II 

118TH CONGRESS 

2D SESSION S. 4079 

To improve obstetric emergency care. 

IN THE SENATE OF THE UNITED STATES 

APRIL 9, 2024 

Ms. HASSAN (for herself, Ms. COLLINS, Mrs. BRITT, and Ms. SMITH) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To improve obstetric emergency care. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Rural Obstetrics Read5 iness Act’’. 

6 SEC. 2. OBSTETRIC EMERGENCY TRAINING PROGRAM. 

7 Section 330O of the Public Health Service Act (42 

8 U.S.C. 254c–21) is amended— 

9 (1) in subsection (a)— 

10 (A) in paragraph (3), by striking ‘‘; and’’ 

11 and inserting a semicolon; 


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1 (B) in paragraph (4), by striking the pe2 riod and inserting ‘‘; and’’; and 

3 (C) by adding at the end the following: 

4 ‘‘(5) developing, and facilitating access to, an 

5 evidence-based program to train practitioners in 

6 rural health care facilities without dedicated obstet7 ric units to provide emergency obstetric services dur8 ing pregnancy, labor, delivery, or the postpartum pe9 riod, including training on how to prepare for, iden10 tify, stabilize, and safely transfer, as appropriate 

11 and within the scope of practice of an individual 

12 practitioner, a woman experiencing labor, delivery, 

13 obstetric hemorrhage, severe hypertension, cardiac 

14 conditions, perinatal mental health conditions, sub15 stance use, sepsis, or other conditions, as appro16 priate.’’; 

17 (2) by redesignating subsections (c) and (d) as 

18 subsections (d) and (e), respectively; 

19 (3) by inserting after subsection (b) the fol20 lowing: 

21 ‘‘(c) TRAINING PROGRAM FOR ELIGIBLE PRACTI22 TIONERS IN RURAL HEALTH CARE FACILITIES.—A train23 ing program described in subsection (a)(5) shall include 

24 an assessment of obstetric training needs for rural health 

25 care facilities without dedicated obstetric units. In develVerDate Sep 11 2014 22:31 Apr 14, 2024 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4079.IS S4079

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1 oping the training program, a recipient of a grant under 

2 such subsection shall— 

3 ‘‘(1) work in consultation with at least one rep4 resentative from a national medical society that has 

5 experience or expertise in rural health care delivery 

6 in each of the fields of gynecology and obstetrics, 

7 emergency medicine, family medicine, and anesthesi8 ology; and 

9 ‘‘(2) facilitate access to obstetric readiness 

10 training via regional training partnerships and tech11 nical assistance to rural health care facilities.’’; and 

12 (4) in subsection (e), as so redesignated, by 

13 adding at the end the following: ‘‘In addition to 

14 amounts appropriated under the previous sentence, 

15 for grants for the purpose described in subsection 

16 (a)(5), there are authorized to be appropriated 

17 $5,000,000 for the period of fiscal years 2025 

18 through 2027’’. 

19 SEC. 3. GRANT FUNDING FOR EQUIPMENT AND SUPPLIES. 

20 Part D of title III of the Public Health Service Act 

21 (42 U.S.C. 254b et seq.) is amended by inserting after 

22 section 330A–2 the following: 


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1 ‘‘SEC. 330A–3. PROGRAM OF SUPPORT FOR OBSTETRIC 

2 SERVICES. 

3 ‘‘(a) IN GENERAL.—The Secretary shall award 

4 grants, contracts, or cooperative agreements to eligible en5 tities to integrate obstetric readiness training curriculum 

6 into rural health care settings, build workforce capacity, 

7 and purchase equipment necessary to manage obstetric 

8 emergencies. 

9 ‘‘(b) USE OF FUNDS.—A recipient of funds under 

10 this section shall use such funds for the purpose described 

11 in subsection (a), which may include any of the following: 

12 ‘‘(1) Purchasing or providing equipment and 

13 technical assistance to train practitioners who are 

14 not specialized in obstetrics in preparing for, identi15 fying, stabilizing, and transferring, as appropriate 

16 and within the scope of practice of the practitioner, 

17 individuals experiencing obstetric emergencies. 

18 ‘‘(2) Purchasing or providing equipment nec19 essary to prepare for, identify, stabilize, or transfer, 

20 as appropriate, individuals experiencing obstetric 

21 emergencies. 

22 ‘‘(3) Developing and carrying out protocols for 

23 transfer of patients to other facilities and network 

24 engagement with other facilities. 

25 ‘‘(4) Hiring additional personnel or paying the 

26 salaries of personnel. 


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1 ‘‘(5) Establishing training opportunities to en2 able non-obstetric health professionals to gain expo3 sure to, and expertise in, the delivery of obstetric 

4 services, including through clinical rotations, fellow5 ships, or cross-training clinicians in other specialties. 

6 ‘‘(6) Enabling clinical educators to coordinate, 

7 develop, and implement comprehensive interdiscipli8 nary trainings, including team-based simulation 

9 training for providers who may need to respond to 

10 an obstetric emergency. 

