• 04/06/2015 10:03 PM | Rosanna Davis (Administrator)

    Thanks to your efforts and CAM’s advocacy work, California families will have expanded access to midwifery in 2016. We have heard your many questions about the implementation of Medi-Cal, CPSP, and the Midwife Assistant designation, and we are committed to keeping you-up-to-date on the details that are currently available.


    Thanks to CAM advocacy, licensed midwives will soon be able to enroll in Medi-Cal without billing through a doctor.

    Here are the implementation steps that need to occur before licensed midwives can begin to enroll as Medi-Cal providers:

    • The California Department of Health Care Services (DHCS) is submitting a State Plan Amendment (SPA) to the federally-administered Centers for Medicare and Medicaid Services (CMS). The SPA will authorize licensed midwives to enroll in California’s Medi-Cal plan independent of a supervising physician. CMS must approve this plan before California can begin to enroll licensed midwives in Medi-Cal.

    • After the SPA is approved, the California DHCS must update its regulations and enrollment forms.

    • Once the regulations and forms are updated, individual licensed midwives will be able to enroll as Medi-Cal providers.

    • We do not anticipate any hurdles in this process. We do anticipate that it will take some time to complete - at least until January 1, 2016 and probably longer. We are working with DHCS on this process and monitoring it closely. CAM will keep you up-to-date as the process continues.

    How to enroll as a Medi-Cal provider:

    • Once the implementation process is complete (see above), enrollment forms will be available on the DHCS website alongside all the enrollment forms for all the different types of providers in California. CAM will also link to these forms on our website. We will let you know when these forms are available.

    • For all types of providers, Medi-Cal may take up to 180 days to process new provider applications.

    • As a reminder, you cannot balance bill for clients using Medi-Cal if you are a Medi-Cal provider. Each midwife choosing to enroll in Medi-Cal is responsible for reviewing and understanding Medi-Cal billing rules and regulations.


    What is CPSP?

    The Comprehensive Perinatal Services Program became a Medi-Cal benefit in 1987. Medi-Cal-eligible women receive comprehensive services, including prenatal care, health education, nutrition services, and psychosocial support for up to 60 days after delivery of their infants. Licensed midwives - who have long provided these services - will be eligible to bill for these services (following the implementation process) thanks to the passage of SB407.

    Understanding CPSP practitioners and providers.

    CPSP providers are billing entities, such as health clinics, licensed alternative birth centers, physician practices, and now, licensed midwifery practices. CPSP practitioners are employed by CPSP providers. Previously, licensed midwives were ineligible in either category. Thanks to SB407, licensed midwives can now be either CPSP practitioners or providers.

    Here are the implementation steps that need to occur before licensed midwives can begin to enroll as CPSP practitioners:

    • No earlier than Jan 1, CA DHCS must update the existing CPSP regulations to enable licensed midwives to become CPSP practitioners.

    Here are the implementation steps that need to occur before licensed midwives can begin to enroll as CPSP providers:

    • The effective date for DHCS to enable licensed midwives to be CPSP providers is the same effective date for the new regulations resulting from AB1308. The AB1308-related regulations are being created by the Medical Board.

    CAM will continue to monitor both the process for regulations for AB1308 and for CPSP implementation.

    How to enroll as a CPSP practitioner/provider:

    • All provider/practitioner applicants must complete a State of California training. These trainings are provided periodically with online or in-person options.

    • Once the implementation process is complete (see above), enrollment forms will be available on the California Department of Public Health website. CAM will also link to these forms on our website. We will let you know when these forms are available. There will be different forms for practitioners and providers.

    California Midwife Assistants

    Once implemented, the California Midwife Assistants statue will allow a 'midwife assistant' to legally assist a licensed midwife in out-of-hospital settings including midwife offices, birth centers or private homes. Previously, the opinion of the Medical Board is that only another licensed maternity care provider or a registered student at a board approved school can legally act as an assistant.

    Here are the implementation steps that need to occur before Midwife Assistants can legally practice:

    • As dictated by the statute, the Medical Board of California staff must create a set of regulations for Midwife Assistants. These should be modelled on the medical assistant regulations.

    • The Medical Board will vote on the proposed regulations, which will define the exact training that is required. It is likely to offer two pathways: on-the-job training with an LM or CNM; or, a formal training program.

