[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 380 Reported in Senate (RS)]

<DOC>





                                                       Calendar No. 525
119th CONGRESS
  2d Session
                                 S. 380

                  To improve obstetric emergency care.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            February 4, 2025

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

                             July 28, 2026

               Reported by Mr. Cassidy, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
                  To improve obstetric emergency care.

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

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Rural Obstetrics Readiness 
Act''.</DELETED>

<DELETED>SEC. 2. OBSTETRIC EMERGENCY TRAINING PROGRAM.</DELETED>

<DELETED>    Section 330O of the Public Health Service Act (42 U.S.C. 
254c-21) is amended--</DELETED>
        <DELETED>    (1) in subsection (a)--</DELETED>
                <DELETED>    (A) in paragraph (3), by striking ``; 
                and'' and inserting a semicolon;</DELETED>
                <DELETED>    (B) in paragraph (4), by striking the 
                period and inserting ``; and''; and</DELETED>
                <DELETED>    (C) by adding at the end the 
                following:</DELETED>
        <DELETED>    ``(5) developing, and facilitating access to, an 
        evidence-based program to train practitioners in rural health 
        care facilities without dedicated obstetric units to provide 
        emergency obstetric services during pregnancy, labor, delivery, 
        or the postpartum period, including training on how to prepare 
        for, identify, stabilize, and safely transfer, as appropriate 
        and within the scope of practice of an individual practitioner, 
        a woman experiencing labor, delivery, obstetric hemorrhage, 
        severe hypertension, cardiac conditions, perinatal mental 
        health conditions, substance use, sepsis, or other conditions, 
        as appropriate.'';</DELETED>
        <DELETED>    (2) by redesignating subsections (c) and (d) as 
        subsections (d) and (e), respectively;</DELETED>
        <DELETED>    (3) by inserting after subsection (b) the 
        following:</DELETED>
<DELETED>    ``(c) Training Program for Eligible Practitioners in Rural 
Health Care Facilities.--A training program described in subsection 
(a)(5) shall include an assessment of obstetric training needs for 
rural health care facilities without dedicated obstetric units. In 
developing the training program, a recipient of a grant under such 
subsection shall--</DELETED>
        <DELETED>    ``(1) work in consultation with at least one 
        representative from a national medical society that has 
        experience or expertise in rural health care delivery in each 
        of the fields of gynecology and obstetrics, emergency medicine, 
        family medicine, and anesthesiology; and</DELETED>
        <DELETED>    ``(2) facilitate access to obstetric readiness 
        training via regional training partnerships and technical 
        assistance to rural health care facilities.''; and</DELETED>
        <DELETED>    (4) in subsection (e), as so redesignated, by 
        adding at the end the following: ``In addition to amounts 
        appropriated under the previous sentence, for grants for the 
        purpose described in subsection (a)(5), there are authorized to 
        be appropriated $5,000,000 for the period of fiscal years 2026 
        through 2028''.</DELETED>

<DELETED>SEC. 3. GRANT FUNDING FOR EQUIPMENT AND SUPPLIES.</DELETED>

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

<DELETED>``SEC. 330A-3. PROGRAM OF SUPPORT FOR OBSTETRIC 
              SERVICES.</DELETED>

<DELETED>    ``(a) In General.--The Secretary shall award grants, 
contracts, or cooperative agreements to eligible entities to integrate 
obstetric readiness training curriculum into rural health care 
settings, build workforce capacity, and purchase equipment necessary to 
manage obstetric emergencies.</DELETED>
<DELETED>    ``(b) Use of Funds.--A recipient of funds under this 
section shall use such funds for the purpose described in subsection 
(a), which may include any of the following:</DELETED>
        <DELETED>    ``(1) Purchasing or providing equipment and 
        technical assistance to train practitioners who are not 
        specialized in obstetrics in preparing for, identifying, 
        stabilizing, and transferring, as appropriate and within the 
        scope of practice of the practitioner, individuals experiencing 
        obstetric emergencies.</DELETED>
        <DELETED>    ``(2) Purchasing or providing equipment necessary 
        to prepare for, identify, stabilize, or transfer, as 
        appropriate, individuals experiencing obstetric 
        emergencies.</DELETED>
        <DELETED>    ``(3) Developing and carrying out protocols for 
        transfer of patients to other facilities and network engagement 
        with other facilities.</DELETED>
        <DELETED>    ``(4) Hiring additional personnel or paying the 
        salaries of personnel.</DELETED>
        <DELETED>    ``(5) Establishing training opportunities to 
        enable non-obstetric health professionals to gain exposure to, 
        and expertise in, the delivery of obstetric services, including 
        through clinical rotations, fellowships, or cross-training 
        clinicians in other specialties.</DELETED>
        <DELETED>    ``(6) Enabling clinical educators to coordinate, 
        develop, and implement comprehensive interdisciplinary 
        trainings, including team-based simulation training for 
        providers who may need to respond to an obstetric 
        emergency.</DELETED>
<DELETED>    ``(c) Eligible Entities.--To be eligible to receive a 
grant under this section, an entity shall--</DELETED>
        <DELETED>    ``(1) be--</DELETED>
                <DELETED>    ``(A) a rural hospital, critical access 
                hospital (as determined under section 1820(c)(2) of the 
                Social Security Act), or a rural emergency hospital (as 
                defined in section 1861(kkk)(2) of the Social Security 
                Act) that is located in a maternity care health 
                professional target area or a rural area (as defined by 
                the Secretary); or</DELETED>
                <DELETED>    ``(B) a consortium of 3 entities that 
                includes at least 2 entities described in subparagraph 
                (A); and</DELETED>
        <DELETED>    ``(2) agree to carry out the program described in 
        subsection (a), in coordination with other federally funded 
        maternal and child health programs, to the extent practicable, 
        and in consultation with other maternal and child health 
        programs in the same geographic area.</DELETED>
<DELETED>    ``(d) Definitions.--In this section--</DELETED>
        <DELETED>    ``(1) the term `maternity care health professional 
        target area' means a primary care health professional shortage 
        area that is experiencing a shortage of maternity health care 
        professionals, as identified under section 332(k); 
        and</DELETED>
        <DELETED>    ``(2) the term `rural area' has the meaning given 
        such term by the Federal Office of Rural Health 
        Policy.</DELETED>
<DELETED>    ``(e) Authorization of Appropriations.--To carry out this 
section, there is authorized to be appropriated $15,000,000 for the 
period of fiscal years 2026 through 2029.''.</DELETED>

