House Study Bill 229
HOUSE FILE
BY (PROPOSED COMMITTEE ON
STATE GOVERNMENT BILL BY
CHAIRPERSON MASCHER)
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the licensing of midwives under a title Act
2 and providing for a fee and a penalty.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 2311HC 83
5 jr/rj/14
PAG LIN
1 1 Section 1. Section 147.1, subsections 3 and 6, Code 2009,
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, respiratory care
1 10 practitioner, practitioner of cosmetology arts and sciences,
1 11 practitioner of barbering, funeral director, dietitian,
1 12 marital and family therapist, mental health counselor, social
1 13 worker, massage therapist, midwife, athletic trainer,
1 14 acupuncturist, nursing home administrator, hearing aid
1 15 dispenser, or sign language interpreter or transliterator
1 16 means a person licensed under this subtitle.
1 17 6. "Profession" means medicine and surgery, podiatry,
1 18 osteopathic medicine and surgery, practice as a physician
1 19 assistant, psychology, chiropractic, nursing, dentistry,
1 20 dental hygiene, dental assisting, optometry, speech pathology,
1 21 audiology, pharmacy, physical therapy, physical therapist
1 22 assisting, occupational therapy, occupational therapy
1 23 assisting, respiratory care, cosmetology arts and sciences,
1 24 barbering, mortuary science, marital and family therapy,
1 25 mental health counseling, social work, dietetics, massage
1 26 therapy, midwifery, athletic training, acupuncture, nursing
1 27 home administration, hearing aid dispensing, or sign language
1 28 interpreting or transliterating.
1 29 Sec. 2. Section 147.2, subsection 1, Code 2009, is amended
1 30 to read as follows:
1 31 1. A person shall not engage in the practice of medicine
1 32 and surgery, podiatry, osteopathic medicine and surgery,
1 33 psychology, chiropractic, physical therapy, physical therapist
1 34 assisting, nursing, dentistry, dental hygiene, dental
1 35 assisting, optometry, speech pathology, audiology,
2 1 occupational therapy, occupational therapy assisting,
2 2 respiratory care, pharmacy, cosmetology arts and sciences,
2 3 barbering, social work, dietetics, marital and family therapy
2 4 or mental health counseling, massage therapy, midwifery,
2 5 mortuary science, athletic training, acupuncture, nursing home
2 6 administration, hearing aid dispensing, or sign language
2 7 interpreting or transliterating, or shall not practice as a
2 8 physician assistant, unless the person has obtained a license
2 9 for that purpose from the board for the profession.
2 10 Sec. 3. Section 147.13, Code 2009, is amended by adding
2 11 the following new subsection:
2 12 NEW SUBSECTION. 24. For midwifery, the board of
2 13 midwifery.
2 14 Sec. 4. Section 147.14, subsection 1, Code 2009, is
2 15 amended by adding the following new paragraph:
2 16 NEW PARAGRAPH. x. For midwifery, a total of five members,
2 17 three members who are licensed professional midwives, one
2 18 member who either is licensed under chapter 148, is practicing
2 19 in obstetrics, and has professional experience consulting for
2 20 and collaborating with direct=entry midwives, or is an
2 21 advanced registered nurse practitioner licensed under chapter
2 22 152, is a certified nurse midwife, and has professional
2 23 experience consulting for and collaborating with direct=entry
2 24 midwives, and one member who is not a licensed midwife or a
2 25 licensed health care provider who has received direct=entry
2 26 midwifery services and who shall represent the general public.
2 27 Sec. 5. Section 147.74, Code 2009, is amended by adding
2 28 the following new subsection:
2 29 NEW SUBSECTION. 5A. A midwife licensed under chapter 148F
2 30 may use the words "licensed midwife" or the initials "L.M."
2 31 after the person's name.
2 32 Sec. 6. NEW SECTION. 148F.1 DEFINITIONS.
2 33 As used in this chapter, unless the context otherwise
2 34 requires:
2 35 1. "Board" means the board of midwifery.
3 1 2. "Licensed midwife" means a person who is licensed to
3 2 practice midwifery under this chapter.
3 3 3. "Out=of=hospital" means any facility, institution, or
3 4 place which is not an ambulatory surgical center or a
3 5 hospital, such as a birth center as defined in section 135.61
3 6 or a private home.
