Protecting Moms Who Served Act

IIB 117TH CONGRESS 1ST SESSION H. R. 958 IN THE SENATE OF THE UNITED STATES MAY 13, 2021 Received; read twice and referred to the Committee on Veterans’ Affairs 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 Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS 2 HR 958 RFS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Protecting Moms Who 2 Served Act’’. 3 SEC. 2. SUPPORT FOR MATERNITY CARE COORDINATION. 4 (a) PROGRAM ON MATERNITY CARE COORDINA- 5 TION.— 6 (1) IN GENERAL.—The Secretary of Veterans 7 Affairs shall carry out the maternity care coordina- 8 tion program described in Veterans Health Adminis- 9 tration Handbook 1330.03, or any successor hand- 10 book. 11 (2) TRAINING AND SUPPORT.—In carrying out 12 the program under paragraph (1), the Secretary 13 shall provide to community maternity care providers 14 training and support with respect to the unique 15 needs of pregnant and postpartum veterans, particu- 16 larly regarding mental and behavioral health condi- 17 tions relating to the service of the veterans in the 18 Armed Forces. 19 (b) AUTHORIZATION OF APPROPRIATIONS.—There is 20 authorized to be appropriated to the Secretary 21 $15,000,000 for fiscal year 2022 for the maternity care 22 coordination program. Such amounts are authorized in ad- 23 dition to any other amounts authorized for such purpose. 24 (c) DEFINITIONS.—In this section: 25 VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS 3 HR 958 RFS (1) The term ‘‘community maternity care pro- 1 viders’’ means maternity care providers located at 2 non-Department facilities who provide maternity 3 care to veterans under section 1703 of title 38, 4 United States Code, or other provisions of law ad- 5 ministered by the Secretary of Veterans Affairs. 6 (2) The term ‘‘non-Department facilities’’ has 7 the meaning given that term in section 1701 of title 8 38, United States Code. 9 SEC. 3. REPORT ON MATERNAL MORTALITY AND SEVERE 10 MATERNAL MORBIDITY AMONG PREGNANT 11 AND POSTPARTUM VETERANS. 12 (a) GAO REPORT.—Not later than 2 years after the 13 date of the enactment of this Act, the Comptroller General 14 of the United States shall submit to the Committees on 15 Veterans’ Affairs of the Senate and the House of Rep- 16 resentatives, and make publicly available, a report on ma- 17 ternal mortality and severe maternal morbidity among 18 pregnant and postpartum veterans, with a particular focus 19 on racial and ethnic disparities in maternal health out- 20 comes for veterans. 21 (b) MATTERS INCLUDED.—The report under sub- 22 section (a) shall include the following: 23 (1) To the extent practicable— 24 VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS 4 HR 958 RFS (A) the number of pregnant and postpar- 1 tum veterans who have experienced a preg- 2 nancy-related death or pregnancy-associated 3 death in the most recent 10 years of available 4 data; 5 (B) the rate of pregnancy-related deaths 6 per 100,000 live births for pregnant and post- 7 partum veterans; 8 (C) the number of cases of severe maternal 9 morbidity among pregnant and postpartum vet- 10 erans in the most recent year of available data; 11 (D) the racial and ethnic disparities in ma- 12 ternal mortality and severe maternal morbidity 13 rates among pregnant and postpartum veterans; 14 (E) identification of the causes of maternal 15 mortality and severe maternal morbidity that 16 are unique to veterans, including post-traumatic 17 stress disorder, military sexual trauma, and in- 18 fertility or miscarriages that may be caused by 19 such service; 20 (F) identification of the causes of maternal 21 mortality and severe maternal morbidity that 22 are unique to veterans from racial and ethnic 23 minority groups and other at-risk populations 24 as deemed appropriate; 25 VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS 5 HR 958 RFS (G) identification of any correlations be- 1 tween the former rank of veterans and their 2 maternal health outcomes; 3 (H) the number of veterans who have been 4 diagnosed with infertility by Veterans Health 5 Administration providers each year in the most 6 recent 5 years, disaggregated by age, race, eth- 7 nicity, sex, marital status, sexual orientation, 8 gender identity, and geographical location; 9 (I) the number of veterans who receive a 10 clinical diagnosis of unexplained infertility by 11 Veterans Health Administration providers each 12 year in the most recent 5 years; and 13 (J) the extent to which the rate of inci- 14 dence of clinically diagnosed infertility among 15 veterans compare or differ to the rate of inci- 16 dence of clinically diagnosed infertility among 17 the civilian population. 