I 
117TH CONGRESS 
1ST SESSION H. R. 5163 
To facilitate support and services to women who find themselves with an 
unexpected pregnancy, to meet the emotional, physical, social, financial, 
and other needs women encounter during pregnancy, childbirth, and 
child-rearing, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 3, 2021 
Mr. FORTENBERRY (for himself, Ms. SALAZAR, Mrs. WAGNER, Ms. STEFANIK, 
Ms. CHENEY, Ms. TENNEY, Mrs. KIM of California, Mr. MOORE of Utah, 
Ms. MALLIOTAKIS, and Miss GONZA´LEZ-COLO´N) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committees on Ways and Means, Education and Labor, 
Agriculture, the Judiciary, and Financial Services, for a period to be sub-
sequently determined by the Speaker, in each case for consideration of 
such provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To facilitate support and services to women who find them-
selves with an unexpected pregnancy, to meet the emo-
tional, physical, social, financial, and other needs women 
encounter during pregnancy, childbirth, and child- 
rearing, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Care for Her Act’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Sense of Congress. 
Sec. 3. Definitions. 
Sec. 4. Applicability of certain provisions. 
Sec. 5. Religious and moral objections. 
TITLE I—PREGNANCY AND PARENTING SUPPORT 
COLLABORATIVE 
Sec. 101. Establishment. 
Sec. 102. Pregnant and Parenting Women’s Care Information Service. 
Sec. 103. Education and training support. 
Sec. 104. Toll-free number. 
Sec. 105. Annual review of successful models. 
Sec. 106. Recognizing successful workplace policies and practices. 
Sec. 107. Public Health Service Act programs. 
TITLE II—DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Sec. 201. Pregnancy and parenting support and services. 
Sec. 202. Housing. 
Sec. 203. Assessing outcomes and applying optimal incentives to improve ma-
ternal and child health outcomes. 
TITLE III—INTERNAL REVENUE SERVICE 
Sec. 301. Child tax credit improvements. 
SEC. 2. SENSE OF CONGRESS. 
It is the sense of Congress that— 
(1) many women find themselves with an unex-
pected pregnancy without knowledge of what re-
sources might be available to them at the local, 
State, and Federal levels to support emotional, phys-
ical, social, financial, and other needs that they may 
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encounter during pregnancy, childbirth, and child- 
rearing; 
(2) gaps exist in support and services provided 
throughout communities; 
(3) Federal and State governments, according 
to the Supreme Court ruling in Harris v. McRae, 
448 U.S. 297 (1980), have a vested interest in as-
suring optimal support and outcomes for women and 
their children, and this ruling supports the decided 
interest of the United States Government to help a 
woman through childbirth and child-rearing; 
(4) women and communities alike have univer-
sally voiced the need for safe, affordable, and sup-
portive housing for expectant mothers; 
(5) maternity housing needs in rural and urban 
communities differ, and, as a result, community 
needs should be evaluated and gaps filled where lack 
of housing support and services exist; 
(6) group housing has been shown to be valu-
able to improve health outcomes; 
(7) institutions of higher education should pro-
vide information regarding resources available for 
parenting and pregnant students; 
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(8) communities should work together to pro-
vide support and services, and fulfill unmet needs of 
pregnant and parenting students; 
(9) expectant mothers begin to provide for their 
child as soon as they come to learn of their preg-
nancy, and expenses may include clothing, furniture, 
toys, and food, and, for this reason, a child tax cred-
it for women who are pregnant should be applied; 
(10) information on support and services avail-
able should be readily available to women during 
pregnancy, birth, and child-rearing; 
(11) health care services are covered through 
various insurances including the Medicaid program; 
(12) linking health care services to broader sup-
port and services for a mother and her child, includ-
ing housing, nutrition, education, job training, job 
placement, and childcare, is critical to help facilitate 
a woman through her journey; 
(13) a committed community of care working 
with State and Federal governments has an oppor-
tunity to build comprehensive support systems that 
improve pregnancy outcomes significantly; 
(14) a community of care can help with— 
(A) health care and material support; 
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(B) mentorship and parenting resources 
during pregnancy and following the birth of a 
child; 
(C) opportunities for completion of edu-
cation, employment, and job training; 
(D) safe, affordable, and supportive hous-
ing during pregnancy; and 
(E) workplace and college campus accom-
modation, including child care and lactation 
support; and 
(15) to assure consistent access to information 
about available support and services for a woman 
with an unexpected pregnancy, to fill additional gaps 
that exist in support and services, and to support ex-
pectant mothers, Congress proposes— 
(A) a new Federal-State entity to assure 
all parties are satisfied with the context of sup-
port and services; 
(B) a clearinghouse with geographically 
relevant programs for women seeking support 
during pregnancy; 
(C) an assessment of gaps within support 
and services; 
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(D) an assessment and sharing of success-
ful models in local, State, and Federal pro-
grams; 
(E) provision of grants to support certain 
services such as maternity housing, mentorship 
programs, job-training programs, and childcare; 
(F) engagement with women who have ex-
perienced available support and services to un-
derstand what services are useful and gaps that 
exist in services and support; 
(G) an annual report from the Department 
of Health and Human Services on successes 
and opportunities for improvement; 
(H) a pregnancy child tax credit; and 
(I) establishing new incentives structures 
to improve maternal and child outcomes. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) The terms ‘‘Collaborative’’ and ‘‘State Preg-
nancy Collaborative’’ mean the Pregnancy Support 
Collaborative established under section 101. 
