1.1                          A bill for an act
  1.2             relating to health occupations; clarifying licensure 
  1.3             requirements for the practice of midwifery; 
  1.4             appropriating money; proposing coding for new law as 
  1.5             Minnesota Statutes, chapter 147D; repealing Minnesota 
  1.6             Statutes 1998, sections 148.30; 148.31; and 148.32; 
  1.7             Minnesota Rules, parts 5600.2000; and 5600.2100. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  [147D.01] [DEFINITIONS.] 
  1.10     Subdivision 1.  [APPLICABILITY.] The definitions in this 
  1.11  section apply to this chapter. 
  1.12     Subd. 2.  [ADVISORY COUNCIL.] "Advisory council" means the 
  1.13  advisory council of traditional midwifery established under 
  1.14  section 147D.25. 
  1.15     Subd. 3.  [APPROVED EDUCATION PROGRAM.] "Approved education 
  1.16  program" means a university, college, or other education program 
  1.17  leading to eligibility for certification in midwifery that is 
  1.18  approved or accredited by the Midwifery Education and 
  1.19  Accreditation Council (MEAC) or its successor, or a national 
  1.20  accrediting organization recommended by the advisory council and 
  1.21  approved by the board.  
  1.22     Subd. 4.  [BOARD.] "Board" means the board of medical 
  1.23  practice. 
  1.24     Subd. 5.  [CONTACT HOUR.] "Contact hour" means 50 
  1.25  consecutive minutes, excluding coffee breaks, registration, 
  1.26  meals without a speaker, and social activities, of a 
  2.1   board-approved learning experience either through an 
  2.2   instructional session or clinical practice. 
  2.3      Subd. 6.  [CREDENTIAL.] "Credential" means a license, 
  2.4   permit, certification, registration, or other evidence of 
  2.5   qualification or authorization to engage in the practice of 
  2.6   traditional midwifery in this state or any other state. 
  2.7      Subd. 7.  [CREDENTIALING EXAMINATION.] "Credentialing 
  2.8   examination" means an examination administered by the North 
  2.9   American Registry of Midwives (NARM) or its successor, or other 
  2.10  national testing organization recommended by the advisory 
  2.11  council and approved by the board for credentialing as a 
  2.12  licensed traditional midwife.  A credentialing examination must 
  2.13  include a written examination and a skills assessment.  
  2.14     Subd. 8.  [NORMAL PREGNANCY.] "Normal pregnancy" means a 
  2.15  pregnancy that is progressing and proceeding spontaneously 
  2.16  without the need for medical intervention or the use of 
  2.17  instruments and where spontaneous onset of labor occurs between 
  2.18  37 and 42 weeks. 
  2.19     Subd. 9.  [TRADITIONAL MIDWIFERY SERVICES.] "Traditional 
  2.20  midwifery services" means the assessment and care of a woman and 
  2.21  newborn during pregnancy, labor, birth, and the postpartum 
  2.22  period outside a hospital.  
  2.23     Subd. 10.  [TRANSFER OF CARE.] "Transfer of care" means 
  2.24  transferring, during the course of pregnancy, the responsibility 
  2.25  of providing services to a client from the traditional midwife 
  2.26  to a licensed health care provider.  
  2.27     Subd. 11.  [TRANSPORT.] "Transport" means the transferring 
  2.28  during labor, birth, or the postpartum period of the client to a 
  2.29  hospital.  
  2.30     Sec. 2.  [147D.03] [MIDWIFERY.] 
  2.31     Subdivision 1.  [GENERAL.] Within the meaning of sections 
  2.32  147D.01 to 147D.27, a person who shall publicly profess to be a 
  2.33  traditional midwife and who, for a fee, shall assist or attend 
  2.34  to a woman in pregnancy, childbirth outside a hospital, and 
  2.35  postpartum, shall be regarded as practicing traditional 
  2.36  midwifery.  
  3.1      Subd. 2.  [SCOPE OF PRACTICE.] The practice of traditional 
  3.2   midwifery includes, but is not limited to: 
  3.3      (1) initial and ongoing assessment for suitability of 
  3.4   traditional midwifery care; 
  3.5      (2) providing prenatal education and coordinating with a 
  3.6   licensed health care provider as necessary to provide 
  3.7   comprehensive prenatal care, including the routine monitoring of 
  3.8   vital signs, indicators of fetal developments, and laboratory 
  3.9   tests, as needed, with attention to the physical, nutritional, 
  3.10  and emotional needs of the woman and her family; 
  3.11     (3) attending and supporting the natural process of labor 
  3.12  and birth; 
  3.13     (4) postpartum care of the mother and an initial assessment 
  3.14  of the newborn; and 
  3.15     (5) providing information and referrals to community 
  3.16  resources on childbirth preparation, breast-feeding, exercise, 
  3.17  nutrition, parenting, and care of the newborn. 
