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NACPM Report to the Membership Annual Membership Meeting
October 16. 2010 / Nashville, Tennessee

Back in the spring of 2007, NACPM received a small seed grant to explore a Federal initiative to secure Medicaid reimbursement for CPMs to increase low-income women’s access to our services. At that time, CPMs had no Federal level experience or expertise, there was little knowledge among CPMs about the potential of a Federal initiative for Medicaid reimbursement, CPMs had no presence in Washington, DC, and were entirely unknown to legislators on Capitol Hill. That was just 2 ½ years ago.

With that seed grant, NACPM developed a plan for promoting CPMs as respected members of the nation’s maternity care workforce and, in the spring of 2009, invited our sister-organizations (CfM, ICTC, NARM, MEAC & MANA) to partner with us in the MAMA Campaign.

Today:

  • CPMs have expert representation in Washington, D.C. with Billy Wynne and Health Policy Source, Inc.
  • Key legislators in both the House of Representatives and the Senate support increased access to CPM services
  • The Centers for Medicare and Medicaid Services (CMS) view CPMs as a resource for information about CPMs and their care for women in homes and birth centers
  • Effectively the law of the land now mandates that CPMs offering services in birth centers must soon be reimbursed by Medicaid for their provider and birth center facility fees
  • Many CPMs have become enthusiastic supporters of our Federal legislative efforts, contributing letters to their legislators and unprecedented dollars
  • CPMs are closer than ever before to securing sponsors for our stand-alone Medicaid reimbursement bill in both the House and the Senate
  • And, references to CPMs are included in no less than 5 new pieces of draft legislation under consideration in the House of Representatives, including two bills that have been recently introduced and 3 more that are under consideration!

Funding Success

NACPM is deeply grateful to the Transforming Birth Fund of the New Hampshire Charitable Foundation for a $100,000 grant in 2010 to continue NACPM’s policy work to support the work and practice of CPMs. These funds were used to support our employ of Billy Wynne and Health Policy Source, our valuable representatives in Washington, DC, and for a new Policy Analyst position for NACPM. (See below)

Policy Achievements

  • Birth Center Provider Fee Reimbursement: In March of 2010, Congress passed the historic Patient Protection and Affordable Care Act (PPACA). Thanks to MAMA outreach and to Senator Cantwell’s support, Certified Professional Midwives who are licensed and practicing in licensed birth centers will have their provider fee reimbursed by Medicaid. This provision will increase women’s access to the care of CPMs and provides a strong platform for the ongoing effort to mandate Medicaid reimbursement for all CPM services, regardless of setting.
  • Centers for Medicare & Medicaid Services meeting: In May of 2010, as a result of Health Policy Source connections, representatives of NACPM and the MAMA Campaign met with several key CMS administrators in Baltimore to discuss implementation of the birth center provider and facility fee provisions as they relate to CPMs. The meeting was collegial and dynamic, and we were able to provide information and technical assistance to the CMS staff regarding CPMs and their care for women in homes and birth centers.
  • Stand-Alone CPM Bill: After just 1 ½ year’s advocacy on the Hill, we have secured a commitment from a Congress member to become the primary sponsor for our stand-alone bill this November to amend the Social Security Act to mandate Medicaid reimbursement for CPM services. We have strong interest from a Senate office as well.
  • CPM Inclusion in 5 Maternity Care Bills: The Blueprint for Action recommendations are providing the impetus and foundation for a flurry of maternity care reform bills on the Hill in the last few months. Congresswoman Roybal-Allard (CA 34) has introduced the MOMS for the 21st Century (HR 5807), and four more bills are in the final stages of development. Indicative of our increased visibility and credibility on the Hill, CPMs are included in all references to maternity care providers in every one of these bills! NACPM is included in references to professional associations of maternity care providers. Mary Lawlor has met with each of the offices that are sponsoring these bills to discuss CPMs and the value they bring to the nation’s maternity care system.

Developing Relationships

  • MAMA Campaign Coalition: The MAMA Campaign Steering Committee has drafted a new Memorandum of Understanding and made a continued commitment to pursue Federal recognition of the CPM. We are upgrading our administrative and technical systems to better meet the needs of the Campaign, and we are pursuing our work together as valued and trusted colleagues.
  • ACNM: NACPM welcomes ACNM’s new President, Holly Powell Kennedy, her emphasis on midwives working together toward mutual goals, and her much-appreciated outreach to NACPM.
  • Normal Birth Task Force: ACNM has formed a Normal Birth Task Force to draft an American position paper on Normal Birth. Recently, at Holly’s initiative, ACNM invited representation from NACPM and MANA to the task force, and all three organizations will author the final product, which will give important direction to maternity care policy and research.
  • Abstract for ACNM 2011 Convention: Holly Kennedy has invited Mary Lawlor from NACPM and Gera Simkin from MANA to co-present the Normal Birth Task Force and Position Statement at the next ACNM conference.
  • Federal Maternity Care Coalition: ACNM, NACPM, MANA, AABC, Childbirth Connection, Amnesty International, and the Association of Women’s Health, Obstetrical and Neonatal Nurses (AWHONN) have formed a coalition to support the passage of the various maternity care reform bills that are in process on the Hill.
  • Home Birth Consensus Summit: Under the leadership of Saraswathi Vedam, CNM, a multi-stakeholder group, including NACPM, is moving forward to hold a facilitated summit in 2011 to examine and reach consensus on various issues regarding home birth.

