Remedying the Barriers to Midwifery Licesure in Florida

[Human_Being]

Hello Midwifery Supporter,

As many of you know, no midwife has been licensed when moving to Florida in over ten years. No midwives licensed in other States have become licensed in Florida, and no foreign trained midwives have become licensed. Only two CNMS have become Florida LMs in this time. They use the same mechanism for licensure as a midwife who moves here from out of State- Licensure by Endorsement.

The time to remedy this problem has come.

We currently have a crisis level shortage of Florida Midwives. There have been year long vacancies in at least four birth centers in Florida, and there have been two centers closed and one changed hands in the last year as a result of the Florida LM midwife shortage. Barriers to Licensure encourage the unsafe, unlicensed practice of midwifery- if getting a legal license is impossible, the midwife may elect to practice with out one. Solving the barriers to licensure is an important issue for LMS and consumers, so we need to pay attention to this discussion.

Attached for your review is the proposed new tool for evaluating educational backgrounds for midwives who wish to practice in Florida. Any comments? Please review and discuss with in your midwifery community. This will be discussed, and likely voted on in the Licensed Midwifery Council meeting/call on Jan 26th. The meeting agenda is attached. The meeting call in information is

Friday, January 26, 2007 @ 9:00 am
DEPARTMENT OF HEALTH

MEDICAL QUALITY ASSURANCE

COUNCIL OF LICENSED MIDWIFERY

GENERAL BUSINESS MEETING

[phone], conference code 2454587


Please consider participating in this call and discussion.


The barriers to licensure are a confused application process, a cost of nearly $6000 to the applicant, and a faulty evaluation tool to determine educational equivalency.


If adopted, the tools for out of State/ Foreign Trained Midwives will replace the tool that has been in use for 10 years that required 906 clinical hours, 26 credits, and 50 clinical exams in excess of what was required by Statute to qualify as a LM. The process by which the currently used tool was adopted and applied was riddled with misunderstanding and miscommunication. As a result, for ten years Florida has needlessly rejected untold numbers of potential LMs.

In the last decade, there has been no clear step by step process communicated to potential applicants, nor any records kept of applicant inquires by The Department/ The Council of Licensed Midwifery. We need to insure that there is a process for documenting inquires for licensure and make sure all involved parties (The Council, The Department, The Midwifery Schools offering 4 month courses, and any credential evaluating agencies such as International Credentialing Agency (ICA)) are on the same page about how an inquiry into licensure is handled.


Right now folks on the Council, in the Department, at the midwifery schools offering the 4 month class, or at the credentialing agencies do not agree on a step by step process of how application for licensure should proceed.

Please review the attached documents- a summary of the current barriers/ the current evaluation tool, the proposed evaluation tool for out of State Applicants, and for Foreign Trained Midwives, and a meeting agenda for the Jan 26th Council call. Let's work towards a new era of accessible midwifery licensing in the Sunshine State.

Thank you ,

Heidi Dahlborg, LM

Sarasota, Florida

Former Director of The Rosemary Birthing Home Birthing Center

[Human_Being]

Current Evaulation Technique

__________________________________________________ __
Current Process for Licensing Potential Florida LMs
For CNMs who wish to be LMs, Out of State Licensed Midwives, and Foreign Trained Midwives moving to Florida

Barriers to Midwifery Licensure Identified:
1.Process for Application/Educational Evaluation Uncertain
2.Cost is $5200-$6000 to obtain a License if Moving to FL
3.Educational Evaluation Tool exceeds actual requirements for FL LMs

This is how applicants for Florida midwifery licenses are currently handled-
They call The Department of Health/ Office of The Council of Licensed Midwifery (who keeps no record of the call or inquiry), who refers them to The Florida School of Traditional Midwifery to be evaluated for educational equivalency, who refers them to The International Credentialing Agency. People then must obtain an application from the ICA agency (which they have never sent one to me despite the fact that I have been requesting one for a year) and if you do manage to get an application, they pay them $150 and wait a month to have their education be evaluated with the tool below. Most are found to have numerous shortcomings in their education because they are evaluated on standards that exceed those required by law or are offered in Florida midwifery programs. Thus they are thus needlessly rejected outright, or told to enroll in excessive, time consuming, and expensive midwifery classes prior to being eligible for the licensure by endorsement.

If the applicant completes courses to remedy the fictious deficiencies, and becomes approved for a 4-month program, they must enroll in that 4 month course which can cost an average of $4000.
If they complete the 4-month course (which as of Oct 2006 was not offered in Florida, but is intended to become available again in Jan 2007 at FSTM), and all requirements are met, the applicant can apply for a Florida License by Endorsement for $1,205.00. Breakdown of fees:
·Application Fee - $200.00
·Endorsement Fee - $500.00
·Initial Licensure Fee - $500.00
·Unlicensed Activity Fee - $5.00
If they also wish to get a temporary License, that costs an additional $755.00. Breakdown of fees:
·Application Fee - $200.00
·Licensure Fee - $500.00
·Temporary Certificate - $50.00
·Unlicensed Activity Fee - $5.00
TOTAL COST TO GET A LICENSE IF YOU ARE A MIDWIFE FROM OUT OF STATE: $6000.00 ($1960.00 to The State, $4000+ to the Midwifery School)

Current Educational Requirements from “ICA TOOL Summary”

Basic Science- 8 credits/150 hours with 4 credits in Anatomy and Physiology
Behavioral Sciences- 3 credits/45 hours in Behavioral Sciences like human growth and development, counseling, and psychology
Epidemiology- 4 credits/75 hours in microbiology, public health, or statistics
Basic Health Care Skills- 5 credits/90 hours in public health and community care, health care communication, counseling, charting, history taking, physical assessment, laboratory and diagnostic testing, phlebotomy, courses by study of systems.
Basic Health Care skills Practicum- 5 credit hours/ 225 hours
Basic Pharmacolgy-3 credits/ 60 hours
Genetics and Embryology- 3 credits/45 hours
The Antepartum- 5 credits, 90 hours
Antepartum Practicum- 12 credits/ 340 hours
The Intrapartum- 4 credits/ 60 hours
The Intrapartum Practicum- 10 credits/450 hours/ 50 childbirth and delivery and 50 babies in supervised setting
The Postpartum- 3 credits/45 hours
The Postpartum Practicum- 5 credits/ 225 hours/ 50 women in postpartum in supervised setting
Neonatology and Neonatal Pediatrics- 3 credits/45 hours in extra uterine adaptation, assessment of neonatal well being, neurological and gestational age, Apgar score, neonatal resuscitation, infant feeding, assessment of normal, common complaints and complications of newborns
Neonatal Practicum- 2 credits/ 90 hours/ 50 babies from birth to six weeks
Gynecology and Women’s Health- 3 credits/ 45 hours
Gynecology Women’s Health and Family Planning Practicum- 3 credits/135 hours/50 women well woman visits in supervised setting
Professional and Legal Issues- 3 credits, 45 hours in history of maternity care, ethics and principles of practice, informed consent, legal accountability, ancillary professions and government agencies, referral, collaboration, utilization of emergency care personnel and facilities.
TOTAL: ICA TOOL REQUIRES 116 credits, including 1806 clock hours of Practicum, and 50 well woman exams.

That exceeds FSTM’s curriculum by 26 credits and 906 practicum hours and 50 well woman physical exams!

Besides disqualifying even Florida LMs and Florida program graduates, and all others from all CNM/LM programs, it also automatically disqualifies every midwife who demonstrates all required competencies but is not a graduate of a three-year classroom based education

[Human_Being]

Proposed New Evaluation Tools- Out of State/ Foreign Trained Midwives

Unit of Study - Classroom and Clinical : Aspects of Prenatal, Intrapartal, Postpartal & Neonatal Care* [FS 467.009 (1)] CreditsHoursEvidence FoundEvidence Not Found
Basic Nursing/ Healthcare Skills
Basic Sciences
Behavioral Sciences
Female Reproductive Anatomy and Physiology
Nutrition During Pregnancy and Lactation
Childbirth Education
Breast Feeding
Community Care
Epidemiology
Genetics
Embryology
Neonatology/ Neonatal Pediatrics
Obstetrics/ Common Complications
Gynecology/ Women’s Health
Family Planning
Applied pharmacology
Medico/legal Aspects of Midwifery
Professional Responsibilities
Midwifery Knowledge, Skills and Professional Behavior in:
Primary Management Antepartum Care
Intrapartum Care
Postpartum Care
Neonatal Care
Collaborative Management/ Referral/ Medical Consultation

Other Courses:


Practicum During Training[FS 467.009 (4)(5)] Primary Management of :Number ObtainedAdditional Needed
50 Women in the Antepartum#
50 Women in the Intrapartum #
25 Observations of Women in the Intrapartum#
50 Women in the Postpartum#
50 Babies in the Neonatal Period #
Length of Program[FS 467.009 (2)]
Total Credits 90
Total Clock Hours 1800

Licensure by Endorsement Rule 64B24-2.004 (2)(a)1.Yes/ NoDateCurrent
State Midwifery License 1.**Unrestricted: yes/ no
State Midwifery License 2.**Unrestricted: yes/ no
State Midwifery License 3.**Unrestricted: yes/ no
Licensure by Endorsement Rule 64B24-2.004 (2)(b)1.Yes/ NoDateCurrent
State Approved Midwifery Program Name:
MEAC Accredited (Equivalent 1800 clock hours)
CPM Obtained Apprentice/ Self-study/ Exp. MidwifeCurrent: yes/ no
NARM Exam Passed
Other Verifiable CertificationYear PassedCurrent
1:
2:
3:
4:
5:
6:
7:
8:
Admissible to a Four Month Pre-licensure Course


APPLICANTS NAME:_____________________________________________ _______

MIDWIFERY SCHOOL:___________________________________________ ________

ACCREDITING/ APPROVAL BOARD OR COUNCIL:_________________________

__________________________________________________ ______________________

STATE:____________________________________________ _____________________

------------------------------------------------------------------------------------------------------------

EVALUATOR:________________________________________ ___________________

SIGNATURE:________________________________________ ____________________

DATE:__________________________ AGENCY:______________________________






COMMENTS

* Official Educational Documentation
Documents must be sent directly to evaluator from the Midwifery program.
Transcripts, course outlines, objectives and syllabi should be evaluated for evidence of classroom, clinical and practicum instruction having been met in all outlined areas.

** Submit State Law and Rules for Corresponding State License

Credits or Clock Hours
Credits or clock hours should be totaled and be equivalent to, or exceed, 90 credits or 1800 hours regardless of whether all areas are seen to have been covered.


________________________________________________
Unit of Study - Classroom and Clinical : Aspects of Prenatal, Intrapartal, Postpartal & Neonatal Care* [FS 467.009 (1)] CreditsHoursEvidence FoundEvidence Not Found
Basic Nursing/ Healthcare Skills
Basic Sciences
Behavioral Sciences
Female Reproductive Anatomy and Physiology
Nutrition During Pregnancy and Lactation
Childbirth Education
Breast Feeding
Community Care
Epidemiology
Genetics
Embryology
Neonatology/ Neonatal Pediatrics
Obstetrics/ Common Complications
Gynecology/ Women’s Health
Family Planning
Applied pharmacology
Medico/legal Aspects of Midwifery
Professional Responsibilities
Midwifery Knowledge, Skills and Professional Behavior in:
Primary Management Antepartum Care
Intrapartum Care
Postpartum Care
Neonatal Care
Collaborative Management/ Referral/ Medical Consultation

