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HB598 INTRODUCED
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HB598
L5F5BYW-1
By Representatives Travis, Daniels, Lands, Clarke, Drummond,
Jackson, Warren, McClammy, Rafferty, Morris, Datcher, Sellers,
McCampbell, Moore (M), Bracy, Tillman, Lawrence, Chestnut,
Hassell, Hall, Ensler, Hollis, Gray
RFD: Ways and Means General Fund
First Read: 10-Mar-26
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L5F5BYW-1 12/11/2025 TEW (L)TEW 2025-3531
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First Read: 10-Mar-26
SYNOPSIS:
This bill creates the Rural Maternal and Infant
Health Equity Act to improve birth outcomes in rural
communities by expanding access to prenatal, delivery,
and postpartum care through midwifery and doula
support, rural obstetric workforce development, and
culturally responsive community-based services.
This bill will also create the Rural Maternal
and Infant Health Equity Program Fund.
A BILL
TO BE ENTITLED
AN ACT
Relating to maternal and infant health disparities in
rural areas; to establish a grant program to support midwife
and doula services; to require Medicaid and all insurers to
cover midwife and doula services; to establish a grant program
to support rural birth centers; and to create the Rural
Maternal and Infant Health Equity Program Fund.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. This act shall be known as the Rural
Maternal and Infant Health Equity Act.
Section 2. As used in this act, unless otherwise
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Section 2. As used in this act, unless otherwise
specified or unless the context requires otherwise, the
following terms will have the following meanings:
(1) DEPARTMENT. The Alabama Department of Public
Health.
(2) DOULA. A trained, nonclinical birth support
professional who provides physical, emotional, and
informational assistance.
(3) MIDWIFE. A certified nurse-midwife, certified
professional midwife, or other licensed midwifery provider
licensed by the State Board of Midwifery.
(4) RURAL AREA. Any area within this state not included
within the boundaries of any incorporated city or town having
a population in excess of 25,000 inhabitants, according to the
last federal decennial census.
Section 3. (a) The department shall support rural
access to midwifery and doula services by offering grants to
integrate maternity care providers into hospitals and clinics.
(b) The State Board of Midwifery shall license and
regulate community-based maternity care providers.
(c) Cultural competency and evidence-based training
shall be required.
Section 4. (a) Subject to prior approval or a waiver
from the Centers of Medicare and Medicaid Services, the
Alabama Medicaid Agency shall provide coverage for midwife and
doula services.
(b) Every insurer authorized to offer, sell, or deliver
insurance in this state shall include coverage for midwife and
doula services.
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doula services.
Section 5. (a) The department shall establish the
Obstetric Workforce Training and Incentive Program to support:
(1) Obstetrics and gynecology residencies or rural
clinical rotations;
(2) Recruitment incentives for obstetric providers
locating in rural areas; and
(3) Loan repayment for at least two years of rural
maternity care service.
(b) Priority shall be given to providers trained in
team-based and culturally responsive care.
Section 6. (a) The department shall fund locally led
maternal health partnerships to:
(1) Deliver prenatal home visits by nurses or
midwives;
(2) Complete mobile perinatal clinics; and
(3) Complete group prenatal care and peer-led education
for at-risk populations.
(b) Grantees must demonstrate engagement of target
communities in program design.
Section 7. (a) The department shall offer capital
grants to:
(1) Establish new rural birth centers;
(2) Expand or modernize obstetric units in rural
hospitals; and
(3) Support facilities offering continuous labor
support and postpartum care.
(b) Projects must meet safety and licensure standards.
Section 8. (a) There is created the Rural Maternal and
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Section 8. (a) There is created the Rural Maternal and
Infant Health Equity Program Fund in the State Treasury.
(b) The fund is subject to appropriations by the
Legislature and gifts, grants, and other donations received by
the department for the programs and grants described in this
act. The department may not spend appropriations for the
program for the purposes other than those listed in this act.
(c) Amounts in the fund shall be budgeted and allotted
in accordance with Sections 41-4-80 through 41-4-69 and
Sections 41-19-1 through 41-19-12, Code of Alabama 1975.
Section 9. This act shall become effective on October
1, 2026.
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