II 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Protecting Moms Who 

5 Served Act of 2021’’. 

6 SEC. 2. DEFINITIONS. 

7 In this Act: 

8 (1) MATERNAL MORTALITY.—The term ‘‘mater9 nal mortality’’ means a death occurring during preg10 nancy or within a one-year period after pregnancy 


pamtmann on DSKBC07HB2PROD with BILLS
2 

•S 796 IS

1 that is caused by pregnancy-related or childbirth 

2 complications, including suicide, overdose, or other 

3 death resulting from a mental health or substance 

4 use disorder attributed to or aggravated by preg5 nancy-related or childbirth complications. 

6 (2) POSTPARTUM.—The term ‘‘postpartum’’, 

7 with respect to an individual, means the one-year pe8 riod beginning on the last day of the pregnancy of 

9 the individual. 

10 (3) PREGNANCY-ASSOCIATED DEATH.—The 

11 term ‘‘pregnancy-associated death’’ means the death 

12 of a pregnant or postpartum individual, by any 

13 cause, that occurs during pregnancy or within one 

14 year following pregnancy, regardless of the outcome, 

15 duration, or site of the pregnancy. 

16 (4) PREGNANCY-RELATED DEATH.—The term 

17 ‘‘pregnancy-related death’’ means the death of a 

18 pregnant or postpartum individual that occurs dur19 ing pregnancy or within one year following preg20 nancy from a pregnancy complication, a chain of 

21 events initiated by pregnancy, or the aggravation of 

22 an unrelated condition by the physiologic effects of 

23 pregnancy. 

24 (5) RACIAL AND ETHNIC MINORITY GROUP.— 

25 The term ‘‘racial and ethnic minority group’’ has the 


pamtmann on DSKBC07HB2PROD with BILLS
3 

•S 796 IS

1 meaning given that term in section 1707(g)(1) of 

2 the Public Health Service Act (42 U.S.C. 300u– 

3 6(g)(1)). 

4 (6) SEVERE MATERNAL MORBIDITY.—The term 

5 ‘‘severe maternal morbidity’’ means a health condi6 tion, including a mental health condition or sub7 stance use disorder, attributed to or aggravated by 

8 pregnancy or childbirth that results in significant 

9 short-term or long-term consequences to the health 

10 of the individual who was pregnant. 

11 SEC. 3. SUPPORT BY DEPARTMENT OF VETERANS AFFAIRS 

12 OF MATERNITY CARE COORDINATION. 

13 (a) PROGRAM ON MATERNITY CARE COORDINA14 TION.— 

15 (1) IN GENERAL.—The Secretary of Veterans 

16 Affairs shall carry out the maternity care coordina17 tion program described in Veterans Health Adminis18 tration Handbook 1330.03, or successor handbook. 

19 (2) TRAINING AND SUPPORT.—In carrying out 

20 the program under paragraph (1), the Secretary 

21 shall provide to community maternity care providers 

22 training and support with respect to the unique 

23 needs of pregnant and postpartum veterans, particu24 larly regarding mental and behavioral health condiVerDate Sep 11 2014 18:21 Apr 09, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S796.IS S796

pamtmann on DSKBC07HB2PROD with BILLS
4 

•S 796 IS

1 tions relating to the service of those veterans in the 

2 Armed Forces. 

3 (b) AUTHORIZATION OF APPROPRIATIONS.— 

4 (1) IN GENERAL.—There is authorized to be 

5 appropriated to the Secretary $15,000,000 for fiscal 

6 year 2022 for the program under subsection (a)(1). 

7 (2) SUPPLEMENT NOT SUPPLANT.—Amounts 

8 authorized under paragraph (1) are authorized in 

9 addition to any other amounts authorized for mater10 nity health care and coordination for the Depart11 ment of Veterans Affairs. 

12 (c) DEFINITIONS.—In this section: 

13 (1) COMMUNITY MATERNITY CARE PRO14 VIDERS.—The term ‘‘community maternity care pro15 viders’’ means maternity care providers located at 

16 non-Department facilities who provide maternity 

17 care to veterans under section 1703 of title 38, 

18 United States Code, or any other law administered 

19 by the Secretary of Veterans Affairs. 

20 (2) NON-DEPARTMENT FACILITIES.—The term 

21 ‘‘non-Department facilities’’ has the meaning given 

22 that term in section 1701 of title 38, United States 

23 Code. 


pamtmann on DSKBC07HB2PROD with BILLS
5 

•S 796 IS

1 SEC. 4. REPORT ON MATERNAL MORTALITY AND SEVERE 

2 MATERNAL MORBIDITY AMONG PREGNANT 

3 AND POSTPARTUM VETERANS. 

4 (a) GAO REPORT.—Not later than two years after 

5 the date of the enactment of this Act, the Comptroller 

6 General of the United States shall submit to the Com7 mittee on Veterans’ Affairs of the Senate and the Com8 mittee on Veterans’ Affairs of the House of Representa9 tives, and make publicly available, a report on maternal 

10 mortality and severe maternal morbidity among pregnant 

11 and postpartum veterans, with a particular focus on racial 

12 and ethnic disparities in maternal health outcomes for vet13 erans. 

