morbidity among pregnant and postpartum veterans 
and to address racial and ethnic disparities in ma-
ternal health outcomes for veterans. 
Subtitle D—Perinatal Workforce 
SEC. 1301. HHS AGENCY DIRECTIVES. 
(a) GUIDANCE TO STATES.— 
(1) IN GENERAL.—Not later than 2 years after 
the date of enactment of this Act, the Secretary of 
Health and Human Services shall issue and dissemi-
nate guidance to States to educate providers, man-
aged care entities, and other insurers about the 
value and process of delivering respectful maternal 
health care through diverse and multidisciplinary 
care provider models. 
(2) CONTENTS.—The guidance required by 
paragraph (1) shall address how States can encour-
age and incentivize hospitals, health systems, mid-
wifery practices, freestanding birth centers, other 
maternity care provider groups, managed care enti-
ties, and other insurers— 
(A) to recruit and retain maternity care 
providers, mental and behavioral health care 
providers acting in accordance with State law, 
registered dietitians or nutrition professionals 
(as such term is defined in section 1861(vv)(2) 
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of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395x(vv)(2))), and lactation consultants cer-
tified by the International Board of Lactation 
Consultants Examiners— 
(i) from racially, ethnically, and lin-
guistically diverse backgrounds; 
(ii) with experience practicing in ra-
cially and ethnically diverse communities; 
and 
(iii) who have undergone training on 
implicit bias and racism; 
(B) to incorporate into maternity care 
teams— 
(i) midwives who meet at a minimum 
the international definition of the midwife 
and global standards for midwifery edu-
cation as established by the International 
Confederation of Midwives; and 
(ii) perinatal health workers; 
(C) to provide collaborative, culturally con-
gruent care; and 
(D) to provide opportunities for individuals 
enrolled in accredited midwifery education pro-
grams to participate in job shadowing with ma-
ternity care teams in hospitals, health systems, 
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midwifery practices, and freestanding birth cen-
ters. 
(b) STUDY ON RESPECTFUL AND CULTURALLY CON-
GRUENT MATERNITY CARE.— 
(1) STUDY.—The Secretary of Health and 
Human Services acting through the Director of the 
National Institutes of Health (in this subsection re-
ferred to as the ‘‘Secretary’’) shall conduct a study 
on best practices in respectful and culturally con-
gruent maternity care. 
(2) REPORT.—Not later than 2 years after the 
date of enactment of this Act, the Secretary shall— 
(A) complete the study required by para-
graph (1); 
(B) submit to the Congress and make pub-
licly available a report on the results of such 
study; and 
(C) include in such report— 
(i) a compendium of examples of hos-
pitals, health systems, midwifery practices, 
freestanding birth centers, other maternity 
care provider groups, managed care enti-
ties, and other insurers that are delivering 
respectful and culturally congruent mater-
nal health care; 
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(ii) a compendium of examples of hos-
pitals, health systems, midwifery practices, 
freestanding birth centers, other maternity 
care provider groups, managed care enti-
ties, and other insurers that have made 
progress in reducing disparities in mater-
nal health outcomes and improving birth-
ing 
experiences 
for 
pregnant 
and 
postpartum individuals from racial and 
ethnic minority groups; and 
(iii) recommendations to hospitals, 
health systems, midwifery practices, free-
standing birth centers, other maternity 
care provider groups, managed care enti-
ties, and other insurers, for best practices 
in respectful and culturally congruent ma-
ternity care. 
SEC. 
1302. 
GRANTS 
TO 
GROW 
AND 
DIVERSIFY 
THE 
PERINATAL WORKFORCE. 
Title VII of the Public Health Service Act is amended 
by inserting after section 757 (42 U.S.C. 294f) the fol-
lowing new section: 
‘‘SEC. 758. PERINATAL WORKFORCE GRANTS. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to entities to establish or expand programs de-
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scribed in subsection (b) to grow and diversify the 
perinatal workforce. 
‘‘(b) USE OF FUNDS.—Recipients of grants under 
this section shall use the grants to grow and diversify the 
perinatal workforce by— 
‘‘(1) establishing schools or programs that pro-
vide education and training to individuals seeking 
appropriate licensing or certification as— 
‘‘(A) physician assistants who will complete 
clinical training in the field of maternal and 
perinatal health; or 
‘‘(B) perinatal health workers; and 
‘‘(2) expanding the capacity of existing schools 
or programs described in paragraph (1), for the pur-
poses of increasing the number of students enrolled 
in such schools or programs, including by awarding 
scholarships for students. 
‘‘(c) PRIORITIZATION.—In awarding grants under 
this section, the Secretary shall give priority to any entity 
that— 
‘‘(1) has demonstrated a commitment to re-
cruiting and retaining students and faculty from ra-
cial and ethnic minority groups; 
‘‘(2) has developed a strategy to recruit and re-
tain a diverse pool of students into the perinatal 
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workforce program or school supported by funds re-
ceived through the grant, particularly from racial 
and ethnic minority groups and other underserved 
populations; 
‘‘(3) has developed a strategy to recruit and re-
tain students who plan to practice in a health pro-
fessional shortage area designated under section 
332; 
‘‘(4) has developed a strategy to recruit and re-
tain students who plan to practice in an area with 
significant racial and ethnic disparities in maternal 
health outcomes, to the extent practicable; and 
‘‘(5) includes in the standard curriculum for all 
students within the perinatal workforce program or 
school a bias, racism, or discrimination training pro-
gram that includes training on implicit bias and rac-
ism. 
‘‘(d) REPORTING.—As a condition on receipt of a 
grant under this section for a perinatal workforce program 
or school, an entity shall agree to submit to the Secretary 
an annual report on the activities conducted through the 
grant, including— 
‘‘(1) the number and demographics of students 
participating in the program or school; 
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‘‘(2) the extent to which students in the pro-
gram or school are entering careers in— 
‘‘(A) health professional shortage areas 
designated under section 332; and 
‘‘(B) areas with significant racial and eth-
nic disparities in maternal health outcomes, to 
the extent such data are available; and 
‘‘(3) whether the program or school has in-
cluded in the standard curriculum for all students a 
bias, racism, or discrimination training program that 
includes explicit and implicit bias, and if so the ef-
fectiveness of such training program. 
‘‘(e) PERIOD OF GRANTS.—The period of a grant 
under this section shall be up to 5 years. 
‘‘(f) APPLICATION.—To seek a grant under this sec-
tion, an entity shall submit to the Secretary an application 
at such time, in such manner, and containing such infor-
mation as the Secretary may require, including any infor-
mation necessary for prioritization under subsection (c). 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide, directly or by contract, technical assistance to en-
tities seeking or receiving a grant under this section on 
the development, use, evaluation, and post-grant period 
sustainability of the perinatal workforce programs or 
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schools proposed to be, or being, established or expanded 
through the grant. 
