[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4225 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
2d Session
S. 4225
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
March 26, 2026
Mr. Booker (for himself and Ms. Murkowski) 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.
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 2026'' or the ``DOULA for VA Act of
2026''.
SEC. 2. PILOT PROGRAM ON DOULA SUPPORT FOR VETERANS.
(a) Findings.--Congress finds the following:
(1) There are approximately 2,100,000 women within the
veteran population in the United States, the fastest growing
demographic group of veterans.
(2) By 2020, the proportion of all women veterans using
health care from the Department of Veterans Affairs grew to 28
percent from 17 percent in 2010.
(3) During the period of 2010 through 2020, the number of
women veterans using health care from the Department nearly
doubled, from 316,961 to 556,135.
(4) In 2025, there are more than 600,000 women receiving
health care from the Department.
(5) Although prenatal care and delivery is not provided in
facilities of the Department, pregnant women seeking 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.
(6) The number of women veteran patients with obstetric
deliveries paid for by the Department increased to more than
5,500 in fiscal year 2019, triple the number of such patients
in fiscal year 2009, and 22 times the number from fiscal year
1999.
(7) Notably, a quarter of the deliveries specified in
paragraph (5) from fiscal year 2019 were among veterans of
advanced maternal age (35 years old or older) and a quarter
were among Black or African-American veterans, both groups
known to experience higher risk of severe maternal morbidity.
(8) 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.
(9) The number of women veterans of reproductive age
seeking care from the Department continues to grow (more than
228,000 as of fiscal year 2020).
(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;
(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; 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
(B) serving populations experiencing higher average
risk and prevalence for maternal mental health
disorders, including American Indian 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 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 (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 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 posttraumatic 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, 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 five 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 2027 through
2032, 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-partum) who is enrolled in the patient
enrollment system of the Department of Veterans Affairs
established and operated under section 1705(a) of title 38,
United States Code.
(2) Eligible entity.--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) 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.
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