Reproductive Health Care Accessibility Act
This bill establishes various grants and related programs that address sexual and reproductive health care for individuals with disabilities.
Specifically, the Health Resources and Services Administration must support
The bill also authorizes support for medical schools, nursing schools, and other educational institutions that offer obstetrics and gynecology training programs to expand the number of individuals with disabilities entering the reproductive health care workforce.
Additionally, the Department of Health and Human Services must study the effectiveness and other aspects of reproductive health care services and programs for individuals with disabilities.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9040 Introduced in House (IH)]
<DOC>
117th CONGRESS
2d Session
H. R. 9040
To amend the Public Health Service Act to improve reproductive health
care of individuals with disabilities.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 29, 2022
Ms. Bush (for herself, Ms. Pressley, Ms. Tlaib, Ms. Norton, Ms.
Schakowsky, Mr. Evans, Mr. Soto, Mr. Espaillat, Mr. Connolly, Ms.
Clarke of New York, Ms. Jacobs of California, Ms. Jackson Lee, Mr.
Morelle, Mr. Brown of Maryland, Mr. Auchincloss, Ms. Ocasio-Cortez, Mr.
Takano, Mr. Bowman, Mr. Pocan, and Ms. Jayapal) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to improve reproductive health
care of individuals with disabilities.
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 ``Reproductive Health Care
Accessibility Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) In the United States, there are approximately 1 in 4
adults with disabilities, 1 in 10 individuals with disabilities
who are able to become pregnant, and approximately 4,100,000
parents with disabilities.
(2) All people, including individuals with disabilities,
have the right to decide if, when, and how to start and raise a
family.
(3) Title II and III of the Americans with Disabilities Act
of 1990 (42 U.S.C. 12131 et seq. and 12181 et seq.), section
504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), and
section 1557 of the Patient Protection and Affordable Care Act
(42 U.S.C. 18116) provide individuals with disabilities with
the right to equitably access and receive health care.
(4) Disabled people face unique barriers when accessing
reproductive health care, including accessibility at health
care facilities, lack of accessible medical diagnostic
equipment, barriers to accessible travel, delay in receiving
preventative services, and lack of health care providers with
training and knowledge on the needs of individuals with
disabilities receiving reproductive health care.
(5) The United States Access Board has established
standards for accessible medical diagnostic equipment, however
without enforceable standards adopted by the Department of
Health and Human Services and Department of Justice, systemic
improvements in the availability of accessible medical
diagnostic equipment will not be achieved.
(6) Disabled people have an equal right to reproductive
autonomy, but harmful stereotypes create barriers to getting
care that respects that autonomy.
(7) Laws that restrict access to reproductive health care,
including abortion care, disproportionally harm people who
already face barriers to reproductive health care which
includes disabled people.
(8) Individuals with and without disabilities want children
at the same frequency, but individuals with disabilities
experience less likelihood of receiving contraception
counseling and timely prenatal care, experience a higher rate
of sterilization, and are at a greater risk for adverse
pregnancy outcomes.
(9) Diversity and inclusion in the health care workforce is
a critical factor in the delivery of high-quality, culturally
competent health care and improves patient outcomes. However,
the rate of students and trainees with disabilities in medical
and allied health education remains low compared to those
without disabilities.
SEC. 3. PROGRAM FOR TRAINING THE WORKFORCE.
Part D of title VII of the Public Health Service Act (42 U.S.C. 294
et seq.) is amended by adding at the end the following:
``SEC. 760A. PROGRAM FOR TRAINING THE WORKFORCE CONCERNING REPRODUCTIVE
HEALTH CARE FOR INDIVIDUALS WITH DISABILITIES.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration and in consultation
with the Administrator of the Administration for Community Living,
shall award grants, contracts, or cooperative agreements to eligible
entities to carry out training programs for health care professionals
providing sexual and reproductive health care concerning comprehensive
disability clinical care curricula.
