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SENATE BILL NO. 192
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-SECOND LEGISLATURE - SECOND SESSION
BY SENATOR KAWASAKI
Introduced: 2/15/22
Referred: Health and Social Services, Labor and Commerce, Finance
A BILL
FOR AN ACT ENTITLED
1 "An Act relating to midwives and the practice of midwifery; relating to apprentice
2 midwives; relating to the licensing of midwives; relating to insurance requirements for
3 the practice of midwifery; and providing for an effective date."
4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:
5 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section
6 to read:
7 LEGISLATIVE INTENT. It is the intent of the legislature to preserve the right of
8 women to deliver children at home with licensed midwives, to remove obstacles for safe
9 deliveries outside of hospitals, to assure quality care of pregnant women and the children they
10 deliver, and to guarantee insurance coverage for home births.
11 * Sec. 2. AS 08.01.010(17) is amended to read:
12 (17) Board of Licensed [CERTIFIED DIRECT-ENTRY] Midwives
13 (AS 08.65.010);
14 * Sec. 3. AS 08.02.010(a) is amended to read:
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1 (a) An acupuncturist licensed under AS 08.06, an audiologist or speech-
2 language pathologist licensed under AS 08.11, a behavior analyst licensed under
3 AS 08.15, a person licensed in the state as a chiropractor under AS 08.20, a
4 professional counselor licensed under AS 08.29, a dentist under AS 08.36, a dietitian
5 or nutritionist licensed under AS 08.38, a massage therapist licensed under AS 08.61,
6 a marital and family therapist licensed under AS 08.63, a medical practitioner or
7 osteopath under AS 08.64, a [DIRECT-ENTRY] midwife licensed [CERTIFIED]
8 under AS 08.65, a registered or advanced practice registered nurse under AS 08.68, an
9 optometrist under AS 08.72, a licensed pharmacist under AS 08.80, a physical
10 therapist or occupational therapist licensed under AS 08.84, a psychologist under
11 AS 08.86, or a clinical social worker licensed under AS 08.95, shall use as
12 professional identification appropriate letters or a title after that person's name that
13 represents the person's specific field of practice. The letters or title shall appear on all
14 signs, stationery, or other advertising in which the person offers or displays personal
15 professional services to the public. In addition, a person engaged in the practice of
16 medicine or osteopathy as defined in AS 08.64.380, or a person engaged in any
17 manner in the healing arts who diagnoses, treats, tests, or counsels other persons in
18 relation to human health or disease and uses the letters "M.D." or the title "doctor" or
19 "physician" or another title that tends to show that the person is willing or qualified to
20 diagnose, treat, test, or counsel another person, shall clarify the letters or title by
21 adding the appropriate specialist designation, if any, such as "dermatologist,"
22 "radiologist," "audiologist," "naturopath," or the like.
23 * Sec. 4. AS 08.03.010(c)(8) is amended to read:
24 (8) Board of Licensed [CERTIFIED DIRECT-ENTRY] Midwives
25 (AS 08.65.010) - June 30, 2023;
26 * Sec. 5. AS 08.64.370 is amended to read:
27 Sec. 08.64.370. Exceptions to application of chapter. This chapter does not
28 apply to
29 (1) officers in the regular medical service of the armed services of the
30 United States or the United States Public Health Service while in the discharge of their
31 official duties;
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1 (2) a physician or osteopath, who is not a resident of this state, who is
2 asked by a physician or osteopath licensed in this state to help in the diagnosis or
3 treatment of a case;
4 (3) the practice of the religious tenets of a church;
5 (4) a physician in the regular medical service of the United States
6 Public Health Service or the armed services of the United States volunteering services
7 without pay or other remuneration to a hospital, clinic, medical office, or other
8 medical facility in the state;
9 (5) a person who is a licensed [CERTIFIED AS A DIRECT-ENTRY]
10 midwife [BY THE DEPARTMENT] under AS 08.65 while engaged in the practice of
11 midwifery whether or not the person accepts compensation for those services; in this
12 paragraph, "licensed midwife" has the meaning given in AS 08.65.190;
13 (6) a physician licensed in another state who, under a written
14 agreement with an athletic team located in the state in which the physician is licensed,
15 provides medical services to members of the athletic team while the athletic team is
16 traveling to or from or participating in a sporting event in this state.
