Washington State
Chapter 18.50 RCW MIDWIFERY |
| 18.50.003 | Regulation of health care professions -- Criteria. |
| 18.50.005 | Definitions. |
| 18.50.010 | Practicing midwifery defined -- Gratuitous services -- Duty to consult with physician. |
| 18.50.020 | License required. |
| 18.50.030 | Exemptions -- Practice of religion -- Treatment by prayer. |
| 18.50.032 | Exemptions -- Registered nurses and nurse midwives. |
| 18.50.034 | Exemptions -- Persons enrolled in midwifery programs. |
| 18.50.040 | Candidates for examination -- Application -- Eligibility -- Student midwife permits. |
| 18.50.045 | Midwifery education programs -- Accreditation. |
| 18.50.050 | Compliance with secretary's determination. |
| 18.50.060 | Examinations -- Times and places -- Subjects -- Issuance of license. |
| 18.50.065 | Credentialing by endorsement. |
| 18.50.102 | Registration -- Renewal fee. |
| 18.50.105 | Inform patient of qualifications of midwife -- Form. |
| 18.50.108 | Written plan for consultation, emergency transfer, and transport. |
| 18.50.115 | Administration of drugs and medications -- Rules. |
| 18.50.126 | Application of uniform disciplinary act. |
| 18.50.130 | "Certificate" and "license" synonymous. |
| 18.50.135 | Rules. |
| 18.50.140 | Midwifery advisory committee -- Generally. |
| 18.50.150 | Midwifery advisory committee -- Advice and recommendations. |
| 18.50.900 | Repeal and saving. |
NOTES:
Abortion: Chapter 9.02 RCW.
Actions for injuries resulting from health care: Chapter 7.70 RCW.
Crimes relating to pregnancy and childbirth: RCW 9A.32.060.
Filing certificate of birth: RCW 70.58.080.
Health professions account -- Fees credited -- Requirements for biennial budget request: RCW 43.70.320.
Record as to patients or inmates for purposes of vital statistics: RCW 70.58.270.
Secretary of health or designee ex officio member of health professional licensure and disciplinary boards: RCW 43.70.300.
RCW 18.50.003
Regulation of health care professions -- Criteria.
See chapter 18.120 RCW.
RCW 18.50.005
Definitions.
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter:
(1) "Department" means the department of health.
(2) "Secretary" means the secretary of health.
(3) "Midwife" means a midwife licensed under this chapter.
(4) "Physician" means a physician licensed under chapter 18.57 or 18.71 RCW.
[1991 c 3 ｧ 102; 1987 c 467 ｧ 1; 1981 c 53 ｧ 2.]
NOTES:
Effective date -- 1981 c 53: "Sections 1, 2, 5, 6, 8, 9, 10, 11, and 13 through 17 of this act shall take effect January 15, 1982." [1981 c 53 ｧ 19.]
RCW 18.50.010
Practicing midwifery defined -- Gratuitous services -- Duty to consult with physician.
Any person shall be regarded as practicing midwifery within the meaning of this chapter who shall render medical aid for a fee or compensation to a woman during prenatal, intrapartum, and postpartum stages or who shall advertise as a midwife by signs, printed cards, or otherwise. Nothing shall be construed in this chapter to prohibit gratuitous services. It shall be the duty of a midwife to consult with a physician whenever there are significant deviations from normal in either the mother or the infant.
[1991 c 3 ｧ 103; 1987 c 467 ｧ 2; 1981 c 53 ｧ 5; 1917 c 160 ｧ 8; RRS ｧ 10181. Formerly RCW 18.50.010, 18.50.030, part, and 18.50.090.]
NOTES:
Effective date -- 1981 c 53: See note following RCW 18.50.005.
RCW 18.50.020
License required.
Any person who shall practice midwifery in this state after July 1, 1917, shall first obtain from the secretary a license so to do, and the said secretary is authorized to grant such license after examination of the applicant as hereinafter provided.
[1991 c 3 ｧ 104; 1917 c 160 ｧ 1; RRS ｧ 10174.]
RCW 18.50.030
Exemptions -- Practice of religion -- Treatment by prayer.
This chapter shall not be construed to interfere in any way with the practice of religion, nor be held to apply to or regulate any kind of treatment by prayer.
[1917 c 160 ｧ 12; RRS ｧ 10185. FORMER PART OF SECTION: 1917 c 160 ｧ 8, part; RRS ｧ 10181, part, now codified in RCW 18.50.010.]
NOTES:
Gratuitous services exempted: RCW 18.50.010.
RCW 18.50.032
Exemptions -- Registered nurses and nurse midwives.
Registered nurses and nurse midwives certified by the nursing care quality assurance commission under chapter 18.79 RCW shall be exempt from the requirements and provisions of this chapter.
[1994 sp.s. c 9 ｧ 704; 1981 c 53 ｧ 10.]
NOTES:
Severability -- Headings and captions not law -- Effective date -- 1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Effective date -- 1981 c 53: See note following RCW 18.50.005.
RCW 18.50.034
Exemptions -- Persons enrolled in midwifery programs.
Nothing in this chapter shall be construed to apply to or interfere in any way with the practice of midwifery by a person who is enrolled in a program of midwifery approved and accredited by the secretary: PROVIDED, That the performance of such services is only pursuant to a regular course of instruction or assignment from the student's instructor, and that such services are performed only under the supervision and control of a person licensed in the state of Washington to perform services encompassed under this chapter.
[1991 c 3 ｧ 105; 1981 c 53 ｧ 11.]
NOTES:
Effective date -- 1981 c 53: See note following RCW 18.50.005.
RCW 18.50.040
Candidates for examination -- Application -- Eligibility -- Student midwife permits.
(1) Any person seeking to be examined shall present to the secretary, at least forty-five days before the commencement of the examination, a written application on a form or forms provided by the secretary setting forth under affidavit such information as the secretary may require and proof the candidate has received a high school degree or its equivalent; that the candidate is twenty-one years of age or older; that the candidate has received a certificate or diploma from a midwifery program accredited by the secretary and licensed under chapter 28C.10 RCW, when applicable, or a certificate or diploma in a foreign institution on midwifery of equal requirements conferring the full right to practice midwifery in the country in which it was issued. The diploma must bear the seal of the institution from which the applicant was graduated. Foreign candidates must present with the application a translation of the foreign certificate or diploma made by and under the seal of the consulate of the country in which the certificate or diploma was issued.
