New Mexico Register / Volume XXXII,
Issue 18 / September 28, 2021
NOTICE OF PUBLIC HEARING
The New Mexico Department of Health will
hold a public hearing on the proposed
repeal and replacement of rule, 16.11.3 NMAC, “Licensed Midwives”.
The public hearing will be held on November
4, 2021, at 9:30 a.m.
via Cisco WebEx online, via telephone, and
comments will be received via email through the conclusion of the hearing.
The hearing is being held via internet,
email, and telephonic means due to the concerns surrounding Coronavirus and in consideration
of Governor Michelle Lujan Grisham’s Executive Order 2020-004, Declaration of a
Public Health Emergency, and any subsequent executive orders. Members of the
public who wish to submit public comment regarding the proposed rule changes
will be able to do so via video conference and via telephone during the course
of the hearing, and by submitting written comment before the conclusion of the
hearing.
The hearing will be conducted to receive
public comments regarding the proposed repeal and replacement of the current rule,
16.11.3 NMAC, concerning the licensing, scope of practice, and disciplining of licensed
midwives. The proposed replacement rule
is intended to provide greater clarity in existing regulatory and statutory
requirements, to ensure continued high levels of professionalism among licensees,
and to address recent statutory changes to
revisions to the NM Criminal Offender Employment Act, Section 28-2-4 NMSA 1978.
The legal authority authorizing the
proposed repeal and replacement of the rule by the Department is at Subsection
E of Section 9-7-6 NMSA 1978, and Subsections S and V of Section 24-1-3 NMSA
1978.
Purpose of changes are listed below:
16.11.3.3 - Statutory Authority:
·
To revise
the section to reflect the statutory authority for the regulations.
16.11.3.6 - Definitions:
·
The purpose
of the changes is to clarify existing definitions to ensure clarity and better
understanding by licensed midwives of terms used throughout the regulation.
·
The purpose
of the changes is to add the definitions of “client”, “formulary”, “national
practitioner data bank”, “permitting period”, “portfolio evaluation process”, and
“student midwife” with the purpose of providing a detailed description to the
licensed midwife of the processes within the regulation that will impact the
licensee through the license process and in their daily professional work.
·
The purpose
is to expand on the definition of “contact hour” and “continuing education” in
order to provide greater understanding to licensed midwives of sources for
their required education credits.
16.11.3.8 - Documents Incorporated by
Reference are the Latest Editions of:
·
The purpose
is to provide licensed midwives with references to the current guidelines,
standards and core competencies to which they are required to practice pursuant
to this regulation.
16.11.3.9 - Permits:
·
The purpose
of the changes is to set forth the clear distinction of procedural requirements
for one of three processes for an apprentice or student midwife to care for New
Mexico residents, to obtain renewal of permits and the process by which student
midwives may obtain modified permits.
16.11.3.10 - Licensure:
·
The purpose
of the revisions to this section is to provide a more detailed explanation of
the process of obtaining licensure, and renewal, reactivation and reinstatement
processes in order to ensure better understanding of the process by applicants
and current licensees, and to provide a detailed explanation of the contact
hours for continuing education required for renewal of a license. Section C of 16.11.3.10 NMAC revises the
license renewal schedule for the two-year term of licensure. Section G of 16.11.3.10 NMAC has changed the
fees section to reflect a slightly higher initial fee and a penalty for late
renewals.
16.11.3.11 - Disciplinary Action:
·
In general,
the purpose of the changes to Section A of 16.11.3.11 NMAC is to amend, clarify,
and reorganize certain existing grounds for disciplinary action to ensure that
complaints against licensees are evaluated and adjudicated in a fair and
impartial manner that complies with due process while continuing to give the
public confidence in this licensed profession.
One such change has been made to the existing ground for disciplinary
action for ”obtaining, possessing,
administering, or furnishing prescription drugs” to clarify where the
applicable formulary may be located, to add that practicing midwifery without a
valid “modified permit” may be grounds for disciplinary action, to add as
grounds for disciplinary action the failure to care for a non-adherent client
as required by department of health practice guidelines for New Mexico Licensed
Midwives, and to add that verbally or physically abusing a client may be a
ground for disciplinary action.
Additionally, the rule adds new language governing consideration of
criminal convictions in disciplinary actions, to comply with statutory changes
to
Section 28-2-4 NMSA 1978, has added conviction for misdemeanor offenses related
to the practice of midwifery as grounds for disciplinary action, and added
failure to report in writing to the division any complaint or claim made
against the licensed midwife’s practice in any jurisdiction in which they
practice as a registered, certified or licensed health care provider. The purpose of adding a new Section B of
16.11.3.11 NMAC Non-Disciplinary proceedings is to provide a hearing
opportunity for non-disciplinary license proceedings. The purpose of Section C of 16.11.3.11 NMAC
Disciplinary proceedings changes are to provide additional information to the
licensee of the notifications to be expected in the disciplinary process, to provide clarity on the hearing procedure
to be followed under the Uniform Licensing Act, to advise the public and
licensees of the regulation under which the department will keep a record of
the number of complaints received and their disposition, to specify that any
hearing is to be conducted by a hearing officer designated by the secretary, to
provide clarity that a decision on any disciplinary proceeding will be final
when the secretary renders a final administrative determination, to make it clear
that final administrative decisions are reported to the National Practitioner
Data Bank (NPDB), and to
allow for reinstatement of a license revoked for non-compliance with the
Parental Responsibility Act, Section 40-5A-1 to 13 NMSA 1978 upon presentation
of a subsequent statement of compliance.
