Bill Text: IA HF188 | 2015-2016 | 86th General Assembly | Introduced
Bill Title: A bill for an act providing for midwife licensure and providing for a fee and a penalty, and including effective date provisions.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2015-02-09 - Subcommittee, Watts, Highfill, and Winckler. H.J. 285. [HF188 Detail]
Download: Iowa-2015-HF188-Introduced.html
House File 188 - Introduced HOUSE FILE BY MASCHER A BILL FOR 1 An Act providing for midwife licensure and providing for a fee 2 and a penalty, and including effective date provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 2150YH (2) 86 tr/nh PAG LIN 1 1 Section 1. Section 147.1, subsections 3 and 6, Code 2015, 1 2 are amended to read as follows: 1 3 3. "Licensed" or "certified", when applied to a physician 1 4 and surgeon, podiatric physician, osteopathic physician and 1 5 surgeon, physician assistant, psychologist, chiropractor, 1 6 nurse, dentist, dental hygienist, dental assistant, 1 7 optometrist, speech pathologist, audiologist, pharmacist, 1 8 physical therapist, physical therapist assistant, occupational 1 9 therapist, occupational therapy assistant, orthotist, 1 10 prosthetist, pedorthist, respiratory care practitioner, 1 11 practitioner of cosmetology arts and sciences, practitioner 1 12 of barbering, funeral director, dietitian, marital and family 1 13 therapist, mental health counselor, social worker, massage 1 14 therapist, midwife, athletic trainer, acupuncturist, nursing 1 15 home administrator, hearing aid dispenser, or sign language 1 16 interpreter or transliterator means a person licensed under 1 17 this subtitle. 1 18 6. "Profession" means medicine and surgery, podiatry, 1 19 osteopathic medicine and surgery, practice as a physician 1 20 assistant, psychology, chiropractic, nursing, dentistry, 1 21 dental hygiene, dental assisting, optometry, speech pathology, 1 22 audiology, pharmacy, physical therapy, physical therapist 1 23 assisting, occupational therapy, occupational therapy 1 24 assisting, respiratory care, cosmetology arts and sciences, 1 25 barbering, mortuary science, marital and family therapy, 1 26 mental health counseling, social work, dietetics, massage 1 27 therapy, midwifery, athletic training, acupuncture, nursing 1 28 home administration, hearing aid dispensing, sign language 1 29 interpreting or transliterating, orthotics, prosthetics, or 1 30 pedorthics. 1 31 Sec. 2. Section 147.2, subsection 1, Code 2015, is amended 1 32 to read as follows: 1 33 1. A person shall not engage in the practice of medicine 1 34 and surgery, podiatry, osteopathic medicine and surgery, 1 35 psychology, chiropractic, physical therapy, physical 2 1 therapist assisting, nursing, dentistry, dental hygiene, 2 2 dental assisting, optometry, speech pathology, audiology, 2 3 occupational therapy, occupational therapy assisting, 2 4 orthotics, prosthetics, pedorthics, respiratory care, 2 5 pharmacy, cosmetology arts and sciences, barbering, social 2 6 work, dietetics, marital and family therapy or mental health 2 7 counseling, massage therapy, midwifery, mortuary science, 2 8 athletic training, acupuncture, nursing home administration, 2 9 hearing aid dispensing, or sign language interpreting 2 10 or transliterating, or shall not practice as a physician 2 11 assistant, unless the person has obtained a license for that 2 12 purpose from the board for the profession. 2 13 Sec. 3. Section 147.13, Code 2015, is amended by adding the 2 14 following new subsection: 2 15 NEW SUBSECTION. 25. For midwifery, the board of midwifery. 2 16 Sec. 4. Section 147.14, subsection 1, Code 2015, is amended 2 17 by adding the following new paragraph: 2 18 NEW PARAGRAPH. x. For midwifery, a total of seven members, 2 19 three members who are licensed midwives under chapter 148G; 2 20 one member who is licensed under chapter 148, is a practicing 2 21 family physician, and has professional experience consulting 2 22 for and collaborating with direct=entry midwives; one member 2 23 who is an advanced registered nurse practitioner licensed 2 24 under chapter 152, is certified by the American midwifery 2 25 certification board as a nurse=midwife, and has professional 2 26 experience consulting for and collaborating with direct=entry 2 27 midwives; and two members who are not licensed midwives or 2 28 licensed health care providers who have received direct=entry 2 29 midwifery services and who shall represent the general public. 2 30 Sec. 5. Section 147.74, Code 2015, is amended by adding the 2 31 following new subsection: 2 32 NEW SUBSECTION. 5A. A midwife licensed under chapter 148G 2 33 may use the words "licensed midwife" or the initials "L.M." 2 34 after the person's name. 2 35 Sec. 6. NEW SECTION. 148G.1 Definitions. 3 1 As used in this chapter, unless the context otherwise 3 2 requires: 3 3 1. "Board" means the board of midwifery created under 3 4 chapter 147. 3 5 2. "Licensed midwife" means a person who is licensed to 3 6 practice midwifery as provided in this chapter. 3 7 3. "Out=of=hospital" means any facility, institution, or 3 8 place which is not an ambulatory surgical center or a hospital, 3 9 such as a birth center as defined in section 135.61 or a 3 10 private home. 3 11 4. "Practice of midwifery" means the provision of primary 3 12 maternity care during the antepartum, intrapartum, or 3 13 postpartum period by a person who is neither licensed to 3 14 practice under chapter 148 or 148C, nor a nurse recognized 3 15 by the board of nursing as an advanced registered nurse 3 16 practitioner who is a certified nurse=midwife, and who is not 3 17 rendering emergency services without compensation. "Practice 3 18 of midwifery" may also include the carrying and administration 3 19 of certain medications during the practice of midwifery, 3 20 including oxytocin, as a postpartum antihemorrhagic agent, 3 21 oxygen, intravenous fluids for stabilization, vitamin K, eye 3 22 prophylactics, and other drugs or procedures as appropriate for 3 23 the scope of practice for licensed midwives as determined by 3 24 the board. 3 25 Sec. 7. NEW SECTION. 148G.2 Licensure ==== licensed 3 26 midwifery. 3 27 1. Beginning July 1, 2016, every person engaged in the 3 28 practice of midwifery in this state shall be licensed pursuant 3 29 to this chapter. 3 30 2. Prior to obtaining licensure, an applicant shall 3 31 successfully pass an examination approved by the board by rule 3 32 demonstrating competencies in at least all of the following 3 33 areas: risk assessment and management; prenatal care; 3 34 management of normal labor, birth, and postpartum; newborn care 3 35 up to six weeks; and adult cardiopulmonary resuscitation and 4 1 newborn resuscitation. 4 2 3. The applicant shall provide documentation, satisfactory 4 3 to the board, of all of the following: 4 4 a. Knowledge and proficiency of all didactic components 4 5 of midwifery, including definitions, signs and symptoms, 4 6 differential diagnosis for risk assessment, stabilization and 4 7 treatment, follow=up, referral, and transport. 4 8 b. Complete and thorough preparation as an assistant midwife 4 9 prior to assuming responsibility as a primary midwife which 4 10 shall include clinical care performed under supervision during 4 11 training including, at a minimum: 4 12 (1) Seventy=five prenatal exams. 4 13 (2) Twenty births as an assistant midwife. 4 14 (3) Twenty births as primary midwife from the onset of labor 4 15 to the delivery of the placenta and the stabilization of mother 4 16 and newborn. 4 17 (4) Twenty newborn exams. 4 18 (5) Forty postpartum exams. 4 19 c. Assessment and verification of performance of skills 4 20 during an intensive, hands=on skills assessment, performed for 4 21 and scored by an evaluator approved by the board. 4 22 d. Passage of a three=hundred=fifty=item national board 4 23 examination that covers all aspects of midwifery care as 4 24 identified by job analysis approved by the board. 4 25 e. Evidence that the applicant has provided prenatal, 4 26 intrapartal, and postpartal care as well newborn assessment, 4 27 equivalent to a minimum of one thousand three hundred fifty 4 28 clinical contact hours under the direct supervision of one or 4 29 more instructors approved by the North American registry of 4 30 midwives. 4 31 4. The applicant shall hold a certified professional 4 32 midwife credential issued by the North American registry of 4 33 midwives or any other nationally accredited credential as 4 34 specified by the board. If an applicant has been subject to 4 35 prior revocation of a license to practice medicine or nursing, 5 1 the applicant shall not be eligible for licensure under this 5 2 chapter, except as determined by the board. 5 3 5. The board may request, at the applicant's expense, that 5 4 the department of public safety perform a criminal history 5 5 check and the department of human services perform child and 5 6 dependent adult abuse record checks of the applicant. If an 5 7 applicant has a criminal record or a record of founded child or 5 8 dependent adult abuse, the board shall perform an evaluation to 5 9 determine whether the record warrants denial of licensure. 5 10 Sec. 8. NEW SECTION. 148G.3 Use of title ==== penalty. 5 11 A person shall not use the title "licensed midwife", 5 12 describe or imply that the person is a licensed midwife, or 5 13 represent the person as a licensed midwife unless the person is 5 14 licensed under this chapter or is licensed as a nurse=midwife 5 15 under chapter 152. 5 16 Sec. 9. NEW SECTION. 148G.4 Rules. 5 17 1. The board shall: 5 18 a. Adopt rules relating to standards for professional 5 19 conduct of persons licensed under this chapter. 5 20 b. Adopt rules consistent with this chapter and with 5 21 chapters 17A, 147, and 272C which are necessary for the 5 22 performance of its duties. 5 23 c. Act on matters concerning licensure and the processes 5 24 of applying for, granting, suspending, imposing supervisory 5 25 or probationary conditions upon, reinstating, and revoking a 5 26 license. 5 27 d. Administer the provisions of this chapter requiring 5 28 documentation required to demonstrate competence as a midwife, 5 29 and the processing of applications for licenses and license 5 30 renewal. 5 31 e. Develop continuing education requirements as a condition 5 32 of license renewal. 5 33 f. Evaluate requirements for licensure in other states to 5 34 determine if reciprocity may be granted. 5 35 g. Establish and collect licensure fees as provided in 6 1 section 147.80 and retain fees as provided in section 147.82. 6 2 h. Establish procedures for the issuance, renewal, and 6 3 revocation or suspension of a license under this chapter. 6 4 i. Maintain a registry of licensed midwives and statistics 6 5 on the practice of midwifery utilizing vital statistics data. 6 6 2. In developing rules, the board may consult with 6 7 persons knowledgeable regarding the prenatal and postpartum 6 8 birth process, particularly those possessing experience 6 9 with out=of=hospital births, including but not limited to 6 10 persons licensed under chapter 148, certified professional 6 11 midwives, advanced registered nurse practitioners who are 6 12 certified nurse=midwives, and women who have given birth in 6 13 an out=of=hospital setting. In developing rules relating 6 14 to the practice of midwifery, the board shall reflect the 6 15 knowledge and skills identified by the North American registry 6 16 of midwives' current job description for the profession and the 6 17 standards of practice of midwifery established by the national 6 18 association of certified professional midwives or a successor 6 19 organization. 6 20 3. Rules relating to the practice of midwifery shall be 6 21 consistent with the North American registry of midwives' 6 22 current job description for the profession and the standards 6 23 of practice of midwifery established by the national 6 24 association of certified professional midwives or a successor 6 25 organization, and shall not expand the scope of practice of 6 26 midwifery established by the national association of certified 6 27 professional midwives or a successor organization. 6 28 4. At such time as the board determines that liability 6 29 insurance is available at an affordable price to certified 6 30 professional midwives, the board may mandate such coverage. 6 31 Until that time, each midwife shall comply with the disclosure 6 32 requirements in section 148G.5. 6 33 Sec. 10. NEW SECTION. 148G.5 Client disclosure. 6 34 Prior to accepting a patient for midwifery care, a licensed 6 35 midwife shall provide information to the patient indicating all 7 1 of the following: 7 2 1. Evidence that the care provider is a licensed midwife 7 3 meeting the requirements of this chapter. 7 4 2. Whether the licensed midwife has malpractice liability 7 5 insurance coverage and the policy limits of such coverage. 7 6 3. The midwife's educational background and relevant 7 7 experience, including experience in various birth settings. 7 8 4. The nature, scope, and location of the care to be 7 9 given, including the possibility of and the guidelines for 7 10 consultation, referral, or transfer of the patient to a 7 11 hospital from an out=of=hospital setting. 7 12 Sec. 11. NEW SECTION. 148G.6 Exceptions. 7 13 1. This chapter does not prevent qualified members of other 7 14 professions including but not limited to individuals licensed 7 15 under chapter 148 or 152 from providing services consistent 7 16 with the nature of the practice of midwifery. 