[Congressional Record Volume 167, Number 177 (Thursday, October 7, 2021)]
[Senate]
[Pages S6993-S6994]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROTECTING MOMS WHO SERVED ACT OF 2021
Mr. LUJAN. Madam President, I ask unanimous consent that the Senate
Committee on Veterans' Affairs be discharged from further consideration
of S. 796 and the Senate proceed to its immediate consideration.
The PRESIDING OFFICER. The clerk will report the bill by title.
The senior assistant legislative clerk read as follows:
A bill (S. 796) to codify maternity care coordination
programs at the Department of Veterans Affairs, and for other
purposes.
There being no objection, the committee was discharged, and the
Senate proceeded to consider the bill.
Mr. LUJAN. Madam President, I ask unanimous consent that the Tester
substitute amendment, which is at the desk, be considered and agreed
to; that the bill, as amended, be considered read three times and
passed; and that the motion to reconsider be considered made and laid
upon the table.
The PRESIDING OFFICER. Without objection, it is so ordered.
The amendment (No. 3860) in the nature of a substitute was agreed to,
as follows:
(Purpose: In the nature of a substitute)
Strike all after the enacting clause and insert the
following:
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
[[Page S6994]]
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).
The bill (S. 796), as amended, was ordered to be engrossed for a
third reading, was read the third time, and passed.
Mr. LUJAN. I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. LUJAN. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
____________________