Charleston Birth Place | Support Legislation for Access to Midwives and Birth Centers
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3/2/16 UPDATE

The Senate today introduced Bill 1143 this bill mimics the original language of 3851 and has support of all the SC accredited birth centers and the physician and hospital groups. CBP feels this is the better of the 2 currently active birth center bills and has our full support. We encourage our supporters to continue letting their legislators know they want this bill to pass THIS legislative session.  A huge THANK YOU to Senators Larry Groom, Paul Campbell, and Marlon Kimpson for introducing this bill.

The House Birth Center Bill 3851 was put into adjourn/debate status by the 3M subcommittee on Tuesday. Unfortunately it is unlikely this bill will move forward before the end of the current legislative session.

House Bill 4393 remains in the 3M committee and has not had a hearing scheduled yet. This bill is an abbreviated bill that does change the wording of the statute to read the physician consultant would be available “to” the birth center instead of “at” the birth center. CBP does not oppose this bill. We do have concerns that the bill does not prevent DHEC from making regulations that are not based on national standards and it does not address quality assurance issues either. It would however solve the issue that DHEC has insisted CBP’s physician agreement does not comply with the law.

It is imparitive that a birth center bill is passed this legislative session. If a bill does not get passed then we would have to start completely over with new bill next January. CBP would be able to remain licensed as long as Proviso 3449 is renewed in June. If a new Bill is not passed AND the Proviso is not renewed we would then have to take legal action in the courts.

If you want the option of birth center care in SC it is vital that you continue your support. Without the consumer support we would not have been able to continue fighting for this long.

We appreciate each and everyone of you. Stay tuned for further updates.




H3851 The Birth Center bill is in the 3M committee. A hearing has not been scheduled yet. The physician groups continue to oppose the bill as amended by Rep Ridgeway. We need phone calls, and e-mails to house members specifically 3M committee members to help move the bill forward.

H3078 The APRN bill is in the 3M committee. The FTC released an opinion paper supporting 3078 and stating that requiring MD supervision for advanced practice nurses constitutes restraint of trade. The Coalition for Access to Health Care has offered 9 amended drafts of the bill to the South Carolina Medical Association that have all been opposed. The 9th draft includes a 6 FTE to 1 ratio, 60 mile radius requirements and either collaborative or supervising agreements between the APRN and MD. The SCMA is  resistant to any bill that is not full supervision.

The physician groups have strong influence over the legislators. As consumers we need your voice to be heard. Please let the legislators know that supporting legislation that improves access to midwives and birth centers is important to you.

3M Committee members:

Anne Parks Chair of subcommittee for health regulation

May Tinkler subcommittee member for health regulation

Wendell Gilliard subcommittee member for health regulation

Cezar McKnight subcommittee member for health regulation

Leon Howard Chair 3M committee

Richie Yow

Kit Spires

Justin Bamberg

Mary Gail Douglas

Jonathan Hill

Jay Jordan

robert Ridgeway

Mia McLeod

Pat Henegan

Joseph Jefferson

Leola Robinson-Simpson



H3851 The Birth Center Bill was amended by Rep Ridgeway when sent to the full 3M committee. The amendment changes did not reflect the compromise language between the physician and hospital groups and the CABC accredited  birth centers. Due to pressure from the physician and hospital groups the full House moved to send the bill back to 3M committee for further debate. The committee will not meet on 3851 until next legislative session early 2016. CBP was assured by legislators the proviso would be renewed for another year allowing time for the legislative process to move forward without unfairly jeopardizing the licensure status of CABC accredited birth centers.

H3078 The APRN Bill had a second 3M subcommittee hearing with proposed amendment changes by Rep Ridgeway. A vote of 3:1 was to adjourn to debate. Rep Gilliard (Charleston) voted no to adjourn to debate status. H3851 as originally written CBP strongly supports. This bill would bring SC APRN language including nurse midwives up to date with national recommendations. Both American College of Nurse Midwives and the American College of OB/GYN agree nurse midwives are independent practitioners and support legislation to remove supervision. CBP thanks Rep Gilliard and other legislators who support H3078.

H3508 The SCMA association version of APRN Bill also had a second hearing with 3M subcommittee. The bill was voted unanimously to adjourn to debate until next legislative session. CBP strongly opposes the language and intent of SCMA to push back APRN legislation in SC 20 years.



