Bill Text: HI HB2184 | 2018 | Regular Session | Amended
Bill Title: Relating To The Licensure Of Midwives.
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Introduced - Dead) 2018-02-14 - The committee(s) on CPC recommend(s) that the measure be deferred. [HB2184 Detail]
Download: Hawaii-2018-HB2184-Amended.html
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
2184 |
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TWENTY-NINTH LEGISLATURE, 2018 |
H.D. 1 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO THE LICENSURE OF MIDWIVES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
PART I
SECTION
1. The legislature finds that one of the challenges faced by the country's
health care system is providing quality care to segments of the population who
do not have access to essential services because of geographic
limitations. Further, the legislature
finds that mothers have accessed midwifery services throughout history and that
using midwifery care to deliver maternal child health care is an effective way
of overcoming certain barriers to accessing care, particularly for communities
located in rural and remote areas. This
is especially important in Hawaii, where residents on the neighbor islands and
in rural areas do not have the same level of access to maternal child health
care as residents in urban areas of Oahu.
The legislature further finds that
midwifery services are used extensively across the country with no compromise
in quality of care when the services are within the scope of practice of a
midwife provider.
The legislature additionally finds that
licensing the midwife profession will empower consumer choice, reduce access
disparities, enhance provider availability, and improve quality of maternal
child health care.
As determined by Senate Concurrent Resolution
No. 64, S.D.1 (1998), the subsequent sunrise Auditor's Report No. 99-14 (1999),
House Concurrent Resolution No. 65, H.D.1 (2016), and the subsequent sunrise Auditor's
Report No. 17-01 (2017), the legislature finds that it is necessary to
establish a regulatory process for the entire midwifery profession.
The purpose of this Act is to regulate midwives engaged in the practice of midwifery care by establishing licensure requirements and regulatory requirements under the department of commerce and consumer affairs.
PART II
SECTION 2. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:
"Chapter
MIDWIVES
§ -1 Definitions. As used in this chapter:
"Accreditation Commission for
Midwifery Education" means the United States Department of Education
recognized commission that provides accreditation and pre-accreditation of certificates,
post-baccalaureates, graduate degrees, and pre-certification programs in
nurse-midwifery and midwifery.
"American Midwifery Certification
Board" means the national certifying body for certified nurse-midwife
candidates and certified midwife candidates who have received their graduate
level education in programs accredited by the Accreditation Commission for
Midwifery Education.
"Certified midwife" means a
person who holds a current and valid national certification as a Certified Midwife
from the American Midwifery Certification Board, or any successor organization.
"Certified professional midwife"
means a person who holds a current and valid national certification as a
Certified Professional Midwife from the North American Registry of Midwives, or
any successor organization.
"Client" means a person under the
care of a licensed midwife, as well as the person's fetus and newborn child.
"Department" means the department
of commerce and consumer affairs.
"Director" means the director of commerce
and consumer affairs.
"International Confederation of
Midwives" means the accredited non-governmental organization and
representative of midwives and midwifery to organizations worldwide to achieve
common goals in the care of mothers and newborns.
"Licensed midwife" means a person
who is a certified midwife and/or certified professional midwife:
(1) Who
engages in the practice of midwifery and uses the title of "Licensed Midwife";
(2) Who
has been issued a license under this chapter; and
(3) Whose
license is in effect and not revoked, suspended, or encumbered.
"Midwife" means a person who has
successfully completed a midwifery educational pathway that is recognized in
the United States and meets or exceeds the International Confederation of
Midwives Essential Competencies for Basic Midwifery Practice and the framework
of the International Confederation of Midwives Global Standards for Midwifery
Education, has demonstrated competency in the practice of midwifery by passing
a national midwifery certification exam offered as part of a National
Commission for Certifying Agencies accredited credentialing program, holds a
current certified professional midwife, certified midwife and/or certified
nurse-midwife credential, and who has acquired the requisite qualifications to
be legally licensed to practice midwifery and use the title 'midwife'.
