,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #dbaf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #ab1 #bjad ,mr4  
,cony]s 7= himself & ,ms4 ,de,gette7    
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce  ,a  
,,bill  ,to am5d title ,v ( ! ,social   
,security ,act to provide grants to     
,/ates to e/abli% ,/ate mat]nal         
mortality review committees on          
pregnancy-relat$ dea?s occurr+ )9 su*   
,/ates2 to develop def9itions ( sev]e   
mat]nal morbidity & data collection     
protocols2 & to elim9ate disp>ities 9   
mat]nal heal? outcomes4  #a4 ,%ort title
 ,?is ,act may be cit$ z ! ,mat]nal     
,heal? ,acc\ntability ,act ( #bjad4  #b4
 ,f9d+s2 purposes  7a7 ,f9d+s ,congress 
f9ds ! foll[+3  7#a7 ,! aggregate       
pregnancy-relat$ mortality ratio 9 !    
,unit$ ,/ates z measur$ by ! ,c5t]s =   
,disease ,control & ,prev5tion          
,pregnancy ,mortality ,surveillance     
,sy/em 0 #ad4e = ! #h-ye> p]iod #aiih   
?r\gh #bjje1 high] ?an any o!r p]iod 9 !

 previ\s #bj ye>s4 ,al?\gh ?is increase 
may reflect *anges 9 data collection    
me?ods by ! ,/ates1 ?is report$         
increase1 along ) no improvem5t 9       
previ\s ye>s rema9s a s\rce ( great     
conc]n = ! ,c5t]s = ,disease ,control & 
,prev5tion1 & regi/]$ nurses1 heal? c>e 
provid]s1 & pati5t advocates su* z !    
,jo9t ,commission1 ! ,am]ican ,college (
 ,ob/etricians & ,gynecologi/s1 &       
,amne/y ,int]national4  7#b7 ,! ,c5t]s =
 ,disease ,control & ,prev5tion has f\nd
 t mat]nal dea?s %\ld be inve/igat$     
?r\gh ,/ate-bas$ mat]nal dea? reviews & 
mat]nal quality collaboratives1 z ^!    
entities are well-situat$ to id5tify    
dea?s1 review ! factors associat$ ) !m1 
& take action ) ! f9d+s 9 ord] to       
in/itute ! sy/emic *anges ne$$ to       
decrease pregnancy-relat$ &             
pregnancy-associat$ mortality4  7#c7    
,wom5 ( color & l[-income wom5 face add$
 risks 9 t]ms ( dea?1 complications1 &  
access to quality heal? c>e4            
,african-,am]ican wom5 are ?ree to f\r  

times m likely to die ( pregnancy-relat$
 complications ?an ,:ite wom54 ,9 #bjjf 
! ,c5t]s = ,disease ,control &          
,prev5tion report$ t ! mat]nal mortality
 ratio = non-,hispanic ,:ite wom5 0 #i4a
 dea?s p] #ajj1jjj bir?s comp>$ ) #cd4h 
dea?s p] #ajj1jjj bir?s = non-,hispanic 
,black wom54 ,^! rates & disp>ities h n 
improv$ 9 m ?an #bj ye>s4  7#d7 ,heal?y 
,p #bjaj1 a compreh5sive1 nationwide    
heal? promotion & disease prev5tion     
ag5da laun*$ by ! ,dep>tm5t ( ,heal? &  
,human ,s]vices1 set a t>get goal (     
r$uc+ mat]nal mortality 9 ! ,unit$      
,/ates to #d4c dea?s p] #ajj1jjj live   
bir?s by #bjaj4 ,9 #bjjg1 ! national    
mat]nal mortality ratio 0 #ab4g dea?s p]
 #ajj1jjj live bir?s4  7#e7 ,sev]e      
complications t result 9 wom5 ne>ly dy+1
 kn[n z a ne> miss or sev]e mat]nal     
morbidity has increas$ by #ge p]c5t =   
deliv]y 7bas$ on data comp>+ #aiih ?r\gh
 #aiii7 & #aad p]c5t = po/p>tum         
hospitalizations 7bas$ on data comp>+   
#bjjh ?r\gh #bjji74 ,su* data also      

e/imates t sev]e morbidity affects      
#eb1jjj wom5 a ye> & is expect$ to      
cont9ue to increase4 ,moreov]1 !re is no
 sci5tific cons5sus on uni=m def9itions 
( sev]e mat]nal morbidity & be/         
practices = data collection1 mak+ x     
difficult to measure ! full ext5t (     
sev]e morbidity & develop+ evid5ce-bas$ 
int]v5tions4  7b7 ,purposes ,! purposes 
( ?is ,act are ! foll[+3  7#a7 ,to      
e/abli% gov]nm5tal acc\ntability & a %>$
 responsibility betwe5 ,/ates & ! ,f$]al
 ,gov]nm5t to id5tify opportunities =   
improvem5t 9 quality ( c>e & sy/em      
*anges1 & to educate & in=m heal?       
in/itutions & pr(essionals1 wom51 &     
families ab\t prev5t+ pregnancy-relat$  
dea?s & complications & r$uc+           
disp>ities4  7#b7 ,to develop a model = 
,/ates to op]ate mat]nal mortality      
reviews & assess ! v>i\s factors t may h
 contribut$ to mat]nal mortality1       
includ+ quality ( c>e1 racial           
disp>ities1 & sy/emic problems 9 !      
deliv]y ( heal? c>e1 & to develop       

