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"The governor signed the birth center bill
into law this morning, May 21, 2010!...What
an incredible day for birth centers, midwives, and childbearing women!
We are the first state to have equal reimbursement for CPMs written
into law. Women on medicaid now have expanded birth options. And CPMs
are now a medicaid provider type! We have a great birth center
licensure bill that other states can use as a model. What an incredible
journey." says Kate Saumweber, who works assisting Midwife Amy Johnson-Grass at Health Foundations Birth Center.
 "Thank you to everyone who contributed to this
effort!" Kate Saumweber sent this announcement out to the midwives in
Minnesota with the exciting news. In her email she acknowledges many of
the midwives and birth activists working towards this historical event :
"Without this team, I truly don't think this bill could have come so far
without the hard work of each midwife on this team. I had the honor of
working closely with Amy Johnson-Grass, ND, LN, CPM, LM, Brielle Stoyke,
CNM, Cheryl Heitkamp, CNM, and Mary Rossi, CNM on this journey. This
team of women worked tirelessly on this effort, and were able to drop
everything at a moment's notice to join in a meeting, testify at a
hearing, talk to a bunch of legislators...I think that each midwife took
on a much larger job than they expected, but stuck with it through the
end, even as the work snowballed into new levels.
We were able
to reach out to a lot of others for support that we are very grateful
for: Susan Lane (offering last minute legislative guidance at a moment's
notice), Karin Larson, CNM (who's daughter, Kristin, designed our
handouts), Katie Cavenor (Senate Counsel, who was very willing to work
openly and patiently with us on the language of the bill, to make it the
best possible for midwives and birth centers), midwifery leaders across
the country who offered us help and suggestions on how to turn this
bill into a reality (Suzy Myers, Audry Levine, Mary Lawlor, Kate Bauer,
Wendy Gordon, and I'm sure others that are not coming to the top of my
head), and MCCPM members (who swept in and gave an extra push to our
authors when CPMs were at risk for getting only 65% reimbursement
instead of 100%). A huge thank you goes to Minnesota's ACNM chapter who
was supportive of this bill (and CPMs) and paid for all of our copies
and handouts; there were a number of ACNM members who spend a lot of
time contacting legislators and attending meetings regarding strategy of
the bill. ACNM used their contacts in the medical world to gain support
from ACOG, the MN Hospital Associations, and others so that we could
proudly say that we had no opposition of the bill!"
With a smile, I'd like to add that Linda Berglin first authored a birth center bill in Minnesota in 2009. Linda Berglin is Senate chair for Health and Finance. No one in their right mind would oppose the passion Senator Berglin developed for birth centers. She proposes every Third-party payer have their own or an affliation with a birth center in order to share in state money to be reimbursed for their maternity services in and out of the birth centers (meaning to get money towards their expenses for hospital medicare patients they were to be at least affiliated with a birth center whether or not their patients birthed in the free-standing birth center or the hospital). Her 2009 bill didn't get through, but did get a lot of discussion and education. She got people's attention!
Just like birth, what is expected to go in a predictable
pattern sometimes does not, but the blessing reveals itself in its own
way. Kate Saumweber, aspiring midwife and excellent help to the MCCPM
group here in Minnesota, and now to Naturopath and CPM (Certified
Professional Midwife) Amy Johnson-Grass of Health Foundations Birth
Center shares the news with the Minnesota midwifery community. Kate
described the last hour decision of one of the bill's authors,
"...[B]y
the hard work of our House Author, Rep Maria Ruud, our birth center
language was included into the omnibus budget bill during the special
session. "
Midwife Connection online
newsletter published a celebratory article by CNM, Brielle Stoyker,
Brielle relayed the CNM's motives who worked so
hard on the bill, "Our intention was just licensure, but because it
included fiscal savings, the bill became a bit more
complicated....Certified nurse-midwives (CNMs) in MN are currently paid
at 100% of what physicians receive for their services under Medicaid,
and we would have been brought down to the 65% Medicare rate. But,
because of the new federal
health care reform law that will raise Medicare reimbursement for
CNMs to 100% beginning in January 2011, we were able to persuasively
argue that imposing a 35% reimbursement cut would be unfair and contrary
to the intent of federal policy. In the process of working with
legislators and lobbyists, we were able to whip up an amendment to
exempt CNMs from the Medicare rebasing! On the last day of the session,
both our amendment and the birth center bill were passed by both houses,
and the bill now awaits consideration by the Governor. We have our
fingers crossed that the bill will soon become law. For the hard work it
took to get this far, special thanks go to the American Association of
Birth Centers (AABC), MN midwives, as well as midwives and their
supporters across the US."
This is an amazing and important
acknowledgment for CNMs (Certified Nurse Midwives) and for CPMs
(Certified Professional Midwives). Working together on this project is
promising that unity can expand and continue. Having a two-tiered
midwife credential in this nation need not be any more confusing than
having two types of physicians that catch babies, family practice and
obstetricians.
In Minnesota, we believe women are smart (and men
are good looking...right, Garrison?) and can find the midwife or doctor that fits their needs. We are also practical and fair. Expectant mothers' should get quality maternity care in and out of the hospital, in cost effective ways and with third-party payment. If that means the government coverage they would get for hospital care, they should have that for birth center care, this law affirms. (I'd add homebirth, too, where the postpartum care is optimal.) Midwives
should get paid for the fine work they do. Midwife birth statistics are
excellent overall. Hopefully, this is another midwifery statute that is a
model for the rest of the nation. (Our Traditional Midwife law for CPMs
is one of the very best!)
This is a great start for reforming maternity care in Minnesota and true health reform in any category. Congratulations to all.
note: The first Minnesota birth center in modern times was Jill Kent's center in Moorhead, which closed years ago. The first currently operating center is Morning Star Womens' Health and Birth Center in St. Louis Park.
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