General Assembly Post-Game Wrap-Up/Pre-Game Show: Tues., May 13, 2014
Gonna need some extra strong coffee to recap a whole week and then set the stage for this week. Got some monkeys digesting coffee beans in the kitchen right now. Don’t let my wife know.
(3 hours later…back from scooper doody duty…and highly-caffeinated.)
Here are the Session Activity Reports from last week:
The Senate unanimously passed SB 197(Blevins), one of the best best bills addressing human trafficking in the country.
The Senate unanimously passed SB 191(Henry), which establishes ‘Downtown Development Districts’ in an attempt to revitalize…downtowns.
Good news/bad news: The good news: One of this session’s best bills was introduced. HB 331(Kowalko) ‘removes the exemption from the Freedom of Information Act (FOIA) and thus fully applies FOIA to the University of Delaware and Delaware State University’. Delaware may now be the only holdout when it comes to requiring academic institutions receiving state funds to open their books. The bad news: The bill has been assigned to the House Administration Committee, where Pete Schwartzkopf and Valerie Longhurst are likely to keep it buried. I also wonder why this bill wasn’t introduced earlier in session. It would have given proponents the chance to push for the release of this bill.
A busy and productive day. In the Senate. Crickets emerged from the House.
The Senate passed SB 188(Peterson), a long-overdue repudiation of the excesses of Delaware’s War on Drugs. The bill ‘vests judges with discretion to determine “habitual offender” sentences, rather than the Attorney General’s staff. It also permits some offenders whose sentences were determined by the Attorney General’s Office to be resentenced by judges’. You see, then AG Jane Brady decided that judges would coddle criminals if given this discretion and, along with hardline legislators like Tom Sharp, Jim Vaughn and Wayne Smith, she actually got legislation passed to make the prosecutors the arbiters of just who is an habitual offender, not the judges, who as judges, heretofore had had sentencing authority. Brady, of course, ended up as a judge in one of Ruth Ann Minner’s sleazier maneuvers. The vote on SB 188 was close, and one co-sponsor, Sen. Marshall, voted no.
The Senate also passed SB 209(Townsend), a good first step in considering the potential impact of granting additional charters on existing schools. The bill ‘requires the Department of Education to promulgate regulations to further define the meaning and process for consideration of impact in the charter school application review process, to be considered and approved by the State Board no later than its October 2014 meeting. It also clarifies the conditions that an authorizer may place on an approved application, and provides that the State Board of Education may place or modify conditions to address considerations of impact’.
I think that people are finally seeing that public education is endangered by the worst elements/excesses of the charter movement. Based on the broad sponsorship here, let’s hope that this can be brought under control before it’s too late. The vote, of course, was not unanimous. All D’s voted yes, 7 R’s voted no, Cloutier and Lopez voted yes.
Most of the bill’s on today’s House Agenda appear to be relatively non-controversial. I would, however, like to hear from barristers on the advisability of HB 254(Walker), which claims to reduce both judicial costs and times that juries must serve by removing the need for certain expert witnesses. On the surface, it makes sense to me. But I’d like to know what the legal eagles think.
I also have concerns about HS1/HB 297(D. E. Williams). As originally constituted, HB 297 could potentially have caused the putting down of dogs who were simply doing their duty of protecting their loved ones and their property. I heard this from a few normal animal rights supporters. So, my question to them is, has the substitute bill addressed those concerns?
Pretty substantive Senate Agenda today.
SB 202(Bushweller) seems like a good means of providing statistical analysis to determine whether health organizations have sufficient capital. Only problem is that this tool is to be used by the Insurance Commissioner. Both this bill and SB 203 are pieces of model legislation from the National Association of Insurance Commissioners.
Delaware will jump on the e-cigarettes ban once the Senate passes HB 241(Hudson). The sheer number of prime co-sponsors should tell you that virtually every incumbent’s campaign brochure will herald this dubious achievement.
SB 193(Peterson) requires ‘a mammography service provider to provide specific notice to a patient if that patient presents with dense breast tissue.’ Hard to believe that they aren’t already doing this, but I can’t see anyone opposing this bill.
I support SB 187(Marshall), which ‘provides a safe alternative for the return of prohibited campaign and suspected prohibited campaign contributions. This bill allows a reporting party to donate a prohibited or suspected prohibited contribution to a charitable organization’. Let’s be realistic here, OK? When a campaign receives an illegal contribution here in Delaware, the campaign is almost never aware that it is an illegal contribution. When they find out, they (almost) invariably seek to either give the contribution back or contribute it to charity. The Rethugs, bereft of anything else to run on (except, perhaps, ‘Right to Work’), at least here in Delaware, screamed that it was illegal to donate the money to charity, it needed to be returned to the donor who (illegally) made the donation. SB 187 puts an end to that idiotic rationale. I’m for anything that shuts up Colin Bonini, so I support this bill.