(2) The candidate shall meet the following conditions:
(a) Obtaining a minimum period of midwifery training for at least three years including the study of the basic nursing skills that the department shall prescribe by rule. However, if the applicant is a registered nurse or licensed practical nurse under chapter 18.79 RCW, or has had previous nursing education or practical midwifery experience, the required period of training may be reduced depending upon the extent of the candidate's qualifications as determined under rules adopted by the department. In no case shall the training be reduced to a period of less than two years.
(b) Meeting minimum educational requirements which shall include studying obstetrics; neonatal pediatrics; basic sciences; female reproductive anatomy and physiology; behavioral sciences; childbirth education; community care; obstetrical pharmacology; epidemiology; gynecology; family planning; genetics; embryology; neonatology; the medical and legal aspects of midwifery; nutrition during pregnancy and lactation; breast feeding; nursing skills, including but not limited to injections, administering intravenous fluids, catheterization, and aseptic technique; and such other requirements prescribed by rule.
(c) For a student midwife during training, undertaking the care of not less than fifty women in each of the prenatal, intrapartum, and early postpartum periods, but the same women need not be seen through all three periods. A student midwife may be issued a permit upon the satisfactory completion of the requirements in (a), (b), and (c) of this subsection and the satisfactory completion of the licensure examination required by RCW 18.50.060. The permit permits the student midwife to practice under the supervision of a midwife licensed under this chapter, a physician or a certified nurse-midwife licensed under the authority of chapter 18.79 RCW. The permit shall expire within one year of issuance and may be extended as provided by rule.
(d) Observing an additional fifty women in the intrapartum period before the candidate qualifies for a license.
(3) Notwithstanding subsections (1) and (2) of this section, the department shall adopt rules to provide credit toward the educational requirements for licensure before July 1, 1988, of nonlicensed midwives, including rules to provide:
(a) Credit toward licensure for documented deliveries;
(b) The substitution of relevant experience for classroom time; and
(c) That experienced lay midwives may sit for the licensing examination without completing the required course work.
The training required under this section shall include training in either hospitals or alternative birth settings or both with particular emphasis on learning the ability to differentiate between low-risk and high-risk pregnancies.
[1994 sp.s. c 9 ｧ 705; 1991 c 3 ｧ 106; 1987 c 467 ｧ 3; 1986 c 299 ｧ 24; 1981 c 53 ｧ 6; 1917 c 160 ｧ 2; RRS ｧ 10175.]
NOTES:
Severability -- Headings and captions not law -- Effective date -- 1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Severability -- Effective date -- 1986 c 299: See RCW 28C.10.900 and 28C.10.902.
Effective date -- 1981 c 53: See note following RCW 18.50.005.
RCW 18.50.045
Midwifery education programs -- Accreditation.
The secretary shall promulgate standards by rule under chapter 34.05 RCW for accrediting midwifery educational programs. The standards shall cover the provision of adequate clinical and didactic instruction in all subjects and noncurriculum matters under this section including, but not limited to, staffing and teacher qualifications. In developing the standards, the secretary shall be advised by and receive the recommendations of the midwifery advisory committee.
[1991 c 3 ｧ 107; 1981 c 53 ｧ 7.]
RCW 18.50.050
Compliance with secretary's determination.
Applicants shall comply with administrative procedures, administrative requirements, and fees determined by the secretary as provided by RCW 43.70.250 and 43.70.280.
[1996 c 191 ｧ 24; 1991 c 3 ｧ 108; 1985 c 7 ｧ 48; 1975 1st ex.s. c 30 ｧ 51; 1917 c 160 ｧ 3; RRS ｧ 10176.]
NOTES:
Limitation on increases in midwifery fees: RCW 43.24.086.
RCW 18.50.060
Examinations -- Times and places -- Subjects -- Issuance of license.
(1) The secretary is hereby authorized and empowered to execute the provisions of this chapter and shall offer examinations in midwifery at least twice a year at such times and places as the secretary may select. The examinations shall be written and shall be in the English language.
(2) The secretary, with the assistance of the midwifery advisory committee, shall develop or approve a licensure examination in the subjects that the secretary determines are within the scope of and commensurate with the work performed by a licensed midwife. The examination shall be sufficient to test the scientific and practical fitness of candidates to practice midwifery. All application papers shall be deposited with the secretary and there retained for at least one year, when they may be destroyed.
(3) If the examination is satisfactorily completed, the secretary shall issue to such candidate a license entitling the candidate to practice midwifery in the state of Washington.
[1991 c 3 ｧ 109; 1987 c 467 ｧ 4; 1981 c 53 ｧ 8; 1979 c 158 ｧ 43; 1917 c 160 ｧ 4; RRS ｧ 10177.]
NOTES:
Effective date -- 1981 c 53: See note following RCW 18.50.005.
RCW 18.50.065
Credentialing by endorsement.
An applicant holding a credential in another state may be credentialed to practice in this state without examination if the secretary determines that the other state's credentialing standards are substantially equivalent to the standards in this state.
[1991 c 332 ｧ 32.]
NOTES:
Application to scope of practice -- Captions not law -- 1991 c 332: See notes following RCW 18.130.010.
RCW 18.50.102
Registration -- Renewal fee.
Every person licensed to practice midwifery shall register with the secretary and pay a renewal fee determined by the secretary as provided in RCW 43.70.250 and 43.70.280.
[1996 c 191 ｧ 25; 1991 c 3 ｧ 110; 1985 c 7 ｧ 49; 1981 c 53 ｧ 13.]
NOTES:
Effective date -- 1981 c 53: See note following RCW 18.50.005.
Limitation on increases in midwifery fees: RCW 43.24.086.
RCW 18.50.105
Inform patient of qualifications of midwife -- Form.
The secretary, with the advice of the midwifery advisory committee, shall develop a form to be used by a midwife to inform the patient of the qualifications of a licensed midwife.
[1991 c 3 ｧ 111; 1981 c 53 ｧ 12.]
RCW 18.50.108
Written plan for consultation, emergency transfer, and transport.
Every licensed midwife shall develop a written plan for consultation with other health care providers, emergency transfer, transport of an infant to a newborn nursery or neonatal intensive care nursery, and transport of a woman to an appropriate obstetrical department or patient care area. The written plan shall be submitted annually together with the license renewal fee to the department.
