{"id":10899,"date":"2025-06-18T20:24:40","date_gmt":"2025-06-18T20:24:40","guid":{"rendered":"https:\/\/familymedicine.uw.edu\/chws\/?page_id=10899"},"modified":"2026-05-05T17:45:08","modified_gmt":"2026-05-05T17:45:08","slug":"methods-faq","status":"publish","type":"page","link":"https:\/\/familymedicine.uw.edu\/chws\/resources\/mch-workforce-data-dashboard\/methods-faq\/","title":{"rendered":"Methods &amp; FAQ"},"content":{"rendered":"\n\n  <div class=\"banner has-hover has-parallax\" id=\"banner-1622606889\">\n          <div class=\"banner-inner fill\">\n        <div class=\"banner-bg fill\" data-parallax=\"-4\" data-parallax-container=\".banner\" data-parallax-background>\n            <img loading=\"lazy\" decoding=\"async\" width=\"1920\" height=\"1080\" src=\"https:\/\/familymedicine.uw.edu\/chws\/wp-content\/uploads\/sites\/5\/2025\/06\/Untitled-design.png\" class=\"bg attachment-original size-original\" alt=\"Decorative design\" \/>                        <div class=\"overlay\"><\/div>            \n                    <\/div>\n\t\t\n\t<div class=\"ux-shape-divider ux-shape-divider--bottom ux-shape-divider--style-curve-opacity\">\n\t\t<svg viewBox=\"0 0 1000 100\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" preserveAspectRatio=\"none\">\n\t\t<path class=\"ux-shape-fill\" opacity=\"0.15\" d=\"M0 14C0 14 88.64 17.48 300 50C560 90 814 77 1003 40L1015 68L1018 104H0V14Z\"\/>\n\t\t<path class=\"ux-shape-fill\" opacity=\"0.3\" d=\"M0 45C0 45 271 90.13 500 77C657 68 830 30 1015 14V100H0V45Z\"\/>\n\t\t<path class=\"ux-shape-fill\" d=\"M0 58C0 58 188.29 90 508 90C798 90 1002 55 1002 55V100H0V58Z\"\/>\n<\/svg>\n\t<\/div>\n        <div class=\"banner-layers container\">\n            <a class=\"fill\" href=\"\/chws\/resources\/mch-workforce-data-dashboard\/\"><div class=\"fill banner-link\"><\/div><\/a>            \n\n   <div id=\"text-box-771076246\" class=\"text-box banner-layer x50 md-x50 lg-x50 y15 md-y15 lg-y15 res-text\">\n                                <div class=\"text-box-content text dark\">\n              \n              <div class=\"text-inner text-center\">\n                  \n\n<h3 class=\"uppercase\"><strong><a href=\"\/chws\/resources\/mch-workforce-data-dashboard\/\">maternal and child health (MCH) workforce Data Dashboard<\/a><\/strong><\/h3>\n\n              <\/div>\n           <\/div>\n                            \n<style>\n#text-box-771076246 {\n  width: 60%;\n}\n#text-box-771076246 .text-box-content {\n  font-size: 100%;\n}\n<\/style>\n    <\/div>\n \n\n        <\/div>\n      <\/div>\n\n            \n<style>\n#banner-1622606889 {\n  padding-top: 210px;\n}\n#banner-1622606889 .overlay {\n  background-color: rgba(4, 4, 36, 0.18);\n}\n#banner-1622606889 .ux-shape-divider--bottom svg {\n  height: 150px;\n  --divider-width: 100%;\n}\n<\/style>\n  <\/div>\n\n\n<div class=\"nav-wrapper\"><ul class=\"nav no-underline nav-uppercase nav-horizontal nav-size-large nav-line-bottom text-center nav-center\"><li class=><a href=\"https:\/\/familymedicine.uw.edu\/chws\/resources\/mch-workforce-data-dashboard\/data-dashboards\/\">Data Dashboards<\/a><\/li><li class=><a href=\"https:\/\/familymedicine.uw.edu\/chws\/resources\/mch-workforce-data-dashboard\/my-state\/\">My State<\/a><\/li><li class=active><a href=\"https:\/\/familymedicine.uw.edu\/chws\/resources\/mch-workforce-data-dashboard\/methods-faq\/\">Methods &amp; FAQ<\/a><\/li><\/ul><\/div>\n\n<div class=\"row\"  id=\"row-264347567\">\n\n\n\t<div id=\"col-1756387292\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\n\n\t\t<div class=\"tabbed-content\">\n\t\t\t\n\t\t\t<ul class=\"nav nav-tabs nav-uppercase nav-size-normal nav-left\" role=\"tablist\"><li id=\"tab-methods\" class=\"tab active has-icon\" role=\"presentation\"><a href=\"#tab_methods\" role=\"tab\" aria-selected=\"true\" aria-controls=\"tab_methods\"><span>Methods<\/span><\/a><\/li>\n<li id=\"tab-faq\" class=\"tab has-icon\" role=\"presentation\"><a href=\"#tab_faq\" tabindex=\"-1\" role=\"tab\" aria-selected=\"false\" aria-controls=\"tab_faq\"><span>FAQ<\/span><\/a><\/li><\/ul><div class=\"tab-panels\"><div id=\"tab_methods\" class=\"panel active entry-content\" role=\"tabpanel\" aria-labelledby=\"tab-methods\">\n\n<p>For the <strong>Maternal and Child Health Workforce Supportive Policy Index (&#8220;MCH Workforce Index&#8221;)<\/strong>, is a composite score reflecting workforce policies for midwives and doulas, labor policies, and economic policies. Each state\u2019s overall MCH Index score is based on an average of four sub-index scores. Each sub-index score (Midwifery Workforce, Doula Workforce, Labor, and Economic indices), in turn, is an average of the indicator scores within that sub-index. A more detailed description of each index is below, along with a chart providing detailed information regarding each indicator, its data source, and the scoring approach.<\/p>\n<div class=\"accordion\">\n\n\t<div id=\"accordion-2309702507\" class=\"accordion-item\">\n\t\t<a id=\"accordion-2309702507-label\" class=\"accordion-title plain\" href=\"#accordion-item-midwifery-workforce-index\" aria-expanded=\"false\" aria-controls=\"accordion-2309702507-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Midwifery Workforce Index<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-2309702507-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-2309702507-label\">\n\t\t\t\n\n<p>Midwifery workforce policies are defined as state policies that are intended to improve access to midwives, compensation, education and training, credentialing and licensing, and\/or access to employment. Each of these policy indicators are equally weighted in the sub-index based on standardized scores.<\/p>\n<table dir=\"ltr\" border=\"1\" data-tablestyle=\"MsoNormalTable\" data-tablelook=\"1184\">\n<tbody>\n<tr style=\"background-color: #4e79a7;position:sticky;top:0px\" role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Variable\/Indicator\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Definition\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Data Source\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Year Used\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Index Scoring\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<\/tr>\n<tr style=\"background-color: #71a4db\" role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" colspan=\"5\" data-celllook=\"69905\">\n<p><span style=\"color: #ffffff\"><strong>Scope of Practice\u00a0<\/strong><\/span><\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Certified Nurse Midwives*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>CNM scope of practice varies by state and includes the following categories: Independent Practice and Privileges, Independent Practice, Hybrid, Collaborative Agreement, or Supervision required.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\"><a href=\"https:\/\/www.ncsl.org\/scope-of-practice-policy\/practitioners\/advanced-practice-registered-nurses\/certified-nurse-midwife-practice-and-prescriptive-authority\/maptype\/tile#undefined\" target=\"_blank\" rel=\"noopener\">National Council of State Legislatures<\/a><\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2025<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States scored 0 where there was a physician relationship or supervision required, a 50 where there was collaborative or hybrid practice or transitioning to independent practice, and 100 if CNMs are able to practice independently.\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Certified Midwife*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>CM scope of practice varies by state and is binary in that either the credential is recognized or it is not.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/familymedicine.uw.edu\/chws\/wp-content\/uploads\/sites\/5\/2025\/08\/American-College-of-Midwives-Certified-Midwife-Practice-Authority-Map-2023.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">American College of Nurse Midwives<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2023\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that recognized the CM credential scored 100 and states that did not scored 0.\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Certified Professional Midwife*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>CPM scope of practice varies by state and is binary in that either the profession is regulated or it is not.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/pushformidwives.org\/feelingpushy\/\" target=\"_blank\" rel=\"noreferrer noopener\">Push For Midwives<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2024\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that have regulated CPMs scored 100 and states that did not scored 0.\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Certified Nurse Midwife Prescriptive Authority*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>If a state has full prescriptive authority for CNMs, transitioning to independent prescriptive authority, and no prescriptive authority or requiring a collaborative agreement with physicians\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/www.ncsl.org\/scope-of-practice-policy\/practitioners\/advanced-practice-registered-nurses\/certified-nurse-midwife-practice-and-prescriptive-authority\" target=\"_blank\" rel=\"noreferrer noopener\">National Council of State Legislatures<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2025<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that have full prescriptive authority for CNMs scored 100, for those transitioning to independent scored a 50, and for those with no prescriptive authority scored 0.\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Certified Nurse Midwife Independent Authority to Admit Patients to Hospitals*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>State law may specifically regulate midwives\u2019 authority to admit patients to a hospital and hospital medical staff privileges.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>Herndon A, Vanderlaan J. Associations Between State Practice Regulations and Access to Midwifery Care. Journal of Midwifery &amp; Women&#8217;s Health. 2024;69(1):17-24. doi:10.1111\/jmwh.13528. <a href=\"https:\/\/doi.org\/10.1111\/jmwh.13528\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/doi.org\/10.1111\/jmwh.13528<\/a>\u00a0\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2023\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that allow for CNMs to admit patients to hospitals scored 100 and those that have not scored 0.\u00a0\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr style=\"background-color: #71a4db\" role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" colspan=\"5\" data-celllook=\"69905\">\n<p><span style=\"color: #ffffff\"><strong>Access to Education\u00a0<\/strong><\/span><\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Access to Certified Nurse Midwifery Education*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2022-23 academic year individual completions of CNM programs using the CIP (Classification of Instructional Programs) code for Nurse Midwife\/Nursing Midwifery is 51.3807 or presence of an accredited program.\u00a0\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/nces.ed.gov\/ipeds\/about-ipeds\" target=\"_blank\" rel=\"noreferrer noopener\">Integrated Postsecondary Education Data System<\/a> and <a href=\"https:\/\/theacme.org\/accredited-midwifery-education-programs\/\" target=\"_blank\" rel=\"noopener\">The Accreditation Commission for Midwifery Education<\/a><\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2023 and 2025<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>If a state had one or more schools had at least one completion for the 2022-23 academic year or the presence of at least one accredited program, they scored 100. If a state did not meet these criteria, they scored 0.\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Access to Direct Entry Nurse Midwifery Education*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2022-23 academic year individual completions of direct access midwifery programs using the CIP code for Direct Entry Midwifery is 51.3401.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/nces.ed.gov\/ipeds\/about-ipeds\" target=\"_blank\" rel=\"noreferrer noopener\">Integrated Postsecondary Education Data System<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2023\u202f\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>If a state had one or more schools had at least one completion for the 2022-23 academic year, they scored 100. If a state did not have a school with any completions for the same academic year, they scored 0.