,i #aaf? ,,congress #a/ ,session ,h4 ,r4 #bijb ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,may #bb1 #bjai,ms4 ,adams 7= h]self1 ,mr4 ,butt]field1 ,mr4 ,khanna1 ,ms4 ,haal&1 ,mr4 ,clay1 ,ms4 ,johnson ( ,texas1 ,ms4 ,wilson ( ,florida1 ,ms4 ,s*ak[sky1 ,mrs4 ,beatty1 ,ms4 ,b>ragn1 & ,mr4 ,cri/7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce ,a ,,bill ,to support ,/ates 9 _! "w to end prev5table morbidity & mortality 9 mat]nity c>e by us+ evid5ce-bas$ quality improvem5t to protect ! heal? ( mo!rs dur+ pregnancy1 *ildbir?1 & 9 ! po/p>tum p]iod & to r$uce neonatal & infant mortality1 to elim9ate racial disp>ities 9 mat]nal heal? outcomes1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,mat]nal ,c>e ,access & ,r$uc+ ,em]g5cies ,act or ! ,mat]nal ,,c>e ,act4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,9 ! ,unit$ ,/ates1 mat]nal mortality rates are among ! highe/ 9 ! develop$ _w & increas$ by #bf4f p]c5t betwe5 #bjjj & #bjad4 7#b7 ,( ! #d1jjj1jjj ,am]ican wom5 :o give bir? ea* ye>1 ab\t #gjj suff] fatal complications dur+ pregnancy1 :ile giv+ bir?1 or dur+ ! po/p>tum p]iod1 & an additional #ej1jjj are sev]ely injur$4 7#c7 ,x is e/imat$ t ab\t #fj p]c5t ( ! mat]nal mortalities 9 ! ,unit$ ,/ates c\ld be prev5t$ & half ( ! mat]nal injuries 9 ! ,unit$ ,/ates c\ld be r$uc$ or elim9at$ ) bett] c>e4 7#d7 ,data f ! ,c5t]s = ,disease ,control & ,prev5tion %[ t ,black wom5 are #c to #d times m likely to die f pregnancy-relat$ causes ?an ,:ite wom54 ,!re are #db4h dea?s p] #ajj1jjj live bir?s = ,black wom51 comp>$ to #ac dea?s p] #ajj1jjj live bir?s = ,:ite wom5 & #ag4b dea?s p] #ajj1jjj live bir?s = wom5 nationally4 7#e7 ,black wom5's risk ( mat]nal mortality has rema9$ high] ?an ,:ite wom5's risk = ! pa/ #f decades4 7#f7 ,black wom5 9 ! ,unit$ ,/ates suff] f life-?reat5+ pregnancy complications twice z (t5 z _! ,:ite c\nt]p>ts4 7#g7 ,high rates ( mat]nal mortality among ,black wom5 span income & education levels1 z well z socioeconomic /atus2 moreov]1 risk factors su* z a lack ( access to pr5atal c>e & physical heal? conditions d n fully expla9 ! racial disp>ity 9 mat]nal mortality4 7#h7 ,a gr[+ body ( evid5ce indicates t /ress f racism & racial discrim9ation results 9 conditions--includ+ hyp]t5sion & pre-eclampsia--t contribute to poor mat]nal heal? outcomes among ,black wom54 7#i7 ,p]vasive racial bias aga9/ ,black wom5 & unequal treatm5t ( ,black wom5 exi/ 9 ! heal? c>e sy/em1 (t5 result+ 9 inadequate treatm5t = pa9 & dismissal ( cultural norms ) respect to heal?4 ,a #bjaf /udy by ,univ]sity ( ,virg9ia rese>*]s f\nd t ,:ite m$ical /ud5ts & resid5ts (t5 believ$ biological my?s ab\t racial diff]5ces 9 pati5ts1 includ+ t ,black pati5ts h less-s5sitive n]ve end+s & ?ick] sk9 ?an _! ,:ite c\nt]p>ts4 ,provid]s1 h[ev]1 are n consi/5tly requir$ to und]go implicit bias1 cultural compet5cy1 or empa?y tra9+4 7#aj7 ,nor? ,c>ol9a has e/abli%$ a /atewide ,pregnancy ,m$ical ,home 7,,pmh7 program1 :i* aims to r$uce adv]se mat]nal heal? outcomes & mat]nal dea?s by inc5tiviz+ mat]nal heal? c>e provid]s to provide integral heal? c>e s]vices to pregnant wom5 & new mo!rs4 ,accord+ to ! ,nor? ,c>ol9a ,dep>tm5t ( ,heal? & ,human ,s]vices ,c5t] = ,heal? ,/ati/ics1 ! pregnancy-relat$ mortality rate = ,black wom5 0 approximately #e4a times high] ?an t ( ,:ite wom5 9 #bjjd4 ,almo/ a decade lat]1 9 #bjac1 ! pregnancy-relat$ mortality rates = ,black wom5 & ,:ite wom5 7 #bd4c & #bd4b dea?s p] #ajj1jjj live bir?s1 respectively4 ,! ,,pmh program has be5 cr$it$ ) ! conv]g5ce 9 pregnancy-relat$ mortality rates because ! program p>tn]s ea* high-risk pregnant & po/p>tum woman t is cov]$ "u ,m$icaid ) a pregnancy c>e manag]4 #c4 ,def9itions ,9 ?is ,act3 7#a7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,heal? & ,human ,s]vices4 7#b7 ,/ate ,! t]m ,/ate has ! mean+ giv5 t t]m 9 section #aaja ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acja7 = purposes ( title ,,xix ( t ,act 7#db ,u4,s4,c4 #acif et seq474 #d4 ,implicit bias tra9+ = heal? c>e provid]s 7a7 ,grant program ,! ,secret>y %all e/abli% a grant program "u :i* su* ,secret>y aw>ds grants to accr$it$ s*ools ( allopa?ic m$ic9e1 accr$it$ s*ools ( o/eopa?ic m$ic9e1 accr$it$ nurs+ s*ools1 o!r heal? pr(essional tra9+ programs1 & o!r entities = ! purpose ( support+ implicit bias tra9+1 ) priority giv5 to su* tra9+ ) respect to ob/etrics & gynecology4 7b7 ,collaboration requir$ ,9 develop+ requirem5ts = implicit bias tra9+ c>ri$ out ) grant funds aw>d$ "u ?is section1 ! ,secret>y %all collaborate ) relevant /akehold]s t specialize 9 address+ heal? equity1 includ+-- 7#a7 heal? c>e provid]s :o s]ve pregnant wom51 includ+ doctors1 nurses1 & midwives2 7#b7 academic in/itutions1 includ+ s*ools & tra9+ programs describ$ 9 subsection 7a72 7#c7 community-bas$ heal? work]s1 includ+ p]9atal heal? work]s1 d\las1 & home visitors2 & 7#d7 community-bas$ organizations4 7c7 ,implicit bias tra9+ def9$ ,9 ?is section1 ! t]m implicit bias tra9+ means evid5ce-bas$1 on-go+ pr(essional developm5t & support1 ) respect to-- 7#a7 bias 9 judgm5t or behavior t results f subtle cognitive processes1 includ+ implicit attitudes & implicit /]eotypes1 t (t5 op]ate at a level bel[ consci\s aw>5ess & )\t int5tional control2 or 7#b7 implicit attitudes & /]eotypes t result 9 beliefs or simple associations t a p]son makes betwe5 an object & its evaluation t are automatically activat$ by ! m]e pres5ce 7actual or symbolic7 ( ! attitude object4 7d7 ,prioritization ,9 aw>d+ grants "u ?is section1 ! ,secret>y %all give priority to aw>d+ grants to s*ools1 programs1 or entities locat$ 9 or s]v+ areas ) ! greate/ ne$s1 bas$ su* factors z ! ,secret>y may consid]1 includ+ racial disp>ities 9 mat]nal mortality & ! incid5ce ( sev]e mat]nal morbidity rates4 7e7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ = purposes ( c>ry+ out ! grant program "u subsection 7a71 #e1jjj1jjj = ea* ( fiscal ye>s #bjbj ?r\gh #bjbd4 #e4 ,pregnancy m$ical home demon/ration project 7a7 ,au?ority ,to aw>d grants ,! ,secret>y %all aw>d grants to ,/ates = ! purpose ( e/abli%+ or op]at+ ,/ate pregnancy m$ical home programs t meet ! requirem5ts ( subsection 7b7 to deliv] integrat$ heal? c>e s]vices to pregnant wom5 & new mo!rs & r$uce adv]se mat]nal heal? outcomes1 mat]nal dea?s1 & racial heal? disp>ities 9 mat]nal mortality & morbidity4 7b7 ,/ate pregnancy m$ical home program requirem5ts ,a ,/ate pregnancy m$ical home program meets ! requirem5ts ( ?is subsection if-- 7#a7 ! ,/ate works ) relevant /akehold]s to develop & c>ry out ! program1 includ+-- 7,a7 ,/ate & local ag5cies responsible = ,m$icaid1 public heal?1 social s]vices1 m5tal heal?1 & sub/ance abuse treatm5t & support2 7,b7 heal? c>e provid]s :o s]ve pregnant wom51 includ+ doctors1 