Fiscal Note
Fiscal Services Division
HF 265 – Midwives, Licensure (LSB1036HV.2)
Staff Contact: Christopher Ubben (515.725.0134) chris.ubben@legis.iowa.gov
Fiscal Note Version – Final Action
Description
House File 265 requires a person practicing midwifery in Iowa to obtain a license through the
Board of Nursing in order to practice beginning July 1, 2024, 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 a Midwifery Advisory Council under the Board of
Nursing to advise the Board regarding licensure, continuing education requirements, standards
of practice, professional ethics, disciplinary actions, and other issues related to midwifery.
House File 265 also limits the liability of a health care provider that accepts clients transferred
from a licensed midwife. The Bill requires insurance providers to extend maternity benefits to
cover maternity services provided by licensed midwives on the same terms as similar services
provided by other health care providers.
Assumptions
• The Department of Health and Human Services (HHS) will require start-up costs for the new
licensing board, including for the following: staff time needed to establish the new licensing
board; 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.
• The number of current and future certified professional midwives (CPMs) is unknown. It is
estimated that there are approximately 14 active CPMs practicing in the State of Iowa.
Fiscal Impact
The HHS reports that initial start-up costs of establishing a new licensing board would require
an estimated $149,000 in FY 2024. Of this amount, $94,000 is attributable to database
modification costs, $25,000 is for administrative and staffing costs, and $30,000 is for support
costs paid to the Attorney General’s Office.
Ongoing costs are anticipated by the HHS to be $43,000 annually. Of this amount, $13,000 is
for administrative and staffing costs and $30,000 is for support costs paid to the Attorney
General’s Office.
The Bill directs the Board of Nursing to establish a licensing fee through the administrative rules
process based on these costs.
Sources
Department of Health and Human Services
Board of Nursing
/s/ Jennifer Acton
May 10, 2023
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Doc ID 1374027
The fiscal note for this Bill was prepared pursuant to Joint Rule 17 and the Iowa Code. Data used in developing this
fiscal note is available from the Fiscal Services Division of the Legislative Services Agency upon request.
www.legis.iowa.gov
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Statutes affected:
Introduced: 147.1, 147.14, 147.74, 148I.3, 272C.4
Enrolled: 147.1, 147.74, 148I.3