State highlights: Calif. midwives prepare for new independence; Minn. gov supports nurse board changes; Colo. Medicaid dental care

A selection of health policy stories from California, Minnesota, Colorado, Nebraska, Maryland and Massachusetts.

The California Health Report: New Independence For California Midwives 
California licensed midwives will have increased independence and authority in attending births, potentially giving more pregnant women access to their services under a new law that goes into effect in January. Assembly Bill 1308 removes an unworkable clause that required all licensed midwives to be supervised by a physician. Licensed midwives had been unable to fulfill that requirement since it went into effect 20 years ago because physicians' malpractice insurance prohibited them from filling that role. In addition, licensed midwives will now be authorized to operate birth centers without physician supervision and will have increased access to drugs, tests and medical devices used in their practice (Renner, 12/18).

The Star Tribune: Dayton Favors 'Structural' Changes After Meeting With Nursing Board
After meeting Wednesday with all but one member of the Minnesota Board of Nursing, Gov. Mark Dayton supports the board's view that it needs structural changes to improve its ability to discipline problem nurses. ... Reacting to a Star Tribune investigative series that began in early October, the governor has previously criticized the board, saying it has been "asleep at the switch" and failed to use its authority to crack down on nurses who commit misconduct (Stahl, 12/18).

Health Policy Solutions/I-News (a Colo. news service): Dental Care Still Elusive Despite Coverage Under Medicaid
Almost half a million Coloradans are expected to gain dental benefits under Medicaid by 2016. That doesn't mean they'll be able to see a dentist. Two state policy changes rolling out next year are intended to improve access to oral health care for low-income Coloradans. The state legislature earlier this year voted to expand Medicaid's dental benefits to adults -- it now only covers children for most kinds of care (Jones, 12/18).

The Associated Press: New Nebraska Agreement Focuses On Quality Health Care
A new agreement between Nebraska health care groups and insurers will help doctors' offices focus more on preventative treatment, quality care and helping patients tend to themselves, supporters said Wednesday. Participating insurers will offer reimbursement for patient-centered medical home services under the voluntary pact brokered by two state senators in lieu of a law (Schulte, 12/18).

The Baltimore Sun: City Programs Pitch African-Americans On The Benefits Of Hospice Care
Shirley Kane didn't think she could take it any more. Her 87-year-old mother, diagnosed with terminal cancer, was bedridden at home. ... Although hospice care has dramatically increased in popularity over the past few decades, of the 1.6 million Americans who used such services last year, about 82 percent were Caucasian and fewer than 9 percent African-American (Pitts, 12/18).

The Boston Globe: Child Welfare Agency Still Lacks Medical Guidance 
Seven years ago, after two tragedies, State House investigators identified a major flaw in the Massachusetts child-protection agency: It lacked medical expertise to help caseworkers sort out the complicated conditions affecting children under its watch. The findings led lawmakers to approve reforms, but today, very little has changed. The position of physician medical director was funded by the Legislature but never filled by the agency. A plan to set up a standing panel of pediatric specialists to offer consultations on medically complex cases went unheeded by top state officials. To this day, if staffers within the agency need advice from medical experts, they are often left scrambling to find help on their own (Wen and Swidey, 12/19).