I had my first baby with an ob/cnm combined practice. I had my second (homebirth) with a cnm practice.
The differences between the two were astounding. I was very, very surprised when I went to my first visit and was instructed on how to use the scale and test my own urine and record all findings in my chart. At first, I really could not believe that they trusted me to weigh myself and evaluate my own dipstick and even write on my chart...but then I realized that 1) it's not rocket science and 2) I am perfectly capable and 3) I have a vested interest in doing it accurately and 4) it's my information! It belongs to ME!
I came to love the way the cnm's expected me to take responsibility for myself. I love the way the lines of communication are completely open and clear. If I want something, if I have a question, I ask. If I want to know something about the whys and wherefores of their practice, I ask. I love that the relationship I have with my cnm is a partnership...it's nothing like the paternal relationship I had with my former ob.
What I hear you saying, mama, is that the cnms you are seeing said they were going to do something, and they didn't do it. Maybe I'm reading more into this than is really there, but it seems like you're saying that because of this, you have concerns about the competency of the care they will provide. I think it's absolutely valid to question the competency of your caregivers, but in order to question effectively, you have to be willing to bring your issues to the table.
My suggestion to you is to hash this out with them. Keep an ongoing list of the things you want to talk about, and take that list to every appointment. It could very well be that they had a reason to not do the pap, but since you didn't ask, they didn't know it was a concern for you.
mom to dd (11) and dd (9) and ds (3) and (x2)