[1981 c 53 ｧ 14.]
NOTES:
Effective date -- 1981 c 53: See note following RCW 18.50.005.
RCW 18.50.115
Administration of drugs and medications -- Rules.
A midwife licensed under this chapter may obtain and administer prophylactic ophthalmic medication, postpartum oxytocic, vitamin K, Rho immune globulin (human), and local anesthetic and may administer such other drugs or medications as prescribed by a physician. A pharmacist who dispenses such drugs to a licensed midwife shall not be liable for any adverse reactions caused by any method of use by the midwife.
The secretary, after consultation with representatives of the midwife advisory committee, the board of pharmacy, and the medical quality assurance commission, may adopt rules that authorize licensed midwives to purchase and use legend drugs and devices in addition to the drugs authorized in this chapter.
[1994 sp.s. c 9 ｧ 707; 1991 c 3 ｧ 112; 1987 c 467 ｧ 6.]
NOTES:
Severability -- Headings and captions not law -- Effective date -- 1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
RCW 18.50.126
Application of uniform disciplinary act.
The uniform disciplinary act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses, and the discipline of licensees under this chapter.
[1987 c 150 ｧ 31; 1986 c 259 ｧ 75.]
NOTES:
Severability -- 1987 c 150: See RCW 18.122.901.
Severability -- 1986 c 259: See note following RCW 18.130.010.
RCW 18.50.130
"Certificate" and "license" synonymous.
The words "certificate" and "license" shall be known as interchangeable terms in this chapter.
[1917 c 160 ｧ 11; RRS ｧ 10184.]
RCW 18.50.135
Rules.
The secretary shall promulgate rules under chapter 34.05 RCW as are necessary to carry out the purposes of this chapter.
[1991 c 3 ｧ 113; 1981 c 53 ｧ 15.]
NOTES:
Effective date -- 1981 c 53: See note following RCW 18.50.005.
RCW 18.50.140
Midwifery advisory committee -- Generally.
The midwifery advisory committee is created.
The committee shall be composed of one physician who is a practicing obstetrician; one practicing physician; one certified nurse midwife licensed under chapter 18.79 RCW; three midwives licensed under this chapter; and one public member, who shall have no financial interest in the rendering of health services. The committee may seek other consultants as appropriate, including persons trained in childbirth education and perinatology or neonatology.
The members are appointed by the secretary and serve at the pleasure of the secretary but may not serve more than five years consecutively. The terms of office shall be staggered. Members of the committee shall be reimbursed for travel expenses as provided in RCW 43.03.050 and 43.03.060.
[1994 sp.s. c 9 ｧ 706; 1991 c 3 ｧ 114; 1987 c 467 ｧ 5; 1981 c 53 ｧ 3.]
NOTES:
Severability -- Headings and captions not law -- Effective date -- 1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
RCW 18.50.150
Midwifery advisory committee -- Advice and recommendations.
The midwifery advisory committee shall advise and make recommendations to the secretary on issues including, but not limited to, continuing education, mandatory reexamination, and peer review.
[1998 c 245 ｧ 6; 1991 c 3 ｧ 115; 1981 c 53 ｧ 4.]
RCW 18.50.900
Repeal and saving.
All acts or parts of acts inconsistent with the provisions of this chapter may be and the same are hereby repealed: PROVIDED, This chapter shall not repeal the provisions of the vital statistics laws of the state, but shall be deemed as additional and cumulative provisions.
[1917 c 160 ｧ 10.]
~~~~~~~~~~~~~~~~~~~~~~~
Washington Regulations
Last Update: 11/21/01
WAC SECTIONS
| 246-834-010 | Definitions. |
| 246-834-050 | Examination requirements for licensure as a midwife. |
| 246-834-060 | Application requirements for licensure as a midwife. |
| 246-834-065 | Application for examination -- Out-of-state education. |
| 246-834-070 | Release of examination results. |
| 246-834-080 | Failures. |
| 246-834-090 | Purpose of accreditation of midwifery educational programs. |
| 246-834-100 | Philosophy, purpose and objectives of an accredited midwifery educational program. |
| 246-834-110 | Advisory body. |
| 246-834-120 | Learning sites. |
| 246-834-130 | Staffing and teacher qualifications. |
| 246-834-140 | Curriculum. |
| 246-834-150 | Students. |
| 246-834-160 | Student midwife permit. |
| 246-834-170 | Reports to the department of health by accredited midwifery educational programs. |
| 246-834-180 | Application for accreditation. |
| 246-834-190 | School survey visits. |
| 246-834-200 | Appeal of department of health decisions. |
| 246-834-210 | Closure of an accredited school of midwifery. |
| 246-834-220 | Credit toward educational requirements for licensure. |
| 246-834-230 | Preceptor for midwife-in-training program. |
| 246-834-240 | Trainee permit for midwife-in-training program. |
| 246-834-250 | Legend drugs and devices. |
| 246-834-260 | General provisions. |
| 246-834-270 | Mandatory reporting. |
| 246-834-280 | Health care institutions. |
| 246-834-290 | Midwifery associations or societies. |
| 246-834-310 | Health care service contractors and disability insurance carriers. |
| 246-834-320 | Professional liability carriers. |
| 246-834-330 | Courts. |
| 246-834-340 | State and federal agencies. |
| 246-834-400 | Expired license. |
| 246-834-990 | Midwifery fees and renewal cycle. |
| 246-834-350 | Cooperation with investigation. [Statutory Authority: RCW 18.50.135, 18.50.045, 18.130.050 and 18.130.070. 92-02-018 (Order 224), ｧ 246-834-350, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-350, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), ｧ 308-115-350, filed 6/30/89.] Repealed by 97-20-101, filed 9/29/97, effective 10/30/97. Statutory Authority: RCW 43.70.040. |
| 246-834-500 | AIDS prevention and information education requirements. [Statutory Authority: RCW 18.50.135, 18.50.045 and 70.24.270. 92-02-018 (Order 224), ｧ 246-834-500, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-500, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 70.24.270. 88-22-077 (Order PM 786), ｧ 308-115-500, filed 11/2/88.] Repealed by 98-05-060, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.280. |
WAC 246-834-010 Definitions. (1) Academic director as used in these rules means the individual who is responsible for planning, organizing and implementing all aspects of the curriculum of a midwifery education program.
