,,ii  #aae? ,,congress  #a/ ,session    
,s4 #aaab  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #aa1 #bjag,ms4    
,heitkamp 7= h]self & ,mrs4 ,capito7    
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to support ,/ates 9 _! "w to
 save & su/a9 ! heal? ( mo!rs dur+      
pregnancy1 *ildbir?1 & 9 ! po/p>tum     
p]iod1 to elim9ate disp>ities 9 mat]nal 
heal? outcomes = pregnancy-relat$ &     
pregnancy-associat$ dea?s1 to id5tify   
solutions to improve heal? c>e quality &
 heal? outcomes = mo!rs1 & = o!r        
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,mat]nal ,heal?            
,acc\ntability ,act ( #bjag4  #b4       
,f9d+s2 purposes  7a7 ,f9d+s ,congress  
f9ds ! foll[+3  7#a7 ,! ,unit$ ,/ates is
 rank$ #ej? globally = its mat]nal      
mortality rate1 & x is "o ( eight       
c\ntries 9 :i* ! mat]nal mortality rate 
has be5 on ! rise4  7#b7 ,9 rec5t       
/udies1 ! e/imat$ mat]nal mortality rate

 9 ! ,unit$ ,/ates increas$ by          
approximately #bf4f p]c5t f #bjjj to    
#bjad1 ) ! rate increas+ 9 ne>ly all    
,/ates4 ,?is report$ increase1 along )  
no improvem5t 9 previ\s ye>s1 rema9s a  
s\rce ( great conc]n = ! ,c5t]s =       
,disease ,control & ,prev5tion 7,,cdc71 
heal? c>e provid]s1 & pati5t advocates  
su* z ! ,am]ican ,congress (            
,ob/etricians & ,gynecologi/s1 !        
,association ( ,wom5's ,heal?1          
,ob/etric1 & ,neonatal ,nurses1 & !     
,preeclampsia ,f\ndation4  7#c7 ,mat]nal
 dea?s 9 ! ,unit$ ,/ates result f       
pregnancy-relat$ causes su* z           
hemorrhage1 hyp]t5sive disease &        
preeclampsia1 embolic disease1 sepsis1 &
 sub/ance use disord] & ov]dose1 &      
viol5t causes su* z motor vehicle       
accid5ts1 homicide1 & suicide4  7#d7 ,z 
( #bjag1 less ?an #be ,/ates conduct    
sy/ematic reviews ( mat]nal dea?s &_/or 
h /&+ mat]nal mortality review          
committees 9 ord] to develop ! data ne$$
 to "w t[>d managem5t & solutions4  7#e7

 ,review ( pregnancy-relat$ &           
pregnancy-associat$ dea?s is ess5tial to
 det]m9+ /rategies = develop+ prev5tion 
ef=ts & quality improvem5t & quality    
control programs4 ,! ,unit$ ,/ates mu/  
id5tify at-risk populations & und]/& h[ 
to support !m to make pregnancy & !     
po/p>tum p]iod saf]4  7#f7 ,! mo/ sev]e 
complications ( pregnancy1 g5]ally      
ref]r$ to z sev]e mat]nal morbidity     
7,,smm71 affect m ?an #fe1jjj wom5 9 !  
,unit$ ,/ates e ye>4 ,! ,,cdc uses      
,,icd-#i-;,,cm codes1 :i* indicate a    
pot5tially life-?reat5+ mat]nal         
condition or complication1 to def9e     
,,smm4  7#g7 ,data f ! ,,cdc %[s ,black 
wom5 are ?ree times m likely to die f   
complications ( pregnancy or *ildbir?   
?an ,:ite wom53 #db4h ,black wom5 p]    
#ajj1jjj live bir?s1 z oppos$ to #ab4e  
,:ite wom5 & #ag4c wom5 ( o!r races4    
7#h7 ,! ,,cdc recomm5ds t mat]nal dea?s 
be inve/igat$ ?r\gh ,/ate               
collaboratives4 ,^! ,/ate collaboratives
 w\ld br+ toge!r lead]s 9 ob/etric &    

