HB1328 would replace the current sunset of Hawaii’s non-nurse midwife licensing program with a new, continuing regulatory framework for certified midwives and certified professional midwives under the Department of Commerce and Consumer Affairs. It repeals the existing Part I of chapter 457J and replaces it with a new part that defines the two licensed categories, sets education, certification, age, and application requirements, and creates an advisory committee to help implement the program. The bill also specifies renewal, discipline, fee, reporting, and enforcement provisions, and it makes clear that only properly licensed persons may use the titles “licensed midwife,” “certified midwife,” or “certified professional midwife.”
The bill substantially expands and clarifies scope of practice. Licensed midwives would be authorized to provide independent care in hospitals, clinics, birthing centers, homes, and other community settings, including ordering tests, performing ultrasounds, conducting exams, and collaborating across care settings. Certified midwives could receive prescriptive authority, including for controlled substances and expedited partner therapy, while certified professional midwives could receive more limited prescriptive authority for legend drugs and devices, subject to additional training and department rules. The bill also states that licensed midwife services are eligible for insurance reimbursement, including Medicaid, when within scope, regardless of where services are provided.
HB1328 also creates a temporary home birth task force within the Department of Health to study home birth practices and recommend changes. The task force would include state officials, medical and midwifery representatives, Native Hawaiian customary practitioners, emergency services, hospital representatives, and members of the public with home birth experience. It would examine training, public education, data collection, transport issues, and public health and safety, then report to the Legislature before the 2026 session and dissolve on June 30, 2026.
The overall sentiment reflected in the bill text is supportive of expanding legal access to midwifery and home birth options, with a strong emphasis on cultural practices, maternal health access, and local pathways into licensure. The findings argue that the existing system has not fully achieved its original goal of including all birth practitioners and that continued regulation should be paired with broader legal recognition of traditional and community-based birth attendants. No committee transcripts or recorded votes were provided, so there is no additional evidence of support or opposition from hearings or floor action.
Potential points of contention include the bill’s treatment of traditional birth attendants and unlicensed practitioners, the extent of prescriptive authority and scope of practice for midwives, and whether the state should continue regulating these professions at all versus exempting more community-based birth support. The bill attempts to address those concerns by preserving exemptions for doulas, family care, Native Hawaiian customary practices, religious practices, and traditional birth attendants who do not use drugs or represent themselves as licensed midwives, while still imposing disclosure requirements and penalties for unauthorized title use.
The bill would repeal the current sunset date for chapter 457J and replace the existing midwife licensing provisions with a new statutory structure governing licensed certified midwives and licensed certified professional midwives. It would shift administration to the Department of Commerce and Consumer Affairs, establish licensing and disciplinary authority, require annual reporting to the Legislature, and create a temporary home birth task force under the Department of Health. It would also affect insurance coverage rules by requiring health plans and Medicaid to cover covered midwifery services within scope, and it would clarify when midwives may prescribe drugs, order tests, and practice in various birth settings.
The bill’s stated purpose and findings reflect a generally favorable view of midwifery licensure, home birth access, and culturally responsive maternal care. The measure frames the current law as incomplete and argues for broader legal recognition of community and traditional birth practices, especially in light of access shortages and cultural concerns. Because no committee discussion transcripts or votes were provided, there is no direct record of legislative debate or formal opposition in the supplied materials.
The main areas of likely contention are the scope of state regulation, the balance between licensure and exemptions, and the breadth of practice authority granted to licensed midwives. Supporters appear to favor expanded access, local licensure pathways, and protection for Native Hawaiian and traditional practices, while potential critics may question whether prescriptive authority, independent practice, and insurance mandates go too far or whether the bill sufficiently protects patient safety. The bill tries to split the difference by preserving exemptions for doulas, family care, religious and cultural practices, and traditional birth attendants who do not use restricted drugs or claim licensure.