[Congressional Record Volume 166, Number 163 (Monday, September 21, 2020)]
[House]
[Pages H4623-H4626]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            MATERNAL HEALTH QUALITY IMPROVEMENT ACT OF 2020

  Mrs. DINGELL. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4995) to amend the Public Health Service Act to improve 
obstetric care and maternal health outcomes, and for other purposes, as 
amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4995

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Maternal Health Quality 
     Improvement Act of 2020''.

     SEC. 2. INNOVATION FOR MATERNAL HEALTH.

       Part D of title III of the Public Health Service Act (42 
     U.S.C. 254b et seq.) is amended--
       (1) in the section designation of section 330M of such Act 
     (42 U.S.C. 254c-19) by inserting a period after ``330M''; and
       (2) by inserting after section 330M of such Act (42 U.S.C. 
     254c-19) the following:

     ``SEC. 330N. INNOVATION FOR MATERNAL HEALTH.

       ``(a) In General.--The Secretary, in consultation with 
     experts representing a variety of clinical specialties, 
     State, Tribal, or local public health officials, researchers, 
     epidemiologists, statisticians, and community organizations, 
     shall establish or continue a program to award competitive 
     grants to eligible entities for the purposes of--
       ``(1) identifying, developing, or disseminating best 
     practices to improve maternal health care quality and 
     outcomes, eliminate preventable maternal mortality and severe 
     maternal morbidity, and improve infant health outcomes, which 
     may include--
       ``(A) information on evidence-based practices to improve 
     the quality and safety of maternal health care in hospitals 
     and other health care settings of a State or health care 
     system, including by addressing topics commonly associated 
     with health complications or risks related to prenatal care, 
     labor care, birthing, and postpartum care;
       ``(B) best practices for improving maternal health care 
     based on data findings and reviews conducted by a State 
     maternal mortality review committee that address topics of 
     relevance to common complications or health risks related to 
     prenatal care, labor care, birthing, and postpartum care; and
       ``(C) information on addressing determinants of health that 
     impact maternal health outcomes for women before, during, and 
     after pregnancy;
       ``(2) collaborating with State maternal mortality review 
     committees to identify issues for the development and 
     implementation of evidence-based practices to improve 
     maternal health outcomes and reduce preventable maternal 
     mortality and severe maternal morbidity;
       ``(3) providing technical assistance and supporting the 
     implementation of best practices identified pursuant to 
     paragraph (1) to entities providing health care services to 
     pregnant and postpartum women; and
       ``(4) identifying, developing, and evaluating new models of 
     care that improve maternal and infant health outcomes, which 
     may include the integration of community-based services and 
     clinical care.
       ``(b) Eligible Entities.--To be eligible for a grant under 
     subsection (a), an entity shall--
       ``(1) submit to the Secretary an application at such time, 
     in such manner, and containing such information as the 
     Secretary may require; and
       ``(2) demonstrate in such application that the entity is 
     capable of carrying out data-driven maternal safety and 
     quality improvement initiatives in the areas of obstetrics 
     and gynecology or maternal health.
       ``(c) Authorization of Appropriations.--To carry out this 
     section, there are authorized to be appropriated $5,000,000 
     for each of fiscal years 2021 through 2025.''.

     SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS.

       Title VII of the Public Health Service Act is amended by 
     striking section 763 (42 U.S.C. 294p) and inserting the 
     following:

     ``SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS.

       ``(a) Grant Program.--The Secretary shall establish a 
     program to award grants to accredited schools of allopathic 
     medicine, osteopathic medicine, and nursing, and other health 
     professional training programs for the training of health 
     care professionals to reduce and prevent discrimination 
     (including training related to implicit and explicit biases) 
     in the provision of health care services related to prenatal 
     care, labor care, birthing, and postpartum care.
       ``(b) Eligibility.--To be eligible for 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.
       ``(c) Reporting Requirement.--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, including a description of the impact of such training 
     on patient outcomes, as applicable.
       ``(d) Best Practices.--The Secretary may identify and 
     disseminate best practices for the training of health care 
     professionals to reduce and prevent discrimination (including 
     training related to implicit and explicit biases) in the 
     provision of health care services related to prenatal care, 
     labor care, birthing, and postpartum care.
       ``(e) Authorization of Appropriations.--To carry out this 
     section, there are authorized to be appropriated $5,000,000 
     for each of fiscal years 2021 through 2025.''.

