Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1696592183665.pdf (United States)
I 116TH CONGRESS 2D SESSION H. R. 6142 To end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES MARCH 9, 2020 Ms. UNDERWOOD (for herself, Ms. ADAMS, Ms. SEWELL of Alabama, Ms. NORTON, Ms. SCANLON, Mrs. WATSON COLEMAN, Ms. BARRAGA´N, Ms. OMAR, Mr. RYAN, Ms. MOORE, Mr. CLAY, Mr. KHANNA, Ms. BASS, Ms. BLUNT ROCHESTER, Mr. KENNEDY, Ms. SCHAKOWSKY, Mrs. LURIA, Ms. HAALAND, Ms. PRESSLEY, Mr. LAWSON of Florida, Ms. SHALALA, Ms. SPANBERGER, Ms. SCHRIER, and Mr. MOULTON) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Financial Services, Transportation and Infrastructure, Education and Labor, the Judiciary, Natural Resources, Agriculture, and Veterans’ Affairs, for a period to be subsequently deter- mined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes, and for other purposes.
1 2 Be it enacted by the Senate and House of Representa- tives of the United States of America in Congress assembled SECTION 1.

SHORT TITLE.

2 This Act may be cited as the ‘‘Black Maternal Health Momnibus Act of 2020’’.

SEC.

2.

TABLE OF CONTENTS.

The table of contents for this Act is as follows: Sec.

1.
1.

Short title.

Sec.

2.

Table of contents.

Sec.

3.

Definitions.

TITLE I—SOCIAL DETERMINANTS FOR MOMS Sec.

101.

Task force to coordinate efforts to address social determinants of health for women in the prenatal and postpartum periods.

Sec.

102.

Requirements for guidance relating to social determinants of health for pregnant women.

Sec.

103.

Department of Housing and Urban Development.

Sec.

104.

Department of Transportation.

Sec.

105.

Department of Agriculture.

Sec.

106.


Environmental study through National Academies.

Sec.

107.

Child care access.

Sec.

108.

Grants to State, local, and Tribal public health departments address- ing social determinants of health for pregnant and postpartum women.

TITLE II—HONORING KIRA JOHNSON Sec.

201.

Investments in community-based organizations to improve Black ma- ternal health outcomes.

Sec.

202.

Training for all employees in maternity care settings.

Sec.

203.
Sec.

203.

Study on reducing and preventing bias, racism, and discrimination in maternity care settings.

Sec.

204.

Respectful maternity care compliance program.

Sec.

205.

GAO report.

TITLE III—PROTECTING MOMS WHO SERVED Sec.

301.

Support for maternity care coordination.

Sec.

302.

Sense of Congress on veteran status requirements.

Sec.

303.

Report on maternal mortality and severe maternal morbidity among women veterans.

TITLE IV—PERINATAL WORKFORCE Sec.

401.

HHS agency directives.

Sec.


402.

Grants to grow and diversify the perinatal workforce.

Sec.

403.

Grants to grow and diversify the nursing workforce in maternal and perinatal health.

Sec.

404.

GAO report on barriers to maternity care.

TITLE V—DATA TO SAVE MOMS •HR 6142 IH Sec.

501.
501.

Funding for maternal mortality review committees to promote rep- resentative community engagement.

Sec.

502.

Data collection and review.

Sec.

503.

Task force on maternal health data and quality measures.

Sec.

504.

Indian Health Service study on maternal mortality.

Sec.

505.

Grants to minority-serving institutions to study maternal mortality, severe maternal morbidity, and other adverse maternal health outcomes.

TITLE VI—MOMS MATTER Sec.

601.


Innovative models to reduce maternal mortality.

TITLE VII—JUSTICE FOR INCARCERATED MOMS Sec.

701.

Sense of Congress.

Sec.

702.

Ending the shackling of pregnant individuals.

Sec.

703.

Creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods.

Sec.

704.

Grant program to improve maternal health outcomes for individuals in State and local prisons and jails.

Sec.

705.

GAO report.

Sec.

706.

MACPAC report.


TITLE VIII—TECH TO SAVE MOMS Sec.

801.

CMI modeling of integrated telehealth models in maternity care serv- ices.

Sec.

802.

Grants to expand the use of technology-enabled collaborative learning and capacity models that provide care to pregnant and postpartum women.

Sec.

803.

Grants to promote equity in maternal health outcomes by increasing access to digital tools.

Sec.

804.
Sec.

804.

Report on the use of technology to reduce maternal mortality and se- vere maternal morbidity and to close racial and ethnic dispari- ties in outcomes.

TITLE IX—IMPACT TO SAVE MOMS Sec.

901.

Perinatal Care Alternative Payment Model Demonstration Project.

Sec.

902.

MACPAC report.

SEC.

3.

DEFINITIONS.


In this Act: (1) CULTURALLY CONGRUENT.—The term ‘‘cul- turally congruent’’, with respect to care or maternity care, means care that is in agreement with the pre- ferred cultural values, beliefs, worldview, and prac- •HR 6142 IH tices of the health care consumer and other stake- holders.
(2) MATERNAL MORTALITY.—The term ‘‘mater- nal mortality’’ means a death occurring during or within a one-year period after pregnancy caused by pregnancy or childbirth complications.

(3) POSTPARTUM.—The term ‘‘postpartum’’ means the one-year period beginning on the last day of a woman’s pregnancy.
(4) SEVERE MATERNAL MORBIDITY.—The term ‘‘severe maternal morbidity’’ means an unexpected outcome caused by labor and delivery of a woman that results in significant short-term or long-term consequences to the health of the woman.

TITLE I—SOCIAL DETERMINANTS FOR MOMS SEC.

101.

TASK FORCE TO COORDINATE EFFORTS TO AD- DRESS SOCIAL DETERMINANTS OF HEALTH FOR WOMEN IN THE PRENATAL AND POSTPARTUM PERIODS.
(a) IN GENERAL.—The Secretary of Health and Human Services shall convene a task force (in this section referred to as the ‘‘Task Force’’) to develop strategies to coordinate efforts across the Federal Government to ad- •HR 6142 IH dress social determinants of health for women in the pre- natal and postpartum periods.
(b) MEMBERS.—The members of the Task Force shall consist of the following: (1) The Secretary of Health and Human Serv- ices (or the Secretary’s designee).

(2) The Secretary of Housing and Urban Devel- opment (or the Secretary’s designee).

(3) The Secretary of Transportation (or the Secretary’s designee).

(4) The Secretary of Agriculture (or the Sec- retary’s designee).

(5) The Administrator of the Environmental Protection Agency (or the Administrator’s designee).
(6) The Assistant Secretary for the Administra- tion for Children and Families (or the Assistant Sec- retary’s designee).

(7) The Administrator of the Centers for Medi- care & Medicaid Services (or the Administrator’s designee).

(8) The Director of the Indian Health Service (or the Director’s designee).

(9) The Director of the National Institutes of Health (or the Director’s designee).
•HR 6142 IH (10) The Administrator of the Health Re- sources and Services Administration (or the Admin- istrator’s designee).
(11) The Deputy Assistant Secretary for Minor- ity Health of the Department of Health and Human Services (or the Deputy Assistant Secretary’s des- ignee).

(12) The Deputy Assistant Secretary for Wom- en’s Health of the Department of Health and Human Services (or the Deputy Assistant Sec- retary’s designee).

(13) The Director of the Centers for Disease Control and Prevention (or the Director’s designee).
(14) A woman who has experienced severe ma- ternal morbidity or a family member of a woman who has suffered a pregnancy-related death.

(15) A leader of a community-based organiza- tion that addresses maternal mortality and severe maternal morbidity with a specific focus on racial and ethnic disparities.

(16) A maternal health care provider.

(c) CHAIR.—The Secretary of Health and Human Services shall select the Chair of the Task Force from among the members of the Task Force.
•HR 6142 IH (d) REPORT.—Not later than 2 years after the date of enactment of this Act, the Task Force shall— (1) finalize strategies to coordinate efforts across the Federal Government to address social de- terminants of health for women in the prenatal and postpartum periods; and (2) submit a report on such strategies to the Congress, including— (A) plans for implementing such strategies; and (B) recommendations on the funding amounts needed by each department and agen- cy to implement such strategies.
(e) TERMINATION.—Termination under section 14 of the Federal Advisory Committee Act (5 U.S.C.

App.)

shall not apply to the Task Force.

17 SEC.

102.

REQUIREMENTS FOR GUIDANCE RELATING TO SOCIAL DETERMINANTS OF HEALTH FOR PREGNANT WOMEN.
(a) IN GENERAL.—Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall issue guidance with respect to how medicaid managed care organizations and State Med- icaid programs can use payments made pursuant to sec- tion 1903 of the Social Security Act (42 U.S.C.
1396b) •HR 6142 IH to address the following issues related to social deter- minants of health for high-risk mothers during the pre- sumptive eligibility period for pregnant women: (1) Housing.

(2) Transportation.

(3) Nutrition.

(4) Lactation and other infant feeding options support.

(5) Lead testing and abatement.


(6) Air and water quality.

(7) Car seat installation.

(8) Child care access.

(9) Wellness and stress management programs.

(10) Other social determinants of health (as de- termined by the Secretary).

(b) DEFINITIONS.—In this section: (1) MEDICAID MANAGED CARE ORGANIZA- TIONS.—The term ‘‘medicaid managed care organi- zation’’ has the meaning given such term in section 1903(m)(1)(A) of the Social Security Act (42 U.S.C.

1396b(m)(1)(A)).
1396b(m)(1)(A)).

(2) PRESUMPTIVE ELIGIBILITY PERIOD.—The term ‘‘presumptive eligibility period’’ has the mean- ing given such term in section 1920(b)(1) of the So- cial Security Act (42 U.S.C.

1396r–1(b)(1)).

1 •HR 6142 IH SEC.

103.
103.

DEPARTMENT OF HOUSING AND URBAN DEVEL- OPMENT.

The Secretary of Housing and Urban Development shall establish a new Housing for Moms task force within the Department that shall be responsible for ensuring that women in the prenatal and postpartum periods have safe, stable, affordable, and adequate housing for themselves and their other children.
The task force shall— (1) study how the Department of Housing and Urban Development can support women in the pre- natal and postpartum periods and make rec- ommendations to the Secretary; (2) provide guidance to regional offices of the Department on measures to ensure that local hous- ing infrastructure is supportive to women in the pre- natal and postpartum periods, including providing information on— (A) health-promoting housing codes; (B) enforcement of housing codes; (C) proactive rental inspection programs; (D) code enforcement officer training; and (E) partnerships between regional offices of the Department and community organiza- tions to ensure housing laws are understood and violations are discovered; and •HR 6142 IH 10 (3) not later than 2 years after the date of en- actment of this Act, and annually thereafter, submit to the Congress a report summarizing the activities of the task force.
SEC.

104.

DEPARTMENT OF TRANSPORTATION.
(a) REPORT.—Not later than 1 year after the date of enactment of this Act, the Secretary of Transportation shall submit to Congress a report containing— (1) an assessment of transportation barriers preventing individuals from attending prenatal and postpartum appointments, accessing maternal health care services, or accessing services and resources re- lated to social determinants of health that affect ma- ternal health outcomes, such as healthy foods; (2) recommendations on how to overcome such barriers; and (3) an assessment of transportation safety risks for pregnant individuals and recommendations on how to mitigate such risks.
(b) CONSIDERATIONS.—In carrying out subsection (a), the Secretary shall give special consideration to solu- tions for— 23 24 25 (1) women living in a health professional short- age area designated under section 332 of the Public Health Service Act (42 U.S.C.
254e); and •HR 6142 IH 11 (2) women living in areas with high maternal mortality or severe morbidity rates and significant racial or ethnic disparities in maternal health out- comes.

SEC.

105.

DEPARTMENT OF AGRICULTURE.


(a) SPECIAL SUPPLEMENTAL NUTRITION PRO- GRAM.— (1) EXTENSION OF POSTPARTUM PERIOD.— Section 17(b)(10) of the Child Nutrition Act of 1966 (42 U.S.C.

1786(b)(10)) is amended by strik- ing ‘‘six months’’ and inserting ‘‘24 months’’.

(2) EXTENSION OF BREASTFEEDING PERIOD.— Section 17(d)(3)(A)(ii) of the Child Nutrition Act of 1966 (7 U.S.C.

1431(d)(3)(A)(ii)) is amended by striking ‘‘1 year’’ and inserting ‘‘24 months’’.
(3) REPORT.—Not later than 2 years after the date of the enactment of this section, the Secretary shall submit to Congress a report that includes an evaluation of the effect of each of the amendments made by this subsection on— (A) maternal and infant health outcomes, including racial and ethnic disparities with re- spect to such outcomes; (B) qualitative evaluations of family expe- riences under the special supplemental nutrition •HR 6142 IH 12 program under section 17 of the Child Nutri- tion Act of 1966 (42 U.S.C.
1786); and (C) the cost effectiveness of such special supplemental nutrition program.

(b) GRANT PROGRAM FOR HEALTHY FOOD AND CLEAN WATER FOR PREGNANT AND POSTPARTUM WOMEN.— (1) IN GENERAL.—The Secretary shall carry out a grant program to make grants on a competi- tive basis to eligible entities to carry out the nutri- tional activities described in paragraph (4).
(2) APPLICATION.—To be eligible to receive a grant under this subsection an eligible entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may provide.
(3) PRIORITY.—In awarding grants under this subsection, the Secretary shall give priority to an eli- gible entity that proposes in an application under paragraph (2) to use the grant funds to carry out activities in areas with— (A) high maternal mortality or severe ma- ternal morbidity rates; and (B) significant racial or ethnic disparities in maternal health outcomes.
•HR 6142 IH 13 (4) USE OF FUNDS.—An eligible entity that re- ceives a grant under this subsection shall use funds under the grant to deliver healthy food, infant for- mula, or clean water to pregnant and postpartum women located in areas that are food deserts, as de- termined by the Secretary using data from the Food Access Research Atlas of the Department of Agri- culture.
(5) REPORT.—Not later than 2 years after the date of the enactment of this section, the Secretary shall submit to Congress a report that includes— (A) an evaluation of the effect of the grant program under this subsection on maternal and infant health outcomes, including racial and ethnic disparities with respect to such out- comes; and (B) recommendations with respect to en- suring the activities described in paragraph (4) continue after the grant period funding such ac- tivities expires.
(6) AUTHORIZATION OF APPROPRIATIONS.— There are authorized to be appropriated such sums as may be necessary to carry out this subsection for fiscal years 2021 through 2023.
(c) DEFINITIONS.—In this section: •HR 6142 IH 14 (1) ELIGIBLE ENTITY.—The term ‘‘eligible enti- ty’’ includes public entities, private community enti- ties, community-based organizations, Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C.
5304)), and urban Indian organizations (as such term is defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C.

1603)).

(2) SECRETARY.—The term ‘‘Secretary’’ means the Secretary of Agriculture.

SEC.

106.

ENVIRONMENTAL STUDY THROUGH NATIONAL ACADEMIES.
(a) IN GENERAL.—The Administrator of the Envi- ronmental Protection Agency shall seek to enter an agree- ment, not later than 60 days after the date of enactment of this Act, with the National Academies of Sciences, En- gineering, and Medicine (referred to in this section as the ‘‘National Academies’’) under which the National Acad- emies agree to conduct a study on the impacts of water and air quality, exposure to extreme temperatures, and pollution levels on maternal and infant health outcomes.
(b) STUDY REQUIREMENTS.—The agreement under subsection (a) shall direct the National Academies to make recommendations for— •HR 6142 IH 15 (1) improving environmental conditions to im- prove maternal and infant health outcomes; and (2) reducing or eliminating racial and ethnic disparities in such outcomes.
(c) REPORT.—The agreement under subsection (a) shall direct the National Academies to complete the study under this section and transmit to the Congress a report on the results of the study not later than 24 months after the date of enactment of this Act.

SEC.

107.

CHILD CARE ACCESS.


