[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 796 Enrolled Bill (ENR)]

        S.796

                    One Hundred Seventeenth Congress

                                 of the

                        United States of America


                          AT THE FIRST SESSION

           Begun and held at the City of Washington on Sunday,
          the third day of January, two thousand and twenty one


                                 An Act


 
  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 of 
2021''.
SEC. 2. DEFINITIONS.
    In this Act:
        (1) Maternal mortality.--The term ``maternal mortality'' means 
    a death occurring during pregnancy or within a one-year period 
    after pregnancy that is caused by pregnancy-related or childbirth 
    complications, including 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.--The term ``postpartum'', with respect to an 
    individual, means the one-year period beginning on the last day of 
    the pregnancy of the individual.
        (3) Pregnancy-associated death.--The term ``pregnancy-
    associated death'' means the death of a pregnant or postpartum 
    individual, by any cause, that occurs during pregnancy or within 
    one year following pregnancy, regardless of the outcome, duration, 
    or site of the pregnancy.
        (4) Pregnancy-related death.--The term ``pregnancy-related 
    death'' means the death of a pregnant or postpartum individual that 
    occurs during pregnancy or within one year following 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 that 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 a mental health 
    condition or substance use disorder, 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.
SEC. 3. SUPPORT BY DEPARTMENT OF VETERANS AFFAIRS OF 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 Directive 1330.03.
        (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 
    those veterans in the Armed Forces.
    (b) Authorization of Appropriations.--
        (1) In general.--There is authorized to be appropriated to the 
    Secretary $15,000,000 for fiscal year 2022 for the program under 
    subsection (a)(1).
        (2) Supplement not supplant.--Amounts authorized under 
    paragraph (1) are authorized in addition to any other amounts 
    authorized for maternity health care and coordination for the 
    Department of Veterans Affairs.
    (c) Definitions.--In this section:
        (1) Community maternity care providers.--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 any other 
    law administered by the Secretary of Veterans Affairs.
        (2) Non-department facilities.--The term ``non-Department 
    facilities'' has the meaning given that term in section 1701 of 
    title 38, United States Code.
SEC. 4. 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 Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of 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) an assessment of 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 
        service in the Armed Forces;
            (F) identification of the causes of maternal mortality and 
        severe maternal morbidity that are unique to veterans from 
        racial and ethnic minority groups and such other at-risk 
        populations as the Comptroller General considers 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 a health care provider of the Veterans Health 
        Administration each year in the most recent five years, 
        disaggregated by age, race, ethnicity, sex, marital status, and 
        geographical location;
            (I) the number of veterans who have received a clinical 
        diagnosis of unexplained infertility by a health care provider 
        of the Veterans Health Administration each year in the most 
        recent five years; and
            (J) an assessment of 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 who--
            (A) have health care coverage through the Department;
            (B) are enrolled in the TRICARE program (as defined in 
        section 1072 of title 10, United States Code);
            (C) have employer-based or private insurance;
            (D) are enrolled in the Medicaid program under title XIX of 
        the Social Security Act (42 U.S.C. 1396 et seq.);
            (E) are eligible to receive health care furnished by--
                (i) the Indian Health Service;
                (ii) Tribal health programs; or
                (iii) urban Indian organizations; or
            (F) 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 veteran populations.
        (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 (F) 
    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 care coverage through the Department of 
    Veterans Affairs compared to maternal mortality rates in the 
    general population of the United States.
        (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.
    (c) Definitions.--In this section, the terms ``Tribal health 
program'' and ``urban Indian organization'' have the meanings given 
those terms in section 4 of the Indian Health Care Improvement Act (25 
U.S.C. 1603).

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.