[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 4764 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  2d Session
                                S. 4764

 To amend the Public Health Service Act to improve reproductive health 
                 care of individuals with disabilities.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 3, 2022

Mrs. Murray (for herself, Ms. Duckworth, Mrs. Gillibrand, Mr. Heinrich, 
   Mr. Reed, Ms. Smith, Ms. Hassan, Ms. Hirono, Ms. Warren, Mr. Van 
Hollen, and Mr. Sanders) introduced the following bill; which was read 
 twice and referred to the Committee on Health, Education, Labor, and 
                                Pensions

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to improve reproductive health 
                 care of individuals with disabilities.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Reproductive Health Care 
Accessibility Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) In the United States, there are approximately 1 in 4 
        adults with disabilities, 1 in 10 individuals with disabilities 
        who are able to become pregnant, and approximately 4,100,000 
        parents with disabilities.
            (2) All people, including individuals with disabilities, 
        have the right to decide if, when, and how to start and raise a 
        family.
            (3) Title II and III of the Americans with Disabilities Act 
        of 1990 (42 U.S.C. 12131 et seq. and 12181 et seq.), section 
        504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), and 
        section 1557 of the Patient Protection and Affordable Care Act 
        (42 U.S.C. 18116) provide individuals with disabilities with 
        the right to equitably access and receive health care.
            (4) Disabled people face unique barriers when accessing 
        reproductive health care, including accessibility at health 
        care facilities, lack of accessible medical diagnostic 
        equipment, barriers to accessible travel, delay in receiving 
        preventative services, and lack of health care providers with 
        training and knowledge on the needs of individuals with 
        disabilities receiving reproductive health care.
            (5) The United States Access Board has established 
        standards for accessible medical diagnostic equipment, however 
        without enforceable standards adopted by the Department of 
        Health and Human Services and Department of Justice, systemic 
        improvements in the availability of accessible medical 
        diagnostic equipment will not be achieved.
            (6) Disabled people have an equal right to reproductive 
        autonomy, but harmful stereotypes create barriers to getting 
        care that respects that autonomy.
            (7) Laws that restrict access to reproductive health care, 
        including abortion care, disproportionally harm people who 
        already face barriers to reproductive health care which 
        includes disabled people.
            (8) Individuals with and without disabilities want children 
        at the same frequency, but individuals with disabilities 
        experience less likelihood of receiving contraception 
        counseling and timely prenatal care, experience a higher rate 
        of sterilization, and are at a greater risk for adverse 
        pregnancy outcomes.
            (9) Diversity and inclusion in the health care workforce is 
        a critical factor in the delivery of high-quality, culturally 
        competent health care and improves patient outcomes. However, 
        the rate of students and trainees with disabilities in medical 
        and allied health education remains low compared to those 
        without disabilities.

SEC. 3. PROGRAM FOR TRAINING THE WORKFORCE.

    Part D of title VII of the Public Health Service Act (42 U.S.C. 294 
et seq.) is amended by adding at the end the following:

