I 

116TH CONGRESS 

1ST SESSION H. R. 4215 

To improve maternal health care quality, to improve the training of health 

care professionals to reduce or prevent discrimination in certain health 

care services, to improve perinatal care, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

AUGUST 30, 2019 

Mr. BUCSHON (for himself, Mr. CARSON of Indiana, Mr. BURGESS, Mr. BILIRAKIS, Mrs. BROOKS of Indiana, Ms. HERRERA BEUTLER, Mr. LONG, 

Mrs. MCBATH, and Mr. WALDEN) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To improve maternal health care quality, to improve the 

training of health care professionals to reduce or prevent 

discrimination in certain health care services, to improve 

perinatal care, 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 ‘‘Excellence in Maternal 

5 Health Act of 2019’’. 


kjohnson on DSK79L0C42 with BILLS
2 

•HR 4215 IH

1 SEC. 2. INNOVATION FOR MATERNAL HEALTH. 

2 The Public Health Service Act is amended by insert3 ing after section 330M of such Act (42 U.S.C. 254c–19) 

4 the following: 

5 ‘‘SEC. 330N. INNOVATION FOR MATERNAL HEALTH. 

6 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

7 with experts representing a variety of clinical specialties, 

8 State, tribal, or local public health officials, researchers, 

9 epidemiologists, statisticians, and community organiza10 tions, shall establish or continue a program to award com11 petitive grants to eligible entities for the purpose of— 

12 ‘‘(1) identifying, developing, or disseminating 

13 best practices to improve maternal health care qual14 ity and outcomes, eliminate preventable maternal 

15 mortality and severe maternal morbidity, and im16 prove infant health outcomes, which may include— 

17 ‘‘(A) information on evidence-based prac18 tices to improve the quality and safety of ma19 ternal health care in hospitals and other health 

20 care settings of a State or health care system, 

21 including by addressing topics commonly associ22 ated with health complications or risks related 

23 to prenatal care, labor care, birthing, and 

24 postpartum care; 

25 ‘‘(B) best practices for improving maternal 

26 health care based on data findings and reviews 


kjohnson on DSK79L0C42 with BILLS
3 

•HR 4215 IH

1 conducted by a State maternal mortality review 

2 committee that address topics of relevance to 

3 common complications or health risks related to 

4 prenatal care, labor care, birthing, and postpar5 tum care; and 

6 ‘‘(C) information on addressing deter7 minants of health that impact maternal health 

8 outcomes for women before, during, and after 

9 pregnancy; 

10 ‘‘(2) collaborating with State maternal mor11 tality review committees to identify issues for the de12 velopment and implementation of evidence-based 

13 practices to improve maternal health outcomes and 

14 reduce preventable maternal mortality and severe 

15 maternal morbidity; 

16 ‘‘(3) providing technical assistance and sup17 porting the implementation of best practices identi18 fied in paragraph (1) to entities providing health 

19 care services to pregnant and postpartum women; 

20 and 

21 ‘‘(4) identifying, developing, and evaluating new 

22 models of care that improve maternal and infant 

23 health outcomes, which may include the integration 

24 of community-based services and clinical care. 


kjohnson on DSK79L0C42 with BILLS
4 

•HR 4215 IH

1 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible for a grant 

2 under subsection (a), an entity shall— 

3 ‘‘(1) submit to the Secretary an application at 

4 such time, in such manner, and containing such in5 formation as the Secretary may require; and 

6 ‘‘(2) demonstrate in such application that the 

7 entity is capable of carrying out data-driven mater8 nal safety and quality improvement initiatives in the 

9 areas of obstetrics and gynecology or maternal 

10 health. 

11 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—To 

12 carry out this section, there is authorized to be appro13 priated $10,000,000 for each of fiscal years 2020 through 

14 2024.’’. 

15 SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS. 

16 Title VII of the Public Health Service Act is amended 

17 by striking section 763 (42 U.S.C. 294p) and inserting 

18 the following: 

19 ‘‘SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS. 

20 ‘‘(a) GRANT PROGRAM.—The Secretary shall estab21 lish a program to award grants to accredited schools of 

22 allopathic medicine, osteopathic medicine, and nursing, 

23 and other health professional training programs for the 

24 training of health care professionals to reduce and prevent 

25 discrimination (including training related to implicit biVerDate Sep 11 2014 22:24 Aug 30, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4215.IH H4215

kjohnson on DSK79L0C42 with BILLS
5 

•HR 4215 IH

1 ases) in the provision of health care services related to 

2 prenatal care, labor care, birthing, and postpartum care. 

