[Congressional Record Volume 167, Number 177 (Thursday, October 7, 2021)]
[Senate]
[Pages S7011-S7012]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 3860. Mr. LUJAN (for Mr. TESTER) proposed an amendment to the bill 
S. 796, to codify maternity care coordination programs at the 
Department of Veterans Affairs, and for other purposes; as follows:


 =========================== NOTE =========================== 

  
  On page S7011, October 7, 2021, first column, the following 
appears: SA 3860. Mr. TESTER proposed an amendment to the bill S. 
796, to codify maternity care coordination programs at the 
Department of Veterans Affairs, and for other purposes; . . .
  
  The online Record has been corrected to read: SA 3860. Mr. LUJAN 
(for Mr. TESTER) proposed an amendment to the bill S. 796, to 
codify maternity care coordination programs at the Department of 
Veterans Affairs, and for other purposes; . . .


 ========================= END NOTE ========================= 



        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 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

[[Page S7012]]

     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).

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