Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H4999 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 49
2	2	HOUSE . . . . . . . . . . . . . . No. 4999
3	3	The Commonwealth of Massachusetts
4	4	_______________
5	5	The committee of conference on the disagreeing votes of the two branches with reference
6	6	to the Senate amendments (striking out all after the enacting clause and inserting in place thereof
7	7	the text contained in Senate document numbered 2928; and by striking out the title and inserting
8	8	in place thereof the following title: “An Act relative to increasing access to perinatal health
9	9	care.”) of the House Bill promoting access to midwifery care and out-of-hospital birth options
10	10	(House, No. 4785), reports recommending passage of the accompanying bill (House, No. 4999).
11	11	August 14, 2024.
12	12	Marjorie C. DeckerCindy F. FriedmanMichael J. MoranLiz MirandaKimberly N. FergusonPatrick O’Connor 2 of 49
13	13	FILED ON: 8/14/2024
14	14	HOUSE . . . . . . . . . . . . . . . No. 4999
15	15	The Commonwealth of Massachusetts
16	16	_______________
17	17	In the One Hundred and Ninety-Third General Court
18	18	(2023-2024)
19	19	_______________
20	20	An Act promoting access to midwifery care and out-of-hospital birth options.
21	21	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
22	22	of the same, as follows:
23	23	1 SECTION 1. Chapter 6A of the General Laws is hereby amended by inserting after
24	24	2section 16FF the following section:-
25	25	3 Section 16GG. (a) As used in this section, the following words shall have the following
26	26	4meanings unless the context clearly requires otherwise:
27	27	5 “Eligible entity”, a non-profit or community-based organization or health center serving
28	28	6perinatal individuals including, but not limited to: (i) a recognized Indian tribe or tribal
29	29	7organization; (ii) an organization serving individuals from medically underserved populations
30	30	8and other underserved populations; and (iii) a public health agency, including a municipal public
31	31	9health department.
32	32	10 “Medically underserved populations”, a historically underserved population or a
33	33	11population within a geographic area with a lack of access to primary care, behavioral health or
34	34	12perinatal healthcare providers or have a high infant mortality, high poverty or high elderly
35	35	13population, as determined by the secretary. 3 of 49
36	36	14 “Perinatal health outcomes”, health outcomes related to perinatal individuals.
37	37	15 “Perinatal individual”, an individual that: (i) is either pregnant or is within 12 months
38	38	16from the date of giving birth; (ii) is a biological parent or an adoptive or foster parent who is
39	39	17within 12 months from assuming custodial care of a child; or (iii) has lost a pregnancy due to a
40	40	18stillbirth, miscarriage or a medical termination within the previous 12 months.
41	41	19 “Secretary”, the secretary of health and human services.
42	42	20 (b) Subject to appropriation, the secretary shall establish a program to award grants to
43	43	21eligible entities to address mental health conditions and substance use disorders for perinatal
44	44	22individuals.
45	45	23 (c) The secretary shall promulgate regulations and guidelines as necessary to develop and
46	46	24implement the grant application process and eligible uses of grant funds pursuant to this section.
47	47	25 (d) The secretary shall give preference to eligible entities that:
48	48	26 (i) are community-based organizations or entities partnering with community-based
49	49	27organizations to address mental health conditions or substance use disorders in perinatal
50	50	28individuals; and
51	51	29 (ii) operate in areas with high rates of adverse perinatal health outcomes or significant
52	52	30disparities in perinatal health outcomes, as determined by the secretary.
53	53	31 (e) An eligible entity that receives a grant under this section shall use funds for
54	54	32establishing or expanding programs that improve or address mental health, behavioral health or
55	55	33substance use disorders for perinatal individuals with a focus on perinatal individuals from
56	56	34medically underserved populations. 4 of 49
57	57	35 (f) The secretary shall provide, directly or by contract, technical assistance to eligible
58	58	36entities seeking a grant or receiving a grant under this section for the development, use,
59	59	37evaluation and post-grant period sustainability of the program proposed, established or expanded
60	60	38through the grant. The secretary shall advertise or promote such technical assistance to eligible
61	61	39entities to raise awareness about the grants and technical assistance.
62	62	40 (g) The secretary shall promulgate regulations as necessary to implement subsection (f)
63	63	41and for the collection of quantitative and qualitative data, delineated by demographic
64	64	42information, on the activities conducted and individuals served pursuant to such grants.
65	65	43 SECTION 2. Section 9 of chapter 13 of the General Laws, as appearing in the 2022
66	66	44Official Edition, is hereby amended by inserting after the word “counselors”, in line 7, the
67	67	45following words:- , the board of registration in midwifery.
68	68	46 SECTION 3. Section 11A of said chapter 13, as so appearing, is hereby amended by
69	69	47striking out the first paragraph and inserting in place thereof the following paragraph:-
70	70	48 There shall be a board of allied health professions, hereinafter called the board, which
71	71	49shall consist of 15 members who are residents of the commonwealth to be appointed by the
72	72	50governor, 3 of whom shall be qualified athletic trainers licensed pursuant to section 23B of
73	73	51chapter 112, 2 of whom shall be occupational therapists licensed pursuant to said section 23B of
74	74	52said chapter 112, 1 of whom shall be an occupational therapy assistant licensed pursuant to said
75	75	53section 23B of said chapter 112, 2 of whom shall be physical therapists licensed pursuant to said
76	76	54section 23B of said chapter 112, 1 of whom shall be a physical therapist assistant licensed
77	77	55pursuant to said section 23B of said chapter 112, 3 of whom shall be lactation consultants
78	78	56licensed pursuant to said section 23B of said chapter 112, 2 of whom shall be physicians licensed 5 of 49
79	79	57pursuant to section 2 of said chapter 112 and 1 of whom shall be selected from and shall
80	80	58represent the general public.
81	81	59 SECTION 4. Said section 11A of said chapter 13, as so appearing, is hereby further
82	82	60amended by striking out, in lines 51 and 52, the words “or physical therapy” and inserting in
83	83	61place thereof the following words:- physical therapy or lactation consulting.
84	84	62 SECTION 5. Said chapter 13 is hereby further amended by adding the following section:-
85	85	63 Section 110. (a) There shall be within the department of public health a board of
86	86	64registration in midwifery, hereinafter called the board. The board shall consist of 9 members who
87	87	65are residents of the commonwealth to be appointed by the governor, 5 of whom shall be
88	88	66midwives licensed under section 293 of chapter 112 with not less than 5 years of experience in
89	89	67the practice of midwifery, 1 of whom shall be an obstetrician-gynecologist licensed to practice
90	90	68medicine under section 2 of said chapter 112 with experience working with midwives, 1 of
91	91	69whom shall be a maternal-fetal medicine specialist licensed to practice medicine under said
92	92	70section 2 of said chapter 112 with experience working with midwives, 1 of whom shall be a
93	93	71certified nurse-midwife licensed under section 80B of said chapter 112 and authorized to practice
94	94	72nurse-midwifery under section 80C of said chapter 112 and 1 of whom shall be a member of the
95	95	73public. When making the appointments to the board, the governor shall consider members with
96	96	74experience working on the issue of racial disparities in maternal health. The appointed members
97	97	75of the board shall serve for terms of 3 years. Upon the expiration of a term of office, a member
98	98	76shall continue to serve until a successor has been appointed and qualified. A member shall not
99	99	77serve for more than 2 consecutive full terms; provided, however, that a person who is chosen to
100	100	78fill a vacancy in an unexpired term of a prior board member may serve for 2 consecutive full 6 of 49
101	101	79terms in addition to the remainder of such unexpired term. A member may be removed by the
102	102	80governor for neglect of duty, misconduct, malfeasance or misfeasance in the office after a written
103	103	81notice of the charges against the member and sufficient opportunity to be heard thereon. Upon
104	104	82the death, resignation or removal for cause of a member of the board, the governor shall fill the
105	105	83vacancy for the remainder of that member’s term.
106	106	84 (b) Annually, the board shall elect from its membership a chair and a secretary who shall
107	107	85serve until their successors have been elected and qualified. The board shall meet not less than 4
108	108	86times annually and may hold additional meetings at the call of the chair or upon the request of
109	109	87not less than 5 members. A quorum for the conduct of official business shall be a majority of
110	110	88those appointed. Board members shall serve without compensation but shall be reimbursed for
111	111	89actual and reasonable expenses incurred in the performance of their duties. The members shall be
112	112	90public employees for the purposes of chapter 258 for all acts or omissions within the scope of
113	113	91their duties as board members.
114	114	92 SECTION 6. Chapter 32A of the General Laws is hereby amended by inserting after
115	115	93section 17T, inserted by section 74 of chapter 140 of the acts of 2024, the following 3 sections:-
116	116	94 Section 17U. The commission shall provide to any active or retired employee of the
117	117	95commonwealth who is insured under the group insurance commission coverage for postpartum
118	118	96depression and major depressive disorder screenings conducted pursuant to section 247 of
119	119	97chapter 111.
120	120	98 Section 17V. (a) The commission shall provide to any active or retired employee of the
121	121	99commonwealth who is insured under the group insurance commission coverage for the provision 7 of 49
122	122	100of medically necessary pasteurized donor human milk and donor human milk-derived products;
123	123	101provided, however, that:
124	124	102 (i) the milk is obtained from a human milk bank that meets quality guidelines established
125	125	103by the department of public health;
126	126	104 (ii) a licensed medical practitioner has issued a written order for the provision of such
127	127	105human breast milk or donor human milk-derived products for the covered infant; and
128	128	106 (iii) the covered infant is:
129	129	107 (1) under the age of 6 months;
130	130	108 (2) undergoing treatment in an inpatient setting for a congenital or acquired condition that
131	131	109places the infant at a high risk for development of necrotizing enterocolitis or a congenital or
132	132	110acquired condition that may benefit from the use of such human breast milk as determined by the
133	133	111department of public health; and
134	134	112 (3) medically or physically unable to receive maternal breast milk or participate in
135	135	113breastfeeding or whose mother is medically or physically unable, despite receiving lactation
136	136	114support, to produce maternal breast milk in sufficient quantities or caloric density.
