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Committee passes midwifery licensure bill with broad amendments and carve‑outs for Native Hawaiian practices
Summary
The finance committee passed HB1194 after adopting multiple amendments: exemptions for Native Hawaiian traditional and customary practices, clarified delegation language, peer‑review limits for hospital midwives, telehealth definition changes, CPR/NRP certification requirements, and an effective date of June 29, 2025.
House Committee on Finance members voted to advance HB1194 after the committee adopted a long list of amendments intended to clarify scope, exemptions and practice standards for licensed midwives.
The committee added language, drawn from the Native Hawaiian Legal Corporation’s testimony, to clarify that Native Hawaiian traditional and customary practices are exempt from the chapter. The committee also revised scope and safety language: it deleted references that would allow certain ionizing‑radiation procedures (for example, x‑rays) to be conducted by midwives, clarified global signature authority (removing some forms from the midwife signature authority), limited peer review requirements (excluding midwives working in hospitals and accredited birth facilities), and allowed the Department of Commerce and Consumer Affairs to require data submission as a condition of license renewal for community midwives but not for hospital‑based midwives.
Committee amendments also aligned the telehealth definition with the medical practice statute, clarified delegation authority allowing a midwife to delegate administrative and technical clinical tasks to an unlicensed person, and adopted DCCA language making valid CPR and neonatal resuscitation certifications a condition of licensure and renewal. The committee set the bill’s effective date as June 29, 2025.
Committee members expressed divided views. Representative Hussey said he would vote no. Representative Grandinetti recorded a reservation about aspects of the bill and said she would vote with reservations; Representative Grandinetti described remaining concerns about exemptions for apprenticeship and certain ACLU recommendations that she felt were not fully addressed. The committee recorded “no” votes from Representatives Hussey and Reyes Oda and a noted reservation from Representative Grandinetti.
Why this matters: the bill establishes a state licensure framework for midwives that balances a public‑safety regulatory scheme with recognized cultural and hospital‑based practice exemptions. Key decisions concern delegation, peer review, data reporting requirements and the relationship between licensed midwives and existing health‑care systems.
What’s next: HB1194 will move to the House floor with the adopted amendments; members flagged outstanding concerns and several recorded reservations and no votes during committee action.
Ending detail: committee leadership said the amendments were developed with subject‑matter chairs, DCCA and leadership; the committee made the bill a “clean bill” with an early effective date to allow immediate implementation if enacted.
