Legislative Research –
Office of the Deputy
Secretary for Public
Health Services
Paloma Monteros Newcombe,
MSPH, Health Policy
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2014 Session - HB 1211
Bill summary
Legislative history
Context
Other states
Policy research process
Compiling the evidence
Decision/findings
Discussion
Overview
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2014 Session
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HB 1211
• Licensing and regulation scheme for traditional
midwifery practice
• State Board of Nursing
• Establishes Midwifery Advisory Committee
2014 Session
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2012
• HB 1056 Licensed Midwives, No action
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DHMH convened a Midwives Workgroup to analyze barriers to nurse-midwifery practice and shortage of certified
nurse-midwives (CNMs) - did not reach consensus
2013
• Workgroup reported that there were 214 CNMS licensed to practice in Maryland, and only 4 attended home births
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DHMH recommended exploring barriers to training and practice for CNMS in Maryland
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HB 1202 Certified Professional Midwives – Pilot Program, Withdrawn
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Board of Nursing convened workgroup, did not reach consensus
2014
• HB 1211 Midwives – Licensing and Regulation
Legislative History
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Context
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• Twenty-six states regulate
certified professional
midwives (CPMs) by
licensure, certification,
registration, voluntary
licensure, or permit.
• Two states, Rhode Island
and New York, license
Certified Midwives (CMs)
Other States
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Other States
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General Search
• Grey literature
• News
• Opponents, proponents, controversy
PubMed
• Searched for peer-reviewed literature published from 2013-14
State Legislative Tracking Databases:
• Govtrack.us
• National Conference of State Legislatures (Powered by State Net –
LexisNexis)
• Association of State and Territorial Health Officials (ASTHO) State
Track (State Legislative Tracking)
Policy Research Process
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Policy Research Process
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• Example Search:
• National Conference of State Legislatures (Powered by State Net – LexisNexis)
• Scope of Practice Legislative Tracking Database, 2011-13
Filters:
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Topic: Licensure and Credentialing, Midwifery, Nursing-Midwifery, Obstetrics and
Gynecology
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Status: Enacted, All
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Year: All (2011-13)
Policy Research Process
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Policy Research Process
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Compiling the Evidence
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Compiling the Evidence
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Compiling the Evidence
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Meeting with Bureau of Maternal and Child Health
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Identified key issues with the bill
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Specified which points to feature in testimony and position paper
Position paper and talking points
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Researched key points
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Supported points with evidence from literature and ACOG recommendations
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Collaborated on draft of position paper and talking points
Decision/ Findings
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Key Issues:
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Education and certification requirements
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Definition of high and low-risk pregnancies
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VBAC
Breech
Multiple gestation deliveries
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Transfer of care
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Scope of practice for midwifery
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Newborn care
Gyn care
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Objective oversight of the Midwifery Committee
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Surveillance of practice and outcomes
Decision/ Findings
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Key takeaways:
• Importance of clinical background/ knowledge
• Clear and accessible communication
• Issue framing
• Build relationships outside academia
• Involvement in the policy arena
• Advocacy
Discussion
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Questions?
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