[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6138 Introduced in House (IH)]

<DOC>






116th CONGRESS
  2d Session
                                H. R. 6138

    To improve maternal health outcomes, especially for underserved 
populations, through investments in technology, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 9, 2020

Ms. Johnson of Texas (for herself, Ms. Underwood, Ms. Adams, 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

_______________________________________________________________________

                                 A BILL


 
    To improve maternal health outcomes, especially for underserved 
populations, through investments in technology, 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 ``Tech to Save Moms Act''.

SEC. 2. CMI MODELING OF INTEGRATED TELEHEALTH MODELS IN MATERNITY CARE 
              SERVICES.

    (a) In General.--Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the end the 
following new clauses:
                            ``(xxviii) Focusing on title XIX, providing 
                        for the adoption of and use of telehealth tools 
                        that allow for screening and treatment of 
                        common pregnancy-related complications 
                        (including anxiety and depression, substance 
                        use disorder, hemorrhage, infection, amniotic 
                        fluid embolism, thrombotic pulmonary or other 
                        embolism, hypertensive disorders of pregnancy, 
                        cerebrovascular accidents, cardiomyopathy, and 
                        other cardiovascular conditions) for a pregnant 
                        woman receiving medical assistance under such 
                        title during her pregnancy and for not more 
                        than a 1-year period beginning on the last day 
                        of her pregnancy.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect 1 year after the date of the enactment of this Act.

SEC. 3. GRANTS TO EXPAND THE USE OF TECHNOLOGY-ENABLED COLLABORATIVE 
              LEARNING AND CAPACITY MODELS THAT PROVIDE CARE TO 
              PREGNANT AND POSTPARTUM WOMEN.

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

``SEC. 330N. EXPANDING CAPACITY FOR MATERNAL HEALTH OUTCOMES.