Other Courses:


Practicum During Training[FS 467.009 (4)(5)] Primary Management of :Number ObtainedAdditional Needed
50 Women in the Antepartum#
50 Women in the Intrapartum #
25 Observations of Women in the Intrapartum#
50 Women in the Postpartum#
50 Babies in the Neonatal Period #
Length of Program[FS 467.009 (2)]
Total Credits 90
Total Clock Hours 1800

[Licensure by Endorsement Rule 64B24-2.004 (1)(a)1, 3Yes/ NoDate Current
Certificate / Diploma of Midwifery from:
Documentation of Eligibility to Practice in CountryUnrestricted: yes / no
CPM Obtained Apprentice/ Self-study/ Experienced Midwife/ Foreign-Trained MidwifeUnrestricted: yes / no
NARM Exam Passed
Other Verifiable CertificationYear PassedCurrent
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
Admissible to a Four Month Pre-licensure Course







APPLICANTS NAME:_____________________________________________ _______

MIDWIFERY SCHOOL:___________________________________________ ________

ACCREDITING BOARD OR COUNCIL:_____________________________________

__________________________________________________ ______________________

COUNTRY:__________________________________________ ___________________

------------------------------------------------------------------------------------------------------------

EVALUATOR:________________________________________ ___________________

SIGNATURE:________________________________________ ____________________

DATE:__________________________ AGENCY:______________________________






COMMENTS

* Official Educational Documentation
Documents must be sent directly to the evaluator from the Midwifery program. Transcripts, course outlines, objectives and syllabi should be evaluated for evidence of classroom, clinical and practicum instruction having been met in all outlined areas.

Credits or Clock Hours
Credits or clock hours should be totaled and be equivalent to, or exceed, 90 credits or 1800 hours regardless of whether all areas are seen to have been covered.

[onlyboys]

Heidi!

Thank you so much for taking the energy to do this!

Just wanted to add, I'll be calling in to the meeting. Would it be helpful to get as many people as possible to call in? Would that not be helpful?

Amanda

[fourgrtkidos]

Hi Heidi,

Thought we were going to have a Jan MAF meeting regarding this???

I would love to be in on the call. Blessings, Michelle Eurgatis

[ckhagen]

I would love to help, but i have no idea how this conference call works. Can anyone clarify how to go about it and what is expected of a caller?

[Human_Being]

Great you will be on the call Amanda! I think lots of callers will actually help this time...its time to show them we are paying attention.

Ideally, participating in an organization like Birthnetwork, Citizens for Midwifery, MAF, etc...would be the place to channel your best organizing energy, and we would all be in touch, and could make position letters, etc. But our network is really weak right now so being on the call directly is the best avenue I think....just based on the current realities.

Also, if you are all on board, I can keep you updated because I think this is the tip of the ice berg....there is a lot more work to do on this issue. Right now, I have been suffering with the knowledge that this has been happening, and dealing with the consequences of not being able to hire anyone (which has caused me to decide to leave midwifery for now), and I have not been able to get any action on the issue. Its so exciting it will finally be dealt with. Now, if we pay attention, we can make them do it right. I have learned over the last year of hammering away at this issue not to expect much from the state regulators except incompetence, disorganization, and a total lack of understanding about the issues. But at least now I know what we are really dealing with. In the syrupy southern accented words of one of the very sweet, but incompetent people in charge of regulating midwives, Ronda Bryant, in August 2006, "We do not know what we are doing, we are NOT professionals!" Um, yeah, I am starting to realize that.....

Candace, little is expected of callers, you can just listen, and in fact you need to be "called on" to speak if you are not on the Council. However, when you first call in, it is expected that you introduce yourself. The meeting is run with formal procedural rules (things need to be seconded, adjourned, blah, blah, blah...) and the woman who is charge has a British accent, which makes all the formalities seem that much more formal. But do not be intimidated, and if you wish to speak up, by all means do, just ask to be recognized....