  3.18     Subd. 3.  [UNAUTHORIZED SERVICES.] The practice of 
  3.19  traditional midwifery does not include:  
  3.20     (1) the use of any surgical instrument at a childbirth, 
  3.21  except as necessary to sever the umbilical cord or repair a 
  3.22  first- or second-degree perineal laceration; 
  3.23     (2) the assisting of childbirth by artificial or mechanical 
  3.24  means; or 
  3.25     (3) the removal of a placenta accreta. 
  3.26     Sec. 3.  [147D.05] [PROFESSIONAL CONDUCT.] 
  3.27     Subdivision 1.  [PRACTICE STANDARDS.] (a) A licensed 
  3.28  traditional midwife shall provide an initial and ongoing 
  3.29  screening to ensure that each client receives safe and 
  3.30  appropriate care.  A licensed traditional midwife shall only 
  3.31  accept and provide care to those women who are expected to have 
  3.32  a normal pregnancy, labor, and delivery.  As part of the initial 
  3.33  screening to determine whether any contraindications are 
  3.34  present, the licensed traditional midwife must take a detailed 
  3.35  health history that includes the woman's social, medical, 
  3.36  surgical, menstrual, gynecological, contraceptive, obstetrical, 
  4.1   family, nutritional, and drug/chemical use histories.  If a 
  4.2   licensed traditional midwife determines at any time during the 
  4.3   course of the pregnancy that a woman's condition may preclude 
  4.4   attendance by a traditional midwife, the licensed traditional 
  4.5   midwife must refer the client to a licensed health care 
  4.6   provider.  As part of the initial and ongoing screening, a 
  4.7   licensed traditional midwife must recommend that the client 
  4.8   receive the following services, if indicated, from an 
  4.9   appropriate health care provider: 
  4.10     (1) initial laboratory pregnancy screening, including blood 
  4.11  group and type, antibody screen, Indirect Coombs, rubella titer, 
  4.12  CBC with differential and syphilis serology; 
  4.13     (2) gonorrhea and chlamydia cultures; 
  4.14     (3) screening for sickle cell; 
  4.15     (4) screening for hepatitis B and human immunodeficiency 
  4.16  virus (HIV); 
  4.17     (5) maternal serum alpha-fetoprotein test and ultrasound; 
  4.18     (6) Rh antibody and glucose screening at 28 weeks 
  4.19  gestation; 
  4.20     (7) mandated newborn screening; 
  4.21     (8) Rh screening of the infant for maternal RhoGAM 
  4.22  treatment; and 
  4.23     (9) screening for premature labor. 
  4.24     (b) A client must make arrangements to have the results of 
  4.25  any of the tests described in paragraph (a) sent to the licensed 
  4.26  traditional midwife providing services to the client.  The 
  4.27  licensed traditional midwife must include these results in the 
  4.28  client's record. 
  4.29     Subd. 2.  [WRITTEN PLAN.] A licensed traditional midwife 
  4.30  must prepare a written plan with each client to ensure 
  4.31  continuity of care throughout pregnancy, labor, and delivery.  
  4.32  The written plan must incorporate the conditions under which the 
  4.33  medical consultation plan, including the transfer of care or 
  4.34  transport of the client, may be implemented. 
  4.35     Subd. 3.  [HEALTH REGULATIONS.] A licensed traditional 
  4.36  midwife must comply with all applicable state and municipal 
  5.1   requirements regarding public health. 
  5.2      Subd. 4.  [CLIENT RECORDS.] A licensed traditional midwife 
  5.3   must maintain a client record on each client, including: 
  5.4      (1) a copy of the informed consent form described in 
  5.5   section 147D.07; 
  5.6      (2) evidence of an initial client screening described in 
  5.7   this section; 
  5.8      (3) a copy of the written plan described in subdivision 2; 
  5.9      (4) a record of prenatal and postpartum care provided to 
  5.10  the client at each visit; and 
  5.11     (5) a detailed record of the labor and delivery process. 
  5.12     Subd. 5.  [DATA.] All records maintained on each client by 
  5.13  a licensed traditional midwife are subject to section 144.335.  
