Kentucky. Revised Statutes.
* * *
* * *
15.241 Attorney
General's duty with respect to violations by abortion facilities.
The Attorney General, upon certification by the secretary of the Cabinet for Health and
Family Services, shall seek injunctive relief in a course of proper jurisdiction to prevent
violations of the provisions of KRS Chapter 216B regarding abortion facilities or the
administrative regulations promulgated in furtherance thereof in cases where other
administrative penalties and legal sanctions imposed have failed to prevent or cause a
discontinuance of the violation.
* * *
* * *
18A.225 Health and
dental care insurance coverage -- Emergency during calendar
year 2001 --
Requirements of prospective carriers -- Analysis of carrier
coverage data --
Agency's termination of participation -- Provision of amount
of employer
contribution -- Lapse of excess flexible spending account funds --
Appeal of formulary
change -- Retiree's participation -- Mail order drug
option coverage --
Hearing aid coverage for minors -- Access to certain services
in contiguous counties
-- Study of bid variation -- Regional rating bid scenario.
(1) (a) The term "health maintenance organization" for the purposes of this section
means a health maintenance organization as defined in KRS 304.38-030 or as
a nonprofit hospital, medical-surgical, dental, and health service corporation,
which has been licensed by the Kentucky Health Facilities and Health
Services Certificate of Need and Licensure Board or its successor agency and
issued a certificate of authority by the Office of Insurance as a health
maintenance organization or as a nonprofit hospital, medical-surgical, dental,
and health service corporation and which is qualified under the requirements
of the United States Department of Health, Education and Welfare except as
provided in subsection (2) of this section; and
(b) The term "employee" for purposes of this section means:
1. Any person, including an elected public official, who is regularly
employed by any department, office, board, agency, or branch of state
government; or by a public postsecondary educational institution; or by
any city, urban-county, charter county, county, or consolidated local
government, whose legislative body has opted to participate in the statesponsored
health insurance program pursuant to KRS 79.080; and who
is either a contributing member to any one (1) of the retirement systems
administered by the
state, including but not limited to the
Retirement Systems,
Legislators' Retirement Plan, or the Judicial Retirement Plan; or is
receiving a contractual contribution from the state toward a retirement
plan; or, in the case of a public postsecondary education institution, is an
individual participating in an optional retirement plan authorized by
KRS 161.567;
2. Any certified or classified employee of a local board of education;
3. Any person who is a present or future recipient of a retirement
allowance from the Kentucky Retirement Systems, Kentucky Teachers'
Retirement System, the Legislators' Retirement Plan, the Judicial
Retirement Plan, or the
System's optional retirement plan authorized by KRS 161.567, except
that a person who is receiving a retirement allowance and who is age
sixty-five (65) or older shall not be included, with the exception of
persons covered under KRS 61.702(4)(c), unless he or she is actively
employed pursuant to subparagraph 1. of this paragraph; and
4. Any eligible dependents and beneficiaries of participating employees
and retirees who are entitled to participate in the state-sponsored health
insurance program.
(2) (a) The secretary of the Finance and Administration Cabinet, upon the
recommendation of the secretary of the Personnel Cabinet, shall procure, in
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090,
from one (1) or more health insurance companies or from one (1) or more
health maintenance organizations authorized to do business in this state, a
policy or policies of group health care coverage, that may include but not be
limited to health maintenance organization (HMO), preferred provider
organization (PPO), point of service (POS), and exclusive provider
organization (EPO) benefit plans encompassing all or any class or classes of
employees. With the exception of employers governed by the provisions of
KRS Chapters 16, 18A, and 151B, all employers of any class of employees or
former employees shall enter into a contract with the Personnel Cabinet prior
to including that group in the state health insurance group. The contracts shall
include but not be limited to designating the entity responsible for filing any
federal forms, adoption of policies required for proper plan administration,
acceptance of the contractual provisions with health insurance carriers or
third-party administrators, and adoption of the payment and reimbursement
methods necessary for efficient administration of the health insurance
program. Health insurance coverage provided to state employees under this
section shall, at a minimum, contain the same benefits as provided under
Kentucky Kare Standard as
of
drug option as provided in subsection (14) of this section. All employees and
other persons for whom the health care coverage is provided or made
available shall annually be given an option to elect health care coverage
through a self-funded plan offered by the Commonwealth or, if a self-funded
plan is not available, from a list of coverage options determined by the
competitive bid process under the provisions of KRS 45A.080, 45A.085, and
45A.090 and made available during annual open enrollment.
* * *
(11) Notwithstanding any other provision of law to the contrary, the policy or policies
provided to employees pursuant to this section shall not provide coverage for
obtaining or performing an abortion, nor shall any state funds be used for the
purpose of obtaining or performing an abortion on behalf of employees or their
dependents.
* * *
CHAPTER 156 DEPARTMENT OF EDUCATION
* * *
156.497 Interagency Task Force on
Centers -- Formulation of five-year plan -- Implementation.
(1)
There is created an Interagency Task Force on
Services
Centers which shall consist of twenty-one (21) members appointed by the
Governor.
The twenty-one (21) members appointed shall include one (1)
representative
from each of the following agencies or groups, except the
Department
of Education which shall include three (3) representatives and parents
which
shall have three (3) representatives:
(a)
Department of Education;
(b)
Department for Employment Services of the Cabinet for Workforce
Development;
(c)
Department for Health Services of the Cabinet for Human Resources;
(d)
Department for Mental Health and Mental Retardation Services of the Cabinet
for
Human Resources;
(e)
Department for Social Services of the Cabinet for Human Resources;
(f)
Department for Social Insurance of the Cabinet for Human Resources;
(g)
Justice Cabinet;
(h)
Governor's Office;
(i)
Office of the Secretary, Cabinet for Workforce Development;
(j)
Parents;
(k)
Teachers;
(l)
Local school administrators;
(m)
Local school boards;
(n)
Local community mental health-mental retardation programs;
(o)
Local health departments;
(p)
Local community action agencies; and
(q)
A family resource and youth services coordinator.
(2)
The task force shall be appointed and begin to meet immediately upon July 13,
1990,
to formulate a five (5) year implementation plan establishing family resource
and
youth services centers designed to meet the needs of children and their
families.
By
additional
years, 1996 and 1997. The centers shall provide services which will
enhance
students' abilities to succeed in school. If resources are limited, students
and
families who are the most economically disadvantaged shall receive priority
status
for receiving services. The secretary of the Cabinet for Human Resources
shall
call the first meeting, at which time the task force by majority vote shall
elect a
task
force chair to serve a one (1) year term. A new chair shall be elected annually
thereafter,
and the chair may succeed himself. The Cabinet for Human Resources
shall
provide adequate staff to assist in the development and implementation of the
task
force's plan.
(3)
The plan developed by the task force shall include an effort to implement a
network
of
family resource centers across the Commonwealth. The centers shall be located
in
or near each elementary school in the Commonwealth in which twenty percent
(20%)
or more of the student body are eligible for free or reduced price school
meals.
The plan developed for the centers by the task force shall promote
identification
and coordination of existing resources and shall include, but not be
limited
to, the following components for each site:
(a)
Full-time preschool child care for children two (2) and three (3) years of age;
(b)
After school child care for children ages four (4) through twelve (12), with
the
child
care being full-time during the summer and on other days when school is
not
in session;
(c)
Families in training, which shall consist of an integrated approach to home
visits,
group meetings, and monitoring child development for new and
expectant
parents;
(d)
Parent and child education (PACE) as described in KRS 158.360 or similar
program;
(e)
Support and training for child day care providers; and
(f)
Health services or referral to health services, or both.
(4)
The plan developed by the task force shall include a schedule to implement a
network
of youth services centers across the Commonwealth. The centers shall be
located
in or near each school, except elementary schools, serving youth over
twelve
(12) years of age and in which twenty percent (20%) or more of the student
body
are eligible for free or reduced price school meals. The plan developed for the
centers
by the task force shall promote identification and coordination of existing
resources
and include, but not be limited to, the following components for each site:
(a)
Referrals to health and social services;
(b)
Employment counseling, training, and placement;
(c)
Summer and part-time job development;
(d)
Drug and alcohol abuse counseling; and
(e)
Family crisis and mental health counseling.
(5)
The task force shall complete its implementation plan for the program prior to
resource
centers and youth services centers by
family
resource centers and youth services centers shall be established in or adjacent
to
at least one-fourth (1/4) of the eligible schools, with expansion by one-fourth
(1/4)
by June 30 of each year thereafter or until the centers have been established
in
or
adjacent to all eligible schools.
(6)
A grant program is established to provide financial assistance to eligible
school
districts
establishing family resource centers and youth services centers. The
Cabinet
for Human Resources shall award the grants pursuant to KRS 156.4977. A
school
district shall not operate a family resource center or a youth services center
which
provides abortion counseling or makes referrals to a health care facility for
purposes
of seeking an abortion.
(7)
Funding provided to the Cabinet for Families and Children for the grant program
and
agency administrative costs shall include an increase that is equal to or
greater
than
the general fund growth factor provided in agency budget instructions.
(8)
The task force shall continue to monitor the family resource centers and the
youth
services
centers, review grant applications, and otherwise monitor the
implementation
of the plan until
shall
cease to exist. During its existence, the task force shall report at least
annually
to
the secretary of the Cabinet for Human Resourceformance of
their
duties authorized by the task force. The expenses shall be paid out of the
appropriation
for the task force.
* * *
CHAPTER 205 PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE
* * *
205.560 Scope of care
to be designated by administrative regulations --
Reimbursements
mandated or prohibited -- Assessment of health care provider
credentials.
(1) The scope of medical care for which the Cabinet for Health and Family Services
undertakes to pay shall be designated and limited by regulations promulgated by the
cabinet, pursuant to the provisions in this section. Within the limitations of any
appropriation therefor, the provision of complete upper and lower dentures to
recipients of Medical Assistance Program benefits who have their teeth removed by
a dentist resulting in the total absence of teeth shall be a mandatory class in the
scope of medical care. Payment to a dentist of any Medical Assistance Program
benefits for complete upper and lower dentures shall only be provided on the
condition of a preauthorized agreement between an authorized representative of the
Medical Assistance Program and the dentist prior to the removal of the teeth. The
selection of another class or other classes of medical care shall be recommended by
the council to the secretary for health and family services after taking into
consideration, among other things, the amount of federal and state funds available,
the most essential needs of recipients, and the meeting of such need on a basis
insuring the greatest amount of medical care as defined in KRS 205.510 consonant
with the funds available, including, but not limited to, the following categories,
except where the aid is for the purpose of obtaining an abortion:
(a) Hospital care, including drugs, and medical supplies and services during any
period of actual hospitalization;
(b) Nursing-home care, including medical supplies and services, and drugs during
confinement therein on prescription of a physician, dentist, or podiatrist;
(c) Drugs, nursing care, medical supplies, and services during the time when a
recipient is not in a hospital but is under treatment and on the prescription of a
physician, dentist, or podiatrist. For purposes of this paragraph, drugs shall
include those amino acid modified preparations and low-protein modified
food products for the treatment of the following inherited metabolic diseases,
if the amino acid modified preparations or low-protein modified food products
are prescribed for therapeutic treatment and are administered under the
direction of a physician, and are limited to the following conditions:
1. Phenylketonuria;
2. Hyperphenylalaninemia;
3. Tyrosinemia (types I, II, and III);
4. Maple syrup urine disease;
5. A-ketoacid dehydrogenase deficiency;
6. Isovaleryl-CoA dehydrogenase deficiency;
7. 3-methylcrotonyl-CoA carboxylase deficiency;
8. 3-methylglutaconyl-CoA hydratase deficiency;
9. 3-hydroxy-3-methylglutaryl-CoA lyase deficiency (HMG-CoA lyase
deficiency);
10. B-ketothiolase deficiency;
11. Homocystinuria;
12. Glutaric aciduria (types I and II);
13. Lysinuric protein intolerance;
14. Non-ketotic hyperglycinemia;
15. Propionic acidemia;
16. Gyrate atrophy;
17. Hyperornithinemia/hyperammonemia/homocitrullinuria syndrome;
18. Carbamoyl phosphate synthetase deficiency;
19. Ornithine carbamoyl transferase deficiency;
20. Citrullinemia;
21. Arginosuccinic aciduria;
22. Methylmalonic acidemia; and
23. Argininemia;
(d) Physician, podiatric, and dental services;
(e) Optometric services for all age groups shall be limited to prescription services,
services to frames and lenses, and diagnostic services provided by an
optometrist, to the extent the optometrist is licensed to perform the services
and to the extent the services are covered in the ophthalmologist portion of the
physician's program. Eyeglasses shall be provided only to children under age
twenty-one (21);
(f) Drugs on the prescription of a physician used to prevent the rejection of
transplanted organs if the patient is indigent;
(g) Nonprofit neighborhood health organizations or clinics where some or all of
the medical services are provided by licensed registered nurses or by advanced
medical students presently enrolled in a medical school accredited by the
Association of American Medical Colleges and where the students or licensed
registered nurses are under the direct supervision of a licensed physician who
rotates his services in this supervisory capacity between two (2) or more of the
nonprofit neighborhood health organizations or clinics specified in this
paragraph;
(h) Services provided by health-care delivery networks as defined in KRS
216.900; and
(i) Services provided by midlevel health-care practitioners as defined in KRS
216.900.
