Reference is to the bill as introduced.
Amend the bill, as and if amended, by striking all after the enacting language and inserting:
/ SECTION 1. Section 44-89-30 of the 1976 Code is amended to read:
"Section 44-89-30.
As used in this chapter:
(1)
'Accreditation' means official authorization or
status granted by an agency other than the board but recognized
by the board that recognizes requirements of a birth center to
meet national standards for the quality of the operation and
services provided.
(1)(2)
'Birthing Birth center or birthing
center' means a facility or other place where human births are
planned to occur. This but does not
include the usual residence of the mother or
any a facility which is licensed as a
hospital.
(2)(3) 'Board'
means the South Carolina Board of Health and Environmental
Control.
(3)(4)
'Certified Nurse-Midwife
nurse-midwife (CNM)' means a person educated in
the discipline of nursing and midwifery, certified by
examination by the American College of Nurse-Midwives, and
licensed by the State Board of Nursing as a Registered
Nurse registered nurse licensed by the South
Carolina Board of Nursing as an advanced practice registered
nurse who possesses a current certificate issued by the American
Midwifery Certification Board (AMCB) and maintains ongoing
continuing education requirements by AMCB.
(5)
'Consultant on-call physician' means a medical
doctor or doctor of osteopathy licensed by the South Carolina
Board of Medicine with board certification in family medicine,
obstetrics, maternal fetal medicine, pediatrics, or neonatology
who can meet the needs of mothers and babies that fall outside
the scope of birth center care either in person or through
direct patient to physician interaction by means of video
conference.
(4)(6)
'Department' means the South Carolina Department of Health
and Environmental Control.
(5)(7)
'Lay Licensed midwife' means an
individual so licensed by the department who possesses a
current certificate issued by the North American Registry of
Midwives (NARM) and who maintains ongoing continuing education
requirements by NARM.
(6)
'Low risk' means normal,
uncomplicated prenatal course as determined by adequate prenatal
care and prospects for a normal, uncomplicated birth as defined
by reasonable and generally accepted criteria of maternal and
fetal health.
(7)(8)
'Midwifery' means the application of scientific principles
in the care of 'with woman' care during uncomplicated pregnancy,
birth, and puerperium including care of the newborn, support of
the family unit, and gynecologic health care.
(9)
'National Standards' means standards adopted by
a nationally recognized birth center organization, recognized by
the board, in consultation with the Midwifery Advisory Council,
that are based on scientific evidence and reviewed by experts in
midwifery, birth centers, obstetrics, and pediatrics specific
for birth center services and operation.
(8)(10)
'Person' means a natural individual, private or public
organization, political subdivision, or other governmental
agency.
(9)
'Physician' means a doctor of
medicine or osteopathy with training in obstetrics or midwifery
and licensed by the South Carolina State Board of Medical
Examiners to practice medicine."
SECTION 2. Section 44-89-60 of the 1976 Code is amended to read:
"Section 44-89-60.
(A)(1) The department shall
require reports from, regulate, investigate, and inspect all
birthing centers and records of these facilities as necessary
and promulgate regulations in accordance with the Administrative
Procedures Act to carry out the purposes of this chapter.
The regulations must include, but not be limited to, the
following requirements:
(1) Births
planned to occur at a birthing center must be restricted to
low-risk births following normal, uncomplicated pregnancy.
(2) Birthing
centers shall provide care by physicians, certified
nurse-midwives, or licensed lay-midwives to childbearing women
during pregnancy, birth, and puerperium.
(3) A
physician must be on call and available to provide medical
assistance at the birthing center at all times that it is
serving the public.
(4) A
physician shall make a written determination that the planned
birth is low risk. (2)
The regulations also must provide that
any birthing a birth center which is in
operation at the time of promulgation of these regulations is
given a reasonable period of time, not to exceed one year from
the date of the promulgation, within which to comply with the
regulations. A new birth center not in operation at the time
of promulgation of the regulations shall submit to the
department a verified application for accreditation with the
license application and shall provide proof of accreditation
within one year of submitting the application.
(B) In order
to be licensed by and to operate in this State, a birth center
must be accredited by a birth center accrediting organization
approved by the department, in consultation with the Midwifery
Advisory Council, that determines accreditation based on the
birth center's compliance with national standards for birth
centers. A birth center must maintain accreditation at all times
it is licensed by the department.
(C)(1) The
birth center shall have a consultant on-call physician available
in person or by telecommunication at all times the center is
conducting business to provide consultation regarding medical
management and/or to accept transfers of mothers and babies who
require care outside of the scope of the birth center. All
consultant on-call physicians shall serve on the center's
advisory council and must provide written approval on policy and
procedures before adoption. Contact information for consultant
on-call physicians must be made available to the department.
(2)
The birth center policy and procedures must
require, at a minimum:
(a)
births planned to occur at a birth center must
be evaluated for risk status by a member of the center's
professional staff. The evaluations in the health record on each
client must include, but are not limited to, an evaluation of
formal risk status on initial evaluation, at each trimester, and
upon admission in labor;
(b)
birth center professional staff must be licensed
in this State as a certified nurse-midwife, licensed midwife, or
physician with board certification in family medicine,
obstetrics, maternal fetal medicine, pediatrics, or neonatology;
and
(c)
practice guidelines and policies for birth
center professional staff must address knowledge, skills, and
professional credentials required to provide services offered by
the center. These practice guidelines must be furnished to the
department upon request.
(D)(1) A
birth center shall document in its practice guidelines and
policies the process for transfer of care to an acute care
hospital with obstetrical and/or newborn services that is
located a driving distance of no more than forty-five miles from
the birth center.
(2)
Birth center transfer guidelines must include,
at a minimum, a procedure for both emergent and nonemergent
transfer of a laboring woman, a postpartum woman, and a newborn,
indications for transport, plans for communication with
accepting physicians and hospital staff, and plans for ongoing
post-transport communications between the birth center and the
receiving acute care hospital.
(3)
Birth center transfer policy must require, at a
minimum, notification of the receiving provider or hospital of
the impending transfer, the reason for transfer, a brief
relevant clinical history, the planned mode of transport, the
expected time of arrival, a legible copy of relevant prenatal
and labor medical records, and the plan for postpartum follow
up.
(4)
Contact information for consultant on-call
physicians, transport services, acute care hospitals with
obstetric and newborn services, and any other relevant emergency
transport services must be posted prominently in the birth
center and made available to all clients.
(E) The
birth center shall establish an advisory committee comprised of
the center's clinical staff and consultant on-call physicians to
meet at least biannually. The committee responsibilities
include, but are not limited to, review of all transfers,
practice guidelines, and policy and procedures. Physicians and
the administration of a transferring facility which has received
a transfer from the birth center in the previous twelve months
must be encouraged and invited to participate.
(F) If a
consultant on-call physician acts without malice, has made
reasonable efforts to obtain the facts relating to the issue
presented to him, and acts in the belief that the action taken
is warranted by the facts known to him, the physician is not
liable to a birth center for civil damages or criminal
penalties, and is not subject to civil suit or criminal
prosecution, as a result of acts or omissions arising out of the
provision of services by the consultant on-call physician
pursuant to this section or South Carolina Regulation 61-102.
(G) Birth
centers shall participate in data collection using the American
Association of Birth Centers Perinatal Data Registry, Midwives
Alliance of North America Statistics Project Data, or other
qualified national registers. Data reports must be made
available to a consulting specialist, receiving transport
hospitals, and the department upon request."
SECTION 3. This act takes effect upon approval by the Governor. /
Renumber sections to conform.
Amend title to conform.