Committee hears midwives' fix to let licensed midwives delegate tasks to medical assistants

The committee considered House Bill 23-29 Jan. 14, a technical change intended to allow licensed midwives to delegate tasks to medical assistants (MAs) and to add licensed midwives to the list of health care practitioners authorized to supervise MAs. Staff told lawmakers that the bill addresses an omission — licensed midwives assist with low-risk births and are required to consult physicians when births deviate from normal — and that lactation consultants are typically not regulated by the Washington Department of Health.

Rep. (Barnard), sponsor of the bill, described it as a ‘‘fix it bill’’ to remove barriers to birthing and postpartum care and said removing IBCLC certification language would be part of the amendments because those consultants are not DOH-regulated. Testimony from birth-center operators emphasized the staffing and financial stability implications for rural areas: Cynthia Flynn (Columbia Birth Center) and Lynette Pettibone (Bridge Birth Center) said the omission hindered the ability to use MAs rather than RNs for some tasks, increasing costs and limiting capacity in underserved districts.

Witnesses argued the change would make licensed midwifery more viable and help maintain local birth-center services. Committee members asked clarifying questions about who currently can delegate and how the change would align with existing supervision and delegation rules; staff and advocates said the bill is narrowly targeted to licensed midwives and does not alter the scope of midwifery practice beyond delegation authority. No vote was taken at the hearing; witnesses urged the committee to adopt the amendment removing IBCLC language before advancing the bill.