Organizational Achievements:

  • Membership Development - NACPM:
  • Now offers a one-year free NACPM membership to all new CPMs
  • Is holding a raffle for a free conference fee to either MANA 2011 or ICTC 2011 for new and renewing members in 2010
  • Offers a one-time $50 annual membership fee to new Chapter members
  • Is reaching out personally to each expired member personally to invite them to renew their NACPM membership
  • Communicates on a regular basis with our members through:
  • Annual membership meeting at the MANA Conference
  • Annual Report: NACPM will begin publishing and mailing to all members an annual report beginning in January 2011
  • Membership Newsletters: Sent quarterly as an electronic e-news, with a downloadable pdf file version
  • Standing up for Evidence-Based Practice: A recent meta-analysis by Wax et al published on-line by AJOG, purports to demonstrate significant increased infant mortality with home birth over birth in the hospital. Outraged rebuttal came from many sources. Mary Lawlor, in consultation with researchers Missy Cheney, CPM, and Saraswathi Vedam, CNM, drafted an NACPM press release. It was picked up by the New York Times and also by Medscape, a widely consulted online resource for clinicians. Medscape published the press release and also an article that extensively quoted Mary and the press release. Mary has subsequently been invited by Medscape to participate in a virtual roundtable discussion of the Wax study and home birth.
  • Membership Development - NACPM:
  • Now offers a one-year free NACPM membership to all new CPMs
  • Is holding a raffle for a free conference fee to either MANA 2011 or ICTC 2011 for new and renewing members in 2010
  • Offers a one-time $50 annual membership fee to new Chapter members
  • Is reaching out personally to each expired member personally to invite them to renew their NACPM membership
  • Communicates on a regular basis with our members through:
  • Annual membership meeting at the MANA Conference
  • Annual Report: NACPM will begin publishing and mailing to all members an annual report beginning in January 2011
  • Membership Newsletters: Sent quarterly as an electronic e-news, with a downloadable pdf file version
  • Standing up for Evidence-Based Practice: A recent meta-analysis by Wax et al published on-line by AJOG, purports to demonstrate significant increased infant mortality with home birth over birth in the hospital. Outraged rebuttal came from many sources. Mary Lawlor, in consultation with researchers Missy Cheney, CPM, and Saraswathi Vedam, CNM, drafted an NACPM press release. It was picked up by the New York Times and also by Medscape, a widely consulted online resource for clinicians. Medscape published the press release and also an article that extensively quoted Mary and the press release. Mary has subsequently been invited by Medscape to participate in a virtual roundtable discussion of the Wax study and home birth.

Creation of Policy Analyst Staff Position
This year, for the first time, the work of NACPM was supported by a half-time Policy Analyst position, thanks to Transforming Birth Fund support, bringing added strength to NACPM’s Federal policy initiatives and allowing NACPM to contribute Mary’s services to the MAMA Campaign. The funding of this position assured a consistent presence for CPMs on Capitol Hill, fostered increased development of Federal policy experience and expertise, and helped to further define the MAMA Campaign as an NACPM initiative within the Coalition.

Organizational Development: Next Steps to Sustainability

  • NACPM is reaching out to engage and inspire CPMs in exciting new projects.
  • CPMs: Creating a Vision for Surviving and Thriving in the 21st Century: The board is planning NACPM’s first ever CPM symposium for July 2011 in Washington, DC. This gathering will address the very real challenges that confront CPMs if we truly want our services to be available to all women, as well as dynamic opportunities that are emerging every day. The Blueprint for Action will be used as a guide and a resource in the planning process.
  • NACPM Chapters: Announced in the June 2010 member newsletter, chapters will provide CPMs in the states an opportunity for more engagement with their professional association. The board is currently working with several states interested in forming chapters and will evolve the chapters policy in consultation with state midwifery leaders.
  • NACPM Practice Committee: The board decided in April 2009 to establish this committee, as a further service to CPMs in guiding clinical practice, building on the previously developed NACPM Standards of Practice. We continue our research into establishing this committee, and will convene an advisory council before the end of the year. This committee will offer not only desired clinical guidance, but also an exciting opportunity for member and CPM involvement. It will significantly increase NACPM’s identity as a credible professional organization, within the profession as well as in the larger maternity care world.
  • Webinars: NACPM is planning a series of webinars in 2011 to build momentum for the symposium described above, to engage CPMs and others who will not be able to attend, and to provide important follow-up. We hope to offer MEAC ceus for at least some of the webinars.
  • Staffing
  • Policy Analyst: The cumulative experience of the past several years has clarified for the board that NACPM’s focus on Federal policy is essential to the growth and viability of the organization. For NACPM to effectively support the integration of CPMs into the maternity care system and to assure that these services are available to women, maintaining the position of a point person for the policy work is essential. It assures the ongoing accumulation of a body of knowledge, the building and nourishing of a network of relationships, and the growing effectiveness of NACPM. Mary Lawlor has been hired with Transforming Birth grant funding to fill this position.
  • Executive Assistant: NACPM has applied for funding for this position, which will provide essential staff support for the board and the Policy Analyst.
 
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