Black Maternal Health Momnibus Act of 2020
This bill directs the Department of Health and Human Services (HHS) and other agencies to address maternal health outcomes among minority populations. HHS must (1) establish task forces to address social determinants of health, maternal mental and behavioral health, and other topics; and (2) award grants for maternal mortality review committees, innovative maternity care models, and other purposes. The Centers for Medicare & Medicaid Services must establish a perinatal payment demonstration project. The Department of Housing and Urban Development and the Department of Transportation must report on the impact of housing and transportation during prenatal and postpartum periods, respectively. The Department of Veterans Affairs must submit a plan for maternity care coordination for women veterans, and the Bureau of Prisons must establish programs and award grants to certain prisons and jails to improve maternal health outcomes among incarcerated individuals.
The Government Accountability Office must report on the perinatal health workforce, maternity care compliance offices, and maternal health outcomes among veterans and incarcerated individuals. The National Academies of Sciences, Engineering, and Medicine must report on specified topics, including training programs to reduce bias, racism, and discrimination. The Medicaid and CHIP Payment Access Commission must report on the impact of Medicaid ineligibility on pregnant and postpartum individuals who are incarcerated.
The bill also (1) expands eligibility for certain nutrition programs by increasing the postpartum and breastfeeding periods, and (2) reduces certain funding to states without laws restricting the use of restraints on pregnant women who are incarcerated.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3424 Introduced in Senate (IS)]
<DOC>
116th CONGRESS
2d Session
S. 3424
To end preventable maternal mortality and severe maternal morbidity in
the United States and close disparities in maternal health outcomes,
and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 10, 2020
Ms. Harris (for herself, Mr. Booker, Mr. Peters, Mrs. Gillibrand, Ms.
Baldwin, Ms. Warren, Mr. Sanders, Ms. Duckworth, Mr. Blumenthal, Mr.
Bennet, Ms. Klobuchar, Mr. Menendez, and Mr. Merkley) introduced the
following bill; which was read twice and referred to the Committee on
Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
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 2020''.
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.
TITLE I--SOCIAL DETERMINANTS FOR MOMS
Sec. 101. Task force to coordinate efforts to address social
determinants of health for women in the
prenatal and postpartum periods.
Sec. 102. Requirements for guidance relating to social determinants of
health for pregnant women.
Sec. 103. Department of Housing and Urban Development.
Sec. 104. Department of Transportation.
Sec. 105. Department of Agriculture.
Sec. 106. Environmental study through National Academies.
Sec. 107. Child care access.
Sec. 108. Grants to State, local, and Tribal public health departments
addressing social determinants of health
for pregnant and postpartum women.
TITLE II--HONORING KIRA JOHNSON
Sec. 201. Investments in community-based organizations to improve Black
maternal health outcomes.
Sec. 202. Training for all employees in maternity care settings.
Sec. 203. Study on reducing and preventing bias, racism, and
discrimination in maternity care settings.
Sec. 204. Respectful maternity care compliance program.
Sec. 205. GAO report.
TITLE III--PROTECTING MOMS WHO SERVED
Sec. 301. Support for maternity care coordination.
Sec. 302. Sense of Congress on veteran status requirements.
Sec. 303. Report on maternal mortality and severe maternal morbidity
among women 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 on barriers to maternity care.
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. Task force on maternal health data and quality measures.
Sec. 504. Indian Health Service study on maternal mortality.
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. Innovative models to reduce maternal mortality.
TITLE VII--JUSTICE FOR INCARCERATED MOMS
Sec. 701. Sense of Congress.
Sec. 702. Ending the shackling of pregnant individuals.
Sec. 703. Creating model programs for the care of incarcerated
individuals in the prenatal and postpartum
periods.
Sec. 704. Grant program to improve maternal health outcomes for
individuals in State and local prisons and
jails.
Sec. 705. GAO report.
Sec. 706. MACPAC report.
TITLE VIII--TECH TO SAVE MOMS
Sec. 801. CMI modeling of integrated telehealth models in maternity
care services.
Sec. 802. Grants to expand the use of technology-enabled collaborative
learning and capacity models that provide
care to pregnant and postpartum women.
Sec. 803. Grants to promote equity in maternal health outcomes by
increasing access to digital tools.
Sec. 804. Report on the use of technology to reduce maternal mortality
and severe maternal morbidity and to close
racial and ethnic disparities in outcomes.
TITLE IX--IMPACT TO SAVE MOMS
Sec. 901. Perinatal Care Alternative Payment Model Demonstration
Project.
Sec. 902. MACPAC report.
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, and practices of the health care consumer
and other stakeholders.
(2) Maternal mortality.--The term ``maternal mortality''
means a death occurring during or within a 1-year period after
pregnancy that is caused by pregnancy or childbirth
complications.
(3) Postpartum.--The term ``postpartum'' means the 1-year
period beginning on the last day of a woman's pregnancy.
(4) Severe maternal morbidity.--The term ``severe maternal
morbidity'' means an unexpected outcome caused by labor and
delivery of a woman that results in significant short-term or
long-term consequences to the health of the woman.
TITLE I--SOCIAL DETERMINANTS FOR MOMS
SEC. 101. TASK FORCE TO COORDINATE EFFORTS TO ADDRESS SOCIAL
DETERMINANTS OF HEALTH FOR WOMEN IN THE PRENATAL AND
POSTPARTUM PERIODS.
(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 strategies to coordinate efforts across the Federal
Government to address social determinants of health for women in the
prenatal and postpartum periods.
(b) Members.--The members of the Task Force shall consist of the
following:
(1) The Secretary of Health and Human Services (or the
Secretary's designee).
(2) The Secretary of Housing and Urban Development (or the
Secretary's designee).
(3) The Secretary of Transportation (or the Secretary's
designee).
(4) The Secretary of Agriculture (or the Secretary's
designee).
(5) The Administrator of the Environmental Protection
Agency (or the Administrator's designee).
(6) The Assistant Secretary for the Administration for
Children and Families (or the Assistant Secretary's designee).
(7) The Administrator of the Centers for Medicare &
Medicaid Services (or the Administrator's designee).
(8) The Director of the Indian Health Service (or the
Director's designee).
(9) The Director of the National Institutes of Health (or
the Director's designee).
(10) The Administrator of the Health Resources and Services
Administration (or the Administrator's designee).
(11) The Deputy Assistant Secretary for Minority Health of
the Department of Health and Human Services (or the Deputy
Assistant Secretary's designee).
(12) The Deputy Assistant Secretary for Women's Health of
the Department of Health and Human Services (or the Deputy
Assistant Secretary's designee).
(13) The Director of the Centers for Disease Control and
Prevention (or the Director's designee).
(14) A woman who has experienced severe maternal morbidity
or a family member of a woman who has suffered a pregnancy-
related death.
(15) A leader of a community-based organization that
addresses maternal mortality and severe maternal morbidity with
a specific focus on racial and ethnic disparities.
(16) A maternal health care provider.
(c) Chair.--The Secretary of Health and Human Services shall select
the Chair of the Task Force from among the members of the Task Force.
(d) Report.--Not later than 2 years after the date of enactment of
this Act, the Task Force shall--
(1) finalize strategies to coordinate efforts across the
Federal Government to address social determinants of health for
women in the prenatal and postpartum periods; and
(2) submit a report on such strategies to the Congress,
including--
(A) plans for implementing such strategies; and
(B) recommendations on the funding amounts needed
by each Federal department and agency to implement such
strategies.
(e) Termination.--The termination provisions under section 14 of
the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to
the Task Force.
SEC. 102. REQUIREMENTS FOR GUIDANCE RELATING TO SOCIAL DETERMINANTS OF
HEALTH FOR PREGNANT WOMEN.
(a) In General.--Not later than 1 year after the date of the
enactment of this Act, the Secretary of Health and Human Services shall
issue guidance with respect to how medicaid managed care organizations
and State Medicaid programs can use payments made pursuant to section
1903 of the Social Security Act (42 U.S.C. 1396b) to address the
following issues related to social determinants of health for high-risk
mothers during the presumptive eligibility period for pregnant women:
(1) Housing.
(2) Transportation.
(3) Nutrition.
(4) Lactation and other infant feeding options support.
(5) Lead testing and abatement.
(6) Air and water quality.
(7) Car seat installation.
(8) Child care access.
(9) Wellness and stress management programs.
(10) Other social determinants of health (as determined by
the Secretary).
(b) Definitions.--In this section:
(1) Medicaid managed care organizations.--The term
``medicaid managed care organization'' has the meaning given
such term in section 1903(m)(1)(A) of the Social Security Act
(42 U.S.C. 1396b(m)(1)(A)).
(2) Presumptive eligibility period.--The term ``presumptive
eligibility period'' has the meaning given such term in section
1920(b)(1) of the Social Security Act (42 U.S.C. 1396r-
1(b)(1)).
SEC. 103. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT.
(a) Definitions.--In this section--
(1) the term ``Department'' means the Department of Housing
and Urban Development;
(2) the term ``Secretary'' means the Secretary of Housing
and Urban Development; and
(3) the term ``task force'' means the Housing for Moms Task
Force established under subsection (b).
(b) Task Force.--
(1) Establishment.--The Secretary shall establish within
the Department a Housing for Moms Task Force that shall be
responsible for ensuring that women in the prenatal and
postpartum periods have safe, stable, affordable, and adequate
housing for themselves and their other children.
(2) Responsibilities.--The task force shall--
(A) study how the Department can support women in
the prenatal and postpartum periods and make
recommendations to the Secretary;
(B) provide guidance to regional offices of the
Department on measures to ensure that local housing
infrastructure is supportive to women in the prenatal
and postpartum periods, including providing information
on--
(i) health-promoting housing codes;
(ii) enforcement of housing codes;
(iii) proactive rental inspection programs;
(iv) code enforcement officer training; and
(v) partnerships between regional offices
of the Department and community organizations
to ensure housing laws are understood and
violations are discovered; and
(C) not later than 2 years after the date of
enactment of this Act, and annually thereafter, submit
to Congress a report summarizing the activities of the
task force.
SEC. 104. 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 a
report containing--
(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 health that affect maternal health outcomes, such as healthy
foods;
(2) recommendations on how to overcome such barriers; and
(3) an assessment of transportation safety risks for
pregnant individuals and recommendations on how to mitigate
such risks.
(b) Considerations.--In carrying out subsection (a), the Secretary
shall give special consideration to solutions for--
(1) women living in a health professional shortage area
designated under section 332 of the Public Health Service Act
(42 U.S.C. 254e); and
(2) women living in areas with high maternal mortality or
severe maternal morbidity rates and significant racial or
ethnic disparities in maternal health outcomes.