‘‘(h) REPORT BY THE SECRETARY.—Not later than 
4 years after the date of enactment of this section, the 
Secretary shall prepare and submit to the Congress, and 
post on the internet website of the Department of Health 
and Human Services, a report on the effectiveness of the 
grant program under this section at— 
‘‘(1) recruiting students from racial and ethnic 
minority groups; 
‘‘(2) increasing the number of physician assist-
ants who will complete clinical training in the field 
of maternal and perinatal health, and perinatal 
health workers, from racial and ethnic minority 
groups and other underserved populations; 
‘‘(3) increasing the number of physician assist-
ants who will complete clinical training in the field 
of maternal and perinatal health, and perinatal 
health workers, working in health professional short-
age areas designated under section 332; and 
‘‘(4) increasing the number of physician assist-
ants who will complete clinical training in the field 
of maternal and perinatal health, and perinatal 
health workers, working in areas with significant ra-
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cial and ethnic disparities in maternal health out-
comes, to the extent such data are available. 
‘‘(i) DEFINITION.—In this section, the term ‘racial 
and ethnic minority group’ has the meaning given such 
term in section 1707(g). 
‘‘(j) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $15,000,000 for each of fiscal years 2023 through 
2027.’’. 
SEC. 1303. GRANTS TO GROW AND DIVERSIFY THE NURSING 
WORKFORCE IN MATERNAL AND PERINATAL 
HEALTH. 
Title VIII of the Public Health Service Act is amend-
ed by inserting after section 811 of that Act (42 U.S.C. 
296j) the following: 
‘‘SEC. 812. PERINATAL NURSING WORKFORCE GRANTS. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to schools of nursing to grow and diversify the 
perinatal nursing workforce. 
‘‘(b) USE OF FUNDS.—Recipients of grants under 
this section shall use the grants to grow and diversify the 
perinatal nursing workforce by providing scholarships to 
students seeking to become— 
‘‘(1) nurse practitioners whose education in-
cludes a focus on maternal and perinatal health; or 
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‘‘(2) clinical nurse specialists whose education 
includes a focus on maternal and perinatal health. 
‘‘(c) PRIORITIZATION.—In awarding grants under 
this section, the Secretary shall give priority to any school 
of nursing that— 
‘‘(1) has developed a strategy to recruit and re-
tain a diverse pool of students seeking to enter ca-
reers focused on maternal and perinatal health, par-
ticularly students from racial and ethnic minority 
groups and other underserved populations; 
‘‘(2) has developed a partnership with a prac-
tice setting in a health professional shortage area 
designated under section 332 for the clinical place-
ments of the school’s students; 
‘‘(3) has developed a strategy to recruit and re-
tain students who plan to practice in an area with 
significant racial and ethnic disparities in maternal 
health outcomes, to the extent practicable; and 
‘‘(4) includes in the standard curriculum for all 
students seeking to enter careers focused on mater-
nal and perinatal health a bias, racism, or discrimi-
nation training program that includes education on 
implicit bias and racism. 
‘‘(d) REPORTING.—As a condition on receipt of a 
grant under this section, a school of nursing shall agree 
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to submit to the Secretary an annual report on the activi-
ties conducted through the grant, including, to the extent 
practicable— 
‘‘(1) the number and demographics of students 
in the school of nursing seeking to enter careers fo-
cused on maternal and perinatal health; 
‘‘(2) the extent to which such students are pre-
paring to enter careers in— 
‘‘(A) health professional shortage areas 
designated under section 332; and 
‘‘(B) areas with significant racial and eth-
nic disparities in maternal health outcomes, to 
the extent such data are available; and 
‘‘(3) whether the standard curriculum for all 
students seeking to enter careers focused on mater-
nal and perinatal health includes a bias, racism, or 
discrimination training program that includes edu-
cation on implicit bias and racism. 
‘‘(e) PERIOD OF GRANTS.—The period of a grant 
under this section shall be up to 5 years. 
‘‘(f) APPLICATION.—To seek a grant under this sec-
tion, an entity shall submit to the Secretary an applica-
tion, at such time, in such manner, and containing such 
information as the Secretary may require, including any 
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information necessary for prioritization under subsection 
(c). 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide, directly or by contract, technical assistance to 
schools of nursing seeking or receiving a grant under this 
section on the processes of awarding and evaluating schol-
arships through the grant. 
‘‘(h) REPORT BY THE SECRETARY.—Not later than 
4 years after the date of enactment of this section, the 
Secretary shall prepare and submit to the Congress, and 
post on the internet website of the Department of Health 
and Human Services, a report on the effectiveness of the 
grant program under this section at— 
‘‘(1) recruiting students from racial and ethnic 
minority groups and other underserved populations; 
‘‘(2) increasing the number of nurse practi-
tioners and clinical nurse specialists entering careers 
focused on maternal and perinatal health from racial 
and ethnic minority groups and other underserved 
populations; 
‘‘(3) increasing the number of nurse practi-
tioners and clinical nurse specialists entering careers 
focused on maternal and perinatal health working in 
health professional shortage areas designated under 
section 332; and 
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‘‘(4) increasing the number of nurse practi-
tioners and clinical nurse specialists entering careers 
focused on maternal and perinatal health working in 
areas with significant racial and ethnic disparities in 
maternal health outcomes, to the extent such data 
are available. 
‘‘(i) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $15,000,000 for each of fiscal years 2023 through 
2027.’’. 
SEC. 1304. GAO REPORT. 
(a) IN GENERAL.—Not later than two years after the 
date of enactment of this Act and every five years there-
after, the Comptroller General of the United States shall 
submit to Congress a report on barriers to maternal health 
education and access to care in the United States. Such 
report shall include the information and recommendations 
described in subsection (b). 
(b) CONTENT OF REPORT.—The report under sub-
section (a) shall include— 
(1) an assessment of current barriers to enter-
ing accredited midwifery education programs, and 
recommendations for addressing such barriers, par-
ticularly for low-income women and women from ra-
cial and ethnic minority groups; 
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(2) an assessment of current barriers to enter-
ing and successfully completing accredited education 
programs for other health professional careers re-
lated to maternity care, including maternity care 
providers, mental and behavioral health care pro-
viders acting in accordance with State law, reg-
istered dietitians or nutrition professionals (as such 
term is defined in section 1861(vv)(2) of the Social 
Security Act (42 U.S.C. 1395x(vv)(2))), and lacta-
tion consultants certified by the International Board 
of Lactation Consultants Examiners, particularly for 
low-income women and women from racial and eth-
nic minority groups; 
(3) an assessment of current barriers that pre-
vent midwives from meeting the international defini-
tion of the midwife and global standards for mid-
wifery education as established by the International 
Confederation of Midwives, and recommendations 
for addressing such barriers, particularly for low-in-
come women and women from racial and ethnic mi-
nority groups; 
(4) an assessment of disparities in access to 
maternity care providers, mental or behavioral 
health care providers acting in accordance with 
State law, registered dietitians or nutrition profes-
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sionals (as such term is defined in section 
1861(vv)(2) of the Social Security Act (42 U.S.C. 
1395x(vv)(2))), lactation consultants certified by the 
International Board of Lactation Consultants Exam-
iners, and perinatal health workers, stratified by 
race, ethnicity, gender identity, geographic location, 
and insurance type and recommendations to promote 
greater access equity; and 
(5) recommendations to promote greater equity 
in compensation for perinatal health workers under 
public and private insurers, particularly for such in-
dividuals from racially and ethnically diverse back-
grounds. 
