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Birth assistants and milage reimbursement

post #1 of 13
Thread Starter 
Hello all-

Midwives, do you reimburse your assistants for milage? If so, how much? Are they employees or contractors?


post #2 of 13
When I was an apprentice, I operated all of my birth work like a business. Some parts of the business made money, some lost money. Doula work was profitable, midwifery work, where I was paid between $50 and $200 per birth, was not. Doing it this way made it so that I could deduct all of my mileage from my taxes as well as supplies and equipment, workshops, magazine subscriptions, and memberships. By paying me a general fee per birth, my preceptors made it possible legally for me to call my work for them a job and deduct all of that stuff. I ended up with a business loss and it helped on my family taxes (I think you can declare a loss only 2 of every 3 years or the IRS gets upset, but it was legit that year). If I had just been reimbursed for mileage, even though it might have been similar to the $50 payment, then I'm not sure I would have.

I try to drive my apprentices around as much as possible. Some of them don't live near me, so it doesn't work all that well, but I do try to limit their fuel expenses. I have specifically offered mileage reimbursement once when I had an apprentice run a lengthy errand. Otherwise, I will work up to paying my apprentices the same kind of fees that I was paid.
post #3 of 13
oh, and no employees. Everyone is an independent contractor, getting a 1099 at the end of the year if they have earned enough.
post #4 of 13
I know midwives who do have employees and pay into 401K for their own retirement, as well as have health insurance. There are free small business tools you can access online. I have been to a couple of lectures give by midwives on business admin. One was a CNM who had been president of a large midwife Collective in CA- they did in and out of hospital births
the other is a gal who works for MEAC, she has a LLC -the midwives who work with her get an hourly wage.
I know other midwives who do 1099s for their assistants depends on how you want to structure your business.
(when I delivered a local monthly magazine, I was an independent contractor, filled out a 1099, all my costs, mileage ,and what have you fell to me to pay- I had to pay into social security when filing taxes, but what they paid gave me more money than it cost me )

the cost of midwifery is between 50-75% of your gross- depending on if you are going to provided yourself with health insurance and retirement as well as time off.

I am going to have to find the link for the small business tools and post/send it later.
post #5 of 13
I didn't mean that you couldn't make them employees, moreso that I haven't and probably won't.

I think that, among other things, making my assistants my employees means that I have to pay them minimum wage. Which might not be a problem for someone who works on the model where they come to a prenatal or two to meet the birthing family and then do the birth. But I have apprentices instead, and I just couldn't pay them minimum wage for all of the study sessions I run, meetings, prenatals, births, postnatals, etc. There is a definite exchange of training for experience there. The way I look at it, they are students of mine and I also happen to eventually contract them for work at births.
post #6 of 13
My midwife didn't pay her assistant. I did & it was $200. It was hard though since she was a total stranger to us & it took a bit to get comfy with a new person on the team.
post #7 of 13
Originally Posted by Gray's Mommy View Post
My midwife didn't pay her assistant. I did & it was $200. It was hard though since she was a total stranger to us & it took a bit to get comfy with a new person on the team.
I help out other midwives sometimes and I have had their clients do this so that the midwife didn't need to do a 1099 for me (like if I charge $500 to help another midwife and she hires me 3 times in a year -- normally she would have to even though the one charge is not enough to make it necessary because the three together would be over the limit).

I understand being uncomfortable with someone you meet only once. As my fabulous senior apprentice gets more skills, I am moving away from having other midwives as assistants at my births. I think the families almost always prefer the person they get to spend more time with.
post #8 of 13
Thread Starter 
Thanks for your replies. I am asking because neither of my birth assistants have consistent access to cars, and it's becoming increasingly evident that this is a problem. My thought is, they've chosen this line of work, and getting themselves to births is their responsibility, not mine.

I've decided upon the milage allowance because some midwives offer that. Otherwise, I think, the manner in which they get there is their responsibility. If they have their partner/relative's car, great, they might make out a bit. If they do a short term rental/car sharing service, they might lose out a bit. If they have to take a cab, be it 1 mile or 50, they'll lose a lot, but it's what they've chosen by being a birth assistant without a car.

post #9 of 13
Thread Starter 
My question about employees or contractors is because some would say I have a higher degree of responsibility to an employee than to a contractor.
post #10 of 13
I receive $10 per prenatal (which is nice, because it's per client, not per date, and we usually do all the clients in one day at one location), and then $300 per birth. I get cash, and it's my responsibility to pay taxes.

As far as being a birthworker without a car...I suppose I'd be kind of hard nosed about that, if it were me. Unless they live next door to you and you can drive them...it shouldn't be an issue. Like any other job, if they don't have transportation that is reliable, it was not appropriate for them to apply. It should not be your problem or that of the families for whom you work that they do not have reliable transportation. Sounds cranky, I know...but that is how it would be ANYWHERE in the business world, right?
post #11 of 13
It is nice to be understanding to a degree,yes there are all sorts of reasons to be sans car at times, but it is important to show up. Just like with my magazine delivery job if I didn't have a way to pick up and deliver I was out of a job. I realize it is hard to find good reliable help, and I do not want to go to births without help, but showing up timely is essential.
I think because we are in a caring profession people who work for us ask more of us than they would at any other type of job. You don't have to be ruthless but it is ok to have an expectation - and not have to know the details of how they figure it out just that it happens. I think a while back there was an apprentice on this list who tried to be an apprentice without a car, but I think she figured out it was important.
post #12 of 13
Yes, I am not saying to be ruthless...but if you are expecting that that extra set of hands is there, and they are not, what good are they? I suppose that, if they are looking into birthwork as a career and they are not reliable, perhaps they will figure it out on their own that the current situation is not a good fit?...
post #13 of 13
here is the Small business tools address- I think this is the one that was recommended.


under the template gallery there are several things to look at and use- in particular the breakeven analysis
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