<?xml version="1.0" encoding="UTF-8"?><slim:Document xmlns:slim="urn:legix:slim" xmlns:xhtml="http://www.w3.org/1999/xhtml" xmlns:atipl="http://www.arbortext.com/namespace/PageLayout" class="codeChapter" id="chp148I" name="148I"><slim:About class="header"><slim:Property type="string" name="checkinTime">08/11/2023 14:54</slim:Property><slim:Property type="string" name="taskInfo">30:57BA78A7-EA73-4836-B2C7-8840B0BCBC08</slim:Property><slim:Property type="string" name="version">8</slim:Property></slim:About><slim:TOC><slim:Item idref="sec148I.1" title="148I.1   Definitions."/><slim:Item idref="sec148I.2" title="148I.2   Licensure  licensed midwifery."/><slim:Item idref="sec148I.3" title="148I.3   Exceptions."/><slim:Item idref="sec148I.4" title="148I.4   Board  rules."/><slim:Item idref="sec148I.5" title="148I.5   Liability  limitation."/><slim:Item idref="sec148I.6" title="148I.6   Use of title  penalty."/><slim:Item idref="sec148I.7" title="148I.7   Midwifery advisory council."/></slim:TOC><slim:Body><slim:Level class="codeChapter" id="chp148I"><slim:Heading class="heading"><xhtml:span class="identifier">148I</xhtml:span><xhtml:span class="headnote">MIDWIFERY</xhtml:span></slim:Heading><slim:Section class="codeSection" id="sec148I.1"><xhtml:div class="heading"><xhtml:span class="identifier">148I.1</xhtml:span><xhtml:span class="headnote">Definitions.</xhtml:span></xhtml:div><xhtml:p class="para">As used in <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>, unless the context otherwise requires:</xhtml:p><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Board”</xhtml:span> means the board of nursing created pursuant to <xhtml:span class="iowaCodeRef">chapter 147</xhtml:span>.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Certified nurse midwife”</xhtml:span> or <xhtml:span class="term">“CNM”</xhtml:span> means a registered nurse who holds a current, valid certification from the American midwifery certification board.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Certified professional midwife”</xhtml:span> or <xhtml:span class="term">“CPM”</xhtml:span> means a person who holds a current, valid certification with the North American registry of midwives or its successor organization.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">4</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Client”</xhtml:span> means a person under the care of a midwife and such person’s fetus or newborn.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">5</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Licensed midwife”</xhtml:span> means a person licensed under <xhtml:span class="iowaCodeRef">this chapter</xhtml:span> to practice midwifery in Iowa.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">6</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Midwife”</xhtml:span> means a person practicing midwifery.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">7</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Midwifery”</xhtml:span> means the practice of providing primary maternity care to a client during the preconception, antepartum, intrapartum, and postpartum periods and newborn care up to six weeks.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">8</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Midwifery bridge certificate”</xhtml:span> or <xhtml:span class="term">“MBC”</xhtml:span> means a certificate issued by the North American registry of midwives or its successor organization that documents completion of accredited continuing education for certified professional midwives based upon identified areas to address education in emergency skills and other competencies set by the international confederation of midwives.</xhtml:p></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2023 Acts, ch 127, §4</xhtml:span></xhtml:div></xhtml:div><xhtml:div class="footnotes"/></slim:Section><slim:Section class="codeSection" id="sec148I.2"><xhtml:div class="heading"><xhtml:span class="identifier">148I.2</xhtml:span><xhtml:span class="headnote">Licensure <xhtml:span class="em-dash"/> licensed midwifery.</xhtml:span></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para">Except as provided in <xhtml:span class="iowaCodeRef">section 148I.3</xhtml:span>, beginning July 1, 2024, every person practicing midwifery in this state shall be licensed pursuant to <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>. The board shall adopt rules pursuant to <xhtml:span class="iowaCodeRef">chapters 17A</xhtml:span>, <xhtml:span class="iowaCodeRef">147</xhtml:span>, and <xhtml:span class="iowaCodeRef">272C</xhtml:span> establishing procedures for the licensure of new and practicing midwives.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para">Prior to obtaining a license to practice midwifery, an applicant shall meet all of the following requirements:</xhtml:p><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">a</xhtml:span></xhtml:div><xhtml:p class="para">Be at least twenty-one years old.