FAO Ericka (or anyone else who might know) - reply

Sorry for the out of whack reply, but I don't have a read and post
news server!

Ericka Kammerer wrote:

She might be somewhat confused by the meaning of
"independent." As in all 50 states, CNMs are required to
have a written backup agreement with an OB.

That is not correct. In California, Colorado, Alaska, among other
states that I am aware of but not able to name off the top of my head,
it is not necessary to have a documented agreement with a physician.
In CA CNMs can prescribe medications pertinent to their scope of
practice on their own DEA number, while in CO they can have their DEA
number, but require a back up for prescriptions only.

Kris, formerly of CA and now in CO working with CNMs

hierophant wrote:

Sorry for the out of whack reply, but I don't have a read and post
news server!

Ericka Kammerer wrote:

She might be somewhat confused by the meaning of
"independent." As in all 50 states, CNMs are required to
have a written backup agreement with an OB.

That is not correct. In California, Colorado, Alaska, among other
states that I am aware of but not able to name off the top of my head,
it is not necessary to have a documented agreement with a physician.
In CA CNMs can prescribe medications pertinent to their scope of
practice on their own DEA number, while in CO they can have their DEA
number, but require a back up for prescriptions only.

Wow, that has changed then. It wasn't that long ago
that the ACNM said on their website that all states required
a backup agreement (it doesn't anymore--I just checked). I
stand corrected. Yay for small strides in professional
autonomy! Wish VA would get out of the dark ages...

Best wishes,
Ericka

Ericka Kammerer wrote:

Wow, that has changed then. It wasn't that long ago
that the ACNM said on their website that all states required
a backup agreement (it doesn't anymore--I just checked). I
stand corrected. Yay for small strides in professional
autonomy! Wish VA would get out of the dark ages...

Sorry to have a lousy way of posting... I have to wait until it hits
Google to do it!

The chart is there http://www.midwife.org/legis/display.cfm?id=209#13:

TABLE 13: State Laws Governing the Relationship between CNMs and
Physicians*
States with Physician Supervision/Direction Language (n = 12)

CA, CT, FL, ID, IL3, LA, MA3, NC, SC1,2, SD, VA, WI

States with Physician Collaboration, Consultation and Referral
Language (n = 28)

AL, AZ, AR, CO2, DE, HI1, IN, IA, KY, MD, MS, MO, MT, NE2, NV, NJ,
NM, NY, ND1, OH, OK, PA, RI, TX, UT, VT, WV, WY

States with No Specific Statutory/Regulatory Language Governing the
Relationship between CNMs and Physicians (n = 11)

AK, DC, GA, KS1, ME, MI1, MN, NH, OR, TN1, WA

July 2001

Notes
* No state practice act requires a physician's physical presence at
births attended by CNMs/CMs practicing within their defined scope of
practice.
1 Physician supervision or collaboration is required for CNMs
exercising prescriptive authority.
2 Physician supervision is required for CNMs performing "medical
functions" that are outside the scope of CNM practice.
3 Statute requires collaboration, which is defined to include
physician direction and supervision.

---

In CA for example there is language about the requirement of a
supervising physician, but it isn't required on paper (as far as I can
tell on any of the state documents). The CA CNM I worked with did
have a written back up, but it was her choice; the other CNM I worked
with had a verbal.

The chart was made in 2001 and since then Colorado has changed it's
regulations for CNMs to provide autonomy. So it is likely there have
been other states with changes.

Anyway, sorry to post and run due to Googling my conversation

Kris

That is not correct. In California, Colorado, Alaska, among other
states that I am aware of but not able to name off the top of my head,
it is not necessary to have a documented agreement with a physician.
In CA CNMs can prescribe medications pertinent to their scope of
practice on their own DEA number

Many insurance companies may still require an OB backup/affiliation in
order for a birth center or homebirth to be fully covered, though (at
least that was the case for our California insurance).


Mary S.
mom to the Sproutkin
and a new wee babysprout, due Oct. 1

hierophant wrote:

Ericka Kammerer wrote:


Wow, that has changed then. It wasn't that long ago
that the ACNM said on their website that all states required
a backup agreement (it doesn't anymore--I just checked). I
stand corrected. Yay for small strides in professional
autonomy! Wish VA would get out of the dark ages...


Sorry to have a lousy way of posting... I have to wait until it hits
Google to do it!

The chart is there http://www.midwife.org/legis/display.cfm?id=209#13:

TABLE 13: State Laws Governing the Relationship between CNMs and
Physicians*
States with Physician Supervision/Direction Language (n = 12)

CA, CT, FL, ID, IL3, LA, MA3, NC, SC1,2, SD, VA, WI

Ha! Why doesn't it surprise me to find VA in
the most restrictive category :-P I'm heartened to see
the rise in autonomy for CNMs! Here's hoping there's
more to come, for CNMs and DEMs.

Best wishes,
Ericka