Florida 2025 Regular Session

Florida House Bill H0747 Compare Versions

Only one version of the bill is available at this time.

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10	10	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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14	14	A bill to be entitled 1
15	15	An act relating to doula services in maternal health 2
16	16	initiatives; creating s. 383.295, F.S.; defining 3
17	17	terms; establishing the pilot program in Broward, 4
18	18	Miami-Dade, and Palm Beach Counties for a specified 5
19	19	purpose; providing aims of the pilot program; 6
20	20	requiring the Department of Health, in collaboration 7
21	21	with its maternal and child health section, to 8
22	22	implement and oversee the pilot program; specifying 9
23	23	the duration of the pilot program, subject to funding; 10
24	24	requiring the pilot program to target specified 11
25	25	populations for enrollment; specifying services that 12
26	26	will be provided under the pilot program; requiring 13
27	27	the department to collaborate with specified entities 14
28	28	to integrate doula services into existing maternal 15
29	29	health programs and facilitate outreach and service 16
30	30	delivery; authorizing the department to integrate 17
31	31	doula services into existing maternal and child health 18
32	32	programs as an expansion of the pilot program, s ubject 19
33	33	to certain requirements; providing for funding of the 20
34	34	pilot program; providing an effective date. 21
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36	36	WHEREAS, preterm birth is defined as a live birth before 37 23
37	37	completed weeks of gestation and is associated with increased 24
38	38	morbidities or ailments , such as cerebral palsy, breathing 25
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47	47	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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51	51	difficulties, feeding problems, developmental delay, and vision 26
52	52	and hearing problems, and 27
53	53	WHEREAS, preterm labor occurs when regular contractions 28
54	54	cause the cervix to open between 20 and 37 weeks of gestation, 29
55	55	which can result in a baby being born before 37 weeks of 30
56	56	gestation, and the earlier the delivery, the greater the health 31
57	57	risks for the baby, requiring special care in a neonatal 32
58	58	intensive care unit and potentially causing long -term mental and 33
59	59	physical health concern s, and 34
60	60	WHEREAS, Florida's preterm birth rate has risen annually 35
61	61	since 2014 to its current average rate of 10.9 percent, higher 36
62	62	than the national average of 10.5 percent, and 37
63	63	WHEREAS, Florida ranks among the highest in the nation for 38
64	64	infant mortality, wit h a rate of 5.9 deaths per 1,000 births, 39
65	65	higher than the national average of 5.4 deaths per 1,000 births, 40
66	66	and 41
67	67	WHEREAS, Florida also has one of the highest cesarean 42
68	68	delivery rates in the nation at 37.4 percent, compared to the 43
69	69	national average of 31.8 perc ent, with cesarean delivery being 44
70	70	associated with increased risks to infants, including 45
71	71	respiratory distress, infection, and long -term health 46
72	72	complications, and 47
73	73	WHEREAS, maternal mortality is defined as the annual number 48
74	74	of female deaths from any cause re lated to or aggravated by 49
75	75	pregnancy or its management, excluding accidental or incidental 50
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84	84	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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88	88	causes, during pregnancy and childbirth or within 42 days after 51
89	89	termination of a pregnancy, irrespective of the duration and 52
90	90	site of the pregnancy, and 53
91	91	WHEREAS, Florida ranks 17th in the nation with a maternal 54
92	92	mortality rate of 26.3 deaths per 100,000 births, compared to a 55
93	93	national rate of 23.2 deaths per 100,000 births, and 56
94	94	WHEREAS, Broward County has a maternal mortality rate of 57
95	95	24.8 deaths per 100,000 live births, and an infant mortality 58
96	96	rate of 5 deaths per 1,000 live births, and 59
97	97	WHEREAS, Miami-Dade County has a maternal mortality rate of 60
98	98	20.3 deaths per 100,000 live births, and an infant mortality 61
99	99	rate of 4.8 deaths per 1,000 live births, and 62
100	100	WHEREAS, Palm Beach County has a maternal mortality rate of 63
101	101	33.2 deaths per 100,000 live births, and an infant mortality 64
102	102	rate of 5.4 deaths per 1,000 live births, and 65
