[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 3392 Introduced in Senate (IS)]

<DOC>






115th CONGRESS
  2d Session
                                S. 3392

              To address maternal mortality and morbidity.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            August 28, 2018

 Mrs. Gillibrand (for herself, Mr. Booker, and Ms. Harris) introduced 
the following bill; which was read twice and referred to the Committee 
               on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
              To address maternal mortality and morbidity.

    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 ``Modernizing Obstetric Medicine 
Standards Act of 2018'' or the ``MOMS Act''.

SEC. 2. MATERNAL MORTALITY AND MORBIDITY PREVENTION.

    Section 317K of the Public Health Service Act (42 U.S.C. 247b-12) 
is amended--
            (1) by redesignating subsection (d) as subsection (g); and
            (2) by inserting after subsection (c) the following:
    ``(d) Pregnancy and Postpartum Safety and Monitoring Practices and 
Maternal Mortality and Morbidity Prevention.--
            ``(1) Alliance for innovation on maternal health.--The 
        Secretary, acting through the Associate Administrator of the 
        Maternal and Child Health Bureau of the Health Resources and 
        Services Administration, shall establish a program, known as 
        the Alliance for Innovation on Maternal Health program, to--
                    ``(A) enter into a contract with an 
                interdisciplinary, multi-stakeholder, national 
                organization promulgating a national data-driven 
                maternal safety and quality improvement initiative 
                based on evidence-based best practices to improve 
                maternal safety and outcomes;
                    ``(B) assist States with the development and 
                implementation of postpartum safety and monitoring 
                practices and maternal mortality and morbidity 
                prevention, based on the best practices developed under 
                paragraph (2); and
                    ``(C) improve State-specific maternal health 
                outcomes and reduce variation in response to maternity 
                and postpartum care, in order to eliminate preventable 
                maternal mortality and severe maternal morbidity.
            ``(2) Best practices.--
                    ``(A) In general.--Not later than 1 year after the 
                date of enactment of the Modernizing Obstetric Medicine 
                Standards Act of 2018, the Secretary, acting through 
                the Administrator of the Health Resources and Services 
                Administration, shall work with the contracting entity 
                under paragraph (1)(A) to--
                            ``(i) create and assist State-based 
                        collaborative teams in the implementation of 
                        standardized best practices, to be known as 
                        `maternal safety bundles', for the purpose of 
                        maternal mortality and morbidity prevention; 
                        and
                            ``(ii) collect and analyze data related to 
                        process structure and patient outcomes to drive 
                        continuous quality improvement in the 
                        implementation of the maternal safety bundles 
                        by such State-based teams.
                    ``(B) Maternal safety bundles.--The best practices 
                issued under subparagraph (A) may address the following 
                topics:
                            ``(i) Obstetric hemorrhage.
                            ``(ii) Maternal mental, behavioral, and 
                        emotional health.
                            ``(iii) Maternal venous and 
                        thromboembolism.
                            ``(iv) Severe hypertension in pregnancy, 
                        including preeclampsia.
                            ``(v) Obstetric care for women with 
                        substance abuse disorder.
                            ``(vi) Postpartum care basics for maternal 
                        safety.
                            ``(vii) Reduction of racial and ethnic 
                        disparities in maternity care.
                            ``(viii) Safe reduction of primary cesarean 
                        birth.
                            ``(ix) Severe maternal morbidity review.
                            ``(x) Support after a severe maternal 
                        morbidity event.
                            ``(xi) Ways to empower and listen to women 
                        before, during, and after childbirth to ensure 
                        better communication between patients and 
                        health care providers.
                            ``(xii) Other leading causes of maternal 
                        mortality and morbidity, including infection or 
                        sepsis and cardiomyopathy.
            ``(3) Authorization of appropriations.--To carry out this 
        subsection, in addition to amounts appropriated under 
        subsection (g), there are authorized to be appropriated 
        $5,000,000 for each of fiscal years 2019 through 2023.''.

SEC. 3. MATERNAL MORTALITY AND MORBIDITY PREVENTION GRANTS.