``SEC. 760A. PROGRAM FOR TRAINING THE WORKFORCE CONCERNING REPRODUCTIVE 
              HEALTH CARE FOR INDIVIDUALS WITH DISABILITIES.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration and in consultation 
with the Administrator of the Administration for Community Living, 
shall award grants, contracts, or cooperative agreements to eligible 
entities to carry out training programs for health care professionals 
providing sexual and reproductive health care concerning comprehensive 
disability clinical care curricula.
    ``(b) Eligibility.--
            ``(1) In general.--To be eligible to receive an award under 
        this section an entity shall be a public or private nonprofit 
        entity with demonstrated expertise in serving individuals with 
        disabilities, which may include--
                    ``(A) a multidisciplinary health care provider who 
                provides reproductive health care, such as federally 
                qualified health centers;
                    ``(B) institutions of higher education, as defined 
                in section 101 of the Higher Education Act of 1965, 
                with expertise in reproductive health care;
                    ``(C) an entity primarily led by individuals with 
                disabilities;
                    ``(D) an entity with expertise in reproductive 
                rights and justice;
                    ``(E) an Indian Tribe, Tribal organization, or 
                urban Indian organization; or
                    ``(F) a consortium of entities described in any of 
                subparagraphs (A) through (E).
            ``(2) Application.--To be eligible to receive an award 
        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, that 
        includes--
                    ``(A) a description of the eligible entity's or 
                consortium of entities' expertise in providing 
                technical assistance and training, including evidence 
                such as--
                            ``(i) knowledge of the rights afforded to 
                        individuals with a disability under relevant 
                        Federal and State law;
                            ``(ii) knowledge of accessibility standards 
                        established by the United States Access Board;
                            ``(iii) expertise in evidence-based or 
                        evidence-informed practices in providing sexual 
                        and reproductive health care, including 
                        preventive health care services and perinatal 
                        care, to individuals with disabilities and 
                        those facing compounded barriers to accessing 
                        care;
                            ``(iv) experience working with health care 
                        providers, public or private nonprofit 
                        entities, or Federal, State, or local agencies 
                        focusing on sexual and reproductive health care 
                        services for individuals with disabilities;
                            ``(v) experience working with individuals 
                        with disabilities and their families;
                            ``(vi) expertise in providing, collecting, 
                        compiling, communicating, and disseminating 
                        information in culturally and linguistically 
                        appropriate manner especially in easily 
                        accessible formats; and
                            ``(vii) experience improving coordination 
                        of services, such as mental health, substance 
                        use disorder prevention, treatment, and 
                        recovery support services, social services, 
                        other health care services, and transportation 
                        services for individuals with disabilities;
                    ``(B) a description of the activities to be funded 
                under the award and the goals of such activities, 
                including a description of--
                            ``(i) the training or education program to 
                        be implemented that meets the requirements of 
                        subsection (c);
                            ``(ii) the process to be used to identify 
                        health care providers that will participate in 
                        the training program, including the process to 
                        increase diversity in the pool of participating 
                        providers;
                            ``(iii) the process to be used to engage 
                        stakeholders in such training, including 
                        individuals with disabilities; and
                            ``(iv) the eligible entity's evaluation 
                        plan to determine the scope and impact of the 
                        training program;
                    ``(C) an assurance that the recipients of the 
                training will receive ongoing and comprehensive 
                training or professional development on the sexual and 
                reproductive health care needs of individuals with 
                disabilities; and
                    ``(D) any other assurances that the Secretary may 
                require.
            ``(3) Subawards.--An eligible entity or eligible consortium 
        receiving an award under this section may, for contracting 
        purposes, make subawards to individuals or entities with 
        expertise in reproductive health care and serving individuals 
        with disabilities.
    ``(c) Use of Funds.--An entity or entities shall use amounts 
received under this section to carry out a training program for health 
care professionals providing sexual and reproductive health care that 
provides training concerning--
            ``(1) comprehensive disability clinical care curricula to 
        inform health professionals providing sexual and reproductive 
        health care on how to provide effective, interprofessional 
        team-based health care;
            ``(2) culturally and linguistically competent care for 
        individuals with disabilities;
            ``(3) delivering sexual and reproductive health care for 
        individuals with disabilities in a manner that emphasizes the 
        independence, self-determination, and choices of individuals 
        with disabilities with respect to their sexual and reproductive 
        health through comprehensive disability clinical care 
        curricula;
            ``(4) the rights afforded to individuals with disabilities 
        under relevant Federal and State law; and
            ``(5) methods and evidence-based or evidence-informed 
        practices for providing sexual and reproductive health care, 
        including preventive health care services, to individuals with 
        disabilities.
    ``(d) Evaluation and Report.--
            ``(1) In general.--An entity or entities that receives an 
        award under this section shall, at the end of the award period, 
        carry out an evaluation of any progress made through the 
        program in training health care professionals providing sexual 
        and reproductive health care, consistent with the purposes of 
        this section.
            ``(2) Report.--Not later than 180 days after the end of the 
        award period, an entity that receives an award under this 
        section shall submit to the Secretary a report on the results 
        of the evaluation conducted under paragraph (1).
            ``(3) Secretary.--The Secretary shall annually compile the 
        reports submitted under paragraph (2) and submit such 
        compilation to the Committee on Health, Education, Labor, and 
        Pensions of the Senate and the Committee on Energy and Commerce 
        of the House of Representatives. Such compilations shall be 
        posted on the internet website of the Department of Health and 
        Human Services in an accessible format.
    ``(e) Definitions.--In this section:
            ``(1) Disability.--The terms `disability' and 
        `disabilities' have the meaning given such terms for purposes 
        of the Americans with Disabilities Act of 1990.
            ``(2) Indian tribe.--The terms `Indian Tribe' and `Tribal 
        organization' have the meaning given such terms in section 4 of 
        the Indian Self-Determination and Education Assistance Act.
            ``(3) Urban indian organization.--The term `urban Indian 
        organization' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $10,000,000 for each of fiscal 
years 2023 through 2027. Funds provided to carry out this section shall 
supplement not supplant funds otherwise made available to carry out 
title VII.''.

SEC. 4. PROGRAM FOR EXPANDING THE REPRODUCTIVE HEALTH CARE PHYSICIAN 
              WORKFORCE.

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

``SEC. 742. PROGRAM FOR EXPANDING THE REPRODUCTIVE HEALTH CARE 
              PHYSICIAN WORKFORCE.

    ``(a) Purpose.--It is the purpose of this section--
            ``(1) to establish and sustain a competitive health 
        professions applicant pool of individuals with disabilities by 
        increasing the total number of individuals with disabilities 
        who pursue a career in sexual and reproductive health care, 
        including abortion care and maternal health care; and
            ``(2) to develop a culturally and linguistically competent 
        health care workforce providing reproductive health care that 
        will serve unserved and underserved populations, including 
        individuals with disabilities.
    ``(b) Awards.--To assist individuals with disabilities in 
undertaking education to enter into the reproductive health care 
workforce, the Secretary may award grants, contracts, or cooperative 
agreements to public or private nonprofit health or educational 
entities, including schools of medicine, schools of osteopathic 
medicine, and institutions of higher education, that offer programs, 
including graduate programs, in obstetrics and gynecology or programs 
for the training of health care providers to enable such entities to 
carry out the activities described in subsection (d).
    ``(c) Application.--To be eligible to receive an award under 
subsection (b), 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.
    ``(d) Use of Funds.--An entity shall use amounts received under an 
award under subsection (b) to--
            ``(1) conduct or support activities to develop a 
        competitive applicant pool, through partnership with public or 
        private nonprofit institutions of higher education, local 
        educational agencies, health care providers, such as sexual and 
        reproductive health care providers and primary care providers, 
        or other community-based entities, and establish an education 
        pipeline for individuals with disabilities entering the 
        reproductive health care workforce;
            ``(2) establish, strengthen, or expand programs to support 
        the academic performance of individuals with disabilities 
        participating in activities funded under this section, 
        including mentorship programs;
            ``(3) identify, recruit, enroll, and retain individuals 
        with disabilities in education and training related to sexual 
        and reproductive health care;
            ``(4) improve the capacity of the entity involved to train, 
        recruit, and retain faculty with disabilities including the 
        payment of such stipends and fellowships as the Secretary may 
        determine appropriate;
            ``(5) carry out activities to improve the information 
        resources, clinical education, curricula and competencies of 
        the graduates of the entity involved, as it relates to 
        individuals with disabilities;
            ``(6) facilitate faculty and student research on health 
        issues affecting individuals with disabilities, including 
        research on issues relating to the delivery of sexual and 
        reproductive health care to individuals with disabilities;
            ``(7) carry out programs, or offer experiences, to train 
        students in providing reproductive health services to 
        individuals with disabilities at community-based health 
        facilities that provide reproductive health services;
            ``(8) provide stipends to individuals with disabilities 
        participating in activities funded under this section as the 
        Secretary determines appropriate, in amounts as the Secretary 
        determines appropriate, with an assurance that such stipends 
        shall not result in loss of an individual's Federal or State 
        benefits; or
            ``(9) any other activities that the Secretary may require.
    ``(e) Preference.--In awarding grants, contracts, or cooperative 
agreements under this section, the Secretary shall give preference to 
applications that have been approved for programs that involve a 
comprehensive approach through multiple entities described in 
subsection (b) to establish, enhance, and expand educational programs 
that will result in the development of a competitive applicant pool of 
individuals with disabilities who desire to pursue careers in 
reproductive health care services.
    ``(f) Consideration for Awards.--In awarding grants, contracts, or 
cooperative agreements under this section, the Secretary shall--
            ``(1) consider current enrollment trends and the needs of 
        certain populations, including individuals with disabilities; 
        and
            ``(2) align and coordinate with other training programs 
        administered by the Health Resources and Services 
        Administration.
    ``(g) Effect on Other Programs.--Assistance or stipends provided to 
an individual under this section shall not be considered when applying 
asset or resource limitation provisions related to the eligibility of 
such individual for any benefit, assistance, or service provided under 
any Federal or State program.
    ``(h) Report.--Not later than 180 days after the end of the award 
period, the Secretary shall submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives, a report 
concerning the activities carried out under this section to increase 
the representation of individuals with disabilities in the reproductive 
health profession and related training programs.
    ``(i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $15,000,000 for each of fiscal 
years 2023 through 2027. Funds provided to carry out this section shall 
supplement not supplant funds otherwise made available to carry out 
title VII.''.

