Q&A from Doulas Know Best - Lessons Learned from California’s Doula Pilot Programs - January 26, 2022

Sep 14, 2026

Uploaded by Miles

Q&A summarizes lessons from California’s doula pilot programs based on questions raised during a panel discussion on policy, financing, and workforce implementation. Topics include reimbursement coverage for Federally Qualified Health Centers, approaches to salaried doula models, and how living-wage compensation relates to intervention savings and tracking. It also addresses Medicaid billing and reimbursement rates, comparable pay across doula types, systemic barriers tied to education and lived experience, access to healthcare as contractors, and how doulas fit into 6–12 month postpartum extensions. Workforce recruitment and job description examples are highlighted alongside state tracking resources.

LanguageEnglish

CategoryLetters

FormatPDF

Pages13

Reading Time5 min

AccessFree to download

Panel discussion questions and answers

Reimbursement, billing, and coverage scope

Workforce models, pay, and recruitment

Q&A from Doulas Know Best: Lessons Learned from California’s Doula Pilot Programs January 26, 2022 Questions submitted during panel discussion: 1) There has not been discussions regarding reimbursements with Federally Qualified Health Centers (FQHCs) . Can we make sure that we include FQHC's in future discussions? a) Thank you for bringing up FQHCs. We will keep this in mind for future discussions. 2) Can you share more about the model for salaried doula work? a) Please see Marna’s response to this question during the panel discussion 3) How do we communicate that paying doulas a living wage more than pays for itself with the money they save on interventions? Who is tracking the savings? a) Please see Linda’s response to this question during the panel discussion 4) Khefri you said doulas can and do bill for their services. Is this private insurance, or Medi-cal, or both? Or did you mean just billing patients directly? Is there data on how much doulas are reimbursed in other states, particularly those states that cover doula services within their Medicaid systems? a) The National Health Law Program's Doula Medicaid Project has been tracking state implementation of Medicaid coverage for doula care, including reimbursement rates. You can find our chart of "Current State Doula Medicaid Efforts" at: [https://healthlaw.org/doulamedicaidproject/](https://healthlaw.org/doulamedicaidproject/) 5) Should community doulas be paid in comparison to private doulas, or to other birthing professionals? a) We believe that all doulas and birthing professionals should be paid a thriving wage. b) In addition, community based doulas often have more and diverse experience working with communities of color (Black and Brown) . These communities often have needs and risks that aren’t adequately served through the traditional medical system. Doulas build a bridge and support in clients accessing resources, tools and often have training around the specific needs of their community and should be compensated comparably, if not more for their expertise. 6) One of the systemic barriers is the fallacy of merit associated with higher education-we need to help people who are making decisions about compensation recognize that the power of lived experiences are just as amazing, or honestly, even better. a) Yes, this is a big challenge for community health workers and community-based doulas. b) Yes, we agree. We align with lived and professional experience, cultural inheritance, and traditional wisdoms as well as standard educational pathways. We also believe that family members are a key part of birth support teams and may be the best people to give doula care safely and competently. 7) How do doulas usually access health care especially as contractors? a) This is definitely a barrier and came up as a challenge for some of the pilot programs. 8) Would it be possible to have a doula job description that we can all take a look at? Weare the Venice Family Clinic (FQHC) and piloted a Doula project at the end of 2021. 2022 we will be hiring doulas as staff, would like a JD that maybe we can all have some same language or verbiage. a) If you go to our website [www.sisterweb.org](www.sisterweb.org) and look for the careers, you can see our doula job descriptions 9) How do you envision doulas as part of 6 and 12 month postpartum extensions? a) There are a number of states that are rolling out doula Medicaid coverage in 2022, parallel to rolling out Medicaid postpartum expansions. Here in California we are currently doing both (doula Medicaid as well as 12 month postpartum extension), and many of us are advocating w/ our State Medicaid Agency to have expanded postpartum doula care coverage through that 12 month period as well for our Medicaid enrollees. Many of the doula pilots had multiple postpartum visits with the clients (see summaries doc for more details) . Also FYI chart tracking state doula Medicaid implementation effort

FAQs

Are Federally Qualified Health Centers (FQHCs) included in future reimbursement discussions?

The panel response confirms FQHCs will be kept in mind for future discussions so they are included going forward.

How is the model for salaried doula work addressed in the panel discussion?

The response directs readers to Marna’s answer given during the panel discussion for further detail about the salaried doula model.

How do doulas fit into 6 and 12 month postpartum extensions under Medicaid?

The Q&A explains that multiple states are rolling out doula Medicaid coverage alongside Medicaid postpartum expansions, and in California both are currently pursued, with advocacy to extend postpartum doula coverage through the full 12-month period.

Sep 14, 2026

Uploaded by Miles