,,ii  #aad? ,,congress  #a/ ,session    
,s4 #fgd  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,m>* #d1 #bjae ,mrs4   
,murray 7= h]self1 ,ms4 ,mikulski1 &    
,mrs4 ,box]7 introduc$ ! foll[+ bill2   
:i* 0 read twice & ref]r$ to !          
,committee on ,heal?1 ,education1       
,labor1 & ,p5sions  ,a ,,bill  ,to exp& 
programs ) respect to wom5's heal?4  #a4
 ,%ort title  ,?is ,act may be cit$ z ! 
#ba/ ,c5tury ,wom5's ,heal? ,act (      
#bjae4  #b4 ,purpose ,x is ! purpose (  
?is ,act to provide wom5 ) af=dable     
access to compreh5sive heal? c>e1       
includ+ prev5tive s]vices 7su* z        
contraception & brea/ canc] scre5+s71 to
 improve mat]nal heal?1 & to ensure t a 
woman has ! same b5efits & s]vices no   
matt] :at "p ( ! ,unit$ ,/ates %e lives 
91 all :i* is critical to improv+ !     
heal? & well-be+ ( wom51 *ildr51 _!     
families1 society z a :ole1 & is an     
ess5tial "p ( a woman's economic        
security & opportunity4  #c4 ,/r5g!n+   
family plann+  7a7 ,9 g5]al ,title ,x ( 

! ,public ,heal? ,s]vice ,act 7#db      
,u4,s4,c4 #cjj et seq47 is am5d$ by     
ins]t+ aft] section #ajjc ! foll[+3     
#ajjc;,a4 ,grants = facilities          
improvem5ts  7a7 ,9 g5]al ,! ,secret>y  
is au?oriz$ to make grants to & ent]    
into contracts ) public or nonpr(it     
private entities to plan1 develop1 or   
make improvem5ts to facilities c>ry+ out
 family plann+ s]vice projects1 & exp&  
prev5tive heal? s]vices1 "u section     
#ajja4  7b7 ,au?orization (             
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section1    
#ej1jjj1jjj = ea* ( fiscal ye>s #bjaf   
?r\gh #bjai4  4  7b7 ,fund+ ,!re is     
au?oriz$ to be appropriat$ to c>ry out  
programs "u title ,x ( ! ,public ,heal? 
,s]vice ,act 7#db ,u4,s4,c4 #cjj et     
seq471 #cbg1jjj1jjj = ea* ( fiscal ye>s 
#bjaf ?r\gh #bjai4  #d4 ,ensur+ p>ity 9 
wom5's heal? cov]age "u ,m$icaid  7a7   
,/ate plan requirem5t ,section #aijb7;a7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acif;a7a77 is am5d$ by ins]t+

 aft] p>agraph 7#gg7 ! foll[+3  7#gh7   
provide t ! ,/ate %all1 at a m9imum & 9 
addition to any o!r prev5tive c>e &     
scre5+s requir$ "u ?is title1 provide   
m$ical assi/ance = prev5tive c>e &      
scre5+s requir$ "u section #bgac7;a7 ( !
 ,public ,heal? ,s]vice ,act1 includ+   
evid5ce-bas$ items or s]vices requir$ "u
 section #bgac7;a77#a7 ( su* ,act1      
evid5ce-in=m$ prev5tive c>e & scre5+s   
requir$ "u section #bgac7;a77#c7 ( su*  
,act1 & additional prev5tive c>e &      
scre5+s requir$ = wom5 "u section       
#bgac7;a77#d7 ( su* ,act & z provid$ = 9
 compreh5sive guidel9es support$ by !   
,heal? ,res\rces & ,s]vices             
,adm9i/ration1 & %all n impose any      
copaym5t1 co9surance1 d$uctible1        
co/-%>+1 or simil> *>ge = su* prev5tive 
c>e & scre5+s2  4  7b7 ,application to  
manag$ c>e ,section #aicb7;b7 ( su* ,act
 7#db ,u4,s4,c4 #acifu-#b7;b77 is am5d$ 
by add+ at ! end ! foll[+3  7#i7 ,p>ity 
9 wom5's heal? cov]age ,ea* m$icaid     
manag$ c>e organization %all at a m9imum

 & 9 addition to any o!r prev5tive c>e &
 scre5+s requir$ "u a contract ) ! ,/ate
 "u section #aijc7m71 provide m$ical    
assi/ance = prev5tive c>e & scre5+s     
requir$ "u section #bgac7;a7 ( ! ,public
 ,heal? ,s]vice ,act1 includ+           
evid5ce-bas$ items or s]vices requir$ "u
 section #bgac7;a77#a7 ( su* ,act1      
evid5ce-in=m$ prev5tive c>e & scre5+s   
requir$ "u section #bgac7;a77#c7 ( su*  
,act1 & additional prev5tive c>e &      
scre5+s requir$ = wom5 "u section       
#bgac7;a77#d7 ( su* ,act & z provid$ = 9
 compreh5sive guidel9es support$ by !   
,heal? ,res\rces & ,s]vices             
,adm9i/ration1 & %all n impose any      
copaym5t1 co9surance1 d$uctible1        
co/-%>+1 or simil> *>ge = su* prev5tive 
c>e & scre5+s4  4  7c7 ,application to  
b5*m>k b5efit plans ,section            
#aicg7;b77#e7 ( su* ,act 7#db ,u4,s4,c4 
#acifu-#g7;b77#e77 is am5d$ by ins]t+ &1
 effective ,janu>y #a1 #bjaf1 mu/       
provide1 at a m9imum & 9 addition to any
 o!r prev5tive c>e & scre5+s requir$ "u 

