II 

118TH CONGRESS 

2D SESSION S. 4060 

To improve maternal health policies in correctional facilities, and for other 

purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 22, 2024 

Mr. BOOKER (for himself, Mr. DURBIN, and Ms. HIRONO) introduced the following bill; which was read twice and referred to the Committee on the 

Judiciary 

A BILL 

To improve maternal health policies in correctional facilities, 

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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Justice for Incarcer5 ated Moms Act’’. 

6 SEC. 2. ENDING THE SHACKLING OF PREGNANT INDIVID7 UALS. 

8 (a) IN GENERAL.—Beginning on the date that is 180 

9 days after the date of enactment of this Act, and annually 

10 thereafter, for each State that receives a grant under subVerDate Sep 11 2014 05:29 Apr 09, 2024 Jkt 049200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S4060.IS S4060

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1 part 1 of part E of title I of the Omnibus Crime Control 

2 and Safe Streets Act of 1968 (34 U.S.C. 10151 et seq.) 

3 (commonly referred to as the ‘‘Edward Byrne Memorial 

4 Justice Assistance Grant Program’’) and that does not 

5 have in effect throughout the State for such fiscal year 

6 laws restricting the use of restraints on pregnant individ7 uals in correctional facilities that are substantially similar 

8 to the rights, procedures, requirements, effects, and pen9 alties set forth in section 4322 of title 18, United States 

10 Code, the amount of such grant that would otherwise be 

11 allocated to such State under such subpart for the fiscal 

12 year shall be decreased by 25 percent. 

13 (b) REALLOCATION.—Amounts not allocated to a 

14 State for failure to comply with subsection (a) shall be 

15 reallocated in accordance with subpart 1 of part E of title 

16 I of the Omnibus Crime Control and Safe Streets Act of 

17 1968 (34 U.S.C. 10151 et seq.) to States that have com18 plied with such subsection. 

19 SEC. 3. CREATING MODEL PROGRAMS FOR THE CARE OF 

20 INCARCERATED INDIVIDUALS IN THE PRE21 NATAL AND POSTPARTUM PERIODS. 

22 (a) IN GENERAL.— 

23 (1) ESTABLISHMENT.—Not later than 1 year 

24 after the date of enactment of this Act, the Attorney 

25 General, acting through the Director of the Bureau 


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1 of Prisons (referred to in this section as the ‘‘Direc2 tor’’), shall establish, in not fewer than 6 Bureau of 

3 Prisons facilities, programs to optimize maternal 

4 health outcomes for pregnant and postpartum indi5 viduals incarcerated in such facilities. 

6 (2) CONSULTATION WITH STAKEHOLDERS.— 

7 The Attorney General shall establish such programs 

8 in consultation with stakeholders such as— 

9 (A) relevant community-based organiza10 tions, particularly organizations that represent 

11 incarcerated and formerly incarcerated individ12 uals and organizations that seek to improve ma13 ternal health outcomes for pregnant and 

14 postpartum individuals from demographic 

15 groups with elevated rates of maternal mor16 tality, severe maternal morbidity, maternal 

17 health disparities, or other adverse perinatal or 

18 childbirth outcomes; 

19 (B) relevant organizations representing pa20 tients, with a particular focus on patients from 

21 demographic groups with elevated rates of ma22 ternal mortality, severe maternal morbidity, ma23 ternal health disparities, or other adverse 

24 perinatal or childbirth outcomes; 


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1 (C) organizations representing maternity 

2 care providers and maternal health care edu3 cation programs; 

4 (D) perinatal health workers; and 

5 (E) researchers and policy experts in fields 

6 related to maternal health care for incarcerated 

7 individuals. 

8 (b) START DATE.—A facility selected under sub9 section (a) shall begin the programs described in sub10 section (e) not later than 18 months after the date of en11 actment of this Act. 

12 (c) FACILITY PRIORITY.—In carrying out subsection 

13 (a), the Director shall give priority to a facility based on— 

14 (1) the number of pregnant and postpartum in15 dividuals incarcerated in such facility and, among 

16 such individuals, the number of pregnant and 

17 postpartum individuals from demographic groups 

18 with elevated rates of maternal mortality, severe ma19 ternal morbidity, maternal health disparities, or 

20 other adverse perinatal or childbirth outcomes; and 

21 (2) the extent to which the leaders of such facil22 ity have demonstrated a commitment to developing 

23 exemplary programs for pregnant and postpartum 

24 individuals incarcerated in such facility. 


