As Introduced

135th General Assembly

Regular Session S. B. No. 93

2023-2024

A BILL

To enact sections 4723.89, 4723.90, 5120.658, and 5164.071 of the Revised Code regarding doula services.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 4723.89, 4723.90, 5120.658, and 5164.071 of the Revised Code be enacted to read as follows:

Sec. 4723.89. (A) As used in this section:

(1) "Doula" means a trained, nonmedical professional who advocates for, and provides continuous physical, emotional, and informational support to, a pregnant woman during any of the following periods:

(a) The antepartum period;

(b) The intrapartum period;

(2) "Doula certification organization" means organizations that are recognized, at an international, national, state, or local level, for training and certifying doulas.

(B) Beginning on the date that occurs one year after the effective date of this section, a person shall not use or assume the title "certified doula" unless the person holds a certificate issued under this section by the board of nursing.

(C) The board of nursing shall seek and consider the opinion of the doula advisory board established in section 4723.90 of the Revised Code when an individual is seeking to be eligible for medicaid reimbursement as a certified doula.

(D) The board of nursing shall adopt rules in accordance with Chapter 119. of the Revised Code establishing standards and procedures for issuing certificates to doulas under this section. The rules shall include all of the following:

(1) Requirements for certification as a doula, including a requirement that a doula either be certified by a doula certification organization or, if not certified, have education and experience considered by the board to be appropriate, as specified in the rules;

(2) Requirements for renewal of a certificate and continuing education;

(3) Requirements for training on racial bias, health disparities, and cultural competency as a condition of initial certification and certificate renewal;

(4) Certificate application and renewal fees, as well as a waiver of those fees for applicants with a family income not exceeding three hundred per cent of the federal poverty line;

(5) Requirements and standards of practice for certified doulas;

(6) The amount of a fine to be imposed under division (F) of this section;

(7) Any other standards or procedures the board considers necessary to implement this section.

(E) The board of nursing shall develop and regularly update a registry of doulas who hold certificates issued under this section. The registry shall be made available to the public on a web site maintained by the board.

(F) In an adjudication under Chapter 119. of the Revised Code, the board of nursing may impose a fine against any person who violates division (B) of this section. On request of the board, the attorney general shall bring and prosecute to judgment a civil action to collect any fine imposed under this division that remains unpaid.

Sec. 4723.90. (A) There is hereby established within the board of nursing the doula advisory board.

(B)(1) The advisory board shall consist of the following sixteen members:

(a) The following members appointed by the board of nursing:

(i) Three members representing communities most impacted by negative maternal and infant health outcomes;

(ii) Five members who are doulas with current, valid certification from a doula certification organization;

(iii) Two members who are public health officials, physicians, nurses, or social workers;

(iv) Two members who are consumers;

(v) Two members representing a doula certification program or organization established in Ohio.

(b) One member representing the commission on minority health appointed by the executive director of the commission on minority health;

(2) Both of the following apply to the board of nursing in appointing members to the advisory board:

(a) A good faith effort shall be made to select members who represent counties with higher rates of infant and maternal mortality, particularly those counties with the largest disparities.

(b) Priority shall be given to individuals with direct service experience providing care to infants and pregnant and postpartum women.

(C) The advisory board, by a majority vote of a quorum of its members, shall select an individual to serve as its chairperson. The advisory board may replace a chairperson in the same manner.

(D) Of the initial appointments to the advisory board made pursuant to divisions (B)(1)(a) and (b) of this section, half shall be appointed to a term of one year and half shall be appointed to a term of two years. Thereafter, all terms shall be two years.

(E) The board of nursing, the executive director of the commission on minority health, and the director of health shall fill a vacancy as soon as practicable.

Members may be reappointed for an unlimited number of terms.

(F) The advisory board shall meet at the call of the advisory board's chairperson as often as the chairperson determines necessary for timely completion of the board's duties as described in this section.

(G) The board of nursing shall provide meeting space, virtual meeting technology, staff services, and other technical assistance required by the advisory board in carrying out its duties.

(H) The advisory board shall do all of the following:

(1) Provide general advice, guidance, and recommendations to the board of nursing regarding doula certification and the adoption of rules under divisions (C)(3) and (5) of section 4723.89 of the Revised Code;

(2) Advise the board of nursing regarding individuals seeking to be eligible for medicaid reimbursement as certified doulas;

(3) Provide general advice, guidance, and recommendations to the department of medicaid regarding the program operated under section 5164.071 of the Revised Code;

(4) Make recommendations to the medicaid director regarding the adoption of rules for purposes of section 5164.071 of the Revised Code.

Sec. 5120.658. (A) As used in this section, "doula" has the same meaning as in section 4723.89 of the Revised Code.

(B) Beginning one year after the effective date of this section, the department of rehabilitation and correction shall operate a program to provide to inmates participating in any prison nursery program established under section 5120.65 of the Revised Code doula services that are provided by a doula certified under section 4723.89 of the Revised Code.

Sec. 5164.071. (A) As used in this section, "doula" has the same meaning as in section 4723.89 of the Revised Code.

(B) Beginning one year after the effective date of this section, the medicaid program shall operate a program to cover doula services that are provided by a doula if the doula has a valid provider agreement and is certified under section 4723.89 of the Revised Code. Medicaid payments for doula services shall be determined on the basis of each pregnancy, regardless of whether multiple births occur as a result of that pregnancy.

(C) Outcome measurements and incentives for the program shall be consistent with this state's medicare-medicaid plan quality withhold methodology and benchmarks. The medicaid director shall complete an annual report regarding the program outcomes, including related to maternal health and morbidity and an estimated fiscal impact. The director shall provide a copy of the annual report to the joint medicaid oversight committee.

(D) The medicaid director shall adopt rules under section 5164.02 of the Revised Code to implement this section.