Arkansas Administrative Code › Agency 007 - ARKANSAS DEPARTMENT OF HEALTH › Division 13 - Division of Maternal and Child Health › Rule 007.13.20-001 - Rules Governing the Practice of Licensed Lay Midwifery in Arkansas

Current through Register Vol. 49, No. 6, June, 2024
100.
GENERAL
			 PROVISIONS
101.
PURPOSE AND AUTHORITY
Act 838 of 1983 provided for the lawful practice of Licensed
				Lay Midwifery in counties having 32.5% or more of their population below the
				poverty level. Act 481 of 1987 superseded Act 838 of 1983, and expanded the lay
				midwifery licensure statewide. These Rules govern the practice of Licensed Lay
				Midwives (LLMs) in Arkansas.
The following Rules are promulgated pursuant to the authority
				conferred by the Licensed Lay Midwife Act A.C.A. §
									17-85-101
				et seq. and A.C.A. §
									20-7-109.
				Specifically, the LLM Act directs the Arkansas State Board of Health to
				administer the provisions of the Act and authorizes and directs the Board to
				adopt rules governing the qualifications for licensure of lay midwives and the
				practice of Licensed Lay Midwifery. The broad authority vested in the Board of
				Health, pursuant to ACA §
									20-7-109,
				to regulate and to ultimately protect the health of the public is the same
				authority the Board utilizes in enforcing the Rules, determining sanctions,
				revoking licenses, etc.
102.
ADMINISTRATION OF PROGRAM
The State Board of Health (BOH) has delegated the authority to
				the Arkansas Department of Health (ADH).
103.
DEFINITIONS
As used in these Rules, the terms below will be defined as
				follows, except where the context clearly requires otherwise:
1. ADVERTISEMENT AND ADVERTISING
Any statements, oral or written, disseminated to or before the
				public, with the intent of selling professional services, or offering to
				perform professional services. Advertising includes - but is not limited to -
				promotional literature, websites, and social media sites used for the purpose
				of selling services.
2.
			 APPRENTICE
A person who is training to become an LLM in Arkansas working
				under the direct supervision of a preceptor.
3. ARKANSAS DEPARTMENT OF HEALTH CLINICIAN
An ADH physician, Certified Nurse Midwife (CNM) or nurse
				practitioner providing ADH maternity services at a local health unit.
4. ARKANSAS RULES EXAMINATION
The exam that tests knowledge of the Rules Governing the
				Practice of Licensed Lay Midwifery in Arkansas.
5. BIRTHING/BIRTH CENTER
Any facility licensed by ADH which is organized to provide
				family-centered maternity care in which births are planned to occur in a
				home-like atmosphere away from the mother's usual residence following a
				low-risk pregnancy.
6.
			 CERTIFIED MIDWIFE (CM)
Individuals who have or receive a background in a
				health-related field other than nursing, and graduate from a midwifery
				education program accredited by the Accreditation Commission for Midwifery
				Education (ACME). Graduates of an ACME accredited midwifery education program
				take the same national certification examination as CNMs but receive the
				professional designation of certified midwife.
7. CERTIFIED NURSE MIDWIFE (CNM)
A person who is certified by the American College of Nurse
				Midwives and is also currently licensed by the Arkansas State Board of Nursing
				or the appropriate licensing authority of a bordering state to perform nursing
				skills relevant to the management of women's health care for compensation,
				focusing on pregnancy, childbirth, the postpartum period, care of the newborn,
				family planning, and the gynecological needs of women. The CNM must be
				currently practicing midwifery unless stated otherwise in these Rules.
8. CERTIFIED PROFESSIONAL MIDWIFE
			 (CPM)
A professional midwifery practitioner who has met the standards
				for certification set by the North American Registry of Midwives (NARM).
9. CLIENT
A pregnant woman, a postpartum woman for a minimum of thirty
				(30) days, or her healthy newborn for the first fourteen (14) days of life who
				is the recipient of LLM services.
10. CONSULTATION
The process by which an LLM who maintains primary
				responsibility for the client's care, seeks the advice of a physician, CNM, or
				ADH clinician. This may be by phone, in person or by written request. The
				physician, CNM, or ADH clinician may require the client to come into their
				office for evaluation.
11.
			 CONTACT HOUR
A unit of measure to describe 50-60 minutes of an approved,
				organized learning experience that is designed to meet professional educational
				objectives. It is a measurement for continuing education. One contact hour is
				equal to 0.1 CEU. Ten contact hours are equal to one (1) CEU.
12. LABOR SUPPORT ATTENDANT
An individual who is present at the request of the client to
				provide emotional or physical support for the client and her family.
13. LLM ASSISTANT
An individual who is present at the request of the LLM at any
				point during the course of midwifery care of the client to provide services
				under LLM supervision.
14.
			 LICENSED LAY MIDWIFE (LLM)
Any person who is licensed by ADH to practice midwifery and who
				performs for compensation those skills relevant to the management of care of
				women in the antepartum, intrapartum, and postpartum periods of the maternity
				cycle. Also manages care of the healthy newborn for the first fourteen (14)
				days of life.
15. LOCAL
			 HEALTH UNIT
A community-based ADH clinic site that provides medical and
				environmental services.
16.
			 MIDWIFERY BRIDGE CERTIFICATE
A certification administered by NARM awarded to CPMs following
				the completion of accredited approved continuing education contact hours based
				upon identified areas to address emergency skills and the International
				Confederation of Midwives (ICM) competencies.
17. NORTH AMERICAN REGISTRY OF MIDWIVES
			 (NARM)
The international certification agency that established, and
				continues to administer, certification for the credential "Certified
				Professional Midwife" (CPM) and the Midwifery Bridge Certificate (MBC).
18. PHYSICIAN
A person who is currently licensed by the Arkansas State
				Medical Board - or the appropriate licensing authority of a bordering state -
				to practice medicine or surgery. For the purposes of any sections of these
				Rules governing the care of pregnant and postpartum women, "physician" refers
				to those currently practicing obstetrics. For the purposes of any sections of
				these Rules governing the care of newborn infants, "physician" refers to those
				physicians who currently include care of newborns in their practices.
19. PRECEPTOR
A legally practicing obstetric or midwifery practitioner who
				participates in the teaching and training of apprentice midwifery students and
				meets NARM preceptor standards including credentials, years of experience, and
				birth attendance requirements. A preceptor assumes responsibility for
				supervising the practical (clinical obstetric) experience of an apprentice and
				for the midwifery services they render during their apprenticeship. In the case
				of transitional apprentices, the definition of preceptor in Appendix B
				applies.
20. REFERRAL
The process by which the client is directed to a physician, CNM
				or ADH clinician for management of a particular problem or aspect of the
				client's care, after informing the client of the risks to the health of the
				client or newborn.
21.
			 SUPERVISION
The direct observation and evaluation by the preceptor of the
				clinical experiences and technical skills of the apprentice while present in
				the same room.
22. TRANSFER
			 OF CARE
The process by which the LLM relinquishes care of her client
				for pregnancy, labor, delivery, or postpartum care to a physician, CNM or ADH
				clinician, after informing the client of the risks to the health or life of the
				client.