Midwives Association of Florida

MAF CONFERENCE 2011

Michelle — Wed, 23 Feb 2011 05:55:18 +0000

*ALL CEU’S WILL BE OFFERED FOR LICENSE RENEWAL*

WHERE : THE CROWNE PLAZA HOTEL ON BEAUTIFUL MELBOURNE BEACH

WHEN: 9/30, 10/1, 10/2

PLAN NOW – MORE INFORMATION TO FOLLOW AS IT BECOMES AVAILABLE

March for Midwives on Capital Day

Michelle — Wed, 23 Feb 2011 05:42:00 +0000

WHEN: 3/17/2011 9:00am – 6:00pm

WHERE: The Capital in Tallahassee

Protect your right to birth where you birth and with whom…

Included key points that should be covered in these brief informational meetings:

Discuss the differences between Licensed Midwives and Nurse Midwives tactfully. For example, generally Nurse-Midwives practice in hospitals, and Licensed Midwives deliver babies out of the hospital – in birth centers and homes. Please feel free to use the two educational handouts on our we…bsite “What is a Licensed Midwife?” and “The Art & Science of Midwifery” (www.midwivesassociation.org) and “the Midwives Model of Care” from Citizens for Midwifery website (http://cfmidwifery.org/mmoc/define.aspx).

We appreciate the work you do to mobilize and inform midwifery consumers. We look forward to collaborating on this very important project.

KEY POINTS
• Midwives have been licensed in the state of Florida since 1931.
• The most recent version of the licensing law has been in place since 1992.
• Midwives are safe.
• Midwives are cost effective.
• Midwives are Medicaid providers.
• Licensed Midwives must pass the North American Registry of Midwives national certification examination to become licensed in Florida.
• Midwives provide continuity of care that features prevention, nutrition education, healthy lifestyles, which improves newborn outcomes, reduces premature and low birth weight and encourages breastfeeding.
See More

Lobbyist Report 2011

Michelle — Wed, 23 Feb 2011 03:56:06 +0000

Report – April 10, 2011

Dawn Steward Stu2130@aol.com

Cell – 407.645.0273

Well the session is halfway over. Both the House and the Senate have approved their budgets that are billions of dollars apart. The budget calls for cuts in health care, schools, sate worker layoffs and privatization.

The next step is to appoint the conference committees to iron out the differences between the two chambers (House and Senate). If the conference committee cannot iron out the differences – the differences it called a bump up and will go to the Senate President and the Speaker of the House. Fortunately the budget for the birthing centers (you did take a small hit – but not the 20% as proposed) is the same for the House and Senate – therefore not going into the conference process.

What a Surprise! Governor Scott actually made his first committee appearance on Friday at the House Select Committee on Government Reorganization. The bill of great interest to the Governor is PCB –SCGR-11-02 – this is a 677 page bill that combines agencies to basically make a single point of entry for economic development. Creates a new agency – Department of Economic Opportunity.

Medicaid reform is still the big item that needs to be resolved. Birth Centers are written into the bill and licensed practitioners. This week there was a big win for the HMO providers – the loss ratio does not have to be 90%. Please note this is still a very troublesome bill as the Medicaid Reform in the pilot counties is fraught with problems. But that doesn’t seem to be stopping the House and the Senate from putting reform into all 67 districts. The Governor is in support of Medicaid Reform. I am sure for many sessions to come we will be working to improve Medicaid reform.

FYI – During the week of April 18^th – only House members will be in Tallahassee – not the Senate members in observance of religious holidays.

Bills of Interest:

SB 432 (last report typed the number wrong – 732 sorry) HB 155-Gun/Doctors

This bill is moving – would not allow doctors to inquire about firearms in the home. It is normal practice for a pediatrician to ask a family about firearms in the home in order to educate the family of the importance of keeping the fun in a safe place. As you probably have guessed – the NRA (National Rifle Association) is in support of the bill and is a powerful lobbyist force in the state and the nation.

HB 1127/SB 1744 – Ultrasound before Abortion – bill is traveling – May very likely pass – will continue to monitor. (Former Senator Webster now Congressman Webster was the author of this bill originally)

HB 561/SB 122 – Relating to Sudden Unexpected Infant Death – this bill has stalled and probably will not survive.