(a) GRANT PROGRAM.—The Secretary of Health and Human Services (in this section referred to as the ‘‘Sec- retary’’) shall award grants to eligible organizations to provide pregnant and postpartum women with free drop- in child care services during prenatal and postpartum ap- pointments.
(b) ELIGIBLE ORGANIZATIONS.—To be eligible to re- ceive a grant under this section, an organization shall— (1) be an organization that carries out pro- grams providing pregnant and postpartum women with free and accessible drop-in child care services during prenatal and postpartum appointments in areas which the Secretary determines have a high maternal mortality and severe morbidity rate and •HR 6142 IH 16 significant racial and ethnic disparities in maternal health outcomes; and (2) not have previously received a grant under this section.
(c) DURATION.—The Secretary shall commence the grant program under subsection (a) not later than 1 year after the date of the enactment of this Act.
(d) EVALUATION.—The Secretary shall evaluate each grant awarded under this section to determine the effects 10 of the grant on— (1) prenatal and postpartum appointment at- tendance rates; (2) maternal health outcomes with a specific focus on racial and ethnic disparities in such out- comes; (3) pregnant and postpartum women partici- pating in the funded programs, and the families of such women; and (4) cost effectiveness.
(e) REPORT.—Not later than September 30, 2023, the Secretary shall submit to the Congress a report con- 22 taining the following: 23 24 (1) A summary of the evaluations under sub- section (d).
•HR 6142 IH 17 (2) A description of actions the Secretary can take to ensure that pregnant and postpartum women eligible for medical assistance under a State plan under title XIX of the Social Security Act (42 U.S.C.

1936 et seq.)
1936 et seq.)

have access to free drop-in child care services during prenatal and postpartum appointments, including identification of the funding necessary to carry out such actions.
(f) DROP-IN CHILD CARE SERVICES DEFINED.—In this section, the term ‘‘drop-in child care services’’ means child care and early childhood education services that are— (1) delivered at a facility that meets the re- quirements of all applicable laws and regulations of the State or local government in which it is located, including the licensing of the facility as a child care facility; and (2) provided in single encounters without re- quiring full-time enrollment of a person in a child care program.
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is authorized to be appropriated $1,000,000 for each of fiscal years 2021 through 2023 •HR 6142 IH SEC.

108.

GRANTS TO STATE, LOCAL, AND TRIBAL PUBLIC 18 HEALTH DEPARTMENTS ADDRESSING SOCIAL DETERMINANTS OF HEALTH FOR PREGNANT AND POSTPARTUM WOMEN.
(a) IN GENERAL.—The Secretary of Health and Human Services (in this section referred to as the ‘‘Sec- retary’’) shall award grants to State, local, and Tribal public health departments to address social determinants of maternal health in order to reduce or eliminate racial and ethnic disparities in maternal health outcomes.
(b) USE OF FUNDS.—A public health department re- ceiving a grant under this section may use funds received through the grant to— 26 (1) build capacity and hire staff to coordinate efforts of the public health department to address social determinants of maternal health; (2) develop, and provide for distribution of, re- source lists of available social services for women in the prenatal and postpartum periods, which social services may include— (A) transportation vouchers; (B) housing supports; (C) child care access; (D) healthy food access; (E) nutrition counseling; (F) lactation supports; •HR 6142 IH 19 (G) lead testing and abatement; (H) clean water; (I) infant formula; (J) maternal mental and behavioral health care services; (K) wellness and stress management pro- grams; and (L) other social services as determined by the public health department; (3) in consultation with local stakeholders, es- tablish or designate a ‘‘one-stop’’ resource center that provides coordinated social services in a single location for women in the prenatal or postpartum period; or (4) directly address specific social determinant needs for the community that are related to mater- nal health as identified by the public health depart- ment, such as— (A) transportation; (B) housing; (C) child care; (D) healthy foods; (E) infant formula; (F) nutrition counseling; (G) lactation supports; •HR 6142 IH 20 (H) lead testing and abatement; (I) air and water quality; (J) wellness and stress management pro- grams; and (K) other social determinants as deter- mined by the public health department.
(c) SPECIAL CONSIDERATION.—In awarding grants under subsection (a), the Secretary shall give special con- sideration to State, local, and Tribal public health depart- ments that— (1) propose to use the grants to reduce or end racial and ethnic disparities in maternal mortality and severe morbidity rates; and (2) operate in areas with high rates of— (A) maternal mortality and severe mor- bidity; or (B) significant racial and ethnic disparities in maternal mortality and severe morbidity rates.
(d) GUIDANCE ON STRATEGIES.—In carrying out this section, the Secretary shall provide guidance to grantees on strategies for long-term viability of programs funded through this section after such funding ends.
(e) REPORTING.— •HR 6142 IH 21 (1) BY GRANTEES.—As a condition on receipt of a grant under this section, a grantee shall agree to— (A) evaluate the activities funded through the grant with respect to— (i) maternal health outcomes with a specific focus on racial and ethnic dispari- ties; (ii) the subjective assessment of such activities by the beneficiaries of such ac- tivities, including mothers and their fami- lies; and (iii) cost effectiveness and return on investment; and (B) not later than 180 days after the end of the period of the grant, submit a report on the results of such evaluation to the Secretary.
(2) BY SECRETARY.—Not later than the end of fiscal year 2026, the Secretary shall submit a report to the Congress— (A) summarizing the evaluations submitted under paragraph (1); and (B) making recommendations for improv- ing maternal health and reducing or eliminating racial and ethnic disparities in maternal health •HR 6142 IH 22 outcomes, based on the results of grants under this section.
(f) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2021 through 2025.

TITLE II—HONORING KIRA JOHNSON SEC.

201.

INVESTMENTS IN COMMUNITY-BASED ORGANIZA- TIONS TO IMPROVE BLACK MATERNAL HEALTH OUTCOMES.
(a) AWARDS.—Following the 1-year period described in subsection (c), the Secretary of Health and Human Services (in this section referred to as the ‘‘Secretary’’), acting through the Administrator of the Health Resources and Services Administration, shall award grants to eligible entities to establish or expand programs to prevent mater- nal mortality and severe maternal morbidity among Black 18 women.
19 20 21 22 (b) ELIGIBILITY.—To be eligible to seek a grant under this section, an entity shall be a community-based organization offering programs and resources aligned with evidence-based practices for improving maternal health 23 outcomes for Black women.
•HR 6142 IH 23 (c) OUTREACH AND TECHNICAL ASSISTANCE PE- RIOD.—During the 1-year period beginning on the date of enactment of this Act, the Secretary shall— (1) conduct outreach to encourage eligible enti- ties to apply for grants under this section; and (2) provide technical assistance to eligible enti- ties on best practices for applying for grants under this section.
(d) SPECIAL CONSIDERATION.— (1) OUTREACH.—In conducting outreach under subsection (c), the Secretary shall give special con- sideration to eligible entities that— (A) are based in, and provide support for, communities with— (i) high rates of adverse maternal health outcomes; and (ii) significant racial and ethnic dis- parities in maternal health outcomes; (B) are led by Black women; and (C) offer programs and resources that are aligned with evidence-based practices for im- proving maternal health outcomes for Black women.
•HR 6142 IH 24 (2) AWARDS.—In awarding grants under this section, the Secretary shall give special consideration to eligible entities that— (A) are described in subparagraphs (A), (B), and (C) of paragraph (1); (B) offer programs and resources designed in consultation with and intended for Black women; and (C) offer programs and resources in the communities in which the respective eligible en- tities are located that— (i) promote maternal mental health and maternal substance use disorder treat- ments that are aligned with evidence-based practices for improving maternal mental health outcomes for Black women; (ii) address social determinants of health for women in the prenatal and postpartum periods, including— (I) housing; (II) transportation; (III) nutrition counseling; (IV) healthy foods; (V) lactation support; •HR 6142 IH (VI) lead abatement and other efforts to improve air and water qual- ity; (VII) child care access; (VIII) car seat installation; (IX) wellness and stress manage- ment programs; or (X) coordination across safety- net and social support services and programs; (iii) promote evidence-based health lit- eracy and pregnancy, childbirth, and par- enting education for women in the prenatal and postpartum periods; (iv) provide support from doulas and other perinatal health workers to women from pregnancy through the postpartum period; (v) provide culturally congruent train- ing to perinatal health workers such as doulas, community health workers, peer supporters,
 certified lactation consultants, nutritionists and dietitians, social workers, home visitors, and navigators; •HR 6142 IH 26 (vi) conduct or support research on Black maternal health issues; or (vii) have developed other programs and resources that address community-spe- cific needs for women in the prenatal and postpartum periods and are aligned with evidence-based practices for improving ma- ternal health outcomes for Black women.
(e) TECHNICAL ASSISTANCE.—The Secretary shall provide to grant recipients under this section technical as- 11 sistance on— (1) capacity building to establish or expand pro- grams to prevent adverse maternal health outcomes among Black women; (2) best practices in data collection, measure- ment, evaluation, and reporting; and (3) planning for sustaining programs to prevent maternal mortality and severe maternal morbidity among Black women after the period of the grant.
(f) EVALUATION.—Not later than the end of fiscal year 2026, the Secretary shall submit to the Congress an evaluation of the grant program under this section that— (1) assesses the effectiveness of outreach efforts during the application process in diversifying the pool of grant recipients; •HR 6142 IH 27 (2) makes recommendations for future outreach efforts to diversify the pool of grant recipients for Department of Health and Human Services grant programs and funding opportunities; (3) assesses the effectiveness of programs fund- ed by grants under this section in improving mater- nal health outcomes for Black women; and (4) makes recommendations for future Depart- ment of Health and Human Services grant programs and funding opportunities that deliver funding to community-based organizations to improve Black maternal health outcomes through programs and re- sources that are aligned with evidence-based prac- tices for improving maternal health outcomes for Black women.
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is authorized to be appropriated $5,000,000 for each of fiscal years 2021 through 2025.

SEC.

202.

TRAINING FOR ALL EMPLOYEES IN MATERNITY CARE SETTINGS.

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 the following new section •HR 6142 IH 28 ‘‘SEC.

742.

TRAINING FOR ALL EMPLOYEES IN MATERNITY CARE SETTINGS.
‘‘(a) GRANTS.—The Secretary shall award grants for programs to reduce and prevent bias, racism, and dis- crimination in maternity care settings.
‘‘(b) SPECIAL CONSIDERATION.—In awarding grants under subsection (a), the Secretary shall give special con- sideration to applications for programs that would— ‘‘(1) apply to all birthing professionals and any employees who interact with pregnant and postpar- tum women in the provider setting, including front desk employees, sonographers, schedulers, health care professionals, hospital or health system admin- istrators, and security staff; ‘‘(2) emphasize periodic, as opposed to one- time, trainings for all birthing professionals and em- ployees described in paragraph (1); ‘‘(3) address implicit bias and explicit bias; ‘‘(4) be delivered in ongoing education settings for providers maintaining their licenses, with a pref- erence for trainings that provide continuing edu- cation units and continuing medical education; ‘‘(5) include trauma-informed care best prac- tices and an emphasis on shared decision making be- tween providers and patients; •HR 6142 IH 29 ‘‘(6) include a service-learning component that sends providers to work in underserved communities to better understand patients’ lived experiences; ‘‘(7) be delivered in undergraduate programs that funnel into medical schools, like biology and pre-medicine majors; ‘‘(8) be delivered in settings that apply to pro- viders of the special supplemental nutrition program for women, infants, and children under section 17 of the Child Nutrition Act of 1966; ‘‘(9) integrate bias training in obstetric emer- gency simulation trainings; ‘‘(10) offer training to all maternity care pro- viders on the value of racially, ethnically, and profes- sionally diverse maternity care teams to provide cul- turally congruent care, including doulas, community health workers, peer supporters, certified lactation consultants, nutritionists and dietitians, social work- ers, home visitors, and navigators; or ‘‘(11) be based on one or more programs de- signed by a historically Black college or university.
‘‘(c) APPLICATION.—To seek a grant under sub- section (a), an entity shall submit an application at such time, in such manner, and containing such information as the Secretary may require.
•HR 6142 IH 30 ‘‘(d) REPORTING.—Each recipient of a grant under this section shall annually submit to the Secretary a report on the status of activities conducted using the grant, in- cluding, as applicable, a description of the impact of train- ing provided through the grant on patient outcomes and patient experience for women of color and their families.
‘‘(e) BEST PRACTICES.—Based on the annual reports submitted pursuant to subsection (d), the Secretary— ‘‘(1) shall produce an annual report on the find- ings resulting from programs funded through this section; ‘‘(2) shall disseminate such report to all recipi- ents of grants under this section and to the public; and ‘‘(3) may include in such report findings on best practices for improving patient outcomes and patient experience for women of color and their fam- ilies in maternity care settings.
‘‘(f) DEFINITIONS.—In this section: ‘‘(1) The term ‘postpartum’ means the one-year period beginning on the last day of a woman’s preg- nancy.
‘‘(2) The term ‘culturally congruent’ means in agreement with the preferred cultural values, beliefs, •HR 6142 IH 31 worldview, and practices of the health care consumer and other stakeholders.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is authorized to be appro- priated $5,000,000 for each of fiscal years 2021 through 2025.’’.

SEC.

203.

STUDY ON REDUCING AND PREVENTING BIAS, RACISM, AND DISCRIMINATION IN MATER- NITY CARE SETTINGS.
(a) IN GENERAL.—The Secretary of Health and Human Services shall seek to enter into an agreement, not later than 90 days after the date of enactment of this Act, with the National Academies of Sciences, Engineer- ing, and Medicine (referred to in this section as the ‘‘Na- tional Academies’’) under which the National Academies agrees to— (1) conduct a study on the design and imple- mentation of programs to reduce and prevent bias, racism, and discrimination in maternity care set- tings; and (2) not later than 24 months after the date of enactment of this Act, complete the study and trans- mit a report on the results of the study to the Con- gress.
•HR 6142 IH 32 (b) POSSIBLE TOPICS.—The agreement entered into pursuant to subsection (a) may provide for the study of any of the following: (1) The development of a scorecard for pro- grams designed to reduce and prevent bias, racism, and discrimination in maternity care settings to as- sess the effectiveness of such programs in improving patient outcomes and patient experience for women of color and their families.
(2) Determination of the types of training to re- duce and prevent bias, racism, and discrimination in maternity care settings that are demonstrated to im- prove patient outcomes or patient experience for women of color and their families.

SEC.

204.

RESPECTFUL MATERNITY CARE COMPLIANCE PROGRAM.


(a) IN GENERAL.—The Secretary of Health and Human Services (referred to in this section as the ‘‘Sec- retary’’) shall award grants to accredited hospitals, health systems, and other maternity care delivery settings to es- tablish within one or more hospitals or other birth settings a respectful maternity care compliance office.
(b) OFFICE REQUIREMENTS.—A respectful maternity care compliance office funded through a grant under this section shall— •HR 6142 IH 33 (1) institutionalize mechanisms to allow pa- tients receiving maternity care services, the families of such patients, or doulas or other perinatal work- ers supporting such patients to report instances of disrespect or evidence of bias on the basis of race, ethnicity, or another protected class; (2) institutionalize response mechanisms through which representatives of the office can di- rectly follow up with the patient, if possible, and the patient’s family in a timely manner; (3) prepare and make publicly available a hospital- or health system-wide strategy to reduce bias on the basis of race, ethnicity, or another pro- tected class in the delivery of maternity care that in- cludes— (A) information on the training programs to reduce and prevent bias, racism, and dis- crimination on the basis of race, ethnicity, or another protected class for all employees in ma- ternity care settings; and (B) the development of methods to rou- tinely assess the extent to which bias, racism, or discrimination on the basis of race, ethnicity, or another protected class are present in the de- •HR 6142 IH 34 livery of maternity care to minority patients; and (4) provide annual reports to the Secretary with information about each case reported to the compli- ance office over the course of the year containing such information as the Secretary may require, such as— (A) de-identified demographic information on the patient in the case, such as race, eth- nicity, gender identity, and primary language; (B) the content of the report from the pa- tient or the family of the patient to the compli- ance office; and (C) the response from the compliance of- fice.
(c) SECRETARY REQUIREMENTS.— (1) PROCESSES.—Not later than 180 days after the date of enactment of this Act, the Secretary shall establish processes for— (A) disseminating best practices for estab- lishing and implementing a respectful maternity care compliance office within a hospital or other birth setting; (B) promoting coordination and collabora- tion between hospitals, health systems, and •HR 6142 IH 35 other maternity care delivery settings on the es- tablishment and implementation of respectful maternity care compliance offices; and (C) evaluating the effectiveness of respect- ful maternity care compliance offices on mater- nal health outcomes and patient and family ex- periences, especially for minority patients and their families.
(2) STUDY.— (A) IN GENERAL.—Not later than 2 years after the date of enactment of this Act, the Sec- retary shall, through a contract with an inde- pendent research organization, conduct a study on strategies to address disrespect or bias on the basis of race, ethnicity, or another protected class in the delivery of maternity care services.
(B) COMPONENTS OF STUDY.—The study shall include the following: (i) An assessment of the reports sub- mitted to the Secretary from the respectful maternity care compliance offices pursuant to subsection (b)(4); and (ii) Based on such assessment, rec- ommendations for potential accountability mechanisms related to cases of disrespect •HR 6142 IH 36 or bias on the basis of race, ethnicity, or another protected class in the delivery of maternity care services at hospitals and other birth settings.
Such recommenda- tions shall take into consideration medical and non-medical factors that contribute to adverse patient experiences and maternal health outcomes.

