[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4215 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 4215

  To improve maternal health care quality, to improve the training of 
   health care professionals to reduce or prevent discrimination in 
certain health care services, to improve perinatal care, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            August 30, 2019

   Mr. Bucshon (for himself, Mr. Carson of Indiana, Mr. Burgess, Mr. 
Bilirakis, Mrs. Brooks of Indiana, Ms. Herrera Beutler, Mr. Long, Mrs. 
   McBath, and Mr. Walden) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To improve maternal health care quality, to improve the training of 
   health care professionals to reduce or prevent discrimination in 
certain health care services, to improve perinatal care, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Excellence in Maternal Health Act of 
2019''.

SEC. 2. INNOVATION FOR MATERNAL HEALTH.

    The Public Health Service Act is amended by inserting after section 
330M of such Act (42 U.S.C. 254c-19) the following:

``SEC. 330N. INNOVATION FOR MATERNAL HEALTH.

    ``(a) In General.--The Secretary, in consultation with experts 
representing a variety of clinical specialties, State, tribal, or local 
public health officials, researchers, epidemiologists, statisticians, 
and community organizations, shall establish or continue a program to 
award competitive grants to eligible entities for the purpose of--
            ``(1) identifying, developing, or disseminating best 
        practices to improve maternal health care quality and outcomes, 
        eliminate preventable maternal mortality and severe maternal 
        morbidity, and improve infant health outcomes, which may 
        include--
                    ``(A) information on evidence-based practices to 
                improve the quality and safety of maternal health care 
                in hospitals and other health care settings of a State 
                or health care system, including by addressing topics 
                commonly associated with health complications or risks 
                related to prenatal care, labor care, birthing, and 
                postpartum care;
                    ``(B) best practices for improving maternal health 
                care based on data findings and reviews conducted by a 
                State maternal mortality review committee that address 
                topics of relevance to common complications or health 
                risks related to prenatal care, labor care, birthing, 
                and postpartum care; and
                    ``(C) information on addressing determinants of 
                health that impact maternal health outcomes for women 
                before, during, and after pregnancy;
            ``(2) collaborating with State maternal mortality review 
        committees to identify issues for the development and 
        implementation of evidence-based practices to improve maternal 
        health outcomes and reduce preventable maternal mortality and 
        severe maternal morbidity;
            ``(3) providing technical assistance and supporting the 
        implementation of best practices identified in paragraph (1) to 
        entities providing health care services to pregnant and 
        postpartum women; and
            ``(4) identifying, developing, and evaluating new models of 
        care that improve maternal and infant health outcomes, which 
        may include the integration of community-based services and 
        clinical care.
    ``(b) Eligible Entities.--To be eligible for a grant under 
subsection (a), an entity shall--
            ``(1) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require; and
            ``(2) demonstrate in such application that the entity is 
        capable of carrying out data-driven maternal safety and quality 
        improvement initiatives in the areas of obstetrics and 
        gynecology or maternal health.
    ``(c) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $10,000,000 for each of fiscal 
years 2020 through 2024.''.

SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS.

    Title VII of the Public Health Service Act is amended by striking 
section 763 (42 U.S.C. 294p) and inserting the following:

``SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS.

    ``(a) Grant Program.--The Secretary shall establish a program to 
award grants to accredited schools of allopathic medicine, osteopathic 
medicine, and nursing, and other health professional training programs 
for the training of health care professionals to reduce and prevent 
discrimination (including training related to implicit biases) in the 
provision of health care services related to prenatal care, labor care, 
birthing, and postpartum care.
    ``(b) Eligibility.--To be eligible for a grant under subsection 
(a), an entity described in such subsection shall submit to the 
Secretary an application at such time, in such manner, and containing 
such information as the Secretary may require.
    ``(c) Reporting Requirement.--Each entity awarded a grant under 
this section shall periodically submit to the Secretary a report on the 
status of activities conducted using the grant, including a description 
of the impact of such training on patient outcomes, as applicable.
    ``(d) Best Practices.--The Secretary may identify and disseminate 
best practices for the training of health care professionals to reduce 
and prevent discrimination (including training related to implicit 
biases) in the provision of health care services related to prenatal 
care, labor care, birthing, and postpartum care.
    ``(e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $5,000,000 for each of fiscal 
years 2020 through 2024.''.

SEC. 4. STUDY ON TRAINING TO REDUCE AND PREVENT DISCRIMINATION.

    Not later than 2 years after date of enactment of this Act, the 
Secretary of Health and Human Services (referred to in this section as 
the ``Secretary'') shall, through a contract with an independent 
research organization, conduct a study and make recommendations for 
accredited schools of allopathic medicine, osteopathic medicine, and 
nursing, and other health professional training programs on best 
practices related to training to reduce and prevent discrimination, 
including training related to implicit biases, in the provision of 
health care services related to prenatal care, labor care, birthing, 
and postpartum care.

SEC. 5. PERINATAL QUALITY COLLABORATIVES.