SB 702/HB 471 – Relating to Umbilical Cord Blood Banking – the bill is in messages to the House – if the House takes the bill up – the bill will probably pass.

HB 779/SB 106 – Relating to restraining of incarcerated pregnant women – this bill traveling but might run out of time.

SB 1056/HB 793 – Relating to infant to infant Eye Care – still no movement. I have followed this bill for years – history – the grandmother lost her grandson due to a type of cancer in the eye – that could have been detected and possibility saved her grandson’s life.

SB 528/0124 – Relation to Creating of the Department of Health and Human Services – bill has stalled

Council Midwifery – remain in MQA under the DOH

*******************************************************************************

February 20, 2011 – Dawn Steward

BUDGET

Governor Rick Scott released his proposed state budget for February 7

The Governor’s budget is only a starting point, never in my 20 plus years of walking the halls have I seen the legislature accept a Governor’s budget as written. This budget was not received well by either Republican or Democrat party and is considered Dead on Arrival.

th. Instead of the normal one year spending plan the Governor laid out his proposal for the next two fiscal years (FY 2011-12 and FY 2012-13). The proposed budget was difficult to read as it collapsed figures and name changes for subject areas. It took a lot more time to comb through the 166 pages of the budget. (this is actually a short budget bill) Even then, many of us are not sure where and if the money is there for the areas of concern.

MEDICAID REFORM

Last summer Senator Haridolopis and various legislative members went on a listening tour throughout the state– listening to recipients, physicians, and local government. It is unfortunate the “listening tour” was not well publicized and not well intended. With 2.95 million Floridians on Medicaid; of which are 81,800 pregnant women and 1.73 million children – there is a lot at stake.

There is major unknown – will the Federal government approve the state’s plan. Last year the Federal government declined a straight extension of a five-county Medicaid pilot program that began in 2006. A threat was made if the Feds do not approve the State’s plan, Florida will pull out of the Federal Medicaid system and design its own.

Thursday Feb. 17

Reimbursement – it is the intent of the bill to raise reimbursements rates to the same as Medicare rates to physician with some services being at a capped amount. This raises concern for us – pregnancy will more than likely be capped and we will have to pay close attention to the codes. Since we are not a physician they might try to lower the reimbursement for licensed midwives/licensed birth centers.

th the Medicaid bill was released in the Budget Subcommittee on Health and Human Services Appropriations. This bill expands Medicaid Reform into all 67 districts and will put clients into a managed care program. The bill describes a Health Care Provider – “

Health care providers include Florida-licensed health care professionals or licensed health care facilities, federally qualified health care centers, and home health care agencies” This is good language as it includes licensed midwives and licensed birth centers. COUNCIL OF MIDWIFERY

I spoke with Mr. Jusevitch, Exec. Director of Council of Midwifery and Jacqui SoSa, Legislative Planning – they had not heard anything about an anticipated move of the Council and I considered it to be good news. The Council is not on the radar screen. I requested the calendar as I did not see it on line. The calendar dates are as follows:

April 15, 2011, 10-1 June 17, 2011, 10-1 October 14, 2011, 10-2

SELECT COMMITTEE ON GOVERNMENT REORGANIZATION

Speaker Cannon has created the Select Committee on Government Reorganization. Their goal is to engage in the work of identifying the specific and necessary work of government in order to eliminate the extraneous tasks that have been added over the years. In other words – to take out what they consider not being the core mission or fluff. Carol Gormley, staff director for the Health and Human Services Committee is to serve as the lead staff for this committee. This week I have an appointment with Ms. Gormley.

Why do I have an appointment with Ms. Gormley? It is much easier to ensure the Midwives and licensed birth centers are placed in the right agency/councils in the beginning rather than trying to undue their work. Carol Gormley is well versed on maternal child health issues as she used to be with Healthy Start.

CAPITOL DAY

March 17, 2011 3

Please make your hotel reservations NOW! I would suggest that you come up to Tally on March 16

rd Floor Capitol Building th. With the impending budget cuts – Tallahassee will prove to very crowded with advocates and protestors.

ACTION NEEDED

If you are planning to participate in Capitol Day – please make your hotel reservation.

