75th OREGON LEGISLATIVE ASSEMBLY--2009 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 766
House Bill 2242
Ordered printed by the Speaker pursuant to House Rule 12.00A (5).
Presession filed (at the request of Governor Theodore R.
Kulongoski for Oregon Health Licensing Agency)
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
Creates new category of and definitions and qualifications for
licensed direct entry midwife and unlicensed direct entry
midwife.
Prohibits licensed direct entry midwife from practicing
midwifery if license suspended or revoked under certain
circumstances.
A BILL FOR AN ACT
Relating to direct entry midwives; amending ORS 687.405, 687.415,
687.420, 687.425, 687.445, 687.480, 687.493 and 687.495.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 687.405 is amended to read:
687.405. As used in ORS 687.405 to 687.495 { + : + } { - ,
'licensed direct entry midwife' means a person who: - }
{ - (1) Supervises the conduct of labor and childbirth; - }
{ - (2) Advises the parent as to the progress of the
childbirth; and - }
{ - (3) Renders prenatal, intrapartum and postpartum
care. - }
{ + (1) 'Direct entry midwife' means a person who is:
(a) Educated in the practice of midwifery through self-study,
apprenticeship, midwifery school or through a college or
university program that is distinct from a nursing program; and
(b) Trained to provide, in out-of-hospital settings, a
midwifery care model to newborns and healthy women throughout the
childbearing cycle.
(2) 'Licensed direct entry midwife' means a person who:
(a) Meets the qualifications for licensure and is eligible for
reimbursement under ORS 687.420;
(b) Holds, but is not required to hold, a credential issued by
a nationally recognized registry of midwives; and
(c) Adheres to prescribed midwifery practice standards, risk
assessment criteria and standards of care established by Oregon
law or adopted by the Oregon Health Licensing Agency by rule.
(3) 'Practice of midwifery' means a direct entry midwife
working in partnership with women to:
(a) Give support, midwifery care and advice throughout the
prenatal, intrapartum and postpartum periods; and
(b) Conduct births and provide midwifery care for newborns and
infants. Midwifery care includes preventive measures, promotion
of vaginal birth, detection of complications in mother and child,
provision of health counseling and education, use of medical or
other appropriate assistance and provision of emergency measures.
(4) 'Unlicensed direct entry midwife' means a person who:
(a) May, but is not required to, hold a credential issued by a
nationally recognized registry of midwives; and
(b) Is educated through informal means, such as self-study or
apprenticeship, or through completion of a formal program. + }
SECTION 2. ORS 687.415 is amended to read:
687.415. (1) A license authorized by ORS { - 687.405 to
687.495 - } { + 687.420 + } is required { - only - } for
purposes of reimbursement under medical assistance programs { + .
A license + } { - and - } is not required for the practice of
direct entry midwifery in this state.
(2) { - Nothing in - } ORS 687.405 to 687.495 { - is
intended to - } { + do not + } require a direct entry midwife
to become licensed as described in ORS 687.420 { - (2) - } .
SECTION 3. ORS 687.420 is amended to read:
687.420. (1) The State Board of Direct Entry Midwifery shall
establish standards for qualifications for the licensure of
direct entry midwives. Such standards shall include:
(a) Sufficient knowledge in the following areas:
(A) Techniques in taking patient histories;
(B) Anatomy and physiology of the female reproductive system;
(C) Appropriate use of diagnostic testing;
(D) Necessity for referral;
(E) Pathology in childbirth;
(F) Mechanisms of labor;
(G) Aseptic techniques;
(H) Postpartum care;
(I) Examinations of newborn infants; and
(J) Family planning;
(b) Successful passage of { - written and oral - }
{ + prescribed + } examinations { + that are recognized or
approved by the board + };
(c) Participation in:
(A) 25 assisted deliveries;
(B) 25 deliveries for which the midwife was the primary care
provider;
(C) 100 prenatal care visits;
(D) 25 newborn examinations; and
(E) 40 postnatal examinations;
(d) Current certification in cardiopulmonary resuscitation for
infants and adults; { - and - }
(e) { + Preparation of + } a written plan for emergency
transport { + ; and
(f) Preparation of a professional disclosure statement that
includes requirements for informed consent as determined by the
Oregon Health Licensing Agency by rule + }.
(2) { - Any person who desires to become licensed as a direct
entry midwife - } { + An applicant for licensure as a direct
entry midwife + } shall submit an application to the { - Oregon
Health Licensing - } agency { - stating - } { + on forms
prescribed by the agency. The application shall include
satisfactory evidence of + } the applicant's qualifications for
licensure { + pursuant to this section and payment of fees
required pursuant to ORS 687.435 + }.
{ + (3) Subject to ORS 676.612, + } { - If the applicant
meets the standards established under subsection (1) of this
section and the applicant is not disqualified from licensure
under ORS 676.612, - } the agency shall issue { - an annual
license to the - } { + a license to practice as a + } direct
entry midwife. { - The agency shall impose a fee for licensure
and examination in the amount established pursuant to ORS
687.435. - }
{ - (3) - } { + (4) + } Any direct entry midwife licensed
under this section is entitled to payment under the rules of the
medical assistance program for services provided to any eligible
recipient of medical assistance.
