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AN ACT relating to sexual assault emergency response training. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 216B.400 is amended to read as follows: 3
(1) Where a person has been determined to be in need of emergency care by any person 4
with admitting authority, the person shall not be denied admission by reason only of 5
his or her inability to pay for services to be rendered by the hospital. 6
(2) A[Every] hospital that[of this state which] offers emergency services shall provide 7
that a physician, a sexual assault nurse examiner, who shall be a registered nurse 8
licensed in the Commonwealth and credentialed by the Kentucky Board of Nursing 9
as provided under KRS 314.142, or another qualified medical professional, as 10
defined by administrative regulation promulgated by the Justice and Public Safety 11
Cabinet in consultation with the Sexual Assault Response Team Advisory 12
Committee as defined in KRS 403.707, is available on call twenty-four (24) hours 13
each day for the examinations of persons seeking treatment as victims of sexual 14
offenses as defined by KRS 510.040, 510.050, 510.060, 510.070, 510.080, 510.090, 15
510.110, 510.120, 510.130, 510.140, 530.020, 530.064(1)(a), and 531.310. 16
(3) (a) A hospital that offers emergency services shall provide mandatory training 17
for all emergency medical services staff on sexual assault emergency 18
response requirements, protocols, and resources. 19
(b) The training curriculum shall be developed in collaboration with the 20
members of the Sexual Assault Response Team Advisory Committee 21
appointed pursuant to Section 3 of this Act and shall include but not be 22
limited to the following: 23
1. Instruction on the provisions of: 24
a. KRS 49.270 to 49.490 relating to crime victims' compensation 25
coverage and reimbursement and any related administrative 26
regulations promulgated by the Public Protection Cabinet; 27 UNOFFICIAL COPY 25 RS BR 1170
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b. KRS 214.185 relating to the diagnosis and treatment of disease, 1
addictions, or other conditions of a minor; 2
c. KRS 216B.015 relating to the definition of a sexual assault 3
examination facility; 4
d. KRS 216B.140 relating to medical and diagnostic services for 5
minor victims of sexual violence; 6
e. This section relating to hospital duties to victims of sexual 7
violence and victims' rights and related administrative 8
regulations promulgated by the Cabinet for Health and Family 9
Services; 10
f. KRS 216B.401 relating to SANE-ready hospitals that have 11
sexual assault nurse examiner available on call twenty-four (24) 12
hours a day; 13
g. Administrative regulations promulgated by the Justice and 14
Public Safety Cabinet relating to protocols for sexual assault 15
forensic exams and storage of sexual assault forensic exam kits; 16
and 17
h. Administrative regulations promulgated by the Kentucky Board 18
of Nursing relating to sexual assault nurse examiner 19
credentialing and standards; 20
2. An overview of: 21
a. The Kentucky Medical Protocol for Child Sexual Assault/Abuse 22
Evaluation; 23
b. Resources related to sexual assault available from the Kentucky 24
Hospital Association; and 25
c. The Kentucky State Police sexual assault forensic examination 26
(SAFE) kit tracking portal; and 27 UNOFFICIAL COPY 25 RS BR 1170
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3. Instruction on: 1
a. Forensic evidence collection provided by a credentialed sexual 2
assault nurse examiner; and 3
b. Services provided by a rape crisis center. 4
(4) An examination provided in accordance with this section of a victim of a sexual 5
offense may be performed in a sexual assault examination facility as defined in 6
KRS 216B.015. An examination under this section shall apply only to an 7
examination of a victim. 8
(5)[(4)] The physician, sexual assault nurse examiner, or other qualified medical 9
professional, acting under a statewide medical forensic protocol which shall be 10
developed by the Justice and Public Safety Cabinet in consultation with the Sexual 11
Assault Response Team Advisory Committee as defined in KRS 403.707, and 12
promulgated by the secretary of justice and public safety pursuant to KRS Chapter 13
13A shall, upon the request of any peace officer or prosecuting attorney, and with 14
the consent of the victim, or upon the request of the victim, examine the victim for 15
the purposes of providing basic medical care relating to the incident and gathering 16
samples that may be used as physical evidence. This examination shall include but 17
not be limited to: 18
(a) Basic treatment and sample gathering services; and 19
(b) Laboratory tests, as appropriate. 20
(6)[(5)] Each victim shall be informed of available services for treatment of sexually 21
transmitted infections, pregnancy, and other medical and psychiatric problems. 22
Pregnancy counseling shall not include abortion counseling or referral information. 23
(7)[(6)] Each victim shall be informed of available crisis intervention or other mental 24
health services provided by regional rape crisis centers providing services to 25
victims of sexual assault. 26
(8)[(7)] Notwithstanding any other provision of law, a minor may consent to 27 UNOFFICIAL COPY 25 RS BR 1170
