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HF 3274

as introduced - 88th Legislature (2013 - 2014) Posted on 03/24/2014 12:39pm

KEY: stricken = removed, old language.
underscored = added, new language.

Bill Text Versions

Introduction Posted on 03/24/2014

Current Version - as introduced

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A bill for an act
relating to health; changing requirements for birth centers; amending Minnesota
Statutes 2012, section 144.615.


Section 1.

Minnesota Statutes 2012, section 144.615, is amended to read:


Subdivision 1.


(a) For purposes of this section, the following definitions
have the meanings given them.

(b) "Birth center" means a facility licensed for the primary purpose of performing
low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are
planned to occur away from the mother's usual residence following a low-risk pregnancy.

(c) deleted text begin"CABC"deleted text endnew text begin "AABC"new text end means the deleted text beginCommission for the Accreditationdeleted text endnew text begin American
new text end of Birth Centers.

(d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as
determined by documentation of adequate prenatal care and the anticipation of a normal,
uncomplicated labor and birth, as defined by reasonable and generally accepted criteria
adopted by professional groups for maternal, fetal, and neonatal health care.

Subd. 2.

License required.

(a) Beginning January 1, 2011, no birth center shall be
established, operated, or maintained in the state without first obtaining a license from the
commissioner of health according to this section.

(b) A license issued under this section is not transferable or assignable and is subject
to suspension or revocation at any time for failure to comply with this section.

(c) A birth center licensed under this section shall not assert, represent, offer,
provide, or imply that the center is or may render care or services other than the services it
is permitted to render within the scope of the license or the accreditation issued.

(d) The license must be conspicuously posted in an area where patients are admitted.

Subd. 3.

Temporary license.

For new birth centers planning to begin operations
after January 1, 2011, the commissioner may issue a temporary license to the birth center
that is valid for a period of six months from the date of issuance. The birth center must
submit to the commissioner an application and applicable fee for licensure as required
under subdivision 4. The application must include the information required in subdivision
4, clauses (1) to (3) and (5) to (7), and documentation that the birth center has deleted text beginsubmitted
an application for accreditation to the CABC
deleted text endnew text begin implemented the most recent standards for
birth centers approved by the American Association of Birth Centers (AABC)
new text end. Upon
deleted text beginreceipt of accreditation from the CABCdeleted text endnew text begin certification by the commissioner of health that
the birth center has implemented the AABC standards
new text end, the birth center must submit to the
commissioner the information required in subdivision 4, clause (4), and the applicable fee
under subdivision 8. The commissioner shall issue a new license.

Subd. 4.


An application for a license to operate a birth center and the
applicable fee under subdivision 8 must be submitted to the commissioner on a form
provided by the commissioner and must contain:

(1) the name of the applicant;

(2) the site location of the birth center;

(3) the name of the person in charge of the center;

(4) documentation that the deleted text beginaccreditation described under subdivision 6 has been
issued, including the effective date and the expiration date of the accreditation, and the
date of the last site visit by the CABC
deleted text endnew text begin AABC standards have been implementednew text end;

(5) the number of patients the birth center is capable of serving at a given time;

(6) the names and license numbers, if applicable, of the health care professionals
on staff at the birth center; and

(7) any other information the commissioner deems necessary.

Subd. 5.

Suspension, revocation, and refusal to renew.

The commissioner may
refuse to grant or renew, or may suspend or revoke, a license on any of the grounds
described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or upon
deleted text beginthe loss of accreditation by the CABCdeleted text endnew text begin a finding that the birth center is out of substantial
compliance with AABC standards
new text end. The applicant or licensee is entitled to notice and
a hearing as described under section 144.55, subdivision 7, and a new license may be
issued after deleted text beginproper inspection of the birth center has been conducteddeleted text endnew text begin the commissioner
determines the birth center is in substantial compliance with AABC standards
new text end.

Subd. 6.

Standards for licensure.

(a) To be eligible for licensure under this
section, a birth center must be deleted text beginaccredited by the CABC or must obtain accreditation
within six months of the date of the application for licensure. If the birth center loses its
accreditation, the birth center must immediately notify the commissioner
deleted text endnew text begin in substantial
compliance with AABC standards
new text end.

(b) The center must have procedures in place specifying criteria by which risk status
will be established and applied to each woman at admission and during labor.

deleted text begin (c) Upon request, the birth center shall provide the commissioner of health with any
material submitted by the birth center to the CABC as part of the accreditation process,
including the accreditation application, the self-evaluation report, the accreditation
decision letter from the CABC, and any reports from the CABC following a site visit.
deleted text end

new text begin Subd. 6a. new text end

new text begin Annual inspection. new text end

new text begin The commissioner shall conduct an inspection of a
licensed birth center at least annually to determine whether the birth center is in substantial
compliance with AABC standards and meets the reasonable rules and standards which the
commissioner determines to be necessary and in the public interest.
new text end

Subd. 7.

Limitations of services.

(a) The following limitations apply to the services
performed at a birth center:

(1) surgical procedures must be limited to those normally accomplished during an
uncomplicated birth, including episiotomy and repair;

(2) no abortions may be administered; and

(3) no general or regional anesthesia may be administered.

(b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth
center if the administration of the anesthetic is performed within the scope of practice of a
health care professional.

Subd. 8.


(a) The biennial license fee for a birth center is $365.

(b) The temporary license fee is $365.

(c) Fees shall be collected and deposited according to section 144.122.

Subd. 9.


(a) Except as provided in paragraph (b), a license issued under
this section expires two years from the date of issue.

(b) A temporary license issued under subdivision 3 expires six months from the date
of issue and may be renewed for one additional six-month period.

(c) An application for renewal shall be submitted at least 60 days prior to expiration
of the license on forms prescribed by the commissioner of health.

Subd. 10.


All health records maintained on each client by a birth center
are subject to sections 144.292 to 144.298.

Subd. 11.


(a) The commissioner of health, in consultation with the
commissioner of human services and representatives of the licensed birth centers,
the American College of Obstetricians and Gynecologists, the American Academy
of Pediatrics, the Minnesota Hospital Association, and the Minnesota Ambulance
Association, shall evaluate the quality of care and outcomes for services provided in
licensed birth centers, including, but not limited to, the utilization of services provided at a
birth center, the outcomes of care provided to both mothers and newborns, and the numbers
of transfers to other health care facilities that are required and the reasons for the transfers.
The commissioner shall work with the birth centers to establish a process to gather and
analyze the data within protocols that protect the confidentiality of patient identification.

(b) The commissioner of health shall report the findings of the evaluation to the
legislature by January 15, 2014.