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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3137 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  1st Session
                                S. 3137

 To allow Americans to receive paid leave time to process and address 
 their own health needs and the health needs of their partners during 
    the period following a pregnancy loss, an unsuccessful round of 
  intrauterine insemination or of an assisted reproductive technology 
     procedure, a failed adoption arrangement, a failed surrogacy 
    arrangement, or a diagnosis or event that impacts pregnancy or 
  fertility, to support related research and education, and for other 
                               purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            October 26, 2023

Ms. Duckworth (for herself, Ms. Baldwin, Mr. Blumenthal, Mr. Casey, Mr. 
 Fetterman, Mrs. Gillibrand, Ms. Hirono, Mr. Merkley, Mr. Padilla, Ms. 
 Smith, Ms. Warren, and Mr. Whitehouse) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL

 
 To allow Americans to receive paid leave time to process and address 
 their own health needs and the health needs of their partners during 
    the period following a pregnancy loss, an unsuccessful round of 
  intrauterine insemination or of an assisted reproductive technology 
     procedure, a failed adoption arrangement, a failed surrogacy 
    arrangement, or a diagnosis or event that impacts pregnancy or 
  fertility, to support related research and education, and for other 
                               purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Support Through Loss Act''.

SEC. 2. PURPOSES.

    The purposes of this Act are--
            (1) to allow individuals in the United States to receive 
        supplementary paid leave time to process and address their own 
        health needs and the health needs of their partners during the 
        period following a pregnancy loss, an unsuccessful round of 
        intrauterine insemination or of an assisted reproductive 
        technology procedure, a failed adoption arrangement, a failed 
        surrogacy arrangement, or a diagnosis or event that impacts 
        pregnancy or fertility; and
            (2) to support related research or education.

             TITLE I--PAID LEAVE FOLLOWING A PREGNANCY LOSS

SEC. 101. DEFINITIONS.

