344 
tity, and embraces the principles of nondiscrimina-
tion based on sexual orientation and gender identity; 
(7) counters the perpetuation of narrow gender 
roles, including the sexualization of female children, 
adolescents, and adults; 
(8) teaches young people the skills to make re-
sponsible decisions about sexuality, including how to 
avoid unwanted verbal, physical, and sexual ad-
vances and how to avoid making verbal, physical, 
and sexual advances that are not wanted by the 
other party; 
(9) develops healthy relationships, including the 
prevention of dating and sexual violence; 
(10) teaches young people how alcohol and drug 
use can affect responsible decisionmaking; and 
(11) does not teach or promote religion. 
(c) ADDITIONAL ACTIVITIES.—In carrying out a pro-
gram of sex education, a State may expend grant funds 
awarded under subsection (a) to carry out educational and 
motivational activities that help young people— 
(1) gain knowledge about the physical, emo-
tional, biological, and hormonal changes of adoles-
cence and subsequent stages of human maturation; 
(2) develop the knowledge and skills nec-
essary— 
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(A) to ensure and protect their sexual and 
reproductive health from unintended pregnancy 
and sexually transmitted disease, including 
HIV/AIDS, throughout their lifespan; 
(B) to be aware that certain racial and 
ethnic groups are more affected by certain sex-
ually transmitted diseases; and 
(C) to receive the education to prevent fur-
ther transmission; 
(3) gain knowledge about the specific involve-
ment and responsibility of each individual in sexual 
decisionmaking; 
(4) develop healthy attitudes and values about 
adolescent growth and development, body image, 
gender roles, racial and ethnic diversity, sexual ori-
entation and gender identity, and other subjects; 
(5) develop and practice healthy life skills in-
cluding goal-setting, decisionmaking, negotiation, 
communication, and stress management; and 
(6) promote self-esteem and positive inter-
personal skills focusing on relationship dynamics, in-
cluding friendships, dating, romantic involvement, 
marriage, and family interactions. 
(d) MATCHING FUNDS.—The Secretary may not 
make payments to a State under this section in an amount 
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exceeding Federal medical assistance percentage for such 
State (as such term is defined in section 1905(b) of the 
Social Security Act (42 U.S.C. 1396d(b))) of the costs of 
the programs conducted by the State under this section. 
(e) EVALUATION OF PROGRAMS.— 
(1) IN GENERAL.—For the purpose of evalu-
ating the effectiveness of programs of sex education 
carried out with a grant under this section, evalua-
tions shall be carried out in accordance with para-
graphs (2) and (3). 
(2) NATIONAL EVALUATION.— 
(A) METHOD.—The Secretary shall pro-
vide for a national evaluation of a representa-
tive sample of programs of sex education car-
ried out with grants under this section to deter-
mine— 
(i) the effectiveness of such programs 
in helping to delay the initiation of sexual 
intercourse and other high-risk behaviors; 
(ii) the effectiveness of such programs 
in preventing adolescent pregnancy; 
(iii) the effectiveness of such pro-
grams in preventing sexually transmitted 
disease, including HIV/AIDS and viral 
hepatitis; 
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(iv) the effectiveness of such programs 
in increasing contraceptive knowledge and 
contraceptive behaviors when sexual inter-
course occurs; and 
(v) a list of best practices that— 
(I) is based upon essential pro-
grammatic components of evaluated 
programs that have led to success de-
scribed in clauses (i) through (iv); and 
(II) documents the racial and 
ethnic minority populations that are 
recipients of grant funds under this 
section or are served by programs of 
sex education funded under this sec-
tion. 
(B) GRANT CONDITION.—A condition for 
the receipt of a grant to a State under this sec-
tion is that the State cooperate with the evalua-
tion under subparagraph (A). 
(C) REPORT.—The Secretary shall submit 
to the Congress— 
(i) not later than the end of each fis-
cal year during the 5-year period beginning 
with fiscal year 2015, an interim report on 
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the national evaluation under subpara-
graph (A); and 
(ii) not later than March 31, 2020, a 
final report providing the results of such 
national evaluation. 
