California 2019-2020 Regular Session Status: Enacted

SB 1237 — Nurse-midwives: scope of practice.

Last action — Chaptered by Secretary of State. Chapter 88, Statutes of 2020.

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed Assembly
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced February 20, 2020. Enacted.

Prognosis

Likely to advance 76% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 4 sponsors

    1 primary, 3 co-sponsors signed on.

  • Cleared a recorded vote

    Passed 8 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Summary

(1) Existing law, the Nursing Practice Act, establishes the Board of Registered Nursing within the Department of Consumer Affairs for the licensure and regulation of the practice of nursing. A violation of the act is a crime. Existing law requires the board to issue a certificate to practice nurse-midwifery to a person who, among other qualifications, meets educational standards established by the board or the equivalent of those educational standards. Existing law 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. Existing law defines the practice of nurse-midwifery as the furthering or undertaking by a certified person, under the supervision of 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. Existing law requires all complications to be referred to a physician immediately. Existing law excludes the assisting of childbirth by any artificial, forcible, or mechanical means, and the performance of any version from the definition of the practice of nurse-midwifery. This bill would delete the above-described provisions defining the practice of nurse-midwifery, would delete the condition that a certified nurse-midwife practice under the supervision of a physician and surgeon, and would instead authorize a certified nurse-midwife to attend cases of low-risk pregnancy, as defined, and childbirth and to provide prenatal, intrapartum, and postpartum care, including family-planning services, interconception care, and immediate care of the newborn, consistent with standards adopted by a specified professional organization, or its successor, as approved by the board. The bill would authorize a certified nurse-midwife to practice with a physician and surgeon under mutually agreed-upon policies and protocols that delineate the parameters for consultation, collaboration, referral, and transfer of a patient's care, signed by both the certified nurse-midwife and a physician and surgeon to provide a patient with specified services. The bill, except as specified, would require the patient to be transferred to the care of a physician and surgeon to provide those services if the nurse-midwife does not have those mutually agreed-upon policies and protocols in place, and would authorize the return of that patient to the care of the nurse-midwife after the physician and surgeon has determined that the condition or circumstance that required, or would require, the transfer is resolved. The bill would authorize a certified nurse-midwife to continue to attend the birth of the newborn and participate in physical care, counseling, guidance, teaching, and support, if a physician and surgeon assumes care of the patient, as indicated by the mutually agreed-upon policies and protocols. The bill would authorize a certified nurse-midwife, after referring a patient to a physician and surgeon, to continue care of a patient the patient during a reasonable interval between the referral and the initial appointment with the physician and surgeon. The bill would authorize a certified nurse-midwife to attend pregnancy and childbirth in an out-of-hospital setting if consistent with the above-described provisions. Under the bill, a certified nurse-midwife would not be authorized to assist childbirth by vacuum or forceps extraction, or to perform any external cephalic version. The bill would require a certified nurse-midwife to refer all emergencies to a physician and surgeon immediately, and would authorize a certified nurse-midwife to provide emergency care until the assistance of a physician and surgeon is obtained. This bill would require a certified nurse-midwife who is not under the supervision of a physician and surgeon to provide oral and written disclosure to a patient and obtain a patient's written consent, as specified. By expanding the scope of a crime, the bill would impose a state-mandated local program. (2) Existing law authorizes the board to appoint a committee of qualified physicians and nurses, including, but not limited to, obstetricians and nurse-midwives, to develop the necessary standards relating to educational requirements, ratios of nurse-midwives to supervising physicians, and associated matters. Existing law, additionally, authorizes the committee to include family physicians. This bill, instead, would require the board to appoint a committee of qualified physicians and surgeons and nurses called the Nurse-Midwifery Advisory Committee. The bill would require the committee to consist of 4 qualified nurse-midwives, 2 qualified physicians and surgeons, including, but not limited to, obstetricians or family physicians, and one public member. The bill would delete the provision including ratios of nurse-midwives to supervising physicians and associated matters in the standards developed by the committee, and would instead require the committee to make recommendations to the board on all matters related to midwifery practice, education, appropriate standard of care, and other matters as specified by the board. The bill would require the committee to provide recommendations or guidance on care when the board is considering disciplinary action against a certified nurse-midwife. The bill would authorize the committee to continue to make the recommendations if the board, despite good faith efforts, is unable to solicit and appoint to the committee 4 qualified nurse-midwives, 2 qualified physicians and surgeons, including, but not limited to, obstetricians or family physicians, and one public member. (3) Existing law authorizes a certified nurse-midwife to furnish drugs or devices, including controlled substances, in specified circumstances, including if drugs or devices are furnished or ordered incidentally to the provision of care in specified settings, including certain licensed health care facilities, birth centers, and maternity hospitals provided that the furnishing or ordering of drugs or devices occur under physician and surgeon supervision. Existing law requires the drugs or devices to be furnished in accordance with standardized procedures or protocols, and defines standardized procedure to mean a document, including protocols, developed and approved by specified persons, including a facility administrator. Existing law requires Schedule II or III controlled substances furnished or ordered by a certified nurse-midwife to be furnished or ordered in accordance with a patient-specific protocol approved by the treating or supervising physician and surgeon. Existing law requires a certified nurse-midwife who is authorized to furnish or issue a drug order for a controlled substance to register with the United States Drug Enforcement Administration. This bill would