(2) The terms ‘‘pregnancy and parenting sup-
port and services’’ and ‘‘pregnancy or parenting sup-
port or services’’ refer to support or services, as ap-
plicable, offered during or after pregnancy to preg-
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nant women or new mothers in order to help such 
women to alleviate the physical, financial, social, 
emotional, and other difficulties that may be encoun-
tered during or after pregnancy, including the fol-
lowing: 
(A) Material assistance, including mater-
nity and baby clothing, diapers and wipes, food 
supporting a child’s nutrition, baby furniture, 
and car seats. 
(B) Housing for women and children. 
(C) Provision of information on available 
resources regarding pregnancy and childbirth, 
infant feeding, time management, parenting 
special needs children, and nutrition during and 
after pregnancy. 
(D) Referrals for secondary and postsec-
ondary education, including with respect to vo-
cational training and community college, job 
training and placement, housing, personal safe-
ty, food stamps, adoption, and other govern-
mental assistance. 
(E) Wrap-around health care and social 
support services for a woman carrying a child 
to term, and neonatal care services. 
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(F) Access to nutrition programs for preg-
nant women and mothers, including the pro-
gram under section 17 of the Child Nutrition 
Act of 1966 (42 U.S.C. 1786; commonly known 
as ‘‘WIC’’), the program under section 4 of the 
Food and Nutrition Act of 2008 (7 U.S.C. 
2013; commonly known as ‘‘SNAP’’), the con-
solidated block grants for Puerto Rico and 
American Samoa under section 19 of the Food 
and Nutrition Act of 2008 (7 U.S.C. 2028), 
and similar programs for the Commonwealth of 
the Northern Mariana Islands. 
(G) Legal services, including pro bono, to 
assist women who wish to give birth and par-
ents with newborn children. 
(H) Childcare services. 
(I) Pursuing collection of child support and 
alimony from uncooperative parents. 
(J) Services to assist parents— 
(i) to care for, and prepare to care 
for, a newborn, including a newborn with 
Down syndrome or another prenatally di-
agnosed condition or disability; and 
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(ii) to facilitate the adoption of such 
children according to the desire of the 
mother. 
(K) Life-skills mentoring, including to en-
hance the following competencies: 
(i) Strengthening capacities for fos-
tering long-term relationships with others. 
(ii) Communication and conflict man-
agement. 
(iii) Decision-making and relationship- 
building skills prior to marriage. 
(iv) High-risk behavior awareness. 
(L) Life-skills counseling. 
(M) 
Mammograms 
and 
services 
for 
postpartum depression treatment. 
(N) Provision of any of the services identi-
fied in subparagraphs (A) through (M) through 
pregnancy support centers. 
(3) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(4) The term ‘‘State’’ includes, in addition to 
the several States, the District of Columbia, and 
each territory or possession of the United States. 
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SEC. 4. APPLICABILITY OF CERTAIN PROVISIONS. 
Sections 506 and 507 of division A of the Further 
Consolidated Appropriations Act, 2020 (Public Law 116– 
94; 133 Stat. 2534, 2606–2607) apply with respect to any 
funds made available to carry out this Act to the same 
extent and in the same manner as such sections apply with 
respect to funds appropriated to carry out such division 
A. 
SEC. 5. RELIGIOUS AND MORAL OBJECTIONS. 
A provider, including a faith-based provider, that is 
otherwise eligible to be listed in the clearinghouse under 
section 102, or to receive assistance under this Act— 
(1) shall not be required, as a condition of such 
listing or receiving such assistance, to endorse, uti-
lize, make a referral to, become integrated with, or 
otherwise participate in any program or activity to 
which the provider has a religious or moral objec-
tion; and 
(2) shall not be discriminated against in the so-
licitation or issuance of grants, contracts, or cooper-
ative agreements under this Act for refusing to meet 
any requirement described in paragraph (1). 
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TITLE I—PREGNANCY AND PAR-
ENTING SUPPORT COLLABO-
RATIVE 
SEC. 101. ESTABLISHMENT. 
(a) IN GENERAL.—The Secretary shall establish 
within the Department of Health and Human Services a 
Federal-State collaborative, to be known as the Pregnancy 
Support Collaborative. 
(b) MEMBERSHIP.—The members of the Collabo-
rative shall consist of the following: 
(1) The Secretary (or the Secretary’s designee), 
who shall serve as the chair of the Collaborative. 
(2) The chief executive officer of each State 
that chooses to participate in the Collaborative (or 
the chief executive officer’s designee). 
(c) STAFF; SINGLE POINT OF CONTACT; FEDERAL 
EXPERTS.—The Secretary— 
(1) shall assign to the Collaborative such per-
sonnel as the Secretary determines appropriate to 
assist the Collaborative in carrying out its duties 
under this Act; 
(2) from among the personnel assigned pursu-
ant to paragraph (1), shall designate an Executive 
Director of the Collaborative; 
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(3) may request that Federal departments and 
agencies detail relevant experts to the Collaborative 
to assist the Collaborative in carrying out its duties 
under this Act; and 
(4) on an annual basis, shall publish a list of 
the members of the Collaborative. 
(d) TWO-THIRDS VOTE REQUIRED.—The Collabo-
rative may not take any action or make any recommenda-
tion or decision unless such action, decision, or rec-
ommendation is authorized by a vote of at least two-thirds 
of the members of the Collaborative. 
(e) RESPONSIBILITIES.—The Collaborative shall— 
(1) work with States and localities to learn 
about existing successful models for pregnancy and 
parenting support and services; 
(2) on an annual basis, submit a report to the 
Congress— 
(A) describing the activities of the Collabo-
rative, the funds expended on such activities, 
and the results achieved through such activities; 
and 
(B) recommending— 
(i) how to fill gaps experienced by 
women who have benefited from pregnancy 
and parenting support and services; and 
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(ii) how to maintain and expand Fed-
eral funding levels for pregnancy and par-
enting support and services; 
(3) develop and maintain the Pregnant and 
Parenting Women’s Care Information Service, in ac-
cordance with section 102; 
(4) provide educational support in accordance 
with section 103; 
(5) provide for a toll-free number in accordance 
with section 104; 
(6) conduct an annual review of nationwide suc-
cessful models in accordance with section 105; and 
(7) recognize successful workplace policies and 
practices in accordance with section 106. 
(f) AVOIDING DUPLICATION OF EFFORT.—The Col-
laborative shall, where possible, avoid duplicating the pro-
grams and activities of other entities. 
SEC. 102. PREGNANT AND PARENTING WOMEN’S CARE IN-
FORMATION SERVICE. 
(a) IN GENERAL.—The Collaborative shall develop 
and maintain a comprehensive, publicly accessible, and 
user-friendly clearinghouse to be known as the Pregnant 
and Parenting Women’s Care Information Service (in this 
section referred to as the ‘‘clearinghouse’’) to serve as a 
consolidated source of information on qualified public and 
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private service providers that provide pregnancy and par-
enting support and services, including in low-income, 
urban, suburban, and rural areas. 
(b) IDENTIFICATION OF PROVIDERS, SUPPORT, AND 
SERVICES.—The Collaborative— 
(1) shall request that each State identify, and 
enter into a template provided by the Collaborative, 
each provider, support, and service in the State to 
be included in the clearinghouse; and 
(2) shall not include in the clearinghouse any 
provider, support, or service in a State unless the 
State involved has requested pursuant to paragraph 
(1) (and not withdrawn its request) to include such 
provider, support, or service in the clearinghouse. 
(c) QUALIFIED PROVIDERS.—For a provider to be 
qualified to be listed in the clearinghouse— 
(1) the provider shall have been engaged in pro-
viding pregnancy or parenting support or services 
for mothers and infants for a minimum of 3 con-
secutive years; and 
(2) pregnancy support or services for mothers 
and infants shall be the primary focus of the pro-
vider’s work. 
(d) INPUT.—In developing and maintaining the clear-
inghouse, the Collaborative shall seek the input of— 
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(1) qualified experts involved in providing preg-
nancy and parenting support and services; and 
(2) relevant State officials. 
(e) CONTENTS.—Subject to subsections (b)(2) and 
(c), the clearinghouse shall include each of the following: 
(1) A complete list of Federal, State, and local 
programs that provide pregnancy and parenting sup-
port and services. 
(2) A rating system that allows clients to rate 
qualified providers of pregnancy and parenting sup-
port and services after receiving such services. 
(3) Information on qualified providers of preg-
nancy and parenting resources, including— 
(A) contact information; 
(B) years in service; 
(C) qualifications; 
(D) references; 
(E) women’s ratings under the system 
under paragraph (2); and 
(F) links to the providers’ websites. 
(4) Information on the education and training 
opportunities identified pursuant to section 103. 
SEC. 103. EDUCATION AND TRAINING SUPPORT. 
(a) IN GENERAL.—The Collaborative, in collabora-
tion with State and local governments, shall— 
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(1) identify, assess, and increase understanding 
and awareness of— 
(A) appropriate education and training op-
portunities to ensure that women have access to 
all available programs, funding, and support to 
maximize their employment opportunities; and 
(B) specific supports and services for 
women during pregnancy, nursing, and child- 
rearing; and 
(2) direct individuals to information on such op-
portunities, and such supports and services, in a 
manner that is geographically relevant. 
(b) SUPPORT
FOR STUDENTS.—The Collaborative 
shall work with secondary schools, institutions of higher 
education, and other entities providing education or job 
training to maximize support within the learning setting, 
including with respect to— 
(1) childcare services, family housing, health in-
surance (for students and their families), flexible 
academic scheduling (such as telecommuting pro-
grams), parenting classes and programs, and 
postpartum counseling and support groups; 
(2) 
access 
to 
locations 
designated 
for 
breastfeeding within the learning setting; 
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(3) identifying scholarships, financial and in- 
kind resources, grants, and loans for which such stu-
dents may be eligible; 
(4) job placement and apprenticeship; 
(5) working with employers to optimize work 
site support for child care and breastfeeding, trans-
portation, or other services to assist a mother to 
achieve successful employment; and 
(6) options for tele-education. 
(c) PROVISION OF INFORMATION.—As a condition on 
receipt of Federal funds for providing education or job 
training, an entity shall agree to provide to the Collabo-
rative such information as the Collaborative may request 
on education and training opportunities for purposes of 
carrying out subsections (a) and (b). 
SEC. 104. TOLL-FREE NUMBER. 
If approved by a vote of at least two-thirds of the 
members of the Collaborative, as described in section 
101(d), the Collaborative shall enter into a contract, 
through the use of competitive procedures, with an entity 
to establish and operate a toll-free number to provide 
women with referrals for obtaining pregnancy and par-
enting support and services, including services to support 
mental and emotional health. 
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SEC. 105. ANNUAL REVIEW OF SUCCESSFUL MODELS. 
(a) ANNUAL REVIEW.—The Collaborative shall con-
duct an annual review of nationwide successful models in 
women’s pregnancy and parenting support and services. 
(b) INPUT.—In conducting each annual review under 
subsection (a), the Collaborative shall— 
(1) gather input from qualified providers listed 
in the clearinghouse under section 102 and qualified 
experts referred to in section 102(d), including such 
providers and experts from— 
(A) State and local governments; 
(B) the private and faith-based sectors; 
(C) prenatal and parenting care centers; 
and 
(D) other qualified providers; and 
(2) in gathering such input, encourage such 
qualified providers and experts— 
(A) to share information on successful 
models in pregnancy and parenting support and 
services; and 
(B) to identify and address— 
(i) key burdens or adverse cir-
cumstances facing pregnant women; and 
(ii) the challenges for providers. 
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SEC. 106. RECOGNIZING SUCCESSFUL WORKPLACE POLI-
CIES AND PRACTICES. 
(a) IN GENERAL.—The Collaborative shall— 
(1) recognize employers that successfully imple-
ment innovative policies and practices to meet the 
needs of pregnant and parenting employees with re-
spect to children below school age; 
(2) make recommendations regarding such in-
novative policies and practices; and 
(3) publicize such policies and practices that 
prove to be successful. 
(b) POLICIES AND PRACTICES.—The innovative poli-
cies and practices referred to in subsection (a) may in-
clude— 
(1) family friendly policies proposed by both 
employees and the employer; 
(2) childcare facilities; 
(3) family cafeterias and separate areas for 
those who do not have children and may prefer not 
to eat with other families; 
(4) small employer family leave policies not cov-
ered by the Family and Medical Leave Act of 1993 
(29 U.S.C. 2601 et seq.); 
(5) paid family leave policies for larger employ-
ers with a sliding scale for medium-sized companies; 
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(6) rooms set aside for mothers to breastfeed in 
comfort, with refrigerators for the storage of breast 
milk; 
(7) telecommuting and flexible work schedules 
for jobs that do not require being on-site, and meet-
ing times set for the convenience of caregivers, im-
plemented in a manner that is not at the expense of 
traditional full-time employees; and 
(8) establishment of a committee comprised of 
employers, human resource staff, and employees at 
all levels to discuss matters related to employer sup-
port for employees who are pregnant or parenting. 
SEC. 107. PUBLIC HEALTH SERVICE ACT PROGRAMS. 
(a) SAFE MOTHERHOOD.—Section 317K of the Pub-
lic Health Service Act (42 U.S.C. 247b–12) is amended— 
(1) in subsection (a)(2), by adding at the end 
the following: 
‘‘(E) Assessment of the role of the State 
Pregnancy Collaborative in— 
‘‘(i) improving perinatal outcomes, in-
cluding maternal and infant morbidity and 
mortality; and 
‘‘(ii) data collection for the community 
shared savings accounts under section 
203(c) of the Care for Her Act.’’; 
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(2) in subsection (b)(2)— 
(A) in subparagraph (L), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (M), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(N) the prevention role of the State Preg-
nancy Collaborative for mothers and children 
based on the support of the whole community.’’; 
(3) by amending subsection (c)(3) to read as 
follows: 
‘‘(3) activities to promote community support 
services for pregnant women, including providers 
listed in the clearinghouse of the State Pregnancy 
Collaborative under section 102 of the Care for Her 
Act; and’’; and 
(4) in subsection (e), by adding at the end the 
following: 
‘‘(4) The term ‘State Pregnancy Collaborative’ 
has the meaning given to that term in section 3 of 
the Care for Her Act.’’. 
(b) INFANT MORTALITY GRANTS.—Section 330(f) of 
the Public Health Service Act (42 U.S.C. 254b(f)) is 
amended— 
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(1) in the matter before subparagraph (A) in 
paragraph (1), by striking ‘‘health centers’’ each 
place it appears and inserting ‘‘health centers and 
providers listed in the clearinghouse of the State 
Pregnancy Collaborative under section 102 of the 
Care for Her Act (in this subsection referred to as 
‘listed providers’)’’; 
(2) except in the matter before subparagraph 
(A) in paragraph (1), by striking ‘‘health centers’’ 
each place it appears and inserting ‘‘health centers 
and listed providers’’; 
(3) by striking ‘‘such centers’’ each place it ap-
pears and inserting ‘‘such centers and providers’’; 
(4) by striking ‘‘the health center’’ each place 
it appears and inserting ‘‘the health center or listed 
provider’’; 
(5) by striking ‘‘the center’’ each place it ap-
pears and inserting ‘‘the center or listed provider’’; 
and 
(6) in paragraph (2)— 
(A) by striking ‘‘shall give priority to 
health centers’’ and inserting ‘‘shall give pri-
ority to— 
‘‘(A) health centers’’; 
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(B) by striking the period at the end and 
inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(B) listed providers that offer support 
services for a mother and infant as a known 
benefit for improving pregnancy outcomes.’’. 
