Information and Updates:

California Licensed Midwife Board

In the midst of a chaotic 2020, circumstances coalesced after years of laying the groundwork to form a Licensed Midwife Board in California. The Medical Board of California (MBC) has included in their draft Sunset Review Report to the legislature a recommendation to form a Licensed Midwife Board independent of the MBC.

A Licensed Midwife Board will bring licensed midwives on par with other states not regulated by a medical board and with all other health care professionals in California. A Licensed Midwife Board will pave the way for better integration into the health care system, improve transfers and outcomes, and create greater sustainability for the midwifery profession.

This opportunity is due to tireless advocacy by CALM, midwives around the state, the Midwifery Advisory Counsel and midwifery advocates. Thank you to all who have helped in this effort, no single contribution is small. We stand on the shoulders of advocates who made the original licensed midwifery practice act happen, subsequent bills and regulatory actions that advanced and protected access, and those who helped stopped hostile legislation and regulations that would undermine safety and access.

The Medical Board of California met for their the quarterly meeting November 12 & 13, 2020 and voted to approve The Sunset Review Report, including the recommendation to Sunrise the Licensed Midwife Program. Sunrise is the process by which a professional board is formed under the Department of Consumer Affairs.

What is next? The Sunset Review Report will be officially presenting to the legislature as the foundation for a bill that will take action on issues in the report and reauthorize the MBC to function. The biggest issue in the report and for the MBC is that the MBC is financially insolvent.

Frequently Asked Questions:

What is Sunset Review?

Professional boards of all kinds are authorized to function by the state legislature. Periodically, professional boards are reviewed by the legislature and reauthorized to continue functioning through the Sunset Review process. The process involves a detailed Sunset Review Report by the board to the legislature. Subsequently, there is a bill that is initiated by the Business and Professions Committee(s) that both reauthorizes the board but also makes any necessary statutory changes to improve function and appropriate regulation of the profession. The Medical Board of California (MBC) and many other boards are up for Sunset Review in the coming legislative cycle in 2021. All professional boards and bureaus in California are under the Department of Consumer Affairs (DCA).

What is the Sunrise Process?

When a profession forms a new board under the DCA it goes through the Sunrise process which starts with a 52-question report that justifies the need for regulation and a board. CALM has completed and submitted the Sunrise questionnaire to Assembly Business & Professions in anticipation of a Licensed Midwife Board.

How many members will the board have?

In California, a typical board has an odd number of members, with no more than nine for a small profession such as licensed midwives. A majority of members are from the profession being regulated, while at least two are members of the public.

What will be the criteria for board member appointments?

Each professional member of a board must:

• Be a citizen of the state for at least five years preceding their appointment
• Have a valid license as a member of the profession
• Have engaged in the licensed practice of that profession in California for at least five years preceding their appointment.

Public members of a board must also have been citizens of the state for at least five years and should not be a licensee of the board they will serve on or any other professional board.

Who appoints board members?

Professional members of a board are appointed by the Governor while the Senate Rules Committee and the Speaker of the Assembly appoint public members.

All individuals in the state who meet the above criteria and who have professional and personal experience they believe qualifies them to serve on a board may submit an application to be considered for nomination.

How will complaints be reviewed and disciplinary cases handled?

The standardized process for the intake and review of complaints and any resulting disciplinary action will remain the same. However, instead of being sent to the medical board to be reviewed by physicians, complaints against licensed midwives will be filed with a Licensed Midwife Board and reviewed by midwives, according to midwifery standards of practice.

What about licensing fees?

To forestall impending insolvency, the Medical Board of California is seeking legislation to increase licensed midwife fees by 50% in 2021. Other MBC licensees will see fee increases from between 25% and 47% (physician fees will increase by 41%). One of the primary factors behind the fee increase are the costs associated with regulating physicians. See the report here.

A licensed midwife board whose resources are allocated solely to licensed midwives, and not to other MBC licensees, will be much more cost-efficient. Moreover, a licensed midwife board with the authority to manage the funds drawn from licensed midwife fees (approximately $400k currently held in reserve), will create opportunities to support a broad range of initiatives to advance professional development.