CHAPTER 207
Legislative Research Commission PDF Version
1
CHAPTER 207
( SB 74 )
AN ACT relating to public health.
Be it enacted by the General Assembly of the Commonwealth of Kentucky:
SECTION 1. A NEW SECTION OF KRS CHAPTER 211 IS CREATED TO READ AS FOLLOWS:
(1) The Kentucky maternal psychiatry access program, also known as the Kentucky Lifeline for Moms, is
hereby established. The purpose of the program shall be to help health care practitioners in the
Commonwealth meet the needs of a mother with mental illness or an intellectual disability.
(2) The program shall be operated by the Cabinet for Health and Family Services, Department for Public
Health, Division of Maternal and Child Health.
(3) The program shall, at a minimum, employ a psychiatrist licensed pursuant to KRS Chapter 311 and a
psychologist licensed pursuant to KRS Chapter 319.
(4) The program shall operate a dedicated hotline phone number Monday through Friday from 8 a.m. to 5 p.m.
local time that serves as the entry point to the program for health care practitioners to be able to get services
for a mother with mental illness or with an intellectual disability. Services shall include:
(a) An immediate clinical consultation over the telephone;
(b) An expedited face-to-face mental health consultation;
(c) Care coordination for assistance with referrals to community behavioral health services; and
(d) Continuing professional education specifically designed for health care practitioners.
(5) The department shall, within sixty (60) days of the effective date of this Act, promulgate administrative
regulations in accordance with KRS Chapter 13A to implement the provisions of this section.
Section 2. KRS 211.122 is amended to read as follows:
(1) The Cabinet for Health and Family Services shall, in cooperation with maternal and infant health and mental
health professional societies:
(a) Develop written information on perinatal mental health disorders and make it available on its website
for access by birthing centers, hospitals that provide labor and delivery services, and the public; and
(b) Provide access on its website to one (1) or more evidence-based clinical assessment tools designed to
detect the symptoms of perinatal mental health disorders for use by health care providers providing
perinatal care and health care providers providing pediatric infant care.
(2) The Cabinet for Health and Family Services shall establish the Kentucky maternal and infant health
collaborative. The collaborative shall be composed of the following members appointed by the secretary of
the Cabinet for Health and Family Services:[a collaborative panel composed of ]
(a) Four (4) representatives of health care facilities that provide obstetrical, [and ]newborn[ care],
maternal, and infant health care, one (1) of whom shall be a member of the Kentucky Chapter of the
American College of Obstetricians and Gynecologists;
(b) Two (2) providers of[,] maternal mental health care;
(c) Two (2)[providers,] representatives of university mental health training programs;
(d) Two (2)[,] maternal health advocates;
(e) Three (3)[,] women, each of whom shall have[ with] experience living with at least one (1) of the
following:
1. Perinatal mental health disorders;
2. Substance use disorder; and
3. Intimate partner violence; ACTS OF THE GENERAL ASSEMBLY 2
(f) One (1) public health director of a local health department in the Commonwealth; and
(g) The commissioner of the Department for Public Health or his or her designee.
(3) The[, and other stakeholders for the] purposes of the collaborative shall be:
(a) Improving the quality of prevention and treatment of perinatal mental health disorders;
(b) Promoting the implementation of evidence-based bundles of care to improve patient safety;
(c) Identifying unaddressed gaps in service related to perinatal mental health disorders that are linked to
geographic, racial, and ethnic inequalities; lack of screenings; and insufficient access to treatments,
professionals, or support groups; and
(d) Exploring grant and other funding opportunities and making recommendations for funding allocations
to address the need for services and supports for perinatal mental health disorders.
(4)[(3)] The collaborative shall annually review the operations of the Kentucky maternal psychiatry access
program established in Section 1 of this Act.
(5) The objectives set forth in subsection (3)[(2)(a) to (d)] of this section may be achieved by incorporating the
collaborative's[panel's] findings and recommendations into other programs administered by the Cabinet for
Health and Family Services that are intended to improve maternal health care quality and safety.
(6)[(4)] On or before November 1 of each year, the collaborative[panel] shall submit a report to the Interim
Joint Committee on Families and Children, the Interim Joint Committee on Health Services, and the Advisory
Council for Medical Assistance describing the collaborative's[panel's] work and any recommendations to
address identified gaps in services and supports for perinatal mental health disorders.
Section 3. KRS 211.690 is amended to read as follows:
(1) There is established within the Cabinet for Health and Family Services the Health Access Nurturing
Development Services (HANDS) program as a voluntary statewide home visitation program, for the purpose
of providing assistance to at-risk parents during the prenatal period and until the child's third birthday. The
HANDS program recognizes that parents are the primary decision-makers for their children. The goals of the
HANDS program shall be[are] to:
(a) Facilitate safe and healthy delivery of babies;
(b) Provide information about optimal child growth and human development;
(c) Facilitate the safety and health of homes; and
(d) Encourage greater self-sufficiency of families.
(2) The cabinet shall administer the HANDS program in cooperation with the Cabinet for Health and Family
Services and the local public health departments. The voluntary home visitation program may supplement, but
shall not duplicate, any existing program that provides assistance to parents of young children.
(3) The HANDS program shall include [an ]educational components[component] on:
(a) [ ]The recognition and prevention of pediatric abusive head trauma, as defined in KRS 620.020;
(b) Information related to lactation consultation and breastfeeding information; and
(c) Information related to the importance of safe sleep for babies as a way to prevent sudden infant
death syndrome as defined in KRS 213.011.
(4) Participants in the HANDS program shall express informed consent to participate by[ written] agreement on a
form promulgated by the Cabinet for Health and Family Services.
(5) Participants in the HANDS program shall participate in the home visitation program through in-person
face-to-face methods or through tele-service delivery methods. For the purposes of this subsection, "tele-
service" means a home visitation service provided through video communication with the HANDS provider,
parent, and child present in real time.
SECTION 4. A NEW SECTION OF SUBTITLE 17 OF KRS CHAPTER 304 IS CREATED TO READ
AS FOLLOWS:
(1) As used in this section: CHAPTER 207
Legislative Research Commission PDF Version
3
(a) "Health benefit plan" has the same meaning as in KRS 304.17A-005, except for purposes of this
section, the term includes student health insurance offered by a Kentucky-licensed insurer under
written contract with a university or college whose students it proposes to insure; and
(b) "Individual Exchange":
1. Means a governmental agency or nonprofit entity that makes qualified health plans, as
defined in 42 U.S.C. sec. 18021, as amended, available to qualified individuals;
2. Includes an exchange serving the individual market for qualified individuals; and
3. Does not include a Small Business Health Options Program serving the small group market
for qualified employers.
(2) To the extent permitted by federal law:
(a) The following shall provide a special enrollment period to pregnant women who are eligible for
coverage:
1. Any insurer offering a health benefit plan in the individual market, which shall include
student health insurance coverage as defined in 45 C.F.R. sec. 147.145, as amended; and
2. Any individual exchange operating in this state;
(b) Except as provided in paragraph (c) of this subsection, the insurer or exchange shall allow a
pregnant woman, and any individual who is eligible for coverage because of a relationship to a
pregnant woman, to enroll for coverage under the plan or on the exchange at any time during the
pregnancy;
(c) If the insurer or exchange is required by federal law to limit the enrollment period to a period that is
less than the period provided in paragraph (b) of this subsection:
1. The enrollment period shall not be less than the maximum period of time permitted by federal
law; and
2. The enrollment period shall begin not earlier than the date that the pregnant woman receives
confirmation of the pregnancy from a medical professional;
(d) The coverage required under this subsection shall begin no later than the first day of the first
calendar month in which a medical professional determines that the pregnancy began, except that a
pregnant woman may direct coverage to begin on the first day of any month occurring after that date
but during the pregnancy; and
(e) If a directive under paragraph (d) of this subsection falls outside of the pregnancy period, the
coverage required under this subsection shall begin no later than the first day of the last month that
occurred during the pregnancy.
(3) (a) Nothing in this section shall be construed to imply that the insured is not responsible for the payment
of premiums for each month during which coverage is provided.
(b) For any coverage provided under this section, the original or first premium shall become due and
owing not earlier than thirty (30) days after the date of enrollment.
Section 5. KRS 304.17A-145 is amended to read as follows:
(1) As used in this section:
(a) "Health benefit plan" has the same meaning as in KRS 304.17A-005, except for purposes of this
section, the term:
1. Includes student health insurance offered by a Kentucky-licensed insurer under written
contract with a university or college whose students it proposes to insure; and
2. Does not include a group health benefit plan that provides grandfathered health plan coverage
as defined in 45 C.F.R. sec. 147.140(a), as amended;
(b) "In-home program" means a program offered by a health care facility or health care professional
for the treatment of substance use disorder which the insured accesses through telehealth or digital
health services; and ACTS OF THE GENERAL ASSEMBLY 4
(c) "Telehealth" or "digital health" has the same meaning as in KRS 211.332.