(2) Health care provider as used in RCW 18.50.108 means any licensed physician who is engaged in active clinical obstetrical practice.
(3) Nursing education as used in these rules means completion of courses for credit in a school that is approved to train persons for licensure as registered nurses or licensed practical nurses, or courses in other formal training programs which include instruction in basic nursing skills.
(4) Practical midwifery experience as used in these rules means performance in midwifery functions, prior to obtaining a license, that is verified by affidavit, testimony or other sworn written documentation that verifies that the experience and its documentation is equivalent to that required of regularly enrolled midwifery students.
(5) Preceptor. A preceptor is a licensed or legally practicing obstetric practitioner who assumes responsibility for supervising the practical (clinical obstetric) experience of a student midwife. The preceptor shall be physically present whenever the student is managing a birth, and shall evaluate in writing the student's overall performance.
(6) Supervision means the observation and evaluation of a student midwife's practical performance. A supervisor need not be physically present in nonbirth situations. However, when a student midwife undertakes managing a birth, the supervisor must be physically present.
(7) Survey visit is an information gathering and observational visit intended to provide the basis for the director's assessment of a school's compliance with all aspects of chapter 18.50 RCW.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-010, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-010, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 85-23-044 (Order PL 566), ｧ 308-115-050, filed 11/18/85; 82-19-079 (Order PL 406), ｧ 308-115-050, filed 9/21/82.]
WAC 246-834-050 Examination requirements for licensure as a midwife. This rule provides the minimum examination requirements for licensure as a midwife.(1) The midwifery examination offered by the North American Registry of Midwives (NARM) is the official examination for midwifery licensure. All applicants must complete this examination with a passing score. This examination shall be offered by the department of health midwifery program twice a year. If the applicant passes the examination within two years prior to applying for a Washington license, the department will accept the results.
(2) In addition to the NARM examination, all applicants must pass the Washington state specific component examination.
[Statutory Authority: RCW 18.50.060. 99-03-064, ｧ 246-834-050, filed 1/18/99, effective 2/18/99.]
WAC 246-834-060 Application requirements for licensure as a midwife. This rule provides the requirements for application for a midwife license.(1) All applicants must submit a Washington state application for licensure, along with the applicable fees specified in WAC 246-830-990 and additional documentation as specified below. Applications must be received fifty-six days prior to the examination.
(2) Applicants must submit the following documentation:
(a) Transcripts sent directly from an approved school which indicate the applicant has received a certificate or diploma in midwifery. Those applicants applying under WAC 246-834-220 will be exempted from this requirement.
(b) One current passport type photograph, signed and dated across the bottom of the photo or on the back.
(c) Proof of high school graduation or passing the general educational development test.
(d) A current plan for consultation, emergency transfer and transport.
(e) Verification of seven clock hours of AIDS education as required in chapter 246-12 WAC, Part 8.
(f) Applicants with disabilities who wish to request special accommodations must do so when submitting their application.
(g) Applicants who have passed the NARM examination within the past two years must have verification of the examination results sent directly from NARM to the department.
(3) It is the applicant's responsibility to complete an application for the NARM examination and submit the application along with the NARM examination fee directly to NARM. A NARM application and instructions will be provided in the state application packet sent to the applicant.
[Statutory Authority: RCW 18.50.060. 99-03-064, ｧ 246-834-060, filed 1/18/99, effective 2/18/99. Statutory Authority: RCW 43.70.280. 98-05-060, ｧ 246-834-060, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-060, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-060, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-060, filed 9/21/82.]
WAC 246-834-065 Application for examination -- Out-of-state education. (1) A midwife not licensed in the state of Washington may sit for the licensing examination without completing the required coursework or the midwife-in-training program provided the midwife meets the following requirements:(a) Has completed a program preparing candidates to practice as a midwife provided such program is equivalent to the minimum course requirements of approved midwifery programs in Washington at the time of applicant's program completion. Proof of equivalency shall be submitted by the applicant with the application.
(b) The transcript of the applicant's completed midwifery program verifies that:
(i) All courses were completed with a grade of C (pass) or better; and
(ii) At least fifteen managed births were completed under the preceptorship of an experienced midwife approved by the candidate's educational program.
(c) If managed births completed under the preceptorship in (b)(ii) of this subsection are less than fifty, then affidavits of births the applicant has managed must be submitted in a sufficient number to prove that the applicant has managed a total of at least fifty births.
(2) The applicant shall submit to the department:
(i) A complete notarized application with the required fee.
(ii) Notarized copies of educational preparation or an official transcript verifying educational preparation or an official transcript verifying educational preparation to practice midwifery.
(iii) Declarations of managed births as required in subsection (1)(c) of this section.
(3) Applicants must demonstrate completion of seven clock hours of AIDS education as provided in chapter 246-12 WAC, Part 8.
[Statutory Authority: RCW 43.70.280. 98-05-060, ｧ 246-834-065, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-065, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 89-16-037 (Order PM 856), ｧ 308-115-065, filed 7/25/89, effective 8/25/89.]
WAC 246-834-070 Release of examination results. (1) Applicants shall be notified of examination results. All notices shall be by mail. The minimum passing score for both the NARM examination and the Washington state specific component examination is 75.(2) Applicants who pass both the NARM examination and the Washington state specific component examination and meet all eligibility requirements shall receive a license to practice as a midwife, unless there are grounds for disciplinary action under chapter 18.130 RCW.
(3) Applicants who fail shall receive notice of their eligibility to be reexamined, and of the procedure for applying for reexamination.
(4) Results of the examination will not be released to anyone except as provided above unless release is authorized by the applicant in writing.
[Statutory Authority: RCW 18.50.060. 99-03-064, ｧ 246-834-070, filed 1/18/99, effective 2/18/99. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-070, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-070, filed 9/21/82.]
WAC 246-834-080 Failures. (1) An applicant who has failed either the NARM examination or the Washington state specific component examination or both must retake and pass the examination(s) which he or she failed. The applicant may sit for the examination if he or she:(a) Applies to the department at least fifty-six days prior to the next scheduled examination; and
(b) Pays any required fee as specified in WAC 246-834-990.
(2) Applicants who fail the second retest shall be required to submit evidence to the secretary of completion of an individualized program of study approved in advance by the department prior to retaking the examination.
(3) Applicants may have their examination hand-scored by submitting a request and appropriate fee directly to NARM within ninety days of the examination administration. A copy of their request must be sent to the department. The department will inform the applicant of the results of the hand-scored examination.
