Return to Advocacy > ACNM Policy Updates

ACNM Policy Update - 6/23/15

State Issues
1.  Colorado Law Reduces Requirements for Prescriptive Authority
2.  New Delaware CM-CPM Law
3.  State Developments: Introductions and Progress - DC, FL, IL, RI
4.  State Developments: New Laws! - CT, OR, TX
5.  State Developments: Administrative Rules - VA, WA
 
 
Federal Issues
1.  KFF Releases Interactive Tool Showing Medicaid Delivery System and Payment Reforms
2.  CDC releases Preliminary 2014 Births Data
3.  Premier Hospital Alliance Posts Recording of Webinar on Neonatal Abstinence Syndrome

  

State Issues

1.  Colorado Law Reduces Requirements for Prescriptive Authority

Colorado S.197 alters the requirements for obtaining prescriptive authority. Under previous law, CNMs were required to complete 1,800 hours of prescribing in a preceptorship followed by 1,800 hours of prescribing in a mentorship. S.197 reduces the requirement to achieve full prescriptive authority to 1,000 hours within a mentorship, provided the CNM has had at least 3 years of combined clinical work experience as a professional or advanced practice nurse. The mentorship may be with an advanced practice nurse. The bill was signed by the Governor on May 18. The Colorado Affiliate was an active participant in efforts to pass this bill. A job well done!


2.  New Delaware CM-CPM Law

Delaware H.70 was signed into law on June 9. While CMs and CPMs were previously authorized to practice in the state, the statutory consideration of the roles was insufficient. The new law establishes clear scope of practice for each credential, establishes a midwifery advisory council, and incorporates US MERA compliant licensure standards, among other things. The Delaware affiliate was a key participant in efforts to draft and pass this legislation. Congratulations, Delaware!


3.  State Developments: Introductions and Progress - DC, FL, IL, RI

DC B21 6, the Healthy Hearts of Babies Act, would require every newborn delivered in a hospital, maternity center, or home to be screened for critical congenital heart disease. The bill was transmitted to the Mayor for consideration on June 8. 
 
Florida H.27a, which would grant controlled substance prescriptive authority to CNMs, passed the House 97-2 on June 12. Unfortunately, the Senate has declined to hear any health care bills during the special session.

Illinois H.1407 requires a hospital to provide information and instructional materials regarding sudden infant death syndrome, including information developed by the National Institutes of Health concerning safe sleep environments. The bill was sent to the Governor for consideration on June 17.

Rhode Island H.5583, which proposes to grant prescriptive authority to CMs that is equivalent to the authority granted to CNMs, passed the House on June 17.  This bill is a companion to S.319, which unanimously passed the Senate on June 4.


4.  State Developments: New Laws! - CT, OR, TX

Connecticut S.258 requires each hospital to provide the parent(s) or the legal guardian of a newborn infant with written informational materials containing the American Academy of Pediatrics' recommendations concerning safe sleep practices at the time of such infant's discharge from the hospital. The bill was signed into law on June 5. It is effective October 1.

Oregon S.283 prohibits individuals from using title "Advanced Practice Registered Nurse" or abbreviation "APRN" unless the individual is a clinical nurse specialist, nurse practitioner or certified registered nurse anesthetist. (CNMs are licensed as a category of nurse practitioners in Oregon.) The bill was signed into law on June 16.

Oregon S.547 authorizes the creation of a nurse emeritus license to permit certain retired nurses, including advanced practice nurses, to engage in volunteer nursing practice. The bill became law on June 10.

Texas H.2131 would require one or more health care entities which provide comprehensive maternal, fetal, and neonatal health care for pregnant women with high-risk pregnancies complicated by one or more fetuses with anomalies, with genetic conditions, or with compromise caused by a pregnancy condition or by exposure to be designated as centers of excellence for fetal diagnosis and therapy. The bill was signed into law by the Governor on June 19.

Texas S.791 requires the Department of State Health Services to develop and publish informational materials for women who may become pregnant, expectant parents, and parents of infants regarding:  
(1)  the incidence of cytomegalovirus; 
(2)  the transmission of cytomegalovirus to pregnant women and women who may become pregnant; 
(3)  birth defects caused by congenital cytomegalovirus; 
(4)  available preventive measures to avoid the infection of women who are pregnant or may become pregnant; and 
(5)  resources available for families of children born with congenital cytomegalovirus. 
The bill was signed by the Governor on June 19.


