[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 958 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 958

  To codify maternity care coordination programs at the Department of 
               Veterans Affairs, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 8, 2021

   Ms. Underwood (for herself, Mr. Bilirakis, Ms. Brownley, and Mr. 
 Fitzpatrick) introduced the following bill; which was referred to the 
                     Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
  To codify maternity care coordination programs at the Department of 
               Veterans Affairs, and for other purposes.

    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 ``Protecting Moms Who Served Act''.

SEC. 2. SUPPORT FOR MATERNITY CARE COORDINATION.

    (a) Program on Maternity Care Coordination.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        carry out the maternity care coordination program described in 
        Veterans Health Administration Handbook 1330.03, or any 
        successor handbook.
            (2) Training and support.--In carrying out the program 
        under paragraph (1), the Secretary shall provide to community 
        maternity care providers training and support with respect to 
        the unique needs of pregnant and postpartum veterans, 
        particularly regarding mental and behavioral health conditions 
        relating to the service of the veterans in the Armed Forces.
    (b) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary $15,000,000 for fiscal year 2022 for the 
maternity care coordination program. Such amounts are authorized in 
addition to any other amounts authorized for such purpose.
    (c) Definitions.--In this section:
            (1) The term ``community maternity care providers'' means 
        maternity care providers located at non-Department facilities 
        who provide maternity care to veterans under section 1703 of 
        title 38, United States Code, or other provisions of law 
        administered by the Secretary of Veterans Affairs.
            (2) The term ``non-Department facilities'' has the meaning 
        given that term in section 1701 of title 38, United States 
        Code.

SEC. 3. REPORT ON MATERNAL MORTALITY AND SEVERE MATERNAL MORBIDITY 
              AMONG PREGNANT AND POSTPARTUM VETERANS.

