Bill Text: IA HF2291 | 2021-2022 | 89th General Assembly | Introduced
Bill Title: A bill for an act relating to midwife licensure, providing for fees, and making penalties applicable.(Formerly HSB 123; See HF 2547.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2022-06-22 - Subcommittee recommends passage. Vote Total: 3-0 [HF2291 Detail]
Download: Iowa-2021-HF2291-Introduced.html
House
File
2291
-
Introduced
HOUSE
FILE
2291
BY
COMMITTEE
ON
STATE
GOVERNMENT
(SUCCESSOR
TO
HSB
123)
A
BILL
FOR
An
Act
relating
to
midwife
licensure,
providing
for
fees,
and
1
making
penalties
applicable.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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1348HV
(2)
89
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H.F.
2291
Section
1.
Section
147.1,
subsections
3
and
6,
Code
2022,
1
are
amended
to
read
as
follows:
2
3.
“Licensed”
or
“certified”
,
when
applied
to
a
physician
3
and
surgeon,
podiatric
physician,
osteopathic
physician
and
4
surgeon,
genetic
counselor,
physician
assistant,
psychologist,
5
chiropractor,
nurse,
dentist,
dental
hygienist,
dental
6
assistant,
optometrist,
speech
pathologist,
audiologist,
7
pharmacist,
physical
therapist,
physical
therapist
assistant,
8
occupational
therapist,
occupational
therapy
assistant,
9
orthotist,
prosthetist,
pedorthist,
respiratory
care
10
practitioner,
practitioner
of
cosmetology
arts
and
sciences,
11
practitioner
of
barbering,
funeral
director,
dietitian,
12
behavior
analyst,
assistant
behavior
analyst,
marital
and
13
family
therapist,
mental
health
counselor,
midwife,
respiratory
14
care
and
polysomnography
practitioner,
polysomnographic
15
technologist,
social
worker,
massage
therapist,
athletic
16
trainer,
acupuncturist,
nursing
home
administrator,
hearing
17
aid
specialist,
or
sign
language
interpreter
or
transliterator
18
means
a
person
licensed
under
this
subtitle
.
19
6.
“Profession”
means
medicine
and
surgery,
podiatry,
20
osteopathic
medicine
and
surgery,
genetic
counseling,
practice
21
as
a
physician
assistant,
psychology,
chiropractic,
nursing,
22
dentistry,
dental
hygiene,
dental
assisting,
optometry,
speech
23
pathology,
audiology,
pharmacy,
physical
therapy,
physical
24
therapist
assisting,
occupational
therapy,
occupational
therapy
25
assisting,
respiratory
care,
cosmetology
arts
and
sciences,
26
barbering,
mortuary
science,
applied
behavior
analysis,
marital
27
and
family
therapy,
mental
health
counseling,
midwifery,
28
polysomnography,
social
work,
dietetics,
massage
therapy,
29
athletic
training,
acupuncture,
nursing
home
administration,
30
practice
as
a
hearing
aid
specialist,
sign
language
31
interpreting
or
transliterating,
orthotics,
prosthetics,
or
32
pedorthics.
33
Sec.
2.
Section
147.13,
Code
2022,
is
amended
by
adding
the
34
following
new
subsection:
35
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NEW
SUBSECTION
.
25.
For
midwifery,
the
board
of
midwifery.
1
Sec.
3.
Section
147.14,
subsection
1,
Code
2022,
is
amended
2
by
adding
the
following
new
paragraph:
3
NEW
PARAGRAPH
.
x.
For
midwifery,
a
total
of
seven
members,
4
four
members
who
are
professional
midwives
eligible
for
5
licensure
under
chapter
148I;
one
member
who
is
licensed
under
6
chapter
148,
is
certified
by
the
American
college
of
obstetrics
7
and
gynecology,
and
has
professional
experience
consulting
8
for
and
collaborating
with
direct-entry
midwives;
one
member
9
who
is
a
nurse
midwife;
and
one
member
who
is
not
a
licensed
10
midwife
or
a
licensed
health
care
provider
who
has
received
11
direct-entry
midwifery
services
and
who
shall
represent
the
12
general
public.
13
Sec.
4.
Section
147.74,
Code
2022,
is
amended
by
adding
the
14
following
new
subsection:
15
NEW
SUBSECTION
.
28.