neonatal heal? c>e f private1 academic1 
& public heal? c>e sett+s to make       
recomm5dations = prev5t+                
pregnancy-relat$ & pregnancy-associat$  
dea?s & heal? complications & id5tify   
ways to improve quality ( c>e = wom5 &  
infants4  7#i7 ,a few ,/ates1 includ+   
,cali=nia1 h work$ to develop & /r5g!n  
mat]nal morbidity & mortality review    
sy/ems & utilize data to r$uce mat]nal  
dea?s & injuries to address lead+ issues
 su* z mat]nal hemorrhage1 hyp]t5sion & 
preeclampsia1 & heal? & racial          
disp>ities4  7b7 ,purposes ,! purposes (
 ?is ,act are ! foll[+3 7#a7 ,to e/abli%
 a %>$ responsibility betwe5 ,/ates & ! 
,f$]al ,gov]nm5t to id5tify             
opportunities = improvem5t 9 quality (  
c>e & sy/em *anges1 & to educate & in=m 
heal? in/itutions & pr(essionals1 wom51 
& families ab\t prev5t+ pregnancy-relat$
 & pregnancy-associat$ dea?s &          
complications & r$uc+ disp>ities4  7#b7 
,to develop a model = ,/ates & ,f$]ally 
recogniz$ ,indian tribes & tribal       

organizations 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$uce &      
prev5t su* dea?s4  #c4 ,/ate mat]nal    
mortality review committees on          
pregnancy-relat$ & pregnancy-associat$  
dea?s  7a7 ,program au?oriz$  7#a7 ,9   
g5]al ,! ,secret>y ( ,heal? & ,human    
,s]vices1 ?r\gh ! ,director ( ! ,c5t]s =
 ,disease ,control & ,prev5tion1 %all   
e/abli% a grant program "u :i* !        
,secret>y may make grants to ,/ates1 &  
,f$]ally recogniz$ ,indian tribes &     
tribal organizations1 = ! purpose (--   
7,a7 c>ry+ out ! activities describ$ 9  
subsection 7b77#a72  7,b7 e/abli%+ &    
su/a9+ a ,/ate mat]nal mortality review 
committee1 9 accordance ) subsection    
7b77#b72  7,c7 ensur+ t ! ,/ate dep>tm5t
 ( heal? c>ries out ! activities        
describ$ 9 subsection 7b77#c72  7,d7    

dissem9at+ ! case ab/raction =m develop$
 "u subsection 7c72 &  7,e7 provid+ = ! 
public disclosure ( in=mation1 9        
accordance ) subsection 7d74  7#b7      
,crit]ia ,! ,secret>y %all e/abli%      
crit]ia = det]m9+ eligibility =1 & !    
am\nt ( a grant aw>d$ to1 a ,/ate "u    
p>agraph 7#a74 ,su* crit]ia %all provide
 t 9 ! case ( a ,/ate t receives a grant
 "u p>agraph 7#a7 = a fiscal ye> & is   
det]m9$ by ! ,secret>y to h n us$ su*   
grant 9 accordance ) ?is section1 su*   
,/ate may n be eligible = su* a grant = 
any subsequ5t fiscal ye>4  7b7 ,use (   
funds  7#a7 ,review ( pregnancy-relat$ &
 pregnancy-associat$ dea?s ,) respect to
 a ,/ate t receives a grant "u          
subsection 7a77#a71 ! foll[+ %all apply3
 7,a7 ,process = m&atory report+ (      
pregnancy-relat$ & pregnancy-associat$  
dea?s  7i7 ,9 g5]al ,! ,/ate1 ?r\gh !   
,/ate mat]nal mortality review committee
 e/abli%$ "u subsection 7a77#a71 %all   
develop a process t provides = m&atory &
 confid5tial case report+ to ! ,/ate    

dep>tm5t ( heal? by individuals &       
entities describ$ 9 clause 7ii7 )       
respect to pregnancy-relat$ &           
pregnancy-associat$ dea?s4  7ii7        
,individuals & entities describ$        
,individuals & entities describ$ 9 ?is  
clause include ea* ( ! foll[+3 7,i7     
,heal? c>e pr(essionals4  7,,ii7 ,m$ical
 exam9]s4  7,,iii7 ,m$ical coron]s4     
7,,iv7 ,hospitals4  7,v7 ,bir? c5t]s4   
7,,vi7 ,o!r heal? c>e facilities4       
7,,vii7 ,o!r individuals responsible =  
complet+ dea? records4  7,,viii7 ,o!r   
appropriate individuals or entities     
specifi$ by ! ,secret>y4  7,b7 ,process 
= volunt>y report+ ( pregnancy-relat$ & 
pregnancy-associat$ dea?s ,! ,/ate1     
?r\gh ! ,/ate mat]nal mortality review  
committee e/abli%$ "u subsection        
7a77#a71 %all develop a process t       
provides = volunt>y & confid5tial case  
report+ to ! ,/ate dep>tm5t ( heal? by  
family memb]s ( ! deceas$ & o!r         
individuals on possible pregnancy-relat$
 & pregnancy-associat$ dea?s4 ,su*      

