793 
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; 
‘‘(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 inequities 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 not exceed 5 years. 
‘‘(f) APPLICATION.—To seek a grant under this sec-
tion, an entity shall submit to the Secretary an application 
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794 
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 
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 
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795 
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-
cial and ethnic inequities 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.’’. 
(c) GRANTS TO GROW AND DIVERSIFY THE NURSING 
WORKFORCE IN MATERNAL AND PERINATAL HEALTH.— 
Title VIII of the Public Health Service Act is amended 
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. 
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796 
‘‘(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 
‘‘(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 inequities in maternal 
health outcomes, to the extent practicable; and 
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797 
‘‘(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 
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 inequities 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. 
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798 
‘‘(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 
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 
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799 
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 
‘‘(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 inequities 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.’’. 
(d) GAO REPORT.— 
(1) IN GENERAL.—Not later than 2 years after 
the date of enactment of this Act, and every 5 years 
thereafter, 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 in-
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800 
formation and recommendations described in para-
graph (2). 
(2) CONTENT OF REPORT.—The report under 
paragraph (1) shall include— 
(A) an assessment of current barriers to 
entering accredited midwifery education pro-
grams, and recommendations for addressing 
such barriers, particularly for low-income people 
and people from racial and ethnic minority 
groups; 
(B) an assessment of current barriers to 
entering and successfully completing accredited 
education programs for other health profes-
sional careers related to maternity care, includ-
ing maternity care providers, mental and behav-
ioral health care providers acting in accordance 
with State law, registered 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 lactation consult-
ants certified by the International Board of 
Lactation Consultants Examiners, particularly 
for low-income people and people from racial 
and ethnic minority groups; 
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801 
(C) an assessment of current barriers that 
prevent midwives from meeting the inter-
national definition of the midwife and global 
standards for midwifery education as estab-
lished by the International Confederation of 
Midwives, and recommendations for addressing 
such barriers, particularly for low-income people 
and people from racial and ethnic minority 
groups; 
(D) an assessment of inequities in access 
to maternity care providers, mental or behav-
ioral health care providers acting in accordance 
with State law, registered 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))), lactation consultants 
certified by the International Board of Lacta-
tion Consultants Examiners, and perinatal 
health workers, stratified by race, ethnicity, 
gender identity, geographic location, and insur-
ance type and recommendations to promote 
greater access equity; and 
(E) recommendations to promote greater 
equity in compensation for perinatal health 
workers under public and private insurers, par-
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802 
ticularly for such individuals from racially and 
ethnically diverse backgrounds. 
(e) DEFINITIONS.—In this section: 
(1) CULTURALLY CONGRUENT.—The term ‘‘cul-
turally congruent’’, with respect to care or maternity 
care, means care that is in agreement with the pre-
ferred cultural values, beliefs, worldview, language, 
and practices of the health care consumer and other 
stakeholders. 
(2) MATERNITY
CARE
PROVIDER.—The term 
‘‘maternity care provider’’ means a health care pro-
vider who— 
(A) is a physician, physician assistant, 
midwife who meets at a minimum the inter-
national definition of the midwife and global 
standards for midwifery education as estab-
lished by the International Confederation of 
Midwives, nurse practitioner, or clinical nurse 
specialist; and 
(B) has a focus on maternal or perinatal 
health. 
(3) PERINATAL HEALTH WORKER.—The term 
‘‘perinatal health worker’’ means a doula, commu-
nity health worker, peer supporter, breastfeeding 
and lactation educator or counselor, nutritionist or 
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803 
dietitian, childbirth educator, social worker, home 
visitor, language interpreter, or navigator. 
(4) POSTPARTUM AND POSTPARTUM PERIOD.— 
The terms ‘‘postpartum’’ and ‘‘postpartum period’’ 
refer to the 1-year period beginning on the last day 
of the pregnancy of an individual. 
(5) RACIAL AND ETHNIC MINORITY GROUP.— 
The term ‘‘racial and ethnic minority group’’ has the 
meaning given such term in section 1707(g)(1) of 
the Public Health Service Act (42 U.S.C. 300u– 
6(g)(1)). 
