H. R. 2471—748 
and make recommendations for accredited schools of allopathic 
medicine, osteopathic medicine, and nursing, and other health 
professional training programs on best practices related to training 
to improve the provision of prenatal care, labor care, birthing, 
and postpartum care for racial and ethnic minority populations, 
including with respect to perceptions and biases that may affect 
the approach to, and provision of, care. 
SEC. 134. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM 
WOMEN. 
(a) GRANTS.—Title III of the Public Health Service Act (42 
U.S.C. 241 et seq.) is amended by inserting after section 330O 
of such Act, as added by section 131, the following: 
‘‘SEC. 330P. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM 
WOMEN. 
‘‘(a) IN GENERAL.—The Secretary may award grants for the 
purpose of establishing or operating evidence-based or innovative, 
evidence-informed programs to deliver integrated health care serv-
ices to pregnant and postpartum women to optimize the health 
of women and their infants, including to reduce adverse maternal 
health outcomes, pregnancy-related deaths, and related health 
disparities (including such disparities associated with racial and 
ethnic minority populations), and, as appropriate, by addressing 
issues researched under subsection (b)(2) of section 317K. 
‘‘(b) INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM 
WOMEN.— 
‘‘(1) ELIGIBILITY.—To be eligible to receive a grant under 
subsection (a), a State, Indian Tribe, or Tribal organization 
(as such terms are defined in section 4 of the Indian Self- 
Determination and Education Assistance Act) shall work with 
relevant stakeholders that coordinate care to develop and carry 
out the program, including— 
‘‘(A) State, Tribal, and local agencies responsible for 
Medicaid, public health, social services, mental health, and 
substance use disorder treatment and services; 
‘‘(B) health care providers who serve pregnant and 
postpartum women; and 
‘‘(C) community-based health organizations and health 
workers, including providers of home visiting services and 
individuals representing communities with disproportion-
ately high rates of maternal mortality and severe maternal 
morbidity, and including those representing racial and 
ethnic minority populations. 
‘‘(2) TERMS.— 
‘‘(A) PERIOD.—A grant awarded under subsection (a) 
shall be made for a period of 5 years. Any supplemental 
award made to a grantee under subsection (a) may be 
made for a period of less than 5 years. 
‘‘(B) PRIORITIES.—In awarding grants under subsection 
(a), the Secretary shall— 
‘‘(i) give priority to States, Indian Tribes, and 
Tribal organizations that have the highest rates of 
maternal mortality and severe maternal morbidity rel-
ative to other such States, Indian Tribes, or Tribal 
organizations, respectively; and 
‘‘(ii) shall consider health disparities related to 
maternal mortality and severe maternal morbidity,
H. R. 2471—749 
including such disparities associated with racial and 
ethnic minority populations. 
‘‘(C) 
EVALUATION.—The 
Secretary 
shall 
require 
grantees to evaluate the outcomes of the programs sup-
ported under the grant. 
‘‘(c) 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.’’. 
(b) REPORT ON GRANT OUTCOMES AND DISSEMINATION OF BEST 
PRACTICES.— 
(1) REPORT.—Not later than February 1, 2027, the Sec-
retary of Health and Human Services shall submit to the Com-
mittee on Health, Education, Labor, and Pensions of the Senate 
and the Committee on Energy and Commerce of the House 
of Representatives a report that describes— 
(A) the outcomes of the activities supported by the 
grants awarded under the amendments made by this sec-
tion on maternal and child health; 
(B) best practices and models of care used by recipients 
of grants under such amendments; and 
(C) obstacles identified by recipients of grants under 
such amendments, and strategies used by such recipients 
to deliver care, improve maternal and child health, and 
reduce health disparities. 
(2) DISSEMINATION
OF
BEST
PRACTICES.—Not later than 
August 1, 2027, the Secretary of Health and Human Services 
shall disseminate information on best practices and models 
of care used by recipients of grants under the amendments 
made by this section (including best practices and models of 
care relating to the reduction of health disparities, including 
such disparities associated with racial and ethnic minority 
populations, in rates of maternal mortality and severe maternal 
morbidity) to relevant stakeholders, which may include health 
providers, medical schools, nursing schools, relevant State, 
Tribal, and local agencies, and the general public. 
SEC. 135. MATERNAL VACCINATION AWARENESS. 
In carrying out the public awareness initiative related to vac-
cinations pursuant to section 313 of the Public Health Service 
Act (42 U.S.C. 245), the Secretary of Health and Human Services 
shall take into consideration the importance of increasing awareness 
and knowledge of the safety and effectiveness of vaccines to prevent 
disease in pregnant and postpartum women and in infants and 
the need to improve vaccination rates in communities and popu-
lations with low rates of vaccination. 
CHAPTER 2—RURAL MATERNAL AND OBSTETRIC 
MODERNIZATION OF SERVICES 
SEC. 141. IMPROVING RURAL MATERNAL AND OBSTETRIC CARE DATA. 
(a) MATERNAL MORTALITY AND MORBIDITY ACTIVITIES.—Section 
301(e) of the Public Health Service Act (42 U.S.C. 241) is amended 
by inserting ‘‘, preventable maternal mortality and severe maternal 
morbidity,’’ after ‘‘delivery’’. 
(b) OFFICE OF WOMEN’S HEALTH.—Section 310A(b)(1) of the 
Public Health Service Act (42 U.S.C. 242s(b)(1)) is amended by 
striking ‘‘and sociocultural contexts,’’ and inserting ‘‘sociocultural
H. R. 2471—750 
(including among American Indians, Native Hawaiians, and Alaska 
Natives), and geographical contexts,’’. 
