I 
116TH CONGRESS 
2D SESSION 
H. R. 6164 
To grow and diversify the perinatal workforce, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 10, 2020 
Ms. MOORE (for herself, Ms. UNDERWOOD, Ms. ADAMS, Ms. SEWELL of Ala-
bama, Ms. NORTON, Ms. SCANLON, Mr. CLAY, Mr. KHANNA, Ms. 
PRESSLEY, and Mr. LAWSON of Florida) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
A BILL 
To grow and diversify the perinatal workforce, 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; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Perinatal Workforce Act of 2020’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. HHS agency directives. 
Sec. 3. Grants to grow and diversify the perinatal workforce. 
Sec. 4. Grants to grow and diversify the nursing workforce in maternal and 
perinatal health. 
Sec. 5. GAO report on barriers to maternity care. 
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SEC. 2. 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 
International Confederation of Midwives, nurse 
practitioners, and clinical nurse specialists— 
(i) from racially and ethnically diverse 
backgrounds; 
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(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. 
(b) STUDY ON CULTURALLY CONGRUENT MATER-
NITY CARE.— 
(1) STUDY.—The Secretary of Health and 
Human Services acting through the Director of the 
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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 
groups, and managed care entities that 
have low levels of racial and ethnic dispari-
ties in maternal health outcomes; and 
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(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. 
(c) DEFINITION.—In this section, the term ‘‘cul-
turally congruent’’, with respect to care or maternity care, 
means care that is in agreement with the preferred cul-
tural values, beliefs, worldview, and practices of the health 
care consumer and other stakeholders. 
SEC. 3. 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— 
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‘‘(1) establishing schools or programs that pro-
vide education and training to individuals seeking 
appropriate licensing or certification as— 
‘‘(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; 
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‘‘(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— 
‘‘(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-
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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-
retary shall prepare and submit to the Congress, and post 
on the internet website of the Department of Health and 
Human Services, a report on the effectiveness of the grant 
program under this section at— 
‘‘(1) recruiting minority students, particularly 
from demographic groups experiencing high rates of 
maternal mortality and severe maternal morbidity; 
‘‘(2) increasing the number of physician assist-
ants who will complete clinical training in the field 
of maternal and perinatal health, and other 
perinatal health workers, from demographic groups 
experiencing high rates of maternal mortality and 
severe maternal morbidity; 
‘‘(3) increasing the number of physician assist-
ants who will complete clinical training in the field 
of maternal and perinatal health, and other 
perinatal health workers, working in health profes-
sional shortage areas designated under section 332; 
and 
‘‘(4) increasing the number of physician assist-
ants who will complete clinical training in the field 
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of maternal and perinatal health, and other 
perinatal health workers, working in areas with sig-
nificant racial and ethnic disparities in maternal 
health outcomes. 
‘‘(i) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $15,000,000 for each of fiscal years 2021 through 
2025.’’. 
SEC. 4. GRANTS TO GROW AND DIVERSIFY THE NURSING 
WORKFORCE IN MATERNAL AND PERINATAL 
HEALTH. 
Title VIII of the Public Health Service Act is amend-
ed by inserting after section 811 of that Act (42 U.S.C. 
296j) the following: 
‘‘SEC. 812. PERINATAL NURSING WORKFORCE GRANTS. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to schools of nursing to grow and diversify the perinatal 
nursing workforce. 
‘‘(b) USE OF FUNDS.—Recipients of grants under 
this section shall use the grants to grow and diversify the 
perinatal nursing workforce by providing scholarships to 
students seeking to become— 
‘‘(1) nurse practitioners whose education in-
cludes a focus on maternal and perinatal health; or 
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‘‘(2) clinical nurse specialists whose education 
includes a focus on maternal and perinatal health. 
