[Congressional Record Volume 167, Number 199 (Tuesday, November 16, 2021)]
[House]
[Pages H6286-H6288]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROTECTING MOMS WHO SERVED ACT OF 2021
Mr. TAKANO. Mr. Speaker, I move to suspend the rules and pass the
bill (S. 796) to codify maternity care coordination programs at the
Department of Veterans Affairs, and for other purposes.
The Clerk read the title of the bill.
The text of the bill is as follows:
S. 796
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
[[Page H6287]]
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 SPEAKER pro tempore. Pursuant to the rule, the gentleman from
California (Mr. Takano) and the gentleman from Illinois (Mr. Bost) each
will control 20 minutes.
The Chair recognizes the gentleman from California.
General Leave
Mr. TAKANO. Mr. Speaker, I ask unanimous consent that all Members may
have 5 legislative days in which to revise and extend their remarks and
insert extraneous material on S. 796.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of S. 796, the Protecting Moms
Who Served Act of 2021, sponsored by Senator Tammy Duckworth. The House
companion to this bill, H.R. 958, was championed by the gentlewoman
from Illinois (Ms. Underwood) and unanimously passed the House this
past May.
The Protecting Moms Who Served Act of 2021 will codify the maternity
care coordination program that the Veterans Health Administration first
established in 2012 and updated in a November 2020 policy directive.
This will help ensure that veterans across the Nation receive high-
quality, culturally competent healthcare throughout their pregnancies
and immediately afterward.
The majority of veterans' maternity care is delivered by a contracted
network of non-VA community providers. However, many veterans have
coexisting medical or mental health conditions for which they receive
ongoing care from VA providers. This means it is absolutely critical to
ensure pregnant veterans' care is coordinated among all healthcare
professionals involved in it. Such information sharing is crucial for
patient safety and positive health outcomes--for parents and newborns.
In addition to codifying VA's maternity care coordination program, S.
796 will require the Department to provide training for community
providers on the unique needs of pregnant and postpartum veterans and
on behavioral health conditions related to service in the Armed Forces.
Today, women veterans are the fastest growing cohort in the veteran
population, and more than 40 percent of women veterans using VA
healthcare are of reproductive age. Black women serve in higher numbers
and represent nearly one-third of women using VA for their healthcare.
In the population at large, Black, American Indian, and Alaska Native
moms die from pregnancy-related complications at approximately three
times the rate of White, Latina, Asian American, and Pacific Islander
women, regardless of income or education levels.
However, little is known about whether pregnant and postpartum
veterans have better, worse, or equal rates of maternal mortality
compared to nonveterans. That is why S. 796 also mandates a U.S.
Government Accountability Office study on maternal mortality and
morbidity among pregnant and postpartum veterans, with a particular
focus on racial and ethnic disparities in maternal health outcomes for
veterans.
Last year, approximately 6,000 veterans using VA became new moms.
Moms who have served our Nation exemplify strength and resilience.
Supporting moms means ensuring gender equity, and that begins with
healthcare equity. I therefore ask my colleagues to join me in
supporting final passage of S. 796, the Protecting Moms Who Served Act
of 2021.
Mr. Speaker, I reserve the balance of my time.
Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of S. 796, the Protecting Moms Who
Served Act.
This bill would require VA to improve the care that is provided to
veterans who are pregnant. More and more women are volunteering to
serve in the military and seeking services from VA as veterans.
As they grow their families, VA must provide them with high-quality,
easy-to-access, pre- and postpartum care.
Strengthening services to women veterans is one of my priorities as
the lead Republican on this committee, and I am proud to help do that
by supporting this bill today.
I thank Illinois Senator Tammy Duckworth for sponsoring this bill on
behalf of our fellow veterans. I urge my colleagues to support it
today.
Mr. Speaker, I reserve the balance of my time.
Mr. TAKANO. Mr. Speaker, I have no further speakers. I am prepared to
close, and I reserve the balance of my time.
Mr. BOST. Mr. Speaker, I encourage my colleagues to support this
bill. I yield back the balance of my time.
