GENERAL GOVERNMENT
CABINET
Kentucky Board of
Medical Licensure
(New Administrative
Regulation)
201 KAR 9:470. Standardized medical order
for scope of treatment form.
RELATES TO: KRS 311.530-311.620, 311.990
STATUTORY AUTHORITY: KRS 311.565(1)(a),
311.6225(2)
NECESSITY, FUNCTION, AND CONFORMITY: KRS
311.565(1)(a) authorizes the board to promulgate administrative regulations to
regulate the conduct of its licensees. KRS 311.6225(2) authorizes the board to
promulgate administrative regulations to develop the format for a standardized
medical order for scope of treatment form to be approved by the board. This
administrative regulation establishes the format of the standardized medical
order for scope of treatment form approved by the board and authorized for use
by board licensees practicing within the Commonwealth of Kentucky.
Section 1. Definition. "MOST form"
means the medical order for scope of treatment form defined in KRS 311.621(12).
Section 2. Format of the MOST form. The
MOST form shall have the title "MOST, Medical Orders for Scope of
Treatment," shall be printed on a single double-sided eight and a half (8.5)
x eleven (11) inch piece of pink paper and shall be in a typed font of a size and
style sufficient to include the following information:
(1) An advisory that completing the
medical order for scope of treatment form is voluntary and not required for
treatment;
(2) Identification of the person who
discussed and agreed to the options for medical intervention that are selected;
(3) The effective date of the form;
(4) The expiration or review date of the
form, which shall be no more than one (1) calendar year from the effective date
of the form;
(5) Indication of whether the patient has
a living will directive or health care power of attorney, a copy of which shall
be attached to the form if available;
(6) An advisory that the medical order
for scope of treatment may be revoked by the patient, the surrogate, or a
responsible party at any time;
(7) A statement written in boldface type
directly above the signature line for the patient that states "You are not
required to sign this form to receive treatment"; and
(8) All other information mandated by KRS
311.6225(1).
Section 3. Availability of the MOST form.
The MOST form shall be available for board licensees to download and print
directly from the board’s Web site.
PRESTON P. NUNNELLEY, M.D., President
APPROVED BY AGENCY: October 9, 2015
FILED WITH LRC: October 12, 2015 at 4
p.m.
PUBLIC HEARING AND PUBLIC COMMENT PERIOD:
A public hearing on this administrative regulation shall be held on November
30, 2015 at 10:00 a.m. at the offices of the Kentucky Board of Medical
Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222. Individuals
interested in being heard at this hearing shall notify this agency in writing
by November 19, 2015, 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 wishes to be heard 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 the proposed
administrative regulation. Written comments shall be accepted through November
30, 2015. Send written notification of intent to be heard at the public hearing
or written comments on the proposed administrative regulation to the contact
person.
CONTACT PERSON: Leanne K. Diakov, General
Counsel, Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite
1B, Louisville, Kentucky 40222, phone (502) 429-7150, fax (502) 429-7118.
REGULATORY IMPACT
ANALYSIS AND TIERING STATEMENT
Contact Person: Leanne K. Diakov
(1) Provide a brief summary of:
(a) What this administrative regulation
does: This administrative regulation establishes the format of the standardized
medical order for scope of treatment form in the Commonwealth of Kentucky as
mandated by KRS 311.6225 and to be used by the board’s licensees.
(b) The necessity of this administrative
regulation: This regulation is being promulgated as mandated by the General
Assembly and to make available to the board’s licensees a medical order for
scope of treatment form consistent with KRS 311.6225.
(c) How this administrative regulation
conforms to the content of the authorizing statutes: This administrative
regulation acts specifically to establish the format of the standardized
medical order for scope of treatment form in the Commonwealth of Kentucky as
mandated by KRS 311.6225.
(d) How this administrative regulation
currently assists or will assist in the effective administration of the
statutes: This administrative regulation acts specifically
to establish the format of the standardized medical order for scope of
treatment form in the Commonwealth of Kentucky as mandated by KRS 311.6225 and
to be used by the board’s licensees.
(2) If this is an amendment to an
existing regulation, provide a brief summary of:
(a) How the amendment will change this
existing administrative regulation: Not applicable.
(b) The necessity of the amendment to
this administrative regulation: Not applicable.
(c) How the amendment conforms to the
content of the authorizing statutes: Not applicable.
(d) How the amendment will assist in the
effective administration of the statutes: Not applicable.
(3) List the type and number of
individuals, businesses, organizations, or state and local governments affected
by this administrative regulation: This amendment will affect all physicians
licensed in Kentucky whose patients wish to memorialize their preferences for
levels of life-prolonging treatment within their medical charts.
(4) Provide an analysis of how the
entities identified in question (3) will be impacted by either the
implementation of this 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: Physicians whose patients wish to
memorialize their preferences for levels of life-prolonging treatment within
their medical charts are required to use the standardized MOST form mandated by
KRS 311.6225. This regulation sets forth the authorized format for the MOST
form.
(b) In complying with this administrative
regulation or amendment, how much will it cost each of the entities identified
in question (3): There is no cost associated with the requirements of this
administrative regulation known to the board.
(c) As a result of compliance, what
benefits will accrue to the entities identified in question (3): Benefits to
the physician include having clear directives on what information the MOST form
must include and the format in which it must be presented.
(5) Provide an estimate of how much it
will cost the administrative body to implement this administrative regulation:
(a) Initially: None
(b) On a continuing basis: None
(6) What is the source of funding to be
used for the implementation and enforcement of this administration regulation: None.
(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: No increase of fees
or funding will be necessary.
(8) State whether or not this
administrative regulation establishes any fees or directly or indirectly increases
any fees: This administrative regulation does not establish any fees nor does
it directly or indirectly increase any fees.
(9) TIERING: Is tiering applied? Tiering
was not appropriate in this administrative regulation because the
administrative regulation applies equally to all those individuals regulated by
it.
FISCAL NOTE ON STATE OR
LOCAL GOVERNMENT
(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? The
Kentucky Board of Medical Licensure will be impacted by this administrative
regulation.
(2) Identify each state or federal
statute or federal regulation that requires or authorizes the action taken by
the administrative regulation. KRS 311.565(1)(a) and 311.6225(2)
(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. None
(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? None
(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? None
(c) How much will it cost to administer
this program for the first year? None
(d) How much will it cost to administer
this program for subsequent years? None
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:
