Relating to midwife licensure, providing for fees, and making penalties applicable

Description

House File 2547 requires a person practicing midwifery in Iowa to obtain a license to practice beginning July 1, 2023, with exclusions listed for certain classes. The Bill prohibits any person other than a licensed midwife from using the title “licensed midwife.” The Bill also creates the Board of Midwifery to regulate the practice of midwifery in Iowa and makes conforming changes. House File 2547 also limits the liability of a health care provider accepting a transfer of clients from a licensed midwife and requires insurance providers to provide maternity benefits to cover maternity services provided by licensed midwives on the same terms as for similar benefits provided by other health care providers.

Assumptions

The University of Iowa reports there were 138 certified nurse-midwives employed in Iowa in 2018. The costs associated with establishing a new licensing board and the required fees to sustain the licensing board are calculated based on this number.

Fiscal Impact

The Iowa Department of Public Health (IDPH) reports that initial start-up costs of establishing a new licensing board would require an estimated $216,000 and 0.4 full-time equivalent (FTE) position. Ongoing costs are anticipated by the IDPH to be $122,000 for every two-year licensing cycle.

The IDPH attributes the start-up costs to the extensive staff time needed to establish the new licensing board, including time for researching and developing administrative rules for licensure and discipline and time for updating the licensing software application to establish the new board and all of the associated requirements for licensure. Of the $216,000 in start-up costs, an estimated $94,000 will be dedicated to contracting with the IDPH’s third-party information technology vendor to perform software and database upgrades to accommodate the new board. The 0.4 FTE position includes 0.2 FTE position assigned to a board executive and 0.2 FTE position assigned to legal counsel.

Absent an appropriation to assist with start-up costs, and based on the number of active certified nurse-midwives reported by the University of Iowa, the initial licensure fees required to cover the costs of establishing the Board will be set at approximately $1,563. The renewal fee to sustain the Board’s ongoing activities would need to be set at approximately $443. The IDPH mentioned in its response a potential cost-saving alternative of creating a new license class under the Board of Nursing or other existing board rather than creating a new board. The Iowa Insurance Division of the Department of Commerce and the Iowa Hospital Association report that they would incur no appreciable fiscal impact by the proposed legislation.

Sources

• Iowa Department of Public Health
• Iowa Insurance Division, Department of Commerce
• Iowa Hospital Association