In this subtitle the following words have the meanings indicated. “ACME” means the Accreditation Commission for Midwifery Education, or a successor organization that is an accrediting agency for midwifery education programs and institutions and is approved by the United States Department of Education. “AMCB” means the American Midwifery Certification Board, or a successor organization that is a certifying agency for midwifery education programs and is approved by the National Commission for Certifying Agencies. “Applicant” means an individual who has submitted an application to the Board to be licensed as a certified midwife. “Board” means the State Board of Nursing. “License” means, unless the context requires otherwise, a license issued by the Board to practice certified midwifery. “Licensed certified midwife” means an individual who has been issued a license by the Board under this subtitle to practice certified midwifery. “Licensed certified midwife” does not include a licensed direct–entry midwife or a licensed nurse certified as a nurse–midwife under this title. “Practice certified midwifery” means the management and care of essentially normal newborns and of essentially normal women antepartally, intrapartally, and postpartally. “Practice certified midwifery” includes: Family planning and well woman reproductive care; The prescribing of substances commonly used in the practice of midwifery; The prescribing of Schedule II, Schedule III, Schedule IV, and Schedule V controlled dangerous substances commonly used in the practice of midwifery; and The dispensing of the substances prescribed in accordance with the provisions of items (ii) and (iii) of this paragraph in the course of treating a patient: At a medical facility or clinic that is operated on a nonprofit basis; At a health center that operates on a campus of an institution of higher education; At a public health facility, a medical facility under contract with a state or local health department, or a facility funded with public funds; or With a starter dosage of a drug as authorized under § 8–508 of this title.

Except as otherwise provided in this subtitle or §§ 10–14A–03 and 10–14B–03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice certified midwifery in the State. This section does not apply to: An individual who assists at a birth in an emergency; An individual who is licensed as a health care practitioner whose scope of practice allows the individual to practice certified midwifery; A student who is practicing certified midwifery while engaged in an approved clinical midwifery education experience under the supervision of a licensed certified midwife or a licensed nurse certified as a nurse–midwife; or An individual who has graduated from a graduate level accredited program for midwifery education approved by ACME, and who is: Practicing certified midwifery under the supervision of a licensed certified midwife or a licensed nurse certified as a nurse–midwife; and Meets any other requirements set by the Board.

In addition to the certification and education requirements under subsection (b) of this section, to qualify for a license, an applicant must: Be of good moral character; and Submit to a criminal history records check in accordance with § 8–303 of this title. An applicant must: Hold a current, valid certification as a certified midwife from AMCB; Have graduated from a graduate–level accredited program for midwifery education approved by ACME; and Have passed the AMCB examination.

To apply for a license, an applicant shall: Submit to a criminal history records check in accordance with § 8–303 of this title; Submit to the Board: An application on the form that the Board requires, including a current address; Written, verified evidence that the requirement of item (1) of this section is being or has been met; and Written, verified evidence of satisfying the requirements in § 8–6D–03(b) of this subtitle; and Pay to the Board a fee set by the Board as required in § 8–6D–05 of this subtitle.

The Board shall set reasonable fees for the issuance and renewal of licenses and other services it provides to licensed certified midwives. The fees charged shall be set to produce funds to approximate the cost of maintaining the licensing program and the other services to licensed certified midwives. The Board shall pay all fees collected under this subtitle to the Comptroller. The Comptroller shall distribute all fees to the Board of Nursing Fund. The fees collected under this section shall be used exclusively to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by this subtitle.

Subject to subsection (c) of this section, the Board shall issue a license to any applicant who meets the requirements of this subtitle. The Board shall: Issue each new licensee a license number that indicates that the initial license was issued by the Board; and Electronically record each license in the Board’s database and on the Board’s website. Each license shall include an expiration date. On receipt of the criminal history records information of an applicant for licensure in accordance with § 8–303 of this title, in determining whether to grant a license, the Board shall consider: The age at which the crime was committed; The circumstances surrounding the crime; The length of time that has passed since the crime; Subsequent work history; Employment and character references; and Other evidence that demonstrates whether the applicant poses a threat to the public health or safety. The Board may not issue a license if the criminal history records information required under § 8–303 of this title has not been received.

A license issued under this subtitle authorizes the licensee to practice certified midwifery while the license is active.

A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section. A license may not be renewed for a term longer than 2 years. At least 3 months before a license expires, the Board shall send to the licensee a renewal notice by: First–class mail to the last known mailing address of the licensee; or Electronic means to the last known e–mail address of the licensee. A renewal notice shall state: The date on which the current license expires; The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and The amount of the renewal fee. If a licensee is required to have a criminal history records check before a license may be renewed, the Board shall send the licensee information regarding how the licensee may complete the required criminal history records check. Except as otherwise provided in this subtitle, before a license expires, the licensee periodically may renew it for an additional term if the licensee: Otherwise is entitled to be licensed; Pays to the Board a renewal fee set by the Board as required by § 8–6D–05 of this subtitle; and Submits to the Board, by paper or electronic submission: A renewal application on the form that the Board requires; and Satisfactory evidence of current certification as a certified midwife by AMCB. The Board may grant a 30–day extension, beyond a license’s expiration date, to a licensee so that the licensee may renew the license before it expires. Subject to subsection (i) of this section, the Board shall renew the license of each licensee who meets the requirements of this section. Each licensee shall notify the Board in writing of any change in the name or address of the licensee within 60 days after the change occurred. If a licensee fails to notify the Board within the time required under this subsection, subject to the hearing provisions of § 8–317 of this title, the Board may impose an administrative penalty of $100. The Board shall reinstate the license of a licensee who has failed to renew the license for any reason if the licensee meets the renewal requirements of this section. A criminal history records check is required in accordance with § 8–303 of this title on: Selected annual renewal applicants as determined by regulations adopted by the Board; and Each licensee who files for reinstatement under subsection (h) of this section after failing to renew the license for a period of 1 year or more. An additional criminal history records check shall be performed every 12 years thereafter. On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with § 8–303 of this title, in determining whether to initiate a disciplinary action against a licensee based on the information received, the Board shall consider: The age at which the crime was committed; The circumstances surrounding the crime; The length of time that has passed since the crime; Subsequent work history; Employment and character references; and Other evidence that demonstrates whether the licensee poses a threat to the public health or safety. The Board may not renew a license without written documentation that the applicant has submitted to a criminal history records check required under § 8–303 of this title.

Unless the Board agrees to accept the surrender of a license, a licensed certified midwife may not surrender the license. The Board may require terms and conditions on an agreement with the licensed certified midwife to accept surrender of the license. An agreement to accept the surrender of a license is a final order of the Board and is a public record.

Subject to the hearing provisions of § 8–317 of this title, the Board may deny a license or grant a license, including a license subject to a reprimand, probation, or suspension, to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke the license of a licensee if the applicant or licensee: Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or for another; Fraudulently or deceptively uses a license; Is disciplined by a licensing or disciplinary authority of any state or country, convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs for an act that would be grounds for disciplinary action under the Board’s disciplinary statutes; Is convicted of or pleads guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside; Willfully and knowingly: Files a false report or record of an individual under the licensee’s care; Gives any false or misleading information about a material matter in an employment application; Fails to file or record any health record that is required by law; Obstructs the filing or recording of any health record as required by law; or Induces another individual to fail to file or record any health record as required by law; Knowingly commits any act that has been determined by the Board, in its regulations, to exceed the scope of practice authorized to the individual under this subtitle; Provides professional services while: Under the influence of alcohol; or Using any narcotic or controlled dangerous substance, as defined in § 5–101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication; Commits an act that is inconsistent with generally accepted professional standards in the practice of certified midwifery; Is grossly negligent in the practice of certified midwifery; Has violated any provision of this title; Submits a false statement to collect a fee; Is physically or mentally incompetent; Knowingly fails to report suspected child abuse in violation of § 5–704 of the Family Law Article; Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV–positive; Except in an emergency life–threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control and Prevention’s guidelines on universal precautions; Has a substance use disorder; Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article; Fails to cooperate with a lawful investigation conducted by the Board; Is expelled from the safe practice program established in accordance with § 8–208 of this title for failure to comply with the conditions of the program; Engages in conduct that violates the professional code of ethics; Is professionally incompetent; Practices certified midwifery without a license before obtaining or renewing a license, including any period when practicing certified midwifery on an expired license or a lapsed license; When holding an expired license or a lapsed license, commits any act that would be grounds for disciplinary action under this section; Engages in unprofessional or immoral conduct; Violates regulations adopted by the Board or an order from the Board; Performs an act that is beyond the licensee’s knowledge and skills; Fails to submit to a criminal history records check in accordance with § 8–303 of this title; Has misappropriated the property of a patient or a facility; or Fails to comply with § 1–223 of this article. If, after a hearing under § 8–317 of this title, the Board finds that there are grounds under subsection (a) of this section to suspend or revoke a license to practice certified midwifery, to reprimand a licensee, or to place a licensee on probation, the Board may impose a penalty not exceeding $5,000 instead of or in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation. In addition to any sanction authorized under this section, the Board may require a licensee to comply with specified terms and conditions determined by the Board. If a license issued under this subtitle was suspended or revoked for a period of more than 1 year, or if a period of more than 1 year has passed since a license was surrendered, the Board may reinstate the license if the licensee: Applies to the Board for reinstatement; Meets the requirements for renewal under § 8–6D–08 of this subtitle; Meets any other requirements for reinstatement as established by the Board in regulations; and Submits to a criminal history records check in accordance with § 8–303 of this title. If a licensee meets the requirements of paragraph (1) of this subsection, the Board shall: Reinstate the license; Reinstate the license subject to terms and conditions that the Board considers necessary, including a period of probation; or Deny reinstatement of the license.

Unless authorized to practice certified midwifery under this subtitle, an individual may not represent to the public by title, description of service, method, procedure, or otherwise, that the individual is authorized to practice certified midwifery in the State. A licensee may not advertise in a manner that is unreasonable, misleading, or fraudulent. Unless authorized to practice certified midwifery under this subtitle, an individual may not use the abbreviation “CM” or use the designation “Certified Midwife” with the intent to represent that the individual practices certified midwifery in the State. Unless an individual is authorized to practice certified midwifery under this subtitle or is a licensed nurse certified as a nurse–midwife or as a direct–entry midwife under this title, an individual may not use the designation “Midwife”.

Except as provided in subsection (b) of this section, the following applies: If a licensed certified midwife knows of an action or condition that might be grounds for action under § 8–316, § 8–6A–10, or § 8–6C–20 of this title or § 8–6D–10 of this subtitle, the licensed certified midwife shall report the action or condition to the Board; and An individual shall have the immunity from liability described under § 5–709 of the Courts Article for making a report required under item (1) of this subsection. If a licensed certified midwife has reason to know that a licensee or certificate holder has committed an action or has a condition that might be grounds for reprimand or probation of the licensee or certificate holder or suspension or revocation of the license or certificate under § 8–316, § 8–6A–10, or § 8–6C–20 of this title or § 8–6D–10 of this subtitle because the licensee or certificate holder has a substance use disorder, the licensed certified midwife is not required to report the licensee or certificate holder to the Board if: The licensed certified midwife knows that the licensee or certificate holder is in an alcohol or drug treatment program that is accredited by the Joint Commission, is certified by the Department, or is under the care of a health care practitioner who is competent and capable of dealing with substance use disorder; The licensed certified midwife is able to verify that the licensee or certificate holder remains in the treatment program until discharge; and The action or condition of the licensee or certificate holder has not caused injury to any individual while the licensee or certificate holder is practicing. An individual is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of patient substance use disorder records.

Except as provided in this section for an action under § 8–6D–10 of this subtitle, any person aggrieved by a final decision of the Board in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act. Any person aggrieved by a final decision of the Board under § 8–6D–10 of this subtitle may not appeal to the Secretary but may take a direct judicial appeal as provided in the Administrative Procedure Act. A Board decision may not be stayed while judicial review is pending.

The authority of the Board established under this subtitle: Vests with the Board at the time an individual applies for certification; Continues during periods of licensure; and Includes authority over an individual holding an expired license, a lapsed license, or a temporary license that has expired under § 8–6D–08 of this subtitle.

Each licensed certified midwife practicing as a licensed certified midwife in the State shall notify a patient in writing or by written electronic communication if: The licensed certified midwife does not maintain professional liability insurance coverage; or The licensed certified midwife’s professional liability insurance coverage has lapsed for any period of time and has not been renewed. The written notification provided to the patient under subsection (a) of this section shall be: Provided: At the first visit by the patient during the period in which the licensed certified midwife does not maintain professional liability insurance, unless the visit is for the purpose of receiving incidental medical care that will be rendered free of charge; and As part of each informed consent obtained before any procedure discussed or offered for the patient’s consideration is performed; Signed by the patient at the time of the patient’s visit or at the time the informed consent is signed; and Retained by the licensed certified midwife as part of the licensed certified midwife’s patient records. Each licensed certified midwife practicing as a licensed certified midwife in the State who does not maintain professional liability insurance coverage shall post this information in a conspicuous location in the licensed certified midwife’s place of practice.

This subtitle may be cited as the Maryland Licensure of Certified Midwives Act.