[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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