| 1 | 1 | | 25 LC 55 0511 |
|---|
| 2 | 2 | | House Bill 520 |
|---|
| 3 | 3 | | By: Representatives Mathiak of the 82 |
|---|
| 4 | 4 | | nd |
|---|
| 5 | 5 | | , Powell of the 33 |
|---|
| 6 | 6 | | rd |
|---|
| 7 | 7 | | , Momtahan of the 17 |
|---|
| 8 | 8 | | th |
|---|
| 9 | 9 | | , Williams |
|---|
| 10 | 10 | | of the 168 |
|---|
| 11 | 11 | | th |
|---|
| 12 | 12 | | , Dempsey of the 13 |
|---|
| 13 | 13 | | th |
|---|
| 14 | 14 | | , and others |
|---|
| 15 | 15 | | A BILL TO BE ENTITLED |
|---|
| 16 | 16 | | AN ACT |
|---|
| 17 | 17 | | To amend Title 31 of the Official Code of Georgia Annotated, relating to health, so as to |
|---|
| 18 | 18 | | 1 |
|---|
| 19 | 19 | | repeal in its entirety Chapter 26, relating to the practice of midwifery; to revise provisions2 |
|---|
| 20 | 20 | | relating to peer review to include midwives; to amend Title 43 of the Official Code of3 |
|---|
| 21 | 21 | | Georgia Annotated, relating to professions and businesses, so as to provide for the licensure4 |
|---|
| 22 | 22 | | and regulation of midwives; to provide for a short title; to provide for legislative findings;5 |
|---|
| 23 | 23 | | to provide for definitions; to provide for the creation of the Advisory Board for Licensed6 |
|---|
| 24 | 24 | | Midwives; to provide for its membership and duties; to provide for licensure requirements;7 |
|---|
| 25 | 25 | | to provide for renewal of licenses; to provide for the revocation, suspension, denial, or8 |
|---|
| 26 | 26 | | refusal to issue or renew a license; to provide fines for violations; to provide for the9 |
|---|
| 27 | 27 | | promulgation of rules and regulations; to prohibit the practice of midwifery without a license;10 |
|---|
| 28 | 28 | | to provide exceptions; to provide for informed consent and written disclosures to clients; to11 |
|---|
| 29 | 29 | | limit the practice of midwifery; to provide for standards of care and liability in certain12 |
|---|
| 30 | 30 | | situations; to provide for prohibited acts; to authorize the filing of birth certificates; to13 |
|---|
| 31 | 31 | | provide for statutory construction; to provide for coverage; to provide for abatement; to14 |
|---|
| 32 | 32 | | provide for an exception under the "Georgia Registered Professional Nurse Practice Act";15 |
|---|
| 33 | 33 | | to provide for related matters; to provide for an effective date; to repeal conflicting laws; and16 |
|---|
| 34 | 34 | | for other purposes.17 |
|---|
| 35 | 35 | | H. B. 520 |
|---|
| 36 | 36 | | - 1 - 25 LC 55 0511 |
|---|
| 37 | 37 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: |
|---|
| 38 | 38 | | 18 |
|---|
| 39 | 39 | | SECTION 1.19 |
|---|
| 40 | 40 | | Title 31 of the Official Code of Georgia Annotated, relating to health, is amended in20 |
|---|
| 41 | 41 | | paragraph (2) of Code Section 31-7-131, relating to definitions relative to peer review21 |
|---|
| 42 | 42 | | groups, by striking "and" at the end of subparagraph (L), by replacing the period at the end22 |
|---|
| 43 | 43 | | of subparagraph (M) with "; and", and by adding a new subparagraph to read as follows:23 |
|---|
| 44 | 44 | | "(N) A midwife. |
|---|
| 45 | 45 | | "24 |
|---|
| 46 | 46 | | SECTION 2.25 |
|---|
| 47 | 47 | | Said title is further amended by repealing in its entirety Chapter 26, relating to the practice26 |
|---|
| 48 | 48 | | of midwifery, and designating said chapter as reserved.27 |
|---|
| 49 | 49 | | SECTION 3.28 |
|---|
| 50 | 50 | | Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,29 |
|---|
| 51 | 51 | | is amended by adding a new chapter to read as follows:30 |
|---|
| 52 | 52 | | "CHAPTER 24B31 |
|---|
| 53 | 53 | | 43-24B-1.32 |
|---|
| 54 | 54 | | This chapter shall be known and may be cited as the 'Georgia Licensed Midwife Act.'33 |
|---|
| 55 | 55 | | 43-24B-2.34 |
|---|
| 56 | 56 | | (a) The General Assembly finds that:35 |
|---|
| 57 | 57 | | (1) Parents are entitled to freedom in choosing their provider and setting for childbirth;36 |
|---|
| 58 | 58 | | (2) Some potential parents in this state desire alternatives to currently available hospital37 |
|---|
| 59 | 59 | | based maternity care;38 |
|---|
| 60 | 60 | | H. B. 520 |
|---|
| 61 | 61 | | - 2 - 25 LC 55 0511 |
|---|
