reglab/statecodes huggingface dataset:
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.318 - Admission criteria

Current through May 31, 2024
(a) A hospice agency may accept a client for
				  hospice care only if the hospice agency has a reasonable expectation that the
				  hospice agency will adequately meet the client's needs. At the time an
				  individual is accepted for care, or no later than two days after the day when
				  care is initiated, the agency shall obtain written certification that the
				  client has a terminal illness. If written certification cannot be obtained
				  within two days, the agency shall obtain verbal certification within two days,
				  and obtain written certification as follows:
(1) for a volunteer hospice agency, within 21
				  days, from the attending physician;
(2) for a full-service hospice agency, before
				  billing for services, from the physician member of the interdisciplinary team
				  or, if the team does not have a physician member, from the attending physician
				  or another physician.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.319 - Plan of care

Current through May 31, 2024
(a) The interdisciplinary team designated
				  under 7 AAC 12.327 by a full-service
				  hospice agency shall develop and maintain a written plan of care for each
				  client admitted to a hospice program. The agency shall ensure that care
				  provided to a client is in accordance with the plan of care.
(b) The hospice agency shall review each
				  client's plan of care and document each review in the client's clinical record.
				  The agency shall update the plan of care at intervals specified in the plan of
				  care, or more frequently if determined necessary by the
(1) medical director;
(2) attending physician;
(3) advanced practice registered nurse
				  responsible for the client's care; or
(4) interdisciplinary team.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.320 - Advance health care directives; client rights

Current through May 31, 2024
(a) Before
				  initiation of care or services, a hospice agency shall provide each client who
				  is 18 years of age or older, or the client's legal representative, with forms
				  and information regarding
(1) the client's
				  right to make health care decisions, including the right to accept or refuse
				  medical or surgical treatment, and the right to execute an advance health care
				  directive and durable health care power of attorney;
(2) agency policies for implementing the
				  client's right to make health care decisions;
(3) living wills and do-not-resuscitate
				  orders; and
(4) persons who can
				  provide additional information concerning advance health care directives and
				  durable health care powers of attorney.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.321 - Abuse, neglect, and mistreatment

Current through May 31, 2024
(a) A hospice
				  agency shall
(1) develop and implement written
				  policies and procedures that prohibit abuse, neglect, and mistreatment of
				  clients;
(2) document alleged or
				  suspected incidents of abuse, neglect, or mistreatment by an employee,
				  volunteer, or contractor;
(3)
				  investigate alleged or suspected incidents of abuse, neglect, or
				  mistreatment;
(4) take any
				  necessary action to remove the potential for further abuse, neglect, or
				  mistreatment of a client or further misappropriation of a client's
				  property;
(5) document the result
				  of the investigation and the corrective action taken within five days after the
				  agency becomes aware of an incident described in (2) and (3) of this
				  subsection;
(6) submit the
				  documentation prepared under (5) of this subsection to the department;
				  and
(7) assure that an employee,
				  volunteer, or contractor does not obtain a client's power of attorney in
				  violation of
				  AS
				  13.26.358.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.323 - Quality improvement plan

Current through May 31, 2024
(a) A full-service
				  hospice agency shall conduct an ongoing comprehensive self-assessment of the
				  quality and appropriateness of care provided, including inpatient care and care
				  provided under contract. The agency shall document the findings from its
				  self-assessment and use them to correct identified problems and to revise
				  hospice policies as necessary.
(b)
				  A full-service hospice agency shall establish a quality improvement plan for
				  continually
(1) monitoring and evaluating
				  care provided;
(2) identifying
				  existing and potential issues; and
(3) proposing and implementing improvements,
				  and reevaluating care provided to determine if further improvement is possible
				  or necessary.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.325 - Governing body

Current through May 31, 2024
A hospice agency must have a governing body that assumes
					 full legal responsibility for determining, implementing, and monitoring the
					 policies that govern operation of the hospice. In addition to meeting the
					 applicable requirements of
					 7 AAC 12.630, the governing body shall
(1) adopt, and revise as necessary, written
				  bylaws that provide for the
(A) election or
				  appointment of officers and committees;
(B) appointment of a local advisory board of
				  individuals who reside in the service area, if the governing body is outside
				  the state; and
(C) establishment of
				  the frequency of meetings;
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.326 - Professional advisory committee

