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 for facilities providing out-of-hospital maternity care. The measure removes the mandate that birth centers maintain comprehensive perinatal services certification and eliminates specific proximity requirements to hospitals handling obstetrical emergencies.

In place of previous location restrictions, the bill requires alternative birth centers to establish detailed written transfer policies. These protocols must outline procedures for sharing medical records with receiving hospitals, facilitate direct communication between providers during transfers, and provide patients with estimated transfer times and emergency plans. The legislation maintains the requirement for two birth attendants, with at least one being a physician, licensed midwife, or certified nurse-midwife.

The bill preserves the existing Medi-Cal reimbursement structure, which caps payments at 80% of rates for general acute care hospitals based on an average 1.7-day length of stay. Centers must continue meeting American Association of Birth Centers standards or state-determined equivalents to qualify for Medi-Cal payments. Implementation of new reimbursement provisions remains contingent on federal approval, while the July 2022 exemption from certain payment reductions continues as previously established.