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California Bill SB255 Fails to Change "Supervision" to "Collaboration"

Subject: Sad news on midwifery bill
Date: 17 Feb 1996 23:46:50 +0100

Thanks to all who helped support SB-255, the midwifery bill in California. A consortium of insurance companies and hostile doctors were able to add amendments to the bill that would have made it worse than the old law, and the bill was abandoned.

The bill was intended to lower barriers to practice for Certified Nurse Midwives and to improve access to care for California mothers. The bill had two parts. The first was a one-word change, from requiring a "supervising" physician to requiring a "collaborating" physician. The definition of collaboration was to be defined by the American College of Obstetricians (who supported the bill) and the American College of Nurse Midwives. The second part of the bill would have permitted Certified Nurse Midwives to become members of the medical staff at hospitals.

The bill was stuck in committee. Thanks to the e-mail, FAX and phone calls from you all, Senator Maddy was persuaded to vote for the bill, and Senator Mello was persuaded to abstain, and the bill went to the Senate floor. A compromise was required to get the bill out of committee, and the section on medical staff privileges was withdrawn.

All 1995 bills had to be voted on by Jan 31, and the bill reached the floor on Jan 28, so there was very little time for debate. At the last minute (Jan 30), a hostile amendment was introduced, defining "collaboration" as being "under the direction of the physician or surgeon and that ultimate authority for all care would reside with the physician and surgeon". It also required a written contract placing all responsibility with the doctor.

This was exactly opposite to the bill's intention. It was more restrictive than the existing requirement for a "supervising" physician.

Senator Maddy abstained from the vote on the hostile amendment, to his credit. Senator Mello voted for the hostile amendments. Senator Killea, who introduced the bill, was forced to withdraw it.

Those of you who wrote to Senator Mello got a letter back saying that the compromise offered by Senator Killea (withdrawing the staff privileges) had allowed him to "not vote against" the bill. This was dishonest. He colluded with the sponsors of the hostile amendments. His opposition to the bill was not influenced by the desires of his constituents. He merely concealed his opposition to placate voters, then worked behind the scenes to defeat the bill. If you wrote to him originally, please send him a note or give him a call, and let him know you were not deceived or placated.

It's a long struggle to change institutions. This was a setback, but we've made a lot of progress in the last few years. We'll try again next year. If we keep at it, we'll wear them down. Keep heart. Don't let *them* wear *you* down.

Thanks again for your help and support. Give Mello hell.

The final vote:

Against hostile amendments (for midwives):
Dills  Greene  Hayden  Killea  Lewis    Petris   Rosenthal   Solis  
Thompson  Watson

For hostile amendments (against midwives):
Alquist   Ayala    Beverly  Boatwright   Calderon  Costa    Haynes  
Hughes   Hurtt  Johannessen   Johnson   Johnston   Kelley    Kopp 
Leonard  Leslie   Marks    Mello    Monteith   Mountjoy   Rogers  Russell 
Wright

Absent or abstained:
Craven    Lockyer  Maddy    O'Connell   Peace    Polanco