Existing law requires a midwife to perform certain duties relating to reporting births and deaths and testing newborn babies for certain diseases. (NRS 440.100, 440.740, 442.008-442.110, 442.600-442.680) Sections 2-32 of this bill provide for: (1) the licensure of licensed certified professional midwives by the Division of Public and Behavioral Health of the Department of Health and Human Services; and (2) the regulation of licensed certified professional midwives by the Division and the Board of Licensed Certified Professional Midwives created by section 17 of this bill. Sections 2-14, 45, 69 and 74 of this bill define certain terms related to the practice of certified professional midwifery. Section 15 of this bill: (1) exempts certain providers of health care from requirements governing the licensure and regulation of licensed certified professional midwives; and (2) provides that sections 2-32 do not abridge, limit or otherwise affect the right of a person to deliver a baby in the manner and location that the person desires. Sections 36, 38, 39 and 42-44 of this bill similarly exempt licensed certified professional midwives and certified professional midwife student midwives from provisions governing certain other providers of health care. Licensed certified professional midwives and certified professional midwife student midwives would also be exempt from provisions governing allopathic physicians. (NRS 630.047) Section 16 of this bill authorizes the Division to accept gifts, grants and donations to pay the costs of performing its duties under the provisions of this bill. Section 17 creates the Board of Licensed Certified Professional Midwives. Sections 34, 55 and 58-62 of this bill make various changes to ensure that the Board is treated similarly to other boards that regulate health-related professions. Section 34 also provides that a person may obtain a license as a licensed certified professional midwife through reciprocity if the person has been in practice for at least 1 year immediately preceding the date on which the person submits an application. Section 18 of this bill prescribes certain requirements concerning the operations and duties of the Board. Section 19 of this bill requires the Board to adopt regulations governing the practice of certified professional midwifery, including: (1) requirements governing the issuance and renewal of a license as a licensed certified professional midwife, including a requirement that an applicant to renew a license must have completed continuing education in cultural humility or the elimination of racism or bias; (2) requirements governing the investigation of misconduct and discipline; (3) requirements governing the management of a client who is at a moderate or high risk of an adverse outcome; and (4) requirements governing certain other aspects of the practice of certified professional midwifery. Section 76.5 of this bill provides that continuing education in cultural humility or the elimination of racism or bias completed by a licensed certified professional midwife satisfies a requirement that an agent or employee of certain health care facilities receive training in cultural competency. Section 20 of this bill prescribes the requirements for the issuance of a license as a licensed certified professional midwife. Section 103 of this bill revises the requirements for the issuance of a license as a licensed certified professional midwife on January 1, 2026, to authorize the Division to exempt certain applicants from certain education requirements to address shortages in the number of midwives practicing in rural or underserved areas in the State or barriers for applicants from marginalized identities. Section 21 of this bill: (1) authorizes a licensed certified professional midwife to utilize a certified professional midwife birth assistant to perform certain simple, routine medical tasks; and (2) prescribes the required training for a certified professional midwife birth assistant. Existing federal law requires each state to adopt procedures to ensure that applicants for certain licenses and certificates comply with child support obligations. (42 U.S.C. § 666) Sections 22 and 29 of this bill enact such procedures as applicable to an applicant for a license as a licensed certified professional midwife in order to comply with federal law. Sections 104 and 110 of this bill remove a requirement that an application for a license as a licensed certified professional midwife include the social security number of the applicant on the date that those federal requirements are repealed, while leaving in place the other requirements of sections 22 and 29 until 2 years after that date. Section 33 of this bill makes a conforming change to account for applicants for licensure who do not have a social security number. Section 23 of this bill prescribes the authorized activities of a certified professional midwife student midwife and requirements governing the supervision of a certified professional midwife student midwife by a preceptor. Section 24 of this bill requires any midwife who provides services in this State to provide to a client a Community Birth Disclosure that contains certain information. Section 24 additionally requires the Board to create the Community Birth Disclosure in collaboration with all types of midwives practicing in this State. Section 24 further requires a licensed certified professional midwife to obtain informed written consent from each client before providing services. Existing law authorizes only certain practitioners who are licensed in this State and registered with the State Board of Pharmacy to prescribe drugs and devices. (NRS 639.235, 639.23505) Sections 25, 40, 41 and 78 of this bill authorize a licensed certified professional midwife to: (1) order, possess and administer certain drugs, devices, chemicals and solutions; and (2) order certain devices and vaccines for a client. Sections 26, 40 and 78 of this bill authorize a licensed certified professional midwife to apply to the Division for a special endorsement for his or her license to: (1) order, dispense and implant contraceptive devices; or (2) possess, administer, prescribe and dispense certain dangerous drugs. Sections 21, 23 and 79 of this bill authorize a certified professional midwife birth assistant or certified professional midwife student midwife to administer certain drugs, devices, chemicals and solutions under the direct supervision of a licensed certified professional midwife or in certain emergency situations. Section 23 additionally authorizes a certified professional midwife student midwife to administer or implant a contraceptive device under the supervision of a preceptor who holds the