Physician duties · CNM · Florida
Signing for a Certified Nurse-Midwife in Florida: what the physician takes on
The agreement is mandatory for the clinician, which makes its duties mandatory for you. Florida does not name a specific instrument.
Florida's 2020 autonomous-practice law (§464.0123) includes an explicit CNM carve-out to the full statutory midwifery scope (§464.012(4)(c)) — broader than general NP's primary-care-only autonomy — gated behind the same 3,000-hour/coursework threshold plus a required written emergency transfer-of-care policy for out-of-hospital births.
Independent practice requires: Same numeric thresholds as `np`: ≥3,000 supervised clinical hours within 5 years; 3 semester hours each in differential diagnosis and pharmacology within 5 years; active unencumbered license; no discipline in 5 years; Board-set financial-responsibility coverage once autonomous practice begins ($100,000/claim, $300,000 annual aggregate, via insurance/surplus-lines/risk-retention group/JUA plan/self-insurance/irrevocable letter of credit); For out-of-hospital intrapartum care: a written, patient-signed emergency transfer-of-care policy meeting §464.0123(3)(b)'s content requirements.
What you take on as the physician
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
non-autonomous CNM: No proximity requirement
No explicit on-site/immediate-availability standard codified (unlike CRNA's ASC/hospital on-site rule) — governed instead by the medical-staff-approval/physician-backup structure in §464.012(4)(c) (see agreementRequiredNote) plus the generic phone/communication-device availability language in the standard protocol template.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
non-autonomous CNM: As needed, in person or via telehealth
Not fixed by statute or rule — the Board of Nursing's official protocol template (floridasnursing.gov/forms/aprn-protocol-format.pdf) uses only generic language: parties 'share equally in the responsibility for reviewing treatment protocols as needed,' with the physician 'available by telephone or by other communication device when not physically available.' Actual cadence is whatever the individual protocol specifies.
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
§464.012(4)(c) explicitly authorizes CNMs to order appropriate medications and order/initiate/perform anesthetic procedures — broader than CRNA's administration-only model, tied to obstetric/reproductive-health/newborn scope (family planning, well-woman care). Subject to the general APRN Schedule II 7-day-supply cap (§464.012(3)(a)); no CNM-specific schedule restriction identified.
Written agreement
Required
Branches like `np` — autonomous-registered CNMs need no protocol. Non-autonomous CNMs need a protocol approved by the facility's medical staff (birth center/hospital) OR by a designated physician backup for home births (§464.012(4)(c)) — a facility-approval layer not present in the general NP protocol requirement.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Same framework as `np` — §400.9905(4)(g) applies identically. Note: Florida separately licenses non-nurse midwives under Ch. 467 (Midwifery Practice Act) via the Council of Licensed Midwifery — this entry covers only the APRN/Ch. 464 Certified Nurse-Midwife pathway, a distinct license from Ch. 467's direct-entry midwives.
Legal sources for these rules (5)
- Fla. Stat. § 464.0123(3)(a)2 — Autonomous practice, CNM carve-out
- Fla. Stat. § 464.012(4)(c) — APRN protocol, CNM-specific functions
- Fla. Stat. Ch. 467 — Midwifery (separate non-APRN license, distinguished from CNM)
- Florida DOH — Midwife licensing overview
- Florida Board of Nursing — Official APRN Protocol Format template
What physicians charge for this role
Typical monthly compensation in Florida
$500 – $600
Estimate for one Certified Nurse-Midwife. Standard-tier state.
About Florida's rules
Florida's 2020 autonomous-practice law (§464.0123, ≥3,000 supervised hours + coursework) creates a real independence pathway for NP and CNM — but excludes PMHNP, CRNA, and CNS entirely; CRNA autonomy bills have died three sessions running (2024-2026). Florida has no corporate-practice-of-medicine doctrine (secondary-source consensus) — entity ownership instead turns on the Health Care Clinic Act's §400.9905 exemption mechanics. Supervision ratio/chart-review/meeting-cadence are largely uncodified; PA's 10-supervisee cap is the exception.
Other clinicians in Florida: see the state overview.