137	137	115 (b) If an inpatient stay is reimbursed through a diagnosis related group or other bundled
138	138	116payment arrangement, the commission shall include the cost of reimbursement provided under
139	139	117subsection (a) for donor human milk and donor human milk-derived products in the development
140	140	118of the reimbursement rate for such diagnosis related group or bundled payment.
141	141	119 Section 17W. The commission shall provide to any active or retired employee of the
142	142	120commonwealth who is insured under the group insurance commission coverage for universal 8 of 49
143	143	121postpartum home visiting services in accordance with operational standards set by the
144	144	122department of public health pursuant to section 248 of chapter 111. Such coverage shall not be
145	145	123subject to cost-sharing, including co-payments and co-insurance, and shall not be subject to any
146	146	124deductible; provided, however, that cost-sharing shall be required if the applicable plan is
147	147	125governed by the Internal Revenue Code and would lose its tax-exempt status as a result of the
148	148	126prohibition on cost-sharing for this service.
149	149	127 SECTION 7. Section 1E of chapter 46 of the General Laws, as appearing in the 2022
150	150	128Official Edition, is hereby amended by inserting after the definition of “Administrator” the
151	151	129following definition:-
152	152	130 “Certified nurse-midwife”, a nurse licensed under section 80B of said chapter 112 and
153	153	131authorized to practice nurse-midwifery under section 80C of said chapter 112.
154	154	132 SECTION 8. Said section 1E of said chapter 46, as so appearing, is hereby further
155	155	133amended by inserting after the definition of “Hospital medical officer” the following definition:-
156	156	134 “Licensed certified professional midwife”, a midwife licensed to practice by the board of
157	157	135registration in midwifery pursuant to section 293 of chapter 112.
158	158	136 SECTION 9. Section 3B of said chapter 46, as so appearing, is hereby amended by
159	159	137inserting after the word “physician”, in line 1, the following words:- , certified nurse-midwife or
160	160	138licensed certified professional midwife.
161	161	139 SECTION 10. Section 1 of chapter 94C of the General Laws, as so appearing, is hereby
162	162	140amended by inserting after the definition of “Isomer” the following definition:- 9 of 49
163	163	141 “Licensed certified professional midwife”, a midwife licensed to practice by the board of
164	164	142registration in midwifery pursuant to section 293 of chapter 112.
165	165	143 SECTION 11. Section 7 of said chapter 94C, as so appearing, is hereby amended by
166	166	144adding the following subsection:-
167	167	145 (j) The commissioner shall promulgate regulations that provide for the automatic
168	168	146registration of licensed certified professional midwives, upon the receipt of the fee as herein
169	169	147provided, to issue written prescriptions in accordance with the provisions of section 295 of
170	170	148chapter 112 and the regulations issued by the board of registration in midwifery under said
171	171	149section 295 of said chapter 112, unless the registration of such licensed certified professional
172	172	150midwife has been suspended or revoked pursuant to the provisions of section 13 or section 14 or
173	173	151unless such registration is denied for cause by the commissioner pursuant to chapter 30A. Prior
174	174	152to promulgating such regulations, the commissioner shall consult with the board of registration in
175	175	153midwifery and the department of public health.
176	176	154 SECTION 12. Section 9 of said chapter 94C, as so appearing, is hereby amended by
177	177	155inserting after the figure “112”, in line 7, the following words:- , licensed certified professional
178	178	156midwife as limited by subsection (j) of said section 7 and section 295 of said chapter 112.
179	179	157 SECTION 13. Said section 9 of said chapter 94C, as so appearing, is hereby further
180	180	158amended by inserting after the word “midwife”, in lines 24, 33, 38, 69, 75, 78 and 87, in each
181	181	159instance, the following words:- , licensed certified professional midwife.
182	182	160 SECTION 14. Said section 9 of said chapter 94C, as so appearing, is hereby further
183	183	161amended by inserting after the word “nurse-midwifery”, in line 29, the following word:- ,
184	184	162midwifery. 10 of 49
185	185	163 SECTION 15. Section 24O of chapter 111 of the General Laws, as inserted by section 43
186	186	164of chapter 28 of the acts of 2023, is hereby amended by striking out subsection (d), the second
187	187	165time the subsection appears, and subsection (e), and inserting in place thereof the following 3
188	188	166subsections:-
189	189	167 (e)(1) The committee shall consist of the following members: the commissioner, or their
190	190	168designee, who shall serve as chair; the assistant secretary for MassHealth, or their designee, a
191	191	169representative of the department of public health; the executive director of the health policy
192	192	170commission, or their designee; a representative of the Perinatal-Neonatal Quality Improvement
193	193	171Network of Massachusetts; the chief medical examiner, or their designee; the chair of the
194	194	172Massachusetts chapter of the American College of Obstetrics and Gynecology, or their designee;
195	195	173the chair of the Massachusetts chapter of the American College of Nurse Midwives, or their
196	196	174designee; the chair of the Massachusetts chapter of the Association of Women's Health, Obstetric
197	197	175and Neonatal Nurses, or their designee; and the commissioner shall appoint the following
198	198	176members: a medical professional with obstetric and neonatal nursing training; a medical
199	199	177professional with training in cardiology; a medical professional with training in pathology; a
200	200	178medical professional with expertise in substance use prevention and treatment; a psychology,
201	201	179social work or other mental health professional; a representative from academia in a relevant
202	202	180field; a medical professional with formal anesthesiology training; a medical professional with
203	203	181maternal fetal medicine or perinatology training; a medical professional with psychiatric
204	204	182training; a medical professional with family medicine training; the director of a federally-funded
205	205	183Healthy Start program, or their designee; 2 individuals who practice as doulas; 2 community or
206	206	184family members who have been directly affected by a maternal death; a member of a 11 of 49
207	207	185community-based organization; a representative from the department of children and families;
208	208	186and a law enforcement officer.
209	209	187 (2) Each member, other than the commissioner, shall serve for a term of 3 years and until
210	210	188their successor is appointed. Nothing in this section shall prohibit the commissioner from
211	211	189appointing a committee member to serve additional terms. The committee shall convene as
212	212	190deemed necessary by the department. The commissioner shall, to the extent feasible, appoint
213	213	191members representing the racial, ethnic and geographic diversity of the commonwealth and shall
214	214	192prioritize appointing members from communities and groups most impacted by maternal
215	215	193mortality and maternal morbidity.
216	216	194 (f) Not later than December 31 of each even-numbered year, the committee shall submit
217	217	195to the clerks of the house of representatives and the senate, the house and senate committees on
218	218	196ways and means and the joint committee on public health a report, including, but not limited to:
219	219	197 (i) a description of the incidents of maternal mortality and severe maternal morbidity
220	220	198reviewed during the immediately preceding 24 months, provided in a manner that shall not allow
221	221	199for the identification of any person;
222	222	200 (ii) a summary of the disparities identified and reviewed;
223	223	201 (iii) recommendations to reduce maternal mortality and severe maternal morbidity in the
224	224	202commonwealth; and
225	225	203 (iv) recommendations for any legislation or other changes to policy to reduce maternal
226	226	204mortality and severe maternal morbidity or otherwise improve the delivery of health care in the
227	227	205commonwealth. 12 of 49
228	228	206 (g) Notwithstanding any general or special law to the contrary, upon the determination of
229	229	207a majority of the committee that the review of any information or record is necessary to carry out
230	230	208the purpose of this section, the committee shall request and the relevant offices and agencies
231	231	209shall provide requested records or information from any agency, department or office of the
232	232	210commonwealth including, but not limited to: (i) the executive office of health and human
233	233	211services and its constituent agencies; (ii) the executive office of public safety and security; (iii)
234	234	212the center for health information and analysis; (iv) the office of patient protection; (v) a health
235	235	213care facility, state comprehensive health planning agency or acute-care hospital as defined in
236	236	214section 25B; and (vi) a health care provider or professional licensed pursuant to chapter 112. The
237	237	215committee may receive and solicit voluntary information, including oral or written statements
238	238	216relating to any case that may come before the committee from any public or private entity and
239	239	217any person including, but not limited to, a patient in a case of maternal morbidity.
240	240	218 SECTION 16. Said chapter 111 is hereby further amended by inserting after section 24O
241	241	219the following section:-
242	242	220 Section 24P. (a) As used in this section the following words shall, unless the context
243	243	221clearly requires otherwise, have the following meanings:
244	244	222 “Fetal death”, as defined in section 202.
245	245	223 “Infant death”, the death of an infant that occurs between the birth of the infant and 1
246	246	224year of age.
247	247	225 (b) The department shall establish a program to conduct an in-depth fetal and infant
248	248	226mortality review of each individual fetal or infant death occurring within the commonwealth in
249	249	227order to identify social, economic and systems factors associated with fetal and infant deaths and 13 of 49
250	250	228inform public health policy programs. For each case of fetal or infant death to be reviewed, the
251	251	229department may collect relevant data from a variety of sources including, but not limited to,
252	252	230physician and hospital records and relevant information from local boards of health and
253	253	231community organizations.
254	254	232 (c) The department shall promulgate regulations consistent with this section regarding the
255	255	233process for conducting fetal infant mortality reviews, which shall include provisions for
256	256	234protecting confidential information and guidance from the federal Health Resources and Services
257	257	235Administration’s National Fetal, Infant, and Child Death Review Program.
