<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="billres.xsl"?>
<!DOCTYPE bill PUBLIC "-//US Congress//DTDs/bill.dtd//EN" "bill.dtd">
<bill bill-stage="Introduced-in-House" dms-id="HE68E462259B746FD9C3023C16C2994D3" public-private="public" key="H" bill-type="olc"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>119 HR 7973 IH: Momnibus Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2026-03-18</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>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.</dc:rights>
</dublinCore>
</metadata>
<form>
<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">H. R. 7973</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20260318">March 18, 2026</action-date><action-desc><sponsor name-id="U000040">Ms. Underwood</sponsor> (for herself, <cosponsor name-id="A000370">Ms. Adams</cosponsor>, <cosponsor name-id="A000371">Mr. Aguilar</cosponsor>, <cosponsor name-id="A000380">Mr. Amo</cosponsor>, <cosponsor name-id="A000381">Ms. Ansari</cosponsor>, <cosponsor name-id="B001318">Ms. Balint</cosponsor>, <cosponsor name-id="B001300">Ms. Barragán</cosponsor>, <cosponsor name-id="B001281">Mrs. Beatty</cosponsor>, <cosponsor name-id="B001324">Mr. Bell</cosponsor>, <cosponsor name-id="B001287">Mr. Bera</cosponsor>, <cosponsor name-id="B000490">Mr. Bishop</cosponsor>, <cosponsor name-id="B001278">Ms. Bonamici</cosponsor>, <cosponsor name-id="B001296">Mr. Boyle of Pennsylvania</cosponsor>, <cosponsor name-id="B001313">Ms. Brown</cosponsor>, <cosponsor name-id="B001285">Ms. Brownley</cosponsor>, <cosponsor name-id="C001112">Mr. Carbajal</cosponsor>, <cosponsor name-id="C001072">Mr. Carson</cosponsor>, <cosponsor name-id="C001125">Mr. Carter of Louisiana</cosponsor>, <cosponsor name-id="C001117">Mr. Casten</cosponsor>, <cosponsor name-id="C001066">Ms. Castor of Florida</cosponsor>, <cosponsor name-id="C001091">Mr. Castro of Texas</cosponsor>, <cosponsor name-id="C001127">Mrs. Cherfilus-McCormick</cosponsor>, <cosponsor name-id="C001080">Ms. Chu</cosponsor>, <cosponsor name-id="C001101">Ms. Clark of Massachusetts</cosponsor>, <cosponsor name-id="C001067">Ms. Clarke of New York</cosponsor>, <cosponsor name-id="C001061">Mr. Cleaver</cosponsor>, <cosponsor name-id="C000537">Mr. Clyburn</cosponsor>, <cosponsor name-id="C001068">Mr. Cohen</cosponsor>, <cosponsor name-id="C001136">Mr. Conaway</cosponsor>, <cosponsor name-id="C001110">Mr. Correa</cosponsor>, <cosponsor name-id="C001069">Mr. Courtney</cosponsor>, <cosponsor name-id="C001119">Ms. Craig</cosponsor>, <cosponsor name-id="C001130">Ms. Crockett</cosponsor>, <cosponsor name-id="C001121">Mr. Crow</cosponsor>, <cosponsor name-id="C001063">Mr. Cuellar</cosponsor>, <cosponsor name-id="D000629">Ms. Davids of Kansas</cosponsor>, <cosponsor name-id="D000096">Mr. Davis of Illinois</cosponsor>, <cosponsor name-id="D000631">Ms. Dean of Pennsylvania</cosponsor>, <cosponsor name-id="D000197">Ms. DeGette</cosponsor>, <cosponsor name-id="M001232">Mrs. McClain Delaney</cosponsor>, <cosponsor name-id="D000216">Ms. DeLauro</cosponsor>, <cosponsor name-id="D000617">Ms. DelBene</cosponsor>, <cosponsor name-id="D000530">Mr. Deluzio</cosponsor>, <cosponsor name-id="D000623">Mr. DeSaulnier</cosponsor>, <cosponsor name-id="D000635">Ms. Dexter</cosponsor>, <cosponsor name-id="D000624">Mrs. Dingell</cosponsor>, <cosponsor name-id="E000301">Ms. Elfreth</cosponsor>, <cosponsor name-id="E000299">Ms. Escobar</cosponsor>, <cosponsor name-id="E000297">Mr. Espaillat</cosponsor>, <cosponsor name-id="F000110">Mr. Fields</cosponsor>, <cosponsor name-id="F000481">Mr. Figures</cosponsor>, <cosponsor name-id="F000468">Mrs. Fletcher</cosponsor>, <cosponsor name-id="F000454">Mr. Foster</cosponsor>, <cosponsor name-id="F000477">Mrs. Foushee</cosponsor>, <cosponsor name-id="F000462">Ms. Lois Frankel of Florida</cosponsor>, <cosponsor name-id="F000476">Mr. Frost</cosponsor>, <cosponsor name-id="G000559">Mr. Garamendi</cosponsor>, <cosponsor name-id="G000587">Ms. Garcia of Texas</cosponsor>, <cosponsor name-id="G000586">Mr. García of Illinois</cosponsor>, <cosponsor name-id="G000598">Mr. Garcia of California</cosponsor>, <cosponsor name-id="G000592">Mr. Golden of Maine</cosponsor>, <cosponsor name-id="G000599">Mr. Goldman of New York</cosponsor>, <cosponsor name-id="G000581">Mr. Vicente Gonzalez of Texas</cosponsor>, <cosponsor name-id="G000604">Ms. Goodlander</cosponsor>, <cosponsor name-id="G000583">Mr. Gottheimer</cosponsor>, <cosponsor name-id="G000605">Mr. Gray</cosponsor>, <cosponsor name-id="G000553">Mr. Green of Texas</cosponsor>, <cosponsor name-id="G000606">Mrs. Grijalva</cosponsor>, <cosponsor name-id="H001090">Mr. Harder of California</cosponsor>, <cosponsor name-id="H001081">Mrs. Hayes</cosponsor>, <cosponsor name-id="H001066">Mr. Horsford</cosponsor>, <cosponsor name-id="H001085">Ms. Houlahan</cosponsor>, <cosponsor name-id="H000874">Mr. Hoyer</cosponsor>, <cosponsor name-id="H001094">Ms. Hoyle of Oregon</cosponsor>, <cosponsor name-id="H001068">Mr. Huffman</cosponsor>, <cosponsor name-id="I000058">Mr. Ivey</cosponsor>, <cosponsor name-id="J000309">Mr. Jackson of Illinois</cosponsor>, <cosponsor name-id="J000305">Ms. Jacobs</cosponsor>, <cosponsor name-id="J000298">Ms. Jayapal</cosponsor>, <cosponsor name-id="J000294">Mr. Jeffries</cosponsor>, <cosponsor name-id="J000288">Mr. Johnson of Georgia</cosponsor>, <cosponsor name-id="J000310">Ms. Johnson of Texas</cosponsor>, <cosponsor name-id="K000400">Ms. Kamlager-Dove</cosponsor>, <cosponsor name-id="K000009">Ms. Kaptur</cosponsor>, <cosponsor name-id="K000385">Ms. Kelly of Illinois</cosponsor>, <cosponsor name-id="K000402">Mr. Kennedy of New York</cosponsor>, <cosponsor name-id="K000389">Mr. Khanna</cosponsor>, <cosponsor name-id="K000391">Mr. Krishnamoorthi</cosponsor>, <cosponsor name-id="L000601">Mr. Landsman</cosponsor>, <cosponsor name-id="L000560">Mr. Larsen of Washington</cosponsor>, <cosponsor name-id="L000557">Mr. Larson of Connecticut</cosponsor>, <cosponsor name-id="L000606">Mr. Latimer</cosponsor>, <cosponsor name-id="L000602">Ms. Lee of Pennsylvania</cosponsor>, <cosponsor name-id="L000590">Ms. Lee of Nevada</cosponsor>, <cosponsor name-id="L000273">Ms. Leger Fernandez</cosponsor>, <cosponsor name-id="L000593">Mr. Levin</cosponsor>, <cosponsor name-id="L000607">Mr. Liccardo</cosponsor>, <cosponsor name-id="L000582">Mr. Lieu</cosponsor>, <cosponsor name-id="L000562">Mr. Lynch</cosponsor>, <cosponsor name-id="M001223">Mr. Magaziner</cosponsor>, <cosponsor name-id="M001231">Mr. Mannion</cosponsor>, <cosponsor name-id="M001163">Ms. Matsui</cosponsor>, <cosponsor name-id="M001208">Mrs. McBath</cosponsor>, <cosponsor name-id="M001238">Ms. McBride</cosponsor>, <cosponsor name-id="M001227">Ms. McClellan</cosponsor>, <cosponsor name-id="M001143">Ms. McCollum</cosponsor>, <cosponsor name-id="M001237">Ms. McDonald Rivet</cosponsor>, <cosponsor name-id="M001220">Mr. McGarvey</cosponsor>, <cosponsor name-id="M000312">Mr. McGovern</cosponsor>, <cosponsor name-id="M001229">Mrs. McIver</cosponsor>, <cosponsor name-id="M001137">Mr. Meeks</cosponsor>, <cosponsor name-id="M001245">Mr. Menefee</cosponsor>, <cosponsor name-id="M001226">Mr. Menendez</cosponsor>, <cosponsor name-id="M000687">Mr. Mfume</cosponsor>, <cosponsor name-id="M001241">Mr. Min</cosponsor>, <cosponsor name-id="M001160">Ms. Moore of Wisconsin</cosponsor>, <cosponsor name-id="M001206">Mr. Morelle</cosponsor>, <cosponsor name-id="M001217">Mr. Moskowitz</cosponsor>, <cosponsor name-id="M001196">Mr. Moulton</cosponsor>, <cosponsor name-id="M001214">Mr. Mrvan</cosponsor>, <cosponsor name-id="M001225">Mr. Mullin</cosponsor>, <cosponsor name-id="N000002">Mr. Nadler</cosponsor>, <cosponsor name-id="N000191">Mr. Neguse</cosponsor>, <cosponsor name-id="N000188">Mr. Norcross</cosponsor>, <cosponsor name-id="N000147">Ms. Norton</cosponsor>, <cosponsor name-id="O000172">Ms. Ocasio-Cortez</cosponsor>, <cosponsor name-id="O000176">Mr. Olszewski</cosponsor>, <cosponsor name-id="O000173">Ms. Omar</cosponsor>, <cosponsor name-id="P000613">Mr. Panetta</cosponsor>, <cosponsor name-id="P000614">Mr. Pappas</cosponsor>, <cosponsor name-id="P000197">Ms. Pelosi</cosponsor>, <cosponsor name-id="P000620">Ms. Pettersen</cosponsor>, <cosponsor name-id="P000597">Ms. Pingree</cosponsor>, <cosponsor name-id="P000610">Ms. Plaskett</cosponsor>, <cosponsor name-id="P000607">Mr. Pocan</cosponsor>, <cosponsor name-id="P000617">Ms. Pressley</cosponsor>, <cosponsor name-id="Q000023">Mr. Quigley</cosponsor>, <cosponsor name-id="R000617">Mrs. Ramirez</cosponsor>, <cosponsor name-id="R000621">Ms. Randall</cosponsor>, <cosponsor name-id="R000606">Mr. Raskin</cosponsor>, <cosponsor name-id="R000622">Mr. Riley of New York</cosponsor>, <cosponsor name-id="R000620">Ms. Rivas</cosponsor>, <cosponsor name-id="R000305">Ms. Ross</cosponsor>, <cosponsor name-id="R000599">Mr. Ruiz</cosponsor>, <cosponsor name-id="R000579">Mr. Ryan</cosponsor>, <cosponsor name-id="S001226">Ms. Salinas</cosponsor>, <cosponsor name-id="S001205">Ms. Scanlon</cosponsor>, <cosponsor name-id="S001145">Ms. Schakowsky</cosponsor>, <cosponsor name-id="S001190">Mr. Schneider</cosponsor>, <cosponsor name-id="S001221">Ms. Scholten</cosponsor>, <cosponsor name-id="S001216">Ms. Schrier</cosponsor>, <cosponsor name-id="S001157">Mr. David Scott of Georgia</cosponsor>, <cosponsor name-id="S000185">Mr. Scott of Virginia</cosponsor>, <cosponsor name-id="S001185">Ms. Sewell</cosponsor>, <cosponsor name-id="S000344">Mr. Sherman</cosponsor>, <cosponsor name-id="S001231">Ms. Simon</cosponsor>, <cosponsor name-id="S000510">Mr. Smith of Washington</cosponsor>, <cosponsor name-id="S001225">Mr. Sorensen</cosponsor>, <cosponsor name-id="S001200">Mr. Soto</cosponsor>, <cosponsor name-id="S001218">Ms. Stansbury</cosponsor>, <cosponsor name-id="S001211">Mr. Stanton</cosponsor>, <cosponsor name-id="S001215">Ms. Stevens</cosponsor>, <cosponsor name-id="S001159">Ms. Strickland</cosponsor>, <cosponsor name-id="S001230">Mr. Subramanyam</cosponsor>, <cosponsor name-id="S001201">Mr. Suozzi</cosponsor>, <cosponsor name-id="S001193">Mr. Swalwell</cosponsor>, <cosponsor name-id="T000472">Mr. Takano</cosponsor>, <cosponsor name-id="T000488">Mr. Thanedar</cosponsor>, <cosponsor name-id="T000460">Mr. Thompson of California</cosponsor>, <cosponsor name-id="T000193">Mr. Thompson of Mississippi</cosponsor>, <cosponsor name-id="T000468">Ms. Titus</cosponsor>, <cosponsor name-id="T000481">Ms. Tlaib</cosponsor>, <cosponsor name-id="T000487">Ms. Tokuda</cosponsor>, <cosponsor name-id="T000469">Mr. Tonko</cosponsor>, <cosponsor name-id="T000486">Mr. Torres of New York</cosponsor>, <cosponsor name-id="T000482">Mrs. Trahan</cosponsor>, <cosponsor name-id="T000491">Mr. Tran</cosponsor>, <cosponsor name-id="V000130">Mr. Vargas</cosponsor>, <cosponsor name-id="V000131">Mr. Veasey</cosponsor>, <cosponsor name-id="V000138">Mr. Vindman</cosponsor>, <cosponsor name-id="W000831">Mr. Walkinshaw</cosponsor>, <cosponsor name-id="W000797">Ms. Wasserman Schultz</cosponsor>, <cosponsor name-id="W000187">Ms. Waters</cosponsor>, <cosponsor name-id="W000822">Mrs. Watson Coleman</cosponsor>, <cosponsor name-id="W000788">Ms. Williams of Georgia</cosponsor>, <cosponsor name-id="W000808">Ms. Wilson of Florida</cosponsor>, <cosponsor name-id="E000296">Mr. Evans of Pennsylvania</cosponsor>, <cosponsor name-id="G000585">Mr. Gomez</cosponsor>, <cosponsor name-id="C001131">Mr. Casar</cosponsor>, <cosponsor name-id="H001047">Mr. Himes</cosponsor>, <cosponsor name-id="P000621">Ms. Pou</cosponsor>, <cosponsor name-id="T000474">Mrs. Torres of California</cosponsor>, <cosponsor name-id="B001315">Ms. Budzinski</cosponsor>, <cosponsor name-id="B001326">Ms. Bynum</cosponsor>, <cosponsor name-id="F000483">Ms. Friedman</cosponsor>, <cosponsor name-id="K000375">Mr. Keating</cosponsor>, <cosponsor name-id="S001223">Mrs. Sykes</cosponsor>, <cosponsor name-id="N000015">Mr. Neal</cosponsor>, <cosponsor name-id="H001103">Mr. Hernández</cosponsor>, and <cosponsor name-id="C001059">Mr. Costa</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name>, and in addition to the Committees on <committee-name committee-id="HED00">Education and Workforce</committee-name>, <committee-name committee-id="HVR00">Veterans' Affairs</committee-name>, <committee-name committee-id="HII00">Natural Resources</committee-name>, and <committee-name committee-id="HJU00">the Judiciary</committee-name>, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes.</official-title></form><legis-body id="H41492729F3CE4C1085925FCFAAA37B19" style="OLC"> 
<section id="H4717439B5C8F44669E771F03C50AC577" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Momnibus Act</short-title></quote>.</text></section> <section id="H9A79203506D54C4395F9BDBA9D9EB0F2" commented="no"><enum>2.</enum><header>Table of contents</header><text display-inline="no-display-inline">The table of contents for this Act is as follows:</text> 
<toc container-level="legis-body-container" quoted-block="no-quoted-block" lowest-level="section" regeneration="yes-regeneration" lowest-bolded-level="division-lowest-bolded"> 
<toc-entry idref="H4717439B5C8F44669E771F03C50AC577" level="section">Sec. 1. Short title.</toc-entry> 
<toc-entry idref="H9A79203506D54C4395F9BDBA9D9EB0F2" level="section">Sec. 2. Table of contents.</toc-entry> 
<toc-entry idref="H64A8BA7244ED4539A52AC5F6D96C32B7" level="section">Sec. 3. Definitions.</toc-entry> 
<toc-entry idref="HA44C83A1682544D7B6DF34CC26DD4306" level="section">Sec. 4. Sense of Congress.</toc-entry> 
<toc-entry idref="H1BD978FEF0F24795B1234607629BD3BA" level="title">Title I—Social Determinants for Moms</toc-entry> 
<toc-entry idref="H6B14016C34EB403B90EF352D3F84791B" level="section">Sec. 101. Task force to address the United States maternal health crisis.</toc-entry> 
<toc-entry idref="H1D776559726147F88E9FACE62A1C1F08" level="section">Sec. 102. Sustained funding to address social determinants of maternal health.</toc-entry> 
<toc-entry idref="HACAB3134DB1B43949E2036E224D13F39" level="title">Title II—Extending WIC for New Moms</toc-entry> 
<toc-entry idref="HF4A67C5EF3DB423E8763D63FA1836396" level="section">Sec. 201. Extending WIC eligibility for new moms.</toc-entry> 
<toc-entry idref="H38044C51D4144F47A34ABD02A8E50057" level="title">Title III—Honoring Kira Johnson</toc-entry> 
<toc-entry idref="HA26B3731BE0F47A8919E8107261DB49D" level="section">Sec. 301. Sustained funding for community-based organizations to advance maternal health equity.</toc-entry> 
<toc-entry idref="H74584617C79245ADAD58BCF6589B39A9" level="section">Sec. 302. Respectful maternity care training for all employees in maternity care settings.</toc-entry> 
<toc-entry idref="HF29214C5EFD242A2A7E35D82E33CEC8F" level="section">Sec. 303. Study on reducing and preventing bias, racism, and discrimination in maternity care settings.</toc-entry> 
<toc-entry idref="H190997FE5CCD473CA5B2C795015FA834" level="section">Sec. 304. Respectful maternity care compliance program.</toc-entry> 
<toc-entry idref="H90540AF3E1D249BE92FCA0BE5DF45740" level="section">Sec. 305. GAO report.</toc-entry> 
<toc-entry idref="H56B008F54042431DBE97B8112937D7CA" level="title">Title IV—Maternal health for veterans</toc-entry> 
<toc-entry idref="H14689AFFC1F345258D7AD882A8B33F6D" level="section">Sec. 401. Support for maternity health care and coordination programs of the Department of Veterans Affairs.</toc-entry> 
<toc-entry idref="H1D95E3F6928145A590AB8599AADD9170" level="title">Title V—Perinatal workforce</toc-entry> 
<toc-entry idref="H0A366A9F0C264032A8A939F7AB0C49FD" level="section">Sec. 501. HHS agency directives.</toc-entry> 
<toc-entry idref="H48E06014AB36415BAC5039FB894C692D" level="section">Sec. 502. Grants to grow and diversify the perinatal workforce.</toc-entry> 
<toc-entry idref="H6B14CD28CCF94699B223C0305C48C4A3" level="section">Sec. 503. Grants to grow and diversify the nursing workforce in maternal and perinatal health.</toc-entry> 
<toc-entry idref="H9D6F8912DCB9410E9E541B4A508E50D3" level="section">Sec. 504. GAO report.</toc-entry> 
<toc-entry idref="H48FB6E903AA34294A4A4613FAE04A8E0" level="title">Title VI—Data to save moms</toc-entry> 
<toc-entry idref="H25125DABD6D648D4B88DA21460C46F4C" level="section">Sec. 601. Funding for maternal mortality review committees to promote representative community engagement.</toc-entry> 
<toc-entry idref="H19C00441B3624357A3E34E64766B1D3B" level="section">Sec. 602. Data collection and review.</toc-entry> 
<toc-entry idref="H5EC5959F5AA54270936561502283075E" level="section">Sec. 603. Review of maternal health data collection processes and quality measures.</toc-entry> 
<toc-entry idref="H7C7C7585AB8847FF91EE69B334515ED3" level="section">Sec. 604. Study on maternal health among American Indian and Alaska Native individuals.</toc-entry> 
<toc-entry idref="H67A790ACB074442FA223A49359A0930B" level="section">Sec. 605. Grants to minority-serving institutions to study maternal mortality, severe maternal morbidity, and other adverse maternal health outcomes.</toc-entry> 
<toc-entry idref="H605023C3E9444827829C8421D01E28C6" level="title">Title VII—Moms matter</toc-entry> 
<toc-entry idref="H2A0F09A53236475F9D289BBF6164271F" level="section">Sec. 701. Maternal mental health equity grant program.</toc-entry> 
<toc-entry idref="H6C82C126D1C047B0A807AB9B6A361A8F" level="section">Sec. 702. Grants to grow and diversify the maternal mental and behavioral health care workforce.</toc-entry> 
<toc-entry idref="HCF88503D53F8432294AC9FE787CB54B3" level="title">Title VIII—Justice for incarcerated moms</toc-entry> 
<toc-entry idref="H226E3BBE92C2440DAD27CF41BDD5A9E1" level="section">Sec. 801. Ending the shackling of pregnant individuals.</toc-entry> 
<toc-entry idref="H8D654764D6684D708CC43F3B67E67331" level="section">Sec. 802. Creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods.</toc-entry> 
<toc-entry idref="H3F89FD9C72F547ABBE50232A4898DDEC" level="section">Sec. 803. Grant program to improve maternal health outcomes for individuals in State and local prisons and jails.</toc-entry> 
<toc-entry idref="H1C5A97E634584988A4A7894B9D75D02C" level="section">Sec. 804. GAO report.</toc-entry> 
<toc-entry idref="H8373B6779357452FA4976D71D07E3750" level="title">Title IX—Tech to save moms</toc-entry> 
<toc-entry idref="H558A5CBAB0CB442DBD4598A00CE8EB2A" level="section">Sec. 901. Integrated telehealth models in maternity care services.</toc-entry> 
<toc-entry idref="HE380CEA08AFF42B9BC83EF4CDB2A08C9" level="section">Sec. 902. Grants to expand the use of technology-enabled collaborative learning and capacity models for pregnant and postpartum individuals.</toc-entry> 
<toc-entry idref="H8D6A2F0D9EE043E29A15EB30E689B9E3" level="section">Sec. 903. Grants to promote equity in maternal health outcomes through digital tools.</toc-entry> 
<toc-entry idref="HB8DA2D67C3CD472B9A787B5E678F3779" level="section">Sec. 904. Report on the use of technology in maternity care.</toc-entry> 
<toc-entry idref="H1FAF9E7EF8F045E28577B82157097B11" level="title">Title X—Impact to save moms</toc-entry> 
<toc-entry idref="H44F2E3EBD0EE4BA18F1DAF7D43695DFC" level="section">Sec. 1001. Perinatal Care Alternative Payment Model Demonstration Project.</toc-entry> 
<toc-entry idref="HF777ABDE0C644D11874E11BB5B9F87A6" level="title">Title XI—Maternal health pandemic response</toc-entry> 
<toc-entry idref="HC7623FB7C8DB453888F89167D8FDF8FB" level="section">Sec. 1101. Definitions.</toc-entry> 
<toc-entry idref="HE1F3DA12743A4CD3A1DE4EC363637FA8" level="section">Sec. 1102. Funding for data collection, surveillance, and research on maternal health outcomes during public health emergencies.</toc-entry> 
<toc-entry idref="H676029BEBB31423DA5B9E3F1AD54C54A" level="section">Sec. 1103. Public health emergency maternal health data collection and disclosure.</toc-entry> 
<toc-entry idref="HA593AB9733F14700934BE7276083DD57" level="section">Sec. 1104. Public health communication regarding maternal care during public health emergencies.</toc-entry> 
<toc-entry idref="HA477B569BF7E430D892F4A4AD8D59EF4" level="section">Sec. 1105. Task force on birthing experience and safe, respectful, responsive, and empowering maternity care during public health emergencies.</toc-entry> 
<toc-entry idref="H0F64630B33164B64BD9B9291CAA846C1" level="title">Title XII—Protecting moms and babies against climate change</toc-entry> 
<toc-entry idref="HB901717ACFB040468A33C84C11EDD48C" level="section">Sec. 1201. Definitions.</toc-entry> 
<toc-entry idref="HDECAA14C96BB43A1BFB8CCD92ABF45FC" level="section">Sec. 1202. Grant program to protect vulnerable mothers and babies from climate change risks.</toc-entry> 
<toc-entry idref="H7C6FF2AA310B40BBBA8E5ACE23BFDA19" level="section">Sec. 1203. Grant program for education and training at health profession schools.</toc-entry> 
<toc-entry idref="HBB931EAC26084046902D508882EC6A38" level="section">Sec. 1204. NIH Consortium on Birth and Climate Change Research.</toc-entry> 
<toc-entry idref="H3D2487E6CC9346B09CA1FFFBF6473A3B" level="section">Sec. 1205. Strategy for identifying climate change risk zones for vulnerable mothers and babies.</toc-entry> 
<toc-entry idref="H80ACBB682664466BB32A3ECA95789A63" level="title">Title XIII—NIH IMPROVE</toc-entry> 
<toc-entry idref="H92F0691C8EEF47EF88540C542D1E17C0" level="section">Sec. 1301. IMPROVE Initiative.</toc-entry> 
<toc-entry idref="HBD5C3D860DB74399AA56BEDF9546EB79" level="title">Title XIV—Maternal vaccinations</toc-entry> 
<toc-entry idref="HFC3FFEA2EF9C4F0DB8531EE8C8B8317A" level="section">Sec. 1401. Maternal vaccination awareness and equity campaign.</toc-entry> </toc></section> 
<section id="H64A8BA7244ED4539A52AC5F6D96C32B7"><enum>3.</enum><header>Definitions</header><text display-inline="no-display-inline">In this Act:</text> <paragraph id="H185B0C00F0F8417C815DEE54FFCFB9B9"><enum>(1)</enum><header>Culturally and linguistically congruent</header><text display-inline="yes-display-inline">The term <term>culturally and linguistically congruent</term>, 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.</text></paragraph> 
<paragraph id="HE6B71AE342424D79938226F3459E8533"><enum>(2)</enum><header>Maternal mortality</header><text display-inline="yes-display-inline">The term <term>maternal mortality</term> 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.</text></paragraph> <paragraph id="H2AF2A39F4974423E8C24F804020B5061"><enum>(3)</enum><header>Maternity care provider</header><text display-inline="yes-display-inline">The term <term>maternity care provider</term> means a health care provider who—</text> 
<subparagraph id="H2ECA534E16CF4AF3843C94C6BD955F5C"><enum>(A)</enum><text display-inline="yes-display-inline">is a physician, a physician assistant, a midwife who meets, at a minimum, the international definition of a midwife and global standards for midwifery education as established by the International Confederation of Midwives, an advanced practice registered nurse, a doula accredited by a State to receive reimbursement for doula services under a State plan (or a waiver of such plan) under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>), or a lactation consultant certified by the International Board of Lactation Consultant Examiners; and</text></subparagraph> <subparagraph id="HF69C27D993144D17ABA751F3CEE489F2"><enum>(B)</enum><text>has a focus on maternal or perinatal health.</text></subparagraph></paragraph> 
<paragraph id="HB65A63B4DA3E4381A6FA156CB448CC02"><enum>(4)</enum><header>Perinatal health worker</header><text display-inline="yes-display-inline">The term <term>perinatal health worker</term> 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.</text></paragraph> <paragraph id="H54272D6D523F49109106115BCDCE4B5A" display-inline="no-display-inline"><enum>(5)</enum><header>Postpartum and postpartum period</header><text>The terms <term>postpartum</term> and <term>postpartum period</term> refer to the 1-year period beginning on the last day of the pregnancy of an individual.</text></paragraph> 
<paragraph id="H7C30AF9A322743629569684E590ADB7B"><enum>(6)</enum><header>Pregnancy-associated death</header><text>The term <term>pregnancy-associated death</term> 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="HFD6DB5DC8F5F45F69D81B85C5EC6E23C"><enum>(7)</enum><header>Pregnancy-related death</header><text display-inline="yes-display-inline">The term <term>pregnancy-related death</term> 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> 
<paragraph id="HED47F0E40E3C4B738A431C4D7981C02F" commented="no"><enum>(8)</enum><header>Public health emergency</header><text>The term <quote>public health emergency</quote> means a public health emergency declared 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>).</text></paragraph> <paragraph id="H7993C0A58422420AA5FA5678DDC49004"><enum>(9)</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) 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="HF75FD567704A4BC4901008DAA9EE0607"><enum>(10)</enum><header>Severe maternal morbidity</header><text display-inline="yes-display-inline">The term <term>severe maternal morbidity</term> 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.</text></paragraph> <paragraph id="HC17E3A9F55C344449F8117B3BFEEF76F" display-inline="no-display-inline"><enum>(11)</enum><header>Social determinants of maternal health</header><text display-inline="yes-display-inline">The term <term>social determinants of maternal health</term> means nonclinical factors that impact maternal health outcomes.</text></paragraph></section> 
<section id="HA44C83A1682544D7B6DF34CC26DD4306"><enum>4.</enum><header>Sense of Congress</header><text display-inline="no-display-inline">It is the sense of Congress that—</text> <paragraph id="H80FED4DA9B504EB1ACC30A117437C400"><enum>(1)</enum><text>the respect and proper care that birthing people deserve is inclusive; and</text></paragraph> 