(3) INDIVIDUAL STATE EVALUATIONS.—A con-
dition for the receipt of a grant under this section 
is that the State evaluate the programs of sex edu-
cation funded through such grant in accordance with 
the following requirements: 
(A) The evaluation will be conducted by an 
external, independent entity. 
(B) The purposes of the evaluation will be 
the determination of— 
(i) the effectiveness of such programs 
in helping to delay the initiation of sexual 
intercourse and other high-risk behaviors; 
(ii) the effectiveness of such programs 
in preventing adolescent pregnancy; 
(iii) the effectiveness of such pro-
grams in preventing sexually transmitted 
disease, including HIV/AIDS; and 
(iv) the effectiveness of such programs 
in increasing contraceptive and barrier 
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method knowledge and contraceptive be-
haviors when sexual intercourse occurs. 
(f) LIMITATIONS ON USE OF FUNDS.— 
(1) LIMITATIONS
ON
SECRETARY.—Of the 
amounts appropriated for a fiscal year for purposes 
of this section, the Secretary may not use more 
than— 
(A) 7 percent of such amounts for admin-
istrative expenses related to carrying out this 
section for that fiscal year; and 
(B) 10 percent of such amounts for the 
national evaluation under subsection (e)(2). 
(2) LIMITATIONS TO STATES.—Of amounts pro-
vided to an eligible State under this subsection, the 
State may not use more than 10 percent of the 
grant to conduct any evaluation under subsection 
(e)(3). 
(g) 
NONDISCRIMINATION
REQUIRED.—Programs 
funded under this section shall not discriminate on the 
basis of sex, race, ethnicity, national origin, disability, reli-
gion, marital status, familial status, sexual orientation, or 
gender identity. Nothing in this section shall be construed 
to invalidate or limit rights, remedies, procedures, or legal 
standards available to victims of discrimination under any 
other Federal law or any law of a State or a political sub-
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division of a State, including title VI of the Civil Rights 
Act of 1964 (42 U.S.C. 2000d et seq.), title IX of the 
Education Amendments of 1972 (20 U.S.C. 1681 et seq.), 
section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 
794), and the Americans with Disabilities Act of 1990 (42 
U.S.C. 12101 et seq.). 
(h) DEFINITIONS.—For purposes of this section: 
(1) The term ‘‘age appropriate’’ means, with re-
spect to topics, messages, and teaching methods, 
those suitable to particular ages or age groups of 
children, adolescents, and adults, based on devel-
oping cognitive, emotional, and behavioral capacity 
typical for the age or age group. 
(2) The term ‘‘eligible State’’ means a State 
that submits to the Secretary an application for a 
grant under this section that is in such form, is 
made in such manner, and contains such agree-
ments, assurances, and information as the Secretary 
determines to be necessary to carry out this section. 
(3) The term ‘‘HIV/AIDS’’ means the human 
immunodeficiency virus, and includes acquired im-
mune deficiency syndrome. 
(4) The term ‘‘medically accurate’’, with respect 
to information, means information that is supported 
by research, recognized as accurate and objective by 
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leading medical, psychological, psychiatric, and pub-
lic health organizations and agencies, and, published 
in journals that are peer reviewed. 
(5) The term ‘‘State’’ means the 50 States, the 
District of Columbia, the Commonwealth of Puerto 
Rico, the Commonwealth of the Northern Mariana 
Islands, American Samoa, Guam, the United States 
Virgin Islands, and any other territory or possession 
of the United States. 
(i) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
to be appropriated $50,000,000 for each of the fiscal years 
2015 through 2019. 
SEC. 512. COMPASSIONATE ASSISTANCE FOR RAPE EMER-
GENCIES. 
(a) MEDICARE.— 
(1) 
LIMITATION
ON
PAYMENT.—Section 
1866(a)(1) of the Social Security Act (42 U.S.C. 
