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CNMA Newsletter: February 2022

Welcome to Black History Month!

This Black History Month, I invite you to join me in continuing our own antiracism education by listening to Black voices.

As part of their commitment to helping to end health inequities, the California HealthCare Foundation (CHCF) commissioned Listening to Black Californians, a three-phase qualitative and quantitative study to understand the health and health care experiences of Black Californians. The research is being conducted by EVITARUS, a Black-owned public opinion research firm in Los Angeles.

Another important piece from CHCF, In Their Own Words: Black Californians on Racism and Health Care describes the results of Phase I of Listening to Black Californians. EVITARUS conducted individual, hour-long interviews with 100 Black Californians to understand their views on health and well-being, their perceptions of discrimination and bias in the health care system, and their views on what a quality health care system looks like.

And finally, In Birth Justice Denied: The Continued Marginalization of Community Birth Settings and Midwives, Neelu Shruti describes the “historical racist and sexist marginalization of Black, Indigenous, and Immigrant midwives.” An excellent, easy-to-digest read, it explains our systems were designed for racial disparities in maternity care.

At CNMA, we have a long way to go toward becoming an antiracist organization, but we are grateful for the opportunity to learn and do better. We are led humbly by our Antiracism and Reproductive Justice Committee, whose platform guides are advocacy and educational efforts. You can read more about their work (and ours) here.

As always, I’m available by email at parisbury@gmail.com and by text at (805) 415-2553.

In the spirit of service,

Paris Maloof-Bury, CNM, IBCLC

President, California Nurse-Midwives Association

California Health Policy

Policy Priorities for 2022

We entered January without a moment to spare on the health policy front. The Governor's Budget Proposal was released a couple weeks ago, and there is some very good news for midwives.

First, one of our main legislative priorities this year was to reverse Medi-Cal 10% rate reduction to midwives and birth centers that was put into place by the Budget Act of 2011. The Health Policy team and our lobbyists have been in multiple conversations with other stakeholders also affected by this rate reduction, Senate and Assembly budget staff, and even legislators. We assumed this would be a hard climb this year and would require a difficult Budget Change Proposal or new legislation introduced into regular session. However, to our happy surprise, the Governor's own Budget Proposal includes a reversal of this rate reduction! While this isn't final, because it requires the legislature to agree on this change, this is the absolute best place we can be at the moment. Our lobbyists and health policy team will continue to vigorously pursue this through the budget process. Click these links if you would like to understand more about the California budget process versus the typical legislative process.

Secondly, this year we are also pursuing two previous items from our past bills that remain unfunded. The Midwifery Workforce Training Act was created in SB 65 last year. CNMA and coalition partners who worked on this bill are working together to get this funded. We have good support for this in the legislature, and again, the Governor's Budget Proposal also includes 270 million dollar investment in the workforce, and specifically names nurse-midwives as a possible recipient of a portion of these funds (see page 198 of the Governor's Budget Proposal). While this is great news, in order to cover all bases, we are also considering introducing a bill into the regular session in addition to pursuing funding through the budget process.

Also, SB 1237 (the physician supervision removal bill of 2020) created a data collection mandate for community based midwives but was not funded in 2021. Given the momentum on the above topics regarding midwifery training and reversal of the Medi-Cal rate reduction, we also hope that there are sympathetic ears to getting the data collection section of SB 1237 funded through this year's budget process. We believe that showing the superior outcomes of community birth by CNMs will only serve to enhance our integration endeavors in coming years.

Future of Abortion Council

In the last newsletter, we noted that the CNMA participated in the recommendations created by the Future of Abortion Council. There is now a brand new website where you can find all documents and updates. Additionally, in January, The California Women's Caucus introduced 8 bills that will create new laws and regulations that are a direct result of the Future of Abortion Council's recommendations, including a recommendation to enhance the reproductive health care workforce. CNMA looks forward to possibly co-sponsoring one of these pieces of legislation. On the 49th anniversary of Roe v. Wade, CNMA promises to continue our strong support of the FAB Council moving forward. This anniversary stands to be the last anniversary of this landmark decision. In June, the Supreme Court will give its ruling on whether Roe will be overturned.