appropriate int]v5tions to r$uce &      
prev5t su* dea?s4  #c4 ,uni=m ,/ate     
mat]nal mortality review committees on  
pregnancy-relat$ dea?s  7a7 ,condition (
 receipt ( paym5ts f allotm5t "u        
,mat]nal & ,*ild ,heal? ,s]vice ,block  
,grant ,title ,v ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #gja et seq47 is    
am5d$ by add+ at ! end ! foll[+ new     
section3  #ead4 ,uni=m ,/ate mat]nal    
mortality review committees on          
pregnancy-relat$ dea?s  7a7 ,grants     
7#a7 ,9 g5]al ,not)/&+ any o!r provision
 ( ?is title1 = ea* ( fiscal ye>s #bjae 
?r\gh #bjba1 9 addition to paym5ts f    
allotm5ts = ,/ates "u section #ejb = su*
 ye>1 ! ,secret>y %all1 subject to      
p>agraph 7#c7 & 9 accordance ) ! crit]ia
 e/abli%$ "u p>agraph 7#b71 aw>d grants 
to ,/ates to--  7,a7 c>ry out !         
activities describ$ 9 subsection        
7b77#a72  7,b7 e/abli% a ,/ate mat]nal  
mortality review committee1 9 accordance
 ) subsection 7b77#b71 to c>ry out !    
activities describ$ 9 subsection        

7b77#b77;,a71 & to e/abli% ! processes  
describ$ 9 subsection 7b77#a72  7,c7    
ensure ! ,/ate dep>tm5t ( heal? c>ries  
out ! applicable activities describ$ 9  
subsection 7b77#c71 ) respect to        
pregnancy-relat$ dea?s occurr+ )9 !     
,/ate dur+ su* fiscal ye>2  7,d7        
implem5t & use ! compreh5sive case      
ab/raction =m develop$ "u subsection    
7c71 9 accordance ) su* subsection2     
7,e7 provide = public disclosure (      
in=mation1 9 accordance ) subsection    
7e72 &  7,f7 collect1 analyze1 & report 
to ! ,secret>y cases ( mat]nal          
morbidity1 includ+ reports ( mat]nal    
morbidity data on admissions to an      
int5sive c>e unit or ! transfusion ( m  
?an ?ree units ( blood products4  7#b7  
,crit]ia ,! ,secret>y %all e/abli%      
crit]ia = det]m9+ eligibility = & !     
am\nt ( a grant aw>d$ to a ,/ate "u     
p>agraph 7#a74 ,su* crit]ia %all provide
 t 9 ! case ( a ,/ate t receives su* a  
grant = a fiscal ye> & is det]m9$ by !  
,secret>y to h n us$ su* grant 9        

accordance ) ?is section1 su* ,/ate %all
 n be eligible = su* a grant = any      
subsequ5t fiscal ye>4  7#c7             
,au?orization ( appropriations ,=       
purposes ( c>ry+ out ! grant program "u 
?is section1 includ+ = adm9i/rative     
purposes1 !re is au?oriz$ to be         
appropriat$ #aj1jjj1jjj = ea* ( fiscal  
ye>s #bjae ?r\gh #bjba4  7b7            
,pregnancy-,relat$ dea? review  7#a7    
,review ( pregnancy-relat$ dea? &       
pregnancy-associat$ dea? cases ,=       
purposes ( subsection 7a71 ) respect to 
a ,/ate t receives a grant "u subsection
 7a71 ! foll[+ %all apply3  7,a7        
,m&atory report+ ( pregnancy-relat$     
dea?s  7i7 ,9 g5]al ,! ,/ate %all1 ?r\gh
 ! ,/ate mat]nal mortality review       
committee1 develop a process1 sep>ate f 
any report+ process e/abli%$ by ! ,/ate 
dep>tm5t ( heal? prior to ! date ( !    
enactm5t ( ?is section1 t provides =    
m&atory & confid5tial case report+ by   
individuals & entities describ$ 9 clause
 7ii7 ( pregnancy-relat$ dea?s to !     

