[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6349623,"mediaKeyId","2238065-6f2e55f3308bfd44c078d7160ec7f814","parentId",2238065,"title","North Dakota hearing on postpartum doula certification and Medicaid coverage highlights training, cost and program questions","audioSeconds",1001,"startMs",212000,"endMs",1213000,"viewUrl","/Search/View?dp=1&key=2238065-6f2e55f3308bfd44c078d7160ec7f814&start=212&end=1213","thumbnailUrl","https://assets.pipeline.soar.com/2238065-6f2e55f3308bfd44c078d7160ec7f814/thumbnail_212000.jpg","articleUrl","/articles/6349623/North-Dakota/North-Dakota-hearing-on-postpartum-doula-certification-and-Medicaid-coverage-highlights-training-cost-and-program-questions","mediaUrl","https://secure.pipeline.soar.com/6349623-a011ae8dc5818037750341956cf7828c/orig.mp4?Expires=1771149155&Signature=G~NkFVJ5VV0Ne2i8ldJ8cARWSYSaZ1Pbiu9shPOK0gUn1A1Irl8WeNd3Me48AFiEKLaMyAZ9U~j2KqIXkkod6y5st3vLTWUMx9bKMIzsB~ZCZo6YbcLNsEImg2dkhJpL9Kezq0P0YSRsPtdhSbFYlMwJ7xT13wjkD687jmrFnbdTYz-frG9JI7eZoG4fh7PPxTNDN2JvrCSX7kcURXP2dPCQnJpe6ouk7EBjsd45CJN6PmLN~lpBKQeDrWb95QEWNHxkHet9RSwsrkAvGl75Izp4IYlXelFJQWQzhhgTqBqLruj2EeSvzl~apq~gQV57sgsLv2xjxm8wdN83A6McTg__&Key-Pair-Id=KUT5TJCACFTXG","author","State of North Dakota","date","2025-02-03T00:00:00Z","article","House Human Services Committee opened a hearing on House Bill 14-64, which would create a postpartum doula certification process and add postpartum doula services to Medicaid coverage in North Dakota. Representative Gretchen Dobrevitch (D-11, Fargo), sponsor of the bill, told the committee it “recognizes the critical role doulas play in supporting parents and newborns during the postpartum period, the first 6 months after birth.”

The bill would require certification through Doulas of North America or another reputable doula organization determined by the North Dakota Department of Health and Human Services (HHS) by administrative rule, and would add postpartum doula services to medical assistance benefits. Representative Dobrevitch said the fiscal note estimates $280,800 for the biennium, based on 30 certified doulas providing three one‑hour visits per patient billed at $15 per 15‑minute unit.

The committee heard technical and programmatic details from Alicia Belai, assistant director of the HHS community engagement unit, who described training currently provided with Doulas of North America. Belai said HHS and partner organizations trained 36 people in the past year, that certification involves classroom and reading requirements, supervised visits and submission of documentation to the certifying organization, and that an intensive training option offered recently cost about $2,500 for a four‑day virtual course for a cohort of trainees. “Folks don't need to have any kind of credentials ahead of time,” Belai said, noting the training is used to cross‑train community health workers and other frontline staff.

Krista Fremming of the HHS Medical Services Division answered questions about billing and program design. Fremming said the fiscal note assumes a separate 15‑minute billing unit for postpartum doula visits distinct from other prenatal or delivery payments. She told the committee that adding the unit would not, by itself, automatically lower reimbursement rates for labor and delivery services: “It is a 15 minute billing unit, which would be separate and distinct from any other services.” She also said any move to bundled payments would require additional notice and provider engagement.

During questioning committee members asked about certification fees, how many doulas currently practice in the state and program rollout. Representative Dobrevitch said she does not have a statewide count but pointed to HHS witnesses; HHS staff confirmed 36 people trained in the past year and that others may be working toward certification privately. The sponsor asked the committee to consider an amendment to prohibit the department from imposing an additional licensing or certification fee beyond the fees doulas pay to the certifying organization.

No testimony in opposition was recorded. The committee closed the hearing on House Bill 14-64 with no committee vote taken during the session.

The hearing record includes HHS explanations of training content, billing mechanics and the fiscal assumptions underlying the fiscal note; committee members pressed for additional data on numbers of practicing doulas and cost assumptions before any final committee action.

","mediaType","Video","parentTitle","House Human Services Feb 3, 2025","oneSentenceSummary","House Human Services Committee opened a hearing on House Bill 14-64, which would create a postpartum doula certification process and add postpartum doula services to Medicaid coverage in North Dakota.","taxTitle","Human Services, House of Representatives, Legislative, North Dakota","taxId",28893,"location","North Dakota","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6349614,"Fluoride ban bill sparks wide testimony in Human Services hearing; medical and water officials urge local control and cite evidence for fluoridation",4104,4968000,9072000,"/Search/View?dp=1&key=2238065-6f2e55f3308bfd44c078d7160ec7f814&start=4968&end=9072","https://assets.pipeline.soar.com/2238065-6f2e55f3308bfd44c078d7160ec7f814/thumbnail_4968000.jpg","/articles/6349614/North-Dakota/Fluoride-ban-bill-sparks-wide-testimony-in-Human-Services-hearing-medical-and-water-officials-urge-local-control-and-cite-evidence-for-fluoridation","https://secure.pipeline.soar.com/6349614-4dc473bcbfd4ac38e69ba9102ef6dbae/orig.mp4?Expires=1771149155&Signature=EOiAObznZ52QJ386G2MfMBpS3fBqgRWb5DVfOs-32nJOeMtTzxbK5tTSW3wFS4QjAJY~N0cgfrFTMfjyN6bibnhsZTj6h~I7hZb3s7vat3xlnT1ptz2Bw2bWBrThBSkrdlJfcbJkF9vMJD5H1l~6~fTVqtKwTBa7Ljm93eCgIRzSJx6dfbZ5Ci~igFpixykhOpfxaOiv9CV9HgKgnAXCCKXkRykcTNjDaekXopvV4l81WTUeAHNukXr1SdhyoPM~tiEcxzBcNXTT-Okq~Zqegq6zcjuB~qmWXAGnQ2Sdd2PN6pi51UzDXGwM7EUeGg6tqXDapLxVRDsilm3CyOXd2g__&Key-Pair-Id=KUT5TJCACFTXG","Representative Matt Heilman opened the hearing on House Bill 16-05, which would prohibit adding fluoride to public water systems statewide, impose fines for violations and include an effective date to allow local systems time to adjust. Heilman cited recent publications and a U.S. district‑court ruling and said public officials should not force fluoride on water consumers.

Proponents offered diverse arguments. Keith Tihapab Jr., a Washburn city commissioner, testified he plans to pursue cessation of fluoridation locally and disputed commonly cited benefit figures, saying some recent studies show smaller effects on cavities and that cost‑benefit studies may omit certain costs or adverse effects. He and other proponents cited a National Toxicology Program review and a JAMA Pediatrics meta‑analysis assessing associations between fluoride exposure and neurodevelopmental outcomes, and they referenced a recent federal court decision in California.

Dentists, health officials, water operators and state agencies testified in opposition. Dr. Bradley King, a Bismarck dentist, called community water fluoridation “one of the greatest public health successes in the twentieth century,” said it substantially reduced tooth loss and argued removal would disproportionately harm children and low‑income residents. Vanessa Bopp of the Department of Health and Human Services public‑health division described community water fluoridation as a “controlled addition” intended to achieve an optimal concentration that prevents cavities and noted the public‑health division’s view of fluoridation as the most effective, cost‑efficient delivery method.

William Sherwin of the North Dakota Dental Association and other clinical witnesses highlighted that most studies showing severe neurodevelopmental effects were conducted in settings with naturally occurring fluoride levels far above U.S. fluoridation levels or with other confounding exposures; they stressed that the U.S. HHS recommended level since 2015 is 0.7 milligrams per liter and that the EPA regulates higher contaminant thresholds. Greg Wavra, the state drinking water programs administrator, explained that fluoridation has historically been implemented at the local level in North Dakota and that systems testing and reporting occur monthly; he said some systems must remove naturally occurring fluoride where levels exceed safety thresholds.

Committee members asked technical questions about measurement, data sources and local decision processes. Representative Heilman and proponents highlighted CDC data cited in testimony that “74 water systems do not have fluoride while 299 do have fluoride,” and said the Department of Health and Human Services reports 96.5 percent of North Dakotans drink water with fluoride. Opponents pointed to long public‑health practice, state and national professional association endorsements, and the potential for increased cavities and related hospitalizations if fluoridation were removed.

After extensive testimony from local officials, dental professionals, public‑health program staff and water operators, the committee closed the hearing with no vote recorded.

