What’s happening: The California Department of Public Health (CDPH) released All Facilities Letter (AFL) 25-13 on March 24 that offers guidance to hospitals on supporting the Medi-Cal doula benefit — available since January 1, 2023 — and outlines recommendations for patient visitation policies and procedures.
What else to know: As noted in the AFL, called Benefits of Doula Support and Recommendations to Accommodate Doula Services and Foster a Doula-Friendly Environment, doulas offer emotional, physical, and informational support during pregnancy, labor, delivery, and up to one year postpartum. Hospital policies play a key role in creating a welcoming environment for doulas and the families they serve.
Doulas are non-clinical professionals who provide continuous support for birthing individuals and families, but do not offer medical care or advice. Doula services are covered under Medi-Cal through both fee-for-service and managed care plans. CDPH added doulas as a Medi-Cal benefit to help prevent perinatal complications and improve health outcomes for parents and infants.
Recognizing concerns about doulas being treated solely as “visitors,” CDPH encourages hospitals to revisit and refine their policies and recommends the following steps to foster a more doula-friendly environment:
- Review and, if necessary, revise visitation policies and procedures to specifically address doulas.
- Exclude doulas from the visitor limits when restrictions apply (e.g., if the hospital has a limit of two visitors, doulas should not count toward that limit).
- Ensure accessibility of visitation FAQs, both online and on-site.
- Provide training to hospital staff at all levels — administrative, clinical, and executive — on implementing visitation policies that support doula access and patients’ rights.
CHA has developed an informational presentation on this topic: Doula Access in Hospitals: What the Law Requires.