    ``(a) Program Established.--Beginning not later than 1 year after 
the date of enactment of this Act, the Secretary of Health and Human 
Services shall, as appropriate, award grants to eligible entities to 
evaluate, develop, and, as appropriate, expand the use of technology-
enabled collaborative learning and capacity building models, to improve 
maternal health outcomes in health professional shortage areas; areas 
with high rates of maternal mortality and severe maternal morbidity, 
and significant racial and ethnic disparities in maternal health 
outcomes; and for medically underserved populations or American Indians 
and Alaska Natives, including Indian tribes, Tribal organizations, and 
urban Indian organizations.
    ``(b) Use of Funds.--
            ``(1) Required uses.--Grants awarded under subsection (a) 
        shall be used for--
                    ``(A) the development and acquisition of 
                instructional programming, and the training of maternal 
                health care providers and other professionals that 
                provide or assist in the provision of services through 
                models such as--
                            ``(i) training on adopting and effectively 
                        implementing Alliance for Innovation on 
                        Maternal Health (referred to in this section as 
                        `AIM') safety and quality improvement bundles;
                            ``(ii) training on implicit and explicit 
                        bias, racism, and discrimination for providers 
                        of maternity care;
                            ``(iii) training on best practices in 
                        screening for and, as needed, evaluating and 
                        treating maternal mental health conditions and 
                        substance use disorders;
                            ``(iv) training on how to screen for social 
                        determinants of health risks in the prenatal 
                        and postpartum periods such as inadequate 
                        housing, lack of access to nutrition, 
                        environmental risks, and transportation 
                        barriers; and
                            ``(v) training on the use of remote patient 
                        monitoring tools for pregnancy-related 
                        complications described in section 
                        1115A(b)(2)(B)(xxviii);
                    ``(B) information collection and evaluation 
                activities to--
                            ``(i) study the impact of such models on--
                                    ``(I) access to and quality of 
                                care;
                                    ``(II) patient outcomes;
                                    ``(III) subjective measures of 
                                patient experience; and
                                    ``(IV) cost-effectiveness; and
                            ``(ii) identify best practices for the 
                        expansion and use of such models;
                    ``(C) information collection and evaluation 
                activities to study the impact of such models on 
                patient outcomes and maternal health care providers, 
                and to identify best practices the expansion and use of 
                such models; and
                    ``(D) any other activity consistent with achieving 
                the objectives of grants awarded under this section, as 
                determined by the Secretary.
            ``(2) Permissible uses.--In addition to any of the uses 
        under paragraph (1), grants awarded under subsection (a) may be 
        used for--
                    ``(A) equipment to support the use and expansion of 
                technology-enabled collaborative learning and capacity 
                building models, including for hardware and software 
                that enables distance learning, maternal health care 
                provider support, and the secure exchange of electronic 
                health information; and
                    ``(B) support for maternal health care providers 
                and other professionals that provide or assist in the 
                provision of maternity care services through such 
                models.
    ``(c) Limitations.--
            ``(1) Number.--The Secretary may not award more than 1 
        grant under this section to an eligible entity.
            ``(2) Duration.--Each grant under this section shall be 
        made for a period of up to 5 years.
            ``(3) Amount.--The Secretary shall determine the maximum 
        amount of each grant under this section.
    ``(d) Grant Requirements.--The Secretary shall require entities 
awarded a grant under this section to collect information on the effect 
of the use of technology-enabled collaborative learning and capacity 
building models, such as on maternal health outcomes, access to 
maternal health care services, quality of maternal health care, and 
maternal health care provider retention in areas and populations 
described in subsection (a). The Secretary may award a grant or 
contract to assist in the coordination of such models, including to 
assess outcomes associated with the use of such models in grants 
awarded under subsection (a), including for the purpose described in 
subsection (b)(1)(B).
    ``(e) Application.--
            ``(1) In general.--An eligible entity that seeks to receive 
        a grant under subsection (a) shall submit to the Secretary an 
        application, at such time, in such manner, and containing such 
        information as the Secretary may require.
            ``(2) Matters to be included.--Such application shall 
        include plans to assess the effect of technology-enabled 
        collaborative learning and capacity building models on 
        indicators, including access to and quality of care, patient 
        outcomes, subjective measures of patient experience, and cost-
        effectiveness. Such indicators may focus on--
                    ``(A) health professional shortage areas;
                    ``(B) areas with high rates of maternal mortality 
                and severe maternal morbidity, and significant racial 
                and ethnic disparities in maternal health outcomes; and
                    ``(C) medically underserved populations or American 
