Today Councilmember Charles Allen (Ward 6) introduced legislation that proposes expanding the list of maternal health care services that must be covered under insurance, creates a Center for Maternal Wellness, and requires implicit bias training in continuing medical education instruction.
“Last year, this Council created a Maternal Mortality Review Committee, but we don’t have to wait for results to make improvements. We know women need more access to health care during and after a pregnancy. We know community-centered health care can improve outcomes. We know a sense of community can help pregnant women and new mothers talk through challenges,” said Councilmember Allen. “Finally, we know for some women transportation is a barrier. That’s why this bill also includes a travel stipend to get to their preferred health care provider. If we can’t get people there, none of these other changes will make a difference.”
The Maternal Health Care Improvement and Expansion Act of 2019 was co-introduced by Councilmembers Cheh, Grosso, Bonds, McDuffie, Evans, Mendelson, Robert White, Trayon White, Silverman, and Nadeau and co-sponsored by Councilmember Gray.
In 2018, there were approximately 36.1 maternal deaths for every 100,000 live births in the District, compared to the national rate of 20.7. Racial and ethnic disparities further exacerbate poor maternal health outcomes. Nationally, black women are dying at a rate that is three to four times higher than that of white women. Without regular preventive, prenatal, and postpartum care for all District women, the District’s maternal mortality rate will remain high.
Here’s what the bill does:
Expands Maternal Health Services Covered by Insurance
The bill proposes requiring private insurance, Medicaid, and DC Healthcare Alliance to include at least two postpartum health care visits, cover maternal care home visits, fertility preservation services, and transportation stipends for travel to and from prenatal and postpartum visits. Currently, Medicaid only includes one postpartum visit after six weeks and ends postpartum medical coverage at 60 days. This bill would extend coverage for one full year for anyone at 319% of the federal poverty line. It also requires the District’s Department of Health to analyze the feasibility of developing a curriculum to train doulas.
Creates Center on Maternal Health and Wellness
Additionally, the bill would create a Center on Maternal Health and Wellness to build community among women who are pregnant as well as co-locating some services conveniently in one location. The Center will provide onsite childcare, as well as make its services available through telehealth and online. At the Center, maternal care coordinators will help pregnant individuals navigate services available in the District before and during pregnancy and postpartum. Additionally, it will promote maternal group support, provide health and nutrition counseling, distribute prenatal vitamins, and provide group counseling for individuals or family members who have been impacted by a severe maternal morbidity or a maternal mortality. This is similar to the District’s one-stop breastfeeding center.
Codifies Implicit Bias Training in Continuing Medical Training
Finally, the bill requires implicit bias training to be included in continuing medical education for all medical professionals.
Special thanks to Mamatoto Village, Black Mamas Matter Alliance, the American College of Obstetrics and Gynecology, and many others for sharing their experiences in caring for pregnant women and new mothers and providing insights into the in crafting of this legislation.
In 2018, the Council unanimously passed Councilmember Allen’s legislation creating the Maternal Mortality Review Committee, under the Office of the Chief Medical Examiner, whose members have since been confirmed.