Legislature(2013 - 2014)BELTZ 105 (TSBldg)
03/13/2014 01:30 PM Senate LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SB166 | |
| SB167 | |
| SB156 | |
| SB190 | |
| SB140 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 99 | TELECONFERENCED | |
| += | SB 166 | TELECONFERENCED | |
| += | SB 167 | TELECONFERENCED | |
| += | SB 140 | TELECONFERENCED | |
| += | SB 190 | TELECONFERENCED | |
| += | SB 156 | TELECONFERENCED | |
| += | SB 193 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 156-DIRECT-ENTRY MIDWIVES
1:49:08 PM
CHAIR DUNLEAVY reconvened the meeting and announced the
consideration of SB 156. "An Act relating to direct-entry
midwives." He noted that this was the first hearing.
1:49:27 PM
HEATHER SHADDUCK, Staff, Senator Pete Kelly, introduced SB 156
on behalf of the sponsor speaking to the following sponsor
statement:
SB 156 will update and streamline the Certified
Direct-entry Midwife ("CDM") practice act. The initial
law was enacted in 1992, prior to establishing a
functioning Board of Certified Direct-entry Midwives.
Due to the lack of a professional board to set ongoing
regulations at the time, a detailed set of practices
were placed in Alaska Statue. The Board has tried to
establish and develop a comprehensive regulatory
framework through practice regulations and guidelines
crafted to ensure public safety and professional
discipline. However, the outdated statute cements
certain obsolete practice requirements in place, and
can only be updated by an act of the legislature.
SB 156 will neither lessen the regulatory governance
of CDMs, nor will it expand their scope of practice.
Rather, the bill clarifies regulatory intent and
defines CDM scope of practice. SB 156 would give the
board greater flexibility and efficiency by placing
CDM required practices into regulation rather than
statute. This enables the Board to oversee the
profession more effectively and incorporate current
nationally-recognized best practices. This type of
authority is granted to most professional boards in
order to develop and maintain professional practice
standards.
The proposed changes in the bill will also ensure
greater public safety in the field of midwifery. SB
156 requires a CDM to be licensed arid practicing for
two years and attend 50 or more births as a primary or
assistant midwife in order to supervise an apprentice
direct-entry midwife. Well-baby care will also be
covered under the scope of CDM practice for up to 4
weeks after birth, which ensures the delivering
midwife can properly follow up with both mother and
baby. SB 156 repeals the cultural midwives exemption,
requiring all CDMs in the state to be licensed and
under the disciplinary regulation of the Board of
CDMs. Currently, an individual whose cultural
traditions have included, for at least two
generations, the attendance of midwives at birth, and
has assisted in at least 10 births does not fall under
regulation of the board. The health and safety of all
mothers and babies using midwifery services will be
improved by holding all certified direct-entry
midwives to a higher level of training and care.
1:54:06 PM
SENATOR OLSON asked what the current requirement is to become a
certified direct-entry midwife.
MS. SHADDUCK clarified that the bill requires a CDM to be
licensed and to practice for two years and to attend 50 births
as a primary or assistant midwife to qualify to supervise an
apprentice direct-entry midwife. She deferred to Cheryl Corrick
to discuss the licensing requirements.
SENATOR OLSON asked how many midwives practicing in rural Alaska
would be affected by the bill.
MS. SHADDUCK said she didn't have a number but her understanding
was that the board brought the provision forward because it
hasn't been used as intended.
SENATOR OLSON asked how many rural midwives would be affected.
MS. SHADDUCK said she didn't have a number but it would be very
small.
SENATOR OLSON asked if there were complaints that prompted this
legislation.
MS. SHADDUCK deferred the question to the representative from
the Board of Certified Direct-entry Midwives.
1:56:31 PM
SUSAN TERWILLIGER, CDM and President, Midwives Association of
Alaska (MAA), Eagle River, Alaska, stated support for SB 167.