14 (b) MATTERS INCLUDED.—The report under sub15 section (a) shall include the following: 

16 (1) To the extent practicable— 

17 (A) the number of pregnant and 

18 postpartum veterans who have experienced a 

19 pregnancy-related death or pregnancy-associ20 ated death in the most recent 10 years of avail21 able data; 

22 (B) the rate of pregnancy-related deaths 

23 per 100,000 live births for pregnant and 

24 postpartum veterans; 


pamtmann on DSKBC07HB2PROD with BILLS
6 

•S 796 IS

1 (C) the number of cases of severe maternal 

2 morbidity among pregnant and postpartum vet3 erans in the most recent year of available data; 

4 (D) an assessment of the racial and ethnic 

5 disparities in maternal mortality and severe ma6 ternal morbidity rates among pregnant and 

7 postpartum veterans; 

8 (E) identification of the causes of maternal 

9 mortality and severe maternal morbidity that 

10 are unique to veterans, including post-traumatic 

11 stress disorder, military sexual trauma, and in12 fertility or miscarriages that may be caused by 

13 service in the Armed Forces; 

14 (F) identification of the causes of maternal 

15 mortality and severe maternal morbidity that 

16 are unique to veterans from racial and ethnic 

17 minority groups and such other at-risk popu18 lations as the Comptroller General considers ap19 propriate; 

20 (G) identification of any correlations be21 tween the former rank of veterans and their 

22 maternal health outcomes; 

23 (H) the number of veterans who have been 

24 diagnosed with infertility by a health care pro25 vider of the Veterans Health Administration 


pamtmann on DSKBC07HB2PROD with BILLS
7 

•S 796 IS

1 each year in the most recent five years, 

2 disaggregated by age, race, ethnicity, sex, mar3 ital status, sexual orientation, gender identity, 

4 and geographical location; 

5 (I) the number of veterans who have re6 ceived a clinical diagnosis of unexplained infer7 tility by a health care provider of the Veterans 

8 Health Administration each year in the most 

9 recent five years; and 

10 (J) an assessment of the extent to which 

11 the rate of incidence of clinically diagnosed in12 fertility among veterans compare or differ to 

13 the rate of incidence of clinically diagnosed in14 fertility among the civilian population. 

15 (2) An assessment of the barriers to deter16 mining the information required under paragraph 

17 (1) and recommendations for improvements in track18 ing maternal health outcomes among pregnant and 

19 postpartum veterans who— 

20 (A) have health care coverage through the 

21 Department; 

22 (B) are enrolled in the TRICARE program 

23 (as defined in section 1072 of title 10, United 

24 States Code); 


pamtmann on DSKBC07HB2PROD with BILLS
8 

•S 796 IS

1 (C) have employer-based or private insur2 ance; 

3 (D) are enrolled in the Medicaid program 

4 under title XIX of the Social Security Act (42 

5 U.S.C. 1396 et seq.); 

6 (E) are eligible to receive health care fur7 nished by— 

8 (i) the Indian Health Service; 

9 (ii) Tribal health programs; or 

10 (iii) urban Indian organizations; or 

11 (F) are uninsured. 

12 (3) Recommendations for legislative and admin13 istrative actions to increase access to mental and be14 havioral health care for pregnant and postpartum 

15 veterans who screen positively for maternal mental 

16 or behavioral health conditions. 

17 (4) Recommendations to address homelessness, 

18 food insecurity, poverty, and related issues among 

19 pregnant and postpartum veterans. 

20 (5) Recommendations on how to effectively edu21 cate maternity care providers on best practices for 

22 providing maternity care services to veterans that 

23 addresses the unique maternal health care needs of 

24 veteran populations. 


pamtmann on DSKBC07HB2PROD with BILLS
9 

•S 796 IS

1 (6) Recommendations to reduce maternal mor2 tality and severe maternal morbidity among preg3 nant and postpartum veterans and to address racial 

4 and ethnic disparities in maternal health outcomes 

5 for each of the groups described in subparagraphs 

6 (A) through (F) of paragraph (2). 

7 (7) Recommendations to improve coordination 

8 of care between the Department and non-Depart9 ment facilities for pregnant and postpartum vet10 erans, including recommendations to improve— 

11 (A) health record interoperability; and 

12 (B) training for the directors of the Vet13 erans Integrated Service Networks, directors of 

14 medical facilities of the Department, chiefs of 

15 staff of such facilities, maternity care coordina16 tors, and staff of relevant non-Department fa17 cilities. 

18 (8) An assessment of the authority of the Sec19 retary of Veterans Affairs to access maternal health 

20 data collected by the Department of Health and 

21 Human Services and, if applicable, recommendations 

22 to increase such authority. 

23 (9) To the extent applicable, an assessment of 

24 potential causes of or explanations for lower mater25 nal mortality rates among veterans who have health 


pamtmann on DSKBC07HB2PROD with BILLS
10 

•S 796 IS

1 care coverage through the Department of Veterans 

2 Affairs compared to maternal mortality rates in the 

3 general population of the United States. 

4 (10) Any other information the Comptroller 

5 General determines appropriate with respect to the 

6 reduction of maternal mortality and severe maternal 

7 morbidity among pregnant and postpartum veterans 

8 and to address racial and ethnic disparities in ma9 ternal health outcomes for veterans. 

10 (c) DEFINITIONS.—In this section, the terms ‘‘Tribal 

11 health program’’ and ‘‘urban Indian organization’’ have 

12 the meanings given those terms in section 4 of the Indian 

13 Health Care Improvement Act (25 U.S.C. 1603). 

Æ 


pamtmann on DSKBC07HB2PROD with BILLS