116 S3424 IS: Black Maternal Health Momnibus Act of 2020
U.S. Senate
2020-03-10
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.This Act may be cited as the Black Maternal Health Momnibus Act of 2020
. 2.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.
3.In this Act: (1)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)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)The term postpartum means the 1-year period beginning on the last day of a woman’s pregnancy.
(4)Severe maternal morbidityThe 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. <enum>I</enum><header>Social Determinants for Moms</header> <section id="H5E605AC1178F48CDBF60CCA1E20A3216"><enum>101.</enum><header>Task force to coordinate efforts to address social determinants of health for women in the prenatal and postpartum periods</header> <subsection id="H757D2088440E4BDBA3162FF0CE5885D2"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services shall convene a task force (in this section referred to as the <quote>Task Force</quote>) to develop strategies to coordinate efforts across the Federal Government to address social determinants of health for women in the prenatal and postpartum periods.</text></subsection>
<subsection id="HBE5CC63FEF864CD590B471E4BA789DEF"><enum>(b)</enum><header>Members</header><text display-inline="yes-display-inline">The members of the Task Force shall consist of the following:</text> <paragraph id="HB92D8661942244A2A66620765B3C7EE7"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary of Health and Human Services (or the Secretary’s designee).</text></paragraph>
<paragraph id="HF7C36040D74D42A78042746C13068C9F"><enum>(2)</enum><text display-inline="yes-display-inline">The Secretary of Housing and Urban Development (or the Secretary’s designee).</text></paragraph> <paragraph id="HCD68455858264A85842A85F1B3FBB7D3"><enum>(3)</enum><text>The Secretary of Transportation (or the Secretary’s designee).</text></paragraph>
<paragraph id="H7ACB4DC978F24B7CA59ECBF62BF5828E"><enum>(4)</enum><text>The Secretary of Agriculture (or the Secretary’s designee).</text></paragraph> <paragraph id="H4EA9A5ED223F41D4A0E02D8405A67EC1"><enum>(5)</enum><text display-inline="yes-display-inline">The Administrator of the Environmental Protection Agency (or the Administrator’s designee).</text></paragraph>
<paragraph id="H96AC6BCBEC5B4471B1FD02506C96A6FE"><enum>(6)</enum><text display-inline="yes-display-inline">The Assistant Secretary for the Administration for Children and Families (or the Assistant Secretary’s designee).</text></paragraph> <paragraph id="H5402A7DE0E6B44AE9AE1713C30E483B1"><enum>(7)</enum><text display-inline="yes-display-inline">The Administrator of the Centers for Medicare & Medicaid Services (or the Administrator’s designee).</text></paragraph>
<paragraph id="H6AA3AE6E46694BFCA719D920636666FE"><enum>(8)</enum><text display-inline="yes-display-inline">The Director of the Indian Health Service (or the Director’s designee).</text></paragraph> <paragraph id="H74C6E4AFFB3B4D76A779CA1407727263"><enum>(9)</enum><text display-inline="yes-display-inline">The Director of the National Institutes of Health (or the Director’s designee).</text></paragraph>
<paragraph id="HD828F6C137444E69B3D7D01E112160C5"><enum>(10)</enum><text display-inline="yes-display-inline">The Administrator of the Health Resources and Services Administration (or the Administrator’s designee).</text></paragraph> <paragraph id="HE1A37CCAE1C7462795DD518FA294906A"><enum>(11)</enum><text display-inline="yes-display-inline">The Deputy Assistant Secretary for Minority Health of the Department of Health and Human Services (or the Deputy Assistant Secretary’s designee).</text></paragraph>
<paragraph id="HD76D6211BB0747D997A07D95FE39CED4"><enum>(12)</enum><text display-inline="yes-display-inline">The Deputy Assistant Secretary for Women’s Health of the Department of Health and Human Services (or the Deputy Assistant Secretary’s designee).</text></paragraph> <paragraph id="HF5F92D5CC8AD4D50A7333357FF2632DB"><enum>(13)</enum><text display-inline="yes-display-inline">The Director of the Centers for Disease Control and Prevention (or the Director’s designee).</text></paragraph>
<paragraph id="H9CCA449D7C8D4AC59ADF71AAF5203549"><enum>(14)</enum><text>A woman who has experienced severe maternal morbidity or a family member of a woman who has suffered a pregnancy-related death.</text></paragraph> <paragraph id="HE2E3AC6FF9044FEEB7E66F2D2B00C972"><enum>(15)</enum><text>A leader of a community-based organization that addresses maternal mortality and severe maternal morbidity with a specific focus on racial and ethnic disparities.</text></paragraph>
<paragraph id="HC7E19799872F415286FC46836158B924"><enum>(16)</enum><text>A maternal health care provider.</text></paragraph></subsection> <subsection id="H26040DFBB72249CAACE2958826AD43CF"><enum>(c)</enum><header>Chair</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services shall select the Chair of the Task Force from among the members of the Task Force.</text></subsection>
<subsection id="H2102B8CEAC4940799B8E9AE18D2AC14C"><enum>(d)</enum><header>Report</header><text>Not later than 2 years after the date of enactment of this Act, the Task Force shall—</text> <paragraph id="HA905FD82F69F4B1CB97AB62AAD4B6108"><enum>(1)</enum><text display-inline="yes-display-inline">finalize strategies to coordinate efforts across the Federal Government to address social determinants of health for women in the prenatal and postpartum periods; and </text></paragraph>
<paragraph id="HC2DE3CD113EE48E69C0C25AE7A791A47"><enum>(2)</enum><text display-inline="yes-display-inline">submit a report on such strategies to the Congress, including—</text> <subparagraph id="HC7C25C2169864623B5B5C6C7FA58020F"><enum>(A)</enum><text>plans for implementing such strategies; and</text></subparagraph>
<subparagraph id="H2923EE44107147349551AC80B8E26705"><enum>(B)</enum><text>recommendations on the funding amounts needed by each Federal department and agency to implement such strategies.</text></subparagraph></paragraph></subsection> <subsection id="HE2D57103E80E4C8495540D3BD57BACD6"><enum>(e)</enum><header>Termination</header><text display-inline="yes-display-inline">The termination provisions under <external-xref legal-doc="usc-act" parsable-cite="usc-act/Federal Advisory Committee Act /14">section 14</external-xref> of the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Task Force.</text></subsection></section>
<section commented="no" id="HB23718314B0741128FFB791F6868C640"><enum>102.</enum><header>Requirements for guidance relating to social determinants of health for pregnant women</header>
<subsection commented="no" id="H88A258841FBD4334AA63C65388609C0A"><enum>(a)</enum><header>In general</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b</external-xref>) to address the following issues related to social determinants of health for high-risk mothers during the presumptive eligibility period for pregnant women:</text> <paragraph commented="no" id="H7BC78DEADAC941F7837F2C03C1941F01"><enum>(1)</enum><text>Housing.</text></paragraph>
<paragraph commented="no" id="H7CD98A54178741F298131FD2632211CD"><enum>(2)</enum><text>Transportation.</text></paragraph> <paragraph commented="no" id="HDF05451FD3094F1E841E7939737A3393"><enum>(3)</enum><text>Nutrition.</text></paragraph>
<paragraph commented="no" id="HD47B4C4227E8483BB7B3AE9DAF135CA8"><enum>(4)</enum><text display-inline="yes-display-inline">Lactation and other infant feeding options support.</text></paragraph> <paragraph commented="no" id="HF41977496E5943EBBE08A2C4DECEE380"><enum>(5)</enum><text>Lead testing and abatement.</text></paragraph>
<paragraph id="HDB3CB5362C104A658B867B081D1C59E9"><enum>(6)</enum><text>Air and water quality.</text></paragraph> <paragraph commented="no" id="HAD6F506CF3FB4FDFB160BCD6FCA320A7"><enum>(7)</enum><text>Car seat installation.</text></paragraph>
<paragraph id="H97C1FB9B35A64A7BBCFFB2786E460414"><enum>(8)</enum><text display-inline="yes-display-inline">Child care access.</text></paragraph> <paragraph commented="no" id="H8575B39F28BC49949E500D9D36BB800D"><enum>(9)</enum><text>Wellness and stress management programs.</text></paragraph>
<paragraph commented="no" id="HE2A7963D0C384CA8B59EF8DA18DDEC29"><enum>(10)</enum><text>Other social determinants of health (as determined by the Secretary).</text></paragraph></subsection> <subsection commented="no" id="H06385D0B0B324A70BB85A41466409483"><enum>(b)</enum><header>Definitions</header><text>In this section:</text>
<paragraph commented="no" id="HFE597A62DA2A42C48295DCB6693714B5"><enum>(1)</enum><header>Medicaid managed care organizations</header><text display-inline="yes-display-inline">The term <term>medicaid managed care organization</term> has the meaning given such term in section 1903(m)(1)(A) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(m)(1)(A)</external-xref>).</text></paragraph> <paragraph commented="no" id="HA690EA6497BF4BA7B53DCB20F03349C3"><enum>(2)</enum><header>Presumptive eligibility period</header><text display-inline="yes-display-inline">The term <term>presumptive eligibility period</term> has the meaning given such term in section 1920(b)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-1">42 U.S.C. 1396r–1(b)(1)</external-xref>).</text></paragraph></subsection></section>
<section commented="no" id="HF7533BAB85584D7F8A7CBDC3634B8D51"><enum>103.</enum><header>Department of Housing and Urban Development</header>
<subsection commented="no" id="idFBAD631137854B9284D97DF2DA9AC7A2"><enum>(a)</enum><header>Definitions</header><text>In this section—</text> <paragraph commented="no" id="id9C25B22DD8884CD6B4C2F4ABBC143150"><enum>(1)</enum><text>the term <term>Department</term> means the Department of Housing and Urban Development;</text></paragraph>
<paragraph commented="no" id="id8633158358B344D9AD60D65B5959D3E5"><enum>(2)</enum><text>the term <term>Secretary</term> means the Secretary of Housing and Urban Development; and</text></paragraph> <paragraph commented="no" id="idF19699036C8E4DF7B85EF53D17DFE57B"><enum>(3)</enum><text>the term <term>task force</term> means the Housing for Moms Task Force established under subsection (b).</text></paragraph></subsection>
<subsection commented="no" id="id4BEF7FF746CE456BB8B7CC71BF752C6E"><enum>(b)</enum><header>Task Force</header>
<paragraph commented="no" id="id0282D1EFB4024A228EB912D556A327DB"><enum>(1)</enum><header>Establishment</header><text display-inline="yes-display-inline">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. </text></paragraph> <paragraph commented="no" id="id7D130FCEF5F24EF2A9BB9C1DD02D6423"><enum>(2)</enum><header>Responsibilities</header><text display-inline="yes-display-inline">The task force shall—</text>
<subparagraph commented="no" id="H8905714745C94CDDADD9610291CF777C"><enum>(A)</enum><text>study how the Department can support women in the prenatal and postpartum periods and make recommendations to the Secretary;</text></subparagraph> <subparagraph commented="no" id="H516913E4C4E34228AF3EE449B5934EF8"><enum>(B)</enum><text display-inline="yes-display-inline">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—</text>
<clause commented="no" id="H54BC08E3A54D47209DBFC1D2EC05EAF3"><enum>(i)</enum><text>health-promoting housing codes;</text></clause> <clause commented="no" id="H52A7728E60A54A69954FB6FF69B3CAE0"><enum>(ii)</enum><text>enforcement of housing codes;</text></clause>
<clause commented="no" id="HA456608D611A4D8BB3236AC10E55679A"><enum>(iii)</enum><text>proactive rental inspection programs;</text></clause> <clause commented="no" id="H59DBF34153744D9382C5335CA1C8705B"><enum>(iv)</enum><text>code enforcement officer training; and</text></clause>
<clause commented="no" id="HACE0946D45C349D68CBA1DD38AD77DEA"><enum>(v)</enum><text display-inline="yes-display-inline">partnerships between regional offices of the Department and community organizations to ensure housing laws are understood and violations are discovered; and</text></clause></subparagraph> <subparagraph id="H3FAB0B234AC74D68B05FD624A2F9ECDB" commented="no" display-inline="no-display-inline"><enum>(C)</enum><text display-inline="yes-display-inline">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. </text></subparagraph></paragraph></subsection></section>
<section commented="no" id="H7F4A9D7FD792440AB7CEF2E8C5A8F252"><enum>104.</enum><header>Department of Transportation</header>
<subsection commented="no" id="H1897A0D604CE446F967DA22CABF25AAC"><enum>(a)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 1 year after the date of enactment of this Act, the Secretary of Transportation shall submit to Congress a report containing—</text> <paragraph id="H4091847A2104414399134B980DE6E5B9"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text></paragraph>
<paragraph id="H37CC159D129F4DFB8771A3748ED3C619"><enum>(2)</enum><text>recommendations on how to overcome such barriers; and</text></paragraph> <paragraph id="H55DABB41945247CCB06B8B27AE644C18"><enum>(3)</enum><text>an assessment of transportation safety risks for pregnant individuals and recommendations on how to mitigate such risks.</text></paragraph></subsection>
<subsection commented="no" id="H522E149C2EDF4183A4A2CE3CC3F19417"><enum>(b)</enum><header>Considerations</header><text>In carrying out subsection (a), the Secretary shall give special consideration to solutions for—</text> <paragraph commented="no" id="H57AE7B3355D34C089B65532C1162404E"><enum>(1)</enum><text>women living in a health professional shortage area designated under section 332 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254e">42 U.S.C. 254e</external-xref>); and</text></paragraph>
<paragraph commented="no" id="H424A11E17F384D37878B0DE17503E38C"><enum>(2)</enum><text>women living in areas with high maternal mortality or severe maternal morbidity rates and significant racial or ethnic disparities in maternal health outcomes.</text></paragraph></subsection></section> <section commented="no" id="id1A5E770E2FA04A8D850903704C52CC2E"><enum>105.</enum><header>Department of Agriculture</header> <subsection id="idC425FE3E8DEA463FBDE3CD9876C09DFC"><enum>(a)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="idA460F7A3C5364ACBB49CD4A6BC3167B9"><enum>(1)</enum><header>Eligible entity</header><text display-inline="yes-display-inline">The term <term>eligible entity</term> means—</text> <subparagraph id="idF12AEA4AC2FA493EAE4E874AE4B7F12F"><enum>(A)</enum><text display-inline="yes-display-inline">a public entity;</text></subparagraph>
<subparagraph id="id29CBF3E3082C4EB081A73CA47CBF69CB"><enum>(B)</enum><text display-inline="yes-display-inline">a private community entity;</text></subparagraph> <subparagraph id="id4F7F0F95E94446178F69E397E4F93DDC"><enum>(C)</enum><text display-inline="yes-display-inline">a community-based organization;</text></subparagraph>
<subparagraph id="idD24AD736296342BCBFC5C7AF9C553F48"><enum>(D)</enum><text display-inline="yes-display-inline">an Indian tribe or tribal organization (as those terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>)); and </text></subparagraph> <subparagraph id="id2F96FC843F4040038612E5EE084E8628"><enum>(E)</enum><text display-inline="yes-display-inline">an urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>)). </text></subparagraph></paragraph>
<paragraph id="idD25B61EE72134DDE83336AA70BE78A23" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Agriculture. </text></paragraph></subsection> <subsection commented="no" id="idEFD44243D3484076B0210A8A0FDCEA6B"><enum>(b)</enum><header>Special supplemental nutrition program for women, infants, and children</header> <paragraph commented="no" id="idE4923BC774AA4C9EB767F4CC484005F7"><enum>(1)</enum><header>Extension of postpartum period</header><text>Section 17(b)(10) of the Child Nutrition Act of 1966 (<external-xref legal-doc="usc" parsable-cite="usc/42/1786">42 U.S.C. 1786(b)(10)</external-xref>) is amended by striking <quote>six months</quote> and inserting <quote>24 months</quote>.</text></paragraph>
<paragraph commented="no" id="id6CDF975DFF3E4B708A12BE7189940853"><enum>(2)</enum><header>Extension of breastfeeding period</header><text>Section 17(d)(3)(A)(ii) of the Child Nutrition Act of 1966 (<external-xref legal-doc="usc" parsable-cite="usc/42/1786">42 U.S.C. 1786(d)(3)(A)(ii)</external-xref>) is amended by striking <quote>1 year</quote> and inserting <quote>24 months</quote>. </text></paragraph> <paragraph commented="no" id="idEB2B5092333649A6A12D5686162D5A67"><enum>(3)</enum><header>Report</header><text>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—</text>
<subparagraph commented="no" id="id3A3227727D564DA7A76053A86A744CE3"><enum>(A)</enum><text>maternal and infant health outcomes, including racial and ethnic disparities with respect to those outcomes;</text></subparagraph> <subparagraph commented="no" id="id5E4867ABBACA4AF9808FAE8BE67300A2"><enum>(B)</enum><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1786">42 U.S.C. 1786</external-xref>); and</text></subparagraph>
<subparagraph commented="no" id="id37B574CC2C7F4377AE8E19537282B622"><enum>(C)</enum><text>the cost effectiveness of that special supplemental nutrition program.</text></subparagraph></paragraph></subsection> <subsection commented="no" id="idBE5C928A49C2411EAD083E2E667284F2"><enum>(c)</enum><header>Grant program for healthy food and clean water for pregnant and postpartum women</header> <paragraph id="id633F12F6030A4BCFA0D8BD1B49E8E216"><enum>(1)</enum><header>In general</header><text>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).</text></paragraph>
<paragraph id="idE2BC9344106B4E92B04C09923315226C"><enum>(2)</enum><header>Application</header><text>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.</text></paragraph> <paragraph id="id215B0243D9744C0BB964A6506DB10248"><enum>(3)</enum><header>Priority</header><text>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—</text>
<subparagraph id="idCF7F18B4D07242BF8B5499D68E0A0965"><enum>(A)</enum><text>high maternal mortality or severe maternal morbidity rates; and</text></subparagraph> <subparagraph id="id8A7DE599E50D4A739F7EC72C8982ECBC"><enum>(B)</enum><text>significant racial or ethnic disparities in maternal health outcomes.</text></subparagraph></paragraph>
<paragraph id="id19181B0B5E224E83BE3143EC7641E787"><enum>(4)</enum><header>Use of funds</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1786">42 U.S.C. 1786(b)</external-xref>) 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.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="id669A05E5627B4DB3B61D386CD42A4004"><enum>(5)</enum><header>Report</header><text>Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to Congress a report that includes—</text>
<subparagraph id="idF83F790DFA0A43C9911A9C422933934C"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph commented="no" id="id1659D977B64D406FA5D381717EF50044"><enum>(B)</enum><text>recommendations with respect to ensuring the activities described in paragraph (4) continue after the period for grant funding for those activities expires.</text></subparagraph></paragraph>
<paragraph id="id95142695FA85497DB2FA18DA934AD398"><enum>(6)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated such sums as are necessary to carry out this subsection for each of fiscal years 2021 through 2023. </text></paragraph></subsection></section> <section id="HB4E2E9FD9517417CA5910A515ABF0ECA"><enum>106.</enum><header>Environmental study through National Academies</header> <subsection id="HF4B31F033CAF4E38972CD9B3D3D306D3"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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 <quote>National Academies</quote>) 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.</text></subsection>
<subsection id="HD8D9AE840CBA47A897C95836D795C1F6"><enum>(b)</enum><header>Study requirements</header><text>The agreement under subsection (a) shall direct the National Academies to make recommendations for—</text> <paragraph id="HD46E8FF7FD4549F893B51278BA04B8E3"><enum>(1)</enum><text>improving environmental conditions to improve maternal and infant health outcomes; and</text></paragraph>
<paragraph id="H550D63741009497BA6997EF05603616F"><enum>(2)</enum><text display-inline="yes-display-inline">reducing or eliminating racial and ethnic disparities in those outcomes.</text></paragraph></subsection> <subsection id="H3FD4867FE9184B4B95306B4905F42520" commented="no" display-inline="no-display-inline"><enum>(c)</enum><header>Report</header><text>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. </text></subsection></section>
<section commented="no" id="HFBEB73563496449C86533EF48D64234D"><enum>107.</enum><header>Child care access</header>
<subsection commented="no" id="H695822EE40C04C43BCF95A87457850D1"><enum>(a)</enum><header>Grant program</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>) shall award grants to eligible organizations to provide pregnant and postpartum women with free drop-in child care services during prenatal and postpartum appointments.</text></subsection> <subsection commented="no" id="H30E97BC273E447BE8CC7059D6CD346CA"><enum>(b)</enum><header>Eligible organizations</header><text display-inline="yes-display-inline">To be eligible to receive a grant under this section, an organization shall—</text>
<paragraph id="HC2813884D7624B08AF4AAF9DDC76699E"><enum>(1)</enum><text>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</text></paragraph> <paragraph id="H7D8111A0CDD44DCEB27EE93834FEE0B9"><enum>(2)</enum><text>not have previously received a grant under this section.</text></paragraph></subsection>
<subsection id="H1A4DDA593A5047FAA79D94C20008477D"><enum>(c)</enum><header>Duration</header><text>The Secretary shall commence the grant program under subsection (a) not later than 1 year after the date of the enactment of this Act.</text></subsection> <subsection commented="no" id="HF23D9FAE22DD45BEA44F21B7B2930B72"><enum>(d)</enum><header>Evaluation</header><text>The Secretary shall evaluate each grant awarded under this section to determine the effects of the grant on—</text>
<paragraph commented="no" id="HDAD71AABCCE041C7914AA333B5B522B5"><enum>(1)</enum><text display-inline="yes-display-inline">prenatal and postpartum appointment attendance rates;</text></paragraph> <paragraph id="HC54CAA3654D54EC38C544A223BE0001B"><enum>(2)</enum><text>maternal health outcomes with a specific focus on racial and ethnic disparities in such outcomes;</text></paragraph>
