Bill Summary
The Delivering Optimally Urgent Labor Access for Veterans Affairs Act of 2020, or the DOULA for VA Act of 2020, requires the Secretary of Veterans Affairs to establish a pilot program to furnish doula services to veterans. The bill aims to improve maternal and mental health outcomes for pregnant veterans by providing them with doula support services. The pilot program will be carried out for five years and will allow eligible entities and covered veterans to participate. The bill also requires the Secretary to submit annual reports and recommendations on the effectiveness of the pilot program. The bill authorizes appropriations for fiscal years 2021 to 2026.
Possible Impacts
1. The pilot program could provide much needed doula support to pregnant veterans who may otherwise not have access to such services. This could positively affect the mental and physical health outcomes for both the mothers and their infants.
2. The program could also help to reengage veterans with the Department after giving birth, leading to improved continuity of care and potential long-term benefits for the veterans and their families.
3. By consulting with stakeholders and experts in promoting health equity, this legislation aims to address potential racial and gender biases in healthcare that may affect pregnant veterans. This could have a significant impact on improving the overall quality of care and health outcomes for this population.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9016 Introduced in House (IH)]
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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 Gonzalez-
Colon 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 Representatives 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 VETERANS.
(a) Findings.--Congress finds the following:
(1) There are approximately 2,300,000 women within the
veteran population in the United States.
(2) The number of women veterans using services 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 Department 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 patients with an
obstetric delivery paid for by the Department increased by
1,778 percent from 200 deliveries 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 Department increased 16-fold
from fiscal year 2000 to fiscal year 2015.
(7) A study in 2010 found that veterans returning from
Operation Enduring Freedom and Operation Iraqi Freedom who
experienced pregnancy were twice as likely to have a diagnosis
of depression, anxiety, posttraumatic stress disorder, bipolar
disorder, or schizophrenia as those who had not experienced a
pregnancy.
(8) The number of women veterans of reproductive age
seeking care from the Veterans Health Administration 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 Secretary of Veterans Affairs
shall establish a pilot program to furnish doula services to
covered veterans through eligible entities by expanding the
Whole Health model of the Department of Veterans Affairs, 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 doulas, including
traditional and community-based doulas.
(3) Consultation.--In designing and implementing the pilot
program the Secretary shall consult with stakeholders,
including--
(A) organizations representing veterans, including
veterans that are disproportionately impacted by poor
maternal health outcomes;
(B) community-based health care professionals,
including doulas, and other stakeholders; 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 infant
care outcomes;
(ii) integration of doula support services
into the Whole Health model of the Department,
or successor model; and
(iii) the experience of women receiving
maternity care from the Department, including
by increasing the ability of a woman to develop
and follow her own birthing plan.
(B) To reengage veterans with the Department after
giving birth.
(c) Locations.--The Secretary shall carry out the pilot program
in--
(1) the three Veterans Integrated Service Networks of the
Department that have the highest percentage 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; and
(2) the three Veterans Integrated Service Networks that
have the lowest percentage of female veterans enrolled in the
patient enrollment system compared to the total number of
enrolled veterans in such Network.
(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 sessions 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 paragraph (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 participating 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 recommend 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 consultation with the
Office of Women's Health, or successor office, shall establish
a Doula Service Coordinator within the functions of the
Maternity Care Coordinator at each medical facility of the
Department that is participating in the pilot program.
(2) Duties.--A Doula Service Coordinator established 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 entities and
the Department under the pilot program.
(3) Tracking of information.--A doula providing 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 medical facility of the Department
shall coordinate with the women's program manager for that
facility in carrying out the duties of the Doula Service
Coordinator 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 eligible 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 annually 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 program.
(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 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 pregnant 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 maternity 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.
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