(2) Except as provided for in subsection (5) of this section:
(a) A health benefit plan shall provide[issued or renewed on or after July 15, 1996, that provides] maternity
coverage; and
(b) The coverage required by this subsection includes coverage for:[shall provide ]
1. All individuals covered under the plan, including dependents, regardless of age;
2. Maternity care associated with pregnancy, childbirth, and postpartum care;
3. Labor and delivery;
4. All breastfeeding services and supplies required under 42 U.S.C. sec. 300gg-13(a) and any
related federal regulations, as amended; and
5. [Coverage for ]Except as provided in subsection (3) of this section, inpatient care for a mother
and her newly-born child for a minimum of:
a. Forty-eight (48) hours after vaginal delivery; or[ and a minimum of ]
b. Ninety-six (96) hours after delivery by Cesarean section.
(3)[(2)] The provisions of subsection (2)(b)5.[(1)] of this section shall not apply to a health benefit plan if:
(a) The[ health benefit] plan authorizes an initial postpartum home visit which would include the collection
of an adequate sample for the hereditary and metabolic newborn screening; and[ if ]
(b) The attending physician, with the consent of the mother of the newly born[newly-born] child,
authorizes a shorter length of stay[ than that required of health benefit plans in subsection (1) of this
section] upon the physician's determination that the mother and newborn meet the criteria for medical
stability in the most current version of "Guidelines for Perinatal Care" prepared by the American
Academy of Pediatrics and the American College of Obstetricians and Gynecologists.
(4) Except as provided for in subsection (5) of this section, a health benefit plan shall provide coverage:
(a) To pregnant and postpartum women for an in-home program; and
(b) For telehealth or digital health services that are related to maternity care associated with pregnancy,
childbirth, and postpartum care.
(5) If the application of any requirement of this section to a qualified health plan as defined in 42 U.S.C. sec.
18021(a)(1), as amended, would result in a determination that the state must make payments to defray the
cost of the requirement under 42 U.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as amended, then the
requirement shall not apply to the qualified health plan until the cost defrayal requirement is no longer
applicable.
Section 6. KRS 18A.225 (Effective January 1, 2025) is amended to read as follows:
(1) (a) 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 state-sponsored 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 Kentucky
Retirement Systems, County Employees Retirement System, Kentucky Teachers' Retirement
System, the 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; or is eligible to participate in a retirement plan established by an
employer who ceases participating in the Kentucky Employees Retirement System pursuant to
KRS 61.522 whose employees participated in the health insurance plans administered by the
Personnel Cabinet prior to the employer's effective cessation date in the Kentucky Employees
Retirement System; CHAPTER 207
Legislative Research Commission PDF Version
5
2. Any certified or classified employee of a local board of education or a public charter school as
defined in KRS 160.1590;
3. Any elected member of a local board of education;
4. Any person who is a present or future recipient of a retirement allowance from the Kentucky
Retirement Systems, County Employees Retirement System, Kentucky Teachers' Retirement
System, the Legislators' Retirement Plan, the Judicial Retirement Plan, or the Kentucky
Community and Technical College 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(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively employed pursuant to
subparagraph 1. of this paragraph; and
5. Any eligible dependents and beneficiaries of participating employees and retirees who are
entitled to participate in the state-sponsored health insurance program;
(b) The term "health benefit plan" for the purposes of this section means a health benefit plan as defined in
KRS 304.17A-005;
(c) The term "insurer" for the purposes of this section means an insurer as defined in KRS 304.17A-005;
and
(d) The term "managed care plan" for the purposes of this section means a managed care plan as defined in
KRS 304.17A-500.
(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 insurers authorized to do business in this state, a group health benefit
plan 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 January 1, 1994,
and shall include a mail-order drug option as provided in subsection (13) 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.
(b) The policy or policies shall be approved by the commissioner of insurance and may contain the
provisions the commissioner of insurance approves, whether or not otherwise permitted by the
insurance laws.
(c) Any carrier bidding to offer health care coverage to employees shall agree to provide coverage to all
members of the state group, including active employees and retirees and their eligible covered
dependents and beneficiaries, within the county or counties specified in its bid. Except as provided in
subsection (20) of this section, any carrier bidding to offer health care coverage to employees shall also
agree to rate all employees as a single entity, except for those retirees whose former employers insure
their active employees outside the state-sponsored health insurance program and as otherwise provided
in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b.
(d) Any carrier bidding to offer health care coverage to employees shall agree to provide enrollment,
claims, and utilization data to the Commonwealth in a format specified by the Personnel Cabinet with
the understanding that the data shall be owned by the Commonwealth; to provide data in an electronic
form and within a time frame specified by the Personnel Cabinet; and to be subject to penalties for ACTS OF THE GENERAL ASSEMBLY 6
noncompliance with data reporting requirements as specified by the Personnel Cabinet. The Personnel
Cabinet shall take strict precautions to protect the confidentiality of each individual employee; however,
confidentiality assertions shall not relieve a carrier from the requirement of providing stipulated data to
the Commonwealth.
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities for timely analysis of
data received from carriers and, to the extent possible, provide in the request-for-proposal specifics
relating to data requirements, electronic reporting, and penalties for noncompliance. The
Commonwealth shall own the enrollment, claims, and utilization data provided by each carrier and shall
develop methods to protect the confidentiality of the individual. The Personnel Cabinet shall include in
the October annual report submitted pursuant to the provisions of KRS 18A.226 to the Governor, the
General Assembly, and the Chief Justice of the Supreme Court, an analysis of the financial stability of
the program, which shall include but not be limited to loss ratios, methods of risk adjustment,
measurements of carrier quality of service, prescription coverage and cost management, and statutorily
required mandates. If state self-insurance was available as a carrier option, the report also shall provide
a detailed financial analysis of the self-insurance fund including but not limited to loss ratios, reserves,
and reinsurance agreements.
(f) If any agency participating in the state-sponsored employee health insurance program for its active
employees terminates participation and there is a state appropriation for the employer's contribution for
active employees' health insurance coverage, then neither the agency nor the employees shall receive
the state-funded contribution after termination from the state-sponsored employee health insurance
program.
(g) Any funds in flexible spending accounts that remain after all reimbursements have been processed shall
be transferred to the credit of the state-sponsored health insurance plan's appropriation account.
(h) Each entity participating in the state-sponsored health insurance program shall provide an amount at
least equal to the state contribution rate for the employer portion of the health insurance premium. For
any participating entity that used the state payroll system, the employer contribution amount shall be
equal to but not greater than the state contribution rate.
(3) The premiums may be paid by the policyholder:
(a) Wholly from funds contributed by the employee, by payroll deduction or otherwise;
(b) Wholly from funds contributed by any department, board, agency, public postsecondary education
institution, or branch of state, city, urban-county, charter county, county, or consolidated local
government; or
(c) Partly from each, except that any premium due for health care coverage or dental coverage, if any, in
excess of the premium amount contributed by any department, board, agency, postsecondary education
institution, or branch of state, city, urban-county, charter county, county, or consolidated local
government for any other health care coverage shall be paid by the employee.
(4) If an employee moves his or her place of residence or employment out of the service area of an insurer
offering a managed health care plan, under which he or she has elected coverage, into either the service area of
another managed health care plan or into an area of the Commonwealth not within a managed health care plan
service area, the employee shall be given an option, at the time of the move or transfer, to change his or her
coverage to another health benefit plan.
(5) No payment of premium by any department, board, agency, public postsecondary educational institution, or
branch of state, city, urban-county, charter county, county, or consolidated local government shall constitute
compensation to an insured employee for the purposes of any statute fixing or limiting the compensation of
such an employee. Any premium or other expense incurred by any department, board, agency, public
postsecondary educational institution, or branch of state, city, urban-county, charter county, county, or
consolidated local government shall be considered a proper cost of administration.
(6) The policy or policies may contain the provisions with respect to the class or classes of employees covered,
amounts of insurance or coverage for designated classes or groups of employees, policy options, terms of
eligibility, and continuation of insurance or coverage after retirement.
(7) Group rates under this section shall be made available to the disabled child of an employee regardless of the
child's age if the entire premium for the disabled child's coverage is paid by the state employee. A child shall CHAPTER 207
Legislative Research Commission PDF Version
7
be considered disabled if he or she has been determined to be eligible for federal Social Security disability
benefits.