| 62 | 62 | | (3) Trained and competent midwifery professionals can enhance health and safety during39 |
|---|
| 63 | 63 | | planned, out-of-hospital births;40 |
|---|
| 64 | 64 | | (4) Midwives are independent, autonomous healthcare providers who are trained in41 |
|---|
| 65 | 65 | | managing normal physiological births in the community setting;42 |
|---|
| 66 | 66 | | (5) Numerous counties in this state are underserved by obstetricians;43 |
|---|
| 67 | 67 | | (6) Midwives can assist women and their families with safe and effective childbirth44 |
|---|
| 68 | 68 | | while guiding the health, safety, and welfare of mothers and their offspring through the45 |
|---|
| 69 | 69 | | childbearing year; and46 |
|---|
| 70 | 70 | | (7) Regulating midwifery promotes access to safe and effective antepartum, intrapartum,47 |
|---|
| 71 | 71 | | and postpartum care.48 |
|---|
| 72 | 72 | | (b) The General Assembly, therefore, declares it to be the purpose of this chapter to protect49 |
|---|
| 73 | 73 | | the health, safety, and welfare of the public by providing for the licensure and regulation50 |
|---|
| 74 | 74 | | of the activities of midwives.51 |
|---|
| 75 | 75 | | 43-24B-3.52 |
|---|
| 76 | 76 | | As used in this chapter, the term:53 |
|---|
| 77 | 77 | | (1) 'Advisory board' means the Advisory Board for Licensed Midwives established54 |
|---|
| 78 | 78 | | pursuant to Code Section 43-24B-4.55 |
|---|
| 79 | 79 | | (2) 'Collaboration' means a process by which a licensed midwife and a physician or other56 |
|---|
| 80 | 80 | | appropriate healthcare provider jointly manage the care of a client, the requirements for57 |
|---|
| 81 | 81 | | which shall be defined by the advisory board.58 |
|---|
| 82 | 82 | | (3) 'Consultation' means a communication between a licensed midwife and a physician59 |
|---|
| 83 | 83 | | or appropriate healthcare provider with expertise in providing medical services to women60 |
|---|
| 84 | 84 | | during the prenatal, childbirth, and postpartum periods when assessing a condition during61 |
|---|
| 85 | 85 | | such periods.62 |
|---|
| 86 | 86 | | (4) 'Informed consent' means a written certification by the client consenting to or63 |
|---|
| 87 | 87 | | declining procedures, protocols, and treatments or recommended diagnostic tests after full64 |
|---|
| 88 | 88 | | H. B. 520 |
|---|
| 89 | 89 | | - 3 - 25 LC 55 0511 |
|---|
| 90 | 90 | | disclosure of the current standard of care and its purpose, benefits, known risks,65 |
|---|
| 91 | 91 | | contraindications, and associated risks, as well as any alternative options.66 |
|---|
| 92 | 92 | | (5) 'License' means a license issued pursuant to this chapter to engage in the practice of67 |
|---|
| 93 | 93 | | midwifery.68 |
|---|
| 94 | 94 | | (6) 'Licensed midwife' or 'licensee' means an individual licensed under this chapter who69 |
|---|
| 95 | 95 | | is engaging in the practice of midwifery.70 |
|---|
| 96 | 96 | | (7) 'Practice of midwifery' means assistance given, in exchange for compensation, to71 |
|---|
| 97 | 97 | | women during pregnancy, birth, and the postpartum period, including well-woman72 |
|---|
| 98 | 98 | | screening and education. Such assistance may be provided in out-of-hospital settings,73 |
|---|
| 99 | 99 | | such as a private home or a birth center. Such assistance, which is provided within a74 |
|---|
| 100 | 100 | | network of relationships with other maternity care providers who may provide75 |
|---|
| 101 | 101 | | consultation and collaboration when needed, includes:76 |
|---|
| 102 | 102 | | (A) Providing care, education, counseling, and support to women and their families77 |
|---|
| 103 | 103 | | throughout pregnancy, birth, and the postpartum period; identifying unique physical78 |
|---|
| 104 | 104 | | social and emotional needs; recognizing abnormal conditions requiring the services of79 |
|---|
| 105 | 105 | | a healthcare provider such as a physician, physician assistant, or advanced practice80 |
|---|
| 106 | 106 | | registered nurse and developing a plan for consultation and referral when such81 |
|---|
| 107 | 107 | | conditions arise; and providing emergency care and support for mothers and babies82 |
|---|
| 108 | 108 | | until additional assistance is available;83 |