Bills of In Interest – February 20, 2021

SB 322 – Claims Bill – Nurse Midwife -

HB 561/SB 122 – Relating To Sudden Unexpected Infant Death

SB 702/HB 471 – Relating to Umbilical Cord Blood Banking

HB 779/ SB 106 – Relating to Restraining of Incarcerated Pregnant Women

SB 1056/HB 792 – Relating to Infant Eye Care

SB 528/0114 – Relating to Creating of the Department of Health and Human Services

MEDICAID OVERHAUL UNVEILED

###

… Senate Republicans this week unveiled their long-awaited bill to overhaul Medicaid and the sweeping 202-page measure covers everything from lawsuit limitations to shifting patients into managed care. And just as importantly the bill would set a deadline for the federal government to sign off on the overhaul. Florida will walk away from the Medicaid program by December 31, 2011 and set up its own safety-net program if the federal government doesn’t within four months approve its requests to have more flexibility in the health care program that treats the poor and disabled. Sen. Joe Negron, R-Stuart and one of the main architects, called the bill a “measured approach” that includes reasonable timelines to transition to the new system. But the legislation raised concerns with Democratic legislators, especially because it would scale back existing safety net programs such as the Medically Needy program. And there’s no guarantee that House Republicans will go along with it. House Speaker Dean Cannon has questioned the idea of threatening to pull out of the state-federal Medicaid program and has also said that the Senate version is not what the House had been expecting. Cannon went so far as to call the notion of pulling out of Medicaid a “hazardous threat” that could jeopardize the state’s negotiation with the federal government. Negron responded by saying that there were many elements in the Senate plan that were the same as the overhaul that the House proposed a year ago. The Senate legislation requires all Medicaid patients to enroll in “managed care” except for those who were in nursing homes before July 2011 and who are developmentally disabled or who are eligible for Medicaid only because of a catastrophic illness. 

 Capitol Day – Display Board – who is going to be in charge of the Display board and handouts?

 Stories – Success stories needed from your consumers – preferably hand written.

 Midwifery services/birth centers reimbursement – your story in reference to reimbursement rates – how long it takes? Is paperwork cumbersome? Especially want to hear from the pilot counties that are already in Medicaid reform.

 Any other barriers?

Lobbyist Report 2011 – Report #1

admin — Tue, 08 Feb 2011 04:28:21 +0000

Dawn Steward

January Report #1
During the recent election cycle the Republican Party swept all of the races for the Governor and Cabinet posts. The Republicans have easily secured a “veto-proof” (2/3) super-majority in both the Florida House and Senate. This power makes it much easier for Governor Rick Scott, Senate President Mike Hairdopolos, and House Speaker Dean Canton to successfully pursue their priorities.
This week the Governor used social media to get his message out and had a town hall meeting using social media – Twitter for 40 minutes. Questions and answers are limited to 140 characters. He repeatedly focused on jobs and the economy. Governor Scott will be using FaceBook as opposed to press releases with reporters complaining they have limited access.

BUDGET
Florida has a $3.6 billion budget shortfall with the Governor’s office looking at ways to cut the budget and removing inefficiencies from agencies. The Governor says the existing budget is “bloated” and that too many people were making money off of government. He is pursing proposed tax cuts even while dealing with the budget shortfall. Many legislators are skeptical; however Scott is confident that even with this shortfall you can cut property taxes, state corporate income tax. These proposed cuts will be an incentive for businesses to relocate to Florida. Governor’s Scott’s budget is expected to come out in February.

AGENCY HEADS
 Scott is tapping heads of agencies that have little to no public sector experience.
(good or bad? – will remain to be seen)
 Scott is running the state like a corporate business.
 Not filled yet are two of the biggest and most complicated state agencies – Agency for Health Care Administration and Department of Health.