,/ate dep>tm5t ( heal?4  7ii7           
,individuals & ,entities describ$       
,individuals & entities describ$ 9 ?is  
clause include ea* ( ! foll[+3  7,i7    
,heal? c>e provid]s4  7,,ii7 ,m$ical    
exam9]s4  7,,iii7 ,m$ical coron]s4      
7,,iv7 ,hospitals4  7,v7 ,free-/&+ bir? 
c5t]s4  7,,vi7 ,o!r heal? c>e           
facilities4  7,,vii7 ,any o!r           
individuals responsible = complet+ dea? 
c]tificates4  7,,viii7 ,any o!r         
appropriate individuals or entities     
specifi$ by ! ,secret>y4  7,b7 ,volunt>y
 report+ ( pregnancy-relat$ &           
pregnancy-associat$ dea?s  7i7 ,! ,/ate 
%all1 ?r\gh ! ,/ate mat]nal mortality   
review committee1 develop a process = & 
enc\rage1 sep>ate f any report+ process 
e/abli%$ by ! ,/ate dep>tm5t ( heal?    
prior to ! date ( ! enactm5t ( ?is      
section1 volunt>y & confid5tial case    
report+ by individuals describ$ 9 clause
 7ii7 ( pregnancy-associat$ dea?s to !  
,/ate dep>tm5t ( heal?4  7ii7 ,! ,/ate  
%all1 ?r\gh ! ,/ate mat]nal mortality   

review committee1 develop a process =   
volunt>y & confid5tial report+ by family
 memb]s ( ! deceas$ & by o!r individuals
 on possible pregnancy-relat$ &         
pregnancy-associat$ dea?s to ! ,/ate    
dep>tm5t ( heal?4 ,su* process %all     
include--  7,i7 mak+ publicly available 
on ! ,int]net ,web site ( ! ,/ate       
dep>tm5t ( heal? a telephone numb]1     
,int]net ,web l9k1 & email address = su*
 report+2 &  7,,ii7 publiciz+ to local  
pr(essional organizations1 community    
organizations1 & social s]vices ag5cies 
! availability ( ! telephone numb]1     
,int]net ,web l9k1 & email address made 
available "u subclause 7,i74  7,c7      
,developm5t ( case-f9d+ ,! ,/ate1 ?r\gh 
! vital /ati/ics unit ( ! ,/ate1 %all   
annually id5tify pregnancy-relat$ &     
pregnancy-associat$ dea?s occurr+ 9 su* 
,/ate dur+ ! ye> involv$ by--  7i7 mat*+
 all dea? records1 ) respect to su* ye>1
 = wom5 ( *ildbe>+ age to live bir?     
c]tificates & infant dea? c]tificates to
 id5tify dea?s ( wom5 t occurr$ dur+    

pregnancy & )9 "o ye> aft] ! end ( a    
pregnancy2  7ii7 id5tify+ dea?s report$ 
dur+ su* ye> z hav+ an und]ly+ or       
contribut+ cause ( dea? relat$ to       
pregnancy1 reg>dless ( ! "t t has pass$ 
betwe5 ! end ( ! pregnancy & ! dea?2    
7iii7 collect+ data f m$ical exam9] &   
coron] reports2 &  7iv7 any o!r me?ods !
 ,/ates may devise to id5tify mat]nal   
dea?s1 su* z ?r\gh review ( a r&om      
sample ( report$ dea?s ( wom5 ( *ildbe>+
 age to asc]ta9 cases ( pregnancy-relat$
 & pregnancy-associat$ dea?s t are n    
disc]nable f a review ( dea? c]tificates
 alone4  ,:5 feasible & = purposes (    
effectively collect+ & obta9+ data on   
pregnancy-relat$ & pregnancy-associat$  
dea?s1 ! ,/ate %all adopt ! mo/ rec5t   
/&>diz$ bir? & dea? c]tificates1 z issu$
 by ! ,national ,c5t] = ,vital ,heal?   
,/ati/ics1 includ+ ! recomm5d$ *eckbox  
section = pregnancy on ! dea?           
c]tificates4  7,d7 ,case inve/igation & 
developm5t ( case summ>ies ,foll[+      
receipt ( reports by ! ,/ate dep>tm5t ( 

heal? pursuant to subp>agraph 7,a7 or   
7,b7 & collection by ! vital /ati/ics   
unit ( ! ,/ate ( possible cases (       
pregnancy-relat$ & pregnancy-associat$  
dea?s pursuant to subp>agraph 7,c71 !   
,/ate1 ?r\gh ! ,/ate mat]nal mortality  
review committee e/abli%$ "u subsection 
7a71 %all inve/igate ea* case1 utiliz+ !
 case ab/raction =m describ$ 9          
subsection 7c71 & prep>e de-id5tifi$    
case summ>ies1 :i* %all be review$ by ! 
committee & includ$ 9 applicable        
reports4 ,= purposes ( subsection 7a71  
"u ! processes e/abli%$ "u subp>agraphs 
7,a71 7,b71 & 7,c71 a ,/ate dep>tm5t (  
heal? or vital /ati/ics unit ( a ,/ate  
%all provide to ! ,/ate mat]nal         
mortality review committee access to    
in=mation collect$ pursuant to su*      
subp>agraphs z necess>y to c>ry out ?is 
subp>agraph4 ,data & in=mation collect$ 
= ! case summ>y & review are = purposes 
( public heal? activities1 9 accordance 
) ,,hipaa privacy & security law 7z     
def9$ 9 section #cjji7;a77#b7 ( !       

