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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, the immediate 7
postpartum period, and the newborn immediately following delivery. 8
(2) The cabinet shall promulgate updated administrative regulations establishing 9
licensure standards for freestanding birthing centers by December 1, 2023. 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; 15
(c) Consistent with the requirements of paragraphs (a) and (b) of this 16
subsection, require plans for transfer and safe transport to a hospital when 17
such transfer and transport are needed, including to facilities providing 18
maternal and neonatal intensive care when such care is indicated; and 19
(d) Not prohibit a hospital from owning or operating a freestanding birthing 20
center that complies with the requirements of this section. 21
(3) A certificate of need shall not be required to establish and license a freestanding 22
birthing center. 23
(4) Nothing in this section is intended to expand or limit liability of a health care 24
provider or a freestanding birthing center. In the event of an action for injury or 25
death due to any act or omission of a health care provider rendering services at a 26
freestanding birthing center where an injured patient is transferred to any other 27 UNOFFICIAL COPY 23 RS BR 24
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licensed health care provider or licensed health care facility, the liability of the 1
subsequent licensed health care provider or licensed health care facility shall be 2
limited to their own negligent acts and omissions that violate their standards of 3
care according to existing law, unless the subsequent licensed health care 4
provider or licensed health care facility owns, operates, or provides care at the 5
freestanding birthing center, and under those circumstances the licensed health 6
care provider or licensed health care facility shall be liable for acts or omissions 7
that violate their standards of care and that occur at a freestanding birthing 8
center that the licensed health care provider or licensed health care facility owns 9
or operates. 10
Section 2. KRS 216B.020 is amended to read as follows: 11
(1) The provisions of this chapter that relate to the issuance of a certificate of need shall 12
not apply to abortion facilities as defined in KRS 216B.015; any hospital which 13
does not charge its patients for hospital services and does not seek or accept 14
Medicare, Medicaid, or other financial support from the federal government or any 15
state government; assisted living residences; family care homes; state veterans' 16
nursing homes; services provided on a contractual basis in a rural primary-care 17
hospital as provided under KRS 216.380; community mental health centers for 18
services as defined in KRS Chapter 210; primary care centers; rural health clinics; 19
private duty nursing services operating as health care services agencies as defined 20
in KRS 216.718; group homes; licensed residential crisis stabilization units; 21
licensed free-standing residential substance use disorder treatment programs with 22
sixteen (16) or fewer beds, but not including Levels I and II psychiatric residential 23
treatment facilities or licensed psychiatric inpatient beds; outpatient behavioral 24
health treatment, but not including partial hospitalization programs; end stage renal 25
disease dialysis facilities, freestanding or hospital based; swing beds; special 26
clinics, including but not limited to wellness, weight loss, family planning, 27 UNOFFICIAL COPY 23 RS BR 24
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disability determination, speech and hearing, counseling, pulmonary care, and other 1
clinics which only provide diagnostic services with equipment not exceeding the 2
major medical equipment cost threshold and for which there are no review criteria 3
in the state health plan; nonclinically related expenditures; nursing home beds that 4
shall be exclusively limited to on-campus residents of a certified continuing care 5
retirement community; home health services provided by a continuing care 6
retirement community to its on-campus residents; the relocation of hospital 7
administrative or outpatient services into medical office buildings which are on or 8
contiguous to the premises of the hospital; the relocation of acute care beds which 9
occur among acute care hospitals under common ownership and which are located 10
in the same area development district so long as there is no substantial change in 11
services and the relocation does not result in the establishment of a new service at 12
the receiving hospital for which a certificate of need is required; the redistribution 13
of beds by licensure classification within an acute care hospital so long as the 14
redistribution does not increase the total licensed bed capacity of the hospital; 15
residential hospice facilities established by licensed hospice programs; freestanding 16
birthing centers as defined in Section 1 of this Act; the following health services 17
provided on site in an existing health facility when the cost is less than six hundred 18
thousand dollars ($600,000) and the services are in place by December 30, 1991: 19
psychiatric care where chemical dependency services are provided, level one (1) 20
and level two (2) of neonatal care, cardiac catheterization, and open heart surgery 21
where cardiac catheterization services are in place as of July 15, 1990; or 22
ambulance services operating in accordance with subsection (6), (7), or (8) of this 23
section. These listed facilities or services shall be subject to licensure, when 24
applicable. 25
(2) Nothing in this chapter shall be construed to authorize the licensure, supervision, 26
regulation, or control in any manner of: 27 UNOFFICIAL COPY 23 RS BR 24
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(a) Private offices and clinics of physicians, dentists, and other practitioners of 1
the healing arts, except any physician's office that meets the criteria set forth 2
in KRS 216B.015(5) or that meets the definition of an ambulatory surgical 3
center as set out in KRS 216B.015; 4
(b) Office buildings built by or on behalf of a health facility for the exclusive use 5
of physicians, dentists, and other practitioners of the healing arts; unless the 6
physician's office meets the criteria set forth in KRS 216B.015(5), or unless 7
the physician's office is also an abortion facility as defined in KRS 216B.015, 8
except no capital expenditure or expenses relating to any such building shall 9
be chargeable to or reimbursable as a cost for providing inpatient services 10
offered by a health facility; 11
(c) Outpatient health facilities or health services that: 12
1. Do not provide services or hold patients in the facility after midnight; 13
and 14
2. Are exempt from certificate of need and licensure under subsection (3) 15
of this section; 16
(d) Dispensaries and first-aid stations located within business or industrial 17
establishments maintained solely for the use of employees, if the facility does 18
not contain inpatient or resident beds for patients or employees who generally 19
remain in the facility for more than twenty-four (24) hours; 20
(e) Establishments, such as motels, hotels, and boarding houses, which provide 21
domiciliary and auxiliary commercial services, but do not provide any health 22
related services and boarding houses which are operated by persons 23
contracting with the United States Department of Veterans Affairs for 24
boarding services; 25
(f) The remedial care or treatment of residents or patients in any home or 26
institution conducted only for those who rely solely upon treatment by prayer 27 UNOFFICIAL COPY 23 RS BR 24
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or spiritual means in accordance with the creed or tenets of any recognized 1
church or religious denomination and recognized by that church or 2
denomination; and 3
(g) On-duty police and fire department personnel assisting in emergency 4
situations by providing first aid or transportation when regular emergency 5
units licensed to provide first aid or transportation are unable to arrive at the 6
scene of an emergency situation within a reasonable time. 7
(3) The following outpatient categories of care shall be exempt from certificate of need 8
and licensure on July 14, 2018: 9
(a) Primary care centers; 10
(b) Special health clinics, unless the clinic provides pain management services 11
and is located off the campus of the hospital that has majority ownership 12
interest; 13
(c) Specialized medical technology services, unless providing a State Health Plan 14
service; 15
(d) Retail-based health clinics and ambulatory care clinics that provide 16
nonemergency, noninvasive treatment of patients; 17
(e) Ambulatory care clinics treating minor illnesses and injuries; 18
(f) Mobile health services, unless providing a service in the State Health Plan; 19
(g) Rehabilitation agencies; 20
(h) Rural health clinics; and 21
(i) Off-campus, hospital-acquired physician practices. 22
(4) The exemptions established by subsections (2) and (3) of this section shall not 23
apply to the following categories of care: 24
(a) An ambulatory surgical center as defined by KRS 216B.015(4); 25
(b) A health facility or health service that provides one (1) of the following types 26
of services: 27 UNOFFICIAL COPY 23 RS BR 24
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1. Cardiac catheterization; 1
2. Megavoltage radiation therapy; 2
3. Adult day health care; 3
4. Behavioral health services; 4
5. Chronic renal dialysis;[ 5