SECTION 4. ORS 687.445 is amended to read:
687.445. { + (1) + } In the manner prescribed in ORS chapter
183 for contested cases and in consultation with the State Board
of Direct Entry Midwifery, the Oregon Health Licensing Agency may
impose a form of discipline specified in ORS 676.612 against any
person practicing direct entry midwifery for any of the grounds
listed in ORS 676.612 and for any violation of the provisions of
ORS 687.405 to 687.495, or the rules adopted thereunder.
{ + (2) A direct entry midwife licensed under ORS 687.420 may
not continue to practice direct entry midwifery in Oregon if:
(a) The licensee's license has been suspended under ORS 183.430
(2); or
(b) The licensee has been issued a final order under ORS
183.470 revoking the individual's license.
(3) When the agency, in consultation with the board, proposes
to refuse to issue a license, to suspend a license or to revoke a
license, opportunity for hearing shall be accorded as provided in
ORS chapter 183.
(4) Any licensee who has been disciplined by the agency may
obtain judicial review of the decision in the manner prescribed
by ORS chapter 183.
(5) When a license issued under ORS 687.420 is denied or
revoked for any cause, the agency may, after the lapse of two
years from the date of such revocation and upon written
application by the person formerly licensed, issue or restore the
license.
(6) The lapse, suspension or revocation of a license issued
under ORS 687.420, by order of the agency or by a court decision
or the voluntary surrender of a license by a licensee, does not
deprive the agency of jurisdiction to proceed with any
investigation of or any action or disciplinary proceedings
against the licensee or to revise or render null and void an
order of disciplinary action against the licensee. + }
SECTION 5. ORS 687.480 is amended to read:
687.480. The State Board of Direct Entry Midwifery shall
develop practice standards that { - shall - } include but
{ - not be - } { + are not + } limited to:
(1) Maintenance of records of care, including client charts;
(2) Participation in peer review;
(3) Development of a written plan for emergency transport;
(4) Guidelines for equipment; { - and - }
(5) Maintenance of patient disclosure forms, which includes
information regarding whether the midwife has malpractice
insurance { - . - } { + ;
(6) Adoption of a professional disclosure statement; and
(7) Establishment of procedures for obtaining informed
consent. + }
SECTION 6. ORS 687.425 is amended to read:
687.425. (1) A license issued by the Oregon Health Licensing
Agency for a direct entry midwife shall expire after one year.
The agency shall renew a license upon receipt of the renewal
application and fee and proof of current cardiopulmonary
resuscitation certification for infants and adults, if the
applicant is otherwise in compliance with the rules adopted by
the State Board of Direct Entry Midwifery and the agency. { +
The agency may require records of births attended by a direct
entry midwife as a condition of license renewal. + }
(2) The agency shall establish a procedure for the renewal of
licenses. Notwithstanding subsection (1) of this section, the
agency may vary the renewal date of a license by giving the
applicant written notice of the renewal date being assigned and
by making prorated adjustments to the renewal fee.
(3) The board shall prescribe requirements for license renewal
including, but not limited to, continuing education that must
include training in use of legend drugs and devices. In addition
to continuing education requirements, a midwife who has attended
fewer than five births in the previous year shall be required to
take an additional 10 hours of continuing education as prescribed
by the board. All licensing requirements shall be approved by the
board by rule.
(4) Any license that is not renewed shall automatically revert
to inactive status. The license may be reactivated only if the
license holder meets other qualifications for reactivation as
prescribed by the agency in consultation with the board.
(5) The agency may mail a notice of renewal to the last-known
address of the license holder.
SECTION 7. ORS 687.493 is amended to read:
687.493. (1) A { + direct entry + } midwife licensed under ORS
{ - 687.405 to 687.495 - } { + 687.420 + } may purchase and
administer authorized scheduled legend drugs and devices that are
used in pregnancy, birth, postpartum care, newborn care or
resuscitation and that are deemed integral to providing safe care
to the public by the State Board of Direct Entry Midwifery by
rule.
(2) Legend drugs authorized under subsection (1) of this
section are limited:
(a) For neonatal use to prophylactic ophthalmic medications,
vitamin K and oxygen; and
(b) For maternal use to postpartum antihemorrhagics, Rho(D)
immune globulin, epinephrine, intravenous fluids, local
anesthetic and oxygen.
(3) Legend devices authorized under subsection (1) of this
section are limited to devices for injection of medications, for
the administration of intravenous fluids, for adult and infant
resuscitation and for rupturing the amniotic membranes.
(4) A pharmacist who dispenses drugs and devices to a licensed
midwife as authorized by this section and in conformity with the
provisions of ORS chapter 689 is not liable for any adverse
reactions caused by administration of the legend drugs and
devices by the midwife.
SECTION 8. ORS 687.495 is amended to read:
687.495. In cooperation with the State Board of Direct Entry
Midwifery, the Oregon Health Licensing Agency shall collect and
report data on births for which a direct entry midwife was the
primary care provider. The report shall distinguish outcomes
between licensed direct entry midwives and { + unlicensed + }
direct entry midwives { - who are not licensed - } under ORS
687.405 to 687.495.
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