    (a) GAO Report.--Not later than two years after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committees on Veterans' Affairs of the Senate and 
the House of Representatives, and make publicly available, a report on 
maternal mortality and severe maternal morbidity among pregnant and 
postpartum veterans, with a particular focus on racial and ethnic 
disparities in maternal health outcomes for veterans.
    (b) Matters Included.--The report under subsection (a) shall 
include the following:
            (1) To the extent practicable--
                    (A) the number of pregnant and postpartum veterans 
                who have experienced a pregnancy-related death or 
                pregnancy-associated death in the most recent 10 years 
                of available data;
                    (B) the rate of pregnancy-related deaths per 
                100,000 live births for pregnant and postpartum 
                veterans;
                    (C) the number of cases of severe maternal 
                morbidity among pregnant and postpartum veterans in the 
                most recent year of available data;
                    (D) the racial and ethnic disparities in maternal 
                mortality and severe maternal morbidity rates among 
                pregnant and postpartum veterans;
                    (E) identification of the causes of maternal 
                mortality and severe maternal morbidity that are unique 
                to veterans, including post-traumatic stress disorder, 
                military sexual trauma, and infertility or miscarriages 
                that may be caused by such service;
                    (F) identification of the causes of maternal 
                mortality and severe maternal morbidity that are unique 
                to veterans from racial and ethnic minority groups and 
                other at-risk populations as deemed appropriate;
                    (G) identification of any correlations between the 
                former rank of veterans and their maternal health 
                outcomes;
                    (H) the number of veterans who have been diagnosed 
                with infertility by Veterans Health Administration 
                providers each year in the most recent five years, 
                disaggregated by age, race, ethnicity, sex, marital 
                status, sexual orientation, gender identity, and 
                geographical location;
                    (I) the number of veterans who receive a clinical 
                diagnosis of unexplained infertility by Veterans Health 
                Administration providers each year in the most recent 
                five years; and
                    (J) the extent to which the rate of incidence of 
                clinically diagnosed infertility among veterans compare 
                or differ to the rate of incidence of clinically 
                diagnosed infertility among the civilian population.
            (2) An assessment of the barriers to determining the 
        information required under paragraph (1) and recommendations 
        for improvements in tracking maternal health outcomes among 
        pregnant and postpartum veterans--
                    (A) who have health care coverage through the 
                Department;
                    (B) enrolled in the TRICARE program;
                    (C) who are eligible to use the Indian Health 
                Service, Tribal health programs, or urban Indian health 
                organizations;
                    (D) with employer-based or private insurance;
                    (E) enrolled in the Medicaid program; and
                    (F) who are uninsured.
            (3) Recommendations for legislative and administrative 
        actions to increase access to mental and behavioral health care 
        for pregnant and postpartum veterans who screen positively for 
        maternal mental or behavioral health conditions.
            (4) Recommendations to address homelessness, food 
        insecurity, poverty, and related issues among pregnant and 
        postpartum veterans.
            (5) Recommendations on how to effectively educate maternity 
        care providers on best practices for providing maternity care 
        services to veterans that addresses the unique maternal health 
        care needs of the veteran population.
            (6) Recommendations to reduce maternal mortality and severe 
        maternal morbidity among pregnant and postpartum veterans and 
        to address racial and ethnic disparities in maternal health 
        outcomes for each of the groups described in subparagraphs (A) 
        through (E) of paragraph (2).
            (7) Recommendations to improve coordination of care between 
        the Department and non-Department facilities for pregnant and 
        postpartum veterans, including recommendations to improve--
                    (A) health record interoperability; and
                    (B) training for the directors of the Veterans 
                Integrated Service Networks, directors of medical 
                facilities of the Department, chiefs of staff of such 
                facilities, maternity care coordinators, and staff of 
                relevant non-Department facilities.
            (8) An assessment of the authority of the Secretary of 
        Veterans Affairs to access maternal health data collected by 
        the Department of Health and Human Services and, if applicable, 
        recommendations to increase such authority.
            (9) To the extent applicable, an assessment of potential 
        causes of or explanations for lower maternal mortality rates 
        among veterans who have health coverage through the Department 
        of Veterans Affairs compared to maternal mortality rates in the 
        general United States population.
            (10) Any other information the Comptroller General 
        determines appropriate with respect to the reduction of 
        maternal mortality and severe maternal morbidity among pregnant 
        and postpartum veterans and to address racial and ethnic 
        disparities in maternal health outcomes for veterans.

SEC. 4. DEFINITIONS.

    In this Act:
            (1) Maternal mortality.--The term ``maternal mortality'' 
        means a death occurring during or within a one-year period 
        after pregnancy, caused by pregnancy-related or childbirth 
        complications, including a suicide, overdose, or other death 
        resulting from a mental health or substance use disorder 
        attributed to or aggravated by pregnancy-related or childbirth 
        complications.
            (2) Postpartum and postpartum period.--The terms 
        ``postpartum'' and ``postpartum period'' refer to the 1-year 
        period beginning on the last day of the pregnancy of an 
        individual.
            (3) Pregnancy-associated death.--The term ``pregnancy-
        associated death'' means a death of a pregnant or postpartum 
        individual, by any cause, that occurs during, or within 1 year 
        following, the individual's pregnancy, regardless of the 
        outcome, duration, or site of the pregnancy.
            (4) Pregnancy-related death.--The term ``pregnancy-related 
        death'' means a death of a pregnant or postpartum individual 
        that occurs during, or within 1 year following, the 
        individual's pregnancy, from a pregnancy complication, a chain 
        of events initiated by pregnancy, or the aggravation of an 
        unrelated condition by the physiologic effects of pregnancy.
            (5) Racial and ethnic minority group.--The term ``racial 
        and ethnic minority group'' has the meaning given such term in 
        section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 
        300u-6(g)(1)).
            (6) Severe maternal morbidity.--The term ``severe maternal 
        morbidity'' means a health condition, including mental health 
        conditions and substance use disorders, attributed to or 
        aggravated by pregnancy or childbirth that results in 
        significant short-term or long-term consequences to the health 
        of the individual who was pregnant.
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