(C) REPORT.—The Secretary shall submit to the Congress and make publicly available a report on the results of the study under this paragraph.
(d) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2021 through 2026.

17 SEC.

205.

GAO REPORT.


(a) IN GENERAL.—Not later than 2 years after date of enactment of this Act and every 2 years thereafter, the Comptroller General of the United States shall submit to the Congress and make publicly available a report on the establishment of respectful maternity care compliance of- fices within hospitals, health systems, and other maternity 24 care settings.
•HR 6142 IH 37 (b) MATTERS INCLUDED.—The report under para- graph (1) shall include the following: (1) Information regarding the extent to which hospitals, health systems, and other maternity care settings have elected to establish respectful mater- nity care compliance offices, including— (A) which hospitals and other birth set- tings elect to establish compliance offices and when such offices are established; (B) to the extent practicable, impacts of the establishment of such offices on maternal health outcomes and patient and family experi- ences in the hospitals and other birth settings that have established such offices, especially for minority women and their families; (C) information on geographic areas, and types of hospitals or other birth settings, where respectful maternity care compliance offices are not being established and information on fac- tors contributing to decisions to not establish such offices; and (D) recommendations for establishing re- spectful maternity care compliance offices in ge- ographic areas, and types of hospitals or other •HR 6142 IH 38 birth settings, where such offices are not being established.
(2) Whether the funding made available to carry out this section has been sufficient and, if ap- plicable, recommendations for additional appropria- tions to carry out this section.

(3) Such other information as the Comptroller General determines appropriate.

TITLE III—PROTECTING MOMS WHO SERVED SEC.

301.

SUPPORT FOR MATERNITY CARE COORDINATION.


(a) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to the Secretary of Veterans Affairs $15,000,000 for fiscal year 2022 to improve ma- ternity care coordination for women veterans throughout pregnancy and the one-year postpartum period beginning on the last day of the pregnancy.

Such amounts are au- thorized in addition to any other amounts authorized for such purpose.
(b) PLAN.— (1) IN GENERAL.—Not later than one year after the date of the enactment of this Act, the Sec- retary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representa- tives a plan to improve maternity care coordination •HR 6142 IH 39 to fulfill the responsibilities and requirements de- scribed in the Veterans Health Administration Handbook 1330.03, or any successor handbook.
(2) ELEMENTS.—The plan under paragraph (1) shall include the following: (A) With respect to the amounts author- ized to be appropriated by subsection (a), a de- scription of how the Secretary will ensure such amounts are used to— (i) hire full-time maternity care coor- dinators; (ii) train maternity care coordinators; and (iii) improve support programs led by maternity care coordinators.
(B) Recommendations for the amount of funding the Secretary determines appropriate to improve maternity care coordination as de- scribed in paragraph (1) for each of the five fis- cal years following the date of the plan.
(3) CONSULTATION.—The Secretary shall de- velop the plan under paragraph (1) in consultation with veterans service organizations, military service organizations, women’s health care providers, and community-based organizations representing women •HR 6142 IH 40 from demographic groups disproportionately im- pacted by poor maternal health outcomes, that the Secretary determines appropriate.
SEC.

302.

SENSE OF CONGRESS ON VETERAN STATUS RE- QUIREMENTS.

It is the sense of Congress that each State should list the veteran status of a mother— (1) in fetal death records; and (2) in maternal mortality review committee re- views of pregnancy-related deaths and pregnancy-as- sociated deaths.

SEC.

303.

REPORT ON MATERNAL MORTALITY AND SEVERE MATERNAL MORBIDITY AMONG WOMEN VET- ERANS.
(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 Commit- tees on Veterans’ Affairs of the Senate and the House of Representatives, and make publicly available, a report on maternal mortality and severe maternal morbidity among women veterans, with a particular focus on racial and eth- nic disparities in maternal health outcomes for women vet- erans.
24 25 (b) MATTERS INCLUDED.—The report under sub- section (a) shall include the following: •HR 6142 IH 41 (1) To the extent practicable— (A) the number of women 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 women veterans; (C) the number of cases of severe maternal morbidity among women veterans in the most recent year of available data; (D) the racial and ethnic disparities in ma- ternal mortality and severe maternal morbidity rates among women veterans; (E) identification of the causes of maternal mortality and severe maternal morbidity that are unique to women who have served in the military, including post-traumatic stress dis- order, military sexual trauma, and infertility or miscarriages that may be caused by such serv- ice; (F) identification of the causes of maternal mortality and severe maternal morbidity that are unique to women veterans of color; and •HR 6142 IH 42 (G) identification of any correlations be- tween the former rank of women veterans and their maternal health outcomes.
(2) An assessment of the barriers to deter- mining the information required under paragraph (1) and recommendations for improvements in track- ing maternal health outcomes among— (A) women veterans who have health care coverage through the Department; (B) women veterans enrolled in the TRICARE program; (C) women veterans with employer-based or private insurance; and (D) women veterans enrolled in the Med- icaid program.
(3) Recommendations for legislative and admin- istrative actions to increase access to mental and be- havioral health care for women veterans who screen positively for postpartum mental or behavioral health conditions.

(4) Recommendations to address homelessness among pregnant and postpartum women veterans.
(5) Recommendations on how to effectively edu- cate maternity care providers on best practices for providing maternity care services to women veterans •HR 6142 IH 43 that addresses the unique maternal health care needs of veteran populations.
(6) Recommendations to reduce maternal mor- tality and severe maternal morbidity among women veterans and to address racial and ethnic disparities in maternal health outcomes for each of the groups described in subparagraphs (A) through (D) of para- graph (2).
(7) Recommendations to improve coordination of care between the Department and non-Depart- ment facilities for pregnant and postpartum women veterans, including recommendations to improve training for the directors of the Veterans Integrated Service Networks, directors of medical facilities of the Department, chiefs of staff of such facilities, ma- ternity care coordinators, and relevant non-Depart- ment facilities.
(8) An assessment of the authority of the Sec- retary 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) Any other information the Comptroller Gen- eral determines appropriate with respect to the re- duction of maternal mortality and severe maternal •HR 6142 IH 44 morbidity among women veterans and to address ra- cial and ethnic disparities in maternal health out- comes for women veterans.
TITLE IV—PERINATAL WORKFORCE SEC.

401.

HHS AGENCY DIRECTIVES.

(a) GUIDANCE TO STATES.— (1) IN GENERAL.—Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall issue and dissemi- nate guidance to States to educate providers and managed care entities about the value and process of delivering respectful maternal health care through diverse care provider models.
(2) CONTENTS.—The guidance required by paragraph (1) shall address how States can encour- age and incentivize hospitals, health systems, free- standing birth centers, other maternity care provider groups, and managed care entities— (A) to recruit and retain maternity care providers, such as obstetrician-gynecologists, family physicians, physician assistants, mid- wives who meet at a minimum the international definition of the midwife and global standards for midwifery education as established by the •HR 6142 IH 45 International Confederation of Midwives, nurse practitioners, and clinical nurse specialists— (i) from racially and ethnically diverse backgrounds; (ii) with experience practicing in ra- cially and ethnically diverse communities; and (iii) who have undergone trainings on implicit and explicit bias and racism; (B) to incorporate into maternity care teams midwives who meet at a minimum the international definition of the midwife and glob- al standards for midwifery education as estab- lished by the International Confederation of Midwives, doulas, community health workers, peer supporters, certified lactation consultants, nutritionists and dietitians, social workers, home visitors, and navigators; (C) to provide collaborative, culturally con- gruent care; and (D) to provide opportunities for individuals enrolled in accredited midwifery education pro- grams to participate in job shadowing with ma- ternity care teams in hospitals, health systems, and freestanding birth centers.
•HR 6142 IH 46 (b) STUDY ON CULTURALLY CONGRUENT MATER- NITY CARE.— (1) STUDY.—The Secretary of Health and Human Services acting through the Director of the National Institutes of Health (in this subsection re- ferred to as the ‘‘Secretary’’) shall conduct a study on best practices in culturally congruent maternity care.
(2) REPORT.—Not later than 2 years after the date of enactment of this Act, the Secretary shall— (A) complete the study required by para- graph (1); (B) submit to the Congress and make pub- licly available a report on the results of such study; and (C) include in such report— (i) a compendium of examples of hos- pitals, health systems, freestanding birth centers, other maternity care provider groups, and managed care entities that are delivering culturally congruent maternal health care; (ii) a compendium of examples of hos- pitals, health systems, freestanding birth centers, other maternity care provider •HR 6142 IH 47 groups, and managed care entities that have low levels of racial and ethnic dispari- ties in maternal health outcomes; and (iii) recommendations to hospitals, health systems, freestanding birth centers, other maternity care provider groups, and managed care entities for best practices in culturally congruent maternity care.
SEC.

402.

GRANTS TO GROW AND DIVERSIFY THE PERINATAL WORKFORCE.

Title VII of the Public Health Service Act is amended by inserting after section 757 (42 U.S.C.

294f) the fol- lowing new section: 14 15 16 17 ‘‘SEC.

758.

PERINATAL WORKFORCE GRANTS.

‘‘(a) IN GENERAL.—The Secretary may award grants to entities to establish or expand programs described in subsection (b) to grow and diversify the perinatal work- 18 force.
19 20 ‘‘(b) USE OF FUNDS.—Recipients of grants under this section shall use the grants to grow and diversify the 21 perinatal workforce by— 22 23 24 ‘‘(1) establishing schools or programs that pro- vide education and training to individuals seeking appropriate licensing or certification as— •HR 6142 IH 48 ‘‘(A) physician assistants who will complete clinical training in the field of maternal and perinatal health; and ‘‘(B) other perinatal health workers such as doulas, community health workers, peer sup- porters, certified lactation consultants, nutri- tionists and dietitians, social workers, home visitors, and navigators; and ‘‘(2) expanding the capacity of existing schools or programs described in paragraph (1), for the pur- poses of increasing the number of students enrolled in such schools or programs, including by awarding scholarships for students.
‘‘(c) PRIORITIZATION.—In awarding grants under this section, the Secretary shall give priority to any insti- tution of higher education that— ‘‘(1) has demonstrated a commitment to re- cruiting and retaining minority students, particu- larly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity; ‘‘(2) has developed a strategy to recruit and re- tain a diverse pool of students into the perinatal workforce program or school supported by funds re- ceived through the grant, particularly from demo- •HR 6142 IH 49 graphic groups experiencing high rates of maternal mortality and severe maternal morbidity; ‘‘(3) has developed a strategy to recruit and re- tain students who plan to practice in a health pro- fessional shortage area designated under section 332; ‘‘(4) has developed a strategy to recruit and re- tain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes; and ‘‘(5) includes in the standard curriculum for all students within the perinatal workforce program or school a bias, racism, or discrimination training pro- gram that includes training on explicit and implicit bias.
‘‘(d) REPORTING.—As a condition on receipt of a grant under this section for a perinatal workforce program or school, an entity shall agree to submit to the Secretary an annual report on the activities conducted through the grant, including— 21 22 23 24 ‘‘(1) the number and demographics of students participating in the program or school; ‘‘(2) the extent to which students in the pro- gram or school are entering careers in— •HR 6142 IH 50 ‘‘(A) health professional shortage areas designated under section 332; and ‘‘(B) areas with significant racial and eth- nic disparities in maternal health outcomes; and ‘‘(3) whether the program or school has in- cluded in the standard curriculum for all students a bias, racism, or discrimination training program that includes explicit and implicit bias, and if so the ef- fectiveness of such training program.
‘‘(e) PERIOD OF GRANTS.—The period of a grant under this section shall be up to 5 years.

‘‘(f) APPLICATION.—To seek a grant under this sec- tion, an entity shall submit to the Secretary an application at such time, in such manner, and containing such infor- mation as the Secretary may require, including any infor- mation necessary for prioritization under subsection (c).
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall provide, directly or by contract, technical assistance to in- stitutions of higher education seeking or receiving a grant under this section on the development, use, evaluation, and post-grant period sustainability of the perinatal work- force programs or schools proposed to be, or being, estab- lished or expanded through the grant.
‘‘(h) REPORT BY SECRETARY.—Not later than 4 years after the date of enactment of this section, the Sec- •HR 6142 IH 51 retary shall prepare and submit to the Congress, and post on the internet website of the Department of Health and Human Services, a report on the effectiveness of the grant program under this section at— ‘‘(1) recruiting minority students, particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity; ‘‘(2) increasing the number of physician assist- ants who will complete clinical training in the field of maternal and perinatal health, and other perinatal health workers, from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity; ‘‘(3) increasing the number of physician assist- ants who will complete clinical training in the field of maternal and perinatal health, and other perinatal health workers, working in health profes- sional shortage areas designated under section 332; and ‘‘(4) increasing the number of physician assist- ants who will complete clinical training in the field of maternal and perinatal health, and other perinatal health workers, working in areas with sig- nificant racial and ethnic disparities in maternal health outcomes.
•HR 6142 IH 52 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is authorized to be appro- priated $15,000,000 for each of fiscal years 2021 through 2025.’’.

SEC.

403.

GRANTS TO GROW AND DIVERSIFY THE NURSING WORKFORCE IN MATERNAL AND PERINATAL HEALTH.
Title VIII of the Public Health Service Act is amend- ed by inserting after section 811 of that Act (42 U.S.C.

1 296j) the following: 11 12 13 ‘‘SEC.

812.

PERINATAL NURSING WORKFORCE GRANTS.

‘‘(a) IN GENERAL.—The Secretary may award grants to schools of nursing to grow and diversify the perinatal 14 nursing workforce.
15 16 17 ‘‘(b) USE OF FUNDS.—Recipients of grants under this section shall use the grants to grow and diversify the perinatal nursing workforce by providing scholarships to 18 students seeking to become— ‘‘(1) nurse practitioners whose education in- cludes a focus on maternal and perinatal health; or ‘‘(2) clinical nurse specialists whose education includes a focus on maternal and perinatal health.
‘‘(c) PRIORITIZATION.—In awarding grants under this section, the Secretary shall give priority to any school 25 of nursing that— •HR 6142 IH 53 ‘‘(1) has developed a strategy to recruit and re- tain a diverse pool of students seeking to enter ca- reers focused on maternal and perinatal health; ‘‘(2) has developed a partnership with a prac- tice setting in a health professional shortage area designated under section 332 for the clinical place- ments of the school’s students; ‘‘(3) has developed a strategy to recruit and re- tain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes; and ‘‘(4) includes in the standard curriculum for all students seeking to enter careers focused on mater- nal and perinatal health a bias, racism, or discrimi- nation training program that includes education on explicit and implicit bias.
‘‘(d) REPORTING.—As a condition on receipt of a grant under this section, a school of nursing shall agree to submit to the Secretary an annual report on the activi- ties conducted through the grant, including, to the extent practicable— 22 23 24 ‘‘(1) the number and demographics of students in the school of nursing seeking to enter careers fo- cused on maternal and perinatal health; •HR 6142 IH 54 ‘‘(2) the extent to which such students are pre- paring to enter careers in— ‘‘(A) health professional shortage areas designated under section 332; and ‘‘(B) areas with significant racial and eth- nic disparities in maternal health outcomes; and ‘‘(3) whether the standard curriculum for all students seeking to enter careers focused on mater- nal and perinatal health includes a bias, racism, or discrimination training program that includes edu- cation on explicit and implicit bias.
‘‘(e) PERIOD OF GRANTS.—The period of a grant under this section shall be up to 5 years.