    In this title:
            (1) Assisted reproductive technology procedure.--The term 
        ``assisted reproductive technology procedure'' has the meaning 
        given the term ``assisted reproductive technology'' in section 
        8 of the Fertility Clinic Success Rate and Certification Act of 
        1992 (42 U.S.C. 263a-7).
            (2) Commerce.--The terms ``commerce'' and ``industry or 
        activity affecting commerce'' mean any activity, business, or 
        industry in commerce or in which a labor dispute would hinder 
        or obstruct commerce or the free flow of commerce, and include 
        ``commerce'' and any ``industry affecting commerce'', as 
        defined in paragraphs (1) and (3) of section 501 of the Labor 
        Management Relations Act, 1947 (29 U.S.C. 142 (1) and (3)).
            (3) Domestic partner.--The term ``domestic partner'', used 
        with respect to an unmarried employee, includes--
                    (A) the person recognized as the domestic partner 
                of the employee under any domestic partnership or civil 
                union law of a State or political subdivision of a 
                State; and
                    (B) an unmarried, adult person who is in a 
                committed, personal relationship with the employee, who 
                is not a domestic partner as described in subparagraph 
                (A) to or in such a relationship with any other person, 
                and who is designated to the employee's employer by 
                such employee as that employee's domestic partner.
            (4) Employee.--The term ``employee'' means an individual 
        who is--
                    (A)(i) an employee, as defined in section 3(e) of 
                the Fair Labor Standards Act of 1938 (29 U.S.C. 
                203(e)), who is not covered under any other provision 
                of this paragraph, except that a reference in such 
                section to an employer shall be considered to be a 
                reference to an employer described in clauses (i)(I) 
                and (ii) of paragraph (5)(A); or
                    (ii) an employee of the Government Accountability 
                Office;
                    (B) a State employee described in section 304(a) of 
                the Government Employee Rights Act of 1991 (42 U.S.C. 
                2000e-16c(a));
                    (C) a covered employee, as defined in section 101 
                of the Congressional Accountability Act of 1995 (2 
                U.S.C. 1301), other than an applicant for employment;
                    (D) a covered employee, as defined in section 
                411(c) of title 3, United States Code; or
                    (E) a Federal officer or employee covered under 
                subchapter V of chapter 63 of title 5, United States 
                Code (without regard to the limitation in section 
                6381(1)(B) of that title), who is not covered under 
                subparagraph (D).
            (5) Employer.--
                    (A) In general.--The term ``employer'' means a 
                person who is--
                            (i)(I) a covered employer who is not 
                        described in any other subclause of this 
                        clause;
                            (II) an entity employing a State employee 
                        described in section 304(a) of the Government 
                        Employee Rights Act of 1991;
                            (III) an employing office, as defined in 
                        section 101 of the Congressional Accountability 
                        Act of 1995;
                            (IV) an employing office, as defined in 
                        section 411(c) of title 3, United States Code; 
                        or
                            (V) an employing agency covered under 
                        subchapter V of chapter 63 of title 5, United 
                        States Code; and
                            (ii) engaged in commerce (including 
                        government), or an industry or activity 
                        affecting commerce (including government).
                    (B) Covered employer.--
                            (i) In general.--In subparagraph (A)(i)(I), 
                        the term ``covered employer''--
                                    (I) means any person engaged in 
                                commerce or in any industry or activity 
                                affecting commerce who employs 5 or 
                                more employees for each working day 
                                during each of 20 or more calendar 
                                workweeks in the current or preceding 
                                year;
                                    (II) includes--
                                            (aa) any person who acts, 
                                        directly or indirectly, in the 
                                        interest of an employer covered 
                                        by this clause to any of the 
                                        employees of such employer; and
                                            (bb) any successor in 
                                        interest of an employer;
                                    (III) includes any public agency; 
                                and
                                    (IV) includes the Government 
                                Accountability Office.
                            (ii) Public agency.--For purposes of clause 
                        (i)(III), a public agency shall be considered 
                        to be a person engaged in commerce or in an 
                        industry or activity affecting commerce.
                            (iii) Definitions.--For purposes of this 
                        subparagraph:
                                    (I) Employee.--The term 
                                ``employee'' has the meaning given such 
                                term in section 3(e) of the Fair Labor 
                                Standards Act of 1938 (29 U.S.C. 
                                203(e)).
                                    (II) Person.--The term ``person'' 
                                has the meaning given such term in 
                                section 3(a) of the Fair Labor 
                                Standards Act of 1938 (29 U.S.C. 
                                203(a)).
                                    (III) Public agency.--The term 
                                ``public agency'' has the meaning given 
                                such term in section 3(x) of the Fair 
                                Labor Standards Act of 1938 (29 U.S.C. 
                                203(x)).
                    (C) Predecessors.--Any reference in this paragraph 
                to an employer shall include a reference to any 
                predecessor of such employer.
            (6) Employment benefits.--The term ``employment benefits'' 
        means all benefits provided or made available to employees by 
        an employer, including group life insurance, health insurance, 
        disability insurance, sick leave, annual leave, educational 
        benefits, and pensions, regardless of whether such benefits are 
        provided by a practice or written policy of an employer or 
        through an ``employee benefit plan'', as defined in section 
        3(3) of the Employee Retirement Income Security Act of 1974 (29 
        U.S.C. 1002(3)).
            (7) Paid leave time.--The term ``paid leave time'' means an 
        increment of compensated leave that can be granted to an 
        employee for use during an absence from employment for any 
        reason described in section 102(b).
            (8) Secretary.--The term ``Secretary'' means the Secretary 
        of Labor.
            (9) Spouse.--The term ``spouse'', with respect to an 
        employee, has the meaning given such term by the marriage laws 
        of the State in which the marriage was celebrated.
            (10) State.--The term ``State'' has the meaning given the 
        term in section 3 of the Fair Labor Standards Act of 1938 (29 
        U.S.C. 203).
            (11) Unpaid leave time.--The term ``unpaid leave time'' 
        means the leave granted and used in the same manner and under 
        the same conditions as paid leave time for the purposes of this 
        title, except that no compensation shall be paid.

SEC. 102. PAID LEAVE TIME.

