JCARR Hears Testimony on Nursing Board Doula Rules, Continued Opposition to DEW Gifted Rule
Bills in this Story
135-HB101 APPROPRIATIONS, STATE PROGRAM OPERATIONS (Bird, A)
Mentioned in this Story
Rep. Jamie Callender (R-Concord)
Rep. Michael Skindell (D-Lakewood)

The chair Ohio’s state-convened Doula Advisory Group pushed back Monday on Ohio Board of Nursing rules that interpret HB101’s (Bird) near-unanimous provisions signed in January and effective since only April. Chairwoman Marie McCausland told the Joint Committee on Agency Rule Review (JCARR) that agency- versus state-certified doulas under Rule 4723-24 could be left out of the workforce and are getting little help from the nursing board at a critical time for Medicaid-funded maternity care.

JCARR Director Ian Dollenmayer announced Friday that he was expecting McCausland, a certified post-partum doula and certified lactation consultant, for oral testimony. Noting several committee members had co-sponsored or voted for the multi-subject bill and/or standalone predecessors, she cited the following language in newly approved Ohio Administrative Code 4723-24-01(D):

“‘Certified doula’ means an individual who holds a certificate to practice issued or renewed by the board under section 4723.89 of the Revised Code.”

She said the definition would appear to exclude doulas licensed with certifying agencies including Doulas of North America (DONA) and Childbirth and Postpartum Professional Association (CAPPA), even though the nursing board apparently recognizes the validity of agency-certified doulas by listing the advisory group’s five members -- none state-certified -- as “certified doulas,” McCausland observed.

“I have asked if there is a recommendation by the Board of Nursing for what agency-certified doulas should call themselves post Oct. 3, and we have been told there is no recommendation,” she said, citing R.C. Section 4723.89(B): “Beginning on Oct. 3, 2024, a person shall not use or assume the title ‘certified doula’ unless the person holds a certificate issued under this section by the Board of Nursing.”

At the same time, said McCausland, nursing board staff told the advisory group last week that the board “doesn’t plan to actually protect this title … and sanction individuals” beginning in October.

Adding to the confusion, the advisory group has learned that legal counsel to the board will ask members to dispatch their legislative liaison to push for a statutory fix. Putting her concerns into context, she said Ohio will need around 3,000 doulas for Medicaid recipients and likely must grow its workforce to do so.

“In Ohio, over 67,000 births were covered by Medicaid in 2020, which was approximately 53 percent of

Ohio births,” the advisory chair said. “If these rules go into effect as written, I foresee continued loss of life, continued cost-of-care burdens, and a loss in the doula workforce as agency-certified doulas leave the state to avoid fines for representing themselves as ‘certified doulas.’”

In sum, she called for the following amendment to Rule 4723-24-01(D):

“‘Certified Doula’ means an individual who holds a certificate to practice issued or renewed by the board under section 4723.89 of the Revised Code, not to be confused with the agency certifications provided by a doula certification organization.”

Citing a second concern, she said disciplinary powers in O.A.C. 4723-24-07 comprise the largest section of doula rules even though they weren’t addressed by HB101.

“Much of the public comment regarded the disciplinary section and folks were especially concerned with the potential for racial bias given the need for culturally competent doulas to address the disparities for Black mothers in maternal mortality and infant mortality and [who] would be disciplined by the Board of Nursing, which currently has zero Black individuals,” said McCausland.

“Doulas are rightfully concerned, and the Board of Nursing is neither addressing these comments in changes to the rules or even in public meetings where they could assuage these concerns with commitments to addressing any potential bias, having doulas part of the disciplinary process, or even committing to adhere to the same standards of racial bias training being requested of our doulas in the state,” she concluded.

Speaking for the committee, Rep. Jamie Callender (R-Concord) noted that JCARR cannot address statutory scruples, though he said members’ nodding heads during her remarks demonstrated their sentiments.

“We are limited to the law as it is, not as we wish it were,” he said. “We appreciate your effort. It was not in vain. We have a grasp of what the issue is, and we do not disagree with the concerns you have.”

JCARR also received written-only testimony from Executive Director Abbie Sigmon of the Ohio Association for Gifted Children (OAGC). She reprised her concerns with Ohio Department of Education and Workforce (DEW) Rule 3301-51-15 from the committee’s July meeting, after which Ohio Administrative Code language was refiled. (See The Hannah Report, 7/22/24.)

“There are 225,000 identified gifted students in Ohio [but] fewer than 940 gifted intervention specialists (GIS) and fewer than 1,150 gifted staff -- including educational service center (ESC) staff,” said Sigmon, a workforce she called “deeply unsatisfactory” and a contributor to “daily burnout, struggles and exhaustion.”

She said the refiled rule of Aug. 21 removed professional development hours for general education teachers backed by OAGC and the Ohio Education Association (OEA).

“Even with the support of both of those associations, DEW replaced that language, citing a desire to remain less authoritative. This is a frustrating step backwards in ensuring gifted students are recognized, differentiated, and taught according to their needs,” said Sigmon.

In addition, she said OAGC continues to oppose removal of corrective plans following a state audit that were included in the original draft rule. She said parents and others should be allowed to file gifted education complaints and ask DEW to investigate alleged violations of R.C. 3324 or Rule 3301-51-15. Districts could then respond to allegations, and the department could proceed with any corrective action, she said.

At the same time, Sigmon thanked DEW for amending the rule with “letters of no services,” which she also addressed in July.

“Ohio mandates the identification of gifted students, but the service of gifted students is not mandated,” she observed. “No services letters are a powerful tool that would provide parents and guardians of gifted children ongoing updates on gifted services.”

Sigmon thanked Rep. Mike Skindell (D-Lakewood) for standing up for parents and guardians of gifted students. He responded by thanking DEW and OAGC and said the General Assembly will need to address her concerns.

McCausland and Sigmon’s testimony can be found at www.hannah.com>Important Documents and Notices>Library.

Story originally published in The Hannah Report on September 9, 2024.  Copyright 2024 Hannah News Service, Inc.