<paragraph id="HBA47F2E184D44CDBA04CF40CCF0FE845"><enum>(3)</enum><text display-inline="yes-display-inline">pregnant and postpartum women participating in the funded programs, and the families of such women; and</text></paragraph> <paragraph id="H4CF1FF72A7EF45679F8F25A970BFF610"><enum>(4)</enum><text>cost effectiveness.</text></paragraph></subsection>
<subsection id="HB6BBFE70B2B04116A8F259F97DF49D06"><enum>(e)</enum><header>Report</header><text>Not later than September 30, 2023, the Secretary shall submit to the Congress a report containing the following:</text> <paragraph id="HF203049A868248A186E7BCC849396A14"><enum>(1)</enum><text>A summary of the evaluations under subsection (d).</text></paragraph>
<paragraph id="H5921FDE8FEBC4945A98BB449146498AF"><enum>(2)</enum><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> 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.</text></paragraph></subsection> <subsection id="HB86AB96DC27044AAADEF5D2C920069A8"><enum>(f)</enum><header>Drop-In child care services defined</header><text display-inline="yes-display-inline">In this section, the term <term>drop-in child care services</term> means child care and early childhood education services that are—</text>
<paragraph id="H660034A172844ABDB83E6CCF089342A3"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph> <paragraph id="HEBC781AEDDFF4B2DA5A58BC6C3733046"><enum>(2)</enum><text display-inline="yes-display-inline">provided in single encounters without requiring full-time enrollment of a person in a child care program.</text></paragraph></subsection>
<subsection id="HDA9C488378D14FFBA211A6897A110038"><enum>(g)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">To carry out this section, there is authorized to be appropriated $1,000,000 for each of fiscal years 2021 through 2023.</text></subsection></section> <section id="H820A8355DFCB4A84A83265C1387B2E31"><enum>108.</enum><header>Grants to State, local, and Tribal public health departments addressing social determinants of health for pregnant and postpartum women</header> <subsection id="HA15D1C1E498447E7A158C7194DBF4C46"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>) 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.</text></subsection>
<subsection id="H8A7FF4A3215D4FA0A5B872C4814D77E0"><enum>(b)</enum><header>Use of funds</header><text display-inline="yes-display-inline">A public health department receiving a grant under this section may use funds received through the grant to—</text> <paragraph id="H964B1D3C1D51470B81E366EFD252627B"><enum>(1)</enum><text display-inline="yes-display-inline">build capacity and hire staff to coordinate efforts of the public health department to address social determinants of maternal health;</text></paragraph>
<paragraph id="H25C1A449D6BE4469A4029237B6F043CB"><enum>(2)</enum><text>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—</text> <subparagraph id="H4EE08207A36848F99DC2B0A765939AB7"><enum>(A)</enum><text>transportation vouchers;</text></subparagraph>
<subparagraph id="H9574A63A65964163B371DE2BDDCA2772"><enum>(B)</enum><text>housing supports;</text></subparagraph> <subparagraph id="HB699F6DC753C4CD48F64446A507C9AA4"><enum>(C)</enum><text>child care access;</text></subparagraph>
<subparagraph id="HEA23CCF7B45E4491BAEB3F5F5FB62C52"><enum>(D)</enum><text>healthy food access;</text></subparagraph> <subparagraph id="H38F1FB2406C24583862DFE086D847B42"><enum>(E)</enum><text>nutrition counseling;</text></subparagraph>
<subparagraph id="H641FCA8935AB4B59BF1B4086F320D4D5"><enum>(F)</enum><text>lactation supports;</text></subparagraph> <subparagraph id="H93DD816236F44D2F835D472E169D7583"><enum>(G)</enum><text>lead testing and abatement;</text></subparagraph>
<subparagraph id="H5DB487CE3F394BE5B82D44FE7CAD0160"><enum>(H)</enum><text>clean water;</text></subparagraph> <subparagraph id="HC891B234A3B84D4C9BF6587315D4E11C"><enum>(I)</enum><text>infant formula;</text></subparagraph>
<subparagraph id="H0032B2D5E855448587F2227185FFDD70"><enum>(J)</enum><text>maternal mental and behavioral health care services;</text></subparagraph> <subparagraph id="HFDE2005993E54FE2B0757F59F2139DA9"><enum>(K)</enum><text>wellness and stress management programs; and</text></subparagraph>
<subparagraph id="H6419595B59434095A87670B1632C7944"><enum>(L)</enum><text display-inline="yes-display-inline">other social services as determined by the public health department;</text></subparagraph></paragraph> <paragraph id="HD1FE4F00EF2141259460AD4A5FAB7CC4"><enum>(3)</enum><text>in consultation with local stakeholders, establish or designate a <quote>one-stop</quote> resource center that provides coordinated social services in a single location for women in the prenatal or postpartum period; or</text></paragraph>
<paragraph id="H79D500F7E64A4C7BB3803BBCA112ACDA"><enum>(4)</enum><text>directly address specific social determinant needs for the community that are related to maternal health as identified by the public health department, such as—</text> <subparagraph id="HD64CE3A0DCCD42B1B345B858E112A449"><enum>(A)</enum><text>transportation;</text></subparagraph>
<subparagraph id="H50A2F552EC4340E5AE828AF3F6DC82CB"><enum>(B)</enum><text>housing;</text></subparagraph> <subparagraph id="HA2E1AAD1D54B46468F8DD9E91D235954"><enum>(C)</enum><text>child care;</text></subparagraph>
<subparagraph id="HDAFE915A33414B12BEC86C0ACE0CA49D"><enum>(D)</enum><text>healthy foods;</text></subparagraph> <subparagraph id="H25A6A9FFADBF48B6895B4681C40C20F0"><enum>(E)</enum><text>infant formula;</text></subparagraph>
<subparagraph id="HF719499FD3DD44CCBCFAC1B82739DB31"><enum>(F)</enum><text>nutrition counseling;</text></subparagraph> <subparagraph id="H5488A691F34E43BC85A4A522429FF4A6"><enum>(G)</enum><text>lactation supports;</text></subparagraph>
<subparagraph id="H333CBE3CE15B459A82A17834DFCC31FE"><enum>(H)</enum><text display-inline="yes-display-inline">lead testing and abatement;</text></subparagraph> <subparagraph id="H08D9F2C538924F6BB1BC82924CCD474D"><enum>(I)</enum><text>air and water quality;</text></subparagraph>
<subparagraph id="HE7F0FD0B42D94ED08F6ED244A018033D"><enum>(J)</enum><text>wellness and stress management programs; and</text></subparagraph> <subparagraph id="H0C09B585D2BF40BBB930B9E0D1253D64"><enum>(K)</enum><text>other social determinants as determined by the public health department.</text></subparagraph></paragraph></subsection>
<subsection id="HA2C4FA4E697643BC985BF97E5A5955B2"><enum>(c)</enum><header>Special consideration</header><text display-inline="yes-display-inline">In awarding grants under subsection (a), the Secretary shall give special consideration to State, local, and Tribal public health departments that—</text> <paragraph id="HD76A676A9B994594B3B36A5FCAE102DE"><enum>(1)</enum><text>propose to use the grants to reduce or end racial and ethnic disparities in maternal mortality and severe maternal morbidity rates; and</text></paragraph>
<paragraph id="HF02609AB858B4178A27F6546F7D8FCFF"><enum>(2)</enum><text>operate in areas with high rates of—</text> <subparagraph id="H6A3B03F0A5744AB589C09D69DAC029E1"><enum>(A)</enum><text>maternal mortality and severe maternal morbidity; or</text></subparagraph>
<subparagraph id="H9F3651B244034A679FA96580B70DA274"><enum>(B)</enum><text display-inline="yes-display-inline">significant racial and ethnic disparities in maternal mortality and severe maternal morbidity rates.</text></subparagraph></paragraph></subsection> <subsection id="HFC405BE0E6BB44B7AFADCE3F7439A31F"><enum>(d)</enum><header>Guidance on strategies</header><text>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.</text></subsection>
<subsection id="H8710D8F161764FCAB890C33D48F574BB"><enum>(e)</enum><header>Reporting</header>
<paragraph id="H836AC036921448FCAF81E533334E97FA"><enum>(1)</enum><header>By grantees</header><text display-inline="yes-display-inline">As a condition on receipt of a grant under this section, a grantee shall agree to—</text> <subparagraph id="HF0DFAF64FE62488199A050D7473B60AA"><enum>(A)</enum><text>evaluate the activities funded through the grant with respect to—</text>
<clause id="H563526074E2249FA81B667D481FE5CFB"><enum>(i)</enum><text display-inline="yes-display-inline">maternal health outcomes with a specific focus on racial and ethnic disparities;</text></clause> <clause id="H10C2802D464E43A19A354491247DB9D4"><enum>(ii)</enum><text>the subjective assessment of such activities by the beneficiaries of such activities, including mothers and their families; and</text></clause>
<clause id="H134202490D9F479E9B35CD061AC4CD55"><enum>(iii)</enum><text display-inline="yes-display-inline">cost effectiveness and return on investment; and</text></clause></subparagraph> <subparagraph id="H6834A2F2D90A4490BDDA6BF4562F08AB"><enum>(B)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="HFD18455BA01B41DE8FD5F76248196C5A"><enum>(2)</enum><header>By Secretary</header><text>Not later than the end of fiscal year 2026, the Secretary shall submit a report to the Congress—</text> <subparagraph id="H24182AF2EC8F4BD2B1850BDF83188C76"><enum>(A)</enum><text>summarizing the evaluations submitted under paragraph (1); and</text></subparagraph>
<subparagraph id="H38D8CA4B720044A5ABE3DA2324714378"><enum>(B)</enum><text>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.</text></subparagraph></paragraph></subsection> <subsection commented="no" id="HAA7ABDD0EE4C40508F5E03C65E38E323"><enum>(f)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2021 through 2025.</text></subsection></section>
<enum>II</enum><header>Honoring Kira Johnson</header>
<section commented="no" id="HE16B155CEDB64DEBA8991583CB44D55F"><enum>201.</enum><header>Investments in community-based organizations to improve Black maternal health outcomes</header>
<subsection commented="no" id="HD20B094CAA38478A87454A1EAD26D6C2"><enum>(a)</enum><header>Awards</header><text display-inline="yes-display-inline">Following the 1-year period described in subsection (c), the Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>), 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.</text></subsection> <subsection commented="no" id="HA37F8030108642958D565562F0433DE5"><enum>(b)</enum><header>Eligibility</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection commented="no" id="H2367240B04A34C3EBA610796478B3E3E"><enum>(c)</enum><header>Outreach and technical assistance period</header><text>During the 1-year period beginning on the date of enactment of this Act, the Secretary shall—</text> <paragraph commented="no" id="H60E6B641B3FB4E94833BD30117930E2A"><enum>(1)</enum><text>conduct outreach to encourage eligible entities to apply for grants under this section; and</text></paragraph>
<paragraph commented="no" id="HA1FB9A02605E45D08D14C43E539DBF76"><enum>(2)</enum><text>provide technical assistance to eligible entities on best practices for applying for grants under this section.</text></paragraph></subsection> <subsection commented="no" id="HA87336AFD90E413A9AA51D97A29DD029"><enum>(d)</enum><header>Special consideration</header> <paragraph commented="no" id="H57435798B1974DF8BF36CBD3A8208AF6"><enum>(1)</enum><header>Outreach</header><text>In conducting outreach under subsection (c), the Secretary shall give special consideration to eligible entities that—</text>
<subparagraph commented="no" id="H205E9452E32F4354A88139B678F2D95C"><enum>(A)</enum><text>are based in, and provide support for, communities with—</text> <clause commented="no" id="H84673988D6BC4A0DB05B21001E0FE293"><enum>(i)</enum><text display-inline="yes-display-inline">high rates of adverse maternal health outcomes; and</text></clause>
<clause commented="no" id="HCA7170A0149F48AC81A7E67CB9F8E43B"><enum>(ii)</enum><text>significant racial and ethnic disparities in maternal health outcomes; </text></clause></subparagraph> <subparagraph commented="no" id="HDF149738ADF84476B350127DBBC04CE7"><enum>(B)</enum><text>are led by Black women; and</text></subparagraph>
<subparagraph id="H3A4CCFDEAD4440BF9B051C4614B2B657"><enum>(C)</enum><text display-inline="yes-display-inline">offer programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for Black women.</text></subparagraph></paragraph> <paragraph commented="no" id="HAA276D05DCB347468B5AE9C07DA9BACB"><enum>(2)</enum><header>Awards</header><text>In awarding grants under this section, the Secretary shall give special consideration to eligible entities that—</text>
<subparagraph commented="no" id="H214915357D7F448A953F84DA3934900B"><enum>(A)</enum><text>are described in subparagraphs (A), (B), and (C) of paragraph (1); </text></subparagraph> <subparagraph commented="no" id="H472C422557F44C6488A96A35EB56028C"><enum>(B)</enum><text display-inline="yes-display-inline">offer programs and resources designed in consultation with and intended for Black women; and</text></subparagraph>
<subparagraph commented="no" id="HDDF4708D147E40CB9FB1661C357B1CC1"><enum>(C)</enum><text>offer programs and resources in the communities in which the respective eligible entities are located that—</text> <clause commented="no" id="HF0D2DC5B011E46E7A0D7202AA1C99891"><enum>(i)</enum><text display-inline="yes-display-inline">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;</text></clause>
<clause commented="no" id="H57523EDF15BD469BAAF1B46E3646FAC5"><enum>(ii)</enum><text>address social determinants of health for women in the prenatal and postpartum periods, including—</text> <subclause commented="no" id="HEF3E42F5E6D447DDA9C58BCBDFC04B22"><enum>(I)</enum><text>housing;</text></subclause>
<subclause commented="no" id="HEB2D0EF3750547FA93597C976E643465"><enum>(II)</enum><text>transportation;</text></subclause> <subclause commented="no" id="HFC33E020698F45358F91C2EB958A8F83"><enum>(III)</enum><text>nutrition counseling;</text></subclause>
<subclause commented="no" id="H64E4384BAB0F4DD18DD14938302A00A3"><enum>(IV)</enum><text>healthy foods;</text></subclause> <subclause commented="no" id="H7378EFF728534D48A7D75E04BEBD0894"><enum>(V)</enum><text>lactation support;</text></subclause>
<subclause commented="no" id="HBC9EC0BCA10C4CF6B1E1EA37D4D56025"><enum>(VI)</enum><text>lead abatement and other efforts to improve air and water quality;</text></subclause> <subclause commented="no" id="H6451AEE994BB4AAC9566AFFF7466D46B"><enum>(VII)</enum><text>child care access;</text></subclause>
<subclause commented="no" id="H3833A3C510B647B2AC65635B5687733C"><enum>(VIII)</enum><text>car seat installation;</text></subclause> <subclause commented="no" id="HF2B4EFA7627A45ADAB48E6F0606E40A1"><enum>(IX)</enum><text>wellness and stress management programs; or</text></subclause>
<subclause commented="no" id="H447F4CF3FE6E4EC49FDF64282AAB7D09"><enum>(X)</enum><text>coordination across safety-net and social support services and programs;</text></subclause></clause> <clause commented="no" id="HFBF811C80B9C4E36BE11C82180F739BC"><enum>(iii)</enum><text display-inline="yes-display-inline">promote evidence-based health literacy and pregnancy, childbirth, and parenting education for women in the prenatal and postpartum periods;</text></clause>
<clause commented="no" id="HCEAD23799B6D4A6AB0D4BE28A6DC00A8"><enum>(iv)</enum><text display-inline="yes-display-inline">provide support from doulas and other perinatal health workers to women from pregnancy through the postpartum period;</text></clause> <clause id="H3EDDA341FAF3486B95EBFB21A164194F"><enum>(v)</enum><text display-inline="yes-display-inline">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;</text></clause>
<clause id="HF59A7085009343258787F2C4F72F3749"><enum>(vi)</enum><text>conduct or support research on Black maternal health issues; or</text></clause> <clause commented="no" id="HEF578FFAAA0B421D9C2FE3FAE6BE997E"><enum>(vii)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph></paragraph></subsection>
<subsection commented="no" id="HCC736673301442B8A8AE9543BD302D8D"><enum>(e)</enum><header>Technical assistance</header><text>The Secretary shall provide to grant recipients under this section technical assistance on—</text> <paragraph commented="no" id="HDA129FCC4938403399835C5E36DFDB90"><enum>(1)</enum><text display-inline="yes-display-inline">capacity building to establish or expand programs to prevent adverse maternal health outcomes among Black women;</text></paragraph>
<paragraph commented="no" id="HAEC23B85367144F2BDC1AFE79C2EA524"><enum>(2)</enum><text>best practices in data collection, measurement, evaluation, and reporting; and</text></paragraph> <paragraph commented="no" id="H9E089A119DBA4BC0BC1E9D080E04A983"><enum>(3)</enum><text display-inline="yes-display-inline">planning for sustaining programs to prevent maternal mortality and severe maternal morbidity among Black women after the period of the grant.</text></paragraph></subsection>
<subsection commented="no" id="H2CD157971D1C4B5FB9437F69ECEBAE69"><enum>(f)</enum><header>Evaluation</header><text display-inline="yes-display-inline">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—</text> <paragraph commented="no" id="HC846BA678DDD41759081E1919ED23020"><enum>(1)</enum><text>assesses the effectiveness of outreach efforts during the application process in diversifying the pool of grant recipients;</text></paragraph>
<paragraph commented="no" id="H38D9A22023634E14980A150CFB199D54"><enum>(2)</enum><text display-inline="yes-display-inline">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;</text></paragraph> <paragraph commented="no" id="HD509EE734A9C4688ABB0304AF3A81BDB"><enum>(3)</enum><text display-inline="yes-display-inline">assesses the effectiveness of programs funded by grants under this section in improving maternal health outcomes for Black women; and</text></paragraph>
<paragraph commented="no" id="HF37175D190F545C9991FDEF095C42720"><enum>(4)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection> <subsection commented="no" id="H18C20A0CE78B48AF98DA8370237D59A2"><enum>(g)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $5,000,000 for each of fiscal years 2021 through 2025.</text></subsection></section>
<section id="HEF56B7A149464AA592CAD960D5F319D8"><enum>202.</enum><header>Training for all employees in maternity care settings</header><text display-inline="no-display-inline">Part B of title VII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/293">42 U.S.C. 293</external-xref> et seq.) is amended by adding at the end the following new section:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HAF760066B7A74846BF0FAEE537E669EE"> <section id="HB1C7246AE1D94B10A6ED48C89E1E24DB"><enum>742.</enum><header>Training for all employees in maternity care settings</header> <subsection id="H2BDA59EF72DE4372949205612152A597"><enum>(a)</enum><header>Grants</header><text display-inline="yes-display-inline">The Secretary shall award grants for programs to reduce and prevent bias, racism, and discrimination in maternity care settings.</text></subsection>
<subsection id="HE2D94306A09D42C5BBF605484D0426F0"><enum>(b)</enum><header>Special consideration</header><text>In awarding grants under subsection (a), the Secretary shall give special consideration to applications for programs that would—</text> <paragraph id="H43C8061046DB415F892B94C892DD0FF2"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text></paragraph>
<paragraph id="H4BC706F6A35642568B3B6C00B3BE89A7"><enum>(2)</enum><text>emphasize periodic, as opposed to one-time, trainings for all birthing professionals and employees described in paragraph (1);</text></paragraph> <paragraph id="H28D7AB4DCF9F4F2CA680B72DEB35C953"><enum>(3)</enum><text display-inline="yes-display-inline">address implicit bias and explicit bias;</text></paragraph>
<paragraph id="HB5DAF6DF510F44A992E46C6CBDF0C06E"><enum>(4)</enum><text>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;</text></paragraph> <paragraph id="HCB20A9AA51E647A1ABEF0D0628604B42"><enum>(5)</enum><text>include trauma-informed care best practices and an emphasis on shared decision making between providers and patients;</text></paragraph>
<paragraph id="HBD4CEFDA273A4621834E88DE8E1A5023"><enum>(6)</enum><text>include a service-learning component that sends providers to work in underserved communities to better understand patients’ lived experiences;</text></paragraph> <paragraph id="H224B200758F444DA88EEB62CC5164342"><enum>(7)</enum><text>be delivered in undergraduate programs that funnel into medical schools, like biology and pre-medicine majors;</text></paragraph>
<paragraph id="HFD2129F2FBD348DD9C9E1DD115593B12"><enum>(8)</enum><text>be delivered at local agencies (as defined in subsection (b) of section 17 of the Child Nutrition Act of 1966 (<external-xref legal-doc="usc" parsable-cite="usc/42/1786">42 U.S.C. 1786</external-xref>)) that provide benefits or services under the special supplemental nutrition program for women, infants, and children established by that section; </text></paragraph> <paragraph id="H0EC6775A04D24478A46FD17FAA6B82E6"><enum>(9)</enum><text>integrate bias training in obstetric emergency simulation trainings;</text></paragraph>
<paragraph id="H595A2F72B6FA48FEBC9839BBC48B581B"><enum>(10)</enum><text display-inline="yes-display-inline">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</text></paragraph> <paragraph id="H2B842C2E6CE8481FAA551DA30FDBF905"><enum>(11)</enum><text>be based on one or more programs designed by a historically Black college or university.</text></paragraph></subsection>
<subsection id="HB9E07AFCA1C049CE80D278B3224040BF"><enum>(c)</enum><header>Application</header><text>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.</text></subsection> <subsection id="H5D5337748C234C849D0699CA46493031"><enum>(d)</enum><header>Reporting</header><text>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.</text></subsection>
<subsection id="HC45858A8325F479E9915BCD26F0E2D1C"><enum>(e)</enum><header>Best practices</header><text>Based on the annual reports submitted pursuant to subsection (d), the Secretary—</text> <paragraph id="H5DB96E6BD13B4285AA425B7E203B6F90"><enum>(1)</enum><text>shall produce an annual report on the findings resulting from programs funded through this section;</text></paragraph>
<paragraph id="H07613FAB091D4ED7BB1369B377DE8652"><enum>(2)</enum><text>shall disseminate such report to all recipients of grants under this section and to the public; and</text></paragraph> <paragraph id="H5D67759B6A464258875938489EF6F1C9"><enum>(3)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection>
<subsection id="HDEE26178F6C443ACAEB43FA42451A3E5"><enum>(f)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HC0063948CA054908A3DA465A1E1E5E28"><enum>(1)</enum><text>The term <term>postpartum</term> means the 1-year period beginning on the last day of a woman’s pregnancy.</text></paragraph>