18 (2) An assessment of the barriers to deter- 19 mining the information required under paragraph 20 (1) and recommendations for improvements in track- 21 ing maternal health outcomes among pregnant and 22 postpartum veterans— 23 (A) who have health care coverage through 24 the Department; 25 VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS 6 HR 958 RFS (B) enrolled in the TRICARE program; 1 (C) who are eligible to use the Indian 2 Health Service, Tribal health programs, or 3 urban Indian health organizations; 4 (D) with employer-based or private insur- 5 ance; 6 (E) enrolled in the Medicaid program; and 7 (F) who are uninsured. 8 (3) Recommendations for legislative and admin- 9 istrative actions to increase access to mental and be- 10 havioral health care for pregnant and postpartum 11 veterans who screen positively for maternal mental 12 or behavioral health conditions. 13 (4) Recommendations to address homelessness, 14 food insecurity, poverty, and related issues among 15 pregnant and postpartum veterans. 16 (5) Recommendations on how to effectively edu- 17 cate maternity care providers on best practices for 18 providing maternity care services to veterans that 19 addresses the unique maternal health care needs of 20 the veteran population. 21 (6) Recommendations to reduce maternal mor- 22 tality and severe maternal morbidity among preg- 23 nant and postpartum veterans and to address racial 24 and ethnic disparities in maternal health outcomes 25 VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS 7 HR 958 RFS for each of the groups described in subparagraphs 1 (A) through (E) of paragraph (2). 2 (7) Recommendations to improve coordination 3 of care between the Department and non-Depart- 4 ment facilities for pregnant and postpartum vet- 5 erans, including recommendations to improve— 6 (A) health record interoperability; and 7 (B) training for the directors of the Vet- 8 erans Integrated Service Networks, directors of 9 medical facilities of the Department, chiefs of 10 staff of such facilities, maternity care coordina- 11 tors, and staff of relevant non-Department fa- 12 cilities. 13 (8) An assessment of the authority of the Sec- 14 retary of Veterans Affairs to access maternal health 15 data collected by the Department of Health and 16 Human Services and, if applicable, recommendations 17 to increase such authority. 18 (9) To the extent applicable, an assessment of 19 potential causes of or explanations for lower mater- 20 nal mortality rates among veterans who have health 21 coverage through the Department of Veterans Af- 22 fairs compared to maternal mortality rates in the 23 general United States population. 24 VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS 8 HR 958 RFS (10) Any other information the Comptroller 1 General determines appropriate with respect to the 2 reduction of maternal mortality and severe maternal 3 morbidity among pregnant and postpartum veterans 4 and to address racial and ethnic disparities in ma- 5 ternal health outcomes for veterans. 6 SEC. 4. DEFINITIONS. 7 In this Act: 8 (1) MATERNAL MORTALITY.—The term ‘‘mater- 9 nal mortality’’ means a death occurring during or 10 within a 1-year period after pregnancy, caused by 11 pregnancy-related or childbirth complications, in- 12 cluding a suicide, overdose, or other death resulting 13 from a mental health or substance use disorder at- 14 tributed to or aggravated by pregnancy-related or 15 childbirth complications. 16 (2) POSTPARTUM AND POSTPARTUM PERIOD.— 17 The terms ‘‘postpartum’’ and ‘‘postpartum period’’ 18 refer to the 1-year period beginning on the last day 19 of the pregnancy of an individual. 20 (3) PREGNANCY-ASSOCIATED DEATH.—The 21 term ‘‘pregnancy-associated death’’ means a death of 22 a pregnant or postpartum individual, by any cause, 23 that occurs during, or within 1 year following, the 24 VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS 9 HR 958 RFS individual’s pregnancy, regardless of the outcome, 1 duration, or site of the pregnancy. 2 (4) PREGNANCY-RELATED DEATH.—The term 3 ‘‘pregnancy-related death’’ means a death of a preg- 4 nant or postpartum individual that occurs during, or 5 within 1 year following, the individual’s pregnancy, 6 from a pregnancy complication, a chain of events 7 initiated by pregnancy, or the aggravation of an un- 8 related condition by the physiologic effects of preg- 9 nancy. 10 (5) RACIAL AND ETHNIC MINORITY GROUP.— 11 The term ‘‘racial and ethnic minority group’’ has the 12 meaning given such term in section 1707(g)(1) of 13 the Public Health Service Act (42 U.S.C. 300u– 14 6(g)(1)). 15 (6) SEVERE MATERNAL MORBIDITY.—The term 16 ‘‘severe maternal morbidity’’ means a health condi- 17 tion, including mental health conditions and sub- 18 stance use disorders, attributed to or aggravated by 19 pregnancy or childbirth that results in significant 20 VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS 10 HR 958 RFS short-term or long-term consequences to the health 1 of the individual who was pregnant. 2 Passed the House of Representatives May 12, 2021. Attest: CHERYL L. JOHNSON, Clerk. VerDate Sep 11 2014 02:08 May 14, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H958.RFS H958 kjohnson on DSK79L0C42PROD with BILLS