Bill Summary – FastDemocracy

SENATE BILL NO. 301
     April 27, 2023, Introduced by Senators GEISS, ANTHONY, SANTANA, CHANG,
       CAVANAGH, MCMORROW, BAYER, WOJNO, SHINK and MCCANN and referred to the
       Committee on Health Policy.
          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
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 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.
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       (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,
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 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
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 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
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 333.1101 to 333.25211.
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Statutes affected: 
Senate Introduced Bill: 400.1, 400.119