An Act To Ensure the Safety of Home Birth
Maine Legislature, Session 127, LD 0690
Committee Amendment CA_A_S484 (Senate)
Amends: 32 MRSA §12501, 32 MRSA §12502, 32 MRSA §12503, 32 MRSA §12504, 32 MRSA §12505-A, 32 MRSA §13811, 32 MRSA §13812

COMMITTEE AMENDMENT "A " to S.P. 248, L.D. 690, Bill, "An Act To Ensure 
the Safety of Home Birth" 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 32 MRSA §12501, sub-§1-A is enacted to read: 
1-A. 
Accreditation commission for midwiferv education. 
"Accreditation 
commission for midwifery education" means the United States Department of Education-
recognized commission approved in rules adopted by the board that provides 
accreditation. pre-accreditation of certificate. graduate and precertification programs that 
meet the national college of nurse midwives core competencies for midwifery practice. 
Sec. 2. 32 MRSA §12501, sub-§§4-A and 4-B are enacted to read: 
4-A. Certified midwife. "Certified midwife" means an individual who holds a 
current and valid national certification as a certified midwife from the national midwifery 
certification board and is licensed under this chapter to practice midwifery. 
4-B. Certified professional midwife. "Certified professional midwife" means an 
individual who holds a current and valid national certification as a certified professional 
midwife from the national registry of midwives and is licensed under this chapter and 
practices midwifery. 
Sec. 3. 32 MRSA §12501, sub-§5-A is enacted to read: 
5-A. 
Department. 
"Department" means the Department of Professional and 
Financial Regulation. 
Sec. 4. 32 MRSA §12501, sub-§§6-A to 6-J are enacted to read: 
6-A. International confederation of midwives. "International confederation of 
midwives" means a nongovernmental organization, approved in rules adopted by the 
board. representing midwives and midwifery associations that authors international 
standards for education and essential competencies for practice. 
COMMITTEE AMENDMENT 
P OF~ 
COMMITTEE AMENDMENT "A "to S.P. 248, L.D. 690 
6-B. Midwife. "Midwife" means a person who practices midwifery. 
6-C. Midwifery. "Midwifery" means providing primary health or maternity care to 
women and infants. "Midwifery" includes consultation with or referral to medical and 
other health care providers when indicated by client health care needs. 
6-D. 
Midwifery bridge certificate. 
"Midwifery bridge certificate" means a 
certificate issued by the national registry of midwives that documents completion of 
accredited continuing education for certified professional midwives based upon identified 
areas to address education in emergency skills and other competencies set by the 
international confederation of midwives. 
6-E. 
Midwifery education accreditation council. 
"Midwifery education 
accreditation council" means the United States Department of Education-recognized 
commission that provides accreditation for programs and institutions that meet the 
national midwives alliance core competencies, the international confederation of 
midwives competencies and the national registry of midwives skills and standards for 
basic midwifery practice. 
6-F. 
National association of certified professional midwives. 
"National 
association of certified professional midwives" means the national professional and 
standard-setting association for certified professional midwives approved in rules adopted 
by the board. 
6-G. National college of nurse midwives. "National college of nurse midwives" 
means the national professional and standard-setting organization for midwives certified 
by the national midwifery certification board. 
6-H. National midwifery certification board. "National midwifery certification 
board" means the national certifying body, approved in rules adopted by the board, for 
candidates in midwifery who have received graduate-level education in programs 
accredited by the accreditation commission for midwifery education. 
6-1. National midwives alliance. "National midwives alliance" means the national 
midwifery organization, approved in rules adopted by the board, that has articulated core 
competencies for midwives. 
6-J. National registry of midwives. "National registry of midwives" means the 
organization that sets national standards for the certified professional midwife credential 
approved in rules adopted by the board. 
Sec. 5. 32 MRSA §12501, sub-§14-A is enacted to read: 
14-A. 
Qualified midwife preceptor. 
"Qualified midwife preceptor'' means a 
licensed and experienced midwife, or other health professional licensed in this State, who 
participates in the clinical education of individuals enrolled in a midwifery education 
program accredited by the midwifery education accreditation council or accreditation 
commission for midwifery education and who meets the criteria for midwife preceptors 
set forth by the organization. 
