SF 383

  1.1                          A bill for an act
  1.2             relating to health occupations; clarifying licensure 
  1.3             requirements for the practice of midwifery; proposing 
  1.4             coding for new law as Minnesota Statutes, chapter 
  1.5             147D; repealing Minnesota Statutes 1998, sections 
  1.6             148.30; 148.31; and 148.32; Minnesota Rules, parts 
  1.7             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  accredited by the Midwifery Education and Accreditation Council 
  1.19  (MEAC) or a national accrediting organization approved by the 
  1.20  board.  
  1.21     Subd. 4.  [BOARD.] "Board" means the board of medical 
  1.22  practice. 
  1.23     Subd. 5.  [CONTACT HOUR.] "Contact hour" means 50 
  1.24  consecutive minutes, excluding coffee breaks, registration, 
  1.25  meals without a speaker, and social activities, of a 
  1.26  board-approved learning experience either through an 
  2.1   instructional session or clinical practice. 
  2.2      Subd. 6.  [CREDENTIAL.] "Credential" means a license, 
  2.3   permit, certification, registration, or other evidence of 
  2.4   qualification or authorization to engage in the practice of 
  2.5   traditional midwifery in this state or any other state. 
  2.6      Subd. 7.  [CREDENTIALING EXAMINATION.] "Credentialing 
  2.7   examination" means an examination administered by the North 
  2.8   American Registry of Midwives (NARM) or other national testing 
  2.9   organization approved by the board for credentialing as a 
  2.10  licensed traditional midwife.  A credentialing examination must 
  2.11  include a written examination and a skills assessment.  
  2.12     Subd. 8.  [NORMAL PREGNANCY.] "Normal pregnancy" means a 
  2.13  pregnancy that is progressing and proceeding spontaneously 
  2.14  without the need for medical intervention or the use of 
  2.15  instruments and where spontaneous onset of labor occurs between 
  2.16  36 and 42 weeks. 
  2.17     Subd. 9.  [TRADITIONAL MIDWIFERY SERVICES.] "Traditional 
  2.18  midwifery services" means the assessment and care of a woman and 
  2.19  newborn during pregnancy, labor, birth, and the postpartum 
  2.20  period outside a licensed hospital.  
  2.21     Subd. 10.  [TRANSFER OF CARE.] "Transfer of care" means 
  2.22  transferring, during the course of pregnancy, the responsibility 
  2.23  of providing services to a client from the traditional midwife 
  2.24  to a licensed physician or certified nurse midwife.  
  2.25     Subd. 11.  [TRANSPORT.] "Transport" means the transferring 
  2.26  during labor, birth, or the postpartum period of the client from 
  2.27  a home setting to a hospital facility.  
  2.28     Sec. 2.  [147D.03] [MIDWIFERY.] 
  2.29     Subdivision 1.  [GENERAL.] Within the meaning of sections 
  2.30  147D.01 to 147D.27, a person who shall publicly profess to be a 
  2.31  traditional midwife and who, for a fee, shall assist or attend 
  2.32  to a woman in pregnancy, childbirth outside a licensed hospital, 
  2.33  and postpartum, shall be regarded as practicing traditional 
  2.34  midwifery.  
  2.35     Subd. 2.  [SCOPE OF PRACTICE.] The practice of traditional 
  2.36  midwifery includes, but is not limited to: 
  3.1      (1) initial and ongoing assessment for suitability of 
  3.2   traditional midwifery care; 
  3.3      (2) providing prenatal education and coordinating with a 
  3.4   licensed physician or certified nurse midwife comprehensive 
  3.5   prenatal care, including the routine monitoring of:  vital 
  3.6   signs, indicators of fetal developments, and laboratory tests, 
  3.7   as needed, with attention to the physical, nutritional, and 
  3.8   emotional needs of the woman and her family; 
  3.9      (3) attending and supporting the natural process of labor 
  3.10  and birth; 
  3.11     (4) postpartum care of the mother and an initial assessment 
  3.12  of the newborn; and 
  3.13     (5) providing information and referrals to community 
  3.14  resources on childbirth preparation, breast-feeding, exercise, 
  3.15  nutrition, parenting, and care of the newborn. 
  3.16     Subd. 3.  [UNAUTHORIZED SERVICES.] The practice of 
  3.17  traditional midwifery does not include:  
  3.18     (1) the use of any instrument at a childbirth, except as 
  3.19  necessary to sever the umbilical cord or repair a first- or 
  3.20  second-degree perineal laceration; 
  3.21     (2) the assisting of childbirth by artificial, or 
  3.22  mechanical means; or 
  3.23     (3) the removal of a placenta accreta. 