     SEC. 4. STUDY ON TRAINING TO REDUCE AND PREVENT 
                   DISCRIMINATION.

       Not later than 2 years after date of enactment of this Act, 
     the Secretary of Health and Human Services shall, through a 
     contract with an independent research organization, conduct a 
     study and make recommendations for accredited schools of 
     allopathic medicine, osteopathic medicine, and nursing, and 
     other health professional training programs, on best 
     practices related to training to reduce and prevent 
     discrimination, including training related to implicit and 
     explicit biases, in the provision of health care services 
     related to prenatal care, labor care, birthing, and 
     postpartum care.

     SEC. 5. PERINATAL QUALITY COLLABORATIVES.

       Section 317K(a)(2) of the Public Health Service Act (42 
     U.S.C. 247b-12(a)(2)) is amended by adding at the end the 
     following:
       ``(E)(i) The Secretary, acting through the Director of the 
     Centers for Disease Control and Prevention and in 
     coordination with other offices and agencies, as appropriate, 
     shall establish or continue a competitive grant program for 
     the establishment or support of perinatal quality 
     collaboratives to improve perinatal care and perinatal health 
     outcomes for pregnant and postpartum women and their infants. 
     A State, Indian Tribe, or Tribal organization may use funds 
     received through such grant to--
       ``(I) support the use of evidence-based or evidence-
     informed practices to improve outcomes for maternal and 
     infant health;
       ``(II) work with clinical teams; experts; State, local, 
     and, as appropriate, Tribal public health officials; and 
     stakeholders, including patients and families, to identify, 
     develop, or disseminate best practices to improve perinatal 
     care and outcomes; and
       ``(III) employ strategies that provide opportunities for 
     health care professionals and clinical teams to collaborate 
     across health care settings and disciplines, including 
     primary care and mental health, as appropriate, to improve 
     maternal and infant health outcomes, which may include the 
     use of data to provide timely feedback across hospital and 
     clinical teams to inform responses, and to provide support 
     and training to hospital and clinical teams for quality 
     improvement, as appropriate.
       ``(ii) To be eligible for a grant under clause (i), an 
     entity shall submit to the Secretary an application in such 
     form and manner and containing such information as the 
     Secretary may require.''.

     SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM 
                   WOMEN.

       (a) Grants.--Title III of the Public Health Service Act is 
     amended by inserting after section 330N of such Act, as added 
     by section 2, the following:

     ``SEC. 330O. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM 
                   WOMEN.

       ``(a) In General.--The Secretary may award grants to 
     States, Indian Tribes, and Tribal organizations for the 
     purpose of establishing or operating evidence-based or 
     innovative, evidence-informed programs to deliver integrated 
     health care services to pregnant and postpartum women to 
     optimize the health of women and their infants, including to 
     reduce adverse maternal health outcomes, pregnancy-related 
     deaths, and related health disparities (including such 
     disparities associated with racial and ethnic minority 
     populations), and, as appropriate, by addressing issues 
     researched under subsection (b)(2) of section 317K.
       ``(b) Integrated Services for Pregnant and Postpartum 
     Women.--
       ``(1) Eligibility.--To be eligible to receive a grant under 
     subsection (a), a State, Indian Tribe, or Tribal organization 
     shall work with relevant stakeholders that coordinate care 
     (including coordinating resources and referrals for health 
     care and social services) to develop and carry out the 
     program, including--
       ``(A) State, Tribal, and local agencies responsible for 
     Medicaid, public health, social services, mental health, and 
     substance use disorder treatment and services;
       ``(B) health care providers who serve pregnant and 
     postpartum women; and
       ``(C) community-based health organizations and health 
     workers, including providers of home visiting services and 
     individuals representing communities with disproportionately 
     high rates of maternal mortality and severe maternal 
     morbidity, and including individuals representing racial and 
     ethnic minority populations.
       ``(2) Terms.--
       ``(A) Period.--A grant awarded under subsection (a) shall 
     be made for a period of 5 years. Any supplemental award made 
     to a grantee under subsection (a) may be made for a period of 
     less than 5 years.