(8) The health care contract or contracts for employees shall be entered into for a period of not less than one (1)
year.
(9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of State Health Insurance
Subscribers to advise the secretary or the secretary's designee regarding the state-sponsored health insurance
program for employees. The secretary shall appoint, from a list of names submitted by appointing authorities,
members representing school districts from each of the seven (7) Supreme Court districts, members
representing state government from each of the seven (7) Supreme Court districts, two (2) members
representing retirees under age sixty-five (65), one (1) member representing local health departments, two (2)
members representing the Kentucky Teachers' Retirement System, and three (3) members at large. The
secretary shall also appoint two (2) members from a list of five (5) names submitted by the Kentucky
Education Association, two (2) members from a list of five (5) names submitted by the largest state employee
organization of nonschool state employees, two (2) members from a list of five (5) names submitted by the
Kentucky Association of Counties, two (2) members from a list of five (5) names submitted by the Kentucky
League of Cities, and two (2) members from a list of names consisting of five (5) names submitted by each
state employee organization that has two thousand (2,000) or more members on state payroll deduction. The
advisory committee shall be appointed in January of each year and shall meet quarterly.
(10) 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.
(11) Interruption of an established treatment regime with maintenance drugs shall be grounds for an insured to
appeal a formulary change through the established appeal procedures approved by the Department of
Insurance, if the physician supervising the treatment certifies that the change is not in the best interests of the
patient.
(12) Any employee who is eligible for and elects to participate in the state health insurance program as a retiree, or
the spouse or beneficiary of a retiree, under any one (1) of the state-sponsored retirement systems shall not be
eligible to receive the state health insurance contribution toward health care coverage as a result of any other
employment for which there is a public employer contribution. This does not preclude a retiree and an active
employee spouse from using both contributions to the extent needed for purchase of one (1) state sponsored
health insurance policy for that plan year.
(13) (a) The policies of health insurance coverage procured under subsection (2) of this section shall include a
mail-order drug option for maintenance drugs for state employees. Maintenance drugs may be
dispensed by mail order in accordance with Kentucky law.
(b) A health insurer shall not discriminate against any retail pharmacy located within the geographic
coverage area of the health benefit plan and that meets the terms and conditions for participation
established by the insurer, including price, dispensing fee, and copay requirements of a mail-order
option. The retail pharmacy shall not be required to dispense by mail.
(c) The mail-order option shall not permit the dispensing of a controlled substance classified in Schedule II.
(14) The policy or policies provided to state employees or their dependents pursuant to this section shall provide
coverage for obtaining a hearing aid and acquiring hearing aid-related services for insured individuals under
eighteen (18) years of age, subject to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36)
months pursuant to KRS 304.17A-132.
(15) Any policy provided to state employees or their dependents pursuant to this section shall provide coverage for
the diagnosis and treatment of autism spectrum disorders consistent with KRS 304.17A-142.
(16) Any policy provided to state employees or their dependents pursuant to this section shall provide coverage for
obtaining amino acid-based elemental formula pursuant to KRS 304.17A-258.
(17) If a state employee's residence and place of employment are in the same county, and if the hospital located
within that county does not offer surgical services, intensive care services, obstetrical services, level II
neonatal services, diagnostic cardiac catheterization services, and magnetic resonance imaging services, the ACTS OF THE GENERAL ASSEMBLY 8
employee may select a plan available in a contiguous county that does provide those services, and the state
contribution for the plan shall be the amount available in the county where the plan selected is located.
(18) If a state employee's residence and place of employment are each located in counties in which the hospitals do
not offer surgical services, intensive care services, obstetrical services, level II neonatal services, diagnostic
cardiac catheterization services, and magnetic resonance imaging services, the employee may select a plan
available in a county contiguous to the county of residence that does provide those services, and the state
contribution for the plan shall be the amount available in the county where the plan selected is located.
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and in the best interests of the
state group to allow any carrier bidding to offer health care coverage under this section to submit bids that may
vary county by county or by larger geographic areas.
(20) Notwithstanding any other provision of this section, the bid for proposals for health insurance coverage for
calendar year 2004 shall include a bid scenario that reflects the statewide rating structure provided in calendar
year 2003 and a bid scenario that allows for a regional rating structure that allows carriers to submit bids that
may vary by region for a given product offering as described in this subsection:
(a) The regional rating bid scenario shall not include a request for bid on a statewide option;
(b) The Personnel Cabinet shall divide the state into geographical regions which shall be the same as the
partnership regions designated by the Department for Medicaid Services for purposes of the Kentucky
Health Care Partnership Program established pursuant to 907 KAR 1:705;
(c) The request for proposal shall require a carrier's bid to include every county within the region or regions
for which the bid is submitted and include but not be restricted to a preferred provider organization
(PPO) option;
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the carrier all of the counties
included in its bid within the region. If the Personnel Cabinet deems the bids submitted in accordance
with this subsection to be in the best interests of state employees in a region, the cabinet may award the
contract for that region to no more than two (2) carriers; and
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including other requirements or
criteria in the request for proposal.
(21) Any fully insured health benefit plan or self-insured plan issued or renewed on or after July 12, 2006, to public
employees pursuant to this section which provides coverage for services rendered by a physician or osteopath
duly licensed under KRS Chapter 311 that are within the scope of practice of an optometrist duly licensed
under the provisions of KRS Chapter 320 shall provide the same payment of coverage to optometrists as
allowed for those services rendered by physicians or osteopaths.
(22) Any fully insured health benefit plan or self-insured plan issued or renewed to public employees pursuant to
this section shall comply with:
(a) KRS 304.12-237;
(b) KRS 304.17A-270 and 304.17A-525;
(c) KRS 304.17A-600 to 304.17A-633;
(d) KRS 205.593;
(e) KRS 304.17A-700 to 304.17A-730;
(f) KRS 304.14-135;
(g) KRS 304.17A-580 and 304.17A-641;
(h) KRS 304.99-123;
(i) KRS 304.17A-138;
(j) KRS 304.17A-148;
(k) KRS 304.17A-163 and 304.17A-1631;
(l) KRS 304.17A-265;
(m) KRS 304.17A-261; CHAPTER 207
Legislative Research Commission PDF Version
9
(n) KRS 304.17A-262;[ and]
(o) Section 5 of this Act; and
(p) Administrative regulations promulgated pursuant to statutes listed in this subsection.
(23) (a) Any fully insured health benefit plan or self-insured plan issued or renewed to public employees
pursuant to this section shall provide a special enrollment period to pregnant women who are eligible
for coverage in accordance with the requirements set forth in Section 4 of this Act.
(b) The Department of Employee Insurance shall, at or before the time a public employee is initially
offered the opportunity to enroll in the plan or coverage, provide the employee a notice of the special
enrollment rights under this subsection.
Section 7. KRS 164.2871 (Effective January 1, 2025) is amended to read as follows:
(1) The governing board of each state postsecondary educational institution is authorized to purchase liability
insurance for the protection of the individual members of the governing board, faculty, and staff of such
institutions from liability for acts and omissions committed in the course and scope of the individual's
employment or service. Each institution may purchase the type and amount of liability coverage deemed to
best serve the interest of such institution.
(2) All retirement annuity allowances accrued or accruing to any employee of a state postsecondary educational
institution through a retirement program sponsored by the state postsecondary educational institution are
hereby exempt from any state, county, or municipal tax, and shall not be subject to execution, attachment,
garnishment, or any other process whatsoever, nor shall any assignment thereof be enforceable in any court.
Except retirement benefits accrued or accruing to any employee of a state postsecondary educational
institution through a retirement program sponsored by the state postsecondary educational institution on or
after January 1, 1998, shall be subject to the tax imposed by KRS 141.020, to the extent provided in KRS
141.010 and 141.0215.
(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for members of governing boards,
faculty and staff of institutions of higher education in this state shall not be construed to be a waiver of
sovereign immunity or any other immunity or privilege.
(4) The governing board of each state postsecondary education institution is authorized to provide a self-insured
employer group health plan to its employees, which plan shall:
(a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and
(b) Except as provided in subsection (5) of this section, be exempt from conformity with Subtitle 17A of
KRS Chapter 304.
(5) A self-insured employer group health plan provided by the governing board of a state postsecondary education
institution to its employees shall comply with:
(a) KRS 304.17A-163 and 304.17A-1631;
(b) KRS 304.17A-265;
(c) KRS 304.17A-261;[ and]
(d) KRS 304.17A-262; and
(e) Section 5 of this Act.
(6) (a) A self-insured employer group health plan provided by the governing board of a state postsecondary
education institution to its employees shall provide a special enrollment period to pregnant women
who are eligible for coverage in accordance with the requirements set forth in Section 4 of this Act.
