Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1696592357776.pdf (United States)
I 118TH CONGRESS 1ST SESSION H. R. 4901 To amend the Public Health Service Act to improve reproductive health care of individuals with disabilities.

IN THE HOUSE OF REPRESENTATIVES JULY 26, 2023 Ms. BUSH (for herself, Ms. PRESSLEY, Mr. CONNOLLY, Mr.
BOWMAN, Mr. MCGOVERN, Mrs. RAMIREZ, Ms. VELA´ZQUEZ, Ms. BARRAGA´N, Ms. CROCKETT, Ms. TLAIB, Ms. NORTON, Ms. MCCLELLAN, Mr. POCAN, Ms. JAYAPAL, Ms. MENG, Ms. MOORE of Wisconsin, Ms. SALINAS, Mr. MORELLE, Ms. TOKUDA, Ms. ESCOBAR, Mr. CASTRO of Texas, Ms. WIL- SON of Florida, Mr. TONKO, and Mr. NADLER) 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 Representa- tives 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.
SEC.

2.

FINDINGS.

Congress finds the following (1) In the United States, approximately 1 in 4 adults have some type of disability, more than 1 in 10 individuals with disabilities can become pregnant, and over 4,100,000 people are parents with disabil- ities.
(2) All people, including individuals with dis- abilities, have the right to decide if, when, and how to start and raise a family as well as have healthy pregnancies and postpartum periods.

(3) Title II and III of the Americans with Dis- abilities 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 accessi- bility issues at health care facilities, lack of acces- sible medical diagnostic equipment, barriers to ac- cessible travel, delay in receiving preventative serv- ices, and lack of health care providers with training and knowledge on the needs of individuals with dis- abilities receiving reproductive health care.
•HR 4901 IH (5) Reproductive health care is critical to a per- son’s long-term health.

Disabled people have higher mortality rates from reproductive related cancers often due to lack of access to reproductive health care.
(6) The United States Access Board has estab- lished standards for accessible medical diagnostic equipment; however without enforceable standards adopted by the Department of Health and Human Services and Department of Justice, systemic im- provements in the availability of accessible medical diagnostic equipment will not be achieved.
(7) Disabled people have an equal right to re- productive autonomy, but harmful stereotypes about people with disabilities create barriers to getting care that respects that autonomy.

(8) Laws that restrict access to reproductive health care, including abortion care, disproportionally harm people who already face bar- riers to reproductive health care, which includes dis- abled people.
(9) Individuals with and without disabilities want children at the same frequency, but individuals with disabilities are less likely to receive contracep- tion counseling and timely prenatal care, experience •HR 4901 IH higher rate of sterilization, and are at a greater risk for adverse pregnancy outcomes.
(10) Diversity and inclusion in the health care workforce is a critical factor in the delivery of high- quality, culturally competent health care and im- proves patient outcomes.

However, the rate of stu- dents 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.)
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 en- tities to carry out training programs for health care pro- fessionals providing sexual and reproductive health care concerning comprehensive disability clinical care curricula.
‘‘(b) ELIGIBILITY.— •HR 4901 IH ‘‘(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 exper- tise in serving individuals with disabilities, which may include— ‘‘(A) a multidisciplinary health care pro- vider who provides reproductive health care, such as Federally qualified health centers and title X clinics; ‘‘(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 reproduc- tive 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 sub- mit to the Secretary an application at such time, in •HR 4901 IH 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 evi- dence such as— ‘‘(i) knowledge of the rights afforded to individuals with a disability under rel- evant Federal and State law; ‘‘(ii) knowledge of accessibility stand- ards established by the United States Ac- cess Board; ‘‘(iii) expertise in evidence-based or evidence-informed practices in providing sexual and reproductive health care, in- cluding preventive health care services and perinatal care, to individuals with disabil- ities 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 disabil- ities; •HR 4901 IH ‘‘(v) experience working with individ- uals with disabilities and their families; ‘‘(vi) expertise in providing, collecting, compiling, communicating, and dissemi- nating reproductive health care informa- tion in culturally and linguistically appro- priate manner especially in easily acces- sible formats; and ‘‘(vii) experience improving coordina- tion of
 services, such as mental health, substance use disorder prevention, treat- ment, 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 require- ments of subsection (c); ‘‘(ii) the process to be used to identify health care providers that will participate in the training program, including the •HR 4901 IH process to increase diversity in the pool of participating providers; ‘‘(iii) the process to be used to engage stakeholders in such training, including in- dividuals 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 com- prehensive training or professional development on the sexual and reproductive health care needs of individuals with disabilities; and ‘‘(D) any other assurances that the Sec- retary 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 con- cerning— •HR 4901 IH ‘‘(1) comprehensive disability clinical care cur- ricula to inform health professionals providing sexual and reproductive health care on how to provide ef- fective, 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-determina- tion, and choices of individuals with disabilities with respect to their sexual and reproductive health through comprehensive disability clinical care cur- ricula; ‘‘(4) the rights afforded to individuals with dis- abilities under relevant Federal and State law; and ‘‘(5) methods and evidence-based or evidence-in- formed practices for providing sexual and reproduc- tive 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 repro- •HR 4901 IH 10 ductive 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 Sec- retary a report on the results of the evaluation con- ducted under paragraph (1).

