Legislature(1997 - 1998)
02/25/1998 09:08 AM HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
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.