delete the condition that the furnishing or ordering of drugs or devices occur under physician and surgeon supervision, and would authorize a certified nurse-midwife to furnish drugs or devices incidentally to the provision of care and services allowed by a certificate to practice nurse-midwifery as provided by the bill and when care is rendered in an out-of-hospital setting, as specified. The bill would limit the requirement that the furnishing or ordering of drugs or devices by a certified nurse-midwife be in accordance with the standardized procedures or protocols to the furnishing or ordering of drugs or devices for services that do not fall within the scope of services specified by the bill and Schedule IV or V controlled substances by a nurse-midwife for any condition. The bill would require Schedule II or III controlled substances furnished or ordered by a certified nurse-midwife for any condition to be furnished or ordered in accordance with a patient-specific protocol approved by a physician and surgeon. The bill would revise the definition of standardized procedure to mean a document, including protocols, developed in collaboration with, and approved by, a physician and surgeon and the certified nurse-midwife. The bill would require a certified nurse-midwife who is authorized to furnish or issue a drug order for a controlled substance to additionally register with the Controlled Substance Utilization Review and Enforcement System (CURES) . The bill would authorize a certified nurse-midwife to procure supplies and devices, obtain and administer diagnostic tests, obtain and administer nonscheduled drugs consistent with the provision of services that fall within the scope of services specified by the bill, order laboratory and diagnostic testing, and receive reports, as specified. The bill would make it a misdemeanor for a certified nurse-midwife to refer a person for specified laboratory and diagnostic testing, home infusion therapy, and imaging goods or services if the certified nurse-midwife or their immediate family member has a financial interest with the person receiving a referral. By expanding the scope of a crime, the bill would impose a state-mandated local program. (4) Existing law authorizes a certified nurse-midwife to perform and repair episiotomies and repair lacerations of the perineum in specified health care facilities only if specified conditions are met, including that the protocols and procedures ensure that all complications are referred to a physician and surgeon immediately, and that immediate care of patients who are in need of care beyond the scope of practice of the certified nurse-midwife, or emergency care for times when the supervising physician and surgeon is not on the premises. This bill would delete those conditions, and instead would require a certified nurse-midwife performing and repairing lacerations of the perineum to ensure that all complications are referred to a physician and surgeon immediately, and that immediate care of patients who are in need of care beyond the scope of practice of the certified nurse-midwife, or emergency care when a physician and surgeon is not on the premises. (5) Existing law requires each live birth to be registered with the local registrar of births and deaths for the district in which the birth occurred within 10 days following the date of the event. Existing law makes the professionally licensed midwife in attendance at a live birth that occurs outside of a hospital or outside of a state-licensed alternative birth center responsible for entering the information on the birth certificate, securing the required signatures, and for registering the certificate with the local registrar. This bill instead would make the professionally licensed midwife or the certified nurse-midwife in attendance responsible for those duties. The bill would additionally require the information collected to include the planned place of birth and whether it was a hospital, freestanding birthing center, home delivery, clinic or physician's office, or other specified place. (6) Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest. This bill would make legislative findings to that effect. (7) Existing law, for live births that occur outside of a hospital or outside of a state-licensed alternative birth center, requires the physician in attendance at the birth or, in the absence of a physician, the professionally licensed nurse-midwife in attendance at the birth or, in the absence of a physician or midwife, either one of the parents to be responsible for entering the information on the certificate of live birth, securing the required signatures, and registering the birth. This bill would add specified reporting and data collection requirements for certified nurse-midwives to the Nursing Practice Act. The bill, for all maternal or neonatal transfers to the hospital setting during labor or the immediate postpartum period when the place of birth intended at the onset of labor was an out-of-hospital setting with a certified nurse-midwife as birth care provider, would require the certified nurse-midwife to report certain data to the State Department of Public Health within 90 days of the transfer or death, as specified. If a maternal, fetal, or neonatal death occurred in an out-of-hospital setting during labor or the immediate postpartum period, the bill would require the nurse-midwife to report specified data to the department within 90 days of the death, as specified. The bill would require the department to specify the final form of the data submission. By expanding the scope of a crime, the bill would impose a state-mandated local program. The bill would require, no later than 412 years after these provisions are operative, and annually thereafter, the department to submit a report to the Legislature of the aggregate information, including, but not limited to, birth outcomes of patients under the care of a certified nurse-midwife, collected pursuant to these provisions. The bill would require the department to treat the information and data gathered for the creation of the report to the Legislature as confidential records and prohibit the disclosure of any patient or certified nurse-midwife information to any law enforcement or regulatory agency for any purpose, including, but not limited to, investigations for licensing, certification, or regulatory purposes. The bill would require information collected by the department pursuant to these provisions, not otherwise subject to current confidentiality requirements, to be treated as confidential records and made available only as provided. Under the bill, a violation of these provisions would subject the certified nurse-midwife to disciplinary or administrative action by the Board of Registered Nursing. This bill would make the operation of the provisions described in paragraph (7) contingent upon appropriation by the Legislature, as specified. (8) This bill would incorporate additional changes to Section 650.01 of the Business and Professions Code proposed by AB 890 to be operative only if this bill and AB 890 are enacted and this bill is enacted last. (9) 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.