SEC. 5214. MIDWIVES SCHOOLS AND PROGRAMS EXPAN-
SION. 
(a) MIDWIFERY SCHOOLS AND PROGRAMS.— 
(1) IN
GENERAL.—Title VII of the Public 
Health Service Act is amended by inserting after 
section 760 of such Act (42 U.S.C. 294k) the fol-
lowing: 
‘‘SEC. 760A. MIDWIFERY SCHOOLS AND PROGRAMS. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to institutions of higher education (as defined in sub-
sections (a) and (b) of section 101 of the Higher Edu-
cation Act of 1965) for the following: 
‘‘(1) Direct support of students in an accredited 
midwifery school or program. 
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804 
‘‘(2) Establishment or expansion of an accred-
ited midwifery school or program. 
‘‘(3) Securing, preparing, or providing support 
for increasing the number of, qualified preceptors 
for training the students of an accredited midwifery 
school or program. 
‘‘(b) 
SPECIAL
CONSIDERATIONS.—In 
awarding 
grants under subsection (a), the Secretary shall give spe-
cial consideration to any institution of higher education 
that— 
‘‘(1) agrees to prioritize students who plan to 
practice in a health professional shortage area des-
ignated under section 332; and 
‘‘(2) demonstrates a focus on increasing racial 
and ethnic minority representation in midwifery edu-
cation. 
‘‘(c) RESTRICTION.—The Secretary shall not provide 
any assistance under this section to be used with respect 
to a midwifery school or program within a school of nurs-
ing (as defined in section 801). 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—There is authorized to be 
appropriated to carry out this section $15,000,000 
for the period of fiscal years 2023 through 2027. 
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805 
‘‘(2) ALLOCATION.—Of the amounts made 
available to carry out this section for any fiscal year, 
the Secretary shall use— 
‘‘(A) 50 percent to award grants for pur-
poses specified in subsection (a)(1); 
‘‘(B) 25 percent to award grants for pur-
poses specified in subsection (a)(2); and 
‘‘(C) 25 percent to award grants for pur-
poses specified in subsection (a)(3).’’. 
(2) DEFINITIONS.— 
(A) MIDWIFERY SCHOOL OR PROGRAM.— 
Section 799B(1)(A) of the Public Health Serv-
ice Act (42 U.S.C. 295p(1)(A)) is amended— 
(i) by inserting ‘‘ ‘midwifery school or 
program’,’’ before ‘‘and ‘school of chiro-
practic’ ’’; 
(ii) by inserting ‘‘a degree or certifi-
cate in midwifery or an equivalent degree 
or certificate,’’ before ‘‘and a degree of 
doctor of chiropractic or an equivalent de-
gree’’; and 
(iii) by striking ‘‘any such school’’ and 
inserting ‘‘any such school or program’’. 
(B) ACCREDITED.—Section 799B(1)(E) of 
the Public Health Service Act (42 U.S.C. 
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806 
295p(1)(E)) is amended by inserting ‘‘or a mid-
wifery school or program,’’ before ‘‘or a grad-
uate program in health administration’’. 
(b) NURSE-MIDWIVES.—Title VIII of the Public 
Health Service Act, as amended by section 5213, is fur-
ther amended by inserting after section 812 of that Act, 
as added by section 5213, the following: 
‘‘SEC. 812A. MIDWIFERY EXPANSION PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to schools of nursing for the following: 
‘‘(1) Direct support of students in an accredited 
nurse-midwifery school or program. 
‘‘(2) Establishment or expansion of an accred-
ited nurse-midwifery school or program. 
‘‘(3) Securing, preparing, or providing support 
for increasing the numbers of, preceptors at clinical 
training sites to precept students training to become 
certified nurse-midwives. 
‘‘(b) 
SPECIAL
CONSIDERATIONS.—In 
awarding 
grants under subsection (a), the Secretary shall give spe-
cial consideration to any school of nursing that— 
‘‘(1) agrees to prioritize students who choose to 
pursue an advanced education degree in nurse-mid-
wifery to practice in a health professional shortage 
area designated under section 332; and 
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807 
‘‘(2) demonstrates a focus on increasing racial 
and ethnic minority representation in nurse-mid-
wifery education. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there is authorized to be appropriated $20,000,000 
for the period of fiscal years 2023 through 2027. 