    (a) Grants.--Section 317K(a)(2) of the Public Health Service Act 
(42 U.S.C. 247b-12(a)(2)) is amended by adding at the end the 
following:
                    ``(E)(i) The Secretary, acting through the Director 
                of the Centers for Disease Control and Prevention and 
                in coordination with other offices and agencies, as 
                appropriate, shall establish or continue a competitive 
                grant program for the establishment or support of 
                perinatal quality collaboratives to improve perinatal 
                care and perinatal health outcomes for pregnant and 
                postpartum women and their infants. A State, Indian 
                Tribe, or Tribal organization may use funds received 
                through such grant to--
                                    ``(I) support the use of evidence-
                                based or evidence-informed practices to 
                                improve outcomes for maternal and 
                                infant health;
                                    ``(II) work with clinical teams; 
                                experts; State, local, and, as 
                                appropriate, tribal public health 
                                officials; and stakeholders, including 
                                patients and families, to identify, 
                                develop, or disseminate best practices 
                                to improve perinatal care and outcomes; 
                                and
                                    ``(III) employ strategies that 
                                provide opportunities for health care 
                                professionals and clinical teams to 
                                collaborate across health care settings 
                                and disciplines, including primary care 
                                and mental health, as appropriate, to 
                                improve maternal and infant health 
                                outcomes, which may include the use of 
                                data to provide timely feedback across 
                                hospital and clinical teams to inform 
                                responses, and to provide support and 
                                training to hospital and clinical teams 
                                for quality improvement, as 
                                appropriate.
                            ``(ii) To be eligible for a grant under 
                        clause (i), an entity shall submit to the 
                        Secretary an application in such form and 
                        manner and containing such information as the 
                        Secretary may require.''.
    (b) Authorization of Appropriations.--Section 317K(f) of the Public 
Health Service Act (42 U.S.C. 247b-12(f)) is amended by striking 
``$58,000,000 for each of fiscal years 2019 through 2023'' and 
inserting ``$65,000,000 for each of fiscal years 2020 through 2024''.

SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM WOMEN.

    (a) Grants.--The Public Health Service Act is amended by inserting 
after section 330N of such Act, as added by section 2, the following:

``SEC. 330O. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM WOMEN.

    ``(a) In General.--The Secretary may award grants for the purpose 
of establishing or operating evidence-based or innovative, evidence-
informed programs to deliver integrated health care services to 
pregnant and postpartum women to optimize the health of women and their 
infants, including to reduce adverse maternal health outcomes, 
pregnancy-related deaths, and related health disparities (including 
such disparities associated with racial and ethnic minority 
populations), and, as appropriate, by addressing issues researched 
under subsection (b)(2) of section 317K.
    ``(b) Integrated Services for Pregnant and Postpartum Women.--
            ``(1) Eligibility.--To be eligible to receive a grant under 
        subsection (a), a State, Indian Tribe, or Tribal organization 
        (as such terms are defined in section 4 of the Indian Self-
        Determination and Education Assistance Act) shall work with 
        relevant stakeholders that coordinate care (including 
        coordinating resources and referrals for health care and social 
        services) to develop and carry out the program, including--
                    ``(A) State, Tribal, and local agencies responsible 
                for Medicaid, public health, social services, mental 
                health, and substance use disorder treatment and 
                services;
                    ``(B) health care providers who serve pregnant and 
                postpartum women; and
                    ``(C) community-based health organizations and 
                health workers, including providers of home visiting 
                services and individuals representing communities with 
                disproportionately high rates of maternal mortality and 
                severe maternal morbidity, and including those 
                representing racial and ethnicity minority populations.
            ``(2) Terms.--
                    ``(A) Period.--A grant awarded under subsection (a) 
                shall be made for a period of 5 years. Any supplemental 
                award made to a grantee under subsection (a) may be 
                made for a period of less than 5 years.
                    ``(B) Preference.--In awarding grants under 
                subsection (a), the Secretary shall--
                            ``(i) give preference to States, Indian 
                        Tribes, and Tribal organizations that have the 
                        highest rates of maternal mortality and severe 
                        maternal morbidity relative to other such 
                        States, Indian Tribes, or Tribal organizations, 
                        respectively; and
                            ``(ii) shall consider health disparities 
                        related to maternal mortality and severe 
                        maternal morbidity, including such disparities 
                        associated with racial and ethnic minority 
                        populations.
                    ``(C) Priority.--In awarding grants under 
                subsection (a), the Secretary shall give priority to 
                applications from up to 15 entities described in 
                subparagraph (B)(i).
                    ``(D) Evaluation.--The Secretary shall require 
                grantees to evaluate the outcomes of the programs 
                supported under the grant.
    ``(c) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $15,000,000 for each of fiscal 
years 2020 through 2024.''.
    (b) Report on Grant Outcomes and Dissemination of Best Practices.--
            (1) Report.--Not later than February 1, 2026, the Secretary 
        of Health and Human Services shall submit to the Committee on 
        Health, Education, Labor, and Pensions of the Senate and the 
        Committee on Energy and Commerce of the House of 
        Representatives a report that describes--
                    (A) the outcomes of the activities supported by the 
                grants awarded under the amendments made by this 
                section on maternal and child health;
                    (B) best practices and models of care used by 
                recipients of grants under such amendments; and
                    (C) obstacles identified by recipients of grants 
                under such amendments, and strategies used by such 
                recipients to deliver care, improve maternal and child 
                health, and reduce health disparities.
            (2) Dissemination of best practices.--Not later than August 
        1, 2026, the Secretary of Health and Human Services shall 
        disseminate information on best practices and models of care 
        used by recipients of grants under the amendments made by this 
        section (including best practices and models of care relating 
        to the reduction of health disparities, including such 
        disparities associated with racial and ethnic minority 
        populations, in rates of maternal mortality and severe maternal 
        morbidity) to relevant stakeholders, which may include health 
        providers, medical schools, nursing schools, relevant State, 
        tribal, and local agencies, and the general public.
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