[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1605 Introduced in Senate (IS)]

<DOC>






118th CONGRESS
  1st Session
                                S. 1605

  To authorize appropriations for data collection, surveillance, and 
research on maternal health outcomes during public health emergencies, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 15, 2023

 Ms. Warren (for herself, Mr. Booker, and Mrs. Gillibrand) introduced 
the following bill; which was read twice and referred to the Committee 
               on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To authorize appropriations for data collection, surveillance, and 
research on maternal health outcomes during public health emergencies, 
                        and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Maternal Health Pandemic Response 
Act''.

SEC. 2. FUNDING FOR DATA COLLECTION, SURVEILLANCE, AND RESEARCH ON 
              MATERNAL HEALTH OUTCOMES DURING PUBLIC HEALTH 
              EMERGENCIES.

    To conduct or support data collection, surveillance, and research 
on maternal health as a result of public health emergencies and 
infectious diseases that pose a risk to maternal and infant health, 
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--
            (1) $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--
                    (A) 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;
                    (B) partner with more State, Tribal, territorial, 
                and local public health programs in the collection and 
                analysis of clinical data on the impact of public 
                health emergencies and infectious diseases that pose a 
                risk to maternal and infant health on pregnant and 
                postpartum patients and their newborns, particularly 
                among patients from racial and ethnic minority groups; 
                and
                    (C) establish regionally based centers of 
                excellence to offer medical, public health, and other 
                knowledge to ensure communities can help pregnant and 
                postpartum individuals and newborns get the care and 
                support they need, particularly in areas with large 
                populations of individuals from demographic groups with 
                elevated rates of maternal mortality, severe maternal 
                morbidity, maternal health disparities, or other 
                adverse perinatal or childbirth outcomes;
            (2) $30,000,000 for the Enhancing Reviews and Surveillance 
        to Eliminate Maternal Mortality program (commonly known as the 
        ``ERASE MM program'') 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;
            (3) $45,000,000 for the Pregnancy Risk Assessment 
        Monitoring System (commonly known as the ``PRAMS'') of the 
        Centers for Disease Control and Prevention, to support the 
        Centers for Disease Control and Prevention in its efforts to--
                    (A) create a supplement to its PRAMS survey related 
                to public health emergencies and infectious diseases 
                that pose a risk to maternal and infant health;
                    (B) add questions around experiences of respectful 
                maternity care in prenatal, intrapartum, and postpartum 
                care; and
                    (C) work to transition such PRAMS survey to an 
                electronic platform and expand such PRAMS survey to a 
                larger population, with a special focus on reaching 
                underrepresented communities, and other program 
                improvements; and
            (4) $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 public health 
        emergencies and infectious diseases that pose a risk to 
        maternal and infant health, with a particular focus on 
        individuals from demographic groups with elevated rates of 
        maternal mortality, severe maternal morbidity, maternal health 
        disparities, or other adverse perinatal or childbirth outcomes.

SEC. 3. PUBLIC HEALTH EMERGENCY MATERNAL HEALTH DATA COLLECTION AND 
              DISCLOSURE.

    (a) Availability of Collected Data.--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).
    (b) Data Described.--The data described in this subsection are data 
collected through Federal surveillance systems under the Centers for 
Disease Control and Prevention with respect to public health 
emergencies and individuals who are pregnant or in a postpartum period. 
Such data shall include the following:
            (1) Diagnostic testing, confirmed cases, hospitalizations, 
        deaths, and other health outcomes related to an infectious 
        disease outbreak among pregnant and postpartum individuals.
            (2) Maternal and infant health outcomes among individuals 
        who test positive for an infectious disease during or after 
        pregnancy.
    (c) American Indian and Alaska Native Health Outcomes.--In carrying 
out subsection (a), the Secretary shall consult with Indian Tribes and 
confer with Urban Indian organizations.
    (d) Disaggregated Information.--In carrying out subsection (a), the 
Secretary shall disaggregate data by race, ethnicity, gender, primary 
language, geography, socioeconomic status, and other relevant factors.
    (e) Update.--During public health emergencies, the Secretary shall 
update the data made available under this section--
            (1) at least on a monthly basis; and
            (2) not less than one month after the end of such public 
        health emergency.
    (f) Privacy.--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 (42 U.S.C. 1320d-2 note).
    (g) Guidance.--
            (1) In general.--Not later than 30 days after the 
        declaration of a public health emergency, the Secretary shall 
        issue guidance to States and local public health departments to 
        ensure that--
                    (A) laboratories that test specimens for an 
                infectious disease receive all relevant demographic 
                data on race, ethnicity, pregnancy status, and other 
                demographic data as determined by the Secretary; and
                    (B) data described in subsection (b) are 
                disaggregated by race, ethnicity, gender, primary 
                language, geography, socioeconomic status, and other 
                relevant factors.
            (2) Consultation.--In carrying out paragraph (1), the 
        Secretary shall consult with Indian Tribes--
                    (A) to ensure that such guidance includes tribally 
                developed best practices; and
                    (B) to reduce misclassification of American Indians 
                and Alaska Natives.