* * *
CHAPTER 212
LOCAL HEALTH PROGRAMS
* * *
212.275 Distribution
of nonscheduled legend drugs at health department by
advanced registered
nurse practitioner or registered nurse -- Written policy --
Record of prescription
drugs -- Responsibility for inventory -- Pharmacist --
Dispensing medication
or device prescribed for purpose of causing abortion.
(1) The governing board for each local, district, and independent health department
shall have a written policy concerning the distribution of nonscheduled legend drugs
at the health department by an advanced registered nurse practitioner or a registered
nurse. In a health department, an advanced registered nurse practitioner or a
registered nurse may distribute nonscheduled legend drugs from a list that has been
prepared by the commissioner of the Department for Public Health. Nothing in this
section shall be construed to limit advanced registered nurse practitioners from
dispensing nonscheduled drug samples under KRS 314.011. Each prescription drug
distributed or dispensed at the health department shall be recorded in the patient
record. The director of each health department shall be responsible for keeping track
of the inventory of stock medications and accounting for the medications dispensed
or distributed.
(2) Only a health department board having within its membership a pharmacist holding
a valid license issued pursuant to KRS 315.030 shall be authorized to permit
advanced registered nurse practitioners or registered nurses to dispense
nonscheduled legend drugs according to the written policy of the board. If a health
department is unable to recruit a licensed pharmacist to serve on the board, the
board shall document consultation with a pharmacist licensed pursuant to KRS
315.030 in the public health practice of the health department.
(3) No health department shall dispense any medication or device prescribed for the
purpose of causing an abortion as defined in KRS 311.720(1).
* * *
CHAPTER 216B
LICENSURE AND REGULATION OF HEALTH FACILITIES AND SERVICES
216B.015 Definitions
for chapter.
Except as otherwise provided, for purposes of this chapter, the following definitions shall
apply:
(1) "Abortion facility" means any place in which an abortion is performed;
* * *
216B.020 Certificate
of need -- Exemptions -- Requirements for issuance of
certificate of need.
(1) The provisions of this chapter that relate to the issuance of a certificate of need shall
not apply to abortion facilities as defined in KRS 216B.015; any hospital which
does not charge its patients for hospital services and does not seek or accept
Medicare, Medicaid, or other financial support from the federal government or any
state government; assisted living residences; family care homes; state veterans'
nursing homes; services provided on a contractual basis in a rural primary-care
hospital as provided under KRS 216.380; community mental health centers for
services as defined in KRS Chapter 210; primary care centers; rural health clinics;
private duty nursing services licensed as nursing pools; group homes; end stage
renal disease dialysis facilities, freestanding or hospital based; swing beds; special
clinics, including, but not limited to, wellness, weight loss, family planning,
disability determination, speech and hearing, counseling, pulmonary care, and other
clinics which only provide diagnostic services with equipment not exceeding the
major medical equipment cost threshold and for which there are no review criteria
in the state health plan; nonclinically-related expenditures; nursing home beds that
shall be exclusively limited to on-campus residents of a certified continuing care
retirement community; the relocation of hospital administrative or outpatient
services into medical office buildings which are on or contiguous to the premises of
the hospital; residential hospice facilities established by licensed hospice programs;
or the following health services provided on site in an existing health facility when
the cost is less than six hundred thousand dollars ($600,000) and the services are in
place by
are provided, level one (1) and level two (2) of neonatal care, cardiac
catheterization, and open heart surgery where cardiac catheterization services are in
place as of
homes, personal care homes, intermediate care facilities, and family care homes; or
nonconforming ambulance services as defined by administrative regulation. These
listed facilities or services shall be subject to licensure, when applicable.
(2) Nothing in this chapter shall be construed to authorize the licensure, supervision,
regulation, or control in any manner of:
(a) Private offices and clinics of physicians, dentists, and other practitioners of
the healing arts, except any physician's office that meets the criteria set forth
in KRS 216B.015(4);
(b) Office buildings built by or on behalf of a health facility for the exclusive use
of physicians, dentists, and other practitioners of the healing arts; unless the
physician's office meets the criteria set forth in KRS 216B.015(4), or unless
the physician's office is also an abortion facility as defined in KRS 216B.015,
except no capital expenditure or expenses relating to any such building shall
be chargeable to or reimbursable as a cost for providing inpatient services
offered by a health facility;
(c) Dispensaries and first-aid stations located within business or industrial
establishments maintained solely for the use of employees, if the facility does
not contain inpatient or resident beds for patients or employees who generally
remain in the facility for more than twenty-four (24) hours;
(d) Establishments, such as motels, hotels, and boarding houses, which provide
domiciliary and auxiliary commercial services, but do not provide any health
related services and boarding houses which are operated by persons
contracting with the United States Veterans Administration for boarding
services;
(e) The remedial care or treatment of residents or patients in any home or
institution conducted only for those who rely solely upon treatment by prayer
or spiritual means in accordance with the creed or tenets of any recognized
church or religious denomination and recognized by that church or
denomination; and
(f) On-duty police and fire department personnel assisting in emergency
situations by providing first aid or transportation when regular emergency
units licensed to provide first aid or transportation are unable to arrive at the
scene of an emergency situation within a reasonable time.
(3) An existing facility licensed as skilled nursing, intermediate care, or nursing home
shall notify the cabinet of its intent to change to a nursing facility as defined in
Public Law 100-203. A certificate of need shall not be required for conversion of
skilled nursing, intermediate care, or nursing home to the nursing facility licensure
category.
(4) Notwithstanding any other provision of law to the contrary, dual-license acute care
beds licensed as of
and in process prior to
by
acute care beds not
converted to nursing facility beds by
as of
(5) Notwithstanding any other provision of law to the contrary, no dual-license acute
care beds or acute care nursing home beds that have been converted to nursing
facility beds pursuant to the provisions of subsection (3) of this section may be
certified as Medicaid
eligible after
authorization of the secretary.
(6) Notwithstanding any other provision of law to the contrary, total dual-license acute
care beds shall be
limited to those licensed as of
a licensure application
filed and in process prior to
care hospital may obtain a new dual license for acute care beds unless the hospital
had a licensure
application filed and in process prior to
(7) Ambulance services owned and operated by a city government, which propose to
provide services in coterminous cities outside of the ambulance service's designated
geographic service area, shall not be required to obtain a certificate of need if the
governing body of the city in which the ambulance services are to be provided
enters into an agreement with the ambulance service to provide services in the city.
(8) Notwithstanding any other provision of law, a continuing care retirement
community's nursing home beds shall not be certified as Medicaid eligible unless a
certificate of need has been issued authorizing applications for Medicaid
certification. The provisions of subsection (3) of this section notwithstanding, a
continuing care retirement community shall not change the level of care licensure
status of its beds without first obtaining a certificate of need.
* * *
216B.042 Licenses -- Authority
to enter upon premises -- Authority for
administrative
regulations.
(1) The cabinet shall:
(a) Establish by promulgation of administrative regulation under KRS Chapter
13A reasonable application fees for licenses and promulgate other
administrative regulations necessary for the proper administration of the
licensure function;
(b) Issue, deny, revoke, modify, or suspend licenses or provisional licenses in
accordance with the provisions of this chapter;
(c) Establish licensure standards and procedures to ensure safe, adequate, and
efficient abortion facilities, health facilities and health services. These
regulations, under KRS Chapter 13A, shall include, but need not be limited to:
1. Patient care standards and safety standards, minimum operating
standards, minimum standards for training, required licenses for medical
staff personnel, and minimum standards for maintaining patient records;
2. Licensure application and renewal procedures; and
3. Classification of health facilities and health services according to type,
size, range of services, and level of care; and
(d) Compile in a single document, maintain, and make available to abortion
facilities and the public during regular business hours, all licensure standards
and procedures promulgated under KRS Chapter 13A related to abortion
facilities.
(2) The cabinet may authorize its agents or representatives to enter upon the premises
of any health care facility for the purpose of inspection, and under the conditions set
forth in administrative regulations promulgated under KRS Chapter 13A by the
cabinet.
(3) The cabinet may revoke licenses or certificates of need for specific health facilities
or health services or
lign:none'>regulations.
(1) The cabinet shall, no
later than
KRS Chapter 13A, promulgate administrative regulations providing licensure
standards and procedures for abortion facilities. The cabinet shall begin enforcing
the administrative
regulations on
(2) Any person operating an abortion facility for which a license is required under this
chapter may apply for the
license prior to
(3) Each abortion facility shall report monthly to the cabinet the information required
by the cabinet by administrative regulation for each abortion performed in the
facility.
(4) Licensed acute-care hospitals shall be exempt from the provisions of this section,
except for any reporting requirements issued by the cabinet.
216B.0435 Requirement
of written agreements between abortion facility and acute care
hospital and ambulance
service.
(1) Each abortion facility shall enter into a written agreement with a licensed acute-care
hospital capable of treating patients with unforeseen complications related to an
abortion facility procedure by which agreement the hospital agrees to accept and
treat these patients.
(2) If unforeseen complications arise prior to or during an abortion facility procedure,
the patient shall be transferred to the licensed acute-care hospital with which the
abortion facility has a written agreement as provided under subsection (1) of this
section or to the hospital selected by the patient, if the patient so chooses.
(3) Each abortion facility shall enter into a written agreement with a licensed local
ambulance service for the transport of any emergency patient within the scope of
subsection (1) of this section to the licensed acute-care hospital.
(4) The written agreements of an abortion facility with an acute-care hospital and with a
local ambulance service shall be filed by the abortion facility with the cabinet.
* * *
216B.400 Emergency
care -- Examination services for victims of sexual offenses --
Examination expenses
paid by Crime Victims' Compensation Board.
(1) Where a person has been determined to be in need of emergency care by any person
with admitting authority, no such person shall be denied admission by reason only
of his inability to pay for services to be rendered by the hospital.
(2) Every hospital of this state which offers emergency services shall provide that a
physician or a sexual assault nurse examiner, who shall be a registered nurse
licensed in the Commonwealth and credentialed by the Kentucky Board of Nursing
as provided under KRS 314.142, is available on call twenty-four (24) hours each
day for the examinations of persons reported to any law enforcement agency to be
victims of sexual offenses as defined by KRS 510.010 to 510.140, 530.020,
530.064, and 531.310.
(3) An examination provided in accordance with this section of a victim of a sexual
offense may be performed in a sexual assault examination facility as defined in
KRS 216B.015. An examination under this section shall apply only to an
examination of a victim.