<DELETED>SEC. 4. PILOT PROGRAM FOR TELECONSULTATION.</DELETED>

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

<DELETED>``SEC. 330A-4. PILOT PROGRAM FOR TELECONSULTATION.</DELETED>

<DELETED>    ``(a) In General.--The Secretary, acting through the 
Administrator of the Health Resources and Services Administration and 
in consultation with the Administrator of the Centers for Medicare & 
Medicaid Services, shall award grants or cooperative agreements to 
States, political subdivisions of States, and Indian Tribes and Tribal 
organizations (as such terms are defined in section 4 of the Indian 
Self-Determination and Education Assistance Act) to support the 
provision of urgent maternal health care in rural facilities without a 
dedicated obstetric unit, including by--</DELETED>
        <DELETED>    ``(1) supporting the development of statewide or 
        regional maternal health care telehealth access programs; 
        and</DELETED>
        <DELETED>    ``(2) supporting the improvement of existing 
        statewide or regional maternal health care telehealth access 
        programs described in subsection (b).</DELETED>
<DELETED>    ``(b) Statewide or Regional Maternal Health Care 
Telehealth Access Programs.--A maternal health care telehealth access 
program described in this section, with respect to which an award under 
subsection (a) may be used, shall--</DELETED>
        <DELETED>    ``(1) be a statewide or regional network of 
        maternal health care teams that provide urgent support to rural 
        non-obstetric settings of care;</DELETED>
        <DELETED>    ``(2) support and further develop organized State 
        or regional networks of maternal health care teams to provide 
        urgent consultative support to rural non-obstetric settings of 
        care;</DELETED>
        <DELETED>    ``(3) conduct an assessment of urgent maternal 
        health consultation needs among providers in rural non-
        obstetric settings of care;</DELETED>
        <DELETED>    ``(4) provide assurances that the physicians 
        responsive to the tele-consultation line are credentialed 
        within their employing facility and can provide consultation 
        where the patient is receiving care consistent with State 
        requirements to provide care to individuals experiencing labor, 
        delivery, obstetric hemorrhage, severe hypertension in 
        pregnancy and postpartum, cardiac conditions related to or 
        exacerbated by pregnancy, perinatal mental health conditions, 
        substance use during pregnancy or the postpartum period, sepsis 
        during pregnancy or after pregnancy end, or other conditions, 
        as appropriate;</DELETED>
        <DELETED>    ``(5) provide rapid statewide or regional clinical 
        telephone or telehealth consultations when requested between 
        the maternal care teams and providers in rural emergency non-
        obstetric settings; and</DELETED>
        <DELETED>    ``(6) provide information to health care providers 
        about available maternal health services for people in the 
        community and assist with referrals to specialty care and 
        community or behavioral health resources.</DELETED>
<DELETED>    ``(c) Reporting.--An entity receiving an award under this 
section shall submit a report to the Secretary, in such manner and 
containing such information as the Secretary may require, not later 
than 18 months after initial receipt of the grant.</DELETED>
<DELETED>    ``(d) Authorization of Appropriations.--To carry out this 
section, there is authorized to be appropriated $5,000,000 for the 
period of fiscal years 2026 through 2029.''.</DELETED>

<DELETED>SEC. 5. STUDY ON OBSTETRIC UNITS IN RURAL AREAS.</DELETED>

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Obstetrics Readiness Act''.

SEC. 2. RURAL OBSTETRIC MEDICAL EMERGENCY TRAINING.

    Section 330A-2 of the Public Health Service Act (42 U.S.C. 254c-1b) 
is amended--
            (1) in subsection (b)--
                    (A) by amending paragraph (3) to read as follows:
            ``(3) develop a model for maternal health care 
        collaboration between health care settings to improve access to 
        care, including stabilizing prenatal care, labor care, 
        birthing, and postpartum care services during obstetric 
        emergencies, in areas described in subsection (a) that do not 
        have specialty maternity care or dedicated obstetric units, 
        which may include the use of telehealth;''; and
                    (B) by amending paragraph (4) to read as follows:
            ``(4) provide training for professionals in areas described 
        in subsection (a) that do not have specialty maternity care or 
        dedicated obstetric units, including providing training in 
        stabilizing prenatal care, labor care, birthing, and postpartum 
        care during obstetric emergencies;'';
                    (C) in paragraph (5), by striking ``; and'' and 
                inserting a semicolon;
                    (D) in paragraph (6), by striking the period and 
                inserting ``; and''; and
                    (E) by adding at the end the following:
            ``(7) develop obstetric readiness programs, in areas 
        described in subsection (a) that do not have specialty 
        maternity care or dedicated obstetric units, that provide 
        technical assistance necessary to provide stabilizing prenatal 
        care, labor care, birthing, and postpartum care services during 
        obstetric emergencies.'';
            (2) in subsection (d)--
                    (A) in the subsection heading, by striking 
                ``Report'' and inserting ``Reports'';
                    (B) in the matter preceding paragraph (1), by 
                striking ``2026,'' and inserting ``2028, and every 2 
                years thereafter,'';
                    (C) in paragraph (1)--
                            (i) by striking ``(6)'' and inserting 
                        ``(7)''; and
                            (ii) by striking ``; and'' and inserting a 
                        semicolon;
                    (D) in paragraph (2), by striking the period at the 
                end and inserting ``; and''; and
                    (E) by adding at the end the following:
            ``(3) a study that maps maternity ward closures and 
        regional patterns of patient transport and examines models for 
        regional partnerships for rural obstetric care.'';
            (3) by redesignating subsection (e) as subsection (f);
            (4) by inserting after subsection (d) the following:
    ``(e) Allocation.--
            ``(1) In general.--Subject to the availability of 
        appropriations, the Secretary shall award a total of not less 
        than $2,000,000 per fiscal year in grants or cooperative 
        agreements under this section to eligible entities for purposes 
        of carrying out activities described in paragraph (3), (4), or 
        (7) of subsection (b).
            ``(2) Limitation.--Paragraph (1) shall not apply to a 
        fiscal year unless the amount made available to carry out this 
        section for such fiscal year exceeds the amount appropriated to 
        carry out this section for fiscal year 2026.''; and
            (5) in subsection (f), as so redesignated, by inserting ``, 
        and $15,000,000 for each of fiscal years 2028 through 2032'' 
        before the period at the end.