?is section1 prev5tive c>e & scre5+s1   
requir$ "u section #bgac7;a7 ( ! ,public
 ,heal? ,s]vice ,act1 includ+           
evid5ce-bas$ items or s]vices requir$ "u
 section #bgac7;a77#a7 ( su* ,act1      
evid5ce-in=m$ prev5tive c>e & scre5+s   
requir$ "u section #bgac7;a77#c7 ( su*  
,act1 & additional prev5tive c>e &      
scre5+s requir$ = wom5 "u section       
#bgac7;a77#d7 ( su* ,act & z provid$ = 9
 compreh5sive guidel9es support$ by !   
,heal? ,res\rces & ,s]vices             
,adm9i/ration1 & %all n impose any      
copaym5t1 co9surance1 d$uctible1 co/-%>+
 or simil> *>ge = su* prev5tive c>e &   
scre5+s be=e ! p]iod4  7d7 ,p>ity 9     
cov]age ( all ,,fda-,approv$ =ms (      
contraception ,section                  
#aije7;a77#d77;,c7 ( su* ,act 7#db      
,u4,s4,c4 #acif;d7a77#d77;,c77 is am5d$ 
by ins]t+ 1 includ+ family plann+       
s]vices & supplies t are requir$ "u     
section #bgac7;a7 ( ! ,public ,heal?    
,s]vice ,act & z provid$ = 9            
compreh5sive guidel9es support$ by !    

,heal? ,res\rces & ,s]vices             
,adm9i/ration = purposes ( section      
#bgac7;a77#d7 ( su* ,act1 be=e furni%$4 
7e7 ,con=m+ am5dm5ts prohibit+ co/-,%>+ 
7#a7 ,9 g5]al ,subsections 7a77#b77;,d7 
& 7b77#b77;,d7 ( section #aiaf ( su*    
,act 7#db ,u4,s4,c4 #acifo7 are ea*     
am5d$ by ins]t+ & items & s]vices       
requir$ "u section #aijb7;a77#gh71 be=e 
or4  7#b7 ,alt]native au?ority ,section 
#aiaf;,a7b77#c77;,b7 ( su* ,act 7#db    
,u4,s4,c4 #acifo-#a7;b77#c77;,b77 is    
am5d$ by add+ at ! end ! foll[+3  7xi7  
,items & s]vices requir$ "u section     
#aijb7;a77#gh74  4  7f7 ,application to 
waiv]s  7#a7 ,limitation ( waiv]        
au?ority ,not)/&+ section #aaae7;a7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acae7;a771 subject to p>agraph 7#b71 ! 
,secret>y ( ,heal? & ,human ,s]vices may
 n grant a waiv] "u section #aaae ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acae7 or o!rwise ( ! requirem5ts impos$
 "u ! am5dm5ts made by ?is section4     
7#b7 ,exception = curr5t waiv]s ,!      

am5dm5ts made by ?is section %all n     
apply to any waiv] grant$ to a ,/ate "u 
section #aaae ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acae7 or o!rwise :i*   
relates to ! provision ( m$ical         
assi/ance "u a ,/ate plan "u title ,,xix
 ( su* ,act 7#db ,u4,s4,c4 #acif et     
seq47 t is 9 effect z ( ! date (        
enactm5t ( ?is ,act be=e ! expiration   
7det]m9$ )\t reg>d to any ext5sions7 ( !
 waiv] to ! ext5t su* am5dm5ts are      
inconsi/5t ) ! waiv]4  7g7 ,effective   
date  7#a7 ,9 g5]al ,except z provid$ 9 
p>agraphs 7#b7 & 7#c71 ! am5dm5ts made  
by ?is section %all be effective )      
respect to items or s]vices furni%$ on  
or aft] ! date ( enactm5t ( ?is ,act4   
7#b7 ,b5*m>k & manag$ c>e plans ,!      
am5dm5ts made by subsections 7b7 & 7c7  
%all apply to plan ye>s beg9n+ on or    
aft] ,janu>y #a1 #bjaf4  7#c7           
,transition rule ,9 ! case ( a ,/ate    
plan "u title ,,xix or ,,xxi ( ! ,social
 ,security ,act1 :i* ! ,secret>y (      
,heal? & ,human ,s]vices det]m9es       

requires ,/ate legislation 9 ord] = !   
respective plan to meet any requirem5t  
impos$ by am5dm5ts made by ?is section1 
! respective plan %all n be reg>d$ z    
fail+ to comply ) ! requirem5ts ( su*   
title solely on ! basis ( its failure to
 meet su* an additional requirem5t be=e 
! fir/ day ( ! fir/ cal5d> qu>t] beg9n+ 
aft] ! close ( ! fir/ regul> session ( !
 ,/ate legislature t beg9s aft] ! date (
 enactm5t ( ?is section4 ,= purposes ( !
 previ\s s5t5ce1 9 ! case ( a ,/ate t   
has a #b-ye> legislative session1 ea*   
ye> ( ! session %all be consid]$ to be a
 sep>ate regul> session ( ! ,/ate       
legislature4  #e4 ,access to ,wom5's    
,heal? ,c>e ,provid]s  ,"p ,b ( title   
,,viii ( ! ,public ,heal? ,s]vice ,act  
7#db ,u4,s4,c4 #bif;j et seq47 is am5d$ 
by add+ at ! end ! foll[+3  #hab4       
,demon/ration grants = nurse practition]
 tra9+ program  7a7 ,e/abli%m5t (       
program ,! ,secret>y %all e/abli% a     
demon/ration program 7ref]r$ to 9 ?is   
section z ! program7 to aw>d grants to  

eligible entities = ! tra9+ ( nurse     
practition]s specializ+ 9 wom5's heal?  
c>e = c>e]s z provid]s 9 heal? c5t]s t  
receive assi/ance "u title ,x 7ref]r$ to
 9 ?is section z heal? c5t]s74  7b7     
,purpose ,! purpose ( ! program is to   
enable ea* grant recipi5t to-- 7#a7     
provide new nurse practition]s ) cl9ical
 tra9+ to enable su* practition]s to    
s]ve z provid]s 9 heal? c5t]s2  7#b7    
tra9 new nurse practition]s to "w "u a  
model ( c>e t is consi/5t ) ! pr9ciples 
set =? by ! ,report ,provid+ ,quality   
,family ,plann+ ,s]vices ( ! ,c5t]s =   
,disease ,control & ,prev5tion2 &  7#c7 
e/abli% a model ( tra9+ = nurse         
practition]s t specialize 9 wom5's heal?
 c>e t may be replicat$ nationwide4  7c7
 ,grants ,"u ! program1 ! ,secret>y %all
 aw>d #c-ye> grants to eligible entities
 t meet ! requirem5ts e/abli%$ by !     
,secret>y1 = ! purpose ( op]at+ ! nurse 
practition] programs describ$ 9         
subsection 7a7 at su* entities4  7d7    
,eligible entities ,to be eligible to   

