Black Maternal Health Momnibus Act of 2021
Bill: S.346 | Sponsor: Sen. Booker, Cory A. (D-NJ)
Policy area: Health

Summary:
Black Maternal Health Momnibus Act of 2021
This bill directs multi-agency efforts to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19 (i.e., coronavirus disease 2019).
The Department of Health and Human Services (HHS) and other specified departments must address the social determinants of maternal health, which include child care, housing, food security, transportation, and environmental conditions.
The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children.
Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce.
To increase access to maternity care, HHS and other agencies must (1) award specified grants; (2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and (3) support training, technology, and telehealth initiatives.
The bill also increases research and data collection on maternal morbidity and mortality, particularly among tribal populations and minority groups.
The Bureau of Prisons and the Department of Justice must establish programs to improve maternity care for incarcerated populations. The Medicaid and CHIP Payment and Access Commission must also report on the impact of Medicaid ineligibility for pregnant and postpartum prisoners. Additionally, as a condition for certain grants, states and territories must have laws limiting the use of restraints on pregnant individuals in prisons.
The bill also directs activities to mitigate adverse maternal health outcomes associated with climate change and to improve maternal vaccination rates.

To end preventable maternal mortality and severe maternal morbidity in 
 the United States and close disparities in maternal health outcomes, 
                        and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Black Maternal Health Momnibus Act 
of 2021''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Definitions.
Sec. 4. Sense of Congress.
                 TITLE I--SOCIAL DETERMINANTS FOR MOMS

Sec. 101. Task force to develop a strategy to address social 
                            determinants of maternal health.
Sec. 102. Housing for Moms grant program.
Sec. 103. Department of Transportation.
Sec. 104. Department of Agriculture.
Sec. 105. Environmental study through National Academies.
Sec. 106. Child care access.
Sec. 107. Grants to local entities addressing social determinants of 
                            maternal health.
                    TITLE II--HONORING KIRA JOHNSON

Sec. 201. Investments in community-based organizations to improve Black 
                            maternal health outcomes.
Sec. 202. Investments in community-based organizations to improve 
                            maternal health outcomes in underserved 
                            communities.
Sec. 203. Respectful maternity care training for all employees in 
                            maternity care settings.
Sec. 204. Study on reducing and preventing bias, racism, and 
                            discrimination in maternity care settings.
Sec. 205. Respectful maternity care compliance program.
Sec. 206. GAO report.
                 TITLE III--PROTECTING MOMS WHO SERVED

Sec. 301. Codification of maternity coordination program of Department 
                            of Veterans Affairs.
Sec. 302. Report on maternal mortality and severe maternal morbidity 
                            among pregnant and postpartum veterans.
                     TITLE IV--PERINATAL WORKFORCE

Sec. 401. HHS agency directives.
Sec. 402. Grants to grow and diversify the perinatal workforce.
Sec. 403. Grants to grow and diversify the nursing workforce in 
                            maternal and perinatal health.
Sec. 404. GAO report.
                       TITLE V--DATA TO SAVE MOMS

Sec. 501. Funding for maternal mortality review committees to promote 
                            representative community engagement.
Sec. 502. Data collection and review.
Sec. 503. Review of maternal health data collection processes and 
                            quality measures.
Sec. 504. Indian Health Service study and report on maternal mortality 
                            and severe maternal morbidity.
Sec. 505. Grants to minority-serving institutions to study maternal 
                            mortality, severe maternal morbidity, and 
                            other adverse maternal health outcomes.
                         TITLE VI--MOMS MATTER

Sec. 601. Maternal mental health equity grant program.
Sec. 602. Grants to grow and diversify the maternal mental and 
                            behavioral health care workforce.
                TITLE VII--JUSTICE FOR INCARCERATED MOMS

Sec. 701. Ending the shackling of pregnant individuals.
Sec. 702. Creating model programs for the care of incarcerated 
                            individuals in the prenatal and postpartum 
                            periods.
Sec. 703. Grant program to improve maternal health outcomes for 
                            individuals in State and local prisons and 
                            jails.
Sec. 704. GAO report.
Sec. 705. MACPAC report.
                     TITLE VIII--TECH TO SAVE MOMS

Sec. 801. Integrated telehealth models in maternity care services.
Sec. 802. Grants to expand the use of technology-enabled collaborative 
                            learning and capacity models for pregnant 
                            and postpartum individuals.
Sec. 803. Grants to promote equity in maternal health outcomes through 
                            digital tools.
Sec. 804. Report on the use of technology in maternity care.
                     TITLE IX--IMPACT TO SAVE MOMS

Sec. 901. Perinatal Care Alternative Payment Model Demonstration 
                            Project.
Sec. 902. MACPAC report.
               TITLE X--MATERNAL HEALTH PANDEMIC RESPONSE

Sec. 1001. Definitions.
Sec. 1002. Funding for data collection, surveillance, and research on 
                            maternal health outcomes during the COVID-
                            19 public health emergency.
Sec. 1003. COVID-19 maternal health data collection and disclosure.
Sec. 1004. Inclusion of pregnant individuals and lactating individuals 
                            in vaccine and therapeutic development for 
                            COVID-19.
Sec. 1005. Public health communication regarding maternal care during 
                            COVID-19.
Sec. 1006. Task force on birthing experience and safe maternity care 
                            during a public health emergency.
Sec. 1007. GAO report on maternal health and public health emergency 
                            preparedness.
      TITLE XI--PROTECTING MOMS AND BABIES AGAINST CLIMATE CHANGE

Sec. 1101. Definitions.
Sec. 1102. Grant program to protect vulnerable mothers and babies from 
                            climate change risks.
Sec. 1103. Grant program for education and training at health 
                            profession schools.
Sec. 1104. NIH Consortium on Birth and Climate Change Research.
Sec. 1105. Strategy for identifying climate change risk zones for 
                            vulnerable mothers and babies.
                    TITLE XII--MATERNAL VACCINATIONS

Sec. 1201. Maternal vaccination awareness and equity campaign.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Culturally congruent.--The term ``culturally 
        congruent'', with respect to care or maternity care, means care 
        that is in agreement with the preferred cultural values, 
        beliefs, worldview, language, and practices of the health care 
        consumer and other stakeholders.
            (2) Maternity care provider.--The term ``maternity care 
        provider'' means a health care provider who--
                    (A) is a physician, physician assistant, midwife 
                who meets at a minimum the international definition of 
                the midwife and global standards for midwifery 
                education as established by the International 
                Confederation of Midwives, nurse practitioner, or 
                clinical nurse specialist; and
                    (B) has a focus on maternal or perinatal health.
            (3) Maternal mortality.--The term ``maternal mortality'' 
        means a death occurring during or within a one-year period 
        after pregnancy, caused by pregnancy-related or childbirth 
        complications, including a suicide, overdose, or other death 
        resulting from a mental health or substance use disorder 
        attributed to or aggravated by pregnancy-related or childbirth 
        complications.
            (4) Perinatal health worker.--The term ``perinatal health 
        worker'' means a doula, community health worker, peer 
        supporter, breastfeeding and lactation educator or counselor, 
        nutritionist or dietitian, childbirth educator, social worker, 
        home visitor, language interpreter, or navigator.
            (5) Postpartum and postpartum period.--The terms 
        ``postpartum'' and ``postpartum period'' refer to the 1-year 
        period beginning on the last day of the pregnancy of an 
        individual.
            (6) Pregnancy-associated death.--The term ``pregnancy-
        associated death'' means a death of a pregnant or postpartum 
        individual, by any cause, that occurs during, or within 1 year 
        following, the individual's pregnancy, regardless of the 
        outcome, duration, or site of the pregnancy.
            (7) Pregnancy-related death.--The term ``pregnancy-related 
        death'' means a death of a pregnant or postpartum individual 
        that occurs during, or within 1 year following, the 
        individual's pregnancy, from a pregnancy complication, a chain 
        of events initiated by pregnancy, or the aggravation of an 
        unrelated condition by the physiologic effects of pregnancy.
            (8) Racial and ethnic minority group.--The term ``racial 
        and ethnic minority group'' has the meaning given such term in 
        section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 
        300u-6(g)(1)).
            (9) Severe maternal morbidity.--The term ``severe maternal 
        morbidity'' means a health condition, including mental health 
        conditions and substance use disorders, attributed to or 
        aggravated by pregnancy or childbirth that results in 
        significant short-term or long-term consequences to the health 
        of the individual who was pregnant.
            (10) Social determinants of maternal health.--The term 
        ``social determinants of maternal health'' means non-clinical 
        factors that impact maternal health outcomes, including--
                    (A) economic factors, which may include poverty, 
                employment, food security, support for and access to 
                lactation and other infant feeding options, housing 
                stability, and related factors;
                    (B) neighborhood factors, which may include quality 
                of housing, access to transportation, access to child 
                care, availability of healthy foods and nutrition 
                counseling, availability of clean water, air and water 
                quality, ambient temperatures, neighborhood crime and 
                violence, access to broadband, and related factors;
                    (C) social and community factors, which may include 
                systemic racism, gender discrimination or 
                discrimination based on other protected classes, 
                workplace conditions, incarceration, and related 
                factors;
                    (D) household factors, which may include ability to 
                conduct lead testing and abatement, car seat 
                installation, indoor air temperatures, and related 
                factors;
                    (E) education access and quality factors, which may 
                include educational attainment, language and literacy, 
                and related factors; and
                    (F) health care access factors, including health 
                insurance coverage, access to culturally congruent 
                health care services, providers, and non-clinical 
                support, access to home visiting services, access to 
                wellness and stress management programs, health 
                literacy, access to telehealth and items required to 
                receive telehealth services, and related factors.

SEC. 4. SENSE OF CONGRESS.

    It is the sense of Congress that--
            (1) the respect and proper care that birthing people 
        deserve is inclusive; and
            (2) regardless of race, ethnicity, gender identity, sexual 
        orientation, religion, marital status, familial status, 
        socioeconomic status, immigration status, incarceration status, 
        or disability, all deserve dignity.

                 TITLE I--SOCIAL DETERMINANTS FOR MOMS

SEC. 101. TASK FORCE TO DEVELOP A STRATEGY TO ADDRESS SOCIAL 
              DETERMINANTS OF MATERNAL HEALTH.

    (a) In General.--The Secretary of Health and Human Services shall 
convene a task force (in this section referred to as the ``Task 
Force'') to develop a strategy to coordinate efforts between Federal 
agencies to address social determinants of maternal health with respect 
to pregnant and postpartum individuals.
    (b) Ex Officio Members.--The ex officio members of the Task Force 
shall consist of the following:
            (1) The Secretary of Health and Human Services (or a 
        designee thereof).
            (2) The Secretary of Housing and Urban Development (or a 
        designee thereof).
            (3) The Secretary of Transportation (or a designee 
        thereof).
            (4) The Secretary of Agriculture (or a designee thereof).
            (5) The Secretary of Labor (or a designee thereof).
            (6) The Secretary of Defense (or a designee thereof).
            (7) The Secretary of Veterans Affairs (or a designee 
        thereof).
            (8) The Administrator of the Environmental Protection 
        Agency (or a designee thereof).
            (9) The Assistant Secretary for the Administration for 
        Children and Families (or a designee thereof).
            (10) The Administrator of the Centers for Medicare & 
        Medicaid Services (or a designee thereof).
            (11) The Director of the Indian Health Service (or a 
        designee thereof).
            (12) The Director of the National Institutes of Health (or 
        a designee thereof).
            (13) The Administrator of the Health Resources and Services 
        Administration (or a designee thereof).
            (14) The Deputy Assistant Secretary for Minority Health of 
        the Department of Health and Human Services (or a designee 
        thereof).
            (15) The Deputy Assistant Secretary for Women's Health of 
        the Department of Health and Human Services (or a designee 
        thereof).
            (16) The Director of the Centers for Disease Control and 
        Prevention (or a designee thereof).
            (17) The Director of the Office on Violence Against Women 
        at the Department of Justice (or a designee thereof).
    (c) Appointed Members.--In addition to the ex officio members of 
the Task Force, the Secretary of Health and Human Services shall 
appoint the following members of the Task Force:
            (1) At least 2 representatives of patients, to include--
                    (A) a representative of patients who have suffered 
                from severe maternal morbidity; or
                    (B) a representative of patients who is a family 
                member of an individual who suffered a pregnancy-
                related death.
            (2) At least 2 leaders of community-based organizations 
        that address maternal mortality and severe maternal morbidity 
        with a specific focus on racial and ethnic disparities. In 
        appointing such leaders under this paragraph, the Secretary of 
        Health and Human Services shall give priority to individuals 
        who are leaders of organizations led by individuals from racial 
        and ethnic minority groups.
            (3) At least 2 perinatal health workers.
            (4) A professionally diverse panel of maternity care 
        providers.
    (d) Chair.--The Secretary of Health and Human Services shall select 
the chair of the Task Force from among the members of the Task Force.
    (e) Report.--Not later than 2 years after the date of enactment of 
this Act, the Task Force shall submit to Congress a report on--
            (1) the strategy developed under subsection (a);
            (2) recommendations on funding amounts with respect to 
        implementing such strategy;
            (3) recommendations for how to expand coverage of social 
        services to address social determinants of maternal health 
        under Medicaid managed care organizations and State Medicaid 
        programs.
    (f) Termination.--Section 14 of the Federal Advisory Committee Act 
(5 U.S.C. App.) shall not apply to the Task Force with respect to 
termination.

SEC. 102. HOUSING FOR MOMS GRANT PROGRAM.

    (a) In General.--The Secretary of Housing and Urban Development 
shall establish a Housing for Moms grant program under this section to 
make grants to eligible entities to increase access to safe, stable, 
affordable, and adequate housing for pregnant and postpartum 
individuals and their families.
    (b) Application.--To be eligible to receive a grant under this 
section, an eligible entity shall submit to the Secretary an 
application at such time, in such manner, and containing such 
information as the Secretary may provide.
    (c) Priority.--In awarding grants under this section, the Secretary 
shall give priority to an eligible entity that--
            (1) is a community-based organization or will partner with 
        a community-based organization to implement initiatives to 
        increase access to safe, stable, affordable, and adequate 
        housing for pregnant and postpartum individuals and their 
        families;
            (2) is operating in an area with high rates of adverse 
        maternal health outcomes or significant racial or ethnic 
        disparities in maternal health outcomes, to the extent such 
        data are available; and
            (3) is operating in an area with a high poverty rate or 
        significant number of individuals who lack consistent access to 
        safe, stable, affordable, and adequate housing.
    (d) Use of Funds.--An eligible entity that receives a grant under 
this section shall use funds under the grant for the purposes of--
            (1) identifying and conducting outreach to pregnant and 
        postpartum individuals who are low-income and lack consistent 
        access to safe, stable, affordable, and adequate housing;
            (2) providing safe, stable, affordable, and adequate 
        housing options to such individuals;
            (3) connecting such individuals with local organizations 
        offering safe, stable, affordable, and adequate housing 
        options;
            (4) providing application assistance to such individuals 
        seeking to enroll in programs offering safe, stable, 
        affordable, and adequate housing options;
            (5) providing direct financial assistance to such 
        individuals for the purposes of maintaining safe, stable, and 
        adequate housing for the duration of the individual's pregnancy 
        and postpartum periods; and
            (6) working with relevant stakeholders to ensure that local 
        housing and homeless shelter infrastructure is supportive to 
        pregnant and postpartum individuals, including through--
                    (A) health-promoting housing codes;
                    (B) enforcement of housing codes;
                    (C) proactive rental inspection programs;
                    (D) code enforcement officer training; and
                    (E) partnerships between regional offices of the 
                Department of Housing and Urban Development and 
                community-based organizations to ensure housing laws 
                are understood and violations are discovered.
    (e) Reporting.--
            (1) Eligible entities.--The Secretary shall require each 
        eligible entity receiving a grant under this section to 
        annually submit to the Secretary and make publicly available a 
        report on the status of activities conducted using the grant.
            (2) Secretary.--Not later than the end of each fiscal year 
        in which grants are made under this section, the Secretary 
        shall submit to Congress and make publicly available a report 
        that--
                    (A) summarizes the reports received under paragraph 
                (1);
                    (B) evaluates the effectiveness of grants awarded 
                under this section in increasing access to safe, 
                stable, affordable, and adequate housing for pregnant 
                and postpartum individuals and their families; and
                    (C) makes recommendations with respect to ensuring 
                activities described subsection (d) continue after 
                grant amounts made available under this section are 
                expended.
    (f) Definitions.--In this section:
            (1) Eligible entity.--The term ``eligible entity'' means--
                    (A) a community-based organization;
                    (B) a State or local governmental entity, including 
                a State or local public health department;
                    (C) an Indian tribe or tribal organization (as such 
                terms are defined in section 4 of the Indian Self-
                Determination and Education Assistance Act (25 U.S.C. 
                5304)); or
                    (D) an Urban Indian organization (as such term is 
                defined in section 4 of the Indian Health Care 
                Improvement Act (25 U.S.C. 1603)).
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Housing and Urban Development.
    (g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $10,000,000 for fiscal year 
2022, which shall remain available until expended.

SEC. 103. DEPARTMENT OF TRANSPORTATION.

    (a) Report.--Not later than 1 year after the date of enactment of 
this Act, the Secretary of Transportation shall submit to Congress and 
make publicly available a report that contains--
            (1) an assessment of transportation barriers preventing 
        individuals from attending prenatal and postpartum 
        appointments, accessing maternal health care services, or 
        accessing services and resources related to social determinants 
        of maternal health;
            (2) recommendations on how to overcome the barriers 
        described in paragraph (1);
            (3) an assessment of transportation safety risks for 
        pregnant individuals and recommendations on how to mitigate 
        those risks; and
            (4) an assessment of the impact of disabilities, including 
        service-related disabilities, on pregnant and postpartum 
        women's mobility and access to appropriate care.
    (b) Considerations.--In carrying out subsection (a), the Secretary 
of Transportation shall give special consideration to solutions for--
            (1) pregnant and postpartum individuals living in a health 
        professional shortage area designated under section 332 of the 
        Public Health Service Act (42 U.S.C. 254e);
            (2) pregnant and postpartum individuals living in areas 
        with high maternal mortality or severe morbidity rates or 
        significant racial or ethnic disparities in maternal health 
        outcomes; and
            (3) pregnant and postpartum individuals with a disability 
        that impacts mobility.

SEC. 104. DEPARTMENT OF AGRICULTURE.

