117 S346 IS: Black Maternal Health Momnibus Act of 2021
U.S. Senate
2021-02-22
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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 2021
.2.The table of contents for this Act is as follows:Sec. 1. Short title.Sec. 2. Table of contents.Sec. 3. Definitions.Sec. 4. Sense of Congress.TITLE I—Social determinants for momsSec. 101. Task force to develop a strategy to address social determinants of maternal health.Sec. 102. Housing for Moms grant program.Sec. 103. Department of Transportation.Sec. 104. Department of Agriculture.Sec. 105. Environmental study through National Academies.Sec. 106. Child care access.Sec. 107. Grants to local entities addressing social determinants of maternal health.TITLE II—Honoring Kira JohnsonSec. 201. Investments in community-based organizations to improve Black maternal health outcomes.Sec. 202. Investments in community-based organizations to improve maternal health outcomes in underserved communities.Sec. 203. Respectful maternity care training for all employees in maternity care settings.Sec. 204. Study on reducing and preventing bias, racism, and discrimination in maternity care settings.Sec. 205. Respectful maternity care compliance program.Sec. 206. GAO report.TITLE III—Protecting moms who servedSec. 301. Codification of maternity coordination program of Department of Veterans Affairs.Sec. 302. Report on maternal mortality and severe maternal morbidity among pregnant and postpartum veterans.TITLE IV—Perinatal workforceSec. 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.TITLE V—Data to save momsSec. 501. Funding for maternal mortality review committees to promote representative community engagement.Sec. 502. Data collection and review.Sec. 503. Review of maternal health data collection processes and quality measures.Sec. 504. Indian Health Service study and report on maternal mortality and severe maternal morbidity.Sec. 505. Grants to minority-serving institutions to study maternal mortality, severe maternal morbidity, and other adverse maternal health outcomes.TITLE VI—Moms matterSec. 601. Maternal mental health equity grant program.Sec. 602. Grants to grow and diversify the maternal mental and behavioral health care workforce.TITLE VII—Justice for incarcerated momsSec. 701. Ending the shackling of pregnant individuals.Sec. 702. Creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods.Sec. 703. Grant program to improve maternal health outcomes for individuals in State and local prisons and jails.Sec. 704. GAO report.Sec. 705. MACPAC report.TITLE VIII—Tech to save momsSec. 801. Integrated telehealth models in maternity care services.Sec. 802. Grants to expand the use of technology-enabled collaborative learning and capacity models for pregnant and postpartum individuals.Sec. 803. Grants to promote equity in maternal health outcomes through digital tools.Sec. 804. Report on the use of technology in maternity care.TITLE IX—Impact to save momsSec. 901. Perinatal Care Alternative Payment Model Demonstration Project.Sec. 902. MACPAC report.TITLE X—Maternal health pandemic responseSec. 1001. Definitions.Sec. 1002. Funding for data collection, surveillance, and research on maternal health outcomes during the COVID–19 public health emergency.Sec. 1003. COVID–19 maternal health data collection and disclosure.Sec. 1004. Inclusion of pregnant individuals and lactating individuals in vaccine and therapeutic development for COVID–19.Sec. 1005. Public health communication regarding maternal care during COVID–19.Sec. 1006. Task force on birthing experience and safe maternity care during a public health emergency.Sec. 1007. GAO report on maternal health and public health emergency preparedness.TITLE XI—Protecting moms and babies against climate changeSec. 1101. Definitions.Sec. 1102. Grant program to protect vulnerable mothers and babies from climate change risks.Sec. 1103. Grant program for education and training at health profession schools.Sec. 1104. NIH Consortium on Birth and Climate Change Research.Sec. 1105. Strategy for identifying climate change risk zones for vulnerable mothers and babies.TITLE XII—Maternal vaccinationsSec. 1201. Maternal vaccination awareness and equity campaign.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, language, and practices of the health care consumer and other stakeholders.(2)The term maternity care provider means a health care provider who—(A)is a physician, physician assistant, 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; and(B)has a focus on maternal or perinatal health.(3)The term maternal mortality means a death occurring during or within a one-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-related or childbirth complications.(4)The term perinatal health worker means a doula, community health worker, peer supporter, breastfeeding and lactation educator or counselor, nutritionist or dietitian, childbirth educator, social worker, home visitor, language interpreter, or navigator.(5)Postpartum and postpartum periodThe terms postpartum and postpartum period refer to the 1-year period beginning on the last day of the pregnancy of an individual.(6)Pregnancy-associated deathThe term pregnancy-associated death means a death of a pregnant or postpartum individual, by any cause, that occurs during, or within 1 year following, the individual’s pregnancy, regardless of the outcome, duration, or site of the pregnancy.(7)The term pregnancy-related death means a death of a pregnant or postpartum individual that occurs during, or within 1 year following, the individual’s pregnancy, from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.(8)Racial and ethnic minority groupThe 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)).(9)Severe maternal morbidityThe 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.(10)Social determinants of maternal healthThe 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.4.It is the sense of Congress that—(1)the respect and proper care that birthing people deserve is inclusive; and(2)regardless of race, ethnicity, gender identity, sexual orientation, religion, marital status, familial status, socioeconomic status, immigration status, incarceration status, or disability, all deserve dignity.<enum>I</enum><header>Social determinants for moms</header><section id="H0A104218951145EA9343FE91CCAC4491"><enum>101.</enum><header>Task force to develop a strategy to address social determinants of maternal health</header><subsection id="H2E8A57EBDDE34742B35DACD7E0046120"><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 a strategy to coordinate efforts between Federal agencies to address social determinants of maternal health with respect to pregnant and postpartum individuals.</text></subsection><subsection id="H7F9612981301411E86286333A0662EE2"><enum>(b)</enum><header>Ex officio members</header><text display-inline="yes-display-inline">The ex officio members of the Task Force shall consist of the following:</text><paragraph id="HFC613159B03B428CA0D9A9F70FE2A793"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary of Health and Human Services (or a designee thereof).</text></paragraph><paragraph id="H9B3EE8385B8E4DFC8ACB8AB5B494496E"><enum>(2)</enum><text display-inline="yes-display-inline">The Secretary of Housing and Urban Development (or a designee thereof).</text></paragraph><paragraph id="H9034016CCF6D4D99BB6B149D7E14C7FA"><enum>(3)</enum><text display-inline="yes-display-inline">The Secretary of Transportation (or a designee thereof).</text></paragraph><paragraph id="HC242EE7A10C744E48DAC29030870A933"><enum>(4)</enum><text display-inline="yes-display-inline">The Secretary of Agriculture (or a designee thereof).</text></paragraph><paragraph id="H39AEDB70D6E043B68550A27C3C79D612"><enum>(5)</enum><text display-inline="yes-display-inline">The Secretary of Labor (or a designee thereof).</text></paragraph><paragraph id="id8F813528318F4727A154A0DE48DAE3EF"><enum>(6)</enum><text>The Secretary of Defense (or a designee thereof).</text></paragraph><paragraph id="id366DDF365F3C4CA7A476320810C12142"><enum>(7)</enum><text>The Secretary of Veterans Affairs (or a designee thereof).</text></paragraph><paragraph id="H9BBE106E77A047B68EE785A5FECCC836"><enum>(8)</enum><text display-inline="yes-display-inline">The Administrator of the Environmental Protection Agency (or a designee thereof).</text></paragraph><paragraph id="H9ECF989420AF4E84AB01F43F52C4D9C0"><enum>(9)</enum><text display-inline="yes-display-inline">The Assistant Secretary for the Administration for Children and Families (or a designee thereof).</text></paragraph><paragraph id="H8D63F83227774481B72B1CA3A35E9D2E"><enum>(10)</enum><text display-inline="yes-display-inline">The Administrator of the Centers for Medicare & Medicaid Services (or a designee thereof).</text></paragraph><paragraph id="HDFD9D270926E4D2E98F4E11FD5926EA7"><enum>(11)</enum><text display-inline="yes-display-inline">The Director of the Indian Health Service (or a designee thereof).</text></paragraph><paragraph id="H40EFC8518B3F47C9B3E8D82F35314781"><enum>(12)</enum><text display-inline="yes-display-inline">The Director of the National Institutes of Health (or a designee thereof).</text></paragraph><paragraph id="H483F278DDCEF47A3A1B2E1D53D28570F"><enum>(13)</enum><text display-inline="yes-display-inline">The Administrator of the Health Resources and Services Administration (or a designee thereof).</text></paragraph><paragraph id="H88439BA4196F40DCBC0C052E1634C3EF"><enum>(14)</enum><text display-inline="yes-display-inline">The Deputy Assistant Secretary for Minority Health of the Department of Health and Human Services (or a designee thereof).</text></paragraph><paragraph id="H9D899E1FB0CF4788B3A6D512627BAB2F"><enum>(15)</enum><text display-inline="yes-display-inline">The Deputy Assistant Secretary for Women’s Health of the Department of Health and Human Services (or a designee thereof).</text></paragraph><paragraph id="H997405F413D64CA490C84203426B4CA5"><enum>(16)</enum><text display-inline="yes-display-inline">The Director of the Centers for Disease Control and Prevention (or a designee thereof).</text></paragraph><paragraph id="HCBC2BF3A1AE04BDC918D0849BCA20D90"><enum>(17)</enum><text display-inline="yes-display-inline">The Director of the Office on Violence Against Women at the Department of Justice (or a designee thereof).</text></paragraph></subsection><subsection id="HF20C855F61D849428E3D427777854C01"><enum>(c)</enum><header>Appointed members</header><text>In addition to the ex officio members of the Task Force, the Secretary of Health and Human Services shall appoint the following members of the Task Force:</text><paragraph id="HA4FD8F2515024B52B718C51A3A840DB2"><enum>(1)</enum><text>At least 2 representatives of patients, to include—</text><subparagraph id="HF9EB21C8D16C45C696A9679006C28E4C"><enum>(A)</enum><text>a representative of patients who have suffered from severe maternal morbidity; or</text></subparagraph><subparagraph id="HA1D2000D01F14BC0A4D5138E86FA8BAA"><enum>(B)</enum><text>a representative of patients who is a family member of an individual who suffered a pregnancy-related death.</text></subparagraph></paragraph><paragraph id="H39271756CDE346F780F1CF8D11684884"><enum>(2)</enum><text>At least 2 leaders of community-based organizations that address maternal mortality and severe maternal morbidity with a specific focus on racial and ethnic disparities. In appointing such leaders under this paragraph, the Secretary of Health and Human Services shall give priority to individuals who are leaders of organizations led by individuals from racial and ethnic minority groups.</text></paragraph><paragraph id="H7B620A41693B494F8072DC39C5D52369"><enum>(3)</enum><text>At least 2 perinatal health workers.</text></paragraph><paragraph id="H479D8C8C7A3C43D3A9DA9D58B8110C79"><enum>(4)</enum><text>A professionally diverse panel of maternity care providers.</text></paragraph></subsection><subsection id="HDDC054E001214632944202137BADB84A"><enum>(d)</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="HA946AB4018754B98B878AEF0729395E1"><enum>(e)</enum><header>Report</header><text>Not later than 2 years after the date of enactment of this Act, the Task Force shall submit to Congress a report on—</text><paragraph id="H32CC4F559AE04CADAB243EF3B97816F6"><enum>(1)</enum><text>the strategy developed under subsection (a); </text></paragraph><paragraph id="HE983FA0CF04E412F804B595D604E16F2"><enum>(2)</enum><text>recommendations on funding amounts with respect to implementing such strategy;</text></paragraph><paragraph id="H42456B4F4C7B4DD4BDB73C1E4CACC808"><enum>(3)</enum><text display-inline="yes-display-inline">recommendations for how to expand coverage of social services to address social determinants of maternal health under Medicaid managed care organizations and State Medicaid programs.</text></paragraph></subsection><subsection id="HD1CD50303D004FED98DFF1C8CAE2CB87"><enum>(f)</enum><header>Termination</header><text display-inline="yes-display-inline">Section 14 of the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Task Force with respect to termination.</text></subsection></section><section id="H71E92E6607184F0E97B0332F5E3079B2"><enum>102.</enum><header>Housing for Moms grant program</header><subsection id="H40B7BF1D9D364EBE81A7FF1149696519"><enum>(a)</enum><header>In general</header><text>The Secretary of Housing and Urban Development shall establish a Housing for Moms grant program under this section to make grants to eligible entities to increase access to safe, stable, affordable, and adequate housing for pregnant and postpartum individuals and their families.</text></subsection><subsection id="HA8578C48BC8D42B090846EB7FC4033AD"><enum>(b)</enum><header>Application</header><text>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 provide.</text></subsection><subsection id="HAF8E89DDAE034C39B2591C3681866C07"><enum>(c)</enum><header>Priority</header><text>In awarding grants under this section, the Secretary shall give priority to an eligible entity that—</text><paragraph id="HC178B426E3F54F3584B337432BE5C219"><enum>(1)</enum><text>is a community-based organization or will partner with a community-based organization to implement initiatives to increase access to safe, stable, affordable, and adequate housing for pregnant and postpartum individuals and their families;</text></paragraph><paragraph id="H32F6C052A3124603836E0436D6FF7CA0"><enum>(2)</enum><text>is operating in an area with high rates of adverse maternal health outcomes or significant racial or ethnic disparities in maternal health outcomes, to the extent such data are available; and</text></paragraph><paragraph id="H4B5405B230DB44D481F86CA13FDEEE4F"><enum>(3)</enum><text>is operating in an area with a high poverty rate or significant number of individuals who lack consistent access to safe, stable, affordable, and adequate housing.</text></paragraph></subsection><subsection id="H19359900D1B5483690EAE54B0D82AE04"><enum>(d)</enum><header>Use of funds</header><text>An eligible entity that receives a grant under this section shall use funds under the grant for the purposes of—</text><paragraph id="HAF9BAB3315D242B79D34EEEEDB459E14"><enum>(1)</enum><text>identifying and conducting outreach to pregnant and postpartum individuals who are low-income and lack consistent access to safe, stable, affordable, and adequate housing;</text></paragraph><paragraph id="H366C7D9A27614684A3DD5ACFDD40D5ED"><enum>(2)</enum><text>providing safe, stable, affordable, and adequate housing options to such individuals;</text></paragraph><paragraph id="H01874F617DB44050B737A9B6F1B276E9"><enum>(3)</enum><text>connecting such individuals with local organizations offering safe, stable, affordable, and adequate housing options;</text></paragraph><paragraph id="HA75ED557EB69448999D80C3EE7431F61"><enum>(4)</enum><text>providing application assistance to such individuals seeking to enroll in programs offering safe, stable, affordable, and adequate housing options;</text></paragraph><paragraph id="HA4AE73C5E4C14D38836C3BAEBC34D7C5"><enum>(5)</enum><text>providing direct financial assistance to such individuals for the purposes of maintaining safe, stable, and adequate housing for the duration of the individual’s pregnancy and postpartum periods; and</text></paragraph><paragraph id="HCE819653ED9F4E2FB8CFE495E33EF672"><enum>(6)</enum><text display-inline="yes-display-inline">working with relevant stakeholders to ensure that local housing and homeless shelter infrastructure is supportive to pregnant and postpartum individuals, including through—</text><subparagraph id="HA79F1E76124640E6BFB6B0E00FDA5582"><enum>(A)</enum><text>health-promoting housing codes;</text></subparagraph><subparagraph id="H742F11A576BB4421910C5F607578280C"><enum>(B)</enum><text>enforcement of housing codes;</text></subparagraph><subparagraph id="H7AE9743637E5409DA8C32A36B49B86C7"><enum>(C)</enum><text>proactive rental inspection programs;</text></subparagraph><subparagraph id="HECECA8B6847A489EA7D7093C1928E646"><enum>(D)</enum><text>code enforcement officer training; and</text></subparagraph><subparagraph id="H241E67C8A99F42A6B5BD7D9BC260FBAD"><enum>(E)</enum><text>partnerships between regional offices of the Department of Housing and Urban Development and community-based organizations to ensure housing laws are understood and violations are discovered.</text></subparagraph></paragraph></subsection><subsection id="H0185795261DF45FEA22BB52EB9A29CA4"><enum>(e)</enum><header>Reporting</header><paragraph id="HB63671EBB10D465BA6299141C75D3F85"><enum>(1)</enum><header>Eligible entities</header><text>The Secretary shall require each eligible entity receiving a grant under this section to annually submit to the Secretary and make publicly available a report on the status of activities conducted using the grant.</text></paragraph><paragraph id="HDF7BF4A306674140914EABA07FB2BB30"><enum>(2)</enum><header>Secretary</header><text>Not later than the end of each fiscal year in which grants are made under this section, the Secretary shall submit to Congress and make publicly available a report that—</text><subparagraph id="H039757E9F95748C2B53AA52521D03E8E"><enum>(A)</enum><text>summarizes the reports received under paragraph (1);</text></subparagraph><subparagraph id="H24064FEA1CD7495186173ABCCF05206B"><enum>(B)</enum><text>evaluates the effectiveness of grants awarded under this section in increasing access to safe, stable, affordable, and adequate housing for pregnant and postpartum individuals and their families; and</text></subparagraph><subparagraph id="HA57B8FCB167847DA9F04976825B0713A"><enum>(C)</enum><text>makes recommendations with respect to ensuring activities described subsection (d) continue after grant amounts made available under this section are expended.</text></subparagraph></paragraph></subsection><subsection id="H72675B2E869D40BAB1517AC15DA98909"><enum>(f)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H477C2153847046AF85DBAC6A782E3D3E"><enum>(1)</enum><header>Eligible entity</header><text>The term <term>eligible entity</term> means—</text><subparagraph id="H219A1DB0ADC340FFA1B04D60FF5070B6"><enum>(A)</enum><text>a community-based organization;</text></subparagraph><subparagraph id="H1A6F29C9D6E948BF9C8F1A7B39E899D7"><enum>(B)</enum><text>a State or local governmental entity, including a State or local public health department;</text></subparagraph><subparagraph id="HCD1330B3AC514F9CAF3B1DBF55C52C8A"><enum>(C)</enum><text>an Indian tribe or tribal organization (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>)); or</text></subparagraph><subparagraph id="HAFF8969805C94D38B6DF4463950DB8AA"><enum>(D)</enum><text>an 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></subparagraph></paragraph><paragraph id="H409337C86CB84D35A89002F48DD8D60E"><enum>(2)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Housing and Urban Development.</text></paragraph></subsection><subsection id="H86128B7AE6144B5CBABE65DB84BDA448"><enum>(g)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $10,000,000 for fiscal year 2022, which shall remain available until expended.</text></subsection></section><section id="id0B19AE8D0EEC4E2483A362A4656F2D49"><enum>103.</enum><header>Department of Transportation</header><subsection id="idDA1DD866ACC444F996AB1F3AAAFAF7B4"><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 and make publicly available a report that contains—</text><paragraph id="id6237F2D8BB1646D09ABAF4909DCA4A6E"><enum>(1)</enum><text>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 maternal health;</text></paragraph><paragraph id="idB4EEE8D47EAA4528AE6DF10E0F00C6C3"><enum>(2)</enum><text>recommendations on how to overcome the barriers described in paragraph (1); </text></paragraph><paragraph id="id4CE608C3AD7941B3A8A870E8360FD968"><enum>(3)</enum><text>an assessment of transportation safety risks for pregnant individuals and recommendations on how to mitigate those risks; and</text></paragraph><paragraph id="id4632B85BDD0C49A09DB30FADC505A575"><enum>(4)</enum><text>an assessment of the impact of disabilities, including service-related disabilities, on pregnant and postpartum women’s mobility and access to appropriate care.</text></paragraph></subsection><subsection id="idD53C133C2CD844C4BA07FCAFB66D0FB0"><enum>(b)</enum><header>Considerations</header><text>In carrying out subsection (a), the Secretary of Transportation shall give special consideration to solutions for—</text><paragraph id="idD997E1A383BC43C4A618B2CFBD53E607"><enum>(1)</enum><text>pregnant and postpartum individuals 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>); </text></paragraph><paragraph id="id0F05E7EEBE9546ACA0941C6AE7A64648"><enum>(2)</enum><text>pregnant and postpartum individuals living in areas with high maternal mortality or severe morbidity rates or significant racial or ethnic disparities in maternal health outcomes; and</text></paragraph><paragraph id="idF3C0377C2F2F4661B2E47AC31A2D8AE2"><enum>(3)</enum><text>pregnant and postpartum individuals with a disability that impacts mobility. </text></paragraph></subsection></section><section id="H78A9FC8AC57A46ADAEE9353B19BE17FE" section-type="subsequent-section"><enum>104.</enum><header>Department of Agriculture</header><subsection id="H4CEF70708C494D33B205083434C610ED"><enum>(a)</enum><header>Special supplemental nutrition program for women, infants, and children</header><paragraph id="H139FCD49198D43D8A18BB5DD60E15E7B"><enum>(1)</enum><header>Breastfeeding women</header><subparagraph id="id4D65E5701A2F4671A6B840479943D538" commented="no"><enum>(A)</enum><header>Definition of breastfeeding woman</header><text>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>) is amended by striking paragraph (1) and inserting the following: </text><quoted-block style="OLC" display-inline="no-display-inline" id="iddbdb10d6eafa43f38fb02e3f341ed4bc"><paragraph id="id9b37da6470a343a29f4bd241ee293f1c"><enum>(1)</enum><header>Breastfeeding woman</header><text>The term <term>breastfeeding woman</term> means—</text><subparagraph id="id314b5689655a45a0b9dd1acdf8a454ac"><enum>(A)</enum><text>a woman who is not more than 1 year postpartum and is breastfeeding the infant of the woman; and</text></subparagraph><subparagraph id="idf628343fe51a4149a76c38731f9d3181"><enum>(B)</enum><text>for purposes of subsection (d), a woman who is not more than 2 years postpartum and is breastfeeding the infant of the woman.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph><subparagraph id="HF4B4672B89BE486893C0E5C6DBDC3012"><enum>(B)</enum><header>Extension of breastfeeding period</header><text display-inline="yes-display-inline">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>2 years</quote>.</text></subparagraph></paragraph><paragraph commented="no" id="id417EADF498D04F8985CA8D7F3306686F"><enum>(2)</enum><header>Postpartum women</header><subparagraph id="id04BB3CDB3D9742CE89BE6C3A9F2D3846"><enum>(A)</enum><header>Definition of postpartum women</header><text display-inline="yes-display-inline">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>2 years</quote>.</text></subparagraph><subparagraph id="id6b9cd0372db24bcba91ff6a1debd45a6"><enum>(B)</enum><header>Certification</header><text>Section 17(d)(3)(A) 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)</external-xref>) is amended by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idc9f6d2d8cb6f49e2b1f4772c33cc4815"><clause id="idd27794a303ca418ca4e58384b6e12265"><enum>(iv)</enum><header>Postpartum women</header><text>A State may elect to certify a postpartum woman for a period of up to 2 years after the termination of pregnancy of the postpartum woman.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="H63AB9E56228D41CC81BF92FAB71A8A53"><enum>(3)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of enactment of this section, the Secretary of Agriculture 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 id="H1EA572314D0D4D849ECC760BF8AF91AF"><enum>(A)</enum><text display-inline="yes-display-inline">maternal and infant health outcomes, including racial and ethnic disparities with respect to those outcomes;</text></subparagraph><subparagraph id="H949C1832035549DEBF046D2A637D8CE9"><enum>(B)</enum><text display-inline="yes-display-inline">breastfeeding rates among postpartum individuals;</text></subparagraph><subparagraph id="H374F2FFA38574E8DA0294C5D2D36CA05"><enum>(C)</enum><text display-inline="yes-display-inline">qualitative evaluations of family experiences under the special supplemental nutrition program for women, infants, and children established 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 id="HC47F111EC8F64532A72C27F847407E68"><enum>(D)</enum><text display-inline="yes-display-inline">other relevant information as determined by the Secretary of Agriculture.</text></subparagraph></paragraph></subsection><subsection id="H7F564935C18E47F681BE1760BCAED757"><enum>(b)</enum><header>Grant program for healthy food and clean water for pregnant and postpartum individuals</header><paragraph id="H66AB7AC4A1A44B518F915338DCF29FED"><enum>(1)</enum><header>Definitions</header><text>In this subsection:</text><subparagraph id="id9F3D6881405B41A481DBC4277B2C7E3D"><enum>(A)</enum><header>Eligible entity</header><text>The term <term>eligible entity</term> means—</text><clause id="H919F51EBC4AB41F4B40AF181E58C6D74"><enum>(i)</enum><text display-inline="yes-display-inline">a community-based organization;</text></clause><clause id="H04A9FFC1AF3B4215974BE50529B78D2A"><enum>(ii)</enum><text display-inline="yes-display-inline">a State or local governmental entity, including a State or local public health department;</text></clause><clause id="H5B37E5A470C640329CFBA2989E4B0178"><enum>(iii)</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></clause><clause id="H53240D9ED87B48449BB9EAD4F69B75AC"><enum>(iv)</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></clause></subparagraph><subparagraph id="H9FA4C29F3A8549EABCE9D9B2A19790BE"><enum>(B)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Agriculture. </text></subparagraph></paragraph><paragraph id="HD65F85BCD05247BB83C91F90AE10A9C2"><enum>(2)</enum><header>Establishment</header><text display-inline="yes-display-inline">The Secretary shall establish a program to award grants, on a competitive basis, to eligible entities to carry out the activities described in paragraph (5).</text></paragraph><paragraph id="HE7A1B43419524235B4915C1B0F68D219"><enum>(3)</enum><header>Application</header><text display-inline="yes-display-inline">To be eligible for 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 determines appropriate.</text></paragraph><paragraph id="H8FA4021DA2214583837D640022DF6129"><enum>(4)</enum><header>Priority</header><text display-inline="yes-display-inline">In awarding grants under this subsection, the Secretary shall give priority to an eligible entity that—</text><subparagraph id="HC68F058D1F5B44779CC5688A6B836993"><enum>(A)</enum><text display-inline="yes-display-inline"> is, or will partner with, a community-based organization; and</text></subparagraph><subparagraph id="H266A100B33ED46549FF854E3EC0F7DD6"><enum>(B)</enum><text display-inline="yes-display-inline">is operating in an area with high rates of—</text><clause id="H705E305369F9458BB343655E6A2765AA"><enum>(i)</enum><text>adverse maternal health outcomes; or</text></clause><clause id="HAE0821AD3D984B3DBFE15CFCD532CA1A"><enum>(ii)</enum><text>significant racial or ethnic disparities in maternal health outcomes.</text></clause></subparagraph></paragraph><paragraph id="HFBD3BFE06F9D4231AEB2158CAC6B50C1"><enum>(5)</enum><header>Use of funds</header><text display-inline="yes-display-inline">An eligible entity shall use grant funds awarded under this subsection to deliver healthy food, infant formula, clean water, or diapers to pregnant women (as 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>)) and postpartum individuals 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 id="H90A574ADD6854828A11D62FEDF842DE2"><enum>(6)</enum><header>Reports</header><subparagraph id="H9F587A61FA2F410FB36B0B716058E428"><enum>(A)</enum><header>Eligible entity</header><text display-inline="yes-display-inline">Each eligible entity that receives a grant under this subsection shall, not later than 1 year after receiving the grant, and annually thereafter, submit to the Secretary a report on the status of activities conducted using the grant, which shall contain such information as the Secretary may require.</text></subparagraph><subparagraph id="HAACD199A9A3C4A2DAB8173591DE35754"><enum>(B)</enum><header>Secretary</header><clause id="H3F25B6D58CEB474299020E7FD6F66FA8"><enum>(i)</enum><header>In general</header><text>Not later than 2 years after the date on which the first grant is awarded under this subsection, the Secretary shall submit to Congress a report that includes—</text><subclause id="H132FEBB5782D4C6E9C3CBDA1F54CCEC9"><enum>(I)</enum><text display-inline="yes-display-inline">a summary of the reports submitted by eligible entities under subparagraph (A);</text></subclause><subclause id="H58CCFBAEDA574115A2DB51F3E1E3488B"><enum>(II)</enum><text display-inline="yes-display-inline">an assessment of the extent to which food distributed through the grant program under this subsection was purchased from local and regional food systems;</text></subclause><subclause id="H771AD1CC946641E69A25C2F0C3F1D104"><enum>(III)</enum><text display-inline="yes-display-inline">an evaluation of the effect of the grant program under this subsection on maternal and infant health outcomes, including racial and ethnic disparities and disparities impacting other underserved mothers, such as mothers living in rural areas, with respect to those outcomes; and</text></subclause><subclause id="HB795BE1B2C244F3F8B5F052D8312ED20"><enum>(IV)</enum><text display-inline="yes-display-inline">recommendations with respect to ensuring the activities described in paragraph (5) continue after the grant funding for those activities expires.</text></subclause></clause><clause id="H911AAAFC3AC84F908D38E99E69572FF7"><enum>(ii)</enum><header>Publication</header><text display-inline="yes-display-inline">The Secretary shall make the report submitted under clause (i) publicly available on the website of the Department of Agriculture.</text></clause></subparagraph></paragraph><paragraph id="H862D02BD68574FF09C0CE4AF06D76FFB"><enum>(7)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to the Secretary $5,000,000 to carry out this subsection for the period of fiscal years 2022 through 2024.</text></paragraph></subsection></section><section id="idB0D50B062FED43AB97B29CA5580AEC0C"><enum>105.</enum><header>Environmental study through National Academies</header><subsection id="id3D13C0876F9A46EE95FAF6F05CCB6664"><enum>(a)</enum><header>In general</header><text>Not later than 60 days after the date of enactment of this Act, the Administrator of the Environmental Protection Agency shall seek to enter into 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 agree to conduct a study on the impacts of water and air quality, exposure to extreme temperatures, exposure to environmental chemicals, environmental risks in the workplace and the home, and pollution levels on maternal and infant health outcomes.</text></subsection><subsection id="idF5F8AF9CBD7B4120BEDE762CD5CF61CF"><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="H67E928E0568A4701BB15C40D272A6812"><enum>(1)</enum><text>improving the environmental conditions described in that subsection to improve maternal and infant health outcomes; and</text></paragraph><paragraph id="H6C4BBD97E5F94BBF875F2EF034DB814E" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text display-inline="yes-display-inline">reducing or eliminating racial and ethnic disparities in those outcomes. </text></paragraph></subsection><subsection display-inline="no-display-inline" commented="no" id="id4883E19D22CA42E397B3DF218B166747"><enum>(c)</enum><header>Report</header><text>The agreement under subsection (a) shall require the National Academies—</text><paragraph display-inline="no-display-inline" commented="no" id="idF0FCBA768CEF4E13B97CF5FA6794FA77"><enum>(1)</enum><text>to complete the study described in that subsection; and</text></paragraph><paragraph display-inline="no-display-inline" commented="no" id="id6F0188F0E0A4404E8C5A8E6D5D82F050"><enum>(2)</enum><text>not later than 1 year after the date of enactment of this Act, to transmit to Congress and make publicly available a report that—</text><subparagraph display-inline="no-display-inline" commented="no" id="id80B74C85F2F849F5B812877F38375B9C"><enum>(A)</enum><text>describes the results of the study; and</text></subparagraph><subparagraph display-inline="no-display-inline" commented="no" id="id6354E357E2D3497582DC4FA03A80B28D"><enum>(B)</enum><text>includes the recommendations described in subsection (b).</text></subparagraph></paragraph></subsection></section><section commented="no" id="H1F4716B57DC6442ABB1B4E0EAB03D36D"><enum>106.</enum><header>Child care access</header><subsection commented="no" id="HA60953D7AE034B1FB42223FB8B6E4994"><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 individuals with free and accessible drop-in child care services during prenatal and postpartum appointments, including for mental health care, prenatal and childbirth classes, and labor and delivery. The Secretary shall coordinate with the Secretary of Defense to disseminate information regarding such services and to expand on-installation drop-in child care services for military parents. </text></subsection><subsection commented="no" id="HA12A334BB15C4B4EBB15D8E58E91B0CD"><enum>(b)</enum><header>Application</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 commented="no" id="H97876088749340D38518B31DAB956216"><enum>(c)</enum><header>Eligible organizations</header><paragraph commented="no" id="H4825F44E812240C1A5E7A2083CDB0EA3"><enum>(1)</enum><header>Eligibility</header><text display-inline="yes-display-inline">To be eligible to receive a grant under this section, an organization shall be an organization that provides child care services and can carry out programs providing pregnant and postpartum individuals with free and accessible drop-in child care services during prenatal and postpartum appointments.