|---|
| 109 | 109 | | (B) Ordering prenatal, postpartum, and well-woman laboratory analyses performed by84 |
|---|
| 110 | 110 | | a licensed laboratory for screening purposes; ordering obstetric ultrasounds; obtaining85 |
|---|
| 111 | 111 | | and using appropriate equipment and devices such as a Doppler ultrasound, blood86 |
|---|
| 112 | 112 | | pressure cuff, and phlebotomy supplies, instruments, and sutures; obtaining, carrying, 87 |
|---|
| 113 | 113 | | and administering antihemorrhagic agents including but not limited to Pitocin88 |
|---|
| 114 | 114 | | (oxytocin), misoprostol and methergine, intravenous fluids for stabilization of the89 |
|---|
| 115 | 115 | | laboring person, magnesium sulfate, terbutaline, neonatal injectable vitamin K,90 |
|---|
| 116 | 116 | | newborn antibiotic eye prophylaxis, oxygen, intravenous antibiotics for Group B91 |
|---|
| 117 | 117 | | H. B. 520 |
|---|
| 118 | 118 | | - 4 - 25 LC 55 0511 |
|---|
| 119 | 119 | | Streptococcal antibiotic prophylaxis, Rho(D) immune globulin, local anesthetic,92 |
|---|
| 120 | 120 | | epinephrine, and other drugs or supplies approved by the advisory board; provided,93 |
|---|
| 121 | 121 | | however, that nothing in this subparagraph shall be interpreted to include the94 |
|---|
| 122 | 122 | | prescribing of medications;95 |
|---|
| 123 | 123 | | (C) Managing the postpartum period, including the suturing of an episiotomy and the96 |
|---|
| 124 | 124 | | suturing of first and second degree natural perineal and labial lacerations, including the97 |
|---|
| 125 | 125 | | administration of a local anesthetic;98 |
|---|
| 126 | 126 | | (D) Managing the newborn period, including:99 |
|---|
| 127 | 127 | | (i) Providing care for a newborn baby, including performing a normal newborn baby100 |
|---|
| 128 | 128 | | examination;101 |
|---|
| 129 | 129 | | (ii) Resuscitating a newborn baby; and102 |
|---|
| 130 | 130 | | (iii) Performing newborn screenings;103 |
|---|
| 131 | 131 | | (E) Providing limited interconception services in order to provide continuity of care,104 |
|---|
| 132 | 132 | | including:105 |
|---|
| 133 | 133 | | (i) Breastfeeding support and counseling;106 |
|---|
| 134 | 134 | | (ii) Family planning, limited to natural family planning, cervical caps, and107 |
|---|
| 135 | 135 | | diaphragms; and108 |
|---|
| 136 | 136 | | (iii) Pap smears, where each client with an abnormal result is to be referred to an109 |
|---|
| 137 | 137 | | appropriate licensed healthcare provider; and110 |
|---|
| 138 | 138 | | (F) Executing the orders of a physician, if the orders are within the education,111 |
|---|
| 139 | 139 | | knowledge, and skill of the licensed midwife.112 |
|---|
| 140 | 140 | | (8) 'Qualified instructor' means an individual who:113 |
|---|
| 141 | 141 | | (A) Holds a license under this chapter; or114 |
|---|
| 142 | 142 | | (B) Is a licensed healthcare provider who has at least five years of experience or who115 |
|---|
| 143 | 143 | | has participated in 50 documented births as the primary healthcare provider.116 |
|---|
| 144 | 144 | | H. B. 520 |
|---|
| 145 | 145 | | - 5 - 25 LC 55 0511 |
|---|
| 146 | 146 | | (9) 'Referral' means a request made by a licensed midwife to a physician or other117 |
|---|
| 147 | 147 | | healthcare provider for an assessment of a mother or her offspring in order to determine118 |
|---|
| 148 | 148 | | appropriate care.119 |
|---|
| 149 | 149 | | 43-24B-4.120 |
|---|
| 150 | 150 | | (a) There is created within the division the Advisory Board for Licensed Midwives which121 |
|---|
| 151 | 151 | | shall consist of six members.122 |
|---|
| 152 | 152 | | (b) The Governor shall appoint all members of the advisory board as follows:123 |
|---|
| 153 | 153 | | (1) Four licensed midwives;124 |
|---|
| 154 | 154 | | (2) One physician with experience collaborating in out-of-hospital birth; and125 |
|---|
| 155 | 155 | | (3) One member of the general public who has used the services of a licensed midwife126 |
|---|
| 156 | 156 | | in this state.127 |
|---|
| 157 | 157 | | (c) The members of the advisory board shall serve for terms of two years and may succeed128 |
|---|
| 158 | 158 | | themselves.129 |
|---|
