RD248 - Annual Report to the Joint Commission on Health Care On the Impact and Effectiveness of the Pilot Programs to Expand Access to Obstetric, Prenatal, and Pediatric Services


Executive Summary:
The 2005 General Assembly (GA) passed HB2656 authorizing the State Board of Health to approve birthing center pilot projects in Emporia and in the Northern Neck as an alternative way to improve access to obstetrical and pediatric care in areas without inpatient maternity services.. In accordance with the provisions contained with HB 2656, approved pilot projects were permitted to employ certified nurse midwives (CNM) licensed by the Board of Medicine and Nursing to practice in collaboration with a physician rather than requiring a supervisory relationship with a physician.

HB2656 also added a provision requiring the Virginia Department of Health (VDH) prepare an annual report to the Joint Commission on Health Care on the impact and effectiveness of the pilot programs to expand access to obstetrical and pediatric services in these communities. VDH has issued four such reports in 2006, 2007, 2008, and 2009 to the Joint Commission on Health Care on the progress made to date on the development of birthing centers.

In FY10, state funding in support of the Northern Neck pilot birth center project was eliminated leaving Emporia/Greensville as the only state funded pilot project. A new Memoranda of Agreement (MOA) was established with Southern Dominion Health Systems, Inc. (SDHS) for the Emporia/Greensville project. The MOA contained provisions to administer start-up funds and provide management oversight for this project. Over the past 12 months, stakeholders in the Emporia/Greensville communities have continued to perform work in support of establishing birthing centers utilizing the services of CNMs in accordance with the Board of Health’s recommendations.

In the spring of 2010, the Northern Neck’s birth center project coordinator along with community stakeholders sought the Board of Health’s approval to operate the Family Maternity Center of Northern Neck. Having met all of the provisions contained within HB 2656, the Board unanimously approved the center and doors were open for business in May 2010. During this same time frame Southern Dominion Health Systems has moved closer to establishing a birth center in Emporia, however, it has not as yet become operational.

The issue of Medicaid coverage for freestanding birth center services is still being discussed. With the passage of the Health Care Reform bill, Section 2301 provides for Medicaid payments to providers in a freestanding birth center. In Virginia birthing centers are not licensed, therefore there is no Medicaid reimbursement for facility fees. There are no anticipated changes to state law to license freestanding birth centers.