Midwives

Military Service Members, Veterans, and Spouses - For more information about obtaining a TDLR license or renewing a TDLR license that expired while serving on active duty, please go to the Military Outreach page.

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Enforcement Penalties Updates

The Texas Commission of Licensing and Regulation (Commission) provides this public notice that at their regularly scheduled meeting held March 1, 2017, the Commission adopted the Texas Department of Licensing and Regulation’s (Department) revised enforcement plan which was established in compliance with Texas Occupations Code, §51.302(c).

The enforcement plan gives all license holders notice of the specific ranges of penalties and license sanctions that apply to specific alleged violations of the statutes and rules enforced by the Department. The enforcement plan also presents the criteria that are considered by the Department’s Enforcement staff in determining the amount of a proposed administrative penalty or the magnitude of a proposed sanction. The enforcement plan is revised to include the penalty matrix for the Midwives program.

The Texas Legislature enacted Senate Bill 202 (S.B. 202), 84th Legislature, Regular Session (2015), which transferred regulatory authority of 13 programs, to include the Midwives program from the Texas Department of State Health Services to the Commission and Department. The Midwives penalty matrix provides for a single range of penalties to eliminate confusion and allow the industry to fully understand the penalties assessed. The matrix separates standard of care violations from the others to allow for an expert witness, when needed, to assist the Department in understanding the violation. This penalty matrix may differ slightly from others as the agency focuses on aligning strategic plan goals with agency resources.

The Midwives Advisory Board recommended approval of the revised matrix at their meeting held January 25, 2017. The penalty matrix was presented to the Commission on March 1, 2017, and was adopted as recommended. The Commission also requested the Midwives Advisory Board meet to discuss an issue raised during the adoption of the penalty matrix.

A copy of the revised enforcement plan is posted on the Department’s website and may be downloaded at www.tdlr.texas.gov/enforcement.htm.  You may also contact the Enforcement Division at (512) 539-5600 or by e-mail at enforcement@tdlr.texas.gov to obtain a copy of the revised plan.

This agency hereby certifies that this notice been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on March 27, 2017.


Advisory Board Meetings

The Midwives Advisory Board met March 27, 2017 in Austin. The agenda and the staff reports are available online. The meeting was archived and is available on TDLR's YouTube channel.

The Midwives Advisory Board met August 17, 2016 in Austin. The agenda and the Staff Reports are online. The meeting was archived and is available on TDLR's YouTube channel.

On October 14, 2015, the Texas Commission of Licensing and Regulation voted unanimously to appoint nine members to the Midwives Advisory Board:

  • Midwife: Brenda Buffington, Livingston, Texas. Term expires 1/31/2017.
  • Midwife: Janet Dirmeyer, Comfort, Texas. Term expires 1/31/2019.
  • Midwife: Laurie Fremgen, Austin, Texas. Term expires 1/31/2019.
  • Physician Family Practitioner/Pediatrician: Dr. Charleta Guillory, Houston, Texas. Term expires 1/31/2017.
  • Public Member - Parent: Linda Hart, Texas City, Texas. Term expires 1/31/2017.
  • Midwife: Victoria Meinhardt, Austin, Texas. Term expires 1/31/2021.
  • Midwife: Helen Nelson, Grand Prairie, Texas. Term expires 1/31/2019.
  • Physician OB/GYN: Dr. Michael Nix, Austin, Texas. Term expires 1/31/2021.
  • Public Member: Meredith A. Rentz Cook (Presiding Officer), Keller, TX. Term expires 1/31/2021.

 


Health Professions Transition FAQs

1. When did the transfer happen?
The Texas Department of Licensing and Regulation (TDLR) assumed all activities relating to the Midwives program including licenses and renewals, customer service and enforcement on October 3, 2016.

2. Now that the transfer is complete, will I need to get a new license issued by TDLR?
No. The license you have now issued by the Texas Department of State Health Services (DSHS) remains valid until its expiration date. When you renew, you will receive a TDLR license.

