Chapter Amendments signficicantly change the intent of Birth Center Accredidation bill A259a/S1414a

Original Bill: any MLBC that demonstrates intent and capability to achieve national accreditation shall be deemed to meet requirements for Article 28

Amendment 1: An MLBC that completes the following shall be deemed to meet the requirements of article 28

• shows intent and capability to obtain and maintain accreditation by an accrediting organization,
• fully completes and files an application with PHHPC on forms provided by the department,
• Receives approval of PHHPC

Interpretation: MLBCs will still have to go through the PHHPC process and receive approval from PHHPC, but once those requirements are completed, accreditation and licensure cannot be unreasonably withheld.

Amendment 2: PHHPC application must include:

• character and competence criteria
• demonstrate that the legal structure of the proposed operator
• evidence of the capability to fund any acquisition, renovations, and construction costs ; and
• demonstrate that the premises and equipment complies with required life safety and building standards

Interpretation: The PHHPC application is still a big barrier to lower resourced birth centers from opening, particularly those birth centers who do not own property or have the resources to complete the expensive and lengthy application process.

Amendment 3: PHHPC must schedule MLBC applications for consideration at the next meeting

• Upon receipt of a completed application, the department shall schedule such application for consideration at the next available and appropriate committee meeting designated by PHHPC.
• If the department receives an incomplete application, the department will communicate with the applicant until such time as the application is completed and filed with the PHHPC for its approval or disapproval, or the applicant withdraws the application.

Interpretation: This requirement is great for birth centers who do have the resources to complete a PHHPC application as it requires PHHPC to respond.

Amendment 4: New regulations will be written with midwives and MLBCs in consultation. Where the regulations between national and state regulations are inconsistent, they must be “harmonized”.

New Regulations and requirements shall be issued after consultation with representatives of midwives, midwifery birth centers, and general hospitals providing obstetric services. Regulations and requirements shall not be inconsistent with:

• article one hundred forty of the education law;
• the standards of the accrediting organization from which the midwifery birth center proposes to seek, seeks or has obtained accreditation;
• life safety code or other building standards the commissioner deems necessary
• PHHPC application requirements: (A) satisfy the character and competence criteria (B) demonstrate that the legal structure of the proposed operator © evidence of the capability to fund any acquisition, renovations, and construction costs ; and (D) demonstrate that the premises and equipment complies with required life safety and building standards

To the extent any of the standards in this subparagraph conflict, the commissioner shall accommodate or modify the application of any standard to harmonize and maximize the intent of the standards.

Interpretation: The opportunity to write new regulations is a double-edged sword. In the past the DOH has not acted in good faith, so there is a good possibility that the new regulations still apply the most rigorous standards. However, with a new more progressive Commissioner there is some optimism for improvement.

Amendment 5: The new regulations have to completed in 180 days

• Act becomes law in 180 days provided that commissioner and PHHPC make regulations to implement this act on that date

Interpretation: The required timeline for new regulations means that they should be done by around June 2022.