[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6143 Introduced in House (IH)]

<DOC>






116th CONGRESS
  2d Session
                                H. R. 6143

 To amend the Public Health Service Act to improve maternal mental and 
  behavioral health outcomes with a particular focus on outcomes for 
                minority women, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 9, 2020

  Mr. Kennedy (for himself, Ms. Underwood, Mr. Katko, Ms. Adams, Ms. 
  Scanlon, Mr. Long, and Mr. Moulton) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to improve maternal mental and 
  behavioral health outcomes with a particular focus on outcomes for 
                minority women, 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 ``Moms Maternal and Behavioral Health 
Screening Access, Treatment, and Task Force to Expand Innovative Models 
to Reduce Maternal Mortality and Severe Maternal Morbidity Act of 
2020'' or the ``Moms MATTER Act of 2020''.

SEC. 2. INNOVATIVE MODELS TO REDUCE MATERNAL MORTALITY.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by adding at the end the following new part:

  ``PART W--INNOVATIVE MODELS TO REDUCE MATERNAL MORTALITY AND SEVERE 
                           MATERNAL MORBIDITY

``SEC. 399OO. DEFINITIONS.

    ``In this part:
            ``(1) The terms `postpartum' and `postpartum period' refer 
        to the 1-year period beginning on the last day of the 
        pregnancy.
            ``(2) The term `Secretary' means the Secretary of Health 
        and Human Services.
            ``(3) The term `Task Force' means the Maternal Mental and 
        Behavioral Health Task Force established pursuant to section 
        399OO-1.
            ``(4) The term `behavioral health' includes substance use 
        disorder and other behavioral health conditions.

``SEC. 399OO-1. MATERNAL MENTAL AND BEHAVIORAL HEALTH TASK FORCE.