    (a) Special Supplemental Nutrition Program for Women, Infants, and 
Children.--
            (1) Breastfeeding women.--
                    (A) Definition of breastfeeding woman.--Section 
                17(b) of the Child Nutrition Act of 1966 (42 U.S.C. 
                1786(b)) is amended by striking paragraph (1) and 
                inserting the following:
            ``(1) Breastfeeding woman.--The term `breastfeeding woman' 
        means--
                    ``(A) a woman who is not more than 1 year 
                postpartum and is breastfeeding the infant of the 
                woman; and
                    ``(B) for purposes of subsection (d), a woman who 
                is not more than 2 years postpartum and is 
                breastfeeding the infant of the woman.''.
                    (B) Extension of breastfeeding period.--Section 
                17(d)(3)(A)(ii) of the Child Nutrition Act of 1966 (42 
                U.S.C. 1786(d)(3)(A)(ii)) is amended by striking ``1 
                year'' and inserting ``2 years''.
            (2) Postpartum women.--
                    (A) Definition of postpartum women.--Section 
                17(b)(10) of the Child Nutrition Act of 1966 (42 U.S.C. 
                1786(b)(10)) is amended by striking ``six months'' and 
                inserting ``2 years''.
                    (B) Certification.--Section 17(d)(3)(A) of the 
                Child Nutrition Act of 1966 (42 U.S.C. 1786(d)(3)(A)) 
                is amended by adding at the end the following:
                            ``(iv) Postpartum women.--A State may elect 
                        to certify a postpartum woman for a period of 
                        up to 2 years after the termination of 
                        pregnancy of the postpartum woman.''.
            (3) Report.--Not later than 2 years after the date of 
        enactment of this section, the Secretary of Agriculture shall 
        submit to Congress a report that includes an evaluation of the 
        effect of each of the amendments made by this subsection on--
                    (A) maternal and infant health outcomes, including 
                racial and ethnic disparities with respect to those 
                outcomes;
                    (B) breastfeeding rates among postpartum 
                individuals;
                    (C) qualitative evaluations of family experiences 
                under the special supplemental nutrition program for 
                women, infants, and children established under section 
                17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786); 
                and
                    (D) other relevant information as determined by the 
                Secretary of Agriculture.
    (b) Grant Program for Healthy Food and Clean Water for Pregnant and 
Postpartum Individuals.--
            (1) Definitions.--In this subsection:
                    (A) Eligible entity.--The term ``eligible entity'' 
                means--
                            (i) a community-based organization;
                            (ii) a State or local governmental entity, 
                        including a State or local public health 
                        department;
                            (iii) an Indian tribe or tribal 
                        organization (as those terms are defined in 
                        section 4 of the Indian Self-Determination and 
                        Education Assistance Act (25 U.S.C. 5304)); and
                            (iv) an urban Indian organization (as 
                        defined in section 4 of the Indian Health Care 
                        Improvement Act (25 U.S.C. 1603)).
                    (B) Secretary.--The term ``Secretary'' means the 
                Secretary of Agriculture.
            (2) Establishment.--The Secretary shall establish a program 
        to award grants, on a competitive basis, to eligible entities 
        to carry out the activities described in paragraph (5).
            (3) Application.--To be eligible for a grant under this 
        subsection, an eligible entity shall submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary determines appropriate.
            (4) Priority.--In awarding grants under this subsection, 
        the Secretary shall give priority to an eligible entity that--
                    (A) is, or will partner with, a community-based 
                organization; and
                    (B) is operating in an area with high rates of--
                            (i) adverse maternal health outcomes; or
                            (ii) significant racial or ethnic 
                        disparities in maternal health outcomes.
            (5) Use of funds.--An eligible entity shall use grant funds 
        awarded under this subsection to deliver healthy food, infant 
        formula, clean water, or diapers to pregnant women (as defined 
        in section 17(b) of the Child Nutrition Act of 1966 (42 U.S.C. 
        1786(b))) and postpartum individuals located in areas that are 
        food deserts, as determined by the Secretary using data from 
        the Food Access Research Atlas of the Department of 
        Agriculture.
            (6) Reports.--
                    (A) Eligible entity.--Each eligible entity that 
                receives a grant under this subsection shall, not later 
                than 1 year after receiving the grant, and annually 
                thereafter, submit to the Secretary a report on the 
                status of activities conducted using the grant, which 
                shall contain such information as the Secretary may 
                require.
                    (B) Secretary.--
                            (i) In general.--Not later than 2 years 
                        after the date on which the first grant is 
                        awarded under this subsection, the Secretary 
                        shall submit to Congress a report that 
                        includes--
                                    (I) a summary of the reports 
                                submitted by eligible entities under 
                                subparagraph (A);
                                    (II) an assessment of the extent to 
                                which food distributed through the 
                                grant program under this subsection was 
                                purchased from local and regional food 
                                systems;
                                    (III) an evaluation of the effect 
                                of the grant program under this 
                                subsection on maternal and infant 
                                health outcomes, including racial and 
                                ethnic disparities and disparities 
                                impacting other underserved mothers, 
                                such as mothers living in rural areas, 
                                with respect to those outcomes; and
                                    (IV) recommendations with respect 
                                to ensuring the activities described in 
                                paragraph (5) continue after the grant 
                                funding for those activities expires.
                            (ii) Publication.--The Secretary shall make 
                        the report submitted under clause (i) publicly 
                        available on the website of the Department of 
                        Agriculture.
            (7) Authorization of appropriations.--There is authorized 
        to be appropriated to the Secretary $5,000,000 to carry out 
        this subsection for the period of fiscal years 2022 through 
        2024.

SEC. 105. ENVIRONMENTAL STUDY THROUGH NATIONAL ACADEMIES.

    (a) In General.--Not later than 60 days after the date of enactment 
of this Act, the Administrator of the Environmental Protection Agency 
shall seek to enter into an agreement with the National Academies of 
Sciences, Engineering, and Medicine (referred to in this section as the 
``National Academies'') under which the National Academies agree to 
conduct a study on the impacts of water and air quality, exposure to 
extreme temperatures, exposure to environmental chemicals, 
environmental risks in the workplace and the home, and pollution levels 
on maternal and infant health outcomes.
    (b) Study Requirements.--The agreement under subsection (a) shall 
direct the National Academies to make recommendations for--
            (1) improving the environmental conditions described in 
        that subsection to improve maternal and infant health outcomes; 
        and
            (2) reducing or eliminating racial and ethnic disparities 
        in those outcomes.
    (c) Report.--The agreement under subsection (a) shall require the 
National Academies--
            (1) to complete the study described in that subsection; and
            (2) not later than 1 year after the date of enactment of 
        this Act, to transmit to Congress and make publicly available a 
        report that--
                    (A) describes the results of the study; and
                    (B) includes the recommendations described in 
                subsection (b).

SEC. 106. CHILD CARE ACCESS.

    (a) Grant Program.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall award grants to 
eligible organizations to provide pregnant and postpartum individuals 
with free and accessible drop-in child care services during prenatal 
and postpartum appointments, including for mental health care, prenatal 
and childbirth classes, and labor and delivery. The Secretary shall 
coordinate with the Secretary of Defense to disseminate information 
regarding such services and to expand on-installation drop-in child 
care services for military parents.
    (b) Application.--To be eligible to receive a grant under this 
section, an eligible entity shall submit to the Secretary an 
application at such time, in such manner, and containing such 
information as the Secretary may require.
    (c) Eligible Organizations.--
            (1) Eligibility.--To be eligible to receive a grant under 
        this section, an organization shall be an organization that 
        provides child care services and can carry out programs 
        providing pregnant and postpartum individuals with free and 
        accessible drop-in child care services during prenatal and 
        postpartum appointments.
            (2) Prioritization.--In selecting grant recipients under 
        this section, the Secretary shall give priority to eligible 
        organizations that operate in an area with high rates of 
        adverse maternal health outcomes or significant racial or 
        ethnic disparities in maternal health outcomes, to the extent 
        such data are available.
    (d) Timing.--The Secretary shall commence the grant program under 
subsection (a) not later than 1 year after the date of enactment of 
this Act.
    (e) Reporting.--
            (1) Grantees.--Each recipient of a grant under this section 
        shall annually submit to the Secretary and make publicly 
        available a report on the status of activities conducted using 
        the grant. Each such report shall include--
                    (A) an analysis of the effect of the funded program 
                on prenatal and postpartum appointment attendance 
                rates;
                    (B) summaries of qualitative assessments of the 
                funded program from--
                            (i) pregnant and postpartum individuals 
                        participating in the program; and
                            (ii) the families of such individuals; and
                    (C) such additional information as the Secretary 
                may require.
            (2) Secretary.--Not later than the end of fiscal year 2024, 
        the Secretary shall submit to Congress and make publicly 
        available a report containing the following:
                    (A) A summary of the reports under paragraph (1).
                    (B) An assessment of the effects, if any, of the 
                funded programs on maternal health outcomes, with a 
                specific focus on racial and ethnic disparities in such 
                outcomes.
                    (C) A description of actions the Secretary can take 
                to ensure that pregnant and postpartum individuals 
                eligible for medical assistance under a State plan 
                under title XIX of the Social Security Act (42 U.S.C. 
                1936 et seq.) have access to free and accessible drop-
                in child care services during prenatal and postpartum 
                appointments, including identification of the funding 
                necessary to carry out such actions.
    (f) Drop-In Child Care Services Defined.--In this section, the term 
``drop-in child care services'' means child care and early childhood 
education services that are--
            (1) delivered at a facility that meets the requirements of 
        all applicable laws and regulations of the State or local 
        government in which it is located, including the licensing of 
        the facility as a child care facility; and
            (2) provided in single encounters without requiring full-
        time enrollment of a person in a child care program.
    (g) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $5,000,000 for the period of 
fiscal years 2022 through 2024.

SEC. 107. GRANTS TO LOCAL ENTITIES ADDRESSING SOCIAL DETERMINANTS OF 
              MATERNAL HEALTH.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall award grants to 
eligible entities to--
            (1) address social determinants of maternal health for 
        pregnant and postpartum individuals; and
            (2) eliminate racial and ethnic disparities in maternal 
        health outcomes.
    (b) Application.--To be eligible to receive a grant under this 
subsection an eligible entity shall submit to the Secretary an 
application at such time, in such manner, and containing such 
information as the Secretary may provide.
    (c) Prioritization.--In awarding grants under subsection (a), the 
Secretary shall give priority to an eligible entity that--
            (1) is, or will partner with, a community-based 
        organization to carrying out the activities under subsection 
        (d);
            (2) is operating in an area with high rates of adverse 
        maternal health outcomes or significant racial or ethnic 
        disparities in maternal health outcomes; and
            (3) is operating in an area with a high poverty rate.
    (d) Activities.--An eligible entity that receives a grant under 
this section may--
            (1) hire and retain staff;
            (2) develop and distribute a culturally and linguistically 
        appropriate list of available resources with respect to social 
        service programs in a community, including housing supports, 
        child care access, nutrition counseling, and resources for 
        pregnant women facing intimate partner violence;
            (3) establish a culturally appropriate resource center that 
        provides multiple social service programs in a single location;
            (4) offer programs and resources in the communities in 
        which the respective eligible entities are located to address 
        social determinants of health for pregnant and postpartum 
        individuals; and
            (5) consult with such pregnant and postpartum individuals, 
        including undocumented pregnant individuals, to conduct an 
        assessment of the activities under this subsection.
    (e) Technical Assistance.--The Secretary shall provide to grant 
recipients under this section technical assistance to plan for 
sustaining programs to address social determinants of maternal health 
among pregnant and postpartum individuals after the period of the 
grant.
    (f) Reporting.--
            (1) Grantees.--Not later than 1 year after an eligible 
        entity first receives a grant under this section, and annually 
        thereafter, an eligible entity shall submit to the Secretary, 
        and make publicly available, a report on the status of 
        activities conducted using the grant. Each such report shall 
        include data on the effects of such activities, disaggregated 
        by race, ethnicity, gender, and other relevant factors.
            (2) Secretary.--Not later than the end of fiscal year 2026, 
        the Secretary shall submit to Congress a report that includes--
                    (A) a summary of the reports under paragraph (1); 
                and
                    (B) recommendations for--
                            (i) improving maternal health outcomes; and
                            (ii) reducing or eliminating racial and 
                        ethnic disparities in maternal health outcomes.
    (g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $15,000,000 for each of fiscal 
years 2022 through 2026.

                    TITLE II--HONORING KIRA JOHNSON

SEC. 201. INVESTMENTS IN COMMUNITY-BASED ORGANIZATIONS TO IMPROVE BLACK 
              MATERNAL HEALTH OUTCOMES.

    (a) Awards.--Following the 1-year period beginning on the date of 
enactment of this Act, the Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall award grants to 
eligible entities to establish or expand programs to prevent maternal 
mortality and severe maternal morbidity among Black pregnant and 
postpartum individuals.
    (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 Black pregnant and postpartum 
individuals.
    (c) Outreach and Technical Assistance Period.--During the 1-year 
period beginning on the date of enactment of this Act, the Secretary 
shall--
            (1) conduct outreach to encourage eligible entities to 
        apply for grants under this section; and
            (2) provide technical assistance to eligible entities on 
        best practices for applying for grants under this section.
    (d) Special Consideration.--
            (1) Outreach.--In conducting outreach under subsection (c), 
        the Secretary shall give special consideration to eligible 
        entities that--
                    (A) are based in, and provide support for, 
                communities with high rates of adverse maternal health 
                outcomes or significant racial and ethnic disparities 
                in maternal health outcomes, to the extent such data 
                are available;
                    (B) are led by Black women; and
                    (C) offer programs and resources that are aligned 
                with evidence-based practices for improving maternal 
                health outcomes for Black 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 Black pregnant and 
                postpartum individuals; and
                    (C) offer programs and resources in the communities 
                in which the respective eligible entities are located 
                that--
                            (i) promote maternal mental health and 
                        maternal substance use disorder treatments and 
                        supports that are aligned with evidence-based 
                        practices for improving maternal mental and 
                        behavioral health outcomes for Black pregnant 
                        and postpartum individuals;
                            (ii) address social determinants of 
                        maternal health for pregnant and postpartum 
                        individuals;
                            (iii) promote evidence-based health 
                        literacy and pregnancy, childbirth, and 
                        parenting education for pregnant and postpartum 
                        individuals;
                            (iv) provide support from perinatal health 
                        workers to pregnant and postpartum individuals;
                            (v) provide culturally congruent training 
                        to perinatal health workers;
                            (vi) conduct or support research on 
                        maternal health issues disproportionately 
                        impacting Black pregnant and postpartum 
                        individuals;
                            (vii) provide support to family members of 
                        individuals who suffered a pregnancy-associated 
                        death or pregnancy-related death;
                            (viii) operate midwifery practices that 
                        provide culturally congruent maternal health 
                        care and support, including for the purposes 
                        of--
                                    (I) supporting additional 
                                education, training, and certification 
                                programs, including support for 
                                distance learning;
                                    (II) providing financial support to 
                                current and future midwives to address 
                                education costs, debts, and other 
                                needs;
                                    (III) clinical site investments;
                                    (IV) supporting preceptor 
                                development trainings;
                                    (V) expanding the midwifery 
                                practice; or
                                    (VI) related needs identified by 
                                the midwifery practice and described in 
                                the practice's application; or
                            (ix) have developed other programs and 
                        resources that address community-specific needs 
                        for pregnant and postpartum individuals and are 
                        aligned with evidence-based practices for 
                        improving maternal health outcomes for Black 
                        pregnant and postpartum individuals.
    (e) Technical Assistance.--The Secretary shall provide to grant 
recipients under this section technical assistance on--
            (1) capacity building to establish or expand programs to 
        prevent adverse maternal health outcomes among Black pregnant 
        and postpartum individuals;
            (2) best practices in data collection, measurement, 
        evaluation, and reporting; and
            (3) planning for sustaining programs to prevent maternal 
        mortality and severe maternal morbidity among Black pregnant 
        and postpartum individuals after the period of the grant.
    (f) Evaluation.--Not later than the end of fiscal year 2026, the 
Secretary shall submit to Congress an evaluation of the grant program 
under this section that--
            (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 maternal health;
            (3) assesses the effectiveness of programs funded by grants 
        under this section in improving maternal health outcomes for 
        Black pregnant and postpartum individuals, to the extent 
        practicable; and
            (4) makes recommendations for future Department of Health 
        and Human Services grant programs and funding opportunities 
        that deliver funding to community-based organizations that 
        provide programs and resources that are aligned with evidence-
        based practices for improving maternal health outcomes for 
        Black pregnant and postpartum individuals.
    (g) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $10,000,000 for each of fiscal 
years 2022 through 2026.

SEC. 202. INVESTMENTS IN COMMUNITY-BASED ORGANIZATIONS TO IMPROVE 
              MATERNAL HEALTH OUTCOMES IN UNDERSERVED COMMUNITIES.

    (a) Awards.--Following the 1-year period beginning on the date of 
enactment of this Act, the Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall award grants to 
eligible entities to establish or expand 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 Period.--During the 1-year 
period beginning on the date of enactment of this Act, the Secretary 
shall--
            (1) conduct outreach to encourage eligible entities to 
        apply for grants under this section; and
            (2) provide technical assistance to eligible entities on 
        best practices for applying for grants under this section.
    (d) Special Consideration.--
            (1) Outreach.--In conducting outreach under subsection (c), 
        the Secretary shall give special consideration to eligible 
        entities that--
                    (A) are based in, and provide support for, 
                communities with high rates of adverse maternal 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 backgrounds; and
                    (C) offer programs and resources that are aligned 
                with evidence-based practices for improving 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
                    (C) offer programs and resources in the communities 
                in which the respective eligible entities are located 
                that--
                            (i) promote maternal mental health and 
                        maternal substance use disorder treatments and 
                        support that are aligned with evidence-based 
                        practices for improving maternal mental and 
                        behavioral health outcomes for pregnant and 
                        postpartum individuals;
                            (ii) address social determinants of 
                        maternal health for pregnant and postpartum 
                        individuals;
                            (iii) promote evidence-based health 
                        literacy and pregnancy, childbirth, and 
                        parenting education for pregnant and postpartum 
                        individuals;
                            (iv) provide support from perinatal health 
                        workers to pregnant and postpartum individuals;
                            (v) provide culturally congruent training 
                        to perinatal health workers;
                            (vi) conduct or support research on 
                        maternal health outcomes and disparities;
                            (vii) provide support to family members of 
                        individuals who suffered a pregnancy-associated 
                        death or pregnancy-related death;
                            (viii) operate midwifery practices that 
                        provide culturally congruent maternal health 
                        care and support, including for the purposes 
                        of--
                                    (I) supporting additional 
                                education, training, and certification 
                                programs, including support for 
                                distance learning;
                                    (II) providing financial support to 
                                current and future midwives to address 
                                education costs, debts, and other 
                                needs;
                                    (III) clinical site investments;
                                    (IV) supporting preceptor 
                                development trainings;
                                    (V) expanding the midwifery 
                                practice; or
                                    (VI) related needs identified by 
                                the midwifery practice and described in 
                                the practice's application; or
                            (ix) have developed other programs and 
                        resources that address community-specific 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 assistance on--
            (1) capacity building to establish or expand programs to 
        prevent adverse maternal health outcomes among pregnant and 
        postpartum individuals from underserved groups;
            (2) best practices in data collection, measurement, 
        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 2026, the 
Secretary shall submit to Congress an evaluation of the grant program 
under this section that--
            (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 maternal health;
            (3) assesses the effectiveness of programs funded by grants 
        under this section in improving maternal health outcomes for 
        pregnant and postpartum individuals from underserved groups, to 
        the extent practicable; and
            (4) makes recommendations for future Department of Health 
        and Human Services grant programs and funding opportunities 
        that deliver funding to community-based organizations that 
        provide programs and resources that are aligned with evidence-
        based practices for improving maternal health outcomes for 
        pregnant and postpartum individuals.
    (g) Definition.--In this section, the term ``underserved groups'' 
means to pregnant and postpartum individuals--
            (1) from racial and ethnic minority groups (as such term is 
        defined in section 1707(g)(1) of the 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 offering 
        obstetric care, no birth center, and no obstetric provider; or
            (5) who live in counties with a level of vulnerability 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 2022 through 2026.

SEC. 203. RESPECTFUL MATERNITY CARE TRAINING FOR ALL EMPLOYEES IN 
              MATERNITY CARE SETTINGS.

    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:

``SEC. 742. RESPECTFUL MATERNITY CARE TRAINING FOR ALL EMPLOYEES IN 
              MATERNITY CARE SETTINGS.

    ``(a) Grants.--The Secretary shall award grants for programs to 
reduce and prevent bias, racism, and discrimination in maternity care 
settings and to advance respectful, culturally congruent, trauma-
informed care.
    ``(b) Special Consideration.--In awarding grants under subsection 
(a), the Secretary shall give special consideration 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, including front desk employees, 
        sonographers, schedulers, health care professionals, hospital 
        or health system administrators, security staff, and other 
        employees;
            ``(2) emphasize periodic, as opposed to one-time, trainings 
        for all birthing professionals and employees 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 preference for 
        trainings that provide continuing education units;
            ``(5) include trauma-informed care best practices and an 
        emphasis on shared decision making between 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 providers 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 emergency 
        simulation trainings or related trainings;
            ``(10) include training for emergency department employees 
        and emergency medical technicians on recognizing warning signs 
        for severe pregnancy-related complications;
            ``(11) offer training to all maternity care providers on 
        the value of racially, ethnically, and professionally diverse 
        maternity care teams to provide culturally congruent care; or
            ``(12) be based on one or more programs designed by a 
        historically Black college or university or other minority-
        serving institution.
    ``(c) Application.--An entity desiring a grant under subsection 
(a), shall submit an application at such 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, including, as applicable, a 
description of the impact of training provided through the grant on 
patient outcomes and patient experience for pregnant and postpartum 
individuals from racial and ethnic minority groups and their families.
    ``(e) Best Practices.--Based on the annual reports submitted 
pursuant to subsection (d), the Secretary--
            ``(1) shall produce an annual report on the findings 
        resulting from programs funded through this section;
            ``(2) shall disseminate such report to all recipients 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 individuals from racial and ethnic 
        minority groups and their families in maternity care settings.
    ``(f) Definitions.--In this section:
            ``(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 appropriated $5,000,000 for each of fiscal 
years 2022 through 2026.''.

SEC. 204. STUDY ON REDUCING AND PREVENTING BIAS, RACISM, AND 
              DISCRIMINATION IN MATERNITY 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, 
Engineering, and Medicine (referred to in this section as the 
``National Academies'') under which the National Academies agree to--
            (1) conduct a study on the design and implementation 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 2 years after the date of enactment of 
        this Act--
                    (A) complete the study; and
                    (B) transmit a report on the results of the study 
                to 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 reduce 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 
        individuals 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 discrimination in 
        maternity care settings that are demonstrated to improve 
        patient outcomes or patient experience for pregnant and 
        postpartum individuals from racial and ethnic minority groups 
        and their families.