  3.24     Sec. 3.  [147D.05] [PROFESSIONAL CONDUCT.] 
  3.25     Subdivision 1.  [PRACTICE STANDARDS.] (a) A licensed 
  3.26  traditional midwife shall provide an initial and ongoing 
  3.27  screening to ensure that each client receives safe and 
  3.28  appropriate care.  A licensed traditional midwife shall only 
  3.29  accept and provide care to those women who have had initial 
  3.30  laboratory pregnancy screening, including blood group and 
  3.31  typing, antibody screen, Indirect Coombs, rubella titer, CBC 
  3.32  with differential and syphillis serology performed by a licensed 
  3.33  health care provider who is licensed to perform and interpret 
  3.34  diagnostic laboratory work.  A licensed traditional midwife 
  3.35  shall only accept and provide care to those women who are 
  3.36  expected to have a normal pregnancy, labor, and delivery.  As 
  4.1   part of the initial screening to determine whether any 
  4.2   contraindications are present, the traditional midwife must take 
  4.3   a detailed health history that includes the woman's social, 
  4.4   medical, surgical, menstrual, gynecological, contraceptive, 
  4.5   obstetrical, family, nutritional, and drug/chemical use 
  4.6   histories.  If a licensed traditional midwife determines at any 
  4.7   time during the course of the pregnancy that a woman's condition 
  4.8   may preclude attendance by a traditional midwife, the 
  4.9   traditional midwife must refer the client to a licensed 
  4.10  physician or a certified nurse midwife.  As part of the initial 
  4.11  and ongoing screening, a traditional midwife must recommend that 
  4.12  the client receive the following services, if necessary, from an 
  4.13  appropriate health care provider: 
  4.14     (1) gonorrhea and chlamydia cultures, if indicated; 
  4.15     (2) screening for sickle cell, if indicated; 
  4.16     (3) screening for hepatitis B and human immunodeficiency 
  4.17  virus (HIV) if indicated; 
  4.18     (4) maternal serum alpha-fetoprotein test and ultrasound; 
  4.19     (5) Rh antibody and glucose screening at 28 weeks 
  4.20  gestation; 
  4.21     (6) screening for phenylketonuria; 
  4.22     (7) Rh screening of the infant for maternal RhoGAM 
  4.23  treatment if indicated; and 
  4.24     (8) screening for premature labor. 
  4.25     (b) If a client refuses to have any of the tests listed in 
  4.26  paragraph (a) upon the recommendation of the traditional 
  4.27  midwife, the licensed traditional midwife must terminate the 
  4.28  relationship with the client. 
  4.29     (c) A client must make arrangements to have the results of 
  4.30  any of the tests described in paragraph (a) sent to the licensed 
  4.31  traditional midwife providing services to the client.  The 
  4.32  licensed traditional midwife must include these results in the 
  4.33  client's record. 
  4.34     Subd. 2.  [WRITTEN PLAN.] A traditional midwife must 
  4.35  prepare a written plan with each client to ensure continuity of 
  4.36  care throughout pregnancy, labor, and delivery.  The written 
  5.1   plan must incorporate the conditions under which the medical 
  5.2   consultation plan, including the transfer of care or transport 
  5.3   of the client, may be implemented. 
  5.4      Subd. 3.  [HEALTH REGULATIONS.] A traditional midwife must 
  5.5   comply with all applicable state and municipal requirements 
  5.6   regarding public health. 
  5.7      Subd. 4.  [CLIENT RECORDS.] A traditional midwife must 
  5.8   maintain a client record on each client, including: 
  5.9      (1) a copy of the informed consent form described in 
  5.10  section 147D.07; 
  5.11     (2) evidence of an initial client screening described in 
  5.12  section 147D.05; 
  5.13     (3) a copy of the written plan described in subdivision 2; 
  5.14     (4) a record of prenatal and postpartum care provided to 
  5.15  the client at each visit; and 
  5.16     (5) a detailed record of the labor and delivery process. 
  5.17     Subd. 5.  [DATA.] All records maintained on each client by 
  5.18  a traditional midwife are subject to section 144.335.  
