II 

116TH CONGRESS 

2D SESSION S. 4753 

To require the Secretary of Veterans Affairs to establish a pilot program 

to furnish doula services to veterans. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 29, 2020 

Mr. BOOKER (for himself and Mrs. BLACKBURN) introduced the following bill; 

which was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To require the Secretary of Veterans Affairs to establish 

a pilot program to furnish doula services to veterans. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Delivering Optimally 

5 Urgent Labor Access for Veterans Affairs Act of 2020’’ 

6 or the ‘‘DOULA for VA Act of 2020’’. 

7 SEC. 2. PILOT PROGRAM ON DOULA SUPPORT FOR VET8 ERANS. 

9 (a) FINDINGS.—Congress finds the following: 


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1 (1) There are approximately 2,300,000 women 

2 within the veteran population in the United States. 

3 (2) The number of women veterans using serv4 ices from the Veterans Health Administration has 

5 increased by 28.8 percent from 423,642 in 2014 to 

6 545,670 in 2019. 

7 (3) During the period of 2010 through 2015, 

8 the use of maternity services from the Veterans 

9 Health Administration increased by 44 percent. 

10 (4) Although prenatal care and delivery is not 

11 provided in facilities of the Department of Veterans 

12 Affairs, pregnant women seek care from the Depart13 ment for other conditions may also need emergency 

14 care and require coordination of services through the 

15 Veterans Community Care Program under section 

16 1703 of title 38, United States Code. 

17 (5) The number of unique women veteran pa18 tients with an obstetric delivery paid for by the De19 partment increased by 1,778 percent from 200 deliv20 eries in 2000 to 3,756 deliveries in 2015. 

21 (6) The number of women age 35 years or older 

22 with an obstetric delivery paid for by the Depart23 ment increased 16-fold from fiscal year 2000 to fis24 cal year 2015. 


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1 (7) A study in 2010 found that veterans return2 ing from Operation Enduring Freedom and Oper3 ation Iraqi Freedom who experienced pregnancy 

4 were twice as likely to have a diagnosis of depres5 sion, anxiety, posttraumatic stress disorder, bipolar 

6 disorder, or schizophrenia as those who had not ex7 perienced a pregnancy. 

8 (8) The number of women veterans of reproduc9 tive age seeking care from the Veterans Health Ad10 ministration continues to grow (more than 185,000 

11 as of fiscal year 2015). 

12 (b) PROGRAM.— 

13 (1) IN GENERAL.—Not later than one year 

14 after the date of the enactment of this Act, the Sec15 retary of Veterans Affairs shall establish a pilot pro16 gram to furnish doula services to covered veterans 

17 through eligible entities by expanding the Whole 

18 Health model of the Department of Veterans Af19 fairs, or successor model, to measure the impact 

20 that doula support services have on birth and mental 

21 health outcomes of pregnant veterans (in this section 

22 referred to as the ‘‘pilot program’’). 

23 (2) CONSIDERATION.—In carrying out the pilot 

24 program, the Secretary shall consider all types of 


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1 doulas, including traditional and community-based 

2 doulas. 

3 (3) CONSULTATION.—In designing and imple4 menting the pilot program the Secretary shall con5 sult with stakeholders, including— 

6 (A) organizations representing veterans, 

7 including veterans that are disproportionately 

8 impacted by poor maternal health outcomes; 

9 (B) community-based health care profes10 sionals, including doulas, and other stake11 holders; and 

12 (C) experts in promoting health equity and 

13 combating racial bias in health care settings. 

14 (4) GOALS.—The goals of the pilot program are 

15 the following: 

16 (A) To improve— 

17 (i) maternal, mental health, and in18 fant care outcomes; 

19 (ii) integration of doula support serv20 ices into the Whole Health model of the 

21 Department, or successor model; and 

22 (iii) the experience of women receiving 

23 maternity care from the Department, in24 cluding by increasing the ability of a 


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1 woman to develop and follow her own 

2 birthing plan. 

3 (B) To reengage veterans with the Depart4 ment after giving birth. 

5 (c) LOCATIONS.—The Secretary shall carry out the 

6 pilot program in— 

7 (1) the three Veterans Integrated Service Net8 works of the Department that have the highest per9 centage of female veterans enrolled in the patient 

10 enrollment system of the Department established 

11 and operated under section 1705(a) of title 38, 

12 United States Code, compared to the total number 

13 of enrolled veterans in such Network; and 

14 (2) the three Veterans Integrated Service Net15 works that have the lowest percentage of female vet16 erans enrolled in the patient enrollment system com17 pared to the total number of enrolled veterans in 

18 such Network. 

19 (d) OPEN PARTICIPATION.—The Secretary shall 

20 allow any eligible entity or covered veteran interested in 

21 participating in the pilot program to participate in the 

22 pilot program. 

23 (e) SERVICES PROVIDED.— 

24 (1) IN GENERAL.—Under the pilot program, a 

25 covered veteran shall receive not more than 10 sesVerDate Sep 11 2014 03:28 Oct 17, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4753.IS S4753

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1 sions of care from a doula under the Whole Health 

2 model of the Department, or successor model, under 

3 which a doula works as an advocate for the veteran 

4 alongside the medical team for the veteran. 

