II 

115TH CONGRESS 

1ST SESSION S. 1112 

To support States in their work to save and sustain the health of mothers 

during pregnancy, childbirth, and in the postpartum period, to eliminate 

disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths, to identify solutions to improve health care 

quality and health outcomes for mothers, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 11, 2017 

Ms. HEITKAMP (for herself and Mrs. CAPITO) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To support States in their work to save and sustain the 

health of mothers during pregnancy, childbirth, and in 

the postpartum period, to eliminate disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths, to identify solutions to improve 

health care quality and health outcomes for mothers, 

and for other purposes. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Maternal Health Ac3 countability Act of 2017’’. 

4 SEC. 2. FINDINGS; PURPOSES. 

5 (a) FINDINGS.—Congress finds the following: 

6 (1) The United States is ranked 50th globally 

7 for its maternal mortality rate, and it is one of eight 

8 countries in which the maternal mortality rate has 

9 been on the rise. 

10 (2) In recent studies, the estimated maternal 

11 mortality rate in the United States increased by ap12 proximately 26.6 percent from 2000 to 2014, with 

13 the rate increasing in nearly all States. This re14 ported increase, along with no improvement in pre15 vious years, remains a source of great concern for 

16 the Centers for Disease Control and Prevention 

17 (CDC), health care providers, and patient advocates 

18 such as the American Congress of Obstetricians and 

19 Gynecologists, the Association of Women’s Health, 

20 Obstetric, and Neonatal Nurses, and the 

21 Preeclampsia Foundation. 

22 (3) Maternal deaths in the United States result 

23 from pregnancy-related causes such as hemorrhage, 

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1 dose, and violent causes such as motor vehicle acci2 dents, homicide, and suicide. 

3 (4) As of 2017, less than 25 States conduct 

4 systematic reviews of maternal deaths and/or have 

5 standing maternal mortality review committees in 

6 order to develop the data needed to work toward 

7 management and solutions. 

8 (5) Review of pregnancy-related and pregnancy9 associated deaths is essential to determining strate10 gies for developing prevention efforts and quality im11 provement and quality control programs. The United 

12 States must identify at-risk populations and under13 stand how to support them to make pregnancy and 

14 the postpartum period safer. 

15 (6) The most severe complications of preg16 nancy, generally referred to as severe maternal mor17 bidity (SMM), affect more than 65,000 women in 

18 the United States every year. The CDC uses ICD– 

19 9–CM codes, which indicate a potentially life-threat20 ening maternal condition or complication, to define 

21 SMM. 

22 (7) Data from the CDC shows Black women 

23 are three times more likely to die from complications 

24 of pregnancy or childbirth than White women: 42.8 


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1 Black women per 100,000 live births, as opposed to 

2 12.5 White women and 17.3 women of other races. 

3 (8) The CDC recommends that maternal deaths 

4 be investigated through State collaboratives. These 

5 State collaboratives would bring together leaders in 

6 obstetric and neonatal health care from private, aca7 demic, and public health care settings to make rec8 ommendations for preventing pregnancy-related and 

9 pregnancy-associated deaths and health complica10 tions and identify ways to improve quality of care 

11 for women and infants. 

12 (9) A few States, including California, have 

13 worked to develop and strengthen maternal mor14 bidity and mortality review systems and utilize data 

15 to reduce maternal deaths and injuries to address 

16 leading issues such as maternal hemorrhage, hyper17 tension and preeclampsia, and health and racial dis18 parities. 

19 (b) PURPOSES.—The purposes of this Act are the fol20 lowing: 

21 (1) To establish a shared responsibility between 

22 States and the Federal Government to identify op23 portunities for improvement in quality of care and 

24 system changes, and to educate and inform health 

25 institutions and professionals, women, and families 


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1 about preventing pregnancy-related and pregnancy2 associated deaths and complications and reducing 

3 disparities. 

4 (2) To develop a model for States and Federally 

5 recognized Indian tribes and tribal organizations to 

6 operate maternal mortality reviews and assess the 

7 various factors that may have contributed to mater8 nal mortality, including quality of care, racial dis9 parities, and systemic problems in the delivery of 

10 health care, and to develop appropriate interventions 

11 to reduce and prevent such deaths. 

12 SEC. 3. STATE MATERNAL MORTALITY REVIEW COMMIT13 TEES ON PREGNANCY-RELATED AND PREG14 NANCY-ASSOCIATED DEATHS. 

15 (a) PROGRAM AUTHORIZED.— 

16 (1) IN GENERAL.—The Secretary of Health and 

17 Human Services, through the Director of the Cen18 ters for Disease Control and Prevention, shall estab19 lish a grant program under which the Secretary may 

20 make grants to States, and Federally recognized In21 dian tribes and tribal organizations, for the purpose 

22 of— 

23 (A) carrying out the activities described in 

24 subsection (b)(1); 


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1 (B) establishing and sustaining a State 

2 maternal mortality review committee, in accord3 ance with subsection (b)(2); 

4 (C) ensuring that the State department of 

5 health carries out the activities described in 

6 subsection (b)(3); 

7 (D) disseminating the case abstraction 

8 form developed under subsection (c); and 

9 (E) providing for the public disclosure of 

10 information, in accordance with subsection (d). 

11 (2) CRITERIA.—The Secretary shall establish 

12 criteria for determining eligibility for, and the 

13 amount of a grant awarded to, a State under para14 graph (1). Such criteria shall provide that in the 

15 case of a State that receives a grant under para16 graph (1) for a fiscal year and is determined by the 

17 Secretary to have not used such grant in accordance 

18 with this section, such State may not be eligible for 

19 such a grant for any subsequent fiscal year. 

20 (b) USE OF FUNDS.— 

21 (1) REVIEW OF PREGNANCY-RELATED AND

22 PREGNANCY-ASSOCIATED DEATHS.—With respect to 

23 a State that receives a grant under subsection 

24 (a)(1), the following shall apply: 


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1 (A) PROCESS FOR MANDATORY REPORTING

2 OF PREGNANCY-RELATED AND PREGNANCY-AS3 SOCIATED DEATHS.— 

4 (i) IN GENERAL.—The State, through 

5 the State maternal mortality review com6 mittee established under subsection (a)(1), 

7 shall develop a process that provides for 

8 mandatory and confidential case reporting 

9 to the State department of health by indi10 viduals and entities described in clause (ii) 

11 with respect to pregnancy-related and 

12 pregnancy-associated deaths. 

13 (ii) INDIVIDUALS AND ENTITIES DE14 SCRIBED.—Individuals and entities de15 scribed in this clause include each of the 

16 following: 

17 (I) Health care professionals. 

18 (II) Medical examiners. 

19 (III) Medical coroners. 

20 (IV) Hospitals. 

21 (V) Birth centers. 

22 (VI) Other health care facilities. 

23 (VII) Other individuals respon24 sible for completing death records. 


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1 (VIII) Other appropriate individ2 uals or entities specified by the Sec3 retary. 

4 (B) PROCESS FOR VOLUNTARY REPORTING

5 OF PREGNANCY-RELATED AND PREGNANCY-AS6 SOCIATED DEATHS.—The State, through the 

7 State maternal mortality review committee es8 tablished under subsection (a)(1), shall develop 

9 a process that provides for voluntary and con10 fidential case reporting to the State department 

11 of health by family members of the deceased 

12 and other individuals on possible pregnancy-re13 lated and pregnancy-associated deaths. Such 

14 process shall include— 

15 (i) making publicly available on the 

16 website of the State department of health 

17 a telephone number, Internet web link, and 

18 email address for such reporting; and 

19 (ii) publicizing to local professional or20 ganizations, community organizations, and 

21 social services agencies the availability of 

22 the telephone number, Internet web link, 

23 and email address made available under 

24 clause (i). 


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1 (C) IDENTIFICATION OF PREGNANCY-RE2 LATED AND PREGNANCY-ASSOCIATED DEATHS

3 BY STATE VITAL STATISTICS UNIT.—The State, 

4 through the vital statistics unit of the State, 

5 shall annually identify pregnancy-related and 

6 pregnancy-associated deaths occurring in such 

7 State in the year involved by— 

8 (i) matching each death record of a 

9 woman in such year to a live birth certifi10 cate or an infant death record for the pur11 pose of identifying deaths of women that 

12 occurred during pregnancy and within one 

13 year after the end of a pregnancy; 

14 (ii) identifying each death of a woman 

15 reported during such year as having an un16 derlying or contributing cause of death re17 lated to pregnancy, regardless of the time 

18 that has passed between the end of the 

19 pregnancy and the death; 

20 (iii) collecting data from medical ex21 aminer and coroner reports; and 

22 (iv) using any other method the State 

23 may devise to identify maternal deaths 

24 such as reviewing a random sample of re25 ported deaths of women to ascertain cases 


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1 of pregnancy-related and pregnancy-associ2 ated deaths that are not discernable from 

3 a review of death records alone. 

4 For purposes of effectively collecting and ob5 taining data on pregnancy-related and preg6 nancy-associated deaths, the State shall adopt 

7 the most recent standardized birth and death 

8 records, as issued by the National Center for 

9 Vital Health Statistics, including the rec10 ommended checkbox section for pregnancy on 

11 each death record. 

12 (D) CASE INVESTIGATION AND DEVELOP13 MENT OF CASE SUMMARIES.— 

14 (i) IN GENERAL.—Following the re15 ceipt of reports by the State department of 

16 health pursuant to subparagraph (A) or 

17 (B) and the collection of cases of preg18 nancy-related and pregnancy-associated 

19 deaths by the vital statistics unit of the 

20 State under subparagraph (C), the State, 

21 through the State maternal mortality re22 view committee established under sub23 section (a)(1), shall investigate each case, 

24 using the case abstraction form described 

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1 fied case summary for each case, which 

2 shall be reviewed by the committee and in3 cluded in applicable reports. The State de4 partment of health or vital statistics unit 

5 of the State, as the case may be, shall pro6 vide the State maternal mortality review 

7 committee with access to the information 

8 collected pursuant to subparagraphs (A) or 

9 (B), or under subparagraph (C), as nec10 essary to carry out this subparagraph. 

11 (ii) MANDATORY DATA AND INFORMA12 TION.—Each case investigation under this 

13 subparagraph shall, subject to availability, 

14 include data and information obtained 

15 through— 

16 (I) medical examiner and autopsy 

17 reports of the woman involved; 

18 (II) medical records of the 

19 woman, including such records related 

20 to health care prior to pregnancy, pre21 natal and postnatal care, labor and 

22 delivery care, emergency room care, 

23 hospital discharge records, and any 

24 care delivered up until the time of 

25 death of the woman; 


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1 (III) oral and written interviews 

2 of individuals directly involved in the 

3 maternal care of the woman during 

4 and immediately following the preg5 nancy of the woman, including health 

6 care, mental health, and social service 

7 providers, as applicable; 

8 (IV) socioeconomic and other rel9 evant background information about 

10 the woman; 

11 (V) any information collected 

12 under subparagraph (C)(i); and 

13 (VI) any other information on 

14 the cause of death of the woman, such 

15 as social services and child welfare re16 ports. 

17 (iii) DISCRETIONARY DATA AND IN18 FORMATION.—Each case investigation 

19 under this subparagraph may include data 

20 and information obtained through oral or 

21 written interviews of the family of the 

22 woman. 

23 (2) STATE MATERNAL MORTALITY REVIEW

24 COMMITTEES.— 


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1 (A) MANDATORY ACTIVITIES.—A State 

2 maternal mortality review committee established 

3 under subsection (a)(1) shall carry out the fol4 lowing activities: 

5 (i) Develop the processes described in 

6 subparagraphs (A) and (B) of paragraph 

7 (1). 

8 (ii) Review the data and information 

9 collected by the vital statistics unit of the 

10 State under paragraph (1)(C) regarding 

11 pregnancy-related and pregnancy-associ12 ated deaths to identify trends, patterns, 

13 and disparities in adverse outcomes and 

14 address medical, non-medical, and system15 related factors that may have contributed 

16 to such pregnancy-related and pregnancy17 associated deaths and disparities. 

18 (iii) Carry out the activities described 

19 in paragraph (1)(D). 

20 (iv) Develop recommendations, based 

21 on the case summaries prepared under 

22 paragraph (1)(D) and the data and infor23 mation collected under paragraph (1)(C), 

24 to improve maternal care, social and health 

25 services, and public health policy and instiVerDate Sep 11 2014 04:33 May 13, 2017 Jkt 069200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S1112.IS S1112

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1 tutions, including improving access to ma2 ternal care and social and health services 

3 and identifying disparities in maternal care 

4 and outcomes. 

