SENATE BILL REPORT

                   SB 5920

              As Passed Senate, February 9, 2000

Title:  An act relating to adding midwives to the definition of health care practitioners that provide women's health care services.

Brief Description:  Including midwives in women's health care services.

Sponsors:  Senators Costa, Thibaudeau, Deccio, Haugen and Kohl‑Welles.

Brief History:

Committee Activity:  Health & Long‑Term Care:  3/2/99, 3/3/99 [DP].

Passed Senate, 3/17/99, 44-0; 2/9/00, 47-0.

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  Do pass.

  Signed by Senators Thibaudeau, Chair; Wojahn, Vice Chair; Costa, Deccio, Franklin and Winsley.

Staff:  Jonathan Seib (786-7427)

Background:  Under current law, health insurance plans must provide women with direct access to certain types of health care providers without requiring a prior referral from another provider.  Licensed midwives are not among the list of providers to whom these direct access provisions apply.

Summary of Bill:  Insurers must provide women with direct access to licensed midwives.

Appropriation:  None.

Fiscal Note:  Requested on March 1, 1999.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  This bill does not expand the scope of practice of midwives.  Rather, it puts midwives on a level playing field with other women=s health care providers.  The current system has led to substantial delays in women=s access to midwives, causing delays in care that jeopardize both the health of the mother and the baby.  A referral process is not necessary, and often the primary care provider is not familiar with the services that a midwife can provide.

Testimony Against:  This bill would put limited license practitioners on the same level as general care practitioners with regard to direct access.  It suggests a scope of practice that is not consistent with midwives= current scope of practice.  Sufficient safeguards are not always in place to assure a safe delivery absent the oversight that the referral process provides.

Testified:  PRO:  Nick Federici, Sarah Huntington, Lee Anne Shelley, Midwives Association of Washington State; CON:  Carl Nelson, Washington State Medical Association.