NOVEMBER 2020 | NEWSLETTER
Table of Contents
Message from incoming President Paris Maloof-Bury
Hello California midwives!
As the incoming president of CNMA, I’d like to introduce myself and share with you my vision and priorities for my term. But first, I want to share my gratitude with each of you for trusting me with this position. I am humbled and honored by this opportunity to serve my fellow midwives, birth workers, advocates, and families in this great state of California. So thank you!
Over the course of my tenure, I intend to do everything within my power to increase access to midwifery care, and to make the practice of midwifery more equitable.
This means advocating for midwives to have full active medical staff privileges in hospitals throughout California so that midwives can serve families in every community, and that community-based nurse-midwives can gain privileges to admit their own patients to hospitals when they need to move from home or birth center setting to hospital. It means closing the gaps to completely eliminate maternity care deserts by bringing midwives to those communities and gaining access to critical access hospitals for the families we will serve there.
It means CNMs and LMs joining forces and working synergistically to offer more community-based birth and interconception care. It means partnering to offer smooth transitions when needed.
It means helping CNMA to become a truly antiracist organization so that we can fulfill our mandate as a profession to reduce racial disparities in maternity care. It means collaborating with BIPOC-led organizations to enact reproductive justice. It means diversifying our leadership and our workforce, and creating pipelines for BIPOC folks to have a seat at the table.
It means increasing access to clinical placement sites and mentorship for student nurse-midwives throughout the state. It means growing and empowering our membership with continuing education opportunities, professional practice guidance, as well as the advocacy we are already known for.
It means that we have a lot of work to do if we’re going to achieve all of this in just two years!
Again, thank you for this opportunity to serve. I look forward to all we will achieve together, and to doing the work to get us there.
With undying enthusiasm and fierce optimism,
Paris Maloof-Bury, MSN, CNM, RNC-OB, IBCLC
SB 1237 - What’s new and what’s next?
The BRN will soon be soliciting new members for the Nurse-Midwifery Advisory Committee. The committee has a meeting on November 10 and they will begin discussions of implementation of the bill. CNMA met with members on that Committee and we will keep open lines of communication so we can ensure the bill is implemented in the way it was intended.
We have recently met with, and will continue to meet with, major hospital systems. They are quite motivated to become compliant with the law as soon as possible and are engaging with the APRN/CNM leadership within their facilities to gain their expertise and perspective. We are encouraged by this.
We will be co-hosting a webinar with the California Hospital Association on November 30th from 1-2:30pm. Please save the date! Paris Maloof Bury, Holly Smith, and Kathleen Belzer will be presenting a one hour tutorial on the bill and a half hour Q&A session. This is directed toward hospital administrators and obstetrical physician department leads, but this is open to everyone and it is free! If you haven’t yet joined a webinar to review the bill, this is your chance! Please join and encourage your institutions to attend. The registration link is HERE.
We will continue to hold “office hours” on SB 1237 throughout November! Anyone or any group who needs a 1-to-1 tutorial on the new law, or simply wants to ask questions, please register HERE for an “office hours” session. We encourage everyone to listen to (or view the slides) for the SB 1237 presentation during the CNMA Annual Meeting and read the SB 1237 Q&A before attending office hours. This will make the office hours process much more efficient.
Be on the look out for more informational webinars, including one focused on the impact of the law on community birth practices.
We will be updating the CNMA website very shortly. For now, the resources you need for SB 1237 are all located HERE. This document will continually be updated as we get closer to January 1, 2020 when SB 1237 truly becomes a reality!
California Hospital Association Webinar on SB1237 Implementation
The California Hospital Association will be hosting a webinar on the implementation of SB1237 on November 30, from 1-2:30 PM! This webinar will:
Inform hospitals and health systems on the new law provisions
Describe the timeline of events for bill provisions
Discuss scope and obligations of the new nurse-midwives' roles
Describe how the bill relates to medical staff membership, discipline, privileging, and corporate bar
Identify areas of bill ambiguity and future legislative work
A registration link is coming soon, so save the date! In the meantime, you can check back in the coming weeks at https://www.calhospital.org/current-programs
Update to Abortion Services Due To COVID-19
Recently a federal preliminary injunction Civil Action No. TDC 20-1320 was released regarding the “In-Person requirements contained in the mifepristone REMS as to medication abortion patients, to extend until the resolution of this case or until 30 days after the end of the public
health emergency declared by the Secretary of HHS pursuant to 42 U.S.C. § 247d, whichever comes first.”