(b) The governing board of a state postsecondary education institution shall, at or before the time an
employee is initially offered the opportunity to enroll in the plan or coverage, provide the employee a
notice of the special enrollment rights under this subsection.
Section 8. KRS 194A.099 is amended to read as follows:
(1) The Division of Health Benefit Exchange within the Office of Data Analytics shall administer the provisions
of the Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148. ACTS OF THE GENERAL ASSEMBLY 10
(2) The Division of Health Benefit Exchange shall:
(a) Facilitate enrollment in health coverage and the purchase and sale of qualified health plans in the
individual market;
(b) Facilitate the ability of eligible individuals to receive premium tax credits and cost-sharing reductions
and enable eligible small businesses to receive tax credits, in compliance with all applicable federal and
state laws and regulations;
(c) Oversee the consumer assistance programs of navigators, in-person assisters, certified application
counselors, and insurance agents as appropriate;
(d) At a minimum, carry out the functions and responsibilities required pursuant to 42 U.S.C. sec. 18031 to
implement and comply with federal regulations in accordance with 42 U.S.C. sec. 18041;[ and]
(e) Regularly consult with stakeholders in accordance with 45 C.F.R. sec. 155.130; and
(f) Comply with Section 4 of this Act.
(3) The Office of Data Analytics:
(a) May enter into contracts and other agreements with appropriate entities, including but not limited to
federal, state, and local agencies, as permitted under 45 C.F.R. sec. 155.110, to the extent necessary to
carry out the duties and responsibilities of the office if[, provided that] the agreements incorporate
adequate protections with respect to the confidentiality of any information to be shared;[.]
(b)[(4)] [The office ]Shall pursue all available federal funding for the further development and operation
of the Division of Health Benefit Exchange;[.]
(c)[(5)] [The Office of Health Data and Analytics ]Shall promulgate administrative regulations in
accordance with KRS Chapter 13A to implement this section; and[.]
(d)[(6)] [The office ]Shall not establish procedures and rules that conflict with or prevent the application
of the Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148.
Section 9. KRS 205.522 is amended to read as follows:
(1) With respect to the administration and provision of Medicaid benefits pursuant to this chapter, the
Department for Medicaid Services,[ and] any managed care organization contracted to provide Medicaid
benefits pursuant to this chapter, and the state's medical assistance program shall be subject to, and comply
with, the following, as applicable:[provisions of ]
(a) KRS 304.17A-163;[, ]
(b) KRS 304.17A-1631;[, ]
(c) KRS 304.17A-167;[, ]
(d) KRS 304.17A-235;[, ]
(e) KRS 304.17A-257;[, ]
(f) KRS 304.17A-259;[, ]
(g) KRS 304.17A-263;[, ]
(h) KRS 304.17A-515;[, ]
(i) KRS 304.17A-580;[, ]
(j) KRS 304.17A-600, 304.17A-603, and 304.17A-607;[, and ]
(k) KRS 304.17A-740 to 304.17A-743; and[, as applicable]
(l) Section 5 of this Act.
(2) A managed care organization contracted to provide Medicaid benefits pursuant to this chapter shall comply
with the reporting requirements of KRS 304.17A-732.
Section 10. KRS 205.592 is amended to read as follows: CHAPTER 207
Legislative Research Commission PDF Version
11
(1) Except as provided in subsection (2) of this section, pregnant women, new mothers up to twelve (12) months
postpartum, and children up to age one (1) shall be eligible for participation in the Kentucky Medical
Assistance Program if:
(a)[(1)] They have family income up to but not exceeding one hundred and eighty-five percent (185%) of
the nonfarm income official poverty guidelines as promulgated by the Department of Health and
Human Services of the United States as revised annually; and
(b)[(2)] They are otherwise eligible for the program.
(2) The percentage established in subsection (1)(a) of this section may be increased to the extent:
(a) Permitted under federal law; and
(b) Funding is available.
Section 11. KRS 205.6485 is amended to read as follows:
(1) As used in this section, "KCHIP" means the Kentucky Children's Health Insurance Program.
(2) The Cabinet for Health and Family Services shall:
(a) Prepare a state child health plan, known as KCHIP, meeting the requirements of Title XXI of the
Federal Social Security Act, for submission to the Secretary of the United States Department of Health
and Human Services within such time as will permit the state to receive the maximum amounts of
federal matching funds available under Title XXI; and[. The cabinet shall, ]
(b) By administrative regulation promulgated in accordance with KRS Chapter 13A, establish the
following:
1.[(a)] The eligibility criteria for children covered by KCHIP, which shall include a provision that[the
Kentucky Children's Health Insurance Program. However,] no person eligible for services under
Title XIX of the Social Security Act, 42 U.S.C. secs. 1396 to 1396v, as amended, shall be
eligible for services under KCHIP,[the Kentucky Children's Health Insurance Program] except to
the extent that Title XIX coverage is expanded by KRS 205.6481 to 205.6495 and KRS
304.17A-340;
2.[(b)] The schedule of benefits to be covered by KCHIP[the Kentucky Children's Health Insurance
Program], which shall:[ include preventive services, vision services including glasses, and dental
services including at least sealants, extractions, and fillings, and which shall]
a. Be at least equivalent to one (1) of the following:
i.[1.] The standard Blue Cross/Blue Shield preferred provider option under the Federal
Employees Health Benefit Plan established by 5 U.S.C. sec. 8903(1);
ii.[2.] A mid-range health benefit coverage plan that is offered and generally available to
state employees; or
iii.[3.] Health insurance coverage offered by a health maintenance organization that has
the largest insured commercial, non-Medicaid enrollment of covered lives in the
state; and
b. Comply with subsection (6) of this section;
3.[(c)] The premium contribution per family for[of] health insurance coverage available under the
KCHIP, which[Kentucky Children's Health Insurance Program with provisions for the payment
of premium contributions by families of children eligible for coverage by the program based
upon a sliding scale relating to family income. Premium contributions] shall be based:
a. On a six (6) month period; and
b. Upon a sliding scale relating to family income not to exceed:
i.[1.] Ten dollars ($10), to be paid by a family with income between one hundred percent
(100%) to one hundred thirty-three percent (133%) of the federal poverty level;
ii.[2.] Twenty dollars ($20), to be paid by a family with income between one hundred
thirty-four percent (134%) to one hundred forty-nine percent (149%) of the federal ACTS OF THE GENERAL ASSEMBLY 12
poverty level; and
iii.[3.] One hundred twenty dollars ($120), to be paid by a family with income between
one hundred fifty percent (150%) to two hundred percent (200%) of the federal
poverty level, and which may be made on a partial payment plan of twenty dollars
($20) per month or sixty dollars ($60) per quarter;
4.[(d)] There shall be no copayments for services provided under KCHIP[the Kentucky Children's
Health Insurance Program]; and
5.[(e)] a. The criteria for health services providers and insurers wishing to contract with the
Commonwealth to provide[ the children's health insurance] coverage under KCHIP.
b. [However, ]The cabinet shall provide, in any contracting process for coverage of[the]
preventive services[health insurance program], the opportunity for a public health
department to bid on preventive health services to eligible children within the public
health department's service area. A public health department shall not be disqualified from
bidding because the department does not currently offer all the services required by[
paragraph (b) of] this section[subsection]. The criteria shall be set forth in administrative
regulations under KRS Chapter 13A and shall maximize competition among the providers
and insurers. The[ Cabinet for] Finance and Administration Cabinet shall provide
oversight over contracting policies and procedures to assure that the number of applicants
for contracts is maximized.
(3)[(2)] Within twelve (12) months of federal approval of the state's Title XXI child health plan, the Cabinet for
Health and Family Services shall assure that a KCHIP program is available to all eligible children in all
regions of the state. If necessary, in order to meet this assurance, the cabinet shall institute its own program.
(4)[(3)] KCHIP recipients shall have direct access without a referral from any gatekeeper primary care provider
to dentists for covered primary dental services and to optometrists and ophthalmologists for covered primary
eye and vision services.
(5)[(4)] KCHIP[The Kentucky Children's Health Insurance Plan] shall comply with KRS 304.17A-163 and
304.17A-1631.
(6) The schedule of benefits required under subsection (2)(b)2. of this section shall include:
(a) Preventive services;
(b) Vision services, including glasses;
(c) Dental services, including sealants, extractions, and fillings; and
(d) The coverage required under Section 5 of this Act.
