The 4th meeting of the Interim Joint Committee on Licensing and Occupations was held on Friday, October 10, 2008, at 10:00 AM, in Room 129 of the Capitol Annex. Representative Joni L. Jenkins, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Representative Joni L. Jenkins, Co-Chair; Senators Tom Buford, Julian M. Carroll, Julie Denton, Carroll Gibson, Denise Harper Angel, Bob Leeper, Dan Seum, and Damon Thayer; Representatives Tom Burch, Larry Clark, Tim Firkins, Dennis Horlander, Dennis Keene, Adam Koenig, Reginald Meeks, Charles Miller, David Osborne, Ruth Ann Palumbo, Carl Rollins II, Sal Santoro, Arnold Simpson, and Susan Westrom.
Guests: Carl Metz, Goodwill Industries; Linda Romine, Public Relations Coordinator, St. Vincent de Paul Society, Louisville, KY; Valerie Thompson, Kentucky State Assembly of Surgical Technologists; Jeff Bidwell, Surgical Technology Program Coordinator, KCTCS Madisonville Campus; Sherry Wells, Surgical Technology Program Coordinator, KCTCS Bowling Green Campus; Henry Lackey, Commissioner, Marty Hammons, Deputy Commissioner, Bob Sparrow, Director of Enforcement, and Leah Boggs, Director of Licensing, Department of Charitable Gaming.
LRC Staff: Tom Hewlett, Bryce Amburgey, Michel Sanderson, and Susan Cunningham.
Representative Jenkins called the meeting to order and asked for a motion to adopt the minutes from the September 12, 2008, meeting. Senator Carroll made a motion seconded by Senator Harper-Angel and the minutes were adopted by voice vote.
Representative Jenkins welcomed Michel Sanderson, new committee analyst, and new committee member Representative Arnold Simpson, to the committee. Representative Jenkins asked for a moment of silence in memory of the loss of Representative Larry Belcher and Representative Osborne's mother, who passed away since the last committee meeting.
First on the agenda Carl Metz, from the Kentucky Association of Goodwill Industries, and Linda Romine, Public Relations Director of the St. Vincent de Paul Society in Louisville, KY, explained BR 34; Senator Buford's pre-filed bill on donation boxes. Mr. Metz said BR 34 was a truth in labeling bill. He said it requires a for-profit entity that places a donation box in any public place to label the box in a manner that tells the public the entity is not a charity. He said that there are approximately 187 red boxes in the Louisville and Southern Indiana, as well as a number in Lexington and Nicholasville and other places around the state. Mr. Metz said those red boxes are placed by a for-profit entity headquartered in Cicero, Illinois. Mr. Metz said that Goodwill Industries has no objection to a for-profit entity placing a donation box; however, the public should not be mislead into thinking that they are making a donation to a charity when they are not. He said that the Louisville Metro Council passed an ordinance in December of 2007 with this requirement. Linda Romine said that St. Vincent de Paul is a charitable, not-for-profit agency serving Louisville for the past 155 years and includes six homeless shelters, a community soup kitchen, and a free community clothes closet as well as four thrift stores in Louisville and Indiana. She said their mission is to help people who have become homeless maintain dignity and respect by meeting basic needs. Ms. Romaine said the society works with individuals to help them become self sufficient. She said that St. Vincent de Paul respects their donors and believes it is unethical for donors to be led to believe their donations are for charitable purposes when they are not. Ms. Romaine told the committee that she is concerned about solicitations for used clothing by for-profit companies; specifically the use of donations boxes placed on commercial sites with the donation boxes unclear about how the items placed in the box will be used. Ms. Romaine said that when for-profit companies take donated items the not-for-profit, charitable organizations need it may become necessary for the charity to compete against the for-profit entity. She said this would create a proliferation of brightly colored donation boxes. Ms. Romaine asked that there be a mandate to clearly label donation boxes as commercial enterprises.
Senator Seum asked if the owners of the commercial property where these donation boxes were located rent the location to the organization. Mr. Metz said that to the best of his knowledge the space was not rented, adding that he thought the owners of the property were under the assumption that placement of the box was for a charitable purpose. Senator Buford said that individuals put items in the boxes and then use the donation for a tax credit noting this could lend to an unintentional tax code violation.