process %all include--  7i7 mak+        
publicly available on ! website ( !     
,/ate dep>tm5t ( heal? a telephone      
numb]1 ,int]net web l9k1 & email address
 = su* report+2 &  7ii7 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 clause  
7i74  7,c7 ,id5tification (             
pregnancy-relat$ & pregnancy-associat$  
dea?s by ,/ate vital /ati/ics unit ,!   
,/ate1 ?r\gh ! vital /ati/ics unit ( !  
,/ate1 %all annually id5tify            
pregnancy-relat$ & pregnancy-associat$  
dea?s occurr+ 9 su* ,/ate 9 ! ye>       
involv$ by--  7i7 mat*+ ea* dea? record 
( a woman 9 su* ye> to a live bir?      
c]tificate or an infant dea? record = ! 
purpose ( id5tify+ dea?s ( wom5 t       
occurr$ dur+ pregnancy & )9 "o ye> aft] 
! end ( a pregnancy2  7ii7 id5tify+ ea* 
dea? ( a woman 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$ical exam9] & coron] reports2 &    
7iv7 us+ any o!r me?od ! ,/ate may      
devise to id5tify mat]nal dea?s su* z   
review+ a r&om sample ( report$ dea?s ( 
wom5 to asc]ta9 cases ( pregnancy-relat$
 & pregnancy-associat$ dea?s t are n    
disc]nable f a review ( dea? records    
alone4  ,= purposes ( effectively       
collect+ & obta9+ data on               
pregnancy-relat$ & pregnancy-associat$  
dea?s1 ! ,/ate %all adopt ! mo/ rec5t   
/&>diz$ bir? & dea? records1 z issu$ by 
! ,national ,c5t] = ,vital ,heal?       
,/ati/ics1 includ+ ! recomm5d$ *eckbox  
section = pregnancy on ea* dea? record4 
7,d7 ,case inve/igation & developm5t (  
case summ>ies  7i7 ,9 g5]al ,foll[+ !   
receipt ( reports by ! ,/ate dep>tm5t ( 
heal? pursuant to subp>agraph 7,a7 or   
7,b7 & ! collection ( cases (           
pregnancy-relat$ & pregnancy-associat$  
dea?s by ! vital /ati/ics unit ( ! ,/ate

 "u subp>agraph 7,c71 ! ,/ate1 ?r\gh !  
,/ate mat]nal mortality review committee
 e/abli%$ "u subsection 7a77#a71 %all   
inve/igate ea* case1 us+ ! case         
ab/raction =m describ$ 9 subsection 7c71
 & prep>e a de-id5tifi$ case summ>y =   
ea* case1 :i* %all be review$ by !      
committee & includ$ 9 applicable        
reports4 ,! ,/ate dep>tm5t ( heal? or   
vital /ati/ics unit ( ! ,/ate1 z ! case 
may be1 %all provide ! ,/ate mat]nal    
mortality review committee ) access to !
 in=mation collect$ pursuant to         
subp>agraphs 7,a7 or 7,b71 or "u        
subp>agraph 7,c71 z necess>y to c>ry out
 ?is subp>agraph4  7ii7 ,m&atory data & 
in=mation ,ea* case inve/igation "u ?is 
subp>agraph %all1 subject to            
availability1 include data & in=mation  
obta9$ ?r\gh--  7,i7 m$ical exam9] &    
autopsy reports ( ! woman involv$2      
7,,ii7 m$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? ( ! woman2 
7,,iii7 oral & writt5 int]views (       
individuals directly involv$ 9 ! mat]nal
 c>e ( ! woman dur+ & imm$iately foll[+ 
! pregnancy ( ! woman1 includ+ heal?    
c>e1 m5tal heal?1 & social s]vice       
provid]s1 z applicable2  7,,iv7         
socioeconomic & o!r relevant backgr\nd  
in=mation ab\t ! woman2  7,v7 any       
in=mation collect$ "u subp>agraph       
7,c77i72 &  7,,vi7 any o!r in=mation on 
! cause ( dea? ( ! woman1 su* z social  
s]vices & *ild welf>e reports4  7iii7   
,discretion>y data & in=mation ,ea* case
 inve/igation "u ?is subp>agraph may    
include data & in=mation obta9$ ?r\gh   
oral or writt5 int]views ( ! family ( ! 
woman4  7#b7 ,/ate mat]nal mortality    
review committees  7,a7 ,m&atory        
activities ,a ,/ate mat]nal mortality   
review committee e/abli%$ "u subsection 
7a77#a7 %all c>ry out ! foll[+          
activities3  7i7 ,develop ! processes   
describ$ 9 subp>agraphs 7,a7 & 7,b7 (   

