September 25, 2012, Introduced by Senator GREEN and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
(MCL 333.1101 to 333.25211) by adding section 16326 and part 171.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
1 Sec. 16326. Fees for an individual licensed or seeking
2 licensure to practice as a midwife under part 171 are as follows:
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(a) Application processing fee................... $ 20.00 |
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(b) License fee, per year........................ 75.00 |
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(c) Student license fee, per year................ 10.00 |
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(d) Temporary license............................ 10.00 |
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(e) Limited license, per year.................... 10.00 |
8 PART 171. MIDWIFERY
1 Sec. 17101. (1) As used in this part:
2 (a) "Appropriate health professional", for the purposes of
3 referral, consultation, or collaboration with a midwife under
4 this part, means any of the following:
5 (i) A physician.
6 (ii) A certified nurse midwife.
7 (iii) As identified in rules promulgated under section 17117,
8 another appropriate health professional licensed, registered, or
9 otherwise authorized to engage in a health profession under this
10 article.
11 (b) "Certified nurse midwife" means a registered
12 professional nurse under part 172 who has been issued a specialty
13 certification in the profession specialty field of nurse
14 midwifery by the board of nursing under section 17210.
15 (c) "Midwife" means an individual licensed under this part
16 to engage in the practice of midwifery.
17 (d) "Physician" means an individual licensed to engage in
18 the practice of medicine under part 170 or the practice of
19 osteopathic medicine and surgery under part 175.
20 (e) "Practice of midwifery", subject to subsection (2),
21 means providing maternity care that is consistent with a
22 midwife's training, education, and experience, to women and
23 neonates during the antepartum, intrapartum, and postpartum
24 periods.
25 (2) Practice of midwifery does not include either of the
26 following:
27 (a) The practice of medicine or osteopathic medicine and
1 surgery.
2 (b) The practice of nursing, including the practice of
3 nursing with a specialty certification in the profession
4 specialty field of nurse midwifery under part 172.
5 (3) In addition to the definitions of this part, article 1
6 contains general definitions and principles of construction
7 applicable to all articles in this code and part 161 contains
8 definitions applicable to this part.
9 Sec. 17103. Beginning the effective date of rules
10 promulgated under section 17117, an individual shall not use the
11 titles "licensed midwife", "professional midwife", or "l.m.", or
12 similar words or initials that indicate that the individual is a
13 licensed midwife, unless the individual is licensed under this
14 part.
15 Sec. 17105. (1) Beginning on the effective date of rules
16 promulgated under section 17117, an individual shall not engage
17 in the practice of midwifery unless licensed under this part or
18 is otherwise authorized by this article.
19 (2) A midwife shall not perform an act, task, or function
20 within the practice of midwifery unless he or she is trained to
21 perform the act, task, or function and the performance of that
22 act, task, or function is consistent with the rules promulgated
23 under section 17117.
24 (3) In addition to the exemptions from licensure under
25 section 16171, subsection (1) does not prevent any of the
26 following:
27 (a) An individual licensed, registered, or certified under
1 any other part or act from performing activities that are
2 considered to be within the practice of midwifery if those
3 activities are within the individual's scope of practice and if
4 the individual does not use the titles protected under section
5 17103.
6 (b) Subject to section 16215, an employee or other
7 individual who is assisting a midwife; who is under the midwife's
8 supervision; and who is performing activities or functions that
9 are delegated by the midwife, that are nondiscretionary, that do
10 not require the exercise of professional judgment for their
11 performance, and that are within the midwife's authority to
12 perform.
13 (c) An individual from performing activities that are within
14 the practice of midwifery if those activities are performed under
15 the direct and immediate supervision of an appropriate health
16 professional during completion of the North American registry of
17 midwives portfolio evaluation process or as a student at a
18 midwifery education program accredited by the midwifery education
19 accreditation council or other accrediting body approved by the
20 board.
21 (d) Self-care by a patient or uncompensated care by a friend
22 or family member who does not represent or hold himself or
23 herself out to be a midwife.
24 (e) Services provided by a religious practitioner if that
25 religious practitioner does not hold himself or herself out to
26 the public as a midwife and does not use any of the titles
27 protected under section 17103.
1 (f) Services provided by a member of a bona fide church or
2 religious denomination if all of the following are met:
3 (i) The services are provided to another member of that
4 church or denomination and that other member is an adherent of
5 the established tenets or teachings of that church or
6 denomination and relies on treatment by prayer or spiritual means
7 only, in accordance with the creed or tenets of that church or
8 denomination.
9 (ii) The individual providing the services does not receive a
10 fee for those services. For purposes of this subparagraph, a
11 voluntary contribution is not considered a fee for the services
12 provided by that individual.
13 Sec. 17107. A midwife shall consult with or refer a patient
14 to an appropriate health professional if the midwife determines
15 the patient has significant deviations from normal that may
16 affect the patient's or neonate's outcome during the antepartum,
17 intrapartum, or postpartum periods.
18 Sec. 17109. A midwife shall not provide care to a patient
19 without first obtaining her informed consent to that care. If the
20 patient has significant deviations from normal that may affect
21 the patient's or the neonate's outcome during the antepartum,
22 intrapartum, or postpartum periods, the midwife must again obtain
23 that patient's informed consent before providing additional care.