``(b) Eligibility.--
``(1) In general.--To be eligible to receive an award under
this section an entity shall be a public or private nonprofit
entity with demonstrated expertise in serving individuals with
disabilities, which may include--
``(A) a multidisciplinary health care provider who
provides reproductive health care, such as federally
qualified health centers;
``(B) institutions of higher education, as defined
in section 101 of the Higher Education Act of 1965,
with expertise in reproductive health care;
``(C) an entity primarily led by individuals with
disabilities;
``(D) an entity with expertise in reproductive
rights and justice;
``(E) an Indian Tribe, Tribal organization, or
urban Indian organization; or
``(F) a consortium of entities described in any of
subparagraphs (A) through (E).
``(2) Application.--To be eligible to receive an award
under this section an eligible entity shall submit to the
Secretary an application at such time, in such manner, and
containing such information as the Secretary may require, that
includes--
``(A) a description of the eligible entity's or
consortium of entities' expertise in providing
technical assistance and training, including evidence
such as--
``(i) knowledge of the rights afforded to
individuals with a disability under relevant
Federal and State law;
``(ii) knowledge of accessibility standards
established by the United States Access Board;
``(iii) expertise in evidence-based or
evidence-informed practices in providing sexual
and reproductive health care, including
preventive health care services and perinatal
care, to individuals with disabilities and
those facing compounded barriers to accessing
care;
``(iv) experience working with health care
providers, public or private nonprofit
entities, or Federal, State, or local agencies
focusing on sexual and reproductive health care
services for individuals with disabilities;
``(v) experience working with individuals
with disabilities and their families;
``(vi) expertise in providing, collecting,
compiling, communicating, and disseminating
information in culturally and linguistically
appropriate manner especially in easily
accessible formats; and
``(vii) experience improving coordination
of services, such as mental health, substance
use disorder prevention, treatment, and
recovery support services, social services,
other health care services, and transportation
services for individuals with disabilities;
``(B) a description of the activities to be funded
under the award and the goals of such activities,
including a description of--
``(i) the training or education program to
be implemented that meets the requirements of
subsection (c);
``(ii) the process to be used to identify
health care providers that will participate in
the training program, including the process to
increase diversity in the pool of participating
providers;
``(iii) the process to be used to engage
stakeholders in such training, including
individuals with disabilities; and
``(iv) the eligible entity's evaluation
plan to determine the scope and impact of the
training program;
``(C) an assurance that the recipients of the
training will receive ongoing and comprehensive
training or professional development on the sexual and
reproductive health care needs of individuals with
disabilities; and
``(D) any other assurances that the Secretary may
require.
``(3) Subawards.--An eligible entity or eligible consortium
receiving an award under this section may, for contracting
purposes, make subawards to individuals or entities with
expertise in reproductive health care and serving individuals
with disabilities.
``(c) Use of Funds.--An entity or entities shall use amounts
received under this section to carry out a training program for health
care professionals providing sexual and reproductive health care that
provides training concerning--
``(1) comprehensive disability clinical care curricula to
inform health professionals providing sexual and reproductive
health care on how to provide effective, interprofessional
team-based health care;
``(2) culturally and linguistically competent care for
individuals with disabilities;
``(3) delivering sexual and reproductive health care for
individuals with disabilities in a manner that emphasizes the
independence, self-determination, and choices of individuals
with disabilities with respect to their sexual and reproductive
health through comprehensive disability clinical care
curricula;
``(4) the rights afforded to individuals with disabilities
under relevant Federal and State law; and
``(5) methods and evidence-based or evidence-informed
practices for providing sexual and reproductive health care,
including preventive health care services, to individuals with
disabilities.
``(d) Evaluation and Report.--
``(1) In general.--An entity or entities that receives an
award under this section shall, at the end of the award period,
carry out an evaluation of any progress made through the
program in training health care professionals providing sexual
and reproductive health care, consistent with the purposes of
this section.
``(2) Report.--Not later than 180 days after the end of the
award period, an entity that receives an award under this
section shall submit to the Secretary a report on the results
of the evaluation conducted under paragraph (1).
``(3) Secretary.--The Secretary shall annually compile the
reports submitted under paragraph (2) and submit such
compilation to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and Commerce
of the House of Representatives. Such compilations shall be
posted on the internet website of the Department of Health and
Human Services in an accessible format.
``(e) Definitions.--In this section:
``(1) Disability.--The terms `disability' and
`disabilities' have the meaning given such terms for purposes
of the Americans with Disabilities Act of 1990.
``(2) Indian tribe.--The terms `Indian Tribe' and `Tribal
organization' have the meaning given such terms section 4 of
the Indian Self-Determination and Education Assistance Act.
``(3) Urban indian organization.--The term `urban Indian
organization' has the meaning given such term in section 4 of
the Indian Health Care Improvement Act.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $10,000,000 for each of fiscal
years 2023 through 2027. Funds provided to carry out this section shall
supplement not supplant funds otherwise made available to carry out
title VII.''.
SEC. 4. PROGRAM FOR EXPANDING THE REPRODUCTIVE HEALTH CARE PHYSICIAN
WORKFORCE.
Part B of title VII of the Public Health Service Act (42 U.S.C. 293
et seq.) is amended by adding at the end the following:
``SEC. 742. PROGRAM FOR EXPANDING THE REPRODUCTIVE HEALTH CARE
PHYSICIAN WORKFORCE.
``(a) Purpose.--It is the purpose of this section--
``(1) to establish and sustain a competitive health
professions applicant pool of individuals with disabilities by
increasing the total number of individuals with disabilities
who pursue a career in sexual and reproductive health care,
including abortion care and maternal health care; and
``(2) to develop a culturally and linguistically competent
health care workforce providing reproductive health care that
will serve unserved and underserved populations, including
individuals with disabilities.
``(b) Awards.--To assist individuals with disabilities in
undertaking education to enter into the reproductive health care
workforce, the Secretary may award grants, contracts, or cooperative
agreements to public or private nonprofit health or educational
entities, including schools of medicine, schools of osteopathic
medicine, and institutions of higher education, that offer programs,
including graduate programs, in obstetrics and gynecology or programs
for the training of health care providers to enable such entities to
carry out the activities described in subsection (d).
``(c) Application.--To be eligible to receive an award under
subsection (b), an entity described in such subsection shall submit to
the Secretary an application at such time, in such manner, and
containing such information as the Secretary may require.
``(d) Use of Funds.--An entity shall use amounts received under an
award under subsection (b) to--
``(1) conduct or support activities to develop a
competitive applicant pool, through partnership with public or
private nonprofit institutions of higher education, local
educational agencies, health care providers, such as sexual and
reproductive health care providers and primary care providers,
or other community-based entities, and establish an education
pipeline for individuals with disabilities entering the
reproductive health care workforce;
``(2) establish, strengthen, or expand programs to support
the academic performance of individuals with disabilities
participating in activities funded under this section,
including mentorship programs;
``(3) identify, recruit, enroll, and retain individuals
with disabilities in education and training related to sexual
and reproductive health care;
``(4) improve the capacity of the entity involved to train,
recruit, and retain faculty with disabilities including the
payment of such stipends and fellowships as the Secretary may
determine appropriate;
``(5) carry out activities to improve the information
resources, clinical education, curricula and competencies of
the graduates of the entity involved, as it relates to
individuals with disabilities;
``(6) facilitate faculty and student research on health
issues affecting individuals with disabilities, including
research on issues relating to the delivery of sexual and
reproductive health care to individuals with disabilities;
``(7) carry out programs, or offer experiences, to train
students in providing reproductive health services to
individuals with disabilities at community-based health
facilities that provide reproductive health services;
``(8) provide stipends to individuals with disabilities
participating in activities funded under this section as the
Secretary determines appropriate, in amounts as the Secretary
determines appropriate, with an assurance that such stipends
shall not result in loss of an individual's Federal or State
benefits; or
``(9) any other activities that the Secretary may require.
