Vermont 2025-2026 Regular Session

Vermont Senate Bill S0053 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~BILLASINTRODUCEDANDPASSEDBYSENATE~~ S.53
	1	+	BILL AS INTRODUCED S.53
2	2		2025 Page 1 of 9
3		-	S.53
4		-	IntroducedbySenatorsGulick,Clarkson,Hardy,Vyhovsky,Watsonand
5		-	White
6		-	ReferredtoCommitteeonGovernmentOperations
7		-	Date:February6,2025
8		-	Subject:Professionsandoccupations;OfficeofProfessionalRegulation;
9		-	community-basedperinataldoulas;certification;Medicaid
10		-	Statementofpurposeofbillasintroduced:Thisbillproposestoestablisha
11		-	processofvoluntarycertificationforcommunity-basedperinataldoulas.It
12		-	wouldalsorequireMedicaidcoveragefordoulaservicesduringlaborandbirth
13		-	andfortheprenatalandpostpartumperiods.
14		-	Anactrelatingtocertificationofcommunity-basedperinataldoulasand
15		-	Medicaidcoveragefordoulaservices
16		-	ItisherebyenactedbytheGeneralAssemblyoftheStateofVermont:
17		-	Sec.1.26V.S.A.chapter84isaddedtoread:
18		-	CHAPTER84.COMMUNITY-BASEDPERINATALDOULAS
19		-	§ 4171.DEFINITIONS
20		-	Asusedinthischapter:
21		-	(1)“Certifiedcommunity-basedperinataldoula”meansacommunity-
22		-	basedperinataldoulawhoholdsacertificateissuedpursuanttothischapter.
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42		-	20 BILLASINTRODUCEDANDPASSEDBYSENATE S.53
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	4	+
	5	+	VT LEG #380200 v.1
	6	+	S.53 1
	7	+	Introduced by Senators Gulick, Clarkson, Hardy, Vyhovsky, Watson and 2
	8	+	White 3
	9	+	Referred to Committee on 4
	10	+	Date: 5
	11	+	Subject: Professions and occupations; Office of Professional Regulation; 6
	12	+	community-based perinatal doulas; certification; Medicaid 7
	13	+	Statement of purpose of bill as introduced: This bill proposes to establish a 8
	14	+	process of voluntary certification for community-based perinatal doulas. It 9
	15	+	would also require Medicaid coverage for doula services during labor and birth 10
	16	+	and for the prenatal and postpartum periods. 11
	17	+	An act relating to certification of community-based perinatal doulas and 12
	18	+	Medicaid coverage for doula services 13
	19	+	It is hereby enacted by the General Assembly of the State of Vermont: 14
	20	+	Sec. 1. 26 V.S.A. chapter 84 is added to read: 15
	21	+	CHAPTER 84. COMMUNITY-BASED PERINATAL DOULAS 16
	22	+	§ 4171. DEFINITIONS 17
	23	+	As used in this chapter: 18
	24	+	(1) “Certified community-based perinatal doula” means a community-19
	25	+	based perinatal doula who holds a certificate issued pursuant to this chapter. 20 BILL AS INTRODUCED S.53
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44		-	(2)“Community-baseddoula”meansanindividualwhoprovidesdoula
45		-	servicestounder-resourcedandmarginalizedpopulationsatlowornocost,
46		-	oftenthroughacommunity-basedagency.
47		-	(3)“Community-basedperinataldoula”meansacommunity-based
48		-	doulawhoprovidesdoulaservicestoindividualsduringtheperinatalperiod.
49		-	(4)“Director”meanstheDirectoroftheOfficeofProfessional
50		-	Regulation.
51		-	(5)“Doula”meansanonclinical,nonmedicalindividualwhoprovides
52		-	directemotionalandphysicalsupportandeducationalandinformational
53		-	servicestobirthingindividualsbefore,during,andafterlaborandchildbirth.
54		-	(6)“Perinatal”meanstheperiodoftimeencompassingpregnancy,
55		-	childbirth,anduptooneyearpostpartum.