\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr style=\"background-color: #71a4db\" role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" colspan=\"5\" data-celllook=\"69905\">\n<p><strong><span style=\"color: #ffffff\">Reimbursement\u202f\u00a0<\/span><\/strong><\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Certified Nurse Midwife Medicaid Reimbursement*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>CNM Medicaid reimbursement rates are set at the state level and represented as percentages of physician reimbursement rates.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/nashp.org\/state-tracker\/midwife-medicaid-reimbursement-policies-by-state\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Academy for State Health Policy<\/a> and <a href=\"https:\/\/legacy.midwife.org\/reimbursement-equity\" target=\"_blank\" rel=\"noopener\">American College of Nurse Midwives\u00a0<\/a><\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2023 (NASHP) and 2022 (ACNM)**\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that provided CNM Medicaid reimbursement rates at less than 90% of the physician rate scored 0, those with 90-99% scored a 50, and those at 100% scored 100\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Certified Professional Midwife Reimbursement*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>CPM Medicaid reimbursement rates are set at the state level and use a binary value to determine if reimbursement is provided under Medicaid.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/nashp.org\/state-tracker\/midwife-medicaid-reimbursement-policies-by-state\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Academy for State Health Policy<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2023\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that provided Medicaid reimbursement for CPMs scored 100 and those that did not scored 0.\u00a0\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Certified Nurse Midwife Included in Global Maternity Payment*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>This variable uses a binary value to determine if global maternity payments includes CNM services under state Medicaid programs.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/nashp.org\/state-tracker\/midwife-medicaid-reimbursement-policies-by-state\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Academy for State Health Policy<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2023\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that included CNM services under global maternity payments in Medicaid reimbursement scored 100 and those that did not scored 0.\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Certified Nurse Midwife Serve as Primary Care Provider Under Medicaid*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>Under state Medicaid programs, states can designate if CNMs qualify as primary care physicians. This is coded as a binary variable.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/nashp.org\/state-tracker\/midwife-medicaid-reimbursement-policies-by-state\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Academy for State Health Policy<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>\u202f2023\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that allow for CNMs to serve as PCP in Medicaid scored 100 and those that did not scored 0.\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Mandated Certified Professional Midwife by Private Insurance*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States may have laws or regulations requiring private insurance companies to reimburse for services provided by CPMs in their health insurance plans.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>Ijaz N, Carrie H (2023) Governing therapeutic pluralism: An environmental scan of the statutory regulation and government reimbursement of traditional and complementary medicine practitioners in the United States. PLOS Global Public Health 3(8): e0001996. <a href=\"https:\/\/doi.org\/10.1371\/journal.pgph.0001996\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/doi.org\/10.1371\/journal.pgph.0001996<\/a>\u00a0\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>\u202f2023\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that require private insurance reimbursement scored 100 and those that did not scored 0.\u00a0\u00a0<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-size: 75%\"><br \/>* Data available on website and manually inserted<br \/>**The most recent data available was used for each state.<br \/>\u00b1 Data manipulated by UW CHWS<\/span><\/p>\n<p>\u00a0<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-2056422353\" class=\"accordion-item\">\n\t\t<a id=\"accordion-2056422353-label\" class=\"accordion-title plain\" href=\"#accordion-item-doula-workforce-index\" aria-expanded=\"false\" aria-controls=\"accordion-2056422353-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Doula Workforce Index<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-2056422353-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-2056422353-label\">\n\t\t\t\n\n<p>Doula workforce policies are defined as state policies intended to improve access to doulas under Medicaid and private insurance programs, compensation, education and training, and credentialing and licensing. Each of these policy indicators are equally weighted in the sub-index based on standardized scores.<\/p>\n<table dir=\"ltr\" border=\"1\" data-tablestyle=\"MsoNormalTable\" data-tablelook=\"1184\">\n<tbody>\n<tr style=\"background-color: #59a14f;position:sticky;top:0px\" role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Variable\/Indicator\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><strong><span style=\"color: #ffffff\">Definition<\/span>\u00a0<\/strong><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><strong><span style=\"color: #ffffff\">Data Source<\/span>\u00a0<\/strong><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Year Used\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><strong><span style=\"color: #ffffff\">Index Scoring<\/span>\u00a0<\/strong><\/h4>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">Private Insurance Coverage of Doulas Mandated*<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States that have implemented doula coverage in private insurance.