Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S782 Compare Versions

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

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1	1	1 of 1
2	2	SENATE DOCKET, NO. 1638 FILED ON: 1/19/2023
3	3	SENATE . . . . . . . . . . . . . . No. 782
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Liz Miranda
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to Medicaid coverage for doula services.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Liz MirandaSecond SuffolkLindsay N. Sabadosa1st HampshireJacob R. OliveiraHampden, Hampshire and Worcester2/7/2023Jack Patrick Lewis7th Middlesex2/8/2023Carmine Lawrence Gentile13th Middlesex2/8/2023Lydia EdwardsThird Suffolk2/8/2023Thomas M. Stanley9th Middlesex2/8/2023Sal N. DiDomenicoMiddlesex and Suffolk2/13/2023Angelo J. Puppolo, Jr.12th Hampden2/21/2023Jason M. LewisFifth Middlesex2/21/2023Daniel R. Carey2nd Hampshire3/2/2023Patricia D. JehlenSecond Middlesex3/2/2023Rebecca L. RauschNorfolk, Worcester and Middlesex3/6/2023 1 of 8
16	16	SENATE DOCKET, NO. 1638 FILED ON: 1/19/2023
17	17	SENATE . . . . . . . . . . . . . . No. 782
18	18	By Ms. Miranda, a petition (accompanied by bill, Senate, No. 782) of Liz Miranda, Lindsay N.
19	19	Sabadosa, Jacob R. Oliveira, Jack Patrick Lewis and other members of the General Court for
20	20	legislation relative to Medicaid coverage for doula services. Health Care Financing.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Third General Court
24	24	(2023-2024)
25	25	_______________
26	26	An Act relative to Medicaid coverage for doula services.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Chapter 118E of the General Laws is hereby amended by inserting after
30	30	2section 10N the following section:-
31	31	3 Section 10-O: Medicaid Coverage for Doula Services.
32	32	4 (A) For purposes of this section, the term “doula services” shall have the following
33	33	5meaning:
34	34	6 “Doula Services” are physical, emotional, and informational support, but not medical
35	35	7care, provided by trained doulas to individuals and families during and after pregnancy, labor,
36	36	8childbirth, miscarriage, stillbirth or pregnancy loss. Doula services include but are not limited to:
37	37	9 (1) continuous labor support;
38	38	10 (2) prenatal, postpartum, and bereavement home or in-person visits throughout the
39	39	11perinatal period, lasting until 1 year after birth, pregnancy loss, stillbirth, or miscarriage; 2 of 8
40	40	12 (3) accompanying pregnant individuals to health care and social services appointments;
41	41	13 (4) providing support to individuals for loss of pregnancy or infant from conception
42	42	14 through one year postpartum;
43	43	15 (5) connecting individuals to community-based and state- and federally-funded resources,
44	44	16including those which address social determinants of health;
45	45	17 (6) making oneself available (being on-call) around the time of birth or loss as well as
46	46	18providing support for any concerns of pregnant individuals throughout pregnancy and until one
47	47	19year after birth, pregnancy loss, stillbirth, or miscarriage.
48	48	20 (7) providing support for other individuals providing care for a birthing parent, including
49	49	21a birthing parent’s partner and family members.
50	50	22 (B) Coverage of Doula Services:
51	51	23 (1) The Division shall provide coverage of doula services to pregnant individuals and
52	52	24postpartum individuals up to 12 months following the end of the pregnancy who are eligible for
53	53	25medical assistance under this chapter and/or through Title XIX or Title XXI of the Social
54	54	26Security Act. The Division shall provide the same coverage of doula services to pregnant and
55	55	27postpartum individuals who are not otherwise eligible for medical assistance under this chapter
56	56	28or Titles XIX or XXI of the Social Security Act solely because of their immigration status.
57	57	29 (2) The Division must cover continuous support through labor and childbirth, and at least
58	58	30up to six doula visits across the prenatal and one year postpartum period, including at least two
59	59	31postpartum visits, without the need for prior authorization. The Division must also establish a
60	60	32procedure to cover additional doula visits as needed. 3 of 8
61	61	33 (C) Creation of Doula Advisory Committee: There is hereby created a Doula Advisory
62	62	34Committee.