[[Page H4624]]

       ``(B) Preference.--In awarding grants under subsection (a), 
     the Secretary shall--
       ``(i) give preference to States, Indian Tribes, and Tribal 
     organizations that have the highest rates of maternal 
     mortality and severe maternal morbidity relative to other 
     such States, Indian Tribes, or Tribal organizations, 
     respectively; and
       ``(ii) shall consider health disparities related to 
     maternal mortality and severe maternal morbidity, including 
     such disparities associated with racial and ethnic minority 
     populations.
       ``(C) Priority.--In awarding grants under subsection (a), 
     the Secretary shall give priority to applications from up to 
     15 entities described in subparagraph (B)(i).
       ``(D) Evaluation.--The Secretary shall require grantees to 
     evaluate the outcomes of the programs supported under the 
     grant.
       ``(c) Definitions.--In this section, the terms `Indian 
     Tribe' and `Tribal organization' have the meanings given the 
     terms `Indian tribe' and `tribal organization', respectively, 
     in section 4 of the Indian Self-Determination and Education 
     Assistance Act.
       ``(d) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $10,000,000 for each of fiscal years 2021 through 2025.''.
       (b) Report on Grant Outcomes and Dissemination of Best 
     Practices.--
       (1) Report.--Not later than February 1, 2026, the Secretary 
     of Health and Human Services shall submit to the Committee on 
     Health, Education, Labor, and Pensions of the Senate and the 
     Committee on Energy and Commerce of the House of 
     Representatives a report that describes--
       (A) the outcomes of the activities supported by the grants 
     awarded under the amendment made by this section on maternal 
     and child health;
       (B) best practices and models of care used by recipients of 
     grants under such amendment; and
       (C) obstacles identified by recipients of grants under such 
     amendment, and strategies used by such recipients to deliver 
     care, improve maternal and child health, and reduce health 
     disparities.
       (2) Dissemination of best practices.--Not later than August 
     1, 2026, the Secretary of Health and Human Services shall 
     disseminate information on best practices and models of care 
     used by recipients of grants under the amendment made by this 
     section (including best practices and models of care relating 
     to the reduction of health disparities, including such 
     disparities associated with racial and ethnic minority 
     populations, in rates of maternal mortality and severe 
     maternal morbidity) to relevant stakeholders, which may 
     include health providers, medical schools, nursing schools, 
     relevant State, Tribal, and local agencies, and the general 
     public.

     SEC. 7. IMPROVING RURAL MATERNAL AND OBSTETRIC CARE DATA.

