II 

117TH CONGRESS 

1ST SESSION S. 341 

To provide justice for incarcerated moms, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 22, 2021 

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 provide justice for incarcerated moms, 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 6 

9 months after the date of enactment of this Act, and annu10 ally thereafter, in each State that receives a grant under 


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1 subpart 1 of part E of title I of the Omnibus Crime Con2 trol and Safe Streets Act of 1968 (34 U.S.C. 10151 et 

3 seq.) (commonly referred to as the ‘‘Edward Byrne Memo4 rial Justice Grant Program’’) and that does not have in 

5 effect throughout the State for such fiscal year laws re6 stricting the use of restraints on pregnant individuals in 

7 prison that are substantially similar to the rights, proce8 dures, requirements, effects, and penalties set forth in sec9 tion 4322 of title 18, United States Code, the amount of 

10 such grant that would otherwise be allocated to such State 

11 under such subpart for the fiscal year shall be decreased 

12 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) ESTABLISHMENT.— 

23 (1) IN GENERAL.—Not later than 1 year after 

24 the date of enactment of this Act, the Attorney Gen25 eral, acting through the Director of the Bureau of 


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1 Prisons, shall establish, in not fewer than 6 Bureau 

2 of Prisons facilities, programs to optimize maternal 

3 health outcomes for pregnant and postpartum indi4 viduals incarcerated in such facilities. 

5 (2) REQUIRED CONSULTATION.—The Attorney 

6 General shall establish the programs authorized 

7 under paragraph (1) in consultation with stake8 holders 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 racial and ethnic 

15 minority groups; 

16 (B) relevant organizations representing pa17 tients, with a particular focus on patients from 

18 racial and ethnic minority groups; 

19 (C) organizations representing maternity 

20 care providers and maternal health care edu21 cation programs; 

22 (D) perinatal health workers; and 

23 (E) researchers and policy experts in fields 

24 related to maternal health care for incarcerated 

25 individuals. 


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1 (b) START DATE.—Each facility selected under sub2 section (a) shall begin facility programs not later than 18 

3 months after the date of enactment of this Act. 

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

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

6 (1) the number of pregnant and postpartum in7 dividuals incarcerated in such facility and, among 

8 such individuals, the number of pregnant and 

9 postpartum individuals from racial and ethnic mi10 nority groups; and 

11 (2) the extent to which the leaders of such facil12 ity have demonstrated a commitment to developing 

13 exemplary programs for pregnant and postpartum 

14 individuals incarcerated in such facility. 

15 (d) PROGRAM DURATION.—The programs established 

16 under this section shall be for a 5-year period. 

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

18 by the Director shall establish programs for pregnant and 

19 postpartum incarcerated individuals, and such pro20 grams— 

21 (1) may— 

22 (A) provide access to perinatal health 

23 workers from pregnancy through the 

24 postpartum period; 


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1 (B) provide access to healthy foods and 

2 counseling on nutrition, recommended activity 

3 levels, and safety measures throughout preg4 nancy; 

5 (C) train correctional officers to ensure 

6 that pregnant incarcerated individuals receive 

7 safe and respectful treatment; 

8 (D) train medical personnel to ensure that 

9 pregnant incarcerated individuals receive trau10 ma-informed, culturally congruent care that 

11 promotes the health and safety of the pregnant 

12 individuals; 

13 (E) provide counseling and treatment for 

14 individuals who have suffered from— 

15 (i) diagnosed mental or behavioral 

16 health conditions, including trauma and 

17 substance use disorders; 

18 (ii) trauma or violence, including do19 mestic violence; 

20 (iii) human immunodeficiency virus; 

21 (iv) sexual abuse; 

22 (v) pregnancy or infant loss; or 

23 (vi) chronic conditions; 


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1 (F) provide evidence-based pregnancy and 

2 childbirth education, parenting support, and 

3 other relevant forms of health literacy; 

4 (G) provide clinical education opportunities 

5 to maternity care providers in training to ex6 pand pathways into maternal health care ca7 reers serving incarcerated individuals; 

8 (H) offer opportunities for postpartum in9 dividuals to maintain contact with the individ10 ual’s newborn child to promote bonding, includ11 ing enhanced visitation policies, access to prison 

12 nursery programs, or breastfeeding support; 