<paragraph id="H89F8DBCE88A0474AA5C7DD9D83F0132C"><enum>(2)</enum><text>regardless of race, ethnicity, gender identity, sexual orientation, religion, marital status, primary language, familial status, socioeconomic status, immigration status, incarceration status, or disability, all deserve dignity.</text></paragraph></section> <title id="H1BD978FEF0F24795B1234607629BD3BA"><enum>I</enum><header>Social Determinants for Moms</header> <section id="H6B14016C34EB403B90EF352D3F84791B"><enum>101.</enum><header>Task force to address the United States maternal health crisis</header> <subsection id="H47F9DA42360A4A26B1DF0A60B9AB50E7"><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 strategies and coordinate efforts between Federal agencies and other stakeholders to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, including actions to address clinical and nonclinical causes of maternal mortality, severe maternal morbidity, and maternal health disparities.</text></subsection> 
<subsection id="H073F2E205833491F8D057396B9EE36B3"><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="HFABE98BF8ADD43E88A037F7A3B9A7E02"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary of Health and Human Services (or a designee thereof).</text></paragraph> 
<paragraph id="HC345EFA2ED2A4E5685592708DD5F2A41"><enum>(2)</enum><text display-inline="yes-display-inline">The Secretary of Housing and Urban Development (or a designee thereof).</text></paragraph> <paragraph id="H3B2C52AA928B428EA18BDF9F08981928"><enum>(3)</enum><text display-inline="yes-display-inline">The Secretary of Transportation (or a designee thereof).</text></paragraph> 
<paragraph id="H700C42CE2CF44ECD8F6B4C7855F48A5E"><enum>(4)</enum><text display-inline="yes-display-inline">The Secretary of Agriculture (or a designee thereof).</text></paragraph> <paragraph id="H4028BE2E427346F992D655F14B589E5B"><enum>(5)</enum><text display-inline="yes-display-inline">The Secretary of Labor (or a designee thereof).</text></paragraph> 
<paragraph id="HB6D7A78200914C0A81E18C1B09522A55"><enum>(6)</enum><text display-inline="yes-display-inline">The Administrator of the Environmental Protection Agency (or a designee thereof).</text></paragraph> <paragraph id="HDE5A35AC4DA14CEC9A4B660191DF003A"><enum>(7)</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="H18E27E22F055471C8D2939CD697D6140"><enum>(8)</enum><text display-inline="yes-display-inline">The Administrator of the Centers for Medicare &amp; Medicaid Services (or a designee thereof).</text></paragraph> <paragraph id="H2164B72041CB4B88B20E024A9E4C3978"><enum>(9)</enum><text display-inline="yes-display-inline">The Director of the Indian Health Service (or a designee thereof).</text></paragraph> 
<paragraph id="HC94E77756B7149209C220BEDB87958FC"><enum>(10)</enum><text display-inline="yes-display-inline">The Director of the National Institutes of Health (or a designee thereof).</text></paragraph> <paragraph id="H33069EF7E1C042DFBB5E1B4E15B3D40E"><enum>(11)</enum><text display-inline="yes-display-inline">The Director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (or a designee thereof).</text></paragraph> 
<paragraph id="HEBD3B09FDE7C4FCE86D4275DB99F5CFA" commented="no"><enum>(12)</enum><text display-inline="yes-display-inline">The Director of the Tribal Health Research Office of the National Institutes of Health (or a designee thereof).</text></paragraph> <paragraph id="H1B46A2A832C741D59272DCC4AE551A23"><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="H64488991808F414387F9BD3195FE4AAC"><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="H146B0227EB634BD3A5FE53C3B9ED97A0"><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="H621A9751BA6C4CCA915A001561CCF52E"><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="HEBBE6FC275434ADD8A07BE170CD4831C"><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="HC5ED0AB066F745D8AF131F3E20E26FC7"><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 may appoint the following members of the Task Force:</text> <paragraph id="H733BB5AC2FED4EB7B3C3BA7BD8CD27E2"><enum>(1)</enum><text>Representatives of patients, to include—</text> 
<subparagraph id="H98B5848F1B4849A981503552C0D60E37"><enum>(A)</enum><text>a representative of patients who have suffered from severe maternal morbidity; or</text></subparagraph> <subparagraph id="H01C396C8DD294F1DA2D884AE31B7C7DE"><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="H27E1B859FFDD420B9CBC934F465EB1A3"><enum>(2)</enum><text display-inline="yes-display-inline">Leaders of community-based organizations that address maternal mortality, severe maternal morbidity, and maternal health 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 demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></paragraph> <paragraph id="H9044001BED614D09925777408F050ECB" commented="no"><enum>(3)</enum><text display-inline="yes-display-inline">Leaders from the Indian health care system, including leaders from Tribal Epidemiology Centers.</text></paragraph> 
<paragraph id="H2D56185978564E0FB135FB2FBE6A2FF5"><enum>(4)</enum><text>Perinatal health workers.</text></paragraph> <paragraph id="HD48F2445FA8640C58A8EE103215B28EB"><enum>(5)</enum><text>A professionally and geographically diverse panel of maternity care providers.</text></paragraph> 
<paragraph id="HF89D122E376C4CB58DB3C50774D8DAFA"><enum>(6)</enum><text display-inline="yes-display-inline">Other maternal health stakeholders outside of the Federal Government with expertise in maternal health, including social determinants of maternal health.</text></paragraph></subsection> <subsection id="H8A023A3DA47549B4B4669133DBB040ED"><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="H42B35A7C9B8B4A6A94C79DFD18408E4D"><enum>(e)</enum><header>Topics</header><text display-inline="yes-display-inline">In developing strategies coordinating efforts between Federal agencies and other stakeholders to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States under this section, the Task Force may address topics such as—</text> <paragraph id="H059EDEC6DD6E4D2C839BF8CF26550351"><enum>(1)</enum><text>addressing barriers that prevent 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="H0AC67F3E854F44AA9F8C074D3710F87F"><enum>(2)</enum><text>increasing access to safe, stable, affordable, and adequate housing for pregnant and postpartum individuals and their families;</text></paragraph> <paragraph id="HB4CCB26A0B754DEDA4F4A7328AAB00FF"><enum>(3)</enum><text>delivering healthy food, infant formula, clean water, diapers, or other perinatal necessities to pregnant and postpartum individuals located in areas that are food deserts;</text></paragraph> 
<paragraph id="H87B147F95DD5492B8D0977C01EAF71AF"><enum>(4)</enum><text>addressing the impacts of water and air quality, exposure to extreme temperatures, environmental chemicals, environmental risks in the workplace and the home, and pollution levels, on maternal and infant health outcomes;</text></paragraph> <paragraph id="H449968B1A18A4D6BB5A005972CE33C0C"><enum>(5)</enum><text>offering free and accessible drop-in childcare services during prenatal and postpartum appointments;</text></paragraph> 
<paragraph id="H004FA9FC1D5F4555B7DC434D778EC96F"><enum>(6)</enum><text>addressing the clinical and nonclinical needs of postpartum individuals and their families for the duration of the postpartum period;</text></paragraph> <paragraph id="H64646A0022A64D46A36C61C45ADA13CC"><enum>(7)</enum><text>engaging with nongovernmental entities to address social determinants of maternal health, including through public-private partnerships;</text></paragraph> 
<paragraph id="H99142511EB474D64AF0BDFC830D00D24"><enum>(8)</enum><text display-inline="yes-display-inline">addressing the impact of domestic or intimate partner violence on maternal health outcomes; and</text></paragraph> <paragraph id="HF44DAA9FD98C4986920F3C9DC078218B"><enum>(9)</enum><text>other topics determined by the chair of the Task Force.</text></paragraph></subsection> 
<subsection id="HC93D8EF2C15B4B4E804659C5587BAE20"><enum>(f)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of enactment of this Act, and every year thereafter, the Task Force shall submit to Congress and make publicly available on the website of the Department of Health and Human Services a report—</text> <paragraph id="HC5EBD55F7E6A4AAAB2738ADDD2362B08"><enum>(1)</enum><text>describing the Task Force’s efforts to develop strategies and coordinate efforts between Federal agencies and other stakeholders to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States;</text></paragraph> 
<paragraph id="H8D46D15012974FCEB94587D051486B63"><enum>(2)</enum><text>providing an overview of actions taken by each member of the Task Force listed under subsection (b) to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States;</text></paragraph> <paragraph id="H3123D5B52DC943348A229EACE6EC5272"><enum>(3)</enum><text>providing recommendations on Federal funding amounts and authorities needed to implement strategies developed by the Task Force to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States;</text></paragraph> 
<paragraph id="H9A79F9619D8345AFA4E3A9816B18C985"><enum>(4)</enum><text>providing recommendations on actions that stakeholders outside of the Federal Government can take to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States; and</text></paragraph> <paragraph id="H65A81432F84E4351B03E78319FF98085"><enum>(5)</enum><text>addressing other topics as determined by the chair of the Task Force.</text></paragraph></subsection> 
<subsection id="HE69D8CF6E998441FA6CCAA0BBE23FB4A"><enum>(g)</enum><header>Termination</header><text display-inline="yes-display-inline">Section 1013 of title 5, United States Code, shall not apply to the Task Force with respect to termination.</text></subsection></section> <section id="H1D776559726147F88E9FACE62A1C1F08"><enum>102.</enum><header>Sustained funding to address social determinants of maternal health</header> <subsection id="H39448FB5D07E460DA5F04E419718ED2A"><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 address social determinants of maternal health to eliminate maternal mortality, severe maternal morbidity, and maternal health disparities.</text></subsection> 
<subsection id="H2C9B37010AE7415784261F21D8C3F890"><enum>(b)</enum><header>Eligible entities</header><text display-inline="yes-display-inline">In this section, the term <term>eligible entity</term> means—</text> <paragraph id="H5BD20A00EA594D8CB11E2F6A09F15833"><enum>(1)</enum><text>a community-based organization, Indian Tribe or Tribal organization, or Urban Indian organization;</text></paragraph> 
<paragraph id="HD28C5226F9DF4D07AE50A1162210BD16"><enum>(2)</enum><text>a public health department or nonprofit organization working with an entity listed in paragraph (1); or</text></paragraph> <paragraph id="H0B577C035AD247A59B3D94BC7D694E5D"><enum>(3)</enum><text>a consortium of entities listed in paragraph (1) or (2) that includes at minimum one entity listed in paragraph (1).</text></paragraph></subsection> 
<subsection id="HC34041E7E53A4BB0B9DC9DC904E41D83"><enum>(c)</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 provide.</text></subsection> <subsection id="H03689BCF1CFE40E89CD26BFF7530EA59"><enum>(d)</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 is operating in an area with—</text> 
<paragraph id="HFEB2E5DFC3D74F82B4A8B02D7B4F20B6"><enum>(1)</enum><text display-inline="yes-display-inline">high rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; and</text></paragraph> <paragraph id="HDFA91F8BE118425F8F347781CF8FBC03"><enum>(2)</enum><text display-inline="yes-display-inline">a high poverty rate.</text></paragraph></subsection> 
<subsection id="H2475673EF20643BF990F4BB2D786D644"><enum>(e)</enum><header>Activities</header><text display-inline="yes-display-inline">An eligible entity that receives a grant under this section may use the grant to address social determinants of maternal health such as—</text> <paragraph id="H333F3B65E00A4DB3A1A740CE978A85F8"><enum>(1)</enum><text>housing;</text></paragraph> 
<paragraph id="H4CB9186FCE3D43DF94F3C1043B1A855C"><enum>(2)</enum><text>transportation;</text></paragraph> <paragraph id="H76A4550491DF4B62B1272749CDA0E9CA"><enum>(3)</enum><text>nutrition;</text></paragraph> 
<paragraph id="HC85DCE07F5644506AFFC789DE4BA1BFA"><enum>(4)</enum><text>employment, workplace conditions, and other economic factors;</text></paragraph> <paragraph id="H5282383B945249D9AD62AEC275C3DE97"><enum>(5)</enum><text>environmental conditions;</text></paragraph> 
<paragraph id="HF0CDF325CAB24825B44B48C836DDB60C"><enum>(6)</enum><text>intimate partner violence; and</text></paragraph> <paragraph id="HAB59CE0609B946CCBA2C236559492723"><enum>(7)</enum><text>other nonclinical factors that impact maternal health outcomes.</text></paragraph></subsection> 
<subsection id="HE6D6E42635CA47049BA0E6BF4BCD452E"><enum>(f)</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 after the period of the grant.</text></subsection> <subsection id="HEC8954624E534B0195B0AFC08D420E28"><enum>(g)</enum><header>Reporting</header> <paragraph id="HD3ABA29CF55846FCB2F1F839BB99403E"><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, primary language, geography, socioeconomic status, and other relevant factors.</text></paragraph> 
<paragraph id="H2CD1A25C221746BDB4E3E5D396B4AA16"><enum>(2)</enum><header>Secretary</header><text>Not later than the end of fiscal year 2031, the Secretary shall submit to Congress a report that includes—</text> <subparagraph id="HCD7E15186F6B4AD4B83DDF9E12160517"><enum>(A)</enum><text>a summary of the reports under paragraph (1); and</text></subparagraph> 
<subparagraph id="HBF866BDCB66145A88CE2EE784542CFB3"><enum>(B)</enum><text display-inline="yes-display-inline">recommendations for future Federal grant allocations to address social determinants of maternal health.</text></subparagraph></paragraph></subsection> <subsection id="H2EEC2EAE203C47CF9C3201AA4C4D2948" commented="no"><enum>(h)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $100,000,000 for each of fiscal years 2027 through 2031.</text></subsection></section></title> 
<title id="HACAB3134DB1B43949E2036E224D13F39"><enum>II</enum><header>Extending WIC for New Moms</header> 
<section id="HF4A67C5EF3DB423E8763D63FA1836396" section-type="subsequent-section"><enum>201.</enum><header>Extending WIC eligibility for new moms</header> 
<subsection id="HC97F76E7E2704E33B158B736FD8A8D0C"><enum>(a)</enum><header>Extension of postpartum period</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>24 months</quote>.</text></subsection> <subsection id="HDB1798417BD54985BE52B202A0E52C8A"><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>24 months</quote>.</text></subsection> 
<subsection id="HE0A694B92B394194A0E5708D776EA076"><enum>(c)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of the enactment of this section, the Secretary shall submit to Congress a report that includes an evaluation of the effect of each of the amendments made by this section on—</text> <paragraph id="HDFEB7065D4DC47F7B3607E1587E547C7"><enum>(1)</enum><text display-inline="yes-display-inline">maternal and infant health outcomes, including racial and ethnic disparities with respect to such outcomes;</text></paragraph> 
<paragraph id="HC4ECB1C4547743A1A69C785B1E980673"><enum>(2)</enum><text display-inline="yes-display-inline">breastfeeding rates among postpartum individuals;</text></paragraph> <paragraph id="H7F5E1A334EF64E258D043A6715C09BBE"><enum>(3)</enum><text display-inline="yes-display-inline">qualitative evaluations of family experiences under the special supplemental nutrition program 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></paragraph> 
<paragraph id="HC0CCBB7858C74EFC81396F6D8A082CA0"><enum>(4)</enum><text display-inline="yes-display-inline">other relevant information as determined by the Secretary.</text></paragraph></subsection></section></title> <title id="H38044C51D4144F47A34ABD02A8E50057"><enum>III</enum><header>Honoring Kira Johnson</header> <section id="HA26B3731BE0F47A8919E8107261DB49D" commented="no"><enum>301.</enum><header>Sustained funding for community-based organizations to advance maternal health equity</header> <subsection id="H0E7373211F4945A583B07DC78A3A54CA"><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 establish or expand programs to advance maternal health equity.</text></subsection> 
<subsection id="HF179D24E6CE3425C8A4DFA2058A66DBB" commented="no"><enum>(b)</enum><header>Timing</header><text display-inline="yes-display-inline">Following the 1-year period described in subsection (d), the Secretary shall commence awarding the grants authorized by subsection (a).</text></subsection> <subsection id="HAD9BE74357DB47F1B74B27CFEC605AD0" commented="no"><enum>(c)</enum><header>Eligible entities</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 demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></subsection> 
<subsection id="H649E3B204A434E5988CCF1E73B459269" commented="no"><enum>(d)</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="HADDB9BFAFAE74C54A8864CB61FD13E66" commented="no"><enum>(1)</enum><text>conduct outreach to encourage eligible entities to apply for grants under this section; and</text></paragraph> 
<paragraph id="H35432037D26247FEA686167D662FB3FC" commented="no"><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="HA1A26BF7F3AC49D58A40F0E9BD59FB6D" commented="no"><enum>(e)</enum><header>Special consideration</header> <paragraph id="HEA79B7B0544C4D2AAA2685A74D1A6E36" commented="no"><enum>(1)</enum><header>Outreach</header><text>In conducting outreach under subsection (d), the Secretary shall give special consideration to eligible entities that—</text> 
<subparagraph id="HD1D82D4893F74DE4AE617A7163477C60" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">are based in, and provide support for, communities with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes, to the extent such data are available;</text></subparagraph> <subparagraph id="HDB64BE5D13B046DFBB773BE2D8A092C0" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">are led by individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; and</text></subparagraph> 
<subparagraph id="H9A14982ACFE247BE93A190D0BB2F9199"><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 individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></subparagraph></paragraph> <paragraph id="HC61A2F330290407C84993E52881007AF" commented="no"><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="H26414EB21AF84ED0AC8CBE7595D60D1D" commented="no"><enum>(A)</enum><text>are described in subparagraphs (A), (B), and (C) of paragraph (1);</text></subparagraph> <subparagraph id="H49F95D06EBD04CB5BBD857590AEB9CE7" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">offer programs and resources designed in consultation with and intended for individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></subparagraph> 
<subparagraph id="HE267088B7F6B4D07B70CD680F9B058E5" commented="no"><enum>(C)</enum><text>offer programs and resources in the communities in which the respective eligible entities are located that—</text> <clause id="HF34477CDE1314F3499435D3358CE7B18" commented="no"><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 individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></clause> 
<clause id="H40B22C15BE734269AB70F7AAA966642C" commented="no"><enum>(ii)</enum><text display-inline="yes-display-inline">address social determinants of maternal health;</text></clause> <clause id="H8915D6636AB64AE783A1D972658CEB5C" commented="no"><enum>(iii)</enum><text display-inline="yes-display-inline">promote evidence-based health literacy and pregnancy, childbirth, and parenting education;</text></clause> 
<clause id="H644A134C070C4509ABE7F7F4B5B885DD" commented="no"><enum>(iv)</enum><text display-inline="yes-display-inline">provide support from perinatal health workers;</text></clause> <clause id="H995327D90E2447F6A8DE4A1A6B099C57"><enum>(v)</enum><text display-inline="yes-display-inline">provide culturally and linguistically congruent training to perinatal health workers;</text></clause> 
<clause id="H61E4531CE606426598DE87C4DC44A534"><enum>(vi)</enum><text display-inline="yes-display-inline">conduct or support research on maternal health issues disproportionately impacting individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></clause> <clause id="H6E68EA1E51E743EDB845F8D687BDC152"><enum>(vii)</enum><text display-inline="yes-display-inline">offer group prenatal care or group postpartum care;</text></clause> 
<clause id="HE1EB080E14384A8D96A7A0853903EB09"><enum>(viii)</enum><text display-inline="yes-display-inline">coordinate mutual aid efforts during infant formula shortages, including community milk depots, donor human milk banks and exchanges, and forums for community outreach and education;</text></clause> <clause id="H4FCF7649604A4EC9B9EEB23CD8144D4D"><enum>(ix)</enum><text>provide support to individuals or family members of individuals who suffered a pregnancy loss, pregnancy-associated death, or pregnancy-related death; or</text></clause> 
<clause id="H5D95DA8FB6334899A19B2823DF2B7AB9"><enum>(x)</enum><text display-inline="yes-display-inline">operate midwifery practices that provide culturally and linguistically congruent maternal health care and support, including for the purposes of—</text> <subclause id="HA9A4E3722E104E9CBC6134869516AFF8"><enum>(I)</enum><text>supporting additional education, training, and certification programs, including support for distance learning;</text></subclause> 
<subclause id="HF4EB983F20494DB5BC68A0F880F4E37E"><enum>(II)</enum><text>providing financial support to current and future midwives to address education costs, debts, and other needs;</text></subclause> <subclause id="H56BD58D77124484AA4D514CA2A40015D"><enum>(III)</enum><text>clinical site investments;</text></subclause> 
<subclause id="H77E10707242B43C18FBBCC3DBCF33B1D"><enum>(IV)</enum><text>supporting preceptor development trainings;</text></subclause> <subclause id="HB643BB10D1CE484DA0405298EC84E814"><enum>(V)</enum><text>expanding the midwifery practice; or</text></subclause> 
<subclause id="H68D2696AC55A40469D25FA7EBE11A454"><enum>(VI)</enum><text>related needs identified by the midwifery practice and described in the practice’s application; and</text></subclause></clause></subparagraph> <subparagraph id="H9D1730C968C7411C81E8D29D9BE8BF4C" commented="no"><enum>(D)</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 individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></subparagraph></paragraph></subsection> 
<subsection id="H3D11E284D58B4C70B44A87011E863628" commented="no"><enum>(f)</enum><header>Technical assistance</header><text>The Secretary shall provide to grant recipients under this section technical assistance on—</text> <paragraph id="HA4722E6E9BE44F0E97A47801ED7390EC" commented="no"><enum>(1)</enum><text display-inline="yes-display-inline">capacity building to establish or expand programs to advance maternal health equity;</text></paragraph> 
<paragraph id="H7ED12FB2EBE146B9B890EB81847CC480" commented="no"><enum>(2)</enum><text>best practices in data collection, measurement, evaluation, and reporting; and</text></paragraph> <paragraph id="H9041300D1DD040E49BD0896E1C3494BD" commented="no"><enum>(3)</enum><text display-inline="yes-display-inline">planning for sustaining programs to advance maternal health equity after the period of the grant.</text></paragraph></subsection> 
<subsection id="H3B29096ED0F7475183F80BC29BB56BD1" commented="no"><enum>(g)</enum><header>Evaluation</header><text display-inline="yes-display-inline">Not later than the end of fiscal year 2031, the Secretary shall submit to the Congress an evaluation of the grant program under this section that—</text> <paragraph id="H777A547DE686447C9556F4F9E5BA3AB4" commented="no"><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="H19BEA02641DA477DB85DDEDBC1DF1FBB" commented="no"><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="H59285BE0BA28493F93A9B4E0100D4B83" commented="no"><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 individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes, to the extent practicable; and</text></paragraph> 
<paragraph id="H3EEB6AE7F83B4420A9055BF3C3E2AF7F" commented="no"><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 individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></paragraph></subsection> <subsection id="H6842C05E37624F118B81B166F20615A4" commented="no"><enum>(h)</enum><header>Authorization of appropriations</header><text>To carry out this section, there is authorized to be appropriated $100,000,000 for each of fiscal years 2027 through 2031.</text></subsection></section> 
<section id="H74584617C79245ADAD58BCF6589B39A9"><enum>302.</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 et seq.</external-xref>) is amended by adding at the end the following new section:</text> <quoted-block style="OLC" id="HAC985AA0BD074E61B2546AB125A2843A" display-inline="no-display-inline"> <section id="H1F29FF4F002043FBBC4AD6BA957EB9BB"><enum>742.</enum><header>Respectful maternity care training for all employees in maternity care settings</header> <subsection id="HE0EB2942B668479C932294C115E06A4D"><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 and linguistically congruent, trauma-informed care.</text></subsection> 
<subsection id="H09FA406C3A7D4D508CB9319BE385A227"><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="HF48C1585D1AD4A3E88C96029B3B90D63"><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="HB8D23539E841483097DFBA533E438B2E"><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="H415CAF88BA1C4784901B6760F9BA8D53"><enum>(3)</enum><text display-inline="yes-display-inline">address implicit bias, racism, and cultural humility;</text></paragraph> 
<paragraph id="H84E75BB38F3E4ACCA13F64BA88043D6F"><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="HF810A0F7B7D04838830DE4440D81BEC0"><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="H6682C0F241194429B44940FC8E91A8C0"><enum>(6)</enum><text>include antiracism training and programs;</text></paragraph> <paragraph id="H158A7A6147D946CEAB709A1C3989EA07"><enum>(7)</enum><text>be delivered in undergraduate programs that funnel into health professions schools;</text></paragraph> 
<paragraph id="H35D249634EE94459BB865B5370387D8F"><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="H820702DEC368419CB2B0708D07007D2F"><enum>(9)</enum><text display-inline="yes-display-inline">integrate bias training in obstetric emergency simulation trainings or related trainings;</text></paragraph> 
