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Senate advances bill to create state doula certification process; TennCare language to be removed
Summary
Committee approved Senate Bill 44 to direct the Department of Health to establish rules for verifying doula certification. An amendment delayed rule start to 2026; sponsor said she will remove optional TennCare coverage from the bill and let TennCare decide separately.
The Senate Health and Welfare Committee approved Senate Bill 44 on a vote that sent the measure to the finance committee on Tuesday. The bill, carried by Senator Lamar, would direct the Tennessee Department of Health to establish a rule and verification process for certifying doulas who complete qualifying training programs. The committee approved an amendment that delays rule promulgation until 2026.
“Doula services are associated with improved health outcomes,” Senator Lamar said, citing research presented to the committee that links doula support with lower cesarean and induction rates, higher breastfeeding, and improved birth experiences. Lamar told the committee she intends to file an amendment to remove TennCare coverage language and keep the bill focused on certification.
The committee heard questions about who administers certification and how training is defined. Lamar said the Department of Health would promulgate rules based on recommendations from a doula advisory committee that the legislature previously created; that committee includes health professionals, doulas and clinicians and will submit competency recommendations for Tennessee.
A fiscal note discussed TennCare costs if the program added doula coverage: the estimate assumed 20% of covered pregnant women would use doula services (about 7,841 women) and projected increased annual Medicaid expenditures of about $8.6 million, of which roughly $3.0 million would be state funds and $5.6 million federal funds; the note also estimated potential offsetting savings from lower preterm or cesarean rates. Senator Lamar said she plans to remove TennCare language so the committee would consider certification only and allow TennCare to make its own coverage decisions.
The committee passed the amendment that moved the rule start date to 2026 and advanced the bill to finance. The committee recorded seven ayes, zero nays and two present not voting on the bill.
