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Delaware General AssemblyDelaware RegulationsMonthly Register of RegulationsJuly 2016

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The Midwifery Advisory Council, pursuant to 24 Del.C. §1799HH(c), proposed to adopt regulations governing the practice of midwifery in the State of Delaware. As a newly created Council, regulating a profession that first required licensure by virtue of legislation enacted June 9, 2015, these regulations are comprehensive, and all newly created.
Following publication in the Delaware Register of Regulations on May 1, 2016 a public hearing was held on May 25, 2016. Written comment periods were held open for thirty days following the initial publication on May 1, 2016, and an additional fifteen days following the May 25, 2016 public hearing. At the hearing, the Board accepted as evidence and marked as the Board’s Exhibit 1 documentation of publication of the notice of the public hearing in the News Journal and the Delaware State News.
During the written public comment period, a letter dated June 3, 2016 was received from Cara A. Kinzelman, PhD, Director, State Government Affairs for the American College of Nurse-Midwives. This comment was labeled Board Exhibit 2. Ms. Kinzelman indicated that the CM credential is equivalent to the CNM credential, and that the CM credential has a scope of practice that includes a full range of primary health care services for women from adolescence beyond menopause, including prescribing controlled substances and other medications. CNMs and CMs provide care in diverse settings such as ambulatory care clinics, private offices, community and public health systems, homes, hospitals and birth centers. CPMs, by contrast, provide care to normal, low-risk populations in the out-of-hospital setting, and have a more limited scope of practice than CNMs and CMs. Ms. Kinzelman expressed that the American College of Nurse-Midwives is concerned that the current regulations conflate the CM credential with the CPM credential, and requests that the MAC amend the rules to replace each occurrence of “midwife” with the more specific term “Certified Professional Midwife” and defer consideration of the CM role at this time, promulgating separate rules governing the CM credential to avoid conflation of the two distinct midwifery roles. If deferment is not possible, Ms. Kinzelman requests that the MAC conform its regulations to the ACNM national standards, including granting CMs full prescriptive authority, up to and including, the ability to prescribe all Schedule II controlled substances and incorporating the ACNM standard-setting document, Standards for the Practice of Midwifery, into the regulations.
As a newly created council, the Midwifery Advisory Council is charged with the responsibility of creating regulations: 24 Del.C. §1799HH(c). Beginning in September 2015, the MAC met on a monthly basis, formulating regulations governing the practice of midwifery in the state of Delaware. In so doing, the MAC conducted an in-depth review of its statutory mandates, reviewed the governance of midwifery in other states to determine what has and has not worked, reviewed national association guidelines, sought and received input from the Board of Medical Licensure and Discipline, and drew upon its collective expertise in the practice to create the regulations published as proposed on May 1, 2016.
The MAC recognizes that changes to the regulations may need to be made once they are put into operation. However, the MAC is cognizant of the public comments received that urge the swift adoption of these regulation. See comments of Ms. Panunto, Ms. Kline, and Ms. Heiger. Moreover, the MAC recognizes that the practice of midwifery is completely unregulated until such time as these regulations are adopted and applications for licensure can be accepted.
Finally, the MAC recognizes the commenters’ suggestion that regulations specifically relating to CMs may still be necessary. In order to effectuate such a scheme without unduly delaying the implementation of regulations in toto the MAC plans to meet with representatives of the ACNM in the upcoming months to address the specific concerns of that organization and its membership and develop additional regulations specifically pertaining to CMs for submission for approval from the Board of Medical Licensure and Discipline.
IT IS SO ORDERED this 15th day of June, 2016 by the Midwifery Advisory Council.
Board” means Delaware Board of Medical Licensure and Discipline.
Certified midwife” or “CM” means a practitioner who has received certification by the American Midwifery Certification Board (“AMCB”) or its equivalent or successor.
Certified professional midwife” or “CPM” means a practitioner who has received certification by the North American Registry of Midwives (NARM) or its equivalent or successor.
Council” means the Midwifery Advisory Council of the Board of Medical Licensure and Discipline.
12.4.2 Documentation. When a licensee is selected for audit, the licensee shall be required to submit documentation showing detailed accounting of the various hours claimed by the licensee. Licensees selected for random audit are required to supplement the attestation with supporting materials which may include a syllabus, agenda, itinerary or brochure published by the sponsor of the activity and a document showing proof of attendance (i.e., certificate, a signed letter from the sponsor attesting to attendance, report of passing test score). The Council shall attempt to verify the hours shown on the documentation provided by the licensee. Upon completion of the review, the Council will determine whether the licensee's hours meet the requirements of these regulations.
Last Updated: December 31 1969 19:00:00.
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