    ``(a) Establishment.--The Secretary shall establish a task force, 
to be known as the Maternal Mental and Behavioral Health Task Force, to 
improve maternal mental and behavioral health outcomes with a 
particular focus on outcomes for minority women.
    ``(b) Membership.--
            ``(1) Composition.--The Task Force shall be composed of no 
        fewer than 20 members, to be appointed by the Secretary.
            ``(2) Co-chairs.--The Secretary shall designate 2 members 
        of the Task Force to serve as the Co-chairs of the Task Force.
            ``(3) Members.-- The Task Force shall include the 
        following:
                    ``(A) Maternal mental and behavioral health care 
                specialists; maternity care providers; and researchers, 
                government officials, and policy experts who specialize 
                in women's health, maternal mental and behavioral 
                health, maternal substance use disorder, or maternal 
                mortality and severe maternal morbidity. In selecting 
                such members of the Task Force, the Secretary shall 
                give special consideration to individuals from diverse 
                racial and ethnic backgrounds or individuals with 
                experience providing culturally congruent maternity 
                care in diverse communities.
                    ``(B) One or more patients who have suffered from a 
                diagnosed mental or behavioral health condition during 
                the prenatal or postpartum period, or a spouse or 
                family member of such patient.
                    ``(C) One or more representatives of a community-
                based organization that addresses adverse maternal 
                health outcomes with a specific focus on racial and 
                ethnic disparities in maternal health outcomes. In 
                selecting such representatives, the Secretary shall 
                give special consideration to organizations from 
                communities with significant minority populations.
                    ``(D) One or more perinatal health workers who 
                provide non-clinical support to pregnant and postpartum 
                women, such as a doula, community health worker, peer 
                supporter, certified lactation consultant, nutritionist 
                or dietitian, social worker, home visitor, or 
                navigator. In selecting such perinatal health workers, 
                the Secretary shall give special consideration to 
                individuals with experience working in communities with 
                significant minority populations.
                    ``(E) One or more representatives of relevant 
                patient advocacy organizations, with a particular focus 
                on organizations that address racial and ethnic 
                disparities in maternal health outcomes.
                    ``(F) One or more representatives of relevant 
                health care provider organizations, with a particular 
                focus on organizations that address racial and ethnic 
                disparities in maternal health outcomes.
                    ``(G) One or more leaders of a Federally qualified 
                health center or rural health clinic (as such terms are 
                defined in section 1861 of the Social Security Act).
                    ``(H) One or more representatives of health 
                insurers.
            ``(4) Timing of appointments.--Not later than 180 days 
        after the date of enactment of this part, the Secretary shall 
        appoint all members of the Task Force.
            ``(5) Period of appointment; vacancies.--
                    ``(A) In general.--Each member of the Task Force 
                shall be appointed for the life of the Task Force.
                    ``(B) Vacancies.--Any vacancy in the Task Force--
                            ``(i) shall not affect the powers of the 
                        Task Force; and
                            ``(ii) shall be filled in the same manner 
                        as the original appointment.
            ``(6) No pay.--Members of the Task Force (other than 
        officers or employees of the United States) shall serve without 
        pay. Members of the Task Force who are full-time officers or 
        employees of the United States may not receive additional pay, 
        allowances, or benefits by reason of their service on the Task 
        Force.
            ``(7) Travel expenses.--Members of the Task Force may be 
        allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies 
        under subchapter I of chapter 57 of title 5, United States 
        Code, while away from their homes or regular places of business 
        in the performance of services for the Task Force.
    ``(c) Staff.--The Co-chairs of the Task Force may appoint and fix 
the pay of staff to the Task Force.
    ``(d) Detailees.--Any Federal Government employee may be detailed 
to the Task Force without reimbursement from the Task Force, and the 
detailee shall retain the rights, status, and privileges of his or her 
regular employment without interruption.
    ``(e) Meetings.--
            ``(1) In general.--Subject to paragraph (2), the Task Force 
        shall meet at the call of the Co-chairs of the Task Force.
            ``(2) Initial meeting.--The Task Force shall meet not later 
        than 30 days after the date on which all members of the Task 
        Force have been appointed.
            ``(3) Quorum.--A majority of the members of the Task Force 
        shall constitute a quorum.
    ``(f) Information From Federal Agencies.--
            ``(1) In general.--The Task Force may secure directly from 
        any Federal department or agency such information as may be 
        relevant to carrying out this part.
            ``(2) Furnishing information.--On request of the Co-chairs 
        of the Task Force pursuant to paragraph (1), the head of a 
        Federal department or agency shall, not later than 60 days 
        after the date of receiving such request, furnish to the Task 
        Force the information so requested.
    ``(g) Termination.--Termination under section 14 of the Federal 
Advisory Committee Act (5 U.S.C. App.) shall not apply to the Task 
Force.
    ``(h) Duties.--
            ``(1) National strategy.--The Task Force shall make 
        recommendations for a national strategy to improve maternal 
        mental and behavioral health outcomes with a particular focus 
        on outcomes for minority women. Such strategy shall--
                    ``(A) define collaborative maternity care;
                    ``(B) make recommendations to the Secretary and the 
                Assistant Secretary for Mental Health and Substance Use 
                on how to implement collaborative maternity care models 