SECTION 12. A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO READ AS FOLLOWS:
(1) As used in this section:
(a) "Breast pump kit" means a collection of tubing, valves, flanges, bottles, and other parts required to
extract human milk using a breast pump;
(b) "In-home program" means a program offered by a health care facility or health care professional
for the treatment of substance use disorder which the insured accesses through telehealth or digital
health service;
(c) "Lactation consultation" means the clinical application of scientific principles and a
multidisciplinary body of evidence for evaluation, problem identification, treatment, education, and
consultation to families regarding the course of lactation and feeding by a qualified clinical lactation
care practitioner, including but not be limited to:
1. Clinical maternal, child, and feeding history and assessment related to breastfeeding and
human lactation through the systematic collection of subjective and objective information;
2. Analysis of data;
3. Development of a lactation management and child feeding plan with demonstration and
instruction to parents; CHAPTER 207
Legislative Research Commission PDF Version
13
4. Provision of lactation and feeding education;
5. The recommendation and use of assistive devices;
6. Communication to the primary health care practitioner or practitioners and referral to other
health care practitioners, as needed;
7. Appropriate follow-up with evaluation of outcomes; and
8. Documentation of the encounter in a patient record;
(d) "Qualified clinical lactation care practitioner" means a licensed health care practitioner wherein
lactation consultation is within their legal scope of practice; and
(e) "Telehealth" or "digital health" has the same meaning as in KRS 211.332.
(2) The Department for Medicaid Services and any managed care organization with which the department
contracts for the delivery of Medicaid services shall provide coverage:
(a) For lactation consultation;
(b) For breastfeeding equipment;
(c) To pregnant and postpartum women for an in-home program; and
(d) For telehealth or digital health services that are related to maternity care associated with pregnancy,
childbirth, and postpartum care.
(3) The coverage required by this section shall:
(a) Not be subject to:
1. Any cost-sharing requirements, including but not limited to copayments; or
2. Utilization management requirements, including but not limited to prior authorization,
prescription, or referral, except as permitted in paragraph (d) of this subsection;
(b) Be provided in conjunction with each birth for the duration of breastfeeding, as defined by the
beneficiary;
(c) For lactation consultation, include:
1. In-person, one-on-one consultation, including home visits, regardless of location of service
provision;
2. The delivery of consultation via telehealth, as defined in KRS 205.510, if the beneficiary
requests telehealth consultation in lieu of in-person, one-on-one consultation; or
3. Group consultation, if the beneficiary requests group consultation in lieu of in-person, one-
on-one consultation; and
(d) For breastfeeding equipment, include:
1. Purchase of a single-user, double electric breast pump, or a manual pump in lieu of a double
electric breast pump, if requested by the beneficiary;
2. Rental of a multi-user breast pump on the recommendation of a licensed health care provider;
and
3. Two (2) breast pump kits as well as appropriately sized breast pump flanges and other
lactation accessories recommended by a health care provider.
(4) (a) The breastfeeding equipment described in subsection (3)(d) of this section shall be furnished within
forty-eight (48) hours of notification of need, if requested after the birth of the child, or by the later
of two (2) weeks before the beneficiary's expected due date or seventy-two (72) hours after
notification of need, if requested prior to the birth of the child.
(b) If the department cannot ensure delivery of breastfeeding equipment in accordance with paragraph
(a) of this subsection, an individual may purchase equipment and the department or a managed care
organization with whom the department contracts for the delivery of Medicaid services shall ACTS OF THE GENERAL ASSEMBLY 14
reimburse the individual for all out-of-pocket expenses incurred by the individual, including any
balance billing amounts.
Section 13. If the application of a provision of Section 4 or 5 of this Act results, or would result, in a
determination that the state must make payments to defray the cost of the provision under 42 U.S.C. sec. 18031(d)(3)
and 45 C.F.R. sec. 155.170, as amended, or would be required to make payments to defray the cost of the provision
under 42 U.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as amended, if the provision were not suspended or
otherwise inapplicable under state law, then the Department of Insurance shall, within 180 days of the effective date
of this section, apply for a waiver under 42 U.S.C. sec. 18052, as amended, or any other applicable federal law of all
or any of the cost defrayal requirements.
Section 14. If the Cabinet for Health and Family Services determines that a waiver or other authorization
from a federal agency is necessary to implement Section 8, 9, 10, 11, or 12 of this Act for any reason, including the
loss of federal funds, the cabinet shall, within 90 days of the effective date of this section, request the waiver or
authorization, and may only delay implementation of those provisions for which a waiver or authorization was
deemed necessary until the waiver or authorization is granted.
Section 15. The Cabinet for Health and Family Services shall study existing doula certification programs
in the United States and currently operating doula services in the Commonwealth of Kentucky. The study shall
review the training and quality requirements of doula certifications and consider potential recommendations
regarding doula services for populations most at risk for poor perinatal outcomes. The Cabinet for Health and Family
Services may receive input from parties concerned with this study. By December 1, 2024, the Cabinet for Health and
Family Services shall provide a report on the study to the Legislative Research Commission for referral to the Interim
Joint Committee on Health Services. As used in this section, "doula services" means services provided by a trained
nonmedical professional to support women and families throughout labor and birth, and intermittently during the
prenatal and postpartum periods.
Section 16. Sections 4 to 8 of this Act apply to plans issued or renewed on or after January 1, 2025.
Section 17. Sections 4, 5, 6, 7, 8, and 16 of this Act take effect January 1, 2025.
Section 18. KRS 211.684 is amended to read as follows:
(1) For the purposes of KRS Chapter 211:
(a) "Child fatality" means the death of a person under the age of eighteen (18) years; and
(b) ["Local child and maternal fatality response team" and "local team" means a community team
composed of representatives of agencies, offices, and institutions that investigate child and maternal
deaths, including but not limited to, coroners, social service workers, medical professionals, law
enforcement officials, and Commonwealth's and county attorneys; and
(c) ]"Maternal fatality" means the death of a woman during pregnancy and within one (1) year of the end
of the pregnancy[giving birth].
(2) The Department for Public Health may establish a state child [and maternal ]fatality review team. The state
child fatality review team may include representatives of public health, social services, law enforcement
agencies with investigation responsibilities for child fatalities, the offices of Commonwealth's and county
attorneys[prosecution], coroners, health-care providers, and other agencies or professions deemed appropriate
by the commissioner of the department.
(3) If a state child fatality review team is created, the duties of the state team may include but not be limited to the
following:
(a) Develop and distribute a model protocol for local child [and maternal ]fatality response teams for the
investigation of child[ and maternal] fatalities;
(b) Facilitate the development of local child [and maternal ]fatality response teams, as permitted under
Section 19 of this Act, including but[ which may include, but is] not limited to[,] providing joint
training opportunities and, upon request, providing technical assistance;
(c) Review and approve local protocols prepared and submitted by local teams;
(d) Receive data and information on child [and maternal ]fatalities and analyze the information to identify
trends, patterns, and risk factors;
(e) Evaluate the effectiveness of prevention and intervention strategies adopted;[ and] CHAPTER 207
Legislative Research Commission PDF Version
15
(f) Recommend changes in state programs, legislation, administrative regulations, policies, budgets, and
treatment and service standards which may facilitate strategies for prevention and reduce the number of
child[ and maternal] fatalities; and
(g) Cooperate, as appropriate, with the external child fatality and near fatality review panel established
by KRS 620.055 upon request.
(4) The department shall establish a state maternal fatality review team. The state maternal fatality review team
may include representatives of public health, social services, law enforcement, coroners, health-care
providers, and other agencies or professions deemed appropriate by the commissioner of the department.
(5) The duties of the state maternal fatality review team may include but not be limited to the following:
(a) Receive data and information on maternal fatalities and analyze the information to identify trends,
patterns, and risk factors;
(b) Evaluate the effectiveness of prevention and intervention strategies adopted; and
(c) Recommend changes in state programs, legislation, administrative regulations, policies, budgets, and
treatment and service standards which may facilitate strategies for prevention and reduce the number
of maternal fatalities.
(6) The department shall prepare an annual report to be submitted no later than November 1 of each year to the
Governor, the Legislative Research Commission for referral to the Interim Joint Committee on Families and
Children and the Interim Joint Committee on Health Services, the Chief Justice of the Kentucky Supreme
Court, and to be made available to the citizens of the Commonwealth. The report shall include a statistical
analysis, including but not limited to Medicaid, Kentucky Children's Health Insurance Program, or other
health benefit coverage,[that includes the demographics of] race, ethnicity[income], and geography, of the
incidence and causes of child and maternal fatalities in the Commonwealth during the past fiscal year and
recommendations for action. The report shall not include any information which would identify specific child
and maternal fatality cases. Separate reports may be submitted for the state child fatality review team and the
state maternal fatality review team.
