03/06/2003 09:04 AM Senate FIN

                                                                                                                                
     HOUSE BILL NO. 71                                                                                                          
     "An  Act  extending  the  termination  date  of  the  Board  of                                                            
     Certified Direct-Entry Midwives."                                                                                          
                                                                                                                                
                                                                                                                                
This  was the first  hearing  for this  bill in  the Senate  Finance                                                            
Committee.                                                                                                                      
                                                                                                                                
Co-Chair Wilken explained the legislation as follows.                                                                           
                                                                                                                                
     House  Bill  71 extends  the Board  of  Certified Direct-Entry                                                             
     Midwives  four years  to June 30, 2007.  The extension  matches                                                            
     the Division of Legislative  Budget and Audit's recommendation.                                                            
                                                                                                                                
LINDA SYLVESTER,  Staff to Representative Weyhrauch,  sponsor of the                                                            
bill, informed  that all of the Representative's children  were born                                                            
using the services  of a direct-entry midwife. Ms.  Sylvester read a                                                            
statement as follows.                                                                                                           
                                                                                                                                
     The  Board has  served as  a means  to make  people  practicing                                                            
     midwifery  aware of the level of experience and  education that                                                            
     is  expected of  them. The  State  of Alaska  women seeking  an                                                            
     alternative  to hospital care for a normal pregnancy  and birth                                                            
     rely on the diligence  of the Board to enhance both the quality                                                            
     and accessibility of their health care.                                                                                    
                                                                                                                                
     Based  on the recommendations  of legislative audit,  the Board                                                            
     is operating well and it should be extended.                                                                               
                                                                                                                                
     The   regulation  and   licensure  of   direct-entry   midwives                                                            
      contributes to the protection of the public's welfare.                                                                    
                                                                                                                                
Ms. Sylvester  asserted  that  the members  do not  oppose the  high                                                            
licensure  fees, as they  realize they are  small group. She  stated                                                            
that  the Board  should  not be  merged  with a  board representing                                                             
another  medical profession  for the  sole purpose  of lowering  the                                                            
license fees.                                                                                                                   
                                                                                                                                
Senator Taylor supported  the bill and indicated he had reviewed the                                                            
audit  report.  He  offered   a motion   to  report  the  bill  from                                                            
Committee.                                                                                                                      
                                                                                                                                
KAYE KANNE,  President,  Midwives Association  of Alaska,  testified                                                            
that  she served  on the  Board  for two  terms beginning  with  its                                                            
inception  in  1992.  She  remarked  that the  Board  has  "done  an                                                            
excellent job." She informed  that when the Board was first created,                                                            
the  certified  direct-entry  midwives   performed  a  "very  small"                                                            
percentage of  the births in Alaska and that currently  midwives are                                                            
attending almost ten percent  of the births. She pointed out that in                                                            
some areas, this  percentage is higher: 25 percent  of births in the                                                            
Mat-Su Borough,  16 percent in Juneau, and 12 percent  in Fairbanks.                                                            
She  reported  "very  low"  incidences  requiring  cesarean-section                                                             
delivery and overall,  "really good outcomes for mothers  and babies                                                            
and a very low cost to the State."                                                                                              
                                                                                                                                
Ms.  Kanne reminded  that  in  1998, midwifery  services  have  been                                                            
eligible for Medicaid coverage  and attested this is less costly for                                                            
the State.                                                                                                                      
                                                                                                                                
Senator Olson asked the licensure fee.                                                                                          
                                                                                                                                
Ms. Kanne  listed  $1,350 as  the fee  for a two-year  license.  She                                                            
compared this to the original  fee of $1,500 and the $950 fee of two                                                            
years ago.                                                                                                                      
                                                                                                                                
Senator  Olson  asked if  any  actions  have  been taken  against  a                                                            
licensee.                                                                                                                       
                                                                                                                                
Ms. Kanne  told of one  investigation of  unlicensed activities  and                                                            
another investigation  pending. She did not have details  of the on-                                                            
going instance.                                                                                                                 
                                                                                                                                
Senator  Olson asked  if  action would  be  taken against  a  person                                                            
attending to a home birth for a family member or friend.                                                                        
                                                                                                                                
Ms. Kanne  assured that this  activity is  legal and indicated  that                                                            
statutes   specifically  protect   Native   and  cultural   birthing                                                            
practices. She  stated that the Board and licensure  is intended for                                                            
modern-day midwives.                                                                                                            
                                                                                                                                
Senator  Olson  wanted to  ensure  that health  aides  operating  in                                                            
smaller  communities  are  "free   from  prosecution  to  a  certain                                                            
degree."                                                                                                                        
                                                                                                                                
Co-Chair Wilken  referenced page 11  of the Division of Legislative                                                             
Budget  and  Audit  report,   "The  Board  believes  it  is  in  the                                                            
profession's  and the  public's  best interest  to  require all  CDM                                                            
applicants  and  renewals to  pass  an exam  on State  statutes  and                                                            
regulations  applicable  to the profession."  He  noted that such  a                                                            
provision  is not  included in  this legislation  and  asked if  the                                                            
witness would prefer one.                                                                                                       
                                                                                                                                
Ms.  Kanne  explained  that  the  Board  supports   a jurisprudence                                                             
requirement,  although  the  consensus  of  the  Association  is  to                                                            
request   this   in   separate   legislation    along   with   other                                                            
"housekeeping"  items.  She clarified  she would  not object if  the                                                            
provision were added to this bill.                                                                                              
                                                                                                                                
Co-Chair Wilken  commented that extension  of lapse dates  of boards                                                            
and commissions  is  partially intended  as an  opportunity to  make                                                            
changes such as proposed  in the audit. He requested the sponsor and                                                            
the witness collaborate  with Finance Committee staff to incorporate                                                            
the "housekeeping" matters into this bill.                                                                                      
                                                                                                                                
Senator  Taylor  WITHDREW   his  motion  to  report  the  bill  from                                                            
Committee without objection.                                                                                                    
                                                                                                                                
Co-Chair Wilken ordered the bill HELD in Committee.