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  • Summary date: May 21 2014 - View Summary

    Amends GS Chapter 90 by adding new section, GS 90-18.7, Limitations on nurse-midwives, providing that nurse-midwives approved under Article 10A of GS Chapter 90 may use the title certified nurse-midwife. Others that hold themselves out as such are in violation. Certified nurse-midwives are authorized to write prescriptions if (1) the individual has been approved by the joint subcommittee of the North Carolina Medical Board and the Board of Nursing (subcommittee) established under GS 90-178.4; (2) the subcommittee has assigned an identification number to the nurse-midwife, which appears on the written prescription; (3) written instructions about indications and contraindications for prescribing drugs and policy for periodic review of the drugs prescribed have been provided to the nurse-midwife by the subcommittee. Directs the subcommittee to adopt rules for approving individual nurse-midwifes to write prescriptions, with any limitations deemed in the best interest of patient health and safety.

    Amends GS 90-178.2, Definitions, by adding and defining certified nurse-midwife, collaborating provider, and collaborating provider agreement. Updates, adds language to, and makes technical and conforming changes to interconceptual care, midwifery, newborn care, postpartum care, and prenatal care definitions.

    Amends GS 90-178.3, Regulation of midwifery, to provide that a certified nurse mid-wife approved under this Article (Article 1, GS Chapter 90) must consult, collaborate with, or refer a patient to other providers licensed under this Article, if indicated by the health status of the patient. Authorizes a certified nurse-midwife approved under this Article to write drug prescriptions in accordance with GS 90-18.7(b).

    Requires a certified nurse-midwife with less than 24 months and 2,400 hours of practice (1) to have a collaborative provider agreement with a collaborating provider and (2) to maintain signed and dated copies of the collaborative provider agreement as required by practice guidelines and any rules adopted by the joint subcommittee of the North Carolina Medical Board and the Board of Nursing. Provides that if a provider agreement is terminated before the certified nurse-midwife attains the level of experience required under this Article, then the certified nurse-midwife has 90 days from the termination date to enter into a new collaborative provider agreement. Permits the certified nurse-midwife to continue to practice midwifery as defined under this Article during the 90-day period.

    Amends GS 90-178.4(a) regarding the membership and qualifications of the appointees to the joint subcommittee of the North Carolina Medical Board and the Board of Nursing created under GS 90-18.2.

    Enacts new subsection (a1) to GS 90-178.4 to require that a certified nurse-midwife who attends a planned birth outside of a hospital setting, (1) obtain a signed informed consent agreement from the patient and (2) provide the patient with a detailed, written plan for emergent and nonemergent transfer. Specifies content that must be included in the informed consent agreement and that which must be included in the written plan for emergent and nonemergent transfer.                                                                                                                                                      

    Midwifery standards must be consistent with the standards of care established by the American Midwifery Certification Board. Amends GS 90-178.5, Qualification for approval, requiring a person seeking approval of certification under this Article to submit evidence of certification by the American Midwifery Certification Board (under current law, American College of Nurse Midwives) and of a collaborative provider agreement. Authorizes a certified nurse-midwife who submits evidence to the joint subcommittee of having completed 24 months and 2,400 hours of practice under a collaborative provider agreement to practice midwifery independently .

    Amends GS 90-178.7, Enforcement, to provide that any person practicing midwifery without being approved and registered in as required under this Article is prohibited from maintaining any action to collect any fee for midwifery services. Makes practicing midwifery without meeting the standards and requirements in this Article guilty of a Class 3 misdemeanor. Makes it a Class I felony to falsely represent oneself as having met the requirements and been approved as a certified nurse-midwife under this Article.

    Enacts new GS 90-178.8, Limit vicarious liability, limiting the liability of physicians, physician assistants, or nurses licensed under GS 90 from being held liable for civil damages as a result of medical care given to a woman or infant in an emergency situation when the emergency situation arises during the delivery or birth of the infant as a consequence of care provided by a nurse midwife approved under GS Chapter 90, who attends a planned birth outside of a hospital setting. However, provides that the physician, physician assistant, or nurse remains liable for his or her own independent acts of negligence.  Also limits the liability of health care facilities licensed under GS 122C and 131E in the same manner. However, provides that the health care facility remains liable for its own independent acts of negligence. Additionally, provides that liability is not limited in cases of gross negligence or wanton misconduct.

    Makes other technical and conforming changes. Effective when this act becomes law.