S 18 — An act relating to licensure of freestanding birth centers

A copy of the findings and decision shall be sent by registered mail or served personally upon the applicant or licensee.

The procedure governing BILL AS INTRODUCED AND PASSED BY SENATE S.18 Page 5 of 14 hearings authorized by this section shall be in accordance with the usual and customary rules provided for such hearings.

§ 2356.

APPEAL Any applicant or licensee, or the State acting through the Attorney General, aggrieved by the decision of the Department of Health after a hearing may, within 30 days after entry of the decision as provided in section 2355 of this title, appeal to the Superior Court for the district in which the appellant is located.

The court may affirm, modify, or reverse the Department’s decision, and either the applicant or licensee or the Department or State may appeal to the Vermont Supreme Court for such further review as is provided by law.

Pending final disposition of the matter, the status quo of the applicant or licensee shall be preserved, except as the court otherwise orders in the public interest.

§ 2357.

INSPECTIONS The Department of Health shall make or cause to be made such inspections and investigations as it deems necessary.

If the Department finds a violation as the result of an inspection or investigation, the Department shall post a report on the Department’s website summarizing the violation and any corrective action required.

BILL AS INTRODUCED AND PASSED BY SENATE S.18 Page 6 of 14 § 2358.

RECORDS (a) Information received by the Department of Health through filed reports, inspections, or as otherwise authorized by law shall:

(1) not be disclosed publicly in a manner that identifies or may lead to the identification of one or more individuals or birth centers;

(2) be exempt from public inspection and copying under the Public Records Act;

and (3) be kept confidential except as it relates to a proceeding regarding licensure of a birth center.

(b) The provisions of subsection (a) of this section shall not apply to the summary reports of violations required to be posted on the Department’s website pursuant to section 2357 of this chapter.

§ 2359.

RULES The Department of Health shall adopt rules in accordance with 3 V.S.A.

chapter 25 as needed to carry out the purposes of this chapter.

The rules shall align the regulation of birth centers in Vermont with the national birth center standards published by the American Association of Birth Centers and may include provisions regarding:

(1) the scope of services that may be provided at a birth center;

(2) appropriate staffing for a birth center, including the types of licensed health care professionals who may practice at a birth center;

and BILL AS INTRODUCED AND PASSED BY SENATE S.18 Page 7 of 14 (3) a requirement for written practice guidelines and policies that include procedures for transferring a patient to a hospital if circumstances warrant.

§ 2360.

NO EFFECT ON SCOPE OF SERVICES Nothing in this chapter or in rules adopted pursuant to this chapter shall be construed to limit the scope of the services that a licensed midwife, certified nurse midwife, or other health care professional working within that health care professional’s scope of practice may offer or perform in a space that is shared with or adjacent to a birth center.

Sec.

2.

8 V.S.A.

§ 4099d is amended to read:

§ 4099d.

MIDWIFERY COVERAGE;

HOME BIRTHS (a) A health insurance plan or health benefit plan providing maternity benefits shall also provide coverage:

(1) for services rendered by a midwife licensed pursuant to 26 V.S.A.

chapter 85 or an advanced practice registered nurse licensed pursuant to 26 V.S.A.

chapter 28 who is certified as a nurse midwife for services within the licensed midwife’s or certified nurse midwife’s scope of practice and provided in a hospital, birth center, or other health care facility or at home;

and (2) for prenatal, maternity, postpartum, and newborn services provided at a birth center licensed pursuant to 18 V.S.A.

chapter 53.

* * * BILL AS INTRODUCED AND PASSED BY SENATE S.18 Page 8 of 14 Sec.

3.

18 V.S.A.

§ 9435(a) is amended to read:

(a) Excluded from this subchapter are offices of physicians, dentists, or other practitioners of the healing arts, meaning the physical places that are occupied by such providers on a regular basis in which such providers perform the range of diagnostic and treatment services usually performed by such providers on an outpatient basis unless they are subject to review under subdivision 9434(a)(4) of this title.

The exclusion provisions of this subsection shall also apply to birth centers licensed pursuant to chapter 53 of this title.

Sec.

4.

AGENCY OF HUMAN SERVICES;

MEDICAID;

REQUEST FOR FEDERAL APPROVAL The Agency of Human Services shall seek approval from the Centers for Medicare and Medicaid Services to allow Vermont Medicaid to cover prenatal, maternity, postpartum, and newborn services provided at a licensed birth center and to allow Vermont Medicaid to reimburse separately for birth center services and for professional services.

