Bill Text: IN SB0342 | 2011 | Regular Session | Introduced
Bill Title: Midwives.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2011-01-11 - First reading: referred to Committee on Health and Provider Services [SB0342 Detail]
Download: Indiana-2011-SB0342-Introduced.html
Citations Affected: IC 16-18-2-163; IC 16-34-2-1.1; IC 16-37-2;
IC 16-38-4-9; IC 25-1; IC 25-22.5; IC 25-23-1; IC 25-23.4; IC 34-6-2;
IC 34-18-2.
Synopsis: Midwives. Establishes the midwifery board (board). Sets
qualifications for a certified direct entry midwife (CDEM). Requires
the board to: (1) establish continuing education requirements; (2)
develop peer review procedures; and (3) adopt rules concerning the
competent practice of CDEMs. Establishes penalties for practicing
midwifery without a license. Adds culpability standards to the crimes
of practicing medicine or osteopathic medicine and acting as a
physician assistant without a license. Allows CDEMs to administer
certain prescription drugs. Allows certain individuals to act under the
supervision of a CDEM. Repeals the definition of "midwife" in the
medical malpractice law, and adds a definition of "certified nurse
midwife". Makes conforming changes.
Effective: July 1, 2011.
January 11, 2011, read first time and referred to Committee on Health and Provider
Services.
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in
Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution.
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A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
(1) An individual, a partnership, a corporation, a professional corporation, a facility, or an institution licensed or legally authorized by this state to provide health care or professional services as a licensed physician, a psychiatric hospital, a hospital, a health facility, an emergency ambulance service (IC 16-31-3), a dentist, a registered or licensed practical nurse, a certified nurse midwife, a certified direct entry midwife, an optometrist, a pharmacist, a podiatrist, a chiropractor, a physical therapist, a respiratory care practitioner, an occupational therapist, a psychologist, a paramedic, an emergency medical technician, an emergency medical technician-basic advanced, an emergency medical technician-intermediate, or a person who is an officer, employee, or agent of the individual, partnership, corporation,
professional corporation, facility, or institution acting in the
course and scope of the person's employment.
(2) A college, university, or junior college that provides health
care to a student, a faculty member, or an employee, and the
governing board or a person who is an officer, employee, or agent
of the college, university, or junior college acting in the course
and scope of the person's employment.
(3) A blood bank, community mental health center, community
mental retardation center, community health center, or migrant
health center.
(4) A home health agency (as defined in IC 16-27-1-2).
(5) A health maintenance organization (as defined in
IC 27-13-1-19).
(6) A health care organization whose members, shareholders, or
partners are health care providers under subdivision (1).
(7) A corporation, partnership, or professional corporation not
otherwise qualified under this subsection that:
(A) provides health care as one (1) of the corporation's,
partnership's, or professional corporation's functions;
(B) is organized or registered under state law; and
(C) is determined to be eligible for coverage as a health care
provider under IC 34-18 for the corporation's, partnership's, or
professional corporation's health care function.
Coverage for a health care provider qualified under this subdivision is
limited to the health care provider's health care functions and does not
extend to other causes of action.
(b) "Health care provider", for purposes of IC 16-35, has the
meaning set forth in subsection (a). However, for purposes of IC 16-35,
the term also includes a health facility (as defined in section 167 of this
chapter).
(c) "Health care provider", for purposes of IC 16-36-5, means an
individual licensed or authorized by this state to provide health care or
professional services as:
(1) a licensed physician;
(2) a registered nurse;
(3) a licensed practical nurse;
(4) an advanced practice nurse;
(5) a licensed certified nurse midwife or a certified direct entry
midwife;
(6) a paramedic;
(7) an emergency medical technician;
(8) an emergency medical technician-basic advanced;
(9) an emergency medical technician-intermediate; or
(10) a first responder, as defined under IC 16-18-2-131.
The term includes an individual who is an employee or agent of a health care provider acting in the course and scope of the individual's employment.
(d) "Health care provider", for purposes of IC 16-40-4, means any of the following:
(1) An individual, a partnership, a corporation, a professional corporation, a facility, or an institution licensed or authorized by the state to provide health care or professional services as a licensed physician, a psychiatric hospital, a hospital, a health facility, an emergency ambulance service (IC 16-31-3), an ambulatory outpatient surgical center, a dentist, an optometrist, a pharmacist, a podiatrist, a chiropractor, a psychologist, or a person who is an officer, employee, or agent of the individual, partnership, corporation, professional corporation, facility, or institution acting in the course and scope of the person's employment.
(2) A blood bank, laboratory, community mental health center, community mental retardation center, community health center, or migrant health center.
(3) A home health agency (as defined in IC 16-27-1-2).
(4) A health maintenance organization (as defined in IC 27-13-1-19).
(5) A health care organization whose members, shareholders, or partners are health care providers under subdivision (1).
(6) A corporation, partnership, or professional corporation not otherwise specified in this subsection that:
(A) provides health care as one (1) of the corporation's, partnership's, or professional corporation's functions;
(B) is organized or registered under state law; and
(C) is determined to be eligible for coverage as a health care provider under IC 34-18 for the corporation's, partnership's, or professional corporation's health care function.
(7) A person that is designated to maintain the records of a person described in subdivisions (1) through (6).
(e) "Health care provider", for purposes of IC 16-45-4, has the meaning set forth in 47 CFR 54.601(a).
whom the abortion is to be performed. Except in the case of a medical
emergency, consent to an abortion is voluntary and informed only if the
following conditions are met:
(1) At least eighteen (18) hours before the abortion and in the
presence of the pregnant woman, the physician who is to perform
the abortion, the referring physician or a physician assistant (as
defined in IC 25-27.5-2-10), an advanced practice nurse (as
defined in IC 25-23-1-1(b)), or a certified nurse midwife (as
defined in IC 34-18-2-19) IC 34-18-2-6.5) to whom the
responsibility has been delegated by the physician who is to
perform the abortion or the referring physician has orally
informed the pregnant woman of the following:
(A) The name of the physician performing the abortion.
(B) The nature of the proposed procedure or treatment.
(C) The risks of and alternatives to the procedure or treatment.
