519 
after, the Secretary of Health and Human Services shall 
publicize the availability, features, and uses of the data-
base under this section to the stakeholders described in 
subsection (e). 
(e) CONSULTATION.—For purposes of developing the 
database under this section and maintaining and updating 
such database, the Secretary of Health and Human Serv-
ices shall convene and consult with an advisory committee 
composed of relevant stakeholders, including— 
(1) Federal Medicaid administrators and State 
agencies administrating State plans under title XIX 
of the Social Security Act pursuant to section 
1902(a)(5) of such Act (42 U.S.C. 1396a(a)(5)); 
(2) providers of maternity and newborn care 
from both academic and community-based settings, 
including obstetrician-gynecologists, family physi-
cians, certified nurse midwives, certified midwives, 
certified professional midwives, physician assistants, 
perinatal nurses, pediatricians, and nurse practi-
tioners; 
(3) maternal-fetal medicine specialists; 
(4) neonatologists; 
(5) childbearing individuals and advocates for 
such individuals, including childbirth educators cer-
tified by a nationally accredited program, rep-
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resenting communities that are diverse in terms of 
race, ethnicity, indigenous status, and geographic 
area; 
(6) employers and purchasers; 
(7) health facility and system leaders, including 
both hospital and birth center facilities; 
(8) journalists; and 
(9) bibliographic informatics specialists. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated $2,500,000 for each of the 
fiscal years 2021 through 2023 for the purpose of devel-
oping the database and such sums as may be necessary 
for each subsequent fiscal year for updating the database 
and providing outreach and notification to users, as de-
scribed in this section. 
SEC. 518. EXPANSION OF CDC PREVENTION RESEARCH 
CENTERS PROGRAM TO INCLUDE CENTERS 
ON OPTIMAL MATERNITY OUTCOMES. 
(a) IN GENERAL.—Not later than one year after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services shall support the establishment of 
additional Prevention Research Centers under the Preven-
tion Research Center Program administered by the Cen-
ters for Disease Control and Prevention. Such additional 
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centers shall each be known as a Center for Excellence 
on Optimal Maternity Outcomes. 
(b) RESEARCH.—Each Center for Excellence on Opti-
mal Maternity Outcomes shall— 
(1) conduct at least one focused program of re-
search to improve maternity outcomes, including the 
reduction of cesarean birth rates, elective inductions, 
prematurity rates, and low birth weight rates within 
an underserved population that has a disproportion-
ately large burden of suboptimal maternity out-
comes, including maternal mortality and morbidity, 
infant mortality, prematurity, or low birth weight, 
and developing performance and quality measures 
for accountability; 
(2) work with partners on special interest 
projects, as specified by the Centers for Disease 
Control and Prevention and other relevant agencies 
within the Department of Health and Human Serv-
ices, and on projects funded by other sources; and 
(3) involve a minimum of two distinct birth set-
ting models, such as a hospital labor and delivery 
model and freestanding birth center model; or a hos-
pital labor and delivery model and planned home 
birth model. 
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(c) INTERDISCIPLINARY PROVIDERS.—Each Center 
for Excellence on Optimal Maternity Outcomes shall in-
clude the following interdisciplinary providers of maternity 
care: 
(1) Obstetrician-gynecologists. 
(2) At least two of the following providers: 
(A) Family practice physicians. 
(B) Nurse practitioners. 
(C) Physician assistants. 
(D) Certified professional midwives. 
(d) SERVICES.—Research conducted by each Center 
for Excellence on Optimal Maternity Outcomes shall in-
clude at least 2 (and preferably more) of the following sup-
portive provider services: 
(1) Mental health. 
(2) Doula labor support. 
(3) Nutrition education. 
(4) Childbirth education. 
(5) Social work. 
(6) Physical therapy or occupation therapy. 
(7) Substance abuse services. 
(8) Home visiting. 
(e) COORDINATION.—The programs of research at 
each of the two Centers of Excellence on Optimal Mater-
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nity Outcomes shall complement and not replicate the 
work of the other. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$2,000,000 for each of the fiscal years 2021 through 
2025. 
SEC. 519. EXPANDING MODELS ALLOWED TO BE TESTED BY 
CENTER FOR MEDICARE & MEDICAID INNO-
VATION TO INCLUDE MATERNITY CARE MOD-
ELS. 
Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the 
end the following new clause: 
‘‘(xxviii) 
Promoting 
evidence-based 
models of care that have been associated 
with reductions in maternal and infant 
health disparities, including incorporating 
the use of doula and promotoras support 
for pregnant and childbearing individuals 
into evidence-based models of prenatal 
care, labor and delivery, and postpartum 
care, and supporting the appropriate use of 
out-of-hospital 
birth 
models, 
including 
births at home and in freestanding birth 
centers.’’. 
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SEC. 520. DEVELOPMENT OF INTERPROFESSIONAL MATER-
NITY 
CARE 
EDUCATIONAL 
MODELS 
AND 
TOOLS. 
(a) IN GENERAL.—Not later than 6 months after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, acting in conjunction with the Ad-
ministrator of Health Resources and Services Administra-
tion, shall convene, for a 1-year period, an Interprofes-
sional Maternity Provider Education Commission to dis-
cuss and make recommendations for— 
(1) a consensus standard physiologic maternity 
care curriculum that takes into account the core 
competencies for basic midwifery practice such as 
those developed by the American College of Nurse 
Midwives and the North American Registry of Mid-
wives, and the educational objectives for physicians 
practicing in obstetrics and gynecology as deter-
mined by the Council on Resident Education in Ob-
stetrics and Gynecology; 
(2) suggestions for multidisciplinary use of the 
consensus physiologic curriculum; 
(3) strategies to integrate and coordinate edu-
cation across maternity care disciplines, including 
recommendations to increase medical and midwifery 
student exposure to out-of-hospital birth; and 
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(4) pilot demonstrations of interprofessional 
educational models. 
(b) PARTICIPANTS.—The Commission shall include 
maternity care educators, curriculum developers, service 
leaders, certification leaders, and accreditation leaders 
from the various professions that provide maternity care 
in the United States. Such professions shall include obste-
trician gynecologists, certified nurse midwives or certified 
midwives, family practice physicians, nurse practitioners, 
physician assistants, certified professional midwives, and 
perinatal nurses. Additionally, the Commission shall in-
clude representation from maternity care consumer advo-
cates. 
(c) CURRICULUM.—The consensus standard physio-
logic maternity care curriculum described in subsection 
(a)(1) shall— 
(1) have a public health focus with a foundation 
in health promotion and disease prevention; 
(2) foster physiologic childbearing and woman 
and family centered care; 
(3) integrate strategies to reduce maternal and 
infant morbidity and mortality; 
(4) incorporate recommendations to ensure re-
spectful, safe, and seamless consultation, referral, 
transport, and transfer of care when necessary; 
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(5) include cultural sensitivity and strategies to 
decrease disparities in maternity outcomes; and 
(6) include implicit bias training. 
(d) REPORT.—Not later than 6 months after the final 
meeting of the Commission, the Secretary of Health and 
Human Services shall— 
(1) submit to Congress a report containing the 
recommendations made by the Commission under 
this section; and 
(2) make such report publicly available. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$1,000,000 for each of the fiscal years 2021 and 2022, 
and such sums as are necessary for each of the fiscal years 
2023 through 2025. 
SEC. 521. INCLUDING SERVICES FURNISHED BY CERTAIN 
STUDENTS, INTERNS, AND RESIDENTS SU-
PERVISED BY CERTIFIED NURSE MIDWIVES 
WITHIN 
INPATIENT 
HOSPITAL 
SERVICES 
UNDER MEDICARE. 
(a) IN GENERAL.—Section 1861(b) of the Social Se-
curity Act (42 U.S.C. 1395x(b)) is amended— 
(1) in paragraph (6), by striking ‘‘; or’’ at the 
end and inserting ‘‘, or in the case of services in a 
hospital or osteopathic hospital by a student midwife 
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or an intern or resident-in-training under a teaching 
program previously described in this paragraph who 
is in the field of obstetrics and gynecology, if such 
student midwife, intern, or resident-in-training is su-
pervised by a certified nurse-midwife to the extent 
permitted under applicable State law and as may be 
authorized by the hospital;’’; 
(2) in paragraph (7), by striking the period at 
the end and inserting ‘‘; or’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(8) a certified nurse-midwife where the hos-
pital has a teaching program approved as specified 
in paragraph (6), if— 
‘‘(A) the hospital elects to receive any pay-
ment due under this title for reasonable costs of 
such services; and 
‘‘(B) all certified nurse-midwives in such 
hospital agree not to bill charges for profes-
sional services rendered in such hospital to indi-
viduals covered under the insurance program 
established by this title.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to services furnished on or after 
the date of the enactment of this Act. 
