,,ii #aaeth ,,congress #b;d ,session ,h4 ,r4 #acah ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #ab1 #bjah,received ,,an ,,act ,to support ,states in their work to save and sustain the health of mothers during pregnancy1 childbirth1 and in the postpartum period1 to eliminate disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths1 to identify solutions to improve health care quality and health outcomes for mothers1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,preventing ,maternal ,deaths ,act of #bjah4 #b4 ,safe motherhood ,section #cag,k of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a7-- 7i7 by striking purpose of this subsection is to develop and inserting purposes of this subsection are to establish or continue a ,federal initiative to support ,state and tribal maternal mortality review committees1 to improve data collection and reporting around maternal mortality1 and to develop or support2 7ii7 by striking population at risk of death and and inserting populations at risk of death and severe2 and 7,b7 in paragraph 7#b7-- 7i7 by amending subparagraph 7,a7 to read as follows3 7,a7 ,the ,secretary may continue and improve activities related to a national maternal mortality data collection and surveillance program to identify and support the review of pregnancy-associated deaths and pregnancy-related deaths that occur during1 or within #a year following1 pregnancy4 2 and 7ii7 by inserting after subparagraph 7,c7 the following3 7,d7 ,the ,secretary may1 in cooperation with ,states1 ,indian tribes1 and tribal organizations1 develop a program to support ,states1 ,indian tribes1 and tribal organizations in establishing or operating maternal mortality review committees1 in accordance with subsection 7d74 2 7#b7 in subsection 7b77#b7-- 7,a7 in subparagraph 7,a7-- 7i7 by striking encouraging preconception and inserting prepregnancy2 and 7ii7 by striking diabetics and inserting women with diabetes and women with substance use disorder before the semicolon2 7,b7 in subparagraph 7,h7-- 7i7 by inserting the identification of the determinants of disparities in maternal care1 health risks1 and health outcomes1 including before an examination2 and 7ii7 by inserting and other groups of women with disproportionately high rates of maternal mortality before the semicolon2 7,c7 in subparagraph 7,i71 by striking domestic and inserting interpersonal2 7,d7 by redesignating subparagraphs 7,i7 through 7,l7 as subparagraphs 7,j7 through 7,m71 respectively2 7,e7 by inserting after subparagraph 7,h7 the following3 7,i7 activities to reduce disparities in maternity services and outcomes2 2 and 7,f7 in subparagraph 7,k71 as so redesignated1 by striking 1 alcohol and illegal drug use and inserting and substance abuse and misuse2 7#c7 in subsection 7c7-- 7,a7 by striking 7#a7 ,in general--,the ,secretary and inserting ,the ,secretary2 7,b7 by redesignating subparagraphs 7,a7 through 7,c7 as paragraphs 7#a7 through 7#c71 respectively1 and adjusting the margins accordingly2 7,c7 in paragraph 7#a71 as so redesignated1 by striking and the building of partnerships with outside organizations concerned about safe motherhood2 7,d7 in paragraph 7#b71 as so redesignated1 by striking 2 and and inserting a semicolon2 7,e7 in paragraph 7#c71 as so redesignated1 by striking the period and inserting 2 and2 and 7,f7 by adding at the end the following3 7#d7 activities to promote physical1 mental1 and behavioral health during1 and up to #a year following1 pregnancy1 with an emphasis on prevention of1 and treatment for1 mental health disorders and substance use disorder4 2 7#d7 by redesignating subsection 7d7 as subsection 7f72 7#e7 by inserting after subsection 7c7 the following3 7d7 ,maternal mortality review committees 7#a7 ,in general ,in order to participate in the program under subsection 7a77#b77;,d71 the applicable maternal mortality review committee of the ,state1 ,indian tribe1 or tribal organization shall-- 7,a7 include multidisciplinary and diverse membership that represents a variety of clinical specialties1 ,state1 tribal1 or local public health officials1 epidemiologists1 statisticians1 community organizations1 geographic regions within the area covered by such committee1 and individuals or organizations that represent the populations in the area covered by such committee that are most affected by pregnancy-related deaths or pregnancy-associated deaths and lack of access to maternal health care services2 and 7,b7 demonstrate to the ,centers for ,disease ,control and ,prevention that such maternal mortality review committee's methods and processes for data collection and review1 as required under paragraph 7#c71 use best practices to reliably determine and include all pregnancy-associated deaths and pregnancy-related deaths1 regardless of the outcome of the pregnancy4 7#b7 ,process for confidential reporting ,states1 ,indian tribes1 and tribal organizations that participate in the program described in this subsection shall1 through the ,state maternal mortality review committee1 develop a process that-- 7,a7 provides for confidential case reporting of pregnancy-associated and pregnancy-related deaths to the appropriate ,state or tribal health agency1 including such reporting by-- 7i7 health care professionals2 7ii7 health care facilities2 7iii7 any individual responsible for completing death records1 including medical examiners and medical coroners2 and 7iv7 other appropriate individuals or entities2 and 7,b7 provides for voluntary and confidential case reporting of pregnancy-associated deaths and pregnancy-related deaths to the appropriate ,state or tribal health agency by family members of the deceased1 and other appropriate individuals1 for purposes of review by the applicable