Sec. 6. 32 MRSA §12502, sub-§1, as amended by PL 2007, c. 402, Pt. AA, §1, is 
further amended to read: 
COMMITTEE AMENDMENT 
ROFS 
COMMITTEE AMENDMENT "A "to S.P. 248, L.D. 690 
1. 
Membership. 
The Board of Complementary Health Care Providers, as 
established in Title 5, section 12004-A, subsection 8-A, shall regulate the professions of 
acupuncture arul~ naturopathic medicine and midwifery according to the provisions of this 
chapter. The board consists of+ .2. members appointed by the Governor. The Governor 
shall make the initial appointments to the board no later than 60 days after the effective 
date of this section and shall inform the Commissioner of Professional and Financial 
Regulation of these appointments. The commissioner shall call the first meeting of the 
board on a date no later than 30 days following notification of appointments by the 
Governor. All members of the board must be residents of this State. Two members of 
the board must be acupuncturists licensed in this State. Two members of the board must 
be praetitioBers of naturopathic medieiBe doctors who are eligible for licensure under, or 
are licensed pursuant to, the requirements of subchapter 3. 
One member must be a 
certified professional midwife licensed in this State. One member must be a midwife of 
any classification licensed in this State. 
One member must be a public member as 
defined in Title 5, section 12004-A. One member must be an allopathic or osteopathic 
physician, board-certified in obstetrics and gynecology, who is licensed in this State. One 
member must be a pBa11Baeist wi1.o is lieeBsea physician or nurse practitioner with a 
specialty in pediatric care who is licensed in this State. 
Sec. 7. 32 MRSA §12503, sub-§1, ~-1 is enacted to read: 
B-1. Set the standards of practice for midwives. Prior to January 1, 2021, rules 
relating to the limitations in section 12536, the drug formulary, informed consent 
documentation, preexisting conditions that render a pregnancy ineligible for out-of-
hospital birth and data collection and reporting must be adopted by the board in joint 
rulemaking with the Board of Licensure in Medicine. On or after January 1, 2021, 
rules adopted pursuant to this paragraph must be adopted by the board. All other 
rules must be adopted by the board. 
Sec. 8. 32 MRSA §12503, sub-§1, ,in, as amended by PL 2007, c. 402, Pt. AA, 
§2, is further amended to read: 
D. Ensure that acupuncturists arul~ naturopathic doctors and midwives serving the 
public meet minimum standards of proficiency and competency to protect the health, 
safety and welfare of the public; and 
Sec. 9. 32 MRSA §12504, as enacted by PL 1995, c. 671, §13, is amended to 
read: 
§12504. Unauthorized employment 
A person in the course of business may not employ an acupuncturist er~ naturopathic 
doctor or midwife who does not have a license unless that person is a student or intern 
within the meaning of this chapter. 
Sec. 10. 32 MRSA §12505-A, as enacted by PL 2007, c. 402, Pt. AA, §5, is 
amended to read: 
§12505-A. Unlicensed practice 
A person who violates section 12504, 12511 er~ 12521 or 12531 is subject to the 
provisions of Title 10, section 8003. 
COMMITTEE AMENDMENT 
ROFS 
COMMITTEE AMENDMENT "A" to S.P. 248, L.D. 690 
Sec. 11. 32 MRSA c. 113-B, sub-c. 4 is enacted to read: 
SUBCHAPTER 4 
MIDWIFERY LICENSING REQUIREMENTS AND SCOPE OF 
PRACTICE 
§12531. License required 
1. License required. Beginning January 1, 2020, a person may not practice, offer to 
practice or profess to be authorized to practice midwifery, or hold oneself out to the 
public, as a midwife licensed in this State or use the words "certified professional 
midwife" or "certified midwife" or the letters "C.P.M." or "C.M." or other words or letters 
to indicate that the person using the words or letters is a licensed certified midwife or 
licensed certified professional midwife or that may misrepresent to the public that the 
person is authorized to practice midwifery in this State, unless that person is licensed in 
accordance with this subchapter. 
2. National certification. This section is not intended to prohibit persons holding 
national certifications as midwives from identifying themselves as holding such 
certifications, so long as those persons are not practicing midwifery or professing to be 
authorized to practice midwifery in this State. 