6. Birthing services;] or 6
6.[7.] Emergency services above the level of treatment for minor illnesses or 7
injuries; 8
(c) A pain management facility as defined by KRS 218A.175(1); 9
(d) An abortion facility that requires licensure pursuant to KRS 216B.0431; or 10
(e) A health facility or health service that requests an expenditure that exceeds the 11
major medical expenditure minimum. 12
(5) An existing facility licensed as an intermediate care or nursing home shall notify 13
the cabinet of its intent to change to a nursing facility as defined in Public Law 100-14
203. A certificate of need shall not be required for conversion of an intermediate 15
care or nursing home to the nursing facility licensure category. 16
(6) Ambulance services owned and operated by a city government, which propose to 17
provide services in coterminous cities outside of the ambulance service's designated 18
geographic service area, shall not be required to obtain a certificate of need if the 19
governing body of the city in which the ambulance services are to be provided 20
enters into an agreement with the ambulance service to provide services in the city. 21
(7) Ambulance services owned by a hospital shall not be required to obtain a certificate 22
of need for the sole purpose of providing non-emergency and emergency transport 23
services originating from its hospital. 24
(8) (a) As used in this subsection, "emergency ambulance transport services" means 25
the transportation of an individual that has an emergency medical condition 26
with acute symptoms of sufficient severity that the absence of immediate 27 UNOFFICIAL COPY 23 RS BR 24
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medical attention could reasonably be expected to place the individual's health 1
in serious jeopardy or result in the serious impairment or dysfunction of the 2
individual's bodily organs. 3
(b) A city or county government that has conducted a public hearing for the 4
purposes of demonstrating that an imperative need exists in the city or county 5
to provide emergency ambulance transport services within its jurisdictional 6
boundaries shall not be required to obtain a certificate of need for the city or 7
county to: 8
1. Directly provide emergency ambulance transport services as defined in 9
this subsection within the city's or county's jurisdictional boundaries; or 10
2. Enter into a contract with a hospital or hospitals within its jurisdiction, 11
or within an adjoining county if there are no hospitals located within the 12
county, for the provision of emergency ambulance transport services as 13
defined in this subsection within the city's or county's jurisdictional 14
boundaries. 15
(c) Any license obtained under KRS Chapter 311A by a city or county for the 16
provision of ambulance services operating under a certificate of need 17
exclusion pursuant to this subsection shall be held exclusively by the city or 18
county government and shall not be transferrable to any other entity. 19
(d) Prior to obtaining the written agreement of a city, an ambulance service 20
operating under a county government certificate of need exclusion pursuant to 21
this subsection shall not provide emergency ambulance transport services 22
within the boundaries of any city that: 23
1. Possesses a certificate of need to provide emergency ambulance 24
services; 25
2. Has an agency or department thereof that holds a certificate of need to 26
provide emergency ambulance services; or 27 UNOFFICIAL COPY 23 RS BR 24
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3. Is providing emergency ambulance transport services within its 1
jurisdictional boundaries pursuant to this subsection. 2
(9) (a) Except where a certificate of need is not required pursuant to subsection (6), 3
(7), or (8) of this section, the cabinet shall grant nonsubstantive review for a 4
certificate of need proposal to establish an ambulance service that is owned by 5
a: 6
1. City government; 7
2. County government; or 8
3. Hospital, in accordance with paragraph (b) of this subsection. 9
(b) A notice shall be sent by the cabinet to all cities and counties that a certificate 10
of need proposal to establish an ambulance service has been submitted by a 11
hospital. The legislative bodies of the cities and counties affected by the 12
hospital's certificate of need proposal shall provide a response to the cabinet 13
within thirty (30) days of receiving the notice. The failure of a city or county 14
legislative body to respond to the notice shall be deemed to be support for the 15
proposal. 16
(c) An ambulance service established under this subsection shall not be 17
transferred to another entity that does not meet the requirements of paragraph 18
(a) of this subsection without first obtaining a substantive certificate of need. 19
