THE NEWFOUNDLAND AND LABRADOR GAZETTE EXTRAORDINARY

Part II PUBLISHED BY AUTHORITY ST. JOHN'S, THURSDAY, APRIL 28, 2016 NEWFOUNDLAND AND LABRADOR REGULATION NLR 17/16

Extraordinary Gazette April 28, 2016 3 NEWFOUNDLAND AND LABRADOR REGULATION 17/16 Midwives Regulations under the Health Professions Act (Filed April 28, 2016) Under the authority of

section 53 of the Health Professions Act, the Newfoundland and Labrador Council of Health Professionals, with the approval of the Minister of Health and Community Services, makes the following regulations. Dated at St. John’s, April 27, 2016. Colin Power Chairperson of the Council Dr. John Haggie Minister of Health and Community Services

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 4 REGULATIONS Analysis 1.

Short title 2.

Definitions 3. Member register 4. Requirements for registr a- tion 5. General status 6. General temporary status 7. Conditions or restrictions 8. Continuing education 9. Registration renewal 10. Renewal requirements 11. Failure to renew registration 12. Registration after expiry 13. Designated titles 14. Notification of changes 15. Practice of midwifery 16. Commencement 1. These regulations may be cited as the Midwives Regulations. 2.

In these regulations (a) "Act" means the Health Professions Act; (b) "applicant" means a person who applies to the registration committee for registration as a midwife; (c) "college" means the College of Midwives of Newfoundland and Labrador established under the Act; (d) "continuing education" means a continuing education pr o- gram developed by the college under paragraph 29(3)(

b) of the Act; (e) "general status" means the status of a member who is regi s- tered under

section 5; (f) "general temporary status" means the status of a member who is registered under

section 6; (g) "hours of midwifery practice" means hours involving direct care, education, research and administration as approved by the college; (i) "member" means a member of the college; (h) "midwife" means a person who practices midwifery;

Short title

Definitions

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 5 (j) "midwifery" means the application of knowledge, skills and judgment to assess, monitor and provide care to (

i) healthy women in respect of health promotion, pregna n- cy, labour, delivery and the postpartum period, and (ii) healthy infants; (k) "midwifery registration exam" means an exam approved by the college to determine eligibility for registration; (l) "primary midwife" means a midwife who assumes primary responsibility for providing midwifery care during the intr a- partum period; and (m) "registration committee" means the committee established under subsection 19(1) of the Act. 3.

(1) The register of health professionals maintained by the regi s- trar shall have the following categories for the purpose of registration of members: (

a) general status; and (

b) general temporary status.

(2) When a member's name has been added to the register, the registration committee shall issue a certificate of registration which shall be valid for the period of time set out in the certificate and which shall expire at the end of that period, unless renewed in accordance with these regulations.

(3) Upon each renewal of registration, the registration commi t- tee shall issue a certificate of registration to the member. 4.

(1) An applicant shall comply with the following registration requirements: (

a) submission of a completed application for registration in the form set by the registration committee; (

b) payment of any required fees; and Member register Requirements for registration

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 6 (

c) provision of the following information as requested by the registration committee: (

i) proof of identity by means of a valid photo identific a- tion card issued by the province or another government or other proof of identity acceptable to the registration committee, (ii) a current Certificate of Conduct acceptable to the regi s- tration committee from the Royal Newfoundland Co n- stabulary, Royal Canadian Mounted Police or other a p- propriate policing agency, (iii) a current Vulnerable Sector Check acceptable to the registration committee from the Royal Newfoundland Constabulary, Royal Canadian Mounted Police or other appropriate policing agency, (iv) a current cardiopulmonary resuscitation certificate a p- proved by the college and acceptable to the registration committee, (

v) a current neonatal resuscitation certificate approved by the college and acceptable to the registration committee, (vi) a current midwifery or obstetrical emergency skills ce r- tif icate approved by the college and acceptable to the registration committee, (vii) a written consent for release of information, (viii) a declaration stating (

A) that the applicant has never been convicted of an offence under the Criminal Code (Canada), the Controlled Drugs and Substances Act (Canada) or a similar penal statute of another country, or (

B) the details of his or her conviction under the Crimi- nal Code (Canada), the Controlled Drugs and Su b- stances Act (Canada) or a similar penal statute of another country,

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 7 (ix) proof of a working knowledge of the English language that the registration committee considers sufficient to enable the applicant to practice midwifery in the pro v- ince, (

x) proof of professional liability insurance of a type and in an amount acceptable to the council, and (xi) other documentation the registration committee consi d- ers necessary.

