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:
The Fiscal Estimate and Economic Impact Analysis is attached.
Effect on small business:
These proposed rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator may be contacted by email at Daniel.Hereth@wisconsin.gov, or by calling (608) 267-2435. Agency contact person:
Jon Derenne, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, Wisconsin 53708-8366; telephone 608-266-0955; email at DSPSAdminRules@wisconsin.gov. Place where comments are to be submitted and deadline for submission:
Comments may be submitted to Jon Derenne, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, 4822 Madison Yards Way, P.O. Box 8366, Madison, WI 53708-8366, or by email to DSPSAdminRules@wisconsin.gov. Comments must be received on or before the public hearing scheduled for 8:00 AM on December 10, 2020 to be included in the record of rule-making proceedings. ---------------------------------------------------------------------------------------------------------------------
TEXT OF RULE
Section 1. N 4.01 (1) is amended to read:
N 4.01 (1) The rules in this chapter are adopted pursuant to authority of ss. 15.08 (5), 227.11 (b) and 441.15 (3) (c), Stats., and interpret s. 441.15, Stats. Section 2. N 4.01 (2) is renumbered N 4.01 (2) (intro.) and amended to read:
N 4.01 (2) (intro.) The intent of the board of nursing in adopting rules in this chapter, interpreting s. 441.15, Stats., is to specify the requirements for obtaining licensure as a nurse-midwife; the scope of practice of nurse-midwifery; the types of facilities in which such practice may occur; and malpractice insurance requirements for nurse-midwives. all of the following:
Section 3. N 4.01 (2) (a) to (d) are created to read:
N 4.01 (2) (a) Requirements for licensure as a nurse-midwife and renewal of a license to practice nurse-midwifery.
(b) The scope of practice of nurse-midwifery.
(c) Requirements for health care facilities where the practice of nurse-midwifery may occur.
(d) Malpractice insurance requirements for nurse-midwives.
Section 4. N 4.02 (2) is repealed.
Section 5. N 4.02 (2m) and (4) are amended to read:
N 4.02 (2m) “Collaboration" has the meaning specified given in s. 441.15 (1) (a), Stats.
(4) “Complications" means those conditions which jeopardized specified in a written agreement under s. N 4.06 (2) as being conditions that jeopardize the health or life of the a patient and which deviate from normal as defined in the written agreement consistent with the standards of practice of the American College of Nurse-Midwives. Section 6. N 4.02 (6) is repealed.
Section 7. N 4.025 (4) is created to read:
N 4.025 (4) A license to practice nurse-midwifery shall be issued separately from a license to practice professional nursing.
Section 8. N 4.03 (1) to (3) are amended to read:
N 4.03 (1) Has completed an educational program in nurse-midwifery accredited by the American College of Nurse-Midwives Accreditation Commission for Midwifery Education, or another accrediting body approved by the board.
(2) Holds a certificate issued by the American College of Nurse-Midwives or the American College of Nurse-Midwives Certification Council American Midwifery Certification Board, or another national certifying body approved by the board.
(3) Is currently licensed to practice as a professional nurse in Wisconsin, this state or is currently licensed has the privilege to practice professional nursing in another state which that has adopted the nurse licensure compact.
Section 9. N 4.04 (title) is amended to read:
N 4.04 (title) Application procedures for licensure.
Section 10. N 4.04 (1) (intro.) and (a) to (d) are renumbered N 4.04 (intro.) and (1m) to (4m) and amended to read:
N 4.04 (intro.) An applicant for licensure a license to practice as a nurse-midwife nurse-midwifery shall file a completed, notarized application on a form provided by the bureau board. The application shall include all of the following:
(1m) Signature The signature of the applicant.
(2m) Fee The fee specified under s. 440.05 (1), Stats.
(3m) Evidence of completion of an educational program in nurse-midwifery approved by the American College of Nurse-Midwives and evidence of certification as a nurse-midwife from the American College of Nurse-Midwives or the American College of Nurse-Midwives Certification Council Accreditation Commission for Midwifery Education, or another accrediting body approved by the board.
(4m) Identification Evidence of current licensure as a professional nurse in Wisconsin this state or of current licensure privilege to practice professional nursing in another state which that has adopted the nurse licensure compact, including the license number and renewal information.
Section 11. N 4.04 (2) to (4) are repealed.
Section 12. N 4.04 (5) is created to read:
N 4.04 (5) Evidence of certification as a nurse-midwife from the American Midwifery Certification Board, or another national certifying body approved by the board.
Section 13. N 4.043 is created to read:
N 4.043 License renewal. An individual holding a license to practice nurse-midwifery may renew the license by doing all of the following:
(1) Pay the renewal fee as determined by the department under s. 440.03 (9) (a), Stats., the workforce survey fee, and any applicable late renewal fee. (2) Complete the nursing workforce survey to the satisfaction of the board.
(3) Provide evidence of current certification as a nurse-midwife by the American Midwifery Certification Board, or another national certifying body approved by the board.
(4) If applicable, provide evidence to the board that the applicant maintains in effect malpractice insurance meeting the requirements under s. N 4.10 (1). Section 14. N 4.05 (1) is renumbered N 4.05 (1) (intro.) and amended to read:
N 4.05 (1) (intro.) Eligibility Application. An applicant for licensure as a nurse-midwife a license to practice nurse-midwifery who has completed an educational program in nurse-midwifery approved by the American college of nurse-midwives, who is currently licensed to practice as a professional nurse in Wisconsin and who has paid the fee specified in s. 440.05 (6), Stats., may be eligible for granted a temporary permit to practice nurse-midwifery. An application for a temporary permit to practice nurse-midwifery shall include all of the following:
Section 15. N 4.05 (1) (a) to (c) are created to read:
N 4.05 (1) (a) Verification the applicant has completed an educational program in nurse midwifery accredited by the Accreditation Commission for Midwifery Education, or another accrediting body approved by the board.
(b) Verification the applicant is currently licensed to practice as a professional nurse in this state or currently has the privilege to practice professional nursing in another state that has adopted the nurse licensure compact.
Section 16. N 4.05 (2) and (3) are amended to read:
