[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6318 Introduced in House (IH)]
111th CONGRESS
2d Session
H. R. 6318
To amend the Public Health Service Act to ensure a national,
coordinated approach to improving maternal and infant health.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 29, 2010
Mrs. Capps (for herself, Ms. Roybal-Allard, and Mr. Murphy of
Connecticut) introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to ensure a national,
coordinated approach to improving maternal and infant health.
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 ``Maternity Care Improvement Act of
2010''.
SEC. 2. TABLE OF CONTENTS.
The table of contents of this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--ENHANCED REPORTING, RESEARCH, AND EVALUATION
Sec. 101. National registry of maternal and infant health data.
TITLE II--STRENGTHENING THE MATERNITY CARE WORKFORCE
Sec. 201. Maternal and infant health workforce education and training.
Sec. 202. Report on creation of a uniform maternity care core
curriculum.
Sec. 203. Demonstration projects to promote use of core curriculum and
interdisciplinary team teaching in
maternity care health professions
education.
Sec. 204. Report on maternity care workforce.
Sec. 205. Allocation of funds for maternity care workforce development.
TITLE III--ADDRESSING MATERNAL HEALTH DISPARITIES
Sec. 301. CDC Centers for Research and Demonstration of Health
Promotion and Disease Prevention.
Sec. 302. Grants to support a diversified maternity care workforce.
TITLE IV--COORDINATION OF MATERNITY CARE
Sec. 401. Maternal health coordinator.
TITLE I--ENHANCED REPORTING, RESEARCH, AND EVALUATION
SEC. 101. NATIONAL REGISTRY OF MATERNAL AND INFANT HEALTH DATA.
Title III of the Public Health Service Act is amended by inserting
after section 317L of such Act (42 U.S.C. 247b-13) the following:
``SEC. 317L-1. IMPROVEMENT OF MATERNAL AND INFANT HEALTH THROUGH
ENHANCED REPORTING, RESEARCH, AND EVALUATION.
``(a) National Registry.--
``(1) In general.--The Secretary shall establish and
maintain a national registry of maternal and infant health
information (in this section referred to as the `Registry').
``(2) Contents.--The Registry shall include information on
maternal and infant health, including any such information
submitted to the Secretary through the Pregnancy Risk
Assessment Monitoring System. The Secretary shall disaggregate
information in the Registry by race and ethnicity.
``(3) Standardization.--In carrying out this subsection,
the Secretary shall ensure that information is collected and
maintained pursuant to standardized measures of maternal
health, including a standardized definition of maternal death.
``(b) Reporting and Collection of Information.--The Secretary shall
expand, enhance, and ensure the coordination of programs of the
Department of Health and Human Services relating to the reporting and
collection of information on maternal and infant health. Activities
under this subsection may include--
``(1) expansion of the Pregnancy Risk Assessment Monitoring
System to include standardized reporting, including core
questions and any additional State-added information reporting
by all States;
``(2) expansion of programs to assist and encourage vital
registration systems in each State to use enhanced,
standardized electronic birth certificates; and
``(3) disaggregation of information by race and ethnicity.
``(c) Electronic Birth and Death Systems.--The Secretary shall
award grants to vital records jurisdictions for the development and
implementation of electronic birth and death systems--
``(1) to collect 2003 standard certificate data; and
``(2) for the training of individuals responsible for
completing birth and death certificates.
``(d) Analysis of Programs That Mitigate Maternal Morbidity and
Mortality.--The Secretary shall enter into an agreement with the
Institute of Medicine of the National Academies under which the
Institute will--
``(1) conduct an in-depth analysis, including funding
histories, of Federal, State, and local programs (both
governmental and private) across the Nation that mitigate
maternal mortality and morbidity; and
``(2) not later than 12 months after the date of the
enactment of this section, submit a report to the Secretary and
the Congress on the results of such analysis.
``(e) Comparative Effectiveness of Clinical Practices Related to
Childbirth.--
``(1) In general.--The Secretary shall conduct or support
research on the comparative effectiveness of clinical practices
related to childbirth, including home birth and other out-of-
hospital birth, vaginal birth after cesarean, vaginal breech,
multiple gestation, elective induction, and caesarian section
without indication.
``(2) Consideration of liability concerns.--The research
under paragraph (1) shall take into consideration the liability
concerns of health care providers.
``(3) Coordination.--The Secretary shall ensure the
coordination of research under this section with comparative
effectiveness research of the Department of Health and Human
Services under section 1181 of the Social Security Act or other
provisions of law.