Sec.

5.

EFFECTIVE DATES This act shall take effect on January 1, 2026, except that the Agency of Human Services shall submit its request for approval of Medicaid coverage of birth center services as set forth in Sec.

4 to the Centers for Medicare and BILL AS INTRODUCED AND PASSED BY SENATE S.18 Page 9 of 14 Medicaid Services on or before July 1, 2025, and the Medicaid coverage shall begin on the later of the date of approval or January 1, 2026.

Sec.

1.

18 V.S.A.

chapter 53 is added to read:

CHAPTER 53.

BIRTH CENTER LICENSING § 2351.

VT LEG #382196 v.1 AS PASSED BY SENATE S.18 Page 2 of 10 (5) “Licensed maternity care provider” means a licensed provider whose professional scope of practice, as established under Vermont law, includes preconception, prenatal, labor, birth, and postpartum care and early care of a newborn and who may be the primary attendant during the perinatal period.

§§§§ 4122(b) 4122(b) and 4125(b), doctors of nursing practice, and physicians.

§BILL 2352.AS INTRODUCED AND PASSED BY SENATE S.18 Page 10 of 14 § 2352.

(c) No person shall represent itself as a “birth center” or use the term “birth center” in its title or in its advertising, publications, or other form of VT LEG #382196 v.1 AS PASSED BY SENATE S.18 Page 3 of 10 communication unless the person has been licensed as a birth center in accordance with the provisions of this chapter.

§§ 2353. 2353.

§§ 2354. 2354.

§§ 2355. 2355.

HEARING The Department of Health, after notice and opportunity for hearing to the applicant or licensee, is authorized to condition, deny, suspend, or revoke a VT LEG #382196 v.1 AS PASSED BY SENATE S.18 Page 4 of 10 license in any case in which it finds that there has been a substantial failure to comply with the requirements established under this chapter.

A copy of the findings and decision shall be sent by registered mail or BILL AS INTRODUCED AND PASSED BY SENATE S.18 Page 11 of 14 served personally upon the applicant or licensee.

VT§ 2357. LEG #382196 v.1 AS PASSED BY SENATE S.18 Page 5 of 10 § 2357.

§§ 2358. 2358.

and VT LEG #382196 v.1 AS PASSED BY SENATE S.18 Page 6 of 10 (3) be kept confidential except as it relates to a proceeding regarding licensure of a birth center.

BILL AS INTRODUCED AND PASSED BY SENATE S.18 Page 12 of 14 (b) The provisions of subsection (a) of this section shall not apply to the summary reports of violations required to be posted on the Department’s website pursuant to section 2357 of this chapter.

VT LEG #382196 v.1 AS PASSED BY SENATE S.18 Page 7 of 10 (5) appropriate staffing for a birth center, including the types of licensed providers who may practice at a birth center;

§§ 2360. 2360.

BILL AS INTRODUCED AND PASSED BY SENATE S.18 Page 13 of 14 (b) A birth center may serve as a location for additional services offered in shared or adjacent spaces, including outpatient gynecologic care, primary care, and education and support services, provided that any licensed provider VT LEG #382196 v.1 AS PASSED BY SENATE S.18 Page 8 of 10 providing services in those spaces shall only provide those services that are within the licensed provider’s authorized scope of practice.

§§ 4099d 4099d is amended to read:

§§ 9435(a) 9435(a) is amended to read:

(a) Excluded from this subchapter are offices of physicians, dentists, or other practitioners of the healing arts, meaning the physical places that are occupied by such providers on a regular basis in which such providers perform the range of diagnostic and treatment services usually performed by such providers on an outpatient basis unless they are subject to review under VT LEG #382196 v.1 AS PASSED BY SENATE S.18 Page 9 of 10 subdivision 9434(a)(4) of this title.

BILL AS INTRODUCED AND PASSED BY SENATE S.18 Page 14 of 14 (b) Sec.

§§ 4099d) 4099d) shall take effect on January 1, 2027.

§§ 9435a) 9435a) shall take effect on July 1, 2025.

VT LEG #382196 v.1 AS PASSED BY SENATE S.18 Page 10 of 10 (e) This section shall take effect on passage.

VT LEG #382196 v.1