16.11.3.12 - Course of Education:
·
The purpose
of changes made to the section are to clarify for the license applicant what
entry level skills, knowledge, and abilities are necessary to practice
competently and to set forth with specificity the skills, knowledge, and clinical
experiences needed.
16.11.3.13 - Examination:
·
The purpose
of the changes made to this section are to shorten the time to retake an
examination after initial failure of the exam and increase the number of times
per year that the division will administer the licensure examination. This will provide greater opportunity for an
increased number of licensed midwives in the state and thereby increase their
numbers in New Mexico to afford better healthcare to residents.
16.11.3.14 - Responsibilities and Scope of
Practice:
·
The purpose
of the changes to Section A of 16.11.3.14 NMAC is to provide the licensed midwife
with a more definitive scope of practice in a gender neutral manner, by
providing for the healthcare of people without general health or obstetrical
complications; to clarify the time for newborn care is up to six weeks of age;
to provide that a licensed midwife may provide non-pharmacological family
planning and routine reproductive health
care with training and experience, to set out that the licensed midwife may
purchase and use specific drugs and medications as outlined in the
department-approved formulary set out in the department’s practice guidelines
for licensed midwives in New Mexico. The
purpose of the changes to Section B of 16.11.3.14 NMAC is to increase the type
of licensed professionals with whom consultation may be made to include
certified nurse-midwives. The purpose of
the changes to Section C of 16.11.3.14 NMAC is to provide clarity on what
content an informed consent should contain and the responsibility to maintain a
copy in the client records. The purpose
of changes to Section D of 16.11.3.14 NMAC would change the terminology of the
admission criteria section to the gender-neutral term “client”. The purpose of changes to Section G of
16.11.3.14 NMAC is to add “stillbirths” as a reportable neonatal or maternal
mortality reportable incident for a client for whom the licensed midwife has
care for in the perinatal period. The
purpose of changes to Section J of 16.11.3.14 NMAC are to change reporting from
quarterly to annual reporting. The
purpose of changes to Section K of 16.11.3.14 NMAC would set new informational
obligations on licensees such as maintaining the current and accurate contact
information on file with the department.
16.11.3.15 - Advisory Board:
·
The purpose
of the changes to Section A of 16.11.3.15 NMAC are to clarify the definition of
the general public member and to allow the Board to recommend changes to the
department’s practice guidelines for New Mexico Licensed Midwives. The purpose of the changes to Section B of
16.11.3.15 NMAC are to increase the number of members of the general public to
allow for better representation on the board by the residents who are served by
the licensees.
Any interested member of the
public may attend the hearing and submit data, views, or arguments either
orally or in writing on the proposed rule amendments during the hearing. To access the hearing by
telephone: please call 1-844-992-4726. Your telephone comments will be
recorded. To access the hearing via
internet: please go to Webex.com; click the “Join” button; click the “Join a
meeting” button; enter the following meeting number and password where
indicated on screen—Meeting number (access code): 2488 186 6556 #,
Meeting password: vPWsJwAy728; click the “OK” button. You may also provide comment via Chat during
the live streaming.
Written public
comment regarding the proposed rule amendments can be submitted by either
mailing the comment to the following address:
Abigail Reese
Maternal Health Program Manager
Family Health Bureau/Public Health Division
2040 S. Pacheco (Colgate Building)
Santa Fe, New Mexico 87505
(505) 476-8866
Or preferably
by e-mailing the comment to the e-mail address: Abigail. Reese@state.nm.us.
Written comments must be
received by the close of the public rule hearing on November 4, 2021. All written comments will be published on the
agency website at http://nmhealth.org/about/asd/cmo/rules/ within three (3)
days of receipt, and will be available at the New Mexico Department of Health
Public Health Division for public inspection.
If you are an individual with a disability
who is in need of special assistance or accommodations to attend or participate
in the hearing, please contact Sheila Apodaca by telephone at (505) 827-2997. The Department requests at least ten (10) days
advance notice to provide requested special accommodations.
The foregoing are summaries
of the proposed rule. The proposed rule includes
various additional substantive revisions not identified here. Free copies of the full text of the proposed
rule may be obtained online from the
Department’s website at https://nmhealth.org/publication/regulation/