Kentucky
General Assembly

02/21/23	introduced in House to Committee on Committees (H) taken from Committee on Committees (H) 1st reading to Judiciary (H)
03/01/23	taken from Judiciary (H) 2nd reading returned to Judiciary (H)
03/02/23	reported favorably, to Rules with Committee Substitute (1) taken from Rules placed in the Orders of the Day 3rd reading, passed 75-22 with Committee Substitute (1)
03/03/23	received in Senate to Committee on Committees (S)
03/10/23	taken from Committee on Committees (S) 1st reading returned to Committee on Committees (S)
03/13/23	taken from Committee on Committees (S) 2nd reading returned to Committee on Committees (S) to Families & Children (S)
03/14/23	reported favorably, to Rules with Committee Substitute (1) and Committee Amendment (1-title) floor amendments (1) (2) (3) (4) and (5) filed to Committee Substitute
03/15/23	floor amendment amendments (6), (7) and (8) filed to Committee Substitute posted for passage in the Regular Orders of the Day for Wednesday, March 15, 2023 3rd reading Committee Substitute adopted floor amendments (1), (3) (4) and (5) withdrawn floor amendment (2) adopted laid on clerk's desk

Amendment	House Committee Substitute 1
Fiscal Impact Statement	Local Mandate to House Committee Substitute 1
Summary	Retain original provisions of the bill except modify definitions; remove mental health providers from the bill; remove references to social transition services; remove references to local school districts; remove criminal penalties for health care providers not reporting services; remove aiding or assisting in the provision of gender transition services from liability provisions; clarify changes to court authority to exercise personal jurisdiction; remove provisions relating to public school counselors, school-based mental health services providers, or other public employees; remove delayed effective date.
Index Headings	Courts - Name and sex change on certificate, prohibition Crime Victims - Gender transition services, person under age 18 years, liability Crimes and Punishments - Sex classification, prohibition Diseases - Gender transition services, person under age 18 years, liability Drugs and Medicines - Gender transition services, person under age 18 years, liability Health and Medical Services - Gender transition services, person under age 18 years, liability Hospitals and Nursing Homes - Gender transition services, person under age 18 years, liability Insurance, Health - Gender transition services, person under age 18 years, prohibitor Nurses - Gender transition services, person under age 18 years, liability Occupations and Professions - Health providers, gender transition services, person under age 18 years, liability Parental Rights - Gender transition services, person under age 18 years, cause of action Pharmacists - Gender transition services, person under age 18 years, liability Physicians and Practitioners - Gender transition services, person under age 18 years, liability Public Assistance - Gender transition services, prohibition of coverage, person under age 18 years Public Health - Name or sex change on certificate, prohibition Safety - Gender transition services, person under age 18 years Short Titles and Popular Names - Do No Harm Act Taxation, Income--Corporate - Gender transition services, net income Medicaid - Gender transition services, prohibition of coverage, person under age 18 years Attorney General - Gender transition services, persons under age 18 years, action Children and Minors - Gender transition services, persons under age 18 years, liability Local Mandate - Gender transition services

Amendment	Senate Committee Substitute 1
Fiscal Impact Statement	Local Mandate to Senate Committee Substitute 1
Summary	Retain original provisions except limit the ban on the expenditure of public funds for gender transition services to persons under the age of 18; add a new section of KRS Chapter 158 to establish definitions; require specific parental notifications from public schools; require school districts to adopt specific procedures related to parental rights; limit authority of the Kentucky Board of Education and Kentucky Department of Education in relation to parental rights and a student's use of pronouns; prohibit district or school policies with the intent of keeping student information confidential for parents; prohibit a school district from requiring school personnel or pupils to use pronouns for students that do not conform to that student's biological sex; provide school districts and district personnel authority to seek emergency medical services for a student; provide conditions for student confidentiality; amend KRS 158.1415 to establish requirements for any public school's content, course, curriculum, or program on the subject of human sexuality; provide that notification relating to services be focused on human sexuality, contraception, or family planning; include a requirement that specific questionnaires or screening forms given to a child receive parental consent and review and forbid general consent; allow district personnel to seek or provide emergency medical or mental health services pursuant to district policy; specify that nothing removes the duty to report a dependent child or abused or neglected child due to risk of physical or emotional injury; create new section of KRS 158 to require each local board of education or charter school board of directors to adopt policies necessary to protect the privacy rights of students relating to school restrooms; EMERGENCY.
Index Headings	Education, Elementary and Secondary - Parental rights, public schools Effective Dates, Emergency - Parental rights, public schools Parental Rights - Human sexuality, contraception and family planning services, public schools, parental notice State Agencies - Kentucky Department of Education, parental rights to information, limit on authority State Agencies - Kentucky Department of Education, student pronoun usage, limit on authority Boards and Commissions - Education, privacy rights, policies Boards and Commissions - Kentucky Board of Education, parental rights to information, limit on authority Boards and Commissions - Kentucky Board of Education, student pronoun usage, limit on authority Teachers - District employees, rights, use of pronouns Teachers - Student information, parental rights Children and Minors - Dependent, abused, or neglected children, duty to report, risk of physical or emotional harm Children and Minors - Parental rights, public schools Local Mandate - Parental rights, public schools Education, Elementary and Secondary - Dependent, abused, or neglected children, duty to report, risk of physical or emotional harm Education, Elementary and Secondary - Human sexuality, contraception and family planning services, parental notice

