Excellence in Maternal Health Act of 2019
This bill requires the Department of Health and Human Services (HHS) to establish specified grant programs to support positive maternal health care outcomes for pregnant and postpartum women and their infants. Specifically, grants must be used to (1) develop best practices to reduce preventable maternal mortality; (2) train health care professionals about reducing and preventing discrimination when providing maternal health services; (3) support the collaboration of professionals across health settings with respect to maternal health; and may be used to (4) establish evidence-informed, integrated health care services to pregnant and postpartum women and their infants.
HHS also must contract with an independent research organization to study and make recommendations about best practices for reducing and preventing discrimination in the provision of maternal health services. HHS also must meet certain reporting requirements for specified maternal and child health care grant programs.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4215 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 4215
To improve maternal health care quality, to improve the training of
health care professionals to reduce or prevent discrimination in
certain health care services, to improve perinatal care, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
August 30, 2019
Mr. Bucshon (for himself, Mr. Carson of Indiana, Mr. Burgess, Mr.
Bilirakis, Mrs. Brooks of Indiana, Ms. Herrera Beutler, Mr. Long, Mrs.
McBath, and Mr. Walden) introduced the following bill; which was
referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To improve maternal health care quality, to improve the training of
health care professionals to reduce or prevent discrimination in
certain health care services, to improve perinatal care, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Excellence in Maternal Health Act of
2019''.
SEC. 2. INNOVATION FOR MATERNAL HEALTH.
The Public Health Service Act is amended by inserting after section
330M of such Act (42 U.S.C. 254c-19) the following:
``SEC. 330N. INNOVATION FOR MATERNAL HEALTH.
``(a) In General.--The Secretary, in consultation with experts
representing a variety of clinical specialties, State, tribal, or local
public health officials, researchers, epidemiologists, statisticians,
and community organizations, shall establish or continue a program to
award competitive grants to eligible entities for the purpose of--
``(1) identifying, developing, or disseminating best
practices to improve maternal health care quality and outcomes,
eliminate preventable maternal mortality and severe maternal
morbidity, and improve infant health outcomes, which may
include--
``(A) information on evidence-based practices to
improve the quality and safety of maternal health care
in hospitals and other health care settings of a State
or health care system, including by addressing topics
commonly associated with health complications or risks
related to prenatal care, labor care, birthing, and
postpartum care;
``(B) best practices for improving maternal health
care based on data findings and reviews conducted by a
State maternal mortality review committee that address
topics of relevance to common complications or health
risks related to prenatal care, labor care, birthing,
and postpartum care; and
``(C) information on addressing determinants of
health that impact maternal health outcomes for women
before, during, and after pregnancy;
``(2) collaborating with State maternal mortality review
committees to identify issues for the development and
implementation of evidence-based practices to improve maternal
health outcomes and reduce preventable maternal mortality and
severe maternal morbidity;
``(3) providing technical assistance and supporting the
implementation of best practices identified in paragraph (1) to
entities providing health care services to pregnant and
postpartum women; and
``(4) identifying, developing, and evaluating new models of
care that improve maternal and infant health outcomes, which
may include the integration of community-based services and
clinical care.
``(b) Eligible Entities.--To be eligible for a grant under
subsection (a), an entity shall--
``(1) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require; and
``(2) demonstrate in such application that the entity is
capable of carrying out data-driven maternal safety and quality
improvement initiatives in the areas of obstetrics and
gynecology or maternal health.
``(c) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $10,000,000 for each of fiscal
years 2020 through 2024.''.
SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS.
Title VII of the Public Health Service Act is amended by striking
section 763 (42 U.S.C. 294p) and inserting the following:
``SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS.
``(a) Grant Program.--The Secretary shall establish a program to
award grants to accredited schools of allopathic medicine, osteopathic
medicine, and nursing, and other health professional training programs
for the training of health care professionals to reduce and prevent
discrimination (including training related to implicit biases) in the
provision of health care services related to prenatal care, labor care,
birthing, and postpartum care.
``(b) Eligibility.--To be eligible for a grant under subsection
(a), an entity described in such subsection shall submit to the
Secretary an application at such time, in such manner, and containing
such information as the Secretary may require.
``(c) 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, including a description
of the impact of such training on patient outcomes, as applicable.
``(d) Best Practices.--The Secretary may identify and disseminate
best practices for the training of health care professionals to reduce
and prevent discrimination (including training related to implicit
biases) in the provision of health care services related to prenatal
care, labor care, birthing, and postpartum care.
``(e) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $5,000,000 for each of fiscal
years 2020 through 2024.''.
SEC. 4. STUDY ON TRAINING TO REDUCE AND PREVENT DISCRIMINATION.
Not later than 2 years after date of enactment of this Act, the
Secretary of Health and Human Services (referred to in this section as
the ``Secretary'') shall, through a contract with an independent
research organization, conduct a study and make recommendations for
accredited schools of allopathic medicine, osteopathic medicine, and
nursing, and other health professional training programs on best
practices related to training to reduce and prevent discrimination,
including training related to implicit biases, in the provision of
health care services related to prenatal care, labor care, birthing,
and postpartum care.
SEC. 5. PERINATAL QUALITY COLLABORATIVES.