[Statutory Authority: RCW 18.50.060. 99-03-064, ｧ 246-834-080, filed 1/18/99, effective 2/18/99. Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-080, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-080, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-080, filed 9/21/82.]
WAC 246-834-090 Purpose of accreditation of midwifery educational programs. The secretary provides for accreditation of midwifery educational programs for the following reasons:(1) To ensure that only qualified midwives will be licensed to practice in the state of Washington.
(2) To ensure the safe practice of midwifery by setting minimum standards for midwifery educational programs that prepare persons for licensure as midwives.
(3) To ensure that each midwifery educational program has flexibility to develop and implement its program of study and that it is based on minimum standards for accredited schools of midwifery provided herein.
(4) To ensure that standards for each accredited midwifery program promote self evaluation.
(5) To assure the graduates of accredited schools of their eligibility for taking the licensing examination for midwives.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-090, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-090, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-090, filed 9/21/82.]
WAC 246-834-100 Philosophy, purpose and objectives of an accredited midwifery educational program. The philosophy, purpose and objectives of an accredited midwifery educational program shall be stated clearly and shall be in written form.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-100, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-100, filed 9/21/82.]
WAC 246-834-110 Advisory body. Each institution that offers a midwifery educational program shall appoint an advisory body composed of health professionals, midwives and public members. The group should have a minimum of five members and should meet regularly. Functions of the advisory body shall include but not be limited to the following:(1) Promoting communication between the community and the school;
(2) Making recommendations on the curriculum, student selection and faculty;
(3) Informing the school about needs in midwifery education and practices; and
(4) Being informed about the school's finances.
In institutions whose advisory bodies are provided for by statute, or rule as in the case of public community colleges, universities and vocational-technical institutes, it can be presumed that the advisory body provided for meets these requirements.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-110, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-110, filed 9/21/82.]
WAC 246-834-120 Learning sites. (1) Learning sites utilized by accredited midwifery educational programs shall:(a) Include a variety of sites in addition to the school that may be used for student experience. These may include, but need not be limited to, hospitals, clinics, offices of health professionals and health centers.
(b) Provide learning experiences of sufficient number and variety that students can achieve the course/curriculum objectives and requirements of the statute.
(2) Written agreements shall be maintained between the school and any supervising clinicians and faculty. Such agreements shall be reviewed periodically by the parties and shall state the responsibilities and privileges of each party.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-120, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-120, filed 9/21/82.]
WAC 246-834-130 Staffing and teacher qualifications. At the time of application for accreditation pursuant to WAC 246-834-180, the school shall provide proof of the following:(1) That the academic director for the midwifery program is either (a) a midwife licensed under chapter 18.50 RCW or (b) a nurse midwife (ARNP) licensed under chapter 18.88 RCW or (c) has been educated in a midwifery program having standards comparable to standards in Washington and has experience in legal midwifery clinical practice.
(2) That the clinical faculty and preceptors either (a) hold a current license in the jurisdiction where they practice and demonstrate expertise in the subject area to be taught, or (b) are legally engaged in an active clinical practice and demonstrate expertise in the subject area to be taught.
(3) That each member of the faculty either (a) holds a certificate or degree in midwifery or the subject area to be taught, or (b) has no less than three years of experience in the subject area to be taught.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-130, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-130, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.045. 86-16-012 (Order PM 608), ｧ 308-115-130, filed 7/25/86. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-130, filed 9/21/82.]
WAC 246-834-140 Curriculum. (1) The basic curriculum shall be at least three academic years, and shall consist of both didactic and clinical instruction sufficient to meet the educational standards of the school and of chapter 18.50 RCW. However, the school may shorten the length of time for the program after consideration of the student's documented education and experience in the required subjects, if the applicant is a registered nurse under chapter 18.88 RCW, a licensed practical nurse under chapter 18.78 RCW, or has had previous nursing education or practical midwifery experience. The midwifery training shall not be reduced to a period of less than two academic years. Each student must undertake the care of not less than fifty women in each of the prenatal, intrapartum and early postpartum periods. The care of up to thirty five women in each of the periods may be undertaken as a part of previous nursing education or practical midwifery experience as defined in WAC 246-834-010(5). No less than fifteen women must be cared for in each period while enrolled in the school from which the student graduates. The student need not see the same women throughout each of the periods. A candidate for licensure must observe an additional fifty women in the intrapartum period in order to qualify for licensure. Up to thirty five of these observations may be as a part of previous nursing education or practical midwifery experience as defined in WAC 246-834-010(5). No less than fifteen women must be observed in the intrapartum period while enrolled in the school from which the student graduates.(2) Each school must ensure that the students receive instructions in the following instruction area:
(a) Instruction in basic sciences (including biology, physiology, microbiology, anatomy with emphasis on female reproductive anatomy, genetics and embryology) normal and abnormal obstetrics and gynecology, family planning techniques, childbirth education, nutrition both during pregnancy and lactation, breast feeding, neonatology, epidemiology, community care, and medicolegal aspects of midwifery.
(b) Instruction in basic nursing skills and clinical skills, including but not limited to vital signs, perineal prep, enema, catheterization, aseptic techniques, administration of medications both orally and by injection, local infiltration for anesthesia, venipuncture, administration of intravenous fluids, infant and adult resuscitation, and charting.
(c) Clinical practice in midwifery which includes care of women in the prenatal, intrapartal and early postpartum periods, in compliance with RCW 18.50.040.
(3) Provision shall be made for systematic, periodic evaluation of the curriculum.
(4) Any proposed major curriculum revision shall be presented to the secretary at least three months prior to implementation.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-140, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-140, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 87-21-011 (Order PM 686), ｧ 308-115-140, filed 10/9/87; 85-23-044 (Order PL 566), ｧ 308-115-140, filed 11/18/85; 82-19-079 (Order PL 406), ｧ 308-115-140, filed 9/21/82.]
WAC 246-834-150 Students. (1) Written policies and procedures for selection, admission, promotion, graduation and withdrawal of students shall be available.(2) Courses completed prior to enrollment in the midwifery school should have been completed within ten years of enrollment and must be documented by official transcript in order for reduction of basic requirements to be considered.
(3) Students who seek admission by transfer from another midwifery educational program shall meet the equivalent of the school's current standards for those regularly enrolled. The school may grant credit for the care of up to thirty five women in each of the periods undertaken as a part of previous midwifery education. No less than fifteen women must be cared for in each period while enrolled in the school from which the student graduates. The student need not see the same women throughout each of the periods. A candidate for licensure must observe an additional fifty women in the intrapartum period in order to qualify for licensure. Up to thirty five of these observations may be as a part of previous midwifery education. No less than fifteen women must be observed in the intrapartum period while enrolled in the school from which the student graduates.
(4) Individuals may request advanced placement on the basis of their previous practical midwifery experience as specified in RCW 18.50.040(2) and WAC 246-834-010(5) but in no case shall a school grant credit for more than thirty-five of the fifty required managed births. At least fifteen of the managed births must be undertaken while enrolled in the school granting advanced placement.
(5) Each school shall maintain a comprehensive system of student records.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-150, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-150, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 85-23-044 (Order PL 566), ｧ 308-115-150, filed 11/18/85; 82-19-079 (Order PL 406), ｧ 308-115-150, filed 9/21/82.]
WAC 246-834-160 Student midwife permit. (1) A permit may be issued to any individual who has:(a) Successfully completed an accredited midwifery program as specified in RCW 18.50.040 (2)(a) and (b); and
(b) Undertaken the care of not less than fifty women in each of the prenatal, intrapartum and early postpartum periods as required by RCW 18.50.040 (2)(c) and by these rules; and
(c) Satisfactorily completed the licensing examination required by RCW 18.50.060; and
(d) Filed a completed application for student midwife permit accompanied by a nonrefundable fee as specified in WAC 246-834-990.
(2) The student midwife permit authorizes the individuals to practice and observe fifty women in the intrapartum period under the supervision of a licensed midwife, licensed physicians or CRN (nurse midwife).
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-160, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-160, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-160, filed 9/21/82.]
WAC 246-834-170 Reports to the department of health by accredited midwifery educational programs. (1) An annual report on the program and its progress for the period July 1 to June 30 shall be submitted to the department by each midwifery educational program on forms supplied by the department.(2) Written notification shall be sent to the department regarding major changes relating to, but not limited to, the following:
(a) Change in the administrator or academic director.
(b) Organizational change.
(c) Changes in extended learning sites.
The information submitted to the department of health shall include the reason for the proposed change.
(3) The secretary may require submission of additional reports.
[Statutory Authority: RCW 43.70.280. 98-05-060, ｧ 246-834-170, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-170, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-170, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-170, filed 9/21/82.]
WAC 246-834-180 Application for accreditation. Applicants for accreditation as midwifery educational programs shall:(1) Apply for accreditation using a form provided by the secretary.
(2) Comply with the department's accreditation procedures and obtain accreditation before its first class graduates, in order for these graduates to be eligible to take the state licensing examination.
The accreditation will be based on, but not limited to, the quality of the curriculum and the qualifications of the faculty and preceptors.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-180, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-180, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.045. 86-16-012 (Order PM 608), ｧ 308-115-180, filed 7/25/86. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-180, filed 9/21/82.]
WAC 246-834-190 School survey visits. The secretary's designee shall make survey visits to midwifery educational programs:(1) At least annually during the first three years of operation, and
(2) At least every two years after the new school's first three years of operation or more often at the discretion of the secretary.
(3) The cost of a survey visit to a midwifery educational program outside the state of Washington shall be borne by the program requesting accreditation.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-190, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-190, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 85-23-044 (Order PL 566), ｧ 308-115-190, filed 11/18/85; 82-19-079 (Order PL 406), ｧ 308-115-190, filed 9/21/82.]
WAC 246-834-200 Appeal of department of health decisions. A school of midwifery aggrieved by a department decision affecting its accreditation may appeal the decision pursuant to chapter 18.50 RCW and the Administrative Procedure Act, chapter 34.05 RCW.
[Statutory Authority: RCW 43.70.280. 98-05-060, ｧ 246-834-200, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.50.135, 18.50.045 and 34.05.220. 92-02-018 (Order 224), ｧ 246-834-200, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-200, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-200, filed 9/21/82.]
WAC 246-834-210 Closure of an accredited school of midwifery. (1) When an organization decides to discontinue its school of midwifery, written notification of the planned closure should be sent to the department.(2) A school in the process of closing shall remain accredited until the students who are enrolled at the time the department receives the notice of planned closure have been graduated, provided that the minimum standards are maintained by the school.
(3) When a closing midwifery school's last students graduate, its accreditation shall terminate.
(4) A closing midwifery school shall provide for safe storage of vital school records and should confer with the secretary concerning the matter.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-210, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-210, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.135. 82-19-079 (Order PL 406), ｧ 308-115-210, filed 9/21/82.]
WAC 246-834-220 Credit toward educational requirements for licensure. (1) Applicants not meeting the minimum requirements set forth in WAC 246-834-060 may apply to the department for licensure by submitting the following:(a) A completed, notarized application on a form provided by the department accompanied by a nonrefundable fee as specified in WAC 308-115-405;
(b) Credit for academic courses:
(i) Certification by an accrediting body, which has been approved by the department, of completed academic and continuing education courses as required in RCW 18.50.040 (2)(b) for which the applicant has received a grade of "C" or better. A certified copy of the courses taken and grades or scores achieved shall be submitted by the accrediting body directly to the department; or
(ii) Completion of challenge examinations approved by the department with a minimum score of 75% for any academic subject required in RCW 18.50.040 (2)(b). Challenge examinations shall be administered a minimum of twice a year. An applicant for challenge examination must file a completed application for each examination along with the required fee with the department at least 45 days prior to the examination.
(c) A prospectus for permission to undertake a midwife-in-training program. Such a program shall be on such terms as the department finds necessary to assure that the applicant meets the minimum statutory requirements for licensure set forth in RCW 18.50.040, and shall include, but not be limited to the following:
(i) The program shall be under the guidance and supervision of a preceptor, and shall be conducted for a period of not more than five years;
(ii) The program shall be designed to provide for individual learning experiences and instruction based upon the applicant's academic background, training, and experience;
(iii) The prospectus for the program shall be submitted on an approved form, signed by the preceptor, and approved by the department prior to the commencement of the program. Any changes in the program shall be reported within 30 days in writing to the department, and the department may withdraw the approval given, or alter the conditions under which approval was originally given, if the department finds that the program as originally submitted and approved has not been or is not being followed.