Current through May 31, 2024
(a) The governing
				  body of a full-service hospice agency shall appoint a professional advisory
				  committee. The committee shall meet at least twice each year to advise and
				  monitor the agency and shall report its findings in writing to the governing
				  body. The committee must consist of
(1) the
				  program director;
(2) a physician
				  or advanced practice registered nurse;
(3) a registered nurse;
(4) a member of the public who resides in the
				  agency's service area and who is not an owner or employee of the agency;
				  and
(5) at least one representative
				  from one of the client care services provided by the agency.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.327 - Interdisciplinary team

Current through May 31, 2024
(a) A full-service hospice agency shall
				  designate an interdisciplinary team composed of individuals who provide or
				  supervise the care and services offered by the agency. The interdisciplinary
				  team must include at least a
(1)
				  physician;
(2) registered
				  nurse;
(3) social worker described
				  in 7 AAC 12.335 and
				  7 AAC 12.700;
(4) pastoral or other spiritual counselor;
				  and
(5) volunteer coordinator or
				  representative, if applicable.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.329 - Administration

Current through May 31, 2024
(a) A full-service hospice agency shall
				  maintain administrative control over the services provided by the agency. The
				  agency may not delegate administrative and supervisory functions to another
				  agency, individual, or organization. The hospice agency shall describe in
				  writing
(1) the services provided by the
				  agency;
(2) the services provided
				  by contract or another arrangement; and
(3) the lines of authority for the delegation
				  of responsibility to the client care level.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.331 - Professional management

Current through May 31, 2024
(a) A full-service
				  hospice agency shall have a physician or advanced practice registered nurse to
				  serve as medical director and assume overall responsibility for each client's
				  care program. The medical director shall be a member of and oversee the
				  interdisciplinary team and the professional advisory committee. The medical
				  director's duties include verifying that certification of terminal illness has
				  been issued in accordance with
				  7 AAC 12.318(a)(2).
(b) The program director shall designate a
				  registered nurse to serve as the nurse coordinator. The nurse coordinator shall
(1) supervise the agency's employees and
				  contracted staff;
(2) be available
				  at all times for consultation during regular office hours or have a qualified
				  designee if the nurse coordinator is on leave status or otherwise unavailable
				  to the agency;
(3) ensure that the
				  agency has sufficient staff to meet patient needs;
(4) be responsible for the development of
				  nursing objectives, policies, and procedures consistent with hospice
				  philosophy;
(5) establish staffing
				  and on-call schedules for nursing staff to ensure the availability of nursing
				  services 24 hours a day, seven days a week; and
(6) participate in the developing job
				  descriptions and making employment decisions affecting hospice personnel who
				  provide direct services.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.333 - Hospice home health aide services

Current through May 31, 2024
(a) A full-service
				  hospice agency may provide home health aide services. If the agency provides
				  home health aide services, those services must be provided
(1) by a nurse aide with a current
				  certification under
				  AS
				  08.68.331;
(2) in accordance with the plan of care;
				  and
(3) in accordance with written
				  instructions
(A) prepared by a registered
				  nurse providing services under
				  7 AAC 12.331; and
(B) that specify each task to be completed
				  during a home visit.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.334 - Physical therapy services

Current through May 31, 2024
A full-service hospice agency may provide physical therapy
					 services. If the agency provides physical therapy services, the agency shall
					 ensure that
(1) the physical therapist
				  and any physical therapist assistant meet the requirements of
				  7 AAC 12.690; and
(2) in fulfilling supervisory duties required
				  under 7 AAC 12.690, the physical
				  therapist makes supervisory visits to the client's residence at least every two
				  weeks to
(A) evaluate the effectiveness of the
				  services furnished by any physical therapy assistant; and
(B) document the client's condition in the
				  clinical record.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.335 - Social work services

Current through May 31, 2024
(a) A full-service hospice agency shall
				  provide social work services required by
				  7 AAC 12.316(a) (3)
(1) under the direction of a physician or
				  advanced practice registered nurse; and
(2) by a social worker who
(A) has a master's degree from a social work
				  curriculum accredited by the Council on Social Work Education; and
(B) is licensed as a clinical social worker
				  or a master social worker under AS 08.95.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.336 - Volunteer services

