Board Meeting
December 13, 2019
The Alabama State Board of Midwifery met on Friday, December 13, 2019, to conduct business. Board members physically present at the primary physical location were: (1) Ms Noel Leithart (Board Chair), (2) Ms Tori Dennis (member), (3) Ms Stephanie Armstead (member), and (4) Ms Kaycee Cavender (member). Board members in attendance electronically were (1) Ms Marietta Nero (member), (2) Ms Stacey Bufkin (member), and (3) Ms Colleen Tullis (member). Also in attendance were Ms Bettie Carmack, attorney for the Board, and Rebekah Myrick, administrative assistant to the Board. The physical meeting was held at Vestavia City Hall, Vestavia Hills.
The members of the public at the physical location were Laura Reeder, Brandon Reeder, Chris Megginson, Nancy Megginson, Rachel Thompson, Chloe Raum, Evan Brock, Sileah Brock, Alex LaGanke, Millie LaGanke, Elizabeth Rainwater, Jo Crawford, Jessica Smith, Lauren Collins, Sharon Porterfield Miller, and Matt Hart representing the Alabama Board of Medical Examiners.
The Board meeting had been advertised on the Secretary of State’s website, in accordance with the Alabama Open Meetings Act. There being a quorum of board members present electronically and at the physical location, Ms Leithart, Board Chairperson, called the meeting to order at 10:12 a.m. and proceeded to preside over the meeting.
Ms. Leithart presented the August 23, 2019, meeting minutes for the Board’s approval. Copies of the minutes were provided to the members prior to the meeting for their review. No corrections or addendums were made. Ms Dennis made a motion to adopt the August 23, 2019, meeting minutes. The motion was seconded by Ms Cavender and unanimously approved by the Board.
Ms Leithart reported five applications to be examined. Ms Dennis motioned that we move into executive session to discuss the good name and character of the applicants beginning at 10:15am and ending at 12:15. The motion was seconded by Ms Cavender and certified by Ms Carmack. Roll Call vote was taken: Ms Cavender voted aye; Ms Nero voted aye; Ms Leithart voted aye; Ms Dennis voted aye; Ms Armstead voted aye; Ms Bufkin voted aye; Ms Tullis voted aye. The motion was unanimously approved by the Board. Executive session began at 10:15pm. Ms Dennis motioned to reconvene the regular board meeting at 12:15pm. Ms Cavender seconded. Roll call vote was taken: Ms Cavender voted aye; Ms Nero voted aye; Ms Leithart voted aye; Ms Dennis voted aye; Ms Armstead voted aye; Ms Bufkin voted aye. Ms Tullis left the meeting at 11:20, so did not vote. The motion carried unanimously. The Board resumed the general meeting at 12:15pm.
Ms Dennis motioned to grant license to Applicant A12132019. Ms Cavender seconded. Roll call vote: Ms Cavender aye, Ms Dennis aye, Ms Nero aye, Ms Leithart aye, Ms Armstead aye, Ms Bufkin aye. 6 in favor, none opposed.
Ms Dennis motioned to grant license to Applicant B12132019. Ms Cavender seconded. Roll call vote: Ms Cavender aye, Ms Dennis aye, Ms Nero aye, Ms Leithart aye, Ms Armstead aye, Ms Bufkin aye. 6 in favor, none opposed.
Ms Dennis motioned to grant license to Applicant C12132019. Ms Cavender seconded. Roll call vote: Ms Cavender aye, Ms Dennis aye, Ms Nero aye, Ms Leithart aye, Ms Armstead aye, Ms Bufkin aye. 6 in favor, none opposed.
Ms Dennis motioned to grant license to Applicant D12132019. Ms Cavender seconded. Roll call vote: Ms Cavender aye, Ms Dennis aye, Ms Nero aye, Ms Leithart aye, Ms Armstead aye, Ms Bufkin aye. 6 in favor, none opposed.
Ms Dennis motioned to grant license to Applicant E12132019. Ms Cavender seconded. Roll call vote: Ms Cavender aye, Ms Dennis aye, Ms Nero aye, Ms Leithart aye, Ms Armstead aye, Ms Bufkin aye. 6 in favor, none opposed.
Ms Leithart expressed congratulations to newly Licensed Midwives, Laura Reeder LM-0011, Wetawnya Smith LM-0012, Nancy Megginson LM-0013, Sileah Brock LM-0014, and Rachel Thompson LM-0015
Ms Leithart reported that she had received two sets of written comments regarding the amended Complaint Review Rules that were published Oct 31, 2019. She opened the floor for any further comments about the amended rules. No comments. Ms Cavender motioned that the Board go into executive session for 30 minutes to discuss the legal ramifications of the comments from the Medical Association of Alabama (MASA) and the Alabama Hospital Association (AlaHA). The motion was seconded by Ms Dennis and certified by legal counsel. Roll call vote: Ms Cavender aye, Ms Dennis aye, Ms Nero aye, Ms Leithart aye, Ms Armstead aye, Ms Bufkin aye. 6 in favor, none opposed Executive session began at 12:25pm. Ms Dennis motioned to reconvene the regular board meeting at 12:55pm. Ms Cavender seconded. Roll call vote was taken: Ms Cavender voted aye; Ms Nero voted aye; Ms Leithart voted aye; Ms Dennis voted aye; Ms Armstead voted aye; Ms Bufkin voted aye. The motion carried unanimously. The Board resumed the general meeting at 12:55pm.
