Doula certification and Medicaid coverage plan finally in development

By: Brandy Davis, Fellow, Medicaid Policy
Tara Britton, Director of Public Policy and Advocacy | Edward D. and Dorothy E. Lynde Fellow

The state of Ohio continues to move toward increased access to doula services. Last week, the Ohio Department of Medicaid (ODM) and the Ohio Board of Nursing co-hosted a webinar focused on the next steps to expand access to doula services in Ohio through certification by the Board and reimbursement from Medicaid.

Last year’s state budget—House Bill 33—included language that required the Board of Nursing to establish a process by which to certify doulas in Ohio and required reimbursement from Medicaid for certified doula services. The Ohio Department of Medicaid (ODM) and the Board of Nursing spent much of this first stakeholder meeting outlining the plan for the board moving forward as a part of the larger Maternal and Infant Support Program (MISP).

What is the Board of Nursing’s role?

The Board of Nursing began by outlining the timeline and the tasks that the Doula Advisory Board, which now exists under the Board of Nursing, will take on. This must all be in place by October 2024.

The Board of Nursing outlined the following goals for the Doula Advisory Board for the next months:

  1. Developing a central doula advisory board plan that will serve as the framework for Ohio’s doula certification.
  2. Making decisions regarding the criteria that doulas must meet to gain and then maintain certification.

Though there has yet to be a decision on which organizations will be able to certify doulas, the advisory plan plans to explore existing certifying organizations and review what each requires in terms of training. The Board is also exploring ways to offer a sliding scale for licensure fees, based on income, which would allow people of a broader income range to enter the doula workforce.

Doulas should be independent.

What is Medicaid’s role?

As part of the MISP, Medicaid is currently learning from implementation of doula coverage in other states to maintain the integrity of doula profession and the services doulas provide. The Department shared that their counterparts in other stated “Doulas should be independent.”  To preserve this independence, Medicaid is carefully evaluating rate development. An actuary investigated what other states are paying and is determining what rates to allocate to each phase of pregnancy.

While the goal is to explore what other states are paying, there was a clear emphasis on ensuring sustainable rates for doula service providers in Ohio. ODM plans to develop a technical assistance guide to aid doulas in completing the process to become billable providers, by assisting them with garnering a National Provider Identifier and enrolling in ODM’s billing process.

The Center for Community Solutions will continue to follow the process as the Doula Advisory Board implements coverage for doula services.