BILL NUMBER: SB 408 CHAPTERED
BILL TEXT
CHAPTER 280
FILED WITH SECRETARY OF STATE SEPTEMBER 8, 2015
APPROVED BY GOVERNOR SEPTEMBER 8, 2015
PASSED THE SENATE MAY 11, 2015
PASSED THE ASSEMBLY AUGUST 20, 2015
AMENDED IN SENATE MAY 6, 2015
AMENDED IN SENATE APRIL 6, 2015
INTRODUCED BY Senator Morrell
FEBRUARY 25, 2015
An act to add Section 2516.5 to the Business and Professions Code,
relating to healing arts.
LEGISLATIVE COUNSEL'S DIGEST
SB 408, Morrell. Midwife assistants.
The Licensed Midwifery Practice Act of 1993 provides for the
licensing and regulation of midwives by the Medical Board of
California. The license to practice midwifery authorizes the holder
to attend cases of normal childbirth and to provide prenatal,
intrapartum, and postpartum care, including family planning care, for
the mother, and immediate care for the newborn. The Licensed
Midwifery Practice Act of 1993 requires a midwife to refer to a
physician and surgeon under prescribed circumstances. A violation of
the Licensed Midwifery Practice Act of 1993 is a crime.
The Nursing Practice Act provides for the licensure and regulation
of the practice of nursing by the Board of Registered Nursing and
authorizes the board to issue a certificate to practice
nurse-midwifery to a person who meets educational standards
established by the board or the equivalent of those educational
standards. The Nursing Practice Act authorizes a certified
nurse-midwife, under the supervision of a licensed physician and
surgeon, to attend cases of normal childbirth and to provide
prenatal, intrapartum, and postpartum care, including family-planning
care, for the mother, and immediate care for the newborn, and
provides that the practice of nurse-midwifery constitutes the
furthering or undertaking by a certified person, under the
supervision of a licensed physician and surgeon who has current
practice or training in obstetrics, to assist a woman in childbirth
so long as progress meets criteria accepted as normal.
This bill would authorize a midwife assistant to perform certain
assistive activities under the supervision of a licensed midwife or
certified nurse-midwife, including the administration of medicine,
the withdrawing of blood, and midwife technical support services. The
bill would define terms for these purposes. The bill would prohibit
a midwife assistant from being employed for inpatient care in a
licensed general acute care hospital. By adding new requirements and
prohibitions to the Licensed Midwifery Practice Act of 1993, the
violation of which would be a crime, the bill would impose a
state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 2516.5 is added to the Business and Professions
Code, to read:
2516.5. (a) As used in this section, the following definitions
apply:
(1) "Midwife assistant" means a person, who may be unlicensed, who
performs basic administrative, clerical, and midwife technical
supportive services in accordance with this chapter for a licensed
midwife or certified nurse-midwife, is at least 18 years of age, and
has had at least the minimum amount of hours of appropriate training
pursuant to standards established by the board for a medical
assistant pursuant to Section 2069. The midwife assistant shall be
issued a certificate by the training institution or instructor
indicating satisfactory completion of the required training. Each
employer of the midwife assistant or the midwife assistant shall
retain a copy of the certificate as a record.
(2) "Midwife technical supportive services" means simple routine
medical tasks and procedures that may be safely performed by a
midwife assistant who has limited training and who functions under
the supervision of a licensed midwife or certified nurse-midwife.
(3) "Specific authorization" means a specific written order
prepared by the supervising midwife or supervising nurse-midwife
authorizing the procedures to be performed on a patient, which shall
be placed in the patient's medical record, or a standing order
prepared by the supervising midwife or supervising nurse-midwife
authorizing the procedures to be performed. A notation of the
standing order shall be placed in the patient's medical record.
(4) "Supervision" means the supervision of procedures authorized
by this section by a licensed midwife or certified nurse-midwife,
within his or her scope of practice, who is physically present on the
premises during the performance of those procedures.
(b) Notwithstanding any other provision of law, a midwife
assistant may do all of the following:
(1) Administer medication only by intradermal, subcutaneous, or
intramuscular injections and perform skin tests and additional
technical support services upon the specific authorization and
supervision of a licensed midwife or certified nurse-midwife. A
midwife assistant may also perform all these tasks and services in a
clinic licensed in accordance with subdivision (a) of Section 1204 of
the Health and Safety Code upon the specific authorization of a
licensed midwife or certified nurse-midwife.
(2) Perform venipuncture or skin puncture for the purposes of
withdrawing blood upon specific authorization and under the
supervision of a licensed midwife or certified nurse-midwife, if the
midwife assistant has met the educational and training requirements
for medical assistants as established in Section 2070. Each employer
of the assistant shall retain a copy of any related certificates as a
record.
(3) Perform the following midwife technical support services:
(A) Administer medications orally, sublingually, topically, or
rectally, or by providing a single dose to a patient for immediate
self-administration, and administer oxygen at the direction of the
supervising licensed midwife or certified nurse-midwife. The licensed
midwife or certified nurse-midwife shall verify the correct
medication and dosage before the midwife assistant administers
medication.
(B) Assist in immediate newborn care when the licensed midwife or
certified nurse-midwife is engaged in a concurrent activity that
precludes the licensed midwife or certified nurse-midwife from doing
so.
(C) Assist in placement of the device used for auscultation of
fetal heart tones when a licensed midwife or certified nurse-midwife
is engaged in a concurrent activity that precludes the licensed
midwife or certified nurse-midwife from doing so.
(D) Collect by noninvasive techniques and preserve specimens for
testing, including, but not limited to, urine.
(E) Assist patients to and from a patient examination room, bed,
or bathroom.
(F) Assist patients in activities of daily living, such as
assisting with bathing or clothing.
(G) As authorized by the licensed midwife or certified
nurse-midwife, provide patient information and instructions.
(H) Collect and record patient data, including height, weight,
temperature, pulse, respiration rate, blood pressure, and basic
information about the presenting and previous conditions.
(I) Perform simple laboratory and screening tests customarily
performed in a medical or midwife office.
(4) Perform additional midwife technical support services under
regulations and standards established by the board.
(c) (1) Nothing in this section shall be construed as authorizing
the licensure of midwife assistants. Nothing in this section shall be
construed as authorizing the administration of local anesthetic
agents by a midwife assistant. Nothing in this section shall be
construed as authorizing the board to adopt any regulations that
violate the prohibitions on diagnosis or treatment in Section 2052.
(2) Nothing in this section shall be construed as authorizing a
midwife assistant to perform any clinical laboratory test or
examination for which he or she is not authorized under Chapter 3
(commencing with Section 1200).
(d) Notwithstanding any other law, a midwife assistant shall not
be employed for inpatient care in a licensed general acute care
hospital as defined in subdivision (a) of Section 1250 of the Health
and Safety Code.
SEC. 2. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.