Subtitle E—Data to Save Moms 
SEC. 1401. FUNDING FOR MATERNAL MORTALITY REVIEW 
COMMITTEES TO PROMOTE REPRESENTA-
TIVE COMMUNITY ENGAGEMENT. 
(a) IN GENERAL.—Section 317K(d) of the Public 
Health Service Act (42 U.S.C. 247b–12(d)) is amended 
by adding at the end the following: 
‘‘(9) GRANTS
TO
PROMOTE
REPRESENTATIVE 
COMMUNITY
ENGAGEMENT
IN
MATERNAL
MOR-
TALITY REVIEW COMMITTEES.— 
‘‘(A) IN
GENERAL.—The Secretary may, 
using funds made available pursuant to sub-
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paragraph (C), provide assistance to an applica-
ble maternal mortality review committee of a 
State, Indian tribe, tribal organization, or 
urban Indian organization (as such term is de-
fined in section 4 of the Indian Health Care 
Improvement Act (25 U.S.C. 1603))— 
‘‘(i) to select for inclusion in the mem-
bership of such a committee community 
members from the State, Indian tribe, trib-
al organization, or urban Indian organiza-
tion by— 
‘‘(I) prioritizing community mem-
bers who can increase the diversity of 
the committee’s membership with re-
spect to race and ethnicity, location, 
and professional background, includ-
ing members with non-clinical experi-
ences; and 
‘‘(II) to the extent applicable, 
using funds reserved under subsection 
(f), to address barriers to maternal 
mortality review committee participa-
tion for community members, includ-
ing required training, transportation 
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barriers, compensation, and other sup-
ports as may be necessary; 
‘‘(ii) to establish initiatives to conduct 
outreach and community engagement ef-
forts within communities throughout the 
State or Tribe to seek input from commu-
nity members on the work of such mater-
nal mortality review committee, with a par-
ticular focus on outreach to minority 
women; and 
‘‘(iii) to release public reports assess-
ing— 
‘‘(I) the pregnancy-related death 
and pregnancy-associated death review 
processes of the maternal mortality 
review committee, with a particular 
focus on the maternal mortality re-
view committee’s sensitivity to the 
unique circumstances of pregnant and 
postpartum individuals from racial 
and ethnic minority groups (as such 
term is defined in section 1707(g)(1)) 
who have suffered pregnancy-related 
deaths; and 
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‘‘(II) the impact of the use of 
funds made available pursuant to 
paragraph (C) on increasing the diver-
sity of the maternal mortality review 
committee membership and promoting 
community 
engagement 
efforts 
throughout the State or Tribe. 
‘‘(B) TECHNICAL ASSISTANCE.—The Sec-
retary shall provide (either directly through the 
Department of Health and Human Services or 
by contract) technical assistance to any mater-
nal mortality review committee receiving a 
grant under this paragraph on best practices 
for increasing the diversity of the maternal 
mortality review committee’s membership and 
for conducting effective community engagement 
throughout the State or Tribe. 
‘‘(C) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—In addition to any funds made avail-
able under subsection (f), there are authorized 
to be appropriated to carry out this paragraph 
$10,000,000 for each of fiscal years 2023 
through 2027.’’. 
(b) RESERVATION OF FUNDS.—Section 317K(f) of 
the Public Health Service Act (42 U.S.C. 247b–12(f)) is 
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amended by adding at the end the following: ‘‘Of the 
amount made available under the preceding sentence for 
a fiscal year, not less than $1,500,000 shall be reserved 
for grants to Indian tribes, tribal organizations, or urban 
Indian organizations (as those terms are defined in section 
4 of the Indian Health Care Improvement Act (25 U.S.C. 
1603))’’. 
SEC. 1402. DATA COLLECTION AND REVIEW. 
Section 317K(d)(3)(A)(i) of the Public Health Serv-
ice Act (42 U.S.C. 247b–12(d)(3)(A)(i)) is amended— 
(1) by redesignating subclauses (II) and (III) 
as subclauses (V) and (VI), respectively; and 
(2) by inserting after subclause (I) the fol-
lowing: 
‘‘(II) to the extent practicable, 
reviewing cases of severe maternal 
morbidity, according to the most up- 
to-date indicators; 
‘‘(III) to the extent practicable, 
reviewing deaths during pregnancy or 
up to 1 year after the end of a preg-
nancy from suicide, overdose, or other 
death from a mental health condition 
or substance use disorder attributed 
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to or aggravated by pregnancy or 
childbirth complications; 
‘‘(IV) to the extent practicable, 
consulting with local community-based 
organizations representing pregnant 
and postpartum individuals from de-
mographic groups disproportionately 
impacted by poor maternal health out-
comes to ensure that, in addition to 
clinical factors, non-clinical factors 
that might have contributed to a preg-
nancy-related death are appropriately 
considered;’’. 
SEC. 1403. REVIEW OF MATERNAL HEALTH DATA COLLEC-
TION PROCESSES AND QUALITY MEASURES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Administrator for 
Centers for Medicare & Medicaid Services and the Direc-
tor of the Agency for Healthcare Research and Quality, 
shall consult with relevant stakeholders— 
(1) to review existing maternal health data col-
lection processes and quality measures; and 
(2) make recommendations to improve such 
processes and measures, including topics described 
under subsection (c). 
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(b) COLLABORATION.—In carrying out this section, 
the Secretary shall consult with a diverse group of mater-
nal health stakeholders, which may include— 
(1) pregnant and postpartum individuals and 
their family members, and nonprofit organizations 
representing such individuals, with a particular focus 
on patients from racial and ethnic minority groups; 
(2) community-based organizations that provide 
support for pregnant and postpartum individuals, 
with a particular focus on patients from racial and 
ethnic minority groups; 
(3) membership organizations for maternity 
care providers; 
(4) organizations representing perinatal health 
workers; 
(5) organizations that focus on maternal mental 
or behavioral health; 
(6) organizations that focus on intimate partner 
violence; 
(7) institutions of higher education, with a par-
ticular focus on minority-serving institutions; 
(8) licensed and accredited hospitals, birth cen-
ters, midwifery practices, or other medical practices 
that provide maternal health care services to preg-
nant and postpartum patients; 
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(9) relevant State and local public agencies, in-
cluding State maternal mortality review committees; 
and 
(10) the National Quality Forum, or such other 
standard-setting organizations specified by the Sec-
retary. 
