xx Updates to CPM Eligibility Requirements

This page is NOT yet in the site navigation because I don’t know whether it’s necessary/accurate. Based on this page on live site: http://narm.org/req-updates/ and it’s linked on this page in the new site]

NARM is pleased to announce the results of the CPM Eligibility Review Process.  This review process, which has spanned over two years and engaged the entire CPM community, was initiated by NARM in order to consider changes to requirements for entry level certification. The primary mission of the North American Registry of Midwives is to develop, administer and evaluate a certification process through a standardized system for those engaged in midwifery practice. This process results in the credential, Certified Professional Midwife (CPM), which is accredited by the National Commission on Certifying Agencies (NCCA). NCCA sets standards for the evaluation of criteria for certification that NARM follows in the development and ongoing administration and evaluation of educational content utilized in the validation of skills and knowledge required for certification. The developers of the CPM credential originally determined general education requirements outside of specific skills and knowledge content areas defined in the job analysis. These include experience requirements (such a minimum numbers of births attended prior to submission of application for testing), prerequisite education documentation (such as CPR, high school education), and requirements for documents related to professionalism (such as practice guidelines and informed consent documents). For a more detailed history on the creation of the CPM credential and NARM standards for evaluation, please see History of the Development of the CPM. The NARM Board determined that ongoing evaluation of general education requirements for all applicants should be conducted in a format that is in keeping with NCCA standards for setting competencies. The board developed a process that includes all of the steps involved in setting criteria for skills and knowledge. NARM recognizes that any changes to requirements will have an impact on the number and quality of applicants for certification. The goal is to minimize as many unforeseen consequences of any changes as possible and to ensure that all changes are made with the intention of maintaining the high level of competency that the credential ensures to the public and to our profession.

The Portfolio Evaluation Process (PEP)

The Portfolio Evaluation Process (PEP) route to certification was established at the onset of NARM to maintain an education evaluation process so that candidates with prior experience, knowledge, and skills in the field of midwifery may have their qualifications evaluated for credentialing. NARM continues to recognize the value of multiple routes to CPM certification and affirms the need to remove barriers to midwifery education for adult learners. NARM also recognizes the need to balance open pathways with the necessary rigor to achieve competencies in the scope of practice necessary to provide high quality midwifery care to US women and their newborns. A full list of new requirements and implementation dates for Entry Level PEP is now available below.

New requirements for PEP-Entry Level applications effective September 1, 2012:

  • All applicants must complete a minimum of a high school education or equivalent.
  • All applicants must submit proof of completion of an approved module on cultural competency for health professionals.
  • The title “Active Participant” Births will be changed to “Assistant under Supervision” and must be supervised by a qualified preceptor.  Preceptors who verify Assistant under Supervision clinicals will need to meet the existing definition of a qualified preceptor. This requirement will be in effect for clinicals (births, prenatals, newborns, and postpartums) that occur after September 1, 2012.
NEW requirements for PEP-Entry Level applications effective January 1, 2013 The clinical requirements will be documented in four phases.  Documentation may be submitted as each phase is completed, or may be submitted as one complete application at the end of Phase 3.  The advantage of submitting the application in phases is to establish verification, through documentation, of meeting the requirements of each phase. Phase 1:  Births as an Observer Document attendance at ten births in any setting, in any capacity (observer, doula, family member, friend, beginning student). These births may be verified by any witness who was present at the birth. This form may be submitted when complete or at any time prior to submission of Phase 3 forms. Phase 2:  Clinicals as Assistant under Supervision Document at least 20 births, 25 prenatals (including 3 initial prenatal exams), 20 newborn exams, 10 postpartum visits as an assistant under the supervision of a qualified preceptor.  Eighteen births in this category must be completed before beginning Primary under Supervision births.  Determination of readiness for serving as Primary under Supervision is at the discretion of the supervising preceptor, and may require more births as an assistant before moving to the next step. Phase 3:  Clinicals as Primary under Supervision Document 20 births, 75 prenatals (including 20 initial prenatal exams), 20 newborn exams, and 40 postpartum exams as a primary midwife under supervision.  Two intrapartum transports are allowed if labor began in an OOH setting. CPR and NRP are submitted with this phase. The verification of Knowledge and Skills (Form 201) will be submitted with this phase, and may have been signed during Phase 2 or 3. The Knowledge and Skills list will include verification of both the knowledge base and the performance of skills in a clinical setting. The student is eligible to register for the NARM Examination once the first three phases have been submitted and approved.
  • Continuity of Care: Of the 20 Primary births required under Supervision in Phase 3, five require full Continuity of Care and ten more require at least one prenatal under supervision.
  • Full Continuity for 5 Primary Births: Five Continuity of Care as a primary midwife under supervision will include 5 prenatals spanning two trimesters, the birth, newborn exam and two postpartum exams. Multiple preceptors can verify the continuity of care.   The newborn exam must be done within 12 hours of the birth; maternal postpartum exams must be done between 12 hours and 6 weeks following the birth.
  • Prenatals for 10 Additional Primary under Supervision births: Students must have attended at least one prenatal (in a primary or assisting role) with the mother prior to her labor and birth for 10 of the 20 primary births under supervision in Phase 3 (in addition to the 5 with full COC).
Phase 4:  Five Additional Births as Primary under Supervision: Document five additional births as Primary under the supervision of a Qualified Preceptor. These may have occurred after the last birth on Phase 3 documentation, and may be submitted before or after the Written Exam.  Only one maternal transport may be included if the labor begins in the OOH setting. Submission of this form is expected within six months of passing the exam unless a request for an extension is made. Additional Requirements (not related to Phases)
  • Experience in specific settings: A minimum of five home births must be attended in any role in any phase.  A minimum of two planned hospital births must be attended in any role in any phase.  These cannot be intrapartum transports but may be antepartum referrals. These births may be included in documentation of Phases 1, 2, and 3.
  • Time frames: Ten out-of-hospital primary births must occur within the last three years.  All clinicals documented on the NARM application must occur within ten years of application submission.
  • Minimal time frames for entire experience: Clinical training documented in Phases 1, 2, and 3 must span at least two years. [A review of NARM application data indicates that most training spans three to five years. Theoretical/didactic education is integrated within the clinical training period.]
Please state the nature of the complaint below the name of each CPM or CPM Candidate in a Short Summary Statement of five words or less (examples: negligent care; incompetent care; violation of HIPAA; did not practice informed consent; did not practice standard of care; was unprofessional; was unethical; etc.) following the name of each care provider involved in your complaint. You will be given room to write a more extensive story of the entire situation below.