The Department of Health Care Services (DHCS) is complying with the decision made in this injunction that ruled that the U.S. Food and Drug Administration (FDA) must temporarily suspend enforcement of the Risk Evaluation and Mitigation Strategies (REMs) as a restriction on medication used for early abortion, since it subjects patients to COVID 19 by forcing them to make an unnecessary trip to their health care provider just to pick up the medication and sign a form. In compliance with the federal ruling, providers who bill using HCPCS code S0191 to prescribe mifepristone to end early pregnancies, may provide medically necessary services without an in-person visit or signature. Providers should include a notation of “Civil Action No. TDC 20-1320” in the patient’s medical record to indicate prescription compliance with this prescription method.
Further, DHCS is revising the abortion section of the Provider Manual to ensure flexibilities exist for providing medically necessary abortion services during the COVID-19 public health emergency and to remove requirements for a Medicare denial for certain abortion services.
A separate Medi-Cal Update and NewsFlash will be released in the future once the system has been updated and the revised provider manual section has published.
Updates on Medi-Cal Rx
DHCS continues to make significant progress towards a successful transition of pharmacy services on January 1, 2021 to Medi-Cal Rx. Medi-Cal Rx transitioning pharmacy services from Medi-Cal managed care to fee-for-service will, among other things:
Standardize the Medi-Cal pharmacy benefit statewide, under one delivery system.
Improve access to pharmacy services with a pharmacy network that includes the vast majority of the state’s pharmacies and is generally more expansive than individual Medi-Cal managed care plan pharmacy networks.
Apply statewide utilization management protocols to all outpatient drugs, as appropriate.
Strengthen California’s ability to negotiate state supplemental drug rebates with drug manufacturers as the largest Medicaid program in the country with over 13 million beneficiaries.
Recently, DHCS/Magellan launched the training registration application on the Medi-Cal Rx portal for Medi-Cal prescribers and pharmacies. Registration is the first step in the process toward full utilization of the secure Provider Web Portal and the included tools for delivery and management of consumer services. The secure Provider Web Portal includes key functions for providers and prescribers such as:
Prior Authorization Information and Submittal Instructions
Beneficiary Eligibility Look Up
Web Claims Submission, Activities, and Inquiries
For detailed registration and training instructions, access the Medi-Cal Rx Web Portal and Training Registration article located on the Pharmacy News Page (https://medi-calrx.dhcs.ca.gov/provider/pharmacy-news) or visit https://medi-calrx.dhcs.ca.gov/provider/ and click Register in the upper right hand corner.
It is important that registration be completed early so the users training and functionality are complete and active for use on January 1, 2021. Also, be the first to know, a Medi-Cal Rx subscription service is now available - sign up and receive Medi-Cal Rx updates by email.
The California Department of Public Health says that birthing people should have access to both a support person and a doula in labor!
As of August 7, 2020, it is the recommendation of the CDPH that birthing people should have access to both a support person and a doula during labor and birth. Please inform your institutions of this and encourage them to come into compliance. For more information, visit https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-20-38.aspx
CNMA Stands with Jemel Roberson
In October, the Cook County State's Attorney's Office stated that it would not bring charges against the officer who murdered Jemel Roberson, a security guard who was killed while restraining a gunman who had opened fire in the bar where Jemel was working. A heroic man who acted bravely was instead killed by a police officer. Justice has not been served. CNMA opposes this decision and stands with Roberson’s family and our communities of color. We desperately and urgently need significant changes in policing.
Please take a moment to put your passion into action today:
-Sign the petition to urge Illinois Governor Jay Pritzker to demand the Department of Justice investigate the murder of Jemel Roberson by Midlothian Police officer Ian Covey, and calling on President Trump and Attorney General William Barr to follow through on their promise of a federal investigation in this case.
-Visit The Grassroots law project, an organization which combines grassroots organizing with legal expertise to radically transform policing in America. Donate or join their team of volunteers.
-Visit Campaign Zero, an organization which is working towards ending police violence in America through evidence based solutions and policy changes. You can donate, volunteer, or use it to track your local representative and demand they pass legislation to end police violence.
Spotlight on Anti-Racism
CNMA is working towards becoming an antiracist organization. In 2019 new bylaws were approved that recognize CNMA’s responsibility to actively address racism and the resulting health inequalities suffered by communities of color. Importantly, we must actively support efforts to increase racial diversity in our profession while engaging actively in self-education. “Spotlight on Antiracism” is a new section of the newsletter where you will find a monthly educational offering. We encourage our membership to check it out and share widely in your workplaces.