3. Individual license. Only an individual may be licensed under this subchapter. 
§12532. Persons and practices exempt 
Nothing in this subchapter may be construed as preventing: 
1. Licensed persons. A person licensed in this State by any other law who is 
performing services within that person's authorized scope of practice from engaging in 
the profession or occupation for which the person is licensed, including midwives 
authorized and licensed as advanced practice registered nurses under the State Board of 
Nursing to practice as certified nurse midwives; 
2. Students. Midwifery services provided by student midwives acting under the 
direct supervision of a gualified midwife preceptor; 
3. Religious or cultural traditions. A traditional birth attendant from practicing 
midwifery without a license if the traditional birth attendant has cultural or religious 
traditions that have historically included the attendance of traditional birth attendants at 
births and that birth attendant serves only the women and families in that distinct cultural 
or religious group; or 
4. Emereency. The rendering of midwifery services in the case of emergency. 
§12533. Qualifications for licensure as a certified professional midwife 
An applicant for a license to practice midwifery as a certified professional midwife 
shall submit to the board in a format as prescribed by the board the following: 
1. Fee. A completed application together with the fee established under section 
12538; 
COMMITTEE AMENDMENT 
ROFS 
COMMITIEE AMENDMENT "A "to S.P. 248, L.D. 690 
2. Certification. Proof of a current and valid national certification as a certified 
professional midwife from the national registry of midwives; and 
3. Education. Proof of successful completion of a formal midwifery education and 
training program as follows: 
A. An educational program or institution accredited by the midwifery education 
accreditation council; 
B. For an applicant certified as a certified professional midwife who is certified 
before January 1, 2020 and who has completed a midwifery education and training 
program from an educational program or institution that is not accredited by the 
midwifery education accreditation council. a midwifery bridge certificate; or 
C. For an applicant who has maintained an authorization to practice midwifery as a 
licensed certified professional midwife in a state that does not require completion of a 
midwifery education and training program from an educational program or institution 
that is accredited by the midwifery education accreditation council. regardless of the 
date of that authorization. a midwifery bridge certificate. 
§12534. Qualifications for licensure as a certified midwife 
An applicant for a license to practice midwifery as a certified midwife shall submit to 
the board in a format as prescribed by the board the following: 
1. Fee. A completed application together with the fee established under section 
12538; 
2. Certification. Proof of a current and valid national certification as a certified 
midwife from the national midwifery certification board; and 
3. Education. Proof of successful completion of a graduate-level education program 
in midwifery that is accredited by the accreditation commission for midwifery education. 
§12535. Scope of practice for certified professional midwife 
1. Certification. A certified professional midwife may not practice without a 
current and valid certification. 
2. National standards. A certified professional midwife shall at all times practice 
within the scope of practice and national standards as delineated by the national 
association of certified professional midwives. 
3. Medical testing and supplies. The scope of practice of a certified professional 
midwife includes authorization to order and interpret medical laboratory tests and 
ultrasound scanning and to obtain equipment and supplies necessary for the safe practice 
of midwifery. 
4. Administration of drugs. The scope of practice of a certified professional 
midwife includes the authority to obtain and administer certain drugs as determined by 
board rule. The board shall limit the drug formulary for certified professional midwives to 
only those medications that are indicated for the safe conduct of pregnancy, labor and 
birth and care of women and newborns and that a midwife is educationally prepared to 
COMMITTEE AMENDMENT 
ROF~ 
COMMITTEE AMENDMENT" A" to S.P. 248, L.D. 690 
administer and monitor. These may not include schedule II, III or IV drugs as defined in 
the federal Controlled Substances Act of 1970, 21 United States Code, Section 812. 
5. Board rules. Clarifications of the scope of practice of a certified professional 
midwife may be established by board rule. 
§12536. Limitations on scope of practice for certified professional midwife 
1. Limitations. Certified professional midwives must refer clients to a hospital-
based perinatal care provider and may not provide birth services to parents in a home or 
freestanding birth center setting when there is a reasonable likelihood that any of the 
following conditions exist: 
A. Multifetal gestation: 
B. Breech presentation: 
C. Vaginal birth after a cesarean section: and 
D. Conditions that present a moderate or high risk of harm to parent or child as 
defined in board rule. 
