Pulaski representatives back bill to limit out-of-state drug treatment patients

Feb. 1—Just two weeks ago, local governmental leaders made their thoughts known on the issue of transportation of patients when it comes to substance treatment facilities. On Tuesday, local representatives took up the mantle and introduced a bill in Frankfort aimed at some of their concerns.

The bill, House Bill 408, is sponsored by seven representatives, five of whom have districts which carve into Pulaski: Shane Baker, Josh Bray, Josh Branscum, House Speaker Pro Tem David Meade, and Ken Upchurch.

The other two sponsors are Matt Lockett out of Fayette and Jessamine counties, and Kimberly Poore Moser out of Kenton.

The bill, in part, will attempt to tighten up the concept of who is considered to be an out-of-state resident for the purpose of that person seeking help in a Kentucky treatment facility if they require Medicaid for insurance.

Those patients will be required to provide proof of residency when submitting requests for Medicaid reimbursement.

The bill would also prohibit substance abuse treatment facilities from recruiting out-of-state residents who are dependent on Medicaid, and would require licensed programs to provide transportation of patients leaving their programs back to their area of origin if they are unable to be transported by their family, guardians or emergency contacts.

One of the bill's sponsors, 85th Representative Baker, said the idea for it began a couple of years ago due to receiving phone calls from people within both Pulaski and Laurel Counties who were concerned about safety issues surrounding increased numbers of homeless individuals.

"I've talked to some older folks who no longer feel safe walking their streets. I've talked to some families who don't feel safe letting their children play in their yard. People who are finding drugs," he said.

He also said he had seen the problem with his own eyes. "I picked up a hitchhiker who was trying to make his way back home to Nashville because he'd been brought up here and put in a facility — had used Medicaid — and was kicked out and homeless in Somerset."

Earlier in January, Somerset Mayor Keck presented a resolution that was passed by the City Council urging state leaders to pass laws making it illegal to "bus in" out-of-state patients into recovery facilities.

Keck said his intent was not to prevent people from seeking help. Rather, it was a concern that such patients were not being able to find transportation home and were being released onto the streets without finances or a support structure, causing them to add to the growing unhoused population within Pulaski.

That has, in turn, caused an increase in crime, he said.

"We've had three incidents, including one in the last two or three days, of somebody from out of state that takes a vehicle that's not theirs and tries getting back where they came from. That can't continue to happen," Keck said that the Jan. 22 meeting.

The next day, Pulaski County Judge-Executive Marshall Todd submitted his own version of the resolution to Fiscal Court, which was quickly approved.

Baker said he was aware of Pulaski officials' resolutions.

"The good news is, it seems like elected officials across the board are hearing the need and are working to address the need," Baker said. "And honestly, it could be fixed, rather quickly if any [substance abuse facility operator] who's gaming the system would just do what's right and run their facilities in a manner that does not create issues for our residents or their patients. Unfortunately that's not where we are, so we're willing to do what's necessary to provide those protections."

He said it was unfortunate that it was falling to state lawmakers to require such protections.

"The bottom line is, the goal is to make sure we're not recruiting people from out of state, bringing them here and putting them on Kentucky Medicaid, milking the system and in essence creating homeless people in our community," Baker said.

Not only does it create safety concerns for those already living in the community, it is taking advantage of vulnerable people and putting them into a situation that is hurting them, he said.

"We don't want people kicked out on the street," he said. "We want people returned home, returned to their families and sent to where they can become productive members of society."

He noted that many addiction recovery facilities are doing what he called a great job in tending to the needs of their patients.

As with any bill, it could take some time before it moves out of committee and is placed before the full House to be voted on. Then, it would need to be approved by the Senate before reaching the desk of the governor to be signed into law. Some bills do not advance that far in a single legislative session.

"I feel that we're moving in the right direction and hopefully we can make some meaningful changes that will make all of our communities safer. If not, we'll come back again next year and continue to work on this till we get it right," he said.

It does help, he said, that the bill has the support of Meade for the House, and said he felt like it has support from Somerset Senator Rick Girdler.

"What the rest of the senate thinks about it remains to be seen," he said, but noted that the problem is not limited to the Pulaski County area.

"These are some growing issues in other communities as well. This is not just a Pulaski County problem," Baker said. "I've learned through conversations with some of my colleagues here in Frankfort, that they're facing the exact same thing or something very similar in their communities. They're also concerned about it and want to address it, so I know that we have broad support in the House."