Resignation as WA Board Director

The ACM vision........... is to be the leading organisation shaping Australian maternity care for the benefit of women and their families
The Australian College of Midwives (ACM) is the peak professional body for Australian midwives, which strives to maximize the quality of midwifery and maternity care for Australian women and their families through:
• Providing a unified voice for the midwifery profession.
• Supporting midwives to reach their full potential.
• Ensuring all childbearing women have access to continuity of care by a known midwife.
• Setting professional practice and education standards

I believe in the above vision that is why I was both delighted and honoured to be elected the WA Board Director, unfortunately for me the position has only lasted l2mths and it was a challenging year. I spent the first few meetings finding my feet and dealing with the personalities of everyone on the Board as well as assessing the current political situation. I met some phenomenal women on the Board... and everyone works with what they consider is the “best interest” of the ACM.

I feel that WA is in a unique position that we do not have some of the issues faced by our counterparts in the Eastern States. It saddens me to say that I have resigned (December 2010). I am bound by confidentiality of the Board and therefore I cannot divulge the reasons why I resigned except to say that the situation was untenable and I have the support of the whole WA executive committee. This has not been an easy decision it was painstakingly difficult. The decision was made in the best interest of the ACM and its membership.

I continue to support and believe in the ACM Nationally. I will continue to put all my energy into the WA Branch to encourage its growth, support the membership and foster collegial and political relationships to further the profession of midwifery in WA and one day I will return to the National Board. The ACM works to support all midwives, ensuring that childbearing women have access to continuity of midwifery care.
I do believe as a profession we need a strong national body to represent all midwives, a body that is respected and accepted by all midwives to take us forward into the 21st century and I believe that the ACM can deliver this.

Regards your servant Pauline Costins

WA Branch AGM: November 2010

Dear Members, my sincere apologies for reporting so late on the WA ACM AGM. November and December have been extremely busy for me and I have only now caught up with myself. I have quite a few stories to write to keep you updated, so will start in chronological order from the AGM.

As you all remember the AGM was 12th November combined with our yearly conference, this strategy of a yearly conference with a set date has proven to be successful and City West seems to be a great hit with all our members. The WA Branch has experienced a 20% growth in the last year, that is just fantastic and a special thank you to all the student midwives who make up a good percentage of the growth, as you are our future.....and we welcome your input to the College.

WA Branch of the ACM is growing in membership and continues to support its members and has a strong executive team working together for the members of WA. Congratulations to the new members of the executive committee; Liz Ashton, Carol Pinch, Sara Bayes, Liza Kennedy and Judith Wilson.

President Tracy Martin, Vice President Terri Barrett, Treasurer; Sylvia Jenkin, Secretary; Laura Robertson; WA National Director Pauline Costins, Minute secretary Trish Dempsey, Education Standards Janice Butt; Publicity & Merchandise Carli Beange; Aboriginal rep; Karen Kruit; Education Officer Liz Ashton, Education Committee – Carol Pinch, Judith Wilson, Sara Bayes; General committee: Liza Kennedy, Abbey Rodda, Sue Cudlip.

Ms Tracy Martin WA President opened the day, inspiring all who were present; It was a diverse program and as usual the presenters were of a great calibre; they included; Dianne Bond – Diabetes Service, Sadie Geraghty - Vitamin D; Renate McLaurin - Cannabis use and Pregnancy; Mother & baby unit – State-wide Mental Health unit; Debbie Slatter and Lesley Kuliukas – Childbirth Education, there were several other presentations..... All excellent. Everyone seemed to enjoy the day..... the food as usual was brilliant and plenty of it... we ended the day with a sundowner.... a grand way to finish off the day with a glass of red wine.....

A thank you goes to all the sponsors whose generous contributions made this event possible: St John of God Hospital Subiaco & Murdoch, Police and Nurses Credit Society; ACM WA Branch, WELDA & Cell Care; and a big thank you to all who attended the day and made it the success it was..... see you all next year.

Cheers Pauline

PS pictures coming.....

A year in reflection:

A reminder of the College Vision:

Our vision is to be the leading organisation shaping Australian maternity care for the benefit of women and their families
The Australian College of Midwives (ACM) is the peak professional body for Australian midwives, which strives to maximize the quality of midwifery and maternity care for Australian women and their families through:
• Providing a unified voice for the midwifery profession.
• Supporting midwives to reach their full potential.
• Ensuring all childbearing women have access to continuity of care by a known midwife.
• Setting professional practice and education standards

This has been an amazing year with many highs and lows.... everyone working hard for the College and the greater good ..... above all working to improve the choice for childbearing women and the midwives who work with women.