Bill Text

Action History

  1. Chaptered by Secretary of State. Chapter 88, Statutes of 2020.

  2. Approved by the Governor.

  3. Enrolled and presented to the Governor at 3 p.m.

  4. Assembly amendments concurred in. (Ayes 31. Noes 3.) Ordered to engrossing and enrolling.

  5. In Senate. Concurrence in Assembly amendments pending.

  6. Read third time. Passed. (Ayes 68. Noes 0. Page 5420.) Ordered to the Senate.

  7. Ordered to third reading.

  8. Read third time and amended.

  9. Read second time. Ordered to third reading.

  10. Read second time and amended. Ordered to second reading.

  11. From committee: Do pass as amended. (Ayes 15. Noes 1.) (August 20).

  12. August 18 set for first hearing. Placed on suspense file.

  13. From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 1.) (August 10). Re-referred to Com. on APPR.

  14. July 27 hearing postponed by committee.

  15. From committee with author's amendments. Read second time and amended. Re-referred to Com. on B. & P.

  16. Referred to Com. on B. & P.

  17. In Assembly. Read first time. Held at Desk.

  18. Read third time. Passed. (Ayes 35. Noes 1. Page 3876.) Ordered to the Assembly.

  19. Read second time. Ordered to third reading.

  20. Read second time and amended. Ordered to second reading.

  21. From committee: Do pass as amended. (Ayes 6. Noes 0. Page 3770.) (June 18).

  22. Set for hearing June 18.

  23. June 9 hearing: Placed on APPR. suspense file.

  24. Set for hearing June 9.

  25. Hearing rescheduled due to Capitol closure.

  26. Set for hearing June 1.

  27. Read second time and amended. Re-referred to Com. on APPR.

  28. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 8. Noes 0. Page 3550.) (May 18).

