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While we’ve been working on making sure all women in California have access to the care of licensed midwives, ACOG has been throwing up roadblocks.
We need your calls - and your clients’ calls - now to counter ACOG’s influence in Sacramento.
Please share and forward this message with your friends, neighbors, and clients.
1.Click here to find your Assemblymember.
2.If they are on Assembly Business and Professions (see below) then ask them to “please vote yes for SB407”
3.If they are NOT on Assembly Business and Professions, please call and ask them to “please ask your colleagues on Business and Professions to vote in support of this bill.”
We need to pack the hearing room with supporters next Tuesday. No legislative experience necessary! Your main job is being there, showing legislators how many people care about access to licensed midwives.
To RSVP and for additional details, please contact firstname.lastname@example.org
According to ACOG, midwives aren’t qualified to coordinate care for the CPSP. The CPSP program provides Medi-Cal recipients with enhanced services in the areas of nutrition, psychosocial and health education. The role of the CPSP coordinator is to make referrals and follow up.
As you know, midwives receive expert training in identifying the needs of their clients and referring to community resources where needed. Collaborative, coordinated care is a hallmark of midwifery care.
This is just a diversion from what truly matters - ensuring that ALL pregnant women have the option to choose a licensed midwife, regardless of income.
SB407 is a key part of our strategy to extend Medi-Cal coverage to licensed midwives. We just had a major victory yesterday: we passed unanimously out of the Assembly Health committee, even with ACOG opposition. This was thanks to your calls! We also added a new sponsor: Senator Holly Mitchell, (D) 30.
The bad news: ACOG said they plan to further increase their opposition to the bill before next Tuesday’s vote in Assembly Business and Professions.
Please call and share this post today!
Susan Bonilla (Chair) (916) 319-2014
Brian W. Jones (Vice Chair) (916) 319-2071
Catharine B. Baker (916) 319-2016
Richard Bloom (916) 319-2050
Nora Campos (916) 319-2027
Ling Ling Chang (916) 319-2055
Bill Dodd (916) 319-2004
Susan Talamantes Eggman (916) 319-2013
Mike Gatto (916) 319-2043
Chris R. Holden (916) 319-2041
Kevin Mullin (916) 319-2022
Philip Y. Ting (916) 319-2019
Scott Wilk (916) 319-2038
Jim Wood (916) 319-2002
So far, our bill for the Comprehensive Perinatal Services Program (CPSP) - a key piece of our Medi-Cal strategy - has already passed the Senate and is now in the Assembly. We have a strong chance of victory!
But ACOG has said they are planning to wage their battle against the legislation in the Assembly Health committee. Our bill - SB 407 - has been slated for a vote in just one week.
Medi-Cal coverage could dramatically expand insurance coverage for California Families:
Currently, 49% of pregnant women in California are insured by Medi-Cal. This means that nearly half of all families don’t have coverage for licensed midwives.
Private insurers look to Medi-Cal to decide what services they should cover in the health plans provided by employers or purchased by families. This means that Medi-Cal coverage could equal access to midwifery care for even more families in our state.
CAM believes that every family deserves access to the nurturing, hands-on care that a midwife provides.
Please forward this post to your friends, family, and clients in your area and ask them to take action now!
Quick Action Steps
Find your legislator here.
If your representative is on the Assembly Health committee, please ask them to vote YES on SB 407. (See below for members of Assembly Health)
If your representative is NOT on the Assembly Health committee, please ask that they encourage their colleagues on the Assembly Health committee to vote YES on SB 407.
Once you’ve called, please let us know HERE on Facebook that you’ve called and who you called. Thank you!
Calls take less than 5 minutes. You don’t need to be an expert to call and it is MUCH easier than you think. Need quick tips? Check here.
Join us at the hearing!
If you or anyone you know would like to join us June 23rd in Sacramento at the hearing, please email email@example.com for details.