(4) The physician or sexual assault nurse examiner, acting under a statewide medical
protocol which shall be developed by the chief medical examiner, and promulgated
by the secretary of justice pursuant to KRS Chapter 13A shall, upon the request of
any peace officer or prosecuting attorney, and with the consent of the reported
victim, or upon the request of the reported victim, examine such person for the
purpose of gathering physical evidence. This examination shall include but not be
limited to:
(a) Basic treatment and evidence gathering services; and
(b) Laboratory tests, as appropriate.
(5) Each reported victim shall be informed of available services for treatment of
venereal disease, pregnancy, and other medical and psychiatric problems. Pregnancy
counseling shall not include abortion counseling or referral information.
(6) Each reported victim shall be informed of available crisis intervention or other
mental health services provided by regional rape crisis centers providing services to
victims of sexual assault.
(7) Notwithstanding any other provision of law, a minor may consent to examination
under this section. This consent is not subject to disaffirmance because of minority,
and consent of the parents or guardians of the minor is not required for the
examination.
(8) (a) The examinations provided in accordance with this section shall be paid for by
the Crime Victims' Compensation Board at a rate to be determined by the
administrative regulation promulgated by the board after consultation with the
Sexual Assault Response Team Advisory Committee as defined in KRS
403.707.
(b) Upon receipt of a completed original claim form supplied by the board and
itemized billing for a forensic sexual assault examination, the board shall
reimburse the hospital or sexual assault examination facility, and the
physician or sexual assault nurse examiner as provided in administrative
regulations promulgated by the board pursuant to KRS Chapter 13A.
Reimbursement shall be made to an out-of-state nurse who is credentialed in
the other state to provide sexual assault examinations, an out-of-state hospital,
or an out-of-state
physician if the sexual assault occurred in
(c) Independent investigation by the Crime Victims' Compensation Board shall
not be required for payment of claims under this section; however, the board
may require additional documentation or proof that the forensic medical
examination was performed.
(9) No charge shall be made to the victim for sexual assault examinations by the
hospital, the sexual assault examination facility, the physician, the sexual assault
nurse examiner, the victim's insurance carrier, or the Commonwealth.
* * *
216B.990 Penalties.
(1) Any person who, in willful violation of this chapter, operates a health facility or
abortion facility without first obtaining a license or continues to operate a health
facility or abortion facility after a final decision suspending or revoking a license
shall be fined not less than five hundred dollars ($500) nor more than ten thousand
dollars ($10,000) for each violation.
(2) Any person who, in willful violation of this chapter, acquires major medical
equipment, establishes a health facility, or obligates a capital expenditure without
first obtaining a certificate of need, or after the applicable certificate of need has
been withdrawn, shall be fined one percent (1%) of the capital expenditure involved
but not less than five hundred dollars ($500) for each violation.
(3) Any hospital acting by or through its agents or employees which violates any
provision of KRS 216B.400 shall be punished by a fine of not less than one hundred
dollars ($100) nor more than five hundred dollars ($500).
(4) Any hospital acting by or through its agents or employees which violates any
provision of KRS 311.241 to 311.245 shall be punished by a fine of not less than
one hundred dollars ($100) nor more than five hundred dollars ($500).
(5) Any hospital violating the provisions of KRS 311.241 may be denied a license to
operate under the provisions of this chapter.
(6) Any health facility which willfully violates KRS 216B.250 shall be fined one
hundred dollars ($100) per day for failure to post required notices and one hundred
dollars ($100) per instance for willfully failing to provide an itemized statement
within the required time frames.
(7) In addition to the civil penalties established under KRS 216B.306(1) and (4), any
person who advertises, solicits boarders, or operates a boarding home without first
obtaining a registration as required by KRS 216B.305 and any person who aids or
abets the operation of a boarding home that is not registered shall be imprisoned for
no more than twelve (12) months.
(8) Any person or entity establishing, managing, or operating an abortion facility or
conducting the business of an abortion facility which otherwise violates any
provision of this chapter or any administrative regulation promulgated thereunder
regarding abortion facilities shall be subject to revocation or suspension of the
license of the abortion facility. In addition, any violation of any provision of this
chapter regarding abortion facilities or any administrative regulation related thereto
by intent, fraud, deceit, unlawful design, willful and deliberate misrepresentation, or
by careless, negligent, or incautious disregard for the statute or administrative
regulation, either by persons acting individually or in concert with others, shall
constitute a violation and shall be punishable by a fine not to exceed one thousand
dollars ($1,000) for each offense. Each day of continuing violation shall be
considered a separate offense. The venue for prosecution of the violation shall be in
any county of the state in which the violation, or any portion thereof, occurred.
(9) Any hospital acting by or through its agents or employees that violates any
provision of KRS 216B.150 shall be punished by a fine of not less than one hundred
dollars ($100) nor more than five hundred dollars ($500) for each violation.
* * *
* * *
304.5-160 Health
insurance and health care contracts not to cover elective
abortions except by
optional rider.
(1) No health insurance contracts, plans or policies delivered or issued for delivery in
the state shall provide coverage for elective abortions except by an optional rider for
which there must be paid an additional premium. For purposes of this section, an
"elective abortion" means an abortion for any reason other than to preserve the life
of the female upon whom the abortion is performed.
(2) This section shall be applicable to all contracts, plans or policies of:
(a) All health insurers subject to Subtitle 17 of KRS Chapter 304; and
(b) All group and blanket health insurers subject to Subtitle 18 of KRS Chapter
304; and
(c) All nonprofit hospital, medical, surgical, dental and health service
corporations subject to Subtitle 32 of KRS Chapter 304; and
(d) All health maintenance organizations subject to Subtitle 38 of KRS Chapter
304; and
(e) Any provision of medical, hospital, surgical and funeral benefits and of
coverage against accidental death or injury, when such benefits or coverage
are incidental to or part of other insurance described in KRS 304.5-070(1);
and
(f) All employers who provide health insurance for employees on a self-insured
basis.
* * *
304.32-310 Benefits.
(1) A converted policy issued pursuant to the conversion privilege provided in KRS
304.32-300 providing hospital or surgical expense insurance shall provide on an
expense incurred basis, the following minimum benefits:
(a) Hospital room and board benefits of twenty-five dollars ($25) per day, for a
minimum duration of seventy (70) days for any one period of hospital
confinement as defined in the converted policy.
(b) Miscellaneous hospital expense benefits for any one (1) period of hospital
confinement in a minimum amount up to twenty (20) times the hospital room
and board daily benefit provided under the converted policy.
(c) Surgical operation expense benefits according to a relative value schedule, or
a minimum of two hundred fifty dollars ($250).
(d) The option to continue any existing benefits on account of pregnancy,
childbirth, or miscarriage.
(2) The relative values in the surgical schedule shall be consistent with the schedule of
operations generally offered by the insurer under group or individual health
insurance policies. In the event that the insurer and the employer agree upon one
(1) or more additional plans of benefits to be available for converted policies, the
applicant for the converted policy may, at his option, elect such a plan in lieu of a
converted policy providing the benefits of paragraphs (a), (b), and (c) of subsection
(1) of this section. In no event shall the benefits be less than the minimums set forth
in subsection (1) of this section.
(3) In no event need the insurer provide under the converted policy:
(a) Benefits on account of abortion or complications thereof,
(b) The benefits of paragraphs (a) and (b) of subsection (1) of this section, unless
the group policy from which conversion is made provided hospital expense
insurance benefits, or
(c) The benefits of paragraph (c) of subsection (1) of this section, unless the
group policy provided surgical expense insurance benefits. Furthermore, the
converted policy may contain any exclusion, reduction, or limitation contained
in the group policy and any exclusion, reduction, or limitation customarily
used in individual policies issued by the insurer. With respect to any person
who was covered by the group policy, the period specified in the time limit on
certain defenses of the incontestable provision of the converted policy shall
commence with the date the insurance on such person or member became
effective under the group policy.
(4) The converted policy may provide that any hospital, surgical, or medical expense
benefits otherwise payable thereunder with respect to any person covered
thereunder may be reduced by the amount of any such benefits payable under the
group policy for the same loss with respect to such person after termination of such
person's coverage thereunder. The insurer shall not be entitled to use deterioration
of health as the basis for refusing to renew a converted policy. The converted policy
may provide for termination of coverage thereunder on any person when he is or
could be covered by Medicare (Title XVIII of the United States Social Security Act
as added by the Social Security Amendments of 1965 or as later amended or
superseded).
(5) A converted policy may include a provision whereby the insurer may request
information in advance of any premium due date of such policy of any person
covered thereunder as to whether:
(a) He is covered for similar benefits by another hospital, surgical, or medical
expense insurance policy or hospital or medical service subscriber contract or
medical practice or other prepayment plan or by any other plan or program; or
(b) Similar benefits are provided for, or available to, such person pursuant to, or
in accordance with the requirements of, any statute.
If any such person is so covered or such statutory benefits are provided or available,
and such person fails to furnish the insurer the details of such coverage within
thirty-one (31) days after the date of such request, the benefits payable under the
converted policy may be based on the hospital or surgical or medical expenses
actually incurred after excluding expenses to the extent of the amount of benefits
provided or available therefor from any of the sources referred to in paragraphs (a)
and (b) of this subsection. A converted policy may contain any provisions permitted
herein and may also include any other provisions not expressly prohibited by law;
and any provision required to be permitted herein may be made a part of any such
policy by means of an endorsement or rider.
* * *
CHAPTER 311
PHYSICIANS, OSTEOPATHS, PODIATRISTS, AND RELATED MEDICAL PRACTITIONERS
* * *
311.595 Denial,
probation, suspension, or revocation of licenses and permits. [These provisions
have been held to be unconstitutional and unenforceable]
If the power has not been transferred by statute to some other board, commission, or
agency of this state, the board may deny an application or reregistration for a license;
place a licensee on probation for a period not to exceed five (5) years; suspend a license
for a period not to exceed five (5) years; limit or restrict a license for an indefinite period;
or revoke any license heretofore or hereafter issued by the board, upon proof that the
licensee has:
* * *
(3) Committed, procured, or aided in the procurement of an unlawful abortion,
including a partial-birth
abortion;
* * *
311.710 Legislative
findings.
The General Assembly of
the
(1) That it is in the
interest of the people of the
precaution be taken to insure the protection of every viable unborn child being
aborted, and every precaution be taken to provide life-supportive procedures to
insure the unborn child its continued life after its abortion; and
(2) That currently, in the Commonwealth, there is inadequate legislation to protect the
life, health and welfare of pregnant women and unborn human life; and
(3) That it is in the
interest of the people of the
maintain accurate statistical data to aid in providing proper maternal health
regulations.
(4) It is the intention
of the General Assembly of the
assure the integrity and autonomy of a woman's decision whether to submit to an
abortion or to carry her child to term, to protect the rights and interests of a minor
incompetent woman and her parents in the context of abortion, to further the
Commonwealth's compelling interest in protecting the formal integrity of the
marital relation and the procreative rights and interests of the husband, and to
provide for the development of statistical data. The General Assembly finds as fact
that the rights and interests furthered by this chapter are not secure in the context in
which abortion is presently performed.
(5) It is the present intention of the General Assembly to protect the valid and
compelling interests of the Commonwealth and its inhabitants without unduly
burdening a woman's constitutional privacy rights as delineated by the courts. If,
however, the United States Constitution is amended or relevant judicial decisions
are reversed or modified, the declared policy of this Commonwealth to recognize
and to protect the lives of all human beings regardless of their degree of biological
development shall be fully restored.
311.715 Use of public
funds for abortion or in-vitro fertilization prohibited -- Use
of public medical facilities
for in-vitro fertilization permitted -- "Public funds"
defined. [These
provisions have been held to be unenforceable with respect to abortion.]
No public funds shall be used for the purpose of obtaining an abortion or paying for the
performance of an abortion. Public medical facilities may be used for the purpose of
conducting research into or the performance of in-vitro fertilization as long as such
procedures do not result in the intentional destruction of a human embryo. For purposes
of this section,
"public funds" means any money of the
department, agency or instrumentality thereof, or any money of any county, city, agency
or instrumentality thereof or any money of any other political subdivision of the
Commonwealth, agency or instrumentality thereof. Nothing in this section shall be
deemed to deprive a woman of all appropriate medical care necessary to prevent her
physical death. Nothing in this section shall be construed to allow public funds to pay for
in-vitro fertilization procedures performed on any individual patient.