2. Rules. Notwithstanding subsection 1, the board and the Board of Licensure in 
Medicine, jointly, prior to January 1, 2021 or the board beginning January 1, 2021 may 
adopt rules relating to the provision of birth services by certified professional midwives 
in cases in which there is a reasonable likelihood that any condition identified in 
subsection 1 exists. 
3. Contingent repeal. Any paragraph in subsection 1 the subject matter of which is 
addressed in a rule or rules adopted pursuant to subsection 2 is repealed after the effective 
date of the rule or rules upon notification from the Director of the Office of Professional 
and Occupational Regulation within the department, or the commissioner, to the 
Secretary of the Senate, the Clerk of the House of Representatives and the Revisor of 
Statutes that the rule or rules have been adopted. 
§12537. Scope of practice for certified midwife 
1. Certification. A certified midwife may not practice without a current and valid 
certification. 
2. Standards. A certified midwife shall at all times practice within the scope of 
practice and national standards as delineated by the national college of nurse midwives. 
3. Medical testing and supplies. The scope of practice of a certified midwife 
includes authorization to order and interpret medical laboratory tests, to perform 
ultrasound scanning and to obtain equipment and supplies necessary for the safe practice 
of midwifery. 
4. Prescriptive authority. The scope of practice of a certified midwife includes 
prescriptive authority, which may not include schedule II drugs. 
As used in this 
subsection, "schedule II drug" has the same meaning as in the federal Controlled 
Substances Act of 1970, 21 United States Code, Section 812. 
5. Board rules. Clarifications of the scope of practice of a certified midwife may be 
established by board rule, consistent with national standards. 
COMMITTEE AMENDMENT 
"R QI:: •" 
' ' • ' 
,"I. 
COMMITTEE AMENDMENT "A" to S.P. 248, L.D. 690 
§12538. Fees and renewals 
1. Fees. The Director of the Office of Professional and Occupational Regulation 
within the department may establish by rule fees for purposes authorized under this 
subchapter in amounts that are reasonable and necessary for their respective purposes, 
except that the fee for initial and renewal licensure may not exceed $675 annually. Rules 
adopted pursuant to this subsection are routine technical rules pursuant to Title 5, chapter 
375, subchapter 2-A. 
2. Renewal. A license issued under this subchapter expires on the stated expiration 
date as determined by the commissioner. Prior to expiration of a license, a licensee may 
make an application in a format as determined by the commissioner for renewal and upon 
payment of the renewal fee as set pursuant to subsection 1. A license may not be issued 
until the applicant certifies to the board that the applicant has completed the continuing 
education requirements adopted by the board. 
3. Late renewal. Licenses may be renewed up to 90 days after the date of expiration 
upon payment of a late fee in addition to the renewal fee as set pursuant to subsection 1. 
A person who submits an application for renewal more than 90 days after the date of 
expiration is subject to all requirements governing new applicants under this subchapter, 
except that the board, giving due consideration to the protection of the public, may waive 
any such requirement if that renewal application is received, together with the late fee and 
renewal fee, within 2 years from the date of the expiration. 
§12539. Data collection and reporting for a licensed midwife 
1. Report. Beginning February 1, 2017, and on each February 1st thereafter, a 
midwife licensed under this subchapter shall report to the board, in a form specified by 
the board, the following information regarding cases in which the midwife assisted during 
the previous calendar year when the intended place of birth at the onset of care was an 
out-of-hospital setting: 
A. The total number of clients served as primary maternity caregiver at the onset of 
care; 
B. The number, by county, of live births attended as primary maternity caregiver; 
C. The number, by county, of cases of fetal demise, infant deaths and maternal 
deaths attended as primary maternity caregiver at the discovery of the demise or 
death; 
D. The number of women whose primary maternity care was transferred to another 
health care practitioner during the antepartum period and the reason for transfer; 
E. The number, reason for and outcome of each nonemergency transfer during the 
intrapartum or postpartum period; 
F. The number, reason for and outcome of each urgent or emergency transport of an 
expectant mother in the antepartum period; 
G. The number, reason for and outcome of each urgent or emergency transport of an 
infant or mother during the intrapartum or immediate postpartum period; 
COMMITTEE AMENDMENT 
i,.:, n-;:; ~. 
