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BRN draft FAQs tightened; committee votes to adopt with abortion-services language removed pending legal review
Summary
The Nurse Midwifery Advisory Committee reviewed a substantially revised FAQ for nurse-midwife practice on the BRN website; the committee voted to adopt the updated FAQs with two changes: (1) edit scope language to match statute and (2) remove the FAQ on abortion services pending further legal review and clarification.
Loretta Melby, executive officer of the Board of Registered Nursing, presented proposed revisions to the board's nurse-midwife frequently asked questions and asked the committee for feedback. The revisions reflect changes to state law and aim to clarify practice issues such as low-risk definitions, mutual policies and protocols with physicians, furnishing controlled substances and lab-director provisions.
Melby and board legal counsel Reza Pejuez repeatedly emphasized the limits on the board's authority to interpret statute, noting FAQ language must stay tied to statutory text. The draft FAQ clarified that nurse midwives may provide care defined as "low risk" without mutually agreed-upon policies and protocols, but that care falling outside that low-risk definition generally requires signed, mutually agreed-upon policies and protocols with a physician. The draft also removed a prior requirement for standardized procedures and reiterated that furnishing certain controlled substances requires specific coursework, DEA and CURES registration.
The most contested portion concerned one FAQ asking whether a nurse midwife may provide abortion services. The draft stated nurse midwives may provide first-trimester abortion via medication or aspiration without physician supervision but noted additional clinical and didactic competency is statutorily required and, because of that additional training requirement, the practice would fall under the subdivision that requires mutually agreed-upon policies and protocols.
Public commenter Holly Smith and committee member commenters objected to that framing. Smith and others argued the statutory language (including the midwifery scope-of-practice and the dedicated abortion-by-aspiration statute) and national core competencies do not support adding an administrative requirement beyond the competency statutory language; they warned such an interpretation could create unauthorised barriers to care. Counsel Reza Pejuez and EO Melby responded that the statute specific to abortion-by-aspiration (cited in the meeting) requires additional competency and thus presents a legal question about whether FAQs should state the practice requires mutually agreed-upon policies and protocols.
After public comment and committee discussion, a motion passed to adopt the revised FAQ with two modifications: (1) edit the scope-of-practice opening language to mirror statutory phrasing including "care for common gynecologic conditions," and (2) remove the FAQ question and answer on abortion services from the posted FAQ pending further legal review. Committee members asked staff to add an approval date to the published FAQ and to return with legal analysis and proposed language for any future publication on that topic.
Ending: The FAQ package was adopted with the two changes; staff will add a posting date and bring a legal review of the contested abortion section back to the committee before republication.
