I 
116TH CONGRESS 
1ST SESSION H. R. 4215 
To improve maternal health care quality, to improve the training of health 
care professionals to reduce or prevent discrimination in certain health 
care services, to improve perinatal care, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
AUGUST 30, 2019 
Mr. BUCSHON (for himself, Mr. CARSON of Indiana, Mr. BURGESS, Mr. BILI-
RAKIS, Mrs. BROOKS of Indiana, Ms. HERRERA BEUTLER, Mr. LONG, 
Mrs. MCBATH, and Mr. WALDEN) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To improve maternal health care quality, to improve the 
training of health care professionals to reduce or prevent 
discrimination in certain health care services, to improve 
perinatal care, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Excellence in Maternal 
Health Act of 2019’’. 
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SEC. 2. INNOVATION FOR MATERNAL HEALTH. 
The Public Health Service Act is amended by insert-
ing after section 330M of such Act (42 U.S.C. 254c–19) 
the following: 
‘‘SEC. 330N. INNOVATION FOR MATERNAL HEALTH. 
‘‘(a) IN GENERAL.—The Secretary, in consultation 
with experts representing a variety of clinical specialties, 
State, tribal, or local public health officials, researchers, 
epidemiologists, statisticians, and community organiza-
tions, shall establish or continue a program to award com-
petitive grants to eligible entities for the purpose of— 
‘‘(1) identifying, developing, or disseminating 
best practices to improve maternal health care qual-
ity and outcomes, eliminate preventable maternal 
mortality and severe maternal morbidity, and im-
prove infant health outcomes, which may include— 
‘‘(A) information on evidence-based prac-
tices to improve the quality and safety of ma-
ternal health care in hospitals and other health 
care settings of a State or health care system, 
including by addressing topics commonly associ-
ated with health complications or risks related 
to prenatal care, labor care, birthing, and 
postpartum care; 
‘‘(B) best practices for improving maternal 
health care based on data findings and reviews 
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conducted by a State maternal mortality review 
committee that address topics of relevance to 
common complications or health risks related to 
prenatal care, labor care, birthing, and postpar-
tum care; and 
‘‘(C) information on addressing deter-
minants of health that impact maternal health 
outcomes for women before, during, and after 
pregnancy; 
‘‘(2) collaborating with State maternal mor-
tality review committees to identify issues for the de-
velopment and implementation of evidence-based 
practices to improve maternal health outcomes and 
reduce preventable maternal mortality and severe 
maternal morbidity; 
‘‘(3) providing technical assistance and sup-
porting the implementation of best practices identi-
fied in paragraph (1) to entities providing health 
care services to pregnant and postpartum women; 
and 
‘‘(4) identifying, developing, and evaluating new 
models of care that improve maternal and infant 
health outcomes, which may include the integration 
of community-based services and clinical care. 
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‘‘(b) ELIGIBLE ENTITIES.—To be eligible for a grant 
under subsection (a), an entity shall— 
‘‘(1) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require; and 
‘‘(2) demonstrate in such application that the 
entity is capable of carrying out data-driven mater-
nal safety and quality improvement initiatives in the 
areas of obstetrics and gynecology or maternal 
health. 
‘‘(c) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $10,000,000 for each of fiscal years 2020 through 
2024.’’. 
SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS. 
Title VII of the Public Health Service Act is amended 
by striking section 763 (42 U.S.C. 294p) and inserting 
the following: 
‘‘SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS. 
‘‘(a) GRANT PROGRAM.—The Secretary shall estab-
lish a program to award grants to accredited schools of 
allopathic medicine, osteopathic medicine, and nursing, 
and other health professional training programs for the 
training of health care professionals to reduce and prevent 
discrimination (including training related to implicit bi-
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ases) in the provision of health care services related to 
prenatal care, labor care, birthing, and postpartum care. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant under 
subsection (a), an entity described in such subsection shall 
submit to the Secretary an application at such time, in 
such manner, and containing such information as the Sec-
retary may require. 
‘‘(c) 
REPORTING
REQUIREMENT.—Each 
entity 
awarded a grant under this section shall periodically sub-
mit to the Secretary a report on the status of activities 
conducted using the grant, including a description of the 
impact of such training on patient outcomes, as applicable. 
‘‘(d) BEST PRACTICES.—The Secretary may identify 
and disseminate best practices for the training of health 
care professionals to reduce and prevent discrimination 
(including training related to implicit biases) in the provi-
sion of health care services related to prenatal care, labor 
care, birthing, and postpartum care. 
‘‘(e) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $5,000,000 for each of fiscal years 2020 through 
2024.’’. 
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SEC. 4. STUDY ON TRAINING TO REDUCE AND PREVENT 
DISCRIMINATION. 
Not later than 2 years after date of enactment of this 
Act, the Secretary of Health and Human Services (re-
ferred to in this section as the ‘‘Secretary’’) shall, through 
a contract with an independent research organization, con-
duct a study 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 reduce and prevent 
discrimination, including training related to implicit bi-
ases, in the provision of health care services related to pre-
natal care, labor care, birthing, and postpartum care. 
SEC. 5. PERINATAL QUALITY COLLABORATIVES. 
(a) GRANTS.—Section 317K(a)(2) of the Public 
Health Service Act (42 U.S.C. 247b–12(a)(2)) is amended 
by adding at the end the following: 
‘‘(E)(i) The Secretary, acting through the 
Director of the Centers for Disease Control and 
Prevention and in coordination with other of-
fices and agencies, as appropriate, shall estab-
lish or continue a competitive grant program 
for the establishment or support of perinatal 
quality collaboratives to improve perinatal care 
and perinatal health outcomes for pregnant and 
postpartum women and their infants. A State, 
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Indian Tribe, or Tribal organization may use 
funds received through such grant to— 
‘‘(I) support the use of evidence- 
based or evidence-informed practices 
to improve outcomes for maternal and 
infant health; 
‘‘(II) work with clinical teams; 
experts; State, local, and, as appro-
priate, tribal public health officials; 
and stakeholders, including patients 
and families, to identify, develop, or 
disseminate best practices to improve 
perinatal care and outcomes; and 
‘‘(III) employ strategies that pro-
vide opportunities for health care pro-
fessionals and clinical teams to col-
laborate across health care settings 
and disciplines, including primary 
care and mental health, as appro-
priate, to improve maternal and infant 
health outcomes, which may include 
the use of data to provide timely feed-
back across hospital and clinical 
teams to inform responses, and to 
provide support and training to hos-
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pital and clinical teams for quality im-
provement, as appropriate. 
‘‘(ii) To be eligible for a grant under 
clause (i), an entity shall submit to the 
Secretary an application in such form and 
manner and containing such information 
as the Secretary may require.’’. 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 
317K(f) of the Public Health Service Act (42 U.S.C. 
247b–12(f)) is amended by striking ‘‘$58,000,000 for 
each of fiscal years 2019 through 2023’’ and inserting 
‘‘$65,000,000 for each of fiscal years 2020 through 
2024’’. 
SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND 
POSTPARTUM WOMEN. 
(a) GRANTS.—The Public Health Service Act is 
amended by inserting after section 330N of such Act, as 
added by section 2, the following: 
‘‘SEC. 330O. 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 inte-
grated health care services to pregnant and postpartum 
women to optimize the health of women and their infants, 
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including to reduce adverse maternal health outcomes, 
pregnancy-related deaths, and related health disparities 
(including such disparities associated with racial and eth-
nic minority populations), and, as appropriate, by address-
ing 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 Edu-
cation Assistance Act) shall work with relevant 
stakeholders that coordinate care (including coordi-
nating resources and referrals for health care and 
social services) to develop and carry out the pro-
gram, including— 
‘‘(A) State, Tribal, and local agencies re-
sponsible for Medicaid, public health, social 
services, mental health, and substance use dis-
order treatment and services; 
‘‘(B) health care providers who serve preg-
nant and postpartum women; and 
‘‘(C) community-based health organiza-
tions and health workers, including providers of 
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home visiting services and individuals rep-
resenting communities with disproportionately 
high rates of maternal mortality and severe ma-
ternal morbidity, and including those rep-
resenting racial and ethnicity minority popu-
lations. 
‘‘(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) PREFERENCE.—In awarding grants 
under subsection (a), the Secretary shall— 
‘‘(i) give preference to States, Indian 
Tribes, and Tribal organizations that have 
the highest rates of maternal mortality and 
severe maternal morbidity relative to other 
such States, Indian Tribes, or Tribal orga-
nizations, respectively; and 
‘‘(ii) shall consider health disparities 
related to maternal mortality and severe 
maternal morbidity, including such dispari-
ties associated with racial and ethnic mi-
nority populations. 
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‘‘(C) 
PRIORITY.—In 
awarding 
grants 
under subsection (a), the Secretary shall give 
priority to applications from up to 15 entities 
described in subparagraph (B)(i). 
‘‘(D) EVALUATION.—The Secretary shall 
require grantees to evaluate the outcomes of the 
programs supported under the grant. 
‘‘(c) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $15,000,000 for each of fiscal years 2020 through 
2024.’’. 
(b) REPORT ON GRANT OUTCOMES AND DISSEMINA-
TION OF BEST PRACTICES.— 
(1) REPORT.—Not later than February 1, 
2026, the Secretary of Health and Human Services 
shall submit to the Committee on Health, Edu-
cation, 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 sup-
ported by the grants awarded under the amend-
ments made by this section on maternal and 
child health; 
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(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, 2026, the Secretary of Health 
and Human Services shall disseminate information 
on best practices and models of care used by recipi-
ents of grants under the amendments made by this 
section (including best practices and models of care 
relating to the reduction of health disparities, includ-
ing such disparities associated with racial and ethnic 
minority populations, in rates of maternal mortality 
and severe maternal morbidity) to relevant stake-
holders, which may include health providers, medical 
schools, nursing schools, relevant State, tribal, and 
local agencies, and the general public. 
Æ 
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