[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 937 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 937

 To amend title XI of the Social Security Act to integrate telehealth 
       models in maternity care services, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 8, 2021

   Ms. Johnson of Texas (for herself, Ms. Underwood, Ms. Adams, Mr. 
   Khanna, Ms. Velazquez, Mrs. McBath, Mr. Smith of Washington, Ms. 
Scanlon, Mr. Lawson of Florida, Mrs. Hayes, Mr. Butterfield, Ms. Moore 
  of Wisconsin, Ms. Strickland, Mr. Ryan, Mr. Schiff, Mr. Johnson of 
Georgia, Mr. Horsford, Ms. Wasserman Schultz, Ms. Barragan, Mr. Deutch, 
   Mr. Payne, Mr. Blumenauer, Mr. Moulton, Mr. Soto, Mr. Nadler, Mr. 
Trone, Ms. Clarke of New York, Ms. Schakowsky, Ms. Bass, Ms. Pressley, 
Mr. Evans, Ms. Blunt Rochester, Ms. Castor of Florida, Ms. Sewell, and 
   Ms. Williams of Georgia) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend title XI of the Social Security Act to integrate telehealth 
       models in maternity care services, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Tech To Save Moms Act''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Postpartum and postpartum period.--The terms 
        ``postpartum'' and ``postpartum period'' refer to the 1-year 
        period beginning on the last day of the pregnancy of an 
        individual.
            (2) Racial and ethnic minority group.--The term ``racial 
        and ethnic minority group'' has the meaning given such term in 
        section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 
        300u-6(g)(1)).
            (3) Severe maternal morbidity.--The term ``severe maternal 
        morbidity'' means a health condition, including mental health 
        conditions and substance use disorders, attributed to or 
        aggravated by pregnancy or childbirth that results in 
        significant short-term or long-term consequences to the health 
        of the individual who was pregnant.
            (4) Social determinants of maternal health.--The term 
        ``social determinants of maternal health'' means non-clinical 
        factors that impact maternal health outcomes, including--
                    (A) economic factors, which may include poverty, 
                employment, food security, support for and access to 
                lactation and other infant feeding options, housing 
                stability, and related factors;
                    (B) neighborhood factors, which may include quality 
                of housing, access to transportation, access to child 
                care, availability of healthy foods and nutrition 
                counseling, availability of clean water, air and water 
                quality, ambient temperatures, neighborhood crime and 
                violence, access to broadband, and related factors;
                    (C) social and community factors, which may include 
                systemic racism, gender discrimination or 
                discrimination based on other protected classes, 
                workplace conditions, incarceration, and related 
                factors;
                    (D) household factors, which may include ability to 
                conduct lead testing and abatement, car seat 
                installation, indoor air temperatures, and related 
                factors;
                    (E) education access and quality factors, which may 
                include educational attainment, language and literacy, 
                and related factors; and
                    (F) health care access factors, including health 
                insurance coverage, access to culturally congruent 
                health care services, providers, and non-clinical 
                support, access to home visiting services, access to 
                wellness and stress management programs, health 
                literacy, access to telehealth and items required to 
                receive telehealth services, and related factors.

SEC. 3. INTEGRATED TELEHEALTH MODELS IN MATERNITY CARE SERVICES.

    (a) In General.--Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the end the 
following:
                            ``(xxviii) Focusing on title XIX, providing 
                        for the adoption of and use of telehealth tools 
                        that allow for screening, monitoring, and 
                        management of common health complications with 
                        respect to an individual receiving medical 
                        assistance during such individual's pregnancy 
                        and for not more than a 1-year period beginning 
                        on the last day of the pregnancy.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect 1 year after the date of the enactment of this Act.

SEC. 4. GRANTS TO EXPAND THE USE OF TECHNOLOGY-ENABLED COLLABORATIVE 
              LEARNING AND CAPACITY MODELS FOR PREGNANT AND POSTPARTUM 
              INDIVIDUALS.

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

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

    ``(a) Establishment.--Beginning not later than 1 year after the 
date of enactment of this Act, the Secretary shall award grants to 
eligible entities to evaluate, develop, and expand the use of 
technology-enabled collaborative learning and capacity building models 
and improve maternal health outcomes--
            ``(1) in health professional shortage areas;
            ``(2) in areas with high rates of maternal mortality and 
        severe maternal morbidity;
            ``(3) in areas with significant racial and ethnic 
        disparities in maternal health outcomes; and
            ``(4) for medically underserved populations and American 
        Indians and Alaska Natives, including Indian Tribes, Tribal 
        organizations, and Urban Indian organizations.
    ``(b) Use of Funds.--
            ``(1) Required uses.--Recipients of grants under this 
        section shall use the grants to--
                    ``(A) train maternal health care providers, 
                students, and other similar professionals through 
                models that include--
                            ``(i) methods to increase safety and health 
                        care quality;
                            ``(ii) implicit bias, racism, and 
                        discrimination;
                            ``(iii) best practices in screening for 
                        and, as needed, evaluating and treating 
                        maternal mental health conditions and substance 
                        use disorders;
                            ``(iv) training on best practices in 
                        maternity care for pregnant and postpartum 
                        individuals during the COVID-19 public health 
                        emergency or future public health emergencies;
                            ``(v) methods to screen for social 
                        determinants of maternal health risks in the 
                        prenatal and postpartum; and
                            ``(vi) the use of remote patient monitoring 
                        tools for pregnancy-related complications 
                        described in section 1115A(b)(2)(B)(xxviii);
                    ``(B) evaluate and collect information on the 
                effect of such models on--
                            ``(i) access to and quality of care;
                            ``(ii) outcomes with respect to the health 
                        of an individual;
                            ``(iii) the experience of individuals who 
                        receive pregnancy-related health care;
                    ``(C) develop qualitative and quantitative measures 
                to identify best practices for the expansion and use of 
                such models;
                    ``(D) study the effect of such models on patient 
                outcomes and maternity care providers; and
                    ``(E) conduct any other activity determined by the 
                Secretary.
            ``(2) Permissible uses.--Recipients of grants under this 
        section may use grants to support--
                    ``(A) the use and expansion of technology-enabled 
                collaborative learning and capacity building models, 
                including hardware and software that--
                            ``(i) enables distance learning and 
                        technical support; and
                            ``(ii) supports the secure exchange of 
                        electronic health information; and
                    ``(B) maternity care providers, students, and other 
                similar professionals in the provision of maternity 
                care through such models.
    ``(c) Application.--
            ``(1) In general.--An eligible entity seeking a grant under 
        subsection (a) shall submit to the Secretary an application, at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
            ``(2) Assurance.--An application under paragraph (1) shall 
        include an assurance that such entity shall collect information 
        on and assess the effect of the use of technology-enabled 
        collaborative learning and capacity building models, including 
        with respect to--
                    ``(A) maternal health outcomes;
                    ``(B) access to maternal health care services;
                    ``(C) quality of maternal health care; and
                    ``(D) retention of maternity care providers serving 
                areas and populations described in subsection (a).
    ``(d) Limitations.--
            ``(1) Number.--The Secretary may not award more than 1 
        grant under this section to an eligible entity.
            ``(2) Duration.--A grant awarded under this section shall 
        be for a 5-year period.
    ``(e) Access to Broadband.--In administering grants under this 
section, the Secretary may coordinate with other agencies to ensure 
that funding opportunities are available to support access to reliable, 
high-speed internet for grantees.
    ``(f) Technical Assistance.--The Secretary shall provide (either 
directly or by contract) technical assistance to eligible entities, 
including recipients of grants under subsection (a), on the 
development, use, and sustainability of technology-enabled 
collaborative learning and capacity building models to expand access to 
maternal health care services provided by such entities, including--
            ``(1) in health professional shortage areas;
            ``(2) in areas with high rates of maternal mortality and 
        severe maternal morbidity or significant racial and ethnic 
        disparities in maternal health outcomes; and
            ``(3) for medically underserved populations or American 
        Indians and Alaska Natives.
    ``(g) Research and Evaluation.--The Secretary, in consultation with 
experts, shall develop a strategic plan to research and evaluate the 
evidence for such models.
    ``(h) Reporting.--
            ``(1) Eligible entities.--An eligible entity that receives 
        a grant under subsection (a) shall submit to the Secretary a 
        report, at such time, in such manner, and containing such 
        information as the Secretary may require.
            ``(2) Secretary.--Not later than 4 years after the date of 
        enactment of this section, the Secretary shall submit to the 
        Congress, and make available on the website of the Department 
        of Health and Human Services, a report that includes--
                    ``(A) a description of grants awarded under 
                subsection (a) and the purpose and amounts of such 
                grants;
                    ``(B) a summary of--
                            ``(i) the evaluations conducted under 
                        subsection (b)(B);
                            ``(ii) any technical assistance provided 
                        under subsection (g); and
                            ``(iii) the activities conducted under 
                        subsection (a); and
                    ``(C) a description of any significant findings 
                with respect to--
                            ``(i) patient outcomes; and
                            ``(ii) best practices for expanding, using, 
                        or evaluating technology-enabled collaborative 
                        learning and capacity building models.
    ``(i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $6,000,000 for each of fiscal 
years 2022 through 2026.
    ``(j) Definitions.--In this section:
            ``(1) Eligible entity.--
                    ``(A) In general.--The term `eligible entity' means 
                an entity that provides, or supports the provision of, 
                maternal health care services or other evidence-based 
                services for pregnant and postpartum individuals--
                            ``(i) in health professional shortage 
                        areas;
                            ``(ii) in areas with high rates of adverse 
                        maternal health outcomes or significant racial 
                        and ethnic disparities in maternal health 
                        outcomes; or
                            ``(iii) who are--
                                    ``(I) members of medically 
                                underserved populations; or
                                    ``(II) American Indians and Alaska 
                                Natives, including Indian Tribes, 
                                Tribal organizations, and urban Indian 
                                organizations.
                    ``(B) Inclusions.--An eligible entity may include 
                entities that lead, or are capable of leading a 
                technology-enabled collaborative learning and capacity 
                building model.
            ``(2) Health professional shortage area.--The term `health 
        professional shortage area' means a health professional 
        shortage area designated under section 332.
            ``(3) Indian tribe.--The term `Indian Tribe' has the 
        meaning given such term in section 4 of the Indian Self-
        Determination and Education Assistance Act.
            ``(4) Maternal mortality.--The term `maternal mortality' 
        means a death occurring during or within 1-year period after 
        pregnancy caused by pregnancy-related or childbirth 
        complications, including a suicide, overdose, or other death 
        resulting from a mental health or substance use disorder 
        attributed to or aggravated by pregnancy or childbirth 
        complications.
            ``(5) Medically underserved population.--The term 
        `medically underserved population' has the meaning given such 
        term in section 330(b)(3).
            ``(6) Postpartum.--The term `postpartum' means the 1-year 
        period beginning on the last date of an individual's pregnancy.
            ``(7) Severe maternal morbidity.--The term `severe maternal 
        morbidity' means a health condition, including a mental health 
        or substance use disorder, attributed to or aggravated by 
        pregnancy or childbirth that results in significant short-term 
        or long-term consequences to the health of the individual who 
        was pregnant.
            ``(8) Technology-enabled collaborative learning and 
        capacity building model.--The term `technology-enabled 
        collaborative learning and capacity building model' means a 
        distance health education model that connects health care 
        professionals, and other specialists, through simultaneous 
        interactive videoconferencing for the purpose of facilitating 
        case-based learning, disseminating best practices, and 
        evaluating outcomes in the context of maternal health care.
            ``(9) Tribal organization.--The term `Tribal organization' 
        has the meaning given such term in section 4 of the Indian 
        Self-Determination and Education Assistance Act.
            ``(10) Urban indian organization.--The term `urban Indian 
        organization' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act.''.

SEC. 5. GRANTS TO PROMOTE EQUITY IN MATERNAL HEALTH OUTCOMES THROUGH 
              DIGITAL TOOLS.

    (a) In General.--Beginning not later than 1 year after the date of 
the enactment of this Act, the Secretary of Health and Human Services 
shall make grants to eligible entities to reduce racial and ethnic 
disparities in maternal health outcomes by increasing access to digital 
tools related to maternal health care.
    (b) Applications.--To be eligible to receive a grant under this 
section, an eligible entity shall submit to the Secretary an 
application at such time, in such manner, and containing such 
information as the Secretary may require.
    (c) Prioritization.--In awarding grants under this section, the 
Secretary shall prioritize an eligible entity--
            (1) in an area with high rates of adverse maternal health 
        outcomes or significant racial and ethnic disparities in 
        maternal health outcomes;
            (2) in a health professional shortage area designated under 
        section 332 of the Public Health Service Act (42 U.S.C. 254e); 
        and
            (3) that promotes technology that addresses racial and 
        ethnic disparities in maternal health outcomes.
    (d) Limitations.--
            (1) Number.--The Secretary may award not more than 1 grant 
        under this section to an eligible entity.
            (2) Duration.--A grant awarded under this section shall be 
        for a 5-year period.
    (e) Technical Assistance.--The Secretary shall provide technical 
assistance to an eligible entity on the development, use, evaluation, 
and post-grant sustainability of digital tools for purposes of 
promoting equity in maternal health outcomes.
    (f) Reporting.--
            (1) Eligible entities.--An eligible entity that receives a 
        grant under subsection (a) shall submit to the Secretary a 
        report, at such time, in such manner, and containing such 
        information as the Secretary may require.
            (2) Secretary.--Not later than 4 years after the date of 
        the enactment of this Act, the Secretary shall submit to 
        Congress a report that includes--
                    (A) an evaluation on the effectiveness of grants 
                awarded under this section to improve health outcomes 
                for pregnant and postpartum individuals from racial and 
                ethnic minority groups;
                    (B) recommendations on new grant programs that 
                promote the use of technology to improve such maternal 
                health outcomes; and
                    (C) recommendations with respect to--
                            (i) technology-based privacy and security 
                        safeguards in maternal health care;
                            (ii) reimbursement rates for maternal 
                        telehealth services;
                            (iii) the use of digital tools to analyze 
                        large data sets to identify potential 
                        pregnancy-related complications;
                            (iv) barriers that prevent maternity care 
                        providers from providing telehealth services 
                        across States;
                            (v) the use of consumer digital tools such 
                        as mobile phone applications, patient portals, 
                        and wearable technologies to improve maternal 
                        health outcomes;
                            (vi) barriers that prevent access to 
                        telehealth services, including a lack of access 
                        to reliable, high-speed internet or electronic 
                        devices;
                            (vii) barriers to data sharing between the 
                        Special Supplemental Nutrition Program for 
                        Women, Infants, and Children program and 
                        maternity care providers, and recommendations 
                        for addressing such barriers; and
                            (viii) lessons learned from expanded access 
                        to telehealth related to maternity care during 
                        the COVID-19 public health emergency.
    (g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $6,000,000 for each of fiscal 
years 2022 through 2026.

SEC. 6. REPORT ON THE USE OF TECHNOLOGY IN MATERNITY CARE.

    (a) In General.--Not later than 60 days after the date of enactment 
of this Act, the Secretary of Health and Human Services shall seek to 
enter an agreement with the National Academies of Sciences, 
Engineering, and Medicine (referred to in this Act as the ``National 
Academies'') under which the National Academies shall conduct a study 
on the use of technology and patient monitoring devices in maternity 
care.
    (b) Content.--The agreement entered into pursuant to subsection (a) 
shall provide for the study of the following:
            (1) The use of innovative technology (including artificial 
        intelligence) in maternal health care, including the extent to 
        which such technology has affected racial or ethnic biases in 
        maternal health care.
            (2) The use of patient monitoring devices (including pulse 
        oximeter devices) in maternal health care, including the extent 
        to which such devices have affected racial or ethnic biases in 
        maternal health care.
            (3) Best practices for reducing and preventing racial or 
        ethnic biases in the use of innovative technology and patient 
        monitoring devices in maternity care.
            (4) Best practices in the use of innovative technology and 
        patient monitoring devices for pregnant and postpartum 
        individuals from racial and ethnic minority groups.
            (5) Best practices with respect to privacy and security 
        safeguards in such use.
    (c) Report.--The agreement under subsection (a) shall direct the 
National Academies to complete the study under this section, and 
transmit to Congress a report on the results of the study, not later 
than 24 months after the date of enactment of this Act.
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