House
File
2169
-
Introduced
HOUSE
FILE
2169
BY
KAUFMANN
A
BILL
FOR
An
Act
providing
for
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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2169
Section
1.
Section
147.1,
subsections
3
and
6,
Code
2018,
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,
physician
assistant,
psychologist,
chiropractor,
5
nurse,
dentist,
dental
hygienist,
dental
assistant,
6
optometrist,
speech
pathologist,
audiologist,
pharmacist,
7
physical
therapist,
physical
therapist
assistant,
occupational
8
therapist,
occupational
therapy
assistant,
orthotist,
9
prosthetist,
pedorthist,
respiratory
care
practitioner,
10
practitioner
of
cosmetology
arts
and
sciences,
practitioner
11
of
barbering,
funeral
director,
dietitian,
marital
and
family
12
therapist,
mental
health
counselor,
respiratory
care
and
13
polysomnography
practitioner,
polysomnographic
technologist,
14
social
worker,
massage
therapist,
midwife,
athletic
trainer,
15
acupuncturist,
nursing
home
administrator,
hearing
aid
16
specialist,
or
sign
language
interpreter
or
transliterator
17
means
a
person
licensed
under
this
subtitle
.
18
6.
“Profession”
means
medicine
and
surgery,
podiatry,
19
osteopathic
medicine
and
surgery,
practice
as
a
physician
20
assistant,
psychology,
chiropractic,
nursing,
dentistry,
21
dental
hygiene,
dental
assisting,
optometry,
speech
pathology,
22
audiology,
pharmacy,
physical
therapy,
physical
therapist
23
assisting,
occupational
therapy,
occupational
therapy
24
assisting,
respiratory
care,
cosmetology
arts
and
sciences,
25
barbering,
mortuary
science,
marital
and
family
therapy,
mental
26
health
counseling,
polysomnography,
social
work,
dietetics,
27
massage
therapy,
midwifery,
athletic
training,
acupuncture,
28
nursing
home
administration,
practice
as
a
hearing
aid
29
specialist,
sign
language
interpreting
or
transliterating,
30
orthotics,
prosthetics,
or
pedorthics.
31
Sec.
2.
Section
147.13,
Code
2018,
is
amended
by
adding
the
32
following
new
subsection:
33
NEW
SUBSECTION
.
25.
For
midwifery,
the
board
of
midwifery.
34
Sec.
3.
Section
147.14,
subsection
1,
Code
2018,
is
amended
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by
adding
the
following
new
paragraph:
1
NEW
PARAGRAPH
.
x.
For
midwifery,
a
total
of
seven
members,
2
four
members
who
are
licensed
midwives
under
chapter
148H;
3
one
member
who
is
licensed
under
chapter
148,
is
a
practicing
4
family
physician,
and
has
professional
experience
consulting
5
for
and
collaborating
with
direct-entry
midwives;
and
two
6
members
who
are
not
licensed
midwives
or
licensed
health
care
7
providers
who
have
received
direct-entry
midwifery
services
and
8
who
shall
represent
the
general
public.
9
Sec.
4.
Section
147.74,
Code
2018,
is
amended
by
adding
the
10
following
new
subsection:
11
NEW
SUBSECTION
.
26.
A
midwife
licensed
under
chapter
148H
12
may
use
the
words
“licensed
midwife”
or
the
initials
“L.M.”
13
after
the
person’s
name.
14
Sec.
5.
NEW
SECTION
.
148H.1
Midwifery
licensure
——
15
legislative
findings
and
intent.
16
The
general
assembly
recognizes
the
need
for
a
person
to
have
17
the
freedom
to
choose
the
manner,
cost,
and
setting
for
giving
18
birth.
The
general
assembly
finds
that
access
to
prenatal
care
19
and
delivery
services
is
limited
by
the
inadequate
number
of
20
providers
of
such
services
and
that
the
practice
of
midwifery
21
may
help
to
reduce
this
shortage.
The
general
assembly
also
22
recognizes
the
need
for
the
safe
and
effective
delivery
of
23
newborn
babies
and
the
health,
safety,
and
welfare
of
their
24
mothers
in
the
delivery
process.
The
general
assembly,
in
25
the
interest
of
public
health,
promotes
the
regulation
of
the
26
practice
of
midwifery
in
Iowa
for
the
purpose
of
protecting
the
27
health
and
welfare
of
women
and
infants.
