UNOFFICIAL COPY 23 RS BR 147
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AN ACT relating to maternal health disparities in perinatal care. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 211.680 is amended to read as follows: 3
[The Kentucky General Assembly declares that the purpose of KRS 211.680 to 211.686 4
and KRS 72.029 is to reduce the number of child and maternal fatalities. ]The Kentucky 5
General Assembly finds and declares the following: 6
(1) That establishing priorities and developing programs to prevent child and maternal 7
fatalities requires the: 8
(a)[(1)] Accurate determination of the cause and manner of death; 9
(b)[(2)] Cooperation and communication among agencies responsible for the 10
investigation of child and maternal fatalities; and 11
(c)[(3)] Collection and analysis of data to: 12
1.[(a) ]Identify trends, patterns, and risk factors; and 13
2.[(b) ]Evaluate the effectiveness of prevention and intervention strategies;[.] 14
(2) Every person should be entitled to dignity and respect during and after pregnancy 15
and childbirth, and patients should receive the best care possible regardless of 16
their race, age, class, sexual orientation, disability, language proficiency, 17
nationality, or religion; 18
(3) For women of color, particularly black women, the maternal mortality rate 19
remains two (2) to three (3) times higher than white women both in the United 20
States and in Kentucky; 21
(4) Access to prenatal care, socioeconomic status, and general physical health do not 22
fully explain the disparity seen in black women's maternal mortality and 23
morbidity rates, as there is a growing body of evidence that black women are 24
often treated unfairly and unequally in the health care system; and 25
(5) Kentucky has a responsibility to decrease the number of preventable maternal 26
deaths. 27 UNOFFICIAL COPY 23 RS BR 147
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SECTION 2. A NEW SECTION OF KRS CHAPTER 211 IS CREATED TO 1
READ AS FOLLOWS: 2
As used in Sections 2 to 5 of this Act: 3
(1) "Perinatal care" means the provision of care during pregnancy, labor, delivery, 4
and postpartum and neonatal periods; and 5
(2) "Pregnancy-related death" means the death of a person while pregnant or within 6
three hundred sixty-five (365) days of the end of a pregnancy, irrespective of the 7
duration or site of the pregnancy, from any cause related to, or aggravated by, the 8
pregnancy or its management, but not from accidental or incidental causes. 9
SECTION 3. A NEW SECTION OF KRS CHAPTER 211 IS CREATED TO 10
READ AS FOLLOWS: 11
(1) A health facility licensed under KRS Chapter 216B that provides perinatal care 12
shall provide each patient, upon admission or as soon thereafter as reasonably 13
practical, written information regarding the patient's right to the following: 14
(a) To be informed of continuing health care requirements following discharge 15
from the hospital; 16
(b) To be informed that, if the patient so authorizes, a friend or family member 17
may be provided information about the patient's continuing health care 18
requirements following discharge from the hospital; 19
(c) To participate actively in decisions regarding medical care and the right to 20
refuse treatment; 21
(d) To appropriate pain assessment and treatment; 22
(e) To be free of discrimination on the basis of race, color, religion, ancestry, 23
national origin, disability, medical condition, genetic information, marital 24
status, sex, gender, sexual orientation, citizenship, or primary language; 25
and 26
(f) To receive information on how to file a grievance with the following 27 UNOFFICIAL COPY 23 RS BR 147
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entities: 1
1. The State Board of Medical Licensure, in accordance with KRS 2
311.591; and 3
2. The Kentucky Commission on Human Rights. 4
(2) A hospital may include the information required by subsection (1) of this section 5
with other notices to the patient regarding patient rights. 6
SECTION 4. A NEW SECTION OF KRS CHAPTER 211 IS CREATED TO 7
READ AS FOLLOWS: 8
(1) A health facility licensed under KRS Chapter 216B that provides perinatal care 9
shall implement an evidence-based training program on maternal health 10
disparities for all health care providers involved in the perinatal care of patients 11
within that facility. 12
(2) A maternal health disparities program implemented pursuant to subsection (1) of 13
this section shall include all of the following: 14
(a) Corrective measures to improve maternal health outcomes at the 15
interpersonal and institutional levels, including ongoing policies that do not 16
center the patient or that no longer support best practices within the field; 17
(b) Information on the ongoing personal effects of intergenerational trauma 18
and oppression of communities of color; 19
(c) Information about understanding cultural trauma, racism, and centering 20
the complex identity of the pregnant person; 21
(d) Strategies to foster effective communication between client and physician by 22
employing a range of positive communication techniques; 23
(e) Discussion on health inequities within the perinatal care field; 24
(f) Perspectives of diverse, local constituency groups, and experts on particular 25
racial, identity, cultural, and provider-community relations issues in the 26
community; 27 UNOFFICIAL COPY 23 RS BR 147
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(g) Information on reproductive justice and understanding of the ways that 1
social detriments of health such as transportation, economic status, mental 2
health, access to adequate information, immigration status, environmental 3
justice, and toxic lead exposure impact reproductive health; and 4
(h) Materials and resources provided by the Cabinet for Health and Family 5
Services. 6
(3) (a) A health care provider described in subsection (1) of this section shall 7
complete initial basic training through the maternal health disparities 8
program based on the components described in subsection (2) of this 9
section. 10
(b) Upon completion of the initial basic training, a health care provider shall 11
complete a refresher course under the maternal health disparities program 12
every two (2) years thereafter, or on a more frequent basis if deemed 13
necessary by the facility, in order to keep current with changing racial, 14
identity, and cultural trends, and best practices in decreasing maternal 15
health disparities in perinatal facilities. 16
SECTION 5. A NEW SECTION OF KRS CHAPTER 211 IS CREATED TO 17
READ AS FOLLOWS: 18
(1) The Department for Public Health shall track data on maternal death and severe 19
morbidity, including but not limited to all of the following health conditions: 20
(a) Obstetric hemorrhage; 21
(b) Hypertension; 22
(c) Preeclampsia and eclampsia; 23
(d) Venous thromboembolism; 24
(e) Sepsis; 25
(f) Cerebrovascular accident; 26
(g) Amniotic fluid embolism; 27 UNOFFICIAL COPY 23 RS BR 147
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(h) Other indirect obstetric complications; and 1
(i) Other complications pertaining to the pregnancy and puerperium period. 2
(2) The data collected pursuant to subsection (1) of this section shall be published by 3
region, race, and ethnicity on the website of the Department for Public Health. 4