311.720 Definitions
for KRS 311.710 to 311.820 and other laws.
As used in KRS 311.710 to 311.820, and laws of the Commonwealth unless the context
otherwise requires:
(1) "Abortion" shall mean the use of any means whatsoever to terminate the pregnancy
of a woman known to be pregnant with intent to cause fetal death;
(2) "Hospital"
shall mean those institutions licensed in the
pursuant to the provisions of KRS Chapter 216;
(3) "Consent" as used in KRS 311.710 to 311.820 with reference to those who must
give their consent shall mean an informed consent expressed by a written agreement
to submit to an abortion on a written form of consent to be promulgated by the
secretary for health and family services;
(4) "Cabinet"
shall mean the Cabinet for Health and Family Services of the
(5) "Fetus" shall mean a human being from fertilization until birth;
(6) "Human being" shall mean any member of the species homo sapiens from
fertilization until death;
(7) "Partial-birth abortion" shall mean an abortion in which the physician performing
the abortion partially vaginally delivers a living fetus before killing the fetus and
completing the delivery; [This
provisions has been held to be unconstitutional and unenforceable]
(8) "Vaginally delivers a living fetus before killing the fetus" shall mean deliberately
and intentionally delivers into the vagina a living fetus, or a substantial portion
thereof, for the purpose of performing a procedure the physician knows will kill the
fetus, and kills the fetus;
(9) "Physician" shall mean any person licensed to practice medicine in the
Commonwealth or osteopathy pursuant to the provisions of this chapter;
(10) "Viability" shall mean that stage of human development when the life of the unborn
child may be continued by natural or life-supportive systems outside the womb of
the mother;
(11) "Accepted medical procedures" shall mean procedures of the type performed in the
manner and in a facility with equipment sufficient to meet the standards of medical
care which physicians engaged in the same or similar lines of work, would
ordinarily exercise and devote to the benefit of their patients;
(12) "Medical emergency" means any condition which, on the basis of the physician's
good faith clinical judgment, so complicates the medical condition of a pregnant
female as to necessitate the immediate abortion of her pregnancy to avert her death
or for which a delay will create serious risk of substantial and irreversible
impairment of a major bodily function;
(13) "Medical necessity" means a medical condition of a pregnant woman that, in the
reasonable judgment of the physician who is attending the woman, so complicates
the pregnancy that it necessitates the immediate performance or inducement of an
abortion; and
(14) "Probable gestational age of the embryo or fetus" means the gestational age that, in
the judgment of a physician, is, with reasonable probability, the gestational age of
the embryo or fetus at the time that the abortion is planned to be performed.
311.723 When physician
may perform abortion -- Guidelines.
(1) No abortion shall be performed except by a physician after either:
(a) He determines that, in his best clinical judgment, the abortion is necessary; or
(b) He receives what he reasonably believes to be a written statement signed by
another physician, hereinafter called the "referring physician," certifying that
in the referring physician's best clinical judgment the abortion is necessary,
and, in addition, he receives a copy of the report form required by KRS
213.055.
(2) No abortion shall be performed except in compliance with regulations which the
cabinet shall issue to assure that:
(a) Before the abortion is performed, the pregnant woman shall have a private
medical consultation either with the physician who is to perform the abortion
or with the referring physician in a place, at a time and of a duration
reasonably sufficient to enable the physician to determine whether, based
upon his best clinical judgment, the abortion is necessary;
(b) The physician who is to perform the abortion or the referring physician will
describe the basis for his best clinical judgment that the abortion is necessary
on a form prescribed by the cabinet as required by KRS 213.055; and
(c) Paragraph (a) of this subsection shall not apply when, in the medical judgment
of the attending physician based on the particular facts of the case before him,
there exists a medical emergency. In such a case, the physician shall describe
the basis of his medical judgment that an emergency exists on a form
prescribed by the cabinet as required by KRS 213.055.
(3) Notwithstanding any statute to the contrary, nothing in this chapter shall be
construed as prohibiting a physician from prescribing or a woman from using birth
control methods or devices, including, but not limited to, intrauterine devices, oral
contraceptives, or any other birth control method or device.
311.725 Requirement of
voluntary and informed written consent for abortion --
Cabinet's duty to
produce and make available informational materials --
Abortions in medical
emergencies. [The provisions of this
section that require in-person
receipt of state-mandated information and materials are unenforceable by court
order].
(1) No abortion shall be performed or induced except with the voluntary and informed
written consent of the woman upon whom the abortion is to be performed or
induced. Except in the case of a medical emergency, consent to an abortion is
voluntary and informed if and only if:
(a) At least twenty-four (24) hours prior to the abortion, a physician, licensed
nurse, physician assistant, or social worker to whom the responsibility has
been delegated by the physician has verbally informed the woman of all of the
following:
1. The nature and purpose of the particular abortion procedure or treatment
to be performed and of those medical risks and alternatives to the
procedure or treatment that a reasonable patient would consider material
to the decision of whether or not to undergo the abortion;
2. The probable gestational age of the embryo or fetus at the time the
abortion is to be performed; and
3. The medical risks associated with the pregnant woman carrying her
pregnancy to term;
(b) At least twenty-four (24) hours prior to the abortion, in an individual, private
setting, a physician, licensed nurse, physician assistant, or social worker to
whom the responsibility has been delegated by the physician has informed the
pregnant woman that:
1. The cabinet publishes the printed materials described in paragraphs (a)
and (b) of subsection (2) of this section and that she has a right to review
the printed materials and that copies will be provided to her by the
physician, licensed nurse, physician assistant, or social worker free of
charge if she chooses to review the printed materials;
2. Medical assistance benefits may be available for prenatal care,
childbirth, and neonatal care, and that more detailed information on the
availability of such assistance is contained in the printed materials
published by the cabinet; and
3. The father of the fetus is liable to assist in the support of her child, even
in instances where he has offered to pay for the abortion;
(c) At least twenty-four (24) hours prior to the abortion, a copy of the printed
materials has been provided to the pregnant woman if she chooses to view
these materials;
(d) The pregnant woman certifies in writing, prior to the performance or
inducement of the abortion:
1. That she has received the information required to be provided under
paragraphs (a), (b), and (c) of this subsection; and
2. That she consents to the particular abortion voluntarily and knowingly,
and she is not under the influence of any drug of abuse or alcohol; and
(e) Prior to the performance or inducement of the abortion, the physician who is
scheduled to perform or induce the abortion or the physician's agent receives a
copy of the pregnant woman's signed statement, on a form which may be
provided by the physician, on which she consents to the abortion and that
includes the certification required by paragraph (d) of this subsection.
(2) By
not less than 12 point type the following materials:
(a) Materials that inform the pregnant woman about public and private agencies
and services that are available to assist her through her pregnancy, upon
childbirth, and while her child is dependent, including, but not limited to,
adoption agencies. The materials shall include a comprehensive list of the
available agencies and a description of the services offered by the agencies
and the telephone numbers and addresses of the agencies, and inform the
pregnant woman about available medical assistance benefits for prenatal care,
childbirth, and neonatal care and about the support obligations of the father of
a child who is born alive. The cabinet shall ensure that the materials are
comprehensive and do not directly or indirectly promote, exclude, or
discourage the use of any agency or service described in this section; and
(b) Materials that inform the pregnant woman of the probable anatomical and
physiological characteristics of the zygote, blastocyte, embryo, or fetus at two
(2) week gestational increments for the first sixteen (16) weeks of her
pregnancy and at four (4) week gestational increments from the seventeenth
week of her pregnancy to full term, including any relevant information
regarding the time at which the fetus possibly would be viable. The materials
shall use language that is understandable by the average person who is not
medically trained, shall be objective and nonjudgmental, and shall include
only accurate scientific information about the zygote, blastocyte, embryo, or
fetus at the various gestational increments. The materials shall include, for
each of the two (2) of four (4) week increments specified in this paragraph, a
pictorial or photographic depiction of the zygote, blastocyte, embryo, or fetus.
The materials shall also include, in a conspicuous manner, a scale or other
explanation that is understandable by the average person and that can be used
to determine the actual size of the zygote, blastocyte, embryo, or fetus at a
particular gestational increment as contrasted with the depicted size of the
zygote, blastocyte, embryo, or fetus at that gestational increment.
(3) Upon submission of a request to the cabinet by any person, hospital, physician, or
medical facility for one (1) or more copies of the materials published in accordance
with subsection (2) of this section, the cabinet shall make the requested number of
copies of the materials available to the person, hospital, physician, or medical
facility that requested the copies.
(4) If a medical emergency or medical necessity compels the performance or
inducement of an abortion, the physician who will perform or induce the abortion,
prior to its performance or inducement if possible, shall inform the pregnant woman
of the medical indications supporting the physician's judgment that an immediate
abortion is necessary. Any physician who performs or induces an abortion without
the prior satisfaction of the conditions specified in subsection (1) of this section
because of a medical emergency or medical necessity shall enter the reasons for the
conclusion that a medical emergency exists in the medical record of the pregnant
woman.
(5) If the conditions specified in subsection (1) of this section are satisfied, consent to
an abortion shall be presumed to be valid and effective.
(6) The failure of a physician to satisfy the conditions of subsection (1) of this section
prior to performing or inducing an abortion upon a pregnant woman may be the
basis of disciplinary action pursuant to KRS 311.595.
(7) The cabinet shall charge a fee for each copy of the materials distributed in
accordance with subsections (1) and (3) of this section. The fee shall be sufficient to
cover the cost of the administration of the materials published in accordance with
subsection (2) of this section, including the cost of preparation and distribution of
materials.
311.726 Repealed, 1998.
311.729 Repealed, 1998.
311.730 Repealed, 1982.
311.732 Performance of
abortion upon a minor -- Definitions -- Consent
requirement --
Petition in District or Circuit Court -- Medical emergencies.
(1) For purposes of this section the following definitions shall apply:
(a) "Minor" means any person under the age of eighteen (18);
(b) "Emancipated minor" means any minor who is or has been married or has by
court order or otherwise been freed from the care, custody, and control of her
parents; and
(c) "Abortion" means the use of any instrument, medicine, drug, or any other
substance or device with intent to terminate the pregnancy of a woman known
to be pregnant with intent other than to increase the probability of a live birth,
to preserve the life or health of the child after live birth, or to remove a dead
fetus.
(2) No person shall perform an abortion upon a minor unless:
(a) The attending physician or his agent secured the informed written consent of
the minor and one (1) parent or legal guardian;
(b) The minor is emancipated and the attending physician or his agent has
received the informed written consent of the minor; or
(c) The minor elects to petition any Circuit or District Court of the
Commonwealth pursuant to subsection (3) of this section and obtain an order
pursuant to subsection (4) of this section granting consent to the abortion and
the attending physician or his agent has received the informed written consent
of the minor.
(3) Every minor shall have the right to petition any Circuit or District Court of the
Commonwealth for an order granting the right to self-consent to an abortion
pursuant to the following procedures:
(a) The minor or her next friend may prepare and file a petition setting forth the
request of the minor for an order of consent to an abortion;
(b) The court shall insure that the minor prepares or her next friend is given
assistance in preparing and filing the petition and shall insure that the minor's
identity is kept anonymous;
(c) The minor may participate in proceedings in the court on her own behalf or
through her next friend and the court shall appoint a guardian ad litem for her.
The court shall advise her that she has a right to court-appointed counsel and
shall provide her with such counsel upon her request;
(d) All proceedings under this section shall be anonymous and shall be given
preference over other matters to insure that the court may reach a decision
promptly, but in no case shall the court fail to rule within seventy-two (72)
hours of the time of application, provided that the seventy-two (72) hour
limitation may be extended at the request of the minor; and
(e) The court shall hold a hearing on the merits of the petition before reaching a
decision. The court shall hear evidence at the hearing relating to the emotional
development, maturity, intellect, and understanding of the minor; the nature,
possible consequences, and alternatives to the abortion; and any other
evidence that the court may find useful in determining whether the minor
should be granted majority rights for the purpose of consenting to the abortion
or whether the abortion is in the best interest of the minor.
(4) The court shall enter a written order, making specific factual findings and legal
conclusions supporting its decision as follows:
(a) Granting the petition for an abortion if the court finds that the minor is mature
and well informed enough to make the abortion decision on her own;
(b) Granting consent to the abortion if the court finds that the performance of the
abortion would be in the minor's best interest; or
(c) Deny the petition, if the court finds that the minor is immature and that
performance of the abortion would not be in the minor's best interest.
(5) Any minor shall have the right of anonymous and expedited appeal to the Court of
Appeals, and that court shall give precedence over other pending matters.
(6) No fees shall be required of any minor who declares she has no sufficient funds to
pursue the procedures provided by this section.
(7) The Supreme Court is respectfully requested to promulgate any rules and
regulations it feels are necessary to ensure that proceedings under this section are
handled in an expeditious and anonymous manner.
(8) The requirements of subsections (2), (3), and (4) of this section shall not apply
when, in the best medical judgment of the physician based on the facts of the case
before him, a medical emergency exists that so complicates the pregnancy as to
require an immediate abortion. A physician who does not comply with subsection
(2), (3), or (4) of this section due to the utilization of this exception shall certify in
writing the medical indications upon which his judgment was based.
(9) A report indicating the basis for any medical judgment that warrants failure to
obtain consent pursuant to this section shall be filed with the Cabinet for Health and
Family Services on a form supplied by the cabinet. This report shall be confidential.
(10) Failure to obtain consent pursuant to the requirements of this section is prima facie
evidence of failure to obtain informed consent and of interference with family
relations in appropriate civil actions. The law of this state shall not be construed to
preclude the award of exemplary damages in any appropriate civil action relevant to
violations of this section. Nothing in this section shall be construed to limit the
common-law rights of parents.
311.733 Severability.
If any provision, word, phrase, or clause of KRS 311.732 or the application thereof to any
person or circumstance shall be held invalid, such invalidity shall not affect the
provisions, words, phrases, clauses, or application of KRS 311.732 which can be given
effect without the invalid provision, word, phrase, clause, or application and to this end,
the provisions, words, phrases, and clauses of KRS 311.732 are declared to be severable.
311.735 Notice to
spouse -- Exceptions -- Civil remedies. [These provisions have been held to be
unconstitutional and unenforceable.]
(1) Prior to performing an abortion, the physician who is to perform the abortion or his
agent shall notify, if reasonably possible, the spouse of the woman upon whom the
abortion is to be performed. If it is not reasonably possible to notify the spouse prior
to the abortion, the physician or his agent shall do so, if reasonably possible, within
thirty (30) days of the abortion.
(2) (a) The requirements of this section shall not apply if, before the abortion is
performed, either party to a marriage has filed a petition for dissolution of
marriage which has been served on the respondent;
(b) The requirements of this section shall not apply when, in the medical
judgment of the attending physician based on the particular facts of the case
before him, there exists a medical emergency. In such a case, the physician
shall describe the basis of his medical judgment that such an emergency exists
on a form prescribed by the cabinet as required by KRS 213.055, and the
physician or his agent shall notify, if reasonably possible, the spouse of the
woman upon whom the abortion was performed, within thirty (30) days of the
abortion.
(3) Failure to notify a spouse as required by this section is prima facie evidence of
interference with family relations in appropriate civil actions. The law of this
Commonwealth shall not be construed to preclude the award of punitive damages or
damages for emotional distress, even if unaccompanied by physical complications
in any civil action brought pursuant to violations of this section. Nothing in this
section shall be construed to limit the common law rights of a husband.
311.740 Repealed, 1982.
311.750 Performance by
other than licensed physician prohibited.
Subject to the provisions of KRS 311.760(1), no person other than a licensed physician
shall perform an abortion.
311.760 Minimum
standards for performance of abortion.
An abortion may be performed in this state only under the following circumstances:
(1) During the first trimester of pregnancy by a woman upon herself upon the advice of
a licensed physician or by a licensed physician.
(2) After the first trimester of pregnancy, except in cases of emergency to protect the
life or health of the pregnant woman, where an abortion is permitted under other
provisions of KRS 311.710 to 311.820, by a duly licensed physician in a hospital
duly licensed by the Kentucky Health Facilities and Health Services Certificate of
Need and Licensure Board.
311.765 Prohibition
against partial-birth abortion. [This provision has been held to be
unconstitutional and unenforceable]
No physician shall perform a partial-birth abortion.
311.770 Restriction on
use of saline method.
After the first trimester no person shall perform the form of abortion known as the saline
method of abortion.
311.780 Prohibition of
abortion after viability -- Exceptions.
No abortion shall be performed or prescribed knowingly after the unborn child may
reasonably be expected to have reached viability, except when necessary to preserve the
life or health of the woman. In those instances where an abortion is performed under this
section, the person performing the abortion shall take all reasonable steps in keeping with
reasonable medical practices to preserve the life and health of the child, including but not
limited to KRS 311.760(2).
311.790 Issuance of
birth and death certificates for live-born child after attempted
abortion.
Any child which is live born after an induced termination of pregnancy shall be fully
recognized as a human person under the law and a birth certificate shall be issued
certifying the birth of the live-born person even though the person may die thereafter. In
the event death does ensue, a death certificate shall be issued. Both the birth and death
certificates shall be issued as required by KRS 213.046, 213.051, and 213.076.
311.800 Abortions in publicly
owned hospital or health care facility prohibited --
Exception --
Injunction to enforce compliance -- Abortions in private hospital
or health care
facility -- Unlawful discriminatory practices.
(1) No publicly owned hospital or other publicly owned health care facility shall
perform or permit the performance of abortions, except to save the life of the
pregnant woman.
(2) In the event that a publicly owned hospital or publicly owned health facility is
performing or about to perform an abortion in violation of subsection (1) of this
section, and law enforcement authorities in the county have failed or refused to take
action to stop such a practice, any resident of the county in which the hospital or
health facility is located, may apply to the Circuit Court of that county for an
injunction or other court process to require compliance with subsection (1) of this
section.
(3) No private hospital or private health care facility shall be required to, or held liable
for refusal to, perform or permit the performance of abortion contrary to its stated
ethical policy.
(4) No physician, nurse staff member or employee of a public or private hospital or
employee of a public or private health care facility, who shall state in writing to
such hospital or health care facility his objection to performing, participating in, or
cooperating in, abortion on moral, religious or professional grounds, be required to,
or held liable for refusal to, perform, participate in, or cooperate in such abortion.
(5) It shall be an unlawful discriminatory practice for the following:
(a) Any person to impose penalties or take disciplinary action against, or to deny
or limit public funds, licenses, certifications, degrees, or other approvals or
documents of qualification to, any hospital or other health care facility due to
the refusal of such hospital or health care facility to perform or permit to be
performed, participate in, or cooperate in, abortion by reason of objection
thereto on moral, religious or professional grounds, or because of any
statement or other manifestation of attitude by such hospital or health care
facility with respect to abortion; or,
(b) Any person to impose penalties or take disciplinary action against, or to deny
or limit public funds, licenses, certifications, degrees, or other approvals or
documents of qualification to any physician, nurse or staff member or
employee of any hospital or health care facility, due to the willingness or
refusal of such physician, nurse or staff member or employee to perform or
participate in abortion by reason of objection thereto on moral, religious or
professional grounds, or because of any statement or other manifestation of
attitude by such physician, nurse or staff member or employee with respect to
abortion; or,
(c) Any public or private agency, institution or person, including a medical,
nursing or other school, to deny admission to, impose any burdens in terms of
conditions of employment upon, or otherwise discriminate against any
applicant for admission thereto or any physician, nurse, staff member, student
or employee thereof, on account of the willingness or refusal of such
applicant, physician, nurse, staff member, student or employee to perform or
participate in abortion or sterilization by reason of objection thereto on moral,
religious or professional grounds, or because of any statement or other
manifestation of attitude by such person with respect to abortion or
sterilization if that health care facility is not operated exclusively for the
purposes of performing abortions or sterilizations.
311.810 Discrimination
for refusal to submit to abortion prohibited.
No woman may be denied governmental assistance or be otherwise discriminated against
or otherwise subjected to coercion in any way for accepting or refusing to accept or
submit to an abortion, which she may do or not do for any reason without explanation.
311.820 Abortion
referral or counseling agency not to charge fee -- Penalty.
(1) As used in this section, an abortion referral or counseling agency is any person,
group, or organization, whether funded publicly or privately, that provides advice or
help to persons in obtaining abortions.
(2) No abortion referral or counseling agency shall charge or accept any fee, kickback,
or compensation of any nature from a physician, hospital, clinic or other medical
facility for referring a person thereto for an abortion.
311.830 Severability.
If any section of this chapter or any part of any section shall be invalid or
unconstitutional, the declaration of such invalidity shall not affect the validity of the
remaining portions thereof.
* * *
311.990 Penalties.
(1) Any person who violates KRS 311.250 shall be guilty of a violation.
(2) Any college or professor thereof violating the provisions of KRS 311.300 to
311.350 shall be civilly liable on his bond for a sum not less than one hundred
dollars ($100) nor more than one thousand dollars ($1,000) for each violation,
which may be recovered by an action in the name of the Commonwealth.
(3) Any person who presents to the county clerk for the purpose of registration any
license which has been fraudulently obtained, or obtains any license under KRS
311.380 to 311.510 by false or fraudulent statement or representation, or practices
podiatry under a false or assumed name or falsely impersonates another practitioner
or former practitioner of a like or different name, or aids and abets any person in the
practice of podiatry within the state without conforming to the requirements of KRS
311.380 to 311.510, or otherwise violates or neglects to comply with any of the
provisions of KRS 311.380 to 311.510, shall be guilty of a Class A misdemeanor.
Each case of practicing podiatry in violation of the provisions of KRS 311.380 to
311.510 shall be considered a separate offense.
(4) Each first violation of KRS 311.560 is a Class A misdemeanor. Each subsequent
violation of KRS 311.560 shall constitute a Class D felony.
(5) Each violation of KRS 311.590 shall constitute a Class D felony. Conviction under
this subsection of a holder of a license or permit shall result automatically in
permanent revocation of such license or permit.
(6) Conviction of willfully resisting, preventing, impeding, obstructing, threatening, or
interfering with the board or any of its members, or of any officer, agent, inspector,
or investigator of the board or the Cabinet for Health and Family Services, in the
administration of any of the provisions of KRS 311.550 to 311.620 shall be a Class
A misdemeanor.
(7) Each violation of subsection (1) of KRS 311.375 shall, for the first offense, be a
Class B misdemeanor, and, for each subsequent offense shall be a Class A
misdemeanor.
(8) Each violation of subsection (2) of KRS 311.375 shall, for the first offense, be a
violation, and, for each subsequent offense, be a Class B misdemeanor.
(9) Each day of violation of either subsection of KRS 311.375 shall constitute a
separate offense.
(10) (a) Any person who intentionally or knowingly performs an abortion contrary to
the requirements of KRS 311.723(1) shall be guilty of a Class D felony; and
(b) Any person who intentionally, knowingly, or recklessly violates the
requirements of KRS 311.723(2) shall be guilty of a Class A misdemeanor.
(11) (a) 1. Any physician who performs a partial-birth abortion in violation of KRS
311.765 shall be guilty of a Class D felony. However, a physician shall
not be guilty of the criminal offense if the partial-birth abortion was
necessary to save the life of the mother whose life was endangered by a
physical disorder, illness, or injury.
2. A physician may seek a h earing before the State Board of Medical
Licensure on whether the physician's conduct was necessary to save the
life of the mother whose life was endangered by a physical disorder,
illness, or injury. The board's findings, decided by majority vote of a
quorum, shall be admissible at the trial of the physician. The board shall
promulgate administrative regulations to carry out the provisions of this
subparagraph.