The
general
assembly
28
recognizes
that
midwifery
is
a
profession
in
its
own
right
and
29
that
it
is
not
the
practice
of
medicine
or
nursing.
30
Sec.
6.
NEW
SECTION
.
148H.2
Definitions.
31
As
used
in
this
chapter,
unless
the
context
otherwise
32
requires:
33
1.
“Board”
means
the
board
of
midwifery
created
pursuant
to
34
chapter
147.
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2.
“Licensed
midwife”
means
a
person
who
is
licensed
to
1
practice
midwifery
as
provided
in
this
chapter
and
has
obtained
2
national
certification
from
the
North
American
registry
of
3
midwives
or
a
successor
organization.
4
3.
“Midwife”
means
a
person
who
is
trained
to
give
the
5
necessary
care
and
advice
to
a
woman
during
pregnancy,
labor,
6
and
the
post-birth
period,
to
conduct
normal
deliveries
on
7
the
midwife’s
own
responsibility,
and
to
care
for
the
newly
8
born
infant,
and
who
is
able
to
recognize
the
warning
signs
of
9
abnormal
conditions
requiring
referral
to
or
collaboration
with
10
a
physician.
11
4.
“Midwifery”
means
the
practice
of
attending
to
a
woman
12
experiencing
a
low-risk
pregnancy
during
pregnancy,
labor,
and
13
the
post-birth
period
with
the
informed
consent
of
the
woman,
14
and
the
provision
of
comprehensive
care
of
the
pregnant
woman
15
during
the
antepartum
phase,
intrapartum
phase,
and
postpartum
16
phase,
and
the
application
of
emergency
care
when
necessary.
17
5.
“Out-of-hospital”
means
any
facility,
institution,
or
18
place
which
is
not
an
ambulatory
surgical
center
or
a
hospital,
19
such
as
a
birth
center
as
defined
in
section
135.61
or
a
20
private
home.
21
Sec.
7.
NEW
SECTION
.
148H.3
Licensure
——
licensed
22
midwifery.
23
1.
Except
as
provided
in
section
148H.7,
subsection
1,
24
beginning
July
1,
2018,
every
person
practicing
as
a
licensed
25
midwife
in
this
state
shall
be
licensed
pursuant
to
this
26
chapter.
The
board
shall
adopt
rules
pursuant
to
chapters
17A,
27
147,
and
272C
establishing
procedures
for
the
licensure
of
new
28
and
practicing
midwives.
29
2.
Prior
to
obtaining
licensure,
an
applicant
shall
30
successfully
pass
an
examination
prescribed
and
approved
by
the
31
board
by
rule
demonstrating
competencies
in
at
least
all
of
32
the
following
areas:
risk
assessment
and
management;
prenatal
33
care;
management
of
normal
labor,
birth,
and
postpartum;
34
newborn
care
up
to
six
weeks;
and
adult
cardiopulmonary
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resuscitation
and
newborn
resuscitation.
1
3.
The
applicant
shall
hold
a
certified
professional
2
midwife
credential
issued
by
the
North
American
registry
of
3
midwives
or
any
other
nationally
accredited
credential
as
4
specified
by
the
board.
If
an
applicant
has
been
subject
to
5
prior
revocation
of
a
license
to
practice
medicine
or
nursing,
6
the
applicant
shall
not
be
eligible
for
licensure
under
this
7
chapter,
except
as
determined
by
the
board.
8
4.
The
board
may
request,
at
the
applicant’s
expense,
that
9
the
department
of
public
safety
perform
a
criminal
history
10
check
and
the
department
of
human
services
perform
child
and
11
dependent
adult
abuse
record
checks
of
the
applicant.
If
an
12
applicant
has
a
criminal
record
or
a
record
of
founded
child
or
13
dependent
adult
abuse,
the
board
shall
perform
an
evaluation
to
14
determine
whether
the
record
warrants
denial
of
licensure.
15
Sec.
8.
NEW
SECTION
.
148H.4
Use
of
title
——
penalty.
16
A
person
shall
not
use
the
title
“licensed
midwife”,
17
describe
or
imply
that
the
person
is
a
licensed
midwife,
or
18
represent
the
person
as
a
licensed
midwife
unless
the
person
is
19
licensed
under
this
chapter
or
is
licensed
as
a
nurse-midwife
20
under
chapter
152.
21
Sec.
9.
NEW
SECTION
.