                to improve maternal mental and behavioral health with a 
                particular focus on such outcomes for minority women;
                    ``(C) identify barriers to the implementation of 
                collaborative maternity care models to improve maternal 
                mental and behavioral health with a particular focus on 
                such outcomes for minority women, and make 
                recommendations to address such barriers;
                    ``(D) take into consideration as models existing 
                State and other programs that have demonstrated 
                effectiveness in improving maternal mental and 
                behavioral health during the prenatal and postpartum 
                periods;
                    ``(E) promote treatment options and reduce stigma 
                for pregnant and postpartum women with a substance use 
                disorder;
                    ``(F) assess the extent to which insurers are 
                providing coverage for evidence-based mental and 
                behavioral health screenings and services that adhere 
                to existing prenatal and postpartum guidelines;
                    ``(G) assess the extent to which existing 
                guidelines and processes are culturally congruent for 
                minority women, specifically--
                            ``(i) guidelines for identifying maternal 
                        mental and behavioral health conditions, 
                        including substance use disorders;
                            ``(ii) guidelines for screening and, as 
                        needed, follow-up referrals, evaluations, and 
                        treatments after positive screens for--
                                    ``(I) depression;
                                    ``(II) anxiety;
                                    ``(III) trauma;
                                    ``(IV) substance use disorders; and
                                    ``(V) other mental or behavioral 
                                health conditions at the discretion of 
                                the Task Force;
                            ``(iii) processes for incorporating mental 
                        and behavioral health screenings into the 
                        current timeline of standard screening 
                        practices for pregnant and postpartum women, 
                        with distinctions for postpartum screening 
                        timelines for uncomplicated and complicated 
                        births; and
                            ``(iv) processes for referring women with 
                        positive screens for substance use disorder to 
                        addiction treatment centers offering--
                                    ``(I) on-site wraparound treatment 
                                or networks for referrals;
                                    ``(II) multidisciplinary staff;
                                    ``(III) psychotherapy;
                                    ``(IV) contingency management;
                                    ``(V) access to all evidence-based 
                                medication-assisted treatment; and
                                    ``(VI) evidence-based recovery 
                                supports;
                    ``(H) propose to the Secretary a multilingual 
                public awareness campaign for maternal mental health 
                and substance use disorder, with a particular focus on 
                minority women, that includes information on--
                            ``(i) symptoms, triggers, risk factors, and 
                        treatment options for maternal mental and 
                        behavioral health conditions;
                            ``(ii) using the website developed under 
                        paragraph (3);
                            ``(iii) the physiological process of 
                        recovery after birth;
                            ``(iv) the frequency of occurrences for 
                        common conditions such as postpartum 
                        hemorrhage, preeclampsia and eclampsia, 
                        infection, and thromboembolism;
                            ``(v) best practices in patient reporting 
                        of health concerns to their maternity care 
                        providers in the prenatal and postpartum 
                        periods;
                            ``(vi) addressing stigma around maternal 
                        mental and behavioral health conditions;
                            ``(vii) how to seek treatment for substance 
                        use disorder during pregnancy and in the 
                        postpartum period; and
                            ``(viii) infant feeding options; and
                    ``(I) disseminate to all State Medicaid programs 
                under title XIX of the Social Security Act and State 
                child health plans under title XXI of the Social 
                Security Act an assessment of the extent to which 
                States are providing coverage of evidence-based 
                prenatal and postpartum mental and behavioral health 
                screenings through such programs and plans, and an 
                assessment of the benefits of such coverage.
            ``(2) Grant programs.--The Task Force shall evaluate and 
        advise on the grant programs under section 399OO-2.
            ``(3) Centralized website.--The Task Force shall facilitate 
        a coordinated effort between the Substance Abuse and Mental 
        Health Services Administration and State departments of health 
        to develop, either directly or through a contract, a 
        centralized website with information on finding local mental 
        and behavioral health providers who treat prenatal and 
        postpartum mental and behavioral health conditions, including 
        substance use disorder.
            ``(4) Report.--Not later than 18 months after the date of 
        enactment of the Moms MATTER Act of 2020, and every year 
        thereafter, the Task Force shall submit to the Congress, the 
        Centers for Medicare & Medicaid, and the Center for Medicare 
        and Medicaid Innovation, and make publicly available, a report 
        that--
                    ``(A) describes the activities of the Task Force 
                and the results of such activities, with data in such 
                results stratified racially, ethnically, and 
                geographically; and
                    ``(B) includes the strategy developed under 
                paragraph (1).
    ``(i) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2021 through 2025.

