2023 California Code › Business and Professions Code - BPC › DIVISION 2 - HEALING ARTS › CHAPTER 6 - Nursing › ARTICLE 2.5 - Nurse-Midwives › Section 2746.55.

2746.55. (a) For all maternal or neonatal transfers to the hospital setting during labor or the immediate postpartum period, for which the intended place of birth was an out-of-hospital setting at the onset of labor, or for any maternal, fetal, or neonatal death that occurred in the out-of-hospital setting during labor or the immediate postpartum period, and for which the intended birth care provider is a certified nurse-midwife in the out-of-hospital setting, the department shall collect, and the certified nurse-midwife shall be required to submit, within 90 days of the transfer or death, the following data in the form determined by the department. The data shall include all of the following:
(1) Attendant’s name, for the certified nurse-midwife who attended the patient at the time of transfer, or who attended the patient at the time of maternal, fetal, or neonatal death.
(2) Attendant’s license number, for the certified nurse-midwife who attended the patient at the time of transfer, or who attended the patient at the time of maternal, fetal, or neonatal death.
(3) The child’s date of delivery for births attended by the nurse-midwife.
(4) The sex of the child, for births attended by the nurse-midwife.
(5) The date of birth of the parent giving birth.
(6) The date of birth of the parent not giving birth.
(7) The residence ZIP Code of the parent giving birth.
(8) The residence county of the parent giving birth.
(9) The weight of the parent giving birth (prepregnancy weight and delivery weight of parent giving birth).
(10) The height of the parent giving birth.
(11) The race and ethnicity of the genetic parents, unless the parent declines to disclose.
(12) The obstetric estimate of gestation (completed weeks), at time of transfer.
(13) The total number of prior live births.
(14) The principal source of payment code for delivery.
(15) Any complications and procedures of pregnancy and concurrent illnesses up until time of transfer or death.
(16) Any complications and procedures of labor and delivery up until time of transfer or death.
(17) Any abnormal conditions and clinical procedures related to the newborn up until time of transfer or death.
(18) Fetal presentation at birth, or up until time of transfer.
(19) Whether this pregnancy is a multiple pregnancy (more than one fetus this pregnancy).
(20) Whether the patient has had a previous cesarean section.
(21) If the patient had a previous cesarean, indicate how many.
(22) The intended place of birth at the onset of labor, including, but not limited to, home, freestanding birth center, hospital, clinic, doctor’s office, or other location.
(23) Whether there was a maternal death.
(24) Whether there was a fetal death.
(25) Whether there was a neonatal death.
(26) Hospital transfer during the intrapartum or postpartum period, including, who was transferred (mother, infant, or both) and the complications, abnormal conditions, or other indications that resulted in the transfer.
(27) The name of the transfer hospital, or other hospital identification method as required, such as the hospital identification number.
(28) The county of the transfer hospital.
(29) The ZIP Code of the transfer hospital.
(30) The date of the transfer.
(31) Other information as prescribed by the State Department of Public Health.
(b) In the event of a maternal, fetal, or neonatal death that occurred in an out-of-hospital setting during labor or the immediate postpartum period, a certified nurse-midwife shall submit to the department, within 90 days of the death, all of the following data in addition to the data required in subdivision (a):
(1) The date of the maternal, neonatal, or fetal death.
(2) The place of delivery, for births attended by the nurse-midwife.
(3) The county of the place of delivery, for births attended by the nurse-midwife.
(4) The ZIP Code of the place of delivery, for births attended by the nurse-midwife.
(5) The APGAR scores, for births attended by the nurse-midwife.
(6) The birthweight, for births attended by the nurse-midwife.
(7) The method of delivery, for births attended by the nurse-midwife.
(c) The data submitted pursuant to subdivisions (a) and (b) shall be in addition to the certificate of live birth information required pursuant to Sections 102425 and 102426 of the Health and Safety Code.
(d) For those cases that involve a hospital transfer, the department shall link the data submitted by the certified nurse-midwife, pursuant to subdivision (a), to the live birth data reported by hospitals to the department, pursuant to Sections 102425 and 102426 of the Health and Safety Code, and to the patient discharge data that reflects the birth hospitalization and reported by hospitals to the Department of Health Care Access and Information, so that additional data reflecting the outcome can be incorporated into the aggregated reports submitted pursuant to subdivision (i).
(e) The department may adjust, improve, or expand the data elements required to be reported pursuant to subdivisions (a) and (b) to better coordinate with other data collection and reporting systems, or in order to collect more accurate data, as long as the minimum data elements in subdivisions (a) and (b) are preserved.
(f) The department shall treat the information and data gathered pursuant to this section, for the creation of the reports described in subdivision (i), as confidential records, and shall not permit the disclosure of any patient or certified nurse-midwife information to any law enforcement or regulatory agency for any purpose, including, but not limited to, investigations for licensing, certification, or regulatory purposes. This subdivision shall not prevent the department from responding to inquiries from the Board of Registered Nursing as to whether a licensee has reported pursuant to this section.
(g) The information collected by the department pursuant to this section, and not otherwise subject to current confidentiality requirements, shall be treated as confidential records and shall only be made available for use consistent with paragraph (1) of, paragraph (4) of, and subparagraph (A) of paragraph (8) of, subdivision (a) of Section 102430 of the Health and Safety Code and pursuant to the application, review, and approval process established by the department pursuant to Section 102465 of the Health Safety Code.
(h) At the time of each certified nurse-midwife’s license renewal, the Board of Registered Nursing shall send a written notification to the certified nurse-midwife notifying them of the mandated vital records reporting requirements for out-of-hospital births pursuant to subdivisions (a) and (b) and Section 102415 of the Health and Safety Code and that a violation of this section shall subject the certified nurse-midwife to disciplinary or administrative action by the board.
(i) (1) The department shall report to the Legislature on the data collected pursuant to this section. The report shall include the aggregate information, including, but not limited to, birth outcomes of patients under the care of a certified nurse-midwife in an out-of-hospital setting at the onset of labor, collected pursuant to this section and Sections 102425 and 102426 of the Health and Safety Code.
(2) The first report, to reflect a 12-month period of time, shall be submitted no later than four and one-half years after the State Department of Public Health receives an appropriation as specified in subdivision (m) and each subsequent report reflecting a 12-month reporting period shall be submitted annually to the Legislature every year thereafter.
(3) A report required under this subdivision shall be submitted in compliance with Section 9795 of the Government Code.
(j) All reports, including those submitted to the Legislature or made publicly available, shall utilize standard public health reporting practices for accurate dissemination of these data elements, specifically in regards to the reporting of small numbers in a way that does not risk a confidentiality or other disclosure breach. No identifying information in regards to the patient or the nurse-midwife shall be disclosed in the reports submitted pursuant to subdivision (i).
(k) A violation of this section shall subject the certified nurse-midwife to disciplinary or administrative action by the Board of Registered Nursing.
(l) For purposes of this section, “department” means the State Department of Public Health.
(m) This section shall become operative only upon the Legislature making an appropriation to implement the provisions of this section.
(Amended by Stats. 2022, Ch. 511, Sec. 14. (SB 1495) Effective January 1, 2023. Conditionally operative by its own provisions.)