"Midwifery" means providing
primary health and/or maternity care to women and infants.
"Midwifery Education Accreditation
Council" means the United States Department of Education recognized
commission established in 1991 that provides accreditation for programs and
institutions that meet the National Association of Certified Professional
Midwives core competencies and the North American Registry of Midwives skills
and standards for basic midwifery practice.
"National Association of Certified
Professional Midwives" means the national professional and
standard-setting association for certified professional midwives in the United
States.
"North American Registry of Midwives"
means the organization that sets national standards for the certified
professional midwife credential.
"The practice of midwifery as a
licensed midwife" means providing independent primary care services and
management of the health care for persons with female reproductive systems,
focusing particularly on family planning, gynecological needs, pregnancy,
childbirth, the postpartum period, and care of the newborn through the
performance of professional services commensurate with the educational
preparation and demonstrated competency of the individual having specialized
knowledge, judgment, and skill based on the principles of the biological,
physical, behavioral, and sociological sciences and midwifery theory, whereby
the individual shall be accountable and responsible to the consumer for the
quality of midwifery care rendered. The
foregoing may include but shall not be limited to observation, assessment,
development, implementation, and evaluation of a plan of care, health
counseling, supervision and teaching of other personnel, and teaching of
individuals, families, and groups; provision of midwifery services via
telehealth; administration, supervision, coordination, delegation, and
evaluation of midwifery practice; provision of healthcare to the client in
collaboration with other members of the healthcare team as autonomous health
care professionals providing the midwifery component of health care; or use of
reasonable judgment in carrying out prescribed medical orders of a licensed
physician or osteopathic physician licensed in accordance with chapter 453 or
460; orders of an advanced practice registered nurse licensed in accordance
with chapter 457; orders of a physician assistant licensed and practicing with
physician supervision pursuant to chapter 453 and acting as the agent of the
supervising physician; or the orders of a licensed midwife in accordance with
this chapter.
"Qualified midwife preceptor"
means a licensed and experienced midwife, or other health professional licensed
in the State, who participates in the clinical education of individuals
enrolled in a midwifery education program accredited by the Accreditation
Commission for Midwifery Education or Midwifery Education Accreditation Council
and who meets the criteria for midwife preceptors set forth by the
organization.
"Telehealth" means the practice
defined in section 453-1.3.
§ -2 Midwife licensure program. There is established a midwife licensure
program within the department to be administered by the director.
§ -3 License required. (a)
Except as provided in this chapter, no person shall engage in the practice of midwifery, nor use the title "Licensed
Midwife" or "Midwife" or the abbreviation "L.M.", or
any other words, letters, abbreviations, or insignia indicating or implying that
the person is a licensed midwife without a valid license issued pursuant to
this chapter.
(b) Nothing
in this section shall preclude a person holding a national certification as a
midwife from identifying such person as holding such certification, so long as
the person is not practicing midwifery or professing to be authorized to
practice midwifery in the State unless that person is licensed in accordance
with this chapter.
§ -4
Exemptions.
(a) This chapter shall not apply
to any of the following:
(1) Certified
nurse-midwives regulated by the board of nursing pursuant to chapter 457;
(2) A
student midwife providing midwifery services who is currently enrolled in a
midwifery educational program under the direct supervision of a qualified
midwife preceptor;
(3) A
person administering care to a spouse, parent, sibling, or child;
(4) A
person rendering aid in an emergency where no fee for the service is
contemplated, charged, or received; or
(5) A
person performing a service within the person's authorized scope of practice of
a profession that is licensed, certified, or registered under other laws of the
State.
(b) Nothing in this chapter shall prohibit
healing practices by traditional Hawaiian healers engaged in traditional
healing practices of prenatal, maternal, and child care as recognized and
certified by any kupuna council convened by Papa Ola Lokahi. Nothing in this chapter shall limit, alter,
or otherwise adversely impact the practice of traditional native Hawaiian
healing pursuant to the Constitution of the State of Hawaii.
