I 
118TH CONGRESS 
1ST SESSION H. R. 6331 
To require the Secretary of Veterans Affairs to establish a pilot program 
to furnish doula services to veterans. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 9, 2023 
Mr. DAVIS of North Carolina (for himself and Mrs. GONZA´LEZ-COLO´N) intro-
duced the following bill; which was referred to the Committee on Vet-
erans’ 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 2023’’ 
or the ‘‘DOULA for VA Act of 2023’’. 
SEC. 2. PILOT PROGRAM ON DOULA SUPPORT FOR VET-
ERANS. 
(a) FINDINGS.—Congress finds the following: 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS
(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 seeking care from the De-
partment for other conditions may also need emer-
gency 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. 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS
(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 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS
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 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS
woman to develop and follow her own 
birthing plan. 
(B) To reengage veterans with the Depart-
ment after giving birth. 
(c) LOCATIONS.—The Secretary shall carry out the 
pilot program in— 
(1) the three Veterans Integrated Service Net-
works of the Department that have the highest per-
centage of female veterans enrolled in the patient 
enrollment system of the Department established 
and operated under section 1705(a) of title 38, 
United States Code, compared to the total number 
of enrolled veterans in such Network; 
(2) the three Veterans Integrated Service Net-
works that have the lowest percentage of female vet-
erans enrolled in the patient enrollment system com-
pared to the total number of enrolled veterans in 
such Network; and 
(3) at least one Veterans Integrated Services 
Network— 
(A) located in or serving a Frontier State 
(as defined in section 1886(d)(3)(E)(iii)(II) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395ww(d)(3)(E)(iii)(II))) where more than 1⁄3 
of the population lives in frontier land; and 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS
(B) serving populations experiencing high-
er average risk and prevalence for maternal 
mental health disorders, including American In-
dian or Alaska Native veterans. 
(d) OPEN
PARTICIPATION.—The Secretary shall 
allow any eligible entity or covered veteran interested in 
participating in the pilot program to participate in the 
pilot program. 
(e) SERVICES PROVIDED.— 
(1) IN GENERAL.—Under the pilot program, a 
covered veteran shall receive not more than 10 ses-
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.— 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS
(1) IN
GENERAL.—The Office of Women’s 
Health of the Department of Veterans Affairs, or 
successor office (in this section referred to as the 
‘‘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 
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, shall establish a Doula Service 
Coordinator within the functions of the Maternity 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS
Care Coordinator at each medical facility of the De-
partment 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 
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 five years. 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS
(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 
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 2024 through 2029, such sums as may 
be necessary to carry out this section. 
(l) DEFINITIONS.—In this section: 
(1) COVERED
VETERAN.—The term ‘‘covered 
veteran’’ means a pregnant veteran or a formerly 
pregnant veteran (with respect to sessions post- 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS
partum) who is enrolled in the patient enrollment 
system of the Department of Veterans Affairs estab-
lished and operated under section 1705(a) of title 
38, United States Code. 
(2) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means an entity that provides medically accu-
rate, comprehensive maternity services to covered 
veterans under the laws administered by the Sec-
retary, including under the Veterans Community 
Care Program under section 1703 of title 38, United 
States Code. 
(3) VA VIDEO CONNECT.—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 
VerDate Sep 11 2014 
20:32 Nov 20, 2023
Jkt 049200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6301
E:\BILLS\H6331.IH
H6331
ssavage on DSKBC07HB2PROD with BILLS