The Senate Committee on Health & Welfare considered S.18, a bill to license freestanding birth centers and to direct state agencies to seek Medicaid coverage for services provided in those centers.

Sen. Martina Rob Gulick, sponsor of S.18, told the committee the bill would create a new chapter in Title 18 to establish licensing standards for freestanding birth centers, facilities that ‘‘are not a hospital or part of a hospital’’ and that provide prenatal, labor, delivery and postpartum care for planned low‑risk births. ‘‘We are 1 of only 8 states in the entire country without a freestanding birthing center,’’ Gulick said.

Supporters and staff said the bill borrows the licensure structure already used for hospitals and ambulatory surgical centers. Office of Legislative Counsel staff member Jen Hardwick summarized the bill for the committee: "This is an act relating to licensure of freestanding birth centers, And it creates a new chapter in title 18 on birth centered licensing." The bill would require an application to the Department of Health, set a licensing fee, allow accreditation by the Commission for the Accreditation of Birth Centers to satisfy renewal requirements, and require inspection, records protections, and an appeal process similar to other facility types.

The bill directs the Department of Health to adopt rules that align Vermont regulation with the National Birth Center Standards published by the American Association of Birth Centers. The rules may set scope of service, appropriate staffing, and written policies for transfers to hospitals. The draft also clarifies that licensed midwives and certified nurse‑midwives may continue to practice within their statutorily authorized scopes in spaces adjacent to or shared with a birth center.

Section 2 adds birth centers to the list of settings that health insurers must cover for prenatal, maternity, postpartum and newborn services. Section 3 would exclude licensed birth centers from certain certificate‑of‑need requirements in current law, subject to the same thresholds discussed in prior CON bills. Section 4 directs the Agency of Human Services to seek approval from the Centers for Medicare and Medicaid Services so Vermont Medicaid can cover and reimburse birth center services separately; the bill sets a deadline for the agency to submit that request by July 1 and contemplates Medicaid coverage beginning on the date of CMS approval or Jan. 1, 2026.

Committee members raised operational and rural care questions, including how urgent transfers would be handled and whether rural hospital staffing could be affected; Jen Hardwick and members agreed those issues will require testimony and data. Committee leadership said members expressed enough interest to place the bill on the committee’s agenda for further review and to invite testimony from stakeholders and regulators.

The committee did not take a final vote on S.18 during the session recorded in the transcript; members asked staff to schedule follow‑up hearings and to collect testimony and implementation details.

Looking ahead, sponsors and staff said the committee will request testimony from birth‑center advocates, hospital representatives and the Agency of Human Services to address transfer protocols, accreditation, projected costs and the CMS approval pathway.