</text></paragraph><paragraph commented="no" id="H3FAB46FC30334319B0AB4434994A613D"><enum>(2)</enum><header>Prioritization</header><text display-inline="yes-display-inline">In selecting grant recipients under this section, the Secretary shall give priority to eligible organizations that operate in an area with high rates of adverse maternal health outcomes or significant racial or ethnic disparities in maternal health outcomes, to the extent such data are available.</text></paragraph></subsection><subsection commented="no" id="H3C39599C2C544B1C900E06001C1027CE"><enum>(d)</enum><header>Timing</header><text>The Secretary shall commence the grant program under subsection (a) not later than 1 year after the date of enactment of this Act.</text></subsection><subsection commented="no" id="H0CEB1830E2014A44A2423CA9D7220225"><enum>(e)</enum><header>Reporting</header><paragraph commented="no" id="HA84D71A244CE4731B329142289B38B17"><enum>(1)</enum><header>Grantees</header><text display-inline="yes-display-inline">Each recipient of a grant under this section shall annually submit to the Secretary and make publicly available a report on the status of activities conducted using the grant. Each such report shall include—</text><subparagraph commented="no" id="HA0C5120CE4654BB0BA4703AA6A306926"><enum>(A)</enum><text display-inline="yes-display-inline">an analysis of the effect of the funded program on prenatal and postpartum appointment attendance rates;</text></subparagraph><subparagraph commented="no" id="H0241E05AFBF04FADA6FE9748E6EF903F"><enum>(B)</enum><text display-inline="yes-display-inline">summaries of qualitative assessments of the funded program from—</text><clause commented="no" id="HB19570799AF04E9F8CEA64949033E50F"><enum>(i)</enum><text>pregnant and postpartum individuals participating in the program; and</text></clause><clause commented="no" id="H251D877B01EB440686DEF86D648E52F8"><enum>(ii)</enum><text>the families of such individuals; and</text></clause></subparagraph><subparagraph commented="no" id="H9C142ECBBA6C40F4974F97B82F2E1738"><enum>(C)</enum><text>such additional information as the Secretary may require.</text></subparagraph></paragraph><paragraph commented="no" id="HA169FFB8C2F0402FA75C5F517954871F"><enum>(2)</enum><header>Secretary</header><text display-inline="yes-display-inline">Not later than the end of fiscal year 2024, the Secretary shall submit to Congress and make publicly available a report containing the following:</text><subparagraph commented="no" id="H991F530FF1A84EC2B2F5413C900B4664"><enum>(A)</enum><text display-inline="yes-display-inline">A summary of the reports under paragraph (1).</text></subparagraph><subparagraph commented="no" id="H99340B12DCFF494DAE7289C48287CDAB"><enum>(B)</enum><text display-inline="yes-display-inline">An assessment of the effects, if any, of the funded programs on maternal health outcomes, with a specific focus on racial and ethnic disparities in such outcomes. </text></subparagraph><subparagraph commented="no" id="H39BEACB4BD884B31B2C1C9BB23CC9708"><enum>(C)</enum><text display-inline="yes-display-inline">A description of actions the Secretary can take to ensure that pregnant and postpartum individuals eligible for medical assistance under a State plan under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1936">42 U.S.C. 1936</external-xref> et seq.) have access to free and accessible drop-in child care services during prenatal and postpartum appointments, including identification of the funding necessary to carry out such actions.</text></subparagraph></paragraph></subsection><subsection commented="no" id="H7FC275321251496595DE58A91E32553B"><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 commented="no" id="H67F73AD0A0D04F259C3E55E9CEFE04E1"><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 commented="no" id="H5FC2B28B9DD44C48A618C326AB91D81D"><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 commented="no" id="H2CE969F6AB3A42E2A8A1830FB4A492F8"><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 $5,000,000 for the period of fiscal years 2022 through 2024.</text></subsection></section><section id="H1115D1E782CB4E8DB7FCCE193D4FCB07"><enum>107.</enum><header>Grants to local entities addressing social determinants of maternal health</header><subsection id="HE3D1F2617B424EB4B6A77D275A598432"><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 eligible entities to—</text><paragraph id="HAC313CF447DD4D0C8B0E039A98E8C681"><enum>(1)</enum><text display-inline="yes-display-inline">address social determinants of maternal health for pregnant and postpartum individuals; and</text></paragraph><paragraph id="HA8CD22030A4C4EBBB5CA8230EEA879DD"><enum>(2)</enum><text>eliminate racial and ethnic disparities in maternal health outcomes<italic></italic>.</text></paragraph></subsection><subsection id="HC3C12D52D29141F08574FA6C51B89BE0"><enum>(b)</enum><header>Application</header><text display-inline="yes-display-inline">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 provide.</text></subsection><subsection id="H31929233AAD6475C9EC8B2552A96B706"><enum>(c)</enum><header>Prioritization</header><text display-inline="yes-display-inline">In awarding grants under subsection (a), the Secretary shall give priority to an eligible entity that—</text><paragraph id="H5C1BEC5AFFB74001901DE611B19C516E"><enum>(1)</enum><text display-inline="yes-display-inline">is, or will partner with, a community-based organization to carrying out the activities under subsection (d);</text></paragraph><paragraph id="H429A8ACD5C3F440F8DD9EF06417423CD"><enum>(2)</enum><text display-inline="yes-display-inline">is operating in an area with high rates of adverse maternal health outcomes or significant racial or ethnic disparities in maternal health outcomes; and</text></paragraph><paragraph id="HF7372BFFBBBE45C097D010CDE9078C7D"><enum>(3)</enum><text display-inline="yes-display-inline">is operating in an area with a high poverty rate.</text></paragraph></subsection><subsection id="H612190CE3E0A47699186BB42A088E596"><enum>(d)</enum><header>Activities</header><text display-inline="yes-display-inline">An eligible entity that receives a grant under this section may—</text><paragraph id="H4D1958D193EC441B9F537D7125D151D2"><enum>(1)</enum><text display-inline="yes-display-inline">hire and retain staff;</text></paragraph><paragraph id="HE0D69FB2A2004B9398CC73E6051C4A59"><enum>(2)</enum><text display-inline="yes-display-inline">develop and distribute a culturally and linguistically appropriate list of available resources with respect to social service programs in a community, including housing supports, child care access, nutrition counseling, and resources for pregnant women facing intimate partner violence;</text></paragraph><paragraph id="H0C59D6932BE74256879D39C28A992864"><enum>(3)</enum><text display-inline="yes-display-inline">establish a culturally appropriate resource center that provides multiple social service programs in a single location;</text></paragraph><paragraph id="HFE01147DA3B342169173ECA8A5BC1A12"><enum>(4)</enum><text display-inline="yes-display-inline">offer programs and resources in the communities in which the respective eligible entities are located to address social determinants of health for pregnant and postpartum individuals; and</text></paragraph><paragraph id="H8CE2DAA4F0BD44AC9C8F0E7A43C475A9"><enum>(5)</enum><text>consult with such pregnant and postpartum individuals, including undocumented pregnant individuals, to conduct an assessment of the activities under this subsection.</text></paragraph></subsection><subsection id="H953AD3B1A0E04A6E8CC272746F9E8013"><enum>(e)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">The Secretary shall provide to grant recipients under this section technical assistance to plan for sustaining programs to address social determinants of maternal health among pregnant and postpartum individuals after the period of the grant.</text></subsection><subsection id="H9F842EEFFC90428894040B2F9D7E26FA"><enum>(f)</enum><header>Reporting</header><paragraph id="H1B1ED9A678CC427D95BE34E8EFA7407A"><enum>(1)</enum><header>Grantees</header><text display-inline="yes-display-inline">Not later than 1 year after an eligible entity first receives a grant under this section, and annually thereafter, an eligible entity shall submit to the Secretary, and make publicly available, a report on the status of activities conducted using the grant. Each such report shall include data on the effects of such activities, disaggregated by race, ethnicity, gender, and other relevant factors.</text></paragraph><paragraph id="HCD6B094F575F496F85779435330CB74B"><enum>(2)</enum><header>Secretary</header><text>Not later than the end of fiscal year 2026, the Secretary shall submit to Congress a report that includes—</text><subparagraph id="H8BBFED80E49C4DC88FC74824319E5B84"><enum>(A)</enum><text>a summary of the reports under paragraph (1); and</text></subparagraph><subparagraph id="HD6BC8DA5E1D64CD39E4134ECD2E15F58"><enum>(B)</enum><text>recommendations for—</text><clause id="H52317E75D03D475586AF056A8250B223"><enum>(i)</enum><text>improving maternal health outcomes; and</text></clause><clause id="HFA39A99CE2DF46AEB21C66625312486A"><enum>(ii)</enum><text>reducing or eliminating racial and ethnic disparities in maternal health outcomes.</text></clause></subparagraph></paragraph></subsection><subsection commented="no" id="HC70AE94010634FDC842351A5B399D182"><enum>(g)</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 2022 through 2026.</text></subsection></section><enum>II</enum><header>Honoring Kira Johnson</header><section commented="no" id="H7E88DD3E4A984BFBBFB2D8EA64F12787"><enum>201.</enum><header>Investments in community-based organizations to improve Black maternal health outcomes</header><subsection commented="no" id="H5F8B127B284F49B7A25FB91675D85A79"><enum>(a)</enum><header>Awards</header><text display-inline="yes-display-inline">Following the 1-year period beginning on the date of enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>) shall award grants to eligible entities to establish or expand programs to prevent maternal mortality and severe maternal morbidity among Black pregnant and postpartum individuals.</text></subsection><subsection commented="no" id="HC1FDEAE3B3434ED9949A76E0D48C2370"><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 pregnant and postpartum individuals.</text></subsection><subsection commented="no" id="H4C38668607C0420D98A6DE7738AD6BEC"><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="HA8DB9D5C4E35459BBCD392F3E33CC546"><enum>(1)</enum><text>conduct outreach to encourage eligible entities to apply for grants under this section; and</text></paragraph><paragraph commented="no" id="HC8E0D147E35948E78B695147B22B0172"><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="HC5937B58AFE544D9B904F368CFEE2FB3"><enum>(d)</enum><header>Special consideration</header><paragraph commented="no" id="H19562B64FCE64BA3A767CB841B780A7A"><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="HE7E60FE6C0BD420C9F892F71B8B9B5F6"><enum>(A)</enum><text>are based in, and provide support for, communities with high rates of adverse maternal health outcomes or significant racial and ethnic disparities in maternal health outcomes, to the extent such data are available;</text></subparagraph><subparagraph commented="no" id="H207CBBA6A0234690952F307178007872"><enum>(B)</enum><text>are led by Black women; and</text></subparagraph><subparagraph id="HC9A0955A22E9415F8F0E7CDD6BB9316E"><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 pregnant and postpartum individuals.</text></subparagraph></paragraph><paragraph commented="no" id="H3CF2116D87A54CD7946ED8DB244E088A"><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="H40E3C0500F39406AA9047A3CA75BFB0D"><enum>(A)</enum><text>are described in subparagraphs (A), (B), and (C) of paragraph (1);</text></subparagraph><subparagraph commented="no" id="H4E601423CDDC40B48FA27619315519FC"><enum>(B)</enum><text display-inline="yes-display-inline">offer programs and resources designed in consultation with and intended for Black pregnant and postpartum individuals; and</text></subparagraph><subparagraph commented="no" id="H1D2592F489B247C28EB84D658CEE6707"><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="H02376919F31C451AA85848990F592FCF"><enum>(i)</enum><text display-inline="yes-display-inline">promote maternal mental health and maternal substance use disorder treatments and supports that are aligned with evidence-based practices for improving maternal mental and behavioral health outcomes for Black pregnant and postpartum individuals;</text></clause><clause commented="no" id="H91E2843005A841E78174506763FC1F88"><enum>(ii)</enum><text display-inline="yes-display-inline">address social determinants of maternal health for pregnant and postpartum individuals;</text></clause><clause commented="no" id="H6897401AB8C0420097ED8A106C4EA13B"><enum>(iii)</enum><text display-inline="yes-display-inline">promote evidence-based health literacy and pregnancy, childbirth, and parenting education for pregnant and postpartum individuals;</text></clause><clause commented="no" id="H996105DF15EF418884459FB863E7AF1A"><enum>(iv)</enum><text display-inline="yes-display-inline">provide support from perinatal health workers to pregnant and postpartum individuals;</text></clause><clause id="HEC7EC6DCC25B41AA843751AAF3AA3DF0"><enum>(v)</enum><text display-inline="yes-display-inline">provide culturally congruent training to perinatal health workers;</text></clause><clause id="H18E157F4D3BB4D4F8D3AC0F20BB6DD1F"><enum>(vi)</enum><text display-inline="yes-display-inline">conduct or support research on maternal health issues disproportionately impacting Black pregnant and postpartum individuals;</text></clause><clause id="H4AEC108678174FE1981A49EA43B35413"><enum>(vii)</enum><text>provide support to family members of individuals who suffered a pregnancy-associated death or pregnancy-related death;</text></clause><clause id="H83BF91035EDE462F96D91FD7A971699F"><enum>(viii)</enum><text>operate midwifery practices that provide culturally congruent maternal health care and support, including for the purposes of—</text><subclause id="H8909D8FF0CE1474ABCF14D44FB45FFEC"><enum>(I)</enum><text>supporting additional education, training, and certification programs, including support for distance learning;</text></subclause><subclause id="HEFCE0256851C423381136FA34F3E9316"><enum>(II)</enum><text>providing financial support to current and future midwives to address education costs, debts, and other needs;</text></subclause><subclause id="H29E7FF1B2112474681032897C592DC29"><enum>(III)</enum><text>clinical site investments;</text></subclause><subclause id="H5E9F7ED4B42548D296A2D28393576212"><enum>(IV)</enum><text>supporting preceptor development trainings;</text></subclause><subclause id="H5958C1B82D3F4BB2B42DCC9277E3F6FF"><enum>(V)</enum><text>expanding the midwifery practice; or</text></subclause><subclause id="H57FCAEC7BFEF421AA5498681FFC397F1"><enum>(VI)</enum><text>related needs identified by the midwifery practice and described in the practice’s application; or</text></subclause></clause><clause commented="no" id="H20C790E6E0074E0F991C53C909A41847"><enum>(ix)</enum><text display-inline="yes-display-inline">have developed other programs and resources that address community-specific needs for pregnant and postpartum individuals and are aligned with evidence-based practices for improving maternal health outcomes for Black pregnant and postpartum individuals.</text></clause></subparagraph></paragraph></subsection><subsection commented="no" id="H828ED7003A3A43A68916D2572C06DF21"><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="H4676F9C2931E449CA6DB36A79A4F4D15"><enum>(1)</enum><text display-inline="yes-display-inline">capacity building to establish or expand programs to prevent adverse maternal health outcomes among Black pregnant and postpartum individuals;</text></paragraph><paragraph commented="no" id="HA8D617D687FB410C8CFA27D4776F6116"><enum>(2)</enum><text>best practices in data collection, measurement, evaluation, and reporting; and</text></paragraph><paragraph commented="no" id="HC572662A71F742F08A2F244289A69FB2"><enum>(3)</enum><text display-inline="yes-display-inline">planning for sustaining programs to prevent maternal mortality and severe maternal morbidity among Black pregnant and postpartum individuals after the period of the grant.</text></paragraph></subsection><subsection commented="no" id="H99F91D121E2C4F4AB103662DF26ED4AE"><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 Congress an evaluation of the grant program under this section that—</text><paragraph commented="no" id="H2ADD8DD93C0240D0AFCA6F8241EAD131"><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="HAADCE2F383A54297B07F612541BDF02B"><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 related to maternal health;</text></paragraph><paragraph commented="no" id="H78CF594C0D3944C483F6B1F76898B05A"><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 pregnant and postpartum individuals, to the extent practicable; and</text></paragraph><paragraph commented="no" id="H09EC99B1A4E948DC867A751FBFB002E1"><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 that provide programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for Black pregnant and postpartum individuals.</text></paragraph></subsection><subsection commented="no" id="H33718F240D6E40D39EAC7A9F5C155C14"><enum>(g)</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 2022 through 2026.</text></subsection></section><section id="H49F07E0EB4364103B03DA7854E8F056C"><enum>202.</enum><header>Investments in community-based organizations to improve maternal health outcomes in underserved communities</header><subsection id="H67055F98E31844E8BF6FF38D7DD7C027"><enum>(a)</enum><header>Awards</header><text>Following the 1-year period beginning on the date of enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>) shall award grants to eligible entities to establish or expand programs to prevent maternal mortality and severe maternal morbidity among underserved groups.</text></subsection><subsection id="H3E277DB154644F40AAF782D78F7458D1"><enum>(b)</enum><header>Eligibility</header><text>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 pregnant and postpartum individuals.</text></subsection><subsection id="H98CBBE9DFAA54C1FA5B41C219F15720A"><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 id="H418E247F7E4E4D67A5122DEF8642385F"><enum>(1)</enum><text>conduct outreach to encourage eligible entities to apply for grants under this section; and</text></paragraph><paragraph id="HE636B533BCE947EBBF5DA8008BEFF272"><enum>(2)</enum><text>provide technical assistance to eligible entities on best practices for applying for grants under this section.</text></paragraph></subsection><subsection id="H2627B45776A14BB1A4DEB8353D98133E"><enum>(d)</enum><header>Special consideration</header><paragraph id="H6BA4DB4C61B94393BCF28C7A68EDEB0F"><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 id="HA54995E260FF49BA95FC135901BB379D"><enum>(A)</enum><text>are based in, and provide support for, communities with high rates of adverse maternal health outcomes or significant racial and ethnic disparities in maternal health outcomes, to the extent such data are available;</text></subparagraph><subparagraph id="HEDADA20A20EC49DD980E442AADEA9169"><enum>(B)</enum><text>are led by individuals from racially, ethnically, and geographically diverse backgrounds; and</text></subparagraph><subparagraph id="H792E3246FD8146C5A6A2F93DBDE339BB"><enum>(C)</enum><text>offer programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for pregnant and postpartum individuals.</text></subparagraph></paragraph><paragraph id="H547E0A811C7E4CF78F2AD67C251B7CFE"><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 id="H36C09D2AEE6B493EB8316D87A1CD6A53"><enum>(A)</enum><text>are described in subparagraphs (A), (B), and (C) of paragraph (1);</text></subparagraph><subparagraph id="HDAF697CEA06F445D82168CFC3FF282E1"><enum>(B)</enum><text>offer programs and resources designed in consultation with and intended for pregnant and postpartum individuals from underserved groups; and</text></subparagraph><subparagraph id="H6E4D48ABB6BE4585A559F5C59417848D"><enum>(C)</enum><text>offer programs and resources in the communities in which the respective eligible entities are located that—</text><clause id="H83E8FBFDFE434CEA94919076F4A06A15"><enum>(i)</enum><text>promote maternal mental health and maternal substance use disorder treatments and support that are aligned with evidence-based practices for improving maternal mental and behavioral health outcomes for pregnant and postpartum individuals;</text></clause><clause id="HCE3FE694E0CC43BAA1C4CF586CEDE1DE"><enum>(ii)</enum><text>address social determinants of maternal health for pregnant and postpartum individuals;</text></clause><clause id="HD3BC484723BE4F5C95E397E1777FEED6"><enum>(iii)</enum><text>promote evidence-based health literacy and pregnancy, childbirth, and parenting education for pregnant and postpartum individuals;</text></clause><clause id="HA6A8BA8653C2437A8FF03B20C0EFC6AA"><enum>(iv)</enum><text>provide support from perinatal health workers to pregnant and postpartum individuals;</text></clause><clause id="H9731A5C180744302A38EB6E7A4BFF087"><enum>(v)</enum><text>provide culturally congruent training to perinatal health workers;</text></clause><clause id="H193B52DA76C04727BA488EE6D3BDAF43"><enum>(vi)</enum><text>conduct or support research on maternal health outcomes and disparities;</text></clause><clause id="H09F35BCEF7C44739AFD81F7E9B49B161"><enum>(vii)</enum><text>provide support to family members of individuals who suffered a pregnancy-associated death or pregnancy-related death;</text></clause><clause id="H62D0A5618DA04B64BD65DD65B2DCD777"><enum>(viii)</enum><text>operate midwifery practices that provide culturally congruent maternal health care and support, including for the purposes of—</text><subclause id="H976C2FF565CD4F05B849428DB251092F"><enum>(I)</enum><text>supporting additional education, training, and certification programs, including support for distance learning;</text></subclause><subclause id="H2AFC95EE21844D1E8321195C08629F24"><enum>(II)</enum><text>providing financial support to current and future midwives to address education costs, debts, and other needs;</text></subclause><subclause id="HE0CB339C31F24D329A95F0A2C61B15C7"><enum>(III)</enum><text>clinical site investments;</text></subclause><subclause id="HD37E31BABB904124835458FEB5C6F5DF"><enum>(IV)</enum><text>supporting preceptor development trainings;</text></subclause><subclause id="HCE6411422AF34B119D024D26821E37B7"><enum>(V)</enum><text>expanding the midwifery practice; or</text></subclause><subclause id="H8AF2E7B89A104560ADAB630C3802C07D"><enum>(VI)</enum><text>related needs identified by the midwifery practice and described in the practice’s application; or</text></subclause></clause><clause id="HB649FD988C8B48F59D8E3BE0AE64C097"><enum>(ix)</enum><text>have developed other programs and resources that address community-specific needs for pregnant and postpartum individuals and are aligned with evidence-based practices for improving maternal health outcomes for pregnant and postpartum individuals.</text></clause></subparagraph></paragraph></subsection><subsection id="H1AB0EF762C9C49DAA77D29675AC7A6E2"><enum>(e)</enum><header>Technical assistance</header><text>The Secretary shall provide to grant recipients under this section technical assistance on—</text><paragraph id="H3B46CEA8459C4C05B23CE0941618739F"><enum>(1)</enum><text>capacity building to establish or expand programs to prevent adverse maternal health outcomes among pregnant and postpartum individuals from underserved groups;</text></paragraph><paragraph id="HD382FE0F9E534314AC75A4778BEBE196"><enum>(2)</enum><text>best practices in data collection, measurement, evaluation, and reporting; and</text></paragraph><paragraph id="H7B8F513874374406A936794C0E8F5C5E"><enum>(3)</enum><text>planning for sustaining programs to prevent maternal mortality and severe maternal morbidity among pregnant and postpartum individuals from underserved groups after the period of the grant.</text></paragraph></subsection><subsection id="HB30D9DFDC50F4ACFB3BF25EC80E259C5"><enum>(f)</enum><header>Evaluation</header><text>Not later than the end of fiscal year 2026, the Secretary shall submit to Congress an evaluation of the grant program under this section that—</text><paragraph id="H1DF66F0C8C3B41E98B9DE507C6CC0DC0"><enum>(1)</enum><text>assesses the effectiveness of outreach efforts during the application process in diversifying the pool of grant recipients;</text></paragraph><paragraph id="HC8044EF1439348D1BF36D627CB6AAF3F"><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 related to maternal health;</text></paragraph><paragraph id="HBE42BF7AF5C44FAE8093806D129DC517"><enum>(3)</enum><text>assesses the effectiveness of programs funded by grants under this section in improving maternal health outcomes for pregnant and postpartum individuals from underserved groups, to the extent practicable; and</text></paragraph><paragraph id="H454AD90C28DF4C5891634790FF59221B"><enum>(4)</enum><text>makes recommendations for future Department of Health and Human Services grant programs and funding opportunities that deliver funding to community-based organizations that provide programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for pregnant and postpartum individuals.</text></paragraph></subsection><subsection id="HEA398E94813946339EECF31B4127FE39"><enum>(g)</enum><header>Definition</header><text>In this section, the term <term>underserved groups</term> means to pregnant and postpartum individuals—</text><paragraph id="HBF67FDC28A20467B9C0A7FD95C76AE21"><enum>(1)</enum><text>from racial and ethnic minority groups (as such term is defined in section 1707(g)(1) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300u-6">42 U.S.C. 300u–6(g)(1)</external-xref>));</text></paragraph><paragraph id="HA1284762504A4A81AC7DF70AF15291C6"><enum>(2)</enum><text>whose household income is equal to or less than 150 percent of the Federal poverty line;</text></paragraph><paragraph id="H5F830F7D38FA4C0AB445AC750E2DC1F9"><enum>(3)</enum><text>who live in health professional shortage areas (as such term is defined in section 332 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254e">42 U.S.C. 254e(a)(1)</external-xref>));</text></paragraph><paragraph id="H5953D362296B48B096E3858235D43A9B"><enum>(4)</enum><text>who live in counties with no hospital offering obstetric care, no birth center, and no obstetric provider; or</text></paragraph><paragraph id="HCA2832176D1D4100B52B3CDF0B208E87"><enum>(5)</enum><text>who live in counties with a level of vulnerability of moderate-to-high or higher, according to the Social Vulnerability Index of the Centers for Disease Control and Prevention.</text></paragraph></subsection><subsection id="H5D56AE5F8ADC4FBABF05D3DE1C19A8FA"><enum>(h)</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 2022 through 2026.</text></subsection></section><section id="H366DDA564B7A4C06B3496E7E9C1165C5"><enum>203.</enum><header>Respectful maternity care 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="HF27DB850D48D4ADBBE40DE09CB9950F1"><section id="H58E534CAE51C41059AAF9A060531CBF9"><enum>742.</enum><header>Respectful maternity care training for all employees in maternity care settings</header><subsection id="H3F20F51F95CF4D59A7D13A3E1037EB86"><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 and to advance respectful, culturally congruent, trauma-informed care.</text></subsection><subsection id="HA51237F404FF405E9145B6B2DA387C41"><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="H8072E6DF7CC645DCA17BDA2CD2B4796A"><enum>(1)</enum><text display-inline="yes-display-inline">apply to all maternity care providers and any employees who interact with pregnant and postpartum individuals in the provider setting, including front desk employees, sonographers, schedulers, health care professionals, hospital or health system administrators, security staff, and other employees;</text></paragraph><paragraph id="H5CA7A1A02547451A8DB4FFFEBC059C3C"><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="HF40FDEBE5A2948F59219CD666FA809B3"><enum>(3)</enum><text display-inline="yes-display-inline">address implicit bias, racism, and cultural humility;</text></paragraph><paragraph id="H12932354AD4041B5A2D44028EB1FF7BC"><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;</text></paragraph><paragraph id="HCB439957993044A69ADB183061901D8B"><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="H12518E3395464B568E024910DAFF34F5"><enum>(6)</enum><text>include antiracism training and programs;</text></paragraph><paragraph id="H87C870A557254411AEC014DF87197E10"><enum>(7)</enum><text>be delivered in undergraduate programs that funnel into health professions schools;</text></paragraph><paragraph id="H4CBAB0E2834A470B9222169E2F600DC8"><enum>(8)</enum><text display-inline="yes-display-inline">be delivered in settings that apply to providers of the special supplemental nutrition program for women, infants, and children under section 17 of the Child Nutrition Act of 1966;</text></paragraph><paragraph id="H49B7C6FC31C646D4B1EF51B6BC2F8F3A"><enum>(9)</enum><text display-inline="yes-display-inline">integrate bias training in obstetric emergency simulation trainings or related trainings;</text></paragraph><paragraph id="H7AF7E29E27F349F9B757730856FCB085"><enum>(10)</enum><text display-inline="yes-display-inline">include training for emergency department employees and emergency medical technicians on recognizing warning signs for severe pregnancy-related complications;</text></paragraph><paragraph id="H23CC8F1BD4244B3EA66191B6289878B9"><enum>(11)</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; or</text></paragraph><paragraph id="H355AA872069149588C52E46A6713BEDC"><enum>(12)</enum><text display-inline="yes-display-inline">be based on one or more programs designed by a historically Black college or university or other minority-serving institution.</text></paragraph></subsection><subsection id="HE6A1B62FF7114532BB4EEFD50011B777"><enum>(c)</enum><header>Application</header><text>An entity desiring a grant under subsection (a), shall submit an application at such time, in such manner, and containing such information as the Secretary may require.</text></subsection><subsection id="HE7D3B93A89564ADC8BB9B53CE0FCF19D"><enum>(d)</enum><header>Reporting</header><text display-inline="yes-display-inline">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 pregnant and postpartum individuals from racial and ethnic minority groups and their families.</text></subsection><subsection id="H96E17CF12503424589004841EFF86049"><enum>(e)</enum><header>Best practices</header><text>Based on the annual reports submitted pursuant to subsection (d), the Secretary—</text><paragraph id="HA4D7BD1D507149D1807D2317720E9EDB"><enum>(1)</enum><text>shall produce an annual report on the findings resulting from programs funded through this section;</text></paragraph><paragraph id="H2509DC28B2CB41FB96CDBD3B48B9B82F"><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="H6CF0C49F9C2A433F82011958EFAF7D9E"><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 pregnant and postpartum individuals from racial and ethnic minority groups and their families in maternity care settings.</text></paragraph></subsection><subsection id="HB068C1F695164C17B2D0710824EA93D9"><enum>(f)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H1D3026B25F564B8FA9449413EC701F20"><enum>(1)</enum><text>The term <term>postpartum</term> means the one-year period beginning on the last day of an individual’s pregnancy.</text></paragraph><paragraph id="HA908504B42C945F49B199969856BC183"><enum>(2)</enum><text>The term <term>culturally congruent</term> means in agreement with the preferred cultural values, beliefs, world view, language, and practices of the health care consumer and other stakeholders.</text></paragraph><paragraph id="HFD1AE0A977B24B129F88CBE6D5164532"><enum>(3)</enum><text display-inline="yes-display-inline">The term <term>racial and ethnic minority group</term> has the meaning given such term in section 1707(g)(1).</text></paragraph></subsection><subsection commented="no" id="H6CD7CAF5817C4C10B21FEC04F8E91E58"><enum>(g)</enum><header>Authorization of appropriations</header><text>To carry out this section, there is authorized to be appropriated $5,000,000 for each of fiscal years 2022 through 2026.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="H4AF4464B5D1B42C795A668F403FA7323"><enum>204.</enum><header>Study on reducing and preventing bias, racism, and discrimination in maternity care settings</header><subsection id="H826AA97717BF4B599B1C20807E6AFE74"><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="H695B1531BA154EF5B84C316D434AD797"><enum>(1)</enum><text display-inline="yes-display-inline">conduct a study on the design and implementation of programs to reduce and prevent bias, racism, and discrimination in maternity care settings and to advance respectful, culturally congruent, trauma-informed care; and</text></paragraph><paragraph id="HA4D65F9A9B5D4203821DF2585EADAD90"><enum>(2)</enum><text>not later than 2 years after the date of enactment of this Act—</text><subparagraph id="H7E0FD3782AE54DB0961307629F5F7C98"><enum>(A)</enum><text>complete the study; and</text></subparagraph><subparagraph id="HADF6DE73CD584B2DA295DEFC9F63769D"><enum>(B)</enum><text>transmit a report on the results of the study to Congress.</text></subparagraph></paragraph></subsection><subsection id="HA93A27DBACFD4054AE47F39EF5EEACC8"><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="H8B783F6860F7400696E7A1587C1A00DF"><enum>(1)</enum><text display-inline="yes-display-inline">The development of a scorecard or other evaluation standards 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 pregnant and postpartum individuals from racial and ethnic minority groups and their families.</text></paragraph><paragraph id="H0168E50F7E524D1B960F2A88C75F240D"><enum>(2)</enum><text display-inline="yes-display-inline">Determination of the types and frequency 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 pregnant and postpartum individuals from racial and ethnic minority groups and their families.</text></paragraph></subsection></section><section id="HD9ABEDE9376E43B7BB1416BD3165804C"><enum>205.</enum><header>Respectful maternity care compliance program</header><subsection id="H5352AFC97E824F87A18872311CBA81E3"><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 settings to establish as an integral part of quality implementation initiatives within one or more hospitals or other birth settings a respectful maternity care compliance program.