[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6164 Introduced in House (IH)]

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116th CONGRESS
  2d Session
                                H. R. 6164

 To grow and diversify the perinatal workforce, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 10, 2020

    Ms. Moore (for herself, Ms. Underwood, Ms. Adams, Ms. Sewell of 
 Alabama, Ms. Norton, Ms. Scanlon, 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 grow and diversify the perinatal workforce, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Perinatal 
Workforce Act of 2020''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. HHS agency directives.
Sec. 3. Grants to grow and diversify the perinatal workforce.
Sec. 4. Grants to grow and diversify the nursing workforce in maternal 
                            and perinatal health.
Sec. 5. GAO report on barriers to maternity care.

SEC. 2. HHS AGENCY DIRECTIVES.

    (a) Guidance to States.--
            (1) In general.--Not later than 2 years after the date of 
        enactment of this Act, the Secretary of Health and Human 
        Services shall issue and disseminate guidance to States to 
        educate providers and managed care entities about the value and 
        process of delivering respectful maternal health care through 
        diverse care provider models.
            (2) Contents.--The guidance required by paragraph (1) shall 
        address how States can encourage and incentivize hospitals, 
        health systems, freestanding birth centers, other maternity 
        care provider groups, and managed care entities--
                    (A) to recruit and retain maternity care providers, 
                such as obstetrician-gynecologists, family physicians, 
                physician assistants, midwives who meet at a minimum 
                the international definition of the midwife and global 
                standards for midwifery education as established by the 
                International Confederation of Midwives, nurse 
                practitioners, and clinical nurse specialists--
                            (i) from racially and ethnically diverse 
                        backgrounds;
                            (ii) with experience practicing in racially 
                        and ethnically diverse communities; and
                            (iii) who have undergone trainings on 
                        implicit and explicit bias and racism;
                    (B) to incorporate into maternity care teams 
                midwives who meet at a minimum the international 
                definition of the midwife and global standards for 
                midwifery education as established by the International 
                Confederation of Midwives, doulas, community health 
                workers, peer supporters, certified lactation 
                consultants, nutritionists and dietitians, social 
                workers, home visitors, and navigators;
                    (C) to provide collaborative, culturally congruent 
                care; and
                    (D) to provide opportunities for individuals 
                enrolled in accredited midwifery education programs to 
                participate in job shadowing with maternity care teams 
                in hospitals, health systems, and freestanding birth 
                centers.
    (b) Study on Culturally Congruent Maternity Care.--
            (1) Study.--The Secretary of Health and Human Services 
        acting through the Director of the National Institutes of 
        Health (in this subsection referred to as the ``Secretary'') 
        shall conduct a study on best practices in culturally congruent 
        maternity care.
            (2) Report.--Not later than 2 years after the date of 
        enactment of this Act, the Secretary shall--
                    (A) complete the study required by paragraph (1);
                    (B) submit to the Congress and make publicly 
                available a report on the results of such study; and
                    (C) include in such report--
                            (i) a compendium of examples of hospitals, 
                        health systems, freestanding birth centers, 
                        other maternity care provider groups, and 
                        managed care entities that are delivering 
                        culturally congruent maternal health care;
                            (ii) a compendium of examples of hospitals, 
                        health systems, freestanding birth centers, 
                        other maternity care provider groups, and 
                        managed care entities that have low levels of 
                        racial and ethnic disparities in maternal 
                        health outcomes; and
                            (iii) recommendations to hospitals, health 
                        systems, freestanding birth centers, other 
                        maternity care provider groups, and managed 
                        care entities for best practices in culturally 
                        congruent maternity care.
    (c) Definition.--In this section, the term ``culturally 
congruent'', with respect to care or maternity care, means care that is 
in agreement with the preferred cultural values, beliefs, worldview, 
and practices of the health care consumer and other stakeholders.

SEC. 3. GRANTS TO GROW AND DIVERSIFY THE PERINATAL WORKFORCE.

    Title VII of the Public Health Service Act is amended by inserting 
after section 757 (42 U.S.C. 294f) the following new section:

``SEC. 758. PERINATAL WORKFORCE GRANTS.