<paragraph id="HEF343E6908EA4823A5A507AF7F5AC73A"><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="H303D129F2DFC4A019B8C572BCCC75165"><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 and linguistically congruent care; or</text></paragraph> 
<paragraph id="H9982C1E6ABF4462FADD4D7B0D3394451"><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="H03E27ACD1A604A949D51ACB70F8202EA"><enum>(c)</enum><header>Application</header><text>To seek a grant under subsection (a), an entity shall submit an application at such time, in such manner, and containing such information as the Secretary may require.</text></subsection> 
<subsection id="HF20E60A3F296422CAA63EC6E69FCBA3C"><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="HF0229A1FFDD0449AAB5E56E49A7954A7"><enum>(e)</enum><header>Best practices</header><text>Based on the annual reports submitted pursuant to subsection (d), the Secretary—</text> 
<paragraph id="H17C4323489054FE6A1BDDA0EADCEA95A"><enum>(1)</enum><text>shall produce an annual report on the findings resulting from programs funded through this section;</text></paragraph> <paragraph id="H31ECF3FFC75346A0B56D593A76E05036"><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="HACA200A303C14D4785679F43D6180DE5"><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="H4524C6DBAFFE432FAA2D2733F7FB0042"><enum>(f)</enum><header>Definitions</header><text>In this section:</text> 
<paragraph id="H8F1EC257A18D4114AB5AD0878824C0D8"><enum>(1)</enum><text>The term <term>postpartum</term> means the 1-year period beginning on the last day of an individual’s pregnancy.</text></paragraph> <paragraph id="HD8E0FA62198041CBA28B1418E1F35C66"><enum>(2)</enum><text>The term <term>culturally and linguistically congruent</term> means in agreement with the preferred cultural values, beliefs, worldview, language, and practices of the health care consumer and other stakeholders.</text></paragraph> 
<paragraph id="H1DFAFBDBF03E4FFB9282266D60FA037D"><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 id="H7F4A57D61D944372B08299FD696C83E2" commented="no"><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 2027 through 2031.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> 
<section id="HF29214C5EFD242A2A7E35D82E33CEC8F"><enum>303.</enum><header>Study on reducing and preventing bias, racism, and discrimination in maternity care settings</header> 
<subsection id="H21096F3262374F8AA0F42D272F0F9A14"><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="H80845F82D6A547BF82FFE2CD742A50FE"><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 and linguistically congruent, trauma-informed care; and</text></paragraph> 
<paragraph id="H817333C3A3764EAE841750C529BD8255"><enum>(2)</enum><text>not later than 24 months after the date of enactment of this Act—</text> <subparagraph id="H84A5FADF02B64F168DDA8EA52601CBA3"><enum>(A)</enum><text>complete the study; and</text></subparagraph> 
<subparagraph id="HFDF7ADFF7EFD42399747FC126A0B4795"><enum>(B)</enum><text>transmit a report on the results of the study to the Congress.</text></subparagraph></paragraph></subsection> <subsection id="H665BE630439444469ED334C98DFAEA4C"><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="H2B639E8959024C8A9662197F009BEE2B"><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="H6023C34764414328B9009F72A32BF3B7"><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="H190997FE5CCD473CA5B2C795015FA834"><enum>304.</enum><header>Respectful maternity care compliance program</header> 
<subsection id="H7D174F016D3C4EF68B1A681495248BBC"><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="H40FA3D0CB3FF46F581D5635438DE2F9A"><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="H56E264D7B9D5434EB4EF3F4801656F26"><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="H2FF202F77DB84048A3F5F8BD2BE2BEDF"><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="H0617E1ECC7FB46E9918E6A2E5A72F474"><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="H95FC5046E7D44388B8197C0EBA99E9FA"><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="HD93A99B99F1A4A5DA362A18610FBDFDD"><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="H7C81C6B98A514C9DAAF8B4151E030D70"><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 is present in the delivery of maternity care to patients from racial and ethnic minority groups;</text></subparagraph></paragraph> 
<paragraph id="H007594E81BD84D5EBF1C41F4DF0D327D"><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="H92DD8CFFDCC441A485806985B22CE820"><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="HC16246404DD54D99AB51166E69D606F8"><enum>(A)</enum><text>deidentified demographic information on the patient in the case, such as race, ethnicity, gender identity, and primary language;</text></subparagraph> <subparagraph id="H2915D534265049F58C5149A2F137B888"><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="H45BF5517C7974A4F879E64557D4F55ED"><enum>(C)</enum><text>the response from the compliance program; and</text></subparagraph> <subparagraph id="HCEBC3E8025254555B00BBE85C6B0275C"><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="H295F265930EE4C03A1A1F67CF0F600B6"><enum>(c)</enum><header>Secretary requirements</header> 
<paragraph id="HD6D6E3324EA1413CB1B68ADD581D556F"><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="H547CD875FD7544B3AC4E818B2EC0598E"><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="HB37378920A04480DB0B8A86C50BC235B"><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="H4CD886DE287F4E80BBA549DE236BE82E"><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="H100905D27DBB48CFAAEC4E1004CB8336"><enum>(2)</enum><header>Study</header> 
<subparagraph id="H7058C8F65EB44706B4B77C720097530D"><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="HFD4B7822439D4ED4BA56E115BC95F47D"><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="H7AC144ED077A45ED9EA10A1EAAAF244B"><enum>(ii)</enum><text>successful implementation of respectful care initiatives.</text></clause></subparagraph> <subparagraph id="HD5042E04D5C34C4B91D653BF038298F3"><enum>(B)</enum><header>Components of study</header><text>The study shall include the following:</text> 
<clause id="HF8A71E4276D8466EBA5B08FFDAFFCF8A"><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="H722F3326A5F8415EAECCF7F7BDC242BC"><enum>(ii)</enum><text display-inline="yes-display-inline">Based on such assessment, 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 nonmedical factors that contribute to adverse patient experiences and maternal health outcomes.</text></clause></subparagraph> 
<subparagraph id="H0AA69CFCDA6E4F9F8EF35241EC731F92"><enum>(C)</enum><header>Report</header><text>The Secretary shall submit to the Congress and make publicly available a report on the results of the study under this paragraph.</text></subparagraph></paragraph></subsection> <subsection id="HA8FBEFD4E30C4A0B9DD850B42924B4DB"><enum>(d)</enum><header>Authorization of appropriations</header><text>To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2027 through 2032.</text></subsection></section> 
<section id="H90540AF3E1D249BE92FCA0BE5DF45740"><enum>305.</enum><header>GAO report</header> 
<subsection id="H9936479891D646408369D0A3DF3D7D5A"><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 the 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="H5E4FA07F25FB479D969921FCC45DDF42"><enum>(b)</enum><header>Matters included</header><text>The report under subsection (a) shall include the following:</text> 
<paragraph id="HAF195F03E64840629F00154361AE99A1"><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="H51D674EF8B3D4AD8B8E094407B5220CD"><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="H70AF342A950D4005BDFA74B1B14CC958"><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="H1916D70DC1D348219D4727C2B3C6951B"><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="HF655AD4AD1F34773BD4A46E3E890C602"><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="H9997AAC9FF2B4AA39C5E16EEFC2B1098"><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="HE8D3FF7BEA6545048117C120E5473014"><enum>(3)</enum><text>Such other information as the Comptroller General determines appropriate.</text></paragraph></subsection></section></title> <title id="H56B008F54042431DBE97B8112937D7CA"><enum>IV</enum><header>Maternal health for veterans</header> <section id="H14689AFFC1F345258D7AD882A8B33F6D"><enum>401.</enum><header>Support for maternity health care and coordination programs of the Department of Veterans Affairs</header> <subsection id="H71DA2D534C454361A7EE75708F6FCEA4"><enum>(a)</enum><header>Report to Congress</header><text>Not later than 1 year after the date of the enactment of this Act, and annually thereafter until September 30, 2031, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate, and make publicly available, a report that contains the following:</text> 
<paragraph id="H5F5B2383FA0F4C9FA0E170E3029AEC6D"><enum>(1)</enum><text>A summary of the activities carried out under the programs of the Department of Veterans Affairs relating to maternity health care or coordination.</text></paragraph> <paragraph id="H4C7D809E1A7D45DFB2686A088F6A0899"><enum>(2)</enum><text>Data on maternal health outcomes of veterans who receive care furnished by the Secretary of Veterans Affairs, including pursuant to such programs.</text></paragraph> 
<paragraph id="HA75B731FA44F4AB29907F35083190277" commented="no"><enum>(3)</enum><text display-inline="yes-display-inline">Data on patients who are dually eligible to receive assistance from the Department of Veterans Affairs and the Indian Health Service and the maternity health care outcomes associated with receiving such care.</text></paragraph> <paragraph id="HE5F3952E4F234F6599878DF2A0484F07"><enum>(4)</enum><text>Recommendations by the Secretary of Veterans Affairs to improve the maternal health outcomes of veterans, with a particular focus on veterans from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></paragraph></subsection> 
<subsection id="H846B91179EC541EE9C25D4E28ADC6611"><enum>(b)</enum><header>Authorization of appropriations</header> 
<paragraph id="H52D31F43E1BE4B819849F13A81892D6D"><enum>(1)</enum><header>In general</header><text>There is authorized to be appropriated to the Secretary of Veterans Affairs $15,000,000 for each of fiscal years 2027, 2028, 2029, 2030, and 2031, for the programs of the Department of Veterans Affairs relating to maternity care coordination and related programs, including the maternity care coordination program described in Veterans Health Administration Directive 1330.03.</text></paragraph> <paragraph id="H92A8714686BE47BABAF84608E492FC03"><enum>(2)</enum><header>Supplement not supplant</header><text>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></section></title> 
<title id="H1D95E3F6928145A590AB8599AADD9170"><enum>V</enum><header>Perinatal workforce</header> 
<section id="H0A366A9F0C264032A8A939F7AB0C49FD" section-type="subsequent-section"><enum>501.</enum><header>HHS agency directives</header> 
<subsection id="H4801E6353815449DA6DC58B939F74185"><enum>(a)</enum><header>Guidance to States</header> 
<paragraph id="H73E1D880028244E7BC12AD6A86ECE865"><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 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="HA187129483F7472FAEA2820BE51AB36D"><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 id="H582D19BF15314B648678838A1C22A513" commented="no"><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, and 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>))—</text> <clause id="HDACF06FB88FE4595A1926853F15A252A" commented="no"><enum>(i)</enum><text display-inline="yes-display-inline">from racially, ethnically, and linguistically diverse backgrounds;</text></clause> 
<clause id="H9163CEE6C6DA4A03B9B9FEA3CDE26E31" commented="no"><enum>(ii)</enum><text>with experience practicing in racially and ethnically diverse communities; and</text></clause> <clause id="H372E68BB8AD04EECAAF64A8FFA1BF79E" commented="no"><enum>(iii)</enum><text>who have undergone training on implicit bias and racism;</text></clause></subparagraph> 
<subparagraph id="H5CD502BFF36B415A90D0E7FE96F45B8E"><enum>(B)</enum><text display-inline="yes-display-inline">to incorporate into maternity care teams—</text> <clause id="H2DB774562C85458C90B953416A33574C"><enum>(i)</enum><text>midwives who meet, at a minimum, the international definition of a midwife and global standards for midwifery education as established by the International Confederation of Midwives;</text></clause> 
<clause id="HE0EDCF550B674BA89AB9AF399D68DD23"><enum>(ii)</enum><text>perinatal health workers;</text></clause> <clause id="H03446C41454541A5A681B332BA04CEDF"><enum>(iii)</enum><text display-inline="yes-display-inline">physician assistants;</text></clause> 
<clause id="H6B53811B9C904592BFB9451CF7FBD3C6"><enum>(iv)</enum><text>advanced practice registered nurses; and</text></clause> <clause id="HCAB4188FC0524CB78C710EA062C66261"><enum>(v)</enum><text>lactation consultants certified by the International Board of Lactation Consultant Examiners;</text></clause></subparagraph> 
<subparagraph id="HCD3CAF2B7F7145058C94DA0646C18774"><enum>(C)</enum><text display-inline="yes-display-inline">to provide collaborative, culturally and linguistically congruent care; and</text></subparagraph> <subparagraph id="HF9F9680DFDA948488D5DF52D5A24EB4A"><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="H83AE35973527480D87099D97B07F1270"><enum>(b)</enum><header>Study on respectful and culturally and linguistically congruent maternity care</header> 
<paragraph id="H18CA6228B0B541BA9FF83DD52BC331C9"><enum>(1)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services acting through the Director of the National Institutes of Health (in this subsection referred to as the <quote>Secretary</quote>) shall conduct a study on best practices in respectful and culturally and linguistically congruent maternity care.</text></paragraph> <paragraph id="HD523B77A6590407D8A2F59BA6B9E6896"><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="HBFC2848B6B8743B78C7A207C49151A36"><enum>(A)</enum><text>complete the study required by paragraph (1);</text></subparagraph> <subparagraph id="H850FCAE7F1234C2387D14DEFBD219E4C"><enum>(B)</enum><text display-inline="yes-display-inline">submit to the Congress and make publicly available a report on the results of such study; and</text></subparagraph> 
<subparagraph id="H46F0BB13FAD1479AA8D151ACB5A93DEF"><enum>(C)</enum><text>include in such report—</text> <clause id="H9D7964F321E94AF0AA6155E9D6137A0E"><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 and linguistically congruent maternal health care;</text></clause> 
<clause id="H0EC83FE5794C422F906090DDC955E183"><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="H63331B73E72A4E39B3EBF53093C8ED34"><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 and linguistically congruent maternity care.</text></clause></subparagraph></paragraph></subsection></section> 
<section id="H48E06014AB36415BAC5039FB894C692D"><enum>502.</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" id="H3FF7004351EA4B80A0FC32EB595C7E86" display-inline="no-display-inline"> <section id="H5191839BA5764F80B8C49652B3D78FAC"><enum>758.</enum><header>Perinatal workforce grants</header> <subsection id="HF45F59DCA71440A18E84F1146EEDFB03"><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="HE4DF4BC926044141A410CEB50AA21231"><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="H935866480E4947A9BA609E0E01395125"><enum>(1)</enum><text display-inline="yes-display-inline">establishing accredited schools or programs that provide education and training to individuals seeking appropriate licensing and certification as—</text> 
<subparagraph id="H7FD527080FB5451E86948E08C66090E4"><enum>(A)</enum><text>physician assistants who will complete clinical training in the field of maternal and perinatal health;</text></subparagraph> <subparagraph id="HC3FAF45B72B347D1BFB6F83E27C51E5E"><enum>(B)</enum><text display-inline="yes-display-inline">perinatal health workers; or</text></subparagraph> 
<subparagraph id="HBD0EB1EF0AFE4E6A9E6000524391DAD2"><enum>(C)</enum><text display-inline="yes-display-inline">midwives who meet, at a minimum, the international definition of a midwife and global standards for midwifery education as established by the International Confederation of Midwives; and</text></subparagraph></paragraph> <paragraph id="H9476FE45C75D44F6A8861179601F691A"><enum>(2)</enum><text display-inline="yes-display-inline">expanding the capacity of existing accredited schools or programs described in paragraph (1), for the purposes of increasing the number of students enrolled in such accredited schools or programs, such as by awarding scholarships for students (including students from racially, ethnically, and linguistically diverse backgrounds).</text></paragraph></subsection> 
<subsection id="H1E9B9EEE04AF423BAB479B9971A4F854"><enum>(c)</enum><header>Prioritization</header><text>In awarding grants under this section, the Secretary shall give priority to a school or program described in subsection (b) that—</text> <paragraph id="H1F1189471BC14AE487CE8CE06E73A169"><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="HFC659AB42B0D4DB2BBB5D28DEB98F160"><enum>(2)</enum><text display-inline="yes-display-inline">has developed a strategy to recruit and retain a diverse pool of students into the school or program described in subsection (b) that is supported by funds received through the grant, particularly from racial and ethnic minority groups and other underserved populations;</text></paragraph> <paragraph id="HDCF468162D5E46F0834C0CF9F895DEC5"><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="HF53DBE8DDC1341688C352628656C1863"><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="H66AEEA21AE604095AD70D4EDCB1C8971"><enum>(5)</enum><text display-inline="yes-display-inline">includes in the standard curriculum for all students within the school or program described in subsection (b) a bias, racism, or discrimination training program that includes training on implicit bias and racism.</text></paragraph></subsection> 
<subsection id="H9D7BF37F6EB44183883B17587A05E756"><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 school or program described in subsection (b), an entity shall agree to submit to the Secretary an annual report on the activities conducted through the grant, including—</text> <paragraph id="H64128BD10F794F35AF2F7E2D9354843A"><enum>(1)</enum><text>the number and demographics of students participating in the school or program;</text></paragraph> 
<paragraph id="H32A66F9503014630A72AA74BE6515859"><enum>(2)</enum><text>the extent to which students in the school or program are entering careers in—</text> <subparagraph id="HB1F75F4531B54441859349CBF268D93F"><enum>(A)</enum><text display-inline="yes-display-inline">health professional shortage areas designated under section 332; and</text></subparagraph> 
<subparagraph id="HB8BD975DD3F140B1BD40CBEC942083CD"><enum>(B)</enum><text display-inline="yes-display-inline">areas with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes, to the extent such data are available; and</text></subparagraph></paragraph> <paragraph id="H0EF3B01555FF4185BD6079EA6DB0C106"><enum>(3)</enum><text>whether the school or program 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="HEDAD2701E9F24EB2893EAAAD381E8A3B"><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="HCFC25F721E4D4554891F77F7D2714902"><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="HFEB53E7BA7264EEC8052A79098D4A672"><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 postgrant period sustainability of the school or program described in subsection (b) that is proposed to be, or is being, established or expanded through the grant.</text></subsection> <subsection id="HA9A912F6ACE84E7BAD396945CE6DEBFD"><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 the 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="HB378421EDC56489AAB931F5088AF00DB"><enum>(1)</enum><text display-inline="yes-display-inline">recruiting students from racial and ethnic minority groups;</text></paragraph> <paragraph id="H35BF3B3CE05F43F6BD887E11CBCF11B8"><enum>(2)</enum><text display-inline="yes-display-inline">increasing the number of health professionals described in subparagraphs (A), (B), and (C) of subsection (b)(1) from racial and ethnic minority groups and other underserved populations;</text></paragraph> 
<paragraph id="H16E6F02985F2428DAD0B36F01E8B0F10"><enum>(3)</enum><text display-inline="yes-display-inline">increasing the number of such health professionals working in health professional shortage areas designated under section 332; and</text></paragraph> <paragraph id="H265E5D9418034783A601A555FD984D0B"><enum>(4)</enum><text display-inline="yes-display-inline">increasing the number of such health professionals 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="HF2289399FA394D939F5D7AE0CDA69B3C"><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)(1).</text></subsection> <subsection id="H2CE958CB6E5D4D07B24D1CFE5FDB942A"><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 2027 through 2031.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> 
<section id="H6B14CD28CCF94699B223C0305C48C4A3"><enum>503.</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" id="H54A29E83922E45A08EACF1CBF17CA273" display-inline="no-display-inline"> <section id="H3658B61A1D3F43D2B0BC2BEC593BEA71"><enum>812.</enum><header>Perinatal nursing workforce grants</header> <subsection id="HF3CF8023DCA94C159E26676CABA74DCA"><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="HFF68CB2302CE41409CCE10F6F5D569D9"><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="H7F16DF517D4C441DBD8B44F543B06E77"><enum>(1)</enum><text>nurse practitioners whose education includes a focus on maternal and perinatal health;</text></paragraph> 
<paragraph id="H7C360BC309C743BE930973E63FEED73B"><enum>(2)</enum><text>certified nurse-midwives; or</text></paragraph> <paragraph id="HEFF9C561C7E241B988A14D75FD5D0FC0"><enum>(3)</enum><text>clinical nurse specialists whose education includes a focus on maternal and perinatal health.</text></paragraph></subsection> 
<subsection id="H66556B13429B4479ACA42FF8B6E5F7A0"><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="HE5C04ECDF48D46AF83E8197BCD37AC69"><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="H0C7139C5ECAA482F972136F6B3E94CEC"><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="H9A60B8322B594EB0B5ABC23D4F50ABF2"><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="H946525F511074C50B877E848E0C44922"><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="H770D7913D70047249361A6E16649C4D1"><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="HAA3BFB7F62EA4D3C8B515D66F9E10D22"><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="H1EB52CEBE86D4DD9A481AAED17BE5FA2"><enum>(2)</enum><text>the extent to which such students are preparing to enter careers in—</text> 
<subparagraph id="H258686A9547D48FF8045E58FF7BA98A5"><enum>(A)</enum><text>health professional shortage areas designated under section 332; and</text></subparagraph> <subparagraph id="H65A6F38852EA41929B507207AEFF679D"><enum>(B)</enum><text display-inline="yes-display-inline">areas with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes, to the extent such data are available; and</text></subparagraph></paragraph> 
<paragraph id="H259DF32F1C78454A8061C4D354B0E303"><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="H03ADF0419F5F452FB58693072F90634A"><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="HFBD8ED460B7D412A8E533BCDD1511AF5"><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="HFC931E559D7B44EAB91EF7713B5CDE28"><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="HAC36BD265B424368AA8412FBD21E4E6B"><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 the 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="H0101B477B1A74CE988BF99C61095A96F"><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="HE0AFAA8AC76545B0B4710520DD004B36"><enum>(2)</enum><text display-inline="yes-display-inline">increasing the number of advanced practice registered nurses entering careers focused on maternal and perinatal health from racial and ethnic minority groups and other underserved populations;</text></paragraph> <paragraph id="H1CDCA64BE37F457B95AEEA278925A8B9"><enum>(3)</enum><text display-inline="yes-display-inline">increasing the number of advanced practice registered nurses entering careers focused on maternal and perinatal health working in health professional shortage areas designated under section 332; and</text></paragraph> 
<paragraph id="HEB29FF65BD94436A9DCC0C400633DDC3"><enum>(4)</enum><text display-inline="yes-display-inline">increasing the number of advanced practice registered nurses 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="H17D5DC4B36754F299A8D77CEEAB923C3"><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 2027 through 2031.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> 
<section id="H9D6F8912DCB9410E9E541B4A508E50D3"><enum>504.</enum><header>GAO report</header> 
<subsection id="H6A7BD7BF7E874899893230A5D79DD3D7"><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="HA285D45643C6446085728BCE10E6AEC6"><enum>(b)</enum><header>Content of report</header><text>The report under subsection (a) shall include—</text> 
<paragraph id="H14780BD22B7E4887AC2FF0760CA5AE94"><enum>(1)</enum><text display-inline="yes-display-inline">an assessment of current barriers to entering and successfully completing 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 id="HE881BE2DA69E47D0AB7B02289FE04BA2" commented="no"> <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, and 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>)), particularly for low-income women and women from racial and ethnic minority groups;</text>
                    </paragraph> 
<paragraph id="HFF4816DFD2134A2282D12CF698E6FDB3"><enum>(3)</enum><text display-inline="yes-display-inline">an assessment of current barriers that prevent midwives from meeting the international definition of a 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="H34BCC266A35A435C8CA0ED7300DE3C65"><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, and 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 perinatal health workers, stratified by race, ethnicity, gender identity, primary language, geographic location, and insurance type and recommendations to promote greater access equity; and</text></paragraph> 
