[117th Congress Public Law 69]
[From the U.S. Government Publishing Office]
[[Page 135 STAT. 1495]]
Public Law 117-69
117th Congress
An Act
To codify maternity care coordination programs at the Department of
Veterans Affairs, and for other purposes. <<NOTE: Nov. 30, 2021 - [S.
796]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, <<NOTE: Protecting Moms
Who Served Act of 2021. 38 USC 101 note.>>
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Protecting Moms Who Served Act of
2021''.
SEC. 2. <<NOTE: 38 USC 1703 note.>> 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.
[[Page 135 STAT. 1496]]
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) <<NOTE: Public information.>> 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) <<NOTE: Assessments. Recommenda- tions.>> Matters Included.--
The report under subsection (a) shall include the following:
(1) To the extent practicable--
(A) <<NOTE: Time period. Data.>> 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) <<NOTE: Time period. Data.>> 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;
[[Page 135 STAT. 1497]]
(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) <<NOTE: Time period.>> 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) <<NOTE: Time period.>> 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) <<NOTE: Determination.>> 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).
[[Page 135 STAT. 1498]]
(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).
Approved November 30, 2021.
LEGISLATIVE HISTORY--S. 796 (H.R. 958):
---------------------------------------------------------------------------
HOUSE REPORTS: No. 117-
30 (Comm. on Veterans' Affairs) accompanying H.R. 958.
CONGRESSIONAL RECORD, Vol. 167 (2021):
Oct. 7, considered and passed Senate.
Nov. 16, considered and passed House.
DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS (2021):
Nov. 30, Presidential remarks.
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