    ``(a) In General.--The Secretary may award grants to entities to 
establish or expand programs described in subsection (b) to grow and 
diversify the perinatal workforce.
    ``(b) Use of Funds.--Recipients of grants under this section shall 
use the grants to grow and diversify the perinatal workforce by--
            ``(1) establishing schools or programs that provide 
        education and training to individuals seeking appropriate 
        licensing or certification as--
                    ``(A) physician assistants who will complete 
                clinical training in the field of maternal and 
                perinatal health; and
                    ``(B) other perinatal health workers such as 
                doulas, community health workers, peer supporters, 
                certified lactation consultants, nutritionists and 
                dietitians, social workers, home visitors, and 
                navigators; and
            ``(2) expanding the capacity of existing schools or 
        programs described in paragraph (1), for the purposes of 
        increasing the number of students enrolled in such schools or 
        programs, including by awarding scholarships for students.
    ``(c) Prioritization.--In awarding grants under this section, the 
Secretary shall give priority to any institution of higher education 
that--
            ``(1) has demonstrated a commitment to recruiting and 
        retaining minority students, particularly from demographic 
        groups experiencing high rates of maternal mortality and severe 
        maternal morbidity;
            ``(2) has developed a strategy to recruit and retain a 
        diverse pool of students into the perinatal workforce program 
        or school supported by funds received through the grant, 
        particularly from demographic groups experiencing high rates of 
        maternal mortality and severe maternal morbidity;
            ``(3) has developed a strategy to recruit and retain 
        students who plan to practice in a health professional shortage 
        area designated under section 332;
            ``(4) has developed a strategy to recruit and retain 
        students who plan to practice in an area with significant 
        racial and ethnic disparities in maternal health outcomes; and
            ``(5) includes in the standard curriculum for all students 
        within the perinatal workforce program or school a bias, 
        racism, or discrimination training program that includes 
        training on explicit and implicit bias.
    ``(d) Reporting.--As a condition on receipt of a grant under this 
section for a perinatal workforce program or school, an entity shall 
agree to submit to the Secretary an annual report on the activities 
conducted through the grant, including--
            ``(1) the number and demographics of students participating 
        in the program or school;
            ``(2) the extent to which students in the program or school 
        are entering careers in--
                    ``(A) health professional shortage areas designated 
                under section 332; and
                    ``(B) areas with significant racial and ethnic 
                disparities in maternal health outcomes; and
            ``(3) whether the program or school has included in the 
        standard curriculum for all students a bias, racism, or 
        discrimination training program that includes explicit and 
        implicit bias, and if so the effectiveness of such training 
        program.
    ``(e) Period of Grants.--The period of a grant under this section 
shall be up to 5 years.
    ``(f) Application.--To seek a grant under this section, an entity 
shall submit to the Secretary an application at such time, in such 
manner, and containing such information as the Secretary may require, 
including any information necessary for prioritization under subsection 
(c).
    ``(g) Technical Assistance.--The Secretary shall provide, directly 
or by contract, technical assistance to institutions of higher 
education seeking or receiving a grant under this section on the 
development, use, evaluation, and post-grant period sustainability of 
the perinatal workforce programs or schools proposed to be, or being, 
established or expanded through the grant.
    ``(h) Report by 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 on the effectiveness of the grant 
program under this section at--
            ``(1) recruiting minority students, particularly from 
        demographic groups experiencing high rates of maternal 
        mortality and severe maternal morbidity;
            ``(2) increasing the number of physician assistants who 
        will complete clinical training in the field of maternal and 
        perinatal health, and other perinatal health workers, from 
        demographic groups experiencing high rates of maternal 
        mortality and severe maternal morbidity;
            ``(3) increasing the number of physician assistants who 
        will complete clinical training in the field of maternal and 
        perinatal health, and other perinatal health workers, working 
        in health professional shortage areas designated under section 
        332; and
            ``(4) increasing the number of physician assistants who 
        will complete clinical training in the field of maternal and 
        perinatal health, and other perinatal health workers, working 
        in areas with significant racial and ethnic disparities in 
        maternal health outcomes.
    ``(i) 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. 4. GRANTS TO GROW AND DIVERSIFY THE NURSING WORKFORCE IN MATERNAL 
              AND PERINATAL HEALTH.

    Title VIII of the Public Health Service Act is amended by inserting 
after section 811 of that Act (42 U.S.C. 296j) the following:

``SEC. 812. PERINATAL NURSING WORKFORCE GRANTS.