(c) SAFE MOTHERHOOD.—Section 317K of the Public Health 
Service Act (42 U.S.C. 247b–12) is amended— 
(1) in subsection (a)(2)(A), by inserting ‘‘, including 
improving disaggregation of data (in a manner consistent with 
applicable State and Federal privacy laws)’’ before the period; 
and 
(2) in subsection (b)(2)— 
(A) in subparagraph (L), by striking ‘‘and’’ at the end; 
(B) by redesignating subparagraph (M) as subpara-
graph (N); and 
(C) by inserting after subparagraph (L) the following: 
‘‘(M) an examination of the relationship between 
maternal health and obstetric services in rural areas and 
outcomes in delivery and postpartum care; and’’. 
(d) OFFICE
OF
RESEARCH
ON
WOMEN’S
HEALTH.—Section 
486(d)(4)(A)(iv) of the Public Health Service Act (42 U.S.C. 
287d(d)(4)(A)(iv)) is amended by inserting ‘‘, including preventable 
maternal mortality and severe maternal morbidity’’ before the semi-
colon. 
SEC. 142. RURAL OBSTETRIC NETWORK GRANTS. 
The Public Health Service Act is amended by inserting after 
section 330A–1 of such Act (42 U.S.C. 254c–1a) the following: 
‘‘SEC. 330A–2. RURAL OBSTETRIC NETWORK GRANTS. 
‘‘(a) PROGRAM ESTABLISHED.—The Secretary shall award grants 
or cooperative agreements to eligible entities to establish collabo-
rative improvement and innovation networks (referred to in this 
section as ‘rural obstetric networks’) to improve maternal and infant 
health outcomes and reduce preventable maternal mortality and 
severe maternal morbidity by improving maternity care and access 
to care in rural areas, frontier areas, maternity care health profes-
sional target areas, or jurisdictions of Indian Tribes and Tribal 
organizations. 
‘‘(b) USE OF FUNDS.—Grants or cooperative agreements awarded 
pursuant to this section shall be used for the establishment or 
continuation of collaborative improvement and innovation networks 
to improve maternal and infant health outcomes and reduce 
preventable maternal mortality and severe maternal morbidity by 
improving prenatal care, labor care, birthing, and postpartum care 
services in rural areas. Rural obstetric networks established in 
accordance with this section may— 
‘‘(1) develop a network to improve coordination and increase 
access to maternal health care and assist pregnant women 
in the areas described in subsection (a) with accessing and 
utilizing prenatal care, labor care, birthing, and postpartum 
care services to improve outcomes in birth and maternal mor-
tality and morbidity; 
‘‘(2) identify and implement evidence-based and sustainable 
delivery models for providing prenatal care, labor care, birthing, 
and postpartum care services, including home visiting programs 
and culturally appropriate care models that reduce health 
disparities; 
‘‘(3) develop a model for maternal health care collaboration 
between health care settings to improve access to care in areas
H. R. 2471—751 
described in subsection (a), which may include the use of tele-
health; 
‘‘(4) provide training for professionals in health care set-
tings that do not have specialty maternity care; 
‘‘(5) collaborate with academic institutions that can provide 
regional expertise and help identify barriers to providing 
maternal health care, including strategies for addressing such 
barriers; and 
‘‘(6) assess and address disparities in infant and maternal 
health outcomes, including among racial and ethnic minority 
populations and underserved populations in such areas 
described in subsection (a). 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE ENTITIES.—The term ‘eligible entities’ means 
entities providing prenatal care, labor care, birthing, and 
postpartum care services in rural areas, frontier areas, or medi-
cally underserved areas, or to medically underserved popu-
lations or Indian Tribes or Tribal organizations. 
‘‘(2) FRONTIER
AREA.—The term ‘frontier area’ means a 
frontier county, as defined in section 1886(d)(3)(E)(iii)(III) of 
the Social Security Act. 
‘‘(3) INDIAN
TRIBES; TRIBAL
ORGANIZATION.—The terms 
‘Indian Tribe’ and ‘Tribal organization’ have the meanings given 
the terms ‘Indian tribe’ and ‘tribal organization’ in section 
4 of the Indian Self-Determination and Education Assistance 
Act. 
‘‘(4) MATERNITY
CARE
HEALTH
PROFESSIONAL
TARGET 
AREA.—The term ‘maternity care health professional target 
area’ has the meaning described in section 332(k)(2). 
‘‘(d) REPORT TO CONGRESS.—Not later than September 30, 2026, 
the Secretary shall submit to Congress a report on activities sup-
ported by grants awarded under this section, including— 
‘‘(1) a description of activities conducted pursuant to para-
graphs (1) through (6) of subsection (b); and 
‘‘(2) an analysis of the effects of rural obstetric networks 
on improving maternal and infant health outcomes. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 
to be appropriated to carry out this section $3,000,000 for each 
of fiscal years 2023 through 2027.’’. 
SEC. 143. TELEHEALTH NETWORK AND TELEHEALTH RESOURCE CEN-
TERS GRANT PROGRAMS. 
Section 330I of the Public Health Service Act (42 U.S.C. 254c– 
14) is amended— 
(1) in subsection (f)(3), by adding at the end the following: 
‘‘(M) Providers of prenatal, labor care, birthing, and 
postpartum care services, including hospitals that operate 
obstetric care units.’’; and 
(2) in subsection (h)(1)(B), by striking ‘‘or prenatal care 
for high-risk pregnancies’’ and inserting ‘‘prenatal care, labor 
care, birthing care, or postpartum care’’. 
SEC. 144. RURAL MATERNAL AND OBSTETRIC CARE TRAINING DEM-
ONSTRATION. 
Subpart 1 of part E of title VII of the Public Health Service 
Act (42 U.S.C. 294n et seq.) is amended by adding at the end 
the following: