I 118th CONGRESS 1st Session H. R. 5581 IN THE HOUSE OF REPRESENTATIVES September 20, 2023 Ms. McClellan (for herself and Ms. Mace ) introduced the following bill; which was referred to the Committee on Ways and Means A BILL To amend the Social Security Act to authorize grants for demonstration projects to support mothers and families during pregnancy, childbirth, and the postpartum period by increasing access to short-term child care, and for other purposes.

1. Short title This Act may be cited as the Child Care Assistance for Maternal Health Act . 2. Demonstration projects for child care to improve maternal health Subtitle A of title XX of the Social Security Act ( 42 U.S.C. 1397 et seq. ) is amended by inserting after section 2009 the following: 2009A. Demonstration projects for child care to improve maternal health (a) In general (1) Establishment The Secretary shall carry out a program of awarding grants, on a competitive basis, to eligible entities to conduct demonstration projects designed to support mothers and families during pregnancy, childbirth, and the postpartum period by increasing access to short-term child care (such as through crisis nurseries) in order to improve the physical health, mental health, and wellness of the mother and her family. (2) Advisory group The Secretary shall establish an advisory group to advise the Secretary on carrying out the program established under paragraph (1). The advisory group shall be composed of the following members: (A) At least 1 representative of the Administration for Children and Families. (B) At least 1 representative of the Administration for Native Americans. (C) At least 1 representative of the Centers for Medicare & Medicaid Services. (D) At least 1 representative of the Health Resources and Services Administration. (E) At least 1 representative of the Substance Abuse and Mental Health Services Administration. (F) Representatives of such other Federal entities, as the Secretary determines appropriate. (b) Eligible entities To be eligible to receive a grant under this section, an entity shall be— (1) a State, a territory, or the District of Columbia; (2) an Indian Tribe or Tribal organization; (3) an Urban Indian organization; (4) a public health department; (5) a nonprofit community-based organization; or (6) a consortium of entities described in any of paragraphs (1) through (5). (c) Priority for awarding grants In selecting grant recipients under this section, the Secretary shall— (1) give priority to— (A) eligible entities that, in addition to the activities proposed to be funded through the grant, will provide families with assistance in attaining a long-term child care option; (B) eligible entities proposing to serve an area with high rates of maternal mortality and poverty; and (C) eligible entities proposing to serve a maternity care health professional target area identified under section 332(k) of the Public Health Service Act; and (2) award at least 1 grant to an Indian Tribe, a Tribal organization, or an Urban Indian organization. (d) Number (1) In general Subject to paragraph (2), the Secretary shall award at least 10 grants under this section. (2) Exception for insufficient appropriations The Secretary may award fewer than 10 grants if the Secretary determines that the amounts made available to carry out this section are less than the total amounts authorized to be appropriated by subsection (i). (e) Demonstration project requirements (1) Use of funds A grant awarded under this section may be used— (A) to conduct a demonstration project described in subsection (a); (B) to assess community needs in preparation for such demonstration project; and (C) to fund outreach related to such demonstration project. (2) Duration A demonstration project under this section shall be for a period of not less than 3 years. (3) Reports by grantees (A) Interim and final reports A grantee under this section shall agree to submit to the Secretary— (i) interim reports on the demonstration project funded through the grant; and (ii) a final report on such demonstration project. (B) Contents The interim and final reports of a grantee under subparagraph (A) shall include assessments of the effectiveness of the grantee’s demonstration project with respect to— (i) maternal and child health outcomes; (ii) child care quality; and (iii) such other metrics as may be determined by the Secretary. (4) Priority for providing services In providing services through a demonstration project under this section, a grantee shall give priority to vulnerable populations, such as— (A) low-income families; (B) families experiencing homelessness; (C) single-parent households; (D) families who have children with disabilities or special health care needs; and (E) other vulnerable populations as may be determined by the Secretary. (5) Subgrants and contracts (A) In general A grantee under this section may coordinate with entities described in subparagraph (B) in carrying out a demonstration project under this section, including by awarding subgrants to, or entering into contracts with, such entities. (B) Entities The entities described in this subparagraph are the following: (i) State or local child care resource and referral agencies. (ii) Prenatal, perinatal, pediatric, family medicine, and other relevant health care providers. (iii) Doula support services. (6) State and local requirements (A) In general Subject to subparagraph (B), services provided through a demonstration project under this section shall meet the applicable requirements of State and local law in the jurisdiction in which such services are provided, including any applicable licensure and quality of care requirements. (B) Exception Child care may be provided through a demonstration project under this section to children younger than the minimum age allowed under applicable State or local licensing requirements, so long as the grantee providing such child care (either directly or through a subgrant or contract under paragraph (5)) coordinates with the applicable jurisdiction to ensure appropriate quality of care standards. (f) Evaluation The Secretary shall— (1) evaluate the demonstration projects funded under this section; and (2) as part of such evaluation— (A) identify successful activities for improving maternal health outcomes and health outcomes for the birthed child and any other children in the family; and (B) formulate recommendations for reauthorizing the program under this section. (g) Reports to Congress The Secretary shall submit reports to the Congress on the program under this section, including— (1) interim reports; and (2) based on the evaluation under subsection (f), a final report. (h) Definitions In this section: (1) IHCIA terms The terms Indian Tribe , Tribal organization , and Urban Indian organization have the meanings given the terms Indian tribe , tribal organization , and Urban Indian organization , respectively, in section 4 of the Indian Health Care Improvement Act. (2) Postpartum period The term postpartum period means the first year after an individual has given birth. (3) Short-term child care The term short-term child care — (A) means child care provided during pregnancy, childbirth, or the postpartum period— (i) for a limited duration; and (ii) for the birthed child or any other child in the family; and (B) includes respite child care. (i) Authorization of appropriations (1) In general Subject to paragraph (2), there is authorized to be appropriated to carry out this section $5,000,000 for each of fiscal years 2024 through 2026. (2) Evaluation Of the funds appropriated to carry out this section under paragraph (1), not more than 5 percent may be used to fund the evaluation under subsection (f). .