[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4079 Introduced in Senate (IS)]

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118th CONGRESS
  2d Session
                                S. 4079

                  To improve obstetric emergency care.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 9, 2024

   Ms. Hassan (for herself, Ms. Collins, Mrs. Britt, and Ms. Smith) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
                  To improve obstetric emergency care.

    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 ``Rural Obstetrics Readiness Act''.

SEC. 2. OBSTETRIC EMERGENCY TRAINING PROGRAM.

    Section 330O of the Public Health Service Act (42 U.S.C. 254c-21) 
is amended--
            (1) in subsection (a)--
                    (A) in paragraph (3), by striking ``; and'' and 
                inserting a semicolon;
                    (B) in paragraph (4), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following:
            ``(5) developing, and facilitating access to, an evidence-
        based program to train practitioners in rural health care 
        facilities without dedicated obstetric units to provide 
        emergency obstetric services during pregnancy, labor, delivery, 
        or the postpartum period, including training on how to prepare 
        for, identify, stabilize, and safely transfer, as appropriate 
        and within the scope of practice of an individual practitioner, 
        a woman experiencing labor, delivery, obstetric hemorrhage, 
        severe hypertension, cardiac conditions, perinatal mental 
        health conditions, substance use, sepsis, or other conditions, 
        as appropriate.'';
            (2) by redesignating subsections (c) and (d) as subsections 
        (d) and (e), respectively;
            (3) by inserting after subsection (b) the following:
    ``(c) Training Program for Eligible Practitioners in Rural Health 
Care Facilities.--A training program described in subsection (a)(5) 
shall include an assessment of obstetric training needs for rural 
health care facilities without dedicated obstetric units. In developing 
the training program, a recipient of a grant under such subsection 
shall--
            ``(1) work in consultation with at least one representative 
        from a national medical society that has experience or 
        expertise in rural health care delivery in each of the fields 
        of gynecology and obstetrics, emergency medicine, family 
        medicine, and anesthesiology; and
            ``(2) facilitate access to obstetric readiness training via 
        regional training partnerships and technical assistance to 
        rural health care facilities.''; and
            (4) in subsection (e), as so redesignated, by adding at the 
        end the following: ``In addition to amounts appropriated under 
        the previous sentence, for grants for the purpose described in 
        subsection (a)(5), there are authorized to be appropriated 
        $5,000,000 for the period of fiscal years 2025 through 2027''.

SEC. 3. GRANT FUNDING FOR EQUIPMENT AND SUPPLIES.

    Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.) is amended by inserting after section 330A-2 the 
following:

``SEC. 330A-3. PROGRAM OF SUPPORT FOR OBSTETRIC SERVICES.

    ``(a) In General.--The Secretary shall award grants, contracts, or 
cooperative agreements to eligible entities to integrate obstetric 
readiness training curriculum into rural health care settings, build 
workforce capacity, and purchase equipment necessary to manage 
obstetric emergencies.
    ``(b) Use of Funds.--A recipient of funds under this section shall 
use such funds for the purpose described in subsection (a), which may 
include any of the following:
            ``(1) Purchasing or providing equipment and technical 
        assistance to train practitioners who are not specialized in 
        obstetrics in preparing for, identifying, stabilizing, and 
        transferring, as appropriate and within the scope of practice 
        of the practitioner, individuals experiencing obstetric 
        emergencies.
            ``(2) Purchasing or providing equipment necessary to 
        prepare for, identify, stabilize, or transfer, as appropriate, 
        individuals experiencing obstetric emergencies.
            ``(3) Developing and carrying out protocols for transfer of 
        patients to other facilities and network engagement with other 
        facilities.
            ``(4) Hiring additional personnel or paying the salaries of 
        personnel.
            ``(5) Establishing training opportunities to enable non-
        obstetric health professionals to gain exposure to, and 
        expertise in, the delivery of obstetric services, including 
        through clinical rotations, fellowships, or cross-training 
        clinicians in other specialties.
            ``(6) Enabling clinical educators to coordinate, develop, 
        and implement comprehensive interdisciplinary trainings, 
        including team-based simulation training for providers who may 
        need to respond to an obstetric emergency.
    ``(c) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity shall--
            ``(1) be--
                    ``(A) a rural hospital, critical access hospital 
                (as determined under section 1820(c)(2) of the Social 
                Security Act), or a rural emergency hospital (as 
                defined in section 1861(kkk)(2) of the Social Security 
                Act) that is located in a maternity care health 
                professional target area or a rural area (as defined by 
                the Secretary); or
                    ``(B) a consortium of 3 entities that includes at 
                least 2 entities described in subparagraph (A); and
            ``(2) agree to carry out the program described in 
        subsection (a), in coordination with other federally funded 
        maternal and child health programs, to the extent practicable, 
        and in consultation with other maternal and child health 
        programs in the same geographic area.
    ``(d) Definitions.--In this section--
            ``(1) the term `maternity care health professional target 
        area' means a primary care health professional shortage area 
        that is experiencing a shortage of maternity health care 
        professionals, as identified under section 332(k); and
            ``(2) the term `rural area' has the meaning given such term 
        by the Federal Office of Rural Health Policy.
    ``(e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $15,000,000 for the period of 
fiscal years 2025 through 2028.''.

SEC. 4. PILOT PROGRAM FOR TELECONSULTATION.

    Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.), as amended by section 3, is further amended by inserting 
after section 330A-2 the following:

``SEC. 330A-4. PILOT PROGRAM FOR TELECONSULTATION.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration and in consultation 
with the Administrator of the Centers for Medicare & Medicaid Services, 
shall award grants or cooperative agreements to States, political 
subdivisions of States, and Indian Tribes and Tribal organizations (as 
such terms are defined in section 4 of the Indian Self-Determination 
and Education Assistance Act (25 U.S.C. 5304)) to support the provision 
of urgent maternal health care in rural facilities without a dedicated 
obstetric unit, including by--
            ``(1) supporting the development of statewide or regional 
        maternal health care telehealth access programs; and
            ``(2) supporting the improvement of existing statewide or 
        regional maternal health care telehealth access programs 
        described in subsection (b).
    ``(b) Statewide or Regional Maternal Health Care Telehealth Access 
Programs.--A maternal health care telehealth access program described 
in this section, with respect to which an award under subsection (a) 
may be used, shall--
            ``(1) be a statewide or regional network of maternal health 
        care teams that provide urgent support to rural non-obstetric 
        settings of care;
            ``(2) support and further develop organized State or 
        regional networks of maternal health care teams to provide 
        urgent consultative support to rural non-obstetric settings of 
        care;
            ``(3) conduct an assessment of urgent maternal health 
        consultation needs among providers in rural non-obstetric 
        settings of care;
            ``(4) provide assurances that the physicians responsive to 
        the tele-consultation line are credentialed within their 
        employing facility and can provide consultation where the 
        patient is receiving care consistent with State requirements to 
        provide care to individuals experiencing labor, delivery, 
        obstetric hemorrhage, severe hypertension in pregnancy and 
        postpartum, cardiac conditions related to or exacerbated by 
        pregnancy, perinatal mental health conditions, substance use 
        during pregnancy or the postpartum period, sepsis during 
        pregnancy or after pregnancy end, or other conditions, as 
        appropriate;
            ``(5) provide rapid statewide or regional clinical 
        telephone or telehealth consultations when requested between 
        the maternal care teams and providers in rural emergency non-
        obstetric settings; and
            ``(6) provide information to health care providers about 
        available maternal health services for people in the community 
        and assist with referrals to specialty care and community or 
        behavioral health resources.
    ``(c) Reporting.--An entity receiving an award under this section 
shall submit a report to the Secretary, in such manner and containing 
such information as the Secretary may require, not later than 18 months 
after initial receipt of the grant.
    ``(d) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $5,000,000 for the period of 
fiscal years 2025 through 2028.''.

SEC. 5. STUDY ON OBSTETRIC UNITS IN RURAL AREAS.

    The Secretary of Health and Human Services shall--
            (1) conduct a study that maps maternity ward closures and 
        regional patterns of patient transport and examines models for 
        regional partnerships for rural obstetric care; and
            (2) not later than 3 years after the date of enactment of 
        this Act, 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 the Workforce of 
        the House of Representatives, a report on the results of the 
        study conducted under paragraph (1).
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