``(e) Preference.--In awarding grants, contracts, or cooperative
agreements under this section, the Secretary shall give preference to
applications that have been approved for programs that involve a
comprehensive approach through multiple entities described in
subsection (b) to establish, enhance, and expand educational programs
that will result in the development of a competitive applicant pool of
individuals with disabilities who desire to pursue careers in
reproductive health care services.
``(f) Consideration for Awards.--In awarding grants, contracts, or
cooperative agreements under this section, the Secretary shall--
``(1) consider current enrollment trends and the needs of
certain populations, including individuals with disabilities;
and
``(2) align and coordinate with other training programs
administered by the Health Resources and Services
Administration.
``(g) Effect on Other Programs.--Assistance or stipends provided to
an individual under this section shall not considered when applying
asset or resource limitation provisions related to the eligibility of
such individual for any benefit, assistance, or service provided under
any Federal or State program.
``(h) Report.--Not later than 180 days after the end of the award
period, the Secretary shall submit to the Committee on Health,
Education, Labor, and Pensions of the Senate and the Committee on
Energy and Commerce of the House of Representatives, a report
concerning the activities carried out under this section to increase
the representation of individuals with disabilities in the reproductive
health profession and related training programs.
``(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $15,000,000 for each of fiscal
years 2023 through 2027. Funds provided to carry out this section shall
supplement not supplant funds otherwise made available to carry out
title VII.''.
SEC. 5. EXPANDING THE REPRODUCTIVE HEALTH CARE NURSING WORKFORCE.
Section 821 of the Public Health Service Act (42 U.S.C. 296m) is
amended by adding at the end the following:
``(d) Expanding the Reproductive Health Care Nursing Workforce.--
``(1) Awards.--To assist individuals with disabilities in
undertaking education to enter into the reproductive nursing
workforce, the Secretary may award grants, contracts, or
cooperative agreements under subsection (a)(1) to eligible
entities to enable such entities to carry out the activities
described in paragraph (4).
``(2) Application.--To be eligible to receive an award
under paragraph (1), an entity described in such paragraph
shall submit to the Secretary an application at such time, in
such manner, and containing such information as the Secretary
may require.
``(3) Use of funds.--An entity shall use amounts received
under an award under paragraph (1) to--
``(A) conduct activities to develop a competitive
applicant pool, through partnership with public or
private nonprofit institutions of higher education,
local educational agencies, nurse-managed health
clinics, health care providers, such as reproductive
health care providers and nurses, or other community-
based entities, and establish an education pipeline for
individuals with disabilities entering the reproductive
health care nursing workforce;
``(B) establish, strengthen, or expand programs to
support the academic performance of individuals with
disabilities participating in activities funded under
this subsection, including mentorship programs;
``(C) identify, recruit, enroll, and retain
individuals with disabilities in education and training
related to sexual and reproductive health care;
``(D) improve the capacity of the entity involved
to train, recruit, and retain faculty with
disabilities, including the payment of such stipends
and fellowships as the Secretary may determine
appropriate;
``(E) carry out activities to improve the
information resources, clinical education, curricula,
and competencies of the graduates of the entity
involved, as it relates to individuals with
disabilities;
``(F) facilitate faculty and student research to
include evidence-based practice and quality improvement
projects focused on health issues affecting individuals
with disabilities, including research on issues
relating to the delivery of sexual and reproductive
health care to individuals with disabilities;
``(G) carry out programs, or offer experiences, to
train students in providing reproductive health
services to individuals with disabilities at community-
based health care facilities that provide reproductive
health services;
``(H) provide stipends to individuals with
disabilities participating in activities funded under
this subsection as the Secretary determines
appropriate, in amounts as the Secretary determines
appropriate, with an assurance that such stipends shall
not result in the loss of an individual's Federal or
State benefits; or
``(I) any other activities that the Secretary may
require.
``(4) Preference.--In awarding grants, contracts, or
cooperative agreements under this subsection, the Secretary
shall give preference to applications that have been approved
for programs that involve a comprehensive approach through
multiple entities described in paragraph (1) to establish,
enhance, and expand educational programs that will result in
the development of a competitive applicant pool of individuals
with disabilities who desire to pursue careers in reproductive
health care services.
