STATE OF WISCONSIN
BOARD OF NURSING
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IN THE MATTER OF RULE-MAKING : PROPOSED ORDER OF THE
PROCEEDINGS BEFORE THE : BOARD OF NURSING
BOARD OF NURSING : ADOPTING RULES
: (CLEARINGHOUSE RULE )
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PROPOSED ORDER
An order of the Board of Nursing to repeal N 4.02 (2) and (6), 4.04 (2) to (4), 4.05 (6), and 4.10 (3) and (3) (Note); to renumber and amend N 4.01 (2), 4.04 (1) (intro.) and (a) to (d), 4.05 (1) and (4), and 4.08; to amend N 4.01 (1), 4.02 (2m) and (4), 4.03 (1) to (3), 4.04 (title), 4.05 (2), (3), and (7) (intro.), (a), and (b), 4.06 (1) to (4), 4.07 (1) to (4), and 4.10 (1) (intro.) and (2) (a) and (b); to repeal and recreate N 4.05 (5); and to create N 4.01 (2) (a) to (d), 4.025 (4), 4.04 (5), 4.043, 4.05 (1) (a) to (c), (6m), and (7) (d), 4.07 (2m), and 4.10 (2) (d) and (e), relating to licensure of nurse-midwives.
Analysis prepared by the Department of Safety and Professional Services.
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ANALYSIS
Statutes interpreted: Section 441.15, Stats. Explanation of agency authority:
Section 15.08 (5) (b), Stats., provides that each examining board “[s]hall promulgate rules for its own guidance and for the guidance of the trade or profession to which it pertains, and define and enforce professional conduct and unethical practices not inconsistent with the law relating to the particular trade or profession.” Section 441.15 (3) (c), Stats., provides that “[t]he board shall promulgate rules necessary to administer this section, including the establishment of appropriate limitations on the scope of the practice of nurse-midwifery, the facilities in which such practice may occur and the granting of temporary permits to practice nurse-midwifery pending qualification for certification.” Related statute or rule:
Chapter N 7 provides rules of conduct for licensees, including licensed nurse-midwives. Plain language analysis:
The Board conducted a comprehensive review of ch. N 4 to ensure its provisions are statutorily compliant and current with professional standards and practices. As a result of this review, the following changes have been made:
A definition of “bureau” and associated references to the Bureau of Health Service Professions within the Department of Safety and Professional Services are removed, as the Bureau no longer exists.
A definition of “written agreement” is removed, as it contains substantive and self-evident criteria for the required written agreement under which a nurse-midwife works in collaboration with a physician.
Sections N 4.03 and 4.05 are updated to reflect that the current accrediting body of educational programs in nurse-midwifery is the Accreditation Commission for Midwifery Education, and that the American Midwifery Certification Board is the current national certifying body.
Section N 4.04 is revised to remove an obsolete requirement that an application be notarized.
Section N 4.043 is created to specify the requirements for renewal of a license to practice nurse-midwifery.
Section N 4.10, relating to malpractice insurance, is revised to be consistent with the exceptions to the malpractice insurance coverage requirements enumerated in s. 441.15 (5) (a), Stats.
Provisions concerning licensure and temporary permits have been reorganized for connectivity and clarity.
Other revisions throughout ch. N 4 have been made to provide clarity and comply with current drafting standards. Summary of, and comparison with, existing or proposed federal regulation:
None.
Comparison with rules in adjacent states:
Illinois:
Rules of the Illinois Department of Financial and Professional Regulation address the practice of midwifery in Illinois (68 Ill. Adm. Code 1300). This includes requirements for licensure as an advanced practice registered nurse with certification as a nurse-midwife (68 Ill. Adm. Code 1300.400), the scope of practice of advanced practice registered nursing by certified nurse-midwives (68 Ill. Adm. Code 1300.440), requirements for written collaborative agreements (68 Ill. Adm. Code 1300.410), and requirements for late renewal and restoration of a license (68 Ill. Adm. Code 1300.50).
Iowa:
Rules of the Iowa Board of Nursing address the practice of midwifery in Iowa (655 IAC). This includes requirements for licensure as an advanced practice registered nurse with certification as a nurse-midwife (655 IAC 7.2), the scope and standards of advanced nursing practice by certified nurse-midwives (655 IAC 7.4 to 7.6), and requirements for late renewal and reactivation of a license (655 IAC 7.3). Advanced practice registered nurses practicing in Iowa are not required to enter into a collaborative agreement.
Michigan:
Rules of the Michigan Board of Nursing address the practice of midwifery in Michigan (Mich Admin Code, R 338). This includes requirements for licensure as a registered professional nurse with specialty certification as a nurse-midwife (Mich Admin Code, R 338.10203 to R 338.10205 and R 338.10404a), a definition of the practice of a nurse-midwife within the scope of practice of registered professional nursing (Mich Admin Code, R 338.10401), and requirements for late renewal and reregistration of a nurse-midwife specialty certification (Mich Admin Code, R 338.10405a). Registered professional nurses with specialty certification, including specialty certification as a nurse-midwife, practicing in Michigan are not required to enter into a collaborative agreement.
Minnesota:
Rules of the Minnesota Board of Nursing and the Minnesota Statutes address the practice of midwifery in Minnesota (Minnesota Rules, Parts 6305.0100 to 6305.0800 and 2019 Minnesota Statutes, Sections 148.171 to 148.285). This includes requirements for licensure as an advanced practice registered nurse with certification as a nurse-midwife (Minnesota Rules, Part 6305.0410), a definition of nurse-midwife practice (2019 Minnesota Statutes, Section 148.171, Subd. 10), and requirements for late registration and reregistration of a license (2019 Minnesota Statutes, Section 148.231). Advanced practice registered nurses with certification as a nurse-midwife practicing in Minnesota are not required to enter into a collaborative management agreement. Summary of factual data and analytical methodologies:
The Board conducted a comprehensive review and update of ch. N 4 to ensure the chapter is statutorily compliant and current with professional standards and practices. This included a review of the accreditation criteria established by the Accreditation Commission for Midwifery Education and the Standards for the Practice of Midwifery issued by the American College of Nurse-Midwives. Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis:
The proposed rules were posted for a period of 14 days to solicit public comment on economic impact, including how the proposed rules may affect businesses, local government units, and individuals. No comments were received.
Fiscal Estimate and Economic Impact Analysis:
