286 
(2) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services, acting through the 
Director of the Centers for Disease Control and Pre-
vention. 
(c) NATIONWIDE MEDIA CAMPAIGN.—In carrying out 
subsection (a), the Secretary shall conduct or support a 
nationwide media campaign to increase awareness among 
health care providers and at-risk populations about preg-
nancy and breastfeeding information services. 
(d) GRANTS FOR PREGNANCY AND BREASTFEEDING 
INFORMATION SERVICES.— 
(1) IN GENERAL.—In carrying out subsection 
(a), the Secretary shall award grants to State or re-
gional agencies or organizations for any of the fol-
lowing: 
(A) INFORMATION SERVICES.—The provi-
sion of, or campaigns to increase awareness 
about, pregnancy and breastfeeding information 
services. 
(B) SURVEILLANCE AND RESEARCH.—The 
conduct or support of— 
(i) surveillance of or research on— 
(I) maternal exposures and ma-
ternal health conditions that may in-
fluence the risk of birth defects, pre-
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maturity, or other adverse pregnancy 
outcomes; and 
(II) maternal exposures that may 
influence health risks to a breastfed 
infant; or 
(ii) networking to facilitate surveil-
lance or research described in this sub-
paragraph. 
(2) PREFERENCE FOR CERTAIN STATES.—The 
Secretary, in making any grant under this sub-
section, shall give preference to States, otherwise 
equally qualified, that have or had a pregnancy and 
breastfeeding information service in place on or after 
January 1, 2006. 
(3) MATCHING
FUNDS.—The Secretary may 
only award a grant under this subsection to a State 
or regional agency or organization that agrees, with 
respect to the costs to be incurred in carrying out 
the grant activities, to make available (directly or 
through donations from public or private entities) 
non-Federal funds toward such costs in an amount 
equal to not less than 25 percent of the amount of 
the grant. 
(4) COORDINATION.—The Secretary shall en-
sure that activities funded through a grant under 
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this subsection are coordinated, to the maximum ex-
tent practicable, with other birth defects prevention 
and environmental health activities of the Federal 
Government, including with respect to pediatric envi-
ronmental health specialty units and children’s envi-
ronmental health centers. 
(e) EVALUATION.—In furtherance of the program 
under subsection (a), the Secretary shall provide for an 
evaluation of pregnancy and breastfeeding information 
services to identify efficient and effective models of— 
(1) providing information; 
(2) raising awareness and increasing knowledge 
about birth defects prevention measures and tar-
geting education to at-risk groups; 
(3) modifying risk behaviors; or 
(4) other outcome measures as determined ap-
propriate by the Secretary. 
(f) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$5,000,000 for fiscal year 2015, $6,000,000 for fiscal year 
2016, $7,000,000 for fiscal year 2017, $8,000,000 for fis-
cal year 2018, and $9,000,000 for fiscal year 2019. 
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SEC. 505. UNIFORM STATE MATERNAL MORTALITY REVIEW 
COMMITTEES 
ON 
PREGNANCY-RELATED 
DEATHS. 
(a) IN GENERAL.—Title V of the Social Security Act 
(42 U.S.C. 701 et seq.) is amended by adding at the end 
the following new section: 
‘‘SEC. 514. UNIFORM STATE MATERNAL MORTALITY RE-
VIEW 
COMMITTEES 
ON 
PREGNANCY-RE-
LATED DEATHS. 
‘‘(a) GRANTS.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of this title, for each of fiscal years 2015 
through 2021, in addition to payments from allot-
ments for States under section 502 for such year, 
the Secretary shall, subject to paragraph (3) and in 
accordance with the criteria established under para-
graph (2), award grants to States to— 
‘‘(A) carry out the activities described in 
subsection (b)(1); 
‘‘(B) establish a State maternal mortality 
review committee, in accordance with subsection 
(b)(2), to carry out the activities described in 
subsection (b)(2)(A), and to establish the proc-
esses described in subsection (b)(1); 
‘‘(C) ensure the State department of 
health carries out the applicable activities de-
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scribed in subsection (b)(3), with respect to 
pregnancy-related deaths occurring within the 
State during such fiscal year; 
‘‘(D) implement and use the comprehensive 
case abstraction form developed under sub-
section (c), in accordance with such subsection; 
and 
‘‘(E) provide for public disclosure of infor-
mation, in accordance with subsection (e). 
‘‘(2) CRITERIA.—The Secretary shall establish 
criteria for determining eligibility for and the 
amount of a grant awarded to a State under para-
graph (1). Such criteria shall provide that in the 
case of a State that receives such a grant for a fiscal 
year and is determined by the Secretary to have not 
used such grant in accordance with this section, 
such State shall not be eligible for such a grant for 
any subsequent fiscal year. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
For purposes of carrying out the grant program 
under this section, including for administrative pur-
poses, there is authorized to be appropriated 
$10,000,000 for each of fiscal years 2015 through 
2021. 