3. Upon a motion of the physician, the court shall delay the beginning of
the trial for not more than thirty (30) days to permit the hearing, referred
to in subparagraph 2. of this paragraph, to occur.
(b) Any person other than a physician who performs a partial-birth abortion shall
not be prosecuted under this subsection but shall be prosecuted under
provisions of law which prohibit any person other than a physician from
performing any abortion.
(c) No penalty shall be assessed against the woman upon whom the partial-birth
abortion is performed or
attempted to be performed. [These provisions (11) have been held to be
unconstitutional and unenforceable]
(12) Any person who intentionally performs an abortion with knowledge that, or with
reckless disregard as to whether, the person upon whom the abortion is to be
performed is an unemancipated minor, and who intentionally or knowingly fails to
conform to any requirement of KRS 311.732 is guilty of a Class A misdemeanor.
(13) Any person who negligently releases information or documents which are
confidential under KRS 311.732 is guilty of a Class B misdemeanor.
(14) Any person who performs an abortion upon a married woman either with
knowledge or in reckless disregard of whether KRS 311.735 applies to her and who
intentionally, knowingly, or recklessly fails to conform to the requirements of KRS
311.735 shall be guilty of a Class D felony.
(15) Any person convicted of violating KRS 311.750 shall be guilty of a Class B felony.
(16) Any person who violates KRS 311.760(2) shall be guilty of a Class D felony.
(17) Any person who violates KRS 311.770 or 311.780 shall be guilty of a Class D
felony.
(18) A person convicted of violating KRS 311.780 shall be guilty of a Class C felony.
(19) Any person who violates KRS 311.810 shall be guilty of a Class A misdemeanor.
(20) Any professional medical association or society, licensed physician, or hospital or
hospital medical staff who shall have violated the provisions of KRS 311.606 shall
be guilty of a Class B misdemeanor.
(21) Any administrator, officer, or employee of a publicly owned hospital or publicly
owned health care facility who performs or permits the performance of abortions in
violation of KRS 311.800(1) shall be guilty of a Class A misdemeanor.
(22) Any person who violates KRS 311.914 shall be guilty of a violation.
(23) Any person who violates the provisions of KRS 311.820 shall be guilty of a Class A
misdemeanor.
(24) (a) Any person who fails to test organs, skin, or other human tissue which is to be
transplanted, or violates the confidentiality provisions required by KRS
311.281, shall be guilty of a Class A misdemeanor;
(b) Any person who has human immunodeficiency virus infection, who knows he
is infected with human immunodeficiency virus, and who has been informed
that he may communicate the infection by donating organs, skin, or other
human tissue who donates organs, skin, or other human tissue shall be guilty
of a Class D felony.
(25) Any person who sells or makes a charge for any transplantable organ shall be guilty
of a Class D felony.
(26) Any person who offers remuneration for any transplantable organ for use in
transplantation into himself shall be fined not less than five thousand dollars
($5,000) nor more than fifty thousand dollars ($50,000).
(27) Any person brokering the sale or transfer of any transplantable organ shall be guilty
of a Class C felony.
(28) Any person charging a fee associated with the transplantation of a transplantable
organ in excess of the direct and indirect costs of procuring, distributing, or
transplanting the transplantable organ shall be fined not less than fifty thousand
dollars ($50,000) nor more than five hundred thousand dollars ($500,000).
(29) Any hospital performing transplantable organ transplants which knowingly fails to
report the possible sale, purchase, or brokering of a transplantable organ shall be
fined not less than ten thousand dollars ($10,000) or more than fifty thousand
dollars ($50,000).
* * *
CHAPTER 387 GUARDIANS -- CONSERVATORS -- CURATORS OF CONVICTS
* * *
387.660 Specific
powers and duties of guardian.
A guardian of a disabled person shall have the following powers and duties, except as
modified by order of the court:
(1) To take custody of the ward and to establish his place of abode within the state,
except that, if at any time a guardian places a ward in a licensed residential facility
for developmentally disabled persons, the guardian shall, within thirty (30) days of
such placement, file with the court notice of the placement, stating with specificity
the reasons for such placement, and an interdisciplinary evaluation report detailing
the social, psychological, medical or other considerations on which such placement
is predicated, a description of the treatment or habilitation programs which will
benefit the ward as a result of such placement, and a determination that such
placement will provide appropriate treatment in the least restrictive available
treatment and residential program. For purposes of this subsection, the
interdisciplinary evaluation report may be one performed within two (2) months
prior to the placement for purposes of determining whether such placement is
necessary and appropriate, or may be an evaluation and assessment provided by the
residential facility immediately after placement. Notice to the court shall not be
required where the ward is transferred from one licensed residential facility to
another.
(2) To make provision for the ward's care, comfort, and maintenance and arrange for
such educational, social, vocational, and rehabilitation services as are appropriate
and as will assist the ward in the development of maximum self-reliance and
independence.
(3) To give any necessary consent or approval to enable the ward to receive medical or
other professional care, counsel, treatment or service, except that a guardian may
not consent on behalf of a ward to an abortion, sterilization, psychosurgery, removal
of a bodily organ, or amputation of a limb unless the procedure is first approved by
order of the court or is necessary, in an emergency situation, to preserve the life or
prevent serious impairment of the physical health of the ward.
(4) To act with respect to the ward in a manner which limits the deprivation of civil
rights and restricts his personal freedom only to the extent necessary to provide
needed care and services to him.
(5) To expend sums from the financial resources of the ward reasonable and necessary
to carry out the powers and duties assigned to him by the court and, unless a
separate conservator has been appointed, to manage the financial resources of this
ward.
If a separate limited conservator or conservator has been appointed for the ward, the
expenditure of funds by the limited guardian shall be consistent with the duties assigned
to and procedures and policies established by such limited conservator or conservator.
Conflicts arising between a limited guardian and a limited conservator or conservator
regarding the expenditure of funds which are unable to be otherwise resolved shall be
submitted to the court for resolution.
* * *
CHAPTER 605
ADMINISTRATIVE MATTERS [Unified Juvenile Code]
* * *
605.110 Medical care,
educational programs for committed children --
Educational
Collaborative for State Agency Children -- Personnel --
Financing.
(1) Unless provided otherwise, when any child committed to or in the custody of the
Department of Juvenile Justice or the cabinet requires medical or surgical care or
treatment, the Department of Juvenile Justice or the cabinet may provide the same
or arrange for the furnishing thereof by other public or private agencies, and may
give consent to the medical or surgical treatment. For this purpose, the services and
facilities of local health officers and departments shall be made available, at a cost
not to exceed the Medicaid reimbursement rate, to the Department of Juvenile
Justice or the cabinet, and as far as practicable, any publicly owned hospital shall
provide hospitalization without charge for any such child who is a resident of the
political subdivision by which the hospital is owned or operated. This section does
not authorize nor shall permission be granted for abortion or sterilization.
* * *
610.310 Medical
treatment for child.
(1) When the mental or physical health of any child before the juvenile court requires it,
the court may order the child to be placed in a public or private hospital or
institution for examination, evaluation, treatment, or care by a health officer,
comprehensive care center, children's clinic, or any reputable physician or
psychologist who will conduct the examination. The cabinet and the Department of
Juvenile Justice may furnish services under agreements with the individual juvenile
courts. For this purpose, any county judge/executive or chief executive officer of an
urban-county or charter county government may enter into a contract on behalf of
his or her county with the cabinet or the Department of Juvenile Justice for the
furnishings of these services.
(2) The court may order or consent to necessary medical treatment, including surgical
procedures, except for the purpose of abortion, electroshock therapy or
psychosurgery as provided in KRS Chapter 645, or sterilization, after a hearing
conducted to determine the necessity of such treatment or procedure. In making the
order, the court may take into consideration the religious beliefs and practices of the
child and his parents or guardian. Reasonable notice, taking into account any
emergency circumstances, shall be provided to the parents, guardian or person
exercising custodial control or supervision of the child to enable them to attend the
hearing.
* * *
-------------------------------------------------------------
* * *
902 KAR 20:360. Abortion
facilities.
RELATES TO: KRS 213.101,
216B.010-216B.130, 216B.990, 311.710-311.830, 314.011(8), 314.042(8)
STATUTORY AUTHORITY: KRS 216B.0431
NECESSITY, FUNCTION, AND CONFORMITY:
KRS 216B.0431 requires that the Cabinet for Health Services regulate abortion
facilities. This administrative regulation establishes the licensure
requirements for abortion facilities.
Section 1. Definitions. (1)
"Abortion" is defined in KRS 311.720(1).
(2) "Abortion facility" is
defined in KRS 216B.015.
(3) "Cabinet" means the
Cabinet for Health Services.
(4) "Volunteer" means a
person who is not an employee of the abortion facility and who has direct
patient health care responsibilities performed within the abortion facility,
and excludes escort services.
Section 2. Licenses. (1) A license to
operate an abortion facility shall not be required for a health facility
licensed to perform the services regulated by 902 KAR 20:016 or 902 KAR 20:106.
That health facility shall:
(a) Comply with the requirements of
its respective licensure category and provide written notice of its intent to
perform abortions to the Office of Inspector General, Division of Licensing and
Regulation, 275 East Main Street, Frankfort, Kentucky 40621;
(b) Comply with the reporting
requirements of KRS 216B.0431; and
(c) Be exempt from any other
licensure requirements of this administrative regulation.
(2) The license required by KRS
216B.0431 shall be conspicuously posted in a public area of the facility.
(3) An applicant for licensure shall
file with the Office of the Inspector General, Division of Licensing and
Regulation, 275 East Main Street, Frankfort, Kentucky 40621, an application for
license to operate an abortion facility.
(4) An applicant for a license shall,
as a condition precedent to licensure or relicensure, be in compliance with the
applicable administrative regulations relating to an abortion facility:
(a) Compliance with licensure
administrative regulations shall be ascertained through an on-site inspection
of the facility. A licensure inspection may be unannounced.
(b) A representative of the
inspecting agency shall have access to the facility during the hours that the
facility operates.
(c) A regulatory violation identified
during an inspection shall be transmitted in writing to the facility by the
inspecting agency.
(d) The facility shall submit a
written plan for the elimination or correction of the regulatory violation to
the inspecting agency within ten (10) days.
1. The plan shall specify the date by
which each violation shall be corrected.
2. Following a review of the plan,
the inspecting agency shall notify the facility in writing of the acceptability
of the plan.
3. If a portion or all of the plan is
unacceptable:
a. The inspecting agency shall
specify the reasons for the unacceptability; and
b. The facility shall modify or amend
the plan and resubmit it to the inspecting agency within ten (10) days.
(5) A licensee shall, as a condition
of licensure or relicensure, be in compliance with the reporting requirements
of KRS 213.101.
(6) An unannounced inspection shall
be conducted:
(a) On a complaint allegation; and
(b) Utilizing the procedures
established in subsection (3) of this section.
(7) A license shall remain in effect
for one (1) year from the date of issuance unless otherwise expressly provided
in the license certificate.
(8) A license shall be renewed upon
payment of the prescribed fee and compliance with the licensure administrative
regulations.
(9) Each license to operate shall be
issued for the person or persons and premises named in the application.
(10) A new application shall be filed
in the event of change of ownership.
(a) Upon the filing of a new
application for a license because of change of ownership, the new license shall
be automatically issued for the remainder of the current licensure period.
(b) An additional fee shall not be
charged for the remainder of the licensure period.
Section 3. Fee Schedule. (1) Annual
fees. The annual licensure fee (including a renewal) for abortion facilities
shall be $155 for each licensed facility.
(2) Fees shall be paid by check made
payable to Kentucky State Treasurer and sent to Cabinet for Health Services,
Division of Licensing and Regulation, 275 East Main Street, 4E-A, Frankfort,
Kentucky 40621.
Section 4. Appeals. (1) Notice of the
denial, suspension, or revocation of a license shall be made pursuant to the
provisions of KRS Chapter 13B.
(2) A licensee may appeal the denial,
suspension, or revocation of his license to the Secretary of the Cabinet for
Health Services, 275 East Main Street, Frankfort, Kentucky 40621.