appropriate special endorsement. Section 27 of this bill imposes specific requirements concerning the management of a client who is at a moderate or high risk of an adverse outcome, and section 19 requires the Board of Licensed Certified Professional Midwives to adopt additional regulations governing the management of such a client. Section 19.5 of this bill authorizes the Board to establish an advisory committee to advise the Board concerning the adoption of those regulations. Section 27 also exempts: (1) a licensed certified professional midwife from liability resulting from the informed refusal to consent of such a client to consultation, co-management with or referral to another provider of health care or transfer to a medical facility or the inability of the licensed certified professional midwife to arrange for such consultation or carry out such co-management, referral or transfer; and (2) other providers of health care from liability for the actions or omissions of a licensed certified professional midwife. Section 28 of this bill requires a licensed certified professional midwife to report to the Division certain information concerning his or her practice upon the renewal of his or her license. Section 30 of this bill: (1) requires the Division to maintain certain records of proceedings relating to licensing, disciplinary actions and investigations; and (2) declares certain records to be confidential and certain other records to be public. Section 57 of this bill makes a conforming change to clarify that such confidential records of the Division are not public records. Section 31 of this bill prohibits a person who does not hold a license as a licensed certified professional midwife from representing that he or she is licensed to engage in the practice of certified professional midwifery. Section 31 also prohibits a person whose license to perform midwifery in another jurisdiction of the United States has been suspended or revoked from performing midwifery or holding himself or herself out as a midwife in this State until the license in the other district, state or territory is restored. Section 31 authorizes a person to represent that he or she is licensed to engage in the practice of certified professional midwifery if the person is licensed in another district, state or territory of the United States and the person discloses that license to the public. Section 31 also prohibits a certified professional midwife student midwife from: (1) engaging in midwifery in circumstances other than those authorized by this bill; or (2) representing that he or she is qualified to engage in the practice of certified professional midwifery without supervision. Section 31 authorizes the Division to order a person to cease and desist from performing midwifery or holding himself or herself out as a midwife if: (1) his or her license as a licensed certified professional midwife has been suspended or revoked; (2) he or she is the subject of pending disciplinary action; or (3) he or she has voluntarily relinquished his or her license under certain circumstances. Section 31 additionally authorizes the Division to, when it has reason to believe or has received complaints that a person has repeatedly violated the provisions of section 31, certify the facts to the Attorney General, or other appropriate law enforcement officer, who may, in his or her discretion, cause appropriate proceedings to be brought. Section 32 authorizes the Division or the Attorney General to seek an injunction against any person violating any provision of sections 2-32. Existing law defines the term “provider of health care” as a person who practices any of certain professions related to the provision of health care. (NRS 629.031) Existing law imposes certain requirements upon providers of health care, including requirements for billing, standards for advertisements and criminal penalties for acquiring certain debts. (NRS 629.071, 629.076, 629.078) Section 35 of this bill includes licensed certified professional midwives in the definition of “provider of health care,” thereby subjecting licensed certified professional midwives to the same requirements. Section 76 of this bill makes a conforming change to clarify that licensed certified professional midwives are providers of health care. Section 37 of this bill requires a licensed certified professional midwife to report misconduct by a person licensed or certified by the State Board of Nursing to the Executive Director of the Board. Sections 48 and 49 of this bill provide that a licensed certified professional midwife is not liable for civil damages resulting from providing emergency care or gratuitous care to an indigent person under certain circumstances. Section 70 of this bill requires a licensed certified professional midwife who attends a birth that occurs outside a hospital which is not also attended by a physician or advanced practice registered nurse to prepare a birth certificate. Section 71 of this bill provides for the imposition of a fine upon a person who furnishes false information to a licensed certified professional midwife for the purpose of making incorrect certification of births or deaths. Existing law provides that, in any civil action concerning any unwelcome or nonconsensual sexual conduct, there is a rebuttable presumption that the sexual conduct was unwelcome or nonconsensual if the alleged perpetrator was a person in a position of authority over the alleged victim. (NRS 41.138) Section 47 of this bill provides that a licensed certified professional midwife, certified professional midwife student midwife or certified professional midwife birth assistant is a person of authority for that purpose. Sections 46, 50-54, 63, 64, 66-76 and 80-102 of this bill make revisions to treat licensed certified professional midwives similarly to other providers of health care in certain respects. Section 65 of this bill requires Medicaid to cover the services of a licensed certified professional midwife and to provide reimbursement for such services at rates comparable to other providers of health care who provide similar services. Section 56 of this bill makes a conforming change to indicate the proper placement of section 65 in the Nevada Revised Statutes. Section 77 of this bill authorizes a licensed certified professional midwife to serve as the director of a freestanding birthing center. Existing law requires a primary care provider, including a midwife, to take certain actions to facilitate the detection of harmful mutations in the BRCA gene in patients who are adult women. (NRS 457.301) Section 81 of this bill provides that this requirement applies to licensed certified professional midwives, but not to other midwives.

