,,ii #aaith ,,congress #b;d ,session ,s4 #dbbe ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #bf1 #bjbf,mr4 ,booker 7for himself and ,ms4 ,murkowski7 introduced the following bill2 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 veterans4 #a4 ,short title ,this ,act may be cited as the ,delivering ,optimally ,urgent ,labor ,access for ,veterans ,affairs ,act of #bjbf or the ,,doula for ,,va ,act of #bjbf4 #b4 ,pilot program on doula support for veterans 7a7 ,findings ,congress finds the following3 7#a7 ,there are approximately #b1ajj1jjj women within the veteran population in the ,united ,states1 the fastest growing demographic group of veterans4 7#b7 ,by #bjbj1 the proportion of all women veterans using health care from the ,department of ,veterans ,affairs grew to #bh percent from #ag percent in #bjaj4 7#c7 ,during the period of #bjaj through #bjbj1 the number of women veterans using health care from the ,department nearly doubled1 from #caf1ifa to #eef1ace4 7#d7 ,in #bjbe1 there are more than #fjj1jjj women receiving health care from the ,department4 7#e7 ,although prenatal care and delivery is not provided in facilities of the ,department1 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 #agjc of title #ch1 ,united ,states ,code4 7#f7 ,the number of women veteran patients with obstetric deliveries paid for by the ,department increased to more than #e1ejj in fiscal year #bjai1 triple the number of such patients in fiscal year #bjji1 and #bb times the number from fiscal year #aiii4 7#g7 ,notably1 a quarter of the deliveries specified in paragraph 7#e7 from fiscal year #bjai were among veterans of advanced maternal age 7#ce years old or older7 and a quarter were among ,black or ,african-,american veterans1 both groups known to experience higher risk of severe maternal morbidity4 7#h7 ,a study in #bjaj found that veterans returning from ,operation ,enduring ,freedom and ,operation ,iraqi ,freedom who experienced pregnancy were twice as likely to have a diagnosis of depression1 anxiety1 posttraumatic stress disorder1 bipolar disorder1 or schizophrenia as those who had not experienced a pregnancy4 7#i7 ,the number of women veterans of reproductive age seeking care from the ,department continues to grow 7more than #bbh1jjj as of fiscal year #bjbj74 7b7 ,program 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 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 ,affairs1 or successor model1 to measure the impact that doula support services have on birth and mental health outcomes of pregnant veterans 7in this section referred to as the pilot program74 7#b7 ,consideration ,in carrying out the pilot program1 the ,secretary shall consider all types of doulas1 including traditional and community-based doulas4 7#c7 ,consultation ,in designing and implementing the pilot program1 the ,secretary shall consult with stakeholders1 including-- 7,a7 organizations representing veterans1 including veterans that are disproportionately impacted by poor maternal health outcomes2 7,b7 community-based health care professionals1 including doulas1 and other stakeholders2 and 7,c7 experts in promoting health equity and combating racial bias in health care settings4 7#d7 ,goals ,the goals of the pilot program are the following3 7,a7 ,to improve-- 7i7 maternal1 mental health1 and infant care outcomes2 7ii7 integration of doula support services into the ,whole ,health model of the ,department1 or successor model2 and 7iii7 the experience of women receiving maternity care from the ,department1 including by increasing the ability of a woman to develop and follow her own birthing plan4 7,b7 ,to reengage veterans with the ,department after giving birth4 7c7 ,locations ,the ,secretary shall carry out the pilot program in-- 7#a7 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 #agje7;a7 of title #ch1 ,united ,states ,code1 compared to the total number of enrolled veterans in such ,network2 7#b7 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 ,network2 and 7#c7 at least one ,veterans ,integrated ,services ,network-- 7,a7 located in or serving a ,frontier ,state 7as defined in section #ahhf7;d77#c77;,e77iii77,,ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7d77#c77;,e77iii77,,ii777 where more than #a_/c of the population lives in frontier land2 and 7,b7 serving populations experiencing higher average risk and prevalence for maternal mental health disorders1 including ,american ,indian or ,alaska ,native veterans4 7d7 ,open participation ,the ,secretary shall allow any eligible entity or covered veteran interested in participating in the pilot program to participate in the pilot program4 7e7 ,services provided 7#a7 ,in general ,under the pilot program1 a covered veteran shall receive not more than #aj sessions of care from a doula under the ,whole ,health model of the ,department1 or successor model1 under which a doula works as an advocate for the veteran alongside the medical team for the veteran4 7#b7 ,sessions ,sessions covered under paragraph 7#a7 shall be as follows3 7,a7 ,three or four sessions before labor and delivery4 7,b7 ,one session during labor and delivery4 7,c7 ,three or four sessions after post-partum1 which may be conducted via the mobile application for ,,va ,video ,connect4 7f7 ,administration of pilot program 7#a7 ,in general ,the ,office of ,women's ,health of the ,department of ,veterans ,affairs1 or successor office 7in this section referred to as the ,office71 shall-- 7,a7 coordinate services and activities under the pilot program2 7,b7 oversee the administration of the pilot program2 and 7,c7 conduct onsite assessments of medical facilities of the ,department that are participating in the pilot program4 7#b7 ,guidelines for veteran-specific care ,the ,office shall establish guidelines under the pilot program for training doulas on military sexual trauma and posttraumatic stress disorder4 7#c7 ,amounts for care ,the ,office may recommend to the ,secretary appropriate payment amounts for care and services provided under the pilot program1 which shall not exceed #c1ejj per doula per veteran4 7g7 ,doula ,service ,coordinator 7#a7 ,in general ,the ,secretary1 in consultation with the ,office1 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 program4 7#b7 ,duties ,a ,doula ,service ,coordinator established under paragraph 7#a7 at a medical facility shall be responsible for-- 7,a7 working with eligible entities1 doulas1 and covered veterans participating in the pilot program2 and 7,b7 managing payment between eligible entities and the ,department under the pilot program4 7#c7 ,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 program4 7#d7 ,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 program4 7h7 ,term of pilot program ,the ,secretary shall conduct the pilot program for a period of five years4 7i7 ,technical assistance ,the ,secretary shall establish a process to provide technical assistance to eligible entities and doulas participating in the pilot program4 7j7 ,report 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 and annually thereafter for each year in which the pilot program is carried out1 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 program4 7#b7 ,final report ,as part of the final report submitted under paragraph 7#a71 the ,secretary shall include recommendations on whether the model studied in the pilot program should be continued or more widely adopted by the ,department4 7k7 ,authorization of appropriations ,there are authorized to be appropriated to the ,secretary1 for each of fiscal years #bjbg through #bjcb1 such sums as may be necessary to carry out this section4 7l7 ,definitions ,in this section3 7#a7 ,covered veteran ,the term covered veteran means a pregnant veteran or a formerly pregnant veteran 7with respect to sessions post-partum7 who is enrolled in the patient enrollment system of the ,department of ,veterans ,affairs established and operated under section #agje7;a7 of title #ch1 ,united ,states ,code4 7#b7 ,eligible entity ,the term eligible entity means an entity that provides medically accurate1 comprehensive maternity services to covered veterans under the laws administered by the ,secretary1 including under the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code4 7#c7 ,,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 anywhere1 using encryption to ensure a secure and private session4