As I summarise the year from the blog entries I am in two minds as to how well we have done over the year....If I examine the word "well", skilfully, expertly, effectively, efficiently, adequately, admirably, conscientiously and proficiently - then I think as a Branch we have achieved this.... however as I read between the lines there has been some misfortune for me personally: as you can imagine writing a blog for the College I have to be mindful of confidentiality, defamation, ethics, conduct and my own professional standing....there is no such thing as freedom of speech.... however still offering news, honesty, general information etc.... therefore I have to be mindful of what is published.


I have to say that this rule has not been applied to myself and I am in the process of taking legal action against information wrongly published about me threatening my integrity and professional standing... this is a sad reflection of the times and soul destroying. Therefore this is a timely reminder to be mindful of what you publish on the Internet & email...... defamation is the fastest growing litigation....

The blog to date has had over 4500 hits...the blog posts have almost doubled and is up to date with current issues:

January was meeting the then Prime Minister & the Honorable Nicola Roxon, the Big Picture tour of the proposed changes for midwives; Februry.... new midwifery students and Homebirth rallies..... March... GoGirlAustralia... April.... ANMC here to stay as the "appointed accreditation body"... submissions for the "eligible midwife"... May... IMD celebrations...24hr Virtual IMD ..... and the farewell to Jill Banks....June... came the insurance debate, options and collaboration...July was D-Day for National Registration....and Collaborative arrangements... Determination 2010; concern for private practice, fear, stress, tears, it was a nightmare....


August...Australian Election....the nightmare continues; a hung Parliament... Homebirth...Collaborative arrangements...ACM National meeting & Breathing New life Conference Alice Springs....Sept... Determination still dominated the midwifery world... lobbying, emails...meetings with politicians...etc... GoGirlAustralia leaves Fremantle.....


October.. WA joins National Registration... APHRA comes alive for us.... Victorian conference and AGM also AGM for National.... November... History is made... Medicare Provider Numbers for eligible midwives..to date there are approximately 15 eligible midwives throughout Australia...December... first Midwife to get collaborative agreement.... lets hope this continues....
Trail Blazers, the inaugural Bachelor of Midwifery for WA prepares to enter the workforce as Midwives (who are not nurses), Barb Vernon EO of the ACM resigns and change is in the air..... i have always said as a College we need to be united... "united we stand divided we fall" I am going to pinch a quote from Obama's State Union address " we face big and difficult challenges, we do not give up, we do not quit. We do not allow our fear or division to break our spirit".


Xmas dinner
Thank you to a wonderful executive team we have in WA.... the whole team has worked very hard and continue to work hard for the WA members and women of the State....wishing you all a happy and successful 2011.

My wish for the College & the year ahead:

"Teamwork is the ability to work together toward a common vision. The ability to direct individual accomplishments toward organizational objectives. It is the fuel that allows common people to attain uncommon results."~ Andrew Carnegie

"Coming together is a beginning. Keeping together is progress. Working together is success." Henry Ford

signing of for 2010, see you in the New Year, wishing you all a safe, happy, successful 2011. Pauline Costins

Guinea Pigs or Trail Blazers

When I was asked to write something for the ACM blog about the experience of being the first BMid students to get through their training in WA, I realised how difficult it was going to be to sum up the gamut of emotions, the roller coaster ride that my fellow BMidder’s and myself have been on the last 3 years.

We are a diverse bunch of women, some young, some not as young, we have children, husbands, careers, boyfriends, and jobs outside our training to be midwives. Yet I think it is safe to say that for three years we have lived, breathed, eaten, dreamed, hated, loved, and despaired over nothing else but midwifery. Midwifery has been centre stage.


We are the guinea pigs. How often have we heard this girls? The initial reaction to us in some places was palpable. We were told we could not make good midwives (because we are not nurses), that we would not be employed (because we are not nurses), that we would not be able to give certain medications (because we are not nurses). We did wonder at times, if we would be able to do anything at all..........as midwives.