56		-	§ 4172.PROHIBITIONS;PENALTIES
57		-	(a)Nothinginthischaptershallbeconstruedtoprohibittheprovisionof
58		-	doulaservicesbyanoncertifiedindividual,providedthatnopersonshalluse
59		-	inconnectionwiththeperson’snameanyletters,words,orinsigniaindicating
60		-	orimplyingthatthepersonisaStatecertifiedcommunity-basedperinatal
61		-	doulaunlessthepersoniscertifiedinaccordancewiththischapter.
62		-	(b)Apersonwhoviolatesthissectionshallbesubjecttothepenaltiesset
63		-	forthin3V.S.A.§127(c).
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	29	+	VT LEG #380200 v.1
	30	+	(2) “Community-based doula” means an individual who provides doula 1
	31	+	services to under-resourced and marginalized populations at low or no cost, 2
	32	+	often through a community-based agency. 3
	33	+	(3) “Community-based perinatal doula” means a community-based 4
	34	+	doula who provides doula services to individuals during the perinatal period. 5
	35	+	(4) “Director” means the Director of the Office of Professional 6
	36	+	Regulation. 7
	37	+	(5) “Doula” means a nonclinical, nonmedical individual who provides 8
	38	+	direct emotional and physical support and educational and informational 9
	39	+	services to birthing individuals before, during, and after labor and childbirth. 10
	40	+	(6) “Perinatal” means the period of time encompassing pregnancy, 11
	41	+	childbirth, and up to one year postpartum. 12
	42	+	§ 4172. PROHIBITIONS; PENALTIES 13
	43	+	(a) Nothing in this chapter shall be construed to prohibit the provision of 14
	44	+	doula services by a noncertified individual, provided that no person shall use in 15
	45	+	connection with the person’s name any letters, words, or insignia indicating or 16
	46	+	implying that the person is a State certified community-based perinatal doula 17
	47	+	unless the person is certified in accordance with this chapter. 18
	48	+	(b) A person who violates this section shall be subject to the penalties set 19
	49	+	forth in 3 V.S.A. § 127(c). 20 BILL AS INTRODUCED S.53
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85		-	§ 4173.DUTIESOFTHEDIRECTOR
86		-	(a)TheDirectorshall:
87		-	(1)providegeneralinformationtoapplicantsforcertificationas
88		-	certifiedcommunity-basedperinataldoulas;
89		-	(2)receiveapplicantsforcertification;grantandrenewcertificationsin
90		-	accordancewiththischapter;anddeny,revoke,suspend,reinstate,orcondition
91		-	certificationsasdirectedbyanadministrativelawofficer;
92		-	(3)explainappealprocedurestocertifiedcommunity-basedperinatal
93		-	doulasandapplicants;
94		-	(4)explaincomplaintprocedurestothepublic;
95		-	(5)prepareandmaintainaregistryofcertifiedcommunity-based
96		-	perinataldoulas;
97		-	(6)administerfeescollectedinaccordancewiththischapterand
98		-	3 V.S.A.§125;and
99		-	(7)referalldisciplinarymatterstoanadministrativelawofficer
100		-	establishedunder3V.S.A.§129(j).
101		-	(b)TheDirector,afterconsultationwiththeadvisorappointees,mayadopt
102		-	rulesinaccordancewith3V.S.A.chapter25asneededtoperformthe
103		-	Director’sdutiesunderthischapter.
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	51	+
	52	+
	53	+	VT LEG #380200 v.1
	54	+	§ 4173. DUTIES OF THE DIRECTOR 1
	55	+	(a) The Director shall: 2
	56	+	(1) provide general information to applicants for certification as certified 3
	57	+	community-based perinatal doulas; 4
	58	+	(2) receive applicants for certification; grant and renew certifications in 5
	59	+	accordance with this chapter; and deny, revoke, suspend, reinstate, or condition 6
	60	+	certifications as directed by an administrative law officer; 7
	61	+	(3) explain appeal procedures to certified community-based perinatal 8
	62	+	doulas and applicants; 9
	63	+	(4) explain complaint procedures to the public; 10
	64	+	(5) prepare and maintain a registry of certified community-based 11
	65	+	perinatal doulas; 12
	66	+	(6) administer fees collected in accordance with this chapter and 13
	67	+	3 V.S.A. § 125; and 14
	68	+	(7) refer all disciplinary matters to an administrative law officer 15
	69	+	established under 3 V.S.A. § 129(j). 16
	70	+	(b) The Director, after consultation with the advisor appointees, may adopt 17
	71	+	rules in accordance with 3 V.S.A. chapter 25 as needed to perform the 18
	72	+	Director’s duties under this chapter. 19 BILL AS INTRODUCED S.53
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124		-	§ 4174.ADVISORAPPOINTEES
125		-	(a)TheSecretaryofStateshallappointtwocertifiedcommunity-based
126		-	perinataldoulastoserveasadvisorsinmattersrelatingtocommunity-based
127		-	perinataldoulas.Theadvisorsshallbeappointedassetforthin3V.S.A.