(c) TOPICS.—The review of maternal health data col-
lection processes and recommendations to improve such 
processes and measures required under subsection (a) 
shall assess all available relevant information, including 
information from State-level sources, and shall consider at 
least the following: 
(1) Current State and Tribal practices for ma-
ternal health, maternal mortality, and severe mater-
nal morbidity data collection and dissemination, in-
cluding consideration of— 
(A) the timeliness of processes for amend-
ing a death certificate when new information 
pertaining to the death becomes available to re-
flect whether the death was a pregnancy-related 
death; 
(B) relevant data collected with electronic 
health records, including data on race, eth-
nicity, socioeconomic status, insurance type, 
and other relevant demographic information; 
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(C) maternal health data collected and 
publicly reported by hospitals, health systems, 
midwifery practices, and birth centers; 
(D) the barriers preventing States from 
correlating maternal outcome data with race 
and ethnicity data; 
(E) processes for determining the cause of 
a pregnancy-associated death in States that do 
not have a maternal mortality review com-
mittee; 
(F) whether maternal mortality review 
committees include multidisciplinary and di-
verse membership (as described in section 
317K(d)(1)(A) of the Public Health Service Act 
(42 U.S.C. 247b–12(d)(1)(A))); 
(G) whether members of maternal mor-
tality review committees participate in trainings 
on bias, racism, or discrimination, and the qual-
ity of such trainings; 
(H) the extent to which States have imple-
mented systematic processes of listening to the 
stories of pregnant and postpartum individuals 
and their family members, with a particular 
focus on pregnant and postpartum individuals 
from racial and ethnic minority groups (as such 
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term is defined in section 1707(g)(1) of the 
Public Health Service Act (42 U.S.C. 300u– 
6(g)(1))) and their family members, to fully un-
derstand the causes of, and inform potential so-
lutions to, the maternal mortality and severe 
maternal morbidity crisis within their respective 
States; 
(I) the extent to which maternal mortality 
review committees are considering social deter-
minants of maternal health when examining the 
causes of pregnancy-associated and pregnancy- 
related deaths; 
(J) the extent to which maternal mortality 
review committees are making actionable rec-
ommendations based on their reviews of adverse 
maternal health outcomes and the extent to 
which such recommendations are being imple-
mented by appropriate stakeholders; 
(K) the legal and administrative barriers 
preventing the collection, collation, and dissemi-
nation of State maternity care data; 
(L) the effectiveness of data collection and 
reporting processes in separating pregnancy-as-
sociated deaths from pregnancy-related deaths; 
and 
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(M) the current Federal, State, local, and 
Tribal funding support for the activities re-
ferred to in subparagraphs (A) through (L). 
(2) Whether the funding support referred to in 
paragraph (1)(M) is adequate for States to carry out 
optimal data collection and dissemination processes 
with respect to maternal health, maternal mortality, 
and severe maternal morbidity. 
(3) Current quality measures for maternity 
care, including prenatal measures, labor and delivery 
measures, and postpartum measures, including top-
ics such as— 
(A) effective quality measures for mater-
nity care used by hospitals, health systems, 
midwifery practices, birth centers, health plans, 
and other relevant entities; 
(B) the sufficiency of current outcome 
measures used to evaluate maternity care for 
driving improved care, experiences, and out-
comes in maternity care payment and delivery 
system models; 
(C) maternal health quality measures that 
other countries effectively use; 
(D) validated measures that have been 
used for research purposes that could be tested, 
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refined, and submitted for national endorse-
ment; 
(E) barriers preventing maternity care pro-
viders and insurers from implementing quality 
measures that are aligned with best practices; 
(F) the frequency with which maternity 
care quality measures are reviewed and revised; 
(G) the strengths and weaknesses of the 
Prenatal and Postpartum Care measures of the 
Health Plan Employer Data and Information 
Set measures established by the National Com-
mittee for Quality Assurance; 
(H) the strengths and weaknesses of ma-
ternity care quality measures under the Med-
icaid program under title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.) and the 
Children’s Health Insurance Program under 
title XXI of such Act (42 U.S.C. 1397 et seq.), 
including the extent to which States voluntarily 
report relevant measures; 
(I) the extent to which maternity care 
quality measures are informed by patient expe-
riences that include measures of patient-re-
ported experience of care; 
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(J) the current processes for collecting 
stratified data on the race and ethnicity of 
pregnant and postpartum individuals in hos-
pitals, health systems, midwifery practices, and 
birth centers, and for incorporating such ra-
cially and ethnically stratified data in maternity 
care quality measures; 
(K) the extent to which maternity care 
quality measures account for the unique experi-
ences of pregnant and postpartum individuals 
from racial and ethnic minority groups (as such 
term is defined in section 1707(g)(1) of the 
Public Health Service Act (42 U.S.C. 300u– 
6(g)(1))); and 
(L) the extent to which hospitals, health 
systems, midwifery practices, and birth centers 
are implementing existing maternity care qual-
ity measures. 
(4) Recommendations on authorizing additional 
funds and providing additional technical assistance 
to improve maternal mortality review committees 
and State and Tribal maternal health data collection 
and reporting processes. 
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(5) Recommendations for new authorities that 
may be granted to maternal mortality review com-
mittees to be able to— 
(A) access records from other Federal and 
State agencies and departments that may be 
necessary to identify causes of pregnancy-asso-
ciated and pregnancy-related deaths that are 
unique to pregnant and postpartum individuals 
from specific populations, such as veterans and 
individuals who are incarcerated; and 
(B) work with relevant experts who are not 
members of the maternal mortality review com-
mittee to assist in the review of pregnancy-asso-
ciated deaths of pregnant and postpartum indi-
viduals from specific populations, such as vet-
erans and individuals who are incarcerated. 
(6) Recommendations to improve and stand-
ardize current quality measures for maternity care, 
with a particular focus on racial and ethnic dispari-
ties in maternal health outcomes. 
(7) Recommendations to improve the coordina-
tion by the Department of Health and Human Serv-
ices of the efforts undertaken by the agencies and 
organizations within the Department related to ma-
ternal health data and quality measures. 
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(d) REPORT.—Not later than 1 year after the enact-
ment of this Act, the Secretary shall submit to the Con-
gress and make publicly available a report on the results 
of the review of maternal health data collection processes 
and quality measures and recommendations to improve 
such processes and measures required under subsection 
(a). 
(e) DEFINITIONS.—In this section: 
(1) MATERNAL
MORTALITY
REVIEW
COM-
MITTEE.—The term ‘‘maternal mortality review 
committee’’ means a maternal mortality review com-
mittee duly authorized by a State and receiving 
funding under section 317k(a)(2)(D) of the Public 
Health Service Act (42 U.S.C. 247b–12(a)(2)(D)). 
(2) 
PREGNANCY-ASSOCIATED
DEATH.—The 
term ‘‘pregnancy-associated’’, with respect to a 
death, means a death of a pregnant or postpartum 
individual, by any cause, that occurs during, or with-
in 1 year following, the individual’s pregnancy, re-
gardless of the outcome, duration, or site of the 
pregnancy. 
(3) PREGNANCY-RELATED
DEATH.—The term 
‘‘pregnancy-related’’, with respect to a death, means 
a death of a pregnant or postpartum individual that 
occurs during, or within 1 year following, the indi-
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vidual’s pregnancy, from a pregnancy complication, 
a chain of events initiated by pregnancy, or the ag-
gravation of an unrelated condition by the physio-
logic effects of pregnancy. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section for fiscal years 2023 
through 2026. 
SEC. 1404. INDIAN HEALTH SERVICE STUDY ON MATERNAL 
MORTALITY AND SEVERE MATERNAL MOR-
BIDITY. 
(a) IN GENERAL.—The Director of the Indian Health 
Service (referred to in this section as the ‘‘Director’’) 
shall, in coordination with entities described in subsection 
(b)— 
(1) not later than 90 days after the enactment 
of this Act, enter into a contract with an inde-
pendent research organization or Tribal Epidemi-
ology Center to conduct a comprehensive study on 
maternal mortality and severe maternal morbidity in 
the populations of American Indian and Alaska Na-
tive individuals; and 
(2) not later than 3 years after the date of the 
enactment of this Act, submit to Congress a report 
on such study that contains recommendations for 
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policies and practices that can be adopted to im-
prove maternal health outcomes for pregnant and 
postpartum American Indian and Alaska Native in-
dividuals. 
(b) PARTICIPATING
ENTITIES.—The entities de-
scribed in this subsection shall consist of 12 members, se-
lected by the Director from among individuals nominated 
by Indian tribes and tribal organizations (as such terms 
are defined in section 4 of the Indian Self-Determination 
and Education Assistance Act (25 U.S.C. 5304)), and 
urban Indian organizations (as such term is defined in 
section 4 of the Indian Health Care Improvement Act (25 
U.S.C. 1603)). In selecting such members, the Director 
shall ensure that each of the 12 service areas of the Indian 
Health Service is represented. 
(c) CONTENTS
OF STUDY.—The study conducted 
pursuant to subsection (a) shall— 
(1) examine the causes of maternal mortality 
and severe maternal morbidity that are unique to 
American Indian and Alaska Native individuals; 
(2) include a systematic process of listening to 
the stories of American Indian and Alaska Native 
pregnant and postpartum individuals to fully under-
stand the causes of, and inform potential solutions 
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to, the maternal mortality and severe maternal mor-
bidity crisis within their respective communities; 
(3) distinguish between the causes of, landscape 
of maternity care at, and recommendations to im-
prove maternal health outcomes within, the different 
settings in which American Indian and Alaska Na-
tive pregnant and postpartum individuals receive 
maternity care, such as— 
(A) facilities operated by the Indian 
Health Service; 
(B) an Indian health program operated by 
an Indian tribe or tribal organization pursuant 
to a contract, grant, cooperative agreement, or 
compact with the Indian Health Service pursu-
ant to the Indian Self-Determination Act; and 
(C) an urban Indian health program oper-
ated by an urban Indian organization pursuant 
to a grant or contract with the Indian Health 
Service pursuant to title V of the Indian Health 
Care Improvement Act; 
(4) review processes for coordinating programs 
of the Indian Health Service with social services pro-
vided through other programs administered by the 
Secretary of Health and Human Services (other 
than the Medicare program under title XVIII of the 
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Social Security Act, the Medicaid program under 
title XIX of such Act, and the Children’s Health In-
surance Program under title XXI of such Act), in-
cluding coordination with the efforts of the Task 
Force established under section 1403; 
(5) review current data collection and quality 
measurement processes and practices; 
(6) assess causes and frequency of maternal 
mental health conditions and substance use dis-
orders; 
(7) consider social determinants of health, in-
cluding poverty, lack of health insurance, unemploy-
ment, sexual violence, and environmental conditions 
in Tribal areas; 
(8) consider the role that historical mistreat-
ment of American Indian and Alaska Native women 
has played in causing currently high rates of mater-
nal mortality and severe maternal morbidity; 
(9) consider how current funding of the Indian 
Health Service affects the ability of the Service to 
deliver quality maternity care; 
(10) consider the extent to which the delivery of 
maternity care services is culturally appropriate for 
American Indian and Alaska Native pregnant and 
postpartum individuals; 
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(11) 
make 
recommendations 
to 
reduce 
misclassification of American Indian and Alaska Na-
tive pregnant and postpartum individuals, including 
consideration of best practices in training for mater-
nal mortality review committee members to be able 
to correctly classify American Indian and Alaska 
Native individuals; and 
(12) make recommendations informed by the 
stories shared by American Indian and Alaska Na-
tive pregnant and postpartum individuals in para-
graph (2) to improve maternal health outcomes for 
such individuals. 
(d) REPORT.—The agreement entered into under 
subsection (a) with an independent research organization 
or Tribal Epidemiology Center shall require that the orga-
nization or center transmit to Congress a report on the 
results of the study conducted pursuant to that agreement 
not later than 36 months after the date of the enactment 
of this Act. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$2,000,000 for each of fiscal years 2023 through 2025. 
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SEC. 1405. GRANTS TO MINORITY-SERVING INSTITUTIONS 
TO STUDY MATERNAL MORTALITY, SEVERE 
MATERNAL 
MORBIDITY, 
AND 
OTHER 
AD-
VERSE MATERNAL HEALTH OUTCOMES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a program under which 
the Secretary shall award grants to research centers, 
health professions schools and programs, and other enti-
ties at minority-serving institutions to study specific as-
pects of the maternal health crisis among pregnant and 
postpartum individuals from racial and ethnic minority 
groups. Such research may— 
(1) include the development and implementation 
of systematic processes of listening to the stories of 
pregnant and postpartum individuals from racial 
and ethnic minority groups, and perinatal health 
workers supporting such individuals, to fully under-
stand the causes of, and inform potential solutions 
to, the maternal mortality and severe maternal mor-
bidity crisis within their respective communities; 
(2) assess the potential causes of relatively low 
rates of maternal mortality among Hispanic individ-
uals, including potential racial misclassification and 
other data collection and reporting issues that might 
be misrepresenting maternal mortality rates among 
Hispanic individuals in the United States; and 
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(3) assess differences in rates of adverse mater-
nal health outcomes among subgroups identifying as 
Hispanic. 
(b) APPLICATION.—To be eligible to receive a grant 
under subsection (a), an entity described in such sub-
section shall submit to the Secretary an application at 
such time, in such manner, and containing such informa-
tion as the Secretary may require. 
(c) TECHNICAL ASSISTANCE.—The Secretary may 
use not more than 10 percent of the funds made available 
under subsection (f)— 
(1) to conduct outreach to minority-serving in-
stitutions to raise awareness of the availability of 
grants under this subsection (a); 
(2) to provide technical assistance in the appli-
cation process for such a grant; and 
(3) to promote capacity building as needed to 
enable entities described in such subsection to sub-
mit such an application. 
(d) REPORTING REQUIREMENT.—Each entity award-
ed a grant under this section shall periodically submit to 
the Secretary a report on the status of activities conducted 
using the grant. 
(e) EVALUATION.—Beginning one year after the date 
on which the first grant is awarded under this section, 
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the Secretary shall submit to Congress an annual report 
summarizing the findings of research conducted using 
funds made available under this section. 
(f) MINORITY-SERVING INSTITUTIONS DEFINED.—In 
this section, the term ‘‘minority-serving institution’’ has 
the meaning given the term in section 371(a) of the High-
er Education Act of 1965 (20 U.S.C. 1067q(a)). 
(g) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$10,000,000 for each of fiscal years 2023 through 2027. 
Subtitle F—Moms Matter 
SEC. 1501. MATERNAL MENTAL HEALTH EQUITY GRANT 
PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Assistant Secretary 
for Mental Health and Substance Use, shall establish a 
program to award grants to eligible entities to address ma-
ternal mental health conditions and substance use dis-
orders with respect to pregnant and postpartum individ-
uals, with a focus on racial and ethnic minority groups. 
(b) APPLICATION.—To be eligible to receive a grant 
under this section an eligible entity shall submit to the 
Secretary an application at such time, in such manner, 
and containing such information as the Secretary may 
provide, including how such entity will use funds for activi-
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ties described in subsection (d) that are culturally con-
gruent. 
