I 

118TH CONGRESS 

1ST SESSION H. R. 5581 

To amend the Social Security Act to authorize grants for demonstration 

projects to support mothers and families during pregnancy, childbirth, 

and the postpartum period by increasing access to short-term child care, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 20, 2023 

Ms. MCCLELLAN (for herself and Ms. MACE) introduced the following bill; 

which was referred to the Committee on Ways and Means 

A BILL 

To amend the Social Security Act to authorize grants for 

demonstration projects to support mothers and families 

during pregnancy, childbirth, and the postpartum period 

by increasing access to short-term child 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 ‘‘Child Care Assistance 

5 for Maternal Health Act’’. 


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1 SEC. 2. DEMONSTRATION PROJECTS FOR CHILD CARE TO 

2 IMPROVE MATERNAL HEALTH. 

3 Subtitle A of title XX of the Social Security Act (42 

4 U.S.C. 1397 et seq.) is amended by inserting after section 

5 2009 the following: 

6 ‘‘SEC. 2009A. DEMONSTRATION PROJECTS FOR CHILD CARE 

7 TO IMPROVE MATERNAL HEALTH. 

8 ‘‘(a) IN GENERAL.— 

9 ‘‘(1) ESTABLISHMENT.—The Secretary shall 

10 carry out a program of awarding grants, on a com11 petitive basis, to eligible entities to conduct dem12 onstration projects designed to support mothers and 

13 families during pregnancy, childbirth, and the 

14 postpartum period by increasing access to short15 term child care (such as through crisis nurseries) in 

16 order to improve the physical health, mental health, 

17 and wellness of the mother and her family. 

18 ‘‘(2) ADVISORY GROUP.—The Secretary shall 

19 establish an advisory group to advise the Secretary 

20 on carrying out the program established under para21 graph (1). The advisory group shall be composed of 

22 the following members: 

23 ‘‘(A) At least 1 representative of the Ad24 ministration for Children and Families. 

25 ‘‘(B) At least 1 representative of the Ad26 ministration for Native Americans. 


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1 ‘‘(C) At least 1 representative of the Cen2 ters for Medicare & Medicaid Services. 

3 ‘‘(D) At least 1 representative of the 

4 Health Resources and Services Administration. 

5 ‘‘(E) At least 1 representative of the Sub6 stance Abuse and Mental Health Services Ad7 ministration. 

8 ‘‘(F) Representatives of such other Federal 

9 entities, as the Secretary determines appro10 priate. 

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

12 a grant under this section, an entity shall be— 

13 ‘‘(1) a State, a territory, or the District of Co14 lumbia; 

15 ‘‘(2) an Indian Tribe or Tribal organization; 

16 ‘‘(3) an Urban Indian organization; 

17 ‘‘(4) a public health department; 

18 ‘‘(5) a nonprofit community-based organization; 

19 or 

20 ‘‘(6) a consortium of entities described in any 

21 of paragraphs (1) through (5). 

22 ‘‘(c) PRIORITY FOR AWARDING GRANTS.—In select23 ing grant recipients under this section, the Secretary 

24 shall— 

25 ‘‘(1) give priority to— 


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1 ‘‘(A) eligible entities that, in addition to 

2 the activities proposed to be funded through the 

3 grant, will provide families with assistance in 

4 attaining a long-term child care option; 

5 ‘‘(B) eligible entities proposing to serve an 

6 area with high rates of maternal mortality and 

7 poverty; and 

8 ‘‘(C) eligible entities proposing to serve a 

9 maternity care health professional target area 

10 identified under section 332(k) of the Public 

11 Health Service Act; and 

12 ‘‘(2) award at least 1 grant to an Indian Tribe, 

13 a Tribal organization, or an Urban Indian organiza14 tion. 

15 ‘‘(d) NUMBER.— 

16 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

17 the Secretary shall award at least 10 grants under 

18 this section. 

19 ‘‘(2) EXCEPTION FOR INSUFFICIENT APPRO20 PRIATIONS.—The Secretary may award fewer than 

21 10 grants if the Secretary determines that the 

22 amounts made available to carry out this section are 

23 less than the total amounts authorized to be appro24 priated by subsection (i). 

25 ‘‘(e) DEMONSTRATION PROJECT REQUIREMENTS.— 


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1 ‘‘(1) USE OF FUNDS.—A grant awarded under 

2 this section may be used— 

3 ‘‘(A) to conduct a demonstration project 

4 described in subsection (a); 

5 ‘‘(B) to assess community needs in prepa6 ration for such demonstration project; and 

7 ‘‘(C) to fund outreach related to such dem8 onstration project. 

9 ‘‘(2) DURATION.—A demonstration project 

10 under this section shall be for a period of not less 

11 than 3 years. 

