Bill Text: MI HB4749 | 2013-2014 | 97th Legislature | Introduced

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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: Slight Partisan Bill (Republican 18-8)

Status: (Introduced - Dead) 2013-05-22 - Printed Bill Filed 05/22/2013 [HB4749 Detail]

Download: Michigan-2013-HB4749-Introduced.html

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HOUSE BILL No. 4749

 

May 21, 2013, Introduced by Reps. McBroom, Heise, Cavanagh, Schmidt, Shirkey, Bumstead, Rendon, MacGregor, Johnson, Dianda, Irwin, Foster, Darany, O'Brien, Stallworth, Olumba, Yonker, LaFontaine, Tlaib, Muxlow, Hooker, Jenkins, Daley, Franz, Walsh and Kandrevas 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 sections 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

 

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

 

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

 

 1  referral, consultation, or collaboration with a midwife under

 

 2  this part, means any of the following:

 

 3        (i) A physician.

 

 4        (ii) A certified nurse midwife.

 

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

 

 6  another appropriate health professional licensed, registered, or

 

 7  otherwise authorized to engage in a health profession under this

 

 8  article.

 

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

 

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

 

11  certification in the profession specialty field of nurse

 

12  midwifery by the board of nursing under section 17210.

 

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

 

14  to engage in the practice of midwifery.

 

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

 

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

 

17  osteopathic medicine and surgery under part 175.

 

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

 

19  means providing maternity care that is consistent with a

 

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

 

21  neonates during the antepartum, intrapartum, and postpartum

 

22  periods.

 

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

 

24  following:

 

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

 

26  surgery.

 

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

 

 1  nursing with a specialty certification in the profession

 

 2  specialty field of nurse midwifery under part 172.

 

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

 

 4  contains general definitions and principles of construction

 

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

 

 6  definitions applicable to this part.

 

 7        Sec. 17103. Beginning the effective date of rules

 

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

 

 9  titles "licensed midwife" or "l.m.", or similar words or initials

 

10  that indicate that the individual is licensed as a midwife,

 

11  unless the individual is licensed under this part.

 

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

 

13  promulgated under section 17117, an individual shall not engage

 

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

 

15  is otherwise authorized by this article.

 

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

 

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

 

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

 

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

 

20  under section 17117.

 

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

 

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

 

23  following:

 

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

 

25  any other part or act from performing activities that are

 

26  considered to be within the practice of midwifery if those

 

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

 

 1  the individual does not use the titles protected under section

 

 2  17103.

 

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

 

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

 

 5  supervision; and who is performing activities or functions that

 

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

 

 7  not require the exercise of professional judgment for their

 

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

 

 9  perform.

 

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

 

11  the practice of midwifery if those activities are performed under

 

12  the direct and immediate supervision of an appropriate health

 

13  professional during completion of the North American registry of

 

14  midwives portfolio evaluation process or as a student at a

 

15  midwifery education program accredited by the midwifery education

 

16  accreditation council or other accrediting body approved by the

 

17  board.

 

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

 

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

 

20  herself out to be a midwife.

 

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

 

22  religious practitioner does not hold himself or herself out to

 

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

 

24  protected under section 17103.

 

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

 

26  religious denomination if all of the following are met:

 

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

 

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

 

 2  the established tenets or teachings of that church or

 

 3  denomination and relies on treatment by prayer or spiritual means

 

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

 

 5  denomination.

 

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

 

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

 

 8  voluntary contribution is not considered a fee for the services

 

 9  provided by that individual.

 

10        Sec. 17107. At his or her initial consultation with a

 

11  patient, a midwife shall establish a protocol for medical

 

12  emergencies, including transportation to a hospital, that is

 

13  specific to that patient.

 

14        Sec. 17109. A midwife shall obtain informed consent from a

 

15  patient at the inception of care and continuing throughout the

 

16  patient's care.

 

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

 

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

 

19  prescription drugs or medications.

 

20        (b) Use vacuum extractors or forceps.

 

21        (c) Prescribe medications.

 

22        (d) Perform surgical procedures other than episiotomies or

 

23  repairs of perineal lacerations.

 

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

 

25  promulgated under this part.

 

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

 

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

 

 1  prescription from a licensed health care provider with

 

 2  prescriptive authority may administer any of the following:

 

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

 

 4  through intramuscular injection.

 

 5        (b) Postpartum antihemorrhagic agents to a mother.

 

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

 

 7  mother.

 

 8        (d) Oxygen to a mother or newborn.

 

 9        (e) Prophylactic eye agent to a newborn.

 

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

 

11        (g) Agents for group B streptococcus prophylaxis,

 

12  recommended by the federal centers for disease control and

 

13  prevention, to a mother.

 

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

 

15  mother.

 

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

 

17  provider with prescriptive authority that is consistent with the

 

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

 

19  rule.

 

20        (3) The board shall promulgate rules concerning the

 

21  administration of prescription drugs or medications described in

 

22  subsection (2) by midwives.

 

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

 

24  created in the department. The board consists of the following 7

 

25  members who meet the requirements of part 161:

 

26        (a) Five midwives.

 

27        (b) Two members of the general public.

 

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

 

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

 

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

 

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

 

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

 

 6  serve for 4 years.

 

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

 

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

 

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

 

10  applicant meets all of the following:

 

11        (a) He or she has received a high school diploma or passed

 

12  the general educational development (G.E.D.) diploma test or any

 

13  other high school graduate equivalency examination approved by

 

14  the board.

 

15        (b) He or she holds the credential of certified professional

 

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

 

17  equivalent credential from another accredited midwifery training

 

18  program approved by the board under section 16148.

 

19        (c) He or she successfully passes an examination approved by

 

20  the department in consultation with the board. If the training

 

21  program described in subdivision (b) includes an examination that

 

22  meets the requirements of section 16178(1), the board may accept

 

23  passing of that examination as meeting the requirements of this

 

24  subdivision.

 

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

 

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

 

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

 

 1  the following:

 

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

 

 3  practice of midwifery under this part.

 

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

 

 5  continuing education for the practice of midwifery as a condition

 

 6  for license renewal.

 

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

 

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

 

 9  functions by midwives. The department shall include rules that

 

10  recognize and incorporate the requirements under section 17107

 

11  regarding the referral to and consultation with appropriate

 

12  health professionals.

 

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

 

14  which informed consent is obtained.

 

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

 

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

 

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

 

18  to supplement the requirements for licensure under this part,

 

19  including the adoption of updated standards applicable to the

 

20  practice of midwifery established by the North American registry

 

21  of midwives or successor agency.

 

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

 

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

 

24  midwifery established under this article.

 

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

 

26  section that limit the authority of a midwife to administer

 

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

 

 1  prohibit the administration of any of those drugs or medications

 

 2  by a midwife.

 

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

 

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

 

 5  state at the time of application if the applicant provides

 

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

 

 7  the following are met:

 

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

 

 9  rules promulgated under this part for licensure.

 

10        (b) There are no pending disciplinary proceedings against

 

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

 

12  other state or country.

 

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

 

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

 

15  based upon grounds that are substantially similar to those under

 

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

 

17  in force at the time of the application.

 

18        (d) The other state maintains licensure standards equivalent

 

19  to or more stringent than those of this state.

 

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

 

21  whether an applicant meets the requirements described in

 

22  subsection (1)(b) and (c).

 

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

 

24  third party reimbursement or mandated worker's compensation

 

25  benefits for services rendered by an individual licensed under

 

26  this part.