  5.14     Sec. 4.  [147D.07] [INFORMED CONSENT.] 
  5.15     Subdivision 1.  [GENERAL.] Before providing any services to 
  5.16  a client, a licensed traditional midwife must:  
  5.17     (1) advise the client of the information contained in the 
  5.18  informed consent form; 
  5.19     (2) provide the client with an informed consent form; and 
  5.20     (3) have the form returned with the client's signature 
  5.21  attesting that the client understands the consent form and the 
  5.22  information contained in the form. 
  5.23     Subd. 2.  [CONTENTS.] The informed consent form must be 
  5.24  written in language understandable to the client and, at a 
  5.25  minimum, must contain the following: 
  5.26     (1) name, address, telephone number, and license number of 
  5.27  the licensed traditional midwife; 
  5.28     (2) a description of the licensed traditional midwife's 
  5.29  education, training, and experience in traditional midwifery; 
  5.30     (3) the licensed traditional midwife's fees and method of 
  5.31  billing; 
  5.32     (4) the right of the client to file a complaint with the 
  5.33  board and the procedures for filing a complaint; 
  5.34     (5) a description of the licensed traditional midwife's 
  5.35  medical consultation plan and the antepartum, intrapartum, and 
  5.36  postpartum conditions requiring consultation, transfer of care, 
  6.1   or transport to a hospital; 
  6.2      (6) the scope of care and services to be provided to the 
  6.3   client by the licensed traditional midwife; 
  6.4      (7) the available alternatives to traditional midwifery 
  6.5   care; 
  6.6      (8) a statement indicating that the client's records and 
  6.7   any transaction with the licensed traditional midwife are 
  6.8   confidential; 
  6.9      (9) a notice that reads:  "We realize that there are risks 
  6.10  associated with birth, including the risk of death or disability 
  6.11  of either mother or child.  We understand that a situation may 
  6.12  arise, which requires emergency medical care and that it may not 
  6.13  be possible to transport the mother and/or baby to the hospital 
  6.14  in time to benefit from such care.  We fully accept the outcome 
  6.15  and consequences of our decision to have a licensed traditional 
  6.16  midwife attend us during pregnancy and at our birth.  We realize 
  6.17  that our licensed traditional midwife is not licensed to 
  6.18  practice medicine.  We are not seeking a licensed physician or 
  6.19  certified nurse midwife as the primary caregiver for this 
  6.20  pregnancy, and we understand that our licensed traditional 
  6.21  midwife shall inform us of any observed signs or symptoms of 
  6.22  disease, which may require evaluation, care, or treatment by a 
  6.23  medical practitioner.  We agree that we are totally responsible 
  6.24  for obtaining qualified medical assistance for the care of any 
  6.25  disease or pathological condition."; 
  6.26     (10) the right of a client to refuse services unless 
  6.27  otherwise provided by law; 
  6.28     (11) a disclosure of whether the licensed traditional 
  6.29  midwife carries malpractice or liability insurance; and 
  6.30     (12) the client's and licensed traditional midwife's 
  6.31  signatures and date of signing. 
  6.32     Subd. 3.  [FILING.] The licensed traditional midwife must 
  6.33  have a signed informed consent form on file for each client.  
  6.34  Upon request, the licensed traditional midwife must provide a 
  6.35  copy of the informed consent form to the board.  
  6.36     Sec. 5.  [147D.09] [LIMITATIONS OF PRACTICE.] 
  7.1      (a) A licensed traditional midwife shall not prescribe, 
  7.2   dispense, or administer prescription drugs, except as permitted 
  7.3   under paragraph (b). 
  7.4      (b) A licensed traditional midwife may administer vitamin K 
  7.5   either orally or through intramuscular injection, postpartum 
  7.6   antihemorrhagic drugs under emergency situations, local 
  7.7   anesthetic, oxygen, and a prophylactic eye agent to the newborn 
  7.8   infant.  
  7.9      (c) A licensed traditional midwife shall not perform any 
  7.10  operative or surgical procedures except for suture repair of 
  7.11  first- or second-degree perineal lacerations.  
  7.12     Sec. 6.  [147D.11] [MEDICAL CONSULTATION PLAN.] 
  7.13     (a) To be eligible for licensure as a traditional midwife, 
  7.14  an applicant must develop a medical consultation plan, including 
  7.15  an emergency plan.  The plan must describe guidelines and under 
  7.16  what conditions the plan is to be implemented for: 
  7.17     (1) consultation with a licensed health care provider; 
  7.18     (2) the transfer of care to a licensed health care 
  7.19  provider; and 
  7.20     (3) immediate transport to a hospital. 