SEC. 205. RESPECTFUL MATERNITY CARE COMPLIANCE PROGRAM.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall award grants 
to accredited hospitals, health systems, and other maternity care 
settings to establish as an integral part of quality implementation 
initiatives within one or more hospitals or other birth settings a 
respectful maternity care compliance program.
    (b) Program Requirements.--A respectful maternity care compliance 
program funded through a grant under this section shall--
            (1) institutionalize mechanisms to allow patients receiving 
        maternity care services, the families of such patients, or 
        perinatal health workers supporting 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;
            (3) prepare and make publicly available a hospital- or 
        health system-wide strategy to reduce bias on the basis of 
        race, ethnicity, or another protected class in the delivery of 
        maternity care that includes--
                    (A) information on the training programs to reduce 
                and prevent bias, racism, and discrimination on the 
                basis of race, ethnicity, or another protected class 
                for all employees in maternity care settings;
                    (B) information on the number of cases reported to 
                the compliance program; and
                    (C) the development of methods to routinely assess 
                the extent to which bias, racism, or discrimination on 
                the basis of race, ethnicity, or another protected 
                class are present in the delivery 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 compliance program 
        over the course of the year containing such information as the 
        Secretary may require, such as--
                    (A) de-identified demographic information on the 
                patient in the case, such as race, ethnicity, gender 
                identity, and primary language;
                    (B) the content of the report from the patient or 
                the family of the patient to the compliance program;
                    (C) the response from the compliance program; 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 establishing 
                and implementing a respectful maternity care compliance 
                program within a hospital or other birth setting;
                    (B) promoting coordination and collaboration 
                between hospitals, health systems, and other maternity 
                care delivery settings on the establishment and 
                implementation of respectful maternity care compliance 
                programs; and
                    (C) evaluating the effectiveness of respectful 
                maternity care compliance programs on maternal 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 Secretary shall, 
                through a contract with an independent 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 
                        respectful care initiatives.
                    (B) Components of study.--The study under this 
                paragraph shall include the following:
                            (i) An assessment of the reports submitted 
                        to the Secretary from the respectful maternity 
                        care compliance programs pursuant to subsection 
                        (b)(5).
                            (ii) Based on the assessment under clause 
                        (i), recommendations for potential 
                        accountability mechanisms related to cases of 
                        racism or bias on the basis of race, ethnicity, 
                        or another protected class in the delivery of 
                        maternity care services at hospitals and other 
                        birth settings. Such 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 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 2022 through 2027.

SEC. 206. 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 Congress and make publicly available a 
report on the establishment of respectful maternity care compliance 
programs within hospitals, health systems, and other maternity care 
settings.
    (b) Matters Included.--The report under paragraph (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 maternity care compliance programs, 
        including--
                    (A) which hospitals and other birth settings elect 
                to establish compliance programs and when such programs 
                are established;
                    (B) to the extent practicable, impacts of the 
                establishment of such programs on maternal health 
                outcomes and patient and family experiences in the 
                hospitals and other birth settings that have 
                established such programs, especially for patients from 
                racial and ethnic minority 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 respectful 
                maternity care compliance programs in geographic areas, 
                and types of hospitals or 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 applicable, recommendations 
        for additional appropriations to carry out this section.
            (3) Such other information as the Comptroller General 
        determines appropriate.

                 TITLE III--PROTECTING MOMS WHO SERVED

SEC. 301. CODIFICATION OF MATERNITY COORDINATION PROGRAM OF DEPARTMENT 
              OF VETERANS AFFAIRS.

    (a) Program on Maternity Care Coordination.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        carry out the maternity care coordination program described in 
        Veterans Health Administration Handbook 1330.03, or successor 
        handbook.
            (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, 
        particularly regarding mental and behavioral health conditions 
        relating to the service of the veterans in the Armed Forces.
    (b) Authorization of Appropriations.--
            (1) In general.--There is authorized to be appropriated to 
        the Secretary $15,000,000 for fiscal year 2022 for the program 
        under subsection (a)(1).
            (2) Supplement not supplant.--Amounts authorized under 
        paragraph (1) are authorized in addition to any other amounts 
        authorized for maternity health care and coordination for the 
        Department of Veterans Affairs.
    (c) Definitions.--In this section:
            (1) Community maternity care providers.--The term 
        ``community maternity care providers'' 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 any other law administered by the 
        Secretary of Veterans Affairs.
            (2) Non-department facilities.--The term ``non-Department 
        facilities'' has the meaning given that term in section 1701 of 
        title 38, United States Code.

SEC. 302. REPORT ON MATERNAL MORTALITY AND SEVERE MATERNAL MORBIDITY 
              AMONG PREGNANT 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 Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives, and 
make publicly available, a report on maternal mortality and severe 
maternal morbidity among pregnant and postpartum veterans, with a 
particular focus on racial and ethnic disparities in maternal health 
outcomes for veterans.
    (b) Matters Included.--The report under subsection (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-associated death in the most recent 10 years 
                of available 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 veterans in the 
                most recent year of available data;
                    (D) the racial and ethnic disparities in maternal 
                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 infertility or miscarriages 
                that may be caused by service in the Armed Forces;
                    (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 between the 
                former rank of veterans and their maternal health 
                outcomes;
                    (H) the number of veterans who have been diagnosed 
                with infertility by a health care provider of the 
                Veterans Health Administration 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 have received a 
                clinical diagnosis of unexplained infertility by a 
                health care provider of the Veterans Health 
                Administration each year in the most recent five years; 
                and
                    (J) the extent to which the rate of incidence of 
                clinically diagnosed infertility among veterans compare 
                or differ to the rate of incidence of clinically 
                diagnosed infertility among the civilian population.
            (2) An assessment of the barriers to determining the 
        information required under paragraph (1) and recommendations 
        for improvements in tracking 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 insurance;
                    (D) enrolled in the Medicaid program; and
                    (E) who are uninsured.
            (3) Recommendations for legislative and administrative 
        actions to increase access to mental and behavioral 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 educate maternity 
        care providers on best practices for providing maternity care 
        services to veterans that addresses the unique maternal health 
        care needs of veteran populations.
            (6) Recommendations to reduce maternal mortality and severe 
        maternal morbidity among pregnant 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-Department facilities for pregnant and 
        postpartum veterans, including recommendations to improve--
                    (A) health record interoperability; and
                    (B) training for the directors of the Veterans 
                Integrated Service Networks, directors of medical 
                facilities of the Department, chiefs of staff of such 
                facilities, maternity care coordinators, and staff of 
                relevant non-Department facilities.
            (8) An assessment of the authority of the Secretary 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 General 
        determines appropriate with respect to the reduction of 
        maternal mortality and severe maternal morbidity among pregnant 
        and postpartum veterans and to address racial and ethnic 
        disparities in maternal health outcomes for veterans.

                     TITLE IV--PERINATAL WORKFORCE

SEC. 401. HHS AGENCY DIRECTIVES.

    (a) Guidance to States.--
            (1) In general.--Not later than 2 years after the date of 
        enactment of this Act, the Secretary of Health and Human 
        Services (referred to in this section as the ``Secretary'') 
        shall issue and disseminate guidance to States to educate 
        providers, managed care entities, and other insurers about the 
        value and process of delivering respectful maternal health care 
        through diverse and multidisciplinary care provider models.
            (2) Contents.--The guidance required by paragraph (1) shall 
        address how States can encourage and incentivize hospitals, 
        health systems, midwifery practices, freestanding birth 
        centers, other maternity care provider groups, managed care 
        entities, and other insurers--
                    (A) to recruit and retain maternity care providers, 
                mental and behavioral health care providers acting in 
                accordance with State law, registered dietitians or 
                nutrition professionals (as such term is defined in 
                section 1861(vv)(2) of the Social Security Act (42 
                U.S.C. 1395x(vv)(2))), and lactation consultants 
                certified by the International Board of Lactation 
                Consultants Examiners--
                            (i) from racially, ethnically, and 
                        linguistically diverse backgrounds;
                            (ii) with experience practicing in racially 
                        and ethnically diverse communities; and
                            (iii) who have undergone training on 
                        implicit bias and racism;
                    (B) to incorporate into maternity care teams--
                            (i) midwives 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; and
                            (ii) perinatal health workers;
                    (C) to provide collaborative, culturally congruent 
                care; and
                    (D) to provide opportunities for individuals 
                enrolled in accredited midwifery education programs to 
                participate in job shadowing with maternity care teams 
                in hospitals, health systems, midwifery practices, and 
                freestanding birth centers.
    (b) Study on Respectful and Culturally Congruent Maternity Care.--
            (1) Study.--The Secretary, acting through the Director of 
        the National Institutes of Health, shall conduct a study on 
        best practices in respectful and 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 paragraph (1);
                    (B) submit to Congress and make publicly available 
                a report on the results of such study; and
                    (C) include in such report--
                            (i) a compendium of examples of hospitals, 
                        health systems, midwifery practices, 
                        freestanding birth centers, other maternity 
                        care provider groups, managed care entities, 
                        and other insurers that are delivering 
                        respectful and culturally congruent maternal 
                        health care;
                            (ii) a compendium of examples of hospitals, 
                        health systems, midwifery practices, 
                        freestanding birth centers, other maternity 
                        care provider groups, managed care entities, 
                        and other insurers that have made progress in 
                        reducing disparities in maternal health 
                        outcomes and improving birthing experiences for 
                        pregnant and postpartum individuals from racial 
                        and ethnic minority groups; and
                            (iii) recommendations to hospitals, health 
                        systems, midwifery practices, freestanding 
                        birth centers, other maternity care provider 
                        groups, managed care entities, and other 
                        insurers, for best practices in respectful and 
                        culturally congruent maternity care.

SEC. 402. GRANTS TO GROW AND DIVERSIFY THE PERINATAL WORKFORCE.

    Title VII of the Public Health Service Act is amended by inserting 
after section 757 (42 U.S.C. 294f) the following new section:

``SEC. 758. PERINATAL WORKFORCE GRANTS.

    ``(a) In General.--The Secretary shall award grants to entities to 
establish or expand programs described in subsection (b) to grow and 
diversify the perinatal workforce.
    ``(b) Use of Funds.--Recipients of grants under this section shall 
use the grants to grow and diversify the perinatal workforce by--
            ``(1) establishing schools or programs that provide 
        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; or
                    ``(B) perinatal health workers; and
            ``(2) expanding the capacity of existing schools or 
        programs described in paragraph (1), for the purposes 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 entity that--
            ``(1) has demonstrated a commitment to recruiting and 
        retaining students and faculty from racial and ethnic minority 
        groups;
            ``(2) has developed a strategy to recruit and retain a 
        diverse pool of students into the perinatal workforce program 
        or school supported by funds received through the grant, 
        particularly from racial and ethnic minority groups and other 
        underserved populations;
            ``(3) has developed a strategy to recruit and retain 
        students who plan to practice in a health professional shortage 
        area designated under section 332;
            ``(4) has developed a strategy to recruit and retain 
        students who plan to practice in an area with significant 
        racial and ethnic disparities in maternal health outcomes, to 
        the extent practicable; and
            ``(5) includes in the standard curriculum for all students 
        within the perinatal workforce program or school a bias, 
        racism, or discrimination training program that includes 
        training on implicit bias and racism.
    ``(d) Reporting.--As a condition on receipt of a grant under this 
section for a perinatal workforce program or school, an entity shall 
agree to submit to the Secretary an annual report on the activities 
conducted through the grant, including--
            ``(1) the number and demographics of students participating 
        in the program or school;
            ``(2) the extent to which students in the program or school 
        are entering careers in--
                    ``(A) health professional shortage areas designated 
                under section 332; and
                    ``(B) areas with significant racial and ethnic 
                disparities in maternal health outcomes, to the extent 
                such data are available; and
            ``(3) whether the program or school has included in the 
        standard curriculum for all students a bias, racism, or 
        discrimination training program that includes explicit and 
        implicit bias, and if so the effectiveness 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 section, an entity 
shall submit to the Secretary an application at such time, in such 
manner, and containing such information as the Secretary may require, 
including any information necessary for prioritization under subsection 
(c).
    ``(g) Technical Assistance.--The Secretary shall provide, directly 
or by contract, technical assistance to entities seeking or receiving a 
grant under this section on the development, use, evaluation, and post-
grant period sustainability of the perinatal workforce programs or 
schools proposed to be, or being, established or expanded through the 
grant.
    ``(h) Report by the Secretary.--Not later than 4 years after the 
date of enactment of this section, the Secretary shall prepare and 
submit to 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 students from racial and ethnic minority 
        groups;
            ``(2) increasing the number of physician assistants who 
        will complete clinical training in the field of maternal and 
        perinatal health, and perinatal health workers, from racial and 
        ethnic minority groups and other underserved populations;
            ``(3) increasing the number of physician assistants who 
        will complete clinical training in the field of maternal and 
        perinatal health, and perinatal health workers, working in 
        health professional shortage areas designated under section 
        332; and
            ``(4) increasing the number of physician assistants who 
        will complete clinical training in the field of maternal and 
        perinatal health, and perinatal health workers, working in 
        areas with significant racial and ethnic disparities in 
        maternal health outcomes, to the extent such data are 
        available.
    ``(i) Definition.--In this section, the term `racial and ethnic 
minority group' has the meaning given such term in section 1707(g).
    ``(j) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $15,000,000 for each of fiscal 
years 2022 through 2026.''.

SEC. 403. GRANTS TO GROW AND DIVERSIFY THE NURSING WORKFORCE IN 
              MATERNAL AND PERINATAL HEALTH.

    Title VIII of the Public Health Service Act is amended 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 shall 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 includes a focus 
        on maternal and perinatal health; or
            ``(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 retain a 
        diverse pool of students seeking to enter careers focused on 
        maternal and perinatal health, particularly students from 
        racial and ethnic minority groups and other underserved 
        populations;
            ``(2) has developed a partnership with a practice setting 
        in a health professional shortage area designated under section 
        332 for the clinical placements of the school's students;
            ``(3) has developed a strategy to recruit and retain 
        students who plan to practice in an area with significant 
        racial and ethnic disparities in maternal health outcomes, to 
        the extent practicable; and
            ``(4) includes in the standard curriculum for all students 
        seeking to enter careers focused on maternal and perinatal 
        health a bias, racism, or discrimination training program that 
        includes education on implicit bias and racism.
    ``(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 activities 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 focused on maternal and 
        perinatal health;
            ``(2) the extent to which such students are preparing to 
        enter careers in--
                    ``(A) health professional shortage areas designated 
                under section 332; and
                    ``(B) areas with significant racial and ethnic 
                disparities in maternal health outcomes, to the extent 
                such data are available; and
            ``(3) whether the standard curriculum for all students 
        seeking to enter careers focused on maternal and perinatal 
        health includes a bias, racism, or discrimination training 
        program that includes education on implicit bias and racism.
    ``(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 section, an entity 
shall submit to the Secretary an application, at such time, in such 
manner, and containing such information as the Secretary may require, 
including any information necessary for prioritization under subsection 
(c).
    ``(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 scholarships through the grant.
    ``(h) Report by the Secretary.--Not later than 4 years after the 
date of enactment of this section, the Secretary shall prepare and 
submit to 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 students from racial and ethnic minority 
        groups and other underserved populations;
            ``(2) increasing the number of nurse practitioners and 
        clinical nurse specialists entering careers focused on maternal 
        and perinatal health from racial and ethnic minority groups and 
        other underserved populations;
            ``(3) increasing the number of nurse practitioners and 
        clinical nurse specialists entering careers focused on maternal 
        and perinatal health working in health professional shortage 
        areas designated under section 332; and
            ``(4) increasing the number of nurse practitioners 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, to the 
        extent such data are available.
    ``(i) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $15,000,000 for each of fiscal 
years 2022 through 2026.''.

SEC. 404. GAO REPORT.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act and every 5 years thereafter, the Comptroller General of 
the United States shall submit to Congress a report on barriers to 
maternal health education and access to care in the United States. Such 
report shall include the information and recommendations described in 
subsection (b).
    (b) Content of Report.--The report under subsection (a) shall 
include--
            (1) an assessment of current barriers to entering 
        accredited midwifery education programs, and recommendations 
        for addressing such barriers, particularly for low-income women 
        and women from racial and ethnic minority groups;
            (2) an assessment of current barriers to entering and 
        successfully completing accredited education programs for other 
        health professional careers related to maternity care, 
        including maternity care providers, mental and behavioral 
        health care providers acting in accordance with State law, 
        registered dietitians or nutrition professionals (as such term 
        is defined in section 1861(vv)(2) of the Social Security Act 
        (42 U.S.C. 1395x(vv)(2))), and lactation consultants certified 
        by the International Board of Lactation Consultants Examiners, 
        particularly for low-income women and women from racial and 
        ethnic minority groups;
            (3) an assessment of current barriers that prevent midwives 
        from meeting the international definition of the midwife and 
        global standards for midwifery education as established by the 
        International Confederation of Midwives, and recommendations 
        for addressing such barriers, particularly for low-income women 
        and women from racial and ethnic minority groups;
            (4) an assessment of disparities in access to maternity 
        care providers, mental or behavioral health care providers 
        acting in accordance with State law, registered dietitians or 
        nutrition professionals (as such term is defined in section 
        1861(vv)(2) of the Social Security Act (42 U.S.C. 
        1395x(vv)(2))), lactation consultants certified by the 
        International Board of Lactation Consultants Examiners, and 
        perinatal health workers, stratified by race, ethnicity, gender 
        identity, geographic location, and insurance type and 
        recommendations to promote greater access equity; and
            (5) recommendations to promote greater equity in 
        compensation for perinatal health workers under public and 
        private insurers, particularly for such individuals from 
        racially and ethnically diverse backgrounds.

                       TITLE V--DATA TO SAVE MOMS

SEC. 501. FUNDING FOR MATERNAL MORTALITY REVIEW COMMITTEES TO PROMOTE 
              REPRESENTATIVE COMMUNITY ENGAGEMENT.

    (a) In General.--Section 317K(d) of the Public Health Service Act 
(42 U.S.C. 247b-12(d)) is amended by adding at the end the following:
            ``(9) Grants to promote representative community engagement 
        in maternal mortality review committees.--
                    ``(A) In general.--The Secretary may, using funds 
                made available pursuant to subparagraph (C), provide 
                assistance to an applicable maternal mortality review 
                committee of a State, Indian tribe, tribal 
                organization, or urban Indian organization--
                            ``(i) to select for inclusion in the 
                        membership of such a committee community 
                        members from the State, Indian tribe, tribal 
                        organization, or urban Indian organization by--
                                    ``(I) prioritizing community 
                                members who can increase the diversity 
                                of the committee's membership with 
                                respect to race and ethnicity, 
                                location, and professional background, 
                                including members with non-clinical 
                                experiences; and
                                    ``(II) to the extent applicable, 
                                using funds reserved under subsection 
                                (f), to address barriers to maternal 
                                mortality review committee 
                                participation for community members, 
                                including required training, 
                                transportation barriers, compensation, 
                                and other supports as may be necessary;
                            ``(ii) to establish initiatives to conduct 
                        outreach and community engagement efforts 
                        within communities throughout the State or 
                        Tribe to seek input from community members on 
                        the work of such maternal mortality review 
                        committee, with a particular focus on outreach 
                        to minority women; and
                            ``(iii) to release public reports 
                        assessing--
                                    ``(I) the pregnancy-related death 
                                and pregnancy-associated death review 
                                processes of the maternal mortality 
                                review committee, with a particular 
                                focus on the maternal mortality review 
                                committee's sensitivity to the unique 
                                circumstances of pregnant and 
                                postpartum individuals from racial and 
                                ethnic minority groups (as such term is 
                                defined in section 1707(g)(1)) who have 
                                suffered pregnancy-related deaths; and
                                    ``(II) the impact of the use of 
                                funds made available pursuant to 
                                subparagraph (C) on increasing the 
                                diversity of the maternal mortality 
                                review committee membership and 
                                promoting community engagement efforts 
                                throughout the State or Tribe.
                    ``(B) Technical assistance.--The Secretary shall 
                provide (either directly through the Department of 
                Health and Human Services or by contract) technical 
                assistance to any maternal mortality review committee 
                receiving a grant under this paragraph on best 
                practices for increasing the diversity of the maternal 
                mortality review committee's membership and for 
                conducting effective community engagement throughout 
                the State or Tribe.
                    ``(C) Authorization of appropriations.--In addition 
                to any funds made available under subsection (f), there 
                are authorized to be appropriated to carry out this 
                paragraph $10,000,000 for each of fiscal years 2022 
                through 2026.''.
    (b) Definitions.--Section 317K(e) of the Public Health Service Act 
(42 U.S.C. 247b-12(e)) is amended--
            (1) in paragraph (2), by striking ``and'' at the end;
            (2) in paragraph (3)(B), by striking the period and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(4) the term `urban Indian organization' has the meaning 
        given such term in section 4 of the Indian Health Care 
        Improvement Act.''.
    (c) Reservation of Funds.--Section 317K(f) of the Public Health 
Service Act (42 U.S.C. 247b-12(f)) is amended by adding at the end the 
following: ``Of the amount made available under the preceding sentence 
for a fiscal year, not less than $1,500,000 shall be reserved for 
grants to Indian tribes, tribal organizations, or urban Indian 
organizations.''.