AREAS MONITORED
 Medicaid Reform – this is the biggest item on the menu now
 Merging of ACHA and DOH
 Council of Midwifery (as I see it – this is jeopardy as it is a cost to the state)
 Department of Managed Services (DMS)
 Fees

I will be closely monitoring and advocating for MAF and Birth Center Births on activities that may have an impact through the legislative process. I had a discussion with Michael Garner –CEO of Fla Association of Health Plans – he speaks very favorable of licensed midwives and definitely understands the role of midwives in the HMO discussions. I will continue to stay in touch with him.
continued

WHAT YOU CAN DO?
Visit your legislator in your home district. Have an elevator speech. This is what they need to know.
 Why pregnant women like the option of out of hospital birth
 Number of births you attended
 Repeat number of out of hospital birth if available
 Cost of birth vs. Hospital birth (over 1/2 of births in Florida are Medicaid births – with Medicaid reform moving forward we want to be included as an option)
 Research shows planned home and birth center births with certified licensed Midwives result in less cesareans
 Number that had to be transferred to hospital and outcome if any
 Barriers
 How midwives fit into Medicaid reform

MOST IMPORTANT – PLEASE E-MAIL – stu2130@ol.com WHO YOU VISITED – GENERAL DISCUSSION AND OUTCOME. THANK YOU

I recommend the legislative committee draft a page of fast facts so that each midwife or birth center can fill in the blanks – thus ensuring that we are all on the same page and saying the same thing with each legislator statewide.
Important Dates

March 8, 2001 – 2011 Legislative Session Convenes
March 17, 2011 – Midwives Association of Florida Capitol Day
3rd floor
May 6, 2011 – 2011 Legislative Session Adjourns
Dawn Steward
Stu2130@aol.com 407.645.0273

Lobbyist report #5

admin — Sun, 18 Jul 2010 05:26:01 +0000

Hi Ladies,
Attached is Dispatch #5.

Next steps- I want to research California and Tennessee – they went to managed care to curb Medicaid expenditures. I will do a final Dispatch in a couple of weeks (taking some vacation time) with what to expect in the next session.

Dawn Steward
Midwives Association of Florida
Florida Association of Birth Centers
Dispatch # 5
May 5, 2010
The Florida 1020 Legislative adjourned at 8:47 PM on Friday. The final vote on the budget ($70.4 billion) was 77-32 in the Florida House, while the Senate approved the budget by a 33-4 vote. The last hours of the session on Friday night was spent debating and approving measures on abortion, a proposed constitutional amendment on redistricting and a comprehensive property insurance bill. (Appropriations Bill 5001 and Implementing Bill 5003)
2,477 bills were filed this session with 301 bills making it past both the House of Representatives and Senators
Now we wait to see if Governor Crist is going to sign the budget or whether he will call lawmakers back to town this summer to consider ethics legislation.
AHCA – Tom Arnold was confirmed as the Chief of AHCA.
Medicaid Reform
The $19 Medicaid Reform Medicaid died in the waning moments of the session.
Reauthorization of the Department of Health – HB 7183 – Died in Messages
This bill will be back next session as many legislators are not happy with the way the Department of Health is doing business.
###