  7.21     (b) The conditions requiring the implementation of the 
  7.22  medical consultation plan must meet at a minimum the conditions 
  7.23  established by the Minnesota Midwives Guild in the Standards of 
  7.24  Care and Certification Guide, the most current edition. 
  7.25     Sec. 7.  [147D.13] [REPORTING.] 
  7.26     Subdivision 1.  [CERTIFICATE OF BIRTH.] A licensed 
  7.27  traditional midwife must complete a certificate of birth in 
  7.28  accordance with section 144.215. 
  7.29     Subd. 2.  [PRACTICE REPORT.] (a) A licensed traditional 
  7.30  midwife must compile a summary report on each client.  The 
  7.31  report must include the following: 
  7.32     (1) vital statistics; 
  7.33     (2) scope of care administered; 
  7.34     (3) whether the medical consultation plan was implemented; 
  7.35  and 
  7.36     (4) any physician or other health care provider referrals 
  8.1   made. 
  8.2      (b) The board may review these reports at any time upon 
  8.3   request.  
  8.4      Subd. 3.  [PUBLIC HEALTH REPORT.] A licensed traditional 
  8.5   midwife must promptly report to the commissioner of health and 
  8.6   to the board any maternal, fetal, or neonatal mortality or 
  8.7   morbidity. 
  8.8      Subd. 4.  [DISCIPLINARY ACTION.] A licensed traditional 
  8.9   midwife must report to the board termination, revocation, or 
  8.10  suspension of the licensed traditional midwife's certification 
  8.11  or any disciplinary action taken against the licensed 
  8.12  traditional midwife by the North American Registry of Midwives. 
  8.13     Sec. 8.  [147D.15] [PROTECTED TITLES.] 
  8.14     Subd. 1.  [PROTECTED TITLES.] No person may use the title 
  8.15  "licensed traditional midwife," or "licensed midwife," or use, 
  8.16  in connection with the person's name, the letters "LTM," "LM," 
  8.17  or any other titles, words, letters, abbreviations, or insignia 
  8.18  indicating or implying that the person is licensed or eligible 
  8.19  for licensure by the state as a licensed traditional midwife 
  8.20  unless the person has been licensed as a licensed traditional 
  8.21  midwife according to this chapter. 
  8.22     Subd. 2.  [PROHIBITED FROM PRACTICING.] A person whose 
  8.23  license under this chapter has been revoked by the board is 
  8.24  prohibited from practicing traditional midwifery. 
  8.25     Subd. 3.  [PENALTY.] A person who violates this section is 
  8.26  guilty of a misdemeanor. 
  8.27     Sec. 9.  [147D.17] [LICENSURE REQUIREMENTS.] 
  8.28     Subdivision 1.  [GENERAL REQUIREMENTS FOR LICENSURE.] To be 
  8.29  eligible for licensure, an applicant, with the exception of 
  8.30  those seeking licensure by reciprocity under subdivision 2, must:
  8.31     (1) submit a completed application on forms provided by the 
  8.32  board along with all fees required under section 147D.27 that 
  8.33  includes: 
  8.34     (i) the applicant's name, social security number, home 
  8.35  address and telephone number, and business address and telephone 
  8.36  number; 
  9.1      (ii) a list of degrees received from educational 
  9.2   institutions; 
  9.3      (iii) a description of the applicant's professional 
  9.4   training; 
  9.5      (iv) a list of registrations, certifications, and licenses 
  9.6   held in other jurisdictions; 
  9.7      (v) a description of any other jurisdiction's refusal to 
  9.8   credential the applicant; 
  9.9      (vi) a description of all professional disciplinary actions 
  9.10  initiated against the applicant in any jurisdiction; and 
  9.11     (vii) any history of drug or alcohol abuse, and any 
  9.12  misdemeanor or felony conviction; 
  9.13     (2) submit a diploma from an approved education program or 
  9.14  submit evidence of having completed an apprenticeship; 
  9.15     (3) submit a verified copy of a valid and current 
  9.16  credential, issued by the North American Registry of Midwives or 
  9.17  other national organization recommended by the advisory council 
  9.18  and approved by the board, as a certified professional midwife; 
  9.19     (4) submit current certification from the American Heart 
  9.20  Association or the American Red Cross for adult and infant 
  9.21  cardiopulmonary resuscitation; 
  9.22     (5) submit a copy of the applicant's medical consultation 
  9.23  plan; 
  9.24     (6) submit documentation verifying that the applicant has 
  9.25  the following practical experience through an apprenticeship or 
  9.26  other supervisory setting: 
  9.27     (i) the provision of 75 prenatal examinations, including 20 
  9.28  initial examinations; 
  9.29     (ii) supervised participation in 20 births, ten of which 
  9.30  must be in a home setting; 
  9.31     (iii) participation as the primary birth attendant under 
  9.32  the supervision of a licensed traditional midwife at an 
  9.33  additional 20 births, ten of which must have occurred outside a 
  9.34  state licensed health care facility; 
  9.35     (iv) 20 newborn examinations; and 
  9.36     (v) 40 postpartum examinations; 
 10.1      (7) submit additional information as requested by the 
 10.2   board, including any additional information necessary to ensure 
 10.3   that the applicant is able to practice with reasonable skill and 
 10.4   safety to the public; 
 10.5      (8) sign a statement that the information in the 
 10.6   application is true and correct to the best of the applicant's 
 10.7   knowledge and belief; and 
 10.8      (9) sign a waiver authorizing the board to obtain access to 
 10.9   the applicant's records in this or any other state in which the 
 10.10  applicant has completed an approved education program or engaged 
 10.11  in the practice of traditional midwifery. 