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">b</xhtml:span></xhtml:div><xhtml:p class="para">Submit proof of a high school diploma or its equivalent.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">c</xhtml:span></xhtml:div><xhtml:p class="para">Submit proof of a current national certification as a certified professional midwife from the North American registry of midwives or its successor organization.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">d</xhtml:span></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para">Submit proof of completion of an educational program or pathway accredited by the midwifery education accreditation council, except as otherwise provided in this paragraph.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para">A certified professional midwife certified before July 1, 2024, and who received certification other than through completion of an educational program or pathway described in subparagraph (1) shall obtain a midwifery bridge certificate from the North American registry of midwives or its successor organization in order to obtain licensure in Iowa.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para">A person licensed to practice midwifery for at least two years in a state that does not require completion of an educational program or pathway described in subparagraph (1), shall obtain a midwifery bridge certificate from the North American registry of midwives or its successor organization in order to obtain licensure in Iowa.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">e</xhtml:span></xhtml:div><xhtml:p class="para">Submit an application fee as prescribed by the board by rule.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para">The board may request, at the applicant’s expense, that the department of public safety perform a criminal history check and the department of health and human services perform child and dependent adult abuse record checks of the applicant. If an applicant has a criminal record or a record of founded child or dependent adult abuse, the board shall perform an evaluation to determine whether the record warrants denial of licensure.</xhtml:p></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2023 Acts, ch 19, §1358</xhtml:span>; <xhtml:span class="iowaActsRef">2023 Acts, ch 127, §5</xhtml:span></xhtml:div></xhtml:div><xhtml:div class="footnotes"/></slim:Section><slim:Section class="codeSection" id="sec148I.3"><xhtml:div class="heading"><xhtml:span class="identifier">148I.3</xhtml:span><xhtml:span class="headnote">Exceptions.</xhtml:span></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="iowaCodeRef">This chapter</xhtml:span> does not do any of the following:</xhtml:p><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">a</xhtml:span></xhtml:div><xhtml:p class="para">Limit or regulate the practice of qualified members of other professions including but not limited to advanced registered nurse practitioner midwives under <xhtml:span class="iowaCodeRef">chapter 152</xhtml:span>, advanced practice registered nurse midwives under <xhtml:span class="iowaCodeRef">chapter 152E</xhtml:span>, or certified nurse midwives, from providing services that would constitute midwifery under <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">b</xhtml:span></xhtml:div><xhtml:p class="para">Apply to a person who is a member of a Native American, Mennonite, or Amish community who provides traditional midwife services to such a community.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">c</xhtml:span></xhtml:div><xhtml:p class="para">Apply to a person who, in good faith, engages in the practice of the religious tenets of a church or a religious act if no fee is contemplated, charged, or received.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">d</xhtml:span></xhtml:div><xhtml:p class="para">Apply to a person rendering aid in an emergency.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">e</xhtml:span></xhtml:div><xhtml:p class="para">Apply to a student midwife currently enrolled in an accredited midwifery education program and providing services to clients under the direct, on-site, in-person supervision of a certified professional midwife who is licensed and registered as a preceptor with the North American registry of midwives or its successor organization.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">f</xhtml:span></xhtml:div><xhtml:p class="para">Apply to an advanced registered nurse practitioner licensed under <xhtml:span class="iowaCodeRef">chapter 152</xhtml:span>, an advanced practice registered nurse under <xhtml:span class="iowaCodeRef">chapter 152E</xhtml:span>, or a certified nurse midwife.