3 ‘‘(b) ELIGIBILITY.—To be eligible for a grant under 

4 subsection (a), an entity described in such subsection shall 

5 submit to the Secretary an application at such time, in 

6 such manner, and containing such information as the Sec7 retary may require. 

8 ‘‘(c) REPORTING REQUIREMENT.—Each entity 

9 awarded a grant under this section shall periodically sub10 mit to the Secretary a report on the status of activities 

11 conducted using the grant, including a description of the 

12 impact of such training on patient outcomes, as applicable. 

13 ‘‘(d) BEST PRACTICES.—The Secretary may identify 

14 and disseminate best practices for the training of health 

15 care professionals to reduce and prevent discrimination 

16 (including training related to implicit biases) in the provi17 sion of health care services related to prenatal care, labor 

18 care, birthing, and postpartum care. 

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

20 carry out this section, there is authorized to be appro21 priated $5,000,000 for each of fiscal years 2020 through 

22 2024.’’. 


kjohnson on DSK79L0C42 with BILLS
6 

•HR 4215 IH

1 SEC. 4. STUDY ON TRAINING TO REDUCE AND PREVENT 

2 DISCRIMINATION. 

3 Not later than 2 years after date of enactment of this 

4 Act, the Secretary of Health and Human Services (re5 ferred to in this section as the ‘‘Secretary’’) shall, through 

6 a contract with an independent research organization, con7 duct a study and make recommendations for accredited 

8 schools of allopathic medicine, osteopathic medicine, and 

9 nursing, and other health professional training programs 

10 on best practices related to training to reduce and prevent 

11 discrimination, including training related to implicit bi12 ases, in the provision of health care services related to pre13 natal care, labor care, birthing, and postpartum care. 

14 SEC. 5. PERINATAL QUALITY COLLABORATIVES. 

15 (a) GRANTS.—Section 317K(a)(2) of the Public 

16 Health Service Act (42 U.S.C. 247b–12(a)(2)) is amended 

17 by adding at the end the following: 

18 ‘‘(E)(i) The Secretary, acting through the 

19 Director of the Centers for Disease Control and 

20 Prevention and in coordination with other of21 fices and agencies, as appropriate, shall estab22 lish or continue a competitive grant program 

23 for the establishment or support of perinatal 

24 quality collaboratives to improve perinatal care 

25 and perinatal health outcomes for pregnant and 

26 postpartum women and their infants. A State, 


kjohnson on DSK79L0C42 with BILLS
7 

•HR 4215 IH

1 Indian Tribe, or Tribal organization may use 

2 funds received through such grant to— 

3 ‘‘(I) support the use of evidence4 based or evidence-informed practices 

5 to improve outcomes for maternal and 

6 infant health; 

7 ‘‘(II) work with clinical teams; 

8 experts; State, local, and, as appro9 priate, tribal public health officials; 

10 and stakeholders, including patients 

11 and families, to identify, develop, or 

12 disseminate best practices to improve 

13 perinatal care and outcomes; and 

14 ‘‘(III) employ strategies that pro15 vide opportunities for health care pro16 fessionals and clinical teams to col17 laborate across health care settings 

18 and disciplines, including primary 

19 care and mental health, as appro20 priate, to improve maternal and infant 

21 health outcomes, which may include 

22 the use of data to provide timely feed23 back across hospital and clinical 

24 teams to inform responses, and to 

25 provide support and training to hosVerDate Sep 11 2014 22:24 Aug 30, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H4215.IH H4215

kjohnson on DSK79L0C42 with BILLS
8 

•HR 4215 IH

1 pital and clinical teams for quality im2 provement, as appropriate. 

3 ‘‘(ii) To be eligible for a grant under 

4 clause (i), an entity shall submit to the 

5 Secretary an application in such form and 

6 manner and containing such information 

7 as the Secretary may require.’’. 

8 (b) AUTHORIZATION OF APPROPRIATIONS.—Section 

9 317K(f) of the Public Health Service Act (42 U.S.C. 

10 247b–12(f)) is amended by striking ‘‘$58,000,000 for 

11 each of fiscal years 2019 through 2023’’ and inserting 

12 ‘‘$65,000,000 for each of fiscal years 2020 through 

13 2024’’. 

14 SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND 

15 POSTPARTUM WOMEN. 

16 (a) GRANTS.—The Public Health Service Act is 

17 amended by inserting after section 330N of such Act, as 

18 added by section 2, the following: 

19 ‘‘SEC. 330O. INTEGRATED SERVICES FOR PREGNANT AND 

20 POSTPARTUM WOMEN. 

21 ‘‘(a) IN GENERAL.—The Secretary may award grants 

22 for the purpose of establishing or operating evidence-based 

23 or innovative, evidence-informed programs to deliver inte24 grated health care services to pregnant and postpartum 

25 women to optimize the health of women and their infants, 


kjohnson on DSK79L0C42 with BILLS
9 

•HR 4215 IH

1 including to reduce adverse maternal health outcomes, 

2 pregnancy-related deaths, and related health disparities 

3 (including such disparities associated with racial and eth4 nic minority populations), and, as appropriate, by address5 ing issues researched under subsection (b)(2) of section 

6 317K. 