I know that some people will scream about the ‘Mommy State’, but I support SB 94(Cloutier), which bans minors from using tanning beds in tanning facilities. Skin cancer is a dangerous by-product of tanning, as we know. So, if we ban sale of cigarettes to minors based largely on the health risks, then I have no problem doing this.
OK, starting to come down from the buzz, we can look at committee meetings tomorrow. Time to brew another pot. Monkeys, it’s Time:
Major Lance: ‘The Monkey Time’
Tags: Delaware charter schools, El Somnambulo, monkey's pooping coffee beans, Steve Tanzer Delaware, University of Delaware and Delaware State exempt from FOIA
How about some coverage for Paul Baumbach’s HB 319 that will remove the barriers to Certified Professional Midwives practicing in Delaware? We’re now up to 17 co-sponsors . . . .
Here’s the bill Steve Newton references:
http://legis.delaware.gov/LIS/LIS147.nsf/vwLegislation/HB+319?Opendocument
I agree with Steve. Was too busy last year to give it the support it needed… and it didn’t make it… It is a good bill, and needs a lot of public discussion to get over the initial prejudices currently stacked up against it…
What are the prejudices against it?
AQC – the AMA/big Pharma and medical institutions that see a cash cow slipping away
The Chamber sends Lavelle to neuter the state’s escheat revenue.
http://legis.delaware.gov/LIS/LIS147.NSF/vwLegislation/SB+215
I think the concern over licensing midwives is the same concern that’s existed for years – the dangers that come with non-medical professionals delivering children at home with no medical backup for emergencies. Valid or not, that prospect makes a lot of people nervous.
Also, the pro-midwife people leading the public charge last year were just crazy as hell, full of libertarian piss and vinegar and rude to the core – insulting to legislators and opponents both. You’re going to need some people speaking for this bill who don’t look like they’ve just gotten off shift at the commune pot farm.
Well, Sussex Watcher, this year’s legislation comes out of a Division of Public Health task force that included OB/Gyns, Nurses, Nurse midwives, Certified Professional Midwives, public policy experts, and representatives from the insurance industry. We did extensive hearings and created legislation that the majority of the medical professionals on the task force support.
To correct your misinformation (or that of the people you are citing): Certified Professional Midwives ARE medical professionals within their field, and in order to achieve NARM certification and Delaware licensing actually have tougher requirements than most nurse midwifes have within obstetrics.
HB 194 last year was driven by an over-reaction to two bad outcomes in home births. Multiple studies (including the British Medical Journal and New England Journal of Medicine) have found that for low-risk pregnancy home birth attended by a CPM has outcomes that are statistically as good or better than hospital births. On the other hand, in Delaware, we have a C-section rate that is well over the national average and about four times that recommended by international medical groups, and a fetal/neonatal mortality rate that’s quite poor.
Presumably the slow triumph of fact over spin is why the bill already has seventeen co-sponsors, both Democrat and Republican.
(By the way, the Delaware Nurses Association issued a statement opposing the bill that strongly suggested that they hadn’t even read it, since they castigated the legislation for things that weren’t even in the bill.)
I’m not spreading any misinfo, professor. I’m explaining that a good number of people, men and women both, have an instinctive negative reaction to the idea of home births under the care of midwives. The fact that you had a panel and are proposing a certification process doesn’t matter two whits compared to the image of a baby or mother needing emergency care a long ways away from a hospital. You’re not going to pass this unless you realize that. The exact details don’t matter when you’re trying to win broad support. It’s about the optics, as the TV pundits are so fond of saying.
Y’all need to chatter less about NARM certification and low-risk this and that, stop using any medical or legal terminology, IMMEDIATELY avoid the phrase “bad outcomes” (a very dry and clinical term for something horrible), and focus on telling the story of mothers giving birth at home in a safe loving environment attended by a trained, caring midwife. Drop the policy mumbo-jumbo and figure out what your core message is. Pick your spokespeople and advocates very well, and tell the hippie homeschooler types to shut it for the time being. This is going to be won on communications, not certification.
My consulting bill is in the mail.
Fortunately, your consulting is worth exactly what I paid for it.