maternal mortality review committee2 and 7,c7 shall include-- 7i7 making publicly available contact information of the committee for use in such reporting2 and 7ii7 conducting outreach to local professional organizations1 community organizations1 and social services agencies regarding the availability of the review committee4 7#c7 ,data collection and review ,states1 ,indian tribes1 and tribal organizations that participate in the program described in this subsection shall-- 7,a7 annually identify pregnancy-associated deaths and pregnancy-related deaths-- 7i7 through the appropriate vital statistics unit by-- 7,i7 matching each death record related to a pregnancy-associated death or pregnancy-related death in the ,state or tribal area in the applicable year to a birth certificate of an infant or fetal death record1 as applicable2 7,,ii7 to the extent practicable1 identifying an underlying or contributing cause of each pregnancy-associated death and each pregnancy-related death in the ,state or tribal area in the applicable year2 and 7,,iii7 collecting data from medical examiner and coroner reports1 as appropriate2 7ii7 using other appropriate methods or information to identify pregnancy-associated deaths and pregnancy-related deaths1 including deaths from pregnancy outcomes not identified through clause 7i77,i72 7,b7 through the maternal mortality review committee1 review data and information to identify adverse outcomes that may contribute to pregnancy-associated death and pregnancy-related death1 and to identify trends1 patterns1 and disparities in such adverse outcomes to allow the ,state1 ,indian tribe1 or tribal organization to make recommendations to individuals and entities described in paragraph 7#b77;,a71 as appropriate1 to improve maternal care and reduce pregnancy-associated death and pregnancy-related death2 7,c7 identify training available to the individuals and entities described in paragraph 7#b77;,a7 for accurate identification and reporting of pregnancy-associated and pregnancy-related deaths2 7,d7 ensure that1 to the extent practicable1 the data collected and reported under this paragraph is in a format that allows for analysis by the ,centers for ,disease ,control and ,prevention2 and 7,e7 publicly identify the methods used to identify pregnancy-associated deaths and pregnancy-related deaths in accordance with this section4 7#d7 ,confidentiality ,states1 ,indian tribes1 and tribal organizations participating in the program described in this subsection shall establish confidentiality protections to ensure1 at a minimum1 that-- 7,a7 there is no disclosure by the maternal mortality review committee1 including any individual members of the committee1 to any person1 including any government official1 of any identifying information about any specific maternal mortality case2 and 7,b7 no information from committee proceedings1 including deliberation or records1 is made public unless specifically authorized under ,state and ,federal law4 7#e7 ,reports to ,,cdc ,for fiscal year #bjai1 and each subsequent fiscal year1 each maternal mortality review committee participating in the program described in this subsection shall submit to the ,director of the ,centers for ,disease ,control and ,prevention a report that includes-- 7,a7 data1 findings1 and any recommendations of such committee2 and 7,b7 as applicable1 information on the implementation during such year of any recommendations submitted by the committee in a previous year4 7#f7 ,state partnerships ,states may partner with one or more neighboring ,states to carry out the activities under this subparagraph4 ,with respect to the ,states in such a partnership1 any requirement under this subparagraph relating to the reporting of information related to such activities shall be deemed to be fulfilled by each such ,state if a single such report is submitted for the partnership4 7#g7 ,appropriate mechanisms for ,indian tribes and tribal organizations ,the ,secretary1 in consultation with ,indian tribes1 shall identify and establish appropriate mechanisms for ,indian tribes and tribal organizations to demonstrate1 report data1 and conduct the activities as required for participation in the program described in this subsection4 ,such mechanisms may include technical assistance with respect to grant application and submission procedures1 and award management activities4 7#h7 ,research availability ,the ,secretary shall develop a process to ensure that data collected under paragraph 7#e7 is made available1 as appropriate and practicable1 for research purposes1 in a manner that protects individually identifiable or potentially identifiable information and that is consistent with ,state and ,federal privacy law4 7e7 ,definitions ,in this section-- 7#a7 the terms ,indian tribe and tribal organization have the meanings given such terms in section #d of the ,indian ,self-,determination and ,education ,assistance ,act2 7#b7 the term pregnancy-associated death means a death of a woman1 by any cause1 that occurs during1 or within #a year following1 her pregnancy1 regardless of the outcome1 duration1 or site of the pregnancy2 and 7#c7 the term pregnancy-related death means a death of a woman that occurs during1 or within #a year following1 her pregnancy1 regardless of the outcome1 duration1 or site of the pregnancy-- 7,a7 from any cause related to1 or aggravated by1 the pregnancy or its management2 and 7,b7 not from accidental or incidental causes4 2 and 7#f7 in subsection 7f71 as so redesignated1 by striking such sums as may be necessary for each of the fiscal years #bjja through #bjje and inserting #eh1jjj1jjj for each of fiscal years #bjai through #bjbc4 ,passed the ,house of ,representatives ,december #aa1 #bjah4,karen ,l4 ,haas1,clerk4