<paragraph id="H553434A98186409BAD43303A3910A201"><enum>(2)</enum><text>The term <term>culturally congruent</term> means in agreement with the preferred cultural values, beliefs, worldview, and practices of the health care consumer and other stakeholders.</text></paragraph></subsection> <subsection commented="no" id="H73B26FFDC8BE45EF8403774A79C5A6CB"><enum>(g)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $5,000,000 for each of fiscal years 2021 through 2025.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="HD9C2ACD239494F57BC854533B7BAE1D0"><enum>203.</enum><header>Study on reducing and preventing bias, racism, and discrimination in maternity care settings</header>
<subsection id="H6F439941615C452B835FB3EABBD9FC62"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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 <quote>National Academies</quote>) under which the National Academies agree to—</text> <paragraph id="H73274C45FFAE427A9E9B84C071290142"><enum>(1)</enum><text>conduct a study on the design and implementation of programs to reduce and prevent bias, racism, and discrimination in maternity care settings; and</text></paragraph>
<paragraph id="H785B3E35736B44E087F30115648F3C78"><enum>(2)</enum><text>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.</text></paragraph></subsection> <subsection id="H491E8F1CE0FE44C199B032D11E323EE8"><enum>(b)</enum><header>Possible topics</header><text>The agreement entered into pursuant to subsection (a) may provide for the study of any of the following:</text>
<paragraph id="HEBE23AEA064B442FABA5DC2EDB8D479B"><enum>(1)</enum><text>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.</text></paragraph> <paragraph id="HB0D1054BA441473CB81CEF5CC1EC7575"><enum>(2)</enum><text>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.</text></paragraph></subsection></section>
<section id="HF0CDB1B11C6D450BAE46B221BCB9D5B8"><enum>204.</enum><header>Respectful maternity care compliance program</header>
<subsection id="HDFBD069EABCB4BB58A56B69394E8227C"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services (referred to in this section as the <quote>Secretary</quote>) 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.</text></subsection> <subsection id="HBD625FEDE47A4486ADC4EB848B242BE8"><enum>(b)</enum><header>Office requirements</header><text>A respectful maternity care compliance office funded through a grant under this section shall—</text>
<paragraph id="H3CAB0AD4F2F4473DBE01AC06B9091BB0"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text></paragraph> <paragraph id="HD1654AA15A7C4F66BFAF12612A171E69"><enum>(2)</enum><text display-inline="yes-display-inline">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; </text></paragraph>
<paragraph id="H94415164A5934B13AD86463463C3F155"><enum>(3)</enum><text display-inline="yes-display-inline">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—</text> <subparagraph id="H0545C9077D34459D92CBA37E9DAC893A"><enum>(A)</enum><text>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</text></subparagraph>
<subparagraph id="HBBEC1A62C2A2416FBBD8ADBBB36A7DA9"><enum>(B)</enum><text>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</text></subparagraph></paragraph> <paragraph id="H24966CBCB6754434B35B800A780BC2C8"><enum>(4)</enum><text>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—</text>
<subparagraph id="H15ABF443F4B24B189F1D6EFAB195A28E"><enum>(A)</enum><text>de-identified demographic information on the patient in the case, such as race, ethnicity, gender identity, and primary language;</text></subparagraph> <subparagraph id="HF6AD2143B8414A69A421781E6139EE55"><enum>(B)</enum><text>the content of the report from the patient or the family of the patient to the compliance office; and</text></subparagraph>
<subparagraph id="HC77C83D202DC41B9B0C3FF90A8787120"><enum>(C)</enum><text>the response from the compliance office.</text></subparagraph></paragraph></subsection> <subsection id="HAEFAE6D47F58441584A7F1983878A1DF"><enum>(c)</enum><header>Secretary requirements</header> <paragraph id="HFC8D89C66730423CB8A29CC34A74B72D"><enum>(1)</enum><header>Processes</header><text>Not later than 180 days after the date of enactment of this Act, the Secretary shall establish processes for—</text>
<subparagraph id="H29025E05D141473DBC3E66EC1923C00C"><enum>(A)</enum><text>disseminating best practices for establishing and implementing a respectful maternity care compliance office within a hospital or other birth setting;</text></subparagraph> <subparagraph id="H8AF17F7E93D2431E8821955DDB4ABC42"><enum>(B)</enum><text>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</text></subparagraph>
<subparagraph id="HB70962B484484E1AAB874D9179ECF7A1"><enum>(C)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="H8145AA3E965F4EA18EA4E1335A87C0B9"><enum>(2)</enum><header>Study</header> <subparagraph id="H3C6AA88185444EE88F8E0820FA57C9BD"><enum>(A)</enum><header>In general</header><text>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.</text></subparagraph>
<subparagraph id="HC4EE94BAD78E43BB99A6D47556E9CEBE"><enum>(B)</enum><header>Components of study</header><text>The study shall include the following:</text> <clause id="H5239B725F4764E84A97BF8806349628B"><enum>(i)</enum><text>An assessment of the reports submitted to the Secretary from the respectful maternity care compliance offices pursuant to subsection (b)(4).</text></clause>
<clause id="H06E2726049474A3EBAFAB282CB1915C7"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph> <subparagraph id="HC235A8F63AE54443ABEC863D786EA778"><enum>(C)</enum><header>Report</header><text>The Secretary shall submit to the Congress and make publicly available a report on the results of the study under this paragraph.</text></subparagraph></paragraph></subsection>
<subsection id="HA238C66D16EF423AB032AD67C4D03469"><enum>(d)</enum><header>Authorization of appropriations</header><text>To carry out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2021 through 2026.</text></subsection></section> <section id="HDA630FDC256E4725BDD60A8ABA7BA073"><enum>205.</enum><header>GAO report</header> <subsection id="H307FC2C69E4D499F8E576DD799B40D84"><enum>(a)</enum><header>In general</header><text>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. </text></subsection>
<subsection id="H694A397397BB422D988CE6246405B201"><enum>(b)</enum><header>Matters included</header><text>The report under subsection (a) shall include the following:</text> <paragraph id="HB43EF84441D940D4B87FD2BDA710C325"><enum>(1)</enum><text>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—</text>
<subparagraph id="H9AF1DDB95EB645CDAE2D769947BDD913"><enum>(A)</enum><text>which hospitals and other birth settings elect to establish compliance offices and when such offices are established;</text></subparagraph> <subparagraph id="H587AF962DE014529AC62705F927C4744"><enum>(B)</enum><text>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;</text></subparagraph>
<subparagraph id="HA1750B59D58F42889A65292D5303AE2E"><enum>(C)</enum><text>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</text></subparagraph> <subparagraph id="H046A19782DCB4A83B3D829850B477A42"><enum>(D)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="H0A4E4014F64F40DD9A36888CF32229A1"><enum>(2)</enum><text>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.</text></paragraph> <paragraph id="H0E3DF82841DC4FD889275459336F77B0"><enum>(3)</enum><text>Such other information as the Comptroller General determines appropriate.</text></paragraph></subsection></section>
<enum>III</enum><header>Protecting Moms Who Served</header>
<section id="H8DFEFC8310874E27B082CBD0151A156E"><enum>301.</enum><header>Support for maternity care coordination</header>
<subsection id="HA701D04DFA54402D94D0F7C2C856F52C"><enum>(a)</enum><header>Authorization of appropriations</header>
<paragraph id="id1394546C07554138B348714C733C2200"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="idCF3DF252B06240B283F55E8A348E0CD8"><enum>(2)</enum><header>Supplement not supplant</header><text display-inline="yes-display-inline">Amounts authorized under paragraph (1) are in addition to any other amounts authorized for the purpose specified in that paragraph.</text></paragraph></subsection>
<subsection id="HF2AAFE1B80264070A6BE482B6BD9EAF1"><enum>(b)</enum><header>Plan</header>
<paragraph id="H05472C29FA7C4E8E81E62F1BDEBDED08"><enum>(1)</enum><header>In general</header><text>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 <quote>Maternity Health Care and Coordination</quote>, or any successor handbook.</text></paragraph> <paragraph id="H5F52FE6B0F6A43478695800D1FE68BE2"><enum>(2)</enum><header>Elements</header><text>The plan under paragraph (1) shall include the following:</text>
<subparagraph id="H330B6C284CD24802A772773D4B2F1361"><enum>(A)</enum><text display-inline="yes-display-inline">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—</text> <clause id="H0668969DC6FD44F588B456E034A237FD"><enum>(i)</enum><text>hire full-time maternity care coordinators;</text></clause>
<clause id="HF9DAD773B9FC4B7CAA6422BD17850EF5"><enum>(ii)</enum><text display-inline="yes-display-inline">train maternity care coordinators; and</text></clause> <clause id="H7088A3498D7D4D57855AB62741CF4BB2"><enum>(iii)</enum><text>improve support programs led by maternity care coordinators.</text></clause></subparagraph>
<subparagraph id="HFAFCB1F7919947C6A35F668E34CB081D"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph> <paragraph id="H3F66277A5E764149B1B9B2C8CCD21E45"><enum>(3)</enum><header>Consultation</header><text display-inline="yes-display-inline">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.</text></paragraph></subsection></section>
<section commented="no" id="H94B4A4F91452445FB8DF4F31EE6D7222"><enum>302.</enum><header>Sense of Congress on veteran status requirements</header><text display-inline="no-display-inline">It is the sense of Congress that each State should list the veteran status of a mother—</text> <paragraph commented="no" id="H1F11CCE6F3784D94B6BFC1A384F8EE8F"><enum>(1)</enum><text>in fetal death records; and</text></paragraph>
<paragraph commented="no" id="HFA9BBF031F4F480DA4B16F53A4B4B33E"><enum>(2)</enum><text display-inline="yes-display-inline">in maternal mortality review committee reviews of pregnancy-related deaths and pregnancy-associated deaths.</text></paragraph></section> <section id="H49C96F52D1584B6789AE95DD01E4EC68"><enum>303.</enum><header>Report on maternal mortality and severe maternal morbidity among women veterans</header> <subsection id="H9AE32B2A36544FC78820D79115132739"><enum>(a)</enum><header>GAO report</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="H362356C129F04634B019A54CF6B1BF2F"><enum>(b)</enum><header>Matters included</header><text>The report under subsection (a) shall include the following:</text> <paragraph id="H476AC7611B354D98B4DFA26AAE022702"><enum>(1)</enum><text display-inline="yes-display-inline">To the extent practicable—</text>
<subparagraph id="H2ECA4E648AEB4745967B3038C093E1A0"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H26513BA61C5D464DAC537E0B73AA57FA"><enum>(B)</enum><text display-inline="yes-display-inline">the rate of pregnancy-related deaths per 100,000 live births for women veterans;</text></subparagraph>
<subparagraph id="HAC2D2F0A638C4CBA8722DC98D9B50F1D"><enum>(C)</enum><text display-inline="yes-display-inline">the number of cases of severe maternal morbidity among women veterans in the most recent year of available data; </text></subparagraph> <subparagraph id="H4AE42E88850745A1BDF992A8246FBA11"><enum>(D)</enum><text display-inline="yes-display-inline">the racial and ethnic disparities in maternal mortality and severe maternal morbidity rates among women veterans;</text></subparagraph>
<subparagraph id="HA8D469F74E8E40D099E73A9816ED5529"><enum>(E)</enum><text display-inline="yes-display-inline">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;</text></subparagraph> <subparagraph id="H791A9FBBF241411CB4E8DEA082109A4B"><enum>(F)</enum><text>identification of the causes of maternal mortality and severe maternal morbidity that are unique to women veterans of color; and</text></subparagraph>
<subparagraph id="HF2D3C95FC1BC40138E5D025919D044B2"><enum>(G)</enum><text display-inline="yes-display-inline">identification of any correlations between the former rank of women veterans and their maternal health outcomes.</text></subparagraph></paragraph> <paragraph id="HC0E8A36B27B0439C898174A1CEFD5258"><enum>(2)</enum><text display-inline="yes-display-inline">An assessment of the barriers to determining the information required under paragraph (1) and recommendations for improvements in tracking maternal health outcomes among—</text>
<subparagraph id="HBEFAEDCB89384A95A6E2EE4B1F137DD2"><enum>(A)</enum><text>women veterans who have health care coverage through the Department;</text></subparagraph> <subparagraph id="HFAAF6847BD264369BD63393B8F850299"><enum>(B)</enum><text>women veterans enrolled in the TRICARE program (as defined in section 1072 of title 10, United States Code);</text></subparagraph>
<subparagraph id="H0BC5B774CDE7458BACC9F10EC80985F8"><enum>(C)</enum><text>women veterans with employer-based or private insurance; and</text></subparagraph> <subparagraph id="H16CCCAC9D26748EA854181D5FEFB3C9F"><enum>(D)</enum><text>women veterans enrolled in the Medicaid program under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> et seq.).</text></subparagraph></paragraph>
<paragraph id="HA335C6BC88A14075AB5CA9707BF7F6D6"><enum>(3)</enum><text display-inline="yes-display-inline">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. </text></paragraph> <paragraph id="H013DFBA6A53D4A2F905F47616AB2ADE2"><enum>(4)</enum><text>Recommendations to address homelessness among pregnant and postpartum women veterans.</text></paragraph>
<paragraph id="HD50C019843F24878BCC4AEAD4B6BCCAC"><enum>(5)</enum><text>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.</text></paragraph> <paragraph id="HB3473550A47B4E05AB1CF6DE632EB677"><enum>(6)</enum><text display-inline="yes-display-inline">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).</text></paragraph>
<paragraph id="HCD39D2C31CB74C0EA39C191A19AC6874"><enum>(7)</enum><text>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.</text></paragraph> <paragraph id="H2548EBEA26E54CA2BFB55B394AC3FB18"><enum>(8)</enum><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="HDE98997D4D864D13A0BE9D4E18191565" commented="no" display-inline="no-display-inline"><enum>(9)</enum><text>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. </text></paragraph></subsection></section> <enum>IV</enum><header>Perinatal Workforce</header> <section id="HAB0E163FFAC74046AAFAB79F7203BC99"><enum>401.</enum><header>HHS agency directives</header> <subsection id="HDFACE5D4C27C4E6498BA4524EE02BD8A"><enum>(a)</enum><header>Guidance to States</header> <paragraph id="H3EEB381D36A34E7085D8FB38942CC261"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph>
<paragraph id="H3EC365CC59F8480BB9CE6914997336E6"><enum>(2)</enum><header>Contents</header><text display-inline="yes-display-inline">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—</text> <subparagraph id="H2380D7D1A07C4A53A5CA3EE4DD38705C"><enum>(A)</enum><text display-inline="yes-display-inline">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—</text>
<clause id="H4F9A998341A24AA28CCD7C11A3F482F5"><enum>(i)</enum><text>from racially and ethnically diverse backgrounds;</text></clause> <clause id="HA87E951249344D45AE8761C85A37FAB5"><enum>(ii)</enum><text>with experience practicing in racially and ethnically diverse communities; and</text></clause>
<clause id="HA4DD0D166E2F437FACB43ECCD515244F"><enum>(iii)</enum><text>who have undergone trainings on implicit and explicit bias and racism;</text></clause></subparagraph> <subparagraph id="H3C6689A3F2144ECBB6751B6BA6F6BE9F"><enum>(B)</enum><text display-inline="yes-display-inline">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; </text></subparagraph>
<subparagraph id="H5B66F803BDB3471CA50145DC5F05900F"><enum>(C)</enum><text>to provide collaborative, culturally congruent care; and</text></subparagraph> <subparagraph id="H2E8FB47F80984E2EB6547D357006CA11"><enum>(D)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph></subsection>
<subsection id="H53652119FD0D423B91DF11246BBC9728"><enum>(b)</enum><header>Study on culturally congruent maternity care</header>
<paragraph id="HC11B5F49ADEE47F096BEC4E263FD0378"><enum>(1)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services, acting through the Director of the National Institutes of Health (in this subsection referred to as the <quote>Secretary</quote>), shall conduct a study on best practices in culturally congruent maternity care.</text></paragraph> <paragraph id="H83AC2C799BCA4ABCAD1188B05BA0081D"><enum>(2)</enum><header>Report</header><text>Not later than 2 years after the date of enactment of this Act, the Secretary shall—</text>
<subparagraph id="HAC75E43B644041F58F97243141E8C3B5"><enum>(A)</enum><text>complete the study required by paragraph (1);</text></subparagraph> <subparagraph id="H525D8C53DE46430E99DD27DFD7CBC592"><enum>(B)</enum><text display-inline="yes-display-inline">submit to the Congress and make publicly available a report on the results of such study; and</text></subparagraph>
<subparagraph id="H235FDDFE268B43D58FBD87F981686D82"><enum>(C)</enum><text>include in such report—</text> <clause id="HEA0165A5EEBB4751924934A8B7E0EF74"><enum>(i)</enum><text display-inline="yes-display-inline">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;</text></clause>
<clause id="H6049DEA3E2EC4EB5BEC5D8E940EA19D1"><enum>(ii)</enum><text display-inline="yes-display-inline">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</text></clause> <clause id="HB02D56F459CF44B0A18858B2215AB5D7"><enum>(iii)</enum><text display-inline="yes-display-inline">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. </text></clause></subparagraph></paragraph></subsection></section>
<section id="HD884491BEF7B47629362182EE759D9B7"><enum>402.</enum><header>Grants to grow and diversify the perinatal workforce</header><text display-inline="no-display-inline">Title VII of the Public Health Service Act is amended by inserting after section 757 (<external-xref legal-doc="usc" parsable-cite="usc/42/294f">42 U.S.C. 294f</external-xref>) the following:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HE507E57727734B2192CFC787BB27E4D8"> <section id="HC9B3276C49424F1C8D58F0309F487CF7"><enum>758.</enum><header>Perinatal workforce grants</header> <subsection id="H6795BF47DB1D461BBC5BB1B92AB08C9A"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="H6C60D43B33AC4DD1B321C364AE1BBCBB"><enum>(b)</enum><header>Use of funds</header><text display-inline="yes-display-inline">Recipients of grants under this section shall use the grants to grow and diversify the perinatal workforce by—</text> <paragraph id="H690992380FB140D79FB144D1E4F69B31"><enum>(1)</enum><text display-inline="yes-display-inline">establishing schools or programs that provide education and training to individuals seeking appropriate licensing or certification as—</text>
<subparagraph id="H9726028875254FFB8C02BA9E531221E0"><enum>(A)</enum><text>physician assistants who will complete clinical training in the field of maternal and perinatal health; and</text></subparagraph> <subparagraph id="H69BC2615F2864C9CA947BEC340D63E3E"><enum>(B)</enum><text>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</text></subparagraph></paragraph>
<paragraph id="H1ACF8DD909EE4E3CB86E9C234E2C769F"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection> <subsection id="H572D03AE33984826B259B1E6E5D4E562"><enum>(c)</enum><header>Prioritization</header><text>In awarding grants under this section, the Secretary shall give priority to any entity that—</text>
<paragraph id="H222142DE737C42B09133A842E7E128C3"><enum>(1)</enum><text display-inline="yes-display-inline">has demonstrated a commitment to recruiting and retaining minority students, particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity;</text></paragraph> <paragraph id="H4112E825A0D244F1A41B5C68E88D6014"><enum>(2)</enum><text display-inline="yes-display-inline">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;</text></paragraph>
<paragraph id="HE75B2D1E8CB34883B114C8A6AC6CABDC"><enum>(3)</enum><text display-inline="yes-display-inline">has developed a strategy to recruit and retain students who plan to practice in a health professional shortage area designated under section 332;</text></paragraph> <paragraph id="H67CA1ACB9E1A488795A2522252C64043"><enum>(4)</enum><text display-inline="yes-display-inline">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</text></paragraph>
<paragraph id="H7DB67E4DDFED40EC914A10FF3ADECEAA"><enum>(5)</enum><text>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.</text></paragraph></subsection> <subsection id="HB83CF3E3EE4449D2ABBE989E897FEA36"><enum>(d)</enum><header>Reporting</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="H4C2F553F51414DE6A3F078F60847433C"><enum>(1)</enum><text>the number and demographics of students participating in the program or school;</text></paragraph> <paragraph id="H28171064ED894F45A73DAE46CD971F43"><enum>(2)</enum><text>the extent to which students in the program or school are entering careers in—</text>
<subparagraph id="HE99F46CA8F1C4AB295A17BB7BEAD8CBA"><enum>(A)</enum><text display-inline="yes-display-inline">health professional shortage areas designated under section 332; and</text></subparagraph> <subparagraph id="H0983E2D37BA54B0FB2605D73B7F6374B"><enum>(B)</enum><text display-inline="yes-display-inline">areas with significant racial and ethnic disparities in maternal health outcomes; and</text></subparagraph></paragraph>
<paragraph id="H8B6D7A0928CF4215A28B86A2FEB18CC3"><enum>(3)</enum><text>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.</text></paragraph></subsection> <subsection id="H437C94B1847340EBBE08AEC4DCEBDFB9"><enum>(e)</enum><header>Period of grants</header><text>The period of a grant under this section shall be up to 5 years.</text></subsection>
<subsection id="HB694ACB3AB604FCB89BE4907CE13ADF7"><enum>(f)</enum><header>Application</header><text display-inline="yes-display-inline">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).</text></subsection> <subsection id="H44E85F9B8F224719BFD833EEDE5C8FE8"><enum>(g)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="H7AFDE1BE63CB43999DB154CB06998A65"><enum>(h)</enum><header>Report by Secretary</header><text display-inline="yes-display-inline">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—</text> <paragraph id="HA8B323DD28C84E9D9DF2BF69C363A814"><enum>(1)</enum><text>recruiting minority students, particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity;</text></paragraph>
<paragraph id="H1289D3044A2C4F47B39C37961F1C6CB1"><enum>(2)</enum><text>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;</text></paragraph> <paragraph id="H81DE1F8BFE65473A8807EFE3FF5BEA51"><enum>(3)</enum><text>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</text></paragraph>
<paragraph id="H4AD76928E1C74EE6AD3FF9404AACB054"><enum>(4)</enum><text>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.</text></paragraph></subsection> <subsection id="H6ABF718076F5416EB69084F4DD9298BF"><enum>(i)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2021 through 2025.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="H3863B5FCA8ED4F8E85F4EFEF0FA19A0E"><enum>403.</enum><header>Grants to grow and diversify the nursing workforce in maternal and perinatal health</header><text display-inline="no-display-inline">Title VIII of the Public Health Service Act is amended by inserting after section 811 of that Act (<external-xref legal-doc="usc" parsable-cite="usc/42/296j">42 U.S.C. 296j</external-xref>) the following:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H05F8EDD75AEA4F9EBCCE721CFA760CDE"> <section id="HDC3AE8B7D8A94915BE4EBACCF4F183DB"><enum>812.</enum><header>Perinatal nursing workforce grants</header> <subsection id="H2B20E979412A474589C3125B87B17285"><enum>(a)</enum><header>In general</header><text>The Secretary may award grants to schools of nursing to grow and diversify the perinatal nursing workforce.</text></subsection>
<subsection id="HF5875F1A53F448BCB6C0EC087006BA70"><enum>(b)</enum><header>Use of funds</header><text>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—</text> <paragraph id="H1ADDCC2FF0F347F4BF7F0CDEE04A1761"><enum>(1)</enum><text>nurse practitioners whose education includes a focus on maternal and perinatal health; or</text></paragraph>
<paragraph id="HDE0B31A129ED400D9BC2E25FE1635586"><enum>(2)</enum><text>clinical nurse specialists whose education includes a focus on maternal and perinatal health.</text></paragraph></subsection> <subsection id="H3A092023BFD54D26A96A01C7024511AE"><enum>(c)</enum><header>Prioritization</header><text>In awarding grants under this section, the Secretary shall give priority to any school of nursing that—</text>
<paragraph id="H1FCC3492ACDA481293C6D45EBDEF815D"><enum>(1)</enum><text>has developed a strategy to recruit and retain a diverse pool of students seeking to enter careers focused on maternal and perinatal health;</text></paragraph> <paragraph id="H71FD9CB94B58497590C967648195473D"><enum>(2)</enum><text>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;</text></paragraph>
<paragraph id="H5D6052E1425F4993AF2DC631E24C6659"><enum>(3)</enum><text>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</text></paragraph> <paragraph id="H7892E2BABDF34EFEA0C92F8650920EC5"><enum>(4)</enum><text>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.</text></paragraph></subsection>
<subsection id="H6E1DEE67074E416C8ACCDAB0F70FEA84"><enum>(d)</enum><header>Reporting</header><text>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—</text> <paragraph id="HDCAF313D29474894B607DCAE7E6231DE"><enum>(1)</enum><text>the number and demographics of students in the school of nursing seeking to enter careers focused on maternal and perinatal health;</text></paragraph>
<paragraph id="H0270181E03594264AB22FEF5F4C2A6EC"><enum>(2)</enum><text>the extent to which such students are preparing to enter careers in—</text> <subparagraph id="H06151208FF274AD9AA67F691471128A6"><enum>(A)</enum><text>health professional shortage areas designated under section 332; and</text></subparagraph>
<subparagraph id="HE34D19EFF21C4EC89ED400566DCC13A6"><enum>(B)</enum><text>areas with significant racial and ethnic disparities in maternal health outcomes; and</text></subparagraph></paragraph> <paragraph id="H2B64A81F3A2642A4A9FFE47AE82E9308"><enum>(3)</enum><text>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.</text></paragraph></subsection>
<subsection id="H9C5A66B341F64CB38B2FFF4F1E4B51F1"><enum>(e)</enum><header>Period of grants</header><text>The period of a grant under this section shall be up to 5 years.</text></subsection> <subsection id="H5CD78C38D5594B929E22A52BCD67E7A0"><enum>(f)</enum><header>Application</header><text>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).</text></subsection>
<subsection id="H044D9473BD8F4045AF262E3090C7B9A1"><enum>(g)</enum><header>Technical assistance</header><text>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.</text></subsection> <subsection id="H4629D638EF8F4CC080125CBE7475A796"><enum>(h)</enum><header>Report by Secretary</header><text>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—</text>
<paragraph id="H4F4B0C8D3C3141878AB7A360ED31F6EF"><enum>(1)</enum><text>recruiting minority students, particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity;</text></paragraph> <paragraph id="HF59E58896D8D48FE877FE840B4F57F9E"><enum>(2)</enum><text>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;</text></paragraph>
<paragraph id="H91023F130EBB40BBABEAD2B1A13A3982"><enum>(3)</enum><text>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</text></paragraph> <paragraph id="H2A4394240A9F4D03A89F903BDC770FED"><enum>(4)</enum><text>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.</text></paragraph></subsection>
<subsection id="H303C53F9EC6C40C49F28A91D7DB985C8"><enum>(i)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2021 through 2025.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H7D4E3274115441C8B83340B4BE2200CA"><enum>404.</enum><header>GAO report on barriers to maternity care</header> <subsection id="HBA2B86382FF9491F9425487504C2BF6C"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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).</text></subsection>
<subsection id="H7B5AF85CD9D14283972312B2B55EDB41"><enum>(b)</enum><header>Content of report</header><text>The report under subsection (a) shall include—</text> <paragraph id="H7397028E68AA413BBBC5157CBFBFFE42"><enum>(1)</enum><text display-inline="yes-display-inline">an assessment of current barriers to entering accredited midwifery education programs, and recommendations for addressing such barriers, particularly for low-income and minority women;</text></paragraph>
<paragraph id="HD6D1DE8E2A4540158B10BCDC0D689EF0"><enum>(2)</enum><text display-inline="yes-display-inline">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;</text></paragraph> <paragraph id="H8F0D8BB49B22470C86E36F738F0F4283"><enum>(3)</enum><text display-inline="yes-display-inline">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</text></paragraph>
<paragraph id="H9B87E62889764AE9B68B1EB377EBE9FE"><enum>(4)</enum><text display-inline="yes-display-inline">recommendations to promote greater equity in compensation for perinatal health workers, particularly for such individuals from racially and ethnically diverse backgrounds.</text></paragraph></subsection></section> <enum>V</enum><header>Data To Save Moms</header> <section id="H8269E51192794B7D9CD55D35019568EF"><enum>501.</enum><header>Funding for maternal mortality review committees to promote representative community engagement</header> <subsection id="HC0871AF80A644EC1BCAB3BBC1236CBE5"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 317K(d) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b-12">42 U.S.C. 247b–12(d)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block style="OLC" id="H1F9EBCC5E6EC402E9ED47E632B73CD1F">
<paragraph id="HF6106064659F4F75A22215314D860F76"><enum>(9)</enum><header>Grants to promote representative community engagement in maternal mortality review committees</header>
<subparagraph id="H60EF821AD7C4404B9CD62570EABF799D"><enum>(A)</enum><header>In general</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>))—</text> <clause id="H64AE0498E7014B36AF53F147AB6ED95F"><enum>(i)</enum><text>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—</text>
<subclause id="HDE99A00A0441450489FA268FD3E6D368"><enum>(I)</enum><text>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</text></subclause> <subclause id="H83D426DD76974DBBBB89FC2C89CF2AA2"><enum>(II)</enum><text>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;</text></subclause></clause>
<clause id="H2617C6502F9945A8A61E03BF97EE3436"><enum>(ii)</enum><text>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</text></clause> <clause id="H52938B0D8C6C4856B5EA1FD2D893E517"><enum>(iii)</enum><text>to release public reports assessing—</text>
<subclause id="HDF27F8EF54CF4D6CB4CFC159DDEA911B"><enum>(I)</enum><text>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</text></subclause> <subclause id="H22B95EF3033844AB848373FFC88DD89D"><enum>(II)</enum><text>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.</text></subclause></clause></subparagraph>
<subparagraph id="H812B0FEEA60A46C8AEC48D1D79E592E7"><enum>(B)</enum><header>Technical assistance</header><text>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.</text></subparagraph> <subparagraph id="HECE6B1F5C247421FBC5269DE50805303"><enum>(C)</enum><header>Authorization of appropriations</header><text>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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HB2CDC70FBAEE40F297D99D64F6811CC9"><enum>(b)</enum><header>Reservation of funds</header><text display-inline="yes-display-inline">Section 317K(f) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b-12">42 U.S.C. 247b–12(f)</external-xref>) is amended by adding at the end the following: <quote>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>))</quote>.</text></subsection></section> <section id="HBF3E9D8DED7F4AE28DFD0F259CC04373"><enum>502.</enum><header>Data collection and review</header> <subsection id="H60F1EE2DC6F54ECC829EA2B0DC6E878F"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 317K(d)(3)(A)(i) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b-12">42 U.S.C. 247b–12(d)(3)(A)(i)</external-xref>) is amended—</text>
<paragraph id="H1EDB02E3E0F2480E8226F5FF6E33886B"><enum>(1)</enum><text>by redesignating subclauses (II) and (III) as subclauses (IV) and (V), respectively; and</text></paragraph> <paragraph id="H31EE4898FE9E45DB9E8B2F62518D590D"><enum>(2)</enum><text>by inserting after subclause (I) the following:</text>
<quoted-block style="OLC" id="HAB2F04FA2FD748BABAB47B3454F0133A">
<subclause id="H69BA39B6516C4D36902A1A1A6C331DD1"><enum>(II)</enum><text>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;</text></subclause> <subclause id="H97DFF75316F5411ABECDAFCCAAA6DE32"><enum>(III)</enum><text display-inline="yes-display-inline">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;</text></subclause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H79B5CF7BDD564A708CE7169DEEBCF24A"><enum>(b)</enum><header>Severe maternal morbidity defined</header><text>Section 317K(e) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b-12">42 U.S.C. 247b–12(e)</external-xref>) is amended—</text> <paragraph id="H13A18AADA094429A95A66A479E7A7E57"><enum>(1)</enum><text>in paragraph (2), by striking <quote>and</quote> at the end;</text></paragraph>
<paragraph id="H57E887EC5D43433DAE9C8B77E2BA7CE0"><enum>(2)</enum><text>in paragraph (3), by striking the period at the end and inserting <quote>; and</quote>; and</text></paragraph> <paragraph id="H64A7AB08E6484F858A5E152C196C8B39"><enum>(3)</enum><text>by adding at the end the following:</text>
<quoted-block style="OLC" id="H4CC4A5FFD80043B4AC0BC4B3669A492F">
<paragraph id="HD1708005314A48EC8C3BEF9FFE1EA552"><enum>(4)</enum><text>the term <term>severe maternal morbidity</term> 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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section> <section id="HF1327E549A1449D9AA18CD2ED79B37EE"><enum>503.</enum><header>Task force on maternal health data and quality measures</header> <subsection id="HB17CCDD5763E46C799DDA4879A94C3D0"><enum>(a)</enum><header>Establishment</header><text>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 <quote>Task Force</quote>).</text></subsection>
<subsection id="HA82D7619D7EC47FB8F64350B0749F8FD"><enum>(b)</enum><header>Duties of task force</header>
<paragraph id="H8BFAD1CF79F144F99AE90881A4043915"><enum>(1)</enum><header>In general</header><text>The Task Force shall use all available relevant information, including information from State-level sources, to prepare and submit a report containing the following:</text> <subparagraph id="H7EF50164DD314EE882B1F40961CE47C3"><enum>(A)</enum><text>An evaluation of current State and Tribal practices for maternal health, maternal mortality, and severe maternal morbidity data collection and dissemination, including consideration of—</text>
<clause id="HBBD8C0F6A9FA4FB988EED9CEEAAB2F39"><enum>(i)</enum><text>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;</text></clause> <clause id="H5D18A748172C4115B3D5DA976148462B"><enum>(ii)</enum><text>maternal health data collected with electronic health records, including data on race and ethnicity;</text></clause>
<clause id="H8FE6A3C8DCF74241B1BC5323122473C1"><enum>(iii)</enum><text>the barriers preventing States from correlating maternal outcome data with race and ethnicity data;</text></clause> <clause id="HA5550A47CBF6445BB21517E375B90644"><enum>(iv)</enum><text>processes for determining the cause of a pregnancy-associated death in States that do not have a maternal mortality review committee;</text></clause>
<clause id="H628B743E8B0849688E26C829CFE97C6D"><enum>(v)</enum><text>whether maternal mortality review committees include multidisciplinary and diverse membership (as described in section 317K(d)(1)(A) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b-12">42 U.S.C. 247b–12(d)(1)(A)</external-xref>);</text></clause> <clause id="H4783FDDE56BC4BEEB6CED003B63877AC"><enum>(vi)</enum><text>whether members of maternal mortality review committees participate in trainings on bias, racism, or discrimination, and the quality of such trainings;</text></clause>
<clause id="HE2DD33A82F634F67A071ADBA49A74C78"><enum>(vii)</enum><text>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;</text></clause> <clause id="H4CE791D7F77C487D90503E24234AD5D4"><enum>(viii)</enum><text>the consideration of social determinants of health by maternal mortality review committees when examining the causes of pregnancy-associated and pregnancy-related deaths;</text></clause>
<clause id="HA31CCB2F6FBB48D9850FAE806F0E767D"><enum>(ix)</enum><text>the legal barriers preventing the collation of State maternity care data;</text></clause> <clause id="H961AC7447E964E2A8017E0450A9A8E43"><enum>(x)</enum><text>the effectiveness of data collection and reporting processes in separating pregnancy-associated deaths from pregnancy-related deaths; and</text></clause>
<clause id="HF59AA429A9894DABBE9637EDD45D3B89"><enum>(xi)</enum><text>the current Federal, State, local, and Tribal funding support for the activities referred to in clauses (i) through (x).</text></clause></subparagraph> <subparagraph id="H0F4DC5AF9A8F418BB00BE025241FC06C"><enum>(B)</enum><text>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.</text></subparagraph>
<subparagraph id="HF06D77F0EF9C4F86B66F8C523B8EE5E6"><enum>(C)</enum><text>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—</text> <clause id="H03103814E8BE4E3F8F311006EEE31D91"><enum>(i)</enum><text>effective quality measures for maternity care used by hospitals, health systems, birth centers, health plans, and other relevant entities;</text></clause>
<clause id="HCB9656ED4EF846C1810AF356F6E57884"><enum>(ii)</enum><text>the sufficiency of current outcome measures used to evaluate maternity care for testing and validating new maternal health care payment and service delivery models;</text></clause> <clause id="H6556A01FDFF040918230117FD77EBA47"><enum>(iii)</enum><text>quality measures for the childbirth experiences of women that other countries effectively use;</text></clause>
<clause id="HBB9F1972FD3A4FCDA6E563EE408DF495"><enum>(iv)</enum><text>current maternity care quality measures that may be eliminated because they are not achieving their intended effect;</text></clause> <clause id="HE17DA3D937AE4F959CD831C87F38624B"><enum>(v)</enum><text>barriers preventing maternity care providers from implementing quality measures that are aligned from best practices;</text></clause>
<clause id="H5B0F546F5DB641E7828896390687B422"><enum>(vi)</enum><text>the frequency with which maternity care quality measures are reviewed and revised;</text></clause> <clause id="H3E699CA72A9F4068A0DFEB2ACB635DF5"><enum>(vii)</enum><text>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;</text></clause>
<clause id="H1B96A474C4934111915CCA496DCDBE83"><enum>(viii)</enum><text>the strengths and weaknesses of maternity care quality measures under the Medicaid program under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> et seq.) and the Children’s Health Insurance Program under title XXI of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa</external-xref> et seq.), including the extent to which States voluntarily report relevant measures;</text></clause> <clause id="H11A4E778D41C45B099B2A0707F9CA7E7"><enum>(ix)</enum><text>the extent to which maternity care quality measures are informed by patient experiences that include subjective measures of patient-reported experience of care;</text></clause>
<clause id="H693B062F39D54DE08A8CF9C2356BDDDD"><enum>(x)</enum><text>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;</text></clause> <clause id="H79C4F8C020D24EEBB7FB25A03818047D"><enum>(xi)</enum><text>the extent to which maternity care quality measures account for the unique experiences of minority women and their families; and</text></clause>
<clause id="H0A541602A36946D0954C528122955CE6"><enum>(xii)</enum><text>the extent to which hospitals, health systems, and birth centers are implementing existing maternity care quality measures.</text></clause></subparagraph> <subparagraph id="HF40AEF21F532438E85F098A38C857E2B"><enum>(D)</enum><text>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.</text></subparagraph>
<subparagraph id="HB0AA29FB824D4888B615B4A508E6B349"><enum>(E)</enum><text>Recommendations for new authorities that may be granted to maternal mortality review committees to be able to—</text> <clause id="H9BD2D7FD4D2E4463833976D5F2273882"><enum>(i)</enum><text>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</text></clause>
<clause id="HD317875ACEB64E07B72E27D9D2D787F4"><enum>(ii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="HA083E2138B4B4B7AAED5191EEEB53A85"><enum>(F)</enum><text>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.</text></subparagraph>
<subparagraph id="H7FAE1BFF1C6A4185AAE17E5205D9346B"><enum>(G)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="H202CAFA025F64C66B91E0C55D5F35A4A"><enum>(2)</enum><header>Public comment</header><text>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).</text></paragraph></subsection>
<subsection id="H81E49EF7D1C04330A77596F5AF606FB4"><enum>(c)</enum><header>Membership</header>
<paragraph id="H253EB7A824CC497A8C91AD9E4F91AE0D"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="H16674BA8BFC14AD385396C500FDEC593"><enum>(2)</enum><header>Member criteria</header><text>To be eligible to be appointed as a member of the Task Force, an individual shall be—</text>
<subparagraph id="HE2B798359C5E478DABF0A478192D533B"><enum>(A)</enum><text>a woman who has experienced severe maternal morbidity;</text></subparagraph> <subparagraph id="H72010AAD85FF4B7A99764CF62BFFCB75"><enum>(B)</enum><text>a family member of a woman who had a pregnancy-related death;</text></subparagraph>
<subparagraph id="H4CE65993C23748849D4208F13EDCDAB7"><enum>(C)</enum><text>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;</text></subparagraph> <subparagraph id="HE0B154E61A94491DA2BFB3ACC7C2F574"><enum>(D)</enum><text>a leader of a community-based organization that addresses adverse maternal health outcomes with a specific focus on racial and ethnic disparities;</text></subparagraph>
<subparagraph id="HFA7FF93D55634346A3DCEBEB6CD4878A"><enum>(E)</enum><text>an academic researcher in a field or policy area related to the duties of the Task Force;</text></subparagraph> <subparagraph id="HED0EF9B3B46C4A67B2C489CA480E80C0"><enum>(F)</enum><text>a maternal health care provider;</text></subparagraph>
<subparagraph id="HC2D225278271439DA3E2AF209D59B029"><enum>(G)</enum><text>an elected or duly appointed leader from an Indian Tribe;</text></subparagraph> <subparagraph id="H8045E5A86995431D893D46D6776325FA"><enum>(H)</enum><text>an expert in a field or policy area related to the duties of the Task Force; or</text></subparagraph>
<subparagraph id="H99CE90D670C843AE86B285B6561116CC"><enum>(I)</enum><text>an individual who has experience with Federal or State government programs related to the duties of the Task Force.</text></subparagraph></paragraph> <paragraph id="H327A727B854C4C4D9A9DD784736870AE"><enum>(3)</enum><header>Appointment timing</header><text>Appointments to the Task Force shall be made not later than 180 days after the date of enactment of this Act.</text></paragraph>
<paragraph id="HBF11526D95424AA1B855A26C51AD9137"><enum>(4)</enum><header>Duration</header><text>Each member shall be appointed for the life of the Task Force.</text></paragraph> <paragraph id="H500385E6B2554E72BBD3F154818C3E5C"><enum>(5)</enum><header>Co-Chair selection</header><text>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.</text></paragraph>
<paragraph id="HE1EBD5909C0648E4AC7D09060FB780AB"><enum>(6)</enum><header>Vacancies</header>
<subparagraph id="HFEC0D6853049460982216860E103CD6F"><enum>(A)</enum><header>In general</header><text>A vacancy in the Task Force—</text> <clause id="H49E0627539CB4680A274085EF147F4FD"><enum>(i)</enum><text>shall not affect the powers of the Task Force; and</text></clause>
<clause id="HF8C98124C8C74972A8F12C95E3CE40E3"><enum>(ii)</enum><text>shall be filled in the same manner as the original appointment.</text></clause></subparagraph> <subparagraph id="H7D18DEF7191B4CB7ABA84D71B5A035D2"><enum>(B)</enum><header>Co-Chair vacancy</header><text>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.</text></subparagraph></paragraph>
