[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 1675 Introduced in Senate (IS)]

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117th CONGRESS
  1st Session
                                S. 1675

                      To improve maternal health.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 18, 2021

   Mr. Warnock (for himself, Mr. Rubio, Ms. Smith, Mr. Marshall, Ms. 
Hassan, and Mr. Cassidy) introduced the following bill; which was read 
 twice and referred to the Committee on Health, Education, Labor, and 
                                Pensions

_______________________________________________________________________

                                 A BILL


 
                      To improve maternal health.

    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 ``Maternal Health Quality Improvement 
Act''.

SEC. 2. INNOVATION FOR MATERNAL HEALTH.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by inserting after section 330N of such Act, the following:

``SEC. 330O. INNOVATION FOR MATERNAL HEALTH.

    ``(a) In General.--The Secretary, in consultation with experts 
representing a variety of clinical specialties, State, tribal, or local 
public health officials, researchers, epidemiologists, statisticians, 
and community organizations, shall establish or continue a program to 
award competitive grants to eligible entities for the purpose of--
            ``(1) identifying, developing, or disseminating best 
        practices to improve maternal health care quality, improve 
        maternal and infant health outcomes, eliminate preventable 
        maternal mortality and severe maternal morbidity, and improve 
        infant health outcomes, which may include--
                    ``(A) information on evidence-based practices to 
                improve the quality and safety of maternal health care 
                in hospitals and other health care settings of a State 
                or health care system by addressing topics commonly 
                associated with health complications or risks related 
                to prenatal care, labor care, birthing, and postpartum 
                care;
                    ``(B) best practices for improving maternal health 
                care based on data findings and reviews conducted by a 
                State maternal mortality review committee that address 
                topics of relevance to common complications or health 
                risks related to prenatal care, labor care, birthing, 
                and postpartum care; and
                    ``(C) information on addressing determinants of 
                health that impact maternal health outcomes for women 
                before, during, and after pregnancy;
            ``(2) collaborating with State maternal mortality review 
        committees to identify issues for the development and 
        implementation of evidence-based practices to improve maternal 
        health outcomes and reduce preventable maternal mortality and 
        severe maternal morbidity, consistent with section 317K;
            ``(3) providing technical assistance and supporting the 
        implementation of best practices identified in paragraph (1) to 
        entities providing health care services to pregnant and 
        postpartum women; and
            ``(4) identifying, developing, and evaluating new models of 
        care that improve maternal and infant health outcomes, which 
        may include the integration of community-based services and 
        clinical care.
    ``(b) Eligible Entities.--To be eligible for a grant under 
subsection (a), an entity shall--
            ``(1) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require; and
            ``(2) demonstrate in such application that the entity is 
        capable of carrying out data-driven maternal safety and quality 
        improvement initiatives in the areas of obstetrics and 
        gynecology or maternal health.
    ``(c) Report.--Not later than September 30, 2024, and every 2 years 
thereafter, the Secretary shall submit a report to Congress on the 
practices described in paragraphs (1) and (2) of subsection (a). Such 
report shall include a description of the extent to which such 
practices reduced preventable maternal mortality and severe maternal 
morbidity, and whether such practices improved maternal and infant 
health. The Secretary shall disseminate information on such practices, 
as appropriate.
    ``(d) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $9,000,000 for each of fiscal 
years 2022 through 2026.''.

SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS.

    Title VII of the Public Health Service Act is amended by striking 
section 763 (42 U.S.C. 294p) and inserting the following:

``SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS.

    ``(a) Grant Program.--The Secretary shall establish a program to 
award grants to accredited schools of allopathic medicine, osteopathic 
medicine, and nursing, and other health professional training programs 
for the training of health care professionals to improve the provision 
of prenatal care, labor care, birthing, and postpartum care for racial 
and ethnic minority populations, including with respect to perceptions 
and biases that may affect the approach to, and provision of, care.
    ``(b) Eligibility.--To be eligible for a grant under subsection 
(a), an entity described in such subsection shall submit to the 
Secretary an application at such time, in such manner, and containing 
such information as the Secretary may require.
    ``(c) Reporting Requirements.--
            ``(1) Periodic grantee reports.--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, including a description of the impact of such 
        training on patient outcomes, as applicable.
            ``(2) Report to congress.--Not later than September 30, 
        2024, the Secretary shall submit a report to Congress on the 
        activities conducted using grants under subsection (a) and any 
        best practices identified and disseminated under subsection 
        (d).
    ``(d) Best Practices.--The Secretary may identify and disseminate 
best practices for the training described in subsection (a).
    ``(e) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $5,000,000 for each of fiscal 
years 2022 through 2026.''.

SEC. 4. STUDY ON IMPROVING TRAINING FOR HEALTH CARE PROVIDERS.

    Not later than 2 years after date of enactment of this Act, the 
Secretary of Health and Human Services shall, through a contract with 
an independent research organization, conduct a study and make 
recommendations for accredited schools of allopathic medicine, 
osteopathic medicine, and nursing, and other health professional 
training programs on best practices related to training to improve the 
provision of prenatal care, labor care, birthing, and postpartum care 
for racial and ethnic minority populations, including with respect to 
perceptions and biases that may affect the approach to, and provision 
of, care.

SEC. 5. PERINATAL QUALITY COLLABORATIVES.