Addressing an earlier question, she clarified that the 50 birth
requirement only applies to midwives who seek to be preceptors.
The number 50 applies to qualifying as a teacher, not
certification to be a CDM.
She said that Alaska has a fairly good midwifery law, but it
needs updating for public safety and to keep current with the
latest childbirth information and studies. Many Alaskan women
seek midwifery care as an option for their pregnancy care and
birth and they expect the licensing laws to reflect best
practices, she said. Moving the practice requirements that are
currently in statute into regulation will make it easier for the
board to make additions and updates. The bill also adds to the
definition of midwifery that the well-baby care is given up to
four weeks and that apprentices are supervised. She said that
midwives have been doing this for years but it isn't in statute.
She opined that passing the bill gives Alaska the opportunity to
be a leader in the nation.
1:59:12 PM
SENATOR OLSON asked how many births a CDM needs to be eligible
for a license.
MS. TERWILLIGER said she didn't know because she received her
Alaska license nine years ago through a reciprocity agreement
with Texas that only required passing an examination.
SENATOR OLSON asked how many births she'd attended.
MS. TERWILLIGER replied she's attended about 750 births.
SENATOR OLSON asked if complaints prompted the legislation.
MS. TERWILLIGER answered no; it was prompted by years of
frustration at not being able to update for best practices.
SENATOR OLSON commented that births have occurred since Cain and
Able and he questioned the sudden need to attend 50 births
before someone can become a preceptor.
MS. TERWILLIGER explained that both the board and the MAA
membership agreed that it was in the profession's best interest
to add to the requirement. It's a matter of professionalism, she
said.
SENATOR OLSON maintained that this would put midwives practicing
in rural areas at a disadvantage.
MS. TERWILLIGER responded that the bill is about the ability to
teach other midwives, not practice midwifery.
SENATOR OLSON said teaching needs to take place in rural areas,
too, and he was reluctant to prohibit someone from being a
preceptor just because they haven't acted as a primary or
assistant midwife at 50 births. He again stressed that it puts
rural sites at a disadvantage.
MS. TERWILLIGER suggested Ms. Corrick be added to the
discussion.
2:03:42 PM
CHERYL CORRICK, Chair, Board of Certified Direct-entry Midwives,
Fairbanks, Alaska, said the board considered that it would be
more difficult for midwives in rural areas to attend 50 births
but as they looked at professionalism they noticed a trend that
the complaints that resulted in investigations were about
preceptors who didn't have much experience. This was discussed
in board meetings and the MAA made the decision to include this
provision in the bill.
SENATOR OLSON observed that there have been complaints that
prompted this legislation.
MS. CORRICK responded that she's been on the board for six years
and has noticed that trend.
SENATOR OLSON asked how he would find out how many licenses have
been revoked or suspended because of complaints.
MS. CORRICK replied there have been no suspensions or
revocations imposed during her six-year tenure on the board, but
there have been some memorandums of agreement and other
disciplinary measures.
SENATOR OLSON asked how many midwives practice in rural areas
and how many would be affected by this legislation.
MS. CORRICK said her understanding was that very few midwives
are practicing in rural areas.
2:07:28 PM
DANA BROWN, Director, Alaska Family Health and Birth Center,
Fairbanks, Alaska, stated that she has been licensed since 1993,
has served on the board in the past, and was speaking in support
of SB 156. She related that during her tenure the board tried to
pass regulations to update practices only to have the statute
prevent it from happening. She pointed out that the statute was
passed many years ago and never updated so it needs to be
brought up to current standards.
SENATOR OLSON asked if she had practiced in rural Alaska.
MS. BROWN said no and added that the direct-entry midwifes in
Alaska generally practice near cities and towns, but serve rural
areas. She explained that women who live in villages usually
come to town for their births so that they're closer to a
hospital.
SENATOR OLSON responded that the bill puts his rural
constituents at a disadvantage because precipitous births do
occur.