  29. Set for hearing May 18.

  30. From committee with author's amendments. Read second time and amended. Re-referred to Com. on B., P. & E.D.

  31. March 30 hearing postponed by committee.

  32. Set for hearing March 30.

  33. Referred to Com. on B., P. & E.D.

  34. From printer. May be acted upon on or after March 22.

  35. Introduced. Read first time. To Com. on RLS. for assignment. To print.

Sponsors

  • Dodd · Primary
  • Mitchell · Cosponsor
  • Burke · Cosponsor
  • Low · Cosponsor

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 3 co-sponsors · 118 not signed on

Sponsors (1)

  • Dodd

Co-sponsors (3)

  • Mitchell
  • Burke
  • Low

Not signed on (118)

118 members have not signed on to this bill.

Show all 118 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

SB 1237 Dodd Senate Third Reading By Burke

Passed 68 Yea · 0 Nay · 11 Other
Party YeaNayPresentNot Voting
Unaffiliated 44007
Democratic 22000
Republican 2004
Total 680011
% of votes cast 86%0%0%14%
How each member voted (79)
Member Party Vote
Diep — Yea
Cunningham — Yea
Daly — Yea
Salas — Yea
Gray — Yea
Ting — Yea
Cooper — Yea
Levine — Yea
Jones-Sawyer — Yea
Mayes — Yea
Nazarian — Yea
Friedman — Yea
Wood — Yea
Rendon — Yea
Holden — Yea
Medina — Yea
Bloom — Yea
Waldron — Yea
Mullin — Yea
Rodriguez — Yea
Chiu — Yea
Burke — Yea
Maienschein — Yea
Weber — Yea
Brough — Yea
Mathis — Yea
Kamlager — Yea
Santiago — Yea
Smith — Yea
Gonzalez — Yea
Quirk — Yea
Gloria — Yea
McCarty — Yea
Chu — Yea
Low — Yea
O'Donnell — Yea
Obernolte — Yea
Chau — Yea
Cooley — Yea
Frazier — Not Voting
Bigelow — Not Voting
Eggman — Not Voting
Voepel — Not Voting
Fong — Not Voting
Kiley — Not Voting
Cristina Garcia — Yea
Eduardo Garcia — Yea
Jim Patterson — Not Voting
Luz Rivas — Yea
Mark Stone — Yea
Wendy Carrillo — Yea
Aguiar-Curry, Cecilia M. Democratic Yea
Arambula, Joaquin Democratic Yea
Bauer-Kahan, Rebecca Democratic Yea
Berman, Marc Democratic Yea
Boerner, Tasha Democratic Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Cervantes, Sabrina Democratic Yea
Gabriel, Jesse Democratic Yea
Gipson, Mike A. Democratic Yea
Grayson, Timothy S. Democratic Yea
Irwin, Jacqui Democratic Yea
Kalra, Ash Democratic Yea
Limón, Monique Democratic Yea
Muratsuchi, Al Democratic Yea
Petrie-Norris, Cottie Democratic Yea
Quirk-Silva, Sharon Democratic Yea
Ramos, James C. Democratic Yea
Reyes, Eloise Gómez Democratic Yea
Rivas, Robert Democratic Yea
Rubio, Blanca E. Democratic Yea
Wicks, Buffy Democratic Yea
Chen, Phillip Republican Not Voting
Choi, Steven S. Republican Not Voting
Dahle, Megan Republican Yea
Flora, Heath Republican Not Voting
Gallagher, James Republican Not Voting
Lackey, Tom Republican Yea