More Info

Be on the lookout for Advocacy Day information in future newsletters (likely still virtual this year) and other ways you can get involved. Contact advocacy@cnma.org if you have questions, want more info, or simply want to get involved.

National Health Policy

AWHONN on Capitol Hill 2022

Registration is now open for AWHONN on Capitol Hill 2022 -- our public policy conference and lobby day! Join us March 27 to 30, 2022, in Washington, DC, for your chance to help AWHONN advance legislation to promote the health of women and newborns. Register by March 6, 2022.

Volunteer Opportunities

Student Volunteers at the ACNM Annual Meeting

ACNM will select 25 students to participate. Students who are selected will receive a complimentary registration for the Annual Meeting. If selected, a confirmation email will be sent by March 1, 2022 with instructions for selecting volunteer tasks. Sign-Up by February 1, 2022.

Annual Medicaid MCO Survey Workgroups

Nominations are being accepted to identify volunteers to join us in the process of refining the annual Medicaid Health Plan survey instrument. We anticipate a complete review of the survey to ensure that our questions remain relevant and timely in collecting meaningful data about the Medicaid program. The survey tool revision process will begin in early 2022. Learn more and apply here.

Call for Proposals

2022 AWHONN Convention

The Call for Poster Proposals for this year’s AWHONN Convention has been extended to February 7, 2022. Your expertise and willingness to share your knowledge play a vital role in advancing best practices in women’s health. Presenting at the AWHONN Convention ensures that your presentation will be received by a highly skilled and influential body of nurses. The 2022 AWHONN Convention, taking place June 25-29 at the Gaylord Rockies Convention Center in Aurora, CO, offers many opportunities for you to bring your knowledge to the table.

Annual Convention of the American Association of Birth Centers

The AABC Program Committee is accepting proposals to present at the 2022 AABC Birth Institute "Birth Centers Rising on the Tides of Change," to be held September 15-18, 2022 in San Diego, California. We welcome abstracts that address clinical issues and administrative challenges for birth center providers/administrators, and others developing innovative solutions in maternity care. Whenever possible, abstract submissions should include content about racism and health disparities, social determinants of health, and diversity and inclusion. Apply by February 25, 2022.

Education, Trainings, and Webinars

The Lived Experience of Severe Maternal Morbidity Among Black Women

Join us for an encore webinar on February 8 that looks into the experiences of Black women who experienced a life-threatening complication during labor or postpartum. Maternal health outcomes for black women have a long history of being inadequate. When compared to White women, Black women are three to four times more likely to die from a pregnancy-related problem and twice as likely to suffer from severe maternal morbidity. There is a significant gap in our understanding of health disparities in maternal health. By the end of this webinar, you will be more knowledgeable about the potential complications and how you can play an important role in combating severe maternal morbidity among women of color. Register here. 1 CEU offered.

Understanding the Maternity Revenue Cycle

Join Industry Relations Committee (IRC) members on Wednesday, February 9th at 9:00 AM PST for IRC Office Hours. The maternity revenue cycle can be complex and drawn-out which can impact birth center sustainability. Join IRC leaders Laura Wiegand and Arden Schwenker to gain a better understanding of the maternity revenue cycle. As always, the session will also include information about AABC tools and resources available to assist members with contracting and payment and an opportunity to brainstorm the issues members are challenged with. Registration is free and open to all AABC members.

AWHONN California State Section Conference

The AWHONN California 2022 Virtual Conference takes place February 11-13. A new pre-conference, Forging the Way with Equity, Safety, and Quality, has been added for students and nurses who are new to perinatal nursing. Learn more and register here.

The Brass Tacks of Billing & Coding Workshop

In this workshop, Marnie Cabezas of Innovation Billing Service, Inc. provides a foundation in medical billing for those who work only tangentially with medical billing, such as practice administrators, and for those who may seek further billing knowledge down the road. We’ll cover basic terminology, where to seek answers, the anatomy of professional and entity claim forms, maternity and initial newborn coding, and steps to maximizing reimbursement. February 16th, 9 AM - 1 PM PST. Register here.

Improving Outcomes and Safety for All Families through the Respectful Care Model