24 Sec. 17111. (1) A midwife shall not do any of the following:
25 (a) Except as provided in subsection (2), administer
26 prescription drugs or medications.
27 (b) Use vacuum extractors or forceps.
1 (c) Prescribe medications.
2 (d) Perform surgical procedures other than episiotomies or
3 repairs of perineal lacerations.
4 (e) Any other act, task, or function prohibited in rules
5 promulgated under this part.
6 (2) Beginning on the effective date of, and subject to, the
7 rules described in subsection (3), a midwife who holds a standing
8 prescription from a licensed health care provider with
9 prescriptive authority may administer any of the following:
10 (a) Prophylactic vitamin K to a newborn, either orally or
11 through intramuscular injection.
12 (b) Postpartum antihemorrhagic agents to a mother.
13 (c) Local anesthetic for the repair of lacerations to a
14 mother.
15 (d) Oxygen to a mother or newborn.
16 (e) Prophylactic eye agent to a newborn.
17 (f) Prophylactic Rho(D) immunoglobulin to a mother.
18 (g) Agents for group B streptococcus prophylaxis,
19 recommended by the federal centers for disease control and
20 prevention, to a mother.
21 (h) Intravenous fluids, excluding blood products, to a
22 mother.
23 (i) Any other drug or medication prescribed by a health care
24 provider with prescriptive authority that is consistent with the
25 scope of the practice of midwifery or authorized by the board by
26 rule.
27 (3) The board shall promulgate rules concerning the
1 administration of prescription drugs or medications described in
2 subsection (2) by midwives.
3 Sec. 17113. (1) The Michigan board of licensed midwifery is
4 created in the department. The board consists of the following 9
5 members who meet the requirements of part 161:
6 (a) Five midwives.
7 (b) Three members of the general public, 1 of whom has
8 received midwifery care outside of a hospital setting.
9 (c) One physician who has experience consulting with
10 midwives who provide midwifery care outside of a hospital
11 setting.
12 (2) Except as otherwise provided in this article, the term
13 of office of a member of the board is 4 years and expires on
14 December 31 of the year in which the term expires. For members
15 first appointed under this section, 2 members shall serve for 2
16 years, 2 members shall serve for 3 years, and 3 members shall
17 serve for 4 years.
18 Sec. 17115. If it receives a complete application and
19 payment of the fee prescribed in section 16326, the department
20 shall issue a license under this part to the applicant if the
21 applicant meets both of the following:
22 (a) He or she holds the credential of certified professional
23 midwife from the North American registry of midwives or holds an
24 equivalent credential from another accredited midwifery training
25 program approved by the board under section 16148.
26 (b) He or she successfully passes an examination approved by
27 the board.
1 Sec. 17117. (1) On or before the expiration of 24 months
2 after the effective date of this part, the department, in
3 consultation with the board, shall promulgate rules to do all of
4 the following:
5 (a) Establish and implement the licensure program for the
6 practice of midwifery under this part.
7 (b) Subject to section 16204, prescribe the completion of
8 continuing education for the practice of midwifery as a condition
9 for license renewal.
10 (c) Subject to subsections (3) and (4), describe and
11 regulate, limit, or prohibit the performance of acts, tasks, or
12 functions by midwives. The department shall include rules that
13 recognize and incorporate the requirements under section 17107
14 regarding the referral to and consultation with appropriate
15 health professionals.
16 (d) For purposes of section 17109, establish the process by
17 which informed consent is obtained.
18 (2) In addition to the authority to promulgate rules under
19 section 16145 and subject to this section and section 16175, the
20 department, in consultation with the board, may promulgate rules
21 to supplement the requirements for licensure under this part,
22 including the adoption of updated standards applicable to the
23 practice of midwifery established by the North American registry
24 of midwives or successor agency.
25 (3) The department shall not promulgate any rules under this
26 section that limit or restrict the scope of the practice of
27 midwifery established under this article.
1 (4) The department shall not promulgate any rules under this
2 section that limit the authority of a midwife to administer
3 prescription drugs or medications under section 17111(2) or
4 prohibit the administration any of those drugs or medications by
5 a midwife.
6 Sec. 17119. (1) The department may grant a license under
7 this part to a person who is licensed as a midwife in another
8 state at the time of application if the applicant provides
9 evidence satisfactory to the board and the department that all of
10 the following are met:
11 (a) The applicant meets the requirements of this part and
12 rules promulgated under this part for licensure.
13 (b) There are no pending disciplinary proceedings against
14 the applicant before a similar licensing agency of this or any
15 other state or country.
16 (c) If sanctions have been imposed against the applicant by
17 a similar licensing agency of this or any other state or country
18 based upon grounds that are substantially similar to those under
19 this article, as determined by the board, the sanctions are not
20 in force at the time of the application.
21 (d) The other state maintains licensure standards equivalent
22 to or more stringent than those of this state.
23 (2) The board may make an independent inquiry to determine
24 whether an applicant meets the requirements described in
25 subsection (1)(b) and (c).
26 Sec. 17121. This part does not require new or additional
27 third party reimbursement or mandated worker's compensation
1 benefits for services rendered by an individual licensed under
2 this part.