<paragraph id="H1A9E57CBB06C45C98ABAB07357438092"><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></title> <title id="H48FB6E903AA34294A4A4613FAE04A8E0"><enum>VI</enum><header>Data to save moms</header> <section id="H25125DABD6D648D4B88DA21460C46F4C"><enum>601.</enum><header>Funding for maternal mortality review committees to promote representative community engagement</header> <subsection id="HB2A9775EA51846BCB821898674BE8C79"><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 id="H35B0E7468AEE4F24AD20BB7BFBB4A12F" style="OLC"> 
<paragraph id="H04392353EFB5411D865B5B62D53EFA04"><enum>(9)</enum><header>Grants to promote representative community engagement in maternal mortality review committees</header> 
<subparagraph id="HAACE627889D04A05996C6011A1591A59"><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 (as such terms are defined in section 4 of the Indian Health Care Improvement Act)—</text> <clause id="H0FEE67504ACF4585836D91BE998BB131"><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="HEAB23B92254A4BE2AE899D51042393D3"><enum>(I)</enum><text display-inline="yes-display-inline">prioritizing community members who can increase the diversity of the committee’s membership with respect to race and ethnicity, location, personal or family experiences of maternal mortality or severe maternal morbidity, and professional background, including members with nonclinical experiences; and</text></subclause> <subclause id="H6BC9F0393D644905A8E4D4FE5213B5F2"><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="H6A292AA543064708BBB51CD5C2692B41"><enum>(ii)</enum><text display-inline="yes-display-inline">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 women from racial and ethnic minority groups (as such term is defined in section 1707(g)(1)); and</text></clause> <clause id="HE884FC2D96D04FE088FC23FF4BAAF191"><enum>(iii)</enum><text>to release public reports assessing—</text> 
<subclause id="H3D12490F7F9F43ECB2135CC379328D6B"><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="HB0FE43F6E2A34F7F87046B0E5A985554"><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="H203E723A999045BCA3A4E163419E4E7C"><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="HE0698AB25FE44F25A019F9A96B0B57B1"><enum>(C)</enum><header>Authorization of appropriations</header><text>In addition to any funds made available under subsection (f), there is authorized to be appropriated to carry out this paragraph $10,000,000 for each of fiscal years 2027 through 2031.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> 
<subsection id="H2C390970CB0E4D0FB8E58EF1C20F9E37"><enum>(b)</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 (as those terms are defined in section 4 of the Indian Health Care Improvement Act)</quote>.</text></subsection></section> <section id="H19C00441B3624357A3E34E64766B1D3B"><enum>602.</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="HFF3CE5DC72054391ACF9810D62C65473"><enum>(1)</enum><text>by redesignating subclauses (II) and (III) as subclauses (V) and (VI), respectively; and</text></paragraph> <paragraph id="H0210C465B73146F9BA028ABE01B2F76D"><enum>(2)</enum><text>by inserting after subclause (I) the following:</text> 
<quoted-block id="H3A42F66D49A94389839F756ACC074AA3" style="OLC"> 
<subclause id="H6085FFF218354CB58790858AB6C51C54"><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="H0568E954C29C41DF9231E85F10BBD917"><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="H58C62BAB13DB49D9A83DE58C5FCFBF2B"><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 with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes to ensure that, in addition to clinical factors, nonclinical 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="H5EC5959F5AA54270936561502283075E"><enum>603.</enum><header>Review of maternal health data collection processes and quality measures</header> <subsection id="H3F44C993EB8C46D6BF4E6C106A668BC3"><enum>(a)</enum><header>In general</header><text>The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare &amp; Medicaid Services and the Director of the Agency for Healthcare Research and Quality, shall consult with relevant stakeholders—</text> 
<paragraph id="H4E393A4A85E74DD39908EA253653D372"><enum>(1)</enum><text>to review existing maternal health data collection processes and quality measures; and</text></paragraph> <paragraph id="H0DBC93CC1C214F0A93ED8F15C82D69BF"><enum>(2)</enum><text>to make recommendations to improve such processes and measures, including topics described under subsection (c).</text></paragraph></subsection> 
<subsection id="H3F8803044B0A4FC38EDBF67EC9AD35A4"><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="H91EA29305F0E4187AE8051E5B6E8A4E0"><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="HE828B99DCD3A41EDB95A1C22CCC093AC"><enum>(2)</enum><text display-inline="yes-display-inline">community-based organizations that provide support for pregnant and postpartum individuals, with a particular focus on patients from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></paragraph> <paragraph id="H3C18C045D7484F0499FA9BD09A1492C6"><enum>(3)</enum><text>membership organizations for maternity care providers;</text></paragraph> 
<paragraph id="H6D10A369DE9E4A45B405C9369B188814"><enum>(4)</enum><text>organizations representing perinatal health workers;</text></paragraph> <paragraph id="H72D17866D9D24BCF8AD5CF9AD9D7FB94"><enum>(5)</enum><text>organizations that focus on maternal mental or behavioral health;</text></paragraph> 
<paragraph id="H3C6285F3BC61402FB3BC2CFBFE033960"><enum>(6)</enum><text>organizations that focus on intimate partner violence;</text></paragraph> <paragraph id="HDC05DF220B03471D81C41969C42343E0"><enum>(7)</enum><text>institutions of higher education, with a particular focus on minority-serving institutions;</text></paragraph> 
<paragraph id="H998C06FFE6AF4299B02DE7B353AA6931"><enum>(8)</enum><text display-inline="yes-display-inline">licensed and accredited hospitals, birth centers, midwifery practices, or other facilities that provide maternal health care services;</text></paragraph> <paragraph id="H2C7837E6EBE143A49394CBB9680EB100"><enum>(9)</enum><text>relevant State and local public agencies, including State maternal mortality review committees; and</text></paragraph> 
<paragraph id="H033CA377602E42E5B7350F5FA0990D5E"><enum>(10)</enum><text>the National Quality Forum, or such other standard-setting organizations specified by the Secretary.</text></paragraph></subsection> <subsection id="HAFB031BD215542B3B2B4522534DB3ABB"><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="HC2738F6996D441ECA6CE843A9A619AD6"><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="H4213CF5F65C146DBAFCEBC556797D0A3"><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="H6AF8AFA776A24E8CA27CA3385B7742D3"><enum>(B)</enum><text display-inline="yes-display-inline">relevant data collected with electronic health records, including data on race, ethnicity, primary language, socioeconomic status, geography, insurance type, and other relevant demographic information;</text></subparagraph> <subparagraph id="HB49DA62065F0410B8B3DEC3BCE5A837D"><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="H4B469A90A2D94EC5BBC811C4991A0EC2"><enum>(D)</enum><text display-inline="yes-display-inline">the barriers preventing States from correlating maternal outcome data with data on race, ethnicity, and other demographic characteristics;</text></subparagraph> <subparagraph id="H2F6229449E1540209F037C4A24A3809D"><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="H18CB843539124468958C545A5BB9FE51"><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="H4A946F7458D843708F6235779848633A"><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="HA4102406EB0747E6AA0AE0EDF617303F"><enum>(H)</enum><text display-inline="yes-display-inline">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 demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes, 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="H745BE5BA7D1D43A5BB68DA95C3924940"><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="HDD0EF382CA85427AA7F57A972783E916"><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="HC754601A345E454295A4262565B8529C"><enum>(K)</enum><text>the legal and administrative barriers preventing the collection, collation, and dissemination of State maternity care data;</text></subparagraph> 
<subparagraph id="HB2AF87B21A8D4CB79394ED48F2CB00A7"><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="H8634A9660FC04ECA80091C8ED6CFAA94"><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="H847DCADC1BF246DAA39B727B84E037D4"><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="H5774E76B52254AACA6F8682860B62C1B"><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="H2BE3FC637626493E877F880376404A52"><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="H62FB7D790ED94BBAA9D12D5201D7E701"><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="HF8BE61375BF9435A81A823DDCBBE7588"><enum>(C)</enum><text display-inline="yes-display-inline">maternal health quality measures that other countries effectively use;</text></subparagraph> <subparagraph id="H177B5D2E65264B6287CFCE432196CF1E"><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="H55CBD867FED94B2E8C3A10934A940BA4"><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="H7E2A85BE426E437488C35918C1061B4D"><enum>(F)</enum><text>the frequency with which maternity care quality measures are reviewed and revised;</text></subparagraph> 
<subparagraph id="H2678FB7F33D2401E90472EF9D5F38E48"><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="HAC88C35D525E4169B4EC7612BD389677"><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 et seq.</external-xref>) 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 et seq.</external-xref>), including the extent to which States voluntarily report relevant measures;</text></subparagraph> 
<subparagraph id="HC1BCF0650D1C462BB84D43AEC8EB5A15"><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="H81A5B901BAF64CDC91DC2F7AAF59B573"><enum>(J)</enum><text display-inline="yes-display-inline">the current processes for collecting and making publicly available, to the extent practicable, stratified data on race, ethnicity, and other demographic characteristics of pregnant and postpartum individuals in hospitals, health systems, midwifery practices, and birth centers, and for incorporating such demographically stratified data in maternity care quality measures;</text></subparagraph> 
<subparagraph id="H06B2120A2FAE48AFAF714452ACCCE369"><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; and</text></subparagraph> <subparagraph id="HE87BF6F9C31B44EDB6F6477E6C9207BA"><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="H702EC21AF82A4A47931AE6CC98B3731D"><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="HE77C04FCF6144251A837701A5D6AB234"><enum>(5)</enum><text>Recommendations for new authorities that may be granted to maternal mortality review committees to be able to—</text> 
<subparagraph id="H3D99C4D8B34B4F63B1E6393DEF95B61C"><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="H0E1E0987611748D4B5DCBC06A613F233"><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="HCD122F2246F748D0BC517EA798DF4AA1"><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 maternal health disparities.</text></paragraph> <paragraph id="HD80F570268A044C58D903989FA3EEF30"><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="HD151FF87DE08407CB274AE606B566E06"><enum>(d)</enum><header>Report</header><text>Not later than 1 year after the enactment of this Act, the Secretary shall submit to the 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="HB3505F6582AF47C8A158E4B57F3EE400"><enum>(e)</enum><header>Definition</header><text>In this section, 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></subsection> 
<subsection id="HF4326524437843D684C75FC6172B43B3"><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 2027 through 2030.</text></subsection></section> <section id="H7C7C7585AB8847FF91EE69B334515ED3"><enum>604.</enum><header>Study on maternal health among American Indian and Alaska Native individuals</header> <subsection id="H90AEF2D37B834C10A4FB85BBC5E7F155"><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, in coordination with entities described in subsection (b)—</text> 
<paragraph id="HB332CEFA6DE44D8F93DC1281095D78C9"><enum>(1)</enum><text display-inline="yes-display-inline">not later than 90 days after the enactment of this Act, enter into a contract with an independent research organization or Tribal Epidemiology Center to conduct a comprehensive study on maternal mortality, severe maternal morbidity, and other adverse perinatal or childbirth outcomes in the populations of American Indian and Alaska Native individuals; and</text></paragraph> <paragraph id="H1B181E64280D486BA0DCE97409BCCF65"><enum>(2)</enum><text display-inline="yes-display-inline">not later than 3 years after the date of the enactment of this Act, submit to Congress a report on such study that contains recommendations for policies and practices that can be adopted to improve maternal health outcomes for American Indian and Alaska Native individuals.</text></paragraph></subsection> 
<subsection id="H8300F38C0EF34416ADB9C79A670357BB"><enum>(b)</enum><header>Participating entities</header><text display-inline="yes-display-inline">The entities described in this subsection shall consist of 12 members, selected by the Secretary from among individuals nominated by 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>)). In selecting such members, the Secretary shall ensure that each of the 12 service areas of the Indian Health Service is represented.</text></subsection> <subsection id="HAC529051FC50416187C3D3C41FDA8AF5"><enum>(c)</enum><header>Contents of study</header><text>The study conducted pursuant to subsection (a) shall—</text> 
<paragraph id="HE21AF526C62D43E780E822ABE3F9C969"><enum>(1)</enum><text>examine the causes of maternal mortality and severe maternal morbidity that are unique to American Indian and Alaska Native individuals;</text></paragraph> <paragraph id="H275979FE69244F96A05D4E4136E1BE88"><enum>(2)</enum><text display-inline="yes-display-inline">include a systematic process of listening to the stories of American Indian and Alaska Native individuals to fully understand the causes of, and inform potential solutions to, the maternal health crisis within their respective communities;</text></paragraph> 
<paragraph id="H62A408A9733E406C8C60BC7F55BD6340"><enum>(3)</enum><text display-inline="yes-display-inline">distinguish between the causes of, landscape of maternity care at, and recommendations to improve maternal health outcomes within, the different settings in which American Indian and Alaska Native individuals receive maternity care, such as—</text> <subparagraph id="H9DA967B232FF4A899B501A5BBA379370"><enum>(A)</enum><text>facilities operated by the Indian Health Service;</text></subparagraph> 
<subparagraph id="H1EDC58B71E53428B86A654C0DDA836FF"><enum>(B)</enum><text>an Indian health program operated by an Indian Tribe or Tribal organization pursuant to a contract, grant, cooperative agreement, or compact with the Indian Health Service pursuant to the Indian Self-Determination Act;</text></subparagraph> <subparagraph id="H5A42FAC33D8349BFAF1BD237D462AF32"><enum>(C)</enum><text>an urban Indian health program operated by an Urban Indian organization pursuant to a grant or contract with the Indian Health Service pursuant to title V of the Indian Health Care Improvement Act; and</text></subparagraph> 
<subparagraph id="HB0620B91A2D74EB98CC4465A486CFE22"><enum>(D)</enum><text display-inline="yes-display-inline">facilities outside of the Indian Health Service in which American Indian and Alaska Native individuals receive maternity care services;</text></subparagraph></paragraph> <paragraph id="HC0869EF57E12482EB180EE029B45D02A"> <enum>(4)</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 et seq.</external-xref>)), the Medicaid Program under title XIX of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>), 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 et seq.</external-xref>);</text>
                    </paragraph> 
<paragraph id="H02C64A61573140D6B47E2149B6BAED66"><enum>(5)</enum><text>review current data collection and quality measurement processes and practices;</text></paragraph> <paragraph id="HDA43414CAFBE4FA287E90599565CC35E"><enum>(6)</enum><text display-inline="yes-display-inline">assess causes and frequency of maternal mental health conditions and substance use disorders;</text></paragraph> 
<paragraph id="H3405447F83524CA8AB570419A529987C"><enum>(7)</enum><text>consider social determinants of health, including poverty, lack of health insurance, unemployment, sexual and domestic violence, and environmental conditions in Tribal areas;</text></paragraph> <paragraph id="HCD7E20290F3340389E363AC8BD387016"><enum>(8)</enum><text display-inline="yes-display-inline">consider the role that historical mistreatment of American Indian and Alaska Native women has played in causing currently elevated rates of maternal mortality, severe maternal morbidity, and other adverse perinatal or childbirth outcomes;</text></paragraph> 
<paragraph id="HF1CD7C8A4A734008BE96651669FB504E"><enum>(9)</enum><text>consider how current funding of the Indian Health Service affects the ability of the Service to deliver quality maternity care;</text></paragraph> <paragraph id="HF6769F3039FD4376B6B18727431E0D8C"><enum>(10)</enum><text display-inline="yes-display-inline">consider the extent to which the delivery of maternity care services is culturally appropriate for American Indian and Alaska Native individuals;</text></paragraph> 
<paragraph id="H88B955C7FBED4326BD255DC4BC45910A"><enum>(11)</enum><text display-inline="yes-display-inline">make recommendations to reduce misclassification of American Indian and Alaska Native individuals, including consideration of best practices in training for maternal mortality review committee members to be able to correctly classify American Indian and Alaska Native individuals; and</text></paragraph> <paragraph id="H47D60CEA59094342A786AC91BF3A841C"><enum>(12)</enum><text display-inline="yes-display-inline">make recommendations informed by the stories shared by American Indian and Alaska Native individuals referred to in paragraph (2) to improve maternal health outcomes for such individuals.</text></paragraph></subsection> 
<subsection id="H6ECF8471E03E49509B3AB491A3FCE941"><enum>(d)</enum><header>Report</header><text>The agreement entered into under subsection (a) with an independent research organization or Tribal Epidemiology Center shall require that the organization or Center transmit to Congress a report on the results of the study conducted pursuant to that agreement not later than 36 months after the date of the enactment of this Act.</text></subsection> <subsection id="HCF83BD9314944D92BEADE374ED1DAAF0"><enum>(e)</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 2027 through 2029.</text></subsection></section> 
<section id="H67A790ACB074442FA223A49359A0930B"><enum>605.</enum><header>Grants to minority-serving institutions to study maternal mortality, severe maternal morbidity, and other adverse maternal health outcomes</header> 
<subsection id="H73A75380FAFE4ECEA6369C1F38EF271D"><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="H391176D3035E43F4A0909FECD29FF50F"><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="HD107B57A6B7B4B40A478AFC53D518D55"><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;</text></paragraph> <paragraph id="H11A9C7BBC7CA4360BEAA9BC8F9532AF7"><enum>(3)</enum><text display-inline="yes-display-inline">assess differences in rates of adverse maternal health outcomes among subgroups identifying as Hispanic, including disparities in access to early prenatal care; and</text></paragraph> 
<paragraph id="HC4D337D2B93E467D859F2D8AF927B441"><enum>(4)</enum><text display-inline="yes-display-inline">include lactation education to promote racial and ethnic diversity within the workforce of health care professionals with breastfeeding and lactation expertise.</text></paragraph></subsection> <subsection id="H8086720A57B040709E592A2EEE9A374C"><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="H1C8448592EF84CF18CCAD39651C0838A"><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="H22460757C6024041A69F52B83724478B"><enum>(1)</enum><text>to conduct outreach to minority-serving institutions to raise awareness of the availability of grants under subsection (a);</text></paragraph> 
<paragraph id="H665E4BBD144541A286F45F86F6BD0DAC"><enum>(2)</enum><text>to provide technical assistance in the application process for such a grant; and</text></paragraph> <paragraph id="H6B1459F94AAD4E5A86AB90B4EBA1568F"><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="HA6B3166B3821427881EEA34F12874C18"><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="H34D06D1D35AD4FA0BA93F201F904F692"><enum>(e)</enum><header>Evaluation</header><text>Beginning 1 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="H6CF7296C01EE4BC780E98AE3FD569C3B"><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="HDAC2F2F55A5D4A6CBE6FA0B7C7DFFD79"><enum>(g)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2027 through 2031.</text></subsection></section></title> 
<title id="H605023C3E9444827829C8421D01E28C6"><enum>VII</enum><header>Moms matter</header> 
<section id="H2A0F09A53236475F9D289BBF6164271F"><enum>701.</enum><header>Maternal mental health equity grant program</header> 
<subsection id="H93155DE8785A4BEBB9F05488D2562A1A"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services, 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 a focus on demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></subsection> <subsection id="H642B676638994D44AAFCEB8304FBFD10"><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 require.</text></subsection> 
<subsection id="H252481575B164EBABA3AE2D44E2C42B9"><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="H7A40D10CE7E24F848E8AC988CE20D3D4"><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="H2DFA69BB9A86421B8B8AAFC2FAC1349D"><enum>(2)</enum><text display-inline="yes-display-inline">is operating in an area with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; and</text></paragraph> <paragraph id="H2CEADB451C16469188EC6C27B53C47C4"><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="HDDE576D9BF83485096F26B491CADDFDC"><enum>(d)</enum><header>Use of funds</header><text display-inline="yes-display-inline">An eligible entity that receives a grant under this section shall use the grant for the following:</text> <paragraph id="HE4B22DDBDD85437E915A6B78FE6AC560"><enum>(1)</enum><text display-inline="yes-display-inline">Establishing or expanding maternity care programs to improve the integration of maternal mental health and behavioral health care services into primary care settings where pregnant individuals regularly receive health care services.</text></paragraph> 
<paragraph id="H62D197AC43464ECC97031B1726DA0119"><enum>(2)</enum><text>Establishing or expanding group prenatal care programs or postpartum care programs.</text></paragraph> <paragraph id="H1F3364D7E3634A9E9245C930CACC2046"><enum>(3)</enum><text display-inline="yes-display-inline">Expanding existing programs that improve maternal mental and behavioral health during the prenatal and postpartum periods, with a 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.</text></paragraph> 
<paragraph id="H778BCD09ABE04EDA9A3FE1010A759ABC"><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="H2F6DBF3DDE4B4280916192A2A60E7E5F"><enum>(5)</enum><text display-inline="yes-display-inline">Addressing stigma associated with maternal mental health conditions and substance use disorders, with a 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.</text></paragraph> 
<paragraph id="H957302B95D5F4344A84274043F3F8D4C"><enum>(6)</enum><text display-inline="yes-display-inline">Raising awareness of warning signs of maternal mental health conditions and substance use disorders, with a focus on pregnant and postpartum individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></paragraph> <paragraph id="H5DE0666036764156931FB34FBFAADC0B"><enum>(7)</enum><text>Establishing or expanding programs to prevent suicide or self-harm among pregnant and postpartum individuals.</text></paragraph> 
<paragraph id="HB4A10D3EF35546A48C20053475A09681"><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="H18216B7004AD453695B153D65384ECFD"><enum>(9)</enum><text>Establishing or expanding programs to provide education and training to maternity care providers with respect to—</text> 
<subparagraph id="HB546AB3CEB27456CBADF05615420C47A"><enum>(A)</enum><text display-inline="yes-display-inline">identifying potential warning signs for maternal mental health conditions or substance use disorders in pregnant and postpartum individuals, with a 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; and</text></subparagraph> <subparagraph id="H2802F5A7A9D3400280CAE3C30C88F167"><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="H14B5D500A7684DE0B66F7A5E77B988F9"><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="H3BD4D6AFFE7A4F68A7736E59C7159AC3"><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="HE227BD8208AE458EAA0849BB71F340D6"><enum>(12)</enum><text display-inline="yes-display-inline">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 demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></paragraph></subsection> <subsection id="HE791E6EE883B480499E1F2A5AD7FEEC8"><enum>(e)</enum><header>Reporting</header> <paragraph id="HAFDC352E41E246178EA4E16E5D55CCBC"><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="H6C92CA75B77A424196FB292CE4782AB4"><enum>(2)</enum><header>Secretary</header><text>Not later than the end of fiscal year 2030, the Secretary shall submit to Congress a report that includes—</text> <subparagraph id="H81DA8F455D1C45BE9852EAB3356DC4B0"><enum>(A)</enum><text>a summary of the reports received under paragraph (1);</text></subparagraph> 