(3) A hearing on the denial,
suspension, or revocation of a license shall be conducted pursuant to the
provisions of KRS Chapter 13B.
Section 5. Administration and
Operation. (1) Licensee.
(a) The licensee shall be legally
responsible for the abortion facility and for compliance with federal, state
and local laws and regulations pertaining to the operation of the abortion
facility.
(b) The licensee shall establish
written policies for the administration and operation of the abortion facility.
(c) The licensee shall establish
lines of authority and designate the person who shall be principally
responsible for the daily operation of the abortion facility.
(2) Policies.
(a) Administrative policies. The abortion
facility shall have written administrative policies covering all aspects of the
operation, including:
1. A description of organizational
structure, staffing and allocation of responsibility and accountability;
2. A description of referral linkages
with inpatient facilities and other providers;
3. Policies and procedures for the
guidance and control of personnel performances;
4. A description of services included
in the program;
5. A description of the
administrative and patient care records and reports;
6. Procedures to be followed in the
storage, handling and administration of drugs and biologicals; and
7. A policy to specify the provision
of emergency medical services.
8. Procedures to be followed in
obtaining the voluntary and informed written consent of the pregnant woman, as
required by KRS 311.725.
(b) Patient rights policies. The
abortion facility shall adopt written policies regarding the rights and
responsibilities of patients. These patients' rights policies shall assure that
each patient:
1. Is informed of these rights and of
a procedure for handling patient grievances.
2. Is informed of services available
at the abortion facility and of related charges including any charges not
covered under third-party payor arrangements.
3. Is informed of her medical
condition, unless medically contraindicated (as documented in her medical
record), and is afforded the opportunity to participate in the planning of her
medical treatment and to refuse to participate in experimental research.
4. Is encouraged and assisted to
understand and exercise her patient rights; to this end she may voice
grievances and recommend changes in policies and services. Upon the patient's
request the grievances and recommendations will be conveyed within a reasonable
time to an appropriate decision making level within the organization which has
authority to take corrective action.
5. Is assured confidential treatment
of her records and is afforded the opportunity to approve or refuse their
release to any individual not involved in her care except as required by
Kentucky law or third-party payment contract.
6. Is treated with consideration,
respect, and full recognition of her dignity and individuality, including
privacy in treatment and in the care of her personal health needs.
(3) Personnel.
(a) A facility shall have a staff
that is adequately trained and capable of providing appropriate service and
supervision to the patients.
1. The licensee shall obtain written
applications for employment from all employees. The licensee shall obtain and
verify informa2) months, then the two (2)
step procedure (one (1) PPD test with negative result followed one (1) to three
(3) weeks later by another PPD test) is required to establish a reliable
baseline. If employees or volunteers have complete documentation of a negative
PPD during the preceding twelve (12) months (may be a single PPD or a two-(2)
step PPD), then a single PPD is acceptable to establish the baseline for
current employment.
a. A person with negative tuberculin
skin tests who has direct contact with patients shall have an annual tuberculin
skin test.
b. An initial or routine chest x-ray
shall not be required for an employee or volunteer with negative tuberculin
test results who is asymptomatic.
c. Personnel with a positive reaction
to the skin test shall have no patient contact until certified noncontagious by
a physician.
d. A chest x-ray shall be required to
determine whether TB disease is present for an employee or volunteer:
(i) With reactions of 10mm and over
to the preemployment tuberculin test;
(ii) Who has previously documented
positive reactions;
(iii) With newly converted skin
tests; and
(iv) With symptoms suggestive of TB
(e.g., cough, weight loss, night sweats, fever, etc.)
e. If TB disease is diagnosed,
appropriate treatment shall be given and patient contacts examined.
f. Personnel who are known or suspected
to have TB shall be required to be evaluated by a physician and shall not be
allowed to return to work until they have been certified noncontagious by the
physician.
g. Preventive treatment of personnel
with new positive reactions is essential, and shall be considered for all
infected employees or volunteers who have patient contact, unless specifically
contraindicated.
(i) An employee or volunteer who
completes treatment, either for disease or infection, may be exempt from
further routine chest radiographic screening unless he has symptoms of TB.
(ii) Positive reactors who are unable
or unwilling to take preventive treatment shall not receive an annual chest
x-ray. These individuals shall be informed of their lifelong risk of developing
and transmitting TB to individuals in the institution and in the community.
They shall be informed of symptoms which suggest the onset of TB, and the
procedure to follow should such symptoms develop.
h. Postexposure skin tests shall be
provided for tuberculin negative employees or volunteers within twelve (12)
weeks after termination of contact for any suspected exposure to a documented
case of pulmonary TB.
i. A person shall be designated in
writing at each facility to coordinate TB screening of personnel and any other
TB control activities.
3. All professional and allied health
professional staff members shall be currently certified with American Red Cross
or American Heart Association to perform cardiopulmonary resuscitation and
capable of recognizing symptoms of distress.
4. No employee or volunteer of the
facility while afflicted with any infected wounds, boils, sores, or an acute
respiratory infection, or any other contagious disease or illness, shall work
in any capacity in which there is a likelihood of such person transmitting
disease to other individuals.
5. Each facility shall have and
execute a written orientation program to familiarize each new staff member with
the facility and its policies and procedures, to include fire safety and other
safety measures, medical emergencies, and infection control.
6. In-service training programs shall
be planned and provided for all employees and volunteers to ensure and maintain
their understanding of their duties and responsibilities. Records shall be
maintained to reflect program content and individual attendance. The following
training shall be provided at least annually:
a. Infection control, to include as a
minimum, universal precautions against blood-borne diseases, general
sanitation, personal hygiene such as hand washing, use of masks and gloves, and
instruction to staff if there is a likelihood of transmitting a disease to
patients or other staff members;
b. Fire protection, to include
evacuating patients, proper use of fire extinguishers, and procedures for
reporting fires;
c. Confidentiality of patient
information and records, and protecting patient rights; and
d. Licensing regulations.
7. Job descriptions.
a. Written job descriptions that
adequately describe the duties of every position shall be maintained.
b. Each job description shall
include: position title, authority, specific responsibilities and minimum
qualifications.
c. Job descriptions shall be reviewed
at least annually, kept current and given to each employee and volunteer when
assigned to the position and when revised.
8. A personnel file shall be
maintained for each employee and for each volunteer. The records shall be
completely and accurately documented, readily available, and systematically
organized to facilitate the compilation and retrieval of information. The file
shall contain a current job description that reflects the individual's
responsibilities and work assignments, and documentation of the person's
orientation, in-service education, appropriate licensure, if applicable, and TB
skin testing.
(b) Clinical staff.
1. Physicians, nurses, and allied
health professionals shall constitute the clinical staff.
2. The clinical staff shall meet at
least quarterly to review and analyze their clinical experiences; minutes shall
be maintained of such meetings.
3. Physicians.
a. Abortions shall be performed only
by a physician who is licensed to practice medicine in Kentucky and who is
properly qualified by training and experience to perform pregnancy termination
procedures.
b. A physician shall remain on the
premises until all patients are discharged.
(c) Nursing.
1. Nursing care shall be under the
supervision of a registered nurse currently licensed in Kentucky.
2. A registered nurse shall be on
duty to provide or supervise all nursing care of patients in preparation,
during the termination procedure, the recovery period and until all patients
leave the facility.
3. Licensed practical nurses, working
under appropriate supervision and direction of a registered nurse, may be
employed as components of the nursing staff.
(d) Allied health professionals,
working under appropriate direction and supervision, may be employed to work
only within areas where their competency has been established.
Section 6. Patient Care. Abortion facilities
shall not serve patients whose needs exceed the resources or capabilities of
the facility. The facility shall formulate and adhere to written patient care
policies and procedures designed to ensure professional and safe care for
patients, to include:
(1) Admission criteria;
(2) Physician and nurse
responsibilities for the services offered;
(3) Specific details regarding the
preoperative procedures performed, to include history and physical examination,
including verification of pregnancy, estimation of gestational age,
identification of any preexisting conditions or complications;
(4) The actual abortion procedure, to
include the use of:
(a) IVs;
(b) Fluids;
(c) Analgesia/anesthesia. General
anesthesia shall be administered only by personnel acting within the limits of
their statutory scope of practice; and
(d) Tissue examination and disposal.
(5) Postprocedure care and recovery
room procedures to include emergency care;
(6) Provisions for the education of
patient, family and others, as appropriate in pre- and postprocedure care;
(7) Plans for follow-up patient care
after discharge from the facility;
(8) Management and appropriate
referral of high-risk conditions;
(9) Transfer of patients who, during
the course of pregnancy termination are determined to need care beyond that of
the facility; and
(10) Infection control and sanitation
procedures to include duties and responsibilities of the infection control
committee that shall include the development and implementation of specific
patient care and administrative policies aimed at investigating, controlling
and preventing infections in the facility.
Section 7. Pharmaceutical Services.
Pharmaceutical services shall be provided in accordance with accepted
professional practice and federal, state and local laws.
(1) Emergency drugs:
(a) Emergency kit or emergency drugs:
Each facility shall maintain an emergency kit or stock supply of drugs and
medicines for use in treating the emergency needs of patients. This kit or
medicine shall be stored in such a manner as to prohibit its access by
unauthorized personnel. A listing of contents by drawer or shelf shall be
placed on the cabinet or emergency cart to allow quick retrieval. Contents
shall correspond with the inventory list. Drugs and equipment shall be available
within the facility to treat, as a minimum, the following conditions:
1. Cardiac arrest;
2. Seizure;
3. Asthmatic attack;
4. Allergic reaction;
5. Narcotic toxicity;
6. Hypovolemic shock;
7. Vasovagal shock.
(b) Drug Reference Sources. Each
facility shall maintain reference sources for identifying and describing drugs
and medicines.
(2) Administering drugs and
medicines. Drugs and medicines shall not be administered to individual patients
or to anyone within or outside the facility except by those authorized by law
under orders of a physician or other ordering personnel acting within the
limits of their statutory scope of practice. Such orders shall be in writing
and signed personally by the physician or other personnel who prescribes the
drug or medicine.
(3) Medicine storage. Medicines and
drugs maintained in the facility for daily administration shall not be expired
and shall be properly stored and safeguarded in enclosures of sufficient size
that are not accessible to unauthorized persons. Refrigerators used for storage
of medications shall maintain an appropriate temperature as determined by the
requirements established on the label of medications. A thermometer accurate to
± three (3) degrees Fahrenheit shall be maintained in these refrigerators. Only
authorized personnel shall have access to storage enclosures. Controlled
substances and ethyl alcohol, if stocked, shall be stored under double locks
and in accordance with applicable state and federal laws.
(4) Medicine preparation area. Medicines
and drugs shall be prepared for administration in an area that contains a
counter and a sink. This area shall be located in such a manner as to prevent
contamination of medicines being prepared for administration.
(5) Records. Records shall be kept of
all stock supplies of controlled substances giving an accounting of all items
received or administered.
(6) Poisonous substances. All
poisonous substances shall be plainly labeled and kept in a cabinet or closet
separate from medicines and drugs to be prepared for administration.
Section 8. Laboratory Services. (1)
Laboratory services shall be provided on site or through arrangement with a
laboratory certified to provide the required procedures under 42 CFR 493.
(a) Facilities for collecting
specimens shall be available on site.
(b) If laboratory services are
provided on site they shall be directed by a person who qualifies as a director
under KRS 333.090 and 42 CFR part 493 and shall be performed in compliance with
KRS Chapter 333 and 42 CFR 493 standards.
(2) Prior to the procedure,
laboratory tests shall include a recognized urine pregnancy test unless the
physician identifies fetal heart beats or fetal movements on physical
examination. If positive, the following additional tests are required:
(a) Urinalysis including albumin and
glucose examination;
(b) Hematocrit or hemoglobin; and
(c) Determination of Rh factor with
appropriate medical intervention.
