Section 7.12.405. Administration.

	(a)  A birth center must have a governing body that is responsible for the overall operation and maintenance of the birth center, including personnel, facilities, equipment, and supplies. The birth center shall  
		(1) ensure that its governing body includes one or more individuals who reside in the service area; or  
		(2) establish a mechanism for an advisory committee comprised of representatives of the public and private sector to advise the birth center regarding the quality of services provided by the birth center.  
	(b)  The governing body shall  
		(1) adopt policies for the care of clients and newborns at the birth center;  
		(2) establish and maintain a written organizational plan that describes the  
			(A) responsibilities and accountability of each staff position, including direct and delegated authority; and  
			(B) interrelationship of each staff position within the birth center;  
		(3) exercise authority and responsibility for appointments to the clinical staff; and  
		(4) ensure that  
			(A) only a member of the clinical staff admits clients to the birth center;  
			(B) during the active phase of the first stage of labor through delivery and postpartum, at least two individuals are present as provided in 7 AAC 12.415(e), each of whom has a current  
				(i) adult cardiopulmonary resuscitation (CPR) certification by or equivalent to the American Heart Association's Basic Life Support Healthcare Provider Course (BLS); and  
				(ii) neonatal resuscitation provider (NRP) certification by or equivalent to the Neonatal Resuscitation Program approved by the American Academy of Pediatrics; and  
			(C) each physician, certified nurse midwife, and direct-entry midwife on the clinical staff has a current license to practice in this state;  
		(5) meet at least twice each year to execute responsibilities for the operation of the birth center, and maintain minutes of each meeting;  
		(6) approve all contracts and agreements with individuals or with service agencies, including hospitals, laboratories, emergency transportation agencies, consulting specialists, teaching institutions, and organizations that conduct research; and  
		(7) approve all contracts for student education or field experience; the governing body shall ensure that all members of the clinical staff responsible for the provision of services to clients and their families also approve these contracts.  
	(c)  The governing body shall appoint  
		(1) an administrator who is responsible for operation of the birth center, and ensure that a qualified alternate individual is available in the administrator's absence; and  
		(2) a director of the clinical staff.  
	(d)  The governing body shall adopt bylaws that include requirements for membership on the clinical staff and delineation of clinical privileges.  
	(e)  The governing body shall establish policies and procedures for implementing the quality evaluation and improvement program under 7 AAC 12.418 and shall, if requested, disclose to the department the nature and results of each review.  
	(f)  The governing body shall establish the organizational structure of the birth center operation, and shall develop, implement, and revise as necessary personnel, clinical, and administrative policies.  
	(g)  A birth center shall develop and implement a written plan for transferring clients and newborns to a hospital that is located within 20 miles by road of the birth center and that provides services that include  
		(1) full-time physician coverage; and  
		(2) the availability of full perinatal, obstetrical, and surgical capability, including  
			(A) anesthesia;  
			(B) a clinical laboratory;  
			(C) a blood bank; and  
			(D) diagnostic radiology services.  
	(h)  The plan required under (g) of this section must include  
		(1) criteria for determining medical necessity for emergency and nonemergency transfer;  
		(2) the procedures for transfer that will be followed if medical care is required for a client or newborn because complications occur during the antepartum, intrapartum, postpartum, or newborn period; in this paragraph, "newborn period" means the first 24 hours after birth; and  
		(3) a requirement that, at the time of transfer, the birth center will provide a complete clinical record to the practitioner who assumes care of the client or newborn.  
	(i)  The birth center shall provide evidence satisfactory to the department that clients and newborns transferred to a hospital by the birth center are being accepted and treated by that hospital.  
	(j)  In addition to meeting the requirements of 7 AAC 12.660, the administrator shall maintain and secure for confidentiality a personnel record for each employee, including contract staff, that includes, as appropriate, evidence of current CPR and NRP certification as described in (b)(4)(B) of this section. The administrator shall also ensure that  
		(1) the birth center's records are maintained and stored in an orderly, secure manner;  
		(2) the birth center develops and implements policies and procedures for interaction with other agencies, institutions, and individuals for services to clients and newborns, including  
			(A) obstetric and newborn acute care in a licensed hospital;  
			(B) transportation services;  
			(C) obstetric, pediatric, or neonatal consultation services, including consultation through telemedicine;  
			(D) laboratory and diagnostic services;  
			(E) childbirth education and parent education support services; and  
			(F) home health care services;  
		(3) contracts, agreements, policies, and procedures are reviewed under 7 AAC 12.418 at least annually, are updated as necessary, and are approved by the governing body;  
		(4) the birth center develops and implements a public education plan for informing the community of the services available at, and limitations of, the birth center;  
		(5) the birth center establishes and maintains a safe, home-like environment for its clients;  
		(6) the birth center provides adequate space for furnishings, equipment, and supplies to comfortably accommodate the number of childbearing families to be served and the personnel providing services;  
		(7) the birth center, in addition to complying with 7 AAC 10.9610(i), maintains a record of routine periodic inspections by state and municipal authorities responsible for health, fire, building, and public safety;  
		(8) smoking is prohibited in the birth center;  
		(9) the birth center submits a detailed written report to the department within 24 hours after any event involving  
			(A) the emergency transfer of a client or newborn to a hospital; and  
			(B) a significant outcome, including  
				(i) the death of a client or newborn;  
				(ii) respiratory instability;  
				(iii) cardiac arrest;  
				(iv) a newborn born with a low Apgar score;  
				(v) a newborn born prematurely;  
				(vi) a newborn displaying a seizure, hyptonia, unresponsiveness, or another neurological manifestation; and  
				(vii) a newborn displaying an organ dysfunction or other abnormality; and  
		(10) the birth center reports in writing to the department within seven days after any occurrence involving a client stay of more than 24 hours, and includes the reason for the stay.  

Authorities

47.32.010;47.32.030

Notes

Reference

7 AAC 12.401
7 AAC 12.403
7 AAC 12.415
7 AAC 12.418

Authority

AS 47.32.010 AS 47.32.030 Editor's note: The address for sending reports required under 7 AAC 12.405 is Department of Health and Social Services, Division of Public Health, Section of Certification and Licensing, 619 East Ship Creek Avenue, Suite 232, Anchorage, Alaska 99501; telephone: [phone]; facsimile: 907-334-2682.

History

Eff. 11/19/83, Register 88; am 9/30/2007, Register 183

References

7.12.405