(D) The probable gestational age of the fetus, including an
offer to provide:
(i) a picture or drawing of a fetus;
(ii) the dimensions of a fetus; and
(iii) relevant information on the potential survival of an
unborn fetus;
at this stage of development.
(E) The medical risks associated with carrying the fetus to
term.
(F) The availability of fetal ultrasound imaging and
auscultation of fetal heart tone services to enable the pregnant
woman to view the image and hear the heartbeat of the fetus
and how to obtain access to these services.
(2) At least eighteen (18) hours before the abortion, the pregnant
woman will be orally informed of the following:
(A) That medical assistance benefits may be available for
prenatal care, childbirth, and neonatal care from the county
office of the division of family resources.
(B) That the father of the unborn fetus is legally required to
assist in the support of the child. In the case of rape, the
information required under this clause may be omitted.
(C) That adoption alternatives are available and that adoptive
parents may legally pay the costs of prenatal care, childbirth,
and neonatal care.
(3) The pregnant woman certifies in writing, before the abortion
is performed, that the information required by subdivisions (1)
and (2) has been provided.
(b) Before an abortion is performed, the pregnant woman may, upon the pregnant woman's request, view the fetal ultrasound imaging and hear the auscultation of the fetal heart tone if the fetal heart tone is audible.
(1) A licensed attending physician.
(2)
(3) Another individual who:
(A) holds a license of the type designated by the governing board of a hospital, after consultation with the hospital's medical staff, to attend births at the hospital; and
(B) is in attendance at the birth.
(b) A person required to report information to the registry under this section may use, when completing reports required by this chapter, information submitted to any other public or private registry or required to be filed with federal, state, or local agencies. However, the state department may require additional, definitive information.
(c) Exchange of information between state department registries is authorized. The state department may use information from another registry administered by the state department. Information used from
other registries remains subject to the confidentiality restrictions on the
other registries.
(1) Certified public accountants, public accountants, and accounting practitioners.
(2) Architects and landscape architects.
(3) Dry cleaners.
(4) Professional engineers.
(5) Land surveyors.
(6) Real estate brokers.
(7) Real estate agents.
(8) Security dealers' licenses issued by the securities commissioner.
(9) Dental hygienists.
(10) Dentists.
(11) Veterinarians.
(12) Physicians.
(13) Chiropractors.
(14) Physical therapists.
(15) Optometrists.
(16) Pharmacists and assistants, drugstores or pharmacies.
(17) Motels and mobile home community licenses.
(18) Nurses.
(19) Podiatrists.
(20) Occupational therapists and occupational therapy assistants.
(21) Respiratory care practitioners.
(22) Social workers, marriage and family therapists, and mental health counselors.
(23) Real estate appraiser licenses and certificates issued by the real estate appraiser licensure and certification board.
(24) Wholesale legend drug distributors.
(25) Physician assistants.
(26) Dietitians.
(27) Athlete agents.
(28) Manufactured home installers.
(29) Home inspectors.
(30) Massage therapists.
(31) Interior designers.
(32) Genetic counselors.
(33) Direct entry midwives.
(b) This section applies to the following entities that regulate occupations or professions under the Indiana Code:
(1) Indiana board of accountancy.
(2) Indiana grain buyers and warehouse licensing agency.
(3) Indiana auctioneer commission.
(4) Board of registration for architects and landscape architects.
(40) Midwifery board.
(c) Notwithstanding any other law, the entities included in subsection (b) shall send a notice of the upcoming expiration of a license to each licensee at least sixty (60) days prior to the expiration of the license. The notice must inform the licensee of the need to renew and the requirement of payment of the renewal fee. If this notice of expiration is not sent by the entity, the licensee is not subject to a sanction for failure to renew if, once notice is received from the entity, the license is renewed within forty-five (45) days of the receipt of the notice.
(1) Indiana board of accountancy (IC 25-2.1-2-1).
(2) Board of registration for architects and landscape architects (IC 25-4-1-2).
(3) Indiana athletic trainers board (IC 25-5.1-2-1).
(4) Indiana auctioneer commission (IC 25-6.1-2-1).
(5) Board of chiropractic examiners (IC 25-10-1).
(6) State board of cosmetology and barber examiners (IC 25-8-3-1).
(7) State board of dentistry (IC 25-14-1).
(8) Indiana dietitians certification board (IC 25-14.5-2-1).
(9) State board of registration for professional engineers (IC 25-31-1-3).
(10) State board of funeral and cemetery service (IC 25-15-9).
(11) Indiana state board of health facility administrators (IC 25-19-1).
(12) Committee of hearing aid dealer examiners (IC 25-20-1-1.5).
(13) Home inspectors licensing board (IC 25-20.2-3-1).
(14) State board of registration for land surveyors (IC 25-21.5-2-1).
(15) Manufactured home installer licensing board (IC 25-23.7).
(16) Medical licensing board of Indiana (IC 25-22.5-2).
(17) Indiana state board of nursing (IC 25-23-1).
(18) Occupational therapy committee (IC 25-23.5).
(19) Indiana optometry board (IC 25-24).
(20) Indiana board of pharmacy (IC 25-26).
(21) Indiana physical therapy committee (IC 25-27-1).
(22) Physician assistant committee (IC 25-27.5).
(23) Indiana plumbing commission (IC 25-28.5-1-3).
(24) Board of podiatric medicine (IC 25-29-2-1).
(25) Private investigator and security guard licensing board (IC 25-30-1-5.2).
(26) State psychology board (IC 25-33).
(27) Indiana real estate commission (IC 25-34.1-2).
(28) Real estate appraiser licensure and certification board (IC 25-34.1-8).
(29) Respiratory care committee (IC 25-34.5).
(30) Behavioral health and human services licensing board (IC 25-23.6).
(31) Speech-language pathology and audiology board (IC 25-35.6-2).
(32) Indiana board of veterinary medical examiners (IC 25-38.1-2).
(33) Midwifery board (IC 25-23.4-2-1).
executive director, secretary, or other statutory administrator of the
following:
(1) Board of chiropractic examiners (IC 25-10-1).
(2) State board of dentistry (IC 25-14-1).