(10) Notwithstanding any other provision of law, a continuing care retirement 20
community's nursing home beds shall not be certified as Medicaid eligible unless a 21
certificate of need has been issued authorizing applications for Medicaid 22
certification. The provisions of subsection (5) of this section notwithstanding, a 23
continuing care retirement community shall not change the level of care licensure 24
status of its beds without first obtaining a certificate of need. 25
(11) An ambulance service established under subsection (9) of this section shall not be 26
transferred to an entity that does not qualify under subsection (9) of this section 27 UNOFFICIAL COPY 23 RS BR 24
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without first obtaining a substantive certificate of need. 1
(12) (a) The provisions of subsections (7), (8), and (9) of this section shall expire on 2
July 1, 2026. 3
(b) All actions taken by cities, counties, and hospitals, exemptions from obtaining 4
a certificate of need, and any certificate of need granted under subsections (7), 5
(8), and (9) of this section prior to July 1, 2026, shall remain in effect on and 6
after July 1, 2026. 7
Section 3. KRS 196.173 is amended to read as follows: 8
(1) Except as provided in subsection (2) of this section, an inmate housed in a jail, 9
penitentiary, or local or state correctional or detention facility, residential center, or 10
reentry center who is known to be pregnant shall be restrained solely with 11
handcuffs in front of her body unless further restraint is required to protect herself 12
or others. 13
(2) (a) Except in an extraordinary circumstance, no inmate who is known to be 14
pregnant shall be restrained during labor, during transport to a medical facility 15
or freestanding birthing center for delivery, or during postpartum recovery. 16
(b) As used in this subsection, "extraordinary circumstance" means that 17
reasonable grounds exist to believe the inmate presents an immediate and 18
credible: 19
1. Serious threat of hurting herself, staff, or others; or 20
2. Risk of escape that cannot be reasonably minimized through any method 21
other than restraints. 22
Section 4. KRS 211.647 is amended to read as follows: 23
(1) The office, on receipt of an auditory screening report of an infant from a hospital or 24
freestanding[alternative] birthing center in accordance with KRS 216.2970 shall 25
review each auditory screening report that indicates a potential hearing loss. The 26
office shall contact the parents to schedule follow-up evaluations or make a referral 27 UNOFFICIAL COPY 23 RS BR 24
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for evaluations within three (3) business days. 1
(2) The office shall secure information missing from birth certificates or hospital 2
referral reports which is relevant to identifying infants with a hearing loss. 3
(3) The office shall establish standards for infant audiological assessment and 4
diagnostic centers based on accepted national standards, including but not limited to 5
the "Guidelines for the Audiologic Assessment of Children From Birth to 5 Years 6
of Age" as published by the American Speech-Language-Hearing Association 7
(ASHA) and the "Year 2007 Position Statement: Principles and Guidelines for 8
Early Hearing Detection and Intervention Programs" as published by the Joint 9
Committee on Infant Hearing (JCIH). The office may promulgate administrative 10
regulations in accordance with KRS Chapter 13A to establish the standards for the 11
centers. 12
(4) The office shall maintain a list of approved infant audiological assessment and 13
diagnostic centers that meet the standards established by the office. An audiological 14
assessment and diagnostic center included on the list shall meet the standards 15
established by the office. An approved center may voluntarily choose not to be 16
included on the list. 17
(5) An approved audiology assessment and diagnostic center shall agree to provide 18
requested data to the office for each infant evaluated and on any newly identified 19
children ages birth to three (3) years with a permanent childhood hearing loss 20
within forty-eight (48) hours and make a referral to the Kentucky Early Intervention 21
System point of entry in the service area of the child's residence for services under 22
KRS 200.664. A center shall submit documentation to the office of a referral made 23
to the Kentucky Early Intervention System. A referral received by the Kentucky 24
Early Intervention System from a center shall be considered a referral from the 25
office. 26
(6) If the audiological evaluation performed by the office contains evidence of a 27 UNOFFICIAL COPY 23 RS BR 24
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hearing loss, within forty-eight (48) hours the office shall: 1
