California Nurse-Midwives Association

Learn more about AB2682 and how you can help on our political action website:






June 2018 Health Policy Update


AB2682: On to the Senate


AB 2682 passed out of the Assembly on May 30th. This is great news but we still have a lot of work to do in the Senate, including ongoing negotiations to amend the bill language.

 

We are now focused on the Senate Business, Professions, and Economic Development Committee (B&P). Likely our bill will be heard in this committee on June 25th This means all letters of support must be received by June 18! 

Action Items

1. All CNMs should send a letter ASAP to the Chair of the Senate B&P Committee, Senator Jerry Hill.  See CNM sample letter on this page.  Feel free to shorten/edit this letter as needed.

It is best to email letters!

Address your letter to:

Senator Jerry Hill

Chair, Senate Business Professions and Economic Development Committee

State Capitol Room 2053

Sacramento CA, 95814

EMAIL your letter to:

Sarah.huchel@sen.gov.ca and cc to

Zachary.leary@asm.ca.gov

Or fax your letter to 

Attn: Sarah Huchel at (916) 266-9343

and cc letter to 

Attn: Zachary Leary at (916) 319-2162

You can also send by regular mail to the address above but time is of the essence!  Letters need to be received by June 18th!

2. If you are a constituent of a member of the B&P Committee, please fax or send letters of support directly to them as well.  Find member of B&P here. Find legislators here.




Worth a Listen!

We applaud Freakonomics for their astute podcast of “Nurses to the Rescue.” This podcast is worth the listen!!! Like Nurse Practitioners (NPs), Certified Nurse-Midwives (CNMs) are Advanced Practice Nurses with graduate level education and rigorous training. In California, our current Bill (AB1612) to remove physician supervision for CNMs has been met with similar opposition from CMA. This is our third attempt to remove physician supervision for CNMs in order to meet the growing demand for women’s health and maternity care services throughout the State. Nine California counties do not have an OBGYN! This podcast explains why full practice authority for Advanced Practice Nurses is so important.

http://freakonomics.com/podcast/nurses-to-the-rescue/




Equity.  
Current regulations make it difficult for nurse-midwives to practice equitable, team-based care. In effective team-based care, each provider is integral to the team and each is able to offer the full scope of what they have to offer, which ultimately provides better health care overall. The “supervision” concept creates a sense of hierarchy that is antithetical to effective team-based care. As providers tethered to physicians, CNMs are unable to promote midwifery care without supervisory permission. Physician supervision also fosters interprofessional tension because of the erroneous idea that the physician is legally responsible for the CNM’s actions.      

Visibility.  

Midwives are often invisible within the healthcare system by not being counted/included as providers by insurance companies or hospitals. Currently, Medi-Cal and private health plans do not track where CNMs work and what we do. That means our impact is often invisible to policy makers, insurance companies, and the general public—but not to budget administrators, who may well eliminate a CNM “line item” because our worth is not known.                                                                                    

Economic Stability.  

Removal of the word “supervision” would expand market opportunities for CNMs and the physicians with whom we collaborate. It will also make it easier for a CNM to obtain hospital privileges and become a full hospital staff member; to work with physicians who are no longer fearful of liability issues; to start a midwife-owned private practice; and to contract with health plans. Likewise, it will be easier for hospitals to hire the appropriate number of CNMs and physicians required for optimal patient care rather than basing hiring decisions on supervision ratios. Removal of supervisory requirements does not, of course, preclude a CNM from working within a physician or hospital group if she or he so chooses.  



The Health Policy Committee is responsible for assisting in the fulfillment of these specific purposes of the California Nurse-Midwives Association (CNMA):

  •       Represent the membership regarding issues impacting the practice of midwifery in the state of California in accordance with the bylaws and policy guidelines of the American College of Nurse-Midwives.
  •       Promote the health and well-being of women and families in the state of California by furthering the profession of midwifery.
  •       Establish a mechanism for cooperation with other groups and organizations in promoting the health and well-being of California families.
  •       Achieve legislation and regulation that is favorable to midwifery practice.
  •       Support and foster appropriate professional licensure regulations and legislation related to midwifery and women’s health issues in California.

Wondering how to get involved?

Join fellow CNMA members that are active proponents of our health policy goals, in either the Health Policy Committee (3 yr commitment) or the Health Policy Workgroup for smaller projects:

  1. Engage locally: Determine what is going on in your local chapter. Does your chapter have a Health Policy liaison? What issues face your local CNM community?; Where do CNMs work in your community? Can you identify local supporters? Build a relationship with your local representatives.
  2. Attend CNMA Lobby Day! Volunteer to help organize!
  3. Make in-district lobbying visits with your legislator, closer to home!
  4. Help CNMA fundraise!
  5. Represent CNMA at coalition, BRN, or other meetings!

Contact the Chair or Vice Chair of the CNMA Health Policy Committee to find out how you can help.


 




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The CNMA works to improve women's health through midwifery. Help us accomplish our maternal legislative goals by donating NOW! Click here to learn more about how we improve the health of women and their families.



Helpful Resources for In-District Advocacy

  1. How-to-Videos Re: Advocacy
  2. Legislative Visits – What to Expect
  3. Plan Your In-District Visit
  4. Talking Points for Legislators
  5. Materials for the In-District Visit
  6. Rainy Day Advocacy - Phone Prompt
  7. Find your CA Legislators HERE
  8. NEW: Customizable PowerPoint Presentation for In-District Visits


AB2682 Letters of Support: Templates




Health Policy Members:

Kim Q Dau, Co-Chair

Holly Smith, Co-Chair

Kavita Noble, Vice Chair

Djina Ariel, Davis

Jenna Breton, Mendocino

Karen Ruby Brown, San Diego

Carol Bryan, Humboldt Co

Mary Croyle Farrell, San Diego

Roberta Frank, San Diego

Parie Lambert, Napa

Timmi Pereira, Santa Cruz
BJ Snell, Orange County

Health Policy Workgroup Members

Emily Beck (SF Bay Area Liaison)

Hannah Brodsky-Pena (San Francisco Bay Area)

Yelena Kolodji (Santa Cruz)

Sarah Levitan (Santa Cruz)

Cara Rasmussen (Santa Cruz)
Natalie Martina (East Bay)

Mari Oxenberg (Los Angeles)

Holly Smith (Sacramento)

Susan Stone (Sacramento)




 

Links to CNMA Coalitions:

California Action Coalition

California Coalition for Reproductive Freedom

Californians Allied for Patient Protection

Sacramento Women + Health Care Reform Coalition


 

Find Your Local Representative:

http://findyourrep.legislature.ca.gov/


 

Comparison of California Certified Nurse-Midwives (CNMs) and Licensed Midwives (LMs): PDF

State Fact Sheet - California: PDF

Certified Nurse-Midwives in California: PDF



Please Submit Your Comments and Issues on:

  • practice barriers
  • CNM practice in CA
  • openings and closings of CNM practices
  • BRN investigations
  • billing/reimbursement issues
  • women's health policy concerns
  • legislative suggestions

 

Email Kim at kim.dau@gmail.com.

 


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