Fiscal Notes for the 2025 Regular Session of the General Assembly
Updated Feb. 5, 2025
HB 15 – AN ACT relating to instruction permits and declaring an emergency
HB 15 is estimated to cost $100,000 from the Road Fund to reprogram the current KDLIS system while the new KINDL system is being developed. Some additional costs and time delays may occur with the new KINDL system by requiring changes to the current system.
HB 16 – AN ACT relating to water fluoridation programs
HB 16 is estimated to costs between $19.7-$59.1 million total ($3.9-$11.8 million state) assuming a 10-30% percentage of the population with non-fluoridated drinking water:
- 10% $19.7 million total ($3.94 million state funds)
- $17 million for one additional carie per year for 68,000 children
- $2.7 million in increased non-preventive dental costs for 90,000 adults
- 30% $59.1 million ($11.8 million state funds)
- $51 million for one additional carie per year for 204,000 children
- $8.1 million in increased non-preventive dental costs for 270,000 adults
HB 20 – AN ACT relating to privacy protection
HB 20 (use of automated license plate readers) – loss of $3.4 million in Road Fund revenues from charges collected at weigh stations, such as overweight truck fines related to weight-distance collections and vehicle impounds at weigh stations, since license plate readers provide evidence of a vehicle's location at a certain time within the state.
HB 23 – AN ACT relating to sex crimes
HB 23 is estimated to cost at least $827,200 for additional treatment, reentry, and offender information staff to oversee the offenders in the community and placements and audits.
HB 28 – AN ACT relating to dementia training
HB 28 is estimated to cost $303,500 in the first fiscal year and $35 for each newly hired employee for each subsequent year.
Contractor development of training at approximate cost of $125,000 plus $178,500 to train employees within the Department for Community Based Services and $35 to train each new hire.
HB28 requires the implementation of a one-hour dementia training and continuing education course for staff of the Department of Community Based Services.
HB 31 – AN ACT relating to weight limits on state roads
HB 31 is estimated to increase system programming costs to issue the permits of approximately $50,000-$100,000.
HB 32 – AN ACT relating to outdoor recreation
HB 32 is estimated to cost $810,000 for personnel and operating costs, but no appropriation has been included with the legislation. The fiscal impact consists of the following estimated costs:
Personnel – (1 Exec Director x $260,000) + (2 staff x $150,000) = $560,000
Operations, Marketing, Resources, Travel – $250,000
HB 43 – AN ACT relating to maternal health disparities in perinatal care
HB 43 is estimated to cost $502,100 for the first year and $406,300 for each subsequent year for additional staff for the Department of Public Health (DPH) at a cost of approximately $350,000, plus information technology costs of about $152,100 initially and $56,300 in ongoing annual support.
HB 43 mandates that DPH track specific data elements on maternal death and severe morbidity. Staffing is needed because morbidity data is difficult to obtain as the reporting diagnosis would need to be obtained through direct chart abstraction from the hospitals.
Maternal fatality reviews are conducted at the state level. If the scope is extended to include morbidity, two additional nurses will be needed to conduct record abstraction at a cost of approximately $150,000 each per year each.
HB 61 – AN ACT relating to Medicaid-covered nonemergency medical transportation
HB 61 is estimated to cost $15.8 million ($4.4 million state funds).
- $15.2 million ($4.1 million state) in increased benefits and utilization, and $600,000 ($300,000 state) in additional staff to address the new enrollment and maintenance costs.
HB 61 requires that the current Medicaid nonemergency medical transport (NEMT) program be completely restructured. The additional expenses are based on the need for additional transports.
HB 86 – AN ACT relating to unpasteurized milk
HB 86 is estimated to cost approximately $85,000 per incident of a foodborne illness outbreak.
If estimating between 50-100 incidents of a foodborne illness outbreak as a result of consuming raw milk and raw milk products, the cost to investigate would be $4.25M – $8.5M.
The breakdown of cost is:
- $50,000 for local health department and state program staff time (not including overtime or other costs associated with travel, specimen collection, and packaging and shipping costs), and
- $35,000 for sample collection and testing.
HB 102 – AN ACT relating to perfluoroalkyl and polyfluoroalkyl substances.
