HLS 25RS-334 ORIGINAL
2025 Regular Session
HOUSE BILL NO. 514
BY REPRESENTATIVE WILLARD
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
INSURANCE/HEALTH: Modifies the Louisiana Doula Registry Board within the
Louisiana Department of Health and provides for respective regulatory authority
1 AN ACT
2To amend and reenact R.S. 22:1059.1, relative to the Louisiana Doula Registry Board; to
3 provide for board composition; to provide with respect to the regulatory authority of
4 the Louisiana Doula Registry Board and the Louisiana Department of Health; to
5 provide relative to administrative staff and further rulemaking requirements of the
6 Louisiana Department of Health; and to provide for related matters.
7Be it enacted by the Legislature of Louisiana:
8 Section 1. R.S. 22:1059.1 is hereby amended and reenacted to read as follows:
9 §1059.1. Legislative findings; Louisiana Doula Registry Board; purpose;
10 composition; duties of the board; administrative staff; rulemaking authority
11 A.(1) The legislature hereby finds and declares that research indicates
12 maternal mortality, severe maternal morbidity, infant mortality, preterm birth, and
13 unexpected outcomes of pregnancy and birth resulting in significant health
14 consequences are rising in the United States, and that these outcomes occur more
15 frequently in Louisiana than in other states. Louisiana has the highest maternal death
16 rate in the nation and the second highest infant death rate in the nation.
17 (2) The benefits of doula care have been documented in numerous studies
18 including the 2017 Cochrane Review of twenty-six trials of continuous labor support
19 and doula care involving over fifteen thousand women in seventeen different
20 countries. The numerous benefits of doula care include decreased cesarean sections,
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1 increased spontaneous vaginal births, shortened duration of birth, increased maternal
2 satisfaction postpartum, improved breastfeeding rates, and lower rates of preterm
3 labor and low birth weight.
4 B.(1)(a) The legislature hereby creates within the Louisiana Department of
5 Health the Louisiana Doula Registry Board, hereafter referred to in this Section as
6 the "doula registry board", for the purpose of reviewing and approving doula
7 registration to allow for health insurance reimbursement of doula services.
8 (b) The doula registry board shall create the criteria for the registration
9 application, review submitted doula registration applications, and grant registration
10 status to doulas seeking health insurance reimbursement to promote safe and
11 equitable care for every mother and every birth in this state.
12 (2) For purposes of this Section, "doula" means an individual who has been
13 trained to provide physical, emotional, and educational support, but not medical or
14 midwifery care, to pregnant and birthing women and their families before, during,
15 and after childbirth.
16 C. B. The doula registry board shall perform all of the following tasks:
17 (1) Review applications for doulas to register to receive health insurance
18 reimbursement in Louisiana Independently review and approve applications for
19 doulas seeking registration to receive health insurance reimbursement in this state.
20 The doula registry board shall oversee and manage the entire registration process to
21 ensure fairness, transparency, and accessibility for all qualified doulas.
22 (2) Approve applications to designate registered doula status Establish and
23 enforce administrative guidelines for the registration process, ensuring that all
24 requirements align with best practices in maternal health and doula care.
25 (3) Notify applicants of approval or denial of doula registration status
26 Develop and implement policies that promote safe and equitable care for every
27 woman giving birth in this state, reinforcing the doula profession’s integrity and
28 autonomy.
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1 (4) Maintain a statewide registry of doulas approved for health insurance
2 reimbursement in Louisiana.
3 D. C.(1) The doula registry board shall be composed of the following
4 members:
5 (a) One representative of an organization providing doula services for people
6 giving birth in Louisiana in Region 1 appointed by the medical director of the
7 Louisiana Perinatal Quality Collaborative Seven individuals who serve as a doula for
8 births in this state from different geographic regions in the state, two of whom shall
9 represent an organization providing doula services.
10 (b) One representative of an organization providing doula services for people
11 giving birth in Louisiana in Region 2 appointed by the medical director of the
12 Louisiana Perinatal Quality Collaborative.
13 (c) One representative of an organization providing doula services for people
14 giving birth in Region 3 appointed by the medical director of the Louisiana Perinatal
15 Quality Collaborative.
16 (d) One representative of an organization providing doula services for people
17 giving birth in Louisiana in Region 4 appointed by the medical director of the
18 Louisiana Perinatal Quality Collaborative.
19 (e) One representative of an organization providing doula services for people
20 giving birth in Louisiana in Region 5 appointed by the medical director of the
21 Louisiana Perinatal Quality Collaborative.
22 (f) One representative of an organization providing doula services for people
23 giving birth in Louisiana in Region 6 appointed by the medical director of the
24 Louisiana Perinatal Quality Collaborative.
25 (g) One representative of an organization providing doula services for people
26 giving birth in Louisiana in Region 7 appointed by the medical director of the
27 Louisiana Perinatal Quality Collaborative.
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1 (h) One representative of an organization providing doula services for people
2 giving birth in Louisiana in Region 8 appointed by the medical director of the
3 Louisiana Perinatal Quality Collaborative.
4 (i) One representative of an organization providing doula services for people
5 giving birth in Louisiana in Region 9 appointed by the medical director of the
6 Louisiana Perinatal Quality Collaborative.
7 (j) (b) One person woman with lived experience having used doula services
8 for at least two births of birth under doula care.
9 (k) One doula with lactation training.
10 (l) One representative from Sista Midwife Productions.
11 (m) One representative from Community Birth Companion.
12 (n) One representative from Birthmark Doula Collective.
13 (o) One representative from H.E.R. Institute.
14 (c) The Quality Initiatives Manager of the Louisiana Department of Health
15 bureau of family health or a designee.
16 (2) Members of the doula registry board shall be appointed by the medical
17 director of the Louisiana Perinatal Quality Collaborative or a designee.
18 (2) (3) The doula registry board shall elect from among its members a
19 practicing doula as chairperson. In addition, the doula registry board may designate
20 any other officers it deems necessary from its membership.
21 (3) (4) Members of the doula registry board shall serve without
22 compensation for up to for a term of two years with the option for reappointment.
23 Members of the doula registry board shall receive no salary for their services but
24 may be reimbursed in accordance with travel regulations of the division of
25 administration.
26 (4) (5) The doula registry board shall hold quarterly public meetings unless
27 otherwise provided by vote of the doula registry board or by order of the chairperson.
28 The chairperson shall dismiss from the board any members who are absent from
29 more than three in-person meetings within a calendar year.
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1 (5) (6) The doula registry board may establish subcommittees and appoint
2 persons to those subcommittees, including persons who are not board members, nor
3 voting members, as it deems necessary and appropriate to accomplish its goals.
4 E. D. Members of the nonvoting subcommittee shall include and are not
5 limited to all of the following:
6 (1) One representative of New Orleans Breastfeeding Center.
7 (2) One representative of March of Dimes.
8 (3) One representative of National Birth Equity Collaborative.
9 (4) One representative of Institute of Women & Ethnic Studies.
10 (5) One obstetrician with demonstrated work rooted in community, health
11 equity, and training in equitable practices.
12 (6) One certified professional midwife.
13 (7) One certified nurse midwife.
14 (8) One community nurse practitioner.
15 (9) One representative from Louisiana Medicaid.
16 (10) One representative from Louisiana Hospital Association.
17 (11) One representative from each private health insurer in Louisiana as
18 determined by the doula registry board.
19 F. The regional representatives described in Paragraph (D)(1) of this Section
20 shall be appointed from the regions specified on the Administrative Regions and
21 Districts map of the Louisiana Department of Health, hereinafter referred to as the
22 "department".
23 G. E. The department Louisiana Department of Health, hereafter referred to
24 in this Section as the "department", shall promulgate and adopt all such rules in
25 accordance with the Administrative Procedure Act as are necessary to implement the
26 provisions of this Section and shall implement and administer the provisions of this
27 Section as directed by the doula registry board, ensuring that the board retains full
28 oversight over regulatory actions.
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1 H. F.(1) The role of the department is strictly administrative and does not
2 supersede the authority of the doula registry board in establishing criteria, reviewing
3 applications, or setting policies. The doula registry board has sole authority to set
4 criteria and standards for doula registration.
5 (2) The department shall not independently determine an applicant’s
6 eligibility for registration. The department shall review all applications prior to
7 sending to the doula registry board to ensure that applicants are eligible under
8 board-established guidelines.
9 (3) The department shall provide staff support administrative staff to support
10 the doula registry board. Assigned administrative staff shall do all of the following:
11 (a) Facilitate the process for registration of doulas as established by the doula
12 registry board.
13 (b) Ensure that all administrative guidelines align with the policies set forth
14 by the doula registry board.
15 (c) Provide logistical support in processing applications with the doula
16 registry board retaining full decision-making authority on all application approvals
17 and denials.
18 (d) Issue notifications of approval or denial of doula registration status only
19 after a decision is made by the doula registry board and in accordance with
20 board-established procedures.
21 I. G. Nothing in this Section prohibits any person from practicing as a doula
22 in this state, regardless of whether such person is registered in accordance with the
23 provisions of this Section.
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DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 514 Original 2025 Regular Session Willard
Abstract: Modifies the La. Doula Registry Board and provides regulatory authority and
restrictions relative to the La. Doula Registry Board and La. Dept. of Health.
Present law provides for the La. Doula Registry Board (board) within the La. Dept. of Health
(LDH). Outlines legislative findings and provides the board’s purpose, composition, and
duties. Proposed law deletes legislative findings and generally retains present law.
Present law requires the board to review applications for doulas registering to receive health
insurance reimbursement in the state of La.; approve or deny such applications; notify
applicants of approval or denial of doula registration status; and maintain a statewide registry
of doulas approved for health insurance reimbursement. Proposed law deletes present law.
Proposed law grants the board full authority to independently review and approve
applications for doulas seeking registration to receive health insurance reimbursement;
oversee and manage the registration process; establish and enforce administrative guidelines
for registration; and develop and implement policies that promote fairness, transparency,
safety, equitable care, and accessibility.
Present law requires board membership to include certain members of doula services
organizations who represent all specified LDH regions of the state. Further requires
membership to include a doula with lactation training, a person who has used a doula for at
least two births, and representatives from certain organizations that provide education and
community support services relative to maternal health. Proposed law deletes present law.
Proposed law requires the board to consist of seven individuals who serve as doulas within
different geographic regions in the state of La., with two representing an organization
providing doula services. Further requires board membership to include one woman with
lived experience of birth under doula care and the Quality Initiative Manager of the bureau
of family health within LDH.
Proposed law requires the medical director of the La. Perinatal Quality Collaborative to
appoint members of the board.
Present law requires board members to serve without compensation for a term of up to two
years. Further provides the option for reappointment. Proposed law retains present law but
authorizes board members to be reimbursed for travel expenses in accordance with
regulations of the division of administration.
Present law requires the board to elect a chairperson. Proposed law retains present law and
requires the chairperson to dismiss from membership any members who are absent from
more than three in-person meetings within a calendar year.
Present law requires LDH to promulgate and adopt rules in accordance with the APA to
implement the provisions for the board. Proposed law retains present law and further
requires LDH to implement provisions as directed by the board, ensuring the board retains
full oversight over regulatory actions.
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Proposed law provides that the role of LDH is strictly administrative and does not supersede
the authority of the board in establishing criteria, reviewing applications, or setting policies.
Further provides the board with sole authority to set criteria and standards for doula
registration.
Proposed law prohibits LDH from independently determining an applicant’s eligibility for
registration. Requires LDH to review applications prior to sending to the board to ensure
that applicants are eligible under board-established guidelines.
Present law requires LDH to provide support staff to the board. Proposed law retains present
law but requires LDH staff to be administrative staff who facilitate the process for
registration of doulas; ensure that all administrative guidelines align with board policies;
provide logistical support in processing applications; and issue notifications of approval or
denial of doula registration status. Further requires all work provided by LDH staff to be in
alignment with board-establish policies and procedures in conjunction with the board's full
decision-making authority.
.
(Amends R.S. 22:1059.1)
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