,public ,heal? ,s]vice ,act74 ,su* case 
inve/igations %all include data &       
in=mation obta9$ ?r\gh--  7i7 m$ical    
exam9] & autopsy reports ( ! woman      
involv$2  7ii7 m$ical records ( ! woman1
 includ+ su* records relat$ to heal? c>e
 prior to pregnancy1 pr5atal & po/natal 
c>e1 labor & deliv]y c>e1 em]g5cy room  
c>e1 hospital dis*>ge records1 & any c>e
 deliv]$ up until ! "t ( dea? ( ! woman 
= purposes ( public heal? activities1 9 
accordance ) ,,hipaa privacy & security 
law 7z def9$ 9 section #cjji7;a77#b7 ( !
 ,public ,heal? ,s]vice ,act72  7iii7   
oral & writt5 int]views ( individuals   
directly involv$ 9 ! mat]nal c>e ( !    
woman dur+ & imm$iately foll[+ !        
pregnancy ( ! woman1 includ+ heal? c>e1 
m5tal heal?1 & social s]vice provid]s1 z
 applicable2  7iv7 optional oral or     
writt5 int]views ( ! family ( ! woman2  
7v7 socioeconomic & o!r relevant        
backgr\nd in=mation ab\t ! woman2  7vi7 
in=mation collect$ 9 subp>agraph        
7,c77i72 &  7vii7 o!r in=mation on !    

cause ( dea? ( ! woman1 su* z social    
s]vices & *ild welf>e reports4  7#b7    
,/ate mat]nal mortality review          
committees  7,a7 ,duties  7i7 ,requir$  
committee activities ,= purposes (      
subsection 7a71 a mat]nal mortality     
review committee e/abli%$ by a ,/ate    
pursuant to a grant "u su* subsection   
%all c>ry out ! foll[+ pregnancy-relat$ 
dea? & pregnancy-associat$ dea? review  
activities & %all include all in=mation 
relevant to ! dea? involv$ on ! case    
ab/raction =m develop$ "u subsection    
7d73  7,i7 ,) respect to a case (       
pregnancy-relat$ or pregnancy-associat$ 
dea? ( a woman1 review ! case summ>ies  
prep>$ "u subp>agraphs 7,a71 7,b71 7,c71
 & 7,d7 ( p>agraph 7#a74  7,,ii7 ,review
 aggregate /ati/ical reports develop$ by
 ! vital /ati/ics unit ( ! ,/ate "u     
p>agraph 7#a77;,c7 reg>d+               
pregnancy-relat$ & pregnancy-associat$  
dea?s to id5tify tr5ds1 patt]ns1 &      
disp>ities 9 adv]se outcomes & address  
m$ical1 non-m$ical1 & sy/em-relat$      

factors t may h contribut$ to su*       
pregnancy-relat$ & pregnancy-associat$  
dea?s & disp>ities4  7,,iii7 ,develop   
recomm5dations1 bas$ on ! review ( !    
case summ>ies "u p>agraph 7#a77;,d7 &   
aggregate /ati/ical reports "u subclause
 7,,ii71 to improve mat]nal c>e1 social 
& heal? s]vices1 & public heal? policy &
 in/itutions1 includ+ ) respect to      
improv+ access to mat]nal c>e1 improv+ !
 availability ( social s]vices1 &       
elim9at+ disp>ities 9 mat]nal c>e &     
outcomes4  7ii7 ,optional committee     
activities ,= purposes ( subsection 7a71
 a mat]nal mortality review committee   
e/abli%$ by a ,/ate "u su* subsection   
may pres5t f9d+s & recomm5dations reg>d+
 a specific case or set ( circum/ances  
directly to a heal? c>e facility or its 
local or ,/ate pr(essional organization 
= ! purpose ( in/itut+ policy *anges1   
educational activities1 or o!rwise      
improv+ ! quality ( c>e provid$ by !    
facilities4  7,b7 ,composition ( mat]nal
 mortality review committees  7i7 ,9    

,g5]al ,ea* ,/ate mat]nal mortality     
review committee e/abli%$ pursuant to a 
grant "u subsection 7a7 %all be         
multi-discipl9>y1 consi/+ ( heal? c>e & 
social s]vice provid]s1 public heal?    
(ficials1 o!r p]sons ) pr(essional      
exp]tise on mat]nal heal? & mortality1 &
 pati5t & community advocates :o        
repres5t ^? communities )9 su* ,/ate t  
are ! mo/ affect$ by mat]nal mortality4 
,memb]%ip on su* a committee ( a ,/ate  
%all be review$ annually by ! ,/ate     
dep>tm5t ( heal? to ensure t memb]%ip   
repres5tation requirem5ts are be+       
fulfill$ 9 accordance ) ?is p>agraph4   
7ii7 ,requir$ memb]%ip ,ea* su* review  
committee %all include--  7,i7          
repres5tatives f m$ical specialities    
provid+ c>e to pregnant & po/p>tum      
pati5ts1 includ+ ob/etricians 7includ+  
g5]ali/s & mat]nal fetal m$ic9e         
speciali/s71 & family practice          
physicians2  7,,ii7 c]tifi$ nurse       
midwives1 c]tifi$ midwives1 & advanc$   
practice nurses2  7,,iii7 hospital-bas$ 

regi/]$ nurses2  7,,iv7 repres5tatives (
 ! ,/ate dep>tm5t ( heal? mat]nal & *ild
 heal? dep>tm5t2  7,v7 social s]vice    
provid]s or social work]s2  7,,vi7 !    
*ief m$ical exam9]s or designees2       
7,,vii7 facility repres5tatives1 su* z f
 hospitals or free-/&+ bir? c5t]s2 &    
7,,viii7 community or pati5t advocates  
:o repres5t ^? communities )9 ! ,/ate t 
are ! mo/ affect$ by mat]nal mortality4 
7iii7 ,additional memb]s ,ea* su* review
 committee may also include             
repres5tatives f o!r relevant academic1 
heal?1 social s]vice1 or policy         
pr(essions1 or community organizations1 
on an ongo+ basis1 or z ne$$1 z det]m9$ 
b5eficial by ! review committee1        
includ+--  7,i7 ane/hesiologi/s2  7,,ii7
 em]g5cy physicians2  7,,iii7           
pa?ologi/s2  7,,iv7 epidemiologi/s or   
bio/ati/icians2  7,v7 int5sivi/s2       
7,,vi7 vital /ati/ics (fic]s2  7,,vii7  
nutritioni/s2  7,,viii7 m5tal heal?     
pr(essionals2  7,,ix7 sub/ance abuse    
treatm5t speciali/s2  7,x7              

repres5tatives ( relevant advocacy      
gr\ps2  7,,xi7 academics2  7,,xii7      
repres5tatives ( b5efici>ies ( ! ,/ate  
plan "u ! ,m$icaid program "u title     
,,xix2  7,,xiii7 p>am$ics2  7,,xiv7     
lawy]s2  7,,xv7 risk managem5t          
speciali/s2  7,,xvi7 repres5tatives ( ! 
dep>tm5ts ( heal? or public heal? (     
major cities 9 ! ,/ate involv$2 &       
7,,xvii7 policy mak]s4  7iv7 ,div]se    
community memb]%ip ,! composition ( su* 
a committee1 ) respect to a ,/ate1 %all 
include--  7,i7 repres5tatives f div]se 
communities1 p>ticul>ly ^? communities  
)9 su* ,/ate mo/ sev]ely affect$ by     
pregnancy-relat$ dea?s or               
pregnancy-associat$ dea?s & by a lack ( 
access to relevant mat]nal c>e s]vices1 
f community mat]nal *ild heal?          
organizations1 & f m9ority advocacy     
gr\ps2  7,,ii7 memb]s1 includ+ heal? c>e
 provid]s1 f diff]5t geographic regions 
9 ! ,/ate1 includ+ any rural1 urban1 &  
tribal areas2 &  7,,iii7 heal? c>e &    
social s]vice provid]s :o "w 9          

communities t are div]se ) reg>d to     
race1 e?nicity1 immigration /atus1      
,indig5\s /atus1 & ,engli% pr(ici5cy4   
7v7 ,mat]nal mortality review /aff ,/aff
 ( ea* su* review committee %all        
include--  7,i7 vital heal? /ati/icians1
 mat]nal *ild heal? /ati/icians1 or     
epidemiologi/s2  7,,ii7 a coord9ator ( !
 ,/ate mat]nal mortality review         
committee1 to be designat$ by ! ,/ate2 &
  7,,iii7 adm9i/rative /aff4  7,c7      
,option = ,/ates to =m regional mat]nal 
mortality reviews ,/ates ) a l[ rate (  
occurr5ce ( pregnancy-associat$ or      
pregnancy-relat$ dea?s may *oose to     
p>tn] ) "o or m neighbor+ ,/ates to     
fulfill ! activities describ$ 9 p>agraph
 7#a77;,c74 ,9 su* a case1 ) respect to 
,/ates 9 su* a p>tn]%ip1 any requirem5t 
"u ?is section relat+ to ! report+ (    
in=mation relat$ to su* activities %all 
be deem$ to be fulfill$ by ea* su* ,/ate
 if a s+le su* report is submitt$ = !   
p>tn]%ip4  7#c7 ,/ate ,dep>tm5t ( ,heal?
 ,activities ,= purposes ( subsection   