  5.19     Sec. 4.  [147D.07] [INFORMED CONSENT.] 
  5.20     Subdivision 1.  [GENERAL.] Before providing any services to 
  5.21  a client, a licensed traditional midwife must:  
  5.22     (1) advise the client of the information contained in the 
  5.23  informed consent form; 
  5.24     (2) provide the client with an informed consent form; and 
  5.25     (3) have the form returned with the client's signature 
  5.26  attesting that the client understands the consent form and the 
  5.27  information contained in the form. 
  5.28     Subd. 2.  [CONTENTS.] The informed consent form must be 
  5.29  written in language understandable to the client and, at a 
  5.30  minimum, must contain the following: 
  5.31     (1) name, address, telephone number, and license number of 
  5.32  the traditional midwife; 
  5.33     (2) a description of the traditional midwife's education, 
  5.34  training, and experience in traditional midwifery; 
  5.35     (3) the traditional midwife's fees and method of billing; 
  5.36     (4) the right of the client to file a complaint with the 
  6.1   board and the procedures for filing a complaint; 
  6.2      (5) a description of the traditional midwife's medical 
  6.3   consultation plan and the antepartum, intrapartum, and 
  6.4   postpartum conditions requiring consultation, transfer of care, 
  6.5   or transport to a hospital facility; 
  6.6      (6) the scope of care and services to be provided to the 
  6.7   client by the traditional midwife; 
  6.8      (7) the available alternatives to traditional midwifery 
  6.9   care; 
  6.10     (8) a statement indicating that the client's records and 
  6.11  any transaction with the traditional midwife are confidential; 
  6.12     (9) a notice that reads:  "We realize that there are risks 
  6.13  associated with homebirth, including the risk of death or 
  6.14  disability of either mother or child.  We understand that a 
  6.15  situation may arise, which requires emergency medical care and 
  6.16  that it may not be possible to transport the mother and/or baby 
  6.17  to the hospital in time to benefit from such care.  We fully 
  6.18  accept the outcome and consequences of our decision to have a 
  6.19  traditional midwife attend us during pregnancy and at our 
  6.20  birth.  We realize that our traditional midwife is not licensed 
  6.21  to practice medicine.  We are not seeking a licensed physician 
  6.22  or certified nurse midwife as the primary caregiver for this 
  6.23  pregnancy, and we understand that our midwife shall inform us of 
  6.24  any observed signs or symptoms of disease, which may require 
  6.25  evaluation, care, or treatment by a medical practitioner.  We 
  6.26  agree that we are totally responsible for obtaining qualified 
  6.27  medical assistance for the care of any disease or pathological 
  6.28  condition."; 
  6.29     (10) the right of a client to refuse services unless 
  6.30  otherwise provided by law; 
  6.31     (11) a disclosure of whether the traditional midwife 
  6.32  carries malpractice or liability insurance; and 
  6.33     (12) the client and traditional midwife signatures and date 
  6.34  of signing. 
  6.35     Subd. 3.  [FILING.] The licensed traditional midwife must 
  6.36  have a signed informed consent form on file for each client.  
  7.1   Upon request, the traditional midwife must provide a copy of the 
  7.2   informed consent form to the board.  
  7.3      Sec. 5.  [147D.09] [LIMITATIONS OF PRACTICE.] 
  7.4      (a) A licensed traditional midwife shall not prescribe, 
  7.5   dispense, or administer prescription drugs, except as permitted 
  7.6   under paragraph (b). 
  7.7      (b) A licensed traditional midwife may administer vitamin K 
  7.8   either orally or through intramuscular injection, postpartum 
  7.9   antihemorrhagic drugs under emergency situations, local 
  7.10  anesthetic, oxygen, and a prophylactic eye agent to the newborn 
  7.11  infant.  
  7.12     (c) A licensed traditional midwife shall not perform any 
  7.13  operative or surgical procedures except for suture repair of 
  7.14  first- or second-degree perineal lacerations.  
  7.15     Sec. 6.  [147D.11] [MEDICAL CONSULTATION PLAN.] 
  7.16     (a) To be eligible for licensure as a traditional midwife, 
  7.17  an applicant must develop a medical consultation plan.  The plan 
  7.18  must describe guidelines and under what conditions the plan is 
  7.19  to be implemented for: 
  7.20     (1) consultation with a licensed physician or certified 
  7.21  nurse midwife; 
  7.22     (2) the transfer of care to a licensed physician or a 
  7.23  certified nurse midwife; and 
  7.24     (3) immediate transport to a licensed hospital. 