(7) The proceedings, records, opinions, and deliberations of the state child fatality review team and of the state
maternal fatality review team shall be privileged and shall not be subject to discovery, subpoena, or
introduction into evidence in any civil action in any manner that would directly or indirectly identify
specific persons or cases reviewed by the state child fatality review team or the state maternal fatality review
team. Nothing in this subsection shall be construed to restrict or limit the right to discover or use in any
civil action any evidence that is discoverable independent of the proceedings of the state child fatality review
team or the state maternal fatality review team.
Section 19. KRS 211.686 is amended to read as follows:
(1) A local child [and maternal ]fatality response team may be established in every county or group of contiguous
counties by the coroner or coroners with jurisdiction in the county or counties. The local coroner may
authorize the creation of additional local teams within the coroner's jurisdiction as needed.
(2) Membership of [the ]local teams[team] may include representatives of the coroner, the local office of the
Department for Community Based Services, law enforcement agencies with investigation responsibilities for
child [and maternal ]fatalities which occur within the jurisdiction of the local team, the Commonwealth's and
county attorneys, representatives of the medical profession, and other members whose participation the local
team believes is important to carry out its purpose. Each local team member shall be appointed by the agency
the member is representing and shall serve at the pleasure of the appointing authority.
(3) The purpose of the local child [and maternal ]fatality response teams[team] shall be to:
(a) Allow each member to share specific and unique information with the local team;
(b) Generate overall investigative direction and emphasis through team coordination and sharing of
specialized information;
(c) Create a body of information that will assist in the coroner's effort to accurately identify the cause and
reasons for death; and
(d) Facilitate the appropriate response by each member agency to the fatality, including but not limited to,
intervention on behalf of others who may be adversely affected by the situation, implementation of ACTS OF THE GENERAL ASSEMBLY 16
health services necessary for protection of other citizens, further investigation by law enforcement, or
legal action by Commonwealth's or county attorneys.
(4) [The ]Local teams[team] may:
(a) Analyze information regarding local child [and maternal ]fatalities to identify trends, patterns, and risk
factors;
(b) Recommend to the state teams[team] established under Section 18 of this Act, and any other entities
deemed appropriate, changes in state or local programs, legislation, administrative regulations, policies,
budgets, and treatment and service standards which may facilitate strategies for prevention and reduce
the number of child [and maternal ]fatalities; and
(c) Evaluate the effectiveness of local prevention and intervention strategies.
(5) [The ]Local teams[team] may establish a protocol for the investigation of child [and maternal ]fatalities and
may establish operating rules and procedures as deemed[it deems] necessary to carry out the purposes of this
section.
(6) The review of a child [and maternal ]fatality by a local team may include information from reports generated
or received by agencies, organizations, or individuals that are responsible for investigation, prosecution, or
treatment in the case.
(7) The proceedings, records, opinions, and deliberations of [the ]local teams[team] shall be privileged and shall
not be subject to discovery, subpoena, or introduction into evidence in any civil action in any manner that
would directly or indirectly identify specific persons or cases reviewed by [the ]local teams[team]. Nothing in
this subsection shall be construed to restrict or limit the right to discover or use in any civil action any
evidence that is discoverable independent of the proceedings of [the ]local teams[team].
Section 20. KRS 216.2929 is amended to read as follows:
(1) (a) The Cabinet for Health and Family Services shall make available on its website information on charges
for health-care services at least annually in understandable language with sufficient explanation to allow
consumers to draw meaningful comparisons between every hospital and ambulatory facility,
differentiated by payor if relevant, and for other provider groups as relevant data becomes available.
(b) Any charge information compiled and reported by the cabinet shall include the median charge and other
percentiles to describe the typical charges for all of the patients treated by a provider and the total
number of patients represented by all charges, and shall be risk-adjusted.
(c) The report shall clearly identify the sources of data used in the report and explain limitations of the data
and why differences between provider charges may be misleading. Every provider that is specifically
identified in any report shall be given thirty (30) days to verify the accuracy of its data prior to public
release and shall be afforded the opportunity to submit comments on its data that shall be included on
the website and as part of any printed report of the data.
(d) The cabinet shall only provide linkages to organizations that publicly report comparative-charge data
for Kentucky providers using data for all patients treated regardless of payor source, which may be
adjusted for outliers, is risk-adjusted, and meets the requirements of paragraph (c) of this subsection.
(2) (a) The cabinet shall make information available on its website at least annually describing quality and
outcome measures in understandable language with sufficient explanations to allow consumers to draw
meaningful comparisons between every hospital and ambulatory facility in the Commonwealth and
other provider groups as relevant data becomes available.
(b) 1. The cabinet shall utilize only national quality indicators that have been endorsed and adopted by
the Agency for Healthcare Research and Quality, the National Quality Forum, or the Centers for
Medicare and Medicaid Services; or
2. The cabinet shall provide linkages only to the following organizations that publicly report quality
and outcome measures on Kentucky providers:
a. The Centers for Medicare and Medicaid Services;
b. The Agency for Healthcare Research and Quality;
c. The Joint Commission; and CHAPTER 207
Legislative Research Commission PDF Version
17
d. Other organizations that publicly report relevant outcome data for Kentucky providers.
(c) The cabinet shall utilize or refer the general public to only those nationally endorsed quality indicators
that are based upon current scientific evidence or relevant national professional consensus and have
definitions and calculation methods openly available to the general public at no charge.
(3) Any report the cabinet disseminates or refers the public to shall:
(a) Not include data for a provider whose caseload of patients is insufficient to make the data a reliable
indicator of the provider's performance;
(b) Meet the requirements of subsection (1)(c) of this section;
(c) Clearly identify the sources of data used in the report and explain the analytical methods used in
preparing the data included in the report; and
(d) Explain any limitations of the data and how the data should be used by consumers.
(4) The cabinet shall report at least biennially, no later than October 1 of each odd-numbered year, on the special
health needs of the minority population in the Commonwealth as compared to the population in the
Commonwealth as compared to the population at large. The report shall contain an overview of the health
status of minority Kentuckians, shall identify the diseases and conditions experienced at disproportionate
mortality and morbidity rates within the minority population, and shall make recommendations to meet the
identified health needs of the minority population.
(5) Beginning December 1, 2024, and at least annually thereafter, the Cabinet for Health and Family Services
shall publish a report on its website for the most recent five (5) years of available data on the number and
types of delivery procedures for pregnancy by hospital, including but not limited to the following
procedures:
(a) Augmentation of labor;
(b) Cesarean section;
(c) Episiotomy;
(d) Induction of labor;
(e) Primary cesarean section;
(f) Nulliparous, term, singleton, vertex (NTSV) cesarean section;
(g) Use of forceps;
(h) Use of vacuum;
(i) Vaginal birth after cesarean (VBAC); and
(j) Vaginal delivery.
The cabinet shall use health data collected pursuant to KRS 216.2920 to 216.2929 to obtain the required
information, and may use additional sources including data derived from birth certificates if the required
information is not available from data collected pursuant to KRS 216.2920 to 216.2929.
(6) The reports[report] required under subsections[subsection] (4) and (5) of this section shall be submitted to the
Legislative Research Commission for referral to the Interim Joint Committees on Appropriations and
Revenue, Families and Children, and Health Services, and to the Governor.
Section 21. KRS 211.575 is amended to read as follows:
(1) As used in this section, "department" means the Department for Public Health.
(2) The Department for Public Health shall establish and implement a plan for achieving continuous quality
improvement in the quality of care provided under a statewide system for stroke response and treatment. In
implementing the plan, the department shall:
(a) Maintain a statewide stroke database to compile information and statistics on stroke care as follows: ACTS OF THE GENERAL ASSEMBLY 18
1. The database shall align with the stroke consensus metrics developed and approved by the
American Heart Association, the American Stroke Association, the Centers for Disease Control
and Prevention, and the Joint Commission;
2. The department shall utilize the "Get With The Guidelines-Stroke" quality improvement program
maintained by the American Heart Association and the American Stroke Association or another
nationally recognized program that utilizes a data set platform with patient confidentiality
standards no less secure than the statewide stroke database established in this paragraph; and
3. Require certified stroke centers as established in KRS 216B.0425 to report to the database each
case of stroke seen at the facility. The data shall be reported in a format consistent with
nationally recognized guidelines on the treatment of individuals within the state with confirmed
cases of stroke;
(b) To the extent possible, coordinate with national voluntary health organizations involved in stroke
quality improvement to avoid duplication and redundancy;
(c) Encourage the sharing of information and data among health care providers on methods to improve the
quality of care of stroke patients in the state;
(d) Facilitate communication about data trends and treatment developments among health care
professionals involved in the care of individuals with stroke;
(e) Require the application of evidence-based treatment guidelines for the transition of stroke patients upon
discharge from a hospital following acute treatment to community-based care provided in a hospital
outpatient, physician office, or ambulatory clinic setting; and
(f) Establish a data oversight process and a plan for achieving continuous quality improvement in the
quality of care provided under the statewide system for stroke response and treatment, which shall
include:
1. Analysis of the data included in the stroke database;
2. Identification of potential interventions to improve stroke care in specific geographic regions of
the state; and
3. Recommendations to the department and the Kentucky General Assembly for improvement in
the delivery of stroke care in the state.
