver was denied; however, clients often had minimal resources with which to defend themselves or appeal. Dr. Kleinert stated that these administrative regulations did not amend provisions pertaining to keeping or losing eligibility status; however, these administrative regulations also did not alleviate anxiety about losing services if eligibility was determined to change. Kentucky Protection and Advocacy supported expanding the definition for eligibility. Representative Lee stated that the point regarding anxiety over losing services was valid, but funding was limited. There were many on the waiver waiting list who qualified based on both developmental and intellectual disability criteria. If these administrative regulations were expanded to include more clients, it would be an empty gesture because funding could not support the expanded number of clients. Additionally, there were federal guidelines that must be complied with to ensure continued federal matching funds.
Mr. Cheely stated that he was the father of a twenty-four (24) year-old son with disabilities and president of the Arc of Kentucky. The definition for eligibility was vague and created anxiety about ongoing access to care. Training programs were required, but the waiver program did not fund the cost of the training. Prospective client employees were required to cover the cost of background checks, although that was not the case for most employees outside the waiver program. Mr. Cheely applauded the goal of adequate wage for adequate work, but had concerns that it may not always be achievable. These administrative regulations provided for too much interpretation, which already varied within the division itself.
Ms. Edwards stated that she was concerned that services would be cut for some currently eligible clients. Some clients that currently received continuous care may be reduced to forty (40) hours of care per week. Many parents had not made preparation for such changes and expected their children to always be waiver eligible. She asked what would occur if a parent in such a case died and then the client was no longer waiver eligible.
Mr. Scureman stated that his daughter had intellectual disabilities. He was opposed to these administrative regulations and noted that these administrative regulations did not fulfill the needs of all waiver clients. Some of the requirements seemed to be unfunded mandates. He was worried that new programs would absorb the funding for successful existing programs. He was worried that adult day programs may be lost, and stated that some program administrators were worried about cabinet retribution if negative comments were submitted.
Ms. Johnson stated that the waiver program began many years ago with the goal of moving clients from institutionalized facilities into communities. To qualify for the waiver program, a client had to meet specific developmental and intellectual criteria.
Mr. Owen stated that, if the definition for eligibility was amended to expand eligibility, it would represent a fundamental change in the existing waiver program and would require approval from CMS.
Co-Chair Bell expressed concern that these administrative regulations may obscure a cost-saving motive on the part of the division. He did not feel that the agency representatives fully answered questions from commenters.
Mr. Hall emphasized that these administrative regulations did not change the definition for eligibility or the criteria on which those determinations were made. These administrative regulations were not the result of cost-saving measures.
In response to a question by Senator Pendleton, Representative Lee stated that clients would not have services removed as a result of these administrative regulations.
Senator Pendleton strongly encouraged the 2013 Regular Session of the General Assembly to consider mental health issues and to ensure funding for services for the treatment of mental illness.
Co-Chair Bowen stated that there were still many unanswered questions regarding these administrative regulations. He encouraged the division to continue to work to amend, fine tune, clarify, and improve these administrative regulations.
A motion was made and seconded to approve the following amendments: (1) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph to clearly state the necessity for and function served by this administrative regulation, as required by KRS 13A.220; (2) to amend Section 1 to align the definitions between this administrative regulation and 907 KAR 12:010; (3) to amend Section 2 to clarify when an extension may be received based on a demonstration of good cause; and (4) to amend Sections 1, 2, 4, 5, 9, 10, and 11 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
907 KAR 1:155. Payments for supports for community living services for an individual with an intellectual or developmental disability.
A motion was made and seconded to approve the following amendments: (1) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph to clearly state the necessity for and function served by this administrative regulation, as required by KRS 13A.220; and (2) to amend Sections 1, 2, 4, 6, 7, 8, 10, and 12 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection and with agreement of the agency, the amendments were approved.
Division of Community Alternatives: Supports for Community Living Waiver
907 KAR 12:010. New supports for community living waiver service and coverage policies.
Representative Lee explained the amendments he proposed. This administrative regulation required that a client have a relationship with a case manager for longer than one (1) year in order to retain that case manager. Representative Lee’s amendments deleted the specific time parameter of “longer than one (1) year.” Additionally, the amendments expanded the training period to one (1) year for existing service providers. The amendments also provided that technology assisted residential services were not restricted only to a provider owned or leased location.