MS. BROWN pointed out that there are no licensed midwives in
those areas and the bill doesn't affect a health aide working in
a village because they aren't under the jurisdiction of a
direct-entry midwife license.
SENATOR OLSON asked if she was saying that there are no
certified direct-entry midwives in rural Alaska.
MS. BROWN asked him to define rural.
SENATOR OLSON said he was talking about places like Bethel,
Barrow, Kotzebue, or Nome.
MS. BROWN responded that she was not aware of any direct-entry
midwives practicing in villages that are off the road system.
2:11:51 PM
JENNITH LUCAS, representing herself, Anchorage, Alaska,
testified in support of SB 156. She said she used a midwife for
the births of her children and she knows that they were aware of
the most recent studies and best practices for safe childbirth.
She described the bill as important for Alaskan consumers.
2:13:32 PM
SASKIA ESSLINGER, representing herself, Anchorage, Alaska, said
she used midwives for the births of her two children. This was
the best option for her, but she did notice that the regulations
didn't always allow for the most current standards of practice.
She said she supports SB 156 because it will allow the board to
update and revise the practice guidelines. It will also enhance
public safety by requiring more experience for preceptors.
2:15:07 PM
SARA CHAMBERS, Administrative Operations Manager, Division of
Corporations, Business and Professional Licensing, Department of
Commerce, Community and Economic Development (DCCED), introduced
herself and offered to answer questions.
SENATOR OLSON asked if there were any licensed midwives in rural
Alaska.
MS. CHAMBERS replied the division doesn't track licenses that
way but she would look at the addresses on the licenses and
follow up with the information.
SENATOR OLSON asked how many midwives would be affected by the
50-birth requirement to be a preceptor.
MS. CHAMBERS said it would take additional research to make that
determination.
SENATOR OLSON asked how many births are required to qualify for
a license.
MS. CHAMBERS suggested he pose the question to Ms. Corrick.
SENATOR OLSON asked if DCCED was in favor of the bill.
MS. CHAMBERS answered that the department didn't have a
position.
SENATOR MICCICHE offered his perspective that the current two-
year requirement had less value in measuring experience than the
proposed 50-birth requirement.
MS. CHAMBERS, responding to an earlier question, reported that
there were 62 midwife licensees in FY13 and 8 investigations.
2:20:48 PM
SENATOR MICCICHE asked Ms. Corrick if she agrees with his logic
that the number of births has more value than the length of time
a person has held a license.
MS. CORRICK agreed that 50 births is more telling of experience.
Responding to an earlier question, she relayed that to get
licensed as a certified direct-entry midwife the apprentice has
to attend 60 births. Ten of the births are observations, 20 are
assisting at the birth, and 30 are as the primary provider under
the supervision of the preceptor. The licensing process takes
approximately two years so a midwife should be able to get the
required 50 births within that timeframe. She acknowledged that
it would be more difficult for someone who moved to a more rural
area, less populated area.
CHAIR DUNLEAVY opened public testimony.
2:23:00 PM
JUDY DAVIDSON, CDM, MatSu Midwifery and Family Health, Wasilla,
Alaska, said she's been licensed since 1993 when the state first
provided licensure for direct-entry midwives. She said it's
important to understand that direct-entry midwives are licensed
to provide care to low-risk women and their training includes
precipitous births. She and a number of other midwives provide
training for people living in other areas and part of the reason
for updating the statute is to show that they're qualified as
preceptors. She said Alaska has the highest rate of out of
hospital births in the nation and it is looked to as an example.
Updating the statute shows continued progress to reflect the
standard of maternity care that midwives offer.
2:26:21 PM
KAYE KANNE, CDM, Juneau, Alaska, said she's been practicing as a
midwife for 30 years and was involved in the 1985 legislation to
keep midwifery legal. Legislation passed in 1992 created a board
for certified direct-entry midwives and she served on the board
for eight years and helped craft the current regulations.
