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AN ACT relating to freestanding birthing centers. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
SECTION 1. A NEW SECTION OF KRS CHAPTER 216B IS CREATED TO 3
READ AS FOLLOWS: 4
(1) As used in this section, "freestanding birthing center" means any health facility, 5
place, or institution which is not a hospital, is not in a hospital or a private 6
residence, and is established to provide care for labor, delivery, and the 7
immediate postpartum period. 8
(2) The cabinet shall promulgate updated administrative regulations establishing 9
licensure standards for freestanding birthing centers by December 1, 2022. The 10
administrative regulations shall: 11
(a) Require accreditation by the Commission for the Accreditation of Birth 12
Centers; 13
(b) Be consistent with the American Association of Birth Centers (AABC) 14
Standards for Birth Centers; and 15
(c) Consistent with requirements in paragraphs (a) and (b) of this subsection, 16
require plans for transfer and safe transport to a hospital when such 17
transfer and transport are needed. 18
(3) A certificate of need shall not be required to establish and license a freestanding 19
birthing center. 20
(4) Nothing in this section is intended to expand or limit liability of a health care 21
provider or a freestanding birthing center. In the event of an action for injury or 22
death due to any act or omission of a health care provider rendering services at a 23
freestanding birthing center where an injured patient is transferred to any other 24
health care provider or health care facility, the liability of the subsequent health 25
care provider or health care facility shall be limited to their own negligent acts 26
and omissions that violate their professional standards of care, unless the 27 UNOFFICIAL COPY 22 RS BR 124
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subsequent health care provider or health care facility owns, operates, or 1
provided care at the freestanding birthing center, and under those circumstances 2
the health care provider or health care facility shall be liable for acts or 3
omissions that violate their professional standards of care and that occur at a 4
freestanding birthing center that the health care provider or health care facility 5
owns or operates. 6
Section 2. KRS 216B.020 is amended to read as follows: 7
(1) The provisions of this chapter that relate to the issuance of a certificate of need shall 8
not apply to abortion facilities as defined in KRS 216B.015; any hospital which 9
does not charge its patients for hospital services and does not seek or accept 10
Medicare, Medicaid, or other financial support from the federal government or any 11
state government; assisted living residences; family care homes; state veterans' 12
nursing homes; services provided on a contractual basis in a rural primary-care 13
hospital as provided under KRS 216.380; community mental health centers for 14
services as defined in KRS Chapter 210; primary care centers; rural health clinics; 15
private duty nursing services operating as nursing pools; group homes; licensed 16
residential crisis stabilization units; licensed free-standing residential substance use 17
disorder treatment programs with sixteen (16) or fewer beds, but not including 18
Levels I and II psychiatric residential treatment facilities or licensed psychiatric 19
inpatient beds; outpatient behavioral health treatment, but not including partial 20
hospitalization programs; end stage renal disease dialysis facilities, freestanding or 21
hospital based; swing beds; special clinics, including but not limited to wellness, 22
weight loss, family planning, disability determination, speech and hearing, 23
counseling, pulmonary care, and other clinics which only provide diagnostic 24
services with equipment not exceeding the major medical equipment cost threshold 25
and for which there are no review criteria in the state health plan; nonclinically 26
related expenditures; nursing home beds that shall be exclusively limited to on-27 UNOFFICIAL COPY 22 RS BR 124
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campus residents of a certified continuing care retirement community; home health 1
services provided by a continuing care retirement community to its on-campus 2
residents; the relocation of hospital administrative or outpatient services into 3
medical office buildings which are on or contiguous to the premises of the hospital; 4
the relocation of acute care beds which occur among acute care hospitals under 5
common ownership and which are located in the same area development district so 6
long as there is no substantial change in services and the relocation does not result 7
in the establishment of a new service at the receiving hospital for which a certificate 8
of need is required; the redistribution of beds by licensure classification within an 9
acute care hospital so long as the redistribution does not increase the total licensed 10
bed capacity of the hospital; residential hospice facilities established by licensed 11
hospice programs; freestanding birthing centers as defined in Section 1 of this 12
Act; or the following health services provided on site in an existing health facility 13
when the cost is less than six hundred thousand dollars ($600,000) and the services 14
are in place by December 30, 1991: psychiatric care where chemical dependency 15
services are provided, level one (1) and level two (2) of neonatal care, cardiac 16
catheterization, and open heart surgery where cardiac catheterization services are in 17
place as of July 15, 1990. The provisions of this section shall not apply to nursing 18
homes, personal care homes, intermediate care facilities, and family care homes; or 19
nonconforming ambulance services as defined by administrative regulation. These 20
listed facilities or services shall be subject to licensure, when applicable. 21
(2) Nothing in this chapter shall be construed to authorize the licensure, supervision, 22
regulation, or control in any manner of: 23
(a) Private offices and clinics of physicians, dentists, and other practitioners of 24
the healing arts, except any physician's office that meets the criteria set forth 25
in KRS 216B.015(5) or that meets the definition of an ambulatory surgical 26
center as set out in KRS 216B.015; 27 UNOFFICIAL COPY 22 RS BR 124
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(b) Office buildings built by or on behalf of a health facility for the exclusive use 1
of physicians, dentists, and other practitioners of the healing arts; unless the 2
physician's office meets the criteria set forth in KRS 216B.015(5), or unless 3
the physician's office is also an abortion facility as defined in KRS 216B.015, 4
except no capital expenditure or expenses relating to any such building shall 5
be chargeable to or reimbursable as a cost for providing inpatient services 6
offered by a health facility; 7
(c) Outpatient health facilities or health services that: 8
1. Do not provide services or hold patients in the facility after midnight; 9
and 10
2. Are exempt from certificate of need and licensure under subsection (3) 11
of this section; 12
(d) Dispensaries and first-aid stations located within business or industrial 13
establishments maintained solely for the use of employees, if the facility does 14
not contain inpatient or resident beds for patients or employees who generally 15
remain in the facility for more than twenty-four (24) hours; 16
(e) Establishments, such as motels, hotels, and boarding houses, which provide 17
domiciliary and auxiliary commercial services, but do not provide any health 18
related services and boarding houses which are operated by persons 19
contracting with the United States Department of Veterans Affairs for 20
boarding services; 21
(f) The remedial care or treatment of residents or patients in any home or 22
institution conducted only for those who rely solely upon treatment by prayer 23
or spiritual means in accordance with the creed or tenets of any recognized 24
church or religious denomination and recognized by that church or 25
denomination; and 26
(g) On-duty police and fire department personnel assisting in emergency 27 UNOFFICIAL COPY 22 RS BR 124
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situations by providing first aid or transportation when regular emergency 1
units licensed to provide first aid or transportation are unable to arrive at the 2
scene of an emergency situation within a reasonable time. 3
(3) The following outpatient categories of care shall be exempt from certificate of need 4
and licensure on July 14, 2018: 5
(a) Primary care centers; 6
(b) Special health clinics, unless the clinic provides pain management services 7
and is located off the campus of the hospital that has majority ownership 8
interest; 9
(c) Specialized medical technology services, unless providing a State Health Plan 10
service; 11
(d) Retail-based health clinics and ambulatory care clinics that provide 12
nonemergency, noninvasive treatment of patients; 13
(e) Ambulatory care clinics treating minor illnesses and injuries; 14
(f) Mobile health services, unless providing a service in the State Health Plan; 15
(g) Rehabilitation agencies; 16
(h) Rural health clinics; and 17
(i) Off-campus, hospital-acquired physician practices. 18
(4) The exemptions established by subsections (2) and (3) of this section shall not apply 19
to the following categories of care: 20
(a) An ambulatory surgical center as defined by KRS 216B.015(4); 21
(b) A health facility or health service that provides one (1) of the following types 22
of services: 23
1. Cardiac catheterization; 24
2. Megavoltage radiation therapy; 25
3. Adult day health care; 26
4. Behavioral health services; 27 UNOFFICIAL COPY 22 RS BR 124
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5. Chronic renal dialysis;[ 1
6. Birthing services;] or 2
6.[7.] Emergency services above the level of treatment for minor illnesses or 3
injuries; 4
(c) A pain management facility as defined by KRS 218A.175(1); 5
(d) An abortion facility that requires licensure pursuant to KRS 216B.0431; or 6
(e) A health facility or health service that requests an expenditure that exceeds the 7
major medical expenditure minimum. 8
(5) An existing facility licensed as an intermediate care or nursing home shall notify the 9
cabinet of its intent to change to a nursing facility as defined in Public Law 100-10
203. A certificate of need shall not be required for conversion of an intermediate 11
care or nursing home to the nursing facility licensure category. 12
(6) Ambulance services owned and operated by a city government, which propose to 13
provide services in coterminous cities outside of the ambulance service's designated 14
geographic service area, shall not be required to obtain a certificate of need if the 15
governing body of the city in which the ambulance services are to be provided 16
enters into an agreement with the ambulance service to provide services in the city. 17
(7) Notwithstanding any other provision of law, a continuing care retirement 18
community's nursing home beds shall not be certified as Medicaid eligible unless a 19
certificate of need has been issued authorizing applications for Medicaid 20
certification. The provisions of subsection (5) of this section notwithstanding, a 21
continuing care retirement community shall not change the level of care licensure 22
status of its beds without first obtaining a certificate of need. 23
Section 3. This Act shall be known as the Mary Carol Akers Birth Centers Act. 24