    • We will not know if any particular existing training programs qualifies until the Medical Board votes in the new training requirements.

    • Implementation will take place in 2016. The implementation process will be outlined at the October 29-30, 2015 quarterly Medical Board meeting.

    CAM will continue to monitor and support the process for Midwife Assistant implementation.

    How to become a Midwife Assistant:

    • The process for becoming a Midwife Assistant will be determined by the Medical Board as a part of implementation (see above).

    • Midwife Assistants will not be licensed, certified, or registered with the state.

    • Midwife Assistants must be directly supervised at all times by an LM or CNM and can only provide technical supportive services as defined by the statute.

    • PLEASE NOTE: the legal protections provided by this bill will not take effect until implementation is complete.

    Questions? We look forward to keeping you up-to-date! Here’s some ways you can keep up-to-date:


    CAM is hosting a webinar on implementation of Medi-Cal, CPSP, and Midwife Assistants.


    Wednesday, Oct 21st, noon pacific

    Click HERE to for FREE registration.

    Note: As a part of our advocacy work on behalf of California licensed midwives, CAM volunteers have become very familiar with the ins-and-outs of the new statutes and their implications for our community. We look forward to sharing with you what we’ve learned. Please note that licensed midwives are responsible for reviewing and understanding the rules and regulations that apply to their practice. CAM webinars and other information cannot replace consultation with the appropriate state officials and your own legal counsel.

    1. 12/05/2014 10:26 AM | Rosanna Davis (Administrator)

      Yesterday, December, 4, CAM leadership, including President Constance Rock and Vice President Rosanna Davis, a number of CAM regional reps from across the state, as well as, individual CAM members represented Licensed Midwives at the Midwifery Advisory Council (MAC) meeting. 

      The meeting was brief and consisted mostly of updates from MAC and Medical Board staff. Here are highlights and next steps:

      Streamlined CNM to LM Process Not A Regulatory Issue
      Recently, the Medical Board was asked to consider a regulatory change that would allow a streamlined process for Certified Nurse Midwives (CNMs) in California to become Licensed Midwives. This issue has become increasingly significant for CNMs as they are still required to document physician supervision.

      Medical Board Chief of Legislation Jennifer Simoes reported today that the Medical Board does not see streamlining as a regulatory issue to be initiated by the board. They encouraged CNMs to continue to find a legislative solution. The Medical Board will not be seeking a sponsor for this type of legislation.

      Update on Midwife Assistant Legislation

      Jennifer Simoes also reported on efforts to craft a bill that will define the role of the midwife assistant, with the goal of providing legal protection for both the midwife and the midwife assistant. (Note that this bill will not create licensure, certification, or registration of midwife assistants.)

      The Medical Board has brought language to two separate committees and are in the process now of developing the strategy most likely to get passage in this session.

      This legislative effort was spearheaded by CAM, who drafted the initial language for the bill.

      Update on Regulatory Changes 
      The regulatory changes happening as the result of AB1308 were also discussed briefly in today's meeting, primarily in the form of updates from the last Interested Parties meeting and the CAM/ACOG meeting.

      The Medical Board staff remains hopeful that stakeholder compromise will be achieved. The next step in the process is the upcoming Interested Parties meeting. We will need your support at this meeting!

      Please see the information about the CAM General Meeting below - we will be attending the Interested Parties Meeting directly after the gathering.

      You Tube Videos (recorded, rendered and uploaded by Rosanna) of the Meeting can be viewed here.

      Also, check back on the Medical Board Website in the coming days for the official recording of the live streaming webcast.

      Support materials handed out at the meeting:

      Regulations Packet

      Agenda and Supporting Materials

      LM CNM comparison summary for incoming Medical Board Members

    2. 10/28/2014 1:47 PM | Caroline Cusenza

      Note:  this applies to specific (mostly N. California) regions in California.  You likely received this notice if you are a NBS provider, but just in case you didn't:

      Western Clinical Laboratories will NO LONGER be testing newborn screen specimens. The lab is closing and is not accepting any more newborn screens. ALL SPECIMENS must be shipped to Allied Laboratories in Mountain View. View attached notice for address of GSO shipping and address for United States Postal Services address. There are two different addresses depending upon which method of shipment you use. Please click the file below for more information.