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examination under this section. This consent is not subject to disaffirmance because 1
of minority, and consent of the parents or guardians of the minor is not required for 2
the examination. 3
(9)[(8)] (a) The examinations provided in accordance with this section and other 4
services provided to a victim pursuant to subsection (9) of this section shall be 5
paid for by the Crime Victims Compensation Board at a rate to be determined 6
by the administrative regulation promulgated by the board after consultation 7
with the Sexual Assault Response Team Advisory Committee as defined in 8
KRS 403.707. Payment for services rendered pursuant to subsection (10)[(9)] 9
of this section shall be made at a rate not to exceed the Medicaid 10
reimbursement rate for the same or similar services. 11
(b) Upon receipt of a completed claim form supplied by the board and an 12
itemized billing for a forensic sexual assault examination or related services 13
that are within the scope of practice of the respective provider and were 14
performed no more than twelve (12) months prior to submission of the form, 15
the board shall reimburse the hospital or sexual assault examination facility, 16
pharmacist, health department, physician, sexual assault nurse examiner, or 17
other qualified medical professional as provided in administrative regulations 18
promulgated by the board pursuant to KRS Chapter 13A. Reimbursement 19
shall be made to an out-of-state nurse who is credentialed in the other state to 20
provide sexual assault examinations, an out-of-state hospital, or an out-of-21
state physician if the sexual assault occurred in Kentucky. 22
(c) Independent investigation by the Crime Victims Compensation Board shall 23
not be required for payment of claims under this section; however, the board 24
may require additional documentation or proof that the forensic medical 25
examination was performed. 26
(10)[(9)] When an examination of a victim of a sexual offense is provided in 27 UNOFFICIAL COPY 25 RS BR 1170
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accordance with this section, no charge shall be made to the victim by the hospital, 1
the sexual assault examination facility, the physician, the pharmacist, the health 2
department, the sexual assault nurse examiner, other qualified medical professional, 3
the victim's insurance carrier, or the Commonwealth for: 4
(a) Sexual assault examinations, whether or not the exam is completed; 5
(b) Prophylactic medical treatment; 6
(c) Strangulation assessments; or 7
(d) Other medical tests or services, including triage and ambulance expenses, 8
related to the incident, exam, or treatment which occur on the same date as the 9
original exam. 10
(11)[(10)] (a) Each victim shall have the right to determine whether a report or other 11
notification shall be made to law enforcement, except where reporting of 12
abuse and neglect of a child or a vulnerable adult is required, as set forth in 13
KRS 209.030 and 620.030. No victim shall be denied an examination, or 14
billed in violation of subsection (10)[(9)] of this section, because the victim 15
chooses not to file a police report, cooperate with law enforcement, or 16
otherwise participate in the criminal justice system. 17
(b) If the victim chooses to report to law enforcement, the hospital shall notify 18
law enforcement within twenty-four (24) hours. 19
(c) 1. All samples collected during an exam where the victim has chosen not 20
to immediately report to law enforcement shall be stored, released, and 21
destroyed, if appropriate, in accordance with an administrative 22
regulation promulgated by the Justice and Public Safety Cabinet in 23
consultation with the Sexual Assault Response Team Advisory 24
Committee as defined in KRS 403.707. 25
2. Facilities collecting samples pursuant to this section may provide the 26
required secure storage, sample destruction, and related activities, or 27 UNOFFICIAL COPY 25 RS BR 1170
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may enter into agreements with other agencies qualified to do so, 1
pursuant to administrative regulation. 2
3. All samples collected pursuant to this section shall be stored for at least 3
one (1) year from the date of collection in accordance with the 4
administrative regulation promulgated pursuant to this subsection. 5
4. Notwithstanding KRS 524.140, samples collected during exams where 6
the victim chose not to report immediately or file a report within one (1) 7
year after collection may be destroyed as set forth in accordance with 8
the administrative regulation promulgated pursuant to this subsection. 9
The victim shall be informed of this process at the time of the 10
examination. No hospital, sexual assault examination facility, or 11
designated storage facility shall be liable for destruction of samples after 12
the required storage period has expired. 13
Section 2. KRS 314.011 is amended to read as follows: 14
As used in this chapter, unless the context thereof requires otherwise: 15
(1) "Board" means Kentucky Board of Nursing; 16
(2) "Delegation" means directing a competent person to perform a selected nursing 17
