Section 265.2700  General Construction Requirements

a)         Program Narrative

The program narrative shall describe the various components planned for the birth center and how they will interface with each other.

1)         Size and Layout

Birth center departments' sizes and clear floor areas depend on program requirements and organization of services within the birth center. As required by community needs, combination or sharing of some functions shall be permitted, provided the layout does not compromise safety standards and medical nursing practices and receives approval from the Department.

2)         Transfer and Service Agreements

Transfer and service agreements with secondary or tertiary care hospitals with full maternity services shall be in place prior to initiating the planning and construction of these facilities.  These agreements shall be submitted to the Department for approval at the time of project submission.

3)         Birth Center Proximity to Secondary or Tertiary Care Hospitals

A birth center shall be located within a ground travel time distance from the secondary or tertiary hospitals with which the birth center maintains a contractual relationship, including a transfer agreement that allows for an emergency caesarian delivery to be started within 30 minutes after the decision that a caesarian delivery is necessary.

b)         Site

The facility shall be sited to avoid placement in a flood plain, seismic fault line, or other natural impediment to maintaining a stable operational environment.

1)         Transfer Support Features

A)        Part of the facility's transfer agreements with secondary and tertiary care hospitals with maternity services providers shall include ambulance services to ensure the timely transfer of clients presenting to the birth center and requiring surgical or other hospital-based interventions.

B)        Ambulance ports shall be located close to the emergency entrance and the designated client rooms holding clients requiring transfer to a secondary or tertiary care facility with maternity services.

C)        Where appropriate, features such as garages, approaches, lighting, and fencing to meet State, federal and/or local regulations that govern the placement, safety features, and elements required to accommodate ambulance service shall be provided.

2)         Accessibility to Public Transportation

The birth center shall be sited to provide easy and convenient access to public transportation, if locally available.

3)         Parking

A)        Each new birth center, major addition, or major change in function shall be provided with parking spaces to satisfy the needs of the client population, personnel, and public.

B)        Additional parking may be required to accommodate other services.

C)        The birth center shall provide accommodation for loading and off-loading clients from vehicles in an area sheltered from the weather.