‘‘(3) SECRETARY.—The Secretary shall annu- ally 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 Com- merce of the House of Representatives.
Such com- pilations 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 in section 4 of the Indian Self-Deter- mination and Education Assistance Act.
•HR 4901 IH 11 ‘‘(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 2024 through 2028.

Funds provided to carry out this section shall supplement not supplant funds otherwise made available to carry out 10 title VII.’’.

11 12 13 14 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.)
293 et seq.)

is amended by adding at the end 15 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 individ- uals with disabilities who pursue a career in sexual and reproductive health care, including abortion care and maternal health care; and •HR 4901 IH 12 ‘‘(2) to develop a culturally and linguistically competent health care workforce providing reproduc- tive health care that will serve unserved and under- served populations, including individuals with dis- abilities.
‘‘(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 institu- tions of higher education, that offer programs, including graduate programs, in obstetrics and gynecology or pro- grams for the training of health care providers to enable such entities to carry out the activities described in sub- section (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 informa- tion 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 •HR 4901 IH 13 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 edu- cation pipeline for individuals with disabilities enter- ing 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 individ- uals with disabilities in education and training re- lated 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 fellow- ships as the Secretary may determine appropriate; ‘‘(5) carry out activities to improve the informa- tion 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 •HR 4901 IH 14 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 commu- nity-based health facilities that provide reproductive health services; ‘‘(8) provide stipends to individuals with disabil- ities participating in activities funded under this sec- tion 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 Sec- retary shall give preference to applications that have been approved for programs that involve a comprehensive ap- proach through multiple entities described in subsection (b) to establish, enhance, and expand educational pro- grams 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.
•HR 4901 IH 15 ‘‘(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 be considered when applying asset or resource limita- tion provisions related to the eligibility of such individual for any benefit, assistance, or service provided under any 15 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 rep- resentation of individuals with disabilities in the reproduc- tive health profession and related training programs.
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this section, •HR 4901 IH $15,000,000 for each of fiscal years 2024 through 2028.
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 fol- lowing: ‘‘(d) EXPANDING THE REPRODUCTIVE HEALTH CARE NURSING WORKFORCE.— ‘‘(1) AWARDS.—To assist individuals with dis- abilities 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 ap- plication at such time, in such manner, and con- taining such information as the Secretary may re- quire.
•HR 4901 IH 17 ‘‘(3) USE OF FUNDS.—An entity shall use amounts received under an award under paragraph (1) to— ‘‘(A) conduct activities to develop a com- petitive applicant pool, through partnership with public or private nonprofit institutions of higher education, local educational agencies, nurse-managed health clinics, health care pro- viders, such as reproductive health care pro- viders and nurses, or other community-based entities, and establish an education pipeline for individuals with disabilities entering the repro- ductive health care nursing workforce; ‘‘(B) establish, strengthen, or expand pro- grams to support the academic performance of individuals with disabilities participating in ac- tivities funded under this subsection, including mentorship programs; ‘‘(C) identify, recruit, enroll, and retain in- dividuals with disabilities in education and training related to sexual and reproductive health care; ‘‘(D) improve the capacity of the entity in- volved to train, recruit, and retain faculty with disabilities, including the payment of such sti- •HR 4901 IH pends and fellowships as the Secretary may de- termine appropriate; ‘‘(E) carry out activities to improve the in- formation resources, clinical education, cur- ricula, 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 individ- uals with disabilities; ‘‘(G) carry out programs, or offer experi- ences, to train students in providing reproduc- tive health services to individuals with disabil- ities 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 deter- mines appropriate, in amounts as the Secretary determines appropriate, with an assurance that •HR 4901 IH 19 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, con- tracts, or cooperative agreements under this sub- section, the Secretary shall give preference to appli- cations that have been approved for programs that involve a comprehensive approach through multiple entities described in paragraph (1) to establish, en- hance, 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 award- ing 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 train- ing programs administered by the Health Re- sources and Services Administration.
‘‘(6) EFFECT ON OTHER PROGRAMS.—Assist- ance or stipends provided to an individual under this •HR 4901 IH 20 subsection shall not be considered when applying asset or resource limitation provisions related to the eligibility of such individual for any benefit, assist- ance, 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 sub- mit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representa- tives, 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 2024 through 2028.

