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Senate panel reviews house changes to S.18, clarifies licensure and coverage for freestanding birth centers
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Summary
The Senate Health & Welfare Committee reviewed the House's amendments to S.18, which establishes licensing for freestanding birth centers, clarifies midwife definitions and permitted services, requires written collaboration and transfer policies, and preserves Medicaid coverage contingent on federal approval.
The Senate Health & Welfare Committee considered House amendments to S.18 on April 24, which would create a licensing framework for freestanding birth centers and clarify what services licensed centers may provide.
Jen Cardi of the Office of Legislative Council summarized the changes the House proposed and the committee considered. The bill establishes a new chapter for birth center licensure and tightens definitions: a certified nurse midwife is defined as an advanced practice registered nurse (APRN) licensed under the APRN subchapter who has specialized training in childbirth, newborn care and reproductive health services. The draft removes a reference to "doctor of nursing practice" as a licensure description and clarifies that a birth center may be independently owned by a licensed maternity-care provider or another person who meets the chapter's requirements.
The bill explicitly prohibits birth centers from providing epidural anesthesia or cesarean delivery, aligning the statute with the intended scope of "low-risk" birth-center care. The proposed rules would require written policies and procedures for collaboration with hospitals and other providers (including lab and diagnostic services, obstetric and pediatric consultation services, transport procedures, childbirth education, and home health services). The bill would also require a birth center to provide a patient’s or newborn’s health record to receiving providers upon transfer in accordance with privacy law.
S.18 keeps birth centers exempt from the state certificate-of-need process if they are licensed under the new chapter and would add "birth center" to the list of settings where midwifery services must be covered by health insurance, while removing a statutory cross-reference that appeared to single out facility fees. The bill delays Medicaid enrollment and coverage for birth-center services until federal approvals are obtained and ties the state effective date to federal timing as requested by the Department of Vermont Health Access.
Committee members noted broad stakeholder consensus reflected in the draft language. "I have thoughts on it. My understanding is that there was broad consensus among all the various parties," said Senator Kulik. After brief questions and a request to carry a one-page summary of agreed changes forward to the floor, the committee signaled concurrence with the House edits and planned to advance the language.
No roll-call vote on S.18 was recorded during the hearing; the committee indicated it would carry the agreed language forward for the committee report and subsequent floor action.