Assemblyperson Rob Bonta
Email: Contact Assembly Member Rob Bonta
Assemblyperson Brian Maienschein
Email: Contact Assembly Member Brian Maienschein
Assemblyperson Susan Bonilla
Email: Contact Assembly Member Susan Bonilla
Assemblyperson Autumn Burke
Email: Contact Assembly Member Autumn R. Burke
Assemblyperson Rocky Chávez
Email: Contact Assembly Member Rocky J. Chávez
Assemblyperson David Chiu
Email: Contact Assembly Member David Chiu
Assemblyperson Jimmy Gomez
Email: Contact Assembly Member Jimmy Gomez
Assemblyperson Lorena Gonzalez
Email: Contact Assembly Member Lorena Gonzalez
Assemblyperson Roger Hernández
Email: Contact Assembly Member Roger Hernández
Assemblyperson Tom Lackey
Email: Contact Assembly Member Tom Lackey
Assemblyperson Adrin Nazarian
Email: Contact Assembly Member Adrin Nazarian
Assemblyperson Jim Patterson
Email: Contact Assembly Member Jim Patterson
Assemblyperson Sebastian Ridley-Thomas
Email: Contact Assembly Member Sebastian Ridley-Thomas
Assemblyperson Freddie Rodriguez
Email: Contact Assembly Member Freddie Rodriguez
Assemblyperson Miguel Santiago
Email: Contact Assembly Member Miguel Santiago
Assemblyperson Marc Steinorth
Email: Contact Assembly Member Marc Steinorth
Assemblyperson Tony Thurmond
Email: Contact Assembly Member Tony Thurmond
Assemblyperson Marie Waldron
Email: Contact Assembly Member Marie Waldron
Assemblyperson Jim Wood
Email: Contact Assembly Member Jim Wood
About half of all birthing families in California are eligible for Medi-Cal.
Now, a major victory takes us one step closer to making those families eligible to receive coverage for a licensed midwife in California.
Yesterday, senior staff at the Dept of Health Care Services (DHCS) met with CAM representatives. In the meeting, DHCS officially acknowledged that there is no statutory barrier to Licensed Midwives enrolling as Medi-Cal providers independently from a physician or clinic. After 18 months of advocacy efforts to make this happen, we are thrilled!
There are still administrative steps needed to overcome this hurdle. CAM will be tracking these closely and working with DHCS to remove these barriers and we will keep you up-to-date.
Passage of SB407 will provide expectant families with Medi-Cal coverage for a key element of care during pregnancy (the CPSP program, learn more here).
1) Find your State Senator here.
2) Call your senator today.
Ask them to “ask the appropriations committee to vote yes on SB 407.”
NOTE: Is your legislator on the appropriations committee? (See our list below). Instead ask them "vote yes on SB 407." Your legislator is especially important - please ask your neighbors to call as well!
(Click here for our quick guide to calling your legislator)
3) Tell us who you called here on Facebook.
4) Share this blog post and this Facebook post with your friends.
Senator Ricardo Lara (Chair)
Senator Patricia Bates (Vice Chair)
Senator Jim Beall
Senator Jerry Hill
Senator Connie Leyva
Senator Tony Mendoza
Senator Jim Nielsen
Cities in this district include Rancho Santa Margarita, Mission Viejo, Laguna Hills, Laguna Niguel, Aliso Viejo, Dana Point, San Juan Capistrano, San Clemente, Oceanside, Vista, Carlsbad, and Encinitas.
Senator Jim Beall district includes: a large portion of Santa Clara County, stretching from Cupertino east to Mount Hamilton and from Los Gatos north to San Jose’s Alum Rock District. The cities of Cupertino, Los Gatos, Campbell, Saratoga, Monte Sereno, and the San Jose communities of Willow Glen, Almaden, Evergreen, East San Jose, and Downtown are included within the district.
The district also contains vast rural expanses of unincorporated areas that extend to the Santa Cruz Mountains and the Stanislaus County border.