| 159 | 159 | | (d) Any vacancy on the advisory board shall be filled in the same manner as the regular130 |
|---|
| 160 | 160 | | appointments.131 |
|---|
| 161 | 161 | | (e) The Governor may remove members of the advisory board for incompetence, neglect132 |
|---|
| 162 | 162 | | of duty, unprofessional conduct, conviction of any felony, failure to meet the qualifications133 |
|---|
| 163 | 163 | | of this chapter, or committing any act prohibited by this chapter.134 |
|---|
| 164 | 164 | | (f) The advisory board shall elect a chairperson from among its membership and may elect135 |
|---|
| 165 | 165 | | other officers at the discretion of the advisory board, who shall each serve for one year.136 |
|---|
| 166 | 166 | | (g) The advisory board shall meet at least once per year or as otherwise called by the137 |
|---|
| 167 | 167 | | chairperson.138 |
|---|
| 168 | 168 | | 43-24B-5.139 |
|---|
| 169 | 169 | | The advisory board shall issue a license to engage in the practice of midwifery to any140 |
|---|
| 170 | 170 | | individual who meets the requirements of this chapter.141 |
|---|
| 171 | 171 | | H. B. 520 |
|---|
| 172 | 172 | | - 6 - 25 LC 55 0511 |
|---|
| 173 | 173 | | 43-24B-6.142 |
|---|
| 174 | 174 | | (a) Each applicant for a license under this chapter shall:143 |
|---|
| 175 | 175 | | (1) Submit an application in a form prescribed by the division;144 |
|---|
| 176 | 176 | | (2) Pay an application fee as determined by the advisory board;145 |
|---|
| 177 | 177 | | (3) Furnish to the advisory board a full set of fingerprints to enable a criminal146 |
|---|
| 178 | 178 | | background investigation to be conducted on the applicant so as to determine the147 |
|---|
| 179 | 179 | | applicant's suitability to be a licensed midwife. The advisory board shall submit the148 |
|---|
| 180 | 180 | | applicant's fingerprints to the Georgia Crime Information Center. If no disqualifying149 |
|---|
| 181 | 181 | | record is identified at the state level, the Georgia Crime Information Center is authorized150 |
|---|
| 182 | 182 | | to submit the fingerprints to the Federal Bureau of Investigation for a national criminal151 |
|---|
| 183 | 183 | | history check. The Georgia Crime Information Center shall notify the advisory board in152 |
|---|
| 184 | 184 | | writing of the results of such criminal background investigation, which shall be used by153 |
|---|
| 185 | 185 | | the advisory board for the exclusive purpose of carrying out its responsibilities under this154 |
|---|
| 186 | 186 | | chapter, shall not be a public record, shall be privileged, and shall not be disclosed to any155 |
|---|
| 187 | 187 | | other person or agency;156 |
|---|
| 188 | 188 | | (4) Hold a current certification in adult cardiopulmonary resuscitation (CPR) and157 |
|---|
| 189 | 189 | | neonatal resuscitation from an organization recognized by the advisory board;158 |
|---|
| 190 | 190 | | (5) Provide documentation of successful completion of a pharmacology course approved159 |
|---|
| 191 | 191 | | by the advisory board; and160 |
|---|
| 192 | 192 | | (6) Hold a current certification in good standing from a midwifery organization161 |
|---|
| 193 | 193 | | recognized by the advisory board, such as the North American Registry of Midwives, the162 |
|---|
| 194 | 194 | | American Midwifery Certification Board, or any successor organizations.163 |
|---|
| 195 | 195 | | (b) The advisory board, in its discretion, may issue a license to an applicant who does not164 |
|---|
| 196 | 196 | | meet the requirements of paragraph (6) of subsection (a) of this Code section but who:165 |
|---|
| 197 | 197 | | (1) Has received midwifery training, which shall include experience in initial obstetrical166 |
|---|
| 198 | 198 | | exams, prenatal care, births, newborn examinations, and postpartum care, from a167 |
|---|
| 199 | 199 | | qualified instructor for at least three years; participated in at least 50 documented births;168 |
|---|
| 200 | 200 | | H. B. 520 |
|---|
| 201 | 201 | | - 7 - 25 LC 55 0511 |
|---|
| 202 | 202 | | and achieved a passing score on an examination approved by the advisory board relating169 |
|---|
| 203 | 203 | | to the practice of midwifery;170 |
|---|
| 204 | 204 | | (2) Has been engaged in the practice of midwifery for at least 25 years; or171 |