§ -5
Powers and duties of the director. In
addition to any other powers and duties authorized by law, the director shall
have the powers and duties to:
(1) Adopt,
amend, or repeal rules pursuant to chapter 91 as the director finds necessary
to carry out this chapter;
(2) Issue
and renew licenses pursuant to this chapter and deny or refuse to renew
licenses for failure to comply with this chapter;
(3) Suspend
or revoke any license for any violation of this chapter, chapter 436B, or rules
adopted by the director pursuant to this chapter;
(4) Reinstate
licenses pursuant to this chapter;
(5) Establish
fees;
(6) Discipline
a licensed midwife on grounds specified by this chapter or chapter 436B or for
any violation of rules adopted by the director pursuant to this chapter;
(7) Administer,
coordinate, and enforce this chapter; and
(8) Appoint
an advisory committee to assist with the implementation of this chapter and the
rules adopted thereto. The advisory
committee shall consist of six persons that shall be composed of:
(A) Three
midwives, with a minimum of one practicing in a hospital setting and one practicing
in a community based setting;
(B) One
obstetrician-gynecologist; and
(C) Two
public members who have either received midwifery
services or have an interest in the rights of consumers of midwifery services
and who have never been a primary attendant or assistant at a birth.
§ -6
Fees. (a) Each applicant shall pay a licensing fee upon
application for a new or renewal license. Fees collected pursuant to this section or by
rule adopted under this section shall be non-refundable.
(b) The
director may establish fees for the restoration of a license, penalty fees, and
any other fees required for the administration of this chapter by rule pursuant
to chapter 91.
§ -7
Application for license as a midwife.
(a) To obtain a license under
this chapter, the applicant shall provide the following:
(1) An
application for licensure;
(2) The
required application fees;
(3) Any
additional requirements adopted by the director; and
(4) Evidence
of qualifications for licensure.
(b)
Evidence of qualifications for licensure as a certified midwife shall be
the following:
(1) Proof
of current, unencumbered certification as a certified midwife by the American
Midwifery Certification Board or a successor organization;
(2) Proof
of successful completion of an Accreditation Commission for Midwifery Education
graduate-level midwifery program with a significant educational and practical
concentration on the direct care of clients leading to a master's degree or
higher as a midwife; and
(3) Proof
of successful completion of at least thirty contact hours, as part of a master's
degree program or higher from an Accreditation Commission for Midwifery
Education accredited college or university, of advanced pharmacology education,
including advanced pharmacotherapeutics that is integrated into the curriculum,
within the three-year time period immediately preceding the date of
application. If the advanced
pharmacology education in a master's degree program was completed prior to the
three-year time period immediately preceding the date of application, then one
of the following shall be completed within the three-year time period
immediately preceding the date of application for initial prescriptive
authority:
(A) At
least thirty contact hours of advanced pharmacology, including advanced
pharmacotherapeutics, from an Accreditation Commission for Midwifery Education
accredited college or university; or
(B) At
least thirty contact hours of continuing education in advanced pharmacology,
including advanced pharmacotherapeutics, approved by an organization recognized
by the American Midwifery Certification Board's, or successor organization's,
Continuing Education Policy. The
continuing education pharmacology contact hours must be related to the applicant's
scope of midwifery practice.