17 * Sec. 6. AS 08.65.010(a) is amended to read:
18 (a) There is established the Board of Licensed [CERTIFIED DIRECT-
19 ENTRY] Midwives.
20 * Sec. 7. AS 08.65.010(b) is amended to read:
21 (b) The board consists of five members appointed by the governor subject to
22 confirmation by the legislature in joint session. Members serve for staggered terms of
23 four years and, except as provided in AS 39.05.080(4), each member serves until a
24 successor is appointed and qualified. The board consists of two members who are
25 licensed [CERTIFIED] in this state as [DIRECT-ENTRY] midwives, two members
26 who are advanced practice registered nurses [ONE PHYSICIAN LICENSED BY
27 THE STATE MEDICAL BOARD IN THIS STATE WHO HAS AN OBSTETRICAL
28 PRACTICE OR HAS SPECIALIZED TRAINING IN OBSTETRICS, ONE
29 CERTIFIED NURSE MIDWIFE] licensed under AS 08.68 by the Board of Nursing
30 in this state and who practice in an out-of-hospital setting, and one public member.
31 * Sec. 8. AS 08.65.030 is amended to read:
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1 Sec. 08.65.030. Duties and powers of board. (a) The board shall
2 (1) review applications for licenses to engage in the practice of
3 midwifery to determine whether the applicants satisfy the requirements of
4 AS 08.65.050 [EXAMINE APPLICANTS AND ISSUE CERTIFICATES TO THOSE
5 APPLICANTS IT FINDS QUALIFIED];
6 (2) after consultation with a nationally recognized midwife
7 organization, adopt regulations from time to time regarding the licensing, license
8 renewal, and practice [ESTABLISHING CERTIFICATION AND CERTIFICATE
9 RENEWAL] requirements for the practice of midwifery that are in the public
10 interest; the regulations must allow a person to become a licensed midwife by any
11 method that the board determines is in the public interest;
12 (3) issue permits to apprentice [DIRECT-ENTRY] midwives;
13 (4) hold hearings and order the disciplinary sanction of a person who
14 violates this chapter or a regulation of the board;
15 (5) supply forms for applications, licenses, permits,
16 [CERTIFICATES,] and other papers and records;
17 (6) enforce the provisions of this chapter and adopt regulations
18 necessary to make the provisions of this chapter effective;
19 (7) [APPROVE CURRICULA AND ADOPT STANDARDS FOR
20 BASIC EDUCATION, TRAINING, AND APPRENTICE PROGRAMS;
21 (8) PROVIDE FOR SURVEYS OF THE BASIC DIRECT-ENTRY
22 MIDWIFE EDUCATION PROGRAMS IN THE STATE AT THE TIMES IT
23 CONSIDERS NECESSARY;
24 (9) APPROVE EDUCATION, TRAINING, AND APPRENTICE
25 PROGRAMS THAT MEET THE REQUIREMENTS OF THIS CHAPTER AND OF
26 THE BOARD, AND DENY, REVOKE, OR SUSPEND APPROVAL OF THOSE
27 PROGRAMS FOR FAILURE TO MEET THE REQUIREMENTS;
28 (10)] adopt regulations establishing practice requirements for
29 [CERTIFIED DIRECT-ENTRY] midwives under AS 08.65.140.
30 (b) The board may by regulation require that a licensed [CERTIFIED
31 DIRECT-ENTRY] midwife undergo a uniform or random period of peer review to
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1 ensure the quality of care provided by the licensed [CERTIFIED DIRECT-ENTRY]
2 midwife.
3 * Sec. 9. AS 08.65.040 is amended by adding new subsections to read:
4 (b) The board may not adopt a regulation that
5 (1) requires a person to have a nursing degree or diploma to be
6 licensed under this chapter;
7 (2) requires a licensed midwife to practice midwifery under the
8 supervision of, or in collaboration with, another health care provider or a health care
9 facility;
10 (3) requires a licensed midwife to enter into an agreement, whether
11 written, oral, or in another form, with another health care provider or a health care
12 facility; or
13 (4) limits the location where a licensed midwife may practice
14 midwifery.
15 (c) In this section,
16 (1) "health care facility" has the meaning given in AS 18.35.399;
17 (2) "health care provider" has the meaning given in AS 09.65.300.
