Olympia — State officials and community advocates on July 22 gave the Senate Health and Long Term Care Committee an update on Washington’s new Apple Health Medicaid doula benefit, the companion doula hub and related outreach and certification work.

The state launched the Apple Health Medicaid doula benefit on Jan. 1, 2025. The Department of Health (DOH) began a voluntary doula credential in October 2023, and community organizations contracted with the Health Care Authority (HCA) to design a statewide hub and referral system to smooth referrals, certification, training and billing.

Why it matters: Presenters said doula care — emotional, physical and informational nonmedical support during prenatal, birth and postpartum care — is evidence‑based and linked to better birth outcomes, higher breastfeeding rates and fewer unnecessary interventions. Advocates highlighted the potential to reduce inequities for Black, Indigenous and people of color.

What presenters reported
- Certification and enrollment: The DOH reported 336 state‑certified doulas and 110 certification applications pending; DOH has approved 28 training programs. HCA said 134 doulas are enrolled in Apple Health Medicaid as providers, they have served 287 unique Apple Health clients and HCA has paid 641 claims since the Jan. 1 launch.
- Benefit design: HCA’s clinical policy covers prenatal intake visits, labor and delivery in‑person attendance, additional prenatal and postpartum visits (including a required 1.5‑hour comprehensive postpartum visit) and allows up to 20 hours of doula service with specified telehealth allowances for some visits.
- Community hub and recommendations: Doulas for All, a coalition that spearheaded community engagement, led a participatory process — seven virtual “community cafes,” surveys and statewide family forums — and produced design recommendations. Their priorities included a centralized directory and referral system, peer‑supported certification and ProviderOne enrollment assistance, access to HIPAA‑compliant client-management and billing software at discounted rates, and supports to reduce doula administrative burden.

Next steps and funding
HCA said a new operating budget appropriation provides funding for continued implementation; HCA aims to implement doula services in the uniform medical plan mid‑2026. Doulas for All said it is working to transition to an independent fiscal sponsor for the hub and recommended that the state fund peer‑support and administrative roles to sustain the work.

Committee discussion
Lawmakers asked about geographic distribution and access. HCA and DOH showed maps that demonstrate the doulas are concentrated in some counties (for example, King County) but that smaller counties have doulas as well; HCA said access is uneven and the hub work aims to reduce gaps. Advocates said doulas largely built the enrollment effort through volunteer certification and enrollment parties and that sustaining the model will require funding for workforce supports, HIPAA compliance help and affordable billing software.

Ending
State officials and community leaders described the early implementation as promising: the credential and benefit are in place, hundreds of doulas are certified or enrolled, and the doula hub design offers specific operational recommendations that the state and managed care organizations can use to scale access.