    (a) Granting Leave Time.--
            (1) In general.--An employer shall grant to each employee 
        employed by the employer, not less than 56 hours of paid leave 
        time on the employee's first workday of each calendar year. The 
        employee may use the paid leave time as needed during that 
        calendar year for reasons described in subsection (b).
            (2) Carryover.--Paid leave time granted under paragraph (1) 
        shall not carry over from 1 year to the next.
            (3) Employers with existing policies.--Any employer with a 
        paid leave policy who makes available an amount of paid leave 
        that is sufficient to meet the requirements of this section and 
        that is made available for all stated reasons and under all 
        stated conditions that are the same as the reasons and 
        conditions outlined in subsection (b) shall not be required to 
        grant an employee additional paid leave time under this 
        section.
            (4) Construction.--Nothing in this section shall be 
        construed as requiring financial or other reimbursement to an 
        employee from an employer upon the employee's termination, 
        resignation, retirement, or other separation from employment 
        for granted paid leave time that has not been used.
            (5) Prohibition.--An employer may not require, as a 
        condition of providing paid leave time under this title, that 
        the employee involved search for or find a replacement employee 
        to cover the hours during which the employee is using paid 
        leave time.
    (b) Uses.--Paid leave time granted under subsection (a)(1) may be 
used by an employee for any of the following:
            (1) An absence resulting from--
                    (A) a pregnancy loss;
                    (B) an unsuccessful round of intrauterine 
                insemination or of an assisted reproductive technology 
                procedure;
                    (C) a failed adoption match or an adoption that is 
                not finalized because it is contested by another party;
                    (D) a failed surrogacy arrangement; or
                    (E) a diagnosis or event that impacts pregnancy or 
                fertility.
            (2) An absence to care for a spouse or domestic partner who 
        experiences a circumstance described in paragraph (1).
    (c) Procedures.--Paid leave time granted under subsection (a)(1) 
shall be provided upon the oral or written request of an employee. Such 
request shall--
            (1) include the expected duration of the period of such 
        time; and
            (2) be provided as soon as practicable after the employee 
        is aware of the need for such period.

SEC. 103. NOTICE REQUIREMENT.

    (a) In General.--Each employer shall notify each employee and 
include in any employee handbook the information described in 
paragraphs (1) through (3). Each employer shall post and keep posted a 
notice, to be prepared or approved in accordance with procedures 
specified in regulations prescribed under section 110, setting forth 
excerpts from, or summaries of, the pertinent provisions of this title, 
including--
            (1) information describing paid leave time available to 
        employees under this title;
            (2) information pertaining to the filing of an action under 
        this title; and
            (3) information that describes--
                    (A) the protections that an employee has in 
                exercising rights under this title; and
                    (B) how the employee can contact the Secretary (or 
                other appropriate authority as described in section 
                105) if any of the rights are violated.
    (b) Location.--The notice described under subsection (a) shall be 
posted--
            (1) in conspicuous places on the premises of the employer, 
        where notices to employees (including applicants) are 
        customarily posted; or
            (2) in employee handbooks.
    (c) Violation; Penalty.--Any employer who willfully violates the 
posting requirements of this section shall be subject to a civil fine 
in an amount not to exceed $100 for each separate offense.

SEC. 104. PROHIBITED ACTS.

    (a) Interference With Rights.--
            (1) Exercise of rights.--It shall be unlawful for any 
        employer to interfere with, restrain, or deny the exercise of, 
        or the attempt to exercise, any right provided under this 
        title, including--
                    (A) discharging or discriminating against 
                (including retaliating against) any individual, 
                including a job applicant, for exercising, or 
                attempting to exercise, any right provided under this 
                title;
                    (B) using the taking of paid leave time or unpaid 
                leave time under this title as a negative factor in an 
                employment action, such as hiring, promotion, reducing 
                hours or number of shifts, or a disciplinary action; or
                    (C) counting the paid leave time or unpaid leave 
                time under a no-fault attendance policy or any other 
                absence control policy.
            (2) Discrimination.--It shall be unlawful for any employer 
        to discharge or in any other manner discriminate against 
        (including retaliating against) any individual, including a job 
        applicant, for opposing any practice made unlawful by this 
        title.
    (b) Interference With Proceedings or Inquiries.--It shall be 
unlawful for any person to discharge or in any other manner 
discriminate against (including retaliating against) any individual, 
including a job applicant, because such individual--
            (1) has filed an action, or has instituted or caused to be 
        instituted any proceeding, under or related to this title;
            (2) has given, or is about to give, any information in 
        connection with any inquiry or proceeding relating to any right 
        provided under this title; or
            (3) has testified, or is about to testify, in any inquiry 
        or proceeding relating to any right provided under this title.
    (c) Construction.--Nothing in this section shall be construed to 
state or imply that the scope of the activities prohibited by section 
105 of the Family and Medical Leave Act of 1993 (29 U.S.C. 2615) or the 
Civil Rights Act of 1964 (42 U.S.C. 2000a et seq.) is less than the 
scope of the activities prohibited by this section or is otherwise 
altered by the activities prohibited by this section.