(a) Contact the attending physician and parents and provide information to the 2
parents in an accessible format as supplied by the Kentucky Commission on 3
the Deaf and Hard of Hearing; and 4
(b) Make a referral to the Kentucky Early Intervention System point of entry in 5
the service area of the child's residence for services under KRS 200.664. 6
(7) The office shall forward a report of an audiological evaluation that indicates a 7
hearing loss, with no information that personally identifies the child, to: 8
(a) The Kentucky Commission on the Deaf and Hard of Hearing for census 9
purposes; and 10
(b) The Kentucky Birth Surveillance Registry for information purposes. 11
(8) Cumulative demographic data of identified infants with a hearing loss shall be made 12
available to agencies and organizations including but not limited to the Cabinet for 13
Health and Family Services and the Early Childhood Advisory Council, requesting 14
the information for planning purposes. 15
Section 5. KRS 211.660 is amended to read as follows: 16
(1) The Department for Public Health shall establish and maintain a Kentucky birth 17
surveillance registry that will provide a system for the collection of information 18
concerning birth defects, stillbirths, and high-risk conditions. The system may cover 19
all or part of the Commonwealth. 20
(2) In establishing the system, the department may review vital statistics records, and 21
shall also consider expanding the current list of congenital anomalies and high-risk 22
conditions as reported on birth certificates. 23
(3) (a) The department may require general acute-care hospitals licensed under KRS 24
Chapter 216B to maintain a list of all inpatients and voluntarily to maintain a 25
list of all outpatients up to the age of five (5) years with a primary diagnosis 26
of a congenital anomaly or high-risk condition as defined by the department 27 UNOFFICIAL COPY 23 RS BR 24
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upon the recommendation of the appointed advisory committee. Hospital 1
participation regarding its outpatients shall be voluntary and subject to the 2
discretion of each hospital. 3
(b) The department may require medical laboratories licensed under KRS Chapter 4
333 to maintain medical records for all persons up to the age of five (5) years 5
with a primary diagnosis of or a laboratory test result indicating congenital 6
anomaly or high-risk condition as defined by the department upon the 7
recommendation of the appointed advisory committee. 8
(4) Each licensed freestanding[free-standing] birthing center, general acute-care 9
hospital licensed under KRS Chapter 216B, and medical laboratory licensed under 10
KRS Chapter 333 shall grant, if required or otherwise participating voluntarily 11
under the provisions of subsection (3) of this section, to any Kentucky Birth 12
Surveillance Registry personnel or his or her designee, upon presentation of proper 13
identification, access to the medical records of any patient meeting the criteria in 14
subsection (3) of this section. If the department's agent determines that copying of 15
the medical records is necessary, associated costs shall be borne by the Department 16
for Public Health at the rate pursuant to KRS 422.317. 17
(5) No liability of any kind, character, damages, or other relief shall arise or be 18
enforced against any licensed freestanding[free-standing] birthing center, general 19
acute-care hospital, or medical laboratory by reason of having provided the 20
information or material to the Kentucky Birth Surveillance Registry. 21
(6) The Department for Public Health may implement the provisions of KRS 211.651 22
to 211.670 through the promulgation of administrative regulations in accordance 23
with the provisions of KRS Chapter 13A. 24
Section 6. KRS 213.046 is amended to read as follows: 25
(1) A certificate of birth for each live birth which occurs in the Commonwealth shall be 26
filed with the state registrar within five (5) working days after such birth and shall 27 UNOFFICIAL COPY 23 RS BR 24
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be registered if it has been completed and filed in accordance with this section and 1
applicable administrative regulations. No certificate shall be held to be complete 2
and correct that does not supply all items of information called for in this section 3
and in KRS 213.051, or satisfactorily account for their omission except as provided 4
in KRS 199.570(3). If a certificate of birth is incomplete, the local registrar shall 5
immediately notify the responsible person and require that person to supply the 6
missing items, if that information can be obtained. 7
(2) When a birth occurs in an institution or en route thereto, the person in charge of the 8
institution or that person's designated representative, shall obtain the personal data, 9