63	63	35 (1) The committee shall consist of 10-12 members to be appointed by the commissioner
64	64	36of public health, or designee.
65	65	37 (a) All but 2 of the members must be practicing doulas from the community; the
66	66	38remaining 2 members must be individuals from the community who have experienced pregnancy
67	67	39as a MassHealth member and are not practicing doulas.
68	68	40 (b) Among the members described in (a) above:
69	69	41 (i) at least 1 member must be a person who identifies as belonging to the LGBTQIA+
70	70	42community;
71	71	43 (iii) at least 1 member must be a person who has experienced a severe maternal
72	72	44morbidity, a perinatal mental health or mood disorder, or a near-death experience while pregnant
73	73	45or in maternity care;
74	74	46 (iv) at least 1 member must be a person who identifies as a person with disabilities or
75	75	47disabled person;
76	76	48 (c) The members of the committee shall represent a diverse range of experience levels-
77	77	49from doulas new to the practice to more experienced doulas.
78	78	50 (d) The members of the committee shall be from areas within the Commonwealth where
79	79	51maternal and infant outcomes are worse than the state average, as evidenced by the MA
80	80	52Department of Public Health’s most current perinatal data available at the time the member is
81	81	53appointed. 4 of 8
82	82	54 (e) The members of the committee shall represent an equitable geographic distribution
83	83	55from across the Commonwealth.
84	84	56 (2) The committee must be convened within six months of passage of this law.
85	85	57 (3) Of the initial appointments to the Doula Advisory Committee, half shall be appointed
86	86	58to a term of 2 years and half shall be appointed to a term of 18 months. Thereafter, all terms shall
87	87	59be 2 years. The commissioner of public health, or designee, shall fill vacancies as soon as
88	88	60practicable.
89	89	61 (4) At least once every 8 weeks, the Division must meet with the Doula Advisory
90	90	62Committee to consult about at least the following:
91	91	63 (a) the scope of doula services covered by MassHealth;
92	92	64 (b) doula competencies required for reimbursement by MassHealth, and standards of
93	93	65proof or demonstration of those competencies;
94	94	66 (c) the recruitment of a diverse workforce of doulas to provide services to MassHealth
95	95	67members;
96	96	68 (d) the development of comprehensive and high quality continuing education and training
97	97	69that is free or low cost to doulas committed to providing services to MassHealth members, as
98	98	70well as the development of mentorship and career growth opportunities for doulas providing
99	99	71services to MassHealth members;
100	100	72 (e) the performance of any third party administrators of MassHealth’s doula coverage
101	101	73program, and standards and processes around billing for and prompt reimbursement of doula
102	102	74services; 5 of 8
103	103	75 (f) establishing grievance procedures for doulas, MassHealth members, and health care
104	104	76providers about MassHealth’s coverage of doula services and/or the provision of doula services
105	105	77to MassHealth members;
106	106	78 (g) outreach to the public and stakeholders about how to access doula care for
107	107	79MassHealth members, and about the availability of and advantages of doula care;
108	108	80 (h) the evaluation and collection of data on the provision of, outcomes of, access to, and
109	109	81satisfaction with doula care services provided to MassHealth members;
110	110	82 (i) maintaining a reimbursement rate for doula services that incentivizes and supports a
111	111	83diverse workforce representative of the communities served, and establishing a recurring
112	112	84timeframe to review that rate in light of inflation and changing costs of living in the
113	113	85commonwealth;
114	114	86 (j) how to ensure that MassHealth’s doula reimbursement program is directed towards the
115	115	87goal of reducing inequities in maternal and birth outcomes among racial, ethnic, and cultural
116	116	88populations who reside in all areas within the commonwealth, as evidenced by the most current
117	117	89perinatal data supplied by the department of public health.
118	118	90 (5) Each year, the Doula Advisory Committee must, by a majority vote of a quorum of its
119	119	91members, select an individual to serve as its chairperson for a one year term. The Doula
120	120	92Advisory Committee may replace the chairperson in the same manner mid-term.
121	121	93 (6) The Doula Advisory Committee may, by a majority vote of a quorum of its members,
122	122	94reduce the frequency of meetings with MassHealth to less than once every 8 weeks. 6 of 8
123	123	95 (7) The division and the Department of Public Health shall seek resources to offer
124	124	96reasonable compensation to members of the Doula Advisory Committee for fulfilling their
125	125	97duties, and must reimburse members for actual and necessary expenses incurred while fulfilling
126	126	98their duties.
127	127	99 (8) The division, in partnership with the Doula Advisory Committee, shall conduct at
128	128	100least 1 public hearing or forum each year until three years after passage of this law. The purposes
129	129	101of these hearings or forums shall be to gather feedback from the public and to inform the public
130	130	102about MassHealth’s coverage of doula care.
131	131	103 SECTION 2. Chapter 29 of the Massachusetts General Laws is hereby amended by
132	132	104inserting after section 2QQQQQ the following section:-
133	133	105 Section 2RRRRR. (a) There shall be established and set up on the books of the
134	134	106commonwealth a separate fund known as the Doula Workforce Development Trust Fund,
135	135	107hereinafter called the fund. The fund shall be administered by the department of career services
136	136	108which shall contract with the Commonwealth Corporation to administer the fund. The fund shall
137	137	109be credited with: (i) revenue from appropriations or other money authorized by the general court
138	138	110and specifically designated to be credited to the fund; (ii) interest earned on such revenues; and
139	139	111(iii) funds from public and private sources; and other gifts, grants and donations for the growth,
140	140	112training and continuous support of the doula workforce. Amounts credited to the fund shall not
141	141	113be subject to further appropriation and any money remaining in the fund at the end of a fiscal
142	142	114year shall not revert to the General Fund.
143	143	115 (b) The Commonwealth Corporation shall make expenditures from the fund for the
144	144	116purposes of: 7 of 8
145	145	117 (i) the development and expansion of comprehensive doula training available across the
146	146	118commonwealth. including the development of doula training focused on meeting the needs of
147	147	119MassHealth members;
148	148	120 (ii) ensuring that doulas committed to serving MassHealth members have access to high
149	149	121quality doula training at no- or low-cost to them;
150	150	122 (iii) the recruitment and retention of doulas from communities with high concentrations
151	151	123of MassHealth members, as well as areas within the commonwealth where maternal and infant
152	152	124outcomes are worse than the state average, as evidenced by the MA Department of Public
153	153	125Health’s perinatal data.
154	154	126 (iv) expanding doula mentoring opportunities across the state, which provide new doulas
155	155	127the opportunity to attend births and incentivize experienced practicing doulas to take on mentees.
156	156	128 (v) leveraging funds to secure future federal funding to support doula workforce
157	157	129development in the commonwealth.
158	158	130 (c) The director of career services shall annually, not later than December 31, report to
159	159	131the secretary of administration and finance, the house and senate committees on ways and means
160	160	132and the joint committee on labor and workforce development on the efforts undertaken in
161	161	133support of section (b) above; the number of doulas recruited and trained as a result of activities
162	162	134taken in support of (b) above, including but not limited to sex, gender identity, race, and ethnicity
163	163	135of such doulas; the amount of grants and identities of grantees awarded in support of section (b)
164	164	136above; and the availability of doula training at no- or low-cost to doulas committed to serving
165	165	137MassHealth members. 8 of 8
166	166	138 SECTION 3. Chapter 111 of the General Laws is hereby amended by inserting in section
167	167	13970E after “Every patient or resident of a facility shall have the right:”:
168	168	140 (p) to have their birth doula’s continuous presence during labor and delivery. Facilities
169	169	141shall not place an undue burden on a patient’s doula’s access to clinical labor and delivery
170	170	142settings, and shall not arbitrarily exclude a patient’s doula from such settings.