128		-	§ 129bandserveatthepleasureoftheSecretary.Oneoftheinitial
129		-	appointmentsmaybeforlessthanafullterm.Appointeesshallnothaveless
130		-	thanthreeyears’experienceprovidingcommunity-basedperinataldoula
131		-	servicesimmediatelyprecedingappointmentandshallbeactivelyengagedin
132		-	deliveringcommunity-basedperinataldoulaservicesinVermontduring
133		-	incumbency.
134		-	(b)TheDirectorshallseektheadviceofthecommunity-basedperinatal
135		-	doulaadvisorsincarryingouttheprovisionsofthischapter.Theadvisor
136		-	appointeesshallbeentitledtoperdiemcompensationandreimbursementof
137		-	expensesaspermittedunder32V.S.A.§1010forattendanceatanymeeting
138		-	calledbytheDirectorforthispurpose.
139		-	§ 4175.ELIGIBILITY
140		-	Tobeeligibleforcertificationasacertifiedcommunity-basedperinatal
141		-	doula,anapplicantshallcompleteandsubmitanapplicationinthemanner
142		-	prescribedbytheDirectorbyrule,accompaniedbytheapplicablefees,and
143		-	evidencesatisfactorytotheDirectorthattheapplicant:
144		-	(1)isatleast18yearsofage;
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165		-	21 BILLASINTRODUCEDANDPASSEDBYSENATE S.53
	74	+
	75	+
	76	+	VT LEG #380200 v.1
	77	+	§ 4174. ADVISOR APPOINTEES 1
	78	+	(a) The Secretary of State shall appoint two certified community-based 2
	79	+	perinatal doulas to serve as advisors in matters relating to community-based 3
	80	+	perinatal doulas. The advisors shall be appointed as set forth in 3 V.S.A. 4
	81	+	§ 129b and serve at the pleasure of the Secretary. One of the initial 5
	82	+	appointments may be for less than a full term. Appointees shall not have less 6
	83	+	than three years’ experience providing community-based perinatal doula 7
	84	+	services immediately preceding appointment and shall be actively engaged in 8
	85	+	delivering community-based perinatal doula services in Vermont during 9
	86	+	incumbency. 10
	87	+	(b) The Director shall seek the advice of the community-based perinatal 11
	88	+	doula advisors in carrying out the provisions of this chapter. The advisor 12
	89	+	appointees shall be entitled to per diem compensation and reimbursement of 13
	90	+	expenses as permitted under 32 V.S.A. § 1010 for attendance at any meeting 14
	91	+	called by the Director for this purpose. 15
	92	+	§ 4175. ELIGIBILITY 16
	93	+	To be eligible for certification as a certified community-based perinatal 17
	94	+	doula, an applicant shall complete and submit an application in the manner 18
	95	+	prescribed by the Director by rule, accompanied by the applicable fees, and 19
	96	+	evidence satisfactory to the Director that the applicant: 20
	97	+	(1) is at least 18 years of age; 21 BILL AS INTRODUCED S.53
166	98		2025 Page 5 of 9
167		-	(2)hassufficientandappropriatecompetenciesincommunity-based
168		-	perinataldoulaservices,whetheracquiredthroughexperience,mentorship,
169		-	training,formaleducation,oracombinationofthese,asdeterminedbythe
170		-	Directorbyrule;and
171		-	(3)haspassedanycriminalhistorybackgroundorregistrychecks
172		-	requiredbytheDirectorbyrule.
173		-	§ 4176.CERTIFICATERENEWAL
174		-	Acommunity-basedperinataldoulacertificationshallberenewedevery
175		-	twoyearsuponapplication,paymentoftherequiredfeeinaccordancewith
176		-	3 V.S.A.§ 125,andproofofcompliancewithanycontinuingeducationor
177		-	demonstratedcompetencyrequirementsestablishedbyrule.
178		-	§ 4177.UNPROFESSIONAL CONDUCT
179		-	(a)Unprofessionalconductmeansmisusingatitleinprofessionalactivity
180		-	andanyoftheconductlistedin3V.S.A.§ 129a,whethercommittedbya
181		-	certifiedcommunity-basedperinataldoulaoranapplicant.
182		-	(b)TheOfficeofProfessionalRegulationmaydisciplineacertified
183		-	community-basedperinataldoulaforunprofessionalconductasprovidedin
184		-	3 V.S.A.§ 129a.
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	99	+
	100	+
	101	+	VT LEG #380200 v.1
	102	+	(2) has sufficient and appropriate competencies in community-based 1
	103	+	perinatal doula services, whether acquired through experience, mentorship, 2
	104	+	training, formal education, or a combination of these, as determined by the 3
	105	+	Director by rule; and 4
	106	+	(3) has passed any criminal history background or registry checks 5
	107	+	required by the Director by rule. 6
	108	+	§ 4176. CERTIFICATE RENEWAL 7
	109	+	A community-based perinatal doula certification shall be renewed every 8
	110	+	two years upon application, payment of the required fee in accordance with 9
	111	+	3 V.S.A. § 125, and proof of compliance with any continuing education or 10
	112	+	demonstrated competency requirements established by rule. 11
	113	+	§ 4177. UNPROFESSIONAL CONDUCT 12
	114	+	(a) Unprofessional conduct means misusing a title in professional activity 13
	115	+	and any of the conduct listed in 3 V.S.A. § 129a, whether committed by a 14
	116	+	certified community-based perinatal doula or an applicant. 15
	117	+	(b) The Office of Professional Regulation may discipline a certified 16
	118	+	community-based perinatal doula for unprofessional conduct as provided in 17
	119	+	3 V.S.A. § 129a. 18 BILL AS INTRODUCED S.53
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204		-	Sec.2.3V.S.A.§ 122isamendedtoread:
205		-	§122.OFFICEOFPROFESSIONALREGULATION
206		-	TheOfficeofProfessionalRegulationiscreatedwithintheOfficeofthe
207		-	SecretaryofState.TheOfficeshallhaveadirectorwhoshallbequalifiedby
208		-	educationandprofessionalexperiencetoperformthedutiesoftheposition.
209		-	TheDirectoroftheOfficeofProfessionalRegulationshallbeaclassified
210		-	positionwiththeOfficeoftheSecretaryofState.Thefollowingboardsor
211		-	professionsareattachedtotheOfficeofProfessionalRegulation:
212		-	***
213		-	(54)Community-BasedPerinatalDoulas
214		-	Sec.3.3V.S.A.§ 123(j)isamendedtoread:
215		-	(j)(1)TheOfficemayinquireintothecriminalbackgroundhistoriesof
216		-	applicantsforinitiallicensureandforlicenserenewalofanyOffice-issued
217		-	credential,includingalicense,certification,registration,orspecialty
218		-	designationforthefollowingprofessions:
219		-	***
220		-	(M)occupationaltherapistslicensedunder26V.S.A.chapter71;and
221		-	(N)peerprovidersandpeerrecoverysupportspecialistscertified
222		-	under26V.S.A.chapter60;and
223		-	(O)community-basedperinataldoulascertifiedunder26V.S.A.
224		-	chapter84.
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	121	+
	122	+
	123	+	VT LEG #380200 v.1
	124	+	Sec. 2. 3 V.S.A. § 122 is amended to read: 1
	125	+	§ 122. OFFICE OF PROFESSIONAL REGULATION 2
	126	+	The Office of Professional Regulation is created within the Office of the 3
	127	+	Secretary of State. The Office shall have a director who shall be qualified by 4
	128	+	education and professional experience to perform the duties of the position. 5
	129	+	The Director of the Office of Professional Regulation shall be a classified 6
	130	+	position with the Office of the Secretary of State. The following boards or 7
	131	+	professions are attached to the Office of Professional Regulation: 8
	132	+	* * * 9
	133	+	(54) Community-Based Perinatal Doulas 10
	134	+	Sec. 3. 3 V.S.A. § 123(j) is amended to read: 11
	135	+	(j)(1) The Office may inquire into the criminal background histories of 12
	136	+	applicants for initial licensure and for license renewal of any Office-issued 13
	137	+	credential, including a license, certification, registration, or specialty 14
	138	+	designation for the following professions: 15
	139	+	* * * 16
	140	+	(M) occupational therapists licensed under 26 V.S.A. chapter 71; and 17
	141	+	(N) peer providers and peer recovery support specialists certified 18
	142	+	under 26 V.S.A. chapter 60; and 19
	143	+	(O) community-based perinatal doulas certified under 26 V.S.A. 20
	144	+	chapter 84. 21 BILL AS INTRODUCED S.53
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247		-	***
248		-	Sec.4.3V.S.A.§ 125isamendedtoread:
249		-	§125.FEES
250		-	***
251		-	(b)Unlessotherwiseprovidedbylaw,thefollowingfeesshallapplytoall
252		-	professionsregulatedbytheDirectorinconsultationwithadvisorappointees
253		-	underTitle26:
254		-	***
255		-	(2)Applicationforlicensureorcertification,$115.00,except
256		-	applicationfor:
257		-	***
258		-	(R)Community-basedperinataldoulas,$75.00.
259		-	***
260		-	(4)Biennialrenewal,$275.00,exceptbiennialrenewalfor:
261		-	***
262		-	(W)Community-basedperinataldoulas,$120.00.
263		-	***
264		-	Sec.5.33V.S.A.§ 1901nisaddedtoread:
265		-	§ 1901n.MEDICAIDCOVERAGEFORDOULASERVICES
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	146	+
	147	+
	148	+	VT LEG #380200 v.1
	149	+	* * * 1
	150	+	Sec. 4. 3 V.S.A. § 125 is amended to read: 2
	151	+	§ 125. FEES 3
	152	+	* * * 4
	153	+	(b) Unless otherwise provided by law, the following fees shall apply to all 5
	154	+	professions regulated by the Director in consultation with advisor appointees 6
	155	+	under Title 26: 7
	156	+	* * * 8
	157	+	(2) Application for licensure or certification, $115.00, except application 9
	158	+	for: 10
	159	+	* * * 11
	160	+	(R) Community-based perinatal doulas, $75.00. 12
	161	+	* * * 13
	162	+	(4) Biennial renewal, $275.00, except biennial renewal for: 14
	163	+	* * * 15
	164	+	(W) Community-based perinatal doulas, $120.00. 16
	165	+	* * * 17
	166	+	Sec. 5. 33 V.S.A. § 1901n is added to read: 18
	167	+	§ 1901n. MEDICAID COVERAGE FOR DOULA SERVICES 19 BILL AS INTRODUCED S.53
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286		-	(a)Asusedinthissection,“certifiedcommunity-basedperinataldoula”
287		-	meansacommunity-basedperinataldoulawhoholdsacertificateissued
288		-	pursuantto26V.S.A.chapter84.
289		-	(b)(1)TheDepartmentofVermontHealthAccessshallprovide
290		-	reimbursementtoacertifiedcommunity-basedperinataldoulaforproviding
291		-	directemotionalandphysicalsupportandeducationalandinformational
292		-	servicestobirthingindividualscoveredbyMedicaidduringpregnancy,labor
293		-	anddelivery,andthepostpartumperiod,regardlessoftheoutcomeofthe
294		-	pregnancy.
295		-	(2)Acertifiedcommunity-basedperinataldoulashallnotreceive
296		-	reimbursementfortraveltimeormileageexpenses.
297		-	Sec.6.MEDICAIDREIMBURSEMENT FORDOULASERVICES;
298		-	LEGISLATIVEINTENT
299		-	ItistheintentoftheGeneralAssemblythattheDepartmentofVermont
300		-	HealthAccessreimbursequalifieddoulasinamountsthatarereasonableand
301		-	adequatefortheservicesprovidedandthatareconsistentwiththe
302		-	reimbursementratessetbyotherstates’Medicaidprograms.
