A person who violates this chapter is guilty of a class B misdemeanor.
The board shall meet twice annually and may hold special meetings at the call of the chair or on the written notice of two board members.
The department shall set fees under AS 08.01.065 to implement this chapter.
If a certified direct-entry midwife seeks to consult with or refer a patient to a licensed physician, the responsibility of the physician for the patient does not begin until the patient is physically within the physician's care.
AS 44.62 (Administrative Procedure Act) applies to regulations and proceedings under this chapter.
Except as provided in AS 08.65.170 , a person who is not certified under this chapter as a direct-entry midwife may not practice midwifery for compensation.
A person who is not certified under this chapter or whose certification is suspended or revoked, or whose certification has lapsed, who knowingly uses in connection with the person's name the words or letters 'C.D.M.,' 'Certified Direct-Entry Midwife,' or other letters, words, or insignia indicating or implying that the person is certified as a direct-entry midwife by this state or who in any way, orally or in writing, directly or by implication, knowingly holds out as being certified by the state as a direct-entry midwife in this state is guilty of a class B misdemeanor.
The board shall conduct examinations at least once each year. Examinations may be written, oral, or practical or a combination of these. The board shall utilize the examination provided by a nationally certified midwives organization recognized by the board. An applicant who has failed the examination may not retake the examination for a period of six months. An applicant who has failed the examination more than one time may not retake the examination unless the applicant has participated in or successfully completed further education and training programs as prescribed by the board. The board may require an applicant to pass an examination about Alaska laws that are applicable to the profession of direct-entry midwives.
A certificate issued under AS 08.65.050 or 08.65.070 expires on a date determined by the board and may be renewed every two years upon payment of the required fee and the submission of evidence satisfactory to the board that the certified direct-entry midwife has met the continuing education requirements of the board, has demonstrated continued practical professional competence under regulations adopted by the board, and has not committed an act that is a ground for discipline under AS 08.65.110 .
In this chapter,
(1) 'board' means the Board of Certified Direct-Entry Midwives;
(2) 'department' means the Department of Commerce, Community, and Economic Development;
(3) 'practice of midwifery' means providing necessary supervision, health care, and education to women during pregnancy, labor, and the postpartum period, conducting deliveries on the midwife's own responsibility, and providing immediate postpartum care of the newborn; 'practice of midwifery' includes preventative measures, the identification of physical, social, and emotional needs of the newborn and the woman, and arranging for consultation, referral, and continued involvement when the care required extends beyond the abilities of the midwife, and the execution of emergency measures in the absence of medical assistance, as specified in regulations adopted by the board.
This chapter does not apply to a person
(1) who is licensed as a physician in this state;
(2) who is licensed as a certified nurse midwife by the Board of Nursing in this state;
(3) who is practicing midwifery on June 26, 1992, and who receives compensation for services if the person's cultural traditions have included, for at least two generations, the attendance of lay midwives at births, and if the person has attended at least 10 births;
(4) whose cultural traditions have included, for at least two generations, the attendance of midwives at births, who accepts compensation for the practice of midwifery if the person has assisted another in at least 10 births and the person assisted is excluded from registration under this section or is a certified direct-entry midwife, physician, nurse midwife, or public health nurse.
The board shall issue a certificate to practice direct-entry midwifery to a person who
(1) applies on a form provided by the board;
(2) pays the fees required under AS 08.65.100 ;
(3) furnishes evidence satisfactory to the board that the person has not engaged in conduct that is a ground for imposing disciplinary sanctions under AS 08.65.110 ;
(4) furnishes evidence satisfactory to the board that the person has completed a course of study and supervised clinical experience; the study and experience must be of at least one year's duration;
(5) successfully completes the examination required by the board.
(a) There is established the Board of Certified Direct-Entry Midwives.
(b) The board consists of five members appointed by the governor subject to confirmation by the legislature in joint session. Members serve for staggered terms of four years and, except as provided in AS 39.05.080(4), each member serves until a successor is appointed and qualified. The board consists of two members who are certified in this state as direct-entry midwives, one physician licensed by the State Medical Board in this state who has an obstetrical practice or has specialized training in obstetrics, one certified nurse midwife licensed by the Board of Nursing in this state, and one public member.
(c) The board shall elect a chair and a secretary from among its members to terms of one year.
(d) A member may serve no more than two complete consecutive terms on the board.
The board may by regulation provide for the certification without examination of a person who meets the requirements of AS 08.65.050 (1) - (4), who is currently licensed in another state with licensing requirements at least equivalent in scope, quality, and difficulty to those of this state, and who has passed the national examination required of certified direct-entry midwives in this state. At a minimum, an applicant for certification by credentials
(1) may not be the subject of an unresolved complaint or disciplinary action before a regulatory authority in this state or another jurisdiction;
(2) may not have failed the examination for a certificate or license to practice midwifery in this state;
(3) may not have had a certificate or license to practice midwifery revoked in this state or another jurisdiction;
(4) shall submit proof of continued competency satisfactory to the board; and
(5) shall pay the required fees.
(a) The board shall
(1) examine applicants and issue certificates to those applicants it finds qualified;
(2) adopt regulations establishing certification and certificate renewal requirements;
(3) issue permits to apprentice direct-entry midwives;
(4) hold hearings and order the disciplinary sanction of a person who violates this chapter or a regulation of the board;
(5) supply forms for applications, licenses, permits, certificates, and other papers and records;
(6) enforce the provisions of this chapter and adopt regulations necessary to make the provisions of this chapter effective;
(7) approve curricula and adopt standards for basic education, training, and apprentice programs;
(8) provide for surveys of the basic direct-entry midwife education programs in the state at the times it considers necessary;
(9) approve education, training, and apprentice programs that meet the requirements of this chapter and of the board, and deny, revoke, or suspend approval of such programs for failure to meet the requirements.
(b) The board may by regulation require that a certified direct-entry midwife undergo a uniform or random period of peer review to ensure the quality of care provided by the certified direct-entry midwife.
(a) The board shall issue a permit to practice as an apprentice direct-entry midwife to a person who satisfies the requirements of AS 08.65.050(1) - (3) and who has been accepted into a program of education, training, and apprenticeship approved by the board under AS 08.65.030. A permit application under this section must include information the board may require. The permit is valid for a term of two years and may be renewed in accordance with regulations adopted by the board.
(b) An apprentice direct-entry midwife may perform all the activities of a certified direct-entry midwife if supervised in a manner prescribed by the board by
(1) a certified-direct-entry midwife who has been licensed and practicing in this state for at least two years;
(2) a certified direct-entry midwife who has been licensed for at least two years in a state with licensing requirements at least equivalent in scope, quality, and difficulty to those of this state at the time of licensing, who is certified in this state, and who has practiced midwifery for the last two years;
(3) a physician licensed in this state with an obstetrical practice at the time of undertaking the apprenticeship; or
(4) a certified nurse midwife licensed by the Board of Nursing in this state with an obstetrical practice at the time of undertaking the apprenticeship.
The board may impose a disciplinary sanction on a person holding a certificate or permit under this chapter if the board finds that the person
(1) secured a certificate or permit through deceit, fraud, or intentional misrepresentation;
(2) engaged in deceit, fraud, or intentional misrepresentation in the course of providing professional services or engaging in professional activities;
(3) advertised professional services in a false or misleading manner;
(4) has been convicted of a felony or other crime that affects the licensee's ability to continue to practice competently and safely;
(5) intentionally or negligently engaged in or permitted the performance of client care by persons under the certified direct-entry midwife's supervision that does not conform to minimum professional standards regardless of whether actual injury to the client occurred;
(6) failed to comply with this chapter, with a regulation adopted under this chapter, or with an order of the board;
(7) continued to practice after becoming unfit due to
(A) professional incompetence;
(B) failure to keep informed of current professional practices;
(C) addiction or severe dependency on alcohol or other drugs that impairs the ability to practice safely;
(D) physical or mental disability;
(8) engaged in lewd or immoral conduct in connection with the delivery of professional service to clients.
(a) When it finds that a person holding a certificate or permit is guilty of an offense under AS 08.65.110 , the board, in addition to the powers provided in AS 08.01.075 , may impose the following sanctions singly or in combination:
(1) permanently revoke a certificate or permit to practice;
(2) suspend a certificate or permit for a determinate period of time;
(3) censure a person holding a certificate or permit;
(4) issue a letter of reprimand;
(5) place a person holding a certificate or permit on probationary status and require the person to
(A) report regularly to the board upon matters involving the basis of probation;
(B) limit practice to those areas prescribed;
(C) continue professional education until a satisfactory degree of skill has been attained in those areas determined by the board to need improvement;
(6) impose limitations or conditions on the practice of a person holding a certificate or permit.
(b) The board may withdraw probationary status if it finds that the deficiencies that required the sanction have been remedied.
(c) The board may summarily suspend a license before final hearing or during the appeals process if the board finds that the licensee poses a clear and immediate danger to the public health and safety if the licensee continues to practice. A person whose license is suspended under this section is entitled to a hearing conducted by the office of administrative hearings (AS 44.64.010 ) not later than seven days after the effective date of the order, and the person may appeal the suspension after a hearing to a court of competent jurisdiction.
(d) The board may reinstate a certificate or permit that has been suspended or revoked if the board finds after a hearing that the applicant is able to practice with reasonable skill and safety.
(e) The board shall seek consistency in the application of disciplinary sanctions, and significant departure from prior decisions involving similar situations shall be explained in findings of fact or orders.
(a) Except as provided in (e) of this section, a certified direct-entry midwife may not assume the care or delivery of a client unless the certified direct-entry midwife has recommended that the client undergo a physical examination performed by a physician, physician assistant, advanced nurse practitioner, or certified nurse midwife, who is licensed in this state.
(b) A certified direct-entry midwife shall inform a woman seeking home birth of the possible risks of home birth and shall obtain a signed informed consent, including the recommendation for a physical examination required under (a) of this section, from the woman before the onset of labor. The consent shall be maintained by the certified direct-entry midwives as part of the woman's record. A certified direct-entry midwife shall accept full legal responsibility for the direct-entry midwife's acts or omissions.
(c) A certified direct-entry midwife shall comply with the requirements of AS 18.15.150 concerning taking of blood samples, AS 18.15.200 concerning screening of phenylketonuria (PKU), AS 18.50.160 concerning birth registration, AS 18.50.230 concerning registration of deaths, AS 18.50.240 concerning fetal death registration, and regulations adopted by the Department of Health and Social Services concerning prophylactic treatment of the eyes of newborn infants.
(d) A certified direct-entry midwife may not knowingly deliver a woman who
(1) has a history of thrombophlebitis or pulmonary embolism;
(2) has gestational diabetes, diabetes, hypertension, Rh disease with positive titer, active tuberculosis, active syphilis, active gonorrhea, epilepsy, heart disease, or kidney disease;
(3) contracts genital herpes simplex in the first trimester of pregnancy or has active genital herpes in the last two weeks of pregnancy;
(4) has severe psychiatric illness;
(5) inappropriately uses controlled substances, including those obtained by prescription;
(6) has multiple gestation;
(7) has a fetus of less than 37 weeks gestation at the onset of labor;
(8) has a gestation of more than 42 weeks by dates and examination;
(9) has a fetus in any presentation other than vertex at the onset of labor;
(10) is a primigravida with an unengaged fetal head in active labor, or any woman who has rupture of membranes with unengaged fetal head, with or without labor;
(11) has a fetus with suspected or diagnosed congenital anomalies that may require immediate medical intervention;
(12) has pre-eclampsia or eclampsia;
(13) has bleeding with evidence of placenta previa;
(14) any condition determined by the board to be of high risk to the pregnant woman and newborn;
(15) has had a previous caesarian delivery or other uterine surgery;
(16) experienced the rupture of membranes at least 24 hours before the onset of labor; or
(17) is less than 16 years of age at the time of delivery.
(e) Notwithstanding (d) of this section, a certified direct-entry midwife may deliver a woman with any of the complications or conditions listed in (d)(1) - (17) of this section if
(1) the delivery is a verifiable emergency; and
(2) a physician or certified nurse midwife is not available in the geographic vicinity.
(f) A certified direct-entry midwife may not attempt to correct fetal presentation by external or internal inversion unless
(1) there is a verifiable emergency; and
(2) a physician or certified nurse midwife is not available in the geographic vicinity.
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