Cal. HSC § 1204.3 — California Code / Code hsc / Division 2 / Chapter 1 / Article 1 / Section 1204.3
Section 1204.3
Status: in_force

(a) An alternative birth center that is licensed as an alternative birth center specialty clinic pursuant to paragraph (4) of subdivision (b) of Section 1204 shall, as a condition of licensure, and a primary care clinic licensed pursuant to subdivision (a) of Section 1204 that provides services as an alternative birth center shall, meet all of the following requirements:

(1) Provide perinatal services that are comprehensive in nature, including, but not limited to, all of the following, consistent with the standards of the midwifery and birth center model of care and as described in paragraph (3):

(A) Psychosocial assessments.

(B) When appropriate, referrals to counseling.

(C) Nutritional assessments.

(D) When appropriate, referrals to counseling on food supplement programs, vitamins, and breastfeeding.

(E) Education on overall health, childbirth, and parenting.

(2) Maintain a quality assurance program.

(3) Meet the standards for certification established by the American Association of Birth Centers, or at least equivalent standards as determined by the state department.

(4) In addition to standards of the American Association of Birth Centers regarding proximity to hospitals and presence of attendants at births, meet both of the following conditions:

(A) Have and implement a written policy for hospital transfer, approved by the governing body of the alternative birth center or the governing body of the primary care clinic that provides services as an alternative birth center, as applicable. The written policy shall include, but not be limited to, all of the following:

(i) The specific arrangements for the referral of a complication to a physician and surgeon for consultation. The certified nurse-midwife or licensed midwife shall not be required to identify a specific physician and surgeon.

(ii) The specific arrangements for the transfer of care during the prenatal period, hospital transfer during the intrapartum and postpartum periods, and access to appropriate emergency medical services for the patient or client and the baby if necessary, and recommendations for preregistration at a hospital that has obstetric emergency services and is most likely to receive the transfer.

(iii) A requirement that at the time of transfer the certified nurse-midwife or licensed midwife, who was responsible for the patient’s or client’s care immediately prior to the time of transfer, provide the hospital with all of the transferred patient’s or client’s medical records that are available at the time of the transfer, including prenatal records, and speak with the receiving provider who is responsible for the patient’s or client’s hospital care at the time of transfer, about labor up to the point of the transfer, including any information that has not yet been added to the medical record. Other records that are not yet available or included in the medical record shall be sent as soon as practicable after transfer.

(iv) A requirement that, during consultation with the patient or client at the time of initial orientation to the alternative birth center, or the primary care clinic that provides services as an alternative birth center, and its model of care, all patients and clients be informed of the estimated transfer time, which is the expected duration from departure from the birth center to arrival at the planned receiving hospital. This information shall also include a clear explanation of the birth center’s overall emergency transfer plan, including specified measures in place to mitigate any risk associated with distance from the planned receiving hospital and to ensure safe transfer for both pregnant person and fetus or neonate. This information shall be provided in writing and shall be included in the patient’s or client’s medical file with the patient’s or client’s signed acknowledgment.

(B) Require the presence of at least two attendants at all times during birth, one of whom shall be a physician and surgeon, a licensed midwife, or a certified nurse-midwife.

(5) Have a written policy relating to the dissemination of the following information to patients and clients:

(A) A summary of current state laws requiring child passenger restraint systems to be used when transporting children in motor vehicles.

(B) A listing of child passenger restraint system programs located within the county, as required by Section 27362 of the Vehicle Code.

(C) Information describing the risks of death or serious injury associated with the failure to utilize a child passenger restraint system.

(b) The state department shall issue a permit to a primary care clinic licensed pursuant to subdivision (a) of Section 1204 certifying that the primary care clinic has met the requirements of this section and may provide services as an alternative birth center. Nothing in this section shall be construed to require that a licensed primary care clinic obtain an additional license in order to provide services as an alternative birth center.

(c) (1) Notwithstanding subdivision (a) of Section 1206, no place or establishment owned or leased and operated as a clinic or office by one or more licensed health care practitioners and used as an office for the practice of their profession, within the scope of their license, shall be represented or otherwise held out to be an alternative birth center licensed by the state unless it meets the requirements of this section.

(2) Nothing in this subdivision shall be construed to prohibit licensed health care practitioners from providing birth-related services, within the scope of their license, in a place or establishment described in paragraph (1).