Program Coverage:
I understand that my birth doula services are covered through Washington Apple Health (Medicaid) and are subject to my continued Medicaid eligibility, Washington State Health Care Authority (HCA) policies, and program guidelines.
I understand that Medicaid coverage is limited to approved birth doula services and does not guarantee payment for services that are not covered under the Washington Apple Health Birth Doula benefit.
I understand that my eligibility for services is determined by Washington Apple Health and that continued coverage depends on maintaining my Medicaid eligibility.
Doula Services:
I understand that my assigned doula is an independent contractor partnering with The Shades of Motherhood Network and is certified by the Washington State Department of Health and enrolled as a Washington Apple Health Birth Doula Provider.
I understand that Washington Apple Health covers eligible birth doula services throughout pregnancy, labor and birth, and the postpartum period.
The Medicaid Birth Doula benefit includes the following services:
Prenatal Intake Visit:
Covered Once Per Pregnancy
- Comprehensive intake assessment
- Individualized care plan
- Birth preferences discussion
- Health history review
- Resource assessment
- Care coordination planning
Prenatal Support:
Up to 18.5 Hours (Combined with Postpartum Visits)
Services may include:
- Prenatal education
- Birth preparation
- Birth plan development
- Comfort measures
- Pain management education
- Lactation preparation
- Emotional support
- Resource navigation
- Care coordination
Labor & Birth Support:
Covered Once Per Pregnancy
Includes:
- Continuous in-person labor support
- Physical comfort measures
- Emotional support
- Advocacy
- Immediate postpartum support following birth
Postpartum Support:
Up to 12 Months After Pregnancy
Services may include:
- Physical recovery support
- Emotional wellness support
- Infant feeding support
- Newborn education
- Parenting support
- Resource navigation
- Community referrals
- Care coordination
I understand that Washington Apple Health determines the services and coverage available through the Birth Doula benefit.
Services Not Covered:
I understand that Washington Apple Health does not cover certain services provided by a birth doula, including but not limited to:
- Childcare
- Housekeeping or household chores
- Shopping or meal preparation
- Travel time or mileage
- Phone calls, text messages, or emails
- Documentation time
- Group services
- Overnight postpartum support
- Overnight newborn care
- Household tasks performed during overnight support
I understand that if I choose to receive non-covered services, I may be responsible for those costs only after discussing them with my doula and signing any required payment agreement before services are provided.
Care Coordination:
I understand that The Shades of Motherhood Network is my primary point of contact regarding enrollment, concerns, complaints, service coordination, and program questions.
I understand that my birth doula may communicate and coordinate with my healthcare providers, hospitals, midwives, community organizations, behavioral health providers, and other support services when appropriate to help support my pregnancy, birth, postpartum recovery, and family wellness.
I understand that any concerns regarding my doula services should be communicated to The Shades of Motherhood Network so that support and resolution can be provided.
Client Rights:
I understand that:
- Participation in birth doula services is voluntary.
- I may discontinue services at any time.
- I may request to change birth doulas.
- I have the right to ask questions about my care.
- I have the right to participate in decisions regarding my birth and postpartum care.
- My doula provides non-medical support and does not replace my healthcare provider.
Employment Status:
I understand that services received through Washington Apple Health (Medicaid) do not constitute employment compensation and do not create an employment relationship between myself, The Shades of Motherhood Network, Washington Apple Health, the Washington State Health Care Authority, or my birth doula.
Documentation, Privacy, and Program Evaluation:
I understand that my birth doula is required to maintain documentation of services provided, including visit dates, duration of services, care coordination activities, referrals, and other information necessary to meet Washington Apple Health documentation requirements.
I authorize The Shades of Motherhood Network to collect information related to my participation, including assessments, surveys, attendance records, outcomes, referrals, and service documentation.
I authorize the use of de-identified information for:
- Medicaid billing and reimbursement
- Quality improvement
- Program evaluation
- Compliance with Washington Apple Health requirements
- Community education
- Research activities
- Grant reporting, when applicable
- Advocacy efforts
- Reasonable efforts will be made to protect my confidentiality.
Personally identifiable information will not be publicly shared without my written authorization unless required or permitted by law for treatment, payment, healthcare operations, audits, or Medicaid program administration.