|---|
| 205 | 205 | | (3) Is licensed to engage in the practice of midwifery in another jurisdiction whose laws,172 |
|---|
| 206 | 206 | | in the opinion of the advisory board, require qualifications and maintain standards173 |
|---|
| 207 | 207 | | substantially the same as those of this state for licensed midwives.174 |
|---|
| 208 | 208 | | 43-24B-7.175 |
|---|
| 209 | 209 | | (a) A license issued by the advisory board shall be renewed every two years if the licensee176 |
|---|
| 210 | 210 | | is not in violation of this chapter at the time of application for renewal and has completed177 |
|---|
| 211 | 211 | | 20 hours of continuing education approved by the advisory board since the license was178 |
|---|
| 212 | 212 | | issued or last renewed.179 |
|---|
| 213 | 213 | | (b) Each individual licensed under this chapter is responsible for renewing his or her180 |
|---|
| 214 | 214 | | license before the expiration date.181 |
|---|
| 215 | 215 | | 43-24B-8.182 |
|---|
| 216 | 216 | | (a) The advisory board may revoke, suspend, deny, or refuse to issue or renew a license;183 |
|---|
| 217 | 217 | | place a licensee on probation; or issue a letter of admonition upon proof that the licensee184 |
|---|
| 218 | 218 | | or applicant has:185 |
|---|
| 219 | 219 | | (1) Procured or attempted to procure a license by fraud, deceit, misrepresentation,186 |
|---|
| 220 | 220 | | misleading omission, or material misstatement of fact;187 |
|---|
| 221 | 221 | | (2) Been convicted of a felony or of any crime involving moral turpitude as provided188 |
|---|
| 222 | 222 | | under state law;189 |
|---|
| 223 | 223 | | (3) Willfully or negligently acted in a manner inconsistent with the health or safety of190 |
|---|
| 224 | 224 | | persons under such licensee's care;191 |
|---|
| 225 | 225 | | H. B. 520 |
|---|
| 226 | 226 | | - 8 - 25 LC 55 0511 |
|---|
| 227 | 227 | | (4) Had a license to practice a business or profession suspended or revoked or has192 |
|---|
| 228 | 228 | | otherwise been subject to discipline related to such licensee's practice of a business or193 |
|---|
| 229 | 229 | | profession in any other jurisdiction;194 |
|---|
| 230 | 230 | | (5) Committed a fraudulent act that materially affects the fitness of the licensee or195 |
|---|
| 231 | 231 | | applicant to practice a business or profession;196 |
|---|
| 232 | 232 | | (6) Excessively or habitually used alcohol or drugs, provided that the advisory board197 |
|---|
| 233 | 233 | | shall not discipline a licensee under this paragraph if such licensee is enrolled in a198 |
|---|
| 234 | 234 | | substance abuse program approved by the advisory board; or199 |
|---|
| 235 | 235 | | (7) A physical or mental disability that renders such licensee incapable of safely200 |
|---|
| 236 | 236 | | engaging in the practice of midwifery.201 |
|---|
| 237 | 237 | | (b) The advisory board is authorized to conduct investigations into allegations of conduct202 |
|---|
| 238 | 238 | | described in subsection (a) of this Code section.203 |
|---|
| 239 | 239 | | (c) In addition to revoking, suspending, denying, or refusing to renew a license, the204 |
|---|
| 240 | 240 | | advisory board may fine a licensee found to have violated any provision of this chapter or205 |
|---|
| 241 | 241 | | any rule adopted by the advisory board under this chapter in an amount of not less than206 |
|---|
| 242 | 242 | | $100.00 nor more than $500.00 for each such violation.207 |
|---|
| 243 | 243 | | (d) The provisions of Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act,'208 |
|---|
| 244 | 244 | | shall be applicable to the advisory board and the provisions of this chapter.209 |
|---|
| 245 | 245 | | (e) Any person may file a complaint with the advisory board with respect to a licensed210 |
|---|
| 246 | 246 | | midwife.211 |
|---|
| 247 | 247 | | 43-24B-9.212 |
|---|
| 248 | 248 | | (a) The advisory board may promulgate any rules and regulations necessary to carry out213 |
|---|
| 249 | 249 | | the provisions of this chapter.214 |
|---|
| 250 | 250 | | (b) The advisory board may act as a facilitator of the state-wide dissemination of215 |
|---|
| 251 | 251 | | information concerning the practice of midwifery and the services of licensed midwives.216 |