 10.12     Subd. 2.  [LICENSURE BY RECIPROCITY.] To be eligible for 
 10.13  licensure by reciprocity, the applicant must be credentialed by 
 10.14  the North American Registry of Midwives or other national 
 10.15  organization recommended by the advisory council and approved by 
 10.16  the board and must: 
 10.17     (1) submit the application materials and appropriate fees 
 10.18  as required under subdivision 1, clauses (1), (3), (4), (5), 
 10.19  (6), (7), (8), and (9); and section 147D.27; 
 10.20     (2) provide a verified copy from the appropriate body of a 
 10.21  current and unrestricted credential for the practice of 
 10.22  traditional midwifery in another jurisdiction that has initial 
 10.23  credentialing requirements equivalent to or higher than the 
 10.24  requirements in subdivision 1; and 
 10.25     (3) provide letters of verification from the appropriate 
 10.26  government body in each jurisdiction in which the applicant 
 10.27  holds a credential.  Each letter must state the applicant's 
 10.28  name, date of birth, credential number, date of issuance, a 
 10.29  statement regarding disciplinary actions, if any, taken against 
 10.30  the applicant, and if the applicant is in good standing in that 
 10.31  jurisdiction. 
 10.32     Subd. 3.  [TEMPORARY PERMIT.] The board may issue a 
 10.33  temporary permit to practice as a licensed traditional midwife 
 10.34  to an applicant eligible for licensure under this section if the 
 10.35  application for licensure is complete, all applicable 
 10.36  requirements in this section have been met, and a nonrefundable 
 11.1   fee set by the board has been paid.  The permit remains valid 
 11.2   only until the meeting of the board at which a decision is made 
 11.3   on the application for licensure. 
 11.4      Subd. 4.  [LICENSURE BY EQUIVALENCY DURING TRANSITION 
 11.5   PERIOD.] (a) From July 1, 1999, to July 1, 2001, a person may 
 11.6   qualify for licensure if the person has engaged in the practice 
 11.7   of traditional midwifery in this state for at least five years 
 11.8   in the period from July 1, 1994, to June 30, 1999, and submits 
 11.9   documentation verifying the practical experience described in 
 11.10  subdivision 1, clause (6).  To be eligible for licensure under 
 11.11  this subdivision, the person must also submit the application 
 11.12  materials and the appropriate fees required under subdivision 1, 
 11.13  clauses (1), (4), (5), (6), (7), (8), and (9), and section 
 11.14  147D.27. 
 11.15     (b) An application for licensure under this subdivision 
 11.16  must be submitted to the board between July 1, 1999, and June 
 11.17  30, 2001.  Licensure under this subdivision may be renewed once. 
 11.18  Within a two-year period from the date a license is issued by 
 11.19  the board in accordance with this subdivision, the licensed 
 11.20  traditional midwife must obtain a certification from the North 
 11.21  American Registry of Midwives as a certified professional 
 11.22  midwife.  If certification is not obtained within this time 
 11.23  period, the licensed traditional midwife must obtain a new 
 11.24  license by applying for licensure and fulfilling the 
 11.25  requirements then in existence for obtaining an initial license 
 11.26  as a licensed traditional midwife. 
 11.27     Subd. 5.  [LICENSE EXPIRATION.] Licenses issued under this 
 11.28  chapter expire annually. 