Senator Jerry Hill district includes: San Mateo County south of SD 11 and northern Santa Clara County, including the sister cities of Mountain View and Sunnyvale. This district keeps the San Mateo coastline from Pacifica to the Ano Nuevo State Reserve and peninsula cities from South San Francisco to Sunnyvale together. South San Francisco is the only city split to achieve population equality.
Senator Connie Leyva district includes: Pomona, Chino, Montclair, Ontario, Fontana, Bloomington, Rialto, Colton, Grand Terrace, and San Bernadino.
Senator Tony Mendoza district includes: Commerce, Montebello, Pico Rivera, Downey, Santa Fe Springs, Whittier, Hacienda Heights, La Habra Heights, La Miranda, Norwalk, Bellflower, Artesia, Cerritos, Buena Park, Lakewood, Hawaiian Gardens
Senator Jim Nielsen district includes: Manton, Paynes Creek, Mineral, Mill Creek, Red Bluff, Proberta, Gerber, Tehama, Corning, Flournoy, Vina, Forest Ranch, Orland, Chico, Magalia, Hamilton City, Paradise, Elk Creek, Artois, Durham, Berry Creek, Willows, Glenn, Nelson, Strawberry Valley, Clipper Mills, Richvale, Thermalito, Challenge, Butte City, Palermo, Camptonville, Princeton, Biggs, Rackerby, Bangor, Gridley, Oregon House, Dobbins, Maxwell, Live Oak, Browns Valley, Colusa, Smartsville, Williams, Sutter, Wheatland, Sheridan, Rio Oso, Robbins, Pleasant Grove, and Nicolaus
CAM's legislative agenda was designed to support you as a California licensed midwife. Our legislative work means additional costs, including travel to Sacramento, expert advice, and more.
Even small donations will make a big difference. Please consider a contribution today!
Click here to DONATE NOW
California families want to be able to choose midwifery care, but a lack of insurance coverage (including Medi-Cal) and a shortage of providers limits access.
Two bills can help and are making their way through the legislature now. Your calls and support have helped both bills clear important hurdles.
Your calls - and calls from your clients - are more important than ever. Without your support, these bills will not pass the Senate.
If passed, SB 407 will expand the Comprehensive Perinatal Services Program to reimburse licensed midwives and is a critical step in our strategy to secure Medi-Cal coverage. Because private insurers look to Medi-Cal to decide what services to cover, this strategy has the capacity to impact nearly *all* women in California.
SB 408 will, if passed, allow a 'midwife assistant' to legally assist a licensed midwife at a birth center or home birth. This bill will expand access to midwifery care, particularly in rural or underserved areas, by expanding the reach of existing providers. As two providers typically attend each birth, allowing a 'midwife assistant' (instead of another licensed midwife) could double capacity.
Please take just a few moments to help California families access licensed midwives.
Four easy steps:
One: find your legislator here.
Two: Please call your senators today and ask them to “vote yes to help families access midwives: vote yes for SB 407 and SB 408.” (Click here for our quick guide to calling your legislator)
Three: Tell us who you called here on Facebook.
Four: Share this blog post and this Facebook post with your friends, family, and clients.
Together we can expand access to midwifery care in California. Thank you!
Thank you for your efforts to increase access to midwives in California!
Here are tools you can use to reach California State legislators.
Click here to find your legislator.
Click here to download tips for for contacting your legislator.
Click here to learn more about our current legislative agenda to expand access to midwifery care in California.
We are very pleased to report that thanks to all of your phone calls and emails, SB 408, the bill to legally authorize Midwife Assistants to practice, passed unanimously out of committee and is headed to the Senate Appropriations Committee. Thank you to everyone who helped make this victory happen!
But our work is not over. Sister bill SB 407, which will authorize reimbursement for Licensed Midwives who provide prenatal care to women covered by Medi‐Cal, is in jeopardy.
We need you to call or email you State Senator in support of SB 407 TODAY!
To find your State Senator and how to contact them, click here.
Please take a few moments today to call your State Senator’s office and ask them to support SB 407 to authorize Licensed Midwives to provide care through the Comprehensive Perinatal Services Program for women covered by Medi‐Cal. Once you've called, please come show your support by leaving a comment on our Facebook post here.