(2) The midwife-in-training program prospectus must include the following components:
(a) A plan for completion of required academic subjects required in RCW 18.50.040 (2)(b);
(b) Planned reading and written assignments;
(c) A project including at least one problem-solving component to be submitted in writing. The problem-solving component should include the definition of an acknowledged problem, the method of approach to the problem, the listing of possible alternatives, the actions taken, evaluation, and final recommendations to improve care given;
(d) Other planned learning experiences including acquisition of knowledge about other health and welfare agencies in the community;
(e) A quarterly written report, on an approved form, submitted to the department by the trainee, which shall include a detailed outline of progress toward meeting the objectives of the prospectus during the reporting period;
(f) The program must provide for a broad range of experience with a close working relationship between preceptor and the trainee. Toward that end, as a general rule, no program will be approved which would result in an individual preceptor supervising more than two midwives-in-training simultaneously. Exception to this rule may be granted by the department in unusual circumstances;
(g) The department may, in an individual case, require additional approved education, based upon assessment of the individual applicant's background, training and experience.
(3) Upon approval of the application, a trainee permit will be issued which enables the trainee to practice under the supervision of a preceptor. The permit shall expire within one year of issuance and may be extended as provided by rule.
(4) The trainee shall provide documentation of care given as follows:
(a) Records of no more than thirty-five women to whom the trainee has given care in each of the prenatal, intrapartum, and early postpartum periods, although the same women need not have been seen through all three periods. These records must contain affidavits from the clients certifying that the care was given. If a client is unavailable to sign an affidavit, an affidavit from a preceptor or a certified copy of the birth certificate may be substituted. The care may have been given prior to the beginning of the midwife-in-training program or during the trainee period;
(b) After being issued a trainee permit, the trainee must manage care in the prenatal, intrapartum, and early postpartum period of fifteen women under the supervision of the preceptor. These women shall be in addition to the women whose records were used to meet the conditions of (a) of this subsection. The preceptor shall submit, on approved forms, completed check-lists of skills and experiences when this requirement has been met;
(c) Evidence, on an approved form, of observing 50 deliveries in addition to those specified in (b) of this subsection. The deliveries may have been observed prior to the beginning of the midwife-in-training program or may be observed during the trainee period.
(5) Upon satisfactory completion of subsections (1)(a) through (4)(c) of this section, the trainee is eligible to apply for the examination.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-220, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-220, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.040(3) and 18.50.115. 88-12-040 (Order PM 732), ｧ 308-115-220, filed 5/27/88.]
WAC 246-834-230 Preceptor for midwife-in-training program. (1) In reviewing a proposed midwife-in-training program, the department shall use the following criteria in assessing the qualifications and determining the responsibilities of the preceptor:(a) Qualifications of preceptor:
(i) The preceptor shall have demonstrated the ability and skill to provide safe, quality care;
(ii) The preceptor shall have demonstrated continued interest in professional development beyond the requirements of basic licensure;
(iii) The preceptor shall participate in and successfully complete any preceptor workshop or other training deemed necessary by the department; and,
(iv) The preceptor shall be licensed in the state of Washington. Exception to this rule may be granted by the department in unusual circumstances.
(b) Responsibilities of the preceptor:
(i) The preceptor shall monitor the educational activities of the trainee and shall have at least one conference with the trainee quarterly to discuss progress;
(ii) The preceptor shall submit quarterly progress reports on approved forms to the department, and,
(iii) The preceptor shall maintain and submit the checklists as specified in WAC 246-834-220 (4)(b).
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-230, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-230, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.040(3) and 18.50.115. 88-12-040 (Order PM 732), ｧ 308-115-230, filed 5/27/88.]
WAC 246-834-240 Trainee permit for midwife-in-training program. (1) A trainee permit may be issued to any individual who has:(a) Been approved for a midwife-in-training program; and,
(b) Filed a completed application accompanied by a non-refundable fee.
(2) The trainee permit authorizes individuals to manage care as required in WAC 246-834-220 (4)(b).
(3) Permits will be issued yearly for the duration of the trainee's midwife-in-training program.
[Statutory Authority: RCW 18.50.135 and 18.50.045. 92-02-018 (Order 224), ｧ 246-834-240, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-240, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.040(3) and 18.50.115. 88-12-040 (Order PM 732), ｧ 308-115-240, filed 5/27/88.]
WAC 246-834-250 Legend drugs and devices. (1) Licensed midwives may purchase and use legend drugs and devices which are deemed integral to providing safe care to the public. Such devices include the following:(a) Dopplers, syringes, needles, phlebotomy equipment, suture, urinary catheters, intravenous equipment, heparin locks, amnihooks, and "DeLee type" mucous traps;
(b) Pharmacies may fill orders for diaphragms which have been issued by licensed midwives for postpartum women.
(2) In addition to medications listed in RCW 18.50.115, licensed midwives may administer the following medications:
(a) Intravenous fluids limited to Lactated Ringers, 5% Dextrose with Lactated Ringers, and 5% Dextrose with water;
(b) Heparin for use in heparin locks, Epinephrine for use in allergic reactions, and Magnesium Sulphate shall be used according to midwifery advisory committee established protocols. Such protocols shall state the indications for use, the dosage and the administration of these medications.
(c) Licensed midwives may obtain and administer Rubella vaccine to non-immune postpartum women.
(3) The client's records shall contain documentation of all medications administered.
(4) Whenever Epinephrine or Magnesium Sulfate is administered, a report, on approved forms, shall be submitted within thirty days to the midwifery advisory committee.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-250, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.50.040(3) and 18.50.115. 88-12-040 (Order PM 732), ｧ 308-115-250, filed 5/27/88.]
WAC 246-834-260 General provisions. (1) "Unprofessional conduct" as used in this chapter shall mean the conduct described in RCW 18.130.180.(2) "Hospital" means any health care institution licensed pursuant to chapter 70.41 RCW.
(3) "Nursing home" means any health care institution which comes under chapter 18.51 RCW.
(4) "Department" means the department of health, whose address is:
Department of Health
Midwifery Program
1300 S.E. Quince St.
P.O. Box 47864
Olympia, Washington 98504-7864
(5) "Midwife" means a person licensed pursuant to chapter 18.50 RCW.