COMMITTEE AMENDMENT ·A "to S.P. 248, L.D. 690 
H. The number of planned out-of-hospital births at the onset of labor and the number 
of births completed in an out-of-hospital setting: 
I. A brief description of any complications resulting in the morbidity or mortality of 
a mother or a neonate: and 
J. Any information required by the board in rules. 
2. Penalty. Failure to comply with the reporting requirements under subsection 1 is 
grounds for discipline by the board. 
§12540. Qualified immunity 
Other health care practitioners or health care providers, as defined in Title 24, section 
2502, subsections 1-A and 2, respectively, are immune from civil liability for any injuries 
or death resulting from the acts or omissions of a midwife. Notwithstanding any 
inconsistent provisions of any public or private and special law, a health care practitioner 
or health care provider who consults or collaborates with a midwife or acc~ts transfer of 
care of clients of a midwife is not liable for damages for injuries or death alleged to have 
occurred by reason of an act or omission, unless it is established that the injuries or the 
death were caused willfully, wantonly or recklessly or by gross negligence on the part of 
the health care practitioner or health care provider. 
§12541. Informed consent to care 
In a format accepted by the board, a midwife licensed under this subchapter attending 
a birth at a home or freestanding birth center shall provide each client with and maintain a 
record of a signed informed consent to care form that describes the midwife's education 
and credentials, written practice guidelines, services provided, whether the midwife has 
professional liability insurance coverage, procedures and risks of birth in the client's 
chosen environment, components of the emergency plan and the address and telephone 
number of the board where complaints may be filed. The board shall establish by rule a 
form for this purpose. 
§12542. Public health authority and responsibility 
A certified professional midwife or certified midwife is a licensed health care 
provider and has the same authority and responsibility as other licensed health care 
providers regarding public health laws, reportable disease and conditions, communicable 
disease control and prevention, recording of vital statistics, health and physical 
examinations and local boards of health, except that this authority is limited to activity 
consistent with the scope of practice authorized by this subchapter. 
§12543. Disciplinary actions 
1. Disciplinary action. The board may deny a license, refuse to renew a license or 
impose the disciplinary sanctions authorized by Title 10, section 8003, subsection 5-A for 
any of the reasons enumerated in Title 10, section 8003, subsection 5-A. paragraph A. 
2. 
Consultation. 
In any disciplinary actions involving consultation between 
midwives and physicians. informed consent. transport. transfer of care. scope of practice, 
drug formulary or standards of care. the board shall act in consultation with the Board of 
Licensure in Medicine but is not bound by that board's recommendations. 
COMMITTEE AMENDMENT 
·i_·. or·C 
J{ 
,:' :": 
COMMITTEE AMENDMENT" A" to S.P. 248, L.D. 690 
3. Reinstatement after revocation. An application for reinstatement may be made 
to the board one year from the date of revocation of a license. The board may accept or 
reject the application for reinstatement and hold a hearing to consider reinstatement. 
Sec.12. 32 MRSA §13811, as enacted by PL 2007, c. 669, §1, is repealed. 
Sec. 13. 32 MRSA §13812, as enacted by PL 2007, c. 669, §2, is repealed. 
Sec. 14. Midwife data collection and reporting guidelines pending initial 
licensure. The Board of Complementary Health Care Providers, established in the 
Maine Revised Statutes, Title 5, section 12004-A, subsection 8-A, shall invite and 
encourage every midwife who intends to be licensed in this State to keep data records and 
report them to the board upon application for initial licensure. Those records must contain 
the following information: 
1. The total number of clients served as primary maternity caregiver at the onset of 
care; 
2. The number, by county, of live births attended as primary maternity caregiver; 
3. The number, by county, of cases of fetal demise, infant deaths and maternal deaths 
attended as primary maternity caregiver at the discovery of the demise or death; 
4. The number of women whose primary maternity care was transferred to another 
health care practitioner during the antepartum period and the reason for transfer; 
5. The number, reason for and outcome of each nonemergency transfer of care during 
the intrapartum or postpartum period; 
6. The number, reason for and outcome of each urgent or emergency transfer of care 
of an expectant mother in the antepartum period; 
7. The number, reason for and outcome of each urgent or emergency transfer of care 
of an infant or mother during the intrapartum or immediate postpartum period; 
8. The number of planned home or freestanding birth center out-of-hospital births at 
the onset oflabor and the number of births completed in an out-of-hospital setting; 
9. A brief description of any complications resulting in the morbidity or mortality of a 
mother or a neonate that occurs during pregnancy, postpartum and the newborn period; 
and 
10. The number of cases involving vaginal birth after cesarean section, breech 
presentation and multifetal gestation, including for each such case the information 
contained in subsections 1 to 9. 
Sec. 15. Transition provisions 
1. Midwife members; initial appointments. For purposes of initial appointments 
to the Board of Complementary Health Care Providers pursuant to that section of this Act 
that amends the Maine Revised Statutes, Title 32, section 12502, subsection 1, the 
midwife members need only hold a current and valid national certification as a midwife, 
except that after January 1, 2020 all midwife members of the board must be licensed 
pursuant to the requirements of Title 32, chapter 113-B, subchapter 4. 
COMMITTEE AMENDMENT 
ROFS 
COMMITTEE AMENDMENT"()." to S.P. 248, L.D. 690 
2. Expiration of terms. The terms of members of the Board of Complementary 
Health Care Providers who on the effective date of this Act do not meet the requirements 
of the Maine Revised Statutes, Title 32, section 12502, subsection 1 expire on September 
1, 2016. New members appointed in accordance with the provisions of Title 32, section 
12502, subsection 1 must be appointed by September 1, 2016. 
Sec. 16. Transfer by August 1, 2016. Notwithstanding any other provision of 
law, the State Controller shall transfer $76,365 from the General Fund unappropriated 
surplus to the Licensing and Enforcement, Other Special Revenue Funds account within 
the Department of Professional and Financial Regulation no later than August 1, 2016. 
Sec. 17. Transfer by August 1, 2017. Notwithstanding any other provision of 
law, the State Controller shall transfer $26,985 from the General Fund unappropriated 
surplus to the Licensing and Enforcement, Other Special Revenue Funds account within 
the Department of Professional and Financial Regulation no later than August 1, 2017. 
Sec. 18. Transfer by August 1, 2018. Notwithstanding any other provision of 
law, the State Controller shall transfer $26,985 from the General Fund unappropriated 
surplus to the Licensing and Enforcement, Other Special Revenue Funds account within 
the Department of Professional and Financial Regulation no later than August 1, 2018. 
Sec. 19. Transfer by August 1, 2019. Notwithstanding any other provision of 
law, the State Controller shall transfer $26,985 from the General Fund unappropriated 
surplus to the Licensing and Enforcement, Other Special Revenue Funds account within 
the Department of Professional and Financial Regulation no later than August 1, 2019. 
Sec. 20. Appropriations and allocations. The following appropriations and 
allocations are made. 
PROFESSIONAL AND FINANCIAL REGULATION, DEPARTMENT OF 
Administrative Services - Professional and Financial Regulation 0094 
Initiative: Allocates funds for the additional administrative costs including service center 
fees and STA-CAP charges. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Licensing and Enforcement 0352 
2015-16 
$0 
$0 
2016-17 
$3,451 
$3,451 
Initiative: Allocates funds for the per diem and All Other costs of adding 2 members to 
the Board of Complementary Health Care Providers beginning in fiscal year 2016-17. 
