Section 9. 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 in good standing to practice as a professional nurse in Wisconsin, this state, or is currently licensed has been issued a multistate license under the nurse licensure compact, that is current and in good standing, to practice professional nursing in by another state which that has adopted the nurse licensure compact.
Section 10. N 4.04 (title) is amended to read:
N 4.04 (title) Application procedures for licensure.
Section 11. 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 in good standing as a professional nurse in Wisconsin this state or of having been issued a multistate license under the nurse licensure compact, that is current and in good standing, current licensure privilege to practice professional nursing in by another state which that has adopted the nurse licensure compact, including the license number and renewal information.
Section 12. N 4.04 (2) to (4) are repealed.
Section 13. 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 14. N 4.043 is created to read:
N 4.043 License renewal. The board shall renew a license to practice nurse-midwifery upon the applicant demonstrating completion of each of the following:
(1) Paying 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) Completing the nursing workforce survey to the satisfaction of the board.
(3) Providing 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, providing evidence to the board that the applicant maintains in effect malpractice insurance meeting the requirements under s. N 4.10 (1). Section 15. 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 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., a license to practice nurse-midwifery 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 16. 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 in good standing to practice as a professional nurse in this state, or of having been issued a multistate license under the nurse licensure compact to practice professional nursing, that is current and in good standing, by another state that has adopted the nurse licensure compact.
Section 17. N 4.05 (2) and (3) are amended to read:
N 4.05 (2) Issuing a temporary permit. The bureau of health service professions board shall issue a temporary permit to an eligible applicant within one week of the determination of eligibility.
(3) Supervision required. The holder of a temporary permit shall practice under the direct supervision of a nurse-midwife certified licensed under s. 441.15, Stats., or a physician. The holder may not practice beyond the scope of practice of a nurse-midwife as set forth in s. N 4.06. Section 18. N 4.05 (4) is renumbered N 4.025 (3) and amended to read:
N 4.025 (3) The holder of a valid temporary permit under this section s. N 4.05 may use the title “graduate nurse-midwife" or the letters “G.N.M.". Section 19. N 4.05 (5) is repealed and recreated to read:
N 4.05 (5) Duration. (a) Except as provided under par. (b), a temporary permit is valid for a period of 6 months or until the permit holder receives notification of failing the examination required for certification under s. N 4.03 (2), whichever occurs first. (b) If the holder of a temporary permit has also been granted a temporary permit to practice as a registered nurse under s. N 2.31, the temporary permit is valid for the period that coincides with the duration of the temporary permit under s. N 2.34 or until the permit holder receives notification of failing the examination required for certification under s. N 4.03 (2), whichever occurs first. (c) Practice under a temporary permit, including renewals under sub. (6m), may not exceed 12 months.
Section 20. N 4.05 (6) is repealed.
Section 21. N 4.05 (6m) is created to read:
N 4.05 (6m) Renewals. A temporary permit may be renewed twice for a period of 3 months for each renewal. A second renewal under this subsection may only be granted if the holder of the temporary permit is awaiting examination results or an affidavit is filed with the board identifying a hardship.
Section 22. N 4.05 (7) (intro.), (a), and (b) are amended to read:
N 4.05 (7) (intro.) Revocation Denial or revocation. A temporary permit may, after notice and hearing, be denied or revoked by the board for any of the following reasons:
(a) Violation of any of the rules of conduct for registered nurses in ch. N 7 or for violation of the rules governing nurse-midwives under ch. N 4 this chapter.
(b) Failure to pay the required fees a fee required under s. 440.05 (6) (1), Stats.
Section 23. N 4.05 (7) (d) is created to read:
N 4.05 (7) (d) Misrepresentation of being a nurse-midwife or a graduate nurse-midwife when applying for a temporary permit under this section.
Section 24. N 4.06 (1) to (4) are amended to read:
N 4.06 (1) The scope of practice of nurse-midwifery is the overall management of women's health care, pregnancy, childbirth, postpartum care for newborns, family planning, and gynecological services consistent with the standards of practice of the American College of Nurse-Midwives and the education, training, and experience of the nurse-midwife.
(2) The A nurse-midwife shall collaborate with a physician with postgraduate training in obstetrics pursuant to a written agreement with that physician.
(3) The A nurse-midwife shall consult with the consulting collaborating physician regarding any complications discovered by the nurse-midwife, or refer the patient pursuant to the written agreement under sub. (2).
(4) Upon referral under sub. (3), the a nurse-midwife may independently manage that part of the care of the for a patient which that is appropriate to consistent with the knowledge and skills education, training, and experience of the nurse-midwife.
Section 25. N 4.07 (1) and (2) are amended to read:
N 4.07 (1) The A nurse-midwife shall may not independently manage those complications that require referral pursuant to the written agreement under s. N 4.06 (2). (2) The A nurse-midwife may not perform deliveries by forceps or Caesarean section. The nurse-midwife may use vacuum extractors only in emergency delivery situations.
Section 26. N 4.07 (2m) is created to read:
N 4.07 (2m) A nurse-midwife may use vacuum extractors only in emergency delivery situations.
Section 27. N 4.07 (3) and (4) are amended to read:
N 4.07 (3) The A nurse-midwife may not assume any responsibilities, either by physician-delegation or otherwise, which he or she is not competent to perform by that are inconsistent with the education, training, or and experience of the nurse-midwife.
(4) Following notification of a physician as required by s. 441.15 (4), Stats., a nurse-midwife may continue to manage the a delivery when complications occur if emergency measures are required and the physician has not yet arrived.
Section 28. N 4.08 is renumbered N 4.025 and amended to read:
N 4.025 Licensure and exception exceptions.
(1) No Except as provided under subs. (2) and (3), unless licensed under this chapter, no person may practice or attempt to practice nurse-midwifery or use the title or letters “Certified Nurse-Midwife", or “C.N.M.", “Nurse-Midwife", or “N.M.", or anything else any other title or letters to indicate that he or she person is a nurse-midwife unless he or she is licensed under this chapter.
(2) Nothing in this chapter shall be construed either to prohibit or to require a license under this chapter for any Any person lawfully practicing professional nursing within the scope of a license granted under ch. 441, Stats., is not required to be licensed under this chapter.
Section 29. N 4.10 (1) (intro.) and (2) (a) and (b) are amended to read:
N 4.10 (1) (intro.) Nurse-midwives A nurse-midwife shall maintain have in effect malpractice insurance evidenced by one of the following:
(2) (a) A nurse-midwife who practices nurse-midwifery within the scope of employment as a federal, state, county, city, village, or town employee who practices nurse-midwifery within the scope of his or her employment.
(b) A nurse-midwife who practices nurse-midwifery as an employee of the federal public health service under 42 USC 233 (g). Section 30. N 4.10 (2) (d) and (e) are created to read:
N 4.10 (2) (d) A nurse-midwife whose employer has in effect malpractice liability insurance that provides coverage for the nurse-midwife in an amount equal to or greater than the amounts specified in sub. (1) (a) or (b).
(e) A nurse-midwife providing nurse-midwifery services under s. 257.03, Stats. Section 31. N 4.10 (3) and (3) (Note) are repealed.
Section 32. Effective date. The rules adopted in this order shall take effect on the first day of the month following publication in the Wisconsin Administrative Register, pursuant to s. 227.22 (2) (intro.), Stats. ---------------------------------------------------------------------------------------------------------------------
(END OF TEXT OF RULE)
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