[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3424 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  2d Session
                                S. 3424

To end preventable maternal mortality and severe maternal morbidity in 
 the United States and close disparities in maternal health outcomes, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 10, 2020

 Ms. Harris (for herself, Mr. Booker, Mr. Peters, Mrs. Gillibrand, Ms. 
 Baldwin, Ms. Warren, Mr. Sanders, Ms. Duckworth, Mr. Blumenthal, Mr. 
 Bennet, Ms. Klobuchar, Mr. Menendez, and Mr. Merkley) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To end preventable maternal mortality and severe maternal morbidity in 
 the United States and close disparities in maternal health outcomes, 
                        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 ``Black Maternal Health Momnibus Act 
of 2020''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Definitions.
                 TITLE I--SOCIAL DETERMINANTS FOR MOMS

Sec. 101. Task force to coordinate efforts to address social 
                            determinants of health for women in the 
                            prenatal and postpartum periods.
Sec. 102. Requirements for guidance relating to social determinants of 
                            health for pregnant women.
Sec. 103. Department of Housing and Urban Development.
Sec. 104. Department of Transportation.
Sec. 105. Department of Agriculture.
Sec. 106. Environmental study through National Academies.
Sec. 107. Child care access.
Sec. 108. Grants to State, local, and Tribal public health departments 
                            addressing social determinants of health 
                            for pregnant and postpartum women.
                    TITLE II--HONORING KIRA JOHNSON

Sec. 201. Investments in community-based organizations to improve Black 
                            maternal health outcomes.
Sec. 202. Training for all employees in maternity care settings.
Sec. 203. Study on reducing and preventing bias, racism, and 
                            discrimination in maternity care settings.
Sec. 204. Respectful maternity care compliance program.
Sec. 205. GAO report.
                 TITLE III--PROTECTING MOMS WHO SERVED

Sec. 301. Support for maternity care coordination.
Sec. 302. Sense of Congress on veteran status requirements.
Sec. 303. Report on maternal mortality and severe maternal morbidity 
                            among women veterans.
                     TITLE IV--PERINATAL WORKFORCE

Sec. 401. HHS agency directives.
Sec. 402. Grants to grow and diversify the perinatal workforce.
Sec. 403. Grants to grow and diversify the nursing workforce in 
                            maternal and perinatal health.
Sec. 404. GAO report on barriers to maternity care.
                       TITLE V--DATA TO SAVE MOMS

Sec. 501. Funding for maternal mortality review committees to promote 
                            representative community engagement.
Sec. 502. Data collection and review.
Sec. 503. Task force on maternal health data and quality measures.
Sec. 504. Indian Health Service study on maternal mortality.
Sec. 505. Grants to minority-serving institutions to study maternal 
                            mortality, severe maternal morbidity, and 
                            other adverse maternal health outcomes.
                         TITLE VI--MOMS MATTER

Sec. 601. Innovative models to reduce maternal mortality.
                TITLE VII--JUSTICE FOR INCARCERATED MOMS

Sec. 701. Sense of Congress.
Sec. 702. Ending the shackling of pregnant individuals.
Sec. 703. Creating model programs for the care of incarcerated 
                            individuals in the prenatal and postpartum 
                            periods.
Sec. 704. Grant program to improve maternal health outcomes for 
                            individuals in State and local prisons and 
                            jails.
Sec. 705. GAO report.
Sec. 706. MACPAC report.
                     TITLE VIII--TECH TO SAVE MOMS

Sec. 801. CMI modeling of integrated telehealth models in maternity 
                            care services.
Sec. 802. Grants to expand the use of technology-enabled collaborative 
                            learning and capacity models that provide 
                            care to pregnant and postpartum women.
Sec. 803. Grants to promote equity in maternal health outcomes by 
                            increasing access to digital tools.
Sec. 804. Report on the use of technology to reduce maternal mortality 
                            and severe maternal morbidity and to close 
                            racial and ethnic disparities in outcomes.
                     TITLE IX--IMPACT TO SAVE MOMS

Sec. 901. Perinatal Care Alternative Payment Model Demonstration 
                            Project.
Sec. 902. MACPAC report.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Culturally congruent.--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.
            (2) Maternal mortality.--The term ``maternal mortality'' 
        means a death occurring during or within a 1-year period after 
        pregnancy that is caused by pregnancy or childbirth 
        complications.
            (3) Postpartum.--The term ``postpartum'' means the 1-year 
        period beginning on the last day of a woman's pregnancy.
            (4) Severe maternal morbidity.--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.

                 TITLE I--SOCIAL DETERMINANTS FOR MOMS

SEC. 101. 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 Federal department and agency to implement such 
                strategies.
    (e) Termination.--The termination provisions under section 14 of 
the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to 
the Task Force.

SEC. 102. 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. 103. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT.

    (a) Definitions.--In this section--
            (1) the term ``Department'' means the Department of Housing 
        and Urban Development;
            (2) the term ``Secretary'' means the Secretary of Housing 
        and Urban Development; and
            (3) the term ``task force'' means the Housing for Moms Task 
        Force established under subsection (b).
    (b) Task Force.--
            (1) Establishment.--The Secretary shall establish within 
        the Department a Housing for Moms Task Force 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.
            (2) Responsibilities.--The task force shall--
                    (A) study how the Department can support women in 
                the prenatal and postpartum periods and make 
                recommendations to the Secretary;
                    (B) 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--
                            (i) health-promoting housing codes;
                            (ii) enforcement of housing codes;
                            (iii) proactive rental inspection programs;
                            (iv) code enforcement officer training; and
                            (v) partnerships between regional offices 
                        of the Department and community organizations 
                        to ensure housing laws are understood and 
                        violations are discovered; and
                    (C) not later than 2 years after the date of 
                enactment of this Act, and annually thereafter, submit 
                to Congress a report summarizing the activities of the 
                task force.

SEC. 104. 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 maternal morbidity rates and significant racial or 
        ethnic disparities in maternal health outcomes.

SEC. 105. DEPARTMENT OF AGRICULTURE.

    (a) Definitions.--In this section:
            (1) Eligible entity.--The term ``eligible entity'' means--
                    (A) a public entity;
                    (B) a private community entity;
                    (C) a community-based organization;
                    (D) an Indian tribe or tribal organization (as 
                those terms are defined in section 4 of the Indian 
                Self-Determination and Education Assistance Act (25 
                U.S.C. 5304)); and
                    (E) an urban Indian organization (as 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.
    (b) Special Supplemental Nutrition Program for Women, Infants, and 
Children.--
            (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 (42 U.S.C. 
        1786(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 
        enactment of this Act, 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 those 
                outcomes;
                    (B) qualitative evaluations of family experiences 
                under the special supplemental nutrition program for 
                women, infants, and children under section 17 of the 
                Child Nutrition Act of 1966 (42 U.S.C. 1786); and
                    (C) the cost effectiveness of that special 
                supplemental nutrition program.
    (c) 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 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 require.
            (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 women and postpartum women (as those terms are defined 
        in section 17(b) of the Child Nutrition Act of 1966 (42 U.S.C. 
        1786(b)) 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 
        enactment of this Act, 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 those outcomes; and
                    (B) recommendations with respect to ensuring the 
                activities described in paragraph (4) continue after 
                the period for grant funding for those activities 
                expires.
            (6) Authorization of appropriations.--There are authorized 
        to be appropriated such sums as are necessary to carry out this 
        subsection for each of fiscal years 2021 through 2023.

SEC. 106. 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 those outcomes.
    (c) Report.--The agreement under subsection (a) shall direct the 
National Academies to complete the study under subsection (a) and 
submit to Congress a report on the results of the study not later than 
2 years after the date of enactment of this Act.

SEC. 107. 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 maternal 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. 1396 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. 108. 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 maternal 
        morbidity rates; and
            (2) operate in areas with high rates of--
                    (A) maternal mortality and severe maternal 
                morbidity; or
                    (B) significant racial and ethnic disparities in 
                maternal mortality and severe maternal 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.

                    TITLE II--HONORING KIRA JOHNSON

SEC. 201. INVESTMENTS IN COMMUNITY-BASED ORGANIZATIONS TO IMPROVE BLACK 
              MATERNAL HEALTH OUTCOMES.

