Existing law finds and declares that prenatal care, delivery service, postpartum care, and neonatal and infant care are essential services necessary to assure maternal and infant health, and that these services are not currently distributed so as to meet the minimum maternal and infant health needs of many Californians. Existing law requires the State Department of Public Health to develop and maintain a statewide community-based comprehensive perinatal services program, as specified, to deliver services in medically underserved areas or areas with demonstrated need. Existing law provides for the licensure of health facilities, including general acute care hospitals, by the department. Existing law generally makes a violation of those licensing provisions a crime. Existing law sets forth provisions for critical access hospitals, as designated by the department and certified as such by the Secretary of the United States Department of Health and Human Services under the federal Medicare Rural Hospital Flexibility Program. This bill would require the department, by July 1, 2026, to establish a 10-year pilot project within up to 5 critical access hospitals to allow participating hospitals, on an application basis, to establish standby perinatal services, as defined. Under the bill, the first 2 hospitals selected, if qualified, would be nonprofit and located in the County of Humboldt and the County of Plumas. The bill would set forth various criteria for the selection of the participating hospitals with regard to standards and resources. The bill would require the department to develop a template to collect and evaluate data on safety, outcomes, utilization, and populations served under the pilot project, as specified. The bill would require the department to prepare and submit an evaluation to the Legislature and to make the evaluation publicly available. Under the bill, an approved standby perinatal service would be subject to all relevant licensing enforcement provisions, as specified. The bill would set forth provisions relating to suspension or revocation for noncompliance and to a hospital's request for program flexibility. The bill would require a hospital requesting approval to establish a standby perinatal service to implement and maintain certain requirements relating to, among other things, compliance with professional standards and recommendations, having specified equipment and supplies, defining the responsibility of the medical staff and administration, implementing contracts, and developing a quality improvement program. The bill would set forth specific requirements for a physician who has responsibility of the standby perinatal services. Because a violation of these provisions would be a crime, the bill would impose a state-mandated local program. This bill would make legislative findings and declarations as to the necessity of a special statute for the County of Humboldt and the County of Plumas. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.