HR 4995 RFS
‘‘(D) EVALUATION.—The Secretary shall 
require grantees to evaluate the outcomes of the 
programs supported under the grant. 
‘‘(c) DEFINITIONS.—In this section, the terms ‘In-
dian Tribe’ and ‘Tribal organization’ have the meanings 
given the terms ‘Indian tribe’ and ‘tribal organization’, re-
spectively, in section 4 of the Indian Self-Determination 
and Education Assistance Act. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$10,000,000 for each of fiscal years 2021 through 2025.’’. 
(b) REPORT ON GRANT OUTCOMES AND DISSEMINA-
TION OF BEST PRACTICES.— 
(1) REPORT.—Not later than February 1, 
2026, the Secretary of Health and Human Services 
shall submit to the Committee on Health, Edu-
cation, Labor, and Pensions of the Senate and the 
Committee on Energy and Commerce of the House 
of Representatives a report that describes— 
(A) the outcomes of the activities sup-
ported by the grants awarded under the amend-
ment made by this section on maternal and 
child health; 
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
(B) best practices and models of care used 
by recipients of grants under such amendment; 
and 
(C) obstacles identified by recipients of 
grants under such amendment, and strategies 
used by such recipients to deliver care, improve 
maternal and child health, and reduce health 
disparities. 
(2) DISSEMINATION OF BEST PRACTICES.—Not 
later than August 1, 2026, the Secretary of Health 
and Human Services shall disseminate information 
on best practices and models of care used by recipi-
ents of grants under the amendment made by this 
section (including best practices and models of care 
relating to the reduction of health disparities, includ-
ing such disparities associated with racial and ethnic 
minority populations, in rates of maternal mortality 
and severe maternal morbidity) to relevant stake-
holders, which may include health providers, medical 
schools, nursing schools, relevant State, Tribal, and 
local agencies, and the general public. 
SEC. 7. IMPROVING RURAL MATERNAL AND OBSTETRIC 
CARE DATA. 
(a) MATERNAL MORTALITY AND MORBIDITY ACTIVI-
TIES.—Section 301(e) of the Public Health Service Act 
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
(42 U.S.C. 241(e)) is amended by inserting ‘‘, preventable 
maternal mortality and severe maternal morbidity,’’ after 
‘‘delivery’’. 
(b) 
OFFICE
OF
WOMEN’S
HEALTH.—Section 
310A(b)(1) of the Public Health Service Act (42 U.S.C. 
242s(b)(1)) is amended by striking ‘‘and sociocultural con-
texts,’’ and inserting ‘‘sociocultural (including among 
American Indians, Native Hawaiians, and Alaska Na-
tives), and geographical contexts’’. 
(c) SAFE MOTHERHOOD.—Section 317K of the Pub-
lic Health Service Act (42 U.S.C. 247b–12) is amended— 
(1) in subsection (a)(2)(A), by inserting ‘‘, in-
cluding improving collection of data on race, eth-
nicity, and other demographic information’’ before 
the period; and 
(2) in subsection (b)(2)— 
(A) in subparagraph (L), by striking 
‘‘and’’ at the end; 
(B) by redesignating subparagraph (M) as 
subparagraph (N); and 
(C) by inserting after subparagraph (L) 
the following: 
‘‘(M) an examination of the relationship 
between maternal health and obstetric services 
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
in rural areas and outcomes in delivery and 
postpartum care; and’’. 
(d) OFFICE OF RESEARCH ON WOMEN’S HEALTH.— 
Section 486 of the Public Health Service Act (42 U.S.C. 
287d) is amended— 
(1) in subsection (b), by amending paragraph 
(3) to read as follows: 
‘‘(3) carry out paragraphs (1) and (2) with re-
spect to— 
‘‘(A) the aging process in women, with pri-
ority given to menopause; and 
‘‘(B) pregnancy, with priority given to 
deaths related to preventable maternal mor-
tality and severe maternal morbidity;’’; and 
(2) in subsection (d)(4)(A)(iv), by inserting ‘‘, 
including preventable maternal morbidity and severe 
maternal morbidity’’ before the semicolon. 