``(f) Report to Congress.--Not later than 12 months after the date
of the enactment of this section, the Secretary shall submit a report
to the Congress on programs and activities under this section,
including an analysis of progress in improving the quality and outcomes
of maternity care and infant health.
``(g) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be
necessary.''.
TITLE II--STRENGTHENING THE MATERNITY CARE WORKFORCE
SEC. 201. MATERNAL AND INFANT HEALTH WORKFORCE EDUCATION AND TRAINING.
(a) Health Professionals.--Part D of title VII of the Public Health
Service Act (42 U.S.C. 294 et seq.) is amended by adding at the end the
following:
``SEC. 760. EDUCATION AND TRAINING RELATING TO MATERNAL AND INFANT
HEALTH.
``The Secretary shall, with respect to maternal and infant health
education and training, carry out services and programs equivalent (as
determined by the Secretary) to the services and programs under section
753 with respect to maternal and infant health education and
training.''.
(b) Nursing.--Title VIII of the Public Health Service Act (42
U.S.C. 296 et seq.) is amended by adding at the end the following:
``PART J--COMPREHENSIVE MATERNAL AND INFANT HEALTH PROFESSIONS
EDUCATION
``SEC. 861. COMPREHENSIVE MATERNAL AND INFANT HEALTH PROFESSIONS
EDUCATION.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to develop and implement, in coordination with
programs under section 760, programs and initiatives to train and
educate individuals in providing evidence-based maternal and infant
health care.
``(b) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use funds under such grant to--
``(1) provide training to individuals who will provide
maternal and infant health care;
``(2) develop and disseminate core curricula for all
maternity care providers that emphasizes health promotion and
disease prevention;
``(3) train faculty members in maternal and infant health
care;
``(4) provide continuing education to individuals who
provide maternal and infant health care; or
``(5) establish traineeships for individuals who are
preparing for advanced education nursing degrees deemed
appropriate by the Secretary.
``(c) Application.--An eligible entity desiring a grant under
subsection (a) shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may reasonably require.
``(d) Eligible Entity.--For purposes of this section, the term
`eligible entity' includes a school of nursing, a health care facility,
a program leading to certification as a certified nurse assistant, a
partnership of such a school and facility, a partnership of such a
program and facility, or a nonprofit entity that issues continuing
nursing education.''.
SEC. 202. REPORT ON CREATION OF A UNIFORM MATERNITY CARE CORE
CURRICULUM.
(a) In General.--The Secretary of Health and Human Services shall
seek to enter into an arrangement with the Institute of Medicine of the
National Academies to prepare a report on the creation of a uniform
maternity care core curriculum to foster a shared knowledge base among
maternity care professionals. At a minimum, the report shall address
ways in which such core curriculum can support--
(1) preventing and treating complications in pregnancy and
childbirth;
(2) physiologic pregnancy, birth, and early parenting;
(3) psychosocial aspects of pregnancy and birth;
(4) woman- and family-centered care;
(5) cultural competence;
(6) collaborative practice;
(7) shared decisionmaking between childbearing women and
clinicians;
(8) avoiding overuse of maternity interventions in low-risk
women and newborns;
(9) improved systemic approaches to maternity care; and
(10) eliminating disparities in maternal care and maternal
outcomes.
(b) Consultation.--The arrangement under subsection (a) shall
require the Institute of Medicine, in preparing the report, to consult
with consumer and advocacy representatives and with each of the
following organizations and their associated educational, accrediting,
and certification bodies:
(1) The American College of Obstetricians and
Gynecologists.
(2) The American Academy of Family Physicians.
(3) The American College of Nurse-Midwives.
(4) The National Association of Certified Professional
Midwives.
(5) The Association of Women's Health, Obstetric, and
Neonatal Nurses.
(6) The Accreditation Council for Graduate Medical
Education.
(7) The American Academy of Pediatrics.
(8) The Society for Maternal-Fetal Medicine.
(c) Submission of Report.--The arrangement under subsection (a)
shall provide for completion of the report and the submission of the
report to the Congress within 18 months after the date of the enactment
of this Act.
SEC. 203. DEMONSTRATION PROJECTS TO PROMOTE USE OF CORE CURRICULUM AND
INTERDISCIPLINARY TEAM TEACHING IN MATERNITY CARE HEALTH
PROFESSIONS EDUCATION.
(a) In General.--Beginning not later than the deadline specified in
section 202(c) for completion and submission of the report under
section 202, the Secretary shall, on a competitive basis and pursuant
to a peer review process, make available grants to eligible entities or
consortia to carry out demonstration projects in academic educational
programs to develop, implement, and evaluate--
(1) a uniform core maternity care curriculum recommended in
the report under section 202; and
(2) interdisciplinary team teaching and learning in
maternity care education.
(b) Eligibility.--To be eligible to receive a grant under this
section, an entity or consortium shall be or include--
(1) a health professions school;
(2) an academic health sciences center; or
(3) another type of institution specified by the Secretary.
(c) Application.--To seek a grant under subsection (a) for a
demonstration project, an entity or consortium shall submit to the
Secretary an application that includes--
(1) a plan for developing and implementing the
demonstration project, including by--
(A) developing collaborative programs in all
maternity care program settings to allow students of
all relevant disciplines to observe different practice
styles, collaborate, and learn together from faculty
including a full range of maternity care providers;
(B) offering a mix of teaching modalities including
cognitive, hands-on, and simulation training;
(C) using--
(i) acute hospital settings; and
(ii) community health centers, public
health department clinics, freestanding birth
clinics, or other sites determined appropriate
by the Secretary; and
(D) using an interdisciplinary teaching team
approach involving multiple disciplines, which approach
may include teaching by an obstetrician, family
physician, a nurse-midwife, a nurse, a doula, a mental
health professional, and other providers specified by
the Secretary;
(2) an agreement to provide for the collection of data
regarding the effectiveness of the demonstration project; and
(3) an agreement to provide matching funds in accordance
with subsection (d).
(d) Matching Funds.--
(1) In general.--The Secretary may award a grant to an
entity or consortium under this section only if the entity or
consortium agrees to make available non-Federal contributions
toward the costs of the demonstration program to be funded
under the grant in an amount that is not less than $1 for each
$5 of Federal funds provided through the grant.
(2) Non-federal contributions.--Non-Federal contributions
under paragraph (1) may be in cash or in-kind, fairly
evaluated, including equipment or services. Amounts provided by
the Federal Government, or services assisted or subsidized to
any significant extent by the Federal Government, may not be
included in determining the amount of such contributions.
(e) Evaluation.--The Secretary shall take such action as may be
necessary to--
(1) evaluate the projects funded under this section; and
(2) make publicly available, publish, and disseminate the
results of such evaluation as widely as practicable.
(f) Reports.--Not later than 2 years after the date of the
enactment of this Act, and annually thereafter, the Secretary shall
submit to the Committee on Health, Education, Labor, and Pensions and
the Committee on Finance of the Senate and the Committee on Energy and
Commerce and the Committee on Ways and Means of the House of
Representatives a report that--
(1) describes the specific projects supported under this
section; and
(2) contains recommendations to Congress based on the
evaluation conducted under subsection (e).
(g) Definition.--In this section, the term ``Secretary'' means the
Secretary of Health and Human Services.
SEC. 204. REPORT ON MATERNITY CARE WORKFORCE.
(a) Assessment.--The National Health Care Workforce Commission
(established by section 5101 of the Patient Protection and Affordable
Care Act (Public Law 111-148)) shall conduct an assessment of current
and projected workforce needs for achieving the optimal delivery of
maternity care services. At a minimum, the assessment shall include an
evaluation of--
(1) an appropriate volume of maternity care providers;
(2) an appropriate geographic distribution of maternity
care providers;
(3) an appropriate number of maternity care providers in
various health care disciplines to meet the maternity care
needs of women with both low- and high-risk pregnancies;
(4) an appropriate sociodemographic diversity of the
maternity care workforce;
(5) demographic composition and trends of childbearing
families; and
(6) demographic composition and trends (including total
hours worked per week, number of years of providing maternity
care, and willingness to provide care at night and on weekends)
of the workforce that serves childbearing families.
(b) Report.--Not later than 18 months after the date of the
enactment of this Act, the National Health Care Workforce Commission
shall complete the assessment under subsection (a) and submit a report
on the results of such assessment to the Congress.
SEC. 205. ALLOCATION OF FUNDS FOR MATERNITY CARE WORKFORCE DEVELOPMENT.
Section 740 of the Public Health Service Act (42 U.S.C. 293d) is
amended--
(1) by redesignating subsection (d) as subsection (e); and
(2) by inserting after subsection (c) the following:
``(d) Activities Relating to Maternity Care Workforce.--Of the
amounts made available to carry out sections 737, 738, and 739 for
fiscal year 2013 and each succeeding fiscal year, the Secretary shall
allocate a percentage (to be determined by the Secretary) of such
amounts for activities relating to maternity care workforce development
under such sections.''.
TITLE III--ADDRESSING MATERNAL HEALTH DISPARITIES
SEC. 301. CDC CENTERS FOR RESEARCH AND DEMONSTRATION OF HEALTH
PROMOTION AND DISEASE PREVENTION.
Paragraph (2) of section 1706(b) of the Public Health Service Act
(42 U.S.C. 300u-5(b)) is amended--
(1) in subparagraph (B), by striking ``and'' at the end;
(2) in subparagraph (C) by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(D) community-based participatory research on
maternal and infant health, focusing on disparities in
maternal and infant health.''.
SEC. 302. GRANTS TO SUPPORT A DIVERSIFIED MATERNITY CARE WORKFORCE.
(a) In General.--The Secretary may award grants to eligible
entities or consortia to carry out demonstration projects to increase
recruitment of underrepresented minorities into the maternity care
professions. Such awards shall be made on a competitive basis and
pursuant to peer review.
(b) Eligibility.--To be eligible to receive a grant under this
section, an entity or consortium shall be or include--
(1) a health professions school;
(2) an institution with a graduate medical education
program;
(3) a hospital;
(4) a community health center;
(5) a freestanding birth center;
(6) a public health department clinic;
(7) a nonprofit professional organization; or
(8) another type of institution specified by the Secretary.
(c) Application.--To seek a grant under subsection (a) for a
demonstration project, an entity or consortium shall submit to the
Secretary an application that includes each of the following:
(1) A plan for carrying out the demonstration project,
including by performing one or more of the following:
(A) Strengthening recruitment, education,
retention, and mentoring of underrepresented
minorities.
(B) Increasing the racial, ethnic, geographic,
linguistic, and socioeconomic diversity of the
maternity care workforce.
(C) Engaging in early outreach to students in
elementary and secondary schools in disparity
communities about maternity care careers.
(D) Creating assistance programs in community
colleges and other institutions of higher learning to
support low-income students and students from
underrepresented backgrounds who wish to become
maternity caregivers. Such assistance programs may
include the provision of grants, scholarships, housing
stipends, health insurance for students and their
families, and childcare services for student-parents.
(E) Establishing community-based doula, childbirth
educator, and peer breastfeeding counselor training
programs for women in underserved communities.
(2) An agreement to provide for the collection of data
regarding the effectiveness of the demonstration project.
(3) An agreement to provide matching funds in accordance
with subsection (d).
(d) Matching Funds.--
(1) In general.--The Secretary may award a grant to an
entity or consortium under this section only if the entity or
consortium agrees to make available non-Federal contributions
toward the costs of the project to be funded under the grant in
an amount that is not less than $1 for each $5 of Federal funds
provided through the grant.
(2) Non-federal contributions.--Non-Federal contributions
under paragraph (1) may be in cash or in-kind, fairly
evaluated, including equipment or services. Amounts provided by
the Federal Government, or services assisted or subsidized to
any significant extent by the Federal Government, may not be
included in determining the amount of such contributions.
(e) Evaluation.--The Secretary shall take such action as may be
necessary to--
(1) evaluate the projects funded under this section; and
(2) make publicly available, publish, and disseminate the
results of such evaluation as widely as practicable.
(f) Reports.--Not later than 2 years after the date of enactment of
this section, and annually thereafter, the Secretary shall submit to
the Committee on Health, Education, Labor, and Pensions and the
Committee on Finance of the Senate and the Committee on Energy and
Commerce and the Committee on Ways and Means of the House of
Representatives a report that--
(1) describes the specific projects supported under this
section; and
(2) contains recommendations for Congress based on the
evaluation conducted under subsection (e).
(g) Definition.--In this section, the term ``Secretary'' means the
Secretary of Health and Human Services.
TITLE IV--COORDINATION OF MATERNITY CARE
SEC. 401. MATERNAL HEALTH COORDINATOR.
Title III of the Public Health Service Act is amended--
(1) by redesignating section 317K (42 U.S.C. 247b-12) as
section 317K-1; and
(2) by inserting after section 317J the following:
``SEC. 317K. COORDINATION OF MATERNAL HEALTH PROGRAMS AND ACTIVITIES.
``The Secretary shall designate an official within the Office of
the Secretary whose primary responsibility shall be to coordinate the
programs and activities of the Department of Health and Human Services
relating to maternal health.''.
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