Current through May 31, 2024
(a) A hospice agency shall ensure that each
				  volunteer provides care and services in accordance with the client's plan of
				  care, and under the supervision of a designated hospice employee.
(b) The agency shall develop and maintain
				  policies and procedures that address the following with respect to volunteers
				  in the program:
(1) recruitment, retention,
				  and dismissal;
(2)
				  screening;
(3)
				  orientation;
(4) scope of
				  function;
(5)
				  supervision;
(6) ongoing training
				  and support;
(7) team
				  conferencing;
(8) records of
				  volunteer activities;
(9)
				  bereavement services.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.337 - Counseling services

Current through May 31, 2024
(a) A full-service hospice agency shall
				  develop an organized program to provide spiritual, emotional, bereavement, and
				  other counseling services under the supervision of a qualified professional.
				  Counseling services may include the provision of written material, social
				  reorientation, and group support.
(b) While the client is receiving hospice
				  care, a full-service hospice agency shall make available spiritual, emotional,
				  and other counseling services to the client and to the client's family as
				  reasonable and necessary for palliative care and management of terminal illness
				  and related conditions.
(c) A
				  full-service hospice agency shall make available bereavement counseling to
				  assist the client's family and caregivers in coping with grief experienced
				  after the client's death.
(d) Any
				  spiritual counseling, if desired by the client or the client's family, must be
				  provided by a pastoral or spiritual counselor recognized by the governing body
				  to be capable of providing spiritual, religious, and emotional support to the
				  client and, as necessary, the client's family. The hospice agency may not
				  request or require the client or the client's family to accept any value or
				  belief system. The pastoral or spiritual counselor shall
(1) regularly reassess the spiritual needs of
				  the client and the client's family related to the changing status of the
				  client's terminal condition;
(2)
				  support and assist the client, the client's family, or both;
(3) develop and maintain contact, subject to
				  the client's approval, with the client's identified religious representative;
				  and
(4) be a member of the
				  interdisciplinary team.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.338 - Hiring, orientation, and training

Current through May 31, 2024
(a) A full-service
				  or volunteer hospice agency shall require each volunteer and each direct
				  service provider
(1) to submit a written
				  application;
(2) to undergo a
				  screening interview and an interview after training;
(3) to receive the orientation and training
				  required
(A) under (b), (c), and (k) of this
				  section, if a volunteer; and
(B)
				  under (b) - (k) of this section, if a direct service provider;
(4) to submit a confidentiality
				  statement, signed by the volunteer or direct service provider, in which the
				  volunteer or direct service provider agrees to follow the program's policy
				  regarding confidentiality; and
(5)
				  if the volunteer or direct service provider will transport individuals, to
				  provide proof of
(A) the motor vehicle
				  liability insurance required under
				  AS
				  28.22.019; and
(B) a valid driver's license issued by this
				  state.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.339 - Clinical and administrative records

Current through May 31, 2024
(a) A hospice
				  agency shall establish and maintain a clinical record for each client receiving
				  care and services. The record must provide for identification, security,
				  confidentiality, control, retrieval, and preservation of client care data and
				  information. Each clinical record must be a comprehensive compilation of
				  information. The agency shall ensure that entries are
(1) made for all services provided, whether
				  furnished directly by or indirectly through the agency; and
(2) made and signed by the staff providing
				  the services.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.340 - Employee health

Current through May 31, 2024
A hospice agency shall have an employee health program
					 that meets the requirements of
					 7 AAC 12.650. The agency shall require contractors and
					 volunteers performing patient care or services for the agency to meet the
					 requirements of
					 7 AAC 12.650.
Authority:
AS
						18.05.040
AS 47.32.010
AS
						47.32.030
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.341 - Infection control

Current through May 31, 2024
A hospice agency shall develop and implement written
					 policies and procedures applicable to all agency staff that
(1) minimize the risk of transmitting
				  infection in all client care or services; and
(2) provide for the safe handling and
				  disposal of pathological, biohazardous, or infectious materials.
Authority:
AS
						47.32.010
AS
						47.32.030
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.342 - Central supply; medical supplies and appliances