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SEC. 522. GRANTS TO PROFESSIONAL ORGANIZATIONS TO 
INCREASE DIVERSITY IN MATERNAL, REPRO-
DUCTIVE, AND SEXUAL HEALTH PROFES-
SIONALS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, through the Administrator of the Health 
Resources and Services Administration, shall carry out a 
grant program under which the Secretary may make to 
eligible organizations— 
(1) for fiscal year 2021, planning grants de-
scribed in subsection (b); and 
(2) for the subsequent 4-year period, implemen-
tation grants described in subsection (c). 
(b) PLANNING GRANTS.— 
(1) IN GENERAL.—Planning grants described in 
this subsection are grants for the following purposes: 
(A) To collect data and identify any work-
force disparities, with respect to a health pro-
fession, at each of the following areas along the 
health professional continuum: 
(i) Pipeline availability with respect to 
students at the high school and college or 
university levels considering and working 
toward entrance in the profession, includ-
ing barriers triggered by criminal records. 
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(A) information on the extent and distribu-
tion of workforce disparities identified through 
the grant; and 
(B) reasonable objectives and strategies 
developed to address such disparities within a 
5-, 10-, and 25-year period. 
(c) IMPLEMENTATION GRANTS.— 
(1) IN GENERAL.—Implementation grants de-
scribed in this subsection are grants to implement 
one or more of the strategies developed pursuant to 
a planning grant awarded under subsection (b). 
(2) APPLICATION.—To be eligible to receive a 
grant under this subsection, an eligible health pro-
fessional organization shall submit to the Secretary 
of Health and Human Services an application in 
such form and manner as specified by the Secretary. 
Each such application shall contain information on 
the capability of the organization to carry out a 
strategy described in paragraph (1), involvement of 
partners or coalitions, plans for developing sustain-
ability of the efforts after the culmination of the 
grant cycle, and any other information specified by 
the Secretary. 
(3) AMOUNT.—Each grant awarded under this 
subsection shall be for an amount not to exceed 
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$500,000 each year during the 4-year period of the 
grant. 
(4) REPORTS.—For each of the first 3 years for 
which an eligible health professional organization is 
awarded a grant under this subsection, the organiza-
tion shall submit to the Secretary of Health and 
Human Services a report on the activities carried 
out by such organization through the grant during 
such year and objectives for the subsequent year. 
For the fourth year for which an eligible health pro-
fessional organization is awarded a grant under this 
subsection, the organization shall submit to the Sec-
retary a report that includes an analysis of all the 
activities carried out by the organization through the 
grant and a detailed plan for continuation of out- 
reach efforts. 
(d) ELIGIBLE HEALTH PROFESSIONAL ORGANIZA-
TION DEFINED.—For purposes of this section, the term 
‘‘eligible health professional organization’’ means a profes-
sional organization representing obstetrician-gynecolo-
gists, certified nurse midwives, certified midwives, family 
practice physicians, nurse practitioners whose scope of 
practice includes maternity or sexual and reproductive 
health care, physician assistants whose scope of practice 
includes obstetrical or sexual and reproductive health care, 
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or certified professional midwives adolescent medicine spe-
cialists, and pediatricians who provide sexual and repro-
ductive health care. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$2,000,000 for fiscal year 2021 and $3,000,000 for each 
of the fiscal years 2022 through 2025. 
SEC. 523. INTERAGENCY UPDATE TO THE QUALITY FAMILY 
PLANNING GUIDELINES. 
(a) IN GENERAL.—Not later than six months after 
the date of enactment of this Act, the Director of the Cen-
ters for Disease Control and Prevention and the Office 
of Population Affairs shall review and expand the 2014 
Quality Family Planning Guidelines to address— 
(1) health disparities; and 
(2) the importance of patient-directed contra-
ceptive decisionmaking. 
(b) CONSULTATION.—In carrying out subsection (a), 
the Director of the Centers for Disease Control and Pre-
vention and the Office of Population Affairs shall convene 
a meeting, and solicit the views of, stakeholders including 
experts on health disparities, experts on reproductive coer-
cion, representatives of provider organizations, patient ad-
vocates, reproductive justice organizations, organizations 
that represent racial and ethnic minority communities, or-
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ganizations that represent people with disabilities, organi-
zations that represent LGBTQ persons, and organizations 
that represent people with limited English proficiency. 
SEC. 524. DISSEMINATION OF THE QUALITY FAMILY PLAN-
NING GUIDELINES. 
