CNMA Newsletter- October 2022
Welcome to National Midwifery Week!
Hello fellow midwives, student midwives, aspiring midwives, and midwife supporters!
Welcome to National Midwifery Week! For #MidwiferyWeek2022, we’re celebrating #MidwivesforJustice. I encourage each of you to share your stories on Facebook, Instagram, and Twitter and let everyone know what midwives are all about.
I want to take a quick moment to remind you to vote. The CNMA annual election is happening now, and we have a diverse and talented slate of midwives running to serve and to lead our organization–I am honored and humbled to be among them.
And I’m thrilled to announce that we’ve finally nailed down all the details for the CNMA Pre-Meeting Abortion Workshops (didactic and hands-on)–lots more about that in the Newsletter! In case you missed it, the governor signed almost every bill we supported this year, including SB 1375, which allows nurse-midwives and nurse practitioners to perform first trimester abortion without standardized procedures or physician supervision. It’s up to us to ensure that everyone who wants it has access to safe abortion care, so I hope ot see you on November 5th at the Workshops!
As always, I’m available by email at email@example.com and by text at (805) 415-2553.
In the spirit of service,
Paris Maloof-Bury, CNM, IBCLC
President, California Nurse-Midwives Association
National Health Policy
Support the Improving Care and Access to Nurses Act (I CAN)
Take one minute to urge your representative to support the I Can Act! The American College of Nurse-Midwives (ACNM) applauds long-standing nursing and midwifery supporters and House Nursing Caucus Co-chairs Representatives Lucille Roybal-Allard (D-CA) and Dave Joyce (R-OH) and original cosponsors Representatives Earl Blumenauer (D-OR), Adrian Smith (R-NE) Jan Schakowsky (D-IL) and Rodney Davis (R-IL) on the introduction of the Increasing Care and Access to Nurses (I CAN) Act, bipartisan legislation that seeks to improve access to evidence-based care as provided by the nation’s over 230,000 Advanced Practice Registered Nurses (APRN).
Introduced in the House on September 13, the I CAN Act would ensure that certified nurse-midwives (CNMs) and other APRNs are able to provide comprehensive, coordinated, high-value care to the people and families they serve. The legislation addresses many of the remaining barriers to APRN care under the Medicare and Medicaid programs that are controlled by federal statute. Of specific interest to midwives licensed as CNMs and paneled as Medicare providers are the provisions that:
Authorize CNMs to bill for services related to training medical interns and residents in obstetrics in teaching facilities;
Enable CNMs to be included alongside nurse practitioners and physician assistants as providers eligible to certify and recertify a Medicare beneficiary for home health services without being subject to physician supervision; and
Enable CNMs to issue a prescription or written order for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) to Medicare beneficiaries as well as provide face-to-face encounters without being subject to physician supervision.
Updates our certifying body to the appropriate name (i.e., currently Medicare refers to the American College of Nurse-Midwives Certification Council. This has proven to be problematic for midwives trying to get paneled as Medicare providers b/c Medicare doesn’t recognize AMCB in federal statute).
Updated Standards for the Practice of Midwifery
The ACNM Board of Directors convened a Task Force in Fall 2021 to update the Standards for the Practice of Midwifery which had not been reviewed since 2011. After 1 year, 10 meetings, and multiple iterations, we present a renewed Standards for the Practice of Midwifery. The midwifery profession has grown and matured in the last decade, and more states have licensed midwives with independent practice and the ability to practice to the top of our education and scope.
The document was reorganized and streamlined. One major change is the removal of clinical practice guidelines (CPG) language. A stated requirement for CPGs does not appear in any other Standards language for U.S. providers that the Task Force reviewed (NP, MD, DO). Moreover, CPGs are frequently used to justify physician supervision. In its place now is language around evidence-informed practice, shared decision-making, and the hallmarks of midwifery, along with references to other ACNM standard-bearing documents. The Taskforce believes that this is more than adequate to allow states to create regulations that will assist in protecting the public. Certified nurse-midwives and certified midwives will continue to practice according to up-to-date quality standards.
California Prenatal Screening Program
On September 19th, The California Prenatal Screening (PNS) Program moved from an integrated biochemical screening to Cell-free DNA (cfDNA) and MSAFP from 15-21 weeks. Lab orders are now entered exclusively on the PNS portal. While midwives are able to access the portal directly and place their own orders, CNMA is aware that midwives are not yet able to delegate the ordering of these tests to medical assistants. CNMA is actively working with the CDPH PNS Program to correct this, and you can look forward to updates on corrections in the coming weeks and months. Meanwhile, below are some resources and web pages to guide you in the new process: