; and (ii) has completed— (I) a midwifery education program accredited by the Midwifery Education and Accreditation Council or any other entity recognized by the Department of Education; or (II) the requirements to obtain a Midwifery Bridge Certificate from the North American Registry of Midwives, and maintains the certification by completing any required continuing education for the certification. (F) Licensed midwife The term licensed midwife means, with respect to a State, an individual who is licensed under State law to practice midwifery. (G) Tribally-recognized midwife The term tribally-recognized midwife means an individual who is recognized by an Indian tribe (as defined in section 4 of the Indian Health Care Improvement Act) to practice midwifery for the tribe. (6) Appropriation Out of any funds in the Treasury of the United States not otherwise appropriated, there are appropriated to the Secretary to carry out this subsection $10,000,000 for fiscal year 2020. . 3. Effective date The amendment made by this Act shall take effect on October 1, 2019.