A
midwife
licensed
under
chapter
148I
16
may
use
the
words
“licensed
midwife”
or
the
initials
“L.M.”
17
after
the
person’s
name.
18
Sec.
5.
NEW
SECTION
.
148I.1
Definitions.
19
As
used
in
this
chapter,
unless
the
context
otherwise
20
requires:
21
1.
“Board”
means
the
board
of
midwifery
created
pursuant
to
22
chapter
147.
23
2.
“Certified
nurse
midwife”
or
“CNM”
means
a
registered
24
nurse
who
holds
a
current,
valid
certification
from
the
25
American
midwifery
certification
board.
26
3.
“Certified
professional
midwife”
or
“CPM”
means
a
person
27
who
holds
a
current,
valid
certification
with
the
North
28
American
registry
of
midwives
or
its
successor
organization.
29
4.
“Client”
means
a
person
under
the
care
of
a
midwife
and
30
such
person’s
fetus
or
newborn.
31
5.
“Licensed
midwife”
means
a
person
licensed
under
this
32
chapter
to
practice
midwifery
in
Iowa.
33
6.
“Midwife”
means
a
person
practicing
midwifery.
34
7.
“Midwifery”
means
the
practice
of
providing
primary
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maternity
care
to
a
client
during
the
preconception,
1
antepartum,
intrapartum,
and
postpartum
periods
and
newborn
2
care
up
to
six
weeks.
3
8.
“Midwifery
bridge
certificate”
or
“MBC”
means
a
4
certificate
issued
by
the
North
American
registry
of
midwives
5
or
its
successor
organization
that
documents
completion
of
6
accredited
continuing
education
for
certified
professional
7
midwives
based
upon
identified
areas
to
address
education
8
in
emergency
skills
and
other
competencies
set
by
the
9
international
confederation
of
midwives.
10
Sec.
6.
NEW
SECTION
.
148I.2
Licensure
——
licensed
11
midwifery.
12
1.
Except
as
provided
in
section
148I.3,
beginning
July
1,
13
2023,
every
person
practicing
midwifery
in
this
state
shall
be
14
licensed
pursuant
to
this
chapter.
The
board
shall
adopt
rules
15
pursuant
to
chapters
17A,
147,
and
272C
establishing
procedures
16
for
the
licensure
of
new
and
practicing
midwives.
17
2.
Prior
to
obtaining
a
license
to
practice
midwifery,
an
18
applicant
shall
meet
all
of
the
following
requirements:
19
a.
Be
at
least
twenty-one
years
old.
20
b.
Submit
proof
of
a
high
school
diploma
or
its
equivalent.
21
c.
Submit
proof
of
a
current
national
certification
as
a
22
certified
professional
midwife
from
the
North
American
registry
23
of
midwives
or
its
successor
organization.
24
d.
(1)
Submit
proof
of
completion
of
an
educational
program
25
or
pathway
accredited
by
the
midwifery
education
accreditation
26
council,
except
as
otherwise
provided
in
this
paragraph.
27
(2)
A
certified
professional
midwife
certified
before
July
28
1,
2023,
and
who
received
certification
other
than
through
29
completion
of
an
educational
program
or
pathway
described
in
30
subparagraph
(1)
shall
obtain
a
midwifery
bridge
certificate
31
from
the
North
American
registry
of
midwives
or
its
successor
32
organization
in
order
to
obtain
licensure
in
Iowa.
33
(3)
A
person
licensed
to
practice
midwifery
in
a
state
34
that
does
not
require
completion
of
an
educational
program
or
35
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pathway
described
in
subparagraph
(1),
shall
obtain
a
midwifery
1
bridge
certificate
from
the
North
American
registry
of
midwives
2
or
its
successor
organization
in
order
to
obtain
licensure
in
3
Iowa.
4
e.
Submit
an
application
fee
as
prescribed
by
the
board
by
5
rule.
6
3.
The
board
may
request,
at
the
applicant’s
expense,
that
7
the
department
of
public
safety
perform
a
criminal
history
8
check
and
the
department
of
human
services
perform
child
and
9
dependent
adult
abuse
record
checks
of
the
applicant.
If
an
10
applicant
has
a
criminal
record
or
a
record
of
founded
child
or
11
dependent
adult
abuse,
the
board
shall
perform
an
evaluation
to
12
determine
whether
the
record
warrants
denial
of
licensure.
13
Sec.
7.
NEW
SECTION
.
148I.3
Exceptions.
14
1.
This
chapter
does
not
do
any
of
the
following:
15
a.
Limit
or
regulate
the
practice
of
qualified
members
16
of
other
professions
including
but
not
limited
to
advanced
17
registered
nurse
practitioner
midwives
under
chapter
152,
18
advanced
practice
registered
nurse
midwives
under
chapter
152E,
19
or
certified
nurse
midwives,
from
providing
services
that
would
20
constitute
midwifery
under
this
chapter.
21
b.
Apply
to
a
person
who
is
a
member
of
a
Native
American,
22
Mennonite,
or
Amish
community
who
provides
traditional
midwife
23
services
to
such
a
community.
24
c.
Apply
to
a
person
who,
in
good
faith,
engages
in
the
25
practice
of
the
religious
tenets
of
a
church
or
a
religious
act
26
if
no
fee
is
contemplated,
charged,
or
received.
27
d.
Apply
to
a
person
rendering
aid
in
an
emergency.
28
e.
Apply
to
a
student
midwife
currently
enrolled
in
an
29
accredited
midwifery
education
program
and
providing
services
30
to
clients
under
the
direct,
on-site,
in-person
supervision
of
31
a
certified
professional
midwife
who
is
licensed
and
registered
32
as
a
preceptor
with
the
North
American
registry
of
midwives
or
33
its
successor
organization.
34
f.
Apply
to
an
advanced
registered
nurse
practitioner
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licensed
under
chapter
152,
an
advanced
practice
registered
1
nurse
under
chapter
152E,
or
a
certified
nurse
midwife.
2
2.
The
practice
of
midwifery
shall
not
constitute
the
3
practice
of
medicine,
certified
nurse
midwifery,
certified
4
midwifery,
or
emergency
medical
care
to
the
extent
that
a
5
midwife
advises,
attends,
or
assists
a
person
during
pregnancy,
6
labor,
childbirth,
or
the
postpartum
period.
7
Sec.
8.
NEW
SECTION
.
148I.4
Board
——
rules.
8
1.
The
board
shall
adopt
rules
consistent
with
this
chapter
9
and
chapter
147
which
are
necessary
for
the
performance
of
the
10
board’s
duties.
The
rules
shall
do
all
of
the
following:
11
a.
Regulate
the
practice
of
midwifery
based
on
rules
12
established
by
the
national
association
of
certified
13
professional
midwives
and
the
North
American
registry
of
14
midwives
or
its
successor
organization.
15
b.
Define
professional
and
unprofessional
conduct.
16
c.
Permit
a
licensee
to
obtain
appropriate
screening
and
17
testing
for
clients,
including
but
not
limited
to
laboratory
18
tests
and
ultrasounds.
19
d.
Permit
a
licensee
to
obtain
and
administer
all
of
the
20
following
during
the
practice
of
midwifery:
21
(1)
Antihemorrhagic
agents
including
but
not
limited
to
22
oxytocin,
misoprostol,
and
methylergonovine.
23
(2)
Intravenous
fluids
for
stabilization
of
the
laboring
24
person.
25
(3)
Neonatal
injectable
vitamin
K.
26
(4)
Newborn
antibiotic
eye
prophylaxis.
27
(5)
Oxygen.
28
(6)
Intravenous
antibiotics
for
group
B
streptococcal
29
antibiotic
prophylaxis.
30
(7)
Rho
(D)
immune
globulin.
31
(8)
Local
anesthetic.
32
(9)
Epinephrine.
33
(10)
Other
drugs
consistent
with
the
practice
of
certified
34
professional
midwifery.
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e.
Permit
a
licensee
to
administer
a
drug
prescribed
by
a
1
licensed
health
care
provider
for
a
client
of
a
licensee.
2
f.
Prohibit
a
licensee
from
using
forceps
or
a
vacuum
3
extractor.
4
g.
Require
a
licensee
to
develop
a
written
plan
for
the
5
consultation,
collaboration,
emergency
transfer,
and
transport
6
of
the
birthing
client
and
newborn
when
necessary,
and
to
7
submit
that
plan
to
the
board.
8
h.