 11.29     Subd. 6.  [RENEWAL.] To be eligible for license renewal, a 
 11.30  licensed traditional midwife must: 
 11.31     (1) complete a renewal application on a form provided by 
 11.32  the board; 
 11.33     (2) submit the renewal fee; 
 11.34     (3) provide evidence every three years of a total of 30 
 11.35  hours of continuing education approved by the board as described 
 11.36  in section 147D.21; 
 12.1      (4) submit evidence of an annual peer review and update of 
 12.2   the licensed traditional midwife's medical consultation plan; 
 12.3   and 
 12.4      (5) submit any additional information requested by the 
 12.5   board.  The information must be submitted within 30 days after 
 12.6   the board's request, or the renewal request is nullified. 
 12.7      Subd. 7.  [CHANGE OF ADDRESS.] A licensed traditional 
 12.8   midwife who changes addresses must inform the board within 30 
 12.9   days, in writing, of the change of address.  All notices or 
 12.10  other correspondence mailed to or served on a licensed 
 12.11  traditional midwife by the board at the licensed traditional 
 12.12  midwife's address on file with the board shall be considered as 
 12.13  having been received by the licensed traditional midwife. 
 12.14     Subd. 8.  [LICENSE RENEWAL NOTICE.] At least 30 days before 
 12.15  the license renewal date, the board shall send out a renewal 
 12.16  notice to the last known address of the licensed traditional 
 12.17  midwife on file.  The notice must include a renewal application 
 12.18  and a notice of fees required for renewal.  It must also inform 
 12.19  the licensed traditional midwife that licensure will expire 
 12.20  without further action by the board if an application for 
 12.21  license renewal is not received before the deadline for 
 12.22  renewal.  The licensed traditional midwife's failure to receive 
 12.23  this notice shall not relieve the licensed traditional midwife 
 12.24  of the obligation to meet the deadline and other requirements 
 12.25  for license renewal.  Failure to receive this notice is not 
 12.26  grounds for challenging expiration of licensure status. 
 12.27     Subd. 9.  [RENEWAL DEADLINE.] The renewal application and 
 12.28  fee must be postmarked on or before July 1 or as determined by 
 12.29  the board.  If the postmark is illegible, the application shall 
 12.30  be considered timely if received by the third working day after 
 12.31  the deadline. 
 12.32     Subd. 10.  [INACTIVE STATUS AND RETURN TO ACTIVE STATUS.] 
 12.33  (a) A license may be placed in inactive status upon application 
 12.34  to the board by the licensed traditional midwife and upon 
 12.35  payment of an inactive status fee.  
 12.36     (b) Licensed traditional midwives seeking restoration to 
 13.1   active from inactive status must pay the current renewal fees 
 13.2   and all unpaid back inactive fees.  They must meet the criteria 
 13.3   for renewal specified in subdivision 6, including continuing 
 13.4   education hours equivalent to one hour for each month of 
 13.5   inactive status, prior to submitting an application to regain 
 13.6   licensure status.  If the inactive status extends beyond five 
 13.7   years, a qualifying score on a credentialing examination, or 
 13.8   completion of an advisory council-approved eight-week supervised 
 13.9   practical experience is required.  If the licensed traditional 
 13.10  midwife intends to regain active licensure by means of eight 
 13.11  weeks of advisory council-approved practical experience, the 
 13.12  licensed traditional midwife shall be granted temporary 
 13.13  licensure for a period of no longer than six months. 
 13.14     Subd. 11.  [LICENSURE FOLLOWING LAPSE OF LICENSURE STATUS 
 13.15  FOR TWO YEARS OR LESS.] For any individual whose licensure 
 13.16  status has lapsed for two years or less, to regain licensure 
 13.17  status, the individual must: 
 13.18     (1) apply for license renewal according to subdivision 6; 
 13.19     (2) document compliance with the continuing education 
 13.20  requirements of section 147D.21 since the licensed traditional 
 13.21  midwife's initial licensure or last renewal; and 
 13.22     (3) submit the fees required under section 147D.27 for the 
 13.23  period not licensed, including the fee for late renewal. 
 13.24     Subd. 12.  [CANCELLATION DUE TO NONRENEWAL.] The board 
 13.25  shall not renew, reissue, reinstate, or restore a license that 
 13.26  has lapsed and has not been renewed within two licensure renewal 
 13.27  cycles starting July 1999.  A licensed traditional midwife whose 
 13.28  license is canceled for nonrenewal must obtain a new license by 
 13.29  applying for licensure and fulfilling all requirements then in 
 13.30  existence for initial licensure as a licensed traditional 
 13.31  midwife.  
