​Regional Cooperation Agreement 

The Regional Cooperation Agreement (RCA) is a written transfer agreement between referring and receiving California Children’s Services (CCS) approved Neonatal Intensive Care Units (NICUs) with the goal of providing risk appropriate care for high risk pregnant women and their infants.

The RCA is required for all NICUs participating CCS Program. The standards for the RCA are outlined in the CCS Standards, Chapter 3 – Provider Standards 3.25.

There are three levels of care designations for CCS NICUs: Intermediate, Community, and Regional (highest level of care).  All hospital facilities that have Intermediate and Community NICUs MUST have Regional Cooperation Agreements with one Regional level NICU.

Title 22 requires that all hospitals providing perinatal care, including NICUs not participating in the CCS program, enter into “formal agreements for consultation and/or transfer/transport of an infant to an intensive care newborn nursery, or a mother to a hospital with the necessary services for problems beyond the capability of the perinatal unit.” California Code of Regulations, Title 22, § 70547.