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Cuomo & DeRosa announce increased access to midwife-led birth centers amid COVID-19 pandemic


Tue, Jun 16th 2020 05:45 pm

Gov. Andrew Cuomo and the New York State COVID-19 Maternity Task Force, chaired by Secretary Melissa DeRosa, on Tuesday announced Gov. Andrew Cuomo directed the State Department of Health to allow midwife-led birthing centers in New York for the first time.

This directive to diversify birthing site options and support patient choice was one of six key recommendations of the task force, which launched in April at Cuomo’s direction. The governor's directive will provide expecting mothers more labor and delivery options.

DOH is now accepting certificate of need applications for midwifery birth centers pursuant to Public Health Law Article 28.

"COVID-19 has brought unprecedented stress and anxiety into the lives of expecting parents whose pregnancies have been disrupted by the uncertainty caused by this virus," Cuomo said. "Our coronavirus maternity task force worked quickly to put together a full set of recommendations to assist expecting mothers during this stressful time, and New York is acting to implement these measures so expecting mothers have access to a diverse range of birthing site options that meet their specific needs."

DeRosa said, "New York's health care system stepped up to provide unprecedented emergency care during the COVID-19 pandemic and to ensure expecting parents have access to quality health facility options when giving birth. By adding midwife-led birthing centers to state Health Department oversight, we are recognizing their vital role as safe and healthy birthing options and continuing to expand patient choice for expecting mothers."

When the task force met virtually in April at the height of the COVID-19 crisis, its members recommended Cuomo issue an executive order to allow for the establishment of additional birthing surge sites operated by currently established licensed birthing hospitals and centers to help ease the stress of hospitals caring for COVID-19 patients and increase birthing options.

Recognizing that midwifery services are essential to achieving this goal, the task force also recommended DOH move to expedite within 45 days the finalization of the licensure process for the establishment of midwifery led birthing centers in New York to ensure there are sufficient birthing facilities available to meet community need during emergency situations.

The task force also recommended the New York State Department of Health be directed to develop a streamlined process to accept applications from licensed health care facilities, such as community health centers and federally qualified health centers, to convert unused space in their facility to dedicated labor and delivery spaces during an emergency.

Through that streamlined process, the New York State Department of Health approved two new temporary birthing centers, Brooklyn Birthing Center in Brooklyn, and Refuah Health Center in Valhalla, consistent with the task force recommendation.

The Brooklyn Birthing Center, a certified diagnostic and treatment center, requested and was granted emergency approval from the task force to open an extension of its existing center, Brooklyn Birthing Center d/b/a Jazz Birthing Center of Manhattan. This second site will have five birthing rooms and will operate on a temporary basis during the COVID-19 public health emergency.

Refuah Health Center is a licensed Article 28 diagnostic and treatment center and federally qualified health center located in Spring Valley. Refuah requested and was granted an emergency approval request to add a four-bed birthing center in the space adjacent to its main site. Refuah Health Center will accept maternity patients from Westchester Medical Center in Valhalla and Good Samaritan Hospital of Suffern. The birthing center is temporary and will only operate during the COVID-19 public health emergency.

Under executive order 202, these requests are considered emergency approvals necessary to provide services during the COVID-19 public health emergency. If the sites continue to operate on a permanent basis, a CON will be required.

About Certificate of Need process

New York's certificate of need process governs establishment, construction, renovation and major medical equipment acquisitions of health care facilities, such as hospitals, nursing homes, home care agencies, and diagnostic and treatment centers. The objectives of the CON process are to promote delivery of high-quality health care and ensure that services are aligned with community need. CON provides the Department of Health oversight in limiting investment in duplicate beds, services and medical equipment which, in turn, limits associated health care costs.

As with other health care facilities, MBCs must meet requirements and standards specific to the program. The department has created an MBC-specific CON submission guidance document to assist new applicants which can be found on the CON web page.

About New York State COVID-19 Maternity Task Force

In April 2018, Cuomo announced a multifaceted initiative to combat maternal mortality and racial disparate outcomes in New York. Continuing the state's commitment to improve maternal and child outcomes and recognizing the significant strain the COVID-19 pandemic has placed on hospital infrastructure and the concerns of many pregnant individuals across New York, Cuomo directed the NYS Council on Women and Girls, with the support of the New York State Department of Health, to convene an expert task force to address the impact of COVID-19 on maternity. Chaired by DeRosa, the task force was charged with examining the best approach to provide mothers a safe alternative, when appropriate, to already stressed hospitals amid the ongoing COVID-19 pandemic.

Comprised of a multidisciplinary group of maternal and infant health professionals from across New York, the task force met remotely to discuss these issues and propose recommendations. Given the urgency of the COVID-19 emergency and its impact on pregnant people, meetings of the task force were held within a week in order to make an initial set of recommendations. Recommendations were compiled and analyzed by DOH staff and shared with task force members, who reviewed the submissions and made a collective determination to advance the recommendations.

Prior to the creation of the task force, New York took several steps to expand access to access to maternal care during the COVID-19 pandemic, including:

  • Expanding access to telehealth and telephonic visits;
  • Mandating the presence of a support person throughout the birthing process and recovery;
  • Authorizing out-of-state obstetrician-gynecologists and midwives from other states to practice in New York to improve surge capacity; and
  • Identifying sexual and reproductive health services as essential.

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