103	103	WHEREAS, continued perinatal support, including the 66
104	104	services provided by trained doulas, is associated wit h reduced 67
105	105	rates of cesarean delivery and improved birth outcomes, and 68
106	106	WHEREAS, Florida has ongoing challenges related to child 69
107	107	safety and welfare, with statistics showing disparities in 70
108	108	health and safety outcomes for children across racial and 71
109	109	socioeconomic groups, and 72
110	110	WHEREAS, doula care is the continuous, one -to-one 73
111	111	emotional, informational, and physical support provided by a 74
112	112	trained nonmedical professional to pregnant women and their 75
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121	121	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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125	125	families during pregnancy, labor, and the postpartum period, and 76
126	126	WHEREAS, while doulas do not perform medical tasks, they 77
127	127	provide an array of educational and support services throughout 78
128	128	the birthing process to ensure that the mother has a positive 79
129	129	and empowering experience, including, but not limited to, 80
130	130	educational resources and information about pregnancy, 81
131	131	childbirth, and postpartum care; assistance in creating a birth 82
132	132	plan; continuous emotional support during labor and delivery; 83
133	133	assistance with breathing techniques, relaxation, and 84
134	134	positioning during labor; massage and c ounterpressure measures; 85
135	135	facilitation of communication with medical staff; advocacy in 86
136	136	and navigation of the medical setting; and postpartum support 87
137	137	with newborn care and feeding, and 88
138	138	WHEREAS, evidence-based support provided by trained doulas 89
139	139	has been shown to enhance birth experiences, reduce cesarean 90
140	140	deliveries, and improve overall health outcomes for mothers and 91
141	141	infants, and 92
142	142	WHEREAS, the state has a compelling interest in improving 93
143	143	maternal and infant outcomes through increased access to high -94
144	144	quality doula services, NOW, THEREFORE, 95
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146	146	Be It Enacted by the Legislature of the State of Florida: 97
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148	148	Section 1. Section 383.295, Florida Statutes, is created 99
149	149	to read: 100
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158	158	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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162	162	383.295 Doulas.— 101
163	163	(1) DEFINITIONS.—As used in this section, the term: 102
164	164	(a) "Department" means the Department of Health. 103
165	165	(b) "Doula" means a nonmedical professional who provides 104
166	166	health education, advocacy, and physical, emotional, and 105
167	167	nonmedical support for pregnant and postpartum women before, 106
168	168	during, and after childbirth, including support during 107
169	169	miscarriage and stillbirth. Doulas are not licensed or clinical 108
170	170	providers, and they do not require supervision. 109
171	171	(c) "Doula services" means the provision of physical, 110
172	172	emotional, and informational support by a nonmedical 111
173	173	professional to a pregnant woman during the prenatal, 112
174	174	intrapartum, and postpartum periods. Activities may include 113
175	175	childbirth education, labor support, postpartum recovery 114
176	176	support, assistance with infant care, lactation support, and 115
177	177	connection to community resources. 116
178	178	(d) "Evidence-based" means a process in which decisions 117
179	179	are made and actions or activities are carried out, based on the 118
180	180	best evidence available, with the goal of removing subjective 119
181	181	opinion, unfounded beliefs, or bias from decisions and actions. 120
182	182	Such evidence may inclu de practitioner experience and expertise 121
183	183	as well as feedback from other practitioners and beneficiaries. 122
184	184	(2) PILOT PROGRAM ESTABLISHED. — 123
185	185	(a) The Doula Support for Healthy Births pilot program is 124
186	186	established in Broward, Miami -Dade, and Palm Beach Counti es to 125
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195	195	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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197	197
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199	199	integrate doula services into existing maternal health 126
200	200	initiatives, targeting parents who are uninsured, underinsured, 127
201	201	or eligible for Medicaid or the Special Supplemental Nutrition 128
202	202	Program for Women, Infants, and Children (WIC). 129
203	203	(b) The purpose of the pilot program is to improve birth 130
204	204	outcomes by decreasing preterm birth rates and cesarean 131
205	205	deliveries, enhancing access to care, and supporting maternal 132
206	206	well-being throughout the pregnancy, labor, and postpartum 133
207	207	periods using evidence -based methods. 134
208	208	(c) The Department of Health shall work in collaboration 135
209	209	with its maternal and child health section to implement and 136
210	210	oversee the pilot program. 137
211	211	(3) PROGRAM STRUCTURE. — 138
212	212	(a) The pilot program may operate for 12 to 24 months, 139
213	213	subject to funding. 140
214	214	(b) The pilot program shall target the enrollment of 141
215	215	uninsured and underinsured pregnant women, WIC participants, and 142
216	216	Medicaid-eligible parents. 143
217	217	(c) The following support services must be offered under 144
218	218	the pilot program: 145
219	219	1. Prenatal support. —Educational resources, personalized 146
220	220	birth plans, and emotional support. 147
221	221	2. Labor support.—Continuous emotional support, comfort 148
222	222	measures, and communication facilitation. 149
223	223	3. Postpartum support. —Assistance with newborn care, 150
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232	232	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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236	236	postpartum resources, and household tasks. 151
237	237	4. Advocacy support.—Assistance with preferences and needs 152
238	238	within medical settings and health care navigation. 153
239	239	5. Emotional support. —Comprehensive emotional support 154
240	240	during the pregnancy and postpartum periods. 155
241	241	(4) COLLABORATION; INTEGRATION. — 156
242	242	(a) The department shall collaborate with: 157
243	243	1. Health care providers, community organizations, 158
244	244	community coalitions, and advocacy groups to integrate doulas 159
245	245	and doula services into existing maternal health programs, 160
246	246	ensuring that such doulas are trained and meet all of the 161
247	247	following criteria: 162
248	248	a. Demonstrate a strong understanding of the reproductive 163
249	249	system, labor process, and postpartum recovery. 164
250	250	b. Are proficient in hands -on techniques such as massage, 165
251	251	counterpressure, breathing exercises, and nonmedicated pa in 166
252	252	management. 167
253	253	c. Support a client's birth plan, communicate effectively 168
254	254	with medical staff, and advocate for informed consent. 169
255	255	d. Provide guidance on breastfeeding, basic newborn care, 170
256	256	and both the physical and emotional aspects of postpartum 171
257	257	recovery. 172
258	258	e. Use active listening, clear communication, and conflict 173
259	259	resolution skills in interactions with clients and health care 174
260	260	providers. 175
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269	269	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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273	273	f. Understand common medical complications and provide 176
274	274	emotional and physical support to clients in challengi ng 177
275	275	situations. 178
276	276	g. Uphold professionalism, ethical decisionmaking, and 179
277	277	legal responsibilities in doula practice. 180
278	278	2. Local WIC programs, hospitals, birth centers, and 181
279	279	community health centers to facilitate outreach and service 182
280	280	delivery. 183
281	281	(b) The department may integrate doula services into 184
282	282	existing maternal and child health programs as an expansion of 185
283	283	the pilot program, focusing on uninsured, underinsured, and 186
284	284	Medicaid populations. Any such expansion of the pilot program 187
285	285	must include annual reporting req uirements for the department to 188
286	286	evaluate effectiveness, equity, and quality of integrating doula 189
287	287	services into the existing maternal and child health programs. 190
288	288	(5) FUNDING.—The pilot program shall be funded using 191
289	289	appropriations for the Closing the Gap gr ant program established 192
290	290	under ss. 381.7351-381.7356. The department shall collaborate 193
291	291	with its Division of Community Health Promotion and Office of 194
292	292	Minority Health and Health Equity to seek additional federal 195
293	293	funds to support implementation. 196
294	294	Section 2. This act shall take effect upon becoming a law. 197
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