258	258	236 SECTION 17. Said chapter 111 is hereby further amended by inserting after section 51L
259	259	237the following section:-
260	260	238 Section 51M. (a) The department shall promulgate regulations relative to the operation
261	261	239and maintenance of birth centers licensed as clinics pursuant to section 51, hereinafter referred to
262	262	240as “freestanding birth centers”.
263	263	241 (b) The regulations shall include, but shall not be limited to, requirements that a licensed
264	264	242freestanding birth center have:
265	265	243 (i) a detailed and written plan on the premises for transfer of a client to a nearby hospital
266	266	244providing obstetrical and newborn services as needed for emergency treatment beyond that
267	267	245provided by the birth center;
268	268	246 (ii) policies and procedures to ensure coordination of ongoing care and transfer when
269	269	247complications occur that render the patient ineligible for birth center care during the antepartum,
270	270	248intrapartum or postpartum period; 14 of 49
271	271	249 (iii) an administrative director responsible for implementing and overseeing the
272	272	250operational policies of the birth center;
273	273	251 (iv) a director of clinical affairs on staff who shall be a certified nurse-midwife, licensed
274	274	252certified professional midwife or physician licensed to practice in the commonwealth whose
275	275	253professional scope of practice includes preconception, prenatal, labor, birth and postpartum care
276	276	254and early care of the newborn and who may be the primary attendants during the perinatal
277	277	255period; and
278	278	256 (v) birth attendants that are certified nurse-midwives, licensed certified professional
279	279	257midwives, physicians or other providers licensed to practice in the commonwealth whose
280	280	258professional scope of practice includes preconception, prenatal, labor, birth and postpartum care
281	281	259and early care of the newborn and who may be the primary attendants in accordance with their
282	282	260professional scope of practice.
283	283	261 (c) The department shall not require a licensed freestanding birth center or the directors
284	284	262and providers on staff to practice under the supervision of a hospital or another health care
285	285	263provider or to enter into an agreement, written or otherwise, with another hospital or health care
286	286	264provider, or maintain privileges at a hospital.
287	287	265 (d) In order to be licensed as a freestanding birth center pursuant to subsection (a) and
288	288	266under section 51 by the department, a freestanding birth center shall provide reimbursable
289	289	267services to individuals with public health insurance on a non-discriminatory basis.
290	290	268 (e) Only freestanding birth centers and hospital-affiliated birth centers licensed by the
291	291	269department shall include the words “birth center” or “birthing center” in such center’s name. 15 of 49
292	292	270 SECTION 18. Section 110A of said chapter 111, as appearing in the 2022 Official
293	293	271Edition, is hereby amended by striking out the first paragraph and inserting in place thereof the
294	294	272following paragraph:-
295	295	273 The physician attending a newborn child shall cause said child to be subjected to tests for
296	296	274phenylketonuria, cretinism, Duchenne muscular dystrophy and such other specifically treatable
297	297	275genetic or biochemical disorders or treatable infectious diseases which may be determined by
298	298	276testing as specified by the commissioner. The commissioner shall convene an advisory
299	299	277committee on newborn screening to assist the commissioner in determining which tests are
300	300	278necessary; provided, however, that said advisory committee shall convene not less than twice per
301	301	279year.
302	302	280 SECTION 19. Section 202 of said chapter 111, as so appearing, is hereby amended by
303	303	281inserting after the word “physician”, in line 17, the following words:- , certified nurse-midwife
304	304	282or licensed certified professional midwife.
305	305	283 SECTION 20. Said section 202 of said chapter 111, as so appearing, is hereby further
306	306	284amended by inserting after the word “attendance”, in line 17, the following words:- , or without
307	307	285the attendance of a certified nurse-midwife or licensed certified professional midwife.
308	308	286 SECTION 21. Said chapter 111 is hereby further amended by adding the following 4
309	309	287sections:-
310	310	288 Section 245. (a) The commissioner shall develop and disseminate to the public,
311	311	289information regarding pregnancy loss, including miscarriage and recurrent miscarriage, which
312	312	290shall include information on: (i) the awareness of pregnancy loss and the incidence and
313	313	291prevalence of pregnancy loss among pregnant people; and (ii) the accessibility of the range of 16 of 49
314	314	292evidence-based treatment options, as medically appropriate, for pregnancy loss, including, but
315	315	293not limited to, comprehensive mental health supports, necessary procedures and medications and
316	316	294culturally responsive supports including pregnancy loss doula care. The commissioner shall
317	317	295ensure that information disseminated pursuant to this section is available in multiple languages,
318	318	296including, but not limited to Spanish, Portuguese, Mandarin, Cantonese, Haitian Creole and other
319	319	297spoken languages in the commonwealth.
320	320	298 (b) The commissioner may disseminate information to the public directly through the
321	321	299department’s website or through arrangements with agencies carrying out intra-agency
322	322	300initiatives, nonprofit organizations, consumer groups, community organizations, institutions of
323	323	301higher education or state or local public-private partnerships.
324	324	302 (c) The commissioner shall develop and coordinate programs for conducting and
325	325	303supporting evidence-based research with respect to the causes of pregnancy loss and treatment
326	326	304options.
327	327	305 (d) The commissioner shall, in consultation with and in accordance with guidelines from
328	328	306relevant professional boards of registration, develop and disseminate to perinatal health care
329	329	307workers information on pregnancy loss to ensure that such perinatal health care workers remain
330	330	308informed about current information regarding pregnancy loss and prioritizing both the physical
331	331	309and mental health care of patients experiencing pregnancy loss. For the purposes of this
332	332	310subsection, the term “perinatal health care worker” shall include, but shall not be limited to, a
333	333	311physician, certified nurse-midwife, licensed certified professional midwife, physician assistant,
334	334	312nurse practitioner, clinical nurse specialist, doula, community health worker, peer supporter, 17 of 49
335	335	313licensed lactation consultant, nutritionist or dietitian, childbirth educator, social worker, trained
336	336	314family support specialist or home visitor, and language interpreter or navigator.
337	337	315 (e) The commissioner shall, in a manner that protects personal privacy and complies with
338	338	316federal law, collect and assess data regarding pregnancy loss, including information
339	339	317disaggregated by race, ethnicity, health insurance status, disability, income level and geography
340	340	318on the prevalence of, the incidence of and knowledge about pregnancy loss.
341	341	319 Section 246. (a) As used in this section, the following words shall have the following
342	342	320meanings unless the context clearly requires otherwise:
343	343	321 “Perinatal individual”, an individual that: (i) is either pregnant or is within 12 months
344	344	322from the date of giving birth; (ii) is a biological parent or an adoptive or foster parent who is
345	345	323within 12 months from assuming custodial care of a child; or (iii) has lost a pregnancy due to a
346	346	324stillbirth, miscarriage or a medical termination within the previous 12 months.
347	347	325 “Perinatal mood and anxiety disorders”, a mental health disorder experienced by an
348	348	326individual during the period of time from the beginning of pregnancy up until 12 months
349	349	327following the birth of a child or after the end of pregnancy, including, but not limited to,
350	350	328postpartum depression, or major depressive disorder associated with: (i) the care of a child
351	351	329experienced by a biological parent or an adoptive or foster parent who is within 12 months from
352	352	330assuming custodial care of a child; or (ii) pregnancy loss experienced by an individual who has
353	353	331lost a pregnancy due to a stillbirth, miscarriage or a medical termination within the previous 12
354	354	332months.
355	355	333 (b) The department shall develop and maintain a comprehensive digital resource center
356	356	334on perinatal mood and anxiety disorders. The digital resource center shall be available to the 18 of 49
357	357	335public at no cost on the department’s website, and shall include information and resources for: (i)
358	358	336health care providers and organizations serving perinatal individuals to aid them in diagnosing,
359	359	337treating or making appropriate referrals for individuals experiencing perinatal mood and anxiety
360	360	338disorders; (ii) perinatal individuals and their families to aid them in understanding and
361	361	339identifying perinatal mood and anxiety disorders and how to navigate available resources and
362	362	340obtain treatment.
363	363	341 (c) Prior to developing the comprehensive digital resource center, the department shall
364	364	342consult with: (i) health care professionals, including, but not limited to, obstetricians,
365	365	343gynecologists, pediatricians, primary care providers, certified nurse-midwives, licensed certified
366	366	344professional midwives, psychiatrists, and other mental health clinicians; (ii) organizations
367	367	345serving perinatal individuals; and (iii) health insurance carriers.
368	368	346 (d) The department shall develop and implement a public information campaign to
369	369	347promote awareness of perinatal mood and anxiety disorders, which shall promote the digital
370	370	348resource center developed pursuant to this section.
371	371	349 Section 247. (a) For the purposes of this section, “postnatal individual” shall refer to an
372	372	350individual who: (i) is within 12 months of giving birth; (ii) is a biological parent or an adoptive
373	373	351or foster parent that is within 12 months from assuming custodial care of a child; or (iii) has lost
374	374	352a pregnancy due to a stillbirth, miscarriage or a medical termination within the previous 12
375	375	353months.
376	376	354 (b) Every postnatal individual who receives health care services from a primary care
377	377	355provider, obstetrician, gynecologist, certified nurse-midwife or licensed certified professional
378	378	356midwife shall be offered a screening for postpartum depression or major depressive disorder and, 19 of 49
379	379	357if the postnatal individual does not object to such screening, such primary care provider, certified
380	380	358nurse-midwife or licensed certified professional midwife shall ensure that the postnatal
381	381	359individual is appropriately screened for postpartum depression or major depressive disorder in
382	382	360line with evidence-based guidelines.
383	383	361 (c) Every postnatal individual whose infant receives health care services from a
384	384	362pediatrician shall be offered a screening for postpartum depression or major depressive disorder
385	385	363by the infant’s pediatrician, and, if the postnatal individual does not object to such screening,
386	386	364such pediatrician shall ensure that the postnatal individual is appropriately screened for
387	387	365postpartum depression or major depressive disorder in accordance with evidence-based
388	388	366guidelines.
389	389	367 (d) If a health care professional administering a screening in accordance with this section
390	390	368determines, based on the screening methodology administered, that the postnatal individual is
391	391	369likely to be suffering from postpartum depression or major depressive disorder, such health care
392	392	370professional shall discuss available treatments for postpartum depression or major depressive
393	393	371disorder, including pharmacological treatments, and provide an appropriate referral to a mental
394	394	372health clinician.
395	395	373 Section 248. (a) As used in this section, the following words shall have the following
396	396	374meanings unless the context clearly requires otherwise:
397	397	375 “Programs”, entities or providers qualified by the department to provide universal
398	398	376postpartum home visiting services.
399	399	377 “Provider”, an entity or individual that provides universal postpartum home visiting
400	400	378services. 20 of 49
401	401	379 “Universal postpartum home visiting services”, evidence-based, voluntary home or
402	402	380community-based services for birthing people and caregivers with newborns, including, but not
403	403	381limited to: (i) screenings for unmet health needs including reproductive health services; (ii)
404	404	382maternal and infant nutritional needs; and (iii) emotional health supports, including postpartum
405	405	383depression supports.
406	406	384 (b) The department shall establish and administer a statewide system of programs
407	407	385providing universal postpartum home visiting services; provided, however, that the department
408	408	386may contract with third-party service providers. Services shall be delivered by a qualified health
409	409	387professional with maternal and pediatric health training, as defined by the department; provided,
410	410	388however, that at least 1 visit shall occur at the patient’s home or a mutually agreed upon location
411	411	389within 8 weeks postpartum.
412	412	390 (c) A provider of universal postpartum home visiting services shall determine whether a
413	413	391recipient of its services is covered or may be eligible for coverage through an alternative source.
414	414	392A provider shall request payment for services it provides from third-party payers pursuant to
415	415	393chapters 32A, 118E, 175, 176A, 176B or 176G before payment is requested from the
416	416	394department.
417	417	395 (d) The department shall monitor and assess the effectiveness of universal postpartum
418	418	396home visiting services. Programs which are in receipt of state or federal funding for said services
419	419	397shall report such information as requested by the department for the purpose of monitoring,
420	420	398assessing the effectiveness of such programs, initiating quality improvement and reducing health
421	421	399disparities. 21 of 49
422	422	400 SECTION 22. Chapter 112 of the General Laws is hereby amended by inserting after
423	423	401section 2D the following section:-
424	424	402 Section 2E. A person shall not provide ultrasound services pertaining to a possible or
425	425	403actual pregnancy except under the supervision of a provider or other licensed health care
426	426	404professional who, acting within their scope of practice, provides medical care for people who are
427	427	405pregnant or may become pregnant.
428	428	406 SECTION 23. Section 23A of said chapter 112, as appearing in the 2022 Official Edition,
429	429	407is hereby amended by striking out, in lines 1 and 2, the words “twenty-three A to twenty-three P”
430	430	408and inserting in place thereof the following words:- 23A to 23P¾.
431	431	409 SECTION 24. Said section 23A of said chapter 112, as so appearing, is hereby further
432	432	410amended by inserting after the definition of “Board” the following 4 definitions:-
433	433	411 “International board-certified lactation consultant”, a person who holds current
434	434	412certification from the International Board of Lactation Consultant Examiners as a lactation
435	435	413consultant after demonstrating the appropriate education, knowledge and experience necessary
436	436	414for independent clinical practice.
437	437	415 “International Board of Lactation Consultant Examiners”, the international certification
438	438	416body that confers the International Board Certified Lactation Consultant credential and which is
439	439	417independently accredited by the National Commission for Certifying Agencies.
440	440	418 “Lactation consulting”, the clinical application of scientific principles and a
441	441	419multidisciplinary body of evidence for evaluation, problem identification, treatment, education
442	442	420and consultation to families regarding the course of lactation and infant feeding; including, but 22 of 49
443	443	421not limited to: (i) clinical lactation assessment through the systematic collection of subjective
444	444	422and objective data; (ii) analysis of data and creation of a plan of care; (iii) development and
445	445	423implementation of a lactation care plan with demonstration and instruction to parents and
446	446	424communication to the primary health care provider; (iv) provision of lactation education to
447	447	425parents and health care providers; and (v) recommendation and use of assistive devices.
448	448	426 “Licensed lactation consultant”, a person licensed to practice lactation consulting in
449	449	427accordance with section 23B.
450	450	428 SECTION 25. Section 23B of said chapter 112, as so appearing, is hereby amended by
451	451	429striking out, in line 8, the words “and physical therapist assistants” and inserting in place thereof
452	452	430the following words:- , physical therapist assistants and lactation consultants.
453	453	431 SECTION 26. The first paragraph of said section 23B of said chapter 112, as so
454	454	432appearing, is hereby amended by striking out the fourth sentence and inserting in place thereof
455	455	433the following sentence:- An applicant who furnishes satisfactory proof that they are of good
456	456	434moral character and that they have met the educational and clinical practice requirements set
457	457	435forth in section 23F, 23G, 23H, 23I, 23J or 23J½ shall, upon payment of a fee determined by the
458	458	436secretary of administration and finance, be examined by the board and, if the applicant is found
459	459	437to be qualified and passes the examination, the applicant shall be licensed to practice.
460	460	438 SECTION 27. Section 23C of said chapter 112, as so appearing, is hereby amended by
461	461	439inserting after the word “assistant”, in line 4, the following words:- or lactation consultant.
462	462	440 SECTION 28. Said section 23C of said chapter 112, as so appearing, is hereby further
463	463	441amended by inserting after the word “chapter”, in line 11, the following words:- ; or as a licensed
464	464	442lactation consultant. 23 of 49
465	465	443 SECTION 29. Section 23D of said chapter 112, as so appearing, is hereby amended by
466	466	444inserting after the words “physical therapist assistant”, in line 3, the following words:- , or a
467	467	445licensed lactation consultant.
468	468	446 SECTION 30. Section 23E of said chapter 112, as so appearing, is hereby amended by
469	469	447inserting after the word “assistant”, in line 8, the following words:- or lactation consultant.
470	470	448 SECTION 31. Said section 23E of said chapter 112, as so appearing, is hereby further
471	471	449amended by inserting after the word “therapy”, in line 14, the following words:- or lactation
472	472	450consulting.
473	473	451 SECTION 32. Said section 23E of said chapter 112, as so appearing, is hereby further
474	474	452amended by inserting after the words “physical therapy services”, in line 21, the following
475	475	453words:- or lactation consulting services.
476	476	454 SECTION 33. Said section 23E of said chapter 112, as so appearing, is hereby further
477	477	455amended by inserting after the words “physical therapist”, in line 24, the following words:- or
478	478	456licensed lactation consultant.
479	479	457 SECTION 34. Said chapter 112 is hereby further amended by inserting after section 23J
480	480	458the following section:-
481	481	459 Section 23J½. An applicant for licensure as a lactation consultant shall:
482	482	460 (i) be not less than18 years of age;
483	483	461 (ii) have submitted a completed application upon a form and in such manner as the board
484	484	462prescribes, accompanied by applicable fees; 24 of 49
485	485	463 (iii) have met the education and clinical standards established for international board-
486	486	464certified lactation consultants by the International Board of Lactation Consultant Examiners or
487	487	465its successor organization;
488	488	466 (iv) have passed an examination adopted or administered by the board; provided,
489	489	467however, that the board may adopt a standardized national exam, including the examination
490	490	468required for certification by the International Board of Lactation Consultant Examiners or a
491	491	469successor or equivalent entity; and
492	492	470 (v) have completed such other requirements as may be prescribed by the board.
493	493	471 SECTION 35. Section 23K of said chapter 112, as appearing in the 2022 Official Edition,
494	494	472is hereby amended by inserting after the words “physical therapy”, in line 9, the following
495	495	473words:- or lactation consulting.
496	496	474 SECTION 36. Section 23L of said chapter 112, as so appearing, is hereby amended by
497	497	475striking out, in line 3, the words “or physical therapist assistant” and inserting in place thereof
498	498	476the following words:- physical therapist assistant or licensed lactation consultant.
499	499	477 SECTION 37. Said chapter 112 is hereby further amended by inserting after section
500	500	47823P½ the following section:-
501	501	479 Section 23P¾. (a) Except as otherwise provided in this section and sections 23C and 23E,
502	502	480no person shall hold themselves out to others as a licensed lactation consultant unless they hold a
503	503	481valid license issued in accordance with section 23B.
504	504	482 (b) Nothing in this section shall be construed to prevent the practice of lactation
505	505	483consulting by members of other licensed health care professions when such practice is consistent 25 of 49
506	506	484with the accepted standards and scope of practice for their respective professions; provided,
507	507	485however, that such persons shall not use the title “licensed lactation consultant” unless licensed
508	508	486pursuant to this chapter.
509	509	487 (c) Nothing in this chapter shall prevent perinatal health workers from performing
510	510	488breastfeeding education functions consistent with the accepted standards of their respective
511	511	489occupations; provided, however, such persons shall not use the title “licensed lactation
512	512	490consultant” unless licensed pursuant to this chapter. For the purposes of this subsection,
513	513	491“perinatal health worker” shall mean any perinatal educator and support provider, including, but
514	514	492not limited to, a doula, community health worker, peer counselor, peer supporter, breastfeeding
515	515	493and lactation counselor, breastfeeding and lactation educator or peer counselor within the
516	516	494Women, Infants, and Children Program, childbirth educator or social worker.