‘‘(b) PREGNANCY-RELATED DEATH REVIEW.— 
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‘‘(IV) Hospitals. 
‘‘(V) Free-standing birth centers. 
‘‘(VI) Federally qualified health 
centers. 
‘‘(VII) Other health care facili-
ties. 
‘‘(VIII) Any other individuals re-
sponsible for completing death certifi-
cates. 
‘‘(IX) Any other appropriate in-
dividuals or entities specified by the 
Secretary. 
‘‘(B) VOLUNTARY
REPORTING
OF
PREG-
NANCY-RELATED AND PREGNANCY-ASSOCIATED 
DEATHS.— 
‘‘(i) The State shall, through the 
State maternal mortality review committee, 
develop a process for and encourage, sepa-
rate from any reporting process established 
by the State department of health prior to 
the date of the enactment of this section, 
voluntary and confidential case reporting 
by individuals described in clause (ii) of 
pregnancy-associated deaths to the State 
department of health. 
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‘‘(ii) The State shall, through the 
State maternal mortality review committee, 
develop a process for voluntary and con-
fidential reporting by family members of 
the deceased and by other individuals on 
possible pregnancy-related and pregnancy- 
associated deaths to the State department 
of health. Such process shall include— 
‘‘(I) making publicly available on 
the Internet Web site of the State de-
partment of health a telephone num-
ber, Internet Web link, and email ad-
dress for such reporting; and 
‘‘(II) publicizing to local profes-
sional organizations, community orga-
nizations, and social services agencies 
the availability of the telephone num-
ber, Internet Web link, and email ad-
dress made available under subclause 
(I). 
‘‘(C) DEVELOPMENT OF CASE-FINDING.— 
The State, through the vital statistics unit of 
the State, shall annually identify pregnancy-re-
lated and pregnancy-associated deaths occur-
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ring in such State during the year involved 
by— 
‘‘(i) matching all death records, with 
respect to such year, for women of child-
bearing age to live birth certificates and in-
fant death certificates to identify deaths of 
women that occurred during pregnancy 
and within one year after the end of a 
pregnancy; 
‘‘(ii) identifying deaths reported dur-
ing such year as having an underlying or 
contributing cause of death related to 
pregnancy, regardless of the time that has 
passed between the end of the pregnancy 
and the death; 
‘‘(iii) collecting data from medical ex-
aminer and coroner reports; and 
‘‘(iv) any other methods the States 
may devise to identify maternal deaths, 
such as through review of a random sam-
ple of reported deaths of women of child-
bearing age to ascertain cases of preg-
nancy-related 
and 
pregnancy-associated 
deaths that are not discernable from a re-
view of death certificates alone. 
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When feasible and for purposes of effectively 
collecting and obtaining data on pregnancy-re-
lated and pregnancy-associated deaths, the 
State shall adopt the most recent standardized 
birth and death certificates, as issued by the 
National Center for Vital Health Statistics, in-
cluding the recommended checkbox section for 
pregnancy on the death certificates. 
‘‘(D) CASE INVESTIGATION AND DEVELOP-
MENT OF CASE SUMMARIES.—Following receipt 
of reports by the State department of health 
pursuant to subparagraph (A) or (B) and col-
lection by the vital statistics unit of the State 
of possible cases of pregnancy-related and preg-
nancy-associated deaths pursuant to subpara-
graph (C), the State, through the State mater-
nal mortality review committee established 
under subsection (a), shall investigate each 
case, utilizing the case abstraction form de-
scribed in subsection (c), and prepare de-identi-
fied case summaries, which shall be reviewed by 
the committee and included in applicable re-
ports. For purposes of subsection (a), under the 
processes established under subparagraphs (A), 
(B), and (C), a State department of health or 
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vital statistics unit of a State shall provide to 
the State maternal mortality review committee 
access to information collected pursuant to such 
subparagraphs as necessary to carry out this 
subparagraph. Data and information collected 
for the case summary and review are for pur-
poses of public health activities, in accordance 
with HIPAA privacy and security law (as de-
fined in section 3009(a)(2) of the Public Health 
Service Act). Such case investigations shall in-
clude data and information obtained through— 
‘‘(i) medical examiner and autopsy re-
ports of the woman involved; 
‘‘(ii) medical records of the woman, 
including such records related to health 
care prior to pregnancy, prenatal and post-
natal care, labor and delivery care, emer-
gency 
room 
care, 
hospital 
discharge 
records including immunization status and 
screening status for prevalent diseases, and 
any care delivered up until the time of 
death of the woman for purposes of public 
health 
activities, 
in 
accordance 
with 
HIPAA privacy and security law (as de-
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fined in section 3009(a)(2) of the Public 
Health Service Act); 
‘‘(iii) oral and written interviews of in-
dividuals directly involved in the maternal 
care of the woman during and immediately 
following the pregnancy of the woman, in-
cluding health care, mental health, and so-
cial service providers in-language when 
possible, as applicable; 
‘‘(iv) optional oral or written inter-
views of the family of the woman; 
‘‘(v) socioeconomic and other relevant 
background information about the woman; 
‘‘(vi) information collected in subpara-
graph (C)(i); and 
‘‘(vii) other information on the cause 
of death of the woman, such as social serv-
ices and child welfare reports, including ex-
periences with intimate partner violence. 