</text></subsection><subsection id="H3C17284783D64861A7F4921ED640B8F7"><enum>(b)</enum><header>Program requirements</header><text>A respectful maternity care compliance program funded through a grant under this section shall—</text><paragraph id="H5FE34947B2C946E3B6AB91EDD21C087E"><enum>(1)</enum><text display-inline="yes-display-inline">institutionalize mechanisms to allow patients receiving maternity care services, the families of such patients, or perinatal health workers supporting such patients to report instances of racism or evidence of bias on the basis of race, ethnicity, or another protected class;</text></paragraph><paragraph id="H30AC88282BB54D8DA1955D7C825B52C6"><enum>(2)</enum><text display-inline="yes-display-inline">institutionalize response mechanisms through which representatives of the program can directly follow up with the patient, if possible, and the patient’s family in a timely manner; </text></paragraph><paragraph id="HB1CD36E353AB431D97932F5240171853"><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="H29F9B04918BB4429845DC2B6B5136C8D"><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;</text></subparagraph><subparagraph id="H9BF329B00E9E4A10875B1C0E2062C035"><enum>(B)</enum><text display-inline="yes-display-inline">information on the number of cases reported to the compliance program; and</text></subparagraph><subparagraph id="HD90EC9A4EB1948C0B862999D2B77E0E1"><enum>(C)</enum><text display-inline="yes-display-inline">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 patients from racial and ethnic minority groups;</text></subparagraph></paragraph><paragraph id="H1418731AA0BF41AAA26EB00BD1C978DD"><enum>(4)</enum><text display-inline="yes-display-inline">develop mechanisms to routinely collect and publicly report hospital-level data related to patient-reported experience of care; and</text></paragraph><paragraph id="HB44982F6DA094F2084FDA087FC27AA9C"><enum>(5)</enum><text>provide annual reports to the Secretary with information about each case reported to the compliance program over the course of the year containing such information as the Secretary may require, such as—</text><subparagraph id="H536582649E0E4DD092A6598B54A301A0"><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="H5700D6524AC54B4385DF6637EA10ACAD"><enum>(B)</enum><text>the content of the report from the patient or the family of the patient to the compliance program; </text></subparagraph><subparagraph id="H1FC43369876D416C93A2338265FEE83E"><enum>(C)</enum><text>the response from the compliance program; and</text></subparagraph><subparagraph id="HE257E54B2BFD43D4A829E54B1B829ABF"><enum>(D)</enum><text display-inline="yes-display-inline">to the extent applicable, institutional changes made as a result of the case.</text></subparagraph></paragraph></subsection><subsection id="H5F441EB10BE2433E8F4854F80A529B4A"><enum>(c)</enum><header>Secretary requirements</header><paragraph id="H7588580C7B3A4247B73D84A735D4712A"><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="H7C66AE75C7B6417B8F5846DD4CC3EAFB"><enum>(A)</enum><text>disseminating best practices for establishing and implementing a respectful maternity care compliance program within a hospital or other birth setting;</text></subparagraph><subparagraph id="H649A24C3FBCF43449F9949FC2548F153"><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 programs; and</text></subparagraph><subparagraph id="H682EF7BB0F7B43398E3D7AA317030F89"><enum>(C)</enum><text display-inline="yes-display-inline">evaluating the effectiveness of respectful maternity care compliance programs on maternal health outcomes and patient and family experiences, especially for patients from racial and ethnic minority groups and their families.</text></subparagraph></paragraph><paragraph id="H18C520E0E5B84969ADA3FA0CD680EECA"><enum>(2)</enum><header>Study</header><subparagraph id="HC12C77760F4F4884977AEE104C2DF5CC"><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 Secretary shall, through a contract with an independent research organization, conduct a study on strategies to address—</text><clause id="H6FC3EAC2494A40F3947E2E32C7B8CE20"><enum>(i)</enum><text>racism or bias on the basis of race, ethnicity, or another protected class in the delivery of maternity care services; and</text></clause><clause id="HC7A345E300B64F88BE0084BF7BB4188E"><enum>(ii)</enum><text>successful implementation of respectful care initiatives.</text></clause></subparagraph><subparagraph id="H48E67F25C3154EF6B826DD2DE03BBC31"><enum>(B)</enum><header>Components of study</header><text>The study under this paragraph shall include the following:</text><clause id="HB5E0B3E085A540BBB74470A9C2922BAC"><enum>(i)</enum><text>An assessment of the reports submitted to the Secretary from the respectful maternity care compliance programs pursuant to subsection (b)(5).</text></clause><clause id="HB8AAC0A272FE42C8BAC4A3FCA188DE2F"><enum>(ii)</enum><text display-inline="yes-display-inline">Based on the assessment under clause (i), recommendations for potential accountability mechanisms related to cases of racism 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="HE72D834C8EE44976A24DAEA6200A7F35"><enum>(C)</enum><header>Report</header><text>The Secretary shall submit to Congress and make publicly available a report on the results of the study under this paragraph.</text></subparagraph></paragraph></subsection><subsection id="H45D302AD49EC4F40BBD4990A4771E660"><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 2022 through 2027.</text></subsection></section><section id="HF344020664D5467B851CED75A6D6D854"><enum>206.</enum><header>GAO report</header><subsection id="H3265180658C747EEB37CE5E920803E2E"><enum>(a)</enum><header>In general</header><text>Not later than 2 years after the date of enactment of this Act and annually thereafter, the Comptroller General of the United States shall submit to Congress and make publicly available a report on the establishment of respectful maternity care compliance programs within hospitals, health systems, and other maternity care settings.</text></subsection><subsection id="HA26005D0444648E399AFBE026CD4A62F"><enum>(b)</enum><header>Matters included</header><text>The report under paragraph (1) shall include the following:</text><paragraph id="H6E6D53241EA94A81A2640B4521300E67"><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 programs, including—</text><subparagraph id="HDA9C51EEB24547E4A27E4E08864DFA9F"><enum>(A)</enum><text>which hospitals and other birth settings elect to establish compliance programs and when such programs are established;</text></subparagraph><subparagraph id="H36B66AB8AAF749879B099EFE898E4B6D"><enum>(B)</enum><text display-inline="yes-display-inline">to the extent practicable, impacts of the establishment of such programs on maternal health outcomes and patient and family experiences in the hospitals and other birth settings that have established such programs, especially for patients from racial and ethnic minority groups and their families;</text></subparagraph><subparagraph id="H3EC7130A56F24C0E8B86B20B76A49AC4"><enum>(C)</enum><text>information on geographic areas, and types of hospitals or other birth settings, where respectful maternity care compliance programs are not being established and information on factors contributing to decisions to not establish such programs; and</text></subparagraph><subparagraph id="H784B0438F15F4583B83F5384AC69422A"><enum>(D)</enum><text>recommendations for establishing respectful maternity care compliance programs in geographic areas, and types of hospitals or other birth settings, where such programs are not being established.</text></subparagraph></paragraph><paragraph id="HF5418C33280C4329A1CB1007DCC7B8B7"><enum>(2)</enum><text>Whether the funding made available to carry out this section has been sufficient and, if applicable, recommendations for additional appropriations to carry out this section.</text></paragraph><paragraph id="H18975C41B46246A4BE98E11D484363B9"><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="HA3EC892345BF436281762FB0057BBD13"><enum>301.</enum><header>Codification of maternity coordination program of Department of Veterans Affairs</header><subsection id="HE3DBAA52D8334CD18B16717AACC3D40D"><enum>(a)</enum><header>Program on maternity care coordination</header><paragraph id="HE8A8C3DCAC184756B1ECAEC61E77E4AB"><enum>(1)</enum><header>In general</header><text>The Secretary of Veterans Affairs shall carry out the maternity care coordination program described in Veterans Health Administration Handbook 1330.03, or successor handbook.</text></paragraph><paragraph id="H62E1F95D3F0A4FC88FF1F64A21685BA8"><enum>(2)</enum><header>Training and support</header><text display-inline="yes-display-inline">In carrying out the program under paragraph (1), the Secretary shall provide to community maternity care providers training and support with respect to the unique needs of pregnant and postpartum veterans, particularly regarding mental and behavioral health conditions relating to the service of the veterans in the Armed Forces.</text></paragraph></subsection><subsection id="H6B2D88913BFD44E095EEEDA21C0526C7"><enum>(b)</enum><header>Authorization of appropriations</header><paragraph id="id4F73136EFCD7476E82DC6385A5923F0D"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">There is authorized to be appropriated to the Secretary $15,000,000 for fiscal year 2022 for the program under subsection (a)(1).</text></paragraph><paragraph id="id01E6619FA2F04DA6A8ECE05BFA28064C"><enum>(2)</enum><header>Supplement not supplant</header><text display-inline="yes-display-inline">Amounts authorized under paragraph (1) are authorized in addition to any other amounts authorized for maternity health care and coordination for the Department of Veterans Affairs.</text></paragraph></subsection><subsection id="H03C0315FF21F471FB24E6CE8A910FAB0"><enum>(c)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H0F079211CCFE417EB16267035E6EA8B6"><enum>(1)</enum><header>Community maternity care providers</header><text>The term <term>community maternity care providers</term> means maternity care providers located at non-Department facilities who provide maternity care to veterans under section 1703 of title 38, United States Code, or any other law administered by the Secretary of Veterans Affairs.</text></paragraph><paragraph id="HA1C747DA0B9C42B1ADE3C837625FC9CB"><enum>(2)</enum><header>Non-Department facilities</header><text display-inline="yes-display-inline">The term <term>non-Department facilities</term> has the meaning given that term in section 1701 of title 38, United States Code.</text></paragraph></subsection></section><section id="HCA62D27686C34711BD9F9D50A11182BB"><enum>302.</enum><header>Report on maternal mortality and severe maternal morbidity among pregnant and postpartum veterans</header><subsection id="HED37EF19D5F94B16BF03069BCE662CEE"><enum>(a)</enum><header>GAO report</header><text display-inline="yes-display-inline">Not later than two 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 pregnant and postpartum veterans, with a particular focus on racial and ethnic disparities in maternal health outcomes for veterans.</text></subsection><subsection id="HE8FAA3D8EB5C4EEFACCFA82F6536142E"><enum>(b)</enum><header>Matters included</header><text>The report under subsection (a) shall include the following:</text><paragraph id="H2CF1843A44D04B69BF9F0E17CDCB7C6F"><enum>(1)</enum><text display-inline="yes-display-inline">To the extent practicable—</text><subparagraph id="H5DFBB46C8DA544F8BC2951296C5E33E5"><enum>(A)</enum><text display-inline="yes-display-inline">the number of pregnant and postpartum 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="H5E001194CABC4F6DB8BA00A1E64B4F8C"><enum>(B)</enum><text display-inline="yes-display-inline">the rate of pregnancy-related deaths per 100,000 live births for pregnant and postpartum veterans;</text></subparagraph><subparagraph id="H3DAFF5C5F85349C388235266C7C7F7E5"><enum>(C)</enum><text display-inline="yes-display-inline">the number of cases of severe maternal morbidity among pregnant and postpartum veterans in the most recent year of available data; </text></subparagraph><subparagraph id="HDE4EED356C6640E687C978EB90B7B1D0"><enum>(D)</enum><text display-inline="yes-display-inline">the racial and ethnic disparities in maternal mortality and severe maternal morbidity rates among pregnant and postpartum veterans;</text></subparagraph><subparagraph id="H3E1109CB514D48B1BFBBD49E11562118"><enum>(E)</enum><text display-inline="yes-display-inline">identification of the causes of maternal mortality and severe maternal morbidity that are unique to veterans, including post-traumatic stress disorder, military sexual trauma, and infertility or miscarriages that may be caused by service in the Armed Forces;</text></subparagraph><subparagraph id="H2AECB5A49B7F4B7CB9FFDBA80C7A048E"><enum>(F)</enum><text display-inline="yes-display-inline">identification of the causes of maternal mortality and severe maternal morbidity that are unique to veterans from racial and ethnic minority groups; </text></subparagraph><subparagraph id="H490BA1F576F64AF7B1556C82B4C73E19"><enum>(G)</enum><text display-inline="yes-display-inline">identification of any correlations between the former rank of veterans and their maternal health outcomes; </text></subparagraph><subparagraph id="HB91C06ABCDBC478B8CF247526B01498C"><enum>(H)</enum><text display-inline="yes-display-inline">the number of veterans who have been diagnosed with infertility by a health care provider of the Veterans Health Administration each year in the most recent five years, disaggregated by age, race, ethnicity, sex, marital status, sexual orientation, gender identity, and geographical location;</text></subparagraph><subparagraph id="HD0518560D7594A21A08FF99035709DF8"><enum>(I)</enum><text>the number of veterans who have received a clinical diagnosis of unexplained infertility by a health care provider of the Veterans Health Administration each year in the most recent five years; and</text></subparagraph><subparagraph id="H4EA57F449548499494CED29C8B564579"><enum>(J)</enum><text>the extent to which the rate of incidence of clinically diagnosed infertility among veterans compare or differ to the rate of incidence of clinically diagnosed infertility among the civilian population.</text></subparagraph></paragraph><paragraph id="H085C6C5957D54C5CAFDA2E79E510CB8C"><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 pregnant and postpartum veterans—</text><subparagraph id="HAA38588D065A4C008F17B2604689BF6A"><enum>(A)</enum><text>who have health care coverage through the Department;</text></subparagraph><subparagraph id="H30F30BF3AD1B475E98B4A6D9FA027BAC"><enum>(B)</enum><text>enrolled in the TRICARE program;</text></subparagraph><subparagraph id="H83F02F2976A743368A0B8BF7A4A98A2F"><enum>(C)</enum><text>with employer-based or private insurance; </text></subparagraph><subparagraph id="HAA9AA888E9484101837D8C54ED9B12CC"><enum>(D)</enum><text>enrolled in the Medicaid program; and</text></subparagraph><subparagraph id="HB283D4E26A604E4F9235DFD5DDB2BCC2"><enum>(E)</enum><text display-inline="yes-display-inline">who are uninsured.</text></subparagraph></paragraph><paragraph id="HFB022B302C434A40827990B7FDB6BF42"><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 pregnant and postpartum veterans who screen positively for maternal mental or behavioral health conditions. </text></paragraph><paragraph id="H094C442A77F349CCAF4E37A7C8957187"><enum>(4)</enum><text display-inline="yes-display-inline">Recommendations to address homelessness, food insecurity, poverty, and related issues among pregnant and postpartum veterans.</text></paragraph><paragraph id="H112F31B8868143098A54DA60326675E5"><enum>(5)</enum><text>Recommendations on how to effectively educate maternity care providers on best practices for providing maternity care services to veterans that addresses the unique maternal health care needs of veteran populations.</text></paragraph><paragraph id="H8F366DE72EAC4CC9AA87375428A6F424"><enum>(6)</enum><text display-inline="yes-display-inline">Recommendations to reduce maternal mortality and severe maternal morbidity among pregnant and postpartum veterans and to address racial and ethnic disparities in maternal health outcomes for each of the groups described in subparagraphs (A) through (E) of paragraph (2).</text></paragraph><paragraph id="H31854E76C0C74B1FAE4B65F0DA923928"><enum>(7)</enum><text display-inline="yes-display-inline">Recommendations to improve coordination of care between the Department and non-Department facilities for pregnant and postpartum veterans, including recommendations to improve—</text><subparagraph id="H1827292487F24AF7B8F2224BB0166D8C"><enum>(A)</enum><text>health record interoperability; and</text></subparagraph><subparagraph id="H89DF8A431AC64D29BFE936E72E13CBBF"><enum>(B)</enum><text>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 staff of relevant non-Department facilities.</text></subparagraph></paragraph><paragraph id="H1987D87002794667831225C557A547D8"><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="H5961F6BFC4D94C90B1F618F8CC572FA4" 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 pregnant and postpartum veterans and to address racial and ethnic disparities in maternal health outcomes for veterans. </text></paragraph></subsection></section><enum>IV</enum><header>Perinatal workforce</header><section id="H0490BD9154964FE98B7DEEF199EF92ED"><enum>401.</enum><header>HHS agency directives</header><subsection id="H3D50983671EA4C4C8141BE4A798252EE"><enum>(a)</enum><header>Guidance to States</header><paragraph id="HB1590017DBD345BAB45707A11C6A1429"><enum>(1)</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 Secretary of Health and Human Services (referred to in this section as the <quote>Secretary</quote>) shall issue and disseminate guidance to States to educate providers, managed care entities, and other insurers about the value and process of delivering respectful maternal health care through diverse and multidisciplinary care provider models.</text></paragraph><paragraph id="H318D5281FC434A9BA9F034BB856D08C4"><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, midwifery practices, freestanding birth centers, other maternity care provider groups, managed care entities, and other insurers—</text><subparagraph commented="no" id="H93C838021B1D443B81340C12FD5EE301"><enum>(A)</enum><text display-inline="yes-display-inline">to recruit and retain maternity care providers, mental and behavioral health care providers acting in accordance with State law, registered dietitians or nutrition professionals (as such term is defined in section 1861(vv)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(vv)(2)</external-xref>)), and lactation consultants certified by the International Board of Lactation Consultants Examiners—</text><clause commented="no" id="H6EEC75D7B6EF44A3A2074E9EAE7BE2DE"><enum>(i)</enum><text display-inline="yes-display-inline">from racially, ethnically, and linguistically diverse backgrounds;</text></clause><clause commented="no" id="HB6A4A426A27D40ED87AAD9E2922EA221"><enum>(ii)</enum><text>with experience practicing in racially and ethnically diverse communities; and</text></clause><clause commented="no" id="H5C963074D2CD4ABC831F3B038F28E791"><enum>(iii)</enum><text>who have undergone training on implicit bias and racism;</text></clause></subparagraph><subparagraph id="H1DA90D55FAEA4B53944EFD23AAB6BF8D"><enum>(B)</enum><text display-inline="yes-display-inline">to incorporate into maternity care teams—</text><clause id="H21193A16654D4E72A97DF42B0FCE1FE2"><enum>(i)</enum><text>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; and</text></clause><clause id="HD1FE6A67AF624118A15A89DB7C4F4223"><enum>(ii)</enum><text>perinatal health workers;</text></clause></subparagraph><subparagraph id="H365C557DA40F448E95059A2E8D2D851F"><enum>(C)</enum><text>to provide collaborative, culturally congruent care; and</text></subparagraph><subparagraph id="HDB27BA16856841C7822F11EFF5527024"><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, midwifery practices, and freestanding birth centers.</text></subparagraph></paragraph></subsection><subsection id="H41DD3DCE87B044789331F1E04700867E"><enum>(b)</enum><header>Study on respectful and culturally congruent maternity care</header><paragraph id="H7C839394EB64409B98503B6E3EB17DCB"><enum>(1)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary, acting through the Director of the National Institutes of Health, shall conduct a study on best practices in respectful and culturally congruent maternity care.</text></paragraph><paragraph id="H47D2977F328546E4847B23DF3B9D07AF"><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="HB26D94ED007A43F69894C89CD6E2CA2E"><enum>(A)</enum><text>complete the study required by paragraph (1);</text></subparagraph><subparagraph id="HB5E1FA235CFC4218A042E3B141265F2E"><enum>(B)</enum><text display-inline="yes-display-inline">submit to Congress and make publicly available a report on the results of such study; and</text></subparagraph><subparagraph id="H91D12B119207462F9EBC516C7135994C"><enum>(C)</enum><text>include in such report—</text><clause id="HFD6A34230E3A4B2BBA0D285E17DBE8BE"><enum>(i)</enum><text display-inline="yes-display-inline">a compendium of examples of hospitals, health systems, midwifery practices, freestanding birth centers, other maternity care provider groups, managed care entities, and other insurers that are delivering respectful and culturally congruent maternal health care;</text></clause><clause id="H0E3434B7286B4F5E90F125B58369C7F1"><enum>(ii)</enum><text display-inline="yes-display-inline">a compendium of examples of hospitals, health systems, midwifery practices, freestanding birth centers, other maternity care provider groups, managed care entities, and other insurers that have made progress in reducing disparities in maternal health outcomes and improving birthing experiences for pregnant and postpartum individuals from racial and ethnic minority groups; and</text></clause><clause id="HADD4CA8510E64851A0867F24EB9D5452"><enum>(iii)</enum><text display-inline="yes-display-inline">recommendations to hospitals, health systems, midwifery practices, freestanding birth centers, other maternity care provider groups, managed care entities, and other insurers, for best practices in respectful and culturally congruent maternity care. </text></clause></subparagraph></paragraph></subsection></section><section id="HAA873C9021534A31ABC15D5DA2884D56"><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 new section:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H0AF057626DB84773AC56028D82773A7B"><section id="HA8799D6E4EE44C458480CC98084BF78D"><enum>758.</enum><header>Perinatal workforce grants</header><subsection id="HCD62D0DDDE1745D9AB229F800CE358D6"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall award grants to entities to establish or expand programs described in subsection (b) to grow and diversify the perinatal workforce.</text></subsection><subsection id="HA7B847572C1F49648950917D6061C30B"><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="H2AAB485A4A97478193630BAB76119201"><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="HAE18F329AD2747B484C3C43AA11E6D76"><enum>(A)</enum><text>physician assistants who will complete clinical training in the field of maternal and perinatal health; or</text></subparagraph><subparagraph id="HF193C61F89AB4996A91A3EC29E511373"><enum>(B)</enum><text display-inline="yes-display-inline">perinatal health workers; and</text></subparagraph></paragraph><paragraph id="H64A73EF1D4A5404B8A80BC644A19336A"><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="HBC6CD964C88A406E8BA0227C4C9D64AA"><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="H39CE90225DD047B28F61B363BAE307E7"><enum>(1)</enum><text display-inline="yes-display-inline">has demonstrated a commitment to recruiting and retaining students and faculty from racial and ethnic minority groups;</text></paragraph><paragraph id="H6FE55EF289814CC99A528DF1EE3A4903"><enum>(2)</enum><text display-inline="yes-display-inline">has developed a strategy to recruit and retain a diverse pool of students into the perinatal workforce program or school supported by funds received through the grant, particularly from racial and ethnic minority groups and other underserved populations;</text></paragraph><paragraph id="HEECF392711AD428D9F42F8A0F45FF0F2"><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="HD68DBD180F1D47F583B6E3C866B60CE4"><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, to the extent practicable; and</text></paragraph><paragraph id="H4182CD765F814FE7A730826F1DDDB67E"><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 implicit bias and racism.</text></paragraph></subsection><subsection id="H625239EC7E0C4396882FD37557824AF0"><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="HBD10D133BF0A476696C20D172D6B62B6"><enum>(1)</enum><text>the number and demographics of students participating in the program or school;</text></paragraph><paragraph id="H9D052E6809524461865694508AE0B132"><enum>(2)</enum><text>the extent to which students in the program or school are entering careers in—</text><subparagraph id="H31532EBE160C4B88A46DA1361B387219"><enum>(A)</enum><text display-inline="yes-display-inline">health professional shortage areas designated under section 332; and</text></subparagraph><subparagraph id="H74FD6F1B844440C08A74F9042F6BD2D7"><enum>(B)</enum><text display-inline="yes-display-inline">areas with significant racial and ethnic disparities in maternal health outcomes, to the extent such data are available; and</text></subparagraph></paragraph><paragraph id="H0DB79E4B873842F68B79A2529B82CC35"><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="H50D6CD0430804682952AD022DF0B79B9"><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="H8E078F81CD8F40389523DAA84BA5E519"><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="HB7ED902CB1A84D218391623A16EC3924"><enum>(g)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">The Secretary shall provide, directly or by contract, technical assistance to entities 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="HB655E00BBE124BD28D54DFD363DB6530"><enum>(h)</enum><header>Report 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 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="HD0EEE423DF6A46F78F9E5E20912E6954"><enum>(1)</enum><text display-inline="yes-display-inline">recruiting students from racial and ethnic minority groups;</text></paragraph><paragraph id="HDB183C5EBE814058A1A24B1FE9F1710F"><enum>(2)</enum><text display-inline="yes-display-inline">increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health, and perinatal health workers, from racial and ethnic minority groups and other underserved populations;</text></paragraph><paragraph id="H78D08A47CAE94D6AA0A3ED352D38BE3A"><enum>(3)</enum><text>increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health, and perinatal health workers, working in health professional shortage areas designated under section 332; and</text></paragraph><paragraph id="HAFA1F0D79CEB4230A1EEA4DE3E7C7102"><enum>(4)</enum><text display-inline="yes-display-inline">increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health, and perinatal health workers, working in areas with significant racial and ethnic disparities in maternal health outcomes, to the extent such data are available.</text></paragraph></subsection><subsection id="H0D12C672FFE2498BABF2DFCAD2D89746"><enum>(i)</enum><header>Definition</header><text display-inline="yes-display-inline">In this section, the term <term>racial and ethnic minority group</term> has the meaning given such term in section 1707(g).</text></subsection><subsection id="HF0259DAF78764D2F951E640E6D7E4D05"><enum>(j)</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 2022 through 2026.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="HCB197ABF7DDD4475BD9C72AE649C67E9"><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="H5E7C1F037B06455FAB5001ACEF5741E8"><section id="H48CB0746991C40D687F6A355F03CA152"><enum>812.</enum><header>Perinatal nursing workforce grants</header><subsection id="HF39DB18B72104F178E299042328AE68C"><enum>(a)</enum><header>In general</header><text>The Secretary shall award grants to schools of nursing to grow and diversify the perinatal nursing workforce.</text></subsection><subsection id="H5B3599A597B64AFB9A67B444A4857901"><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="HC83E4007C0F04467900CFEF003F710A6"><enum>(1)</enum><text>nurse practitioners whose education includes a focus on maternal and perinatal health; or</text></paragraph><paragraph id="H964B27C8E67E49A6B3C7EB3DCFAA8B30"><enum>(2)</enum><text>clinical nurse specialists whose education includes a focus on maternal and perinatal health.</text></paragraph></subsection><subsection id="H53041004654B421EBC6945D03580BF96"><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="HD7DAD564ABAB438FA069277B79AFC81B"><enum>(1)</enum><text display-inline="yes-display-inline">has developed a strategy to recruit and retain a diverse pool of students seeking to enter careers focused on maternal and perinatal health, particularly students from racial and ethnic minority groups and other underserved populations;</text></paragraph><paragraph id="H17CCC9EE860E4A118647AB18BBC96658"><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="H130941205C5B448BADD2E9206C5E0D54"><enum>(3)</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, to the extent practicable; and</text></paragraph><paragraph id="H20BE557A6E2649BD97A94166F39DAB70"><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 implicit bias and racism.</text></paragraph></subsection><subsection id="H9BED52AFA5DD4A45B863D81F03B8BD1A"><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="HB9DCACA524EA4FC2AC4D1436A7D31C54"><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="HCF501D1A6DC24F96AC4A878C8462CF67"><enum>(2)</enum><text>the extent to which such students are preparing to enter careers in—</text><subparagraph id="HBA90124BE9194CB1BF577D4F63EACED7"><enum>(A)</enum><text>health professional shortage areas designated under section 332; and</text></subparagraph><subparagraph id="H06808FE7AC54462E8A8A233577697470"><enum>(B)</enum><text display-inline="yes-display-inline">areas with significant racial and ethnic disparities in maternal health outcomes, to the extent such data are available; and</text></subparagraph></paragraph><paragraph id="H5432D29275DB44AD9C46C318ECF16A38"><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 implicit bias and racism.</text></paragraph></subsection><subsection id="H1935766458CC4C909E570B592F2F9F35"><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="H5E07860F42AF4E19A27DD572368CFC48"><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="H52D56582DCC54433BB529859C94BB693"><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="HE760914E1EEB480FB52AEFCB40DDF67C"><enum>(h)</enum><header>Report by the Secretary</header><text>Not later than 4 years after the date of enactment of this section, the Secretary shall prepare and submit to 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="HFA5B8EB8B5BD45E2A59643EA1C604B32"><enum>(1)</enum><text display-inline="yes-display-inline">recruiting students from racial and ethnic minority groups and other underserved populations;</text></paragraph><paragraph id="H6988D096647A418A8B8001622D8BBBB7"><enum>(2)</enum><text display-inline="yes-display-inline">increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health from racial and ethnic minority groups and other underserved populations;</text></paragraph><paragraph id="HB921248D09EA45F39FB41EDDB550861F"><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="HC7CA94EAF21849369C524C7F71AD30D5"><enum>(4)</enum><text display-inline="yes-display-inline">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, to the extent such data are available.</text></paragraph></subsection><subsection id="HAB4260CF431A4288AE7C7131D9AB4A3F"><enum>(i)</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 2022 through 2026.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="H170BD3299C2541DA85A385C1CF0C1E6A"><enum>404.</enum><header>GAO report</header><subsection id="H650B506AE70141408378733FA4730040"><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 and every 5 years thereafter, the Comptroller General of the United States shall submit to Congress a report on barriers to maternal health education and access to care in the United States. Such report shall include the information and recommendations described in subsection (b).</text></subsection><subsection id="H5C6D1E35F9A7488EA7DD7523D43F9AFF"><enum>(b)</enum><header>Content of report</header><text>The report under subsection (a) shall include—</text><paragraph id="H7F47504DEABF47E88FEEB615D414F8DD"><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 women and women from racial and ethnic minority groups;</text></paragraph><paragraph commented="no" id="H180180B563EF4644A802FE2217D6FDB6"><enum>(2)</enum><text display-inline="yes-display-inline">an assessment of current barriers to entering and successfully completing accredited education programs for other health professional careers related to maternity care, including maternity care providers, mental and behavioral health care providers acting in accordance with State law, registered dietitians or nutrition professionals (as such term is defined in section 1861(vv)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(vv)(2)</external-xref>)), and lactation consultants certified by the International Board of Lactation Consultants Examiners, particularly for low-income women and women from racial and ethnic minority groups;</text></paragraph><paragraph id="HD94CAD66D43B488D8B5A62DFC5704279"><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 women and women from racial and ethnic minority groups;</text></paragraph><paragraph id="H625BBF8F7EC24FE6BDC3CD46EAFD31C6"><enum>(4)</enum><text display-inline="yes-display-inline">an assessment of disparities in access to maternity care providers, mental or behavioral health care providers acting in accordance with State law, registered dietitians or nutrition professionals (as such term is defined in section 1861(vv)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(vv)(2)</external-xref>)), lactation consultants certified by the International Board of Lactation Consultants Examiners, and perinatal health workers, stratified by race, ethnicity, gender identity, geographic location, and insurance type and recommendations to promote greater access equity; and</text></paragraph><paragraph id="HA5330C7170D34D1099620515CFF5A918"><enum>(5)</enum><text display-inline="yes-display-inline">recommendations to promote greater equity in compensation for perinatal health workers under public and private insurers, 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="H9424593B1F58410B9501A11B196CC272"><enum>501.</enum><header>Funding for maternal mortality review committees to promote representative community engagement</header><subsection id="H12C04CF6C1F4430F9D1CDE0E19F320AD"><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="HA1B056607099482795AAEF5ECAC6CEC4"><paragraph id="HB2A58A60EB2A4696B390EB047DA63D07"><enum>(9)</enum><header>Grants to promote representative community engagement in maternal mortality review committees</header><subparagraph id="HF6CA30F56E7445BBA0ECA96345AC8E03"><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—</text><clause id="HCC4595275B5D47ADB81DF50E81B9E9A5"><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="H68D354580A5747439B0147E9759ABBF8"><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="H4A8306B4F5AE4CF39A2C7348FC1DCC9B"><enum>(II)</enum><text>to the extent applicable, using funds reserved under subsection (f), 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="H6491FAD5C3B24B56835F9FF5DF9C3ED2"><enum>(ii)</enum><text>to establish initiatives to conduct outreach and community engagement efforts within communities throughout the State or 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="H58BE57093CD344C89E026AC49D33CB01"><enum>(iii)</enum><text>to release public reports assessing—</text><subclause id="H28ED50049F7F4A378944F24F3FC2DCFE"><enum>(I)</enum><text display-inline="yes-display-inline">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 pregnant and postpartum individuals from racial and ethnic minority groups (as such term is defined in section 1707(g)(1)) who have suffered pregnancy-related deaths; and</text></subclause><subclause id="H475E3934BE34464998C841C7FEE5F35E"><enum>(II)</enum><text>the impact of the use of funds made available pursuant to subparagraph (C) on increasing the diversity of the maternal mortality review committee membership and promoting community engagement efforts throughout the State or Tribe.</text></subclause></clause></subparagraph><subparagraph id="HE4EC2323C55646648DAA37A335CD7E7A"><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 Tribe.</text></subparagraph><subparagraph id="HE069C03C5E044EA789C6330172604BE0"><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 2022 through 2026.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection id="HAA831B0C913C4CD1BF02A17B3A957D97"><enum>(b)</enum><header>Definitions</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="id8E12124CD3E54DB7A098807D8A3E5FF3"><enum>(1)</enum><text>in paragraph (2), by striking <quote>and</quote> at the end;</text></paragraph><paragraph id="idF7FF833655D54B0CB0A93F6514ED9170"><enum>(2)</enum><text>in paragraph (3)(B), by striking the period and inserting <quote>; and</quote>; and</text></paragraph><paragraph id="id2C1B28C57654471DA77584400165675C"><enum>(3)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id1F0DA5AA618C4FAABDECDDC1468F36F2"><paragraph id="idC34E7B4DAD0A4E5B82B7060EC8C69FAC"><enum>(4)</enum><text>the term <term>urban Indian organization</term> has the meaning given such term in section 4 of the Indian Health Care Improvement Act.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="id454E8C2382A4484E9DCE0DA8A732BBB4"><enum>(c)</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.</quote>.</text></subsection></section><section id="HF89EBA393E11466282C22BE4F3BDAA23"><enum>502.</enum><header>Data collection and review</header><text display-inline="no-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="HED453C2CAC784E11B59230FC9EB2D521"><enum>(1)</enum><text>by redesignating subclauses (II) and (III) as subclauses (V) and (VI), respectively; and</text></paragraph><paragraph id="H4AC4ED469A3B4DC88AA38766D8146139"><enum>(2)</enum><text>by inserting after subclause (I) the following:</text><quoted-block style="OLC" id="H5DC33657473147CB9E52430AEED427F7"><subclause id="H55D7A2FEA4274AE0B32034E0B1EC9651"><enum>(II)</enum><text>to the extent practicable, reviewing cases of severe maternal morbidity, according to the most up-to-date indicators;</text></subclause><subclause id="H71616485482A42D49AE2E99BD1C49443"><enum>(III)</enum><text display-inline="yes-display-inline">to the extent practicable, reviewing deaths during pregnancy or up to 1 year after the end of a pregnancy from suicide, overdose, or other death from a mental health condition or substance use disorder attributed to or aggravated by pregnancy or childbirth complications;</text></subclause><subclause id="H22A3974CD52E44EB8F58B6341464AE40"><enum>(IV)</enum><text display-inline="yes-display-inline">to the extent practicable, consulting with local community-based organizations representing pregnant and postpartum individuals 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></section><section id="HB5DE6E15157E4120ABBC66B66F83FB03"><enum>503.</enum><header>Review of maternal health data collection processes and quality measures</header><subsection id="H1882C03C969E49A78BC921149E18FA91"><enum>(a)</enum><header>In general</header><text>The Secretary of Health and Human Services, acting through the Administrator for Centers for Medicare & Medicaid Services and the Director of the Agency for Healthcare Research and Quality, shall consult with relevant stakeholders—</text><paragraph id="H3C27B274DFF84359A6AF9E902637E94C"><enum>(1)</enum><text>to review existing maternal health data collection processes and quality measures; and</text></paragraph><paragraph id="H1C3D939EE3974301B5920E091F33ACA5"><enum>(2)</enum><text>make recommendations to improve such processes and measures, including topics described in subsection (c).</text></paragraph></subsection><subsection id="HCBA6859B5A5945B38DC832AD0F54BF2C"><enum>(b)</enum><header>Collaboration</header><text>In carrying out this section, the Secretary shall consult with a diverse group of maternal health stakeholders, which may include—</text><paragraph id="H4AF44349C46F4A3ABB4B4D2130B428A8"><enum>(1)</enum><text>pregnant and postpartum individuals and their family members, and nonprofit organizations representing such individuals, with a particular focus on patients from racial and ethnic minority groups;</text></paragraph><paragraph id="HDF8D1B7049A244F496FCD737D549ED29"><enum>(2)</enum><text>community-based organizations that provide support for pregnant and postpartum individuals, with a particular focus on patients from racial and ethnic minority groups;</text></paragraph><paragraph id="HD40B232BF2BE42EE9521204ED6EE81E5"><enum>(3)</enum><text>membership organizations for maternity care providers;</text></paragraph><paragraph id="H71608912DB9C40A7A2F3DCC69EFB2B94"><enum>(4)</enum><text>organizations representing perinatal health workers;</text></paragraph><paragraph id="H075B9654CB5D43728EF2D4E66ABF7B65"><enum>(5)</enum><text>organizations that focus on maternal mental or behavioral health;</text></paragraph><paragraph id="H1F0E0FCC48A246969DF7F3503AEBC2A8"><enum>(6)</enum><text>organizations that focus on intimate partner violence;</text></paragraph><paragraph id="HE961C1FBCF2D423C870E7AD9205822C3"><enum>(7)</enum><text>institutions of higher education, with a particular focus on minority-serving institutions;</text></paragraph><paragraph id="H9C8B94FB64F449E480A05EB666BDF3BB"><enum>(8)</enum><text>licensed and accredited hospitals, birth centers, midwifery practices, or other medical practices that provide maternal health care services to pregnant and postpartum patients;</text></paragraph><paragraph id="H51C6AEC1DA984D38A78590591BA733C8"><enum>(9)</enum><text>relevant State and local public agencies, including State maternal mortality review committees; and</text></paragraph><paragraph id="H5A30C2D318D8495F8CF25ED11DF16018"><enum>(10)</enum><text>the National Quality Forum, or such other standard-setting organizations specified by the Secretary.</text></paragraph></subsection><subsection id="H55EACA256BC14F0C9AE4C502D5BCF3E3"><enum>(c)</enum><header>Topics</header><text>The review of maternal health data collection processes and recommendations to improve such processes and measures required under subsection (a) shall assess all available relevant information, including information from State-level sources, and shall consider at least the following:</text><paragraph id="HFFE55C5450954F90AAF625AED6F097BD"><enum>(1)</enum><text>Current State and Tribal practices for maternal health, maternal mortality, and severe maternal morbidity data collection and dissemination, including consideration of—</text><subparagraph id="HA97FE8B4075D4AAF93EEA57D899B7E10"><enum>(A)</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></subparagraph><subparagraph id="HFD1E34F42CDE43DDA0EDFE55038C7A69"><enum>(B)</enum><text display-inline="yes-display-inline">relevant data collected with electronic health records, including data on race, ethnicity, socioeconomic status, insurance type, and other relevant demographic information;</text></subparagraph><subparagraph id="H91D1266B9E5A4D858BC58E18ED57CBA4"><enum>(C)</enum><text display-inline="yes-display-inline">maternal health data collected and publicly reported by hospitals, health systems, midwifery practices, and birth centers;</text></subparagraph><subparagraph id="H8DBE8B99AF5D49B58212B745A86D7EA4"><enum>(D)</enum><text>the barriers preventing States from correlating maternal outcome data with race and ethnicity data;</text></subparagraph><subparagraph id="H20B077B7D2434DA399DBF09537168DEA"><enum>(E)</enum><text>processes for determining the cause of a pregnancy-associated death in States that do not have a maternal mortality review committee;</text></subparagraph><subparagraph id="H0BE8F71AD3534EA88EA6299A33FA3D02"><enum>(F)</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></subparagraph><subparagraph id="H5BF6A31D42A44660B7DDA730E1BBADED"><enum>(G)</enum><text>whether members of maternal mortality review committees participate in trainings on bias, racism, or discrimination, and the quality of such trainings;</text></subparagraph><subparagraph id="H0B441D2A0FCD42BD9D76F8856F570E85"><enum>(H)</enum><text>the extent to which States have implemented systematic processes of listening to the stories of pregnant and postpartum individuals and their family members, with a particular focus on pregnant and postpartum individuals from racial and ethnic minority groups (as such term is defined in section 1707(g)(1) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300u-6">42 U.S.C. 300u–6(g)(1)</external-xref>)) 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></subparagraph><subparagraph id="HF9D02F1AE830427DA1DAA394D7A085B0"><enum>(I)</enum><text>the extent to which maternal mortality review committees are considering social determinants of maternal health when examining the causes of pregnancy-associated and pregnancy-related deaths;</text></subparagraph><subparagraph id="H6A35EBA625634C9E8A99081046457747"><enum>(J)</enum><text>the extent to which maternal mortality review committees are making actionable recommendations based on their reviews of adverse maternal health outcomes and the extent to which such recommendations are being implemented by appropriate stakeholders;</text></subparagraph><subparagraph id="H05DB5EF824944F1DB216F7254DD3C13B"><enum>(K)</enum><text>the legal and administrative barriers preventing the collection, collation, and dissemination of State maternity care data;</text></subparagraph><subparagraph id="HE9158FB3F5DA44CEB74340AFFAE26653"><enum>(L)</enum><text>the effectiveness of data collection and reporting processes in separating pregnancy-associated deaths from pregnancy-related deaths; and</text></subparagraph><subparagraph id="H05545E5C35A2497B8CDD490DDC4BC9D5"><enum>(M)</enum><text>the current Federal, State, local, and Tribal funding support for the activities referred to in subparagraphs (A) through (L).</text></subparagraph></paragraph><paragraph id="H163B3C83AE3344A0850E21C31D851185"><enum>(2)</enum><text>Whether the funding support referred to in paragraph (1)(M) 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></paragraph><paragraph id="HF2C178AE28FD49B0A5FD51BFD2BEB059"><enum>(3)</enum><text>Current quality measures for maternity care, including prenatal measures, labor and delivery measures, and postpartum measures, including topics such as—</text><subparagraph id="HA717A39A12DB45F2B1BDC1F88EAB84D1"><enum>(A)</enum><text display-inline="yes-display-inline">effective quality measures for maternity care used by hospitals, health systems, midwifery practices, birth centers, health plans, and other relevant entities;</text></subparagraph><subparagraph id="H4DE046713D984DB1ACFEDE939A90D06F"><enum>(B)</enum><text display-inline="yes-display-inline">the sufficiency of current outcome measures used to evaluate maternity care for driving improved care, experiences, and outcomes in maternity care payment and delivery system models;</text></subparagraph><subparagraph id="H2F853FADEF654BEBB2680171029D9C45"><enum>(C)</enum><text display-inline="yes-display-inline">maternal health quality measures that other countries effectively use;</text></subparagraph><subparagraph id="HB6F74E3A077248ED8CB4A78D87ACB4E0"><enum>(D)</enum><text display-inline="yes-display-inline">validated measures that have been used for research purposes that could be tested, refined, and submitted for national endorsement;</text></subparagraph><subparagraph id="HCD94DB727DC141C2A2CF33B8901DF36C"><enum>(E)</enum><text>barriers preventing maternity care providers and insurers from implementing quality measures that are aligned with best practices;</text></subparagraph><subparagraph id="H75F287112B8F4581AEA82010E4EDEF1B"><enum>(F)</enum><text>the frequency with which maternity care quality measures are reviewed and revised;</text></subparagraph><subparagraph id="H53256074440C426B91540EAB846E48A3"><enum>(G)</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></subparagraph><subparagraph id="H9F5180A910794CF18264EE4E940CBC7B"><enum>(H)</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/42/1397">42 U.S.C. 1397</external-xref> et seq.), including the extent to which States voluntarily report relevant measures;</text></subparagraph><subparagraph id="H8EC91B0D8C9F4A76BA2125F49F8F7DAE"><enum>(I)</enum><text>the extent to which maternity care quality measures are informed by patient experiences that include measures of patient-reported experience of care;</text></subparagraph><subparagraph id="HC861F573E09B454399304BD85BF62C47"><enum>(J)</enum><text display-inline="yes-display-inline">the current processes for collecting stratified data on the race and ethnicity of pregnant and postpartum individuals in hospitals, health systems, midwifery practices, and birth centers, and for incorporating such racially and ethnically stratified data in maternity care quality measures;</text></subparagraph><subparagraph id="H1C8EA8AFD3CE4099BADB5087CAD291EF"><enum>(K)</enum><text>the extent to which maternity care quality measures account for the unique experiences of pregnant and postpartum individuals from racial and ethnic minority groups (as such term is defined in section 1707(g)(1) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300u-6">42 U.S.C. 300u–6(g)(1)</external-xref>)); and</text></subparagraph><subparagraph id="HF0810CE83CA04DC387F95243C5EAE23F"><enum>(L)</enum><text display-inline="yes-display-inline">the extent to which hospitals, health systems, midwifery practices, and birth centers are implementing existing maternity care quality measures.</text></subparagraph></paragraph><paragraph id="HDDB4B69B13FA4B83B269C2A65A760AA7"><enum>(4)</enum><text display-inline="yes-display-inline">Recommendations on authorizing additional funds and providing additional technical assistance to improve maternal mortality review committees and State and Tribal maternal health data collection and reporting processes.</text></paragraph><paragraph id="H7EE41FF360AC4389B1EF573842AE9159"><enum>(5)</enum><text>Recommendations for new authorities that may be granted to maternal mortality review committees to be able to—</text><subparagraph id="H4929A83FA4844873A8EC734A1C6B559E"><enum>(A)</enum><text display-inline="yes-display-inline">access records from other Federal and State agencies and departments that may be necessary to identify causes of pregnancy-associated and pregnancy-related deaths that are unique to pregnant and postpartum individuals from specific populations, such as veterans and individuals who are incarcerated; and</text></subparagraph><subparagraph id="H67D805328E5C4BCEAF97E6F7A2EB4FE3"><enum>(B)</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 pregnant and postpartum individuals from specific populations, such as veterans and individuals who are incarcerated.</text></subparagraph></paragraph><paragraph id="HC3630F4AD0674944AA8878AAD58A265D"><enum>(6)</enum><text display-inline="yes-display-inline">Recommendations to improve and standardize current quality measures for maternity care, with a particular focus on racial and ethnic disparities in maternal health outcomes.</text></paragraph><paragraph id="HA65AA2ACC8AC4C0A97442ADE799D4EB3"><enum>(7)</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></paragraph></subsection><subsection id="HD90CD77D638341A88568D1694239C5D1"><enum>(d)</enum><header>Report</header><text>Not later than 1 year after the date of enactment of this Act, the Secretary shall submit to Congress and make publicly available a report on the results of the review of maternal health data collection processes and quality measures and recommendations to improve such processes and measures required under subsection (a).</text></subsection><subsection id="H9925C1C9EC5349F4818D0EF498E03A32"><enum>(e)</enum><header>Definitions</header><text>In this section:</text><paragraph id="id0dc4fdeba71b42bb918ad790dae0aea9"><enum>(1)</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="HEFD2BCEEC40C40B49B77D25C0FC2C0C8"><enum>(2)</enum><header>Pregnancy-associated death</header><text>The term <term>pregnancy-associated</term>, with respect to a death, means a death of a pregnant or postpartum individual, by any cause, that occurs during, or within 1 year following, the individual’s pregnancy, regardless of the outcome, duration, or site of the pregnancy.</text></paragraph><paragraph id="H96E9253051B8489E9A5CF31166D738BF"><enum>(3)</enum><header>Pregnancy-related death</header><text display-inline="yes-display-inline">The term <term>pregnancy-related</term>, with respect to a death, means a death of a pregnant or postpartum individual that occurs during, or within 1 year following, the individual’s pregnancy, from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.</text></paragraph></subsection><subsection id="H4E151905A93D461F8F06000B355726AF"><enum>(f)</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 2022 through 2025.</text></subsection></section><section id="HEEBD92D9534340E39889499F6DE09623"><enum>504.</enum><header>Indian Health Service study and report on maternal mortality and severe maternal morbidity</header><subsection id="idC43D3DB573F540B3AF8DAC5DCD6BD94D"><enum>(a)</enum><header>Definitions</header><text>In this section:</text><paragraph id="id61E34F9418EA4BE6A74C12CAB2333D83"><enum>(1)</enum><header>Director</header><text>The term <term>Director</term> means the Director of the Indian Health Service.</text></paragraph><paragraph id="idB0E40CF278F84A83B50370DCD477D1E3"><enum>(2)</enum><header>Indian tribe</header><text>The term <term>Indian Tribe</term> has the meaning given the 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="HC59206405DE3438DAE5D43562BF3E1F9" commented="no"><enum>(3)</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="id7966920D2E0F4998A4065C10D002CCA1"><enum>(4)</enum><header>Tribal epidemiology center</header><text>The term <term>Tribal epidemiology center</term> means a 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>).</text></paragraph><paragraph id="idBEA0D7DC08D848E9BED3D7CDDD4F44AF"><enum>(5)</enum><header>Tribal organization</header><text>The term <term>tribal organization</term> has the meaning given the 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="idB715143FE8E54DD195FF7839E2158F5B"><enum>(6)</enum><header>Urban Indian organization</header><text>The term <term>urban Indian organization</term> has the meaning given the 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><subsection id="HC2BFE7FC117545A4AC91FFE9F2003652"><enum>(b)</enum><header>Study and report</header><paragraph id="id349C42C896234092BB0B95AFC3DC1A76"><enum>(1)</enum><header>Study</header><subparagraph id="idE1021D8FD1A74181B0D8C822F32FC43C"><enum>(A)</enum><header>In general</header><text>Not later than 90 days after the date of enactment of this Act, the Director, in coordination with the individuals selected under subsection (c), shall enter into an agreement with an independent research organization or a Tribal epidemiology center to conduct a comprehensive study on maternal mortality and severe maternal morbidity in Indian and Alaska Native populations.</text></subparagraph><subparagraph id="H4D9EA01D9B57464AA7BCD223747171E6"><enum>(B)</enum><header>Report</header><text>The agreement entered into under subparagraph (A) shall require that the independent research organization or Tribal epidemiology center submit to the Director a report describing the results of the study conducted pursuant to that agreement by not later than 2 years after the date of enactment of this Act.</text></subparagraph></paragraph><paragraph id="idEF41C457A39C4DD0AD9130084203AD61"><enum>(2)</enum><header>Contents of study</header><text>The study conducted under paragraph (1) shall—</text><subparagraph id="HE9DEAEF90BFF4CA4A04C8628F38DC83C"><enum>(A)</enum><text>examine the causes of maternal mortality and severe maternal morbidity that are unique to Indians and Alaska Natives;</text></subparagraph><subparagraph id="H481783BCDFAE4DD59444220E48CA9503"><enum>(B)</enum><text display-inline="yes-display-inline">include a systematic process of listening to the stories of pregnant and postpartum Indians and Alaska Natives to fully understand the causes of, and inform potential solutions to, the maternal mortality and severe maternal morbidity crisis within the Indian and Alaska Native communities;</text></subparagraph><subparagraph id="HA2654609F9FA4C02B9353A58539054EA"><enum>(C)</enum><text display-inline="yes-display-inline">identify the different settings in which pregnant and postpartum Indians and Alaska Natives receive maternity care, such as—</text><clause id="H955A9C1F4FFE4CA59620DF44CAA39623"><enum>(i)</enum><text>facilities operated by the Indian Health Service;</text></clause><clause id="H611DA82F5F1B475EA4FD51260C68427A"><enum>(ii)</enum><text>an Indian health program operated by an Indian Tribe or tribal organization pursuant to a grant from, or contract, cooperative agreement, or compact with, the Indian Health Service pursuant to the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/5301">25 U.S.C. 5301</external-xref> et seq.); and</text></clause><clause id="H8922E06158624D6984908ECF4A15905E"><enum>(iii)</enum><text>an urban Indian health program operated by an urban Indian organization pursuant to a grant from 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></clause></subparagraph><subparagraph id="id34F1381519F54E5A8F8883A1C59DCB47"><enum>(D)</enum><text>determine the different landscapes of maternity care received by pregnant and postpartum Indians and Alaska Natives at the different settings identified under subparagraph (C);</text></subparagraph><subparagraph id="H3CC2DC66A1EE4A4E9154288319F73E71"><enum>(E)</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 State Children’s Health Insurance Program established 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.));</text></subparagraph><subparagraph id="HC65888992F444776BCC4CB0C7CE265CD"><enum>(F)</enum><text>review current data collection and quality measurement processes and practices with respect to pregnant and postpartum Indians and Alaska Natives;</text></subparagraph><subparagraph id="H088E293CC5444DBBA986D6103A5B4338"><enum>(G)</enum><text display-inline="yes-display-inline">assess causes and frequency of maternal mental health conditions and substance use disorders with respect to Indians and Alaska Natives;</text></subparagraph><subparagraph id="HE0E7D2FED3C84B8380D04C44D22583EB"><enum>(H)</enum><text>consider social determinants of health, including poverty, lack of health insurance, unemployment, sexual violence, and environmental conditions in Tribal areas;</text></subparagraph><subparagraph id="HE8E94EB06A8B4FB8AEB9429BA5EB9015"><enum>(I)</enum><text>consider the role that historical mistreatment of Indian and Alaska Native women has played in causing currently high rates of maternal mortality and severe maternal morbidity;</text></subparagraph><subparagraph id="HBC0697B4AC6A450B8CC0282431498BD0"><enum>(J)</enum><text>consider how current funding of the Indian Health Service affects the ability of the Indian Health Service to deliver quality maternity care; and</text></subparagraph><subparagraph id="H9F83A8CC1D8F49068FBEF00BB5486665"><enum>(K)</enum><text display-inline="yes-display-inline">consider the extent to which the delivery of maternity care services is culturally appropriate for pregnant and postpartum Indians and Alaska Natives.</text></subparagraph></paragraph><paragraph id="HCA0FEB29919840DE81D92619C5F2A683"><enum>(3)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 3 years after the date of enactment of this Act, the Director shall submit to Congress a report describing the results of the study conducted under paragraph (1), including recommendations for policies and practices that can be adopted to improve maternal health outcomes for pregnant and postpartum Indians and Alaska Natives, including recommendations—</text><subparagraph id="id27C9B27F03C248E488F657D4ECCA1E91"><enum>(A)</enum><text>on how to improve maternal health outcomes for Indians and Alaska Natives receiving care at the different settings identified under paragraph (2)(C); </text></subparagraph><subparagraph id="H6328791DF9BD47A7AB326989C7280629"><enum>(B)</enum><text display-inline="yes-display-inline">on how to reduce misclassification of pregnant and postpartum Indians and Alaska Natives, including consideration of best practices in training for members of maternal mortality review committees to be able to correctly classify Indians and Alaska Natives; and</text></subparagraph><subparagraph id="H2A8E1341990344FEB0E84971E83D8D6D"><enum>(C)</enum><text display-inline="yes-display-inline">informed by the stories shared by pregnant and postpartum Indians and Alaska Natives under paragraph (2)(B) to improve maternal health outcomes for those individuals. </text></subparagraph></paragraph></subsection><subsection id="H965A811B159445DD90DE10E414817683"><enum>(c)</enum><header>Participating individuals</header><paragraph id="idCFAA06BE04EC472C9CEBF08B708291B6"><enum>(1)</enum><header>In general</header><text>The Director shall select from among individuals nominated by Indian Tribes, tribal organizations, and urban Indian organizations 12 individuals for participation in the study conducted under subsection (b)(1). </text></paragraph><paragraph id="id36E7B7418B974A3E8103384C653AF0D0"><enum>(2)</enum><header>Requirement</header><text>In selecting members 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="HDA572E9A97064592800D75AA08C91E03" commented="no" display-inline="no-display-inline"><enum>(d)</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 2022 through 2024.</text></subsection></section><section id="H39AB8E65EA224D019D6755E00367DE98"><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="H19CB8EAE616547F7AD74F94EB7F78960"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services shall establish a program under which the Secretary shall award grants to research centers, health professions schools and programs, and other entities at minority-serving institutions to study specific aspects of the maternal health crisis among pregnant and postpartum individuals from racial and ethnic minority groups. Such research may—</text><paragraph id="HD77B0B7EC4A1471E872E515ABDEA61DA"><enum>(1)</enum><text display-inline="yes-display-inline">include the development and implementation of systematic processes of listening to the stories of pregnant and postpartum individuals from racial and ethnic minority groups, and perinatal health workers supporting such individuals, 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="H92FA5CC83E4C4D9B8DAEFB079F4E1EE4"><enum>(2)</enum><text>assess the potential causes of relatively low rates of maternal mortality among Hispanic individuals, including potential racial misclassification and other data collection and reporting issues that might be misrepresenting maternal mortality rates among Hispanic individuals in the United States; and</text></paragraph><paragraph id="HC10C1279A2194546A9B4B12E99D80D11"><enum>(3)</enum><text display-inline="yes-display-inline">assess differences in rates of adverse maternal health outcomes among subgroups identifying as Hispanic.</text></paragraph></subsection><subsection id="H5F9C6C4CE7D74B4DB718798173F65D44"><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="HA1362911AA0A4AE9B2DE53B589440571"><enum>(c)</enum><header>Technical assistance</header><text>The Secretary may use not more than 10 percent of the funds made available under subsection (g)—</text><paragraph id="H1F665DE4D08D4E31AC4CCD14A61833DB"><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="HFAC562EFFAF64A148AF02485192D0FF2"><enum>(2)</enum><text>to provide technical assistance in the application process for such a grant; and</text></paragraph><paragraph id="H4A3150D10E814360B132C113095F3093"><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="H68F977CEF55246A288B0D94AF46C119C"><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="HED7F979888E7476BBE1B0862E8EFD699"><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="H6C99510842A142AC948CD76D27FBD695"><enum>(f)</enum><header>Minority-Serving institutions defined</header><text>In this section, the term <term>minority-serving institution</term> has the meaning given the term 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><subsection id="HA98FFF0FE6494ED39B634CD15508466F"><enum>(g)</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 2022 through 2026.</text></subsection></section><enum>VI</enum><header>Moms matter</header><section id="H6C875B6BAF554980812213988FFBE286"><enum>601.</enum><header>Maternal mental health equity grant program</header><subsection id="H0CC1267A87144D7586694E3CF1CA0A9F"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall establish a program to award grants to eligible entities to address maternal mental health conditions and substance use disorders with respect to pregnant and postpartum individuals, with a focus on racial and ethnic minority groups.</text></subsection><subsection id="H1549BB99CA9241E091F911528C856CB0"><enum>(b)</enum><header>Application</header><text>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 provide, including how such entity will use funds for activities described in subsection (d) that are culturally congruent.</text></subsection><subsection id="H4F4EEE25F3D348E08A63B8C828F22D47"><enum>(c)</enum><header>Priority</header><text>In awarding grants under this section, the Secretary shall give priority to an eligible entity that—</text><paragraph id="H855189BEB2574EE981F1389CB454E9F3"><enum>(1)</enum><text>is, or will partner with, a community-based organization to address maternal mental health conditions and substance use disorders described in subsection (a);</text></paragraph><paragraph id="H65C29486D1034F28AFACF0CD66E2AEEF"><enum>(2)</enum><text>is operating in an area with high rates of—</text><subparagraph id="HEA482DE0DE7948FB8E0D7F7AF0374B31"><enum>(A)</enum><text>adverse maternal health outcomes; or</text></subparagraph><subparagraph id="H3CD4CBCB961840FE969E6C33CEB82A2D"><enum>(B)</enum><text>significant racial or ethnic disparities in maternal health outcomes; and</text></subparagraph></paragraph><paragraph id="H41427F57804D45AC97632F714CD2DB01"><enum>(3)</enum><text>is operating 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>).</text></paragraph></subsection><subsection id="H774AE588A8C341DCB372F6F0D6C7106A"><enum>(d)</enum><header>Use of funds</header><text>An eligible entity that receives a grant under this section shall use funds for the following:</text><paragraph id="HD92F4DA29F0B4176A54AC5767F5D1AFE"><enum>(1)</enum><text display-inline="yes-display-inline">Establishing or expanding maternity care programs to improve the integration of maternal health and behavioral health care services into primary care settings where pregnant individuals regularly receive health care services.</text></paragraph><paragraph id="H1DDCCCC2480244108F0EC6B120CBE8D4"><enum>(2)</enum><text>Establishing or expanding group prenatal care programs or postpartum care programs.</text></paragraph><paragraph id="H99895F12F85E44C89DAE1CA374FB5352"><enum>(3)</enum><text>Expanding existing programs that improve maternal mental and behavioral health during the prenatal and postpartum periods, with a focus on individuals from racial and ethnic minority groups.</text></paragraph><paragraph id="H5A4A15AEC56F43A88EDFF28CDB138D7E"><enum>(4)</enum><text>Providing services and support for pregnant and postpartum individuals with maternal mental health conditions and substance use disorders, including referrals to addiction treatment centers that offer evidence-based treatment options.</text></paragraph><paragraph id="HB58551A0B0E1497D925F30619415CF11"><enum>(5)</enum><text>Addressing stigma associated with maternal mental health conditions and substance use disorders, with a focus on racial and ethnic minority groups.</text></paragraph><paragraph id="H633033FF20DD4CD8BC3791AFFCE848DB"><enum>(6)</enum><text>Raising awareness of warning signs of maternal mental health conditions and substance use disorders, with a focus on pregnant and postpartum individuals from racial and ethnic minority groups.</text></paragraph><paragraph id="HC7B4155FCA274E228AF6AC9B2A48E601"><enum>(7)</enum><text>Establishing or expanding programs to prevent suicide or self-harm among pregnant and postpartum individuals.</text></paragraph><paragraph id="HA616A4EDC5F147F88E44C6EABE89D3AD"><enum>(8)</enum><text>Offering evidence-aligned programs at freestanding birth centers that provide maternal mental and behavioral health care education, treatments, and services, and other services for individuals throughout the prenatal and postpartum period.</text></paragraph><paragraph id="HA3C8EBE8E2AD41C89BF8249EEBDF06B0"><enum>(9)</enum><text>Establishing or expanding programs to provide education and training to maternity care providers with respect to—</text><subparagraph id="HA290B25CFF1A42D5A263559F5D4EB28C"><enum>(A)</enum><text>identifying potential warning signs for maternal mental health conditions or substance use disorders in pregnant and postpartum individuals, with a focus on individuals from racial and ethnic minority groups; and</text></subparagraph><subparagraph id="HCEE60DEC53A740C69CF1C04D068D44E9"><enum>(B)</enum><text>in the case where such providers identify such warning signs, offering referrals to mental and behavioral health care professionals.</text></subparagraph></paragraph><paragraph id="H95896D4132B54566836954782EFD68A0"><enum>(10)</enum><text>Developing a website, or other source, that includes information on health care providers who treat maternal mental health conditions and substance use disorders.</text></paragraph><paragraph id="HD30D089655524357AC9368351927A7A0"><enum>(11)</enum><text>Establishing or expanding programs in communities to improve coordination between maternity care providers and mental and behavioral health care providers who treat maternal mental health conditions and substance use disorders, including through the use of toll-free hotlines.</text></paragraph><paragraph id="HFAA8186A4E6841898F1F7AE5112BA622"><enum>(12)</enum><text>Carrying out other programs aligned with evidence-based practices for addressing maternal mental health conditions and substance use disorders for pregnant and postpartum individuals from racial and ethnic minority groups.</text></paragraph></subsection><subsection id="H6B62443F09094907A4D68A15303E1306"><enum>(e)</enum><header>Reporting</header><paragraph id="HE28297642B9A4B20957CC61CBB5C8908"><enum>(1)</enum><header>Eligible entities</header><text>An eligible entity that receives a grant under subsection (a) shall submit annually to the Secretary, and make publicly available, a report on the activities conducted using funds received through a grant under this section. Such reports shall include quantitative and qualitative evaluations of such activities, including the experience of individuals who received health care through such grant.</text></paragraph><paragraph id="HF0F2578EE540457395D2814CD9076D4D"><enum>(2)</enum><header>Secretary</header><text>Not later than the end of fiscal year 2024, the Secretary shall submit to Congress a report that includes—</text><subparagraph id="H34EBEFFE7791467DA60C3720E41860A4"><enum>(A)</enum><text>a summary of the reports received under paragraph (1);</text></subparagraph><subparagraph id="H551D75162D51498781FEB0DE051E48A2"><enum>(B)</enum><text display-inline="yes-display-inline">an evaluation of the effectiveness of grants awarded under this section;</text></subparagraph><subparagraph id="H5424AE54974849F3939BB7DDBE1F2317"><enum>(C)</enum><text> recommendations with respect to expanding coverage of evidence-based screenings and treatments for maternal mental health conditions and substance use disorders; and</text></subparagraph><subparagraph id="HB1E94FB820BF400B815D626FD5C5EB1D"><enum>(D)</enum><text>recommendations with respect to ensuring activities described under subsection (d) continue after the end of a grant period.</text></subparagraph></paragraph></subsection><subsection id="HE9A806D1E9A34B4786B24871695AA2B7"><enum>(f)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H11D00B78B61344D8B94348E9C5D3F002"><enum>(1)</enum><header>Eligible entity</header><text>The term <term>eligible entity</term> means—</text><subparagraph id="H905D444E53044969BFF6170848B0C20E"><enum>(A)</enum><text>a community-based organization serving pregnant and postpartum individuals, including such organizations serving individuals from racial and ethnic minority groups and other underserved populations;</text></subparagraph><subparagraph id="H1853A0D4845A49C7A7CE0C1A7EAFA2DC"><enum>(B)</enum><text>a nonprofit or patient advocacy organization with expertise in maternal mental and behavioral health;</text></subparagraph><subparagraph id="H1214B60698A6422382DEFC9BC032B503"><enum>(C)</enum><text>a maternity care provider;</text></subparagraph><subparagraph id="HBE3B673870CA4620AEEB44AAD49DEA7C"><enum>(D)</enum><text>a mental or behavioral health care provider who treats maternal mental health conditions or substance use disorders;</text></subparagraph><subparagraph id="H748A4F98F1A140BE8542CE363916E944"><enum>(E)</enum><text>a State or local governmental entity, including a State or local public health department;</text></subparagraph><subparagraph id="H120C9C79A3C546868DEB63D33A0331CC"><enum>(F)</enum><text>an Indian Tribe or Tribal organization (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</text></subparagraph><subparagraph id="H4229600CC0694765B86544A9EACEAAB1"><enum>(G)</enum><text>an 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></subparagraph></paragraph><paragraph id="HE1F8B27D6B694EDBB30CC8C7985F95FA"><enum>(2)</enum><header>Freestanding birth center</header><text display-inline="yes-display-inline">The term <term>freestanding birth center</term> has the meaning given that term under section 1905(l) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(1)</external-xref>).</text></paragraph><paragraph id="H7ADC4FD3B64C4F89B657872A732BE15F"><enum>(3)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph></subsection><subsection id="H6D73D468E0534C549BDA323C58A596D6"><enum>(g)</enum><header>Authorization of appropriations</header><text>To carry out this section, there is authorized to be appropriated $25,000,000 for each of fiscal years 2022 through 2025.</text></subsection></section><section id="HCEB017317B1A47D3BAB75C5BEEC642C6"><enum>602.</enum><header>Grants to grow and diversify the maternal mental and behavioral health care workforce</header><text display-inline="no-display-inline">Title VII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/292">42 U.S.C. 292</external-xref> et seq.) is amended by inserting after section 758 of such Act, as added by section 402 of this Act, the following new section:</text><quoted-block style="OLC" id="HAFE0DF32D4514055AE890D2CD751D03D"><section id="H831E099B040E4A67ACCCFD1BC5136D56"><enum>758A.</enum><header>Maternal mental and behavioral health care workforce grants</header><subsection id="H3133736DFA0C48E39899FE99D8A79824"><enum>(a)</enum><header>In general</header><text>The Secretary may award grants to entities to establish or expand programs described in subsection (b) to grow and diversify the maternal mental and behavioral health care workforce.</text></subsection><subsection id="H0A823C0475F44C1DA02C16EDE9495E4A"><enum>(b)</enum><header>Use of funds</header><text>Recipients of grants under this section shall use the grants to grow and diversify the maternal mental and behavioral health care workforce by—</text><paragraph id="H3043FCAF2CB947E7B3104F62B0012FEB"><enum>(1)</enum><text>establishing schools or programs that provide education and training to individuals seeking appropriate licensing or certification as mental or behavioral health care providers who will specialize in maternal mental health conditions or substance use disorders; or</text></paragraph><paragraph id="H93924DBFAE114BEE8400488FE9271810"><enum>(2)</enum><text>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="HAA265F8B915C460C9D2B4CC0AD2A4DFB"><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="H1D4A8204BCC6489FBF486F982CB0C15C"><enum>(1)</enum><text>has demonstrated a commitment to recruiting and retaining students and faculty from racial and ethnic minority groups;</text></paragraph><paragraph id="H6D5AB6C403D7421CB5A6DC67F148CB3A"><enum>(2)</enum><text>has developed a strategy to recruit and retain a diverse pool of students into the maternal mental or behavioral health care workforce program or school supported by funds received through the grant, particularly from racial and ethnic minority groups and other underserved populations;</text></paragraph><paragraph id="HD4E928AE0DB44C66B1768A8F65972640"><enum>(3)</enum><text>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="H5AB307AF8E2548159353B9E283316E2C"><enum>(4)</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, to the extent practicable; and</text></paragraph><paragraph id="H3DE03B23831B41468FBDC388368C51DF"><enum>(5)</enum><text>includes in the standard curriculum for all students within the maternal mental or behavioral health care workforce program or school a bias, racism, or discrimination training program that includes training on implicit bias and racism.</text></paragraph></subsection><subsection id="HE92ED682E95E4C74BE32008F160B549E"><enum>(d)</enum><header>Reporting</header><text>As a condition on receipt of a grant under this section for a maternal mental or behavioral health care 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="H129D1B74B14B4F4589F2E841749C1DE2"><enum>(1)</enum><text>the number and demographics of students participating in the program or school;</text></paragraph><paragraph id="H2D4F3C3077FC4B59AD72AA1EF85F2D20"><enum>(2)</enum><text>the extent to which students in the program or school are entering careers in—</text><subparagraph id="H14D3B0C2B1824A11B372D1E93FEE390A"><enum>(A)</enum><text>health professional shortage areas designated under section 332; and</text></subparagraph><subparagraph id="H5EA3AF3BDBDB4114A26C57AAC5BB21B8"><enum>(B)</enum><text>areas with significant racial and ethnic disparities in maternal health outcomes, to the extent such data are available; and</text></subparagraph></paragraph><paragraph id="H1FE617FD214A47A0A3D6268015D8E4EB"><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 training on implicit bias and racism, and if so the effectiveness of such training program.</text></paragraph></subsection><subsection id="H33462DED6EF8474AA54F2BE39A922E43"><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="H96FC6553A488475EBC4F5423887E5E4A"><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="HBC925CF82D9243668A66D62F1AB9C3BC"><enum>(g)</enum><header>Technical assistance</header><text>The Secretary shall provide, directly or by contract, technical assistance to entities seeking or receiving a grant under this section on the development, use, evaluation, and post-grant period sustainability of the maternal mental or behavioral health care workforce programs or schools proposed to be, or being, established or expanded through the grant.</text></subsection><subsection id="H864AD988E91D44E3BFF875A5781EA0A7"><enum>(h)</enum><header>Report by the secretary</header><text>Not later than 4 years after the date of enactment of this section, the Secretary shall prepare and submit to 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="H9C3C516FAB854BFA888F7F1DCDC4A599"><enum>(1)</enum><text>recruiting students from racial and ethnic minority groups and other underserved populations;</text></paragraph><paragraph id="HE4604113BC404B818538C812C5881474"><enum>(2)</enum><text>increasing the number of mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders from racial and ethnic minority groups and other underserved populations;</text></paragraph><paragraph id="H2D58A0535EE14ACB9E2CF0F8B650B037"><enum>(3)</enum><text>increasing the number of mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders working in health professional shortage areas designated under section 332; and</text></paragraph><paragraph id="H6577182B4F1042E69A7481DCF84283EA"><enum>(4)</enum><text>increasing the number of mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders working in areas with significant racial and ethnic disparities in maternal health outcomes, to the extent such data are available.</text></paragraph></subsection><subsection id="HFF384939D11945A6902DBE8BCE8343FF"><enum>(i)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section:</text><paragraph id="H1DF8958D37BA41709457FAC1642C1E6A"><enum>(1)</enum><header>Racial and ethnic minority group</header><text>The term <term>racial and ethnic minority group</term> has the meaning given such term in section 1707(g)(1).</text></paragraph><paragraph id="H04A62E5E22D448538892AE2E2AF63C7F"><enum>(2)</enum><header>Mental or behavioral health care provider</header><text>The term <term>mental or behavioral health care provider</term> refers to a health care provider in the field of mental and behavioral health, including substance use disorders, acting in accordance with State law.</text></paragraph></subsection><subsection id="H285460D6D7BF485280CFB57238CAE95F"><enum>(j)</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 2022 through 2026.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><enum>VII</enum><header>Justice for incarcerated moms</header><section id="HFD86CBE8AEE74A51AB95511A1EAC21E1"><enum>701.</enum><header>Ending the shackling of pregnant individuals</header><subsection id="HDF33D58B30224F2D9A2D3DEC6CD65270"><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 annually thereafter, in each State that receives a grant 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>) and that does not have in effect throughout the State for such fiscal year laws restricting 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, the amount of such grant that would otherwise be allocated to such State under such subpart for the fiscal year shall be decreased by 25 percent.</text></subsection><subsection id="HCB9BFFFD4A4541DBBF570D1A3EEBA08F"><enum>(b)</enum><header>Reallocation</header><text>Amounts not allocated to a State for failure to comply with 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 have complied with such subsection.</text></subsection></section><section id="HF04F142C4B104043B62254C3DE97B86B"><enum>702.</enum><header>Creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods</header><subsection id="H2091BC78F8B64730A1849B7A21298ED9"><enum>(a)</enum><header>Establishment</header><paragraph id="idA8BDA15267F642C4BB5B0BCE16D6E273"><enum>(1)</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 fewer than 6 Bureau of Prisons facilities, programs to optimize maternal health outcomes for pregnant and postpartum individuals incarcerated in such facilities. </text></paragraph><paragraph id="id6D1D39A3BE874541892325BA87D9A488"><enum>(2)</enum><header>Required consultation</header><text display-inline="yes-display-inline">The Attorney General shall establish the programs authorized under paragraph (1) in consultation with stakeholders such as—</text><subparagraph id="H91FA012F66A04170988423F4B2F82C6E"><enum>(A)</enum><text display-inline="yes-display-inline">relevant community-based organizations, particularly organizations that represent incarcerated and formerly incarcerated individuals and organizations that seek to improve maternal health outcomes for pregnant and postpartum individuals from racial and ethnic minority groups;</text></subparagraph><subparagraph id="HFD1D8AB52A92497CB8B678728E99FD39"><enum>(B)</enum><text display-inline="yes-display-inline">relevant organizations representing patients, with a particular focus on patients from racial and ethnic minority groups;</text></subparagraph><subparagraph id="H2D90C4CD786A40059BFA896774709204"><enum>(C)</enum><text display-inline="yes-display-inline">organizations representing maternity care providers and maternal health care education programs;</text></subparagraph><subparagraph id="HD6009C9A0E84447C8131380B1B9EA748" commented="no"><enum>(D)</enum><text>perinatal health workers; and</text></subparagraph><subparagraph id="HAB20B8D616144BCBABD69B9A212335C6"><enum>(E)</enum><text>researchers and policy experts in fields related to maternal health care for incarcerated individuals.</text></subparagraph></paragraph></subsection><subsection id="HCABC89BE1BCF4FC3B5146876A19B5884" commented="no"><enum>(b)</enum><header>Start date</header><text>Each facility selected under subsection (a) shall begin facility programs not later than 18 months after the date of enactment of this Act. </text></subsection><subsection id="HC720B8C801144F08BE9F347E632D5DFD"><enum>(c)</enum><header>Facility priority</header><text display-inline="yes-display-inline">In carrying out subsection (a), the Director shall give priority to a facility based on—</text><paragraph id="H291FE70EA5434EEEB90FCA4827E79EBA"><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 individuals from racial and ethnic minority groups; and</text></paragraph><paragraph id="H94AF22A23A864F7B92D043669703DFF5"><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="H96DFCD8CBB9349199E7BF7507463ECF5"><enum>(d)</enum><header>Program duration</header><text display-inline="yes-display-inline">The programs established under this section shall be for a 5-year period.</text></subsection><subsection id="H6B0DA6F9E80847B9B5BA44A1A57D9E20"><enum>(e)</enum><header>Programs</header><text display-inline="yes-display-inline">Bureau of Prisons facilities selected by the Director shall establish programs for pregnant and postpartum incarcerated individuals, and such programs—</text><paragraph id="id72AE68C4F2FC4507A7FB7715C02A6968"><enum>(1)</enum><text display-inline="yes-display-inline">may—</text><subparagraph id="HE89945C9495B44F8B9B35E0E077779CB"><enum>(A)</enum><text display-inline="yes-display-inline">provide access to perinatal health workers from pregnancy through the postpartum period;</text></subparagraph><subparagraph id="HC8AAC979C3B2419095E7A74834DB6F83"><enum>(B)</enum><text>provide access to healthy foods and counseling on nutrition, recommended activity levels, and safety measures throughout pregnancy;</text></subparagraph><subparagraph id="H7202E0AD713A46889616ED9C4EA537A5"><enum>(C)</enum><text display-inline="yes-display-inline">train correctional officers to ensure that pregnant incarcerated individuals receive safe and respectful treatment;</text></subparagraph><subparagraph id="H34CFB670A6EF4006844FCD7FEE4CF7E8"><enum>(D)</enum><text display-inline="yes-display-inline">train 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></subparagraph><subparagraph id="HE785A90A016D4797AD4E16ED802CB4DD"><enum>(E)</enum><text>provide counseling and treatment for individuals who have suffered from—</text><clause id="HF9D8B99352004845A626D9DF0232E319"><enum>(i)</enum><text display-inline="yes-display-inline">diagnosed mental or behavioral health conditions, including trauma and substance use disorders;</text></clause><clause id="H39EB65F62B064C428B434EDA6851D52C"><enum>(ii)</enum><text display-inline="yes-display-inline">trauma or violence, including domestic violence;</text></clause><clause id="H0A33F9A8465E4853A2194FEAC0BE9B5E"><enum>(iii)</enum><text>human immunodeficiency virus;</text></clause><clause id="H6665A7DD844B462786B0DB8F9049CE8A"><enum>(iv)</enum><text>sexual abuse;</text></clause><clause id="H7045AC3566D0477AB2BAB40D49E5DE08"><enum>(v)</enum><text display-inline="yes-display-inline">pregnancy or infant loss; or</text></clause><clause id="HA33CE78E08EB4953BDEBB74450D5679B"><enum>(vi)</enum><text>chronic conditions; </text></clause></subparagraph><subparagraph id="H01177C8BD6D645509103D3036547399F"><enum>(F)</enum><text display-inline="yes-display-inline">provide evidence-based pregnancy and childbirth education, parenting support, and other relevant forms of health literacy;</text></subparagraph><subparagraph id="HBDF542C0B3264647AACC9135B1800AE4"><enum>(G)</enum><text display-inline="yes-display-inline">provide clinical education opportunities to maternity care providers in training to expand pathways into maternal health care careers serving incarcerated individuals;</text></subparagraph><subparagraph id="H96201BDC588F426BBC16E9D5D94ADE57"><enum>(H)</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></subparagraph><subparagraph id="H4BC78A156BC94B4BA7A5224F892A0172" commented="no"><enum>(I)</enum><text display-inline="yes-display-inline">provide reentry assistance, particularly to—</text><clause id="H3C16FDBC484E465B9AAEBB3605846EC5"><enum>(i)</enum><text display-inline="yes-display-inline">ensure access to health insurance coverage and transfer of health records to community providers if an incarcerated individual exits the criminal justice system during such individual’s pregnancy or in the postpartum period; and</text></clause><clause id="HC03466242E4F481CBAE574ACC6206111"><enum>(ii)</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, substance use disorder treatments, and social services that address social determinants maternal of health; or</text></clause></subparagraph><subparagraph id="H8954C69C194D4E72991E3BFD7146AE0E"><enum>(J)</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; and</text></subparagraph></paragraph><paragraph id="id814287280595439DBD23D8CF5D5D1F86"><enum>(2)</enum><text>may include—</text><subparagraph id="H50CE63B36380407C87627F27202FF3F3"><enum>(A)</enum><text display-inline="yes-display-inline">evidence-based childbirth education or parenting classes;</text></subparagraph><subparagraph id="H442D638BAD3B4464AD22ABF9934B8AC4"><enum>(B)</enum><text>prenatal health coordination;</text></subparagraph><subparagraph id="H0EE76DF9FAB84C2C968102B96ED02FCC"><enum>(C)</enum><text>family and individual counseling;</text></subparagraph><subparagraph id="HAB9D1856BD214E4EB8BCB9E60C47740B"><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="HA567418772B5469ABA1FBE447D642D30"><enum>(E)</enum><text>family case management services;</text></subparagraph><subparagraph id="HE5A0DAD8F3A8471D818E56AE2233391F"><enum>(F)</enum><text>domestic violence education and prevention;</text></subparagraph><subparagraph id="H82F5EBCB65524D89AE6BF17BAA3DEA15"><enum>(G)</enum><text>physical and sexual abuse counseling; and</text></subparagraph><subparagraph id="H839FAAF504F543C49CC6D079557024CC"><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="H236BA4632B1A43AEB425A3E3740E804E" commented="no"><enum>(f)</enum><header>Implementation and reporting</header><text>A selected facility shall be responsible for—</text><paragraph id="H18AAF58C22244C138A2139E8EF801C06" commented="no"><enum>(1)</enum><text>implementing programs, which may include the programs described in subsection (e); and</text></paragraph><paragraph id="H0593BB56C5B24DBC861CECAEBEF34933" commented="no"><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, including information describing—</text><subparagraph id="H5228D27C321D4EE38D0DD9D70CB9B1BD" commented="no"><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 in the facility, including data stratified by race, ethnicity, sex, gender, 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 and morbidity, rates of preterm births and low-birthweight births, 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="H620BAD4D3B394DAEA5699331C1662506" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">relevant qualitative and quantitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs, including measures of patient-reported experience of care; and</text></subparagraph><subparagraph id="H3454535D8EC84E3A9412E26C96981C7B" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">strategies to sustain such programs after fiscal year 2026 and expand such programs to other facilities.</text></subparagraph></paragraph></subsection><subsection id="H8FD1763C7AFE4E5E886817D725DF46D7"><enum>(g)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 6 years after the date of enactment of this Act, the Director shall submit to the Attorney General and to the Congress a report describing the results of the programs funded under this section.</text></subsection><subsection id="HDDA8A8775AED4D1B9AF1F48DA1B2989F"><enum>(h)</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 (e).</text></subsection><subsection id="H9E3F1DE2045F4BC68F79F23B6F7EFFC8"><enum>(i)</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 2022 through 2026.</text></subsection></section><section id="H7AEB302774004EFC8107A79F274E25D8"><enum>703.</enum><header>Grant program to improve maternal health outcomes for individuals in State and local prisons and jails</header><subsection id="H825C45DCE0D8450AB4F9F0CB6379DA58"><enum>(a)</enum><header>Establishment</header><paragraph id="id42E68DC9AA2D46DFAFCFD30251F87B36"><enum>(1)</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 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></paragraph><paragraph id="idCECD0116963945A38CEC010AEA0FD47B"><enum>(2)</enum><header>Required consultation</header><text display-inline="yes-display-inline">The Attorney General shall award the grants authorized under paragraph (1) in consultation with stakeholders such as—</text><subparagraph id="H339148522D794CED894B8AF483756F43"><enum>(A)</enum><text display-inline="yes-display-inline">relevant community-based organizations, particularly organizations that represent incarcerated and formerly incarcerated individuals and organizations that seek to improve maternal health outcomes for pregnant and postpartum individuals from racial and ethnic minority groups;</text></subparagraph><subparagraph id="H39A51D0D6E5D4DC78FAB0DFFC86261DF"><enum>(B)</enum><text display-inline="yes-display-inline">relevant organizations representing patients, with a particular focus on patients from racial and ethnic minority groups;</text></subparagraph><subparagraph id="H5FB7630B99D448A59D19EA94848FF141"><enum>(C)</enum><text display-inline="yes-display-inline">organizations representing maternity care providers and maternal health care education programs;</text></subparagraph><subparagraph id="H586374F763F74794A27E77D4BF3716D0" commented="no"><enum>(D)</enum><text>perinatal health workers; and</text></subparagraph><subparagraph id="HDAB4AC240B72400EA4F5B206E2701D13"><enum>(E)</enum><text>researchers and policy experts in fields related to maternal health care for incarcerated individuals.</text></subparagraph></paragraph></subsection><subsection id="H997CD1D2F16D481CB60FD821507AD6CC"><enum>(b)</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="H831E7BA65F134BCDBF4F71BDE966B1CA"><enum>(c)</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—</text><paragraph id="id46470FCCE2524F749466A6BE9EA2AB4E"><enum>(1)</enum><text display-inline="yes-display-inline">may—</text><subparagraph id="H26D21963A91F4E76A46EF60503132E3B"><enum>(A)</enum><text display-inline="yes-display-inline">provide access to perinatal health workers from pregnancy through the postpartum period;</text></subparagraph><subparagraph id="HDF2364CC09184E1F95E075121AEA045D"><enum>(B)</enum><text>provide access to healthy foods and counseling on nutrition, recommended activity levels, and safety measures throughout pregnancy;</text></subparagraph><subparagraph id="HA27186848ED94125B0CC0AD4F90B3974"><enum>(C)</enum><text display-inline="yes-display-inline">train correctional officers to ensure that pregnant incarcerated individuals receive safe and respectful treatment;</text></subparagraph><subparagraph id="H0EFF1A6F724843EBAC9ED2D4151345CA"><enum>(D)</enum><text display-inline="yes-display-inline">train 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></subparagraph><subparagraph id="H32F303452B3447F884121B0D16F07EA5"><enum>(E)</enum><text>provide counseling and treatment for individuals who have suffered from—</text><clause id="HBC151DCCE3074CBFB79D47203A445EBB"><enum>(i)</enum><text display-inline="yes-display-inline">diagnosed mental or behavioral health conditions, including trauma and substance use disorders;</text></clause><clause id="HDE4C9C3878D7405389B386B241C40467"><enum>(ii)</enum><text display-inline="yes-display-inline">trauma or violence, including domestic violence;</text></clause><clause id="HF400F89C638C4A0ABA12855EE00AAC63"><enum>(iii)</enum><text>human immunodeficiency virus;</text></clause><clause id="HF507D585ECE54240B9DAA062FB80E90A"><enum>(iv)</enum><text>sexual abuse;</text></clause><clause id="H5F2BBD9525EF44EC88F4BC59EE47FD32"><enum>(v)</enum><text>pregnancy or infant loss; or </text></clause><clause id="H88AE0210B9384F96BA2181268ABCB2AB"><enum>(vi)</enum><text>chronic conditions;</text></clause></subparagraph><subparagraph id="H3ADD0E60786F420B8834C1BD1313EF5C"><enum>(F)</enum><text display-inline="yes-display-inline">provide evidence-based pregnancy and childbirth education, parenting support, and other relevant forms of health literacy;</text></subparagraph><subparagraph id="H8121734FE68C4C2483DB7F985899CA32"><enum>(G)</enum><text display-inline="yes-display-inline">provide clinical education opportunities to maternity care providers in training to expand pathways into maternal health care careers serving incarcerated individuals;</text></subparagraph><subparagraph id="HAD19C6AAE9E4494C99D2B2D837CAB5AC"><enum>(H)</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></subparagraph><subparagraph id="HBB483C7CAC8C43B9B2EAB8155CC9C113"><enum>(I)</enum><text display-inline="yes-display-inline">provide reentry assistance, particularly to—</text><clause id="H26BD26AF171C45F99FFE6F07BD897DB7"><enum>(i)</enum><text display-inline="yes-display-inline">ensure access to health insurance coverage and transfer of health records to community providers if an incarcerated individual exits the criminal justice system during such individual’s pregnancy or in the postpartum period; and</text></clause><clause id="H5E401978CBBF458D8BD44AB704598DD0"><enum>(ii)</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, substance use disorder treatments, and social services that address social determinants of maternal health; or</text></clause></subparagraph><subparagraph id="H228CF8CDDC774AE48DD7B19FEEB4F1CA"><enum>(J)</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; and</text></subparagraph></paragraph><paragraph id="id1D7F8DE420274D82A28956268B0C24EE"><enum>(2)</enum><text display-inline="yes-display-inline">may include—</text><subparagraph id="H52C99C9C0EA64A73958BB48645E645C2"><enum>(A)</enum><text display-inline="yes-display-inline">evidence-based childbirth education or parenting classes;</text></subparagraph><subparagraph id="H29BA952ADA644BADB43F888E63B845CA"><enum>(B)</enum><text>prenatal health coordination;</text></subparagraph><subparagraph id="H2C76A55A3E724942A9D65A67F89FA27A"><enum>(C)</enum><text>family and individual counseling;</text></subparagraph><subparagraph id="H2E201A1B8F6F4C20B49B950205BA99D7"><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="HED5355D9CCF74CC1B11B031D426EC77B"><enum>(E)</enum><text>family case management services;</text></subparagraph><subparagraph id="H821DC336C6554D6BA31BF0028BBC74AB"><enum>(F)</enum><text>domestic violence education and prevention;</text></subparagraph><subparagraph id="H6E51C9FCD69640AABD958BF48994DF89"><enum>(G)</enum><text>physical and sexual abuse counseling; and</text></subparagraph><subparagraph id="H5F9155A9198444DE88E38DA6827EA506"><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="HCF6666CC302045FB862A00DA790DFAD7"><enum>(d)</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="HF7CF72A0B3324D4188A03228D8125787"><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 individuals from racial and ethnic minority groups; and</text></paragraph><paragraph id="H27A2AE8F045E4F20883CBDBE58733503"><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="H5937E1BEA21B4772B48A0292944B073B"><enum>(e)</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="HA453B539AF3E40CF9672BC9AB1C2D560"><enum>(f)</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="H72E7443AE0924ACAA2B3E1A96F998B38"><enum>(1)</enum><text>implementing the program funded by the grant; and</text></paragraph><paragraph id="HE5972B2BDC2D4E3E85CF7DD3BA523EF7"><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="HC4C358DDFA374C9DB911C8A3D4525F44"><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 in the facility, including data stratified by race, ethnicity, sex, gender, 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 and morbidity, rates of preterm births and low-birthweight births, 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="H0E2D1B51895245E6A772FBA947A629B1"><enum>(B)</enum><text display-inline="yes-display-inline">relevant qualitative and quantitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs, including measures of patient-reported experience of care; and</text></subparagraph><subparagraph id="HA4FB542355D04C0FAD0CE3429A9ED131"><enum>(C)</enum><text display-inline="yes-display-inline">strategies to sustain such programs beyond the duration of the grant and expand such programs to other facilities.</text></subparagraph></paragraph></subsection><subsection id="HBBE2B46EBD654298BC31E41DCBACAB5C"><enum>(g)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 6 years after the date of enactment of this Act, the Attorney General shall submit to the Congress a report describing the results of such grant programs.</text></subsection><subsection id="H90C8371A806644BAAD2A3521BA5B7B7C"><enum>(h)</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 (c).</text></subsection><subsection id="H2F7A81AF21844D69B90ACF23FE87C844"><enum>(i)</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 2022 through 2026.</text></subsection></section><section id="HA223A76A81994218B14B7108EB9D2577"><enum>704.</enum><header>GAO report</header><subsection id="H74DD024717F94F82A09035053E1E7077"><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 and infant health outcomes among incarcerated individuals and infants born to such individuals, with a particular focus on racial and ethnic disparities in maternal and infant health outcomes for incarcerated individuals. </text></subsection><subsection id="H47DE1FD907BF4FE79059D961372D14EE"><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="H878309CFF972445883954AA1946A640E"><enum>(1)</enum><text display-inline="yes-display-inline">to the extent practicable—</text><subparagraph id="HDE0BC40397CC46B2A6914172C72AFD96"><enum>(A)</enum><text display-inline="yes-display-inline">the number of pregnant individuals who are incarcerated in Bureau of Prisons facilities;</text></subparagraph><subparagraph id="HE8AA9E71871244F6A2E2E159D8E83C1C"><enum>(B)</enum><text>the number of incarcerated individuals, including those incarcerated in Federal, State, and local correctional facilities, who have experienced a pregnancy-related death, pregnancy-associated death, or the death of an infant in the most recent 10 years of available data;</text></subparagraph><subparagraph id="HE499DC62DF9E49AD9ECA89CB1D2C6C21"><enum>(C)</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 10 years of available data;</text></subparagraph><subparagraph id="HFA72075F51354AED89050F7005715695"><enum>(D)</enum><text display-inline="yes-display-inline">the number of preterm and low-birthweight births of infants born to incarcerated individuals, including those incarcerated in Federal, State, and local correctional facilities, in the most recent 10 years of available data; and</text></subparagraph><subparagraph id="HDEF5985096D5488DB88727BDE85ECEB0"><enum>(E)</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="HA0CBFCFE7E3043F5823D6B1FF56602A3"><enum>(2)</enum><text display-inline="yes-display-inline">in the case that the Comptroller General of the United States is unable 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="HC3F332900F804BE4A53A44D8D69B6524"><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="HD09EC8AB166F498BA943639B883E04C2"><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 from racial and ethnic minority groups;</text></paragraph><paragraph id="H62AD96983DDF4F8899A589955D8007AD"><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="H73927F34B4804EEEB9A01BEBA30C57B7" 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="H9CBD1E1C638D430098E03CB70248C8C4" display-inline="no-display-inline" section-type="subsequent-section"><enum>705.</enum><header>MACPAC report</header><subsection id="H99393CB2648C4F9A919BCA07390B315D"><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 <term>MACPAC</term>) 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.) that contains the information described in subsection (b). </text></subsection><subsection id="H83C810F21BB347618734D5DF119EAA39"><enum>(b)</enum><header>Information described</header><text display-inline="yes-display-inline">The information described in this subsection includes—</text><paragraph id="H5F19487968324408A7CBD8EB73017A13"><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 from racial and ethnic minority groups; and</text></paragraph><paragraph id="HDF94293CABFE4B7289FC61AD6CF188D6" commented="no" display-inline="no-display-inline"><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 when a pregnant or postpartum individual is incarcerated. </text></paragraph></subsection></section><enum>VIII</enum><header>Tech to save moms</header><section display-inline="no-display-inline" section-type="subsequent-section" id="HD5109847611F4A7FBB8361987594EE4B"><enum>801.</enum><header>Integrated telehealth models in maternity care services</header><subsection id="HE225F8442F6D439582872D9C26FD6177"><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:</text><quoted-block style="OLC" display-inline="no-display-inline" id="HC5950A96E27143D2A48FF695B552BEDA"><clause id="H4037A322A2A4444AB74C10C0104E461D"><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, 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.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection id="H97FD540CADEA4545982383FDF1A54EE8"><enum>(b)</enum><header>Effective date</header><text>The amendment made by subsection (a) shall take effect 1 year after the date of enactment of this Act.