A motion was made and seconded to approve the following amendments: (1) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph to clearly state the necessity for and function served by this administrative regulation, as required by KRS 13A.220; (2) to amend Section 1 to align the definitions between this administrative regulation and 907 KAR 1:145; (3) to amend Section 2 to clarify when an extension may be received based on a demonstration of good cause; (4) to amend Section 3 to specify that an SCL provider, employee, or volunteer may use or possess a medically necessary and legally prescribed controlled substance; (5) to amend Section 5 to clarify that if a participant does not wish to continue receiving the service, the service shall be terminated; (6) to amend Sections 1 through 7 to comply with the drafting and formatting requirements of KRS Chapter 13A; (7) to amend Section 4 to remove the requirement that the relationship with a case manager be at least one (1) year in length; (8) to amend Section 5 to specify that: (a) employees providing a participant directed service on the effective date of this administrative regulation shall complete the required training within one (1) year; and (b) new providers of those services shall complete the training within six (6) months of the date of hire; (9) to amend Section 4(20) to require that technology assisted residential services shall be furnished: (a) in the participant’s residence, rather than a provider-owned or leased residence; and (b) to three (3) or fewer participants who reside, rather than previously resided, in the residence with twenty-four (24) hour staff support; and (10) to amend the material incorporated by reference to reflect these other amendments. Without objection, and with agreement of the agency, the amendments were approved.
907 KAR 12:020. Reimbursement for new supports for community living waiver services.
A motion was made and seconded to approve the following amendments: (1) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph to clearly state the necessity for and function served by this administrative regulation, as required by KRS 13A.220; and (2) to amend Sections 1 through 6, and 9 to comply with the drafting and formatting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
Department for Mental Health and Mental Retardation Services: Division of Administration and Financial Management: Institutional Care
908 KAR 3:050. Per diem rates. Betsy Dunnigan, deputy commissioner, and Kevin Mudd, division director, represented the department.
In response to a question by Senator Givens, Ms. Dunnigan stated that funding for financial discrepancies would be balanced with General Fund dollars. If patients had private assets, some of the balance would be paid by private funds.
A motion was made and seconded at the November ARRS meeting to approve the following amendments: to amend the STATUTORY AUTHORITY and NECESSITY, FUNCTION, AND CONFORMITY paragraphs and Section 2 to comply with the drafting requirements of KRS Chapter 13A. Without objection, and with agreement of the agency, the amendments were approved.
Other Business: Resolutions honoring Senator Joey Pendleton and Representative Danny Ford were read and approved. The Subcommittee meeting adjourned in honor of these two (2) statesmen and with thanks for their many years of service. A moment of silence was observed on behalf of the community of Sandy Hook, Connecticut.
The following administrative regulations were deferred to the January 7, 2013, meeting of the Subcommittee:
GENERAL GOVERNMENT CABINET: Board of Medical Licensure: Board
201 KAR 9:001 & E. Definitions for terms used in 201 KAR Chapter 9.
201 KAR 9:081 & E. Disciplinary proceedings.
201 KAR 9:200 & E. National Practitioner Data Bank reports.
201 KAR 9:210 & E. Criminal background checks required for all new applicants.
201 KAR 9:220 & E. Restriction upon dispensing of Schedule II controlled substances and Schedule III controlled substances containing Hydrocodone.
201 KAR 9:230 & E. Required registration in the KASPER system; legal requirements for prescribing controlled substances in the Commonwealth of Kentucky; enforcement.
201 KAR 9:240 & E. Emergency orders and hearings; appeals and other proceedings.
201 KAR 9:250 & E. Registration and oversight of pain management facilities.
201 KAR 9:260 & E. Professional standards for prescribing and dispensing controlled substances.
201 KAR 9:310 & E. Continuing medical education.
Kentucky Applied Behavior Analysis Licensing Board: Board
201 KAR 43:050. Requirements for supervision.
ENERGY AND ENVIRONMENT CABINET: Department for Environmental Protection: Division of Water: Water Quality
401 KAR 5:055. Scope and applicability of the KPDES Program.
401 KAR 5:060. KPDES application requirements.
Water Quality Standards
401 KAR 10:001. Definitions for 401 KAR Chapter 10.
401 KAR 10:026. Designation of uses of surface waters.
401 KAR 10:030. Antidegradation policy implementation methodology.
401 KAR 10:031. Surface water standards.
CABINET FOR HEALTH AND FAMILY SERVICES: Office of Inspector General: Division of Health Care: Health Services and Facilities
902 KAR 20:420 & E. Pain management facilities. Mary Begley, inspector general; Stephanie Brammer-Barnes, policy analyst; and Stephanie Hold, director, represented the office. Mary Chandler, patient and citizen; John Daniels, owner, Central Kentucky Wellness Center; and Derek Humfleet, attorney, appeared in opposition to this administrative regulation and 902 KAR 55:110.
Senator Pendleton expressed thanks to the office for resolving some of the issues pertaining to these administrative regulations. He requested that the division be vigilant in maintaining the KASPER system, which was an important tool for fighting drug abuse in the Commonwealth.
Representative Damron also thanked the office and emphasized the excellent job the office had performed in educating providers and addressing problems quickly as they arose.
Mr. Daniels stated that he had some concerns with specific parts of these administrative regulations. These administrative regulations helped compliant pain management facilities; however, there was disparity between requirements for pain management facilities owned by physicians and those not owned by physicians. Staffing requirements were likely to overburden pain management facilities trying to comply with these requirements because there were few prescribers who met the stringent certification standards. Many facilities may have to close, which would leave legitimate patients without care.
