Kentucky Administrative Regulations › Title 201 - GENERAL GOVERNMENT CABINET › Chapter 20 - Board of Nursing › Section 201 KAR 20:670 - Licensed certified professional midwives consultation, collaboration, and referral provisions

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				314.400 - 314.414
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				314.131(1) authorizes the
				Board of Nursing to promulgate administrative regulations as may be necessary
				to enable it to carry into effect the provisions of KRS Chapter 314.
				KRS
				314.404(12) requires the
				board to promulgate an administrative regulation to define a list of conditions
				requiring collaboration, consultation, or referral of a client to a physician
				or other appropriate licensed health care provider, and the process for such
				collaboration, consultation, or referral. This administrative regulation
				establishes the process for and the list of conditions requiring collaboration,
				consultation, and referral.
Section 1.
(1) Consultation does not require an
			 in-person visit. It may include a discussion by the LCPM and an appropriate
			 healthcare provider by telephone or other appropriate electronic
			 communication.
(2) The consultant
			 may recommend further evaluation which may be either in-person, by telehealth,
			 or a records review.
(3) It is the
			 responsibility of the LCPM to initiate a consultation and to communicate
			 clearly to the consultant that the LCPM is seeking a consultation.
(4) A consultation may involve the consultant
			 providing advice and information, providing care to the client or newborn, or
			 prescribing treatment or medication for the client or newborn.
(5) It is the responsibility of the LCPM to
			 provide all relevant client records to the consultant, including a written
			 summary of the client's history and presenting problem, as
			 appropriate.
(6) Consultation shall
			 be fully documented by the LCPM in the client's record, including the
			 consultant's name, date of service, and the consultant's findings, opinions,
			 and recommendations. The LCPM shall discuss the consultant's recommendations
			 with the client.
(7) After
			 consultation and with the informed consent of the client as required by
			 201 KAR 20:640, care of the
			 client and responsibility for decision making either:
(a) Continues with the LCPM;
(b) Is shared in collaboration by the LCPM
			 and an appropriate licensed healthcare provider;
(c) Is referred completely to an appropriate
			 licensed healthcare provider; or
(d) Is transferred to a licensed healthcare
			 facility providing a higher level of care pursuant to
			 201 KAR 20:690.
(8) Referral or collaboration
			 shall occur only after dialogue and agreement among the client, the LCPM, and
			 the consultant.
(9) The LCPM shall
			 ensure that the client can understand each provider's role and is able to
			 identify which healthcare provider is responsible for various aspects of the
			 client's care.
(10) Collaboration
			 shall be documented by the LCPM in the client's record, including the name of
			 the collaborating provider and the conditions or symptoms the collaborating
			 provider is managing.
(11) The LCPM
			 shall maintain communication with the collaborating provider to the extent
			 necessary to coordinate client care.
(12) If the condition or symptom requiring
			 collaboration is resolved as mutually agreed upon by the LCPM and the
			 collaborating provider, the LCPM may resume sole management of the client's
			 care if appropriate, and document the decision in the client's
			 record.
(13) Discussion with the
			 client regarding the indications for complete referral of care shall take place
			 in a timely manner following the decision for referral. If possible, this
			 discussion shall occur in person and be documented in the client's
			 record.
(14) It is the
			 responsibility of the LCPM to provide all relevant client records to
			 appropriate providers or facilities, including a written summary of the
			 client's history and presenting problem, as appropriate.
(15) If the condition or symptom requiring
			 referral of care is resolved as mutually agreed upon by the LCPM and other
			 participating providers, the LCPM may resume primary management or enter into a
			 collaboration of care if appropriate, and document the decision in the client's
			 record.