‘‘(2) ALLOCATION.—Of the amounts made 
available to carry out this section for any fiscal year, 
the Secretary shall use— 
‘‘(A) 50 percent to award grants for pur-
poses specified in subsection (a)(1); 
‘‘(B) 25 percent to award grants for pur-
poses specified in subsection (a)(2); and 
‘‘(C) 25 percent to award grants for pur-
poses specified in subsection (a)(3).’’. 
SEC. 5215. GESTATIONAL DIABETES. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by adding after section 
317H the following: 
‘‘SEC. 317H–1. GESTATIONAL DIABETES. 
‘‘(a) UNDERSTANDING
AND MONITORING GESTA-
TIONAL DIABETES.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
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808 
Control and Prevention, in consultation with the Di-
abetes Mellitus Interagency Coordinating Committee 
established under section 429 and representatives of 
appropriate national health organizations, shall de-
velop a multisite gestational diabetes research 
project within the diabetes program of the Centers 
for Disease Control and Prevention to expand and 
enhance surveillance data and public health research 
on gestational diabetes. 
‘‘(2) AREAS TO BE ADDRESSED.—The research 
project developed under paragraph (1) shall ad-
dress— 
‘‘(A) procedures to establish accurate and 
efficient systems for the collection of gestational 
diabetes data within each State and common-
wealth, territory, or possession of the United 
States; 
‘‘(B) the progress of collaborative activities 
with the National Vital Statistics System, the 
National Center for Health Statistics, and 
State health departments with respect to the 
standard birth certificate, in order to improve 
surveillance of gestational diabetes; 
‘‘(C) postpartum methods of tracking indi-
viduals with gestational diabetes after delivery 
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809 
as well as targeted interventions proven to 
lower the incidence of type 2 diabetes in that 
population; 
‘‘(D) variations in the distribution of diag-
nosed and undiagnosed gestational diabetes, 
and of impaired fasting glucose tolerance and 
impaired fasting glucose, within and among 
groups of pregnant individuals; and 
‘‘(E) factors and culturally sensitive inter-
ventions that influence risks and reduce the in-
cidence of gestational diabetes and related com-
plications during childbirth, including cultural, 
behavioral, racial, ethnic, geographic, demo-
graphic, socioeconomic, and genetic factors. 
‘‘(3) REPORT.—Not later than 2 years after the 
date of the enactment of this section, and annually 
thereafter, the Secretary shall generate a report on 
the findings and recommendations of the research 
project including prevalence of gestational diabetes 
in the multisite area and disseminate the report to 
the appropriate Federal and non-Federal agencies. 
‘‘(b) EXPANSION OF GESTATIONAL DIABETES RE-
SEARCH.— 
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810 
‘‘(1) IN GENERAL.—The Secretary shall expand 
and intensify public health research regarding gesta-
tional diabetes. Such research may include— 
‘‘(A) developing and testing novel ap-
proaches for improving postpartum diabetes 
testing or screening and for preventing type 2 
diabetes in individuals who can become preg-
nant with a history of gestational diabetes; and 
‘‘(B) conducting public health research to 
further understanding of the epidemiologic, 
socioenvironmental, behavioral, translation, and 
biomedical factors and health systems that in-
fluence the risk of gestational diabetes and the 
development of type 2 diabetes in individuals 
who can become pregnant with a history of ges-
tational diabetes. 
‘‘(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection $5,000,000 for each of fiscal years 
2023 through 2027. 
‘‘(c) DEMONSTRATION GRANTS TO LOWER
THE 
RATE OF GESTATIONAL DIABETES.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall award grants, on a 
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811 
competitive basis, to eligible entities for demonstra-
tion projects that implement evidence-based inter-
ventions to reduce the incidence of gestational diabe-
tes, the recurrence of gestational diabetes in subse-
quent pregnancies, and the development of type 2 di-
abetes in individuals who can become pregnant with 
a history of gestational diabetes. 