(c)
Evidence of qualifications for licensure as a certified professional
midwife shall be the following:
(1) Proof
of current and valid certification as a certified professional midwife by the
North American Registry of Midwives or a successor organization;
(2) Proof
of successful completion of a formal midwifery education and training program
as follows:
(A) An
educational program or pathway accredited by the Midwifery Education
Accreditation Council; or
(B) A
midwifery bridge certificate issued by the North American Registry of Midwives for
certified professional midwife applicants who either obtained certification
before January 1, 2020, through a non-accredited pathway or who have maintained
licensure in a state that does not require an accredited education;
(3) Proof
of a current, unencumbered recognition or license as a licensed midwife in all
other states or jurisdiction of the United States in which the applicant has a
current and active recognition or license as a licensed midwife or similar
designation;
(4) Documentation
relating to any disciplinary action ordered by or pending before any board or
program in any state or jurisdiction of the United States; and
(5) Documentation
from the appropriate agencies or parties regarding any criminal conviction of
which the applicant is the subject that has not been annulled or expunged. This includes, but is not limited to,
certified copies of any court records, orders, or other documents that state
the facts and statutes upon which the applicant was convicted, the judgment of
the court with regard to the conviction, the sentence imposed, the actual terms
of the sentence, and whether sentence was completed.
§ -8
Renewal of license.
(a) Licenses issued pursuant to
this chapter shall be renewed triennially on or before June 30, with the first
renewal deadline occurring on June 30, . Licenses shall be renewed upon the payment of
a renewal fee within sixty days before the expiration of the license. Failure to renew a license shall result in
forfeiture of that license. Licenses
that have been forfeited may be restored within one year of the forfeiture date
upon payment of renewal and restoration fees. Failure to restore a forfeited license within
one year shall result in the automatic termination of the license. A person whose license has been terminated
pursuant to this section shall be required to reapply for a new license as a
new applicant.
(b) For
each license renewal, the licensed midwife shall:
(1) Pay
all required non-refundable fees;
(2) Provide
proof of current certification:
(A) As
a certified midwife by the American Midwifery Certification Board or a
successor organization; or
(B) As a certified professional midwife by the North American Registry of Midwives or a successor organization;
(3) Provide
documentation of successful completion during the prior triennium of
appropriate continuing education as defined by rules adopted by the director;
(4) Provide
certified documentation from agencies or parties relating to any disciplinary
action ordered by or pending before any regulatory board in any state or
jurisdiction of the United States within the three years prior to application
for renewal of recognition; and
(5) Provide
information, including but not limited to, certified documents from appropriate
agencies and persons regarding any criminal conviction within the past three
years which has not been annulled or expunged.
§ -9 Grounds for refusal to renew, reinstate, or
restore a license and for revocation, suspension, denial, or condition of a
license. In addition to any other
acts or conditions provided by law, the director may refuse to renew,
reinstate, or restore and may deny, revoke, suspend, or condition in any manner
any license for any one or more of the following acts or conditions on the part
of a licensee or license applicant:
(1) Failure
to meet or to maintain the conditions and requirements necessary to qualify for
the granting of a license;
(2) Engaging
in false, fraudulent, or deceptive advertising, or making untruthful or
improbable statements in advertising;
(3) Engaging
in the practice of midwifery while impaired by alcohol, drugs, non-accommodated
physical disability, or mental instability;
(4) Procuring
a license to practice midwifery through fraud, misrepresentation, or deceit;
(5) Aiding
and abetting an unlicensed person to directly or indirectly perform activities
requiring a license to practice midwifery;
(6) Engaging
in unprofessional conduct, incompetence, gross negligence, or manifest
incapacity in the practice of midwifery;
(7) Engaging
in conduct or a practice contrary to recognized standards of ethics for the
practice of midwifery;
(8) Violating
any condition or limitation imposed on a license to practice midwifery by the
director;
(9) Engaging
in the practice of midwifery in a manner that causes injury to one or more
members of the public;
(10) Failing
to comply with, observe, or adhere to any law in a manner that causes the
director to determine that the applicant or holder is unfit to hold a license;
(11) Having
a license revoked or suspended or other disciplinary action by any state or
federal agency for any reason that is provided by the applicable licensing laws
or by this section;
(12) Having
been convicted or pleaded nolo contendere to a crime directly related to the
qualifications, functions, or duties of the practice of midwifery;
(13) Failing
to report in writing to the director any disciplinary decision issued against
the licensee or applicant in another jurisdiction within thirty days of the
disciplinary decision;
(14) Employing,
whether gratuitously or for pay, any person not licensed pursuant to this
chapter to perform the functions or duties of the practice of midwifery; and
(15) Violating
this chapter, chapter 436B, or any rule or order of the director.