Legislative Update:

Birth Center Proviso

We have been informed by the House Ways and Means Committee the birth center proviso has not been deleted. We have reassured the committee and legislators that we are working on a collaborative bill with birth center stakeholders and are very close to having a draft to present soon.

H.3078 Nurse Practitioner/Nurse Midwife UPDATE:

As you may already know, despite the best efforts of our great APRN turnout, compelling testimonies, Representative Gillard’s strong support, and Chairman Howard’s willingness to help pass H.3078 favorably out of subcommittee, Representatives Anne Parks and Phyllis Henderson ultimately voted to adjourn debate on the bill. THIS DOES NOT MEAN THE BILL IS DEAD! This means that the bill may be brought back to subcommittee for another hearing. Representative Henderson’s reasoning for her motion to adjourn debate was because her bill (the SCMA bill) H.3508 has not received a hearing yet. We were informed by 3M staff that there will potentially be a meeting on both H.3078 and H.3508 in Rep. Park’s subcommittee on either Tuesday, February 24th or Tuesday, March 3rd.

Please continue to call Representative Anne Parks at her statehouse number (803) 734-3069 or her home number (864) 229-3206 and ask her to please support H.3078 and to call another 3M subcommittee hearing.

Please also continue to call and email our current sponsors on H.3078 and thank them for their support!

(803) 212-6871
(803) 212-6877
(803) 734-3053
(803) 212-6908

(803) 212-6941
R.L. Brown
(803) 734-3170
(803) 212-6880
(803) 734-2973
(843) 991-0519
(803) 212-6793
(803) 734-3142
(803) 212-6884
(803) 212-6917
(803) 734-3063
(803) 734-2951
(803) 212-6878
(803) 417-7353
(803) 212-6930


H.3508 is NOT our compromise as many legislators were led to believe and we need to have ALL sponsors remove their names from this bill.

We are currently meeting with the SCMA and Family Practice groups to work once again on compromise language. Representative Jenny Horne is facilitating the negotiations and is dedicated to help us reach an agreement on both sides. We meet again on Tuesday morning.

Please help us by calling the co-sponsors of H.3508 from the list provided below and ask them to remove their names from the bill as it is NOT the compromise between the APRNs and physician groups. Ask them to please sign on to H.3078 and let them know the lobbyists on both sides are currently working on real compromise language.

Your help thus far has already gotten Representatives Bernstein, Cole, Hiott, Limehouse, Tallon, and Quinn to remove their names as co-sponsors from H.3508!!!

J.E. Smith
M.S. McLeod

*Please note that the primary sponsors Representatives Murrell Smith and Phyllis Henderson’s numbers have not been included in this list. We feel that our efforts are best spent on the members listed above and do not want to exacerbate unnecessary tensions with the primary bill sponsors.

Change takes time and though it may not always seem like it, we are making progress and it is because of YOUR help that we have gotten this far. Thank you for your dedication to help make SC healthcare more accessible!