Let me suggest you introduce yourself as
"Hi I am Candace, a consumer that is interested in remedying the midwifery shortage in Florida by broadening licensing opportunities for out of State midwives". (Student midwives could do the same thing, saying "I am *your name* a MAF supporter, a student midwife, and consumer interested in remedying the midwifery shortage in Florida by broadening licensing opportunities for out of State midwives". )

This is likely all you will say. But it will be powerful, even if you are the only "consumer" on the call. There has been little midwifery or consumer attention to these important meetings, so much so that last time there was a meeting, they did not even follow the sunshine law that requires they publish the call in number. So no one could be on the call/participate if they tried.....What I mean, is midwifery is a totally neglected aspect of the many regulatory duties these government people have on their plates. This means things can really deteriorate and result in real problems in practice, like not being able to get a license, fees becoming prohibitively high, and even "canceling" the professional licensing. When people simply show up and listen, it is a VERY POWERFUL message that we are paying attention.....and the regulators are hugely motivated to do the right thing.

This licensing problem has persisted mainly because very few people were in a position to be aware of it. I only discovered it when I tried to hire a midwife from out of State, and knew of others that had tried to move here and found out it was a pattern over years, did some digging, discovered the source of the problem, and agitated until it got looked at. Anyone who had an inkling that this was going on was by and large to overwhelmed to address it. When I pointed out these problems to the Council last January, I was told essentially they did not have time to fix it, maybe in a few years.... Attention from Midwives, and much prodding has led to action on this issue. Consumer/ midwife presence on the call will demonstrate interest and need for action, and result in change.

The other reason being in engaged in this discussion, and demonstrating interest in the outcome is important is because this problem will not be solved Jan 26th. This will be an ongoing problem. The more we pay attention, the more they will have to work on it, and do it properly. They got so lax they stopped even announcing our regulatory meeting for jeeps sake! So, even if a new tool is adopted, a sane procedure for implementing it needs to follow, and then we have to make sure that the process works from inquiry to Florida license.

This will require effort, and the two paid staff we have regulating midwifery have many other duties and are used to doing nothing for midwives. Getting them to do this RIGHT will be a big deal.....

So I think really a rules change that outlines it will need to follow...and as soon as I am not helping moms birth all the time (after Jan), I will try to get that done....

So.....Hi Michelle! Yes, there was going to be a January MAF meeting, but Marianne and I each kinda thought the other one of use were going to make and disperse the minutes from the last meeting. I really have been slammed over here, and have a bunch of excuses ....still on call full time here, orienting new midwife and doing change over duties for sale of the birth center, holidays with nearly 2 year old ) So in the end the shell of MAF never got a Jan meeting announced in a decent time frame. You can see how relying on a group of busy midwives to take care of these administrative things could lead to neglect of important duties, huh? So MAF meeting will not get in under the wire for the meeting, so instead I am organized via internet before the call....What I posted here I sent via email to every midwife I had an address for. Cut and paste it, pass it on to anyone you know too.... As you know, MAF needs lots of help to get on its feet, so when that ground work is more sound business like this will be easier to do. Right now, this is just whatever I can pull together....

Great to have any and all support!

This will be an ongoing issue, so there is certainly more to come!

Lets fix the Florida midwife shortage!

[homemademomma]

heidi- it is so great to know you are working on this problem. i have heard inklings of the licensure problems from glenn cameron, but i had no idea of the whole issue. we met briefly at a waterbirth workshop in the keys, and i was a classmate of harmony. i went down and visited the birthing home recently, and it is amazing! you did a wonderful job with it!

-jen

[onlyboys]

Curious...in reading the laws and rules last night it said that if you pay the fees for licensure by endorsement, then it is non-refundable. Did anyone who had applied get their money back?

