SB 451

Practice of nurse-midwifery

Under current law, to practice nurse-midwifery a licensed nurse-midwife must

collaborate with and enter into a written agreement with a physician who has

postgraduate training in obstetrics. If a person practicing nurse-midwifery

discovers evidence of any aspect of care that jeopardizes the health or life of a

newborn or mother, the nurse-midwife must either consult with the collaborating

physician with whom the nurse-midwife has entered into a written agreement or

make a referral as specified in the written agreement.

This bill eliminates the requirement that a licensed nurse-midwife collaborate

with and enter into a written agreement with a physician. If a person practicing

nurse-midwifery discovers evidence of any aspect of care that jeopardizes the health

or life of a newborn or mother, a licensed nurse-midwife must consult with a

qualified health care professional or make a referral. The bill defines a qualified

health care professional as a health care practitioner who is performing services

within his or her scope of practice. A health care practitioner is defined under current

law to include an individual who is licensed, registered, or certified by the medical

examining board, the board of nursing, and the pharmacy examining board.

Health care liability coverage

Under the health care liability statutes in current law, certain health care

providers must carry health care liability insurance with specified limits and pay

assessments to the injured patients and families compensation fund (fund). Certain

other health care providers may elect to be subject to the health care liability

statutes, including the insurance and assessment requirements. If a medical

malpractice claim is made against a health care provider who is subject to the health

care liability statutes, or against an employee of such a health care provider, the

portion of the claim that exceeds the limits of the provider's health care liability

insurance is paid on behalf of the provider or provider's employee by the fund.

However, certain employees, called health care practitioners, who are providing

services not in collaboration with a physician or under the direction and supervision

of a physician or nurse anesthetist, are not covered by the fund as employees in the

event that a medical malpractice claim is made against them. Nurse-midwives are

not required to provide services under the direction and supervision of a physician

or nurse anesthetist and since, under the bill, they are no longer required to provide

services in collaboration with a physician, they would not be covered by the fund as

employees. Therefore, the bill modifies the definition of a health care practitioner

to exclude nurse-midwives so that a nurse-midwife is covered by the fund, as under

current law, if he or she is providing services as an employee of a health care provider

who is subject to the health care liability statutes.

In addition, the bill authorizes nurse-midwives to elect to be subject to the

health care liability statutes. If a nurse-midwife elects to be subject to those