1. (a) A birth center must develop and implement written policies and procedures for client management that are approved by the governing body and that include

   1. (1) policies and procedures to ensure that eligibility for birth services offered by the birth center is limited to low-risk maternal clients, as determined upon admission and at regular intervals after admission through a physical examination and through a risk assessment conducted in accordance with the standards developed under 7 AAC 12.403(f);
   2. (2) a procedure for identification and transfer of a client who, during the course of pregnancy, labor, or recovery, is determined to be ineligible for continued care in the birth center;
   3. (3) plans for consultation, backup services, transfer, and transport of a client or newborn to a hospital where appropriate care is available;

   4. (4) a requirement for an informed consent that

      1. (A) is signed by the client before the onset of labor; and
      2. (B) includes evidence that the client has received an explanation by personnel of the birth services offered and potential risks involved;
   5. (5) provision of education of clients, family, and support persons in childbirth and newborn care;
   6. (6) plans for immediate follow-up of clients after discharge from the birth center;
   7. (7) entering onto the client's medical record evidence of registration of birth with the bureau of vital statistics and completion of a birth certificate;
   8. (8) reporting of complications and anomalies to the department, and to the pediatric or neonatal provider identified by the client;
   9. (9) prophylactic care of the newborn's eyes;

   10. (10) procedures for

       1. (A) distribution of information to clients regarding availability of resources for vitamin K, erythromycin eye prophylaxis, newborn hearing screening tests, bloodspot screening, and other screening tests required by law;
       2. (B) providing a referral to each client before discharge;
       3. (C) following up with each client after discharge to remind the client that the tests referred to in (A) of this paragraph are critical to the newborn's health; and
       4. (D) documenting that the steps set out in (A) - (C) of this paragraph have been followed;
   11. (11) methods to protect each client's right to dignity, privacy, safety, and confidentiality;
   12. (12) procedures for administering newborn bloodspot screening in compliance with 7 AAC 27.510 - 7 AAC 27.590 (Screening of Newborn Children for Congenital Disorders);
   13. (13) policies and procedures that cover medical emergencies, client teaching, and discharge planning; in this paragraph, "client teaching" means instruction of a client in diet, medication, exercise, and other therapeutic measures suggested for consideration by the client after discharge; and

   14. (14) policies and procedures for

       1. (A) gram positive Group B Streptococcus screening, management, and treatment;
       2. (B) information to be provided to the client regarding Group B Streptococcus; and
       3. (C) monitoring after delivery of each newborn born to a client who tests positive for Group B Streptococcus or to a client with unknown status.
2. (b) In addition to the orientation and training required under 7 AAC 12.860(4), the birth center shall provide and document orientation and in-service training for all employees in client management consistent with the policies and procedures developed under (a) of this section.

(Eff. 5/14/82, Register 82; am 11/19/83, Register 88; am 9/30/2007, Register 183; am 7/1/2018, Register 226)

Authority: AS 47.32.010, AS 47.32.030