Bill Text: MI SB1310 | 2011-2012 | 96th Legislature | Introduced

---

Bill Title: Health; occupations; midwives; provide for licensing and regulation. Amends 1978 PA 368 (MCL 333.1101 - 333.25211) by adding sec. 16326 & pt. 171.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2012-09-25 - Referred To Committee On Health Policy [SB1310 Detail]

Download: Michigan-2011-SB1310-Introduced.html

---

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SENATE BILL No. 1310

 

 

September 25, 2012, Introduced by Senator GREEN and referred to the Committee on Health Policy.

 

 

 

      A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

(MCL 333.1101 to 333.25211) by adding section 16326 and part 171.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

 1        Sec. 16326. Fees for an individual licensed or seeking

 

 2  licensure to practice as a midwife under part 171 are as follows:

 

 

3	(a) Application processing fee...................  $ 20.00
4	(b) License fee, per year........................    75.00
5	(c) Student license fee, per year................    10.00
6	(d) Temporary license............................    10.00
7	(e) Limited license, per year....................    10.00

 

 

 8                       PART 171. MIDWIFERY

 

 1        Sec. 17101. (1) As used in this part:

 

 2        (a) "Appropriate health professional", for the purposes of

 

 3  referral, consultation, or collaboration with a midwife under

 

 4  this part, means any of the following:

 

 5        (i) A physician.

 

 6        (ii) A certified nurse midwife.

 

 7        (iii) As identified in rules promulgated under section 17117,

 

 8  another appropriate health professional licensed, registered, or

 

 9  otherwise authorized to engage in a health profession under this

 

10  article.

 

11        (b) "Certified nurse midwife" means a registered

 

12  professional nurse under part 172 who has been issued a specialty

 

13  certification in the profession specialty field of nurse

 

14  midwifery by the board of nursing under section 17210.

 

15        (c) "Midwife" means an individual licensed under this part

 

16  to engage in the practice of midwifery.

 

17        (d) "Physician" means an individual licensed to engage in

 

18  the practice of medicine under part 170 or the practice of

 

19  osteopathic medicine and surgery under part 175.

 

20        (e) "Practice of midwifery", subject to subsection (2),

 

21  means providing maternity care that is consistent with a

 

22  midwife's training, education, and experience, to women and

 

23  neonates during the antepartum, intrapartum, and postpartum

 

24  periods.

 

25        (2) Practice of midwifery does not include either of the

 

26  following:

 

27        (a) The practice of medicine or osteopathic medicine and

 

 1  surgery.

 

 2        (b) The practice of nursing, including the practice of

 

 3  nursing with a specialty certification in the profession

 

 4  specialty field of nurse midwifery under part 172.

 

 5        (3) In addition to the definitions of this part, article 1

 

 6  contains general definitions and principles of construction

 

 7  applicable to all articles in this code and part 161 contains

 

 8  definitions applicable to this part.

 

 9        Sec. 17103. Beginning the effective date of rules

 

10  promulgated under section 17117, an individual shall not use the

 

11  titles "licensed midwife", "professional midwife", or "l.m.", or

 

12  similar words or initials that indicate that the individual is a

 

13  licensed midwife, unless the individual is licensed under this

 

14  part.

 

15        Sec. 17105. (1) Beginning on the effective date of rules

 

16  promulgated under section 17117, an individual shall not engage

 

17  in the practice of midwifery unless licensed under this part or

 

18  is otherwise authorized by this article.

 

19        (2) A midwife shall not perform an act, task, or function

 

20  within the practice of midwifery unless he or she is trained to

 

21  perform the act, task, or function and the performance of that

 

22  act, task, or function is consistent with the rules promulgated

 

23  under section 17117.

 

24        (3) In addition to the exemptions from licensure under

 

25  section 16171, subsection (1) does not prevent any of the

 

26  following:

 

27        (a) An individual licensed, registered, or certified under

 

 1  any other part or act from performing activities that are

 

 2  considered to be within the practice of midwifery if those

 

 3  activities are within the individual's scope of practice and if

 

 4  the individual does not use the titles protected under section

 

 5  17103.

 

 6        (b) Subject to section 16215, an employee or other

 

 7  individual who is assisting a midwife; who is under the midwife's

 

 8  supervision; and who is performing activities or functions that

 

 9  are delegated by the midwife, that are nondiscretionary, that do

 

10  not require the exercise of professional judgment for their

 

11  performance, and that are within the midwife's authority to

 

12  perform.

 

13        (c) An individual from performing activities that are within

 

14  the practice of midwifery if those activities are performed under

 

15  the direct and immediate supervision of an appropriate health

 

16  professional during completion of the North American registry of

 

17  midwives portfolio evaluation process or as a student at a

 

18  midwifery education program accredited by the midwifery education

 

19  accreditation council or other accrediting body approved by the

 

20  board.

 

21        (d) Self-care by a patient or uncompensated care by a friend

 

22  or family member who does not represent or hold himself or

 

23  herself out to be a midwife.

 

24        (e) Services provided by a religious practitioner if that

 

25  religious practitioner does not hold himself or herself out to

 

26  the public as a midwife and does not use any of the titles

 

27  protected under section 17103.

 

 1        (f) Services provided by a member of a bona fide church or

 

 2  religious denomination if all of the following are met:

 

 3        (i) The services are provided to another member of that

 

 4  church or denomination and that other member is an adherent of

 

 5  the established tenets or teachings of that church or

 

 6  denomination and relies on treatment by prayer or spiritual means

 

 7  only, in accordance with the creed or tenets of that church or

 

 8  denomination.

 

 9        (ii) The individual providing the services does not receive a

 

10  fee for those services. For purposes of this subparagraph, a

 

11  voluntary contribution is not considered a fee for the services

 

12  provided by that individual.

 

13        Sec. 17107. A midwife shall consult with or refer a patient

 

14  to an appropriate health professional if the midwife determines

 

15  the patient has significant deviations from normal that may

 

16  affect the patient's or neonate's outcome during the antepartum,

 

17  intrapartum, or postpartum periods.

 

18        Sec. 17109. A midwife shall not provide care to a patient

 

19  without first obtaining her informed consent to that care. If the

 

20  patient has significant deviations from normal that may affect

 

21  the patient's or the neonate's outcome during the antepartum,

 

22  intrapartum, or postpartum periods, the midwife must again obtain

 

23  that patient's informed consent before providing additional care.

 

24        Sec. 17111. (1) A midwife shall not do any of the following:

 

25        (a) Except as provided in subsection (2), administer

 

26  prescription drugs or medications.

 

27        (b) Use vacuum extractors or forceps.

 

 1        (c) Prescribe medications.

 

 2        (d) Perform surgical procedures other than episiotomies or

 

 3  repairs of perineal lacerations.

 

 4        (e) Any other act, task, or function prohibited in rules

 

 5  promulgated under this part.

 

 6        (2) Beginning on the effective date of, and subject to, the

 

 7  rules described in subsection (3), a midwife who holds a standing

 

 8  prescription from a licensed health care provider with

 

 9  prescriptive authority may administer any of the following:

 

10        (a) Prophylactic vitamin K to a newborn, either orally or

 

11  through intramuscular injection.

 

12        (b) Postpartum antihemorrhagic agents to a mother.

 

13        (c) Local anesthetic for the repair of lacerations to a

 

14  mother.

 

15        (d) Oxygen to a mother or newborn.

 

16        (e) Prophylactic eye agent to a newborn.

 

17        (f) Prophylactic Rho(D) immunoglobulin to a mother.

 

18        (g) Agents for group B streptococcus prophylaxis,

 

19  recommended by the federal centers for disease control and

 

20  prevention, to a mother.

 

21        (h) Intravenous fluids, excluding blood products, to a

 

22  mother.

 

23        (i) Any other drug or medication prescribed by a health care

 

24  provider with prescriptive authority that is consistent with the

 

25  scope of the practice of midwifery or authorized by the board by

 

26  rule.

 

27        (3) The board shall promulgate rules concerning the

 

 1  administration of prescription drugs or medications described in

 

 2  subsection (2) by midwives.

 

 3        Sec. 17113. (1) The Michigan board of licensed midwifery is

 

 4  created in the department. The board consists of the following 9

 

 5  members who meet the requirements of part 161:

 

 6        (a) Five midwives.

 

 7        (b) Three members of the general public, 1 of whom has

 

 8  received midwifery care outside of a hospital setting.

 

 9        (c) One physician who has experience consulting with

 

10  midwives who provide midwifery care outside of a hospital

 

11  setting.

 

12        (2) Except as otherwise provided in this article, the term

 

13  of office of a member of the board is 4 years and expires on

 

14  December 31 of the year in which the term expires. For members

 

15  first appointed under this section, 2 members shall serve for 2

 

16  years, 2 members shall serve for 3 years, and 3 members shall

 

17  serve for 4 years.

 

18        Sec. 17115. If it receives a complete application and

 

19  payment of the fee prescribed in section 16326, the department

 

20  shall issue a license under this part to the applicant if the

 

21  applicant meets both of the following:

 

22        (a) He or she holds the credential of certified professional

 

23  midwife from the North American registry of midwives or holds an

 

24  equivalent credential from another accredited midwifery training

 

25  program approved by the board under section 16148.

 

26        (b) He or she successfully passes an examination approved by

 

27  the board.

 

 1        Sec. 17117. (1) On or before the expiration of 24 months

 

 2  after the effective date of this part, the department, in

 

 3  consultation with the board, shall promulgate rules to do all of

 

 4  the following:

 

 5        (a) Establish and implement the licensure program for the

 

 6  practice of midwifery under this part.

 

 7        (b) Subject to section 16204, prescribe the completion of

 

 8  continuing education for the practice of midwifery as a condition

 

 9  for license renewal.

 

10        (c) Subject to subsections (3) and (4), describe and

 

11  regulate, limit, or prohibit the performance of acts, tasks, or

 

12  functions by midwives. The department shall include rules that

 

13  recognize and incorporate the requirements under section 17107

 

14  regarding the referral to and consultation with appropriate

 

15  health professionals.

 

16        (d) For purposes of section 17109, establish the process by

 

17  which informed consent is obtained.

 

18        (2) In addition to the authority to promulgate rules under

 

19  section 16145 and subject to this section and section 16175, the

 

20  department, in consultation with the board, may promulgate rules

 

21  to supplement the requirements for licensure under this part,

 

22  including the adoption of updated standards applicable to the

 

23  practice of midwifery established by the North American registry

 

24  of midwives or successor agency.

 

25        (3) The department shall not promulgate any rules under this

 

26  section that limit or restrict the scope of the practice of

 

27  midwifery established under this article.

 

 1        (4) The department shall not promulgate any rules under this

 

 2  section that limit the authority of a midwife to administer

 

 3  prescription drugs or medications under section 17111(2) or

 

 4  prohibit the administration any of those drugs or medications by

 

 5  a midwife.

 

 6        Sec. 17119. (1) The department may grant a license under

 

 7  this part to a person who is licensed as a midwife in another

 

 8  state at the time of application if the applicant provides

 

 9  evidence satisfactory to the board and the department that all of

 

10  the following are met:

 

11        (a) The applicant meets the requirements of this part and

 

12  rules promulgated under this part for licensure.

 

13        (b) There are no pending disciplinary proceedings against

 

14  the applicant before a similar licensing agency of this or any

 

15  other state or country.

 

16        (c) If sanctions have been imposed against the applicant by

 

17  a similar licensing agency of this or any other state or country

 

18  based upon grounds that are substantially similar to those under

 

19  this article, as determined by the board, the sanctions are not

 

20  in force at the time of the application.

 

21        (d) The other state maintains licensure standards equivalent

 

22  to or more stringent than those of this state.

 

23        (2) The board may make an independent inquiry to determine

 

24  whether an applicant meets the requirements described in

 

25  subsection (1)(b) and (c).

 

26        Sec. 17121. This part does not require new or additional

 

27  third party reimbursement or mandated worker's compensation

 

 1  benefits for services rendered by an individual licensed under

 

 2  this part.