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.