7a71 a ,/ate dep>tm5t ( heal? ( a ,/ate 
receiv+ a grant "u su* subsection %all--
  7,a7 9 consultation ) ! mat]nal       
mortality review committee ( ! ,/ate & 9
 conjunction ) relevant pr(essional     
organizations1 develop a plan = ongo+   
heal? c>e provid] education1 bas$ on !  
f9d+s & recomm5dations ( ! committee1 9 
ord] to improve ! quality ( mat]nal c>e2
 &  7,b7 take /eps to widely dissem9ate 
! f9d+s & recomm5dations ( ! ,/ate      
mat]nal mortality review committees ( ! 
,/ate & to implem5t ! recomm5dations (  
su* committee4  7c7 ,case ab/raction =m 
7#a7 ,developm5t ,! ,director ( ! ,c5t]s
 = ,disease ,control & ,prev5tion %all  
develop a uni=m1 compreh5sive case      
ab/raction =m & make su* =m available to
 ,/ates = ,/ate mat]nal mortality review
 committees = use by su* committees 9   
ord] to--  7,a7 ensure t ! cases &      
in=mation collect$ & review$ by su*     
committees c be pool$ = review by !     
,dep>tm5t ( ,heal? & ,human ,s]vices &  
its ag5cies2 &  7,b7 pres]ve ! uni=mity 

( ! in=mation & its use = ,f$]al public 
heal? purposes4  7#b7 ,p]missible ,/ate 
modification ,ea* ,/ate may modify ! =m 
develop$ "u p>agraph 7#a7 =             
implem5tation & use by su* ,/ate or by !
 ,/ate mat]nal mortality review         
committee ( su* ,/ate by includ+ on su* 
=m additional in=mation to be collect$1 
b may n alt] ! /&>d que/ions on su* =m1 
9 ord] to ensure t ! in=mation c be     
collect$ & review$ c5trally at ! ,f$]al 
level4  7d7 ,treatm5t z public heal?    
au?ority = purposes ( ,,hipaa ,=        
purposes ( apply+ ,,hipaa privacy &     
security law 7z def9$ 9 section         
#cjji7;a77#b7 ( ! ,public ,heal? ,s]vice
 ,act71 a ,/ate mat]nal mortality review
 committee ( a ,/ate e/abli%$ pursuant  
to ?is section to c>ry out activities   
describ$ 9 subsection 7b77#b77;,a7 %all 
be deem$ to be a public heal? au?ority  
describ$ 9 section #afd4eja 7& ref]5c$ 9
 section #afd4eab7;b77#a77;i77 ( title  
#de1 ,code ( ,f$]al ,regulations 7or any
 successor regulation71 c>ry+ out public

 heal? activities & purposes describ$ 9 
su* section #afd4eab7;b77#a77;i7 7or any
 su* successor regulation74  7e7 ,public
 disclosure ( in=mation  7#a7 ,9 g5]al  
,= fiscal ye> #bjae or a subsequ5t      
fiscal ye>1 ea* ,/ate receiv+ a grant "u
 ?is section = su* ye> %all1 subject to 
p>agraph 7#c71 provide = ! public       
disclosure1 & submission to ! in=mation 
cle>+h\se e/abli%$ "u p>agraph 7#b71 ( !
 in=mation includ$ 9 ! report ( ! ,/ate 
"u section #ejf7;a77#b77;,f7 = su* ye>  
7relat+ to ! f9d+s = su* ye> ( ! ,/ate  
mat]nal mortality review committee      
e/abli%$ by ! ,/ate "u ?is section74    
7#b7 ,in=mation cle>+h\se ,! ,secret>y (
 ,heal? & ,human ,s]vices %all e/abli%  
an in=mation cle>+h\se1 t %all be       
adm9i/]$ by ! ,director ( ! ,c5t]s =    
,disease ,control & ,prev5tion1 t w     
ma9ta9 f9d+s & recomm5dations submitt$  
pursuant to p>agraph 7#a7 & provide su* 
f9d+s & recomm5dations = public review &
 rese>* purposes by ,/ate heal?         
dep>tm5ts1 mat]nal mortality review     

committees1 & heal? provid]s &          
in/itutions4  7#c7 ,confid5tiality (    
in=mation ,9 no case %all any           
individually id5tifiable heal? in=mation
 be provid$ to ! public1 or submitt$ to 
! in=mation cle>+h\se1 "u p>agraph 7#a74
  7f7 ,confid5tiality ( review committee
 proce$+s  7#a7 ,9 g5]al ,all proce$+s &
 activities ( a ,/ate mat]nal mortality 
review committee "u ?is section1 op9ions
 ( memb]s ( su* a committee =m$ z a     
result ( su* proce$+s & activities1 &   
records obta9$1 creat$1 or ma9ta9$      
pursuant to ?is section1 includ+ records
 ( int]views1 writt5 reports1 & /atem5ts
 procur$ by ! ,dep>tm5t ( ,heal? &      
,human ,s]vices or by any o!r p]son1    
ag5cy1 or organization act+ jo9tly ) !  
,dep>tm5t1 9 connection ) morbidity &   
mortality reviews "u ?is section1 %all  
be confid5tial1 & n subject to discov]y1
 subpo5a1 or introduction into evid5ce 9
 any civil1 crim9al1 legislative1 or o!r
 proce$+4 ,su* records %all n be op5 to 
public inspection4  7#b7 ,te/imony (    