<subparagraph id="H2173C35BB68F4CC3813390E9DDD14844"><enum>(B)</enum><text display-inline="yes-display-inline">an evaluation of the effectiveness of grants awarded under this section;</text></subparagraph> <subparagraph id="H367DEF2EBD964CDB85B52E196E49C295"><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="H881F860B07074A7685982034F3AFAAA9"><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="H47E835F184734AB1AD9C682E9ABE0168"><enum>(f)</enum><header>Definitions</header><text>In this section:</text> 
<paragraph id="H2F8530227F744661A7D6B1E8AD1FD948"><enum>(1)</enum><header>Eligible entity</header><text>The term <term>eligible entity</term> means—</text> <subparagraph id="HCA3DB8C459084295938BB7E09EB0CCE0"><enum>(A)</enum><text display-inline="yes-display-inline">a community-based organization serving pregnant and postpartum individuals, including such organizations serving individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></subparagraph> 
<subparagraph id="H17FFFA219B954323AD2AA5BAB514EBEF"><enum>(B)</enum><text>a nonprofit or patient advocacy organization with expertise in maternal mental and behavioral health;</text></subparagraph> <subparagraph id="H6FA37B2304D94CAA957BDED883BCC691"><enum>(C)</enum><text>a maternity care provider;</text></subparagraph> 
<subparagraph id="H9DE02A74E1A542579ECE2505CBC3D736"><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="H6D4FD027B76B44A0B49ACD18D2881335"><enum>(E)</enum><text>a State or local governmental entity, including a State or local public health department;</text></subparagraph> 
<subparagraph id="HBCEF45C68ED8498BBA0A9AEE0039B171"><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="H9986497958C24109912B24B2151D7B19"><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="H0FCF3E2B989349809881A7A152CEC2E9"><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="HBA2A3860DAC24488B8FC90F88DAE3B1C"><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="H3C11BEECFF134814B11186A2290BA4B6" commented="no"><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 2027 through 2031.</text></subsection></section> <section id="H6C82C126D1C047B0A807AB9B6A361A8F"><enum>702.</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 is amended by inserting after section 758 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/294f">42 U.S.C. 294f</external-xref>), as added by section 402 of this Act, the following new section:</text> 
<quoted-block id="HB7F5CA6CBB964829A4D902055CFC372F" style="OLC"> 
<section id="H2B5AA269E2654E87B4EFD7F126BB5602"><enum>758A.</enum><header>Maternal mental and behavioral health care workforce grants</header> 
<subsection id="H7F2A95FB70104EE1B7A38C1BC45E539D"><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="HCA42B783CA254B1F82C48E3BFA52F0E0"><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="HA1D15EE400004674ADBCE0467482B12C"><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="H70A6498EF1D54CACB224B605FA1C01FE"><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="H1DE2E29184DD474584ABA1DDF31A0206"><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="HDB97A996052D405281C02CD12DAD7868"><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="H9816CBB7DAEB4B88AF13C886AC871815"><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="H7EC276E610BB45E5B0A8D186DE2FE1BE"><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="H382D4C279BD34DACACA13171183243AC"><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 maternal health disparities, to the extent practicable; and</text></paragraph> <paragraph id="H1550DE59C47E4BD2B2E09EF9B5521166"><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="H9E1BC46E0DB34FAF968995A8CFF2BBFC"><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="H83F586CFDC144F918CE933D8FBD30164"><enum>(1)</enum><text>the number and demographics of students participating in the program or school;</text></paragraph> 
<paragraph id="H0AC094E0517A43A4B422332486EF0A80"><enum>(2)</enum><text>the extent to which students in the program or school are entering careers in—</text> <subparagraph id="H1EC336C2BB6143B5B02E5AA716A76B55"><enum>(A)</enum><text>health professional shortage areas designated under section 332; and</text></subparagraph> 
<subparagraph id="H1084A3F7D514400C949DEF955D8DAFC4"><enum>(B)</enum><text>areas with significant maternal health disparities, to the extent such data are available; and</text></subparagraph></paragraph> <paragraph id="H861317BAE5BA48169B09096AEAAE8336"><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="H8102FCF9F01E4F72A5D93CD73057661F"><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="H3E1283C3FA094D0B8AB4F7CD0CB71664"><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="H191764447BBD4E81B3D73276CD4BF201"><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 postgrant 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="H57D92150702A445898AC585D8B84C575"><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 the 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="HDFC3B13E112F498696AE1B93A5A39661"><enum>(1)</enum><text>recruiting students from racial and ethnic minority groups and other underserved populations;</text></paragraph> <paragraph id="H9DA2BB51CBAF451DA39A61D4741CF8E6"><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="H5EC755F9E2774C44A7F124DF29A37FC4"><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="H351D5795A62B40FE979020EFBC75A321"><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 maternal health disparities, to the extent such data are available.</text></paragraph></subsection> 
<subsection id="H1639FA47AEF44E998210503ED6D4B3A8"><enum>(i)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section:</text> <paragraph id="H79E0D9E88F1B427DB8A7FEF85AD7C695"><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="HE34CFF533D874889B2A096508A0C8753"><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="HA7E7EAFD6E504F8A929B4D43518D71F3"><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 2027 through 2031.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section></title> 
<title id="HCF88503D53F8432294AC9FE787CB54B3"><enum>VIII</enum><header>Justice for incarcerated moms</header> 
<section id="H226E3BBE92C2440DAD27CF41BDD5A9E1"><enum>801.</enum><header>Ending the shackling of pregnant individuals</header> 
<subsection id="H828FBA304E264CB68D2C9DCD0200E8F8"><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 et seq.</external-xref>) (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="HD12A1889AC02434CBB0F9126CD942692"><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 et seq.</external-xref>) to States that have complied with such subsection.</text></subsection></section> 
<section id="H8D654764D6684D708CC43F3B67E67331"><enum>802.</enum><header>Creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods</header> 
<subsection id="HEC9F4DD204FB431E8B9036F39FD5AB6C"><enum>(a)</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. The Attorney General shall establish such programs in consultation with stakeholders such as—</text> <paragraph id="H42A236CA202942E093AC0DD91715F8F1"><enum>(1)</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 demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></paragraph> 
<paragraph id="H434C65F9074146D1AF3007D417D824A0"><enum>(2)</enum><text display-inline="yes-display-inline">relevant organizations representing patients, with a particular focus on patients from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></paragraph> <paragraph id="H608A0211A9A64FB386A4B3A0BBECFFE4"><enum>(3)</enum><text display-inline="yes-display-inline">organizations representing maternity care providers and maternal health care education programs;</text></paragraph> 
<paragraph id="H0EE1F091B21A4DCEB491238B8508E949" commented="no"><enum>(4)</enum><text>perinatal health workers; and</text></paragraph> <paragraph id="H8A9CD6CDC0B54538A053A951981BB3C9"><enum>(5)</enum><text>researchers and policy experts in fields related to maternal health care for incarcerated individuals.</text></paragraph></subsection> 
<subsection id="H43F55E3D6A2048C3B69C9B31AD33C0F4" commented="no"><enum>(b)</enum><header>Start date</header><text>Each selected facility shall begin facility programs not later than 18 months after the date of enactment of this Act.</text></subsection> <subsection id="H7EFE66F31C5549C88F974AB42BD90737"><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="H916FBCDE779B4B2BBE496AADAA244AE6"><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 demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; and</text></paragraph> <paragraph id="H2718E0AD81EF4C0CBE4CEC4F0107EB75"><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="HE5A5FAE345664EBDAD35AC791AD27802"><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="HE187F70AA9334364BE070ABF333CA6EC"><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 may—</text> 
<paragraph id="HE3529501F44F433A8B26EF7729D8F908"><enum>(1)</enum><text display-inline="yes-display-inline">provide access to perinatal health workers from pregnancy through the postpartum period;</text></paragraph> <paragraph id="H6FDA78A623904827B119BB9BCA1B4BC2"><enum>(2)</enum><text>provide access to healthy foods and counseling on nutrition, recommended activity levels, and safety measures throughout pregnancy;</text></paragraph> 
<paragraph id="H05A91082565E46A19E83047CA6E2D75B"><enum>(3)</enum><text display-inline="yes-display-inline">train correctional officers to ensure that pregnant incarcerated individuals receive safe and respectful treatment;</text></paragraph> <paragraph id="H954AAD6BDE9E4DBD9B86D032CA4CB13C"><enum>(4)</enum><text display-inline="yes-display-inline">train medical personnel to ensure that pregnant incarcerated individuals receive trauma-informed, culturally and linguistically congruent care that promotes the health and safety of the pregnant individuals;</text></paragraph> 
<paragraph id="H030863FE816841B3A37965EC1EF001E3"><enum>(5)</enum><text>provide counseling and treatment for individuals who have suffered from—</text> <subparagraph id="HA35789F3414746ABA1F62B0AE96CF1C1"><enum>(A)</enum><text display-inline="yes-display-inline">diagnosed mental or behavioral health conditions, including trauma and substance use disorders;</text></subparagraph> 
<subparagraph id="H27AE4600E2A64B3CBD25E4763C9EB4FF"><enum>(B)</enum><text display-inline="yes-display-inline">trauma or violence, including domestic violence;</text></subparagraph> <subparagraph id="H2361D2F6868D4E90B79F27C55B4F1048"><enum>(C)</enum><text>human immunodeficiency virus;</text></subparagraph> 
<subparagraph id="HC7187DEF35734A3CA56C701CAEB7862D"><enum>(D)</enum><text>sexual abuse;</text></subparagraph> <subparagraph id="HEF98C3688F8746658A3E824273F04BCB"><enum>(E)</enum><text display-inline="yes-display-inline">pregnancy or infant loss; or</text></subparagraph> 
<subparagraph id="H5231460244D84846A52B888ECF266E91"><enum>(F)</enum><text>chronic conditions;</text></subparagraph></paragraph> <paragraph id="H15B0217B916649638BEFD35C90F2BB6A"><enum>(6)</enum><text display-inline="yes-display-inline">provide evidence-based pregnancy and childbirth education, parenting support, and other relevant forms of health literacy;</text></paragraph> 
<paragraph id="HBDB253531F354D77860B5C419217B465"><enum>(7)</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></paragraph> <paragraph id="HBF3E7517C5344CDD8FED4BBDD3A1EE05"><enum>(8)</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></paragraph> 
<paragraph id="HFED7C4E49D25430BB10863661CB753D8" commented="no"><enum>(9)</enum><text display-inline="yes-display-inline">provide reentry assistance, particularly to—</text> <subparagraph id="H55E6DBCC4B994535AE1A4A6FBB280821"><enum>(A)</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></subparagraph> 
<subparagraph id="H9F2F4672057C4AD8AB4823C60AE858EB"><enum>(B)</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></subparagraph></paragraph> <paragraph id="H8614F43264074CDCAB950AA647F52824"><enum>(10)</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. Such programs may include—</text> 
<subparagraph id="H668A0F0B11664696BBB6F697DCCDBEDB"><enum>(A)</enum><text display-inline="yes-display-inline">evidence-based childbirth education or parenting classes;</text></subparagraph> <subparagraph id="H407B781EB3174DA5932334329195BE83"><enum>(B)</enum><text>prenatal health coordination;</text></subparagraph> 
<subparagraph id="HADE4227C6A054773BFB3E5A4E827634B"><enum>(C)</enum><text>family and individual counseling;</text></subparagraph> <subparagraph id="H512C8F6E13B344E7AB3B06F3B65CC329"><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="H0CF13FBBCDB746408EAD0B52F2A1F541"><enum>(E)</enum><text>family case management services;</text></subparagraph> <subparagraph id="H4CC64F0868B245CB8273A52BD404CE9A"><enum>(F)</enum><text>domestic violence education and prevention;</text></subparagraph> 
<subparagraph id="H474BA969DDB44D2DA1C9813F88569EB5"><enum>(G)</enum><text>physical and sexual abuse counseling; and</text></subparagraph> <subparagraph id="H88346B58DC85410BA8DF117D7ED71AE6"><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="H0D02E9E6C636499C8DDF8996D9DA7BB8" commented="no"><enum>(f)</enum><header>Implementation and reporting</header><text>A selected facility shall be responsible for—</text> <paragraph id="H9093D3DEA06B4B6C94D89D8BE154F5B3" commented="no"><enum>(1)</enum><text>implementing programs, which may include the programs described in subsection (e); and</text></paragraph> 
<paragraph id="HF07EA9874F3E46549A56F2B2D5292C3F" 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="HD64BE0638A6D4DD2B3DAEA0754BA4D8B" 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, primary language, 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="HF5628BF3F1C04A05B49F7FCCACDC2898" 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="H34A92C3B574746B0856EDD0BA35B72DF" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">strategies to sustain such programs after fiscal year 2031 and expand such programs to other facilities.</text></subparagraph></paragraph></subsection> 
<subsection id="H2957A5898F4E4BF0A29E0B9AE46A0B27"><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="HDE31568EB16E4F2DB4821BD20428D53C"><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="H8FC6C1C6347D41C9A958FC43FA558D6E"><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 $10,000,000 for each of fiscal years 2027 through 2031.</text></subsection></section> <section id="H3F89FD9C72F547ABBE50232A4898DDEC"><enum>803.</enum><header>Grant program to improve maternal health outcomes for individuals in State and local prisons and jails</header> <subsection id="H6927DD0AB0314B578A4D2C3E581CFECD"><enum>(a)</enum><header>Establishment</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. The Attorney General shall award such grants in consultation with stakeholders such as—</text> 
<paragraph id="HD2189A632A864C7AB91E4848A591C20D"><enum>(1)</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 demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></paragraph> <paragraph id="H96785DB853CE4996A40C2908B02B7AE0"><enum>(2)</enum><text display-inline="yes-display-inline">relevant organizations representing patients, with a particular focus on patients from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></paragraph> 
<paragraph id="H8FD892D2AF8C45908FE3DBBEBD22E567"><enum>(3)</enum><text display-inline="yes-display-inline">organizations representing maternity care providers and maternal health care education programs;</text></paragraph> <paragraph id="HB87A80F821804AEB894F57ACB0DC0156" commented="no"><enum>(4)</enum><text>perinatal health workers; and</text></paragraph> 
<paragraph id="H202D1F9369AF4B9D97BCBEF1C4D75C99"><enum>(5)</enum><text>researchers and policy experts in fields related to maternal health care for incarcerated individuals.</text></paragraph></subsection> <subsection id="HAD68F9602EDE4804AC46AA0C11BB164A"><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="H3E6FB301B3814F06BA0D9DB85F0275B0"><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 may—</text> <paragraph id="HFB0C3BB7567C4ACDBC0D6A2EC3D543F6"><enum>(1)</enum><text display-inline="yes-display-inline">provide access to perinatal health workers from pregnancy through the postpartum period;</text></paragraph> 
<paragraph id="H4D5FDEFB356D402497DDA7F9896C6E9E"><enum>(2)</enum><text>provide access to healthy foods and counseling on nutrition, recommended activity levels, and safety measures throughout pregnancy;</text></paragraph> <paragraph id="H9900A6E6DEF1490FBF13F7416CB8690D"><enum>(3)</enum><text display-inline="yes-display-inline">train correctional officers to ensure that pregnant incarcerated individuals receive safe and respectful treatment;</text></paragraph> 
<paragraph id="H3B8DE770EBD842129C0F4266AEED3C7D"><enum>(4)</enum><text display-inline="yes-display-inline">train medical personnel to ensure that pregnant incarcerated individuals receive trauma-informed, culturally and linguistically congruent care that promotes the health and safety of the pregnant individuals;</text></paragraph> <paragraph id="HE020E45662AE4AE384F88DE68EC6272C"><enum>(5)</enum><text>provide counseling and treatment for individuals who have suffered from—</text> 
<subparagraph id="HF5F22B2E8C964DB5934FF25E609C70F3"><enum>(A)</enum><text display-inline="yes-display-inline">diagnosed mental or behavioral health conditions, including trauma and substance use disorders;</text></subparagraph> <subparagraph id="HFF3AB2F0D66E44E49578AC7F94CF1F86"><enum>(B)</enum><text display-inline="yes-display-inline">trauma or violence, including domestic violence;</text></subparagraph> 
<subparagraph id="HB2D7258E03CB49B88D0C4A04FFB0588A"><enum>(C)</enum><text>human immunodeficiency virus;</text></subparagraph> <subparagraph id="H5BEC8C6860AC4C739E0C0AA522C2D49F"><enum>(D)</enum><text>sexual abuse;</text></subparagraph> 
<subparagraph id="HCD94C26151CB415C9C7BF2E047427CA7"><enum>(E)</enum><text>pregnancy or infant loss; or</text></subparagraph> <subparagraph id="H6B478CDABB1841B4B9F8868ABD6189A7"><enum>(F)</enum><text>chronic conditions;</text></subparagraph></paragraph> 
<paragraph id="H0EDFBD40D7154410BAA6FE111179DEDE"><enum>(6)</enum><text display-inline="yes-display-inline">provide evidence-based pregnancy and childbirth education, parenting support, and other relevant forms of health literacy;</text></paragraph> <paragraph id="H996085D09F2D48CEA1CB11829E2B5F6A"><enum>(7)</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></paragraph> 
<paragraph id="H31594166DBF3404DAC5EFB5390E95057"><enum>(8)</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></paragraph> <paragraph id="H5A35E9CC3F0F49FC957893B15A32BD90"><enum>(9)</enum><text display-inline="yes-display-inline">provide reentry assistance, particularly to—</text> 
<subparagraph id="H9DF1B688966F4C8C8A2D41E77BCB7CE8"><enum>(A)</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></subparagraph> <subparagraph id="H6E95BFB8312A4C0AAEE02BF9F698A82D"><enum>(B)</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></subparagraph></paragraph> 
<paragraph id="H713EF5DF7D334E8AB44C32B1DDE71C03"><enum>(10)</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. Such programs may include—</text> <subparagraph id="HB07169B2CE9E41BC85761E3D03237297"><enum>(A)</enum><text display-inline="yes-display-inline">evidence-based childbirth education or parenting classes;</text></subparagraph> 
<subparagraph id="H9A34B8FD9E8744398801C73E8D6BCB86"><enum>(B)</enum><text>prenatal health coordination;</text></subparagraph> <subparagraph id="H44A3943CDD944553B9835683262AB86A"><enum>(C)</enum><text>family and individual counseling;</text></subparagraph> 
<subparagraph id="H9D846B1B9F0B4A0A91D67DF8B60A0CB4"><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="HDE3402D341494BF19404962915BF2C91"><enum>(E)</enum><text>family case management services;</text></subparagraph> 
<subparagraph id="H017BCE7D5ADF4F5F8408FD338C2CFC38"><enum>(F)</enum><text>domestic violence education and prevention;</text></subparagraph> <subparagraph id="HEEA0432DB36B41288E1728EFE3AEB4C6"><enum>(G)</enum><text>physical and sexual abuse counseling; and</text></subparagraph> 
<subparagraph id="HD2D6F0D070D34471AB783EBC0FE5E8F5"><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="H0D0C50054E174556B9703CA7A57328F0"><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="H7E8BB5CA85794F0590BB045795C1A629"><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 demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; and</text></paragraph> <paragraph id="H30E87A3AD30E478EB425D34D96AE65D4"><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="H46EEFB0FB30247EBAC55F91222B64001"><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="H72F60AB1903242E89F98318ECFEA0AE5"><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="HBF28EC563E094D5B91FF4ECE3CDE48BF"><enum>(1)</enum><text>implementing the program funded by the grant; and</text></paragraph> <paragraph id="H2DF5B9ED68A54001A1530BC2B839BAD0"><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="HD14D362DA824479B99ACD09DA3C792EA"><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, primary language, 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="H67EC451E32A143FBAE6C32914F3C8864"><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="H0374D20A7B8A4787B6C87B2F42703A26"><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="HB3C5482800AA46FDBF989F67EC3E906F"><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="HB004965DF71047088DC686D3E23858C7"><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="H7A642061105647C682B59A85E02A2469"><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 $10,000,000 for each of fiscal years 2027 through 2031.</text></subsection></section> 
<section id="H1C5A97E634584988A4A7894B9D75D02C"><enum>804.</enum><header>GAO report</header> 
<subsection id="H8B5D6C20A23342DBA3EFAFCC08A1C3C8"><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="H1918EDE947E34880B521C03EDF5E3E66"><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="HEB3032A9DD09416FAE98BCA7ECD7BBCB"><enum>(1)</enum><text display-inline="yes-display-inline">to the extent practicable—</text> <subparagraph id="HFE7F895F77A448548D7E733E3632E71B"><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="HF341CEFBC7A546949AC170CAD312C2DF"><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="HF313CE00875A496485B2843F443CC681"><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="H10DD0170D10646C38A70114393AFE713"><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="H5FE60DBD20A641A783245A0396C78D43"><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="H8545285EEBB548BCAE22084138546941"><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="HA2186DCDCADE424F8F43AE024E82BCB1"><enum>(3)</enum><text>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 et seq.</external-xref>) including information about—</text> 
<subparagraph id="HED55EA3BA48D4CFB9267DDA22B4141F9"><enum>(A)</enum><text display-inline="yes-display-inline">the effects of such ineligibility on maternal health outcomes for pregnant and postpartum incarcerated individuals, with emphasis given to such effects for pregnant and postpartum individuals from racial and ethnic minority groups; and</text></subparagraph> <subparagraph id="H8F1A66EABF524B8F8B86687173475177"><enum>(B)</enum><text>potential implications on maternal health outcomes resulting from temporarily suspending, rather than permanently terminating, such eligibility when a pregnant or postpartum individual is incarcerated;</text></subparagraph></paragraph> 
<paragraph id="H8A68695F38854CA38DD547E133D61A1C"><enum>(4)</enum><text>the extent to which Federal, State, and local correctional facilities are holding pregnant and postpartum individuals who test positive for illicit drug use in detention with special conditions, such as additional bond requirements, due to the individual’s drug use, and the effect of such detention policies on maternal and infant health outcomes;</text></paragraph> <paragraph id="H9DD4EA4F73EF427EA1B7B70763BFED02"><enum>(5)</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="HBA334358F02F4BD68C67CCF1A831C49B"><enum>(6)</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="HD92CCD52C8834B8F8B82B61051B17E1C"><enum>(7)</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="H2F5108E8890243C89E0F48F9B9141A5F"><enum>(8)</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></title> <title id="H8373B6779357452FA4976D71D07E3750"><enum>IX</enum><header>Tech to save moms</header> <section id="H558A5CBAB0CB442DBD4598A00CE8EB2A" display-inline="no-display-inline" section-type="subsequent-section"><enum>901.</enum><header>Integrated telehealth models in maternity care services</header> <subsection id="H826E77BAEB05448D90062FBE5FD18108"><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="H57CA14E47F9047BEA89250CB25DDC7A3"> 
<clause id="H3F7652B980944E0AABCF763EC07E3899"><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="HF7ACFA2B1A7A495EA02445069675DA87"><enum>(b)</enum><header>Effective date</header><text>The amendment made by subsection (a) shall take effect 1 year after the date of the enactment of this Act.</text></subsection></section> 
<section id="HE380CEA08AFF42B9BC83EF4CDB2A08C9"><enum>902.</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 330P (<external-xref legal-doc="usc" parsable-cite="usc/42/254c-22">42 U.S.C. 254c–22</external-xref>) the following:</text> <quoted-block style="OLC" id="HBB5AE66814D14B529496F62F1CACD0EE" display-inline="no-display-inline"> <section id="H9738E4A36EC04002BB46CD8D2067C43A"><enum>330Q.</enum><header>Expanding capacity for maternal health outcomes</header> <subsection id="H5B81D600F59A472882AF78F77A76CAC1"><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 Act, 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="H9C5F0748FF9F4A59B0754C924F9F233B"><enum>(1)</enum><text>in health professional shortage areas;</text></paragraph> <paragraph id="H81B76434A3D94B569783A46626699072"><enum>(2)</enum><text>in areas with high rates of maternal mortality and severe maternal morbidity;</text></paragraph> 