p>agraph 7#a74  7ii7 ,review ! data &   
in=mation collect$ 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 
7iii7 ,c>ry out ! activities describ$ 9 
p>agraph 7#a77;,d74  7iv7 ,develop      
recomm5dations1 bas$ on ! case summ>ies 
prep>$ "u p>agraph 7#a77;,d7 & ! data & 
in=mation collect$ "u p>agraph          
7#a77;,c71 to improve mat]nal c>e1      
social & heal? s]vices1 & public heal?  
policy & in/itutions1 includ+ improv+   
access to mat]nal c>e & social & heal?  
s]vices & id5tify+ disp>ities 9 mat]nal 
c>e & outcomes4  7,b7 ,discretion>y     
activities  7i7 ,9 g5]al ,a ,/ate       
mat]nal mortality review committee      
e/abli%$ "u subsection 7a77#a7 may1 :ile
 subject to confid5tiality requirem5ts1 

pres5t f9d+s & recomm5dations bas$ on ! 
case summ>ies prep>$ "u p>agraph        
7#a77;,d7 directly to a heal? c>e       
facility or its local or ,/ate          
pr(essional organization = ! purpose (--
  7,i7 in/itut+ policy *anges1          
educational activities1 & improvem5ts 9 
! quality ( c>e provid$ by ! facility2 &
  7,,ii7 explor+ & =m+ regional         
collaborations4  7ii7 ,inve/igation (   
cases ( ,sev]e ,mat]nal ,morbidity ,a   
,/ate mat]nal mortality review committee
 may inve/igate cases ( sev]e mat]nal   
morbidity & any su* inve/igation may    
include data & in=mation obta9$ ?r\gh-- 
7,i7 id5tifi$ pati5t regi/ries2 or      
7,,ii7 oral or writt5 int]views ( !     
woman conc]n$ & ! family ( su* woman4   
7,c7 ,composition ( ,/ate mat]nal       
mortality review committees  7i7 ,9     
g5]al ,a ,/ate mat]nal mortality review 
committee e/abli%$ "u subsection 7a77#a7
 %all be multidiscipl9>y & div]se4      
,memb]%ip on ! ,/ate mat]nal mortality  
review committee %all be review$        

annually by ! ,/ate dep>tm5t ( heal? to 
ensure t memb]%ip repres5tation         
requirem5ts are be+ fulfill$ 9          
accordance ) ?is subp>agraph4  7ii7     
,requir$ memb]%ip ,ea* ,/ate mat]nal    
mortality 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/s7 & family practice          
physicians2  7,,ii7 c]tifi$ nurse       
midwives1 c]tifi$ midwives1 & advanc$   
practice nurses2  7,,iii7 hospital-bas$ 
regi/]$ nurses2  7,,iv7 repres5tatives (
 ! mat]nal & *ild heal? dep>tm5t ( !    
,/ate dep>tm5t ( heal?2  7,v7 social    
s]vice provid]s or social work]s1       
includ+ ^? ) exp]i5ce work+ )           
communities div]se ) respect to race1   
e?nicity1 & limit$ ,engli% pr(ici5cy2   
7,,vi7 *ief m$ical exam9]s or designees2
  7,,vii7 facility repres5tatives1 su* z
 f hospitals or bir? c5t]s2  7,,viii7   
pati5t advocates1 community mat]nal     