12 ‘‘(3) REPORTS BY GRANTEES.— 

13 ‘‘(A) INTERIM AND FINAL REPORTS.—A 

14 grantee under this section shall agree to submit 

15 to the Secretary— 

16 ‘‘(i) interim reports on the demonstra17 tion project funded through the grant; and 

18 ‘‘(ii) a final report on such dem19 onstration project. 

20 ‘‘(B) CONTENTS.—The interim and final 

21 reports of a grantee under subparagraph (A) 

22 shall include assessments of the effectiveness of 

23 the grantee’s demonstration project with re24 spect to— 


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1 ‘‘(i) maternal and child health out2 comes; 

3 ‘‘(ii) child care quality; and 

4 ‘‘(iii) such other metrics as may be 

5 determined by the Secretary. 

6 ‘‘(4) PRIORITY FOR PROVIDING SERVICES.—In 

7 providing services through a demonstration project 

8 under this section, a grantee shall give priority to 

9 vulnerable populations, such as— 

10 ‘‘(A) low-income families; 

11 ‘‘(B) families experiencing homelessness; 

12 ‘‘(C) single-parent households; 

13 ‘‘(D) families who have children with dis14 abilities or special health care needs; and 

15 ‘‘(E) other vulnerable populations as may 

16 be determined by the Secretary. 

17 ‘‘(5) SUBGRANTS AND CONTRACTS.— 

18 ‘‘(A) IN GENERAL.—A grantee under this 

19 section may coordinate with entities described 

20 in subparagraph (B) in carrying out a dem21 onstration project under this section, including 

22 by awarding subgrants to, or entering into con23 tracts with, such entities. 

24 ‘‘(B) ENTITIES.—The entities described in 

25 this subparagraph are the following: 


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1 ‘‘(i) State or local child care resource 

2 and referral agencies. 

3 ‘‘(ii) Prenatal, perinatal, pediatric, 

4 family medicine, and other relevant health 

5 care providers. 

6 ‘‘(iii) Doula support services. 

7 ‘‘(6) STATE AND LOCAL REQUIREMENTS.— 

8 ‘‘(A) IN GENERAL.—Subject to subpara9 graph (B), services provided through a dem10 onstration project under this section shall meet 

11 the applicable requirements of State and local 

12 law in the jurisdiction in which such services 

13 are provided, including any applicable licensure 

14 and quality of care requirements. 

15 ‘‘(B) EXCEPTION.—Child care may be pro16 vided through a demonstration project under 

17 this section to children younger than the min18 imum age allowed under applicable State or 

19 local licensing requirements, so long as the 

20 grantee providing such child care (either di21 rectly or through a subgrant or contract under 

22 paragraph (5)) coordinates with the applicable 

23 jurisdiction to ensure appropriate quality of 

24 care standards. 

25 ‘‘(f) EVALUATION.—The Secretary shall— 


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1 ‘‘(1) evaluate the demonstration projects funded 

2 under this section; and 

3 ‘‘(2) as part of such evaluation— 

4 ‘‘(A) identify successful activities for im5 proving maternal health outcomes and health 

6 outcomes for the birthed child and any other 

7 children in the family; and 

8 ‘‘(B) formulate recommendations for reau9 thorizing the program under this section. 

10 ‘‘(g) REPORTS TO CONGRESS.—The Secretary shall 

11 submit reports to the Congress on the program under this 

12 section, including— 

13 ‘‘(1) interim reports; and 

14 ‘‘(2) based on the evaluation under subsection 

15 (f), a final report. 

16 ‘‘(h) DEFINITIONS.—In this section: 

17 ‘‘(1) IHCIA TERMS.—The terms ‘Indian Tribe’, 

18 ‘Tribal organization’, and ‘Urban Indian organiza19 tion’ have the meanings given the terms ‘Indian 

20 tribe’, ‘tribal organization’, and ‘Urban Indian orga21 nization’, respectively, in section 4 of the Indian 

22 Health Care Improvement Act. 

23 ‘‘(2) POSTPARTUM PERIOD.—The term 

24 ‘postpartum period’ means the first year after an in25 dividual has given birth. 


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1 ‘‘(3) SHORT-TERM CHILD CARE.—The term 

2 ‘short-term child care’— 

3 ‘‘(A) means child care provided during 

4 pregnancy, childbirth, or the postpartum pe5 riod— 

6 ‘‘(i) for a limited duration; and 

7 ‘‘(ii) for the birthed child or any other 

8 child in the family; and 

9 ‘‘(B) includes respite child care. 

10 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

11 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

12 there is authorized to be appropriated to carry out 

13 this section $5,000,000 for each of fiscal years 2024 

14 through 2026. 

15 ‘‘(2) EVALUATION.—Of the funds appropriated 

16 to carry out this section under paragraph (1), not 

17 more than 5 percent may be used to fund the eval18 uation under subsection (f).’’. 

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