(3) Indiana state board of health facility administrators
(IC 25-19-1).
(4) Medical licensing board of Indiana (IC 25-22.5-2).
(5) Indiana state board of nursing (IC 25-23-1).
(6) Indiana optometry board (IC 25-24).
(7) Indiana board of pharmacy (IC 25-26).
(8) Board of podiatric medicine (IC 25-29-2-1).
(9) Speech-language pathology and audiology board
(IC 25-35.6-2).
(10) State psychology board (IC 25-33).
(11) Indiana board of veterinary medical examiners
(IC 25-38.1-2).
(12) Committee of hearing aid dealer examiners (IC 25-20).
(13) Indiana physical therapy committee (IC 25-27).
(14) Respiratory care committee (IC 25-34.5).
(15) Occupational therapy committee (IC 25-23.5).
(16) Behavioral health and human services licensing board
(IC 25-23.6).
(17) Physician assistant committee (IC 25-27.5).
(18) Indiana athletic trainers board (IC 25-5.1-2-1).
(19) Indiana dietitians certification board (IC 25-14.5-2-1).
(20) Midwifery board (IC 25-23.4-2).
(b) Nothing in this chapter may be construed to give the agency
policy making authority, which authority remains with each board.
(1) Board of chiropractic examiners (IC 25-10-1).
(2) State board of dentistry (IC 25-14-1).
(3) Indiana state board of health facility administrators (IC 25-19-1).
(4) Medical licensing board of Indiana (IC 25-22.5-2).
(5) Indiana state board of nursing (IC 25-23-1).
(6) Indiana optometry board (IC 25-24).
(7) Indiana board of pharmacy (IC 25-26).
(8) Board of podiatric medicine (IC 25-29-2-1).
(9) Speech-language pathology and audiology board (IC 25-35.6-2).
(10) State psychology board (IC 25-33).
(11) Indiana board of veterinary medical examiners (IC 25-38.1-2).
(12) Indiana physical therapy committee (IC 25-27).
(13) Respiratory care committee (IC 25-34.5).
(14) Occupational therapy committee (IC 25-23.5).
(15) Behavioral health and human services licensing board (IC 25-23.6).
(16) Physician assistant committee (IC 25-27.5).
(17) Indiana athletic trainers board (IC 25-5.1-2-1).
(18) Indiana dietitians certification board (IC 25-14.5-2-1).
(19) Midwifery board (IC 25-23.4-2-1).
(b) The agency shall create and maintain a provider profile for each provider described in subsection (a).
(c) A provider profile must contain the following information:
(1) The provider's name.
(2) The provider's license, certification, registration, or permit number.
(3) The provider's license, certification, registration, or permit type.
(4) The date the provider's license, certification, registration, or permit was issued.
(5) The date the provider's license, certification, registration, or permit expires.
(6) The current status of the provider's license, certification, registration, or permit.
(7) The provider's city and state of record.
(8) A statement of any disciplinary action taken against the provider within the previous ten (10) years by a board or committee described in subsection (a).
(d) The agency shall make provider profiles available to the public.
(e) The computer gateway administered by the office of technology established by IC 4-13.1-2-1 shall make the information described in subsection (c)(1), (c)(2), (c)(3), (c)(6), (c)(7), and (c)(8) generally available to the public on the Internet.
(f) The agency may adopt rules under IC 4-22-2 to implement this section.
[EFFECTIVE JULY 1, 2011]: Sec. 1. As used in this chapter:
"Board" means the appropriate agency listed in the definition of
regulated occupation in this section.
"Director" refers to the director of the division of consumer
protection.
"Division" refers to the division of consumer protection, office of
the attorney general.
"Licensee" means a person who is:
(1) licensed, certified, or registered by a board listed in this
section; and
(2) the subject of a complaint filed with the division.
"Person" means an individual, a partnership, a limited liability
company, or a corporation.
"Regulated occupation" means an occupation in which a person is
licensed, certified, or registered by one (1) of the following:
(1) Indiana board of accountancy (IC 25-2.1-2-1).
(2) Board of registration for architects and landscape architects
(IC 25-4-1-2).
(3) Indiana auctioneer commission (IC 25-6.1-2-1).
(4) State board of barber examiners (IC 25-7-5-1).
(4) State athletic commission (IC 25-9-1).
(5) (4) Board of chiropractic examiners (IC 25-10-1).
(6) (5) State board of cosmetology and barber examiners
(IC 25-8-3-1).
(7) (6) State board of dentistry (IC 25-14-1).
(8) (7) State board of funeral and cemetery service (IC 25-15-9).
(9) (8) State board of registration for professional engineers
(IC 25-31-1-3).
(10) (9) Indiana state board of health facility administrators
(IC 25-19-1).
(11) (10) Medical licensing board of Indiana (IC 25-22.5-2).
(12) (11) Indiana state board of nursing (IC 25-23-1).
(13) (12) Indiana optometry board (IC 25-24).
(14) (13) Indiana board of pharmacy (IC 25-26).
(15) (14) Indiana plumbing commission (IC 25-28.5-1-3).
(16) (15) Board of podiatric medicine (IC 25-29-2-1).
(17) Board of environmental health specialists (IC 25-32-1).
(17) (18) (16) State psychology board (IC 25-33).
(18) (19) (17) Speech-language pathology and audiology board
(IC 25-35.6-2).
(19) (20) (18) Indiana real estate commission (IC 25-34.1-2).
(20) (21) (19) Indiana board of veterinary medical examiners
(IC 25-38.1).
(21) (22) (20) Department of natural resources for purposes of
licensing water well drillers under IC 25-39-3.
(22) (23) (21) Respiratory care committee (IC 25-34.5).
(23) (24) (22) Private investigator and security guard licensing
board (IC 25-30-1-5.2).
(24) (25) (23) Occupational therapy committee (IC 25-23.5).
(25) (26) (24) Behavioral health and human services licensing
board (IC 25-23.6).
(26) (27) (25) Real estate appraiser licensure and certification
board (IC 25-34.1-8).
(27) (28) (26) State board of registration for land surveyors
(IC 25-21.5-2-1).
(28) (29) (27) Physician assistant committee (IC 25-27.5).
(29) (30) (28) Indiana athletic trainers board (IC 25-5.1-2-1).
(30) (31) (29) Indiana dietitians certification board
(IC 25-14.5-2-1).
(32) Indiana hypnotist committee (IC 25-20.5-1-7).
(31) (33) (30) Indiana physical therapy committee (IC 25-27).
(32) (34) (31) Manufactured home installer licensing board
(IC 25-23.7).
(33) (35) (32) Home inspectors licensing board (IC 25-20.2-3-1).
(34) (36) (33) State department of health, for out-of-state mobile
health care entities.
(35) (37) (34) State board of massage therapy (IC 25-21.8-2-1).
(35) Midwifery board (IC 25-23.4-2-1).
(36) (38) (36) Any other occupational or professional agency
created after June 30, 1981.
(1) Indiana board of accountancy (IC 25-2.1-2-1).
(2) Board of registration for architects and landscape architects (IC 25-4-1-2).
(3) Indiana auctioneer commission (IC 25-6.1-2-1).
(36) Midwifery board (IC 25-23.4-2-1).
(37)
(1) Indiana board of accountancy (IC 25-2.1-2-1).
(2) Board of registration for architects and landscape architects (IC 25-4-1-2).
(3) Indiana athletic trainers board (IC 25-5.1-2-1).
(4) Indiana auctioneer commission (IC 25-6.1-2-1).
(5) Board of chiropractic examiners (IC 25-10-1).
(6) State board of cosmetology and barber examiners (IC 25-8-3-1).
(7) State board of dentistry (IC 25-14-1).
(8) Indiana dietitians certification board (IC 25-14.5-2-1).
(9) State board of registration for professional engineers (IC 25-31-1-3).
(10) State board of funeral and cemetery service (IC 25-15-9).
(11) Indiana state board of health facility administrators (IC 25-19-1).
(12) Committee of hearing aid dealer examiners (IC 25-20-1-1.5).
(13) Home inspectors licensing board (IC 25-20.2-3-1).
(14) State board of registration for land surveyors (IC 25-21.5-2-1).
(15) Manufactured home installer licensing board (IC 25-23.7).
(16) Medical licensing board of Indiana (IC 25-22.5-2).
(17) Indiana state board of nursing (IC 25-23-1).
(18) Occupational therapy committee (IC 25-23.5).
(19) Indiana optometry board (IC 25-24).
(20) Indiana board of pharmacy (IC 25-26).
(21) Indiana physical therapy committee (IC 25-27).
(22) Physician assistant committee (IC 25-27.5).
(23) Indiana plumbing commission (IC 25-28.5-1-3).
(24) Board of podiatric medicine (IC 25-29-2-1).
(25) Private investigator and security guard licensing board (IC 25-30-1-5.2).
(26) State psychology board (IC 25-33).
(27) Indiana real estate commission (IC 25-34.1-2).
(28) Real estate appraiser licensure and certification board
(IC 25-34.1-8).
(29) Respiratory care committee (IC 25-34.5).
(30) Behavioral health and human services licensing board
(IC 25-23.6).
(31) Speech-language pathology and audiology board
(IC 25-35.6-2).
(32) Indiana board of veterinary medical examiners (IC 25-38.1).
(33) State board of massage therapy (IC 25-21.8-2-1).
(34) Midwifery board (IC 25-23.4-2-1).
(b) This section does not apply to a license, certificate, or
registration that has been revoked or suspended.
(c) Notwithstanding any other law regarding the reinstatement of a
delinquent or lapsed license, certificate, or registration and except as
provided in section 8 of this chapter, the holder of a license, certificate,
or registration that was issued by the board that is three (3) years or less
delinquent must be reinstated upon meeting the following
requirements:
(1) Submission of the holder's completed renewal application.
(2) Payment of the current renewal fee established by the board
under section 2 of this chapter.
(3) Payment of a reinstatement fee established by the Indiana
professional licensing agency.
(4) If a law requires the holder to complete continuing education
as a condition of renewal, the holder:
(A) shall provide the board with a sworn statement, signed by
the holder, that the holder has fulfilled the continuing
education requirements required by the board; or
(B) shall, if the holder has not complied with the continuing
education requirements, meet any requirements imposed under
IC 25-1-4-5 and IC 25-1-4-6.
(d) Notwithstanding any other law regarding the reinstatement of a
delinquent or lapsed license, certificate, or registration and except as
provided in section 8 of this chapter, unless a statute specifically does
not allow a license, certificate, or registration to be reinstated if it has
lapsed for more than three (3) years, the holder of a license, certificate,
or registration that was issued by the board that is more than three (3)
years delinquent must be reinstated upon meeting the following
requirements:
(1) Submission of the holder's completed renewal application.
(2) Payment of the current renewal fee established by the board
under section 2 of this chapter.
(3) Payment of a reinstatement fee equal to the current initial
application fee.
(4) If a law requires the holder to complete continuing education
as a condition of renewal, the holder:
(A) shall provide the board with a sworn statement, signed by
the holder, that the holder has fulfilled the continuing
education requirements required by the board; or
(B) shall, if the holder has not complied with the continuing
education requirements, meet any requirements imposed under
IC 25-1-4-5 and IC 25-1-4-6.
(5) Complete such remediation and additional training as deemed
appropriate by the board given the lapse of time involved.
(6) Any other requirement that is provided for in statute or rule
that is not related to fees.
(1) A student in training in a medical school approved by the board, or while performing duties as an intern or a resident in a hospital under the supervision of the hospital's staff or in a program approved by the medical school.
(2) A person who renders service in case of emergency where no fee or other consideration is contemplated, charged, or received.
(3) A paramedic (as defined in IC 16-18-2-266), an emergency medical technician-basic advanced (as defined in IC 16-18-2-112.5), an emergency medical technician-intermediate (as defined in IC 16-18-2-112.7), an emergency medical technician (as defined in IC 16-18-2-112), or a person with equivalent certification from another state who renders advanced life support (as defined in IC 16-18-2-7) or basic life support (as defined in IC 16-18-2-33.5):
(A) during a disaster emergency declared by the governor under IC 10-14-3-12 in response to an act that the governor in good faith believes to be an act of terrorism (as defined in IC 35-41-1-26.5); and
(B) in accordance with the rules adopted by the Indiana emergency medical services commission or the disaster emergency declaration of the governor.
