Bill Text: HI SB2428 | 2020 | Regular Session | Introduced
Bill Title: Relating To The Licensure Of Midwives.
Spectrum: Moderate Partisan Bill (Democrat 5-1)
Status: (Introduced - Dead) 2020-01-30 - The committee on CPH deferred the measure. [SB2428 Detail]
Download: Hawaii-2020-SB2428-Introduced.html
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THE SENATE |
S.B. NO. |
2428 |
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THIRTIETH LEGISLATURE, 2020 |
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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 Act 32, Session Laws of Hawaii 2019, established, among other things, chapter 457J, Hawaii Revised Statutes, related to midwives, and the Hawaii home birth task force. The task force members included representatives from the department of commerce and consumer affairs, department of health, American College of Obstetricians and Gynecologists, and Healthcare Association of Hawaii, as well as certified professional midwives, certified nurse midwives, home birth elders, traditional midwives, and public members. The task force investigated issues relating to direct entry midwives and home births and submitted a report of its findings and recommendations to the legislature.
The purpose of this Act is to incorporate the recommendations of the Hawaii home birth task force as it relates to the licensing of midwives. Additionally, the legislature notes that practicing midwifery according to this Act shall not impede one's ability to incorporate or provide cultural practices.
SECTION 2. Section 457J-1, Hawaii Revised Statutes, is amended to read as follows:
"[[]§457J-1[]] Findings and purpose.
The legislature finds that:
(1) Midwives offer maternity and newborn care from the antepartum period through the intrapartum period to the postpartum period;
(2) The [improper practice
of midwifery poses a significant risk of harm to the mother or newborn, and may
result in death; and] term "midwife" is used by all direct-entry
midwives regardless of their educational pathway or licensure status;
(3) [The regulation
of the practice of midwifery is reasonably necessary to protect the health,
safety, and welfare of mothers and their newborns.] Traditional midwives
currently exist in Hawaii, define themselves as traditional midwives, and are in
demand by the communities they serve. Traditional
midwives are recognized and defined by the Midwives Alliance of North America, and
states, such as Oregon and Utah, as well as Canada, formally recognize and perpetuate
their practices by creating pathways other than licensure to allow traditional midwives
to continue to serve their communities;
(4) Available data for
fetal and infant morbidity from planned home birth indicate lower rates of resuscitation,
assisted ventilation, and neonatal intensive care unit admission than planned hospital
births. Available data from vital records
at the department of health indicates that maternal and infant mortality rates for
planned home births in Hawaii in 2017 and 2018 were zero. Comparative data from the department of health
clearly shows that home to hospital transfers with significant mortality or morbidity
consequences for mother and infant are exceedingly rare and do not occur daily in
Hawaii hospitals;
(5) Direct entry midwives
in Hawaii can be classified into two groups: those who hold certification (certified midwives
and certified professional midwives) and are best regulated through licensure; and
traditional midwives, who can be best regulated through exemption; and
(6) There is limited
opportunity in Hawaii for the Midwifery Education and Accreditation Council, portfolio
evaluation process, and the North American Registry of Midwives licensure pathways."
SECTION 3. Section 457J-2, Hawaii Revised Statutes, is amended as follows:
1. By adding four new definitions to be appropriately inserted and to read:
""Direct-entry midwife"
means an independent practitioner educated in the discipline of midwifery through
self-study, apprenticeship, a midwifery school, college, or university-based program
distinct from the discipline of nursing and who is trained to provide the midwives
model of care to healthy women and newborns throughout the childbearing cycle, primarily
in out-of-hospital settings.
"Licensed midwife" means
a person licensed under this chapter.
"Midwifery model of care"
means monitoring the physical, psychological, and social well-being of a birthing
parent throughout the childbearing cycle; providing them with individualized education,
counseling, and prenatal care, continuous hands-on assistance during labor and delivery,
and postpartum support; minimizing technological interventions; and referring birthing
persons who require obstetrical attention.
"Traditional midwife" means
an autonomous midwife who has acquired the skills to care for pregnant people, babies,
and their families throughout pregnancy, birth, and postpartum through a spiritual
or cultural lineage, is recognized nationally and internationally by the Midwifery
Education Accreditation Commission and Midwifery Alliance of North America, and
does not advertise as a certified or licensed midwife."
2. By
amending the definition of "qualified midwife preceptor" to read:
""Qualified midwife
preceptor" means [a] an exempt or licensed and experienced
midwife, or other maternal health professional licensed in the State, who participates
in the clinical education of [individuals enrolled in a midwifery education
program accredited by the Midwifery Education Accreditation Council or
Accreditation Commission For Midwifery Education and who meets the criteria for
midwife preceptors set forth by the applicable organization.] midwives."
3. By
deleting the definition of "midwife":
[""Midwife" means a person licensed under this chapter."]
SECTION 4. Section 457J-3, Hawaii Revised Statutes, is amended to read as follows:
"[[]§457J-3[]] [Midwives]
Midwife licensing program. There is established a [midwives]
midwife licensing program within the department to be administered by
the director."
