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LEGISLATURE
OF
THE
STATE
OF
IDAHO
Sixty-eighth
Legislature
Second
Regular
Session
-
2026
IN
THE
HOUSE
OF
REPRESENTATIVES
HOUSE
BILL
NO.
639
BY
HEALTH
AND
WELFARE
COMMITTEE
AN
ACT
1
RELATING
TO
MIDWIFERY;
AMENDING
SECTION
54
-
5504,
IDAHO
CODE,
TO
REVISE
CER
-
2
TAIN
RULEMAKING
AUTHORITY;
AMENDING
CHAPTER
55,
TITLE
54,
IDAHO
CODE,
3
BY
THE
ADDITION
OF
A
NEW
SECTION
54
-
5504A,
IDAHO
CODE,
TO
PROVIDE
THAT
A
4
LICENSED
MIDWIFE
MAY
OBTAIN
AND
ADMINISTER
ANY
MEDICATION
INDICATED
FOR
5
MATERNAL
CARE
OR
NEONATAL
CARE
FOR
WHICH
THE
MIDWIFE
POSSESSES
THE
REQ
-
6
UISITE
EDUCATION,
TRAINING,
AND
EXPERIENCE;
AMENDING
SECTION
54
-
5510,
7
IDAHO
CODE,
TO
PROVIDE
CORRECT
CODE
REFERENCES;
PROVIDING
THAT
CERTAIN
8
ADMINISTRATIVE
RULES
CONTAINED
IN
IDAPA
24.26.01.
SHALL
BE
NULL,
VOID,
9
AND
OF
NO
FORCE
AND
EFFECT;
AND
DECLARING
AN
EMERGENCY
AND
PROVIDING
AN
10
EFFECTIVE
DATE.
1
1
Be
It
Enacted
by
the
Legislature
of
the
State
of
Idaho:
12
SECTION
1.
That
Section
54
-
5504,
Idaho
Code,
be,
and
the
same
is
hereby
13
amended
to
read
as
follows:
14
54
-
5504.
RULEMAKING.
(1)
The
rules
adopted
by
the
board
shall:
15
(a)
Allow
a
midwife
to
obtain
and
administer,
during
the
practice
of
16
midwifery,
the
following:
17
(i)
Oxygen;
18
(ii)
Oxytocin,
misoprostol,
and
methylergonovine
as
postpartum
19
antihemorrhagic
agents;
20
(iii)
Injectable
local
anesthetic
for
the
repair
of
lacerations
21
that
are
no
more
extensive
than
second
degree;
22
(iv)
Antibiotics
to
the
mother
for
group
b
streptococcus
prophy
-
23
laxis
consistent
with
guidelines
of
the
United
States
centers
for
24
disease
control
and
prevention;
25
(v)
Epinephrine
to
the
mother
administered
for
anaphylactic
26
shock;
27
(vi)
Intravenous
fluids
for
stabilization
of
the
mother;
28
(vii)
Rho
(D)
immune
globulin;
29
(viii)
Phytonadione;
and
30
(ix)
Eye
prophylactics
to
the
child.
31
(b)
Prohibit
the
use
of
other
legend
drugs,
except
those
of
a
similar
32
nature
and
character
as
determined
by
the
board
to
be
consistent
with
33
the
practice
of
midwifery;
provided
that
at
least
one
hundred
twenty
34
(120)
days'
advance
notice
of
the
proposal
to
allow
the
use
of
such
drugs
35
is
given
to
the
board
of
pharmacy
and
the
board
of
medicine
and
neither
36
board
objects
to
the
addition
of
such
drugs
to
the
midwifery
formulary;
37
(c)
(a)
Define
a
formulary
and
protocol
for
use
by
licensed
midwives
of
38
drugs
approved
in
paragraphs
(a)
and
(b)
of
this
subsection
indicated
39
for
maternal
care
or
neonatal
care,
as
provided
for
in
section
54
-
5504A,
40
Idaho
Code,
that
shall
include
methods
of
obtaining,
storing,
and
dis
-
41
2
posing
of
such
drugs
and
an
indication
for
use,
dosage,
route
of
admin
-
1
istration,
and
duration
of
treatment;
2
(d)
(b)
Define
a
protocol
for
medical
waste
disposal;
and
3
(e)
(c)
Establish
scope
and
practice
standards
for
antepartum,
intra
-
4
partum,
postpartum,
and
newborn
care
that
shall,
at
a
minimum:
5
(i)
Prohibit
a
licensed
midwife
from
providing
care
for
a
client
6
with
a
history
of
disorders,
diagnoses,
conditions,
or
symptoms
7
that
include:
8
1.
Placental
abnormality;
9
2.