Next on the agenda, representatives of the Association of Surgical Technologist and the Kentucky Community and Technical College System (KCTCS) came before the committee to discuss possible legislation regarding certification of surgical technologists. Kim Nelson, registered agent for the surgical technologists, told the members that this has been before the General Assembly in the past. He said the surgical technology program has been very well received across the state with a very high placement record. Mr. Nelson said that designating the program as a credentialing program would make it even more attractive to prospective students. Jeff Bidwell, Program Director for the surgical technology program at the Madisonville Community College, said the surgical technology legislative initiative will improve patient safety by ensuring all surgical technologist employed in Kentucky healthcare facilities in the future are competently trained. Also, Mr. Bidwell said, professionalism and regard of peers is increased when certification is earned. The KCTCS currently has nine accredited Surgical Technology programs located throughout the state providing an associate degree as well as a diploma. Students who complete the program earn up to 22 general education credits and 34 college credit hours in surgical technology studies. Mr. Bidwell said that surgical technology practices have a vast potential to impact patient care negatively and therefore requires formal training in anatomy, physiology and surgical procedures that go beyond basic on-the-job training. He said that advances in medicine and surgery require an educated, well prepared surgical assistant. Mr. Bidwell said it was his belief that surgical technologists should receive formal didactic and clinical training in an accredited academic setting and be able to demonstrate that he or she has the skills necessary for safe, competent and knowledgeable practice by passing a nationally recognized and accredited Certification for Surgical Technologist examination that is administered by the National Board of Surgical Technology and Surgical Assistant. Mr. Bidwell said he felt he could not over-emphasize the importance of the surgical technologist in the surgical theatre. He said the surgical technologist sets up the instrumentation, prepares the table and must know the anatomy of the procedure.
Representative Koenig asked if there were surgical technologists currently in the operating rooms that have no formal schooling and if this posed an insurance liability. Mr. Bidwell said that there are some sites that have on-the-job training and certain facilities do not require the certification. Mr. Nelson said one of the challenges of starting a new certification program is that there are a number of people already performing this job. Therefore, legislation would grandfather in persons already performing these jobs. Representative Clark asked how many states certify surgical technologist and suggested that continuing education should be added to the legislation in particular for the technologists who will be grandfathered. Mr. Bidwell said that currently South Carolina and Tennessee certify surgical technologists. Mr. Bidwell said that current language does have a continuing education provision. Representative Rollins asked if there was an agency other than the National Board of Surgical Technology and Surgical Assisting that certifies. He also asked who would provide the continuing education. Mr. Bidwell said the Association of Surgical Technologist, the Association of Operating Room Nurses and several other associations are recognized to provide continuing education courses. Senator Carroll asked if a person must have the two year associate degree before he or she could take the national test. Valerie Thompson said he or she would have to graduate from an accredited program in the state of Kentucky. Mr. Bidwell said KCTCS offers a diploma option; however, they were moving toward an associate degree level. He further stated that all KCTCS surgical technology programs were accredited by the Commission on Accreditation on Allied Health Programs. Representative Westrom asked what the difference was between credit hour requirements for a surgical assistant and a surgical technologist. Mr. Bidwell said the assisting program would be a post surgical technologist program. Senator Denton asked if most of the people hired now as surgical technologist have been trained through an accredited program. Mr. Bidwell replied that they have. Senator Denton asked what groups were against the bill. Mr. Bidwell said they have not been approached by any opposition; however, there have been discussions with members of the nursing associations. Mr. Nelson said there have been questions and concerns from the hospital associations regarding availability of technologist. Senator Denton commented that it was unusual for a facility to maintain records of continuing education for surgical technologists. Ms. Thompson said that there is a nurse educator in the hospital where she works who would track that information for the facility. Senator Denton asked if there would be a board that would oversee certification. Mr. Bidwell said they were in discussions with the Cabinet of Health and Family Services who regulate hospitals. Representative Meeks asked how many students were graduating per year and if there was potential to expand that number. Mr. Bidwell said there was an average annual enrollment of 20 students per year, per school, with approximately 180 graduates per year. Senator Leeper asked if Mr. Bidwell could report back on the pay scale of the states that have certification and an accurate range of the pay scale in Kentucky. Representative Burch asked if there were surgical technologists in every operating room and if the services they provide could be provided by anyone else. Ms. Thompson said there was always a team in the operating room that included a surgical technologist. Representative Burch asked why the hospitals were against the legislation. Mr. Nelson said the hospitals are opposed to the legislation affecting the way they are doing business by requiring a mandatory hiring of certified people. He said the hospitals are concerned that would prevent them from having the number of people they need on staff. Representative Jenkins asked if surgical technologists work for the hospital or if they billed separately. Ms. Thompson replied that surgical technologists are employed by the hospital.
Next on the agenda, an update from the Department of Charitable Gaming was provided. Henry Lackey, Commissioner for the Department of Charitable Gaming, told the committee he is making presentations to civic clubs and organizations across the state; and is happy to visit any organization interested in charitable gaming. He said that the department has seen a significant increase in the number of exempt licenses issued to organizations whose annual gross receipts are $25,000 or less. He said last year there were 493 exempt organizations and to date this year there are a total of 564 exempt licenses. Mr. Lackey said the department believes it is a direct result of informing charities and civic groups of what charitable gaming can do for an organization. He said that in 2007 the average profit for a charity was $69,000. Mr. Lackey said training was a key factor to successful charitable gaming, adding that training is offered on the first Tuesday of each month at the office in Frankfort. Mr. Lackey told the committee that money generated by charitable gaming is larger than pari-mutuel betting and it is an all cash business. He said that the big money made in charitable gaming is in pull-tabs, followed by Bingo and raffles. He said any organization that has 501c status, has been in existence in the county for three years as a charitable organization, and has an office in the county where the license is held can game. He said there are two types of licenses; a regular gaming license requiring the organization to file a quarterly report and an exempt license that requires the charity to file an annual report. Mr. Lackey said that most charities have problems with the 40% rule; however, the office is willing to work with any organization that has questions regarding maintaining 40 percent.