303		-	Sec.7.STATEPLANAMENDMENT
304		-	TheDepartmentofVermontHealthAccessshallseekastateplan
305		-	amendmentfromtheCentersforMedicareandMedicaidServicesifneededto
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	169	+
	170	+
	171	+	VT LEG #380200 v.1
	172	+	(a) As used in this section, “certified community-based perinatal doula” 1
	173	+	means a community-based perinatal doula who holds a certificate issued 2
	174	+	pursuant to 26 V.S.A. chapter 84. 3
	175	+	(b)(1) The Department of Vermont Health Access shall provide 4
	176	+	reimbursement to a certified community-based perinatal doula for providing 5
	177	+	direct emotional and physical support and educational and informational 6
	178	+	services to birthing individuals covered by Medicaid during pregnancy, labor 7
	179	+	and delivery, and the postpartum period, regardless of the outcome of the 8
	180	+	pregnancy. 9
	181	+	(2) A certified community-based perinatal doula shall not receive 10
	182	+	reimbursement for travel time or mileage expenses. 11
	183	+	Sec. 6. MEDICAID REIMBURSEMENT FOR DOULA SERVICES; 12
	184	+	LEGISLATIVE INTENT 13
	185	+	It is the intent of the General Assembly that the Department of Vermont 14
	186	+	Health Access reimburse qualified doulas in amounts that are reasonable and 15
	187	+	adequate for the services provided and that are consistent with the 16
	188	+	reimbursement rates set by other states’ Medicaid programs. 17
	189	+	Sec. 7. STATE PLAN AMENDMENT 18
	190	+	The Department of Vermont Health Access shall seek a state plan 19
	191	+	amendment from the Centers for Medicare and Medicaid Services if needed to 20 BILL AS INTRODUCED S.53
326	192		2025 Page 9 of 9
327		-	allowVermont’sMedicaidprogramtoprovidecoveragefordoulaservicesin
328		-	accordancewith33V.S.A.§ 1901n,asaddedbythisact.
329		-	Sec.8.EFFECTIVEDATES
330		-	(a)Secs.1–4(establishingcertificationprogramforcommunity-based
331		-	perinataldoulas)shalltakeeffectonJuly1,2026,providedthattheDirectorof
332		-	theOfficeofProfessionalRegulationshallcommencetherulemakingprocess
333		-	priortothatdateinordertoensurethattheruleswillbeineffectonJuly1,
334		-	2026.
335		-	(b)Sec.5(33V.S.A.§ 1901n;Medicaidcoveragefordoulaservices)shall
336		-	takeeffectonJuly1,2026or,ifastateplanamendmentisnecessary,upon
337		-	approvalofthestateplanamendment,whicheverislater.
338		-	(c)Theremainingsectionsshalltakeeffectonpassage.
339		-	1
340		-	2
341		-	3
342		-	4
343		-	5
344		-	6
345		-	7
346		-	8
347		-	9
348		-	10
349		-	11
350		-	12
	193	+
	194	+
	195	+	VT LEG #380200 v.1
	196	+	allow Vermont’s Medicaid program to provide coverage for doula services in 1
	197	+	accordance with 33 V.S.A. § 1901n, as added by this act. 2
	198	+	Sec. 8. EFFECTIVE DATES 3
	199	+	(a) Secs. 1–4 (establishing certification program for community-based 4
	200	+	perinatal doulas) shall take effect on July 1, 2026, provided that the Director of 5
	201	+	the Office of Professional Regulation shall commence the rulemaking process 6
	202	+	prior to that date in order to ensure that the rules will be in effect on July 1, 7
	203	+	2026. 8
	204	+	(b) Sec. 5 (33 V.S.A. § 1901n; Medicaid coverage for doula services) shall 9
	205	+	take effect on July 1, 2026 or, if a state plan amendment is necessary, upon 10
	206	+	approval of the state plan amendment, whichever is later. 11
	207	+	(c) The remaining sections shall take effect on passage. 12