(4) Commissioned medical officers or medical service officers of the armed forces of the United States, the United States Public Health Service, and medical officers of the United States
Department of Veterans Affairs in the discharge of their official
duties in Indiana.
(5) An individual who is not a licensee who resides in another
state or country and is authorized to practice medicine or
osteopathic medicine there, who is called in for consultation by an
individual licensed to practice medicine or osteopathic medicine
in Indiana.
(6) A person administering a domestic or family remedy to a
member of the person's family.
(7) A member of a church practicing the religious tenets of the
church if the member does not make a medical diagnosis,
prescribe or administer drugs or medicines, perform surgical or
physical operations, or assume the title of or profess to be a
physician.
(8) A school corporation and a school employee who acts under
IC 34-30-14 (or IC 34-4-16.5-3.5 before its repeal).
(9) A chiropractor practicing the chiropractor's profession under
IC 25-10 or to an employee of a chiropractor acting under the
direction and supervision of the chiropractor under IC 25-10-1-13.
(10) A dental hygienist practicing the dental hygienist's profession
under IC 25-13.
(11) A dentist practicing the dentist's profession under IC 25-14.
(12) A hearing aid dealer practicing the hearing aid dealer's
profession under IC 25-20.
(13) A nurse practicing the nurse's profession under IC 25-23.
However, a certified registered nurse anesthetist (as defined in
IC 25-23-1-1.4) may administer anesthesia if the certified
registered nurse anesthetist acts under the direction of and in the
immediate presence of a physician.
(14) An optometrist practicing the optometrist's profession under
IC 25-24.
(15) A pharmacist practicing the pharmacist's profession under
IC 25-26.
(16) A physical therapist practicing the physical therapist's
profession under IC 25-27.
(17) A podiatrist practicing the podiatrist's profession under
IC 25-29.
(18) A psychologist practicing the psychologist's profession under
IC 25-33.
(19) A speech-language pathologist or audiologist practicing the
pathologist's or audiologist's profession under IC 25-35.6.
(20) An employee of a physician or group of physicians who
performs an act, a duty, or a function that is customarily within
the specific area of practice of the employing physician or group
of physicians, if the act, duty, or function is performed under the
direction and supervision of the employing physician or a
physician of the employing group within whose area of practice
the act, duty, or function falls. An employee may not make a
diagnosis or prescribe a treatment and must report the results of
an examination of a patient conducted by the employee to the
employing physician or the physician of the employing group
under whose supervision the employee is working. An employee
may not administer medication without the specific order of the
employing physician or a physician of the employing group.
Unless an employee is licensed or registered to independently
practice in a profession described in subdivisions (9) through
(18), nothing in this subsection grants the employee independent
practitioner status or the authority to perform patient services in
an independent practice in a profession.
(21) A hospital licensed under IC 16-21 or IC 12-25.
(22) A health care organization whose members, shareholders, or
partners are individuals, partnerships, corporations, facilities, or
institutions licensed or legally authorized by this state to provide
health care or professional services as:
(A) a physician;
(B) a psychiatric hospital;
(C) a hospital;
(D) a health maintenance organization or limited service
health maintenance organization;
(E) a health facility;
(F) a dentist;
(G) a registered or licensed practical nurse;
(H) a certified nurse midwife or a certified direct entry
midwife;
(I) an optometrist;
(J) a podiatrist;
(K) a chiropractor;
(L) a physical therapist; or
(M) a psychologist.
(23) A physician assistant practicing the physician assistant
profession under IC 25-27.5.
(24) A physician providing medical treatment under
IC 25-22.5-1-2.1.
(25) An attendant who provides attendant care services (as
defined in IC 16-18-2-28.5).
(26) A personal services attendant providing authorized attendant
care services under IC 12-10-17.1.
(b) A person described in subsection (a)(9) through (a)(18) is not
excluded from the application of this article if:
(1) the person performs an act that an Indiana statute does not
authorize the person to perform; and
(2) the act qualifies in whole or in part as the practice of medicine
or osteopathic medicine.
(c) An employment or other contractual relationship between an
entity described in subsection (a)(21) through (a)(22) and a licensed
physician does not constitute the unlawful practice of medicine under
this article if the entity does not direct or control independent medical
acts, decisions, or judgment of the licensed physician. However, if the
direction or control is done by the entity under IC 34-30-15 (or
IC 34-4-12.6 before its repeal), the entity is excluded from the
application of this article as it relates to the unlawful practice of
medicine or osteopathic medicine.
(d) This subsection does not apply to a prescription or drug order for
a legend drug that is filled or refilled in a pharmacy owned or operated
by a hospital licensed under IC 16-21. A physician licensed in Indiana
who permits or authorizes a person to fill or refill a prescription or drug
order for a legend drug except as authorized in IC 16-42-19-11 through
IC 16-42-19-19 is subject to disciplinary action under IC 25-1-9. A
person who violates this subsection commits the unlawful practice of
medicine under this chapter.
(e) A person described in subsection (a)(8) shall not be authorized
to dispense contraceptives or birth control devices.
(a) "Board" means the Indiana state board of nursing.
(b) "Advanced practice nurse" means:
(1) a nurse practitioner;
(2) a certified nurse midwife; or
(3) a clinical nurse specialist;
who is a registered nurse qualified to practice nursing in a specialty role based upon the additional knowledge and skill gained through a formal organized program of study and clinical experience, or the equivalent as determined by the board, which does not limit but extends or expands the function of the nurse which may be initiated by the client or provider in settings that shall include hospital outpatient clinics and health maintenance organizations.
(c) "Human response" means those signs, symptoms, behaviors, and processes that denote the individual's interaction with the environment.
(b) The applicant shall submit to an examination in certified nurse midwifery prescribed or administered by the board. If the application and qualifications are approved by the board, the applicant is entitled to receive a limited license that allows the applicant to practice midwifery as a certified nurse midwife.
(c) The board shall adopt rules under
(1) defining the scope of practice
(2) for implementing this section.