    3. 05/07/2014 10:05 PM | Rosanna Davis (Administrator)
      Cheryl at Cascade Healthcare Products informs us that they are temporarily unable to fill orders for pharmaceuticals to California.  She expects the situation to be resolved in a matter of weeks.

      In the meantime, if you have more urgent need of pharmaceuticals the following companies are filling orders from California Licensed Midwives:

      Baby Birth and Beyond; Everything Birth; Henry Schein; In His Hands; Physician Sales and Services



    4. 03/08/2012 8:38 AM | Anonymous
      Stand up for Licensed Midwives on Thursday, March 29th in Sacramento!

      A critical meeting regarding the future of the practice of Licensed Midwives in California is taking place on Thursday, March 29th at the Medical Board building in Sacramento. All Licensed Midwives, consumers of midwifery services, and other supporters of midwifery are urged to attend the Interested Parties Meeting of the Midwifery Advisory Council of the Medical Board of California.  This pivotal meeting addresses the issue of physician supervision of Licensed Midwives.  There has been a proposal to the Medical Board to define physician supervision of Licensed Midwives as collaboration- a definition that would end the unobtainable and problematic current requirement.  Please join us in supporting this incredibly important proposal, which would eliminate some of the ongoing barriers to safe, effective and accessible Licensed Midwifery care in California. Your presence and support are crucial! 

      Licensed Midwives in California have made many attempts to secure supervision, but it is essentially an impossible requirement to fulfill due to the medico-legal and political climate. Licensed Midwives in California are currently providing care with good birth outcomes without such supervision, despite the requirement. In fact the physician supervision requirement creates barriers to safe care by not allowing supportive physicians to work collaboratively with Licensed Midwives, for fear of liability and retribution from peers.  The physician supervision requirement also limits access to Licensed Midwives for low income Californians, because the requirement prevents Licensed Midwives from becoming Medi-Cal providers independent of a physician.

      Please attend this meeting in person!!!  Licensed Midwives, consumers, student midwives, midwifery supporters, ICAN members, doulas and other birth workers, please join us for this critical meeting.  Thank you! 

      See CAM website for details such as the time, which has not been announced by the Medical Board yet. 
      Medical Board address:  2005 Evergreen St. Sacramento, CA 95815
      Medical Board website: Time will be announced on Medical Board committee meeting page. Here is the link:

      ***Please visit this link for the Medical Board Agenda items, staff report, and new proposed code regulations- which includes a new definition of "supervision" and new regulation regarding obtaining drugs and administering drugs. ***

    5. 01/16/2012 2:15 PM | Deleted user
      Please log in to the CAM website, go to the Members-Only section, and you will see the Labcorp info page directly below the Updates section. If you are not a current CAM member and you are a practicing midwife who would like a Labcorp account with the CAM discount, please visit our Become A Member page. You can pay online via Paypal or credit card. Or click here to join via Snail Mail. 
    6. 12/30/2011 7:55 PM | Jocelyn Dugan (Administrator)
      I am doing my best to get these up and running, but currently I am the CFO, acting membership coordinator, and now I have somehow stumbled onto managing content as well.  Can you tell midwives are important to me?  I would love some feedback on the forums, but so far the only ones that are true forums are the ones that are accessible to everyone, like VBAC, Breastfeeding, and Baby Wearing.  Please take a look around, create some topics and give me feedback to work with.


    7. 11/08/2011 2:18 PM | Jocelyn Dugan (Administrator)
      Hi everyone, 

      Go ahead and check out the CAM Directory.  If your membership is current and you are a practicing midwife, you should be able to find your directory listing.  

      Due to privacy concerns, I only listed people's names, phone numbers, websites, and job titles.  

      This is still in a state of flux, so feel free to contact me with questions and/or concerns.

    8. 10/06/2011 3:06 PM | Jocelyn Dugan (Administrator)
      Please bring a photo and written consent to use it to the Board meeting!  We are looking for something gorgeous to go on on post card!  If you have questions, please contact Laura or Jocelyn.
    9. 10/06/2011 3:04 PM | Jocelyn Dugan (Administrator)
      For anyone who might be logging in, I hope you  love our new membership site!  We have been working diligently to make sure we can provide the value you need from CAM as an organization and there are some major changes on the horizon!  

      Stay tuned and definitely come to the Board Meeting to learn more!

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