New York State Assembly

 
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A05435 Summary:

A05435 Actions:

A05435 Committee Votes:

Committee:HEALTH   Chair:Paulin      
DATE:05/23/2023AYE/NAY:26/0  Action: Favorable refer to committee Ways and Means        
Paulin
Aye
Jensen
Aye
Dinowitz
Aye
Byrnes
Aye
Gunther
Aye
Gandolfo
Aye
Rosenthal L 
Aye
Mikulin
Aye
Hevesi
Aye
Blumencranz
Aye
Steck
Aye
Bendett
Aye
Braunstein
Aye
Gray
Aye
Solages
Aye
McGowan
Aye
Bichotte Hermel
Aye
Sayegh
Aye
Rosenthal D 
Aye
McDonald
Aye
Reyes
Aye
Gonzalez-Rojas
Aye
Rajkumar
Aye
Forrest
Aye
Kelles
Aye
Lucas
Aye

Committee:WAYS AND MEANS   Chair:Weinstein      
DATE:06/01/2023AYE/NAY:35/0  Action: Favorable refer to committee Rules        
Weinstein
Aye
Ra
Aye
Glick
Aye
Fitzpatrick
Aye
Pretlow
Aye
Hawley
Aye
Colton
Aye
Blankenbush
Aye
Cook
Aye
Norris
Aye
Aubry
Aye
Brabenec
Aye
Benedetto
Aye
Palmesano
Aye
Weprin
Aye
Walsh
Aye
Ramos
Aye
DeStefano
Aye
Braunstein
Aye
Manktelow
Aye
McDonald
Aye
Smullen
Aye
Rozic
Aye
Dinowitz
Aye
Joyner
Aye
Magnarelli
Aye
Zebrowski
Aye
Bronson
Aye
Dilan
Aye
Seawright
Aye
Hyndman
Aye
Walker
Aye
Bichotte Hermel
Aye
Simon
Aye
Cruz
Aye

Committee:RULES   Chair:Pretlow      
DATE:06/05/2023AYE/NAY:28/0  Action: Favorable         
Heastie
Excused
Barclay
Aye
Weinstein
Aye
Hawley
Aye
Pretlow
Aye
Giglio
Aye
Cook
Aye
Blankenbush
Excused
Glick
Aye
Norris
Aye
Aubry
Aye
Ra
Aye
Dinowitz
Aye
Brabenec
Aye
Colton
Aye
Palmesano
Aye
Magnarelli
Aye
Reilly
Aye
Paulin
Aye
Peoples-Stokes
Aye
Benedetto
Aye
Lavine
Aye
Lupardo
Aye
Zebrowski
Aye
Thiele
Aye
Braunstein
Aye
Dickens
Aye
Davila
Aye
Hyndman
Excused
Rozic
Aye
Bronson
Aye

A05435 Floor Votes:

A05435 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
 submitted in accordance with Assembly Rule III, Sec 1(f)



 
BILL NUMBER: A5435A
 
SPONSOR: Solages

 
TITLE OF BILL:
 
An act to amend the public health law, in relation to establishing the
New York state community doula directory for doulas serving Medicaid
patients
 
 
PURPOSE::
 
To establish the New York State Community Doula Directory and develop
specific admittance criteria for doulas providing services to Medicaid
patients.
 
 
SUMMARY::
 
Section 1. Legislative findings and declarations.
 
Section 2. Amends article 25 of the public health law by adding a new
title 6-A.
 
Section 3. Sets the effective date.
 
 
JUSTIFICATION::
 
The United States is facing a maternal health crisis, with the rates of
mortality higher than other similarly developed nations. In 2020, the
United States mortality rate was 23.8 deaths per 100,000 live births.
This maternal mortality rate is three times higher than the rate of
France, which holds the second highest rate for industrialized coun-
tries. This maternal mortality rate has continually increased since 2018
(1).
 
In the United States, the mortality rate for Black mothers is dispropor-
tionately higher than that for White women. This statistic also applies
to New York State, where Black women die from pregnancy-related causes
at three times the rate of White women.  Further, in New York City,
Black women are twelve times as likely to suffer a pregnancy-related
death (2).
 
New York State lacks adequate and equitable health care for pregnant
people. This growing issue needs a solution. Doula care is a promising
approach to combating disparities in maternal health.  Doulas offer
prenatal, intranatal, and postpartum care to provide support and comfort
to birthing people. Growing research shows that doula care improves
health outcomes for both pregnant people and newborn babies, including
higher breastfeeding initiation rates, fewer low-birth weight babies,
and lower rates of cesarean births.
 
Despite the benefits of doula care, only a small percentage of pregnant
people use a doula due to lack of information and economic barriers.
Furthermore, Black women are the most likely to want doula services, yet
face the largest barriers in accessing them  
3. New York State can
improve access to doula services by creating a centralized location for
pregnant people to Connect with qualified local doulas. A community
doula directory will provide a cascading benefit in all spectrums of
maternal care in New York.
 
 
RACIAL JUSTICE IMPACT:

Pregnant people of color face disproportionately higher rates of preg-
nancy complications, mistreatment during childbirth, and maternal
mortality. Doulas help combat this inequality by finding low-cost
resources, avoiding unnecessary medical interventions, advocating for
the patient, and by serving as a guide and caregiver to the expecting
person. Doulas can also help reduce the impacts of racism and racial
bias in healthcare by providing individually tailored, culturally appro-
priate, and patient-centered care. Providing a centralized and accessi-
ble space for pregnant people to find quality doula care is a step
towards addressing and reducing racial inequalities in maternal health-
care.
 