5 (2) SESSIONS.—Sessions covered under para6 graph (1) shall be as follows: 

7 (A) Three or four sessions before labor and 

8 delivery. 

9 (B) One session during labor and delivery. 

10 (C) Three or four sessions after post11 partum, which may be conducted via the mobile 

12 application for VA Video Connect. 

13 (f) ADMINISTRATION OF PILOT PROGRAM.— 

14 (1) IN GENERAL.—The Center for Women Vet15 erans under section 318 of title 38, United States 

16 Code, in consultation with the Advisory Committee 

17 on Women Veterans established under section 542 of 

18 such title (in this section referred to as the ‘‘Advi19 sory Committee’’), shall— 

20 (A) coordinate services and activities under 

21 the pilot program; 

22 (B) oversee the administration of the pilot 

23 program; and 


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1 (C) conduct onsite assessments of medical 

2 facilities of the Department that are partici3 pating in the pilot program. 

4 (2) GUIDELINES FOR VETERAN-SPECIFIC

5 CARE.—The Center for Women Veterans, in con6 sultation with the Advisory Committee, shall estab7 lish guidelines under the pilot program for training 

8 doulas on military sexual trauma and post traumatic 

9 stress disorder. 

10 (3) AMOUNTS FOR CARE.—The Advisory Com11 mittee may recommend to the Secretary appropriate 

12 payment amounts for care and services provided 

13 under the pilot program, which shall not exceed 

14 $3,500 per doula per veteran. 

15 (4) INCLUSION OF OTHER MEMBERS IN ADVI16 SORY COMMITTEE.—Only for purposes of carrying 

17 out the duties of the Advisory Committee under this 

18 section, the Secretary shall appoint to the Advisory 

19 Committee representatives of organizations that pro20 vide doula services, including representatives that 

21 can speak to the unique challenges endured by vet22 erans of color. 

23 (g) DOULA SERVICE COORDINATOR.— 

24 (1) IN GENERAL.—The Secretary, in consulta25 tion with the Center for Women Veterans and the 


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1 Advisory Committee, shall establish a Doula Service 

2 Coordinator within the functions of the Maternity 

3 Care Coordinator at each medical facility of the De4 partment that is participating in the pilot program. 

5 (2) DUTIES.—A Doula Service Coordinator es6 tablished under paragraph (1) at a medical facility 

7 shall be responsible for— 

8 (A) working with eligible entities, doulas, 

9 and covered veterans participating in the pilot 

10 program; and 

11 (B) managing payment between eligible en12 tities and the Department under the pilot pro13 gram. 

14 (3) TRACKING OF INFORMATION.—A doula pro15 viding services under the pilot program shall report 

16 to the applicable Doula Service Coordinator after 

17 each session conducted under the pilot program. 

18 (4) COORDINATION WITH WOMEN’S PROGRAM

19 MANAGER.—A Doula Service Coordinator for a med20 ical facility of the Department shall coordinate with 

21 the women’s program manager for that facility in 

22 carrying out the duties of the Doula Service Coordi23 nator under the pilot program. 

24 (h) TERM OF PILOT PROGRAM.—The Secretary shall 

25 conduct the pilot program for a period of 5 years. 


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1 (i) TECHNICAL ASSISTANCE.—The Secretary shall 

2 establish a process to provide technical assistance to eligi3 ble entities and doulas participating in the pilot program. 

4 (j) REPORT.— 

5 (1) IN GENERAL.—Not later than one year 

6 after the date of the enactment of this Act, and an7 nually thereafter for each year in which the pilot 

8 program is carried out, the Secretary shall submit to 

9 the Committee on Veterans’ Affairs of the Senate 

10 and the Committee on Veterans’ Affairs of the 

11 House of Representatives a report on the pilot pro12 gram. 

13 (2) FINAL REPORT.—As part of the final report 

14 submitted under paragraph (1), the Secretary shall 

15 include recommendations on whether the model 

16 studied in the pilot program should be continued or 

17 more widely adopted by the Department. 

18 (k) AUTHORIZATION OF APPROPRIATIONS.—There 

19 are authorized to be appropriated to the Secretary, for 

20 each of fiscal years 2021 through 2026, such sums as may 

21 be necessary to carry out this section. 

22 (l) DEFINITIONS.—In this section: 

23 (1) COVERED VETERAN.—The term ‘‘covered 

24 veteran’’ means a pregnant veteran or a formerly 

25 pregnant veteran (with respect to sessions postVerDate Sep 11 2014 03:28 Oct 17, 2020 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S4753.IS S4753

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1 partum) who is enrolled in the patient enrollment 

2 system of the Department of Veterans Affairs under 

3 section 1705 of title 38, United States Code. 

4 (2) ELIGIBLE ENTITY.—The term ‘‘eligible enti5 ty’’ means an entity that provides medically accu6 rate, comprehensive maternity services to covered 

7 veterans under the laws administered by the Sec8 retary, including under the Veterans Community 

9 Care Program under section 1703 of title 38, United 

10 States Code. 

11 (3) VA VIDEO CONNECT.—The term ‘‘VA Video 

12 Connect’’ means the program of the Department of 

13 Veterans Affairs to connect veterans with their 

14 health care team from anywhere, using encryption to 

15 ensure a secure and private session. 

Æ 


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