Newsletters > Summer 1999 > Legislative Reports, by Leo Cashman

MIDWIFERY LICENSURE APPROVED

A landmark bill to license the practice of lay midwifery in Minnesota has easily passed both houses of the legislature and appears to be headed for final approval. Nurse midwives have been helping mothers give birth for many years in a hospital setting, but lay midwives have been practicing in a gray area, legally; an old law on the books has called for the Medical Board to grant licenses to midwives, but the board has declined to do so. The new legislation also provides for licensure of lay midwives, but an advisory council on midwifery is expected to effectively regulate most issues pertaining to midwives. The new bill emerged from a House/Senate conference committee as a voluntary licensure bill for lay midwives; lay midwives wishing to continue their practices will be able to do so without being forced to become licensed. Licensure, however, is designed to be accessible to most lay midwives and uses the Certified Professional Midwife (CPM) credential, which is used nationally, as the route to obtaining a state license. The language of the bill also allows the lay midwives to practice at birthing centers; they will be able to use anti hemorrhagic agents, oxygen and perform suturing of tears. Much of the last minute debate over the bill centered around whether the licensure should be mandatory or voluntary. However, most advocates for midwifery agreed that some form of licensure or regulation is needed in order to protect midwives from the type of investigations that some have faced before the Medical Board in recent years. For them, the passage of the midwifery bill is seen a victory for all those seeking access to health care alternatives. As this goes to press, the bill remains to be signed or vetoed by Gov. Ventura.

MASSAGE REGISTRATION BILL DEFEATED

Controversial even within the community of massage therapists and bodyworkers, a bill calling for registration of massage therapists was narrowly defeated in a House Health Subcommittee in March. The bill, authored by Rep. Betty McCollum, was supposedly a voluntary registration bill. It was intended, McCollum said, to help consumers sort out the more skilled therapists from the less trained practitioners. But the bill was mandatory in the sense that a therapist who does not register would no longer be allowed to call herself a massage therapist. Critics of the bill said that the measure was not needed, and was designed to particularly benefit the massage therapy schools; it would tend to drive out part-time and lower income practitioners, raise prices to the consumer and make massage therapy a more elitist profession, they argued. The bill was defeated by a 4 to 3 vote in the Health Subcommittee.

SALES TAX EXEMPTION STALLED

While pharmaceutical drugs and over the counter medications such as aspirin and tylenol enjoy exemption from the Minnesota sales tax, vitamins, food supplements and herbal and homeopathic remedies are taxed. This is not fair, say some users of the vitamins and natural supplements, and the law ought to be changed. A bill to exempt the vitamins, food supplements and remedies was authored by Rep Karen Clark and Sen. Steve Kelly. It passed tax committees in both houses and supporters had hoped that it would be rolled into the Omnibus Tax bills in both houses. However, Rep. Ron Abrams, (IR, St. Louis Park) refused to include it in the House Omnibus Tax bill and so it will not become law this session.

BILL TO CURB PESTICIDES IN SCHOOLS STALLED

Pesticides such as Dursban, commonly used in schools, can cause dizziness, aching joints, inability to concentrate and even damage the nervous system. But House Education Chair Harry Mares (IR, White Bear Lake) has refused to even give a hearing to a bill that declares that parents have a right to know in advance before their schools are sprayed by toxic pesticides. Supported by the Minnesota PTA, the "Parents Right To Know" bill was authored by Sen. Janet Johnson and Rep. Jean Wagenius. It passed in a Senate Education committee despite opposition there from the State Dept. of Agriculture, which called for "more study" and from the Association of School Boards. Because children’s' immune systems are less developed, they are particularly susceptible to toxic effects of pesticides. Because there are no federal standards requiring the warnings to parents, ten other states have some kind of provision for warning the parents in advance of the spraying.

PATIENT'S RIGHTS BILL FOILED

A bill to enhance the rights of patients enrolled in state health plans was killed in the House Health Committee. One of the prime movers behind the bill was new attorney general Mike Hatch. It would have made it illegal for HMOs to provide financial incentives to doctors who limit referrals to specialists and hospitals; and it would have made it possible for patients denied needed care to sue their health plans for damages, much as patients are now able to sue their doctors for malpractice when needed care is not provided. The latter provision aimed to make the health plans more responsible for decisions made under their much touted "managed care" schemes. But the bill was attacked by Blue Cross, Blue Shield and by the Minnesota Council of Health Plans as having dire consequences—would be a setback for "managed care" and HMO premiums would skyrocket, they suggested. The allies of the HMOs had their way with the legislation: the provision outlawing incentives to doctors for limiting referrals was cut out of the bill in a Senate Health Committee hearing, by an amendment. In the House Health Committee, the bill was finally defeated, with Reps. Lee Greenfield and Tom Huntley leading the charge against it.

STIRRINGS AT THE FEDERAL LEVEL

This year is the five year anniversary of an important consumer victory, the Dietary Supplement Health and Education Act (DSHEA), passed at the federal level. Thanks to nation wide grass roots efforts, that legislation says that "the Federal Government should not take any actions to impose unreasonable regulatory barriers limiting or slowing the flow of safe products and accurate information to consumers." But consumer watchdogs say that the spirit and the letter of the law has often not been followed by the Food and Drug Administration (FDA) and by the Federal Trade Commission (FTC). The FDA regulates all labeling of food , supplements and drugs and the FTC regulates the advertising. The critics say the FDA has banned or harassed food supplements and other natural products while allowing dangerous drugs and additives onto the market. The cases in point are almost too numerous to mention: the FDA has continued to allow aspartame ("Nutrasweet") to be widely used as a food additive, despite having received thousands of documented complaints of health problems, including seizures and brain damage; meanwhile, stevia, a natural, safe sweetener has not been approved, because of the prohibitive cost of getting FDA approval. The FDA has approved Thalidomide for certain limited conditions, despite the toxicity of the drug that was demonstrated back in the 1950's when about 10,000 babies were born with limb deformities. Recently the FDA has approved an antibiotic, fluoroquinolone, to treat respiratory problems in livestock, even though the antibiotic's use in chickens has produced drug resistant strains of Campylobacker bacteria and Salmonella. Last year, the FDA attempted to limit claims made on labels regarding benefits for pregnancy, aging, menopause by reclassifying pregnancy, aging and menopause as disease conditions. Critics said that the proposed changes were a clear attempt by the FDA to circumvent DSHEA; the FDA was deluged with comments criticizing the proposed changes. The FDA does not require genetically engineered food to be labeled. The implications are too great to discuss here. Recently, the FDA has proposed rule changes on irradiated food: even the innocent-looking radura symbol (which resembles a flower) is too much of a consumer warning for the comfort of the irradiation industry. Now the FDA has approved an industry request to reduce the size of the type on food labels indicating the food has been irradiated, making it illegible or easy to miss; industry is pushing to eliminate the food labeling requirement entirely. Citizens and citizen groups have been fighting back, sometimes with lawsuits and also with new legislation. New legislation authored by Sen. Michael Crapo (R-Idaho) is called the Dietary Supplement Fairness in Labeling and Advertising Act. It is aimed mainly at forcing the FTC to more fairly allow truthful advertising claims in dietary supplements and to allow views to be expressed in advertising which are different from the views of the FTC's own experts. But part of the bill is aimed at the FDA: it would direct the FDA to withdraw its proposed regulations on dietary supplements labeling which sought to reclassify aging, pregnancy and menopause as a disease.