CNM

Scope of Practice

• All Certified Nurse Midwives (CNM) must hold an active South Dakota nursing license to practice nursing.
• SDCL 36-9A-13 outlines the legal scope of practice for CNMs practicing in South Dakota in-person or via telehealth.
• Nurses and employers are encouraged to use the Board's approved APRN Scope of Practice Decisioning Algorith as a guide to making decisions on whether a specific task, intervention, or activity is in a CNM's scope.

Telehealth

• All health care providers, including nurses, are expected to adhere to the requirements in SDCL 34-52  when providing services to patients located in South Dakota through telehealth. SDCL 34-52 includes the definition of telehealth and the requirements for treatment of patients, provider-patient relationship and exceptions, consultation recommendations, examination, prescribing, informed consent, and medical records.

Collaboration Requirement

• Pursuant to SDCL 36-9A-13.1, all CNMs are expected to collaborate with other health care providers and refer or transfer patients as appropriate.
• Pursuant to SDCL 36-9A-1 (6), collaboration is defined as "the act of communicating pertinent information or consulting with a licensed physician or other licensed health care provider with each provider contributing the provider's respective expertise to optimize the overall care delivered to the patient".
• To practice without a collaborative agreement, a CNM must have on file with the Board office a Practice Verification Form verifying a minimum of 1,040 licensed practice hours within the role of a CNM. 
  • The Board's Verification Site provides information on a CNM's practice authority status.

Out-of-Hospital Birth Practice

• Prior to attending Out-of-Hospital (OOH) births a SD licensed CNM must agree to follow the CNM OOH Birth Practice Guidelines.  Applicable rule 20:62:03:10.

Approved OOH Birth Providers

Prescribing

• Upon licensure a CNM may prescribe, procure, furnish, and administer over-the-counter, legend, and controlled substance (CS) drugs within the CNM's licensed role and focus area. South Dakota CS drugs, schedules II-IV, are listed in SDCL 34-20B. CNMs who order CS drugs must meet requirements and be registered with the:
  • Federal DEA 
  • South Dakota Controlled Substance Registration
  • South Dakota Prescription Drug Monitoring Program (PDMP)
• See ARSD 20:62:03:11 regarding providing drug samples, documentation, and guidelines for treatment of chronic, non-cancer pain.

Additional Links

• Opioid Prescribing:

  • CDC 2022 Clinical Practice Guideline for Prescribing Opioids for Pain
  • Agency for Healthcare Research and Quality (AHRQ) Toolkit for Primary Care Providers who Manage Patients Taking Opioids

• National Provider Identifier Number: NPI

• CMS Billing Guidelines: CMS