[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 796 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  1st Session
                                 S. 796

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


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

               March 17 (legislative day, March 16), 2021

 Ms. Duckworth (for herself and Ms. Collins) introduced the following 
 bill; which was read twice and 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 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 Handbook 1330.03, or 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 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, sexual orientation, 
                gender identity, 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).
                                 <all>