As you are reading this message, physician opposition to SB 407 continues to mount.
Why? According to Big Medicine, midwives are not qualified to coordinate prenatal care to healthy women because . . . wait for it . . . midwives are not obstetricians, specialists in providing high‐risk and surgical care to women experiencing complicated pregnancies.
If you agree that women experiencing healthy pregnancies should not be limited to OB care and deserve access to midwives, please take a few moments today to call your State Senator’s office and ask them to support SB 407.
For those of you who live near Sacramento, please SAVE THE DATE!
Join us on Wednesday, April 15, at 1:30 pm at the State Capitol in the John L. Burton Hearing Room (4203) to stand in support of SB 407. Plan to attend? Please RSVP to firstname.lastname@example.org.
Legislation Will Expand Pregnancy Care Options for Medi-Cal Patients; Increase Access To Midwifery in Areas With Limited Providers
In an effort to expand health care options for pregnant women in California, two new bills were introduced today. The first, SB407, will expand pregnancy care options for families on Medi-Cal by including licensed midwife services under a component of the program. The bill is authored by Senator Mike Morrell, R-Rancho Cucamonga, co-authored by Senator Lois Wolk, D-Davis, and sponsored by the California Association of Midwives.
A second bill, SB408, will expand midwifery care – particularly in rural and other underserved areas – by allowing ‘midwife assistants’ to legally assist licensed midwives at births. Typically, two providers attend each birth, but licensed midwives are scarce in some areas of the state. This bill would allow a specially trained ‘midwife assistant’ to legally assist a licensed midwife, expanding the reach of existing providers. The bill is authored by Senator Mike Morrell, R-Rancho Cucamonga and sponsored by the Medical Board of California.
Get the full update here.
October 26, 2014: Interview with Sarah Davis, CAM Legislative Chair
Rosanna: Sarah, what happened at the medical board meeting this week that is news for California Midwives?
Sarah: The Medical Board meeting took place on Thursday and Friday, and was attended by myself and several other licensed midwives, and a student midwife. As usual, most of the agenda did not pertain directly to the midwifery program, as the Medical Board licenses physicians and since there are far more physicians than midwives, there are more committees, proposals, enforcement actions, etc relating to physicians than midwives.
Carrie Sparrevohn, chair of the Midwifery Advisory Council, which operates under the Medical Board, gave her report. She did not have any action items to present to the full Medical Board at this meeting.
Here is a link to her report, as submitted for materials for the meeting:
Medical Board legislative director Jennifer Simoes presented a proposal regarding midwife assistants. The proposal is a change to the law that would require a bill in the legislature. CAM supports this proposal, and in fact we worked on the language several years back, which was tweaked by Carrie and the Medical Board staff earlier this year.
When we are discussing midwife assistants for purposes of this proposal, we aren't discussing a person who only cleans up, carries equipment, etc. We are discussing a midwife assistant who performs some basic technical and clinical tasks.
Current law only allows two categories of people to assist an LM:
1. another midwife with her/his own California license (LM or CNM)
2. a student midwife who is enrolled in a Medical Board approved midwifery school and is directly supervised by the LM at all times.
This proposal will allow people who do not fall into either of those categories to become a midwife assistant by obtaining and documenting training. This will be beneficial to many midwives, particularly those in more rural areas, and areas with few midwives.
The Medical Board approved this proposal with no questions or concerns. The next step is for Medical Board staff to take the proposal to the legislature. So, this definitely isn't happening overnight, but it the wheels are turning.
Rosanna: Is it possible to see the language for the proposed midwife assistant legislation?
Yes! It is available as a publicly viewable document on the Medical Board's website, in the materials for the August Midwifery Advisory Council meeting.
Rosanna: There was some discussion on Facebook about this the last couple of days. What were some of the questions and discussion there?