Current through May 31, 2024
(a) A full-service
				  hospice agency is subject to this section unless the agency provides inpatient
				  care on agency premises. An agency that provides inpatient care on agency
				  premises shall comply with
				  7 AAC 12.730. A hospice agency that is subject to this
				  section shall maintain a separate area for the
(1) storage of sterile supplies and materials
				  to protect those supplies and materials from contamination; and
(2) cleaning, disinfection, or sterilizing,
				  as appropriate under (b) of this section.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.343 - Pharmaceutical hospice services

Current through May 31, 2024
(a) A full-service
				  hospice agency is subject to this section unless the agency provides inpatient
				  care on agency premises. An agency that provides inpatient care on agency
				  premises shall comply with
				  7 AAC 12.680. A hospice agency that is subject to this
				  section shall develop policies and procedures for the dispensing and
				  administering of drugs and biologicals related to hospice treatment. Whether
				  drugs and biologicals are obtained from a pharmacist or are stocked by the
				  agency, the agency is responsible for ensuring that
(1) drugs and biologicals are provided as
				  needed for its clients for palliative care and the management of the terminal
				  illness and related conditions; and
(2) pharmaceutical services are provided in
				  accordance with the client's plan of care, the agency's written policies and
				  procedures, and applicable federal, state, and municipal statutes, ordinances,
				  and regulations, including AS 08.68, AS 08.80, 12 AAC 44, and 12 AAC
				  52.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.344 - Contracts

Current through May 31, 2024
If a hospice agency contracts with another entity or agent
					 to perform services for or provide resources to the agency, the agency shall
					 monitor and control those services and resources. In addition to meeting the
					 requirements of
					 7 AAC 12.910, the agency shall ensure that the
					 contract
(1) provides that clients are
				  accepted for care or services only by the contracting agency;
(2) requires the contractor to conform to all
				  applicable agency policies, including personnel qualifications;
(3) delineates the role of the hospice and of
				  the contractor in the admission process, patient and family assessment, and the
				  interdisciplinary team care conferences;
(4) specifies the contractor's responsibility
				  for participating in developing a plan of care; this paragraph does not apply
				  to a volunteer hospice agency;
(5)
				  specifies that the contracted services may be provided only with the express
				  authorization of the agency;
(6)
				  specifies the manner in which the agency will control, coordinate, and evaluate
				  the care or services; and
(7)
				  identifies the procedures for payment for services furnished under the
				  contract.
Authority:
AS
						47.32.010
AS
						47.32.030
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 7 - Hospice Agencies › 7 AAC 12.349 - Definitions

Current through May 31, 2024
In
					 7 AAC 12.310 - 7 AAC 12.349, unless the context requires
					 otherwise,
(1) "advance health care
				  directive" means an instruction described in AS 13.52 regarding the provision
				  or nonprovision of health care;
(2)
				  "agency" means hospice agency;
(3)
				  "bereavement counseling" means emotional support services to assist a client's
				  family or caregivers in coping with the client's death;
(4) "client" means an individual with a
				  terminal illness who has been accepted to receive hospice care;
(5) "direct service" means service provided
				  directly to a client receiving services in a hospice program;
(6) "employee" means a paid staff person
				  designated by the hospice agency to provide services to a client or the
				  client's family under the direction of the plan of care for the client;
				  "employee" includes an individual providing services to the client or the
				  client's family under contract with the hospice agency;
(7) "family" means
(A) individuals related to a client by blood,
				  marriage, or court decree; and
(B)
				  one or more individuals who have a significant personal relationship with a
				  client and who have been designated, by mutual agreement between each
				  individual and the client, as members of the client's family;
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 8 - Ambulatory Surgical Centers › 7 AAC 12.350 - Scope

Current through May 31, 2024
A facility that is not a part of a hospital, nor part of a
					 physician's general medical practice, and that operates primarily for the
					 purpose of providing surgical services to patients who do not require
					 hospitalization is an ambulatory surgical center and must comply with 7 AAC 12.350 - 7 AAC 12.370.
Authority:
AS
						18.05.040
AS 47.32.010
AS
						47.32.030
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 8 - Ambulatory Surgical Centers › 7 AAC 12.352 - Medical staff