517	517	495 SECTION 38. Said chapter 112 is hereby further amended by adding the following 8
518	518	496sections:-
519	519	497 Section 290. As used in sections 291 to 297, inclusive, the following words shall have the
520	520	498following meanings unless the context clearly requires otherwise:
521	521	499 “Board”, the board of registration in midwifery, established under section 110 of chapter
522	522	50013.
523	523	501 “Certified nurse-midwife”, a nurse licensed under section 80B and authorized to practice
524	524	502nurse-midwifery under section 80C.
525	525	503 “Client”, a person under the care of a licensed certified professional midwife. 26 of 49
526	526	504 “Licensed certified professional midwife”, a person registered by the board to practice
527	527	505midwifery in the commonwealth under section 293.
528	528	506 “Low-risk pregnancy”, a pregnancy with no maternal or fetal factors that place the
529	529	507pregnancy at significantly increased risk for complications, as determined through regulation by
530	530	508the board in consultation with the department of public health, including, but not limited to,
531	531	509factors related to maternal or fetal health conditions likely to affect the pregnancy and the
532	532	510gestational age and presentation of the fetus at the time of labor and delivery.
533	533	511 “MEAC”, the Midwifery Education Accreditation Council or its successor organization.
534	534	512 “NARM”, the North American Registry of Midwives or its successor organization.
535	535	513 Section 291. (a) The practice of midwifery by a licensed certified professional midwife
536	536	514shall include, but shall not be limited to:
537	537	515 (i) the practice of providing maternity care to a client during the preconception period and
538	538	516the antepartum, intrapartum and postpartum periods of a low-risk pregnancy;
539	539	517 (ii) the practice of providing newborn care; and
540	540	518 (iii) prescribing, dispensing or administering pharmaceutical agents consistent with
541	541	519section 295.
542	542	520 (b) A licensed certified professional midwife shall accept and provide care to clients only
543	543	521in accordance with the scope and standards of practice under this section and regulations
544	544	522promulgated by the board pursuant to section 292. 27 of 49
545	545	523 (c) The practice of midwifery shall not constitute the practice of medicine, certified
546	546	524nurse-midwifery or emergency medical care.
547	547	525 (d) Nothing in this section shall regulate, restrict or prohibit the practice, service or
548	548	526activities of:
549	549	527 (i) a person licensed in the commonwealth from engaging in activities within the scope of
550	550	528practice of the profession or occupation for which such person is licensed, including, but not
551	551	529limited to, the practice of a licensed physician, certified nurse-midwife or certified emergency
552	552	530medical technician; provided, however, that such person does not represent to the public, directly
553	553	531or indirectly, that such person is licensed under section 293 and that such person does not use
554	554	532any name, title or designation indicating that such person is licensed under said section 293;
555	555	533 (ii) a person employed as a midwife by the federal government or an agency thereof if
556	556	534that person provides midwifery services solely under the direction and control of the
557	557	535organization by which such person is employed;
558	558	536 (iii) a traditional birth attendant who provides midwifery services to a client that has
559	559	537cultural or religious birth traditions that have historically included the attendance of traditional
560	560	538birth attendants; provided, however, that no fee for the traditional birth attendant’s services is
561	561	539contemplated, charged or received and the birth attendant serves only individuals and families in
562	562	540a distinct cultural or religious group;
563	563	541 (iv) persons who are members of Native American communities and provide traditional
564	564	542midwife services to their communities; or
565	565	543 (v) any person rendering aid in an emergency. 28 of 49
566	566	544 Section 292. (a) The board shall:
567	567	545 (i) adopt rules and promulgate regulations governing licensed certified professional
568	568	546midwives and the practice of midwifery to promote the public health, welfare and safety
569	569	547consistent with the essential competencies identified by NARM;
570	570	548 (ii) administer the licensing process, including, but not limited to: (A) receiving,
571	571	549reviewing, approving and rejecting applications for licensure; (B) issuing, renewing, suspending,
572	572	550revoking and reinstating licenses; (C) investigating complaints against persons licensed under
573	573	551section 293; and (D) holding hearings and ordering disciplinary sanctions against a person who
574	574	552violates sections 290 to 297, inclusive, or any regulation promulgated by the board;
575	575	553 (iii) establish administrative procedures for processing applications and renewals;
576	576	554 (iv) adopt and provide a uniform, proctored examination for applicants to measure the
577	577	555qualifications necessary for licensure; provided, however, that the board may adopt a
578	578	556standardized national exam, including the examination required for certification by NARM or a
579	579	557successor or equivalent entity;
580	580	558 (v) develop practice standards for licensed certified professional midwives that shall
581	581	559include, but not be limited to: (A) the adoption of ethical standards for licensed certified
582	582	560professional midwives; (B) the maintenance of records of care, including client charts; (C) the
583	583	561participation in peer review; (D) the development of standardized informed consent forms; and
584	584	562(E) the development of a standardized written emergency transport plan forms relative to the
585	585	563timely transfer of a newborn or client to a hospital; 29 of 49
586	586	564 (vi) promulgate regulations that may require licensed certified professional midwives to
587	587	565have professional malpractice liability insurance or a suitable bond or other indemnity against
588	588	566liability for professional malpractice in such an amount as may be determined by the board;
589	589	567 (vii) establish and maintain records of its actions and proceedings in accordance with
590	590	568public records laws; and
591	591	569 (viii) adopt professional continuing education requirements for licensed certified
592	592	570professional midwives seeking renewal consistent with those maintained by NARM.
593	593	571 (b) Nothing in this section shall be construed to authorize the board to promulgate
594	594	572regulations that require a licensed certified professional midwife to practice under the
595	595	573supervision of or in collaboration with another health care provider.
596	596	574 Section 293. (a) A person seeking licensure as a midwife under this section shall apply to
597	597	575the board in writing on an application form prescribed and furnished by the board. The
598	598	576application shall include a sworn statement and contain information satisfactory to the board to
599	599	577demonstrate that the applicant possesses the qualifications necessary for licensure under this
600	600	578section.
601	601	579 (b) The initial license and renewal fee shall be established pursuant to section 3B of
602	602	580chapter 7; provided, however, that such fees shall not exceed $200 biennially. The board, in
603	603	581consultation with the secretary of administration and finance, shall institute a process for
604	604	582applicants to apply for a financial hardship waiver, which may reduce or fully exempt an
605	605	583applicant from paying the fee pursuant to this section. Fees collected by the board shall be
606	606	584deposited into the Quality in Health Professions Trust Fund pursuant to section 35X of chapter 30 of 49
607	607	58510 to support board operations and administration and to reimburse board members for
608	608	586reasonable expenses incurred in the performance of their official duties.
609	609	587 (c) An applicant for licensure under this section shall: (i) be of good moral character; (ii)
610	610	588be a graduate of a high school or its equivalent; (iii) have completed a formal midwifery
611	611	589education and training program consistent with subsection (d); (iv) possess a valid certified
612	612	590professional midwife credential from NARM; and (v) have satisfactorily completed the
613	613	591examination required by the board.
614	614	592 (d) An applicant for a license to practice midwifery as a licensed certified professional
615	615	593midwife shall submit to the board as proof of successful completion of a formal midwifery
616	616	594education and training program either:
617	617	595 (i) a certificate of completion, or its equivalent, from an educational program or
618	618	596institution accredited by MEAC; or
619	619	597 (ii) a midwifery bridge certificate issued by NARM or a successor credential; provided,
620	620	598however, that the applicant: (A) received such bridge certification on or after September 1, 2019
621	621	599and completed a midwifery education and training program from an educational program or
622	622	600institution that is not accredited by MEAC; or (B) is licensed as a professional midwife in a state
623	623	601that does not require completion of a midwifery education and training program from an
624	624	602educational program or institution that is accredited by MEAC.
625	625	603 (e) The board may license in a like manner, without examination, any midwife who has
626	626	604been licensed in another state under laws which, in the opinion of the board, require
627	627	605qualifications and maintain standards substantially the same as those of this commonwealth for 31 of 49
628	628	606licensed certified professional midwives; provided, however, that such midwife applies and
629	629	607remits to the board the appropriate application fee under this section.
630	630	608 (f) The board may petition a court of competent jurisdiction for an injunction against any
631	631	609person practicing midwifery without a license granted pursuant to this section. Proof of damage
632	632	610or harm sustained by any person shall not be required for issuance of such an injunction. Nothing
633	633	611in this section shall relieve a person from criminal prosecution for practicing midwifery without
634	634	612a license.
635	635	613 Section 294. (a) The board may, after a hearing pursuant to chapter 30A, suspend or
636	636	614revoke the license of a licensed certified professional midwife or reprimand, censure or
637	637	615otherwise discipline a licensed certified professional midwife for any of the reasons set forth in
638	638	616section 61.
639	639	617 (b) No person filing a complaint or reporting information pursuant to this section or
640	640	618assisting the board at its request in any manner in discharging its duties and functions shall be
641	641	619liable in any cause of action arising out of providing such information or assistance; provided,
642	642	620however, that the person making the complaint or reporting such information or providing such
643	643	621assistance does so in good faith.
644	644	622 (c) A person subject to any disciplinary action taken by the board pursuant to this section
645	645	623may file a petition for judicial review pursuant to section 64.