‘‘(f) APPLICATION.—To seek a grant under this sec- tion, an entity shall submit to the Secretary an applica- tion, at such time, in such manner, and containing such information as the Secretary may require, including any information necessary for prioritization under subsection (c).
20 21 22 23 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall provide, directly or by contract, technical assistance to schools of nursing seeking or receiving a grant under this section on the processes of awarding and evaluating schol- 24 arships through the grant.
•HR 6142 IH 55 ‘‘(h) REPORT BY SECRETARY.—Not later than 4 years after the date of enactment of this section, the Sec- retary shall prepare and submit to the Congress, and post on the internet website of the Department of Health and Human Services, a report on the effectiveness of the grant program under this section at— ‘‘(1) recruiting minority students, particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity; ‘‘(2) increasing the number of nurse practi- tioners and clinical nurse specialists entering careers focused on maternal and perinatal health from de- mographic groups experiencing high rates of mater- nal mortality and severe maternal morbidity; ‘‘(3) increasing the number of nurse practi- tioners and clinical nurse specialists entering careers focused on maternal and perinatal health working in health professional shortage areas designated under section 332; and ‘‘(4) increasing the number of nurse practi- tioners and clinical nurse specialists entering careers focused on maternal and perinatal health working in areas with significant racial and ethnic disparities in maternal health outcomes.
•HR 6142 IH 56 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is authorized to be appro- priated $15,000,000 for each of fiscal years 2021 through 2025.’’.

SEC.

404.

GAO REPORT ON BARRIERS TO MATERNITY CARE.


(a) IN GENERAL.—Not later than two years after the date of the enactment of this Act and every five years thereafter, the Comptroller General of the United States shall submit to Congress a report on barriers to maternity care in the United States.

Such report shall include the information and recommendations described in subsection (b).
13 (b) CONTENT OF REPORT.—The report under sub- 14 section (a) shall include— (1) an assessment of current barriers to enter- ing accredited midwifery education programs, and recommendations for addressing such barriers, par- ticularly for low-income and minority women; (2) an assessment of current barriers to enter- ing accredited education programs for other mater- nity care professional careers, including obstetrician- gynecologists, family physicians, physician assist- ants, nurse practitioners, and clinical nurse special- ists, particularly for low-income and minority women; •HR 6142 IH 57 (3) an assessment of current barriers that pre- vent midwives from meeting the international defini- tion of the midwife and global standards for mid- wifery education as established by the International Confederation of Midwives, and recommendations for addressing such barriers, particularly for low-in- come and minority women; and (4) recommendations to promote greater equity in compensation for perinatal health workers, par- ticularly for such individuals from racially and eth- nically diverse backgrounds.
TITLE V—DATA TO SAVE MOMS SEC.

501.

FUNDING FOR MATERNAL MORTALITY REVIEW COMMITTEES TO PROMOTE REPRESENTA- TIVE COMMUNITY ENGAGEMENT.

(a) IN GENERAL.—Section 317K(d) of the Public Health Service Act (42 U.S.C.
247b–12(d)) is amended by adding at the end the following: ‘‘(9) GRANTS TO PROMOTE REPRESENTATIVE COMMUNITY ENGAGEMENT IN MATERNAL MOR- TALITY REVIEW COMMITTEES.— ‘‘(A) IN GENERAL.—The Secretary may, using funds made available pursuant to sub- paragraph (C), provide assistance to an applica- ble maternal mortality review committee of a •HR 6142 IH 58 State, Indian tribe, tribal organization, or urban Indian organization (as such term is de- fined in section 4 of the Indian Health Care Improvement Act (25 U.S.C.
1603))— ‘‘(i) to select for inclusion in the mem- bership of such a committee community members from the State, Indian tribe, trib- al organization, or urban Indian organiza- tion by— ‘‘(I) prioritizing community mem- bers who can increase the diversity of the committee’s membership with re- spect to race and ethnicity, location, and professional background, includ- ing members with non-clinical experi- ences; and ‘‘(II) to the extent applicable, using funds reserved under subsection (f) to address barriers to maternal mortality review committee participa- tion for community members, includ- ing required training, transportation barriers, compensation, and other sup- ports as may be necessary; •HR 6142 IH 59 ‘‘(ii) to establish initiatives to conduct outreach and community engagement ef- forts within communities throughout the State or Tribe to seek input from commu- nity members on the work of such mater- nal mortality review committee, with a par- ticular focus on outreach to minority women; and ‘‘(iii) to release public reports assess- ing— ‘‘(I) the pregnancy-related death and pregnancy-associated death review processes of the maternal mortality review committee, with a particular focus on the maternal mortality re- view committee’s sensitivity to the unique circumstances of minority women who have suffered pregnancy- related deaths; and ‘‘(II) the impact of the use of funds made available pursuant to paragraph (C) on increasing the diver- sity of the maternal mortality review committee membership and promoting •HR 6142 IH 60 community engagement efforts throughout the State or Tribe.
‘‘(B) TECHNICAL ASSISTANCE.—The Sec- retary shall provide (either directly through the Department of Health and Human Services or by contract) technical assistance to any mater- nal mortality review committee receiving a grant under this paragraph on best practices for increasing the diversity of the maternal mortality review committee’s membership and for conducting effective community engagement throughout the State or Tribe.
‘‘(C) AUTHORIZATION OF APPROPRIA- TIONS.—In addition to any funds made avail- able under subsection (f), there are authorized to be appropriated to carry out this paragraph $10,000,000 for each of fiscal years 2021 through 2025.’’.

(b) RESERVATION OF FUNDS.—Section 317K(f) of the Public Health Service Act (42 U.S.C.
247b–12(f)) is amended by adding at the end the following: ‘‘Of the amount made available under the preceding sentence for a fiscal year, not less than $1,500,000 shall be reserved for grants to Indian tribes, tribal organizations, or urban Indian organizations (as such term is defined in section •HR 6142 IH of the Indian Health Care Improvement Act (25 U.S.C.
61 1603))’’.

SEC.

502.

DATA COLLECTION AND REVIEW.

(a) IN GENERAL.—Section 317K(d)(3)(A)(i) of the Public Health Service Act (42 U.S.C.
247b– 12(d)(3)(A)(i)) is amended— (1) by redesignating subclauses (II) and (III) as subclauses (V) and (VI), respectively; and (2) by inserting after subclause (I) the fol- lowing: ‘‘(II) to the extent practicable, reviewing cases of severe maternal morbidity in which the patient re- ceived a transfusion of four or more units of blood and was admitted to an intensive care unit; ‘‘(III) to the extent practicable, consulting with local community-based organizations representing women from demographic groups dispropor- tionately impacted by poor maternal health outcomes to ensure that, in ad- dition to clinical factors, non-clinical factors that might have contributed to •HR 6142 IH 62 a pregnancy-related death are appro- priately considered;’’.
(b) SEVERE MATERNAL MORBIDITY DEFINED.—Sec- tion 317K(e) of the Public Health Service Act (42 U.S.C.

247b–12(e)) is amended— (1) in paragraph (2), by striking ‘‘and’’ at the end; (2) in paragraph (3), by striking the period at the end and inserting ‘‘; and’’; and (3) by adding at the end the following: ‘‘(4) the term ‘severe maternal morbidity’ means one or more unexpected outcomes of labor and delivery that result in significant short-term or long-term consequences to a woman’s health.’’.

SEC.

503.
SEC.

503.

TASK FORCE ON MATERNAL HEALTH DATA AND QUALITY MEASURES.

(a) ESTABLISHMENT.—Not later than 180 days after the date of enactment of this Act, the Secretary of Health and Human Services shall establish a task force, to be known as the Task Force on Maternal Health Data and Quality Measures (in this section referred to as the ‘‘Task Force’’).
23 24 25 (b) DUTIES OF TASK FORCE.— (1) IN GENERAL.—The Task Force shall use all available relevant information, including information •HR 6142 IH 63 from State-level sources, to prepare and submit a re- port containing the following: (A) An evaluation of current State and Tribal practices for maternal health, maternal mortality, and severe maternal morbidity data collection and dissemination, including consider- ation of— (i) the timeliness of processes for amending a death certificate when new in- formation pertaining to the death becomes available to reflect whether the death was a pregnancy-related death; (ii) maternal health data collected with electronic health records, including data on race and ethnicity; (iii) the barriers preventing States from correlating maternal outcome data with race and ethnicity data; (iv) processes for determining the cause of a pregnancy-associated death in States that do not have a maternal mor- tality review committee; (v) whether maternal mortality review committees include multidisciplinary and diverse membership (as described in sec- •HR 6142 IH 64 tion 317K(d)(1)(A) of the Public Health Service Act (42 U.S.C.
247b–12(d)(1)(A)); (vi) whether members of maternal mortality review committees participate in trainings on bias, racism, or discrimina- tion, and the quality of such trainings; (vii) the extent to which States have implemented systematic processes of listen- ing to the stories of pregnant and postpar- tum women and their family members, with a particular focus on minority women and their family members, to fully under- stand the causes of, and inform potential solutions to, the maternal mortality and se- vere maternal morbidity crisis within their respective States; (viii) the consideration of social deter- minants of health by maternal mortality review committees when examining the causes of pregnancy-associated and preg- nancy-related deaths; (ix) the legal barriers preventing the collation of State maternity care data; (x) the effectiveness of data collection and reporting processes in separating preg- •HR 6142 IH 65 nancy-associated deaths from pregnancy- related deaths; and (xi) the current Federal, State, local, and Tribal funding support for the activi- ties referred to in clauses (i) through (x).
(B) An assessment of whether the funding referred to in subparagraph (A)(xi) is adequate for States to carry out optimal data collection and dissemination processes with respect to ma- ternal health, maternal mortality, and severe maternal morbidity.

(C) An evaluation of current quality meas- ures for maternity care, including prenatal measures, labor and delivery measures, and postpartum measures up to one year postpar- tum.
Such evaluation shall be conducted in con- sultation with the National Quality Forum and shall include consideration of— (i) effective quality measures for ma- ternity care used by hospitals, health sys- tems, birth centers, health plans, and other relevant entities; (ii) the sufficiency of current outcome measures used to evaluate maternity care for testing and validating new maternal •HR 6142 IH 66 health care payment and service delivery models; (iii) quality measures for the child- birth experiences of women that other countries effectively use; (iv) current maternity care quality measures that may be eliminated because they are not achieving their intended ef- fect; (v) barriers preventing maternity care providers from implementing quality meas- ures that are aligned from best practices; (vi) the frequency with which mater- nity care quality measures are reviewed and revised; (vii) the strengths and weaknesses of the Prenatal and Postpartum Care meas- ures of the Health Plan Employer Data and Information Set measures established by the National Committee for Quality As- surance; (viii) the strengths and weaknesses of maternity care quality measures under the Medicaid program under title XIX of the Social Security Act (42 U.S.C.
1396 et •HR 6142 IH 67 seq.)

and the Children’s Health Insurance Program under title XXI of such Act (42 U.S.C.

1397 et seq.
), including the extent to which States voluntarily report relevant measures; (ix) the extent to which maternity care quality measures are informed by pa- tient experiences that include subjective measures of patient-reported experience of care; (x) the current processes for collecting stratified data on the race and ethnicity of pregnant and postpartum women in hos- pitals, health systems, and birth centers, and for incorporating such racially and ethnically stratified data in maternity care quality measures; (xi) the extent to which maternity care quality measures account for the unique experiences of minority women and their families; and (xii) the extent to which hospitals, health systems, and birth centers are im- plementing existing maternity care quality measures.
•HR 6142 IH 68 (D) Recommendations on authorizing addi- tional funds to improve maternal mortality re- view committees and relevant maternal health initiatives by the agencies and organizations within the Department of Health and Human Services.
(E) Recommendations for new authorities that may be granted to maternal mortality re- view committees to be able to— (i) access records from other Federal and State agencies and departments that may be necessary to identify causes of pregnancy-associated deaths that are unique to women from specific populations, such as women veterans and women who are incarcerated; and (ii) work with relevant experts who are not members of the maternal mortality review committee to assist in the review of pregnancy-associated deaths of women from specific populations, such as women veterans and women who are incarcerated.
(F) Recommendations to improve current quality measures for maternity care, including recommendations on updating the Pregnancy & •HR 6142 IH 69 Delivery Care measures on the Hospital Com- pare website of the Centers for Medicare & Medicaid Services or any successor website, with a particular focus on racial and ethnic dis- parities in maternal health outcomes.
(G) Recommendations to improve the co- ordination by the Department of Health and Human Services of the efforts undertaken by the agencies and organizations within the De- partment related to maternal health data and quality measures.
(2) PUBLIC COMMENT.—Not later than 60 days after the date on which a majority of the members of the Task Force have been appointed, the Task Force shall publish in the Federal Register a notice for public comment period of 90 days, beginning on the date of publication, on the duties and activities of the Task Force.

(c) MEMBERSHIP.— (1) IN GENERAL.—The Task Force shall be composed of 18 members appointed by the Secretary of Health and Human Services.
The Secretary shall give special consideration to individuals who are rep- resentative of populations most affected by maternal mortality and severe maternal morbidity.
•HR 6142 IH 70 (2) MEMBER CRITERIA.—To be eligible to be appointed as a member of the Task Force, an indi- vidual shall be— (A) a woman who has experienced severe maternal morbidity; (B) a family member of a woman who had a pregnancy-related death; (C) an individual who provides non-clinical support to women from pregnancy through the postpartum period, such as a doula, community health worker, peer supporter, certified lacta- tion consultant, nutritionist or dietitian, social worker, home visitor, or a patient navigator; (D) a leader of a community-based organi- zation that addresses adverse maternal health outcomes with a specific focus on racial and ethnic disparities; (E) an academic researcher in a field or policy area related to the duties of the Task Force; (F) a maternal health care provider; (G) an elected or duly appointed leader from an Indian Tribe; (H) an expert in a field or policy area re- lated to the duties of the Task Force; or •HR 6142 IH 71 (I) an individual who has experience with Federal or State government programs related to the duties of the Task Force.
(3) APPOINTMENT TIMING.—Appointments to the Task Force shall be made not later than 180 days after the date of enactment of this Act.

(4) DURATION.—Each member shall be ap- pointed for the life of the Task Force.

(5) CO-CHAIR SELECTION.—Not later than 30 days after the date on which a majority of the mem- bers of the Task Force have been appointed, the Secretary shall select two of the members of the Task Force to serve as co-chairs of the Task Force.
(6) VACANCIES.— (A) IN GENERAL.—A vacancy in the Task Force— (i) shall not affect the powers of the Task Force; and (ii) shall be filled in the same manner as the original appointment.

(B) CO-CHAIR VACANCY.—In the event of a vacancy of a co-chair of the Task Force, a re- placement co-chair shall be selected in the same manner as the original selection.
•HR 6142 IH 72 (7) COMPENSATION.—Except as provided in paragraph (8), members of the Task Force shall serve without pay.
(8) TRAVEL EXPENSES.—Members of the Task Force shall be allowed travel expenses, including per diem in lieu of subsistence, at rates authorized for employees of agencies under subchapter I of chapter 57 of title 5, United States Code, while away from their homes or regular places of business in the per- formance of service for the Task Force.

(d) MEETINGS.— (1) IN GENERAL.—The Task Force shall meet at the call of the co-chairs of the Task Force.
(2) QUORUM.—A majority of the members of the Task Force shall constitute a quorum.

(3) INITIAL MEETING.—The Task Force shall meet not later than 60 days after the date on which a majority of the members of the Task Force have been appointed.