","House Bill 16-05 would prohibit adding fluoride to public water systems. Sponsor and supporters cited recent studies and a federal court ruling; dental and public‑health witnesses and state drinking‑water officials opposed a statewide ban and emphasized local decision‑making, testing protocols and the CDC/HHS recommended level of 0.7 mg/L.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6349619,"Debate in Human Services hearing pits parental access bill against pediatricians’ concerns over confidential adolescent care",3817,1194000,5011000,"/Search/View?dp=1&key=2238065-6f2e55f3308bfd44c078d7160ec7f814&start=1194&end=5011","https://assets.pipeline.soar.com/2238065-6f2e55f3308bfd44c078d7160ec7f814/thumbnail_1194000.jpg","/articles/6349619/North-Dakota/Debate-in-Human-Services-hearing-pits-parental-access-bill-against-pediatricians-concerns-over-confidential-adolescent-care","https://secure.pipeline.soar.com/6349619-9839bbb8c13e01ccb77e6f156da6884d/orig.mp4?Expires=1771149155&Signature=aydDXff1tzJU2c56Yw3BkfVs6~GOC2gtwL0PDc8iebIKgo027xte8xqXcG-O36Jf2J2WK8o~BpEVwZN3ZBjZ98epYDAfxi~TWQzhJVbfH~1OlYxgKASV8t9QI3QIdMcNOfb6xS2vTB4XauPEsZr3VcPTA3lggbrr0h8yXH-0FpEveucGSyQDZcXD0dyKb9uOmSS4bs9AonXROwO~GAW3yFzMgWkYwtp-zpx-HRDeJyLHE8AyXwLkgqF~yLJ25PDhBBiIlJ6gPaFJdydtTu2hUZe4s6gQaHIDSBl~FzjUu1xfdRPWFjVouMl9URVMzHFj5Sb7rlWQz1layu6bocyiZQ__&Key-Pair-Id=KUT5TJCACFTXG","House Human Services Committee heard extensive testimony on House Bill 14-50, which would add a section to chapter 14-10 clarifying that a parent or guardian has access to the medical examination room of their minor child and requiring providers to give notice of that right and of the questions they intend to ask. Representative Sue Ann Olson (District 8), sponsor of the bill, said the measure is “a simple but important bill that protects parents' rights in medical exam rooms.”

Supporters told the committee that parents should be present to protect children and to know how answers will be recorded; Matt Flanders, legislative and policy director at Citizens' Council for Health Freedom, argued that parents should decide whether their child receives confidential care and that the bill protects parental authority. “This bill affirms the parental and guardian's rights as far as what a medical provider may be able to ascertain by having a private conversation with that child,” Flanders said.

Medical organizations and clinicians testified in opposition. Donna Throdson of the North Dakota Medical Association introduced Dr. David Field, a family physician, who said the bill would limit clinicians' ability to ask unpredictable, open‑ended questions necessary for diagnosis and to detect child abuse, substance use, suicide risk and other conditions. “There are definitely times when a health care provider needs a private conversation with the child or adolescent,” Dr. Field said, noting that 77 percent of offenders in cited statistics are parents or close relatives. Dr. Cathy Anderson, a pediatrician and immediate past president of the North Dakota Chapter of the American Academy of Pediatrics, said confidential time is a best practice that encourages adolescents to disclose suicidal ideation, depression, substance use and sexual health concerns that they would not discuss with a parent present.

Committee members raised trafficking and abuse concerns. Representative Gretchen Dobrevitch asked how the bill would apply if a trafficker or abusive parent is the person accompanying the child; the sponsor and witnesses noted the bill’s exemptions for emancipated minors and suspected abuse and said clinicians retain mandatory reporting duties. Several public health and school health witnesses described cases in which children disclosed abuse only to a trusted clinician or school nurse when the parent was not present.

Opponents warned about practical effects. Clinicians said the bill’s requirement that providers give written notice ahead of time of the specific questions they intend to ask could be infeasible in many clinical encounters, where the questions follow the patient's answers. Dr. Field testified that listing all possible questions in advance would limit clinicians’ ability to follow the course of an exam and identify safety risks.

The committee closed the hearing on House Bill 14-50 after receiving testimony from sponsors, advocacy groups, pediatricians, hospitals and public health representatives. No committee vote was recorded during the session.

","House Bill 14-50 would require providers to allow parents or guardians into a minor's medical exam room and give written notice of certain screening questions; supporters said the bill protects parental rights while medical groups warned it would reduce confidential time clinicians need to detect abuse, mental health risks and risky behavior.","actionData","errors"]

Article not found

North Dakota hearing on postpartum doula certification and Medicaid coverage highlights training, cost and program questions

Fluoride ban bill sparks wide testimony in Human Services hearing; medical and water officials urge local control and cite evidence for fluoridation

Debate in Human Services hearing pits parental access bill against pediatricians’ concerns over confidential adolescent care