(3) All data reported under subsection (2)(a) of this section shall be made available to the department and all
government agencies or contractors of government agencies which are responsible for the management and
administration of emergency medical services throughout the state.
(4) By September[On June 1, 2013, and annually on June] 1 of each year[thereafter], the department shall provide
a report of its data and any related findings and recommendations to the Governor and to the Legislative
Research Commission for referral to the Interim Joint Committee on Health Services. The report also shall
be made available on the department's website[ Web site].
(5) Nothing in this section shall be construed to require the disclosure of confidential information or data in
violation of the federal Health Insurance Portability and Accountability Act of 1996.
Section 22. KRS 211.689 is amended to read as follows:
(1) As used in this section and KRS 211.690:
(a) "Home visitation" means a service delivery strategy with voluntary participation [by eligible families
that is carried out in the homes ]of at-risk parents during the prenatal period and until the child's third
birthday that provides [face-to-face ]visits by nurses, social workers, and other [early childhood
]professionals or trained and supervised paraprofessionals to improve maternal, infant, and child health
and well-being, including:
1. Reducing preterm births;
2. Promoting positive parenting practices;
3. Improving school readiness;
4. Enhancing the social, emotional, and cognitive development of children; CHAPTER 207
Legislative Research Commission PDF Version
19
5. Reducing child abuse and neglect;
6. Improving the health of the family; and
7. Empowering families to be self-sufficient;
(b) "Home visitation program" means the voluntary statewide home visiting program established by KRS
211.690 or a program implementing a research-based model or a promising model that includes
voluntary home visitation as a primary service delivery strategy that may supplement but shall not
duplicate any existing program that provides assistance to parents [of young children ]and that does not
include:
1. Programs with few or infrequent home visits;
2. Home visits based on professional judgment or medical referrals that are infrequent and
supplemental to a treatment plan;
3. Programs in which home visiting is supplemental to other services, such as child protective
services;
4. In-home services delivered to at-risk parents through provisions of an individualized family
service plan or individualized education program under the federal Individuals with Disabilities
Education Act, Part B or C; or
5. Programs with goals related to direct intervention of domestic violence or substance abuse;
(c) "Research-based model" means a home visitation model based on a clear, consistent program model
that:
1. Is research-based, grounded in relevant empirically based knowledge, linked to program
determined outcomes, has comprehensive home visitation standards that ensure high-quality
service delivery and continuous quality improvement, and has demonstrated significant,
sustained positive outcomes;
2. Employs highly trained and competent professionals or paraprofessionals who are provided close
supervision and continual professional development and training relevant to the specific model
being delivered;
3. Demonstrates strong linkages to other community-based services; and
4. Is operated within an organization to ensure program fidelity and meets the outlined objectives
and criteria for the model design; and
(d) "Promising model" means a home visitation model that has ongoing research, is modeled after
programs with proven standards and outcomes, and has demonstrated its effectiveness or is actively
incorporating model evaluation protocols designed to measure its efficacy.
(2) [Beginning fiscal year 2014, ]An agency receiving state funds for the purpose of the delivery of home
visitation services shall:
(a) Meet the definition of home visitation program in this section;
(b) Demonstrate to the Department for Public Health that it is part of a coordinated system of care for
promoting health and well-being for at-risk parents during the prenatal period and until the child's third
birthday; and
(c) Report data to the statewide home visiting data system managed by the Department for Public Health in
a uniform format prescribed by the department ensuring[assuring ]common data elements, relevant
home visiting data, and information to monitor program effectiveness, including program outcomes,
numbers of families served, and other relevant data as determined by the department.
Section 23. KRS 213.046 is amended to read as follows:
(1) A certificate of birth for each live birth which occurs in the Commonwealth shall be filed with the state
registrar within five (5) working days after such birth and shall be registered if it has been completed and filed
in accordance with this section and applicable administrative regulations. No certificate shall be held to be
complete and correct that does not supply all items of information called for in this section and in KRS
213.051, or satisfactorily account for their omission except as provided in KRS 199.570(3). If a certificate of ACTS OF THE GENERAL ASSEMBLY 20
birth is incomplete, the state[local] registrar shall immediately notify the responsible person and require that
person to supply the missing items, if that information can be obtained.
(2) When a birth occurs in an institution or en route thereto, the person in charge of the institution or that person's
designated representative, shall obtain the personal data, prepare the certificate, secure the signatures required,
and file the certificate as directed in subsection (1) of this section or as otherwise directed by the state registrar
within the required five (5) working days. The physician or other person in attendance shall provide the
medical information required for the certificate and certify to the fact of birth within five (5) working days
after the birth. If the physician or other person in attendance does not certify to the fact of birth within the five
(5) working day period, the person in charge of the institution shall complete and sign the certificate.
(3) When a birth occurs in a hospital or en route thereto to a woman who is unmarried, the person in charge of the
hospital or that person's designated representative shall immediately before or after the birth of a child, except
when the mother or the alleged father is a minor:
(a) Meet with the mother prior to the release from the hospital;
(b) Attempt to ascertain whether the father of the child is available in the hospital, and, if so, to meet with
him, if possible;
(c) Provide written materials and oral, audio, or video materials about paternity;
(d) Provide the unmarried mother, and, if possible, the father, with the voluntary paternity form necessary
to voluntarily establish paternity;
(e) Provide a written and an oral, audio, or video description of the rights and responsibilities, the
alternatives to, and the legal consequences of acknowledging paternity;
(f) Provide written materials and information concerning genetic paternity testing;
(g) Provide an opportunity to speak by telephone or in person with staff who are trained to clarify
information and answer questions about paternity establishment;
(h) If the parents wish to acknowledge paternity, require the voluntary acknowledgment of paternity
obtained through the hospital-based program be signed by both parents and be authenticated by a notary
public;
(i) Upon both the mother's and father's request, help the mother and father in completing the affidavit of
paternity form;
(j) Upon both the mother's and father's request, transmit the affidavit of paternity to the state registrar; and
(k) In the event that the mother or the alleged father is a minor, information set forth in this section shall be
provided in accordance with Civil Rule 17.03 of the Kentucky Rules of Civil Procedure.
If the mother or the alleged father is a minor, the paternity determination shall be conducted pursuant to KRS
Chapter 406.
(4) The voluntary acknowledgment of paternity and declaration of paternity forms designated by the Vital
Statistics Branch shall be the only documents having the same weight and authority as a judgment of paternity.
(5) The Cabinet for Health and Family Services shall:
(a) Provide to all public and private birthing hospitals in the state written materials in accessible formats
and audio or video materials concerning paternity establishment forms necessary to voluntarily
acknowledge paternity;
(b) Provide copies of a written description in accessible formats and an audio or video description of the
rights and responsibilities of acknowledging paternity; and
(c) Provide staff training, guidance, and written instructions regarding voluntary acknowledgment of
paternity as necessary to operate the hospital-based program.
(6) When a birth occurs outside an institution, verification of the birth shall be in accordance with the
requirements of the state registrar and a birth certificate shall be prepared and filed by one (1) of the following
in the indicated order of priority:
(a) The physician in attendance at or immediately after the birth; or, in the absence of such a person, CHAPTER 207
Legislative Research Commission PDF Version
21
(b) A midwife or any other person in attendance at or immediately after the birth; or, in the absence of such
a person,
(c) The father, the mother, or in the absence of the father and the inability of the mother, the person in
charge of the premises where the birth occurred or of the institution to which the child was admitted
following the birth.
(7) No physician, midwife, or other attendant shall refuse to sign or delay the filing of a birth certificate.
(8) If a birth occurs on a moving conveyance within the United States and the child is first removed from the
conveyance in the Commonwealth, the birth shall be registered in the Commonwealth, and the place where the
child is first removed shall be considered the place of birth. If a birth occurs on a moving conveyance while in
international waters or air space or in a foreign country or its air space and the child is first removed from the
conveyance in the Commonwealth, the birth shall be registered in the Commonwealth, but the certificate shall
show the actual place of birth insofar as can be determined.