Despite these frustration’s, and thanks to the tenacity and support of amazing and wonderful women: Jenny Wood, Lesley Kuliukas, Janice Butt and our tutors, we marched on because we knew deep down inside that it is midwives we want to be, NOT nurses.


As a group we feel very lucky to have experienced many models of care. We were able to see home birth and family birth centre births. We watched women make informed choices about their care and become empowered in women centred models of care. We experienced continuity of care and developed an appreciation of how continuity of care is the gold standard in maternity care.


We were privileged to develop relationships with many women, and care for them during their pregnancy, labour, birth and beyond. We have been “with woman” for a diverse group of women: women with mental illness, women who are still teenagers, women from remote Aboriginal communities, refugee and migrant women, single and married women, women addicted to substances, diabetic and healthy, free and incarcerated, public and private. We are coloured by these experiences.

We have had three years to soak up the political environment. I am not sure any of us realised JUST how political midwifery and healthcare could be. We are now well informed of this fact and have consented to being a part of the debate. The same debate as always; how do we work together with other health professionals and how do we respect women’s choices.

There are 17 students in my graduating class, and through our trials and tribulations we have leaned on one another for support and friendship. We are grateful that we have had one another and will continue to support each another as we work as midwives. We are also grateful to the hospitals that have provided clinical placements and the midwives who have had the patience to take us under their wings.


So now that we are heading down the birth canal, there is a lot of stretching, and discomfort, a little bit of fear of what it means to be completely responsible for our actions as registered midwives. We have come a long way, and the learning is only just about to start. Most importantly, we have realised (and we hope everybody else does too) that, we are not guinea pigs, we are trail blazers and we are very proud to be moving the profession of midwifery forward.

Don't forget WA Midwives & Nurses need to renew your registration:

WA Registrations are now due: don't forget!

Amid the rush and excitement of Christmas, please do not forget to renew your registration with AHPRA - (on-line registration) due for most 31st December; it will cost you $48.00 to renew until May due to the change over dates of National Registration:

You need to renew both Midwifery and Nursing - or choose one or the other it is your choice as there are now two registers; remember what you are contracted to work before dropping off any of the registers:

The process is easy online or go into the AHPRA office in Hay St Subiaco WA:

Have a safe and Happy Festive Season:

A farewell tribute to Barb Vernon

Midwife means ‘with woman’. This meaning shapes midwifery’s philosophy, work and relationships........recognises every woman’s right to self-determination in attaining choice, control and continuity of care from one or more known caregivers...

The Australian College of Midwives (ACM) is the peak professional body for Australian midwives, which strives to maximize the quality of midwifery and maternity care for Australian women and their families through:
• Providing a unified voice for the midwifery profession.
• Supporting midwives to reach their full potential.
• Ensuring all childbearing women have access to continuity of care by a known midwife.
• Setting professional practice and education standards

I remember meeting Barb Vernon at the WA conference in 2003; this was around the time that Barb started off as the Executive Office for the College. I have always found Barb to be engaging, passionate and her focus was always to take the College to great heights; She has taught me the benefits of being politically savvy and most importantly being a quiet but forceful lobbyer; I regret having less than 10 months as a Board Director to learn from this phenomenal woman. I will not spend my time saying how amazing I thought Barb was, we all know that, and yes we all have our short comings, none of us are perfect, least of all me, however Barbs achievements speaks volumes.....and here creditability is without question.


It is remarkable what Barb has done for women, midwives and midwifery of Australia and where she has taken the College too in the last 7.5 years.... if you mention her name it is synonymous with the ACM: I can’t count the number of times I have heard people say “Barb Vernon, yes a very articulate and intelligent woman” “you’re lucky to have her” and they are correct.


Barb has always put her heart and soul into everything she has done for the College... her major achievements is as follows: (and I have not listed them all).
Medicare funding, provision of PBS and prescribing rights for midwives, national standards for entry to midwifery, establishment of separate, national professional standards for midwifery, separate register for midwives in the new national registration recognising midwifery in its own right, the development of the Midwifery Practice Review, MidPLUS, online CPD and portfolios, the development of an internationally recognised peer review journal for midwives, the list is endless;


For me what Barb has done most is establish mutually respectful and collaborative relationships with key national health organisations, such as, Australian Nursing Federation, the Australian Nursing and Midwifery Council, the Nursing and Midwifery Board of Australia, the National Rural Health Alliance and many others...... She has forged a way forward politically, established good working relationships..... with Health Ministers etc. The college has had phenomenal growth to date; excellent collegial relationships with major stake holders expanded the College activities and services to members for the future and good political ties, the College is at the table for discussions and this is due to Barbs excellent political and lobbying skills.