This bill will pass or not the way that others do in the General Assembly, by carefully working the Senators and Representatives and getting the supposed “stakeholders” on board. It is not exceptionally high-profile (news coverage has been scant).
I’m not going to spend a lot of time worrying about the people who have an “instinctive” fear of midwives because those folks aren’t going to support this bill no matter what.
Don’t give up your day job. If you have one.
Who determines the level of risk, a doctor or the midwife?
AQC, risk regulations will be determined by the professional council, which has doctors, nurses, and midwives serving on it (fortunately no legislators :), unless they are a doctor, a nurse, or a midwife). They will be looking at national standards, and local/regional standards of care, and the council works in public, with public comment welcome. The midwifery advisory council reports to the state’s board of medicine.
Professor Newton, you have an exceptionally limiting view of how to impact public policy. I hope that you don’t run your campaign that way, for your sake. If you don’t understand how language and perception affects opinion and can help influence people – the general public or specific legislators – you are harming your own cause.
If you’re not able or willing to explain this bill without jargon and inside-baseball terminology, you’re going to have a hard time getting many more than 17 votes.
I have mixed emotions on this issue. First, I have had several friends who have used midwives and had the most amazing, personal experience. So, I’m sorta okay with this. Where I hesitate… I had a perfectly normal first pregnancy (zero red flags) and a normal labor up until something went wrong and the baby went into fetal distress. I have never seen people move so fast – hell, I’ve never been moved so fast. Suddenly, I was in the operating room receiving an emergency C-section with my blood pressure crashing. It was terrifying, and once they removed the baby the medical team set about stabilizing me. Did I mention how frightening it was – and how quickly everything happened?
So… while I, personally, would never use a midwife (and would strongly encourage my daughter not to use one either) because of the time issue – and seconds count in these situations – I wouldn’t be comfortable denying someone that choice. However, they should be made completely aware of the rare dangers.
(I had a scheduled C-section for my second child. I really didn’t want to go through that trauma again – 8 hours of labor, 2 hours of pushing and then an emergency C-section. Nope. Wasn’t risking it.)
I haven’t read through the entire bill, (My bad, but I’m still dealing with family issues) but am curious… who’s responsible if something goes wrong? And yes, I know things go wrong in a hospital, but is anyone responsible if a pregnant woman decides on using a midwife and complications arise that could be easily handled in a hospital, but not in a home. Personally, I think the responsibility should belong to the pregnant women because she’s rolling the dice (ouch, loaded term. Sorry.) with her choice. (That said, I do know most home births don’t result in a situation like mine and I’m kinda bummed that I didn’t get to experience the “happy” birth.)
Hey, can you tell I’m conflicted on this issue?
As for midwifes, I want to make sure I’m right about this.
The websites of the midwife accreditation groups all dance around the issue of the education requirements, so I want to just ask directly.
A certified midwife need not have any college degree, like we require of our nurses. Right?
There are various schools that offer certification classes, but a person can receive certification even if they haven’t attended the midwife school. Instead, the can submit an application detailing their experience regarding childbirth, right?
If I have this wrong, then tell me what post-secondary degrees are necessary for a person to become a certified midwife.
An Associate’s Degree, Bachelor’s Degree, Master’s Degree, a Phd? In what major?
Here are some of the websites I visited, looking for information:
http://narm.org/certification/how-to-become-a-cpm/
http://mana.org/pdfs/CPMIssueBrief.pdf
Thanks, Larry
I struggle with this, also related to my own experience. After three uneventful deliveries, my fourth was unexpectedly complicated and resulted in me having a stroke at the age of 26. I don’t know what would have happened to me or my son if we were not already in a hospital. I, too, cannot figure out what the educational/training requirements are to become a midwife.
‘midwife’ describes a profession, and there are three midwife credentials. CNMs, certified nurse midwives, are nurses, with a midwifery focus. CMs, certified midwives, are not nurses, but have higher institutional education requirements than CPMs, certified professional midwives, which require high school graduation plus coursework in related areas, among other requirements.
Just today I heard concern from CNMs that there is great confusion amongst consumers with what a midwife is, and they would like much improved understanding of the different credentials, and their requirements. This is one reason that the Delaware code distinguishes between ‘nurse midwives’ and ‘non-nurse midwives.’ This bill, HB 319, deals solely with the licensure of non-nurse midwives.
So a CPM – someone who possibly barely graduated high school and took a few extra courses – could be delivering babies under this bill?
Thank you Rep. Baumbach. It sounds like the bill would make the important distinction between midwives who are, and who are not, also trained as nurses.