What’s New?

Take Action: Urge Governor Murphy to sign the child care enrollment bill S2478/A4177.

Posted on January 9, 2024

GREAT NEWS! The S2478/A4177 Child Care Enrollment bill would extend the duration of a law requiring certain provider subsidy payments for child care services to be based on enrollment.

And now, it is headed to the Governor’s desk…

Urge Governor Murphy to say “YES” to small businesses, working families and their children by signing A4177/S2478 into law!

When signed into law, this bill will:
•    Continue to provide center-based and family child care programs with one stable source of funding;
•    Provide support to help programs attract and retain teachers and other staff;
•    Reduce the chances of program closings due to financial volatility;
•    Support working families who need stable child care.

Did you know there are only 80 doula service providers registered with NJ FamilyCare?

Posted on December 20, 2023

headshot-diane

By Diane Dellanno
Policy Analyst

For more information on this topic, contact Diane at ddellanno@acnj.org

Footnotes:
  1. Kenneth J. Gruber et. al., Impact of Doulas on Healthy Birth Outcomes, 22 J. Perinatal Education, 49, 50–51; National Partnership for Women and Families, Improving our Maternity Care Now: Four Care Models Decisionmakers Must Implement for Healthier Moms and Babies. 7 (Jorge Morales ed. 2020).  ↵
  2. Astier Bey et al., Advancing Birth Justice: Community-Based Doula Models as a Standard of Care for Ending Racial Disparities 16 (2019). ↵
  3.  Visit the NJ Doula Learning Collaborative website for updated list of approved trainings (njdlc.org). ↵
  4. Department of Human Services | First Lady Murphy & Human Services Commissioner Adelman Announce Enhanced NJ FamilyCare Maternal Health Care Reimbursement ↵
  5. Getting Doulas Paid Policy Brief  - HealthConnect One↵
Did You Know Blog Banner

What are Doulas?

Doulas are non-clinical support workers who provide continuous emotional, informational and physical support for individuals before, during and after labor. This includes explanations and guidance on medical procedures, lactation support, physical comfort measures during labor, education on coping skills and infant care, and encouragement of bodily autonomy and personal advocacy in the medical institution.

Community-based doulas are often of and from the same communities as their clients.  As trusted members of the community, they help to bridge language and cultural barriers to pregnancy care and education.

Benefits of Doulas

There are widely noted health benefits to using doula services1  including:

  • Reduce contributing factors of maternal mortality and morbidity in health care settings, particularly for Black women.
  • Decreased risk of cesarean birth.
  • Decreased usage of pain medication or epidural anesthesia.
  • Lower rate of vacuum- or forceps-assisted birth.
  • Increased rates of breastfeeding initiation, particularly among low-income and racially/ethnically diverse individuals.
  • Decrease in length of birthing time.
  • Increased Apgar scores for infants at birth.

Doulas can be particularly beneficial for Black, Indigenous and People of Color (BIPOC) with low incomes, who are more likely to have negative birth experiences.2

However, economic insecurity or lack of health insurance coverage means doula care is often out of reach for the families who need it the most. 

The Issue

Due to inadequate compensation structures for this model of care, access to and availability of community-based doulas are lacking throughout New Jersey.

Doulas in New Jersey

As of January 2021, doulas and doula agencies have been able to enroll as Medicaid/NJ FamilyCare providers in fee-for-services (FFS) and managed care. NJ FamilyCare doula care can only be provided by those doulas who have completed NJ Department of Human Services and NJ Department of Health training.3 The current doula reimbursement rate for standard care is  $1,165, which includes up to 8 visits in the prenatal or postpartum period and attendance at the delivery for labor support.

All pregnant, birthing and postpartum individuals are eligible for doula care, regardless of medical complexity. Services are available starting in the prenatal period and up to 180 days postpartum. Doula services may be provided in the community, in clinicians’ offices, or in hospitals.

As of September 2023, 80 individuals and agencies are registered as FFS providers with NJ FamilyCare.