``SEC. 399OO-2. INNOVATION IN MATERNITY CARE TO CLOSE RACIAL AND ETHNIC 
              MATERNAL HEALTH DISPARITIES GRANTS.

    ``(a) In General.--The Secretary shall award grants to eligible 
entities to establish, implement, evaluate, or expand innovative models 
in maternity care that are designed to reduce racial and ethnic 
disparities in maternal health outcomes.
    ``(b) Use of Funds.--An eligible entity receiving a grant under 
this section may use the grant to establish, implement, evaluate, or 
expand innovative models described in subsection (a) including--
            ``(1) collaborative maternity care models to improve 
        maternal mental health, treat maternal substance use disorders, 
        and reduce maternal mortality and severe maternal morbidity, 
        especially for minority women, consistent with the national 
        strategy developed by the Task Force under section 399O-1(h)(1) 
        and other recommendations of the Task Force;
            ``(2) evidence-based programming at clinics that--
                    ``(A) provide wraparound services for women with 
                substance use disorders in the prenatal and postpartum 
                periods that may include multidisciplinary staff, 
                access to all evidence-based medication-assisted 
                treatment, psychotherapy, contingency management, and 
                recovery supports; or
                    ``(B) make referrals for any such services that are 
                not provided within the clinic;
            ``(3) evidence-based programs at freestanding birth centers 
        that provide culturally congruent maternal mental and 
        behavioral health care education, treatments, and services, and 
        other wraparound supports for women throughout the prenatal and 
        postpartum period; and
            ``(4) the development and implementation of evidence-based 
        programs, including toll-free telephone hotlines, that connect 
        maternity care providers with women's mental health clinicians 
        to provide maternity care providers with guidance on addressing 
        maternal mental and behavioral health conditions identified in 
        patients.
    ``(c) Special Consideration.--In awarding grants under this 
section, the Secretary shall give special consideration to applications 
for models that will--
            ``(1) operate in--
                    ``(A) areas with high rates of adverse maternal 
                health outcomes;
                    ``(B) areas with significant racial and ethnic 
                disparities in maternal health outcomes; or
                    ``(C) health professional shortage areas designated 
                under section 332;
            ``(2) be led by minority women from demographic groups with 
        disproportionate rates of adverse maternal health outcomes; or
            ``(3) be implemented with a culturally congruent approach 
        that is focused on improving outcomes for demographic groups 
        experiencing disproportionate rates of adverse maternal health 
        outcomes.
    ``(d) Evaluation.--As a condition on receipt of a grant under this 
section, an eligible entity shall agree to provide annual evaluations 
of the activities funded through the grant to the Secretary and the 
Task Force. Such evaluations may address--
            ``(1) the effects of such activities on maternal health 
        outcomes and subjective assessments of patient and family 
        experiences, especially for minority women from demographic 
        groups with disproportionate rates of adverse maternal health 
        outcomes; and
            ``(2) the cost-effectiveness of such activities.
    ``(e) Definitions.--In this section:
            ``(1) The term `eligible entity' means any public or 
        private entity.
            ``(2) The term `collaborative maternity care' means an 
        integrated care model that includes the delivery of maternal 
        mental and behavioral health care services in primary clinics 
        or other care settings familiar to pregnant and postpartum 
        patients.
            ``(3) The term `culturally congruent' means care that is in 
        agreement with the preferred cultural values, beliefs, 
        worldview, language, and practices of the health care consumer 
        and other stakeholders.
            ``(4) The term `freestanding birth center' has the meaning 
        given that term under section 1905(l)(3)(A) of the Social 
        Security Act.
    ``(f) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $15,000,000 for each of fiscal 
years 2021 through 2025.

``SEC. 399OO-3. GROUP PRENATAL AND POSTPARTUM CARE MODELS.

    ``(a) In General.--The Secretary shall award grants to eligible 
entities to establish, implement, evaluate, or expand culturally 
congruent group prenatal care models or group postpartum care models 
that are designed to reduce racial and ethnic disparities in maternal 
and infant health outcomes.
    ``(b) Use of Funds.--An eligible entity receiving a grant under 
this section may use the grant for--
            ``(1) programming;
            ``(2) capital investments required to improve existing 
        physical infrastructure for group prenatal care and group 
        postpartum care programming, such as building space needed to 
        implement such models; and
            ``(3) evaluations of group prenatal care and group 
        postpartum care programming, with a particular focus on the 
        impacts of such programming on minority women.
    ``(c) Special Consideration.--In awarding grants under this 
section, the Secretary shall give special consideration to applicants 
that will--
            ``(1) operate in--
                    ``(A) areas with high rates of adverse maternal 
                health outcomes;
                    ``(B) areas with significant racial and ethnic 
                disparities in maternal health outcomes; or
                    ``(C) health professional shortage areas designated 
                under section 332;
            ``(2) be led by minority women from demographic groups with 
        disproportionate rates of adverse maternal health outcomes; or
            ``(3) be implemented with a culturally congruent approach 
        that is focused on improving outcomes for demographic groups 
        experiencing disproportionate rates of adverse maternal health 
        outcomes.
    ``(d) Evaluation.--As a condition on receipt of a grant under this 
section, an eligible entity shall agree to provide annual evaluations 
of the activities funded through the grant to the Secretary and the 
Task Force and address in each such evaluation--
            ``(1) the effects of such activities on maternal health 
        outcomes with a particular focus on the effects of such 
        activities on minority women, including measures such as--
                    ``(A) avoidable emergency room visits;
                    ``(B) postpartum care visits after delivery;
                    ``(C) rates of preterm birth;
                    ``(D) rates of breastfeeding initiation;
                    ``(F) psychological outcomes; and
                    ``(G) subjective measures of patient-reported 
                experience of care; and
            ``(2) the cost-effectiveness of such activities.
    ``(e) Definitions.--In this section:
            ``(1) The term `eligible entity' means any public or 
        private entity.
            ``(2) The term `culturally congruent' means care that is in 
        agreement with the preferred cultural values, beliefs, 
        worldview, language, and practices of the health care consumer 
        and other stakeholders.
    ``(f) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $10,000,000 for each of fiscal 
years 2021 through 2025.''.
                                 <all>