HB 102 is estimated to cost $760,000 annually from the General Fund to operate the program.
The bill attaches the PFAS Working Group to the Cabinet for Health and Family Services and includes numerous requirements and deliverables These requirements would require additional staffing, as well as technical and administrative support, that currently do not exist. At least 3 additional staff (2 programmatic and 1 administrative) would be needed along with associated expenses such as space, computer, phone, copier/printer, staff travel, and program operating expenses. There are penalties in the bill but the revenue from this source is expected to be minimal.
HB 136 – AN ACT relating to corrections data reporting
HB 136 is estimated to cost $50,000 to update the Kentucky Offender Management System to add new data reporting features required by the bill.
HB 140 – AN ACT relating to public health and safety
HB 140 is estimated to cost $5.1 million ($1.1 million state) in increased costs from processing, testing, and administering the expanded directed donation processes, and an additional staff position in the Office of Inspector General.
Any donated blood would need to meet medical necessity criteria and be subject to federal testing requirements. Direct donations of blood require additional processing, storage and handling.
This would have a large cost because many disorders, illnesses, and accidents would result in higher mortality, morbidity, and more expensive treatment if blood is not available due to this bill.
HB 147 – AN ACT relating to railroad operations
HB 147 is estimated to increase Road Fund revenues based on the number of violations resulting in civil penalties.
HB 148 – AN ACT relating to the Child Care Assistance Program
HB 148 is estimated to cost $30.1 to $30.5 million annually from the General Fund based on the proposed changes and copayments. The cost of updating the Integrated Eligibility and Enrollment System regarding benefits or services related to the child care assistance program is estimated between $100k - $500K (federal funds).
This estimate does not take into consideration any other additional federal funds that could be reduced for being in violation of the federal rule. Copayments are established within 922 KAR 2:160, which was amended to be compliant with the recent federal CCDF Final Rule issued in April 2024 capping family co-pays at no more than 7% of a family's income.
HB 152 – AN ACT relating to a Medicaid supplemental payment program for public ground ambulance providers
HB 152 is estimated to cost around $200,000 to seek or expand a third-party contract to administer the program.
There is fiscal risk to this supplemental payment program, however, because federal regulations prohibit state Medicaid agencies from determining provider eligibility based on if the provider pays the intergovernmental transfer (IGT) or not.
HB 157 – AN ACT relating to special license plates
HB 157 is estimated to require a $5,000 programming fee for a new Friends of Kentucky Agriculture license plate.
HB 161 – AN ACT relating to identity documents
HB 161 is estimated to cost $250,000 from the Road Fund per year for three staff to handle the approvals, training and auditing of the third-party providers, plus an extra $50 per background check.
HB 175 – AN ACT relating to signage on state-maintained highways
HB 175 is estimated to cost $315,500 from the Road Fund for removing the plaques below the 13 large panel signs on the interstate routes entering Kentucky with appropriate traffic control, and to fabricate and install 75 smaller sheeting signs on conventional roadways entering the state. These cost estimates include appropriate traffic control.
HB 188 – AN ACT relating to motor vehicle driveaway plates
HB 188 is estimated to cost $230,000, of which $130,000 is recurring from the Road Fund to fund a program investigator and for enforcement actions, and $100,000 for KAVIS and ICA database programming.
HJR 8 – A JOINT RESOLUTION designating the President Donald J. Trump Highway in Boone County
The Transportation Cabinet estimates a cost of $250 for fabrication and installation of most signs. Road and bridge naming requires two signs for a total estimated cost of $500.
SB 13 – AN ACT relating to exceptions to restrictions on maternal healthcare.
SB 13 is estimated to cost $2.8 million in total funds ($1.4 million in state funds) to procure managed care organizations.
SB 16 – Medicaid coverage for licensed certified professional midwives
SB 16 is estimated to cost of about $400,000 per year, $80,000 from the General Fund.
Based on data available, about 25% of the infants born after the intrapartum transfers – or about 32 – would need additional care in the Neonatal Intensive Care Unit (NICU). This is care that would most likely not have been needed if the delivery had occurred in a hospital setting. The average cost of a NICU stay in 2020 based on total stays, hospital payments, and number of distinct members was $11,643, an additional $372,576 in NICU costs. The estimated costs include $20,000 from emergency transports for about 130 additional intrapartum transports. If certified professional midwives (CPMs) were introduced within the existing medical infrastructure – as support staff in hospitals and/or birthing centers – then improved outcomes and even cost savings could be achieved.
If the home birth rate were to be higher, these costs would similarly rise.
SB 17 – AN ACT relating to freestanding birthing centers
SB 17 is estimated to cost of about $400,000 per year, $80,000 from the General Fund.
Based on data available, about 25% of the infants born after the intrapartum transfers – or about 32 – would need additional care in the Neonatal Intensive Care Unit (NICU). This is care that would most likely not have been needed if the delivery had occurred in a hospital setting. The average cost of a NICU stay in 2020 based on total stays, hospital payments, and number of distinct members was $11,643. Therefore, in addition to the emergency transports, DMS would anticipate an additional $372,576 in NICU costs. Total anticipated costs, therefore, would be at least $392,576 per year.
Kentucky Medicaid already pays for more than 1,000 ambulance trips in a year that occur within 48 hours of a delivery. DMS has layered these existing estimates on top of an estimated 1.8% home birth rate.
SB 21 – AN ACT relating to traffic control signal monitoring systems
SB 21 is expected to have an upfront cost of $100,000 with an estimated $25,000 in ongoing support costs. This bill will require two new interfaces to the KAVIS system.
SB 27 – AN ACT relating to Parkinson's disease
SB 27 is estimated to require an initial one-time costs of $635,000 to $1 million and $100,000 in annual ongoing costs in state funding to set up a Parkinson's Disease Registry.
This estimate comes from looking at six other states, including Utah, Nebraska, and South Carolina, that have already established or are working to establish similar registries.
Building the system involves:
- $200,000-$400,000 initial costs for designing, developing, and maintaining the system over time,
- $150,000-$175,000 initial costs for including the cabinet's Office of Application and Technology Services (OATS) requirement to hire additional staff,
- $50,000-$100,000 initial costs for new technology or data systems,
- $100,000-140,000 initial costs for developing a secure data collection system,
- $35,000-$60,000 initial costs for develop data storage and management of that storage,
- $100,000-$125,000 initial costs for developing reporting and analysis tools or buying those tools from external vendors, i.e. licenses, and
The bill does not appropriate funding, and it specifically states the cabinet shall be responsible for any costs incurred in administering the registry and advisory committee, etc.
SB43 – AN ACT relating to operator's licenses
SB 43 is estimated to cost less than $100,000. The bill removes the $200 per day cap on review board member compensation, which will increase the cost of hearings.
SB 57 – AN ACT relating to funding health care services from increased penalties for speeding violations
SB 57 is estimated to cost $700,000 of which $200,000 is recurring from the Road Fund for an information technology administrative system and two administrative staff to handle the additional work and additional postage costs.
SB 61 – AN ACT relating to swimming pools
SB 61 is estimated to cost approximately $85,000 per incident of a waterborne illness outbreak. If estimating between 50-100 incidents of a waterborne illness outbreak, the cost for the Department of Public Health to investigate would be $4.25– $8.5 million.
$50,000 per incident for local health department and state program staff time (not including overtime or other costs associated with travel, specimen collection, and packaging and shipping costs), and $35,000 per incident for sample collection and testing.
SB 63 – AN ACT relating to street-legal special purpose vehicles
SB 63 is estimated to cost $492,000. This includes three additional Motor Vehicle Licensing staff to cover the additional workload: $317,000, $100,000 for changes to the KAVIS system changes, and $75,000 for additional enforcement efforts by the Motor Vehicle Commission regarding dealers that would be under the jurisdiction of the Commission.
SB 74 – AN ACT relating to coverage of annual mental health wellness examinations
SB 74 will have a minimal fiscal impact to the Cabinet for Health and Family Services (CHFS/cabinet), Department for Medicaid Services (DMS), because a federal approval clause limits the fiscal impact.
A mental health wellness examination bill has had a fiscal impact in the past. This version does not have a fiscal impact, because various existing services would already qualify. In addition, DMS does not have a referral requirement for mental health or substance use disorder (SUD) services. This information is preliminary and subject to additional review and analysis.