|---|
| 252 | 252 | | H. B. 520 |
|---|
| 253 | 253 | | - 9 - 25 LC 55 0511 |
|---|
| 254 | 254 | | 43-24B-10.217 |
|---|
| 255 | 255 | | (a) Except as provided in subsection (b) of this Code section, no person shall engage in the218 |
|---|
| 256 | 256 | | practice of midwifery in this state unless such person holds a license issued by the advisory219 |
|---|
| 257 | 257 | | board pursuant to Code Section 43-24B-5.220 |
|---|
| 258 | 258 | | (b) A person may engage in the practice of midwifery in this state without a license if:221 |
|---|
| 259 | 259 | | (1) The person is a licensed healthcare practitioner and the services provided are within222 |
|---|
| 260 | 260 | | the scope of the person's license; or223 |
|---|
| 261 | 261 | | (2)(A) The person does not advertise that the person is a licensed midwife; and224 |
|---|
| 262 | 262 | | (B) The person discloses the following to each client on an informed disclosure225 |
|---|
| 263 | 263 | | document that is signed by the client:226 |
|---|
| 264 | 264 | | (i) That the person does not possess a license to engage in the practice of midwifery227 |
|---|
| 265 | 265 | | in this state;228 |
|---|
| 266 | 266 | | (ii) That the person's education and qualifications have not been reviewed by the229 |
|---|
| 267 | 267 | | state;230 |
|---|
| 268 | 268 | | (iii) That the person is not authorized to carry and administer potentially life-saving231 |
|---|
| 269 | 269 | | medications;232 |
|---|
| 270 | 270 | | (iv) A plan for transporting the client to the hospital if a problem arises during labor233 |
|---|
| 271 | 271 | | or childbirth; and234 |
|---|
| 272 | 272 | | (v) That the client will not have recourse through a complaint process conducted by235 |
|---|
| 273 | 273 | | a professional licensing board.236 |
|---|
| 274 | 274 | | (c) Any individual engaging in the practice of midwifery without a license in violation of237 |
|---|
| 275 | 275 | | this Code section shall be subject to a fine of not less than $100.00 nor more than $500.00238 |
|---|
| 276 | 276 | | for each such violation.239 |
|---|
| 277 | 277 | | H. B. 520 |
|---|
| 278 | 278 | | - 10 - 25 LC 55 0511 |
|---|
| 279 | 279 | | 43-24B-11.240 |
|---|
| 280 | 280 | | (a) Prior to engaging in the practice of midwifery with a client, a licensed midwife shall241 |
|---|
| 281 | 281 | | obtain informed consent from such client and retain a copy of such informed consent for242 |
|---|
| 282 | 282 | | at least four years.243 |
|---|
| 283 | 283 | | (b) A licensed midwife shall be authorized to file a birth certificate for each birth that such244 |
|---|
| 284 | 284 | | licensed midwife provides services in connection with in accordance with the laws of this245 |
|---|
| 285 | 285 | | state.246 |
|---|
| 286 | 286 | | 43-24B-12.247 |
|---|
| 287 | 287 | | A licensed midwife shall:248 |
|---|
| 288 | 288 | | (1) Limit his or her practice to pregnancy, labor, delivery, and postpartum, newborn, and249 |
|---|
| 289 | 289 | | interconception care that is not a pharmacologically induced labor and in which the infant250 |
|---|
| 290 | 290 | | is born spontaneously between 37 and 43 completed weeks of gestation; provided,251 |
|---|
| 291 | 291 | | however, that the limitation contained in this paragraph shall not prohibit a licensed252 |
|---|
| 292 | 292 | | midwife from delivering an infant when there is intrauterine fetal demise or a fetal253 |
|---|
| 293 | 293 | | anomaly incompatible with life; and254 |
|---|
| 294 | 294 | | (2) Appropriately recommend and facilitate consultation or collaboration with or referral255 |
|---|
| 295 | 295 | | or transfer of care to a licensed healthcare professional when the circumstances require256 |
|---|
| 296 | 296 | | such action in accordance with this chapter and standards established by advisory board257 |
|---|
| 297 | 297 | | rule.258 |
|---|
| 298 | 298 | | 43-24B-13.259 |
|---|
| 299 | 299 | | (a) If, after a client has been informed that she has or may have a condition indicating the260 |
|---|
| 300 | 300 | | need for medical consultation, collaboration, referral, or transfer, and the client declines a261 |
|---|
| 301 | 301 | | referral or transfer of care, the licensed midwife shall:262 |
