Dear President Skelos, Speaker Silver, and Assembly Member Gottfried, 

As advocates of midwife- and physician-led freestanding birth centers, we ask that you hold the Midwifery Birth Center Bill (S7121) until more stakeholders have had the opportunity to weigh in.  We need a more comprehensive bill that addresses the unique obstacles to opening accredited freestanding birth centers in New York. 

Our concerns about S7121 are as follows:

1.  Freestanding birth centers (FSBCs) should not be a defined as a category of hospitals. There are many reasons why this model will not work for FSBCs, including federal and private national payment models. FSBCs should be defined specifically as freestanding outpatient facilities, which is how they almost universally are characterized.

2.  To prevent consumer confusion, FSBCs should be distinct from hospital labor and delivery units that have been renamed or branded as so-called "birthing centers" but do not meet American Association of Birth Centers (AABC) standards. The federal Medicaid definition of “freestanding birth center” should be adopted to make New York’s law consistent with federal law and also with national usage by government and private health insurance, and by the birth center industry itself. 

3.  FSBCs should be exempted from the Certificate of Need (CON) process. This process is cumbersome, prohibitively expensive, and unnecessary for small outpatient facliities such as FSBCs. CON requirements create a significant barrier to entry for birth centers. 

4.  The provision of the bill that delegates rule-making authority to the Commissioner should explicitly outline rules that are CONSISTENT with AABC standards. It should explicitly prohibit the Commissioner from imposing certain types of restrictions that we know, from experience, will kill birth centers; it should also explicitly exempt FSBCs from CON4.  The bill should prohibit any rule that would allow competitors of birth centers or midwives – that is, hospitals and physicians – to exercise veto power over the development or operation of a FSBC. 

In light of these shortcomings of S7121, we respectfully ask that you hold the bill until these concerns are addressed.