‘‘(2) PRIORITY.—In making grants under this 
subsection, the Secretary shall give priority to 
projects focusing on— 
‘‘(A) helping individuals who can become 
pregnant who have 1 or more risk factors for 
developing gestational diabetes; 
‘‘(B) working with individuals who can be-
come pregnant with a history of gestational dia-
betes during a previous pregnancy; 
‘‘(C) providing postpartum care for indi-
viduals who can become pregnant with gesta-
tional diabetes; 
‘‘(D) tracking cases where individuals who 
can become pregnant with a history of gesta-
tional diabetes developed type 2 diabetes; 
‘‘(E) educating mothers with a history of 
gestational diabetes about the increased risk of 
their child developing diabetes; 
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812 
‘‘(F) working to prevent gestational diabe-
tes and prevent or delay the development of 
type 2 diabetes in individuals who can become 
pregnant with a history of gestational diabetes; 
and 
‘‘(G) achieving outcomes designed to assess 
the efficacy and cost-effectiveness of interven-
tions that can inform decisions on long-term 
sustainability, including third-party reimburse-
ment. 
‘‘(3) APPLICATION.—An eligible entity desiring 
to receive a grant under this subsection shall submit 
to the Secretary— 
‘‘(A) an application at such time, in such 
manner, and containing such information as the 
Secretary may require; and 
‘‘(B) a plan to— 
‘‘(i) lower the rate of gestational dia-
betes during pregnancy; or 
‘‘(ii) develop methods of tracking indi-
viduals who can become pregnant with a 
history of gestational diabetes and develop 
effective interventions to lower the inci-
dence of the recurrence of gestational dia-
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813 
betes in subsequent pregnancies and the 
development of type 2 diabetes. 
‘‘(4) USES OF FUNDS.—An eligible entity re-
ceiving a grant under this subsection shall use the 
grant funds to carry out demonstration projects de-
scribed in paragraph (1), including— 
‘‘(A) expanding community-based health 
promotion education, activities, and incentives 
focused on the prevention of gestational diabe-
tes and development of type 2 diabetes in indi-
viduals who can become pregnant with a history 
of gestational diabetes; 
‘‘(B) aiding State- and Tribal-based diabe-
tes prevention and control programs to collect, 
analyze, disseminate, and report surveillance 
data on individuals who can become pregnant 
with, and at risk for, gestational diabetes, the 
recurrence of gestational diabetes in subsequent 
pregnancies, and, for individuals who can be-
come pregnant with a history of gestational dia-
betes, the development of type 2 diabetes; and 
‘‘(C) training and encouraging health care 
providers— 
‘‘(i) to promote risk assessment, high- 
quality care, and self-management for ges-
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tational diabetes and the recurrence of ges-
tational diabetes in subsequent preg-
nancies; and 
‘‘(ii) to prevent the development of 
type 2 diabetes in individuals who can be-
come pregnant with a history of gesta-
tional diabetes, and its complications in the 
practice settings of the health care pro-
viders. 
‘‘(5) REPORT.—Not later than 4 years after the 
date of the enactment of this section, the Secretary 
shall prepare and submit to the Congress a report 
concerning the results of the demonstration projects 
conducted through the grants awarded under this 
subsection. 
‘‘(6) DEFINITION
OF
ELIGIBLE
ENTITY.—In 
this subsection, the term ‘eligible entity’ means a 
nonprofit organization (such as a nonprofit academic 
center or community health center) or a State, Trib-
al, or local health agency. 
‘‘(7) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection $5,000,000 for each of fiscal years 
2023 through 2027. 
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815 
‘‘(d) POSTPARTUM FOLLOWUP REGARDING GESTA-
TIONAL DIABETES.—The Secretary, acting through the 
Director of the Centers for Disease Control and Preven-
tion, shall work with the State- and Tribal-based diabetes 
prevention and control programs assisted by the Centers 
to encourage postpartum followup after gestational diabe-
tes, as medically appropriate, for the purpose of reducing 
the incidence of gestational diabetes, the recurrence of 
gestational diabetes in subsequent pregnancies, the devel-
opment of type 2 diabetes in individuals with a history 
of gestational diabetes, and related complications.’’. 