    (a) Awards.--Following the 1-year period described in subsection 
(c), the Secretary of Health and Human Services (in this section 
referred to as the ``Secretary''), acting through the Administrator of 
the Health Resources and Services Administration, shall award grants to 
eligible entities to establish or expand programs to prevent maternal 
mortality and severe maternal morbidity among Black women.
    (b) Eligibility.--To be eligible to seek a grant under this 
section, an entity shall be a community-based organization offering 
programs and resources aligned with evidence-based practices for 
improving maternal health outcomes for Black women.
    (c) Outreach and Technical Assistance Period.--During the 1-year 
period beginning on the date of enactment of this Act, the Secretary 
shall--
            (1) conduct outreach to encourage eligible entities to 
        apply for grants under this section; and
            (2) provide technical assistance to eligible entities on 
        best practices for applying for grants under this section.
    (d) Special Consideration.--
            (1) Outreach.--In conducting outreach under subsection (c), 
        the Secretary shall give special consideration to eligible 
        entities that--
                    (A) are based in, and provide support for, 
                communities with--
                            (i) high rates of adverse maternal health 
                        outcomes; and
                            (ii) significant racial and ethnic 
                        disparities in maternal health outcomes;
                    (B) are led by Black women; and
                    (C) offer programs and resources that are aligned 
                with evidence-based practices for improving maternal 
                health outcomes for Black women.
            (2) Awards.--In awarding grants under this section, the 
        Secretary shall give special consideration to eligible entities 
        that--
                    (A) are described in subparagraphs (A), (B), and 
                (C) of paragraph (1);
                    (B) offer programs and resources designed in 
                consultation with and intended for Black women; and
                    (C) offer programs and resources in the communities 
                in which the respective eligible entities are located 
                that--
                            (i) promote maternal mental health and 
                        maternal substance use disorder treatments that 
                        are aligned with evidence-based practices for 
                        improving maternal mental health outcomes for 
                        Black women;
                            (ii) address social determinants of health 
                        for women in the prenatal and postpartum 
                        periods, including--
                                    (I) housing;
                                    (II) transportation;
                                    (III) nutrition counseling;
                                    (IV) healthy foods;
                                    (V) lactation support;
                                    (VI) lead abatement and other 
                                efforts to improve air and water 
                                quality;
                                    (VII) child care access;
                                    (VIII) car seat installation;
                                    (IX) wellness and stress management 
                                programs; or
                                    (X) coordination across safety-net 
                                and social support services and 
                                programs;
                            (iii) promote evidence-based health 
                        literacy and pregnancy, childbirth, and 
                        parenting education for women in the prenatal 
                        and postpartum periods;
                            (iv) provide support from doulas and other 
                        perinatal health workers to women from 
                        pregnancy through the postpartum period;
                            (v) provide culturally congruent training 
                        to perinatal health workers such as doulas, 
                        community health workers, peer supporters, 
                        certified lactation consultants, nutritionists 
                        and dietitians, social workers, home visitors, 
                        and navigators;
                            (vi) conduct or support research on Black 
                        maternal health issues; or
                            (vii) have developed other programs and 
                        resources that address community-specific needs 
                        for women in the prenatal and postpartum 
                        periods and are aligned with evidence-based 
                        practices for improving maternal health 
                        outcomes for Black women.
    (e) Technical Assistance.--The Secretary shall provide to grant 
recipients under this section technical assistance on--
            (1) capacity building to establish or expand programs to 
        prevent adverse maternal health outcomes among Black women;
            (2) best practices in data collection, measurement, 
        evaluation, and reporting; and
            (3) planning for sustaining programs to prevent maternal 
        mortality and severe maternal morbidity among Black women after 
        the period of the grant.
    (f) Evaluation.--Not later than the end of fiscal year 2026, the 
Secretary shall submit to the Congress an evaluation of the grant 
program under this section that--
            (1) assesses the effectiveness of outreach efforts during 
        the application process in diversifying the pool of grant 
        recipients;
            (2) makes recommendations for future outreach efforts to 
        diversify the pool of grant recipients for Department of Health 
        and Human Services grant programs and funding opportunities;
            (3) assesses the effectiveness of programs funded by grants 
        under this section in improving maternal health outcomes for 
        Black women; and
            (4) makes recommendations for future Department of Health 
        and Human Services grant programs and funding opportunities 
        that deliver funding to community-based organizations to 
        improve Black maternal health outcomes through programs and 
        resources that are aligned with evidence-based practices for 
        improving maternal health outcomes for Black women.
    (g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2021 through 2025.

SEC. 202. TRAINING FOR ALL EMPLOYEES IN MATERNITY CARE SETTINGS.

    Part B of title VII of the Public Health Service Act (42 U.S.C. 293 
et seq.) is amended by adding at the end the following new section:

``SEC. 742. TRAINING FOR ALL EMPLOYEES IN MATERNITY CARE SETTINGS.

    ``(a) Grants.--The Secretary shall award grants for programs to 
reduce and prevent bias, racism, and discrimination in maternity care 
settings.
    ``(b) Special Consideration.--In awarding grants under subsection 
(a), the Secretary shall give special consideration to applications for 
programs that would--
            ``(1) apply to all birthing professionals and any employees 
        who interact with pregnant and postpartum women in the provider 
        setting, including front desk employees, sonographers, 
        schedulers, health care professionals, hospital or health 
        system administrators, and security staff;
            ``(2) emphasize periodic, as opposed to one-time, trainings 
        for all birthing professionals and employees described in 
        paragraph (1);
            ``(3) address implicit bias and explicit bias;
            ``(4) be delivered in ongoing education settings for 
        providers maintaining their licenses, with a preference for 
        trainings that provide continuing education units and 
        continuing medical education;
            ``(5) include trauma-informed care best practices and an 
        emphasis on shared decision making between providers and 
        patients;
            ``(6) include a service-learning component that sends 
        providers to work in underserved communities to better 
        understand patients' lived experiences;
            ``(7) be delivered in undergraduate programs that funnel 
        into medical schools, like biology and pre-medicine majors;
            ``(8) be delivered at local agencies (as defined in 
        subsection (b) of section 17 of the Child Nutrition Act of 1966 
        (42 U.S.C. 1786)) that provide benefits or services under the 
        special supplemental nutrition program for women, infants, and 
        children established by that section;
            ``(9) integrate bias training in obstetric emergency 
        simulation trainings;
            ``(10) offer training to all maternity care providers on 
        the value of racially, ethnically, and professionally diverse 
        maternity care teams to provide culturally congruent care, 
        including doulas, community health workers, peer supporters, 
        certified lactation consultants, nutritionists and dietitians, 
        social workers, home visitors, and navigators; or
            ``(11) be based on one or more programs designed by a 
        historically Black college or university.
    ``(c) Application.--To seek a grant under subsection (a), an entity 
shall submit an application at such time, in such manner, and 
containing such information as the Secretary may require.
    ``(d) Reporting.--Each recipient of a grant under this section 
shall annually submit to the Secretary a report on the status of 
activities conducted using the grant, including, as applicable, a 
description of the impact of training provided through the grant on 
patient outcomes and patient experience for women of color and their 
families.
    ``(e) Best Practices.--Based on the annual reports submitted 
pursuant to subsection (d), the Secretary--
            ``(1) shall produce an annual report on the findings 
        resulting from programs funded through this section;
            ``(2) shall disseminate such report to all recipients of 
        grants under this section and to the public; and
            ``(3) may include in such report findings on best practices 
        for improving patient outcomes and patient experience for women 
        of color and their families in maternity care settings.
    ``(f) Definitions.--In this section:
            ``(1) The term `postpartum' means the 1-year period 
        beginning on the last day of a woman's pregnancy.
            ``(2) The term `culturally congruent' means in agreement 
        with the preferred cultural values, beliefs, worldview, and 
        practices of the health care consumer and other stakeholders.
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2021 through 2025.''.

SEC. 203. STUDY ON REDUCING AND PREVENTING BIAS, RACISM, AND 
              DISCRIMINATION IN MATERNITY CARE SETTINGS.

    (a) In General.--The Secretary of Health and Human Services shall 
seek to enter into an agreement, not later than 90 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--
            (1) conduct a study on the design and implementation of 
        programs to reduce and prevent bias, racism, and discrimination 
        in maternity care settings; and
            (2) not later than 24 months after the date of enactment of 
        this Act, complete the study and transmit a report on the 
        results of the study to the Congress.
    (b) Possible Topics.--The agreement entered into pursuant to 
subsection (a) may provide for the study of any of the following:
            (1) The development of a scorecard for programs designed to 
        reduce and prevent bias, racism, and discrimination in 
        maternity care settings to assess the effectiveness of such 
        programs in improving patient outcomes and patient experience 
        for women of color and their families.
            (2) Determination of the types of training to reduce and 
        prevent bias, racism, and discrimination in maternity care 
        settings that are demonstrated to improve patient outcomes or 
        patient experience for women of color and their families.

SEC. 204. RESPECTFUL MATERNITY CARE COMPLIANCE PROGRAM.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall award grants 
to accredited hospitals, health systems, and other maternity care 
delivery settings to establish within one or more hospitals or other 
birth settings a respectful maternity care compliance office.
    (b) Office Requirements.--A respectful maternity care compliance 
office funded through a grant under this section shall--
            (1) institutionalize mechanisms to allow patients receiving 
        maternity care services, the families of such patients, or 
        doulas or other perinatal workers supporting such patients to 
        report instances of disrespect or evidence of bias on the basis 
        of race, ethnicity, or another protected class;
            (2) institutionalize response mechanisms through which 
        representatives of the office can directly follow up with the 
        patient, if possible, and the patient's family in a timely 
        manner;
            (3) prepare and make publicly available a hospital- or 
        health system-wide strategy to reduce bias on the basis of 
        race, ethnicity, or another protected class in the delivery of 
        maternity care that includes--
                    (A) information on the training programs to reduce 
                and prevent bias, racism, and discrimination on the 
                basis of race, ethnicity, or another protected class 
                for all employees in maternity care settings; and
                    (B) the development of methods to routinely assess 
                the extent to which bias, racism, or discrimination on 
                the basis of race, ethnicity, or another protected 
                class are present in the delivery of maternity care to 
                minority patients; and
            (4) provide annual reports to the Secretary with 
        information about each case reported to the compliance office 
        over the course of the year containing such information as the 
        Secretary may require, such as--
                    (A) de-identified demographic information on the 
                patient in the case, such as race, ethnicity, gender 
                identity, and primary language;
                    (B) the content of the report from the patient or 
                the family of the patient to the compliance office; and
                    (C) the response from the compliance office.
    (c) Secretary Requirements.--
            (1) Processes.--Not later than 180 days after the date of 
        enactment of this Act, the Secretary shall establish processes 
        for--
                    (A) disseminating best practices for establishing 
                and implementing a respectful maternity care compliance 
                office within a hospital or other birth setting;
                    (B) promoting coordination and collaboration 
                between hospitals, health systems, and other maternity 
                care delivery settings on the establishment and 
                implementation of respectful maternity care compliance 
                offices; and
                    (C) evaluating the effectiveness of respectful 
                maternity care compliance offices on maternal health 
                outcomes and patient and family experiences, especially 
                for minority patients and their families.
            (2) Study.--
                    (A) In general.--Not later than 2 years after the 
                date of enactment of this Act, the Secretary shall, 
                through a contract with an independent research 
                organization, conduct a study on strategies to address 
                disrespect or bias on the basis of race, ethnicity, or 
                another protected class in the delivery of maternity 
                care services.
                    (B) Components of study.--The study shall include 
                the following:
                            (i) An assessment of the reports submitted 
                        to the Secretary from the respectful maternity 
                        care compliance offices pursuant to subsection 
                        (b)(4).
                            (ii) Based on such assessment, 
                        recommendations for potential accountability 
                        mechanisms related to cases of disrespect or 
                        bias on the basis of race, ethnicity, or 
                        another protected class in the delivery of 
                        maternity care services at hospitals and other 
                        birth settings. Such recommendations shall take 
                        into consideration medical and non-medical 
                        factors that contribute to adverse patient 
                        experiences and maternal health outcomes.
                    (C) Report.--The Secretary shall submit to the 
                Congress and make publicly available a report on the 
                results of the study under this paragraph.
    (d) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated such sums as may be necessary 
for fiscal years 2021 through 2026.