(a) IN GENERAL.—Not later than six months after 
the date of enactment of this Act, the Secretary of Health 
and Human Services and the Director of the Centers for 
Disease Control and Prevention shall— 
(1) develop a plan for outreach to publicly fund-
ed health care providers, including federally qualified 
health centers and branches of the Indian Health 
Service, about the quality family planning guidelines 
referred to in section 524; and 
(2) award grants to eligible entities to imple-
ment these guidelines for all patients seeking family 
planning services. 
(b) DEFINITION.—In this section, the term ‘‘eligible 
entity’’ means a publicly funded health care provider that 
serves persons of reproductive age. 
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Subtitle B—Pregnancy Screening 
SEC. 531. PREGNANCY INTENTION SCREENING INITIATIVE 
DEMONSTRATION PROGRAM. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 399V–7. PREGNANCY INTENTION SCREENING INITIA-
TIVE DEMONSTRATION PROGRAM. 
‘‘(a) PROGRAM ESTABLISHMENT.—The Secretary, 
acting through the Director of the Centers for Disease 
Control and Prevention, shall establish a demonstration 
program to facilitate the clinical adoption of pregnancy in-
tention screening initiatives by health care and social serv-
ices providers. 
‘‘(b) GRANTS.—The Secretary may carry out the 
demonstration program through awarding grants to eligi-
ble entities to implement pregnancy intention screening 
initiatives, collect data, and evaluate such initiatives. 
‘‘(c) ELIGIBLE ENTITIES.— 
‘‘(1) IN
GENERAL.—An eligible entity under 
this section is an entity described in paragraph (2) 
that provides non-directive, comprehensive, medically 
accurate information. 
‘‘(2) ENTITIES DESCRIBED.—For purposes of 
paragraph (1), an entity described in this paragraph 
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is a community-based organization, voluntary health 
organization, public health department, community 
health center, or other interested public or private 
primary, behavioral, or other health care or social 
service provider or organization. 
‘‘(d) PREGNANCY INTENTION SCREENING INITIA-
TIVE.—For purposes of this section, the term ‘pregnancy 
intention screening initiative’ means any initiative by an 
eligible entity to routinely screen women with respect to 
their pregnancy intentions and goals to either prevent un-
intended pregnancies or improve the likelihood of healthy 
pregnancies, in order to better provide health care that 
meets the contraceptive or pre-pregnancy needs and goals 
of such women. 
‘‘(e) EVALUATION.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall, by grant or contract, 
and after consultation as described in paragraph (2), 
conduct an evaluation of the demonstration pro-
gram, with respect to pregnancy intention screening 
initiatives, conducted under this section. Such eval-
uation shall include: 
‘‘(A) Assessment of the implementation of 
pregnancy intention screening protocols among 
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a diverse group of patients and providers, in-
cluding collecting data on the experiences and 
outcomes for diverse patient populations in a 
variety of clinical settings. 
‘‘(B) Analysis of outcome measures that 
will facilitate effective and widespread adoption 
of such protocols by health care providers for 
inquiring about and responding to pregnancy 
goals of women with both contraceptive and 
pre-pregnancy care. 
‘‘(C) Consideration of health disparities 
among the population served. 
‘‘(D) Assessment of the equitable and vol-
untary application of such initiatives to minor-
ity and medically underserved communities. 
‘‘(E) Assessment of the training, capacity, 
and ongoing technical assistance needed for 
providers to effectively implement such preg-
nancy intention screening protocols. 
‘‘(F) Assessment of whether referral sys-
tems for selected protocols follow evidence-based 
standards that ensure access to comprehensive 
health services and appropriate follow-up care. 
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‘‘(G) Measuring through rigorous methods 
the effect of such initiatives on key health out-
comes. 
‘‘(2) CONSULTATION WITH INDEPENDENT, EX-
PERT ADVISORY PANEL.—In conducting evaluation 
under paragraph (1), the Director of the Centers for 
Disease Control and Prevention shall consult with 
physicians, physician assistants, advanced practice 
registered nurses, nurse midwives, and other health 
care providers who specialize in women’s health, and 
other experts in public health, clinical practice, pro-
gram evaluation, and research. 
‘‘(3) REPORT.—Not later than one year after 
the last day of the demonstration program under 
this section, the Director of the Centers for Disease 
Control and Prevention shall submit to Congress a 
report on the results of the evaluation conducted 
under paragraph (1) and shall make the report pub-
licly available. 