<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\"><a href=\"https:\/\/www.badoulatrainings.org\/blog\/state-of-the-states-efforts-to-expand-access-to-doula-care-in-medicaid-and-private-insurance\">Birthing Advocacy Doula Trainings<\/a><\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">2024<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States that have implemented private insurance coverage for doula services scored 100 and those that did not scored 0.<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">Doula Medicaid Reimbursement*<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States that have implemented or are in the process of implementing legislative or administrative efforts related to Medicaid coverage for doula care.<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\"><a href=\"https:\/\/healthlaw.org\/doulamedicaidproject\/\">National Health Law Program\u2019s Doula Medicaid Project<\/a><\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">2025<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States that have expanded access to doula services under Medicaid scored 100, states where implementation is progress scored 50, and states where there is no action on reimbursement scored 0.<\/td>\n<\/tr>\n<tr style=\"background-color: #59a14f;color: white\" role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p><strong><span style=\"color: #ffffff\">Doula Credentialing<\/span><\/strong>\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\"><em>Experience or Legacy Pathway*<\/em><\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">Experience or legacy pathways allow for doulas to attest to competency through previous experience.\u00a0<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\"><a href=\"https:\/\/healthlaw.org\/doulamedicaidproject\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Health Law Program\u2019s Doula Medicaid Project<\/a> \u00a0<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">2025<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States that scored 100 allow for an experience pathway whereas those that do not have scored 0.\u00a0\u00a0<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\"><em>Organizations for Core Competencies*<\/em><\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States compile lists of credentialing organizations or have no organization requirements and\/or have the option for core competency attestation.<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\"><a href=\"https:\/\/healthlaw.org\/doulamedicaidproject\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Health Law Program\u2019s Doula Medicaid Project<\/a><\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">2025<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States that included only DONA scored 0, states that included local or BIPOC-led options scored 50, and states that had no organizational requirement or core competency attestation scored 100.<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\"><em>Support Provided for Credentialing Process*<\/em><\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States may grant funds or scholarships to support doula training and credentialing.<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/nashp.org\/state-tracker\/state-medicaid-approaches-to-doula-service-benefits\/\" target=\"_blank\" rel=\"noopener\">National Academy for State Health Policy, State Medicaid Approaches to Doula Service Benefits<\/a><\/p>\n<p>\u00a0<\/p>\n<p><a href=\"https:\/\/pn3policy.org\/pn-3-state-policy-roadmap-2023\/us\/community-based-doulas\" target=\"_blank\" rel=\"noopener\">Prenatal-to-3 Policy Impact Center<\/a><\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">2024<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States that provide support for doula training and credentialing scored 100 and those that do not scored 0.<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\"><em>Flexible Credentialing Requirements*<\/em><\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States may work with doulas to help with the enrollment and credentialing process, for example: waiving or minimizing application fees, funding and providing technical assistance, and flexible enrollment processes that enable doulas to enroll as an individual or with a group to allow for more doulas to go through the process.<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/www.chcs.org\/resource\/covering-doula-services-under-medicaid-design-and-implementation-considerations-for-promoting-access-and-health-equity\/\" target=\"_blank\" rel=\"noopener\">Center for Health Care Strategies<\/a><\/p>\n<p>\u00a0<\/p>\n<p><a href=\"https:\/\/healthlaw.org\/doulamedicaidproject\/\" target=\"_blank\" rel=\"noopener\">National Health Law Program\u2019s Doula Medicaid Project<\/a>\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">2022 and 2025<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">States that have offered any flexibility in credentialing requirements scored 100 and those that have not scored 0. \u00a0<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\"><em>Fingerprinting and\/or Background Check Required for Credential*<\/em><\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States may require doulas to submit to a background check or a fingerprint background check during the state certification process.<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/healthlaw.org\/doulamedicaidproject\/\" target=\"_blank\" rel=\"noopener\">National Health Law Program\u2019s Doula Medicaid Project<\/a>\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">2025<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States that do not require background checks or fingerprinting scored 100 and those that required a background check scored 0.