5 (B) DISCRETIONARY ACTIVITIES.— 

6 (i) IN GENERAL.—A State maternal 

7 mortality review committee established 

8 under subsection (a)(1) may, while subject 

9 to confidentiality requirements, present 

10 findings and recommendations based on 

11 the case summaries prepared under para12 graph (1)(D) directly to a health care facil13 ity or its local or State professional organi14 zation for the purpose of— 

15 (I) instituting policy changes, 

16 educational activities, and improve17 ments in the quality of care provided 

18 by the facility; and 

19 (II) exploring and forming re20 gional collaborations. 

21 (ii) INVESTIGATION OF CASES OF SE22 VERE MATERNAL MORBIDITY.—A State 

23 maternal mortality review committee may 

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1 clude data and information obtained 

2 through— 

3 (I) identified patient registries; 

4 or 

5 (II) oral or written interviews of 

6 the woman concerned and the family 

7 of such woman. 

8 (C) COMPOSITION OF STATE MATERNAL

9 MORTALITY REVIEW COMMITTEES.— 

10 (i) IN GENERAL.—A State maternal 

11 mortality review committee established 

12 under subsection (a)(1) shall be multidisci13 plinary and diverse. Membership on the 

14 State maternal mortality review committee 

15 shall be reviewed annually by the State de16 partment of health to ensure that member17 ship representation requirements are being 

18 fulfilled in accordance with this subpara19 graph. 

20 (ii) REQUIRED MEMBERSHIP.—Each 

21 State maternal mortality review committee 

22 shall include— 

23 (I) representatives from medical 

24 specialties providing care to pregnant 

25 and postpartum patients, including 


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1 obstetricians (including generalists 

2 and maternal fetal medicine special3 ists) and family practice physicians; 

4 (II) certified nurse midwives, cer5 tified midwives, and advanced practice 

6 nurses; 

7 (III) hospital-based registered 

8 nurses; 

9 (IV) representatives of the ma10 ternal and child health department of 

11 the State department of health; 

12 (V) social service providers or so13 cial workers, including those with ex14 perience working with communities di15 verse with respect to race, ethnicity, 

16 and limited English proficiency; 

17 (VI) chief medical examiners or 

18 designees; 

19 (VII) facility representatives, 

20 such as from hospitals or birth cen21 ters; 

22 (VIII) patient advocates, commu23 nity maternal health organizations, 

24 and minority advocacy groups that 

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1 nic communities within the State that 

2 are the most affected by pregnancy3 related or pregnancy-associated deaths 

4 and by a lack of access to maternal 

5 health care services; and 

6 (IX) representatives of the de7 partments of health or public health 

8 of major cities in the State. 

9 (iii) DISCRETIONARY MEMBERSHIP.— 

10 Each State maternal mortality review com11 mittee may also include representatives 

12 from other relevant academic, health, so13 cial service, or policy professions or com14 munity organizations on an ongoing basis, 

15 or as needed, as determined beneficial by 

16 the committee, including— 

17 (I) anesthesiologists; 

18 (II) emergency physicians; 

19 (III) pathologists; 

20 (IV) epidemiologists; 

21 (V) intensivists; 

22 (VI) nutritionists; 

23 (VII) mental health professionals; 

24 (VIII) substance use disorder 

25 treatment specialists; 


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1 (IX) representatives of relevant 

2 patient and provider advocacy groups; 

3 (X) academics; 

4 (XI) paramedics; 

5 (XII) risk management special6 ists; and 

7 (XIII) representatives of Feder8 ally recognized Indian tribes and trib9 al organizations. 

10 (iv) STAFF.—Staff of each State ma11 ternal mortality review committee shall in12 clude— 

13 (I) vital health statisticians, ma14 ternal child health statisticians, or 

15 epidemiologists; 

16 (II) a coordinator of the State 

17 maternal mortality review committee, 

18 to be designated by the State; and 

19 (III) administrative staff. 

