BILL ANALYSIS

H.B. 465

By: Thierry

Human Services

Committee Report (Unamended)

BACKGROUND AND PURPOSE

The Texas Maternal Mortality and Morbidity Review Committee makes recommendations to improve maternal health outcomes, and one such recommendation involved increasing access to doula support throughout a woman's pregnancy. Doulas are trained professionals who advise, inform, and oversee the emotional and physical needs of the mother. Studies approved by the National Institutes of Health indicate that doula care reduces the likelihood of costly medical interventions, such as cesarean deliveries. Furthermore, doula-assisted mothers are less likely to have a low birth weight baby or to experience birth complications. Many private insurance companies already cover doula services in their health plans, but the Texas Medicaid program does not. H.B. 465 seeks to address this problem by establishing a pilot program to provide Medicaid reimbursement for doula services.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 1 of this bill.

ANALYSIS

H.B. 465 amends the Human Resources Code to require the Health and Human Services Commission (HHSC) to establish a pilot program to provide Medicaid reimbursement for doula services provided by a doula. The bill requires the executive commissioner of HHSC, by rule and in consultation with the Perinatal Advisory Council, to determine the qualifications necessary for an individual to be considered a doula and the doula services to be covered under the pilot program. The bill requires HHSC to prescribe eligibility requirements for participation in the program. The bill defines "doula" as a nonmedical birthing coach who provides doula services and meets the prescribed qualifications and defines "doula services" as nonmedical childbirth education, coaching, and support services, including emotional and physical support provided during pregnancy, labor, delivery, and the postpartum period, or provided intermittently during pregnancy and the postpartum period.

H.B. 465 requires HHSC, not later than September 1, 2024, to implement the pilot program in the most populous county in Texas and in the county with the greatest maternal health support needs, as determined by the county's maternal and infant mortality rates and the number of births in the county by Medicaid recipients. The bill requires HHSC, not later than September 1, 2025, and not later than September 1 of each subsequent year during the operation of the program, to prepare and publish a report evaluating the costs and impact of the program on the HHSC website. Not later than September 1, 2028, HHSC must prepare and submit a written report to the legislature that summarizes the results of the program, includes feedback from participating doulas and Medicaid recipients who received doula services under the program, and includes a recommendation on whether the program should be continued, expanded, or terminated. The pilot program terminates and the bill's provisions expire September 1, 2029.

H.B. 465 provides for the delayed implementation of any provision for which an applicable state agency determines a federal waiver or authorization is necessary for implementation until the waiver or authorization is requested and granted.

EFFECTIVE DATE

September 1, 2023.