Medi-Cal Benefit for Doulas and Healthcare Providers
Doulas and health care providers- including doctors and midwives licensed to practice in California- can support optimal birth and pregnancy outcomes working together. With the new Medi-Cal Benefit covering doula support for pregnancy, birth, and postpartum more families can access doula support. And together doulas and perinatal care providers can make headway improving outcomes and reducing disparities in birth outcomes.
Did you know Black, Indigenous, and Latina people are more likely to have complications in labor through no fault of their own. Doula support helps reduce the disparities- or differences in outcomes- that make it more dangerous for black, indigenous, and Latina people to give birth. Differences in rate of complications- birth inequities– are associated with cultural misalignment between care providers and birthing people, biased health care systems, impacts of poverty and racism and other causes whether unintentional or otherwise. Doulas, especially doulas from similar cultural backgrounds, are part of the solution and one reason the Medi-Cal Benefit came into being.
If you are a doula and want to become a Medi-Cal Provider
Doulas must be 18 years or older, have training or 5-years’ experience providing doula support and testimonials from families and health care providers. They also need to be certified in Cardiopulmonary Resuscitation and have training in the Health Information Portability & Accountability ACT (HIPAA).
What the Benefit Covers
The Medi-Cal doula benefit covers visits during pregnancy, birth and labor support, and postpartum. It covers up to 9 combined prenatal and postpartum visits. Reimbursement rates can be found in the Doula Stakeholder Meeting PowerPoint from October 2022.
The following documents are available through the Department of Health Care Services website here- Doula Services (ca.gov)
The Department of Health Care Services will be offering ongoing education and training to doulas on becoming Medi-Cal providers, billing, and more. A short 10 minute presentation introducing the benefit can be found here- Doula Services Benefit
For Health Care Providers
Integration of doulas in the care team is a recommendation of The California Maternity Quality Care Collaborative (CMQCC). The CMQCC created a series on working with midwives and doulas including videos you can find here Integrating Midwives, Doulas, and Community-Based Birth Care – YouTube and there toolkits including Support Vaginal Birth and Reduce Primary Cesareans Toolkit | California Maternal Quality Care Collaborative (cmqcc.org) which describes doula support as an effective tool to reduce the number of primary cesareans.
Per the Department of Health Care Services All Plan Letter written recommendations must be made by a
“physician or other licensed practitioner of the healing arts acting within their scope of practice under state law. The recommending physician or licensed practitioner does not need to be enrolled in Medi-Cal or be a Network Provider within the Member’s MCP.”
These can include standing orders from a plan or care provider group, recommendation in beneficiary chart, or standard form provided to a beneficiary from a care provider.
Sample doula recommendation form from Blue Shield of California StreamDocumentServlet (blueshieldca.com)
Doula support improves outcomes
Because doula support improves outcomes, doula services are appropriate for any pregnant person who desires the support of a doula. However, a recommendation is required. Any pregnant person can receive a recommendation for doula support. There are no restrictions for complicating factor but anyone with pre-existing conditions or complications can also benefit from doula support. Services are available for families experiencing miscarriage, abortion, or stillbirth.