646	646	624 Section 295. (a) A licensed certified professional midwife duly registered to issue written
647	647	625prescriptions in accordance with the provisions of subsection (j) of section 7 of chapter 94C may
648	648	626order, possess, purchase and administer pharmaceutical agents consistent with the scope of
649	649	627midwifery practice, including: (i) antihemorrhagic agents, including, but not limited to, oxytocin, 32 of 49
650	650	628misoprostol and methergine; (ii) intravenous fluids for stabilization; (iii) vitamin K; (iv) eye
651	651	629prophylaxes; (v) oxygen; (vi) antibiotics for Group B Streptococcal; (vii) antibiotic prophylaxes;
652	652	630(viii) Rho(D) immune globulin; (ix) local anesthetic; (x) epinephrine; and (xi) other
653	653	631pharmaceutical agents identified by the board through rules or regulations in consultation with
654	654	632the department of public health.
655	655	633 (b) Nothing in this section shall be construed to permit a licensed certified professional
656	656	634midwife’s use of pharmaceutical agents which are: (i) controlled substances as defined in chapter
657	657	63594C, except for those listed in schedule VI; or (ii) not identified by the board of registration in
658	658	636midwifery as consistent with the scope of midwifery practice pursuant to subsection (a).
659	659	637 Section 296. When accepting a client for care, a licensed certified professional midwife
660	660	638shall obtain the client’s informed consent, which shall be evidenced by a written statement in a
661	661	639form prescribed by the board and signed by both the licensed certified professional midwife and
662	662	640the client. The signed form shall be included in the client’s record of care. The form shall
663	663	641include, but not be limited to, the following: (i) an acknowledgement that the licensed certified
664	664	642professional midwife is not authorized to practice medicine; (ii) a description of written practice
665	665	643guidelines, services provided and the risks and benefits of birth in the client’s chosen
666	666	644environment; and (iii) disclosure that the client may be referred for a consultation with or have
667	667	645their care transferred to a physician if the client requires care that is outside the midwife’s scope
668	668	646of practice.
669	669	647 Section 297. (a) A licensed certified professional midwife shall only provide care to a
670	670	648client in the case of a low-risk pregnancy. If at any point during pregnancy, childbirth or
671	671	649postpartum care a client or the newborn’s condition deviates from normal, it shall be the duty of 33 of 49
672	672	650the licensed certified professional midwife to immediately refer or transfer the client or newborn
673	673	651to a physician. If a physician determines that the client’s condition has been resolved such that
674	674	652the risk factors presented by a client’s disease or condition are not likely to significantly affect
675	675	653the course of pregnancy or childbirth, the licensed certified professional midwife may resume
676	676	654care of the client and resume assisting the client during their pregnancy, childbirth or postpartum
677	677	655care. A licensed certified professional midwife shall not provide or continue to provide
678	678	656midwifery care to a client whose pregnancy is no longer low-risk; provided, however, in such
679	679	657circumstances nothing in this section shall prohibit a licensed certified professional midwife
680	680	658from remaining present in a supportive capacity throughout pregnancy and childbirth, in
681	681	659accordance with the client’s wishes. If at any point after delivery, the newborn’s condition
682	682	660deviates from normal, the licensed certified professional midwife shall immediately refer or
683	683	661transfer the client to a physician.
684	684	662 (b) A licensed certified professional midwife shall prepare, in a form prescribed by the
685	685	663board, a written plan for the appropriate delivery of emergency care. The plan shall include, but
686	686	664not be limited to: (i) consultation with other health care providers; (ii) emergency transfer to a
687	687	665hospital; and (iii) access to neonatal intensive care units and obstetrical units or other patient care
688	688	666areas.
689	689	667 (c) A health care provider that consults with or accepts a transport, transfer or referral
690	690	668from a licensed certified professional midwife, or that provides care to a client of a licensed
691	691	669certified professional midwife or such client’s newborn, shall not be liable in a civil action for
692	692	670personal injury or death resulting solely from an act or omission by the licensed certified
693	693	671professional midwife. 34 of 49
694	694	672 SECTION 39. Section 10A of chapter 118E of the General Laws, as appearing in the
695	695	6732022 Official Edition, is hereby amended by striking out, in lines 17 and 21, the words “or
696	696	674certified nurse midwife” and inserting in place thereof, in each instance, the following words:-
697	697	675certified nurse-midwife or licensed certified professional midwife.
698	698	676 SECTION 40. Said section 10A of said chapter 118E, as so appearing, is hereby further
699	699	677amended by inserting after the first paragraph the following 2 paragraphs:-
700	700	678 The division shall provide coverage for services rendered by a certified nurse-midwife
701	701	679designated to engage in the practice of nurse-midwifery by the board of registration in nursing
702	702	680pursuant to section 80C of chapter 112, and the payment rate for a service provided by a certified
703	703	681nurse-midwife that is within the scope of the certified nurse-midwife’s authorization to practice
704	704	682shall be equal to the payment rate for the same service if performed by a physician.
705	705	683 The division shall provide coverage for midwifery services, including prenatal care,
706	706	684childbirth and postpartum care, provided by a licensed certified professional midwife regardless
707	707	685of the site of services.
708	708	686 SECTION 41. Said chapter 118E is hereby further amended by inserting after section
709	709	68710Q the following 5 sections:-
710	710	688 Section 10R. (a) For the purposes of this section, “noninvasive prenatal screening” shall
711	711	689mean a cell-free DNA prenatal screening to ascertain if a pregnancy has a risk of fetal
712	712	690chromosomal aneuploidy; provided, however, that such screening shall include, but not be
713	713	691limited to, an analysis of chromosomes 13, 18 and 21. 35 of 49
714	714	692 (b) The division and its contracted health insurers, health plans, health maintenance
715	715	693organizations, behavioral health management firms and third-party administrators under contract
716	716	694to a Medicaid managed care organization or primary care clinician shall provide coverage under
717	717	695all benefit plans for noninvasive prenatal screening and shall not limit availability and coverage
718	718	696for such screening based on the age of the pregnant patient or any other risk factor, unless the
719	719	697limitation is part of the generally accepted standards of professional practice as recommended by
720	720	698the American College of Obstetricians and Gynecologists.
721	721	699 Section 10S. The division and its contracted health insurers, health plans, health
722	722	700maintenance organizations, behavioral health management firms and third-party administrators
723	723	701under contract to a Medicaid managed care organization or primary care clinician plan shall
724	724	702provide coverage for postpartum depression and major depressive disorder screenings conducted
725	725	703pursuant to section 247 of chapter 111.
726	726	704 Section 10T. (a) The division and its contracted health insurers, health plans, health
727	727	705maintenance organizations, behavioral health management firms and third-party administrators
728	728	706under contract to a Medicaid managed care organization or primary care clinician plan shall
729	729	707provide coverage for the provision of medically necessary pasteurized donor human milk and
730	730	708donor human milk-derived products; provided, however, that:
731	731	709 (i) the milk is obtained from a human milk bank that meets quality guidelines established
732	732	710by the department of public health;
733	733	711 (ii) a licensed medical practitioner has issued a written order for the provision of such
734	734	712human breast milk or donor human milk-derived products for the covered infant; and
735	735	713 (iii) the covered infant is: 36 of 49
736	736	714 (1) under the age of 6 months;
737	737	715 (2) undergoing treatment in an inpatient setting for a congenital or acquired condition that
738	738	716places the infant at a high risk for development of necrotizing enterocolitis or a congenital or
739	739	717acquired condition that may benefit from the use of such human breast milk as determined by the
740	740	718department of public health; and
741	741	719 (3) medically or physically unable to receive maternal breast milk or participate in
742	742	720breastfeeding or whose mother is medically or physically unable, despite receiving lactation
743	743	721support, to produce maternal breast milk in sufficient quantities or caloric density.
744	744	722 (b) If an inpatient stay is reimbursed through a diagnosis related group or other bundled
745	745	723payment arrangement, the commission shall include the cost of reimbursement provided under
746	746	724subsection (a) for donor human milk and donor human milk-derived products in the development
747	747	725of the reimbursement rate for such diagnosis related group or bundled payment.
748	748	726 Section 10U. (a) For purposes of this section, the following terms shall have the
749	749	727following meanings unless the context clearly requires otherwise:
750	750	728 “Maternal and infant health outcomes”, outcomes arising for the gestational parent and
751	751	729the gestational parent’s offspring during the pregnancy including pregnancy complications,
752	752	730maternal morbidity, infant mortality and preterm births.
753	753	731 “Doula services”, physical, emotional and informational support provided by trained
754	754	732doulas to individuals and families during and after pregnancy, labor, childbirth, miscarriage,
755	755	733stillbirth, adoption or pregnancy loss, as determined appropriate by the division; provided,
756	756	734however, that “doula services” shall not constitute medical care. 37 of 49
757	757	735 (b) The division and its contracted health insurers, health plans, health maintenance
758	758	736organizations, behavioral health management firms and third-party administrators under contract
759	759	737to a Medicaid managed care organization, accountable care organization or primary care
760	760	738clinician plan shall provide coverage of doula services to pregnant individuals and postpartum
761	761	739individuals up to 12 months following the end of the pregnancy and adoptive parents of infants
762	762	740until the infants reach 1 year of age; provided, however, that the division shall cover not less than
763	763	7416 doula visits across the prenatal and 1-year postpartum period or until an adopted infant reaches
764	764	7421 year of age.
765	765	743 (c) In determining the scope of doula services, the division shall consult with the
766	766	744department of public health and bureau of family health and nutrition.
