H_HIE_2016A 04/05/2016 10:19:13 AM Committee Summary

10:20 AM -- HB 16-1360



Representative Landgraf and Representative Lontine, co-prime bill sponsors, presented House Bill 16-1360. The bill implements the recommendations made by the Department of Regulatory Agencies (DORA) in its sunset review of the regulation of direct-entry midwives, with some modifications. It continues the regulation of direct-entry midwives by the Division of Professions and Occupations in the DORA for seven years, through September 1, 2023. In addition, the bill makes the following changes to the scope of practice for direct-entry midwives:

• permits direct-entry midwives to suture first- and second-degree perineal tears, if the registrant demonstrates to the director that he or she has received specific training, and to obtain and administer local anesthesia for the procedure;
• makes changes to the disclosure form that direct-entry midwives must provide to clients;
• requires direct-entry midwives to inform parents of the importance of critical congenital heart defect screening, and requires a direct-entry midwife to refer parents to a health care provider who can provide the screening if the direct-entry midwife is unable to perform the screening;
• allows a direct-entry midwife to enter into a confidential agreement to voluntarily limit his or her practice if a physical or mental illness or condition renders him or her unable to practice direct-entry midwifery safely;
• adds prohibited practices for direct-entry midwives concerning the failure to notify DORA of such an illness or condition affecting his or her ability to practice midwifery or noncompliance with practice limitations under a confidential agreement; and
• repeals the requirement that the director send letters of admonition via certified mail.

The bill also requires DORA to convene a stakeholder group to review data that is reported by direct-entry midwives. The stakeholder group must report to specified legislative committees by January 31, 2017. Finally, the bill requires DORA to establish a working group to investigate ways of managing risks in the practice of midwifery, including the need for, and access to, professional liability insurance. The working group must report its findings to DORA by October 1, 2016, and DORA must report any recommendations for legislation as a result of the report to certain legislative committees by November 1, 2016.



The committee discussed the Sunset Report: Direct-entry Midwives (Attachment A) at previous committee meetings on January 26, 2016, and March 8, 2016.



160405 AttachA.pdf



10:22 AM



Representative Brown made discussed potential amendments to the bill. Representative Joshi discussed amendment L.002 (Attachment B).



160405 AttachB.pdf



10:25 AM -- Dr. Caleb Hernandez, Colorado Chapter of the American College of Emergency Physicians, testified on the bill and amendment L.002. Dr. Hernandez answered questions from the committee.



10:37 AM -- Dr. Brent Keeler, Colorado Medical Society and Colorado Section of the American College of Obstetricians and Gynecologists, testified on the bill and amendment L.002. Dr. Keeler answered questions from the committee.



10:50 AM



Representative Lontine made comments to the committee. Committee discussion with Dr. Keeler continued.



10:52 AM -- Larry Sarner, Colorado Citizens for Science in Medicine, testified in opposition to the bill. Mr. Sarner answered questions from the committee.



11:04 AM -- Linda Rosa, Colorado Citizens for Science in Medicine, testified in opposition to the bill. She provided an informational packet (Attachment C) to the committee. Ms. Rosa answered questions from the committee.



160405 AttachC.pdf



11:15 AM -- Maureen Maker, Colorado Citizens for Science in Medicine, testified on the bill. Ms. Maker answered questions from the committee.



11:23 AM



Ms. Lontine made comments to the committee about medical malpractice insurance and answered questions from the committee.



11:26 AM -- Janet Schwab, representing herself, testified on the bill. She provided a handout (Attachment D) to the committee. Ms. Schwab answered questions from the committee.



160405 AttachD.pdf



11:41 AM -- Yvette Gentry, representing herself, testified on the bill and discussed her experience with direct-entry midwifery training. Ms. Gentry answered questions from the committee.



11:48 AM -- Jan Lapetino, Colorado Midwives Association, testified in support of the bill. Ms. Lapetino answered questions from the committee.



12:04 PM -- Dr. Courtney Everson, Colorado Midwives Alliance, testified in support of the bill. Dr. Everson answered questions from the committee.



12:10 PM -- Dr. Heather Thompson, Elephant Circle, testified in support of the bill.



12:14 PM -- Indra Lusero, Birth Rights Bar Association, testified in support of the bill. Ms. Lusero answered questions from the committee.



12:28 PM -- Dick Brown, Colorado Section of the American Congress of Obstetricians and Gynecologists, answered questions from the committee.



12:40 PM -- Saul Larsen, DORA, answered questions from the committee.



12:46 PM -- Ms. Lapetino returned to the table to answer additional questions from the committee.



12:48 PM



Christy Chase, Office of Legislative Legal Services, responded to questions from the committee.



12:53 PM



The committee discussed amendment L.002 and a conceptual amendment to include a woman who has a surgically scarred uterus or has had a myomectomy.

12:58 PM



Committee discussion about amendment L.002 ensued.

01:02 PM



Committee members discussed amendment L.007 (Attachment E). Ms. Chase answered questions from the committee about amendment L.007.



160405 AttachE.pdf

01:12 PM



Representative Landgraf explained amendment L.003 (Attachment F).



160405 AttachF.pdf

01:12 PM



Committee members made comments about the bill. Representative Landgraf and Representative Lontine made concluding remarks about the bill. Committee members made additional comments about the bill.

01:19 PM



The committee adjourned.