Legislative Issues & Lobby Day
Over 75 midwives, consumers, students and apprentices traveled down to Olympia this year for Midwife Lobby Day 2016!
We met with our elected representatives and communicated to them:
- Our need for a more sustainable Birth Center reimbursement rate from Medicaid
- Our desire to protect pregnant workers ensuring they have access to reasonable accommodations including the ability to take bathroom breaks and to have flexibility
for prenatal visits
- Our thanks for their support in previous years
We asked our legislators to require the Health Care Authority to review the antiquated methodology used for determining Birth Center reimbursement and to support the Pregnant Workers Fairness Act (HB2307/SB6149).
View our Lobby Day 101 Webinar to learn more about this important event. We hope you will join us next winter!
Don’t have time to view the full webinar? Check out the Lobby Day 101 Webinar Power Points:
• Why is Midwife Lobby Day so Important?
• MAWS Legislative Agenda 2016 Slides
• Visiting Your Legislator
• The Elevator Speech
• Parking and Logistics
Spread the word to other midwives and supporters that Lobby Day is not intimidating at all.
Never been? Here's what Lobby Day looked like in 2015: Everyone travels in teams so no one has to speak up if they don’t want to, but the representatives take note of who visits from their districts and they are more likely to vote favorably if they meet you, their constituents face to face. Trust those of us who come back year after year – it’s worth the trip! And we gain energy and momentum when more members show up! Those who can't make it can still participate by making sure they are signed up for our electronic news alerts and stay tuned for how to contact their legislators to let them know to vote for midwives and families!
2014 Legislative Report
Thank you to everyone for your communications with your WA representatives! It made a difference! Lobby Day held last year on Valentine's Day was a big part of this two year success story!
Spread the word to other midwives and supporters that Lobby Day is not intimidating at all.
Never been? Here's what Lobby Day looked like in 2014: Everyone travels in teams so no one has to speak up if they don’t want to, but the representatives take note of who visits from their districts and they are more likely to vote favorably if they meet you, their constituents face to face. Trust those of us who come back year after year – it’s worth the trip! And we gain energy and momentum when more members show up! Those who can't make it can still participate by making sure they are signed up for our electronic news alerts and stay tuned for how to contact their legislators to let them know to vote for midwives and families!
As a thank you for coming to Olympia and making your voice heard, we held a post-Lobby Day celebration dinner at the home of MAWS board member, Audrey Levine. There was wine and lots of great food!
This year, we educated legislators about Licensed Midwifery care, and more specifically about our bill that will strengthen our profession through new licensing requirements, create a CPM to LM bridge, clarify scope of practice for newborn care, and finally put the final piece in place to allow Licensed Midwives to delegate duties to nurses.
The work we do is capturing the attention of legislators and policy makers at both the state and the national level because (as you know) midwifery care, home birth and birth center birth are SAFE and COST-EFFECTIVE options for childbearing families. We have an important role to play in transforming maternity care in this country so we hope to see you there next year!
At 8 am on Lobby Day, we gathered at the home of our lobbyist, Amber Ulvenes. There was bagels and coffee/tea while we got oriented to the day’s agenda and picked up our legislative packets. This location served as a base for the day. We walked from there with our teams for our visits with legislators.
2013 Legislative Report
Agenda Item: Support companion bills SB 5626 (Kline)/HB 1773 (Morrell) to enact several important advancements for midwifery care.
Result: Of the two, HB 1773 was the bill to advance, but after a long road it died on the Senate Floor Calendar.
While still in the House, the newborn care provision had been stripped during negotiations and was replaced by a Sunrise Review process at the Department of Health. Fortunately, even though the bill died, the DOH is still moving forward with the Sunrise Review of newborn care at the request of Rep. Eileen Cody.
The DOH has also stated that they plan to do rulemaking on the CPM-LM bridge absent the bill. We will be back in 2014 with another bill both as a backstop and to make further advancements. Our original bill sought to make the following changes:
- It is standard practice and is elsewhere referred to in statute that a midwife provides care to both a mother and baby at birth, but that reference is lacking in the portion of law that refers to compensation. These bills correct a problem that resulted in a midwife not being paid for newborn care by a health insurer. Paying for this care is the norm for insurers and Medicaid today.
- Some midwives have had applications for licensure at the Department of Health (DOH) for up to two years because there is no clear path from the national credential (CPM) to the more rigorous state credential (LM). These bills require the DOH to write rules to develop that bridge and provide clear expectations for applicants. This is a simple change that will build capacity in the midwifery profession and address a critical shortage of maternity care providers in our state.
- Midwifery care is highest quality care, and we want to prove it! The bills create the following requirements for licensure:
- 30 hours of continuing education every three years.
- Mandatory peer review for quality assurance.
- Submission of perinatal outcome data to a research organization (such as MANAstats.)
Agenda Item: Prevent exorbitant professional licensing fees for Licensed Midwives.
Result: The licensing fee cap will continue for the 2013-2015 biennium. Annual licensing fees will remain at $525.
