15 Mar Legislative Update March 15, 2017
S242 the Senate version of the birth center bill that CBP strongly endorses has a hearing scheduled for Thursday March 30th at 10:00 AM in the Gressette Building 1101 Pendleton St, Columbia, SC. It is vital we show the legislators the bill has strong support from consumers. We need as many people as possible to go to the hearing and for some to testify. If you are unable to attend please make phone calls to your legislators asking for their support. We have 2 local Senators on the Medical Affairs committee Sen Paul Campbell and Sen Marlon Kimpson. Sen Larry Grooms sponsored the bill. You can find your legislators at scstatehouse.gov. You will likely speak to a staff member and it only takes a couple of minutes. “My name is _________ I live in Sen/Rep__________ district and I am calling to ask his/her support for H3133 on the House side and S242 on the Senate side. Without legislation this year our local birth center is at risk of closure.”
CBP will have a caravan of people driving to the State House on March 30th leaving from CBP at 8 AM.
The Proviso (temporary stop gap law) that is allowing CBP and the other accredited birth centers to remain in compliance for licensure runs out June of 2018 and will not be renewed.
All three accredited birth centers in SC endorse H3133 and S242, including both CNM and CPM staffed centers. The two non-accredited centers oppose H3133 and S242 and endorse H3845 as an alternate bill. CBP does not oppose H3845 but we believe H3133/S242 are the better bills. These bills require accreditation as a basis for licensure ensuring all birth centers regardless of provider follow the same evidence based standards. It also requires a consulting physician to be available by phone for consults and to sit on the advisory board for the birth center. The physician also has to have hospital privileges within 45 miles of the center. We believe these are reasonable requirements that put the needs of the mothers and babies first. If the bill is passed it will allow centers a year to comply.
We would like to address some concerns that have circulated on social media.
The Ft Mill birth center that had a high number of infant deaths over a short time was accredited therefore accreditation does not ensure safety. Not true. The Carolina Community Birth Center never was granted full accreditation.
Accreditation is an over reach of government and is not required by other health care facilities. Other health care facilities already have accreditation so a law is not required. Hospitals, Nursing Homes, Ambulatory Surgery Centers etc. must be accredited to be in network with insurance companies. It won’t be too far in the future that insurance companies will also require accreditation for birth centers. Accreditation requirement will prevent DHEC from over regulation that is not evidence based.
Accreditation is too expensive and difficult. The American Association for Birth Centers Foundation has grants available to assist centers. The Commission for Accreditation of Birth Centers is the only birth center specific organization that uses national birth center standards. They work with centers to come up to standard if they do not meet the requirements. The bill does not require specifically CABC accreditation.
Accreditation is more difficult for CPM centers. Not true. Labors of Love CPM center in Spartanburg is accredited as are many other CPM centers throughout the U.S. Both AABC who writes the Standards and CABC who writes the indicators for birth centers have equal input from CPMs and CNMs. Both CNM and CPM national professional organizations had input on the AABC Standards.
Physicians will not agree to consult with CPMs. Not true. There are physicians who meet the requirements in both the low country and the upstate willing and who do consult with both CPMs and CNMs.
If a physician consults with CPMs or birth centers his hospital would revoke his privileges. Not true. Never has a physician who consulted with midwives of either credential ever had his privileges revoked in South Carolina.
H3133/S242 requires written agreements that are against AABC policy for birth center legislation. Not true. The bills do not require written agreements or contracts with physicians or hospitals. H3133/S242 have been endorsed in writing by both AABC and CABC. H3845 does require a written approval from either a CNM or physician for mothers to birth at CPM centers. We do not feel this is appropriate or provides the safety and quality assurances needed to protect consumers. Rarely do physicians have any training or experience in birth centers and are not the authority for birth center care. Centers could have a physician on retainer that would sign for the mother to meet birth center criteria that is against national standards. There are bad actors of all credentials. CPMs who follow national birth center standards are just as qualified as CNMs and physicians to determine a birth center mother’s risk status.
H3133/S242 would close all CPM centers and H3845 would keep all birth centers open. H3133/S242 will not close any birth center it gives a year for all centers to reach compliance. A year is reasonable to comply. H3845 has strong opposition from powerful lobby groups and has no realistic chance of passing even with strong consumer support. Without a bill passed this session Charleston Birth Place is at risk of closure first. With our transport hospital stopping maternity services next year we will be left without a place to go. Labor of Love CPM center in Spartanburg will also be at risk of closure when the Proviso runs out. DHEC will continue to cite the non-accredited centers for not meeting their interpretation of physician support. This will put all entrepreneur centers at risk and the Greenville Hospital owned center the only one safe.
All birth centers should stand together for H3845. It does not matter if all the birth centers agree if other more powerful stakeholders disagree. In the words of a SC legislator,”politics is not logical.” Legislators do not like to deal with controversial bills. They will just delay and move onto issues that have more priority. Birth centers deliver less than 1% of babies in SC. We are not a priority. The lesson learned in the 4 years of trying to pass a birth center bill is in order to move forward compromises must be reached.
Please help us move H3133/S242 forward this legislative session.