Current through August 30, 2024
(a) A birth center must have a governing body
that is responsible for the overall operation and maintenance of the birth
center, including personnel, facilities, equipment, and supplies. The birth
center shall
(1) ensure that its governing
body includes one or more individuals who reside in the service area;
or
(2) establish a mechanism for an
advisory committee comprised of representatives of the public and private
sector to advise the birth center regarding the quality of services provided by
the birth center.
(b)
The governing body shall
(1) adopt policies
for the care of clients and newborns at the birth center;
(2) establish and maintain a written
organizational plan that describes the
(A)
responsibilities and accountability of each staff position, including direct
and delegated authority; and
(B)
interrelationship of each staff position within the birth center;
(3) exercise authority and
responsibility for appointments to the clinical staff; and
(4) ensure that
(A) only a member of the clinical staff
admits clients to the birth center;
(B) during the active phase of the first
stage of labor through delivery and postpartum, at least two individuals are
present as provided in
7 AAC 12.415(e), each of whom has a
current
(i) adult cardiopulmonary
resuscitation (CPR) certification by or equivalent to the American Heart
Association's Basic Life Support Healthcare Provider Course (BLS);
and
(ii) neonatal resuscitation
provider (NRP) certification by or equivalent to the Neonatal Resuscitation
Program approved by the American Academy of Pediatrics; and
(C) each physician, certified
nurse midwife, and direct-entry midwife on the clinical staff has a current
license to practice in this state;
(5) meet at least twice each year to execute
responsibilities for the operation of the birth center, and maintain minutes of
each meeting;
(6) approve all
contracts and agreements with individuals or with service agencies, including
hospitals, laboratories, emergency transportation agencies, consulting
specialists, teaching institutions, and organizations that conduct research;
and
(7) approve all contracts for
student education or field experience; the governing body shall ensure that all
members of the clinical staff responsible for the provision of services to
clients and their families also approve these contracts.
(c) The governing body shall appoint
(1) an administrator who is responsible for
operation of the birth center, and ensure that a qualified alternate individual
is available in the administrator's absence; and
(2) a director of the clinical
staff.
(d) The governing
body shall adopt bylaws that include requirements for membership on the
clinical staff and delineation of clinical privileges.
(e) The governing body shall establish
policies and procedures for implementing the quality evaluation and improvement
program under
7 AAC 12.418 and shall, if requested, disclose to the
department the nature and results of each review.
(f) The governing body shall establish the
organizational structure of the birth center operation, and shall develop,
implement, and revise as necessary personnel, clinical, and administrative
policies.
(g) A birth center shall
develop and implement a written plan for transferring clients and newborns to a
hospital that is located within 20 miles by road of the birth center and that
provides services that include
(1) full-time
physician coverage; and
(2) the
availability of full perinatal, obstetrical, and surgical capability, including
(A) anesthesia;
(B) a clinical laboratory;
(C) a blood bank; and
(D) diagnostic radiology services.
(h) The plan required
under (g) of this section must include
(1)
criteria for determining medical necessity for emergency and nonemergency
transfer;
(2) the procedures for
transfer that will be followed if medical care is required for a client or
newborn because complications occur during the antepartum, intrapartum,
postpartum, or newborn period; in this paragraph, "newborn period" means the
first 24 hours after birth; and
(3)
a requirement that, at the time of transfer, the birth center will provide a
complete clinical record to the practitioner who assumes care of the client or
newborn.
(i) The birth
center shall provide evidence satisfactory to the department that clients and
newborns transferred to a hospital by the birth center are being accepted and
treated by that hospital.
(j) In
addition to meeting the requirements of
7 AAC 12.660, the administrator shall maintain and
secure for confidentiality a personnel record for each employee, including
contract staff, that includes, as appropriate, evidence of current CPR and NRP
certification as described in (b)(4)(B) of this section. The administrator
shall also ensure that
(1) the birth center's
records are maintained and stored in an orderly, secure manner;
(2) the birth center develops and implements
policies and procedures for interaction with other agencies, institutions, and
individuals for services to clients and newborns, including
(A) obstetric and newborn acute care in a
licensed hospital;
(B)
transportation services;
(C)
obstetric, pediatric, or neonatal consultation services, including consultation
through telemedicine;
(D)
laboratory and diagnostic services;
(E) childbirth education and parent education
support services; and
(F) home
health care services;
(3) contracts, agreements, policies, and
procedures are reviewed under
7 AAC 12.418 at least annually, are updated as
necessary, and are approved by the governing body;
(4) the birth center develops and implements
a public education plan for informing the community of the services available
at, and limitations of, the birth center;
(5) the birth center establishes and
maintains a safe, home-like environment for its clients;
(6) the birth center provides adequate space
for furnishings, equipment, and supplies to comfortably accommodate the number
of childbearing families to be served and the personnel providing
services;
(7) the birth center, in
addition to complying with
7 AAC 10.9610(i), maintains a record of
routine periodic inspections by state and municipal authorities responsible for
health, fire, building, and public safety;
(8) smoking is prohibited in the birth
center;
(9) the birth center
submits a detailed written report to the department within 24 hours after any
event involving
(A) the emergency transfer of
a client or newborn to a hospital; and
(B) a significant outcome, including
(i) the death of a client or
newborn;
(ii) respiratory
instability;
(iii) cardiac
arrest;
(iv) a newborn born with a
low Apgar score;
(v) a newborn born
prematurely;
(vi) a newborn
displaying a seizure, hyptonia, unresponsiveness, or another neurological
manifestation; and
(vii) a newborn
displaying an organ dysfunction or other abnormality; and
(10) the birth center reports in
writing to the department within seven days after any occurrence involving a
client stay of more than 24 hours, and includes the reason for the
stay.
The address for sending reports required under
7 AAC 12.405 is Department of Health and Social
Services, Division of Public Health, Section of Certification and Licensing,
619 East Ship Creek Avenue, Suite 232, Anchorage, Alaska 99501; telephone:
907-334-2482; facsimile: 907-334-2682.
Authority:AS
47.32.010
AS
47.32.030
