AN ACT ESTABLISHING A LICENSURE PROCESS AND ANNUAL LICENSE FEES FOR BIRTH CENTERS.
Enacts new Part 4A to Article 6 of GS Chapter 131E, titled the Birth Center Licensure Act (Act).
Sets out the purpose of the Act and defines terms. Prohibits the establishment or operation of a birth center in the state without first obtaining a license from the Department of Health and Human Services (DHHS) pursuant to new Part 4A. Defines birth center as a facility licensed for the primary purpose of performing normal, uncomplicated deliveries that is not a hospital, and where births are planned to occur away from the mother's usual residence following a low-risk pregnancy, as that term is defined. Requires DHHS to provide applications for licensure and details the information required to be included in applications. Directs DHHS to issue a license upon the recommendation of the NC Birth Center Commission (Commission) if it finds the applicant is in compliance with the provisions of Part 4A and any rules adopted by the Commission. Provides that the license is valid for one year and is required to designate the number of beds and the number of rooms on the licensed premises. Establishes a $100 nonrefundable annual license fee to be credited to DHHS as a departmental receipt and applied to offset costs for licensing and inspecting birth centers. Provides for license renewal by DHHS pursuant to rules adopted by the Commission. Establishes that a license is not transferable or assignable except with written approval of DHHS. Requires operators to post the license on the licensed premises in an area accessible to the public.
Authorizes the denial, suspension, or revocation of a license for substantial failure to comply with the provisions of Part 4A or rules adopted by the Commission. Provides five factors the DHHS Secretary must consider in determining whether to suspend admissions or services when the birth center's conditions are dangerous to the health or safety of the patients, including whether all other reasonable means of correcting the problem have been exhausted and no less restrictive alternative to suspension of admissions or services exists. Provides for a birth center to contest any adverse action on its license in accordance with GS Chapter 150B (APA).
Prohibits a licensed birth center from representing or providing services outside of the scope the license. Sets the following limitations on services at a licensed birth center: (1) surgical procedures must be limited to those normally accomplished during an uncomplicated birth, (2) no abortions can be performed, (3) no general or conduction anesthesia can be performed, and (4) no vaginal birth after cesarean or trial of labor after cesarean can be performed.
Requires DHHS to review and, as necessary, revise the Freestanding Birth Center Fee Schedule every three years to ensure that the fees are sufficient to cover the costs of services and that the cost for any State-mandated newborn screening is reimbursed at least at cost.
Directs DHHS to inspect birth centers as it deems necessary to investigate unexpected occurrences involving death or serious physical injury and reportable adverse outcomes identified in the rules adopted by the Commission. Requires all licensed birth centers be subject to DHHS inspections at all times. Provides for access to licensed premises by authorized DHHS representatives. Makes it unlawful for any person to resist proper entry by authorized DHHS representatives upon premises other than a private dwelling. Prohibits those representatives from endangering the health or well-being of any patient being treated in the birth center by his or her entry onto the premises. Grants DHHS the authority to investigate birth centers in the same manner as it investigates hospitals under GS 131E-80(d). Permits public disclosure of information received by the Commission or DHHS through filed reports, license applications, or inspection required or authorized by new Part 4 except where disclosure would violate applicable laws concerning patient records and confidentiality. Prohibits disclosure from identifying the patient involved without permission of the patient or court order.
Creates the seven-member NC Birth Center Commission of DHHS. Specifies the powers and duties of the Commission, including adopting rules establishing standards for licensure, operation, and regulation of birth centers in the State. Details the Commission membership. Provides parameters for vacancies, removal, and member expenses, as well as Commission quorum and the provision of clerical services.
Requires the Commission to adopt rules establishing seven licensure requirements, including: (1) a requirement that the birth center obtain and maintain accreditation with the Commission for the Accreditation of Birth Centers (CABC), and including several documentation and reporting requirements; (2) a requirement that the birth center establish procedures specifying the criteria by which each person's risk status will be evaluated at admission and during labor, pursuant to CABC standards; and (3) a requirement that the birth center develop and submit a plan for complying with the standards of CABC with respect to transfer of care procedures. Requires DHHS to enforce the provisions of new Part 4 and any rules adopted by the Commission.
Directs DHHS to, by October 1, 2019, review, and as necessary, revise, its current Freestanding Birth Center Fee Schedule to ensure that the fees are sufficient to cover the costs of services and that the cost for any State-mandated newborn screening is reimbursed at least at cost.
Effective July 1, 2019.
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