<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-size: 75%\">* Data available on website and manually inserted<\/span><\/p>\n<p><span style=\"font-size: 75%\">\u00b1 Data manipulated by UW CHWS<\/span><\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-3167754766\" class=\"accordion-item\">\n\t\t<a id=\"accordion-3167754766-label\" class=\"accordion-title plain\" href=\"#accordion-item-labor-policy-index\" aria-expanded=\"false\" aria-controls=\"accordion-3167754766-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Labor Policy Index<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-3167754766-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-3167754766-label\">\n\t\t\t\n\n<p>Labor policies are defined as state policies intended to support the ability of all workers to access health insurance, take paid time off, achieve greater economic stability, and access and maintain employment without discrimination. Each of these policy indicators are equally weighted in the sub-index based on standardized scores.<\/p>\n<table dir=\"ltr\" border=\"1\" data-tablestyle=\"MsoNormalTable\" data-tablelook=\"1184\">\n<tbody>\n<tr style=\"background-color: #b07aa1;position:sticky;top:0px\" role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Variable\/Indicator\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Definition\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Data Source\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Year Used\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Index Scoring\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Medicaid Expansion*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States have the option to access additional federal funding to expand Medicaid eligibility for all adults to 138% of the federal poverty level under the Affordable Care Act.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/www.kff.org\/affordable-care-act\/issue-brief\/status-of-state-medicaid-expansion-decisions-interactive-map\/\" target=\"_blank\" rel=\"noreferrer noopener\">Kaiser Family Foundation<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2025\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States where Medicaid has been expanded scored 100 and states without expansion scored 0.\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Paid Family and Medical Leave*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States have either enacted mandatory paid family leave systems, voluntary systems that provide leave through private insurance, or do not have any systems implemented.\u00a0\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/bipartisanpolicy.org\/explainer\/state-paid-family-leave-laws-across-the-u-s\/\" target=\"_blank\" rel=\"noreferrer noopener\">Bipartisan Policy Center<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2024\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States with mandatory paid family leave scored 100, those with voluntary paid family leave scored 50, and those that have not taken action scored 0.\u00a0\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Protections for LGBTQ+ Workers*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States may offer a variety of protections for LGBTQ+ workers, including: the Equal Employment Opportunity Commission accepting complaints of sexual orientation and gender identity discrimination in employment based on Title VII\u2019s prohibition against sex discrimination, laws explicitly prohibiting discrimination based on sexual orientation and gender identity, prohibition of discrimination based on sexual orientation only, or no statutory or enforcement authority protections.\u00a0\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/www.hrc.org\/resources\/state-maps\" target=\"_blank\" rel=\"noreferrer noopener\">Human Rights Campaign<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2024\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States with any sort of enforcement or protections for LGBTQ+ workers scored 100, whereas those with no statutory of enforcement authority protections scored 0.\u00a0\u00a0<\/p>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>State-based Earned Income Tax Credit (EITC)*\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>State earned income tax credits provide an additional benefit to the federal credit for low-income taxpayers by reducing their state income tax liability. A\u202frefundable EITC\u202fcan result in a tax refund if the credit exceeds the taxes owed, while a\u202fnon-refundable EITC\u202fcan only reduce the tax owed to zero but cannot generate a refund.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/taxpolicycenter.org\/briefing-book\/how-do-state-earned-income-tax-credits-work#eitc\/\" target=\"_blank\" rel=\"noreferrer noopener\">Tax Policy Center (TPC)<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2024\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States with no EITC programs scored 0, whereas states with non-refundable EITC scored 50, and those with refundable EITC scored 100.\u00a0\u00a0<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-size: 75%\">* Data available on website and manually inserted<\/span><\/p>\n<p><span style=\"font-size: 75%\">\u00b1 Data manipulated by UW CHWS<\/span><\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-1436034839\" class=\"accordion-item\">\n\t\t<a id=\"accordion-1436034839-label\" class=\"accordion-title plain\" href=\"#accordion-item-economic-policy-index\" aria-expanded=\"false\" aria-controls=\"accordion-1436034839-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Economic Policy Index<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-1436034839-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-1436034839-label\">\n\t\t\t\n\n<p>The economic index includes data on federal maternal health funding and information on wage competitiveness and sufficiency to meet the cost of living in that state. Each of these policy indicators are equally weighted in the sub-index based on standardized scores.