13 (I) provide reentry assistance, particularly 

14 to— 

15 (i) ensure access to health insurance 

16 coverage and transfer of health records to 

17 community providers if an incarcerated in18 dividual exits the criminal justice system 

19 during such individual’s pregnancy or in 

20 the postpartum period; and 

21 (ii) connect individuals exiting the 

22 criminal justice system during pregnancy 

23 or in the postpartum period to community24 based resources, such as referrals to health 

25 care providers, substance use disorder 


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1 treatments, and social services that ad2 dress social determinants maternal of 

3 health; or 

4 (J) establish partnerships with local public 

5 entities, private community entities, community6 based organizations, Indian Tribes and tribal 

7 organizations (as such terms are defined in sec8 tion 4 of the Indian Self-Determination and 

9 Education Assistance Act (25 U.S.C. 5304)), 

10 and urban Indian organizations (as such term 

11 is defined in section 4 of the Indian Health 

12 Care Improvement Act (25 U.S.C. 1603)) to es13 tablish or expand pretrial diversion programs as 

14 an alternative to incarceration for pregnant and 

15 postpartum individuals; and 

16 (2) may include— 

17 (A) evidence-based childbirth education or 

18 parenting classes; 

19 (B) prenatal health coordination; 

20 (C) family and individual counseling; 

21 (D) evidence-based screenings, education, 

22 and, as needed, treatment for mental and be23 havioral health conditions, including drug and 

24 alcohol treatments; 

25 (E) family case management services; 


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1 (F) domestic violence education and pre2 vention; 

3 (G) physical and sexual abuse counseling; 

4 and 

5 (H) programs to address social deter6 minants of health such as employment, housing, 

7 education, transportation, and nutrition. 

8 (f) IMPLEMENTATION AND REPORTING.—A selected 

9 facility shall be responsible for— 

10 (1) implementing programs, which may include 

11 the programs described in subsection (e); and 

12 (2) not later than 3 years after the date of en13 actment of this Act, and 6 years after the date of 

14 enactment of this Act, reporting results of the pro15 grams to the Director, including information de16 scribing— 

17 (A) relevant quantitative indicators of suc18 cess in improving the standard of care and 

19 health outcomes for pregnant and postpartum 

20 incarcerated individuals in the facility, including 

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

22 age, geography, disability status, the category 

23 of the criminal charge against such individual, 

24 rates of pregnancy-related deaths, pregnancy25 associated deaths, cases of infant mortality and 


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1 morbidity, rates of preterm births and low2 birthweight births, cases of severe maternal 

3 morbidity, cases of violence against pregnant or 

4 postpartum individuals, diagnoses of maternal 

5 mental or behavioral health conditions, and 

6 other such information as appropriate; 

7 (B) relevant qualitative and quantitative 

8 evaluations from pregnant and postpartum in9 carcerated individuals who participated in such 

10 programs, including measures of patient-re11 ported experience of care; and 

12 (C) strategies to sustain such programs 

13 after fiscal year 2026 and expand such pro14 grams to other facilities. 

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

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

17 Attorney General and to the Congress a report describing 

18 the results of the programs funded under this section. 

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

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

21 award a contract to an independent organization or inde22 pendent organizations to conduct oversight of the pro23 grams described in subsection (e). 


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1 (i) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out this section 

3 $10,000,000 for each of fiscal years 2022 through 2026. 

4 SEC. 4. GRANT PROGRAM TO IMPROVE MATERNAL HEALTH 

5 OUTCOMES FOR INDIVIDUALS IN STATE AND 

6 LOCAL PRISONS AND JAILS. 

7 (a) ESTABLISHMENT.— 

8 (1) IN GENERAL.—Not later than 1 year after 

9 the date of enactment of this Act, the Attorney Gen10 eral, acting through the Director of the Bureau of 

11 Justice Assistance, shall award Justice for Incarcer12 ated Moms grants to States to establish or expand 

13 programs in State and local prisons and jails for 

14 pregnant and postpartum incarcerated individuals. 

