[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6132 Introduced in House (IH)]

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116th CONGRESS
  2d Session
                                H. R. 6132

To address social determinants of health for women in the prenatal and 
              postpartum periods, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 9, 2020

  Mrs. McBath (for herself, Ms. Underwood, Ms. Adams, Mr. Lewis, Ms. 
 Sewell of Alabama, Ms. Norton, Ms. Scanlon, Ms. Moore, Mr. Clay, Mr. 
    Khanna, Ms. Pressley, and Mr. Lawson of Florida) introduced the 
   following bill; which was referred to the Committee on Energy and 
  Commerce, and in addition to the Committees on Financial Services, 
   Agriculture, Transportation and Infrastructure, and Education and 
 Labor, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To address social determinants of health for women in the prenatal and 
              postpartum periods, 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 ``Social Determinants for Moms Act of 
2020''.

SEC. 2. 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 department and agency to implement such 
                strategies.
    (e) Termination.--Termination under section 14 of the Federal 
Advisory Committee Act (5 U.S.C. App.) shall not apply to the Task 
Force.

SEC. 3. 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. 4. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT.

    The Secretary of Housing and Urban Development shall establish a 
new Housing for Moms task force within the Department 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. The task force shall--
            (1) study how the Department of Housing and Urban 
        Development can support women in the prenatal and postpartum 
        periods and make recommendations to the Secretary;
            (2) 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--
                    (A) health-promoting housing codes;
                    (B) enforcement of housing codes;
                    (C) proactive rental inspection programs;
                    (D) code enforcement officer training; and
                    (E) partnerships between regional offices of the 
                Department and community organizations to ensure 
                housing laws are understood and violations are 
                discovered; and
            (3) not later than 2 years after the date of enactment of 
        this Act, and annually thereafter, submit to the Congress a 
        report summarizing the activities of the task force.

SEC. 5. 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 morbidity rates and significant racial or ethnic 
        disparities in maternal health outcomes.

SEC. 6. DEPARTMENT OF AGRICULTURE.

    (a) Special Supplemental Nutrition Program.--
            (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 (7 U.S.C. 
        1431(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 the 
        enactment of this section, 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 such 
                outcomes;
                    (B) qualitative evaluations of family experiences 
                under the special supplemental nutrition program under 
                section 17 of the Child Nutrition Act of 1966 (42 
                U.S.C. 1786); and
                    (C) the cost effectiveness of such special 
                supplemental nutrition program.
    (b) 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 nutritional 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 provide.
            (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 and postpartum women 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 the 
        enactment of this section, 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 such outcomes; and
                    (B) recommendations with respect to ensuring the 
                activities described in paragraph (4) continue after 
                the grant period funding such activities expires.
            (6) Authorization of appropriations.--There are authorized 
        to be appropriated such sums as may be necessary to carry out 
        this subsection for fiscal years 2021 through 2023.
    (c) Definitions.--In this section:
            (1) Eligible entity.--The term ``eligible entity'' includes 
        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)).
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Agriculture.

SEC. 7. 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 such outcomes.
    (c) Report.--The agreement under subsection (a) shall direct the 
National Academies to complete the study under this section and 
transmit to the Congress a report on the results of the study not later 
than 24 months after the date of enactment of this Act.

SEC. 8. 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 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. 1936 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. 9. 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 morbidity 
        rates; and
            (2) operate in areas with high rates of--
                    (A) maternal mortality and severe morbidity; or
                    (B) significant racial and ethnic disparities in 
                maternal mortality and severe 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.

SEC. 10. DEFINITION.

    In this Act, the term ``postpartum'' means the one-year period 
beginning on the last day of a woman's pregnancy.
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