</text></subsection></section><section id="H9904E7F2E8DB40088F31F59D72F1E770"><enum>802.</enum><header>Grants to expand the use of technology-enabled collaborative learning and capacity models for pregnant and postpartum individuals</header><text display-inline="no-display-inline">Title III of the Public Health Service Act is amended by inserting after section 330N (<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" id="H384342B3640F48DA84297BE45BBF7214" display-inline="no-display-inline"><section id="H646EEC26007B44FBABA2D6B2D6106C06"><enum>330O.</enum><header>Expanding capacity for maternal health outcomes</header><subsection id="H5D7C973DA83F400495E773FDD25FB159"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">Beginning not later than 1 year after the date of enactment of this section, 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—</text><paragraph id="HC357BDAEFE00410883330D84B27AEDB7"><enum>(1)</enum><text>in health professional shortage areas;</text></paragraph><paragraph id="HFD1E0F7B850F4104BDCEB0E341490965"><enum>(2)</enum><text>in areas with high rates of maternal mortality and severe maternal morbidity;</text></paragraph><paragraph id="H7A9B703C1DB847D3968D098D4E16E879"><enum>(3)</enum><text>in areas with significant racial and ethnic disparities in maternal health outcomes; and</text></paragraph><paragraph id="H7EC5E4E257734B298FD9B83CC0D81054"><enum>(4)</enum><text>for medically underserved populations and American Indians and Alaska Natives, including Indian Tribes, Tribal organizations, and Urban Indian organizations.</text></paragraph></subsection><subsection id="HD8553C7139F0433199EF31EC4B11088D"><enum>(b)</enum><header>Use of Funds</header><paragraph id="H24FF42E657144EDEAAF06B8BCA8446E6"><enum>(1)</enum><header>Required uses</header><text display-inline="yes-display-inline">Recipients of grants under this section shall use the grants to—</text><subparagraph id="HB759028E84B245CF84491AB8169F5AC2"><enum>(A)</enum><text display-inline="yes-display-inline">train maternal health care providers, students, and other similar professionals through models that include—</text><clause id="H82B79F0F4A694B1B819A954BA2001950"><enum>(i)</enum><text display-inline="yes-display-inline">methods to increase safety and health care quality;</text></clause><clause id="H80DAE2260ED147DE873FC345AF19FC53"><enum>(ii)</enum><text display-inline="yes-display-inline">methods to address implicit bias, racism, and discrimination;</text></clause><clause id="HBCF7D46609314046B41D2645B62C7C48"><enum>(iii)</enum><text display-inline="yes-display-inline">best practices in screening for maternal mental health conditions and substance use disorders and, as needed, evaluating and treating such conditions and disorders;</text></clause><clause id="HB72DADFB574A419885652C536DB9A2D0"><enum>(iv)</enum><text display-inline="yes-display-inline">training on best practices in maternity care for pregnant and postpartum individuals during the COVID–19 public health emergency or future public health emergencies;</text></clause><clause id="HC6D719A587614259BE804BF971C2BE19"><enum>(v)</enum><text display-inline="yes-display-inline">methods to screen for social determinants of maternal health risks in the prenatal and postpartum; and</text></clause><clause id="HA730E4BC00AC4359BD1FE887CC78E2F4"><enum>(vi)</enum><text display-inline="yes-display-inline">the use of remote patient monitoring tools for pregnancy-related complications described in section 1115A(b)(2)(B)(xxviii);</text></clause></subparagraph><subparagraph id="HD52EE586E2604EC2AD251F248FCB9AC1"><enum>(B)</enum><text>evaluate and collect information on the affect of such models on—</text><clause id="H8A00475DF15F4C45A93756FF63514392"><enum>(i)</enum><text>access to and quality of care;</text></clause><clause id="HB4E87B7EDB4442FB9A0BD9A057565141"><enum>(ii)</enum><text>outcomes with respect to the health of an individual; and</text></clause><clause id="H1C8E3B21809A4E2FADC614BF4AC81576"><enum>(iii)</enum><text>the experience of individuals who receive pregnancy-related health care;</text></clause></subparagraph><subparagraph id="H7FBBB5CD5F8049E1AF961C4CD966BE3A"><enum>(C)</enum><text display-inline="yes-display-inline">develop qualitative and quantitative measures to identify best practices for the expansion and use of such models;</text></subparagraph><subparagraph id="HA9435FFA3E8B4D7FBFB902A510947853"><enum>(D)</enum><text display-inline="yes-display-inline">study the effect of such models on patient outcomes and maternity care providers; and</text></subparagraph><subparagraph id="HB45753FAAF2B47ABBA9AB5870C49F74B"><enum>(E)</enum><text display-inline="yes-display-inline">conduct any other activity, as determined by the Secretary.</text></subparagraph></paragraph><paragraph id="HEC2CD6551385422396853F8174581D87"><enum>(2)</enum><header>Permissible uses</header><text display-inline="yes-display-inline">Recipients of grants under this section may use grants to support—</text><subparagraph id="H08609E389AE148318CB638B97BF99AD6"><enum>(A)</enum><text display-inline="yes-display-inline">the use and expansion of technology-enabled collaborative learning and capacity building models, including hardware and software that—</text><clause id="HFCCC1BB17A244186B107A1366A4CC2F1"><enum>(i)</enum><text>enables distance learning and technical support; and</text></clause><clause id="HDF872B5E471542CFBD7F341DD2256AE7"><enum>(ii)</enum><text>supports the secure exchange of electronic health information; and</text></clause></subparagraph><subparagraph id="H1C3FED2E184C4351B0E54D35D68B2541"><enum>(B)</enum><text display-inline="yes-display-inline">maternity care providers, students, and other similar professionals in the provision of maternity care through such models.</text></subparagraph></paragraph></subsection><subsection id="H2E804E6B8DC44AB09BE29FA56F33E581"><enum>(c)</enum><header>Application</header><paragraph id="H28A6423690D446B780794C90987B33D0"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="H9318BAE968E94224A5CD6B20EC48972D"><enum>(2)</enum><header>Assurance</header><text>An application under paragraph (1) shall include an assurance that such entity shall collect information on, and assess the affect of, the use of technology-enabled collaborative learning and capacity building models, including with respect to—</text><subparagraph id="H3E9A0B236542407292A25CC9F1C6E81C" display-inline="no-display-inline"><enum>(A)</enum><text>maternal health outcomes;</text></subparagraph><subparagraph id="H2063CB1A8B4A4099BCD2466F9DA6C759"><enum>(B)</enum><text>access to maternal health care services;</text></subparagraph><subparagraph id="H0D40C560CC704592BA41A98569906685"><enum>(C)</enum><text>quality of maternal health care; and</text></subparagraph><subparagraph id="H92FC80E0A1B04EF6AAA26EF85283B206"><enum>(D)</enum><text>retention of maternity care providers serving areas and populations described in subsection (a).</text></subparagraph></paragraph></subsection><subsection id="H60BC521B3BE94162A8E40C80DE2B2EDA"><enum>(d)</enum><header>Limitations</header><paragraph id="H65AEC105C7AD4FEE8DF949D0B9DC58F0"><enum>(1)</enum><header>Number</header><text display-inline="yes-display-inline">Each entity receiving a grant under this section may receive not more than 1 such grant.</text></paragraph><paragraph id="H4125D06BEE48497992A585FFC4CF16AE"><enum>(2)</enum><header>Duration</header><text display-inline="yes-display-inline">A grant awarded under this section shall be for a 5-year period.</text></paragraph></subsection><subsection id="H7AB9129412FD42B3B276F354ACF7CA73"><enum>(e)</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="HA33E613FDB7B4D7D8A1A226E25F83F3A"><enum>(f)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">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—</text><paragraph id="HF00BBF3D5C8C4342AC9029F6E0E7980C"><enum>(1)</enum><text>in health professional shortage areas;</text></paragraph><paragraph id="H24895249D82D4A67A42E05AD1A5048EE"><enum>(2)</enum><text>in areas with high rates of maternal mortality and severe maternal morbidity or significant racial and ethnic disparities in maternal health outcomes; and</text></paragraph><paragraph id="H245F9A20AF8B4F23B39015907324073B"><enum>(3)</enum><text>for medically underserved populations or American Indians and Alaska Natives.</text></paragraph></subsection><subsection id="H7A8B074EEB9942148F7E2A217220B38C"><enum>(g)</enum><header>Research and evaluation</header><text display-inline="yes-display-inline">The Secretary, in consultation with experts, shall develop a strategic plan to research and evaluate the evidence for such models.</text></subsection><subsection id="H446181F584D64B70AF3D149BA7408451"><enum>(h)</enum><header>Reporting</header><paragraph id="HB963D7DE185345C7A4FE19583722AE41"><enum>(1)</enum><header>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="H7FAFB77F58444F80855553F4D36F72C2"><enum>(2)</enum><header>Secretary</header><text display-inline="yes-display-inline">Not later than 4 years after the date of enactment of this section, the Secretary shall submit to Congress, and make available on the website of the Department of Health and Human Services, a report that includes—</text><subparagraph id="HCBA31B6744444C62BB496B188382C7AF"><enum>(A)</enum><text display-inline="yes-display-inline">a description of grants awarded under subsection (a) and the purpose and amounts of such grants;</text></subparagraph><subparagraph id="HC2A63FF2850F4F96969172B68699CA1F"><enum>(B)</enum><text display-inline="yes-display-inline">a summary of—</text><clause id="HA99FFA8187BA4FCEA0DE9EE3B441BA49"><enum>(i)</enum><text display-inline="yes-display-inline">the evaluations conducted under subsection (b)(1)(B);</text></clause><clause id="HEB10CAECD7BD4DF7B68213D7E83F2A5B"><enum>(ii)</enum><text display-inline="yes-display-inline">any technical assistance provided under subsection (f); and</text></clause><clause id="HBA5BEA4BFC5B4519AAB990BFF67C3198"><enum>(iii)</enum><text display-inline="yes-display-inline">the activities conducted under a grant awarded under subsection (a); and</text></clause></subparagraph><subparagraph id="HC15BF9B672BF4AFA91B7C0C533AC4B78"><enum>(C)</enum><text display-inline="yes-display-inline">a description of any significant findings with respect to—</text><clause id="H00C4AED079F84789B15960867A192C7A"><enum>(i)</enum><text>patient outcomes; and</text></clause><clause id="H847EA704F9A64BB8A3CC94133CC4A026"><enum>(ii)</enum><text>best practices for expanding, using, or evaluating technology-enabled collaborative learning and capacity building models.</text></clause></subparagraph></paragraph></subsection><subsection id="H2C0EDB3514874C27B4F4B555C308AA5D"><enum>(i)</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 2022 through 2026.</text></subsection><subsection id="H50F58B60701C4424BCDFAF5D8D337004"><enum>(j)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H0E92ECCF541840088A4000852161250F"><enum>(1)</enum><header>Eligible entity</header><subparagraph id="HF1799F53649242C987022888C852DD64"><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 individuals—</text><clause id="H7937B808670E46FA92E150C741ECEB76"><enum>(i)</enum><text display-inline="yes-display-inline">in health professional shortage areas;</text></clause><clause id="HC495646B221D4E899942C4A3D654BCD9"><enum>(ii)</enum><text display-inline="yes-display-inline">in areas with high rates of adverse maternal health outcomes or significant racial and ethnic disparities in maternal health outcomes; and</text></clause><clause id="HF318A0A0325E41AD951C7D6483849F82"><enum>(iii)</enum><text display-inline="yes-display-inline">who are—</text><subclause id="HC72ADA22D26047B8B6A702BF0EDDBABF"><enum>(I)</enum><text>members of medically underserved populations; or</text></subclause><subclause id="H11258CBFF7794EACBBF48E042BDC6F23"><enum>(II)</enum><text>American Indians and Alaska Natives, including Indian Tribes, Tribal organizations, and urban Indian organizations.</text></subclause></clause></subparagraph><subparagraph id="H45B4E92F71014742BBCC5B558E3ECD03"><enum>(B)</enum><header>Inclusions</header><text display-inline="yes-display-inline">An eligible entity may include entities that lead, or are capable of leading, a technology-enabled collaborative learning and capacity building model.</text></subparagraph></paragraph><paragraph id="H3E64A3D6625D402DA81A9542060120AB"><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="H970D86F8966A4FA3AEF64BC36A4AD043"><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.</text></paragraph><paragraph id="H5CF9268FC9DE4168B05F455893F38911"><enum>(4)</enum><header>Maternal mortality</header><text display-inline="yes-display-inline">The term <term>maternal mortality</term> 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.</text></paragraph><paragraph id="H7481DBF05C63410DBEAFF6BE924EA24A"><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="H6023AC37E4594BCCB5022E1A81152553"><enum>(6)</enum><header>Postpartum</header><text display-inline="yes-display-inline">The term <term>postpartum</term> means the 1-year period beginning on the last date of an individual’s pregnancy.</text></paragraph><paragraph id="HE1128F6237FA445FBC55AB84E22D240E"><enum>(7)</enum><header>Severe maternal morbidity</header><text display-inline="yes-display-inline">The term <term>severe maternal morbidity</term> 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.</text></paragraph><paragraph id="H88348E32B11E4819BD5E531C8C08ED69"><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 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.</text></paragraph><paragraph id="H32F4D43A274B4CE4A6E4F3E69E1E71E2"><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.</text></paragraph><paragraph id="HA2689076764343EA8D56CACE44645E8E"><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.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="HCFAE03A186D54DB994D970665602046A"><enum>803.</enum><header>Grants to promote equity in maternal health outcomes through digital tools</header><subsection id="H1E38DC8AB7F3455E8AAA29A2ECB34A9A"><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 award 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="H85EBA3B0B1BF4B25B20B2E2E42BAB66D"><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 id="H8BBED5406F3B4DB4A348008C26BCF51A"><enum>(c)</enum><header>Prioritization</header><text>In awarding grants under this section, the Secretary shall prioritize an eligible entity—</text><paragraph id="H350E50B560EF4B639E03311D69D52F51"><enum>(1)</enum><text display-inline="yes-display-inline">in an area with high rates of adverse maternal health outcomes or significant racial and ethnic disparities in maternal health outcomes;</text></paragraph><paragraph id="HEF341BEEE8B04E0AB49525128DA3A59F"><enum>(2)</enum><text display-inline="yes-display-inline">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 id="H0D9EC55F63474A819DB0BA5FD1688596"><enum>(3)</enum><text display-inline="yes-display-inline">that promotes technology that addresses racial and ethnic disparities in maternal health outcomes.</text></paragraph></subsection><subsection id="H3B2ADB50D01344BFB81A142770294C7D" display-inline="no-display-inline"><enum>(d)</enum><header>Limitations</header><paragraph id="H1AB5CB74C6AE4F8D9645AA49AE91E00A"><enum>(1)</enum><header>Number</header><text display-inline="yes-display-inline">Each entity receiving a grant under this section may receive not more than 1 such grant.</text></paragraph><paragraph id="H785EA2FBE9634BCFB2F465D0946C7DF9"><enum>(2)</enum><header>Duration</header><text display-inline="yes-display-inline">A grant awarded under this section shall be for a 5-year period.</text></paragraph></subsection><subsection id="HE7B636CB66574DA3A5139570B59617BA"><enum>(e)</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="HEC913FDD22C745D1A59525FBC14B805B"><enum>(f)</enum><header>Reporting</header><paragraph id="H08FE6B03407A4949BA0B9120346CF81B"><enum>(1)</enum><header>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="H44F5C885B76C4CF1988AFC3C7DA77A41"><enum>(2)</enum><header>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 includes—</text><subparagraph id="H3A4836C142CA420BA9BED4293D65786B"><enum>(A)</enum><text display-inline="yes-display-inline">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;</text></subparagraph><subparagraph id="H689A0C63CBA14E1ABCEF43206638C18C"><enum>(B)</enum><text display-inline="yes-display-inline">recommendations on new grant programs that promote the use of technology to improve such maternal health outcomes; and</text></subparagraph><subparagraph id="HB0831D5C43BA4CE4B103D84B76D4114B"><enum>(C)</enum><text>recommendations with respect to—</text><clause id="HEB9594DF5146497F85D4658E1516CA00"><enum>(i)</enum><text>technology-based privacy and security safeguards in maternal health care;</text></clause><clause id="H27F68E9E6AA44E18B5D89073CD657024"><enum>(ii)</enum><text>reimbursement rates for maternal telehealth services;</text></clause><clause id="H42ABB627580E4B17BC6E260FE48F12B5"><enum>(iii)</enum><text>the use of digital tools to analyze large data sets to identify potential pregnancy-related complications;</text></clause><clause id="H457B8998892D42C79C1CB3564846FD8C"><enum>(iv)</enum><text display-inline="yes-display-inline">barriers that prevent maternity care providers from providing telehealth services across States;</text></clause><clause id="H849364015AB446FAAA143A154052E5C9"><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="H5910A5A9FF9E453980D255DCC168C307"><enum>(vi)</enum><text display-inline="yes-display-inline">barriers that prevent access to telehealth services, including a lack of access to reliable, high-speed internet or electronic devices;</text></clause><clause id="H378E3EE1F8C5425C8EC3C65BEE965FF3"><enum>(vii)</enum><text>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</text></clause><clause id="HA9675BB631CA47E088FEAA2654283D2E"><enum>(viii)</enum><text>lessons learned from expanded access to telehealth related to maternity care during the COVID–19 public health emergency.</text></clause></subparagraph></paragraph></subsection><subsection id="H5159D5B7A6354684B7261FF004E76053" display-inline="no-display-inline"><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 2022 through 2026.</text></subsection></section><section id="HB6645185171545F39016E38A4C1C971C"><enum>804.</enum><header>Report on the use of technology in maternity care</header><subsection id="HFE02F091BA6A429D9193303F6FD100BB"><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 Act as the <quote>National Academies</quote>) under which the National Academies shall conduct a study on the use of technology and patient monitoring devices in maternity care.</text></subsection><subsection id="HC7A64609EA2E41309098B2A96ED1C16B"><enum>(b)</enum><header>Content</header><text>The agreement entered into pursuant to subsection (a) shall provide for the study of the following:</text><paragraph id="H44AA2BF6A94141A9AD23710694DFB434"><enum>(1)</enum><text display-inline="yes-display-inline">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.</text></paragraph><paragraph id="H2FCA8EBA94534041867CAC93076F1B6B"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph><paragraph id="H90425050791847EC98F92266C0F375EC"><enum>(3)</enum><text display-inline="yes-display-inline">Best practices for reducing and preventing racial or ethnic biases in the use of innovative technology and patient monitoring devices in maternity care.</text></paragraph><paragraph id="H51D8C63E9E7144D1813CE63AFF2F0367"><enum>(4)</enum><text display-inline="yes-display-inline">Best practices in the use of innovative technology and patient monitoring devices for pregnant and postpartum individuals from racial and ethnic minority groups.</text></paragraph><paragraph id="H2DFE9CE791B14D788EA2CCFC8E27D66F"><enum>(5)</enum><text display-inline="yes-display-inline">Best practices with respect to privacy and security safeguards in such use.</text></paragraph></subsection><subsection id="H644B73CBA32546B08933EC0767428522"><enum>(c)</enum><header>Report</header><text display-inline="yes-display-inline">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 2 years after the date of enactment of this Act. </text></subsection></section><enum>IX</enum><header>Impact to save moms</header><section id="H765F136B83144C10B2B105B435B3F15F" section-type="subsequent-section" display-inline="no-display-inline"><enum>901.</enum><header>Perinatal Care Alternative Payment Model Demonstration Project</header><subsection id="H7FF03120EE2249F7A26521219D55F320"><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 individuals enrolled in such State plans and State child health plans.</text></subsection><subsection id="HAC363843ECE54C8899DFBECE8BCF9723"><enum>(b)</enum><header>Coordination</header><text>In establishing the Demonstration Project, the Secretary shall coordinate with stakeholders such as—</text><paragraph id="H43B23855FEDE4851A6007E69BAEC6DF0"><enum>(1)</enum><text>State Medicaid programs;</text></paragraph><paragraph id="H8FE1D20EC6D543759D8D69F17015F352"><enum>(2)</enum><text display-inline="yes-display-inline">maternity care providers and organizations representing maternity care providers;</text></paragraph><paragraph id="H389E1DE186014E8BB790B9B400D5CA38"><enum>(3)</enum><text display-inline="yes-display-inline">relevant organizations representing patients, with a particular focus on patients from racial and ethnic minority groups;</text></paragraph><paragraph id="H27D44A316F96452E94FC07ADDDC7EB64"><enum>(4)</enum><text display-inline="yes-display-inline">relevant community-based organizations, particularly organizations that seek to improve maternal health outcomes for pregnant and postpartum individuals from racial and ethnic minority groups;</text></paragraph><paragraph id="H34E3DEF63B4A4AE790594DFA7DF5AD89"><enum>(5)</enum><text display-inline="yes-display-inline">perinatal health workers;</text></paragraph><paragraph id="HDCE1EA970AEB4A6BB43D058850BE4262"><enum>(6)</enum><text>relevant health insurance issuers;</text></paragraph><paragraph id="HDC5A1BA03322444F9131558ACCB5A5CA"><enum>(7)</enum><text display-inline="yes-display-inline">hospitals, health systems, midwifery practices, 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="H7566134A09EB4DB5A481D46525108056"><enum>(8)</enum><text>researchers and policy experts in fields related to maternity care payment models; and</text></paragraph><paragraph id="H1F39FA23E27B49B3A9BD034FA995F194"><enum>(9)</enum><text display-inline="yes-display-inline">any other stakeholders as the Secretary determines appropriate, with a particular focus on stakeholders from racial and ethnic minority groups.</text></paragraph></subsection><subsection id="H5815496FE7A1420792E6A527733D7532"><enum>(c)</enum><header>Considerations</header><text display-inline="yes-display-inline">In establishing the Demonstration Project, the Secretary shall consider any alternative payment model that—</text><paragraph id="HFFA8ADF8659B478483F7FEDA9BF93BE8"><enum>(1)</enum><text>is designed to improve maternal health outcomes for racial and ethnic groups with disproportionate rates of adverse maternal health outcomes;</text></paragraph><paragraph id="H56D2C2C78D8248D48D00DBFA9579F915"><enum>(2)</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></paragraph><paragraph id="H9D7A57BD01A0476384BA20B51FAB5410"><enum>(3)</enum><text>establishes evidence-based quality metrics for such payments;</text></paragraph><paragraph id="HFFDBCE2AA84D42A78EFBBE235217EB0D"><enum>(4)</enum><text>includes consideration of non-hospital birth settings such as freestanding birth centers (as so defined);</text></paragraph><paragraph id="HB62BE167D48B489781E98F8B8D183A26"><enum>(5)</enum><text>includes consideration of social determinants of maternal health; or</text></paragraph><paragraph id="H3B67CD1E851E431093C01F1F1C88C5D0"><enum>(6)</enum><text>includes diverse maternity care teams that include—</text><subparagraph id="H4CCCD45994B74B2694F9ED51D0C82C85" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">maternity care providers, mental and behavioral health care providers acting in accordance with State law, registered dietitians or nutrition professionals (as such term is defined in section 1861(vv)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(vv)(2)</external-xref>)), and International Board Certified Lactation Consultants—</text><clause id="H8405177324C04B8AB8915F76130C54D4" commented="no"><enum>(i)</enum><text>from racially, ethnically, and professionally diverse backgrounds;</text></clause><clause id="H293AB64B84364065807CA2214AC41980" commented="no"><enum>(ii)</enum><text>with experience practicing in racially and ethnically diverse communities; or</text></clause><clause id="H092C49A3F8D04AF89C30F02B91C79CBE" commented="no"><enum>(iii)</enum><text>who have undergone training on implicit bias and racism; and</text></clause></subparagraph><subparagraph id="H1716E709439D415AADB1F85F5D86805F"><enum>(B)</enum><text display-inline="yes-display-inline">perinatal health workers.</text></subparagraph></paragraph></subsection><subsection id="H1F6FA704592D48DBA601CD3D57E7B177"><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="HDAC35ADBCE2F4F11A302995A9FD0EEA7"><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="HB5875E71FD96430593174328187A3EE4"><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="HD93CC4114B9F42309FAB0377257DD1AD"><enum>(2)</enum><text>spending on maternity care by States participating in the Demonstration Project;</text></paragraph><paragraph id="HB1B1CE4AC7B74A9F8E717F74125628B1"><enum>(3)</enum><text display-inline="yes-display-inline">to the extent practicable, qualitative and quantitative measures of patient experience; and</text></paragraph><paragraph id="HF9EDD9FEAADC4FF48F1C88DF0A71DBDE"><enum>(4)</enum><text>any other areas of assessment that the Secretary determines relevant.</text></paragraph></subsection><subsection id="H16EFC75D9DA54D139EF0734CDF751633"><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 Congress, and make publicly available, a report containing—</text><paragraph id="HE47F54AC77BA42118D302763050E53B5"><enum>(1)</enum><text>the results of any evaluation conducted under subsection (e); and</text></paragraph><paragraph id="H81C14F12BDF64ABC9E447AE777433311"><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="HB2FF48E62B2B42DBA74E76FE0E1FE814"><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="H66E792E1008647D192F28026856488BE"><enum>(h)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H979136B2E5CB4364A3723C42E12D02D2"><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="H98C853F4C1C94A2B984D5029B5B2967A"><enum>(2)</enum><header>Perinatal</header><text display-inline="yes-display-inline">The term <term>perinatal</term> means the period beginning on the day an individual becomes pregnant and ending on the last day of the 1-year period beginning on the last day of such individual’s pregnancy.</text></paragraph><paragraph id="H16A53245390143CA98BBE0060C8385D7"><enum>(3)</enum><header>Racial and ethnic minority group</header><text display-inline="yes-display-inline">The term <term>racial and ethnic minority group</term> has the meaning given such term in section 1707(g)(1) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300u-6">42 U.S.C. 300u–6(g)(1)</external-xref>).</text></paragraph></subsection></section><section id="H0B923F6BB305461B8DA89E8838C9F318" display-inline="no-display-inline" section-type="subsequent-section"><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 individuals. Such report shall, at a minimum, include the following:</text><paragraph id="H81FEDAE1DE7E4B34BD2D3DA63E6BB58F"><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 individuals while their application for enrollment in such a State plan or such a State child health plan is being processed.</text></paragraph><paragraph id="H60A2F15E58CB404EBCD48260215A7162"><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 individuals, including such individuals who need to change their health insurance coverage during their pregnancy or the postpartum period following their pregnancy.</text></paragraph><paragraph id="H55466C641C5C4188BC8E9F77D1B7658F"><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 individuals who are eligible to enroll under such a State plan or such a State child health plan as a parent.</text></paragraph><paragraph id="H5B09E6ED59924DC2913135EB10BBDA8E" commented="no" display-inline="no-display-inline"><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 individuals.</text></paragraph></section><enum>X</enum><header>Maternal health pandemic response</header><section id="H62019093F6A84517A4D1CE98D828EA12"><enum>1001.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text><paragraph id="H638B10B997F64E1D9753C1E93242219D"><enum>(1)</enum><header>COVID–19 public health emergency</header><text>The term <term>COVID–19 public health emergency</term> means the period—</text><subparagraph id="HAC86474AA5344FE7B9D0EBFA057CE9EB"><enum>(A)</enum><text display-inline="yes-display-inline">beginning on the date that the Secretary of Health and Human Services declared a public health emergency under section 319 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247d">42 U.S.C. 247d</external-xref>), with respect to COVID–19; and</text></subparagraph><subparagraph id="H0F1EB005076D4225A25B61D4BBF95567"><enum>(B)</enum><text>ending on the later of the end of such public health emergency, or January 1, 2023.</text></subparagraph></paragraph><paragraph id="HFB32721351324DF7BEE238F4E5F8E203"><enum>(2)</enum><header>Respectful maternity care</header><text>The term <term>respectful maternity care</term> refers to care organized for, and provided to, pregnant and postpartum individuals in a manner that—</text><subparagraph id="H8B0A1BB05A3C46AD8760CB82E48F5089"><enum>(A)</enum><text>is culturally congruent;</text></subparagraph><subparagraph id="HBAB148581E7F4D6D860E3FDBC84DB898"><enum>(B)</enum><text>maintains their dignity, privacy, and confidentiality;</text></subparagraph><subparagraph id="H160095D64EB541BAA57A2106129BE3A8"><enum>(C)</enum><text>ensures freedom from harm and mistreatment; and</text></subparagraph><subparagraph id="HEB46B1C2255D412EB7837E3CFFB164C0"><enum>(D)</enum><text>enables informed choice and continuous support.</text></subparagraph></paragraph><paragraph id="H9C137557769040C1977F91C63AC59A21"><enum>(3)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph></section><section section-type="subsequent-section" id="H3C428D04122F453DBF271A9734F790FB"><enum>1002.</enum><header>Funding for data collection, surveillance, and research on maternal health outcomes during the COVID–19 public health emergency</header><text display-inline="no-display-inline">To conduct or support data collection, surveillance, and research on maternal health as a result of the COVID–19 public health emergency, including support to assist in the capacity building for State, Tribal, territorial, and local public health departments to collect and transmit racial, ethnic, and other demographic data related to maternal health, there are authorized to be appropriated—</text><paragraph id="HDAEF64030171437792A7685D5CD3C508"><enum>(1)</enum><text>$100,000,000 for the Surveillance for Emerging Threats to Mothers and Babies program of the Centers for Disease Control and Prevention, to support the Centers for Disease Control and Prevention in its efforts to—</text><subparagraph id="H6260FB9654C949BE809E866F6DE49808"><enum>(A)</enum><text>work with public health, clinical, and community-based organizations to provide timely, continually updated guidance to families and health care providers on ways to reduce risk to pregnant and postpartum individuals and their newborns and tailor interventions to improve their long-term health;</text></subparagraph><subparagraph id="HDBA8C4E833464DCA92257F51022BA49E"><enum>(B)</enum><text>partner with more State, Tribal, territorial, and local public health programs in the collection and analysis of clinical data on the impact of COVID–19 on pregnant and postpartum patients and their newborns, particularly among patients from racial and ethnic minority groups; and</text></subparagraph><subparagraph id="H1022598CB53A49EDBDA4BEBD61AF56C5"><enum>(C)</enum><text>establish regionally based centers of excellence to offer medical, public health, and other knowledge to ensure communities, especially communities with large populations of individuals from racial and ethnic minority groups, can help pregnant and postpartum individuals and newborns get the care and support they need;</text></subparagraph></paragraph><paragraph id="H135D2AC974384C30A3401B0BD4595EAF"><enum>(2)</enum><text>$30,000,000 for the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality program (commonly known as the <quote>ERASE MM program</quote>) of the Centers for Disease Control and Prevention, to support the Centers for Disease Control and Prevention in expanding its partnerships with States and Indian Tribes and provide technical assistance to existing Maternal Mortality Review Committees;</text></paragraph><paragraph id="H6F634DF8922B43D5AE2A138E348A1128"><enum>(3)</enum><text>$45,000,000 for the Pregnancy Risk Assessment Monitoring System (commonly known as the <quote>PRAMS</quote>) of the Centers for Disease Control and Prevention, to support the Centers for Disease Control and Prevention in its efforts to—</text><subparagraph id="H08811BA9922B4AE7AF1F05B6CD7652AC"><enum>(A)</enum><text>create a COVID–19 supplement to its PRAMS questionnaire;</text></subparagraph><subparagraph id="HA3A6F5495F144B55899E4AEF725001E5"><enum>(B)</enum><text>add questions around experiences of respectful maternity care in prenatal, intrapartum, and postpartum care;</text></subparagraph><subparagraph id="HADB5A7E1AF1A45EF9E7B090EA58F0607"><enum>(C)</enum><text>conduct a rapid assessment of COVID–19 awareness, impact on care and experiences, and use of preventive measures among pregnant, laboring and birthing, and postpartum individuals during the COVID–19 public health emergency; and</text></subparagraph><subparagraph id="HF636C9A873434CF088FD9386CE650B92"><enum>(D)</enum><text>work to transition the survey to an electronic platform and expand the survey to a larger population, with a special focus on reaching underrepresented communities; and</text></subparagraph></paragraph><paragraph id="H53C4D5668E29436DB172724F881BC111"><enum>(4)</enum><text>$15,000,000 for the National Institute of Child Health and Human Development, to conduct or support research for interventions to mitigate the effects of the COVID–19 public health emergency on pregnant and postpartum individuals, with a particular focus on individuals from racial and ethnic minority groups.</text></paragraph></section><section id="HD40C1FC301064EA0921BA668AC9F614D"><enum>1003.</enum><header>COVID–19 maternal health data collection and disclosure</header><subsection id="H68F9DC7C86CC4781BFC1613D92E51F17"><enum>(a)</enum><header>Availability of collected data</header><text display-inline="yes-display-inline">The Secretary, acting through the Director of the Centers for Disease Control and Prevention and the Administrator of the Centers for Medicare & Medicaid Services, shall make publicly available on the website of the Centers for Disease Control and Prevention data described in subsection (b).