Senator Kerr stated that the lack of parity hinted that deferral would be a good idea. These administrative regulations could be compared and discussed along with those administrative regulations for the Kentucky Board of Medical Licensure in January 2013. Mr. Humfleet stated that pain management facilities were regulated by both the Kentucky Board of Medical Licensure and the Cabinet for Health and Family Services. Ms. Begley stated that the authorizing statute required nonphysician-owned facilities to be regulated by the cabinet.
In response to a question by Co-Chair Bowen, Mr. Daniels stated that Tennessee allowed pain management facilities to be nonphysician owned. Indiana did not have pain management statutes yet and was reviewing allowing joint ownership of facilities. Ohio did not seem to authorize nonphysician-owned pain management facilities.
Senator Pendleton recommended deferral of these administrative regulations so that they could be considered along with the Kentucky Board of Medical Licensure administrative regulations. He stated that it was wrong to degrade our senior citizens by forcing them to take and pay for unnecessary drug testing. Pain management facilities should not be singled out for special treatment.
Representative Damron stated that the media and some medical communities have obscured what is actually required by House Bill 1 of the 2012 Special Session of the General Assembly. The initial administrative regulations from the Kentucky Board of Medical Licensure may have been overburdensome and maybe House Bill 1 of the 2012 Special Session of the General Assembly needed amendment; however, these administrative regulations as amended after comments required the minimum stringency necessary to comply with the authorizing statutes as they now existed.
In response to questions by Representative Damron, Ms. Begley stated that the office did not have specific information on how many pain management facilities would be impacted by these administrative regulations, but the office was currently researching this issue. Ms. Begley noted that, regardless of deferral or research information, the office was required to continue enforcing House Bill 1 of the 2012 Special Session of the General Assembly. She estimated that eleven (11) or twelve (12) pain management facilities would be impacted by these administrative regulations. The division had included a grace period for pain management facilities to continue operating until the division had more information and was able to better proceed.
Representative Lee stated that he would also like to have these administrative regulations deferred to the January 2013 meeting of the Subcommittee. He was concerned that many physicians would stop prescribing necessary pain medicine out of fear or misunderstanding of these administrative regulations. He agreed that House Bill 1 of the 2012 Special Session of the General Assembly needed further amendment. Additionally, he called for parity with administrative regulations from the Kentucky Board of Medical Licensure. It was crucial to balance protecting people from drug addiction with treating patients with legitimate needs.
In response to a question by Representative Lee, Ms. Begley stated that, if the division suspected inappropriate prescribing, the concern was directed to the specific regulating board for investigation and enforcement.
In response to a question by Co-Chair Bowen, Ms. Begley stated that a “nonphysician-owned pain management facility” was one that was wholly, 100 percent, owned by a nonphysician, as required by the authorizing statute.
Senator Givens stated that these administrative regulations indirectly impacted prescribing issues because they worked in concert with requirements from the specific boards. There were legal concerns with certain parts of House Bill 1 of the 2012 Special Session of the General Assembly. Additionally, interpretation and enforcement may be diverging from the authorizing statute, especially regarding certification issues. Ms. Begley responded that the office expanded on the requirements in the authorizing statute only to the extent that the office provided a grace period for continuing operation of pain management facilities. Mr. Humfleet stated that the authorizing statute required residency and certification.
Co-Chair Bell formally requested deferral of these administrative regulations as amended to the January 2013 Subcommittee meeting. Ms. Begley agreed. These administrative regulations as amended were deferred to the January 2013 meeting of the Subcommittee.
A motion was made and seconded to approve the following amendments: (1) to amend the STATUTORY AUTHORITY paragraph to correct statutory citations; (2) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph to clearly state the necessity for and function served by this administrative regulation, as required by KRS 13A.220; and (3) to amend Sections 1 to 12 to: (a) comply with the drafting and formatting requirements of KRS Chapter 13A; and (b) delete provisions that restated statutory provisions. Without objection, and with agreement of the agency, the amendments were approved.
Division of Audits and Investigations: Controlled Substances
902 KAR 55:110 & E. Monitoring system for prescription controlled substances.
A motion was made and seconded to approve the following amendments: (1) to amend the NECESSITY, FUNCTION, AND CONFORMITY paragraph and Sections 2, 7, 8, 10, and 11 to comply with the drafting requirements of KRS Chapter 13A; and (2) to amend Section 10 to clarify that a practitioner or pharmacist who obtains KASPER data or a report and who in good faith believes that a person, including a patient, has violated the law in attempting to obtain a prescription for a controlled substance is authorized to report the suspected improper or illegal use of a controlled substance to law enforcement or the appropriate licensing board. Without objection, and with agreement of the agency, the amendments were approved.
Department for Community Based Services: Division of Child Care: Day Care
922 KAR 2:090. Child-care center licensure.
922 KAR 2:100. Certification of family child-care homes.
922 KAR 2:110. Child-care center provider requirements.
922 KAR 2:190. Civil penalties.
The Subcommittee adjourned at 5 p.m. until January 7, 2013.