7 17 2. This chapter does not prevent or prohibit a student 7 18 midwife from performing tasks related to the practice of 7 19 midwifery under the supervision of a licensed midwife, a 7 20 certified nurse=midwife, or a licensed physician during 7 21 completion of the licensure process. 7 22 3. The practice of midwifery in this state prior to July 1, 7 23 2016, shall not constitute grounds for disciplinary action by 7 24 the board. The board may issue a license to a person who has 7 25 practiced midwifery in this state prior to that date upon that 7 26 person's application and compliance with the provisions of this 7 27 chapter and the rules adopted pursuant to this chapter. 7 28 Sec. 12. NEW SECTION. 148G.7 Prohibited practice. 7 29 A person shall not practice midwifery, or represent that the 7 30 person is a midwife, unless the person is licensed as provided 7 31 in this chapter. 7 32 Sec. 13. NEW SECTION. 148G.8 Requirements for licensure ==== 7 33 temporary license. 7 34 Beginning July 1, 2016, an individual who does not meet 7 35 the requirements for licensure by examination pursuant to 8 1 section 148G.2 may apply for a one=year temporary license, the 8 2 qualifications for which shall be determined by the board by 8 3 rule. Renewal of the temporary license shall be determined 8 4 by the board. The board may revoke a temporary license if it 8 5 determines that the temporary licensee has violated standards 8 6 established by rule. 8 7 Sec. 14. Section 272C.1, subsection 6, Code 2015, is amended 8 8 by adding the following new paragraph: 8 9 NEW PARAGRAPH. ag. The board of midwifery, created pursuant 8 10 to chapter 147. 8 11 Sec. 15. Section 272C.4, subsection 6, Code 2015, is amended 8 12 to read as follows: 8 13 6. Define by rule acts or omissions that are grounds for 8 14 revocation or suspension of a license under section 100D.5, 8 15 105.22, 147.55, 148.6, 148B.7, 148G.4, 152.10, 153.34, 154A.24, 8 16 169.13, 455B.219, 542.10, 542B.21, 543B.29, 544A.13, 544B.15, 8 17 or 602.3203 or chapter 151 or 155, as applicable, and to define 8 18 by rule acts or omissions that constitute negligence, careless 8 19 acts, or omissions within the meaning of section 272C.3, 8 20 subsection 2, paragraph "b", which licensees are required to 8 21 report to the board pursuant to section 272C.9, subsection 2. 8 22 Sec. 16. INITIAL APPOINTMENTS. 8 23 1. Notwithstanding any provision to the contrary in this 8 24 Act, the initial midwife appointees to the board of midwifery 8 25 created pursuant to this Act shall fulfill the national 8 26 certification requirements of the North American registry of 8 27 midwives. 8 28 2. One of the initial midwife appointments to the board 8 29 shall be appointed for a one=year term, one shall be appointed 8 30 for a two=year term, and one shall be appointed for a 8 31 three=year term. The members who are licensed under chapter 8 32 148 or 152 shall each be appointed for a two=year term, and the 8 33 members representing the general public shall each be appointed 8 34 to a three=year term. 8 35 Sec. 17. EFFECTIVE DATE. The following provision or 9 1 provisions of this Act take effect July 1, 2016: 9 2 1. The section of this Act amending section 147.2, 9 3 subsection 1. 9 4 2. The section of this Act enacting section 148G.7. 9 5 EXPLANATION 9 6 The inclusion of this explanation does not constitute agreement with 9 7 the explanation's substance by the members of the general assembly. 9 8 This bill creates new Code chapter 148G that provides for 9 9 the licensure of midwives beginning July 1, 2016. A midwife 9 10 is not an allopathic or osteopathic physician licensed under 9 11 Code chapter 148 or a nurse licensed under Code chapter 9 12 152 providing primary maternity care during the antepartum, 9 13 intrapartum, or postpartum period. 9 14 The bill provides for the establishment of a seven=member 9 15 board of midwifery consisting of three members who are 9 16 midwives, one physician, one nurse, and two members who 9 17 represent the general public. The bill provides for fees to 9 18 fund the board and provides penalties for violation of the 9 19 licensure requirement; those penalties are set out for all 9 20 health=related boards in Code chapters 147 and 272C. Code 9 21 section 147.86 provides that it is a serious misdemeanor to 9 22 violate a provision of the licensing laws. 9 23 The board is similar in composition and responsibilities to 9 24 other health=related licensing boards. 9 25 The provisions of the bill amending Code section 147.2 and 9 26 enacting Code section 148G.7, both prohibiting the practice of 9 27 midwifery without a license, take effect July 1, 2016. LSB 2150YH (2) 86 tr/nh
