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Purpose and Objectives of the Rule(s)
6. Identify the behavior and frequency of behavior that the proposed rules are designed to alter.
The proposed rules are designed to modify the following behavior: require licensed midwives to meet the
requirements in the Public Health Code-General Rules, R 338.7001 through R 338.7005, including complying with a
minimum English language requirement and an implicit bias training requirement; require applicants for endorsement
and relicensure to disclose all licenses with other entities, report current discipline or sanctions on a license, meet the
human trafficking training requirement, English language requirement, and implicit bias training; require licensed
midwives to consult with or refer a patient to a physician, physician’s assistant, or advanced practice registered nurse,
if an infant has an abnormal blood spot infant screening or failed critical congenital heart defect screening; allow
licensed midwives to use additional drugs listed in Table 1 and Table 2 for the treatment of patients; and allow
licensed midwives in the renewal process to use the two required hours of implicit bias training for credit towards the
two required hours of cultural awareness training.
A. Estimate the change in the frequency of the targeted behavior expected from the proposed rules.
It is expected that licensed midwives will meet the requirements in the Public Health Code-General Rules, R
338.7001 through R 338.7005, including complying with a minimum English language requirement and an implicit
bias training requirement; applicants for endorsement and relicensure will disclose all licenses with other entities,
report current discipline or sanctions on a license, meet the human trafficking training requirement, English language
requirement, and implicit bias training; licensed midwives will consult with or refer a patient to a physician,
physician’s assistant, or advanced practice registered nurse, if an infant has an abnormal blood spot infant screening or
failed critical congenital heart defect screening; licensed midwives may use the additional drugs listed in Table 1 and
Table 2 for the treatment of patients; and licensed midwives in the renewal process will submit the two required hours
of implicit bias training for credit toward the two required hours of cultural awareness training.
B. Describe the difference between current behavior/practice and desired behavior/practice.
The difference between the current behavior/practice and desired behavior/practice is: require licensed midwives to
meet the requirements in the Public Health Code-General Rules, R 338.7001 through R 338.7005, including
complying with a minimum English language requirement and an implicit bias training requirement versus not
complying with these requirements; require applicants for endorsement and relicensure to disclose all licenses with
other entities, report current discipline or sanctions on a license, and meet the human trafficking training requirement,
English language requirement, and implicit bias training versus an applicant for endorsement or relicensure not
submitting this information to the Department; require licensed midwives to consult with or refer a patient to a
physician, physician’s assistant, or advanced practice registered nurse, if an infant has an abnormal blood spot infant
screening or failed critical congenital heart defect screening versus not referring the patient; allow licensed midwives
to use additional drugs listed in Table 1 and Table 2 for the treatment of patients versus not allowing licensed
midwives to use the additional drugs; and allow licensed midwives in the renewal process to use the two required
hours of implicit bias training for credit toward the two required hours of cultural awareness training versus requiring
licensed midwives to have both the hours for implicit bias and the hours for cultural awareness.
C. What is the desired outcome?
The desired outcome is: licensed midwives will meet the requirements in the Public Health Code-General Rules, R
338.7001 through R 338.7005, including complying with a minimum English language requirement and an implicit
bias training requirement; applicants for endorsement and relicensure will disclose all licenses with other entities,
report current discipline or sanctions on a license, meet the human trafficking training requirement, English language
requirement, and implicit bias training; licensed midwives will consult with or refer a patient to a physician,
physician’s assistant, or advanced practice registered nurse, if an infant has an abnormal blood spot infant screening or
failed critical congenital heart defect screening; licensed midwives will have the ability to use additional drugs listed in
Table 1 and Table 2 for the treatment of patients; and in the renewal process, licensed midwives will use the two
required hours of implicit bias training for credit toward the two required hours of cultural awareness training.
7. Identify the harm resulting from the behavior that the proposed rules are designed to alter and the likelihood
that the harm will occur in the absence of the rule.
MCL 24.245(3)