|---|
| 302 | 302 | | (1) Terminate care in accordance with procedures established by advisory board rule; or263 |
|---|
| 303 | 303 | | H. B. 520 |
|---|
| 304 | 304 | | - 11 - 25 LC 55 0511 |
|---|
| 305 | 305 | | (2) Continue to provide care for the client if the client signs an informed consent waiver264 |
|---|
| 306 | 306 | | of medical consultation, collaboration, referral, or transfer. A licensed midwife shall not265 |
|---|
| 307 | 307 | | be held liable when such informed consent waiver is signed.266 |
|---|
| 308 | 308 | | (b) If, after a client has been informed that she has or may have a condition indicating the267 |
|---|
| 309 | 309 | | need for immediate transfer, and the client declines such transfer, the licensed midwife268 |
|---|
| 310 | 310 | | shall, in accordance with procedures established by advisory board rule, terminate the care269 |
|---|
| 311 | 311 | | or initiate transfer by:270 |
|---|
| 312 | 312 | | (1) Calling 9-1-1 and reporting the need for immediate transfer;271 |
|---|
| 313 | 313 | | (2) Immediately transporting the client by private vehicle to the receiving provider; or272 |
|---|
| 314 | 314 | | (3) Contacting the physician to whom the client will be transferred and following such273 |
|---|
| 315 | 315 | | physician's orders.274 |
|---|
| 316 | 316 | | (c) The standards for consultation and transfer provided in this Code section represent the275 |
|---|
| 317 | 317 | | minimum requirements that a licensed midwife must adhere to. A licensed midwife shall276 |
|---|
| 318 | 318 | | initiate consultation or collaboration with or referral or transfer of a client to a licensed277 |
|---|
| 319 | 319 | | healthcare provider or facility at an earlier stage than mandated by administrative rule if,278 |
|---|
| 320 | 320 | | based on the licensed midwife's professional judgment and experience, the health status of279 |
|---|
| 321 | 321 | | the mother or infant necessitates such action.280 |
|---|
| 322 | 322 | | 43-24B-14.281 |
|---|
| 323 | 323 | | (a) If a licensed midwife initiates consultation or collaboration with or the referral or282 |
|---|
| 324 | 324 | | transfer of a client to a licensed healthcare provider or facility, the responsibility of the283 |
|---|
| 325 | 325 | | provider or facility for the client shall not begin until the client is physically within the care284 |
|---|
| 326 | 326 | | of such provider or facility.285 |
|---|
| 327 | 327 | | (b) A licensed healthcare provider who examines a licensed midwife's client shall only be286 |
|---|
| 328 | 328 | | liable for the actual examination and shall not be held accountable for the client's decision287 |
|---|
| 329 | 329 | | to pursue an out-of-hospital birth or the services of a licensed midwife.288 |
|---|
| 330 | 330 | | H. B. 520 |
|---|
| 331 | 331 | | - 12 - 25 LC 55 0511 |
|---|
| 332 | 332 | | (c)(1) A licensed healthcare provider may, upon receiving a briefing or data from a289 |
|---|
| 333 | 333 | | licensed midwife, issue a medical order for the licensed midwife's client, without that290 |
|---|
| 334 | 334 | | client being an explicit patient of such provider.291 |
|---|
| 335 | 335 | | (2) Regardless of the advice given or order issued, the responsibility and liability for292 |
|---|
| 336 | 336 | | caring for the client shall be that of the licensed midwife.293 |
|---|
| 337 | 337 | | (3) The provider giving the order shall be responsible and liable only for the294 |
|---|
| 338 | 338 | | appropriateness of the order, given the briefing or data received.295 |
|---|
| 339 | 339 | | (4) The issuing of an order for a licensed midwife's client shall not constitute a296 |
|---|
| 340 | 340 | | delegation of duties from the other provider to the licensed midwife.297 |
|---|
| 341 | 341 | | (d) A licensed midwife shall be solely responsible for the administration of medications298 |
|---|
| 342 | 342 | | by such licensed midwife as authorized under this chapter.299 |
|---|
| 343 | 343 | | 43-24B-15.300 |
|---|
| 344 | 344 | | A licensed midwife shall not be authorized to:301 |
|---|
| 345 | 345 | | (1) Administer a prescription drug to a client in a manner that violates this chapter;302 |
|---|