</text></subsection><subsection id="HBB44AA74D21F46019869FB9264F05695"><enum>(b)</enum><header>Data described</header><text display-inline="yes-display-inline">The data under subsection (a) means data collected through Federal surveillance systems under the Centers for Disease Control and Prevention with respect to COVID–19 and individuals who are pregnant or in a postpartum period. Such data shall include the following:</text><paragraph id="H077D37A0335B4BB98D42CE9AB87BCA73"><enum>(1)</enum><text display-inline="yes-display-inline">Diagnostic testing, including the number of pregnant and postpartum individuals who are tested for COVID–19 and the number of positive cases.</text></paragraph><paragraph id="H96B1EF86073F4EB0883D6CB20BDCF9AC"><enum>(2)</enum><text>Suspected cases of COVID–19 in pregnant and birthing individuals and individuals in a postpartum period.</text></paragraph><paragraph id="H7410C61ECBA349188F599FD215E9020D"><enum>(3)</enum><text>Serologic testing, including the number of pregnant and postpartum individuals tested and the number of such serologic tests that were positive.</text></paragraph><paragraph id="HB04CEFB04EF44490B2C955DF8AAB16F1"><enum>(4)</enum><text display-inline="yes-display-inline">Health care treatment for individuals who were infected with the virus, including hospitalizations, emergency room visits, and intensive care unit admissions.</text></paragraph><paragraph id="H035060F20A224C1697E9560A4C477577"><enum>(5)</enum><text display-inline="yes-display-inline">Health outcomes for pregnant individuals and infants confirmed or suspected of being infected with the virus, including—</text><subparagraph id="H2053A021FA954C3DB9CA134139CEE766"><enum>(A)</enum><text>the number of fatalities and case fatalities (expressed as the proportion of individuals who were infected with the virus to individuals who died from the virus); and</text></subparagraph><subparagraph id="HB668A349DB9D427DA52DBE732C990BF6"><enum>(B)</enum><text>the number of stillbirths, infant mortality, pre-term births, infants born with a low-birth weight, and cesarean section births.</text></subparagraph></paragraph></subsection><subsection id="HB87197D05C9247E39DF6598CC96CE4C6"><enum>(c)</enum><header>Indian health service</header><text>In carrying out subsection (a), the Secretary shall consult with Indian Tribes and confer with urban Indian organizations.</text></subsection><subsection id="HFF0CFC66630148AB8F65488341F6C67B"><enum>(d)</enum><header>Disaggregated information</header><text>In carrying out subsection (a), the Secretary shall disaggregate data by race, ethnicity, and location.</text></subsection><subsection id="H70AE7A3D5F2B41B99D4EF74A3F44ECA4"><enum>(e)</enum><header>Update</header><text>During the COVID–19 public health emergency, the Secretary shall update the data made available under this section—</text><paragraph id="HB66555EC2B27497ABD282CC77481511E"><enum>(1)</enum><text>at least on a monthly basis; and</text></paragraph><paragraph id="HA6385F8A845647DEA82E9F162312B98A"><enum>(2)</enum><text>not less than one month after the end of such public health emergency.</text></paragraph></subsection><subsection id="HF1A912E9019A46AF921313ABC61E36EC"><enum>(f)</enum><header>Privacy</header><text display-inline="yes-display-inline">In carrying out subsection (a), the Secretary shall take steps to protect the privacy of individuals pursuant to regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2</external-xref> note).</text></subsection><subsection id="H2FD4FE3DEDF44808B0A5AE6FA9D00F51"><enum>(g)</enum><header>Guidance</header><paragraph id="H4350B3D7CB5744D6BF21ECE7D0F3FBAB"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 30 days after the date of enactment of this Act, the Secretary shall issue guidance to States and local public health departments to ensure that—</text><subparagraph id="HA7AEAFA1E1824A67B970798EE835F7EB"><enum>(A)</enum><text display-inline="yes-display-inline">laboratories that test specimens for COVID–19 receive all relevant demographic data on race, ethnicity, pregnancy status, and other demographic data as determined by the Secretary; and</text></subparagraph><subparagraph id="H656976BE52BA4D0F84C7F5655BC83EE3"><enum>(B)</enum><text display-inline="yes-display-inline">data described in subsection (b) is disaggregated by race, ethnicity, and location.</text></subparagraph></paragraph><paragraph id="H2C88523224B64C7BB4DEE2F55C548A34"><enum>(2)</enum><header>Consultation</header><text>In carrying out paragraph (1), the Secretary shall consult with Indian Tribes—</text><subparagraph id="HDFE6D542C1DE4F97907529EEF49ABE2D"><enum>(A)</enum><text>to ensure that such guidance includes Tribally developed best practices; and</text></subparagraph><subparagraph id="H9092ADD4181B4C64A37A06E424FF51D6"><enum>(B)</enum><text>to reduce misclassification of American Indians and Alaska Natives.</text></subparagraph></paragraph></subsection></section><section id="H468A84E0DB1F472E882EDD07244E64F2"><enum>1004.</enum><header>Inclusion of pregnant individuals and lactating individuals in vaccine and therapeutic development for COVID–19</header><text display-inline="no-display-inline">The Director of the National Institutes of Health shall, when safe and appropriate, support and advance the inclusion of pregnant and lactating individuals in therapeutic and vaccine clinical trials with respect to the treatment or prevention of COVID–19, including prioritizing recommendations made by the Task Force on Research Specific to Pregnant Women and Lactating Women established under section 2041 of the 21st Century Cures Act (<external-xref legal-doc="usc" parsable-cite="usc/42/289a-2">42 U.S.C. 289a–2</external-xref> note) with respect to including such individuals in such clinical trials.</text></section><section id="HD959A1E72B12489194B83F5E85A31AC9"><enum>1005.</enum><header>Public health communication regarding maternal care during COVID–19</header><text display-inline="no-display-inline">The Director of the Centers for Disease Control and Prevention shall conduct a public health education campaign to increase access by pregnant individuals, their employers, and their health care providers to accurate, evidence-based information on COVID–19 and pregnancy risks, with a particular focus pregnant individuals in underserved communities.</text></section><section id="H84C711B0A0F4436EA7EEE4780E2B4321"><enum>1006.</enum><header>Task force on birthing experience and safe maternity care during a public health emergency</header><subsection commented="no" id="HB533890AA4974CD48436FFE66C6AA0E5"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">The Secretary, in consultation with the Director of the Centers for Disease Control and Prevention and the Administrator of the Health Resources and Services Administration, shall convene a task force (in this subsection referred to as the <quote>Task Force</quote>) to develop recommendations, and make such recommendations publicly available in multiple languages, on respectful maternity care during the COVID–19 public health emergency and other public health emergencies, with a particular focus on outcomes for individuals from racial and ethnic minority groups and other underserved communities.</text></subsection><subsection id="HBED83091D1814BFE987FCA52A587AE94"><enum>(b)</enum><header>Content</header><text>In developing recommendations under paragraph (1), the Task Force shall address the following:</text><paragraph id="H3CC34F413E96445C90848F201FA2D228"><enum>(1)</enum><text>Measures to facilitate respectful maternity care.</text></paragraph><paragraph id="H65C919CE08904A4A8D39C4068FDFAF7E"><enum>(2)</enum><text display-inline="yes-display-inline">Strategies to increase access to specialized care for individuals with high-risk pregnancies. </text></paragraph><paragraph id="H995549EBBD99466BAC58015E4CEDDDEA"><enum>(3)</enum><text>COVID–19 diagnostic testing for pregnant individuals and individuals in labor.</text></paragraph><paragraph id="HA9681854281241DE9A36264D1CC9D65C"><enum>(4)</enum><text>The designation of a companion during birthing.</text></paragraph><paragraph id="HEE5D92705A634F78B5E8DFD2D520F31E"><enum>(5)</enum><text>The ability to communicate using an electronic mobile device during birthing.</text></paragraph><paragraph id="H4909F2C3CE4E4028BEC297F0A98AD5EC"><enum>(6)</enum><text display-inline="yes-display-inline">With respect to an individual who has the virus that causes COVID–19—</text><subparagraph id="HCCEFF9A5DAD349CF9E3E012656FA0FC0"><enum>(A)</enum><text>separation from a newborn after birth; and</text></subparagraph><subparagraph id="H81C65416C04944CDBFEAEBF9AE790DD2"><enum>(B)</enum><text>ensuring safety while breastfeeding.</text></subparagraph></paragraph><paragraph id="HEEE48EA8961C45A29CE74772B0D1BAB0"><enum>(7)</enum><text>Licensing, training, and reimbursement for midwives from racial and ethnic minority groups and underserved communities.</text></paragraph><paragraph id="H004EEAC5373B4ADCA8396AB6A2D56FD2"><enum>(8)</enum><text>Financial support for perinatal health workers who provide nonclinical support to pregnant individuals and postpartum individuals from underserved communities.</text></paragraph><paragraph id="H0658AF1EAD7C4DC588AD6592840B60F2"><enum>(9)</enum><text display-inline="yes-display-inline">The identification and treatment of prenatal and postpartum mental and behavioral health conditions that may have developed during, or worsened because of, the COVID–19 public health emergency or future public health emergencies, including anxiety, substance use disorder, and depression.</text></paragraph><paragraph id="HC24DEAC548214EA5878291E3B37F1BDE"><enum>(10)</enum><text>Strategies to address hospital capacity issues in communities with an increase in COVID–19 cases, or cases of other infectious diseases.</text></paragraph><paragraph id="H65C081C0DB4846B086AF660E108F9E30"><enum>(11)</enum><text>Options for maternal care that reduce cross-contamination and maintain safety and quality of care, including auxiliary maternity units and freestanding birth centers.</text></paragraph><paragraph id="H98550595787A409793440E1292DBB890"><enum>(12)</enum><text>Methods to identify and address racism, bias, and discrimination in treatment, and to provide support to pregnant and postpartum individuals, including—</text><subparagraph id="H6300DFCB0A454A5B8145F090EC995B7C"><enum>(A)</enum><text>evaluating the training of hospital staff on implicit bias and racism and respectful maternity care; and</text></subparagraph><subparagraph id="HAC86679A0C034A9591738EC22E1768E1"><enum>(B)</enum><text>the collection of demographic data.</text></subparagraph></paragraph><paragraph id="H7880573AEB464B7287D7AAF0F3E9EDA2"><enum>(13)</enum><text>Other matters the Task Force determines appropriate.</text></paragraph></subsection><subsection id="H6CAE8D0D56D44D599AA9734A35A241EF"><enum>(c)</enum><header>Membership</header><paragraph id="H04D79E966DB34F3095F7FD8090660113"><enum>(1)</enum><header>Chair</header><text display-inline="yes-display-inline">The Secretary shall select the chair of the Task Force from among the members of the Task Force.</text></paragraph><paragraph id="H576097AC6E624AA98D46D9F0DC8FEB50"><enum>(2)</enum><header>Composition</header><text display-inline="yes-display-inline">The Task Force shall be composed of—</text><subparagraph id="HE8F2D066CA3346B6A21F6C2EBC6207EB"><enum>(A)</enum><text display-inline="yes-display-inline">representatives of Federal agencies, including the agencies listed in paragraph (3);</text></subparagraph><subparagraph id="HDC4967F1450344329DF1A2D3F250B781"><enum>(B)</enum><text>3 or more representatives of State, local, or territorial public health departments from different areas in the United States that have a large historically marginalized population;</text></subparagraph><subparagraph id="H2945748AA29445AEB417A9B35E0D9ACE"><enum>(C)</enum><text display-inline="yes-display-inline">one or more representatives of Tribal public health departments;</text></subparagraph><subparagraph id="H367F505E49D3406B9C6CC3BF524C8C09"><enum>(D)</enum><text display-inline="yes-display-inline">one or more obstetrician-gynecologists or other physicians who provide obstetric care, with consideration for physicians who are from, or work in, communities experiencing a high rate of mortality and morbidity from COVID–19;</text></subparagraph><subparagraph id="H20C245AC196A4EA086624D718160CCBA"><enum>(E)</enum><text display-inline="yes-display-inline">one or more nurses who provide obstetric care, with consideration for physicians who are from, or work in, communities experiencing a high rate of mortality and morbidity from COVID–19;</text></subparagraph><subparagraph id="H917CA2F7C4C04F84BAB1F96C7C4BE765"><enum>(F)</enum><text>one or more perinatal health workers;</text></subparagraph><subparagraph id="H2E2C97379D35471DBFD184D42AB2117D"><enum>(G)</enum><text>one or more individuals who were pregnant or gave birth during the COVID–19 public health emergency;</text></subparagraph><subparagraph id="H6280CE106C6F4DC9A997260F69D8E8A0"><enum>(H)</enum><text>one or more individuals who had the virus that causes COVID–19 and later gave birth;</text></subparagraph><subparagraph id="H2DFB028919AA490993A08C2D84405D62"><enum>(I)</enum><text>one or more individuals who have received support from a perinatal health; and</text></subparagraph><subparagraph id="H01CB4CBCB80F4049B5E0EEA483FC1200"><enum>(J)</enum><text display-inline="yes-display-inline">3 or more independent experts who are racially and ethnically diverse with knowledge on racial and ethnic disparities in—</text><clause id="H257E0500497546458B3CAEEE651A2B18"><enum>(i)</enum><text>public health;</text></clause><clause id="H78DA3A80F1714A76887BDA7502F9BBD0"><enum>(ii)</enum><text>maternal health; or</text></clause><clause id="HF92CAFE1EA604C95B9DEDF41B8947B36"><enum>(iii)</enum><text>maternal mortality and severe maternal morbidity.</text></clause></subparagraph></paragraph><paragraph display-inline="no-display-inline" id="H603CE9CC7BCC4BFF87787605DC1C64B7"><enum>(3)</enum><header>Federal agencies</header><text display-inline="yes-display-inline">The agencies represented under paragraph (2)(A) shall include the following:</text><subparagraph id="H1B2E7BED613A4AAEBC0A55D9BC628D1A"><enum>(A)</enum><text display-inline="yes-display-inline">The Department of Health and Human Services.</text></subparagraph><subparagraph id="H105CE4CE2C0E4F6E860B276CB5AF3ABF"><enum>(B)</enum><text display-inline="yes-display-inline">The Centers for Disease Control and Prevention.</text></subparagraph><subparagraph id="H2C19A59476EA4128BCDC2F0C586855C0"><enum>(C)</enum><text display-inline="yes-display-inline">The Centers for Medicare & Medicaid Services.</text></subparagraph><subparagraph id="HBC76E85114F64E55BF1987FB35C564B7"><enum>(D)</enum><text display-inline="yes-display-inline">The Health Resources and Services Administration.</text></subparagraph><subparagraph id="HACC95CFF94C54B19A46776773543E8DB"><enum>(E)</enum><text display-inline="yes-display-inline">The Indian Health Service.</text></subparagraph><subparagraph id="H8721A8ABFBCB4EE9BF904E9B8A8A9F26"><enum>(F)</enum><text display-inline="yes-display-inline">The National Institutes of Health.</text></subparagraph></paragraph></subsection></section><section id="H1FE4CA23066A4A38A4306E066416FB50"><enum>1007.</enum><header>GAO report on maternal health and public health emergency preparedness</header><subsection id="HE9F9670E95A641A28E78366BAD57959E"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than one year after the date of enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on maternal health and public health emergency preparedness. Such report shall include the information and recommendations described in subsection (b).</text></subsection><subsection id="H010C8C04E60D4AD187FA1F565B3BC2EA"><enum>(b)</enum><header>Content of report</header><text>The report under subsection (b) shall include the following:</text><paragraph id="H0C7F4FA9499F4DEA902F4815641D2FBF"><enum>(1)</enum><text>A review of prenatal, labor and delivery, and postpartum experiences of individuals during such public health emergency, including—</text><subparagraph id="H38E03F7686A74B4889126924D3E44180"><enum>(A)</enum><text>barriers to accessing pregnancy, birth, and postpartum care during a pandemic;</text></subparagraph><subparagraph id="H39958435EDCD4254B5FF2A206F6C5468"><enum>(B)</enum><text>public and private insurance coverage with respect to maternal health care, including telehealth services;</text></subparagraph><subparagraph id="HEB44830631664E89B9CB2D6B10219858"><enum>(C)</enum><text>to the extent practicable, maternal and infant health outcomes by race and ethnicity (including quality of care, mortality, morbidity, cesarean section rates, preterm birth, prevalence of prenatal and postpartum mental health conditions and substance use disorders);</text></subparagraph><subparagraph id="H1D09657B2D7B4383A313466AD778C851"><enum>(D)</enum><text>with respect to such health outcomes, the impact of Federal and State policy changes during such public health emergency;</text></subparagraph><subparagraph id="H6BC609447569466BB0594C81E9F7C08E"><enum>(E)</enum><text>contributing factors to population-based disparities in health outcomes, including bias and discrimination toward individuals from racial and ethnic minority groups; and</text></subparagraph><subparagraph id="H703BC51557F94E00A6EC01C72865E294"><enum>(F)</enum><text>the effect of increased unemployment, paid family leave, changes in health care coverage, and other social determinants of health for pregnant and postpartum individuals during the public health emergency.</text></subparagraph></paragraph><paragraph id="H18D6D7CD687F421BAE3440FDFCAC4901"><enum>(2)</enum><text>Recommendations on improving the public health emergency response and preparedness efforts of the Federal Government with respect to maternal health, with a focus on outcomes for pregnant and postpartum individuals from racial and ethnic minority groups, including—</text><subparagraph id="HEB2A6D03CD854EC7892CFED9C239588F"><enum>(A)</enum><text>improving research, surveillance, and data collection with respect to maternal health;</text></subparagraph><subparagraph id="H11430390C9024D2BA25329BC3A98EF74"><enum>(B)</enum><text>factoring maternal health outcomes and disparities into decisions regarding distribution of resources;</text></subparagraph><subparagraph id="HB48CFD011F814B91A47BAFDF7A2F2FDF"><enum>(C)</enum><text>improving the distribution of public health funds, data, and information to Indian Tribes and Tribal organizations with regard to maternal health during a public health emergency; and</text></subparagraph><subparagraph id="H7D035D10C418440D94D61E9F339E3740"><enum>(D)</enum><text display-inline="yes-display-inline">improving communications during a public health emergency with—</text><clause id="H4C8D7C0A364343CFB0B13A47C8836C19"><enum>(i)</enum><text>maternity care providers;</text></clause><clause id="HB08D89FA29BD4D9189BA046CA52BE3A4"><enum>(ii)</enum><text>maternal mental and behavioral health care providers;</text></clause><clause id="H4C7A5D6B2E3B4D258A6D9A0B902111BD"><enum>(iii)</enum><text display-inline="yes-display-inline">researchers who specialize in maternal health, maternal mortality, or severe maternal morbidity;</text></clause><clause id="H3B879A34D99E406E9D3E56A5D2CC4D29"><enum>(iv)</enum><text display-inline="yes-display-inline">individuals who experienced pregnancy or childbirth during the COVID–19 public health emergency;</text></clause><clause id="HE1CDEE2ED2024BBD8E122CA8C4861D68"><enum>(v)</enum><text>representatives from community-based organizations that address maternal health; and</text></clause><clause id="H0FBD6F9A4D8642B1B6934993C82A8312"><enum>(vi)</enum><text>perinatal health workers.</text></clause></subparagraph></paragraph></subsection></section><enum>XI</enum><header>Protecting moms and babies against climate change</header><section id="idFC0BAD9C55E9408880BAA4444C38CF79" section-type="subsequent-section"><enum>1101.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title, the following definitions apply:</text><paragraph id="H27C875C0E7C84378A297F5A4752D5A8A"><enum>(1)</enum><header>Adverse maternal and infant health outcomes</header><text>The term <term>adverse maternal and infant health outcomes</term> includes the outcomes of preterm birth, low birth weight, stillbirth, infant or maternal mortality, and severe maternal morbidity.</text></paragraph><paragraph id="H31C8D96860974E3BB352408201ADC222"><enum>(2)</enum><header>Institution of higher education</header><text>The term <term>institution of higher education</term> has the meaning given such term in section 101 of the Higher Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/1001">20 U.S.C. 1001</external-xref>).</text></paragraph><paragraph id="idD7E535D03126440A89EBAFCFF6902482"><enum>(3)</enum><header>Minority-serving institution</header><text>The term <term>minority-serving institution</term> means an entity specified in any of paragraphs (1) through (7) of 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></paragraph><paragraph id="HA0D2649E1FE54CA3B01E588299A8AD02"><enum>(4)</enum><header>Risks associated with climate change</header><text>The term <term>risks associated with climate change</term> includes risks associated with extreme heat, air pollution, extreme weather events, and other environmental issues associated with climate change that can result in adverse maternal and infant health outcomes.</text></paragraph><paragraph id="id833755B038D1413481714F4F805831F4"><enum>(5)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph><paragraph id="HAD15C7D35C414836B9D86BEF26F2E65C"><enum>(6)</enum><header>Stakeholder organization</header><text>The term <term>stakeholder organization</term> means—</text><subparagraph id="HB5EF0C3D58614B99B3F4CB384EC04EC0"><enum>(A)</enum><text display-inline="yes-display-inline">a community-based organization with expertise in providing assistance to vulnerable individuals;</text></subparagraph><subparagraph id="H706284A80A564D26801032C596029214"><enum>(B)</enum><text display-inline="yes-display-inline">a nonprofit organization with expertise in maternal or infant health or environmental justice; and</text></subparagraph><subparagraph id="H5A961E5A2FC94310844AB0A4ACBC46D7"><enum>(C)</enum><text display-inline="yes-display-inline">a patient advocacy organization representing vulnerable individuals. </text></subparagraph></paragraph><paragraph id="H7C9D153B047E421ABE52EF1CF4397156"><enum>(7)</enum><header>Vulnerable individual</header><text>The term <term>vulnerable individual</term> means—</text><subparagraph id="HFD5426E3BDE04347BB44EF721B1E96FB"><enum>(A)</enum><text>an individual who is pregnant;</text></subparagraph><subparagraph id="H0F62177ABB944DAC8E9339B515DAA25F"><enum>(B)</enum><text>an individual who was pregnant during any portion of the preceding 1-year period; and</text></subparagraph><subparagraph id="HC2DD707906DA4E92B273C65A4756D2A9"><enum>(C)</enum><text>an individual under 3 years of age.</text></subparagraph></paragraph></section><section id="H1BEAF1FDB4014E4892C4FDA3A66EC9E2"><enum>1102.</enum><header>Grant program to protect vulnerable mothers and babies from climate change risks</header><subsection id="H58A847F216EC4C09B3FE0CAD23A39185"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 180 days after the date of enactment of this Act, the Secretary shall establish a grant program (in this section referred to as the <quote>Program</quote>) to protect vulnerable individuals from risks associated with climate change.</text></subsection><subsection id="H46C095C9D71C4B54A0BC6897A74E7386"><enum>(b)</enum><header>Grant authority</header><text display-inline="yes-display-inline">In carrying out the Program, the Secretary may award, on a competitive basis, grants to 10 covered entities. </text></subsection><subsection id="HEBADB1CE4D294EB389854F0F63F7DE05"><enum>(c)</enum><header>Applications</header><text display-inline="yes-display-inline">To be eligible for a grant under the Program, a covered entity shall submit to the Secretary an application at such time, in such form, and containing such information as the Secretary may require, which shall include, at a minimum, a description of the following:</text><paragraph id="HE8373506F41345ED81C1F06105852EAB"><enum>(1)</enum><text display-inline="yes-display-inline">Plans for the use of grant funds awarded under the Program and how patients and stakeholder organizations were involved in the development of such plans.</text></paragraph><paragraph id="H87A797E9FE224B00BB8F857E4B2CF8E4"><enum>(2)</enum><text display-inline="yes-display-inline">How such grant funds will be targeted to geographic areas that have disproportionately high levels of risks associated with climate change for vulnerable individuals.</text></paragraph><paragraph id="HC5F962DDFB464DF7BD6C2A474E032E22"><enum>(3)</enum><text display-inline="yes-display-inline">How such grant funds will be used to address racial and ethnic disparities in—</text><subparagraph id="H63EA90F056DE47A3B4EEE8C591F1CF3A"><enum>(A)</enum><text display-inline="yes-display-inline">adverse maternal and infant health outcomes; and</text></subparagraph><subparagraph id="H245C5DDD28EC43629F3C0EDDC98797F1"><enum>(B)</enum><text display-inline="yes-display-inline">exposure to risks associated with climate change for vulnerable individuals. </text></subparagraph></paragraph><paragraph id="H265C0E7FF1CA4A7BBB276A2FCA8DCD2E"><enum>(4)</enum><text display-inline="yes-display-inline">Strategies to prevent an initiative assisted with such grant funds from causing—</text><subparagraph id="HD66EE8C4B66B4DBE901AF85EB55D5746"><enum>(A)</enum><text>adverse environmental impacts; </text></subparagraph><subparagraph id="HDED6EF27574E4104AF2394D948B1A527"><enum>(B)</enum><text>displacement of residents and businesses;</text></subparagraph><subparagraph id="H6466FEB6A8474E90AB4EA91DE59396BF"><enum>(C)</enum><text>rent and housing price increases; or</text></subparagraph><subparagraph id="H504E01897CD6464D860B37D248B28347"><enum>(D)</enum><text>disproportionate adverse impacts on racial and ethnic minority groups and other underserved populations. </text></subparagraph></paragraph></subsection><subsection id="H8E89880806604D4BB5DFA38C3A48017E"><enum>(d)</enum><header>Selection of grant recipients</header><paragraph id="H9D16618AF1A44528A6E53CD88E20BB18"><enum>(1)</enum><header>Timing</header><text display-inline="yes-display-inline">Not later than 270 days after the date of enactment of this Act, the Secretary shall select the recipients of grants under the Program.</text></paragraph><paragraph id="H6293FD47052E4AFEA6D179C61A76234C"><enum>(2)</enum><header>Consultation</header><text display-inline="yes-display-inline">In selecting covered entities for grants under the Program, the Secretary shall consult with—</text><subparagraph id="HE965EB135B8F4B6990CF847F39B3AD13"><enum>(A)</enum><text display-inline="yes-display-inline">representatives of stakeholder organizations;</text></subparagraph><subparagraph id="H6C898CE24D874143AE1E52152DB2F2DB"><enum>(B)</enum><text display-inline="yes-display-inline">the Administrator of the Environmental Protection Agency;</text></subparagraph><subparagraph id="H0F929FC89CCE4E6D9F1484DE2753FC11"><enum>(C)</enum><text display-inline="yes-display-inline">the Administrator of the National Oceanic and Atmospheric Administration; and</text></subparagraph><subparagraph id="H5368682B70D3444F9AF6FCF8A5A51A49"><enum>(D)</enum><text>from the Department of Health and Human Services—</text><clause id="H55BD5C4DCF2E490AB40F12D42E0D1D8A"><enum>(i)</enum><text>the Deputy Assistant Secretary for Minority Health;</text></clause><clause id="H3967746648E04082A6EC8E40C48C90C2"><enum>(ii)</enum><text>the Administrator of the Centers for Medicare & Medicaid Services;</text></clause><clause id="H74F269800F934645ACAD94C96C8433AB"><enum>(iii)</enum><text>the Administrator of the Health Resources and Services Administration; </text></clause><clause id="HA67BC95AF1414D3896F5C0EF0C6396D6"><enum>(iv)</enum><text display-inline="yes-display-inline">the Director of the National Institutes of Health; and</text></clause><clause id="H1ADA9A31F30D457F8A841169079D1C3C"><enum>(v)</enum><text display-inline="yes-display-inline">the Director of the Centers for Disease Control and Prevention.</text></clause></subparagraph></paragraph><paragraph id="H2874396498C54CFE994969676A43BE78"><enum>(3)</enum><header>Priority</header><text display-inline="yes-display-inline">In selecting a covered entity to be awarded a grant under the Program, the Secretary shall give priority to covered entities that serve a county— </text><subparagraph id="HBF6257540B884618B673A840788D70A1"><enum>(A)</enum><text display-inline="yes-display-inline">designated, or located in an area designated, as a nonattainment area pursuant to section 107 of the Clean Air Act (<external-xref legal-doc="usc" parsable-cite="usc/42/7407">42 U.S.C. 7407</external-xref>) for any air pollutant for which air quality criteria have been issued under section 108(a) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/7408">42 U.S.C. 7408(a)</external-xref>);</text></subparagraph><subparagraph id="HEE7DEFA3BC254C2596963BEE0A370814"><enum>(B)</enum><text display-inline="yes-display-inline">with a level of vulnerability of moderate-to-high or higher, according to the Social Vulnerability Index of the Centers for Disease Control and Prevention; or</text></subparagraph><subparagraph id="H168291585FE24836A7CDC06DD11DA1AF"><enum>(C)</enum><text display-inline="yes-display-inline">with temperatures that pose a risk to human health, as determined by the Secretary, in consultation with the Administrator of the National Oceanic and Atmospheric Administration and the Chair of the United States Global Change Research Program, based on the best available science.</text></subparagraph></paragraph><paragraph id="HAD15DD8BEE3640C68EC02E71FBDC37B3"><enum>(4)</enum><header>Limitation</header><text>A covered entity awarded grant funds under the Program may not use such grant funds to serve a county that is served by any other recipient of a grant under the Program. </text></paragraph></subsection><subsection id="HCAA591BE066547CC8A4CC57B7DBABAF2"><enum>(e)</enum><header>Use of funds</header><text display-inline="yes-display-inline">A covered entity awarded grant funds under the Program may only use such grant funds for the following: </text><paragraph id="H667C7D163BC140338D58DD87E87D02BA"><enum>(1)</enum><text display-inline="yes-display-inline">Initiatives to identify risks associated with climate change for vulnerable individuals and to provide services and support to such individuals that address such risks, including— </text><subparagraph id="HCCD977290C564AE48E1603D1422DBC45"><enum>(A)</enum><text display-inline="yes-display-inline">training for health care providers, doulas, and other employees in hospitals, birth centers, midwifery practices, and other health care practices that provide prenatal or labor and delivery services to vulnerable individuals on the identification of, and patient counseling relating to, risks associated with climate change for vulnerable individuals;</text></subparagraph><subparagraph id="H1E9EE4B06BB748A18EF480DCFDA647E0"><enum>(B)</enum><text display-inline="yes-display-inline">hiring, training, or providing resources to community health workers and perinatal health workers who can help identify risks associated with climate change for vulnerable individuals, provide patient counseling about such risks, and carry out the distribution of relevant services and support;</text></subparagraph><subparagraph id="H7A8371B09DBF49D5A5149D73D8AA7A82"><enum>(C)</enum><text display-inline="yes-display-inline">enhancing the monitoring of risks associated with climate change for vulnerable individuals, including by—</text><clause id="HA91A13811CB2496A80BC87DE1DFF7BF3"><enum>(i)</enum><text>collecting data on such risks in specific census tracts, neighborhoods, or other geographic areas; and</text></clause><clause id="H5CB23CB196BC40D1A69D871D1D224744"><enum>(ii)</enum><text display-inline="yes-display-inline">sharing such data with local health care providers, doulas, and other employees in hospitals, birth centers, midwifery practices, and other health care practices that provide prenatal or labor and delivery services to local vulnerable individuals; and </text></clause></subparagraph><subparagraph id="H5AD55923B4244E93898652A5EF2CF0DB"><enum>(D)</enum><text display-inline="yes-display-inline">providing vulnerable individuals—</text><clause id="H17D2481D23104B9B8E7712B7E15D9F5E"><enum>(i)</enum><text>air conditioning units, residential weatherization support, filtration systems, household appliances, or related items;</text></clause><clause id="HB69190E0D94248D4BB8499C6B1EE3C6A"><enum>(ii)</enum><text display-inline="yes-display-inline">direct financial assistance; and</text></clause><clause id="H86B45A635C374E69AB89BEA1249B1586"><enum>(iii)</enum><text display-inline="yes-display-inline">services and support, including housing and transportation assistance, to prepare for or recover from extreme weather events, which may include floods, hurricanes, wildfires, droughts, and related events.</text></clause></subparagraph></paragraph><paragraph id="HB22C73813BED4D8D92134A1C4E2EAE28"><enum>(2)</enum><text display-inline="yes-display-inline">Initiatives to mitigate levels of and exposure to risks associated with climate change for vulnerable individuals, which shall be based on the best available science and which may include initiatives to— </text><subparagraph id="HCC102E26A2584F87A0291D292D2DB257"><enum>(A)</enum><text display-inline="yes-display-inline">develop, maintain, or expand urban or community forestry initiatives and tree canopy coverage initiatives;</text></subparagraph><subparagraph id="H5E72ADDADA6B49CC8D26A987C97B465A"><enum>(B)</enum><text display-inline="yes-display-inline">improve infrastructure, including buildings and paved surfaces;</text></subparagraph><subparagraph id="H65BE5A41B48D431991C6AE4297F835EB"><enum>(C)</enum><text display-inline="yes-display-inline">develop or improve community outreach networks to provide culturally and linguistically appropriate information and notifications about risks associated with climate change for vulnerable individuals; and</text></subparagraph><subparagraph id="HE5934AE3CFF2499EABCB059AE0AFCA3F"><enum>(D)</enum><text display-inline="yes-display-inline">provide enhanced services to racial and ethnic minority groups and other underserved populations.</text></subparagraph></paragraph></subsection><subsection id="HF03D54EEEAD846A1B0D38BFC09CF7240"><enum>(f)</enum><header>Length of award</header><text display-inline="yes-display-inline">A grant under this section shall be disbursed over 4 fiscal years.</text></subsection><subsection id="H5464C40CD3414B76991A3C45DB33E367"><enum>(g)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">The Secretary shall provide technical assistance to a covered entity awarded a grant under the Program to support the development, implementation, and evaluation of activities funded with such grant.