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para">The practice of midwifery shall not constitute the practice of medicine, certified nurse midwifery, certified midwifery, or emergency medical care to the extent that a midwife advises, attends, or assists a person during pregnancy, labor, childbirth, or the postpartum period.</xhtml:p></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2023 Acts, ch 127, §6</xhtml:span></xhtml:div></xhtml:div><xhtml:div class="footnotes"/></slim:Section><slim:Section class="codeSection" id="sec148I.4"><xhtml:div class="heading"><xhtml:span class="identifier">148I.4</xhtml:span><xhtml:span class="headnote">Board <xhtml:span class="em-dash"/> rules.</xhtml:span></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para">The board shall adopt rules consistent with <xhtml:span class="iowaCodeRef">this chapter</xhtml:span> and <xhtml:span class="iowaCodeRef">chapter 147</xhtml:span> which are necessary for the performance of the board’s duties. The rules shall do all of the following:</xhtml:p><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">a</xhtml:span></xhtml:div><xhtml:p class="para">Regulate the practice of midwifery based on rules established by the national association of certified professional midwives and the North American registry of midwives or its successor organization.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">b</xhtml:span></xhtml:div><xhtml:p class="para">Define professional and unprofessional conduct.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">c</xhtml:span></xhtml:div><xhtml:p class="para">Permit a licensee to obtain appropriate screening and testing for clients, including but not limited to laboratory tests and ultrasounds.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">d</xhtml:span></xhtml:div><xhtml:p class="para">Permit a licensee to obtain and administer all of the following during the practice of midwifery:</xhtml:p><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para">Antihemorrhagic agents including but not limited to oxytocin, misoprostol, and methylergonovine.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para">Intravenous fluids for stabilization of the laboring person.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para">Neonatal injectable vitamin K.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">4</xhtml:span></xhtml:div><xhtml:p class="para">Newborn antibiotic eye prophylaxis.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">5</xhtml:span></xhtml:div><xhtml:p class="para">Oxygen.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">6</xhtml:span></xhtml:div><xhtml:p class="para">Intravenous antibiotics for group B streptococcal antibiotic prophylaxis.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">7</xhtml:span></xhtml:div><xhtml:p class="para">Rho (D) immune globulin.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">8</xhtml:span></xhtml:div><xhtml:p class="para">Local anesthetic.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">9</xhtml:span></xhtml:div><xhtml:p class="para">Epinephrine.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">10</xhtml:span></xhtml:div><xhtml:p class="para">Other drugs consistent with the practice of certified professional midwifery, as approved by the board.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">e</xhtml:span></xhtml:div><xhtml:p class="para">Permit a licensee to administer a drug prescribed by a licensed health care provider for a client of a licensee.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">f</xhtml:span></xhtml:div><xhtml:p class="para">Prohibit a licensee from using forceps or a vacuum extractor.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">g</xhtml:span></xhtml:div><xhtml:p class="para">Require a licensee to develop a written plan for the consultation, collaboration, emergency transfer, and transport of the birthing client and newborn when necessary, and to submit that plan to the board.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">h</xhtml:span></xhtml:div><xhtml:p class="para">Require a licensee to provide each client with, and maintain a record of, a signed consent form that describes the licensee’s qualifications, a copy of the licensee’s emergency plan, whether the licensee carries professional liability insurance and a copy of the licensee’s professional liability insurance, if any, and the benefits and risks of birth in the client’s setting of choice.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">i</xhtml:span></xhtml:div><xhtml:p class="para">Require a licensee to report client data to the department of health and human services, the midwives alliance of North America statistics registry, the American association of birth centers perinatal data registry, or other similar databases, and to verify the submission of such data with the board.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">j</xhtml:span></xhtml:div><xhtml:p class="para">Adopt continuing education requirements consistent with those required by the North American registry of midwives or its successor organization.