5.  State Developments: Administrative Rules - VA, WA

Reminder: Full-text of these regulations is available online at ACNM’s regulatory tracking tool, which members can access after logging into the site.

The Virginia Board of Nursing has finalized multiple rules required by the 2012 changes to the Nurse Practice Act, including establishing rules for the practice of nurse practitioners (which includes CNMs)  in collaboration and consultation with a patient care team physician.

The Washington Health Care Authority is looking for interested individuals to help develop amended regulations for home births and birth centers in order to implement a new state requirement that hospitals and health care providers attending births screen newborns for critical congenital heart disease. During the course of this review, the agency may identify additional changes that are required in order to improve clarity or update policy.
 


Federal Issues

1.  KFF Releases Interactive Tool Showing Medicaid Delivery System and Payment Reforms

The Kaiser Family Foundation (KFF) has released an interactive tool that provides an overview of the increasing number of delivery system and payment reform efforts underway as alternatives to fee-for-service arrangements in state Medicaid programs across the country. Users can scroll over the interactive map and see highlights of the initiatives that exist in each state, including Medicaid managed care, Patient-Centered Medical Homes, Accountable Care Organizations, Health Homes and Delivery System Reform Incentive Payment Program (DSRIP) waivers. While the map is a portal introducing users to the various types of initiatives, related briefs at the bottom of each page enable users to dive more deeply into the details of each topic. Also available from the Foundation is an updated glossary of key terms and concepts in delivery system and payment reform initiatives to help readers understand terms that can often be technical and heavy with jargon. This resource will be updated periodically to reflect the constantly changing landscape of delivery system and payment reform efforts.   


2.  CDC releases Preliminary 2014 Births Data

The Centers for Diseases Control and Prevention (CDC) has released a report with preliminary data on births in 2014.  Of note:
• The 2014 preliminary number of U.S. births was 3,985,924, an increase of 1% from 2013.
• The number of births increased for women in all race and Hispanic origin groups in 2014 except for American Indian or Alaska Native women, for whom births decreased. 
• The general fertility rate was 62.9 births per 1,000 women aged 15–44, up 1% from 2013, and the first increase in the fertility rate since 2007. 
• The birth rate for teenagers aged 15–19 decreased 9% in 2014 to 24.2 births per 1,000 women, yet another historic low for the nation; rates decreased for both younger and older teenagers to record lows. 
• The birth rate for women in their early 20s declined to 79.0 births per 1,000 women, another record low. 
• Birth rates for women in their 30s and early 40s increased in 2014. 
• The non-marital birth rate declined 1% in 2014, to 44.0 births per 1,000 unmarried women aged 15–44, dropping for six consecutive years. 
• The cesarean delivery rate was down 2%, and the low-risk cesarean delivery rate was down 3%, in 2014. 
• The preterm birth rate (based on a change in measure) was down in 2014 to 9.57%. 
• The low birthweight rate was essentially unchanged in 2014 at 8.00%


3.  Premier Hospital Alliance Posts Recording of Webinar on Neonatal Abstinence Syndrome

The Premier Hospital Alliance has posted a recording of a webinar held June 9, 2015, covering the topic of neonatal abstinence syndrome.  Physicians and other clinicians involved in the treatment of opiate use disorder are invited to download the slides and view the recording. Faculty shared an overview of the incidence of neonatal abstinence syndrome (NAS), the clinical presentation of NAS, and treatment options for this syndrome. They will also review short and long-term outcome data for infants who have undergone NAS. Integrating this information into clinical practice will better prepare clinicians to educate pregnant women on the treatment course for their infants after delivery.



Please share this Policy Update with any CNMs/CMs you know who are not ACNM members.  We want them to know what the association is doing to help them out and encourage them to become a part of the association.



Should you have questions about state issues, please contact Cara Kinzelman, ACNM's Manager of State Government Affairs at [email protected] or 240-485-1841.  

If you have questions regarding federal issues, please contact Jesse Bushman, ACNM’s Director of Advocacy and Government Affairs at [email protected] or 240-485-1843. 



Not an ACNM member?  You can access all of the member benefits, including receipt of every ACNM Policy Update, by joining today.  

Want to take action or get involved?  Contact ACNM's Government Affairs Committee.

Don't have the time or energy to get involved, but still want to contribute?  Support the Midwives-PAC.
 


American College of Nurse-Midwives.
8403 Colesville Rd, Suite 1550 | Silver Spring MD 20910
Phone: 240-485-1800 | Fax: 240-485-1818
Follow Us


space