SEC. 5. EXPANDING THE REPRODUCTIVE HEALTH CARE NURSING WORKFORCE.

    Section 821 of the Public Health Service Act (42 U.S.C. 296m) is 
amended by adding at the end the following:
    ``(d) Expanding the Reproductive Health Care Nursing Workforce.--
            ``(1) Awards.--To assist individuals with disabilities in 
        undertaking education to enter into the reproductive nursing 
        workforce, the Secretary may award grants, contracts, or 
        cooperative agreements under subsection (a)(1) to eligible 
        entities to enable such entities to carry out the activities 
        described in paragraph (4).
            ``(2) Application.--To be eligible to receive an award 
        under paragraph (1), an entity described in such paragraph 
        shall submit to the Secretary an application at such time, in 
        such manner, and containing such information as the Secretary 
        may require.
            ``(3) Use of funds.--An entity shall use amounts received 
        under an award under paragraph (1) to--
                    ``(A) conduct activities to develop a competitive 
                applicant pool, through partnership with public or 
                private nonprofit institutions of higher education, 
                local educational agencies, nurse-managed health 
                clinics, health care providers, such as reproductive 
                health care providers and nurses, or other community-
                based entities, and establish an education pipeline for 
                individuals with disabilities entering the reproductive 
                health care nursing workforce;
                    ``(B) establish, strengthen, or expand programs to 
                support the academic performance of individuals with 
                disabilities participating in activities funded under 
                this subsection, including mentorship programs;
                    ``(C) identify, recruit, enroll, and retain 
                individuals with disabilities in education and training 
                related to sexual and reproductive health care;
                    ``(D) improve the capacity of the entity involved 
                to train, recruit, and retain faculty with 
                disabilities, including the payment of such stipends 
                and fellowships as the Secretary may determine 
                appropriate;
                    ``(E) carry out activities to improve the 
                information resources, clinical education, curricula, 
                and competencies of the graduates of the entity 
                involved, as it relates to individuals with 
                disabilities;
                    ``(F) facilitate faculty and student research to 
                include evidence-based practice and quality improvement 
                projects focused on health issues affecting individuals 
                with disabilities, including research on issues 
                relating to the delivery of sexual and reproductive 
                health care to individuals with disabilities;
                    ``(G) carry out programs, or offer experiences, to 
                train students in providing reproductive health 
                services to individuals with disabilities at community-
                based health care facilities that provide reproductive 
                health services;
                    ``(H) provide stipends to individuals with 
                disabilities participating in activities funded under 
                this subsection as the Secretary determines 
                appropriate, in amounts as the Secretary determines 
                appropriate, with an assurance that such stipends shall 
                not result in the loss of an individual's Federal or 
                State benefits; or
                    ``(I) any other activities that the Secretary may 
                require.
            ``(4) Preference.--In awarding grants, contracts, or 
        cooperative agreements under this subsection, the Secretary 
        shall give preference to applications that have been approved 
        for programs that involve a comprehensive approach through 
        multiple entities described in paragraph (1) to establish, 
        enhance, and expand educational programs that will result in 
        the development of a competitive applicant pool of individuals 
        with disabilities who desire to pursue careers in reproductive 
        health care services.
            ``(5) Consideration for awards.--In awarding grants, 
        contracts, or cooperative agreements under this subsection, the 
        Secretary shall--
                    ``(A) consider current enrollment trends and the 
                needs of certain populations, including individuals 
                with disabilities; and
                    ``(B) align and coordinate with other training 
                programs administered by the Health Resources and 
                Services Administration.
            ``(6) Effect on other programs.--Assistance or stipends 
        provided to an individual under this subsection shall not be 
        considered when applying asset or resource limitation 
        provisions related to the eligibility of such individual for 
        any benefit, assistance, or service provided under any Federal 
        or State program.
            ``(7) Report.--Not later than 180 days after the end of the 
        award period, the Secretary shall submit to the Committee on 
        Health, Education, Labor, and Pensions of the Senate and the 
        Committee on Energy and Commerce of the House of 
        Representatives, a report concerning the activities carried out 
        under this subsection to increase the representation of 
        individuals with disabilities in the reproductive health 
        profession and related training programs.
            ``(8) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this subsection, $15,000,000 
        for each of fiscal years 2023 through 2027. Funds provided to 
        carry out this subsection shall supplement not supplant funds 
        otherwise made available to carry out title VIII.''.