11 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

12 a grant under this section, an entity shall— 

13 ‘‘(1) be— 

14 ‘‘(A) a rural hospital, critical access hos15 pital (as determined under section 1820(c)(2) 

16 of the Social Security Act), or a rural emer17 gency hospital (as defined in section 

18 1861(kkk)(2) of the Social Security Act) that is 

19 located in a maternity care health professional 

20 target area or a rural area (as defined by the 

21 Secretary); or 

22 ‘‘(B) a consortium of 3 entities that in23 cludes at least 2 entities described in subpara24 graph (A); and 


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1 ‘‘(2) agree to carry out the program described 

2 in subsection (a), in coordination with other feder3 ally funded maternal and child health programs, to 

4 the extent practicable, and in consultation with other 

5 maternal and child health programs in the same geo6 graphic area. 

7 ‘‘(d) DEFINITIONS.—In this section— 

8 ‘‘(1) the term ‘maternity care health profes9 sional target area’ means a primary care health pro10 fessional shortage area that is experiencing a short11 age of maternity health care professionals, as identi12 fied under section 332(k); and 

13 ‘‘(2) the term ‘rural area’ has the meaning 

14 given such term by the Federal Office of Rural 

15 Health Policy. 

16 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

17 carry out this section, there is authorized to be appro18 priated $15,000,000 for the period of fiscal years 2025 

19 through 2028.’’. 

20 SEC. 4. PILOT PROGRAM FOR TELECONSULTATION. 

21 Part D of title III of the Public Health Service Act 

22 (42 U.S.C. 254b et seq.), as amended by section 3, is fur23 ther amended by inserting after section 330A–2 the fol24 lowing: 


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1 ‘‘SEC. 330A–4. PILOT PROGRAM FOR TELECONSULTATION. 

2 ‘‘(a) IN GENERAL.—The Secretary, acting through 

3 the Administrator of the Health Resources and Services 

4 Administration and in consultation with the Administrator 

5 of the Centers for Medicare & Medicaid Services, shall 

6 award grants or cooperative agreements to States, political 

7 subdivisions of States, and Indian Tribes and Tribal orga8 nizations (as such terms are defined in section 4 of the 

9 Indian Self-Determination and Education Assistance Act 

10 (25 U.S.C. 5304)) to support the provision of urgent ma11 ternal health care in rural facilities without a dedicated 

12 obstetric unit, including by— 

13 ‘‘(1) supporting the development of statewide or 

14 regional maternal health care telehealth access pro15 grams; and 

16 ‘‘(2) supporting the improvement of existing 

17 statewide or regional maternal health care telehealth 

18 access programs described in subsection (b). 

19 ‘‘(b) STATEWIDE OR REGIONAL MATERNAL HEALTH

20 CARE TELEHEALTH ACCESS PROGRAMS.—A maternal 

21 health care telehealth access program described in this 

22 section, with respect to which an award under subsection 

23 (a) may be used, shall— 

24 ‘‘(1) be a statewide or regional network of ma25 ternal health care teams that provide urgent support 

26 to rural non-obstetric settings of care; 


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1 ‘‘(2) support and further develop organized 

2 State or regional networks of maternal health care 

3 teams to provide urgent consultative support to 

4 rural non-obstetric settings of care; 

5 ‘‘(3) conduct an assessment of urgent maternal 

6 health consultation needs among providers in rural 

7 non-obstetric settings of care; 

8 ‘‘(4) provide assurances that the physicians re9 sponsive to the tele-consultation line are credentialed 

10 within their employing facility and can provide con11 sultation where the patient is receiving care con12 sistent with State requirements to provide care to in13 dividuals experiencing labor, delivery, obstetric hem14 orrhage, severe hypertension in pregnancy and 

15 postpartum, cardiac conditions related to or exacer16 bated by pregnancy, perinatal mental health condi17 tions, substance use during pregnancy or the 

18 postpartum period, sepsis during pregnancy or after 

19 pregnancy end, or other conditions, as appropriate; 

20 ‘‘(5) provide rapid statewide or regional clinical 

21 telephone or telehealth consultations when requested 

22 between the maternal care teams and providers in 

23 rural emergency non-obstetric settings; and 

24 ‘‘(6) provide information to health care pro25 viders about available maternal health services for 


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1 people in the community and assist with referrals to 

2 specialty care and community or behavioral health 

3 resources. 

4 ‘‘(c) REPORTING.—An entity receiving an award 

5 under this section shall submit a report to the Secretary, 

6 in such manner and containing such information as the 

7 Secretary may require, not later than 18 months after ini8 tial receipt of the grant. 

9 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—To 

10 carry out this section, there is authorized to be appro11 priated $5,000,000 for the period of fiscal years 2025 

12 through 2028.’’. 

13 SEC. 5. STUDY ON OBSTETRIC UNITS IN RURAL AREAS. 

14 The Secretary of Health and Human Services shall— 

15 (1) conduct a study that maps maternity ward 

16 closures and regional patterns of patient transport 

17 and examines models for regional partnerships for 

18 rural obstetric care; and 

19 (2) not later than 3 years after the date of en20 actment of this Act, submit to the Committee on 

21 Health, Education, Labor, and Pensions of the Sen22 ate and the Committee on Energy and Commerce 

23 and the Committee on Education and the Workforce 


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1 of the House of Representatives, a report on the re2 sults of the study conducted under paragraph (1). 

Æ 


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