SEC. 4. PUBLIC HEALTH COMMUNICATION REGARDING MATERNAL CARE DURING 
              PUBLIC HEALTH EMERGENCIES.

    The Director of the Centers for Disease Control and Prevention 
shall conduct public health education campaigns during public health 
emergencies to ensure that pregnant and postpartum individuals, their 
employers, and their health care providers have accurate, evidence-
based information on maternal and infant health risks during the public 
health emergency, with a particular focus on reaching pregnant and 
postpartum individuals in underserved communities.

SEC. 5. TASK FORCE ON BIRTHING EXPERIENCE AND SAFE, RESPECTFUL, 
              RESPONSIVE, AND EMPOWERING MATERNITY CARE DURING PUBLIC 
              HEALTH EMERGENCIES.

    (a) Establishment.--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 section referred to as the ``Task 
Force'') to develop Federal recommendations regarding respectful, 
responsive, and empowering maternity care, including safe birth care 
and postpartum care, during public health emergencies.
    (b) Duties.--The Task Force shall develop, publicly post, and 
update Federal recommendations in multiple languages to ensure high-
quality, nondiscriminatory maternity care, promote positive birthing 
experiences, and improve maternal health outcomes during public health 
emergencies, with a particular focus on outcomes for individuals from 
demographic groups with elevated rates of maternal mortality, severe 
maternal morbidity, maternal health disparities, or other adverse 
perinatal or childbirth outcomes. Such recommendations shall--
            (1) address, with particular attention to ensuring 
        equitable treatment on the basis of race and ethnicity--
                    (A) measures to facilitate respectful, responsive, 
                and empowering maternity care;
                    (B) measures to facilitate telehealth maternity 
                care for pregnant people who cannot regularly access 
                in-person care;
                    (C) strategies to increase access to specialized 
                care for those with high-risk pregnancies or pregnant 
                individuals with elevated risk factors;
                    (D) diagnostic testing for pregnant and laboring 
                patients;
                    (E) birthing without one's chosen companions, with 
                one's chosen companions, and with smartphone or other 
                telehealth connection to one's chosen companions;
                    (F) newborn separation after birth in relation to 
                maternal infection status;
                    (G) breast milk feeding in relation to maternal 
                infection status;
                    (H) licensure, training, scope of practice, and 
                Medicaid and other insurance reimbursement for 
                certified midwives, certified nurse-midwives, and 
                certified professional midwives, in a manner that 
                facilitates inclusion of midwives of color and midwives 
                from underserved communities;
                    (I) financial support and training for perinatal 
                health workers who provide nonclinical support to 
                people from pregnancy through the postpartum period in 
                a manner that facilitates inclusion from underserved 
                communities;
                    (J) strategies to ensure and expand doula coverage 
                under State Medicaid programs;
                    (K) how to identify, address, and treat prenatal 
                and postpartum mental and behavioral health conditions, 
                such as anxiety, substance use disorder, and 
                depression, during public health emergencies;
                    (L) how to identify and address instances of 
                intimate partner violence during pregnancy which may 
                arise or intensify during public health emergencies;
                    (M) strategies to address hospital capacity 
                concerns in communities with a surge in infectious 
                disease cases and to provide childbearing people with 
                options that reduce the potential for cross-
                contamination and increase the ability to implement 
                their care preferences while maintaining safety and 
                quality, such as the use of auxiliary maternity units 
                and freestanding birth centers;
                    (N) provision of child care services during 
                prenatal and postpartum appointments for mothers whose 
                children are unable to attend as a result of 
                restrictions relating to the public health emergencies;
                    (O) how to identify and address racism, bias, and 
                discrimination in the delivery of maternity care 
                services to pregnant and postpartum people, including 
                evaluating the value of training for hospital staff on 
                implicit bias and racism, respectful, responsive, and 
                empowering maternity care, and demographic data 
                collection;
                    (P) how to address the needs of undocumented 
                pregnant individuals and new mothers who may be afraid 
                or unable to seek needed care during the public health 
                emergency;
                    (Q) how to address the needs of uninsured pregnant 
                individuals who have historically relied on emergency 
                departments for care;
                    (R) how to identify pregnant and postpartum 
                individuals at risk for depression, anxiety disorder, 
                psychosis, obsessive-compulsive disorder, and other 
                maternal mood disorders before, during, and after 
                pregnancy, and how to treat those diagnosed with a 
                postpartum mood disorder;
                    (S) how to effectively and compassionately screen 
                for substance use disorder during pregnancy and 
                postpartum and help pregnant and postpartum individuals 
                find support and effective treatment;
                    (T) how to ensure access to infant nutrition during 
                public health emergencies; and
                    (U) such other matters as the Task Force determines 
                appropriate;
            (2) identify barriers to the implementation of the 
        recommendations;
            (3) take into consideration existing State and other 
        programs that have demonstrated effectiveness in addressing 
        pregnancy, birth, and postpartum care during public health 
        emergencies; and
            (4) identify policies specific to COVID-19 that should be 
        discontinued when safely possible and those that should be 
        continued as the public health emergency abates.
    (c) Membership.--The Secretary shall appoint the members of the 
Task Force. Such members shall be comprised of--
            (1) representatives of the Department of Health and Human 
        Services, including representatives of--
                    (A) the Secretary;
                    (B) the Director of the Centers for Disease Control 
                and Prevention;
                    (C) the Administrator of the Health Resources and 
                Services Administration;
                    (D) the Administrator of the Centers for Medicare & 
                Medicaid Services;
                    (E) the Director of the Agency for Healthcare 
                Research and Quality;
                    (F) the Commissioner of Food and Drugs;
                    (G) the Assistant Secretary for Mental Health and 
                Substance Use; and
                    (H) the Director of the Indian Health Service;
            (2) at least 3 State, local, or territorial public health 
        officials representing departments of public health, who shall 
        represent jurisdictions from different regions of the United 
        States with relatively high concentrations of historically 
        marginalized populations;
            (3) at least 1 Tribal public health official representing 
        departments of public health;
            (4) 1 or more representatives of community-based 
        organizations that address adverse maternal health outcomes 
        with a specific focus on racial and ethnic inequities in 
        maternal health outcomes, with special consideration given to 
        representatives of such organizations that are led by a person 
        of color or from communities with significant minority 
        populations;
            (5) a professionally diverse panel of maternity care 
        providers and perinatal health workers;
            (6) 1 or more patients who were pregnant or gave birth 
        during the COVID-19 public health emergency;
            (7) 1 or more patients who contracted COVID-19 and later 
        gave birth;
            (8) 1 or more patients who have received support from a 
        perinatal health worker; and
            (9) racially and ethnically diverse representation from at 
        least 3 independent experts with knowledge or field experience 
        with racial and ethnic disparities in public health, women's 
        health, or maternal mortality and severe maternal morbidity.