SEC. 5216. CONSUMER EDUCATION CAMPAIGN. 
Section 229(b) of the Public Health Service Act (42 
U.S.C. 237a(b)), as amended— 
(1) in paragraph (6), at the end, by striking 
‘‘and’’; 
(2) in paragraph (7), at the end, by striking the 
period and inserting a semicolon; and 
(3) by adding at the end the following: 
‘‘(8) not later than one year after the date of 
the enactment of this paragraph, develop and imple-
ment a 4-year culturally and linguistically appro-
priate multimedia consumer education campaign 
that is designed to promote understanding and ac-
ceptance of evidence-based maternity practices and 
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816 
models of care for optimal maternity outcomes 
among individuals of childbearing ages and families 
of such individuals and that— 
‘‘(A) highlights the importance of pro-
tecting, promoting, and supporting the innate 
capacities of childbearing individuals and their 
newborns for childbirth, breastfeeding, and at-
tachment; 
‘‘(B) promotes understanding of the impor-
tance of using obstetric interventions when 
medically necessary and when supported by 
strong, high-quality evidence; 
‘‘(C) highlights the widespread overuse of 
maternity practices that have been shown to 
have benefit when used appropriately in situa-
tions of medical necessity, but which can expose 
pregnant individuals, infants, or both to risk of 
harm if used routinely and indiscriminately; 
‘‘(D) emphasizes the noninvasive maternity 
practices that have proven correlation or may 
be associated with improvement in outcomes 
with no detrimental side effects, and are signifi-
cantly underused in the United States, includ-
ing smoking cessation programs in pregnancy, 
group model prenatal care, continuous labor 
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817 
support, nonsupine positions for birth, and ex-
ternal version to turn breech babies at term; 
‘‘(E) educates consumers about— 
‘‘(i) the qualifications of licensed pro-
viders of maternity care, including obstetri-
cian-gynecologists, family physicians, cer-
tified nurse-midwives, certified midwives, 
and certified professional midwives; and 
‘‘(ii) the best evidence about the safe-
ty, satisfaction, outcomes, and costs of 
such providers; 
‘‘(F) informs consumers about the best 
available research comparing birth center 
births, planned home births, and hospital 
births, including information about each set-
ting’s safety, satisfaction, outcomes, and costs; 
‘‘(G) fosters participation in high-quality, 
evidence-based childbirth education that pro-
motes a healthy and safe approach to preg-
nancy, childbirth, and early parenting; is taught 
by certified educators, peer counselors, and 
health professionals; and promotes informed de-
cision making by childbearing individuals; 
‘‘(H) informs consumers about— 
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818 
‘‘(i) the effects of systemic, institu-
tional, and interpersonal racism on the 
health, well-being, and outcomes of birth-
ing people; 
‘‘(ii) the importance of respectful, cul-
turally and linguistically appropriate, and 
culturally congruent care; and 
‘‘(iii) the value of community-based 
and community-led maternal care and sup-
port; and 
‘‘(I) is pilot tested for consumer com-
prehension, cultural sensitivity, and acceptance 
of the messages across geographically, racially, 
ethnically, and linguistically diverse popu-
lations;’’. 
SEC. 5217. BIBLIOGRAPHIC DATABASE OF SYSTEMATIC RE-
VIEWS FOR CARE OF CHILDBEARING INDI-
VIDUALS AND NEWBORNS. 
(a) IN GENERAL.—Not later than one year after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, acting through the Director of the 
Agency for Healthcare Research and Quality, shall— 
(1) make publicly available an online biblio-
graphic database identifying systematic reviews, in-
cluding an explanation of the level and quality of 
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819 
evidence, for care of childbearing individuals and 
newborns; and 
(2) initiate regular updates that incorporate 
newly issued and updated systematic reviews. 