‘‘(2) STATE
MATERNAL
MORTALITY
REVIEW 
COMMITTEES.— 
‘‘(A) DUTIES.— 
‘‘(i) REQUIRED
COMMITTEE
ACTIVI-
TIES.—For purposes of subsection (a), a 
maternal mortality review committee estab-
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lished by a State pursuant to a grant 
under such subsection shall carry out the 
following 
pregnancy-related 
death 
and 
pregnancy-associated death review activi-
ties and shall include all information rel-
evant to the death involved on the case ab-
straction form developed under subsection 
(d): 
‘‘(I) With respect to a case of 
pregnancy-related or pregnancy-asso-
ciated death of a woman, review the 
case summaries prepared under sub-
paragraphs (A), (B), (C), and (D) of 
paragraph (1). 
‘‘(II) Review aggregate statistical 
reports developed by the vital statis-
tics unit of the State under paragraph 
(1)(C) 
regarding 
pregnancy-related 
and pregnancy-associated deaths to 
identify trends, patterns, and dispari-
ties in adverse outcomes and address 
medical, nonmedical, and system-re-
lated factors that may have contrib-
uted to such pregnancy-related and 
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pregnancy-associated deaths and dis-
parities. 
‘‘(III) Develop recommendations, 
based on the review of the case sum-
maries under paragraph (1)(D) and 
aggregate statistical reports under 
subclause (II), to improve maternal 
care, social and health services, and 
public health policy and institutions, 
including with respect to improving 
access to maternal care, improving the 
availability of social services, and 
eliminating disparities in maternal 
care and outcomes. 
‘‘(ii) OPTIONAL
COMMITTEE
ACTIVI-
TIES.—For purposes of subsection (a), a 
maternal mortality review committee estab-
lished by a State under such subsection 
may present findings and recommendations 
regarding a specific case or set of cir-
cumstances directly to a health care facil-
ity or its local or State professional organi-
zation for the purpose of instituting policy 
changes, educational activities, or other-
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wise improving the quality of care provided 
by the facilities. 
‘‘(B) COMPOSITION
OF
MATERNAL
MOR-
TALITY REVIEW COMMITTEES.— 
‘‘(i) IN GENERAL.—Each State mater-
nal mortality review committee established 
pursuant to a grant under subsection (a) 
shall be multidisciplinary, consisting of 
health care, behavioral health, and social 
service providers, public health officials, 
other persons with professional expertise 
on maternal health and mortality, and pa-
tient and community advocates who rep-
resent those communities within such State 
that are the most affected by maternal 
mortality. Membership on such a com-
mittee of a State shall be reviewed annu-
ally by the State department of health to 
ensure that membership representation re-
quirements are being fulfilled in accord-
ance with this paragraph. 
‘‘(ii) REQUIRED MEMBERSHIP.—Each 
such review committee shall include— 
‘‘(I) representatives from medical 
specialties providing care to pregnant 
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and postpartum patients, including 
obstetricians 
(including 
generalists 
and maternal fetal medicine special-
ists), and family practice physicians; 
‘‘(II) representatives from mid-
wifery specialties (including certified 
professional midwives and certified 
midwives); 
‘‘(III) advanced practice nurses; 
‘‘(IV) hospital-based nurses; 
‘‘(V) representatives of the State 
department of health maternal and 
child health department; 
‘‘(VI) social service providers or 
social workers; 
‘‘(VII) the chief medical exam-
iners or designees; 
‘‘(VIII) facility representatives, 
such as from hospitals or free-stand-
ing birth centers; and 
‘‘(IX) community or patient ad-
vocates who represent those commu-
nities within the State that are the 
most affected by maternal mortality. 
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‘‘(iii) ADDITIONAL
MEMBERS.—Each 
such review committee may also include 
representatives from other relevant aca-
demic, health, social service, or policy pro-
fessions, or community organizations, on 
an ongoing basis, or as needed, as deter-
mined beneficial by the review committee, 
including— 
‘‘(I) anesthesiologists; 
‘‘(II) emergency physicians; 
‘‘(III) pathologists; 
‘‘(IV) epidemiologists or biostat-
isticians; 
‘‘(V) intensivists; 
‘‘(VI) orthopedic surgeons and/or 
orthopedic physicians; 
‘‘(VII) vital statistics officers; 
‘‘(VIII) nutritionists; 
‘‘(IX) 
mental 
health 
profes-
sionals; 
‘‘(X) substance abuse treatment 
specialists; 
‘‘(XI) representatives of relevant 
advocacy groups; 
‘‘(XII) academics; 
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‘‘(XIII) representatives of bene-
ficiaries of the State plan under the 
Medicaid Program under title XIX; 
‘‘(XIV) paramedics; 
‘‘(XV) lawyers; 
‘‘(XVI) risk management special-
ists; 
‘‘(XVII) representatives of the 
departments of health or public health 
of major cities in the State involved; 
and 
‘‘(XVIII) policymakers. 
