livery of maternity care to minority patients; 
and 
(4) provide annual reports to the Secretary with 
information about each case reported to the compli-
ance office over the course of the year containing 
such information as the Secretary may require, such 
as— 
(A) de-identified demographic information 
on the patient in the case, such as race, eth-
nicity, gender identity, and primary language; 
(B) the content of the report from the pa-
tient or the family of the patient to the compli-
ance office; and 
(C) the response from the compliance of-
fice. 
(c) SECRETARY REQUIREMENTS.— 
(1) PROCESSES.—Not later than 180 days after 
the date of enactment of this Act, the Secretary 
shall establish processes for— 
(A) disseminating best practices for estab-
lishing and implementing a respectful maternity 
care compliance office within a hospital or other 
birth setting; 
(B) promoting coordination and collabora-
tion between hospitals, health systems, and 
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other maternity care delivery settings on the es-
tablishment and implementation of respectful 
maternity care compliance offices; and 
(C) evaluating the effectiveness of respect-
ful maternity care compliance offices on mater-
nal health outcomes and patient and family ex-
periences, especially for minority patients and 
their families. 
(2) STUDY.— 
(A) IN GENERAL.—Not later than 2 years 
after the date of enactment of this Act, the Sec-
retary shall, through a contract with an inde-
pendent research organization, conduct a study 
on strategies to address disrespect or bias on 
the basis of race, ethnicity, or another protected 
class in the delivery of maternity care services. 
(B) COMPONENTS OF STUDY.—The study 
shall include the following: 
(i) An assessment of the reports sub-
mitted to the Secretary from the respectful 
maternity care compliance offices pursuant 
to subsection (b)(4); and 
(ii) Based on such assessment, rec-
ommendations for potential accountability 
mechanisms related to cases of disrespect 
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or bias on the basis of race, ethnicity, or 
another protected class in the delivery of 
maternity care services at hospitals and 
other birth settings. Such recommenda-
tions shall take into consideration medical 
and non-medical factors that contribute to 
adverse patient experiences and maternal 
health outcomes. 
(C) REPORT.—The Secretary shall submit 
to the Congress and make publicly available a 
report on the results of the study under this 
paragraph. 
(d) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
such sums as may be necessary for fiscal years 2021 
through 2026. 
SEC. 205. GAO REPORT. 
(a) IN GENERAL.—Not later than 2 years after date 
of enactment of this Act and every 2 years thereafter, the 
Comptroller General of the United States shall submit to 
the Congress and make publicly available a report on the 
establishment of respectful maternity care compliance of-
fices within hospitals, health systems, and other maternity 
care settings. 
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(b) MATTERS INCLUDED.—The report under para-
graph (1) shall include the following: 
(1) Information regarding the extent to which 
hospitals, health systems, and other maternity care 
settings have elected to establish respectful mater-
nity care compliance offices, including— 
(A) which hospitals and other birth set-
tings elect to establish compliance offices and 
when such offices are established; 
(B) to the extent practicable, impacts of 
the establishment of such offices on maternal 
health outcomes and patient and family experi-
ences in the hospitals and other birth settings 
that have established such offices, especially for 
minority women and their families; 
(C) information on geographic areas, and 
types of hospitals or other birth settings, where 
respectful maternity care compliance offices are 
not being established and information on fac-
tors contributing to decisions to not establish 
such offices; and 
(D) recommendations for establishing re-
spectful maternity care compliance offices in ge-
ographic areas, and types of hospitals or other 
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birth settings, where such offices are not being 
established. 
(2) Whether the funding made available to 
carry out this section has been sufficient and, if ap-
plicable, recommendations for additional appropria-
tions to carry out this section. 
(3) Such other information as the Comptroller 
General determines appropriate. 
TITLE III—PROTECTING MOMS 
WHO SERVED 
SEC. 301. SUPPORT FOR MATERNITY CARE COORDINATION. 
(a) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to the Secretary of Veterans 
Affairs $15,000,000 for fiscal year 2022 to improve ma-
ternity care coordination for women veterans throughout 
pregnancy and the one-year postpartum period beginning 
on the last day of the pregnancy. Such amounts are au-
thorized in addition to any other amounts authorized for 
such purpose. 
(b) PLAN.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary shall submit to the Committees on Veterans’ 
Affairs of the Senate and the House of Representa-
tives a plan to improve maternity care coordination 
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to fulfill the responsibilities and requirements de-
scribed in the Veterans Health Administration 
Handbook 1330.03, or any successor handbook. 
(2) ELEMENTS.—The plan under paragraph (1) 
shall include the following: 
(A) With respect to the amounts author-
ized to be appropriated by subsection (a), a de-
scription of how the Secretary will ensure such 
amounts are used to— 
(i) hire full-time maternity care coor-
dinators; 
(ii) train maternity care coordinators; 
and 
(iii) improve support programs led by 
maternity care coordinators. 
(B) Recommendations for the amount of 
funding the Secretary determines appropriate to 
improve maternity care coordination as de-
scribed in paragraph (1) for each of the five fis-
cal years following the date of the plan. 
(3) CONSULTATION.—The Secretary shall de-
velop the plan under paragraph (1) in consultation 
with veterans service organizations, military service 
organizations, women’s health care providers, and 
community-based organizations representing women 
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from demographic groups disproportionately im-
pacted by poor maternal health outcomes, that the 
Secretary determines appropriate. 
SEC. 302. SENSE OF CONGRESS ON VETERAN STATUS RE-
QUIREMENTS. 
It is the sense of Congress that each State should 
list the veteran status of a mother— 
(1) in fetal death records; and 
(2) in maternal mortality review committee re-
views of pregnancy-related deaths and pregnancy-as-
sociated deaths. 
SEC. 303. REPORT ON MATERNAL MORTALITY AND SEVERE 
MATERNAL MORBIDITY AMONG WOMEN VET-
ERANS. 
(a) GAO REPORT.—Not later than two years after 
the date of the enactment of this Act, the Comptroller 
General of the United States shall submit to the Commit-
tees on Veterans’ Affairs of the Senate and the House of 
Representatives, and make publicly available, a report on 
maternal mortality and severe maternal morbidity among 
women veterans, with a particular focus on racial and eth-
nic disparities in maternal health outcomes for women vet-
erans. 
(b) MATTERS INCLUDED.—The report under sub-
section (a) shall include the following: 
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(1) To the extent practicable— 
(A) the number of women veterans who 
have experienced a pregnancy-related death or 
pregnancy-associated death in the most recent 
10 years of available data; 
(B) the rate of pregnancy-related deaths 
per 100,000 live births for women veterans; 
(C) the number of cases of severe maternal 
morbidity among women veterans in the most 
recent year of available data; 
(D) the racial and ethnic disparities in ma-
ternal mortality and severe maternal morbidity 
rates among women veterans; 
(E) identification of the causes of maternal 
mortality and severe maternal morbidity that 
are unique to women who have served in the 
military, including post-traumatic stress dis-
order, military sexual trauma, and infertility or 
miscarriages that may be caused by such serv-
ice; 
(F) identification of the causes of maternal 
mortality and severe maternal morbidity that 
are unique to women veterans of color; and 
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(G) identification of any correlations be-
tween the former rank of women veterans and 
their maternal health outcomes. 
(2) An assessment of the barriers to deter-
mining the information required under paragraph 
(1) and recommendations for improvements in track-
ing maternal health outcomes among— 
(A) women veterans who have health care 
coverage through the Department; 
(B) women veterans enrolled in the 
TRICARE program; 
(C) women veterans with employer-based 
or private insurance; and 
(D) women veterans enrolled in the Med-
icaid program. 
(3) Recommendations for legislative and admin-
istrative actions to increase access to mental and be-
havioral health care for women veterans who screen 
positively for postpartum mental or behavioral 
health conditions. 
(4) Recommendations to address homelessness 
among pregnant and postpartum women veterans. 
(5) Recommendations on how to effectively edu-
cate maternity care providers on best practices for 
providing maternity care services to women veterans 
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that addresses the unique maternal health care 
needs of veteran populations. 
(6) Recommendations to reduce maternal mor-
tality and severe maternal morbidity among women 
veterans and to address racial and ethnic disparities 
in maternal health outcomes for each of the groups 
described in subparagraphs (A) through (D) of para-
graph (2). 