SEC. 8. RURAL OBSTETRIC NETWORK GRANTS. 
The Public Health Service Act is amended by insert-
ing after section 330A–1 (42 U.S.C. 254c–1a) the fol-
lowing: 
‘‘SEC. 330A–2. RURAL OBSTETRIC NETWORK GRANTS. 
‘‘(a) PROGRAM ESTABLISHED.—The Secretary shall 
award grants or cooperative agreements to eligible entities 
to establish collaborative improvement and innovation net-
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
works (referred to in this section as ‘rural obstetric net-
works’) to improve maternal and infant health outcomes 
and reduce preventable maternal mortality and severe ma-
ternal morbidity by improving maternity care and access 
to care in rural areas, frontier areas, maternity care health 
professional target areas, or jurisdictions of Indian Tribes 
and Tribal organizations. 
‘‘(b) USE OF FUNDS.—Grants or cooperative agree-
ments awarded pursuant to this section shall be used for 
the establishment or continuation of collaborative improve-
ment and innovation networks to improve maternal health 
in rural areas by improving infant health and maternal 
outcomes and reducing preventable maternal mortality 
and severe maternal morbidity. Rural obstetric networks 
established in accordance with this section may— 
‘‘(1) develop a network to improve coordination 
and increase access to maternal health care and as-
sist pregnant women in the areas described in sub-
section (a) with accessing and utilizing maternal and 
obstetric care, including health care services related 
to 
prenatal 
care, 
labor 
care, 
birthing, 
and 
postpartum care to improve outcomes in birth and 
maternal mortality and morbidity; 
‘‘(2) identify and implement evidence-based and 
sustainable delivery models for maternal and obstet-
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
ric care (including health care services related to 
prenatal care, labor care, birthing, and postpartum 
care for women in the areas described in subsection 
(a), including home visiting programs and culturally 
appropriate care models that reduce health dispari-
ties; 
‘‘(3) develop a model for maternal health care 
collaboration between health care settings to improve 
access to care in areas described in subsection (a), 
which may include the use of telehealth; 
‘‘(4) provide training for professionals in health 
care settings that do not have specialty maternity 
care; 
‘‘(5) collaborate with academic institutions that 
can provide regional expertise and help identify bar-
riers to providing maternal health care, including 
strategies for addressing such barriers; and 
‘‘(6) assess and address disparities in infant 
and maternal health outcomes, including among ra-
cial and ethnic minority populations and underserved 
populations in areas described in subsection (a). 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE ENTITIES.—The term ‘eligible 
entities’ means entities providing maternal health 
care services in rural areas, frontier areas, or medi-
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
cally underserved areas, or to medically underserved 
populations or Indian Tribes or Tribal organizations. 
‘‘(2) FRONTIER
AREA.—The term ‘frontier 
area’ means a frontier county, as defined in section 
1886(d)(3)(E)(iii)(III) of the Social Security Act. 
‘‘(3) INDIAN TRIBES; TRIBAL ORGANIZATION.— 
The terms ‘Indian Tribe’ and ‘Tribal organization’ 
have the meanings given the terms ‘Indian tribe’ and 
‘tribal organization’, respectively, in section 4 of the 
Indian Self-Determination and Education Assistance 
Act. 
‘‘(4) MATERNITY CARE HEALTH PROFESSIONAL 
TARGET
AREA.—The term ‘maternity care health 
professional target area’ has the meaning described 
in section 332(k)(2). 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$3,000,000 for each of fiscal years 2021 through 2025.’’. 
SEC. 9. TELEHEALTH NETWORK AND TELEHEALTH RE-
SOURCE CENTERS GRANT PROGRAMS. 
Section 330I of the Public Health Service Act (42 
U.S.C. 254c–14) is amended— 
(1) in subsection (f)(3), by adding at the end 
the following: 
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
‘‘(M) Providers of maternal care, including 
prenatal, labor care, birthing, and postpartum 
care services and entities operating obstetric 
care units.’’; and 
(2) in subsection (h)(1)(B), by inserting ‘‘labor 
care, birthing care, postpartum care,’’ before ‘‘or 
prenatal’’. 