receive a grant "u ?is section1 an      
entity %all be-- 7#a7 a heal? c5t] t    
receives fund+ "u section #ajja2 &  7#b7
 submit to ! ,secret>y an application at
 su* "t1 9 su* mann]1 & conta9+ su*     
in=mation z ! ,secret>y may require4    
7e7 ,eligibility ( nurse practition]s   
7#a7 ,9 g5]al ,to be eligible =         
acceptance into a tra9+ program c>ri$   
out by an eligible entity "u a grant "u 
?is section1 an individual %all--  7,a7 
be lic5s$1 or eligible = lic5sure1 9 !  
,/ate 9 :i* ! program is be+ c>ri$ out z
 an advanc$ practice regi/]$ nurse or   
advanc$ practice nurse & be eligible or 
bo>d-c]tifi$ z a nurse practition]2 &   
7,b7 demon/rate commitm5t to a c>e] z a 
provid] 9 a heal? c5t]4  7#b7 ,pref]5ce 
,9 accept+ individuals into a tra9+     
program "u ?is section1 a grant recipi5t
 %all give pref]5ce to bil+ual          
applicants t meet ! requirem5ts describ$
 9 p>agraph 7#a74  7f7 ,grant am\nt ,ea*
 grant aw>d$ "u ?is section %all be 9 an
 am\nt n to exce$ #fjj1jjj p] ye>4 ,a   

grant recipi5t may c>ry ov] funds f #a  
fiscal ye> to ano!r )\t obta9+ approval 
f ! ,secret>y4  7g7 ,te*nical assi/ance 
grants ,! ,secret>y may aw>d te*nical   
assi/ance grants to #a or m heal? c5t]s 
t h demon/rat$ exp]tise 9 e/abli%+ a    
nurse practition] resid5cy tra9+        
program4 ,su* te*nical assi/ance grants 
%all be = ! purpose ( provid+ te*nical  
assi/ance to o!r recipi5ts ( grants "u  
subsection 7c74  7h7 ,au?orization (    
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#aj1jjj1jjj = ea* ( fiscal ye>s #bjaf   
?r\gh #bjai4  4  #f4 ,compassionate     
assi/ance & aw>5ess = survivors ( rape  
7a7 ,def9itions ,9 ?is section3 7#a7    
,em]g5cy contraception ,! t]m em]g5cy   
contraception means a drug or device 7z 
su* t]ms are def9$ 9 section #bja ( !   
,f$]al ,food1 ,drug1 & ,cosmetic ,act   
7#ba ,u4,s4,c4 #cba771 or drug regim5   
t--  7,a7 is us$ po/coitally2  7,b7     
prev5ts pregnancy prim>ily by prev5t+ or
 delay+ ovulation1 & does n t]m9ate an  

e/abli%$ pregnancy2 &  7,c7 is approv$  
by ! ,food & ,drug ,adm9i/ration4  7#b7 
,heal? c>e provid] ,! t]m heal? c>e     
provid] means an individual :o is lic5s$
 or c]tifi$ "u ,/ate law to provide     
heal? c>e s]vices & :o is op]at+ )9 !   
scope ( su* lic5se4 ,su* t]m %all       
include a ph>maci/4  7#c7 ,hospital ,!  
t]m hospital means-- 7,a7 a hospital z  
def9$ 9 section #ahfa7;e7 ( ! ,social   
,security ,act 7#db ,u4,s4,c4           
#aciex7e772  7,b7 a critical access     
hospital z def9$ 9 section #ahfa7mm77#a7
 ( su* ,act 7#db ,u4,s4,c4              
#aciex7mm77#a772 &  7,c7 a heal? cl9ic  
locat$ on ! campus ( an in/itution (    
high] education4  7#d7 ,in/itution (    
high] education ,! t]m in/itution (     
high] education has ! mean+ giv5 su* t]m
 9 section #aja7;a7 ( ! ,high]          
,education ,act ( #aife 7#bj ,u4,s4,c4  
#ajja7;a774  7#e7 ,nonpr(its ,! t]m     
nonpr(its 7o!r ?an in/itutions ( high]  
education7 means a community-bas$       
organization1 o!r ?an an in/itution (   

high] education1 ) exp]i5ce 9 provid+   
evid5ce-bas$ effective programs1        
/rategies1 & policies to prev5t sexual  
viol5ce1 intimate p>tn] viol5ce1 & o!r  
=ms ( viol5ce on ! campus ( in/itutions 
( high] education4  7#f7 ,secret>y ,!   
t]m ,secret>y means ! ,secret>y ( ,heal?
 & ,human ,s]vices4  7#g7 ,sexual       
assault  7,a7 ,9 g5]al ,! t]m sexual    
assault means a sexual act 7z def9$ 9   
subp>agraphs 7,a7 ?r\gh 7,c7 ( section  
#bbdf7b7 ( title #ah1 ,unit$ ,/ates     
,code7 :]e ! victim involv$ does n      
cons5t or lacks ! capacity to cons5t4   
7,b7 ,application ( provisions ,!       
def9ition 9 subp>agraph 7,a7 %all apply 
to all individuals4  7b7 ,survivors (   
sexual assault2 provision by hospitals (
 em]g5cy contraception )\t *>ge  7#a7 ,9
 g5]al ,f$]al funds may n be provid$ to 
a hospital unless su* hospital complies 
) ! conditions specifi$ 9 p>agraph 7#b7 
9 ! case (--  7,a7 any woman :o arrives 
at ! hospital & /ates t %e is a victim (
 sexual assault1 or is accompani$ by    