(9) The following provisions shall apply if the mother was married at the time of either conception or birth or
anytime between conception and birth:
(a) If there is no dispute as to paternity, the name of the husband shall be entered on the certificate as the
father of the child. The surname of the child shall be any name chosen by the parents; however, if the
parents are separated or divorced at the time of the child's birth, the choice of surname rests with the
parent who has legal custody following birth;[.]
(b) If the mother claims that the father of the child is not her husband and the husband agrees to such a
claim and the putative father agrees to the statement, a three (3) way affidavit of paternity may be
signed by the respective parties and duly notarized. The state registrar of vital statistics shall enter the
name of a nonhusband on the birth certificate as the father and the surname of the child shall be any
name chosen by the mother; and[.]
(c) If a question of paternity determination arises which is not resolved under paragraph (b) of this
subsection, it shall be settled by the District Court.
(10) The following provisions shall apply if the mother was not married at the time of either conception or birth or
between conception and birth or the marital relationship between the mother and her husband has been
interrupted for more than ten (10) months prior to the birth of the child:
(a) The name of the father shall not be entered on the certificate of birth. The state registrar shall upon
acknowledgment of paternity by the father and with consent of the mother pursuant to KRS 213.121,
enter the father's name on the certificate. The surname of the child shall be any name chosen by the
mother and father. If there is no agreement, the child's surname shall be determined by the parent with
legal custody of the child;[.]
(b) If an affidavit of paternity has been properly completed and the certificate of birth has been filed
accordingly, any further modification of the birth certificate regarding the paternity of the child shall
require an order from the District Court;[.]
(c) In any case in which paternity of a child is determined by a court order, the name of the father and
surname of the child shall be entered on the certificate of birth in accordance with the finding and order
of the court; and[.]
(d) In all other cases, the surname of the child shall be any name chosen by the mother.
(11) If the father is not named on the certificate of birth, no other information about the father shall be entered on
the certificate. In all cases, the maiden name of the gestational mother shall be entered on the certificate.
(12) Any child whose surname was restricted prior to July 13, 1990, shall be entitled to apply to the state registrar
for an amendment of a birth certificate showing as the surname of the child, any surname chosen by the mother
or parents as provided under this section.
(13) The birth certificate of a child born as a result of artificial insemination shall be completed in accordance with
the provisions of this section.
(14) Each birth certificate filed under this section shall include all Social Security numbers that have been issued to
the parents of the child. ACTS OF THE GENERAL ASSEMBLY 22
(15) Either of the parents of the child, or other informant, shall attest to the accuracy of the personal data entered on
the certificate in time to permit the filing of the certificate within five (5)[ten (10)] days prescribed in
subsection (1) of this section.
(16) When a birth certificate is filed for any birth that occurred outside an institution, the Cabinet for Health and
Family Services shall forward information regarding the need for an auditory screening for an infant and a list
of options available for obtaining an auditory screening for an infant. The list shall include the Office for
Children with Special Health Care Needs, local health departments as established in KRS Chapter 212,
hospitals offering obstetric services, alternative birthing centers required to provide an auditory screening
under KRS 216.2970, audiological assessment and diagnostic centers approved by the Office for Children with
Special Health Care Needs in accordance with KRS 211.647 and licensed audiologists, and shall specify the
hearing methods approved by the Office for Children with Special Health Care Needs in accordance with KRS
216.2970.
Section 24. KRS 387.540 is amended to read as follows:
(1) (a) Prior to a hearing on a petition for a determination of partial disability or disability and the appointment
of a limited guardian, guardian, limited conservator, or conservator, an interdisciplinary evaluation
report shall be filed with the court. The report may be filed as a single and joint report of the
interdisciplinary evaluation team, or it may otherwise be constituted by the separate reports filed by
each individual of the team.
(b) If the court and all parties to the proceeding and their attorneys agree to the admissibility of the report
or reports, the report or reports shall be admitted into evidence and shall be considered by the court or
the jury if one is impaneled.
(c) The report shall be compiled by at least three (3) individuals, including:
1. A physician, an advanced practice registered nurse, or a physician assistant;[,]
2. A psychologist licensed or certified under the provisions of KRS Chapter 319;[,] and
3. A person licensed or certified as a social worker or an employee of the Cabinet for Health and
Family Services who has at least one (1) year of investigative experience and has completed
training in conducting decisional capacity assessments[meets the qualifications of KRS
335.080(1)(a), (b), and (c) or 335.090(1)(a), (b), and (c)]. The social worker shall, when possible,
be chosen from among employees of the Cabinet for Health and Family Services residing or
working in the area, and there shall be no additional compensation for their service on the
interdisciplinary evaluation team.
(2) At least one (1) person participating in the compilation of the report shall have knowledge of the particular
disability which the respondent is alleged to have or knowledge of the skills required of the respondent to care
for himself and his estate.
(3) If the respondent is alleged to be partially disabled or disabled due to mental illness, at least one (1) person
participating in the compilation of the interdisciplinary evaluation report shall be a qualified mental health
professional as defined in KRS 202A.011(12). If the respondent is alleged to be partially disabled or disabled
due to an intellectual disability, at least one (1) person participating in the compilation of the evaluation report
shall be a qualified professional in the area of intellectual disabilities as defined in KRS 202B.010(12).
(4) The interdisciplinary evaluation report shall contain:
(a) A description of the nature and extent of the respondent's disabilities, if any;
(b) Current evaluations of the respondent's social, intellectual, physical, and educational condition, adaptive
behavior, and social skills. Such evaluations may be based on prior evaluations not more than three (3)
months old, except that evaluations of the respondent's intellectual condition may be based on
individual intelligence test scores not more than one (1) year old;
(c) An opinion as to whether guardianship or conservatorship is needed, the type of guardianship or
conservatorship needed, if any, and the reasons therefor;
(d) An opinion as to the length of time guardianship or conservatorship will be needed by the respondent, if
at all, and the reasons therefor; CHAPTER 207
Legislative Research Commission PDF Version
23
(e) If limited guardianship or conservatorship is recommended, a further recommendation as to the scope of
the guardianship or conservatorship, specifying particularly the rights to be limited and the
corresponding powers and duties of the limited guardian or limited conservator;
(f) A description of the social, educational, medical, and rehabilitative services currently being utilized by
the respondent, if any;
(g) A determination whether alternatives to guardianship or conservatorship are available;
(h) A recommendation as to the most appropriate treatment or rehabilitation plan and living arrangement
for the respondent and the reasons therefor;
(i) A listing of all medications the respondent is receiving, the dosage, and a description of the impact of
the medication upon the respondent's mental and physical condition and behavior;
(j) An opinion whether attending a hearing on a petition filed under KRS 387.530 would subject the
respondent to serious risk of harm;
(k) The names and addresses of all individuals who examined or interviewed the respondent or otherwise
participated in the evaluation; and
(l) Any dissenting opinions or other comments by the evaluators.
(5) The evaluation report may be compiled by a community center for mental health or individuals with an
intellectual disability, a licensed facility for mentally ill or developmentally disabled persons, if the respondent
is a resident of such facility, or a similar agency.
(6) In all cases where the respondent is a resident of a licensed facility for mentally ill or developmentally disabled
persons and the petition is filed by an employee of that facility, the petition shall be accompanied by an
interdisciplinary evaluation report prepared by the facility.
(7) Except as provided in subsection (6) of this section, the court shall order appropriate evaluations to be
performed by qualified persons or a qualified agency. The report shall be prepared and filed with the court and
copies mailed to the attorneys for both parties at least ten (10) days prior to the hearing. All items specified in
subsection (4) of this section shall be included in the report.
(8) If the person evaluated is a poor person as defined in KRS 453.190, the examiners shall be paid by the county
in which the petition is filed upon an order of allowance entered by the court. Payment shall be in an amount
which is reasonable as determined by the court, except no payment shall be required of the county for an
evaluation performed by a salaried employee of a state agency for an evaluation performed within the course
of his employment. Additionally, no payment shall be required of the county for an evaluation performed by a
salaried employee of a community center for mental health or individuals with an intellectual disability or
private facility or agency where the costs incurred by the center, facility, or agency are reimbursable through
third-party payors. Affidavits or other competent evidence shall be admissible to prove the services rendered
but not to prove their value.
(9) The respondent may file a response to the evaluation report no later than five (5) days prior to the hearing.
(10) The respondent may secure an independent evaluation. If the respondent is unable to pay for the evaluation,
compensation for the independent evaluation may be paid by the county in an amount which is reasonable as
determined by the court.
Signed by Governor April 18, 2024.