nurses1 & midwives2 7,c7 community-bas$ heal? work]s1 includ+ p]9atal heal? work]s1 d\las1 & home visitors2 & 7,d7 community-bas$ organizations & individuals repres5t+ ! communities )-- 7i7 ! highe/ ov]all rates ( mat]nal mortality & morbidity2 & 7ii7 ! greate/ racial disp>ities 9 rates ( mat]nal mortality & morbidity2 7#b7 ! ,/ate selects heal? c>e provid]s :o s]ve pregnant wom51 includ+ doctors1 nurses1 & midwives1 to p>ticipate 9 ! program z pregnancy m$ical homes1 & requires t any provid] t wi%es to p>ticipate 9 ! program z a pregnancy m$ical home-- 7,a7 commits to foll[+ evid5ce-bas$ practices = mat]nity c>e1 z develop$ by ! ,/ate 9 consultation ) relevant /akehold]s2 & 7,b7 completes tra9+ to provide culturally & l+ui/ically compet5t c>e2 7#c7 "u ! program1 ea* pregnancy m$ical home is requir$ to conduct a /&>diz$ m$ical1 ob/etric1 & psy*osocial risk assessm5t = e pati5t ( ! m$ical home :o is pregnant at ! pati5t's fir/ pr5atal appo9tm5t ) ! m$ical home2 7#d7 "u ! program1 a c>e manag]-- 7,a7 is assign$ to ea* pregnancy m$ical home2 & 7,b7 coord9ates c>e 7includ+ coord9at+ res\rces & ref]rals = heal? c>e & social s]vices t are n available f ! pregnancy m$ical home7 = ea* pati5t ( a pregnancy m$ical home :o is eligible = s]vices "u ! program2 & 7#e7 ! program prioritizes pregnant & po/p>tum wom5 :o are un9sur$ or enroll$ 9 ! ,/ate ,m$icaid plan "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq471 or a waiv] ( su* plan4 7c7 ,grants 7#a7 ,limitation ,! ,secret>y may aw>d a grant "u ?is section to up to #aj ,/ates4 7#b7 ,p]iod ,grants "u ?is section %all be = a #e-ye> p]iod4 7#c7 ,prioritization ,9 aw>d+ grants "u ?is section1 ! ,secret>y %all give priority to ! ,/ates ) ! greate/ racial disp>ities 9 mat]nal mortality & sev]e morbidity rates4 7d7 ,report on grant impact & dissem9ation ( be/ practices ,n lat] ?an #a ye> aft] all ! grant p]iods aw>d$ "u ?is section h end$1 ! ,secret>y %all-- 7#a7 submit a report to ,congress t describes-- 7,a7 ! impact ( ! grants aw>d$ "u ?is section on mat]nal & *ild heal?2 7,b7 be/ practices & models ( c>e us$ by recipi5ts ( grants "u ?is section2 & 7,c7 ob/acles fac$ by recipi5ts ( grants "u ?is section 9 deliv]+ c>e1 improv+ mat]nal & *ild heal?1 & r$uc+ racial disp>ities 9 rates ( mat]nal & infant mortality & morbidity2 & 7#b7 dissem9ate in=mation on be/ practices & models ( c>e us$ by recipi5ts ( grants "u ?is section 7includ+ be/ practices & models ( c>e relat+ to ! r$uction ( racial disp>ities 9 rates ( mat]nal & infant mortality & morbidity7 to int]e/$ p>ties1 includ+ heal? provid]s1 m$ical s*ools1 relevant ,/ate & local ag5cies1 & ! g5]al public4 7e7 ,au?orization ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section1 #be1jjj1jjj = ea* ( fiscal ye>s #bjbj ?r\gh #bjbd1 to rema9 available until exp5d$4 #f4 ,national ,academy ( ,m$ic9e ,/udy 7a7 ,9 g5]al ,! ,secret>y %all ent] into an arrangem5t ) ! ,national ,academy ( ,m$ic9e "u :i* ! ,national ,academy agrees to /udy & make recomm5dations = incorporat+ bias recognition 9 cl9ical skills te/+ = accr$it$ s*ools ( allopa?ic m$ic9e & accr$it$ s*ools ( o/eopa?ic m$ic9e4 7b7 ,report ,! arrangem5t "u subsection 7a7 %all provide = submission by ! ,national ,academy ( ,m$ic9e to ! ,secret>y & ,congress1 n lat] ?an #c ye>s aft] ! date ( enactm5t ( ?is ,act1 ( a report on ! results ( ! /udy t includes su* recomm5dations4