    ``(a) In General.--The Secretary may award grants to schools of 
nursing to grow and diversify the perinatal nursing workforce.
    ``(b) Use of Funds.--Recipients of grants under this section shall 
use the grants to grow and diversify the perinatal nursing workforce by 
providing scholarships to students seeking to become--
            ``(1) nurse practitioners whose education includes a focus 
        on maternal and perinatal health; or
            ``(2) clinical nurse specialists whose education includes a 
        focus on maternal and perinatal health.
    ``(c) Prioritization.--In awarding grants under this section, the 
Secretary shall give priority to any school of nursing that--
            ``(1) has developed a strategy to recruit and retain a 
        diverse pool of students seeking to enter careers focused on 
        maternal and perinatal health;
            ``(2) has developed a partnership with a practice setting 
        in a health professional shortage area designated under section 
        332 for the clinical placements of the school's students;
            ``(3) has developed a strategy to recruit and retain 
        students who plan to practice in an area with significant 
        racial and ethnic disparities in maternal health outcomes; and
            ``(4) includes in the standard curriculum for all students 
        seeking to enter careers focused on maternal and perinatal 
        health a bias, racism, or discrimination training program that 
        includes education on explicit and implicit bias.
    ``(d) Reporting.--As a condition on receipt of a grant under this 
section, a school of nursing shall agree to submit to the Secretary an 
annual report on the activities conducted through the grant, including, 
to the extent practicable--
            ``(1) the number and demographics of students in the school 
        of nursing seeking to enter careers focused on maternal and 
        perinatal health;
            ``(2) the extent to which such students are preparing to 
        enter careers in--
                    ``(A) health professional shortage areas designated 
                under section 332; and
                    ``(B) areas with significant racial and ethnic 
                disparities in maternal health outcomes; and
            ``(3) whether the standard curriculum for all students 
        seeking to enter careers focused on maternal and perinatal 
        health includes a bias, racism, or discrimination training 
        program that includes education on explicit and implicit bias.
    ``(e) Period of Grants.--The period of a grant under this section 
shall be up to 5 years.
    ``(f) Application.--To seek a grant under this section, an entity 
shall submit to the Secretary an application, at such time, in such 
manner, and containing such information as the Secretary may require, 
including any information necessary for prioritization under subsection 
(c).
    ``(g) Technical Assistance.--The Secretary shall provide, directly 
or by contract, technical assistance to schools of nursing seeking or 
receiving a grant under this section on the processes of awarding and 
evaluating scholarships through the grant.
    ``(h) Report by 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 on the effectiveness of the grant 
program under this section at--
            ``(1) recruiting minority students, particularly from 
        demographic groups experiencing high rates of maternal 
        mortality and severe maternal morbidity;
            ``(2) increasing the number of nurse practitioners and 
        clinical nurse specialists entering careers focused on maternal 
        and perinatal health from demographic groups experiencing high 
        rates of maternal mortality and severe maternal morbidity;
            ``(3) increasing the number of nurse practitioners and 
        clinical nurse specialists entering careers focused on maternal 
        and perinatal health working in health professional shortage 
        areas designated under section 332; and
            ``(4) increasing the number of nurse practitioners and 
        clinical nurse specialists entering careers focused on maternal 
        and perinatal health working in areas with significant racial 
        and ethnic disparities in maternal health outcomes.
    ``(i) 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. 5. GAO REPORT ON BARRIERS TO MATERNITY CARE.

    (a) In General.--Not later than two years after the date of the 
enactment of this Act and every five years thereafter, the Comptroller 
General of the United States shall submit to Congress a report on 
barriers to maternity care in the United States. Such report shall 
include the information and recommendations described in subsection 
(b).
    (b) Content of Report.--The report under subsection (a) shall 
include--
            (1) an assessment of current barriers to entering 
        accredited midwifery education programs, and recommendations 
        for addressing such barriers, particularly for low-income and 
        minority women;
            (2) an assessment of current barriers to entering 
        accredited education programs for other maternity care 
        professional careers, including obstetrician-gynecologists, 
        family physicians, physician assistants, nurse practitioners, 
        and clinical nurse specialists, particularly for low-income and 
        minority women;
            (3) an assessment of current barriers that prevent midwives 
        from meeting the international definition of the midwife and 
        global standards for midwifery education as established by the 
        International Confederation of Midwives, and recommendations 
        for addressing such barriers, particularly for low-income and 
        minority women; and
            (4) recommendations to promote greater equity in 
        compensation for perinatal health workers, particularly for 
        such individuals from racially and ethnically diverse 
        backgrounds.
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