(6) "Mentally or physically disabled midwife" means a midwife who is currently mentally incompetent or mentally ill as determined by a court, or who is unable to practice midwifery with reasonable skill and safety to patients by reason of any mental or physical condition and who continues to practice while so impaired.
[Statutory Authority: RCW 43.70.280. 98-05-060, ｧ 246-834-260, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.50.135, 18.50.045, 18.130.050 and 18.130.070. 92-02-018 (Order 224), ｧ 246-834-260, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-260, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), ｧ 308-115-260, filed 6/30/89.]
WAC 246-834-270 Mandatory reporting. (1) All reports required by this chapter shall be submitted to the department as soon as possible, but no later than twenty days after a determination is made.(2) A report should contain the following information if known:
(a) The name, address, and telephone number of the person making the report.
(b) The name and address and telephone numbers of the midwife being reported.
(c) The case number of any patient whose treatment is a subject of the report.
(d) A brief description or summary of the facts which gave rise to the issuance of the report, including dates of occurrences.
(e) If court action is involved, the name of the court in which the action is filed along with the date of filing and docket number.
(f) Any further information which would aid in the evaluation of the report.
(3) Mandatory reports shall be exempt from public inspection and copying to the extent permitted under RCW 42.17.310 or to the extent that public inspection or copying of the report or any portion of the report would invade or violate a person's right to privacy as set forth in RCW 42.17.255.
(4) A person is immune from civil liability, whether direct or derivative, for providing information to the department pursuant to RCW 18.130.070.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-270, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), ｧ 308-115-270, filed 6/30/89.]
WAC 246-834-280 Health care institutions. The chief administrator or executive officer or their designee of any hospital or nursing home shall report to the department when any midwife's services are terminated or are restricted based on a determination that the midwife has either committed an act or acts which may constitute unprofessional conduct or that the midwife may be unable to practice with reasonable skill or safety to clients by reason of any mental or physical condition.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-280, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), ｧ 308-115-280, filed 6/30/89.]
WAC 246-834-290 Midwifery associations or societies. The president or chief executive officer of any midwifery association or society within this state shall report to the department when the association or society determines that a midwife has committed unprofessional conduct or that a midwife may not be able to practice midwifery with reasonable skill and safety to patients as the result of any mental or physical condition. The report required by this section shall be made without regard to whether the license holder appeals, accepts, or acts upon the determination made by the association or society. Notification of appeal shall be included.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-290, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), ｧ 308-115-290, filed 6/30/89.]
WAC 246-834-310 Health care service contractors and disability insurance carriers. The executive officer of every health care service contractor and disability insurer, licensed under chapters 48.20, 48.21, 48.21A, and 48.44 RCW, operating in the state of Washington shall report to the department all final determinations that a midwife has engaged in fraud in billing for services.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-310, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), ｧ 308-115-310, filed 6/30/89.]
WAC 246-834-320 Professional liability carriers. Every institution or organization providing professional liability insurance directly or indirectly to midwives shall send a complete report to the department of any malpractice settlement, award, or payment in excess of twenty thousand dollars as a result of a claim or action for damages alleged to have been caused by an insured midwife's incompetency or negligence in the practice of midwifery. Such institution or organization shall also report the award, settlement, or payment of three or more claims during a twelve-month period as a result of the midwife's alleged incompetence or negligence in the practice of midwifery.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-320, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), ｧ 308-115-320, filed 6/30/89.]
WAC 246-834-330 Courts. The department requests the assistance of the clerk of trial courts within the state to report all professional malpractice judgments and all convictions of licensed midwives, other than minor traffic violations.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-330, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), ｧ 308-115-330, filed 6/30/89.]
WAC 246-834-340 State and federal agencies. The department requests the assistance of executive officers of any state or federal program operating in the state of Washington, under which a midwife is employed to provide patient care services, to report to the department whenever such a midwife has been judged to have demonstrated his/her incompetency or negligence in the practice of midwifery, or has otherwise committed unprofessional conduct, or is a mentally or physically disabled midwife. These requirements do not supersede any federal or state law.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-340, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), ｧ 308-115-340, filed 6/30/89.]
WAC 246-834-400 Expired license. (1) If the license has expired for three years or less, the practitioner must meet the requirements of chapter 246-12 WAC, Part 2.(2) If the license has expired for over three years, the practitioner must:
(a) Demonstrate competence to the standards established by the secretary;
(b) Meet the requirements of chapter 246-12 WAC, Part 2.
[Statutory Authority: RCW 43.70.280. 98-05-060, ｧ 246-834-400, filed 2/13/98, effective 3/16/98.]
WAC 246-834-990 Midwifery fees and renewal cycle. (1) Licenses must be renewed every year on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2.(2) The following fees are nonrefundable:
| Title
of Fee |
Fee |
| Initial application | $500.00 |
| National examination administration (initial/retake) | 100.00 |
| State examination (initial/retake) | 150.00 |
| Renewal | 950.00 |
| Late renewal penalty | 300.00 |
| Duplicate license | 25.00 |
| Certification of license | 25.00 |
| Application fee -- Midwife-in-training program | 950.00 |
| Expired license reissuance | 300.00 |
[Statutory Authority: RCW 43.70.250, 2001 2nd sp.s. c 7 and RCW 18.50.102. 01-23-101, ｧ 246-834-990, filed 11/21/01, effective 1/21/02. Statutory Authority: RCW 18.50.102 and 43.70.250. 98-11-069, ｧ 246-834-990, filed 5/19/98, effective 7/13/98. Statutory Authority: RCW 43.70.250. 91-13-002 (Order 173), ｧ 246-834-990, filed 6/6/91, effective 7/7/91. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as ｧ 246-834-990, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.70.250. 90-04-094 (Order 029), ｧ 308-115-405, filed 2/7/90, effective 3/10/90. Statutory Authority: RCW 18.50.135. 89-08-008 (Order PM 827), ｧ 308-115-405, filed 3/24/89. Statutory Authority: RCW 43.24.086. 87-18-031 (Order PM 667), ｧ 308-115-405, filed 8/27/87. Statutory Authority: 1983 c 168 ｧ 12. 83-17-031 (Order PL 442), ｧ 308-115-405, filed 8/10/83. Formerly WAC 308-115-400.]
覧覧覧覧覧
Updated 8-28-2003
Home :: Site Map :: Contact
What is MANA? :: News
:: Definitions :: Conferences
:: Resources :: Links