BRN advisory committee approves FAQ updates to reflect midwifery scope changes; legal review required

The Nurse Midwifery Advisory Committee of the California Board of Registered Nursing voted to update the board’s FAQs and website language to reflect statutory changes that removed references to standardized procedures for certified nurse‑midwives, the committee said during a Webex meeting.

Committee members said the updates are intended to reflect two recent statutory changes discussed during the meeting: SB 1375, which the committee noted amended the law to allow some nurse‑midwives to provide first‑trimester abortion care without physician supervision (effective Jan. 2023, as discussed in the meeting), and SB 667, which committee members said removed references to required standardized procedures (effective Jan. 2024, as discussed in the meeting). The committee approved moving forward with the FAQ edits “pending legal review,” and asked staff to report back on the changes at the next NMAC meeting.

Why it matters: Committee members and outside midwifery stakeholders told the panel that BRN’s website still included outdated references to “standardized procedures” and other text that could be read as limiting midwifery scope. Several presenters said health systems and employers reference BRN guidance when writing local policy and that delays in updating the board’s materials were affecting clinical practice.

At the meeting, BRN staff said they have already implemented several updates and that the remaining changes — notably FAQ language that referred to standardized procedures, patient‑specific protocols, and certain dispensing/furnishing rules — require careful legal review before posting. The proposed edits discussed include removing references to standardized procedures where statute no longer requires them; clarifying when a certified nurse‑midwife (CNM) may furnish or dispense drugs or devices; noting that first‑trimester abortion care is included in CNM scope where statutory requirements are met; and adding text about CLIA‑waived laboratory roles that SB 667 addressed.

Public comment and next steps: Paris Malouf‑Burry, representing the California Midwives Association, told the committee she has repeatedly sought updates and said delays are hindering practice changes at health systems. “We have effectively spent the first hour and 42 minutes of the two‑hour meeting getting nothing done other than talking about how we could make changes,” she said. Paris requested written notification when the board posts the changes; BRN staff responded that they would notify stakeholders once updates are live.

Legal and interagency checks: BRN legal counsel and staff emphasized the need to coordinate changes with pharmacy and DEA law where dispensing or furnishing is discussed, and to ensure that web language does not cross into rulemaking or interpretive policy that requires a regulatory process. The committee’s motion to proceed with the edits was made with the condition that BRN legal staff review the final text; the motion passed on a roll‑call vote.

Ending: Committee members asked staff and the newly operational public engagement and website subcommittee to continue refining FAQs, coordinate with other agencies or associations where necessary, and present a status report at the next NMAC meeting. The committee also agreed staff would post the clarified FAQ language after completing legal review.