RELATING TO MIDWIVES.

Removed all provisions establishing licensure requirements, scope of practice definitions, prescriptive authority, peer review requirements, and medical record retention rules

Removed sunset provisions that would have made midwifery regulations permanent after June 30, 2025

Added clause stating the chapter cannot be construed to establish criminal penalties

Changed document format from House bill to Senate floor amendment format with different header information

Changes the effective date from June 30, 2025 (when current regulations expire) to July 1, 2050, making midwifery regulation permanent.

Establishes continuing education requirements for all midwives, including specific hours in pharmacology for certified midwives and additional clinical skills training for certified professional midwives.

Creates peer review requirements requiring midwives to review at least five clinical cases every three years and participate in Hawaii-based peer review.

Mandates data submission to a department-approved organization for every gestational parent and newborn when birth does not occur at a birth facility.

Grants prescriptive authority to certified midwives (but not certified professional midwives) to prescribe certain drugs and controlled substances.

Defines two distinct categories of licensed midwives: certified midwives (graduate-level accredited education) and certified professional midwives (accredited pathway or bridge certificate).

Explicitly affirms that the practice of midwifery under this Act does not include Native Hawaiian traditional and customary practices, which remain exempt from licensure.

Establishes grounds for license refusal, revocation, or suspension including failure to meet continuing education requirements, practicing while impaired, and engaging in professional misconduct.

Clarifies that the scope of practice includes telehealth services and expands the list of approved legend drugs and devices that midwives may administer.

Updates exemptions to include practicing Native Hawaiian traditional and customary practices as protected under the Hawaii State Constitution.

Changes midwifery regulation from a temporary sunset on June 30, 2025 to permanent licensure effective June 29, 2025

Requires certified midwives to complete 30 contact hours of continuing education every three years starting July 1, 2026

Establishes peer review requirements requiring midwives to review at least 5 clinical cases every three years starting June 30, 2029

Requires data submission for every gestational parent and newborn when birth does not occur at a birth facility

Grants midwives global signature authority to sign healthcare documents for their clients

Grants prescriptive authority to certified midwives to prescribe certain drugs and controlled substances

Expands scope of practice to include telehealth services and adds specific definitions for certified midwives and certified professional midwives

Establishes grounds for license denial or revocation including failure to meet continuing education, peer review, or data submission requirements

Clarifies that traditional Native Hawaiian healing practices are exempt from licensure requirements

Clarified that the bill adds nine new sections to chapter 457J instead of eight.

Added a severability clause to ensure remaining provisions stay valid if any part is declared unconstitutional.

Updated the definition of certified professional midwife to include portfolio evaluation pathway certification alongside traditional education requirements.

Restructured exemptions for unlicensed midwifery practice, removing emergency care exemptions and adding specific requirements for birth attendants including disclosure obligations and record-keeping.

Changed the effective date to June 29, 3000, making the bill immediately effective for all practical purposes.

Corrected the prefatory language to indicate the bill adds nine new sections to chapter 457J instead of eight.

Updated the definition of 'certified professional midwife' to include two pathways: graduation from an accredited program with national certification, or completion of a portfolio evaluation bridge certificate pathway.

Added a new exemption for traditional Hawaiian healers engaged in prenatal, maternal, and child care practices recognized by Papa Ola Lokahi council.

Added exemptions for persons practicing Native Hawaiian traditional and customary practices protected under the Hawaii State Constitution.

Added exemptions for persons engaged in birth-related spiritual healing practices within well-recognized religious denominations.

Expanded birth attendant exemptions to include additional requirements such as disclosure of lack of professional license, education review status, and legend drug restrictions.

Changed the effective date of the Act from June 29, 2025 to June 30, 2000.

Changes the sunset date for midwifery regulation from June 30, 2025 to permanent licensure, with a new repeal date of June 30, 2025 for the previous temporary framework.

Establishes continuing education requirements: 30 contact hours per triennium for all midwives, with 8 hours in pharmacology for certified midwives and 6 hours in shock/IV therapy/suturing for certified professional midwives.

Creates peer review requirements starting June 30, 2029, requiring midwives to participate in Hawaii-based peer review and attest to reviewing at least 5 clinical cases per triennium.

Mandates data submission to an approved organization for every gestational parent and newborn when birth is not in a hospital or accredited birth facility.

Requires midwives to maintain continuing education records for at least six years and allows the director to conduct random audits for compliance.

Establishes global signature authority for midwives to sign, certify, or endorse all documents relating to health care provided to their clients within their scope of practice.

Grants prescriptive authority to certified midwives (not certified professional midwives) to prescribe controlled substances, over-the-counter drugs, and legend drugs within their scope of practice.

Expands exemptions from licensure to include practicing Native Hawaiian traditional and customary practices as protected under the State Constitution.

Adds new definitions for 'certified midwife' (graduate-level accredited program) and 'certified professional midwife' (Midwifery Education Accreditation Council pathway or bridge certificate), replacing the previous 'midwifery' definition.

Amends the definition of 'practitioner' in the controlled substances chapter to include licensed midwives practicing as certified midwives.

Mandates continuing education requirements (30 contact hours per triennium) starting July 1, 2026, with specific requirements for certified midwives and certified professional midwives.

Requires peer review participation beginning June 30, 2029, including review of at least five clinical cases and specific reviews for adverse outcomes.

Establishes data submission requirements beginning June 30, 2029, requiring midwives to submit care data to approved research organizations.

Grants prescriptive authority to certified midwives (but not certified professional midwives) to prescribe certain drugs and devices.

Updates exemptions to clarify that traditional Hawaiian healers are not subject to midwifery licensure requirements.

Adds new definitions for 'certified midwife,' 'certified professional midwife,' 'accredited birth facility,' 'peer review,' and 'telehealth.'

Clarifies that 'practice of midwifery' does not include traditional Hawaiian healing practices performed by traditional Hawaiian healers.

Establishes peer review and data submission as conditions for license renewal, with potential license forfeiture for non-compliance.

Sets effective date as July 1, 3000 (likely a placeholder for future legislative action), with continuing education requirements beginning July 1, 2026.

Expands scope of practice for certified midwives to include admitting clients to hospitals and assisting in surgery.