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Committee approves certification for community-based perinatal doulas and seeks Medicaid coverage pathway
Summary
S.53, creating voluntary certification for community-based perinatal doulas and directing the state to pursue Medicaid reimbursement, was reported favorably 7-0. The Office of Professional Regulation estimated modest licensing revenue and asked for $25,000 to stand up the program.
The Vermont Senate Finance Committee on March 18 voted 7-0 to report S.53 favorably. The bill would add voluntary certification and a certification title for community-based perinatal doulas, permit certified doulas to participate as providers in Medicaid (subject to federal approval if a state plan amendment is required), and establish application and renewal fees administered by the Office of Professional Regulation (OPR).
OPR witnesses told the committee that Act 97 of 2024 directed OPR to perform a sunrise review of perinatal doulas and that OPR concluded certification is the appropriate, least-restrictive form of regulation to protect the public. OPR recommended a $75 initial application fee and a $120 biennial renewal fee. The department estimated it would cost roughly $25,000 to stand up the certification program (stakeholder engagement, IT updates, rulemaking and initial administrative work); the committee amendment included a $25,000 appropriation to OPR for implementation.
Proponents and OPR said certification is voluntary but that Medicaid reimbursement is likely to require a certified provider; the bill directs the state to pursue a state plan amendment if federal approval is necessary. OPR and witnesses noted evidence that doula services can improve maternal outcomes and lower some costs—reducing C-section rates, preterm births and postpartum complications—but JFO cautioned that potential savings cannot be booked now and depend on uptake and program design.
Committee members discussed fees, outreach to communities that doulas serve, and OPR’s broader fee and revenue situation. OPR said it has run multi-year deficits and has asked for two additional years to study broader fee adjustments; the agency emphasized it set fees for doulas to cover program costs while minimizing barriers to entry for a profession that serves vulnerable populations.
The committee recorded the roll call and reported S.53 favorably to the Senate with unanimous support.