someone :o /ates %e is a victim ( sexual
 assault2 &  7,b7 any woman :o arrives  
at ! hospital :om hospital p]sonnel h   
reason to believe is a victim ( sexual  
assault4  7#b7 ,assi/ance = victims ,!  
conditions specifi$ 9 ?is subsection    
reg>d+ a hospital & a woman describ$ 9  
p>agraph 7#a7 are z foll[s3  7,a7 ,!    
hospital promptly provides ! woman )    
m$ically & factually accurate & unbias$ 
writt5 & oral in=mation ab\t em]g5cy    
contraception1 includ+ in=mation expla9+
 t--  7i7 "s =ms ( em]g5cy contraception
 h be5 approv$ by ! ,food & ,drug       
,adm9i/ration z ov]-!-c\nt] m$ications =
 all wom5 )\t age re/rictions & su*     
contraception is a safe & effective way 
to prev5t pregnancy aft] unprotect$     
int]c\rse or contraceptive failure if   
tak5 9 a timely mann]2  7ii7 em]g5cy    
contraception is m effective ! soon] x  
is tak52 &  7iii7 em]g5cy contraception 
does n cause an abortion & _c int]rupt  
an e/abli%$ pregnancy4  7,b7 ,! hospital
 promptly (f]s em]g5cy contraception to 

! woman1 & promptly provides su*        
contraception to h] at ! hospital on h] 
reque/4  7,c7 ,! in=mation provid$      
pursuant to subp>agraph 7,a7 is 9 cle> &
 concise language1 is readily           
compreh5sible1 & meets su* conditions   
reg>d+ ! provision ( ! in=mation 9      
languages o!r ?an ,engli% z ! ,secret>y 
may e/abli%4  7,d7 ,! s]vices describ$ 9
 subp>agraphs 7,a7 ?r\gh 7,c7 are n d5i$
 because ( ! inability ( ! woman or h]  
family to pay = ! s]vices4  7#c7        
,effective date2 ag5cy crit]ia ,?is     
subsection %all take effect ^u !        
expiration ( ! #ahj-;day p]iod beg9n+ on
 ! date ( ! enactm5t ( ?is ,act4 ,n lat]
 ?an #cj days prior to ! expiration (   
su* p]iod1 ! ,secret>y %all publi% 9 !  
,f$]al ,regi/] crit]ia = c>ry+ out ?is  
section4  7c7 ,survivors ( campus sexual
 assault2 provision by community-,bas$  
organizations & nonpr(its 7,o!r ?an     
in/itutions ( high] education7 ( em]g5cy
 contraception & sexual assault         
prev5tion programs ,nonpr(its 7o!r ?an  

in/itutions ( high] education7 %all     
provide = campus programs focus$ on     
effective prev5tion /rategies t         
include--  7#a7 ! implem5tation ( a     
compreh5sive prev5tion /rategy bas$ on  
evid5ce-bas$ rese>* t id5tifies         
/rategies to prev5t sexually viol5t     
behavior2  7#b7 ! use ( risk &          
protective factors ?r\gh ! provision (  
tra9+ to /ud5ts on sexual viol5ce &     
prev5tion & ! provision ( campus outrea*
 on prev5t+ sexual viol5ce & in=mation  
ab\t em]g5cy contraception2 &  7#c7 !   
coord9ation ( activities ) campus-bas$  
heal? facilities to ensure prompt access
 to m$ically & factually accurate &     
unbias$ writt5 & oral in=mation ab\t    
em]g5cy contraception & assi/ance z     
det]m9$ "u subsection 7b77#b74  7d7     
,em]g5cy contraception education &      
in=mation programs  7#a7 ,em]g5cy       
contraception public education program  
7,a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh !
 ,director ( ! ,c5t]s = ,disease        
,control & ,prev5tion1 %all develop &   

dissem9ate to ! public in=mation on     
em]g5cy contraception4  7,b7            
,dissem9ation ,! ,secret>y may          
dissem9ate in=mation on em]g5cy         
contraception "u subp>agraph 7,a7       
directly or ?r\gh arrangem5ts ) heal?   
ag5cies1 pr(essional & nonpr(it         
organizations1 consum] gr\ps1           
in/itutions ( high] education1 cl9ics1 !
 m$ia1 & ,f$]al1 ,/ate1 & local ag5cies4
  7,c7 ,in=mation ,! in=mation on       
em]g5cy contraception dissem9at$ "u     
subp>agraph 7,a7 %all include1 at a     
m9imum1 ! mo/ curr5t evid5ce-bas$ &     
evid5ce-in=m$ /&>ds ( c>e ) respect to  
em]g5cy contraception & an explanation (
 ! prop]1 use1 safety1 efficacy1 &      
availability ( su* contraception1 & !   
availability ( c\nsel+ ) respect to su* 
contraception4  7#b7 ,em]g5cy           
contraception in=mation program = heal? 
c>e provid]s  7,a7 ,9 g5]al ,!          
,secret>y1 act+ ?r\gh ! ,adm9i/rator ( !
 ,heal? ,res\rces & ,s]vices            
,adm9i/ration & 9 consultation ) major  

m$ical & public heal? organizations1    
%all develop & dissem9ate to heal? c>e  
provid]s in=mation on em]g5cy           
contraception4  7,b7 ,in=mation ,!      
in=mation dissem9at$ "u subp>agraph 7,a7
 %all include1 at a m9imum-- 7i7        
in=mation describ+ ! mo/ curr5t         
evid5ce-bas$ & evid5ce-in=m$ /&>ds (    
c>e1 prop] use1 safety1 efficacy1 &     
availability ( em]g5cy contraception1 & 
! availability ( c\nsel+ ) respect to   
su* contraception2  7ii7 recomm5dations 
reg>d+ ! use ( su* contraception 9      
appropriate cases2  7iii7 recomm5dations
 = heal? c>e provid]s work+ 9 em]g5cy   
rooms to consult ) survivors ( sexual   
assault1 once su* survivors are         
cl9ically /able1 reg>d+ options =       
em]g5cy contraception & to provide any  
necess>y foll[-up c>e & ref]ral s]vices2
 &  7iv7 in=mation expla9+ h[ to obta9  
copies ( ! in=mation develop$ "u        
p>agraph 7#a7 = di/ribution to ! pati5ts
 ( ! provid]s4  7#c7 ,au?orization (    
appropriations ,!re are au?oriz$ to be  

appropriat$ to c>ry out ?is section1 su*
 sums z may be necess>y = ea* ( ! fiscal
 ye>s #bjaf ?r\gh #bjbj4  7#d7 ,/udy ,! 
,ag5cy = ,heal?c>e ,rese>* & ,quality   
%all conduct a /udy ( access ( survivors
 ( sexual assault to em]g5cy            
contraception 9 ea* ,/ate & nationally1 
to make access & c>e saf]1 ( high]      
quality1 & m accessible1 equitable1 &   
af=dable4  #g4 ,improv$ cu/om] s]vice & 
protections = wom5 ,title ,,iii ( !     
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bda et seq47 is am5d$ by add+
 at ! end ! foll[+3  ,w ,wom5's heal?   
#cii,,oo4 ,(fice ( ! ,ombudsp]son on    
,wom5's ,heal?  7a7 ,e/abli%m5t ,!re is 
e/abli%$ )9 ! ,(fice ( ,secret>y ( !    
,dep>tm5t ( ,heal? & ,human ,s]vices an 
,(fice ( ! ,ombudsp]son on ,wom5's      
,heal? 79 ?is section ref]r$ to z !     
,(fice74 ,! ,(fice %all be head$ by an  
,ombudsp]son :o is appo9t$ by !         
,secret>y & reports directly to !       
,secret>y4  7b7 ,deadl9e = designation (
 ombudsp]son ,n lat] ?an #ahj days aft] 

! date ( ! enactm5t ( ?is ,act1 !       
,secret>y %all designate an individual  
to s]ve z ! ,ombudsp]son ( ! ,(fice on  
,wom5's ,heal? 7ref]r$ to 9 ?is "p z !  
,ombudsp]son74  7c7 ,duties ( (fice     
7#a7 ,9 g5]al ,! ,ombudsp]son1 9        
coord9ation 7z def9$ 9 p>agraph 7#d77 ) 
major m$ical1 public heal?1 & legal     
organizations1 ag5cies )9 ! ,dep>tm5t ( 
,heal? & ,human ,s]vices1 ! ,dep>tm5t ( 
,labor1 & consum] organizations %all    
develop recomm5dations to id5tify &     
bett] assi/ wom5 9 access+ heal? & human
 s]vices4  7#b7 ,additional duties ,!   
,(fice %all-- 7,a7 s]ve z ! coord9ator =
 ! ,dep>tm5t ( ,heal? & ,human ,s]vices 
= compla9ts & issues ) respect to !     
provision ( heal? s]vices to wom5 t     
involve any adm9i/rative body )9 !      
,dep>tm5t ( ,heal? & ,human ,s]vices1   
includ+ ! ,(fice on ,wom5's ,heal?1 !   
,(fice ( ,population ,affairs1 ! ,c5t]s 
= ,disease ,control & ,prev5tion1 !     
,national ,in/itutes ( ,heal?1 ! ,food &
 ,drug ,adm9i/ration1 ! ,(fice (        

,adolesc5t ,heal?1 ! ,heal? ,res\rces & 
,s]vices ,adm9i/ration1 ! ,(fice (      
,civil ,rights1 & ! ,c5t] = ,consum]    
,in=mation & ,insurance ,ov]sight1 &    
%all consult ) ! ,dep>tm5t ( ,labor     
reg>d+ su* compla9ts & issues1 9 ord] to
 ref] wom5 to ! appropriate ag5cy = h]  
compla9t & issue2  7,b7 collect data &  
in=mation ab\t ! compla9ts conc]n+ heal?
 s]vices = wom5 t are receiv$ across !  
,dep>tm5t by ! ,ombudsp]son & o!r       
ag5cies2  7,c7 help to coord9ate        
assi/ance = wom5 among ! v>i\s          
adm9i/rative bodies ( ! ,dep>tm5t (     
,heal? & ,human ,s]vices2  7,d7 ma9ta9 &
 publicize a toll-free telephone numb] =
 wom5 seek+ assi/ance reg>d+ issues     
relat$ to a heal? s]vice1 & to report   
compla9ts2  7,e7 provide assi/ance )9 ! 
,dep>tm5t ( ,heal? & ,human ,s]vices1 & 
9 consultation ) ! ,secret>y ( ,labor1  
:5 !re are b>ri]s to gett+ in=mation    
ab\t a compla9t1 or access+ s]vices or  
b5efits2  7,f7 issue reports on h[      
wom5's heal? c>e issues are address$ &  

h&l$ )9 ! ,dep>tm5t ( ,heal? & ,human   
,s]vices & track :at ag5cies are be+    
responsive to compla9ts 9 ord] to       
improve cu/om] s]vice & improve wom5's  
access to heal? s]vices2  7,g7 "w ) o!r 
adm9i/rative bodies ( ! ,dep>tm5t (     
,heal? & ,human ,s]vices to address     
issues id5tifi$ ?r\gh fact-f9d+ &       
inquiries2  7,h7 ,"w ) ext]nal          
/akehold]s1 su* z ph>macies1 provid]s1  
community-bas$ organizations1 cl9ics1 & 
hospitals1 to ensure t !re is in=mation 
reg>d+ ! co/-%>+ & prev5tive s]vices1   
includ+ access to all ,food & ,drug     
,adm9i/ration approv$ =ms (             
contraception made available "u !       
,pati5t ,protection & ,af=dable ,c>e    
,act 7,public ,law #aaa-adh72 &  7,i7   
submit an annual report to ,congress 9  
accordance ) subsection 7e74  7#c7      
,responsibilities ( ! ,ombudsp]son ,9   
c>ry+ out ! duties ( ! ,(fice1 !        
,ombudsp]son %all--  7,a7 evaluate ea*  
compla9t receiv$ by ! ,(fice            
objectively2  7,b7 ma9ta9 confid5tiality