How Your Medical Information will be Used

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. It explains specific ways we may share your medical and/or Protected Health Information (PHI). Your records will be used for peer review as required by NARM (North American Registry of Midwives). Although we make every effort to communicate with discretion and confidentiality, we acknowledge that some electronic communication via fax, phone, text, email, or voicemail may be unencrypted and may not be secure. Please indicate your preferences below. By initiating communication with us in any of these formats, you are consenting to the unencrypted transmission of your PHI.

You have the right to refuse any of the following authorizations:

NARM Confidentiality Agreement for Complaint Review

As a participant in NARM's accountability process, NARM may send you case files via US Mail or by email. NARM will issue you a Case Password for you to use to open password-protected files sent via email. Since these files contain PHI (protected health information) and are protected by HIPAA, participants in the accountability process are expected to abide by the following safeguards:

  • Save the unzipped files to a computer that logs you off when not in use, and requires a password in order to log you on after periods of inactivity. Do not share that password with anyone.
  • If your computer is shared with others, case files should be stored in password-protected zip files on your computer.

  • Use only HIPAA-Compliant file sharing methods. For example, do not save accountability files to Yahoo Groups or Google Drive as they are not HIPAA-Compliant. NARM uses Drop Box for Accountability files but all files are password protected. When file sharing is necessary, NARM recommends all files containing PHI should be saved as password-protected zip files and sent via email. Passwords should be sent in a separate email message or by phone or US Mail.

  • Share the files only with people authorized by NARM to have access to this information, and notify accountability@NARM.org whenever case files are shared with anyone.

  • The names of the ZIP file, as well as the files contained in the ZIP file should not include personally identifiable information.

  • Delete all files related to the case from your computer, once the accountability process has been completed and the participants have been informed of the outcome.

  • Notify accountability@NARM.org that your case files have been deleted.

  • Refer only to the case number, and refrain from including case information (participant names, details of the case, or other sensitive information) in any unencrypted electronic communication, such as in an email or text message. The Case number is the date the complaint was filed.

  • Report any HIPAA breaches to accountability@NARM.org

  • To protect the integrity of the NARM Accountability process, it is extremely important to assemble an unbiased Complaint Peer Review or Grievance committee. Therefore, to begin a NARM Accountability process the client will be required to read and sign a Confidentiality Form. Once the midwife is notified of the complaint the Midwife will also be required to sign a Confidentiality Form. All parties must refrain from discussion or disclosure about the complaint during the process and will not disclose information obtained from the Complaint Peer Review or Grievance. No information about the Complaint or the existence of a Complaint may be shared on social media, with news outlets, or discussed with any other non-participants.
Upon receipt of this signed Confidentiality Agreement, NARM Accountability will send you a case password to be used for any files you send or receive electronically. Additional information about HIPAA can be found at: www.hhs.gov/ocr/privacy/index.html
NARM will not begin the processes of Complaint Review or Grievance Mechanism with a CPM or applicant who is also facing regulatory investigation, or civil or criminal litigation related to midwifery care. If a CPM faces such regulatory investigation or civil or criminal litigation, the timeline for receiving complaints is extended. In order to proceed with the Complaint Review or Grievance Mechanism processes, NARM must receive a formal complaint against the CPM within one year of the conclusion of regulatory investigation or litigation.

With my signature below, I verify that I am currently unaware of any regulatory investigation, or civil or criminal litigation related to midwifery care against the midwife or midwives involved with my complaint.

I further verify that, if in the future I personally pursue regulatory investigation, or civil or criminal litigation or become aware of any regulatory investigation or civil or criminal litigation against the midwife or midwives related to midwifery care, I will immediately notify NARM Accountability, and the processing of the case will be suspended until the appropriate time mentioned above.

After submitting this form, you will be taken to another page with a pdf and online Records Release Form. We must receive this form within 2 weeks of your submitting this Initial Complaint in order to process your complaint.
I submit that the statements above are accurate and honest and assign my signature: