Grant County midwife Sherry Dress’ license has been revoked for misconduct, but she claims she has done nothing that cannot be explained.
Dress, 69, was accused of falsifying birth certificates and submitting a fraudulent Medicaid claim. Her Oregon direct-entry midwifery license, which expired in September 2015, was revoked.
She recently reached a settlement to repay $20,000 to the Department of Human Services for Medicaid overpayments.
Dress is also awaiting trial in Washington on new charges of practicing midwifery without a license — after pleading guilty to the same in May 2016, after being issued a cease-and-desist order by the state in 2013.
Dress said she simply could not afford to continue fighting the Oregon cases but plans to plead her case in court in Washington. She said she did not break the Washington law because she offered her services for free, accepting only “gratuitous” reimbursements for expenses, as a Christian ministry.
“I’m a very passionate, loving person, and this is what I do,” she said. “I love delivering babies, and I love taking care of people. As a loving Christian woman, I believe that God called me to do this.”
Oregon license revocation
Oregon’s Board of Direct Entry Midwifery accused Dress of falsifying five birth certificates between May 2014 and May 2015. For each, Dress certified the children were born at her Canyon City residence, when they were born in Pasco or Walla Walla, Washington. Dress told the Eagle she did list Oregon as the birthplace for Washington births under “special circumstances.”
In one of the five cases, she said, the mother planned to drive to Grant County so Dress could bill an Oregon insurance provider for the services, which she could only do for births in Oregon. However, the baby came before the mother made it to Oregon, so Dress said she listed Oregon so she could still submit the bill.
Dress said, in her professional experience, the exact place of birth is not always listed on a birth certificate. When she worked as a registered nurse in California in 1971, she said, the hospital was often listed as the birthplace, even for babies born in ambulances, vehicles, abandoned buildings or other places without addresses at the Mexican border, because an address was required.
She also said, for two of the five cases for babies born in June 2014, the clients contacted her in December 2014, requesting that she help acquire the birth certificates because they had not yet been able to get them from the state.
“It was wrong of me to give them Oregon birth certificates when I did in fact deliver them in Washington, but I didn’t know it was serious,” she said. “I did not know it was a felony. I thought it was more important to get them a birth certificate.”
Dress said she wanted to explain her actions before the Board of Direct Entry Midwifery “midwife to midwife” but was not allowed to do so. The case was referred to the Office of Administrative Hearings.
Dress withdrew her request for a hearing on the case March 7, resulting in the final order by default including the license revocation and about $8,500 in penalties.
She also withdrew a request for a hearing on another case for submitting a false Medicaid claim, stating she was present for a birth she did not attend in October 2014, resulting in about $4,400 in penalties.
Dress said she performed prenatal and postpartum care, but the mother delivered the baby at home when Dress was not present and later visited a hospital without informing her. She said, as she normally would do, she filled out the paperwork for global billing — including everything from prenatal to postpartum care, including the delivery — but it raised a red flag when the hospital also submitted a bill.
Dress’ attorney told her the legal costs to continue appealing the cases would likely cost as much as the penalties, she said, so she decided to move on.
Oregon Medicaid payments
Dress also agreed to repay $20,000 to the Oregon Department of Human Services for Medicaid disbursements in a settlement in Marion County Circuit Court in February. Her midwifery case files were audited in 2014 by the state, which sent her an invoice of almost $69,500 for Medicaid overpayments. After an administrative appeal in 2015, Charles Hibner, the administrator of the Office of Payment Accuracy and Recovery, said in a letter the appeal was denied, but the amount due was reduced to about $48,400.
“You explained that (Oregon Health Authority’s) inability to keep you updated was in large part the reason you were unaware and did not comply with the service plan and other critical billing elements,” he said in the November 2015 letter. “When a provider agrees to become a Medicaid provider they also agree to understand the rules and appropriately bill Medicaid services and further to retain and then provide reimbursement support upon request of the state.”
Dress appealed the decision in circuit court in November 2015 before reaching the settlement. In the court filing, she said many of the files requested for the audit had been destroyed in a flood in 2010, and then the “entire file and record relevant” to the court appeal burned along with Dress’ house in the Canyon Creek Complex fire.
The audit and amount due had nothing to do with “bad outcomes” for the patients, she said, but rather billing and paperwork errors, such as using an outdated form. She and her lawyer itemized about $7,000 worth of discrepancies she needed to repay, but the state also applied an error rate of 41 percent to all of the files she lost in the flood, resulting in about $30,300 of the $48,400 bill.
Dress told the Eagle she also took issue with DHS maternity case management paperwork and refused to fill out the entire questionnaire with questions about how many guns and how many toilets were in a household. She said it was “none of the state’s business.”
“I’m a midwife, not a social worker,” she said.
She said the state offered a deal in which she would have owed no money if she agreed never to practice midwifery again — even as a traditional midwife, which requires no license in Oregon but does not allow for the administration of medication. Dress declined.
“There isn’t any licensed midwives in Eastern Oregon or anywhere close to us,” she said. “How can you tell me I can no longer deliver babies since I’ve been doing it since 1971?”
Certifying the profession
The first child Dress delivered as a midwife in Oregon was 16 years old before the state developed a midwife licensing program in 1993.
Dress said she helped initiate the licensing program in Oregon so insurance companies could reimburse midwives as they do hospitals for births and was one of the first to be licensed the same year the program began. She served on the Oregon Board of Direct Entry Midwifery for nine years, the last year as the chair.
Her Oregon attorney, Hermine Hayes-Klein, said Dress had been a traditional home birth midwife for more than 40 years and had safely delivered more than 3,000 babies.
“Ms. Dress was a midwife before midwives were a legally recognized profession. ... Like many other traditional midwives in the US who have attempted to keep up with the changing rules and paperwork requirements of new and evolving licensure schemes, Ms. Dress has been accused of falling afoul of State regulatory compliance,” Hayes-Klein said. “... Through such allegations, the skills and services of many valuable midwives can be laid to waste, and maternity care options for rural communities reduced or eliminated.”
Dress said she believed the goal was to end home births so all babies are born in a medical setting.
“It’s open season on midwives,” she said. “The bottom line is I’m the oldest, most experienced midwife in the Northwest. They want to do away with home birth.”
She said she started the home birth movement in southern Washington decades ago. She said she has trained at least 12 midwives and is very popular among her clients.
“I’m delivering babies of babies I’ve delivered now,” she said. “There’s never been a problem ever.”
A stillborn boy
Dress described the allegations against her as lies and said it was politically motivated, “fabricated from an incident that happened a year and a half ago” in which a mother she assisted in Walla Walla in 2015 had a stillbirth after arriving at a hospital when the labor for the planned home birth failed to progress.
The mother, Sarah Magill, told the Union-Bulletin newspaper Dress should serve jail time for the death and that Dress’ methods should have raised numerous red flags.
“We should have known not to trust someone who is in such conflict with modern medicine,” she told the newspaper.
The coroner who listed the cause of death as prolonged labor with fetal hypoxia — insufficient oxygen — said he believed the child could have lived if Dress acted differently during labor, according to the Union-Bulletin.
Dress told the Eagle she did nothing wrong and disputed many of the claims in the article. She said more than an hour of fetal monitoring at the hospital showed a heartbeat and no signs of oxygen deprivation. Dress never faced charges for the stillbirth.
Previous Washington court cases
Dress admitted to the Eagle the state of Washington issued a cease-and-desist order, prohibiting her from practicing midwifery without a license, in 2013. That’s when she began listing Oregon as the birthplace for some Washington births, she said, because her access to Washington’s online birth registry was revoked.
After the order was issued, Dress claimed she obeyed the Washington law by offering her services for free as a Christian ministry. She said she began requiring clients to sign a waiver indicating that she is not licensed and does not charge for midwifery, only seeking reimbursement for expenses.
“I say, ‘What can you afford? This is how much it costs for me to drive to you,’” she said. “I’ve been paid between $500 and $2,500 for my expenses. If they only have $20, that’s all they give me. I truly believe that my patients are not my provider. I believe that God is and that he will provide.”
Dress said her full price in Oregon ranges from $3,900-4,500 for prenatal, delivery and postpartum care, though Medicaid only pays about $2,000.
Dress pleaded guilty to practicing without a license in Walla Walla District Court in May 2016, stemming from the Magill incident, but she maintained she “didn’t do anything illegal.” She said her lawyer suggested she take a plea deal minutes before a court appearance, and regretfully, she did.
The terms of her two-year probation include not performing midwifery in Washington, and she said she has not done so — even as a gratuitous ministry — while on probation.
The case pending trial
With a new lawyer, Dress vowed to fight the new charges against her in Washington, two counts of practicing without a license, one a gross misdemeanor and the other a felony.
The Tri-City Herald reported she pleaded not guilty March 15 to both charges related to two Kennewick, Washington, births whose families were given birth certificates stating the children were born in Oregon.
Washington law defines the practice of midwifery as rendering “medical aid for a fee or compensation” from pregnancy to two weeks after birth or “advertis(ing) as a midwife by signs, printed cards, or otherwise.” However, it also states, “Nothing shall be construed in this chapter to prohibit gratuitous services.”
Dress said she has 50 letters of support from previous clients, and she is prepared to argue her case at trial June 5 in Benton Superior Court.
In Oregon, no license is required for a traditional midwife, who can charge for services provided, but the person cannot advertise as a midwife and must disclose the lack of licensure to the patient. Dress said she has continued to operate as a traditional midwife since her license expired in 2015.
Even now, a young family is staying at her residence where they welcomed their first child Sunday morning. The baby boy and his mother already share a common experience.
Dress delivered the mother in a home birth 21 years ago.