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Page 5 .B. NO. <br /> 1 licensed midwives do not reside in Hawai'i at all. Equitable balancing and assurance of access <br /> 2 to licensure for Hawai'i residents is important. <br /> 3 6. Justice. Since licensure began in 2019,new scholarly data clarified that people of <br /> 4 color experience systemic injustice at disproportionate rates. Meaningful choices about where, <br /> 5 how, and with whom to birth are constrained when those who are needed to help enact those <br /> 6 choices face legal penalties for doing so, and the birthing person could also be implicated. Fear <br /> 7 of systemic discrimination has resulted in some birthing people in Hawai`i choosing to give <br /> 8 birth with no assistance, rather than risk potential systemic repercussions from use of an <br /> 9 unlicensed provider. It is therefore urgent that systemic barriers to birth support be removed, to <br /> 10 ensure both safety and increased systemic justice. <br /> 11 7. Diversity. The White House Blueprint for Addressing the Maternal Health Crisis <br /> 12 (June, 2022) is clear that"The lack of diversity in clinical providers and non-clinical workers is <br /> 13 troubling, especially given studies that show how beneficial care from diverse providers can be, <br /> 14 especially for women of color." A diversity of practices are needed in order to address the <br /> 15 current maternal health crisis in Hawai`i and meet the needs of Hawai`i`s multicultural and <br /> 16 rural communities. Since licensure began in 2019, it has become clear that there is a very broad <br /> 17 spectrum of cultural,religious, and historically traditional birth practices in Hawai`i, outside of <br /> 18 licensed clinical midwife practice. Diversification of legally available options is urgently <br /> 19 needed to protect cultural practices, ensure reproductive autonomy, increase access to care, and <br /> 20 improve health outcomes and mortality rates. <br /> 21 The Hawaii Regulatory Licensing Reform Act, HRS Chapter 26H requires the State to <br /> 22 regulate professions only"when the health, safety, or welfare of the consumer may be <br /> 23 jeopardized by the nature of the service"based upon"evidence of abuses by providers of the <br /> 5 <br />