 ( any matt] relat$ to compla9ts1       
includ+ ! id5tities ( ! compla9ants &   
witnesses2 &  7,c7 ensure t any action  
tak5 by ! ,ombudsp]son1 & o!r (fices ( !
 ,dep>tm5t ( ,heal? & ,human ,s]vices1 )
 respect to su* a matt] does n          
negatively affect ! ability ( any woman 
to receive heal? c>e or b5efits "u a law
 adm9i/]$ by ! ,secret>y4  7#d7         
,coord9ation ,to bett] id5tify & address
 issues relat$ to heal? c>e = wom51 !   
,ombudsp]son %all coord9ate ef=ts )     
respect to su* issues among--  7,a7 all 
entities )9 ! ,dep>tm5t ( ,heal? &      
,human ,s]vices2  7,b7 ! ,dep>tm5t (    
,labor2 &  7,c7 any o!r ,f$]al ag5cy )  
jurisdiction ov] matt]s relat$ to access
 to heal? c>e s]vices = wom54  7#e7     
,public meet+s ,! ,ombudsp]son %all     
conv5e a public meet+ qu>t]ly to ensure 
communication & coord9ation ( s]vices = 
wom54  7d7 ,consultation ,9 c>ry+ out ! 
duties ( ! ,(fice1 ! ,ombudsp]son1 z    
appropriate1 %all consult ) ,/ate (fices
 ( heal? insurance consum] assi/ance &  

heal? insurance ombudsman programs = :i*
 a ,/ate has receiv$ a grant "u section 
#bgic4  7e7 ,annual reports  7#a7 ,9    
g5]al ,n lat] ?an ,septemb] #cj ( ea*   
ye>1 ! ,(fice %all submit a report to   
,congress on ! actions tak5 by ! ,(fice 
ov] ! prec$+ ye> & ! objectives ( ^?    
actions4 ,su* report %all be provid$ by 
! ,ombudsp]son directly to ,congress )\t
 any prior comm5t or am5dm5t by !       
,secret>y4  7#b7 ,cont5ts ,ea* report   
submitt$ "u p>agraph 7#a7 %all include1 
) respect to ! prec$+ ye>-- 7,a7        
/ati/ical in=mation1 by region1 on !    
volume ( compla9ts receiv$ by ! ,(fice1 
! g5]al nature ( compla9ts1 g5]al       
in=mation on compla9ants1 & ! p]c5tage (
 compla9ts t result$ 9 a fact-f9d+      
inquiry2  7,b7 a summ>y ( problems      
enc\nt]$ by compla9ants1 includ+        
in=mation on ! mo/ p]vasive or s]i\s    
types ( problems enc\nt]$ by            
compla9ants1 includ+ an enum]ation (    
actions t ! ,(fice has tak5 9 response  
to su* problems2  7,c7 policy           

recomm5dations t ! ,(fice made to !     
,dep>tm5t ( ,heal? & ,human ,s]vices & !
 ,dep>tm5t ( ,labor to rem$y cont9ual   
problems or address areas ( conc]ns t   
are report$ to ! ,(fice to bett] in=m   
policymak+1 includ+ an enum]ation (     
actions t ! ,(fice has tak5 9 response  
to su* problems or conc]ns2 &  7,d7 su* 
o!r in=mation z ! ,(fice consid]s       
relevant4  7#c7 ,report f ! ,secret>y ,!
 ,ombudsp]son %all seek comm5t f !      
,secret>y on ! report prep>$ =          
submission "u p>agraph 7#a71 & !        
,ombudsp]son %all submit to ,congress ! 
comm5ts ( ! ,secret>y toge!r ) ! annual 
report "u p>agraph 7#a74  7#d7 ,o!r     
reports ,no?+ 9 ?is subsection %all be  
con/ru$ to preclude ! ,(fice f issu+    
additional reports on ! activities ( !  
,(fice4  7f7 ,network adequacy /udy     
7#a7 ,/udy ,! ,ombudsp]son %all conduct 
a /udy on ! network adequacy = wom5's   
heal? s]vices4 ,su* /udy %all include-- 
7,a7 an analysis ( ! numb] ( 9-network  
provid]s = wom5's heal? s]vices across !

 ,unit$ ,/ates1 includ+ ,/ate-by-,/ate  
in=mation on wait+ times & di/ance      
travel$2  7,b7 an analysis ( !          
availability ( wom5's heal? s]vices1    
includ+ contraception c\nsel+ &         
reproductive heal? s]vices2  7,c7 !     
id5tification ( geographic areas 9 :i*  
!re may be a %ortage ( provid]s1 cl9ics1
 & hospitals t are able to provide wom5 
) ! full reproductive s]vices2  7,d7 a  
comp>ison ( in=mation provid$ to wom5   
conc]n+ 9-network & out-(-network       
provid]s2  7,e7 an analysis ( factors   
relat$ to wom5's heal? c>e access t     
id5tifies geographic gaps1 heal? c5t]   
availability1 & b>ri]s to provid+ su*   
c>e 9 tra9+1 exp]tise1 & /ock+ ( drugs2 
7,f7 in=mation on a ,/ate's balance     
bill+ policies z relat$ to consum]s &   
provid]s2 &  7,g7 a ,/ate-by-,/ate      
comp>ison ( accessibility1 ess5tial     
community provid]s1 & transp>5cy (      
in=mation4  7#b7 ,report ,n lat] ?an    
,janu>y #a1 #bjag1 ! ,ombudsp]son %all  
submit a report to ,congress on ! /udy  