Issues Preventing Access to Doula Care

  1. The number of doulas in NJ is not sufficient to serve all the families that may potentially want to access doula care. There are approximately 30,000 Medicaid-covered births annually.4 NJ currently has 80 doulas who are able to bill Medicaid for their services. The availability of doulas that can bill Medicaid is not evenly distributed across the state creating geographic disparities.  Since the average caseload of a doula is 3 to 4 birthing people per month, NJ will need at least 3,000 doulas to be able to sufficiently serve the Medicaid birthing population.
  2. There is a lack of scholarship opportunities to become trained as a doula.  Scholarship programs need to be created to encourage more persons to enter the profession. There is also a need to recruit more organizations to provide the approved training.
  3. The Medicaid application and billing process are not designed for the community-based doula population. To become recognized as a Medicaid FFS provider is lengthy (72 pages), written for medical professionals and difficult to complete.
  4. The reimbursement rate for doula care lags far behind the average fee for private pay doulas. Most private doulas charge rates upwards of $2,000 per client.5 The standard fee a NJ doula can receive from Medicaid is $1,165.

As of September 2023,

80

doula care providers
are registered with
NJ FamilyCare.

NJ will need at least

3,000

doulas to sufficiently
serve the Medicaid
birthing population.

Without a pathway toward adequate and reliable compensation and strategic investments in workforce development, the community-based doula labor supply will remain too low to meet the communities' demand.

Recommendations

  1. Increase the reimbursement rate for Medicaid doulas for both standard and enhanced care. 
  2. Simplify the application process for doulas to become approved by Medicaid.
  3. Increase training and scholarship opportunities for persons interested in becoming a doula.
  4. Develop a sustainable community-based doula program that provides fair, equitable, and sustainable compensation to their doulas as well as regular pay, health benefits, and paid leave.
Read our latest updates on maternal and infant health.

ACNJ’s 8th Annual Breakfast Celebration Recap

Posted on December 9, 2023

It was wonderful seeing new and familiar faces at ACNJ's annual breakfast last week! In addition to celebrating our wins for children, we welcomed an engaging panel discussion focused on moving forward with social media. The event also recognized senior policy analyst Cynthia Rice, who will be retiring this December after 31 years of advocacy.

View pictures from ACNJ's breakfast celebration

View highlight video, recognizing Senior Policy Analyst Cynthia Rice

Special thanks to the panelists: Rosy Arroyo, Administrator, Camden County Youth Services Commission, Member, ACNJ Board of Trustees, Jeffrey Lane, Ph.D., Associate Professor of Communication, Rutgers University, New Brunswick, Ravjit (Ruby) Sekhon MSW, LCSW, Program Manager, School and Community Based Programs, Director, Middlesex County NJ4S HUB, Rutgers University Behavioral Health Care, and Ziany Lee Gunther, Web Design Intern, Hopeworks, Camden.

This event would not be possible without our generous supporters including our sponsors and raffle prize donors.

Thank you to everyone who joined us to celebrate what we accomplished this past year and helped make it a success.

All the best,
ACNJ Team

ACNJ 2023 Annual Report

Posted on November 30, 2023

Thank You to Our Supporters

As we reflect on this year’s achievements, and look to opportunities ahead, we know our wins for children would not be possible without our many supporters and partners.

2023_11_22_ACNJ_annual_report

Download 2023 Annual Report
Photos From 8th Annual Breakfast Celebration
Highlight Video, Reflecting on 2023 and Recognizing Senior Policy Analyst Cynthia Rice
Donate

Take Action: Urge Leaders in the Legislature to Support Bills A4819/S2887

Posted on November 29, 2023

Urge your leaders in the legislature to provide ALL New Jersey families the resources and services needed to successfully raise their children from before birth to adulthood.

Limited employment opportunities, insufficient and substandard housing, unsafe and unhealthy environments, inadequate and remote essential services –these overlapping conditions cultivate family distress and are prevalent in too many New Jersey communities. Adjacent towns are often an oasis of opportunity, in which families experience the quality of education, recreation, security and support that are the hallmarks of thriving communities and the foundation for healthy families.

Legislative bills A4819/S2887 establish a state-level Council for Community Recovery and Family Success to pilot 21 county-based Family Success Councils, each charged with organizing community-based family success service networks. Rather than focusing on the effects of distress, these councils will provide support to ALL families and strengthen communities, by investing in success. Over four years in development, these bills direct state funding and programs to provide ALL families the resources and services needed to successfully raise their children from before birth to adulthood.

Please send a message TODAY to leaders in the NJ Legislature who can act now to move these bills forward.