Mr. Lackey said that the mission of the department was to set standards that ensure honesty and integrity, to prevent the commercialization of charitable gaming, and to prevent the participation of criminals or other undesirable actions such as slot machines. He told the committee that most charities get into trouble because they have not had the proper training. He said he felt that training should be mandatory due to the amount of cash that is handled. Additionally, the Internal Revenue Service comes to the office on a weekly basis to audit reports from charities.
Senator Carroll asked if security was a concern for charity groups. Mr. Lackey responded that in speaking to organizations he always encourages them to hire security, adding that over 50% of the groups do not have security. Representative Miller asked how charities make large amounts of money when the 501c status permits gaming only twice a week. Representative Miller also asked if there were guidelines for the rent facilities charge. Mr. Lackey replied that the gaming license allows for two gaming sessions per week and that facilities are allowed to charge per session. Representative Miller asked for an explanation of how taxes were paid for each session. Mr. Lackey said that .06 percent, just over one half of one cent, is taken from every dollar. This is the only money that comes to the agency for day to day operations. Representative Palumbo asked who has to go through training. Leah Boggs, Director of Licensing and Compliance, said that currently there are no particular people who are required to attend training, unless there is a settlement agreement. She said in most of the settlement agreements the office asks that the CEO, the CFO and the chair-people of gaming come to training. The training is open to any volunteer, any officer, any booker, and is free once a month in the office. She said that once a quarter additional training is done just for raffles and church festivals because a large number of organizations only have these events. She said that the office will go out in the state as requested. Mr. Lackey said that an auditor is also at the training session to show groups how to correctly complete reporting forms. Representative Firkins said the Jefferson County Delegation had recently met with charitable organizations who said the office's investigators and enforcement officers typically come into their gaming sessions with a threatening manner. He asked if the office was aware of this behavior in Jefferson County. Mr. Lackey said he would like to talk to the individual who has the complaint as he has personally been visiting groups and has not heard any complaints about enforcement officers visits. Mr. Lackey added that he felt that the people in questions were compliance officers who inspect the facilities every six to eight weeks. Senator Seum said he was concerned about a mandate on charities to come to Frankfort for training at their own expense and suggested that the office take the training to the charities. Mr. Lackey responded that the Chief Executive Officer, the Chief Financial Officer and those that chair the games would be mandated to attend the training. Senator Seum asked if a person was required to have a license for a raffle only. Mr. Lackey said that if the ticket sales exceed $150 there was a license requirement. Representative Meeks asked if it was legal for a charity to own the facility they are gaming in. Mr. Lackey said if you own a facility such as the Catholic Church or the veterans, you can have a full gaming session at your facility and do not have to have a facility license. Representative Meeks asked if the department was not trying to identify businesses who operate slot machines in the back of their businesses. Mr. Lackey replied that if a proprietor of a business has slot machines that he is making a profit from it is gambling, which is illegal in this state; however, enforcement is difficult due to lack of manpower. He added that the department has no arrest authority unless a felony is witnessed at the time of the offense. Representative Meeks said the legislature should be more diligent in providing the department with enforcement powers for illegal gambling. Representative Santoro said the charitable organizations in his district have been pleased with the department since Mr. Lackey had taken over the office. Senator Buford said the department staff was doing an excellent job. Marty Hammons said that compliance officers are having training programs installed on their laptops. He said it was very important to the department that all staff perform in a professional manner. Larry Bond, Deputy Secretary of the Public Protection Cabinet, said that the department takes its job very seriously and wants to work with the charities in a spirit of cooperation. He added that the General Assembly created the Department of Charitable Gaming and that the department was limited to "charitable gaming." He said that illegal gambling was a law enforcement issue.
Representative Jenkins said that the committee was going to have someone from the Auditor's Office come before the committee to discuss their report on charitable gaming in Kentucky, possibly in November. Representative Westrom asked if the Department of Justice and the Kentucky State Police could come before the committee to explain how they actually handle the situation with the illegal slot machines, as no one is able to provide concrete information. Senator Buford said that the U.S. District Attorney's office deals with this offense.
Representative Jenkins reminded members that the next meeting is November 14th at 10:00 AM. The meeting was adjourned at 11:35 AM