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HF 1296

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to insurance; requiring coverage for doula services; requiring medical
assistance to cover doula services; establishing a doula registry; ensuring in the
patient bill of rights the presence of a doula if requested by a patient; amending
Minnesota Statutes 2006, sections 144.651, subdivisions 9, 10; 256B.0625, by
adding a subdivision; proposing coding for new law in Minnesota Statutes,
chapter 62A; proposing coding for new law as Minnesota Statutes, chapter 146B.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62A.0412] COVERAGE FOR DOULA SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Scope of coverage. new text end

new text begin This section applies to all health plans as defined
in section 62A.011 that offer maternity benefits.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage. new text end

new text begin Every health plan in subdivision 1 must provide
coverage for doula services when provided by a nationally certified doula of the mother's
choice.
new text end

new text begin Subd. 3. new text end

new text begin Special restrictions prohibited. new text end

new text begin Coverage under this section shall not be
subject to any greater coinsurance, co-payment, or deductible than that applicable to any
other nonpreventive service provided by the health plan.
new text end

new text begin Subd. 4. new text end

new text begin Definitions. new text end

new text begin The definitions in this subdivision apply to this section.
new text end

new text begin (a) "Doula services" means emotional and physical support during pregnancy, labor,
birth, and postpartum.
new text end

new text begin (b) "Nationally certified doula" means an individual who has received certification
to perform doula services from the International Childbirth Education Association, the
Doulas of North America (DONA), the Association of Labor Assistants and Childbirth
Educators (ALACE), Birthworks, Childbirth and Postpartum Professional Association
(CAPPA), or Childbirth International.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007, and applies to coverage
issued or renewed to Minnesota residents on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2006, section 144.651, subdivision 9, is amended to read:


Subd. 9.

Information about treatment.

Patients and residents shall be given by
their physicians complete and current information concerning their diagnosis, treatment,
alternatives, risks, and prognosis as required by the physician's legal duty to disclose. This
information shall be in terms and language the patients or residents can reasonably be
expected to understand. Patients and residents may be accompanied by a family member
or other chosen representativenew text begin, or bothnew text end. This information shall include the likely medical
or major psychological results of the treatment and its alternatives. In cases where it is
medically inadvisable, as documented by the attending physician in a patient's or resident's
medical record, the information shall be given to the patient's or resident's guardian or
other person designated by the patient or resident as a representative. Individuals have the
right to refuse this information.

Every patient or resident suffering from any form of breast cancer shall be fully
informed, prior to or at the time of admission and during her stay, of all alternative
effective methods of treatment of which the treating physician is knowledgeable, including
surgical, radiological, or chemotherapeutic treatments or combinations of treatments and
the risks associated with each of those methods.

Sec. 3.

Minnesota Statutes 2006, section 144.651, subdivision 10, is amended to read:


Subd. 10.

Participation in planning treatment; notification of family members.

(a) Patients and residents shall have the right to participate in the planning of their
health care. This right includes the opportunity to discuss treatment and alternatives
with individual caregivers, the opportunity to request and participate in formal care
conferences, and the right to include a family member or other chosen representativenew text begin, or
both
new text end. In the event that the patient or resident cannot be present, a family member or other
representative chosen by the patient or resident may be included in such conferences.new text begin A
patient who is an expectant mother has the right to the presence of a doula of the patient's
choice except in the case of an emergency as provided in section 144.652, subdivision 2.
new text end

(b) If a patient or resident who enters a facility is unconscious or comatose or is
unable to communicate, the facility shall make reasonable efforts as required under
paragraph (c) to notify either a family member or a person designated in writing by the
patient as the person to contact in an emergency that the patient or resident has been
admitted to the facility. The facility shall allow the family member to participate in
treatment planning, unless the facility knows or has reason to believe the patient or
resident has an effective advance directive to the contrary or knows the patient or resident
has specified in writing that they do not want a family member included in treatment
planning. After notifying a family member but prior to allowing a family member to
participate in treatment planning, the facility must make reasonable efforts, consistent
with reasonable medical practice, to determine if the patient or resident has executed an
advance directive relative to the patient or resident's health care decisions. For purposes of
this paragraph, "reasonable efforts" include:

(1) examining the personal effects of the patient or resident;

(2) examining the medical records of the patient or resident in the possession
of the facility;

(3) inquiring of any emergency contact or family member contacted under this
section whether the patient or resident has executed an advance directive and whether the
patient or resident has a physician to whom the patient or resident normally goes for
care; and

(4) inquiring of the physician to whom the patient or resident normally goes for care,
if known, whether the patient or resident has executed an advance directive. If a facility
notifies a family member or designated emergency contact or allows a family member
to participate in treatment planning in accordance with this paragraph, the facility is not
liable to the patient or resident for damages on the grounds that the notification of the
family member or emergency contact or the participation of the family member was
improper or violated the patient's privacy rights.

(c) In making reasonable efforts to notify a family member or designated emergency
contact, the facility shall attempt to identify family members or a designated emergency
contact by examining the personal effects of the patient or resident and the medical records
of the patient or resident in the possession of the facility. If the facility is unable to notify
a family member or designated emergency contact within 24 hours after the admission,
the facility shall notify the county social service agency or local law enforcement agency
that the patient or resident has been admitted and the facility has been unable to notify a
family member or designated emergency contact. The county social service agency and
local law enforcement agency shall assist the facility in identifying and notifying a family
member or designated emergency contact. A county social service agency or local law
enforcement agency that assists a facility in implementing this subdivision is not liable
to the patient or resident for damages on the grounds that the notification of the family
member or emergency contact or the participation of the family member was improper or
violated the patient's privacy rights.

Sec. 4.

new text begin [146B.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin The definitions in this section apply to this chapter.
new text end

new text begin Subd. 2. new text end

new text begin Certified doula. new text end

new text begin "Certified doula" means an individual who has received
a certification to perform doula services from the International Childbirth Education
Association, the Doulas of North America (DONA), the Association of Labor Assistants
and Childbirth Educators (ALACE), Birthworks, Childbirth and Postpartum Professional
Association (CAPPA), or Childbirth International.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of health.
new text end

new text begin Subd. 4. new text end

new text begin Doula services. new text end

new text begin "Doula services" means emotional and physical support
during pregnancy, labor, birth, and postpartum.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 5.

new text begin [146B.02] REGISTRY.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner of health shall maintain a registry
of certified doulas who have met the requirements listed in subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Qualifications. new text end

new text begin The commissioner shall include on the registry any
individual who:
new text end

new text begin (1) submits an application on a form provided by the commissioner. The form must
include the applicant's name, address, and contact information;
new text end

new text begin (2) maintains a current certification from one of the organizations listed in section
146B.01, subdivision 3;
new text end

new text begin (3) completes a criminal background check; and
new text end

new text begin (4) pays the fees required under section 146B.04.
new text end

new text begin Subd. 3. new text end

new text begin Renewal. new text end

new text begin Inclusion on the registry maintained by the commissioner is
valid for three years. At the end of the three-year period, the certified doula may submit a
new application to remain on the doula registry by meeting the requirements described in
subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 6.

new text begin [146B.03] COMMISSIONER DUTIES.
new text end

new text begin The commissioner shall establish and maintain the doula registry and:
new text end

new text begin (1) provide registry application forms;
new text end

new text begin (2) complete the criminal background checks on registry applicants; and
new text end

new text begin (3) maintain public access to the registry by providing a link to the registry on the
Department of Health's Web site.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 7.

new text begin [146B.04] FEES.
new text end

new text begin Subdivision 1. new text end

new text begin Fees. new text end

new text begin (a) The application fee is $........
new text end

new text begin (b) The criminal background check fee is $.......
new text end

new text begin Subd. 2. new text end

new text begin Nonrefundable fees. new text end

new text begin The fees in this section are nonrefundable.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 8.

Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:


new text begin Subd. 28b. new text end

new text begin Doula services. new text end

new text begin Medical assistance covers doula services provided by a
nationally certified doula as defined in section 62A.0412, subdivision 4, of the mother's
choice. For purposes of this section, "doula services" means childbirth education and
support services, including emotional and physical support, provided during pregnancy,
labor, birth, and postpartum.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007, and applies to services
provided on or after that date.
new text end