SEC. 502. DATA COLLECTION AND REVIEW.

    Section 317K(d)(3)(A)(i) of the Public Health Service Act (42 
U.S.C. 247b-12(d)(3)(A)(i)) is amended--
            (1) by redesignating subclauses (II) and (III) as 
        subclauses (V) and (VI), respectively; and
            (2) by inserting after subclause (I) the following:
                                    ``(II) to the extent practicable, 
                                reviewing cases of severe maternal 
                                morbidity, according to the most up-to-
                                date indicators;
                                    ``(III) to the extent practicable, 
                                reviewing deaths during pregnancy or up 
                                to 1 year after the end of a pregnancy 
                                from suicide, overdose, or other death 
                                from a mental health condition or 
                                substance use disorder attributed to or 
                                aggravated by pregnancy or childbirth 
                                complications;
                                    ``(IV) to the extent practicable, 
                                consulting with local community-based 
                                organizations representing pregnant and 
                                postpartum individuals from demographic 
                                groups disproportionately impacted by 
                                poor maternal health outcomes to ensure 
                                that, in addition to clinical factors, 
                                non-clinical factors that might have 
                                contributed to a pregnancy-related 
                                death are appropriately considered;''.

SEC. 503. REVIEW OF MATERNAL HEALTH DATA COLLECTION PROCESSES AND 
              QUALITY MEASURES.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Administrator for Centers for Medicare & Medicaid Services 
and the Director of the Agency for Healthcare Research and Quality, 
shall consult with relevant stakeholders--
            (1) to review existing maternal health data collection 
        processes and quality measures; and
            (2) make recommendations to improve such processes and 
        measures, including topics described in subsection (c).
    (b) Collaboration.--In carrying out this section, the Secretary 
shall consult with a diverse group of maternal health stakeholders, 
which may include--
            (1) pregnant and postpartum individuals and their family 
        members, and nonprofit organizations representing such 
        individuals, with a particular focus on patients from racial 
        and ethnic minority groups;
            (2) community-based organizations that provide support for 
        pregnant and postpartum individuals, with a particular focus on 
        patients from racial and ethnic minority groups;
            (3) membership organizations for maternity care providers;
            (4) organizations representing perinatal health workers;
            (5) organizations that focus on maternal mental or 
        behavioral health;
            (6) organizations that focus on intimate partner violence;
            (7) institutions of higher education, with a particular 
        focus on minority-serving institutions;
            (8) licensed and accredited hospitals, birth centers, 
        midwifery practices, or other medical practices that provide 
        maternal health care services to pregnant and postpartum 
        patients;
            (9) relevant State and local public agencies, including 
        State maternal mortality review committees; and
            (10) the National Quality Forum, or such other standard-
        setting organizations specified by the Secretary.
    (c) Topics.--The review of maternal health data collection 
processes and recommendations to improve such processes and measures 
required under subsection (a) shall assess all available relevant 
information, including information from State-level sources, and shall 
consider at least the following:
            (1) Current State and Tribal practices for maternal health, 
        maternal mortality, and severe maternal morbidity data 
        collection and dissemination, including consideration of--
                    (A) the timeliness of processes for amending a 
                death certificate when new information pertaining to 
                the death becomes available to reflect whether the 
                death was a pregnancy-related death;
                    (B) relevant data collected with electronic health 
                records, including data on race, ethnicity, 
                socioeconomic status, insurance type, and other 
                relevant demographic information;
                    (C) maternal health data collected and publicly 
                reported by hospitals, health systems, midwifery 
                practices, and birth centers;
                    (D) the barriers preventing States from correlating 
                maternal outcome data with race and ethnicity data;
                    (E) processes for determining the cause of a 
                pregnancy-associated death in States that do not have a 
                maternal mortality review committee;
                    (F) whether maternal mortality review committees 
                include multidisciplinary and diverse membership (as 
                described in section 317K(d)(1)(A) of the Public Health 
                Service Act (42 U.S.C. 247b-12(d)(1)(A)));
                    (G) whether members of maternal mortality review 
                committees participate in trainings on bias, racism, or 
                discrimination, and the quality of such trainings;
                    (H) the extent to which States have implemented 
                systematic processes of listening to the stories of 
                pregnant and postpartum individuals and their family 
                members, with a particular focus on pregnant and 
                postpartum individuals from racial and ethnic minority 
                groups (as such term is defined in section 1707(g)(1) 
                of the Public Health Service Act (42 U.S.C. 300u-
                6(g)(1))) and their family members, to fully understand 
                the causes of, and inform potential solutions to, the 
                maternal mortality and severe maternal morbidity crisis 
                within their respective States;
                    (I) the extent to which maternal mortality review 
                committees are considering social determinants of 
                maternal health when examining the causes of pregnancy-
                associated and pregnancy-related deaths;
                    (J) the extent to which maternal mortality review 
                committees are making actionable recommendations based 
                on their reviews of adverse maternal health outcomes 
                and the extent to which such recommendations are being 
                implemented by appropriate stakeholders;
                    (K) the legal and administrative barriers 
                preventing the collection, collation, and dissemination 
                of State maternity care data;
                    (L) the effectiveness of data collection and 
                reporting processes in separating pregnancy-associated 
                deaths from pregnancy-related deaths; and
                    (M) the current Federal, State, local, and Tribal 
                funding support for the activities referred to in 
                subparagraphs (A) through (L).
            (2) Whether the funding support referred to in paragraph 
        (1)(M) is adequate for States to carry out optimal data 
        collection and dissemination processes with respect to maternal 
        health, maternal mortality, and severe maternal morbidity.
            (3) Current quality measures for maternity care, including 
        prenatal measures, labor and delivery measures, and postpartum 
        measures, including topics such as--
                    (A) effective quality measures for maternity care 
                used by hospitals, health systems, midwifery practices, 
                birth centers, health plans, and other relevant 
                entities;
                    (B) the sufficiency of current outcome measures 
                used to evaluate maternity care for driving improved 
                care, experiences, and outcomes in maternity care 
                payment and delivery system models;
                    (C) maternal health quality measures that other 
                countries effectively use;
                    (D) validated measures that have been used for 
                research purposes that could be tested, refined, and 
                submitted for national endorsement;
                    (E) barriers preventing maternity care providers 
                and insurers from implementing quality measures that 
                are aligned with best practices;
                    (F) the frequency with which maternity care quality 
                measures are reviewed and revised;
                    (G) the strengths and weaknesses of the Prenatal 
                and Postpartum Care measures of the Health Plan 
                Employer Data and Information Set measures established 
                by the National Committee for Quality Assurance;
                    (H) the strengths and weaknesses of maternity care 
                quality measures under the Medicaid program under title 
                XIX of the Social Security Act (42 U.S.C. 1396 et seq.) 
                and the Children's Health Insurance Program under title 
                XXI of such Act (42 U.S.C. 1397 et seq.), including the 
                extent to which States voluntarily report relevant 
                measures;
                    (I) the extent to which maternity care quality 
                measures are informed by patient experiences that 
                include measures of patient-reported experience of 
                care;
                    (J) the current processes for collecting stratified 
                data on the race and ethnicity of pregnant and 
                postpartum individuals in hospitals, health systems, 
                midwifery practices, and birth centers, and for 
                incorporating such racially and ethnically stratified 
                data in maternity care quality measures;
                    (K) the extent to which maternity care quality 
                measures account for the unique experiences of pregnant 
                and postpartum individuals from racial and ethnic 
                minority groups (as such term is defined in section 
                1707(g)(1) of the Public Health Service Act (42 U.S.C. 
                300u-6(g)(1))); and
                    (L) the extent to which hospitals, health systems, 
                midwifery practices, and birth centers are implementing 
                existing maternity care quality measures.
            (4) Recommendations on authorizing additional funds and 
        providing additional technical assistance to improve maternal 
        mortality review committees and State and Tribal maternal 
        health data collection and reporting processes.
            (5) Recommendations for new authorities that may be granted 
        to maternal mortality review committees to be able to--
                    (A) access records from other Federal and State 
                agencies and departments that may be necessary to 
                identify causes of pregnancy-associated and pregnancy-
                related deaths that are unique to pregnant and 
                postpartum individuals from specific populations, such 
                as veterans and individuals who are incarcerated; and
                    (B) work with relevant experts who are not members 
                of the maternal mortality review committee to assist in 
                the review of pregnancy-associated deaths of pregnant 
                and postpartum individuals from specific populations, 
                such as veterans and individuals who are incarcerated.
            (6) Recommendations to improve and standardize current 
        quality measures for maternity care, with a particular focus on 
        racial and ethnic disparities in maternal health outcomes.
            (7) Recommendations to improve the coordination by the 
        Department of Health and Human Services of the efforts 
        undertaken by the agencies and organizations within the 
        Department related to maternal health data and quality 
        measures.
    (d) Report.--Not later than 1 year after the date of enactment of 
this Act, the Secretary shall submit to Congress and make publicly 
available a report on the results of the review of maternal health data 
collection processes and quality measures and recommendations to 
improve such processes and measures required under subsection (a).
    (e) Definitions.--In this section:
            (1) Maternal mortality review committee.--The term 
        ``maternal mortality review committee'' means a maternal 
        mortality review committee duly authorized by a State and 
        receiving funding under section 317K(a)(2)(D) of the Public 
        Health Service Act (42 U.S.C. 247b-12(a)(2)(D)).
            (2) Pregnancy-associated death.--The term ``pregnancy-
        associated'', with respect to a death, means a death of a 
        pregnant or postpartum individual, by any cause, that occurs 
        during, or within 1 year following, the individual's pregnancy, 
        regardless of the outcome, duration, or site of the pregnancy.
            (3) Pregnancy-related death.--The term ``pregnancy-
        related'', with respect to a death, means a death of a pregnant 
        or postpartum individual that occurs during, or within 1 year 
        following, the individual's pregnancy, from a pregnancy 
        complication, a chain of events initiated by pregnancy, or the 
        aggravation of an unrelated condition by the physiologic 
        effects of pregnancy.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal years 2022 through 2025.

SEC. 504. INDIAN HEALTH SERVICE STUDY AND REPORT ON MATERNAL MORTALITY 
              AND SEVERE MATERNAL MORBIDITY.

    (a) Definitions.--In this section:
            (1) Director.--The term ``Director'' means the Director of 
        the Indian Health Service.
            (2) Indian tribe.--The term ``Indian Tribe'' has the 
        meaning given the term in section 4 of the Indian Self-
        Determination and Education Assistance Act (25 U.S.C. 5304).
            (3) Maternal mortality review committee.--The term 
        ``maternal mortality review committee'' means a maternal 
        mortality review committee duly authorized by a State and 
        receiving funding under section 317k(a)(2)(D) of the Public 
        Health Service Act (42 U.S.C. 247b-12(a)(2)(D)).
            (4) Tribal epidemiology center.--The term ``Tribal 
        epidemiology center'' means a Tribal epidemiology center 
        established under section 214 of the Indian Health Care 
        Improvement Act (25 U.S.C. 1621m).
            (5) Tribal organization.--The term ``tribal organization'' 
        has the meaning given the term in section 4 of the Indian Self-
        Determination and Education Assistance Act (25 U.S.C. 5304).
            (6) Urban indian organization.--The term ``urban Indian 
        organization'' has the meaning given the term in section 4 of 
        the Indian Health Care Improvement Act (25 U.S.C. 1603).
    (b) Study and Report.--
            (1) Study.--
                    (A) In general.--Not later than 90 days after the 
                date of enactment of this Act, the Director, in 
                coordination with the individuals selected under 
                subsection (c), shall enter into an agreement with an 
                independent research organization or a Tribal 
                epidemiology center to conduct a comprehensive study on 
                maternal mortality and severe maternal morbidity in 
                Indian and Alaska Native populations.
                    (B) Report.--The agreement entered into under 
                subparagraph (A) shall require that the independent 
                research organization or Tribal epidemiology center 
                submit to the Director a report describing the results 
                of the study conducted pursuant to that agreement by 
                not later than 2 years after the date of enactment of 
                this Act.
            (2) Contents of study.--The study conducted under paragraph 
        (1) shall--
                    (A) examine the causes of maternal mortality and 
                severe maternal morbidity that are unique to Indians 
                and Alaska Natives;
                    (B) include a systematic process of listening to 
                the stories of pregnant and postpartum Indians and 
                Alaska Natives to fully understand the causes of, and 
                inform potential solutions to, the maternal mortality 
                and severe maternal morbidity crisis within the Indian 
                and Alaska Native communities;
                    (C) identify the different settings in which 
                pregnant and postpartum Indians and Alaska Natives 
                receive maternity care, such as--
                            (i) facilities operated by the Indian 
                        Health Service;
                            (ii) an Indian health program operated by 
                        an Indian Tribe or tribal organization pursuant 
                        to a grant from, or contract, cooperative 
                        agreement, or compact with, the Indian Health 
                        Service pursuant to the Indian Self-
                        Determination and Education Assistance Act (25 
                        U.S.C. 5301 et seq.); and
                            (iii) an urban Indian health program 
                        operated by an urban Indian organization 
                        pursuant to a grant from or contract with the 
                        Indian Health Service pursuant to title V of 
                        the Indian Health Care Improvement Act (25 
                        U.S.C. 1651 et seq.);
                    (D) determine the different landscapes of maternity 
                care received by pregnant and postpartum Indians and 
                Alaska Natives at the different settings identified 
                under subparagraph (C);
                    (E) review processes for coordinating programs of 
                the Indian Health Service with social services provided 
                through other programs administered by the Secretary of 
                Health and Human Services (other than the Medicare 
                program under title XVIII of the Social Security Act 
                (42 U.S.C. 1395 et seq.), the Medicaid program under 
                title XIX of that Act (42 U.S.C. 1396 et seq.), and the 
                State Children's Health Insurance Program established 
                under title XXI of that Act (42 U.S.C. 1397aa et 
                seq.));
                    (F) review current data collection and quality 
                measurement processes and practices with respect to 
                pregnant and postpartum Indians and Alaska Natives;
                    (G) assess causes and frequency of maternal mental 
                health conditions and substance use disorders with 
                respect to Indians and Alaska Natives;
                    (H) consider social determinants of health, 
                including poverty, lack of health insurance, 
                unemployment, sexual violence, and environmental 
                conditions in Tribal areas;
                    (I) consider the role that historical mistreatment 
                of Indian and Alaska Native women has played in causing 
                currently high rates of maternal mortality and severe 
                maternal morbidity;
                    (J) consider how current funding of the Indian 
                Health Service affects the ability of the Indian Health 
                Service to deliver quality maternity care; and
                    (K) consider the extent to which the delivery of 
                maternity care services is culturally appropriate for 
                pregnant and postpartum Indians and Alaska Natives.
            (3) Report.--Not later than 3 years after the date of 
        enactment of this Act, the Director shall submit to Congress a 
        report describing the results of the study conducted under 
        paragraph (1), including recommendations for policies and 
        practices that can be adopted to improve maternal health 
        outcomes for pregnant and postpartum Indians and Alaska 
        Natives, including recommendations--
                    (A) on how to improve maternal health outcomes for 
                Indians and Alaska Natives receiving care at the 
                different settings identified under paragraph (2)(C);
                    (B) on how to reduce misclassification of pregnant 
                and postpartum Indians and Alaska Natives, including 
                consideration of best practices in training for members 
                of maternal mortality review committees to be able to 
                correctly classify Indians and Alaska Natives; and
                    (C) informed by the stories shared by pregnant and 
                postpartum Indians and Alaska Natives under paragraph 
                (2)(B) to improve maternal health outcomes for those 
                individuals.
    (c) Participating Individuals.--
            (1) In general.--The Director shall select from among 
        individuals nominated by Indian Tribes, tribal organizations, 
        and urban Indian organizations 12 individuals for participation 
        in the study conducted under subsection (b)(1).
            (2) Requirement.--In selecting members under paragraph (1), 
        the Director shall ensure that each of the 12 service areas of 
        the Indian Health Service is represented.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $2,000,000 for each of fiscal 
years 2022 through 2024.

SEC. 505. GRANTS TO MINORITY-SERVING INSTITUTIONS TO STUDY MATERNAL 
              MORTALITY, SEVERE MATERNAL MORBIDITY, AND OTHER ADVERSE 
              MATERNAL HEALTH OUTCOMES.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a program under which the Secretary shall award grants to 
research centers, health professions schools and programs, and other 
entities at minority-serving institutions to study specific aspects of 
the maternal health crisis among pregnant and postpartum individuals 
from racial and ethnic minority groups. Such research may--
            (1) include the development and implementation of 
        systematic processes of listening to the stories of pregnant 
        and postpartum individuals from racial and ethnic minority 
        groups, and perinatal health workers supporting such 
        individuals, to fully understand the causes of, and inform 
        potential solutions to, the maternal mortality and severe 
        maternal morbidity crisis within their respective communities;
            (2) assess the potential causes of relatively low rates of 
        maternal mortality among Hispanic individuals, including 
        potential racial misclassification and other data collection 
        and reporting issues that might be misrepresenting maternal 
        mortality rates among Hispanic individuals in the United 
        States; and
            (3) assess differences in rates of adverse maternal health 
        outcomes among subgroups identifying as Hispanic.
    (b) Application.--To be eligible to receive 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 Secretary may require.
    (c) Technical Assistance.--The Secretary may use not more than 10 
percent of the funds made available under subsection (g)--
            (1) to conduct outreach to minority-serving institutions to 
        raise awareness of the availability of grants under this 
        subsection (a);
            (2) to provide technical assistance in the application 
        process for such a grant; and
            (3) to promote capacity building as needed to enable 
        entities described in such subsection to submit such an 
        application.
    (d) Reporting Requirement.--Each entity awarded a grant under this 
section shall periodically submit to the Secretary a report on the 
status of activities conducted using the grant.
    (e) Evaluation.--Beginning one year after the date on which the 
first grant is awarded under this section, the Secretary shall submit 
to Congress an annual report summarizing the findings of research 
conducted using funds made available under this section.
    (f) Minority-Serving Institutions Defined.--In this section, the 
term ``minority-serving institution'' has the meaning given the term in 
section 371(a) of the Higher Education Act of 1965 (20 U.S.C. 
1067q(a)).
    (g) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2022 through 2026.

                         TITLE VI--MOMS MATTER

SEC. 601. MATERNAL MENTAL HEALTH EQUITY GRANT PROGRAM.

    (a) In General.--The Secretary, acting through the Assistant 
Secretary for Mental Health and Substance Use, shall establish a 
program to award grants to eligible entities to address maternal mental 
health conditions and substance use disorders with respect to pregnant 
and postpartum individuals, with a focus on racial and ethnic minority 
groups.
    (b) Application.--To be eligible to receive a grant under this 
section an eligible entity shall submit to the Secretary an application 
at such time, in such manner, and containing such information as the 
Secretary may provide, including how such entity will use funds for 
activities described in subsection (d) that are culturally congruent.
    (c) Priority.--In awarding grants under this section, the Secretary 
shall give priority to an eligible entity that--
            (1) is, or will partner with, a community-based 
        organization to address maternal mental health conditions and 
        substance use disorders described in subsection (a);
            (2) is operating in an area with high rates of--
                    (A) adverse maternal health outcomes; or
                    (B) significant racial or ethnic disparities in 
                maternal health outcomes; and
            (3) is operating in a health professional shortage area 
        designated under section 332 of the Public Health Service Act 
        (42 U.S.C. 254e).
    (d) Use of Funds.--An eligible entity that receives a grant under 
this section shall use funds for the following:
            (1) Establishing or expanding maternity care programs to 
        improve the integration of maternal health and behavioral 
        health care services into primary care settings where pregnant 
        individuals regularly receive health care services.
            (2) Establishing or expanding group prenatal care programs 
        or postpartum care programs.
            (3) Expanding existing programs that improve maternal 
        mental and behavioral health during the prenatal and postpartum 
        periods, with a focus on individuals from racial and ethnic 
        minority groups.
            (4) Providing services and support for pregnant and 
        postpartum individuals with maternal mental health conditions 
        and substance use disorders, including referrals to addiction 
        treatment centers that offer evidence-based treatment options.
            (5) Addressing stigma associated with maternal mental 
        health conditions and substance use disorders, with a focus on 
        racial and ethnic minority groups.
            (6) Raising awareness of warning signs of maternal mental 
        health conditions and substance use disorders, with a focus on 
        pregnant and postpartum individuals from racial and ethnic 
        minority groups.
            (7) Establishing or expanding programs to prevent suicide 
        or self-harm among pregnant and postpartum individuals.
            (8) Offering evidence-aligned programs at freestanding 
        birth centers that provide maternal mental and behavioral 
        health care education, treatments, and services, and other 
        services for individuals throughout the prenatal and postpartum 
        period.
            (9) Establishing or expanding programs to provide education 
        and training to maternity care providers with respect to--
                    (A) identifying potential warning signs for 
                maternal mental health conditions or substance use 
                disorders in pregnant and postpartum individuals, with 
                a focus on individuals from racial and ethnic minority 
                groups; and
                    (B) in the case where such providers identify such 
                warning signs, offering referrals to mental and 
                behavioral health care professionals.
            (10) Developing a website, or other source, that includes 
        information on health care providers who treat maternal mental 
        health conditions and substance use disorders.
            (11) Establishing or expanding programs in communities to 
        improve coordination between maternity care providers and 
        mental and behavioral health care providers who treat maternal 
        mental health conditions and substance use disorders, including 
        through the use of toll-free hotlines.
            (12) Carrying out other programs aligned with evidence-
        based practices for addressing maternal mental health 
        conditions and substance use disorders for pregnant and 
        postpartum individuals from racial and ethnic minority groups.
    (e) Reporting.--
            (1) Eligible entities.--An eligible entity that receives a 
        grant under subsection (a) shall submit annually to the 
        Secretary, and make publicly available, a report on the 
        activities conducted using funds received through a grant under 
        this section. Such reports shall include quantitative and 
        qualitative evaluations of such activities, including the 
        experience of individuals who received health care through such 
        grant.
            (2) Secretary.--Not later than the end of fiscal year 2024, 
        the Secretary shall submit to Congress a report that includes--
                    (A) a summary of the reports received under 
                paragraph (1);
                    (B) an evaluation of the effectiveness of grants 
                awarded under this section;
                    (C) recommendations with respect to expanding 
                coverage of evidence-based screenings and treatments 
                for maternal mental health conditions and substance use 
                disorders; and
                    (D) recommendations with respect to ensuring 
                activities described under subsection (d) continue 
                after the end of a grant period.
    (f) Definitions.--In this section:
            (1) Eligible entity.--The term ``eligible entity'' means--
                    (A) a community-based organization serving pregnant 
                and postpartum individuals, including such 
                organizations serving individuals from racial and 
                ethnic minority groups and other underserved 
                populations;
                    (B) a nonprofit or patient advocacy organization 
                with expertise in maternal mental and behavioral 
                health;
                    (C) a maternity care provider;
                    (D) a mental or behavioral health care provider who 
                treats maternal mental health conditions or substance 
                use disorders;
                    (E) a State or local governmental entity, including 
                a State or local public health department;
                    (F) an Indian Tribe or Tribal organization (as such 
                terms are defined in section 4 of the Indian Self-
                Determination and Education Assistance Act (25 U.S.C. 
                5304)); and
                    (G) an Urban Indian organization (as such term is 
                defined in section 4 of the Indian Health Care 
                Improvement Act (25 U.S.C. 1603)).
            (2) Freestanding birth center.--The term ``freestanding 
        birth center'' has the meaning given that term under section 
        1905(l) of the Social Security Act (42 U.S.C. 1396d(1)).
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
    (g) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $25,000,000 for each of fiscal 
years 2022 through 2025.

SEC. 602. GRANTS TO GROW AND DIVERSIFY THE MATERNAL MENTAL AND 
              BEHAVIORAL HEALTH CARE WORKFORCE.

    Title VII of the Public Health Service Act (42 U.S.C. 292 et seq.) 
is amended by inserting after section 758 of such Act, as added by 
section 402 of this Act, the following new section:

``SEC. 758A. MATERNAL MENTAL AND BEHAVIORAL HEALTH CARE 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 maternal mental and behavioral health care workforce.
    ``(b) Use of Funds.--Recipients of grants under this section shall 
use the grants to grow and diversify the maternal mental and behavioral 
health care workforce by--
            ``(1) establishing schools or programs that provide 
        education and training to individuals seeking appropriate 
        licensing or certification as mental or behavioral health care 
        providers who will specialize in maternal mental health 
        conditions or substance use disorders; or
            ``(2) expanding the capacity of existing schools or 
        programs described in paragraph (1), for the purposes 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 entity that--
            ``(1) has demonstrated a commitment to recruiting and 
        retaining students and faculty from racial and ethnic minority 
        groups;
            ``(2) has developed a strategy to recruit and retain a 
        diverse pool of students into the maternal mental or behavioral 
        health care workforce program or school supported by funds 
        received through the grant, particularly from racial and ethnic 
        minority groups and other underserved populations;
            ``(3) has developed a strategy to recruit and retain 
        students who plan to practice in a health professional shortage 
        area designated under section 332;
            ``(4) has developed a strategy to recruit and retain 
        students who plan to practice in an area with significant 
        racial and ethnic disparities in maternal health outcomes, to 
        the extent practicable; and
            ``(5) includes in the standard curriculum for all students 
        within the maternal mental or behavioral health care workforce 
        program or school a bias, racism, or discrimination training 
        program that includes training on implicit bias and racism.
    ``(d) Reporting.--As a condition on receipt of a grant under this 
section for a maternal mental or behavioral health care workforce 
program or school, an entity shall agree to submit to the Secretary an 
annual report on the activities conducted through the grant, 
including--
            ``(1) the number and demographics of students participating 
        in the program or school;
            ``(2) the extent to which students in the program or school 
        are entering careers in--
                    ``(A) health professional shortage areas designated 
                under section 332; and
                    ``(B) areas with significant racial and ethnic 
                disparities in maternal health outcomes, to the extent 
                such data are available; and
            ``(3) whether the program or school has included in the 
        standard curriculum for all students a bias, racism, or 
        discrimination training program that includes training on 
        implicit bias and racism, and if so the effectiveness 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 section, an entity 
shall submit to the Secretary an application at such time, in such 
manner, and containing such information as the Secretary may require, 
including any information necessary for prioritization under subsection 
(c).
    ``(g) Technical Assistance.--The Secretary shall provide, directly 
or by contract, technical assistance to entities seeking or receiving a 
grant under this section on the development, use, evaluation, and post-
grant period sustainability of the maternal mental or behavioral health 
care workforce programs or schools proposed to be, or being, 
established or expanded through the grant.
    ``(h) Report by the Secretary.--Not later than 4 years after the 
date of enactment of this section, the Secretary shall prepare and 
submit to 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 students from racial and ethnic minority 
        groups and other underserved populations;
            ``(2) increasing the number of mental or behavioral health 
        care providers specializing in maternal mental health 
        conditions or substance use disorders from racial and ethnic 
        minority groups and other underserved populations;
            ``(3) increasing the number of mental or behavioral health 
        care providers specializing in maternal mental health 
        conditions or substance use disorders working in health 
        professional shortage areas designated under section 332; and
            ``(4) increasing the number of mental or behavioral health 
        care providers specializing in maternal mental health 
        conditions or substance use disorders working in areas with 
        significant racial and ethnic disparities in maternal health 
        outcomes, to the extent such data are available.
    ``(i) Definitions.--In this section:
            ``(1) Racial and ethnic minority group.--The term `racial 
        and ethnic minority group' has the meaning given such term in 
        section 1707(g)(1).
            ``(2) Mental or behavioral health care provider.--The term 
        `mental or behavioral health care provider' refers to a health 
        care provider in the field of mental and behavioral health, 
        including substance use disorders, acting in accordance with 
        State law.
    ``(j) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $15,000,000 for each of fiscal 
years 2022 through 2026.''.

                TITLE VII--JUSTICE FOR INCARCERATED MOMS

SEC. 701. ENDING THE SHACKLING OF PREGNANT INDIVIDUALS.

    (a) In General.--Beginning on the date that is 6 months after the 
date of enactment of this Act, and annually thereafter, in each State 
that receives a grant under subpart 1 of part E of title I of the 
Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C. 10151 et 
seq.) (commonly referred to as the ``Edward Byrne Memorial Justice 
Grant Program'') and that does not have in effect throughout the State 
for such fiscal year laws restricting the use of restraints on pregnant 
individuals in prison that are substantially similar to the rights, 
procedures, requirements, effects, and penalties set forth in section 
4322 of title 18, United States Code, the amount of such grant that 
would otherwise be allocated to such State under such subpart for the 
fiscal year shall be decreased by 25 percent.
    (b) Reallocation.--Amounts not allocated to a State for failure to 
comply with subsection (a) shall be reallocated in accordance with 
subpart 1 of part E of title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (34 U.S.C. 10151 et seq.) to States that have 
complied with such subsection.

SEC. 702. CREATING MODEL PROGRAMS FOR THE CARE OF INCARCERATED 
              INDIVIDUALS IN THE PRENATAL AND POSTPARTUM PERIODS.

    (a) Establishment.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Attorney General, acting through the 
        Director of the Bureau of Prisons, shall establish, in not 
        fewer than 6 Bureau of Prisons facilities, programs to optimize 
        maternal health outcomes for pregnant and postpartum 
        individuals incarcerated in such facilities.
            (2) Required consultation.--The Attorney General shall 
        establish the programs authorized under paragraph (1) in 
        consultation with stakeholders such as--
                    (A) relevant community-based organizations, 
                particularly organizations that represent incarcerated 
                and formerly incarcerated individuals and organizations 
                that seek to improve maternal health outcomes for 
                pregnant and postpartum individuals from racial and 
                ethnic minority groups;
                    (B) relevant organizations representing patients, 
                with a particular focus on patients from racial and 
                ethnic minority groups;
                    (C) organizations representing maternity care 
                providers and maternal health care education programs;
                    (D) perinatal health workers; and
                    (E) researchers and policy experts in fields 
                related to maternal health care for incarcerated 
                individuals.
    (b) Start Date.--Each facility selected under subsection (a) shall 
begin facility programs not later than 18 months after the date of 
enactment of this Act.
    (c) Facility Priority.--In carrying out subsection (a), the 
Director shall give priority to a facility based on--
            (1) the number of pregnant and postpartum individuals 
        incarcerated in such facility and, among such individuals, the 
        number of pregnant and postpartum individuals from racial and 
        ethnic minority groups; and
            (2) the extent to which the leaders of such facility have 
        demonstrated a commitment to developing exemplary programs for 
        pregnant and postpartum individuals incarcerated in such 
        facility.
    (d) Program Duration.--The programs established under this section 
shall be for a 5-year period.
    (e) Programs.--Bureau of Prisons facilities selected by the 
Director shall establish programs for pregnant and postpartum 
incarcerated individuals, and such programs--
            (1) may--
                    (A) provide access to perinatal health workers from 
                pregnancy through the postpartum period;
                    (B) provide access to healthy foods and counseling 
                on nutrition, recommended activity levels, and safety 
                measures throughout pregnancy;
                    (C) train correctional officers to ensure that 
                pregnant incarcerated individuals receive safe and 
                respectful treatment;
                    (D) train medical personnel to ensure that pregnant 
                incarcerated individuals receive trauma-informed, 
                culturally congruent care that promotes the health and 
                safety of the pregnant individuals;
                    (E) provide counseling and treatment for 
                individuals who have suffered from--
                            (i) diagnosed mental or behavioral health 
                        conditions, including trauma and substance use 
                        disorders;
                            (ii) trauma or violence, including domestic 
                        violence;
                            (iii) human immunodeficiency virus;
                            (iv) sexual abuse;
                            (v) pregnancy or infant loss; or
                            (vi) chronic conditions;
                    (F) provide evidence-based pregnancy and childbirth 
                education, parenting support, and other relevant forms 
                of health literacy;
                    (G) provide clinical education opportunities to 
                maternity care providers in training to expand pathways 
                into maternal health care careers serving incarcerated 
                individuals;
                    (H) offer opportunities for postpartum individuals 
                to maintain contact with the individual's newborn child 
                to promote bonding, including enhanced visitation 
                policies, access to prison nursery programs, or 
                breastfeeding support;
                    (I) provide reentry assistance, particularly to--
                            (i) ensure access to health insurance 
                        coverage and transfer of health records to 
                        community providers if an incarcerated 
                        individual exits the criminal justice system 
                        during such individual's pregnancy or in the 
                        postpartum period; and
                            (ii) connect individuals exiting the 
                        criminal justice system during pregnancy or in 
                        the postpartum period to community-based 
                        resources, such as referrals to health care 
                        providers, substance use disorder treatments, 
                        and social services that address social 
                        determinants maternal of health; or
                    (J) establish partnerships with local public 
                entities, private community entities, community-based 
                organizations, Indian Tribes and tribal organizations 
                (as such terms are defined in section 4 of the Indian 
                Self-Determination and Education Assistance Act (25 
                U.S.C. 5304)), and urban Indian organizations (as such 
                term is defined in section 4 of the Indian Health Care 
                Improvement Act (25 U.S.C. 1603)) to establish or 
                expand pretrial diversion programs as an alternative to 
                incarceration for pregnant and postpartum individuals; 
                and
            (2) may include--
                    (A) evidence-based childbirth education or 
                parenting classes;
                    (B) prenatal health coordination;
                    (C) family and individual counseling;
                    (D) evidence-based screenings, education, and, as 
                needed, treatment for mental and behavioral health 
                conditions, including drug and alcohol treatments;
                    (E) family case management services;
                    (F) domestic violence education and prevention;
                    (G) physical and sexual abuse counseling; and
                    (H) programs to address social determinants of 
                health such as employment, housing, education, 
                transportation, and nutrition.
    (f) Implementation and Reporting.--A selected facility shall be 
responsible for--
            (1) implementing programs, which may include the programs 
        described in subsection (e); and
            (2) not later than 3 years after the date of enactment of 
        this Act, and 6 years after the date of enactment of this Act, 
        reporting results of the programs to the Director, including 
        information describing--
                    (A) relevant quantitative indicators of success in 
                improving the standard of care and health outcomes for 
                pregnant and postpartum incarcerated individuals in the 
                facility, including data stratified by race, ethnicity, 
                sex, gender, age, geography, disability status, the 
                category of the criminal charge against such 
                individual, rates of pregnancy-related deaths, 
                pregnancy-associated deaths, cases of infant mortality 
                and morbidity, rates of preterm births and low-
                birthweight births, cases of severe maternal morbidity, 
                cases of violence against pregnant or postpartum 
                individuals, diagnoses of maternal mental or behavioral 
                health conditions, and other such information as 
                appropriate;
                    (B) relevant qualitative and quantitative 
                evaluations from pregnant and postpartum incarcerated 
                individuals who participated in such programs, 
                including measures of patient-reported experience of 
                care; and
                    (C) strategies to sustain such programs after 
                fiscal year 2026 and expand such programs to other 
                facilities.
    (g) Report.--Not later than 6 years after the date of enactment of 
this Act, the Director shall submit to the Attorney General and to the 
Congress a report describing the results of the programs funded under 
this section.
    (h) Oversight.--Not later than 1 year after the date of enactment 
of this Act, the Attorney General shall award a contract to an 
independent organization or independent organizations to conduct 
oversight of the programs described in subsection (e).
    (i) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2022 through 2026.

SEC. 703. GRANT PROGRAM TO IMPROVE MATERNAL HEALTH OUTCOMES FOR 
              INDIVIDUALS IN STATE AND LOCAL PRISONS AND JAILS.

    (a) Establishment.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Attorney General, acting through the 
        Director of the Bureau of Justice Assistance, shall award 
        Justice for Incarcerated Moms grants to States to establish or 
        expand programs in State and local prisons and jails for 
        pregnant and postpartum incarcerated individuals.
            (2) Required consultation.--The Attorney General shall 
        award the grants authorized under paragraph (1) in consultation 
        with stakeholders such as--
                    (A) relevant community-based organizations, 
                particularly organizations that represent incarcerated 
                and formerly incarcerated individuals and organizations 
                that seek to improve maternal health outcomes for 
                pregnant and postpartum individuals from racial and 
                ethnic minority groups;
                    (B) relevant organizations representing patients, 
                with a particular focus on patients from racial and 
                ethnic minority groups;
                    (C) organizations representing maternity care 
                providers and maternal health care education programs;
                    (D) perinatal health workers; and
                    (E) researchers and policy experts in fields 
                related to maternal health care for incarcerated 
                individuals.
    (b) Applications.--Each applicant for a grant under this section 
shall submit to the Director of the Bureau of Justice Assistance an 
application at such time, in such manner, and containing such 
information as the Director may require.
    (c) Use of Funds.--A State that is awarded a grant under this 
section shall use such grant to establish or expand programs for 
pregnant and postpartum incarcerated individuals, and such programs--
            (1) may--
                    (A) provide access to perinatal health workers from 
                pregnancy through the postpartum period;
                    (B) provide access to healthy foods and counseling 
                on nutrition, recommended activity levels, and safety 
                measures throughout pregnancy;
                    (C) train correctional officers to ensure that 
                pregnant incarcerated individuals receive safe and 
                respectful treatment;
                    (D) train medical personnel to ensure that pregnant 
                incarcerated individuals receive trauma-informed, 
                culturally congruent care that promotes the health and 
                safety of the pregnant individuals;
                    (E) provide counseling and treatment for 
                individuals who have suffered from--
                            (i) diagnosed mental or behavioral health 
                        conditions, including trauma and substance use 
                        disorders;
                            (ii) trauma or violence, including domestic 
                        violence;
                            (iii) human immunodeficiency virus;
                            (iv) sexual abuse;
                            (v) pregnancy or infant loss; or
                            (vi) chronic conditions;
                    (F) provide evidence-based pregnancy and childbirth 
                education, parenting support, and other relevant forms 
                of health literacy;
                    (G) provide clinical education opportunities to 
                maternity care providers in training to expand pathways 
                into maternal health care careers serving incarcerated 
                individuals;
                    (H) offer opportunities for postpartum individuals 
                to maintain contact with the individual's newborn child 
                to promote bonding, including enhanced visitation 
                policies, access to prison nursery programs, or 
                breastfeeding support;
                    (I) provide reentry assistance, particularly to--
                            (i) ensure access to health insurance 
                        coverage and transfer of health records to 
                        community providers if an incarcerated 
                        individual exits the criminal justice system 
                        during such individual's pregnancy or in the 
                        postpartum period; and
                            (ii) connect individuals exiting the 
                        criminal justice system during pregnancy or in 
                        the postpartum period to community-based 
                        resources, such as referrals to health care 
                        providers, substance use disorder treatments, 
                        and social services that address social 
                        determinants of maternal health; or
                    (J) establish partnerships with local public 
                entities, private community entities, community-based 
                organizations, Indian Tribes and tribal organizations 
                (as such terms are defined in section 4 of the Indian 
                Self-Determination and Education Assistance Act (25 
                U.S.C. 5304)), and urban Indian organizations (as such 
                term is defined in section 4 of the Indian Health Care 
                Improvement Act (25 U.S.C. 1603)) to establish or 
                expand pretrial diversion programs as an alternative to 
                incarceration for pregnant and postpartum individuals; 
                and
            (2) may include--
                    (A) evidence-based childbirth education or 
                parenting classes;
                    (B) prenatal health coordination;
                    (C) family and individual counseling;
                    (D) evidence-based screenings, education, and, as 
                needed, treatment for mental and behavioral health 
                conditions, including drug and alcohol treatments;
                    (E) family case management services;
                    (F) domestic violence education and prevention;
                    (G) physical and sexual abuse counseling; and
                    (H) programs to address social determinants of 
                health such as employment, housing, education, 
                transportation, and nutrition.
    (d) Priority.--In awarding grants under this section, the Director 
of the Bureau of Justice Assistance shall give priority to applicants 
based on--
            (1) the number of pregnant and postpartum individuals 
        incarcerated in the State and, among such individuals, the 
        number of pregnant and postpartum individuals from racial and 
        ethnic minority groups; and
            (2) the extent to which the State has demonstrated a 
        commitment to developing exemplary programs for pregnant and 
        postpartum individuals incarcerated in the prisons and jails in 
        the State.
    (e) Grant Duration.--A grant awarded under this section shall be 
for a 5-year period.
    (f) Implementing and Reporting.--A State that receives a grant 
under this section shall be responsible for--
            (1) implementing the program funded by the grant; and
            (2) not later than 3 years after the date of enactment of 
        this Act, and 6 years after the date of enactment of this Act, 
        reporting results of such program to the Attorney General, 
        including information describing--
                    (A) relevant quantitative indicators of the 
                program's success in improving the standard of care and 
                health outcomes for pregnant and postpartum 
                incarcerated individuals in the facility, including 
                data stratified by race, ethnicity, sex, gender, age, 
                geography, disability status, category of the criminal 
                charge against such individual, incidence rates of 
                pregnancy-related deaths, pregnancy-associated deaths, 
                cases of infant mortality and morbidity, rates of 
                preterm births and low-birthweight births, cases of 
                severe maternal morbidity, cases of violence against 
                pregnant or postpartum individuals, diagnoses of 
                maternal mental or behavioral health conditions, and 
                other such information as appropriate;
                    (B) relevant qualitative and quantitative 
                evaluations from pregnant and postpartum incarcerated 
                individuals who participated in such programs, 
                including measures of patient-reported experience of 
                care; and
                    (C) strategies to sustain such programs beyond the 
                duration of the grant and expand such programs to other 
                facilities.
    (g) Report.--Not later than 6 years after the date of enactment of 
this Act, the Attorney General shall submit to the Congress a report 
describing the results of such grant programs.
    (h) Oversight.--Not later than 1 year after the date of enactment 
of this Act, the Attorney General shall award a contract to an 
independent organization or independent organizations to conduct 
oversight of the programs described in subsection (c).
    (i) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2022 through 2026.