‘‘(f) FUNDING.— 
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this section, there is authorized to be 
appropriated $10,000,000 for each of fiscal years 
2021 through 2025. 
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‘‘(2) LIMITATION.—Not more than 20 percent 
of funds appropriated to carry out this section pur-
suant to paragraph (1) for a fiscal year may be used 
for purposes of the evaluation under subsection 
(e).’’. 
TITLE VI—MENTAL HEALTH 
SEC. 601. MENTAL HEALTH FINDINGS. 
Congress finds the following: 
(1) Despite the existence of effective treat-
ments, inequities lie in the availability, accessibility, 
and quality of mental health services for racial and 
ethnic minorities and people with disabilities. 
(2) These inequities have powerful significance 
for minority groups and for society as a whole. 
(3) Racial and ethnic minorities and people 
with disabilities bear a greater burden from unmet 
mental health needs and thus suffer a greater loss 
to their overall health and productivity. 
(4) Improving community conditions and one’s 
home environment, paired with high-quality, acces-
sible, and culturally tailored mental health services, 
can reduce the likelihood, frequency, and intensity of 
challenges to one’s mental health. 
(5) The presence of strong social connections 
and trust, opportunities to experience and share cul-
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tural identity, safe gathering places, and economic 
opportunity are community factors that benefit men-
tal health. 
(6) The social, physical, and economic condi-
tions in communities can have tremendous influence 
on daily stressors that shape mental health out-
comes. 
(7) The foremost barriers include the cost of 
care, societal stigma, and the fragmented organiza-
tion of services. 
(8) People with disabilities who are racial or 
ethnic minorities may have co-occurring mental 
health conditions which, without proper accommoda-
tions and support, further stigmatize them and limit 
their participation in society. 
(9) African-American, Latinx, Asian-American, 
Pacific Islander, Native, and other people of color 
have attitudes toward mental health challenges that 
are another barrier to seeking mental health care. 
(10) Mental illness retains considerable stigma 
in many communities of color, including those of 
Asian Americans and Pacific Islanders, and seeking 
treatment is not always encouraged. 
(11) Addressing mental health stigma and in-
creasing culturally appropriate treatment modalities 
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607 
ordinate a uniform message relating to prostate can-
cer screening and treatment where appropriate, in-
cluding representatives of the following: 
(A) The Department of Veterans Affairs, 
including representatives of each relevant pro-
gram area of the Department of Veterans Af-
fairs. 
(B) The Prostate Cancer Research Pro-
gram of the Congressionally Directed Medical 
Research program of the Department of De-
fense. 
(C) The Department of Health and 
Human Services, including at a minimum rep-
resentatives of each of the following: 
(i) The National Institutes of Health. 
(ii) National research institutes and 
centers, including the National Cancer In-
stitute, the National Institute of Allergy 
and Infectious Diseases, and the Office of 
Minority Health. 
(iii) The Centers for Medicare & Med-
icaid Services. 
(iv) The Food and Drug Administra-
tion. 
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668 
acute hepatitis B and hepatitis C surveillance pro-
gram, in order to identify— 
‘‘(A) trends in the incidence of acute and 
chronic hepatitis B and acute and chronic hepa-
titis C; 
‘‘(B) trends in the prevalence of acute and 
chronic hepatitis B and acute and chronic hepa-
titis C infection among groups that may be dis-
proportionately affected; and 
‘‘(C) trends in liver cancer and end-stage 
liver disease incidence and deaths, caused by 
chronic hepatitis B and chronic hepatitis C in 
the high-risk ethnic populations. 
‘‘(2) SEROPREVALENCE
AND
LIVER
CANCER 
STUDIES.—The Secretary, acting through the Direc-
tor of the Centers for Disease Control and Preven-
tion, shall prepare a report outlining the population- 
based seroprevalence studies currently underway, fu-
ture planned studies, the criteria involved in deter-
mining which seroprevalence studies to conduct, 
defer, or suspend, and the scope of those studies, the 
economic and clinical impact of hepatitis B and hep-
atitis C, and the impact of chronic hepatitis B and 
chronic hepatitis C infections on the quality of life. 
Not later than one year after the date of the enact-
VerDate Sep 11 2014 
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Jkt 099200
PO 00000
Frm 00668
Fmt 6652
Sfmt 6201
E:\BILLS\H6637.IH
H6637
pbinns on DSKJLVW7X2PROD with BILLS