148H.5
Rules.
22
1.
The
board
shall:
23
a.
Adopt
rules
relating
to
standards
for
professional
24
conduct
of
persons
licensed
under
this
chapter.
25
b.
Adopt
rules
consistent
with
this
chapter
and
with
26
chapters
17A,
147,
and
272C
which
are
necessary
for
the
27
performance
of
the
board’s
duties.
28
c.
Act
on
matters
concerning
licensure
and
the
processes
29
of
applying
for,
granting,
suspending,
imposing
supervisory
30
or
probationary
conditions
upon,
reinstating,
and
revoking
a
31
license.
32
d.
Administer
the
provisions
of
this
chapter
requiring
33
documentation
required
to
demonstrate
competence
as
a
midwife,
34
and
the
processing
of
applications
for
licenses
and
license
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renewal.
1
e.
Develop
continuing
education
requirements
as
a
condition
2
of
license
renewal.
3
f.
Evaluate
requirements
for
licensure
in
other
states
to
4
determine
if
reciprocity
may
be
granted.
5
g.
Establish
and
collect
licensure
fees
as
provided
in
6
section
147.80
and
retain
fees
as
provided
in
section
147.82.
7
h.
Establish
procedures
for
the
issuance,
renewal,
and
8
revocation
or
suspension
of
a
license
under
this
chapter.
9
i.
Maintain
a
registry
of
licensed
midwives
and
statistics
10
on
the
practice
of
midwifery
utilizing
vital
statistics
data.
11
2.
In
developing
rules,
the
board
may
consult
with
12
persons
knowledgeable
regarding
the
prenatal
and
postpartum
13
birth
process,
particularly
those
possessing
experience
14
with
out-of-hospital
births,
including
but
not
limited
to
15
persons
licensed
under
chapter
148,
certified
professional
16
midwives,
advanced
registered
nurse
practitioners
who
are
17
certified
nurse-midwives,
and
women
who
have
given
birth
in
18
an
out-of-hospital
setting.
In
developing
rules
relating
19
to
the
practice
of
midwifery,
the
board
shall
reflect
the
20
knowledge
and
skills
identified
by
the
North
American
registry
21
of
midwives’
current
job
description
for
the
profession
and
the
22
standards
of
practice
of
midwifery
established
by
the
national
23
association
of
certified
professional
midwives
or
a
successor
24
organization.
25
3.
Rules
relating
to
the
practice
of
midwifery
shall
be
26
consistent
with
the
North
American
registry
of
midwives’
27
current
job
description
for
the
profession
and
the
standards
28
of
practice
of
midwifery
established
by
the
national
29
association
of
certified
professional
midwives
or
a
successor
30
organization,
and
shall
not
expand
the
scope
of
practice
of
31
midwifery
established
by
the
national
association
of
certified
32
professional
midwives
or
a
successor
organization.
33
Sec.
10.
NEW
SECTION
.
148H.6
Client
disclosure.
34
Prior
to
accepting
a
patient
for
midwifery
care,
a
licensed
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midwife
shall
provide
information
to
the
patient
indicating
all
1
of
the
following:
2
1.
Evidence
that
the
care
provider
is
a
licensed
midwife
3
meeting
the
requirements
of
this
chapter.
4
2.
Whether
the
licensed
midwife
has
malpractice
liability
5
insurance
coverage
and
the
policy
limits
of
such
coverage.
6
3.
The
midwife’s
educational
background
and
relevant
7
experience,
including
experience
in
various
birth
settings.
8
4.
The
nature,
scope,
and
location
of
the
care
to
be
9
given,
including
the
possibility
of
and
the
guidelines
for
10
consultation,
referral,
or
transfer
of
the
patient
to
a
11
hospital
from
an
out-of-hospital
setting.
12
Sec.
11.
NEW
SECTION
.
148H.7
Exceptions.
13
1.
This
chapter
does
not
prevent
qualified
members
of
other
14
professions
including
but
not
limited
to
individuals
licensed
15
under
chapter
148
or
152
from
providing
services
consistent
16
with
the
nature
of
the
practice
of
midwifery.
17
2.
This
chapter
does
not
prevent
or
prohibit
a
student
18
midwife
from
performing
tasks
related
to
the
practice
of
19
midwifery
under
the
supervision
of
a
licensed
midwife,
a
20
certified
nurse-midwife,
or
a
licensed
physician
during
21
completion
of
the
licensure
process.