Current through May 31, 2024
The ambulatory surgical center medical staff shall
(1) recommend to the governing body the
				  appointment of and the medical and surgical privileges for each member of the
				  medical staff annually, or if approved by the governing body,
				  biennially;
(2) ensure that each
				  patient is under the care of a credentialed medical practitioner;
(3) require that an order relating to patient
				  care from a credentialed medical practitioner acting within the scope of the
				  practitioner's license, including a telephonic or other oral order, be
				  transcribed by date and time and be initialed or signed by the credentialed
				  medical practitioner or by another credentialed medical practitioner
				  responsible for the care of the patient, even if the order did not originate
				  with the other practitioner;
(4)
				  establish procedures for circumstances in which consultation is
				  required;
(5) establish standards of
				  care by residents, interns, and medical students in accordance with a residency
				  training program approved by the Council on Medical Education of the American
				  Medical Association, the American Dental Association, or an applicable
				  specialty board;
(6) review at
				  regular intervals, but not less than once every three months, clinical and
				  scientific work, medical services, and maintenance of accurate medical
				  records;
(7) establish guidelines
				  for referral to a pathologist of anatomical parts, foreign objects, and tissues
				  removed by surgery;
(8) establish
				  procedures for supervision of advanced practice registered nurses and physician
				  assistants; and
(9) ensure that
				  patient admission, assessment, and discharge meet the requirements of
				  42 C.F.R.
				  416.52, revised November 29, 2019 and adopted
				  by reference.
Authority:
AS
						18.05.040
AS 47.32.010
AS
						47.32.030
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 8 - Ambulatory Surgical Centers › 7 AAC 12.355 - Services required

Current through May 31, 2024
An ambulatory surgical facility shall provide the following
					 services:
(1) surgical services that
				  meet the following requirements:
(A) a
				  registered nurse with knowledge and experience in surgical techniques and
				  procedures shall have supervisory responsibility for the surgical suite and, in
				  cooperation with the surgical committee of the medical staff and the infection
				  control committee, establish policies and procedures for the surgical
				  service;
(B) a list of which
				  surgical privileges are held by individual members of the medical staff must be
				  available in the surgical suite for reference by the supervisor;
(C) before a surgical procedure begins,
				  either the surgeon or the person responsible for administering anesthesia, and
				  the surgical supervisor or the supervisor's designee shall
(i) confirm the patient's identity and the
				  site and side of the body to be operated upon; and
(ii) except in the event of an emergency,
				  ensure that the patient's medical record contains pre-surgical assessments that
				  meet the requirements of 42
				  C.F.R. 416.52(a), adopted by
				  reference in 7 AAC 12.352(9), and a signed statement of informed consent for
				  the surgery;
(D) a daily
				  register of operations must be maintained;
(E) as determined by medical staff under 7 AAC 12.352(7), anatomical parts, foreign objects, and tissues that have been
				  removed by surgery shall be referred to a pathologist designated by the
				  ambulatory surgical center; a report of the pathologist's findings must be
				  filed in the patient's medical record;
(F) a registered nurse shall be present as a
				  circulating nurse during each surgical procedure;
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 8 - Ambulatory Surgical Centers › 7 AAC 12.360 - Emergency equipment, treatment and requirements

Current through May 31, 2024
(a) The following
				  emergency equipment must be available in the operating rooms:
(1) an emergency call system;
(2) equipment for the delivery of
				  oxygen;
(3) mechanical ventilatory
				  assistance equipment, including airways in a range of sizes, and a manual
				  breathing bag;
(4) a cardiac
				  defibrillator;
(5) cardiac
				  monitoring equipment;
(6) a
				  tracheotomy set;
(7) laryngoscopes
				  and endotracheal tubes in a range of sizes;
(8) suction equipment; and
(9) emergency drugs and supplies determined
				  by the medical staff.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 8 - Ambulatory Surgical Centers › 7 AAC 12.365 - Obstetrical care

Current through May 31, 2024
An ambulatory surgical center that provides labor and
					 delivery services shall provide a separate and individual suite for those
					 services.
Authority:
AS
						18.50.040
AS 47.32.010
AS
						47.32.030
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 8 - Ambulatory Surgical Centers › 7 AAC 12.370 - Abortions