heal? organizations1 & m9ority advocacy 
gr\ps t repres5t ^? div]se racial &     
e?nic communities )9 ! ,/ate t are ! mo/
 affect$ by pregnancy-relat$ or         
pregnancy-associat$ dea?s & by a lack ( 
access to mat]nal heal? c>e s]vices2 &  
7,,ix7 repres5tatives ( ! dep>tm5ts (   
heal? or public heal? ( major cities 9 !
 ,/ate4  7iii7 ,discretion>y memb]%ip   
,ea* ,/ate mat]nal mortality review     
committee may also include              
repres5tatives f o!r relevant academic1 
heal?1 social s]vice1 or policy         
pr(essions or community organizations on
 an ongo+ basis1 or z ne$$1 z det]m9$   
b5eficial by ! committee1 includ+--     
7,i7 ane/hesiologi/s2  7,,ii7 em]g5cy   
physicians2  7,,iii7 pa?ologi/s2  7,,iv7
 epidemiologi/s2  7,v7 int5sivi/s2      
7,,vi7 nutritioni/s2  7,,vii7 m5tal     
heal? pr(essionals2  7,,viii7 sub/ance  
use disord] treatm5t speciali/s2  7,,ix7
 repres5tatives ( relevant pati5t &     
provid] advocacy gr\ps2  7,x7 academics2
  7,,xi7 p>am$ics2  7,,xii7 risk        

managem5t speciali/s2 &  7,,xiii7       
repres5tatives ( ,f$]ally recogniz$     
,indian tribes & tribal organizations4  
7iv7 ,/aff ,/aff ( ea* ,/ate mat]nal    
mortality 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,d7      
,option = ,/ates to e/abli% regional    
mat]nal mortality review committees     
,/ates may *oose to p>tn] ) "o or m     
neighbor+ ,/ates to c>ry out !          
activities requir$ ( a ,/ate mat]nal    
mortality review committee "u ?is       
section4 ,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,e7 ,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
 ,act 7#db ,u4,s4,c4 #cjj;jj-#ai771 ea* 
,/ate mat]nal mortality review committee
 & regional mat]nal mortality review    
committee e/abli%$ "u subsection 7a77#a7
 or subsection 7b77#b77;,d71 z ! case   
may be1 %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  7#c7 ,/ate     
dep>tm5t ( heal? activities ,) respect  
to a ,/ate t receives a grant "u        
subsection 7a77#a71 ! ,/ate dep>tm5t (  
heal? %all--  7,a7 9 consultation ) !   
,/ate mat]nal mortality review committee
 & 9 conjunction ) relevant pr(essional 
organizations & pati5t advocacy         
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 committee &    
implem5t ! recomm5dations ( ! committee4
  7c7 ,case ab/raction =m  7#a7         
,dissem9ation ,! ,director ( ! ,c5t]s = 
,disease ,control & ,prev5tion %all     
dissem9ate a uni=m case ab/raction =m to
 ,/ates & ,/ate mat]nal mortality review
 committees = ! purpose (--  7,a7 ensur+
 t ! data & in=mation collect$ & review$
 by su* committees c be pool$ = review  
by ! ,dep>tm5t ( ,heal? & ,human        
,s]vices & its ag5cies2 &  7,b7 pres]v+ 
! uni=mity ( ! in=mation collect$ =     
,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$]al level4  7d7
 ,public disclosure ( in=mation  7#a7 ,9
 g5]al ,= fiscal ye> #bjah1 or a        
subsequ5t fiscal ye>1 ea* ,/ate receiv+ 
a grant "u ?is section = su* ye> %all1  
subject to p>agraph 7#c71 provide = !   
public disclosure1 & submission to !    
in=mation cle>+h\se e/abli%$ "u p>agraph
 7#b71 ( ! in=mation includ$ 9 ! report 
( ! ,/ate "u subsection 7f77#a7 = su*   
ye>4  7#b7 ,in=mation cle>+h\se ,!      
,secret>y %all e/abli% an in=mation     
cle>+h\se1 to 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 dep>tm5ts ( heal?1    
,/ate mat]nal mortality review          
committees1 & heal? provid]s &          
in/itutions4  7#c7 ,confid5tiality (    

