Present law requires medical assistance, including programs and projects designed to enhance the efficient and economic operation of the TennCare program, to be provided to eligible individuals. This medical assistance, in regard to the amount, scope, and duration, includes multiple types of medical services.
This bill adds to the list of available medical services doula services performed by a person who has received a certification to perform such services from the department of health. "Doula services" refers to a service that provides continuous emotional and physical support throughout labor and birth, and intermittently during the prenatal and postpartum periods.
This bill requires the department to establish a process by which the department may certify a person who has met either of the following requirements:
(1) Received a certification to perform doula services from certain associations or organizations listed in the bill; or
(2) Demonstrated (A) an understanding of basic anatomy and physiology as related to pregnancy, the childbearing process, breastfeeding or chestfeeding, and the postpartum period; (B) the capacity to employ different strategies for providing emotional support, education, and resources during the perinatal period; (C) knowledge of and the ability to assist families with utilizing a wide variety of nonclinical labor coping and physical comfort strategies; (D) Demonstrated an awareness of strategies to foster effective communication between clients, their families, support services, and healthcare providers; and (E) knowledge of community-based, publicly funded and federally, and clinical resources available to the client for any need outside the doula’s scope of practice.
Present law provides that, with respect to TennCare recipients determined to be medically needy, all or part of the medical services under the TennCare program may be made available. This bill amends this provision by requiring doula services to be provided to such medically needy recipients.
ON MARCH 30, 2023, THE SENATE ADOPTED AMENDMENT #2 AND RE-REFERRED SENATE BILL 394, AS AMENDED, TO THE SENATE GOVERNMENT OPERATIONS COMMITTEE.
AMENDMENT #2 rewrites this bill to create a five-member doula services advisory committee. The full text of this bill specifies various responsibilities for the advisory committee. Generally, the advisory committee will:
(1) Advise the department of health by establishing core competencies and standards for the provision of doula services in this state; and
(2) Recommend reimbursement rates and fee schedules for TennCare reimbursement for doula services.
For purposes of this amendment:
(1) "Doula" means a birth worker who provides child birth education, advocacy, and physical, emotional, and nonmedical support for pregnant and postpartum women before, during, and after childbirth and loss; and
(2) "Doula services" means at least three prenatal appointments, continuous labor support during birth, and at least three postpartum appointments with a pregnant woman.
The advisory committee will consist of the following members:
(1) The commissioner of health, or the commissioner's designee with experience in maternal health or medicaid policy;
(2) The director of TennCare, or the director's designee;
(3) Two community-based doulas, to be appointed by the commissioner of health or the commissioner's designee, who have documented experience providing services to medicaid recipients or women in areas in this state with high rates of maternal and infant mortality; and
(4) One doula, to be appointed by the commissioner of health or the commissioner's designee, who has documented experience providing services to medicaid recipients.
The full text of this amendment specifies various procedural processes for the advisory committee, such as filling vacancies, attendance requirements, and selection of officers.
The advisory committee will cease to exist on July 1, 2026; however, the advisory committee will be subject to governmental entity review.
ON APRIL 13, 2023, THE SENATE ADOPTED AMENDMENT #3 AND PASSED SENATE BILL 394, AS AMENDED.
AMENDMENT #3 rewrites this bill to create a five-member doula services advisory committee. The full text of this bill specifies various responsibilities for the advisory committee. Generally, the advisory committee will:
(1) Advise the department of health by establishing core competencies and standards for the provision of doula services in this state; and
(2) Recommend reimbursement rates and fee schedules for TennCare reimbursement for doula services.
For purposes of this amendment:
(1) "Doula" means a birth worker who provides child birth education, advocacy, and physical, emotional, and nonmedical support for pregnant and postpartum women before, during, and after childbirth and loss; and
(2) "Doula services" means at least three prenatal appointments, continuous labor support during birth, and at least three postpartum appointments with a pregnant woman.
The advisory committee will consist of the following members:
(1) The commissioner of health, or the commissioner's designee with experience in maternal health or medicaid policy;
(2) The director of TennCare, or the director's designee;
(3) Two community-based doulas, to be appointed by the commissioner of health or the commissioner's designee, who have documented experience providing services to medicaid recipients women in areas in this state with high rates of maternal and infant mortality; and
(4) One doula, to be appointed by the commissioner of health or the commissioner's designee, who has documented experience providing services to medicaid recipients.
The full text of this amendment specifies various procedural processes for the advisory committee, such as filling vacancies, attendance requirements, and selection of officers.
The advisory committee will cease to exist on July 1, 2026.

Statutes affected:
Introduced: 71-5-107(a), 71-5-107, 71-5-107(b)