<paragraph id="H99E0237F2EE64A708677BD61275D4CB1"><enum>(3)</enum><text display-inline="yes-display-inline">in rural and underserved areas;</text></paragraph> <paragraph id="HBC67047B831E4F4FB5EBAC4544D5B6F6"><enum>(4)</enum><text display-inline="yes-display-inline">in areas with significant maternal health disparities; and</text></paragraph> 
<paragraph id="H14489D9795E3476489593CA847C2E852"><enum>(5)</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="HBC2C046613914E3E965F36BB0C9E9C71"><enum>(b)</enum><header>Use of Funds</header> <paragraph id="H24EEF8820EC442F79B8C8AE9C08BF60E"><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="H69F8F1A04C2A4E69A4053A8305C78526"><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="HD291E3489F5040348F333336DC926E6B"><enum>(i)</enum><text display-inline="yes-display-inline">methods to increase safety and health care quality;</text></clause> 
<clause id="H1F6F3A3ECD7E4F3BA39B6D4EEB6F75FA"><enum>(ii)</enum><text display-inline="yes-display-inline">implicit bias, racism, and discrimination;</text></clause> <clause id="H39A3D52877384E9F9A5BDBA9E3EA011F"><enum>(iii)</enum><text display-inline="yes-display-inline">best practices in screening for and, as needed, evaluating and treating maternal mental health conditions and substance use disorders;</text></clause> 
<clause id="H37D88086D78F4329BCCF0F2CA1736391"><enum>(iv)</enum><text display-inline="yes-display-inline">training on best practices in maternity care for pregnant and postpartum individuals during public health emergencies;</text></clause> <clause id="H2F4AA537DF8C4ABC92C3FEAF6C03D038"><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="H3F4270AEFE60495591D7C7DE9081D395"><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="HC15181599C134BCB8EFE16D1F76E60CC"><enum>(B)</enum><text>evaluate and collect information on the effect of such models on—</text> 
<clause id="H3738BE356AB6409FA85153EEC38FD793"><enum>(i)</enum><text>access to and quality of care;</text></clause> <clause id="H9C0A05F305C34179B9A3D286EFAB7F56"><enum>(ii)</enum><text>outcomes with respect to the health of an individual; and</text></clause> 
<clause id="H6508A40F641F4CEA81862F07D9AF5624"><enum>(iii)</enum><text>the experience of individuals who receive pregnancy-related health care;</text></clause></subparagraph> <subparagraph id="HC1139E4278BE4780A1FA7267ABB7F66C"><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="HBD39AC24B8194F4BA46A7C5348924631"><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="H6D869820BF9248E7A8699B741C17CB7C"><enum>(E)</enum><text display-inline="yes-display-inline">conduct any other activity determined by the Secretary.</text></subparagraph></paragraph> 
<paragraph id="H074D0F6D1596496DAEEB1F0768CCD518"><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="H7E2E601661D94811A1CCA8F8926483E4"><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="HEB2B14C47B58476DB37E2C5AE5556397"><enum>(i)</enum><text>enables distance learning and technical support; and</text></clause> <clause id="HFD5D9218869A4272A455D2E3E1F91098"><enum>(ii)</enum><text>supports the secure exchange of electronic health information; and</text></clause></subparagraph> 
<subparagraph id="HEE0BDE78382247889BF9235A75632936"><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="H744FD033791C4D63BFAAB26754158A11"><enum>(c)</enum><header>Application</header> <paragraph id="H6F900CE82DE04AA3A598C93EB0225443"><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="H2CAF1F39409F41B7B7C954316DB30583"><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 effect of the use of technology-enabled collaborative learning and capacity building models, including with respect to—</text> <subparagraph id="H6B054F92E9534B958D39492687013978" display-inline="no-display-inline"><enum>(A)</enum><text>maternal health outcomes;</text></subparagraph> 
<subparagraph id="H6E967B1CF60D4ABEB29DBE3DB2A39995"><enum>(B)</enum><text>access to maternal health care services;</text></subparagraph> <subparagraph id="H657F95D825E645638AEADC1D015645E0"><enum>(C)</enum><text>quality of maternal health care; and</text></subparagraph> 
<subparagraph id="H344ED4D6BFA8401D889066EB648191DC"><enum>(D)</enum><text>retention of maternity care providers serving areas and populations described in subsection (a).</text></subparagraph></paragraph></subsection> <subsection id="H5B4CFDA6E5C142828E2B0ABC1552AB00"><enum>(d)</enum><header>Limitations</header> <paragraph id="HC59C04F4639047CC808C8AE79187B322"><enum>(1)</enum><header>Number</header><text display-inline="yes-display-inline">The Secretary may not award more than 1 grant under this section.</text></paragraph> 
<paragraph id="HE50A5846F3D4494F9C9301BA15926494"><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="H8068AA7BC3EC44559BC0B4430F56A482"><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="H0B93956C80F64FEF83163D3185957855"><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="H3D3528C2F8C04ED2AAEB3C6824E0905E"><enum>(1)</enum><text>in health professional shortage areas;</text></paragraph> 
<paragraph id="HA37C257D0D6D42F89D6D8122F3C36BE4"><enum>(2)</enum><text display-inline="yes-display-inline">in areas with high rates of maternal mortality and severe maternal morbidity or significant maternal health disparities;</text></paragraph> <paragraph id="H26EB428F7F3B41F98024C665A0970881"><enum>(3)</enum><text display-inline="yes-display-inline">in rural and underserved areas; and</text></paragraph> 
<paragraph id="H8332030E098F4D0489ABE80BE7851F5B"><enum>(4)</enum><text>for medically underserved populations or American Indians and Alaska Natives.</text></paragraph></subsection> <subsection id="H06F23A5F2B4940369300F3AD8F9AD59E"><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 technology-enabled collaborative learning and capacity building models.</text></subsection> 
<subsection id="HB9A6F9225A8D4249ABA99DDEF16D9664"><enum>(h)</enum><header>Reporting</header> 
<paragraph id="HE309E78250B4492C83E8327C652609AE"><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="HBB3B2885282744C0AB74D01F7C047259"><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 the Congress, and make available on the website of the Department of Health and Human Services, a report that includes—</text> 
<subparagraph id="H49A35FB10653443F900B2C9B7FC2057F"><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="HC1E66799EBC8486D931DAB9BABC21128"><enum>(B)</enum><text display-inline="yes-display-inline">a summary of—</text> 
<clause id="H86B6726DFB6C4D8AA8543B6642FD518C"><enum>(i)</enum><text display-inline="yes-display-inline">the evaluations conducted under subsection (b)(1)(B);</text></clause> <clause id="H21D6768DA15C42D6B71A21160268514F"><enum>(ii)</enum><text display-inline="yes-display-inline">any technical assistance provided under subsection (f); and</text></clause> 
<clause id="HA55129BCA605456186FADA17A6090E6A"><enum>(iii)</enum><text display-inline="yes-display-inline">the activities conducted under subsection (a); and</text></clause></subparagraph> <subparagraph id="HDA678DF3E8794AA5A0453641ABEEE687"><enum>(C)</enum><text display-inline="yes-display-inline">a description of any significant findings with respect to—</text> 
<clause id="H64D8565017AE4312A358A2CDD13B125A"><enum>(i)</enum><text>patient outcomes; and</text></clause> <clause id="H293D19AE7EFD4042A3EA6DF9CBA348A4"><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="H61A4526D35164967B05905A3770C9564"><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 2027 through 2031.</text></subsection> <subsection id="HAA8C766BF6EA47F3AB3F045AD14228AA"><enum>(j)</enum><header>Definitions</header><text>In this section:</text> 
<paragraph id="H6454B93698984F1F85B381EF91C53F4C"><enum>(1)</enum><header>Eligible entity</header> 
<subparagraph id="HA0CE1BCC077F4423864A686BF594FF9E"><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="H6DDA0D3B975941F1B7888B1C18B8CF50"><enum>(i)</enum><text display-inline="yes-display-inline">in health professional shortage areas;</text></clause> 
<clause id="H0D5D80F2C79A41E6B82BD6E9B638A565"><enum>(ii)</enum><text display-inline="yes-display-inline">in rural or underserved areas;</text></clause> <clause id="H1308FA8A11734AA0B09622B579779D22"><enum>(iii)</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="H97261499F5F7442E942A86AEABB01274"><enum>(iv)</enum><text display-inline="yes-display-inline">who are—</text> <subclause id="H722A0632DBF34F2FB425385737AF3840"><enum>(I)</enum><text>members of medically underserved populations; or</text></subclause> 
<subclause id="H72F8557B7FB040ECAC8F248E0B24BEF0"><enum>(II)</enum><text>American Indians and Alaska Natives, including Indian Tribes, Tribal organizations, and Urban Indian organizations.</text></subclause></clause></subparagraph> <subparagraph id="HD233E6EB89054A728CD9EFFFF6F6ECAD"><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="HA9FEC00EE4E4453191B419D7F452A4FF"><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="HEF526D7975EB4D589046BEACCF6399CB"><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="HBD401C81C0C040BDA5A15E07A5D05AE1"><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="HC8F6F53D920C4C43AC115B3448C3ACFC"><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="HEBCE18F38F7D4E589DC32C7A2B89BFD0"><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="H078B3DA393284792A0797AC8A7FC7787"><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="HF584B832A70E4965BB606654B52F14E3"><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 video conferencing 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="HFDFFDD5541634F20893BE1A88F6E3285"><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="HBCAA5387FCB644BB9DDE250DF5E7D5D1"><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="H8D6A2F0D9EE043E29A15EB30E689B9E3"><enum>903.</enum><header>Grants to promote equity in maternal health outcomes through digital tools</header> <subsection id="H17DF41CF97314DD19A88B3328BED1A79"><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 (in this section referred to as the <quote>Secretary</quote>) shall make grants to eligible entities to reduce maternal health disparities by increasing access to digital tools related to maternal health care, including provider-facing technologies, such as early warning systems and clinical decision support mechanisms.</text></subsection> 
<subsection id="HE3FA2E2ACBEF48A2BAAE8FD28A31F27E"><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="H0349E1D3A34A4785941DDEFC1FE32FC1"><enum>(c)</enum><header>Prioritization</header><text>In awarding grants under this section, the Secretary shall prioritize an eligible entity—</text> 
<paragraph id="H696F35236E4F42FB8B811BDBC57619FB"><enum>(1)</enum><text display-inline="yes-display-inline">in an area with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></paragraph> <paragraph id="HAA207EFCEFA5460290D1ADFE66CFF6B9"><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>) or a rural or underserved area; and</text></paragraph> 
<paragraph id="H321B5442F2124D51B8F8C7B39ADDD9C4"><enum>(3)</enum><text display-inline="yes-display-inline">that promotes technology that addresses maternal health disparities.</text></paragraph></subsection> <subsection id="H1DE76DF9DEFA46E1A404CCB0B60DA8FE" display-inline="no-display-inline"><enum>(d)</enum><header>Limitations</header> <paragraph id="H75CFFF39570249C7B31232B87C86841C"><enum>(1)</enum><header>Number</header><text display-inline="yes-display-inline">The Secretary may award not more than 1 grant under this section.</text></paragraph> 
<paragraph id="HC16DB6CC97A1436A9091FBD0C5FC2211"><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="H2B671418E044411888139D0D52DAF6F0"><enum>(e)</enum><header>Technical assistance</header><text>The Secretary shall provide technical assistance to an eligible entity on the development, use, evaluation, and postgrant sustainability of digital tools for purposes of promoting equity in maternal health outcomes.</text></subsection> 
<subsection id="H2E839E45ABE44EA9B69C5BA9511BE8BA"><enum>(f)</enum><header>Reporting</header> 
<paragraph id="H13479921EC89427BA4F736144E59ABC0"><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="H969F8F511B934064BAFA25040DCE6EFD"><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="HEFB9FA27346A4384A5D338D90BDB4342"><enum>(A)</enum><text display-inline="yes-display-inline">an evaluation on the effectiveness of grants awarded under this section to improve maternal health outcomes, particularly for pregnant and postpartum individuals from racial and ethnic minority groups;</text></subparagraph> <subparagraph id="H1C67D9D55AA24E5CB50B6062F9F22A16"><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="HD1475D0C42B9423EB1F636D53CD85102"><enum>(C)</enum><text>recommendations with respect to—</text> <clause id="H0C964D21F996439EA110DAE29E858F97"><enum>(i)</enum><text>technology-based privacy and security safeguards in maternal health care;</text></clause> 
<clause id="H5310BD08CD894441BD011273C4FA8138"><enum>(ii)</enum><text>reimbursement rates for maternal telehealth services;</text></clause> <clause id="HF87CAAAE811D41B69FB3CFC45957CD26"><enum>(iii)</enum><text>the use of digital tools to analyze large data sets to identify potential pregnancy-related complications;</text></clause> 
<clause id="H522456A076434876BAA846DBE927F623"><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="HF08F0743DD864202B9EA683CF44DEBE1"><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="H176965102912440E835F0D4401A02EA4"><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="H1B4FBEF2C6204B8588495FB9784CD36A"><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="H45543DC9726B4052B1E42550A8C0B7B6"><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="H33CAC1A258564B0FBB478927B03C502E" 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 2027 through 2031.</text></subsection></section> 
<section id="HB8DA2D67C3CD472B9A787B5E678F3779"><enum>904.</enum><header>Report on the use of technology in maternity care</header> 
<subsection id="HC020B839A22B44E68B88441050D63A7F"><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="HFCC39F98246D465C890AC815C46B1C5D"><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="H4E5F9FBC263B4BADB5527646415FD4C5"><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="HE40E75FE52044B4DA51CFBD4365480D2"><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="HA7E391FDB7CA4D268A22CC1FF5F38D3D"><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="HF5A328EBC70F41108D892CC06CA5417D"><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="HE69ECBC19D744C32B8DB9D4240E739B9"><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="H35FB2AFF67144B4F83B4833E25BD220E"><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 24 months after the date of enactment of this Act.</text></subsection></section></title> 
<title id="H1FAF9E7EF8F045E28577B82157097B11"><enum>X</enum><header>Impact to save moms</header> 
<section id="H44F2E3EBD0EE4BA18F1DAF7D43695DFC" section-type="subsequent-section" display-inline="no-display-inline"><enum>1001.</enum><header>Perinatal Care Alternative Payment Model Demonstration Project</header> 
<subsection id="HBA838AC973E24DE287325E240362166C"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">For the period of fiscal years 2027 through 2031, 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 &amp; 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 et seq.</external-xref>) 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 et seq.</external-xref>) 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="H0A539466F03948D69DE336D0FC474706"><enum>(b)</enum><header>Coordination</header><text>In establishing the Demonstration Project, the Secretary shall coordinate with stakeholders such as—</text> 
<paragraph id="HEE726379E745473C810BDBDF999130E9"><enum>(1)</enum><text>State Medicaid programs;</text></paragraph> <paragraph id="H6A5B42C3C5914499B22A0E0E33E17A44"><enum>(2)</enum><text display-inline="yes-display-inline">maternity care providers and organizations representing maternity care providers;</text></paragraph> 
<paragraph id="H6909FB1241CF472BB6F3BDA26F5DA5D0"><enum>(3)</enum><text display-inline="yes-display-inline">relevant organizations representing patients, with a particular focus on patients from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></paragraph> <paragraph id="H329DAB4A0B1B4B1592B5EDD5CF1EA363"><enum>(4)</enum><text display-inline="yes-display-inline">relevant community-based organizations, particularly organizations that seek to improve maternal health 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;</text></paragraph> 
<paragraph id="H5352AC08C4A4410996FF5644565D4F1D"><enum>(5)</enum><text display-inline="yes-display-inline">perinatal health workers;</text></paragraph> <paragraph id="HBCD67C2AFBF7429394A17BE5FB8C79B9"><enum>(6)</enum><text>relevant health insurance issuers;</text></paragraph> 
<paragraph id="H457DAEFE7EFB455894C543088D5F6614">
            <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="H375ABE31632742A183D2F480CCD8EF43"><enum>(8)</enum><text>researchers and policy experts in fields related to maternity care payment models; and</text></paragraph> <paragraph id="H9A413EE782EB41DB939A80AA087BD0E9"><enum>(9)</enum><text display-inline="yes-display-inline">any other stakeholders as the Secretary determines appropriate, with a particular focus on stakeholders from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes.</text></paragraph></subsection> 
<subsection id="H672979BA50714D13B8B81266370026B0"><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="H6A32EF9D3B7A4F348099D22347197AEF"><enum>(1)</enum><text display-inline="yes-display-inline">is designed to improve maternal health 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;</text></paragraph> 
<paragraph id="H3CD74E7E71CD447DAE8CA3C235F54818"><enum>(2)</enum><text display-inline="yes-display-inline">includes methods for stratifying patients by pregnancy risk level and, as appropriate, adjusting payments under such model to take into account pregnancy risk level, including consideration of the appropriate transfer of patients by pregnancy risk level;</text></paragraph> <paragraph id="H3DA5C8B90094411886E8D9AEB811E2FB"><enum>(3)</enum><text>establishes evidence-based quality metrics for such payments;</text></paragraph> 
<paragraph id="H7924A962DE18477F9BFD50302734C845"><enum>(4)</enum><text>includes consideration of nonhospital birth settings such as freestanding birth centers (as so defined);</text></paragraph> <paragraph id="H81F8564CDE8F4CB38E73E503F7027724"><enum>(5)</enum><text>includes consideration of social determinants of maternal health;</text></paragraph> 
<paragraph id="H843DA25E736E4C258E48CE0A7482539B"><enum>(6)</enum><text>includes diverse maternity care teams that include—</text> <subparagraph id="H7EAB96902A3442F39DAEE1E4497AB78B" 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, and registered dietitians or nutrition professionals (as such term is defined in section 1395x(vv)(2) of title 42, United States Code)—</text> 
<clause id="H8E74058893B24E3EA19F516061CFD9F6" commented="no"><enum>(i)</enum><text>from racially, ethnically, and professionally diverse backgrounds;</text></clause> <clause id="HF5FE89BF94D043B087817C4C7C862D4E" commented="no"><enum>(ii)</enum><text>with experience practicing in racially and ethnically diverse communities; or</text></clause> 
<clause id="H7B398E9E831A454BBD2D3067FC8F5C35" commented="no"><enum>(iii)</enum><text>who have undergone training on implicit bias and racism; and</text></clause></subparagraph> <subparagraph id="H8F9A471F0FA54BEDB9363FFA0509544C"><enum>(B)</enum><text display-inline="yes-display-inline">perinatal health workers; or</text></subparagraph></paragraph> 
<paragraph id="H92A0C1A9A7E6435B9CF1233717BAB3C9"><enum>(7)</enum><text display-inline="yes-display-inline">includes consideration of maternal mental health conditions and substance use disorders.</text></paragraph></subsection> <subsection id="HB58219A327084EAE9C103A137E1AB42D"><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="H0BB22AB826294F3CAA8BAF0501988432"><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="H0131569D31B1464FB2A07EAC8358B045"><enum>(1)</enum><text display-inline="yes-display-inline">maternal health outcomes, with data stratified by race, ethnicity, primary language, socioeconomic status, geography, insurance type, and other factors as the Secretary determines appropriate;</text></paragraph> 
<paragraph id="H90412A31342545AFAC3108A20D32BC04"><enum>(2)</enum><text>spending on maternity care by States participating in the Demonstration Project;</text></paragraph> <paragraph id="H5D898B2D0590435AAF83330C267E1E93"><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="HA9EE4BDFEB014E108A0F22C7C4368FB4"><enum>(4)</enum><text>any other areas of assessment that the Secretary determines relevant.</text></paragraph></subsection> <subsection id="H5964102CF1274B7FAA0D83D3F61209F6"><enum>(f)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than one 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="H6CFED433D64A46AE82256918EB816FBB"><enum>(1)</enum><text>the results of any evaluation conducted under subsection (e); and</text></paragraph> <paragraph id="HC47311107F0A41F98E977537D3E9F970"><enum>(2)</enum><text>a recommendation regarding whether the Demonstration Project should be continued after fiscal year 2031 and expanded on a national basis.</text></paragraph></subsection> 
<subsection id="H517ECAB42B84459E9DCC24A649E021DF"><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="H6917962A47F8403499ACD64CE37B8E93"><enum>(h)</enum><header>Definitions</header><text>In this section:</text> 
<paragraph id="HD18E01CE1BA94977BAA62107BBFA8627"><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="H7CD0D954931849F4937B4BCB156B4B09"><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></subsection></section></title> 
<title id="HF777ABDE0C644D11874E11BB5B9F87A6"><enum>XI</enum><header>Maternal health pandemic response</header> 
<section id="HC7623FB7C8DB453888F89167D8FDF8FB"><enum>1101.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text> <paragraph id="H2AB8FA317A3A462BB1F3029938592755"><enum>(1)</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="HE203FE797B97497D9186393EB7417669"><enum>(A)</enum><text display-inline="yes-display-inline">is culturally and linguistically congruent;</text></subparagraph> <subparagraph id="H202048C3AF73401C86BA8814E8B21D27"><enum>(B)</enum><text>maintains their dignity, privacy, and confidentiality;</text></subparagraph> 
<subparagraph id="H53C87E76354F4332BA5C950D049D1B91"><enum>(C)</enum><text>ensures freedom from harm and mistreatment; and</text></subparagraph> <subparagraph id="H07A129E106904828867EB3CA9F45E193"><enum>(D)</enum><text>enables informed choice and continuous support.</text></subparagraph></paragraph> 
<paragraph id="H4845BC1BCDF645D8AEA8EAA1FDD5950D"><enum>(2)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph></section> <section id="HE1F3DA12743A4CD3A1DE4EC363637FA8" section-type="subsequent-section"><enum>1102.</enum><header>Funding for data collection, surveillance, and research on maternal health outcomes during public health emergencies</header><text display-inline="no-display-inline">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—</text> 
<paragraph id="HB8FD20A5DA494AE0815B0DD12184B153"><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="H701D34C43513463DBB1B34CACE0428CE"><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="H5AEB0306900942E08E40A013C29D520D"><enum>(B)</enum><text display-inline="yes-display-inline">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</text></subparagraph> <subparagraph id="HB63626B4DDB4474E9E00A799B17D6022"><enum>(C)</enum><text display-inline="yes-display-inline">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;</text></subparagraph></paragraph> 
<paragraph id="H57C6477026C849E6AEE9EF38775EA8FA"><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="H5D1C287C2F3E46768E4DC00FDA66BF9B"><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="H8FF361D9E9F341AABB997E914C12A494"><enum>(A)</enum><text display-inline="yes-display-inline">create a supplement to its PRAMS survey related to public health emergencies and infectious diseases that pose a risk to maternal and infant health;</text></subparagraph> <subparagraph id="H01EE72B0334C4ADCA6F83D28C7E00A9B"><enum>(B)</enum><text>add questions around experiences of respectful maternity care in prenatal, intrapartum, and postpartum care; and</text></subparagraph> 
<subparagraph id="H1B28A43A2A37492BA6795F15EE12ABA0"><enum>(C)</enum><text display-inline="yes-display-inline">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</text></subparagraph></paragraph> <paragraph id="H3B9278C3CF9F40E2806A8711C179FA5D"><enum>(4)</enum><text display-inline="yes-display-inline">$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.</text></paragraph></section> 
<section id="H676029BEBB31423DA5B9E3F1AD54C54A"><enum>1103.</enum><header>Public health emergency maternal health data collection and disclosure</header> 
<subsection id="H9E94C145F22948099024F9E3CAF9288E"><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 &amp; 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="HBEB6E6B3874F443B9A297F1611B09CEB"><enum>(b)</enum><header>Data described</header><text display-inline="yes-display-inline">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:</text> 
<paragraph id="H598DEBFC15E64DAD826925E464CE150C"><enum>(1)</enum><text display-inline="yes-display-inline">Diagnostic testing, confirmed cases, hospitalizations, deaths, and other health outcomes related to an infectious disease outbreak among pregnant and postpartum individuals.</text></paragraph> <paragraph id="H43A667D42D514BABBD24B570B13E432B"><enum>(2)</enum><text display-inline="yes-display-inline">Maternal and infant health outcomes among individuals who test positive for an infectious disease during or after pregnancy.</text></paragraph></subsection> 
