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

Sponsored by the House Ways and Means (successor To Hsb 123) Committee

Topics:Health care Insurance Professional licensing

Same legislation: HSB 123, HF 2291

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Official bill page Lobbyist declarations One-pager to print

Where it is now

Done: IntroducedFebruary 8, 2022
Done: SubcommitteeFebruary 9, 2022
Done: House committeeMarch 1, 2022
Done: Passes the HouseMarch 7, 202293–2
Done: Senate committeeMarch 16, 2022
Stopped: Passes the SenateDied when the General Assembly ended
Next: To the Governor
Next: Signed into law

Died when the session ended The 2022 session adjourned on May 24, 2022, the General Assembly’s last regular session. Bills that didn’t pass both chambers died. What’s a funnel?

What’s in it

AI summary Starting in July 2023, people practicing midwifery in Iowa must obtain a license and follow rules set by a new board of midwifery. This law protects the title "licensed midwife" for those with the proper training and ensures insurance companies cover their services. Certain groups, such as students, emergency responders, and those providing traditional services in specific communities, are exempt from these new rules.¹

Read the official explanation

This bill relates to the practice of midwifery in Iowa. The bill requires a person practicing midwifery in Iowa to obtain a license to practice beginning July 1, 2023. The bill exempts from regulation health care providers providing services consistent with midwifery, members of Native American tribes or Mennonite or Amish communities providing traditional midwife services, persons who gratuitously engage in the practice of the religious tenets of a church or a religious act, student midwives, and persons rendering emergency aid. Prior to obtaining a midwifery license, a person must be at least years of age, submit proof of a high school diploma or equivalent, submit a fee, submit proof of having completed an educational program or pathway, and hold a current certified professional midwife certificate from the North American registry of midwives. The bill prohibits any person other than a licensed midwife from using the title “licensed midwife”. The bill provides an alternative means to completion of an educational program or pathway for persons who received a certified professional midwife certification prior to July 1, 2023, or who received a license from a state that does not require completion of an educational program or pathway. The bill creates the board of midwifery to regulate the practice of midwifery in Iowa and makes conforming changes to Code chapters 147 and 272C. The bill requires the board to adopt certain rules for the practice of midwifery and prohibits the board from adopting rules allowing a licensed midwife to order or administer narcotics, limiting the locations where a midwife may practice, or requiring a midwife to practice under a collaborative practice agreement with another health care provider. The bill provides certain requirements for membership on the board of midwifery. The bill limits the liability of a health care provider accepting a transfer of clients from a licensed midwife with respect to outcomes that are the result of actions of the midwife. The bill also requires insurance providers that provide maternity benefits to cover maternity services provided by licensed midwives on the same terms as for similar benefits provided by other providers.

Full bill text²

Senate subcommittee

Named March 14, 2022. On March 15, 2022 it recommended amendment and passage.

Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part

Fiscal note

Cost: up to $122,000 Compare with other bills

AI summary This bill requires people practicing midwifery in Iowa to obtain a license and creates a Board of Midwifery to regulate the practice. The Iowa Department of Public Health estimates initial start-up costs of $216,000 and ongoing costs of $122,000 for every two-year licensing cycle from the state's funds. The Iowa Insurance Division and the Iowa Hospital Association expect no appreciable fiscal impact.³

Read the fiscal note

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.