All Roll Calls
Yes: 170 • No: 49
HawaiiHB 11942025–2026 Regular Session (Year 1)HouseWALLET
RELATING TO MIDWIVES.
Sponsored By: Linda Ichiyama (Democratic)
Became Law
Summary
Makes laws regulating midwives and the practice of midwifery permanent. Clarifies the scope of practice of midwifery. Establishes licensure requirements for certified midwives and certified professional midwives. Establishes continuing education requirements. Grants global signature authority to midwives. Grants prescriptive authority to licensed midwives practicing as certified midwives and amends the list of approved legend drugs that may be administered by midwives. Establishes peer review and data submission requirements. Affirms that the practice of midwifery does not include Native Hawaiian traditional and customary practices. Clarifies exemptions from licensure and grounds for refusal to grant, renew, reinstate, or restore licenses or for revocation, suspension, denial, or condition of a license. Clarifies medical record availability and retention requirements for the purposes of medical torts. (SD3)
MidwivesPractice of MidwiferyScope of PracticeNative Hawaiian and Customary PracticesCertified MidwivesCertified Professional MidwivesLicensureRequirementsLicense RenewalPrescriptive AuthorityPeer ReviewData SubmissionMedical RecordsHHS, CPN/JDC
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 0 benefits, 2 costs, 4 mixed.
Uninsured midwives must report settlements
A midwife without professional liability insurance must report certain signed settlements or served arbitration awards to the director within 30 days. The claim must involve a death or personal injury allegedly caused by professional conduct. A first failure to report brings a fine of at least $100; later fines range from $250 to $500 for a second offense and $500 to $1,000 for later offenses.
New training rules for midwife licenses
Applicants for certified midwife licenses need current certification, an approved graduate degree, and 30 hours of advanced pharmacology training. Certified professional midwife applicants need current certification and approved education or a qualifying bridge certificate. All applicants need current hands-on adult and pediatric CPR and neonatal resuscitation certifications. The director can take licensing action for specified failures, including missing certifications or aiding unlicensed practice; delegating administrative and technical tasks alone does not count as aiding unlicensed practice.
Midwives can provide broader care
The law defines midwifery care to include pregnancy, birth, postpartum care, healthy newborn care, and reproductive services. Midwives must refer or transfer clients whose needs exceed their scope, and call 911 when they find an immediate risk of serious harm at a birth site without a physician or operating room. Patients can invite someone to attend a birth outside a birth facility, and midwives can sign certain health forms. The law defines postpartum as ending six weeks after birth, down from up to eight weeks.
More medicine access through midwives
Licensed certified midwives can prescribe approved medicines and provide or order suitable devices. They need state registration to prescribe or give controlled substances, and they cannot use approved drugs to start or strengthen labor. Certified professional midwives cannot prescribe, but they can carry out certain orders from listed licensed clinicians. Pharmacists who follow the law are not liable for covered adverse reactions caused by a midwife’s use of those drugs or devices.
Hawaii keeps midwife licensing rules
Hawaii’s midwife licensing rules stay in force; the law removes the scheduled June 30, 2025 repeal. Some professionals, supervised students, Native Hawaiian traditional practitioners, emergency helpers, and family caregivers remain exempt from the chapter. The law removes the former exemption for birth attendants who began practice on or before July 1, 2023, and states that the chapter creates no criminal penalty. Licensed midwives and their employees also count as health care providers for a state statutory definition.
Midwives face new renewal duties
Midwives renew licenses every three years by June 30, pay fees, keep required certifications current, and complete continuing education. Starting July 1, 2026, they need 30 education hours from the prior three years, with added subject requirements for each license type. Starting June 30, 2029, renewal also requires peer review, generally covering five cases; some serious cases must be reviewed within 90 days. The department can require data about births planned outside birth facilities, and these reviews and reports add oversight as well as work for licensees.
Sponsors & Cosponsors
Sponsor
Linda Ichiyama
Democratic • House
Cosponsors
Lisa Marten
Democratic • House
Scot Z. Matayoshi
Democratic • House
Gregg Takayama
Democratic • House
Roll Call Votes
House vote • 4/14/2025
House Floor Vote
Yes: 35 • No: 16
Senate vote • 4/10/2025
Senate Floor Vote
Yes: 20 • No: 4
Senate vote • 4/1/2025
The committee(s) on CPN recommend(s) that the measure be PASSED, WITH AMENDMENT...
Yes: 4 • No: 1
Senate vote • 4/1/2025
The committee(s) on JDC recommend(s) that the measure be PASSED, WITH AMENDMENT...