There does come a time to say goodbye, when you have done all you can and for someone else to come along and take the college the next step, sadly that time has come for us. I bid Barb Vernon a fond good bye and wish her every success in life; and say the ACM & women owe her a multitude of thanks – we went part of the way in thanking her when we celebrated Barb’s achievements at a farewell in Canberra last week.

I am going to leave you with one of my favourite sayings Barb; an Irish Blessing (A Blessing from St. Patrick)

May the road rise to meet you,
May the wind be always at your back,
May the sun shine warm upon your face,
May the rains fall soft upon your fields,
And, until we meet again,
May God hold you in the hollow of His hand.

(Traditional Irish Blessing; origin unknown,
although some attribute it to St. Patrick.)



THANK YOU: THANK YOU: THANK YOU: THANK YOU: THANK YOU:

A Directors responsibility under the Corporations Act 2001 (Cth) (the Act)

The Australian College of Midwives is an incorporation therefore falls under the rules and regulations of the Corporations Act (Cth) and the statue of limitation is 6 years, therefore a responsible position.
By law a Board Director is responsible for: The following information comes from Directors Duties under the Corporations Act 2001

Duty to act with care and diligence - s180(1)
A director or other officer must exercise their duties with a degree of care and diligence that a reasonable person would exercise in their position. The standard of care and diligence required as determined by a court would take into consideration the company's circumstances and the director or officers position within the company. The skill required by an executive director is measured objectively in regard to that directors' special calling. So, in considering whether a director is so negligent as to be in breach of the statutory duty, the conduct is measured in two ways: against the (objective) standard of care; and against the standard of skill held by the particular director or officer.

Duty to exercise powers in good faith – s181(1) (Conflict of duties)
A director or other officer of a corporation must exercise their powers and discharge their duties: in good faith in the best interests of the corporation; and for a proper purpose.

Duty not to improperly use position - s182 (Duty not to profit from position)
A director, secretary, other officer or employee of a corporation must not improperly use their position to: gain an advantage for themselves or someone else; or cause detriment to the corporation.

Duty not to fetter discretion's Directors have certain discretion's conferred on them by law and the company's constitution. When exercising such discretion's the directors are subject to two duties, namely: a duty to retain discretion; and duty to give adequate consideration.

Directors must exercise active discretion, they cannot ignore issues or blindly rely on another person. They must give adequate consideration when purporting to exercise a particular discretion.

Material personal interest - director's duty to disclose - Section 191
s191 requires a director who has material personal interest in a matter that relates to the affairs of the company to give the other directors notice of this interest. s191(2) outlines the exceptions to this requirement to provide notice.

The notice must give details of the nature and extent of the interest and the relation of the interest to the affairs of the company and be provided at a directors' meeting as soon as practicable after the director becomes aware of their interest. The details must be recorded in the minutes of the meeting.

Failure to disclose a material personal interest according to s191(4) does not invalidate a resolution by the directors at first instance. It has been held that the threshold for determining whether an interest is material is quite low however this contrasts with Magellan v Mount King Mining NL where the Western Australian Supreme Court stated that the nature of the interest ``should have the capacity to influence the vote of the particular director upon the decision to be made, bearing in mind that the conflict of interest must be of a real or substantial kind''.

Therefore it is considered appropriate to declare even minor conflicts of interest where there is a potential for conflict so as to err on the side of caution.

s192 of the Act provides that a director may give other directors standing notice about an interest. The notice may be given at any time and whether or not the matter relates to the affairs of the Company at the time the notice is given.

This is worth reading and taking note if you are a Board Director........

In the best interest

This blog is not meant to reflect any one person or persons: it is pondering on the phrase “In the best interest”: what does this really mean? when it comes to law and ethics there are two very different meanings, traditionally when we refer to children you might consider that parents and doctors talk about “in the best interest” it means what is considered to be best for the child...not what is best for the adult, there are times when both the doctor and the parents do not agree as to what is in the child’s best interest. “Best interests” is the doctrine used by most courts to determine a wide range of issues relating to the well-being of children.