<\/p>\n<table dir=\"ltr\" border=\"1\" data-tablestyle=\"MsoNormalTable\" data-tablelook=\"1184\">\n<tbody>\n<tr style=\"background-color: #e15759;position:sticky;top:0px\" role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Variable\/Indicator\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Definition\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Data Source\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Year Used\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"padding: 10px\" role=\"columnheader\" data-celllook=\"69905\">\n<h4><span style=\"color: #ffffff\"><strong>Index Scoring\u00a0<\/strong><\/span><\/h4>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>MOMNIBUS Funding\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>The Momnibus Money Tracker is a record of \u201cfederal maternal health funding streams\u201d that have been enacted by Congress, collected by staff of the U.S. House of Representatives\u2019 Black Maternal Health Caucus leaders, Rep. Alma Adams &amp; Rep. Lauren Underwood. Data can be sorted by the federal, state or local program receiving the funds, the year of the funding, the sponsor, the funding amount, etc.\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/blackmaternalhealthcaucus-underwood.house.gov\/our-work\/momnibus-money-tracker\" target=\"_blank\" rel=\"noreferrer noopener\">U.S. House of Representatives Black Maternal Health Caucus Momnibus Money Tracker<\/a> \u00a0<\/p>\n<p>\u00a0<\/p>\n<p>\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2024<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States were scored based on the amount of money received as of 2024:<\/p>\n<ul>\n<li>25=&lt; $2mil<\/li>\n<li>50=$2mil-$3mil<\/li>\n<li>75 = $3mil-$5mil<\/li>\n<li>100=$5mil plus<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>CNM Wage Competitiveness\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>This compares average hourly wages for certified nurse midwives and nurse practitioners in 2023, with data retrieved from the Occupational Employment and Wage Statistics (OEWS) database.<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"mailto:https:\/\/www.bls.gov\/oes\/\">Occupational Employment and Wage Statistics<\/a><\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2023<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States were scored based on the following criteria:<\/p>\n<ul>\n<li>0=CNM hourly wage $10 or more below NP wage<\/li>\n<li>25=CNM hourly wage between $3 and $10 below NP hourly wage.<\/li>\n<li>50=CNM hourly wage up to $3 below NP hourly wage.<\/li>\n<li>75= CNM hourly wage equal to up to $3 above NP hourly wage<\/li>\n<li>100= CNM hourly wage greater than $3 above NP hourly wage<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr role=\"row\">\n<td style=\"padding: 10px\" role=\"rowheader\" data-celllook=\"69905\">\n<p>Doula Reimbursement Adequate for Cost of Living\u00b1\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>Based on the <a href=\"https:\/\/healthlaw.org\/doulamedicaidproject\/\" target=\"_blank\" rel=\"noreferrer noopener\">Doula Medicaid Project\u2019s<\/a> dashboard of maximum reimbursement rates per birth for doulas under state Medicaid programs, we estimated a full-time workload to be 3 births per month per doula. We then took that amount and used the living wage calculator provided by MIT.\u00a0\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p><a href=\"https:\/\/livingwage.mit.edu\/\" target=\"_blank\" rel=\"noreferrer noopener\">MIT Living Wage Calculator<\/a> \u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>2025\u00a0<\/p>\n<\/td>\n<td style=\"padding: 10px\" data-celllook=\"69905\">\n<p>States were scored based on the following reimbursement amount equivalent to an annual wage:<\/p>\n<ul>\n<li>0 = &lt; -$9,000<\/li>\n<li>25 = &gt; -$9,000 &amp; &lt; $0<\/li>\n<li>50 = &gt; $0 &amp; &lt; $16,000<\/li>\n<li>75 = &gt; $16,000 &amp; &lt;$40,000<\/li>\n<li>100 = &gt; $40,000<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-size: 75%\">* Data available on website and manually inserted<\/span><\/p>\n<p><span style=\"font-size: 75%\">\u00b1 Data manipulated by UW CHWS<\/span><\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\n<\/div>\n\n<\/div>\n<div id=\"tab_faq\" class=\"panel entry-content\" role=\"tabpanel\" aria-labelledby=\"tab-faq\">\n\n<div class=\"accordion\">\n\n\t<div id=\"accordion-3698077139\" class=\"accordion-item\">\n\t\t<a id=\"accordion-3698077139-label\" class=\"accordion-title plain\" href=\"#accordion-item-what-is-the-maternal-and-child-health-workforce-index?\" aria-expanded=\"false\" aria-controls=\"accordion-3698077139-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>What is the Maternal and Child Health Workforce Index?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-3698077139-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-3698077139-label\">\n\t\t\t\n\n<p>The MCH Worker Supportive Policy index offers a state-level, data-driven picture of the experience of the maternal and child health workforce. This interactive tool is meant to offer opportunities to examine specific experiences for 2 groups within the MCH workforce \u2013 midwives and doulas \u2013 as well as how economic and labor policies may be affecting this workforce. The tool allows for state-by-state comparisons and for an in-depth look within a particular state, with the goal of helping decision-makers prioritize potential areas for improvement.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-3802813676\" class=\"accordion-item\">\n\t\t<a id=\"accordion-3802813676-label\" class=\"accordion-title plain\" href=\"#accordion-item-why-was-this-index-created?\" aria-expanded=\"false\" aria-controls=\"accordion-3802813676-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Why was this index created?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-3802813676-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-3802813676-label\">\n\t\t\t\n\n<p>While there has been increasing interest in understanding and supporting the MCH workforce, greater investment is needed to ensure access to and availability of this workforce for comprehensive obstetric services. The MCH Worker Supportive Policy Index provides information for states, policymakers, and other decision-makers on where states excel in supporting this workforce, how states compare to each other, and opportunities for additional state policies targeted towards MCH workforce development and support.