<paragraph id="HDACD75EDC0D84932AC0F9F7BB901CCB0"><enum>(7)</enum><header>Compensation</header><text>Except as provided in paragraph (8), members of the Task Force shall serve without pay.</text></paragraph> <paragraph id="H546F4AD3885642B792B7D8ED867AE867"><enum>(8)</enum><header>Travel expenses</header><text>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 <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/57">chapter 57</external-xref> 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.</text></paragraph></subsection>
<subsection id="HDFE3A64E27FA42BB93B3A4D9E9680AE2"><enum>(d)</enum><header>Meetings</header>
<paragraph id="HA3B71E219A34401893E0F0B663FEE6AC"><enum>(1)</enum><header>In general</header><text>The Task Force shall meet at the call of the Co-Chairs of the Task Force.</text></paragraph> <paragraph id="H3AA2DB1C8AB747379FD805D1F78BCCCD"><enum>(2)</enum><header>Quorum</header><text>A majority of the members of the Task Force shall constitute a quorum.</text></paragraph>
<paragraph id="H9F4B5C2A757240AE96D339B3772E49AB"><enum>(3)</enum><header>Initial meeting</header><text>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.</text></paragraph></subsection> <subsection id="H44477B6181874A5C963F58E00F17A400"><enum>(e)</enum><header>Staff of task force</header> <paragraph id="H9DED9AADC59A4620A498ED8F49DE37C3"><enum>(1)</enum><header>Additional staff</header><text>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.</text></paragraph>
<paragraph id="H919676E3D3724E809AA3FD064BADCA4A"><enum>(2)</enum><header>Applicability of certain civil service laws</header><text>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.</text></paragraph> <paragraph id="H6E9EC1E8773B4B9EBB87F3479BB924AE"><enum>(3)</enum><header>Detailees</header><text>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.</text></paragraph></subsection>
<subsection id="HE42D98546DFE4E31B0690EF7201FB8FF"><enum>(f)</enum><header>Powers of task force</header>
<paragraph id="H243C92CB4262473BA13A451A584DB540"><enum>(1)</enum><header>Testimony and evidence</header><text>The Task Force may take such testimony and receive such evidence as the Task Force considers advisable to carry out this section.</text></paragraph> <paragraph id="HB9E75F981F29481E9E4BDF0E587A28D7"><enum>(2)</enum><header>Obtaining official data</header><text>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.</text></paragraph>
<paragraph id="H4D2D2865006744FE9B4A5EA4F244A3A1"><enum>(3)</enum><header>Postal services</header><text>The Task Force may use the United States mails in the same manner and under the same conditions as other Federal departments and agencies.</text></paragraph></subsection> <subsection id="HB46D3008B2A245FFA7961F69AE3F2EC4"><enum>(g)</enum><header>Report</header><text>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—</text>
<paragraph id="H96DD1687CB93439B82060B67FFBAA07D"><enum>(1)</enum><text>contains the information, evaluations, and recommendations described in subsection (b); and</text></paragraph> <paragraph id="H72041C6912CC482F895EA4090EAE7DFE"><enum>(2)</enum><text>is signed by more than half of the members of the Task Force.</text></paragraph></subsection>
<subsection id="H995A95C51D4F47AB8C13063CBB147A56"><enum>(h)</enum><header>Termination</header><text>Section 14 of the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Task Force.</text></subsection> <subsection id="H785112C326834656AF1B0C3AD50AB0EA"><enum>(i)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H66C84B0A4EA4484790AF3773A86C6D16"><enum>(1)</enum><header>Maternal health care provider</header><text>The term <term>maternal health care provider</term> 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.</text></paragraph> <paragraph id="HB7739CACACFD42ED803649490DDC4B0E"><enum>(2)</enum><header>Maternal mortality review committee</header><text>The term <term>maternal mortality review committee</term> 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 (<external-xref legal-doc="usc" parsable-cite="usc/42/247b-12">42 U.S.C. 247b–12(a)(2)(D)</external-xref>).</text></paragraph>
<paragraph id="H616D36B45C734A9FB4CAF37A86F75B42"><enum>(3)</enum><header>Pregnancy-associated death</header><text>The term <term>pregnancy-associated death</term> 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.</text></paragraph> <paragraph id="HE7D1377F96C647F68FC62378FB204D08"><enum>(4)</enum><header>Pregnancy-related death</header><text>The term <term>pregnancy-related death</term> 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—</text>
<subparagraph id="HB26EA7E21F6149B0B660E0FD05002E2E"><enum>(A)</enum><text>from any cause related to, or aggravated by, the pregnancy or its management; and</text></subparagraph> <subparagraph id="H62942F6A239D4B888D974BBE6538959B"><enum>(B)</enum><text>not from accidental or incidental causes.</text></subparagraph></paragraph></subsection>
<subsection id="H9317001DD70F4656B6E8E83D353CA57F"><enum>(j)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated such sums as may be necessary to carry out this section for fiscal years 2021 through 2024.</text></subsection></section> <section id="H8B6F2B7B8F074C4FA8A3BEB3D78006CC"><enum>504.</enum><header>Indian Health Service study on maternal mortality</header> <subsection id="H94BCA18993EB4F37A7029C8B58494CA1"><enum>(a)</enum><header>In general</header><text>The Director of the Indian Health Service (referred to in this section as the <quote>Director</quote>) shall, in coordination with the individuals described in subsection (b)(1)—</text>
<paragraph id="H0615EFEE6F2843D3B3547652080DF822"><enum>(1)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/1621m">25 U.S.C. 1621m</external-xref>) to conduct a comprehensive study on maternal mortality and severe maternal morbidity in the populations of American Indian and Alaska Native women; and</text></paragraph> <paragraph id="H4B36D82890CB461E9252F5419E29AA94"><enum>(2)</enum><text>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.</text></paragraph></subsection>
<subsection id="HC31EAB9C65654030919E072EEB3529F3"><enum>(b)</enum><header>Participating entities</header>
<paragraph id="idC08D35376247481FA01F9614F9EE1ED4"><enum>(1)</enum><header>In general</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>)).</text></paragraph> <paragraph id="id974EE8D6DE004D8EB6B007107FA29ACB"><enum>(2)</enum><header>Requirement</header><text>In selecting individuals under paragraph (1), the Director shall ensure that each of the 12 service areas of the Indian Health Service is represented.</text></paragraph></subsection>
<subsection id="H8C0EAA93942F42588D5BF9F2BF2AD942"><enum>(c)</enum><header>Contents of study</header><text>The study conducted pursuant to subsection (a) shall—</text> <paragraph id="H13894F2F5BD94EB2A4112B70805383FB"><enum>(1)</enum><text>examine the causes of maternal mortality and severe maternal morbidity that are unique to American Indian and Alaska Native women;</text></paragraph>
<paragraph id="H11A90AE919634C6C9453605683EAB7D0"><enum>(2)</enum><text>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;</text></paragraph> <paragraph id="H3E448174CC76490AA5E7239AE39E3CF1"><enum>(3)</enum><text>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—</text>
<subparagraph id="H53FDFA1740914B2D94CD6F2018068BAE"><enum>(A)</enum><text>facilities operated by the Indian Health Service;</text></subparagraph> <subparagraph id="HB3D90930971044DB89EB5116398E6AF0"><enum>(B)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/5321">25 U.S.C. 5321</external-xref> et seq.); and</text></subparagraph>
<subparagraph id="HAC0CCDC5B6B94B19BF9D374038A9B6C4"><enum>(C)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/1651">25 U.S.C. 1651</external-xref> et seq.);</text></subparagraph></paragraph> <paragraph id="H2CA263A45B374C43A62D41B603FE360B"><enum>(4)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395</external-xref> et seq.), the Medicaid program under title XIX of that Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> et seq.), and the Children’s Health Insurance Program under title XXI of that Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa</external-xref> et seq.)), including coordination with the efforts of the Task Force established under section 503;</text></paragraph>
<paragraph id="HECD8BA5509AB4EA6A5B12DBFF739FE08"><enum>(5)</enum><text>review current data collection and quality measurement processes and practices;</text></paragraph> <paragraph id="H3025D2057F8844B4AE92E060BEC37DFF"><enum>(6)</enum><text>consider social determinants of health, including poverty, lack of health insurance, unemployment, sexual violence, and environmental conditions in Tribal areas;</text></paragraph>
<paragraph id="H67241732063F4C7BB4D1CF107776A305"><enum>(7)</enum><text>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;</text></paragraph> <paragraph id="H0CC7324692CB4F03B68B1B9E5AF8E7DF"><enum>(8)</enum><text>consider how current funding of the Indian Health Service affects the ability of the Indian Health Service to deliver quality maternity care;</text></paragraph>
<paragraph id="H27E34290A3494DF2ABDE54CFA67F2322"><enum>(9)</enum><text>consider the extent to which the delivery of maternity care services is culturally appropriate for American Indian and Alaska Native women;</text></paragraph> <paragraph id="H8F2CE11FDA9C4E678EC7B0D546EAF44A"><enum>(10)</enum><text>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</text></paragraph>
<paragraph id="HDE2268B6D85B460181AFA5A6B97715B9"><enum>(11)</enum><text>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.</text></paragraph></subsection> <subsection id="HAA781EADC8654369A1EBBA53F3C34228"><enum>(d)</enum><header>Report</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/1621m">25 U.S.C. 1621m</external-xref>) 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.</text></subsection>
<subsection id="HEF689B82FD6B46788B5EB873DB2F37B6" commented="no" display-inline="no-display-inline"><enum>(e)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2021 through 2023. </text></subsection></section> <section id="H93DC060485684000923E16B5870FDACF"><enum>505.</enum><header>Grants to minority-serving institutions to study maternal mortality, severe maternal morbidity, and other adverse maternal health outcomes</header> <subsection id="H75C33F9EEE4B47CE860F6E38C764D3AE"><enum>(a)</enum><header>In general</header><text>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—</text>
<paragraph id="HDF865380485B4D09982C59A6F0F235BA"><enum>(1)</enum><text>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</text></paragraph> <paragraph id="H3F8E247C1D8A44468E9B3689CA3B6DE1"><enum>(2)</enum><text>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.</text></paragraph></subsection>
<subsection id="HC6427BCB205F4723B5903BA5C387ACC3"><enum>(b)</enum><header>Application</header><text>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.</text></subsection> <subsection id="H292F0BFD5093477BB178A98F53C1E2A3"><enum>(c)</enum><header>Technical assistance</header><text>The Secretary may use not more than 10 percent of the funds made available under subsection (f)—</text>
<paragraph id="HDBC3FBD2EF1642679B6D3D4F9138C5D8"><enum>(1)</enum><text>to conduct outreach to minority-serving institutions to raise awareness of the availability of grants under this subsection (a);</text></paragraph> <paragraph id="HB260ED206B044BB19D5B035A6FF33608"><enum>(2)</enum><text>to provide technical assistance in the application process for such a grant; and</text></paragraph>
<paragraph id="HFEFB411FFACF45AD83A32CFB5023D27F"><enum>(3)</enum><text>to promote capacity building as needed to enable entities described in such subsection to submit such an application.</text></paragraph></subsection> <subsection id="HD179685D005241D9A8BB599BC7730A82"><enum>(d)</enum><header>Reporting requirement</header><text>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.</text></subsection>
<subsection id="H888DD906211940A3B032A6FF1DEE6B74"><enum>(e)</enum><header>Evaluation</header><text>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.</text></subsection> <subsection id="H8090007F1CDC45ABB36F3E459EC74013"><enum>(f)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2021 through 2025.</text></subsection>
<subsection id="HD67FBBFAF6F14857ACA4DF091F7A06DA"><enum>(g)</enum><header>Minority-Serving institutions defined</header><text>In this section, the term <term>minority-serving institution</term> means an eligible institution described in section 371(a) of the Higher Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/1067q">20 U.S.C. 1067q(a)</external-xref>).</text></subsection></section> <enum>VI</enum><header>Moms MATTER</header> <section id="H0146E30DFC674F4ABE4B949B0067CD8F"><enum>601.</enum><header>Innovative models to reduce maternal mortality</header><text display-inline="no-display-inline">Title III of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/241">42 U.S.C. 241</external-xref> et seq.) is amended by adding at the end the following new part:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H5628524B60C945D5A3B72CE080C4C248">
<part id="H31507B0C6E9749BE92E21BB7C53E47E3"><enum>W</enum><header>Innovative Models To Reduce Maternal Mortality and Severe Maternal Morbidity</header>
<section id="H03DFB17FF1A74FEE9472CB6874856FE7"><enum>399OO.</enum><header>Definitions</header><text display-inline="no-display-inline">In this part:</text> <paragraph id="H516CB5DEF6BF4D98A6F74E42E9B91D46"><enum>(1)</enum><text>The terms <term>postpartum</term> and <term>postpartum period</term> refer to the 1-year period beginning on the last day of the pregnancy.</text></paragraph>
<paragraph id="HE9D48B22CE4844E5969ECC8C762CD106"><enum>(2)</enum><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph> <paragraph id="H0DC811D06BA24CFEB9FCAFE7081EFF85"><enum>(3)</enum><text>The term <term>Task Force</term> means the Maternal Mental and Behavioral Health Task Force established pursuant to section 399OO–1. </text></paragraph>
<paragraph id="H1059BE4769F7452F92CF9A0281CC978A"><enum>(4)</enum><text>The term <term>behavioral health</term> includes substance use disorder and other behavioral health conditions.</text></paragraph></section> <section id="H1FA6D092C075445EA25B97A47F04D3DA"><enum>399OO–1.</enum><header>Maternal Mental and Behavioral Health Task Force</header> <subsection id="HF3D87CC1EB5C415B8E4328E646A0A391"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="H4C6858C948AD45E8B31AA4513730074F"><enum>(b)</enum><header>Membership</header>
<paragraph id="HFB693386C7BE4F2A86727275AB22F8D8"><enum>(1)</enum><header>Composition</header><text>The Task Force shall be composed of no fewer than 20 members, to be appointed by the Secretary.</text></paragraph> <paragraph id="H6F4DCC38508C41FFAE0E5BD2BEEA2F1C"><enum>(2)</enum><header>Co-Chairs</header><text>The Secretary shall designate 2 members of the Task Force to serve as the Co-Chairs of the Task Force.</text></paragraph>
<paragraph id="H6CAA6C2ED3AB4CE98123838ADC396C44"><enum>(3)</enum><header>Members</header><text>The Task Force shall include the following:</text> <subparagraph id="HE54EBCFAEE804143BF29C72386A0EA33"><enum>(A)</enum><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph id="H5BCA1CCAA24F44D582B6990C02672059"><enum>(B)</enum><text>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.</text></subparagraph> <subparagraph id="H5A175CF59EB74266BCDF86F5FC387D6B"><enum>(C)</enum><text>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.</text></subparagraph>
<subparagraph id="HF2F73DA2DB1B44618F877A31A2EAFBA5"><enum>(D)</enum><text>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.</text></subparagraph> <subparagraph id="H4406096FD3514F3193F238DECF539D7C"><enum>(E)</enum><text>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.</text></subparagraph>
<subparagraph id="HC4CEEBA344C144A8B203791D8F9489B6"><enum>(F)</enum><text>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.</text></subparagraph> <subparagraph id="H3460779D9EC045CE91D5CFB50C4F0F24"><enum>(G)</enum><text>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).</text></subparagraph>
<subparagraph id="H27C030A300CA4B8688C64155AD382257"><enum>(H)</enum><text>One or more representatives of health insurers.</text></subparagraph></paragraph> <paragraph id="H01E2AF281C244BB0A4D20D313EC0B746"><enum>(4)</enum><header>Timing of appointments</header><text>Not later than 180 days after the date of enactment of this part, the Secretary shall appoint all members of the Task Force.</text></paragraph>
<paragraph id="H76A45216549A450D86BD8FF2A41EB65A"><enum>(5)</enum><header>Period of appointment; vacancies</header>
<subparagraph id="H0CB57A50339B4CBA8ADADB82B4886D84"><enum>(A)</enum><header>In general</header><text>Each member of the Task Force shall be appointed for the life of the Task Force.</text></subparagraph> <subparagraph id="H79008C97C62D4760B5CE7F964B86FFC9"><enum>(B)</enum><header>Vacancies</header><text>Any vacancy in the Task Force—</text>
<clause id="HDF3D62319BFD45849ADB9E6FC4A9810A"><enum>(i)</enum><text>shall not affect the powers of the Task Force; and</text></clause> <clause id="H286F0D115012407BB4B568F37F9C91C0"><enum>(ii)</enum><text>shall be filled in the same manner as the original appointment.</text></clause></subparagraph></paragraph>
<paragraph id="H01D993976CAD4C46ACF1052C5F2E5086"><enum>(6)</enum><header>No pay</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H7704BCDAC04E46BF81A32618376991F1"><enum>(7)</enum><header>Travel expenses</header><text>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 <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/57">chapter 57</external-xref> 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.</text></paragraph></subsection>
<subsection id="H3CA52FB9D46C4CC987FD2EA008AB536E"><enum>(c)</enum><header>Staff</header><text>The Co-Chairs of the Task Force may appoint and fix the pay of staff to the Task Force.</text></subsection> <subsection id="H821B0CF962E3469FBB25707EEB77B523"><enum>(d)</enum><header>Detailees</header><text>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.</text></subsection>
<subsection id="HEE158A029FCA4EDFA20D93C1BE9A2A6A"><enum>(e)</enum><header>Meetings</header>
<paragraph id="HFD6740CF524B4569B54CB5EE709D9BB6"><enum>(1)</enum><header>In general</header><text>Subject to paragraph (2), the Task Force shall meet at the call of the Co-Chairs of the Task Force.</text></paragraph> <paragraph id="H6A86F5D0D79F4FE8A4B6C8D8F5B706C0"><enum>(2)</enum><header>Initial meeting</header><text>The Task Force shall meet not later than 30 days after the date on which all members of the Task Force have been appointed.</text></paragraph>
<paragraph id="H9CABA47167B54CFA9959AE1510C237E6"><enum>(3)</enum><header>Quorum</header><text>A majority of the members of the Task Force shall constitute a quorum.</text></paragraph></subsection> <subsection id="H77807ACEB3B04B4A8C7E297296A2B02E"><enum>(f)</enum><header>Information from Federal Agencies</header> <paragraph id="H62FB5DC0EB574F6097589206DD79CECF"><enum>(1)</enum><header>In general</header><text>The Task Force may secure directly from any Federal department or agency such information as may be relevant to carrying out this part.</text></paragraph>
<paragraph id="H352FDD4F8A1B430081E4F518F74C2216"><enum>(2)</enum><header>Furnishing information</header><text>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.</text></paragraph></subsection> <subsection id="H3ED0B55D7E4748F5AB937AD31117E9AC" commented="no"><enum>(g)</enum><header>Termination</header><text display-inline="yes-display-inline">Termination under section 14 of the <act-name parsable-cite="FACA">Federal Advisory Committee Act</act-name> (5 U.S.C. App.) shall not apply to the Task Force.</text></subsection>
<subsection commented="no" id="HF5D95DEA05B24071809B874DF2F2F1B1"><enum>(h)</enum><header>Duties</header>
<paragraph commented="no" id="H896D09BD4FF845D5B3732496785E8856"><enum>(1)</enum><header>National strategy</header><text display-inline="yes-display-inline">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—</text> <subparagraph commented="no" id="H784D5E046BF44438B512F8A04DCB267E"><enum>(A)</enum><text>define collaborative maternity care;</text></subparagraph>
<subparagraph commented="no" id="HC3F42AD191534172852A0D9923EA5147"><enum>(B)</enum><text display-inline="yes-display-inline">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;</text></subparagraph> <subparagraph id="H5C4E4E78F64F4FDA899F1746FD48A0B0"><enum>(C)</enum><text display-inline="yes-display-inline">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;</text></subparagraph>
<subparagraph commented="no" id="H851DB9527D814328B5C39F255DEFF2D3"><enum>(D)</enum><text display-inline="yes-display-inline">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;</text></subparagraph> <subparagraph id="HD70C8CB89B654D87B233B007703BB8B3"><enum>(E)</enum><text display-inline="yes-display-inline">promote treatment options and reduce stigma for pregnant and postpartum women with a substance use disorder;</text></subparagraph>
<subparagraph id="H5E2E1D6FB8CF4BF3A57E6DA0082AFB61"><enum>(F)</enum><text>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;</text></subparagraph> <subparagraph id="HC813CB61547347438B7399F41D7401AF"><enum>(G)</enum><text>assess the extent to which existing guidelines and processes are culturally congruent for minority women, specifically—</text>
<clause id="HD890FD14547F4BA095C9E958DF541532"><enum>(i)</enum><text>guidelines for identifying maternal mental and behavioral health conditions, including substance use disorders;</text></clause> <clause id="HB39E5A8EE2D7491AB8A6CE554892D2CD"><enum>(ii)</enum><text>guidelines for screening and, as needed, follow-up referrals, evaluations, and treatments after positive screens for—</text>
<subclause id="HBCF3ABED5865450281DECE1B451CFB30"><enum>(I)</enum><text>depression;</text></subclause> <subclause id="H17F25A4F85E1490B8294F31976640A39"><enum>(II)</enum><text>anxiety;</text></subclause>
<subclause id="H14C45EE08E1B4AA3B8096823047A1E98"><enum>(III)</enum><text>trauma;</text></subclause> <subclause id="HF4ED984EE0B1411BA6BBC50694475CD8"><enum>(IV)</enum><text>substance use disorders; and</text></subclause>
<subclause id="H532A3E3EB8E64903BEC897ACA8F9E316"><enum>(V)</enum><text>other mental or behavioral health conditions at the discretion of the Task Force;</text></subclause></clause> <clause id="H97AB88E24076434E9DE3B789CE7F551A"><enum>(iii)</enum><text>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</text></clause>
<clause id="H8C753D20A78041E380040715899F0602"><enum>(iv)</enum><text>processes for referring women with positive screens for substance use disorder to addiction treatment centers offering—</text> <subclause id="HC5D303518E1E43C9A8AAF3DA6C68CC3C"><enum>(I)</enum><text>on-site wraparound treatment or networks for referrals;</text></subclause>
<subclause id="H58A81C62BB5B4C1C9DFE68C6821004AB"><enum>(II)</enum><text>multidisciplinary staff;</text></subclause> <subclause id="H419D3C492FCE44379A37CB53982C5E93"><enum>(III)</enum><text>psychotherapy;</text></subclause>
<subclause id="H83FFB863818D49E9A16A15C9799E99FF"><enum>(IV)</enum><text>contingency management;</text></subclause> <subclause id="H007D83384B63489AB2840D5D93DD3483"><enum>(V)</enum><text>access to all evidence-based medication-assisted treatment; and</text></subclause>
<subclause id="H439F23FA4E984BEEA123B485187E2B06"><enum>(VI)</enum><text>evidence-based recovery supports;</text></subclause></clause></subparagraph> <subparagraph id="HE04E7EF825FE4D21801C98DC02DD964A"><enum>(H)</enum><text>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—</text>
<clause id="H937D446CBC094087915264EC22B510A4"><enum>(i)</enum><text>symptoms, triggers, risk factors, and treatment options for maternal mental and behavioral health conditions;</text></clause> <clause id="H24B84257DD2B461E88740B8998409F4D"><enum>(ii)</enum><text>using the website developed under paragraph (3);</text></clause>
<clause id="HC2E64DF722194559A25986011337AE33"><enum>(iii)</enum><text>the physiological process of recovery after birth;</text></clause> <clause id="H62C503F8A34B49E79C26D147BC9E985C"><enum>(iv)</enum><text>the frequency of occurrences for common conditions such as postpartum hemorrhage, preeclampsia and eclampsia, infection, and thromboembolism;</text></clause>
<clause id="HAC6B85DBB563487DB0078EF6A17030AF"><enum>(v)</enum><text>best practices in patient reporting of health concerns to their maternity care providers in the prenatal and postpartum periods;</text></clause> <clause id="H1D246F07EE6849FC99EA092F7313517E"><enum>(vi)</enum><text display-inline="yes-display-inline">addressing stigma around maternal mental and behavioral health conditions;</text></clause>
<clause id="HEE09F4BCCD714EA6BF58401E38CE1156"><enum>(vii)</enum><text display-inline="yes-display-inline">how to seek treatment for substance use disorder during pregnancy and in the postpartum period; and</text></clause> <clause id="HE7D37C7B59424EC38974EEA07D3A7E83"><enum>(viii)</enum><text>infant feeding options; and</text></clause></subparagraph>
<subparagraph id="H0BE41290C5564304B377DCD23FFFE158"><enum>(I)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph> <paragraph commented="no" id="H8CAA6993D2784FEF912F26D3A08458F0"><enum>(2)</enum><header>Grant programs</header><text>The Task Force shall evaluate and advise on the grant programs under section 399OO–2.</text></paragraph>
<paragraph commented="no" id="H9ADA5A2D68C94EF3954FD68D47741379"><enum>(3)</enum><header>Centralized website</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph commented="no" id="H3F9FE5CDCA3B463C95F5F641D09F264D"><enum>(4)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 18 months after the date of enactment of the <short-title>Black Maternal Health Momnibus Act of 2020</short-title>, 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— </text>
<subparagraph id="H22760707DC2F47D5AF19218B6C5251EB"><enum>(A)</enum><text display-inline="yes-display-inline">describes the activities of the Task Force and the results of such activities, with data in such results stratified racially, ethnically, and geographically; and</text></subparagraph> <subparagraph id="H4C249A9DC5E9444FBA5FD2A228ACA775"><enum>(B)</enum><text>includes the strategy developed under paragraph (1).</text></subparagraph></paragraph></subsection>
<subsection id="H5B76205ED5CD4B659FAE9C5EB488AA10"><enum>(i)</enum><header>Authorization of appropriations</header><text>To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2021 through 2025.</text></subsection></section> <section id="HD1304AFA1BAD40F398642C0F972E3D48"><enum>399OO–2.</enum><header>Innovation in maternity care to close racial and ethnic maternal health disparities grants</header> <subsection id="H4D1742D622DD4D6E82425B656E5E3EF4"><enum>(a)</enum><header>In general</header><text>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.</text></subsection>
<subsection id="HDA0FA3F71B0A47FEB60D75F36C18DCA9"><enum>(b)</enum><header>Use of funds</header><text>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—</text> <paragraph id="H71D31B59A9194F9D9C6D17CAC9CAC12F"><enum>(1)</enum><text>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;</text></paragraph>
<paragraph id="H2B26A61BDF8D40729B981807A68ECBCE"><enum>(2)</enum><text>evidence-based programming at clinics that—</text> <subparagraph id="HE3631A36E75041F39521EE7C3F072F45"><enum>(A)</enum><text>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</text></subparagraph>
<subparagraph id="HD2879788631547F6B705EB12738726DA"><enum>(B)</enum><text>make referrals for any such services that are not provided within the clinic;</text></subparagraph></paragraph> <paragraph id="HCFF7278A1AB042C6A79EEB68034184B9"><enum>(3)</enum><text display-inline="yes-display-inline">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</text></paragraph>
<paragraph id="HB7D3674E80C3474C93E6B1740C15E99B"><enum>(4)</enum><text display-inline="yes-display-inline">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. </text></paragraph></subsection> <subsection id="HDA9F26833DE243C2B45D9A6DCFF5EDDF"><enum>(c)</enum><header>Special consideration</header><text>In awarding grants under this section, the Secretary shall give special consideration to applications for models that will—</text>
<paragraph id="H42013099E306439D8ED71E6DF65B3694"><enum>(1)</enum><text>operate in—</text> <subparagraph id="HCC3A1AD29AE943AEA98244AC5455F254"><enum>(A)</enum><text display-inline="yes-display-inline">areas with high rates of adverse maternal health outcomes; </text></subparagraph>
<subparagraph id="H2B8F8AFB43974AC6991164F40AA6E8BD"><enum>(B)</enum><text>areas with significant racial and ethnic disparities in maternal health outcomes; or</text></subparagraph> <subparagraph id="HAA733EC110E24E06B494C7A27043C01E"><enum>(C)</enum><text display-inline="yes-display-inline">health professional shortage areas designated under section 332; </text></subparagraph></paragraph>
<paragraph id="H81D66A93430943A0B6F1D9CFFBE6F9F9"><enum>(2)</enum><text>be led by minority women from demographic groups with disproportionate rates of adverse maternal health outcomes; or</text></paragraph> <paragraph id="HF337E2047F0F4C2584269C3C6AE53F82"><enum>(3)</enum><text display-inline="yes-display-inline">be implemented with a culturally congruent approach that is focused on improving outcomes for demographic groups experiencing disproportionate rates of adverse maternal health outcomes.</text></paragraph></subsection>
<subsection id="HE33EF49612F74684B32677B84E42DA5D"><enum>(d)</enum><header>Evaluation</header><text>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—</text> <paragraph id="HC1780E78B0074A8D9E83A19EA52CCF7C"><enum>(1)</enum><text>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</text></paragraph>
<paragraph id="HBE2882F0E8E14BA6A8A484AD33A7386D"><enum>(2)</enum><text>the cost-effectiveness of such activities.</text></paragraph></subsection> <subsection id="H83DFE3459E9B405FBE7CFF5EE3F748E2"><enum>(e)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H1552E46B91A24346AF54A30FB590C123"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>eligible entity</term> means any public or private entity.</text></paragraph> <paragraph id="HD7C565B9E2004551B6177CFEE0A1A1DC"><enum>(2)</enum><text>The term <term>collaborative maternity care</term> 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.</text></paragraph>
<paragraph id="H97ED07263A5F4FBBB4C053043E63EA4C"><enum>(3)</enum><text>The term <term>culturally congruent</term> means care that is in agreement with the preferred cultural values, beliefs, worldview, language, and practices of the health care consumer and other stakeholders.</text></paragraph> <paragraph id="H871F1E5CA28B43FB8A41F153875C8E9B"><enum>(4)</enum><text>The term <term>freestanding birth center</term> has the meaning given that term under section 1905(l)(3)(A) of the Social Security Act.</text></paragraph></subsection>
<subsection id="H2656E101196B4AACA416AC0F94A3AC8C"><enum>(f)</enum><header>Authorization of appropriations</header><text>To carry out this section, there is authorized to be appropriated $15,000,000 for each of fiscal years 2021 through 2025.</text></subsection></section> <section id="H9629CDC9E11E4EEA8628776945228A73"><enum>399OO–3.</enum><header>Group prenatal and postpartum care models</header> <subsection id="H6CDEC61335554392909902E5B42F8727"><enum>(a)</enum><header>In general</header><text>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.</text></subsection>
<subsection id="H96F38D7E71DF491492377A8CC1A9E047"><enum>(b)</enum><header>Use of funds</header><text>An eligible entity receiving a grant under this section may use the grant for—</text> <paragraph id="H94CBED60C4514AF595506C9062BBA167"><enum>(1)</enum><text>programming;</text></paragraph>
<paragraph id="HC8EFCEC0FB1D4D429D8941127B04F5F3"><enum>(2)</enum><text>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</text></paragraph> <paragraph id="H7B38EB648D064C80BE4385ADD03F85EB"><enum>(3)</enum><text>evaluations of group prenatal care and group postpartum care programming, with a particular focus on the impacts of such programming on minority women.</text></paragraph></subsection>
<subsection id="H26AEE7CB2EB6449D82F5EB34D76082CB"><enum>(c)</enum><header>Special consideration</header><text>In awarding grants under this section, the Secretary shall give special consideration to applicants that will—</text> <paragraph id="HF6B9B0B3C1794370AC885D5A38033CC1"><enum>(1)</enum><text>operate in—</text>
<subparagraph id="H93D8EDABC95648B986131E4251159AFA"><enum>(A)</enum><text>areas with high rates of adverse maternal health outcomes;</text></subparagraph> <subparagraph id="HCA60CBC39F3B43B19F115D700FEB645A"><enum>(B)</enum><text>areas with significant racial and ethnic disparities in maternal health outcomes; or</text></subparagraph>
<subparagraph id="HB5F122256C5E4A06851B42E0A05FB831"><enum>(C)</enum><text>health professional shortage areas designated under section 332;</text></subparagraph></paragraph> <paragraph id="H04B92296198248478B17E90D26143EBC"><enum>(2)</enum><text>be led by minority women from demographic groups with disproportionate rates of adverse maternal health outcomes; or</text></paragraph>
<paragraph id="H2F65AD0312FE46AC85EBEBA9C7EA47AF"><enum>(3)</enum><text>be implemented with a culturally congruent approach that is focused on improving outcomes for demographic groups experiencing disproportionate rates of adverse maternal health outcomes.</text></paragraph></subsection> <subsection id="H89FFE469185042A3991174D875FD252B"><enum>(d)</enum><header>Evaluation</header><text>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—</text>
<paragraph id="H3C40E6FBBC914CAFB8C8FBE9F8BEBF53"><enum>(1)</enum><text>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—</text> <subparagraph id="HE1ECC8C2F5F34EDDAD42A67E7DAE79BB"><enum>(A)</enum><text>avoidable emergency room visits;</text></subparagraph>
<subparagraph id="H876A4A2E61BC44EAADA5BE4D1577DD04"><enum>(B)</enum><text>postpartum care visits after delivery;</text></subparagraph> <subparagraph id="H488BDD2592BF42CEB3558246B024DA9C"><enum>(C)</enum><text>rates of preterm birth;</text></subparagraph>
<subparagraph id="HB3B0CB49081E4D70A1A2B350F1D91BF8"><enum>(D)</enum><text>rates of breastfeeding initiation;</text></subparagraph> <subparagraph id="H24A2B012E0F24C978502D28B88C06E31"><enum>(E)</enum><text>psychological outcomes; and</text></subparagraph>
<subparagraph id="HE45A7036A4534660A1A67066F2B9E80C"><enum>(F)</enum><text>subjective measures of patient-reported experience of care; and</text></subparagraph></paragraph> <paragraph id="H9273D1FF15D744EDBD0EA6C0D44BAF61"><enum>(2)</enum><text>the cost-effectiveness of such activities.</text></paragraph></subsection>
<subsection id="H00A4D8CC60AE4E939A1846ACAAFCF80A"><enum>(e)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H7DF60E2593BD4641A922AE11DA3D181E"><enum>(1)</enum><text>The term <term>eligible entity</term> means any public or private entity.</text></paragraph>
<paragraph id="H8EE4421948544343ADA12B5400FE5331"><enum>(2)</enum><text>The term <term>culturally congruent</term> means care that is in agreement with the preferred cultural values, beliefs, worldview, language, and practices of the health care consumer and other stakeholders.</text></paragraph></subsection> <subsection id="H35552E9E253A4043935A8FE0B9250097"><enum>(f)</enum><header>Authorization of appropriations</header><text>To carry out this section, there is authorized to be appropriated $10,000,000 for each of fiscal years 2021 through 2025.</text></subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block></section>
<enum>VII</enum><header>Justice for Incarcerated Moms</header>
<section section-type="subsequent-section" id="H3BF049CBEB03488A9C6B740E69500104"><enum>701.</enum><header>Sense of Congress</header><text display-inline="no-display-inline">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. </text></section> <section id="H0709348CCE0448C38E0A30CDB4907ABF"><enum>702.</enum><header>Ending the shackling of pregnant individuals</header> <subsection id="HC91452DC164A45C7B901E03584AB8F78"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/34/10151">34 U.S.C. 10151</external-xref> et seq.) (commonly referred to as the <quote>Edward Byrne Memorial Justice Grant Program</quote>) 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.</text></subsection>
<subsection id="H2419294698814999984491C32A407A7F" commented="no" display-inline="no-display-inline"><enum>(b)</enum><header>Reallocation</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/34/10151">34 U.S.C. 10151</external-xref> et seq.) to States that are not subject to the decrease under subsection (a).</text></subsection></section> <section id="id2D5FD3E8214145C597F088AA0EA7DC39"><enum>703.</enum><header>Creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods</header> <subsection id="idA05563381FDF4FDC8D1AB0DCA6543C7B"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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. </text></subsection>
<subsection id="id00C01B7FB1BA439D8A8C3860F57A8255"><enum>(b)</enum><header>Consultation</header><text display-inline="yes-display-inline">The Attorney General shall establish the programs required under subsection (a) in consultation with interested entities such as—</text> <paragraph id="id30B6B47C66034346BAC3D59461C457E0"><enum>(1)</enum><text>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;</text></paragraph>
<paragraph id="id172D667F454249EBB348D1572490E493"><enum>(2)</enum><text>relevant organizations representing patients, with a particular focus on minority patients;</text></paragraph> <paragraph id="id5FE990A530B94AD589EE58F2C7990218"><enum>(3)</enum><text>relevant organizations representing maternal health care providers;</text></paragraph>
<paragraph id="idAC9249C1E1794013B149A4C4D4B0B9D6"><enum>(4)</enum><text>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</text></paragraph> <paragraph id="idA6BD5A32ED044FB7B4A33E97EE662AE8"><enum>(5)</enum><text>researchers and policy experts in fields related to women’s health care for incarcerated individuals.</text></paragraph></subsection>
<subsection commented="no" id="id1C9DEB585A0D4AF6981B96B5D37CBDD8"><enum>(c)</enum><header>Start date</header><text>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. </text></subsection> <subsection id="idF34FD65C7D6343E189C532CA3763ADF3"><enum>(d)</enum><header>Facility priority</header><text display-inline="yes-display-inline">In carrying out subsection (a), the Director of the Bureau of Prisons shall give priority to a facility based on—</text>
<paragraph id="idDF6A5D4E30FC4A7C9384442675A519A4"><enum>(1)</enum><text display-inline="yes-display-inline">the number of pregnant and postpartum individuals incarcerated in such facility and, among such individuals, the number of pregnant and postpartum minority individuals; and</text></paragraph> <paragraph id="id8FE0FB2C6D8247FFB33B596786678C37"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection>
<subsection id="idED7FFDA950AA43C79E93D3497D680164"><enum>(e)</enum><header>Program duration</header><text display-inline="yes-display-inline">Each program established under this section shall be for a 5-year period.</text></subsection> <subsection id="idDA2C5173AF38476E8E9FBFD2C78F9DE4"><enum>(f)</enum><header>Programs</header><text display-inline="yes-display-inline">Each Bureau of Prisons facility selected under subsection (a) shall establish programs for pregnant and postpartum incarcerated individuals, and such programs may—</text>
<paragraph id="idDA1538E5E9B545788DF27DBFB3A46BB1"><enum>(1)</enum><text display-inline="yes-display-inline">provide access to doulas and other perinatal health workers from pregnancy through the postpartum period;</text></paragraph> <paragraph id="id7D5855764843450CAD4C45449D206520"><enum>(2)</enum><text>provide access to healthy foods and counseling on nutrition, recommended activity levels, and safety measures throughout pregnancy;</text></paragraph>
<paragraph id="idDAC0BC7BE8F74D9288D04398BE8ED9E3"><enum>(3)</enum><text display-inline="yes-display-inline">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;</text></paragraph> <paragraph id="idBC953E0CCC134A389F5FF82C8CEF9CC6"><enum>(4)</enum><text>provide counseling and treatment for individuals who have suffered from—</text>
<subparagraph id="id1A80DF1D7FC74FC3BDA496BFD774B78B"><enum>(A)</enum><text display-inline="yes-display-inline">diagnosed mental or behavioral health conditions, including trauma and substance use disorders;</text></subparagraph> <subparagraph id="id69586DF1B65B46CE8FFB7C5E80855C9E"><enum>(B)</enum><text>domestic violence;</text></subparagraph>
<subparagraph id="id0B2870C577E94D5CBC60062E91BF57F9"><enum>(C)</enum><text>human immunodeficiency virus;</text></subparagraph> <subparagraph id="idC2E686791AF94B7DAEBBD181C82D0E14"><enum>(D)</enum><text>sexual abuse;</text></subparagraph>
<subparagraph id="id5CBAE1D06A864CD2890998833157345E"><enum>(E)</enum><text display-inline="yes-display-inline">pregnancy or infant loss; or</text></subparagraph> <subparagraph id="id864FB0C3189B4951BFD15AD2A1B2A4A2"><enum>(F)</enum><text>chronic conditions, including heart disease, diabetes, osteoporosis and osteopenia, hypertension, asthma, liver disease, and bleeding disorders; </text></subparagraph></paragraph>
<paragraph id="id2B6A3A35DB4E485E862A6F63F9F621BD"><enum>(5)</enum><text display-inline="yes-display-inline">provide pregnancy and childbirth education, parenting support, and other relevant forms of health literacy;</text></paragraph> <paragraph id="id49FB126FAB2E4923851A939FEFA651BC"><enum>(6)</enum><text display-inline="yes-display-inline">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;</text></paragraph>
<paragraph commented="no" id="id6EAD07BC2AE2418FA6E4998203D1AA4E"><enum>(7)</enum><text display-inline="yes-display-inline">provide reentry assistance, particularly to—</text> <subparagraph id="id1BB8D513C82E4CFE83AA187AB81A5CFE"><enum>(A)</enum><text display-inline="yes-display-inline">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</text></subparagraph>
<subparagraph id="id3B780873EA8F452C900F4924DFF2EB24"><enum>(B)</enum><text display-inline="yes-display-inline">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</text></subparagraph></paragraph> <paragraph id="idA9F282C372034331AC406B765D067EF0"><enum>(8)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>)), and urban Indian organizations (as such term is defined in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>)) to establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals. Such programs may include—</text>
<subparagraph id="idDCE6753C57F5440697EC5A16C2C81FF0"><enum>(A)</enum><text>parenting classes;</text></subparagraph> <subparagraph id="id90C1FA526B6D498F9D06A3F5BD03FBEB"><enum>(B)</enum><text>prenatal health coordination;</text></subparagraph>
<subparagraph id="idD2DE2B8058314164B4F10D83E75E93B8"><enum>(C)</enum><text>family and individual counseling;</text></subparagraph> <subparagraph id="idD9CC40A21ABE40F3ADFF8839220B2BCD"><enum>(D)</enum><text>evidence-based screenings, education, and, as needed, treatment for mental and behavioral health conditions, including drug and alcohol treatments;</text></subparagraph>
<subparagraph id="id125DED7F195A4CBF904AFAC396F11748"><enum>(E)</enum><text>family case management services;</text></subparagraph> <subparagraph id="idA5A763FDA7584C6E82BDBF01E17B4AB6"><enum>(F)</enum><text>domestic violence education and prevention;</text></subparagraph>
<subparagraph id="id998065FDBB334891A3ACBB65BE8C74A7"><enum>(G)</enum><text>physical and sexual abuse counseling; and</text></subparagraph> <subparagraph id="idCFB906744406458DA9C3C85061D84091"><enum>(H)</enum><text>programs to address social determinants of health such as employment, housing, education, transportation, and nutrition.</text></subparagraph></paragraph></subsection>
<subsection id="id309BFF1D3E954055B92841582AAD9B29"><enum>(g)</enum><header>Implementation and reporting</header><text>Each Bureau of Prisons facility selected under subsection (a) shall be responsible for—</text> <paragraph id="idDECD03F7C6E443A8B791AD6D960747C2"><enum>(1)</enum><text>implementing programs, which may include the programs described in subsection (f); and</text></paragraph>
<paragraph id="idD6A120A128764F6BADAEB4331D76F523"><enum>(2)</enum><text display-inline="yes-display-inline">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—</text> <subparagraph id="id9DE3E81870BF4308AF398D29D1BEC561"><enum>(A)</enum><text display-inline="yes-display-inline">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;</text></subparagraph>
<subparagraph id="id769AC06605334EF38B2CB757AA79A228"><enum>(B)</enum><text display-inline="yes-display-inline">relevant qualitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs, including subjective measures of patient-reported experience of care;</text></subparagraph> <subparagraph id="id4F63DFE0D6724BE9A539A682A9B8F7D8"><enum>(C)</enum><text display-inline="yes-display-inline">evaluations of cost effectiveness; and</text></subparagraph>
<subparagraph id="idBF30DB32BE1A4F2BB341224A0A431001"><enum>(D)</enum><text display-inline="yes-display-inline">strategies to sustain such programs beyond 2026.</text></subparagraph></paragraph></subsection> <subsection id="id76832943055A45F0AEE935E2F26DB649"><enum>(h)</enum><header>Report</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="id7F64389FAD744D7AA01CFF09BF02B3DD"><enum>(i)</enum><header>Oversight</header><text display-inline="yes-display-inline">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).</text></subsection> <subsection id="idCCFEBC5F222A4EBC9A2DA8573E49562F"><enum>(j)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There are authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2021 through 2025.</text></subsection></section>
<section id="id3CE1002DDF7A44B3918DE8419013E213"><enum>704.</enum><header>Grant program to improve maternal health outcomes for individuals in State and local prisons and jails</header>
<subsection id="idD97D39D6C5F14B29B443C3F502817192"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">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. </text></subsection> <subsection id="idCBFD07C78765477694F206CA1847E1C4"><enum>(b)</enum><header>Consultation</header><text display-inline="yes-display-inline">The Attorney General shall award the grants authorized under subsection (a) in consultation with interested entities such as—</text>
<paragraph id="id9BA33B14A5314840AEAFD7FAD9ED8E06"><enum>(1)</enum><text>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;</text></paragraph> <paragraph id="id95811392CD9C4602831972FCB93DF40A"><enum>(2)</enum><text>relevant organizations representing patients, with a particular focus on minority patients;</text></paragraph>
<paragraph id="id586AE1CE35BF4F1D80EB540A7B1FC020"><enum>(3)</enum><text>relevant organizations representing maternal health care providers;</text></paragraph> <paragraph id="idE8CEABD195E946558B62E6BDBC90EC6B"><enum>(4)</enum><text>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</text></paragraph>
<paragraph id="idB45E7A79E397481F8AEB7915844E611C"><enum>(5)</enum><text>researchers and policy experts in fields related to women’s health care for incarcerated individuals.</text></paragraph></subsection> <subsection id="idB07090777E14411B988F6A5B8F57D997"><enum>(c)</enum><header>Applications</header><text>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.</text></subsection>
<subsection id="id7998D5FF9F42464CAEC42F5090F8599B"><enum>(d)</enum><header>Use of funds</header><text display-inline="yes-display-inline">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—</text> <paragraph id="id32EDF00A2F86439B88158F64B5DFD98D"><enum>(1)</enum><text display-inline="yes-display-inline">provide access to doulas and other perinatal health workers from pregnancy through the postpartum period;</text></paragraph>
<paragraph id="id490AAA0A449F46C8A4EDBC30818751FE"><enum>(2)</enum><text>provide access to healthy foods and counseling on nutrition, recommended activity levels, and safety measures throughout pregnancy;</text></paragraph> <paragraph id="id008E6E9AC8724A5BBD1330FEF628296C"><enum>(3)</enum><text display-inline="yes-display-inline">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;</text></paragraph>
<paragraph id="id98E56490520644A38E0CB18C83C40F62"><enum>(4)</enum><text>provide counseling and treatment for individuals who have suffered from—</text> <subparagraph id="id36E318C4C6324430A2D7BA7F7117D996"><enum>(A)</enum><text display-inline="yes-display-inline">diagnosed mental or behavioral health conditions, including trauma and substance use disorders;</text></subparagraph>
<subparagraph id="id61443CF217724022934A3F5B5174F932"><enum>(B)</enum><text>domestic violence;</text></subparagraph> <subparagraph id="idA541F91817A948DDAF79EBA7735BBFEE"><enum>(C)</enum><text>human immunodeficiency virus;</text></subparagraph>
<subparagraph id="idC50466CC43AD41FCB035DF117B167E50"><enum>(D)</enum><text>sexual abuse;</text></subparagraph> <subparagraph id="id8488DB93595344688BBB3B8506A5A3C5"><enum>(E)</enum><text>pregnancy or infant loss; or </text></subparagraph>
<subparagraph id="idF09967ADE9DD49B38C224515C4851555"><enum>(F)</enum><text>chronic conditions, including heart disease, diabetes, osteoporosis and osteopenia, hypertension, asthma, liver disease, and bleeding disorders;</text></subparagraph></paragraph> <paragraph id="id1B49CD3183154E5996346C75F040DD97"><enum>(5)</enum><text display-inline="yes-display-inline">provide pregnancy and childbirth education, parenting support, and other relevant forms of health literacy;</text></paragraph>
<paragraph id="idB1C7D4F491BB4FDEBF095DC4FB7FFA91"><enum>(6)</enum><text display-inline="yes-display-inline">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;</text></paragraph> <paragraph id="id5F212ADF803A48F2B1698EAF5AE6B3BE"><enum>(7)</enum><text display-inline="yes-display-inline">provide reentry assistance, particularly to—</text>
<subparagraph id="idC62194B016C94E0F89F85D6E7500795E"><enum>(A)</enum><text display-inline="yes-display-inline">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</text></subparagraph> <subparagraph id="id8755E4D196C54CE1B63C3F5E62045AEC"><enum>(B)</enum><text display-inline="yes-display-inline">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</text></subparagraph></paragraph>
<paragraph id="id5A953E14008C4E67ADFABF3726B46BAC"><enum>(8)</enum><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>)), and urban Indian organizations (as such term is defined in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>)) to establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals. Such programs may include—</text> <subparagraph id="id5180F5662CB24E12A406DE7B0C579820"><enum>(A)</enum><text>parenting classes;</text></subparagraph>
<subparagraph id="id41215A244CC84C6CB0B3E93A9D39B192"><enum>(B)</enum><text>prenatal health coordination;</text></subparagraph> <subparagraph id="idF98163CF3F9C4F1296941F1D76C193B7"><enum>(C)</enum><text>family and individual counseling;</text></subparagraph>
<subparagraph id="id36CA5DB9B88944BFA35C1D797956C26B"><enum>(D)</enum><text>evidence-based screenings, education, and, as needed, treatment for mental and behavioral health conditions, including drug and alcohol treatments;</text></subparagraph> <subparagraph id="idFB42B67E0D0C49DCA0904905A2E48412"><enum>(E)</enum><text>family case management services;</text></subparagraph>
<subparagraph id="id839B6A4A191D4E489E9355EF25F241A9"><enum>(F)</enum><text>domestic violence education and prevention;</text></subparagraph> <subparagraph id="id3D4B5D6AD75C41818ABB0BD25D8D70ED"><enum>(G)</enum><text>physical and sexual abuse counseling; and</text></subparagraph>
<subparagraph id="id806E421BF99240539811EEF16A210D2B"><enum>(H)</enum><text>programs to address social determinants of health such as employment, housing, education, transportation, and nutrition.</text></subparagraph></paragraph></subsection> <subsection id="id8BC593831FA547DAAC40085DF26DAA9B"><enum>(e)</enum><header>Priority</header><text display-inline="yes-display-inline">In awarding grants under this section, the Director of the Bureau of Justice Assistance shall give priority to applicants based on—</text>
<paragraph id="id8EBACAA1E7764BAB882397719B0AD842"><enum>(1)</enum><text display-inline="yes-display-inline">the number of pregnant and postpartum individuals incarcerated in the State and, among such individuals, the number of pregnant and postpartum minority individuals; and</text></paragraph> <paragraph id="id293D5E214BE44BE2BFBF9EA1AC7A5622"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection>
<subsection id="id9DEB6B9FEBBC48658CCC7D58EE2D5095"><enum>(f)</enum><header>Grant duration</header><text display-inline="yes-display-inline">A grant awarded under this section shall be for a 5-year period.</text></subsection> <subsection id="idF66E5BBED7374A179BEB4D8A969F9144"><enum>(g)</enum><header>Implementing and reporting</header><text display-inline="yes-display-inline">A State that receives a grant under this section shall be responsible for—</text>
<paragraph id="id0DB1B633600E4837A85DFEDFE4ACE848"><enum>(1)</enum><text>implementing the program funded by the grant; and</text></paragraph> <paragraph id="id9F241EB7E2214A788F7F026070E1B553"><enum>(2)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph id="id9F1ED512E29442DB9838F65D7A1293BF"><enum>(A)</enum><text display-inline="yes-display-inline">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;</text></subparagraph> <subparagraph id="idAFF203112CA24B65B35B9479EF769137"><enum>(B)</enum><text display-inline="yes-display-inline">relevant qualitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs, including subjective measures of patient-reported experience of care;</text></subparagraph>
<subparagraph id="id1F91B3975242436195C91604E49DFB83"><enum>(C)</enum><text>evaluations of cost effectiveness; and</text></subparagraph> <subparagraph id="idE400ED1A9ECA458A936486B234607660"><enum>(D)</enum><text>strategies to sustain such programs beyond the duration of the grant.</text></subparagraph></paragraph></subsection>
<subsection id="id1F74DFA66FAA44008706B832CCE1E969"><enum>(h)</enum><header>Report</header><text display-inline="yes-display-inline">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.</text></subsection> <subsection id="id2BDF3A3D84634BC98DF775F54B8D2128"><enum>(i)</enum><header>Oversight</header><text display-inline="yes-display-inline">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).</text></subsection>
<subsection id="id22AA75893FB54072A2633AE35D49872B"><enum>(j)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There are authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2021 through 2025.</text></subsection></section> <section id="idD69203071F604AF5BA01917695CE5DA8"><enum>705.</enum><header>GAO report</header> <subsection id="idEE23EC8E72BD43D2840D9ADB53C58862"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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. </text></subsection>
<subsection id="idE9628209AA914484AF5D4E23AE7C0AF1"><enum>(b)</enum><header>Contents of report</header><text display-inline="yes-display-inline">The report required under subsection (a) shall include—</text> <paragraph id="id708D0550E50B44CAA65C170207196386"><enum>(1)</enum><text display-inline="yes-display-inline">to the extent practicable—</text>
<subparagraph id="id99E87DE9EEC548F09133DC88963374C5"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="idE1C1FF3474954E19AA56762E6FC91217"><enum>(B)</enum><text display-inline="yes-display-inline">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</text></subparagraph>
<subparagraph id="id5ED3528D0A064AAEA86CF5DF2124FF60"><enum>(C)</enum><text display-inline="yes-display-inline">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;</text></subparagraph></paragraph> <paragraph id="id6FA43BD22A5D48878A179E1B071C3B95"><enum>(2)</enum><text display-inline="yes-display-inline">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;</text></paragraph>
<paragraph id="id5AC0634D39EC422B8C1F4A79A802D6DC"><enum>(3)</enum><text display-inline="yes-display-inline">causes of adverse maternal health outcomes that are unique to incarcerated individuals, including those incarcerated in Federal, State, and local detention facilities;</text></paragraph> <paragraph id="id9BD9E385ED8E4EBB828C927F8ECDD908"><enum>(4)</enum><text display-inline="yes-display-inline">causes of adverse maternal health outcomes and severe maternal morbidity that are unique to incarcerated individuals of color;</text></paragraph>
<paragraph id="idFAAA1E34E0E3468480B87500CCF7826D"><enum>(5)</enum><text display-inline="yes-display-inline">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</text></paragraph> <paragraph id="idC33AED94DEC4433C956F9D86DDE05BDB" commented="no" display-inline="no-display-inline"><enum>(6)</enum><text display-inline="yes-display-inline">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. </text></paragraph></subsection></section>
<section id="HA1EF6376F6974628996C70A4B4A580DD"><enum>706.</enum><header>MACPAC report</header>
<subsection id="H361531B229D84F0D9F7E8AA84C1151F9"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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 <quote>MACPAC</quote>) 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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> et seq.). </text></subsection> <subsection id="H863BB72535C34935AC76E1239EEC1922"><enum>(b)</enum><header>Contents of report</header><text display-inline="yes-display-inline">The report described in this section shall include—</text>
<paragraph id="HA92C701C0C0E4A5B9986CE5EB673ADC3"><enum>(1)</enum><text display-inline="yes-display-inline">information on the effect of ineligibility for medical assistance under a State plan under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> 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</text></paragraph> <paragraph id="H5836EABDC5BB46ADA092709F91DD0731"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection></section>
<enum>VIII</enum><header>Tech To Save Moms</header>
<section id="HE82A02E06B6F42CAB68A755C043AB650"><enum>801.</enum><header>CMI modeling of integrated telehealth models in maternity care services</header>
<subsection id="H853628B214D04F769131415DC4EF2818"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1115A(b)(2)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1315a">42 U.S.C. 1315a(b)(2)(B)</external-xref>) is amended by adding at the end the following new clauses:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H7C52053CC6CB4FBCBB5A18C5209F5B80"> <clause id="H3E6B1C428E704C638EEC870269360591"><enum>(xxviii)</enum><text display-inline="yes-display-inline">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.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H027424C88D4C4D8AA051889C09977D73"><enum>(b)</enum><header>Effective date</header><text>The amendment made by subsection (a) shall take effect 1 year after the date of the enactment of this Act.</text></subsection></section> <section id="H82628C7403E14C8D956916BAFEFC871F"><enum>802.</enum><header>Grants to expand the use of technology-enabled collaborative learning and capacity models that provide care to pregnant and postpartum women</header><text display-inline="no-display-inline">Title III of the Public Health Service Act is amended by inserting after section 330M (<external-xref legal-doc="usc" parsable-cite="usc/42/254c-19">42 U.S.C. 254c–19</external-xref>) the following:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H2CDC8F08168E4EA2A315AD3663C6B5D5">
<section id="H2AB3F8B5FA6241379E3204DA14D07A2F"><enum>330N.</enum><header>Expanding capacity for maternal health outcomes</header>
<subsection id="H83334793F42B4AC5979B781034348227"><enum>(a)</enum><header>Program established</header><text display-inline="yes-display-inline">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—</text> <paragraph id="idF5085CA9A5CC481598780EE508C77FC4"><enum>(1)</enum><text display-inline="yes-display-inline">in health professional shortage areas; </text></paragraph>
<paragraph id="id05FCE960E24D43EE8B3529CF683A3A5E"><enum>(2)</enum><text display-inline="yes-display-inline">in areas with high rates of maternal mortality and severe maternal morbidity, and significant racial and ethnic disparities in maternal health outcomes; and </text></paragraph> <paragraph id="idDCA3C40BE4C44C42967006963CF498F8"><enum>(3)</enum><text display-inline="yes-display-inline">for medically underserved populations or American Indians and Alaska Natives, including Indian tribes, tribal organizations, and urban Indian organizations. </text></paragraph></subsection>
<subsection id="H2FDB3D5A67DD44448CAEC35A3825E5C1"><enum>(b)</enum><header>Use of Funds</header>
<paragraph id="H52389D7955624880BDF90B156B67B37E"><enum>(1)</enum><header>Required uses</header><text display-inline="yes-display-inline">Grants awarded under subsection (a) shall be used for—</text> <subparagraph id="HE558D3D3499C4D83A19833CE2069DA91"><enum>(A)</enum><text display-inline="yes-display-inline">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—</text>
<clause id="H09AE224D7447486F911A190FE10AB64D"><enum>(i)</enum><text display-inline="yes-display-inline">training on adopting and effectively implementing Alliance for Innovation on Maternal Health (referred to in this section as <quote>AIM</quote>) safety and quality improvement bundles;</text></clause> <clause id="H4BC5596899BC49229E1AA73137B03463"><enum>(ii)</enum><text display-inline="yes-display-inline">training on implicit and explicit bias, racism, and discrimination for providers of maternity care;</text></clause>
<clause id="HF77E526AF5CF410FB7375F5AEA00A114"><enum>(iii)</enum><text display-inline="yes-display-inline">training on best practices in screening for and, as needed, evaluating and treating maternal mental health conditions and substance use disorders;</text></clause> <clause id="H9BACCF5C053C46C19AA5FECAE5A6BD90"><enum>(iv)</enum><text display-inline="yes-display-inline">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</text></clause>
<clause id="HAE0FB377A03E4C60A94114D5B59A3D69"><enum>(v)</enum><text display-inline="yes-display-inline">training on the use of remote patient monitoring tools for pregnancy-related complications;</text></clause></subparagraph> <subparagraph id="H86BA06F13F724B3A8C466E380E36797E"><enum>(B)</enum><text>information collection and evaluation activities to—</text>
<clause id="H0F1DE70C2A5F46309AF75D7DE744CC6F"><enum>(i)</enum><text>study the impact of such models on—</text> <subclause id="H7CC0A1C10ABF46D1AA1B306127BB3DB9"><enum>(I)</enum><text>access to and quality of care;</text></subclause>
<subclause id="H98CEB1091B9D4C43984F75B47F23C6AF"><enum>(II)</enum><text>patient outcomes;</text></subclause> <subclause id="H7423B8045EDA41D9B035326B309B10EA"><enum>(III)</enum><text>subjective measures of patient experience; and</text></subclause>
<subclause id="HFBEFED556BA542E395DC5A09C469B6AC"><enum>(IV)</enum><text>cost-effectiveness; and</text></subclause></clause> <clause id="H5B58F8E3F64B4456A08A9DEBD2A70953"><enum>(ii)</enum><text>identify best practices for the expansion and use of such models;</text></clause></subparagraph>
<subparagraph id="HF2B0046C6B0F48079C08BE5B5ADE828D"><enum>(C)</enum><text display-inline="yes-display-inline">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</text></subparagraph> <subparagraph id="HC89EE52744F9476F957FB9498B15773E"><enum>(D)</enum><text display-inline="yes-display-inline">any other activity consistent with achieving the objectives of grants awarded under this section, as determined by the Secretary.</text></subparagraph></paragraph>
<paragraph id="H1D60A919BEF143F3AC5DFD2F6AF030E9"><enum>(2)</enum><header>Permissible uses</header><text display-inline="yes-display-inline">In addition to any of the uses under paragraph (1), grants awarded under subsection (a) may be used for—</text> <subparagraph id="H7A64374F286C40EA87A77FEF88EABC8D"><enum>(A)</enum><text display-inline="yes-display-inline">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</text></subparagraph>
<subparagraph id="H8B91E40929574A40B999AFAB71613F6D"><enum>(B)</enum><text display-inline="yes-display-inline">support for maternal health care providers and other professionals that provide or assist in the provision of maternity care services through such models.</text></subparagraph></paragraph></subsection> <subsection id="H5A73C2086AAB4502930F47BDC2F5EDA4"><enum>(c)</enum><header>Limitations</header> <paragraph id="H054F7F9067FA4433BBA0895F545A2AE2"><enum>(1)</enum><header>Number</header><text display-inline="yes-display-inline">The Secretary may not award more than 1 grant under this section to an eligible entity.</text></paragraph>
<paragraph id="H8EB74509A33044EF992A9135F6129821"><enum>(2)</enum><header>Duration</header><text display-inline="yes-display-inline">Each grant under this section shall be made for a period of up to 5 years.</text></paragraph> <paragraph id="H11BD778B8F7746CE9CC93E408E5A9D75"><enum>(3)</enum><header>Amount</header><text display-inline="yes-display-inline">The Secretary shall determine the maximum amount of each grant under this section.</text></paragraph></subsection>
<subsection id="H085D3D7D0434430D8B2BC429E3A83FE0"><enum>(d)</enum><header>Grant requirements</header>
<paragraph id="idCC723912197745C4BC91F0342B9C5B4E"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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). </text></paragraph> <paragraph id="id17A8BD557F034E58AFC9F8E334234A4D"><enum>(2)</enum><header>Coordination support</header><text display-inline="yes-display-inline">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). </text></paragraph></subsection>
<subsection id="H25C90EADFA6440A8B098089CD03D5559"><enum>(e)</enum><header>Application</header>
<paragraph id="H8AF860434B2C4C0FAF1E5DB570F14A33"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="H90A209607D67462EB4F5854BA91B8CE6"><enum>(2)</enum><header>Matters to be included</header><text>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—</text>
<subparagraph id="H2BF2199BE7A24906A98695F3A1E0A676"><enum>(A)</enum><text>health professional shortage areas;</text></subparagraph> <subparagraph id="H82E6C48BF432421EAE0C827EDC71B5BC"><enum>(B)</enum><text display-inline="yes-display-inline">areas with high rates of maternal mortality and severe maternal morbidity, and significant racial and ethnic disparities in maternal health outcomes; and</text></subparagraph>
<subparagraph id="HC3984FBBF01F4F2FB46EC12794F4D9BE"><enum>(C)</enum><text display-inline="yes-display-inline">medically underserved populations or American Indians and Alaska Natives, including Indian tribes, tribal organizations, and urban Indian organizations.</text></subparagraph></paragraph></subsection> <subsection id="HE13C5B1B8F414E59B9D012BBAD250916"><enum>(f)</enum><header>Access to broadband</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="H55E3ABD41ABF47E3BEF17F81A92C33FD"><enum>(g)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">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—</text> <paragraph id="idDA2D0837D99C4F2DB3D3F2289F17BB36"><enum>(1)</enum><text display-inline="yes-display-inline">for health professional shortage areas;</text></paragraph>
<paragraph id="id34B791441B0340FD9592D321A0A6EAB9"><enum>(2)</enum><text display-inline="yes-display-inline">for areas with high rates of maternal mortality and severe maternal morbidity, and significant racial and ethnic disparities in maternal health outcomes; and </text></paragraph> <paragraph id="idBFC2012A9E5F42E4BCAA99451BD0BADF"><enum>(3)</enum><text display-inline="yes-display-inline">to medically underserved populations or American Indians and Alaska Natives, including Indian tribes, tribal organizations, and urban Indian organizations.</text></paragraph></subsection>
<subsection id="HC656DE21B04C49538A18AFE141C5C0CF"><enum>(h)</enum><header>Research and evaluation</header><text display-inline="yes-display-inline">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.</text></subsection> <subsection id="H61F54F2BA56A4D4BA176F188EE98A3AE"><enum>(i)</enum><header>Reporting</header> <paragraph id="HDE4E884AEA8A4D57B6ECD223CD8776E8"><enum>(1)</enum><header>By eligible entities</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="H4B71903670224EF69EC7E56BEA409DC5"><enum>(2)</enum><header>By the Secretary</header><text display-inline="yes-display-inline">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—</text> <subparagraph id="H4E4B9CF589FD4D909FDC63E023981739"><enum>(A)</enum><text display-inline="yes-display-inline">a description of any new and continuing grants awarded under subsection (a) and the specific purpose and amounts of such grants;</text></subparagraph>
<subparagraph id="H197773E5D2C44E4CB96010A57632D251"><enum>(B)</enum><text display-inline="yes-display-inline">an overview of—</text> <clause id="H2271BCDC555D4FEC9540D52B9F5065EC"><enum>(i)</enum><text display-inline="yes-display-inline">the evaluation activities conducted under subsection (b)(1)(B)(i);</text></clause>
<clause id="H39FA255CDB44453681E185C52E88F773"><enum>(ii)</enum><text display-inline="yes-display-inline">technical assistance provided under subsection (g); and</text></clause> <clause id="H61EC177CA77B4632A672B55177D2A413"><enum>(iii)</enum><text display-inline="yes-display-inline">activities conducted by entities awarded grants under subsection (a); and</text></clause></subparagraph>
<subparagraph id="H44D69B78DF524A7DA7EF84CA3D88CB1F"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph></subsection> <subsection id="HB7997A0691904B0B88FADEB05140AA07"><enum>(j)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section $6,000,000 for each of fiscal years 2021 through 2025.</text></subsection>
<subsection id="HF6DF823491E44C55A3B8B6DBCF8DE9A8"><enum>(k)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HC85F2F2B42E64CC9B3C52D958A73F5E1"><enum>(1)</enum><header>Eligible entity</header> <subparagraph id="H3B7CAB982B3B42FC83D31DB0E9272AA1"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The term <term>eligible entity</term> means an entity that provides, or supports the provision of, maternal health care services or other evidence-based services for pregnant and postpartum women—</text>
<clause id="HC4E131E157354E59BD7DA8E78B8262A7"><enum>(i)</enum><text display-inline="yes-display-inline">in health professional shortage areas;</text></clause> <clause id="H6BB177A8E631415891C6062CE0B2E667"><enum>(ii)</enum><text>in areas with high rates of adverse maternal health outcomes and significant racial and ethnic disparities in maternal health outcomes; or</text></clause>
<clause id="HFE026BBAAAE64419B857E2A4FCC0867B"><enum>(iii)</enum><text display-inline="yes-display-inline">from medically underserved populations or American Indians and Alaska Natives, including Indian tribes, tribal organizations, and urban Indian organizations.</text></clause></subparagraph> <subparagraph id="H85F96EF0ABBB4A05A0FC65EC82D5BE7A"><enum>(B)</enum><header>Inclusions</header><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph>
<paragraph id="H32A19E4F2EA143069C03E20CD15B5210"><enum>(2)</enum><header>Health professional shortage area</header><text display-inline="yes-display-inline">The term <term>health professional shortage area</term> means a health professional shortage area designated under section 332.</text></paragraph> <paragraph id="H8DF6E73BD5464AEB99C756B13A320535"><enum>(3)</enum><header>Indian tribe</header><text display-inline="yes-display-inline">The term <term>Indian tribe</term> has the meaning given such term in section 4 of the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>).</text></paragraph>
<paragraph id="HDC3A6E5B673E44FEAFBE1C83048FD86B"><enum>(4)</enum><header>Maternal mortality</header><text>The term <term>maternal mortality</term> means a death occurring during or within 1-year period after pregnancy caused by pregnancy or childbirth complications.</text></paragraph> <paragraph id="H0CBB826FD09B401294BFDFBF6247C47A"><enum>(5)</enum><header>Medically underserved population</header><text display-inline="yes-display-inline">The term <term>medically underserved population</term> has the meaning given such term in section 330(b)(3).</text></paragraph>
<paragraph id="H963950D0C3444B5C911383CE30AF9957"><enum>(6)</enum><header>Postpartum</header><text>The term <term>postpartum</term> means the 1-year period beginning on the last date of the pregnancy of a woman.</text></paragraph> <paragraph id="HE001553FD5E448F990F1EDC69908CC38"><enum>(7)</enum><header>Severe maternal morbidity</header><text>The term <term>severe maternal morbidity</term> 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.</text></paragraph>
<paragraph id="H2C94DEC2DE504EFF8333FC882866E55D"><enum>(8)</enum><header>Technology-enabled collaborative learning and capacity building model</header><text display-inline="yes-display-inline">The term <term>technology-enabled collaborative learning and capacity building model</term> 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.</text></paragraph> <paragraph id="H6B050E4D8A2C4396AA6314FF62FAE4C8"><enum>(9)</enum><header>Tribal organization</header><text display-inline="yes-display-inline">The term <term>tribal organization</term> has the meaning given such term in section 4 of the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>).</text></paragraph>
<paragraph id="H7AD2D006D4D04656AE05D18914580310"><enum>(10)</enum><header>Urban Indian organization</header><text display-inline="yes-display-inline">The term <term>urban Indian organization</term> has the meaning given such term in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>).</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H65E1A87BDF9C41EAA343E0C67DB7CBDB"><enum>803.</enum><header>Grants to promote equity in maternal health outcomes by increasing access to digital tools</header> <subsection id="HAC6F6F7F526D4A9399DA04F73EE9265B"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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 <quote>Investments in Digital Tools to Promote Equity in Maternal Health Outcomes Program</quote>, 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.</text></subsection>
<subsection id="H5D53ED6BCC9E4A069633A2D7736655E6"><enum>(b)</enum><header>Applications</header><text display-inline="yes-display-inline">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.</text></subsection> <subsection display-inline="no-display-inline" id="HED2D6D42F9894269ACAEC844194DDED8"><enum>(c)</enum><header>Limitations</header> <paragraph id="H2E4BC6A5E574424EA06FFAD1C739C992"><enum>(1)</enum><header>Number</header><text display-inline="yes-display-inline">The Secretary may not award more than 1 grant under this section to an eligible entity.</text></paragraph>
<paragraph id="H6C6E3D2892D149FC886882961C52B6B7"><enum>(2)</enum><header>Duration</header><text display-inline="yes-display-inline">Each grant under this section shall be made for a period of not more than 5 years.</text></paragraph> <paragraph id="H64E1D94D78CF4208A83F6668171241AF"><enum>(3)</enum><header>Amount</header><text>The Secretary shall determine the maximum amount of each grant under this section.</text></paragraph>
<paragraph id="HBA12E19AC8C641E49B75F79397E4D3F2"><enum>(4)</enum><header>Prioritization</header><text>In awarding grants under this section, the Secretary shall prioritize the selection of an eligible entity that—</text> <subparagraph id="H5A165E6014F74452A56F450EDB850AB4"><enum>(A)</enum><text display-inline="yes-display-inline">operates in an area with high rates of adverse maternal health outcomes and significant racial and ethnic disparities in maternal health outcomes; and</text></subparagraph>
<subparagraph id="HD7572D2B89FF4749B3BDF2822A9750F8"><enum>(B)</enum><text display-inline="yes-display-inline">promotes technology that addresses racial and ethnic disparities in maternal health outcomes.</text></subparagraph></paragraph></subsection> <subsection id="HF23C2D04D0DA420AB1B3B1F17225BE6E"><enum>(d)</enum><header>Technical assistance</header><text>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.</text></subsection>
<subsection id="H4D8AD6EA9EF346AD89E1893926D65AD8"><enum>(e)</enum><header>Reporting</header>
<paragraph id="HC354995D35254F219B86FF51135237DB"><enum>(1)</enum><header>By eligible entities</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H5B683BF15F2140B6908F2CE46434B9C7"><enum>(2)</enum><header>By the Secretary</header><text>Not later than 4 years after the date of the enactment of this Act, the Secretary shall submit to Congress a report that—</text>
<subparagraph id="HC24458A5D29247C5A81EF0685D2FDF0A"><enum>(A)</enum><text display-inline="yes-display-inline">evaluates the effectiveness of grants awarded under this section in improving maternal health outcomes for minority women;</text></subparagraph> <subparagraph id="HAA6B03C96A8745C5B1044A91820AC5C9"><enum>(B)</enum><text>makes recommendations for future grant programs that promote the use of technology to improve maternal health outcomes for minority women; and</text></subparagraph>
<subparagraph id="H37C4725EBE4041088870DD7F91A465E4"><enum>(C)</enum><text>makes recommendations that address—</text> <clause id="H76FB8E1CDFD747CDB3C3BCCCCFF6B08A"><enum>(i)</enum><text>privacy and security safeguards that should be implemented in the use of technology in maternal health care;</text></clause>
<clause id="H3CBCF9812B0B4FE6B32BFBF6F9749B99"><enum>(ii)</enum><text>reimbursement rates for maternal telehealth services;</text></clause> <clause id="H28682CC997F1421EA7F250BBAD7C3233"><enum>(iii)</enum><text>the use of digital tools to analyze large data sets for the purposes of identifying potential pregnancy-related complications as early as possible;</text></clause>
<clause id="HC3FC5CEB53064163BC8707F3111320B3"><enum>(iv)</enum><text display-inline="yes-display-inline">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;</text></clause> <clause id="HA007491AB09B4C4E8B379F0B48BF2DF9"><enum>(v)</enum><text>the use of consumer digital tools such as mobile phone applications, patient portals, and wearable technologies to improve maternal health outcomes;</text></clause>
<clause id="H2FB11EA3A66E40FA91C981301FF2DD53"><enum>(vi)</enum><text display-inline="yes-display-inline">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</text></clause> <clause id="H5C0AFA26BEC04E87AEEF026165DA56A5"><enum>(vii)</enum><text>any other related issues as determined by the Secretary.</text></clause></subparagraph></paragraph></subsection>
<subsection id="H915FF47FAC3F40CC9061A341499808C8"><enum>(f)</enum><header>Eligible entity defined</header><text display-inline="yes-display-inline">In this section, the term <term>eligible entity</term> 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.</text></subsection> <subsection display-inline="no-display-inline" id="H857FBD30EA614C3B9C4E98918C7CDAC9"><enum>(g)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $6,000,000 for each of fiscal years 2021 through 2025. </text></subsection></section>
<section id="H9359F3C1BF62444DA12D982883F1FDB7"><enum>804.</enum><header>Report on the use of technology to reduce maternal mortality and severe maternal morbidity and to close racial and ethnic disparities in outcomes</header>
<subsection id="H531540A933F94CA6873D66067D5B1E7F"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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 <quote>National Academies</quote>) 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—</text> <paragraph id="H529F26BA07024E5DBC70107A87AE0285"><enum>(1)</enum><text>the extent to which artificial intelligence technologies are currently being used in maternal health care;</text></paragraph>
<paragraph id="HFEE38B3B8B184ADFABBC07F369325148"><enum>(2)</enum><text>the extent to which artificial intelligence technologies have exacerbated racial or ethnic biases in maternal health care;</text></paragraph> <paragraph id="H20C2A6B9F79E4D258EED6F561F2D4653"><enum>(3)</enum><text>recommendations for reducing racial or ethnic biases in artificial intelligence technologies used in maternal health care;</text></paragraph>
<paragraph id="HF6DC96ABA5E443E5A7589438715CA1E4"><enum>(4)</enum><text>recommendations for potential applications of artificial intelligence technologies that could improve maternal health outcomes, particularly for minority women; and</text></paragraph> <paragraph id="H86FA1A5A091947A9A26649BCF97DC16A"><enum>(5)</enum><text>recommendations for privacy and security safeguards that should be implemented in the development of artificial intelligence technologies in maternal health care.</text></paragraph></subsection>
<subsection id="H6195FCEAECE549B09F9552504F6EF228"><enum>(b)</enum><header>Report</header><text>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.</text></subsection></section> <enum>IX</enum><header>IMPACT To Save Moms</header> <section section-type="subsequent-section" id="H6D123555183349F3BCB14B32ACF28650"><enum>901.</enum><header>Perinatal Care Alternative Payment Model Demonstration Project</header> <subsection id="H93C3681C46E34D1482EA939F551E7D1D"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">For the period of fiscal years 2022 through 2026, the Secretary of Health and Human Services (referred to in this section as the <quote>Secretary</quote>), 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 <quote>Demonstration Project</quote>), for purposes of allowing States to test payment models under their State plans under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> et seq.) and State child health plans under title XXI of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa</external-xref> et seq.) with respect to maternity care provided to pregnant and postpartum women enrolled in such State plans and State child health plans.</text></subsection>
<subsection id="H050D1AC2D4A34FE6A86A11CAADC1E145"><enum>(b)</enum><header>Coordination</header><text>In establishing the Demonstration Project, the Secretary shall coordinate with stakeholders such as—</text> <paragraph id="H654F52B3C7CC46AA843E5B81534A7291"><enum>(1)</enum><text>State Medicaid programs;</text></paragraph>
<paragraph id="HC77D11B84F634403A67FFB5196F7B607"><enum>(2)</enum><text>relevant organizations representing maternal health care providers;</text></paragraph> <paragraph id="H22FA35382B98406D87E62898F2EB6217"><enum>(3)</enum><text>relevant organizations representing patients, with a particular focus on women from demographic groups with disproportionate rates of adverse maternal health outcomes;</text></paragraph>
<paragraph id="H5B3441181A9B45B18FCFDB3BA96AD95E"><enum>(4)</enum><text>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;</text></paragraph> <paragraph id="H934242FF8F324281AA320960AB8D1FF7"><enum>(5)</enum><text>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;</text></paragraph>
<paragraph id="HFB07729666704E57B580ADF53E30E71E"><enum>(6)</enum><text>relevant health insurance issuers;</text></paragraph> <paragraph id="H6A0D26DAC7534A7EBF5E1218A90DBF66"><enum>(7)</enum><text display-inline="yes-display-inline">hospitals, health systems, freestanding birth centers (as such term is defined in paragraph (3)(B) of section 1905(l) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(l)</external-xref>), 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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)</external-xref>));</text></paragraph>
<paragraph id="HFEECA98AC014495EAB700C551D51C4D7"><enum>(8)</enum><text>researchers and policy experts in fields related to maternity care payment models; and</text></paragraph> <paragraph id="HAD3A2FA0915C461C8DBA31FFFFFFABE0"><enum>(9)</enum><text>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.</text></paragraph></subsection>
<subsection id="HB98EC89DE12B4D9D886C6436E9298E89"><enum>(c)</enum><header>Considerations</header><text display-inline="yes-display-inline">In establishing the Demonstration Project, the Secretary shall consider each of the following:</text> <paragraph id="H39E1FC621C2E4309897701406493E549"><enum>(1)</enum><text>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.</text></paragraph>
<paragraph id="H4154C308F4F84657A774936D34EA7654"><enum>(2)</enum><text>Any alternative payment model that—</text> <subparagraph id="HA4CC0A25F21B434A8B5013158D60CEE8"><enum>(A)</enum><text>is designed to improve maternal health outcomes for racial and ethnic groups with disproportionate rates of adverse maternal health outcomes;</text></subparagraph>
<subparagraph id="HF500EDA1259A40F080B89D906499EE7B"><enum>(B)</enum><text>includes methods for stratifying patients by pregnancy risk level and, as appropriate, adjusting payments under such model to take into account pregnancy risk level;</text></subparagraph> <subparagraph id="H6E3C14B4F66A4E71BC4DBE940A56AC50"><enum>(C)</enum><text>establishes evidence-based quality metrics for such payments;</text></subparagraph>
<subparagraph id="HC1301B44FD6741128E16AE3A5B0C680A"><enum>(D)</enum><text>includes consideration of non-hospital birth settings such as freestanding birth centers (as so defined);</text></subparagraph> <subparagraph id="H3CF01469D7A34879A64E2B25282F57C1"><enum>(E)</enum><text>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</text></subparagraph>
<subparagraph id="H4A937A0FA9494436BD922C260EB07D37"><enum>(F)</enum><text>includes diverse maternity care teams that include—</text> <clause id="HC32A781E604147AF82D1C6CD1CAA713F"><enum>(i)</enum><text>maternity care providers, including obstetrician-gynecologists, family physicians, physician assistants, midwives who meet, at a minimum, the international definition of the term <term>midwife</term> and global standards for midwifery education (as established by the International Confederation of Midwives), and nurse practitioners—</text>
<subclause id="HDD3C176B990340DFB9AF228CD936C317"><enum>(I)</enum><text>from racially, ethnically, and professionally diverse backgrounds;</text></subclause> <subclause id="H0841F9C57B384AA5B3F2374C3B8E9CCC"><enum>(II)</enum><text>with experience practicing in racially and ethnically diverse communities; or</text></subclause>
<subclause id="HAC33FA946EC149EC8A930A5AEAA268FD"><enum>(III)</enum><text>who have undergone trainings on racism, implicit bias, and explicit bias; and</text></subclause></clause> <clause id="H8190954F955149CEA195851458697AC6"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph></paragraph></subsection>
<subsection id="H265498E072634A4998D2E64CC65259D7"><enum>(d)</enum><header>Eligibility</header><text>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.</text></subsection> <subsection id="HB50D873A05CF4FCFBBA416CDF496F12D"><enum>(e)</enum><header>Evaluation</header><text display-inline="yes-display-inline">The Secretary shall conduct an evaluation of the Demonstration Project to determine the impact of the Demonstration Project on—</text>
<paragraph id="H14309003164B4DEFA203458A3205599E"><enum>(1)</enum><text>maternal health outcomes, with data stratified by race, ethnicity, socioeconomic indicators, and any other factors as the Secretary determines appropriate;</text></paragraph> <paragraph id="HA70E6C9E7AEB49B6B45FD7FE6F1A9698"><enum>(2)</enum><text>spending on maternity care by States participating in the Demonstration Project;</text></paragraph>
<paragraph id="HE06EA38927944AEB8308949D89A6E19C"><enum>(3)</enum><text>to the extent practicable, subjective measures of patient experience; and</text></paragraph> <paragraph id="H54CB4CEF1C56439190D3C0A4B7095581"><enum>(4)</enum><text>any other areas of assessment that the Secretary determines relevant.</text></paragraph></subsection>
<subsection id="H7ECC2F255FFA41989389FA07EE03641C"><enum>(f)</enum><header>Report</header><text display-inline="yes-display-inline">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—</text> <paragraph id="HA7F815F75CA246BA97CE2C058F98E792"><enum>(1)</enum><text>the results of any evaluation conducted under subsection (e); and</text></paragraph>
<paragraph id="H4958AC20359E4409935508566A0F823B"><enum>(2)</enum><text>a recommendation regarding whether the Demonstration Project should be continued after fiscal year 2026 and expanded on a national basis.</text></paragraph></subsection> <subsection id="H999F4648BF224094843067F7A0A0589B"><enum>(g)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There are authorized to be appropriated such sums as are necessary to carry out this section.</text></subsection>
<subsection id="HE63A2D148D074641BDA716A6B49DB304"><enum>(h)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H8A6B5B4CC12A4D92847C65B35047A195"><enum>(1)</enum><header>Alternative payment model</header><text>The term <term>alternative payment model</term> has the meaning given such term in section 1833(z)(3)(C) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(z)(3)(C)</external-xref>). </text></paragraph>
<paragraph id="H0A52A9FF103647D39853FFE2879B4F83"><enum>(2)</enum><header>Perinatal</header><text display-inline="yes-display-inline">The term <term>perinatal</term> 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.</text></paragraph></subsection></section> <section id="HD8B8455E3CF24523824B55BC307C289F"><enum>902.</enum><header>MACPAC report</header><text display-inline="no-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396</external-xref> et seq.) and State child health plans under title XXI of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa</external-xref> et seq.) for pregnant and postpartum women. Such report shall, at a minimum, include the following:</text>
<paragraph id="H7A02E4A30E86460D98A0D10D1AB28BA0"><enum>(1)</enum><text>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.</text></paragraph> <paragraph id="HB4D7F7AB61C843B4BAABA123C3E8B6BC"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="H22C47F09E2F64F9E94AACA2DEBFACEBF"><enum>(3)</enum><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H4BAE6E275B57476BB2F732D9FEF85684"><enum>(4)</enum><text display-inline="yes-display-inline">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.</text></paragraph></section>