    (a) In General.--Section 317K(a)(2) of the Public Health Service 
Act (42 U.S.C. 247b-12(a)(2)) is amended by adding at the end the 
following:
            ``(E)(i) The Secretary, acting through the Director of the 
        Centers for Disease Control and Prevention and in coordination 
        with other offices and agencies, as appropriate, shall 
        establish or continue a competitive grant program for the 
        establishment or support of perinatal quality collaboratives to 
        improve perinatal care and perinatal health outcomes for 
        pregnant and postpartum women and their infants. A State, 
        Indian Tribe, or Tribal organization may use funds received 
        through such grant to--
                    ``(I) support the use of evidence-based or 
                evidence-informed practices to improve outcomes for 
                maternal and infant health;
                    ``(II) work with clinical teams; experts; State, 
                local, and, as appropriate, tribal public health 
                officials; and stakeholders, including patients and 
                families, to identify, develop, or disseminate best 
                practices to improve perinatal care and outcomes; and
                    ``(III) employ strategies that provide 
                opportunities for health care professionals and 
                clinical teams to collaborate across health care 
                settings and disciplines, including primary care and 
                mental health, as appropriate, to improve maternal and 
                infant health outcomes, which may include the use of 
                data to provide timely feedback across hospital and 
                clinical teams to inform responses, and to provide 
                support and training to hospital and clinical teams for 
                quality improvement, as appropriate.
            ``(ii) To be eligible for a grant under clause (i), an 
        entity shall submit to the Secretary an application in such 
        form and manner and containing such information as the 
        Secretary may require.''.
    (b) Report to Congress.--Not later than September 30, 2025, the 
Secretary of Health and Human Services shall submit to Congress a 
report regarding the activities conducted by recipients of grants under 
subsection (a)(2)(E) of section 317K of the Public Health Service Act 
(42 U.S.C. 247b-12).

SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM WOMEN.

    (a) Grants.--Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended by inserting after section 330O of such Act, as 
added by section 2, the following:

``SEC. 330P. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM WOMEN.

    ``(a) In General.--The Secretary may award grants for the purpose 
of establishing or operating evidence-based or innovative, evidence-
informed programs to deliver integrated health care services to 
pregnant and postpartum women to optimize the health of women and their 
infants, including to reduce adverse maternal health outcomes, 
pregnancy-related deaths, and related health disparities (including 
such disparities associated with racial and ethnic minority 
populations), and, as appropriate, by addressing issues researched 
under subsection (b)(2) of section 317K.
    ``(b) Integrated Services for Pregnant and Postpartum Women.--
            ``(1) Eligibility.--To be eligible to receive a grant under 
        subsection (a), a State, Indian Tribe, or Tribal organization 
        (as such terms are defined in section 4 of the Indian Self-
        Determination and Education Assistance Act) shall work with 
        relevant stakeholders that coordinate care to develop and carry 
        out the program, including--
                    ``(A) State, Tribal, and local agencies responsible 
                for Medicaid, public health, social services, mental 
                health, and substance use disorder treatment and 
                services;
                    ``(B) health care providers who serve pregnant and 
                postpartum women; and
                    ``(C) community-based health organizations and 
                health workers, including providers of home visiting 
                services and individuals representing communities with 
                disproportionately high rates of maternal mortality and 
                severe maternal morbidity, and including those 
                representing racial and ethnic minority populations.
            ``(2) Terms.--
                    ``(A) Period.--A grant awarded under subsection (a) 
                shall be made for a period of 5 years. Any supplemental 
                award made to a grantee under subsection (a) may be 
                made for a period of less than 5 years.
                    ``(B) Preference.--In awarding grants under 
                subsection (a), the Secretary shall--
                            ``(i) give preference to States, Indian 
                        Tribes, and Tribal organizations that have the 
                        highest rates of maternal mortality and severe 
                        maternal morbidity relative to other such 
                        States, Indian Tribes, or Tribal organizations, 
                        respectively; and
                            ``(ii) shall consider health disparities 
                        related to maternal mortality and severe 
                        maternal morbidity, including such disparities 
                        associated with racial and ethnic minority 
                        populations.
                    ``(C) Evaluation.--The Secretary shall require 
                grantees to evaluate the outcomes of the programs 
                supported under the grant.
    ``(c) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2022 through 2026.''.
    (b) Report on Grant Outcomes and Dissemination of Best Practices.--
            (1) Report.--Not later than February 1, 2026, the Secretary 
        of Health and Human Services shall submit to the Committee on 
        Health, Education, Labor, and Pensions of the Senate and the 
        Committee on Energy and Commerce of the House of 
        Representatives a report that describes--
                    (A) the outcomes of the activities supported by the 
                grants awarded under the amendments made by this 
                section on maternal and child health;
                    (B) best practices and models of care used by 
                recipients of grants under such amendments; and
                    (C) obstacles identified by recipients of grants 
                under such amendments, and strategies used by such 
                recipients to deliver care, improve maternal and child 
                health, and reduce health disparities.
            (2) Dissemination of best practices.--Not later than August 
        1, 2026, the Secretary of Health and Human Services shall 
        disseminate information on best practices and models of care 
        used by recipients of grants under the amendments made by this 
        section (including best practices and models of care relating 
        to the reduction of health disparities, including such 
        disparities associated with racial and ethnic minority 
        populations, in rates of maternal mortality and severe maternal 
        morbidity) to relevant stakeholders, which may include health 
        providers, medical schools, nursing schools, relevant State, 
        tribal, and local agencies, and the general public.
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