3 7 4. "Practice of midwifery" means the provision of primary
3 8 maternity care during the antepartum, intrapartum, and
3 9 postpartum periods by a person who is neither licensed to
3 10 practice under chapter 148, nor a nurse recognized by the Iowa
3 11 board of nursing as an advanced registered nurse practitioner
3 12 who is a certified nurse midwife, and who is not rendering
3 13 emergency services without compensation.
3 14 Sec. 7. NEW SECTION. 148F.2 LICENSURE == LICENSED
3 15 MIDWIFERY.
3 16 An applicant for a license to practice midwifery shall be
3 17 granted a license by the board when the applicant satisfies
3 18 all of the following requirements:
3 19 1. Has submitted an application in a form prescribed by
3 20 the department.
3 21 2. Has paid a fee as determined by the board.
3 22 3. Has fulfilled national certification requirements of
3 23 the North American registry of midwives or its successor
3 24 organization.
3 25 4. Holds current adult cardiopulmonary resuscitation and
3 26 newborn resuscitation certifications through an organization
3 27 approved by the department in collaboration with the board.
3 28 Sec. 8. NEW SECTION. 148F.3 USE OF TITLE == PENALTY.
3 29 A person shall not use the title "licensed midwife",
3 30 describe or imply that the person is a licensed midwife, or
3 31 represent the person as a licensed midwife unless the person
3 32 is granted a license under this chapter or is licensed as a
3 33 nurse=midwife under chapter 152.
3 34 Sec. 9. NEW SECTION. 148F.4 RULES.
3 35 1. The board shall adopt rules relating to:
4 1 a. Standards for professional conduct of persons licensed
4 2 under this chapter.
4 3 b. The administration of this chapter.
4 4 c. The application of the certification requirements of
4 5 the North American registry of midwives or its successor
4 6 organization to criteria for licensure as a midwife under this
4 7 chapter.
4 8 d. Procedures for the issuance, renewal, and revocation or
4 9 suspension of a license under this chapter based on
4 10 qualifications, standards, and scope of practice established
4 11 by the North American registry of midwives or its successor
4 12 organization.
4 13 e. The maintenance of a registry of licensed midwives and
4 14 statistics on the practice of midwifery utilizing vital
4 15 statistics data.
4 16 2. In establishing rules, the board shall consult with
4 17 persons knowledgeable regarding the prenatal and postpartum
4 18 birth process, particularly those possessing experience with
4 19 out=of=hospital births, including but not limited to persons
4 20 licensed under chapter 148, certified professional midwives,
4 21 advanced registered nurse practitioners who are certified
4 22 nurse midwives, and women who have given birth in an
4 23 out=of=hospital setting.
4 24 3. Rules regarding the practice of midwifery shall be
4 25 consistent with the North American registry of midwives'
4 26 current job description for the profession and the standards
4 27 regarding the practice of midwifery established by the
4 28 national association of certified professional midwives or a
4 29 successor organization, including guidelines for consultation,
4 30 referral, and transfer of care to the hospital setting when
4 31 appropriate.
4 32 4. Rules may permit a licensed midwife to carry and
4 33 administer certain medications during the practice of
4 34 midwifery, including oxytocin, as a postpartum antihemorrhagic
4 35 agent, oxygen, intravenous fluids for stabilization, vitamin
5 1 K, eye prophylactics, and other drugs or procedures as
5 2 appropriate for the scope of practice for licensed midwives
5 3 and as determined by the board.
5 4 5. Rules shall not permit a licensed midwife to use
5 5 forceps or vacuum extraction, or perform a surgical delivery.
5 6 Sec. 10. NEW SECTION. 148F.5 CLIENT DISCLOSURE.
5 7 Prior to accepting a patient for midwifery care, a licensed
5 8 midwife shall provide information indicating all of the
5 9 following:
5 10 1. Evidence that the care provider is a licensed midwife
5 11 meeting the requirements of this chapter.
5 12 2. Whether the licensed midwife has malpractice liability
5 13 insurance coverage and the policy limits of such coverage.
5 14 3. The midwife's educational background and relevant
5 15 experience, including experience in various birth settings.