SEC. 3. SUPPORT OF EMERGENCY OBSTETRIC MEDICAL SERVICES.

    Section 330O of the Public Health Service Act (42 U.S.C. 254c-21) 
is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1)--
                            (i) in the matter preceding subparagraph 
                        (A) by inserting ``and training'' after ``best 
                        practices'';
                            (ii) in subparagraph (B)--
                                    (I) by inserting ``evidence-based'' 
                                before ``best practices''; and
                                    (II) by striking ``; and'' and 
                                inserting a semicolon;
                            (iii) in subparagraph (C), by adding 
                        ``and'' after the semicolon at the end; and
                            (iv) by adding at the end the following:
                    ``(D) evidence-based best practices for health care 
                professionals in rural health care settings that do not 
                have specialty maternity care or dedicated obstetric 
                units to provide stabilizing prenatal care, labor care, 
                birthing, and postpartum care services during obstetric 
                emergencies;''; and
                    (B) in paragraph (3), by inserting ``, including in 
                rural health care settings that do not have specialty 
                maternity care or dedicated obstetric units'' before 
                the semicolon; and
            (2) in subsection (d), by inserting ``, and $17,300,000 for 
        each of fiscal years 2028 through 2032'' before the period at 
        the end.

SEC. 4. TELEHEALTH NETWORK; TELEHEALTH RESOURCE CENTERS GRANT PROGRAM; 
              EXPANDING CAPACITY FOR HEALTH OUTCOMES.

    (a) Telehealth Network; Telehealth Resource Centers Grant 
Program.--Section 330I of the Public Health Service Act (42 U.S.C. 
254c-14) is amended--
            (1) in subsection (h)(1), by amending subparagraph (B) to 
        read as follows:
                    ``(B) Services.--The eligible entity proposes to 
                use Federal funds made available through such a grant 
                to develop plans for, or to establish, telehealth 
                networks that provide mental health care, public health 
                services, long-term care, home care, preventive care, 
                case management services, urgent care, prenatal care, 
                labor care, birthing care, or postpartum care.''; and
            (2) in subsection (q), by striking ``2021 through 2025'' 
        and inserting ``2027 through 2031''.
    (b) Expanding Capacity for Health Outcomes.--Section 330N(k) of the 
Public Health Service Act (42 U.S.C. 254c-20(k)) is amended by striking 
``2022 through 2026'' and inserting ``2027 through 2031''.
                                                       Calendar No. 525

119th CONGRESS

  2d Session

                                 S. 380

_______________________________________________________________________

                                 A BILL

                  To improve obstetric emergency care.

_______________________________________________________________________

                             July 28, 2026

                       Reported with an amendment