(c) CERTAIN SERVICES FOR PREGNANT WOMEN.— 
Section 330F(a)(1) of the Public Health Service Act (42 
U.S.C. 254c–6(a)(1)) is amended by striking ‘‘to train the 
designated staff of eligible health centers’’ and inserting 
‘‘to train the designated staff of eligible health centers and 
providers listed in the clearinghouse of the State Preg-
nancy Collaborative under section 102 of the Care for Her 
Act’’. 
(d) PROJECTS TO IMPROVE MATERNAL, INFANT, 
AND CHILD HEALTH.— 
(1) IN
GENERAL.—Section 399(a)(1) of the 
Public Health Service Act (42 U.S.C. 280c–6(a)(1)) 
is amended by striking ‘‘shall make grants to eligible 
entities to pay the Federal share of the cost of pro-
viding’’ and inserting ‘‘shall make grants to eligible 
entities, including providers listed in the clearing-
house of the State Pregnancy Collaborative under 
section 102 of the Care for Her Act, to pay the Fed-
eral share of the cost of providing’’. 
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(2) REQUIREMENT
OF
STATUS
AS
MEDICAID 
PROVIDER.—Section 399(a)(3) of the Public Health 
Service Act (42 U.S.C. 280c–6(a)(3)) is amended by 
inserting after ‘‘only if, in the case of any service 
under such paragraph that is covered in the State 
plan approved under title XIX of the Social Security 
Act for the State involved’’ the following: ‘‘, the 
State plan includes providers listed in the clearing-
house of the State Pregnancy Collaborative under 
section 102 of the Care for Her Act, and’’. 
(3) HOME
VISITING
SERVICES
FOR
ELIGIBLE 
FAMILIES.—The matter before paragraph (1) is sec-
tion 399(b) of the Public Health Service Act (42 
U.S.C. 280c–6(b)) is amended by inserting after 
‘‘directly or through arrangement with other public 
or nonprofit private entities,’’ the following: ‘‘includ-
ing providers listed in the clearinghouse of the State 
Pregnancy Collaborative under section 102 of the 
Care for Her Act,’’. 
TITLE II—DEPARTMENT OF 
HEALTH AND HUMAN SERVICES 
SEC. 201. PREGNANCY AND PARENTING SUPPORT AND 
SERVICES. 
(a) 
HEALTHY
BIRTH
AND
HEALTHY
LIFE 
GRANTS.— 
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(1) IN GENERAL.—The Secretary, with the ap-
proval of the Collaborative, may award grants to 
qualified providers listed in the clearinghouse under 
section 102 to provide pregnancy and parenting sup-
port and services. 
(2) SUPPLEMENT, NOT SUPPLANT.—The Sec-
retary may award a grant to a qualified provider 
under this subsection only if the qualified provider 
agrees that the grant will be used to supplement, 
and not supplant, pregnancy and parenting support 
and services. 
(b) MENTORSHIP AND JOB TRAINING GRANTS.—The 
Secretary, with the approval of the Collaborative, shall 
award grants to qualified providers listed in the clearing-
house under section 102 for the exclusive purpose of pro-
viding mentorships or job training to pregnant women and 
new mothers. 
SEC. 202. HOUSING. 
(a) IDENTIFICATION OF GAPS.—The Secretary, with 
the approval of the Collaborative, shall identify gaps in 
maternity housing within rural and urban communities. 
(b) GRANTS.—The Secretary, with approval of the 
Collaborative, shall award grants to qualified public and 
private service providers listed in the clearinghouse under 
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section 102 for addressing gaps in maternity housing iden-
tified pursuant to subsection (a). 
SEC. 203. ASSESSING OUTCOMES AND APPLYING OPTIMAL 
INCENTIVES TO IMPROVE MATERNAL AND 
CHILD HEALTH OUTCOMES. 
(a) MAKING EPIDEMIOLOGY AND HEALTH ENCOUN-
TER DATA RELEVANT TO MATERNAL CHILD HEALTH IM-
PROVEMENT.—Beginning not later than April 1, 2022, the 
Secretary, acting through the Director of the Centers for 
Disease Control and Prevention in collaboration with the 
Administrator of the Centers for Medicare & Medicaid 
Services, in conjunction with local programs supporting 
pregnant women, shall provide for the maintenance of a 
database of deidentified epidemiological and claims health 
information for the purpose of making such information 
available in a useful and informative manner to partici-
pating communities in participating States to assess the 
outcome impact of maternity homes in improving preg-
nancy outcomes and reducing maternal mortality; and im-
proving infant mortality including reduction of preterm 
deliveries, and low-birth-rate incidence. In carrying out 
this subsection, the Secretary shall provide— 
(1) for a mechanism that enables the integra-
tion of such epidemiological and claims health infor-
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mation within the Medicaid program under title XIX 
of the Social Security Act (42 U.S.C. 1396 et seq.); 
(2) that pregnancy and newborns will be as-
sessed based on clinical outcomes and costs related 
to the Medicaid program under title XIX of the So-
cial Security Act (42 U.S.C. 1396 et seq.); 
(3) that such epidemiological and claims health 
information is made available to participating States 
in a manner that enables participating communities 
within such States to access such information that 
is relevant to improving maternal child health out-
comes in such communities; and 
(4) for a mechanism by which the Secretary, 
working in collaboration with the Governor of the re-
spective State of each participating community, 
may— 
(A) update such information specific to 
each participating community, to the extent 
practicable, in real-time or near real-time and 
as specified by the Secretary; 
(B) verify the validity of such information 
and the validity of the changes in such informa-
tion for each such participating community over 
a specified period; and 
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(C) assess and measure the extent of such 
changes for each participating community, in-
cluding— 
(i) the amount of any reductions in 
expenditures under the State plan under 
the Medicaid program under title XIX of 
the Social Security Act (42 U.S.C. 1396 et 
seq.); and 
(ii) the extent to which such reduc-
tions are attributable to such changes with 
respect to each participating community. 
(b) LOCALIZED COMMUNITY HEALTH IMPROVEMENT 
PROGRAM GRANTS.— 
(1) IN
GENERAL.—The Collaborative shall 
award grants to States for purposes of carrying out 
localized community health improvement programs 
described in paragraph (3). 
(2) APPLICATION.—To be eligible for a grant 
under this subsection, a State shall— 
(A) submit to the Collaborative an applica-
tion in such manner, at such time, and con-
taining such information as specified by the 
Collaborative; and 
(B) enter into an arrangement with the 
Collaborative under which— 
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(i) the State agrees to establish and 
maintain a localized community health im-
provement program described in paragraph 
(3); 
(ii) the Collaborative agrees to provide 
the State with integrated epidemiological 
and claims health information maintained 
in the database established under sub-
section (a) specific to each participating 
community within the State; 
(iii) the State and each participating 
community in the State will assess the im-
pact of the localized community health im-
provement program on outcomes, including 
reductions in cost to the Medicaid program 
under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.); 
(iv) each participating community in 
the State has a community shared savings 
board that will establish and maintain a 
community shared savings account in ac-
cordance with subsection (c), including the 
terms listed in subsection (c)(2); 
(v) 70 percent of savings from health 
improvements and cost reductions will be 
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verified by the Collaborative and trans-
ferred to the community shared savings ac-
count of the respective participating com-
munities in accordance with subsection 
(c)(2)(A); and 
(vi) savings in a community shared 
savings account will be used for pregnancy 
and parenting support and services. 
(3) LOCALIZED COMMUNITY HEALTH IMPROVE-
MENT PROGRAM.—For purposes of this section, a lo-
calized community health improvement program of a 
State is a program under which the State— 
(A) maintains the integrated health infor-
mation provided to the State by the Collabo-
rative pursuant to the arrangement described in 
paragraph (2)(B); 
(B) makes such information available to 
qualifying communities (as defined in para-
graph (4)) within such State which request 
such information and agree to the terms de-
scribed in subsection (c), in a secure manner 
and format that is most informative to such 
communities in assisting such communities in 
analyzing and applying such data to the specific 
needs of such communities to reduce the rates 
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(1) IN GENERAL.—For purposes of this section, 
a community shared savings account shall, with re-
spect to a participating community within a partici-
pating State, be a trust created or organized in the 
United States for the exclusive benefit of the com-
munity, as defined by the community shared savings 
board for such participating community, but only if 
the written governing instrument creating the trust 
meets the following requirements: 
(A) The trustee is— 
(i) a bank (as defined in section 
408(n) of the Internal Revenue Code of 
1986 (26 U.S.C. 408(n)); or 
(ii) a person who demonstrates to the 
satisfaction of the State that the manner 
in which such person will administer the 
trust will be consistent with the require-
ments of this section. 