SEC. 6. PROGRAM FOR REPRODUCTIVE HEALTH EDUCATION.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), acting through the 
Administrator of the Health Resources and Services Administration and 
in consultation with the Administrator of the Administration for 
Community Living, shall award grants, contracts, or cooperative 
agreements to eligible entities to provide funding for education 
programs focused on sexual and reproductive health needs for 
individuals with disabilities.
    (b) Eligibility.--
            (1) In general.--To be eligible to receive an award under 
        this section an entity shall be a public or private nonprofit 
        entity with a demonstrated expertise in serving individuals 
        with disabilities, which may include--
                    (A) a multidisciplinary health care provider who 
                provides reproductive health care services, such as a 
                federally qualified health center;
                    (B) institutions of higher education, as defined in 
                section 101 of the Higher Education Act of 1965, with 
                expertise in reproductive health care;
                    (C) an entity primarily led by individuals with 
                disabilities;
                    (D) an entity with expertise in reproductive rights 
                and justice;
                    (E) an Indian Tribe, Tribal organization, or urban 
                Indian organization; and
                    (F) a consortium of entities described in any of 
                subparagraphs (A) through (E).
            (2) Application.--To be eligible to receive a grant, 
        contract, or cooperative agreement under this section an 
        eligible entity or consortium of entities shall submit to the 
        Secretary an application at such time, in such manner, and 
        containing such information as the Secretary may require, that 
        includes a description of the eligible entity's or entities' 
        expertise in providing education programs including evidence 
        that such entity has--
                    (A) knowledge of best practices in providing 
                reproductive health care, including preventive health 
                care services, to individuals with disabilities;
                    (B) experience working with individuals with 
                disabilities and their families; and
                    (C) demonstrated expertise of developing materials 
                in culturally and linguistically accessible formats 
                including plain language.
            (3) Subawards.--An eligible entity or eligible consortium 
        receiving an award under this section may, for contracting 
        purposes, make subawards to individuals or entities with 
        expertise in reproductive health care and serving individuals 
        with disabilities.
    (c) Use of Funds.--An entity or entities' shall use amounts 
received under subsection (a) to--
            (1) carry out evidence-based or evidence-informed sexual 
        and reproductive health education programs for individuals with 
        disabilities, including youth, in culturally and linguistically 
        accessible formats;
            (2) develop sexual and reproductive health education 
        programs in culturally and linguistically accessible formats to 
        be used in carrying out paragraph (1);
            (3) provide education to individuals with disabilities, 
        including youth, concerning abortion care options and their 
        sexual, reproductive, and perinatal health care needs;
            (4) provide education to individuals with disabilities, 
        including youth, concerning their rights under relevant Federal 
        and State law;
            (5) provide access to disability affirmative and supportive 
        clinical resources that are accessible to individuals with 
        disabilities;
            (6) build the entity's or entities' capacity and enhance 
        their leadership of the entity or entities within the community 
        to promote community engagement in, and advancement of, 
        evidence-based or evidence-informed sexual and reproductive 
        health care education in easily accessible formats; and
            (7) support dissemination of newly developed sexual and 
        reproductive health care education programs as described in 
        paragraph (2) throughout the State, territorial, and Tribal 
        communities.
    (d) Evaluation and Report.--
            (1) In general.--An entity that receives an award under 
        this section shall, at the end of the award period, carry out 
        an evaluation of success of the entity in achieving the goals 
        of the program for which the award was made.
            (2) Report.--Not later than 180 days after the end of the 
        award period, an entity that receives an award under this 
        section shall submit to the Secretary a report on the results 
        of the evaluation conducted under paragraph (1).
            (3) Secretary.--The Secretary shall annually compile the 
        reports submitted under paragraph (2) and submit such 
        compilation to the Committee on Health, Education, Labor, and 
        Pensions of the Senate and the Committee on Energy and Commerce 
        of the House of Representatives. Such compilations shall be 
        posted on the internet website of the Department of Health and 
        Human Services in an accessible format.
    (e) Definitions.--In this section:
            (1) Disability.--The terms ``disability'' and 
        ``disabilities'' have the meaning given such terms for purposes 
        of the Americans with Disabilities Act of 1990.
            (2) Indian tribe.--The terms ``Indian Tribe'' and ``Tribal 
        organization'' have the meaning given such terms in section 4 
        of the Indian Self-Determination and Education Assistance Act.
            (3) Urban indian organization.--The term ``urban Indian 
        organization'' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $10,000,000 for each of fiscal 
years 2023 through 2027.