SEC. 105. ENFORCEMENT AUTHORITY.

    (a) In General.--
            (1) Definition.--In this subsection--
                    (A) the term ``employee'' means an employee 
                described in subparagraph (A) or (B) of section 101(4); 
                and
                    (B) the term ``employer'' means an employer 
                described in subclause (I) or (II) of section 
                101(5)(A)(i).
            (2) Investigative authority.--
                    (A) In general.--To ensure compliance with the 
                provisions of this title, or any regulation or order 
                issued under this title, the Secretary shall have, 
                subject to subparagraph (C), the investigative 
                authority provided under section 11(a) of the Fair 
                Labor Standards Act of 1938 (29 U.S.C. 211(a)), with 
                respect to employers, employees, and other individuals 
                affected.
                    (B) Obligation to keep and preserve records.--An 
                employer shall make, keep, and preserve records 
                pertaining to compliance with this title in accordance 
                with section 11(c) of the Fair Labor Standards Act of 
                1938 (29 U.S.C. 211(c)) and in accordance with 
                regulations prescribed by the Secretary.
                    (C) Required submissions generally limited to an 
                annual basis.--The Secretary shall not require, under 
                the authority of this paragraph, an employer to submit 
                to the Secretary any books or records more than once 
                during any 12-month period, unless the Secretary has 
                reasonable cause to believe there may exist a violation 
                of this title or any regulation or order issued 
                pursuant to this title, or is investigating a charge 
                pursuant to paragraph (4).
                    (D) Subpoena authority.--For the purposes of any 
                investigation provided for in this paragraph, the 
                Secretary shall have the subpoena authority provided 
                for under section 9 of the Fair Labor Standards Act of 
                1938 (29 U.S.C. 209).
            (3) Civil action by employees or individuals.--
                    (A) Right of action.--An action to recover the 
                damages or equitable relief prescribed in subparagraph 
                (B) may be maintained against any employer in any 
                Federal or State court of competent jurisdiction by an 
                employee or individual or a representative for and on 
                behalf of--
                            (i) the employee or individual; or
                            (ii) the employee or individual and others 
                        similarly situated.
                    (B) Liability.--Any employer who violates section 
                104 (including a violation relating to rights provided 
                under section 102) shall be liable to any employee or 
                individual affected--
                            (i) for damages equal to--
                                    (I) the amount of--
                                            (aa) any wages, salary, 
                                        employment benefits, or other 
                                        compensation denied or lost by 
                                        reason of the violation; or
                                            (bb) in a case in which 
                                        wages, salary, employment 
                                        benefits, or other compensation 
                                        have not been denied or lost, 
                                        any actual monetary losses 
                                        sustained as a direct result of 
                                        the violation up to a sum equal 
                                        to 56 hours of wages or salary 
                                        for the employee or individual;
                                    (II) the interest on the amount 
                                described in subclause (I) calculated 
                                at the prevailing rate; and
                                    (III) an additional amount as 
                                liquidated damages; and
                            (ii) for such equitable relief as may be 
                        appropriate, including employment, 
                        reinstatement, and promotion.
                    (C) Fees and costs.--The court in an action under 
                this paragraph shall, in addition to any judgment 
                awarded to the plaintiff, allow a reasonable attorney's 
                fee, reasonable expert witness fees, and other costs of 
                the action to be paid by the defendant.
            (4) Action by the secretary.--
                    (A) Administrative action.--The Secretary shall 
                receive, investigate, and attempt to resolve complaints 
                of violations of section 104 (including a violation 
                relating to rights provided under section 102) in the 
                same manner that the Secretary receives, investigates, 
                and attempts to resolve complaints of violations of 
                sections 6 and 7 of the Fair Labor Standards Act of 
                1938 (29 U.S.C. 206 and 207).
                    (B) Civil action.--The Secretary may bring an 
                action in any court of competent jurisdiction to 
                recover the damages described in paragraph (3)(B)(i).
                    (C) Sums recovered.--Any sums recovered by the 
                Secretary pursuant to subparagraph (B) shall be held in 
                a special deposit account and shall be paid, on order 
