Act No. 35 (S.15). Health; health insurance; midwives; maternity; births; birth certificates

This act requires all health insurers to provide coverage for services provided by licensed midwives and certified nurse midwives, including home births. It requires licensed midwives to verify on their license renewal forms that they have filed a timely birth certificate for each birth at which they were the attending midwife, as required by law.

Existing law requires licensed midwives to develop a written plan for consulting with doctors and other health care professionals for the emergency transfer or transport of a patient or newborn to a health care facility, and to submit the plan to the director of the office of professional regulation (OPR). The act requires the plan to be reviewed and approved by OPR's advisor appointees on matters related to midwives and to be provided to any health care facility or health care professional named in the plan. It also requires the director of OPR to develop a single form for use in all cases of transfer or transport.

Existing law requires licensed midwives to complete a peer review of any death, significant morbidity to client or child, transfer to hospital, or practice performed outside the standards set for midwives. The act allows other health care professionals involved in the care or treatment of the client to provide written input during the peer review process, to be filed with OPR, and requires the director of OPR to provide notice of the disposition of the peer review to any health care professional who provided written input.

The act requires licensed midwives and certified nurse midwives to submit to a national database information about each home birth in Vermont for which he or she was the attending midwife. Annually from 2012 through 2016, the act directs the commissioner of health to access the database and to provide testimony to the general assembly regarding the activities of licensed midwives and certified nurse midwives during the preceding year.

The act establishes a maternal mortality review panel to look at all deaths in Vermont that occurred while a woman was pregnant or within one year after the end of a pregnancy. The panel will make recommendations for system changes to improve health care services for women in Vermont. The act requires the commissioner of health to report annually to the general assembly about maternal deaths and recommend ways to address systemic problems identified.

The act provides a process through which an individual who has completed sexual reassignment may receive a new birth certificate that reflects the new sex without indicating that a change in name or sex, or both, has occurred. It also allows an individual to apply for a new birth certificate if he or she currently has a birth certificate marked as having been amended to change the individual's sex.

The act directs the commissioner of health to use information from the Vermont health care claims uniform reporting and evaluation system (VHCURES) to collect information for the birth information network, allows the commissioner to amend by rule the list of the 40 most significant health conditions of newborns in Vermont for which information is collected, and requires the collection of information on conditions relating to upper and lower limbs.

Multiple effective dates, beginning May 18, 2011