‘‘(iv) DIVERSE COMMUNITY MEMBER-
SHIP.—The composition of such a com-
mittee, with respect to a State, shall in-
clude— 
‘‘(I) representatives from diverse 
communities, particularly those com-
munities within such State most se-
verely affected by pregnancy-related 
deaths or pregnancy-associated deaths 
and by a lack of access to relevant 
maternal care services, from commu-
nity maternal child health organiza-
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tions, and from minority advocacy 
groups; 
‘‘(II) members, including health 
care providers, from different geo-
graphic regions in the State, including 
any rural, urban, and tribal areas; 
and 
‘‘(III) health care and social serv-
ice providers who work in commu-
nities that are diverse with regard to 
race, ethnicity, immigration status, in-
digenous status, and English pro-
ficiency. 
‘‘(v) MATERNAL MORTALITY REVIEW 
STAFF.—Staff of each such review com-
mittee shall include— 
‘‘(I) vital health statisticians, ma-
ternal child health statisticians, or 
epidemiologists; 
‘‘(II) a coordinator of the State 
maternal mortality review committee, 
to be designated by the State; and 
‘‘(III) administrative staff. 
‘‘(C) OPTION FOR STATES TO FORM RE-
GIONAL
MATERNAL
MORTALITY
REVIEWS.— 
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States with a low rate of occurrence of preg-
nancy-associated or pregnancy-related deaths 
may choose to partner with one or more neigh-
boring States to fulfill the activities described in 
paragraph (1)(C). In such a case, with respect 
to States in such a partnership, any require-
ment under this section relating to the report-
ing of information related to such activities 
shall be deemed to be fulfilled by each such 
State if a single such report is submitted for 
the partnership. 
‘‘(3) STATE DEPARTMENT OF HEALTH ACTIVI-
TIES.—For purposes of subsection (a), a State de-
partment of health of a State receiving a grant 
under such subsection shall— 
‘‘(A) in consultation with the maternal 
mortality review committee of the State and in 
conjunction with relevant professional organiza-
tions, develop a plan for ongoing health care 
provider education, based on the findings and 
recommendations of the committee, in order to 
improve the quality of maternal care; and 
‘‘(B) take steps to widely disseminate the 
findings and recommendations of the State ma-
ternal mortality review committees of the State 
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and to implement the recommendations of such 
committee. 
‘‘(c) CASE ABSTRACTION FORM.— 
‘‘(1) DEVELOPMENT.—The Director of the Cen-
ters for Disease Control and Prevention shall de-
velop a uniform, comprehensive case abstraction 
form and make such form available to States for 
State maternal mortality review committees for use 
by such committees in order to— 
‘‘(A) ensure that the cases and information 
collected and reviewed by such committees can 
be pooled for review by the Department of 
Health and Human Services and its agencies; 
and 
‘‘(B) preserve the uniformity of the infor-
mation and its use for Federal public health 
purposes. 
‘‘(2) PERMISSIBLE
STATE
MODIFICATION.— 
Each State may modify the form developed under 
paragraph (1) for implementation and use by such 
State or by the State maternal mortality review com-
mittee of such State by including on such form addi-
tional information to be collected, but may not alter 
the standard questions on such form, in order to en-
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sure that the information can be collected and re-
viewed centrally at the Federal level. 
‘‘(d) TREATMENT AS PUBLIC HEALTH AUTHORITY 
FOR PURPOSES OF HIPAA.—For purposes of applying 
HIPAA privacy and security law (as defined in section 
3009(a)(2) of the Public Health Service Act), a State ma-
ternal mortality review committee of a State established 
pursuant to this section to carry out activities described 
in subsection (b)(2)(A) shall be deemed to be a public 
health authority described in section 164.501 (and ref-
erenced in section 164.512(b)(1)(i)) of title 45, Code of 
Federal Regulations (or any successor regulation), car-
rying out public health activities and purposes described 
in such section 164.512(b)(1)(i) (or any such successor 
regulation). 
‘‘(e) PUBLIC DISCLOSURE OF INFORMATION.— 
‘‘(1) IN GENERAL.—For fiscal year 2015 or a 
subsequent fiscal year, each State receiving a grant 
under this section for such year shall, subject to 
paragraph (3), provide for the public disclosure, and 
submission to the information clearinghouse estab-
lished under paragraph (2), of the information in-
cluded in the report of the State under section 
506(a)(2)(F) for such year (relating to the findings 
for such year of the State maternal mortality review 
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committee established by the State under this sec-
tion). 