MS. KANNE said she believes that the number of births that a
midwife has attended since being licensed is important in terms
of having the knowledge to be a preceptor, but the number of
years is not important. For example, a former student who has
been licensed for eight months has attended 180 births. She's
very qualified to be a preceptor, but she can't until she's been
licensed for two years.
She explained that the required practices that they're trying to
move into regulation were put into statute in 1985 because there
wasn't a board and there were no regulations. Now that there's a
very well-functioning board it makes sense to move those
required practices into regulation so that the board can keep it
up to date, she said.
SENATOR OLSON asked if she was in favor of the legislation.
MS. KANNE replied she was definitely in favor of the
legislation.
SENATOR OLSON asked if midwives have a requirement for
continuing education.
MS. KANNE replied the law requires 20 hours of continuing
education per licensing period.
SENATOR OLSON asked where a midwife can get continuing
education.
MS. KANNE said there's an annual midwifery conference in Juneau
and there are a number of them held every year in other states.
SENATOR OLSON asked if courses were available online.
MS. KANNE answered yes.
SENATOR OLSON asked if she had ever practiced in rural Alaska.
MS. KANNE said she has practiced in Juneau for 30 years serving
this community and all of Southeast Alaska.
SENATOR OLSON asked if there were midwives in places like
Klawock, Hollis, or Coffman Cove.
MS. KANNE replied she wasn't aware of any.
SENATOR OLSON asked to hear from the recently licensed midwife.
2:31:41 PM
MADISON NOLAN, CDM, Juneau, Alaska, told the committee that she
was an apprentice for three years and was licensed last
September.
SENATOR OLSON, noting that she had attended 180 births, asked if
she feels qualified to be a preceptor.
MS. NOLAN said she had only attended 40 births since she was
licensed so she wouldn't qualify under the proposed 50-birth
requirement. She added that for her personal comfort she'd want
at least a year of licensure before becoming a preceptor. The
time component isn't as important, but it does have some value.
SENATOR OLSON said he'd like to hear from rural hospitals.
CHAIR DUNLEAVY agreed.
2:33:42 PM
CHAIR DUNLEAVY announced that he would hold SB 156 in committee
for further consideration. Public testimony remained open.
| Document Name | Date/Time | Subjects |
|---|---|---|
| CS SB99 version C.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 99 |
| CSSB 99 Explanation of Changes Version C.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 99 |
| CSSB 99 Sectional Analysis Version C.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 99 |
| SB166_DCCEDResponseLetter.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 166 |
| SB167_ Infograph.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 167 |
| CS SB 140 Explanation of Changes Version R.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 140 |
| CS SB 140 Sectional Analysis version R.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 140 |
| CS SB140 Version R.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 140 |
| SB0190A.PDF |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190 CS ver U.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB 190 Sponsor Statement.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190 Summary of Changes ver A to ver U.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_ support letters_Bishop.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Chadd.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Entsminger.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Geary.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Harms.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Jacobson.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Joyce.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_King.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Klutsch.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Kubat.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Leonard.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_McCarthy.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Munsey.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Parker.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Pitts.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Smith.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190_support letters_Tiffany IV.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190-DCCED-CBPL-03-07-14.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB190-DPS-AWT-03-07-14.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 190 |
| SB 156 - Sponsor Statement.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156 - Sectional Analysis.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB156-DCCED-CBPL-03-07-14.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156 - Support letter - Lucey.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156 - Board letter to Rep Munoz Aug 2012.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156 - Letter from CDM Board.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156 - Letter of Support - Downing.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156 - Letter of Support - MAA.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156 - Letter of Support - Norton.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156 - Letter of Support - Taygan.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 156 - CDM Annual Report FY 13.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 156 |
| SB 193 Sectional Analysis_Updated.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 193 |
| SB 140 ARPA_Polar map.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 140 |
| SB166_SupportLetter_ProNurses.pdf |
SL&C 3/13/2014 1:30:00 PM |
SB 166 |