,,ii #aae? ,,congress #b;d ,session ,s4 #cefh ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,octob] #aj1 #bjah ,ms4 ,heitkamp introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to am5d ! ,social ,security ,act & ,public ,heal? ,s]vice ,act to improve ob/etric c>e 9 rural areas4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,rural ,mat]nal & ,ob/etric ,mod]nization ( ,s]vices ,act or ! ,rural ,,moms ,act4 #b4 ,improv+ rural mat]nal & ob/etric c>e data 7a7 ,mat]nal mortality & morbidity activities ,section #cja ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bda7 is am5d$-- 7#a7 by r$esignat+ subsections 7e7 ?r\gh 7h7 z subsections 7f7 ?r\gh 7i71 respectively2 & 7#b7 by ins]t+ aft] subsection 7d71 ! foll[+3 7e7 ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all exp&1 int5sify1 & coord9ate ! activities ( ! ,c5t]s = ,disease ,control & ,prev5tion ) respect to mat]nal mortality & morbidity4 4 7b7 ,(fice ( ,wom5's ,heal? ,section #caj;,a7b77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdbs7b77#a77 is am5d$ by ins]t+ sociocultural1 & geographic contexts1 aft] biological14 7c7 ,safe mo!rhood ,section #cag,k7b77#b7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;b77#b77 is am5d$-- 7#a7 9 subp>agraph 7,k71 by /rik+ & at ! end2 7#b7 by r$esignat+ subp>agraph 7,l7 z subp>agraph 7,m72 & 7#c7 by ins]t+ aft] subp>agraph 7,k71 ! foll[+3 7,l7 an exam9ation ( ! relation%ip betwe5 mat]nal & ob/etric heal? s]vices 9 rural areas & outcomes 9 deliv]y & po/p>tum c>e2 & 4 7d7 ,(fice ( ,rese>* on ,wom5's ,heal? ,section #dhf ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bhg;d7 is am5d$-- 7#a7 9 subsection 7b7-- 7,a7 by r$esignat+ p>agraphs 7#d7 ?r\gh 7#i7 z p>agraphs 7#e7 ?r\gh 7#aj71 respectively2 7,b7 by ins]t+ aft] p>agraph 7#c7 ! foll[+3 7#d7 c>ry out p>agraphs 7#a7 & 7#b7 ) respect to pregnancy1 ) priority giv5 to dea?s relat$ to pregnancy2 2 & 7,c7 9 p>agraph 7#e7 7z s r$esignat$71 by /rik+ ?r\gh 7#c7 & ins]t+ ?r\gh 7#d72 & 7#b7 9 subsection 7d77#d77;,a77iv71 by ins]t+ 1 includ+ mat]nal mortality & o!r mat]nal morbidity outcomes be=e ! semicolon4 #c4 ,collaborative improvem5t & innovation networks to improve ob/etric heal? 9 rural areas ,section #eja ( ! ,social ,security ,act 7#db ,u4,s4,c4 #gja7 is am5d$-- 7#a7 9 subsection 7a77#b71 by ins]t+ & ! e/abli%m5t ( collaborative improvem5t & innovation networks to improve ob/etric heal? 9 rural areas by improv+ outcomes 9 bir? & mat]nal morbidity & mortality aft] s]vices developm5t2 & 7#b7 by add+ at ! end ! foll[+3 7d7 7#a7 7,a7 ,= ! purpose ( enabl+ ! ,secret>y 7?r\gh grants1 contracts1 or o!rwise7 to e/abli%1 z special projects ( regional & national significance1 collaborative improvem5t & innovation networks 7ref]r$ to 9 ?is subsection z rural ob/etric heal? ,co,i,i,ns7 to improve ob/etric heal? 9 rural areas by improv+ outcomes 9 bir? & mat]nal morbidity & mortality1 !re is appropriat$ to ! ,secret>y1 out ( any money 