SEC. 205. GAO REPORT.

    (a) In General.--Not later than 2 years after date of enactment of 
this Act and every 2 years thereafter, the Comptroller General of the 
United States shall submit to the Congress and make publicly available 
a report on the establishment of respectful maternity care compliance 
offices supported under section 204 within hospitals, health systems, 
and other maternity care settings.
    (b) Matters Included.--The report under subsection (a) shall 
include the following:
            (1) Information regarding the extent to which hospitals, 
        health systems, and other maternity care settings have elected 
        to establish respectful maternity care compliance offices 
        supported under section 204, including--
                    (A) which hospitals and other birth settings elect 
                to establish compliance offices and when such offices 
                are established;
                    (B) to the extent practicable, impacts of the 
                establishment of such offices on maternal health 
                outcomes and patient and family experiences in the 
                hospitals and other birth settings that have 
                established such offices, especially for minority women 
                and their families;
                    (C) information on geographic areas, and types of 
                hospitals or other birth settings, where respectful 
                maternity care compliance offices are not being 
                established and information on factors contributing to 
                decisions to not establish such offices; and
                    (D) recommendations for establishing respectful 
                maternity care compliance offices in geographic areas, 
                and types of hospitals or other birth settings, where 
                such offices are not being established.
            (2) Whether the funding made available to carry out section 
        204 has been sufficient and, if applicable, recommendations for 
        additional appropriations to carry out such section.
            (3) Such other information as the Comptroller General 
        determines appropriate.

                 TITLE III--PROTECTING MOMS WHO SERVED

SEC. 301. SUPPORT FOR MATERNITY CARE COORDINATION.

    (a) Authorization of Appropriations.--
            (1) In general.--There is authorized to be appropriated to 
        the Secretary of Veterans Affairs $15,000,000 for fiscal year 
        2022 to improve maternity care coordination for women veterans 
        throughout pregnancy and the 1-year postpartum period beginning 
        on the last day of the pregnancy.
            (2) Supplement not supplant.--Amounts authorized under 
        paragraph (1) are in addition to any other amounts authorized 
        for the purpose specified in that paragraph.
    (b) Plan.--
            (1) In general.--Not later than 1 year after the date of 
        the enactment of this Act, the Secretary shall submit to the 
        Committee on Veterans' Affairs of the Senate and Committee on 
        Veterans' Affairs of the House of Representatives a plan to 
        improve maternity care coordination to fulfill the 
        responsibilities and requirements described in the Veterans 
        Health Administration Handbook 1330.03 dated October 5, 2012, 
        and entitled ``Maternity Health Care and Coordination'', or any 
        successor handbook.
            (2) Elements.--The plan under paragraph (1) shall include 
        the following:
                    (A) With respect to the amounts authorized to be 
                appropriated under subsection (a), a description of how 
                the Secretary will ensure such amounts are used to--
                            (i) hire full-time maternity care 
                        coordinators;
                            (ii) train maternity care coordinators; and
                            (iii) improve support programs led by 
                        maternity care coordinators.
                    (B) Recommendations for the amount of funding the 
                Secretary determines appropriate to improve maternity 
                care coordination as described in paragraph (1) for 
                each of the 5 fiscal years following the date of the 
                plan.
            (3) Consultation.--The Secretary shall develop the plan 
        under paragraph (1) in consultation with veterans service 
        organizations, military service organizations, women's health 
        care providers, and community-based organizations representing 
        women from demographic groups disproportionately impacted by 
        poor maternal health outcomes, that the Secretary determines 
        appropriate.

SEC. 302. SENSE OF CONGRESS ON VETERAN STATUS REQUIREMENTS.

    It is the sense of Congress that each State should list the veteran 
status of a mother--
            (1) in fetal death records; and
            (2) in maternal mortality review committee reviews of 
        pregnancy-related deaths and pregnancy-associated deaths.

SEC. 303. REPORT ON MATERNAL MORTALITY AND SEVERE MATERNAL MORBIDITY 
              AMONG WOMEN VETERANS.

    (a) GAO Report.--Not later than 2 years after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives, and 
make publicly available, a report on maternal mortality and severe 
maternal morbidity among women veterans, with a particular focus on 
racial and ethnic disparities in maternal health outcomes for women 
veterans.
    (b) Matters Included.--The report under subsection (a) shall 
include the following:
            (1) To the extent practicable--
                    (A) the number of women veterans who have 
                experienced a pregnancy-related death or pregnancy-
                associated death in the most recent 10 years of 
                available data;
                    (B) the rate of pregnancy-related deaths per 
                100,000 live births for women veterans;
                    (C) the number of cases of severe maternal 
                morbidity among women veterans in the most recent year 
                of available data;
                    (D) the racial and ethnic disparities in maternal 
                mortality and severe maternal morbidity rates among 
                women veterans;
                    (E) identification of the causes of maternal 
                mortality and severe maternal morbidity that are unique 
                to women who have served in the military, including 
                post-traumatic stress disorder, military sexual trauma, 
                and infertility or miscarriages that may be caused by 
                such service;
                    (F) identification of the causes of maternal 
                mortality and severe maternal morbidity that are unique 
                to women veterans of color; and
                    (G) identification of any correlations between the 
                former rank of women veterans and their maternal health 
                outcomes.
            (2) An assessment of the barriers to determining the 
        information required under paragraph (1) and recommendations 
        for improvements in tracking maternal health outcomes among--
                    (A) women veterans who have health care coverage 
                through the Department;
                    (B) women veterans enrolled in the TRICARE program 
                (as defined in section 1072 of title 10, United States 
                Code);
                    (C) women veterans with employer-based or private 
                insurance; and
                    (D) women veterans enrolled in the Medicaid program 
                under title XIX of the Social Security Act (42 U.S.C. 
                1396 et seq.).
            (3) Recommendations for legislative and administrative 
        actions to increase access to mental and behavioral health care 
        for women veterans who screen positively for postpartum mental 
        or behavioral health conditions.
            (4) Recommendations to address homelessness among pregnant 
        and postpartum women veterans.
            (5) Recommendations on how to effectively educate maternity 
        care providers on best practices for providing maternity care 
        services to women veterans that addresses the unique maternal 
        health care needs of veteran populations.
            (6) Recommendations to reduce maternal mortality and severe 
        maternal morbidity among women veterans and to address racial 
        and ethnic disparities in maternal health outcomes for each of 
        the groups described in subparagraphs (A) through (D) of 
        paragraph (2).
            (7) Recommendations to improve coordination of care between 
        the Department and non-Department facilities for pregnant and 
        postpartum women veterans, including recommendations to improve 
        training for the directors of the Veterans Integrated Service 
        Networks, directors of medical facilities of the Department, 
        chiefs of staff of such facilities, maternity care 
        coordinators, and relevant non-Department facilities.
            (8) An assessment of the authority of the Secretary of 
        Veterans Affairs to access maternal health data collected by 
        the Department of Health and Human Services and, if applicable, 
        recommendations to increase such authority.
            (9) Any other information the Comptroller General 
        determines appropriate with respect to the reduction of 
        maternal mortality and severe maternal morbidity among women 
        veterans and to address racial and ethnic disparities in 
        maternal health outcomes for women veterans.

                     TITLE IV--PERINATAL WORKFORCE

SEC. 401. 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.

SEC. 402. 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:

``SEC. 758. PERINATAL WORKFORCE GRANTS.

    ``(a) In General.--The Secretary may award grants to entities to 
establish or expand schools or 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 entity 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 into, and retain, 
        a diverse pool of students 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.--There is authorized to be 
appropriated to carry out this section $15,000,000 for each of fiscal 
years 2021 through 2025.''.

SEC. 403. 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.--There is authorized to be 
appropriated to carry out this section $15,000,000 for each of fiscal 
years 2021 through 2025.''.

SEC. 404. GAO REPORT ON BARRIERS TO MATERNITY CARE.

    (a) In General.--Not later than 2 years after the date of the 
enactment of this Act and every 5 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.

                       TITLE V--DATA TO SAVE MOMS

SEC. 501. FUNDING FOR MATERNAL MORTALITY REVIEW COMMITTEES TO PROMOTE 
              REPRESENTATIVE COMMUNITY ENGAGEMENT.

    (a) In General.--Section 317K(d) of the Public Health Service Act 
(42 U.S.C. 247b-12(d)) is amended by adding at the end the following:
            ``(9) Grants to promote representative community engagement 
        in maternal mortality review committees.--
                    ``(A) In general.--The Secretary may, using funds 
                made available pursuant to subparagraph (C), provide 
                assistance to an applicable maternal mortality review 
                committee of a State, Indian tribe, tribal 
                organization, or urban Indian organization (as such 
                term is defined in section 4 of the Indian Health Care 
                Improvement Act (25 U.S.C. 1603))--
                            ``(i) to select for inclusion in the 
                        membership of such a committee community 
                        members from the State, Indian tribe, tribal 
                        organization, or urban Indian organization by--
                                    ``(I) prioritizing community 
                                members who can increase the diversity 
                                of the committee's membership with 
                                respect to race and ethnicity, 
                                location, and professional background, 
                                including members with non-clinical 
                                experiences; and
                                    ``(II) to the extent applicable, to 
                                address barriers to maternal mortality 
                                review committee participation for 
                                community members, including required 
                                training, transportation barriers, 
                                compensation, and other supports as may 
                                be necessary;
                            ``(ii) to establish initiatives to conduct 
                        outreach and community engagement efforts 
                        within communities throughout the State or 
                        Indian tribe to seek input from community 
                        members on the work of such maternal mortality 
                        review committee, with a particular focus on 
                        outreach to minority women; and
                            ``(iii) to release public reports 
                        assessing--
                                    ``(I) the pregnancy-related death 
                                and pregnancy-associated death review 
                                processes of the maternal mortality 
                                review committee, with a particular 
                                focus on the maternal mortality review 
                                committee's sensitivity to the unique 
                                circumstances of minority women who 
                                have suffered pregnancy-related deaths; 
                                and
                                    ``(II) the impact of the use of 
                                funds made available under subparagraph 
                                (C) on increasing the diversity of the 
                                maternal mortality review committee 
                                membership and promoting community 
                                engagement efforts throughout the State 
                                or Indian tribe.
                    ``(B) Technical assistance.--The Secretary shall 
                provide (either directly through the Department of 
                Health and Human Services or by contract) technical 
                assistance to any maternal mortality review committee 
                receiving a grant under this paragraph on best 
                practices for increasing the diversity of the maternal 
                mortality review committee's membership and for 
                conducting effective community engagement throughout 
                the State or Indian tribe.
                    ``(C) Authorization of appropriations.--In addition 
                to any funds made available under subsection (f), there 
                are authorized to be appropriated to carry out this 
                paragraph $10,000,000 for each of fiscal years 2021 
                through 2025.''.
    (b) Reservation of Funds.--Section 317K(f) of the Public Health 
Service Act (42 U.S.C. 247b-12(f)) is amended by adding at the end the 
following: ``Of the amount made available under the preceding sentence 
for a fiscal year, not less than $1,500,000 shall be reserved for 
grants to Indian tribes, tribal organizations, or urban Indian 
organizations (as such term is defined in section 4 of the Indian 
Health Care Improvement Act (25 U.S.C. 1603))''.

SEC. 502. DATA COLLECTION AND REVIEW.

    (a) In General.--Section 317K(d)(3)(A)(i) of the Public Health 
Service Act (42 U.S.C. 247b-12(d)(3)(A)(i)) is amended--
            (1) by redesignating subclauses (II) and (III) as 
        subclauses (IV) and (V), respectively; and
            (2) by inserting after subclause (I) the following:
                                    ``(II) to the extent practicable, 
                                reviewing cases of severe maternal 
                                morbidity in which the patient received 
                                a transfusion of four or more units of 
                                blood and was admitted to an intensive 
                                care unit;
                                    ``(III) to the extent practicable, 
                                consulting with local community-based 
                                organizations representing women from 
                                demographic groups disproportionately 
                                impacted by poor maternal health 
                                outcomes to ensure that, in addition to 
                                clinical factors, non-clinical factors 
                                that might have contributed to a 
                                pregnancy-related death are 
                                appropriately considered;''.
    (b) Severe Maternal Morbidity Defined.--Section 317K(e) of the 
Public Health Service Act (42 U.S.C. 247b-12(e)) is amended--
            (1) in paragraph (2), by striking ``and'' at the end;
            (2) in paragraph (3), by striking the period at the end and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(4) the term `severe maternal morbidity' means one or 
        more unexpected outcomes of labor and delivery that result in 
        significant short-term or long-term consequences to a woman's 
        health.''.

SEC. 503. TASK FORCE ON MATERNAL HEALTH DATA AND QUALITY MEASURES.

