January 22, 2010 - Introduced by Representatives Roys, Smith, Berceau, Pasch,
Sinicki, Turner, Vruwink and Young, cosponsored by Senators Robson and
Vinehout. Referred to Committee on Health and Healthcare Reform.
AB675,1,6
1An Act to repeal 441.15 (1) (a);
to renumber and amend 655.001 (7t);
to
2amend 441.15 (2) (b), 441.15 (4) and 655.005 (2) (a); and
to create 50.36 (3i),
3441.15 (1) (c), 655.001 (7t) (b) and 655.002 (2) (d) of the statutes;
relating to:
4hospital staff privileges for and written agreements required for
5nurse-midwives and allowing nurse-midwives to elect to be covered under the
6injured patients and families compensation fund.
Analysis by the Legislative Reference Bureau
Practice of nurse-midwifery
Under current law, to practice nurse-midwifery a licensed nurse-midwife must
collaborate with and enter into a written agreement with a physician who has
postgraduate training in obstetrics. If a person practicing nurse-midwifery
discovers evidence of any aspect of care that jeopardizes the health or life of a
newborn or mother, the nurse-midwife must either consult with the collaborating
physician with whom the nurse-midwife has entered into a written agreement or
make a referral as specified in the written agreement.
This bill eliminates the requirement that a licensed nurse-midwife collaborate
with and enter into a written agreement with a physician. If a person practicing
nurse-midwifery discovers evidence of any aspect of care that jeopardizes the health
or life of a newborn or mother, a licensed nurse-midwife must consult with a
qualified health care professional or make a referral. The bill defines a qualified
health care professional as a health care practitioner who is performing services
within his or her scope of practice. A health care practitioner is defined under current
law to include an individual who is licensed, registered, or certified by the medical
examining board, the board of nursing, and the pharmacy examining board.
Health care liability coverage
Under the health care liability statutes in current law, certain health care
providers must carry health care liability insurance with specified limits and pay
assessments to the injured patients and families compensation fund (fund). Certain
other health care providers may elect to be subject to the health care liability
statutes, including the insurance and assessment requirements. If a medical
malpractice claim is made against a health care provider who is subject to the health
care liability statutes, or against an employee of such a health care provider, the
portion of the claim that exceeds the limits of the provider's health care liability
insurance is paid on behalf of the provider or provider's employee by the fund.
However, certain employees, called health care practitioners, who are providing
services not in collaboration with a physician or under the direction and supervision
of a physician or nurse anesthetist, are not covered by the fund as employees in the
event that a medical malpractice claim is made against them. Nurse-midwives are
not required to provide services under the direction and supervision of a physician
or nurse anesthetist and since, under the bill, they are no longer required to provide
services in collaboration with a physician, they would not be covered by the fund as
employees. Therefore, the bill modifies the definition of a health care practitioner
to exclude nurse-midwives so that a nurse-midwife is covered by the fund, as under
current law, if he or she is providing services as an employee of a health care provider
who is subject to the health care liability statutes.
In addition, the bill authorizes nurse-midwives to elect to be subject to the
health care liability statutes. If a nurse-midwife elects to be subject to those
statutes, the nurse-midwife would be required to carry health care liability
insurance with the specified limits, would be required to pay the assessments, and,
even if not an employee of a health care provider subject to the health care liability
statutes, would be covered by the fund for damages exceeding the limits of the
insurance.
Hospital staff privileges
Under current law, only a physician, dentist, or podiatrist may admit a patient
to a hospital. The bill provides that a hospital may grant to nurse-midwives who are
covered under the fund any hospital staff privileges that the hospital must afford to
persons who are licensed to practice medicine or podiatry, including hospital staff
privileges to admit, treat, and discharge patients for whom nurse-midwives are
qualified to provide care.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB675, s. 1
1Section
1. 50.36 (3i) of the statutes is created to read:
AB675,3,82
50.36
(3i) A hospital may grant a nurse-midwife licensed under s. 441.15 (3)
3who is covered under the injured patients and families compensation fund under s.
4655.27 any hospital staff privilege that a hospital must, under sub. (3) (a), afford to
5persons licensed to practice medicine and surgery under subch. II of ch. 448 or to
6practice podiatry under subch. IV of 448, including hospital staff privileges to admit,
7treat, and discharge any patient for whom a nurse-midwife is qualified to provide
8care.
AB675, s. 2
9Section
2. 441.15 (1) (a) of the statutes is repealed.
AB675, s. 3
10Section
3. 441.15 (1) (c) of the statutes is created to read:
AB675,3,1311
441.15
(1) (c) "Qualified health care professional" means a health care
12practitioner as defined in s. 180.1901 (1m) who is performing services within his or
13her scope of practice.
AB675, s. 4
14Section
4. 441.15 (2) (b) of the statutes is amended to read:
AB675,3,1715
441.15
(2) (b) The practice occurs in a health care facility approved by the board
16by rule under sub. (3) (c)
, in collaboration with a physician with postgraduate
17training in obstetrics, and pursuant to a written agreement with that physician.
AB675, s. 5
18Section
5. 441.15 (4) of the statutes is amended to read:
AB675,3,2319
441.15
(4) A nurse-midwife who discovers evidence that any aspect of care
20involves any complication which jeopardizes the health or life of a newborn or mother
21shall consult with
the collaborating physician under sub. (2) (b) or the physician's
22designee, or make a referral as specified in a written agreement under sub. (2) (b) a
23qualified health care professional or make a referral.
AB675, s. 6
24Section
6. 655.001 (7t) of the statutes is renumbered 655.001 (7t) (a) and
25amended to read:
AB675,4,6
1655.001
(7t) (a)
"Health
Except as provided in par. (b), "health care
2practitioner" means a health care professional, as defined in s. 180.1901 (1m), who
3is an employee of a health care provider described in s. 655.002 (1) (d), (e), (em), or
4(f) and who has the authority to provide health care services that are not
in
5collaboration with a physician under s. 441.15 (2) (b) or under the direction and
6supervision of a physician or nurse anesthetist.
AB675, s. 7
7Section
7. 655.001 (7t) (b) of the statutes is created to read:
AB675,4,98
655.001
(7t) (b) "Health care practitioner" does not include a person licensed
9to practice nurse-midwifery under s. 441.15.
AB675, s. 8
10Section
8. 655.002 (2) (d) of the statutes is created to read:
AB675,4,1111
655.002
(2) (d) A person licensed to practice nurse-midwifery under s. 441.15.
AB675, s. 9
12Section
9. 655.005 (2) (a) of the statutes is amended to read:
AB675,4,1613
655.005
(2) (a) An employee of a health care provider if the employee is a
14physician or a nurse anesthetist or is a health care practitioner who is providing
15health care services that are not
in collaboration with a physician under s. 441.15 (2)
16(b) or under the direction and supervision of a physician or nurse anesthetist.