7 ‘‘(b) INTEGRATED SERVICES FOR PREGNANT AND

8 POSTPARTUM WOMEN.— 

9 ‘‘(1) ELIGIBILITY.—To be eligible to receive a 

10 grant under subsection (a), a State, Indian Tribe, or 

11 Tribal organization (as such terms are defined in 

12 section 4 of the Indian Self-Determination and Edu13 cation Assistance Act) shall work with relevant 

14 stakeholders that coordinate care (including coordi15 nating resources and referrals for health care and 

16 social services) to develop and carry out the pro17 gram, including— 

18 ‘‘(A) State, Tribal, and local agencies re19 sponsible for Medicaid, public health, social 

20 services, mental health, and substance use dis21 order treatment and services; 

22 ‘‘(B) health care providers who serve preg23 nant and postpartum women; and 

24 ‘‘(C) community-based health organiza25 tions and health workers, including providers of 


kjohnson on DSK79L0C42 with BILLS
10 

•HR 4215 IH

1 home visiting services and individuals rep2 resenting communities with disproportionately 

3 high rates of maternal mortality and severe ma4 ternal morbidity, and including those rep5 resenting racial and ethnicity minority popu6 lations. 

7 ‘‘(2) TERMS.— 

8 ‘‘(A) PERIOD.—A grant awarded under 

9 subsection (a) shall be made for a period of 5 

10 years. Any supplemental award made to a 

11 grantee under subsection (a) may be made for 

12 a period of less than 5 years. 

13 ‘‘(B) PREFERENCE.—In awarding grants 

14 under subsection (a), the Secretary shall— 

15 ‘‘(i) give preference to States, Indian 

16 Tribes, and Tribal organizations that have 

17 the highest rates of maternal mortality and 

18 severe maternal morbidity relative to other 

19 such States, Indian Tribes, or Tribal orga20 nizations, respectively; and 

21 ‘‘(ii) shall consider health disparities 

22 related to maternal mortality and severe 

23 maternal morbidity, including such dispari24 ties associated with racial and ethnic mi25 nority populations. 


kjohnson on DSK79L0C42 with BILLS
11 

•HR 4215 IH

1 ‘‘(C) PRIORITY.—In awarding grants 

2 under subsection (a), the Secretary shall give 

3 priority to applications from up to 15 entities 

4 described in subparagraph (B)(i). 

5 ‘‘(D) EVALUATION.—The Secretary shall 

6 require grantees to evaluate the outcomes of the 

7 programs supported under the grant. 

8 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—To 

9 carry out this section, there is authorized to be appro10 priated $15,000,000 for each of fiscal years 2020 through 

11 2024.’’. 

12 (b) REPORT ON GRANT OUTCOMES AND DISSEMINA13 TION OF BEST PRACTICES.— 

14 (1) REPORT.—Not later than February 1, 

15 2026, the Secretary of Health and Human Services 

16 shall submit to the Committee on Health, Edu17 cation, Labor, and Pensions of the Senate and the 

18 Committee on Energy and Commerce of the House 

19 of Representatives a report that describes— 

20 (A) the outcomes of the activities sup21 ported by the grants awarded under the amend22 ments made by this section on maternal and 

23 child health; 


kjohnson on DSK79L0C42 with BILLS
12 

•HR 4215 IH

1 (B) best practices and models of care used 

2 by recipients of grants under such amendments; 

3 and 

4 (C) obstacles identified by recipients of 

5 grants under such amendments, and strategies 

6 used by such recipients to deliver care, improve 

7 maternal and child health, and reduce health 

8 disparities. 

9 (2) DISSEMINATION OF BEST PRACTICES.—Not 

10 later than August 1, 2026, the Secretary of Health 

11 and Human Services shall disseminate information 

12 on best practices and models of care used by recipi13 ents of grants under the amendments made by this 

14 section (including best practices and models of care 

15 relating to the reduction of health disparities, includ16 ing such disparities associated with racial and ethnic 

17 minority populations, in rates of maternal mortality 

18 and severe maternal morbidity) to relevant stake19 holders, which may include health providers, medical 

20 schools, nursing schools, relevant State, tribal, and 

21 local agencies, and the general public. 

Æ 


kjohnson on DSK79L0C42 with BILLS