20250SB__052096CHP INTRODUCED 2025-02-19 AMENDED_SENATE 2025-03-24 PASSED_ASSEMBLY 2025-09-08 PASSED_SENATE 2025-05-29 ENROLLED 2025-09-10 CHAPTERED 2025-10-11 APPROVED 2025-10-11 FILED 2025-10-11 2025 SB CHP CHP 0 Introduced by Senator Caballero (Coauthors: Senators Becker, Cervantes, Cortese, Ochoa Bogh, and Valladares) (Coauthors: Assembly Members Alanis, Bonta, Carrillo, Davies, Krell, Macedo, Ortega, and Stefani) LEAD_AUTHOR SENATE Caballero COAUTHOR SENATE Becker COAUTHOR SENATE Cervantes COAUTHOR SENATE Cortese COAUTHOR SENATE Ochoa Bogh COAUTHOR SENATE Valladares COAUTHOR ASSEMBLY Alanis COAUTHOR ASSEMBLY Bonta COAUTHOR ASSEMBLY Carrillo COAUTHOR ASSEMBLY Davies COAUTHOR ASSEMBLY Krell COAUTHOR ASSEMBLY Macedo COAUTHOR ASSEMBLY Ortega COAUTHOR ASSEMBLY Stefani

An act to add

Article 7 (commencing with

Section 128570) to

Chapter of Part of Division of the Health and Safety Code, relating to maternal care and services. maternal care and services Nurse-midwifery education program. Existing law creates the Vocational Nurse Education Program within the Department of Health Care Access and Information for persons agreeing to serve in an eligible county health facility, state-operated health facility, or a health workforce shortage area, before completing vocational nursing school. Existing law authorizes a person who qualifies for admission to a vocational nursing program to apply for funding under the program, as specified.

Existing law establishes the Vocational Nurse Education Fund for the purpose of promoting the education of vocational nurses and related administrative costs. This bill would create the California Nurse-Midwifery Education Fund within the department for the purpose of establishing California-based, master’s level, nurse-midwifery education programs within the California State University, the University of California, or both. The bill would require the department to administer the fund, and receive moneys from the General Fund for these purposes upon appropriation by the Legislature.

The bill would require the department to establish a competitive application criteria to ensure the optimal sites selection for the education programs within the California State University system or the University of California, would require the department to ensure that a master’s degree is an option for students as the culminating degree of the education programs receiving funds, and would require the education programs to meet specified requirements.

The bill would also require the fund to support the annual operating costs for the development, operation, and maintenance of the education programs through the graduation of the first cohort of matriculated students, or years, whichever is shorter. MAJORITY NO YES NO NO NO NO NO NO NO NO The people of the State of California do enact as follows:

SECTION 1. The Legislature finds and declares all of the following: (

a) California is experiencing a maternity care access crisis. Over maternity wards in California have closed since 2013, and freestanding birth centers have closed in just over three years. These closures create significant barriers to reproductive health care, and potential risk to birthing people. The closures compound an already significant problem, the obstetrical and reproductive health care workforce shortage in California. (

b) Midwifery care has demonstrated excellent outcomes to improve maternal health. (

c) When midwives are integrated into health systems, we find more spontaneous vaginal birth, labor after cesarean, vaginal birth after cesarean, breastfeeding, patient confidence and control, patient-centered care, and lower cost, and we also see fewer undesirable outcomes, including cesarean birth, operative vaginal delivery, induction of labor, episiotomy, perineal lacerations, use of pain medicine, epidural anesthesia, continuous fetal monitoring, neonatal intensive care unit admissions, preterm birth and low birth weight infants, infant emergency department visits, and hospitalizations and neonatal deaths. (

d) Midwives are also recognized as a component of the solution to address race-based disparities, especially when provided by culturally, linguistically, and racially competent providers. (

e) The supply of California midwives falls short of other high-income countries where birth outcomes are better. Countries with better birth outcomes rely on midwives to provide the safest, highest quality care to healthy people, freeing up physicians to give the highest quality specialty care to high-risk patients. For example, the California maternal mortality rate is 10.5 per 100,000 births and the ratio of midwives to obstetrics physicians is to 3.3. In the Netherlands, the maternal mortality rate is 2.8 per 100,000 births and the ratio of midwife to physician is 2.5 to 1.

In Australia, the maternal mortality rate is 3.5 per 100,000 births and the ratio of midwife to physician is 8.8 to 1. (

f) The Legislature understands and declares that with a robust education pipeline, midwives can provide high-quality outcomes to Californians and fill an urgent need. California currently has only one nurse-midwifery program accepting new students at California State University, Fullerton.

SEC.

Article 7 (commencing with

Section 128570) is added to

Chapter of Part of Division of the Health and Safety Code , to read: 7. Nurse-Midwifery Education Program 128570. (

a) The California Nurse-Midwifery Education Fund is hereby created within the Department of Health Care Access and Information for the purpose of establishing California-based, master’s level, nurse-midwifery education programs within the California State University, the University of California, or both. (

b) The department shall administer the fund. The fund shall receive moneys from the General Fund for the purposes of this

article upon appropriation by the Legislature. (

c) It is the intent of the Legislature for the 2025–26 state fiscal year, for two million dollars ($2,000,000) to be appropriated from the General Fund to the department for use in the California Nurse-Midwifery Education Fund. (

d) The fund may receive donations and contributions from public and private entities, partnerships between public and private entities, fees, cash advances, and transfers from the General Fund. 128571. (

a) The department shall establish competitive application criteria to ensure the optimal sites selection for the education programs within the California State University system or the University of California, including prioritization of programs that serve an area of demonstrated maternity or midwifery workforce need. (

b) The department shall ensure that a master’s degree is an option for students as the culminating degree of the education programs receiving funds. (

c) The education programs shall meet the regulatory requirements for nurse-midwifery education in California and the necessary requirements to be accredited or preaccredited by the Accreditation Commission for Midwifery Education. The programs are not required to be located within a school of nursing. (

d) The fund shall support the annual operating costs for the development, operation, and maintenance of the education programs through the graduation of the first cohort of matriculated students, or five years, whichever is shorter. 128572. Any funds, public or private, received for the fund shall supplement, not supplant, any current or future funding to midwifery workforce education programs, including allocations to midwifery education programs administered through the Song-Brown Health Care Workforce Training Act pursuant to

Article 1 (commencing with

Section 128200) of

Chapter 4. Any funds allocated to the education programs receiving funds shall supplement, not supplant, the university’s budget allocations for any fiscal year.