Require
a
licensee
to
provide
each
client
with,
and
9
maintain
a
record
of,
a
signed
consent
form
that
describes
the
10
licensee’s
qualifications,
a
copy
of
the
licensee’s
emergency
11
plan,
whether
the
licensee
carries
professional
liability
12
insurance,
and
the
benefits
and
risks
of
birth
in
the
client’s
13
setting
of
choice.
14
i.
Require
a
licensee
to
report
client
data
to
the
midwives
15
alliance
of
North
America
statistics
registry,
the
American
16
association
of
birth
centers
perinatal
data
registry,
or
other
17
similar
databases,
and
to
verify
the
submission
of
such
data
18
with
the
board.
19
j.
Adopt
continuing
education
requirements
consistent
with
20
those
required
by
the
North
American
registry
of
midwives
or
21
its
successor
organization.
22
k.
Establish
requirements
for
peer
review.
23
l.
Require
a
licensee
to
file
a
birth
certificate
for
each
24
birth.
25
m.
Establish
an
annual
license
fee.
26
n.
Require
a
licensee
to
comply
with
sections
136A.5
and
27
136A.5A.
28
2.
The
board
shall
not
adopt
rules
that
do
any
of
the
29
following:
30
a.
Permit
a
licensee
to
order
or
administer
narcotic
drugs.
31
b.
Limit
the
location
where
a
licensee
may
practice
32
midwifery.
33
c.
Require
a
licensee
to
practice
under
the
supervision
of
34
or
under
a
collaborative
practice
agreement
with
another
health
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care
provider.
1
Sec.
9.
NEW
SECTION
.
148I.5
Liability
——
limitation.
2
A
health
care
provider
accepting
a
transfer
of
a
client
from
3
a
licensed
midwife
shall
not
be
liable
for
outcomes
arising
4
from
actions
of
the
licensed
midwife.
5
Sec.
10.
NEW
SECTION
.
148I.6
Use
of
title
——
penalty.
6
A
person
shall
not
use
the
title
“licensed
midwife”,
or
7
describe
or
imply
that
the
person
is
a
licensed
midwife,
or
8
represent
that
person
as
a
licensed
midwife
unless
the
person
9
is
licensed
under
this
chapter.
10
Sec.
11.
Section
272C.1,
subsection
6,
Code
2022,
is
amended
11
by
adding
the
following
new
paragraph:
12
NEW
PARAGRAPH
.
ah.
The
board
of
midwifery,
created
pursuant
13
to
chapter
147.
14
Sec.
12.
Section
272C.4,
subsection
6,
Code
2022,
is
amended
15
to
read
as
follows:
16
6.
Define
by
rule
acts
or
omissions
that
are
grounds
for
17
revocation
or
suspension
of
a
license
under
section
100D.5
,
18
105.22
,
147.55
,
148.6
,
148B.7
,
152.10
,
153.34
,
154A.24
,
169.13
,
19
455B.219
,
542.10
,
542B.21
,
543B.29
,
544A.13
,
544B.15
,
or
20
602.3203
or
chapter
148I,
151
,
or
155
,
as
applicable,
and
to
21
define
by
rule
acts
or
omissions
that
constitute
negligence,
22
careless
acts,
or
omissions
within
the
meaning
of
section
23
272C.3,
subsection
2
,
paragraph
“b”
,
which
licensees
are
24
required
to
report
to
the
board
pursuant
to
section
272C.9,
25
subsection
2
.
26
Sec.
13.
NEW
SECTION
.
514C.12A
Licensed
midwife
services.
27
1.
Notwithstanding
section
514C.6,
a
person
who
provides
28
an
individual
or
group
policy
of
accident
or
health
insurance
29
or
individual
or
group
hospital
or
health
care
service
30
contract
issued
pursuant
to
chapter
509,
509A,
514,
or
514A
31
or
an
individual
or
group
health
maintenance
organization
32
contract
issued
and
regulated
under
chapter
514B,
which
is
33
delivered,
amended,
or
renewed
on
or
after
July
1,
1996,
and
34
which
provides
maternity
benefits,
which
are
not
limited
to
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complications
of
pregnancy,
or
newborn
care
benefits,
shall
1
provide
coverage
for
maternity
services
rendered
by
a
midwife
2
licensed
pursuant
to
chapter
148I,
regardless
of
the
site
of
3
services,
in
accordance
with
guidelines
adopted
by
rule
by
the
4
commissioner.
5
2.