ARTICLE 23.4. CERTIFIED DIRECT ENTRY MIDWIVES
Chapter 1. Definitions
Sec. 1. The definitions in this chapter apply throughout this article.
Sec. 2. "Antepartum period" means the period that begins when a woman becomes pregnant and ends when the birthing period begins.
Sec. 3. "Board" refers to the midwifery board established by IC 25-23.4-2-1.
Sec. 4. (a) "Certified direct entry midwife" or "CDEM" means
an individual who has completed and passed the credentialing
process as administered by the North American Registry of
Midwives or a successor organization and met requirements
established by the board.
(b) The term does not include any of the following:
(1) An individual engaged in the practice of medicine under
IC 25-22.5.
(2) A certified nurse midwife engaged in the practice of
midwifery only under IC 25-23.
(3) An individual providing emergency medical services.
Sec. 5."Intrapartum period" means the period that begins when
a woman starts labor and ends when the woman gives birth.
Sec. 6. "Licensed certified direct entry midwife" means an
individual who is a certified direct entry midwife and licensed
under this article.
Sec. 7. "Licensing agency" refers to the Indiana professional
licensing agency.
Sec. 8. "Practice of midwifery" means services delivered by a
licensed certified direct entry midwife, for compensation, to advise,
attend, or assist a woman during pregnancy, labor, natural
childbirth, or the postpartum period. The term includes the
following:
(1) Providing the mother with individualized prenatal care.
(2) Identifying and referring women who require obstetrical
attention.
(3) Providing the mother with continuous direct participation
and assistance during labor and delivery.
(4) Administering medications as provided in IC 25-23.4-4-5.
(5) Providing the mother with postpartum support.
Sec. 9. "Postpartum period" means the six (6) week period after
a birth.
Chapter 2. Midwifery Board
Sec. 1. The midwifery board is established.
Sec. 2. (a) The board consists of seven (7) members appointed by
the governor as follows:
(1) Three (3) members who are licensed certified direct entry
midwives.
(2) Two (2) members who have unlimited licenses to practice
medicine in Indiana, one (1) of whom has experience acting as
a collaborative home birth physician with a midwife.
(3) One (1) certified nurse midwife with experience in the
practice of home births.
(4) One (1) member representing the public.
(b) Notwithstanding subsection (a)(1), a certified direct entry
midwife appointed to the board under subsection (a)(1) after June
30, 2011, and before July 1, 2012, is not required to be licensed
under this article. However, a certified direct entry midwife
appointed to the board after June 30, 2011, and before July 1,
2012, under subsection (a), must be a Certified Professional
Midwife by the North American Registry of Midwives.
Sec. 3. (a) The term of each board member is four (4) years.
(b) A board member may be reappointed for not more than
three (3) consecutive terms.
(c) A board member serves until the board member's successor
is appointed. A vacancy occurring in the membership of the board
for any cause shall be filled by appointment by the governor for the
unexpired term.
(d) Board members annually shall select a chairperson and a
vice chairperson from among the board's members.
Sec. 4. (a) The board shall meet at least one (1) time each year
at the call of the chairperson.
(b) With the approval of the executive director of the licensing
agency, the board may meet upon:
(1) the call of the chairperson; or
(2) the request of a majority of the members of the board.
(c) Four (4) members of the board constitute a quorum.
(d) The affirmative vote of four (4) members of the board is
required for the board to take action.
Sec. 5. The licensing agency shall provide staff support for the
board.
Sec. 6. (a) The board shall do the following:
(1) Establish as a requirement for licensure as a certified
direct entry midwife the Certified Professional Midwife
(CPM) credentials developed by the North American Registry
of Midwives or a successor organization.
(2) Establish fees for the licensure of certified direct entry
midwives. The amount of the license fee must be the lesser of
the following:
(A) The amount determined by the board to be sufficient
for the administration of this article.
(B) Five hundred dollars ($500).
(3) Establish annual continuing education requirements for
license renewal, which must include continuing education in
pharmacology.
(4) Develop a peer review procedure, using as guidelines the
peer review procedures established by:
(A) the Indiana Midwives Association or a successor
organization; and
(B) the North American Registry of Midwives or a
successor organization.
(5) Adopt rules under IC 4-22-2 that define the competent
practice for certified direct entry midwives. Rules adopted
under this subdivision must limit the practice of certified
direct entry midwives to nonhospital settings.
(b) The board may not adopt rules to grant a certified direct
entry midwife prescriptive authority. However, this subsection
does not limit a certified direct entry midwife's authority to
administer prescription drugs under IC 25-23.4-4-5.
Sec. 7. The board shall adopt rules under IC 4-22-2 to
administer this article.
Chapter 3. Certified Direct Entry Midwifery Licensing
Sec. 1. (a) This section does not apply to an individual who has
a limited license under IC 25-23-1-13.1 to practice midwifery as a
certified nurse midwife and is practicing within the scope of that
license.
(b) After July 1, 2012, an individual may not engage in the
practice of midwifery unless:
(1) the individual is licensed or certified by a board under
IC 25-1-5 and is acting within the scope of the person's license
or certification; or
(2) the individual has a certified direct entry midwife license
under this article.
(c) To become licensed as a certified direct entry midwife, an
applicant must satisfy the following requirements:
(1) Be at least twenty-one (21) years of age.
(2) Possess a high school degree or its equivalent.
(3) Satisfactorily complete educational curriculum approved
by:
(A) the Midwifery Education Accreditation Council
(MEAC) or a successor organization; or
(B) the educational equivalent of a Midwifery Education
Accreditation Council curriculum approved by the board.
(4) Acquire and document practical experience as outlined in
the Certified Professional Midwife credentialing process in
accordance with the standards of the North American
Registry of Midwives or a successor organization.
(5) Obtain certification by the accredited association in adult
cardiopulmonary resuscitation.
(6) Complete the program sponsored by the American
Academy of Pediatrics in neonatal resuscitation, excluding
endotracheal intubation and the administration of drugs.
(7) Observe twenty (20) births, assist with an additional
twenty (20) births, and act as the primary attendant for an
additional twenty (20) births.