1395cc(a)(1)) is amended— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (V); 
(B) in the subparagraph (W) added by sec-
tion 3005(1)(C) of Public Law 111–148— 
(i) by striking the period at the end 
and inserting a comma; 
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(ii) by moving the indentation 2 ems 
to the left; and 
(iii) by moving such subparagraph to 
immediately follow subparagraph (V); 
(C) in the subparagraph (W) added by sec-
tion 6406(b)(3) of Public Law 111–148— 
(i) by striking the period at the end 
and inserting ‘‘, and’’; 
(ii) by moving the indentation 2 ems 
to the left; 
(iii) by redesignating such subpara-
graph as subparagraph (X); and 
(iv) by moving such subparagraph to 
immediately follow subparagraph (W), as 
moved under paragraph (2)(C); and 
(D) by inserting after the subparagraph 
(X), as redesignated and moved under para-
graph (3), the following: 
‘‘(Y) in the case of a hospital or critical ac-
cess hospital, to adopt and enforce a policy to 
ensure compliance with the requirements of 
subsection (l) and to meet the requirements of 
such subsection.’’. 
(2) ASSISTANCE TO VICTIMS.—Section 1866 of 
the Social Security Act (42 U.S.C. 1395cc) is 
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amended by adding at the end the following new 
subsection: 
‘‘(l) COMPASSIONATE ASSISTANCE FOR RAPE EMER-
GENCIES.— 
‘‘(1) IN
GENERAL.—For purposes of section 
1866(a)(1)(Y), a hospital meets the requirements of 
this subsection if the hospital provides each of the 
services described in paragraph (2) to each female 
individual, whether or not eligible for benefits under 
this title or under any other form of health insur-
ance. who comes to the hospital on or after January 
1, 2015, and— 
‘‘(A) who states to hospital personnel that 
she is a victim of sexual assault; 
‘‘(B) who is accompanied by an individual 
who states to hospital personnel that the female 
individual is a victim of sexual assault; or 
‘‘(C) whom hospital personnel, during the 
course of treatment and care for the female in-
dividual, have reason to believe is a victim of 
sexual assault. 
‘‘(2) REQUIRED
SERVICES
DESCRIBED.—For 
purposes of paragraph (1), the services described in 
this subparagraph are the following: 
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‘‘(A) Provision of medically and factually 
accurate and unbiased written and oral infor-
mation about emergency contraception that— 
‘‘(i) is written in clear and concise 
language; 
‘‘(ii) is readily comprehensible; 
‘‘(iii) includes an explanation that— 
‘‘(I) emergency contraception has 
been approved by the Food and Drug 
Administration as an over-the-counter 
medication for female individuals, and 
is a safe and effective way to prevent 
pregnancy after unprotected inter-
course or contraceptive failure if 
taken in a timely manner; 
‘‘(II) emergency contraception is 
more effective the sooner it is taken; 
and 
‘‘(III) emergency contraception 
does not cause an abortion and cannot 
interrupt an established pregnancy; 
‘‘(iv) meets such conditions regarding 
the provision of such information in lan-
guages other than English as the Secretary 
may establish; and 
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‘‘(iii) is approved by the Food and 
Drug Administration. 
‘‘(B) The term ‘hospital’ includes a critical 
access 
hospital, 
as 
defined 
in 
section 
1861(mm)(1). 
‘‘(C) The term ‘sexual assault’ means co-
itus in which the individual involved does not 
consent or lacks the legal capacity to consent.’’. 
(b) LIMITATION ON PAYMENT UNDER MEDICAID.— 
Section 1903(i) of the Social Security Act (42 U.S.C. 
1396b(i)) is amended by inserting after paragraph (11) 
the following new paragraph: 
‘‘(12) with respect to any amount expended for 
care or services furnished under the plan by a hos-
pital on or after January 1, 2015, unless such hos-
pital meets the requirements specified in section 
1866(l) for purposes of title XVIII.’’. 
SEC. 513. ACCESS TO BIRTH CONTROL DUTIES OF PHAR-
MACIES TO ENSURE PROVISION OF FDA-AP-
PROVED CONTRACEPTION. 
Part B of title II of the Public Health Service Act 
(42 U.S.C. 238 et seq.) is amended by adding at the end 
the following: 
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shall obtain the contraceptive under the phar-
macy’s standard procedure for expedited order-
ing of medication and notify the customer when 
the contraceptive arrives. 