Current through May 31, 2024
An ambulatory surgical facility may perform a voluntary
					 termination of pregnancy if
(1) it
				  receives written authorization from a competent patient, or, if a patient is
				  not competent, from the patient's legal representative;
(2) it has evidence of a verified pregnancy
				  test;
(3) the pregnancy has not
				  exceeded the first trimester of approximately three months or less;
(4) it has conducted a Papanicolaou (PAP)
				  test, a blood-type and Rh factor test and an antibody screening, except that
				  the PAP test is not required if the patient has had one within the past six
				  months; and
(5) it performs a
				  cross-match of Rh immune globulin and provides Rh immune globulin therapy for
				  Rh negative patients.
Authority:
AS
						18.05.040
AS
						18.16.010
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.400 - Licensure (Repealed)

Current through May 31, 2024
The substance of this regulation was revised and
						reorganized as part of a comprehensive revision of this chapter, effective
						11/19/83, Register 88, and appears in
						7 AAC 12.610. The history note at the end of that
						section does not reflect the history of this
						section.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.401 - Determination of a free-standing birth center; scope of services

Current through May 31, 2024
(a) Subject to (b)
				  of this section, the department will consider an entity to be a free-standing
				  birth center if the entity
(1) is a publicly
				  or privately owned facility, place, or institution that is constructed,
				  renovated, leased, rented, or otherwise established;
(2) is a place
(A) where midwifery services are
				  provided;
(B) that is physically
				  separate from acute care obstetrical services;
(C) that is administratively autonomous from
				  a hospital or other health facility; and
(D) that has a separate and required staff,
				  including administrative staff;
(3) is located within 20 miles by road from a
				  hospital that provides the services required under
				  7 AAC 12.405(g); and
(4) provides planned, nonemergency midwifery
				  services for low-risk maternal clients
(A)
				  away from the client's residence; a birth center may not offer or provide labor
				  or delivery services at a location other than its licensed premises;
(B) after a documented period of prenatal
				  care for a normal, uncomplicated pregnancy that is determined to be low-risk
				  through physical examinations, and through risk assessments conducted in
				  accordance with the standards developed under
				  7 AAC 12.403(f); and
(C) who do not require
				  hospitalization.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.402 - Penalties (Repealed)

Current through May 31, 2024
The substance of this regulation was revised and
						reorganized as part of a comprehensive revision of this chapter, effective
						11/19/83, Register 88, and appears in
						7 AAC 12.620. The history note at the end of that
						section does not reflect the history of this
						section.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.403 - General service requirements; restrictions

Current through May 31, 2024
(a) A birth center
				  may provide midwifery services only to a woman who is a low-risk maternal
				  client under
				  7 AAC 12.446.
(b) If the midwife providing midwifery
				  services in a birth center is a
(1)
				  direct-entry midwife, the birth center shall ensure that the direct-entry
				  midwife provides midwifery services in accordance with the requirements of AS
				  08.65 and 12 AAC 14, and within the scope of practice set out under AS 08.65
				  and 12 AAC 14; and
(2) certified
				  nurse midwife, the birth center shall ensure that the certified nurse midwife
				  provides midwifery services in accordance with the requirements of AS 08.68 and
				  12 AAC 44, and within the scope of practice set out under AS 08.68 and 12 AAC
				  44.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.404 - Application

Current through May 31, 2024
Before providing services, a free-standing birth center
					 must have a current license issued under
					 7 AAC 12.605 -
					 7 AAC 12.610. In addition to meeting the requirements of
					 7 AAC 12.605 -
					 7 AAC 12.610, the applicant shall provide the following
					 information with the initial application for a license, and with each
					 application for renewal:
(1)
				  identification of the proposed service area;
(2) an assessment of the demographic data and
				  vital statistics of the community served, including
(A) the population to be served;
(B) environmental factors that might affect
				  access to the birth center or transfer to a hospital;
(C) availability of and access to maternal
				  and newborn services, including
(i)
				  practitioners;
(ii) hospital
				  obstetrics and newborn services;
(iii) home birth services;
(iv) family-centered maternity care
				  programs;
(v) birth rooms and
				  suites;
(vi) clinics for
				  disadvantaged families;
(vii)
				  laboratory services;
(viii)
				  supplementary social and welfare services;
(ix) childbirth education; and
(x) parent support programs;
(D) the birth center's impact on
				  the community and the needs of childbearing families in the population served;
				  and
(E) for an application for
				  license renewal,
(i) changes in the
				  demographic data and vital statistics under (A) - (C) of this paragraph since
				  the previous application was submitted;
(ii) the number of births at the birth center
				  during the previous 12 months;
(iii) the number of births with complications
				  that required transfer of the newborn to a hospital during the previous 12
				  months; and
(iv) the number of
				  births with complications that required transfer of the client to a hospital
				  during the previous 12 months.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.405 - Administration

