Midwife hospital‑privileges bill stalls after heated committee debate; sponsors say they will keep negotiating

A contentious debate over midwives’ access to hospital admitting privileges culminated with sponsors and opponents failing to reach consensus and the panel ultimately postponing the bill indefinitely.

What the bill would do: HB 10‑92 would require public hospitals that offer labor and childbirth services and allow admitting privileges to maintain a transparent process for certified nurse midwives (CNMs) and certified midwives (CMs) to apply for admitting privileges. Sponsors said the goal is continuity of care so that a patient’s chosen midwife may continue care if a hospital admission becomes necessary.

Supporters’ case: Representative Luck and co‑sponsor Representative Wilford said the measure targets public hospitals that have created barriers by requiring written collaborative agreements signed by an obstetrician before a midwife can access privileges. Midwives and patient advocates testified that those written agreements have been used in practice to block midwives from admitting their own patients, fracturing continuity during transfers. Nurse midwife Jolene Hammond testified that midwives already meet credentialing standards and urged the committee to remove barriers that require physician signatures.

Opposition and safety concerns: The Colorado Hospital Association, rural‑hospital representatives and medical societies opposed the bill as written. They said hospital credentialing and medical staff bylaws exist to verify training, manage escalation and protect patients in high‑risk settings. Dr. Kim Warner of ACOG and the Colorado Medical Society said credentialing and collaborative pathways are patient‑safety safeguards and said removing written collaborative agreements could create two standards of care.

Amendments tried: Sponsors offered three amendments: L001 (striking the legislative declaration), L002 (rewriting the privilege‑process language to require a hospital process for midwife credentialing but to forbid requiring a physician’s permission as a gatekeeper), and L003 (increasing required malpractice coverage for midwives who hold hospital privileges to $1,000,000 per incident and $3,000,000 aggregate). L002 and L003 were adopted, but the debate about collaborative agreements and clinical governance persisted.

Vote and procedural outcome: The bill was brought to a roll‑call vote; the panel recorded multiple no votes and the bill did not carry. Committee leadership then moved and the committee agreed to permanently postpone the bill (postpone indefinitely) after additional procedural motion. Sponsors said they will continue stakeholder discussions and work to refine the language.

Ending: The hearing reflected sharp divisions over whether legislative direction is needed to ensure continuity of care or whether hospital credentialing processes should be left intact to manage clinical governance. Sponsors argued for patient choice and continuity; hospital groups stressed credentialing, escalation pathways and rural hospital capacity.