(B) Withdrawals may only be made by the 
fiduciary agent referred to in paragraph (3)(C) 
pursuant to a plan— 
(i) developed by the community; and 
(ii) approved by the State and local 
governments. 
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(2) 
TERMS.—For 
purposes 
of 
subsection 
(b)(2)(B)(iv), the terms described in this subsection, 
with respect to the Collaborative, a participating 
State, and participating communities within such 
State, are the following: 
(A) In the case that the database main-
tained under subsection (a), through the mecha-
nism provided for under subsection (a)(4), dem-
onstrates for any specified period (as deter-
mined by the Collaborative) that there are 
verified reductions in expenditures under the 
State plan under title XIX of the Social Secu-
rity Act (42 U.S.C. 1396 et seq.), which results 
in reductions in expenditures by the Federal 
Government under such title, and attributes 
such reductions to one or more of the partici-
pating communities within such State, the Col-
laborative shall transfer to the community 
shared savings account established pursuant to 
subparagraph (B) an amount equal to 70 per-
cent of the amount of such reduction so dem-
onstrated for such specified period. 
(B) The respective community shared sav-
ings board establishes such a community shared 
savings account in accordance with paragraph 
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(1) for receipt of amounts transferred pursuant 
to subparagraph (A). 
(C) Each participating community in such 
State shall— 
(i) establish a community shared sav-
ings board described in paragraph (3) that 
determines how funds transferred to such 
community under subparagraph (A) are to 
be used for purposes of promoting the 
health and wellness of pregnant women, 
new mothers, and their children of such 
community; and 
(ii) uses such funds only for such pur-
poses and in accordance with the uses de-
termined by such board. 
(3) COMMUNITY SHARED SAVINGS BOARD.—For 
purposes of this section, a community shared savings 
board, with respect to a participating community 
within a participating State, shall be a board— 
(A) consisting of at least 7 members, ap-
pointed by the governing officials of the com-
munity through a process that is specified by 
the community (and approved by the State), in-
cluding— 
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(i) at least 1 member with public 
health experience; and 
(ii) members with business, civic, edu-
cational, or faith-based experience; 
(B) that is representative of the geographic 
components that are included in the commu-
nity; and 
(C) that hires a fiduciary agent to manage 
a community shared savings account on behalf 
of the board. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘community shared savings ac-
count’’ means a community shared savings account 
meeting the criteria in subsection (c)(1). 
(2) The term ‘‘community shared savings 
board’’ means a community shared savings board 
meeting the criteria of subsection (c)(4). 
(3) The term ‘‘participating community’’ means 
a qualifying community that enters into an agree-
ment with a participating State as described in sub-
section (b)(3)(B). 
(4) The term ‘‘participating State’’ means a 
State receiving a grant under subsection (b)(1). 
(5) The term ‘‘qualifying community’’ means a 
local community— 
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(A) that has the capacity to assess health 
data, including epidemiology and health encoun-
ter data, for a census track or block that can 
be extrapolated into a geographic information 
system to support analysis of health outcomes; 
and 
(B) 
whose 
geographic 
boundary 
cor-
responds to the boundary of— 
(i) a municipality; 
(ii) a county; or 
(iii) a high school feeder pattern. 
TITLE III—INTERNAL REVENUE 
SERVICE 
SEC. 301. CHILD TAX CREDIT IMPROVEMENTS. 
(a) IN GENERAL.—Section 24(c)(1) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following new sentence: ‘‘Such term shall include a 
child of an eligible taxpayer for the taxable year imme-
diately preceding the year in which such child is born, if 
such child is born alive on or before the due date of the 
return of tax for such taxable year (not including exten-
sions)’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
December 31, 2020. 
Æ 
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