Current through Reg. 49, No. 38; September 20, 2024
(a) One
person may act in the capacity of the administrator, the clinical director, and
the birth attendant provided that person meets all the minimum qualifications
set out in paragraphs (2)(A) and (3)(A) of this subsection and is capable of
performing all of the duties specifically stated in paragraphs (1)(B), (2)(B),
and (3)(B) of this subsection. The minimum qualifications and duties for the
administrator, the clinical director, the birth attendant, other clinical care
providers and nonprofessional personnel of a center are as follows.
(1) Administrator.
(A) Qualifications.
(i) Shall not have been employed in the last
year as an administrator with another center or health care facility at the
time the center or facility was cited for violations of a licensing law or rule
which resulted in enforcement action taken against the center or health related
facility. For purposes of this clause only, the term "enforcement action" means
license revocation, suspension, emergency suspension, or denial of a license or
injunction action but does not include administrative or civil
penalties.
(ii) Shall not have been
convicted of a felony or misdemeanor listed in §
137.22
of this title (relating to License Denial, Suspension, Probation, or
Revocation).
(B) Duties.
(i) Administratively supervise the provision
of services at the center.
(ii)
Organize and direct the center's ongoing functions.
(iii) Employ qualified staff.
(iv) Ensure adequate education and
evaluations of staff.
(v) Supervise
non-professional staff.
(vi)
Implement an effective budgeting and accounting system which must include an
auditing system for monitoring state or federal funds. The administrator shall
ensure all billings or insurance claims (e.g. Medicaid) submitted are
accurate.
(vii) Ensure that issues
and complaints relating to the conduct or actions by licensed health care
professional(s) are addressed and, if warranted, referred and reported to the
appropriate board, and that such review and action taken is
documented.
(viii) Administratively
conduct or supervise the resolution(s) of complaint(s) received from clients in
the delivery of their care or services received at the center.
(2) Clinical director.
(A) Qualifications. A licensed physician, a
certified nurse-midwife (CNM), or a licensed midwife.
(B) Duties.
(i) Develop, implement, and monitor the
clinical policies of a birthing center and ensure the adherence to these
policies.
(ii) Advise and consult
with the staff of the center on all matters relating to the clinical management
of all clients.
(iii) Supervise all
birth attendants and all other persons who provide direct client
care.
(iv) Ensure the accuracy of
public education information materials and activities in relation to pregnancy
and birth, mother and newborn care, and the center.
(3) Birth attendant.
(A) Qualifications. A physician, certified
nurse-midwife (CNM), or a licensed midwife.
(B) Duties. Responsible for the clinical care
provided to clients of the center.
(4) Other clinical care providers.
(A) Qualifications. Licensed, certified or
trained appropriately for the care to be provided. Prior to providing direct
client care the clinical director shall verify licensure, certification or
competence. Shall be certified in CPR for health care providers.
(B) Duties. Provides care only under the
supervision of a birth attendant in accordance with all laws, rules and
policies appropriate to his or her professional scope of practice.
(5) Nonprofessional staff.
(A) Qualifications. Nonprofessional staff
must be able to demonstrate the knowledge, skills, and abilities of their
specified job duty within the center. This staff must be at least 16 years
old.
(B) Duties. Responsible for
the provision of nonclinical services such as housekeeping, laundry, and
sanitation in the operation of the center.
(b) A center shall ensure that its birth
attendants meet the following requirements.
(1) Licensed midwives must be licensed in
accordance with Texas Midwifery Act, Occupations Code, Chapter 203.
(2) Certified nurse-midwives (CNM) must
maintain certification as a CNM as defined in §
137.2 of
this title (relating to Definitions).
(3) Physicians must maintain current
licensure as a physician as defined in §
137.2 of
this title.
(c) A center
shall ensure that the personnel record for each employee includes:
(1) job descriptions for all personnel
providing client care;
(2)
orientation and training of all employees, volunteers, students and
contractors;
(3) an annual written
evaluation of employee performance;
(4) in-service and continuing
education;
(5) evidence of current
certification of all birth attendants by the American Heart Association or the
American Red Cross in basic life support and the American Academy of Pediatrics
or the American Heart Association in neonatal resuscitation; and
(6) verification of current licensure or a
current copy of the license for licensed personnel.