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1 (d) PROGRAM DURATION.—The programs established 

2 under subsection (e) shall be carried out for a 5-year pe3 riod. 

4 (e) PROGRAMS.—Bureau of Prisons facilities selected 

5 by the Director shall establish programs for pregnant and 

6 postpartum incarcerated individuals, and such programs 

7 may— 

8 (1) provide access to perinatal health workers 

9 from pregnancy through the postpartum period; 

10 (2) provide access to healthy foods and coun11 seling on nutrition, recommended activity levels, and 

12 safety measures throughout pregnancy; 

13 (3) train correctional officers to ensure that 

14 pregnant incarcerated individuals receive safe and 

15 respectful treatment; 

16 (4) train medical personnel to ensure that preg17 nant incarcerated individuals receive trauma-in18 formed, culturally and linguistically congruent care 

19 that promotes the health and safety of the pregnant 

20 individuals; 

21 (5) provide counseling and treatment for indi22 viduals who have suffered from— 

23 (A) diagnosed mental or behavioral health 

24 conditions, including trauma and substance use 

25 disorders; 


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1 (B) trauma or violence, including domestic 

2 violence; 

3 (C) human immunodeficiency virus; 

4 (D) sexual abuse; 

5 (E) pregnancy or infant loss; or 

6 (F) chronic conditions; 

7 (6) provide evidence-based pregnancy and child8 birth education, parenting support, and other rel9 evant forms of health literacy; 

10 (7) provide clinical education opportunities to 

11 maternity care providers in training to expand path12 ways into maternal health care careers serving incar13 cerated individuals; 

14 (8) offer opportunities for postpartum individ15 uals to maintain contact with the individual’s new16 born child to promote bonding, including enhanced 

17 visitation policies, access to prison nursery pro18 grams, or breastfeeding support; 

19 (9) provide reentry assistance, particularly to— 

20 (A) ensure access to health insurance cov21 erage and transfer of health records to commu22 nity providers if an incarcerated individual exits 

23 the criminal justice system during such individ24 ual’s pregnancy or in the postpartum period; 

25 and 


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1 (B) connect individuals exiting the criminal 

2 justice system during pregnancy or in the 

3 postpartum period to community-based re4 sources, such as referrals to health care pro5 viders, substance use disorder treatments, and 

6 social services that address social determinants 

7 of maternal health; or 

8 (10) establish partnerships with local public en9 tities, private community entities, community-based 

10 organizations, Indian Tribes and Tribal organiza11 tions (as such terms are defined in section 4 of the 

12 Indian Self-Determination and Education Assistance 

13 Act (25 U.S.C. 5304)), and Urban Indian organiza14 tions (as such term is defined in section 4 of the In15 dian Health Care Improvement Act (25 U.S.C. 

16 1603)) to establish or expand pretrial diversion pro17 grams as an alternative to incarceration for preg18 nant and postpartum individuals, including— 

19 (A) evidence-based childbirth education or 

20 parenting classes; 

21 (B) prenatal health coordination; 

22 (C) family and individual counseling; 

23 (D) evidence-based screenings, education, 

24 and, as needed, treatment for mental and beVerDate Sep 11 2014 05:29 Apr 09, 2024 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S4060.IS S4060

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1 havioral health conditions, including drug and 

2 alcohol treatments; 

3 (E) family case management services; 

4 (F) domestic violence education and pre5 vention; 

6 (G) physical and sexual abuse counseling; 

7 and 

8 (H) programs to address social deter9 minants of health such as employment, housing, 

10 education, transportation, and nutrition. 

11 (f) IMPLEMENTATION AND REPORTING.—A facility 

12 selected under subsection (a) shall be responsible for— 

13 (1) implementing programs, which may include 

14 the programs described in subsection (e); and 

15 (2) not later than 3 years after the date of en16 actment of this Act, reporting results of the pro17 grams to the Director, including information de18 scribing— 

19 (A) relevant quantitative indicators of suc20 cess in improving the standard of care and 

21 health outcomes for pregnant and postpartum 

22 incarcerated individuals in the facility, including 

23 data stratified by race, ethnicity, sex, gender, 

24 primary language, age, geography, disability 

25 status, the category of the criminal charge 


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1 against such individual, rates of pregnancy-re2 lated deaths, pregnancy-associated deaths, cases 

3 of infant mortality and morbidity, rates of 

4 preterm births and low-birthweight births, cases 

5 of severe maternal morbidity, cases of violence 

6 against pregnant or postpartum individuals, di7 agnoses of maternal mental or behavioral health 

8 conditions, and other such information as ap9 propriate; 

10 (B) relevant qualitative and quantitative 

11 evaluations from pregnant and postpartum in12 carcerated individuals who participated in such 

13 programs, including measures of patient-re14 ported experience of care; and 

15 (C) strategies to sustain such programs 

16 after fiscal year 2029 and expand such pro17 grams to other facilities. 