Official roll call →

Unfinished Business SB1237 Dodd et al. Concurrence

Passed 31 Yea · 3 Nay · 6 Other
Party YeaNayPresentNot Voting
Unaffiliated 20304
Democratic 10000
Republican 1002
Total 31306
% of votes cast 78%8%0%15%
How each member voted (40)
Member Party Vote
Roth — Yea
Galgiani — Yea
Portantino — Yea
Rubio — Yea
Atkins — Yea
Wieckowski — Yea
Wilk — Yea
Hertzberg — Yea
Mitchell — Yea
Monning — Yea
Glazer — Yea
Beall — Yea
Hueso — Yea
Leyva — Yea
Allen — Yea
Chang — Yea
Bradford — Yea
Skinner — Yea
Dodd — Yea
Hill — Yea
Melendez — Nay
Morrell — Nay
Bates — Nay
Borgeas — Not Voting
Moorlach — Not Voting
Pan — Not Voting
Nielsen — Not Voting
Archuleta, Bob Democratic Yea
Caballero, Anna M. Democratic Yea
Durazo, Maria Elena Democratic Yea
Gonzalez, Lena A. Democratic Yea
Hurtado, Melissa Democratic Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Stern, Henry I. Democratic Yea
Umberg, Thomas J. Democratic Yea
Wiener, Scott D. Democratic Yea
Dahle, Megan Republican Yea
Grove, Shannon Republican Not Voting
Jones, Brian W. Republican Not Voting

Official roll call →

Do pass as amended.

Passed 15 Yea · 1 Nay · 2 Other
Party YeaNayPresentNot Voting
Democratic 6000
Unaffiliated 8102
Republican 1000
Total 15102
% of votes cast 83%6%0%11%
How each member voted (18)
Member Party Vote
Quirk — Yea
Gonzalez — Yea
Diep — Yea
Bloom — Yea
Chau — Yea
Eggman — Yea
Fong — Nay
Voepel — Not Voting
Bigelow — Not Voting
Eduardo Garcia — Yea
Wendy Carrillo — Yea
Bauer-Kahan, Rebecca Democratic Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gabriel, Jesse Democratic Yea
Petrie-Norris, Cottie Democratic Yea
Rivas, Robert Democratic Yea
Dahle, Megan Republican Yea

Official roll call →

Do pass as amended and be re-referred to the Committee on [Appropriations]

Passed 16 Yea · 1 Nay · 2 Other
Party YeaNayPresentNot Voting
Democratic 4000
Unaffiliated 11100
Republican 1002
Total 16102
% of votes cast 84%5%0%11%
How each member voted (19)
Member Party Vote
Obernolte — Yea
Low — Yea
Eggman — Yea
Gloria — Yea
Holden — Yea
McCarty — Yea
Ting — Yea
Chiu — Yea
Mullin — Yea
Medina — Yea
Bloom — Yea
Fong — Nay
Arambula, Joaquin Democratic Yea
Gipson, Mike A. Democratic Yea
Grayson, Timothy S. Democratic Yea
Irwin, Jacqui Democratic Yea
Chen, Phillip Republican Not Voting
Dahle, Megan Republican Yea
Flora, Heath Republican Not Voting

Official roll call →

3rd Reading SB1237 Dodd et al.

Passed 35 Yea · 1 Nay · 4 Other
Party YeaNayPresentNot Voting
Republican 2001
Unaffiliated 23103
Democratic 10000
Total 35104
% of votes cast 88%3%0%10%
How each member voted (40)
Member Party Vote
Chang — Yea
Leyva — Yea
Atkins — Yea
Skinner — Yea
Allen — Yea
Dodd — Yea
Hertzberg — Yea
Glazer — Yea
Borgeas — Yea
Roth — Yea
Rubio — Yea
Wilk — Yea
Hill — Yea
Mitchell — Yea
Beall — Yea
Wieckowski — Yea
Melendez — Yea
Galgiani — Yea
Portantino — Yea
Moorlach — Yea
Bradford — Yea
Hueso — Yea
Morrell — Nay
Bates — Not Voting
Nielsen — Not Voting
Pan — Not Voting
Monning — Yea
Archuleta, Bob Democratic Yea
Caballero, Anna M. Democratic Yea
Durazo, Maria Elena Democratic Yea
Gonzalez, Lena A. Democratic Yea
Hurtado, Melissa Democratic Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Stern, Henry I. Democratic Yea
Umberg, Thomas J. Democratic Yea
Wiener, Scott D. Democratic Yea
Dahle, Megan Republican Yea
Grove, Shannon Republican Yea
Jones, Brian W. Republican Not Voting