‘‘(2) 
INFORMATION
CLEARINGHOUSE.—The 
Secretary of Health and Human Services shall es-
tablish an information clearinghouse, that shall be 
administered by the Director of the Centers for Dis-
ease Control and Prevention, that will maintain find-
ings and recommendations submitted pursuant to 
paragraph (1) and provide such findings and rec-
ommendations for public review and research pur-
poses by State health departments, maternal mor-
tality review committees, and health providers and 
institutions. 
‘‘(3) CONFIDENTIALITY OF INFORMATION.—In 
no case shall any individually identifiable health in-
formation be provided to the public, or submitted to 
the information clearinghouse, under paragraph (1). 
‘‘(f) CONFIDENTIALITY
OF
REVIEW
COMMITTEE 
PROCEEDINGS.— 
‘‘(1) IN GENERAL.—All proceedings and activi-
ties of a State maternal mortality review committee 
under this section, opinions of members of such a 
committee formed as a result of such proceedings 
and activities, and records obtained, created, or 
maintained pursuant to this section, including 
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records of interviews, written reports, and state-
ments procured by the Department of Health and 
Human Services or by any other person, agency, or 
organization acting jointly with the Department, in 
connection with morbidity and mortality reviews 
under this section, shall be confidential, and not sub-
ject to discovery, subpoena, or introduction into evi-
dence in any civil, criminal, legislative, or other pro-
ceeding. Such records shall not be open to public in-
spection. 
‘‘(2) TESTIMONY
OF
MEMBERS
OF
COM-
MITTEE.— 
‘‘(A) IN GENERAL.—Members of a State 
maternal mortality review committee under this 
section may not be questioned in any civil, 
criminal, legislative, or other proceeding regard-
ing information presented in, or opinions 
formed as a result of, a meeting or communica-
tion of the committee. 
‘‘(B) CLARIFICATION.—Nothing in this 
subsection shall be construed to prevent a mem-
ber of such a committee from testifying regard-
ing information that was obtained independent 
of such member’s participation on the com-
mittee, or that is public information. 
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‘‘(3) AVAILABILITY OF INFORMATION FOR RE-
SEARCH
PURPOSES.—Nothing in this subsection 
shall prohibit the publishing by such a committee or 
the Department of Health and Human Services of 
statistical compilations and research reports that— 
‘‘(A) are based on confidential information, 
relating to morbidity and mortality review; and 
‘‘(B) do not contain identifying informa-
tion or any other information that could be 
used to ultimately identify the individuals con-
cerned. 
‘‘(g) DEFINITIONS.—For purposes of this section: 
‘‘(1) The term ‘pregnancy-associated death’ 
means the death of a woman while pregnant or dur-
ing the one-year period following the date of the end 
of pregnancy, irrespective of the cause of such death. 
‘‘(2) The term ‘pregnancy-related death’ means 
the death of a woman while pregnant or during the 
one-year period following the date of the end of 
pregnancy, irrespective of the duration or site of the 
pregnancy, from any cause related to or aggravated 
by the pregnancy or its management, but not from 
any accidental or incidental cause. 
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‘‘(3) The term ‘woman of childbearing age’ 
means a woman who is at least 10 years of age and 
not more than 54 years of age.’’. 
(b) INCLUSION OF FINDINGS OF REVIEW COMMIT-
TEES IN REQUIRED REPORTS.— 
(1) STATE
TRIENNIAL
REPORTS.—Paragraph 
(2) of section 506(a) of such Act (42 U.S.C. 706(a)) 
is amended by inserting after subparagraph (E) the 
following new subparagraph: 
‘‘(F) In the case of a State receiving a 
grant under section 514, beginning for the first 
fiscal year beginning after 3 years after the 
date of establishment of the State maternal 
mortality review committee established by the 
State pursuant to such grant and once every 3 
years thereafter, information containing the 
findings and recommendations of such com-
mittee and information on the implementation 
of such recommendations during the period in-
volved.’’. 
(2) ANNUAL
REPORTS
TO
CONGRESS.—Para-
graph (3) of such section is amended— 
(A) in subparagraph (D), at the end, by 
striking ‘‘and’’; 
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(B) in subparagraph (E), at the end, by 
striking the period and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(F) For fiscal year 2015 and each subse-
quent fiscal year, taking into account the find-
ings, recommendations, and implementation in-
formation submitted by States pursuant to 
paragraph (2)(F), on the status of pregnancy- 
related deaths and pregnancy-associated deaths 
in the United States and including rec-
ommendations on methods to prevent such 
deaths in the United States.’’. 
SEC. 
506. 
ELIMINATING 
DISPARITIES 
IN 
MATERNITY 
HEALTH OUTCOMES. 
Part B of title III of the Public Health Service Act 
is amended by inserting after section 317V, as added, the 
following new section: 
‘‘SEC. 317W. ELIMINATING DISPARITIES IN MATERNITY 
HEALTH OUTCOMES. 