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-272528911\" class=\"accordion-item\">\n\t\t<a id=\"accordion-272528911-label\" class=\"accordion-title plain\" href=\"#accordion-item-why-did-we-focus-on-midwives-and-doulas?\" aria-expanded=\"false\" aria-controls=\"accordion-272528911-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Why did we focus on midwives and doulas?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-272528911-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-272528911-label\">\n\t\t\t\n\n<p>We chose to focus on midwives and doulas for the initial iteration of this index as research demonstrates the importance of these two workforce groups for supporting better perinatal health outcomes and the need for more targeted workforce support for both midwives and doulas. There are a range of other important workforce groups who contribute to maternal and child health, including physicians, nurses, lactation consultants, physical, occupational, and speech therapists, community health workers, and behavioral health professionals. Future iterations of this index may work to include these as well.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-2527780675\" class=\"accordion-item\">\n\t\t<a id=\"accordion-2527780675-label\" class=\"accordion-title plain\" href=\"#accordion-item-how-do-we-define-midwives-and-doulas?\" aria-expanded=\"false\" aria-controls=\"accordion-2527780675-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>How do we define midwives and doulas?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-2527780675-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-2527780675-label\">\n\t\t\t\n\n<p>For this study, we used the following definitions to define the midwifery and doula workforce:<\/p>\n<ul>\n<li><strong>Certified Nurse-Midwives (CNMs)<\/strong> are advanced practice registered nurses who receive graduate-level training in midwifery and are certified by the American Midwifery Certification Board. They provide comprehensive reproductive and primary care\u2014including pregnancy, birth, postpartum, and gynecologic services\u2014and are licensed in all 50 states.<\/li>\n<li><strong>Certified Midwives (CMs)<\/strong> are healthcare providers educated in midwifery at the graduate level without first becoming nurses, and they are also certified by the American Midwifery Certification Board. Their scope of practice is similar to CNMs, but they are licensed in fewer states and typically practice in hospital or birth center settings.<\/li>\n<li><strong>Certified Professional Midwives (CPMs)<\/strong> are trained specifically in out-of-hospital birth and earn certification through the North American Registry of Midwives. They provide prenatal, birth, and postpartum care primarily in home or birth center settings, focusing on low-risk pregnancies and physiologic birth.<\/li>\n<li><strong>Birth doulas<\/strong> are non-medical professionals who provide emotional, physical, and informational support during pregnancy, labor, and the postpartum period. They do not perform clinical tasks or deliver babies, but instead support the birthing person\u2019s comfort, decision-making, and overall experience.<\/li>\n<\/ul>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-1211091760\" class=\"accordion-item\">\n\t\t<a id=\"accordion-1211091760-label\" class=\"accordion-title plain\" href=\"#accordion-item-how-is-this-index-funded?\" aria-expanded=\"false\" aria-controls=\"accordion-1211091760-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>How is this index funded?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-1211091760-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-1211091760-label\">\n\t\t\t\n\n<p>This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $481,001 with zero percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government. For more information, please visit HRSA.gov.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-1159493229\" class=\"accordion-item\">\n\t\t<a id=\"accordion-1159493229-label\" class=\"accordion-title plain\" href=\"#accordion-item-who-are-the-primary-audiences-and-users-of-this-index?\" aria-expanded=\"false\" aria-controls=\"accordion-1159493229-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Who are the primary audiences and users of this index?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-1159493229-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-1159493229-label\">\n\t\t\t\n\n<p>Researchers, policymakers, health workforce planners, and other decisionmakers will likely be interested in the findings presented in these indices. The information is intended to improve understanding of the support available for the maternal and child health workforce at a state level, specifically support for midwives and doulas.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-3730690447\" class=\"accordion-item\">\n\t\t<a id=\"accordion-3730690447-label\" class=\"accordion-title plain\" href=\"#accordion-item-what-data-does-this-index-include?\" aria-expanded=\"false\" aria-controls=\"accordion-3730690447-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>What data does this index include?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-3730690447-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-3730690447-label\">\n\t\t\t\n\n<p>All variables included within the overall index and each sub-index are created sourcing publicly available data. Detailed information on how each index is defined, along with the variables within each index, can be found in the <a href=\"https:\/\/familymedicine.uw.edu\/chws\/resources\/mch-workforce-data-dashboard\/methods-faq\/#tab_methods\">methods table<\/a>.\u00a0<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-1849148508\" class=\"accordion-item\">\n\t\t<a id=\"accordion-1849148508-label\" class=\"accordion-title plain\" href=\"#accordion-item-why-aren&#039;t-all-indicators-using-the-same-year-of-data?\" aria-expanded=\"false\" aria-controls=\"accordion-1849148508-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Why aren't all indicators using the same year of data?