<subsection id="HE46654C3621C426C95ED60796C09E15E"><enum>(c)</enum><header>American Indian and Alaska Native Health outcomes</header><text>In carrying out subsection (a), the Secretary shall consult with Indian Tribes and confer with Urban Indian organizations.</text></subsection> <subsection id="H6058152532474FC399632CAFA44BF9FB"><enum>(d)</enum><header>Disaggregated information</header><text display-inline="yes-display-inline">In carrying out subsection (a), the Secretary shall disaggregate data by race, ethnicity, gender, primary language, geography, socioeconomic status, and other relevant factors.</text></subsection> 
<subsection id="H0CD846446FDA40D889E2E012F94F1D24"><enum>(e)</enum><header>Update</header><text>During public health emergencies, the Secretary shall update the data made available under this section—</text> <paragraph id="H05C48AC5419E4A2F8FC93A984B17937E"><enum>(1)</enum><text>at least on a monthly basis; and</text></paragraph> 
<paragraph id="HEFF93013FB184C4ABC91D14F29A82F1B"><enum>(2)</enum><text>not less than one month after the end of such public health emergency.</text></paragraph></subsection> <subsection id="H4442358DD45B41BC9A04C0CE9CFB0375" commented="no"><enum>(f)</enum><header>Privacy</header><text display-inline="yes-display-inline">In carrying out subsection (a), the Secretary shall—</text> 
<paragraph id="H87267B81EB4C4B909C91908BB3DD47F7" commented="no"><enum>(1)</enum><text>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); and</text></paragraph> <paragraph id="HB3D0DF765B0F4287A810859ED71B74BF" commented="no"><enum>(2)</enum><text>ensure that—</text> 
<subparagraph id="HD6D8A7FF1AAF4D31B0CC586D8BE5F0E1" commented="no"><enum>(A)</enum><text>all data collected is deidentified;</text></subparagraph> <subparagraph id="HCE74407E42E3464992EFA38D777AD89F" commented="no"><enum>(B)</enum><text>at a minimum, there is no disclosure of any individually identifying or potentially identifying information regarding a patient or a patient’s health care provider; and</text></subparagraph> 
<subparagraph id="HA4F9483691614DE298660E79EFD27868" commented="no"><enum>(C)</enum><text>all data is collected in a manner that is consistent with applicable Federal and State privacy law.</text></subparagraph></paragraph></subsection> <subsection id="H633068803D68430EBFAFE25FCF3019D8"><enum>(g)</enum><header>Guidance</header> <paragraph id="H4E556F75EA394220A517353CC67B0F26"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 30 days after the declaration of 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>), the Secretary shall issue guidance to States and local public health departments to ensure that—</text> 
<subparagraph id="H55CEAFA537654218905DEC2061FBF6ED"><enum>(A)</enum><text display-inline="yes-display-inline">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</text></subparagraph> <subparagraph id="HDC45B41763F347CDA47A6071FF637589"><enum>(B)</enum><text display-inline="yes-display-inline">data described in subsection (b) are disaggregated by race, ethnicity, gender, primary language, geography, socioeconomic status, and other relevant factors.</text></subparagraph></paragraph> 
<paragraph id="H5806E523FEFD41B3A3FD67ED121F9160"><enum>(2)</enum><header>Consultation</header><text>In carrying out paragraph (1), the Secretary shall consult with Indian Tribes—</text> <subparagraph id="H49361D849FA7424EAD3A5874185BA09F"><enum>(A)</enum><text>to ensure that such guidance includes tribally developed best practices; and</text></subparagraph> 
<subparagraph id="H02C1543B73AD4D0AB574D24EF0F42F4E"><enum>(B)</enum><text>to reduce misclassification of American Indians and Alaska Natives.</text></subparagraph></paragraph></subsection></section> <section id="HA593AB9733F14700934BE7276083DD57"><enum>1104.</enum><header>Public health communication regarding maternal care during public health emergencies</header><text display-inline="no-display-inline">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.</text></section> 
<section id="HA477B569BF7E430D892F4A4AD8D59EF4"><enum>1105.</enum><header>Task force on birthing experience and safe, respectful, responsive, and empowering maternity care during public health emergencies</header> 
<subsection id="HBEAFE8AB0CB94EA3A252B2EA589C4AF2" commented="no"><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 Federal recommendations regarding respectful, responsive, and empowering maternity care, including safe birth care and postpartum care, during public health emergencies.</text></subsection> <subsection id="H3A630F2D122F42BAA9A55805C867988E"><enum>(b)</enum><header>Duties</header><text>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—</text> 
<paragraph id="H0C0E981B92A442D7B2214D6B026C5E1B"><enum>(1)</enum><text>address, with particular attention to ensuring equitable treatment on the basis of race and ethnicity—</text> <subparagraph id="HB4C9D42769F644549793FEA3737AAC95"><enum>(A)</enum><text>measures to facilitate respectful, responsive, and empowering maternity care;</text></subparagraph> 
<subparagraph id="HB95CBC291D13461C9204C1E829A1C219"><enum>(B)</enum><text display-inline="yes-display-inline">measures to facilitate telehealth maternity care for pregnant individuals who cannot regularly access in-person care;</text></subparagraph> <subparagraph id="HA9AFDD35D4BC4D2692C4CA057D12CE27"><enum>(C)</enum><text>strategies to increase access to specialized care for those with high-risk pregnancies or pregnant individuals with elevated risk factors;</text></subparagraph> 
<subparagraph id="H025B3371CA3745819D5725846DC9B278"><enum>(D)</enum><text>diagnostic testing for pregnant and laboring patients;</text></subparagraph> <subparagraph id="HE96A2B56038D45E0B106246EF635D81D"><enum>(E)</enum><text>birthing without one’s chosen companions, with one’s chosen companions, and with smartphone or other telehealth connection to one’s chosen companions;</text></subparagraph> 
<subparagraph id="H5CF9032A7A234A9F9DA91401766E3C75"><enum>(F)</enum><text>newborn separation after birth in relation to maternal infection status;</text></subparagraph> <subparagraph id="HEC1FAB51CE184CCB8CF0FDDD8D4D37B9"><enum>(G)</enum><text>breast milk feeding in relation to maternal infection status;</text></subparagraph> 
<subparagraph id="HBF64EE83F5184FFD9BBEC2945DC02AE4"><enum>(H)</enum><text display-inline="yes-display-inline">licensure, training, scope of practice, and Medicaid and other insurance reimbursement for certified midwives, certified nurse-midwives, and certified professional midwives, who meet, at a minimum, the international definition of a midwife and global standards for midwifery education, as established by the International Confederation of Midwives, in a manner that facilitates inclusion of midwives of color and midwives from underserved communities;</text></subparagraph> <subparagraph id="H66D945BA35344842A0616E6335437545"><enum>(I)</enum><text display-inline="yes-display-inline">financial support and training for perinatal health workers who provide nonclinical support to individuals from pregnancy through the postpartum period in a manner that facilitates inclusion from underserved communities;</text></subparagraph> 
<subparagraph id="H7B705B3530F94F8CA7BFCDFA05968BCE"><enum>(J)</enum><text>strategies to ensure and expand doula coverage under State Medicaid programs;</text></subparagraph> <subparagraph id="H6EE20C2915C646DEA3D4DC78BEDC7D5F"><enum>(K)</enum><text>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;</text></subparagraph> 
<subparagraph id="H59D3FEC0BA1A4EDA8D6E32286312F07B"><enum>(L)</enum><text>how to identify and address instances of intimate partner violence during pregnancy which may arise or intensify during public health emergencies;</text></subparagraph> <subparagraph id="H576EFDFBF4C4409E9A1F5E45E657D165"><enum>(M)</enum><text display-inline="yes-display-inline">strategies to address hospital capacity concerns in communities with a surge in infectious disease cases and to provide childbearing individuals 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 freestanding birth centers;</text></subparagraph> 
<subparagraph id="H02CE25D912E2485F962412EAAE597F31"><enum>(N)</enum><text>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;</text></subparagraph> <subparagraph id="H1D990C18E23046FA92C8F09F175F711B"><enum>(O)</enum><text display-inline="yes-display-inline">how to identify and address racism, bias, and discrimination in the delivery of maternity care services to pregnant and postpartum individuals, including evaluating the value of training for hospital staff on implicit bias and racism, respectful, responsive, and empowering maternity care, and demographic data collection;</text></subparagraph> 
<subparagraph id="HF27EF6CE2DD845D289992DD31578EBE3"><enum>(P)</enum><text>how to address the needs of undocumented pregnant individuals and new mothers who may be afraid or unable to seek needed care during the COVID–19 public health emergency;</text></subparagraph> <subparagraph id="HBFE5B2107FAD43E0A7C7821B3856F3D2"><enum>(Q)</enum><text display-inline="yes-display-inline">how to address the needs of uninsured and underinsured pregnant individuals who have historically relied on emergency departments for care;</text></subparagraph> 
<subparagraph id="H95F0764CAF8042C1A371492F8211D094"><enum>(R)</enum><text>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 prenatal or postpartum mood disorder;</text></subparagraph> <subparagraph id="HDCDE936FAD904575BD1DE4B87E432005"><enum>(S)</enum><text>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;</text></subparagraph> 
<subparagraph id="HFE89A6277F2743C1B74B96F31DD96B9C"><enum>(T)</enum><text>how to ensure access to infant nutrition during public health emergencies; and</text></subparagraph> <subparagraph id="H8918140E8C8F4CE1BD9A7DB20C4A574F"><enum>(U)</enum><text>such other matters as the Task Force determines appropriate;</text></subparagraph></paragraph> 
<paragraph id="H88BD2CBD25584B06905B049310FC8A75"><enum>(2)</enum><text>identify barriers to the implementation of the recommendations;</text></paragraph> <paragraph id="H3BB35F27F5F640A0BA1505B485B949A0"><enum>(3)</enum><text>take into consideration existing State and other programs that have demonstrated effectiveness in addressing pregnancy, birth, and postpartum care during public health emergencies; and</text></paragraph> 
<paragraph id="H31242DF91A684557BD840430CC8C9B6A"><enum>(4)</enum><text>identify policies specific to public health emergencies that should be discontinued when safely possible and those that should be continued as the public health emergency abates.</text></paragraph></subsection> <subsection id="HDFB8B44C585B47918B68EFF84ED2522C"><enum>(c)</enum><header>Membership</header><text>The Secretary shall appoint the members of the Task Force. Such members shall be comprised of—</text> 
<paragraph id="H2747C0E2E8AA46C9B90236A68788F604"><enum>(1)</enum><text>representatives of the Department of Health and Human Services, including representatives of—</text> <subparagraph id="H1CC8314BF1EC4AD091A908393D2E373C"><enum>(A)</enum><text>the Secretary;</text></subparagraph> 
<subparagraph id="HC01558A4671341C3929A1DA8EF449B27"><enum>(B)</enum><text>the Director of the Centers for Disease Control and Prevention;</text></subparagraph> <subparagraph id="H8C2CDAAD8C054D41B20C141297A82BB4"><enum>(C)</enum><text>the Administrator of the Health Resources and Services Administration;</text></subparagraph> 
<subparagraph id="H655531B05C024236AD8267B9BB837D6D"><enum>(D)</enum><text>the Administrator of the Centers for Medicare &amp; Medicaid Services;</text></subparagraph> <subparagraph id="HF041583A11C549BAA6706D05862C29B7"><enum>(E)</enum><text>the Director of the Agency for Healthcare Research and Quality;</text></subparagraph> 
<subparagraph id="H991A8838E0DD4293A0D5B441FE12F2D1"><enum>(F)</enum><text>the Commissioner of Food and Drugs;</text></subparagraph> <subparagraph id="H858A76E0437740B4A554BF5E1873A309"><enum>(G)</enum><text>the Assistant Secretary for Mental Health and Substance Use; and</text></subparagraph> 
<subparagraph id="H9E0F673B2F7D4AE3A2C5E4F84CF10541"><enum>(H)</enum><text>the Director of the Indian Health Service;</text></subparagraph></paragraph> <paragraph id="H79BFBEC3CF184DE69839F59D7D71A26B"><enum>(2)</enum><text>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;</text></paragraph> 
<paragraph id="H9584FCD644DE4177830A4D76EA202F33"><enum>(3)</enum><text>at least 1 Tribal public health official representing departments of public health;</text></paragraph> <paragraph id="H6394FA70FDB64ABF93C1A3C0219FEF3E"><enum>(4)</enum><text display-inline="yes-display-inline">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;</text></paragraph> 
<paragraph id="H00DDB4E105F34042BFFCF75A65D0D517"><enum>(5)</enum><text>a professionally diverse panel of maternity care providers and perinatal health workers;</text></paragraph> <paragraph id="H05DC286929904ADE87D0ECCD0DDA2A78"><enum>(6)</enum><text display-inline="yes-display-inline">1 or more patients who were pregnant or gave birth during the COVID–19 public health emergency or a subsequent public health emergency;</text></paragraph> 
<paragraph id="HFAB6D7F222304420800FCD82944BF314"><enum>(7)</enum><text>1 or more patients who have received support from a perinatal health worker; and</text></paragraph> <paragraph id="H0292804B734546B69FC34D12ADD9A3C5"><enum>(8)</enum><text>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.</text></paragraph></subsection></section></title> 
<title id="H0F64630B33164B64BD9B9291CAA846C1"><enum>XII</enum><header>Protecting moms and babies against climate change</header> 
<section id="HB901717ACFB040468A33C84C11EDD48C"><enum>1201.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title, the following definitions apply:</text> <paragraph id="H61AAC4F4DD1646DF9949AC1847E99CC9"><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="H00D718F350154D5F922F2403F6AA314F"><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="HBC938EA5BB1643E7BD9E07BB86244468"><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="H77CE222957DF442BAAB27A53EB750877"><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="HDCF1B82B66614A0D9F9BC4CD1C74C4C4"><enum>(5)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph> 
<paragraph id="H8ADD089089DF47968C5087AFCE46F87C"><enum>(6)</enum><header>Stakeholder organization</header><text>The term <term>stakeholder organization</term> means—</text> <subparagraph id="H1F01B7B1F70D41AD83268199A4EDDF9B"><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="H4F124B2D08B1429B885B31D58F66070D"><enum>(B)</enum><text display-inline="yes-display-inline">a nonprofit organization with expertise in—</text> <clause id="H2FD870AE1AAB45CA9889D65BD6EF9ECC"><enum>(i)</enum><text>maternal or infant health; or</text></clause> 
<clause id="H3E99655953B24051848390B4BA6137D5"><enum>(ii)</enum><text display-inline="yes-display-inline">environmental or climate justice; and</text></clause></subparagraph> <subparagraph id="HE871CDF3B81E455B9D73E62831C54E1C"><enum>(C)</enum><text display-inline="yes-display-inline">a patient advocacy organization representing vulnerable individuals.</text></subparagraph></paragraph> 
<paragraph id="HD525E2212C1D4BA6B2C4C3BE1E7D63BA"><enum>(7)</enum><header>Vulnerable individual</header><text>The term <term>vulnerable individual</term> means—</text> <subparagraph id="H4E43878419F847598243BAA7895610B5"><enum>(A)</enum><text>an individual who is pregnant;</text></subparagraph> 
<subparagraph id="H0F408FDE57B0416EA252AC29F621B212"><enum>(B)</enum><text>an individual who was pregnant during any portion of the preceding 1-year period; and</text></subparagraph> <subparagraph id="H85E2D0E978BA41968B09122C94961B54"><enum>(C)</enum><text>an individual under 3 years of age.</text></subparagraph></paragraph></section> 
<section id="HDECAA14C96BB43A1BFB8CCD92ABF45FC"><enum>1202.</enum><header>Grant program to protect vulnerable mothers and babies from climate change risks</header> 
<subsection id="H89BCC3EBFC844063A9F258B9A916148D"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 180 days after the date of the enactment of this Act, the Secretary shall establish a grant program to protect vulnerable individuals from risks associated with climate change.</text></subsection> <subsection id="HFB3C67FEF74E4EDAB4121AB65CAABB95"><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="HDB42E356324C4160A806966805AC370B"><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="H04D2998B96414544A4B19A6EB8699167"><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="H06A9467E91AC4EA48D0DB2587A3E1C71"><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="H92F0EA7095D74F32BA12F5CFA32E6F8B"><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="H29858D24AD1C495E80A7BCC534893430"><enum>(A)</enum><text display-inline="yes-display-inline">adverse maternal and infant health outcomes; and</text></subparagraph> <subparagraph id="H644E49CB23A948D6A1A9ABAA11F0E622"><enum>(B)</enum><text display-inline="yes-display-inline">exposure to risks associated with climate change for vulnerable individuals.</text></subparagraph></paragraph> 
<paragraph id="HC36E0B5126134FC69D3AF4BF1F4B3696"><enum>(4)</enum><text display-inline="yes-display-inline">Strategies to prevent an initiative assisted with such grant funds from causing—</text> <subparagraph id="HE89FBE1D66DD4FF9B98134D75DD6D668"><enum>(A)</enum><text>adverse environmental impacts;</text></subparagraph> 
<subparagraph id="H3C720A3520934B30AD8888CB20D021A6"><enum>(B)</enum><text>displacement of residents and businesses;</text></subparagraph> <subparagraph id="H0A9566D090024227B2950CE4944773CB"><enum>(C)</enum><text>rent and housing price increases; or</text></subparagraph> 
<subparagraph id="H86C463E20B4A488A93B5BCCB9EF52767"><enum>(D)</enum><text>disproportionate adverse impacts on racial and ethnic minority groups and other underserved populations.</text></subparagraph></paragraph></subsection> <subsection id="H43D70E9D75C24A4B9CF5084B10B65083"><enum>(d)</enum><header>Selection of grant recipients</header> <paragraph id="H9050B0580F0C4D8CB34D2FA99FCB4C26"><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="HB27B608FF9444D209D0386DD6E11B19F"><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="HA7B07B1DB27742E58134A8B005080559"><enum>(A)</enum><text display-inline="yes-display-inline">representatives of stakeholder organizations;</text></subparagraph> 
<subparagraph id="HFF1141A539FB4202819B6B3EAD9C98F9"><enum>(B)</enum><text display-inline="yes-display-inline">the Administrator of the Environmental Protection Agency;</text></subparagraph> <subparagraph id="HBD856CFA78564CD6969761C059347A76"><enum>(C)</enum><text display-inline="yes-display-inline">the Administrator of the National Oceanic and Atmospheric Administration; and</text></subparagraph> 
<subparagraph id="H571042C518544383A44B7B4FA0A0F3F3"><enum>(D)</enum><text>from the Department of Health and Human Services—</text> <clause id="H0777E0AEA7114C7C981B24E2014CCAF3"><enum>(i)</enum><text>the Deputy Assistant Secretary for Minority Health;</text></clause> 
<clause id="H67B346F8F3C14896807AF9215C54203A"><enum>(ii)</enum><text>the Administrator of the Centers for Medicare &amp; Medicaid Services;</text></clause> <clause id="H75FD58B8B15F40FD8321ADACA6C2BFD3"><enum>(iii)</enum><text>the Administrator of the Health Resources and Services Administration;</text></clause> 
<clause id="H1226D2CA08F64F7A950C093C1B6643CF"><enum>(iv)</enum><text display-inline="yes-display-inline">the Director of the National Institutes of Health; and</text></clause> <clause id="HAFBA56F6ADA540DB9DDD2765E141FE2A"><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="HA7196AD443C2492491A85ABF4061392A"><enum>(3)</enum><header>Priority</header><text display-inline="yes-display-inline">In selecting grantees under the Program, the Secretary shall give priority to covered entities that serve a county or locality—</text> <subparagraph id="H655CE12F22E1451299963D116E566A0B"><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="H328903006377457EA97DB1B8EACDB9AC"><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 a similar rating of social vulnerability according to related Federal mapping tools;</text></subparagraph> <subparagraph id="H489F4E661FCA4E408F135FA307CE3730"><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> 
<subparagraph id="HCA7D962D2EEB466FB75EF81B39A63A2F"><enum>(D)</enum><text>with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes;</text></subparagraph> <subparagraph id="H556B40CE31B447A3A1FFDB25483FF602"><enum>(E)</enum><text>with a rating of very high or relatively high risk according to the National Risk Index for Natural Hazards of the Federal Emergency Management Agency; or</text></subparagraph> 
<subparagraph id="H08569F2F6A9E47838214EB52C49150CB"><enum>(F)</enum><text>with other climate-sensitive hazards with associations to adverse maternal or infant health outcomes, as determined by the Secretary.</text></subparagraph></paragraph> <paragraph id="HAC85CBDB6EB340B68B3CEDAFE7CA7626"><enum>(4)</enum><header>Limitation</header><text display-inline="yes-display-inline">A recipient of grant funds under the Program may not use such grant funds to serve a county or locality that is served by any other recipient of a grant under the Program.</text></paragraph></subsection> 
<subsection id="H88A0CFFF3AE84E74B82DA95FC090D1AB"><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="H3A762996C482421381696336D5FE7A41"><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, which may include—</text> 
<subparagraph id="H290A40171BAA431A8D5A90FD8AA83359"><enum>(A)</enum><text display-inline="yes-display-inline">training for health care providers, perinatal health workers, 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="HD50DF9E5CC274292B22C5E1FC41E4505"><enum>(B)</enum><text display-inline="yes-display-inline">hiring, training, or providing resources to 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="HEB059172D108465DB93C3361FA629C53"><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="HCC24FCBB1DED4F84B8B009845DAF9AA8"><enum>(i)</enum><text>collecting data on such risks in specific census tracts, neighborhoods, or other geographic areas; and</text></clause> 
<clause id="HAC87881416E045549A05B083A78E921F"><enum>(ii)</enum><text display-inline="yes-display-inline">sharing such data with local health care providers, perinatal health workers, 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="HB11DBF31D46C47E38EC30C28D57D7B74"><enum>(D)</enum><text display-inline="yes-display-inline">providing vulnerable individuals—</text> 
<clause id="H3BCC162D19DB4593B49630E6BAC1F2A9"><enum>(i)</enum><text>air conditioning units, residential weatherization support, filtration systems, household appliances, or related items;</text></clause> <clause id="HDF4F4771B4C64B4F9CD72DF712580425"><enum>(ii)</enum><text display-inline="yes-display-inline">direct financial assistance; and</text></clause> 
<clause id="HFB6C857673904797BB1873EDA0967374"><enum>(iii)</enum><text display-inline="yes-display-inline">services and support, including housing assistance, evacuation assistance, transportation assistance, access to cooling shelters, and mental health counseling, 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="H4D33B47E815344C2BB6659DEEEC3EB8B"><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="HB83CB15062BA4B8EB3B8BCB34FCCE07B"><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="H4DE87C8565F54A72B8820ECC3BD6F253"><enum>(B)</enum><text display-inline="yes-display-inline">improve infrastructure, such as buildings and paved surfaces;</text></subparagraph> 
<subparagraph id="H60FFF86F5A1042A3B2A43CBFF15C5343"><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="HF719B4D9C6894D8C85C0CAE10A44948D"><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="H026BE69BE1054B00984A8714BB74DF88"><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="H8D5CE8F6DB1F4C079D5E43A6168C278D"><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="HBD0F9F12109144A68EDCD38B5E7B71AA"><enum>(h)</enum><header>Reports to Secretary</header> 
<paragraph id="HBC1D7B6B3B0240279E0D597646DCEC4F"><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, which shall include a description of the following:</text> <subparagraph id="H52930C901FB740B8A4CDEDDEBAB67E56"><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="H74D559C48D8A4D0AA10E391674AFB3D0"><enum>(B)</enum><text display-inline="yes-display-inline">Relevant health and environmental data, disaggregated, to the extent practicable, by race, ethnicity, primary language, socioeconomic status, geography, insurance type, pregnancy status, and other relevant demographic information.</text></subparagraph> <subparagraph id="H307D4D9910114CD3955D53B208EE490A"><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="H0FEEF8B935E5445CB4C6975A3D779441"><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="HE190A21C338646208145D8F21F933D10"><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="H9ECA58777DD9487E93FBF9ADBA2C0DAD"><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="HF189D87F7AE34E96B8E5CD5318DE6569"><enum>(i)</enum><text>adverse environmental impacts;</text></clause> 
<clause id="HA753E9330946447195F7D1B4104569D7"><enum>(ii)</enum><text>displacement of residents and businesses;</text></clause> <clause id="H78C76FF06223461D80BC10135A041C2B"><enum>(iii)</enum><text>rent and housing price increases; and</text></clause> 
<clause id="H9FD4FA0785C0406685FDDF79EC919B29"><enum>(iv)</enum><text>disproportionate adverse impacts on racial and ethnic minority groups and other underserved populations.</text></clause></subparagraph> <subparagraph id="HB48B0F86DFC3410D9E9C210E05010EF1"><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="H69194FD924714A869D6E4D60934FC672"><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="H541A0CED817E4161AA862C92D6CE9B96"><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="HA602C2CDAE794196A1448729A5568F1E"><enum>(1)</enum><text display-inline="yes-display-inline">Summaries of the annual reports submitted under subsection (h).</text></paragraph> <paragraph id="H8645F12042F34B3C81FBED42103F6A22"><enum>(2)</enum><text display-inline="yes-display-inline">Evaluations of the initiatives assisted with grant funds under the Program.</text></paragraph> 
