Legislature Passes Bill to Improve Rural Access to Maternity Care

SACRAMENTO — Some rural areas in California are considered to be “maternity care deserts” where labor and delivery care is not available locally. Several factors, including high cost, low birth rates, high proportions of Medicaid patients and staffing challenges make labor and delivery services difficult to maintain in rural areas.

Plumas County became one of 12 California counties with no local facility for labor and delivery care when Quincy’s Plumas District Hospital closed its maternity service in 2022. Since then, none of the county’s three critical access hospitals provide labor and delivery care, so the nearest services for most county residents are 60-90 minutes away by road in Truckee, Reno or Chico. Traveling an hour or more to deliver is a concern in itself, especially in bad weather, and the travel time can increase the risk of complications for the mother and newborn. Plumas County Public Health Officer Dr. Mark Satterfield said about the current situation, “Do you mean to tell me we are the fourth largest economy in the world and we can’t provide a safe place for a woman to deliver less than an hour from her home? We need to do better.”

A bipartisan bill passed recently by the legislature seeks to improve that situation by easing some requirements for maternity services at critical access hospitals. The bill, SB 669, was introduced by District 2 Senator Mike McGuire and co-authored by District 1 Senator Megan Dahle, among others. The law would change current requirements to facilitate the so-called “Plumas Model” for rural maternity care. The model, developed by a team at Plumas District Hospital, aims to provide needed care through linkages between critical access hospitals, rural health clinics and alternative birthing centers.

If signed by the Governor, SB 669 would create a 10-year pilot program that would allow licensed birthing centers to operate in conjunction with critical access hospitals providing labor and delivery care on a standby basis, available within 30 minutes, rather than in-house 24 hours a day year-round, as currently required. The pilot program would be open to as many as five critical access hospitals, the first two of which would be non-profit hospitals in Plumas and Humboldt counties. The bill would also require the state Department of Public Health to evaluate the pilot program and report back to the legislature on the populations served, safety, and the quality of outcomes.

In anticipation of the bill becoming law, Plumas District Hospital is moving forward with plans to open a birthing center primarily staffed by a midwife and a nurse and supported by a standby physician and medical team at the hospital. A certified nurse midwife will be available for all deliveries. Dr. Satterfield said that the new facility will make it possible for most women with low-risk pregnancies to deliver locally if they wish to.