(8) Provide proof to the board that the applicant has obtained
the Certified Professional Midwife credential as administered
by the North American Registry of Midwives or a successor
organization.
(9) Present additional documentation or certifications
required by the board. The board may adopt standards that
require more training than required by the North American
Registry of Midwives.
(d) The board shall exempt an individual from the requirements
under subsection (c) and grant the individual a certified direct
entry midwife license if the individual:
(1) holds a Certified Professional Midwife credential as
administered by the North American Registry of Midwives
not later than July 1, 2012; and
(2) files an initial application with the board not later than
July 1, 2012.
This subsection expires July 30, 2012.
Sec. 2. The board shall establish formal education requirements
in addition to those required in section 1 of this chapter. The
requirements must include course material on:
(1) emergency life support procedures;
(2) identification of high risk births for mothers;
(3) identification of potential complications during labor; and
(4) other material the board specifies.
Sec. 3. The board shall grant a license to practice certified direct
entry midwifery to an applicant who satisfies the requirements of
sections 1 and 2 of this chapter.
Sec. 4. (a) A license issued under this chapter expires after four
(4) years, on a date established by the licensing agency. Failure to
renew a license on or before the expiration date makes the license
invalid without any action by the board.
(b) The board shall adopt fees under IC 25-1-8-2.
(c) To be eligible for the renewal of a license issued under this
chapter, an individual must meet continuing education
requirements set by the board.
Sec. 5. The board:
(1) shall adopt rules under IC 4-22-2 to set the fees for
issuance of a license under this article; and
(2) may adopt rules under IC 4-22-2 to set other fees the
board considers necessary to administer this article.
Sec. 6. After July 1, 2012, only an individual who is licensed
under this article may use the title "certified direct entry midwife".
Sec. 7. The board may issue a license to an individual who is
licensed as a midwife in another state with requirements that the
board determines are at least equal to the licensing requirements
of this article.
Sec. 8. (a) This section does not apply to an individual who has
a limited license under IC 25-23-1-13.1 to practice midwifery as a
certified nurse midwife.
(b) After July 1, 2012, an individual who knowingly or
intentionally practices midwifery without a license required under
this article commits the following:
(1) A Class A misdemeanor on the first violation.
(2) A Class D felony on the second and any subsequent
unrelated violation.
Sec. 9. (a) A registered nurse who holds a limited license to
practice midwifery under IC 25-23-1-13.1 (formerly referred to as
a "midwife" before the repeal of IC 34-18-2-19 by an enrolled act
in the 2011 session of the general assembly) shall, beginning July
1, 2011, be known as a "certified nurse midwife", as provided in
IC 34-18-2-6.5.
(b) This section expires December 31, 2014.
Chapter 4. Informed Consent for the Practice of Certified
Direct Entry Midwifery
Sec. 1. All the following must occur before a certified direct
entry midwife may accept a client for midwifery care:
(1) The certified direct entry midwife must provide the
potential client with an informed disclosure of practice form.
(2) The potential client must sign and date the form.
(3) The certified direct entry midwife must sign and date the
form.
(4) If the potential client refuses a procedure or treatment
required by law, the potential client must so indicate on a
separate procedure or treatment form.
(5) The certified direct entry midwife must have an
emergency plan for the care of the client if an emergency
arises.
(6) The certified direct entry midwife must make an effort to
have a written agreement with a physician to provide for
backup care for the client. The backup physician should be
located in an area close to where the delivery will occur. The
board shall set standards for determining:
(A) the type of effort sufficient to have a written agreement
with a physician to provide for backup care for the client;
and
(B) the geographic area close enough to the planned
location of the delivery to make the backup physician a
reasonable choice to provide backup care.
The board shall, in cooperation with the medical licensing
board or professional organizations of physicians, develop a
list of physicians willing to provide backup care and make the
list available to certified direct entry midwives.
Sec. 2. A certified direct entry midwife may not perform on a
client a specific procedure or treatment that is not described on the
informed disclosure of practice form described in section 1 of this
chapter until both of the following occur:
(1) The specific procedure or treatment is disclosed to the
client in writing on a form that is separate from the informed
disclosure of practice form.
(2) The client agrees to the procedure or treatment by signing
the procedure or treatment form.
Sec. 3. The informed disclosure of practice form must be in
writing and must contain the following information:
(1) A description of the certified direct entry midwife's
education and training in midwifery, including completion of
continuing education courses and participation in the peer
review process.
(2) The certified direct entry midwife's experience level in the
field of midwifery.
(3) The certified direct entry midwife's philosophy of practice.
(4) Antepartum, intrapartum, and postpartum conditions
requiring consultation, transfer of care, and transport to a
hospital.
(5) The emergency medical backup plan, including the
emergency plan and the agreement with a physician for
backup care required under section 1 of this chapter.
(6) The services to be provided to the client by the certified
direct entry midwife.
(7) The certified direct entry midwife's current licensure status.
(8) A detailed explanation of treatments and procedures.
(9) A detailed description of the risks and expected benefits of midwifery care.
(10) The availability of a grievance process in a case in which a client is dissatisfied with the performance of the certified direct entry midwife.
(11) A statement that if the client is advised by the certified direct entry midwife or a collaborating physician that the client is or has become at risk (as described in IC 25-23.4-5-1), the certified direct entry midwife:
(A) shall refer the client to a physician for consultation;
(B) may refuse to provide or continue care; and
(C) may transfer care of the client to a physician.
(12) A statement disclosing whether or not the certified direct entry midwife maintains liability insurance.
(13) That state licensure of a certified direct entry midwife does not ensure that a home setting for delivery of a child is safe.
(14) That the client understands that the client is waiving the right to sue a physician or health care provider for the acts or omissions of the certified direct entry midwife.
(15) A statement that under IC 25-23.4-6 a health care provider (as defined in IC 34-18-2-14) may not be held jointly or severally liable for the acts or omissions of a:
(A) certified direct entry midwife; or
(B) licensed physician who has entered into a collaborative agreement under IC 25-23.4-5 with a certified direct entry midwife, for the acts or omissions of the licensed physician while the physician assists or collaborates with the certified direct entry midwife to perform midwifery.