       (a) Maternal Mortality and Morbidity Activities.--Section 
     301(e) of the Public Health Service Act (42 U.S.C. 241(e)) is 
     amended by inserting ``, preventable maternal mortality and 
     severe maternal morbidity,'' after ``delivery''.
       (b) Office of Women's Health.--Section 310A(b)(1) of the 
     Public Health Service Act (42 U.S.C. 242s(b)(1)) is amended 
     by striking ``and sociocultural contexts,'' and inserting 
     ``sociocultural (including among American Indians, Native 
     Hawaiians, and Alaska Natives), and geographical contexts''.
       (c) Safe Motherhood.--Section 317K of the Public Health 
     Service Act (42 U.S.C. 247b-12) is amended--
       (1) in subsection (a)(2)(A), by inserting ``, including 
     improving collection of data on race, ethnicity, and other 
     demographic information'' before the period; and
       (2) in subsection (b)(2)--
       (A) in subparagraph (L), by striking ``and'' at the end;
       (B) by redesignating subparagraph (M) as subparagraph (N); 
     and
       (C) by inserting after subparagraph (L) the following:
       ``(M) an examination of the relationship between maternal 
     health and obstetric services in rural areas and outcomes in 
     delivery and postpartum care; and''.
       (d) Office of Research on Women's Health.--Section 486 of 
     the Public Health Service Act (42 U.S.C. 287d) is amended--
       (1) in subsection (b), by amending paragraph (3) to read as 
     follows:
       ``(3) carry out paragraphs (1) and (2) with respect to--
       ``(A) the aging process in women, with priority given to 
     menopause; and
       ``(B) pregnancy, with priority given to deaths related to 
     preventable maternal mortality and severe maternal 
     morbidity;''; and
       (2) in subsection (d)(4)(A)(iv), by inserting ``, including 
     preventable maternal morbidity and severe maternal 
     morbidity'' before the semicolon.

     SEC. 8. RURAL OBSTETRIC NETWORK GRANTS.

       The Public Health Service Act is amended by inserting after 
     section 330A-1 (42 U.S.C. 254c-1a) the following:

     ``SEC. 330A-2. RURAL OBSTETRIC NETWORK GRANTS.

       ``(a) Program Established.--The Secretary shall award 
     grants or cooperative agreements to eligible entities to 
     establish collaborative improvement and innovation networks 
     (referred to in this section as `rural obstetric networks') 
     to improve maternal and infant health outcomes and reduce 
     preventable maternal mortality and severe maternal morbidity 
     by improving maternity care and access to care in rural 
     areas, frontier areas, maternity care health professional 
     target areas, or jurisdictions of Indian Tribes and Tribal 
     organizations.
       ``(b) Use of Funds.--Grants or cooperative agreements 
     awarded pursuant to this section shall be used for the 
     establishment or continuation of collaborative improvement 
     and innovation networks to improve maternal health in rural 
     areas by improving infant health and maternal outcomes and 
     reducing preventable maternal mortality and severe maternal 
     morbidity. Rural obstetric networks established in accordance 
     with this section may--
       ``(1) develop a network to improve coordination and 
     increase access to maternal health care and assist pregnant 
     women in the areas described in subsection (a) with accessing 
     and utilizing maternal and obstetric care, including health 
     care services related to prenatal care, labor care, birthing, 
     and postpartum care to improve outcomes in birth and maternal 
     mortality and morbidity;
       ``(2) identify and implement evidence-based and sustainable 
     delivery models for maternal and obstetric care (including 
     health care services related to prenatal care, labor care, 
     birthing, and postpartum care for women in the areas 
     described in subsection (a), including home visiting programs 
     and culturally appropriate care models that reduce health 
     disparities;
       ``(3) develop a model for maternal health care 
     collaboration between health care settings to improve access 
     to care in areas described in subsection (a), which may 
     include the use of telehealth;
       ``(4) provide training for professionals in health care 
     settings that do not have specialty maternity care;
       ``(5) collaborate with academic institutions that can 
     provide regional expertise and help identify barriers to 
     providing maternal health care, including strategies for 
     addressing such barriers; and
       ``(6) assess and address disparities in infant and maternal 
     health outcomes, including among racial and ethnic minority 
     populations and underserved populations in areas described in 
     subsection (a).
       ``(c) Definitions.--In this section:
       ``(1) Eligible entities.--The term `eligible entities' 
     means entities providing maternal health care services in 
     rural areas, frontier areas, or medically underserved areas, 
     or to medically underserved populations or Indian Tribes or 
     Tribal organizations.
       ``(2) Frontier area.--The term `frontier area' means a 
     frontier county, as defined in section 
     1886(d)(3)(E)(iii)(III) of the Social Security Act.
       ``(3) Indian tribes; tribal organization.--The terms 
     `Indian Tribe' and `Tribal organization' have the meanings 
     given the terms `Indian tribe' and `tribal organization', 
     respectively, in section 4 of the Indian Self-Determination 
     and Education Assistance Act.
       ``(4) Maternity care health professional target area.--The 
     term `maternity care health professional target area' has the 
     meaning described in section 332(k)(2).
       ``(d) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $3,000,000 for each of fiscal years 2021 through 2025.''.