memb]s ( committee  7,a7 ,9 g5]al       
,memb]s ( a ,/ate mat]nal mortality     
review committee "u ?is section may n be
 que/ion$ 9 any civil1 crim9al1         
legislative1 or o!r proce$+ reg>d+      
in=mation pres5t$ 91 or op9ions =m$ z a 
result (1 a meet+ or communication ( !  
committee4  7,b7 ,cl>ification ,no?+ 9  
?is subsection %all be con/ru$ to prev5t
 a memb] ( su* a committee f te/ify+    
reg>d+ in=mation t 0 obta9$ indep5d5t ( 
su* memb]'s p>ticipation on ! committee1
 or t is public in=mation4  7#c7        
,availability ( in=mation = rese>*      
purposes ,no?+ 9 ?is subsection %all    
prohibit ! publi%+ by su* a committee or
 ! ,dep>tm5t ( ,heal? & ,human ,s]vices 
( /ati/ical compilations & rese>*       
reports t--  7,a7 are bas$ on           
confid5tial in=mation1 relat+ to        
morbidity & mortality review2 &  7,b7 d 
n conta9 id5tify+ in=mation or any o!r  
in=mation t c\ld be us$ to ultimately   
id5tify ! individuals conc]n$4  7g7     
,def9itions ,= purposes ( ?is section3  

7#a7 ,! t]m pregnancy-associat$ dea?    
means ! dea? ( a woman :ile pregnant or 
dur+ ! "o-ye> p]iod foll[+ ! date ( !   
end ( pregnancy1 irrespective ( ! cause 
( su* dea?4  7#b7 ,! t]m                
pregnancy-relat$ dea? means ! dea? ( a  
woman :ile pregnant or dur+ ! "o-ye>    
p]iod foll[+ ! date ( ! end ( pregnancy1
 irrespective ( ! duration or site ( !  
pregnancy1 f any cause relat$ to or     
aggravat$ by ! pregnancy or its         
managem5t1 b n f any accid5tal or       
incid5tal cause4  7#c7 ,! t]m woman (   
*ildbe>+ age means a woman :o is at lea/
 #aj ye>s ( age & n m ?an #ed ye>s (    
age4  4  7b7 ,inclusion ( f9d+s ( review
 committees 9 requir$ reports  7#a7     
,/ate tri5nial reports ,p>agraph 7#b7 ( 
section #ejf7;a7 ( su* ,act 7#db        
,u4,s4,c4 #gjf7;a77 is am5d$ by ins]t+  
aft] subp>agraph 7,e7 ! foll[+ new      
subp>agraph3  7,f7 ,9 ! case ( a ,/ate  
receiv+ a grant "u section #ead1 beg9n+ 
= ! fir/ fiscal ye> beg9n+ aft] #c ye>s 
aft] ! date ( e/abli%m5t ( ! ,/ate      

mat]nal mortality review committee      
e/abli%$ by ! ,/ate pursuant to su*     
grant & once e #c ye>s !reaft]1         
in=mation conta9+ ! f9d+s &             
recomm5dations ( su* committee &        
in=mation on ! implem5tation ( su*      
recomm5dations dur+ ! p]iod involv$4  4 
7#b7 ,annual reports to ,congress       
,p>agraph 7#c7 ( su* section is am5d$-- 
7,a7 9 subp>agraph 7,d71 at ! end1 by   
/rik+ &2  7,b7 9 subp>agraph 7,e71 at ! 
end1 by /rik+ ! p]iod & ins]t+ 2 &2 &   
7,c7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,f7 ,= fiscal ye> #bjae &
 ea* subsequ5t fiscal ye>1 tak+ into    
acc\nt ! f9d+s1 recomm5dations1 &       
implem5tation in=mation submitt$ by     
,/ates pursuant to p>agraph 7#b77;,f71  
on ! /atus ( pregnancy-relat$ dea?s &   
pregnancy-associat$ dea?s 9 ! ,unit$    
,/ates & includ+ recomm5dations on      
me?ods to prev5t su* dea?s 9 ! ,unit$   
,/ates4  4  #d4 ,,nih work%op & rese>*  
plan developm5t on sev]e mat]nal        
morbidity  7a7 ,work%op ,! ,secret>y (  

,heal? & ,human ,s]vices1 act+ ?r\gh !  
,director ( ,,nih & 9 consultation ) !  
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 ! ,director ( ! 
,c5t]s = ,disease ,control & ,prev5tion1
 ! heads ( o!r ,f$]al ag5cies t adm9i/] 
,f$]al heal? programs1 & relevant       
national pr(essional organizations deal+
 ) mat]nal morbidity1 %all organize a   
national work%op to id5tify def9itions =
 sev]e mat]nal morbidity & make         
recomm5dations = a rese>* plan to       
id5tify & monitor sev]e mat]nal         
morbidity 9 ! ,unit$ ,/ates4  7b7       
,rese>* plan & data collection protocols
 ,! ,secret>y1 tak+ into acc\nt ! f9d+s 
( ! work%op "u p>agraph 7#a71 %all      
develop uni=m def9itions ( sev]e mat]nal
 morbidity1 a rese>* plan on sev]e      
mat]nal morbidity1 & possible data      
collection protocols to assi/ ,/ates 9  
id5tify+ & monitor+ cases ( sev]e       
mat]nal morbidity & to develop          
recomm5dations on address+ su* cases4   
7c7 ,report ,n lat] ?an #b ye>s aft] !  