(2) In addition to the requirements of subsection (1), where an applicant is currently or was previously licensed or registered to pra c- tice midwifery in another jurisdiction, the applicant shall provide a le t- ter of good standing from the licensing or registration body of that j u- risdiction which includes confirmation of whether or not the applicant is or has been the subject of investigative or disciplinary proceedings in the jurisdiction and the particulars of those investigative or disciplinary proceedings. 5.

(1) An applicant is entitled to be registered with a general status where he or she has (

a) complied with the requirements of

section 4 ; (

b) provided proof of the successful completion of a midwifery program of study approved by the college; and (

c) provided proof of successful completion of a midwifery reg- istration exam.

(2) Notwithstanding that the applicant satisfies the requirements in subsection (1), where (

a) he or she has not completed any hours of midwifery pra c- tice; and (b) 2 to 4 years have elapsed between the submission of the application for registration and either (

i) the completion of a program of study referred to in pa r- agraph (1)(b), or General status

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 8 (ii) the completion of a midwifery registration exam , the registration committee shall assess the applicant and may require him or her to complete a refresher course or a re-entry program before registering the applicant under subsection (1).

(3) Notwithstanding that the applicant satisfies the requirements in subsection (1), where more than 4 years have elapsed between the submission of the application for registration and either the successful completion of a program of study referred to in paragraph (1)(

b) or the successful completion of a midwifery registration exam, or both, the applicant is entitled to be registered with a general status where he or she has (

a) within the 4 years immediately preceding the application , completed at least 1000 hours of midwifery practice inclu d- ing attendance at a minimum of 20 births as a primary mi d- wife; or (

b) within the 2 years immediately preceding the application, completed a midwifery refresher course or re-entry program that is approved by the college. 6.

(1) An applicant who has not successfully completed a midwif e- ry registration exam is entitled to be registered with a general temp o- rary status where he or she has (

a) complied with the requirements of

section 4; and (

b) in the 2 years immediately preceding the application, su c- cessfully completed a program of study referred to in par a- graph 5(1)(b).

(2) The registration of a member with a general temporary status is valid for the period of time set by the registration committee and is not subject to renewal or reapplication.

(3) A member registered with a general temporary status shall notify the registration committee of the date on which he or she is scheduled to write a midwifery registration exam.

(4) When a member registered with a general temporary status successfully completes a midwifery registration exam and continues to General temporary status

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 9 comply with the requirements of

section 4, he or she shall be registered with a general status.

(5) When a member registered with a general temporary status does not successfully complete a midwifery registration exam within the period of time set by the registration committee under subsection (2), his or her registration shall expire and may not be further extended.

(6) A member registered with a general temporary status shall not practice midwifery unless he or she is supervised, in a manner a c- ceptable to the council, by (

a) a member registered with a general status whose registration is not subject to conditions or restrictions; or (

b) a medical practitioner registered under the Medical Act, 2011, whose registration is not subject to conditions or r e- s trictions. 7.

(1) The registration committee may attach those conditions or restrictions to a registration that the registration committee considers appropriate, including (

a) placing limits on the activities the member may perform; and (

b) setting requirements for supervision of the member which may specify the form or duration of the supervision.

(2) A member shall comply with all conditions and restrictions that are attached to his or her registration by the registration committee. 8.

(1) A member shall participate in continuing education as d i- rected by the council.

(2) Where a member who is registered with a general status does not comply with subsection (1), the registration committee may require the member to (

a) complete a program of continuing education within a spec i- fied period of time; or (

b) undergo a period of supervised practice. Conditions or restrictions Continuing educa- tion

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 10 9.

(1) The registration committee shall advise each member who is registered with a general status of the expiry date of his or her registr a- tion and the renewal date applicable to that registration at the time of the initial registration and upon each renewal of that registration.

(2) An application to renew a member's registration shall be made before the expiry date of the member's registration and as d i- rected by the registration committee. 10.