Official roll call →

Do pass as amended

Passed 6 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Republican 1000
Unaffiliated 5001
Total 6001
% of votes cast 86%0%0%14%
How each member voted (7)
Member Party Vote
Leyva — Yea
Wieckowski — Yea
Hill — Yea
Portantino — Yea
Bradford — Yea
Bates — Not Voting
Jones, Brian W. Republican Yea

Official roll call →

Placed on suspense file

Passed 7 Yea · 0 Nay
Party YeaNayPresentNot Voting
Republican 1000
Unaffiliated 6000
Total 7000
% of votes cast 100%0%0%0%
How each member voted (7)
Member Party Vote
Leyva — Yea
Wieckowski — Yea
Hill — Yea
Portantino — Yea
Bates — Yea
Bradford — Yea
Jones, Brian W. Republican Yea

Official roll call →

Subjects

healthcare labor
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Frequently asked questions

What does SB 1237 do?
(1) Existing law, the Nursing Practice Act, establishes the Board of Registered Nursing within the Department of Consumer Affairs for the licensure and regulation of the practice of nursing. A violation of the act is a crime. Existing law requires the board to issue a certificate to practice nurse-midwifery to a person who, among other qualifications, meets educational standards established by the board or the equivalent of those educational standards. Existing law 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. Existing law defines the practice of nurse-midwifery as the furthering or undertaking by a certified person, under the supervision of 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. Existing law requires all complications to be referred to a physician immediately. Existing law excludes the assisting of childbirth by any artificial, forcible, or mechanical means, and the performance of any version from the definition of the practice of nurse-midwifery. This bill would delete the above-described provisions defining the practice of nurse-midwifery, would delete the condition that a certified nurse-midwife practice under the supervision of a physician and surgeon, and would instead authorize a certified nurse-midwife to attend cases of low-risk pregnancy, as defined, and childbirth and to provide prenatal, intrapartum, and postpartum care, including family-planning services, interconception care, and immediate care of the newborn, consistent with standards adopted by a specified professional organization, or its successor, as approved by the board. The bill would authorize a certified nurse-midwife to practice with a physician and surgeon under mutually agreed-upon policies and protocols that delineate the parameters for consultation, collaboration, referral, and transfer of a patient's care, signed by both the certified nurse-midwife and a physician and surgeon to provide a patient with specified services. The bill, except as specified, would require the patient to be transferred to the care of a physician and surgeon to provide those services if the nurse-midwife does not have those mutually agreed-upon policies and protocols in place, and would authorize the return of that patient to the care of the nurse-midwife after the physician and surgeon has determined that the condition or circumstance that required, or would require, the transfer is resolved. The bill would authorize a certified nurse-midwife to continue to attend the birth of the newborn and participate in physical care, counseling, guidance, teaching, and support, if a physician and surgeon assumes care of the patient, as indicated by the mutually agreed-upon policies and protocols. The bill would authorize a certified nurse-midwife, after referring a patient to a physician and surgeon, to continue care of a patient the patient during a reasonable interval between the referral and the initial appointment with the physician and surgeon. The bill would authorize a certified nurse-midwife to attend pregnancy and childbirth in an out-of-hospital setting if consistent with the above-described provisions. Under the bill, a certified nurse-midwife would not be authorized to assist childbirth by vacuum or forceps extraction, or to perform any external cephalic version. The bill would require a certified nurse-midwife to refer all emergencies to a physician and surgeon immediately, and would authorize a certified nurse-midwife to provide emergency care until the assistance of a physician and surgeon is obtained. This bill would require a certified nurse-midwife who is not under the supervision of a physician and surgeon to provide oral and written disclosure to a patient and obtain a patient's written consent, as specified. By expanding the scope of a crime, the bill would impose a state-mandated local program. (2) Existing law authorizes the board to appoint a committee of qualified physicians and nurses, including, but not limited to, obstetricians and nurse-midwives, to develop the necessary standards relating to educational requirements, ratios of nurse-midwives to supervising physicians, and associated matters. Existing