15 (2) REQUIRED CONSULTATION.—The Attorney 

16 General shall award the grants authorized under 

17 paragraph (1) in consultation with stakeholders such 

18 as— 

19 (A) relevant community-based organiza20 tions, particularly organizations that represent 

21 incarcerated and formerly incarcerated individ22 uals and organizations that seek to improve ma23 ternal health outcomes for pregnant and 

24 postpartum individuals from racial and ethnic 

25 minority groups; 


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1 (B) relevant organizations representing pa2 tients, with a particular focus on patients from 

3 racial and ethnic minority groups; 

4 (C) organizations representing maternity 

5 care providers and maternal health care edu6 cation programs; 

7 (D) perinatal health workers; and 

8 (E) researchers and policy experts in fields 

9 related to maternal health care for incarcerated 

10 individuals. 

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

12 under this section shall submit to the Director of the Bu13 reau of Justice Assistance an application at such time, in 

14 such manner, and containing such information as the Di15 rector may require. 

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

17 under this section shall use such grant to establish or ex18 pand programs for pregnant and postpartum incarcerated 

19 individuals, and such programs— 

20 (1) may— 

21 (A) provide access to perinatal health 

22 workers from pregnancy through the post23 partum period; 

24 (B) provide access to healthy foods and 

25 counseling on nutrition, recommended activity 


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1 levels, and safety measures throughout preg2 nancy; 

3 (C) train correctional officers to ensure 

4 that pregnant incarcerated individuals receive 

5 safe and respectful treatment; 

6 (D) train medical personnel to ensure that 

7 pregnant incarcerated individuals receive trau8 ma-informed, culturally congruent care that 

9 promotes the health and safety of the pregnant 

10 individuals; 

11 (E) provide counseling and treatment for 

12 individuals who have suffered from— 

13 (i) diagnosed mental or behavioral 

14 health conditions, including trauma and 

15 substance use disorders; 

16 (ii) trauma or violence, including do17 mestic violence; 

18 (iii) human immunodeficiency virus; 

19 (iv) sexual abuse; 

20 (v) pregnancy or infant loss; or 

21 (vi) chronic conditions; 

22 (F) provide evidence-based pregnancy and 

23 childbirth education, parenting support, and 

24 other relevant forms of health literacy; 


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1 (G) provide clinical education opportunities 

2 to maternity care providers in training to ex3 pand pathways into maternal health care ca4 reers serving incarcerated individuals; 

5 (H) offer opportunities for postpartum in6 dividuals to maintain contact with the individ7 ual’s newborn child to promote bonding, includ8 ing enhanced visitation policies, access to prison 

9 nursery programs, or breastfeeding support; 

10 (I) provide reentry assistance, particularly 

11 to— 

12 (i) ensure access to health insurance 

13 coverage and transfer of health records to 

14 community providers if an incarcerated in15 dividual exits the criminal justice system 

16 during such individual’s pregnancy or in 

17 the postpartum period; and 

18 (ii) connect individuals exiting the 

19 criminal justice system during pregnancy 

20 or in the postpartum period to community21 based resources, such as referrals to health 

22 care providers, substance use disorder 

23 treatments, and social services that ad24 dress social determinants of maternal 

25 health; or 


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1 (J) establish partnerships with local public 

2 entities, private community entities, community3 based organizations, Indian Tribes and tribal 

4 organizations (as such terms are defined in sec5 tion 4 of the Indian Self-Determination and 

6 Education Assistance Act (25 U.S.C. 5304)), 

7 and urban Indian organizations (as such term 

8 is defined in section 4 of the Indian Health 

9 Care Improvement Act (25 U.S.C. 1603)) to es10 tablish or expand pretrial diversion programs as 

11 an alternative to incarceration for pregnant and 

12 postpartum individuals; and 

13 (2) may include— 

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 of the Bureau of Justice Assistance 

8 shall give priority to applicants based 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 racial and ethnic minority groups; 

13 and 

14 (2) the extent to which the State has dem15 onstrated a commitment to developing exemplary 

16 programs for pregnant and postpartum individuals 

17 incarcerated in the prisons and jails in the State. 

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

19 section shall be for a 5-year period. 

