Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Health Care & Wellness Committee
HB 2329
Brief Description: Concerning midwife supervision of medical assistants and lactation consultants.
Sponsors: Representative Barnard.
Brief Summary of Bill
  • Allows a licensed midwife to delegate specific tasks to a medical assistant or international board-certified lactation consultant.
  • Adds licensed midwives to the list of health care practitioners that may supervise medical assistants.
Hearing Date: 1/14/26
Staff: Emily Poole (786-7106).
Background:

Licensed Midwives.
Licensed midwives are one of two types of midwives in Washington, in addition to certified nurse-midwives.  Licensed midwives are licensed by the Department of Health (DOH) and they must generally have completed an accredited midwifery program and three years of midwifery training before licensure.  Applicants must also pass the national and state midwifery licensure examinations.  

 

Licensed midwives are required to consult with physicians whenever there are significant deviations from normal in either the gestational parent or the newborn.  A licensed midwife may delegate to a registered nurse or a licensed practical nurse selected acts, tasks, or procedures that constitute the practice of midwifery but do not exceed the education of the nurse.

 

Medical Assistants.
The DOH issues certifications for several different types of medical assistants (MAs), including certified MAs and registered MAs.  The Secretary of Health adopts minimum qualifications and requirements for each type of MA.

 

An MA may perform specific authorized duties when delegated by, and under the supervision of, a health care practitioner, but the required level of supervision may vary for different types of MAs and the specific task.  A "health care practitioner" that may supervise an MA is defined to include:

  • a physician;
  • an osteopathic physician and surgeon; or
  • acting within the scope of their respective licensure, a podiatric physician and surgeon, a registered nurse or advanced practice registered nurse, a naturopath, a physician assistant, or an optometrist.

 

Lactation Consultants.
Lactation consultants offer expertise and resources to new parents regarding lactation.  Lactation consultants are not licensed by the DOH, but they may be certified by the International Board of Lactation Consultant Examiners, which is an international credentialing body for lactation consultants.   
Summary of Bill:

A licensed midwife may delegate to an MA or international board-certified lactation consultant selected tasks that constitute the practice of midwifery but do not exceed the education and scope of practice of the MA or lactation consultant.

 

Licensed midwives, acting within the scope of their licensure, are added to the list of "health care practitioners" that may supervise MAs.
Appropriation: None.
Fiscal Note: Requested on January 9, 2026.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.