Short title

This Act may be cited as the

Women Expansion of Learning and Labor Safety Act

or the

WELLS Act

Requiring hospitals participating in Medicare to develop discharge plans for pregnant individuals

Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is amended—(1)in subsection (a)(1)—(A)in subparagraph (X), by striking and at the end;(B)in subparagraph (Y), by striking the period at the end and inserting , and; and(C)by adding at the end the following new subparagraph:

(Z)beginning January 1, 2027, in the case of a hospital, critical access hospital, or rural emergency hospital, to comply with the requirements described in subsection (l)(1).

; and

(2)by adding at the end the following new subsection:

(l)

Discharge plan requirements for pregnant individuals

(1)

In general

For purposes of subsection (a)(1)(Z), the requirements described in this paragraph are, with respect to a hospital, critical access hospital, or rural emergency hospital, that the hospital—(A)provides for the development and implementation of a discharge plan meeting the standards under paragraph (2) with respect to any individual (whether or not eligible for benefits under this title) admitted to the hospital who—(i)is identified as pregnant;(ii)is experiencing signs or symptoms consistent with labor, which may include contractions; and(iii)is expected to be discharged from the hospital, critical access hospital, or rural emergency hospital prior to delivery, as determined based on the documented clinical judgment of the treating physician or practitioner at the time that such discharge is contemplated;(B)includes such discharge plan in the individual’s medical record; and(C)provides for such discharge plan to be discussed with the individual (or the individual’s representative) prior to discharge.(2)

Discharge plan standards

A discharge plan for an individual described in paragraph (1)(A) meets the standards under this paragraph if such plan includes at least the following information:(A)A clinical justification for the discharge.(B)An assessment of travel distance and time between the primary residence of the individual and the hospital, critical access hospital, or rural emergency hospital.(C)Verification of reliable transportation between the primary residence of the individual and the hospital, critical access hospital, or rural emergency hospital.(D)Identification of a back-up hospital or facility at which such individual may obtain labor and delivery services.(E)Confirmation that the plan was reviewed and approved by a qualified medical professional (as defined by the Secretary through regulations).(F)Confirmation that the individual (or the individual’s representative) has received the information described in subparagraphs (A) through (D), that such information was provided in the primary language of such individual (or representative), and that such individual (or representative) confirmed their understanding of such information.(3)

Rule of construction

Nothing in this subsection shall be construed as limiting or otherwise affecting the discharge planning requirements otherwise applicable to a hospital, critical access hospital, or rural emergency hospital under this title.

Rural maternal and obstetric care training demonstration grants

(a)

In general

The first section 764 of the Public Health Service Act (42 U.S.C. 294s; relating to rural maternal and obstetric care training demonstration) is amended—(1)in subsection (c)(1)—(A)in subparagraph (A), by striking and at the end;(B)by redesignating subparagraph (B) as subparagraph (C); and(C)by inserting after subparagraph (A) the following:

(B)shall use the grant funds to provide racial bias training as part of such training program; and

;

(2)by redesignating subsections (d) and (e) as subsections (e) and (f), respectively;(3)by inserting after subsection (c) the following:

(d)

Minimum performance milestones

(1)

Establishment

Beginning with the grants awarded under this section for fiscal year 2027, the Secretary shall establish minimum performance milestones that grant recipients must meet during a fiscal year as a condition of remaining eligible for funding through such a grant for any subsequent fiscal year.(2)

Milestones related to percent of staff trained

The minimum performance milestones referred to in paragraph (1) shall include milestones related to the percent of all staff of the grant recipient that are trained, or that receive refresher training, with support from a grant under this section.

; and

(4)in subsection (e), as so redesignated—(A)in the subsection heading, by striking

report

and inserting

reports

;(B)in paragraph (1)(B), by striking the report described in paragraph (2) and inserting the reports described in paragraphs (2) and (3); and(C)by adding at the end the following:

(3)

Subsequent reports

Not later than January 1, 2027, and annually thereafter, the Secretary shall submit to Congress, and make publicly available, a report that includes—(A)updates to the information described in subparagraphs (A) through (C) of paragraph (2); and(B)additional information regarding the grants under this section, including—(i)a list of the entities receiving such grants;(ii)the number and amount of such grants;(iii)whether training supported by such grants was delivered in-person, virtually, asynchronously, or through some other format; and(iv)descriptions of the geographical coverage of such grants, the number of providers trained under such grants, and patient-level metrics linked to such training (such as changes in clinical outcomes, patient experience, and racial disparities).

(b)

Technical amendment

The second section 764 of the Public Health Service Act (42 U.S.C. 294t; relating to programs to promote mental health among the health professional workforce) is redesignated as section 764A.

Multi-center implementation science initiative for maternal health

The Secretary of Health and Human Services, in consultation with the Director of the Agency for Healthcare Research and Quality and the Director of the National Institutes of Health, shall establish a multi-center implementation science initiative for maternal health to rigorously evaluate different training models for health care professionals (including in-person, virtual, simulation, and cohort-based) and the impact of such models on provider behavior, patient outcomes, and maternal health disparities.

Maternal health dashboard

The Secretary of Health and Human Services shall develop, maintain, and make publicly available on the websites of the Department of Health and Human Services an interagency maternal health dashboard, which shall include maternal health outcome metrics from agencies within the Department of Health and Human Services and the data collected as part of the initiative under section 4, such as data related to maternal mortality and severe maternal morbidity, the number and outcomes of discharges of pregnant individuals prior to delivery from institutions, and data on Federal investments in maternal health research.