Multiple
gestation,
except
that
midwives
may
provide
an
-
10
tepartum
care
that
is
supplementary
to
the
medical
care
of
1
1
the
physician
overseeing
the
pregnancy,
as
long
as
it
does
12
not
interfere
with
the
physician's
recommended
schedule
of
13
care;
14
3.
Noncephalic
presentation
at
the
onset
of
labor
or
rupture
15
of
membranes,
whichever
occurs
first;
16
4.
Birth
under
thirty
-
seven
and
zero
-
sevenths
(37
0/7)
17
weeks
and
beyond
forty
-
two
and
zero
-
sevenths
(42
0/7)
weeks
18
gestational
age;
19
5.
A
history
of
more
than
one
(1)
prior
cesarean
section,
20
a
cesarean
section
within
eighteen
(18)
months
of
the
esti
-
21
mated
due
date
or
any
cesarean
section
that
was
surgically
22
closed
with
a
classical
or
vertical
uterine
incision;
23
6.
Platelet
sensitization,
hematological,
or
coagulation
24
disorders;
25
7.
A
body
mass
index
of
forty
(40.0)
or
higher
at
the
time
of
26
conception;
27
8.
Prior
chemotherapy
and/or
radiation
treatment
for
a
ma
-
28
lignancy;
29
9.
Previous
preeclampsia
resulting
in
premature
delivery;
30
10.
Cervical
insufficiency;
31
11.
HIV
positive
status;
or
32
12.
Opiate
use
that
places
the
infant
at
risk
of
neonatal
ab
-
33
stinence
syndrome.
34
(ii)
Prohibit
a
licensed
midwife
from
providing
care
for
a
client
35
with
a
history
of
the
following
disorders,
diagnoses,
conditions,
36
or
symptoms,
unless
such
disorders,
diagnoses,
conditions,
or
37
symptoms
are
being
treated,
monitored,
or
managed
by
a
licensed
38
health
care
provider:
39
1.
Diabetes;
40
2.
Thyroid
disease;
41
3.
Epilepsy;
42
4.
Hypertension;
43
5.
Cardiac
disease;
44
6.
Pulmonary
disease;
45
7.
Renal
disease;
46
8.
Gastrointestinal
disorders;
47
9.
Previous
major
surgery
of
the
pulmonary
system,
cardio
-
48
vascular
system,
urinary
tract,
or
gastrointestinal
tract;
49
10.
Abnormal
cervical
cytology;
50
3
11.
Sleep
apnea;
1
12.
Previous
bariatric
surgery;
2
13.
Hepatitis;
3
14.
History
of
illegal
drug
use
or
excessive
prescription
4
drug
use;
or
5
15.
Rh
or
other
blood
group
disorders
and
a
physician
deter
-
6
mines
the
pregnancy
can
safely
be
attended
by
a
midwife.
7
(iii)
Require
a
licensed
midwife
to
recommend
that
a
client
see
8
a
physician
licensed
pursuant
to
chapter
18,
title
54,
Idaho
9
Code,
or
an
equivalent
provision
of
the
law
of
a
state
bordering
10
Idaho
and
to
document
and
maintain
a
record
as
required
by
section
1
1
54
-
5510,
Idaho
Code,
if
such
client
has
a
history
of
disorders,
12
diagnoses,
conditions,
or
symptoms
that
include:
13
1.
Previous
complicated
pregnancy;
14
2.
Previous
cesarean
section;
15
3.
Previous
pregnancy
loss
in
second
or
third
trimester;
16
4.
Previous
spontaneous
premature
labor;
17
5.
Previous
preterm
rupture
of
membranes;
18
6.
Previous
preeclampsia;
19
7.
Previous
hypertensive
disease
of
pregnancy;
20
8.
Parvo;
21
9.
Toxo;
22
10.
CMV;
23
11.
HSV;
24
12.
Previous
maternal/newborn
group
b
streptococcus
infec
-
25
tion;
26
13.
A
body
mass
index
of
at
least
thirty
-
five
(35.0)
but
less
27
than
forty
(40.0)
at
the
time
of
conception;
28
14.
Underlying
family
genetic
disorders
with
potential
for
29
transmission;
or
30
15.
Psychosocial
situations
that
may
complicate
pregnancy.
31
(iv)
Require
that
a
licensed
midwife
facilitate
the
immediate
32
transfer
to
a
hospital
for
emergency
care
for
disorders,
diag
-
33
noses,
conditions,
or
symptoms
that
include:
34
1.
Maternal
fever
in
labor;
35
2.
Suggestion
of
fetal
jeopardy,
such
as
bleeding
or
meco
-
36
nium
or
abnormal
fetal
heart
tones;
37
3.
Noncephalic
presentation
at
the
onset
of
labor
or
rup
-
38
ture
of
membranes,
whichever
occurs
first,
unless
imminent
39
delivery
is
safer
than
transfer;
40
4.