My discussion today is about “in the best interest for the College” – now we are looking at “best interest” from a different perspective: you are looking at a philosophy, an organisation and the people within that organisation: 8 people on a Board an EO, office support staff and the membership & stakeholders: Without the membership nothing else exists:

Defintion of “Best Interest” Authority delegated for taking any action or step the delegatee thinks to be the most advantageous to the organization, under the circumstances. This power is conferred usually where it is impossible to anticipate every eventuality, or where the need for rapid decisions or quick response is critical. It is normally given for a short period, or until the time adequate information is available to formulate specific directions or guidelines.

Just to explain some general governance processes of a board for those who may not be familiar with this process: Usually an organisation will have a Constitution Governance Charter (which sets out the ground rules and job descriptions)and several other polices: The board directors are the strategic thinkers they set future goals and represent the college on the National & political front; The directors are selected by the State Membership, this does not mean that the State Board director is responsible to the state they are the National Board director from each state and territory looking after the best interest of the National College: the board director may choose to report back to the State branch to keep them informed about National issues: Therefore the National College has 8 board directors: from this the office bearers are elected the; College President, Vice President and Treasurer; All the directors are volunteers, this is an unpaid position, done as a professional duty to further the profession.

The executive officer is a salaried position; appointed via advertisement and a panel interview: The EO is responsible for carrying out the strategic plans that the board develops: and managing the office staff to carry out the work required in assisting the membership etc the day to day minutia that is required of an organisation of a 5500 membership; The board directors do not venture into the realm of the EO, that is the day to day running of the college.

In order for an organisation to function well you have to have a president and an EO that can work together and a board that is united in philosophy – they do not have to necessarily see eye to eye but they have to know how to agree to disagree and come to reasoned decisions, the ability to argue respectfully, have insight to their behaviour and most importantly have integrity. You have to leave your own agenda at the door, because the focus is “in the best interest of the College” that is for all 5500 members not just certain sectors of the membership. Confidentiality is a vital component to any board, mutual respect and good governance. Once on the board it is a National board, no state or territory exists, however this does not stop factions, such as state biases, homebirth etc

If directors come to the table with different agendas and ego’s the ability to have insight is difficult and decisions are clouded by the comment “in the best interest” my question is whose “best interest” are they truly serving? When you have powerful people in the room you are bound to get explosions, what is required is reasoned arguments, powers of persuasion without bullying and mutual respect.... once respect is gone there is a breakdown in communication because there is a tug of war about “the best interest” this is blatantly clear because there is a breakdown of respect and the factions then take over or the personal loyalties to people rather than “the best interest of the College” and then the battle begins.

The other over powering conflict that may influence how boards behave is outside influence – everyone else knows how to run the board – everyone looking into the fish bowl thinks they know best and want their two cents worth – this can be detrimental – again this comes down to a breakdown of trust and the issue of “the best interest” again I ask “whose best interest” or “whose agenda”? Once you as a board member breach confidentiality and let the outside world in...... it opens the board to criticism.... there is a fine line between being transparent and breaching confidences that lead to untenable situations.

If you do not have good governance you will not be able to function as expected and when things go pear shaped you have nothing to fall back on, it is imperative to ensure there are appropriate governance structures in place to protect your board and organisation.

I am truly saddened that great women have been wounded –in my experience 95% of people are good....but sure as hell that 5% can cause havoc, there is always a minority that cause you to have to reconsider your point of view:

I am disappointed that I have not been able to achieve the things I wanted and have a heavy heart however I am confident I have followed my heart and acted “in the best interest of the College”.

KEEPING BIRTH NORMAL:

Thanks Carolyn (Thinkbirth)for this link: and yes Carolyn you are correct in saying every item could be a blog on its own......

The World Health Organization (WHO) definition of normal birth is: ‘Spontaneous in onset, low-risk at the start of labour and remaining so throughout labour and delivery. The infant is born spontaneously in the vertex position between 37 and 42 completed weeks of pregnancy. After birth mother and infant are in good condition’.

It is a pity not every State and Territory in Australia adopts this policy TOWARDS NORMAL BIRTH: NSW is leading the way: the policy is aimed to increase normal birth and decrease surgical intervention. Western Australia needs to take a leaf out of the NSW book: I may even suggest it to our Minister of Health and our Chief Nurse and our Midwifery Advisor to see if we could not adopt this proactive lead to ensure that Normal Birth is the focus; even better I might give them Carolyn's 21 strategies to keep birth normal........

