Cal. Health and Safety Code - HSC § 128295. Section 128295.
This article shall be known, and may be cited, as the Midwifery Workforce Training Act.
ARTICLE 4. Midwifery Workforce Training Act [128295. - 128300.]
Cal. Health and Safety Code - HSC 4.
in effectCal. Health and Safety Code - HSC § 128296. Section 128296.
The Legislature finds and declares that maternity care providers are in short supply and maldistributed around the state, resulting in what the March of Dimes defines as “maternity care deserts” and “limited-access maternity care areas.” Many major counties are on track to have a critical shortage of maternity care providers by 2025. Maternity care is often the very first primary health care interaction, and the most common primary care interaction over the life of a woman and birthing person’s reproductive lifespan. Black and Native American individuals and other people of color in particular have significant difficulty in accessing maternity care and family planning services. Black women die from pregnancy-related causes at a rate of three to
four
times that of White women. Black infants are more than twice as likely to die in their first year as White infants. Access to quality care and resultant outcomes are intricately linked. Racial disparities in outcomes, especially, are connected in part to quality of and ability to access maternity care, especially by care providers whose care models elevate patient-centered, holistic, and culturally sensitive care. This kind of care is the hallmark of the midwifery model.
Cal. Health and Safety Code - HSC § 128297. Section 128297.
For purposes of this article, the following definitions apply:
(a)
“Certified nurse-midwife” means an advanced practice nurse with training in midwifery, as specified in, and a certificate issued pursuant to, Article 2.5 (commencing with Section 2746) of Chapter 6 of Division 2 of the Business and Professions Code.
(b)
“Licensed midwife” means an individual who has been issued a license to practice midwifery pursuant to Article 24 (commencing with Section 2505) of Chapter 5 of Division 2 of the Business and Professions Code.
(c)
“Office” means the Office of
Statewide Health Planning and Development (OSHPD).
(d)
“Programs that train certified nurse-midwives” means a nurse-midwifery education program that is operated by a California school of nursing and approved by the Accreditation Commission for Midwifery Education, or that is authorized by the Regents of the University of California or by the Trustees of the California State University, or that is approved by the Board of Registered Nursing.
(e)
“Programs that train licensed midwives” means a midwifery education program operated by a California school of midwifery, and accredited by the Midwifery Education Accreditation Council (MEAC), or approved by the Bureau for Private and Postsecondary Education, or approved by the state licensing and regulatory board for licensed
midwives.
Cal. Health and Safety Code - HSC § 128298. Section 128298.
(a)
It is the intent of the Legislature to provide for a program designed primarily to increase the number of students receiving quality education and training as a certified nurse-midwife or a licensed midwife in accordance with the global standards for midwifery education and the international definition of “midwife” as established by the International Confederation of Midwives, in order to maximize the delivery of reproductive services to specific areas of California where there is a recognized unmet priority need.
(b)
(1)
The office shall establish a program to contract with programs that train certified nurse-midwives and programs that
train licensed midwives in accordance with the global standards for midwifery education and the international definition of “midwife” as established by the International Confederation of Midwives in order to increase the number of students receiving quality education and training as a certified nurse-midwife or as a licensed midwife.
(2)
The office shall only contract with programs that train certified nurse-midwives and programs that train licensed midwives that, at minimum, include, or that intend to create, a component of training designed for medically underserved multicultural communities, lower socioeconomic neighborhoods, or rural communities, and that are organized to prepare program graduates for service in those neighborhoods and communities, or that seek to recruit and retain racially and ethnically
diverse students, underrepresented groups, or people from underserved or historically marginalized communities.
(3)
The office may adopt standards and regulations necessary to carry out this article. In adopting eligibility standards for programs that train certified nurse-midwives and that train licensed midwives in accordance with the standards set forth in subdivisions (a) and (b), the office may accept those educational standards and competencies established by the respective state licensing and regulatory bodies for certified nurse-midwives and for licensed midwives. The office shall take care not to implement education or competency standards beyond what is
required for the training programs by their respective state licensing and regulatory bodies that could inadvertently create an unnecessary barrier for training programs to obtain funding for the training of midwives in California.