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 EDU- CATION.
(a) IN GENERAL.—The Secretary of Health and Human Services (referred to in this section as the ‘‘Sec- retary’’), acting through the Administrator of the Health •HR 4901 IH 21 Resources and Services Administration and in consulta- tion with the Administrator of the Administration for Community Living, shall award grants, contracts, or coop- erative agreements to eligible entities to provide funding for education programs focused on sexual and reproduc- tive 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 ex- pertise 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 and title X clinics; (B) institutions of higher education, as de- fined 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 reproduc- tive rights and justice; •HR 4901 IH 22 (E) an Indian Tribe, Tribal organization, or urban Indian organization; and (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 informa- tion as the Secretary may require, that includes a description of the eligible entity’s or entities’ exper- tise in providing education programs including evi- dence that such entity has— (A) knowledge of best practices in pro- viding reproductive health care, including pre- ventive 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 acces- sible 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 •HR 4901 IH 23 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-in- formed sexual and reproductive health education programs for individuals with disabilities, including youth, in culturally and linguistically accessible for- mats; (2) develop sexual and reproductive health edu- cation programs in culturally and linguistically ac- cessible formats to be used in carrying out para- graph (1); (3) provide education to individuals with dis- abilities, including youth, concerning abortion care options and their sexual, reproductive, and perinatal health care needs; (4) provide education to individuals with dis- abilities, 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 •HR 4901 IH 24 within the community to promote community en- gagement 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 pro- grams 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 Sec- retary a report on the results of the evaluation con- ducted 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 Sen- ate and the Committee on Energy and Commerce of the House of Representatives.
Such compilations •HR 4901 IH 25 shall be posted on the internet website of the De- partment of Health and Human Services in an ac- cessible 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 in section 4 of the Indian Self-Deter- mination 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 2024 through 2028.

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, con- tract, or cooperative agreement, establish a National Tech- nical Assistance Center to— •HR 4901 IH 26 (1) provide recommendations and best practices to States, Territories, Indian Tribes, Tribal organi- zations, 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 as- sistance to assist covered entities in complying with applicable Federal laws and regulations; and (4) develop resources for individuals with dis- abilities 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 •HR 4901 IH 27 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 in section 4 of the Indian Self-Deter- mination 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 2024 through 2028.

SEC.
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 re- productive 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, com- •HR 4901 IH 28 prehensive reproductive health care for individuals with disabilities; and (3) identify necessary memoranda of under- standing 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 sub- section (a).
16 17 18 (c) DEFINITION.—In this section the terms ‘‘dis- ability’’ and ‘‘disabilities’’ have the meanings given such terms for purposes of the Americans with Disabilities Act 19 of 1990.

20 21 22 (d) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this section, $15,000,000 for fiscal year 2024.
•HR 4901 IH