(3) Aspirated tissues shall be
examined to verify that villi or fetal parts are present; if villi or fetal
parts cannot be identified with certainty, the tissue specimen shall be sent
for further pathologic examination and the patient alerted to the possibility
of an ectopic pregnancy.
(4) A written report of each
laboratory test and examination shall be a part of the patient's record.
(5) If a patient is bleeding
profusely and a transfusion of red blood cells is necessary, she shall be
administered fluids and transported immediately to an acute care hospital.
(6) All laboratory supplies shall be
monitored for expiration dates, if applicable.
Section 9. Medical Waste Disposal.
(1) Sharp wastes.
(a) Sharp wastes, including needles,
scalpels, razors, or other sharp instruments used for patient care procedures,
shall be segregated from other wastes and placed in puncture resistant
containers immediately after use.
(b) Needles shall not be purposely
bent or broken, or otherwise manipulated by hand as a means of disposal, except
as permitted by Centers for Disease Control and Occupational Safety and Health
Administration guidelines.
(c) The containers of sharp wastes
shall either be incinerated on or off site, or be rendered nonhazardous.
(2) Disposable waste.
(a) All disposable waste shall be
placed in suitable bags or closed containers so as to prevent leakage or
spillage, and shall be handled, stored, and disposed of in such a way as to
minimize direct exposure of personnel to waste materials.
(b) The abortion facility shall
establish specific written policies regarding handling and disposal of all
wastes.
(c) Pathological waste, such as
tissues, organs, body parts, and bodily fluids, shall be incinerated.
(d) The following wastes shall be
disposed of by incineration, or be autoclaved before disposal, or be carefully
poured down a drain connected to sanitary sewer: blood, blood specimens, used
blood tubes, or blood products.
(e) Any wastes conveyed to a sanitary
sewer shall comply with applicable federal, state, and local pretreatment
administrative regulations.
(f) Any incinerator used for the
disposal of waste shall be in compliance with 401 KAR 59:023 or 401 KAR 61:013.
Section 10. Emergency Care. (1) An
abortion facility shall enter into written agreements with a licensed
acute-care hospital and a local ambulance service for the transport and
treatment of patients when hospitalization becomes necessary, as required by
KRS 216B.0435.
(2) These written agreements shall be
filed with the cabinet.
Section 11. Equipment and Supplies.
There shall be appropriate equipment and supplies maintained for the patients
to include:
(1) A bed or recliner suitable for
recovery;
(2) Oxygen with flow meters and masks
or equivalent;
(3) Mechanical suction;
(4) Resuscitation equipment to
include resuscitation bags and oral airways;
(5) Emergency medications, intravenous
fluids, and related supplies and equipment;
(6) A clock with a sweep second hand;
(7) Sterile suturing equipment and
supplies;
(8) Adjustable examination light;
(9) Containers for soiled linen and
waste materials with covers;
(10) Refrigerator; and
(11) Appropriate equipment for the
administering of general anesthesia, if applicable.
Section 12. Consultation.
Arrangements shall be made for consultation or referral services to be
available as needed.
Section 13. Quality Improvement. (1)
The facility shall establish and implement a written plan for a quality
improvement program for patient care. The plan shall specify the individual
responsible for coordinating the quality improvement program and shall provide
for ongoing monitoring of staff and patient care services.
(2) There shall be an ongoing process
for monitoring and evaluating patient care services, staffing, infection
prevention and control, housekeeping, sanitation, safety, maintenance of
physical plant and equipment, patient care statistics, and discharge planning
services.
(3) Evaluation of patient care
throughout the facility shall be criteria-based, so that certain actions are
taken or triggered when specific quantified, predetermined levels of outcomes
or potential problems are identified.
(4) The quality improvement process
shall incorporate quarterly review of a minimum of five (5) percent of medical
records of patients undergoing procedures during a given quarter, but not less
than five (5) records shall be reviewed.
(5) The quality improvement process
shall include evaluation by patients of care and services provided by the
facility. If the families of patients are involved in the care and services
provided by the facility, the quality improvement process shall include a means
for obtaining input from families of patients.
(6) The administrator shall review
the findings of the quality improvement program to ensure that effective
corrective actions have been taken, including as a minimum, policy revisions,
procedural changes, educational activities, and follow-up on recommendations,
or that additional actions are no longer indicated or needed.
(7) The quality improvement program
shall identify and establish indicators of quality care, specific to the
facility, that shall be monitored and evaluated.
(8) The results of the quality
improvement program shall be submitted to the licensee for review at least
annually and shall include at least the deficiencies found and recommendations
for corrections or improvements. Deficiencies that jeopardize patient safety
shall be reported immediately in writing to the licensee.
Section 14. Medical Records. (1)
Medical records shall be maintained for all patients examined or treated in the
abortion facility. The records shall be completely and accurately documented,
readily available, and systematically organized to facilitate the compilation
and retrieval of information. All information shall be centralized in the
patient's medical record. All entries shall be legibly written or typed, dated
and signed.
(a) The record shall include the
following information:
1. A face sheet with patient
identification data, to include: name, address, telephone number, Social
Security number, date of birth, and name, address and telephone number of
person to be notified in the event of an emergency;
2. Signed consent for the procedure;
3. Date of initial examination;
4. Date of abortion;
5. Referring and attending
physicians' names and phone numbers, if applicable;
6. Complete medical history to
include medications currently being taken;
7. Physical examination, to the
extent necessary to determine the health status of the patient, within fifteen
(15) days of the procedure, including detail of findings of pelvic examination
and estimated gestational age, according to the first day of the last menstrual
period;
8. Results of diagnostic tests and
examinations, e.g., x-ray, electrocardiography, clinical laboratory, pathology,
consultations, ultrasound;
9. Preoperative diagnosis;
10. Counselor's notes if applicable;
11. Physician's orders;
12. Complete record of abortion
procedure to include:
a. Vital signs, i.e., temperature,
pulse, respiration, and blood pressure, prior to and following the procedure;
b. Name of procedure performed;
c. Anesthetic agent utilized;
d. Name of attending physician
performing the procedure;
e. Names of clinical assistants in
attendance, to include other physicians, physician's assistants, anesthetists,
nurses, or specially-trained technicians;
f. Signature of physician performing
the procedure.
13. Nurses' notes;
14. Progress notes to include a
postanesthesia note if general anesthesia is utilized;
15. Attending physician's description
of gross appearance of tissue removed;
16. Final diagnosis;
17. Condition on discharge;
18. Post-op orders and follow-up
care; and
19. Documented verification that the
woman has received information and was offered printed materials as required by
KRS 311.725.
(b) The attending physician shall
complete and sign the medical record within seventy-two (72) hours following
discharge.
(2) Confidentiality of all patient
records shall be maintained at all times.
(3) Transfer of records. The abortion
facility shall establish systematic procedures to assist in continuity of care
where the patient moves to another source of care, and shall, upon proper
release, transfer medical records or an abstract thereof when requested.
(4) Retention of records. After
patient's death or discharge the complete medical record shall be placed in an
inactive file and retained for five (5) years or, in case of a minor, three (3)
years after the patient reaches the age of majority under state law, whichever
is the longest.
Section 15. Infection Control. (1)
There shall be an infection control program developed to prevent, identify, and
control infections.
(2) Written policies and procedures
pertaining to the operation of the infection control program shall be
established, reviewed at least annually, and revised as necessary.
(3) A practical system shall be
developed for reporting, evaluating, and maintaining records of infections
among residents and personnel.
(4) The system shall include
assignment of responsibility for the ongoing collection and analysis of data,
as well as for the implementation of required follow-up actions.
(5) Corrective actions shall be taken
on the basis of records and reports of infections and infection potentials
among patients and personnel and shall be documented.
(6) All new employees shall be
instructed in the importance of infection control and personal hygiene and in
their responsibility in the infection control program.
(7) The facility shall document that
in-service education in infection prevention and control is provided to all
services and program components.
(8) Adequate space shall be provided
for storage, maintenance and distribution of sterile supplies and equipment.
(9) Sterile supplies and equipment
shall not be mixed with unsterile supplies, and shall be stored in dust-proof
and moisture-free units. They shall be properly labeled.
(10) Sterilizing equipment of
appropriate type shall be available and of adequate capacity to properly
sterilize instruments and materials. The sterilizing equipment shall have
approved control and safety features.
Section 16. Linen and Laundry. (1) An
adequate supply of clean linen or disposable materials shall be maintained in
order to ensure change of linen on procedure tables between patients.
(2) Provisions for proper laundering
of linen and washable goods shall be made. Soiled and clean linen shall be
handled and stored separately. Storage shall be in covered containers.
(3) A sufficient supply of cloth or
disposable towels shall be available so that a fresh towel can be used after
each hand washing. Towels shall not be shared.
Section 17. Housekeeping. (1)
General.
(a) A facility shall be kept neat,
clean and free from odors;
(b) Accumulated waste material shall
be removed daily or more often if necessary;
(c) There shall be frequent cleaning
of floors, walls, ceilings, woodwork and windows;
(d) The premises shall be kept free
from rodent and insect infestation; and
(e) Bath and toilet facilities shall
be maintained in a clean and sanitary condition at all times.
(2) Cleaning materials and supplies
shall be stored in a safe manner. All harmful agents shall be locked in a
closet or cabinet used for this purpose only.
Section 18. Refuse and Waste
Disposal. (1) All garbage and waste shall be collected, stored and disposed of
in a manner designed to prevent the transmission of disease.
(a) Containers shall be washed and
sanitized before being returned to work areas; and
(b) Disposable type containers shall
not be reused.
(2) Containers for garbage and refuse
shall be covered and stored outside and placed on an approved platform to
prevent overturning by animals, the entrance of flies or the creation of a
nuisance. All solid waste shall be disposed of at sufficient frequencies in a
manner so as not to create a rodent, insect or other vermin problem.
(3) Immediately after emptying,
containers for garbage shall be cleaned.
(4) All medical waste shall be
managed in accordance with Section 9 of this administrative regulation.
Section 19. Outside Areas. All
outside areas, grounds and adjacent buildings shall be kept free of rubbish,
grass, and weeds that may serve as a fire hazard or as a haven for insects,
rodents and other pests. Outside stairs, walkways, ramps and porches shall be
maintained free from accumulations of water, ice, snow and other impediments.
Section 20. Disaster Preparedness.
(1) All staff shall be knowledgeable of a written plan and procedure for
meeting potential disasters and emergencies such as fires or severe weather.
The plan shall be posted. Staff shall be trained in properly reporting a fire,
extinguishing a small fire, and in evacuation from the building. Fire drills
shall be practiced in accordance with state fire administrative regulations.
(2) All fire protection and alarm
systems and other fire fighting equipment shall be inspected and tested at
least once each year, and more often if necessary to maintain them in
serviceable condition.
Section 21. Facility Specifications.
(1) An abortion facility shall provide a functionally safe and sanitary
environment for patients, personnel, and the public.
(2) An abortion facility shall
include space for the following functions:
(a) Reception and waiting;
(b) Administrative activities such as
patient admission, record storage, and business affairs;
(c) Patient dressing and storage of
personal items;
(d) Preoperative evaluation,
including physical examination, laboratory testing, and preparation for
anesthesia;
(e) Performance of surgical
procedures;
(f) Preparation and sterilization of
instruments;
(g) Storage of equipment, drugs, and
fluids;
(h) Postanesthetic recovery; and
(i) Janitorial and utility support.
Section 22. Injunctive Relief. The
Office of Inspector General shall refer instances where administrative
penalties and legal sanctions have failed to prevent or cause a discontinuance
of a violation of KRS Chapter 216B to the secretary of the cabinet for action
in accordance with KRS 15.241.
Section 23. Incorporation by
Reference. (1) The Application for License to Operate an Abortion Facility,
L&R 240 (7/98), is incorporated by reference.
(2) This material may be inspected,
copied or obtained at the Office of Inspector General, Division of Licensing
and Regulation, 275 East Main Street, Frankfort, Kentucky 40621, Monday through
Friday, 8 a.m. to 4:30 p.m. (25 Ky.R. 1293; Am. 2168; 2388; eff. 3-17-99.)
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