                Indians and Alaska Natives, including Indian tribes, 
                Tribal organizations, and urban Indian organizations.
    ``(f) Access to Broadband.--In administering grants under this 
section, the Secretary may coordinate with other agencies to ensure 
that funding opportunities are available to support access to reliable, 
high-speed internet for grantees.
    ``(g) Technical Assistance.--The Secretary shall provide (either 
directly through the Department of Health and Human Services or by 
contract) technical assistance to eligible entities, including 
recipients of grants under subsection (a), on the development, use, and 
post-grant sustainability of technology-enabled collaborative learning 
and capacity building models in order to expand access to maternal 
health care services provided by such entities, including for health 
professional shortage areas and areas with high rates of maternal 
mortality and severe maternal morbidity, and significant racial and 
ethnic disparities in maternal health outcomes, and to medically 
underserved populations or American Indians and Alaska Natives, 
including Indian tribes, Tribal organizations, and urban Indian 
organizations.
    ``(h) Research and Evaluation.--The Secretary, in consultation with 
stakeholders with appropriate expertise in such models, shall develop a 
strategic plan to research and evaluate the evidence for such models. 
The Secretary shall use such plan to inform the activities carried out 
under this section.
    ``(i) Reporting.--
            ``(1) By eligible entities.--An eligible entity that 
        receives a grant under subsection (a) shall submit to the 
        Secretary a report, at such time, in such manner, and 
        containing such information as the Secretary may require.
            ``(2) By the secretary.--Not later than 4 years after the 
        date of enactment of this section, the Secretary shall prepare 
        and submit to the Congress, and post on the internet website of 
        the Department of Health and Human Services, a report 
        including, at minimum--
                    ``(A) a description of any new and continuing 
                grants awarded under subsection (a) and the specific 
                purpose and amounts of such grants;
                    ``(B) an overview of--
                            ``(i) the evaluations conducted under 
                        subsection (b);
                            ``(ii) technical assistance provided under 
                        subsection (g); and
                            ``(iii) activities conducted by entities 
                        awarded grants under subsection (a); and
                    ``(C) a description of any significant findings 
                related to patient outcomes or maternal health care 
                providers and best practices for eligible entities 
                expanding, using, or evaluating technology-enabled 
                collaborative learning and capacity building models.
    ``(j) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $6,000,000 for each of fiscal 
years 2021 through 2025.
    ``(k) Definitions.--In this section:
            ``(1) Eligible entity.--
                    ``(A) In general.--The term `eligible entity' means 
                an entity that provides, or supports the provision of, 
                maternal health care services or other evidence-based 
                services for pregnant and postpartum women--
                            ``(i) in health professional shortage 
                        areas;
                            ``(ii) in areas with high rates of adverse 
                        maternal health outcomes and significant racial 
                        and ethnic disparities in maternal health 
                        outcomes; or
                            ``(iii) medically underserved populations 
                        or American Indians and Alaska Natives, 
                        including Indian tribes, Tribal organizations, 
                        and urban Indian organizations.
                    ``(B) Inclusions.--An eligible entity may include 
                entities leading, or capable of leading, a technology-
                enabled collaborative learning and capacity building 
                model or engaging in technology-enabled collaborative 
                training of participants in such model.
            ``(2) Health professional shortage area.--The term `health 
        professional shortage area' means a health professional 
        shortage area designated under section 332.
            ``(3) Indian tribe.--The term `Indian tribe' has the 
        meaning given such term in section 4 of the Indian Self-
        Determination and Education Assistance Act.
            ``(4) Maternal mortality.--The term `maternal mortality' 
        means a death occurring during or within a 1-year period after 
        pregnancy caused by pregnancy or childbirth complications.
            ``(5) Medically underserved population.--The term 
        `medically underserved population' has the meaning given such 
        term in section 330(b)(3).
            ``(6) Postpartum.--The term `postpartum' means the 1-year 
        period beginning on the last date of the pregnancy of a woman.
            ``(7) Severe maternal mortality.--The term `severe maternal 
        morbidity' means an unexpected outcome caused by labor and 
        delivery of a woman that results in a significant short-term or 
        long-term consequences to the health of the woman.
            ``(8) Technology-enabled collaborative learning and 
        capacity building model.--The term `technology-enabled 
        collaborative learning and capacity building model' means a 
        distance health education model that connects health care 
        professionals, and particularly specialists, with multiple 
        other health care professionals through simultaneous 
        interactive videoconferencing for the purpose of facilitating 
        case-based learning, disseminating best practices, and 
        evaluating outcomes in the context of maternal health care.
            ``(9) Tribal organization.--The term `Tribal organization' 
        has the meaning given such term in section 4 of the Indian 
        Self-Determination and Education Assistance Act.
            ``(10) Urban indian organization.--The term `urban Indian 
        organization' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act.''.

