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MAC members question transfer reporting form and enforcement triage after program update
Summary
Members pressed board staff on the usefulness of transfer-to-hospital reporting forms and the gap between complaints received and investigations referred; staff said many complaints are triaged out for lack of evidence and recommended legislative fixes would be needed to change reporting requirements.
During the Midwifery Advisory Council meeting, members challenged whether the transfer-to-hospital reporting requirement serves the public or primarily functions as a policing tool for midwives. Program staff presented quarterly statistics showing dozens of transfer-reporting forms received each quarter but very few referrals to investigation.
One member said the transfer form often acts as a "proto-complaint" filed by upset hospital staff and observed that midwives typically have little visibility into what is being reported about their care. "What I'm hearing is that these forms are used as a proto-complaint process by those people who are upset in the hospital," a member said, adding that midwives rarely see the completed form or its narrative unless they take steps to document it for the medical record.
Staff explained how complaints are triaged in the complaints unit: anonymous or weakly supported reports often do not meet thresholds for investigation. "These are how the complaints are coded," a staff member said, adding that some complaints are not supported by evidence or are mischaracterized (for example, listings that misclassify nurses or nurse-midwives as licensed midwives in DHCS provider datasets).
Council members asked whether the statutory requirement to file a transfer report for licensed midwives — and not for some other providers — should be revisited. Staff said changing the requirement would require a legislative fix and highlighted sunset review as an opportunity to pursue statutory changes. Members and staff requested clearer data on the content of transfer forms and an explanation of how forms are used in complaint triage.
The council asked staff to work with HQIU and the Department of Consumer Affairs to schedule an enforcement-process presentation at a future meeting so members can better understand how complaints are investigated and how midwives can access any resulting documents.
Next steps: staff to coordinate a presentation from HQIU (investigative unit) or enforcement leadership that explains complaint intake, triage, investigative thresholds and outcomes, and to prepare clearer reporting on transfer-form content and use.
