Bill Text: MI SB0301 | 2023-2024 | 102nd Legislature | Introduced
Bill Title: Human services: medical services; coverage for doula services; require. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 109o.
Spectrum: Partisan Bill (Democrat 11-0)
Status: (Introduced) 2023-04-27 - Referred To Committee On Health Policy [SB0301 Detail]
Download: Michigan-2023-SB0301-Introduced.html
SENATE BILL NO. 301
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
(MCL 400.1 to 400.119b) by adding section 109o.
the people of the state of michigan enact:
Sec. 109o. (1) An individual who is eligible for medical assistance and who is an expectant mother may receive doula services before, during, and after childbirth. Medical assistance will cover different types of doula services, including, but not limited to, community-based doulas, prenatal doulas, labor and birth doulas, and postpartum doulas.
(2) As required by federal regulations at CFR 440.130(c), doula services must be recommended by a health care provider, including, but not limited to, a licensed practical nurse, registered nurse, social worker, midwife, certified nurse midwife, nurse practitioner, physician assistant, or physician. The health care provider recommending doula services is not required to be part of the recipient's health care team, but collaboration is highly encouraged.
(3) Dependent on person-centered needs, doula support during the perinatal period may include, but is not limited to, the following:
(a) Prenatal services that include the following:
(i) Promoting health literacy and knowledge.
(ii) Assisting with the development of a birth plan.
(iii) Supporting personal and cultural preferences around childbirth.
(iv) Providing emotional support and encouraging self-advocacy.
(v) Reinforcing practices known to promote positive outcomes such as breastfeeding.
(vi) Identifying and addressing social determinants of health.
(vii) Coordinating referrals to community-based support services, including, but not limited to, the women, infants and children program (WIC), behavioral health services, transportation, and home visiting services.
(b) Labor and delivery services that include the following:
(i) Providing continual physical comfort measures, information, and emotional support.
(ii) Advocating for beneficiary needs.
(iii) Being an active member of the birth team.
(c) Postpartum services that include the following:
(i) Providing education regarding newborn care, nutrition, and safety.
(ii) Supporting breastfeeding.
(iii) Providing emotional support and encouraging self-care measures.
(iv) Supporting the recipient in attending recommended medical appointments.
(v) Identifying and addressing social determinants of health.
(vi) Coordinating referrals to community-based support services, including, but not limited to, the women, infants and children program (WIC), behavioral health services, transportation, and home visiting services.
(vii) Grief support services.
(4) Doula services must be provided on a face-to-face basis with the recipient, except that prenatal and postpartum services may be provided via telehealth. A doula provider must follow current department policy regarding telemedicine.
(5) Doula services may include a maximum of 6 total visits during the prenatal and postpartum periods and 1 visit for attendance at labor and delivery. All prenatal and postpartum visits must be at least a minimum of 20 minutes in duration with a recipient to be considered eligible for reimbursement. Additional visits beyond the limits described in this subsection may be requested through the prior authorization process. A health care provider should contact the Medicaid health plan regarding the prior authorization requirements.
(6) A doula must be physically present during labor, delivery, and the immediate postpartum period in order for the visit to be a qualifying visit for attendance at labor and delivery.
(7) Documentation for doula services must include a start time and end time of services provided, a description of the professional services rendered, and information regarding the source of the health care provider recommendation for services. Documentation must be kept in accordance with the record-keeping requirements of the medical assistance program and may be subject to review and postpayment audit.
(8) An individual qualified to be a doula must be at least 18 years of age and possess a high school diploma or equivalent. The department shall certify doulas who have completed training provided by a department-approved doula training program or organization. A doula must provide proof of training to the department on request. At a minimum, a doula training program must include skill development in the following areas:
(a) Communication, including active listening, cross-cultural communication, and interprofessional communication.
(b) Perinatal self-care measures.
(c) Coordination of and linkage to community services and resources.
(d) Labor and coping strategies.
(e) Newborn care and supportive measures.
(9) A doula provider is expected to work within their scope of training. The department, with community input, must continue to review doula training programs, including those created for specific populations to support cultural and community needs. The department shall continue to research pathways for legacy certification, or certification for a doula by providing proof of experience in lieu of training, within the confines of state and federal regulations.
(10) A doula provider seeking reimbursement for professional doula services provided to medical assistance recipients must be medical-assistance-enrolled providers. A doula providing services to a medical assistance recipient is required to register with the department doula registry to enroll as a medical assistance provider.
(11) As used in this section:
(a) "Certified nurse midwife" means an individual who is licensed as a registered professional nurse under part 172 of the public health code, MCL 333.17201 to 333.17242, who has been granted a specialty certification in the practice of nurse midwifery by the Michigan board of nursing under section 17210 of the public health code, MCL 333.17210.
(b) "Doula" means a professional trained in childbirth who provides continuous physical, emotional, and informational support to an expectant mother.
(c) "Health care provider" means any of the following:
(i) A health professional licensed or registered under article 15 of the public health code, MCL 333.16101 to 333.18838.
(ii) A health facility or agency licensed under article 17 of the public health code, MCL 333.20101 to 333.22260.
(iii) A local health department as that term is defined in section 1105 of the public health code, MCL 333.1105.
(d) "Midwife" means an individual licensed under part 171 of the public health code, MCL 333.17101 to 333.17123 to engage in the practice of midwifery.
(e) "Public health code" means the public health code, MCL 333.1101 to 333.25211.