SECTION 5. Section 457J-4, Hawaii Revised Statutes, is amended to read as follows:
"[[]§457J-4[]] Powers and duties of the
director. In addition to any other powers and duties authorized by law, the
director shall have the power and duties to:
(1) Grant permission
to a person to use the title of ["midwife" or] "licensed
midwife" and engage in the practice of midwifery in this State pursuant to
this chapter and the rules adopted pursuant thereto;
(2) Adopt, amend, or repeal rules pursuant to
chapter 91 to carry out the purposes of this chapter;
(3) Administer, coordinate, and enforce this chapter and rules adopted pursuant thereto;
(4) Discipline a licensee for any cause
described by this chapter or for any violation of rules or refuse to license a
person for failure to meet the licensing requirements or for any cause that
would be grounds for disciplining a licensee;
(5) Appoint an advisory committee to assist
with the implementation of this chapter and the rules adopted pursuant thereto. The advisory committee shall consist of the
following:
(A) Three midwives who are certified professional
[midwives or certified] midwives;
(B) Two members of the public; and
(C) A certified [nurse] midwife[;],
if available; and
(6) Add, remove, or otherwise modify the authorized non-controlled legend drugs and legend devices listed in 457J-11 by rule under chapter 91."
SECTION 6. Section 457J-5, Hawaii Revised Statutes, is amended to read as follows:
"[[]§457J-5[]] License required. (a)
Beginning July 1, 2020, except as provided in this chapter, no person
shall [engage in the practice of midwifery, or] use the title ["midwife",]
"licensed 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 the 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] a licensed
midwife unless that person is licensed in accordance with this chapter."
SECTION 7. Section 457J-6, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) A person may practice
midwifery without a license to practice midwifery if the person is:
(1) A certified nurse-midwife holding a valid license under chapter 457;
(2) Licensed and performing work within the scope of practice or duties of the person's profession that overlaps with the practice of midwifery;
(3) A student midwife
who is [currently enrolled] studying midwifery through self-study, apprenticeship,
or enrollment in a midwifery educational program under the direct supervision
of a qualified midwife preceptor;
(4) A person rendering aid in an emergency where no fee for the service is contemplated, charged, or received; or
(5) A person acting as
a [birth attendant on or before July 1, 2023,] traditional midwife,
who:
(A) Does not use
legend drugs or devices, the use of which requires a license under the laws of
the State[;], with the exception of oxygen and a department of commerce
and consumer affairs approved anti-hemorrhagic agent;
(B) Does not advertise
that the person is a licensed midwife; and
(C) Discloses to each
client verbally and in writing on a form [adopted by the department],
which shall be received and executed by the person under the [birth
attendant's] traditional midwife's care at the time care is first
initiated:
(i) That the person does not possess a professional license issued by the State to provide health or maternity care to women or infants;
(ii) That the person's education and qualifications have not been reviewed by the State;
(iii) The person's education and training;
(iv) That the person is
not authorized to acquire, carry, administer, or direct others to administer
legend drugs; and
[(v) Any judgment,
award, disciplinary sanction, order, or other determination that adjudges or
finds that the person has committed misconduct or is criminally or civilly
liable for conduct relating to midwifery by a licensing or regulatory
authority, territory, state, or any other jurisdiction; and
(vi)] (v)
A plan for transporting the
client to the nearest hospital if a problem arises during the client's care[;
and
(D) Maintains
a copy of the form required by subparagraph (C) for at least ten years and
makes the form available for inspection upon request by the department]."
SECTION 8. Section 457J-8, Hawaii Revised Statutes, is amended to read as follows:
"[[]§457J-8[]] Application for license as a licensed
midwife. To obtain a license under this
chapter, the applicant shall provide:
(1) An application for licensure;
(2) The required fees;
(3) Proof of current, unencumbered certification as a:
(A) Certified professional midwife; or
(B) Certified midwife;
(4) For certified professional midwives, proof of a successful completion of a formal midwifery education and training program that is either:
(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 accredited education; or
(C) The
North American Registry of Midwives entry-level portfolio evaluation program;
(5) If applicable, evidence of any licenses held or once held in other jurisdictions indicating the status of the license and documenting any disciplinary proceedings pending or taken by any jurisdiction;
(6) Information regarding any conviction of any crime which has not been annulled or expunged; and
(7) Any other information the department may require to investigate the applicant's qualifications for licensure."
SECTION 9. Section 457J-11, Hawaii Revised Statutes, is amended as follows:
1. By amending subsection (a) to read:
"(a) A licensed midwife licensed under this chapter may purchase and administer non-controlled legend drugs and devices that are used in pregnancy, birth, postpartum care, newborn care, or resuscitation, and that are deemed integral to providing care to the public by the department."
2. By amending subsection (d) to read:
"(d) A pharmacist who dispenses drugs and devices to a licensed midwife as authorized by this section and in conformity with chapter 461 is not liable for any adverse reactions caused by the licensed midwife's administration of legend drugs and devices."
PART II
SECTION 10. Section 26H-4, Hawaii Revised Statutes, is amended to read as follows:
"§26H-4 Repeal dates for newly enacted professional and vocational regulatory programs. (a) Any professional or vocational regulatory program enacted after January 1, 1994, and listed in this section shall be repealed as specified in this section. The auditor shall perform an evaluation of the program, pursuant to section 26H-5, prior to its repeal date.
(b) Chapter 465D (behavior analysts) shall be repealed on June 30, 2021.
(c) Chapter 466L (appraisal management companies) shall be repealed on June 30, 2023.
[(d) Chapter 457J (midwives) shall be repealed on
June 30, 2025.]"
PART III
SECTION 11. 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 12. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.
SECTION 13. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 14. This Act shall take effect upon its approval.
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INTRODUCED BY: |
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Report Title:
Midwives; Licensure; Exemption
Description:
Amends various provisions related to the licensure of midwives. Allows certified nurse midwives and direct-entry midwives to refer to themselves as "midwives". Allows a traditional midwife to practice midwifery under certain conditions. Repeals the repeal date for chapter 457J, Hawaii Revised Statutes.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.