conduct$ "u p>agraph 7#a74 ,! report    
%all include ! recomm5dations ( !       
,ombudsp]son ) respect to network       
adequacy = wom54  4  #h4 ,national      
wom5's heal? aw>5ess campaign ,title    
,,iii ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #bda;g et seq471 z am5d$ 
by section #g1 is fur!r am5d$ by add+ at
 ! end ! foll[+3  #cii,,oo-#a4 ,wom5's  
prev5tive heal? aw>5ess campaign  7a7 ,9
 g5]al ,! ,secret>y1 9 coop]ation ) !   
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion1 ! ,adm9i/rator ( ! ,heal?
 ,res\rces & ,s]vices ,adm9i/ration1 !  
,director ( ! ,c5t] = ,consum]          
,in=mation & ,insurance ,ov]sight1 !    
,director ( ! ,(fice ( ,wom5's ,heal?1 !
 ,director ( ! ,national ,in/itutes (   
,heal?1 ! ,commission] ( ,food & ,drugs1
 & ! ,ombudsp]son ( ! ,(fice ( ,wom5's  
,heal?1 %all coord9ate & provide = a    
national public outrea* & education     
campaign to raise public aw>5ess1       
includ+ among provid]s1 ( prev5tive     
heal? s]vices = wom5 & families1 includ+

 contraception cov]age made available "u
 ! ,pati5t ,protection & ,af=dable ,c>e 
,act 7,public ,law #aaa-adh74  7b7      
,dissem9ation ( in=mation ,! outrea* &  
aw>5ess campaign %all include ! m$ia    
campaign "u subsection 7c7 & ! ,int]net 
website "u subsection 7d71 & %all       
provide = ! dissem9ation ( in=mation t--
  7#a7 describes ! guidel9es = prev5tive
 s]vices = wom51 includ+ ! mo/          
up-to-date recomm5dations on dome/ic    
viol5ce scre5+s & c\nsel+1 brea/ canc]1 
c]vical canc]1 & o!r diseases t         
disproportionately impact wom51         
available f ! ,unit$ ,/ates ,prev5tive  
,s]vices ,task ,=ce & major m$ical &    
public heal? organizations2  7#b7       
promotes well-woman visits = heal?      
assessm5ts :i* include scre5+s1         
evaluations1 c\nsel+1 immunizations1    
brea/fe$+ s]vices & supplies1 & pr5atal 
visits1 z appropriate2  7#c7 increases  
aw>5ess ( dome/ic viol5ce scre5+s &     
c\nsel+ made available1 & ensure t wom5 
are able to access & utilize su* scre5+s

 & c\nsel+2  7#d7 expla9s ! prev5tive   
s]vices = wom5 t are requir$ "u section 
#bgac to be cov]$ )\t co/-%>+ by a gr\p 
heal? plan or a heal? insurance issu]   
(f]+ gr\p or individual heal? insurance 
cov]age t is n a gr&fa!r$ plan 7z def9$ 
9 section #abea7;e7 ( ! ,pati5t         
,protection & ,af=dable ,c>e ,act72     
7#e7 provides broad in=mation = wom51   
ph>maci/s1 ph>macies1 & provid]s to     
ensure full access to all ,food & ,drug 
,adm9i/ration-approv$ =ms (             
contraception & prev5tive s]vices t are 
cov]$ 9 accordance ) section #bgac )\t  
co/-%>+2  7#f7 addresses heal?          
disp>ities 9 prev5tive c>e = wom52  7#g7
 in=ms wom5 ab\t :at to d if !y are d5i$
 entitl$ b5efits & s]vices by mak+ !m   
aw>e ( ! ,(fice ( ! ,ombudsp]son ( !    
,(fice on ,wom5's ,heal? "u section     
#cii,,oo2 &  7#h7 provides robu/        
in=mation ab\t access to heal? c>e      
provid]s ?r\gh bo? private & public     
heal? insurance programs1 includ+       
in=mation reg>d+ an employ]'s           

contraceptive cov]age policy4  7c7 ,m$ia
 campaign  7#a7 ,9 g5]al ,n lat] ?an    
#ahj days aft] ! date ( enactm5t ( !    
#ba/ ,c5tury ,wom5's ,heal? ,act (      
#bjae1 ! ,secret>y %all e/abli% &       
implem5t a national m$ia campaign to    
dissem9ate ! in=mation describ$ 9       
subsection 7b74  7#b7 ,requirem5ts ,!   
campaign describ$ 9 p>agraph 7#a7-- 7,a7
 %all provide in=mation ab\t ! updat$   
guidel9es = wom5's prev5tive s]vices    
describ$ 9 subsection 7b77#a71 promote  
well-woman visits describ$ 9 subsection 
7b77#b71 & provide in=mation on !       
prev5tive s]vices = wom5 describ$ 9     
subsection 7b77#c72 &  7,b7 may include 
! use ( television1 radio1 ,int]net1 &  
o!r comm]cial m>ket+ v5ues4  7d7        
,int]net website  7#a7 ,9 g5]al ,!      
,secret>y1 9 consultation ) private     
sector exp]ts1 or ?r\gh a contract ) a  
private entity su* z a m$ical           
association or non-pr(it organization1  
%all e/abli% an ,int]net website to--   
7,a7 dissem9ate in=mation on prev5tive  

heal? s]vices = wom5 & families directly
 or ?r\gh heal? ag5cies1 pr(essional &  
nonpr(it organizations1 consum] gr\ps1  
in/itutions ( high] education1 cl9ics1 !
 m$ia1 or ,f$]al1 ,/ate1 & local        
ag5cies2 &  7,b7 provide in=mation &    
res\rces ab\t ! updat$ guidel9es =      
wom5's prev5tive s]vices1 promote       
well-woman visits1 & provide in=mation  
on wom5's prev5tive s]vices4  7#b7      
,report+ tool ,! ,secret>y1 act+ ?r\gh !
 ,ombudsp]son on ,wom5's ,heal? appo9t$ 
"u section #cii,,oo1 %all develop &     
op]ate a consum]-focus$ report+ tool on 
! ,int]net website e/abli%$ "u p>agraph 
7#a7 t enables wom5 & families to report
 in/ances ( be+ inappropriately *>g$ =1 
or n be+ provid$1 b5efits "u section    
#bgac4  7#c7 ,guidance & policy ,!      
,ombudsp]son %all use in=mation obta9$  
?r\gh ! website to develop              
recomm5dations on policy & implem5tation
 ) respect to ! b5efits & s]vices "u    
section #bgac1 to ensure t wom5 &       
families receive su* b5efits & s]vices z