activity or task in a selected situation under the nurse's supervision and pursuant to 18
administrative regulations promulgated by the board in accordance with the 19
provisions of KRS Chapter 13A; 20
(3) "Nurse" means a person who is licensed or holds the privilege to practice under the 21
provisions of this chapter as a registered nurse or as a licensed practical nurse; 22
(4) "Nursing process" means the investigative approach to nursing practice utilizing a 23
method of problem-solving by means of: 24
(a) Nursing diagnosis, a systematic investigation of a health concern, and an 25
analysis of the data collected in order to arrive at an identifiable problem; and 26
(b) Planning, implementation, and evaluation based on nationally accepted 27 UNOFFICIAL COPY 25 RS BR 1170
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standards of nursing practice; 1
(5) "Registered nurse" means one who is licensed or holds the privilege under the 2
provisions of this chapter to engage in registered nursing practice; 3
(6) "Registered nursing practice" means the performance of acts requiring substantial 4
specialized knowledge, judgment, and nursing skill based upon the principles of 5
psychological, biological, physical, and social sciences in the application of the 6
nursing process in: 7
(a) The care, counsel, and health teaching of the ill, injured, or infirm; 8
(b) The maintenance of health or prevention of illness of others; 9
(c) The administration of medication and treatment as prescribed by a physician, 10
physician assistant, dentist, or advanced practice registered nurse and as 11
further authorized or limited by the board, and which are consistent either 12
with American Nurses' Association Scope and Standards of Practice or with 13
standards of practice established by nationally accepted organizations of 14
registered nurses. Components of medication administration include but are 15
not limited to: 16
1. Preparing and giving medications in the prescribed dosage, route, and 17
frequency, including dispensing medications only as defined in 18
subsection (17)(b) of this section; 19
2. Observing, recording, and reporting desired effects, untoward reactions, 20
and side effects of drug therapy; 21
3. Intervening when emergency care is required as a result of drug therapy; 22
4. Recognizing accepted prescribing limits and reporting deviations to the 23
prescribing individual; 24
5. Recognizing drug incompatibilities and reporting interactions or 25
potential interactions to the prescribing individual; and 26
6. Instructing an individual regarding medications; 27 UNOFFICIAL COPY 25 RS BR 1170
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(d) The supervision, teaching of, and delegation to other personnel in the 1
performance of activities relating to nursing care; and 2
(e) The performance of other nursing acts which are authorized or limited by the 3
board, and which are consistent either with American Nurses' Association 4
Standards of Practice or with Standards of Practice established by nationally 5
accepted organizations of registered nurses; 6
(7) "Advanced practice registered nurse" or "APRN" means a certified nurse 7
practitioner, certified registered nurse anesthetist, certified nurse midwife, or 8
clinical nurse specialist, who is licensed to engage in advance practice registered 9
nursing pursuant to KRS 314.042 and certified in at least one (1) population focus; 10
(8) "Advanced practice registered nursing" means the performance of additional acts by 11
registered nurses who have gained advanced clinical knowledge and skills through 12
an accredited education program that prepares the registered nurse for one (1) of the 13
four (4) APRN roles; who are certified by the American Nurses' Association or 14
other nationally established organizations or agencies recognized by the board to 15
certify registered nurses for advanced practice registered nursing as a certified nurse 16
practitioner, certified registered nurse anesthetist, certified nurse midwife, or 17
clinical nurse specialist; and who certified in at least one (1) population focus. The 18
additional acts shall, subject to approval of the board, include but not be limited to 19
prescribing treatment, drugs, devices, and ordering diagnostic tests. Advanced 20
practice registered nurses who engage in these additional acts shall be authorized to 21
issue prescriptions for and dispense nonscheduled legend drugs as defined in KRS 22
217.905 and to issue prescriptions for but not to dispense Schedules II through V 23
controlled substances described in or as classified pursuant to KRS 218A.020, 24
218A.060, 218A.080, 218A.100, and 218A.120 under the conditions set forth in 25
KRS 314.042 and regulations promulgated by the Kentucky Board of Nursing on or 26
before August 15, 2006. 27 UNOFFICIAL COPY 25 RS BR 1170
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(a) 1. Prescriptions issued by advanced practice registered nurses for Schedule 1
II controlled substances classified under KRS 218A.060, except 2
hydrocodone combination products as defined in KRS 218A.010, shall 3
be limited to a seventy-two (72) hour supply without any refill. 4
2. Prescriptions issued by advanced practice registered nurses for 5
hydrocodone combination products as defined in KRS 218A.010 shall 6