Amendment	Senate Committee Amendment 1
Sponsor	D. Carroll
Summary	Make title amendment.
Index Headings	Title Amendments - HB 470/GA

Amendment	Senate Floor Amendment 1
Sponsor	G. Williams
Summary	Amend KRS 158.1415 to permit a parent or guardian aggrieved by violations of requirements for a public school's course, curriculum, or program on the subject of human sexuality to bring an action for declaratory and injunctive relief in Circuit Court.
Index Headings	Education, Elementary and Secondary - Human sexuality, contraception and family planning services, parental notice Education, Elementary and Secondary - Parental rights, public schools Parental Rights - Human sexuality, contraception and family planning services, public schools, parental notice Boards and Commissions - Human sexuality, contraception and family planning services, public schools, parental notice Teachers - Human sexuality, contraception and family planning services, public schools, parental notice Children and Minors - Parental rights, public schools Courts, Circuit - Human sexuality, contraception and family planning services, public schools, parental notice

Amendment	Senate Floor Amendment 2
Sponsor	D. Carroll
Summary	Remove original provisions relating to gender transition services; create a new section of KRS Chapter 311 to prohibit the provision of surgical or medical treatment to a child under the age of 18 years for gender dysphoria and any nonsurgical medical treatment without the consent of the child's parent or legal guardian; require that the provision of nonsurgical medical treatment to a child under the age of 18 years apply only to a child with a medical diagnosis by a trained and experienced licensed physician in collaboration with a clinical psychologist or psychiatrist using only appropriate nonsurgical medical treatments that meet evidence-based medical standards. .
Index Headings	Health and Medical Services - Gender dysphoria, treatment, children Hospitals and Nursing Homes - Gender dysphoria, treatment, children Mental Health - Gender dysphoria, treatment, children Parental Rights - Gender dysphoria, treatment, children Parental Rights - Parental consent, child health and mental healthcare Pharmacists - Gender dysphoria, treatment, children Physicians and Practitioners - Gender dysphoria, treatment, children Public Health - Gender dysphoria, treatment, children Public Health - Parental consent, child health and mental healthcare Children and Minors - Gender dysphoria, treatment, children Children and Minors - Parental consent, health and mental healthcare

Amendment	Senate Floor Amendment 3
Sponsor	G. Williams
Summary	Remove original provisions relating to gender transition services; create a new section of KRS Chapter 311 to prohibit the provision of surgical or medical treatment to a child under the age of 18 years for gender dysphoria and any nonsurgical medical treatment without the consent of the child's parent or legal guardian; require that the provision of nonsurgical medical treatment to a child under the age of 18 years apply only to a child with a medical diagnosis by a trained and experienced licensed physician in collaboration with a clinical psychologist or psychiatrist using only appropriate nonsurgical medical treatments that meet evidence-based medical standards; add liabillity provisions. .
Index Headings	Health and Medical Services - Gender dysphoria, treatment, children Hospitals and Nursing Homes - Gender dysphoria, treatment, children Mental Health - Gender dysphoria, treatment, children Parental Rights - Gender dysphoria, treatment, children Parental Rights - Parental consent, child health and mental healthcare Pharmacists - Gender dysphoria, treatment, children Physicians and Practitioners - Gender dysphoria, treatment, children Public Health - Gender dysphoria, treatment, children Public Health - Parental consent, child health and mental healthcare Children and Minors - Gender dysphoria, treatment, children Children and Minors - Parental consent, health and mental healthcare

Amendment	Senate Floor Amendment 4
Sponsor	L. Tichenor
Summary	Remove original provisions relating to gender transition services; create a new section of KRS Chapter 311 to prohibit the provision of surgical or medical treatment to a child under the age of 18 years for gender dysphoria and any nonsurgical medical treatment without the consent of the child's parent or parents, or legal guardian; require that the provision of nonsurgical medical treatment to a child under the age of 18 years apply only to a child with a medical diagnosis from a pediatric psychiatrist and by a trained and experienced licensed physician in collaboration with a clinical psychologist or psychiatrist using only appropriate nonsurgical medical treatments approved by the the United States Food and Drug Administration for adolescents and that meet evidence-based medical standards; add liability provisions.
Index Headings	Hospitals and Nursing Homes - Gender dysphoria, treatment, children Mental Health - Gender dysphoria, treatment, children Parental Rights - Gender dysphoria, treatment, children Parental Rights - Parental consent, child health and mental healthcare Pharmacists - Gender dysphoria, treatment, children Physicians and Practitioners - Gender dysphoria, treatment, children Public Health - Gender dysphoria, treatment, children Public Health - Parental consent, child health and mental healthcare Children and Minors - Gender dysphoria, treatment, children Children and Minors - Parental consent, health and mental healthcare Health and Medical Services - Gender dysphoria, treatment, children