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-1849148508-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-1849148508-label\">\n\t\t\t\n\n<p>We used the most recent data available as of August 2025. Unfortunately, not all data is updated annually. For indicators which have more than one dataset and year listed, we used the most recent data available for each state.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-3849733635\" class=\"accordion-item\">\n\t\t<a id=\"accordion-3849733635-label\" class=\"accordion-title plain\" href=\"#accordion-item-were-there-any-other-tools-used-as-guides-in-developing-this-index?\" aria-expanded=\"false\" aria-controls=\"accordion-3849733635-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Were there any other tools used as guides in developing this index?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-3849733635-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-3849733635-label\">\n\t\t\t\n\n<p>Scoring of this index used existing indices as initial guides for building the index, including PHI\u2019s <a href=\"https:\/\/www.phinational.org\/state-index-tool\/\">Direct Care Workforce State Index<\/a> and the Midwifery Integration Scoring System (MISS) by <a href=\"https:\/\/dx.doi.org\/10.1371\/journal.pone.0192523\">Vedam et al. (2018)<\/a>.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-3766192849\" class=\"accordion-item\">\n\t\t<a id=\"accordion-3766192849-label\" class=\"accordion-title plain\" href=\"#accordion-item-i-think-some-information-for-my-state-might-be-missing,-why-is-that?\" aria-expanded=\"false\" aria-controls=\"accordion-3766192849-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>I think some information for my state might be missing, why is that?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-3766192849-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-3766192849-label\">\n\t\t\t\n\n<p>We are not able to capture all the information about every state and acknowledge the state-specific complexity that may exist which is not represented here. This dashboard is meant to provide some insight into areas which may benefit from more focus, but the information provided is limited to what is data is publicly available.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-437639074\" class=\"accordion-item\">\n\t\t<a id=\"accordion-437639074-label\" class=\"accordion-title plain\" href=\"#accordion-item-when-was-this-index-launched?\" aria-expanded=\"false\" aria-controls=\"accordion-437639074-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>When was this index launched?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-437639074-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-437639074-label\">\n\t\t\t\n\n<p>This index was launched in October 2025.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-1768177795\" class=\"accordion-item\">\n\t\t<a id=\"accordion-1768177795-label\" class=\"accordion-title plain\" href=\"#accordion-item-when-was-this-index-updated?\" aria-expanded=\"false\" aria-controls=\"accordion-1768177795-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>When was this index updated?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-1768177795-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-1768177795-label\">\n\t\t\t\n\n<p>This index was last updated September 2025. Further updates are dependent on funding.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-4151790773\" class=\"accordion-item\">\n\t\t<a id=\"accordion-4151790773-label\" class=\"accordion-title plain\" href=\"#accordion-item-who-should-i-contact-if-i-have-questions?\" aria-expanded=\"false\" aria-controls=\"accordion-4151790773-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>Who should I contact if I have questions?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-4151790773-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-4151790773-label\">\n\t\t\t\n\n<p>Please contact us with any questions (<a href=\"mailto:uwchws@uw.edu\">uwchws@uw.edu<\/a>).<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t<div id=\"accordion-3530041138\" class=\"accordion-item\">\n\t\t<a id=\"accordion-3530041138-label\" class=\"accordion-title plain\" href=\"#accordion-item-how-should-i-cite-these-indices?\" aria-expanded=\"false\" aria-controls=\"accordion-3530041138-content\">\n\t\t\t<button class=\"toggle\" aria-label=\"Toggle\"><i class=\"icon-angle-down\" aria-hidden=\"true\"><\/i><\/button>\n\t\t\t<span>How should I cite these indices?<\/span>\n\t\t<\/a>\n\t\t<div id=\"accordion-3530041138-content\" class=\"accordion-inner\" aria-labelledby=\"accordion-3530041138-label\">\n\t\t\t\n\n<p>Recommended citation: Kett PM, Guenther G, Dunlap B, Frogner BK. (2025) Maternal and Child Health Worker Supportive Policy Index. University of Washington Center for Health Workforce Studies.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\n<\/div>\n\n<\/div><\/div><\/div>\n\n\n<script type=\"text\/javascript\">jQuery(function() {\n  jQuery(\"table\").tablesorter({\n    widgets: [\"stickyHeaders\"],\n    widgetOptions : {\n      \/\/ css class name applied to the sticky header\n      stickyHeaders : \"tablesorter-stickyHeader\"\n    }\n  });\n});<\/script>\n\n\n\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":10844,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-blank.php","meta":{"footnotes":""},"class_list":["post-10899","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/familymedicine.uw.edu\/chws\/wp-json\/wp\/v2\/pages\/10899","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/familymedicine.uw.edu\/chws\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/familymedicine.uw.edu\/chws\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/chws\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/chws\/wp-json\/wp\/v2\/comments?post=10899"}],"version-history":[{"count":78,"href":"https:\/\/familymedicine.uw.edu\/chws\/wp-json\/wp\/v2\/pages\/10899\/revisions"}],"predecessor-version":[{"id":11591,"href":"https:\/\/familymedicine.uw.edu\/chws\/wp-json\/wp\/v2\/pages\/10899\/revisions\/11591"}],"up":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/chws\/wp-json\/wp\/v2\/pages\/10844"}],"wp:attachment":[{"href":"https:\/\/familymedicine.uw.edu\/chws\/wp-json\/wp\/v2\/media?parent=10899"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}