SEC. 6. DEFINITIONS.

    In this Act:
            (1) Culturally and linguistically congruent.--The term 
        ``culturally and linguistically 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) Maternal mortality.--The term ``maternal mortality'' 
        means a death occurring during or within a 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-related or childbirth 
        complications.
            (3) Perinatal health worker.--The term ``perinatal health 
        worker'' means a nonclinical health worker focused on maternal 
        or perinatal health, such as a doula, community health worker, 
        peer supporter, lactation educator or counselor, nutritionist 
        or dietitian, childbirth educator, social worker, home visitor, 
        patient navigator or coordinator, or language interpreter.
            (4) Postpartum and postpartum period.--The terms 
        ``postpartum'' and ``postpartum period'' refer to the 1-year 
        period beginning on the last day of the pregnancy of an 
        individual.
            (5) Public health emergency.--The term ``public health 
        emergency'' means a public health emergency declared under 
        section 319 of the Public Health Service Act (42 U.S.C. 247d).
            (6) Racial and ethnic minority group.--The term ``racial 
        and ethnic minority group'' has the meaning given such term in 
        section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 
        300u-6(g)(1)).
            (7) Respectful maternity care.--The term ``respectful 
        maternity care'' refers to care organized for, and provided to, 
        pregnant and postpartum individuals in a manner that--
                    (A) is culturally and linguistically congruent;
                    (B) maintains their dignity, privacy, and 
                confidentiality;
                    (C) ensures freedom from harm and mistreatment; and
                    (D) enables informed choice and continuous support.
            (8) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (9) Severe maternal morbidity.--The term ``severe maternal 
        morbidity'' means a health condition, including mental health 
        conditions and substance use disorders, attributed to or 
        aggravated by pregnancy or childbirth that results in 
        significant short-term or long-term consequences to the health 
        of the individual who was pregnant.
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