Effective January 1, 2026, AB 55 revises licensing requirements for ABCs and PCC/ABCs related to Medi-Cal certification and proximity to a hospital that is licensed to provide perinatal services.
Medi-Cal Certification
AB 55 removes the licensure requirement for ABCs and PCC/ABCs to obtain Medi-Cal certification as a provider of comprehensive perinatal services (as defined in Welfare & Institutions Code section 14134.5).
Instead, AB 55 requires the facility to provide perinatal services that are comprehensive in nature, consistent with standards of the midwifery and birth center model of care and with the American Association of Birth Centers' certification standards. Perinatal services that are comprehensive in nature include, but are not limited to, the following:
- Psychosocial assessments and, when appropriate, referrals to counseling.
- Nutritional assessments and, when appropriate, referrals to counseling on food supplement programs, vitamins, and breastfeeding.
- Education on overall health, childbirth, and parenting.
Proximity to Hospital Perinatal Services
AB 55 removes the licensure requirement for ABCs and PCC/ABCs to be located in proximity (in time and distance) to a facility with the capacity for management of obstetrical and neonatal emergencies, including the ability to provide caesarean section delivery, within 30 minutes from time of diagnosis of the emergency.
Instead, AB 55 requires the ABC or PCC/ABC to have and implement a written policy for hospital transfer that is approved by the ABC's or PCC/ABC's governing body. This written transfer policy must include, but is not limited to, all of the following:
- Specific arrangements for referral of a complication to a physician and surgeon for consultation (identification of a specific physician and surgeon is not required).
- Specific arrangements for the transfer of care during the prenatal period, hospital transfer during the intrapartum and postpartum periods, access to appropriate emergency medical services for the patient/client and baby if necessary, and recommendations for preregistration at a hospital that has obstetric emergency services and is most likely to receive the transfer.
- A requirement that, at the time of transfer, the midwife responsible for the patient's/client's care immediately prior to the transfer must provide the hospital with all of the medical records that are available at that time (including prenatal) and speak with the receiving provider responsible for the patient's/client's hospital care at the time of transfer about labor up to that point (including any information that has not yet been added to the medical record). Other records that are not yet available or included in the medical record must be sent as soon as practicable after the transfer.
- A requirement that the ABC or PCC/ABC provide a patient/client, during consultation at the time of initial orientation to the facility and its model of care, with the estimated transfer time—the expected duration from departure from the birth center to the expected arrival at the planned receiving hospital. This information must also include a clear explanation of the ABC's or PCC/ABC's overall emergency transfer plan, including specified measures in place to mitigate any risk associated with distance from the planned receiving hospital and to ensure safe transfer for both the patient/client and baby. This information must be provided in writing and included in the patient's/client's medical file with their signed acknowledgement.
The information in this AFL is a brief summary of the provisions of AB 55. Facilities are responsible for following all applicable laws. CDPH's failure to expressly notify facilities of statutory or regulatory requirements does not relieve facilities of their responsibility for following all laws and regulations. Facilities should refer to the full text of all applicable sections of HSC and the California Code of Regulations to ensure compliance.
For questions concerning ABC or PCC/ABC initial licensure, change of ownership (CHOW), or license-suspension reinstatement, please email the Clinic (Initial/CHOW) Unit within CDPH's Center for Health Care Quality (CHCQ), Centralized Applications Branch (CAB) at CABClinics@cdph.ca.gov. For questions concerning ABC or PCC/ABC report of change (ROC) applications, please email CAB's Non-Long Term Care ROC Unit at CABNLTC@cdph.ca.gov.
For questions concerning Medi-Cal certification as a comprehensive perinatal service provider, please contact the California Department of Health Care Services.
Sincerely,
Original signed by Mandi Posner
Mandi Posner
Deputy Director