Legislative Priorities 2025 (PDF)

Maintain the cap on midwifery professional licensing fees

• The annual $525 licensing fee cap has been maintained since a legislature-commissioned study determined that midwifery care more than makes up for the cost of the cap. State law requires that the regulation of each profession must be self-sustaining, so the state budget contributes the balance to keep the program solvent. The cap is included in the maintenance level budget and in the Governor’s budget. Cost: $150,000/yr.
  • ​This cap remains in tact in the proposed Senate budget. It is also present in the proposed House budget but at a somewhat reduced rate. ​

​Support HB 1824: Allow for substantial equivalency for birth center inspections

• HB 1824 by Rep. Barnard would allow birth centers accredited with the Commission for the Accreditation of Birth Centers (CABC) to bypass DOH inspections required for licensure. This would be an option for birth centers, who could stay with the existing Department of Health process if they choose. This change would save time and money for both birth centers and the DOH by avoiding duplicate inspections. Cost: savings for Dept of Health
  • This bill which seeks to eliminate duplicate birth center inspections is waiting to be pulled onto the Senate floor for a vote by someone on the Rules Committee. It has already passed out of the Senate committe on Health & Long Term Care after passing unanimously out of the House (see below for video links to the speeches).   
  • ​​To see LM testimony at the public hearing of the House healthcare committee on February 14, watch this video starting at 1h 37 min. Carolee Hall’s Testimony begins at 1:40:42 & Cynthia Flynn after that. Testimonies for our bill finish at 1:45:34.
  • On 2/19/25, the house healthcare committee returned to vote on HB 1824. You can view the vote and comments at this link starting at 27:25 but the interesting part where our elected officials make comments starts at 28:42
  • In March, the bill was unanimously passed on the floor of the House, watch starting at 22:54 

 
Preserve Medicaid reimbursement when a client transfers care intrapartum 

• It is not unusual for a patient to be in labor for a number of hours before needing transfer to a hospital. In that situation, birth centers are reimbursed a facility fee of $366.68, which is not sufficient to cover the cost of utilizing the birth center and paying for necessary staffing. We are requesting an increase to the full delivery fee of $2500. Cost: $930,000

Maintain funding for distressed birth centers and labor & delivery units

• In the current budget, $1,000,000 was allocated to support financially distressed birth centers in addition to funding for labor and delivery units in an effort to maintain access to care in maternity care deserts. This support is still much needed as conditions have not improved. Cost: $1,000,000.

Evidence shows that states integrating midwives into their health care systems have better indicators of maternal and neonatal wellbeing. (NASHP, 2022)


Planting Seeds for Future Policy Goals:

• Families who choose Licensed Midwives for their care consistently ask to receive their well-person care between pregnancies from them as well. They know they can get a pap smear or be screened for a mood disorder, for example, at their 6 week postpartum visit and they would like that option throughout their childbearing years
  
  
  • If LMs could offer the same care to their clients between pregnancies that they offer during pregnancy and postpartum, the benefits for health and for the healthcare system would be even greater, reducing costs and increasing access to high quality care. 
  • Future budget support of data collection 
    • Data entry is a time consuming & financial burden for small practices who are required to submit by law 
    • Funding for data entry & to cover the costs of participating could alleviate this cost & burden 
    • The public benefits from data collection that drives quality improvement​

 

Map of Freestanding Birth Centers in WA

46% of Community Births happen in 
26 Freestanding Birth Centers in WA
Map of WA with Links​

The following Representative Maps Demonstrate what is possible with further support for Increased Access:

Images Source (3 preceding): Elephant Circle. Response to Request For Information Regarding Maternal and Infant Health Care in Rural Communities. 

​Midwifery Facts:

• Birth outcomes are excellent
• Community birth is safe and valued 
• Licensed midwives contract with both private and public payers
• Saves the state money with our cost saving outcomes

​References

Medicaid Reimbursement of Midwifery Services in Minnesota and Washington State Supports Diverse Pathways to Care (2022)

WA State Maternal Mortality Review Panel: Maternal Deaths 2017–2020 Report (Feb 2023)

NPR 2/23/23: The number of mothers who die due to pregnancy or childbirth is 'unacceptable' 

Seattle Times 2/27/23: Black, Native infants in King County die at higher rate than white babies

ACOG Journal (2021): Birth Outcomes for Planned Home and Licensed Freestanding Birth Center Births in WA State 

Value of midwifery care

Department of Health Cost Benefit Study, reaffirmed 2017 
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LM (Licensed Midwife) Fact Sheet

Policy briefs, Evidence & Arguments for Scaling Up Midwifery to Improve Perinatal Outcomes

Clinical Guidelines

​​Click here for more information about our Annual Midwife Lobby Day and plan to join us!