DEPARTMENT OF HEALTH

[Filed March 23, 2026, 8:23 a.m.]

Preproposal statement of inquiry was filed as WSR 25-19-055.

Title of Rule and Other Identifying Information: Midwifery licensure requirements; removing jurisprudence examination requirement. The department of health (department) is proposing amendments to WAC 246-834-050 Examination requirements for licensure as a midwife, and 246-834-060 Initial application requirements for licensure as a midwife, to remove the jurisprudence examination requirement for licensure as a midwife.

Hearing Location(s): On May 5, 2026, at 1:00 p.m. Register in advance for this webinar at https://us02web.zoom.us/webinar/register/WN_AmCCZ9C7SkGVmr-mnFMLXg. After registering, you will receive a confirmation email containing information about joining the webinar. The department will hold a virtual-only hearing. Individuals may provide testimony by attending the virtual [hearing] or by submitting testimony in writing.

Date of Intended Adoption: May 12, 2026.

Submit Written Comments to: Kathy Weed, Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, email kathy.weed@doh.wa.gov, web https://fortress.wa.gov/doh/policyreview, beginning the date and time of this filing, by May 5, 2026, at 11:59 p.m.

Assistance for Persons with Disabilities: Contact Kathy Weed, phone 360-236-4883, fax 360-236-2901, TTY 711, email kathy.weed@doh.wa.gov, by April 28, 2026.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department is proposing amendments to WAC 246-834-050 and 246-834-060 to remove the jurisprudence examination from requirements for licensure as a midwife. The purpose of the proposed amendments is to reduce barriers to enter the midwifery workforce and to streamline and shorten the credentialing process, while still protecting patient safety.

Reasons Supporting Proposal: The proposed rule amendments align with the intent of RCW 18.130.077, which requires disciplining authorities for credentialed professionals to waive education, training, experience, and exam requirements for applicants coming from other states with similar standards. The midwifery profession was not directly impacted by this law because there are currently no states with licensing standards that are substantially equivalent to Washington. However, in alignment with the intent of the legislation to reduce licensing barriers, the department is proposing rule amendments to remove the jurisprudence examination requirement for midwifery licensure.

The department determined, in consultation with the midwifery advisory committee, that the jurisprudence examination is administrative in nature, is open book and untimed, and does not meaningfully assess clinical competency. Removal of the examination does not reduce patient protections because substantive knowledge of Washington law and scope of practice remains available to applicants through department guidance and enforceable statutory and rule requirements.

Statutory Authority for Adoption: RCW 18.50.135.

Statute Being Implemented: RCW 18.50.020 and 18.130.077.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Department of health, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Kathy Weed, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-4883.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Kathy Weed, Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-236-4883, TTY 711, email kathy.weed@doh.wa.gov.

This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:

Is exempt under RCW 19.85.025(4).

Explanation of exemptions: Although many licensees practice within small businesses, the proposed rules regulate only individual license requirements for midwives. It removes an examination requirement and does not impose costs or requirements on business operations, staffing, equipment, or reporting.

Scope of exemption for rule proposal:

Kristin Peterson, JD

for Dennis E. Worsham

AMENDATORY SECTION(Amending WSR 22-13-079, filed 6/10/22, effective 7/11/22)

WAC 246-834-050Examination requirements for licensure as a midwife.

(1) An applicant for midwifery licensure shall successfully pass:

(a) The midwifery examination offered by the North American Registry of Midwives (NARM); and

(b) The Washington state licensure examination with a minimum passing score of 80((; and

(2) The secretary may, by rule, revise examination requirements if necessary, for good cause.

AMENDATORY SECTION(Amending WSR 22-13-079, filed 6/10/22, effective 7/11/22)

WAC 246-834-060Initial application requirements for licensure as a midwife.

(1) An applicant for a midwife license shall submit to the department the following:

(a) Initial application on forms provided by the department.

(b) Fees required in WAC 246-834-990.

(d) Proof of at least three years of midwifery training, per RCW 18.50.040 (2)(a), unless the applicant qualifies for a reduced academic period.

(((e) Proof of successful completion of the midwifery jurisprudence exam, as required in WAC 246-834-050.))

(2) In addition to the requirements in subsection (1) of this section, an applicant for a midwife license shall also:

(a) Have transcripts sent directly to the department from the applicant's midwifery school demonstrating that the applicant has received a certificate or diploma in midwifery. An applicant applying under WAC 246-834-065 or 246-834-066 may be exempted from this requirement.

(b) Have verification of passing the North American Registry of Midwives (NARM) examination as required in WAC 246-834-050. Results must be sent directly to the department from NARM.

(3) Once all application requirements in this section are met, and additional requirements in WAC 246-834-065 or 246-834-066 if applicable, the department will schedule the applicant for the Washington state licensing exam as required in WAC 246-834-050.