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PREMATURITY COLLABORATIVE

POLICY WORKGROUP

May 14, 20194:00-5:00 PM ET

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GENERAL HOUSEKEEPINGPlease note the following: All participants will be muted on entry

To speak to the group, remember to unmute yourself:1. If you are connected through the computer audio, click the mic in the lower left hand

corner of your screen to unmute and mute.2. If you are connected through the phone press *6 to unmute and mute

Be sure to mute yourself when you are not speaking

Please do not place call on hold

Use the chat box, if you would like a moderator to call on you or share your comments with the group

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AGENDA FOR TODAY’S MEETINGWelcome – Cindy Pellegrini, SVP Public Policy and Government Affairs, March of Dimes and Andrea Kane, Vice President Policy & Strategic Partnerships, Power to Decide Doula SupportNortheast perspective: Erin Jones, JD, Regional Director of Advocacy and Government Affairs, March of Dimes, MA, NY and the NortheastWashington State perspective: Christy Curwick Hoff, MPH, Council Manager, WA State Governor’s Interagency Council on Health Disparities & Dila Perera, MSW, MPH, Executive Director, Open Arms Perinatal ServicesMinnesota perspective: Akhmiri Sehkr-Ra, Chief Family Development Officer, Cultural Wellness CenterClosing Business

• Upcoming meetings• Call to Action• Next meeting on June 18th 4-5pm ET/ 1-2pm PT

Adjourn

MARCH OF DIMES

SUPPORTING DOULA COVERAGE LEGISLATION AND POLICY EFFORTS IN THE NORTHEAST

Erin E. Jones JDRegional Director Advocacy and Government Affairs, Northeast Region

April 16, 2019 ejones2@marchofdimes.org

PRESENTATION OUTLINE

• Why Doulas?• Opportunities for increasing integration of doula care in statewide

maternity care system• Current States with legislation pending• Fully collaborative policy development approach

EVIDENCE: DOULAS & BIRTH OUTCOMES

• 2014 ACOG Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery

• 2017 Cochrane review of 26 trials of continuous labor support and doula care involving over 15,000 women in 17 different countries

• 2017 ACOG Committee Opinion on Approaches to Limit Interventions During Labor and Birth

• Cost-effectiveness analysis and modeling literature

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BENEFITS OF DOULA CARE

• Improved health outcomes for moms and babies• Increased spontaneous vaginal birth• Shorter duration of labor• Decreased use of analgesia, instrumental vaginal birth,

and low five-minute Apgar score

• Reduced c-sections• C-sections contribute to risk of maternal morbidity and

mortality

• Fewer reports of patient dissatisfaction with birth experience

• Lower healthcare costs

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BENEFITS OF DOULA CARE AMONG MEDICAID RECIPIENTS AND COMMUNITIES OF COLOR

• Improved health outcomes for moms and babies• Lower rates of preterm birth and low birth weight

• Reduced c-sections• C-sections contribute to risk of maternal

morbidity and mortality• Patient reports of feeling highly valued and having

had a voice in consequential childbirth decisions • Improved health literacy• Improved patient-provider communication• Increased social support

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INDIANA

NEW JERSEY

CONNECTICUT New York

Massachusetts

Rhode Island

Key Areas/Components of Legislation:

- Definition of a Doula

- Pre-Existing Category

- Establish a Registry

- Certification

- Payments

- Establish Rules and Regulations

- Amendments

DOULA LEGISLATIONMaternal Mortality and Morbidity Movement

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-Legislative Process and Advocacy Education/Guidance

-Collaborative Approach – doulas, legislators, advocates, agencies, and health care

-Active Listening, Engaged Conversation

-Repository for Feedback

-Held in MA, CT, RI, (NY)

DOULA TOWN HALLS

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Increase

Doula

Access and

Use

EDUCATION

Licensure/Certification (CMS Requirement)

NOT medical or healthcare providers

Diversity within Medicaid population

Medicaid Reimbursement Rates and Payment System

Community Health Worker

Medicaid Value-Based Payment Models

EDUCATION Licensure/CertificationMaintain Fidelity to Doula ProfessionDiversity – both in women served and DoulasWorkforce Development-sustainable living wage, cost-effective training and educationReimbursement Rates and Payment SystemsCommunity Health Worker Model (?)

DOULASUPPORT NON-MEDICAL

MEDICAIDMEDICAL MODEL

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SUMMARY

Increased equitable access to doula care as one tool to reduce racial disparities in adverse maternal and infant health outcomesOpportunities for adequate and sustainable reimbursement by all payersInvestments in doula profession as workforce development and diversification opportunity

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THANK YOU

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CHRISTY CURWICK HOFF, MPHCOUNCIL MANAGERWA STATE GOVERNOR’S INTERAGENCY COUNCIL ON HEALTH DISPARITIES

GOVERNOR’S INTERAGENCY COUNCIL ON HEALTH DISPARITIES

PREMATURITY COLLABORATIVE—POLICY WORK GROUPMAY 14, 2019

OVERVIEW

About the Council

Adverse Birth Outcomes Recommendations

2019 Legislative Session Highlights

GOVERNOR’S INTERAGENCY COUNCIL ON HEALTH DISPARITIES 16

Inequities in Adverse Birth Outcomes Advisory Committee

First Set of Recommendations

• Fund community-driven prevention programs

• Increase funding for Maternity Support Services

• Promote Equity in State Government

Second Set of Recommendations

• Medicaid reimbursement for doula care

• Support AIHC Maternal-Infant Health Strategic Plan

GOVERNOR’S INTERAGENCY COUNCIL ON HEALTH DISPARITIES 18

2019 SESSION HIGHLIGHTS

• Medicaid Reimbursement for Doula Services

• Office of Equity Task Force

GOVERNOR’S INTERAGENCY COUNCIL ON HEALTH DISPARITIES 19

Twitter/WAHealthEquityFacebook/WAHealthEquitywww.healthequity.wa.gov

THANK YOU

To request this document in an alternate format, please contact Kelie Kahler, Washington State Board of Health Communication Manager, at 360-236-4102, or by email at kelie.kahler@sboh.wa.govTTY users can dial 711

DILA PERERA, MSW, MPH EXECUTIVE DIRECTOROPEN ARMS PERINATAL SERVICES

AKHMIRI SEHKR-RACHIEF FAMILY DEVELOPMENT OFFICER CULTURAL WELLNESS CENTER

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• Fact sheets/issue briefs

• Testimony/talking points

• Sample legislation

• Peer-reviewed literature and other research/studies

• Other

REMINDER: WE NEED YOUR POLICY RESOURCES

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EQUITY IN ACTION: MOVING FROM THEORY TO PRACTICE

Registration is NOW OPEN! http://www.cvent.com/d/f6qd6k

Please reach out at the collaborative@marchofdimes.orgwith questions!

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COLLABORATIVE MEETING SCHEDULE (all times are EST)COLLABORATIVE MEETING SCHEDULE (all times are EST)

2019 Jan Feb March April May June July Aug Sept Oct Nov Dec

Full Collaborative

131:00-2:30

222:00-3:30

181:00-2:30

141:00-2:30

Steering Committee

24 12:30-2:00

111:00-2:30

291:00-2:30

912:30-2:00

Health Equity 303:30-5:00

283:30-5:00

183:30-5:00

263:30-5:00

73:30-5:00

Clinical & Public Health Practice

303:30–5:00

1412:30-2:00

53:30-5:00

313:30-5:00

263:30-5:00

203:30-5:00

Policy 15 | 304-5 | 3:30

124:00-5:00

134:00-5:00

184:00-5:00

144:00-5:00

184:00-5:00

234:00-5:00

204:00-5:00

263:30-5:00

224:00-5:00

194:00-5:00

174:00-5:00

CommunicationsTBD

If you are interested in attending the full Collaborative or specific workgroup meetings please email us at collaborative@marchofdimes.org to receive the registration link and specific meeting information. This calendar is subject to change.

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In the chat box, you will see a link to a brief post-meetingsurvey that will take you less than 5 minutes to complete.Your feedback is very important to us. Thank you forparticipating!

The link for the survey is: http://marchofdimes.org/workgroup

Click on the Chat icon in your toolbox to access the survey link.

ADJOURN