Current through May 31, 2024
(a) A birth center must have a governing body
				  that is responsible for the overall operation and maintenance of the birth
				  center, including personnel, facilities, equipment, and supplies. The birth
				  center shall
(1) ensure that its governing
				  body includes one or more individuals who reside in the service area;
				  or
(2) establish a mechanism for an
				  advisory committee comprised of representatives of the public and private
				  sector to advise the birth center regarding the quality of services provided by
				  the birth center.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.410 - Personnel (Repealed)

Current through May 31, 2024
The substance of this regulation was revised and
						reorganized as part of a comprehensive revision of this chapter, effective
						11/19/83, Register 88, and appears in
						7 AAC 12.650 and
						7 AAC 12.660. The history notes at the end of those
						sections do not reflect the history of this
						section.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.415 - Clinical staff and support staff

Current through May 31, 2024
(a) In addition to
				  meeting the requirements of
				  7 AAC 12.660, a birth center shall ensure that
				  sufficient, qualified clinical staff and support staff are on duty and on call
				  for the routine delivery of services needed by clients and newborns, and for
				  the safe maintenance and operation of the birth center. The birth center shall
				  assure client and newborn safety, including during any period of high demand or
				  emergency, and shall assure that each client who is in active labor is attended
				  as required under (e) of this section. The birth center shall
(1) post a schedule listing available
				  clinical staff and consulting specialists who may be contacted if
				  necessary;
(2) ensure that written
				  personnel policies are available to personnel; these policies must include at
				  least the following:
(A) conditions of
				  employment;
(B) the respective
				  obligations of employer and employee;
(C) grievance procedures;
(3) provide for training,
				  education, and development of the clinical staff and support staff, including
				  at least the following:
(A) orientation of
				  new staff members, including policies and procedures, infection control, fire
				  safety, and the proper use of equipment used to care for clients and newborns
				  in the birth center;
(B) a
				  reference library of current, relevant materials;
(C) an in-service education program to
				  maintain currency in relevant knowledge and skills, including skills that are
				  used infrequently in birth center practice;
(D) participation in continuing professional
				  education programs, or information to assist the staff in participating in
				  professional education programs provided elsewhere;
(E) involvement in activities of professional
				  organizations;
(F) the annual
				  training required under
				  7 AAC 12.860(4);
(G) the training required under
				  7 AAC 12.416(b).
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.418 - Evaluation and improvement of quality of care

Current through May 31, 2024
(a) The birth
				  center shall develop and implement a program for evaluating and improving the
				  quality of
(1) direct care services to
				  childbearing families; and
(2) the
				  environment in which services are provided.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.420 - Drugs and biologicals

Current through May 31, 2024
(a) A birth center must have and observe
				  written policies and procedures for
(1)
				  receiving, transcribing, and implementing orders for the administration of
				  drugs;
(2) labeling of every drug,
				  medication, and chemical in the center with its name, strength, and expiration
				  date; and
(3) ensuring that a
				  midwife who administers medications and intravenous solutions does so only as
				  authorized under
(A) AS 08.68 and 12 AAC 44,
				  if the midwife is a certified nurse midwife; and
(B) AS 08.65 and 12 AAC 14, if the midwife is
				  a direct-entry midwife.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.425 - Medical records