Lobbyist Report #4 4-25-10

admin — Sun, 18 Jul 2010 05:22:31 +0000

Midwives Association of Florida
Florida Association of Birth Centers

Dispatch #4

April 25, 2010

What a Week
As the session is winding down, the House and the Senate went to warp speed on budget discussions. The House and the Senate are anxious to ensure legislators adjourn this Friday as scheduled. This is an election year. (All of the House members are up for election and 20 of the 40 Senator members are up for election). They are very anxious to hit the campaign trail.
Conference committees have stopped meeting and any remaining unresolved item is bumped to the budget chairs for each house –Senator Alexander and Representative Rivera. They will begin to resolve the differences. If they are unable to resolve the differences – then it will be bumped to Speaker Cretul and President Atwater. Negations are scheduled to be completed by tomorrow, Monday, April 26th.
Florida’s Constitution requires the final version of the budget must be placed on the desk of lawmaker 72 hours before it can be approved. This means it has to be done by April 27 in order for lawmakers to vote it out on the last scheduled day of session – Friday.
Midwives Association of Florida – Capitol Day –April 21, 2010
Thank you to all who participated in the Capitol Day. I believe that it was a good step forward. Pamphlets were passed out to educate consumers and legislators of the options that women have in their birth experience. Home birthing and birthing in a birth center with a licensed midwife are very safe options with desirable outcomes and less expense to the consumer.
Senator Storms and Representative Burgin announced from their chambers the presence of the Licensed Midwives.
Medicaid Reform
Legislators are trying to curb the cost of Medicaid. The bills (SB 1484) and (HB 7223 & 7225) have passed out of their chambers. The House bill would move the programs 2.7 million Floridians into managed are plans over the next five years, white the Senate plan would expand the state’s five-county Medicaid pilot program to 19 additional counties. There are many differences in these bills – which will make it unlikely to pass before sine die (end of session).
We need to continue to monitor Medicaid Reform to ensure that Licensed Midwives and Birth Centers are included in the managed care plans.
Reauthorization of the Department of Health – CS/HB 7183/SB 1238
The House bill is in messages to the Senate. This bill would move the Medical Quality Insurance (MQA) to the Department of Business and Professional Regulation (DBPR) in a type two transfer. A type two transfer moves all staff, money …. Into the DBPR if approved. With only five days left of the regular session there is a good possibility the bill will die. If it should die this
session I am sure it will be back next session as many leaders are not happy with the Department of Health.
Bills of Interest
HB 1123/SB 2142 – Relating to Medicaid Postpartum Benefits – Error in last Dispatch – HB 1124 should be 1123) DEAD
SB 0732- Relating to Stillbirth SUID Education and Awareness DEAD
SB 2352 – Maternal and Child Health, Creates the “Florida Nurse Home Visitation”. Requires local Healthy Start Coalitions to administer the program DEAD
HB 7183 –
by Health Care Regulation Policy Committee, Thompson (N) CS Sponsors: Health Care Appropriations Committee
Summary
General Reorganization of the Department of Health: Reorganizes DOH; revises mission & duties of department; requires department to submit plan for new structure to Legislature by specified date; provides for abolition of various department divisions by specified date unless reviewed & reenacted by Legislature; authorizes department to establish multicounty service areas for county health departments; repeals Women’s Health Strategy, department’s injury prevention program, & Children’s Early Investment Program; transfers certain functions from DOH to DBPR. Effective Date: July 1, 2010
IN MESSAGES TO THE SENATE
Florida Administrative Code – Workshop – Status
They expect to have a hearing sometime in May and a ruling in June. I was told that information has been coming in from Consumers and Midwives. I will keep you posted.
As always feel free to contact me with any concern.
Dawn Steward
407.645.0273

Lobbyist Report #3 4-7-2010

admin — Sun, 18 Jul 2010 05:21:07 +0000

Midwives Association of Florida
Florida Association of Birth Centers
Dispatch #3
April 7, 2010
Dear Ladies:
The Budgets are ready for conference. The Senate passed its proposed $69.4 billion 2010-2011 state budgets and House passed its $67.2 billion proposal both along party lines. The difference $2.2 billion is the Senate’s willingness to include the additional Federal Medicaid money anticipated to pass in Congress. (FMAP). Also the Senate is relying on the approval of the expanded Seminole Tribe gaming. The House budget uses money that has been estimated by the various estimating conferences. The House budget includes deep cuts to schools, health programs and human services.
The budget is the only bill the Legislature is constitutionally required to pass each year. This year’s budget will largely be on hold until mid-April when Congress is expected to pass the bill with includes FMAP. As I said above the Senate uses the additional dollars from FMAP. For us this is the desirable budget.
Reducing Medicaid Eligibility for pregnant women from 185% to 150% is still on the table – will be a conference item.
What is conference item? When the House and Senate budgets do not match – the item goes to conference. We are expecting the conference committee to be appointed next week. If the appointed conference members cannot match the items – then it is bumped up to the Speaker of the House and the Senate President.
Legislators are anxious to get the budget passed so they can get to their home districts. This is an election year – all 120 House of Representatives are up for election and 20 of the 40 Senate seats are up for election.
Bills of Interest
HB 1124/SB 2142 – Relating to Medicaid Postpartum Benefits –
SB 0732- Relating to Stillbirth SUID Education and Awareness
SB 2352 – Maternal and Child Health, Creates the “Florida Nurse Home Visitation”. Requires local Healthy Start Coalitions to administer the program
HB 7183 –
by Health Care Regulation Policy Committee, Thompson (N) CS Sponsors: Health Care Appropriations Committee
Summary
General Reorganization of the Department of Health: Reorganizes DOH; revises mission & duties of department; requires department to submit plan for new structure to Legislature by specified date;
provides for abolition of various department divisions by specified date unless reviewed & reenacted by Legislature; authorizes department to establish multicounty service areas for county health departments; repeals Women’s Health Strategy, department’s injury prevention program, & Children’s Early Investment Program; transfers certain functions from DOH to DBPR. Effective Date: July 1, 2010
I have spoken with the budge analyst for the Medical Quality Assurance Trust Fund (MQA) –
Portion of the Summary Analysis
The bill sunsets ten of the 11 departmental divisions on July 1, 2011, unless reviewed and reenacted by the Legislature and sunsets Division of Medical Quality Assurance on July 1, 2011 pursuant to a type-two transfer of the Division to the Department of Business and Professional Regulation (DBPR)”
What this means in short – is they are moving the Council of Midwifery and its staff to the DBPR.
There is 60 days in a legislative session and we are on day 37.
Dawn Steward
407.645.0273
Stu2130@aol.com