 13.32     Subd. 13.  [CANCELLATION OF LICENSURE IN GOOD 
 13.33  STANDING.] (a) A licensed traditional midwife holding an active 
 13.34  license as a licensed traditional midwife in the state may, upon 
 13.35  approval of the board, be granted licensure cancellation if the 
 13.36  board is not investigating the person as a result of a complaint 
 14.1   or information received or if the board has not begun 
 14.2   disciplinary proceedings against the licensed traditional 
 14.3   midwife.  Such action by the board shall be reported as a 
 14.4   cancellation of licensure in good standing. 
 14.5      (b) A licensed traditional midwife who receives board 
 14.6   approval for licensure cancellation is not entitled to a refund 
 14.7   of any license fees paid for the licensure period in which 
 14.8   cancellation of the license occurred. 
 14.9      (c) To obtain licensure after cancellation, a licensed 
 14.10  traditional midwife must obtain a new license by applying for 
 14.11  licensure and fulfilling the requirements then in existence for 
 14.12  obtaining an initial license as a traditional midwife.  
 14.13     Sec. 10.  [147D.19] [BOARD ACTION ON APPLICATIONS FOR 
 14.14  LICENSURE.] 
 14.15     (a) The board shall act on each application for licensure 
 14.16  according to paragraphs (b) to (d). 
 14.17     (b) The board shall determine if the applicant meets the 
 14.18  requirements for licensure under section 147D.17.  The board or 
 14.19  advisory council may investigate information provided by an 
 14.20  applicant to determine whether the information is accurate and 
 14.21  complete.  
 14.22     (c) The board shall notify each applicant in writing of 
 14.23  action taken on the application, the grounds for denying 
 14.24  licensure if licensure is denied, and the applicant's right to 
 14.25  review under paragraph (d).  
 14.26     (d) Applicants denied licensure may make a written request 
 14.27  to the board, within 30 days of the board's notice, to appear 
 14.28  before the advisory council and for the advisory council to 
 14.29  review the board's decision to deny the applicant's license.  
 14.30  After reviewing the denial, the advisory council shall make a 
 14.31  recommendation to the board as to whether the denial shall be 
 14.32  affirmed.  Each applicant is allowed only one request for review 
 14.33  per licensure period.  
 14.34     Sec. 11.  [147D.21] [CONTINUING EDUCATION REQUIREMENTS.] 
 14.35     Subdivision 1.  [NUMBER OF REQUIRED CONTACT HOURS.] Three 
 14.36  years after the date of initial licensure and every three years 
 15.1   thereafter, a licensed traditional midwife must complete a 
 15.2   minimum of 30 contact hours of board-approved continuing 
 15.3   education and attest to completion of continuing education 
 15.4   requirements by reporting to the board.  At least five contact 
 15.5   hours within a three-year reporting period must involve adult 
 15.6   cardiopulmonary resuscitation and either infant cardiopulmonary 
 15.7   resuscitation or neonatal advanced life support. 
 15.8      Subd. 2.  [APPROVAL OF CONTINUING EDUCATION PROGRAMS.] The 
 15.9   board shall approve continuing education programs that meet the 
 15.10  following criteria: 
 15.11     (1) the program content directly relates to the practice of 
 15.12  traditional midwifery; 
 15.13     (2) each member of the program faculty is knowledgeable in 
 15.14  the subject matter as demonstrated by a degree from an 
 15.15  accredited education program, verifiable experience in the field 
 15.16  of traditional midwifery, special training in the subject 
 15.17  matter, or experience teaching in the subject area; 
 15.18     (3) the program lasts at least one contact hour; 
 15.19     (4) there are specific, measurable, written objectives, 
 15.20  consistent with the program, describing the expected outcomes 
 15.21  for the participants; and 
 15.22     (5) the program sponsor has a mechanism to verify 
 15.23  participation and maintains attendance records for three years. 
 15.24     Subd. 3.  [CONTINUING EDUCATION TOPICS.] Continuing 
 15.25  education program topics may include, but are not limited to, 
 15.26  traditional midwifery care in the prenatal, labor, birth, and 
 15.27  postpartum and newborn periods; assessing contraindications; 
 15.28  care in emergency situations; ethics; and nutrition. 
 15.29     Subd. 4.  [ACCUMULATION OF CONTACT HOURS.] A licensed 
 15.30  traditional midwife may not apply contact hours acquired in one 
 15.31  three-year reporting period to a future continuing education 
 15.32  reporting period.  
 15.33     Subd. 5.  [VERIFICATION OF CONTINUING EDUCATION CREDITS.] 
 15.34  The board shall periodically select a random sample of licensed 
 15.35  traditional midwives and require those licensed traditional 
 15.36  midwives to supply the board with evidence of having completed 
 16.1   the continuing education to which they attested.  Documentation 
 16.2   may come directly from the licensed traditional midwife or from 
 16.3   state or national organizations that maintain continuing 
 16.4   education records. 
 16.5      Sec. 12.  [147D.23] [DISCIPLINE; REPORTING.] 
 16.6      For purposes of this chapter, licensed traditional midwives 
 16.7   and applicants are subject to the provisions of sections 147.091 
 16.8   to 147.162. 
 16.9      Sec. 13.  [147D.25] [ADVISORY COUNCIL ON LICENSED 
 16.10  TRADITIONAL MIDWIFERY.] 
 16.11     Subdivision 1.  [MEMBERSHIP.] The board shall appoint a 
 16.12  five-member advisory council on licensed traditional midwifery.  
 16.13  One member shall be a licensed physician who has been or is 
 16.14  currently consulting with licensed traditional midwives, 
 16.15  appointed from a list of names submitted to the board by the 
 16.16  Minnesota Medical Association.  Three members shall be licensed 
 16.17  traditional midwives appointed from a list of names submitted to 
 16.18  the board by Midwifery Now.  One member shall be a homebirth 
 16.19  parent appointed from a list of names submitted to the board by 
 16.20  Minnesota Families for Midwifery.  
 16.21     Subd. 2.  [ORGANIZATION.] The advisory council shall be 
 16.22  organized and administered under section 15.059.  The council 
 16.23  expires June 30, 2003.  
 16.24     Subd. 3.  [DUTIES.] The advisory council shall: 
 16.25     (1) advise the board regarding standards for licensed 
 16.26  traditional midwives; 
 16.27     (2) provide for distribution of information regarding 
 16.28  licensed traditional midwifery practice standards; 
 16.29     (3) advise the board on enforcement of this chapter; 
 16.30     (4) review applications and recommend granting or denying 
 16.31  licensure or license renewal; 
 16.32     (5) advise the board on issues related to receiving and 
 16.33  investigating complaints, conducting hearings, and imposing 
 16.34  disciplinary action in relation to complaints against licensed 
 16.35  traditional midwives; 
 16.36     (6) advise the board regarding approval of continuing 
 17.1   education programs using the criteria in section 147D.21, 
 17.2   subdivision 2; 
 17.3      (7) recommend alternate accrediting and credentialing 
 17.4   organizations or agencies to the board; and 
 17.5      (8) perform other duties authorized for advisory councils 
 17.6   by chapter 214, as directed by the board. 
 17.7      Sec. 14.  [147D.27] [FEES.] 
 17.8      Subdivision 1.  [LICENSURE FEE.] The license application 
 17.9   fee is $100.  The fee for initial licensure and annual renewal 
 17.10  is $100.  The fee for inactive status is $50.  The fee for a 
 17.11  temporary permit is $75.  
 17.12     Subd. 2.  [PRORATION OF FEES.] The board may prorate the 
 17.13  initial licensure fee.  All licensed traditional midwives are 
 17.14  required to pay the full fee upon license renewal. 
 17.15     Subd. 3.  [PENALTY FEE FOR LATE RENEWALS.] An application 
 17.16  for license renewal submitted after the deadline must be 
 17.17  accompanied by a late fee of $75 in addition to the required 
 17.18  fees. 
 17.19     Subd. 4.  [NONREFUNDABLE FEES.] The fees in this section 
 17.20  are nonrefundable.  
 17.21     Sec. 15.  [APPROPRIATION.] 
 17.22     $8,000 is appropriated for fiscal year 2000 and $4,000 is 
 17.23  appropriated for fiscal year 2001 from the state government 
 17.24  special revenue fund to the board of medical practice for the 
 17.25  licensure and regulation of traditional midwives as required 
 17.26  under Minnesota Statutes, chapter 147D. 
 17.27     Sec. 16.  [REPEALER.] 
 17.28     Minnesota Statutes 1998, sections 148.30; 148.31; and 
 17.29  148.32, are repealed. 
 17.30     Minnesota Rules, parts 5600.2000; and 5600.2100, are 
 17.31  repealed.