    Section 317K of the Public Health Service Act (42 U.S.C. 247b-12), 
as amended by section 2, is further amended by inserting after 
subsection (d) the following:
    ``(e) Maternal Mortality and Morbidity Prevention Grant Program.--
            ``(1) In general.--The Secretary, acting through the 
        Associate Administrator of the Maternal and Child Health Bureau 
        of the Health Resources and Services Administration, shall 
        award grants to States or hospitals to assist in the 
        development and implementation of the maternal safety bundles 
        described in subsection (d)(2).
            ``(2) Use of funds.--
                    ``(A) In general.--A State or hospital receiving a 
                grant under this subsection may use such funds--
                            ``(i) to purchase equipment and supplies to 
                        effectively implement and execute the maternal 
                        safety bundles described in subsection (d)(2); 
                        and
                            ``(ii) to develop training on, and 
                        evaluation of the effectiveness of, such 
                        maternal safety bundles.
                    ``(B) Priority use of funds for state grantees.--A 
                State receiving a grant under this subsection shall 
                allocate such funds giving priority to the hospitals in 
                such State that serve high volumes of low-income, at-
                risk, or rural populations.
            ``(3) Prioritization of grant applications.--In awarding 
        grants under this subsection, the Secretary shall prioritize 
        applications from States, or hospitals within States, that--
                    ``(A) have a functioning maternal mortality review 
                committee in accordance with best practices promulgated 
                by the Building U.S. Capacity to Review and Prevent 
                Maternal Deaths Initiative of the Centers for Disease 
                Control and Prevention, the CDC Foundation, and the 
                Association of Maternal and Child Health Programs; or
                    ``(B) serve high volumes of low-income, at-risk, or 
                rural populations.
            ``(4) Reporting requirements.--
                    ``(A) In general.--Not later than 2 years after 
                receipt of a grant under this subsection, each 
                recipient of such a grant shall submit a report to the 
                Secretary describing--
                            ``(i) implementation of the maternal safety 
                        bundles with use of the grant funds;
                            ``(ii) any incidents of pregnancy-related 
                        deaths or pregnancy-associated deaths, and any 
                        pregnancy-related complications or pregnancy-
                        associated complications occurring in the 1-
                        year period prior to implementation of such 
                        procedures; and
                            ``(iii) any incidents of pregnancy-related 
                        deaths or pregnancy-associated deaths, and any 
                        pregnancy-related complications or pregnancy-
                        associated complications occurring after 
                        implementation of such procedures.
                    ``(B) Public availability; report to congress.--
                Within 1 year of receiving the reports under 
                subparagraph (A), the Secretary shall--
                            ``(i) make the reports submitted under 
                        subparagraph (A) publicly available; and
                            ``(ii) submit a report to Congress that 
                        describes the grants awarded under this 
                        subsection, the effectiveness of the grant 
                        program under this subsection, the activities 
                        for which grant funds were used, and any 
                        recommendations to further prevent maternal 
                        mortality and morbidity.
                    ``(C) Authorization of appropriations.--To carry 
                out this subsection, in addition to amounts 
                appropriated under subsection (g), there are authorized 
                to be appropriated $40,000,000 for each of fiscal years 
                2019 through 2023.
    ``(f) Definitions.--In this section--
            ``(1) the terms `pregnancy-associated death' and 
        `pregnancy-associated complication' mean the death or medical 
        complication, respectively, of a woman that occurs during, or 
        within 1 year following, her pregnancy, regardless of the 
        outcome, duration, or site of the pregnancy;
            ``(2) the terms `pregnancy-related death' and `pregnancy-
        related complication' mean the death or medical complication, 
        respectively, of a woman that--
                    ``(A) occurs during, or within 1 year following, 
                her pregnancy, regardless of the outcome, duration, or 
                site of the pregnancy;
                    ``(B) is from any cause related to, or aggravated 
                by, the pregnancy or its management; and
                    ``(C) is not from an accidental or incidental 
                cause; and
            ``(3) the term `severe maternal morbidity' means the 
        unexpected outcomes of labor and delivery that result in 
        significant short- or long-term consequences to a woman's 
        health.''.

SEC. 4. REPORTING ON PREGNANCY-RELATED AND PREGNANCY-ASSOCIATED DEATHS 
              AND COMPLICATIONS.

    (a) In General.--The Secretary of Health and Human Services shall 
encourage each State to voluntarily submit to the Secretary each year a 
report containing the findings of a State maternal mortality review 
committee with respect to each maternal death in the State that the 
committee reviewed during the year.
    (b) Maternal and Infant Health.--The Director of the Centers for 
Disease Control and Prevention shall--
            (1) update the Pregnancy Mortality Surveillance System or 
        develop a separate system so that such system is capable of 
        including data obtained from State maternal mortality review 
        committees; and
            (2) provide technical assistance to States in reviewing 
        cases of pregnancy-related complications and pregnancy-
        associated complications.
    (c) Definitions.--In this section, the terms ``pregnancy-associated 
complication'' and ``pregnancy-related complication'' have the meanings 
given such terms in section 317K of the Public Health Service Act, as 
amended by section 3.
                                 <all>