Regarding complaint #1 from MASA concerning the removal of the complaint form from the website, Ms Dennis motioned to make a minor change in the amended rules to state that “individuals may request a complaint form through the website,” Ms Cavender seconded. Oral vote taken. All in favor. None opposed. Regarding complaint #2 from MASA,concerning the interchangeable words of Complaint Review Committee and Investigative Committee, Ms Dennis motioned to proceed as written with no changes to the amended rules. Ms Cavender seconded. Oral vote. All in favor. None opposed. Regarding complaint #3 from MASA, concerning staff of the ASBM being on the Complaint Review Committee, Ms Dennis motioned to proceed as written. Ms Cavender seconded. Oral vote. All in favor. None opposed.
Complaint from AlaHA concerned staff of the ASBM being on the Complaint Review Committee. Ms Dennis motioned to proceed as written and move the Amended Rules to be certified. Ms Cavender seconded. Oral vote. All in favor. None opposed.
Ms Leithart reported on her communication with STAARS, clarifying that the ASBM is officially a manual agency for filing invoices and purchase orders. She mentioned her progress that the Budget may be filed electronically in the future. She also gave a financial report. Ms Leithart reported that she met on Sept 6, 2019, with the Chief Medical Officer of Medicaid, Dr Robert Moon. She explained to him the education and training of Licensed Midwives. He planned to take the information to Stephanie Azar, the Commissioner of Medicaid. No word from Medicaid yet. Ms Leithart explained that the Licensed Midwives have been told that they cannot file birth certificates electronically because the system is out of date, and that Vital Records is working to fix that problem. Ms Leithart also reported that she has received a letter from the attorney for Alabama Department of Public Health (ADPH) requesting that Licensed Midwives cease attempting to order Newborn Screening cards. Ms Leithart reminded the Board members that the next Board Member Training is to be held in Montgomery on January 29, 2020.
Ms Carmack reported that there is not yet an opinion from the AG’s office regarding the newborn metabolic screening cards, in spite of requesting the opinion on Feb 5, 2019. Ms Dennis mentioned the disconcerting statistics of infant mortality in the state, especially black babies, and it appears that by refusing the LMs access to the newborn screening, ADPH appears to be penalizing home birth families, which could border on racism and classism. Ms Nero confirmed this opinion. Ms Armstead made a motion to pull the AG opinion on giving the cards to LMs. Ms Dennis seconded. Roll call vote: Ms Armstead aye; Ms Cavender aye; Ms Dennis aye; Ms Bufkin aye; Ms Leithart aye; Ms Nero aye. 6 in favor. None opposed.
Rebekah Myrick declined to renew her contract as Administrative Assistant. Ms Sharon Porterfield Miller has submitted a resume for the position. After the Board reviewed her resume and questioned the applicant, Ms Cavender motioned to offer a 12 month contract to Sharon Porterfield Miller beginning Dec 16, 2019, to be reviewed at the end of that term. Ms Dennis seconded the motion. Roll call vote: Ms Nero voted aye, Ms Dennis voted aye, Ms Cavender voted aye, Ms Leithart voted aye, Ms Armstead voted aye; Ms Bufkin voted aye. None opposed. Ms Porterfield Miller will begin December 16, 2019
The Board solicited comments from the public.
Ms Dennis reported that there are three African American midwifery students in the state.
Ms Cavender read a report from a woman in North Alabama who was questioned by an investigator from the Board of Medical Examiners (BME) after her hospital transfer. She asked for the letter to be included in the minutes.
Recently, an Alabama mother shared her experience regarding Alabama Board of Medical Examiner’s investigator, Randy Dixon, showing up at her door after her homebirth away from home transfer. While this mother wishes to remain anonymous, I do have permission to share her experience. This mother had an unplanned cesarean at a north Alabama hospital in 2014 and was satisfied with her care. When she found out she was pregnant August of last year she decided to try for a VBAC with a CPM in Tennessee. This midwife is licensed in Alabama and Tennessee but because VBACs are not included in the scope of practice in Alabama, this mother would have to give birth in Tennessee where this midwife could legally attend her VBAC. Once labor began, she labored at home for a while and then drove to Tennessee to a birth house where her midwife would meet her and her husband. After 33 hours of labor and little progress, she decided to transfer to the hospital to receive an epidural and get some rest. She chose to transfer to the same north Alabama hospital she used in 2014 and stated that she was well taken care while there and that they didn’t seem surprised or concerned that she had attempted a VBAC at home. Both mom and baby were healthy and stable.
This mother stated, “On September 23rd an investigator with Alabama Board of Medical Examiners came to my house and questioned me about my birth, my midwife, and my experience with the hospital. He already knew I’d had a cesarean and vbac. I had not given permission for my records to be shared. He wanted to know if my “nurse midwife” had warned me of the risks involved with a vbac. He asked where I’d labored, how long I’d labored at home and in Tennessee, and how long I’d labored in the hospital. He wanted to know details like who drove me to the hospital, how long it took to get there, and if my husband was warned and aware of the risks and laws. Then he asked who the delivering doctor was, and why I’d chosen Madison Hospital. He wanted to know
why I didn’t go to a hospital in Tennessee. The experience frightened me.”
Ms Dennis motioned for Ms Cavender draft a letter of inquiry to the BME to ascertain if they were investigating a Licensed Midwife and also to inform them that it is the responsibility of the ASBM to investigate LMs. Ms Armstead seconded the motion. Oral Vote. All in favor. None opposed.
Ms Cavender resigned her position as consumer representative on the Board, effective immediately. Ms Dennis motioned that the Board contact the nominating group for replacement to serve the remainder of Ms Cavender’s term. Ms Leithart seconded. Oral vote. All in favor. None opposed.
There was no further business of the Board. Ms. Cavender made a motion to adjourn. Ms. Dennis seconded, and the motion passed unanimously. Ms. Leithart adjourned the meeting at 1:45 p.m.
Respectfully Submitted,
___________________
Noel J. Leithart
Chair