Yes: 3 • No: 2
Senate vote • 3/17/2025
The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENT...
Yes: 5 • No: 0
House vote • 3/4/2025
House Floor Vote
Yes: 34 • No: 15
House vote • 2/26/2025
The committee on FIN recommend that the measure be PASSED, WITH AMENDMENTS. The ...
Yes: 12 • No: 3
House vote • 2/14/2025
Passed Second Reading as amended in HD 1 and referred to the committee(s) on FIN...
Yes: 42 • No: 5
House vote • 2/10/2025
The committee on CPC recommend that the measure be PASSED, WITH AMENDMENTS. The ...
Yes: 8 • No: 1
House vote • 2/10/2025
The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS. The ...
Yes: 7 • No: 2
Actions Timeline
Became law without the Governor's signature, Act 028, 05/05/2025, (Gov. Msg. No. 1128).
5/5/2025SenateBecame law without the Governor's signature, Act 028, 05/02/2025, (Gov. Msg. No. 1128).
5/2/2025HouseReceived notice of House agreement and passage on Final Reading (Hse. Com. No. 730).
4/15/2025SenateReceived notice of House reconsideration of action in disagreeing to the amendments proposed by the Senate (Hse. Com. No. 714).
4/14/2025SenateHouse agrees to Senate amendment(s).
4/14/2025HousePassed Final Reading as amended in SD 3 with none voting aye with reservations; Representative(s) Alcos, Amato, Belatti, Cochran, Garcia, Grandinetti, Hussey, Iwamoto, Matsumoto, Muraoka, Perruso, Pierick, Poepoe, Reyes Oda, Shimizu, Souza voting no (16) and none excused (0).
4/14/2025HouseTransmitted to Governor.
4/14/2025HouseReceived notice of disagreement (Hse. Com. No. 705).
4/11/2025SenateReconsideration of action taken on 04-10-25.
4/11/2025HousePassed Third Reading, as amended (SD 3). Ayes, 20; Aye(s) with reservations: Senator(s) Ihara, Richards. Noes, 4 (Senator(s) Awa, DeCorte, Gabbard, McKelvey). Excused, 1 (Senator(s) Fevella). Transmitted to House.
4/10/2025SenateReturned from Senate (Sen. Com. No. 777) in amended form (SD 3).
4/10/2025HouseHouse disagrees with Senate amendment (s).
4/10/2025HouseFloor Amendment No. 8 offered.
4/8/2025SenateFloor amendment adopted as amended (SD 3). Ayes, 23. Noes, 2 (Senator(s) Awa, DeCorte). Excused, 0 (none).
4/8/2025SenateSeparated Committee Report.
4/8/2025SenateReport filed.
4/8/2025Senate48 Hrs. Notice 04-10-25
4/8/2025SenateReported from CPN/JDC (Stand. Com. Rep. No. 1738) with recommendation of passage on Third Reading, as amended (SD 2).
4/4/2025Senate48 Hrs. Notice 04-08-25.
4/4/2025SenateThe committee(s) on CPN recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in CPN were as follows: 4 Aye(s): Senator(s) Keohokalole, Fukunaga, Richards; Aye(s) with reservations: Senator(s) McKelvey ; 1 No(es): Senator(s) Awa; and 0 Excused: none.
4/1/2025SenateThe committee(s) on JDC recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in JDC were as follows: 3 Aye(s): Senator(s) Rhoads, Chang, San Buenaventura; Aye(s) with reservations: none ; 2 No(es): Senator(s) Gabbard, Awa; and 0 Excused: none.
4/1/2025SenateThe committee(s) on CPN/JDC will hold a public decision making on 04-01-25 9:30AM; Conference Room 016 & Videoconference.
3/24/2025SenateReported from HHS (Stand. Com. Rep. No. 1286) with recommendation of passage on Second Reading, as amended (SD 1) and referral to CPN/JDC.
3/21/2025SenateReport adopted; Passed Second Reading, as amended (SD 1) and referred to CPN/JDC.
3/21/2025SenateThe committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in HHS were as follows: 5 Aye(s): Senator(s) San Buenaventura, Aquino, Hashimoto, Keohokalole, Fevella; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none.
3/17/2025Senate
Bill Text
Bill Text
HB1194_HD1
HB1194_HD2
HB1194_HD2_HFA2
HB1194_HD2_HFA3
HB1194_SD1
HB1194_SD2
HB1194_SD2_SFA8
HB1194_SD3
Original
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