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">k</xhtml:span></xhtml:div><xhtml:p class="para">Establish requirements for peer review.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">l</xhtml:span></xhtml:div><xhtml:p class="para">Require a licensee to file a birth certificate for each birth.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">m</xhtml:span></xhtml:div><xhtml:p class="para">Establish an annual license fee.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">n</xhtml:span></xhtml:div><xhtml:p class="para">Require a licensee to comply with <xhtml:span class="iowaCodeRef">sections 136A.5</xhtml:span> and <xhtml:span class="iowaCodeRef">136A.5A</xhtml:span>.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para">The board shall not adopt rules that do any of the following:</xhtml:p><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">a</xhtml:span></xhtml:div><xhtml:p class="para">Permit a licensee to order or administer narcotic drugs.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">b</xhtml:span></xhtml:div><xhtml:p class="para">Limit the location where a licensee may practice midwifery.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">c</xhtml:span></xhtml:div><xhtml:p class="para">Require a licensee to practice under the supervision of or under a collaborative practice agreement with another health care provider.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para">The board shall adopt rules requiring a licensee to consult with a licensed physician or certified nurse midwife according to the appropriate standard of care for high-risk pregnancies and births in the United States. Such rules shall not require an in-hospital birth due merely to a consultation and shall, to the greatest degree medically responsible, allow a licensee to maintain care of a client according to the client’s wishes.</xhtml:p></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2023 Acts, ch 127, §7</xhtml:span></xhtml:div></xhtml:div><xhtml:div class="footnotes"/></slim:Section><slim:Section class="codeSection" id="sec148I.5"><xhtml:div class="heading"><xhtml:span class="identifier">148I.5</xhtml:span><xhtml:span class="headnote">Liability <xhtml:span class="em-dash"/> limitation.</xhtml:span></xhtml:div><xhtml:p class="para">A health care provider accepting a transfer of a client from a licensed midwife shall not be civilly or criminally liable for outcomes arising from actions or omissions of the licensed midwife.</xhtml:p><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2023 Acts, ch 127, §8</xhtml:span></xhtml:div></xhtml:div><xhtml:div class="footnotes"/></slim:Section><slim:Section class="codeSection" id="sec148I.6"><xhtml:div class="heading"><xhtml:span class="identifier">148I.6</xhtml:span><xhtml:span class="headnote">Use of title <xhtml:span class="em-dash"/> penalty.</xhtml:span></xhtml:div><xhtml:p class="para">A person shall not use the title “licensed midwife”, or describe or imply that the person is a licensed midwife, or represent that person as a licensed midwife unless the person is licensed under <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>.</xhtml:p><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2023 Acts, ch 127, §9</xhtml:span></xhtml:div></xhtml:div><xhtml:div class="footnotes"/></slim:Section><slim:Section class="codeSection" id="sec148I.7"><xhtml:div class="heading"><xhtml:span class="identifier">148I.7</xhtml:span><xhtml:span class="headnote">Midwifery advisory council.</xhtml:span></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para">A midwifery advisory council is established. The board shall appoint members of the council, including four members who are certified professional midwives eligible for licensure under <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>; one member who is licensed under <xhtml:span class="iowaCodeRef">chapter 148</xhtml:span> and is certified by the American college of obstetrics and gynecology; one member who is a certified nurse midwife; and one member who is not a licensed midwife or a licensed health care provider and who shall represent the general public.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para">Members of the council shall serve for terms of four years. Vacancies on the council shall be filled for the remainder of the term of the original appointment. Members whose terms expire may be reappointed.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para">The council shall advise the board regarding licensure and continuing education requirements, standards of practice, professional ethics, disciplinary actions, and other issues relating to midwifery.</xhtml:p></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2023 Acts, ch 127, §10</xhtml:span></xhtml:div></xhtml:div><xhtml:div class="footnotes"/></slim:Section></slim:Level></slim:Body></slim:Document>