in=mation ,9 no case may any            
individually id5tifiable heal? in=mation
 be provid$ to ! public1 or submitt$ to 
! in=mation cle>+h\se1 "u ?is           
subsection4  7e7 ,confid5tiality (      
proce$+s ( ,/ate mat]nal mortality      
review committees  7#a7 ,9 g5]al ,all   
proce$+s & activities ( a ,/ate mat]nal 
mortality review committee e/abli%$ "u  
subsection 7a77#a71 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 confid5tial & may n be 
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
 e/abli%$ "u subsection 7a77#a7 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 may be con/ru$ to prev5t 
a memb] ( a ,/ate mat]nal mortality     
review committee e/abli%$ "u subsection 
7a77#a7 f te/ify+ reg>d+ in=mation t 0  
obta9$ indep5d5t ( su* memb]'s          
p>ticipation on ! committee1 or public  
in=mation4  7#c7 ,availability (        
in=mation = rese>* purposes ,no?+ 9 ?is 
subsection may prohibit a ,/ate mat]nal 
mortality review committee e/abli%$ "u  
subsection 7a77#a7 or ! ,dep>tm5t (     
,heal? & ,human ,s]vices f publi%+      
/ati/ical compilations & rese>* reports 
t--  7,a7 are bas$ on confid5tial       
in=mation1 relat+ to morbidity &        
mortality reviews "u ?is section2 &     
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$4  7f7 ,reports  7#a7 ,/ate      
reports ,= fiscal ye> #bjah1 & ea*      
subsequ5t fiscal ye>1 ea* ,/ate mat]nal 
mortality review committee e/abli%$ "u  
subsection 7a77#a7 & receiv+ a grant "u 
?is section = su* ye>1 %all submit to ! 
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion a report on ! f9d+s &     
recomm5dations ( su* committee &        
in=mation on ! implem5tation ( su*      
recomm5dations dur+ su* ye>4  7#b7      
,annual reports to ,congress ,= fiscal  
ye> #bjah1 & ea* subsequ5t fiscal ye>1 !
 ,secret>y ( ,heal? & ,human ,s]vices   
%all submit to ,congress a report on--  
7,a7 ! f9d+s1 recomm5dations1 &         
implem5tation in=mation submitt$ by any 
,/ate pursuant to p>agraph 7#a72 &  7,b7
 ! /atus ( pregnancy-relat$ &           
pregnancy-associat$ dea?s 9 ! ,unit$    
,/ates1 includ+ recomm5dations on me?ods
 to prev5t su* dea?s 9 ! ,unit$ ,/ates4 
7g7 ,def9itions ,9 ?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 ( ! pregnancy1 f any cause     
relat$ to1 or aggravat$ by1 ! pregnancy 
or its managem5t1 exclud+ any accid5tal 
or incid5tal cause4  7#c7 ,! t]m        
,secret>y means ! ,secret>y ( ,heal? &  
,human ,s]vices4  7#d7 ,! t]m sev]e     
mat]nal morbidity means ! physical &    
psy*ological conditions t result f1 or  
are aggravat$ by1 pregnancy & h an      
adv]se effect on ! heal? ( a woman4     
7#e7 ,! t]m ,/ate means ea* ( ! #ej     
,/ates1 ! ,di/rict ( ,columbia1 & ea* ( 
! t]ritories1 & %all include ,f$]ally   
recogniz$ ,indian tribes & tribal       
organizations t receive a grant "u      
subsection 7a77#a74 ,su* tribes &       
organizations %all meet ! requirem5ts   

applicable to ,/ates "u ?is section z   
det]m9$ appropriate by ! ,secret>y4     
7#f7 ,! t]m vital /ati/ics unit means ! 
entity t is responsible = ma9ta9+ vital 
records = a ,/ate1 includ+ (ficial      
records ( live bir?s1 dea?s1 fetal      
dea?s1 m>riages1 divorces1 & annulm5ts4 
7h7 ,au?orization ( appropriations ,!re 
is au?oriz$ to be appropriat$ to c>ry   
out ?is section #g1jjj1jjj = ea* (      
fiscal ye>s #bjah ?r\gh #bjbb4  #d4     
,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]nal 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 pati5t advocacy 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 heal? c>e s]vices1 res\rces1 &
 in=mation 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$uce     
disp>ities 9 mat]nity s]vices & outcomes
 & to implem5t & assess effective       
int]v5tions4  7b7 ,scope & selection (  
,/ates = demon/ration project ,!        
demon/ration project "u subsection      
7a77#c7 %all be conduct$ 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 ( 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 ensure 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 #bjah1 & end on ,decemb] 
#ca1 #bjba4  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 #bjbb1 ! ,secret>y %all submit to  
,congress a report on ! results ( !     
demon/ration project "u subsection      
7a77#c74  4