We received some great questions and comment on Facebook. It came to my attention that many people aren't aware that there are currently only the two categories of assistants I mentioned above. Because they weren't aware of that situation, it seemed like further defining midwife assistants would create barriers to people becoming midwife assistants. Actually, because existing law is restrictive on who can currently assist, a change in law like this proposal will actually increase the pool of people who can be midwife assistants.
Another great question that came up is whether an expensive certification program will be required, as well as registration or licensing for the midwife assistant. The answer to all these questions is no. The Medical Board would have to further define the training required, but the intention (and the medical assistant model) is to allow the assistant to be trained by an individual licensed midwife or in a course or workshop.
Thanks to our engaged Facebook audience for these questions!
I also want to thank Karen Ehrlich for attending almost every Medical Board meeting over the last few years, and reporting back to CAM. We appreciate it!
Rosanna: Sarah, thanks for keeping us all informed, up to date and representing the interests of California Licensed Midwives and Families
Other news: please join us on CALMidwives@yahoogroups.com, a yahoo group for CAM member midwives and students. Send an email to Rosanna at email@example.com to join the group.
The regulation process, related to AB1308, moved forward this week with an expected Interested Parties Meeting in Sacramento at the Medical Board of California.
CAM was represented at the meeting by Constance Rock LM, Sarah Davis LM, Rosanna Davis LM, Rebekah LakeLM , Madeleine Shernock SM, Diana Vallarta LM and Lora Hart SM.
Members of the Midwifery Advisory Council, Faith Gibson (of CCM), individual midwives, consumer group representatives, ACOG representatives and MBC staff were among the attendees.
Madeleine Shernock, student midwife and CAM Region 5 Co-rep attended the meeting and gave her own account: read about it here.
Sarah Davis and Constance Rock, legislative representatives for CAM gave an overview of the meeting, on a conference call, Sunday October 19. Listen to the recording here. Listen to the call here.
The medical board reports it will publish an audio recording of the meeting within a couple of weeks.
The next interested parties meeting is expected to be in December. Check the medical board website for the most up to date information for meetings and recordings. Medical Board of California, scroll page to find previous events.
Also, recordings are being up-loaded to You Tube at Rosanna Davis' Channel.
Midwifery Law in California as of January 1, 2014
As of January 1, 2014, with the passage of California Assembly Bill No. 1308, the responsibilities and rights of Licensed Midwives in California were amended. While midwives in California have been able to obtain licensure through the Medical Board of California since 1995, the Licensing Law also required Licensed Midwives to obtain physician supervision. Supervision by a physician was untenable and created an obstacle to practicing midwifery legally as well as to accepting state-sponsored health insurance, or Medi-Cal.
With the implementation of AB1308, Licensed Midwives in California are no longer required to obtain physician supervision. Additionally, the law clarified that Licensed Midwives could “directly obtain supplies and devices, obtain and administer drugs and diagnostic tests, order testing, and receive reports that are necessary to the practice of midwifery and consistent with his or her scope of practice.” Finally, the law clarified Licensed Midwives’ Scope of Practice to define Normal pregnancy and childbirth as meeting all of the following conditions:
1. There is an absence of any preexisting maternal disease or condition likely to affect the pregnancy.
2. There is an absence of significant disease arising from the pregnancy.
3. There is a singleton fetus.
4. There is a cephalic presentation.
5. The gestational age of the fetus is greater than 37 0⁄7 weeks and less than 42 0⁄7 completed weeks of pregnancy.
6. Labor is spontaneous or induced in an outpatient setting.
Currently, Licensed Midwives are held by the Medical Board to the STANDARD OF CARE FOR CALIFORNIA LICENSED MIDWIVES. The editing of these standards of care is currently taking place, as of this writing, to adhere to the changes in statute created by AB1308. For up-to-date information about Licensed Midwives’ Requirements for Licensure and the Scope of Practice for a Licensed Midwife, visit: http://www.mbc.ca.gov/Licensees/Midwives/Midwives_Practice_Act.aspx
Kayti Buehler, LM, CPM