SEC. 10. RURAL MATERNAL AND OBSTETRIC CARE TRAIN-
ING DEMONSTRATION. 
Subpart 1 of part E of title VII of the Public Health 
Service Act (42 U.S.C. 294n et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 764. RURAL MATERNAL AND OBSTETRIC CARE TRAIN-
ING DEMONSTRATION. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to accredited schools of allopathic medicine, osteo-
pathic medicine, and nursing, and other appropriate 
health professional training programs, to establish a train-
ing demonstration program to support— 
‘‘(1) training for physicians, medical residents, 
fellows, nurse practitioners, physician assistants, 
nurses, certified nurse midwives, relevant home vis-
iting workforce professionals and paraprofessionals, 
or other professionals who meet relevant State train-
ing and licensing requirements, as applicable, to pro-
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
vide maternal health care services in rural commu-
nity-based settings; and 
‘‘(2) developing recommendations for such 
training programs. 
‘‘(b) APPLICATION.—To be eligible to receive a grant 
under subsection (a), an entity shall submit to the Sec-
retary an application at such time, in such manner, and 
containing such information as the Secretary may require. 
‘‘(c) ACTIVITIES.— 
‘‘(1) TRAINING
FOR
HEALTH
CARE
PROFES-
SIONALS.—A recipient of a grant under subsection 
(a)— 
‘‘(A) shall use the grant funds to plan, de-
velop, and operate a training program to pro-
vide maternal health care in rural areas; and 
‘‘(B) may use the grant funds to provide 
additional support for the administration of the 
program or to meet the costs of projects to es-
tablish, maintain, or improve faculty develop-
ment, or departments, divisions, or other units 
necessary to implement such training. 
‘‘(2) TRAINING
PROGRAM
REQUIREMENTS.— 
The recipient of a grant under subsection (a) shall 
ensure that training programs carried out under the 
grant are evidence-based and address improving ma-
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
ternal health care in rural areas, and such programs 
may include training on topics such as— 
‘‘(A) maternal mental health, including 
perinatal depression and anxiety; 
‘‘(B) substance use disorders; 
‘‘(C) social determinants of health that af-
fect individuals living in rural areas; and 
‘‘(D) implicit and explicit bias. 
‘‘(d) EVALUATION AND REPORT.— 
‘‘(1) EVALUATION.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
evaluate the outcomes of the demonstration 
program under this section. 
‘‘(B) DATA SUBMISSION.—Recipients of a 
grant under subsection (a) shall submit to the 
Secretary performance metrics and other re-
lated data in order to evaluate the program for 
the report described in paragraph (2). 
‘‘(2) REPORT TO CONGRESS.—Not later than 
January 1, 2025, the Secretary shall submit to the 
Committee on Health, Education, Labor, and Pen-
sions of the Senate and the Committee on Energy 
and Commerce of the House of Representatives a re-
port that includes— 
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS
HR 4995 RFS
‘‘(A) an analysis of the effects of the dem-
onstration program under this section on the 
quality, quantity, and distribution of maternal 
health care services, including health care serv-
ices related to prenatal care, labor care, birth-
ing, and postpartum care, and the demo-
graphics of the recipients of those services; 
‘‘(B) an analysis of maternal and infant 
health outcomes (including quality of care, mor-
bidity, and mortality) before and after imple-
mentation of the program in the communities 
served by entities participating in the dem-
onstration program; and 
‘‘(C) recommendations on whether the 
demonstration program should be continued. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2021 through 2025.’’. 
Passed the House of Representatives September 21, 
2020. 
Attest: 
CHERYL L. JOHNSON, 
Clerk. 
VerDate Sep 11 2014 
03:55 Sep 23, 2020
Jkt 099200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H4995.RFS
H4995
pamtmann on DSKBC07HB2PROD with BILLS