5 16 4. The nature, scope, and location of the care to be
5 17 given, including the possibility of and the guidelines for
5 18 consultation, referral, or transfer of the patient to a
5 19 hospital from an out=of=hospital setting.
5 20 Sec. 11. NEW SECTION. 148F.6 EXCEPTIONS.
5 21 1. This chapter does not prevent qualified members of
5 22 other professions, including but not limited to, individuals
5 23 licensed under chapter 148 or 152 from providing services
5 24 consistent with the nature of midwifery.
5 25 2. This chapter does not prevent or prohibit any person
5 26 from performing tasks related to the practice of midwifery
5 27 under the supervision of a licensed midwife, a certified nurse
5 28 midwife, or a licensed physician or osteopathic physician
5 29 during completion of the North American registry of midwives
5 30 certification process.
5 31 3. The practice of midwifery in Iowa prior to the
5 32 effective date of this chapter shall not constitute grounds
5 33 for disciplinary action by the board. The board may issue a
5 34 license to a person who has so practiced midwifery in Iowa
5 35 upon application and compliance with the provisions of this
6 1 chapter and the rules adopted pursuant to this chapter.
6 2 Sec. 12. NEW SECTION. 148F.7 LIABILITY.
6 3 Persons licensed under chapters 148 and 152 and other
6 4 licensed health care providers shall not be held liable for
6 5 the acts or omissions of a licensed midwife when they render
6 6 birth=related services to the client of a licensed midwife.
6 7 The liability of those licensed individuals in rendering care
6 8 or assistance in good faith to a client of a licensed midwife
6 9 is limited to the standard of care of the licensed
6 10 individual's profession as applied to the licensed
6 11 individual's own negligence or acts or omissions.
6 12 Sec. 13. Section 272C.1, subsection 6, Code 2009, is
6 13 amended by adding the following new paragraph:
6 14 NEW PARAGRAPH. af. The board of midwifery, created
6 15 pursuant to chapter 147.
6 16 Sec. 14. Section 272C.4, subsection 6, Code 2009, is
6 17 amended to read as follows:
6 18 6. Define by rule acts or omissions that are grounds for
6 19 revocation or suspension of a license under section 105.22,
6 20 147.55, 148.6, 148B.7, 148F.4, 152.10, 153.34, 154A.24,
6 21 169.13, 455B.219, 542.10, 542B.21, 543B.29, 544A.13, 544B.15,
6 22 or 602.3203 or chapter 151 or 155, as applicable, and to
6 23 define by rule acts or omissions that constitute negligence,
6 24 careless acts, or omissions within the meaning of section
6 25 272C.3, subsection 2, paragraph "b", which licensees are
6 26 required to report to the board pursuant to section 272C.9,
6 27 subsection 2.
6 28 Sec. 15. INITIAL APPOINTMENTS.
6 29 1. Initial professional appointees to the board of
6 30 midwifery shall fulfill the national certification
6 31 requirements of the North American registry of midwives.
6 32 2. One of the initial professional appointments to the
6 33 board shall be appointed for a one=year term, one member shall
6 34 be appointed for a two=year term, and one member shall be
6 35 appointed for a three=year term. The member who is licensed
7 1 under chapter 148 or 152 shall be appointed for a two=year
7 2 term, and the member representing the general public shall be
7 3 appointed to a three=year term.
7 4 EXPLANATION
7 5 This bill creates new Code chapter 148F that provides for
7 6 the licensure of midwives under a title Act. A midwife is not
7 7 an allopathic or osteopathic physician licensed under Code
7 8 chapter 148 or a nurse licensed under Code chapter 152
7 9 providing primary maternity care during the antepartum,
7 10 intrapartum, and postpartum periods.
7 11 The bill provides for the establishment of a five=member
7 12 board of midwifery consisting of three members who are
7 13 midwives, one physician or nurse, and one member who
7 14 represents the general public. The bill provides for fees to
7 15 fund the board and provides penalties for violation of the
7 16 practice requirement; those penalties are set out for all
7 17 health=related boards in Code chapters 147 and 272C. Code
7 18 section 147.86 provides that it is a serious misdemeanor to
7 19 violate a provision of the licensing laws.
7 20 The board is similar in composition and responsibilities to
7 21 other health=related licensing boards.
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