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For purposes of this chapter, the following words and phrases will have the following meanings unless the context clearly indicates otherwise:
(1) "Administration of drugs" means an act in which a single dose of a prescribed drug or biological is given to a patient by an authorized person in accordance with all laws and rules governing these acts. The complete act of administration entails removing an individual dose from a previously dispensed, properly labeled container, including a unit dose container, verifying it with the orders of a practitioner who is legally authorized to prescribe, giving the individual dose to the proper patient and properly recording the time and dose given.
(2) "Applicant" means a person or entity seeking licensure as a birthing center under this chapter.
(3) "Authenticated or authentication" means authorization of an entry in a record by means of a written or electronic signature which must include, minimally, first initial, last name, and title or unique identifier verifying accuracy of information.
(4) "Bathing facility" means a bathtub or shower.
(5) "Bathroom" means a room containing a toilet and a handwashing sink. A bathroom must provide privacy by way of walls or other provisions. A bathroom may or may not include a bathtub or shower. A bathroom that exists inside of a birthing room does not need an additional handwashing sink nor additional privacy walls.
(6) "Birthing center" or "birth center" means any health facility, not part of a hospital or in a hospital, that provides facilities and clinical staff to support a birth service to low-risk maternity clients and their newborns. This chapter does not apply to any hospital approved by the American College of Surgeons, American Osteopathic Association, or its successor. A birthing center is considered B occupancy according to state adopted building codes.
(7) "Birthing room" means a room designed, equipped, and arranged to provide for the care of a patient and their newborn and to accommodate their support people during the process of vaginal childbirth (the three stages of labor and recovery of both patient and newborn).
(8) "Birth service" means the intrapartum and immediate postpartum care provided for low-risk maternity clients, including newborn care during transition and stabilization.
(9) "Client" means a pregnant or postpartum patient, receiving care and services provided by a birth center during labor, birth, and immediate postpartum.
(10) "Clinical staff" means physicians and midwives, including contractors, appointed by the governing body or their representative to practice within the birth center and governed by rules and policies and procedures approved by the governing body.
(11) "Consultation" means the process used by the clinical staff of a birthing center who maintain primary management responsibilities for the client or newborn's care to seek the opinion of a licensed health care provider on clinical issues that are patient specific. The health care provider consulted must be qualified by training and experience in the specific patient need for which consultation is sought.
(12) "Contractor" means an individual who has a written contract with a birthing center licensee to provide birth services. The written contract must be approved by the governing body or their representative, and must include documentation of specific clinical privileges granted. Birth services provided by contractors in licensed birthing centers must meet requirements of this chapter, unless otherwise noted.
(13) "Department" means the Washington state department of health.
(14) "Emergency" means a medical emergency or injury requiring immediate medical or surgical intervention to prevent death or disability.
(15) "Emergency transfer" means the transfer of a client in an emergent situation to a facility that can manage obstetrical and neonatal emergencies beyond the scope of community birth, including the ability to perform cesarean delivery.
(16) "Governing body" means the person or persons responsible for establishing and approving the purposes and policies and procedures of the birthing center.
(17) "Hospital" means any institution, place, building, or agency providing accommodations, facilities, and services as defined in chapter 70.41 RCW.
(18) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as determined by documentation of adequate prenatal care, and anticipation of a normal uncomplicated labor and birth, as defined by reasonable and generally accepted criteria of maternal and fetal health and adopted by the Commission for the Accreditation of Birth Centers (CABC) indicators of compliance with standards for birth centers, reference edition 2.3, effective September 15, 2023.
(20) "Newborn" means a baby delivered by the pregnant client who is admitted to the birth center. Newborns are admitted to the birth center at delivery and receive care by the clinical staff at the birth center until discharge.
(21) "New construction" means any of the following:
(a) New buildings to be used as a birth center;
(b) Addition or additions to an existing building or buildings to be used as a birthing center;
(c) Conversion of existing buildings or portions thereof for use as a birthing center;
(d) Alterations or modifications other than minor alterations. "Minor alterations" means any structural or physical modification within an existing birth center which does not change the approved use of a room or an area. Minor alterations performed under this definition do not require prior review of the department; however, this does not constitute a release from other applicable requirements;
(e) Changes in the approved use of rooms or areas of the birth center.
(22) "Patient" means a client or newborn who is admitted to the birth center and under the care of the clinical staff.
(23) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, and the legal successor thereof.
(24) "Personnel" means individuals employed by the birth center, contractors of the birth center, students and volunteers.
(25) "Physician" means a person licensed under chapter 18.71 RCW, "Physicians," and rules adopted under chapter 246-919 WAC or chapter 18.57 RCW, "Osteopathy—Osteopathic medicine and surgery," and rules adopted under chapter 246-853 WAC.
(26) "Referral" means the process by which the clinical staff of a birthing center directs the patient to a health care provider for management of a particular problem or aspect of the patient's care.
(27) "Registered nurse" means a person licensed under chapter 18.79 RCW, and rules adopted under chapter 246-840 WAC.
(28) "Recovery" means that period or duration of time starting at birth and ending with discharge of a client or newborn from the birth center.
(29) "Support person" means the individual or individuals selected or chosen by the client to provide emotional support and assistance during the process of labor and childbirth.
(30) "Transfer of care" means the process by which the clinical staff of a birthing center directs the client or newborn to a physician or other licensed health care provider for complete management of the client or newborn's care.
(31) "Volunteer" means an individual who is an unpaid worker in the birth center, other than a support person.
[Statutory Authority: RCW 18.46.060 and 43.70.250. WSR 25-15-078, s 246-329-010, filed 7/15/25, effective 8/15/25. Statutory Authority: Chapter 18.46 RCW and RCW 43.70.040. WSR 07-07-075, § 246-329-010, filed 3/16/07, effective 4/16/07. Statutory Authority: RCW 18.46.060. WSR 92-02-018 (Order 224), § 246-329-010, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-329-010, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.46.060. WSR 86-04-031 (Order 2338), § 248-29-010, filed 1/29/86. Statutory Authority: RCW 43.20.050. WSR 80-05-099 (Order 197), § 248-29-010, filed 5/2/80.]