We successfully argued that maintaining this cap is an access to care issue because without it licensing fees are projected by the DOH to be $1100 annually, which would force some midwives out of their profession. The demand for home and birth center births is increasing dramatically. Licensed Midwifery is also a profession that the state wants to promote and build because clients receive high-quality care while saving the state money ($3.1 million/biennium; calculated using a 2007 independent study commissioned by the legislature and data from the Department of Social and Health Services First Steps Database.)
Your participation in Lobby Day DOES make a difference!
As a thank you for coming to Olympia and making your voice heard, we are holding a post-Lobby Day celebration dinner at the home of Board Member, Audrey Levine. There'll be wine and lots of great food!
This year, we will be sharing with WA State lawmakers the compelling case for increased access to our services amongst low-risk women on Medicaid and explaining to them the importance of keeping our licensing fee reasonable so we can continue to grow our profession.
The work we do is capturing the attention of legislators and policy makers at both the state and the national level because midwifery care, home birth and birth center birth are safe and cost-effective options for childbearing families.
We have an important role to play in transforming maternity care in this country so we hope to see you there!
2013 Lobby Day - Agenda for the Day:
At 8 am we will gather at the home of our lobbyist, Amber Ulvenes. There will be bagels and coffee/tea while we get oriented to the day's agenda and pick up our legislative packets. This location will serve as a base for the day. Address: 1610 Water St SW Olympia, WA 98501
Lobbying will occur at appointment times throughout the day in small groups, so no one has to meet with their legislator(s) alone unless they want to do so. Packets will be dropped off at the offices of those legislators with whom we don't meet.
If you plan to come, please contact Sasha Henry at email@example.com so that she can schedule an appointment with your representatives. Legislators are more likely to meet with us if they know their constituents have traveled all the way to Olympia to see them.
Stick around for a thank you dinner and social time at our post-Lobby Day celebration dinner at the home of Board Member, Audrey Levine. There'll be wine and lots of great food! Time to be determined.
Read on for more information about our successful efforts in previous years.
2012 Legislative Session Final Report
Agenda Item: Support HB 2186 - Help Licensed Midwives Collaborate with Nurses
Result: HB 2186, sponsored by Rep. Barbara Bailey from Whidbey Island, was signed into law by the Governor. This bill allows Licensed Midwives to give direction to Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). The Department of Health received $11,000 in their budget to undergo rulemaking in 2012 to implement the new law. The department plans to hold two public hearings as part of this process. Our goals with this bill were threefold:
- It removes a barrier for midwives who have hospital privileges or are seeking hospital privileges. A midwife would be able to follow her client into the hospital in the event of a transport, increasing the likelihood of a vaginal birth which carries fewer risks for mother and baby, and is much less costly than a cesarean section.
- It allows nurses to work in freestanding birth centers, or to work as a birth assistant with a Licensed Midwife at home births. Midwives frequently get applications from nurses, but are not able to hire them.
- It removes one barrier to Licensed Midwives working in Federally Qualified Health Centers. This has been identified as one way to address the problem of access to maternity care in rural and underserved areas of the state.
You can read more about this bill in Rep. Barb Bailey’s Press Release.
Agenda Item: Maintain the current cap on midwifery licensing fees
Result: The $59,000 budget proviso to cap midwifery licensing fees in 2012 was preserved in the 2012 Supplemental Budget. Annual professional licensing fees are currently capped at $525. Maintaining this cap is an access to care issue because without it licensing fees would be approximately $1500, which would force some midwives out of their profession and discourage some from entering. Licensed Midwifery is a profession that the state wants to promote and build because patients receive high-quality care while saving the state money.
2011 Legislative Session
From the 2011 MAWS Legislative Agenda, our goals were:
Control exorbitant midwifery licensing fees
Result: The licensing fee cap will continue for the 2011-2013 biennium. We secured a $115,000 budget proviso to hold fees to a total of $525 per year ($500 for licensing, plus $25 for HEAL-WA access.) This was less than the $160,000 that we were seeking, which means the licensed midwife regulatory account at the Department of Health could be in the red next year. We will revisit this issue during the 2012 session.
Give midwives access to HEAL-WA: Support HB 1176/SB 5071
Result: Through the success of SB 5071, sponsored by Sen. Ed Murray, licensed midwives were granted access to HEAL-WA, the UW research resource for health care providers. LMs will have an additional $25 annual fee at licensing or renewal, and should be able to start accessing the service by fall, probably in September. The Department of Health will do rule-making and hold a hearing (because of the fee) during August. HEAL-WA is planning to drop a post card to midwives in October to let them know about their eligibility.
Preserve the Midwifery Advisory Committee: remove from HB 1371/SB 5469
Result: We succeeded in removing The Midwifery Advisory Committee (MAC) at the Department of Health (DOH) from the cut list in the Governor-request bills, HB 1371 and SB 5469. The MAC will continue to meet.
Promote evidence-based maternal & child health: support HB 1311 and HB 1562
Result: The collaborative formed by HB 1311 will research and recommend evidence-based care guidelines, but as signed into law, can choose any topic for review. They are no longer required to first focus on cesarean section rates and early inductions. HB 1562 did not move forward this session, but both House and Senate health care committees plan to discuss current maternity & child health care in our state and develop strategies to reduce preterm births.
Audrey Levine, MAWS President, (360) 709-0888
Amber Ulvenes, MAWS Lobbyist, at (360) 280-0384