Bill Summary – FastDemocracy

WEST VIRGINIA LEGISLATURE
REGULAR SESSION
                Introduced Senate Bill 748
    By Senators Rucker, Chapman, and Karnes [Introduced February 12, 2024; referred to the Committee on Health and Human Resources;
      and then to the Committee on Finance]
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  A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new article,
            designated §30-44-1, §30-44-2, §30-44-3, §30-44-4, §30-44-5, §30-44-6, §30-44-7, §30-
            44-8, §30-44-9, §30-44-10, §30-44-11, §30-44-12, §30-44-13, §30-44-14, §30-44-14a,
            §30-44-14b, §30-44-15, §30-44-16, and §30-44-17, all relating generally to certified
            professional midwives; providing for definitions; setting forth the license required to
            practice; providing requirements for the license; providing for the license renewal and
            reinstatement; establishing temporary permits; detailing the contents of the license or
            certificate, providing for continuing education; clarifying the use of titles; providing for the
            denial, revocation, or suspension of license; listing exceptions; establishing prohibitions
           and penalties; creating an injunction or other relief against unlawful acts; providing for
           regulations governing the practice of midwifery; defining established medical tests, legend
           drug formulary, and medical devices; creating a drugs legend; creating a medical tests
           legend; providing for midwife responsibilities; providing for confidentiality; and providing for
           immunity.
     Be it enacted by the Legislature of West Virginia:
     ARTICLE                 44.          CERTIFIED                PROFESSIONAL                   MIDWIFE.
     §30-44-1.                                                                                   Definitions.
            As used in this article:
            "Midwife" means any person who provides primary maternity care by affirmative act or
  conduct prior to, during, and subsequent to childbirth, and who is not licensed as a doctor of
  medicine or osteopathy or certified nurse-midwife;
            "Licensed midwife" means a person who has been granted a license under this chapter to
  engage in the practice of midwifery and does not have the same meaning as the practice of an
  APRN-designated certified nurse-midwife;
            "Practicing midwifery" means providing primary maternity care that is consistent with a
  midwife's training, education, and experience to women and their newborns throughout the
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 childbearing cycle, and identifying and referring women or their newborns who require a higher
 level of medical care to an appropriate practitioner;
           "Board" means the West Virginia Board of Registered Nurses;
           "Temporary permit" means a permit authorizing the holder to practice midwifery in this
 state until such permit is no longer effective or the holder is granted a license by the West Virginia
 Board of Registered Nurses;
           "Client" means a person receiving midwifery care and shall be considered synonymous
 with the word "patient";
           "CPM" means the Certified Professional Midwife credential issued by the North American
 Registry of Midwives;
           "NARM" means the North American Registry of Midwives;
           "Administer" means the direct provision of a prescription drug or device, whether by
 injection, ingestion or any other means, to the body of a client;
           "Consultation" means discussing the aspects of an individual client's circumstance with
 other professionals to assure comprehensive and quality care for the client and for purposes of
 making adjustments to the client's treatment plan. Consultation may include history-taking,
 examination of the client, rendering an opinion concerning diagnosis or treatment, or offering
 service, assistance or advice;
           "Direct supervision" means immediate on-premises availability to continually coordinate,
 direct and inspect at first hand the practice of another practitioner;
           "HIPAA" means the Health Insurance Portability and Accountability Act of 1996, 42 USC
 1320d et seq;
           "Collaboration" means the process by which a licensed midwife and a physician or other
 appropriate healthcare provider jointly manage the care of a client;
           "Referral" means the process by which a licensed midwife arranges for an accepting
 physician or other appropriate licensed healthcare provider to assume primary management
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 responsibility for the condition requiring referral, which shall not preclude the licensed midwife
 from continuing in the provision of care as mutually agreed upon with the accepting provider;
           "Transfer" means the act of transporting a client to a licensed healthcare facility providing a
 higher level of care.
     §30-44-2.                  License required to                practice.
            It shall be unlawful for any person to practice midwifery in this state or use the title of
  licensed midwife unless they hold a license issued by the Board. The Board may license an
  applicant as a midwife after such applicant has submitted evidence satisfactory to the Board that
  they have obtained the Certified Professional Midwife (CPM) credential.
     §30-44-3.                  License to               practice midwifery.