be limited to a thirty (30) day supply without any refill. 7
3. Prescriptions issued under this subsection for psychostimulants may be 8
written for a thirty (30) day supply only by an advanced practice 9
registered nurse certified in psychiatric-mental health nursing who is 10
providing services in a health facility as defined in KRS Chapter 216B 11
or in a regional services program for mental health or individuals with 12
an intellectual disability as defined in KRS Chapter 210. 13
(b) Prescriptions issued by advanced practice registered nurses for Schedule III 14
controlled substances classified under KRS 218A.080 shall be limited to a 15
thirty (30) day supply without any refill. Prescriptions issued by advanced 16
practice registered nurses for Schedules IV and V controlled substances 17
classified under KRS 218A.100 and 218A.120 shall be limited to the original 18
prescription and refills not to exceed a six (6) month supply. 19
Nothing in this chapter shall be construed as requiring an advanced practice 20
registered nurse designated by the board as a certified registered nurse anesthetist to 21
obtain prescriptive authority pursuant to this chapter or any other provision of law 22
in order to deliver anesthesia care. The performance of these additional acts shall be 23
consistent with the certifying organization or agencies' scopes and standards of 24
practice recognized by the board by administrative regulation; 25
(9) "Licensed practical nurse" means one who is licensed or holds the privilege under 26
the provisions of this chapter to engage in licensed practical nursing practice; 27 UNOFFICIAL COPY 25 RS BR 1170
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(10) "Licensed practical nursing practice" means the performance of acts requiring 1
knowledge and skill such as are taught or acquired in approved schools for practical 2
nursing in: 3
(a) The observing and caring for the ill, injured, or infirm under the direction of a 4
registered nurse, advanced practice registered nurse, physician assistant, 5
licensed physician, or dentist; 6
(b) The giving of counsel and applying procedures to safeguard life and health, as 7
defined and authorized by the board; 8
(c) The administration of medication or treatment as authorized by a physician, 9
physician assistant, dentist, or advanced practice registered nurse and as 10
further authorized or limited by the board which is consistent with the 11
National Federation of Licensed Practical Nurses or with Standards of 12
Practice established by nationally accepted organizations of licensed practical 13
nurses; 14
(d) Teaching, supervising, and delegating except as limited by the board; and 15
(e) The performance of other nursing acts which are authorized or limited by the 16
board and which are consistent with the National Federation of Practical 17
Nurses' Standards of Practice or with Standards of Practice established by 18
nationally accepted organizations of licensed practical nurses; 19
(11) "School of nursing" means a nursing education program preparing persons for 20
licensure as a registered nurse or a practical nurse; 21
(12) "Continuing education" means offerings beyond the basic nursing program that 22
present specific content planned and evaluated to meet competency based 23
behavioral objectives which develop new skills and upgrade knowledge; 24
(13) "Nursing assistance" means the performance of delegated nursing acts by 25
unlicensed nursing personnel for compensation under supervision of a nurse; 26
(14) "Sexual assault nurse examiner" means a registered nurse who has completed the 27 UNOFFICIAL COPY 25 RS BR 1170
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required education and clinical experience and maintains a current credential from 1
the board as provided under KRS 314.142 to conduct forensic examinations of 2
victims of sexual offenses under the medical protocol issued by the Justice and 3
Public Safety Cabinet in consultation with the Sexual Assault Response Team 4
Advisory Committee pursuant to KRS 216B.400(5)[(4)]; 5
(15) "Competency" means the application of knowledge and skills in the utilization of 6
critical thinking, effective communication, interventions, and caring behaviors 7
consistent with the nurse's practice role within the context of the public's health, 8
safety, and welfare; 9
(16) "Credential" means a current license, registration, certificate, or other similar 10
authorization that is issued by the board; 11
(17) "Dispense" means: 12
(a) To receive and distribute nonscheduled legend drug samples from 13
pharmaceutical manufacturers to patients at no charge to the patient or any 14
other party; or 15
(b) To distribute nonscheduled legend drugs from a local, district, and 16
independent health department, subject to the direction of the appropriate 17
governing board of the individual health department; 18
(18) "Dialysis care" means a process by which dissolved substances are removed from a 19
patient's body by diffusion, osmosis, and convection from one (1) fluid 20
compartment to another across a semipermeable membrane; 21
(19) "Dialysis technician" means a person who is not a nurse, a physician assistant, or a 22
physician and who provides dialysis care in a licensed renal dialysis facility under 23