‘‘(a) IN GENERAL.—The Secretary (in consultation 
with the Deputy Assistant Secretary for Minority Health, 
the Director of the National Institutes of Health, the Di-
rector of the Centers for Disease Control and Prevention, 
the Administrator of the Centers for Medicare & Medicaid 
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Services, and the Administrator of the Agency for 
Healthcare Research & Quality, and in consultation with 
relevant national stakeholder organizations such as na-
tional medical specialty organizations, national maternal 
child health organizations, national groups that represent 
minority populations, and national health disparity organi-
zations) shall carry out the following activities to eliminate 
disparities in maternal health outcomes: 
‘‘(1) Conduct research into the determinants 
and the distribution of disparities in maternal care, 
health risks, and health outcomes, and improve the 
capacity of the performance measurement infrastruc-
ture to measure such disparities. 
‘‘(2) Expand access to services that have been 
demonstrated to improve the quality and outcomes 
of maternity care for vulnerable populations. 
‘‘(3) Establish a demonstration project to com-
pare the effectiveness of interventions to reduce dis-
parities in maternity services and outcomes, and im-
plement and assess effective interventions. 
‘‘(b) SCOPE AND SELECTION OF STATES FOR DEM-
ONSTRATION
PROJECT.—The 
demonstration 
project 
under subsection (a)(3) shall be conducted in no more 
than 8 States, which shall be selected by the Secretary 
based on— 
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‘‘(1) applications submitted by States, which 
specify which regions and populations the State in-
volved will serve under the demonstration project; 
‘‘(2) criteria designed by the Secretary to en-
sure that, as a whole, the demonstration project is, 
to the greatest extent possible, representative of the 
demographic and geographic composition of commu-
nities most affected by disparities; 
‘‘(3) criteria designed by the Secretary to en-
sure that a variety of types of models are tested 
through the demonstration project and that such 
models include interventions that have an existing 
evidence base for effectiveness; and 
‘‘(4) criteria designed by the Secretary to as-
sure that the demonstration projects and models will 
be carried out in consultation with local and regional 
provider organizations, such as community health 
centers, hospital systems, and medical societies rep-
resenting providers of maternity services. 
‘‘(c) DURATION
OF DEMONSTRATION PROJECT.— 
The demonstration project under subsection (a)(3) shall 
begin on January 1, 2015, and end on December 31, 
2019. 
‘‘(d) GRANTS FOR EVALUATION AND MONITORING.— 
The Secretary may make grants to States and health care 
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providers participating in the demonstration project under 
subsection (a)(3) for the purpose of collecting data nec-
essary for the evaluation and monitoring of such project. 
‘‘(e) REPORTS.— 
‘‘(1) STATE REPORTS.—Each State that par-
ticipates in the demonstration project under sub-
section (a)(3) shall report to the Secretary, in a 
time, form, and manner specified by the Secretary, 
the data necessary to— 
‘‘(A) monitor the— 
‘‘(i) outcomes of the project; 
‘‘(ii) costs of the project; and 
‘‘(iii) quality of maternity care pro-
vided under the project; and 
‘‘(B) evaluate the rationale for the selec-
tion of the items and services included in any 
bundled payment made by the State under the 
project. 
‘‘(2) FINAL REPORT.—Not later than December 
31, 2020, the Secretary shall submit to Congress a 
report on the results of the demonstration project 
under subsection (a)(3).’’. 
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SEC. 507. DECREASING THE RISK FACTORS FOR SUDDEN 
UNEXPECTED INFANT DEATH AND SUDDEN 
UNEXPLAINED DEATH IN CHILDHOOD. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services, acting through the Administrator of the 
Health Resources and Services Administration and in con-
sultation with the Director of the Centers for Disease Con-
trol and Prevention and the Director of the National Insti-
tutes of Health (in this section referred to as the ‘‘Sec-
retary’’), shall establish and implement a culturally com-
petent public health awareness and education campaign 
to provide information that is focused on decreasing the 
risk factors for sudden unexpected infant death and sud-
den unexplained death in childhood, including educating 
individuals about safe sleep environments, sleep positions, 
and reducing exposure to smoking during pregnancy and 
after birth. 
(b) TARGETED POPULATIONS.—The campaign under 
subsection (a) shall be designed to reduce health dispari-
ties through the targeting of populations with high rates 
of sudden unexpected infant death and sudden unex-
plained death in childhood. 
(c) CONSULTATION.—In establishing and imple-
menting the campaign under subsection (a), the Secretary 
shall consult with national organizations representing 
health care providers, including nurses and physicians, 
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parents, child care providers, children’s advocacy and safe-
ty organizations, maternal and child health programs, nu-
trition professionals focusing on women, infants, and chil-
dren, and other individuals and groups determined nec-
essary by the Secretary for such establishment and imple-
mentation. 
(d) GRANTS.— 
(1) IN
GENERAL.—In carrying out the cam-
paign under subsection (a), the Secretary shall 
award grants to national organizations, State and 
local health departments, and community-based or-
ganizations for the conduct of education and out-
reach programs for nurses, parents, child care pro-
viders, public health agencies, and community orga-
nizations. 
(2) APPLICATION.—To be eligible to receive a 
grant under paragraph (1), an entity shall submit to 
the Secretary an application at such time, in such 
manner, and containing such information as the Sec-
retary may require. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2015 through 2019. 
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SEC. 
508. 
REDUCING 
UNINTENDED 
TEENAGE 
PREG-
NANCIES. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended by adding at the end the following 
new part: 
‘‘PART W—YOUTH PREGNANCY PREVENTION 
PROGRAMS 
‘‘SEC. 399OO. PURPOSE. 
‘‘It is the purpose of this part to develop and carry 
out research and demonstration projects on new and exist-
ing program interventions to provide youth in communities 
at disproportionate risk for unintended teen pregnancy 
(particularly youth in racial or ethnic minority or immi-
grant communities, youth in the foster care system, youth 
in the juvenile justice system, rural youth, and LGBT 
youth) the information and skills needed to prevent unin-
tended teenage pregnancies, build healthy relationships, 
and improve overall health and well-being. 
‘‘SEC. 399OO–1. LIMITATION. 
‘‘No Federal funds provided under this Act may be 
used for health education programs or media awareness 
campaigns that— 
‘‘(1) deliberately withhold life-saving informa-
tion about the human immunodeficiency virus 
(HIV); 
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‘‘(2) undermine young people’s confidence in 
the effectiveness of contraception; 
‘‘(3) are medically inaccurate or have been sci-
entifically shown to be ineffective; 
‘‘(4) promote gender, racial, or ethnic stereo-
types; 
‘‘(5) are insensitive and unresponsive to the 
needs of sexually active youth or LGBT youth; 
‘‘(6) are inconsistent with the ethical impera-
tives of medicine and public health; or 
‘‘(7) stigmatize and shame youth who are par-
enting or choose to parent. 
‘‘SEC. 399OO–2. DEMONSTRATION GRANTS TO REDUCE UN-
INTENDED TEENAGE PREGNANCIES. 
‘‘(a) IN GENERAL.—The Secretary shall award com-
petitive grants to eligible entities for establishing or ex-
panding programs to provide youth in communities at dis-
proportionate risk for unintended teen pregnancy (particu-
larly youth in racial or ethnic minority or immigrant com-
munities, youth in the foster care system, youth in the 
juvenile justice system, rural youth, and LGBT youth) the 
information and skills needed to prevent unintended teen-
age pregnancy and develop healthy relationships. 
‘‘(b) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to applicants— 
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‘‘(1) proposing to carry out projects in commu-
nities at disproportionate risk for unintended teen 
pregnancy (particularly youth in racial or ethnic mi-
nority or immigrant communities, youth in the foster 
care system, youth in the juvenile justice system, 
rural youth, and LGBT youth); 
‘‘(2) that have a demonstrated history of effec-
tively working with such targeted communities; 
‘‘(3) that have a demonstrated history of engag-
ing in a meaningful and significant partnership with 
such targeted communities; or 
‘‘(4) that have an integrated approach that also 
promotes the skills necessary to build healthy rela-
tionships and recognize abusive or unhealthy behav-
iors. 
‘‘(c) 
PROGRAM
SETTINGS.—Programs 
funded 
through a grant under subsection (a) shall be provided— 
‘‘(1) through classroom-based settings, such as 
school health education, humanities, language arts, 
or family and consumer science education; after- 
school programs; community-based programs; work-
force development programs; and health care set-
tings, including community health centers; or 
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‘‘(2) in collaboration with systems that serve 
large numbers of at-risk youth such as juvenile jus-
tice or foster care systems. 
‘‘(d) PROJECT REQUIREMENTS.—As a condition of 
receipt of a grant under this section, an entity shall agree 
that, with respect to information and skills provided 
through the grant— 
‘‘(1) such information and skills will be— 
‘‘(A) age-appropriate; 
‘‘(B) evidence-based or evidence-informed; 
‘‘(C) provided in accordance with section 
399OO–6(b); and 
‘‘(D) culturally sensitive and relevant to 
the target populations; and 
‘‘(2) any information provided about contracep-
tives shall include the health benefits and side ef-
fects of all contraceptives and barrier methods. 
‘‘(e) EVALUATION.—Of the total amount made avail-
able to carry out this section for a fiscal year, the Sec-
retary, acting through the Director of the Centers for Dis-
ease Control and Prevention and other agencies as appro-
priate, shall allot up to 10 percent of such amount to carry 
out a rigorous, independent evaluation to determine the 
extent and the effectiveness of activities funded through 
this section during such fiscal year in changing attitudes 
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and behavior of teenagers with respect to healthy relation-
ships and childbearing. 
‘‘(f) GRANTS FOR INDIAN TRIBES OR TRIBAL ORGA-
NIZATIONS.—Of the total amount made available to carry 
out this section for a fiscal year, the Secretary shall re-
serve 5 percent of such amount to award grants under 
this section to Indian tribes and tribal organizations in 
such manner, and subject to such requirements, as the 
Secretary, in consultation with Indian tribes and tribal or-
ganizations, determines appropriate. 