    (a) Establishment.--Not later than 180 days after the date of 
enactment of this Act, the Secretary of Health and Human Services shall 
establish a task force, to be known as the Task Force on Maternal 
Health Data and Quality Measures (in this section referred to as the 
``Task Force'').
    (b) Duties of Task Force.--
            (1) In general.--The Task Force shall use all available 
        relevant information, including information from State-level 
        sources, to prepare and submit a report containing the 
        following:
                    (A) An evaluation of current State and Tribal 
                practices for maternal health, maternal mortality, and 
                severe maternal morbidity data collection and 
                dissemination, including consideration of--
                            (i) the timeliness of processes for 
                        amending a death certificate when new 
                        information pertaining to the death becomes 
                        available to reflect whether the death was a 
                        pregnancy-related death;
                            (ii) maternal health data collected with 
                        electronic health records, including data on 
                        race and ethnicity;
                            (iii) the barriers preventing States from 
                        correlating maternal outcome data with race and 
                        ethnicity data;
                            (iv) processes for determining the cause of 
                        a pregnancy-associated death in States that do 
                        not have a maternal mortality review committee;
                            (v) whether maternal mortality review 
                        committees include multidisciplinary and 
                        diverse membership (as described in section 
                        317K(d)(1)(A) of the Public Health Service Act 
                        (42 U.S.C. 247b-12(d)(1)(A));
                            (vi) whether members of maternal mortality 
                        review committees participate in trainings on 
                        bias, racism, or discrimination, and the 
                        quality of such trainings;
                            (vii) the extent to which States have 
                        implemented systematic processes of listening 
                        to the stories of pregnant and postpartum women 
                        and their family members, with a particular 
                        focus on minority women and their family 
                        members, to fully understand the causes of, and 
                        inform potential solutions to, the maternal 
                        mortality and severe maternal morbidity crisis 
                        within their respective States;
                            (viii) the consideration of social 
                        determinants of health by maternal mortality 
                        review committees when examining the causes of 
                        pregnancy-associated and pregnancy-related 
                        deaths;
                            (ix) the legal barriers preventing the 
                        collation of State maternity care data;
                            (x) the effectiveness of data collection 
                        and reporting processes in separating 
                        pregnancy-associated deaths from pregnancy-
                        related deaths; and
                            (xi) the current Federal, State, local, and 
                        Tribal funding support for the activities 
                        referred to in clauses (i) through (x).
                    (B) An assessment of whether the funding referred 
                to in subparagraph (A)(xi) is adequate for States to 
                carry out optimal data collection and dissemination 
                processes with respect to maternal health, maternal 
                mortality, and severe maternal morbidity.
                    (C) An evaluation of current quality measures for 
                maternity care, including prenatal measures, labor and 
                delivery measures, and postpartum measures up to one 
                year postpartum. Such evaluation shall be conducted in 
                consultation with the National Quality Forum and shall 
                include consideration of--
                            (i) effective quality measures for 
                        maternity care used by hospitals, health 
                        systems, birth centers, health plans, and other 
                        relevant entities;
                            (ii) the sufficiency of current outcome 
                        measures used to evaluate maternity care for 
                        testing and validating new maternal health care 
                        payment and service delivery models;
                            (iii) quality measures for the childbirth 
                        experiences of women that other countries 
                        effectively use;
                            (iv) current maternity care quality 
                        measures that may be eliminated because they 
                        are not achieving their intended effect;
                            (v) barriers preventing maternity care 
                        providers from implementing quality measures 
                        that are aligned from best practices;
                            (vi) the frequency with which maternity 
                        care quality measures are reviewed and revised;
                            (vii) the strengths and weaknesses of the 
                        Prenatal and Postpartum Care measures of the 
                        Health Plan Employer Data and Information Set 
                        measures established by the National Committee 
                        for Quality Assurance;
                            (viii) the strengths and weaknesses of 
                        maternity care quality measures under the 
                        Medicaid program under title XIX of the Social 
                        Security Act (42 U.S.C. 1396 et seq.) and the 
                        Children's Health Insurance Program under title 
                        XXI of such Act (42 U.S.C. 1397aa et seq.), 
                        including the extent to which States 
                        voluntarily report relevant measures;
                            (ix) the extent to which maternity care 
                        quality measures are informed by patient 
                        experiences that include subjective measures of 
                        patient-reported experience of care;
                            (x) the current processes for collecting 
                        stratified data on the race and ethnicity of 
                        pregnant and postpartum women in hospitals, 
                        health systems, and birth centers, and for 
                        incorporating such racially and ethnically 
                        stratified data in maternity care quality 
                        measures;
                            (xi) the extent to which maternity care 
                        quality measures account for the unique 
                        experiences of minority women and their 
                        families; and
                            (xii) the extent to which hospitals, health 
                        systems, and birth centers are implementing 
                        existing maternity care quality measures.
                    (D) Recommendations on authorizing additional funds 
                to improve maternal mortality review committees and 
                relevant maternal health initiatives by the agencies 
                and organizations within the Department of Health and 
                Human Services.
                    (E) Recommendations for new authorities that may be 
                granted to maternal mortality review committees to be 
                able to--
                            (i) access records from other Federal and 
                        State agencies and departments that may be 
                        necessary to identify causes of pregnancy-
                        associated deaths that are unique to women from 
                        specific populations, such as women veterans 
                        and women who are incarcerated; and
                            (ii) work with relevant experts who are not 
                        members of the maternal mortality review 
                        committee to assist in the review of pregnancy-
                        associated deaths of women from specific 
                        populations, such as women veterans and women 
                        who are incarcerated.
                    (F) Recommendations to improve current quality 
                measures for maternity care, including recommendations 
                on updating the Pregnancy & Delivery Care measures on 
                the Hospital Compare website of the Centers for 
                Medicare & Medicaid Services or any successor website, 
                with a particular focus on racial and ethnic 
                disparities in maternal health outcomes.
                    (G) Recommendations to improve the coordination by 
                the Department of Health and Human Services of the 
                efforts undertaken by the agencies and organizations 
                within the Department related to maternal health data 
                and quality measures.
            (2) Public comment.--Not later than 60 days after the date 
        on which a majority of the members of the Task Force have been 
        appointed, the Task Force shall publish in the Federal Register 
        a notice for a 90-day public comment period, beginning on the 
        date of publication, on the issues described in paragraph (1).
    (c) Membership.--
            (1) In general.--The Task Force shall be composed of 18 
        members appointed by the Secretary of Health and Human 
        Services. The Secretary shall give special consideration to 
        individuals who are representative of populations most affected 
        by maternal mortality and severe maternal morbidity.
            (2) Member criteria.--To be eligible to be appointed as a 
        member of the Task Force, an individual shall be--
                    (A) a woman who has experienced severe maternal 
                morbidity;
                    (B) a family member of a woman who had a pregnancy-
                related death;
                    (C) an individual who provides non-clinical support 
                to women from pregnancy through the postpartum period, 
                such as a doula, community health worker, peer 
                supporter, certified lactation consultant, nutritionist 
                or dietitian, social worker, home visitor, or a patient 
                navigator;
                    (D) a leader of a community-based organization that 
                addresses adverse maternal health outcomes with a 
                specific focus on racial and ethnic disparities;
                    (E) an academic researcher in a field or policy 
                area related to the duties of the Task Force;
                    (F) a maternal health care provider;
                    (G) an elected or duly appointed leader from an 
                Indian Tribe;
                    (H) an expert in a field or policy area related to 
                the duties of the Task Force; or
                    (I) an individual who has experience with Federal 
                or State government programs related to the duties of 
                the Task Force.
            (3) Appointment timing.--Appointments to the Task Force 
        shall be made not later than 180 days after the date of 
        enactment of this Act.
            (4) Duration.--Each member shall be appointed for the life 
        of the Task Force.
            (5) Co-chair selection.--Not later than 30 days after the 
        date on which a majority of the members of the Task Force have 
        been appointed, the Secretary shall select two of the members 
        of the Task Force to serve as Co-Chairs of the Task Force.
            (6) Vacancies.--
                    (A) In general.--A 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.
                    (B) Co-chair vacancy.--In the event of a vacancy of 
                a Co-Chair of the Task Force, a replacement Co-Chair 
                shall be selected in the same manner as the original 
                selection.
            (7) Compensation.--Except as provided in paragraph (8), 
        members of the Task Force shall serve without pay.
            (8) Travel expenses.--Members of the Task Force shall 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 service for the Task Force.
    (d) Meetings.--
            (1) In general.--The Task Force shall meet at the call of 
        the Co-Chairs of the Task Force.
            (2) Quorum.--A majority of the members of the Task Force 
        shall constitute a quorum.
            (3) Initial meeting.--The Task Force shall meet not later 
        than 60 days after the date on which a majority of the members 
        of the Task Force have been appointed.
    (e) Staff of Task Force.--
            (1) Additional staff.--The Co-Chairs of the Task Force may 
        appoint and fix the pay of additional staff to the Task Force 
        as the Co-Chairs consider appropriate.
            (2) Applicability of certain civil service laws.--The staff 
        of the Task Force may be appointed without regard to the 
        provisions of title 5, United States Code, governing 
        appointments in the competitive service, and may be paid 
        without regard to the provisions of chapter 51 and subchapter 
        III of chapter 53 of that title relating to classification and 
        General Schedule pay rates.
            (3) 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.
    (f) Powers of Task Force.--
            (1) Testimony and evidence.--The Task Force may take such 
        testimony and receive such evidence as the Task Force considers 
        advisable to carry out this section.
            (2) Obtaining official data.--The Task Force may secure 
        directly from any Federal department or agency information 
        necessary to carry out its duties under this section. On 
        request of the Co-Chairs of the Task Force, the head of that 
        department or agency shall furnish such information to the Task 
        Force.
            (3) Postal services.--The Task Force may use the United 
        States mails in the same manner and under the same conditions 
        as other Federal departments and agencies.
    (g) Report.--Not later than 2 years after the date on which the 
initial 18 members of the Task Force are appointed under subsection 
(c)(1), the Task Force shall submit to the Committee on Energy and 
Commerce, the Committee on Education and Labor, and the Committee on 
Ways and Means of the House of Representatives and the Committee on 
Finance and the Committee on Health, Education, Labor, and Pensions of 
the Senate, and make publicly available, a report that--
            (1) contains the information, evaluations, and 
        recommendations described in subsection (b); and
            (2) is signed by more than half of the members of the Task 
        Force.
    (h) Termination.--Section 14 of the Federal Advisory Committee Act 
(5 U.S.C. App.) shall not apply to the Task Force.
    (i) Definitions.--In this section:
            (1) Maternal health care provider.--The term ``maternal 
        health care provider'' means an individual who is an 
        obstetrician-gynecologist, family physician, midwife who meets 
        at a minimum the international definition of the midwife and 
        global standards for midwifery education as established by the 
        International Confederation of Midwives, nurse practitioner, or 
        clinical nurse specialist.
            (2) Maternal mortality review committee.--The term 
        ``maternal mortality review committee'' means a maternal 
        mortality review committee duly authorized by a State and 
        receiving funding under section 317K(a)(2)(D) of the Public 
        Health Service Act (42 U.S.C. 247b-12(a)(2)(D)).
            (3) Pregnancy-associated death.--The term ``pregnancy-
        associated death'' means a death of a woman, by any cause, that 
        occurs during, or within 1 year following, her pregnancy, 
        regardless of the outcome, duration, or site of the pregnancy.
            (4) Pregnancy-related death.--The term ``pregnancy-related 
        death'' means a death of a woman that occurs during, or within 
        1 year following, her pregnancy, regardless of the outcome, 
        duration, or site of the pregnancy--
                    (A) from any cause related to, or aggravated by, 
                the pregnancy or its management; and
                    (B) not from accidental or incidental causes.
    (j) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal years 2021 through 2024.

SEC. 504. INDIAN HEALTH SERVICE STUDY ON MATERNAL MORTALITY.

    (a) In General.--The Director of the Indian Health Service 
(referred to in this section as the ``Director'') shall, in 
coordination with the individuals described in subsection (b)(1)--
            (1) not later than 90 days after the date of enactment of 
        this Act, offer to enter into a contract with an independent 
        research organization or Tribal epidemiology center established 
        under section 214 of the Indian Health Care Improvement Act (25 
        U.S.C. 1621m) to conduct a comprehensive study on maternal 
        mortality and severe maternal morbidity in the populations of 
        American Indian and Alaska Native women; and
            (2) not later than 3 years after the date of enactment of 
        this Act, submit to Congress a report describing the results of 
        that study that contains recommendations for policies and 
        practices that can be adopted to improve maternal health 
        outcomes for those women.
    (b) Participating Entities.--
            (1) In general.--The individuals referred to in subsection 
        (a) are 12 individuals, selected by the Director from among 
        individuals nominated by Indian tribes, tribal organizations, 
        and urban Indian organizations (as those terms are defined in 
        section 4 of the Indian Health Care Improvement Act (25 U.S.C. 
        1603)).
            (2) Requirement.--In selecting individuals under paragraph 
        (1), the Director shall ensure that each of the 12 service 
        areas of the Indian Health Service is represented.
    (c) Contents of Study.--The study conducted pursuant to subsection 
(a) shall--
            (1) examine the causes of maternal mortality and severe 
        maternal morbidity that are unique to American Indian and 
        Alaska Native women;
            (2) include a systematic process of listening to the 
        stories of American Indian and Alaska Native women to fully 
        understand the causes of, and inform potential solutions to, 
        the maternal mortality and severe maternal morbidity crisis 
        within their respective communities;
            (3) distinguish between the causes of, landscape of 
        maternity care at, and recommendations to improve maternal 
        health outcomes within, the different settings in which 
        American Indian and Alaska Native women receive maternity care, 
        such as--
                    (A) facilities operated by the Indian Health 
                Service;
                    (B) an Indian health program operated by an Indian 
                tribe or tribal organization pursuant to a contract, 
                grant, cooperative agreement, or compact with the 
                Indian Health Service pursuant to the Indian Self-
                Determination Act (25 U.S.C. 5321 et seq.); and
                    (C) an urban Indian health program operated by an 
                urban Indian organization pursuant to a grant or 
                contract with the Indian Health Service pursuant to 
                title V of the Indian Health Care Improvement Act (25 
                U.S.C. 1651 et seq.);
            (4) review processes for coordinating programs of the 
        Indian Health Service with social services provided through 
        other programs administered by the Secretary of Health and 
        Human Services (other than the Medicare program under title 
        XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), the 
        Medicaid program under title XIX of that Act (42 U.S.C. 1396 et 
        seq.), and the Children's Health Insurance Program under title 
        XXI of that Act (42 U.S.C. 1397aa et seq.)), including 
        coordination with the efforts of the Task Force established 
        under section 503;
            (5) review current data collection and quality measurement 
        processes and practices;
            (6) consider social determinants of health, including 
        poverty, lack of health insurance, unemployment, sexual 
        violence, and environmental conditions in Tribal areas;
            (7) consider the role that historical mistreatment of 
        American Indian and Alaska Native women has played in causing 
        currently high rates of maternal mortality and severe maternal 
        morbidity;
            (8) consider how current funding of the Indian Health 
        Service affects the ability of the Indian Health Service to 
        deliver quality maternity care;
            (9) consider the extent to which the delivery of maternity 
        care services is culturally appropriate for American Indian and 
        Alaska Native women;
            (10) make recommendations to reduce misclassification of 
        American Indian and Alaska Native women, including 
        consideration of best practices in training for maternal 
        mortality review committee members to be able to correctly 
        classify American Indian and Alaska Native women; and
            (11) make recommendations informed by the stories shared by 
        American Indian and Alaska Native women under paragraph (2) to 
        improve maternal health outcomes for such women.
    (d) Report.--The contract entered into under subsection (a)(1) with 
an independent research organization or Tribal epidemiology center 
established under section 214 of the Indian Health Care Improvement Act 
(25 U.S.C. 1621m) shall require that the organization or center submit 
to Congress a report on the results of the study conducted pursuant to 
that contract not later than 3 years after the date of enactment of 
this Act.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $2,000,000 for each of fiscal 
years 2021 through 2023.

SEC. 505. GRANTS TO MINORITY-SERVING INSTITUTIONS TO STUDY MATERNAL 
              MORTALITY, SEVERE MATERNAL MORBIDITY, AND OTHER ADVERSE 
              MATERNAL HEALTH OUTCOMES.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a program under which the Secretary shall award grants to 
minority-serving institutions to study specific aspects of the maternal 
health crisis among minority women. Such research may--
            (1) include the development and implementation of 
        systematic processes of listening to the stories of minority 
        women to fully understand the causes of, and inform potential 
        solutions to, the maternal mortality and severe maternal 
        morbidity crisis within their respective communities; and
            (2) assess the potential causes of low rates of maternal 
        mortality among Hispanic women, including potential racial 
        misclassification and other data collection and reporting 
        issues that might be misrepresenting maternal mortality rates 
        among Hispanic women in the United States.
    (b) Application.--To be eligible to receive 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) Technical Assistance.--The Secretary may use not more than 10 
percent of the funds made available under subsection (f)--
            (1) to conduct outreach to minority-serving institutions to 
        raise awareness of the availability of grants under this 
        subsection (a);
            (2) to provide technical assistance in the application 
        process for such a grant; and
            (3) to promote capacity building as needed to enable 
        entities described in such subsection to submit such an 
        application.
    (d) 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.
    (e) Evaluation.--Beginning one year after the date on which the 
first grant is awarded under this section, the Secretary shall submit 
to Congress an annual report summarizing the findings of research 
conducted using funds made available under this section.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2021 through 2025.
    (g) Minority-Serving Institutions Defined.--In this section, the 
term ``minority-serving institution'' means an eligible institution 
described in section 371(a) of the Higher Education Act of 1965 (20 
U.S.C. 1067q(a)).

                         TITLE VI--MOMS MATTER

SEC. 601. 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 individuals 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 individual.
                    ``(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 the State Children's Health 
                Insurance Program 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 Black Maternal Health Momnibus Act of 2020, 
        and every year thereafter, the Task Force shall submit to the 
        Congress, the Centers for Medicare & Medicaid Services, 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 399OO-
        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;
                    ``(E) psychological outcomes; and
                    ``(F) 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.''.

                TITLE VII--JUSTICE FOR INCARCERATED MOMS

SEC. 701. SENSE OF CONGRESS.

    It is the sense of Congress that the respect and proper care that 
mothers deserve are inclusive, and whether the mothers are transgender, 
cisgender, or gender nonconforming, all deserve dignity.

SEC. 702. ENDING THE SHACKLING OF PREGNANT INDIVIDUALS.

    (a) In General.--Beginning on the date that is 6 months after the 
date of enactment of this Act, and in each fiscal year thereafter, the 
total amount of a grant to be allocated to a State for a fiscal year 
under subpart 1 of part E of title I of the Omnibus Crime Control and 
Safe Streets Act of 1968 (34 U.S.C. 10151 et seq.) (commonly referred 
to as the ``Edward Byrne Memorial Justice Grant Program'') shall be 
decreased by 25 percent if the State does not have in effect for such 
fiscal year laws restricting, throughout the State, the use of 
restraints on pregnant individuals in prison that are substantially 
similar to the rights, procedures, requirements, effects, and penalties 
set forth in section 4322 of title 18, United States Code.
    (b) Reallocation.--Amounts not allocated to a State because of a 
decrease under subsection (a) shall be reallocated in accordance with 
subpart 1 of part E of title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (34 U.S.C. 10151 et seq.) to States that are not 
subject to the decrease under subsection (a).

SEC. 703. CREATING MODEL PROGRAMS FOR THE CARE OF INCARCERATED 
              INDIVIDUALS IN THE PRENATAL AND POSTPARTUM PERIODS.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Attorney General, acting through the Director of the 
Bureau of Prisons, shall establish, in not more than 6 Bureau of 
Prisons facilities, programs to optimize maternal health outcomes for 
pregnant and postpartum individuals incarcerated in such facilities.
    (b) Consultation.--The Attorney General shall establish the 
programs required under subsection (a) in consultation with interested 
entities such as--
            (1) relevant community-based organizations, particularly 
        organizations that represent incarcerated and formerly 
        incarcerated individuals and organizations that seek to improve 
        maternal health outcomes for minority women;
            (2) relevant organizations representing patients, with a 
        particular focus on minority patients;
            (3) relevant organizations representing maternal health 
        care providers;
            (4) nonclinical perinatal health workers such as doulas, 
        community health workers, peer supporters, certified lactation 
        consultants, nutritionists and dietitians, social workers, home 
        visitors, and navigators; and
            (5) researchers and policy experts in fields related to 
        women's health care for incarcerated individuals.
    (c) Start Date.--Each facility selected by the Director of the 
Bureau of Prisons under subsection (a) shall begin facility programs 
not later than 18 months after the date of enactment of this Act.
    (d) Facility Priority.--In carrying out subsection (a), the 
Director of the Bureau of Prisons shall give priority to a facility 
based on--
            (1) the number of pregnant and postpartum individuals 
        incarcerated in such facility and, among such individuals, the 
        number of pregnant and postpartum minority individuals; and
            (2) the extent to which the leaders of such facility have 
        demonstrated a commitment to developing exemplary programs for 
        pregnant and postpartum individuals incarcerated in such 
        facility.
    (e) Program Duration.--Each program established under this section 
shall be for a 5-year period.
    (f) Programs.--Each Bureau of Prisons facility selected under 
subsection (a) shall establish programs for pregnant and postpartum 
incarcerated individuals, and such programs may--
            (1) provide access to doulas and other perinatal health 
        workers from pregnancy through the postpartum period;
            (2) provide access to healthy foods and counseling on 
        nutrition, recommended activity levels, and safety measures 
        throughout pregnancy;
            (3) train correctional officers and medical personnel to 
        ensure that pregnant incarcerated individuals receive trauma-
        informed, culturally congruent care that promotes the health 
        and safety of the pregnant individuals;
            (4) provide counseling and treatment for individuals who 
        have suffered from--
                    (A) diagnosed mental or behavioral health 
                conditions, including trauma and substance use 
                disorders;
                    (B) domestic violence;
                    (C) human immunodeficiency virus;
                    (D) sexual abuse;
                    (E) pregnancy or infant loss; or
                    (F) chronic conditions, including heart disease, 
                diabetes, osteoporosis and osteopenia, hypertension, 
                asthma, liver disease, and bleeding disorders;
            (5) provide pregnancy and childbirth education, parenting 
        support, and other relevant forms of health literacy;
            (6) offer opportunities for postpartum individuals to 
        maintain contact with the individual's newborn child to promote 
        bonding, including enhanced visitation policies, access to 
        prison nursery programs, or breastfeeding support;
            (7) provide reentry assistance, particularly to--
                    (A) ensure continuity of health insurance coverage 
                if an incarcerated individual exits the criminal 
                justice system during such individual's pregnancy or in 
                the postpartum period; and
                    (B) connect individuals exiting the criminal 
                justice system during pregnancy or in the postpartum 
                period to community-based resources, such as referrals 
                to health care providers and social services that 
                address social determinants of health like housing, 
                employment opportunities, transportation, and 
                nutrition; or
            (8) establish partnerships with local 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)) to 
        establish or expand pretrial diversion programs as an 
        alternative to incarceration for pregnant and postpartum 
        individuals. Such programs may include--
                    (A) parenting classes;
                    (B) prenatal health coordination;
                    (C) family and individual counseling;
                    (D) evidence-based screenings, education, and, as 
                needed, treatment for mental and behavioral health 
                conditions, including drug and alcohol treatments;
                    (E) family case management services;
                    (F) domestic violence education and prevention;
                    (G) physical and sexual abuse counseling; and
                    (H) programs to address social determinants of 
                health such as employment, housing, education, 
                transportation, and nutrition.
    (g) Implementation and Reporting.--Each Bureau of Prisons facility 
selected under subsection (a) shall be responsible for--
            (1) implementing programs, which may include the programs 
        described in subsection (f); and
            (2) not later than 3 years after the date of enactment of 
        this Act, and 6 years after the date of enactment of this Act, 
        reporting results of the programs to the Director of the Bureau 
        of Prisons, including information describing--
                    (A) relevant quantitative indicators of success in 
                improving the standard of care and health outcomes for 
                pregnant and postpartum incarcerated individuals who 
                participated in such programs, including data 
                stratified by race, ethnicity, sex, age, geography, 
                disability status, the category of the criminal charge 
                against such individual, rates of pregnancy-related 
                deaths, pregnancy-associated deaths, cases of infant 
                mortality, cases of severe maternal morbidity, cases of 
                violence against pregnant or postpartum individuals, 
                diagnoses of maternal mental or behavioral health 
                conditions, and other such information as appropriate;
                    (B) relevant qualitative evaluations from pregnant 
                and postpartum incarcerated individuals who 
                participated in such programs, including subjective 
                measures of patient-reported experience of care;
                    (C) evaluations of cost effectiveness; and
                    (D) strategies to sustain such programs beyond 
                2026.
    (h) Report.--Not later than 7 years after the date of enactment of 
this Act, the Director of the Bureau of Prisons shall submit to the 
Attorney General and to the Committee on the Judiciary of the House of 
Representatives and the Committee on the Judiciary of the Senate a 
report describing the results of the programs funded under this 
section.
    (i) Oversight.--Not later than 1 year after the date of enactment 
of this Act, the Attorney General shall award a contract to an 
independent organization or independent organizations to conduct 
oversight of the programs described in subsection (f).
    (j) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2021 through 2025.