Second
-
stage
labor
after
two
(2)
hours
of
initiation
of
41
pushing
when
the
mother
has
had
a
previous
cesarean
section;
42
5.
Current
spontaneous
premature
labor;
43
6.
Current
preterm
premature
rupture
of
membranes;
44
7.
Current
preeclampsia;
45
8.
Current
hypertensive
disease
of
pregnancy;
46
9.
Continuous
uncontrolled
bleeding;
47
10.
Bleeding
that
necessitates
the
administration
of
more
48
than
two
(2)
doses
of
oxytocin
or
other
antihemorrhagic
49
4
agent
does
not
respond
to
the
administration
of
antihemor
-
1
rhagic
agents
;
2
11.
Delivery
injuries
to
the
bladder
or
bowel;
3
12.
Grand
mal
seizure;
4
13.
Uncontrolled
vomiting;
5
14.
Coughing
or
vomiting
of
blood;
6
15.
Severe
chest
pain;
or
7
16.
Sudden
onset
of
shortness
of
breath
and
associated
la
-
8
bored
breathing.
9
A
transfer
of
care
shall
be
accompanied
by
the
client's
medical
10
record,
the
licensed
midwife's
assessment
of
the
client's
current
1
1
condition,
and
a
description
of
the
care
provided
by
the
licensed
12
midwife
prior
to
transfer;
13
(v)
Establish
a
written
plan
for
the
emergency
transfer
and
14
transport
required
in
subparagraph
(iv)
of
this
paragraph
and
for
15
notifying
the
hospital
to
which
a
client
will
be
transferred
in
16
the
case
of
an
emergency.
If
a
client
is
transferred
in
an
emer
-
17
gency,
the
licensed
midwife
shall
notify
the
hospital
when
the
18
transfer
is
initiated
and
accompany
the
client
to
the
hospital
if
19
feasible,
or
communicate
by
telephone
with
the
hospital
if
unable
20
to
be
present
personally,
and
shall
provide
the
client's
medi
-
21
cal
record.
The
record
shall
include
the
client's
name,
address,
22
list
of
diagnosed
medical
conditions,
list
of
prescription
or
23
over
-
the
-
counter
medications
regularly
taken,
history
of
previ
-
24
ous
allergic
reactions
to
medications,
if
feasible,
the
client's
25
current
medical
condition
and
description
of
the
care
provided
by
26
the
midwife,
and
next
-
of
-
kin
contact
information.
A
midwife
who
27
deems
it
necessary
to
transfer
or
terminate
care
pursuant
to
this
28
section
and
any
rules
promulgated
pursuant
to
this
section
or
for
29
any
other
reason
shall
transfer
or
terminate
care
and
shall
not
be
30
regarded
as
having
abandoned
care
or
wrongfully
terminated
ser
-
31
vices.
Before
nonemergent
discontinuing
of
services,
the
midwife
32
shall
notify
the
client
in
writing,
provide
the
client
with
names
33
of
licensed
physicians
and
contact
information
for
the
nearest
34
hospital
emergency
room,
and
offer
to
provide
copies
of
medical
35
records
regardless
of
whether
copying
costs
have
been
paid
by
the
36
client.
37
(f)
(d)
Establish
and
operate
a
system
of
peer
review
for
licensed
38
midwives
that
shall
include
but
not
be
limited
to
the
appropriateness,
39
quality,
utilization,
and
ethical
performance
of
midwifery
care.
40
(2)
The
rules
adopted
by
the
board
may
not:
41
(a)
Require
a
licensed
midwife
to
have
a
nursing
degree
or
diploma;
42
(b)
Except
as
a
condition
imposed
by
disciplinary
proceedings
by
the
43
board,
require
a
licensed
midwife
to
practice
midwifery
under
the
su
-
44
pervision
of
another
health
care
provider;
45
(c)
Except
as
a
condition
imposed
by
disciplinary
proceedings
by
the
46
board,
require
a
licensed
midwife
to
enter
into
an
agreement,
written
or
47
otherwise,
with
another
health
care
provider;
48
(d)
Limit
the
location
where
a
licensed
midwife
may
practice
midwifery;
49
5
(e)
Allow
a
licensed
midwife
to
use
vacuum
extraction
or
forceps
as
an
1
aid
in
the
delivery
of
a
newborn;
2
(f)
Grant
a
licensed
midwife
prescriptive
privilege;
or
3
(g)
Allow
a
licensed
midwife
to
perform
abortions.
4
SECTION
2.
That
Chapter
55,
Title
54,
Idaho
Code,
be,
and
the
same
is
5
hereby
amended
by
the
addition
thereto
of
a
NEW
SECTION
,
to
be
known
and
des
-
6
ignated
as
Section
54
-
5504A,
Idaho
Code,
and
to
read
as
follows:
7
54
-
5504A.
MEDICATIONS.