SEC. 105. DEPARTMENT OF AGRICULTURE.
(a) Definitions.--In this section:
(1) Eligible entity.--The term ``eligible entity'' means--
(A) a public entity;
(B) a private community entity;
(C) a community-based organization;
(D) 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
(E) an urban Indian organization (as 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 Agriculture.
(b) Special Supplemental Nutrition Program for Women, Infants, and
Children.--
(1) Extension of postpartum period.--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 ``24 months''.
(2) 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 ``24 months''.
(3) Report.--Not later than 2 years after the date of
enactment of this Act, the Secretary 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) qualitative evaluations of family experiences
under the special supplemental nutrition program for
women, infants, and children under section 17 of the
Child Nutrition Act of 1966 (42 U.S.C. 1786); and
(C) the cost effectiveness of that special
supplemental nutrition program.
(c) Grant Program for Healthy Food and Clean Water for Pregnant and
Postpartum Women.--
(1) In general.--The Secretary shall carry out a grant
program to make grants on a competitive basis to eligible
entities to carry out the activities described in paragraph
(4).
(2) 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 require.
(3) Priority.--In awarding grants under this subsection,
the Secretary shall give priority to an eligible entity that
proposes in an application under paragraph (2) to use the grant
funds to carry out activities in areas with--
(A) high maternal mortality or severe maternal
morbidity rates; and
(B) significant racial or ethnic disparities in
maternal health outcomes.
(4) Use of funds.--An eligible entity that receives a grant
under this subsection shall use funds under the grant to
deliver healthy food, infant formula, or clean water to
pregnant women and postpartum women (as those terms are defined
in section 17(b) of the Child Nutrition Act of 1966 (42 U.S.C.
1786(b)) 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.
(5) Report.--Not later than 2 years after the date of
enactment of this Act, the Secretary shall submit to Congress a
report that includes--
(A) an evaluation of the effect of the grant
program under this subsection on maternal and infant
health outcomes, including racial and ethnic
disparities with respect to those outcomes; and
(B) recommendations with respect to ensuring the
activities described in paragraph (4) continue after
the period for grant funding for those activities
expires.
(6) Authorization of appropriations.--There are authorized
to be appropriated such sums as are necessary to carry out this
subsection for each of fiscal years 2021 through 2023.
SEC. 106. ENVIRONMENTAL STUDY THROUGH NATIONAL ACADEMIES.
(a) In General.--The Administrator of the Environmental Protection
Agency shall seek to enter an agreement, not later than 60 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
conduct a study on the impacts of water and air quality, exposure to
extreme temperatures, 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 environmental conditions 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 direct the
National Academies to complete the study under subsection (a) and
submit to Congress a report on the results of the study not later than
2 years after the date of enactment of this Act.
SEC. 107. 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 women with
free drop-in child care services during prenatal and postpartum
appointments.
(b) Eligible Organizations.--To be eligible to receive a grant
under this section, an organization shall--
(1) be an organization that carries out programs providing
pregnant and postpartum women with free and accessible drop-in
child care services during prenatal and postpartum appointments
in areas which the Secretary determines have a high maternal
mortality and severe maternal morbidity rate and significant
racial and ethnic disparities in maternal health outcomes; and
(2) not have previously received a grant under this
section.
(c) Duration.--The Secretary shall commence the grant program under
subsection (a) not later than 1 year after the date of the enactment of
this Act.
(d) Evaluation.--The Secretary shall evaluate each grant awarded
under this section to determine the effects of the grant on--
(1) prenatal and postpartum appointment attendance rates;
(2) maternal health outcomes with a specific focus on
racial and ethnic disparities in such outcomes;
(3) pregnant and postpartum women participating in the
funded programs, and the families of such women; and
(4) cost effectiveness.
(e) Report.--Not later than September 30, 2023, the Secretary shall
submit to the Congress a report containing the following:
(1) A summary of the evaluations under subsection (d).
(2) A description of actions the Secretary can take to
ensure that pregnant and postpartum women eligible for medical
assistance under a State plan under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) have access to free 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 $1,000,000 for each of fiscal
years 2021 through 2023.
SEC. 108. GRANTS TO STATE, LOCAL, AND TRIBAL PUBLIC HEALTH DEPARTMENTS
ADDRESSING SOCIAL DETERMINANTS OF HEALTH FOR PREGNANT AND
POSTPARTUM WOMEN.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall award grants to
State, local, and Tribal public health departments to address social
determinants of maternal health in order to reduce or eliminate racial
and ethnic disparities in maternal health outcomes.
(b) Use of Funds.--A public health department receiving a grant
under this section may use funds received through the grant to--
(1) build capacity and hire staff to coordinate efforts of
the public health department to address social determinants of
maternal health;
(2) develop, and provide for distribution of, resource
lists of available social services for women in the prenatal
and postpartum periods, which social services may include--
(A) transportation vouchers;
(B) housing supports;
(C) child care access;
(D) healthy food access;
(E) nutrition counseling;
(F) lactation supports;
(G) lead testing and abatement;
(H) clean water;
(I) infant formula;
(J) maternal mental and behavioral health care
services;
(K) wellness and stress management programs; and
(L) other social services as determined by the
public health department;
(3) in consultation with local stakeholders, establish or
designate a ``one-stop'' resource center that provides
coordinated social services in a single location for women in
the prenatal or postpartum period; or
(4) directly address specific social determinant needs for
the community that are related to maternal health as identified
by the public health department, such as--
(A) transportation;
(B) housing;
(C) child care;
(D) healthy foods;
(E) infant formula;
(F) nutrition counseling;
(G) lactation supports;
(H) lead testing and abatement;
(I) air and water quality;
(J) wellness and stress management programs; and
(K) other social determinants as determined by the
public health department.
(c) Special Consideration.--In awarding grants under subsection
(a), the Secretary shall give special consideration to State, local,
and Tribal public health departments that--
(1) propose to use the grants to reduce or end racial and
ethnic disparities in maternal mortality and severe maternal
morbidity rates; and
(2) operate in areas with high rates of--
(A) maternal mortality and severe maternal
morbidity; or
(B) significant racial and ethnic disparities in
maternal mortality and severe maternal morbidity rates.
(d) Guidance on Strategies.--In carrying out this section, the
Secretary shall provide guidance to grantees on strategies for long-
term viability of programs funded through this section after such
funding ends.
(e) Reporting.--
(1) By grantees.--As a condition on receipt of a grant
under this section, a grantee shall agree to--
(A) evaluate the activities funded through the
grant with respect to--
(i) maternal health outcomes with a
specific focus on racial and ethnic
disparities;
(ii) the subjective assessment of such
activities by the beneficiaries of such
activities, including mothers and their
families; and
(iii) cost effectiveness and return on
investment; and
(B) not later than 180 days after the end of the
period of the grant, submit a report on the results of
such evaluation to the Secretary.
(2) By secretary.--Not later than the end of fiscal year
2026, the Secretary shall submit a report to the Congress--
(A) summarizing the evaluations submitted under
paragraph (1); and
(B) making recommendations for improving maternal
health and reducing or eliminating racial and ethnic
disparities in maternal health outcomes, based on the
results of grants under this section.
(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $15,000,000 for each of fiscal
years 2021 through 2025.
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 described in subsection
(c), the Secretary of Health and Human Services (in this section
referred to as the ``Secretary''), acting through the Administrator of
the Health Resources and Services Administration, shall award grants to
eligible entities to establish or expand programs to prevent maternal
mortality and severe maternal morbidity among Black women.
(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 women.
(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--
(i) high rates of adverse maternal health
outcomes; and
(ii) significant racial and ethnic
disparities in maternal health outcomes;
(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 women.
(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 women; 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 that
are aligned with evidence-based practices for
improving maternal mental health outcomes for
Black women;
(ii) address social determinants of health
for women in the prenatal and postpartum
periods, including--
(I) housing;
(II) transportation;
(III) nutrition counseling;
(IV) healthy foods;
(V) lactation support;
(VI) lead abatement and other
efforts to improve air and water
quality;
(VII) child care access;
(VIII) car seat installation;
(IX) wellness and stress management
programs; or
(X) coordination across safety-net
and social support services and
programs;
(iii) promote evidence-based health
literacy and pregnancy, childbirth, and
parenting education for women in the prenatal
and postpartum periods;
(iv) provide support from doulas and other
perinatal health workers to women from
pregnancy through the postpartum period;
(v) provide culturally congruent training
to perinatal health workers such as doulas,
community health workers, peer supporters,
certified lactation consultants, nutritionists
and dietitians, social workers, home visitors,
and navigators;
(vi) conduct or support research on Black
maternal health issues; or
(vii) have developed other programs and
resources that address community-specific needs
for women in the prenatal and postpartum
periods and are aligned with evidence-based
practices for improving maternal health
outcomes for Black women.
(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 women;
(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 women after
the period of the grant.
(f) Evaluation.--Not later than the end of fiscal year 2026, the
Secretary shall submit to the 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;
(3) assesses the effectiveness of programs funded by grants
under this section in improving maternal health outcomes for
Black women; and
(4) makes recommendations for future Department of Health
and Human Services grant programs and funding opportunities
that deliver funding to community-based organizations to
improve Black maternal health outcomes through programs and
resources that are aligned with evidence-based practices for
improving maternal health outcomes for Black women.
(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $5,000,000 for each of fiscal
years 2021 through 2025.
SEC. 202. 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. 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.
``(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 birthing professionals and any employees
who interact with pregnant and postpartum women in the provider
setting, including front desk employees, sonographers,
schedulers, health care professionals, hospital or health
system administrators, and security staff;
``(2) emphasize periodic, as opposed to one-time, trainings
for all birthing professionals and employees described in
paragraph (1);
``(3) address implicit bias and explicit bias;
``(4) be delivered in ongoing education settings for
providers maintaining their licenses, with a preference for
trainings that provide continuing education units and
continuing medical education;
``(5) include trauma-informed care best practices and an
emphasis on shared decision making between providers and
patients;
``(6) include a service-learning component that sends
providers to work in underserved communities to better
understand patients' lived experiences;
``(7) be delivered in undergraduate programs that funnel
into medical schools, like biology and pre-medicine majors;
``(8) be delivered at local agencies (as defined in
subsection (b) of section 17 of the Child Nutrition Act of 1966
(42 U.S.C. 1786)) that provide benefits or services under the
special supplemental nutrition program for women, infants, and
children established by that section;
``(9) integrate bias training in obstetric emergency
simulation trainings;
``(10) offer training to all maternity care providers on
the value of racially, ethnically, and professionally diverse
maternity care teams to provide culturally congruent care,
including doulas, community health workers, peer supporters,
certified lactation consultants, nutritionists and dietitians,
social workers, home visitors, and navigators; or
``(11) be based on one or more programs designed by a
historically Black college or university.