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

21 receives a grant under this section shall be responsible 

22 for— 

23 (1) implementing the program funded by the 

24 grant; and 


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1 (2) not later than 3 years after the date of en2 actment of this Act, and 6 years after the date of 

3 enactment of this Act, reporting results of such pro4 gram to the Attorney General, including information 

5 describing— 

6 (A) relevant quantitative indicators of the 

7 program’s success in improving the standard of 

8 care and health outcomes for pregnant and 

9 postpartum incarcerated individuals in the facil10 ity, including data stratified by race, ethnicity, 

11 sex, gender, age, geography, disability status, 

12 category of the criminal charge against such in13 dividual, incidence rates of pregnancy-related 

14 deaths, pregnancy-associated deaths, cases of 

15 infant mortality and morbidity, rates of preterm 

16 births and low-birthweight births, cases of se17 vere maternal morbidity, cases of violence 

18 against pregnant or postpartum individuals, di19 agnoses of maternal mental or behavioral health 

20 conditions, and other such information as ap21 propriate; 

22 (B) relevant qualitative and quantitative 

23 evaluations from pregnant and postpartum in24 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 the Congress a report describing the results of such 

9 grant programs. 

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 

16 are authorized to be appropriated to carry out this section 

17 $10,000,000 for each of fiscal years 2022 through 2026. 

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 02:45 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\S341.IS S341

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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 this section shall include— 

5 (1) to the extent practicable— 

6 (A) the number of pregnant individuals 

7 who are incarcerated in Bureau of Prisons fa8 cilities; 

9 (B) the number of incarcerated individuals, 

10 including those incarcerated in Federal, State, 

11 and local correctional facilities, who have expe12 rienced a pregnancy-related death, pregnancy13 associated death, or the death of an infant in 

14 the most recent 10 years of available data; 

15 (C) the number of cases of severe maternal 

16 morbidity among incarcerated individuals, in17 cluding those incarcerated in Federal, State, 

18 and local detention facilities, in the most recent 

19 10 years of available data; 

20 (D) the number of preterm and low-birth21 weight births of infants born to incarcerated in22 dividuals, including those incarcerated in Fed23 eral, State, and local correctional facilities, in 

24 the most recent 10 years of available data; and 


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1 (E) statistics on the racial and ethnic dis2 parities in maternal and infant health outcomes 

3 and severe maternal morbidity rates among in4 carcerated individuals, including those incarcer5 ated in Federal, State, and local detention fa6 cilities; 

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

8 the United States is unable determine the informa9 tion required in subparagraphs (A) through (C) of 

10 paragraph (1), an assessment of the barriers to de11 termining such information and recommendations 

12 for improvements in tracking maternal health out13 comes among incarcerated individuals, including 

14 those incarcerated in Federal, State, and local deten15 tion facilities; 

16 (3) causes of adverse maternal health outcomes 

17 that are unique to incarcerated individuals, including 

18 those incarcerated in Federal, State, and local deten19 tion facilities; 

20 (4) causes of adverse maternal health outcomes 

21 and severe maternal morbidity that are unique to in22 carcerated individuals from racial and ethnic minor23 ity groups; 

24 (5) recommendations to reduce maternal mor25 tality and severe maternal morbidity among incarVerDate Sep 11 2014 02:45 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\S341.IS S341

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1 cerated individuals and to address racial and ethnic 

2 disparities in maternal health outcomes for incarcer3 ated individuals in Bureau of Prisons facilities and 

4 State and local prisons and jails; and 

5 (6) such other information as may be appro6 priate to reduce the occurrence of adverse maternal 

7 health outcomes among incarcerated individuals and 

8 to address racial and ethnic disparities in maternal 

9 health outcomes for such individuals. 

10 SEC. 6. MACPAC REPORT. 

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

12 date of enactment of this Act, the Medicaid and CHIP 

13 Payment and Access Commission (referred to in this sec14 tion as ‘‘MACPAC’’) shall publish a report on the implica15 tions of pregnant and postpartum incarcerated individuals 

16 being ineligible for medical assistance under a State plan 

17 under title XIX of the Social Security Act (42 U.S.C. 

18 1396 et seq.) that contains the information described in 

19 subsection (b). 

20 (b) INFORMATION DESCRIBED.—The information de21 scribed in this subsection includes— 

22 (1) information on the effect of ineligibility for 

23 medical assistance under a State plan under title 

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

25 seq.) on maternal health outcomes for pregnant and 


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1 postpartum incarcerated individuals, concentrating 

2 on the effects of such ineligibility for pregnant and 

3 postpartum individuals from racial and ethnic mi4 nority groups; and 

5 (2) the potential implications on maternal 

6 health outcomes resulting from suspending eligibility 

7 for medical assistance under a State plan under 

8 such title when a pregnant or postpartum individual 

9 is incarcerated. 

Æ 


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