§ -10 Global signature authority. Licensed midwives are authorized to sign,
certify, or endorse all documents relating to health care within their scope of
practice provided for their clients, including workers' compensation
verification documents, verification and evaluation forms of the department of
human services and department of education, verification and authorization
forms of the department of health, and physical examination forms; provided
that nothing in this section shall be construed to expand the scope of practice
of licensed midwives.
§ -11 Penalties Any person who violates this chapter
shall be subject to a fine of not more than $1,000 for each separate offense. Each day of each violation shall constitute a
separate offense. The director may
initiate a civil action to collect the fine imposed under this chapter in
accordance with rules adopted by the director."
PART III
SECTION 3.
The department of commerce and consumer affairs shall adopt interim
rules to carry out the purposes of this Act without regard to chapter 91,
Hawaii Revised Statutes, to read as follows:
"SUBCHAPTER 1
CONTINUING
EDUCATION REQUIREMENTS
§16- - License renewal continuing education
requirement. Licensed midwife applicants must provide
documentation of successful completion during the prior triennium of ten
contact hours of appropriate continuing education, which shall be in
pharmacology and include pharmacotherapeutics, related to the practice of
midwifery from accredited colleges or universities, or:
(1) If
applicant is a certified midwife, continuing education approved by an
organization recognized by the American Midwifery Certification Board's, or
successor organization's, Continuing Education Policy; or
(2) If
applicant is a certified professional midwife, continuing education approved by
an organization recognized by the North American Registry of Midwives', or
successor organization's, Recertification Application Packet Continuing
Education Unit Category 1. Certified
professional midwives are required to include treatment of shock/IV therapy and
suturing in their continuing education.
SUBCHAPTER
2
UNPROFESSIONAL
CONDUCT
§16- - Unprofessional conduct. Midwifery
behavior which fails to conform to legal standards and accepted standards of
the midwife profession and which reflect adversely on the health and welfare of
the public shall constitute unprofessional conduct.
§16- - Types of unprofessional conduct. The
types of unprofessional conduct covered in this provision shall include, but are
not limited to, the following:
(1) Submitting
information to the director pursuant to an application for licensure, renewal
of licensure, or reinstatement of licensure which is fraudulent, deceitful, or
contains misrepresentations;
(2) Impersonating
any applicant, or acting as proxy for the applicant in any midwife certifying
examination, allowing any person to use one's midwife license, or the aiding,
abetting, or assisting an individual to violate or circumvent this chapter;
(3) Practicing
midwifery within the State without a valid and current license, or after
the temporary license has expired;
(4) Misrepresenting
that the person is a licensed midwife, verbally or in writing, when the person
does not possess the appropriate license;
(5) Failing
to report to the director any notice of revocation, suspension, or other
disciplinary actions against the applicant or licensee by another state or
jurisdiction of the United States;
(6) Performing
unsafe client care or failing to conform to professional standards required of
a midwife which poses a danger to the welfare of a client which shall include:
(A) Intentionally
or negligently causing physical or emotional injury to a client;
(B) Administering
medication and treatment in a careless or negligent manner;
(C) Failing
to take appropriate action or to follow policies and procedures in the practice
setting designed to safeguard the client;
(D) Failing
to take appropriate action in safeguarding a client from incompetent health
care practices;
(E) Performing
midwifery techniques or procedures without proper education and training;
(F) Violating
the confidentiality of information or knowledge concerning the client or failing
to safeguard the client's right to privacy; and
(G) Leaving
a midwifery assignment or abandoning a client without properly notifying
appropriate personnel; and
(7) Engaging
in any act inconsistent with the practice of midwifery as defined in this
chapter for that of a licensed midwifery including:
(A) Engaging
in conduct which evidences a lack of ability or fitness to discharge the duty
owed by the licensee to a client;
(B) Practicing
midwifery when physical or mental ability to practice is impaired by alcohol or
drugs, or because of other physical, psychological, or mental impediment;
(C) Willfully,
or deliberately, falsifying or altering a client's, healthcare facility's, or
employee's record;
(D) Unauthorized
use or removal of drugs, supplies, or property from a client or healthcare
facility, institution or other work place location, or diverting or attempting
to divert drugs or controlled substances for unauthorized use or appropriating
money, supplies, or equipment;
(E) Possessing,
obtaining, furnishing, or administering prescription drugs to any person,
including self, except as directed by a person authorized by law to prescribe
drugs; and
(F) Failing
to supervise persons to whom midwifery functions have been delegated under one's
supervision.