Coverage
for
maternity
services
provided
by
a
licensed
6
midwife
shall
not
be
subject
to
any
greater
copayment,
7
deductible,
or
coinsurance
than
is
applicable
to
any
other
8
similar
benefits
provided
by
the
plan.
9
3.
A
person
who
provides
an
individual
or
group
policy
of
10
accident
or
health
insurance
or
individual
or
group
hospital
or
11
health
care
service
contract
issued
pursuant
to
chapter
509,
12
509A,
514,
or
514A
or
an
individual
or
group
health
maintenance
13
organization
contract
issued
and
regulated
under
chapter
514B
14
may
require
that
maternity
services
be
provided
by
a
licensed
15
midwife
under
contract
with
the
person.
16
Sec.
14.
INITIAL
APPOINTMENTS.
17
1.
Notwithstanding
any
provision
to
the
contrary
in
this
18
Act,
the
initial
midwife
appointees
to
the
board
of
midwifery
19
created
pursuant
to
this
Act
shall
fulfill
the
national
20
certification
requirements
of
the
North
American
registry
of
21
midwives
or
its
successor
organization.
22
2.
One
of
the
initial
midwife
appointments
to
the
board
23
shall
be
appointed
for
a
one-year
term,
one
shall
be
appointed
24
for
a
two-year
term,
one
shall
be
appointed
for
a
three-year
25
term,
and
one
shall
be
appointed
for
a
four-year
term.
The
26
member
who
is
licensed
under
chapter
148
shall
be
appointed
for
27
a
two-year
term,
the
member
representing
the
general
public
28
shall
be
appointed
to
a
three-year
term,
and
the
member
who
is
29
a
certified
nurse
midwife
shall
be
appointed
to
a
four-year
30
term.
31
EXPLANATION
32
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
33
the
explanation’s
substance
by
the
members
of
the
general
assembly.
34
This
bill
relates
to
the
practice
of
midwifery
in
Iowa.
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The
bill
requires
a
person
practicing
midwifery
in
Iowa
1
to
obtain
a
license
to
practice
beginning
July
1,
2023.
The
2
bill
exempts
from
regulation
health
care
providers
providing
3
services
consistent
with
midwifery,
members
of
Native
American
4
tribes
or
Mennonite
or
Amish
communities
providing
traditional
5
midwife
services,
persons
who
gratuitously
engage
in
the
6
practice
of
the
religious
tenets
of
a
church
or
a
religious
7
act,
student
midwives,
and
persons
rendering
emergency
aid.
8
Prior
to
obtaining
a
midwifery
license,
a
person
must
be
at
9
least
21
years
of
age,
submit
proof
of
a
high
school
diploma
or
10
equivalent,
submit
a
fee,
submit
proof
of
having
completed
an
11
educational
program
or
pathway,
and
hold
a
current
certified
12
professional
midwife
certificate
from
the
North
American
13
registry
of
midwives.
The
bill
prohibits
any
person
other
than
14
a
licensed
midwife
from
using
the
title
“licensed
midwife”.
15
The
bill
provides
an
alternative
means
to
completion
of
an
16
educational
program
or
pathway
for
persons
who
received
a
17
certified
professional
midwife
certification
prior
to
July
1,
18
2023,
or
who
received
a
license
from
a
state
that
does
not
19
require
completion
of
an
educational
program
or
pathway.
20
The
bill
creates
the
board
of
midwifery
to
regulate
the
21
practice
of
midwifery
in
Iowa
and
makes
conforming
changes
to
22
Code
chapters
147
and
272C.
The
bill
requires
the
board
to
23
adopt
certain
rules
for
the
practice
of
midwifery
and
prohibits
24
the
board
from
adopting
rules
allowing
a
licensed
midwife
to
25
order
or
administer
narcotics,
limiting
the
locations
where
26
a
midwife
may
practice,
or
requiring
a
midwife
to
practice
27
under
a
collaborative
practice
agreement
with
another
health
28
care
provider.
The
bill
provides
certain
requirements
for
29
membership
on
the
board
of
midwifery.
30
The
bill
limits
the
liability
of
a
health
care
provider
31
accepting
a
transfer
of
clients
from
a
licensed
midwife
with
32
respect
to
outcomes
that
are
the
result
of
actions
of
the
33
midwife.
The
bill
also
requires
insurance
providers
that
34
provide
maternity
benefits
to
cover
maternity
services
provided
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