History of the Illinois CPM Licensure Movement

by Rachel Dolan Wickersham, CPM

CFIM was formed in the year 2000. Our mission was to ensure the availability of safe, licensed midwifery services for Illinois home birth families through the passage of legislation requiring the Certified Professional Midwife (CPM) credential as the basis for licensure. The Illinois General Assembly works in a two year cycle. Most bills are introduced in the first of the two years and, generally speaking, only fiscal bills or emergency bills are introduced in the second. At first we only introduced bills in alternate years. As our bill progressed, however, and we pointed out severe shortages of maternity care providers for home birth families, we were gradually able to get more attention in the second year of each cycle. Here is a rundown of the years:

1979 – 2000 Various groups of midwives including the Illinois Alliance of Midwives presented various licensure and decriminalization bills. Hearings were usually short and bills did not get out of committee.

1997 – 1999 The Illinois Council of Certified Professional Midwives (ICCPM) and the consumer group, Illinois Families for Midwifery (IFFM) were formed. On a national level, there was the National Certified Professional Midwives Guild (NCPMG) – part of the AFL-CIO. Union lobbyists gave CFIM, ICCPM and IFFM access to briefings, introductions to some legislators, and taught our
activists the ropes in Springfield.

2000 – Coalition for Illinois Midwifery (CFIM) formed, bringing together midwives and consumers in a coordinated effort to seek out other supportive groups and together, pass CPM legislation.

2001 – First licensure bill submitted specifically referring to CPMs. The bill gets an unusually long hearing due to the committee chair being a strong union supporter. The bill does not pass out of committee.

2003 – NCPMG no longer in existence. Short hearing. The bill does not pass.

2005 – 94th General Assembly. CFIM hires a lobbyist, Dan Johnson, and with little effort, passes a resolution in the Senate. SR189 calls for the Senate to consider midwives as part of the solution to state healthcare shortages

2007 – 95th General Assembly. On lobbyist’s advice we try the Senate first instead of the House as usual. SB385 passes the Senate on a vote of 51 – 7. It picks up 19 sponsors in the House and after long negotiations, gains the support of the Illinois Society of Advance Practice Nurses and a neutral stance from the Illinois Nurses Association. After a spectacular two hour hearing, it does not pass in a House committee and dies in the House.

2009 – 96th General Assembly. Knowing we can pass the Senate, we start in the House again. HB226 gains 18 sponsors including the assistant majority leader of the House (second only to Speaker Michael Madigan) Barbara Flynn Currie. It fails to pass in the spring of 2009 and “remains in committee” (code word for “dead bill).

2010 – Despite the Home Birth Safety Act’s “dead” status, Coalition members start an aggressive campaign to revive the bill. It works and the bill picks up 19 sponsors, however the deadline for a hearing is missed. Leadership indicates a willingess to hear the bill if we can find a vehicle. A shell bill is found – one that has already passed through the Senate and through a first hearing in the House, but is no longer needed. SB3712 – the Veterinary Records Act is gutted and the Home Birth Safety Act is moved into its shell. It picks up 20 sponsors immediately. With the amendment of the new midwifery language the bill goes back to committee, now within deadlines because it is a “second” hearing, and the bill passes out of the Health and Healthcare Disparities committee in early May – the first time ever that a midwifery bill achieves House Committee passage in 30 years of attempts.

2011 – In January, during a lame duck, post election, veto session, just days before the closure of the 96th General Assembly, at a time when the most controversial bills are heard, the bill comes to a floor vote. The Senate prepares to receive it and rush it through, but it fails on the House floor with a vote of 46 – 71.

2011 – 97th General Assembly – Taking the approach that if the legislature refuses to protect home birth families by licensing CPMs, they may at least want to assure that emergency transports go smoothly, the Coalition introduces HB5370 – originally the Home Birth Integration Act, eventually known as the Safe Transport Act. The Illinois Hospital Association assists in amending this bill and takes a neutral stance – another first for a midwifery bill. However before the House Committee hearing we are told essentially that although this idea is interesting, what we really need to do is seek licensure. The bill dies in committee. A Home Birth Safety Act for CPM licensure is also filed in this session but does not receive a hearing.

2012 – Governor Quinn issues a mandate to cut billions from the Medicaid budget. CFIM prepares a 12 page proposal to save Medicaid $5 million annually by licensing CPMs and allowing them to become Medicaid providers. The figures are verified by an economist. The proposal does not make it into the Medicaid Reform Bill despite the fact that it is the only proposal that adds services for those without private insurance, rather than reduce them, while still saving money.

2013 – With a new General Assembly, The Home Birth Safety Act was again assigned to committee – this time the Healthcare Licenses committee. This time, it received a 5 minute hearing and no Yes votes. The committee chair commented that he has been a supporter in the past and that bill is simply in the wrong committee. In May 2013, a new bill is submitted, HB3636. It calls for CPMs to work under supervision, a significant change to a much more restrictive situation. Under this bill, CPMs would be able to work in Birth Centers, clinics, and physician and nurse-midwives offices, however few would be able to attend home births. The bill died in the Rules Committee.

2015  – In the 99th General Assembly, Rep. Tom Morrison files HB424, the Home Birth Safety Act.  The bill is assigned to the Health Care Licenses Committee, and is never brought up for a vote. It does not make it out of committee.

With new information and support from the US MERA group, CFIM prepares to file a new bill in the fall of 2015, including new language that is anticipated to receive the support from ACNM, and will hopefully put our bill in a better position to address opposition from the medical societies.  CFIM files identical bills HB4341 and HB4364, with HB4364 being used for amendments.  The bills gain the support of ACNM.  The Illinois Chapter of ACOG talks to CFIM about the bill, and unprecedented act.  The bill gains 20 co-sponsors.

The bill is currently set for one last committee hearing in April 2016.  If IL ACOG can come up with acceptable bill language before that time, then it is likely that the bill will pass out of committee.  Then the bill must pass the House, then the Senate, then get the Governor’s signature.