``(c) Application.--To seek a grant under subsection (a), an entity
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 women of color 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 women
of color and their families in maternity care settings.
``(f) Definitions.--In this section:
``(1) The term `postpartum' means the 1-year period
beginning on the last day of a woman's pregnancy.
``(2) The term `culturally congruent' means in agreement
with the preferred cultural values, beliefs, worldview, and
practices of the health care consumer and other stakeholders.
``(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $5,000,000 for each of fiscal
years 2021 through 2025.''.
SEC. 203. 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
(2) not later than 24 months after the date of enactment of
this Act, complete the study and transmit a report on the
results of the study to the 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 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 women of color and their families.
(2) Determination of the types 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 women of color and their families.
SEC. 204. 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
delivery settings to establish within one or more hospitals or other
birth settings a respectful maternity care compliance office.
(b) Office Requirements.--A respectful maternity care compliance
office funded through a grant under this section shall--
(1) institutionalize mechanisms to allow patients receiving
maternity care services, the families of such patients, or
doulas or other perinatal workers supporting such patients to
report instances of disrespect or evidence of bias on the basis
of race, ethnicity, or another protected class;
(2) institutionalize response mechanisms through which
representatives of the office 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; and
(B) 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
minority patients; and
(4) provide annual reports to the Secretary with
information about each case reported to the compliance office
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 office; and
(C) the response from the compliance office.
(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
office 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
offices; and
(C) evaluating the effectiveness of respectful
maternity care compliance offices on maternal health
outcomes and patient and family experiences, especially
for minority patients 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
disrespect or bias on the basis of race, ethnicity, or
another protected class in the delivery of maternity
care services.
(B) Components of study.--The study shall include
the following:
(i) An assessment of the reports submitted
to the Secretary from the respectful maternity
care compliance offices pursuant to subsection
(b)(4).
(ii) Based on such assessment,
recommendations for potential accountability
mechanisms related to cases of disrespect 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 the
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 2021 through 2026.
SEC. 205. GAO REPORT.
(a) In General.--Not later than 2 years after date of enactment of
this Act and every 2 years thereafter, the Comptroller General of the
United States shall submit to the Congress and make publicly available
a report on the establishment of respectful maternity care compliance
offices supported under section 204 within hospitals, health systems,
and other maternity care settings.
(b) Matters Included.--The report under subsection (a) 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 offices
supported under section 204, including--
(A) which hospitals and other birth settings elect
to establish compliance offices and when such offices
are established;
(B) to the extent practicable, impacts of the
establishment of such offices on maternal health
outcomes and patient and family experiences in the
hospitals and other birth settings that have
established such offices, especially for minority women
and their families;
(C) information on geographic areas, and types of
hospitals or other birth settings, where respectful
maternity care compliance offices are not being
established and information on factors contributing to
decisions to not establish such offices; and
(D) recommendations for establishing respectful
maternity care compliance offices in geographic areas,
and types of hospitals or other birth settings, where
such offices are not being established.
(2) Whether the funding made available to carry out section
204 has been sufficient and, if applicable, recommendations for
additional appropriations to carry out such section.
(3) Such other information as the Comptroller General
determines appropriate.
TITLE III--PROTECTING MOMS WHO SERVED
SEC. 301. SUPPORT FOR MATERNITY CARE COORDINATION.
(a) Authorization of Appropriations.--
(1) In general.--There is authorized to be appropriated to
the Secretary of Veterans Affairs $15,000,000 for fiscal year
2022 to improve maternity care coordination for women veterans
throughout pregnancy and the 1-year postpartum period beginning
on the last day of the pregnancy.
(2) Supplement not supplant.--Amounts authorized under
paragraph (1) are in addition to any other amounts authorized
for the purpose specified in that paragraph.
(b) Plan.--
(1) In general.--Not later than 1 year after the date of
the enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and Committee on
Veterans' Affairs of the House of Representatives a plan to
improve maternity care coordination to fulfill the
responsibilities and requirements described in the Veterans
Health Administration Handbook 1330.03 dated October 5, 2012,
and entitled ``Maternity Health Care and Coordination'', or any
successor handbook.
(2) Elements.--The plan under paragraph (1) shall include
the following:
(A) With respect to the amounts authorized to be
appropriated under subsection (a), a description of how
the Secretary will ensure such amounts are used to--
(i) hire full-time maternity care
coordinators;
(ii) train maternity care coordinators; and
(iii) improve support programs led by
maternity care coordinators.
(B) Recommendations for the amount of funding the
Secretary determines appropriate to improve maternity
care coordination as described in paragraph (1) for
each of the 5 fiscal years following the date of the
plan.
(3) Consultation.--The Secretary shall develop the plan
under paragraph (1) in consultation with veterans service
organizations, military service organizations, women's health
care providers, and community-based organizations representing
women from demographic groups disproportionately impacted by
poor maternal health outcomes, that the Secretary determines
appropriate.
SEC. 302. SENSE OF CONGRESS ON VETERAN STATUS REQUIREMENTS.
It is the sense of Congress that each State should list the veteran
status of a mother--
(1) in fetal death records; and
(2) in maternal mortality review committee reviews of
pregnancy-related deaths and pregnancy-associated deaths.
SEC. 303. REPORT ON MATERNAL MORTALITY AND SEVERE MATERNAL MORBIDITY
AMONG WOMEN VETERANS.
(a) GAO Report.--Not later than 2 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 women veterans, with a particular focus on
racial and ethnic disparities in maternal health outcomes for women
veterans.
(b) Matters Included.--The report under subsection (a) shall
include the following:
(1) To the extent practicable--
(A) the number of women 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 women veterans;
(C) the number of cases of severe maternal
morbidity among women veterans in the most recent year
of available data;
(D) the racial and ethnic disparities in maternal
mortality and severe maternal morbidity rates among
women veterans;
(E) identification of the causes of maternal
mortality and severe maternal morbidity that are unique
to women who have served in the military, including
post-traumatic stress disorder, military sexual trauma,
and infertility or miscarriages that may be caused by
such service;
(F) identification of the causes of maternal
mortality and severe maternal morbidity that are unique
to women veterans of color; and
(G) identification of any correlations between the
former rank of women veterans and their maternal health
outcomes.
(2) An assessment of the barriers to determining the
information required under paragraph (1) and recommendations
for improvements in tracking maternal health outcomes among--
(A) women veterans who have health care coverage
through the Department;
(B) women veterans enrolled in the TRICARE program
(as defined in section 1072 of title 10, United States
Code);
(C) women veterans with employer-based or private
insurance; and
(D) women veterans enrolled in the Medicaid program
under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.).
(3) Recommendations for legislative and administrative
actions to increase access to mental and behavioral health care
for women veterans who screen positively for postpartum mental
or behavioral health conditions.
(4) Recommendations to address homelessness among pregnant
and postpartum women veterans.
(5) Recommendations on how to effectively educate maternity
care providers on best practices for providing maternity care
services to women veterans that addresses the unique maternal
health care needs of veteran populations.
(6) Recommendations to reduce maternal mortality and severe
maternal morbidity among women veterans and to address racial
and ethnic disparities in maternal health outcomes for each of
the groups described in subparagraphs (A) through (D) of
paragraph (2).
(7) Recommendations to improve coordination of care between
the Department and non-Department facilities for pregnant and
postpartum women veterans, including recommendations to improve
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 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 women
veterans and to address racial and ethnic disparities in
maternal health outcomes for women 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 shall issue and disseminate guidance to States to
educate providers and managed care entities about the value and
process of delivering respectful maternal health care through
diverse care provider models.
(2) Contents.--The guidance required by paragraph (1) shall
address how States can encourage and incentivize hospitals,
health systems, freestanding birth centers, other maternity
care provider groups, and managed care entities--
(A) to recruit and retain maternity care providers,
such as obstetrician-gynecologists, family physicians,
physician assistants, 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, nurse
practitioners, and clinical nurse specialists--
(i) from racially and ethnically diverse
backgrounds;
(ii) with experience practicing in racially
and ethnically diverse communities; and
(iii) who have undergone trainings on
implicit and explicit bias and racism;
(B) to incorporate into maternity care teams
midwives who meet (at a minimum) the international
definition of the midwife and global standards for
midwifery education as established by the International
Confederation of Midwives, doulas, community health
workers, peer supporters, certified lactation
consultants, nutritionists and dietitians, social
workers, home visitors, and navigators;
(C) to provide collaborative, culturally 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, and freestanding birth
centers.
(b) Study on Culturally Congruent Maternity Care.--
(1) Study.--The Secretary of Health and Human Services,
acting through the Director of the National Institutes of
Health (in this subsection referred to as the ``Secretary''),
shall conduct a study on best practices in culturally congruent
maternity care.
(2) Report.--Not later than 2 years after the date of
enactment of this Act, the Secretary shall--
(A) complete the study required by paragraph (1);
(B) submit to the 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, freestanding birth centers,
other maternity care provider groups, and
managed care entities that are delivering
culturally congruent maternal health care;
(ii) a compendium of examples of hospitals,
health systems, freestanding birth centers,
other maternity care provider groups, and
managed care entities that have low levels of
racial and ethnic disparities in maternal
health outcomes; and
(iii) recommendations to hospitals, health
systems, freestanding birth centers, other
maternity care provider groups, and managed
care entities for best practices in culturally
congruent maternity care.
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:
``SEC. 758. PERINATAL WORKFORCE GRANTS.
``(a) In General.--The Secretary may award grants to entities to
establish or expand schools or 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; and
``(B) other perinatal health workers such as
doulas, community health workers, peer supporters,
certified lactation consultants, nutritionists and
dietitians, social workers, home visitors, and
navigators; 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 minority students, particularly from demographic
groups experiencing high rates of maternal mortality and severe
maternal morbidity;
``(2) has developed a strategy to recruit into, and retain,
a diverse pool of students the perinatal workforce program or
school supported by funds received through the grant,
particularly from demographic groups experiencing high rates of
maternal mortality and severe maternal morbidity;
``(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; 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 explicit and implicit bias.
``(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; 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 institutions of higher
education 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 Secretary.--Not later than 4 years after the date
of enactment of this section, the Secretary shall prepare and submit to
the Congress, and post on the internet website of the Department of
Health and Human Services, a report on the effectiveness of the grant
program under this section at--
``(1) recruiting minority students, particularly from
demographic groups experiencing high rates of maternal
mortality and severe maternal morbidity;
``(2) increasing the number of physician assistants who
will complete clinical training in the field of maternal and
perinatal health, and other perinatal health workers, from
demographic groups experiencing high rates of maternal
mortality and severe maternal morbidity;
``(3) increasing the number of physician assistants who
will complete clinical training in the field of maternal and
perinatal health, and other 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 other perinatal health workers, working
in areas with significant racial and ethnic disparities in
maternal health outcomes.
``(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $15,000,000 for each of fiscal
years 2021 through 2025.''.
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 may award grants to schools of
nursing to grow and diversify the perinatal nursing workforce.
``(b) Use of Funds.--Recipients of grants under this section shall
use the grants to grow and diversify the perinatal nursing workforce by
providing scholarships to students seeking to become--
``(1) nurse practitioners whose education 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;
``(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; 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 explicit and implicit bias.
``(d) Reporting.--As a condition on receipt of a grant under this
section, a school of nursing shall agree to submit to the Secretary an
annual report on the 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; 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 explicit and implicit bias.
``(e) Period of Grants.--The period of a grant under this section
shall be up to 5 years.
``(f) Application.--To seek a grant under this 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 Secretary.--Not later than 4 years after the date
of enactment of this section, the Secretary shall prepare and submit to
the Congress, and post on the internet website of the Department of
Health and Human Services, a report on the effectiveness of the grant
program under this section at--
``(1) recruiting minority students, particularly from
demographic groups experiencing high rates of maternal
mortality and severe maternal morbidity;
``(2) increasing the number of nurse practitioners and
clinical nurse specialists entering careers focused on maternal
and perinatal health from demographic groups experiencing high
rates of maternal mortality and severe maternal morbidity;
``(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.
``(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $15,000,000 for each of fiscal
years 2021 through 2025.''.
SEC. 404. GAO REPORT ON BARRIERS TO MATERNITY CARE.
(a) In General.--Not later than 2 years after the date of the
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 maternity care in the United States. Such report shall
include the information and recommendations described in subsection
(b).
(b) Content of Report.--The report under 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 and
minority women;
(2) an assessment of current barriers to entering
accredited education programs for other maternity care
professional careers, including obstetrician-gynecologists,
family physicians, physician assistants, nurse practitioners,
and clinical nurse specialists, particularly for low-income and
minority women;
(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 and
minority women; and
(4) recommendations to promote greater equity in
compensation for perinatal health workers, 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 (as such
term is defined in section 4 of the Indian Health Care
Improvement Act (25 U.S.C. 1603))--
``(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, 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
Indian 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 minority women who
have suffered pregnancy-related deaths;
and
``(II) the impact of the use of
funds made available under subparagraph
(C) on increasing the diversity of the
maternal mortality review committee
membership and promoting community
engagement efforts throughout the State
or Indian 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 Indian 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 2021
through 2025.''.
(b) 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 (as such term is defined in section 4 of the Indian
Health Care Improvement Act (25 U.S.C. 1603))''.
SEC. 502. DATA COLLECTION AND REVIEW.
(a) In General.--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 (IV) and (V), respectively; and
(2) by inserting after subclause (I) the following:
``(II) to the extent practicable,
reviewing cases of severe maternal
morbidity in which the patient received
a transfusion of four or more units of
blood and was admitted to an intensive
care unit;
``(III) to the extent practicable,
consulting with local community-based
organizations representing women 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;''.
(b) Severe Maternal Morbidity Defined.--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), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following:
``(4) the term `severe maternal morbidity' means one or
more unexpected outcomes of labor and delivery that result in
significant short-term or long-term consequences to a woman's
health.''.
SEC. 503. TASK FORCE ON MATERNAL HEALTH DATA AND QUALITY MEASURES.
(a) Establishment.--Not later than 180 days after the date of
enactment of this Act, the Secretary of Health and Human Services shall
establish a task force, to be known as the Task Force on Maternal
Health Data and Quality Measures (in this section referred to as the
``Task Force'').
(b) Duties of Task Force.--
(1) In general.--The Task Force shall use all available
relevant information, including information from State-level
sources, to prepare and submit a report containing the
following:
(A) An evaluation of current State and Tribal
practices for maternal health, maternal mortality, and
severe maternal morbidity data collection and
dissemination, including consideration of--
(i) 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;
(ii) maternal health data collected with
electronic health records, including data on
race and ethnicity;
(iii) the barriers preventing States from
correlating maternal outcome data with race and
ethnicity data;
(iv) processes for determining the cause of
a pregnancy-associated death in States that do
not have a maternal mortality review committee;
(v) 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));
(vi) whether members of maternal mortality
review committees participate in trainings on
bias, racism, or discrimination, and the
quality of such trainings;
(vii) the extent to which States have
implemented systematic processes of listening
to the stories of pregnant and postpartum women
and their family members, with a particular
focus on minority women 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;
(viii) the consideration of social
determinants of health by maternal mortality
review committees when examining the causes of
pregnancy-associated and pregnancy-related
deaths;
(ix) the legal barriers preventing the
collation of State maternity care data;
(x) the effectiveness of data collection
and reporting processes in separating
pregnancy-associated deaths from pregnancy-
related deaths; and
(xi) the current Federal, State, local, and
Tribal funding support for the activities
referred to in clauses (i) through (x).
(B) An assessment of whether the funding referred
to in subparagraph (A)(xi) is adequate for States to
carry out optimal data collection and dissemination
processes with respect to maternal health, maternal
mortality, and severe maternal morbidity.
(C) An evaluation of current quality measures for
maternity care, including prenatal measures, labor and
delivery measures, and postpartum measures up to one
year postpartum. Such evaluation shall be conducted in
consultation with the National Quality Forum and shall
include consideration of--
(i) effective quality measures for
maternity care used by hospitals, health
systems, birth centers, health plans, and other
relevant entities;
(ii) the sufficiency of current outcome
measures used to evaluate maternity care for
testing and validating new maternal health care
payment and service delivery models;
(iii) quality measures for the childbirth
experiences of women that other countries
effectively use;
(iv) current maternity care quality
measures that may be eliminated because they
are not achieving their intended effect;
(v) barriers preventing maternity care
providers from implementing quality measures
that are aligned from best practices;
(vi) the frequency with which maternity
care quality measures are reviewed and revised;
(vii) 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;
(viii) 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. 1397aa et seq.),
including the extent to which States
voluntarily report relevant measures;
(ix) the extent to which maternity care
quality measures are informed by patient
experiences that include subjective measures of
patient-reported experience of care;
(x) the current processes for collecting
stratified data on the race and ethnicity of
pregnant and postpartum women in hospitals,
health systems, and birth centers, and for
incorporating such racially and ethnically
stratified data in maternity care quality
measures;
(xi) the extent to which maternity care
quality measures account for the unique
experiences of minority women and their
families; and
(xii) the extent to which hospitals, health
systems, and birth centers are implementing
existing maternity care quality measures.
(D) Recommendations on authorizing additional funds
to improve maternal mortality review committees and
relevant maternal health initiatives by the agencies
and organizations within the Department of Health and
Human Services.
(E) Recommendations for new authorities that may be
granted to maternal mortality review committees to be
able to--
(i) access records from other Federal and
State agencies and departments that may be
necessary to identify causes of pregnancy-
associated deaths that are unique to women from
specific populations, such as women veterans
and women who are incarcerated; and
(ii) work with relevant experts who are not
members of the maternal mortality review
committee to assist in the review of pregnancy-
associated deaths of women from specific
populations, such as women veterans and women
who are incarcerated.
(F) Recommendations to improve current quality
measures for maternity care, including recommendations
on updating the Pregnancy & Delivery Care measures on
the Hospital Compare website of the Centers for
Medicare & Medicaid Services or any successor website,
with a particular focus on racial and ethnic
disparities in maternal health outcomes.
(G) 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.
(2) Public comment.--Not later than 60 days after the date
on which a majority of the members of the Task Force have been
appointed, the Task Force shall publish in the Federal Register
a notice for a 90-day public comment period, beginning on the
date of publication, on the issues described in paragraph (1).
(c) Membership.--
(1) In general.--The Task Force shall be composed of 18
members appointed by the Secretary of Health and Human
Services. The Secretary shall give special consideration to
individuals who are representative of populations most affected
by maternal mortality and severe maternal morbidity.
(2) Member criteria.--To be eligible to be appointed as a
member of the Task Force, an individual shall be--
(A) a woman who has experienced severe maternal
morbidity;
(B) a family member of a woman who had a pregnancy-
related death;
(C) an individual who provides non-clinical support
to women from pregnancy through the postpartum period,
such as a doula, community health worker, peer
supporter, certified lactation consultant, nutritionist
or dietitian, social worker, home visitor, or a patient
navigator;
(D) a leader of a community-based organization that
addresses adverse maternal health outcomes with a
specific focus on racial and ethnic disparities;
(E) an academic researcher in a field or policy
area related to the duties of the Task Force;
(F) a maternal health care provider;
(G) an elected or duly appointed leader from an
Indian Tribe;
(H) an expert in a field or policy area related to
the duties of the Task Force; or
(I) an individual who has experience with Federal
or State government programs related to the duties of
the Task Force.
(3) Appointment timing.--Appointments to the Task Force
shall be made not later than 180 days after the date of
enactment of this Act.
(4) Duration.--Each member shall be appointed for the life
of the Task Force.
(5) Co-chair selection.--Not later than 30 days after the
date on which a majority of the members of the Task Force have
been appointed, the Secretary shall select two of the members
of the Task Force to serve as Co-Chairs of the Task Force.
(6) Vacancies.--
(A) In general.--A vacancy in the Task Force--
(i) shall not affect the powers of the Task
Force; and
(ii) shall be filled in the same manner as
the original appointment.
(B) Co-chair vacancy.--In the event of a vacancy of
a Co-Chair of the Task Force, a replacement Co-Chair
shall be selected in the same manner as the original
selection.
(7) Compensation.--Except as provided in paragraph (8),
members of the Task Force shall serve without pay.
(8) Travel expenses.--Members of the Task Force shall be
allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of service for the Task Force.
(d) Meetings.--
(1) In general.--The Task Force shall meet at the call of
the Co-Chairs of the Task Force.
(2) Quorum.--A majority of the members of the Task Force
shall constitute a quorum.
(3) Initial meeting.--The Task Force shall meet not later
than 60 days after the date on which a majority of the members
of the Task Force have been appointed.
(e) Staff of Task Force.--
(1) Additional staff.--The Co-Chairs of the Task Force may
appoint and fix the pay of additional staff to the Task Force
as the Co-Chairs consider appropriate.
(2) Applicability of certain civil service laws.--The staff
of the Task Force may be appointed without regard to the
provisions of title 5, United States Code, governing
appointments in the competitive service, and may be paid
without regard to the provisions of chapter 51 and subchapter
III of chapter 53 of that title relating to classification and
General Schedule pay rates.
(3) Detailees.--Any Federal Government employee may be
detailed to the Task Force without reimbursement from the Task
Force, and the detailee shall retain the rights, status, and
privileges of his or her regular employment without
interruption.
(f) Powers of Task Force.--
(1) Testimony and evidence.--The Task Force may take such
testimony and receive such evidence as the Task Force considers
advisable to carry out this section.
(2) Obtaining official data.--The Task Force may secure
directly from any Federal department or agency information
necessary to carry out its duties under this section. On
request of the Co-Chairs of the Task Force, the head of that
department or agency shall furnish such information to the Task
Force.
(3) Postal services.--The Task Force may use the United
States mails in the same manner and under the same conditions
as other Federal departments and agencies.
(g) Report.--Not later than 2 years after the date on which the
initial 18 members of the Task Force are appointed under subsection
(c)(1), the Task Force shall submit to the Committee on Energy and
Commerce, the Committee on Education and Labor, and the Committee on
Ways and Means of the House of Representatives and the Committee on
Finance and the Committee on Health, Education, Labor, and Pensions of
the Senate, and make publicly available, a report that--
(1) contains the information, evaluations, and
recommendations described in subsection (b); and
(2) is signed by more than half of the members of the Task
Force.
(h) Termination.--Section 14 of the Federal Advisory Committee Act
(5 U.S.C. App.) shall not apply to the Task Force.
(i) Definitions.--In this section:
(1) Maternal health care provider.--The term ``maternal
health care provider'' means an individual who is an
obstetrician-gynecologist, family physician, 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.
(2) 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)).
(3) Pregnancy-associated death.--The term ``pregnancy-
associated death'' means a death of a woman, by any cause, that
occurs during, or within 1 year following, her pregnancy,
regardless of the outcome, duration, or site of the pregnancy.
(4) Pregnancy-related death.--The term ``pregnancy-related
death'' means a death of a woman that occurs during, or within
1 year following, her pregnancy, regardless of the outcome,
duration, or site of the pregnancy--
(A) from any cause related to, or aggravated by,
the pregnancy or its management; and
(B) not from accidental or incidental causes.
(j) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section
for fiscal years 2021 through 2024.
SEC. 504. INDIAN HEALTH SERVICE STUDY ON MATERNAL MORTALITY.
(a) In General.--The Director of the Indian Health Service
(referred to in this section as the ``Director'') shall, in
coordination with the individuals described in subsection (b)(1)--
(1) not later than 90 days after the date of enactment of
this Act, offer to enter into a contract with an independent
research organization or Tribal epidemiology center established
under section 214 of the Indian Health Care Improvement Act (25
U.S.C. 1621m) to conduct a comprehensive study on maternal
mortality and severe maternal morbidity in the populations of
American Indian and Alaska Native women; and
(2) not later than 3 years after the date of enactment of
this Act, submit to Congress a report describing the results of
that study that contains recommendations for policies and
practices that can be adopted to improve maternal health
outcomes for those women.
(b) Participating Entities.--
(1) In general.--The individuals referred to in subsection
(a) are 12 individuals, selected by the Director from among
individuals nominated by Indian tribes, tribal organizations,
and urban Indian organizations (as those terms are defined in
section 4 of the Indian Health Care Improvement Act (25 U.S.C.
1603)).
(2) Requirement.--In selecting individuals under paragraph
(1), the Director shall ensure that each of the 12 service
areas of the Indian Health Service is represented.
(c) Contents of Study.--The study conducted pursuant to subsection
(a) shall--
(1) examine the causes of maternal mortality and severe
maternal morbidity that are unique to American Indian and
Alaska Native women;
(2) include a systematic process of listening to the
stories of American Indian and Alaska Native women to fully
understand the causes of, and inform potential solutions to,
the maternal mortality and severe maternal morbidity crisis
within their respective communities;
(3) distinguish between the causes of, landscape of
maternity care at, and recommendations to improve maternal
health outcomes within, the different settings in which
American Indian and Alaska Native women receive maternity care,
such as--
(A) facilities operated by the Indian Health
Service;
(B) an Indian health program operated by an Indian
tribe or tribal organization pursuant to a contract,
grant, cooperative agreement, or compact with the
Indian Health Service pursuant to the Indian Self-
Determination Act (25 U.S.C. 5321 et seq.); and
(C) an urban Indian health program operated by an
urban Indian organization pursuant to a grant 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.);
(4) 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 Children's Health Insurance Program under title
XXI of that Act (42 U.S.C. 1397aa et seq.)), including
coordination with the efforts of the Task Force established
under section 503;
(5) review current data collection and quality measurement
processes and practices;
(6) consider social determinants of health, including
poverty, lack of health insurance, unemployment, sexual
violence, and environmental conditions in Tribal areas;
(7) consider the role that historical mistreatment of
American Indian and Alaska Native women has played in causing
currently high rates of maternal mortality and severe maternal
morbidity;
(8) consider how current funding of the Indian Health
Service affects the ability of the Indian Health Service to
deliver quality maternity care;
(9) consider the extent to which the delivery of maternity
care services is culturally appropriate for American Indian and
Alaska Native women;
(10) make recommendations to reduce misclassification of
American Indian and Alaska Native women, including
consideration of best practices in training for maternal
mortality review committee members to be able to correctly
classify American Indian and Alaska Native women; and
(11) make recommendations informed by the stories shared by
American Indian and Alaska Native women under paragraph (2) to
improve maternal health outcomes for such women.
(d) Report.--The contract entered into under subsection (a)(1) with
an independent research organization or Tribal epidemiology center
established under section 214 of the Indian Health Care Improvement Act
(25 U.S.C. 1621m) shall require that the organization or center submit
to Congress a report on the results of the study conducted pursuant to
that contract not later than 3 years after the date of enactment of
this Act.
(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $2,000,000 for each of fiscal
years 2021 through 2023.
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
minority-serving institutions to study specific aspects of the maternal
health crisis among minority women. Such research may--
(1) include the development and implementation of
systematic processes of listening to the stories of minority
women to fully understand the causes of, and inform potential
solutions to, the maternal mortality and severe maternal
morbidity crisis within their respective communities; and
(2) assess the potential causes of low rates of maternal
mortality among Hispanic women, including potential racial
misclassification and other data collection and reporting
issues that might be misrepresenting maternal mortality rates
among Hispanic women in the United States.
(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 (f)--
(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) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $10,000,000 for each of fiscal
years 2021 through 2025.
(g) Minority-Serving Institutions Defined.--In this section, the
term ``minority-serving institution'' means an eligible institution
described in section 371(a) of the Higher Education Act of 1965 (20
U.S.C. 1067q(a)).
TITLE VI--MOMS MATTER
SEC. 601. INNOVATIVE MODELS TO REDUCE MATERNAL MORTALITY.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by adding at the end the following new part:
``PART W--INNOVATIVE MODELS TO REDUCE MATERNAL MORTALITY AND SEVERE
MATERNAL MORBIDITY
``SEC. 399OO. DEFINITIONS.
``In this part:
``(1) The terms `postpartum' and `postpartum period' refer
to the 1-year period beginning on the last day of the
pregnancy.
``(2) The term `Secretary' means the Secretary of Health
and Human Services.
``(3) The term `Task Force' means the Maternal Mental and
Behavioral Health Task Force established pursuant to section
399OO-1.
``(4) The term `behavioral health' includes substance use
disorder and other behavioral health conditions.
``SEC. 399OO-1. MATERNAL MENTAL AND BEHAVIORAL HEALTH TASK FORCE.
``(a) Establishment.--The Secretary shall establish a task force,
to be known as the Maternal Mental and Behavioral Health Task Force, to
improve maternal mental and behavioral health outcomes with a
particular focus on outcomes for minority women.
``(b) Membership.--
``(1) Composition.--The Task Force shall be composed of no
fewer than 20 members, to be appointed by the Secretary.
``(2) Co-chairs.--The Secretary shall designate 2 members
of the Task Force to serve as the Co-Chairs of the Task Force.
``(3) Members.--The Task Force shall include the following:
``(A) Maternal mental and behavioral health care
specialists, maternity care providers, and researchers,
government officials, and policy experts who specialize
in women's health, maternal mental and behavioral
health, maternal substance use disorder, or maternal
mortality and severe maternal morbidity. In selecting
such members of the Task Force, the Secretary shall
give special consideration to individuals from diverse
racial and ethnic backgrounds or individuals with
experience providing culturally congruent maternity
care in diverse communities.
``(B) One or more individuals who have suffered
from a diagnosed mental or behavioral health condition
during the prenatal or postpartum period, or a spouse
or family member of such individual.
``(C) One or more representatives of a community-
based organization that addresses adverse maternal
health outcomes with a specific focus on racial and
ethnic disparities in maternal health outcomes. In
selecting such representatives, the Secretary shall
give special consideration to organizations from
communities with significant minority populations.
``(D) One or more perinatal health workers who
provide non-clinical support to pregnant and postpartum
women, such as a doula, community health worker, peer
supporter, certified lactation consultant, nutritionist
or dietitian, social worker, home visitor, or
navigator. In selecting such perinatal health workers,
the Secretary shall give special consideration to
individuals with experience working in communities with
significant minority populations.
``(E) One or more representatives of relevant
patient advocacy organizations, with a particular focus
on organizations that address racial and ethnic
disparities in maternal health outcomes.
``(F) One or more representatives of relevant
health care provider organizations, with a particular
focus on organizations that address racial and ethnic
disparities in maternal health outcomes.
``(G) One or more leaders of a Federally-qualified
health center or rural health clinic (as such terms are
defined in section 1861 of the Social Security Act).
``(H) One or more representatives of health
insurers.
``(4) Timing of appointments.--Not later than 180 days
after the date of enactment of this part, the Secretary shall
appoint all members of the Task Force.
``(5) Period of appointment; vacancies.--
``(A) In general.--Each member of the Task Force
shall be appointed for the life of the Task Force.
``(B) Vacancies.--Any vacancy in the Task Force--
``(i) shall not affect the powers of the
Task Force; and
``(ii) shall be filled in the same manner
as the original appointment.
``(6) No pay.--Members of the Task Force (other than
officers or employees of the United States) shall serve without
pay. Members of the Task Force who are full-time officers or
employees of the United States may not receive additional pay,
allowances, or benefits by reason of their service on the Task
Force.
``(7) Travel expenses.--Members of the Task Force may be
allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of services for the Task Force.
``(c) Staff.--The Co-Chairs of the Task Force may appoint and fix
the pay of staff to the Task Force.
``(d) Detailees.--Any Federal Government employee may be detailed
to the Task Force without reimbursement from the Task Force, and the
detailee shall retain the rights, status, and privileges of his or her
regular employment without interruption.
``(e) Meetings.--
``(1) In general.--Subject to paragraph (2), the Task Force
shall meet at the call of the Co-Chairs of the Task Force.
``(2) Initial meeting.--The Task Force shall meet not later
than 30 days after the date on which all members of the Task
Force have been appointed.
``(3) Quorum.--A majority of the members of the Task Force
shall constitute a quorum.
``(f) Information From Federal Agencies.--
``(1) In general.--The Task Force may secure directly from
any Federal department or agency such information as may be
relevant to carrying out this part.
``(2) Furnishing information.--On request of the Co-Chairs
of the Task Force pursuant to paragraph (1), the head of a
Federal department or agency shall, not later than 60 days
after the date of receiving such request, furnish to the Task
Force the information so requested.
``(g) Termination.--Termination under section 14 of the Federal
Advisory Committee Act (5 U.S.C. App.) shall not apply to the Task
Force.
``(h) Duties.--
``(1) National strategy.--The Task Force shall make
recommendations for a national strategy to improve maternal
mental and behavioral health outcomes with a particular focus
on outcomes for minority women. Such strategy shall--
``(A) define collaborative maternity care;
``(B) make recommendations to the Secretary and the
Assistant Secretary for Mental Health and Substance Use
on how to implement collaborative maternity care models
to improve maternal mental and behavioral health with a
particular focus on such outcomes for minority women;
``(C) identify barriers to the implementation of
collaborative maternity care models to improve maternal
mental and behavioral health with a particular focus on
such outcomes for minority women, and make
recommendations to address such barriers;
``(D) take into consideration as models existing
State and other programs that have demonstrated
effectiveness in improving maternal mental and
behavioral health during the prenatal and postpartum
periods;
``(E) promote treatment options and reduce stigma
for pregnant and postpartum women with a substance use
disorder;
``(F) assess the extent to which insurers are
providing coverage for evidence-based mental and
behavioral health screenings and services that adhere
to existing prenatal and postpartum guidelines;
``(G) assess the extent to which existing
guidelines and processes are culturally congruent for
minority women, specifically--
``(i) guidelines for identifying maternal
mental and behavioral health conditions,
including substance use disorders;
``(ii) guidelines for screening and, as
needed, follow-up referrals, evaluations, and
treatments after positive screens for--
``(I) depression;
``(II) anxiety;
``(III) trauma;
``(IV) substance use disorders; and
``(V) other mental or behavioral
health conditions at the discretion of
the Task Force;
``(iii) processes for incorporating mental
and behavioral health screenings into the
current timeline of standard screening
practices for pregnant and postpartum women,
with distinctions for postpartum screening
timelines for uncomplicated and complicated
births; and
``(iv) processes for referring women with
positive screens for substance use disorder to
addiction treatment centers offering--
``(I) on-site wraparound treatment
or networks for referrals;
``(II) multidisciplinary staff;
``(III) psychotherapy;
``(IV) contingency management;
``(V) access to all evidence-based
medication-assisted treatment; and
``(VI) evidence-based recovery
supports;
``(H) propose to the Secretary a multilingual
public awareness campaign for maternal mental health
and substance use disorder, with a particular focus on
minority women, that includes information on--
``(i) symptoms, triggers, risk factors, and
treatment options for maternal mental and
behavioral health conditions;
``(ii) using the website developed under
paragraph (3);
``(iii) the physiological process of
recovery after birth;
``(iv) the frequency of occurrences for
common conditions such as postpartum
hemorrhage, preeclampsia and eclampsia,
infection, and thromboembolism;
``(v) best practices in patient reporting
of health concerns to their maternity care
providers in the prenatal and postpartum
periods;
``(vi) addressing stigma around maternal
mental and behavioral health conditions;
``(vii) how to seek treatment for substance
use disorder during pregnancy and in the
postpartum period; and
``(viii) infant feeding options; and
``(I) disseminate to all State Medicaid programs
under title XIX of the Social Security Act and State
child health plans under the State Children's Health
Insurance Program under title XXI of the Social
Security Act an assessment of the extent to which
States are providing coverage of evidence-based
prenatal and postpartum mental and behavioral health
screenings through such programs and plans, and an
assessment of the benefits of such coverage.
``(2) Grant programs.--The Task Force shall evaluate and
advise on the grant programs under section 399OO-2.
``(3) Centralized website.--The Task Force shall facilitate
a coordinated effort between the Substance Abuse and Mental
Health Services Administration and State departments of health
to develop, either directly or through a contract, a
centralized website with information on finding local mental
and behavioral health providers who treat prenatal and
postpartum mental and behavioral health conditions, including
substance use disorder.
``(4) Report.--Not later than 18 months after the date of
enactment of the Black Maternal Health Momnibus Act of 2020,
and every year thereafter, the Task Force shall submit to the
Congress, the Centers for Medicare & Medicaid Services, and the
Center for Medicare and Medicaid Innovation, and make publicly
available, a report that--
``(A) describes the activities of the Task Force
and the results of such activities, with data in such
results stratified racially, ethnically, and
geographically; and
``(B) includes the strategy developed under
paragraph (1).
``(i) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for fiscal years 2021 through 2025.
``SEC. 399OO-2. INNOVATION IN MATERNITY CARE TO CLOSE RACIAL AND ETHNIC
MATERNAL HEALTH DISPARITIES GRANTS.
``(a) In General.--The Secretary shall award grants to eligible
entities to establish, implement, evaluate, or expand innovative models
in maternity care that are designed to reduce racial and ethnic
disparities in maternal health outcomes.
``(b) Use of Funds.--An eligible entity receiving a grant under
this section may use the grant to establish, implement, evaluate, or
expand innovative models described in subsection (a) including--
``(1) collaborative maternity care models to improve
maternal mental health, treat maternal substance use disorders,
and reduce maternal mortality and severe maternal morbidity,
especially for minority women, consistent with the national
strategy developed by the Task Force under section 399OO-
1(h)(1) and other recommendations of the Task Force;
``(2) evidence-based programming at clinics that--
``(A) provide wraparound services for women with
substance use disorders in the prenatal and postpartum
periods that may include multidisciplinary staff,
access to all evidence-based medication-assisted
treatment, psychotherapy, contingency management, and
recovery supports; or
``(B) make referrals for any such services that are
not provided within the clinic;
``(3) evidence-based programs at freestanding birth centers
that provide culturally congruent maternal mental and
behavioral health care education, treatments, and services, and
other wraparound supports for women throughout the prenatal and
postpartum period; and
``(4) the development and implementation of evidence-based
programs, including toll-free telephone hotlines, that connect
maternity care providers with women's mental health clinicians
to provide maternity care providers with guidance on addressing
maternal mental and behavioral health conditions identified in
patients.
``(c) Special Consideration.--In awarding grants under this
section, the Secretary shall give special consideration to applications
for models that will--
``(1) operate in--
``(A) areas with high rates of adverse maternal
health outcomes;
``(B) areas with significant racial and ethnic
disparities in maternal health outcomes; or
``(C) health professional shortage areas designated
under section 332;
``(2) be led by minority women from demographic groups with
disproportionate rates of adverse maternal health outcomes; or
``(3) be implemented with a culturally congruent approach
that is focused on improving outcomes for demographic groups
experiencing disproportionate rates of adverse maternal health
outcomes.
``(d) Evaluation.--As a condition on receipt of a grant under this
section, an eligible entity shall agree to provide annual evaluations
of the activities funded through the grant to the Secretary and the
Task Force. Such evaluations may address--
``(1) the effects of such activities on maternal health
outcomes and subjective assessments of patient and family
experiences, especially for minority women from demographic
groups with disproportionate rates of adverse maternal health
outcomes; and
``(2) the cost-effectiveness of such activities.
``(e) Definitions.--In this section:
``(1) The term `eligible entity' means any public or
private entity.
``(2) The term `collaborative maternity care' means an
integrated care model that includes the delivery of maternal
mental and behavioral health care services in primary clinics
or other care settings familiar to pregnant and postpartum
patients.
``(3) The term `culturally congruent' means care that is in
agreement with the preferred cultural values, beliefs,
worldview, language, and practices of the health care consumer
and other stakeholders.
``(4) The term `freestanding birth center' has the meaning
given that term under section 1905(l)(3)(A) of the Social
Security Act.
``(f) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $15,000,000 for each of fiscal
years 2021 through 2025.
``SEC. 399OO-3. GROUP PRENATAL AND POSTPARTUM CARE MODELS.
``(a) In General.--The Secretary shall award grants to eligible
entities to establish, implement, evaluate, or expand culturally
congruent group prenatal care models or group postpartum care models
that are designed to reduce racial and ethnic disparities in maternal
and infant health outcomes.
``(b) Use of Funds.--An eligible entity receiving a grant under
this section may use the grant for--
``(1) programming;
``(2) capital investments required to improve existing
physical infrastructure for group prenatal care and group
postpartum care programming, such as building space needed to
implement such models; and
``(3) evaluations of group prenatal care and group
postpartum care programming, with a particular focus on the
impacts of such programming on minority women.
``(c) Special Consideration.--In awarding grants under this
section, the Secretary shall give special consideration to applicants
that will--
``(1) operate in--
``(A) areas with high rates of adverse maternal
health outcomes;
``(B) areas with significant racial and ethnic
disparities in maternal health outcomes; or
``(C) health professional shortage areas designated
under section 332;
``(2) be led by minority women from demographic groups with
disproportionate rates of adverse maternal health outcomes; or
``(3) be implemented with a culturally congruent approach
that is focused on improving outcomes for demographic groups
experiencing disproportionate rates of adverse maternal health
outcomes.
``(d) Evaluation.--As a condition on receipt of a grant under this
section, an eligible entity shall agree to provide annual evaluations
of the activities funded through the grant to the Secretary and the
Task Force and address in each such evaluation--
``(1) the effects of such activities on maternal health
outcomes with a particular focus on the effects of such
activities on minority women, including measures such as--
``(A) avoidable emergency room visits;
``(B) postpartum care visits after delivery;
``(C) rates of preterm birth;
``(D) rates of breastfeeding initiation;
``(E) psychological outcomes; and
``(F) subjective measures of patient-reported
experience of care; and
``(2) the cost-effectiveness of such activities.
``(e) Definitions.--In this section:
``(1) The term `eligible entity' means any public or
private entity.
``(2) The term `culturally congruent' means care that is in
agreement with the preferred cultural values, beliefs,
worldview, language, and practices of the health care consumer
and other stakeholders.
``(f) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $10,000,000 for each of fiscal
years 2021 through 2025.''.
TITLE VII--JUSTICE FOR INCARCERATED MOMS
SEC. 701. SENSE OF CONGRESS.
It is the sense of Congress that the respect and proper care that
mothers deserve are inclusive, and whether the mothers are transgender,
cisgender, or gender nonconforming, all deserve dignity.
SEC. 702. 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 in each fiscal year thereafter, the
total amount of a grant to be allocated to a State for a fiscal year
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'') shall be
decreased by 25 percent if the State does not have in effect for such
fiscal year laws restricting, throughout the State, 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.
(b) Reallocation.--Amounts not allocated to a State because of a
decrease under 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 are not
subject to the decrease under subsection (a).
SEC. 703. 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 more than 6 Bureau of
Prisons facilities, programs to optimize maternal health outcomes for
pregnant and postpartum individuals incarcerated in such facilities.
(b) Consultation.--The Attorney General shall establish the
programs required under subsection (a) in consultation with interested
entities 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 minority women;
(2) relevant organizations representing patients, with a
particular focus on minority patients;
(3) relevant organizations representing maternal health
care providers;
(4) nonclinical perinatal health workers such as doulas,
community health workers, peer supporters, certified lactation
consultants, nutritionists and dietitians, social workers, home
visitors, and navigators; and
(5) researchers and policy experts in fields related to
women's health care for incarcerated individuals.
(c) Start Date.--Each facility selected by the Director of the
Bureau of Prisons under subsection (a) shall begin facility programs
not later than 18 months after the date of enactment of this Act.
(d) Facility Priority.--In carrying out subsection (a), the
Director of the Bureau of Prisons 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 minority individuals; 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.
(e) Program Duration.--Each program established under this section
shall be for a 5-year period.
(f) Programs.--Each Bureau of Prisons facility selected under
subsection (a) shall establish programs for pregnant and postpartum
incarcerated individuals, and such programs may--
(1) provide access to doulas and other 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 and medical personnel to
ensure that pregnant incarcerated individuals receive trauma-
informed, culturally congruent care that promotes the health
and safety of the pregnant individuals;
(4) provide counseling and treatment for individuals who
have suffered from--
(A) diagnosed mental or behavioral health
conditions, including trauma and substance use
disorders;
(B) domestic violence;
(C) human immunodeficiency virus;
(D) sexual abuse;
(E) pregnancy or infant loss; or
(F) chronic conditions, including heart disease,
diabetes, osteoporosis and osteopenia, hypertension,
asthma, liver disease, and bleeding disorders;
(5) provide pregnancy and childbirth education, parenting
support, and other relevant forms of health literacy;
(6) 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;
(7) provide reentry assistance, particularly to--
(A) ensure continuity of health insurance coverage
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 and social services that
address social determinants of health like housing,
employment opportunities, transportation, and
nutrition; or
(8) 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. Such programs may include--
(A) 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.
(g) Implementation and Reporting.--Each Bureau of Prisons facility
selected under subsection (a) shall be responsible for--
(1) implementing programs, which may include the programs
described in subsection (f); 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 of the Bureau
of Prisons, including information describing--
(A) relevant quantitative indicators of success in
improving the standard of care and health outcomes for
pregnant and postpartum incarcerated individuals who
participated in such programs, including data
stratified by race, ethnicity, sex, 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, 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 evaluations from pregnant
and postpartum incarcerated individuals who
participated in such programs, including subjective
measures of patient-reported experience of care;
(C) evaluations of cost effectiveness; and
(D) strategies to sustain such programs beyond
2026.
(h) Report.--Not later than 7 years after the date of enactment of
this Act, the Director of the Bureau of Prisons shall submit to the
Attorney General and to the Committee on the Judiciary of the House of
Representatives and the Committee on the Judiciary of the Senate a
report describing the results of the programs funded under this
section.
(i) 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 (f).
(j) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $10,000,000 for each of fiscal
years 2021 through 2025.
SEC. 704. 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.
(b) Consultation.--The Attorney General shall award the grants
authorized under subsection (a) in consultation with interested
entities 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 minority women;
(2) relevant organizations representing patients, with a
particular focus on minority patients;
(3) relevant organizations representing maternal health
care providers;
(4) nonclinical perinatal health workers such as doulas,
community health workers, peer supporters, certified lactation
consultants, nutritionists and dietitians, social workers, home
visitors, and navigators; and
(5) researchers and policy experts in fields related to
women's health care for incarcerated individuals.
(c) 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.
(d) 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 doulas and other 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 and medical personnel to
ensure that pregnant incarcerated individuals receive trauma-
informed, culturally congruent care that promotes the health
and safety of the pregnant individuals;
(4) provide counseling and treatment for individuals who
have suffered from--
(A) diagnosed mental or behavioral health
conditions, including trauma and substance use
disorders;
(B) domestic violence;
(C) human immunodeficiency virus;
(D) sexual abuse;
(E) pregnancy or infant loss; or
(F) chronic conditions, including heart disease,
diabetes, osteoporosis and osteopenia, hypertension,
asthma, liver disease, and bleeding disorders;
(5) provide pregnancy and childbirth education, parenting
support, and other relevant forms of health literacy;
(6) 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;
(7) provide reentry assistance, particularly to--
(A) ensure continuity of health insurance coverage
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 and social services that
address social determinants of health like housing,
employment opportunities, transportation, and
nutrition; or
(8) 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. Such programs may include--
(A) 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.
(e) 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 minority individuals; 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.
(f) Grant Duration.--A grant awarded under this section shall be
for a 5-year period.
(g) 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 who participated in such
program, including data stratified by race, ethnicity,
sex, 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, 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 evaluations from pregnant
and postpartum incarcerated individuals who
participated in such programs, including subjective
measures of patient-reported experience of care;
(C) evaluations of cost effectiveness; and
(D) strategies to sustain such programs beyond the
duration of the grant.
(h) Report.--Not later than 7 years after the date of enactment of
this Act, the Attorney General shall submit to the Committee on the
Judiciary of the House of Representatives and the Committee on the
Judiciary of the Senate a report describing the results of the grant
program authorized under this section.
(i) 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 (d).
(j) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $10,000,000 for each of fiscal
years 2021 through 2025.
SEC. 705. 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 health outcomes among
incarcerated individuals, with a particular focus on racial and ethnic
disparities in maternal health outcomes for incarcerated individuals.
(b) Contents of Report.--The report required under subsection (a)
shall include--
(1) to the extent practicable--
(A) the number of incarcerated individuals,
including those incarcerated in Federal, State, and
local correctional facilities, who have experienced a
pregnancy-related death or pregnancy-associated death
in the most recent 10 years of available data;
(B) 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 year of
available data; and
(C) 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 to 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
of color;
(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. 706. 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.).
(b) Contents of Report.--The report described in this section shall
include--
(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 of color; 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.
TITLE VIII--TECH TO SAVE MOMS
SEC. 801. CMI MODELING OF 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 new clauses:
``(xxviii) Focusing on title XIX, providing
for the adoption of and use of telehealth tools
that allow for screening and treatment of
common pregnancy-related complications
(including anxiety and depression, substance
use disorder, hemorrhage, infection, amniotic
fluid embolism, thrombotic pulmonary or other
embolism, hypertensive disorders of pregnancy,
cerebrovascular accidents, cardiomyopathy, and
other cardiovascular conditions) for a pregnant
woman receiving medical assistance under such
title during her pregnancy and for not more
than a 1-year period beginning on the last day
of her pregnancy.''.
(b) Effective Date.--The amendment made by subsection (a) shall
take effect 1 year after the date of the enactment of this Act.
SEC. 802. GRANTS TO EXPAND THE USE OF TECHNOLOGY-ENABLED COLLABORATIVE
LEARNING AND CAPACITY MODELS THAT PROVIDE CARE TO
PREGNANT AND POSTPARTUM WOMEN.
Title III of the Public Health Service Act is amended by inserting
after section 330M (42 U.S.C. 254c-19) the following:
``SEC. 330N. EXPANDING CAPACITY FOR MATERNAL HEALTH OUTCOMES.
``(a) Program Established.--Beginning not later than 1 year after
the date of enactment of this Act, the Secretary shall, as appropriate,
award grants to eligible entities to evaluate, develop, and expand the
use of technology-enabled collaborative learning and capacity building
models, to improve maternal health outcomes--
``(1) in health professional shortage areas;
``(2) in areas with high rates of maternal mortality and
severe maternal morbidity, and significant racial and ethnic
disparities in maternal health outcomes; and
``(3) for medically underserved populations or American
Indians and Alaska Natives, including Indian tribes, tribal
organizations, and urban Indian organizations.
``(b) Use of Funds.--
``(1) Required uses.--Grants awarded under subsection (a)
shall be used for--
``(A) the development and acquisition of
instructional programming, and the training of maternal
health care providers and other professionals that
provide or assist in the provision of services, through
models such as--
``(i) training on adopting and effectively
implementing Alliance for Innovation on
Maternal Health (referred to in this section as
`AIM') safety and quality improvement bundles;
``(ii) training on implicit and explicit
bias, racism, and discrimination for providers
of maternity care;
``(iii) training on best practices in
screening for and, as needed, evaluating and
treating maternal mental health conditions and
substance use disorders;
``(iv) training on how to screen for social
determinants of health risks in the prenatal
and postpartum periods such as inadequate
housing, lack of access to nutrition,
environmental risks, and transportation
barriers; and
``(v) training on the use of remote patient
monitoring tools for pregnancy-related
complications;
``(B) information collection and evaluation
activities to--
``(i) study the impact of such models on--
``(I) access to and quality of
care;
``(II) patient outcomes;
``(III) subjective measures of
patient experience; and
``(IV) cost-effectiveness; and
``(ii) identify best practices for the
expansion and use of such models;
``(C) information collection and evaluation
activities to study the impact of such models on
patient outcomes and maternal health care providers,
and to identify best practices for the expansion and
use of such models; and
``(D) any other activity consistent with achieving
the objectives of grants awarded under this section, as
determined by the Secretary.
``(2) Permissible uses.--In addition to any of the uses
under paragraph (1), grants awarded under subsection (a) may be
used for--
``(A) equipment to support the use and expansion of
technology-enabled collaborative learning and capacity
building models, including for hardware and software
that enables distance learning, maternal health care
provider support, and the secure exchange of electronic
health information; and
``(B) support for maternal health care providers
and other professionals that provide or assist in the
provision of maternity care services through such
models.
``(c) Limitations.--
``(1) Number.--The Secretary may not award more than 1
grant under this section to an eligible entity.
``(2) Duration.--Each grant under this section shall be
made for a period of up to 5 years.
``(3) Amount.--The Secretary shall determine the maximum
amount of each grant under this section.
``(d) Grant Requirements.--
``(1) In general.--The Secretary shall require entities
awarded a grant under this section to collect information on
the effect of the use of technology-enabled collaborative
learning and capacity building models, such as on maternal
health outcomes, access to maternal health care services,
quality of maternal health care, and maternal health care
provider retention in areas and for populations described in
subsection (a).
``(2) Coordination support.--The Secretary may award a
grant or contract to assist in the coordination of models
described in paragraph (1), including to assess outcomes
associated with the use of such models in grants awarded under
subsection (a), including grants awarded for the purpose
described in subsection (b)(1)(B).
``(e) Application.--
``(1) In general.--An eligible entity that seeks to receive
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) Matters to be included.--Such application shall
include plans to assess the effect of technology-enabled
collaborative learning and capacity building models on
indicators, including access to and quality of care, patient
outcomes, subjective measures of patient experience, and cost-
effectiveness. Such indicators may focus on--
``(A) health professional shortage areas;
``(B) areas with high rates of maternal mortality
and severe maternal morbidity, and significant racial
and ethnic disparities in maternal health outcomes; and
``(C) medically underserved populations or American
Indians and Alaska Natives, including Indian tribes,
tribal organizations, and urban Indian organizations.
``(f) 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.
``(g) Technical Assistance.--The Secretary shall provide (either
directly through the Department of Health and Human Services or by
contract) technical assistance to eligible entities, including
recipients of grants under subsection (a), on the development, use, and
post-grant sustainability of technology-enabled collaborative learning
and capacity building models in order to expand access to maternal
health care services provided by such entities, including--
``(1) for health professional shortage areas;
``(2) for areas with high rates of maternal mortality and
severe maternal morbidity, and significant racial and ethnic
disparities in maternal health outcomes; and
``(3) to medically underserved populations or American
Indians and Alaska Natives, including Indian tribes, tribal
organizations, and urban Indian organizations.
``(h) Research and Evaluation.--The Secretary, in consultation with
stakeholders with appropriate expertise in such models, shall develop a
strategic plan to research and evaluate the evidence for such models.
The Secretary shall use such plan to inform the activities carried out
under this section.
``(i) Reporting.--
``(1) By 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) By the secretary.--Not later than 4 years after the
date of enactment of this section, the Secretary shall prepare
and submit to the Congress, and post on the internet website of
the Department of Health and Human Services, a report
including, at minimum--
``(A) a description of any new and continuing
grants awarded under subsection (a) and the specific
purpose and amounts of such grants;
``(B) an overview of--
``(i) the evaluation activities conducted
under subsection (b)(1)(B)(i);
``(ii) technical assistance provided under
subsection (g); and
``(iii) activities conducted by entities
awarded grants under subsection (a); and
``(C) a description of any significant findings
related to patient outcomes or maternal health care
providers and best practices for eligible entities
expanding, using, or evaluating technology-enabled
collaborative learning and capacity building models.
``(j) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $6,000,000 for each of fiscal
years 2021 through 2025.
``(k) 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 women--
``(i) in health professional shortage
areas;
``(ii) in areas with high rates of adverse
maternal health outcomes and significant racial
and ethnic disparities in maternal health
outcomes; or
``(iii) from medically underserved
populations or American Indians and Alaska
Natives, including Indian tribes, tribal
organizations, and urban Indian organizations.
``(B) Inclusions.--An eligible entity may include
entities leading, or capable of leading, a technology-
enabled collaborative learning and capacity building
model or engaging in technology-enabled collaborative
training of participants in such 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 (25 U.S.C. 5304).
``(4) Maternal mortality.--The term `maternal mortality'
means a death occurring during or within 1-year period after
pregnancy caused 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 the pregnancy of a woman.
``(7) Severe maternal morbidity.--The term `severe maternal
morbidity' means an unexpected outcome caused by labor and
delivery of a woman that results in significant short-term or
long-term consequences to the health of the woman.
``(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 particularly specialists, with multiple
other health care professionals 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 (25 U.S.C.
5304).
``(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 (25 U.S.C. 1603).''.
SEC. 803. GRANTS TO PROMOTE EQUITY IN MATERNAL HEALTH OUTCOMES BY
INCREASING ACCESS TO 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 carry out a program, to be known as the ``Investments in Digital
Tools to Promote Equity in Maternal Health Outcomes Program'', under
which the Secretary makes 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) Limitations.--
(1) Number.--The Secretary may not award more than 1 grant
under this section to an eligible entity.
(2) Duration.--Each grant under this section shall be made
for a period of not more than 5 years.
(3) Amount.--The Secretary shall determine the maximum
amount of each grant under this section.
(4) Prioritization.--In awarding grants under this section,
the Secretary shall prioritize the selection of an eligible
entity that--
(A) operates in an area with high rates of adverse
maternal health outcomes and significant racial and
ethnic disparities in maternal health outcomes; and
(B) promotes technology that addresses racial and
ethnic disparities in maternal health outcomes.
(d) 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.
(e) Reporting.--
(1) By 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) By the secretary.--Not later than 4 years after the
date of the enactment of this Act, the Secretary shall submit
to Congress a report that--
(A) evaluates the effectiveness of grants awarded
under this section in improving maternal health
outcomes for minority women;
(B) makes recommendations for future grant programs
that promote the use of technology to improve maternal
health outcomes for minority women; and
(C) makes recommendations that address--
(i) privacy and security safeguards that
should be implemented in the use of technology
in maternal health care;
(ii) reimbursement rates for maternal
telehealth services;
(iii) the use of digital tools to analyze
large data sets for the purposes of identifying
potential pregnancy-related complications as
early as possible;
(iv) barriers that prevent maternal health
care providers from providing telehealth
services across States and recommendations from
the Centers for Medicare & Medicaid Services
for addressing such barriers in State Medicaid
programs;
(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 consumers from
accessing telehealth services or other digital
technologies to improve maternal health
outcomes, including a lack of access to
reliable, high-speed internet or lack of access
to electronic devices needed to use such
services and technologies; and
(vii) any other related issues as
determined by the Secretary.
(f) Eligible Entity Defined.--In this section, the term ``eligible
entity'' is an entity that is described in section 51a.3(a) of title
42, Code of Federal Regulations or any successor regulation, including
domestic faith-based and community-based organizations.
(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $6,000,000 for each of fiscal
years 2021 through 2025.
SEC. 804. REPORT ON THE USE OF TECHNOLOGY TO REDUCE MATERNAL MORTALITY
AND SEVERE MATERNAL MORBIDITY AND TO CLOSE RACIAL AND
ETHNIC DISPARITIES IN OUTCOMES.
(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 section as the
``National Academies'') under which the National Academies shall
conduct a study on the use of technology to reduce preventable maternal
mortality and severe maternal morbidity, and close racial and ethnic
disparities in maternal health outcomes in the United States. The study
shall assess current and future uses of artificial intelligence in
maternity care, including issues such as--
(1) the extent to which artificial intelligence
technologies are currently being used in maternal health care;
(2) the extent to which artificial intelligence
technologies have exacerbated racial or ethnic biases in
maternal health care;
(3) recommendations for reducing racial or ethnic biases in
artificial intelligence technologies used in maternal health
care;
(4) recommendations for potential applications of
artificial intelligence technologies that could improve
maternal health outcomes, particularly for minority women; and
(5) recommendations for privacy and security safeguards
that should be implemented in the development of artificial
intelligence technologies in maternal health care.
(b) Report.--As a condition of any agreement under subsection (a),
the Administrator shall require that the National Academies transmit to
Congress a report on the results of the study under subsection (a) not
later than 24 months 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 women 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) relevant organizations representing maternal health
care providers;
(3) relevant organizations representing patients, with a
particular focus on women from demographic groups with
disproportionate rates of adverse maternal health outcomes;
(4) relevant community-based organizations, particularly
organizations that seek to improve maternal health outcomes for
women from demographic groups with disproportionate rates of
adverse maternal health outcomes;
(5) non-clinical perinatal health workers such as doulas,
community health workers, peer supporters, certified lactation
consultants, nutritionists and dieticians, social workers, home
visitors, and navigators;
(6) relevant health insurance issuers;
(7) hospitals, health systems, 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
demographic groups with disproportionate rates of adverse
maternal health outcomes.
(c) Considerations.--In establishing the Demonstration Project, the
Secretary shall consider each of the following:
(1) Findings from any evaluations of the Strong Start for
Mothers and Newborns initiative carried out by the Centers for
Medicare & Medicaid Services, the Health Resources and Services
Administration, and the Administration on Children and
Families.
(2) Any alternative payment model that--
(A) is designed to improve maternal health outcomes
for racial and ethnic groups with disproportionate
rates of adverse maternal health outcomes;
(B) includes methods for stratifying patients by
pregnancy risk level and, as appropriate, adjusting
payments under such model to take into account
pregnancy risk level;
(C) establishes evidence-based quality metrics for
such payments;
(D) includes consideration of non-hospital birth
settings such as freestanding birth centers (as so
defined);
(E) includes consideration of social determinants
of health that are relevant to maternal health outcomes
such as housing, transportation, nutrition, and other
non-clinical factors that influence maternal health
outcomes; or
(F) includes diverse maternity care teams that
include--
(i) maternity care providers, including
obstetrician-gynecologists, family physicians,
physician assistants, midwives who meet, at a
minimum, the international definition of the
term ``midwife'' and global standards for
midwifery education (as established by the
International Confederation of Midwives), and
nurse practitioners--
(I) from racially, ethnically, and
professionally diverse backgrounds;
(II) with experience practicing in
racially and ethnically diverse
communities; or
(III) who have undergone trainings
on racism, implicit bias, and explicit
bias; and
(ii) non-clinical perinatal health workers
such as doulas, community health workers, peer
supporters, certified lactation consultants,
nutritionists and dieticians, social workers,
home visitors, and navigators.
(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, subjective 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 Committee on Energy and Commerce, the Committee on Ways
and Means, and the Committee on Education and Labor of the House of
Representatives and the Committee on Finance and the Committee on
Health, Education, Labor, and Pensions of the Senate, 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 a woman becomes pregnant and ending on the
last day of the 1-year period beginning on the last day of such
woman's pregnancy.
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 women. 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 women 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 women,
including such women 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 women 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
women.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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