prepare the certificate, secure the signatures required, and file the certificate as 10
directed in subsection (1) of this section or as otherwise directed by the state 11
registrar within the required five (5) working days. The physician or other person in 12
attendance shall provide the medical information required for the certificate and 13
certify to the fact of birth within five (5) working days after the birth. If the 14
physician or other person in attendance does not certify to the fact of birth within 15
the five (5) working day period, the person in charge of the institution shall 16
complete and sign the certificate. 17
(3) When a birth occurs in a hospital or en route thereto to a woman who is unmarried, 18
the person in charge of the hospital or that person's designated representative shall 19
immediately before or after the birth of a child, except when the mother or the 20
alleged father is a minor: 21
(a) Meet with the mother prior to the release from the hospital; 22
(b) Attempt to ascertain whether the father of the child is available in the hospital, 23
and, if so, to meet with him, if possible; 24
(c) Provide written materials and oral, audio, or video materials about paternity; 25
(d) Provide the unmarried mother, and, if possible, the father, with the voluntary 26
paternity form necessary to voluntarily establish paternity; 27 UNOFFICIAL COPY 23 RS BR 24
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(e) Provide a written and an oral, audio, or video description of the rights and 1
responsibilities, the alternatives to, and the legal consequences of 2
acknowledging paternity; 3
(f) Provide written materials and information concerning genetic paternity 4
testing; 5
(g) Provide an opportunity to speak by telephone or in person with staff who are 6
trained to clarify information and answer questions about paternity 7
establishment; 8
(h) If the parents wish to acknowledge paternity, require the voluntary 9
acknowledgment of paternity obtained through the hospital-based program be 10
signed by both parents and be authenticated by a notary public; 11
(i) Upon both the mother's and father's request, help the mother and father in 12
completing the affidavit of paternity form; 13
(j) Upon both the mother's and father's request, transmit the affidavit of paternity 14
to the state registrar; and 15
(k) In the event that the mother or the alleged father is a minor, information set 16
forth in this section shall be provided in accordance with Civil Rule 17.03 of 17
the Kentucky Rules of Civil Procedure. 18
If the mother or the alleged father is a minor, the paternity determination shall be 19
conducted pursuant to KRS Chapter 406. 20
(4) The voluntary acknowledgment of paternity and declaration of paternity forms 21
designated by the Vital Statistics Branch shall be the only documents having the 22
same weight and authority as a judgment of paternity. 23
(5) The Cabinet for Health and Family Services shall: 24
(a) Provide to all freestanding birthing centers and public and private birthing 25
hospitals in the state written materials in accessible formats and audio or 26
video materials concerning paternity establishment forms necessary to 27 UNOFFICIAL COPY 23 RS BR 24
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voluntarily acknowledge paternity; 1
(b) Provide copies of a written description in accessible formats and an audio or 2
video description of the rights and responsibilities of acknowledging 3
paternity; and 4
(c) Provide staff training, guidance, and written instructions regarding voluntary 5
acknowledgment of paternity as necessary to operate the hospital-based 6
program. 7
(6) When a birth occurs outside an institution, verification of the birth shall be in 8
accordance with the requirements of the state registrar and a birth certificate shall 9
be prepared and filed by one (1) of the following in the indicated order of priority: 10
(a) The physician in attendance at or immediately after the birth; or, in the 11
absence of such a person, 12
(b) A midwife or any other person in attendance at or immediately after the birth; 13
or, in the absence of such a person, 14
(c) The father, the mother, or in the absence of the father and the inability of the 15
mother, the person in charge of the premises where the birth occurred or of 16
the institution to which the child was admitted following the birth. 17
(7) No physician, midwife, or other attendant shall refuse to sign or delay the filing of a 18
birth certificate. 19
(8) If a birth occurs on a moving conveyance within the United States and the child is 20
first removed from the conveyance in the Commonwealth, the birth shall be 21
registered in the Commonwealth, and the place where the child is first removed 22
shall be considered the place of birth. If a birth occurs on a moving conveyance 23
while in international waters or air space or in a foreign country or its air space and 24
the child is first removed from the conveyance in the Commonwealth, the birth 25
shall be registered in the Commonwealth, but the certificate shall show the actual 26
place of birth insofar as can be determined. 27 UNOFFICIAL COPY 23 RS BR 24
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(9) The following provisions shall apply if the mother was married at the time of either 1
conception or birth or anytime between conception and birth: 2
(a) If there is no dispute as to paternity, the name of the husband shall be entered 3
on the certificate as the father of the child. The surname of the child shall be 4
any name chosen by the parents; however, if the parents are separated or 5
divorced at the time of the child's birth, the choice of surname rests with the 6
parent who has legal custody following birth. 7
(b) If the mother claims that the father of the child is not her husband and the 8
husband agrees to such a claim and the putative father agrees to the statement, 9
a three (3) way affidavit of paternity may be signed by the respective parties 10
and duly notarized. The state registrar of vital statistics shall enter the name of 11
a nonhusband on the birth certificate as the father and the surname of the child 12
shall be any name chosen by the mother. 13
(c) If a question of paternity determination arises which is not resolved under 14
paragraph (b) of this subsection, it shall be settled by the District Court. 15
(10) The following provisions shall apply if the mother was not married at the time of 16
either conception or birth or between conception and birth or the marital 17
relationship between the mother and her husband has been interrupted for more than 18
ten (10) months prior to the birth of the child: 19
(a) The name of the father shall not be entered on the certificate of birth. The 20
state registrar shall upon acknowledgment of paternity by the father and with 21
consent of the mother pursuant to KRS 213.121, enter the father's name on the 22
certificate. The surname of the child shall be any name chosen by the mother 23
and father. If there is no agreement, the child's surname shall be determined 24
by the parent with legal custody of the child. 25
(b) If an affidavit of paternity has been properly completed and the certificate of 26
birth has been filed accordingly, any further modification of the birth 27 UNOFFICIAL COPY 23 RS BR 24
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certificate regarding the paternity of the child shall require an order from the 1
District Court. 2
(c) In any case in which paternity of a child is determined by a court order, the 3
name of the father and surname of the child shall be entered on the certificate 4
of birth in accordance with the finding and order of the court. 5
(d) In all other cases, the surname of the child shall be any name chosen by the 6
mother. 7
(11) If the father is not named on the certificate of birth, no other information about the 8
father shall be entered on the certificate. In all cases, the maiden name of the 9
gestational mother shall be entered on the certificate. 10
(12) Any child whose surname was restricted prior to July 13, 1990, shall be entitled to 11
apply to the state registrar for an amendment of a birth certificate showing as the 12
surname of the child, any surname chosen by the mother or parents as provided 13
under this section. 14
(13) The birth certificate of a child born as a result of artificial insemination shall be 15
completed in accordance with the provisions of this section. 16
(14) Each birth certificate filed under this section shall include all Social Security 17
numbers that have been issued to the parents of the child. 18
(15) Either of the parents of the child, or other informant, shall attest to the accuracy of 19
the personal data entered on the certificate in time to permit the filing of the 20
certificate within ten (10) days prescribed in subsection (1) of this section. 21
(16) When a birth certificate is filed for any birth that occurred outside an institution, the 22
Cabinet for Health and Family Services shall forward information regarding the 23
need for an auditory screening for an infant and a list of options available for 24
obtaining an auditory screening for an infant. The list shall include the Office for 25
Children with Special Health Care Needs, local health departments as established in 26
KRS Chapter 212, hospitals offering obstetric services, freestanding[alternative] 27 UNOFFICIAL COPY 23 RS BR 24
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birthing centers required to provide an auditory screening under KRS 216.2970, 1
audiological assessment and diagnostic centers approved by the Office for Children 2
