Alternative birth centers: licensing and Medi-Cal reimbursement.

Assembly Member Bonta's alternative birth center legislation modifies California's licensing and Medi-Cal reimbursement requirements, replacing the mandate that facilities provide comprehensive perinatal services with new standards for pregnancy and postpartum care. The bill eliminates the requirement that centers be located near emergency obstetrical facilities, instead mandating written hospital transfer plans that detail medical record sharing protocols and estimated transfer times.

The legislation revises Medi-Cal reimbursement structures for alternative birth centers, establishing an all-inclusive delivery rate capped at 80% of payments to general acute care hospitals. Centers must meet American Association of Birth Centers standards or state-determined equivalents and maintain at least two birth attendants, including a physician, licensed midwife, or certified nurse-midwife. The bill preserves centers' ability to employ licensed midwives, certified nurse practitioners, and clinical nurse specialists when appropriate.

New patient safety provisions require facilities to implement written policies on child passenger restraint systems, including information about relevant state laws, local programs, and associated risks. The State Department of Health Care Services retains authority to implement these changes through provider bulletins and policy guidance, while maintaining existing scope-of-practice boundaries for healthcare professionals. Implementation remains contingent on securing necessary federal approvals to maintain Medicaid funding participation.