Lobbyist Report – End of Session

admin — Sun, 18 Jul 2010 05:18:36 +0000

Midwives Association of Florida
Florida Association of Birth Centers
Dispatch #5
May 31, 2010

Governor Crist cut $371 million in spending on Friday May 28th with line-item vetoes of the $70 billion state budget. Crist slashed money intended for projects sought by powerful legislators. (see attached veto list and veto message)

Legislative leadership said they will consider a lawsuit to challenge Crist. House Speaker Larry Cretul, an Ocala Republican, blasted the veto action, particularly Crist’s rejection of the transportation sweep and replacing it with general revenue money. The Florida Transportation Builder’s Association had warned the Governor the sweep from the transportation trust fund would delay road-building projects and as many as 7,000 jobs. These transportation funds were to be used for public school spending.

One bill that may be of interest was the veto of a provision that prohibited state funds going to human stem-cell research. Senator Durell Peaden, Crestview Republican and physician feels this was the right thing to do as could save million of lives and bring millions of dollars to Florida.

HB 1143 which inserts government into women’s health care by forcing nearly every woman seeking a first-trimester abortion to have an ultrasound, view its images and have it described to her. As of 5/28 /2010 the bill had not reached the governor’s desk. This bill is being held hostage for political reasons and many are writing the Governor to veto this very controversial issue.

• Medicaid reform also known as managed care stalled out this session but is expected to come back in the 2011 legislative session.
• Department of Health reauthorization stalled this session. Many legislators felt that HB 7183 had not been vetted enough. Medical Quality Assurance is still under the Department of Health and will sunset July/2011 if not reviewed or re-enacted.
I look for this issue to come back next session and will be monitoring closely.

Be an Advocate This Summer

Please call your local Representative/Senator and make an appointment to educate your member(s) about the benefits of home births and births at birthing centers. Stress that births in a home setting and birth centers are a safe option, more cost effective, excellent birth outcomes and greatly reduces the need for an expensive C-Sections. Births by Florida Licensed Midwives should be part of the solution to reduce prenatal and birth Medicaid costs. This is also useful information for their constituents.

At the end of your appointment leave the policymaker/legislative aid with a fact sheet and your business card. Most importantly, don’t forget to write a hand written thank you note and thank them for their time and reinforce the points that you made in the meeting. I also would like to hear about the outcome of your meeting too. We need to identify champions for our issues/concerns.

Election Year

Go to town hall meetings, candidate forums to educate Candidates running for office and see where they stand on the practice of licensed midwives in Florida. Again we need to identify true champions for licensed midwives who can assist us in the legislative process if it should become necessary.

Florida Administrative Rule Change – Birth Centers –
To date I have not heard anything – will follow up

Next Steps
It has been decided that two Capitol Days would be beneficial. One Capitol Day during committee weeks and one during the regular legislative session. I will be setting them up and hopefully we can get the ground floor of the Capitol Building.

I also will be having ongoing dialogue with key stakeholders in reference to managed care this summer and keeping my ear to the ground as it relates to midwifery and birth centers.

It is expected the 2011 legislative session is going to be more brutal then this year – there will be no stimulus dollars from the Federal government, general revenue is expected to be down again – maybe even more so with the oil spill that will have an impact on tourism.

As always if there is as issue that you think that should be a law in reference to midwifery and birth centers – send it to me what the action item is and the research behind it. I absolutely love to write bills and get the bill sponsors and work the bills.

Thank you for the opportunity to work on your behalf!

Dawn T. Steward
407.645.0273
Stu2130@aol.com