</text></subsection><subsection id="H7E674F4FA5F241F686827A75908F50AD"><enum>(h)</enum><header>Reports to Secretary</header><paragraph id="H17C05965668A43028007E1E5CFC073E0"><enum>(1)</enum><header>Annual report</header><text display-inline="yes-display-inline">For each fiscal year during which a covered entity is disbursed grant funds under the Program, such covered entity shall submit to the Secretary a report that summarizes the activities carried out by such covered entity with such grant funds during such fiscal year, including a description of the following:</text><subparagraph id="HEDE09F92A0D045F087C419BD790D9AD7"><enum>(A)</enum><text display-inline="yes-display-inline">The involvement of stakeholder organizations in the implementation of initiatives assisted with such grant funds.</text></subparagraph><subparagraph id="H35AC7C81FD84408296035F177346D62E"><enum>(B)</enum><text display-inline="yes-display-inline">Relevant health and environmental data, disaggregated, to the extent practicable, by race, ethnicity, gender, and pregnancy status.</text></subparagraph><subparagraph id="H2ACC8B31A7F249088AECECD3FAE41A55"><enum>(C)</enum><text display-inline="yes-display-inline">Qualitative feedback received from vulnerable individuals with respect to initiatives assisted with such grant funds.</text></subparagraph><subparagraph id="H70E34A761D9B427DA0CDDDED2027DB73"><enum>(D)</enum><text display-inline="yes-display-inline">Criteria used in selecting the geographic areas assisted with such grant funds.</text></subparagraph><subparagraph id="HC0CD57906FE94603904DBD84DFADFD5D"><enum>(E)</enum><text display-inline="yes-display-inline">Efforts to address racial and ethnic disparities in adverse maternal and infant health outcomes and in exposure to risks associated with climate change for vulnerable individuals.</text></subparagraph><subparagraph id="HEAE82B6E72C94EACB47227A11BDB8D0A"><enum>(F)</enum><text display-inline="yes-display-inline">Any negative and unintended impacts of initiatives assisted with such grant funds, including—</text><clause id="H9113FE83E33F46D5BFE08E1386BA1916"><enum>(i)</enum><text>adverse environmental impacts;</text></clause><clause id="H0E5191B7747147E6A4E105BA897A77B0"><enum>(ii)</enum><text>displacement of residents and businesses;</text></clause><clause id="H94326F0CF25D4156B5A1719278DF2329"><enum>(iii)</enum><text>rent and housing price increases; and</text></clause><clause id="HBF0CF1088303433B9D36915C6B2DF2A1"><enum>(iv)</enum><text>disproportionate adverse impacts on racial and ethnic minority groups and other underserved populations.</text></clause></subparagraph><subparagraph id="H961A6303A0414CA8A3DEFD70C1DEB889"><enum>(G)</enum><text display-inline="yes-display-inline">How the covered entity will address and prevent any impacts described in subparagraph (F).</text></subparagraph></paragraph><paragraph id="H3176DA63B84149BF9A06FE37D2A3CED7"><enum>(2)</enum><header>Publication</header><text display-inline="yes-display-inline">Not later than 30 days after the date on which a report is submitted under paragraph (1), the Secretary shall publish such report on a public website of the Department of Health and Human Services.</text></paragraph></subsection><subsection id="H0865A6E23ECD46A8B057E42982598372"><enum>(i)</enum><header>Report to Congress</header><text display-inline="yes-display-inline">Not later than the date that is 5 years after the date on which the Program is established, the Secretary shall submit to Congress and publish on a public website of the Department of Health and Human Services a report on the results of the Program, including the following:</text><paragraph id="HC851A02B3678402CAA08C597264C3B9E"><enum>(1)</enum><text display-inline="yes-display-inline">Summaries of the annual reports submitted under subsection (h).</text></paragraph><paragraph id="HCB3A5BC7A4E945AEBA82841A4438510E"><enum>(2)</enum><text display-inline="yes-display-inline">Evaluations of the initiatives assisted with grant funds under the Program.</text></paragraph><paragraph id="HEB610E30D0A04B99863524A99F160D68"><enum>(3)</enum><text display-inline="yes-display-inline">An assessment of the effectiveness of the Program in—</text><subparagraph id="H3F3B1975F3D6488A88CF1CF63030AB0B"><enum>(A)</enum><text display-inline="yes-display-inline">identifying risks associated with climate change for vulnerable individuals;</text></subparagraph><subparagraph id="H895980560B8247889EBFA86FC85ECAF3"><enum>(B)</enum><text>providing services and support to such individuals;</text></subparagraph><subparagraph id="HCD5FB86399D2427C98F1FF2EF291274A"><enum>(C)</enum><text display-inline="yes-display-inline">mitigating levels of and exposure to such risks; and</text></subparagraph><subparagraph id="HF08B7F25C12F47DFB5807C3DD7A606EC"><enum>(D)</enum><text display-inline="yes-display-inline">addressing racial and ethnic disparities in adverse maternal and infant health outcomes and in exposure to such risks.</text></subparagraph></paragraph><paragraph id="H6C56A53BC4B94E768495B5085BFF79F1"><enum>(4)</enum><text display-inline="yes-display-inline">A description of how the Program could be expanded, including— </text><subparagraph id="H59E0E0BB61714E3B919AE873AA6956CF"><enum>(A)</enum><text display-inline="yes-display-inline">monitoring efforts or data collection that would be required to identify areas with high levels of risks associated with climate change for vulnerable individuals;</text></subparagraph><subparagraph id="H7FC553CC47D34375980AF8D8D1A4319B"><enum>(B)</enum><text display-inline="yes-display-inline">how such areas could be identified using the strategy developed under section 5; and</text></subparagraph><subparagraph id="HEFEE8AA1FA1A48409D976FA2E279347B"><enum>(C)</enum><text display-inline="yes-display-inline">recommendations for additional funding.</text></subparagraph></paragraph></subsection><subsection id="H38060A088D0E408BB322A84EBED41313"><enum>(j)</enum><header>Definition of Covered entity</header><text display-inline="yes-display-inline">In this section, the term <term>covered entity</term> means a consortium of organizations serving a county that—</text><paragraph id="HFECDB3F67ADC4681A1494E05AD45EBAD"><enum>(1)</enum><text>shall include a community-based organization; and</text></paragraph><paragraph id="H7BC9FA90B06E4BED9A475708F6E2C553"><enum>(2)</enum><text>may include—</text><subparagraph id="H07A47DCF2F1F48A68891701A37721376"><enum>(A)</enum><text>another stakeholder organization; </text></subparagraph><subparagraph id="H469232860DB14E0DAEBB0FC3624803D3"><enum>(B)</enum><text display-inline="yes-display-inline">the government of such county;</text></subparagraph><subparagraph id="H72B9DCE452AB4160BA8253AD913E99D8"><enum>(C)</enum><text display-inline="yes-display-inline">the governments of one or more municipalities within such county;</text></subparagraph><subparagraph id="H7D704B4BDB93468EB96E2FB98796F703"><enum>(D)</enum><text>a State or local public health department or emergency management agency;</text></subparagraph><subparagraph id="H956295679B774B9AB3DB1407B8F673FD"><enum>(E)</enum><text display-inline="yes-display-inline">a local health care practice, which may include a licensed and accredited hospital, birth center, midwifery practice, or other health care practice that provides prenatal or labor and delivery services to vulnerable individuals;</text></subparagraph><subparagraph id="H96C1E9A3378343C5837B24871773FAD2"><enum>(F)</enum><text display-inline="yes-display-inline">an Indian Tribe or Tribal organization (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>));</text></subparagraph><subparagraph id="HEF2777E2E2CD428D8EAB2B0B6489ACDA"><enum>(G)</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>)); and</text></subparagraph><subparagraph id="H792E37E8C5DE4BB5A446275158AF3024"><enum>(H)</enum><text display-inline="yes-display-inline">an institution of higher education.</text></subparagraph></paragraph></subsection><subsection id="HFC0EE62565B546248E94469FCB68034E"><enum>(k)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section $100,000,000 for the period of fiscal years 2022 through 2025.</text></subsection></section><section id="H95F327C34DC34EF1A845F18C4DE9739C"><enum>1103.</enum><header>Grant program for education and training at health profession schools</header><subsection id="H7D3F92F4ACF44865A058B4E9AEF99CA4"><enum>(a)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of this Act, the Secretary shall establish a grant program (in this section referred to as the <quote>Program</quote>) to provide funds to health profession schools to support the development and integration of education and training programs for identifying and addressing risks associated with climate change for vulnerable individuals.</text></subsection><subsection id="H9936D38C1EF44B49BEB4D96D9851875F"><enum>(b)</enum><header>Grant authority</header><text>In carrying out the Program, the Secretary may award, on a competitive basis, grants to health profession schools.</text></subsection><subsection id="H9A4E99BB1E7B46B58E1B9CA6210F9734"><enum>(c)</enum><header>Application</header><text>To be eligible for a grant under the Program, a health profession school shall submit to the Secretary an application at such time, in such form, and containing such information as the Secretary may require, including a description of the following:</text><paragraph id="H73C01300F8F84FD5919EDEE873B6E0E9"><enum>(1)</enum><text>How such health profession school will engage with vulnerable individuals, and stakeholder organizations representing such individuals, in developing and implementing the education and training programs supported by grant funds awarded under the Program. </text></paragraph><paragraph id="H8717FBFCE5664F2AB349977C6F2FE228"><enum>(2)</enum><text>How such health profession school will ensure that such education and training programs will address racial and ethnic disparities in exposure to, and the effects of, risks associated with climate change for vulnerable individuals.</text></paragraph></subsection><subsection id="HEF048C6969D049928E3731EA5C7C1277"><enum>(d)</enum><header>Use of funds</header><text>A health profession school awarded a grant under the Program shall use the grant funds to develop, and integrate into the curriculum and continuing education of such health profession school, education and training on each of the following:</text><paragraph id="HF7FED998D1F04D0ABB72DACF77F18CF5"><enum>(1)</enum><text display-inline="yes-display-inline">Identifying risks associated with climate change for vulnerable individuals and individuals with the intent to become pregnant.</text></paragraph><paragraph id="HE4159B610F984C54A1040CB0A66A193F"><enum>(2)</enum><text>How risks associated with climate change affect vulnerable individuals and individuals with the intent to become pregnant.</text></paragraph><paragraph id="H560E13D4C3B44F0A8D74B96CF0C51445"><enum>(3)</enum><text>Racial and ethnic disparities in exposure to, and the effects of, risks associated with climate change for vulnerable individuals and individuals with the intent to become pregnant.</text></paragraph><paragraph id="HC87081AC9CC54A748C6627AAB9535E0F"><enum>(4)</enum><text display-inline="yes-display-inline">Patient counseling and mitigation strategies relating to risks associated with climate change for vulnerable individuals.</text></paragraph><paragraph id="H7E58ED6A898D4757913D9FB122CAD523"><enum>(5)</enum><text>Relevant services and support for vulnerable individuals relating to risks associated with climate change and strategies for ensuring vulnerable individuals have access to such services and support.</text></paragraph><paragraph id="HEAD854C0CFA041B1A3E94FA36AEAFB64"><enum>(6)</enum><text>Implicit and explicit bias, racism, and discrimination. </text></paragraph><paragraph id="H773E5329A7674A4A85192E90E4419CBF"><enum>(7)</enum><text>Related topics identified by such health profession school based on the engagement of such health profession school with vulnerable individuals and stakeholder organizations representing such individuals.</text></paragraph></subsection><subsection id="H64B7BB6B59BA4B3E9F276BAF2D89CC68"><enum>(e)</enum><header>Partnerships</header><text display-inline="yes-display-inline">In carrying out activities with grant funds, a health profession school awarded a grant under the Program may partner with— </text><paragraph id="H9A481F61AF224F4EB7632818AD89F4DA"><enum>(1)</enum><text>a State or local public health department;</text></paragraph><paragraph id="HC0F8C6F34B3B43249FEB5736D7A636BE"><enum>(2)</enum><text display-inline="yes-display-inline">a health care professional membership organization;</text></paragraph><paragraph id="HF5651D4CAD2B40FCA3BE590A0742E822"><enum>(3)</enum><text display-inline="yes-display-inline">a stakeholder organization;</text></paragraph><paragraph id="H4156C4244A014D28B429D0E10E89AEF2"><enum>(4)</enum><text>a health profession school; or</text></paragraph><paragraph id="HF4B9E9D847834155BBA480C2C56BF667"><enum>(5)</enum><text>an institution of higher education.</text></paragraph></subsection><subsection id="HC97A250F6A854B7FB296F9984EE5A3FC"><enum>(f)</enum><header>Reports to Secretary</header><paragraph id="H992FAEFC119243DC845495F09BBB279E"><enum>(1)</enum><header>Annual report</header><text display-inline="yes-display-inline">For each fiscal year during which a health profession school is disbursed grant funds under the Program, such health profession school shall submit to the Secretary a report that describes the activities carried out with such grant funds during such fiscal year. </text></paragraph><paragraph id="H39136B51ACD64A268206681EC0C46FA9"><enum>(2)</enum><header>Final report</header><text>Not later than the date that is 1 year after the end of the last fiscal year during which a health profession school is disbursed grant funds under the Program, the health profession school shall submit to the Secretary a final report that summarizes the activities carried out with such grant funds.</text></paragraph></subsection><subsection id="H0608872DCF4C4B3AA931877D852A0A4D"><enum>(g)</enum><header>Report to Congress</header><text>Not later than the date that is 6 years after the date on which the Program is established, the Secretary shall submit to Congress and publish on a public website of the Department of Health and Human Services a report that includes—</text><paragraph id="HAD000B06B8CB4BF29BF763C442EC48CA"><enum>(1)</enum><text>a summary of the reports submitted under subsection (f); and </text></paragraph><paragraph id="HB110C9E734BD455BB642BD3AE90DC207"><enum>(2)</enum><text>recommendations to improve education and training programs at health profession schools with respect to identifying and addressing risks associated with climate change for vulnerable individuals.</text></paragraph></subsection><subsection id="H1374B0D8FF98485EBBFBC526E75CE9EC"><enum>(h)</enum><header>Definition of health profession school</header><text>In this section, the term <term>health profession school</term> means an accredited—</text><paragraph id="H5F7E7D63A6754DDEA4E6CF1F75DB0782"><enum>(1)</enum><text>medical school;</text></paragraph><paragraph id="H1342D49EEBFD4E60AA24F2E08E5D46F3"><enum>(2)</enum><text>school of nursing;</text></paragraph><paragraph id="H9E63663A95ED414FB4EAAB2047879839"><enum>(3)</enum><text>midwifery program; </text></paragraph><paragraph id="H18D92310257C4D78A434B63BA00E8B18"><enum>(4)</enum><text>physician assistant education program;</text></paragraph><paragraph id="HC55D89D96A9E4F8D9E5A1F23B425CF4B"><enum>(5)</enum><text>teaching hospital;</text></paragraph><paragraph id="HEA62EA808C3A4EFAB49E2619BA6FAE01"><enum>(6)</enum><text>residency or fellowship program; or </text></paragraph><paragraph id="HAFB651EAFB474520BBAAC92423D23399"><enum>(7)</enum><text>other school or program determined appropriate by the Secretary.</text></paragraph></subsection><subsection id="HC04AC404EAF844F88B52B14A928BB04F"><enum>(i)</enum><header>Authorization of Appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section $5,000,000 for the period of fiscal years 2022 through 2025.</text></subsection></section><section id="HCA7BEF02175A42618CE86EB8D3C55F6E"><enum>1104.</enum><header>NIH Consortium on Birth and Climate Change Research</header><subsection id="HDBAAB76FB00449FE8CE44BC61DE79878"><enum>(a)</enum><header>Establishment</header><text>Not later than one year after the date of enactment of this Act, the Director of the National Institutes of Health shall establish the Consortium on Birth and Climate Change Research (in this section referred to as the <quote>Consortium</quote>).</text></subsection><subsection id="H84F14897B09A40F680BD87C83C327AF3"><enum>(b)</enum><header>Duties</header><paragraph id="HB4318BE684EB4588BA52323AA4981EC2"><enum>(1)</enum><header>In general</header><text>The Consortium shall coordinate, across the institutes, centers, and offices of the National Institutes of Health, research on the risks associated with climate change for vulnerable individuals.</text></paragraph><paragraph id="H82D8C45B2CE24FD8B691A08CFDB37FF8"><enum>(2)</enum><header>Required activities</header><text>In carrying out paragraph (1), the Consortium shall— </text><subparagraph id="HCD74A15D42754A36981D564D46060154"><enum>(A)</enum><text display-inline="yes-display-inline">establish research priorities, including by prioritizing research that—</text><clause id="H5A6F9941AF8F48DA9940F4A4ED5BE06C"><enum>(i)</enum><text display-inline="yes-display-inline">identifies the risks associated with climate change for vulnerable individuals with a particular focus on disparities in such risks among racial and ethnic minority groups and other underserved populations; and</text></clause><clause id="HD98BC762D07548E5AA994182A503DEF7"><enum>(ii)</enum><text display-inline="yes-display-inline">identifies strategies to reduce levels of, and exposure to, such risks, with a particular focus on risks among racial and ethnic minority groups and other underserved populations; </text></clause></subparagraph><subparagraph id="H28DCD78F01954526BC4C62B098B5DDDE"><enum>(B)</enum><text display-inline="yes-display-inline">identify gaps in available data related to such risks;</text></subparagraph><subparagraph id="HF0B77EA0C98941C5944EDB6A86FDD941"><enum>(C)</enum><text>identify gaps in, and opportunities for, research collaborations;</text></subparagraph><subparagraph id="HBECDFF4CDDCF438EB454498BDF7CE04F"><enum>(D)</enum><text>identify funding opportunities for community-based organizations and researchers from racially, ethnically, and geographically diverse backgrounds; and</text></subparagraph><subparagraph id="H1D6F59AB79FC4C3AAB7EA22DF56B9657"><enum>(E)</enum><text>publish annual reports on the work and findings of the Consortium on a public website of the National Institutes of Health.</text></subparagraph></paragraph></subsection><subsection id="HF0E296A912BB49A7BFB84E1F2AB5D7BF"><enum>(c)</enum><header>Membership</header><text display-inline="yes-display-inline">The Director of the National Institutes of Health shall appoint to the Consortium representatives of such institutes, centers, and offices of the National Institutes of Health as the Director considers appropriate, including representatives of—</text><paragraph id="H7469F1CD39804AF4A52DEE1A8340845B"><enum>(1)</enum><text>the National Institute of Environmental Health Sciences;</text></paragraph><paragraph id="HFED50FBBADA84D2A99F57CE949820B85"><enum>(2)</enum><text>the National Institute on Minority Health and Health Disparities;</text></paragraph><paragraph id="H811070FDA0A64A8CA3F5E55FD2A53F98"><enum>(3)</enum><text>the Eunice Kennedy Shriver National Institute of Child Health and Human Development; </text></paragraph><paragraph id="H078D24BD5BBF4B59A453EF453F42CE8B"><enum>(4)</enum><text>the National Institute of Nursing Research; and</text></paragraph><paragraph id="HC5E13C4862F143D583F5E8207F8966E4"><enum>(5)</enum><text>the Office of Research on Women’s Health.</text></paragraph></subsection><subsection id="HBE219A8E9471477DB549D8CFD3734DD3"><enum>(d)</enum><header>Chairperson</header><text>The Chairperson of the Consortium shall be designated by the Director and selected from among the representatives appointed under subsection (c).</text></subsection><subsection id="HED16D501AECD43BEA9354F00644B1EB6"><enum>(e)</enum><header>Consultation</header><text>In carrying out the duties described in subsection (b), the Consortium shall consult with—</text><paragraph id="H5FD68163A92944709E05AE7FDF3EF724"><enum>(1)</enum><text>the heads of relevant Federal agencies, including—</text><subparagraph id="HADD7DB796C7C4B97A9F4788A5B703651"><enum>(A)</enum><text>the Environmental Protection Agency; </text></subparagraph><subparagraph id="H19362B344F3241A3A7F614F236860169"><enum>(B)</enum><text>the National Oceanic and Atmospheric Administration; </text></subparagraph><subparagraph id="H231CF46FF9554929BB3EE12852E96AD6"><enum>(C)</enum><text>the Occupational Safety and Health Administration; and</text></subparagraph><subparagraph id="H86B60CC0C1144C41BB996E3B85DE6A92"><enum>(D)</enum><text>from the Department of Health and Human Services—</text><clause id="H64A85F2F54604CBFABDE393276D57F8C"><enum>(i)</enum><text display-inline="yes-display-inline">the Office of Minority Health in the Office of the Secretary;</text></clause><clause id="HD5C76D3F2619404283C254CB7118E701"><enum>(ii)</enum><text display-inline="yes-display-inline">the Centers for Medicare & Medicaid Services;</text></clause><clause id="HDADFA3BD8C0F43BD82AB805AA9A862C0"><enum>(iii)</enum><text>the Health Resources and Services Administration;</text></clause><clause id="HE9C5727F40964AB2800B31BDF84E43B5"><enum>(iv)</enum><text>the Centers for Disease Control and Prevention; </text></clause><clause id="H59F640E9AC8341D1B13EAC1B91293F39"><enum>(v)</enum><text>the Indian Health Service; and</text></clause><clause id="HB6A489D279424509867AE499A74C98A2"><enum>(vi)</enum><text>the Administration for Children and Families; and </text></clause></subparagraph></paragraph><paragraph id="H746284060AF04F1FB7822F618FC225F9"><enum>(2)</enum><text>representatives of—</text><subparagraph id="H264BB0CD7C964497B1E00C0E848DED1D"><enum>(A)</enum><text>stakeholder organizations;</text></subparagraph><subparagraph id="HC251DB6F54B048F68575088FCDA9A7B1"><enum>(B)</enum><text>health care providers and professional membership organizations with expertise in maternal health or environmental justice;</text></subparagraph><subparagraph id="H51D378A5277648A88DC873235583D424"><enum>(C)</enum><text>State and local public health departments;</text></subparagraph><subparagraph id="H592AC29121C34FCDB9487D149BE6FDB1"><enum>(D)</enum><text>licensed and accredited hospitals, birth centers, midwifery practices, or other health care practices that provide prenatal or labor and delivery services to vulnerable individuals; and</text></subparagraph><subparagraph id="H61BD7810E70842FEB7D409430059EFC0"><enum>(E)</enum><text>institutions of higher education, including such institutions that are minority-serving institutions or have expertise in maternal health or environmental justice.</text></subparagraph></paragraph></subsection></section><section id="HA9161DC9F01A43D9B9FA52CCFECA608E"><enum>1105.</enum><header>Strategy for identifying climate change risk zones for vulnerable mothers and babies</header><subsection id="HFC07E035DE3B48E8869C2B6B86D78E2F"><enum>(a)</enum><header>In general</header><text>The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall develop a strategy (in this section referred to as the <quote>Strategy</quote>) for designating areas that the Secretary determines to have a high risk of adverse maternal and infant health outcomes among vulnerable individuals as a result of risks associated with climate change.</text></subsection><subsection id="HDEBF0B2A649F4681A4CF3123DA3744CC"><enum>(b)</enum><header>Strategy requirements</header><paragraph id="H7029CA2B1EAC490D9B18F3FAC253DE6F"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">In developing the Strategy, the Secretary shall establish a process to identify areas where vulnerable individuals are exposed to a high risk of adverse maternal and infant health outcomes as a result of risks associated with climate change in conjunction with other factors that can impact such health outcomes, including—</text><subparagraph id="H6B868C6475C34F3CA46A38247BCF23C8"><enum>(A)</enum><text>the incidence of diseases associated with air pollution, extreme heat, and other environmental factors;</text></subparagraph><subparagraph id="H04F20E975D404B70BAA1F8B406E302A2"><enum>(B)</enum><text>the availability and accessibility of maternal and infant health care providers; </text></subparagraph><subparagraph id="H859CBE9D08CF4F9F9CCBEC8745603466"><enum>(C)</enum><text>English-language proficiency among women of reproductive age; </text></subparagraph><subparagraph id="H1708FE3E55A5403DA38BB3C1F5E50A8B"><enum>(D)</enum><text>the health insurance status of women of reproductive age;</text></subparagraph><subparagraph id="H7F026B2CC5CF49AFAF62D51602479FFC"><enum>(E)</enum><text>the number of women of reproductive age who are members of racial or ethnic groups with disproportionately high rates of adverse maternal and infant health outcomes;</text></subparagraph><subparagraph id="HD39645B151704327A9F46EEFA4844A95"><enum>(F)</enum><text>the socioeconomic status of women of reproductive age, including with respect to—</text><clause id="HD4061591A10D4F77B89275566BCBD588"><enum>(i)</enum><text>poverty;</text></clause><clause id="H49557792E6B74BA18CC39F30C5C1DBBC"><enum>(ii)</enum><text>unemployment;</text></clause><clause id="HAF5706292E2846D28528E623B8AE4971"><enum>(iii)</enum><text>household income; and</text></clause><clause id="HC050440126F447E6AF03E887EDF74F64"><enum>(iv)</enum><text>educational attainment; and</text></clause></subparagraph><subparagraph id="HDCA13333E3674043974FF05D1A735A8E"><enum>(G)</enum><text>access to quality housing, transportation, and nutrition.</text></subparagraph></paragraph><paragraph id="H82EF1C7639E0457496ADCFAC77C642F6"><enum>(2)</enum><header>Resources</header><text>In developing the Strategy, the Secretary shall identify, and incorporate a description of, the following:</text><subparagraph id="H0D43497FCB96406DBBA131AE2F67FB0F"><enum>(A)</enum><text display-inline="yes-display-inline">Existing mapping tools or Federal programs that identify—</text><clause id="H79AF3911C82749FD8293101493079610"><enum>(i)</enum><text display-inline="yes-display-inline">risks associated with climate change for vulnerable individuals; and</text></clause><clause id="HABE92660EFC34753A77F8C4D24E3BB97"><enum>(ii)</enum><text>other factors that can influence maternal and infant health outcomes, including the factors described in paragraph (1).</text></clause></subparagraph><subparagraph id="HEB781E07305E417A94F16D4CFD20E347"><enum>(B)</enum><text>Environmental, health, socioeconomic, and demographic data relevant to identifying risks associated with climate change for vulnerable individuals.</text></subparagraph><subparagraph id="H051F948C88474E6DA0560AE2D6DD7C05"><enum>(C)</enum><text>Existing monitoring networks that collect data described in subparagraph (B), and any gaps in such networks.</text></subparagraph><subparagraph id="HC30661618EC54801992859C009FFAC35"><enum>(D)</enum><text>Federal, State, and local stakeholders involved in maintaining monitoring networks identified under subparagraph (C), and how such stakeholders are coordinating their monitoring efforts.</text></subparagraph><subparagraph id="H1835BB5577524CA5AD64D67ACA8B501E"><enum>(E)</enum><text>Additional monitoring networks, and enhancements to existing monitoring networks, that would be required to address gaps identified under subparagraph (C), including at the subcounty and census tract level. </text></subparagraph><subparagraph id="H46555489549A4B11BF53E1CBBD722102"><enum>(F)</enum><text>Funding amounts required to establish the monitoring networks identified under subparagraph (E) and recommendations for Federal, State, and local coordination with respect to such networks.</text></subparagraph><subparagraph id="H524C19A6FF404B97A70A0BC0EC52F416"><enum>(G)</enum><text>Potential uses for data collected and generated as a result of the Strategy, including how such data may be used in determining recipients of grants under the program established by section 2 or other similar programs.</text></subparagraph><subparagraph id="HFFEDA994B7564685A50592F814848A37"><enum>(H)</enum><text>Other information the Secretary considers relevant for the development of the Strategy.</text></subparagraph></paragraph></subsection><subsection id="H3B73382827BF4A4E87868DDCB10D4831"><enum>(c)</enum><header>Coordination and consultation</header><text display-inline="yes-display-inline">In developing the Strategy, the Secretary shall—</text><paragraph id="H36321585EA01497FA148A63D81B05818"><enum>(1)</enum><text>coordinate with the Administrator of the Environmental Protection Agency and the Administrator of the National Oceanic and Atmospheric Administration; and</text></paragraph><paragraph id="H11E977F436F44F50A3AEC7F6D10F7666"><enum>(2)</enum><text>consult with—</text><subparagraph id="H86DA1CCB7E5D4EB1A146C14496A91E28"><enum>(A)</enum><text>stakeholder organizations;</text></subparagraph><subparagraph id="HF5D379E05C0F45EFAF012ECBC24596D3"><enum>(B)</enum><text>health care providers and professional membership organizations with expertise in maternal health or environmental justice;</text></subparagraph><subparagraph id="H4CCAFA6554654B048C940EDA6B50A335"><enum>(C)</enum><text>State and local public health departments;</text></subparagraph><subparagraph id="H14058B02E31746AEA82797B936062BCB"><enum>(D)</enum><text>licensed and accredited hospitals, birth centers, midwifery practices, or other health care providers that provide prenatal or labor and delivery services to vulnerable individuals; and</text></subparagraph><subparagraph id="HC7C16C0AFA004225BDD945218C2B77BA"><enum>(E)</enum><text>institutions of higher education, including such institutions that are minority-serving institutions or have expertise in maternal health or environmental justice.</text></subparagraph></paragraph></subsection><subsection id="HB81D6346D17347B887D72E8B375FC9B1"><enum>(d)</enum><header>Notice and comment</header><text>At least 240 days before the date on which the Strategy is published in accordance with subsection (e), the Secretary shall provide—</text><paragraph id="HE307CE4251D0426AAA09043B5B328DDC"><enum>(1)</enum><text>notice of the Strategy on a public website of the Department of Health and Human Services; and</text></paragraph><paragraph id="H05A0BDF1BBBC47ECA4EE0A01FA158932"><enum>(2)</enum><text>an opportunity for public comment of at least 90 days.</text></paragraph></subsection><subsection id="H6D5ECF5DB7784086901BC5BE1D5ED199"><enum>(e)</enum><header>Publication</header><text display-inline="yes-display-inline">Not later than 18 months after the date of enactment of this Act, the Secretary shall publish on a public website of the Department of Health and Human Services—</text><paragraph id="H5267E87CA6E8417C9FDA4853AC01852D"><enum>(1)</enum><text>the Strategy;</text></paragraph><paragraph id="H27BB5DA7EB2E4829A471193EEAE226B0"><enum>(2)</enum><text>the public comments received under subsection (d); and</text></paragraph><paragraph id="H8585966D9CD14A38A86FC0AE9F4F6D32"><enum>(3)</enum><text>the responses of the Secretary to such public comments.</text></paragraph></subsection></section><enum>XII</enum><header>Maternal vaccinations</header><section id="id5F85439B3A9A445197D67EAA9475C5F1"><enum>1201.</enum><header>Maternal vaccination awareness and equity campaign</header><subsection id="HEAB1065F0819494D96EB9A30784BEFD8"><enum>(a)</enum><header>In general</header><text>The Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>), acting through the Director of the Centers for Disease Control and Prevention, shall carry out a national campaign to—</text><paragraph id="HE2D5019DFB374208A01A7EAA71FE8C8E"><enum>(1)</enum><text>increase awareness of the importance of maternal vaccinations for the health of pregnant and postpartum individuals and their children; and</text></paragraph><paragraph id="HD37F15BACA1640788FB8982C124E7306"><enum>(2)</enum><text>increase maternal vaccination rates, with a focus on communities with historically high rates of unvaccinated individuals.</text></paragraph></subsection><subsection id="H77DE272E272B454EBF5D7080DF9C6C17"><enum>(b)</enum><header>Consultation</header><text>In carrying out the campaign under this section, the Secretary shall consult with relevant community-based organizations, health care professional associations and public health associations, State public health departments and local public health departments, Tribal-serving organizations, nonprofit organizations, and nationally recognized private entities.</text></subsection><subsection id="H38EE486F3D274B8CB34220CE52B9ACED"><enum>(c)</enum><header>Activities</header><text>The campaign under this section shall—</text><paragraph id="H26B081AD982240A78B98D2280C4BC4C9"><enum>(1)</enum><text>focus on increasing maternal vaccination rates in communities with historically high rates of unvaccinated individuals, including for pregnant and postpartum individuals from racial and ethnic minority groups;</text></paragraph><paragraph id="HAFE8E2941D524C86A5EA765F6CCA2823"><enum>(2)</enum><text>include efforts to engage with pregnant and postpartum individuals in communities with historically high rates of unvaccinated individuals to seek input on the development and effectiveness of the campaign;</text></paragraph><paragraph id="HB26D33D1A6E24F3EBCFE5FC9798A7729"><enum>(3)</enum><text>provide evidence-based, culturally congruent resources and communications efforts; and</text></paragraph><paragraph id="HB20FC400D82C4FBA975BF1B5CF4E570A"><enum>(4)</enum><text>be carried out in partnership with trusted individuals and entities in communities with historically high rates of unvaccinated individuals, including community-based organizations, community health centers, perinatal health workers, and maternity care providers.</text></paragraph></subsection><subsection id="HA8F943089CA042A39B4CA81CA389A166"><enum>(d)</enum><header>Collaboration</header><text>The Secretary shall ensure that the information and resources developed for the campaign under this section are made publicly available and shared with relevant Federal, State, and local entities.</text></subsection><subsection id="H2A822A22A612482C870CFD71C968594B"><enum>(e)</enum><header>Evaluation</header><text>Not later than the end of fiscal year 2025, the Secretary shall—</text><paragraph id="H841E74C7AF274A2FB1F86482847FAED0"><enum>(1)</enum><text>establish quantitative and qualitative metrics to evaluate the campaign under this section; and</text></paragraph><paragraph id="H7D3B689A0E734B469D055AEBDB2EF875"><enum>(2)</enum><text>submit a report detailing the impact of the campaign under this section to Congress.</text></paragraph></subsection><subsection id="HB5679C729F7F473BA103E9F1DDC3C28A"><enum>(f)</enum><header>Authorization of appropriations</header><text>To carry out this section, there is authorized to be appropriated $2,000,000 for each of fiscal years 2022 through 2026. </text></subsection></section>