 
GENDER JUSTICE IMPACT:
 
Establishing a directory where pregnant people can easily connect with
qualified doula caregivers will improve the health outcomes of pregnant
women by increasing accessibility. The benefit of this bill expands
beyond expecting mothers and also benefits doulas themselves, as 94.3%
of the doula workforce is made up of women  
4. Creating a centralized
location where their services can be accessed will enable doulas to
acquire more patients and further their career. Doulas improve as they
get more experience. Therefore, the more patients access them, the
greater their impact on maternal health outcomes.  This bill will
increase accessibility for all birthing people to doula care, which will
particularly help women of color who are expecting.
 
 
LEGISLATIVE HISTORY::
 
2022: A10333; referred to health.
 
 
FISCAL IMPLICATIONS:
 
TBD.
 
 
EFFECTIVE DATE::
 
'This act shall take effect six months after it shall become a law.  (1)
https://tcforg/content/commentarv/worsening-u-s-maternal-health-crisis-
three-graphs/
(2) https://www.propublica.org/article/nothing-protects-black-wornen-
from- dying-in-pregnancy-and-childbirth
(3)
https://www.cnn.com/2022/03/27/health/nyc-doula-access-wellness-trnd/
index.html
(4) https://www.zippia.com/doulajobs/demographics/
 
 
 
 
 
 
 
 
 
 
 

A05435 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5435--A
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                     March 10, 2023
                                       ___________
 
        Introduced  by  M.  of  A.  SOLAGES,  THIELE,  SHIMSKY,  GONZALEZ-ROJAS,
          CUNNINGHAM, HYNDMAN, McDONOUGH, J. A. GIGLIO, WALKER,  RAGA,  NOVAKHOV
          --  read  once  and  referred  to the Committee on Health -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee

        AN ACT to amend the public health law, in relation to  establishing  the
          New  York  state community doula directory for doulas serving Medicaid
          patients
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Legislative  findings  and  declarations. The legislature
     2  hereby finds and declares that poor maternal and infant health  outcomes
     3  and  disparities  are  a  public health crisis that pose a threat to the
     4  health, welfare, and quality of life of child  bearing  people,  infants
     5  and  their  families. The legislature acknowledges the imbalances of how
     6  doula care is treated in different communities. Between the rising costs
     7  of reproductive care, the absence of a federal doula Medicaid framework,
     8  and the existing barriers to equitable prenatal, intranatal,  and  post-
     9  partum  care  services,  the  legislature hereby finds the importance in
    10  establishing a community doula directory to  increase  access  to  care.
    11  Having  doula services in an accessible and centralized location that is
    12  open to the public without an economic barrier, will help connect birth-
    13  ing persons with the doula care services they need.
    14    § 2. Article 25 of the public health law is amended by  adding  a  new
    15  title 6-A to read as follows:
    16                                 TITLE VI-A
    17                             DOULAS FOR MEDICAID
    18  Section 2594-a. Definitions.
    19          2594-b. New York state community doula directory.
    20          2594-c. Criteria for admittance into the New York state communi-
    21                    ty doula directory.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04573-02-3
        A. 5435--A                          2
 
     1    §  2594-a.  Definitions.  1.  For  the purposes of this title, "doula"
     2  means a trained person who provides continuous physical, emotional,  and
     3  informational  support to a pregnant person and the family of such preg-
     4  nant person before, during or a reasonable time after childbirth.
     5    2.  A  doula  may  provide services in hospitals, birthing centers, at
     6  home deliveries and other community settings.
     7    § 2594-b. New York state community doula directory. 1. The  department
     8  shall  establish  and maintain a community doula directory for doulas on
     9  the  department's  internet  website  for  the  purposes   of   Medicaid
    10  reimbursement and promoting doula services to Medicaid recipients.
    11    2.  The  directory  shall include the following information concerning
    12  doulas such as:
    13    (a) the name of the doula who provides doula services;
    14    (b) the address  and  location  of  where  the  doula  provides  doula
    15  services;
    16    (c)  the name of each Medicaid provider that employs or contracts with
    17  a doula to provide doula services to eligible Medicaid recipients;
    18    (d) the doula's national provider identification number,  if  applica-
    19  ble; and
    20    (e)  all  documentation  of  criteria  pursuant to section twenty-five
    21  hundred ninety-four-c of this title.
    22    3. The department shall determine the method of registration  and  the
    23  documentation required to verify such criteria has been met.
    24    4.  Each  doula  shall  be responsible for completing the requirements
    25  pursuant to section twenty-five hundred ninety-four-c of this title.
    26    5. The department shall not impose any fee on any  doula  to  register
    27  for admittance into the New York state community doula directory.
    28    6.  The  community  doula directory shall be publicly accessible at no
    29  cost to the doula or birthing person looking to hire a  doula  in  their
    30  community.
    31    §  2594-c.  Criteria  for admittance into the New York state community
    32  doula directory.   1. Each doula seeking  Medicaid  reimbursement  shall
    33  apply to be registered in the New York state community doula directory.
    34    2.  A  doula  shall  submit to the department a certified copy of such
    35  doula's certification from a doula educational organization or by demon-
    36  stration of satisfactory proficiency pursuant to this section, and  his,
    37  her,  or  their  full name, address, phone number, email address, and if
    38  applicable, their national provider identification number.
    39    § 3. This act shall take effect nine months after it shall have become
    40  a law.

A05435 LFIN:

 
NO LFIN