SEC. 7. NATIONAL TECHNICAL ASSISTANCE CENTER.

    (a) Establishment.--The Secretary of Health and Human Services, 
acting through the Administration for Community Living, shall directly, 
or through a grant, contract, or cooperative agreement, establish a 
National Technical Assistance Center to--
            (1) provide recommendations and best practices to States, 
        Indian Tribes, Tribal organizations, and urban Indian 
        organizations concerning improving coordination of services 
        including mental health and substance use disorder services, 
        social services, health care, and transportation to increase 
        access to quality, integrated systems of accessible, 
        comprehensive disability clinical care, and services for 
        individuals with disabilities;
            (2) provide technical assistance to health care providers 
        on culturally and linguistically accessible and appropriate 
        sexual and reproductive health care, including before, during, 
        and after pregnancy and perinatal care and family planning 
        services;
            (3) develop resources and provide technical assistance to 
        assist covered entities in complying with applicable Federal 
        laws and regulations; and
            (4) develop resources for individuals with disabilities 
        facing barriers to accessible care, including related to 
        accessible medical diagnostic equipment and the Barrier-Free 
        Health Care Initiative.
    (b) Definitions.--In this section:
            (1) Disability.--The terms ``disability'' and 
        ``disabilities'' have the meaning given such terms for purposes 
        of the Americans with Disabilities Act of 1990.
            (2) Indian tribe.--The terms ``Indian Tribe'' and ``Tribal 
        organization'' have the meaning given such terms in section 4 
        of the Indian Self-Determination and Education Assistance Act.
            (3) Urban indian organization.--The term ``urban Indian 
        organization'' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act.
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $10,000,000 for each of fiscal 
years 2023 through 2027.

SEC. 8. RESEARCH STUDY.

    (a) In General.--The Secretary of Health and Human Services, in 
consultation with the Administrator of the Administration for Community 
Living, shall carry out a study to--
            (1) identify the types of programs and services that have 
        demonstrated effectiveness in providing reproductive health 
        care services for individuals with disabilities;
            (2) analyze the effectiveness of Federal, State, Tribal, 
        and local partnerships to coordinate efforts to ensure an 
        integrated system of accessible, comprehensive reproductive 
        health care for individuals with disabilities; and
            (3) identify necessary memoranda of understanding or 
        interagency agreements that are needed to foster data and 
        public health research focusing on reproductive health care 
        barriers for individuals with disabilities.
    (b) Report.--Not later than 3 years after the date of enactment of 
this Act, the Secretary of Health and Human Services shall submit to 
the Committee on Health, Education, Labor, and Pensions of the Senate 
and the Committee on Energy and Commerce and the Committee on Education 
and Labor of the House of Representatives, a report on the results of 
the study conducted under subsection (a).
    (c) Definition.--In this section the terms ``disability'' and 
``disabilities'' have the meanings given such terms for purposes of the 
Americans with Disabilities Act of 1990.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $15,000,000 for fiscal year 
2023.
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