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NMAC backs drafting regulations to tie California midwifery licensure to national accreditation and certification
Summary
The Nurse Midwifery Advisory Committee voted to ask the education subcommittee to draft regulatory language that would require applicants for nurse-midwife licensure to show completion of an ACME-accredited education program and proof of AMCB national certification; committee members requested staff and the full BRN be briefed as drafts progress.
Kim Do, presenting as a member of the NMAC education subcommittee, asked the committee to consider updating California Code of Regulations, title 16, sections 1460 and 1462, which set board educational standards for nurse midwives. Do told the committee the regulations were last amended in 1985 and that statutory scope-of-practice changes and national accreditation standards argue for a fresh review.
Do outlined three existing regulatory pathways currently in CCR 14 60: (1) completion of a program that meets BRN standards (pathway most commonly used by California-based programs), (2) an equivalency pathway under which the board reviews an applicant's program and may request remediation, and (3) demonstration of certification by an equivalent national organization. Do explained that in practice many programs and applicants already meet national standards, because Accreditation Commission for Midwifery Education (ACME) accreditation and American Midwifery Certification Board (AMCB) certification are widely used.
Do proposed that the committee consider regulations that would require as the minimum for licensure a nationally accredited program (ACME) and national certification (AMCB), with a temporary license option (analogous to RN temporary licensure) to bridge the gap between program completion and receipt of national certification. Do said the ACME accreditation process covers program administration, policies for student support, curriculum aligned with ACNM core competencies, clinical resources and quality monitoring; AMCB provides standardized national certification.
Committee members asked procedural questions about precedent and process. Staff and counsel explained that the committee may draft regulatory text for the board's consideration, but the full board ultimately determines whether to initiate formal rulemaking. Committee members also discussed whether California's current permissive pathway (licensure without national certification) provides equity or creates differences with other professions. Public comment from Anya Rapoport (California Nurse Midwives Association) supported the proposed move to require ACME accreditation and AMCB certification and asked for a six-month temporary license window parallel to the RN temporary license.
The committee voted to direct the education subcommittee to draft proposed regulatory language requiring applicants to demonstrate completion of a nationally accredited midwifery education program and AMCB certification; the subcommittee will present draft text at a future NMAC meeting and the BRN will be apprised of the committee's direction.
Ending: NMAC will draft proposed regulations and return with text for review; staff warned regulatory change is a multistep process and may take many months to complete, and the full BRN must approve initiation of formal rulemaking.