20 (D) OPTION FOR STATES TO ESTABLISH

21 REGIONAL MATERNAL MORTALITY REVIEW COM22 MITTEES.—States may choose to partner with 

23 one or more neighboring States to carry out the 

24 activities required of a State maternal mortality 

25 review committee under this section. In such a 


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1 case, with respect to the States in such a part2 nership, any requirement under this section re3 lating to the reporting of information related to 

4 such activities shall be deemed to be fulfilled by 

5 each such State if a single such report is sub6 mitted for the partnership. 

7 (E) TREATMENT AS PUBLIC HEALTH AU8 THORITY FOR PURPOSES OF HIPAA.—For pur9 poses of applying HIPAA privacy and security 

10 law (as defined in section 3009(a)(2) of the 

11 Public Health Service Act (42 U.S.C. 300jj– 

12 19)), each State maternal mortality review com13 mittee and regional maternal mortality review 

14 committee established under subsection (a)(1) 

15 or subsection (b)(2)(D), as the case may be, 

16 shall be deemed to be a public health authority 

17 described in section 164.501 (and referenced in 

18 section 164.512(b)(1)(i)) of title 45, Code of 

19 Federal Regulations (or any successor regula20 tion), carrying out public health activities and 

21 purposes described in such section 

22 164.512(b)(1)(i) (or any such successor regula23 tion). 

24 (3) STATE DEPARTMENT OF HEALTH ACTIVI25 TIES.—With respect to a State that receives a grant 


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1 under subsection (a)(1), the State department of 

2 health shall— 

3 (A) in consultation with the State maternal 

4 mortality review committee and in conjunction 

5 with relevant professional organizations and pa6 tient advocacy organizations, develop a plan for 

7 ongoing health care provider education, based 

8 on the findings and recommendations of the 

9 committee, in order to improve the quality of 

10 maternal care; and 

11 (B) take steps to widely disseminate the 

12 findings and recommendations of the State ma13 ternal mortality review committee and imple14 ment the recommendations of the committee. 

15 (c) CASE ABSTRACTION FORM.— 

16 (1) DISSEMINATION.—The Director of the Cen17 ters for Disease Control and Prevention shall dis18 seminate a uniform case abstraction form to States 

19 and State maternal mortality review committees for 

20 the purpose of— 

21 (A) ensuring that the data and information 

22 collected and reviewed by such committees can 

23 be pooled for review by the Department of 

24 Health and Human Services and its agencies; 

25 and 


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1 (B) preserving the uniformity of the infor2 mation collected for Federal public health pur3 poses. 

4 (2) PERMISSIBLE STATE MODIFICATION.—Each 

5 State may modify the form developed under para6 graph (1) for implementation and use by such State 

7 or by the State maternal mortality review committee 

8 of such State by including on such form additional 

9 information to be collected, but may not alter the 

10 standard questions on such form, in order to ensure 

11 that the information can be collected and reviewed 

12 centrally at the Federal level. 

13 (d) PUBLIC DISCLOSURE OF INFORMATION.— 

14 (1) IN GENERAL.—For fiscal year 2018, or a 

15 subsequent fiscal year, each State receiving a grant 

16 under this section for such year shall, subject to 

17 paragraph (3), provide for the public disclosure, and 

18 submission to the information clearinghouse estab19 lished under paragraph (2), of the information in20 cluded in the report of the State under subsection 

21 (f)(1) for such year. 

22 (2) INFORMATION CLEARINGHOUSE.—The Sec23 retary shall establish an information clearinghouse, 

24 to be administered by the Director of the Centers for 

25 Disease Control and Prevention, that will maintain 


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1 findings and recommendations submitted pursuant 

2 to paragraph (1) and provide such findings and rec3 ommendations for public review and research pur4 poses by State departments of health, State mater5 nal mortality review committees, and health pro6 viders and institutions. 

7 (3) CONFIDENTIALITY OF INFORMATION.—In 

8 no case may any individually identifiable health in9 formation be provided to the public, or submitted to 

10 the information clearinghouse, under this subsection. 