(b) SOURCES.—To aim for a comprehensive inventory 
of systematic reviews relevant to maternal and newborn 
care, the database shall identify reviews from diverse 
sources, including— 
(1) scientific peer-reviewed journals; 
(2) databases, including the Cochrane Database 
of Systematic Reviews; and 
(3) internet websites of agencies and organiza-
tions throughout the world that produce such sys-
tematic reviews. 
(c) FEATURES.—The database shall— 
(1) provide bibliographic citations for each 
record within the database, and for each such cita-
tion include an explanation of the level and quality 
of evidence; 
(2) include abstracts, as available; 
(3) provide reference to companion documents 
as may exist for each review, such as evidence tables 
and guidelines or consumer educational materials de-
veloped from the review; 
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820 
(4) provide links to the source of the full review 
and to any companion documents; 
(5) provide links to the source of a previous 
version or update of the review; 
(6) be searchable by intervention or other topic 
of the review, reported outcomes, author, title, and 
source; and 
(7) offer to users periodic electronic notification 
of database updates relating to users’ topics of inter-
est. 
(d) OUTREACH.—Not later than the first date the 
database is made publicly available and periodically there-
after, the Secretary of Health and Human Services shall 
publicize the availability, features, and uses of the data-
base under this section to the stakeholders described in 
subsection (e). 
(e) CONSULTATION.—For purposes of developing the 
database under this section and maintaining and updating 
such database, the Secretary of Health and Human Serv-
ices shall convene and consult with an advisory committee 
composed of relevant stakeholders, including— 
(1) Federal Medicaid administrators and State 
agencies administrating State plans under title XIX 
of the Social Security Act pursuant to section 
1902(a)(5) of such Act (42 U.S.C. 1396a(a)(5)); 
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821 
(2) providers of maternity and newborn care 
from both academic and community-based settings, 
including obstetrician-gynecologists, family physi-
cians, certified nurse midwives, certified midwives, 
certified professional midwives, physician assistants, 
perinatal nurses, pediatricians, and nurse practi-
tioners; 
(3) maternal-fetal medicine specialists; 
(4) neonatologists; 
(5) childbearing individuals and advocates for 
such individuals, including childbirth educators cer-
tified by a nationally accredited program, rep-
resenting communities that are diverse in terms of 
race, ethnicity, indigenous status, and geographic 
area; 
(6) employers and purchasers; 
(7) health facility and system leaders, including 
both hospital and birth center facilities; 
(8) journalists; and 
(9) bibliographic informatics specialists. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated $2,500,000 for each of the 
fiscal years 2023 through 2025 for the purpose of devel-
oping the database and such sums as may be necessary 
for each subsequent fiscal year for updating the database 
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822 
and providing outreach and notification to users, as de-
scribed in this section. 
SEC. 5218. DEVELOPMENT OF INTERPROFESSIONAL MA-
TERNITY CARE EDUCATIONAL MODELS AND 
TOOLS. 
(a) IN GENERAL.—Not later than 6 months after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, acting in conjunction with the Ad-
ministrator of Health Resources and Services Administra-
tion, shall convene, for a 1-year period, an Interprofes-
sional Maternity Provider Education Commission (re-
ferred to in this section as the ‘‘Commission’’) to discuss 
and make recommendations for— 
(1) a consensus standard physiologic maternity 
care curriculum that takes into account the core 
competencies for basic midwifery practice such as 
those developed by the American College of Nurse 
Midwives and the North American Registry of Mid-
wives, and the educational objectives for physicians 
practicing in obstetrics and gynecology as deter-
mined by the Council on Resident Education in Ob-
stetrics and Gynecology; 
(2) suggestions for multidisciplinary use of the 
consensus physiologic curriculum; 
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823 
(3) strategies to integrate and coordinate edu-
cation across maternity care disciplines, including 
recommendations to increase medical and midwifery 
student exposure to out-of-hospital birth; 
(4) curriculum and strategies for continuing 
education of practicing perinatal professionals who 
have completed their undergraduate and graduate 
education; and 
(5) pilot demonstrations of interprofessional 
educational models. 