with Special Health Care Needs in accordance with KRS 211.647 and licensed 3
audiologists, and shall specify the hearing methods approved by the Office for 4
Children with Special Health Care Needs in accordance with KRS 216.2970. 5
Section 7. KRS 216.2920 is amended to read as follows: 6
As used in KRS 216.2920 to 216.2929, unless the context requires otherwise: 7
(1) "Ambulatory facility" means an outpatient facility, including an ambulatory 8
surgical facility, freestanding birthing[birth] center, freestanding or mobile 9
technology unit, or an urgent treatment center, that is not part of a hospital and that 10
provides one (1) or more ambulatory procedures to patients not requiring 11
hospitalization; 12
(2) "Cabinet" means the Cabinet for Health and Family Services; 13
(3) "Charge" means all amounts billed by a hospital or ambulatory facility, including 14
charges for all ancillary and support services or procedures, prior to any adjustment 15
for bad debts, charity contractual allowances, administrative or courtesy discounts, 16
or similar deductions from revenue. However, if necessary to achieve comparability 17
of information between providers, charges for the professional services of hospital-18
based or ambulatory-facility-based physicians shall be excluded from the 19
calculation of charge; 20
(4) "Facility" means any hospital, health care service, or other health care facility, 21
whether operated for profit or not; 22
(5) "Health-care provider" or "provider" means any pharmacist as defined pursuant to 23
KRS Chapter 315, and any of the following independent practicing practitioners: 24
(a) Physicians, osteopaths, and podiatrists licensed pursuant to KRS Chapter 311; 25
(b) Chiropractors licensed pursuant to KRS Chapter 312; 26
(c) Dentists licensed pursuant to KRS Chapter 313; 27 UNOFFICIAL COPY 23 RS BR 24
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(d) Optometrists licensed pursuant to KRS Chapter 320; 1
(e) Physician assistants regulated pursuant to KRS Chapter 311; 2
(f) Nurse practitioners licensed pursuant to KRS Chapter 314; and 3
(g) Other health-care practitioners as determined by the Cabinet for Health and 4
Family Services by administrative regulation promulgated pursuant to KRS 5
Chapter 13A; 6
(6) "Hospital" means a facility licensed pursuant to KRS Chapter 216B as either an 7
acute-care hospital, psychiatric hospital, rehabilitation hospital, or chemical 8
dependency treatment facility; 9
(7) "Procedures" means those surgical, medical, radiological, diagnostic, or therapeutic 10
procedures performed by a provider, as periodically determined by the cabinet in 11
administrative regulations promulgated pursuant to KRS Chapter 13A as those for 12
which reports to the cabinet shall be required. "Procedures" also includes 13
procedures that are provided in hospitals or other ambulatory facilities, or those that 14
require the use of special equipment, including fluoroscopic equipment, computer 15
tomographic scanners, magnetic resonance imagers, mammography, ultrasound 16
equipment, or any other new technology as periodically determined by the cabinet; 17
(8) "Quality" means the extent to which a provider renders care that obtains for patients 18
optimal health outcomes; and 19
(9) "Secretary" means the secretary of the Cabinet for Health and Family Services. 20
Section 8. KRS 216.2970 is amended to read as follows: 21
(1) As a condition of licensure or relicensure, all hospitals offering obstetric services 22
and freestanding[alternative] birthing centers with at least forty (40) births per year 23
shall provide an auditory screening for all infants using one (1) of the methods 24
approved by the Office for Children with Special Health Care Needs by 25
administrative regulation promulgated in accordance with KRS Chapter 13A. 26
(2) An auditory screening report that indicates a finding of potential hearing loss shall 27 UNOFFICIAL COPY 23 RS BR 24
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be forwarded by the hospital or freestanding[alternative] birthing center within 1
twenty-four (24) hours of receipt to the: 2
(a) Attending physician or health care provider; 3
(b) Parents; 4
(c) Office for Children with Special Health Care Needs for evaluation or referral 5
for further evaluation in accordance with KRS 211.647; and 6
(d) Audiological assessment and diagnostic center approved by the office if a 7
follow-up assessment has been scheduled prior to the infant's discharge from 8
the hospital. 9
(3) An auditory screening report that does not indicate a potential hearing loss shall be 10
forwarded within one (1) week to the Office for Children with Special Health Care 11
Needs with no information that personally identifies the child. 12
Section 9. This Act shall be known as the Mary Carol Akers Birth Centers Act. 13