Amendment	Senate Floor Amendment 5
Sponsor	J. Adams
Summary	Add definition of "Health facility or service".
Index Headings	Health and Medical Services - Gender dysphoria, treatment, children Hospitals and Nursing Homes - Gender dysphoria, treatment, children Mental Health - Gender dysphoria, treatment, children Pharmacists - Gender dysphoria, treatment, children Physicians and Practitioners - Gender dysphoria, treatment, children Public Health - Gender dysphoria, treatment, children Children and Minors - Gender dysphoria, treatment, children

Amendment	Senate Floor Amendment 6
Sponsor	G. Williams
Summary	Remove original provisions relating to gender transition services; create a new section of KRS Chapter 311 to define "minor" and "sex"; prohibit a health care provider from providing services to a minor for the purpose of attempting to alter the appearance or perception of the minor's sex with certain exceptions; require a licensing or certifying agency to revoke a health care provider's licensure or certification for finding of violation; permit civil action for injury suffered as a result of a violation by the age of 42 years or within 3 years of discovering that damages were caused by the violation; permit treatment of a minor initiated prior to July 1, 2023 to continue no later than December 31, 2024.
Index Headings	Health and Medical Services - Sex alteration, minors, prohibit Hospitals and Nursing Homes - Sex alteration, minors, prohibit Mental Health - Sex alteration, minors, prohibit Pharmacists - Sex alteration, minors, prohibit Physicians and Practitioners - Sex alteration, minors, prohibit Public Health - Sex alteration, minors, prohibit Children and Minors - Sex alteration, minors, prohibit

Amendment	Senate Floor Amendment 7
Sponsor	G. Williams
Summary	Remove original provisions; create a new section of KRS Chapter 311 to define "minor" and "sex"; prohibit a health care provider from providing services to a minor for the purpose of attempting to alter the appearance or perception of the minor's sex with certain exceptions; require a licensing or certifying agency to revoke a health care provider's licensure or certification for finding of violation; permit civil action for injury suffered as a result of a violation by the age of 42 years or within 3 years of discovering that damages were caused by the violation; permit treatment of a minor initiated prior to July 1, 2023 to continue no later than December 31, 2024; create a new section of KRS Chapter 158 to establish definitions; require specific parental notifications from public schools; require school districts to adopt specific procedures related to parental rights; limit authority of the Kentucky Board of Education and Kentucky Department of Education in relation to parental rights and a student's use of pronouns; prohibit district or school policies with the intent of keeping student information confidential for parents; prohibit a school district from requiring school personnel or pupils to use pronouns for students that do not conform to that student's biological sex; provide school districts and district personnel authority to seek emergency medical services for a student; provide conditions for student confidentiality; amend KRS 158.1415 to establish requirements for any public school's content, course, curriculum, or program on the subject of human sexuality; provide that notification relating to services be focused on human sexuality, contraception, or family planning; include a requirement that specific questionnaires or screening forms given to a child receive parental consent and review and forbid general consent; allow district personnel to seek or provide emergency medical or mental health services pursuant to district policy; specify that nothing removes the duty to report a dependent child or abused or neglected child due to risk of physical or emotional injury; create new section of KRS 158 to require each local board of education or charter school board of directors to adopt policies necessary to protect the privacy rights of students relating to school restrooms; EMERGENCY.
Index Headings	Education, Elementary and Secondary - Dependent, abused, or neglected children, duty to report, risk of physical or emotional harm Education, Elementary and Secondary - Human sexuality, contraception and family planning services, parental notice Education, Elementary and Secondary - Parental rights, public schools Effective Dates, Emergency - Parental rights, public schools Health and Medical Services - Sex alteration, minors, prohibition Hospitals and Nursing Homes - Sex alteration, minors, prohibition Mental Health - Sex alteration, minors, prohibition Parental Rights - Human sexuality, contraception and family planning services, public schools, parental notice Pharmacists - Sex alteration, minors, prohibition Physicians and Practitioners - Sex alteration, minors, prohibition Public Health - Sex alteration, minors, prohibition State Agencies - Kentucky Department of Education, parental rights to information, limit on authority State Agencies - Kentucky Department of Education, student pronoun usage, limit on authority Boards and Commissions - Education, privacy rights, policies Boards and Commissions - Kentucky Board of Education, parental rights to information, limit on authority Boards and Commissions - Kentucky Board of Education, student pronoun usage, limit on authority Teachers - District employees, rights, use of pronouns Teachers - Student information, parental rights Children and Minors - Dependent, abused, or neglected children, duty to report, risk of physical or emotional harm Children and Minors - Parental rights, public schools Children and Minors - Sex alteration, minors, prohibition

Amendment	Senate Floor Amendment 8
Sponsor	A. Southworth
Summary	Retain original provisions; amend definitions and permitted gender transition services; make conforming amendments.
Index Headings	Health and Medical Services - Gender transition, treatment, children Hospitals and Nursing Homes - Gender transition, treatment, children Mental Health - Gender transition, treatment, children Pharmacists - Gender transition, treatment, children Physicians and Practitioners - Gender transition, treatment, children Public Health - Gender transition, treatment, children Children and Minors - Gender transition, treatment, children