This page summarizes the state legislative,regulatory and advocacy work. Below are links to information summarizing the laws and regulations governing CNMs and CMs.
ACNM Needs Members to Urge Finalization of New Jersey CNM and CM Practice Improvements
Formal proposed rulemaking has been published to rescind the signed collaborative agreement requirement applicable to New Jersey CNM/CM practice. ACNM will submit formal comments and encourages members, particularly practitioners in New Jersey, as well as hospital administrators and physicians with whom they are affiliated, to provide letters in support. A separate proposed rule streamlines prescriptive authority requirements for CNMs. Comments to the State Board of Medical Examiners are welcome until July 31st.
For more information on the proposed regulations, including details for providing comment, please link here and here to the text of the proposed regulations.
Pennsylvania Publishes Final Rule Authorizing CNM Prescription-Writing
On April 4, the Pennsylvania State Board of Medicine (BOM) published its final implementing regulations for prescriptive authority for CNMs to take immediate effect. The rules bring an end to a process that had its formal start with the enactment of authorizing legislation in 2007, but had been delayed at the end of 2008 by politicking. With this final regulatory action, Pennsylvania becomes the last state in the nation to implement prescriptive authority for nurse-midwives. For more information, see the new rules. Additional guidance for making application to the BOM for prescriptive authority will be forthcoming from the Pennsylvania State Board of Medicine.
ACNM Deepens Commitment to Fight Scope of Practice Infringements
ACNM has stepped up its involvement in the Coalition for Patients’ Rights (CPR) by joining the group’s steering committee to help the effort reach a broader audience, including policymakers, insurers, health care providers and the general public. CPR consists of numerous organizations representing a variety of non-physician health care professionals who provide a diverse array of safe, effective, and affordable health care services to millions of consumers each year. The Coalition’s members work to ensure that the practitioners they represent do not face unwarranted scope of practice restrictions based upon ill-founded AMA House of Delegates resolutions or similar measures. For more information, read ACNM's letter of support or visit the CPR Web site.
New Missouri Law Grants CNMs Controlled Substances Prescriptive Authority
A new law in Missouri authorizes certified nurse-midwives (CNMs) to prescribe controlled substances in Schedules III through V, with prescribing of Schedule III narcotic controlled substances limited to a 120-hour supply with no refills. Signed by the Governor on June 10th, the law will take full effect on January 1, 2009. Only two other states in the nation still fail to confer controlled substances prescription-writing privileges to CNMs -- Florida and Alabama.
ACNM Opposes AMA House of Delegates Resolution
ACNM has submitted commentsin opposition to the American Medical Association House of Delegates' proposed resolution to allow nurses holding Doctor of Nursing Practice (DNP) degrees to practice only under physician supervision.
South Dakota Law Allows CNM-assisted Out-of-Hospital Birth
South Dakota Senate Bill 34, allowing CNMs to provide out-of-hospital birth services, was signed
into law on March 13th. The bill authorizes the State Medical and Nursing Boards to grant a waiver of the collaborative agreement requirement, providing specific practice guidelines to be established by the
Boards are followed. The bill is set to sunset on June 30, 2013.
New Mexico Law Brings Malpractice Premium Relief
New Mexico House Bill 167 creates the "Birthing Workforce Retention Fund" in the state treasury to assist CNMs and physicians with malpractice premiums when those costs jeopardize their ability to practice in the state. Eligible providers must show that low-income clients make up at least 1/2 of OB practice and that premiums have increased every year for two years. The bill was signed into law on February 29th as Chap.73.
ColoradoLaws Improve CNM Practice Environment
On March 20th, three key bills became law in Colorado. Flanked by nurse-midwives who supported the advancements, Governor Ritter signed into law bills expanding reimbursement eligibility under the state Medical Assistance Act, allowing signatures on various health-related legal documents and ensuring objective criteria for health plan consideration of preferred provider applications.
Colorado Executive Order Directs Collaborative Scopes of Practice Study
Colorado Executive Order B003 08 was issued by Governor Ritter on February 7th, commissioning a study of collaborative scopes of care and creating the Collaborative Scopes of Practice Advisory Committee. Barbara Hughes, CNM, has been named the designated CNM APN appointee on the 12-member committee. The Committee will review research regarding expanding and collaborative scopes of practice for APNs, PAs, and dental hygienists. The study is geared toward identifying systems and settings in which high quality care can be provided by non-physicians and non-dentists to meet the state's provider needs. A report is due to the Governor and legislature by December 31, 2008.
ACNM urged reversal of Alabama Board of Medical Examiners rulemaking surcharging physicians in collaborative practice with CNMs $100.00 per collaborative agreement per year. (See ACNM letter urging reversal of policy). The final rulemaking kept this needlessly restrictive provision.
State Legislative Toolkit: Now that state and federal elections have concluded, it is time to prepare for the 2008 State Legislative Sessions.
One of the key issues will be responding to and evaluating Certified Professional Midwifery Legislation. ACNM has developed a Resource Packet for chapters to use in responding to this proposed legislation.
The Advocate: Read updates on legislative and regulatory news in each month's edition of The Advocate. Our government relations newsletter is published monthly and contains state and federal legislative, regulatory and advocacy information. (PLEASE NOTE: The last issue of the Advocate was published in December 2008.)
TORT REFORM:
Like their physician colleagues across the country, CNMs/CMs are experiencing a professional liability crisis. Many forces that are beyond our control are forcing ACNM members to become experts in this complex topic. In order to meet this critical need for information, ACNM has published a Professional Liability Packet, which was updated in 2007. (Due to its large file size, the Packet has been divided into four parts.)
Statistics on number of CNMs/CMs, births, education programs and other valuable information for your state.
SUMMARIES OF STATE LAWS AND REGULATIONS AFFECTING CNMS/CMS
Topics summarized in this handbook include the identity of the regulatory board, scope of practice, prescriptive authority, tort reform, breastfeeding and other statutory provisions governing the practice of midwifery.