(e) STAFF OF TASK FORCE.— (1) ADDITIONAL STAFF.—The co-chairs of the Task Force may appoint and fix the pay of addi- tional staff to the Task Force as the co-chairs con- sider appropriate.
•HR 6142 IH 73 (2) APPLICABILITY OF CERTAIN CIVIL SERVICE LAWS.—The staff of the Task Force may be ap- pointed without regard to the provisions of title 5, United States Code, governing appointments in the competitive service, and may be paid without regard to the provisions of chapter 51 and subchapter III of chapter 53 of that title relating to classification and General Schedule pay rates.
(3) DETAILEES.—Any Federal Government em- ployee may be detailed to the Task Force without re- imbursement from the Task Force, and the detailee shall retain the rights, status, and privileges of his or her regular employment without interruption.

(f) POWERS OF TASK FORCE.— (1) TESTIMONY AND EVIDENCE.—The Task Force may take such testimony and receive such evi- dence as the Task Force considers advisable to carry out this section.
(2) OBTAINING OFFICIAL DATA.—The Task Force may secure directly from any Federal depart- ment or agency information necessary to carry out its duties under this section.

On request of the co- chairs of the Task Force, the head of that depart- ment or agency shall furnish such information to the Task Force.
•HR 6142 IH 74 (3) POSTAL SERVICES.—The Task Force may use the United States mails in the same manner and under the same conditions as other Federal depart- ments and agencies.
(g) REPORT.—Not later than 2 years after the date on which the initial 18 members of the Task Force are appointed under subsection (c)(1), the Task Force shall submit to the Committee on Energy and Commerce, the Committee on Education and Labor, and the Committee on Ways and Means of the House of Representatives and the Committee on Finance and the Committee on Health, Education, Labor, and Pensions of the Senate, and make publicly available, a report that— (1) contains the information, evaluations, and recommendations described in subsection (b); and (2) is signed by more than half of the members of the Task Force.
(h) TERMINATION.—Section 14 of the Federal Advi- sory Committee Act (5 U.S.C.

App.)

shall not apply to 20 the Task Force.
(i) DEFINITIONS.—In this section: (1) MATERNAL HEALTH CARE PROVIDER.—The term ‘‘maternal health care provider’’ means an indi- vidual who is an obstetrician-gynecologist, family physician, midwife who meets at a minimum the •HR 6142 IH 75 international definition of the midwife and global standards for midwifery education as established by the International Confederation of Midwives, nurse practitioner, or clinical nurse specialist.
(2) MATERNAL MORTALITY REVIEW COM- MITTEE.—The term ‘‘maternal mortality review committee’’ means a maternal mortality review com- mittee duly authorized by a State and receiving funding under section 317k(a)(2)(D) of the Public Health Service Act (42 U.S.C.

247b–12(a)(2)(D)).
247b–12(a)(2)(D)).

(3) PREGNANCY-ASSOCIATED DEATH.—The term ‘‘pregnancy-associated death’’ means a death of a woman, by any cause, that occurs during, or with- in 1 year following, her pregnancy, regardless of the outcome, duration, or site of the pregnancy.
(4) PREGNANCY-RELATED DEATH.—The term ‘‘pregnancy-related death’’ means a death of a woman that occurs during, or within 1 year fol- lowing, her pregnancy, regardless of the outcome, duration, or site of the pregnancy— (A) from any cause related to, or aggra- vated by, the pregnancy or its management; and (B) not from accidental or incidental causes.
•HR 6142 IH 76 (j) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated such sums as may be necessary to carry out this section for fiscal years 2021 through 2024.

SEC.

504.

INDIAN HEALTH SERVICE STUDY ON MATERNAL MORTALITY.
(a) IN GENERAL.—The Director of the Indian Health Service (referred to in this section as the ‘‘Director’’) shall, in coordination with entities described in subsection 10 (b)— (1) not later than 90 days after the enactment of this Act, enter into a contract with an inde- pendent research organization or Tribal Epidemi- ology Center to conduct a comprehensive study on maternal mortality and severe maternal morbidity in the populations of American Indian and Alaska Na- tive women; and (2) not later than 3 years after the date of the enactment of this Act, submit to Congress a report on such study that contains recommendations for policies and practices that can be adopted to im- prove maternal health outcomes for such women.
(b) PARTICIPATING ENTITIES.—The entities de- scribed in this subsection shall consist of 12 members, se- lected by the Director from among individuals nominated •HR 6142 IH 77 by Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C.
5304)), and urban Indian organizations (as such term is defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C.

1603)).

In selecting such members, the Director shall ensure that each of the 12 service areas of the Indian Health Service is represented.
(c) CONTENTS OF STUDY.—The study conducted pursuant to subsection (a) shall— (1) examine the causes of maternal mortality and severe maternal morbidity that are unique to American Indian and Alaska Native women; (2) include a systematic process of listening to the stories of American Indian and Alaska Native women to fully understand the causes of, and inform potential solutions to, the maternal mortality and se- vere maternal morbidity crisis within their respective communities; (3) distinguish between the causes of, landscape of maternity care at, and recommendations to im- prove maternal health outcomes within, the different settings in which American Indian and Alaska Na- tive women receive maternity care, such as— •HR 6142 IH 78 (A) facilities operated by the Indian Health Service; (B) an Indian health program operated by an Indian tribe or tribal organization pursuant to a contract, grant, cooperative agreement, or compact with the Indian Health Service pursu- ant to the Indian Self-Determination Act; and (C) an urban Indian health program oper- ated by an urban Indian organization pursuant to a grant or contract with the Indian Health Service pursuant to title V of the Indian Health Care Improvement Act; (4) review processes for coordinating programs of the Indian Health Service with social services pro- vided through other programs administered by the Secretary of Health and Human Services (other than the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, and the Children’s Health In- surance Program under title XXI of such Act), in- cluding coordination with the efforts of the Task Force established under section 503; (5) review current data collection and quality measurement processes and practices; 1 2 3
measurement processes and practices; •HR 6142 IH 79 (6) consider social determinants of health, in- cluding poverty, lack of health insurance, unemploy- ment, sexual violence, and environmental conditions in Tribal areas; (7) consider the role that historical mistreat- ment of American Indian and Alaska Native women has played in causing currently high rates of mater- nal mortality and severe maternal morbidity; (8) consider how current funding of the Indian Health Service affects the ability of the Service to deliver quality maternity care; (9) consider the extent to which the delivery of maternity care services is culturally appropriate for American Indian and Alaska Native women; (10) make recommendations to reduce misclas- sification of American Indian and Alaska Native women, including consideration of best practices in training for maternal mortality review committee members to be able to correctly classify American Indian and Alaska Native women; and (11) make recommendations informed by the stories shared by American Indian and Alaska Na- tive women in paragraph (2) to improve maternal health outcomes for such women.
•HR 6142 IH 80 (d) REPORT.—The agreement entered into under subsection (a) with an independent research organization or Tribal Epidemiology Center shall require that the orga- nization or center transmit to Congress a report on the results of the study conducted pursuant to that agreement not later than 36 months after the date of the enactment of this Act.
(e) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2021 through 2023.

SEC.

505.

GRANTS TO MINORITY-SERVING INSTITUTIONS TO STUDY MATERNAL MORTALITY, SEVERE MA- TERNAL MORBIDITY, AND OTHER ADVERSE MATERNAL HEALTH OUTCOMES.
(a) IN GENERAL.—The Secretary of Health and Human Services shall establish a program under which the Secretary shall award grants to research centers and other entities at minority-serving institutions to study spe- cific aspects of the maternal health crisis among minority women.
Such research may— 21 22 23 24 (1) include the development and implementation of systematic processes of listening to the stories of minority women to fully understand the causes of, and inform potential solutions to, the maternal mor- •HR 6142 IH 81 tality and severe maternal morbidity crisis within their respective communities; and (2) assess the potential causes of low rates of maternal mortality among Hispanic women, includ- ing potential racial misclassification and other data collection and reporting issues that might be mis- representing maternal mortality rates among His- panic women in the United States.
(b) APPLICATION.—To be eligible to receive a grant under subsection (a), an entity described in such sub- section shall submit to the Secretary an application at such time, in such manner, and containing such informa- tion as the Secretary may require.
(c) TECHNICAL ASSISTANCE.—The Secretary may use not more than 10 percent of the funds made available under subsection (f)— (1) to conduct outreach to Minority-Serving In- stitutions to raise awareness of the availability of grants under this subsection (a); (2) to provide technical assistance in the appli- cation process for such a grant; and (3) to promote capacity building as needed to enable entities described in such subsection to sub- mit such an application.
•HR 6142 IH 82 (d) REPORTING REQUIREMENT.—Each entity award- ed a grant under this section shall periodically submit to the Secretary a report on the status of activities conducted using the grant.
(e) EVALUATION.—Beginning one year after the date on which the first grant is awarded under this section, the Secretary shall submit to Congress an annual report summarizing the findings of research conducted using funds made available under this section.

(f) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2021 through 2025.
(g) MINORITY-SERVING INSTITUTIONS DEFINED.— In this section, the term ‘‘minority-serving institution’’ has the meaning given the term in section 371(a) of the Higher Education Act of 1965 (20 U.S.C.

1067q(a)).

TITLE VI—MOMS MATTER SEC.

601.

INNOVATIVE MODELS TO REDUCE MATERNAL MORTALITY.

Title III of the Public Health Service Act (42 U.S.C.

241 et seq.)
241 et seq.)

is amended by adding at the end the following 22 new part •HR 6142 IH 83 ‘‘PART W—INNOVATIVE MODELS TO REDUCE MA- TERNAL MORTALITY AND SEVERE MATER- NAL MORBIDITY ‘‘SEC.

399OO.

DEFINITIONS.


‘‘In this part: ‘‘(1) The terms ‘postpartum’ and ‘postpartum period’ refer to the 1-year period beginning on the last day of the pregnancy.

‘‘(2) The term ‘Secretary’ means the Secretary of Health and Human Services.

‘‘(3) The term ‘Task Force’ means the Mater- nal Mental and Behavioral Health Task Force estab- lished pursuant to section 399OO–1.

‘‘(4) The term ‘behavioral health’ includes sub- stance use disorder and other behavioral health con- ditions.

‘‘SEC.

399OO–1.
‘‘SEC.

399OO–1.

MATERNAL MENTAL AND BEHAVIORAL HEALTH TASK FORCE.

‘‘(a) ESTABLISHMENT.—The Secretary shall estab- lish a task force, to be known as the Maternal Mental and Behavioral Health Task Force, to improve maternal men- tal and behavioral health outcomes with a particular focus on outcomes for minority women.
‘‘(b) MEMBERSHIP.— •HR 6142 IH 84 ‘‘(1) COMPOSITION.—The Task Force shall be composed of no fewer than 20 members, to be ap- pointed by the Secretary.
‘‘(2) CO-CHAIRS.—The Secretary shall des- ignate 2 members of the Task Force to serve as the Co-Chairs of the Task Force.

‘‘(3) MEMBERS.—The Task Force shall include the following: ‘‘(A) Maternal mental and behavioral health care specialists; maternity care providers; and researchers, government officials, and pol- icy experts who specialize in women’s health, maternal mental and behavioral health, mater- nal substance use disorder, or maternal mor- tality and severe maternal morbidity.
In select- ing such members of the Task Force, the Sec- retary shall give special consideration to individ- uals from diverse racial and ethnic backgrounds or individuals with experience providing cul- turally congruent maternity care in diverse communities.
‘‘(B) One or more patients who have suf- fered from a diagnosed mental or behavioral health condition during the prenatal or •HR 6142 IH 85 postpartum period, or a spouse or family mem- ber of such patient.
‘‘(C) One or more representatives of a community-based organization that addresses adverse maternal health outcomes with a spe- cific focus on racial and ethnic disparities in maternal health outcomes.

In selecting such representatives, the Secretary shall give special consideration to organizations from commu- nities with significant minority populations.
‘‘(D) One or more perinatal health workers who provide non-clinical support to pregnant and postpartum women, such as a doula, com- munity health worker, peer supporter, certified lactation consultant, nutritionist or dietitian, social worker, home visitor, or navigator.

In se- lecting such perinatal health workers, the Sec- retary shall give special consideration to individ- uals with experience working in communities with significant minority populations.
‘‘(E) One or more representatives of rel- evant patient advocacy organizations, with a particular focus on organizations that address racial and ethnic disparities in maternal health outcomes.
•HR 6142 IH 86 ‘‘(F) One or more representatives of rel- evant health care provider organizations, with a particular focus on organizations that address racial and ethnic disparities in maternal health outcomes.
‘‘(G) One or more leaders of a Federally- qualified health center or rural health clinic (as such terms are defined in section 1861 of the Social Security Act).

‘‘(H) One or more representatives of health insurers.

‘‘(4) TIMING OF APPOINTMENTS.—Not later than 180 days after the date of enactment of this part, the Secretary shall appoint all members of the Task Force.

‘‘(5) PERIOD OF APPOINTMENT; VACANCIES.— ‘‘(A) IN GENERAL.—Each member of the Task Force shall be appointed for the life of the Task Force.
‘‘(B) VACANCIES.—Any vacancy in the Task Force— ‘‘(i) shall not affect the powers of the Task Force; and ‘‘(ii) shall be filled in the same man- ner as the original appointment.
•HR 6142 IH 87 ‘‘(6) NO PAY.—Members of the Task Force (other than officers or employees of the United States) shall serve without pay.
Members of the Task Force who are full-time officers or employees of the United States may not receive additional pay, allowances, or benefits by reason of their service on the Task Force.
‘‘(7) TRAVEL EXPENSES.—Members of the Task Force may be allowed travel expenses, includ- ing per diem in lieu of subsistence, at rates author- ized for employees of agencies under subchapter I of chapter 57 of title 5, United States Code, while away from their homes or regular places of business in the performance of services for the Task Force.

‘‘(c) STAFF.—The Co-Chairs of the Task Force may appoint and fix the pay of staff to the Task Force.
‘‘(d) DETAILEES.—Any Federal Government em- ployee may be detailed to the Task Force without reim- bursement from the Task Force, and the detailee shall re- tain the rights, status, and privileges of his or her regular employment without interruption.

‘‘(e) MEETINGS.— ‘‘(1) IN GENERAL.—Subject to paragraph (2), the Task Force shall meet at the call of the Co- Chairs of the Task Force.
•HR 6142 IH 88 ‘‘(2) INITIAL MEETING.—The Task Force shall meet not later than 30 days after the date on which all members of the Task Force have been appointed.

‘‘(3) QUORUM.—A majority of the members of the Task Force shall constitute a quorum.
‘‘(f) INFORMATION FROM FEDERAL AGENCIES.— ‘‘(1) IN GENERAL.—The Task Force may se- cure directly from any Federal department or agency such information as may be relevant to carrying out this part.

‘‘(2) FURNISHING INFORMATION.—On request of the Co-Chairs of the Task Force pursuant to paragraph (1), the head of a Federal department or agency shall, not later than 60 days after the date of receiving such request, furnish to the Task Force the information so requested.
‘‘(g) TERMINATION.—Termination under section 14 of the Federal Advisory Committee Act (5 U.S.C.

App.)

shall not apply to the Task Force.