SEC. 704. GRANT PROGRAM TO IMPROVE MATERNAL HEALTH OUTCOMES FOR 
              INDIVIDUALS IN STATE AND LOCAL PRISONS AND JAILS.

    (a) Establishment.--Not later than 1 year after the date of 
enactment of this Act, the Attorney General, acting through the 
Director of the Bureau of Justice Assistance, shall award Justice for 
Incarcerated Moms grants to States to establish or expand programs in 
State and local prisons and jails for pregnant and postpartum 
incarcerated individuals.
    (b) Consultation.--The Attorney General shall award the grants 
authorized under subsection (a) in consultation with interested 
entities such as--
            (1) relevant community-based organizations, particularly 
        organizations that represent incarcerated and formerly 
        incarcerated individuals and organizations that seek to improve 
        maternal health outcomes for minority women;
            (2) relevant organizations representing patients, with a 
        particular focus on minority patients;
            (3) relevant organizations representing maternal health 
        care providers;
            (4) nonclinical perinatal health workers such as doulas, 
        community health workers, peer supporters, certified lactation 
        consultants, nutritionists and dietitians, social workers, home 
        visitors, and navigators; and
            (5) researchers and policy experts in fields related to 
        women's health care for incarcerated individuals.
    (c) Applications.--Each applicant for a grant under this section 
shall submit to the Director of the Bureau of Justice Assistance an 
application at such time, in such manner, and containing such 
information as the Director may require.
    (d) Use of Funds.--A State that is awarded a grant under this 
section shall use such grant to establish or expand programs for 
pregnant and postpartum incarcerated individuals, and such programs 
may--
            (1) provide access to doulas and other perinatal health 
        workers from pregnancy through the postpartum period;
            (2) provide access to healthy foods and counseling on 
        nutrition, recommended activity levels, and safety measures 
        throughout pregnancy;
            (3) train correctional officers and medical personnel to 
        ensure that pregnant incarcerated individuals receive trauma-
        informed, culturally congruent care that promotes the health 
        and safety of the pregnant individuals;
            (4) provide counseling and treatment for individuals who 
        have suffered from--
                    (A) diagnosed mental or behavioral health 
                conditions, including trauma and substance use 
                disorders;
                    (B) domestic violence;
                    (C) human immunodeficiency virus;
                    (D) sexual abuse;
                    (E) pregnancy or infant loss; or
                    (F) chronic conditions, including heart disease, 
                diabetes, osteoporosis and osteopenia, hypertension, 
                asthma, liver disease, and bleeding disorders;
            (5) provide pregnancy and childbirth education, parenting 
        support, and other relevant forms of health literacy;
            (6) offer opportunities for postpartum individuals to 
        maintain contact with the individual's newborn child to promote 
        bonding, including enhanced visitation policies, access to 
        prison nursery programs, or breastfeeding support;
            (7) provide reentry assistance, particularly to--
                    (A) ensure continuity of health insurance coverage 
                if an incarcerated individual exits the criminal 
                justice system during such individual's pregnancy or in 
                the postpartum period; and
                    (B) connect individuals exiting the criminal 
                justice system during pregnancy or in the postpartum 
                period to community-based resources, such as referrals 
                to health care providers and social services that 
                address social determinants of health like housing, 
                employment opportunities, transportation, and 
                nutrition; or
            (8) establish partnerships with local 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)) to 
        establish or expand pretrial diversion programs as an 
        alternative to incarceration for pregnant and postpartum 
        individuals. Such programs may include--
                    (A) parenting classes;
                    (B) prenatal health coordination;
                    (C) family and individual counseling;
                    (D) evidence-based screenings, education, and, as 
                needed, treatment for mental and behavioral health 
                conditions, including drug and alcohol treatments;
                    (E) family case management services;
                    (F) domestic violence education and prevention;
                    (G) physical and sexual abuse counseling; and
                    (H) programs to address social determinants of 
                health such as employment, housing, education, 
                transportation, and nutrition.
    (e) Priority.--In awarding grants under this section, the Director 
of the Bureau of Justice Assistance shall give priority to applicants 
based on--
            (1) the number of pregnant and postpartum individuals 
        incarcerated in the State and, among such individuals, the 
        number of pregnant and postpartum minority individuals; and
            (2) the extent to which the State has demonstrated a 
        commitment to developing exemplary programs for pregnant and 
        postpartum individuals incarcerated in the prisons and jails in 
        the State.
    (f) Grant Duration.--A grant awarded under this section shall be 
for a 5-year period.
    (g) Implementing and Reporting.--A State that receives a grant 
under this section shall be responsible for--
            (1) implementing the program funded by the grant; and
            (2) not later than 3 years after the date of enactment of 
        this Act, and 6 years after the date of enactment of this Act, 
        reporting results of such program to the Attorney General, 
        including information describing--
                    (A) relevant quantitative indicators of the 
                program's success in improving the standard of care and 
                health outcomes for pregnant and postpartum 
                incarcerated individuals who participated in such 
                program, including data stratified by race, ethnicity, 
                sex, age, geography, disability status, category of the 
                criminal charge against such individual, incidence 
                rates of pregnancy-related deaths, pregnancy-associated 
                deaths, cases of infant mortality, cases of severe 
                maternal morbidity, cases of violence against pregnant 
                or postpartum individuals, diagnoses of maternal mental 
                or behavioral health conditions, and other such 
                information as appropriate;
                    (B) relevant qualitative evaluations from pregnant 
                and postpartum incarcerated individuals who 
                participated in such programs, including subjective 
                measures of patient-reported experience of care;
                    (C) evaluations of cost effectiveness; and
                    (D) strategies to sustain such programs beyond the 
                duration of the grant.
    (h) Report.--Not later than 7 years after the date of enactment of 
this Act, the Attorney General shall submit to the Committee on the 
Judiciary of the House of Representatives and the Committee on the 
Judiciary of the Senate a report describing the results of the grant 
program authorized under this section.
    (i) Oversight.--Not later than 1 year after the date of enactment 
of this Act, the Attorney General shall award a contract to an 
independent organization or independent organizations to conduct 
oversight of the programs described in subsection (d).
    (j) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2021 through 2025.

SEC. 705. GAO REPORT.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, the Comptroller General of the United States shall submit 
to Congress a report on adverse maternal health outcomes among 
incarcerated individuals, with a particular focus on racial and ethnic 
disparities in maternal health outcomes for incarcerated individuals.
    (b) Contents of Report.--The report required under subsection (a) 
shall include--
            (1) to the extent practicable--
                    (A) the number of incarcerated individuals, 
                including those incarcerated in Federal, State, and 
                local correctional facilities, who have experienced a 
                pregnancy-related death or pregnancy-associated death 
                in the most recent 10 years of available data;
                    (B) the number of cases of severe maternal 
                morbidity among incarcerated individuals, including 
                those incarcerated in Federal, State, and local 
                detention facilities, in the most recent year of 
                available data; and
                    (C) statistics on the racial and ethnic disparities 
                in maternal and infant health outcomes and severe 
                maternal morbidity rates among incarcerated 
                individuals, including those incarcerated in Federal, 
                State, and local detention facilities;
            (2) in the case that the Comptroller General of the United 
        States is unable to determine the information required in 
        subparagraphs (A) through (C) of paragraph (1), an assessment 
        of the barriers to determining such information and 
        recommendations for improvements in tracking maternal health 
        outcomes among incarcerated individuals, including those 
        incarcerated in Federal, State, and local detention facilities;
            (3) causes of adverse maternal health outcomes that are 
        unique to incarcerated individuals, including those 
        incarcerated in Federal, State, and local detention facilities;
            (4) causes of adverse maternal health outcomes and severe 
        maternal morbidity that are unique to incarcerated individuals 
        of color;
            (5) recommendations to reduce maternal mortality and severe 
        maternal morbidity among incarcerated individuals and to 
        address racial and ethnic disparities in maternal health 
        outcomes for incarcerated individuals in Bureau of Prisons 
        facilities and State and local prisons and jails; and
            (6) such other information as may be appropriate to reduce 
        the occurrence of adverse maternal health outcomes among 
        incarcerated individuals and to address racial and ethnic 
        disparities in maternal health outcomes for such individuals.

SEC. 706. MACPAC REPORT.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, the Medicaid and CHIP Payment and Access Commission 
(referred to in this section as ``MACPAC'') shall publish a report on 
the implications of pregnant and postpartum incarcerated individuals 
being ineligible for medical assistance under a State plan under title 
XIX of the Social Security Act (42 U.S.C. 1396 et seq.).
    (b) Contents of Report.--The report described in this section shall 
include--
            (1) information on the effect of ineligibility for medical 
        assistance under a State plan under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.) on maternal health 
        outcomes for pregnant and postpartum incarcerated individuals, 
        concentrating on the effects of such ineligibility for pregnant 
        and postpartum individuals of color; and
            (2) the potential implications on maternal health outcomes 
        resulting from suspending eligibility for medical assistance 
        under a State plan under such title of such Act when a pregnant 
        or postpartum individual is incarcerated.

