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Doctor Weber Pearson presses SB 32 to create time‑and‑distance standards for labor‑and‑delivery units
Summary
SB 32 would require regulators to develop time‑and‑distance standards for labor‑and‑delivery units so health plans must document contracting efforts and network adequacy for delivery facilities, supporters said; plans and some stakeholders argued closures stem from workforce, birth‑rate and facility economics rather than contracting and cautioned against administrative requirements that do not create capacity.
Sen. Dr. Weber Pearson presented SB 32 to require the Department of Health Care Services, the Department of Managed Health Care and the Department of Insurance to run a formal, stakeholder process and then adopt time‑and‑distance standards for perinatal units (labor and delivery). The senator argued that explicit L&D standards would bring perinatal services into the network adequacy framework that already governs other provider types and could pressure plans to contract with hospitals that maintain labor‑and‑delivery capacity.
Clinical and hospital witnesses including an OB‑GYN and the California Medical Association supported the bill as a targeted tool to address closures that have forced many pregnant people to travel long distances for childbirth care. Dr. Sarah Kirschner (ACOG District 9) testified that unpredictable obstetric complications can arise in otherwise low‑risk births and that every minute of delay can increase risk; she said network listings of individual OBGYNs do not guarantee timely access to a staffed labor‑and‑delivery unit.
Local Medi‑Cal managed care plans and emergency care groups opposed or raised concerns. Local Health Plans of California said the root causes of L&D closures are low birth rates, workforce shortages and facility finances, and argued standards would not create new L&D capacity; they urged that limited state resources be prioritized for workforce and facility stabilization. The California chapter of the American College of Emergency Physicians and nurses' groups warned about potential patient confusion between urgent care and freestanding facilities in other debates, and asked that any standard be aligned with workforce realities and emergency access protocols.
Committee members were divided. Some senators emphasized the real harms of long travel in labor and urged accountability from plans; others said network adequacy cannot force a hospital to remain open if economic and workforce factors make operation infeasible, and worried regulators would be burdened with waiver reviews that do not solve closures. The author and sponsors said the process would create data and transparency about where and why access fails and allow regulators to evaluate and respond; supporters said the requirement to document contracting efforts would strengthen a hospital’s leverage when negotiating with plans.
Ending: The author closed by saying SB 32 is a tool to include L&D units in network adequacy oversight and to provide regulators with data to inform solutions; the committee discussion left clear differences about whether standards would address root causes or merely create new administrative steps.