11 (e) CONFIDENTIALITY OF PROCEEDINGS OF STATE

12 MATERNAL MORTALITY REVIEW COMMITTEES.— 

13 (1) IN GENERAL.—All proceedings and activi14 ties of a State maternal mortality review committee 

15 established under subsection (a)(1), opinions of 

16 members of such a committee formed as a result of 

17 such proceedings and activities, and records ob18 tained, created, or maintained pursuant to this sec19 tion, including records of interviews, written reports, 

20 and statements procured by the Department of 

21 Health and Human Services or by any other person, 

22 agency, or organization acting jointly with the De23 partment, in connection with morbidity and mor24 tality reviews under this section, shall be confidential 

25 and may not be subject to discovery, subpoena, or 


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1 introduction into evidence in any civil, criminal, leg2 islative, or other proceeding. Such records shall not 

3 be open to public inspection. 

4 (2) TESTIMONY OF MEMBERS OF COM5 MITTEE.— 

6 (A) IN GENERAL.—Members of a State 

7 maternal mortality review committee established 

8 under subsection (a)(1) may not be questioned 

9 in any civil, criminal, legislative, or other pro10 ceeding regarding information presented in, or 

11 opinions formed as a result of, a meeting or 

12 communication of the committee. 

13 (B) CLARIFICATION.—Nothing in this sub14 section may be construed to prevent a member 

15 of a State maternal mortality review committee 

16 established under subsection (a)(1) from testi17 fying regarding information that was obtained 

18 independent of such member’s participation on 

19 the committee, or public information. 

20 (3) AVAILABILITY OF INFORMATION FOR RE21 SEARCH PURPOSES.—Nothing in this subsection may 

22 prohibit a State maternal mortality review com23 mittee established under subsection (a)(1) or the De24 partment of Health and Human Services from pubVerDate Sep 11 2014 04:33 May 13, 2017 Jkt 069200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\S1112.IS S1112

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1 lishing statistical compilations and research reports 

2 that— 

3 (A) are based on confidential information, 

4 relating to morbidity and mortality reviews 

5 under this section; and 

6 (B) do not contain identifying information 

7 or any other information that could be used to 

8 ultimately identify the individuals concerned. 

9 (f) REPORTS.— 

10 (1) STATE REPORTS.—For fiscal year 2018, 

11 and each subsequent fiscal year, each State maternal 

12 mortality review committee established under sub13 section (a)(1) and receiving a grant under this sec14 tion for such year, shall submit to the Director of 

15 the Centers for Disease Control and Prevention a re16 port on the findings and recommendations of such 

17 committee and information on the implementation of 

18 such recommendations during such year. 

19 (2) ANNUAL REPORTS TO CONGRESS.—For fis20 cal year 2018, and each subsequent fiscal year, the 

21 Secretary of Health and Human Services shall sub22 mit to Congress a report on— 

23 (A) the findings, recommendations, and 

24 implementation information submitted by any 

25 State pursuant to paragraph (1); and 


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1 (B) the status of pregnancy-related and 

2 pregnancy-associated deaths in the United 

3 States, including recommendations on methods 

4 to prevent such deaths in the United States. 

5 (g) DEFINITIONS.—In this section: 

6 (1) The term ‘‘pregnancy-associated death’’ 

7 means the death of a woman while pregnant or dur8 ing the one-year period following the date of the end 

9 of pregnancy, irrespective of the cause of such death. 

10 (2) The term ‘‘pregnancy-related death’’ means 

11 the death of a woman while pregnant or during the 

12 one-year period following the date of the end of 

13 pregnancy, irrespective of the duration of the preg14 nancy, from any cause related to, or aggravated by, 

15 the pregnancy or its management, excluding any ac16 cidental or incidental cause. 

17 (3) The term ‘‘Secretary’’ means the Secretary 

18 of Health and Human Services. 

19 (4) The term ‘‘severe maternal morbidity’’ 

20 means the physical and psychological conditions that 

21 result from, or are aggravated by, pregnancy and 

22 have an adverse effect on the health of a woman. 

23 (5) The term ‘‘State’’ means each of the 50 

24 States, the District of Columbia, and each of the 

25 territories, and shall include Federally recognized InVerDate Sep 11 2014 04:33 May 13, 2017 Jkt 069200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S1112.IS S1112

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1 dian tribes and tribal organizations that receive a 

2 grant under subsection (a)(1). Such tribes and orga3 nizations shall meet the requirements applicable to 

4 States under this section as determined appropriate 

5 by the Secretary. 

6 (6) The term ‘‘vital statistics unit’’ means the 

7 entity that is responsible for maintaining vital 

8 records for a State, including official records of live 

9 births, deaths, fetal deaths, marriages, divorces, and 

10 annulments. 