<paragraph id="HFF0323BAB8E543A3B2608CD333CEB328"><enum>(3)</enum><text display-inline="yes-display-inline">An assessment of the effectiveness of the Program in—</text> <subparagraph id="H1DBF1E8003CD4386A135CF30453A8C55"><enum>(A)</enum><text display-inline="yes-display-inline">identifying risks associated with climate change for vulnerable individuals;</text></subparagraph> 
<subparagraph id="H6484892A31C44CCBA3D1584E6F7F3F10"><enum>(B)</enum><text>providing services and support to such individuals;</text></subparagraph> <subparagraph id="HB50AA6972E9F4934A8FCB2958A34870C"><enum>(C)</enum><text display-inline="yes-display-inline">mitigating levels of and exposure to such risks; and</text></subparagraph> 
<subparagraph id="HF301B0A2D4D14F0ABC36C1AFA17040AF"><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="H43A87CBF805544B682A57AE40571898A"><enum>(4)</enum><text display-inline="yes-display-inline">A description of how the Program could be expanded, including—</text> 
<subparagraph id="H5B0F15C7ED1D4498937710FD40F3CD9E"><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="HF2E2FA1DFE644237A53D1A5024C41FEF"><enum>(B)</enum><text display-inline="yes-display-inline">how such areas could be identified using the strategy developed under section 1205; and</text></subparagraph> 
<subparagraph id="HD1A38B6FF9D5453BA5A4077D6262D93C"><enum>(C)</enum><text display-inline="yes-display-inline">recommendations for additional funding.</text></subparagraph></paragraph></subsection> <subsection id="H2EBC1AB360744ABEAEDA986D8E6DE228"><enum>(j)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section:</text> 
<paragraph id="HCD08AD61CCB942348FAE40227EEE9B21"><enum>(1)</enum><text>The term <term>covered entity</term> means a consortium of organizations serving a county that—</text> <subparagraph id="H7659A04E517243F7AA269E228638A8B1"><enum>(A)</enum><text>shall include a community-based organization; and</text></subparagraph> 
<subparagraph id="H1FF5E67D681541099C5BC4433837FC2C"><enum>(B)</enum><text>may include—</text> <clause id="HCCC9A709626C42219FC7CADF8F117ADD"><enum>(i)</enum><text>another stakeholder organization;</text></clause> 
<clause id="HC2C5387B88764E9293262C2D8336C104"><enum>(ii)</enum><text display-inline="yes-display-inline">the government of such county;</text></clause> <clause id="H4E788AD70D7E470781E892C41565D205"><enum>(iii)</enum><text display-inline="yes-display-inline">the governments of one or more municipalities within such county;</text></clause> 
<clause id="H478B40273CB142A7BA3D21E5C29E298E"><enum>(iv)</enum><text>a State or local public health department or emergency management agency;</text></clause> <clause id="H6280BF5D4ACC4271A5206827F178CC6E"><enum>(v)</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></clause> 
<clause id="H58FFCBC79D29469EAADD747099070DCB"><enum>(vi)</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></clause> <clause id="H440C22561BAD4B7C9814AF3DFD596089"><enum>(vii)</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></clause> 
<clause id="HB10F606B8EAA493397A1D7BE3E957528"><enum>(viii)</enum><text display-inline="yes-display-inline">an institution of higher education.</text></clause></subparagraph></paragraph> <paragraph id="H5D48355BAABC4AF78CDE7A5703B91337"><enum>(2)</enum><text>The term <term>Program</term> means the grant program under this section.</text></paragraph></subsection> 
<subsection id="H1FE2DBEDFB7B40268B5D4B3743A133FB"><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 2027 through 2030.</text></subsection></section> <section id="H7C6FF2AA310B40BBBA8E5ACE23BFDA19"><enum>1203.</enum><header>Grant program for education and training at health profession schools</header> <subsection id="H804F1D6E1C1E4CBEBFF45CD618F6F49A"><enum>(a)</enum><header>In general</header><text>Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall establish a grant program 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="H510BF6AE24014BB294C927FCE8998DC3"><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="H8A81B444FEB942248860B6150D589F79"><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, which shall include, at a minimum, a description of the following:</text> 
<paragraph id="H4BB6432C1D9844429881B5F809D86A6C"><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="HA0C95F1329AF465E8F4351620ACA3CB8"><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="H3756BE0B2B1644F28907740E0F1FB9D8"><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="H6B959018624C4AB4A212D78FE6C07AE3"><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="HA161E544538C4EB3B1B6177216F19E58"><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="HF5A9323B61AE4954931A4CA180BA2E0F"><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="H26C40245F9A54BAD93E99CAA306F681F"><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="H1616AB628D3B42A6A32FF615540EB7C4"><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="HDB8E1BD43D93423984DAB50E4C82CEE7"><enum>(6)</enum><text>Implicit and explicit bias, racism, and discrimination.</text></paragraph> <paragraph id="H20FCA00934A0462A82DD451473B0CE06"><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="H1A9AEC7BECD348F69B08EACC516CF1ED"><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 one or more of the following:</text> <paragraph id="H99156DDBA9184E239C2F47508C216B04"><enum>(1)</enum><text>A State or local public health department.</text></paragraph> 
<paragraph id="H348EA9526A2E4C2CB0FB681FDA4F7282"><enum>(2)</enum><text display-inline="yes-display-inline">A health care professional membership organization.</text></paragraph> <paragraph id="HDCBF4D0959A54B5F8A4686D5ED8D2968"><enum>(3)</enum><text display-inline="yes-display-inline">A stakeholder organization.</text></paragraph> 
<paragraph id="H145AC6CBA8094AD99C79750EDF74D0CC"><enum>(4)</enum><text>A health profession school.</text></paragraph> <paragraph id="H9B679A288B09468090A632D011880058"><enum>(5)</enum><text>An institution of higher education.</text></paragraph></subsection> 
<subsection id="H7186C19FCD704166A7AC1FDC556EB56B"><enum>(f)</enum><header>Reports to Secretary</header> 
<paragraph id="HD0AF2572BF6A4160B3ADCAE36C25E465"><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="H38E7A29D8291447BA3E2437E5A90C8B2"><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="HED040FEE879E4D26A0F11E57BA801248"><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 the following:</text> <paragraph id="H9C3EE980783C498FAF2BB2E348072A4E"><enum>(1)</enum><text>A summary of the reports submitted under subsection (f).</text></paragraph> 
<paragraph id="HF3DF09CB7E524A3BB62C17CA428CAC91"><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="H965EC90F90D24EC980AFC95F12E90DFE"><enum>(h)</enum><header>Definitions</header><text>In this section:</text> 
<paragraph id="HD5A3BE63199641AA868A704BF9337E1C"><enum>(1)</enum><text>The term <term>health profession school</term> means an accredited—</text> <subparagraph id="HD14C152010B44EE2BE2189CE63C540D6"><enum>(A)</enum><text>medical school;</text></subparagraph> 
<subparagraph id="HB843B91B48A44840AF25EAC0BBA1B98A"><enum>(B)</enum><text>school of nursing;</text></subparagraph> <subparagraph id="HD01A5B26108349F1A0C88C640C6FF591"><enum>(C)</enum><text>midwifery program;</text></subparagraph> 
<subparagraph id="H6977309230B34ADFAB0EE70ECB316E67"><enum>(D)</enum><text>physician assistant education program;</text></subparagraph> <subparagraph id="H4CD1F99819404B3E8010A717CBB159CE"><enum>(E)</enum><text>teaching hospital;</text></subparagraph> 
<subparagraph id="HB227E03C896144FCAD537BFEA0DAA8EE"><enum>(F)</enum><text>residency or fellowship program; or</text></subparagraph> <subparagraph id="H88960B9DAA7B41CA8B04331BC9AAF05B"><enum>(G)</enum><text>other school or program determined appropriate by the Secretary.</text></subparagraph></paragraph> 
<paragraph id="HA3BC9639AB9D47F49178E7BC4B6856A3"><enum>(2)</enum><text display-inline="yes-display-inline">The term <term>Program</term> means the grant program under this section.</text></paragraph></subsection> <subsection id="HF63DA4D7AFA34BAF87AFA88CE03F85EC"><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 2027 through 2030.</text></subsection></section> 
<section id="HBB931EAC26084046902D508882EC6A38"><enum>1204.</enum><header>NIH Consortium on Birth and Climate Change Research</header> 
<subsection id="H861A26B406D542E783AD38E529196757"><enum>(a)</enum><header>Establishment</header><text>Not later than one year after the date of the 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="HAB8FA32CD42048F9AD15A6CCE21DC349"><enum>(b)</enum><header>Duties</header> <paragraph id="HAFBB6C2FF9954208A09F58AB00A7C66A"><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="H65AE8174B66C40D68A8B29D127B042D4"><enum>(2)</enum><header>Required activities</header><text>In carrying out paragraph (1), the Consortium shall—</text> <subparagraph id="H29DC757015CC4EE2B5B93637FAA2D130"><enum>(A)</enum><text display-inline="yes-display-inline">establish research priorities, including by prioritizing research that—</text> 
<clause id="HFAF1E8C3CC2E4D24BD94A6F6202F6E64"><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="HC54E7399F79B45538EF2A67191CDA187"><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="HEF4748C80F2A4518B0EAF71DFEB8BEB5"><enum>(B)</enum><text display-inline="yes-display-inline">identify gaps in available data related to such risks;</text></subparagraph> <subparagraph id="HB4D006917D234F0AAB14B47137886F37"><enum>(C)</enum><text>identify gaps in, and opportunities for, research collaborations;</text></subparagraph> 
<subparagraph id="HEEBADB3577AB4C5A91F91CD566CDAADC"><enum>(D)</enum><text>identify funding opportunities for community-based organizations and researchers from racially, ethnically, and geographically diverse backgrounds;</text></subparagraph> <subparagraph id="H86BF5635E8E349E2B6302891BC8C8A7F"><enum>(E)</enum><text display-inline="yes-display-inline">identify opportunities to increase public awareness related to risks associated with climate change for vulnerable individuals; and</text></subparagraph> 
<subparagraph id="H2E7B9D3D3C16491E916B753E9AD61A61"><enum>(F)</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="HF5E5DD5A68D146279C6FBF34D7E15F6B"><enum>(c)</enum><header>Membership</header><text display-inline="yes-display-inline">The Director shall appoint to the Consortium representatives of such institutes, centers, and offices of the National Institutes of Health as the Director considers appropriate, including, at a minimum, representatives of—</text> 
<paragraph id="H5AB7D2FA8D53483EB04D68D4FD9A2ED2"><enum>(1)</enum><text>the National Institute of Environmental Health Sciences;</text></paragraph> <paragraph id="H8C9B4F01A7604858A4A89264A4040C05"><enum>(2)</enum><text>the National Institute on Minority Health and Health Disparities;</text></paragraph> 
<paragraph id="H6DACDB5FAECA491F94DF8165A7B1035D"><enum>(3)</enum><text>the Eunice Kennedy Shriver National Institute of Child Health and Human Development;</text></paragraph> <paragraph id="HB9BF38ACC5D041CD85BD5147CA06BE5C"><enum>(4)</enum><text display-inline="yes-display-inline">the National Institute of Mental Health;</text></paragraph> 
<paragraph id="H9A6D4CFB5D304ED3BED8ECE5B4CF1669"><enum>(5)</enum><text>the National Institute of Nursing Research; and</text></paragraph> <paragraph id="H7BFE292D7A084335938AB56CF63C449D"><enum>(6)</enum><text>the Office of Research on Women’s Health.</text></paragraph></subsection> 
<subsection id="HB7E872C3E241467791773A054521A2A4"><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="H52870FD524354B59A25123E3732058EA"><enum>(e)</enum><header>Consultation</header><text>In carrying out the duties described in subsection (b), the Consortium shall consult with—</text> 
<paragraph id="H9E5A21F8993F43CAAF918BD762A4AF68"><enum>(1)</enum><text>the heads of relevant Federal agencies, including—</text> <subparagraph id="HE7C357F8A5A74C6A914AD3C460ED7971"><enum>(A)</enum><text>the Environmental Protection Agency;</text></subparagraph> 
<subparagraph id="HB4591B1A9CE84948911FFD1DB983638B"><enum>(B)</enum><text>the National Oceanic and Atmospheric Administration;</text></subparagraph> <subparagraph id="HEFBE02321C3A4DC09A8BECAD8CA9B2EA"><enum>(C)</enum><text>the Occupational Safety and Health Administration; and</text></subparagraph> 
<subparagraph id="H6BE92146458D4BEC9ECC5EB228646239"><enum>(D)</enum><text>from the Department of Health and Human Services—</text> <clause id="HC57974AA0ED9453184597A7D65F9A10C"><enum>(i)</enum><text display-inline="yes-display-inline">the Office of Minority Health in the Office of the Secretary;</text></clause> 
<clause id="HFA17A454B820475886F2970083E4B94E"><enum>(ii)</enum><text display-inline="yes-display-inline">the Centers for Medicare &amp; Medicaid Services;</text></clause> <clause id="H22327C15D2DD4AE6BC0C3FA46B8A3C18"><enum>(iii)</enum><text>the Health Resources and Services Administration;</text></clause> 
<clause id="HCF6B2D3D96044A41AC2F329D244161F6"><enum>(iv)</enum><text>the Centers for Disease Control and Prevention;</text></clause> <clause id="H0E5055C91E93449F967858BF9ECF7FE3"><enum>(v)</enum><text>the Indian Health Service; and</text></clause> 
<clause id="HD70DF5ED09AD453D8A6DCF3268423EC2"><enum>(vi)</enum><text>the Administration for Children and Families; and</text></clause></subparagraph></paragraph> <paragraph id="H480D514F676544A29F3DD2088DD08A51"><enum>(2)</enum><text>representatives of—</text> 
<subparagraph id="H1F36C06A1A2D4991A0311C3FE14A3AB5"><enum>(A)</enum><text>stakeholder organizations;</text></subparagraph> <subparagraph id="HF3CBAA353CE142028B1A2E37F51C775C"><enum>(B)</enum><text>health care providers and professional membership organizations with expertise in maternal health or environmental justice;</text></subparagraph> 
<subparagraph id="HE1DFBB5115244DDEB1D486EED3D4EFCC"><enum>(C)</enum><text>State and local public health departments;</text></subparagraph> <subparagraph id="H0274A38CEF724AC7BFFBEE911B024E27"><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="H2FC133FB7A1C4014BB736E5C42757BED"><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="H3D2487E6CC9346B09CA1FFFBF6473A3B"><enum>1205.</enum><header>Strategy for identifying climate change risk zones for vulnerable mothers and babies</header> <subsection id="H3AC85C61949C435BA0249AF62623DF8A"><enum>(a)</enum><header>In general</header><text>The Secretary of Health and Human Services, 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="H3BBA99CA64A640058EB215DF0C8189ED"><enum>(b)</enum><header>Strategy requirements</header> 
<paragraph id="H12B1ACF26CB94AF292C3CDAD8EF69A6A"><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="H9D7F658A9B184E24A9CF8F9F8BEE9847"><enum>(A)</enum><text>the incidence of diseases associated with air pollution, extreme heat, and other environmental factors;</text></subparagraph> 
<subparagraph id="H152BAA63720545AAAC117AA99E802E5A"><enum>(B)</enum><text>the availability and accessibility of maternal and infant health care providers;</text></subparagraph> <subparagraph id="H5FA8BA934BF144CA9D4E9E747CD3862B"><enum>(C)</enum><text>English-language proficiency among women of reproductive age;</text></subparagraph> 
<subparagraph id="H1B81B021DFB44E51B2FC3F894A9DB2DB"><enum>(D)</enum><text>the health insurance status of women of reproductive age;</text></subparagraph> <subparagraph id="HBFC8931C1A7749A2A1BF53FD6B685BC6"><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="HE90DBC8E077043FA8AD7FA0DD1386311"><enum>(F)</enum><text>the socioeconomic status of women of reproductive age, including with respect to—</text> <clause id="H0A9CB6C406814010BBA339DA721458D4"><enum>(i)</enum><text>poverty;</text></clause> 
<clause id="H85189C3D2AC041B1B831ECD9215D8216"><enum>(ii)</enum><text>unemployment;</text></clause> <clause id="HD7AB114DFAC94B4C984FA4BBEE049FDF"><enum>(iii)</enum><text>household income; and</text></clause> 
<clause id="HCBA053ABF2E547D8A4828988AA6371BE"><enum>(iv)</enum><text>educational attainment; and</text></clause></subparagraph> <subparagraph id="HAA14606E709E43C38BE85DF90F3BDF72"><enum>(G)</enum><text>access to quality housing, transportation, and nutrition.</text></subparagraph></paragraph> 
<paragraph id="H958CBF0C68BD4C6091CE59FB2EA0A898"><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="HC2EADBDF2C5A4364ACB355D3EB867275"><enum>(A)</enum><text display-inline="yes-display-inline">Existing mapping tools or Federal programs that identify—</text> 
<clause id="HA1D68ABDBEEB4CB9A56B6DA3271D3BE0"><enum>(i)</enum><text display-inline="yes-display-inline">risks associated with climate change for vulnerable individuals; and</text></clause> <clause id="H16D9562A66CC441D891801C90C6E77EB"><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="H9A9DBB7D479C4BFABC51CA8E600765EF"><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="H4B407C24317D47AAB138829F603B877B"><enum>(C)</enum><text>Existing monitoring networks that collect data described in subparagraph (B), and any gaps in such networks.</text></subparagraph> 
<subparagraph id="HF71CAF77034A45E8803DF2DCBD2FDDC0"><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="H8AF46596EEBB45AEB2C13A3F32562C80"><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="H65D26A1331254E1BBC4C38F3F2ADBF78"><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="H31BC564B6C114B0C843123401927ACEE"><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 1202 or other similar programs.</text></subparagraph> 
<subparagraph id="HB466E26DCBB546A69EF7399F53F5472F"><enum>(H)</enum><text>Other information the Secretary considers relevant for the development of the Strategy.</text></subparagraph></paragraph></subsection> <subsection id="HE48D448848D34C8AA67E578F02EF2FB6"><enum>(c)</enum><header>Coordination and consultation</header><text display-inline="yes-display-inline">In developing the Strategy, the Secretary shall—</text> 
<paragraph id="H552B5DECFFEA4C98BF0B718215B6DD3F"><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="H48CC16226E234B4DB2855C8D038D0BDD"><enum>(2)</enum><text>consult with—</text> 
<subparagraph id="H2C2093C493D54BE2A5BD4BE74DFED602"><enum>(A)</enum><text>stakeholder organizations;</text></subparagraph> <subparagraph id="HD9792C825B474DDEBDFEF33E7EC1792D"><enum>(B)</enum><text>health care providers and professional membership organizations with expertise in maternal health or environmental justice;</text></subparagraph> 
<subparagraph id="HA8BD35C3971B45E88A65EC9D7F642CFF"><enum>(C)</enum><text>State and local public health departments;</text></subparagraph> <subparagraph id="H02B0152D194E4210812C1861846A6F5E"><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="H1104D214981240C1AB3C1C80E117FC55"><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="H25EB6E9D0A874835B2E1CE111FA21500"><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="H6FB093A652E740558D8A09EBC12973CE"><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="H6C45C0430FDC46C0A6CAC89B6AA0E695"><enum>(2)</enum><text>an opportunity for public comment of at least 90 days.</text></paragraph></subsection> 
<subsection id="HFE00A7D9EF0641C5B9C63ADA006DE776"><enum>(e)</enum><header>Publication</header><text display-inline="yes-display-inline">Not later than 18 months after the date of the enactment of this Act, the Secretary shall publish on a public website of the Department of Health and Human Services—</text> <paragraph id="H95CB8433CA494992BB4C100A624BC13E"><enum>(1)</enum><text>the Strategy;</text></paragraph> 
<paragraph id="HCDD7C25DD1604DE59858A93855F7E537"><enum>(2)</enum><text>the public comments received under subsection (d); and</text></paragraph> <paragraph id="H164E893757A340D4B2C9940AEB3F23A0"><enum>(3)</enum><text>the responses of the Secretary to such public comments.</text></paragraph></subsection></section></title> 
<title id="H80ACBB682664466BB32A3ECA95789A63" commented="no"><enum>XIII</enum><header>NIH IMPROVE</header> 
<section id="H92F0691C8EEF47EF88540C542D1E17C0" commented="no"><enum>1301.</enum><header>IMPROVE Initiative</header><text display-inline="no-display-inline">Part B of title IV of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/284">42 U.S.C. 284 et seq.</external-xref>) is amended by adding at the end the following:</text> <quoted-block id="HAA3874AD18FB46E2814D1EF3F29A1884" display-inline="no-display-inline" style="OLC"> <section id="H8B93B2F30F8F48F3A6778CEC4F0A0931" commented="no"><enum>409K.</enum><header>IMPROVE initiative</header> <subsection id="H583F5AF2328647DCB20BB60E380FA2E7" commented="no"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Director of NIH shall continue to carry out a program to improve maternal health outcomes, to be known as the Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone Initiative or the <quote>IMPROVE Initiative</quote> (referred to in this section as the <quote>Initiative</quote>).</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H5E4456C9B9A743F7976A964D76A8F61D"><enum>(b)</enum><header>Objectives</header><text>The Initiative shall—</text> <paragraph id="H94D0C9474089464E815DD917EDFF7840" commented="no"><enum>(1)</enum><text>advance research to—</text> 
<subparagraph id="H1C246FAC188C4308AE3DF918206A39DE" commented="no"><enum>(A)</enum><text>reduce preventable causes of maternal mortality and severe maternal morbidity;</text></subparagraph> <subparagraph id="HB80990393F4D447688312A25CB753E33" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">reduce health disparities related to maternal health outcomes, including such disparities associated with populations with disproportionately high rates of maternal mortality and severe maternal morbidity relative to the national rate; and</text></subparagraph> 
<subparagraph id="H93419F85A1BA44BA83BCF4B0E4CFAE56" commented="no"><enum>(C)</enum><text>improve health for pregnant and postpartum women before, during, and after pregnancy;</text></subparagraph></paragraph> <paragraph id="H8C44640B7BF44E9080302EE89159245A" commented="no"><enum>(2)</enum><text display-inline="yes-display-inline">use an integrated approach to understand the factors, including biological, behavioral, and other factors, that affect maternal mortality and severe maternal morbidity by building an evidence base for improved outcomes in specific regions of the United States; and</text></paragraph> 
<paragraph id="H4EB39FBAD91C4B628AF9A14B1473FD6D" commented="no"><enum>(3)</enum><text display-inline="yes-display-inline">target health disparities associated with maternal mortality and severe maternal morbidity by—</text> <subparagraph id="HBC98159B810A41CEADEF2B427F9DAC21" commented="no"><enum>(A)</enum><text>implementing and evaluating community-based interventions for disproportionately affected women; and</text></subparagraph> 
<subparagraph id="HDBA6301074E74478924048D399A0B15C" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">identifying risk factors and the underlying biological mechanisms associated with leading causes of maternal mortality and severe maternal morbidity in the United States.</text></subparagraph></paragraph></subsection> <subsection id="HBAB5E2EBC4924A25B03F7AEAEB2BE4AE" commented="no"><enum>(c)</enum><header>Implementation</header><text display-inline="yes-display-inline">The Director of NIH may award grants or enter into contracts, cooperative agreements, or other transactions to carry out this section.</text></subsection> 
<subsection id="HF23952E23E3E4F9ABC14B0C2A89E31FD" 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 $73,400,000 for each of fiscal years 2027 through 2032.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section></title> <title id="HBD5C3D860DB74399AA56BEDF9546EB79"><enum>XIV</enum><header>Maternal vaccinations</header> <section id="HFC3FFEA2EF9C4F0DB8531EE8C8B8317A"><enum>1401.</enum><header>Maternal vaccination awareness and equity campaign</header> <subsection id="HE1D0257A01DE42ECB1DA0AEC6D972FB8"><enum>(a)</enum><header>Campaign</header><text>Section 313 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/245">42 U.S.C. 245</external-xref>) is amended—</text> 
<paragraph id="H61B889599C884E0F80447099DEB9ABB5"><enum>(1)</enum><text>in subsection (a), by inserting <quote>and among pregnant and postpartum individuals,</quote> after <quote>low rates of vaccination,</quote>;</text></paragraph> <paragraph id="H407649732A474148A5B5BA255D87E714"><enum>(2)</enum><text>in subsection (c)(3), by striking <quote>prenatal and pediatric</quote> and inserting <quote>prenatal, obstetric, and pediatric</quote>;</text></paragraph> 
<paragraph id="H193FE6ADEEBF4F6C94F1E4BE4D4849A1"><enum>(3)</enum><text>in subsection (d)(4)(B), by inserting <quote>pregnant and postpartum individuals and</quote> after <quote>including</quote>; and</text></paragraph> <paragraph id="H42A859BDD107452C9E68AD5C0915A675"><enum>(4)</enum><text>in subsection (g), by striking <quote>$15,000,000 for each of fiscal years 2021 through 2025</quote> and inserting <quote>$17,000,000 for each of fiscal years 2027 through 2031</quote>.</text></paragraph></subsection> 
<subsection id="HB762F3216E5841A8B0DC02264B37F8C1"><enum>(b)</enum><header>Additional activities</header><text>Section 317(k)(1)(E) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b">42 U.S.C. 247b(k)(1)(E)</external-xref>) is amended—</text> <paragraph id="HDBE3C8EDC3614901AF184FCF316DE197"><enum>(1)</enum><text>in clause (v), by striking <quote>and</quote> at the end; and</text></paragraph> 
<paragraph id="H785FD3F8CE9A499390172C476ACF3BC2"><enum>(2)</enum><text>by adding at the end the following:</text> <quoted-block id="H1D913A3ACEA84C2D9312C40546C2F372" style="OLC"> <clause id="H2B8788E1402F400789505B5401360B74"><enum>(vii)</enum><text>increase vaccination rates of pregnant and postpartum individuals, including individuals from racial and ethnic minority groups, and their children; and</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section></title> 
</legis-body></bill>