                of the Secretary, directly to each employee or 
                individual affected. Any such sums not paid to an 
                employee or individual affected because of inability to 
                do so within a period of 3 years shall be deposited 
                into the Treasury of the United States as miscellaneous 
                receipts.
            (5) Limitation.--
                    (A) In general.--Except as provided in subparagraph 
                (B), an action may be brought under paragraph (3), (4), 
                or (6) not later than 2 years after the date of the 
                last event constituting the alleged violation for which 
                the action is brought.
                    (B) Willful violation.--In the case of an action 
                brought for a willful violation of section 104 
                (including a willful violation relating to rights 
                provided under section 102), such action may be brought 
                not later than 3 years after the date of the last event 
                constituting the alleged violation for which such 
                action is brought.
                    (C) Commencement.--In determining when an action is 
                commenced under paragraph (3), (4), or (6) for the 
                purposes of this paragraph, it shall be considered to 
                be commenced on the date when the complaint is filed.
            (6) Action for injunction by secretary.--The district 
        courts of the United States shall have jurisdiction, for cause 
        shown, in an action brought by the Secretary--
                    (A) to restrain violations of section 104 
                (including a violation relating to rights provided 
                under section 102), including the restraint of any 
                withholding of payment of wages, salary, employment 
                benefits, or other compensation, plus interest, found 
                by the court to be due to employees or individuals 
                eligible under this title; or
                    (B) to award such other equitable relief as may be 
                appropriate, including employment, reinstatement, and 
                promotion.
            (7) Solicitor of labor.--The Solicitor of Labor may appear 
        for and represent the Secretary on any litigation brought under 
        paragraph (4) or (6).
            (8) Government accountability office.--Notwithstanding any 
        other provision of this subsection, in the case of the 
        Government Accountability Office, the authority of the 
        Secretary of Labor under this subsection shall be exercised by 
        the Comptroller General of the United States.
    (b) Employees Covered by Congressional Accountability Act of 
1995.--The powers, remedies, and procedures provided in the 
Congressional Accountability Act of 1995 (2 U.S.C. 1301 et seq.) to the 
Board (as defined in section 101 of that Act (2 U.S.C. 1301)), or any 
person, alleging a violation of section 202(a)(1) of that Act (2 U.S.C. 
1312(a)(1)) shall be the powers, remedies, and procedures this title 
provides to that Board, or any person, alleging an unlawful employment 
practice in violation of this title against an employee described in 
section 101(4)(C).
    (c) Employees Covered by Chapter 5 of Title 3, United States 
Code.--The powers, remedies, and procedures provided in chapter 5 of 
title 3, United States Code, to the President, the Merit Systems 
Protection Board, or any person, alleging a violation of section 
412(a)(1) of that title, shall be the powers, remedies, and procedures 
this title provides to the President, that Board, or any person, 
respectively, alleging an unlawful employment practice in violation of 
this title against an employee described in section 101(4)(D).
    (d) Employees Covered by Chapter 63 of Title 5, United States 
Code.--The powers, remedies, and procedures provided in title 5, United 
States Code, to an employing agency, provided in chapter 12 of that 
title to the Merit Systems Protection Board, or provided in that title 
to any person, alleging a violation of chapter 63 of that title, shall 
be the powers, remedies, and procedures this title provides to that 
agency, that Board, or any person, respectively, alleging an unlawful 
employment practice in violation of this title against an employee 
described in section 101(4)(E).
    (e) Remedies for State Employees.--
            (1) Waiver of sovereign immunity.--A State's receipt or use 
        of Federal financial assistance for any program or activity of 
        a State shall constitute a waiver of sovereign immunity, under 
        the 11th Amendment to the Constitution or otherwise, to a suit 
        brought by an employee of that program or activity under this 
        title for equitable, legal, or other relief authorized under 
        this title.
            (2) Official capacity.--An official of a State may be sued 
        in the official capacity of the official by any employee who 
        has complied with the procedures under subsection (a)(3), for 
        injunctive relief that is authorized under this title. In such 
        a suit the court may award to the prevailing party those costs 
        authorized by section 722 of the Revised Statutes (42 U.S.C. 
        1988).
            (3) Applicability.--With respect to a particular program or 
        activity, paragraph (1) applies to conduct occurring on or 
        after the day, after the date of enactment of this title, on 
        which a State first receives or uses Federal financial 
        assistance for that program or activity.
            (4) Definition of program or activity.--In this subsection, 
        the term ``program or activity'' has the meaning given the term 
        in section 606 of the Civil Rights Act of 1964 (42 U.S.C. 
        2000d-4a).