Current through May 31, 2024
(a) A birth center shall keep records for all
				  clients admitted. Originals, or accurate reproductions of the contents of the
				  originals, of all records, including x-rays, must be maintained in a form that
				  is legible and uniform, contains complete and accurate client and newborn
				  information, and fully describes continuity of care. The birth center shall
				  ensure that these records are readily available upon the request of the
				  physician, consulting physician, midwife, or the department or, upon the
				  client's written request, to other practitioners. The birth center shall
				  maintain each record in a system that protects confidentiality of the
				  information contained in its records, that provides for proper storage, easy
				  retrieval, and prevention of loss, and that protects against the use or
				  disclosure of protected health information except as required or permitted by
				   45 C.F.R. Part 160, subpart C, and  45 C.F.R. Part 164, subpart E, adopted by
				  reference in
				  7 AAC 12.770(d). The birth center shall
				  develop, for use by the clinical staff, a form for providing information
				  necessary for a transfer of a client or newborn to a hospital. The birth center
				  shall ensure that a copy of the prenatal record is available before and during
				  labor. The birth center shall ensure that a copy of the complete record for a
				  client or newborn is provided at the time of any transfer or
				  referral.
(b) Each medical record
				  must include
(1) an identification sheet that
				  includes
(A) the client's
(i) name;
(ii) medical record number;
(iii) address on admission;
(iv) date of birth; and
(v) marital status;
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.430 - Equipment and supplies

Current through May 31, 2024
(a) A birth center shall ensure that
				  sufficient supplies and equipment are maintained in a convenient area and
				  immediately available for the care of maternal clients and newborns. Supplies
				  and equipment must include
(1) an emergency
				  cart or tray for the client that
(A) is
				  equipped to assist the staff in carrying out the birth center's written
				  emergency procedures;
(B) is kept
				  secure from unauthorized access;
(C) is readily accessible in an emergency;
				  and
(D) includes a written log of
				  routine maintenance for readiness;
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.435 - Physical environment

Current through May 31, 2024
(a) A birth center must have at least one
				  birth room that is adequate to provide for the equipment, staff, supplies, and
				  emergency procedures required for the physical and emotional care of a client,
				  her support person, and the newborn during birth, labor, and the recovery
				  period. A birth room must
(1) be located so
				  as to provide unimpeded, rapid access to an exit of the building that opens to
				  an area that will accommodate an emergency transportation vehicle;
(2) have a minimum room area, exclusive of a
				  toilet room, closet, locker, wardrobe, alcove, or vestibule, of 100 square feet
				  in a single-bed room, and 80 square feet for each bed in a multi-bed
				  room;
(3) have adequate fixed or
				  portable work surface areas; and
(4) have a toilet and lavatory in its
				  vicinity.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.437 - Physical plant

Current through May 31, 2024
(a) Any renovation, expansion, or new
				  construction must comply with
(1) the
				  requirements of
Guidelines for Design and Construction of Hospital and
				  Health Care Facilities
, American Institute of Architects, 2001
				  edition, secs. 1 - 6 and sec. 9, adopted by reference;
(2)7 AAC 09.010 -
				  7 AAC 09.170;
(3)AS
				  18.60.580-18.60.660; and
(4)AS
				  18.60.705-18.60.740.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.440 - Applicable federal, state, and local laws and regulations (Repealed)

Current through May 31, 2024
The substance of this regulation was revised and
						reorganized as part of a comprehensive revision of this chapter, effective
						11/19/83, Register 88, and appears in
						7 AAC 12.920. The history note at the end of that
						section does not reflect the history of this
						section.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.445 - Definitions (Repealed)

Current through May 31, 2024
The substance of this regulation was revised and
						reorganized as part of a comprehensive revision of this chapter, effective
						11/19/83, Register 88, and appears in
						7 AAC 12.446 and
						7 AAC 12.990. The history note at the end of those
						sections does not reflect the history of this
						section.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 1 - Administration › Chapter 12 - Facilities and Local Units › Article 9 - Free-standing Birth Centers › 7 AAC 12.446 - Determination of low-risk maternal client

Current through May 31, 2024
For purposes of
					 7 AAC 12.401 -
					 7 AAC 12.449, the department will consider a woman who
					 seeks the services of a free-standing birth center to be a low-risk maternal
					 client if, based on physical examinations and risk assessments conducted in
					 accordance with the standards developed under
					 7 AAC 12.403(f), the woman
(1) is in general good health with
				  uncomplicated prenatal care;
(2) is
				  16 years of age or older;
(3) has
				  documented evidence of ongoing prenatal care or meets the requirements of
				  7 AAC 12.403(h) (1) - (3);
(4) has no major medical problems;
(5) has no previous significant obstetrical
				  complications that are likely to recur;
(6) has gestation that is
(A) greater than or equal to 37 weeks at the
				  onset of labor; and
(B) less than
				  or equal to 42 weeks;