law, additionally, authorizes the committee to include family physicians. This bill, instead, would require the board to appoint a committee of qualified physicians and surgeons and nurses called the Nurse-Midwifery Advisory Committee. The bill would require the committee to consist of 4 qualified nurse-midwives, 2 qualified physicians and surgeons, including, but not limited to, obstetricians or family physicians, and one public member. The bill would delete the provision including ratios of nurse-midwives to supervising physicians and associated matters in the standards developed by the committee, and would instead require the committee to make recommendations to the board on all matters related to midwifery practice, education, appropriate standard of care, and other matters as specified by the board. The bill would require the committee to provide recommendations or guidance on care when the board is considering disciplinary action against a certified nurse-midwife. The bill would authorize the committee to continue to make the recommendations if the board, despite good faith efforts, is unable to solicit and appoint to the committee 4 qualified nurse-midwives, 2 qualified physicians and surgeons, including, but not limited to, obstetricians or family physicians, and one public member. (3) Existing law authorizes a certified nurse-midwife to furnish drugs or devices, including controlled substances, in specified circumstances, including if drugs or devices are furnished or ordered incidentally to the provision of care in specified settings, including certain licensed health care facilities, birth centers, and maternity hospitals provided that the furnishing or ordering of drugs or devices occur under physician and surgeon supervision. Existing law requires the drugs or devices to be furnished in accordance with standardized procedures or protocols, and defines standardized procedure to mean a document, including protocols, developed and approved by specified persons, including a facility administrator. Existing law requires Schedule II or III controlled substances furnished or ordered by a certified nurse-midwife to be furnished or ordered in accordance with a patient-specific protocol approved by the treating or supervising physician and surgeon. Existing law requires a certified nurse-midwife who is authorized to furnish or issue a drug order for a controlled substance to register with the United States Drug Enforcement Administration. This bill would delete the condition that the furnishing or ordering of drugs or devices occur under physician and surgeon supervision, and would authorize a certified nurse-midwife to furnish drugs or devices incidentally to the provision of care and services allowed by a certificate to practice nurse-midwifery as provided by the bill and when care is rendered in an out-of-hospital setting, as specified. The bill would limit the requirement that the furnishing or ordering of drugs or devices by a certified nurse-midwife be in accordance with the standardized procedures or protocols to the furnishing or ordering of drugs or devices for services that do not fall within the scope of services specified by the bill and Schedule IV or V controlled substances by a nurse-midwife for any condition. The bill would require Schedule II or III controlled substances furnished or ordered by a certified nurse-midwife for any condition to be furnished or ordered in accordance with a patient-specific protocol approved by a physician and surgeon. The bill would revise the definition of standardized procedure to mean a document, including protocols, developed in collaboration with, and approved by, a physician and surgeon and the certified nurse-midwife. The bill would require a certified nurse-midwife who is authorized to furnish or issue a drug order for a controlled substance to additionally register with the Controlled Substance Utilization Review and Enforcement System (CURES) . The bill would authorize a certified nurse-midwife to procure supplies and devices, obtain and administer diagnostic tests, obtain and administer nonscheduled drugs consistent with the provision of services that fall within the scope of services specified by the bill, order laboratory and diagnostic testing, and receive reports, as specified. The bill would make it a misdemeanor for a certified nurse-midwife to refer a person for specified laboratory and diagnostic testing, home infusion therapy, and imaging goods or services if the certified nurse-midwife or their immediate family member has a financial interest with the person receiving a referral. By expanding the scope of a crime, the bill would impose a state-mandated local program. (4) Existing law authorizes a certified nurse-midwife to perform and repair episiotomies and repair lacerations of the perineum in specified health care facilities only if specified conditions are met, including that the protocols and procedures ensure that all complications are referred