To clarify and update the rule to include the most recent core competencies for licensed midwives.

 

DEPARTMENT OF HEALTH

Council of Licensed Midwifery

RULE NOS.:RULE TITLES:

64B24-4.001Definitions

64B24-4.002Approval of Training Program

64B24-4.003Acceptance into Training Program

64B24-4.005Faculty

64B24-4.006Curriculum Guidelines and Educational Objectives

64B24-4.007Clinical Training

64B24-4.008Administrative Procedures

64B24-4.010Four-month Pre-licensure course

PURPOSE AND EFFECT:  To clarify and update the rule to include the most recent core competencies for licensed midwives.

SUMMARY: The rule is being amended to clarify the rule and to update the standards for midwifery programs to the most decent core competency standards.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION: The agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: Based on the SERC checklist, this rulemaking will not have an adverse impact or regulatory costs in excess of $1 million within five years as established in s.120.541(2)(a), F.S.

Any person who wishes to provide information regarding the statement of estimated regulatory costs, or to provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY:  456.004, 467.005, 467.205 FS.

LAW IMPLEMENTED:  467.009, 467.0125, 467.205 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS:  Claudia Kemp, Executive Director, 4052 Bald Cypress Way, Bin C-06, Tallahassee, FL 32399-3256 or [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64B24-4.001 Definitions.

(1) “Department” means the Department of Health.

(1)(2) “Clinical expertise” means demonstrated proficiency in a specialized area of direct patient care.

(3) through (10) Renumbered (2) through (9) No change.

(10)(11) “Four month pre-licensure course” means an approved program of not less than 15 credit hours which meets the requirements of these rules subsection 64B24-4.010(4), F.A.C.

(11)(12) “Approved program” means a midwifery school or a midwifery training program which is approved by the department pursuant to Section 467.205, F.S.

Rulemaking Authority 467.205(2) FS. Law Implemented 467.205 FS. History–New 1-26-94, Formerly 61E8-4.001, Amended 7-25-96, Formerly 59DD-4.001, Amended 10-11-04,                   .

 

64B24-4.002 Approval of Training Program.

(1) Provisional approval for a term not to exceed five years shall be granted by the department to an organization to initiate a midwifery training program when it has presented documentation satisfactory to the department that it meets the accreditation requirements of Chapter 467 and the requirements for faculty, curriculum, clinical training and administration as set forth in these rules. following criteria :

(a) The training program shall be conducted in either an accredited public institution, or in a non-public institution licensed by the State Board of Independent Postsecondary Vocational, Technical, Trade and Business Schools and which is actively seeking accreditation by a member of the Council on Postsecondary Accreditation All training programs shall include both classroom instruction and clinical training;

(b) The time required to complete the training program shall be pursuant to Section 467.009(2), F.S.;

(c) Faculty pursuant to Rule 64B24-4.005, F.A.C.;

(d) Curriculum Guidelines and Educational Objectives pursuant to Rule 64B24-4.006, F.A.C.;

(e) Clinical Training pursuant to Rule 64B24-4.007, F.A.C.; and

(f) Administrative Procedures pursuant to Rule 64B24-4.008, F.A.C.

(2) Training programs which have been granted provisional approval may be granted full approval upon demonstration to the department they are in compliance with established standards of the department, and at least 80 percent of the first graduating class who took the licensing examination achieved a passing score qualified for licensure.

(3) A training program may be placed on probationary status if at any time when the department determines that the program falls below established standards, or fewer than 80 percent of the midwifery students in the most recent graduating class who took the licensing examination achieved a passing score graduates qualify for licensure. Probationary status shall be on an individual basis for a specified period of time not to exceed 12 months.

(4) The department shall rescind approval of any training program which fails to meet standards established in Chapter 467, F.S., or these rules by this chapter, or fails to make satisfactory progress for corrections of deficiencies within the probationary time period designated by the department.

(5) Any training program having its approval rescinded shall have the right to reapply.

(5)(6) The department shall, at least once every three (3) years, audit the program to certify the approval status of all training programs to determine if the program is in compliance with Chapter 467, F.S. and these rules established standards.

Rulemaking Authority 456.004(5), 467.205(2) FS. Law Implemented 467.205 FS. History–New 1-26-94, Formerly 61E8-4.002, 59DD-4.002,  Amended 10-11-04,                 .

 

64B24-4.003 Acceptance into Training Program.

To be accepted into a department approved midwifery training program, the program shall evidence that the applicant has:

(1) A high school diploma, or its equivalent; and

(2) pPassed the College Level Academic Scholastic Test (CLAST), or has taken and received a passing grade in three college level credits each of math and English, or can demonstrate competencies in communication and computation by passing the College Level Equivalent Proficiency (CLEP) test in communication and computation.

Rulemaking Authority 456.004(5), 467.205(2) FS. Law Implemented 467.009(3), 467.205 FS. History–New 1-26-94, Formerly 61E8-4.003, 59DD-4.003, Amended               .

 

64B24-4.005 Faculty.

(1) At a minimum, Tthe faculty of each approved midwifery training program shall be comprised of, at a minimum, a licensed midwife who is actively teaching, and either a certified nurse midwife, or a board certified physician licensed under Chapter 458 or 459, F.S., who has actively practiced obstetrics within the last 4 years.

(2) It shall be the responsibility of the school of midwifery to furnish current faculty information to the department upon request.

Rulemaking Authority 456.004(5), 467.205(2) FS. Law Implemented 467.205 FS. History–New 1-26-94, Formerly 61E8-4.005, 59DD-4.005, Amended              .