OTHER SPECIAL REVENUE FUNDS 
Personal Services 
All Other 
2015-16 
$0 
$0 
COMMITTEE AMENDMENT 
2016-17 
$3,290 
$12,663 
'" 
fJ·_OPS 
COMMITIEE AMENDMENT" A 
"to S.P. 248, L.D. 690 
OTHER SPECIAL REVENUE FUNDS TOT AL 
Licensing and Enforcement 0352 
$0 
$15,953 
Initiative: Allocates funds for the cost of contracting for staff services to assist the Board 
of Complementary Health Care Providers in establishing the new licensing requirement 
for individuals practicing midwifery in the State. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOT AL 
PROFESSIONAL AND FINANCIAL 
REGULATION, DEPARTMENT OF 
DEPARTMENT TOTALS 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
2015-16 
$0 
$0 
2015-16 
$0 
$0 
2016-17 
$56,961 
$56,961 
2016-17 
$76,365 
$76,365 
Sec. 21. Contingent effective date. Those sections of this Act that repeal the 
Maine Revised Statutes, Title 32, sections 13811 and 13812 do not take effect unless: 
1. The Board of Complementary Health Care Providers, established in the Maine 
Revised Statutes, Title 5, section 12004-A, subsection 8-A, either alone or in joint 
rulemaking with the Board of Licensure in Medicine, established in Title 5, section 
12004-A, subsection 24, adopts a rule or rules concerning drug possession and 
administration by certified professional midwives and certified midwives; and 
2. The Director of the Office of Professional and Occupational Regulation within the 
Department of Professional and Financial Regulation, or the Commissioner of 
Professional and Financial Regulation, notifies the Secretary of the Senate, the Clerk of 
the House of Representatives and the Revisor of Statutes that the rule or rules have been 
adopted.' 
SUMMARY 
This amendment replaces the bill, which is a concept draft, with changes to the 
makeup of the Board of Complementary Health Care Providers and a new licensing 
scheme, under the authority of that board, for 2 categories of individuals practicing 
midwifery in the State. Among other things, the amendment establishes: 
1. Criteria for licensure and oversight of midwives; 
COMMITTEE AMENDMENT 
ROFS 
COMMITTEE AMENDMENT" A " 
to S.P. 248, L.D. 690 
2. Procedures to allow other health care providers to consult with, collaborate with or 
accept transfer of care from a licensed midwife; 
3. Joint rulemaking between the Board of Complementary Health Care Providers and 
the Board of Licensure in Medicine for certain categories of rules pertaining to midwives 
until January 1, 2021; 
4. Authority for midwives to order and interpret medical laboratory tests, obtain 
necessary medical equipment and supplies and administer certain classes of drugs; 
5. Limitations on one category of licensed midwife from providing birth services 
when the person giving birth has certain medical conditions; and 
6. Guidelines for data collection by midwives in the State and submission to the 
Board of Complementary Health Care Providers for quality improvement purposes. 
The amendment also adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
; 
~liiJl 
t~J.!J; 
'l.:.~\;:J 
Approved: 03/30/16 
.:Wac 
LD690 
LR 1132(02) 
An Act To Ensure the Safety of Home Birth 
Fiscal Note for Bill as Amended by Committee Amendment ';4' C 
... l{~t,\) 
Committee: Labor, Commerce, Research and Economic Development 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
Other Special Revenue Funds 
Transfers 
General Fund 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2015-16 
$0 
$0 
$0 
$0 
FY 2016-17 
$76,365 
$76,365 
($76,365) 
$76,365 
Projections 
FY 2017-18 
$26,985 
$26,985 
($26,985) 
$26,985 
Projections 
FY 2018-19 
$26,985 
$26,985 
($26,985) 
$26,985 
This bill includes Other Special Revenue Funds allocations totaling $76,635 in fiscal year 2016-17 to the Department 
of Professional and Financial Regulation for the cost associated with requiring individuals practicing midwifery in the 
State to be licensed by January 1, 2020. Of that amount, $72,914 is allocated to the Licensing and Enforcement 
program for the per diem and All Other costs associated with adding 2 members to the Board of Complementary 
Health Care Providers and for contracted staffing services to assist the board in establishing the new licensing 
requirement for individuals practicing midwifery in the State. Additionally, $3,451 is allocated to the Administrative 
Services Division for the service center and STA-CAP charges. 
Because revenue from licensing fees will not be available to support the additional costs to the board until after 
January 1, 2020, General Fund support will be required in the interim years. This bill includes language that requires 
the State Controller to transfer $76,635 in fiscal year 2016-17 and $26,985 per year in fiscal year 2017-18 through 
fiscal year 2019-20 from the unappropriated surplus of the General Fund to the Licensing and Enforcement program, 
Other Special Revenue Funds account no later than August 1 of each year to fund the cost of this legislation. 
LRl 132(02) - Fiscal Note - Page I of 1