Friday Math Problem

Hello!

   I wanted to reach out again about HB0295 that is coming before you this Tuesday for vote. 

     To give you a little fun change in pace today, here is a fun math lesson in the form of a story problem. We hope this does not cause stress to those who did not like math growing up.

If you look at the fiscal note on this bill, you will see that the cost is $281,879 annually to operate a doula board. The average range of existing TN board fees are between $50 and $300. Representative Love verbally said $400 a year per doula for certification, but it is not on this legislation bill HB0295. It only says "certification fees for doula providers will be set at an amount sufficient to cover any increase in expenditures." 

    The fiscal note  says that it will cost $281,879 to set up the board and run it every year. At a $400 state certification fee ($281,879 / $400 = ?) , TN would need 705 doulas to join the state board to cover the cost of the salaries. According to the fiscal note, there are only 140 doulas in TN. Is 140 doulas = to the 705 doulas needed? No, that is not enough doulas to cover the board costs.  If you took the cost of $281,879 divided by 140 doulas (as assumed in the fiscal note), their cost to get certified by the state would be $2014 per doula. 

Tennessee law (Tenn. Code Ann. § 4-29-121) requires all health-related certifications to be self-sustaining. This means that the board would not be self-sustaining or the doulas would have a certification fee 4x's higher than the doctors in this state, yet the doulas don't make minimum wage. Why vote yes for a board that is doomed to fail and create a financial burden for the state and for the doulas?

Here is a comparison to other professions in  state of TN:

PROFESSION

Cost to certify (license) with state board in TN

Cost to Renew

How often to renew?

Physician (MD)	$510	$300	Every 2 years
Certified Nurse-Midwife (CNM)	$215	$160	Every 2 years
Midwife (CPM)	$335	$216	Every 2 years
Fiscal Note from HB 738 voted into law 2023 about doulas	$500	$710	Every 2 years
Currently in process 2025: HB 0295	What is needed to cover the board annual cost of $281,879. Rep Love said the fee was $400. That would require 705 doulas to certify under the board. We don't have that many doulas in the state. If this board idea is optional, eventually it will be mandatory to cover the salaries of the board members.	?	?: Probably every 2 years because every other state board does that in TN

Assuming the fiscal note is correct on HB0295 and we have 140 doulas in the state.

$2,014

?

?: Probably every 2 years because every other state board does that in TN

For those of you still reading this, here is a comparison of all the other state run boards in TN.

PROFESSION	Cost to certify (license) with state board in TN	Cost to Renew	How often to renew?
Accountant (CPA)	$100	$100	Every 2 years
Architect	$140	$140	Every 2 years
Attorney	$375	$320	Annually
Barber	$70	$70	Every 2 years
Cosmetologist	$50	$50	Every 2 years
Dental Hygienist	$140	$140	Every 2 years
Dentist	$300	$300	Every 2 years
Esthetician (Nail Technician)	$50	$50	Every 2 years
Licensed Practical Nurse (LPN)	$115	$90	Every 2 years
Licensed Professional Counselor	$200	$115	Every 2 years
Massage Therapist	$160	$110	Every 2 years
Pharmacist	$220	$195	Every 2 years
Pharmacy Technician	$75	$50	Every 2 years
Physical Therapist	$300	$240	Every 2 years
Physical Therapy Assistant	$190	$140	Every 2 years
Psychologist	$275	$225	Every 2 years
Real Estate Agent	$91	$80	Every 2 years
Real Estate Broker	$125	$110	Every 2 years
Registered Nurse (RN)	$115	$100	Every 2 years
Social Worker (LCSW)	$200	$115	Every 2 years
Veterinarian	$360	$330	Every 2 years