to a physician and surgeon immediately, and that immediate care of patients who are in need of care beyond the scope of practice of the certified nurse-midwife, or emergency care for times when the supervising physician and surgeon is not on the premises. This bill would delete those conditions, and instead would require a certified nurse-midwife performing and repairing lacerations of the perineum to ensure that all complications are referred to a physician and surgeon immediately, and that immediate care of patients who are in need of care beyond the scope of practice of the certified nurse-midwife, or emergency care when a physician and surgeon is not on the premises. (5) Existing law requires each live birth to be registered with the local registrar of births and deaths for the district in which the birth occurred within 10 days following the date of the event. Existing law makes the professionally licensed midwife in attendance at a live birth that occurs outside of a hospital or outside of a state-licensed alternative birth center responsible for entering the information on the birth certificate, securing the required signatures, and for registering the certificate with the local registrar. This bill instead would make the professionally licensed midwife or the certified nurse-midwife in attendance responsible for those duties. The bill would additionally require the information collected to include the planned place of birth and whether it was a hospital, freestanding birthing center, home delivery, clinic or physician's office, or other specified place. (6) Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest. This bill would make legislative findings to that effect. (7) Existing law, for live births that occur outside of a hospital or outside of a state-licensed alternative birth center, requires the physician in attendance at the birth or, in the absence of a physician, the professionally licensed nurse-midwife in attendance at the birth or, in the absence of a physician or midwife, either one of the parents to be responsible for entering the information on the certificate of live birth, securing the required signatures, and registering the birth. This bill would add specified reporting and data collection requirements for certified nurse-midwives to the Nursing Practice Act. The bill, for all maternal or neonatal transfers to the hospital setting during labor or the immediate postpartum period when the place of birth intended at the onset of labor was an out-of-hospital setting with a certified nurse-midwife as birth care provider, would require the certified nurse-midwife to report certain data to the State Department of Public Health within 90 days of the transfer or death, as specified. If a maternal, fetal, or neonatal death occurred in an out-of-hospital setting during labor or the immediate postpartum period, the bill would require the nurse-midwife to report specified data to the department within 90 days of the death, as specified. The bill would require the department to specify the final form of the data submission. By expanding the scope of a crime, the bill would impose a state-mandated local program. The bill would require, no later than 412 years after these provisions are operative, and annually thereafter, the department to submit a report to the Legislature of the aggregate information, including, but not limited to, birth outcomes of patients under the care of a certified nurse-midwife, collected pursuant to these provisions. The bill would require the department to treat the information and data gathered for the creation of the report to the Legislature as confidential records and prohibit the disclosure of any patient or certified nurse-midwife information to any law enforcement or regulatory agency for any purpose, including, but not limited to, investigations for licensing, certification, or regulatory purposes. The bill would require information collected by the department pursuant to these provisions, not otherwise subject to current confidentiality requirements, to be treated as confidential records and made available only as provided. Under the bill, a violation of these provisions would subject the certified nurse-midwife to disciplinary or administrative action by the Board of Registered Nursing. This bill would make the operation of the provisions described in paragraph (7) contingent upon appropriation by the Legislature, as specified. (8) This bill would incorporate additional changes to Section 650.01 of the Business and Professions Code proposed by AB 890 to be operative only if this bill and AB 890 are enacted and this bill is enacted last. (9) 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.
Who sponsors SB 1237?
SB 1237 is sponsored by Dodd, Mitchell, Burke, and Low.
What is the current status of SB 1237?
This bill has been enacted into law. Introduced February 20, 2020. Enacted.
Where can I track SB 1237?
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