‘‘(g) ELIGIBLE ENTITY DEFINED.— 
‘‘(1) IN GENERAL.—In this section, the term 
‘eligible entity’ means a State, local, or tribal agen-
cy; a school or postsecondary institution; an after- 
school program; a nonprofit organization; or a com-
munity or faith-based organization. 
‘‘(2) PREVENTING
EXCLUSION
OF
SMALLER 
COMMUNITY-BASED
ORGANIZATIONS.—In carrying 
out this section, the Secretary shall ensure that the 
amounts and requirements of grants provided under 
this section do not preclude receipt of such grants 
by community-based organizations with a dem-
onstrated history of effectively working with adoles-
cents in racial or ethnic minority or immigrant com-
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munities or engaged in meaningful and significant 
partnership with such communities. 
‘‘SEC. 399OO–3. MULTIMEDIA CAMPAIGNS TO REDUCE UNIN-
TENDED TEENAGE PREGNANCIES. 
‘‘(a) IN GENERAL.—The Secretary shall award com-
petitive grants to public and private entities to carry out 
multimedia campaigns to provide public education and in-
crease public awareness regarding unintended teenage 
pregnancy and related social and emotional issues, such 
as violence prevention. 
‘‘(b) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to applicants pro-
posing to carry out campaigns developed for communities 
at disproportionate risk for unintended teen pregnancy 
(particularly youth in racial or ethnic minority or immi-
grant communities, youth in the foster care system, youth 
in the juvenile justice system, rural youth, and LGBT 
youth). 
‘‘(c) INFORMATION TO BE PROVIDED.—As a condi-
tion of receipt of a grant under this section, an entity shall 
agree to use the grant to carry out multimedia campaigns 
described in subsection (a) that— 
‘‘(1) at a minimum, shall provide information 
on— 
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‘‘(A) the prevention of unintended teenage 
pregnancy; and 
‘‘(B) healthy relationship development; and 
‘‘(2) may provide information on the prevention 
of dating violence and sexual assault. 
‘‘SEC. 399OO–4. RESEARCH ON REDUCING UNINTENDED 
TEENAGE PREGNANCIES AND TEENAGE DAT-
ING VIOLENCE AND IMPROVING HEALTHY 
RELATIONSHIPS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall make grants to public and private entities 
to conduct, support, or coordinate research on unintended 
teenage pregnancy, dating violence, and healthy relation-
ships among racial or ethnic minority or immigrant com-
munities that— 
‘‘(1) improves data collection on— 
‘‘(A) sexual and reproductive health, in-
cluding unintended teenage pregnancies and 
births, among all minority communities and 
subpopulations in which such data are not col-
lected, including American Indian and Alaska 
Native youth; 
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‘‘(B) sexual behavior, reproductive and sex-
ual coercion, and teenage contraceptive use pat-
terns at the State level, as appropriate; 
‘‘(C) 
unintended 
teenage 
pregnancies 
among youth in and aging out of foster care or 
juvenile justice systems and the underlying fac-
tors that lead to unintended teenage pregnancy 
among youth in foster care or juvenile justice 
systems; and 
‘‘(D) sexual and reproductive health, in-
cluding teenage pregnancies and births, sexual 
behavior, reproductive and sexual coercion, and 
teenage contraceptive use among— 
‘‘(i) LGBT youth; and 
‘‘(ii) rural youth; 
‘‘(2) investigates— 
‘‘(A) the variance in the rates of unin-
tended teenage pregnancy by— 
‘‘(i) racial and ethnic group (such as 
Hispanic, Asian-American, African-Amer-
ican, Pacific Islander, American Indian, 
and Alaska Native); and 
‘‘(ii) socioeconomic status, based on 
the income of the family and education at-
tainment; 
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(1) IN
GENERAL.—Section 1861(s)(2) of the 
Social Security Act (42 U.S.C. 1395x(s)(2)) is 
amended— 
(A) in subparagraph (EE), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (FF), by inserting 
‘‘and’’ at the end; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(GG) marriage and family therapist services 
(as defined in subsection (kkk)(1)) and mental 
health counselor services (as defined in subsection 
(kkk)(3)) and substance abuse counselor services (as 
defined in subsection (kkk)(5));’’. 
(2) DEFINITIONS.—Section 1861 of such Act 
(42 U.S.C. 1395x), as amended by sections 
202(b)(1)(A) and 423(a), is amended by adding at 
the end the following new subsection: 
‘‘Marriage and Family Therapist Services; Marriage and 
Family Therapist; Mental Health Counselor Serv-
ices; Mental Health Counselor 
‘‘(kkk)(1) The term ‘marriage and family therapist 
services’ means services performed by a marriage and 
family therapist (as defined in paragraph (2)) for the diag-
nosis and treatment of mental illnesses, which the mar-
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