Authority: IC 25-22.5-2-7; IC 25-23.4-2-6

Affected: IC 25-22.5; IC 25-23.4

Sec. 8. (a) In addition to the requirements of IC 25-23.4-5, a certified direct entry midwife shall enter into a collaborative agreement with a physician holding an unrestricted license to practice medicine in Indiana. The collaborating physician shall be actively engaged in the practice of obstetrics and shall have staff membership privileges at the designated hospital in the client's emergency care plan, or have coverage arrangements with another physician who has obstetrical/gynecological privileges at the designated hospital.

(b) A collaborating physician may not enter into more than four (4) collaborative agreements, without board approval, at any given time.

(c) Unless the board approves otherwise, the planned location of a delivery attended by a certified direct entry midwife shall be either:

1. (1) within the county or adjoining county, or ninety (90) miles, whichever is further, from the collaborating physician's primary practice location; or
2. (2) within the county or adjoining county, or sixty (60) miles, whichever is further, from the hospital designated in the client's emergency care plan as the location where the client can receive emergency care.

(d) When considering whether to approve more than four (4) collaborative agreements, or to permit a longer distance between the collaborating physician's primary practice location or the hospital designated in the client's emergency care plan and the planned location of a delivery, the board shall consider the physician's ability to collaborate with the certified direct entry midwife in a manner that protects the client's safety. The burden is on the certified direct entry midwife and collaborating physician to establish that the collaboration will not be harmful to the client.

(e) A collaborating physician shall review a certified direct entry midwife's client encounters in accordance with IC 25-23.4-5-1. A collaborating physician shall also review all certified direct entry midwife's client encounters resulting in:

1. (1) death of a client or client's child;
2. (2) intrapartum or postpartum transport of a client from the planned delivery location to a hospital, urgent care center, physician's office, or similar facility for further care or treatment;
3. (3) significant adverse event or injury to the client or client's child, whether temporary or permanent in nature; or
4. (4) transfer of care if required by section 9 of this rule.

(f) Collaboration may occur in either face-to-face encounters, or by electronic or other telecommunication means.

(Medical Licensing Board of Indiana; 844 IAC 17-1-8; filed Apr 20, 2017, 9:26 a.m.: 20170517-IR- 844150448FRA; readopted filed May 30, 2023, 1:19 p.m.: 20230628-IR-844230101RFA; readopted filed Feb 27, 2024, 10:19 a.m.: 20240327-IR-844230772RFA)