(b) PARTICIPANTS.— 
(1) PROFESSIONS.—The Commission shall in-
clude maternity care educators, curriculum devel-
opers, service leaders, certification leaders, and ac-
creditation leaders from the various professions that 
provide or support maternity care in the United 
States. Such professions shall include obstetrician 
gynecologists, certified nurse midwives or certified 
midwives, family practice physicians, nurse practi-
tioners, physician assistants, certified professional 
midwives, perinatal nurses, doulas, lactation per-
sonnel, and community health workers. 
(2) CONSUMER ADVOCATES.—The Commission 
shall also include representation from maternity care 
consumer advocates. 
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837 
delivery, and postpartum doula services, in-
cluding community-based doula services, 
that are— 
‘‘(I) structured to provide pay-
ment to doulas as individuals, health 
care entity staff, or members of a 
doula group or collective, or through a 
third-party administrator; 
‘‘(II) designed to reduce racial 
and intersecting health inequities; 
‘‘(III) designed to provide doulas 
providing support with an equitable 
and sustainable reimbursement rate; 
‘‘(IV) designed to reduce barriers 
to workforce entry for culturally and 
linguistically competent and racially 
congruent doulas to provide services 
to Medicaid enrollees; and 
‘‘(V) designed with input from 
community-based 
doulas, 
maternal 
health advocates, reproductive justice 
advocates, and Medicaid beneficiaries; 
‘‘(ii) a Medicaid episode-based pay-
ment model for pregnancy-related services, 
including health care services and sup-
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838 
portive services to address health-related 
socials 
needs, 
during 
the 
prenatal, 
intrapartum, and postpartum periods, to 
improve health outcomes and reduce racial 
health inequities, and to be designed with 
input from maternity care providers, ma-
ternal health advocates, reproductive jus-
tice advocates, and Medicaid beneficiaries; 
‘‘(iii) a Medicaid alternative payment 
model for a pregnancy-related health home 
to improve health outcomes during and for 
one year after pregnancy and during the 
newborn period, and to reduce racial 
health inequities, designed with input from 
maternity care providers, maternal health 
advocates, reproductive justice advocates, 
and Medicaid beneficiaries; 
‘‘(iv) a Medicaid perinatal health 
worker service delivery model for culturally 
and linguistically appropriate and respect-
ful health care and supportive services that 
are tailored to community health and 
health-related social needs, designed to im-
prove health outcomes and mitigate harm-
ful effects of racism and other forms of 
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872 
(4) APPLICATION.—An eligible entity desiring a 
grant under this subsection shall submit an applica-
tion to the Secretary at such time, in such manner, 
and containing such information as the Secretary 
may require. 
(5) AUTHORIZED ACTIVITIES.— 
(A) REQUIRED
ACTIVITY.—Each eligible 
entity receiving a grant under this subsection 
shall use grant funds for professional develop-
ment and training of relevant teachers, health 
educators, faculty, administrators, and staff, in 
order to increase effective teaching of sex edu-
cation to young people. 
(B) PERMISSIBLE ACTIVITIES.—Each eligi-
ble entity receiving a grant under this sub-
section may use grant funds to— 
(i) provide training and support for 
educators about the content, skills, and 
professional disposition needed to imple-
ment sex education effectively; 
(ii) develop and provide training and 
support to educators on incorporating anti- 
racist and gender inclusive policies and 
practices in sex education; 
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1712 
section and an evaluation of the proposed inter-
ventions and approaches. 
(E) A description of the State, local, and 
Tribal governments, academic institutions, non-
profit organizations, or any other public or pri-
vate sector organizations that would participate 
in implementing the proposed interventions or 
approaches, and the role each would play to 
contribute to the success of the proposed inter-
ventions or approaches. 
(F) The identification of the funding 
sources that would be used to finance the pro-
posed interventions or approaches. 
(G) A description of any financial incen-
tives that may be provided, including outcome- 
focused contracting approaches to encourage 
service providers and other partners to improve 
outcomes of, cost-effectiveness of, and return on 
investment from, Federal, State, local, or Tribal 
government spending. 
(H) The identification of the applicable 
Federal, State, local, or Tribal statutory and 
regulatory authorities, including waiver authori-
ties, to be leveraged to implement the proposed 
interventions or approaches. 
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