Justice for Incarcerated Moms Act of 2021
Bill: H.R.948 | Sponsor: Rep. Pressley, Ayanna (D-MA)
Policy area: Crime and Law Enforcement

Summary:
Justice for Incarcerated Moms Act of 2021
This bill establishes new requirements related to grants, programs, and reports to improve the treatment and care of pregnant and postpartum women who are incarcerated.
Specifically, the bill requires the following:

To improve maternal health outcomes for incarcerated individuals, 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 ``Justice for Incarcerated Moms Act of 
2021''.

SEC. 2. 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.

SEC. 3. 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. 4. CREATING MODEL PROGRAMS FOR THE CARE OF INCARCERATED 
              INDIVIDUALS IN THE PRENATAL AND POSTPARTUM PERIODS.

    (a) 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. 
The Attorney General shall establish such programs in consultation with 
stakeholders such as--
            (1) 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;
            (2) relevant organizations representing patients, with a 
        particular focus on patients from racial and ethnic minority 
        groups;
            (3) organizations representing maternity care providers and 
        maternal health care education programs;
            (4) perinatal health workers; and
            (5) researchers and policy experts in fields related to 
        maternal health care for incarcerated individuals.
    (b) Start Date.--Each selected facility 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 may--
            (1) provide access to perinatal health workers from 
        pregnancy through the postpartum period;
            (2) provide access to healthy foods and counseling on 
        nutrition, recommended activity levels, and safety measures 
        throughout pregnancy;
            (3) train correctional officers to ensure that pregnant 
        incarcerated individuals receive safe and respectful treatment;
            (4) 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;
            (5) provide counseling and treatment for individuals who 
        have suffered from--
                    (A) diagnosed mental or behavioral health 
                conditions, including trauma and substance use 
                disorders;
                    (B) trauma or violence, including domestic 
                violence;
                    (C) human immunodeficiency virus;
                    (D) sexual abuse;
                    (E) pregnancy or infant loss; or
                    (F) chronic conditions;
            (6) provide evidence-based pregnancy and childbirth 
        education, parenting support, and other relevant forms of 
        health literacy;
            (7) provide clinical education opportunities to maternity 
        care providers in training to expand pathways into maternal 
        health care careers serving incarcerated individuals;
            (8) 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;
            (9) provide reentry assistance, particularly to--
                    (A) 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
                    (B) 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
            (10) 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, including--
                    (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 is authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2022 through 2026.

SEC. 5. GRANT PROGRAM TO IMPROVE MATERNAL HEALTH OUTCOMES FOR 
              INDIVIDUALS IN STATE AND LOCAL PRISONS AND JAILS.

    (a) Establishment.--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. The Attorney General shall award such grants 
in consultation with stakeholders such as--
            (1) 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;
            (2) relevant organizations representing patients, with a 
        particular focus on patients from racial and ethnic minority 
        groups;
            (3) organizations representing maternity care providers and 
        maternal health care education programs;
            (4) perinatal health workers; and
            (5) 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 
may--
            (1) provide access to perinatal health workers from 
        pregnancy through the postpartum period;
            (2) provide access to healthy foods and counseling on 
        nutrition, recommended activity levels, and safety measures 
        throughout pregnancy;
            (3) train correctional officers to ensure that pregnant 
        incarcerated individuals receive safe and respectful treatment;
            (4) 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;
            (5) provide counseling and treatment for individuals who 
        have suffered from--
                    (A) diagnosed mental or behavioral health 
                conditions, including trauma and substance use 
                disorders;
                    (B) trauma or violence, including domestic 
                violence;
                    (C) human immunodeficiency virus;
                    (D) sexual abuse;
                    (E) pregnancy or infant loss; or
                    (F) chronic conditions;
            (6) provide evidence-based pregnancy and childbirth 
        education, parenting support, and other relevant forms of 
        health literacy;
            (7) provide clinical education opportunities to maternity 
        care providers in training to expand pathways into maternal 
        health care careers serving incarcerated individuals;
            (8) 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;
            (9) provide reentry assistance, particularly to--
                    (A) 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
                    (B) 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
            (10) 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, including--
                    (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 is authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2022 through 2026.

SEC. 6. 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. 7. 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) Information Described.--For purposes of subsection (a), 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 of such Act when a pregnant 
        or postpartum individual is incarcerated.

SEC. 8. 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 defined.--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.
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