Statutes affected:
As Introduced: 622.238, 622.520, 629.031, 630A.090, 632.472, 633.171, 637B.080, 639.0125, 639.23505, 640A.070, 640B.145, 640C.100, 7.095, 41.138, 41.505, 41.506, 41A.017, 42.021, 52.320, 200.5093, 200.5095, 218G.400, 232.320, 239.010, 284.013, 353.005, 353A.020, 353A.025, 353A.045, 372.7285, 374.731, 432B.220, 439A.0195, 439B.225, 440.280, 440.770, 441A.110, 441A.315, 442.003, 442.119, 442.610, 449.198, 454.00958, 454.213, 454.361, 457.301, 608.0116, 679B.440, 686A.2825, 686B.030, 686B.040, 686B.115, 689A.035, 689B.015, 689C.131, 690B.250, 690B.270, 690B.280, 690B.290, 690B.300, 690B.310, 690B.320, 690B.360, 695A.095, 695B.035, 695C.125, 695G.127, 440.035
Reprint 1: 622.238, 622.520, 629.031, 630A.090, 632.472, 633.171, 637B.080, 639.0125, 639.23505, 640A.070, 640B.145, 640C.100, 7.095, 41.138, 41.505, 41.506, 41A.017, 42.021, 52.320, 200.5093, 200.5095, 218G.400, 232.320, 239.010, 284.013, 353.005, 353A.020, 353A.025, 353A.045, 372.7285, 374.731, 432B.220, 439A.0195, 439B.225, 440.280, 440.770, 441A.110, 441A.315, 442.003, 442.119, 442.610, 449.198, 454.00958, 454.213, 454.361, 457.301, 608.0116, 679B.440, 686A.2825, 686B.030, 686B.040, 686B.115, 689A.035, 689B.015, 689C.131, 690B.250, 690B.270, 690B.280, 690B.290, 690B.300, 690B.310, 690B.320, 690B.360, 695A.095, 695B.035, 695C.125, 695G.127, 440.035
Reprint 2: 622.238, 622.520, 629.031, 630A.090, 632.472, 633.171, 637B.080, 639.0125, 639.23505, 640A.070, 640B.145, 640C.100, 7.095, 41.138, 41.505, 41.506, 41A.017, 42.021, 52.320, 200.5093, 200.5095, 218G.400, 232.320, 239.010, 284.013, 353.005, 353A.020, 353A.025, 353A.045, 372.7285, 374.731, 432B.220, 439A.0195, 439B.225, 440.280, 440.770, 441A.110, 441A.315, 442.003, 442.119, 442.610, 449.103, 449.198, 454.00958, 454.213, 454.361, 457.301, 608.0116, 679B.440, 686A.2825, 686B.030, 686B.040, 686B.115, 689A.035, 689B.015, 689C.131, 690B.250, 690B.270, 690B.280, 690B.290, 690B.300, 690B.310, 690B.320, 690B.360, 695A.095, 695B.035, 695C.125, 695G.127, 440.035
Reprint 3: 622.238, 622.520, 629.031, 630A.090, 632.472, 633.171, 637B.080, 639.0125, 639.23505, 640A.070, 640B.145, 640C.100, 7.095, 41.138, 41.505, 41.506, 41A.017, 42.021, 52.320, 200.5093, 200.5095, 218G.400, 232.320, 239.010, 284.013, 353.005, 353A.020, 353A.025, 353A.045, 372.7285, 374.731, 432B.220, 439A.0195, 439B.225, 440.280, 440.770, 441A.110, 441A.315, 442.003, 442.119, 442.610, 449.103, 449.198, 454.00958, 454.213, 454.361, 457.301, 608.0116, 679B.440, 686A.2825, 686B.030, 686B.040, 686B.115, 689A.035, 689B.015, 689C.131, 690B.250, 690B.270, 690B.280, 690B.290, 690B.300, 690B.310, 690B.320, 690B.360, 695A.095, 695B.035, 695C.125, 695G.127, 440.035
BDR: 622.238, 622.520, 629.031, 630A.090, 632.472, 633.171, 637B.080, 639.0125, 639.23505, 640A.070, 640B.145, 640C.100, 7.095, 41.138, 41.505, 41.506, 41A.017, 42.021, 52.320, 200.5093, 200.5095, 218G.400, 232.320, 239.010, 284.013, 353.005, 353A.020, 353A.025, 353A.045, 372.7285, 374.731, 432B.220, 439A.0195, 439B.225, 440.280, 440.770, 441A.110, 441A.315, 442.003, 442.119, 442.610, 449.198, 454.00958, 454.213, 454.361, 457.301, 608.0116, 679B.440, 686A.2825, 686B.030, 686B.040, 686B.115, 689A.035, 689B.015, 689C.131, 690B.250, 690B.270, 690B.280, 690B.290, 690B.300, 690B.310, 690B.320, 690B.360, 695A.095, 695B.035, 695C.125, 695G.127, 440.035