BILL NUMBER: S9868
SPONSOR: BROUK
 
TITLE OF BILL:
An act to establish a work group to set reimbursement rates for doulas
in the state Medicaid program and address other criteria related to
their practice
 
PURPOSE:
The purpose of this legislation is to establish a work group composed of
majority doulas and other multidisciplinary experts to examine and study
the benefits, costs, and issues related to Medicaid reimbursement for
doulas providing doula care services to Medicaid recipients across the
state.
 
SUMMARY OF PROVISIONS:
Section 1. Declares work group purpose.
Section 2. Establishes the work group.
Section 3. Details work group composition.
Section 4. Describes work group compensation and reimbursement.
Section 5. Sets appointment timeframe.
Section 6. Describes work group duties.
Section 7. Establishes final report deadline.
Section 8. Sets the effective date.
 
JUSTIFICATION:
Historically excluded and low-income communities in the United States
are at disproportionately higher risks of poor birth outcomes, maternal
mortality, and other pregnancy-related complications. On April 13, 2022,
the New York State Department of Health released a report titled New
York State Report on Pregnancy Associated Deaths in 2018, detailing the
state of maternal health affairs in the state. According to the report,
from 2016-2018, New York improved to 23rd in the United States with a
maternal mortality rate of 18.1 deaths per 100,000 lives versus the rate
of 24.4 per 100,000 between 2008-2010. While the decreased rate is
noticeable, BIPOC pregnant people experienced pregnancy-related deaths
four to five times more compared to non-Hispanic or white pregnant
people.
The emerging popularity of doula care is one of the promising approaches
in addressing maternal health and combating maternal health disparities.
Research suggests that a doula's presence during pregnancy, birth, and
the postpartum period have resulted in decreases in negative birthing
outcomes and have subsequently led to reduced impacts of racism and
racial bias in health care on pregnant people of color by providing
birthing patients with culturally appropriate, individually tailored,
and patient-centered advocacy.
Further, in 2019, the Department of Health launched a Doula Medicaid
pilot program to target high maternal mortality rates and reduce racial
disparities in health outcomes in Erie County. The pilot program
accounted for 760 people enrolling in one of six different Medicaid Care
Plans or Medicaid-Fee-for-Service have participated in the pilot
programs. The pilot programs covered up to four visits with a doula
before delivery, up to four visits with the doula after delivery, and
doula support during labor and delivery. While the doula pilot program
primarily focused on Erie County and its high maternal mortality rates,
the intent and purpose of this legislation is to create a Medicaid
reimbursement work group that would identify and examine a framework
that would provide New York's Medicaid recipients with quality doula
care services while simultaneously providing doulas with equitable and
sustainable reimbursements for their services.
 
LEGISLATIVE HISTORY:
2022: S8967 Committed to Rules
2023: S1876 Reported and committed to Finance.
2024: S1876 Referred to Health.
 
FISCAL IMPLICATIONS:
To be determined.
 
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it shall have
become a law.