This month, we encourage our members to look deeper at the historical basis of whiteness with the podcast “Scene on Radio: Seeing White.” This podcast explores the invention of whiteness as a means to systematically exploit and oppress people of color for centuries. Through conversations with leading scholars, we see how our country was founded on white supremacy, and how these ideas are alive and thriving today. Although we urge you to listen to all 14 episodes, there is a specific question which is posed by collaborator Chenjerai Kumanyika in
episode 7: “How attached are you to the idea of being white?” So, we implore our white members to wrestle with this idea individually. What does this mean for you? How does your attachment to being white either positively or negatively affect your ability to engage in antiracist work, and how does this show up in your own practice as a midwife?
Antiracism Workshop Series For White Birth workers
Aïcha K. Scott, Midwife at Kaiser San Leandro is organizing an in depth antiracism workshop series, open to all white-presenting/white identifying female midwives and birth workers. The upcoming course is scheduled for Thursdays, Jan 7, 14, 21, and 28, and Feb 4, 2021 12-2:30pm (CA time) on Zoom.
Aïcha took the class in January 2020 and say "I have been on a personal revolution ever since. It was mind opening/blowing and I literally see everything with new eyes now. I am more skillful and more comfortable as a midwife and a white woman in a world moving toward Black liberation."
Update on the cases of Adora Perez and Chelsea Becker in Kings County
In conjunction with the Drug Policy Alliance and the ACLU, CNMA has signed on to separate Amicus Briefs for both women who are incarcerated in Kings County, and charged with murder for separate fetal deaths. Find more information here.
Racism and Health Disparities chapter in Gynecologic Health Care 4th Edition
Jyesha Wren, Liz Donnelly, Kim Dau, and Karline Wilson-Mitchell co-authored the chapter on Racism and Health Disparities in Gynecologic Health Care 4th Ed. The chapter is being made available free online by the publishers.
National Perinatal Taskforce: Building a movement to Birth a more just and loving world
The National Perinatal Task Force is a grassroots movement to start and grow Perinatal Safe Spots (PSS) in every ‘Materno-toxic Area’ in the USA, in order to eliminate racial and class disparities in birth outcomes, and to create equity and power in maternal child health care.
The task force has opportunities for birth workers and/or their organizations to identify as a "Perinatal Safe Spot" which is defined as follows:
A place to connect moms, family members, community, to each other and the baby
A judgment-free zone that can be physical or virtual
Unique to individual communities, ZIP Codes, Maternal Toxic Areas – breaking through the real barriers to quality care
Giving mothers the real tools they need to have power and agency in their childbearing decisions
A place to gain knowledge for the healthiest pregnancy, mom, and baby
Physical, emotional and informational support so childbearing families have true options
The task force is nationwide and is led by Jennie Joseph who has been active in the birth justice community for some time (many of you will know of her). To learn more, please go to www.perinataltaskforce.com
ACNM Antiracism Webinar Series: “Black Midwifery History”
Know Black Midwifery History in America: It Matters!
November 12, 2020 | 7:00 PM – 8:00 PM ET | CEs Offered | Registration link coming soon
Speaker: Linda Janet Holmes, MPA, author of Into the Light of Day: Reflections on the History of Midwives of Color Within the American College of Nurse-Midwi
ACNM Foundation renames the $1000 Mary Breckinridge donor level the Foundation Level, in acknowledgment of her racist legacy.
Malpractice Insurance Discount for CNMA Members!
Southern Cross Insurance Solutions is now offering a 30% discount off premium costs for CNMs who are members of CNMA. The "Midwife Plan" is a national liability carrier for malpractice insurance through MedPro Group. The discount is available both to new and renewing policies in California. For more information, please visit www.southerncrossins.com.
Free CNMA Membership for Midwives of Color
If you identify as a midwife of color, join or renew your membership with 100% off your California affiliate dues with discount code CA2020!
Job Opportunities at Expecting Justice in San Francisco
The Abundant Birth Project (ABP), an innovative income supplement program for Pacific Islander and Black women in San Francisco, is currently searching for a program manager. Housed in Expecting Justice, the program manager will be responsible for the daily operations of ABP (including program implementation and some case management). The salary range is $85-95K.
Additionally, Expecting Justice--the collective impact collaborative running ABP--is also searching for an Associate Director. Expecting Justice works to advance birth justice in San Francisco, with a focus on Pacific Islander and Black communities. The salary range is $85-95K.
Please share widely!
Job openings to share?
If you have a job opening, please post it at www.CNMA.org/jobs! We will happily share your listing in our newsletter and on social media.
Questions? News? Want to get involved?
Email us at firstname.lastname@example.org
That's all for this month's issue. Catch you next time!
-CNMA MEDIA TEAM
Visit us at cnma.org