A hospital requesting approval to establish a standby perinatal service pursuant to Section 1256.05 shall implement and maintain all of the following requirements: (a) (1) Comply with the most recent standards and recommendations for Level I (Basic Care) of the Levels of Maternal Care and Level 1 (Well Newborn Nursery) of the Neonatal Levels of Care, within the Guidelines for Perinatal Care developed by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. (2) Have the capacity for operative delivery, including caesarean section, and neonatal resuscitation and stabilization at all times. (3) Have the ability, equipment, and supplies necessary to provide care for mothers and infants needing emergency or immediate life support measures to sustain life up to 12 hours or to prevent major disability, including, but not limited to, all of the following services: (A) Administration of intravenous or intramuscular antibiotics. (B) Administration of intravenous or intramuscular uterotonic drugs, including oxytocin. (C) Administration of intravenous or intramuscular anticonvulsants. (D) Administration of antihypertensives. (E) Manual removal of the placenta. (F) Removal of retained products of conception. (G) Basic neonatal resuscitation. (H) Surgery, including caesarean sections. (I) Blood transfusions. (J) Additional services specified by the department, in consultation with relevant stakeholders. (4) Have capabilities for risk identification and determination of conditions necessitating consultation, referral, and transfer. (5) Have capabilities, including necessary equipment, for stabilization and the ability to facilitate transfer or transport to a higher level of care at all times. (6) (A) Have theâequipment and supplies specified in Section 70551 of Title 22 of the California Code of Regulations, or its successor. (B) In addition to the items required under subparagraph (A), have all of the following equipment and supplies: (i) A fetal heart rate monitor that includes both the ability to monitor multiple gestation pregnancies using internal monitors, including fetal scalp electrodes and intrauterine pressure catheters, and maternal pulse integrated to ensure monitoring of fetal pulse and not maternal pulse. (ii) Provision for oxygen and suction for the mother and infant, including, but not limited to, specialized supplies needed for neonatal resuscitation and breathing support. (iii) A ventilatory assistance bag and infant masks of assorted sizes for infants of different gestational ages. (iv) A postpartum hemorrhage kit, including a uterine tamponade device. (v) Neonatal resuscitation supplies, including supplies for umbilical access for medications. (vi) Maternal steroid medications available for initial administration in the case of preterm labor while awaiting transport. (vii) A refrigerated medication storage unit in the standby perinatal service for uterotonic medications requiring refrigerated storage to be immediately accessible in emergencies. (viii) A suction device appropriate for neonatal resuscitation. (b) (1) In consultation with the medical staff, define the responsibilities of the medical staff and administration associated with the standby perinatal services. (2) (A) Ensure that a provider that provides services pursuant to this section in the hospital meets all applicable requirements set forth in both of the following: (i) The medical staff bylaws. (ii) Rules, regulations, and policies of that facility. (B) Nothing in this section shall be construed to require changes to the medical staff bylaws or policies regarding credentialing or privileges. (c) (1) Ensure that a physician who is certified, or eligible for certification, by the American Board of Obstetrics and Gynecology, the American Board of Pediatrics, or the American Board of Family Medicine, and who is a member of the medical staff of the facility, has overall responsibility of the standby perinatal services.
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