SEC. 4. GRANTS TO PROMOTE EQUITY IN MATERNAL HEALTH OUTCOMES BY 
              INCREASING ACCESS TO DIGITAL TOOLS.

    (a) In General.--Beginning not later than 1 year after the date of 
the enactment of this Act, the Secretary of Health and Human Services 
shall carry out a program (in this section referred to as ``Investments 
in Digital Tools to Promote Equity in Maternal Health Outcomes 
Program'' or ``Program'') under which the Secretary makes grants to 
eligible entities reduce racial and ethnic disparities in maternal 
health outcomes by increasing access to digital tools related to 
maternal health care.
    (b) Applications.--To be eligible to receive a grant under this 
section, an eligible entity shall submit to the Secretary an 
application at such time, in such manner, and containing such 
information as the Secretary may require.
    (c) Limitations.--
            (1) Number.--The Secretary may not award more than 1 grant 
        under this section to an eligible entity.
            (2) Duration.--Each grant under this section shall be made 
        for a period of not more than 5 years.
            (3) Amount.--The Secretary shall determine the maximum 
        amount of each grant under this section.
            (4) Prioritization.--In awarding grants under this section, 
        the Secretary shall prioritize the selection of an eligible 
        entity that--
                    (A) operates in an area with high rates of adverse 
                maternal health outcomes and significant racial and 
                ethnic disparities in maternal health outcomes; and
                    (B) promotes technology that address racial and 
                ethnic disparities in maternal health outcomes.
    (d) Technical Assistance.--The Secretary shall provide technical 
assistance to an eligible entity on the development, use, evaluation, 
and post-grant sustainability of digital tools for purposes of 
promoting equity in maternal health outcomes.
    (e) Reporting.--
            (1) By eligible entities.--An eligible entity that receives 
        a grant under subsection (a) shall submit to the Secretary a 
        report, at such time, in such manner, and containing such 
        information as the Secretary may require.
            (2) By the secretary.--Not later than 4 years after the 
        date of the enactment of this Act, the Secretary shall submit 
        to Congress a report that--
                    (A) evaluates the effectiveness of grants awarded 
                under this section in improving maternal health 
                outcomes for minority women;
                    (B) makes recommendations for future grant programs 
                that promote the use of technology to improve maternal 
                health outcomes for minority women; and
                    (C) makes recommendations that address--
                            (i) privacy and security safeguards that 
                        should implemented in the use of technology in 
                        maternal health care;
                            (ii) reimbursement rates for maternal 
                        telehealth services;
                            (iii) the use of digital tools to analyze 
                        large data sets for the purposes of identifying 
                        potential pregnancy-related complications as 
                        early as possible;
                            (iv) barriers that prevent maternal health 
                        care providers from providing telehealth 
                        services across States and recommendations from 
                        the Centers for Medicare and Medicaid Services 
                        for addressing such barriers in State Medicaid 
                        programs;
                            (v) the use of consumer digital tool such 
                        as mobile phone applications, patient portals, 
                        and wearable technologies to improve maternal 
                        health outcomes;
                            (vi) barriers that prevent consumers from 
                        accessing telehealth services or other digital 
                        technologies to improve maternal health 
                        outcomes, including a lack of access to 
                        reliable, high-speed internet or lack of access 
                        to electronic devices needed to use such 
                        services and technologies; and
                            (vii) any other related issues as 
                        determined by the Secretary.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $6,000,000 for each of fiscal 
years 2021 through 2025.
    (g) Eligible Entity Defined.--In this section, the term ``eligible 
entity'' is an entity that is described in section 51a.3(a) of title 
42, Code of Federal Regulations, including domestic faith-based and 
community-based organizations.

SEC. 5. REPORT ON THE USE OF TECHNOLOGY TO REDUCE MATERNAL MORTALITY 
              AND SEVERE MATERNAL MORBIDITY AND TO CLOSE RACIAL AND 
              ETHNIC DISPARITIES IN OUTCOMES.

    (a) In General.--Not later than 60 days after the date of enactment 
of this Act, the Secretary of Health and Human Services shall seek to 
enter an agreement with the National Academies of Sciences, 
Engineering, and Medicine (referred to in this Act as the ``National 
Academies'') under which the National Academies shall conduct a study 
on the use of technology to reduce preventable maternal mortality and 
severe maternal morbidity, and close racial and ethnic disparities in 
maternal health outcomes in the United States. The study shall assess 
current and future uses of artificial intelligence in maternity care, 
including issues such as--
            (1) the extent to which artificial intelligence 
        technologies are currently being used in maternal health care;
            (2) the extent to which artificial intelligence 
        technologies have exacerbated racial or ethnic biases in 
        maternal health care;
            (3) recommendations for reducing racial or ethnic biases in 
        artificial intelligence technologies used in maternal health 
        care;
            (4) recommendations for potential applications of 
        artificial intelligence technologies that could improve 
        maternal health outcomes, particularly for minority women; and
            (5) recommendations for privacy and security safeguards 
        that should implemented in the development of artificial 
        intelligence technologies in maternal health care.
    (b) Report.--As a condition of any agreement under subsection (a), 
the Administrator shall require that the National Academies transmit to 
Congress a report on the results of the study under subsection (a) not 
later than 24 months after the date of enactment of this Act.

SEC. 6. DEFINITIONS.

    In this section:
            (1) Maternal mortality.--The term ``maternal mortality'' 
        means a death occurring during or within a 1-year period after 
        pregnancy caused by pregnancy or childbirth complications.
            (2) Severe maternal mortality.--The term ``severe maternal 
        morbidity'' means an unexpected outcome caused by labor and 
        delivery of a woman that results in significant short-term or 
        long-term consequences to the health of the woman.
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