(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$10,000,000 for each of fiscal years 2023 through 2027. 
SEC. 1102. INVESTMENTS IN COMMUNITY-BASED ORGANI-
ZATIONS TO IMPROVE MATERNAL HEALTH 
OUTCOMES IN UNDERSERVED COMMUNITIES. 
(a) AWARDS.—Following the 1-year period described 
in subsection (c), the Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) 
shall award grants to eligible entities to establish or ex-
pand programs to prevent maternal mortality and severe 
maternal morbidity among underserved groups. 
(b) ELIGIBILITY.—To be eligible to seek a grant 
under this section, an entity shall be a community-based 
organization offering programs and resources aligned with 
evidence-based practices for improving maternal health 
outcomes for pregnant and postpartum individuals. 
(c) OUTREACH
AND TECHNICAL ASSISTANCE PE-
RIOD.—During the 1-year period beginning on the date 
of enactment of this Act, the Secretary shall— 
(1) conduct outreach to encourage eligible enti-
ties to apply for grants under this section; and 
(2) provide technical assistance to eligible enti-
ties on best practices for applying for grants under 
this section. 
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(d) SPECIAL CONSIDERATION.— 
(1) OUTREACH.—In conducting outreach under 
subsection (c), the Secretary shall give special con-
sideration to eligible entities that— 
(A) are based in, and provide support for, 
communities with high rates of adverse mater-
nal health outcomes or significant racial and 
ethnic disparities in maternal health outcomes, 
to the extent such data are available; 
(B) are led by individuals from racially, 
ethnically, and geographically diverse back-
grounds; and 
(C) offer programs and resources that are 
aligned with evidence-based practices for im-
proving maternal health outcomes for pregnant 
and postpartum individuals. 
(2) AWARDS.—In awarding grants under this 
section, the Secretary shall give special consideration 
to eligible entities that— 
(A) are described in subparagraphs (A), 
(B), and (C) of paragraph (1); 
(B) offer programs and resources designed 
in consultation with and intended for pregnant 
and postpartum individuals from underserved 
groups; and 
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(C) offer programs and resources in the 
communities in which the respective eligible en-
tities are located that— 
(i) promote maternal mental health 
and maternal substance use disorder treat-
ments and support that are aligned with 
evidence-based practices for improving ma-
ternal mental and behavioral health out-
comes for pregnant and postpartum indi-
viduals; 
(ii) address social determinants of ma-
ternal health for pregnant and postpartum 
individuals; 
(iii) promote evidence-based health lit-
eracy and pregnancy, childbirth, and par-
enting 
education 
for 
pregnant 
and 
postpartum individuals; 
(iv) provide support from perinatal 
health 
workers 
to 
pregnant 
and 
postpartum individuals; 
(v) provide culturally congruent train-
ing to perinatal health workers; 
(vi) conduct or support research on 
maternal health outcomes and disparities; 
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(vii) provide support to family mem-
bers of individuals who suffered a preg-
nancy-associated death or pregnancy-re-
lated death; 
(viii) operate midwifery practices that 
provide 
culturally 
congruent 
maternal 
health care and support, including for the 
purposes of— 
(I) supporting additional edu-
cation, training, and certification pro-
grams, including support for distance 
learning; 
(II) providing financial support 
to current and future midwives to ad-
dress education costs, debts, and 
other needs; 
(III) clinical site investments; 
(IV) supporting preceptor devel-
opment trainings; 
(V) expanding the midwifery 
practice; or 
(VI) related needs identified by 
the midwifery practice and described 
in the practice’s application; or 
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(ix) have developed other programs 
and resources that address community-spe-
cific needs for pregnant and postpartum 
individuals and are aligned with evidence- 
based practices for improving maternal 
health 
outcomes 
for 
pregnant 
and 
postpartum individuals. 
(e) TECHNICAL ASSISTANCE.—The Secretary shall 
provide to grant recipients under this section technical as-
sistance on— 
(1) capacity building to establish or expand pro-
grams to prevent adverse maternal health outcomes 
among pregnant and postpartum individuals from 
underserved groups; 
(2) best practices in data collection, measure-
ment, evaluation, and reporting; and 
(3) planning for sustaining programs to prevent 
maternal mortality and severe maternal morbidity 
among pregnant and postpartum individuals from 
underserved groups after the period of the grant. 
(f) EVALUATION.—Not later than the end of fiscal 
year 2027, the Secretary shall submit to the Congress an 
evaluation of the grant program under this section that— 
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(1) assesses the effectiveness of outreach efforts 
during the application process in diversifying the 
pool of grant recipients; 
(2) makes recommendations for future outreach 
efforts to diversify the pool of grant recipients for 
Department of Health and Human Services grant 
programs and funding opportunities related to ma-
ternal health; 
(3) assesses the effectiveness of programs fund-
ed by grants under this section in improving mater-
nal health outcomes for pregnant and postpartum 
individuals from underserved groups, to the extent 
practicable; and 
(4) makes recommendations for future Depart-
ment of Health and Human Services grant programs 
and funding opportunities that deliver funding to 
community-based organizations that provide pro-
grams and resources that are aligned with evidence- 
based practices for improving maternal health out-
comes for pregnant and postpartum individuals. 
(g) DEFINITION.—In this section, the term ‘‘under-
served groups’’ refers to pregnant and postpartum individ-
uals— 
(1) from racial and ethnic minority groups (as 
such term is defined in section 1707(g)(1) of the 
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Public Health Service Act (42 U.S.C. 300u– 
6(g)(1))); 
(2) whose household income is equal to or less 
than 150 percent of the Federal poverty line; 
(3) who live in health professional shortage 
areas (as such term is defined in section 332 of the 
Public Health Service Act (42 U.S.C. 254e(a)(1))); 
(4) who live in counties with no hospital offer-
ing obstetric care, no birth center, and no obstetric 
provider; or 
(5) who live in counties with a level of vulner-
ability of moderate-to-high or higher, according to 
the Social Vulnerability Index of the Centers for 
Disease Control and Prevention. 
(h) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$10,000,000 for each of fiscal years 2023 through 2027. 
SEC. 1103. RESPECTFUL MATERNITY CARE TRAINING FOR 
ALL EMPLOYEES IN MATERNITY CARE SET-
TINGS. 
Part B of title VII of the Public Health Service Act 
(42 U.S.C. 293 et seq.) is amended by adding at the end 
the following new section: 
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‘‘SEC. 742. RESPECTFUL MATERNITY CARE TRAINING FOR 
ALL EMPLOYEES IN MATERNITY CARE SET-
TINGS. 
‘‘(a) GRANTS.—The Secretary shall award grants for 
programs to reduce and prevent bias, racism, and dis-
crimination in maternity care settings and to advance re-
spectful, culturally congruent, trauma-informed care. 
‘‘(b) SPECIAL CONSIDERATION.—In awarding grants 
under subsection (a), the Secretary shall give special con-
sideration to applications for programs that would— 
‘‘(1) apply to all maternity care providers and 
any employees who interact with pregnant and 
postpartum individuals in the provider setting, in-
cluding front desk employees, sonographers, sched-
ulers, health care professionals, hospital or health 
system administrators, security staff, and other em-
ployees; 
‘‘(2) emphasize periodic, as opposed to one- 
time, trainings for all birthing professionals and em-
ployees described in paragraph (1); 
‘‘(3) address implicit bias, racism, and cultural 
humility; 
‘‘(4) be delivered in ongoing education settings 
for providers maintaining their licenses, with a pref-
erence for trainings that provide continuing edu-
cation units; 
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‘‘(5) include trauma-informed care best prac-
tices and an emphasis on shared decision making be-
tween providers and patients; 
‘‘(6) include antiracism training and programs; 
‘‘(7) be delivered in undergraduate programs 
that funnel into health professions schools; 
‘‘(8) be delivered in settings that apply to pro-
viders of the special supplemental nutrition program 
for women, infants, and children under section 17 of 
the Child Nutrition Act of 1966; 
‘‘(9) integrate bias training in obstetric emer-
gency simulation trainings or related trainings; 
‘‘(10) include training for emergency depart-
ment employees and emergency medical technicians 
on recognizing warning signs for severe pregnancy- 
related complications; 
‘‘(11) offer training to all maternity care pro-
viders on the value of racially, ethnically, and profes-
sionally diverse maternity care teams to provide cul-
turally congruent care; or 
‘‘(12) be based on one or more programs de-
signed by a historically Black college or university or 
other minority-serving institution. 