11 (h) AUTHORIZATION OF APPROPRIATIONS.—There is 

12 authorized to be appropriated to carry out this section 

13 $7,000,000 for each of fiscal years 2018 through 2022. 

14 SEC. 4. ELIMINATING DISPARITIES IN MATERNITY HEALTH 

15 OUTCOMES. 

16 Part B of title III of the Public Health Service Act 

17 is amended by inserting after section 317T of such Act 

18 (42 U.S.C. 247b–22) the following new section: 

19 ‘‘SEC. 317U. ELIMINATING DISPARITIES IN MATERNAL 

20 HEALTH OUTCOMES. 

21 ‘‘(a) IN GENERAL.—The Secretary shall, in consulta22 tion with relevant national stakeholder organizations, such 

23 as national medical specialty organizations, national ma24 ternal child health organizations, national patient advo25 cacy organizations, and national health disparity organizaVerDate Sep 11 2014 04:33 May 13, 2017 Jkt 069200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\S1112.IS S1112

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1 tions, carry out the following activities to eliminate dis2 parities in maternal health outcomes: 

3 ‘‘(1) Conduct research into the determinants 

4 and the distribution of disparities in maternal care, 

5 health risks, and health outcomes, and improve the 

6 capacity of the performance measurement infrastruc7 ture to measure such disparities. 

8 ‘‘(2) Expand access to health care services, re9 sources, and information that have been dem10 onstrated to improve the quality and outcomes of 

11 maternity care for vulnerable populations. 

12 ‘‘(3) Establish a demonstration project to com13 pare the effectiveness of interventions to reduce dis14 parities in maternity services and outcomes and to 

15 implement and assess effective interventions. 

16 ‘‘(b) SCOPE AND SELECTION OF STATES FOR DEM17 ONSTRATION PROJECT.—The demonstration project 

18 under subsection (a)(3) shall be conducted in no more 

19 than 8 States, which shall be selected by the Secretary 

20 based on— 

21 ‘‘(1) applications submitted by States, which 

22 specify which regions and populations the State in23 volved will serve under the demonstration project; 

24 ‘‘(2) criteria designed by the Secretary to en25 sure that, as a whole, the demonstration project is, 


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1 to the greatest extent possible, representative of the 

2 demographic and geographic composition of commu3 nities most affected by disparities; 

4 ‘‘(3) criteria designed by the Secretary to en5 sure that a variety of models are tested through the 

6 demonstration project and that such models include 

7 interventions that have an existing evidence base for 

8 effectiveness; and 

9 ‘‘(4) criteria designed by the Secretary to en10 sure that the demonstration projects and models will 

11 be carried out in consultation with local and regional 

12 provider organizations, such as community health 

13 centers, hospital systems, and medical societies rep14 resenting providers of maternity services. 

15 ‘‘(c) DURATION OF DEMONSTRATION PROJECT.— 

16 The demonstration project under subsection (a)(3) shall 

17 begin on January 1, 2018, and end on December 31, 

18 2021. 

19 ‘‘(d) GRANTS FOR EVALUATION AND MONITORING.— 

20 The Secretary may make grants to States and health care 

21 providers participating in the demonstration project under 

22 subsection (a)(3) for the purpose of collecting data nec23 essary for the evaluation and monitoring of such project. 

24 ‘‘(e) REPORTS.— 


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1 ‘‘(1) STATE REPORTS.—Each State that par2 ticipates in the demonstration project under sub3 section (a)(3) shall report to the Secretary, in a 

4 time, form, and manner specified by the Secretary, 

5 the data necessary to— 

6 ‘‘(A) monitor the— 

7 ‘‘(i) outcomes of the project; 

8 ‘‘(ii) costs of the project; and 

9 ‘‘(iii) quality of maternity care pro10 vided under the project; and 

11 ‘‘(B) evaluate the rationale for the selec12 tion of the items and services included in any 

13 bundled payment made by the State under the 

14 project. 

15 ‘‘(2) FINAL REPORT.—Not later than December 

16 31, 2022, the Secretary shall submit to Congress a 

17 report on the results of the demonstration project 

18 under subsection (a)(3).’’. 

Æ 


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