            (a) The Board may issue a license to practice midwifery to an applicant who meets the
  following requirements:
            (1) Is at least 21 years of age;
            (2) Has completed an approved four-year high school course of study or the equivalent
  thereof, as determined by the appropriate educational agency;
            (3) Has completed midwifery education according to North American Registry of Midwives
  requirements or a successor organization;
            (4) Holds a valid certified professional midwife credential granted by the North American
  Registry of Midwives or a successor organization;
           (5) Has filed with the Board an application as established by the Board demonstrating that
 they have met the qualifications set forth in this section, and pay an application fee as established
 by the Board.
           (6) Provides evidence of current American Heart Association Basic Life Support (BLS) for
 health care providers and Neonatal Resuscitation Program (NRP) certifications.
           (7) Has completed a criminal background check, as required by §30-1D-1 et seq. of this
 code; and
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           (8) Does not have an active substance use disorder, as these terms are defined in §27-1A-
 11 of this code, unless an applicant in an active recovery process, which may be evidenced by
 participation in a Nurse Health Program, structured aftercare, or a 12-step program or other similar
 group or process, may be considered.
           (9) If an applicant has been licensed or certified in another jurisdiction, the applicant shall
 provide information on the status of each license or certificate held and on any disciplinary action
 taken or pending in that jurisdiction or from their certification organization
           (b) A license to practice midwifery issued by the Board shall for all purposes be considered
 a license issued under this section: Provided, That a person holding a license shall renew the
 license.
     §30-44-4.                License renewal and reinstatement.
            (a) Renewal.
            (1) Persons regulated by this article shall, biennially, renew his or her Board authorization
  by completing a form prescribed by the Board and submitting any other information required by the
  Board.
            (2) The Board shall charge a fee for each renewal of a Board authorization and shall
  charge a late fee for any renewal not paid by the due date.
            (3) The Board may deny an application for renewal for any reason which would justify the
  denial of an original application.
            (4) License renewal shall be contingent upon maintaining a Certified Professional Midwife
 certification.
           (5) Renewal applicants will provide proof of participation in data submission on perinatal
 outcomes to a national or state midwifery organization; and
           (6) A written plan for consultation with other health care providers, emergency transfer,
 transport of an infant to a newborn nursery or neonatal intensive care nursery, and transport of an
 individual to an appropriate obstetrical department or patient care areas shall be submitted with
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 the license renewal fee to the Board.
            (b) Quality improvement program.
            (1) As a condition of renewing a license, a licensed midwife shall:
            (A) Participate in a coordinated quality improvement program peer review process that
 complies with the requirements set by the Board
            (B) Attest every two years that the midwife has completed peer review for a minimum of
 five of the midwife's clinical cases over the course of those two years.
            (2) A midwife may be excused from or granted an extension of participation in a peer
 review process due to illness or other extenuating circumstances. The Board, upon request, will
 determine if the requirements may be waived or if an extension may be granted.
            (3) For auditing purposes, written confirmation of participation in a peer review process
 from the peer review program shall suffice. The midwife must keep her/his participation records.
            (c) Reinstatement.
            (1) A licensed midwife who allows licensure to lapse for a period of two years or more and
 chooses to resume practice shall submit to the Board a reinstatement application, information on
 practice and licensure in other jurisdictions for the period in which the license was lapsed in West
 Virginia, proof of current, active certification by NARM, and the fee for reinstatement of licensure
            (2) A licensed midwife whose license has been revoked by the Board and who wishes to be
 reinstated must make a new application to the Board, hold current, active certification by NARM,
 and pay the fee for reinstatement of a revoked license.
     §30-44-5.                                      Temporary permits.
             The Board may issue a temporary permit to a person applying for a license under this
  article.
     §30-44-6.               Contents of           license or            certificate.
             Each license or certificate issued by the Board shall bear a serial number, the full name of
  the applicant, the date of expiration of any such license and the date of issuance of any such
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  certificate, the seal of the Board, and shall be signed by the executive secretary of the Board.
     §30-44-7.                                    Continuing education.
            (a) A licensed midwife shall complete twenty-four (24) hours of continuing education (CE)
  every two years. CE course work must contribute to the professional knowledge and development
  of clinical practice of midwifery.