767	767	745 Section 10V. The division and its and its contracted health insurers, health plans, health
768	768	746maintenance organizations, behavioral health management firms and third-party administrators
769	769	747under contract to a Medicaid managed care organization, accountable care organization or
770	770	748primary care clinician plan or other entities contracting with the division to administer benefits
771	771	749shall provide coverage for universal postpartum home visiting services, in accordance with
772	772	750operational standards set by the department of public health pursuant to section 248 of chapter
773	773	751111. Such coverage shall not be subject to any cost-sharing; provided, however, that cost-sharing
774	774	752shall be required if the applicable plan is governed by the Internal Revenue Code and would lose
775	775	753its tax-exempt status as a result of the prohibition on cost-sharing for this service.
776	776	754 SECTION 42. Subsection (c) of section 148C of chapter 149 of the General Laws, as
777	777	755appearing in the 2022 Official Edition, is hereby amended by striking out clauses (3) and (4) and
778	778	756inserting in place thereof the following 3 clauses:- 38 of 49
779	779	757 (3) attend the employee’s routine medical appointment or a routine medical appointment
780	780	758for the employee’s child, spouse, parent or parent of spouse;
781	781	759 (4) address the psychological, physical or legal effects of domestic violence as defined in
782	782	760subsection (g1⁄2) of section 1 of chapter 151A, except that the definition of employee in
783	783	761subsection (a) will govern for purposes of this section; or
784	784	762 (5) address the employee’s own physical and mental health needs, and those of their
785	785	763spouse, if the employee or the employee’s spouse experiences pregnancy loss or a failed assisted
786	786	764reproduction, adoption or surrogacy.
787	787	765 SECTION 43. Section 47C of chapter 175 of the General Laws, as so appearing, is
788	788	766hereby amended by striking out, in line 62, the word “annually” and inserting in place thereof the
789	789	767following words:- once per calendar year.
790	790	768 SECTION 44. Said chapter 175 is hereby further amended by inserting after section
791	791	76947VV, inserted by section 145 of chapter 140 of the acts of 2024, the following 3 sections:-
792	792	770 Section 47WW. Any policy, contract, agreement, plan or certificate of insurance issued,
793	793	771delivered or renewed within the commonwealth, which is considered creditable coverage under
794	794	772section 1 of chapter 111M, shall provide coverage for postpartum depression and major
795	795	773depressive disorder screenings conducted pursuant to section 247 of chapter 111.
796	796	774 Section 47XX. (a) Any policy, contract, agreement, plan or certificate of insurance
797	797	775issued, delivered or renewed within the commonwealth, which is considered creditable coverage
798	798	776under section 1 of chapter 111M, shall provide coverage for the provision of medically necessary
799	799	777pasteurized donor human milk and donor human milk-derived products; provided, however, that: 39 of 49
800	800	778 (i) the milk is obtained from a human milk bank that meets quality guidelines established
801	801	779by the department of public health;
802	802	780 (ii) a licensed medical practitioner has issued a written order for the provision of such
803	803	781human breast milk or donor human milk-derived products for the covered infant; and
804	804	782 (iii) the covered infant is:
805	805	783 (1) under the age of 6 months;
806	806	784 (2) undergoing treatment in an inpatient setting for a congenital or acquired condition that
807	807	785places the infant at a high risk for development of necrotizing enterocolitis or a congenital or
808	808	786acquired condition that may benefit from the use of such human breast milk as determined by the
809	809	787department of public health; and
810	810	788 (3) medically or physically unable to receive maternal breast milk or participate in
811	811	789breastfeeding or whose mother is medically or physically unable, despite receiving lactation
812	812	790support, to produce maternal breast milk in sufficient quantities or caloric density.
813	813	791 (b) If an inpatient stay is reimbursed through a diagnosis related group or other bundled
814	814	792payment arrangement, the commission shall include the cost of reimbursement provided under
815	815	793subsection (a) for donor human milk and donor human milk-derived products in the development
816	816	794of the reimbursement rate for such diagnosis related group or bundled payment.
817	817	795 Section 47YY. An individual policy of accident and sickness insurance issued pursuant to
818	818	796section 108 that provides hospital expense and surgical expense insurance or a group blanket or
819	819	797general policy of accident and sickness insurance issued pursuant to section 110 that provides
820	820	798hospital expense and surgical expense insurance that is issued or renewed within the 40 of 49
821	821	799commonwealth shall provide coverage for universal postpartum home visiting services, in
822	822	800accordance with operational standards set by the department of public health pursuant to section
823	823	801248 of chapter 111. Such coverage shall not be subject to any cost-sharing, including co-
824	824	802payments and co-insurance, and shall not be subject to any deductible; provided, however, that
825	825	803co-payments, coinsurance or deductibles shall be required if the applicable plan is governed by
826	826	804the Internal Revenue Code and would lose its tax-exempt status due to the prohibition on co-
827	827	805payments, coinsurance or deductibles for these services.
828	828	806 SECTION 45. Chapter 176A of the General Laws is hereby amended by inserting after
829	829	807section 8WW, inserted by section 148 of chapter 140 of the acts of 2024, the following 3
830	830	808sections:-
831	831	809 Section 8XX. Any contract between a subscriber and the corporation under an individual
832	832	810or group hospital service plan that is delivered, issued or renewed within the commonwealth
833	833	811shall provide coverage for postpartum depression and major depressive disorder screenings
834	834	812conducted pursuant to section 247 of chapter 111.
835	835	813 Section 8YY. (a) Any contract between a subscriber and the corporation under an
836	836	814individual or group hospital service plan that is delivered, issued or renewed within the
837	837	815commonwealth shall provide coverage for the provision of medically necessary pasteurized
838	838	816donor human milk and donor human milk-derived products; provided, however, that:
839	839	817 (i) the milk is obtained from a human milk bank that meets quality guidelines established
840	840	818by the department of public health;
841	841	819 (ii) a licensed medical practitioner has issued a written order for the provision of such
842	842	820human breast milk or donor human milk-derived products for the covered infant; and 41 of 49
843	843	821 (iii) the covered infant is:
844	844	822 (1) under the age of 6 months;
845	845	823 (2) undergoing treatment in an inpatient setting for a congenital or acquired condition that
846	846	824places the infant at a high risk for development of necrotizing enterocolitis or a congenital or
847	847	825acquired condition that may benefit from the use of such human breast milk as determined by the
848	848	826department of public health; and
849	849	827 (3) medically or physically unable to receive maternal breast milk or participate in
850	850	828breastfeeding or whose mother is medically or physically unable, despite receiving lactation
851	851	829support, to produce maternal breast milk in sufficient quantities or caloric density.
852	852	830 (b) If an inpatient stay is reimbursed through a diagnosis related group or other bundled
853	853	831payment arrangement, the commission shall include the cost of reimbursement provided under
854	854	832subsection (a) for donor human milk and donor human milk-derived products in the
855	855	833development of the reimbursement rate for such diagnosis related group or bundled payment.
856	856	834 Section 8ZZ. Any contract between a subscriber and the corporation under an individual
857	857	835or group hospital service plan which is delivered, issued or renewed within the commonwealth
858	858	836shall provide coverage for universal postpartum home visiting services, in accordance with
859	859	837operational standards set by the department of public health pursuant to section 248 of chapter
860	860	838111. Such coverage shall not be subject to any cost-sharing, including co-payments and co-
861	861	839insurance, and shall not be subject to any deductible; provided, however, that co-payments,
862	862	840coinsurance or deductibles shall be required if the applicable plan is governed by the Internal
863	863	841Revenue Code and would lose its tax-exempt status due to the prohibition on co-payments,
864	864	842coinsurance or deductibles for these services. 42 of 49
865	865	843 SECTION 46. Chapter 176B of the General Laws is hereby amended by inserting after
866	866	844section 4WW, inserted by section 149 of chapter 140 of the acts of 2024, the following 3
867	867	845sections:-
868	868	846 Section 4XX. Any subscription certificate under an individual or group medical service
869	869	847agreement delivered, issued or renewed within the commonwealth, which is considered
870	870	848creditable coverage under section 1 of chapter 111M, shall provide coverage for postpartum
871	871	849depression and major depressive disorder screenings conducted pursuant to section 247 of
872	872	850chapter 111.
873	873	851 Section 4YY. (a) Any subscription certificate under an individual or group medical
874	874	852service agreement delivered, issued or renewed within the commonwealth, which is considered
875	875	853creditable coverage under section 1 of chapter 111M, shall provide coverage for the provision of
876	876	854medically necessary pasteurized donor human milk and donor human milk-derived products;
877	877	855provided, however, that:
878	878	856 (i) the milk is obtained from a human milk bank that meets quality guidelines established
879	879	857by the department of public health;
880	880	858 (ii) a licensed medical practitioner has issued a written order for the provision of such
881	881	859human breast milk or donor human milk-derived products for the covered infant; and
882	882	860 (iii) the covered infant is:
883	883	861 (1) under the age of 6 months;
884	884	862 (2) undergoing treatment in an inpatient setting for a congenital or acquired condition that
885	885	863places the infant at a high risk for development of necrotizing enterocolitis or a congenital or 43 of 49
886	886	864acquired condition that may benefit from the use of such human breast milk as determined by the
887	887	865department of public health; and
888	888	866 (3) medically or physically unable to receive maternal breast milk or participate in
889	889	867breastfeeding or whose mother is medically or physically unable, despite receiving lactation
890	890	868support, to produce maternal breast milk in sufficient quantities or caloric density.
891	891	869 (b) If an inpatient stay is reimbursed through a diagnosis related group or other bundled
892	892	870payment arrangement, the commission shall include the cost of reimbursement provided under
893	893	871subsection (a) for donor human milk and donor human milk-derived products in the development
894	894	872of the reimbursement rate for such diagnosis related group or bundled payment.