3. Have the rules changed?
Yes, TDLR adopted rules for all of the transferred programs. Most of the newly adopted rules are very similar, but some changes have been made. The TDLR health profession rules became effective on October 1, 2016. View the rule changes and links to the TDLR rules

4. What is going to happen with open complaints and cases?
If you filed a complaint with DSHS or had a complaint filed against your license and it was not resolved by the transfer date, TDLR assumed responsibility for the case. You should have already received notification by mail that your complaint was transferred to TDLR.

5. How do I stay informed about changes impacting me?
You have several options to stay connected:

  • Email updates - Sign up for email updates to receive notices about rules, the law, fees, examination requirements, meetings and more. Email updates are the best way for you to stay informed.
  • Meetings - TDLR’s advisory board and Commission meetings are available to watch online live or later at your convenience.
  • Facebook and Twitter - TDLR has a Facebook page and Twitter account dedicated to TDLR Health Professions.

6. Why was my license expiration date extended? Will I have the same expiration date in the future?
To ease the transition, DSHS extended the expiration date by two months for licenses previously set to expire in August, September, and October 2016. For example, if your original expiration date was September 30, your new expiration date is November 30. If your license was extended, you will continue to renew your license in the new expiration month in the future.

7. Will I have to renew on a different schedule?
You will renew on the same schedule unless your license expired in August, September or October 2016. Licenses expiring in those months were extended for two months to ease the transition from DSHS to TDLR. If your license was extended, you will now renew in your new expiration month for future renewals. Your license expiration date will not return to your original expiration month.

8. Why were licensing programs transferred from DSHS to TDLR?
The transfer is the result of a change to Texas law. In 2015, the Texas Legislature passed Senate Bill 202, which transferred several licensing programs from the DSHS to TDLR.


Criminal Conviction Guidelines Approved

The Texas Commission of Licensing and Regulation (Commission) provides this public notice that, at their regularly scheduled meeting held October 5, 2016, the Commission adopted amendments to the Texas Department of Licensing and Regulation’s (Department’s) Criminal Conviction Guidelines pursuant to Texas Occupations Code, §53.025(a). The Criminal Conviction Guidelines are updated from the original guidelines published on December 5, 2003 (28 TexReg 11018) to include the Midwives program.

The Criminal Conviction Guidelines (guidelines) describe the process by which the Department determines whether a criminal conviction renders an applicant an unsuitable candidate for the license, or whether a conviction warrants revocation or suspension of a license previously granted. The guidelines present the general factors that are considered in all cases and the reasons why particular crimes are considered to relate to each type of license issued by the Department.

Senate Bill 202, 84th Legislature, Regular Session (2015), transferred regulation of Midwives from the Department of State Health Services to the Texas Department of Licensing and Regulation and amended Texas Occupations Code, Chapter 203. The statutory changes were effective September 1, 2015; the adopted rules became effective October 1, 2016; and the Department commenced all regulatory functions for the Midwives program on October 3, 2016

The Criminal Conviction Guidelines for the Midwives program will become a part of the overall guidelines that are already in place for other Department programs. The Department presented the applicable guidelines to the Midwives Advisory Board at their meeting on August 17, 2016, and received the Board’s recommendation of approval.

A copy of the complete Criminal Conviction Guidelines is posted on the Department’s website and may be obtained at https://www.tdlr.texas.gov/crimconvict.htm . You may also contact the Enforcement Division at (512) 539-5600 or by email at enforcement@tdlr.texas.gov to obtain a copy of the complete guidelines.


Repeal of Chapter 143 Administrative Rules

JUSTIFICATION FOR ADMINISTRATIVE RULE ADOPTION

General Provisions for Athletic Trainers Program

16 TAC Chapter 143, repeal of Subchapter A, §§143.1 - 143.4 and 143.7; Subchapter B, §§143.11 - 143.17 and §§143.20 - 143.25; Subchapter C, §§143.31 - 143.37, and §143.40; Subchapter D, §§143.51, 143.52, 143.57, 143.58, 143.60, 143.65, 143.70, 143.75, 143.101, 143.111, 143.121, 143.131 and 143.141; and Subchapter E, §§143.161 - 143.174

The Texas Commission of Licensing and Regulation (Commission) adopts the repeal of current rules at 16 Texas Administrative Code (TAC), Chapter 143, Subchapter A, §§143.1 - 143.4 and 143.7; Subchapter B, §§143.11 - 143.17 and §§143.20 - 143.25; Subchapter C, §§143.31 - 143.37, and §143.40; Subchapter D, §§143.51, 143.52, 143.57, 143.58, 143.60, 143.65, 143.70, 143.75, 143.101, 143.111, 143.121, 143.131 and 143.141; and Subchapter E, §§143.161 - 143.174, regarding the Midwives program, without changes to the proposed text as published in the October 21, 2016, issue of the Texas Register (41 TexReg 8239). The repeal will not be republished.

The Texas Legislature enacted Senate Bill 202 (S.B. 202), 84th Legislature, Regular Session (2015), which in part, transferred 13 occupational licensing programs in two phases from the Department of State Health Services (DSHS) to the Texas Commission of Licensing and Regulation (Commission) and the Texas Department of Licensing and Regulation (Department). Under Phase 1, the following seven programs were transferred from DSHS to the Commission and the Department: (1) Midwives, Texas Occupations Code, Chapter 203; (2) Speech-Language Pathologists and Audiologists, Chapter 401; (3) Hearing Instrument Fitters and Dispensers, Chapter 402; (4) Licensed Dyslexia Practitioners and Licensed Dyslexia Therapists, Chapter 403; (5) Athletic Trainers, Chapter 451; (6) Orthotists and Prosthetists, Chapter 605; and (7) Dietitians, Chapter 701. The statutory amendments transferring regulation of these seven Phase 1 programs from DSHS to the Commission and the Department took effect on September 1, 2015.

On April 13, 2016, the Commission adopted its own set of rules for the Midwives program located at 16 TAC Chapter 115. The Commission’s rules were effective October 1, 2016. (41 TexReg 4477). The Department officially commenced all regulatory functions for the Midwives program on October 3, 2016.

The current 16 TAC Chapter 143 rules were transferred from DSHS to be repealed to eliminate industry and public confusion. (41 TexReg 7585). These rules were formerly located at 22 TAC Chapter 831. The adopted repeal is necessary to complete the implementation of S.B. 202.

The adopted repeal of Subchapter A, §§143.1 - 143.4 and 143.7 eliminates industry and public confusion by removing duplicate and obsolete rules for the Midwives program.

The adopted repeal of Subchapter B, §§143.11 - 143.17 and §§143.20 - 143.25 eliminates industry and public confusion by removing duplicate and obsolete rules for the Midwives program.

The adopted repeal of Subchapter C, §§143.31 - 143.37, and §143.40 eliminates industry and public confusion by removing duplicate and obsolete rules for the Midwives program.

The adopted repeal of Subchapter D, §§143.51, 143.52, 143.57, 143.58, 143.60, 143.65, 143.70, 143.75, 143.101, 143.111, 143.121, 143.131 and 143.141 eliminates industry and public confusion by removing duplicate and obsolete rules for the Midwives program.

The adopted repeal of Subchapter E, §§143.161 - 143.174 eliminates industry and public confusion by removing duplicate and obsolete rules for the Midwives program.

The Department drafted and distributed the proposed repeal to persons internal and external to the agency. The proposed repeal was published in the October 21, 2016, issue of the Texas Register (41 TexReg 8239). The deadline for public comments was November 21, 2016. The Department did not receive any comments on the proposed repeal during the 30-day public comment period.

At its meeting on January 27, 2017, the Commission adopted the proposed repeal.

