Nur 398 DB 4 Co-stance
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Dec 6, 2023
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Module 4 Discussion Board
September 20, 2023
H421 Bill: Medicaid Coverage for Doula Services
Con stance talking point #1
No support or guidance is given to doulas regarding how to become a Medicaid provider in some
states.
For doulas to become Medicaid providers, there are specific actions they must take. The
initial step involves obtaining authorization from their state. (Chen, 2022)
Following that, they
must establish contractual relationships with Medicaid-managed care plans. Additionally, they
must be capable of translating billing codes to submit claims for payment (Chen, 2022)
. Finally,
they may need to track and report data to the health plan and State Medicaid Agency (Chen,
2022)
. This is done to discourage them from getting reimbursement or filing claims, which can
obscure programs, data, and more.
Con-stance talking point #2
"While I understand some people may find a doula's services helpful, I believe it is unnecessary
and may even detract from the birth experience. In my opinion, relying on medical professionals
and loved ones for support can be just as, if not more, effective."
Con-stance talking point #3
The State Medicaid Agencies' proposed requirements are unnecessarily stringent and pose
unwarranted obstacles to entry for many doulas, such as 1.) requiring doulas to receive training
from specified certified organizations (Chen, 2022)
. 2.)
Numerous doulas, particularly those
from marginalized communities such as Black, Indigenous, or people of color, have expressed
dissatisfaction with the leading doula training and certification organizations with no response or
solution (Chen, 2022)
. 3.) They have observed that these organizations do not prioritize the needs
of underserved communities and fail to provide adequate training to doulas to cater to Medicaid
enrollees (Chen, 2022)
. 4.) Moreover, existing state training and certification regulations do not
offer any prospects for career growth for experienced doulas (Chen, 2022)
.
Reference
Chen, A. (2022, November 18).
Current State of Doula Medicaid implementation efforts in
November 2022
. National Health Law Program. https://healthlaw.org/current-state-of-
doula-medicaid-implementation-efforts-in-november-2022/
Response: Greetings Wayanna,
It is truly disheartening to witness the current situation. The bill in question must undergo a
thorough reevaluation process. Having worked in a local ER and witnessed firsthand the
struggles of young patients, I am acutely aware of the dearth of mental health resources available
to them. Patients and their families are often overwhelmed by behavioral issues and feel lost,
leading to instances of abuse or abandonment. Foster families require even more attention, as
many children in their care have a history of behavioral problems and concerns. Any lapse in
care or change in their surroundings can further impact their mental health. These children must
receive the necessary support, as otherwise, foster parents may become unwilling to continue
caring for them or leave them at the hospital as a last resort for social services to pick them up
again.
Within the United States, North Carolina is among nine states wherein the child welfare system
is overseen at the state level but managed by county governments
(Knopf, 2023)
. DHHS' 2018
report reveals that North Carolina ranked last in per-child investment across all public funding
sources in this system
(Knopf, 2023)
.
What changes would you suggest to improve this bill and better meet the needs of foster children
and families?
Reference
Knopf, T. (2023, July 10).
Lack of mental health treatment resources for minors can land
children in NC’s troubled child welfare system
. North Carolina Health News.
https://www.northcarolinahealthnews.org/2023/07/10/few-mental-health-treatment-
resources-for-kids-troubled-child-welfare-system/
Greetings Daelyn,
This is undoubtedly a complex issue. While I align with pro-life beliefs, I believe that each
situation presents unique circumstances that must be considered. Implementing blanket laws that
apply to all cases can restrict individual freedoms and even drive people to take dangerous and
illegal actions. It is essential to approach this topic with sensitivity and an open mind.
Can you suggest ways to empower individuals to express their opinions without infringing on
their liberty?
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