18 (g) REPORT.—Not later than 6 years after the date 

19 of enactment of this Act, the Director shall submit to the 

20 Attorney General and Congress a report describing the re21 sults of the programs funded under this section. 

22 (h) OVERSIGHT.—Not later than 1 year after the 

23 date of enactment of this Act, the Attorney General shall 

24 award a contract to an independent organization or indeVerDate Sep 11 2014 05:29 Apr 09, 2024 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S4060.IS S4060

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1 pendent organizations to conduct oversight of the pro2 grams described in subsection (e). 

3 (i) AUTHORIZATION OF APPROPRIATIONS.—There is 

4 authorized to be appropriated to carry out this section 

5 $10,000,000 for each of fiscal years 2025 through 2029. 

6 SEC. 4. GRANT PROGRAM TO IMPROVE MATERNAL HEALTH 

7 OUTCOMES FOR INDIVIDUALS IN STATE AND 

8 LOCAL CORRECTIONAL FACILITIES. 

9 (a) IN GENERAL.— 

10 (1) ESTABLISHMENT.—Not later than 1 year 

11 after the date of enactment of this Act, the Attorney 

12 General, acting through the Director of the Bureau 

13 of Justice Assistance (referred to in this section as 

14 the ‘‘Director’’), shall award Justice for Incarcerated 

15 Moms grants to States to establish or expand pro16 grams in State and local correctional facilities for 

17 pregnant and postpartum incarcerated individuals. 

18 (2) CONSULTATION WITH STAKEHOLDERS.— 

19 The Attorney General shall award such grants in 

20 consultation with stakeholders such as— 

21 (A) relevant community-based organiza22 tions, particularly organizations that represent 

23 incarcerated and formerly incarcerated individ24 uals and organizations that seek to improve ma25 ternal health outcomes for pregnant and 


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1 postpartum individuals from demographic 

2 groups with elevated rates of maternal mor3 tality, severe maternal morbidity, maternal 

4 health disparities, or other adverse perinatal or 

5 childbirth outcomes; 

6 (B) relevant organizations representing pa7 tients, with a particular focus on patients from 

8 demographic groups with elevated rates of ma9 ternal mortality, severe maternal morbidity, ma10 ternal health disparities, or other adverse 

11 perinatal or childbirth outcomes; 

12 (C) organizations representing maternity 

13 care providers and maternal health care edu14 cation programs; 

15 (D) perinatal health workers; and 

16 (E) researchers and policy experts in fields 

17 related to maternal health care for incarcerated 

18 individuals. 

19 (b) APPLICATIONS.—Each applicant for a grant 

20 under this section shall submit to the Director an applica21 tion at such time, in such manner, and containing such 

22 information as the Director may require. 

23 (c) USE OF FUNDS.—A State that is awarded a grant 

24 under this section shall use such grant to establish or exVerDate Sep 11 2014 05:29 Apr 09, 2024 Jkt 049200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S4060.IS S4060

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1 pand programs for pregnant and postpartum incarcerated 

2 individuals, and such programs may— 

3 (1) provide access to perinatal health workers 

4 from pregnancy through the postpartum period; 

5 (2) provide access to healthy foods and coun6 seling on nutrition, recommended activity levels, and 

7 safety measures throughout pregnancy; 

8 (3) train correctional officers to ensure that 

9 pregnant incarcerated individuals receive safe and 

10 respectful treatment; 

11 (4) train medical personnel to ensure that preg12 nant incarcerated individuals receive trauma-in13 formed, culturally and linguistically congruent care 

14 that promotes the health and safety of the pregnant 

15 individuals; 

16 (5) provide counseling and treatment for indi17 viduals who have suffered from— 

18 (A) diagnosed mental or behavioral health 

19 conditions, including trauma and substance use 

20 disorders; 

21 (B) trauma or violence, including domestic 

22 violence; 

23 (C) human immunodeficiency virus; 

24 (D) sexual abuse; 

25 (E) pregnancy or infant loss; or 


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1 (F) chronic conditions; 

2 (6) provide evidence-based pregnancy and child3 birth education, parenting support, and other rel4 evant forms of health literacy; 

