Lawmakers discuss perinatal palliative‑care bill to expand supportive services for families facing fetal anomaly or perinatal loss

House Bill 414, presented for discussion only in the Committee on Health Services, would encourage health care providers and birthing centers to refer pregnant patients who receive a serious fetal‑anomaly diagnosis or face perinatal complications to perinatal palliative‑care programs and would ask the Cabinet to keep a list of available programs.

Representative Nancy Tate, sponsor, described the proposal as an effort to provide “perinatal palliative care” or “Love Them Both” services that wrap counseling, genetic testing, bereavement support and spiritual and financial counseling around families facing a diagnosis that may not end in a healthy delivery. Adia Wushner, executive director of Kentucky Right to Life and a registered nurse, described the approach as multidisciplinary and compared it to hospice while emphasizing differences: “Every one of this multidisciplinary team knows that they have two patients. They have the expectant mother, and they have the fetus or the unborn child,” Wushner said.

Sponsors stressed the program would be entirely optional for patients and families; it would not require any patient to accept services. Representative Tate said the proposal is intended to make sure patients are referred when a hospital or provider does not already offer the complementary support services, citing programs such as the Footprints Program at Saint Elizabeth in Northern Kentucky as models for how services can be organized.

Committee members asked about coverage, availability across the state and what enforcement or monitoring — if any — the bill would impose. The sponsors said the bill is not punitive; it asks the Cabinet for Health and Family Services to maintain a state listing of programs and promote referral, but it does not create enforcement penalties for providers who do not participate. On coverage, sponsors said they wanted the services to be available broadly and noted that many plans already blend such services into coverage; one sponsor stated an estimated per‑member premium impact of less than 0.05 percent, but did not provide a precise figure in committee testimony.

Legislators asked how many centers statewide provide diagnostic and perinatal services; sponsors said university hospitals and teaching hospitals in the state offer diagnostic services and that not every hospital offers the full complement of palliative‑care services or bereavement programs. Representative Tate and Wushner said a recent survey (described in testimony as roughly a few hundred patients outside Kentucky) showed varying outcomes: some pregnancies ended before delivery, some infants lived only moments, and about 41 percent of cases in that survey continued to live after birth. Sponsors emphasized that programs offer an array of optional services and that families pick from a “menu” of supports.

Several members urged careful definition of terms such as “counseling.” Representative Fleming recommended specifying licensed mental‑health professionals where appropriate; sponsors expressed willingness to work on clearer definitions. Representative Wilner cautioned organizers not to assume what grieving families need, saying services should remain optional and centered on family preference.

Representative Calloway and others stressed inclusion of fathers and broader family supports. Sponsors said the bill is intended to make supports available to the whole family, including bereavement services for birth fathers and grandparents.

Because HB 414 was presented for discussion only, no committee vote was taken. Sponsors asked for continued conversation with medical societies and stakeholders and indicated they will refine language before any formal committee action.

Why it matters: Sponsors said HB 414 would expand access to coordinated perinatal palliative and bereavement services for families facing fetal anomaly, miscarriage or perinatal loss and ensure referral pathways are more consistently offered statewide.

Next steps: The bill was discussed and not voted on; sponsors indicated they will continue to refine definitions and consult medical societies, pharmacy and counseling stakeholders before bringing it back for formal consideration.

Speakers quoted or who spoke on the record in committee included Representative Nancy Tate and Adia Wushner (Executive Director, Kentucky Right to Life); questions and comments came from Representatives Camille, Fleming, Wilner, Calloway, Marzion and others.