(a) Grants.--Section 317K(a)(2) of the Public Health Service Act
(42 U.S.C. 247b-12(a)(2)) is amended by adding at the end the
following:
``(E)(i) The Secretary, acting through the Director
of the Centers for Disease Control and Prevention and
in coordination with other offices and agencies, as
appropriate, shall establish or continue a competitive
grant program for the establishment or support of
perinatal quality collaboratives to improve perinatal
care and perinatal health outcomes for pregnant and
postpartum women and their infants. A State, Indian
Tribe, or Tribal organization may use funds received
through such grant to--
``(I) support the use of evidence-
based or evidence-informed practices to
improve outcomes for maternal and
infant health;
``(II) work with clinical teams;
experts; State, local, and, as
appropriate, tribal public health
officials; and stakeholders, including
patients and families, to identify,
develop, or disseminate best practices
to improve perinatal care and outcomes;
and
``(III) employ strategies that
provide opportunities for health care
professionals and clinical teams to
collaborate across health care settings
and disciplines, including primary care
and mental health, as appropriate, to
improve maternal and infant health
outcomes, which may include the use of
data to provide timely feedback across
hospital and clinical teams to inform
responses, and to provide support and
training to hospital and clinical teams
for quality improvement, as
appropriate.
``(ii) To be eligible for a grant under
clause (i), an entity shall submit to the
Secretary an application in such form and
manner and containing such information as the
Secretary may require.''.
(b) Authorization of Appropriations.--Section 317K(f) of the Public
Health Service Act (42 U.S.C. 247b-12(f)) is amended by striking
``$58,000,000 for each of fiscal years 2019 through 2023'' and
inserting ``$65,000,000 for each of fiscal years 2020 through 2024''.
SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM WOMEN.
(a) Grants.--The Public Health Service Act is amended by inserting
after section 330N of such Act, as added by section 2, the following:
``SEC. 330O. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM WOMEN.
``(a) In General.--The Secretary may award grants for the purpose
of establishing or operating evidence-based or innovative, evidence-
informed programs to deliver integrated health care services to
pregnant and postpartum women to optimize the health of women and their
infants, including to reduce adverse maternal health outcomes,
pregnancy-related deaths, and related health disparities (including
such disparities associated with racial and ethnic minority
populations), and, as appropriate, by addressing issues researched
under subsection (b)(2) of section 317K.
``(b) Integrated Services for Pregnant and Postpartum Women.--
``(1) Eligibility.--To be eligible to receive a grant under
subsection (a), a State, Indian Tribe, or Tribal organization
(as such terms are defined in section 4 of the Indian Self-
Determination and Education Assistance Act) shall work with
relevant stakeholders that coordinate care (including
coordinating resources and referrals for health care and social
services) to develop and carry out the program, including--
``(A) State, Tribal, and local agencies responsible
for Medicaid, public health, social services, mental
health, and substance use disorder treatment and
services;
``(B) health care providers who serve pregnant and
postpartum women; and
``(C) community-based health organizations and
health workers, including providers of home visiting
services and individuals representing communities with
disproportionately high rates of maternal mortality and
severe maternal morbidity, and including those
representing racial and ethnicity minority populations.
``(2) Terms.--
``(A) Period.--A grant awarded under subsection (a)
shall be made for a period of 5 years. Any supplemental
award made to a grantee under subsection (a) may be
made for a period of less than 5 years.
``(B) Preference.--In awarding grants under
subsection (a), the Secretary shall--
``(i) give preference to States, Indian
Tribes, and Tribal organizations that have the
highest rates of maternal mortality and severe
maternal morbidity relative to other such
States, Indian Tribes, or Tribal organizations,
respectively; and
``(ii) shall consider health disparities
related to maternal mortality and severe
maternal morbidity, including such disparities
associated with racial and ethnic minority
populations.
``(C) Priority.--In awarding grants under
subsection (a), the Secretary shall give priority to
applications from up to 15 entities described in
subparagraph (B)(i).
``(D) Evaluation.--The Secretary shall require
grantees to evaluate the outcomes of the programs
supported under the grant.
``(c) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $15,000,000 for each of fiscal
years 2020 through 2024.''.
(b) Report on Grant Outcomes and Dissemination of Best Practices.--
(1) Report.--Not later than February 1, 2026, the Secretary
of Health and Human Services shall submit to the Committee on
Health, Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of
Representatives a report that describes--
(A) the outcomes of the activities supported by the
grants awarded under the amendments made by this
section on maternal and child health;
(B) best practices and models of care used by
recipients of grants under such amendments; and
(C) obstacles identified by recipients of grants
under such amendments, and strategies used by such
recipients to deliver care, improve maternal and child
health, and reduce health disparities.
(2) Dissemination of best practices.--Not later than August
1, 2026, the Secretary of Health and Human Services shall
disseminate information on best practices and models of care
used by recipients of grants under the amendments made by this
section (including best practices and models of care relating
to the reduction of health disparities, including such
disparities associated with racial and ethnic minority
populations, in rates of maternal mortality and severe maternal
morbidity) to relevant stakeholders, which may include health
providers, medical schools, nursing schools, relevant State,
tribal, and local agencies, and the general public.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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