Political Pulse: State Senate Defeats Lay-Midwifery Licensing Proposal!
The Maine State Senate on Friday defeated the majority report on L.D. 2253 that would have licensed lay-midwives in the state and given them a scope of practice determined principally by their national certifying organization. On a vote of 24 to 11, the Senate rejected the majority report of the Committee on Business, Research & Economic Development and then proceeded to adopt the minority report by the same margin. Later in the day, the House of Representatives, which had previously adopted the majority report by a 30 vote margin, receded and concurred with the Senate action, all but ensuring that the minority report will be enacted and signed into law this coming week.
The minority report rejects licensing but does allow midwives to have access to a limited list of medications to use during home births. MMA and many other medical organizations had opposed licensing, believing that licensing would lead to confusion with certified nurse midwives (CNM's) and would falsely imply that the state had ensured the safety of home births attended by lay midwives.
The legislature is expected to adjourn by the end of the coming week, but must first deal with the Dirigo Health legislation (L.D. 2247) and approximately 150 other bills.
1. Direct entry or "lay" midwife licensing
The legislative action on L.D. 2253 ends at least temporarily the effort by midwives to seek increased stature in the state through licensing. The effort in Maine was also a continuation of a national effort which has seen the midwives gain licensure in 24 states, including both New Hampshire and Vermont. Despite the Department of Professional & Financial Regulation recommending against licensure in its "Sunrise Review" report, a bare majority of the Business, Research & Economic Development Committee voted to proceed with licensing through the existing Board of Complementary Health Care Providers. That Board currently licenses naturopathic doctors and acupuncturists.
The grassroots lobbying associated with the midwives effort was intense with several Senators reporting dozens of calls and contacts by midwives and women who had give birth at home attended by midwives. MMA's efforts were complemented by the work of the Maine chapter of ACOG, the Maine Academy of Family Physicians, the Maine Chapter of the American Academy of Pediatrics, the Maine Chapter of the American College of Emergency Physicians, the Maine Association of Psychiatric Physicians, and the Maine Osteopathic Association. In the later weeks, the Maine Association of Nurse Practitioners also assisted in the effort to oppose licensing. MMA also received addition funds to assist in the lobbying effort from both the Maine Chapter of ACOG and the AMA's Scope of Practice Partnership.
The following is a list of the 24 State Senators who voted to reject licensing. Please take the time to thank them for their effort at protecting the mothers and infants of Maine. If your Senator is not on this list, he or she supported the midwives: Senators Benoit, Brannigan, Bryant, Courtney, Diamond, Dow, Gooley, Hastings, Hobbins, Marrache, McCormick, Mills, Nass, Nutting, Perry, Plowman, Raye, Rosen, Savage, Sherman, Smith, Snowe-Mellow, Turner, and Weston.
In an article in the Bangor Daily News this weekend, a spokesperson for the midwives vows to continue in Maine the effort to become licensed, presumably in the next session of the legislature which convenes in December of 2008.
You can find the legislative history of L.D. 2253, An Act to License Certified Professional Midwives, including the roll call votes, on the web at: http://janus.state.me.us/legis/LawMakerWeb/summary.asp?ID=280028293.
2. Toxics Bill Now in Senate After Passing House Without Debate
The majority "ought to pass as amended report" (9-4) on L.D. 2048, An Act to Protect Children's Health & the Environment from Toxic Chemicals in Toys and Children's Products passed the House without debate last Wednesday, April 9, 2008. The bill is awating Senate action this week.
The majority report authorizes the DEP to include on a list of chemicals of high concern chemicals identified by specific entities. Prior to designating priority chemicals, the DEP is required to consult with affected industries, independent experts, and other interested parties and with the Maine CDC. It authorizes the BEP to adopt rules restricting the sale of children's products containing priority chemicals if safer alternatives are available. It authorizes DEP to designate mercury or a mercury compound as a priority chemical for the purpose of adopting rules to prohibit the sale of a mercury-added product that is not currently regulated.
The minority report recommends a Resolve directing the DEP to work with the Maine CDC to develop a list of chemicals of high concern and to convene a stakeholder group to gather recommendations on the list. It also requires the 2 state agencies to consult with various federal agencies to help identify areas where state action is practical and necessary. Finally, it requires the 2 agencies to report back to the legislature on their efforts.
The MMA Public Health Committee has been actively engaged in supporting this bill.
3. Dirigo Health Bill Remains Tabled in the House
L.D. 2247, An Act to Continue Maine's Leadership in Covering the Uninsured is tabled as unfinished business in the House. With all House Democrats on the IFS Committee supporting the majority report, including the replacement of the "savings offset payment" (SOP) with a 1.8% health access surcharge, likely will pass the House. The bill also includes a $0.50 per pack increase in the cigarette excise tax as part of the funding package. These proposals will be much more controversial in the Senate where members of the Democratic caucus are looking for alternative funding mechanisms, including new soda and snack taxes, alcohol taxes, or money from the Fund for a Healthy Maine. The MMA and other members of Health Policy Partners of Maine (including the Maine Coalition on Smoking or Health) oppose taking money from the Fund for a Healthy Maine for Dirigo funding. Senators Bill Diamond (D-Windham) and Barry Hobbins (D-Saco) seem to be the leading proponents of this effort. The MMA urges physicians concerned about the potential further diversion of funds from the FHM's prevention priority to call members of the Senate on the toll free line this week: 1-800-423-6900. You also can find their contact information on the web at: http://www.maine.gov/legis/senate/senators/index.htm.
4. Legislative Committee Conference Call
The next Legislative Committee conference call is scheduled for tomorrow evening, April 15th at 7 p.m. The conference call number is 1-800-989-2842 and the access code is 6223374#.
5. Legislative Schedule and Other Resources
The Legislature's statutory adjournment deadline is Wednesday, April 16, 2008, but it is likely to take most of this week for legislators to complete their work.
You can find more legislative information on the Maine State Legislature's web site: http://janus.state.me.us/legis.