02/25/1998 09:08 AM Senate HES

       SB 238 - BOARD OF CERTIFIED DIRECT-ENTRY MIDWIVES                       
                                                                               
SENATOR LEMAN, Chairman of the Senate Labor and Commerce Committee             
which sponsored SB 238, announced Pam Weaver, a member of the Board            
of Certified Direct-Entry Midwives, was present to discuss the                 
bill.  He noted SB 238 merely extends the board's existence for                
four more years, and although there are other issues pertaining to             
midwifery that should be reviewed, they were not included in this              
legislation in the interest of time.                                           
                                                                               
Number 469                                                                     
                                                                               
PAM WEAVER, a midwife operating a clinic in Wasilla, informed                  
committee members that although the Division of Legislative Audit              
recommended that the Board of Certified Direct-Entry Midwives be               
extended to June 30, 2004, the bill contains a four year extension             
to 2002, because a six year extension was highly unlikely to pass.             
                                                                               
MS. WEAVER discussed the licensing fees for certified midwives in              
the State of Alaska.  As a member of the national certification                
board, she is aware that the fees in Alaska are the highest in the             
country.  Alaska was second to Colorado, but recent legislation in             
Colorado reduced the fee from $1400 to $300.  That legislation had             
a similar affect on other smaller professions such as naturopaths,             
acupuncturists, and chiropractors and created a general defense                
fund for all of the professions by collecting a tariff on every                
licensee.  She suggested that approach be reviewed as a possible               
solution to licensure fee problems in Alaska.  Ms. Weaver said                 
midwives are willing to support their own board, but the problem is            
exacerbated by midwives' lack of access to the market, specifically            
to medicaid funds.  In 1992 the Legislature unanimously voted for              
licensure and the licensing board.  In 1993 Senator Leman sponsored            
legislation to put midwives on the medicaid provider list and for              
third party reimbursement from insurers.  That legislation passed,             
however midwives still do not receive medicaid reimbursement.  In              
Alaska, 40 percent of births are funded by medicaid.  The Division             
of Legislative Audit has also recommended that the Legislature give            
consideration to that issue.                                                   
                                                                               
MS. WEAVER referred to a letter sent to midwives from Catherine                
Reardon that contained suggestions to resolve the high license                 
fees, and maintained that after reviewing the suggestions, the                 
Board decided none would play out.                                             
                                                                               
Number 416                                                                     
                                                                               
SENATOR LEMAN commented the Board of Direct-Entry Midwives has                 
functioned appropriately since it was created and the profession is            
alive and well.  He asked Ms. Weaver if she had any information to             
the contrary.                                                                  
                                                                               
MS. WEAVER replied from a national perspective, what Alaska has                
done legislatively for direct-entry midwifery is a banner that she             
holds proudly.  In many states it is still illegal for a woman to              
choose to have a baby outside of the hospital.  She affirmed                   
midwifery has fared well in Alaska.                                            
                                                                               
SENATOR LEMAN indicated he is working on an approach to get funding            
for midwifery services under medicaid and through that process                 
Alaska will lose the general fund component of the operating                   
budget, so it will be a win-win situation.                                     
                                                                               
CATHERINE REARDON, Director of the Division of Occupational                    
Licensing (DOL), Department of Commerce and Economic Development,              
stated strong support for the continuation of the Board of Direct-             
Entry Midwives.  She clarified that although the Division of                   
Legislative Audit did recommend a six year extension, the                      
Legislature is more comfortable as a standard matter of course with            
four year extensions of boards.  The board would be happy with                 
either extension.  She stated midwifery is a valued health care                
option for women in Alaska.  The board has tried to be very frugal,            
and in FY 97, spent a total of $700 on travel.  Its small budget is            
caused by the fact that there are very few people to spread the                
costs among.  She explained the State of Colorado has a central                
licensing agency and a financial self-sufficiency mandate; the pool            
of money collected from fees pays for legal and disciplinary costs.            
The midwife license fee in Alaska is $1550 every two years.  For               
those midwives who handle three to five births per year, that cost             
is prohibitive.                                                                
                                                                               
Number 334                                                                     
                                                                               
SENATOR LEMAN commented he is interested in working with Ms.                   
Reardon and the Board to find a way to reduce the fee.  He did not             
intend to include a solution to the fee problem in SB 238 but hopes            
to find another vehicle in which to do so.                                     
                                                                               
SENATOR LEMAN moved to report SB 238 out of committee with                     
individual recommendations and its accompanying fiscal note.  There            
being no objection, the motion carried.