(c) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to an eligible entity 
that— 
(1) is, or will partner with, a community-based 
organization to address maternal mental health con-
ditions and substance use disorders described in sub-
section (a); 
(2) is operating in an area with high rates of— 
(A) adverse maternal health outcomes; or 
(B) significant racial or ethnic disparities 
in maternal health outcomes; and 
(3) is operating in a health professional short-
age area designated under section 332 of the Public 
Health Service Act (42 U.S.C. 254e). 
(d) USE OF FUNDS.—An eligible entity that receives 
a grant under this section shall use funds for the fol-
lowing: 
(1) Establishing or expanding maternity care 
programs to improve the integration of maternal 
health and behavioral health care services into pri-
mary care settings where pregnant individuals regu-
larly receive health care services. 
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(2) Establishing or expanding group prenatal 
care programs or postpartum care programs. 
(3) Expanding existing programs that improve 
maternal mental and behavioral health during the 
prenatal and postpartum periods, with a focus on in-
dividuals from racial and ethnic minority groups. 
(4) Providing services and support for pregnant 
and postpartum individuals with maternal mental 
health conditions and substance use disorders, in-
cluding referrals to addiction treatment centers that 
offer evidence-based treatment options. 
(5) Addressing stigma associated with maternal 
mental health conditions and substance use dis-
orders, with a focus on racial and ethnic minority 
groups. 
(6) Raising awareness of warning signs of ma-
ternal mental health conditions and substance use 
disorders, with a focus on pregnant and postpartum 
individuals from racial and ethnic minority groups. 
(7) Establishing or expanding programs to pre-
vent suicide or self-harm among pregnant and 
postpartum individuals. 
(8) Offering evidence-aligned programs at free-
standing birth centers that provide maternal mental 
and behavioral health care education, treatments, 
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and services, and other services for individuals 
throughout the prenatal and postpartum period. 
(9) Establishing or expanding programs to pro-
vide education and training to maternity care pro-
viders with respect to— 
(A) identifying potential warning signs for 
maternal mental health conditions or substance 
use disorders in pregnant and postpartum indi-
viduals, with a focus on individuals from racial 
and ethnic minority groups; and 
(B) in the case where such providers iden-
tify such warning signs, offering referrals to 
mental and behavioral health care professionals. 
(10) Developing a website, or other source, that 
includes information on health care providers who 
treat maternal mental health conditions and sub-
stance use disorders. 
(11) Establishing or expanding programs in 
communities to improve coordination between mater-
nity care providers and mental and behavioral health 
care providers who treat maternal mental health 
conditions and substance use disorders, including 
through the use of toll-free hotlines. 
(12) Carrying out other programs aligned with 
evidence-based practices for addressing maternal 
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100 
mental health conditions and substance use dis-
orders for pregnant and postpartum individuals from 
racial and ethnic minority groups. 
(e) REPORTING.— 
(1) ELIGIBLE
ENTITIES.—An eligible entity 
that receives a grant under subsection (a) shall sub-
mit annually to the Secretary, and make publicly 
available, a report on the activities conducted using 
funds received through a grant under this section. 
Such reports shall include quantitative and quali-
tative evaluations of such activities, including the ex-
perience of individuals who received health care 
through such grant. 
(2) SECRETARY.—Not later than the end of fis-
cal year 2025, the Secretary shall submit to Con-
gress a report that includes— 
(A) a summary of the reports received 
under paragraph (1); 
(B) an evaluation of the effectiveness of 
grants awarded under this section; 
(C) recommendations with respect to ex-
panding coverage of evidence-based screenings 
and treatments for maternal mental health con-
ditions and substance use disorders; and 
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101 
(D) recommendations with respect to en-
suring activities described under subsection (d) 
continue after the end of a grant period. 
(f) DEFINITIONS.—In this section: 
(1) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means— 
(A) a community-based organization serv-
ing pregnant and postpartum individuals, in-
cluding such organizations serving individuals 
from racial and ethnic minority groups and 
other underserved populations; 
(B) a nonprofit or patient advocacy organi-
zation with expertise in maternal mental and 
behavioral health; 
(C) a maternity care provider; 
(D) a mental or behavioral health care pro-
vider who treats maternal mental health condi-
tions or substance use disorders; 
(E) a State or local governmental entity, 
including a State or local public health depart-
ment; 
(F) an Indian Tribe or Tribal organization 
(as such terms are defined in section 4 of the 
Indian Self-Determination and Education As-
sistance Act (25 U.S.C. 5304)); and 
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102 
(G) an Urban Indian organization (as such 
term is defined in section 4 of the Indian 
Health Care Improvement Act (25 U.S.C. 
1603)). 
(2) FREESTANDING BIRTH CENTER.—The term 
‘‘freestanding birth center’’ has the meaning given 
that term under section 1905(l) of the Social Secu-
rity Act (42 U.S.C. 1396d(1)). 
(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$25,000,000 for each of fiscal years 2023 through 2026. 
SEC. 1502. GRANTS TO GROW AND DIVERSIFY THE MATER-
NAL MENTAL AND BEHAVIORAL HEALTH 
CARE WORKFORCE. 
Title VII of the Public Health Service Act (42 U.S.C. 
292 et seq.) is amended by inserting after section 758 of 
such Act, as added by section 1302 of this title, the fol-
lowing new section: 
‘‘SEC. 758A. MATERNAL MENTAL AND BEHAVIORAL HEALTH 
CARE WORKFORCE GRANTS. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to entities to establish or expand programs described in 
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103 
subsection (b) to grow and diversify the maternal mental 
and behavioral health care workforce. 
‘‘(b) USE OF FUNDS.—Recipients of grants under 
this section shall use the grants to grow and diversify the 
maternal mental and behavioral health care workforce 
by— 
‘‘(1) establishing schools or programs that pro-
vide education and training to individuals seeking 
appropriate licensing or certification as mental or 
behavioral health care providers who will specialize 
in maternal mental health conditions or substance 
use disorders; or 
‘‘(2) expanding the capacity of existing schools 
or programs described in paragraph (1), for the pur-
poses of increasing the number of students enrolled 
in such schools or programs, including by awarding 
scholarships for students. 
‘‘(c) PRIORITIZATION.—In awarding grants under 
this section, the Secretary shall give priority to any entity 
that— 
‘‘(1) has demonstrated a commitment to re-
cruiting and retaining students and faculty from ra-
cial and ethnic minority groups; 
‘‘(2) has developed a strategy to recruit and re-
tain a diverse pool of students into the maternal 
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104 
mental or behavioral health care workforce program 
or school supported by funds received through the 
grant, particularly from racial and ethnic minority 
groups and other underserved populations; 
‘‘(3) has developed a strategy to recruit and re-
tain students who plan to practice in a health pro-
fessional shortage area designated under section 
332; 
‘‘(4) has developed a strategy to recruit and re-
tain students who plan to practice in an area with 
significant racial and ethnic disparities in maternal 
health outcomes, to the extent practicable; and 
‘‘(5) includes in the standard curriculum for all 
students within the maternal mental or behavioral 
health care workforce program or school a bias, rac-
ism, or discrimination training program that in-
cludes training on implicit bias and racism. 