‘‘(c) PRIORITIZATION.—In awarding grants under 
this section, the Secretary shall give priority to any school 
of nursing that— 
‘‘(1) has developed a strategy to recruit and re-
tain a diverse pool of students seeking to enter ca-
reers focused on maternal and perinatal health; 
‘‘(2) has developed a partnership with a prac-
tice setting in a health professional shortage area 
designated under section 332 for the clinical place-
ments of the school’s students; 
‘‘(3) 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 
‘‘(4) includes in the standard curriculum for all 
students seeking to enter careers focused on mater-
nal and perinatal health a bias, racism, or discrimi-
nation training program that includes education on 
explicit and implicit bias. 
‘‘(d) REPORTING.—As a condition on receipt of a 
grant under this section, a school of nursing shall agree 
to submit to the Secretary an annual report on the activi-
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ties conducted through the grant, including, to the extent 
practicable— 
‘‘(1) the number and demographics of students 
in the school of nursing seeking to enter careers fo-
cused on maternal and perinatal health; 
‘‘(2) the extent to which such students are pre-
paring to enter careers in— 
‘‘(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 standard curriculum for all 
students seeking to enter careers focused on mater-
nal and perinatal health includes a bias, racism, or 
discrimination training program that includes edu-
cation on explicit and implicit bias. 
‘‘(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 applica-
tion, at such time, in such manner, and containing such 
information as the Secretary may require, including any 
information necessary for prioritization under subsection 
(c). 
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‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide, directly or by contract, technical assistance to 
schools of nursing seeking or receiving a grant under this 
section on the processes of awarding and evaluating schol-
arships through the grant. 
‘‘(h) REPORT
BY SECRETARY.—Not later than 4 
years after the date of enactment of this section, the Sec-
retary shall prepare and submit to the Congress, and post 
on the internet website of the Department of Health and 
Human Services, a report on the effectiveness of the grant 
program under this section at— 
‘‘(1) recruiting minority students, particularly 
from demographic groups experiencing high rates of 
maternal mortality and severe maternal morbidity; 
‘‘(2) increasing the number of nurse practi-
tioners and clinical nurse specialists entering careers 
focused on maternal and perinatal health from de-
mographic groups experiencing high rates of mater-
nal mortality and severe maternal morbidity; 
‘‘(3) increasing the number of nurse practi-
tioners and clinical nurse specialists entering careers 
focused on maternal and perinatal health working in 
health professional shortage areas designated under 
section 332; and 
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‘‘(4) increasing the number of nurse practi-
tioners and clinical nurse specialists entering careers 
focused on maternal and perinatal health working in 
areas with significant racial and ethnic disparities in 
maternal health outcomes. 
‘‘(i) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $15,000,000 for each of fiscal years 2021 through 
2025.’’. 
SEC. 5. GAO REPORT ON BARRIERS TO MATERNITY CARE. 
(a) IN GENERAL.—Not later than two years after the 
date of the enactment of this Act and every five years 
thereafter, the Comptroller General of the United States 
shall submit to Congress a report on barriers to maternity 
care in the United States. Such report shall include the 
information and recommendations described in subsection 
(b). 
(b) CONTENT OF REPORT.—The report under sub-
section (a) shall include— 
(1) an assessment of current barriers to enter-
ing accredited midwifery education programs, and 
recommendations for addressing such barriers, par-
ticularly for low-income and minority women; 
(2) an assessment of current barriers to enter-
ing accredited education programs for other mater-
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nity care professional careers, including obstetrician- 
gynecologists, family physicians, physician assist-
ants, nurse practitioners, and clinical nurse special-
ists, particularly for low-income and minority 
women; 
(3) an assessment of current barriers that pre-
vent midwives from meeting the international defini-
tion of the midwife and global standards for mid-
wifery education as established by the International 
Confederation of Midwives, and recommendations 
for addressing such barriers, particularly for low-in-
come and minority women; and 
(4) recommendations to promote greater equity 
in compensation for perinatal health workers, par-
ticularly for such individuals from racially and eth-
nically diverse backgrounds. 
Æ 
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