Newest language for AB 1308 – proposed LMPA amendment #4, 1st that did NOT originate with LMs

by faithgibson on April 6, 2013

in AB1308, new regs & new legislative efforts, Info ~ Medical Board Members, Physician Supervision Issues

Introduced by Assemblywoman Susan Bonilla on Feb 22nd
Most recent up-date ~ 03.21.13

This is the latest version. It is moving through committees of both Houses of the Legislature as we speak.

The key to reading ‘mark-up’ language is simple:

Text in the color BLACK means ‘no change’ from existing law; BLUE means new and RED means ‘strike-through’ or replaced.

Happy trails and stay tuned for updates.

AB 1308:
SECTION 1. The Legislature finds and declares the following:

(a) Licensed midwives have been authorized to practice since 1993 under Senate Bill 350 (Chapter 1280 of the Statutes of 1993), which was authored by Senator Killea. Additional legislation, Senate Bill 1950 (Chapter 1085 of the Statutes of 2002), which was authored by Senator Figueroa, was needed in 2002 to clarify certain practice issues. While the midwifery license does not specify or limit the practice setting in which licensed midwives may provide care, the reality is that the majority of births delivered by licensed midwives are planned as home births.

(b) Planned home births are safer when care is provided as part of an integrated delivery model. For a variety of reasons, this integration rarely occurs, and creates a barrier to the best and safest care possible. This is due, in part, to the attempt to fit a midwifery model of care into a medical model of care.

SEC. 2. 

[FG’s note — the following re-statement of 2507 & 2508 reiterates that LMs are ONLY in compliance with the LMPA IF they have physician supervision]

Section 2507 of the Business and Professions Code is amended to read:

2507.

 (a) The license to practice midwifery authorizes the holder, under the supervision of a licensed physician and surgeon, to attend cases of normal childbirth and to provide prenatal, intrapartum, and postpartum care, including family-planning care, for the mother, and immediate care for the newborn.

(b) As used in this article, the practice of midwifery constitutes the furthering or undertaking by any licensed midwife, under the supervision of a licensed physician and surgeon who has current practice or training in obstetrics, to assist a woman in childbirth so long as progress meets criteria accepted as normal. All complications shall be referred to a physician and surgeon immediately. The practice of midwifery does not include the assisting of childbirth by any artificial, forcible, or mechanical means, nor the performance of any version.

(c) As used in this article, “supervision” shall not be construed to require the physical presence of the supervising physician and surgeon.

(d) The ratio of licensed midwives to supervising physicians and surgeons shall not be greater than four individual licensed midwives to one individual supervising physician and surgeon.

(e) A midwife is not authorized to practice medicine and surgery by this article.

(f) A midwife is authorized to directly obtain supplies, order testing, and receive reports that are necessary to his or her practice of midwifery and consistent with his or her scope of practice.

(f) (g)  The board shall, not later than July 1, 2003,  2015, revise and  adopt in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), regulations defining the appropriate standard of care and level of supervision required for the practice of midwifery. midwifery and identifying complications necessitating referral to a physician and surgeon.

SEC. 3.

Section 2508 of the Business and Professions Code is amended to read:

2508.

(a) A licensed midwife shall disclose in oral and written form to a prospective client all of the following:

(1) All of the provisions of Section 2507.

(2) If the licensed midwife does not have liability coverage for the practice of midwifery, he or she shall disclose that fact.

(3) The specific arrangements for the referral of complications to a physician and surgeon.

(3) (4)  The specific arrangements for the transfer of care during the prenatal period, hospital transfer during the intrapartum and postpartum periods, and access to appropriate emergency medical services for mother and baby if necessary.

(4) (5)  The procedure for reporting complaints to the Medical Board of California.

(b) The disclosure shall be signed by both the licensed midwife and the client and a copy of the disclosure shall be placed in the client’s medical record.

(c) The Medical Board of California may prescribe the form for the written disclosure statement required to be used by a licensed midwife under this section.

SEC. 4.

No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.

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