SUBCHAPTER
3
SCOPE
OF PRACTICE FOR LICENSED MIDWIVES
§16- - Practice. (a) "Practice of a certified midwife"
means the full scope of midwifery, regardless of compensation or personal
profit, that incorporates caring for all clients in all settings and is guided
by the scope of practice authorized by this chapter, the rules of the director,
and midwifery standards established or recognized by the director including but
not limited to:
(1) Advanced
assessment and the diagnosis, prescription, selection, and administration of
therapeutic measures including over the counter drugs, legend drugs, expedited
partner therapy provided for in chapter 453, HRS, notwithstanding the
definition of health professional in chapter 453, HRS, and controlled
substances within the licensed midwife practicing as certified midwife's
education, certification, and role; and
(2) The
Standards of Practice of the American College of Nurse-Midwives and American
Midwifery Certification Board, or successor organizations, provided that the
American College of Nurse-Midwives shall have no legal authority over the
director and shall have no legal authority or powers of oversight of the
director in the exercise of its powers and duties authorized by law.
(b)
"Practice of a certified professional midwife" means the full
scope of midwifery, regardless of compensation or personal profit, that
incorporates caring for all clients in all settings and is guided by the scope
of practice authorized by this chapter, the rules of the director, and
midwifery standards established or recognized by the director including but not
limited to:
(1) Advanced
assessment and the diagnosis, selection, and administration of therapeutic
measures according to the limited formulary of this chapter within the licensed
midwife practicing as a certified professional midwife's education, certification,
and role; and
(2) The
Job Analysis and the Comprehensive Skills, Knowledge and Abilities Essential
for the Competent Midwifery Practice defined by the North American Registry of
Midwives, or successor organization, provided that the North American Registry
of Midwives shall have no legal authority over the director and shall have no
legal authority or powers of oversight of the director in the exercise of its
powers and duties authorized by law.
(c) A licensed midwife shall comply with the
requirements of this chapter; recognized limits of the licensed midwife's
knowledge and experience and planning for the management of situations that
exceed the scope of authorized practice; and consult with or refer clients to
other healthcare providers, as appropriate.
(d) The practice of midwifery by licensed midwives
is based on and is consistent with their education and national certification,
which includes, but is not limited to:
(1) Evaluating
the physical and psychosocial health status of clients through a comprehensive
health history and physical examination, using skills of observation,
inspection, palpation, percussion, and auscultation, and using diagnostic
instruments and procedures;
(2) Directing
the midwifery care given by other personnel associated with the healthcare
team;
(3) Providing
education and counseling related to the health care for persons with female
reproductive systems, focusing particularly on pregnancy, childbirth, the
postpartum period, care of the newborn, and the family planning and
gynecological needs of persons with female reproductive systems;
(4) Ordering,
interpreting, and performing diagnostic, screening, and therapeutic
examinations, tests and procedures;
(5) Formulating
a diagnosis;
(6) Initiating
and maintaining accurate records and authorizing appropriate regulatory and
other legal documents; and
(7) Providing
informed consent in adherence with the licensee's professional requirements,
which must, at minimum, include information pursuant to section 671-3(b), (d)
and (e), HRS;
(8) Serving
as a consultant and resource of advanced clinical knowledge and skills to those
involved directly or indirectly in client care;
(9) Operating
within a health care system that provides for consultation, collaborative management,
and referral with other healthcare professionals;
(10) Referring
clients who require care beyond the scope of practice of the licensed midwife to
an appropriate health care provider;
(11) Assisting
in surgery (only licensed midwives practicing as certified midwives);
(12) Admitting
and discharging clients for inpatient care at facilities licensed as hospitals
and birth centers in the State;
(13) Participating
in joint and periodic evaluation of services rendered such as peer review,
including chart reviews, case reviews, client evaluations, and outcomes of case
statistics; and
(14) Participating
in policy analysis and development of new policy initiatives in the area of
practice specialty to improve quality of health care services and consumer
access to services.