22
3.
The
practice
of
midwifery
in
this
state
prior
to
July
1,
23
2018,
shall
not
constitute
grounds
for
disciplinary
action
by
24
the
board.
The
board
may
issue
a
license
to
a
person
who
has
25
practiced
midwifery
in
this
state
prior
to
that
date
upon
that
26
person’s
application
and
compliance
with
the
provisions
of
this
27
chapter
and
the
rules
adopted
pursuant
to
this
chapter.
28
Sec.
12.
NEW
SECTION
.
148H.8
Requirements
for
licensure
——
29
temporary
license.
30
Beginning
July
1,
2018,
an
individual
who
does
not
meet
31
the
requirements
for
licensure
by
examination
pursuant
to
32
section
148H.3
may
apply
for
a
one-year
temporary
license,
the
33
qualifications
for
which
shall
be
determined
by
the
board
by
34
rule.
Renewal
of
the
temporary
license
shall
be
determined
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by
the
board.
The
board
may
revoke
a
temporary
license
if
it
1
determines
that
the
temporary
licensee
has
violated
standards
2
established
by
rule.
3
Sec.
13.
Section
272C.1,
subsection
6,
Code
2018,
is
amended
4
by
adding
the
following
new
paragraph:
5
NEW
PARAGRAPH
.
ah.
The
board
of
midwifery,
created
pursuant
6
to
chapter
147.
7
Sec.
14.
Section
272C.4,
subsection
6,
Code
2018,
is
amended
8
to
read
as
follows:
9
6.
Define
by
rule
acts
or
omissions
that
are
grounds
for
10
revocation
or
suspension
of
a
license
under
section
100D.5
,
11
105.22
,
147.55
,
148.6
,
148B.7
,
148H.5,
152.10
,
153.34
,
154A.24
,
12
169.13
,
455B.219
,
542.10
,
542B.21
,
543B.29
,
544A.13
,
544B.15
,
13
or
602.3203
or
chapter
151
or
155
,
as
applicable,
and
to
define
14
by
rule
acts
or
omissions
that
constitute
negligence,
careless
15
acts,
or
omissions
within
the
meaning
of
section
272C.3,
16
subsection
2
,
paragraph
“b”
,
which
licensees
are
required
to
17
report
to
the
board
pursuant
to
section
272C.9,
subsection
2
.
18
Sec.
15.
INITIAL
APPOINTMENTS.
19
1.
Notwithstanding
any
provision
to
the
contrary
in
this
20
Act,
the
initial
midwife
appointees
to
the
board
of
midwifery
21
created
pursuant
to
this
Act
shall
fulfill
the
national
22
certification
requirements
of
the
North
American
registry
of
23
midwives
or
a
successor
organization.
24
2.
One
of
the
initial
midwife
appointments
to
the
board
25
shall
be
appointed
for
a
one-year
term,
one
shall
be
appointed
26
for
a
two-year
term,
and
one
shall
be
appointed
for
a
27
three-year
term.
The
member
who
is
licensed
under
chapter
28
148
shall
be
appointed
for
a
two-year
term,
and
the
members
29
representing
the
general
public
shall
each
be
appointed
to
a
30
three-year
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
creates
new
Code
chapter
148H
that
provides
for
35
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the
licensure
of
midwives
beginning
July
1,
2018.
A
midwife,
1
as
defined
by
the
bill,
provides
comprehensive
maternity
care
2
to
low-risk
women
during
the
antepartum,
intrapartum,
or
3
postpartum
period.
4
The
bill
provides
for
the
establishment
of
a
seven-member
5
board
of
midwifery
consisting
of
four
members
who
are
midwives,
6
one
physician,
and
two
members
who
represent
the
general
7
public.
The
bill
provides
for
fees
to
fund
the
board
and
8
provides
penalties
for
violation
of
the
licensure
requirement;
9
those
penalties
are
set
out
for
all
health-related
boards
in
10
Code
chapters
147
and
272C.
Code
section
147.86
provides
that
11
it
is
a
serious
misdemeanor
to
violate
a
provision
of
the
12
licensing
laws.
13
The
board
is
similar
in
composition
and
responsibilities
to
14
other
health-related
licensing
boards.
15
The
bill
provides
that
a
midwife
practicing
prior
to
16
the
effective
date
of
the
bill
is
not
required
to
take
an
17
examination
for
licensure.
18
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