(7) Recommendations to improve coordination 
of care between the Department and non-Depart-
ment facilities for pregnant and postpartum women 
veterans, including recommendations to improve 
training for the directors of the Veterans Integrated 
Service Networks, directors of medical facilities of 
the Department, chiefs of staff of such facilities, ma-
ternity care coordinators, and relevant non-Depart-
ment facilities. 
(8) An assessment of the authority of the Sec-
retary of Veterans Affairs to access maternal health 
data collected by the Department of Health and 
Human Services and, if applicable, recommendations 
to increase such authority. 
(9) Any other information the Comptroller Gen-
eral determines appropriate with respect to the re-
duction of maternal mortality and severe maternal 
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morbidity among women veterans and to address ra-
cial and ethnic disparities in maternal health out-
comes for women veterans. 
TITLE IV—PERINATAL 
WORKFORCE 
SEC. 401. 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 and 
managed care entities about the value and process of 
delivering respectful maternal health care through 
diverse care provider models. 
(2) CONTENTS.—The guidance required by 
paragraph (1) shall address how States can encour-
age and incentivize hospitals, health systems, free-
standing birth centers, other maternity care provider 
groups, and managed care entities— 
(A) to recruit and retain maternity care 
providers, such as obstetrician-gynecologists, 
family physicians, physician assistants, mid-
wives who meet at a minimum the international 
definition of the midwife and global standards 
for midwifery education as established by the 
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International Confederation of Midwives, nurse 
practitioners, and clinical nurse specialists— 
(i) from racially and ethnically diverse 
backgrounds; 
(ii) with experience practicing in ra-
cially and ethnically diverse communities; 
and 
(iii) who have undergone trainings on 
implicit and explicit bias and racism; 
(B) to incorporate into maternity care 
teams midwives who meet at a minimum the 
international definition of the midwife and glob-
al standards for midwifery education as estab-
lished by the International Confederation of 
Midwives, doulas, community health workers, 
peer supporters, certified lactation consultants, 
nutritionists and dietitians, social workers, 
home visitors, and navigators; 
(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, 
and freestanding birth centers. 
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(b) STUDY ON CULTURALLY CONGRUENT MATER-
NITY 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 culturally congruent 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, freestanding birth 
centers, other maternity care provider 
groups, and managed care entities that are 
delivering culturally congruent maternal 
health care; 
(ii) a compendium of examples of hos-
pitals, health systems, freestanding birth 
centers, other maternity care provider 
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groups, and managed care entities that 
have low levels of racial and ethnic dispari-
ties in maternal health outcomes; and 
(iii) recommendations to hospitals, 
health systems, freestanding birth centers, 
other maternity care provider groups, and 
managed care entities for best practices in 
culturally congruent maternity care. 
SEC. 
402. 
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 may award grants 
to entities to establish or expand programs described in 
subsection (b) to grow and diversify the perinatal work-
force. 
‘‘(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— 
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‘‘(A) physician assistants who will complete 
clinical training in the field of maternal and 
perinatal health; and 
‘‘(B) other perinatal health workers such 
as doulas, community health workers, peer sup-
porters, certified lactation consultants, nutri-
tionists and dietitians, social workers, home 
visitors, and navigators; 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 insti-
tution of higher education that— 
‘‘(1) has demonstrated a commitment to re-
cruiting and retaining minority students, particu-
larly from demographic groups experiencing high 
rates of maternal mortality and severe maternal 
morbidity; 
‘‘(2) has developed a strategy to recruit and re-
tain a diverse pool of students into the perinatal 
workforce program or school supported by funds re-
ceived through the grant, particularly from demo-
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graphic groups experiencing high rates of maternal 
mortality and severe maternal morbidity; 
‘‘(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; 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 explicit and implicit 
bias. 
‘‘(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— 
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‘‘(A) health professional shortage areas 
designated under section 332; and 
‘‘(B) areas with significant racial and eth-
nic disparities in maternal health outcomes; 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 in-
stitutions of higher education seeking or receiving a grant 
under this section on the development, use, evaluation, 
and post-grant period sustainability of the perinatal work-
force programs or schools proposed to be, or being, estab-
lished or expanded through the grant. 
‘‘(h) REPORT
BY SECRETARY.—Not later than 4 
years after the date of enactment of this section, the Sec-
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