UPDATE/MODERNIZE/MIDWIFERY PRACTICE ACT.

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View NCGA Bill Details2013-2014 Session
Senate Bill 499 (Public) Filed Wednesday, March 27, 2013
A BILL TO BE ENTITLED AN ACT TO UPDATE AND MODERNIZE THE MIDWIFERY PRACTICE ACT.
Intro. by Hartsell, Randleman, Stein.

Status: Ref To Com On Health Care (Senate Action) (Mar 28 2013)

Bill History:

S 499

Bill Summaries:

  • Summary date: Mar 27 2013 - View Summary

    Amends GS 90 by adding new section, GS 90-19.7, 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 i.d. number to the nurse-midwife, which appears on the written prescription; (3) written instructions about indications and contraindications for prescribing drugs and a 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, intrapartum care, and primary care. Deletes interconceptional care term and definition. Updates, adds language to, and makes technical and conforming changes to midwifery, newborn care, postpartum care, and prenatal care definitions.

    Amends GS 90-178.3, Regulation of midwifery, as follows.  Requires certified nurse-midwives to practice within a health care system that provides for consultation, collaborative management, or referral. Midwifery standards must be consistent with the standards of care established by the American College of Nurse-Midwives. Each nurse midwife must provide each patient with information regarding or referral to other providers and services at the request of the patient or when requried care is outside the scope of the midwife's practice.

    Amends GS 90-178.4(a), altering the makeup of the subcommitte. Requires that  seven additional members of the subcommittee consist of five certified nurse-midwives  appointed by the recommendation of the NC Affilaite of the Amercian College of Nurse-Midwives and two physicians actively engaged in the practice of obstetrics (was, four additional members, two certified midwives, and two obstetricians who have worked with certified midwives).

    Amends GS 90-178.4, addding a new subsection requiring the subcommittee to adopt rules requiring a certified nurse-midwife that attends a planned birth outside of a hospital to obtain a signed informed consent agreement from the patient. Information about the certified nurse-midwife's liability insurance coverage must be included.

    Amends GS 90-178.5, Qualification for approval, requiring the submittal of certification by the American Midwifery Certification Board (was, American College of Nurse Midwives). Makes other technical and conforming changes.

    Amends GS 90 by adding a new section, 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 mid-wife approved under GS 90 who attends a planned birth outside of a hospital setting. Provides, however, that the nurse, physician, or physician's assistant 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. Provides, however, that the health care facility remains liable for its own independent acts of negligence. Liability is not limited in cases of gross negligence or wanton misconduct.