(4)
The office shall develop alternative strategies to provide long-term stability for, or expansion of, this act, such as through funding provided by private foundations and administered by the office for the purposes of carrying out this article.
(5)
Nothing in this article prevents the office from developing a protocol to contract with potential programs that train nurse-midwives or that train licensed midwives, in order to support the initial startup of new training programs, as long as the eligibility requirements of this article are met or can
be met through the award of funds.
(6)
The office may pay contracted programs that train certified nurse-midwives and programs that train licensed midwives in an amount calculated based on a single per-student capitation formula, or through another method, in order to cover the costs of innovative special projects or programs.
(7)
Funds appropriated to the office for purposes of this article
and awarded by the office to eligible programs that train certified nurse-midwives or programs that train licensed midwives may be used by the training program to develop new initiatives, projects, or curriculum, or to expand existing initiatives, projects, or curriculum. Awarded funds may also be used for general support and sustainability of the overall training program, or to sustain specific components of the training program, including, but not limited to, tuition assistance for students, or support for preceptor recruitment, or to sustain preceptor training sites for students.
(c)
This section shall be implemented only upon an appropriation by the Legislature for these purposes in the annual Budget Act or another act.
Cal. Health and Safety Code - HSC § 128299. Section 128299.
This article shall become operative on January 1, 2022.
Cal. Health and Safety Code - HSC § 128300. Section 128300.
(a)
Upon appropriation from the Legislature, the Department of Health Care Access and Information shall administer funding for a statewide study on midwifery education. The study shall be conducted by an outside consultant familiar with the health care and midwifery landscapes and workforce in California.
(b)
This study shall include, but is not limited to, all of the following:
(1)
An evaluation of status and trends in midwifery education in California and the United States.
(2)
Financial sustainability plan, including long-term education program financing, cost of educating midwives in California, and the options
for financial stability of midwifery education.
(3)
Assess available state and federal funding resources to cover student tuition and fees, and report on average student debt per program upon program completion.
(4)
Identify and propose pathways to diversify the midwifery student pipeline.
(5)
Assess the opportunities, challenges, and support needs of prospective students, current students, and preceptors.
(6)
Identify institutions and programs of study that are equipped to house midwifery education programs, including those outside of schools of nursing.
(7)
Identify viable education programs that can serve both rural and urban geographic areas.
(8)
Consider education consortium models that pool resources to support student didactic education and allow them to stay in their communities while completing their education.
(9)
Identify and propose solutions to address the shortage of clinical preceptors and precepting sites.
(10)
Identify sites for interprofessional education between resident obstetricians and midwives.
(11)
Consider innovations in education and training that allow nurse-midwives and licensed midwives to train together, with separate exit requirements specific to their path.
(12)
Ensure that proposed solutions for midwifery education meet the needs of California birthing families and future midwives.
(13)
Current and projected needs for midwifery and reproductive health care professionals.
(14)
Assessment of jobs available for new graduates and projected growth.
(c)
(1)
The department shall submit a report from the study’s findings to the Legislature.
(2)
The report shall be submitted in compliance with Section 9795 of the Government Code.
(d)
The department shall post the report on the department’s internet website, and shall notify all persons in the department’s reproductive health and maternity care electronic mailing list no later than 36 months after the actual appropriation of funds to the department.
(e)
For purposes of this section, “reproductive health care professionals” means medical doctors, licensed midwives, certified nurse-midwives, nurse practitioners, registered nurses, physician’s assistants, doulas, licensed vocational nurses, and perinatal community health workers.
Source: CA Legislative Counsel Bulk DataURL: https://downloads.leginfo.legislature.ca.gov/pubinfo_2025.zipFetched: 6/27/2026