‘‘(c) APPLICATION.—To seek a grant under sub-
section (a), an entity shall submit an application at such 
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time, in such manner, and containing such information as 
the Secretary may require. 
‘‘(d) REPORTING.—Each recipient of a grant under 
this section shall annually submit to the Secretary a report 
on the status of activities conducted using the grant, in-
cluding, as applicable, a description of the impact of train-
ing provided through the grant on patient outcomes and 
patient experience for pregnant and postpartum individ-
uals from racial and ethnic minority groups and their fam-
ilies. 
‘‘(e) BEST PRACTICES.—Based on the annual reports 
submitted pursuant to subsection (d), the Secretary— 
‘‘(1) shall produce an annual report on the find-
ings resulting from programs funded through this 
section; 
‘‘(2) shall disseminate such report to all recipi-
ents of grants under this section and to the public; 
and 
‘‘(3) may include in such report findings on 
best practices for improving patient outcomes and 
patient experience for pregnant and postpartum in-
dividuals from racial and ethnic minority groups and 
their families in maternity care settings. 
‘‘(f) DEFINITIONS.—In this section: 
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‘‘(1) The term ‘postpartum’ means the one-year 
period beginning on the last day of an individual’s 
pregnancy. 
‘‘(2) The term ‘culturally congruent’ means in 
agreement with the preferred cultural values, beliefs, 
world view, language, and practices of the health 
care consumer and other stakeholders. 
‘‘(3) The term ‘racial and ethnic minority 
group’ has the meaning given such term in section 
1707(g)(1). 
‘‘(g) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $5,000,000 for each of fiscal years 2023 through 
2027.’’. 
SEC. 1104. STUDY ON REDUCING AND PREVENTING BIAS, 
RACISM, AND DISCRIMINATION IN MATER-
NITY CARE SETTINGS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall seek to enter into an agreement, 
not later than 90 days after the date of enactment of this 
Act, with the National Academies of Sciences, Engineer-
ing, and Medicine (referred to in this section as the ‘‘Na-
tional Academies’’) under which the National Academies 
agree to— 
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(1) conduct a study on the design and imple-
mentation of programs to reduce and prevent bias, 
racism, and discrimination in maternity care settings 
and to advance respectful, culturally congruent, 
trauma-informed care; and 
(2) not later than 24 months after the date of 
enactment of this Act— 
(A) complete the study; and 
(B) transmit a report on the results of the 
study to the Congress. 
(b) POSSIBLE TOPICS.—The agreement entered into 
pursuant to subsection (a) may provide for the study of 
any of the following: 
(1) The development of a scorecard or other 
evaluation standards for programs designed to re-
duce and prevent bias, racism, and discrimination in 
maternity care settings to assess the effectiveness of 
such programs in improving patient outcomes and 
patient experience for pregnant and postpartum in-
dividuals from racial and ethnic minority groups and 
their families. 
(2) Determination of the types and frequency of 
training to reduce and prevent bias, racism, and dis-
crimination in maternity care settings that are dem-
onstrated to improve patient outcomes or patient ex-
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perience for pregnant and postpartum individuals 
from racial and ethnic minority groups and their 
families. 
SEC. 1105. RESPECTFUL MATERNITY CARE COMPLIANCE 
PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’) shall award grants to accredited hospitals, health 
systems, and other maternity care settings to establish as 
an integral part of quality implementation initiatives with-
in one or more hospitals or other birth settings a respect-
ful maternity care compliance program. 
(b) PROGRAM REQUIREMENTS.—A respectful mater-
nity care compliance program funded through a grant 
under this section shall— 
(1) institutionalize mechanisms to allow pa-
tients receiving maternity care services, the families 
of such patients, or perinatal health workers sup-
porting such patients to report instances of racism 
or evidence of bias on the basis of race, ethnicity, or 
another protected class; 
(2) 
institutionalize 
response 
mechanisms 
through which representatives of the program can 
directly follow up with the patient, if possible, and 
the patient’s family in a timely manner; 
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(3) prepare and make publicly available a 
hospital- or health system-wide strategy to reduce 
bias on the basis of race, ethnicity, or another pro-
tected class in the delivery of maternity care that in-
cludes— 
(A) information on the training programs 
to reduce and prevent bias, racism, and dis-
crimination on the basis of race, ethnicity, or 
another protected class for all employees in ma-
ternity care settings; 
(B) information on the number of cases re-
ported to the compliance program; and 
(C) the development of methods to rou-
tinely assess the extent to which bias, racism, 
or discrimination on the basis of race, ethnicity, 
or another protected class are present in the de-
livery of maternity care to patients from racial 
and ethnic minority groups; 
(4) develop mechanisms to routinely collect and 
publicly report hospital-level data related to patient- 
reported experience of care; and 
(5) provide annual reports to the Secretary with 
information about each case reported to the compli-
ance program over the course of the year containing 
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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 program; 
(C) the response from the compliance pro-
gram; and 
(D) to the extent applicable, institutional 
changes made as a result of the case. 
(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 program within a hospital or 
other birth setting; 
(B) promoting coordination and collabora-
tion between hospitals, health systems, and 
other maternity care delivery settings on the es-
tablishment and implementation of respectful 
maternity care compliance programs; and 
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(C) evaluating the effectiveness of respect-
ful maternity care compliance programs on ma-
ternal health outcomes and patient and family 
experiences, especially for patients from racial 
and ethnic minority groups 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— 
(i) racism or bias on the basis of race, 
ethnicity, or another protected class in the 
delivery of maternity care services; and 
(ii) successful implementation of re-
spectful care initiatives. 
(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 programs pur-
suant to subsection (b)(5). 
(ii) Based on such assessment, rec-
ommendations for potential accountability 
mechanisms related to cases of racism or 
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bias on the basis of race, ethnicity, or an-
other protected class in the delivery of ma-
ternity care services at hospitals and other 
birth settings. Such recommendations 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 2023 
through 2028. 
SEC. 1106. GAO REPORT. 
(a) IN GENERAL.—Not later than 2 years after the 
date of enactment of this Act and annually 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 pro-
grams within hospitals, health systems, and other mater-
nity 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 programs, including— 
(A) which hospitals and other birth set-
tings elect to establish compliance programs 
and when such programs are established; 
(B) to the extent practicable, impacts of 
the establishment of such programs on mater-
nal health outcomes and patient and family ex-
periences in the hospitals and other birth set-
tings that have established such programs, es-
pecially for patients from racial and ethnic mi-
nority groups and their families; 
(C) information on geographic areas, and 
types of hospitals or other birth settings, where 
respectful maternity care compliance programs 
are not being established and information on 
factors contributing to decisions to not establish 
such programs; and 
(D) recommendations for establishing re-
spectful maternity care compliance programs in 
geographic areas, and types of hospitals or 
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other birth settings, where such programs 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. 
Subtitle C—Protecting Moms Who 
Served 
SEC. 1201. SUPPORT FOR MATERNITY CARE COORDINA-
TION. 
(a) PROGRAM
ON MATERNITY CARE COORDINA-
TION.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall carry out the maternity care coordina-
tion program described in Veterans Health Adminis-
tration Handbook 1330.03, or any successor hand-
book. 
(2) TRAINING AND SUPPORT.—In carrying out 
the program under paragraph (1), the Secretary 
shall provide to community maternity care providers 
training and support with respect to the unique 
needs of pregnant and postpartum veterans, particu-
larly regarding mental and behavioral health condi-
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tions relating to the service of the veterans in the 
Armed Forces. 
(b) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized 
to 
be 
appropriated 
to 
the 
Secretary 
$15,000,000 for fiscal year 2023 for the maternity care 
coordination program. Such amounts are authorized in ad-
dition to any other amounts authorized for such purpose. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘community maternity care pro-
viders’’ means maternity care providers located at 
non-Department facilities who provide maternity 
care to veterans under section 1703 of title 38, 
United States Code, or other provisions of law ad-
ministered by the Secretary of Veterans Affairs. 
(2) The term ‘‘non-Department facilities’’ has 
the meaning given that term in section 1701 of title 
38, United States Code. 
SEC. 1202. REPORT ON MATERNAL MORTALITY AND SE-
VERE MATERNAL MORBIDITY AMONG PREG-
NANT AND POSTPARTUM VETERANS. 
(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 
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maternal mortality and severe maternal morbidity among 
pregnant and postpartum veterans, with a particular focus 
on racial and ethnic disparities in maternal health out-
comes for veterans. 
(b) MATTERS INCLUDED.—The report under sub-
section (a) shall include the following: 
(1) To the extent practicable— 
(A) 
the 
number 
of 
pregnant 
and 
postpartum veterans who have experienced a 
pregnancy-related death or pregnancy-associ-
ated death in the most recent 10 years of avail-
able data; 
(B) the rate of pregnancy-related deaths 
per 100,000 live births for pregnant and 
postpartum veterans; 
(C) the number of cases of severe maternal 
morbidity among pregnant and postpartum vet-
erans in the most recent year of available data; 
(D) the racial and ethnic disparities in ma-
ternal mortality and severe maternal morbidity 
rates among pregnant and postpartum veterans; 
(E) identification of the causes of maternal 
mortality and severe maternal morbidity that 
are unique to veterans, including post-traumatic 
stress disorder, military sexual trauma, and in-
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fertility or miscarriages that may be caused by 
such service; 
(F) identification of the causes of maternal 
mortality and severe maternal morbidity that 
are unique to veterans from racial and ethnic 
minority groups; 
(G) identification of any correlations be-
tween the former rank of veterans and their 
maternal health outcomes; 
(H) the number of veterans who have been 
diagnosed with infertility by Veterans Health 
Administration providers each year in the most 
recent five years, disaggregated by age, race, 
ethnicity, sex, marital status, sexual orientation, 
gender identity, and geographical location; 
(I) the number of veterans who receive a 
clinical diagnosis of unexplained infertility by 
Veterans Health Administration providers each 
year in the most recent five years; and 
(J) the extent to which the rate of inci-
dence of clinically diagnosed infertility among 
veterans compare or differ to the rate of inci-
dence of clinically diagnosed infertility among 
the civilian population. 
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(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 pregnant and 
postpartum veterans— 
(A) who have health care coverage through 
the Department; 
(B) enrolled in the TRICARE program; 
(C) with employer-based or private insur-
ance; 
(D) enrolled in the Medicaid program; and 
(E) who are uninsured. 
(3) Recommendations for legislative and admin-
istrative actions to increase access to mental and be-
havioral health care for pregnant and postpartum 
veterans who screen positively for maternal mental 
or behavioral health conditions. 
(4) Recommendations to address homelessness, 
food insecurity, poverty, and related issues among 
pregnant and postpartum veterans. 
(5) Recommendations on how to effectively edu-
cate maternity care providers on best practices for 
providing maternity care services to veterans that 
addresses the unique maternal health care needs of 
veteran populations. 
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(6) Recommendations to reduce maternal mor-
tality and severe maternal morbidity among preg-
nant and postpartum veterans and to address racial 
and ethnic disparities in maternal health outcomes 
for each of the groups described in subparagraphs 
(A) through (E) of paragraph (2). 
(7) Recommendations to improve coordination 
of care between the Department and non-Depart-
ment facilities for pregnant and postpartum vet-
erans, including recommendations to improve— 
(A) health record interoperability; and 
(B) training for the directors of the Vet-
erans Integrated Service Networks, directors of 
medical facilities of the Department, chiefs of 
staff of such facilities, maternity care coordina-
tors, and staff of relevant non-Department fa-
cilities. 
(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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