  7.25     (b) The conditions requiring the implementation of the 
  7.26  medical consultation plan must meet at a minimum the conditions 
  7.27  established by the Minnesota Midwives Guild in the Standards of 
  7.28  Care and Certification Guide, 1996 edition. 
  7.29     Sec. 7.  [147D.13] [REPORTING.] 
  7.30     Subdivision 1.  [PRACTICE REPORT.] (a) A licensed 
  7.31  traditional midwife must compile a summary report on each 
  7.32  client.  The report must include the following: 
  7.33     (1) vital statistics; 
  7.34     (2) scope of care administered; 
  7.35     (3) whether the medical consultation plan was implemented; 
  7.36  and 
  8.1      (4) any physician or other health care provider referrals 
  8.2   made. 
  8.3      (b) The board may review these reports at any time upon 
  8.4   request.  
  8.5      Subd. 2.  [PUBLIC HEALTH REPORT.] A licensed traditional 
  8.6   midwife must promptly report to the commissioner of health and 
  8.7   to the board any maternal, fetal, or neonatal mortality or 
  8.8   morbidity. 
  8.9      Subd. 3.  [DISCIPLINARY ACTION.] A licensed traditional 
  8.10  midwife must report to the board termination, revocation, or 
  8.11  suspension of the traditional midwife's certification or any 
  8.12  disciplinary action taken against the traditional midwife by the 
  8.13  North American Registry of Midwives. 
  8.14     Sec. 8.  [147D.15] [LICENSURE RESTRICTIONS; PROTECTED 
  8.15  TITLES.] 
  8.16     Subdivision 1.  [LICENSURE REQUIRED.] No person may engage 
  8.17  in the practice of traditional midwifery unless the person is 
  8.18  licensed as a traditional midwife in accordance with this 
  8.19  chapter. 
  8.20     Subd. 2.  [PROTECTED TITLES.] No person may use the title 
  8.21  "licensed traditional midwife," or "licensed midwife," or use, 
  8.22  in connection with the person's name, the letters "LTM," "LM," 
  8.23  or any other titles, words, letters, abbreviations, or insignia 
  8.24  indicating or implying that the person is licensed or eligible 
  8.25  for licensure by the state as a traditional midwife unless the 
  8.26  person has been licensed as a traditional midwife according to 
  8.27  this chapter. 
  8.28     Subd. 3.  [OTHER HEALTH CARE PRACTITIONERS; STUDENTS.] (a) 
  8.29  Nonphysician individuals practicing in a health care occupation 
  8.30  or profession are not restricted in the provision of services 
  8.31  included in section 147D.03, subdivision 2, as long as they do 
  8.32  not hold themselves out as traditional midwives by or through 
  8.33  the use of the titles protected in subdivision 2 in association 
  8.34  with provision of these services. 
  8.35     (b) A physician licensed under chapter 147 and a registered 
  8.36  nurse or certified nurse midwife licensed under sections 148.171 
  9.1   to 148.285 are exempt from this chapter. 
  9.2      (c) Nothing in this chapter shall be construed to require 
  9.3   licensure of a traditional midwifery student enrolled in an 
  9.4   approved education program or an apprenticeship program. 
  9.5      Subd. 4.  [PENALTY.] A person who violates this section is 
  9.6   guilty of a misdemeanor. 
  9.7      Subd. 5.  [EXCEPTIONS.] Nothing in this chapter shall be 
  9.8   construed to limit gratuitous traditional midwifery services 
  9.9   provided by family members or members of the same religious 
  9.10  community. 
  9.11     Sec. 9.  [147D.17] [LICENSURE REQUIREMENTS.] 
  9.12     Subdivision 1.  [GENERAL REQUIREMENTS FOR LICENSURE.] To be 
  9.13  eligible for licensure, an applicant, with the exception of 
  9.14  those seeking licensure by reciprocity under subdivision 2, must:
  9.15     (1) submit a completed application on forms provided by the 
  9.16  board along with all fees required under section 147D.27 that 
  9.17  includes: 
  9.18     (i) the applicant's name, social security number, home 
  9.19  address and telephone number, and business address and telephone 
  9.20  number; 
  9.21     (ii) a list of degrees received from educational 
  9.22  institutions; 
  9.23     (iii) a description of the applicant's professional 
  9.24  training; 
  9.25     (iv) a list of registrations, certifications, and licenses 
  9.26  held in other jurisdictions; 
  9.27     (v) a description of any other jurisdiction's refusal to 
  9.28  credential the applicant; 
  9.29     (vi) a description of all professional disciplinary actions 
  9.30  initiated against the applicant in any jurisdiction; and 
  9.31     (vii) any history of drug or alcohol abuse, and any 
  9.32  misdemeanor or felony conviction; 
  9.33     (2) submit a diploma from an approved education program or 
  9.34  submit evidence of having completed an apprenticeship program; 
  9.35     (3) submit a verified copy of a valid and current 
  9.36  credential, issued by the North American Registry of Midwives or 
 10.1   other board-approved national organization, as a certified 
 10.2   professional midwife; 
 10.3      (4) submit current certification from the American Heart 
 10.4   Association or the American Red Cross to perform adult and 
 10.5   infant cardiopulmonary resuscitation; 
 10.6      (5) submit a copy of the applicant's medical consultation 
 10.7   plan; 
 10.8      (6) submit documentation verifying that the applicant has 
 10.9   the following practical experience through an apprenticeship or 
 10.10  other supervisory setting: 
 10.11     (i) the provision of 75 prenatal examinations, including 20 
 10.12  initial examinations; 
 10.13     (ii) supervised participation in 20 births; 
 10.14     (iii) participation as the primary birth attendant under 
 10.15  the supervision of a licensed traditional midwife at an 
 10.16  additional 20 births, ten of which must have occurred outside a 
 10.17  state licensed health care facility; 
 10.18     (iv) 20 newborn examinations; and 
 10.19     (v) 40 postpartum examinations; 
 10.20     (7) submit additional information as requested by the 
 10.21  board, including any additional information necessary to ensure 
 10.22  that the applicant is able to practice with reasonable skill and 
 10.23  safety to the public; 
 10.24     (8) sign a statement that the information in the 
 10.25  application is true and correct to the best of the applicant's 
 10.26  knowledge and belief; and 
 10.27     (9) sign a waiver authorizing the board to obtain access to 
 10.28  the applicant's records in this or any other state in which the 
 10.29  applicant has completed an approved education program or engaged 
 10.30  in the practice of traditional midwifery. 
 10.31     Subd. 2.  [LICENSURE BY RECIPROCITY.] To be eligible for 
 10.32  licensure by reciprocity, the applicant must be credentialed by 
 10.33  the North American Registry of Midwives or other board-approved 
 10.34  organization and must: 
 10.35     (1) submit the application materials and appropriate fees 
 10.36  as required under subdivision 1, clauses (1), (3), (4), (5), 
 11.1   (6), (7), (8), and (9); and section 147D.27; 
 11.2      (2) provide a verified copy from the appropriate body of a 
 11.3   current and unrestricted credential for the practice of 
 11.4   traditional midwifery in another jurisdiction that has initial 
 11.5   credentialing requirements equivalent to or higher than the 
 11.6   requirements in subdivision 1; and 
 11.7      (3) provide letters of verification from the appropriate 
 11.8   government body in each jurisdiction in which the applicant 
 11.9   holds a credential.  Each letter must state the applicant's 
 11.10  name, date of birth, credential number, date of issuance, a 
 11.11  statement regarding disciplinary actions, if any, taken against 
 11.12  the applicant, and if the applicant is in good standing in that 
 11.13  jurisdiction. 
 11.14     Subd. 3.  [TEMPORARY PERMIT.] The board may issue a 
 11.15  temporary permit to practice as a traditional midwife to an 
 11.16  applicant eligible for licensure under this section if the 
 11.17  application for licensure is complete, all applicable 
 11.18  requirements in this section have been met, and a nonrefundable 
 11.19  fee set by the board has been paid.  The permit remains valid 
 11.20  only until the meeting of the board at which a decision is made 
 11.21  on the traditional midwife's application for licensure. 
 11.22     Subd. 4.  [LICENSURE BY EQUIVALENCY DURING TRANSITION 
 11.23  PERIOD.] (a) From July 1, 1999, to July 1, 2001, a traditional 
 11.24  midwife may qualify for licensure if the traditional midwife has 
 11.25  engaged in the practice of traditional midwifery in this state 
 11.26  for at least five years in the period from July 1, 1994, to June 
 11.27  30, 1999, and submits documentation verifying the practical 
 11.28  experience described in section 147D.17, subdivision 1, clause 
 11.29  (6).  To be eligible for licensure under this subdivision, the 
 11.30  traditional midwife must also submit the application materials 
 11.31  and the appropriate fees required under subdivision 1, clauses 
 11.32  (1), (4), (5), (6), (7), (8), and (9), and section 147D.27. 
 11.33     (b) Application for licensure under this subdivision must 
 11.34  be submitted to the board between July 1, 1999, and June 30, 
 11.35  2001.  Licensure under this subdivision may be renewed once.  
 11.36  Within a two-year period from the date a license is issued by 
 12.1   the board in accordance with this subdivision, the traditional 
 12.2   midwife must obtain a certification from the North American 
 12.3   Registry of Midwives as a certified professional midwife.  If 
 12.4   certification is not obtained within this time period, the 
 12.5   traditional midwife must obtain a new license by applying for 
 12.6   licensure and fulfilling the requirements then in existence for 
 12.7   obtaining an initial license as a traditional midwife. 
 12.8      Subd. 5.  [LICENSE EXPIRATION.] Licenses issued under this 
 12.9   chapter expire every year. 
 12.10     Subd. 6.  [RENEWAL.] To be eligible for license renewal, a 
 12.11  licensee must: 
 12.12     (1) complete a renewal application on a form provided by 
 12.13  the board; 
 12.14     (2) submit the renewal fee; 
 12.15     (3) provide evidence every three years of a total of 30 
 12.16  hours of continuing education approved by the board as described 
 12.17  in section 147D.21; 
 12.18     (4) submit evidence of an annual review and update of the 
 12.19  licensed traditional midwife's medical consultation plan; and 
 12.20     (5) submit any additional information requested by the 
 12.21  board.  The information must be submitted within 30 days after 
 12.22  the board's request, or the renewal request is nullified. 
 12.23     Subd. 7.  [CHANGE OF ADDRESS.] A licensee who changes 
 12.24  addresses must inform the board within 30 days, in writing, of 
 12.25  the change of address.  All notices or other correspondence 
 12.26  mailed to or served on a licensee by the board at the licensee's 
 12.27  address on file with the board shall be considered as having 
 12.28  been received by the licensee. 
 12.29     Subd. 8.  [LICENSE RENEWAL NOTICE.] At least 30 days before 
 12.30  the license renewal date, the board shall send out a renewal 
 12.31  notice to the last known address of the licensee on file.  The 
 12.32  notice must include a renewal application and a notice of fees 
 12.33  required for renewal.  It must also inform the licensee that 
 12.34  licensure will expire without further action by the board if an 
 12.35  application for license renewal is not received before the 
 12.36  deadline for renewal.  The licensee's failure to receive this 
 13.1   notice shall not relieve the licensee of the obligation to meet 
 13.2   the deadline and other requirements for license renewal.  
 13.3   Failure to receive this notice is not grounds for challenging 
 13.4   expiration of licensure status. 
 13.5      Subd. 9.  [RENEWAL DEADLINE.] The renewal application and 
 13.6   fee must be postmarked on or before July 1 or as determined by 
 13.7   the board.  If the postmark is illegible, the application shall 
 13.8   be considered timely if received by the third working day after 
 13.9   the deadline. 
 13.10     Subd. 10.  [INACTIVE STATUS AND RETURN TO ACTIVE STATUS.] 
 13.11  (a) A license may be placed in inactive status upon application 
 13.12  to the board by the licensee and upon payment of an inactive 
 13.13  status fee.  
 13.14     (b) Licensees seeking restoration to active from inactive 
 13.15  status must pay the current renewal fees and all unpaid back 
 13.16  inactive fees.  They must meet the criteria for renewal 
 13.17  specified in subdivision 6, including continuing education hours 
 13.18  equivalent to one hour for each month of inactive status, prior 
 13.19  to submitting an application to regain licensure status.  If the 
 13.20  inactive status extends beyond five years, a qualifying score on 
 13.21  a credentialing examination, or completion of an advisory 
 13.22  council-approved eight-week supervised practical experience is 
 13.23  required.  If the licensee intends to regain active licensure by 
 13.24  means of eight weeks of advisory council-approved practical 
 13.25  experience, the licensee shall be granted temporary licensure 
 13.26  for a period of no longer than six months. 
 13.27     Subd. 11.  [LICENSURE FOLLOWING LAPSE OF LICENSURE STATUS 
 13.28  FOR TWO YEARS OR LESS.] For any individual whose licensure 
 13.29  status has lapsed for two years or less, to regain licensure 
 13.30  status, the individual must: 
 13.31     (1) apply for license renewal according to subdivision 6; 
 13.32     (2) document compliance with the continuing education 
 13.33  requirements of section 147D.21 since the licensee's initial 
 13.34  licensure or last renewal; and 
 13.35     (3) submit the fees required under section 147D.27 for the 
 13.36  period not licensed, including the fee for late renewal. 
