Rural hospitals: standby perinatal medical services.

Senator McGuire's rural hospital perinatal care legislation establishes a five-year pilot program enabling critical access and small rural hospitals to provide standby emergency obstetric services. The pilot aims to address gaps in maternal care access across rural California, where maternity unit closures have left many areas without nearby delivery services.

Under the program, participating hospitals located more than 60 minutes from full-service maternity facilities must maintain 24-hour physician coverage, emergency equipment, and protocols for maternal and neonatal emergencies. Eligible facilities cannot have closed maternity units since January 2025 and must commit to providing basic Level I maternal and neonatal care per American College of Obstetricians and Gynecologists standards.

The Department of Public Health will oversee the pilot in consultation with medical organizations, hospitals, and other stakeholders. Participating hospitals must collect data on safety, outcomes, and demographics while maintaining specific staffing levels, equipment, and written policies for obstetric emergencies. A board-certified physician in obstetrics-gynecology, pediatrics, or family medicine will supervise each facility's program. The department will evaluate the pilot's effectiveness and submit findings to the Legislature within two years of completion.

The legislation outlines detailed requirements for emergency supplies, resuscitation equipment, and capabilities for stabilization and transfer when higher levels of care are needed. Participating hospitals must also implement quality improvement programs in partnership with higher-level facilities to enhance patient safety.