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HF 265 – Midwives, Licensure (LSB1036HV)
Staff Contact: Christopher Ubben (515.725.0134) chris.ubben@legis.iowa.gov
Fiscal Note Version – New
Description
House File 265 requires a person practicing midwifery in Iowa to obtain a license 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 the
Board of Midwifery to regulate the practice of midwifery in Iowa and makes conforming changes.
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 benefits
provided by other health care providers.
Assumptions
• The University of Iowa reports there were 138 certified nurse-midwives employed in Iowa in
2018. The Bureau of Labor Statistics stated that there were 40 nurse-midwives in Iowa; the
Bureau did not include data on nurse-midwives in 2022. The costs associated with
establishing a new licensing board and the required fees to sustain the licensing board are
calculated based on this number.
• The HHS will require start-up costs for the new licensing board including 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.
• Absent an appropriation to assist with start-up costs, and based on the number of active
certified nurse-midwives reported by the University of Iowa, the initial licensure fees required
to cover the costs for FY 2024-2026 of establishing the board would be approximately
$1,565 per license. The renewal fee to sustain the board’s ongoing activities for FY 2026-
2028 would be approximately $888 per license.
Fiscal Impact
The Department of Health and Human Services (HHS) reports that initial start-up costs of
establishing a new licensing board would require an estimated $216,000 and 0.4 full-time
equivalent (FTE) position beginning in FY 2024. Ongoing costs are anticipated by the HHS to
be $123,000 for every two-year licensing cycle.
Of the $216,000 in start-up costs, an estimated $93,500 will be dedicated to contracting with the
HHS’s third-party information technology vendor to perform software and database upgrades to
accommodate the new board. The 0.4 FTE position includes 0.2 FTE position assigned to a
board executive and 0.2 FTE position assigned to legal counsel.
Table 1 shows the estimated revenue required by the HHS every two years for the program to
cover the costs of the licensure board.
Fiscal Note
Fiscal Services Division 2
Table 1 — Board of Midwifery License Fees
Sources
Department of Health and Human Services
Board of Regents
/s/ Jennifer Acton
March 8, 2023
Doc ID 1368998
The fiscal note for this Bill was prepared pursuant to Joint Rule 17 and the Iowa Code. Data used in developing this
fiscal note is available from the Fiscal Services Division of the Legislative Services Agency upon request.
www.legis.iowa.gov Fiscal YearTotal Cost
Estimated Number
of Licensees
Cost Per
License
FY 2024 216,000$ 138 1,565$
FY 2026 123,000$ 138 888$