895	895	873 Section 4ZZ. Any subscription certificate under an individual or group medical service
896	896	874agreement delivered, issued or renewed within the commonwealth shall provide coverage for
897	897	875universal postpartum home visiting services, in accordance with operational standards set by the
898	898	876department of public health pursuant to section 248 of chapter 111. Such coverage shall not be
899	899	877subject to any cost-sharing, including co-payments and co-insurance, and shall not be subject to
900	900	878any deductible; provided, however, that co-payments, coinsurance or deductibles shall be
901	901	879required if the applicable plan is governed by the Internal Revenue Code and would lose its tax-
902	902	880exempt status due to the prohibition on co-payments, coinsurance or deductibles for these
903	903	881services.
904	904	882 SECTION 47. Chapter 176G of the General Laws is hereby amended by inserting after
905	905	883section 4OO, inserted by section 150 of chapter 140 of the acts of 2024, the following 3
906	906	884sections:- 44 of 49
907	907	885 Section 4PP. An individual or group health maintenance contract that is issued or
908	908	886renewed within or without the commonwealth shall provide coverage for postpartum depression
909	909	887and major depressive disorder screenings conducted pursuant to section 247 of chapter 111.
910	910	888 Section 4QQ. (a) An individual or group health maintenance contract that is issued or
911	911	889renewed within or without the commonwealth shall provide coverage for the provision of
912	912	890medically necessary pasteurized donor human milk and donor human milk-derived products;
913	913	891provided, however, that:
914	914	892 (i) the milk is obtained from a human milk bank that meets quality guidelines established
915	915	893by the department of public health;
916	916	894 (ii) a licensed medical practitioner has issued a written order for the provision of such
917	917	895human breast milk or donor human milk-derived products for the covered infant; and
918	918	896 (iii) the covered infant is:
919	919	897 (1) under the age of 6 months;
920	920	898 (2) undergoing treatment in an inpatient setting for a congenital or acquired condition that
921	921	899places the infant at a high risk for development of necrotizing enterocolitis or a congenital or
922	922	900acquired condition that may benefit from the use of such human breast milk as determined by the
923	923	901department of public health; and
924	924	902 (3) medically or physically unable to receive maternal breast milk or participate in
925	925	903breastfeeding or whose mother is medically or physically unable, despite receiving lactation
926	926	904support, to produce maternal breast milk in sufficient quantities or caloric density. 45 of 49
927	927	905 (b) If an inpatient stay is reimbursed through a diagnosis related group or other bundled
928	928	906payment arrangement, the commission shall include the cost of reimbursement provided under
929	929	907subsection (a) for donor human milk and donor human milk-derived products in the development
930	930	908of the reimbursement rate for such diagnosis related group or bundled payment.
931	931	909 Section 4RR. Any individual or group health maintenance contract that is issued or
932	932	910renewed within or without the commonwealth shall provide coverage for universal postpartum
933	933	911home visiting services, in accordance with operational standards set by the department of public
934	934	912health pursuant to section 248 of chapter 111. Such coverage shall not be subject to any cost-
935	935	913sharing, including co-payments and co-insurance, and shall not be subject to any deductible;
936	936	914provided, however, that co-payments, coinsurance or deductibles shall be required if the
937	937	915applicable plan is governed by the Internal Revenue Code and would lose its tax-exempt status
938	938	916due to the prohibition on co-payments, coinsurance or deductibles for these services.
939	939	917 SECTION 48. (a) There shall be a task force on maternal health access and birthing
940	940	918patient safety. The task force shall consist of: the commissioner of public health or a designee,
941	941	919who shall serve as co-chair; the executive director of the health policy commission or a designee,
942	942	920who shall serve as co-chair; the executive director of the center for health information and
943	943	921analysis or a designee; the executive director of the Betsy Lehman center for patient safety and
944	944	922medical error reduction or a designee; and 5 members appointed by the secretary of health and
945	945	923human services, 1 of whom shall be a representative of the Massachusetts Health and Hospital
946	946	924Association, Inc., 1 of whom shall be a representative of the Massachusetts Nurses Association,
947	947	9251 of whom shall be a representative of the Massachusetts Medical Society, 1 of whom shall be
948	948	926representative of the Perinatal-Neonatal Quality Improvement Network of Massachusetts and 1
949	949	927of whom shall be a representative of the Neighborhood Birth Center, Inc. 46 of 49
950	950	928 (b) The task force shall study and report maternal health access and birthing patient
951	951	929safety. The task force shall: (i) study the current availability of and access to maternal health
952	952	930services and maternal health care across regions of the commonwealth and among birthing
953	953	931patient populations, including the essential service closure process, the adequacy of the maternal
954	954	932health care workforce and other topics identified in subsection (c); (ii) identify methods to
955	955	933increase the financial investment in and patient access to maternal health care across the
956	956	934commonwealth and ensure equitable access for the most vulnerable birthing patient populations;
957	957	935and (iii) issue a report on the task force’s findings and policy recommendations.
958	958	936 (c) The task force shall study: (i) past essential services closures for inpatient maternity
959	959	937units and acute-level birthing centers and closures of community-based, office-based and
960	960	938preventative maternal health care, including family planning services, obstetrics and gynecology
961	961	939services and midwifery services; (ii) patient quality and safety considerations of essential service
962	962	940closures of maternal care units, including quality, safety and staffing regulatory requirements
963	963	941promulgated by the department of public health that inform acute level maternal care essential
964	964	942service closures; and (iii) demographic information on patient populations whose access has been
965	965	943most affected by past closures of or current limitations on the availability of maternal care
966	966	944services, including, but not limited to, geography, type of insurance coverage, age, race,
967	967	945ethnicity, income status, LGBTQIA+ status and immigration status.
968	968	946 (d) Not later than September 1, 2025, the task force shall submit its report to the clerks of
969	969	947the senate and house of representatives, the joint committee on health care financing and the joint
970	970	948committee on public health. 47 of 49
971	971	949 SECTION 49. Notwithstanding any general or special law to the contrary, for the initial
972	972	950appointments by the governor to the board of registration in midwifery pursuant to section 110 of
973	973	951chapter 13 of the General Laws, inserted by section 5, the 5 members required to be licensed
974	974	952certified professional midwives shall be persons with at least 5 years of experience in the
975	975	953practice of midwifery who hold a certificate of completion or equivalent from an educational
976	976	954program or institution accredited by the Midwifery Education Accreditation Council.
977	977	955 SECTION 50. The board of registration in midwifery established pursuant to section 110
978	978	956of chapter 13 of the General Laws, inserted by section 5, shall issue temporary licensure for
979	979	957individuals practicing midwifery and shall promulgate regulations for the temporary licensure of
980	980	958individuals practicing midwifery within 180 days of the effective date of this act. Such
981	981	959temporary licenses shall be valid until the date established by the board pursuant to section 55 by
982	982	960which individuals practicing midwifery shall be licensed.
983	983	961 SECTION 51. The board of registration in midwifery established pursuant to section 110
984	984	962of chapter 13 of the General Laws, inserted by section 5, except as provided in section 50, shall
985	985	963adopt rules and promulgate regulations pursuant to this act within 1 year from the effective date
986	986	964of this act.
987	987	965 SECTION 52. (a) The department of public health shall promulgate regulations pursuant
988	988	966to section 51M of chapter 111 of the General Laws, inserted by section 17, not later than 180
989	989	967days after the effective date of this act.
990	990	968 (b) Prior to promulgating initial regulations pursuant to said section 51M of said chapter
991	991	969111, the department shall consider, when developing regulations, the standards adopted by the
992	992	970American Association of Birth Centers and consult with Seven Sisters Birth Center LLC, 48 of 49
993	993	971Neighborhood Birth Center, Inc., the Massachusetts Affiliate of ACNM, Inc. and other entities
994	994	972operating or planning to open birth centers in the commonwealth.
995	995	973 SECTION 53. The department of public health shall implement newborn screening
996	996	974protocols for Duchenne muscular dystrophy pursuant to section 110A of chapter 111 of the
997	997	975General Laws, as amended by section 18, not later than 18 months after the effective date of this
998	998	976act.
999	999	977 SECTION 54. All individuals practicing lactation consulting required to be licensed
1000	1000	978pursuant to section 23B of chapter 112 of the General Laws, as amended by sections 25 and 26,
1001	1001	979shall be licensed not later than January 1, 2026.
1002	1002	980 SECTION 55. The board of registration in midwifery established pursuant to section 110
1003	1003	981of chapter 13 of the General Laws, inserted by section 5, shall establish a date not later than 1
1004	1004	982year after said board adopts rules and promulgates regulations pursuant to this act by which
1005	1005	983individuals practicing midwifery consistent with section 291 of chapter 112 of the General Laws,
1006	1006	984inserted by section 38, shall be licensed.
1007	1007	985 SECTION 56. The governor shall convene the first meeting of the board of registration in
1008	1008	986midwifery established under section 110 of chapter 13 of the General Laws within 90 days from
1009	1009	987the effective date of this act. At such meeting, the board shall elect a chair and a secretary for its
1010	1010	988membership whose duties shall be established by the board.
1011	1011	989 SECTION 57. The department of public health shall promulgate regulations pursuant to
1012	1012	990subsection (j) of section 7 of chapter 94C of the General Laws, inserted by section 11, providing
1013	1013	991for the automatic registration of licensed certified professional midwives to issue written
1014	1014	992prescriptions within 180 days of the effective date of this act. 49 of 49
1015	1015	993 SECTION 58. The department of public health shall promulgate regulations pursuant to
1016	1016	994subsection (b) of section 248 of chapter 111 of the General Laws, inserted by section 21, for the
1017	1017	995establishment and administration of a statewide system of programs providing universal
1018	1018	996postpartum home visiting services within 90 days of the effective date of this act.