the direct, on-site supervision of a registered nurse or a physician; 24
(20) "Population focus" means the section of the population within which the advanced 25
practice registered nurse has targeted to practice. The categories of population foci 26
are: 27 UNOFFICIAL COPY 25 RS BR 1170
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(a) Family and individual across the lifespan; 1
(b) Adult gerontology; 2
(c) Neonatal; 3
(d) Pediatrics; 4
(e) Women's health and gender-related health; and 5
(f) Psychiatric mental health; and 6
(21) "Conviction" means but is not limited to: 7
(a) An unvacated adjudication of guilt; 8
(b) Pleading no contest or nolo contendere or entering an Alford plea; or 9
(c) Entering a guilty plea pursuant to a pretrial diversion order; 10
Regardless of whether the penalty is rebated, suspended, or probated. 11
Section 3. KRS 403.707 is amended to read as follows: 12
(1) The Sexual Assault Response Team Advisory Committee is established. 13
(2) The Sexual Assault Response Team Advisory Committee shall be co-chaired by the 14
executive director of the Kentucky Association of Sexual Assault Programs and the 15
commissioner of the Department of Kentucky State Police or the commissioner's 16
designee. 17
(3) The membership of the Sexual Assault Response Team Advisory Committee shall 18
consist of the following: 19
(a) The executive director of the Kentucky Board of Nursing or the executive 20
director's designee; 21
(b) The executive director of the Kentucky Nurses Association or the executive 22
director's designee; 23
(c) The executive director of the Kentucky Hospital Association or the executive 24
director's designee; 25
(d) The executive director of the Kentucky Association of Children's Advocacy 26
Centers; 27 UNOFFICIAL COPY 25 RS BR 1170
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(e) The director of the Department of Kentucky State Police Crime Lab; 1
(f) The commissioner of the Department for Community Based Services or the 2
commissioner's designee; 3
(g) The director of the Office of Victims Advocacy in the Office of the Attorney 4
General or the director's designee; 5
(h) A sexual assault nurse examiner appointed by the secretary of the Cabinet for 6
Health and Family Services; 7
(i) A representative from a sexual assault response team appointed by the 8
executive director of the Kentucky Association of Sexual Assault Programs; 9
(j) A physician appointed by the secretary of the Cabinet for Health and Family 10
Services; and 11
(k) A Commonwealth's attorney or an assistant Commonwealth's attorney 12
appointed by the Attorney General. 13
(4) Members appointed under subsection (3)(h) to (k) of this section shall serve at the 14
pleasure of the appointing authority and shall not serve longer than four (4) years 15
without reappointment. 16
(5) The Sexual Assault Response Team Advisory Committee shall: 17
(a) Serve in an advisory capacity to the Kentucky Board of Nursing in 18
accomplishing the duties set forth under KRS 314.142; 19
(b) Serve in an advisory capacity to the Justice and Public Safety Cabinet in the 20
development of the statewide sexual assault protocol required under KRS 21
216B.400(5)[(4)]; 22
(c) Develop a model protocol for the operation of sexual assault response teams 23
which shall include the roles of sexual assault nurse examiners, physicians, 24
law enforcement, prosecutors, and victim advocates; 25
(d) Provide assistance to each regional rape crisis center, as designated by the 26
Cabinet for Health and Family Services, in establishing a regional sexual 27 UNOFFICIAL COPY 25 RS BR 1170
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assault response team; 1
(e) Develop model policies for law enforcement agencies related to handling 2
sexual assault examination kits and investigating sexual assaults with a 3
victim-centered, evidence-based approach; 4
(f) By January 1, 2018, report to the General Assembly on the results of the 5
analysis of previously untested sexual assault examination kits submitted to 6
the Department of Kentucky State Police forensic laboratory pursuant to 2016 7
Ky. Acts ch. 58, sec. 1, including whether analysis of those kits led to the 8
identification and prosecution of suspects and the cost to society of the 9
offenses committed by the suspects identified; 10
(g) By July 1, 2018, and by each July 1 thereafter, report to the General Assembly 11
and to the secretary of the Justice and Public Safety Cabinet on the number of 12
sexual assaults reported, the number of sexual assault examination kits 13
submitted to the Department of Kentucky State Police forensic laboratory, the 14
number of kits tested, and the number of charges filed and convictions 15
obtained in sexual assault cases in the previous calendar year; 16
(h) Provide information and recommendations concerning the activities of the 17
agency or organization represented by each individual committee member as 18
related to sexual assault issues and programs within the purview of the agency 19
or organization; and 20
(i) Recommend to the appropriate state agency any changes in statute, 21
administrative regulation, training, policy, and budget to promote a 22
multidisciplinary response to sexual assault. 23