 

64B24-4.006 Curriculum Guidelines and Educational Objectives.

(1) In order to ensure the preparation of midwives capable of competent practice, Tthe curriculum shall be an organized pattern of classroom instruction and clinical training which is consistent with principles of learning and educational practices, and which reflects the stated philosophy and objectives of the training program.

(2) Standards for midwifery programs shall encompass classroom instruction and clinical training in all aspects of antepartal, intrapartal, postpartal, and neonatal care pursuant to Section 467.009(1), F.S., and shall include:

(a) tThe core competencies established by the American College of Nurse Midwives, effective 8/2011, and the Midwives Alliance of North America, effective 12/2014,  which are incorporated herein by reference, and effective 1-26-94, available at https://flrules.com/gateway/reference.asp?No=Ref-##### and can be obtained upon request from the Council of Licensed Midwifery, Department of Health, 4052 Bald Cypress Way, Bin C06, Tallahassee, Florida 32399-3256; and

(b) a Acomponent on the law and rules which govern the practice of midwifery in Florida.

(3) The administration and faculty of the training program shall formulate and adopt educational objectives that ensure curriculum guideline requirements will be met. Such objectives shall be based on a clearly stated philosophy that is in keeping with currently accepted midwifery standards, and which is consistent with the philosophy of the institution of which the training program is a part.

(4) Training program objectives shall identify competencies expected of graduates from the program. Such objectives shall and serve as the basis of program development. Course objectives shall state expected behavioral outcomes of the student, serve as the basis for course development and student evaluation, and evidence direct relationship to training program objectives.

(5) No change.

Rulemaking Authority 467.005, 467.205(2) FS. Law Implemented 467.009, 467.205 FS. History–New 1-26-94, Formerly 61E8-4.006, 59DD-4.006, Amended 9-10-02, 10-11-04,                 .

 

64B24-4.007 Clinical Training.

(1) No change.

(2) Clinical learning experiences based on program objectives shall include a variety of clinical settings and facilities within the State of Florida such as homes, birth centers, clinics, offices and hospitals.

(3) Clinical experiences shall be conducted under the direct supervision of a preceptor.  No preceptor shall be assigned more than two students during any clinical experience.

(4)(3) It shall be the responsibility of the midwifery training program to obtain and maintain current contractual agreements with each facility utilized for clinical training to insure provision of the appropriate clinical experience necessary to fulfill the requirements of this chapter.

(4) The faculty shall select clinical learning experiences and provide the student midwife with a variety of preceptor role models who shall be physically present at every birth and who shall supervise students at all times when the student is performing in a midwifery capacity with patients. No preceptor shall be assigned more than two students during any clinical experience.

(5) The student midwife, during training, shall undertake, under the supervision of a preceptor, the care of 50 women in each of the antepartal, intrapartal and postpartal periods, but the same women need not be seen through all 3 periods. The intrapartum period includes labor, birth, and the immediate postpartum. No more than five percent (5%) of the required intrapartal managements shall include transfers in active labor.

(6) During training under the supervision of a preceptor, Tthe student midwife shall undertake the neonatal examination of 50 newborns.

(7) through (8) No change.

(9) The student shall perform 5 vaginal sutures.

Rulemaking Authority 467.005, 467.205(2) FS. Law Implemented 467.205 FS. History–New 1-26-94, Formerly 61E8-4.007, 59DD-4.007, Amended 9-10-02, 10-11-04,                 .

 

64B24-4.008 Administrative Procedures.

(1) through (1)(a) No change.

(b) Admission, promotion, and retention policies and procedures for students;

(c) through (f) No change.

(g) An organized system of record making and record keeping which includes, but is not limited to, pertinent information on students, faculty, preceptors, and facilities relative to classroom instruction and clinical training.

(2) Upon request of a student or a graduate, the institution or the midwifery training program shall furnish a copy of the student’s final record to the agency department within 60 days following the successful completion of the program.

Rulemaking Authority 456.004(5), 467.205(2) FS. Law Implemented 467.205 FS. History–New 1-26-94, Formerly 61E8-4.008, 59DD-4.008, Amended                 .

 

64B24-4.010 Four-month Pre-licensure Course.

(1) The Ffour (4) month pre-licensure course programs shall must be approved by the department and shall include, at a minimum:

(a) through (b) No change.

(c) Provisions for five (5) supervised labor and deliveries and ten (10) supervised prenatal visits by each course participant.

(2) Applicants who are applying for licensure as a midwife through endorsement pursuant to Rule 64B24-2.004, F.A.C., shall successfully complete a four (4)-month pre-licensure course conducted within an approved midwifery training program pursuant to Rule 64B24-4.002, F.A.C.

(2)(3) Upon completion, tThe applicant shall provide evidence to the department having completed a four (4) month pre-licensure course which shall include the following:

(a) Aan official transcript sent directly from the institution, or midwifery training approved program where the course was taken which shall include course titles, grades received, dates of attendance and dates the applicant attended the program, date of completion

(b) An original letter on letterhead stationery from the director of the training program which states that the applicant successfully completed the pre-licensure course.

(4) To be admitted to the 4-month pre-licensure course, a person shall meet admission requirements as established by the approved training program and requirements pursuant to Rule 64B24-4.003, F.A.C.

Rulemaking Authority 456.004(5) FS. Law Implemented 467.0125 FS. History–New 1-26-94, Formerly 61E8-4.010, 59DD-4.010, Amended 10-11-04,                .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Claudia Kemp

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: John H. Armstrong, MD, FACS, Surgeon General and Secretary

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: November 18, 2015

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: August 12, 2015