date ( enactm5t ( ?is ,act1 ! ,secret>y 
%all prep>e & submit to ! appropriate   
committees ( ,congress a report conc]n+ 
! def9itions & rese>* plan develop$ "u  
?is section4  7d7 ,au?orization (       
appropriations ,!re is au?oriz$ to be   
appropriat$ = fiscal ye> #bjae--  7#a7  
#ej1jjj to c>ry out subsection 7a72 &   
7#b7 #ajj1jjj to c>ry out subsection    
7b74  #e4 ,elim9at+ disp>ities 9        
mat]nity heal? outcomes ,"p ,b ( title  
,,iii ( ! ,public ,heal? ,s]vice ,act is
 am5d$ by ins]t+ aft] section #cag,t (  
su* ,act 7#db ,u4,s4,c4 #bdg;b-#bb7 !   
foll[+ new section3  #cag,u4 ,elim9at+  
disp>ities 9 mat]nity heal? outcomes    
7a7 ,9 g5]al ,! ,secret>y %all1 9       
consultation ) relevant national        
/akehold] organizations1 su* z national 
m$ical specialty organizations1 national
 mat]nal *ild heal? organizations1 &    
national heal? disp>ity organizations1  
c>ry out ! foll[+ activities to elim9ate
 disp>ities 9 mat]nal heal? outcomes3   
7#a7 ,conduct rese>* into ! det]m9ants &

 ! di/ribution ( disp>ities 9 mat]nal   
c>e1 heal? risks1 & heal? outcomes1 &   
improve ! capacity ( ! p]=mance         
measurem5t infra/ructure to measure su* 
disp>ities4  7#b7 ,exp& access to       
s]vices t h be5 demon/rat$ to improve ! 
quality & outcomes ( mat]nity c>e =     
vuln]able populations4  7#c7 ,e/abli% a 
demon/ration project to comp>e !        
effectiv5ess ( int]v5tions to r$uce     
disp>ities 9 mat]nity s]vices &         
outcomes1 & implem5t & assess+ effective
 int]v5tions4  7b7 ,scope & selection ( 
,/ates = demon/ration project ,!        
demon/ration project "u subsection      
7a77#c7 %all be conduct$ 9 no m ?an #h  
,/ates1 :i* %all be select$ by !        
,secret>y bas$ on--  7#a7 applications  
submitt$ by ,/ates1 :i* specify :i*     
regions & populations ! ,/ate involv$ w 
s]ve "u ! demon/ration project2  7#b7   
crit]ia design$ by ! ,secret>y to ensure
 t1 z a :ole1 ! demon/ration project is1
 to ! greate/ ext5t possible1           
repres5tative ( ! demographic &         

geographic composition ( communities mo/
 affect$ by disp>ities2  7#c7 crit]ia   
design$ by ! ,secret>y to ensure t a    
v>iety ( type ( models are te/$ ?r\gh ! 
demon/ration project & t su* models     
include int]v5tions t h an exi/+ evid5ce
 base = effectiv5ess2 &  7#d7 crit]ia   
design$ by ! ,secret>y to assure t !    
demon/ration projects & models w be     
c>ri$ out 9 consultation ) local &      
regional provid] organizations1 su* z   
community heal? c5t]s1 hospital sy/ems1 
& m$ical societies repres5t+ provid]s ( 
mat]nity s]vices4  7c7 ,duration (      
demon/ration project ,! demon/ration    
project "u subsection 7a77#c7 %all beg9 
on ,janu>y #a1 #bjae1 & end on ,decemb] 
#ca1 #bjai4  7d7 ,grants = evaluation & 
monitor+ ,! ,secret>y may make grants to
 ,/ates & heal? c>e provid]s p>ticipat+ 
9 ! demon/ration project "u subsection  
7a77#c7 = ! purpose ( collect+ data     
necess>y = ! evaluation & monitor+ ( su*
 project4  7e7 ,reports  7#a7 ,/ate     
reports ,ea* ,/ate t p>ticipates 9 !    

demon/ration project "u subsection      
7a77#c7 %all report to ! ,secret>y1 9 a 
"t1 =m1 & mann] specifi$ by ! ,secret>y1
 ! data necess>y to--  7,a7 monitor !-- 
7i7 outcomes ( ! project2  7ii7 co/s ( !
 project2 &  7iii7 quality ( mat]nity   
c>e provid$ "u ! project2 &  7,b7       
evaluate ! rationale = ! selection ( !  
items & s]vices includ$ 9 any bundl$    
paym5t made by ! ,/ate "u ! project4    
7#b7 ,f9al report ,n lat] ?an ,decemb]  
#ca1 #bjbj1 ! ,secret>y %all submit to  
,congress a report on ! results ( !     
demon/ration project "u subsection      
7a77#c74  4