10 Steps
1. Have a written normal birth policy/guidelines, along with other
relevant policies, that are routinely communicated to all health care staff

2. Train all health care staff in skills necessary to
implement this policy

3. Provide or facilitate access to midwifery continuity of carer programs in collaboration with GPs and obstetricians for all women with appropriate consultation, referral and transfer guidelines in place

4. Inform all pregnant women about the benefits of normal birth and
factors that promote normal birth

5. Have a written policy on pain relief in labour that includes the use
of water immersion in labour and birth

6. Have a written postdates policy/guideline that is routinely
communicated to all health care staff (All women have an agreed due date of birth
documented in their health record)

7. Provide or facilitate access to vaginal birth after caesarean section
operation (VBAC) that is supported by a written vaginal birth after
caesarean section operation policy/guideline (develop statewide workshop of GPs, midwives and obstetricians to exchange views and skills regarding VBAC)

8. Provide or facilitate access to external cephalic version

9. Provide one to one care in labour for all women experiencing their
first labour or undertaking a vaginal birth after caesarean section
operation, vaginal breech or vaginal twin birth (implement local guidelines/protocols that discourage activities that separate midwives from the woman in labour. This includes the use of centralised monitoring systems as they discourage midwives from being with the woman in the labour room)

10. Provide formal debriefing in the immediate postpartum period for all women requiring primary caesarean section operation or instrumental birth with the opportunity for further discussion and information transfer

What I really like is Carolyn's inspirational and passionate list: this is how it should really read....in plain simple language that everyone understands....

Carolyn's 21 Strategies to help keep birth Normal:

1. Avert the medical 'gaze'

2. Be powerful and able to negotiate as equals to doctors

3. Establish a "round table culture'

4. Dispel 'urban myths' about birth

5. Support women to choose upright positions in labour

6. Educate teenagers

7. Promote the use of positive images of birth

8. Look at system issues: promote and change to woman centred midwifery models

9. Discuss what normal birth means to us and ensure we are talking about the same things

10. Listen to women with respect - what does the woman want?

11. Encourage women in labour to stay home as long as possible

12. Establish and provide support structures to help women stay at home in early labour

13.Establish and provide support structures so women can choose to stay home to give birth if desired

14. Examine our own attitudes to 'being with woman' in pain and uncertainty

15. Seek to establish a relationship with each woman

16. Allay fear: let woman know what birth is really about

17. Address anxiety of support people and other health professionals

18. Pay attention to the language we use

19. Have confidence in women's ability to give birth

20. Pay attention to our body language as body language conveys meaning: what are we saying?

21. Set up birth space intentionally - find out what makes each woman feel safe and do that.

Yeah AHPRA coming to the party; Good News;

After some frustrated phone calls to the College and a few letters to AHPRA it is good to see that AHPRA are listening and things are becoming easier; it pays to voice your opinion and it is even better when the other party comes to the table; well done to the ACM (Barb Vernon EO) for going in to bat for us and well done to AHPRA for considering the issues on the table and resolving them....... here is some of the good news;

I have just had confirmation from AHPRA that: (via the ACM)

1. MPR certificate will from now on be taken as sufficient evidence of
c. Current competence to provide pregnancy, labour, birth and post natal
care to women and their infants;
d. Successful completion of an approved professional practice review
program for midwives working across the continuum of midwifery care;

2. Professional references can now be provided by a midwifery colleague. The requirement for a reference from a ‘member of the multidisciplinary team’ (obstetrician) has been dropped

3. References do not need to address every element of the ANMC competency standards. They are able to be a general third party statement of support for your application from a midwifery colleague or manager

As for my application I am happy to announce that;

AHPRA has also agreed that they would be happy for ACM to reissue MPR certificates to existing applicants with wording that confirms their review was in relation to their competence across the full scope of midwifery practice. I am still waiting on a response to my questions relating the 3 year / 5 year requirement on the application form & the criteria for certifying documents;

Fantastic; now all I have to wait for is that the college will send a certified copy directly to AHPRA on my behalf, (which won't take long) and I will get the amended original for my midplus folder to replace the current one.... then I will get my notation; yeah!

Step one; MPR completed;
Step two: Eligibility completed: next Medicare!

Keep watching this space............