Amanda

[Human_Being]

Amanda, As far as the Licensure by endorsement fees-I know of two folks that sent money as part of midwife applications that ended up hearing nothing.....Marina, the midwife Jen I were doing training with in the Keys tried to get a few friends of hers down to work with her in the Keys. Her Norwegian midwife friend and a Chicago midwife both sent money and applications to either the State or ICA (following the directions they got from either the State, midwife school, or credentialing agency since they all have a different version), but never heard anything....it was like they sent their applications and money in and they got lost in a void, no one knew who had it, what stage it was in, or how to get info on it, so they both gave up and never even got as far as being told they did not have enough education. Marina, the midwife in the Keys, is now relocating out of State, and she is a real treasure, so in a way she is another casualty of this bad process. Its sad because the Norwegian midwife married an American OB, and she is instead working as an aesthetician in the panhandle, so if you want a good eye brow pluck by a great underemployed midwife I can hook you up..... So yes, folks sent money (if it was to the State or the agency I do not know) but they were not refunded. I spent a few thousand on getting my applicant licensed and used all my life force up, too if that counts? She did get a temporary two year license, which was a victory, but she had to be enrolled in a 4 month course to use it and that was not an option, as the midwifery school elected to close it right then. Also the State said granting the her two year license was no guarantee she could get a permanent one, so it would have been to risky to move her family here if she could not renew it... So we did get a temp license she could not use, for $755.


Hi Jennifer, yes I remember you! Congrats on your second baby! Are you the midiwfe that went to New College and knows my good friend Jesse PAlenchar in G'ville? Glad you liked the center, I did too.... It is really bitter sweet selling it, on one hand I am so tired now, but its because the lack of qualified in state midwives willing to move and these licensing barriers forced me to go it alone. I also have a lot of resentment because it really didn't need to go down this way. When the Council made the determination last June that the schools had the power to make the call about education, I really tried to get, and would have expected FSTM, to step up to the plate for me. Instead with everything going on there they were too overwhelmed to deal and instead of helping told my applicant who was already taking classes that they were going to close the 4 month program...so she moved back to Georgia collected her family and promptly relocated to Virginia. I lobbied every one in the Tallahassee office, credentialing agency, and school to give my applicant a break and just look at her situation individually since we all knew the process was faulty, but they were of no help...But I needed her here last year, and she needed to relocate ASAP. (She was trying to leave Georgia due to the stress of the fact that there is no licensing there- she would say its hard enough to go to a birth with out wondering if the cop behind you on the way home is going to pull you over and take you to jail. There was a rash of arrests/legal hassles for midwives there last year. She'd moved there to be near her dying grandma and with grandma gone, it was too risky to practice there since she had 4 kids and risked jail every time she did a birth). So I guess its important to me that folks realize I did not just "burn out", I would easily still be practicing if I had adequate help, and there were ways others involved could have helped to have gotten my applicant going while we fixed this mess.

[onlyboys]

Bump! Friday is coming up! Get your dialing fingers ready!

[True Blue]

OK...I want to be involved...I'm a military wife who would like to become a midwife and be licensed in FL one day....but it is impossible for me to receive training in Florida for say, oh, 18 years when DH gets out after his 30 in. Soooo....I want to be able to train elsewhere and practice in FL someday!!! I had my DD at home in FL with a LM and had NO idea this problem existed. I want to help!!! Read the post but still not sure how LOL. I may just be tired.

[Human_Being]

Great!

And Jilian asked on the other thread about schools, and mentioned if there were more schools in Florida that would also fix the midwife shortage.

So this is a great time for all aspiring midwives that live too far from a Florida school to pay attention.

The same problems with Licensing individual midwives from out of State have been encountered by OUT OF STATE DISTANCE LEARNING SCHOOLS seeking to become approved in Florida.

Two distance learning schools have tried, but the same nimwits that do not know how to negotiate the process of getting midwives licensed, also give incorrect information to schools that are located out of State but wish to offer programs from a distance that would lead to a Florida License.

Florida law has a few real quirks, and one is that the preceptor must be a FLorida Licensed practitioner like a LM, CNM, or OB. But it never says the program must be located in Florida. So distance programs that offer the content required by Florida should be available to students who wish to precept with practitioners licensed in Florida. But The Council office has told at least one of the distance schools that they can not be a Florida approved program unless they are in Florida. This is wrong. Once again, we need to pay attention, and correct the problems that are limiting access to licenses, and therefore limiting access to midwives!

This will not specifically be addressed on this call, but is an important issue that can be taken on and fixed by the same means the licnesing issues will need to be fixed. And having a strong professional and consumer presence on the Council calls will send the message!

[Human_Being]

Originally Posted by True Blue

OK...I want to be involved...had NO idea this problem existed. I want to help!!! Read the post but still not sure how LOL. I may just be tired.

Oh, good Point. This rambling thread needs to be made into a summation of the problem and a how to help list.

Barriers to Midwifery Licensure Identified:
1.Process for Application/Educational Evaluation Uncertain
2.Cost is $5200-$6000 to obtain a License if Moving to FL
3. Educational Evaluation Tool exceeds actual requirements for FL LMs


Succinct How to Help Instructions:

1) Get on Council of Licensed Midwifery Call in meeting on Friday to show your support for remedying the barriers to licensure:

Friday, January 26, 2007 @ 9:00 am
DEPARTMENT OF HEALTH
MEDICAL QUALITY ASSURANCE
COUNCIL OF LICENSED MIDWIFERY
GENERAL BUSINESS MEETING
[phone], conference code 2454587



2)You need to say nothing in the meeting, in fact you must be recognized in order to speak, but when you get on the call introduce yourself as a consumer to show you are watching this process and making an effort to support midwives. When you first get on the call you identify yourself. Let me suggest you introduce yourself as "Hi I am *YerName*, a consumer (or midwife, or student midwife, founder of an organization) that is interested in remedying the midwifery shortage in Florida by broadening licensing opportunities for out of State midwives". If you feel you want to speak, ask to be recognized.



3)Send a quickie email or write a letter expressing your concerns about limited Licensing opportunities for schools and midwives in Florida. Send to

Email: [e-mail]
Telephone: [phone]
Mailing Address:
Council of Licensed Midwifery
4052 Bald Cypress Way, BIN #C06
Tallahassee, FL 32399-3256



4)Watch for more information and follow up. We are hoping to get a new educational evaluation tool approved at this Friday meeting. It has taken a year to get this far, and it is still being done reluctantly. Your show of support will encourage them to adopt the new tool and implement it wisely. We will probably need to follow up to get the "implement it wisely" part done. We also need to make the licensing more affordable, encourage the schools to make the 4 month program available and easy to interface with, and make sure any credentialing agencies involved are using the tool right. Join Midwives Association of Florida, Citizens for Midwifery, or go to Florida BirthNetwork meetings, or start a local chapter of one of these groups and stay in touch about the issue so we can organize together and address the problems plaguing the regulation of midwifery in Florida.



5) All midwifery advocates should be part of the Grassroots Network, and email alert system by Citizens for Midwifery that communicates needs for support for Midwifery issues. Many states are still illegal, and midwives are even sent to jail for practicing, this network keeps you in touch with news about birth and opportunities for letter and phone advocacy. Its free- go to Citizens for Midwifery Grassroots Network Page to join.



Thanks for your support!

[onlyboys]

Hey Heidi,

Do you mind if I copy and paste your emails into an email for my play groups and LLL? There are many women on my yahoogroups who need to know about this kind of stuff!

Amanda

[onlyboys]

From my research regarding out-of-state schools, the school must apply for licensure through the DOE's Council for Independent Education. The website: http://www.firn.edu/doe/cie/ I called the Council for Independent Education and there is not a single barrier to attaining licensure for an out of state school; they need only apply and fulfill the requirements. There's even provisions already in place for distance education.