 14.1      Subd. 12.  [CANCELLATION DUE TO NONRENEWAL.] The board 
 14.2   shall not renew, reissue, reinstate, or restore a license that 
 14.3   has lapsed and has not been renewed within two licensure renewal 
 14.4   cycles starting July 1999.  A licensee whose license is canceled 
 14.5   for nonrenewal must obtain a new license by applying for 
 14.6   licensure and fulfilling all requirements then in existence for 
 14.7   initial licensure as a traditional midwife.  
 14.8      Subd. 13.  [CANCELLATION OF LICENSURE IN GOOD 
 14.9   STANDING.] (a) A licensee holding an active license as a 
 14.10  traditional midwife in the state may, upon approval of the 
 14.11  board, be granted licensure cancellation if the board is not 
 14.12  investigating the person as a result of a complaint or 
 14.13  information received or if the board has not begun disciplinary 
 14.14  proceedings against the licensee.  Such action by the board 
 14.15  shall be reported as a cancellation of licensure in good 
 14.16  standing. 
 14.17     (b) A licensee who receives board approval for licensure 
 14.18  cancellation is not entitled to a refund of any license fees 
 14.19  paid for the licensure period in which cancellation of the 
 14.20  license occurred. 
 14.21     (c) To obtain licensure after cancellation, a licensee must 
 14.22  obtain a new license by applying for licensure and fulfilling 
 14.23  the requirements then in existence for obtaining an initial 
 14.24  license as a traditional midwife.  
 14.25     Sec. 10.  [147D.19] [BOARD ACTION ON APPLICATIONS FOR 
 14.26  LICENSURE.] 
 14.27     (a) The board shall act on each application for licensure 
 14.28  according to paragraphs (b) to (d). 
 14.29     (b) The board shall determine if the applicant meets the 
 14.30  requirements for licensure under section 147D.17.  The board or 
 14.31  advisory council may investigate information provided by an 
 14.32  applicant to determine whether the information is accurate and 
 14.33  complete.  
 14.34     (c) The board shall notify each applicant in writing of 
 14.35  action taken on the application, the grounds for denying 
 14.36  licensure if licensure is denied, and the applicant's right to 
 15.1   review under paragraph (d).  
 15.2      (d) Applicants denied licensure may make a written request 
 15.3   to the board, within 30 days of the board's notice, to appear 
 15.4   before the advisory council and for the advisory council to 
 15.5   review the board's decision to deny the applicant's license.  
 15.6   After reviewing the denial, the advisory council shall make a 
 15.7   recommendation to the board as to whether the denial shall be 
 15.8   affirmed.  Each applicant is allowed only one request for review 
 15.9   per licensure period.  
 15.10     Sec. 11.  [147D.21] [CONTINUING EDUCATION REQUIREMENTS.] 
 15.11     Subdivision 1.  [NUMBER OF REQUIRED CONTACT HOURS.] Three 
 15.12  years after the date of initial licensure and every three years 
 15.13  thereafter, a licensee must complete a minimum of 30 contact 
 15.14  hours of board-approved continuing education and attest to 
 15.15  completion of continuing education requirements by reporting to 
 15.16  the board.  At least five contact hours within a three-year 
 15.17  reporting period must involve adult cardiopulmonary 
 15.18  resuscitation and either infant cardiopulmonary resuscitation or 
 15.19  neonatal advanced life support. 
 15.20     Subd. 2.  [APPROVAL OF CONTINUING EDUCATION PROGRAMS.] The 
 15.21  board shall approve continuing education programs that meet the 
 15.22  following criteria: 
 15.23     (1) the program content directly relates to the practice of 
 15.24  traditional midwifery; 
 15.25     (2) each member of the program faculty is knowledgeable in 
 15.26  the subject matter as demonstrated by a degree from an 
 15.27  accredited education program, verifiable experience in the field 
 15.28  of traditional midwifery, special training in the subject 
 15.29  matter, or experience teaching in the subject area; 
 15.30     (3) the program lasts at least one contact hour; 
 15.31     (4) there are specific, measurable, written objectives, 
 15.32  consistent with the program, describing the expected outcomes 
 15.33  for the participants; and 
 15.34     (5) the program sponsor has a mechanism to verify 
 15.35  participation and maintains attendance records for three years. 