| 346 | 346 | | (2) Effect any type of surgical delivery except for the cutting of an emergency303 |
|---|
| 347 | 347 | | episiotomy;304 |
|---|
| 348 | 348 | | (3) Administer any type of epidural, spinal, or caudal anesthetic or any type of narcotic305 |
|---|
| 349 | 349 | | analgesic; or306 |
|---|
| 350 | 350 | | (4) Use forceps or a vacuum extractor.307 |
|---|
| 351 | 351 | | 43-24B-16.308 |
|---|
| 352 | 352 | | Nothing in this chapter shall be construed to abridge or limit in any way the right of a309 |
|---|
| 353 | 353 | | parent or parents to deliver a fetus where, when, how, and with whom they choose.310 |
|---|
| 354 | 354 | | 43-24B-17.311 |
|---|
| 355 | 355 | | (a) Nothing in this chapter shall be construed to prevent:312 |
|---|
| 356 | 356 | | H. B. 520 |
|---|
| 357 | 357 | | - 13 - 25 LC 55 0511 |
|---|
| 358 | 358 | | (1) Any licensed healthcare professional from engaging in the authorized scope of313 |
|---|
| 359 | 359 | | practice of his or her profession;314 |
|---|
| 360 | 360 | | (2) Members of a pregnant woman's family from providing incidental care;315 |
|---|
| 361 | 361 | | (3) Representatives of a pregnant woman's culture from providing care consistent with316 |
|---|
| 362 | 362 | | the tenets or practices of such culture or representatives of a pregnant woman's religion317 |
|---|
| 363 | 363 | | from providing care consistent with practices of such religion; provided, however, that318 |
|---|
| 364 | 364 | | such representatives shall not hold themselves out as licensed midwives unless such319 |
|---|
| 365 | 365 | | representatives are licensed under this chapter; or320 |
|---|
| 366 | 366 | | (4) Precepted apprentices, student midwives, and midwifery assistants from providing321 |
|---|
| 367 | 367 | | midwifery services under the supervision and in the physical presence of a licensed322 |
|---|
| 368 | 368 | | midwife.323 |
|---|
| 369 | 369 | | (b) The practice of midwifery shall not constitute the practice of medicine in this state.324 |
|---|
| 370 | 370 | | (c) Nothing in this chapter shall be construed to change the regulation of physicians as325 |
|---|
| 371 | 371 | | provided for in the laws of this state.326 |
|---|
| 372 | 372 | | 43-24B-18.327 |
|---|
| 373 | 373 | | Any health insurance policy, health maintenance organization plan, or other form of health328 |
|---|
| 374 | 374 | | insurance coverage, including Medicaid, that covers maternity care shall not deny coverage329 |
|---|
| 375 | 375 | | for maternity care provided by a licensed midwife in any setting and shall reimburse330 |
|---|
| 376 | 376 | | maternity care by a licensed midwife at the same rate as for other providers of maternity331 |
|---|
| 377 | 377 | | care covered by the policy, plan, or coverage.332 |
|---|
| 378 | 378 | | 43-24B-19.333 |
|---|
| 379 | 379 | | Any violation of this chapter or any rules and regulations adopted pursuant to this chapter334 |
|---|
| 380 | 380 | | is declared to be a public nuisance subject to abatement as provided in Code Section335 |
|---|
| 381 | 381 | | 31-5-9."336 |
|---|
| 382 | 382 | | H. B. 520 |
|---|
| 383 | 383 | | - 14 - 25 LC 55 0511 |
|---|
| 384 | 384 | | SECTION 4. |
|---|
| 385 | 385 | | 337 |
|---|
| 386 | 386 | | Said title is further amended in subsection (a) of Code Section 43-26-12, relating to338 |
|---|
| 387 | 387 | | exceptions to the operation of the "Georgia Registered Professional Nurse Practice Act," by339 |
|---|
| 388 | 388 | | striking "and" at the end of subparagraph (E) of paragraph (9), by replacing the period at the340 |
|---|
| 389 | 389 | | end of paragraph (10) with "; and", and by adding a new paragraph to read as follows:341 |
|---|
| 390 | 390 | | "(11) The practice of midwifery by a licensed midwife pursuant to Chapter 24B of this |
|---|
| 391 | 391 | | 342 |
|---|
| 392 | 392 | | title."343 |
|---|
| 393 | 393 | | SECTION 5.344 |
|---|
| 394 | 394 | | This Act shall become effective upon its approval by the Governor or upon its becoming law345 |
|---|
| 395 | 395 | | without such approval.346 |
|---|
| 396 | 396 | | SECTION 6.347 |
|---|
| 397 | 397 | | All laws and parts of laws in conflict with this Act are repealed.348 |
|---|
| 398 | 398 | | H. B. 520 |
|---|
| 399 | 399 | | - 15 - |
|---|