(e) Licensed midwives must continually assess the
appropriateness of the planned location of birth, and will refer to the
American College of Nurse-Midwives' 2015 Clinical Bulletin: Midwifery Provision
of Home Birth Services, or succeeding document, for guidance, taking into
account the health and condition of the mother and baby.
(f) If the licensed midwife determines that a
condition of the mother or baby is outside of the licensee's scope of practice,
then the licensed midwife shall refer the client to an appropriate health care
provider.
(g) If the licensed midwife is attending a
community-based birth and determines during the licensee's care that the client
faces imminent morbidity or mortality, the licensed midwife shall activate the
911 emergency system.
(h) If
the licensed midwife transfers care of the mother or baby during the
intrapartum or immediate postpartum period, the licensee shall provide the
receiving provider with, at minimum, the information listed on the Community
Birth Transfer State of Hawaii form.
(i)
If the mother or baby's guardian refuses assistance from appropriate licensed
health care providers or the 911 emergency system, the licensed midwife must continually
urge the mother or baby's guardian to transfer care to an appropriate licensed
health care provider and may continue to provide care to save a life and can
only perform actions within the technical ability of the licensed midwife.
SUBCHAPTER
4
PRESCRIPTIVE
AUTHORITY FOR LICENSED MIDWIVES PRACTICING AS CERTIFIED MIDWIVES
§16- - Prescriptive authority. (a) Only licensed midwives
practicing as certified midwives can be granted prescriptive authority. Licensed midwives practicing as certified
midwives shall only prescribe drugs appropriate to midwifery care as recognized
by the director and in accordance with the current exclusionary formulary
defined by the board of nursing for advanced practice registered nurses; the
exclusionary formulary lists the drugs or categories of drugs that shall not be
prescribed.
(b) Only a licensed midwife practicing as a
certified midwife shall be able to use any sign, card, or device to indicate or
in any way imply, that the person is a licensed midwife who is authorized to
prescribe.
(c) The licensed midwife practicing as a certified
midwife shall comply with all applicable state and federal laws and rules
relating to prescribing and administering of drugs. The licensed midwife practicing as a certified
midwife shall only prescribe, order, and dispense medical devices and equipment
appropriate to the licensed midwife's specialty.
(d) Prescriptions by a licensed midwife practicing
as a certified midwife shall be written in accordance with section 16-95-82.
(e) Nothing in this section shall preclude a licensed
midwife practicing as a certified midwife from carrying out the prescribed
medical orders of a licensed physician, osteopath, or advanced practice
registered nurse licensed in accordance with chapter 453 or 457, HRS; orders of
a physician assistant licensed and practicing with physician supervision
pursuant to chapter 453, HRS, and acting as the agent of the supervising
physician; or the orders of a recognized licensed midwife practicing as a
certified midwife in accordance with this chapter.