            (b) A licensed midwife shall obtain CE hours through one or more of the categories listed
  below. Documentation for all activities must include licensee's name, date of activity, and number
  of hours. Additional specific documentation is defined below:
            (1) Acceptable CE course work. A minimum of twenty hours is required per reporting
  period in acceptable CE course work. For the purposes of this section, acceptable CE course work
  means courses offered or authorized by industry recognized local, state, private, national and
 international organizations, agencies or institutions of higher learning. The Board will not authorize
 or approve specific CE courses. The required documentation for this category is a certificate or
 documentation of attendance.
           (2) Course work or classes offered by an accredited college or university. The course work
 must provide skills and knowledge beyond entry-level skills. The required documentation for this
 category is a transcript or documentation of attendance. A maximum of ten hours is allowed per
 reporting period for this category.
           (3) Professional conference or workshop. The required documentation for this category is
 a certificate or documentation of attendance.
     §30-44-8.                             Use of                          titles.
            An individual certified by the Board as a licensed midwife pursuant to the provisions of this
  article shall be known as a West Virginia licensed midwife and may use the initials "LM" after his or
  her name. No other person may assume a title or use abbreviations or any other words, letters,
  figures, signs, or devices to indicate that the person using the same is a Licensed Midwife.
     §30-44-9. Denial, revocation, or suspension of license; grounds for discipline.
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            The Board shall have the power to deny, revoke, or suspend any license to practice
  midwifery issued or applied for in accordance with the provisions of this article, or to otherwise
  discipline a licensee or applicant upon proof that he or she:
            (1) Is or was guilty of fraud or deceit in procuring or attempting to procure a license to
  practice midwifery; or
            (2) Has been convicted of a felony; or
            (3) Is unfit or incompetent by reason of negligence, habits, or other causes; or
            (4) Is habitually intemperate or is addicted to the use of habit-forming drugs; or
            (5) Is mentally incompetent; or
           (6) Is guilty of conduct derogatory to the morals or standing of the profession of midwifery;
 or
           (7) Is practicing or attempting to practice midwifery without a license or reregistration; or
           (8) Has willfully or repeatedly violated any of the provisions of this article; or
           (9) Performing or offering to perform services for which the midwife is not qualified by
 education, training or experience.
     §30-44-10.                                                                                     Exceptions.
            This article shall not be construed to prohibit:
            (1) An appropriate licensed health care provider or other person from providing emergency
  care, including care of a precipitous delivery; or
            (2) Any licensed midwife from delegating to apprentice or personnel under his/her personal
  employ and supervised by him such activities or functions that are nondiscretionary and that do
  not require the exercise of professional judgment for their performance, if such activities or
  functions are authorized by and performed for the licensed midwife and responsibility for such
  activities or functions is assumed by the licensed midwife; or
            (3) Any person from performing tasks related to the practice of midwifery under the direct
 and immediate supervision of a licensed doctor of medicine or osteopathy, a certified nurse-
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 midwife, or a licensed midwife during completion of the North American Registry of Midwives'
 Portfolio Evaluation Process Program within a time period specified in regulations adopted by the
 Board or while enrolled in an accredited midwifery education program; or
           (4) Traditional birth attendants if:
           (A) The traditional birth attendant has cultural or religious traditions that have historically
 included the attendance of traditional birth attendants at births; and
           (B) That birth attendant serves only the women and families in that distinct cultural religious
 group.
     §30-44-11.                        Prohibitions and penalties.
            It shall be a misdemeanor for any person to:
            (1) Practice licensed midwifery unless duly licensed to do so under the provisions of this
  article; or
            (2) Use in connection with his or her name any designation tending to imply that he or she
  is licensed to practice midwifery unless duly licensed so to practice under the provisions of this
  article; or
            (3) Practice midwifery during the time his or her license issued under the provisions of this
  article shall be suspended or revoked; or
            (4) Otherwise violate any provisions of this article.
           Upon conviction, each such misdemeanor shall be punishable by a fine of not less than
 twenty-five ($25) nor more than two hundred fifty ($250).
     §30-44-12.         Injunction or          other relief against unlawful acts.
            The practice of midwifery by any person who has not been licensed under the provisions of
  this article, or whose license has expired or has been suspended or revoked, is h