Senate passes its version of state budget with many health items; $100 million would 'support a response to the nursing shortage'

By Melissa Patrick
Kentucky Health News

The state Senate passed its version of a two-year state budget by a 30-6 vote Wednesday, the same day it passed out of committee. The bill will soon head to a House-Senate conference committee that will write the final version.

The Senate-revised House Bill 1 has a number of health provisions, with some variations from the House version and Gov. Andy Beshear's proposals.

The Republican-controlled chambers and the Democratic governor have three different approaches to addressing the nursing shortage, which has been exacerbated by the coronavirus pandemic. 

Photo from American Nurses Association

The Senate allocated $100 million of federal relief money in the first year of the budget, starting July 1, "to support a response to the nursing shortage," without giving any details. The House included no money for the retention and recruitment of nurses.

Beshear, who said Thursday that the focus needs to be on retention, called for $6 million each year from the General Fund for nursing scholarships; and from relief funds, $5 million a year for five years to create a new student loan-forgiveness program and $2 million for a marketing and outreach campaign.

The House budget and Beshear's budget both include $17.7 million in the first fiscal year and $19 million in the second fiscal year to cover the costs of local health departments required services, but the Senate's budget only allocated money for the second fiscal year in the amount of $19 million. 

Randy Gooch, executive director of the Jessamine County Health Department, said the Kentucky Health Department Association isn't sure why the Senate would have left out an allocation for fiscal year 2023 and Sen. Chris McDaniel, R-Ryland Heights, who crafted the Senate budget has not yet returned a call for clarification. 

The Senate budget includes Beshear's wish for for 500 new Michelle P. waiver program slots for people with intellectual or developmental disabilities; the House provided for 100. The Senate added 200 slots to the Supports for community Living waiver program for similar beneficiaries, double what Beshear and the House proposed. Both programs have thousands of Kentuckians on their waiting lists.  

The Senate agreed with the House on extra funding for domestic-violence shelters, rape crisis centers and child-advocacy centers, allocating $500,000 more for each in each fiscal year. Beshear proposed a 36% increase each year for each type of organization: $2.5 million, $1.78 million and $1.3 million, respectively.

And while the Senate and House budgets both would fund 200 more social workers, Beshear's budget proposal would have funded an additional 350. 

To implement the new 988 suicide hotline, a three-digit number set to replace the National Suicide Prevention Lifeline in July 2024, the Senate budgeted $3.37 million in the first year and $9.9 million in the second, the amounts Beshear recommended. The House allocated much more: $12.4 million in the first year and $17.6 million in the second, but directed that the money also be used to create more mobile crisis units. 

The Senate allocated $500,000 in each year for the Lung Cancer Screening Program that would be established with the passage of HB 219. The bill passed the House in late January and in the Senate Appropriations and Revenue Committee, which wrote the revised budget. 

The Senate budget also says that each Medicaid managed-care organization that has a participating contract with Kentucky in the next contract renewal will cover lung-cancer screenings.  

Here are some other health-related provisions in the Senate budget. 

From the Tobacco Settlement Fund:

• $500,000 in each fiscal year to support the Kentucky Rural Mental Health, Suicide Prevention and Farm Safety Program, titled the "Raising Hope Initiative."
• $1.4 million each year for substance-abuse prevention and treatment for pregnant women with a history of substance-use disorders;
• $7 million each year for the Health Access Nurturing Development Services Program (HANDS) for poor families with young children;
• $900,000 per year for the Healthy Start initiatives;
• $900,000 a year for early-childhood mental health;
• $900,000 a year for early-childhood oral health;
• $2 million a year for smoking cessation. Advocates have long asked for more smoking cessation funding, asking recently on a Kentucky Educational Television lung-cancer forum that this amount, at minimum, go back to the pre-pandemic level of $3.3 million.
  

From the General Fund:

• $6.25 million in each fiscal year for cancer research and screening to be equally shared by the University of Kentucky and the University of Louisville;
• $500,000 in the first year and $493,500 in the second year for spinal-cord and head-injury research (an amount that was previously taken from the Tobacco Settlement Fund); 
• $93,700 in each year for grants to the Brain Injury Association of America, Kentucky Chapter and the Epilepsy Foundation of Kentuckiana to help veterans who have experienced brain trauma;
• $500,000 each year for the Kentucky Colon Cancer Screening Program;
• $100,000 per year for The Hope Center of Lexington for addiction recovery;
• $900,000 a year for The Healing Place, a Louisville recovery program;
• $1,495,000 a year to support the Lee Specialty Clinic, which provides specialty medical services for individuals with moderate developmental and intellectual disabilities living in residential and community settings. 
• $7.2 million in the first year and $14.48 million in the second fiscal year to expand the senior citizens' meal program. The appropriation will come from federal relief funds. 
• $1 million in the first year to support external performance reviews of substance-use treatment programs administered or funded by the health cabinet. 
• $2.5 million in each year to the Kentucky Pediatric Cancer Research Trust Fund; Beshear's proposal provided $3.75 million in each fiscal year. 
• $750,000 per year for the Kentucky Poison Control Center, unless federal emergency relief funds become available;
• $1 million a year for the Ovarian Cancer Screening Outreach Program at the University of Kentucky; the House budget had $500,000 a year. 
• Federal and state funds are allocated in both years to maintain the pandemic-elevated reimbursement of $29 per day per Medicaid patient in nursing homes.
• Money is provided to support expansion of of a pilot program for Tim's Law to additional locations as a way to ensure statewide access. Tim's Law allows judges to order assisted outpatient treatment for people who have been involuntarily hospitalized, aimed at stopping the revolving door them going in and out of jails and state psychiatric hospitals.