                     TITLE VIII--TECH TO SAVE MOMS

SEC. 801. 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. 802. 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 shall, as appropriate, 
award grants to eligible entities to evaluate, develop, and expand the 
use of technology-enabled collaborative learning and capacity building 
models, to improve maternal health outcomes--
            ``(1) in health professional shortage areas;
            ``(2) in areas with high rates of maternal mortality and 
        severe maternal morbidity, and significant racial and ethnic 
        disparities in maternal health outcomes; and
            ``(3) 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;
                    ``(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 for 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.--
            ``(1) In general.--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 for populations described in 
        subsection (a).
            ``(2) Coordination support.--The Secretary may award a 
        grant or contract to assist in the coordination of models 
        described in paragraph (1), including to assess outcomes 
        associated with the use of such models in grants awarded under 
        subsection (a), including grants awarded 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--
            ``(1) for health professional shortage areas;
            ``(2) for areas with high rates of maternal mortality and 
        severe maternal morbidity, and significant racial and ethnic 
        disparities in maternal health outcomes; and
            ``(3) 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 evaluation activities conducted 
                        under subsection (b)(1)(B)(i);
                            ``(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) from 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 (25 U.S.C. 5304).
            ``(4) Maternal mortality.--The term `maternal mortality' 
        means a death occurring during or within 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 morbidity.--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.
            ``(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 (25 U.S.C. 
        5304).
            ``(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 (25 U.S.C. 1603).''.

SEC. 803. 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, to be known as the ``Investments in Digital 
Tools to Promote Equity in Maternal Health Outcomes Program'', under 
which the Secretary makes grants to eligible entities to 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 addresses 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 be 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 & Medicaid Services 
                        for addressing such barriers in State Medicaid 
                        programs;
                            (v) the use of consumer digital tools 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) 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 or any successor regulation, including 
domestic faith-based and community-based organizations.
    (g) 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.

SEC. 804. 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 section 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 be 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.

                     TITLE IX--IMPACT TO SAVE MOMS

SEC. 901. PERINATAL CARE ALTERNATIVE PAYMENT MODEL DEMONSTRATION 
              PROJECT.

    (a) In General.--For the period of fiscal years 2022 through 2026, 
the Secretary of Health and Human Services (referred to in this section 
as the ``Secretary''), acting through the Administrator of the Centers 
for Medicare & Medicaid Services, shall establish and implement, in 
accordance with the requirements of this section, a demonstration 
project, to be known as the Perinatal Care Alternative Payment Model 
Demonstration Project (referred to in this section as the 
``Demonstration Project''), for purposes of allowing States to test 
payment models under their State plans under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.) and State child health plans 
under title XXI of such Act (42 U.S.C. 1397aa et seq.) with respect to 
maternity care provided to pregnant and postpartum women enrolled in 
such State plans and State child health plans.
    (b) Coordination.--In establishing the Demonstration Project, the 
Secretary shall coordinate with stakeholders such as--
            (1) State Medicaid programs;
            (2) relevant organizations representing maternal health 
        care providers;
            (3) relevant organizations representing patients, with a 
        particular focus on women from demographic groups with 
        disproportionate rates of adverse maternal health outcomes;
            (4) relevant community-based organizations, particularly 
        organizations that seek to improve maternal health outcomes for 
        women from demographic groups with disproportionate rates of 
        adverse maternal health outcomes;
            (5) non-clinical perinatal health workers such as doulas, 
        community health workers, peer supporters, certified lactation 
        consultants, nutritionists and dieticians, social workers, home 
        visitors, and navigators;
            (6) relevant health insurance issuers;
            (7) hospitals, health systems, freestanding birth centers 
        (as such term is defined in paragraph (3)(B) of section 1905(l) 
        of the Social Security Act (42 U.S.C. 1396d(l)), Federally-
        qualified health centers (as such term is defined in paragraph 
        (2)(B) of such section), and rural health clinics (as such term 
        is defined in section 1861(aa) of such Act (42 U.S.C. 
        1395x(aa)));
            (8) researchers and policy experts in fields related to 
        maternity care payment models; and
            (9) any other stakeholders as the Secretary determines 
        appropriate, with a particular focus on stakeholders from 
        demographic groups with disproportionate rates of adverse 
        maternal health outcomes.
    (c) Considerations.--In establishing the Demonstration Project, the 
Secretary shall consider each of the following:
            (1) Findings from any evaluations of the Strong Start for 
        Mothers and Newborns initiative carried out by the Centers for 
        Medicare & Medicaid Services, the Health Resources and Services 
        Administration, and the Administration on Children and 
        Families.
            (2) Any alternative payment model that--
                    (A) is designed to improve maternal health outcomes 
                for racial and ethnic groups with disproportionate 
                rates of adverse maternal health outcomes;
                    (B) includes methods for stratifying patients by 
                pregnancy risk level and, as appropriate, adjusting 
                payments under such model to take into account 
                pregnancy risk level;
                    (C) establishes evidence-based quality metrics for 
                such payments;
                    (D) includes consideration of non-hospital birth 
                settings such as freestanding birth centers (as so 
                defined);
                    (E) includes consideration of social determinants 
                of health that are relevant to maternal health outcomes 
                such as housing, transportation, nutrition, and other 
                non-clinical factors that influence maternal health 
                outcomes; or
                    (F) includes diverse maternity care teams that 
                include--
                            (i) maternity care providers, including 
                        obstetrician-gynecologists, family physicians, 
                        physician assistants, midwives who meet, at a 
                        minimum, the international definition of the 
                        term ``midwife'' and global standards for 
                        midwifery education (as established by the 
                        International Confederation of Midwives), and 
                        nurse practitioners--
                                    (I) from racially, ethnically, and 
                                professionally diverse backgrounds;
                                    (II) with experience practicing in 
                                racially and ethnically diverse 
                                communities; or
                                    (III) who have undergone trainings 
                                on racism, implicit bias, and explicit 
                                bias; and
                            (ii) non-clinical perinatal health workers 
                        such as doulas, community health workers, peer 
                        supporters, certified lactation consultants, 
                        nutritionists and dieticians, social workers, 
                        home visitors, and navigators.
    (d) Eligibility.--To be eligible to participate in the 
Demonstration Project, a State shall submit an application to the 
Secretary at such time, in such manner, and containing such information 
as the Secretary may require.
    (e) Evaluation.--The Secretary shall conduct an evaluation of the 
Demonstration Project to determine the impact of the Demonstration 
Project on--
            (1) maternal health outcomes, with data stratified by race, 
        ethnicity, socioeconomic indicators, and any other factors as 
        the Secretary determines appropriate;
            (2) spending on maternity care by States participating in 
        the Demonstration Project;
            (3) to the extent practicable, subjective measures of 
        patient experience; and
            (4) any other areas of assessment that the Secretary 
        determines relevant.
    (f) Report.--Not later than 1 year after the completion or 
termination date of the Demonstration Project, the Secretary shall 
submit to the Committee on Energy and Commerce, the Committee on Ways 
and Means, and the Committee on Education and Labor of the House of 
Representatives and the Committee on Finance and the Committee on 
Health, Education, Labor, and Pensions of the Senate, and make publicly 
available, a report containing--
            (1) the results of any evaluation conducted under 
        subsection (e); and
            (2) a recommendation regarding whether the Demonstration 
        Project should be continued after fiscal year 2026 and expanded 
        on a national basis.
    (g) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as are necessary to carry out this section.
    (h) Definitions.--In this section:
            (1) Alternative payment model.--The term ``alternative 
        payment model'' has the meaning given such term in section 
        1833(z)(3)(C) of the Social Security Act (42 U.S.C. 
        1395l(z)(3)(C)).
            (2) Perinatal.--The term ``perinatal'' means the period 
        beginning on the day a woman becomes pregnant and ending on the 
        last day of the 1-year period beginning on the last day of such 
        woman's pregnancy.

SEC. 902. MACPAC REPORT.

    Not later than 2 years after the date of the enactment of this Act, 
the Medicaid and CHIP Payment and Access Commission shall publish a 
report on issues relating to the continuity of coverage under State 
plans under title XIX of the Social Security Act (42 U.S.C. 1396 et 
seq.) and State child health plans under title XXI of such Act (42 
U.S.C. 1397aa et seq.) for pregnant and postpartum women. Such report 
shall, at a minimum, include the following:
            (1) An assessment of any existing policies under such State 
        plans and such State child health plans regarding presumptive 
        eligibility for pregnant women while their application for 
        enrollment in such a State plan or such a State child health 
        plan is being processed.
            (2) An assessment of any existing policies under such State 
        plans and such State child health plans regarding measures to 
        ensure continuity of coverage under such a State plan or such a 
        State child health plan for pregnant and postpartum women, 
        including such women who need to change their health insurance 
        coverage during their pregnancy or the postpartum period 
        following their pregnancy.
            (3) An assessment of any existing policies under such State 
        plans and such State child health plans regarding measures to 
        automatically reenroll women who are eligible to enroll under 
        such a State plan or such a State child health plan as a 
        parent.
            (4) If determined appropriate by the Commission, any 
        recommendations for the Department of Health and Human 
        Services, or such State plans and such State child health 
        plans, to ensure continuity of coverage under such a State plan 
        or such a State child health plan for pregnant and postpartum 
        women.
                                 <all>