1 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 Fiscal Note Fiscal Services Division 2 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