‘‘(3) The pharmacy shall ensure that its em-
ployees do not— 
‘‘(A) intimidate, threaten, or harass cus-
tomers in the delivery of services relating to a 
request for contraception; 
‘‘(B) interfere with or obstruct the delivery 
of services relating to a request for contracep-
tion; 
‘‘(C) intentionally misrepresent or deceive 
customers about the availability of contracep-
tion or its mechanism of action; 
‘‘(D) breach medical confidentiality with 
respect to a request for contraception or threat-
en to breach such confidentiality; or 
‘‘(E) refuse to return a valid, lawful pre-
scription for contraception upon customer re-
quest. 
‘‘(b) 
CONTRACEPTIVES
NOT
ORDINARILY 
STOCKED.—Nothing in subsection (a)(2) shall be con-
strued to require any pharmacy to comply with such sub-
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section if the pharmacy does not ordinarily stock contra-
ceptives in the normal course of business. 
‘‘(c) REFUSALS PURSUANT
TO STANDARD PHAR-
MACY PRACTICE.—This section does not prohibit a phar-
macy from refusing to provide a contraceptive to a cus-
tomer in accordance with any of the following: 
‘‘(1) If it is unlawful to dispense the contracep-
tive to the customer without a valid, lawful prescrip-
tion and no such prescription is presented. 
‘‘(2) If the customer is unable to pay for the 
contraceptive. 
‘‘(3) If the employee of the pharmacy refuses to 
provide the contraceptive on the basis of a profes-
sional clinical judgment. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to invalidate or limit rights, rem-
edies, procedures, or legal standards under title VII of the 
Civil Rights Act of 1964. 
‘‘(e) PREEMPTION.—This section does not preempt 
any provision of State law or any professional obligation 
made applicable by a State board or other entity respon-
sible for licensing or discipline of pharmacies or phar-
macists, to the extent that such State law or professional 
obligation provides protections for customers that are 
greater than the protections provided by this section. 
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‘‘(f) ENFORCEMENT.— 
‘‘(1) CIVIL PENALTY.—A pharmacy that vio-
lates a requirement of subsection (a) is liable to the 
United States for a civil penalty in an amount not 
exceeding $1,000 per day of violation, not to exceed 
$100,000 for all violations adjudicated in a single 
proceeding. 
‘‘(2) PRIVATE CAUSE OF ACTION.—Any person 
aggrieved as a result of a violation of a requirement 
of subsection (a) may, in any court of competent ju-
risdiction, commence a civil action against the phar-
macy involved to obtain appropriate relief, including 
actual and punitive damages, injunctive relief, and a 
reasonable attorney’s fee and cost. 
‘‘(3) LIMITATIONS.—A civil action under para-
graph (1) or (2) may not be commenced against a 
pharmacy after the expiration of the 5-year period 
beginning on the date on which the pharmacy alleg-
edly engaged in the violation involved. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) The term ‘contraception’ or ‘contraceptive’ 
means any drug or device approved by the Food and 
Drug Administration to prevent pregnancy. 
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‘‘(2) The term ‘employee’ means a person hired, 
by contract or any other form of an agreement, by 
a pharmacy. 
‘‘(3) The term ‘pharmacy’ means an entity 
that— 
‘‘(A) is authorized by a State to engage in 
the business of selling prescription drugs at re-
tail; and 
‘‘(B) employs one or more employees. 
‘‘(4) The term ‘product’ means a Food and 
Drug Administration-approved drug or device. 
‘‘(5) The term ‘professional clinical judgment’ 
means the use of professional knowledge and skills 
to form a clinical judgment, in accordance with pre-
vailing medical standards. 
‘‘(6) The term ‘without delay’, with respect to 
a pharmacy providing, providing a referral for, or 
ordering contraception, or transferring the prescrip-
tion for contraception, means within the usual and 
customary timeframe at the pharmacy for providing, 
providing a referral for, or ordering other products, 
or transferring the prescription for other products, 
respectively. 
‘‘(h) EFFECTIVE DATE.—This section shall take ef-
fect on the 31st day after the date of the enactment of 
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this section, without regard to whether the Secretary has 
issued any guidance or final rule regarding this section.’’. 
SEC. 514. ADDITIONAL FOCUS AREA FOR THE OFFICE ON 
WOMEN’S HEALTH. 
Section 229(b) of the Public Health Service Act (42 
U.S.C. 237a(b)) is amended— 
(1) in paragraph (6), at the end, by striking 
‘‘and’’; 
(2) in paragraph (7), at the end, by striking the 
period and inserting ‘‘; and’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(8) facilitate policymakers, health system lead-
ers and providers, consumers, and other stake-
holders in understanding optimal maternity care and 
support for the provision of such care, including the 
priorities of— 
‘‘(A) protecting, promoting, and supporting 
the innate capacities of childbearing women and 
their newborns for childbirth, breastfeeding, 
and attachment; 
‘‘(B) using obstetric interventions only 
when such interventions are supported by 
strong, high-quality evidence, and minimizing 
overuse of maternity practices that have been 
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shown to have benefit in limited situations and 
that can expose women, infants, or both to risk 
of harm if used routinely and indiscriminately, 
including continuous electronic fetal monitoring, 
labor induction, epidural analgesia, primary ce-
sarean section, and routine repeat cesarean 
birth; 
‘‘(C) reliably incorporating noninvasive, 
evidence-based practices that have documented 
correlation with considerable improvement in 
outcomes with no detrimental side effects, such 
as smoking cessation programs in pregnancy 
and proven models of group prenatal care that 
integrate health assessment, education, and 
support into a unified program; 
‘‘(D) a shared understanding of the quali-
fications of licensed providers of maternity care 
and the best evidence about the safety, satisfac-
tion, outcomes, and costs of their care, and ap-
propriate deployment of such caregivers within 
the maternity care workforce to address the 
needs of childbearing women and newborns and 
the growing shortage of maternity caregivers; 
‘‘(E) a shared understanding of the results 
of the best available research comparing hos-
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pital, birth center, and planned home births, in-
cluding information about each setting’s safety, 
satisfaction, outcomes, and costs; and 
‘‘(F) high-quality, evidence-based child-
birth education that promotes a natural, 
healthy, and safe approach to pregnancy, child-
birth, and early parenting; is taught by certified 
educators, peer counselors, and health profes-
sionals; and promotes informed decisionmaking 
by childbearing women.’’. 
SEC. 515. INTERAGENCY COORDINATING COMMITTEE ON 
THE PROMOTION OF OPTIMAL MATERNITY 
OUTCOMES. 
(a) IN GENERAL.—Part A of title II of the Public 
Health Service Act (42 U.S.C. 202 et seq.) is amended 
by adding at the end the following new section: 
‘‘SEC. 229A. INTERAGENCY COORDINATING COMMITTEE ON 
THE PROMOTION OF OPTIMAL MATERNITY 
OUTCOMES. 
‘‘(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Deputy Assistant 
Secretary for Women’s Health under section 229 and in 
collaboration with the Federal officials specified in sub-
section (b), shall establish the Interagency Coordinating 
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Committee on the Promotion of Optimal Maternity Out-
comes (referred to in this subsection as the ‘ICCPOM’). 
‘‘(b) OTHER AGENCIES.—The officials specified in 
this subsection are the Secretary of Labor, the Secretary 
of Defense, the Secretary of Veterans Affairs, the Surgeon 
General, the Director of the Centers for Disease Control 
and Prevention, the Administrator of the Health Re-
sources and Services Agency, the Administrator of the 
Centers for Medicare & Medicaid Services, the Director 
of the Indian Health Service, the Administrator of the 
Substance Abuse and Mental Health Services Administra-
tion, the Director of the National Institute on Child 
Health and Development, the Director of the Agency for 
Healthcare Research and Quality, the Assistant Secretary 
for Children and Families, the Deputy Assistant Secretary 
for Minority Health, the Director of the Office of Per-
sonnel Management, and such other Federal officials as 
the Secretary of Health and Human Services determines 
to be appropriate. 
‘‘(c) CHAIR.—The Deputy Assistant Secretary for 
Women’s Health shall serve as the chair of the ICCPOM. 
‘‘(d) DUTIES.—The ICCPOM shall guide policy and 
program development across the Federal Government with 
respect to promotion of optimal maternity care, provided, 
however, that nothing in this section shall be construed 
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as transferring regulatory or program authority from an 
agency to the ICCPOM. 
‘‘(e) CONSULTATIONS.—The ICCPOM shall actively 
seek the input of, and shall consult with, all appropriate 
and interested stakeholders, including State health depart-
ments, public health research and interest groups, founda-
tions, childbearing women and their advocates, and mater-
nity care professional associations and organizations, re-
flecting racially, ethnically, demographically, and geo-
graphically diverse communities. 
‘‘(f) ANNUAL REPORT.— 
‘‘(1) IN GENERAL.—The Secretary, on behalf of 
the ICCPOM, shall annually submit to Congress a 
report that summarizes— 
‘‘(A) all programs and policies of Federal 
agencies (including the Medicare Program 
under title XVIII of the Social Security Act and 
the Medicaid program under title XIX of such 
Act) designed to promote optimal maternity 
care, focusing particularly on programs and 
policies that support the adoption of evidence 
based maternity care, as defined by timely, sci-
entifically sound systematic reviews; 
‘‘(B) all programs and policies of Federal 
agencies (including the Medicare Program 
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under title XVIII of the Social Security Act and 
the Medicaid program under title XIX of such 
Act) designed to address the problems of mater-
nal mortality and morbidity, infant mortality, 
prematurity, and low birth weight, including 
such programs and policies designed to address 
racial and ethnic disparities with respect to 
each of such problems; 
‘‘(C) the extent of progress in reducing 
maternal mortality and infant mortality, low 
birth weight, and prematurity at State and na-
tional levels; and 
‘‘(D) such other information regarding op-
timal maternity care as the Secretary deter-
mines to be appropriate. 
The information specified in subparagraph (C) shall 
be included in each such report in a manner that 
disaggregates such information by race, ethnicity, 
and indigenous status in order to determine the ex-
tent of progress in reducing racial and ethnic dis-
parities and disparities related to indigenous status. 
‘‘(2) CERTAIN
INFORMATION.—Each report 
under paragraph (1) shall include information 
(disaggregated by race, ethnicity, and indigenous 
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status, as applicable) on the following rates and 
costs by State: 
‘‘(A) The rate of primary cesarean deliv-
eries and repeat cesarean deliveries. 
‘‘(B) The rate of vaginal births after cesar-
ean. 
‘‘(C) The rate of vaginal breech births. 
‘‘(D) The rate of induction of labor. 
‘‘(E) The rate of freestanding birth center 
births. 
‘‘(F) The rate of planned and unplanned 
home birth. 
‘‘(G) The rate of attended births by pro-
vider, including by an obstetrician-gynecologist, 
family practice physician, obstetrician-gyne-
cologist physician assistant, certified nurse-mid-
wife, certified midwife, and certified profes-
sional midwife. 
‘‘(H) 
The 
cost 
of 
maternity 
care 
disaggregated by place of birth and provider of 
care, including— 
‘‘(i) uncomplicated vaginal birth; 
‘‘(ii) complicated vaginal birth; 
‘‘(iii) uncomplicated cesarean birth; 
and 
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‘‘(iv) complicated cesarean birth. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated, in addition to such 
amounts authorized to be appropriated under section 
229(e), to carry out this section $1,000,000 for each of 
the fiscal years 2015 through 2019.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) INCLUSION AS DUTY OF HHS OFFICE ON 
WOMEN’S HEALTH.—Section 229(b) of such Act (42 
U.S.C. 237a(b)), as amended, is amended— 
(A) in paragraph (7), at the end, by strik-
ing ‘‘and’’; 
(B) in paragraph (8), at the end, by strik-
ing the period and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
paragraph: 
‘‘(9) establish the Interagency Coordinating 
Committee on the Promotion of Optimal Maternity 
Outcomes in accordance with section 229A.’’. 
(2) TREATMENT OF BIENNIAL REPORTS.—Sec-
tion 229(d) of such Act (42 U.S.C. 237a(d)) is 
amended by inserting ‘‘(other than under subsection 
(b)(9))’’ after ‘‘under this section’’. 
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SEC. 516. CONSUMER EDUCATION CAMPAIGN. 
Section 229 of the Public Health Service Act (42 
U.S.C. 237a), as amended, is further amended in sub-
section (b)— 
(1) in paragraph (8), at the end, by striking 
‘‘and’’; 
(2) in paragraph (9), at the end, by striking the 
period and inserting ‘‘; and’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(10) not later than one year after the date of 
the enactment of the Health Equity and Account-
ability Act of 2014, develop and implement a 4-year 
culturally and linguistically appropriate multimedia 
consumer education campaign that is designed to 
promote understanding and acceptance of evidence- 
based maternity practices and models of care for op-
timal maternity outcomes among women of child-
bearing ages and families of such women and that— 
‘‘(A) highlights the importance of pro-
tecting, promoting, and supporting the innate 
capacities of childbearing women and their 
newborns for childbirth, breastfeeding, and at-
tachment; 
‘‘(B) promotes understanding of the impor-
tance of using obstetric interventions when 
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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 
women, infants, or both to risk of harm if used 
routinely and indiscriminately, including contin-
uous fetal monitoring, labor induction, epidural 
anesthesia, elective primary cesarean section, 
and repeat cesarean delivery; 
‘‘(D) emphasizes the noninvasive maternity 
practices that have strong proven correlation or 
may be associated with considerable improve-
ment in outcomes with no detrimental side ef-
fects, and are significantly underused in the 
United States, including smoking cessation pro-
grams in pregnancy, group model prenatal care, 
continuous labor support, nonsupine positions 
for birth, and external version to turn breech 
babies at term; 
‘‘(E) educates consumers about the quali-
fications of licensed providers of maternity care 
and the best evidence about their safety, satis-
faction, outcomes, and costs; 
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‘‘(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 natural, healthy, and safe approach to 
pregnancy, childbirth, and early parenting; is 
taught by certified educators, peer counselors, 
and health professionals; and promotes in-
formed decisionmaking by childbearing women; 
and 
‘‘(H) is pilot tested for consumer com-
prehension, cultural sensitivity, and acceptance 
of the messages across geographically, racially, 
ethnically, and linguistically diverse popu-
lations.’’. 
SEC. 517. BIBLIOGRAPHIC DATABASE OF SYSTEMATIC RE-
VIEWS FOR CARE OF CHILDBEARING WOMEN 
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, through the Agency for Healthcare 
Research and Quality, shall— 
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(1) make publicly available an online biblio-
graphic database identifying systematic reviews, in-
cluding an explanation of the level and quality of 
evidence, for care of childbearing women 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 Cochrane Database of 
Systematic Reviews, Clinical Evidence, and Data-
base of Abstracts of Reviews of Effects; and 
(3) Internet Web sites of agencies and organi-
zations 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; 
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(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; 
(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— 
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(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)); 
(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 women and advocates for such 
women, including childbirth educators certified by a 
nationally accredited program, representing commu-
nities that are diverse in terms of race, ethnicity, in-
digenous 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 
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fiscal years 2015 through 2017 for the purpose of devel-
oping the database and such sums as may be necessary 
for each subsequent fiscal year for updating the database 
and providing outreach and notification to users, as de-
scribed in this section. 
SEC. 
518. 
MATERNITY 
CARE 
HEALTH 
PROFESSIONAL 
SHORTAGE AREAS. 
Section 332 of the Public Health Service Act (42 
U.S.C. 254e) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(k)(1) The Secretary, acting through the Adminis-
trator of the Health Resources and Services Administra-
tion, shall designate maternity care health professional 
shortage areas in the States, publish a descriptive list of 
the area’s population groups, medical facilities, and other 
public facilities so designated, and at least annually review 
and, as necessary, revise such designations. 
‘‘(2) For purposes of paragraph (1), a complete de-
scriptive list shall be published in the Federal Register not 
later than one year after the date of the enactment of the 
Health Equity and Accountability Act of 2014 and annu-
ally thereafter. 