     SEC. 9. TELEHEALTH NETWORK AND TELEHEALTH RESOURCE CENTERS 
                   GRANT PROGRAMS.

       Section 330I of the Public Health Service Act (42 U.S.C. 
     254c-14) is amended--
       (1) in subsection (f)(3), by adding at the end the 
     following:
       ``(M) Providers of maternal care, including prenatal, labor 
     care, birthing, and postpartum care services and entities 
     operating obstetric care units.''; and
       (2) in subsection (h)(1)(B), by inserting ``labor care, 
     birthing care, postpartum care,'' before ``or prenatal''.

     SEC. 10. RURAL MATERNAL AND OBSTETRIC CARE TRAINING 
                   DEMONSTRATION.

       Subpart 1 of part E of title VII of the Public Health 
     Service Act (42 U.S.C. 294n et seq.) is amended by adding at 
     the end the following:

     ``SEC. 764. RURAL MATERNAL AND OBSTETRIC CARE TRAINING 
                   DEMONSTRATION.

       ``(a) In General.--The Secretary shall award grants to 
     accredited schools of allopathic medicine, osteopathic 
     medicine, and nursing, and other appropriate health 
     professional training programs, to establish a training 
     demonstration program to support--
       ``(1) training for physicians, medical residents, fellows, 
     nurse practitioners, physician assistants, nurses, certified 
     nurse midwives, relevant home visiting workforce 
     professionals and paraprofessionals, or other professionals 
     who meet relevant State training and licensing requirements, 
     as applicable, to provide maternal health care services in 
     rural community-based settings; and
       ``(2) developing recommendations for such training 
     programs.
       ``(b) Application.--To be eligible to receive a grant under 
     subsection (a), an entity shall submit to the Secretary an 
     application at such time, in such manner, and containing such 
     information as the Secretary may require.
       ``(c) Activities.--
       ``(1) Training for health care professionals.--A recipient 
     of a grant under subsection (a)--
       ``(A) shall use the grant funds to plan, develop, and 
     operate a training program to provide maternal health care in 
     rural areas; and
       ``(B) may use the grant funds to provide additional support 
     for the administration of the program or to meet the costs of 
     projects to establish, maintain, or improve faculty

[[Page H4625]]

     development, or departments, divisions, or other units 
     necessary to implement such training.
       ``(2) Training program requirements.--The recipient of a 
     grant under subsection (a) shall ensure that training 
     programs carried out under the grant are evidence-based and 
     address improving maternal health care in rural areas, and 
     such programs may include training on topics such as--
       ``(A) maternal mental health, including perinatal 
     depression and anxiety;
       ``(B) substance use disorders;
       ``(C) social determinants of health that affect individuals 
     living in rural areas; and
       ``(D) implicit and explicit bias.
       ``(d) Evaluation and Report.--
       ``(1) Evaluation.--
       ``(A) In general.--The Secretary shall evaluate the 
     outcomes of the demonstration program under this section.
       ``(B) Data submission.--Recipients of a grant under 
     subsection (a) shall submit to the Secretary performance 
     metrics and other related data in order to evaluate the 
     program for the report described in paragraph (2).
       ``(2) Report to congress.--Not later than January 1, 2025, 
     the Secretary shall submit to the Committee on Health, 
     Education, Labor, and Pensions of the Senate and the 
     Committee on Energy and Commerce of the House of 
     Representatives a report that includes--
       ``(A) an analysis of the effects of the demonstration 
     program under this section on the quality, quantity, and 
     distribution of maternal health care services, including 
     health care services related to prenatal care, labor care, 
     birthing, and postpartum care, and the demographics of the 
     recipients of those services;
       ``(B) an analysis of maternal and infant health outcomes 
     (including quality of care, morbidity, and mortality) before 
     and after implementation of the program in the communities 
     served by entities participating in the demonstration 
     program; and
       ``(C) recommendations on whether the demonstration program 
     should be continued.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $5,000,000 for each of fiscal years 2021 through 2025.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
Michigan (Mrs. Dingell) and the gentleman from Montana (Mr. Gianforte) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from Michigan.


                             General Leave

  Mrs. DINGELL. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on H.R. 4995.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Michigan?
  There was no objection.
  Mrs. DINGELL. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 4995, the Maternal 
Health Quality Improvement Act of 2020.
  Every 12 hours, an American woman dies of a pregnancy-related 
complication. This is a public health crisis, and the Maternal Health 
Quality Improvement Act creates robust new programs to meet this need. 
This includes improving rural maternal healthcare through the creation 
of rural obstetric network grants, as well as expanding the use of 
telehealth.
  The legislation also promotes innovation in maternal healthcare by 
creating a new grant program to develop and disseminate best practices 
to improve health quality and outcomes and help eliminate maternal 
mortality.
  Additionally, the Maternal Health Quality Improvement Act includes 
provisions to address racial disparities in maternal health outcomes by 
funding training programs for healthcare professionals, as well as 
allowing HHS to disseminate best practices to reduce and prevent 
discrimination.
  Finally, the legislation authorizes funding for perinatal quality 
collaboratives, multi-State networks to improve health outcomes for 
pregnant and postpartum women and their infants, as well as creating a 
grant program to integrate services and reduce adverse maternal health 
outcomes.
  Madam Speaker, these robust provisions represent a strong step toward 
addressing the ongoing health crisis facing America's pregnant and 
postpartum women.
  Madam Speaker, I thank my colleagues, Representatives Engel, Bucshon, 
Torres Small, Latta, Adams, and Stivers, for their tireless work on 
this legislation.
  Madam Speaker, I urge my colleagues to support this legislation, and 
I reserve the balance of my time.
  Mr. GIANFORTE. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise today in support of H.R. 4995, the Maternal 
Health Quality Improvement Act, which was introduced by Representatives 
Engel, Bucshon, Torres Small, Latta, Adams, and Stivers.
  The legislation authorizes grants for developing and sharing maternal 
health best practices and training health professionals.
  It also supports the Health Resources and Services Administration's 
establishment of rural health networks to reduce maternal and child 
mortality rates and reduce inequities in health outcomes amongst 
different populations.
  It also ensures obstetric care is an eligible service for telehealth 
grants.
  Madam Speaker, I want to thank the American Hospital Association, the 
March of Dimes, the American Medical Association, and others for their 
support of this legislation.
  Madam Speaker, I urge my colleagues to support this bipartisan 
legislation, and I reserve the balance of my time.
  Mrs. DINGELL. Madam Speaker, I reserve the balance of my time.
  Mr. GIANFORTE. Madam Speaker, I yield 3 minutes to the gentleman from 
Indiana (Mr. Bucshon).
  Mr. BUCSHON. Madam Speaker, as a physician and a father of four, I 
understand the importance of ensuring the health of mothers during 
pregnancy and after the delivery of their newborns. This is a critical 
time for both the mother and the child.
  Sadly, Indiana has an unacceptably high maternal mortality rate, 
ranking third in the country. We can do better.
  We must do better in our approach across the entire Nation, 
especially in rural America, to use best practices and provide the 
necessary resources to stop preventable maternal mortality. The 
Maternal Health Quality Improvement Act is a great first step toward 
doing just that.
  H.R. 4995 includes the Excellence in Maternal Health Act, legislation 
I introduced along with my fellow Hoosier, Representative Andre Carson.
  This bipartisan legislation will benefit patients and communities 
that are currently struggling, like those in my home State of Indiana, 
by providing them with the support and the training they so desperately 
need.
  Madam Speaker, together, we can work to help mothers and their 
children achieve better health outcomes. I urge my colleagues to 
support H.R. 4995.
  Mrs. DINGELL. Madam Speaker, I reserve the balance of my time.
  Mr. GIANFORTE. Madam Speaker, I appreciate Dr. Bucshon's leadership 
on this bill. I am excited to see this pass the House.
  Madam Speaker, I urge my colleagues to support this important 
legislation, and I yield back the balance of my time.
  Mrs. DINGELL. Madam Speaker, I agree with my colleagues passionately 
in the need to take care of our mothers when they are pregnant, the 
newborns, and then their postpartum health. This bill is an important 
first step, and I urge my colleagues to support this legislation.
  Madam Speaker, I yield back the balance of my time.
  Mr. CARSON of Indiana. Madam Speaker, I rise today in strong support 
of the Maternal Health Quality Improvement Act of 2019 (H.R. 4995). 
This important bill includes my legislation, the Excellence in Maternal 
Health Act of 2019 (H.R. 4215), that I introduced last year with my 
fellow Hoosier, Rep. Bucshon. l want to thank Rep. Engel for including 
my legislation in this package. I urge my House colleagues to pass H.R. 
4995 without delay.
  Maternal mortality--which occurs when a woman dies during pregnancy 
or within one year of delivery--is a nationwide, public health 
emergency. The United States has the highest maternal death rate in the 
developed world; 26 women die for every 100,000 live birth in our 
country. This unacceptably high level of maternal mortality robs our 
country of between 700 and 900 women from causes related to pregnancy 
and childbirth.
  However, this crisis does not affect all states equally. Maternal 
mortality is especially devastating in states like Indiana. Our state 
has the third highest maternal mortality rate in the country where, 
often due to preventable complications, a staggering 43 out of 100,000 
women die during or shortly after giving birth.
  The maternal mortality crisis also does not affect all mothers 
equally; in fact, the racial and ethnic disparities in maternal 
mortality are

[[Page H4626]]

extremely stark. Nationwide, Black women are three to four times more 
likely to die from maternal health complications than white women. In 
Indiana, Black women are 29 percent more likely to die during 
childbirth than white women, as 53 black women die per 100,000 live 
births versus 41 deaths among white women. Research consistently shows 
that disparities in access to quality health care, inadequate health 
care training, discrimination and bias, and the lack of high-quality 
integrated maternal health care continue to compound existing health 
care disparities that produce the disproportionate levels of maternal 
mortality among Black mothers.
  That's why in August 2019, I introduced the Excellence in Maternal 
Health Act of 2019 with my fellow Hoosier, Rep. Bucshon. Our bipartisan 
legislation works to improve maternal health access and quality, reduce 
racial and ethnic disparities and discrimination in health care 
delivery, and create grant programs to implement best practices and 
strengthen training for health care providers.
  Specifically, our legislation provides $10 million to help develop 
and enact best practices to eliminate maternal morality through 
improved maternal health access and quality. Additionally, our 
legislation provides $25 million over five years to establish a grant 
program to train health care professionals on ways to reduce and 
prevent racial discrimination in providing prenatal care, labor care, 
birthing, and postpartum care. Finally, our legislation provides $15 
million in grants to help states deliver integrated health care 
services that reduce maternal mortality and related health disparities.
  I was pleased that in November 2019, the House Energy and Commerce 
Committee included our Carson/Bucshon legislation into Rep. Engel's 
larger legislative package, the Maternal Health Quality Improvement Act 
of 2019 and was unanimously approved by the Committee. I urge all of my 
House colleagues to now pass H.R. 4995 to implement the programs and 
reforms in my legislation that will help end the scourge of preventable 
maternal mortality in our country and ensure the birth of a child is a 
joyous and safe occasion for families across America.
  The SPEAKER pro tempore (Ms. Stevens). The question is on the motion 
offered by the gentlewoman from Michigan (Mrs. Dingell) that the House 
suspend the rules and pass the bill, H.R. 4995, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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