I am not an authority on anything legal nor am I an expert when comes to government regulations and the political process. I am learning. If you are a doula or any form of birth worker, my recommendation is that it may be time for you to become more politically active, especially if you have been like me and have remained aloof of public policy discussions until now.
So here’s a brief recap, if this is the first time that you are hearing about this. Last month, June 18th, the New York state legislature (Senate and Assembly) passed a bill that would begin to regulate the certification of doulas within the state of New York. While the bill had been on the table since early January of this year, few, if any, in any circles of influence within the doula community knew anything about this bill until its passage. There has been a bit of finger pointing since its passage, and whether the claims are valid or not, it’s a fairly mute point at this stage now that everyone’s eyes are wide open about this law.
A recent townhall-style meeting was held with several of the key legislators backing this bill and a group of concerned citizens to discuss the passage of this bill. The meeting took place on Wednesday, July 10, 2019 at Weeksville Heritage Center in Brooklyn, NY. It was subsequently published by Jennifer Oge to YouTube and can be seen here:
In case you don’t have the time to sit through the hour and half discussion, here’s a highlight of some of the notes that I had garnered from the discussion.
First off, let’s introduce key players in this conversation:
- Chanel Porchia-Albert – Ancient Song Doula Services
- Amy Paulin – assemblyperson, New York state (lead sponsor of “the doula bill”)
- Michaelle Solages – assemblyperson, New York state (additional co-sponsor)
- Velmanette Montgomery – senator, New York state
At one point in the presentation (about 1 hour and 15 minutes), a timeline was given of where this bill is presently, in arriving at being made into law. Assemblyperson Paulin’s expectation was that because this has become a controversial bill, that the governor will hold off on making a decision about signing it until December. This space of time allows for the creation of chapter amendments that may modify the actual bill that has been passed. In December, the governor will then sign or veto the bill. If vetoed, a new bill can be drafted and proposed in January for the next legislature to consider.
While veto is an option, it was emphasized that it was probably not the best option at this point, because the topic is already on the table. As Paulin repeatedly emphasized, the issue is not going to go away with a veto. We will not see a return to the way things were with a veto.
The Legislature’s Perspective
In understanding where this bill came from, it was very helpful to hear the motivation for it from the law-makers who sponsored it. (Bear in mind that I am only reporting here, not endorsing this perspective.) The intention of this bill was to provide the doula community with a legitimacy of profession. By creating a regulatory process, their objective was to professionalize the doula community so that it might hold the same distinction as other professions which are regulated through state offices.
A secondary motive, and this is noteworthy, was to create a vehicle for doula reimbursement through Medicaid. Four other states were cited as having laws that allowed for doula reimbursement via Medicaid through a state-licensed professional. New York’s bill was being crafted in such a way as to make doulas independent of a third-party licensed care-provider as the means of their reimbursement. In otherwords, doulas would be able to apply directly to Medicaid for reimbursement of services, not to a doctor or hospital. The same would be the goal for private insurance, as well.
So in summary, the lawmakers behind this bill, out of a sense of respect for the work of doulas, were attempting to elevate the doula community. At the end of the conversation, Paulin did rescind the use of the word “elevate” in favor of simply acknowledging that what the government is trying to do is encourage more doulas to enter into the profession by providing the financial resources to support them.
The Community’s Concerns
A very well-illustrated presentation starts off the town hall meeting. In it, the bill is dissected and concerns listed that spell out some of the biggest issues with the wording of the law. I will not spell those out here, but similar sentiments have been expressed across the doula community from many organizations.
Beyond this, the feeling that I got from the community’s participation in this meeting was that the attempts by the government to validate the doula profession backfired. Because there was not a group consensus at the outset and the poor wording of the law. Where validation may have been the intent, the result came across as an expression of distrust, with an need to regulate or control or mold the doula profession with a one-size-fits-all stamp of approval. Emotions did get a bit intense at several spots in the meeting, but in the spirit of civil discourse opinions were heard and noted.
Additional Key Insights
Here are a few additional notes that didn’t fit elsewhere:
- Solanges said the the pilot doula program is failing because they are not educating the department of Health.
- The legislature doesn’t write out all the details of the law, the final fleshing out of the law gets handed over to the Department of Health.
- Earlier Paulin said that at the end of the day a doula can still practice as a doulas as they currently do in New York even if this bill passes.
- Ancient Song Doula Services has a reported that 15 different state bills are out there concerning doula legislation.
- Medicaid funding is split 50/50 between state and federal funding, but because doulas are not licensed they cannot gain federal funding. Paulin sees this bill as a first step, a stepping stone as toward licensure for doulas.