 af=d$ by ! law4  7e7 ,fund+ ,f any     
funds o!rwise made available to !       
,dep>tm5t ( ,heal? & ,human ,s]vices1 ! 
,secret>y may allocate su* sums z may be
 necess>y to c>ry out ?is section4  4   
#i4 ,reproductive heal? s]vices access  
,title ,,iii ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bda;g et seq471 z  
am5d$ by section #h1 is fur!r am5d$ by  
add+ at ! end ! foll[+3  #cii,,oo-#b4   
,/udy & ,report on ,wom5's ,heal? ,c>e  
,access to ! ,full ,range (             
,reproductive ,heal? ,c>e ,s]vices  7a7 
,9 g5]al ,! ,secret>y %all conduct a    
/udy on wom5's access to ! full range ( 
reproductive heal? c>e s]vices across ! 
,unit$ ,/ates1 &1 n lat] ?an ,janu>y #a1
 #bjag1 & e #e ye>s !reaft]1 ! ,secret>y
 %all submit a report to ,congress on   
su* /udy4  7b7 ,cont5ts ,! /udy & report
 "u subsection 7a7 %all include-- 7#a7  
id5tification & analysis ( h[ ,/ate laws
 reg>d+ abortion access1 includ+        
facility requirem5ts includ+ admitt+    
privileges1 insurance cov]age           

limitations1 m&atory delays1 ge/ational 
limits1 m$ication re/rictions1 & p>5tal 
notification & cons5t impact a wom5's   
access to reproductive family plann+    
s]vices2  7#b7 id5tification (          
geographic areas 9 :i* su* ,/ate laws & 
practices h a /rong impact on access to 
family plann+ s]vices = wom5 & _!       
families2  7#c7 analysis ( factors      
relat$ to reproductive heal? s]vices t  
impact wom51 *ildr51 & families1 su* z !
 ability to "w1 *ildr5's access to heal?
 insurance1 access to heal? cov]age1 & !
 ,/ate's role 9 mak+ ^! s]vices         
available to wom5 & families2  7#d7     
analysis ( h[ wom5's access to family   
plann+ s]vices 9 su* geographic areas   
correlate ) mat]nity-relat$ heal?       
outcomes1 includ+ ! rates ( infant      
mortality1 premature bir?s1 bir? weight1
 burd5 ( sexually transmitt$ infections1
 & o!r measures deem$ appropriate2 &    
7#e7 ! recomm5dations ( ! ,secret>y )   
respect to ! necess>y cov]age ( s]vices 
to ensure full access to reproductive   

s]vices & be/ practices = ,/ates4  4    
#aj4 ,mat]nal heal? acc\ntability  7a7  
,purposes  ,! purposes ( ?is section 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$uce
 & prev5t su* dea?s4  7b7 ,uni=m ,/ate  
mat]nal mortality review committees on  
pregnancy-,relat$ dea?s  7#a7 ,condition
 ( receipt ( paym5ts f allotm5t "u      
,mat]nal & ,*ild ,heal? ,s]vice ,block  
,grant ,title ,,iii ( ! ,public ,heal?  

,s]vice ,act 7#db ,u4,s4,c4 #bda;g et   
seq471 z am5d$ by section #i1 is fur!r  
am5d$ by add+ at ! end ! foll[+3        
#cii,,oo-#c4 ,uni=m ,/ate mat]nal       
mortality review committees on          
pregnancy-relat$ dea?s  7a7 ,grants     
7#a7 ,9 g5]al ,= ea* ( fiscal ye>s #bjaf
 ?r\gh #bjbb1 ! ,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 provide
 = public disclosure ( in=mation1 9     
accordance ) subsection 7c72 &  7,e7    

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 #bjaf ?r\gh #bjbb4  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 website ( ! ,/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#b774 ,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#b772  
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  
activities3  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 specialties     

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$2 &       
7,,xvii7 policymak]s4  7iv7 ,div]se     
community memb]%ip ,! composition ( su* 
a committee1 ) respect to a ,/ate1 %all 
include--  7,i7 repres5tatives f div]se 
communities1 p>ticul>ly ^? communities  
)9 su* ,/ate mo/ sev]ely affect$ 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 ,public disclosure (
 in=mation  7#a7 ,9 g5]al ,= fiscal ye> 
#bjaf 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
 relat+ to ! f9d+s = su* ye> ( ! ,/ate  
mat]nal mortality review committee      
e/abli%$ by ! ,/ate "u ?is section4     
7#b7 ,in=mation cle>+h\se ,! ,secret>y  
%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
  7d7 ,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$4  7e7     
,def9itions ,= purposes ( ?is section3  
7#a7 ,pregnancy-associat$ dea? ,! 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 ,pregnancy-relat$ dea? ,! 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 ,woman ( *ildbe>+
 age ,! t]m woman ( *ildbe>+ age means a
 woman :o is at lea/ #aj ye>s ( age & n 
m ?an #ed ye>s ( age4  4  7c7 ,,nih     
work%op & rese>* plan developm5t on     
sev]e mat]nal morbidity  7#a7 ,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    
7#b7 ,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   
7#c7 ,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  7#d7 ,au?orization (      
appropriations ,!re is au?oriz$ to be   
appropriat$ = fiscal ye> #bjaf-- 7,a7   
#ej1jjj to c>ry out p>agraph 7#a72 &    
7,b7 #ajj1jjj to c>ry out p>agraph 7#b74
  7d7 ,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