PENNSYLVANIA, June 24 - private health system, hospital, licensed birth center or

part of an interdisciplinary group practice in which at least

one physician practices in the specialty area of the care the

nurse-midwife will provide, shall identify deviations from

normal and appropriate interventions, including the

management of complications and emergencies utilizing

consultation, collaboration or referral to or with a

physician as indicated by the health status of a patient. A

consultation between a nurse-midwife and a physician shall

not alone establish a physician-patient relationship or any

other legal relationship with the physician. A nurse-midwife

shall be solely responsible for the services the nurse-

midwife provides to a patient.

(2) In order to maintain safe midwifery practice during

a collaboration with a physician, a nurse-midwife shall, at a

minimum, take all of the following actions:

(i) Maintain a medical record for each patient.

(ii) In the case of a transfer of care to another

health care provider or facility, transfer a patient's

medical records to the health care provider or facility.

(f) Disclosures.--A nurse-midwife who is not an employee of

a public or private health system, hospital, licensed birth

center or part of an interdisciplinary group practice in which

at least one physician practices in the specialty area of the

care the midwife will provide, shall disclose, verbally and in

written form, the information specified in paragraphs (1) and

(2) to a prospective patient at the beginning of the

professional relationship between nurse-midwife and the patient.

The discussion must be documented by the use of a disclosure

form. The patient shall sign and date the disclosure under this

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