SEC. 704. GAO REPORT.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, the Comptroller General of the United States shall submit 
to Congress a report on adverse maternal and infant health outcomes 
among incarcerated individuals and infants born to such individuals, 
with a particular focus on racial and ethnic disparities in maternal 
and infant health outcomes for incarcerated individuals.
    (b) Contents of Report.--The report described in this section shall 
include--
            (1) to the extent practicable--
                    (A) the number of pregnant individuals who are 
                incarcerated in Bureau of Prisons facilities;
                    (B) the number of incarcerated individuals, 
                including those incarcerated in Federal, State, and 
                local correctional facilities, who have experienced a 
                pregnancy-related death, pregnancy-associated death, or 
                the death of an infant in the most recent 10 years of 
                available data;
                    (C) the number of cases of severe maternal 
                morbidity among incarcerated individuals, including 
                those incarcerated in Federal, State, and local 
                detention facilities, in the most recent 10 years of 
                available data;
                    (D) the number of preterm and low-birthweight 
                births of infants born to incarcerated individuals, 
                including those incarcerated in Federal, State, and 
                local correctional facilities, in the most recent 10 
                years of available data; and
                    (E) statistics on the racial and ethnic disparities 
                in maternal and infant health outcomes and severe 
                maternal morbidity rates among incarcerated 
                individuals, including those incarcerated in Federal, 
                State, and local detention facilities;
            (2) in the case that the Comptroller General of the United 
        States is unable determine the information required in 
        subparagraphs (A) through (C) of paragraph (1), an assessment 
        of the barriers to determining such information and 
        recommendations for improvements in tracking maternal health 
        outcomes among incarcerated individuals, including those 
        incarcerated in Federal, State, and local detention facilities;
            (3) causes of adverse maternal health outcomes that are 
        unique to incarcerated individuals, including those 
        incarcerated in Federal, State, and local detention facilities;
            (4) causes of adverse maternal health outcomes and severe 
        maternal morbidity that are unique to incarcerated individuals 
        from racial and ethnic minority groups;
            (5) recommendations to reduce maternal mortality and severe 
        maternal morbidity among incarcerated individuals and to 
        address racial and ethnic disparities in maternal health 
        outcomes for incarcerated individuals in Bureau of Prisons 
        facilities and State and local prisons and jails; and
            (6) such other information as may be appropriate to reduce 
        the occurrence of adverse maternal health outcomes among 
        incarcerated individuals and to address racial and ethnic 
        disparities in maternal health outcomes for such individuals.

SEC. 705. MACPAC REPORT.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, the Medicaid and CHIP Payment and Access Commission 
(referred to in this section as ``MACPAC'') shall publish a report on 
the implications of pregnant and postpartum incarcerated individuals 
being ineligible for medical assistance under a State plan under title 
XIX of the Social Security Act (42 U.S.C. 1396 et seq.) that contains 
the information described in subsection (b).
    (b) Information Described.--The information described in this 
subsection includes--
            (1) information on the effect of ineligibility for medical 
        assistance under a State plan under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.) on maternal health 
        outcomes for pregnant and postpartum incarcerated individuals, 
        concentrating on the effects of such ineligibility for pregnant 
        and postpartum individuals from racial and ethnic minority 
        groups; and
            (2) the potential implications on maternal health outcomes 
        resulting from suspending eligibility for medical assistance 
        under a State plan under such title when a pregnant or 
        postpartum individual is incarcerated.

                     TITLE VIII--TECH TO SAVE MOMS

SEC. 801. INTEGRATED TELEHEALTH MODELS IN MATERNITY CARE SERVICES.

    (a) In General.--Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the end the 
following:
                            ``(xxviii) Focusing on title XIX, providing 
                        for the adoption of and use of telehealth tools 
                        that allow for screening, monitoring, and 
                        management of common health complications with 
                        respect to an individual receiving medical 
                        assistance during such individual's pregnancy 
                        and for not more than a 1-year period beginning 
                        on the last day of the pregnancy.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect 1 year after the date of enactment of this Act.

SEC. 802. GRANTS TO EXPAND THE USE OF TECHNOLOGY-ENABLED COLLABORATIVE 
              LEARNING AND CAPACITY MODELS FOR PREGNANT AND POSTPARTUM 
              INDIVIDUALS.

    Title III of the Public Health Service Act is amended by inserting 
after section 330N (42 U.S.C. 254c-19) the following:

``SEC. 330O. EXPANDING CAPACITY FOR MATERNAL HEALTH OUTCOMES.

    ``(a) Establishment.--Beginning not later than 1 year after the 
date of enactment of this section, the Secretary shall award grants to 
eligible entities to evaluate, develop, and expand the use of 
technology-enabled collaborative learning and capacity building models 
and improve maternal health outcomes--
            ``(1) in health professional shortage areas;
            ``(2) in areas with high rates of maternal mortality and 
        severe maternal morbidity;
            ``(3) in areas with significant racial and ethnic 
        disparities in maternal health outcomes; and
            ``(4) for medically underserved populations and American 
        Indians and Alaska Natives, including Indian Tribes, Tribal 
        organizations, and Urban Indian organizations.
    ``(b) Use of Funds.--
            ``(1) Required uses.--Recipients of grants under this 
        section shall use the grants to--
                    ``(A) train maternal health care providers, 
                students, and other similar professionals through 
                models that include--
                            ``(i) methods to increase safety and health 
                        care quality;
                            ``(ii) methods to address implicit bias, 
                        racism, and discrimination;
                            ``(iii) best practices in screening for 
                        maternal mental health conditions and substance 
                        use disorders and, as needed, evaluating and 
                        treating such conditions and disorders;
                            ``(iv) training on best practices in 
                        maternity care for pregnant and postpartum 
                        individuals during the COVID-19 public health 
                        emergency or future public health emergencies;
                            ``(v) methods to screen for social 
                        determinants of maternal health risks in the 
                        prenatal and postpartum; and
                            ``(vi) the use of remote patient monitoring 
                        tools for pregnancy-related complications 
                        described in section 1115A(b)(2)(B)(xxviii);
                    ``(B) evaluate and collect information on the 
                affect of such models on--
                            ``(i) access to and quality of care;
                            ``(ii) outcomes with respect to the health 
                        of an individual; and
                            ``(iii) the experience of individuals who 
                        receive pregnancy-related health care;
                    ``(C) develop qualitative and quantitative measures 
                to identify best practices for the expansion and use of 
                such models;
                    ``(D) study the effect of such models on patient 
                outcomes and maternity care providers; and
                    ``(E) conduct any other activity, as determined by 
                the Secretary.
            ``(2) Permissible uses.--Recipients of grants under this 
        section may use grants to support--
                    ``(A) the use and expansion of technology-enabled 
                collaborative learning and capacity building models, 
                including hardware and software that--
                            ``(i) enables distance learning and 
                        technical support; and
                            ``(ii) supports the secure exchange of 
                        electronic health information; and
                    ``(B) maternity care providers, students, and other 
                similar professionals in the provision of maternity 
                care through such models.
    ``(c) Application.--
            ``(1) In general.--An eligible entity seeking a grant under 
        subsection (a) shall submit to the Secretary an application, at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
            ``(2) Assurance.--An application under paragraph (1) shall 
        include an assurance that such entity shall collect information 
        on, and assess the affect of, the use of technology-enabled 
        collaborative learning and capacity building models, including 
        with respect to--
                    ``(A) maternal health outcomes;
                    ``(B) access to maternal health care services;
                    ``(C) quality of maternal health care; and
                    ``(D) retention of maternity care providers serving 
                areas and populations described in subsection (a).
    ``(d) Limitations.--
            ``(1) Number.--Each entity receiving a grant under this 
        section may receive not more than 1 such grant.
            ``(2) Duration.--A grant awarded under this section shall 
        be for a 5-year period.
    ``(e) Access to Broadband.--In administering grants under this 
section, the Secretary may coordinate with other agencies to ensure 
that funding opportunities are available to support access to reliable, 
high-speed internet for grantees.
    ``(f) Technical Assistance.--The Secretary shall provide (either 
directly or by contract) technical assistance to eligible entities, 
including recipients of grants under subsection (a), on the 
development, use, and sustainability of technology-enabled 
collaborative learning and capacity building models to expand access to 
maternal health care services provided by such entities, including--
            ``(1) in health professional shortage areas;
            ``(2) in areas with high rates of maternal mortality and 
        severe maternal morbidity or significant racial and ethnic 
        disparities in maternal health outcomes; and
            ``(3) for medically underserved populations or American 
        Indians and Alaska Natives.
    ``(g) Research and Evaluation.--The Secretary, in consultation with 
experts, shall develop a strategic plan to research and evaluate the 
evidence for such models.
    ``(h) Reporting.--
            ``(1) Eligible entities.--An eligible entity that receives 
        a grant under subsection (a) shall submit to the Secretary a 
        report, at such time, in such manner, and containing such 
        information as the Secretary may require.
            ``(2) Secretary.--Not later than 4 years after the date of 
        enactment of this section, the Secretary shall submit to 
        Congress, and make available on the website of the Department 
        of Health and Human Services, a report that includes--
                    ``(A) a description of grants awarded under 
                subsection (a) and the purpose and amounts of such 
                grants;
                    ``(B) a summary of--
                            ``(i) the evaluations conducted under 
                        subsection (b)(1)(B);
                            ``(ii) any technical assistance provided 
                        under subsection (f); and
                            ``(iii) the activities conducted under a 
                        grant awarded under subsection (a); and
                    ``(C) a description of any significant findings 
                with respect to--
                            ``(i) patient outcomes; and
                            ``(ii) best practices for expanding, using, 
                        or evaluating technology-enabled collaborative 
                        learning and capacity building models.
    ``(i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $6,000,000 for each of fiscal 
years 2022 through 2026.
    ``(j) Definitions.--In this section:
            ``(1) Eligible entity.--
                    ``(A) In general.--The term `eligible entity' means 
                an entity that provides, or supports the provision of, 
                maternal health care services or other evidence-based 
                services for pregnant and postpartum individuals--
                            ``(i) in health professional shortage 
                        areas;
                            ``(ii) in areas with high rates of adverse 
                        maternal health outcomes or significant racial 
                        and ethnic disparities in maternal health 
                        outcomes; and
                            ``(iii) who are--
                                    ``(I) members of medically 
                                underserved populations; or
                                    ``(II) American Indians and Alaska 
                                Natives, including Indian Tribes, 
                                Tribal organizations, and urban Indian 
                                organizations.
                    ``(B) Inclusions.--An eligible entity may include 
                entities that lead, or are capable of leading, a 
                technology-enabled collaborative learning and capacity 
                building model.
            ``(2) Health professional shortage area.--The term `health 
        professional shortage area' means a health professional 
        shortage area designated under section 332.
            ``(3) Indian tribe.--The term `Indian Tribe' has the 
        meaning given such term in section 4 of the Indian Self-
        Determination and Education Assistance Act.
            ``(4) Maternal mortality.--The term `maternal mortality' 
        means a death occurring during or within 1-year period after 
        pregnancy caused by pregnancy-related or childbirth 
        complications, including a suicide, overdose, or other death 
        resulting from a mental health or substance use disorder 
        attributed to or aggravated by pregnancy or childbirth 
        complications.
            ``(5) Medically underserved population.--The term 
        `medically underserved population' has the meaning given such 
        term in section 330(b)(3).
            ``(6) Postpartum.--The term `postpartum' means the 1-year 
        period beginning on the last date of an individual's pregnancy.
            ``(7) Severe maternal morbidity.--The term `severe maternal 
        morbidity' means a health condition, including a mental health 
        or substance use disorder, attributed to or aggravated by 
        pregnancy or childbirth that results in significant short-term 
        or long-term consequences to the health of the individual who 
        was pregnant.
            ``(8) Technology-enabled collaborative learning and 
        capacity building model.--The term `technology-enabled 
        collaborative learning and capacity building model' means a 
        distance health education model that connects health care 
        professionals, and other specialists, through simultaneous 
        interactive videoconferencing for the purpose of facilitating 
        case-based learning, disseminating best practices, and 
        evaluating outcomes in the context of maternal health care.
            ``(9) Tribal organization.--The term `Tribal organization' 
        has the meaning given such term in section 4 of the Indian 
        Self-Determination and Education Assistance Act.
            ``(10) Urban indian organization.--The term `urban Indian 
        organization' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act.''.

SEC. 803. GRANTS TO PROMOTE EQUITY IN MATERNAL HEALTH OUTCOMES THROUGH 
              DIGITAL TOOLS.

    (a) In General.--Beginning not later than 1 year after the date of 
the enactment of this Act, the Secretary of Health and Human Services 
shall award grants to eligible entities to reduce racial and ethnic 
disparities in maternal health outcomes by increasing access to digital 
tools related to maternal health care.
    (b) Applications.--To be eligible to receive a grant under this 
section, an eligible entity shall submit to the Secretary an 
application at such time, in such manner, and containing such 
information as the Secretary may require.
    (c) Prioritization.--In awarding grants under this section, the 
Secretary shall prioritize an eligible entity--
            (1) in an area with high rates of adverse maternal health 
        outcomes or significant racial and ethnic disparities in 
        maternal health outcomes;
            (2) in a health professional shortage area designated under 
        section 332 of the Public Health Service Act (42 U.S.C. 254e); 
        and
            (3) that promotes technology that addresses racial and 
        ethnic disparities in maternal health outcomes.
    (d) Limitations.--
            (1) Number.--Each entity receiving a grant under this 
        section may receive not more than 1 such grant.
            (2) Duration.--A grant awarded under this section shall be 
        for a 5-year period.
    (e) Technical Assistance.--The Secretary shall provide technical 
assistance to an eligible entity on the development, use, evaluation, 
and post-grant sustainability of digital tools for purposes of 
promoting equity in maternal health outcomes.
    (f) Reporting.--
            (1) Eligible entities.--An eligible entity that receives a 
        grant under subsection (a) shall submit to the Secretary a 
        report, at such time, in such manner, and containing such 
        information as the Secretary may require.
            (2) Secretary.--Not later than 4 years after the date of 
        the enactment of this Act, the Secretary shall submit to 
        Congress a report that includes--
                    (A) an evaluation on the effectiveness of grants 
                awarded under this section to improve health outcomes 
                for pregnant and postpartum individuals from racial and 
                ethnic minority groups;
                    (B) recommendations on new grant programs that 
                promote the use of technology to improve such maternal 
                health outcomes; and
                    (C) recommendations with respect to--
                            (i) technology-based privacy and security 
                        safeguards in maternal health care;
                            (ii) reimbursement rates for maternal 
                        telehealth services;
                            (iii) the use of digital tools to analyze 
                        large data sets to identify potential 
                        pregnancy-related complications;
                            (iv) barriers that prevent maternity care 
                        providers from providing telehealth services 
                        across States;
                            (v) the use of consumer digital tools such 
                        as mobile phone applications, patient portals, 
                        and wearable technologies to improve maternal 
                        health outcomes;
                            (vi) barriers that prevent access to 
                        telehealth services, including a lack of access 
                        to reliable, high-speed internet or electronic 
                        devices;
                            (vii) barriers to data sharing between the 
                        Special Supplemental Nutrition Program for 
                        Women, Infants, and Children program and 
                        maternity care providers, and recommendations 
                        for addressing such barriers; and
                            (viii) lessons learned from expanded access 
                        to telehealth related to maternity care during 
                        the COVID-19 public health emergency.
    (g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $6,000,000 for each of fiscal 
years 2022 through 2026.

SEC. 804. REPORT ON THE USE OF TECHNOLOGY IN MATERNITY CARE.

    (a) In General.--Not later than 60 days after the date of enactment 
of this Act, the Secretary of Health and Human Services shall seek to 
enter an agreement with the National Academies of Sciences, 
Engineering, and Medicine (referred to in this Act as the ``National 
Academies'') under which the National Academies shall conduct a study 
on the use of technology and patient monitoring devices in maternity 
care.
    (b) Content.--The agreement entered into pursuant to subsection (a) 
shall provide for the study of the following:
            (1) The use of innovative technology (including artificial 
        intelligence) in maternal health care, including the extent to 
        which such technology has affected racial or ethnic biases in 
        maternal health care.
            (2) The use of patient monitoring devices (including pulse 
        oximeter devices) in maternal health care, including the extent 
        to which such devices have affected racial or ethnic biases in 
        maternal health care.
            (3) Best practices for reducing and preventing racial or 
        ethnic biases in the use of innovative technology and patient 
        monitoring devices in maternity care.
            (4) Best practices in the use of innovative technology and 
        patient monitoring devices for pregnant and postpartum 
        individuals from racial and ethnic minority groups.
            (5) Best practices with respect to privacy and security 
        safeguards in such use.
    (c) Report.--The agreement under subsection (a) shall direct the 
National Academies to complete the study under this section, and 
transmit to Congress a report on the results of the study, not later 
than 2 years after the date of enactment of this Act.

                     TITLE IX--IMPACT TO SAVE MOMS

SEC. 901. PERINATAL CARE ALTERNATIVE PAYMENT MODEL DEMONSTRATION 
              PROJECT.

    (a) In General.--For the period of fiscal years 2022 through 2026, 
the Secretary of Health and Human Services (referred to in this section 
as the ``Secretary''), acting through the Administrator of the Centers 
for Medicare & Medicaid Services, shall establish and implement, in 
accordance with the requirements of this section, a demonstration 
project, to be known as the Perinatal Care Alternative Payment Model 
Demonstration Project (referred to in this section as the 
``Demonstration Project''), for purposes of allowing States to test 
payment models under their State plans under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.) and State child health plans 
under title XXI of such Act (42 U.S.C. 1397aa et seq.) with respect to 
maternity care provided to pregnant and postpartum individuals enrolled 
in such State plans and State child health plans.
    (b) Coordination.--In establishing the Demonstration Project, the 
Secretary shall coordinate with stakeholders such as--
            (1) State Medicaid programs;
            (2) maternity care providers and organizations representing 
        maternity care providers;
            (3) relevant organizations representing patients, with a 
        particular focus on patients from racial and ethnic minority 
        groups;
            (4) relevant community-based organizations, particularly 
        organizations that seek to improve maternal health outcomes for 
        pregnant and postpartum individuals from racial and ethnic 
        minority groups;
            (5) perinatal health workers;
            (6) relevant health insurance issuers;
            (7) hospitals, health systems, midwifery practices, 
        freestanding birth centers (as such term is defined in 
        paragraph (3)(B) of section 1905(l) of the Social Security Act 
        (42 U.S.C. 1396d(l))), Federally-qualified health centers (as 
        such term is defined in paragraph (2)(B) of such section), and 
        rural health clinics (as such term is defined in section 
        1861(aa) of such Act (42 U.S.C. 1395x(aa)));
            (8) researchers and policy experts in fields related to 
        maternity care payment models; and
            (9) any other stakeholders as the Secretary determines 
        appropriate, with a particular focus on stakeholders from 
        racial and ethnic minority groups.
    (c) Considerations.--In establishing the Demonstration Project, the 
Secretary shall consider any alternative payment model that--
            (1) is designed to improve maternal health outcomes for 
        racial and ethnic groups with disproportionate rates of adverse 
        maternal health outcomes;
            (2) includes methods for stratifying patients by pregnancy 
        risk level and, as appropriate, adjusting payments under such 
        model to take into account pregnancy risk level;
            (3) establishes evidence-based quality metrics for such 
        payments;
            (4) includes consideration of non-hospital birth settings 
        such as freestanding birth centers (as so defined);
            (5) includes consideration of social determinants of 
        maternal health; or
            (6) includes diverse maternity care teams that include--
                    (A) maternity care providers, mental and behavioral 
                health care providers acting in accordance with State 
                law, registered dietitians or nutrition professionals 
                (as such term is defined in section 1861(vv)(2) of the 
                Social Security Act (42 U.S.C. 1395x(vv)(2))), and 
                International Board Certified Lactation Consultants--
                            (i) from racially, ethnically, and 
                        professionally diverse backgrounds;
                            (ii) with experience practicing in racially 
                        and ethnically diverse communities; or
                            (iii) who have undergone training on 
                        implicit bias and racism; and
                    (B) perinatal health workers.
    (d) Eligibility.--To be eligible to participate in the 
Demonstration Project, a State shall submit an application to the 
Secretary at such time, in such manner, and containing such information 
as the Secretary may require.
    (e) Evaluation.--The Secretary shall conduct an evaluation of the 
Demonstration Project to determine the impact of the Demonstration 
Project on--
            (1) maternal health outcomes, with data stratified by race, 
        ethnicity, socioeconomic indicators, and any other factors as 
        the Secretary determines appropriate;
            (2) spending on maternity care by States participating in 
        the Demonstration Project;
            (3) to the extent practicable, qualitative and quantitative 
        measures of patient experience; and
            (4) any other areas of assessment that the Secretary 
        determines relevant.
    (f) Report.--Not later than 1 year after the completion or 
termination date of the Demonstration Project, the Secretary shall 
submit to the Congress, and make publicly available, a report 
containing--
            (1) the results of any evaluation conducted under 
        subsection (e); and
            (2) a recommendation regarding whether the Demonstration 
        Project should be continued after fiscal year 2026 and expanded 
        on a national basis.
    (g) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as are necessary to carry out this section.
    (h) Definitions.--In this section:
            (1) Alternative payment model.--The term ``alternative 
        payment model'' has the meaning given such term in section 
        1833(z)(3)(C) of the Social Security Act (42 U.S.C. 
        1395l(z)(3)(C)).
            (2) Perinatal.--The term ``perinatal'' means the period 
        beginning on the day an individual becomes pregnant and ending 
        on the last day of the 1-year period beginning on the last day 
        of such individual's pregnancy.
            (3) Racial and ethnic minority group.--The term ``racial 
        and ethnic minority group'' has the meaning given such term in 
        section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 
        300u-6(g)(1)).