5 (7) provide clinical education opportunities to 

6 maternity care providers in training to expand path7 ways into maternal health care careers serving incar8 cerated individuals; 

9 (8) offer opportunities for postpartum individ10 uals to maintain contact with the individual’s new11 born child to promote bonding, including enhanced 

12 visitation policies, access to prison nursery pro13 grams, or breastfeeding support; 

14 (9) provide reentry assistance, particularly to— 

15 (A) ensure access to health insurance cov16 erage and transfer of health records to commu17 nity providers if an incarcerated individual exits 

18 the criminal justice system during such individ19 ual’s pregnancy or in the postpartum period; 

20 and 

21 (B) connect individuals exiting the criminal 

22 justice system during pregnancy or in the 

23 postpartum period to community-based re24 sources, such as referrals to health care pro25 viders, substance use disorder treatments, and 


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1 social services that address social determinants 

2 of maternal health; or 

3 (10) establish partnerships with local public en4 tities, private community entities, community-based 

5 organizations, Indian Tribes and Tribal organiza6 tions (as such terms are defined in section 4 of the 

7 Indian Self-Determination and Education Assistance 

8 Act (25 U.S.C. 5304)), and Urban Indian organiza9 tions (as such term is defined in section 4 of the In10 dian Health Care Improvement Act (25 U.S.C. 

11 1603)) to establish or expand pretrial diversion pro12 grams as an alternative to incarceration for preg13 nant and postpartum individuals, including— 

14 (A) evidence-based childbirth education or 

15 parenting classes; 

16 (B) prenatal health coordination; 

17 (C) family and individual counseling; 

18 (D) evidence-based screenings, education, 

19 and, as needed, treatment for mental and be20 havioral health conditions, including drug and 

21 alcohol treatments; 

22 (E) family case management services; 

23 (F) domestic violence education and pre24 vention; 


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1 (G) physical and sexual abuse counseling; 

2 and 

3 (H) programs to address social deter4 minants of health such as employment, housing, 

5 education, transportation, and nutrition. 

6 (d) PRIORITY.—In awarding grants under this sec7 tion, the Director shall give priority to applicants based 

8 on— 

9 (1) the number of pregnant and postpartum in10 dividuals incarcerated in the State and, among such 

11 individuals, the number of pregnant and postpartum 

12 individuals from demographic groups with elevated 

13 rates of maternal mortality, severe maternal mor14 bidity, maternal health disparities, or other adverse 

15 perinatal or childbirth outcomes; and 

16 (2) the extent to which the State has dem17 onstrated a commitment to developing exemplary 

18 programs for pregnant and postpartum individuals 

19 incarcerated in the correctional facilities in the 

20 State. 

21 (e) GRANT DURATION.—A grant awarded under this 

22 section shall be for a period of 5 years. 

23 (f) IMPLEMENTING AND REPORTING.—A State that 

24 receives a grant under this section shall be responsible 

25 for— 


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1 (1) implementing the program funded by the 

2 grant; and 

3 (2) not later than 3 years after the date of en4 actment of this Act reporting results of such pro5 gram to the Attorney General, including information 

6 describing— 

7 (A) relevant quantitative indicators of the 

8 success of the program in improving the stand9 ard of care and health outcomes for pregnant 

10 and postpartum incarcerated individuals in the 

11 facility, including data stratified by race, eth12 nicity, sex, gender, primary language, age, ge13 ography, disability status, category of the crimi14 nal charge against such individual, incidence 

15 rates of pregnancy-related deaths, pregnancy16 associated deaths, cases of infant mortality and 

17 morbidity, rates of preterm births and low18 birthweight births, cases of severe maternal 

19 morbidity, cases of violence against pregnant or 

20 postpartum individuals, diagnoses of maternal 

21 mental or behavioral health conditions, and 

22 other such information as appropriate; 

23 (B) relevant qualitative and quantitative 

24 evaluations from pregnant and postpartum in25 carcerated individuals who participated in such 


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1 programs, including measures of patient-re2 ported experience of care; and 

3 (C) strategies to sustain such programs be4 yond the duration of the grant and expand such 

5 programs to other facilities. 

6 (g) REPORT.—Not later than 6 years after the date 

7 of enactment of this Act, the Attorney General shall sub8 mit to Congress a report describing the results of pro9 grams carried out using grants under this subsection. 

10 (h) OVERSIGHT.—Not later than 1 year after the 

11 date of enactment of this Act, the Attorney General shall 

12 award a contract to an independent organization or inde13 pendent organizations to conduct oversight of the pro14 grams described in subsection (c). 