HOUSE BILL 3078, with full expansion of NP/CNM practice to increase access will be heard in the 3M SUBCOMMITTEE at 2pm Feb 10, Blatt Building, Room 425, Statehouse Grounds. Please call the 3M Subcommittee members and ask them to support: Representatives Parks, Gilliard, and Phyllis Henderson are on that subcommittee. (see attached list of all of the 3M Committee’s phone numbers and all of the Legislators emails). Send the 3M Committee emails and call them MONDAY!!!!!! Call and email Reps Parks, Gilliard, and Henderson.
Put in the email subject line: Support H3078 and Oppose H3508
Rep Gilliard is from Charleston.
Here is what you can say about House bill 3078….INCREASE ACCESS
Research and evidence support that Nurse Practitioners/Nurse Midwives provide cost effective, safe, and quality patient care, even in autonomous settings. In fact, there are 49 states that license APRNs (Nurse Practitioners/Nurse Midwives) as autonomous independent providers or in collaborative roles. NPs demonstrate that they do an excellent job of managing chronic health problems, provide cost effective care, reduce healthcare dollars, and reduce hospitalizations.
SC ranks “F” (43rd in the Nation) in healthcare according to United Health Foundation America’s Health Rankings 2013 and 42nd in 2014. This ranking reflects current care in SC rural or urban areas and includes primary and emergency care. SC ranks 33rd in primary care physician supply ( South Carolina must do better!! What can be done NOW? Practice barriers impacting APRNs (Nurse Practitioners/Nurse Midwives) and patients must be removed NOW. What needs to be changed?
Ratios must be removed. There is nothing in the evidence to support the use of ratios of physicians to Nurse Practitioners/Midwives practicing together or independently. SC is the only state with a ratio.
Mileage constraints must be removed. There is nothing in the evidence to support a mileage restriction of the Nurse Practitioner/Midwife practicing off site from the physicians or other providers. With Tele-health and tele-communications, providers connect in a host of timely and efficient methods for patient care.
Supervision of APRNs by physicians must be removed. The Institute of Medicine, Federal Trade Commission, and research state that APRNs are safe and very effective providers that deliver high quality care that patients trust and respect. All providers should work together for patient care. It is anticompetitive for physicians to control or legally restrict other providers, including APRNs (Nurse Practitioners/Midwives) from providing care. Supervision implies that physicians are liable for the Nurse Practitioner’s actions. We work together in a collaborative and consultative relationship.
References to Delegated Medical Acts or the references of the Medical Board in the Nurse Practice Act in determining regulations of Nurse Practitioners/Midwives or the Nurse Practitioner’s/Midwives’s Scope of Practice must be removed. 49 states have Boards of Nursing that regulate Nursing, including Nurse Practitioners. According to the Federal Trade Commission, it is anticompetitive for physicians or the Medical Board to control or restrict the scope of practice of other providers, including APRNs (Nurse Practitioners/Midwives).
Increase prescribing to include Controlled Class 2 by APRNs. Nurse Practitioners/Midwives need this capability to provide patient care in acute and primary care settings. With the reclassification of some C3 medications to C2 in October 2014, the Nurse Practitioner’s legal inability to prescribe C2 impairs patient care resulting in delays in patient care, impedes access, and produces negative patient outcomes in acute and primary care settings.
Total States that Authorize Independent Practice or Collaborative Practice for APRNs: 49
Total States that Authorize Supervisory Practice for APRNs: 3…/nurse-practitioner-scope…/
Sign your name and put your phone number when you send email.
FYI, the physicians had a bill introduced on Wednesday , House Bill 3508. They are telling folks that this is a compromise bill but it is NOT.
Here is what you can say about that bill House 3508……………………………………
My colleagues and I are very concerned about House bill 3508. This bill is NOT a compromise bill. This bill places a greater burden and greater bureaucracy between patients and providers by interfering with Advanced Practice Nurses’ including nurse midwives (APRN) ability to practice.
I live in your district and care for patients who are vulnerable, underserved, and often on Medicaid.
The provision in H.3508 requiring practice agreements rather than protocols, joint Board of Medicine-Board of Nursing jurisdiction over advanced practice nurses, and the 60 mileage requirements impede assess to care by delaying, potentially indefinitely, an APRNs’ ability to care for patients. The ratio is 6 NP or PA per physician, that is what the current ratio is
The bill will increase C2 prescribing but only for 72 hours. Then the patient has to return for evaluation by the physician!!!
The Bill will require NPs to appear before the Board of Medicine and Nursing to ask permission to CHANGE JOBS AND GIVE A REASON AS TO WHY WE WANT TO CHANGE JOBS. This is clearly a delay in access, employment, and job creation.
This bill is more, not less restrictive on APRN practice when the evidence shows that patients of APRNs have as good or better care outcomes compared to patients to other providers. Regardless, providers practice as a team. This bill is adversarial and blatantly an attempt to control the practice of high quality health care providers thereby restricting access to care for South Carolinians.
We can’t afford this in SC, a state that hovers at the bottom of the national health rankings. I would love the opportunity to talk more about other nuances and problems with this bill.
Please remove your name as a supporter of H.3508 as this bill is a step backward and increases the size of bureaucracy adding yet another regulatory “hoop” with no merit. DO NOT SUPPORT HOUSE BILL 3508.
Conversely, House Bill 3078 would increase access to care and reflects the realities of practice as enacted by MDs and APRNs/CNMs every day. I am asking you to support the bill that HELPS patients, H.3078
Thank you for your careful consideration of this important matter,

Sign your name and put your phone number when you send email.
You can access the bills here for House Bill 3508 for House Bill 3078