SEC. 106. EDUCATION AND OUTREACH.

    (a) In General.--The Secretary may conduct a public awareness 
campaign to educate and inform the public of the requirements for paid 
leave time required by this title.
    (b) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary such sums as may be necessary to carry 
out such campaign.

SEC. 107. EFFECT ON OTHER LAWS.

    (a) Federal and State Antidiscrimination Laws.--Nothing in this 
title shall be construed to modify or affect any Federal or State law 
prohibiting discrimination on the basis of race, religion, color, 
national origin, sex, age, or disability.
    (b) Federal, State, and Local Laws.--Nothing in this title shall be 
construed to supersede (including preempting) any provision of any 
Federal, State, or local law that provides greater paid or unpaid 
family or medical leave rights than the rights established under this 
title.

SEC. 108. EFFECT ON EXISTING EMPLOYMENT BENEFITS.

    (a) More Protective.--Nothing in this title shall be construed to 
diminish the obligation of an employer to comply with any contract, 
collective bargaining agreement, or any employment benefit program or 
plan that provides greater paid leave or other leave rights to 
employees or individuals than the rights established under this title.
    (b) Less Protective.--The rights established for employees under 
this title shall not be diminished by any contract, collective 
bargaining agreement, or any employment benefit program or plan.

SEC. 109. ENCOURAGEMENT OF MORE GENEROUS LEAVE POLICIES.

    Nothing in this title shall be construed to discourage employers 
from adopting or retaining leave policies more generous than policies 
that comply with the requirements of this title.

SEC. 110. REGULATIONS.

    (a) In General.--
            (1) Authority.--Except as provided in paragraph (2), not 
        later than 180 days after the date of enactment of this title, 
        the Secretary shall prescribe such regulations as are necessary 
        to carry out this title with respect to employees described in 
        subparagraph (A) or (B) of section 101(4) and other individuals 
        affected by employers described in subclause (I) or (II) of 
        section 101(5)(A)(i).
            (2) Government accountability office.--The Comptroller 
        General of the United States shall prescribe the regulations 
        with respect to employees of the Government Accountability 
        Office and the Library of Congress, respectively, and other 
        individuals affected by the Comptroller General of the United 
        States.
    (b) Employees Covered by Congressional Accountability Act of 
1995.--
            (1) Authority.--Not later than 90 days after the Secretary 
        prescribes regulations under subsection (a), the Board of 
        Directors of the Office of Compliance shall prescribe (in 
        accordance with section 304 of the Congressional Accountability 
        Act of 1995 (2 U.S.C. 1384)) such regulations as are necessary 
        to carry out this title with respect to employees described in 
        section 101(4)(C) and other individuals affected by employers 
        described in section 101(5)(A)(i)(III).
            (2) Agency regulations.--The regulations prescribed under 
        paragraph (1) shall be the same as substantive regulations 
        promulgated by the Secretary to carry out this title except 
        insofar as the Board may determine, for good cause shown and 
        stated together with the regulations prescribed under paragraph 
        (1), that a modification of such regulations would be more 
        effective for the implementation of the rights and protections 
        involved under this section.
    (c) Employees Covered by Chapter 5 of Title 3, United States 
Code.--
            (1) Authority.--Not later than 90 days after the Secretary 
        prescribes regulations under subsection (a), the President (or 
        the designee of the President) shall prescribe such regulations 
        as are necessary to carry out this title with respect to 
        employees described in section 101(4)(D) and other individuals 
        affected by employers described in section 101(5)(A)(i)(IV).
            (2) Agency regulations.--The regulations prescribed under 
        paragraph (1) shall be the same as substantive regulations 
        promulgated by the Secretary to carry out this title except 
        insofar as the President (or designee) may determine, for good 
        cause shown and stated together with the regulations prescribed 
        under paragraph (1), that a modification of such regulations 
        would be more effective for the implementation of the rights 
        and protections involved under this section.
    (d) Employees Covered by Chapter 63 of Title 5, United States 
Code.--
            (1) Authority.--Not later than 90 days after the Secretary 
        prescribes regulations under subsection (a), the Director of 
        the Office of Personnel Management shall prescribe such 
        regulations as are necessary to carry out this title with 
        respect to employees described in section 101(4)(E) and other 
        individuals affected by employers described in section 
        101(5)(A)(i)(V).
            (2) Agency regulations.--The regulations prescribed under 
        paragraph (1) shall be the same as substantive regulations 
        promulgated by the Secretary to carry out this title except 
        insofar as the Director may determine, for good cause shown and 
        stated together with the regulations prescribed under paragraph 
        (1), that a modification of such regulations would be more 
        effective for the implementation of the rights and protections 
        involved under this section.