The repeal is adopted under Texas Occupations Code, Chapters 51 and 203, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the adoption are those set forth in Texas Occupations Code, Chapters 51 and 203. No other statutes, articles, or codes are affected by the adoption.

[Subchapter A. The Board.]

[§143.1. Introduction.]

[§143.2. Definitions.]

[§143.3. Midwifery Board.]

[§143.4. Board Member Training.]

[§143.7. Petition for the Adoption of a Rule.]

[Subchapter B. Licensure.]

[§143.11. License Required.]

[§143.12. Fees.]

[§143.13. Initial Application for Licensure.]

[§143.14. License Renewal.]

[§143.15. Late Renewal.]

[§143.16. Renewal for Retired Midwives Performing Charity Work.]

[§143.17. State Roster of Licensed Midwives.]

[§143.20. Grounds for Denial of Application or Disciplinary Action.]

[§143.21. Application or Renewal with Criminal Conviction.]

[§143.22. License Surrender.]

[§143.23. Application for a New License after Revocation, Suspension, or Surrender.]

[§143.24. Request for a Criminal History Evaluation Letter.]

[§143.25. Licensing of Military Service Members, Military Veterans, and Military Spouses.]

[Subchapter C. Education and Examination.]

[§143.31. Education Committee.]

[§143.32. Basic Midwifery Education.]

[§143.33. Education Course Approval.]

[§143.34. Education Course Denial or Revocation of Approval.]

[§143.35. Exam Approval, Denial, or Revocation of Approval.]

[§143.36. Complaints Concerning Education Courses and Comprehensive Exams.]

[§143.37. Jurisprudence Examination.]

[§143.40. Continuing Education.]

[Subchapter D. Practice of Midwifery.]

[§143.51. Standards for the Practice of Midwifery in Texas.]

[§143.52. Inter-professional Care.]

[§143.57. Termination of the Midwife-Client Relationship.]

[§143.58. Transfer of Care in An Emergency Situation.]

[§143.60. Prenatal Care.]

[§143.65. Labor and Delivery.]

[§143.70. Postpartum Care.]

[§143.75. Newborn Care During the First Six Weeks After Birth.]

[§143.101. Administration of Oxygen.]

[§143.111. Eye Prophylaxis.]

[§143.121. Newborn Screening.]

[§143.131. Informed Choice and Disclosure Statement.]

[§143.141. Provision of Support Services.]

[Subchapter E. Complaint Review.]

[§143.161. Complaint Review Committee.]

[§143.162. Reporting Violations and/or Complaints.]

[§143.163. Records of Complaints.]

[§143.164. Complaint Categories.]

[§143.165. Disciplinary Action and Guidelines.]

[§143.166. Complaint Investigation.]

[§143.167. Informal Settlement Conferences.]

[§143.168. Formal Hearings.]

[§143.169. Disciplinary Action.]

[§143.170. Complaint Disposition and Appeals.]

[§143.171. Refunds.]

[§143.172. Cease and Desist Order.]

[§143.173. Emergency Suspension.]

[§143.174. Default Orders.]

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State, on February 7, 2017.

Brian E. Francis
Executive Director
Texas Department of Licensing and Regulation


About the Midwives Program

The Midwives program regulates licensed midwives and approved midwifery education courses. The Texas Midwifery Act defines midwifery as providing the necessary supervision, care, and advice to a woman during normal pregnancy, labor, and the postpartum period; conducting a normal delivery of a child; and providing normal newborn care from birth through the first six weeks of life.

To practice midwifery in Texas, an individual must hold a current license issued by the Texas Department of Licensing and Regulation (TDLR). For information concerning Certified Nurse-Midwives (CNMs), who are not regulated by TDLR, contact either the Texas Board of Nursing or the American College of Nurse-Midwives. For information concerning licensing and regulation of birthing centers, contact the Department of State Health Services’ Facility Licensing Group.