SUBCHAPTER
5
AUTHORITY
TO OBTAIN AND ADMINISTER LEGEND DRUGS AND DEVICES FOR LICENSED MIDWIVES
PRACTICING AS CERTIFIED PROFESSIONAL MIDWIVES
§16- - Authority for certified professional
midwives. (a) Licensed midwives practicing as certified
professional midwives do not possess prescriptive authority. Licensed midwives practicing as certified
professional midwives are authorized to obtain and administer the following
non-controlled legend drugs or devices during the practice of midwifery:
(1) Oxygen;
(2) Neonatal
eye prophylaxis;
(3) Anti-hemorrhagic
agents for postpartum;
(4) Vitamin
K;
(5) Rho
(D) immune globulin;
(6) Intravenous
fluids;
(7) Local
anesthetic;
(8) Group
beta streptococcus prophylaxis antibiotics;
(9) Epinephrine
for anaphylactic reaction to an administered medication and neonatal
resuscitation;
(10) Non-hormonal
contraceptives; and
(11) Hormonal
implants pursuant to any manufacturer certification requirements, as prescribed
by a licensed provider with prescriptive authority.
(b) A licensed midwife practicing as a certified
professional midwife may obtain formulary drugs as allowed by law.
(c) A licensed midwife practicing as certified
professional midwife must:
(1) Store
all formulary drugs in secure areas suitable for preventing unauthorized access
and for ensuring a proper environment for the preservation of the drugs. However, licensed midwives practicing as
certified professional midwives may carry formulary drugs to a community based
setting while providing care within the course and scope of the practice of
midwifery. The licensed midwife
practicing as a certified professional midwife must promptly return the
formulary drugs to the secure area when the licensed midwife has finished using
them for client care; and
(2) Maintain
proper records of obtaining, storing, and administering drugs and devices.
(d) Nothing in this section shall preclude a
licensed midwife practicing as a certified professional midwife from carrying
out the prescribed medical orders of a licensed physician, osteopath, or
advanced practice registered nurse licensed in accordance with chapter 453 or
457, HRS; orders of a physician assistant licensed and practicing with
physician supervision pursuant to chapter 453, HRS, and acting as the agent of
the supervising physician; or the orders of a recognized licensed midwife
practicing as a certified midwife in accordance with this chapter."
The department of commerce and consumer affairs may adopt additional
interim rules to carry out the purposes of this Act without regard to chapter
91, Hawaii Revised Statutes, provided that the department shall hold at least
one public hearing prior to the adoption of additional interim rules.
PART IV
SECTION 4. The director of commerce and consumer affairs
shall submit a report of its findings and recommendations, including any
proposed legislation, to the legislature no later than twenty days prior to the
convening of the regular sessions of 20
and 20 . The report shall
include but not be limited to:
(1) The status
of any rulemaking, including interim rules, the department of commerce and
consumer affairs has undertaken;
(2) The
number of licensed midwives that have applied for licensure under this Act;
(3) A
summary of all complaints, if any, received by the department of commerce and
consumer affairs against any midwives licensed pursuant to this Act;
(4) A
summary of all investigations, if any, conducted by the department of commerce
and consumer affairs pursuant to this Act;
(5) An
update on the department of commerce and consumer affairs' efforts in
implementing the provisions of this Act;
(6) An
update of the department of commerce and consumer affairs' budget as it relates
to the implementation of this Act; and
(7) Any
proposed amendments to the authorization fee structure.
PART V
SECTION 5. If any provision of this Act, or the application thereof to any person or circumstance, is held invalid, the invalidity does not affect other provisions or applications of the Act that can be given effect without the invalid provision or application, and to this end the provisions of this Act are severable.
SECTION 6. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.
SECTION 7. This Act shall take effect on July 1, 3000; provided that Part III of this Act shall sunset on January 1, 2025.
Report Title:
Midwives; Licensure; Appropriation; Interim Rules
Description:
Establishes the criteria for licensure of midwives by the Department of Commerce and Consumer Affairs. Provides for interim rules for continuing education requirements, standards of professional conduct, prescriptive authority, and penalties for violations. Appropriates funds. (HB2184 HD1)
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.