15 (i) AUTHORIZATION OF APPROPRIATIONS.—There is 

16 authorized to be appropriated to carry out this section 

17 $10,000,000 for each of fiscal years 2025 through 2029. 

18 SEC. 5. GAO REPORT. 

19 (a) IN GENERAL.—Not later than 2 years after the 

20 date of enactment of this Act, the Comptroller General 

21 of the United States shall submit to Congress a report 

22 on adverse maternal and infant health outcomes among 

23 incarcerated individuals and infants born to such individ24 uals, with a particular focus on racial and ethnic dispariVerDate Sep 11 2014 05:29 Apr 09, 2024 Jkt 049200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\S4060.IS S4060

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1 ties in maternal and infant health outcomes for incarcer2 ated individuals. 

3 (b) CONTENTS OF REPORT.—The report described in 

4 subsection (a) shall include— 

5 (1) to the extent practicable, for the available 

6 data for the 10 years preceding the date of the re7 port— 

8 (A) the number of pregnant individuals 

9 who are incarcerated in Bureau of Prisons fa10 cilities; 

11 (B) the number of incarcerated individuals, 

12 including those incarcerated in Federal, State, 

13 and local correctional facilities, who have expe14 rienced a pregnancy-related death, pregnancy15 associated death, or the death of an infant; 

16 (C) the number of cases of severe maternal 

17 morbidity among incarcerated individuals, in18 cluding those incarcerated in Federal, State, 

19 and local correctional facilities; 

20 (D) the number of stillbirths, miscarriages, 

21 and other adverse pregnancy outcomes experi22 enced by incarcerated individuals, including 

23 those incarcerated in Federal, State, and local 

24 correctional facilities; 


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1 (E) the number of pregnant incarcerated 

2 individuals, including those incarcerated in Fed3 eral, State, and local correctional facilities, re4 ceiving prenatal care; 

5 (F) the number of preterm and low-birth6 weight births of infants born to incarcerated in7 dividuals, including those incarcerated in Fed8 eral, State, and local correctional facilities; and 

9 (G) statistics on the racial and ethnic dis10 parities in maternal and infant health outcomes 

11 and severe maternal morbidity rates among in12 carcerated individuals, including those incarcer13 ated in Federal, State, and local correctional fa14 cilities; 

15 (2) in the case that the Comptroller General of 

16 the United States is unable determine the informa17 tion required under paragraph (1), an assessment of 

18 the barriers to determining such information and 

19 recommendations for improvements in tracking ma20 ternal health outcomes among incarcerated individ21 uals, including those incarcerated in Federal, State, 

22 and local correctional facilities; 

23 (3) the implications of pregnant and 

24 postpartum incarcerated individuals being ineligible 

25 for medical assistance under a State plan under title 


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1 XIX of the Social Security Act (42 U.S.C. 1396 et 

2 seq.), including information about— 

3 (A) the effects of such ineligibility on ma4 ternal health outcomes for pregnant and 

5 postpartum incarcerated individuals, with em6 phasis given to such effects for pregnant and 

7 postpartum individuals from racial and ethnic 

8 minority groups; and 

9 (B) potential implications on maternal 

10 health outcomes resulting from temporarily sus11 pending, rather than permanently terminating, 

12 such eligibility when a pregnant or postpartum 

13 individual is incarcerated; 

14 (4) the extent to which Federal, State, and 

15 local correctional facilities are holding pregnant and 

16 postpartum individuals who test positive for illicit 

17 drug use in detention with special conditions, such 

18 as additional bond requirements, due to drug use by 

19 the individual, and the effect of such detention poli20 cies on maternal and infant health outcomes; 

21 (5) causes of adverse maternal health outcomes 

22 that are unique to incarcerated individuals, including 

23 those incarcerated in Federal, State, and local cor24 rectional facilities; 


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1 (6) causes of adverse maternal health outcomes 

2 and severe maternal morbidity that are unique to in3 carcerated individuals from racial and ethnic minor4 ity groups; 

5 (7) recommendations to reduce maternal mor6 tality and severe maternal morbidity among incar7 cerated individuals and to address racial and ethnic 

8 disparities in maternal health outcomes for incarcer9 ated individuals in Bureau of Prisons facilities and 

10 State and local correctional facilities; and 

11 (8) such other information as may be appro12 priate to reduce the occurrence of adverse maternal 

13 health outcomes among incarcerated individuals and 

14 to address racial and ethnic disparities in maternal 

15 health outcomes for such individuals. 

Æ 


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