AB 2258

Bill Subjects

Abstract

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing federal law authorizes, at the option of the state, preventive services, as defined, to be provided by practitioners other than physicians or other licensed practitioners. This bill would require the department to establish, commencing July 1, 2021, a full-spectrum doula care pilot program to operate for 3 years for pregnant and postpartum Medi-Cal beneficiaries residing in 14 counties, including the Counties of Alameda, Sacramento, San Diego, and Solano, that experience the highest burden of birth disparities in the state, and would provide that any Medi-Cal beneficiary who is pregnant as of July 1, 2021, and residing in a pilot program county, is entitled to doula care. The bill would require the department to develop multiple payment and billing options for doula care, and to ensure specified payment and billing practices, including that any doula and community-based doula group participating in the pilot program be guaranteed payment within 30 days of submitting any claim for reimbursement. The bill would require the department to establish a centralized registry listing any doula who is available to take on new clients in each county participating in the pilot program, and would provide several requirements for the registry, such as the information on the registry being accessible by various means, including the internet website. The bill would require each Medi-Cal managed care health plan in any county participating in the pilot program to provide information in its materials, and specified notices, on identified topics related to doula care, including reproductive and sexual health, and to inform pregnant and postpartum enrollees at prenatal and postpartum appointments about doula care, such as the availability of doula care and how to obtain a doula. The bill would require the department to convene a doula advisory board that would be responsible for deciding on a list of core competencies, such as the capacity to employ different strategies for providing emotional support, education, and resources during the perinatal period, required for doulas who are authorized by the department to be reimbursed under the Medi-Cal program. The bill would require a doula to provide documentation that they have met the core competencies specified by the board as a prerequisite to be reimbursed under the Medi-Cal program. The bill would require the department to work with outside entities, such as foundations, to make trainings available at no cost that meet the core competencies to people who are from communities experiencing the highest burden of birth disparities in the state. The bill would require the department to allocate funding and resources for data collection, reporting, and analysis for purposes of conducting an evaluation of the pilot program, to ensure that an evaluation of the pilot program begins no later than July 1, 2023, and that it be completed by January 1, 2024, to submit a report to the appropriate policy and fiscal committees of the Legislature, and to include the board and relevant stakeholders, including practicing doulas, in the department's evaluation design. The bill would authorize the department to consider the feasibility of a statewide doula benefit for Medi-Cal beneficiaries during the perinatal period if, after the first 3 years of the pilot program, the pilot program is achieving improved birth outcomes for people using doulas and their babies, and to terminate the pilot program if the pilot program is not achieving those outcomes during that period. The bill would repeal these provisions on January 1, 2026.