2025 -- H 5858

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LC001903

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2025

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A N   A C T

RELATING TO HEALTH AND SAFETY -- MATERNAL AND CHILD HEALTH SERVICES

FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS

     Introduced By: Representatives Stewart, Alzate, Cruz, Shallcross Smith, Kislak, Potter,
McGaw, and Casimiro

     Date Introduced: February 28, 2025

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 23-13-9 of the General Laws in Chapter 23-13 entitled "Maternal and

Child Health Services for Children with Special Health Care Needs" is hereby amended to read as

follows:

     23-13-9. Licensing and regulation of midwives — Penalty for violations.

     (a) The state director of health is authorized and directed to make rules for the regulation

of the practice of midwifery and for the licensing of midwives, including regulations that require

the payment of an initial application fee equal to that fee that is imposed upon applicants for

licensure as nurse practitioners and a renewal fee also equivalent to that for nurse practitioners. The

rules regarding the regulation of the practice of midwifery shall authorize a licensed, certified

nurse-midwife (CNM) or a licensed, certified midwife (CM) to prescribe medications that might

be reasonably required by his or her patients; provided however, that a licensed, certified nurse-

midwife (CNM) or a licensed, certified midwife (CM) shall prescribe any of those medications as

authorized by the director of health. The provisions of this section relating to prescription authority

by certified nurse-midwives and certified midwives shall be overseen by the department of health

as defined in the department’s rules and regulations for licensing of midwives (R23-13MID). No

person not a licensed midwife or a physician, registered under the provisions of chapter 37 of title

5, shall practice midwifery, or shall make a practice of attending women in childbirth for hire, or

use the name or title of midwife. Any person who violates the provisions of this section, or who

violates any of the rules of the department of health made in pursuance of this section, shall be

fined not more than one hundred dollars ($100), or imprisoned not more than six (6) months, or

both, and the director of health may revoke the license issued to any person when, in the opinion

of the director of health, that person is guilty of unprofessional conduct.

     (b) Scope of prescriptive authority for a certified professional midwife with prescriptive

authority under this section shall have the ability to order, obtain, carry and administer the following

medications in accordance with their training and practice:

     (1) Lactation pumps and equipment;

     (2) Nipple shields;

     (3) Compression stockings and belts;

     (4) Maternity belts;

     (5) Diaphragms and cervical caps;

     (6) Glucometers and testing strips;

     (7) Iron supplements;

     (8) Prenatal vitamins;

     (9) Recommended vaccines;

     (10) Prophylactic ophthalmic medication;

     (11) Postpartum oxytocic;

     (12) Vitamin K;

     (13) Rho (D) immune globulin;

     (14) Local anesthetic;

     (15) Intravenous fluids and equipment;

     (16) Sterile water for intradermal injections for pain relief;

     (17) Magnesium sulfate for prevention or treatment of maternal peripartum seizures

pending transport;

     (18) Epinephrine for use in maternal peripartum anaphylaxis resuscitation and neonatal

resuscitation;

     (19) Measles, Mumps, and Rubella (MMR) vaccine to nonimmune postpartum individuals;

     (20) Tetanus, diphtheria, acellular pertussis (Tdap) vaccine for use in pregnancy;

     (21) Hepatitis B (HBV) birth dose for any newborn administration;

     (22) HBIG and HBV for any neonates born to a hepatitis B positive gestational parent;

     (23) Influenza vaccine;

     (24) Any vaccines recommended by the Centers for Disease Control and Prevention (CDC)

advisory committee on immunization practices for pregnant or postpartum individuals or infants in

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the first two (2) weeks after birth or pregnant or postpartum individuals;

     (25) Terbutaline to temporarily decrease contractions pending emergent intrapartum

transport;

     (26) Antibiotics for intrapartum prophylaxis of Group B (beta hemolytic) Streptococcus

(GBS);

     (27) Antihemorrhagic drugs to treat postpartum hemorrhage including, but not limited to,

intravenous tranexamic acid, oxytocin, misoprostol, methergine, and prostaglandin F2 alpha;

     (28) Nifedipine for indication of preterm labor pending transport;

     (29) Antibiotics;

     (30) Antiemetics;

     (31) Antivirals;

     (32) Antifungals;

     (33) Low-potency topical steroids;

     (34) Antipruritic medications and therapies;

     (35) Galactagogues;

     (36) Topical analgesia for anal, vulvar, and perineal pain;

     (37) Preterm labor preventatives;

     (38) Stool softeners;

     (39) Vitamins and minerals for preventing and treating deficiencies;

     (40) Over-the-counter medications as needed;

     (41) Nonopioid medication for therapeutic rest;

     (42) Medications for miscarriage prevention and completion;

     (43) Smoking cessation;

     (44) Prescription referrals for IV iron infusions;

     (45) Intraosseous;

     (46) Umbilical venous catheters for neonatal resuscitation;

     (47) Intramuscular tranexamic;

     (48) Oxygen and equipment;

     (49) Rhogam;

     (50) All-purpose nipple ointment; and

     (51) Injectable Lidocaine.

     SECTION 2. This act shall take effect upon passage.

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LC001903

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- MATERNAL AND CHILD HEALTH SERVICES

FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS

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     This act would establish the scope of a certified professional midwife’s authority relating

to prescribing medication to patients.

     This act would take effect upon passage.

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LC001903

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