[[Page H6288]]
Mr. TAKANO. Mr. Speaker, I ask all of my colleagues to join me in
passing this important piece of legislation, S. 796, the Protecting
Moms Who Served Act of 2021, and I yield back the balance of my time.
Ms. ADAMS. Mr. Speaker, I rise today to speak in strong support of
the bipartisan legislation, Protecting Moms Who Served Act.
But before I do, I want to thank Congresswoman Lauren Underwood for
her leadership on this bill. I would also like to thank Senator
Duckworth and Representatives Julia Brownley, Gus Bilirakis, and Brian
Fitzpatrick for their co-leadership.
Together, Congresswoman Underwood and I are the co-founders and co-
chairs of the Black Maternal Health Caucus, as well as lead sponsors of
the Momnibus--comprehensive legislation that addresses every dimension
of the maternal health crisis in the United States.
And it gives me great joy to say that the Protecting Moms Who Served
Act will be the first bill of the Momnibus to pass in Congress.
The United States continues to have the highest maternal mortality
rates in the developed world. Women and birthing people of color die
during or after pregnancy at 3 to 4 times the rates of their White
counterparts.
For the nearly 2 million women Veterans, maternal health outcomes are
not any better. Pregnant and postpartum women who served face unique
maternal health risks that deserve our attention.
For example, the risk of pregnancy complications may be higher for
women Veterans receiving maternity care through Veterans Affairs, since
these women frequently have multiple medical conditions that can
increase pregnancy complications.
Furthermore, it is suggested that military deployment may increase
the risk of post-traumatic stress disorder or PTSD. A post-traumatic
stress disorder diagnosis can increase the risk of spontaneous pre-term
birth, preeclampsia, or gestational diabetes.
Women Veterans with more symptoms of PTSD or moral injury like shame,
guilt, or demoralization, are also at greater risk for postpartum
depression in the three years following the end of their military
service.
More specifically a study on the impacts of PTSD or moral injury,
found that one in two women Veterans who became pregnant during the
study, had a negative pregnancy outcome.
These outcomes include postpartum depression or anxiety, miscarriage,
obstetrical medical conditions, emergency c-sections, the baby's need
for intensive care post-delivery, preterm birth, stillbirth, and
ectopic or tubal pregnancy.
Our women Veterans have upheld their duty to serve and protect and,
we as Members of Congress must do the same.
The Protecting Moms Who Served Act bill will codify and strengthen
the Department of Veterans Affairs maternity care coordination programs
to ensure Veterans receive the high-quality maternal health care and
support they have earned.
This is a noteworthy advancement since maternity care coordination
programs are associated with improved maternal and birth outcomes,
increased use of beneficial health services, and decreased costs,
especially among women with chronic or pregnancy-related physical or
mental health conditions, or social vulnerabilities.
Additionally, this bill will commission the first-ever comprehensive
study of America's maternal health crisis among women Veterans, with a
particular emphasis on racial and ethnic disparities.
This study is needed to provide further understanding of the maternal
health challenges experienced among women who served.
On May 12th, this legislation passed the house with unanimous
bipartisan support.
Today, we are here to vote once more and finally send this bill to
the President's desk, changing the lives of millions of women Veterans
and their children.
Let's remember that strong and supportive healthcare for birthing
people supports the future of our Nation by investing in the well-being
of children and families.
And today's vote ensures a healthcare system for women Veterans that
will offer the best maternal care available.
I am proud to see our progress towards ending maternal mortality and
disparities among our moms who served. I look forward to continuing to
address these issues in Congress as we examine and discuss the maternal
mortality and morbidity issues that threaten our Nation.
To all my colleagues--lets pass the Protecting Moms Who Served Act
for our women Veterans, their children, and their families.
What we do here today will live beyond our time in Congress and
impact generations of women who serve.
It is time we make sure that Veterans, who have done so much for our
country, receive the support and resources they need.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from California (Mr. Takano) that the House suspend the rules
and pass the bill, S. 796.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. TAKANO. Mr. Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this motion
are postponed.
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