I 
116TH CONGRESS 
2D SESSION 
H. R. 9016 
To require the Secretary of Veterans Affairs to establish a pilot program 
to furnish doula services to veterans. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 17, 2020 
Mrs. LAWRENCE (for herself, Mrs. LESKO, Ms. DEAN, and Miss GONZA´LEZ- 
COLO´N of Puerto Rico) introduced the following bill; which was 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Delivering Optimally 
Urgent Labor Access for Veterans Affairs Act of 2020’’ 
or the ‘‘DOULA for VA Act of 2020’’. 
SEC. 2. PILOT PROGRAM ON DOULA SUPPORT FOR VET-
ERANS. 
(a) FINDINGS.—Congress finds the following: 
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(1) There are approximately 2,300,000 women 
within the veteran population in the United States. 
(2) The number of women veterans using serv-
ices from the Veterans Health Administration has 
increased by 28.8 percent from 423,642 in 2014 to 
545,670 in 2019. 
(3) During the period of 2010 through 2015, 
the use of maternity services from the Veterans 
Health Administration increased by 44 percent. 
(4) Although prenatal care and delivery is not 
provided in facilities of the Department of Veterans 
Affairs, pregnant women seek care from the Depart-
ment for other conditions may also need emergency 
care and require coordination of services through the 
Veterans Community Care Program under section 
1703 of title 38, United States Code. 
(5) The number of unique women veteran pa-
tients with an obstetric delivery paid for by the De-
partment increased by 1,778 percent from 200 deliv-
eries in 2000 to 3,756 deliveries in 2015. 
(6) The number of women age 35 years or older 
with an obstetric delivery paid for by the Depart-
ment increased 16-fold from fiscal year 2000 to fis-
cal year 2015. 
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(7) A study in 2010 found that veterans return-
ing from Operation Enduring Freedom and Oper-
ation Iraqi Freedom who experienced pregnancy 
were twice as likely to have a diagnosis of depres-
sion, anxiety, posttraumatic stress disorder, bipolar 
disorder, or schizophrenia as those who had not ex-
perienced a pregnancy. 
(8) The number of women veterans of reproduc-
tive age seeking care from the Veterans Health Ad-
ministration continues to grow (more than 185,000 
as of fiscal year 2015). 
(b) PROGRAM.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary of Veterans Affairs shall establish a pilot pro-
gram to furnish doula services to covered veterans 
through eligible entities by expanding the Whole 
Health model of the Department of Veterans Af-
fairs, or successor model, to measure the impact 
that doula support services have on birth and mental 
health outcomes of pregnant veterans (in this section 
referred to as the ‘‘pilot program’’). 
(2) CONSIDERATION.—In carrying out the pilot 
program, the Secretary shall consider all types of 
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doulas, including traditional and community-based 
doulas. 
(3) CONSULTATION.—In designing and imple-
menting the pilot program the Secretary shall con-
sult with stakeholders, including— 
(A) organizations representing veterans, 
including veterans that are disproportionately 
impacted by poor maternal health outcomes; 
(B) community-based health care profes-
sionals, including doulas, and other stake-
holders; and 
(C) experts in promoting health equity and 
combating racial bias in health care settings. 
(4) GOALS.—The goals of the pilot program are 
the following: 
(A) To improve— 
(i) maternal, mental health, and in-
fant care outcomes; 
(ii) integration of doula support serv-
ices into the Whole Health model of the 
Department, or successor model; and 
(iii) the experience of women receiving 
maternity care from the Department, in-
cluding by increasing the ability of a 
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sions of care from a doula under the Whole Health 
model of the Department, or successor model, under 
which a doula works as an advocate for the veteran 
alongside the medical team for the veteran. 
(2) SESSIONS.—Sessions covered under para-
graph (1) shall be as follows: 
(A) Three or four sessions before labor and 
delivery. 
(B) One session during labor and delivery. 
(C) Three or four sessions after post- 
partum, which may be conducted via the mobile 
application for VA Video Connect. 
(f) ADMINISTRATION OF PILOT PROGRAM.— 
(1) IN
GENERAL.—The Office of Women’s 
Health of the Department of Veterans Affairs, or 
successor office, shall— 
(A) coordinate services and activities under 
the pilot program; 
(B) oversee the administration of the pilot 
program; and 
(C) conduct onsite assessments of medical 
facilities of the Department that are partici-
pating in the pilot program. 
(2) 
GUIDELINES
FOR
VETERAN-SPECIFIC 
CARE.—The Office shall establish guidelines under 
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the pilot program for training doulas on military 
sexual trauma and post traumatic stress disorder. 
(3) AMOUNTS FOR CARE.—The Office may rec-
ommend to the Secretary appropriate payment 
amounts for care and services provided under the 
pilot program, which shall not exceed $3,500 per 
doula per veteran. 
(g) DOULA SERVICE COORDINATOR.— 
(1) IN GENERAL.—The Secretary, in consulta-
tion with the Office of Women’s Health, or successor 
office, shall establish a Doula Service Coordinator 
within the functions of the Maternity Care Coordi-
nator at each medical facility of the Department 
that is participating in the pilot program. 
(2) DUTIES.—A Doula Service Coordinator es-
tablished under paragraph (1) at a medical facility 
shall be responsible for— 
(A) working with eligible entities, doulas, 
and covered veterans participating in the pilot 
program; and 
(B) managing payment between eligible en-
tities and the Department under the pilot pro-
gram. 
(3) TRACKING OF INFORMATION.—A doula pro-
viding services under the pilot program shall report 
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to the applicable Doula Service Coordinator after 
each session conducted under the pilot program. 
(4) COORDINATION
WITH
WOMEN’S
PROGRAM 
MANAGER.—A Doula Service Coordinator for a med-
ical facility of the Department shall coordinate with 
the women’s program manager for that facility in 
carrying out the duties of the Doula Service Coordi-
nator under the pilot program. 
(h) TERM OF PILOT PROGRAM.—The Secretary shall 
conduct the pilot program for a period of 5 years. 
(i) TECHNICAL ASSISTANCE.—The Secretary shall 
establish a process to provide technical assistance to eligi-
ble entities and doulas participating in the pilot program. 
(j) REPORT.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, and an-
nually thereafter for each year in which the pilot 
program is carried out, the Secretary shall submit to 
the Committee on Veterans’ Affairs of the Senate 
and the Committee on Veterans’ Affairs of the 
House of Representatives a report on the pilot pro-
gram. 
(2) FINAL REPORT.—As part of the final report 
submitted under paragraph (1), the Secretary shall 
include recommendations on whether the model 
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studied in the pilot program should be continued or 
more widely adopted by the Department. 
(k) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to the Secretary, for 
each of fiscal years 2021 through 2026, such sums as may 
be necessary to carry out this section. 
(l) DEFINITIONS.—In this section: 
(1) The term ‘‘covered veteran’’ means a preg-
nant veteran or a formerly pregnant veteran (with 
respect to sessions post-partum) who is enrolled in 
the patient enrollment system of the Department of 
Veterans Affairs under section 1705 of title 38, 
United States Code. 
(2) The term ‘‘eligible entity’’ means an entity 
that provides medically accurate, comprehensive ma-
ternity services to covered veterans under the laws 
administered by the Secretary, including under the 
Veterans Community Care Program under section 
1703 of title 38, United States Code. 
(3) The term ‘‘VA Video Connect’’ means the 
program of the Department of Veterans Affairs to 
connect veterans with their health care team from 
anywhere, using encryption to ensure a secure and 
private session. 
Æ 
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