SEC. 902. MACPAC REPORT.

    Not later than 2 years after the date of the enactment of this Act, 
the Medicaid and CHIP Payment and Access Commission shall publish a 
report on issues relating to the continuity of coverage under State 
plans under title XIX of the Social Security Act (42 U.S.C. 1396 et 
seq.) and State child health plans under title XXI of such Act (42 
U.S.C. 1397aa et seq.) for pregnant and postpartum individuals. Such 
report shall, at a minimum, include the following:
            (1) An assessment of any existing policies under such State 
        plans and such State child health plans regarding presumptive 
        eligibility for pregnant individuals while their application 
        for enrollment in such a State plan or such a State child 
        health plan is being processed.
            (2) An assessment of any existing policies under such State 
        plans and such State child health plans regarding measures to 
        ensure continuity of coverage under such a State plan or such a 
        State child health plan for pregnant and postpartum 
        individuals, including such individuals who need to change 
        their health insurance coverage during their pregnancy or the 
        postpartum period following their pregnancy.
            (3) An assessment of any existing policies under such State 
        plans and such State child health plans regarding measures to 
        automatically reenroll individuals who are eligible to enroll 
        under such a State plan or such a State child health plan as a 
        parent.
            (4) If determined appropriate by the Commission, any 
        recommendations for the Department of Health and Human 
        Services, or such State plans and such State child health 
        plans, to ensure continuity of coverage under such a State plan 
        or such a State child health plan for pregnant and postpartum 
        individuals.

               TITLE X--MATERNAL HEALTH PANDEMIC RESPONSE

SEC. 1001. DEFINITIONS.

    In this title:
            (1) COVID-19 public health emergency.--The term ``COVID-19 
        public health emergency'' means the period--
                    (A) beginning on the date that the Secretary of 
                Health and Human Services declared a public health 
                emergency under section 319 of the Public Health 
                Service Act (42 U.S.C. 247d), with respect to COVID-19; 
                and
                    (B) ending on the later of the end of such public 
                health emergency, or January 1, 2023.
            (2) Respectful maternity care.--The term ``respectful 
        maternity care'' refers to care organized for, and provided to, 
        pregnant and postpartum individuals in a manner that--
                    (A) is culturally congruent;
                    (B) maintains their dignity, privacy, and 
                confidentiality;
                    (C) ensures freedom from harm and mistreatment; and
                    (D) enables informed choice and continuous support.
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 1002. FUNDING FOR DATA COLLECTION, SURVEILLANCE, AND RESEARCH ON 
              MATERNAL HEALTH OUTCOMES DURING THE COVID-19 PUBLIC 
              HEALTH EMERGENCY.

    To conduct or support data collection, surveillance, and research 
on maternal health as a result of the COVID-19 public health emergency, 
including support to assist in the capacity building for State, Tribal, 
territorial, and local public health departments to collect and 
transmit racial, ethnic, and other demographic data related to maternal 
health, there are authorized to be appropriated--
            (1) $100,000,000 for the Surveillance for Emerging Threats 
        to Mothers and Babies program of the Centers for Disease 
        Control and Prevention, to support the Centers for Disease 
        Control and Prevention in its efforts to--
                    (A) work with public health, clinical, and 
                community-based organizations to provide timely, 
                continually updated guidance to families and health 
                care providers on ways to reduce risk to pregnant and 
                postpartum individuals and their newborns and tailor 
                interventions to improve their long-term health;
                    (B) partner with more State, Tribal, territorial, 
                and local public health programs in the collection and 
                analysis of clinical data on the impact of COVID-19 on 
                pregnant and postpartum patients and their newborns, 
                particularly among patients from racial and ethnic 
                minority groups; and
                    (C) establish regionally based centers of 
                excellence to offer medical, public health, and other 
                knowledge to ensure communities, especially communities 
                with large populations of individuals from racial and 
                ethnic minority groups, can help pregnant and 
                postpartum individuals and newborns get the care and 
                support they need;
            (2) $30,000,000 for the Enhancing Reviews and Surveillance 
        to Eliminate Maternal Mortality program (commonly known as the 
        ``ERASE MM program'') of the Centers for Disease Control and 
        Prevention, to support the Centers for Disease Control and 
        Prevention in expanding its partnerships with States and Indian 
        Tribes and provide technical assistance to existing Maternal 
        Mortality Review Committees;
            (3) $45,000,000 for the Pregnancy Risk Assessment 
        Monitoring System (commonly known as the ``PRAMS'') of the 
        Centers for Disease Control and Prevention, to support the 
        Centers for Disease Control and Prevention in its efforts to--
                    (A) create a COVID-19 supplement to its PRAMS 
                questionnaire;
                    (B) add questions around experiences of respectful 
                maternity care in prenatal, intrapartum, and postpartum 
                care;
                    (C) conduct a rapid assessment of COVID-19 
                awareness, impact on care and experiences, and use of 
                preventive measures among pregnant, laboring and 
                birthing, and postpartum individuals during the COVID-
                19 public health emergency; and
                    (D) work to transition the survey to an electronic 
                platform and expand the survey to a larger population, 
                with a special focus on reaching underrepresented 
                communities; and
            (4) $15,000,000 for the National Institute of Child Health 
        and Human Development, to conduct or support research for 
        interventions to mitigate the effects of the COVID-19 public 
        health emergency on pregnant and postpartum individuals, with a 
        particular focus on individuals from racial and ethnic minority 
        groups.

SEC. 1003. COVID-19 MATERNAL HEALTH DATA COLLECTION AND DISCLOSURE.

    (a) Availability of Collected Data.--The Secretary, acting through 
the Director of the Centers for Disease Control and Prevention and the 
Administrator of the Centers for Medicare & Medicaid Services, shall 
make publicly available on the website of the Centers for Disease 
Control and Prevention data described in subsection (b).
    (b) Data Described.--The data under subsection (a) means data 
collected through Federal surveillance systems under the Centers for 
Disease Control and Prevention with respect to COVID-19 and individuals 
who are pregnant or in a postpartum period. Such data shall include the 
following:
            (1) Diagnostic testing, including the number of pregnant 
        and postpartum individuals who are tested for COVID-19 and the 
        number of positive cases.
            (2) Suspected cases of COVID-19 in pregnant and birthing 
        individuals and individuals in a postpartum period.
            (3) Serologic testing, including the number of pregnant and 
        postpartum individuals tested and the number of such serologic 
        tests that were positive.
            (4) Health care treatment for individuals who were infected 
        with the virus, including hospitalizations, emergency room 
        visits, and intensive care unit admissions.
            (5) Health outcomes for pregnant individuals and infants 
        confirmed or suspected of being infected with the virus, 
        including--
                    (A) the number of fatalities and case fatalities 
                (expressed as the proportion of individuals who were 
                infected with the virus to individuals who died from 
                the virus); and
                    (B) the number of stillbirths, infant mortality, 
                pre-term births, infants born with a low-birth weight, 
                and cesarean section births.
    (c) Indian Health Service.--In carrying out subsection (a), the 
Secretary shall consult with Indian Tribes and confer with urban Indian 
organizations.
    (d) Disaggregated Information.--In carrying out subsection (a), the 
Secretary shall disaggregate data by race, ethnicity, and location.
    (e) Update.--During the COVID-19 public health emergency, the 
Secretary shall update the data made available under this section--
            (1) at least on a monthly basis; and
            (2) not less than one month after the end of such public 
        health emergency.
    (f) Privacy.--In carrying out subsection (a), the Secretary shall 
take steps to protect the privacy of individuals pursuant to 
regulations promulgated under section 264(c) of the Health Insurance 
Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2 note).
    (g) Guidance.--
            (1) In general.--Not later than 30 days after the date of 
        enactment of this Act, the Secretary shall issue guidance to 
        States and local public health departments to ensure that--
                    (A) laboratories that test specimens for COVID-19 
                receive all relevant demographic data on race, 
                ethnicity, pregnancy status, and other demographic data 
                as determined by the Secretary; and
                    (B) data described in subsection (b) is 
                disaggregated by race, ethnicity, and location.
            (2) Consultation.--In carrying out paragraph (1), the 
        Secretary shall consult with Indian Tribes--
                    (A) to ensure that such guidance includes Tribally 
                developed best practices; and
                    (B) to reduce misclassification of American Indians 
                and Alaska Natives.

SEC. 1004. INCLUSION OF PREGNANT INDIVIDUALS AND LACTATING INDIVIDUALS 
              IN VACCINE AND THERAPEUTIC DEVELOPMENT FOR COVID-19.

    The Director of the National Institutes of Health shall, when safe 
and appropriate, support and advance the inclusion of pregnant and 
lactating individuals in therapeutic and vaccine clinical trials with 
respect to the treatment or prevention of COVID-19, including 
prioritizing recommendations made by the Task Force on Research 
Specific to Pregnant Women and Lactating Women established under 
section 2041 of the 21st Century Cures Act (42 U.S.C. 289a-2 note) with 
respect to including such individuals in such clinical trials.

SEC. 1005. PUBLIC HEALTH COMMUNICATION REGARDING MATERNAL CARE DURING 
              COVID-19.

    The Director of the Centers for Disease Control and Prevention 
shall conduct a public health education campaign to increase access by 
pregnant individuals, their employers, and their health care providers 
to accurate, evidence-based information on COVID-19 and pregnancy 
risks, with a particular focus pregnant individuals in underserved 
communities.

SEC. 1006. TASK FORCE ON BIRTHING EXPERIENCE AND SAFE MATERNITY CARE 
              DURING A PUBLIC HEALTH EMERGENCY.

    (a) Establishment.--The Secretary, in consultation with the 
Director of the Centers for Disease Control and Prevention and the 
Administrator of the Health Resources and Services Administration, 
shall convene a task force (in this subsection referred to as the 
``Task Force'') to develop recommendations, and make such 
recommendations publicly available in multiple languages, on respectful 
maternity care during the COVID-19 public health emergency and other 
public health emergencies, with a particular focus on outcomes for 
individuals from racial and ethnic minority groups and other 
underserved communities.
    (b) Content.--In developing recommendations under paragraph (1), 
the Task Force shall address the following:
            (1) Measures to facilitate respectful maternity care.
            (2) Strategies to increase access to specialized care for 
        individuals with high-risk pregnancies.
            (3) COVID-19 diagnostic testing for pregnant individuals 
        and individuals in labor.
            (4) The designation of a companion during birthing.
            (5) The ability to communicate using an electronic mobile 
        device during birthing.
            (6) With respect to an individual who has the virus that 
        causes COVID-19--
                    (A) separation from a newborn after birth; and
                    (B) ensuring safety while breastfeeding.
            (7) Licensing, training, and reimbursement for midwives 
        from racial and ethnic minority groups and underserved 
        communities.
            (8) Financial support for perinatal health workers who 
        provide nonclinical support to pregnant individuals and 
        postpartum individuals from underserved communities.
            (9) The identification and treatment of prenatal and 
        postpartum mental and behavioral health conditions that may 
        have developed during, or worsened because of, the COVID-19 
        public health emergency or future public health emergencies, 
        including anxiety, substance use disorder, and depression.
            (10) Strategies to address hospital capacity issues in 
        communities with an increase in COVID-19 cases, or cases of 
        other infectious diseases.
            (11) Options for maternal care that reduce cross-
        contamination and maintain safety and quality of care, 
        including auxiliary maternity units and freestanding birth 
        centers.
            (12) Methods to identify and address racism, bias, and 
        discrimination in treatment, and to provide support to pregnant 
        and postpartum individuals, including--
                    (A) evaluating the training of hospital staff on 
                implicit bias and racism and respectful maternity care; 
                and
                    (B) the collection of demographic data.
            (13) Other matters the Task Force determines appropriate.
    (c) Membership.--
            (1) Chair.--The Secretary shall select the chair of the 
        Task Force from among the members of the Task Force.
            (2) Composition.--The Task Force shall be composed of--
                    (A) representatives of Federal agencies, including 
                the agencies listed in paragraph (3);
                    (B) 3 or more representatives of State, local, or 
                territorial public health departments from different 
                areas in the United States that have a large 
                historically marginalized population;
                    (C) one or more representatives of Tribal public 
                health departments;
                    (D) one or more obstetrician-gynecologists or other 
                physicians who provide obstetric care, with 
                consideration for physicians who are from, or work in, 
                communities experiencing a high rate of mortality and 
                morbidity from COVID-19;
                    (E) one or more nurses who provide obstetric care, 
                with consideration for physicians who are from, or work 
                in, communities experiencing a high rate of mortality 
                and morbidity from COVID-19;
                    (F) one or more perinatal health workers;
                    (G) one or more individuals who were pregnant or 
                gave birth during the COVID-19 public health emergency;
                    (H) one or more individuals who had the virus that 
                causes COVID-19 and later gave birth;
                    (I) one or more individuals who have received 
                support from a perinatal health; and
                    (J) 3 or more independent experts who are racially 
                and ethnically diverse with knowledge on racial and 
                ethnic disparities in--
                            (i) public health;
                            (ii) maternal health; or
                            (iii) maternal mortality and severe 
                        maternal morbidity.
            (3) Federal agencies.--The agencies represented under 
        paragraph (2)(A) shall include the following:
                    (A) The Department of Health and Human Services.
                    (B) The Centers for Disease Control and Prevention.
                    (C) The Centers for Medicare & Medicaid Services.
                    (D) The Health Resources and Services 
                Administration.
                    (E) The Indian Health Service.
                    (F) The National Institutes of Health.

SEC. 1007. GAO REPORT ON MATERNAL HEALTH AND PUBLIC HEALTH EMERGENCY 
              PREPAREDNESS.

    (a) In General.--Not later than one year after the date of 
enactment of this Act, the Comptroller General of the United States 
shall submit to Congress a report on maternal health and public health 
emergency preparedness. Such report shall include the information and 
recommendations described in subsection (b).
    (b) Content of Report.--The report under subsection (b) shall 
include the following:
            (1) A review of prenatal, labor and delivery, and 
        postpartum experiences of individuals during such public health 
        emergency, including--
                    (A) barriers to accessing pregnancy, birth, and 
                postpartum care during a pandemic;
                    (B) public and private insurance coverage with 
                respect to maternal health care, including telehealth 
                services;
                    (C) to the extent practicable, maternal and infant 
                health outcomes by race and ethnicity (including 
                quality of care, mortality, morbidity, cesarean section 
                rates, preterm birth, prevalence of prenatal and 
                postpartum mental health conditions and substance use 
                disorders);
                    (D) with respect to such health outcomes, the 
                impact of Federal and State policy changes during such 
                public health emergency;
                    (E) contributing factors to population-based 
                disparities in health outcomes, including bias and 
                discrimination toward individuals from racial and 
                ethnic minority groups; and
                    (F) the effect of increased unemployment, paid 
                family leave, changes in health care coverage, and 
                other social determinants of health for pregnant and 
                postpartum individuals during the public health 
                emergency.
            (2) Recommendations on improving the public health 
        emergency response and preparedness efforts of the Federal 
        Government with respect to maternal health, with a focus on 
        outcomes for pregnant and postpartum individuals from racial 
        and ethnic minority groups, including--
                    (A) improving research, surveillance, and data 
                collection with respect to maternal health;
                    (B) factoring maternal health outcomes and 
                disparities into decisions regarding distribution of 
                resources;
                    (C) improving the distribution of public health 
                funds, data, and information to Indian Tribes and 
                Tribal organizations with regard to maternal health 
                during a public health emergency; and
                    (D) improving communications during a public health 
                emergency with--
                            (i) maternity care providers;
                            (ii) maternal mental and behavioral health 
                        care providers;
                            (iii) researchers who specialize in 
                        maternal health, maternal mortality, or severe 
                        maternal morbidity;
                            (iv) individuals who experienced pregnancy 
                        or childbirth during the COVID-19 public health 
                        emergency;
                            (v) representatives from community-based 
                        organizations that address maternal health; and
                            (vi) perinatal health workers.

      TITLE XI--PROTECTING MOMS AND BABIES AGAINST CLIMATE CHANGE

SEC. 1101. DEFINITIONS.

    In this title, the following definitions apply:
            (1) Adverse maternal and infant health outcomes.--The term 
        ``adverse maternal and infant health outcomes'' includes the 
        outcomes of preterm birth, low birth weight, stillbirth, infant 
        or maternal mortality, and severe maternal morbidity.
            (2) Institution of higher education.--The term 
        ``institution of higher education'' has the meaning given such 
        term in section 101 of the Higher Education Act of 1965 (20 
        U.S.C. 1001).
            (3) Minority-serving institution.--The term ``minority-
        serving institution'' means an entity specified in any of 
        paragraphs (1) through (7) of section 371(a) of the Higher 
        Education Act of 1965 (20 U.S.C. 1067q(a)).
            (4) Risks associated with climate change.--The term ``risks 
        associated with climate change'' includes risks associated with 
        extreme heat, air pollution, extreme weather events, and other 
        environmental issues associated with climate change that can 
        result in adverse maternal and infant health outcomes.
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (6) Stakeholder organization.--The term ``stakeholder 
        organization'' means--
                    (A) a community-based organization with expertise 
                in providing assistance to vulnerable individuals;
                    (B) a nonprofit organization with expertise in 
                maternal or infant health or environmental justice; and
                    (C) a patient advocacy organization representing 
                vulnerable individuals.
            (7) Vulnerable individual.--The term ``vulnerable 
        individual'' means--
                    (A) an individual who is pregnant;
                    (B) an individual who was pregnant during any 
                portion of the preceding 1-year period; and
                    (C) an individual under 3 years of age.

SEC. 1102. GRANT PROGRAM TO PROTECT VULNERABLE MOTHERS AND BABIES FROM 
              CLIMATE CHANGE RISKS.

    (a) In General.--Not later than 180 days after the date of 
enactment of this Act, the Secretary shall establish a grant program 
(in this section referred to as the ``Program'') to protect vulnerable 
individuals from risks associated with climate change.
    (b) Grant Authority.--In carrying out the Program, the Secretary 
may award, on a competitive basis, grants to 10 covered entities.
    (c) Applications.--To be eligible for a grant under the Program, a 
covered entity shall submit to the Secretary an application at such 
time, in such form, and containing such information as the Secretary 
may require, which shall include, at a minimum, a description of the 
following:
            (1) Plans for the use of grant funds awarded under the 
        Program and how patients and stakeholder organizations were 
        involved in the development of such plans.
            (2) How such grant funds will be targeted to geographic 
        areas that have disproportionately high levels of risks 
        associated with climate change for vulnerable individuals.
            (3) How such grant funds will be used to address racial and 
        ethnic disparities in--
                    (A) adverse maternal and infant health outcomes; 
                and
                    (B) exposure to risks associated with climate 
                change for vulnerable individuals.
            (4) Strategies to prevent an initiative assisted with such 
        grant funds from causing--
                    (A) adverse environmental impacts;
                    (B) displacement of residents and businesses;
                    (C) rent and housing price increases; or
                    (D) disproportionate adverse impacts on racial and 
                ethnic minority groups and other underserved 
                populations.
    (d) Selection of Grant Recipients.--
            (1) Timing.--Not later than 270 days after the date of 
        enactment of this Act, the Secretary shall select the 
        recipients of grants under the Program.
            (2) Consultation.--In selecting covered entities for grants 
        under the Program, the Secretary shall consult with--
                    (A) representatives of stakeholder organizations;
                    (B) the Administrator of the Environmental 
                Protection Agency;
                    (C) the Administrator of the National Oceanic and 
                Atmospheric Administration; and
                    (D) from the Department of Health and Human 
                Services--
                            (i) the Deputy Assistant Secretary for 
                        Minority Health;
                            (ii) the Administrator of the Centers for 
                        Medicare & Medicaid Services;
                            (iii) the Administrator of the Health 
                        Resources and Services Administration;
                            (iv) the Director of the National 
                        Institutes of Health; and
                            (v) the Director of the Centers for Disease 
                        Control and Prevention.
            (3) Priority.--In selecting a covered entity to be awarded 
        a grant under the Program, the Secretary shall give priority to 
        covered entities that serve a county--
                    (A) designated, or located in an area designated, 
                as a nonattainment area pursuant to section 107 of the 
                Clean Air Act (42 U.S.C. 7407) for any air pollutant 
                for which air quality criteria have been issued under 
                section 108(a) of such Act (42 U.S.C. 7408(a));
                    (B) with a level of vulnerability of moderate-to-
                high or higher, according to the Social Vulnerability 
                Index of the Centers for Disease Control and 
                Prevention; or
                    (C) with temperatures that pose a risk to human 
                health, as determined by the Secretary, in consultation 
                with the Administrator of the National Oceanic and 
                Atmospheric Administration and the Chair of the United 
                States Global Change Research Program, based on the 
                best available science.
            (4) Limitation.--A covered entity awarded grant funds under 
        the Program may not use such grant funds to serve a county that 
        is served by any other recipient of a grant under the Program.
    (e) Use of Funds.--A covered entity awarded grant funds under the 
Program may only use such grant funds for the following:
            (1) Initiatives to identify risks associated with climate 
        change for vulnerable individuals and to provide services and 
        support to such individuals that address such risks, 
        including--
                    (A) training for health care providers, doulas, and 
                other employees in hospitals, birth centers, midwifery 
                practices, and other health care practices that provide 
                prenatal or labor and delivery services to vulnerable 
                individuals on the identification of, and patient 
                counseling relating to, risks associated with climate 
                change for vulnerable individuals;
                    (B) hiring, training, or providing resources to 
                community health workers and perinatal health workers 
                who can help identify risks associated with climate 
                change for vulnerable individuals, provide patient 
                counseling about such risks, and carry out the 
                distribution of relevant services and support;
                    (C) enhancing the monitoring of risks associated 
                with climate change for vulnerable individuals, 
                including by--
                            (i) collecting data on such risks in 
                        specific census tracts, neighborhoods, or other 
                        geographic areas; and
                            (ii) sharing such data with local health 
                        care providers, doulas, and other employees in 
                        hospitals, birth centers, midwifery practices, 
                        and other health care practices that provide 
                        prenatal or labor and delivery services to 
                        local vulnerable individuals; and
                    (D) providing vulnerable individuals--
                            (i) air conditioning units, residential 
                        weatherization support, filtration systems, 
                        household appliances, or related items;
                            (ii) direct financial assistance; and
                            (iii) services and support, including 
                        housing and transportation assistance, to 
                        prepare for or recover from extreme weather 
                        events, which may include floods, hurricanes, 
                        wildfires, droughts, and related events.
            (2) Initiatives to mitigate levels of and exposure to risks 
        associated with climate change for vulnerable individuals, 
        which shall be based on the best available science and which 
        may include initiatives to--
                    (A) develop, maintain, or expand urban or community 
                forestry initiatives and tree canopy coverage 
                initiatives;
                    (B) improve infrastructure, including buildings and 
                paved surfaces;
                    (C) develop or improve community outreach networks 
                to provide culturally and linguistically appropriate 
                information and notifications about risks associated 
                with climate change for vulnerable individuals; and
                    (D) provide enhanced services to racial and ethnic 
                minority groups and other underserved populations.
    (f) Length of Award.--A grant under this section shall be disbursed 
over 4 fiscal years.
    (g) Technical Assistance.--The Secretary shall provide technical 
assistance to a covered entity awarded a grant under the Program to 
support the development, implementation, and evaluation of activities 
funded with such grant.
    (h) Reports to Secretary.--
            (1) Annual report.--For each fiscal year during which a 
        covered entity is disbursed grant funds under the Program, such 
        covered entity shall submit to the Secretary a report that 
        summarizes the activities carried out by such covered entity 
        with such grant funds during such fiscal year, including a 
        description of the following:
                    (A) The involvement of stakeholder organizations in 
                the implementation of initiatives assisted with such 
                grant funds.
                    (B) Relevant health and environmental data, 
                disaggregated, to the extent practicable, by race, 
                ethnicity, gender, and pregnancy status.
                    (C) Qualitative feedback received from vulnerable 
                individuals with respect to initiatives assisted with 
                such grant funds.
                    (D) Criteria used in selecting the geographic areas 
                assisted with such grant funds.
                    (E) Efforts to address racial and ethnic 
                disparities in adverse maternal and infant health 
                outcomes and in exposure to risks associated with 
                climate change for vulnerable individuals.
                    (F) Any negative and unintended impacts of 
                initiatives assisted with such grant funds, including--
                            (i) adverse environmental impacts;
                            (ii) displacement of residents and 
                        businesses;
                            (iii) rent and housing price increases; and
                            (iv) disproportionate adverse impacts on 
                        racial and ethnic minority groups and other 
                        underserved populations.
                    (G) How the covered entity will address and prevent 
                any impacts described in subparagraph (F).
            (2) Publication.--Not later than 30 days after the date on 
        which a report is submitted under paragraph (1), the Secretary 
        shall publish such report on a public website of the Department 
        of Health and Human Services.
    (i) Report to Congress.--Not later than the date that is 5 years 
after the date on which the Program is established, the Secretary shall 
submit to Congress and publish on a public website of the Department of 
Health and Human Services a report on the results of the Program, 
including the following:
            (1) Summaries of the annual reports submitted under 
        subsection (h).
            (2) Evaluations of the initiatives assisted with grant 
        funds under the Program.
            (3) An assessment of the effectiveness of the Program in--
                    (A) identifying risks associated with climate 
                change for vulnerable individuals;
                    (B) providing services and support to such 
                individuals;
                    (C) mitigating levels of and exposure to such 
                risks; and
                    (D) addressing racial and ethnic disparities in 
                adverse maternal and infant health outcomes and in 
                exposure to such risks.
            (4) A description of how the Program could be expanded, 
        including--
                    (A) monitoring efforts or data collection that 
                would be required to identify areas with high levels of 
                risks associated with climate change for vulnerable 
                individuals;
                    (B) how such areas could be identified using the 
                strategy developed under section 5; and
                    (C) recommendations for additional funding.
    (j) Definition of Covered Entity.--In this section, the term 
``covered entity'' means a consortium of organizations serving a county 
that--
            (1) shall include a community-based organization; and
            (2) may include--
                    (A) another stakeholder organization;
                    (B) the government of such county;
                    (C) the governments of one or more municipalities 
                within such county;
                    (D) a State or local public health department or 
                emergency management agency;
                    (E) a local health care practice, which may include 
                a licensed and accredited hospital, birth center, 
                midwifery practice, or other health care practice that 
                provides prenatal or labor and delivery services to 
                vulnerable individuals;
                    (F) an Indian Tribe or Tribal organization (as such 
                terms are defined in section 4 of the Indian Self-
                Determination and Education Assistance Act (25 U.S.C. 
                5304));
                    (G) an Urban Indian organization (as defined in 
                section 4 of the Indian Health Care Improvement Act (25 
                U.S.C. 1603)); and
                    (H) an institution of higher education.
    (k) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $100,000,000 for the period of 
fiscal years 2022 through 2025.

SEC. 1103. GRANT PROGRAM FOR EDUCATION AND TRAINING AT HEALTH 
              PROFESSION SCHOOLS.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary shall establish a grant program (in this 
section referred to as the ``Program'') to provide funds to health 
profession schools to support the development and integration of 
education and training programs for identifying and addressing risks 
associated with climate change for vulnerable individuals.
    (b) Grant Authority.--In carrying out the Program, the Secretary 
may award, on a competitive basis, grants to health profession schools.
    (c) Application.--To be eligible for a grant under the Program, a 
health profession school shall submit to the Secretary an application 
at such time, in such form, and containing such information as the 
Secretary may require, including a description of the following:
            (1) How such health profession school will engage with 
        vulnerable individuals, and stakeholder organizations 
        representing such individuals, in developing and implementing 
        the education and training programs supported by grant funds 
        awarded under the Program.
            (2) How such health profession school will ensure that such 
        education and training programs will address racial and ethnic 
        disparities in exposure to, and the effects of, risks 
        associated with climate change for vulnerable individuals.
    (d) Use of Funds.--A health profession school awarded a grant under 
the Program shall use the grant funds to develop, and integrate into 
the curriculum and continuing education of such health profession 
school, education and training on each of the following:
            (1) Identifying risks associated with climate change for 
        vulnerable individuals and individuals with the intent to 
        become pregnant.
            (2) How risks associated with climate change affect 
        vulnerable individuals and individuals with the intent to 
        become pregnant.
            (3) Racial and ethnic disparities in exposure to, and the 
        effects of, risks associated with climate change for vulnerable 
        individuals and individuals with the intent to become pregnant.
            (4) Patient counseling and mitigation strategies relating 
        to risks associated with climate change for vulnerable 
        individuals.
            (5) Relevant services and support for vulnerable 
        individuals relating to risks associated with climate change 
        and strategies for ensuring vulnerable individuals have access 
        to such services and support.
            (6) Implicit and explicit bias, racism, and discrimination.
            (7) Related topics identified by such health profession 
        school based on the engagement of such health profession school 
        with vulnerable individuals and stakeholder organizations 
        representing such individuals.
    (e) Partnerships.--In carrying out activities with grant funds, a 
health profession school awarded a grant under the Program may partner 
with--
            (1) a State or local public health department;
            (2) a health care professional membership organization;
            (3) a stakeholder organization;
            (4) a health profession school; or
            (5) an institution of higher education.
    (f) Reports to Secretary.--
            (1) Annual report.--For each fiscal year during which a 
        health profession school is disbursed grant funds under the 
        Program, such health profession school shall submit to the 
        Secretary a report that describes the activities carried out 
        with such grant funds during such fiscal year.
            (2) Final report.--Not later than the date that is 1 year 
        after the end of the last fiscal year during which a health 
        profession school is disbursed grant funds under the Program, 
        the health profession school shall submit to the Secretary a 
        final report that summarizes the activities carried out with 
        such grant funds.
    (g) Report to Congress.--Not later than the date that is 6 years 
after the date on which the Program is established, the Secretary shall 
submit to Congress and publish on a public website of the Department of 
Health and Human Services a report that includes--
            (1) a summary of the reports submitted under subsection 
        (f); and
            (2) recommendations to improve education and training 
        programs at health profession schools with respect to 
        identifying and addressing risks associated with climate change 
        for vulnerable individuals.
    (h) Definition of Health Profession School.--In this section, the 
term ``health profession school'' means an accredited--
            (1) medical school;
            (2) school of nursing;
            (3) midwifery program;
            (4) physician assistant education program;
            (5) teaching hospital;
            (6) residency or fellowship program; or
            (7) other school or program determined appropriate by the 
        Secretary.
    (i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for the period of 
fiscal years 2022 through 2025.

SEC. 1104. NIH CONSORTIUM ON BIRTH AND CLIMATE CHANGE RESEARCH.

    (a) Establishment.--Not later than one year after the date of 
enactment of this Act, the Director of the National Institutes of 
Health shall establish the Consortium on Birth and Climate Change 
Research (in this section referred to as the ``Consortium'').
    (b) Duties.--
            (1) In general.--The Consortium shall coordinate, across 
        the institutes, centers, and offices of the National Institutes 
        of Health, research on the risks associated with climate change 
        for vulnerable individuals.
            (2) Required activities.--In carrying out paragraph (1), 
        the Consortium shall--
                    (A) establish research priorities, including by 
                prioritizing research that--
                            (i) identifies the risks associated with 
                        climate change for vulnerable individuals with 
                        a particular focus on disparities in such risks 
                        among racial and ethnic minority groups and 
                        other underserved populations; and
                            (ii) identifies strategies to reduce levels 
                        of, and exposure to, such risks, with a 
                        particular focus on risks among racial and 
                        ethnic minority groups and other underserved 
                        populations;
                    (B) identify gaps in available data related to such 
                risks;
                    (C) identify gaps in, and opportunities for, 
                research collaborations;
                    (D) identify funding opportunities for community-
                based organizations and researchers from racially, 
                ethnically, and geographically diverse backgrounds; and
                    (E) publish annual reports on the work and findings 
                of the Consortium on a public website of the National 
                Institutes of Health.
    (c) Membership.--The Director of the National Institutes of Health 
shall appoint to the Consortium representatives of such institutes, 
centers, and offices of the National Institutes of Health as the 
Director considers appropriate, including representatives of--
            (1) the National Institute of Environmental Health 
        Sciences;
            (2) the National Institute on Minority Health and Health 
        Disparities;
            (3) the Eunice Kennedy Shriver National Institute of Child 
        Health and Human Development;
            (4) the National Institute of Nursing Research; and
            (5) the Office of Research on Women's Health.
    (d) Chairperson.--The Chairperson of the Consortium shall be 
designated by the Director and selected from among the representatives 
appointed under subsection (c).
    (e) Consultation.--In carrying out the duties described in 
subsection (b), the Consortium shall consult with--
            (1) the heads of relevant Federal agencies, including--
                    (A) the Environmental Protection Agency;
                    (B) the National Oceanic and Atmospheric 
                Administration;
                    (C) the Occupational Safety and Health 
                Administration; and
                    (D) from the Department of Health and Human 
                Services--
                            (i) the Office of Minority Health in the 
                        Office of the Secretary;
                            (ii) the Centers for Medicare & Medicaid 
                        Services;
                            (iii) the Health Resources and Services 
                        Administration;
                            (iv) the Centers for Disease Control and 
                        Prevention;
                            (v) the Indian Health Service; and
                            (vi) the Administration for Children and 
                        Families; and
            (2) representatives of--
                    (A) stakeholder organizations;
                    (B) health care providers and professional 
                membership organizations with expertise in maternal 
                health or environmental justice;
                    (C) State and local public health departments;
                    (D) licensed and accredited hospitals, birth 
                centers, midwifery practices, or other health care 
                practices that provide prenatal or labor and delivery 
                services to vulnerable individuals; and
                    (E) institutions of higher education, including 
                such institutions that are minority-serving 
                institutions or have expertise in maternal health or 
                environmental justice.

SEC. 1105. STRATEGY FOR IDENTIFYING CLIMATE CHANGE RISK ZONES FOR 
              VULNERABLE MOTHERS AND BABIES.

    (a) In General.--The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall develop a strategy 
(in this section referred to as the ``Strategy'') for designating areas 
that the Secretary determines to have a high risk of adverse maternal 
and infant health outcomes among vulnerable individuals as a result of 
risks associated with climate change.
    (b) Strategy Requirements.--
            (1) In general.--In developing the Strategy, the Secretary 
        shall establish a process to identify areas where vulnerable 
        individuals are exposed to a high risk of adverse maternal and 
        infant health outcomes as a result of risks associated with 
        climate change in conjunction with other factors that can 
        impact such health outcomes, including--
                    (A) the incidence of diseases associated with air 
                pollution, extreme heat, and other environmental 
                factors;
                    (B) the availability and accessibility of maternal 
                and infant health care providers;
                    (C) English-language proficiency among women of 
                reproductive age;
                    (D) the health insurance status of women of 
                reproductive age;
                    (E) the number of women of reproductive age who are 
                members of racial or ethnic groups with 
                disproportionately high rates of adverse maternal and 
                infant health outcomes;
                    (F) the socioeconomic status of women of 
                reproductive age, including with respect to--
                            (i) poverty;
                            (ii) unemployment;
                            (iii) household income; and
                            (iv) educational attainment; and
                    (G) access to quality housing, transportation, and 
                nutrition.
            (2) Resources.--In developing the Strategy, the Secretary 
        shall identify, and incorporate a description of, the 
        following:
                    (A) Existing mapping tools or Federal programs that 
                identify--
                            (i) risks associated with climate change 
                        for vulnerable individuals; and
                            (ii) other factors that can influence 
                        maternal and infant health outcomes, including 
                        the factors described in paragraph (1).
                    (B) Environmental, health, socioeconomic, and 
                demographic data relevant to identifying risks 
                associated with climate change for vulnerable 
                individuals.
                    (C) Existing monitoring networks that collect data 
                described in subparagraph (B), and any gaps in such 
                networks.
                    (D) Federal, State, and local stakeholders involved 
                in maintaining monitoring networks identified under 
                subparagraph (C), and how such stakeholders are 
                coordinating their monitoring efforts.
                    (E) Additional monitoring networks, and 
                enhancements to existing monitoring networks, that 
                would be required to address gaps identified under 
                subparagraph (C), including at the subcounty and census 
                tract level.
                    (F) Funding amounts required to establish the 
                monitoring networks identified under subparagraph (E) 
                and recommendations for Federal, State, and local 
                coordination with respect to such networks.
                    (G) Potential uses for data collected and generated 
                as a result of the Strategy, including how such data 
                may be used in determining recipients of grants under 
                the program established by section 2 or other similar 
                programs.
                    (H) Other information the Secretary considers 
                relevant for the development of the Strategy.
    (c) Coordination and Consultation.--In developing the Strategy, the 
Secretary shall--
            (1) coordinate with the Administrator of the Environmental 
        Protection Agency and the Administrator of the National Oceanic 
        and Atmospheric Administration; and
            (2) consult with--
                    (A) stakeholder organizations;
                    (B) health care providers and professional 
                membership organizations with expertise in maternal 
                health or environmental justice;
                    (C) State and local public health departments;
                    (D) licensed and accredited hospitals, birth 
                centers, midwifery practices, or other health care 
                providers that provide prenatal or labor and delivery 
                services to vulnerable individuals; and
                    (E) institutions of higher education, including 
                such institutions that are minority-serving 
                institutions or have expertise in maternal health or 
                environmental justice.
    (d) Notice and Comment.--At least 240 days before the date on which 
the Strategy is published in accordance with subsection (e), the 
Secretary shall provide--
            (1) notice of the Strategy on a public website of the 
        Department of Health and Human Services; and
            (2) an opportunity for public comment of at least 90 days.
    (e) Publication.--Not later than 18 months after the date of 
enactment of this Act, the Secretary shall publish on a public website 
of the Department of Health and Human Services--
            (1) the Strategy;
            (2) the public comments received under subsection (d); and
            (3) the responses of the Secretary to such public comments.

                    TITLE XII--MATERNAL VACCINATIONS

SEC. 1201. MATERNAL VACCINATION AWARENESS AND EQUITY CAMPAIGN.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary''), acting through the 
Director of the Centers for Disease Control and Prevention, shall carry 
out a national campaign to--
            (1) increase awareness of the importance of maternal 
        vaccinations for the health of pregnant and postpartum 
        individuals and their children; and
            (2) increase maternal vaccination rates, with a focus on 
        communities with historically high rates of unvaccinated 
        individuals.
    (b) Consultation.--In carrying out the campaign under this section, 
the Secretary shall consult with relevant community-based 
organizations, health care professional associations and public health 
associations, State public health departments and local public health 
departments, Tribal-serving organizations, nonprofit organizations, and 
nationally recognized private entities.
    (c) Activities.--The campaign under this section shall--
            (1) focus on increasing maternal vaccination rates in 
        communities with historically high rates of unvaccinated 
        individuals, including for pregnant and postpartum individuals 
        from racial and ethnic minority groups;
            (2) include efforts to engage with pregnant and postpartum 
        individuals in communities with historically high rates of 
        unvaccinated individuals to seek input on the development and 
        effectiveness of the campaign;
            (3) provide evidence-based, culturally congruent resources 
        and communications efforts; and
            (4) be carried out in partnership with trusted individuals 
        and entities in communities with historically high rates of 
        unvaccinated individuals, including community-based 
        organizations, community health centers, perinatal health 
        workers, and maternity care providers.
    (d) Collaboration.--The Secretary shall ensure that the information 
and resources developed for the campaign under this section are made 
publicly available and shared with relevant Federal, State, and local 
entities.
    (e) Evaluation.--Not later than the end of fiscal year 2025, the 
Secretary shall--
            (1) establish quantitative and qualitative metrics to 
        evaluate the campaign under this section; and
            (2) submit a report detailing the impact of the campaign 
        under this section to Congress.
    (f) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $2,000,000 for each of fiscal 
years 2022 through 2026.
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