 15.36     Subd. 3.  [CONTINUING EDUCATION TOPICS.] Continuing 
 16.1   education program topics may include, but are not limited to, 
 16.2   traditional midwifery care in the prenatal, labor, birth, and 
 16.3   postpartum and newborn periods; assessing contra indications; 
 16.4   care in emergency situations; ethics; and nutrition. 
 16.5      Subd. 4.  [ACCUMULATION OF CONTACT HOURS.] A licensee may 
 16.6   not apply contact hours acquired in one three-year reporting 
 16.7   period to a future continuing education reporting period.  
 16.8      Subd. 5.  [VERIFICATION OF CONTINUING EDUCATION CREDITS.] 
 16.9   The board shall periodically select a random sample of licensees 
 16.10  and require those licensees to supply the board with evidence of 
 16.11  having completed the continuing education to which they 
 16.12  attested.  Documentation may come directly from the licensee or 
 16.13  from state or national organizations that maintain continuing 
 16.14  education records. 
 16.15     Sec. 12.  [147D.23] [DISCIPLINE; REPORTING.] 
 16.16     For purposes of this chapter, licensees and applicants are 
 16.17  subject to the provisions of sections 147.091 to 147.162. 
 16.18     Sec. 13.  [147D.25] [ADVISORY COUNCIL ON TRADITIONAL 
 16.19  MIDWIFERY.] 
 16.20     Subdivision 1.  [MEMBERSHIP.] The board shall appoint a 
 16.21  five-member advisory council on traditional midwifery.  One 
 16.22  member shall be a licensed physician who has been or is 
 16.23  currently consulting with traditional midwives, appointed from a 
 16.24  list of names submitted to the board by the Minnesota Medical 
 16.25  Association.  Three members shall be licensed traditional 
 16.26  midwives appointed from a list of names submitted to the board 
 16.27  by Midwifery Now.  Two members shall be a homebirth parent 
 16.28  appointed from a list of names submitted to the board by 
 16.29  Minnesota Families for Midwifery. 
 16.30     Subd. 2.  [ORGANIZATION.] The advisory council shall be 
 16.31  organized and administered under section 15.059.  The council 
 16.32  expires June 30, 2003.  
 16.33     Subd. 3.  [DUTIES.] The advisory council shall: 
 16.34     (1) advise the board regarding standards for traditional 
 16.35  midwives; 
 16.36     (2) provide for distribution of information regarding 
 17.1   traditional midwifery practice standards; 
 17.2      (3) advise the board on enforcement of this chapter; 
 17.3      (4) review applications and recommend granting or denying 
 17.4   licensure or license renewal; 
 17.5      (5) advise the board on issues related to receiving and 
 17.6   investigating complaints, conducting hearings, and imposing 
 17.7   disciplinary action in relation to complaints against licensed 
 17.8   traditional midwives; 
 17.9      (6) advise the board regarding approval of continuing 
 17.10  education programs using the criteria in section 147D.21, 
 17.11  subdivision 2; and 
 17.12     (7) perform other duties authorized for advisory councils 
 17.13  by chapter 214, as directed by the board. 
 17.14     Sec. 14.  [147D.27] [FEES.] 
 17.15     Subdivision 1.  [LICENSURE FEE.] The license application 
 17.16  fee is $100.  The fee for initial licensure and annual renewal 
 17.17  is $100.  The fee for inactive status is $50.  The fee for a 
 17.18  temporary permit is $75.  
 17.19     Subd. 2.  [PRORATION OF FEES.] The board may prorate the 
 17.20  initial licensure fee.  All licensees are required to pay the 
 17.21  full fee upon license renewal. 
 17.22     Subd. 3.  [PENALTY FEE FOR LATE RENEWALS.] An application 
 17.23  for license renewal submitted after the deadline must be 
 17.24  accompanied by a late fee of $75 in addition to the required 
 17.25  fees. 
 17.26     Subd. 4.  [NONREFUNDABLE FEES.] The fees in this section 
 17.27  are nonrefundable.  
 17.28     Sec. 15.  [REPEALER.] 
 17.29     Minnesota Statutes 1998, sections 148.30; 148.31; and 
 17.30  148.32, are repealed. 
 17.31     Minnesota Rules, parts 5600.2000; and 5600.2100, are 
 17.32  repealed.