(1) A member who is registered with a general status is entitled, on application to the registration committee, to have his or her registr a- tion renewed under

section 9 where he or she (

a) provides a written consent for release of information as r e- quested by the registration committee; (

b) pays the required fees; (

c) provides proof that he or she has completed at least 1000 hours of midwifery practice within the preceding 4 year p e- riod, including attendance at a minimum of 20 births as a primary midwife; (

d) provides proof of professional liability insurance of a type and in an amount acceptable to the council; (

e) provides proof of a current cardiopulmonary resuscitation certificate approved by the college and acceptable to the re g- istration committee; (

f) provides proof of a current neonatal resuscitation certificate approved by the college and acceptable to the registration committee; (

g) provides proof of a current midwifery or obstetrical eme r- gency skills certificate approved by the college and accept a- ble to the registration committee; (

h) provides proof of his or her participation in or completion of continuing education programs and professional develo p- ment requirements as directed by the council; Registration renew- al Renewal require- ments

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 11 (

i) provides proof of participation in peer case review and other quality assurance activities approved by the college and d i- rected by the council; (

j) provides proof of satisfying continuity of care requirements approved by the college and acceptable to the registration committee; (

k) provides a declaration stating (

i) that, within the past year, the member has not been co n- victed of an offence under the Criminal Code (Canada), the Controlled Drugs and Substances Act (Canada) or a similar penal statute of another country, or (ii) the details of his or her conviction, within the past year, under the Criminal Code (Canada), the Controlled Drugs and Substances Act (Canada) or a similar penal statute of another country; and (

l) provides other documentation the registration committee considers necessary. (2) Paragraph (1)(

c) only applies where more than 4 years have elapsed since the member successfully completed (

a) a program of study referred to in paragraph 5(1)(b); (

b) a midwifery registration exam; or (

c) a refresher course or re-entry program approved by the co l- lege, whichever is later.

(3) Where a member does not satisfy the requirement in par a- graph (1)(c), the registration committee may renew the member's regi s- tration subject to the terms and conditions the registration committee determines.

(4) In addition to the requirements of subsection (1), where the member was, within the 12 months immediately preceding the applic a- tion for renewal of registration, licensed or registered to practice mi d-

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 12 wifery in another jurisdiction, the member shall provide a letter of good standing from the licensing or registration body of that jurisdiction which includes confirmation of whether or not the member is or has been the subject of investigative or disciplinary proceedings in the j u- risdiction and the particulars of those investigative or disciplinary pr o- ceedings. 11.

Where a member registered with a general status fails to renew his or her registration on or before the expiry date, his or her registr a- tion shall expire and the member's name shall be removed from the register. 12. A member who allows his or her registration to expire and whose name has been removed from the register under

section 11 shall, for the purpose of a subsequent registration, meet the requirements i m- posed on a new applicant and comply with the applicable requirements of these regulations and with any conditions or restrictions attached to the registration by the registration committee under

section 7. 13.

(1) Only a member who is registered with a general status shall b e entitled to use the title "Registered Midwife", "Midwife" or an ass o- ciated derivation or abbreviation.

(2) Only a member who is a registered with a general temporar y status shall be entitled to use the title "Registered Midwife- Temporary", "Midwife-Temporary" or an associated derivation or a b- breviation. 14. A member shall notify the council immediately of a change in his or her (

a) mailing address; or (

b) employer. 15. A midwife may, in accordance with the midwifery scope of practice, guidelines and policies approved by the college, (

a) prescribe and administer medications ; (

b) prescribe and administer narcotics and sedatives that are controlled drugs within the meaning of the Controlled Drugs Failure to renew registration Registration after expiry Designated titles Notification of changes Practice of midwife- ry

Midwives Regulations 17/16 Extraordinary Gazette April 28, 2016 13 and Substances Act (Canada) as determined by the federal Department of Health; (

c) order , administer and interpret screening and diagnostic tests; (

d) perform minor surgical and invasive procedures, including procedures that may be required in an emergency situation; and (

e) consult with or make a referral to a medical practitioner or other health professionals. 16. These regulations come into force on the day the Health Pro- fessions Act comes into force with respect to the designated health profession of midwives. ©Queen's Printer Commencement

15 ST. JOHN'S THURSDAY, APRIL 28, 2016 Extraordinary Gazette Index Title of Act and Subordinate Legislation CNLR or XNL Gazette made thereunder NL Reg. Amendment Date & Page No. Health Professions Act Midwives Regulations NLR 17/16 New Apr 28/16 p. 3 In force on the day the the Health Professions Act comes into force with respect to the designated health profession of midwives.