Title 902 | Chapter 020 | Regulation 470


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CABINET FOR HEALTH AND FAMILY SERVICES
Department for Public Health
Division of Prevention and Quality Improvement
(New Administrative Regulation)

902 KAR 20:470.Kentucky heart attack response and treatment recognition process.

Section 1.

Definition. "Department" is defined by KRS 211.340.

Section 2.

Hospital Level of Heart Attack Response and Treatment Recognition.

(1)

A hospital seeking recognition in the statewide system for heart attack response and treatment shall complete and submit to the department the Step-by-Step Guide for Recognition in the Kentucky Statewide System for Heart Attack Response and Treatment.

(2)

The application shall include a copy of the hospital's certificate or certification letter from a nationally recognized guidelines-based organization that provides certification for heart attack response and treatment, and that includes the:

(a)

Name of the certifying organization;

(b)

Name of the certification received;

(c)

Date of certification; and

(d)

Expiration date of certification.

(3)

A hospital that holds a current certificate of need (CON) for percutaneous coronary intervention (PCI) or open-heart surgery may submit an application for recognition in the statewide system for heart attack response and treatment. The application shall include:

(a)

A copy of the hospital's accreditation by a nationally recognized organization; and

(b)

Evidence of the current certificate of need.

(4)

A hospital's application for recognition in the statewide system for heart attack response and treatment by the department is voluntary.

(5)

Upon receipt of the information required by subsection (2) or (3) of this section, the department shall list the hospital according to the designated level of cardiac care.

(6)

A recognized hospital shall annually verify continuation of:

(a)

Certification by a nationally recognized guidelines-based organization; or

(b)

State issued CON for PCI or open heart surgery.

Section 3.

Revocation of Recognition.

(1)

A recognized hospital that is unable to maintain current designation as a Level I Comprehensive Cardiac Center, Level II Primary Heart Attack Center, or Level III Acute Heart Attack Ready in accordance with KRS 211.341 shall notify the department within twenty (20) business days.

(2)

If the department becomes aware of a significant change in the status of the hospital that may potentially affect recognition status, the department may request confirmation of current certification or certificate of need from the hospital.

(3)

If the hospital is unable to provide the documentation requested, the department may revoke the hospital's recognition.

(4)

If the recognition is revoked, the hospital may reapply for recognition by providing the information required by Section 2 of this administrative regulation.

(5)

Following the re-application required by subsection (4) of this section, the department shall reinstate the recognition.

Section 4.

Incorporation by Reference.

(1)

The "Step-by-Step Guide for Recognition in the Kentucky Statewide System for Heart Attack Response and Treatment," 9/2022, is incorporated by reference.

(2)

This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Department for Public Health, Commissioner's Office, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m. and is available at https://chfs.ky.gov/agencies/dph/dpqi/cdpb/Pages/heartdiseasestroke.aspx.

STEVEN J. STACK, MD, MBA, Commissioner
ERIC C. FRIEDLANDER, Secretary
APPROVED BY AGENCY: September 22, 2022
FILED WITH LRC: October 12, 2022 at 11:50 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall, if requested, be held on December 21, 2022, at 9:00 a.m. using the CHFS Office of Legislative and Regulatory Affairs Zoom meeting room. The Zoom invitation will be emailed to each requestor the week prior to the scheduled hearing. Individuals interested in attending this virtual hearing shall notify this agency in writing by December 14, 2022, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who attends virtually will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on this proposed administrative regulation until December 31, 2022. Send written notification of intent to attend the public hearing or written comments on the proposed administrative regulation to the contact person. Pursuant to KRS 13A.280(8), copies of the statement of consideration and, if applicable, the amended after comments version of the administrative regulation shall be made available upon request.
CONTACT PERSON: Krista Quarles, Policy Analyst, Office of Legislative and Regulatory Affairs, 275 East Main Street 5 W-A, Frankfort, Kentucky 40621; phone 502-564-6746; fax 502-564-7091; email CHFSregs@ky.gov.

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Julie Brooks
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes the application process for a hospital to be recognized in the statewide system for heart attack response and treatment.
(b) The necessity of this administrative regulation:
KRS 211.341 requires the department to establish and implement a plan for achieving continuous quality improvement in the quality of care provided under a statewide system for heart attack response and treatment. Hospitals may seek recognition by the department based on their level of cardiac care by a nationally recognized guidelines-based organization. KRS 211.343 requires the department to promulgate administrative regulations to implement the requirements of KRS 211.340 to 211.343.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation establishes the hospital recognition process, including the recognition revocation process, and incorporates by reference the application form.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation will ensure all hospitals who seek recognition by the department are aware of the application requirements.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This is a new administrative regulation.
(b) The necessity of the amendment to this administrative regulation:
This is a new administrative regulation.
(c) How the amendment conforms to the content of the authorizing statutes:
This is a new administrative regulation.
(d) How the amendment will assist in the effective administration of the statutes:
This is a new administrative regulation.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This administrative regulation will impact the 118 hospitals in the state.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Hospitals who want to be recognized according to their designated level of cardiac care will need to submit an application and required documentation to the department.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There will be no cost for a hospital to submit an application for recognition to the department.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Hospitals will be recognized according to the designated level of cardiac care.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
The initial costs of the department to implement this administrative regulation will be approximately $100,000.
(b) On a continuing basis:
The ongoing costs to the department to implement this administrative regulation will be approximately $100,000.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
Agency funds will be used to implement and enforce this administrative regulation.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
An increase in funding is not necessary to implement this administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This administrative regulation does not contain fees.
(9) TIERING: Is tiering applied?
Tiering is not applied. While hospitals will be recognized based on their level of certification, the application for recognition process will be applied equally.

FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
This administrative regulation will impact the Heart Disease and Stroke Prevention Program in the Division of Prevention and Quality Improvement, Department for Public Health.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 194A.050 and 211.343.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
This administrative regulation does not generate revenue.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
This administrative regulation does not generate revenue.
(c) How much will it cost to administer this program for the first year?
The initial costs of the department to implement this administrative regulation will be approximately $100,000.
(d) How much will it cost to administer this program for subsequent years?
The ongoing costs to the department to implement this administrative regulation will be approximately $100,000.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Expenditures (+/-):
Other Explanation:
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
This administrative regulation will not generate cost savings for the regulated entities.
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
This administrative regulation will not generate cost savings for the regulated entities.
(c) How much will it cost the regulated entities for the first year?
There will be no cost to the regulated entities the first year.
(d) How much will it cost the regulated entities for subsequent years?
There will be no cost to the regulated entities in subsequent years.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
Expenditures (+/-):
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. [KRS 13A.010(13)] This administrative regulation does not have a major economic impact.

7-Year Expiration: 6/21/2030

Last Updated: 7/5/2023


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