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Meeting of the Board of Regents | January 2009

Thursday, January 1, 2009 - 11:00pm

sed seal                                                                                                 








Frank Muñoz


Regents Permission to Operate in New York State:

Yale University (Nurse-Midwifery Program)


December 23, 2008


Goal 2






Issue for Decision (Consent Agenda)


Should the Regents approve the proposed extension of permission to operate in New York State for Yale University?


Reason(s) for Consideration


Required by State statute.


Proposed Handling


This question will come before the Higher Education Committee at its January 2009 meeting where it will be voted on and action taken.  It will then come before the full Board at its January 2009 meeting for final action.


Procedural History


Regents permission to operate in New York State is required by Section 224 of the Education Law which prohibits out-of-state colleges and universities from transacting business in New York without Regents permission.


Background Information


Yale University is seeking an extension of Regents permission to operate in New York State in order to place its students in health care agencies for supervised clinical experiences in its master’s degree program titled Nurse-Midwifery.  Article 140 of the Education Law restricts the practice of midwifery to licensed persons or students enrolled in educational programs that the State Education Department has registered.  The University’s midwifery program is accredited by the American College of Nurse-Midwives. The program meets the standards for registration as set forth in the Regulations of the Commissioner of Education.




It is recommended that the Regents approve the proposed permission to operate effective January 13, 2009, to authorize Yale University to use clinical agencies in New York for clinical education of students in its Nurse-Midwifery program leading to the Master of Science in Nursing degree.


Timetable for Implementation


This approval will be effective until January 31, 2014.





              Section 6951 of the Education Law defines midwifery as “the management of normal pregnancies, childbirth and postpartum care as well as primary preventive reproductive health care of essentially healthy women as specified in the written practice agreement and shall include newborn evaluation, resuscitation, and referral of infants.”  Pursuant to a written agreement with an obstetrician, a midwife is authorized to “prescribe and administer drugs, immunizing agents, diagnostic tests and devices, and to order laboratory tests.”


              The Nurse-Midwifery program at Yale University is designed to prepare clinically competent nurse-midwives who provide family-centered primary health care to women.  Classroom and clinical work focuses on the management of primary care; care for women and newborns during pregnancy, birth, and postpartum periods; and family planning and gynecological care.  Students learn collaborative management of the care of women and newborns with complications. The Nurse-Midwifery program at Yale University is fully accredited by the American College of Nurse-Midwives, Accreditation Commission for Midwifery Education.


              The Nurse-Midwifery program was initially granted approval by the Board of Regents in December 1995 to use clinical facilities in New York, with approval extended in November 2001 for a five-year period. The current request for extension of this authorization involves the placement of up to two nurse-midwifery students each semester at Jacobi Medical Center and North Central Bronx Hospital. Clinical placements will be for courses titled Advanced Midwifery Care (six credits) and Integration (nine credits), which full-time students complete in the third and fourth semesters of the four-semester program, respectively.  In the Advanced Midwifery Care course, the student will complete a total of 144 clinical contact hours during the semester.  The Integration course will require completion of 480 clinical contact hours during the semester.  Each nurse-midwifery student will be precepted by a senior nurse-midwife or obstetrician on staff at the respective hospitals.  Preceptors will be responsible for completing a competency-based written evaluation for each student.  A Yale University School of Nursing faculty member will conduct a site visit each semester to evaluate each student in the clinical setting. Two Yale University School of Nursing faculty are involved in instructional activities for the two courses in question.  Each of these faculty has a master’s degree in nursing and is licensed as a nurse-midwife in Connecticut.  One of the two faculty has a doctoral degree in nursing.  Full-time Yale University School of Nursing faculty will be in contact with preceptors during the semester and will monitor students’ clinical practices through weekly clinical conferences. 


The Nurse-Midwifery program requires completion of 50.1 semester hours of credit that includes a total of 1,350 clinical contact hours.  Students take core course work in health assessment, pharmacology, pathophysiology, nursing research, statistics and nursing theory, and complete 34 credits of course work in the area of specialization.  Graduates are eligible to become certified by the American College of Nurse-Midwives.  The School of Nursing is accredited by the Commission on Collegiate Nursing Education.


              Currently, Yale University has Regents permission to annually place in New York State up to two students enrolled in its Psychiatric-Mental Health Nursing and Pediatric Nurse Practitioner programs; up to six students enrolled in its Acute Care Nurse Practitioner, Adult Advanced Practice Nursing, and Oncology Nurse Practitioner programs; and up to five students enrolled in its Graduate Entry Prespecialty in Nursing program.


              There are two nurse-midwifery programs (programs that restrict admission to registered nurses) and two direct-entry programs at four New York universities.  Two of the four are independent:  Columbia University and New York University.  The other two are State University campuses:  The State University of New York at Stony Brook and the Health Science Center at Brooklyn.


              Like programs preparing practitioners in other professions, nurse-midwifery programs typically use a large number of health facilities for students’ clinical experiences.  These facilities may be in several states.  Because of statutes like New York’s that restrict practice by students to those enrolled in state approved programs, institutions must undergo a variety of state review processes to assure lawful practice by students.  In New York, this entails receiving the Regents permission to operate and Department registration of the program so that a small number of students each year may practice in the State.


              Staff have determined that there would be no reduction in access to clinical experiences at cooperating facilities if authorization is granted.  Because of the limited nature of the University’s authorization to operate in New York State, it should have no effect on New York institutions.


              The Office of the Professions has determined that Yale University meets the standards for registration set forth in the Regulations of the Commissioner of Education.