Sec. 4. (a) Before March 31 every year, a certified direct entry midwife shall provide an annual report to the board regarding each birth the previous year that the certified direct entry midwife assists. A report must summarize the following on a form prescribed by the board:
(1) Vital statistics.
(2) Scope of care.
(3) Transport information.
(4) Physician referral.
(b) A certified direct entry midwife may not reveal the identity
of the clients referred to in a report under subsection (a).
Sec. 5. (a) Except as provided in subsection (b), a certified direct
entry midwife may not dispense or administer prescription drugs.
(b) A certified direct entry midwife may administer:
(1) vitamin K, either orally or through intramuscular
injection;
(2) postpartum antihemorrhagic drugs in emergency
situations;
(3) local anesthetics by infiltration or topical application, only
for postpartum repair of lacerations, tears, and episiotomy;
(4) oxygen;
(5) Rhogam;
(6) prophylactic eye agents; and
(7) prophylactic antibiotics for Group B Strep (also known as
Beta Strep).
The board may adopt rules specifying the circumstances under
which a certified direct entry midwife may administer the
substances listed in this subsection.
Chapter 5. Management of At Risk Clients
Sec. 1. A client is considered at risk if the client has any of the
following conditions:
(1) Preeclampsia.
(2) Type 1 diabetes.
(3) Severe chronic hypertension.
(4) Severe anemia.
(5) Any other condition determined by the board.
Sec. 2. If a client is at risk, the certified direct entry midwife
shall:
(1) refer the client to a physician licensed under IC 25-22.5;
and
(2) consult with the physician concerning the client's care.
Sec. 3. (a) If the certified direct entry midwife, physician, and
client agree that the certified direct entry midwife may continue to
provide services to the at risk client, the certified direct entry
midwife shall enter into a collaborative plan of treatment with a
physician licensed under IC 25-22.5.
(b) The collaborative plan of treatment under subsection (a)
must include the following provisions:
(1) The circumstances that would require consultation or
referral with a physician.
(2) The circumstances that would require transfer of
responsibility for the primary care of the at risk client.
(3) The services to be provided by the certified direct entry midwife and the licensed physician.
Chapter 6. Liability of Health Care Providers
Sec. 1. A health care provider (as defined in IC 34-18-2-14) may not be held jointly or severally liable for the acts or omissions of a certified direct entry midwife.
Sec. 2. (a) This section applies only to the following:
(1) An employee of a certified direct entry midwife.
(2) A student, an intern, a trainee, or an apprentice who is:
(A) pursuing a course of study to gain licensure under this article; or
(B) accumulating the experience required for licensure under this article;
under the supervision of a certified direct entry midwife.
(b) A person described in subsection (a) may perform an act, a duty, or a function of the practice of midwifery that is customarily within the specific area of practice of the employing certified direct entry midwife if the act, duty, or function is performed under the direction and supervision of the employing certified direct entry midwife.
(c) A person described in subsection (a) may not be held jointly or severally liable for the acts or omissions of a certified direct entry midwife.
Chapter 7. Right to Certified Direct Entry Midwifery Services
Sec. 1. Except as otherwise provided by law, an individual is entitled to:
(1) give birth in the presence of; and
(2) receive assistance during the birth process from;
a certified direct entry midwife.
Sec. 2. This article may not be construed to require a hospital to extend clinical privileges to a certified direct entry midwife.
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 14. "Health care
provider" means any of the following:
(1) An individual, a partnership, a limited liability company, a
corporation, a professional corporation, a facility, or an institution
licensed or legally authorized by this state to provide health care
or professional services as a physician, a psychiatric hospital, a
hospital, a health facility, an emergency ambulance service
(IC 16-18-2-107), a dentist, a registered or licensed practical
nurse, a physician assistant, a certified nurse midwife, a
certified direct entry midwife, an optometrist, a podiatrist, a
chiropractor, a physical therapist, a respiratory care practitioner,
an occupational therapist, a psychologist, a paramedic, an
emergency medical technician-intermediate, an emergency
medical technician-basic advanced, or an emergency medical
technician, or a person who is an officer, employee, or agent of
the individual, partnership, corporation, professional corporation,
facility, or institution acting in the course and scope of the
person's employment.
(2) A college, university, or junior college that provides health
care to a student, faculty member, or employee, and the governing
board or a person who is an officer, employee, or agent of the
college, university, or junior college acting in the course and
scope of the person's employment.
(3) A blood bank, community mental health center, community
mental retardation center, community health center, or migrant
health center.
(4) A home health agency (as defined in IC 16-27-1-2).
(5) A health maintenance organization (as defined in
IC 27-13-1-19).
(6) A health care organization whose members, shareholders, or
partners are health care providers under subdivision (1).
(7) A corporation, limited liability company, partnership, or
professional corporation not otherwise qualified under this section
that:
(A) as one (1) of its functions, provides health care;
(B) is organized or registered under state law; and
(C) is determined to be eligible for coverage as a health care
provider under this article for its health care function.
Coverage for a health care provider qualified under this
subdivision is limited to its health care functions and does not
extend to other causes of action.
; (11)IN0342.1.22. --> SECTION 22. THE FOLLOWING ARE REPEALED [EFFECTIVE
JULY 1, 2011]: IC 34-6-2-81; IC 34-18-2-19.
(b) Notwithstanding IC 25-23.4-2-2, as added by this act, the governor shall appoint the initial members of the board before September 1, 2011, for terms expiring as follows:
(1) One (1) member appointed under IC 25-23.4-2-2(a)(1), as added by this act, one (1) member appointed under IC 25-23.4-2-2(a)(2), as added by this act, and one (1) member appointed under IC 25-23.4-2-2(a)(4), as added by this act, for a term expiring August 31, 2012.
(2) One (1) member appointed under IC 25-23.4-2-2(a)(1), as added by this act, and one (1) member appointed under IC 25-23.4-2-2(a)(2), as added by this act, for a term expiring August 31, 2013.
(3) One (1) member appointed under IC 25-23.4-2-2(a)(1), as added by this act, and one (1) member appointed under IC 25-23.4-2-2(a)(3), as added by this act, for a term expiring August 31, 2014.
(c) This SECTION expires September 1, 2014.