‘‘(3) The provisions of subsections (b), (c), (e), (f), 
(g), (h), (i), and (j) (other than (j)(1)(B)) of this section 
shall apply to the designation of a maternity care health 
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professional shortage area in a similar manner and extent 
as such provisions apply to the designation of health pro-
fessional shortage areas, except in applying subsection 
(b)(3), the reference in such subsection to ‘physicians’ 
shall be deemed to be a reference to nationally certified 
and State licensed obstetricians, family practice physicians 
who practice full-scope maternity care, certified nurse 
midwives, certified midwives, certified professional mid-
wives, and physician’s assistants who practice full scope 
maternity care. 
‘‘(4) For purposes of this subsection, the term ‘ma-
ternity care health professional shortage area’ means— 
‘‘(A) an area in an urban or rural area (which 
need not conform to the geographic boundaries of a 
political subdivision and which is a rational area for 
the delivery of health services) which the Secretary 
determines has a shortage of providers of maternity 
care health services including those referenced in 
paragraph (3) or an urban or rural area that the 
Secretary determines has lost a significant number 
of such providers during the 10-year period begin-
ning with 2004 or has no obstetrical providers li-
censed to provide operative obstetrical services; 
‘‘(B) an area in an urban or rural area (which 
need not conform to the geographic boundaries of a 
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political subdivision and which is a rational area for 
the delivery of health services) which the Secretary 
determines has a shortage of hospital or labor and 
delivery units, hospital birth center units, or free-
standing birth centers or an area that lost a signifi-
cant number of these units during the 10-year pe-
riod beginning with 2004; or 
‘‘(C) a population group which the Secretary 
determines has such a shortage of providers or fa-
cilities.’’. 
SEC. 519. EXPANSION OF CDC PREVENTION RESEARCH 
CENTERS PROGRAM TO INCLUDE CENTERS 
ON OPTIMAL MATERNITY OUTCOMES. 
(a) IN GENERAL.—Not later than one year after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, shall support the establishment of 
additional Prevention Research Centers under the Preven-
tion Research Center Program administered by the Cen-
ters for Disease Control and Prevention. Such additional 
centers shall each be known as a Center for Excellence 
on Optimal Maternity Outcomes. 
(b) RESEARCH.—Each Center for Excellence on Opti-
mal Maternity Outcomes shall— 
(1) conduct at least one focused program of re-
search to improve maternity outcomes, including the 
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riage and family therapist is legally authorized to perform 
under State law (or the State regulatory mechanism pro-
vided by State law) of the State in which such services 
are performed, as would otherwise be covered if furnished 
by a physician or as an incident to a physician’s profes-
sional service, but only if no facility or other provider 
charges or is paid any amounts with respect to the fur-
nishing of such services. 
‘‘(2) The term ‘marriage and family therapist’ means 
an individual who— 
‘‘(A) possesses a master’s or doctoral degree 
which qualifies for licensure or certification as a 
marriage and family therapist pursuant to State 
law; 
‘‘(B) after obtaining such degree has performed 
at least 2 years of clinical supervised experience in 
marriage and family therapy; and 
‘‘(C) in the case of an individual performing 
services in a State that provides for licensure or cer-
tification of marriage and family therapists, is li-
censed or certified as a marriage and family thera-
pist in such State. 
‘‘(3) The term ‘mental health counselor services’ 
means services performed by a mental health counselor (as 
defined in paragraph (4)) for the diagnosis and treatment 
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and hepatitis C, and options available for the treat-
ment of chronic hepatitis B and chronic hepatitis C; 
‘‘(2) the promotion of immunization programs 
that increase awareness and access to hepatitis A 
and hepatitis B vaccines for susceptible adults and 
children; 
‘‘(3) the training of health care professionals 
regarding the importance of vaccinating individuals 
infected with hepatitis C and individuals who are at 
risk for hepatitis C infection against hepatitis A and 
hepatitis B; 
‘‘(4) the training of health care professionals 
regarding the importance of vaccinating individuals 
chronically infected with hepatitis B and individuals 
who are at risk for chronic hepatitis B infection 
against the hepatitis A virus; 
‘‘(5) the training of health care professionals 
and health educators to make them aware of the 
high rates of chronic hepatitis B and chronic hepa-
titis C in certain adult ethnic populations, and the 
importance of prevention, detection, and medical 
management of hepatitis B and hepatitis C and of 
liver cancer screening; 
‘‘(6) the development and distribution of health 
education curricula (including information relating 
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