‘‘(d) REPORTING.—As a condition on receipt of a 
grant under this section for a maternal mental or behav-
ioral health care workforce program or school, an entity 
shall agree to submit to the Secretary an annual report 
on the activities conducted through the grant, including— 
‘‘(1) the number and demographics of students 
participating in the program or school; 
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‘‘(2) the extent to which students in the pro-
gram or school are entering careers in— 
‘‘(A) health professional shortage areas 
designated under section 332; and 
‘‘(B) areas with significant racial and eth-
nic disparities in maternal health outcomes, to 
the extent such data are available; and 
‘‘(3) whether the program or school has in-
cluded in the standard curriculum for all students a 
bias, racism, or discrimination training program that 
includes training on implicit bias and racism, and if 
so the effectiveness of such training program. 
‘‘(e) PERIOD OF GRANTS.—The period of a grant 
under this section shall be up to 5 years. 
‘‘(f) APPLICATION.—To seek a grant under this sec-
tion, an entity shall submit to the Secretary an application 
at such time, in such manner, and containing such infor-
mation as the Secretary may require, including any infor-
mation necessary for prioritization under subsection (c). 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide, directly or by contract, technical assistance to en-
tities seeking or receiving a grant under this section on 
the development, use, evaluation, and post-grant period 
sustainability of the maternal mental or behavioral health 
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care workforce programs or schools proposed to be, or 
being, established or expanded through the grant. 
‘‘(h) REPORT BY THE SECRETARY.—Not later than 
4 years after the date of enactment of this section, the 
Secretary shall prepare and submit to the Congress, and 
post on the internet website of the Department of Health 
and Human Services, a report on the effectiveness of the 
grant program under this section at— 
‘‘(1) recruiting students from racial and ethnic 
minority groups and other underserved populations; 
‘‘(2) increasing the number of mental or behav-
ioral health care providers specializing in maternal 
mental health conditions or substance use disorders 
from racial and ethnic minority groups and other 
underserved populations; 
‘‘(3) increasing the number of mental or behav-
ioral health care providers specializing in maternal 
mental health conditions or substance use disorders 
working in health professional shortage areas des-
ignated under section 332; and 
‘‘(4) increasing the number of mental or behav-
ioral health care providers specializing in maternal 
mental health conditions or substance use disorders 
working in areas with significant racial and ethnic 
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disparities in maternal health outcomes, to the ex-
tent such data are available. 
‘‘(i) DEFINITIONS.—In this section: 
‘‘(1) RACIAL AND ETHNIC MINORITY GROUP.— 
The term ‘racial and ethnic minority group’ has the 
meaning given such term in section 1707(g)(1). 
‘‘(2) MENTAL OR BEHAVIORAL HEALTH CARE 
PROVIDER.—The term ‘mental or behavioral health 
care provider’ refers to a health care provider in the 
field of mental and behavioral health, including sub-
stance use disorders, acting in accordance with State 
law. 
‘‘(j) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $15,000,000 for each of fiscal years 2023 through 
2027.’’. 
Subtitle G—Justice for 
Incarcerated Moms 
SEC. 1601. ENDING THE SHACKLING OF PREGNANT INDI-
VIDUALS. 
(a) IN GENERAL.—Beginning on the date that is 6 
months after the date of enactment of this Act, and annu-
ally thereafter, in each State that receives a grant under 
subpart 1 of part E of title I of the Omnibus Crime Con-
trol and Safe Streets Act of 1968 (34 U.S.C. 10151 et 
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seq.) (commonly referred to as the ‘‘Edward Byrne Memo-
rial Justice Grant Program’’) and that does not have in 
effect throughout the State for such fiscal year laws re-
stricting the use of restraints on pregnant individuals in 
prison that are substantially similar to the rights, proce-
dures, requirements, effects, and penalties set forth in sec-
tion 4322 of title 18, United States Code, the amount of 
such grant that would otherwise be allocated to such State 
under such subpart for the fiscal year shall be decreased 
by 25 percent. 
(b) REALLOCATION.—Amounts not allocated to a 
State for failure to comply with subsection (a) shall be 
reallocated in accordance with subpart 1 of part E of title 
I of the Omnibus Crime Control and Safe Streets Act of 
1968 (34 U.S.C. 10151 et seq.) to States that have com-
plied with such subsection. 
SEC. 1602. CREATING MODEL PROGRAMS FOR THE CARE 
OF INCARCERATED INDIVIDUALS IN THE 
PRENATAL AND POSTPARTUM PERIODS. 
(a) IN GENERAL.—Not later than 1 year after the 
date of enactment of this Act, the Attorney General, act-
ing through the Director of the Bureau of Prisons, shall 
establish, in not fewer than 6 Bureau of Prisons facilities, 
programs to optimize maternal health outcomes for preg-
nant and postpartum individuals incarcerated in such fa-
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cilities. The Attorney General shall establish such pro-
grams in consultation with stakeholders such as— 
(1) relevant community-based organizations, 
particularly organizations that represent incarcer-
ated and formerly incarcerated individuals and orga-
nizations that seek to improve maternal health out-
comes for pregnant and postpartum individuals from 
racial and ethnic minority groups; 
(2) relevant organizations representing patients, 
with a particular focus on patients from racial and 
ethnic minority groups; 
(3) organizations representing maternity care 
providers and maternal health care education pro-
grams; 
(4) perinatal health workers; and 
(5) researchers and policy experts in fields re-
lated to maternal health care for incarcerated indi-
viduals. 
(b) START DATE.—Each selected facility shall begin 
facility programs not later than 18 months after the date 
of enactment of this Act. 
(c) FACILITY PRIORITY.—In carrying out subsection 
(a), the Director shall give priority to a facility based on— 
(1) the number of pregnant and postpartum in-
dividuals incarcerated in such facility and, among 
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such individuals, the number of pregnant and 
postpartum individuals from racial and ethnic mi-
nority groups; and 
(2) the extent to which the leaders of such facil-
ity have demonstrated a commitment to developing 
exemplary programs for pregnant and postpartum 
individuals incarcerated in such facility. 
(d) PROGRAM DURATION.—The programs established 
under this section shall be for a 5-year period. 