They must also follow the guidelines as listed in the Rules. These are certainly met by any MEAC accredited school, except perhaps the part about passing the CLAST test, taking college level credits in math and English, or CLEPping the credits.

[True Blue]

So I wonder if any of these other schools would be willing to apply?

I am fairly certain the LM who attended my DD's birth went to school elsewhere.

[onlyboys]

Yes, there are schools willing to go through the application process.

Who was your midwife? I know of one who transferred from another state, and the powers that be made her take an additional 2 years of training before she could practice. That's the problem, really. I mean, if you had your degree from MCU, you'd likely qualify for the 2 year, instead of the 3 year program. But, come on, after you finish three years somewhere else, passed the NARM, are fully qualified, you shouldn't have to take 2 more years of schooling.

[True Blue]

I was wrong...she schooled in FL.

Yeah it is dumb to have to take 2 more years of school. Drs don't have to do it! How do other states operate?

[Human_Being]

Yes, send this stuff outto anyone interested......It's ok to forward a link to this discusiion, or my first three posts, or the brief how to help post is ok to forward- I sent those out on lists. But these other posts are chatty and if taken out of context could be misunderstood, so I'd rather they be quoted in short snippets or paraphrased, if thats ok?

No other profession requires classes like the 4 month course. That whole thing should be trashed all together, but that would require opening the law which is generally not a good idea. So right now I am trying to fix the crummy system that is set up so it at least works. But yes, the 4 momth thing is unfair, and subjects midwives ot time, costs, and hassle no other profession must endure....

I was trying to figure out how Washington State handles in co,ing midwives, get a detail of the process, but I lost touch with the person I was talking wiht in their regulatory department, and have not found a WA midwife that knows about it yet. They are most comparable to Florida in many ways, and are way ahead of us in many ways. So I hoped their process would be one we could model ours after....

The Midwife I was trying to hire andI helped outline a process that would work. But right now I am settling for getting this dumb tool in use. I'll make the next post below a summary of what would actually work best in my opinion!

Yes, there are schools that would apply and one I can personally confirm has tried! But the information resource is The Council of Licensed Midwifery Office. They are charged with regulating midwifery in Florida and are kind of the call center for anyone trying to get information about midwifery in Florida, and they do not really know anything about it! "The we are not professionals" people!

When you want a license or want to establish a school, you call them. And when they give bad information, folks are stopped and their is really no way for them to know where to go to press further, so folks just do not get licenses, or do not get schools approved. So we all lose. I know for sure of the one school, that despite what Amanda said that highlights its totally legal to have a distance program out of State that meets the requirements, they were told "you have to physically be in Florida". I was looking at this because when I could not get the Midwifery school to offer the 4 month program, I thought I could offer it myself if another school would let me team up with them....so I was looking at the good schools already out there, hoping to offer a 4 month program myself if that was the only way to get the license.

So I talked ot a lot of people in the education world. Its such a great idea ot have a program offered in Florida I was wondering why no one had done it, and found out they had indeed tried but were deterred by the same folks that I was bumping up against. There is a huge need for distance midwifery education- I mean all the wanna be midwives are moms that could precept with their midwives and and do classes at home. Few moms can relocate their families to Gainesville or Miami, where the job market is slim for most partners who would have to be the support why mom becomes an unpaid student midwife on call at all hours of the day..... So we mostly have young single women (as I was ) becoming Florida LMs because logistically that's who the programs work for. I could not imagine trying to get through one of the programs now I am a mom, but it was doable as a single childless woman with a decent car! And it would be do-able if distance education was available....

Anyway, this bad tool was probably behind the long path to midwifery for the out of State midwife. Maybe she really didnt have what she needed, but she may have been judged by false standards too. I think this is why the school has not been proactive in helping fix the tool, if they admit they were part of evaluating people using a tool that exceeded and was not comparable to their program, and they were financially benefiting form it, they are in a sticky position.