[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 796 Introduced in Senate (IS)]
<DOC>
117th CONGRESS
1st Session
S. 796
To codify maternity care coordination programs at the Department of
Veterans Affairs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 17 (legislative day, March 16), 2021
Ms. Duckworth (for herself and Ms. Collins) introduced the following
bill; which was read twice and referred to the Committee on Veterans'
Affairs
_______________________________________________________________________
A BILL
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 Handbook 1330.03, or successor
handbook.
(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, sexual orientation,
gender identity, 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).
<all>