‘‘(h) DUTIES.— ‘‘(1) NATIONAL STRATEGY.—The Task Force shall make recommendations for a national strategy to improve maternal mental and behavioral health outcomes with a particular focus on outcomes for minority women.
Such strategy shall— •HR 6142 IH 89 ‘‘(A) define collaborative maternity care; ‘‘(B) make recommendations to the Sec- retary and the Assistant Secretary for Mental Health and Substance Use on how to imple- ment collaborative maternity care models to im- prove maternal mental and behavioral health with a particular focus on such outcomes for minority women; ‘‘(C) identify barriers to the implementa- tion of collaborative maternity care models to improve maternal mental and behavioral health with a particular focus on such outcomes for minority women, and make recommendations to address such barriers; ‘‘(D) take into consideration as models ex- isting State and other programs that have dem- onstrated effectiveness in improving maternal mental and behavioral health during the pre- natal and postpartum periods; ‘‘(E) promote treatment options and re- duce stigma for pregnant and postpartum women with a substance use disorder; ‘‘(F) assess the extent to which insurers are providing coverage for evidence-based men- tal and behavioral health screenings and serv- •HR 6142 IH 90 ices that adhere to existing prenatal and postpartum guidelines; ‘‘(G) assess the extent to which existing guidelines and processes are culturally con- gruent for minority women, specifically— ‘‘(i) guidelines for identifying mater- nal mental and behavioral health condi- tions, including substance use disorders; ‘‘(ii) guidelines for screening and, as needed, follow-up referrals, evaluations, and
 treatments after positive screens for— ‘‘(I) depression; ‘‘(II) anxiety; ‘‘(III) trauma; ‘‘(IV) substance use disorders; and ‘‘(V) other mental or behavioral health conditions at the discretion of the Task Force; ‘‘(iii) processes for incorporating men- tal and behavioral health screenings into the current timeline of standard screening practices for pregnant and postpartum women, with distinctions for postpartum •HR 6142 IH 91 screening timelines for uncomplicated and complicated births; and ‘‘(iv) processes for referring women with positive screens for substance use dis- order to addiction treatment centers offer- ing— ‘‘(I) on-site wraparound treat- ment or networks for referrals; ‘‘(II) multidisciplinary staff; ‘‘(III) psychotherapy; ‘‘(IV) contingency management; ‘‘(V) access to all evidence-based medication-assisted treatment; and ‘‘(VI) evidence-based recovery supports; ‘‘(H) propose to the Secretary a multi- lingual public awareness campaign for maternal mental health and substance use disorder, with a particular focus on minority women, that in- cludes information on— ‘‘(i) symptoms, triggers, risk factors, and treatment options for maternal mental and behavioral health conditions; ‘‘(ii) using the website developed under paragraph (3); •HR 6142 IH 92 ‘‘(iii) the physiological process of re- covery after birth; ‘‘(iv) the frequency of occurrences for common conditions such as postpartum hemorrhage, preeclampsia and eclampsia, infection, and thromboembolism; ‘‘(v) best
 practices in patient report- ing of health concerns to their maternity care providers in the prenatal and postpar- tum periods; ‘‘(vi) addressing stigma around mater- nal mental and behavioral health condi- tions; ‘‘(vii) how to seek treatment for sub- stance use disorder during pregnancy and in the postpartum period; and ‘‘(viii) infant feeding options; and ‘‘(I) disseminate to all State Medicaid pro- grams under title XIX of the Social Security Act and State child health plans under title XXI of the Social Security Act an assessment of the extent to which States are providing cov- erage of evidence-based prenatal and postpartum mental and behavioral health screenings through such programs and plans, •HR 6142 IH 93 and an assessment of the benefits of such cov- erage.
‘‘(2) GRANT PROGRAMS.—The Task Force shall evaluate and advise on the grant programs under section 399OO–2.
‘‘(3) CENTRALIZED WEBSITE.—The Task Force shall facilitate a coordinated effort between the Sub- stance Abuse and Mental Health Services Adminis- tration and State departments of health to develop, either directly or through a contract, a centralized website with information on finding local mental and behavioral health providers who treat prenatal and postpartum mental and behavioral health conditions, including substance use disorder.
‘‘(4) REPORT.—Not later than 18 months after the date of enactment of the Black Maternal Health Momnibus Act of 2020, and every year thereafter, the Task Force shall submit to the Congress, the Centers for Medicare & Medicaid Services, and the Center for Medicare and Medicaid Innovation, and make publicly available, a report that— ‘‘(A) describes the activities of the Task Force and the results of such activities, with data in such results stratified racially, eth- nically, and geographically; and •HR 6142 IH 94 ‘‘(B) includes the strategy developed under paragraph (1).
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there are authorized to be appro- priated such sums as may be necessary for fiscal years 2021 through 2025.

‘‘SEC.

399OO–2.

INNOVATION IN MATERNITY CARE TO CLOSE RACIAL AND ETHNIC MATERNAL HEALTH DISPARITIES GRANTS.
‘‘(a) IN GENERAL.—The Secretary shall award grants to eligible entities to establish, implement, evaluate, or expand innovative models in maternity care that are designed to reduce racial and ethnic disparities in mater- nal health outcomes.
‘‘(b) USE OF FUNDS.—An eligible entity receiving a grant under this section may use the grant to establish, implement, evaluate, or expand innovative models de- scribed in subsection (a) including— ‘‘(1) collaborative maternity care models to im- prove maternal mental health, treat maternal sub- stance use disorders, and reduce maternal mortality and severe maternal morbidity, especially for minor- ity women, consistent with the national strategy de- veloped by the Task Force under section 399OO– •HR 6142 IH 95 1(h)(1) and other recommendations of the Task Force; ‘‘(2) evidence-based programming at clinics that— ‘‘(A) provide wraparound services for women with substance use disorders in the pre- natal and postpartum periods that may include multidisciplinary staff, access to all evidence- based medication-assisted treatment, psycho- therapy, contingency management, and recovery supports; or ‘‘(B) make referrals for any such services that are not provided within the clinic; ‘‘(3) evidence-based programs at freestanding birth centers that provide culturally congruent ma- ternal mental and behavioral health care education, treatments, and services, and other wraparound sup- ports for women throughout the prenatal and postpartum period; and ‘‘(4) the development and implementation of evidence-based programs, including toll-free tele- phone hotlines, that connect maternity care pro- viders with women’s mental health clinicians to pro- vide maternity care providers with guidance on ad- •HR 6142 IH 96 dressing maternal mental and behavioral health con- ditions identified in patients.
‘‘(c) SPECIAL CONSIDERATION.—In awarding grants under this section, the Secretary shall give special consid- eration to applications for models that will— ‘‘(1) operate in— ‘‘(A) areas with high rates of adverse ma- ternal health outcomes; ‘‘(B) areas with significant racial and eth- nic disparities in maternal health outcomes; or ‘‘(C) health professional shortage areas designated under section 332; ‘‘(2) be led by minority women from demo- graphic groups with disproportionate rates of ad- verse maternal health outcomes; or ‘‘(3) be implemented with a culturally con- gruent approach that is focused on improving out- comes for demographic groups experiencing dis- proportionate rates of adverse maternal health out- comes.
‘‘(d) EVALUATION.—As a condition on receipt of a grant under this section, an eligible entity shall agree to provide annual evaluations of the activities funded through the grant to the Secretary and the Task Force.
Such eval- uations may address— •HR 6142 IH 97 ‘‘(1) the effects of such activities on maternal health outcomes and subjective assessments of pa- tient and family experiences, especially for minority women from demographic groups with dispropor- tionate rates of adverse maternal health outcomes; and ‘‘(2) the cost-effectiveness of such activities.
‘‘(e) DEFINITIONS.—In this section: ‘‘(1) The term ‘eligible entity’ means any public or private entity.

‘‘(2) The term ‘collaborative maternity care’ means an integrated care model that includes the delivery of maternal mental and behavioral health care services in primary clinics or other care settings familiar to pregnant and postpartum patients.
‘‘(3) The term ‘culturally congruent’ means care that is in agreement with the preferred cultural values, beliefs, worldview, language, and practices of the health care consumer and other stakeholders.

‘‘(4) The term ‘freestanding birth center’ has the meaning given that term under section 1905(l)(3)(A) of the Social Security Act.
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is authorized to be appro- •HR 6142 IH priated $15,000,000 for each of fiscal years 2021 through 98 2025.

‘‘SEC.

399OO–3.

GROUP PRENATAL AND POSTPARTUM CARE MODELS.


‘‘(a) IN GENERAL.—The Secretary shall award grants to eligible entities to establish, implement, evaluate, or expand culturally congruent group prenatal care models or group postpartum care models that are designed to re- duce racial and ethnic disparities in maternal and infant health outcomes.
‘‘(b) USE OF FUNDS.—An eligible entity receiving a grant under this section may use the grant for— ‘‘(1) programming; ‘‘(2) capital investments required to improve ex- isting physical infrastructure for group prenatal care and group postpartum care programming, such as building space needed to implement such models; and ‘‘(3) evaluations of group prenatal care and group postpartum care programming, with a par- ticular focus on the impacts of such programming on minority women.
‘‘(c) SPECIAL CONSIDERATION.—In awarding grants under this section, the Secretary shall give special consid- eration to applicants that will— •HR 6142 IH 99 ‘‘(1) operate in— ‘‘(A) areas with high rates of adverse ma- ternal health outcomes; ‘‘(B) areas with significant racial and eth- nic disparities in maternal health outcomes; or ‘‘(C) health professional shortage areas designated under section 332; ‘‘(2) be led by minority women from demo- graphic groups with disproportionate rates of ad- verse maternal health outcomes; or ‘‘(3) be implemented with a culturally con- gruent approach that is focused on improving out- comes for demographic groups experiencing dis- proportionate rates of adverse maternal health out- comes.
‘‘(d) EVALUATION.—As a condition on receipt of a grant under this section, an eligible entity shall agree to provide annual evaluations of the activities funded through the grant to the Secretary and the Task Force and ad- dress in each such evaluation— ‘‘(1) the effects of such activities on maternal health outcomes with a particular focus on the ef- fects of such activities on minority women, including measures such as— ‘‘(A) avoidable emergency room visits; •HR 6142 IH 100 ‘‘(B) postpartum care visits after delivery; ‘‘(C) rates of preterm birth; ‘‘(D) rates of breastfeeding initiation; ‘‘(E) psychological outcomes; and ‘‘(F) subjective measures of patient-re- ported experience of care; and ‘‘(2) the cost-effectiveness of such activities.
‘‘(e) DEFINITIONS.—In this section: ‘‘(1) The term ‘eligible entity’ means any public or private entity.

‘‘(2) The term ‘culturally congruent’ means care that is in agreement with the preferred cultural values, beliefs, worldview, language, and practices of the health care consumer and other stakeholders.
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is authorized to be appro- priated $10,000,000 for each of fiscal years 2021 through 2025.’’.

19 TITLE VII—JUSTICE FOR INCARCERATED MOMS SEC.

701.

SENSE OF CONGRESS.

It is the sense of Congress that the respect and prop- er care that mothers deserve is inclusive, and whether the mothers are transgender, cisgender, or gender noncon- 25 forming, all deserve dignity.
•HR 6142 IH 101 SEC.

702.

ENDING THE SHACKLING OF PREGNANT INDIVID- UALS.


(a) IN GENERAL.—Beginning on the date that is 6 months after the date of enactment of this Act, and annu- ally thereafter, in each State that received a grant under subpart 1 of part E of title I of the Omnibus Crime Con- trol and Safe Streets Act of 1968 (34 U.S.C.

10151 et seq.)
(commonly referred to as the ‘‘Edward Byrne Memo- rial Justice Grant Program’’) and that does not have in effect throughout the State for such fiscal year laws re- stricting the use of restraints on pregnant individuals in prison that are substantially similar to the rights, proce- dures, requirements, effects, and penalties set forth in sec- tion 4322 of title 18, United States Code, the amount of such grant that would otherwise be allocated to such State under such subpart for the fiscal year shall be decreased 17 by 25 percent.
(b) REALLOCATION.—Amounts not allocated to a State for failure to comply with subsection (a) shall be reallocated in accordance with subpart 1 of part E of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C.

10151 et seq.)

to States that have com- 23 plied with such subsection.
•HR 6142 IH 102 SEC.

703.

CREATING MODEL PROGRAMS FOR THE CARE OF INCARCERATED INDIVIDUALS IN THE PRE- NATAL AND POSTPARTUM PERIODS.
(a) IN GENERAL.—Not later than 1 year after the date of enactment of this Act, the Attorney General, act- ing through the Director of the Bureau of Prisons, shall establish, in not more than 6 Bureau of Prisons facilities, programs to optimize maternal health outcomes for preg- nant and postpartum individuals incarcerated in such fa- cilities.
The Attorney General shall establish such pro- grams in consultation with stakeholders such as— (1) relevant community-based organizations, particularly organizations that represent incarcer- ated and formerly incarcerated individuals and orga- nizations that seek to improve maternal health out- comes for minority women; (2) relevant organizations representing patients, with a particular focus on minority patients; (3) relevant organizations representing mater- nal health care providers; (4) nonclinical perinatal health workers such as doulas, community health workers, peer supporters, certified lactation consultants, nutritionists and di- etitians, social workers, home visitors, and naviga- tors; and •HR 6142 IH 103 (5) researchers and policy experts in fields re- lated to women’s health care for incarcerated indi- viduals.
(b) START DATE.—Each selected facility shall begin facility programs not later than 18 months after the date of enactment of this Act.
(c) FACILITY PRIORITY.—In carrying out subsection (a), the Director shall give priority to a facility based on— (1) the number of pregnant and postpartum in- dividuals incarcerated in such facility and, among such individuals, the number of pregnant and post- partum minority individuals; and (2) the extent to which the leaders of such facil- ity have demonstrated a commitment to developing exemplary programs for pregnant and postpartum individuals incarcerated in such facility.
(d) PROGRAM DURATION.—The programs established under this section shall be for a 5-year period.
(e) PROGRAMS.—Bureau of Prisons facilities selected by the Director shall establish programs for pregnant and postpartum incarcerated individuals, and such programs may— 23 24 25 (1) provide access to doulas and other perinatal health workers from pregnancy through the postpartum period; •HR 6142 IH 104 (2) provide access to healthy foods and coun- seling on nutrition, recommended activity levels, and safety measures throughout pregnancy; (3) train correctional officers and medical per- sonnel to ensure that pregnant incarcerated individ- uals receive trauma-informed, culturally congruent care that promotes the health and safety of the pregnant individuals; (4) provide counseling and treatment for indi- viduals who have suffered from— (A) diagnosed mental or behavioral health conditions, including trauma and substance use disorders; (B) domestic violence; (C) human immunodeficiency virus; (D) sexual abuse; (E) pregnancy or infant loss; or (F) chronic conditions, including heart dis- ease, diabetes, osteoporosis and osteopenia, hy- pertension, asthma, liver disease, and bleeding disorders; (5) provide pregnancy and childbirth education, parenting support, and other relevant forms of health literacy; •HR 6142 IH 105 (6) offer opportunities for postpartum individ- uals to maintain contact with the individual’s new- born child to promote bonding, including enhanced visitation policies, access to prison nursery pro- grams, or breastfeeding support; (7) provide reentry assistance, particularly to— (A) ensure continuity of health insurance coverage if
 an incarcerated individual exits the criminal justice system during such individual’s pregnancy or in the postpartum period; and (B) connect individuals exiting the criminal justice system during pregnancy or in the postpartum period to community-based re- sources, such as referrals to health care pro- viders and social services that address social de- terminants of health like housing, employment opportunities, transportation, and nutrition; or (8) establish partnerships with local public enti- ties, private community entities, community-based organizations, Indian Tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C.
5304)), and urban Indian organizations (as such term is defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C.
1603)) to •HR 6142 IH 106 establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals.
Such programs may in- clude— (A) parenting classes; (B) prenatal health coordination; (C) family and individual counseling; (D) evidence-based screenings, education, and, as needed, treatment for mental and be- havioral health conditions, including drug and alcohol treatments; (E) family case management services; (F) domestic violence education and pre- vention; (G) physical and sexual abuse counseling; and (H) programs to address social deter- minants of health such as employment, housing, education, transportation, and nutrition.
(f) IMPLEMENTATION AND REPORTING.—A selected facility shall be responsible for— (1) implementing programs, which may include the programs described in subsection (e); and (2) not later than 3 years after the date of en- actment of this Act, and not 6 years after the date •HR 6142 IH 107 of enactment of this Act, reporting results of the programs to the Director, including information de- scribing— (A) relevant quantitative indicators of suc- cess in improving the standard of care and health outcomes for pregnant and postpartum incarcerated individuals who participated in such programs, including data stratified by race, ethnicity, sex, age, geography, disability status, the category of the criminal charge against such individual, rates of pregnancy-re- lated deaths, pregnancy-associated deaths, cases of infant mortality, cases of severe maternal morbidity, cases of violence against pregnant or postpartum individuals, diagnoses of maternal mental or behavioral health conditions, and other such information as appropriate; (B) relevant qualitative evaluations from pregnant and postpartum incarcerated individ- uals who participated in such programs, includ- ing subjective measures of patient-reported ex- perience of care; (C) evaluations of cost effectiveness; and (D) strategies to sustain such programs beyond 2026.
•HR 6142 IH 108 (g) REPORT.—Not later than 7 years after the date of enactment of this Act, the Director shall submit to the Attorney General and to the Committee on the Judiciary of the House of Representatives and the Senate a report describing the results of the programs funded under this section.
(h) OVERSIGHT.—Not later than 1 year after the date of enactment of this Act, the Attorney General shall award a contract to an independent organization or inde- pendent organizations to conduct oversight of the pro- grams described in subsection (e).

(i) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2021 through 2025.

SEC.

704.
SEC.

704.

GRANT PROGRAM TO IMPROVE MATERNAL HEALTH OUTCOMES FOR INDIVIDUALS IN STATE AND LOCAL PRISONS AND JAILS.

(a) ESTABLISHMENT.—Not later than 1 year after the date of enactment of this Act, the Attorney General, acting through the Director of the Bureau of Justice As- sistance, shall award Justice for Incarcerated Moms grants to States to establish or expand programs in State and local prisons and jails for pregnant and postpartum incarcerated individuals.
The Attorney General shall •HR 6142 IH award such grants in consultation with stakeholders such 109 as— (1) relevant community-based organizations, particularly organizations that represent incarcer- ated and formerly incarcerated individuals and orga- nizations that seek to improve maternal health out- comes for minority women; (2) relevant organizations representing patients, with a particular focus on minority patients; (3) relevant organizations representing mater- nal health care providers; (4) nonclinical perinatal health workers such as doulas, community health workers, peer supporters, certified lactation consultants, nutritionists and di- etitians, social workers, home visitors, and naviga- tors; and (5) researchers and policy experts in fields re- lated to women’s health care for incarcerated indi- viduals.
(b) APPLICATIONS.—Each applicant for a grant under this section shall submit to the Director of the Bu- reau of Justice Assistance an application at such time, in such manner, and containing such information as the Di- rector may require.
•HR 6142 IH 110 (c) USE OF FUNDS.—A State that is awarded a grant under this section shall use such grant to establish or ex- pand programs for pregnant and postpartum incarcerated individuals, and such programs may— (1) provide access to doulas and other perinatal health workers from pregnancy through the postpar- tum period; (2) provide access to healthy foods and coun- seling on nutrition, recommended activity levels, and safety measures throughout pregnancy; (3) train correctional officers and medical per- sonnel to ensure that pregnant incarcerated individ- uals receive trauma-informed, culturally congruent care that promotes the health and safety of the pregnant individuals; (4) provide counseling and treatment for indi- viduals who have suffered from— (A) diagnosed mental or behavioral health conditions, including trauma and substance use disorders; (B) domestic violence; (C) human immunodeficiency virus; (D) sexual abuse; (E) pregnancy or infant loss; or •HR 6142 IH 111 (F) chronic conditions, including heart dis- ease, diabetes, osteoporosis and osteopenia, hy- pertension, asthma, liver disease, and bleeding disorders; (5) provide pregnancy and childbirth education, parenting support, and other relevant forms of health literacy; (6) offer opportunities for postpartum individ- uals to maintain contact with the individual’s new- born child to promote bonding, including enhanced visitation policies, access to prison nursery pro- grams, or breastfeeding support; (7) provide reentry assistance, particularly to— (A) ensure continuity of health insurance coverage if an incarcerated individual exits
 the criminal justice system during such individual’s pregnancy or in the postpartum period; and (B) connect individuals exiting the criminal justice system during pregnancy or in the postpartum period to community-based re- sources, such as referrals to health care pro- viders and social services that address social de- terminants of health like housing, employment opportunities, transportation, and nutrition; or •HR 6142 IH 112 (8) establish partnerships with local public enti- ties, private community entities, community-based organizations, Indian Tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C.
5304)), and urban Indian organizations (as such term is defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C.

1603)) to establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals.
Such programs may in- clude— (A) parenting classes; (B) prenatal health coordination; (C) family and individual counseling; (D) evidence-based screenings, education, and, as needed, treatment for mental and be- havioral health conditions, including drug and alcohol treatments; (E) family case management services; (F) domestic violence education and pre- vention; (G) physical and sexual abuse counseling; and •HR 6142 IH 113 (H) programs to address social deter- minants of health such as employment, housing, education, transportation, and nutrition.
(d) PRIORITY.—In awarding grants under this sec- tion, the Director of the Bureau of Justice Assistance shall give priority to applicants based on— (1) the number of pregnant and postpartum in- dividuals incarcerated in the State and, among such individuals, the number of pregnant and postpartum minority individuals; and (2) the extent to which the State has dem- onstrated a commitment to developing exemplary programs for pregnant and postpartum individuals incarcerated in the prisons and jails in the State.
(e) GRANT DURATION.—A grant awarded under this section shall be for a 5-year period.
(f) IMPLEMENTING AND REPORTING.—A State that receives a grant under this section shall be responsible for— (1) implementing the program funded by the grant; and (2) not later than 3 years after the date of en- actment of this Act, and 6 years after the date of enactment of this Act, reporting results of such pro- •HR 6142 IH 114 gram to the Attorney General, including information describing— (A) relevant quantitative indicators of the program’s success in improving the standard of care and health outcomes for pregnant and postpartum incarcerated individuals who par- ticipated in such program, including data strati- fied by race, ethnicity, sex, age, geography, dis- ability status, category of the criminal charge against such individual, incidence rates of preg- nancy-related deaths, pregnancy-associated deaths, cases of infant mortality, cases of severe maternal morbidity, cases of violence against pregnant or postpartum individuals, diagnoses of maternal mental or behavioral health condi- tions, and other such information as appro- priate; (B) relevant qualitative evaluations from pregnant and postpartum incarcerated individ- uals who participated in such programs, includ- ing subjective measures of patient-reported ex- perience of care; (C) evaluations of cost effectiveness; and (D) strategies to sustain such programs beyond the duration of the grant.
•HR 6142 IH 115 (g) REPORT.—Not later than 7 years after the date of enactment of this Act, the Attorney General shall sub- mit to the Committee on the Judiciary of the House of Representatives and the Senate a report describing the re- sults of such grant programs.
(h) OVERSIGHT.—Not later than 1 year after the date of enactment of this Act, the Attorney General shall award a contract to an independent organization or inde- pendent organizations to conduct oversight of the pro- grams described in subsection (c).

(i) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2021 through 2025.

SEC.

705.

GAO REPORT.


(a) IN GENERAL.—Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on adverse maternal health outcomes among incarcerated individuals, with a particular focus on racial and ethnic disparities in maternal health outcomes for incarcerated 21 individuals.
22 (b) CONTENTS OF REPORT.—The report described in 23 this section shall include— 24 (1) to the extent practicable— •HR 6142 IH 116 (A) the number of incarcerated individuals, including those incarcerated in Federal, State, and local correctional facilities, who have expe- rienced a pregnancy-related death or preg- nancy-associated death in the most recent 10 years of available data; (B) the number of cases of severe maternal morbidity among incarcerated individuals, in- cluding those incarcerated in Federal, State, and local detention facilities, in the most recent year of available data; and (C) statistics on the racial and ethnic dis- parities in maternal and infant health outcomes and severe maternal morbidity rates among in- carcerated individuals, including those incarcer- ated in Federal, State, and local detention fa- cilities; (2) in the case that the Comptroller General of the United States is unable determine the informa- tion required in paragraphs (1) through (4), an as- sessment of the barriers to determining such infor- mation and recommendations for improvements in tracking maternal health outcomes among incarcer- ated individuals, including those incarcerated in Federal, State, and local detention facilities; •HR 6142 IH 117 (3) causes of adverse maternal health outcomes that are unique to incarcerated individuals, including those incarcerated in Federal, State, and local deten- tion facilities; (4) causes of adverse maternal health outcomes and severe maternal morbidity that are unique to in- carcerated individuals of color; (5) recommendations to reduce maternal mor- tality and severe maternal morbidity among incar- cerated individuals and to address racial and ethnic disparities in maternal health outcomes for incarcer- ated individuals in Bureau of Prisons facilities and State and local prisons and jails; and (6) such other information as may be appro- priate to reduce the occurrence of adverse maternal health outcomes among incarcerated individuals and to address racial and ethnic disparities in maternal health outcomes for such individuals.
SEC.

706.

MACPAC REPORT.
(a) IN GENERAL.—Not later than 2 years after the date of enactment of this Act, the Medicaid and CHIP Payment and Access Commission (referred to in this sec- tion as ‘‘MACPAC’’) shall publish a report on the implica- tions of pregnant and postpartum incarcerated individuals being ineligible for medical assistance under a State plan •HR 6142 IH 118 under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.).

(b) CONTENTS OF REPORT.—The report described in this section shall include— (1) information on the effect of ineligibility for medical assistance under a State plan under title XIX of the Social Security Act (42 U.S.C.

1396 et seq.)
1396 et seq.)

on maternal health outcomes for pregnant and postpartum incarcerated individuals, concentrating on the effects of such ineligibility for pregnant and postpartum individuals of color; and (2) the potential implications on maternal health outcomes resulting from suspending eligibility for medical assistance under a State plan under such title of such Act when a pregnant or postpartum individual is incarcerated.

TITLE VIII—TECH TO SAVE MOMS SEC.

801.


CMI MODELING OF INTEGRATED TELEHEALTH MODELS IN MATERNITY CARE SERVICES.

(a) IN GENERAL.—Section 1115A(b)(2)(B) of the Social Security Act (42 U.S.C.
1315a(b)(2)(B)) is amend- ed by adding at the end the following new clauses: ‘‘(xxviii) Focusing on title XIX, pro- viding for the adoption of and use of tele- •HR 6142 IH 119 health tools that allow for screening and treatment of common pregnancy-related complications (including anxiety and de- pression, substance use disorder, hemor- rhage, infection, amniotic fluid embolism, thrombotic pulmonary or other embolism, hypertensive disorders of pregnancy, cere- brovascular accidents, cardiomyopathy, and other cardiovascular conditions) for a preg- nant woman receiving medical assistance under such title during her pregnancy and for not more than a 1-year period begin- ning on the last day of her pregnancy.’’.
(b) EFFECTIVE DATE.—The amendment made by subsection (a) shall take effect 1 year after the date of the enactment of this Act.

17 SEC.

802.

GRANTS TO EXPAND THE USE OF TECHNOLOGY- ENABLED COLLABORATIVE LEARNING AND CAPACITY MODELS THAT PROVIDE CARE TO PREGNANT AND POSTPARTUM WOMEN.

Title III of the Public Health Service Act is amended by inserting after section 330M (42 U.S.C.
254c–19) the 23 following:: •HR 6142 IH 120 ‘‘SEC.

330N.

EXPANDING CAPACITY FOR MATERNAL HEALTH OUTCOMES.
‘‘(a) PROGRAM ESTABLISHED.—Beginning not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall, as appro- priate, award grants to eligible entities to evaluate, de- velop, and, as appropriate, expand the use of technology- enabled collaborative learning and capacity building mod- els, to improve maternal health outcomes in health profes- sional shortage areas; areas with high rates of maternal mortality and severe maternal morbidity, and significant racial and ethnic disparities in maternal health outcomes; and for medically underserved populations or American Indians and Alaska Natives, including Indian tribes, tribal organizations, and urban Indian organizations.
‘‘(b) USE OF FUNDS.— ‘‘(1) REQUIRED USES.—Grants awarded under subsection (a) shall be used for— ‘‘(A) the development and acquisition of instructional programming, and the training of maternal health care providers and other pro- fessionals that provide or assist in the provision of services through models such as— ‘‘(i) training on adopting and effec- tively implementing Alliance for Innovation on Maternal Health (referred to in this 26 •HR 6142 IH 121 section as ‘AIM’) safety and quality im- provement bundles; ‘‘(ii) training on implicit and explicit bias, racism, and discrimination for pro- viders of maternity care; ‘‘(iii) training on best practices in screening for and, as needed, evaluating and treating maternal mental health condi- tions and substance use disorders; ‘‘(iv) training on how to screen for so- cial determinants of health risks in the prenatal and postpartum periods such as inadequate housing, lack of access to nutri- tion, environmental risks, and transpor- tation barriers; and ‘‘(v) training on the use of remote pa- tient monitoring tools for pregnancy-re- lated complications described in section 1115A(b)(2)(B)(xxviii); ‘‘(B) information collection and evaluation activities to— ‘‘(i) study the impact of such models on— ‘‘(I) access to and quality of care; ‘‘(II) patient outcomes; •HR 6142 IH 122 ‘‘(III) subjective measures of pa- tient experience; and ‘‘(IV) cost-effectiveness; and ‘‘(ii) identify best practices for the ex- pansion and use of such models; ‘‘(C) information collection and evaluation activities to
 study the impact of such models on patient outcomes and maternal health care pro- viders, and to identify best practices for the ex- pansion and use of such models; and ‘‘(D) any other activity consistent with achieving the objectives of grants awarded under this section, as determined by the Sec- retary.
‘‘(2) PERMISSIBLE USES.—In addition to any of the uses under paragraph (1), grants awarded under subsection (a) may be used for— ‘‘(A) equipment to support the use and ex- pansion of technology-enabled collaborative learning and capacity building models, including for hardware and software that enables distance learning, maternal health care provider support, and the secure exchange of electronic health in- formation; and •HR 6142 IH 123 ‘‘(B) support for maternal health care pro- viders and other professionals that provide or assist in the provision of maternity care services through such models.
‘‘(c) LIMITATIONS.— ‘‘(1) NUMBER.—The Secretary may not award more than 1 grant under this section to an eligible entity.

‘‘(2) DURATION.—Each grant under this sec- tion shall be made for a period of up to 5 years.

‘‘(3) AMOUNT.—The Secretary shall determine the maximum amount of each grant under this sec- tion.
‘‘(d) GRANT REQUIREMENTS.—The Secretary shall require entities awarded a grant under this section to col- lect information on the effect of the use of technology- enabled collaborative learning and capacity building mod- els, such as on maternal health outcomes, access to mater- nal health care services, quality of maternal health care, and maternal health care provider retention in areas and populations described in subsection (a).
The Secretary may award a grant or contract to assist in the coordina- tion of such models, including to assess outcomes associ- ated with the use of such models in grants awarded under •HR 6142 IH subsection (a), including for the purpose described in sub- 124 section (b)(1)(B).
‘‘(e) APPLICATION.— ‘‘(1) IN GENERAL.—An eligible entity that seeks to receive a grant under subsection (a) shall submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require.
‘‘(2) MATTERS TO BE INCLUDED.—Such appli- cation shall include plans to assess the effect of technology-enabled collaborative learning and capac- ity building models on indicators, including access to and quality of care, patient outcomes, subjective measures of patient experience, and cost-effective- ness.
Such indicators may focus on— ‘‘(A) health professional shortage areas; ‘‘(B) areas with high rates of maternal mortality and severe maternal morbidity, and significant racial and ethnic disparities in ma- ternal health outcomes; and ‘‘(C) medically underserved populations or American Indians and Alaska Natives, includ- ing Indian tribes, tribal organizations, and urban Indian organizations.
•HR 6142 IH 125 ‘‘(f) ACCESS TO BROADBAND.—In administering grants under this section, the Secretary may coordinate with other agencies to ensure that funding opportunities are available to support access to reliable, high-speed internet for grantees.
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall provide (either directly through the Department of Health and Human Services or by contract) technical assistance to eligible entities, including recipients of grants under subsection (a), on the development, use, and post-grant sustainability of technology-enabled collaborative learning and capacity building models in order to expand access to maternal health care services provided by such entities, including for health professional shortage areas and areas with high rates of maternal mortality and severe maternal morbidity, and significant racial and ethnic disparities in maternal health outcomes, and to medically underserved populations or American Indians and Alaska Natives, in- cluding Indian tribes, tribal organizations, and urban In- 20 dian organizations.
21 22 23 24 ‘‘(h) RESEARCH AND EVALUATION.—The Secretary, in consultation with stakeholders with appropriate exper- tise in such models, shall develop a strategic plan to re- search and evaluate the evidence for such models.

The •HR 6142 IH Secretary shall use such plan to inform the activities car- 126 ried out under this section.
‘‘(i) REPORTING.— ‘‘(1) BY ELIGIBLE ENTITIES.—An eligible enti- ty that receives a grant under subsection (a) shall submit to the Secretary a report, at such time, in such manner, and containing such information as the Secretary may require.
‘‘(2) BY THE SECRETARY.—Not later than 4 years after the date of enactment of this section, the Secretary shall prepare and submit to the Congress, and post on the internet website of the Department of Health and Human Services, a report including, at minimum— ‘‘(A) a description of any new and con- tinuing grants awarded under subsection (a) and the specific purpose and amounts of such grants; ‘‘(B) an overview of— ‘‘(i) the evaluations conducted under subsection (b); ‘‘(ii) technical assistance provided under subsection (g); and ‘‘(iii) activities conducted by entities awarded grants under subsection (a); and •HR 6142 IH 127 ‘‘(C) a description of any significant find- ings related to patient outcomes or maternal health care providers and best practices for eli- gible entities expanding, using, or evaluating technology-enabled collaborative learning and capacity building models.
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this section, $6,000,000 for each of fiscal years 2021 through 2025.
‘‘(k) DEFINITIONS.—In this section: ‘‘(1) ELIGIBLE ENTITY.— ‘‘(A) IN GENERAL.—The term ‘eligible en- tity’ means an entity that provides, or supports the provision of, maternal health care services or other evidence-based services for pregnant and postpartum women— ‘‘(i) in health professional shortage areas; ‘‘(ii) in areas with high rates of ad- verse maternal health outcomes and sig- nificant racial and ethnic disparities in ma- ternal health outcomes; or ‘‘(iii) medically underserved popu- lations or American Indians and Alaska Natives, including Indian tribes, tribal or- •HR 6142 IH 128 ganizations, and urban Indian organiza- tions.
‘‘(B) INCLUSIONS.—An eligible entity may include entities leading, or capable of leading, a technology-enabled collaborative learning and capacity building model or engaging in tech- nology-enabled collaborative training of partici- pants in such model.

‘‘(2) HEALTH PROFESSIONAL SHORTAGE AREA.—The term ‘health professional shortage area’ means a health professional shortage area des- ignated under section 332.
‘‘(3) INDIAN TRIBE.—The term ‘Indian tribe’ has the meaning given such term in section 4 of the Indian Self-Determination and Education Assistance Act.

‘‘(4) MATERNAL MORTALITY.—The term ‘ma- ternal mortality’ means a death occurring during or within 1-year period after pregnancy caused by preg- nancy or childbirth complications.

‘‘(5) MEDICALLY UNDERSERVED POPU- LATION.—The term ‘medically underserved popu- lation’ has the meaning given such term in section 330(b)(3).
•HR 6142 IH 129 ‘‘(6) POSTPARTUM.—The term ‘postpartum’ means the 1-year period beginning on the last date of the pregnancy of a woman.
‘‘(7) SEVERE MATERNAL MORBIDITY.—The term ‘severe maternal morbidity’ means an unex- pected outcome caused by labor and delivery of a woman that results in significant short-term or long- term consequences to the health of the woman.
‘‘(8) TECHNOLOGY-ENABLED COLLABORATIVE LEARNING AND CAPACITY BUILDING MODEL.—The term ‘technology-enabled collaborative learning and capacity building model’ means a distance health education model that connects health care profes- sionals, and particularly specialists, with multiple other health care professionals through simultaneous interactive videoconferencing for the purpose of fa- cilitating case-based learning, disseminating best practices, and evaluating outcomes in the context of maternal health care.
‘‘(9) TRIBAL ORGANIZATION.—The term ‘Tribal organization’ has the meaning given such term in section 4 of the Indian Self-Determination and Edu- cation Assistance Act.
‘‘(10) URBAN INDIAN ORGANIZATION.—The term ‘urban Indian organization’ has the meaning •HR 6142 IH 130 given such term in section 4 of the Indian Health Care Improvement Act.’’.

SEC.

803.
SEC.

803.

GRANTS TO PROMOTE EQUITY IN MATERNAL HEALTH OUTCOMES BY INCREASING ACCESS TO DIGITAL TOOLS.
(a) IN GENERAL.—Beginning not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall carry out a program (in this section referred to as ‘‘Investments in Digital Tools to Promote Equity in Maternal Health Outcomes Program’’ or ‘‘Program’’) under which the Secretary makes grants to eligible entities reduce racial and ethnic disparities in maternal health outcomes by increasing ac- cess to digital tools related to maternal health care.
(b) APPLICATIONS.—To be eligible to receive a grant 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 re- 19 quire.

20 (c) LIMITATIONS.— (1) NUMBER.—The Secretary may not award more than 1 grant under this section to an eligible entity.

(2) DURATION.—Each grant under this section shall be made for a period of not more than 5 years.
•HR 6142 IH 131 (3) AMOUNT.—The Secretary shall determine the maximum amount of each grant under this sec- tion.
(4) PRIORITIZATION.—In awarding grants under this section, the Secretary shall prioritize the selection of an eligible entity that— (A) operates in an area with high rates of adverse maternal health outcomes and signifi- cant racial and ethnic disparities in maternal health outcomes; and (B) promotes technology that addresses ra- cial and ethnic disparities in maternal health outcomes.
(d) TECHNICAL ASSISTANCE.—The Secretary shall provide technical assistance to an eligible entity on the de- velopment, use, evaluation, and post-grant sustainability of digital tools for purposes of promoting equity in mater- nal health outcomes.
(e) REPORTING.— (1) BY ELIGIBLE ENTITIES.—An eligible entity that receives a grant under subsection (a) shall sub- mit to the Secretary a report, at such time, in such manner, and containing such information as the Sec- retary may require.
•HR 6142 IH 132 (2) BY THE SECRETARY.—Not later than 4 years after the date of the enactment of this Act, the Secretary shall submit to Congress a report that— (A) evaluates the effectiveness of grants awarded under this section in improving mater- nal health outcomes for minority women; (B) makes recommendations for future grant programs that promote the use of tech- nology to improve maternal health outcomes for minority women; and (C) makes recommendations that ad- dress— (i) privacy and security safeguards that should be implemented in the use of technology in maternal health care; (ii) reimbursement rates for maternal telehealth services; (iii) the use of digital tools to analyze large data sets for the purposes of identi- fying potential pregnancy-related complica- tions as early as possible; (iv) barriers that prevent maternal health care providers from providing tele- health services across states and rec- ommendations from the Centers for Medi- •HR 6142 IH 133 care and Medicaid Services for addressing such barriers in State Medicaid programs; (v) the use of consumer digital tools such as mobile phone applications, patient portals, and wearable technologies to im- prove maternal health outcomes; (vi) barriers that prevent consumers from accessing telehealth services or other digital technologies to improve maternal health outcomes, including a lack of access to reliable, high-speed internet or lack of access to electronic devices needed to use such services and technologies; and (vii) any other related issues as deter- mined by the Secretary.
(f) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this section, $6,000,000 for each of fiscal years 2021 through 2025.

(g) ELIGIBLE ENTITY DEFINED.—In this section, the term ‘‘eligible entity’’ is an entity that is described in section 51a.3(a) of title 42, Code of Federal Regula- tions, including domestic faith-based and community- based organizations.
•HR 6142 IH SEC.

804.

REPORT ON THE USE OF TECHNOLOGY TO RE- 134 DUCE MATERNAL MORTALITY AND SEVERE MATERNAL MORBIDITY AND TO CLOSE RA- CIAL AND ETHNIC DISPARITIES IN OUT- COMES.
(a) IN GENERAL.—Not later than 60 days after the date of enactment of this Act, the Secretary of Health and Human Services shall seek to enter an agreement with the National Academies of Sciences, Engineering, and Medi- cine (referred to in this Act as the ‘‘National Academies’’) under which the National Academies shall conduct a study on the use of technology to reduce preventable maternal mortality and severe maternal morbidity, and close racial and ethnic disparities in maternal health outcomes in the United States.
The study shall assess current and future uses of artificial intelligence in maternity care, including issues such as— 26 (1) the extent to which artificial intelligence technologies are currently being used in maternal health care; (2) the extent to which artificial intelligence technologies have exacerbated racial or ethnic biases in maternal health care; (3) recommendations for reducing racial or eth- nic biases in artificial intelligence technologies used in maternal health care; •HR 6142 IH 135 (4) recommendations for potential applications of artificial intelligence technologies that could im- prove maternal health outcomes, particularly for mi- nority women; and (5) recommendations for privacy and security safeguards that should be implemented in the devel- opment of artificial intelligence technologies in ma- ternal health care.
(b) REPORT.—As a condition of any agreement under subsection (a), the Administrator shall require that the National Academies transmit to Congress a report on the results of the study under subsection (a) not later than 24 months after the date of enactment of this Act.

TITLE IX—IMPACT TO SAVE MOMS SEC.

901.

PERINATAL CARE ALTERNATIVE PAYMENT MODEL DEMONSTRATION PROJECT.
(a) IN GENERAL.—For the period of fiscal years 2022 through 2026, the Secretary of Health and Human Services (referred to in this section as the ‘‘Secretary’’), acting through the Administrator of the Centers for Medi- care & Medicaid Services, shall establish and implement, in accordance with the requirements of this section, a demonstration project, to be known as the Perinatal Care Alternative Payment Model Demonstration Project (re- •HR 6142 IH 136 ferred to in this section as the ‘‘Demonstration Project’’), for purposes of allowing States to test payment models under their State plans under title XIX of the Social Secu- rity Act (42 U.S.C.
1396 et seq.)

and State child health plans under title XXI of such Act (42 U.S.C.

1397aa et seq.)

with respect to maternity care provided to pregnant and postpartum women enrolled in such State plans and State child health plans.
(b) COORDINATION.—In establishing the Demonstra- 10 tion Project, the Secretary shall coordinate with stake- 11 holders such as— (1) State Medicaid programs; (2) relevant organizations representing mater- nal health care providers; (3) relevant organizations representing patients, with a particular focus on women from demographic groups with disproportionate rates of adverse mater- nal health outcomes; (4) relevant community-based organizations, particularly organizations that seek to improve ma- ternal health outcomes for women from demographic groups with disproportionate rates of adverse mater- nal health outcomes; (5) non-clinical perinatal health workers such as doulas, community health workers, peer supporters, •HR 6142 IH 137 certified lactation consultants, nutritionists and di- eticians, social workers, home visitors, and naviga- tors; (6) relevant health insurance issuers; (7) hospitals, health systems, freestanding birth centers (as such term is defined in paragraph (3)(B) of section 1905(l) of the Social Security Act (42 U.S.C.
1396d(l)), Federally-qualified health centers (as such term is defined in paragraph (2)(B) of such section), and rural health clinics (as such term is de- fined in section 1861(aa) of such Act (42 U.S.C.
1395x(aa))); (8) researchers and policy experts in fields re- lated to maternity care payment models; and (9) any other stakeholders as the Secretary de- termines appropriate, with a particular focus on stakeholders from demographic groups with dis- proportionate rates of adverse maternal health out- comes.
(c) CONSIDERATIONS.—In establishing the Dem- onstration Project, the Secretary shall consider each of the following: 23 24 25 (1) Findings from any evaluations of the Strong Start for Mothers and Newborns initiative carried out by the Centers for Medicare & Medicaid •HR 6142 IH 138 Services, the Health Resources and Services Admin- istration, and the Administration on Children and Families.
(2) Any alternative payment model that— (A) is designed to improve maternal health outcomes for racial and ethnic groups with dis- proportionate rates of adverse maternal health outcomes; (B) includes methods for stratifying pa- tients by pregnancy risk level and, as appro- priate, adjusting payments under such model to take into account pregnancy risk level; (C) establishes evidence-based quality metrics for such payments; (D) includes consideration of non-hospital birth settings such as freestanding birth centers (as so defined); (E) includes consideration of social deter- minants of health that are relevant to maternal health outcomes such as housing, transpor- tation, nutrition, and other non-clinical factors that influence maternal health outcomes; or (F) includes diverse maternity care teams that include— •HR 6142 IH 139 (i) maternity care providers, including obstetrician-gynecologists, family physi- cians, physician assistants, midwives who meet, at a minimum, the international def- inition of the term ‘‘midwife’’ and global standards for midwifery education (as es- tablished by the International Confed- eration of Midwives), and nurse practi- tioners— (I) from racially, ethnically, and professionally diverse backgrounds; (II) with experience practicing in racially and ethnically diverse commu- nities; or (III) who have undergone trainings on racism, implicit bias, and explicit bias; and (ii) non-clinical perinatal health work- ers such as doulas, community health workers, peer supporters, certified lacta- tion consultants, nutritionists and dieti- cians, social workers, home visitors, and navigators.
(d) ELIGIBILITY.—To be eligible to participate in the Demonstration Project, a State shall submit an applica- •HR 6142 IH 140 tion to the Secretary at such time, in such manner, and containing such information as the Secretary may require.
(e) EVALUATION.—The Secretary shall conduct an evaluation of the Demonstration Project to determine the impact of the Demonstration Project on— (1) maternal health outcomes, with data strati- fied by race, ethnicity, socioeconomic indicators, and any other factors as the Secretary determines appro- priate; (2) spending on maternity care by States par- ticipating in the Demonstration Project; (3) to the extent practicable, subjective meas- ures of patient experience; and (4) any other areas of assessment that the Sec- retary determines relevant.
(f) REPORT.—Not later than one year after the com- pletion or termination date of the Demonstration Project, the Secretary shall submit to the Committee on Energy and Commerce, the Committee on Ways and Means, and the Committee on Education and Labor of the House of Representatives and the Committee on Finance and the Committee on Health, Education, Labor, and Pensions of the Senate, and make publicly available, a report con- taining— •HR 6142 IH 141 (1) the results of any evaluation conducted under subsection (e); and (2) a recommendation regarding whether the Demonstration Project should be continued after fis- cal year 2026 and expanded on a national basis.
(g) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated such sums as are nec- essary to carry out this section.

(h) DEFINITIONS.—In this section: (1) ALTERNATIVE PAYMENT MODEL.—The term ‘‘alternative payment model’’ has the meaning given such term in section 1833(z)(3)(C) of the So- cial Security Act (42 U.S.C.

1395l(z)(3)(C)).
1395l(z)(3)(C)).

(2) PERINATAL.—The term ‘‘perinatal’’ means the period beginning on the day a woman becomes pregnant and ending on the last day of the 1-year period beginning on the last day of such woman’s pregnancy.

SEC.

902.

MACPAC REPORT.


Not later than two years after the date of the enact- ment of this Act, the Medicaid and CHIP Payment and Access Commission shall publish a report on issues relat- ing to the continuity of coverage under State plans under title XIX of the Social Security Act (42 U.S.C.

1396 et seq.)
1396 et seq.)

and State child health plans under title XXI of such •HR 6142 IH 142 Act (42 U.S.C.

1397aa et seq.)

for pregnant and postpartum women.


Such report shall, at a minimum, in- clude the following: (1) An assessment of any existing policies under such State plans and such State child health plans regarding presumptive eligibility for pregnant women while their application for enrollment in such a State plan or such a State child health plan is being processed.
(2) An assessment of any existing policies under such State plans and such State child health plans regarding measures to ensure continuity of coverage under such a State plan or such a State child health plan for pregnant and postpartum women, including such women who need to change their health insurance coverage during their preg- nancy or the postpartum period following their preg- nancy.
(3) An assessment of any existing policies under such State plans and such State child health plans regarding measures to automatically reenroll women who are eligible to enroll under such a State plan or such a State child health plan as a parent.
(4) If determined appropriate by the Commis- sion, any recommendations for the Department of •HR 6142 IH 143 Health and Human Services, or such State plans and such State child health plans, to ensure con- tinuity of coverage under such a State plan or such a State child health plan for pregnant and postpartum women.
•HR 6142 IH