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-25.0993.01000
+25.0993.02005
+Title.05000
+Prepared for the Senate Appropriations -
+Human Resources Division Committee
 Sixty-ninth
+March 31, 2025
 Legislative Assembly
 of North Dakota
 Introduced by
 Representatives Dobervich, K. Anderson, Brown, Finley-DeVille, Hager, Hanson, Rohr,
 Steiner
 Senators Hogan, Mathern
-A BILL for an Act to create and enact a new section to chapter 23-12 and a new section to
-chapter 50-24.1 of the North Dakota Century Code, relating to postpartum doula certification
-and medical assistance benefits for postpartum doula services.
+In place of the amendments (25.0993.02002) adopted by the Senate, engrossed House Bill
+No. 1464 is amended by amendment (25.0993.02005) as follows:
+A BILL for an Act to create and enact a new section to chapter 23-12 of the North Dakota
+Century Code, relating to postpartum doula certification; and to provide for a legislative
+management report.for an Act to provide for a legislative management study relating to
+maternal care services.
 BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
-SECTION 1. A new section to chapter 23-12 of the North Dakota Century Code is created
+      SECTION 1. A new section to chapter 23-12 of the North Dakota Century Code is created
 and enacted as follows:
-Postpartum doula certification.
-1. As used in this section:
-a. "Certified doula" means an individual who has received a certification to perform
+      Postpartum doula certification.
+      1.    As used in this section:
+              a.    "Certified doula" means an individual who has received a certification to perform
 doula services from the doulas of North America or an organization designated
 by the department.
-b. "Department" means the department of health and human services.
-c. "Doula services" means education and support services for a parent and child,
+              b.    "Department" means the department of health and human services.
+              c.    "Doula services" means education and support services for a parent and child,
 including continuous emotional and physical support during the postpartum
 period, including up to six months after the birth of the child.
-2. The department may:
-a. Designate additional doula certification organizations;
-b. Remove the designation of a doula certification organization; and
-c. Adopt rules to implement and administer this section.
-3. The department shall establish criteria for the designation of doula certification
+      2.    The department may:
+              a.    Designate additional doula certification organizations;
+              b.    Remove the designation of a doula certification organization; and
+Page No. 1 25.0993.02005
+ENGROSSED HOUSE BILL NO. 1464
+FIRST ENGROSSMENT
+PROPOSED AMENDMENTS TO
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+Sixty-ninth
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+              c.    Adopt rules to implement and administer this section.
+      3.    The department shall establish criteria for the designation of doula certification
 organizations and maintain a list of designated organizations on the department's
 website for purposes of facilitating the availability of certified doulas to provide doula
 services under section     2 of this Act.
-Page No. 1 25.0993.01000
- HOUSE BILL NO. 1464
-
+      4.    The department may not impose a licensing or certification fee in addition to any fees
+imposed by a doula certification organization meeting the criteria established by the
+department.
+      SECTION 2. LEGISLATIVE MANAGEMENT REPORT - POSTPARTUM DOULA
+CERTIFICATION. During the 2025-26 interim, the department of health and human services
+shall provide a report to the legislative management regarding postpartum doula certification,
+including the status of implementing and administering the responsibilities relating to
+postpartum doula certification under section 1 of this Act and the impact of certified doula
+services.
+SECTION 1. LEGISLATIVE MANAGEMENT STUDY - MATERNAL CARE SERVICES.
+1. During the 2025-26 interim, the legislative management shall consider studying
+maternal care services. The study must include:
+a. An analysis of the availability of medical and nonmedical prenatal services in the
+state by community and geographic service area, and the utilization rate of each;
+b. A review of childbirth service availability, including in-home and health care
+facility-based services, and the number of obstetrician-gynecologists and family
+practitioners routinely delivering babies by geographic service area;
+c. A review of prenatal, childbirth, and postnatal services covered by public
+assistance, private insurance, and pregnancy resource centers, including an
+analysis of funding, program evaluation, and outcomes;
+d. Consideration of previous studies related to maternal care services;
+e. Consideration of maternal care resource and asset maps, service gaps,
+evidence-based or innovative pilot project solutions for resolving service gaps,
+and approaches for increasing the use of prenatal and postnatal care services
+and programs;
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 Legislative Assembly
-SECTION 2. A new section to chapter 50-24.1 of the North Dakota Century Code is created
-and enacted as follows:
-Medical assistance benefits - Postpartum doula services.
-1. Medical assistance coverage, including Medicaid expansion coverage, must include
-coverage of postpartum doula services, as defined in section 1 of this Act.
-2. The department shall provide notice to an enrollee regarding the coverage required by
-this section.
-Page No. 2 25.0993.01000
+f. An evaluation of ways to increase the number of obstetrician-gynecologists and
+family practitioners practicing in the state;
+g. Exploration of processes for certifying, training, and reimbursing doula and
+midwife services;
+h. Consideration of public assistance and private insurance policy opportunities to
+improve maternal and infant health outcomes; and
+i. Input and consultation from key stakeholders, including:
+(1) The university of North Dakota school of medicine and health sciences;
+(2) The North Dakota maternal mortality review committee;
+(3) The infant mortality review panel;
+(4) The foundation for a healthy North Dakota;
+(5) Doulas, midwives, and home-based service providers practicing in the state;
+(6) The North American college of obstetricians and gynecology;
+(7) The North Dakota medical association;
+(8) The women, infants, and children program; and
+(9) North Dakota health tracks.
+2. The legislative management shall report its findings and recommendations, together
+with any legislation required to implement the recommendations, to the seventieth
+legislative assembly.
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