``(5) Consideration for awards.--In awarding grants,
contracts, or cooperative agreements under this subsection, the
Secretary shall--
``(A) consider current enrollment trends and the
needs of certain populations, including individuals
with disabilities; and
``(B) align and coordinate with other training
programs administered by the Health Resources and
Services Administration.
``(6) Effect on other programs.--Assistance or stipends
provided to an individual under this subsection shall not
considered when applying asset or resource limitation
provisions related to the eligibility of such individual for
any benefit, assistance, or service provided under any Federal
or State program.
``(7) Report.--Not later than 180 days after the end of the
award period, the Secretary shall submit to the Committee on
Health, Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of
Representatives, a report concerning the activities carried out
under this subsection to increase the representation of
individuals with disabilities in the reproductive health
profession and related training programs.
``(8) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection, $15,000,000
for each of fiscal years 2023 through 2027. Funds provided to
carry out this subsection shall supplement not supplant funds
otherwise made available to carry out title VIII.''.
SEC. 6. PROGRAM FOR REPRODUCTIVE HEALTH EDUCATION.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary''), acting through the
Administrator of the Health Resources and Services Administration and
in consultation with the Administrator of the Administration for
Community Living, shall award grants, contracts, or cooperative
agreements to eligible entities to provide funding for education
programs focused on sexual and reproductive health needs for
individuals with disabilities.
(b) Eligibility.--
(1) In general.--To be eligible to receive an award under
this section an entity shall be a public or private nonprofit
entity with a demonstrated expertise in serving individuals
with disabilities, which may include--
(A) a multidisciplinary health care provider who
provides reproductive health care services, such as a
federally qualified health center;
(B) institutions of higher education, as defined in
section 101 of the Higher Education Act of 1965, with
expertise in reproductive health care;
(C) an entity primarily led by individuals with
disabilities;
(D) an entity with expertise in reproductive rights
and justice;
(E) an Indian Tribe, Tribal organization, or urban
Indian organization; or
(F) a consortium of entities described in any of
subparagraphs (A) through (E).
(2) Application.--To be eligible to receive a grant,
contract, or cooperative agreement under this section an
eligible entity or consortium of entities shall submit to the
Secretary an application at such time, in such manner, and
containing such information as the Secretary may require, that
includes a description of the eligible entity's or entities'
expertise in providing education programs including evidence
that such entity has--
(A) knowledge of best practices in providing
reproductive health care, including preventive health
care services, to individuals with disabilities;
(B) experience working with individuals with
disabilities and their families; and
(C) demonstrated expertise of developing materials
in culturally and linguistically accessible formats
including plain language.
(3) Subawards.--An eligible entity or eligible consortium
receiving an award under this section may, for contracting
purposes, make subawards to individuals or entities with
expertise in reproductive health care and serving individuals
with disabilities.
(c) Use of Funds.--An entity or entities' shall use amounts
received under subsection (a) to--
(1) carry out evidence-based or evidence-informed sexual
and reproductive health education programs for individuals with
disabilities, including youth, in culturally and linguistically
accessible formats;
(2) develop sexual and reproductive health education
programs in culturally and linguistically accessible formats to
be used in carrying out paragraph (1);
(3) provide education to individuals with disabilities,
including youth, concerning abortion care options and their
sexual, reproductive, and perinatal health care needs;
(4) provide education to individuals with disabilities,
including youth, concerning their rights under relevant Federal
and State law;
(5) provide access to disability affirmative and supportive
clinical resources that are accessible to individuals with
disabilities;
(6) build the entity's or entities' capacity and enhance
their leadership of the entity or entities within the community
to promote community engagement in, and advancement of,
evidence-based or evidence-informed sexual and reproductive
health care education in easily accessible formats; and
(7) support dissemination of newly developed sexual and
reproductive health care education programs as described in
paragraph (2) throughout the State, territorial, and Tribal
communities.
(d) Evaluation and Report.--
(1) In general.--An entity that receives an award under
this section shall, at the end of the award period, carry out
an evaluation of success of the entity in achieving the goals
of the program for which the award was made.
