[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 796 Enrolled Bill (ENR)]
S.796
One Hundred Seventeenth Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Sunday,
the third day of January, two thousand and twenty one
An Act
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 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).
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.