SEC. 111. EFFECTIVE DATES.

    (a) Effective Date.--This title, other than section 110, shall take 
effect 6 months after the date of issuance of regulations under section 
110(a)(1).
    (b) Collective Bargaining Agreements.--In the case of a collective 
bargaining agreement in effect on the effective date prescribed by 
subsection (a), this title shall take effect on the earlier of--
            (1) the date of the termination of such agreement; or
            (2) the date that occurs 18 months after the date of 
        issuance of regulations under section 110(a)(1).

                    TITLE II--RESEARCH AND EDUCATION

SEC. 201. PREGNANCY LOSS PUBLIC EDUCATION PROGRAM.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Director of the Centers for Disease Control and Prevention, 
shall develop and disseminate to the public information regarding 
pregnancy loss, including information on--
            (1) awareness of pregnancy loss, and the incidence and 
        prevalence of pregnancy loss among pregnant people; and
            (2) the accessibility of the range of evidence-based 
        treatment options, as medically appropriate, for pregnancy 
        loss, including miscarriage and recurrent miscarriage, 
        including comprehensive mental health supports, necessary 
        procedures and medications, and culturally responsive supports 
        including pregnancy-loss doula care.
    (b) Dissemination of Information.--In carrying out subsection (a), 
the Secretary may disseminate information to the public directly or 
through arrangements with agencies carrying out intra-agency 
initiatives, nonprofit organizations, consumer groups, community 
organizations, institutions of higher education (as defined in section 
101 of the Higher Education Act of 1965 (20 U.S.C. 1001)), or Federal, 
State, or local public-private partnerships.
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2023 through 2026.

SEC. 202. RESEARCH WITH RESPECT TO PREGNANCY LOSS.

    (a) In General.--The Director of the National Institutes of Health 
(in this section referred to as the ``Director of NIH'') shall expand 
and coordinate programs for conducting and supporting evidence-based 
research with respect to causes of and current and novel treatment 
options and procedures for pregnancy loss.
    (b) Administration and Coordination.--The Director of NIH, acting 
through the Director of the Office of Research on Women's Health, shall 
carry out evidence-based research conducted pursuant to subsection (a), 
in coordination with the appropriate institutes, offices, and centers 
of the National Institutes of Health, including the National Institute 
of Child Health and Human Development, the National Institute of 
Environmental Health Sciences, the National Institute of Mental Health, 
and the Office on Women's Health of the Department of Health and Human 
Services.
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $45,000,000 for each of fiscal 
years 2023 through 2026.

SEC. 203. EDUCATION AND DISSEMINATION OF INFORMATION TO PERINATAL 
              HEALTH CARE WORKERS WITH RESPECT TO PREGNANCY LOSS.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Administrator of the Health Resources and Services 
Administration and the Director of the Agency for Healthcare Research 
and Quality shall, in consultation with and in accordance with 
guidelines from relevant medical societies, develop and disseminate to 
perinatal health care workers, including midwives, physician 
assistants, nurse practitioners, clinical nurse specialists, and non-
clinical perinatal health care workers, information on pregnancy loss 
for the purpose of ensuring that such perinatal health care workers 
remain informed about current information (as of the date of 
dissemination) regarding pregnancy loss, including miscarriage and 
recurrent miscarriage, and prioritizing both the physical and mental 
health care of the patient.
    (b) Perinatal Health Care Worker.--For purposes of this section, 
the term ``perinatal health care worker'' includes any doula, community 
health worker, peer supporter, breastfeeding and lactation educator or 
counselor, nutritionist or dietitian, childbirth educator, social 
worker, home visitor, language interpreter, or navigator.

SEC. 204. DATA COLLECTION REGARDING PREGNANCY LOSS.

    The Secretary of Health and Human Services shall, in an manner that 
protects personal privacy, collect and assess data regarding pregnancy 
loss, including information (disaggregated by race, ethnicity, health 
insurance status, disability, income level, and geography) on the 
prevalence of, the incidence of, and knowledge about pregnancy loss.
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