A
licensed
midwife
may
obtain
and
administer
8
any
medication
indicated
for
maternal
care
or
neonatal
care
defined
in
the
9
formulary
and
protocol
for
which
the
midwife
possesses
the
requisite
educa
-
10
tion,
training,
and
experience.
Administration
of
such
medication
shall
be
1
1
performed
within
the
acceptable
community
standard
of
care.
12
SECTION
3.
That
Section
54
-
5510,
Idaho
Code,
be,
and
the
same
is
hereby
13
amended
to
read
as
follows:
14
54
-
5510.
DISCLOSURE
AND
RECORDKEEPING
-
-
LICENSE
RENEWAL.
(1)
Before
15
initiating
care,
a
licensed
midwife
shall
obtain
a
signed
informed
consent
16
agreement
from
each
client,
acknowledging
receipt,
at
a
minimum,
of
the
fol
-
17
lowing:
18
(a)
The
licensed
midwife's
training
and
experience;
19
(b)
Instructions
for
obtaining
a
copy
of
the
rules
adopted
by
the
board
20
pursuant
to
this
chapter;
21
(c)
Instructions
for
obtaining
a
copy
of
the
NACPM
essential
documents
22
and
NARM
job
description;
23
(d)
Instructions
for
filing
complaints
with
the
board;
24
(e)
Notice
of
whether
or
not
the
licensed
midwife
has
professional
lia
-
25
bility
insurance
coverage;
26
(f)
A
written
protocol
for
emergencies,
including
hospital
transport,
27
that
is
specific
to
each
individual
client;
28
(g)
A
description
of
the
procedures,
benefits,
and
risks
of
home
birth,
29
primarily
those
conditions
that
may
arise
during
delivery;
and
30
(h)
Any
other
information
required
by
board
rule.
31
(2)
All
licensed
midwives
shall
maintain
a
record
of
all
signed
in
-
32
formed
consent
agreements
for
each
client
for
a
minimum
of
nine
(9)
years
33
after
the
last
day
of
care
for
such
client.
34
(3)
Before
providing
care
for
a
client
who
has
a
history
of
disorders,
35
diagnoses,
conditions,
or
symptoms
identified
in
section
54
-
5504(1)(e)(ii)
36
54
-
5504(1)(c)(ii)
,
Idaho
Code,
the
licensed
midwife
shall
provide
writ
-
37
ten
notice
to
the
client
that
the
client
must
obtain
care
from
a
physician
38
licensed
pursuant
to
chapter
18,
title
54,
Idaho
Code,
as
a
condition
39
to
her
eligibility
to
obtain
maternity
care
from
the
licensed
midwife.
40
Before
providing
care
for
a
client
who
has
a
history
of
disorders,
diag
-
41
noses,
conditions,
or
symptoms
identified
in
section
54
-
5504(1)(e)(iii)
42
54
-
5504(1)(c)(iii)
,
Idaho
Code,
or
who
has
had
a
previous
cesarean
section,
43
the
licensed
midwife
shall
provide
written
notice
to
the
client
that
the
44
client
is
advised
to
consult
with
a
physician
licensed
pursuant
to
chapter
45
18,
title
54,
Idaho
Code,
during
her
pregnancy.
The
midwife
shall
obtain
the
46
client's
signed
acknowledgment
of
receipt
of
said
notice.
47
6
(4)
Any
licensed
midwife
submitting
an
application
to
renew
a
license
1
shall
compile
and
submit
to
the
board
complete
practice
data
for
the
calendar
2
year
preceding
the
date
of
the
application.
Such
information
shall
be
pro
-
3
vided
in
form
and
content
as
prescribed
by
rule
of
the
board
and
shall
include
4
but
not
be
limited
to:
5
(a)
The
number
of
clients
to
whom
care
has
been
provided
by
the
licensed
6
midwife;
7
(b)
The
number
of
deliveries
performed
by
the
licensed
midwife;
8
(c)
The
apgar
scores
of
the
infants
delivered
by
the
licensed
midwife;
9
(d)
The
number
of
prenatal
transfers;
10
(e)
The
number
of
transfers
during
labor,
during
delivery,
and
immedi
-
1
1
ately
following
birth;
12
(f)
Any
perinatal
deaths;
and
13
(g)
Other
morbidity
statistics
as
required
by
the
board.
14
SECTION
4.
The
rules
contained
in
IDAPA
24.26.01.,
Idaho
Board
of
Mid
-
15
wifery,
relating
to
Protocols
for
the
Use
of
Formulary
Drugs,
Section
200.,
16
Subsection
01.,
shall
be
null,
void,
and
of
no
force
and
effect
on
and
after
17
July
1,
2026.
18
SECTION
5.
An
emergency
existing
therefor,
which
emergency
is
hereby
19
declared
to
exist,
this
act
shall
be
in
full
force
and
effect
on
and
after
20
July
1,
2026.
21