Welcome to the January 2025 issue of Prenatal - 5: Grow & Thrive - HCA’s monthly newsletter about our behavioral health work in the early years of life. We hope that this newsletter helps build shared awareness of HCA’s efforts in this area and provides a centralized place to stay up to date on what’s new and happening.  

We’re also excited to announce that we are adding a new section to the newsletter called Ask the Reader. Each month, we’ll have a Menti poll for our readers, because we love to hear from you. Then, tune in next month to see the results!  

Did you get a notification that HCA GovDelivery subscriptions have been updated or closed? 

Earlier in January, some of HCA’s behavioral health communications subscriptions on GovDelivery were changed. Subscriptions to this newsletter and general Prenatal – Age 25 behavioral health communications did not change. Readers are still encouraged to review their subscriptions to stay up-to-date on other topics!  

The Apple Health DC:0-5 Crosswalk has been updated for 2025, effective January 1, 2025. 

What has changed? 

ICD-10-CM codes and code descriptions were updated to align with the 2025 ICD-10-CM. 

What do I need to do? 

• If you use HCA's link to reference the Crosswalk, this link will automatically update, and no action is required. 

• If you use a downloaded or printed version of the Crosswalk, please download or print the updated 2025 Crosswalk. 

• If you have the DC:0-5 Crosswalk programmed into your Electronic Health Record (EHR) system, you can use the 2025 Tabular file to make updates within your system.    

In response to feedback from external partners, HCA updated agency Washington Administrative Code (WAC 182-545-200) effective January 1, 2025. This rule change allows Apple Health (Medicaid) developmental service providers to provide care in community settings (such as childcare settings) for children six years and younger.  

Developmental services, also known as outpatient rehabilitative services, include occupational, physical, and speech therapies. Historically, this WAC only allowed payment for Apple Health developmental services in community settings for children with disabilities age two or younger. This rule change addresses a gap to allow children with disabilities ages three to six years old to receive care in community settings, which can be critical if they do not qualify for or cannot access early childhood special education services. 

In March 2025, the People Powered Workforce will share the first analysis of key themes and potential strategies. Providers, administrators, and systems partners will have an opportunity to provide feedback to ensure the findings are aligned with workforce experiences and perspectives.

TOMORROW! January 23, 2025 | 11 a.m. to noon: In this session, providers will share about screening tools they use as part of the assessment process, as well as how they work with other providers, like pediatricians and early childhood educators, to facilitate referrals and gather collateral information 

Welcome to the newest section of our newsletter, Ask the Reader. In this section, you can participate in a Menti poll with other readers. These polls will provide a fun (and anonymous) way to connect with each other.  

This month’s question is: What are 1-3 words to describe your 2024?  

To participate, click the link below, which will take you to a Menti poll site. Once you’ve completed the poll, you can click ‘View the Results’ on the next screen to see how other readers voted. Tune in next month to see the final results!  

Birth doulas are trained nonclinical professionals who provide physical, emotional, psychosocial, and informational support to pregnant, birthing, and post-pregnant people, as well as their families. Evidence supports doulas improving outcomes across a range of metrics for both pregnant people and infants, and demonstrates a larger positive impact for Black, Indigenous, and other people of color.  

There has long been support in Washington for increasing access to doulas, especially for people on Apple Health. During the 2024 legislative session, Governor Inslee signed Engrossed Substitute Senate Bill 5950 into law authorizing the Health Care Authority (HCA) to implement a doula benefit for Apple Health (Medicaid) clients. The Health Care Authority (HCA) launched the new birth doula benefit on January 1, 2025. 

Doulas and behavioral health 

Perinatal (pregnancy and the first year postpartum) mental health (PMH) and substance use disorders (SUD) are the most common complications of pregnancy, yet they frequently go undetected and untreated, especially among historically underserved communities such as Black, Latina/o/x, Indigenous, and people of low income. Integrating care into community-based settings, such as through the support of trusted individuals like doulas, can be a key strategy to increasing awareness and addressing PMH treatment access. 

With adequate support and training, doulas have the potential to play an important role in supporting their client’s emotional wellbeing. One study found that women who received support from doulas during labor and childbirth were less likely to be diagnosed with postpartum depression or anxiety (Falconi et al., 2022). Interviews with nine doulas and ten doula clients in Washington state found that most doulas were supporting their clients’ mental health in several different ways, but challenges were noted like unmet identified perinatal mental health training needs and concerns about scope of practice and burden.  (Quiray et al., 2024). 

Doula services may also support the development of strong parent-child relationships and infant early childhood mental health. One study found that mothers who received doula services had more positive interactions with their infants at 4 months, though these effects did fade over time (Hans et al., 2013).  

Learn more

Guest speakers from HCA will provide information about doula services at the next Quarterly First Steps Webinar. Even if you cannot attend the webinar live, you can still register to receive webinar materials 

• Date: TOMORROW! January 23, 2025 

• Time: 10-11:30 a.m. 

• Register 

HCA’s doula webpage also includes information on the Apple Health (Medicaid) doula benefit, including covered services, provider enrollment, how to stay updated, and more.