9 ! ,treasury n o!rwise appropriat$1 #c1jjj1jjj = ea* ( fiscal ye>s #bjai ?r\gh #bjbc4 7,b7 ,funds appropriat$ "u subp>agraph 7,a7 %all-- 7i7 be 9 addition to am\nts appropriat$ "u subsection 7a7 & reta9$ "u section #ejb7;a77#a7 = ! purpose ( c>ry+ out activities describ$ 9 subsection 7a77#b72 & 7ii7 rema9 available until exp5d$4 7#b7 ,rural ob/etric heal? ,co,i,i,ns e/abli%$ 9 accordance ) ?is subsection %all-- 7,a7 assi/ pregnant wom5 9 rural areas connect ) mat]nal1 pr5atal & po/natal1 & ob/etric c>e to improve outcomes 9 bir? & mat]nal mortality & morbidity2 7,b7 id5tify successful mat]nal1 pr5atal & po/natal1 & ob/etric heal? deliv]y models = wom5 9 rural areas2 7,c7 develop a model = collaboration betwe5 heal? facilities t h an ob/etric heal? unit & heal? facilities t d n h an ob/etric heal? unit2 7,d7 provide tra9+ & guidance = heal? facilities t d n h ob/etric heal? units2 & 7,e7 collaborate ) academic in/itutions t c provide regional exp]tise & rese>* on access1 outcomes1 ne$s assessm5ts1 & o!r id5tifi$ data4 7#c7 7,a7 ,n lat] ?an ,octob] #a1 #bjai1 ! ,secret>y %all e/abli% rural ob/etric heal? ,co,i,i,ns 9 at lea/ #e regions4 7,b7 ,9 ?is subsection3 7i7 ,! t]m fronti] area means a fronti] c\nty1 z def9$ 9 section #ahhf7;d77#c77;,e77iii77,,iii74 7ii7 ,! t]m ,indian tribe has ! mean+ giv5 su* t]m 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act 7#be ,u4,s4,c4 #afjc74 7iii7 ,! t]m region means a ,/ate1 ,indian tribe1 rural area1 or fronti] area4 7iv7 ,! t]m rural area has ! mean+ giv5 t t]m 9 section #ahhf7;d77#b77;,d74 7v7 ,! t]m ,/ate has ! mean+ giv5 t t]m = purposes ( ?is title 9 section #aaja4 7#d7 ,! provisions ( ?is title t are applicable to ! funds made available to ! ,secret>y "u section #ejb7;a77#a7 apply 9 ! same mann] to funds made available to ! ,secret>y "u p>agraph 7#a77;,a74 4 #d4 ,teleheal? network & teleheal? res\rce c5t]s grant programs ,section #ccj;,i ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;c-#ad7 is am5d$-- 7#a7 9 subsection 7f77#a77;,b77iii71 by add+ at ! end ! foll[+3 7,,xiii7 ,provid]s ( mat]nal1 includ+ pr5atal & po/natal1 & ob/etric c>e s]vices & entities op]ation ob/etric c>e units4 2 7#b7 9 subsection 7i77#a77;,b71 by ins]t+ mat]nal1 includ+ pr5atal & po/natal c>e1 ob/etric c>e1 be=e or pr5atal2 & 7#c7 9 subsection 7k77#a77;,b71 by ins]t+ equipm5t useful = c>+ = pregnant wom51 includ+ ultras\nd ma*9es & fetal monitor+ equipm5t1 be=e & o!r equipm5t4 #e4 ,rural mat]nal & ob/etric c>e tra9+ demon/ration ,"p ,d ( title ,,vii ( ! ,public ,heal? ,s]vice ,act is am5d$ by ins]t+ aft] section #gfj 7#db ,u4,s4,c4 #bidk7 ! foll[+3 #gfj;,a4 ,rural mat]nal & ob/etric c>e tra9+ demon/ration 7a7 ,9 g5]al ,! ,secret>y %all e/abli% a tra9+ demon/ration program to aw>d grants to eligible entities to support-- 7#a7 tra9+ = physicians1 m$ical resid5ts1 includ+ family practice resid5ts1 & fell[s to practice mat]nal & ob/etric m$ic9e 9 rural1 community-bas$ sett+s2 7#b7 tra9+ = nurse practition]s1 physician assi/ants1 nurse midwives1 & d\las to provide mat]nal & ob/etric c>e s]vices 9 rural community-bas$ sett+s2 & 7#c7 e/abli%+1 ma9ta9+1 or improv+ academic units or programs t-- 7,a7 provide tra9+ = /ud5ts or faculty1 includ+ ?r\gh cl9ical exp]i5ces & rese>*1 to improve mat]nal & ob/etric c>e 9 rural areas2 or 7,b7 develop evid5ce-bas$ practices or recomm5dations = ! design ( ! units or programs describ$ 9 subp>agraph 7,a71 includ+ curriculum cont5t /&>ds4 7b7 ,activities 7#a7 ,tra9+ = resid5ts & fell[s ,a recipi5t ( a grant "u subsection 7a77#a7-- 7,a7 %all use ! grant funds-- 7i7 to plan1 develop1 & op]ate a tra9+ program to provide ob/etric c>e 9 rural areas = family practice or ob/etrics resid5ts & fell[s2 or 7ii7 to tra9 new family practice or ob/etrics resid5ts & fell[s 9 mat]nal & ob/etric heal? c>e to provide & exp& access to mat]nal & ob/etric heal? c>e 9 rural areas2 & 7,b7 may use ! grant funds to provide additional support = ! adm9i/ration ( ! program or to meet ! co/s ( projects to e/abli%1 ma9ta91 or improve faculty developm5t1 or dep>tm5ts1 divisions1 or o!r units necess>y to implem5t su* tra9+4 7#b7 ,tra9+ = o!r provid]s ,a recipi5t ( a grant "u subsection 7a77#b7-- 7,a7 %all use ! grant funds to plan1 develop1 or op]ate a tra9+ program to provide mat]nal & ob/etric heal? c>e s]vices 9 rural1 community-bas$ sett+s2 & 7,b7 may use ! grant funds to provide additional support = ! adm9i/ration ( ! program or to meet ! co/s ( projects to e/abli%1 ma9ta91 or improve faculty developm5t1 or dep>tm5ts1 divisions1 or o!r units necess>y to implem5t su* program4 7#c7 ,academic units or programs ,a recipi5t ( a grant "u subsection 7a77#c7 %all ent] into a p>tn]%ip ) organizations su* z an education accr$it+ organization 7su* z ! ,liaison ,committee on ,m$ical ,education1 ! ,accr$itation ,c\ncil = ,graduate ,m$ical ,education1 ! ,commission on ,o/eopa?ic ,college ,accr$itation1 ! ,accr$itation ,commission = ,education 9 ,nurs+1 ! ,commission on ,collegiate ,nurs+ ,education1 or ! ,accr$itation ,review ,commission on ,education = ! ,physician ,assi/ant7 to c>ry out activities "u subsection 7a77#c74 7c7 ,eligible entities 7#a7 ,tra9+ = resid5ts & fell[s ,to be eligible to receive a grant "u subsection 7a77#a71 an entity %all-- 7,a7 be a consortium consi/+ (-- 7i7 at lea/ "o tea*+ heal? c5t]2 & 7ii7 ! sponsor+ in/itution 7or p>5t in/itution ( ! sponsor+ in/itution7 (-- 7,i7 an ob/etric resid5cy program t is accr$it$ by ! ,accr$itation ,c\ncil ( ,graduate ,m$ical ,education 7or ! p>5t in/itution ( su* a program72 or 7,,ii7 a fell[%ip 9 mat]nal or ob/etric m$ic9e1 z det]m9$ appropriate by ! ,secret>y2 or 7,b7 be an entity describ$ 9 subp>agraph 7,a77ii7 t provides opportunities = resid5ts or fell[s to tra9 9 rural community-bas$ sett+s4 7#b7 ,tra9+ = o!r provid]s ,to be eligible to receive a grant "u subsection 7a77#b71 an entity %all be-- 7,a7 a tea*+ heal? c5t] 7z def9$ 9 section #gdi;,a7f772 7,b7 a ,f$]ally qualifi$ heal? c5t] 7z def9$ 9 section #aije7l77#b77;,b7 ( ! ,social ,security ,act72 7,c7 a community m5tal heal? c5t] 7z def9$ 9 section #ahfa7;ff77#c77;,b7 ( ! ,social ,security ,act72 7,d7 a rural heal? cl9ic 7z def9$ 9 section #ahfa7;aa7 ( ! ,social ,security ,act72 7,e7 a heal? c5t] op]at$ by ! ,indian ,heal? ,s]vice1 an ,indian tribe1 a tribal organization1 or an urban ,indian organization 7z def9$ 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act72 or 7,f7 an entity ) a demon/rat$ record ( success 9 provid+ tra9+ = nurse practition]s1 physician assi/ants1 nurse midwives1 or d\las4 7#c7 ,academic units or programs ,to be eligible to receive a grant "u subsection 7a77#c71 an entity %all be a s*ool ( m$ic9e or o/eopa?ic m$ic9e1 a nurs+ s*ool1 a physician assi/ant tra9+ program1 an accr$it$ public or nonpr(it private hospital1 an accr$it$ m$ical resid5cy program1 or a public or private nonpr(it entity :i* ! ,secret>y has det]m9$ is capable ( c>ry+ out su* grant4 7d7 ,duration ,grants aw>d$ "u ?is section %all be = a m9imum ( #e ye>s4 7e7 ,/udy & report 7#a7 ,/udy 7,a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all conduct a /udy on ! results ( ! demon/ration program "u ?is section4 7,b7 ,data submission ,n lat] ?an #ij days aft] ! completion ( ! fir/ ye> ( ! tra9+ program1 & ea* subsequ5t ye> t ! program is 9 effect1 ea* recipi5t ( a grant "u subsection 7a7 %all submit to ! ,secret>y su* data z ! ,secret>y may require = analysis = ! report describ$ 9 p>agraph 7#b74 7#b7 ,report to ,congress ,n lat] ?an #a ye> aft] receipt ( ! data describ$ 9 p>agraph 7#a77;,b71 ! ,secret>y %all submit to ,congress a report t includes-- 7,a7 an analysis ( ! effect ( ! demon/ration program "u ?is section on ! quality1 quantity1 & di/ribution ( mat]nal1 includ+ pr5atal & po/natal1 & ob/etric c>e s]vices2 7,b7 an analysis ( ! effect ( ! demon/ration program on ! preval5ce ( mat]nal mortality 9 ! surr\nd+ communities ( heal? c5t]s p>ticipat+ 9 ! demon/ration2 & 7,c7 recomm5dations on :e!r ! demon/ration program %\ld be exp&$4 7f7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section1 #e1jjj1jjj = ea* ( fiscal ye>s #bjai ?r\gh #bjbc4 #f4 ,,gao report ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! appropriate committees ( ,congress a report on ! mat]nal1 includ+ pr5atal & po/natal1 c>e & ob/etric c>e 9 rural areas4 ,su* report %all include ! foll[+3 7#a7 ,! location ( gaps 9 mat]nal & ob/etric heal? c>e work]s1 includ+ non-physicians su* z d\las & community heal? work]s4 7#b7 ,a li/ ( specific activities t ! ,comptroll] ,g5]al plans to conduct on mat]nal1 includ+ pr5atal & po/natal1 & ob/etric c>e4 7#c7 ,a plan = complet+ su* activities4 7#d7 ,an explanation ( ,f$]al ag5cy involvem5t & coord9ation ne$$ to conduct su* activities4 7#e7 ,a budget = conduct+ su* activities4 7#f7 ,o!r in=mation t ! ,comptroll] ,g5]al det]m9es appropriate4