(2) Report.--Not later than 180 days after the end of the
award period, an entity that receives an award under this
section shall submit to the Secretary a report on the results
of the evaluation conducted under paragraph (1).
(3) Secretary.--The Secretary shall annually compile the
reports submitted under paragraph (2) and submit such
compilation to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and Commerce
of the House of Representatives. Such compilations shall be
posted on the internet website of the Department of Health and
Human Services in an accessible format.
(e) Definitions.--In this section:
(1) Disability.--The terms ``disability'' and
``disabilities'' have the meaning given such terms for purposes
of the Americans with Disabilities Act of 1990.
(2) Indian tribe.--The terms ``Indian Tribe'' and ``Tribal
organization'' have the meaning given such terms section 4 of
the Indian Self-Determination and Education Assistance Act.
(3) Urban indian organization.--The term ``urban Indian
organization'' has the meaning given such term in section 4 of
the Indian Health Care Improvement Act.
(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $10,000,000 for each of fiscal
years 2023 through 2027.
SEC. 7. NATIONAL TECHNICAL ASSISTANCE CENTER.
(a) Establishment.--The Secretary of Health and Human Services,
acting through the Administration for Community Living, shall directly,
or through a grant, contract, or cooperative agreement, establish a
National Technical Assistance Center to--
(1) provide recommendations and best practices to States,
Indian Tribes, Tribal organizations, and urban Indian
organizations concerning improving coordination of services
including mental health and substance use disorder services,
social services, health care, and transportation to increase
access to quality, integrated systems of accessible,
comprehensive disability clinical care, and services for
individuals with disabilities;
(2) provide technical assistance to health care providers
on culturally and linguistically accessible and appropriate
sexual and reproductive health care, including before, during,
and after pregnancy and perinatal care and family planning
services;
(3) develop resources and provide technical assistance to
assist covered entities in complying with applicable Federal
laws and regulations; and
(4) develop resources for individuals with disabilities
facing barriers to accessible care, including related to
accessible medical diagnostic equipment and the Barrier-Free
Health Care Initiative.
(b) Definitions.--In this section:
(1) Disability.--The terms ``disability'' and
``disabilities'' have the meaning given such terms for purposes
of the Americans with Disabilities Act of 1990.
(2) Indian tribe.--The terms ``Indian Tribe'' and ``Tribal
organization'' have the meaning given such terms section 4 of
the Indian Self-Determination and Education Assistance Act.
(3) Urban indian organization.--The term ``urban Indian
organization'' has the meaning given such term in section 4 of
the Indian Health Care Improvement Act.
(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $10,000,000 for each of fiscal
years 2023 through 2027.
SEC. 8. RESEARCH STUDY.
(a) In General.--The Secretary of Health and Human Services, in
consultation with the Administrator of the Administration for Community
Living, shall carry out a study to--
(1) identify the types of programs and services that have
demonstrated effectiveness in providing reproductive health
care services for individuals with disabilities;
(2) analyze the effectiveness of Federal, State, Tribal,
and local partnerships to coordinate efforts to ensure an
integrated system of accessible, comprehensive reproductive
health care for individuals with disabilities; and
(3) identify necessary memoranda of understanding or
interagency agreements that are needed to foster data and
public health research focusing on reproductive health care
barriers for individuals with disabilities.
(b) Report.--Not later than 3 years after the date of enactment of
this Act, the Secretary of Health and Human Services shall submit to
the Committee on Health, Education, Labor, and Pensions of the Senate
and the Committee on Energy and Commerce and the Committee on Education
and Labor of the House of Representatives, a report on the results of
the study conducted under subsection (a).
(c) Definition.--In this section the terms ``disability'' and
``disabilities'' have the meanings given such terms for purposes of the
Americans with Disabilities Act of 1990.
(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $15,000,000 for fiscal year
2023.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
Llama 3.2 · runs locally in your browser
Ask anything about this bill. The AI reads the full text to answer.
Enter to send · Shift+Enter for new line