18 * Sec. 10. AS 08.65.050 is amended to read:
19 Sec. 08.65.050. Qualifications for license. The board shall issue a license
20 [CERTIFICATE] to practice [DIRECT-ENTRY] midwifery to a person who
21 (1) holds a valid certified professional midwife certificate, if the
22 certificate is issued by a nationally recognized midwife organization recognized
23 by the board and the requirements for the certificate are consistent with this
24 chapter;
25 (2) applies on a form provided by the board;
26 (3) [(2)] pays the fees required under AS 08.65.100;
27 (4) [(3)] furnishes evidence satisfactory to the board that the person
28 has not engaged in conduct that is a ground for imposing disciplinary sanctions under
29 AS 08.65.110;
30 (5) is certified in basic life support for health care providers [(4)
31 FURNISHES EVIDENCE SATISFACTORY TO THE BOARD THAT THE
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1 PERSON HAS COMPLETED A COURSE OF STUDY AND SUPERVISED
2 CLINICAL EXPERIENCE; THE STUDY AND EXPERIENCE MUST BE OF AT
3 LEAST ONE YEAR'S DURATION]; and
4 (6) is certified in the interventions used at the time of birth to
5 support the establishment of breathing and circulation of the newborn [(5)
6 SUCCESSFULLY COMPLETES THE EXAMINATION REQUIRED BY THE
7 BOARD].
8 * Sec. 11. AS 08.65.080 is amended to read:
9 Sec. 08.65.080. Renewal. A license [CERTIFICATE] issued under
10 AS 08.65.050 [OR 08.65.070] expires on a date determined by the board and may be
11 renewed every two years upon payment of the required fee and the submission of
12 evidence satisfactory to the board that the licensed [CERTIFIED DIRECT-ENTRY]
13 midwife has met the continuing education requirements of the board and holds a
14 valid certified professional midwife certificate issued by a nationally recognized
15 midwife organization recognized by the board if the requirements for the
16 certificate are consistent with this chapter [, HAS DEMONSTRATED
17 CONTINUED PRACTICAL PROFESSIONAL COMPETENCE UNDER
18 REGULATIONS ADOPTED BY THE BOARD, AND HAS NOT COMMITTED AN
19 ACT THAT IS A GROUND FOR DISCIPLINE UNDER AS 08.65.110].
20 * Sec. 12. AS 08.65.090(a) is amended to read:
21 (a) The board shall issue a permit to practice as an apprentice [DIRECT-
22 ENTRY] midwife to a person who satisfies the requirements for education, training,
23 and apprenticeship that are determined by the board to be in the public interest
24 after consultation with a nationally recognized midwife organization [OF
25 AS 08.65.050(1) - (3) AND WHO HAS BEEN ACCEPTED INTO A PROGRAM OF
26 EDUCATION, TRAINING, AND APPRENTICESHIP APPROVED BY THE
27 BOARD UNDER AS 08.65.030]. A permit application under this section must include
28 information the board may require. The permit is valid for a term of two years and
29 may be renewed in accordance with regulations adopted by the board.
30 * Sec. 13. AS 08.65.110 is amended to read:
31 Sec. 08.65.110. Grounds for discipline, suspension, or revocation of
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1 certification. The board may impose a disciplinary sanction on a person holding a
2 license [CERTIFICATE] or permit under this chapter if the board finds that the person
3 (1) secured a license [CERTIFICATE] or permit through deceit, fraud,
4 or intentional misrepresentation;
5 (2) engaged in deceit, fraud, or intentional misrepresentation in the
6 course of providing professional services or engaging in professional activities;
7 (3) advertised professional services in a false or misleading manner;
8 (4) has been convicted of a felony or other crime that affects the
9 licensee's ability to continue to practice competently and safely;
10 (5) intentionally or negligently engaged in or permitted the
11 performance of client care by persons under the licensed [CERTIFIED DIRECT-
12 ENTRY] midwife's supervision that does not conform to minimum professional
13 standards regardless of whether actual injury to the client occurred;
14 (6) failed to comply with this chapter, with a regulation adopted under
15 this chapter, or with an order of the board;
16 (7) continued to practice after becoming unfit due to
17 (A) professional incompetence;
18 (B) failure to keep informed of current professional practices;
19 (C) addiction or severe dependency on alcohol or other drugs
20 that impairs the ability to practice safely; or
21 (D) physical or mental disability; or
22 (8) engaged in lewd or immoral conduct in connection with the
23 delivery of professional service to clients.
24 * Sec. 14. AS 08.65.120(a) is amended to read:
25 (a) When the board [IT] finds that a person holding a license
26 [CERTIFICATE] or permit under this chapter is guilty of an offense under
27 AS 08.65.110, the board, in addition to the powers provided in AS 08.01.075, may
28 impose the following sanctions singly or in combination:
29 (1) permanently revoke the license [A CERTIFICATE] or permit [TO
30 PRACTICE];
31 (2) suspend the license [A CERTIFICATE] or permit for a
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1 determinate period of time;
2 (3) censure the [A] person [HOLDING A CERTIFICATE OR
3 PERMIT];
4 (4) issue a letter of reprimand;
5 (5) place the [A] person [HOLDING A CERTIFICATE OR PERMIT]