(e) PROGRAMS.—Bureau of Prisons facilities selected 
by the Director shall establish programs for pregnant and 
postpartum incarcerated individuals, and such programs 
may— 
(1) provide access to perinatal health workers 
from pregnancy through the postpartum period; 
(2) provide access to healthy foods and coun-
seling on nutrition, recommended activity levels, and 
safety measures throughout pregnancy; 
(3) train correctional officers to ensure that 
pregnant incarcerated individuals receive safe and 
respectful treatment; 
(4) train medical personnel to ensure that preg-
nant incarcerated individuals receive trauma-in-
formed, culturally congruent care that promotes the 
health and safety of the pregnant individuals; 
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(5) provide counseling and treatment for indi-
viduals who have suffered from— 
(A) diagnosed mental or behavioral health 
conditions, including trauma and substance use 
disorders; 
(B) trauma or violence, including domestic 
violence; 
(C) human immunodeficiency virus; 
(D) sexual abuse; 
(E) pregnancy or infant loss; or 
(F) chronic conditions; 
(6) provide evidence-based pregnancy and child-
birth education, parenting support, and other rel-
evant forms of health literacy; 
(7) provide clinical education opportunities to 
maternity care providers in training to expand path-
ways into maternal health care careers serving incar-
cerated individuals; 
(8) offer opportunities for postpartum individ-
uals to maintain contact with the individual’s new-
born child to promote bonding, including enhanced 
visitation policies, access to prison nursery pro-
grams, or breastfeeding support; 
(9) provide reentry assistance, particularly to— 
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(A) ensure access to health insurance cov-
erage and transfer of health records to commu-
nity providers if an incarcerated individual exits 
the criminal justice system during such individ-
ual’s pregnancy or in the postpartum period; 
and 
(B) connect individuals exiting the criminal 
justice system during pregnancy or in the 
postpartum period to community-based re-
sources, such as referrals to health care pro-
viders, substance use disorder treatments, and 
social services that address social determinants 
maternal of health; or 
(10) establish partnerships with local public en-
tities, private community entities, community-based 
organizations, Indian Tribes and tribal organizations 
(as such terms are defined in section 4 of the Indian 
Self-Determination and Education Assistance Act 
(25 U.S.C. 5304)), and urban Indian organizations 
(as such term is defined in section 4 of the Indian 
Health Care Improvement Act (25 U.S.C. 1603)) to 
establish or expand pretrial diversion programs as 
an alternative to incarceration for pregnant and 
postpartum individuals. Such programs may in-
clude— 
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(A) evidence-based childbirth education or 
parenting classes; 
(B) prenatal health coordination; 
(C) family and individual counseling; 
(D) evidence-based screenings, education, 
and, as needed, treatment for mental and be-
havioral health conditions, including drug and 
alcohol treatments; 
(E) family case management services; 
(F) domestic violence education and pre-
vention; 
(G) physical and sexual abuse counseling; 
and 
(H) programs to address social deter-
minants of health such as employment, housing, 
education, transportation, and nutrition. 
(f) IMPLEMENTATION AND REPORTING.—A selected 
facility shall be responsible for— 
(1) implementing programs, which may include 
the programs described in subsection (e); and 
(2) not later than 3 years after the date of en-
actment of this Act, and 6 years after the date of 
enactment of this Act, reporting results of the pro-
grams to the Director, including information de-
scribing— 
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(A) relevant quantitative indicators of suc-
cess in improving the standard of care and 
health outcomes for pregnant and postpartum 
incarcerated individuals in the facility, including 
data stratified by race, ethnicity, sex, gender, 
age, geography, disability status, the category 
of the criminal charge against such individual, 
rates of pregnancy-related deaths, pregnancy- 
associated deaths, cases of infant mortality and 
morbidity, rates of preterm births and low- 
birthweight births, cases of severe maternal 
morbidity, cases of violence against pregnant or 
postpartum individuals, diagnoses of maternal 
mental or behavioral health conditions, and 
other such information as appropriate; 
(B) relevant qualitative and quantitative 
evaluations from pregnant and postpartum in-
carcerated individuals who participated in such 
programs, including measures of patient-re-
ported experience of care; and 
(C) strategies to sustain such programs 
after fiscal year 2027 and expand such pro-
grams to other facilities. 
(g) REPORT.—Not later than 6 years after the date 
of enactment of this Act, the Director shall submit to the 
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Attorney General and to the Congress a report describing 
the results of the programs funded under this section. 
(h) OVERSIGHT.—Not later than 1 year after the 
date of enactment of this Act, the Attorney General shall 
award a contract to an independent organization or inde-
pendent organizations to conduct oversight of the pro-
grams described in subsection (e). 
(i) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$10,000,000 for each of fiscal years 2023 through 2027. 
SEC. 1603. GRANT PROGRAM TO IMPROVE MATERNAL 
HEALTH OUTCOMES FOR INDIVIDUALS IN 
STATE AND LOCAL PRISONS AND JAILS. 
(a) ESTABLISHMENT.—Not later than 1 year after 
the date of enactment of this Act, the Attorney General, 
acting through the Director of the Bureau of Justice As-
sistance, shall award Justice for Incarcerated Moms 
grants to States to establish or expand programs in State 
and local prisons and jails for pregnant and postpartum 
incarcerated individuals. The Attorney General shall 
award such grants in consultation with stakeholders such 
as— 
(1) relevant community-based organizations, 
particularly organizations that represent incarcer-
ated and formerly incarcerated individuals and orga-
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nizations that seek to improve maternal health out-
comes for pregnant and postpartum individuals from 
racial and ethnic minority groups; 
(2) relevant organizations representing patients, 
with a particular focus on patients from racial and 
ethnic minority groups; 
(3) organizations representing maternity care 
providers and maternal health care education pro-
grams; 
(4) perinatal health workers; and 
(5) researchers and policy experts in fields re-
lated to maternal health care for incarcerated indi-
viduals. 
(b) APPLICATIONS.—Each applicant for a grant 
under this section shall submit to the Director of the Bu-
reau of Justice Assistance an application at such time, in 
such manner, and containing such information as the Di-
rector may require. 
(c) USE OF FUNDS.—A State that is awarded a grant 
under this section shall use such grant to establish or ex-
pand programs for pregnant and postpartum incarcerated 
individuals, and such programs may— 
(1) provide access to perinatal health workers 
from pregnancy through the postpartum period; 
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(b) CONTENTS OF REPORT.—The report described in 
this section shall include— 
(1) to the extent practicable— 
(A) the number of pregnant individuals 
who are incarcerated in Bureau of Prisons fa-
cilities; 
(B) the number of incarcerated individuals, 
including those incarcerated in Federal, State, 
and local correctional facilities, who have expe-
rienced a pregnancy-related death, pregnancy- 
associated death, or the death of an infant in 
the most recent 10 years of available data; 
(C) the number of cases of severe maternal 
morbidity among incarcerated individuals, in-
cluding those incarcerated in Federal, State, 
and local detention facilities, in the most recent 
10 years of available data; 
(D) the number of preterm and low-birth-
weight births of infants born to incarcerated in-
dividuals, including those incarcerated in Fed-
eral, State, and local correctional facilities, in 
the most recent 10 years of available data; and 
(E) statistics on the racial and ethnic dis-
parities in maternal and infant health outcomes 
and severe maternal morbidity rates among in-
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carcerated individuals, including those incarcer-
ated in Federal, State, and local detention fa-
cilities; 
(2) in the case that the Comptroller General of 
the United States is unable determine the informa-
tion required in subparagraphs (A) through (C) of 
paragraph (1), an assessment of the barriers to de-
termining such information and recommendations 
for improvements in tracking maternal health out-
comes among incarcerated individuals, including 
those incarcerated in Federal, State, and local deten-
tion facilities; 
(3) causes of adverse maternal health outcomes 
that are unique to incarcerated individuals, including 
those incarcerated in Federal, State, and local deten-
tion facilities; 
(4) causes of adverse maternal health outcomes 
and severe maternal morbidity that are unique to in-
carcerated individuals from racial and ethnic minor-
ity groups; 
(5) recommendations to reduce maternal mor-
tality and severe maternal morbidity among incar-
cerated individuals and to address racial and ethnic 
disparities in maternal health outcomes for incarcer-
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