,,ib ,union ,cal5d> ,no4 #dad #aaf?     
,,congress  #b;d ,session  ,h4 ,r4 #diie
 ,report ,no4 #aaf-ead ,,9 ,,! ,,h\se   
,,( ,,repres5tatives  ,novemb] #h1      
#bjai,mr4 ,engel 7= himself1 ,mr4       
,buc%on1 ,ms4 ,torres ,small ( ,new     
,mexico1 ,mr4 ,latta1 ,ms4 ,adams1 &    
,mr4 ,/iv]s7 introduc$ ! foll[+ bill2   
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce  ,septemb] #ag1               
#bjbj;,additional sponsors3 ,mr4 ,c>son 
( ,indiana1 ,ms4 ,kelly ( ,ill9ois1 ,ms4
 ,h]r]a ,beutl]1 ,mr4 ,m>%all1 ,mr4     
,burgess1 ,mr4 ,wald51 ,mrs4 ,hayes1    
,mr4 ,o',hall]an1 ,ms4 ,ku/] ( ,new     
,hamp%ire1 ,mr4 ,gu?rie1 ,mr4 ,trone1   
,ms4 ,craig1 ,mr4 ,fitzpatrick1 ,ms4    
,s*ak[sky1 ,mr4 ,ca/5 ( ,ill9ois1 ,mr4  
,cunn+ham1 ,ms4 ,norton1 ,ms4 ,und]wood1
 ,mr4 ,mc,govern1 ,ms4 ,f9k5au]1 ,mr4   
,morelle1 ,ms4 ,h\lahan1 ,ms4 ,gabb>d1  
,mr4 ,ruiz1 ,mrs4 ,napolitano1 & ,mr4   
,lev9 ( ,mi*igan  ,septemb] #ag1        
#bjbj,report$ ) an am5dm5t2 committ$ to 
! ,committee ( ! ,:ole ,h\se on ! ,/ate 

( ! ,union & ord]$ to be printed,strike 
out all aft] ! enact+ clause & ins]t !  
"p pr9t$ 9 italic,for text ( introduc$  
bill1 see copy ( bill z introduc$ on    
,novemb] #h1 #bjai  ,a ,,bill  ,to am5d 
! ,public ,heal? ,s]vice ,act to improve
 ob/etric c>e & mat]nal heal? outcomes1 
& = o!r purposes4  #a4 ,%ort title ,?is 
,act may be cit$ z ! ,mat]nal ,heal?    
,quality ,improvem5t ,act ( #bjai4  #b4 
,table ( cont5ts ,! table ( cont5ts =   
?is ,act is z foll[s3 ,sec4 #a4 ,%ort   
title4,sec4 #b4 ,table ( cont5ts4,title 
,i--,improv+ ,ob/etric ,c>e 9 ,rural    
,areas,sec4 #aja4 ,improv+ rural mat]nal
 & ob/etric c>e data4,sec4 #ajb4 ,rural 
ob/etric network grants4,sec4 #ajc4     
,teleheal? network & teleheal? res\rce  
c5t]s grant programs4,sec4 #ajd4 ,rural 
mat]nal & ob/etric c>e tra9+            
demon/ration4,sec4 #aje4 ,,gao          
report4,title ,,ii--,o!r ,improvem5ts to
 ,mat]nal ,care,sec4 #bja4 ,innovation =
 mat]nal heal?4,sec4 #bjb4 ,tra9+ =     
heal? c>e provid]s4,sec4 #bjc4 ,/udy on 

tra9+ to r$uce & prev5t                 
discrim9ation4,sec4 #bjd4 ,p]9atal      
quality collaboratives4,sec4 #bje4      
,integrat$ s]vices = pregnant & po/p>tum
 wom54  ,i ,improv+ ,ob/etric ,c>e 9    
,rural ,areas  #aja4 ,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 includ+ among ,am]ican   

,indians & ,alaska ,natives1 z su* t]ms 
are def9$ 9 section #d ( ! ,indian      
,heal? ,c>e ,improvem5t ,act1           
geographic1 aft] biological14  7c7 ,safe
 mo!rhood ,section #cag,k ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bdg;b-#ab7 is am5d$-- 7#a7 9 subsection
 7a77#b77;,a71 by ins]t+ be=e ! p]iod at
 ! end ! foll[+3 1 includ+ improv+      
collection ( data on race1 e?nicity1 &  
o!r demographic in=mation2 &  7#b7 9    
subsection 7b77#b7-- 7,a7 9 subp>agraph 
7,l71 by /rik+ & at ! end2  7,b7 by     
r$esignat+ subp>agraph 7,m7 z           
subp>agraph 7,n72 &  7,c7 by ins]t+ aft]
 subp>agraph 7,l71 ! foll[+3  7,m7 an   
exam9ation ( ! relation%ip betwe5       
mat]nal & ob/etric 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 7b71 by am5d+ p>agraph
 7#c7 to read z foll[s3  7#c7 c>ry out  
p>agraphs 7#a7 & 7#b7 ) respect to--    

7,a7 ! ag+ process 9 wom51 ) priority   
giv5 to m5opause2 &  7,b7 pregnancy1 )  
priority giv5 to dea?s relat$ to        
pregnancy2  2 &  7#b7 9 subsection      
7d77#d77;,a77iv71 by ins]t+ 1 includ+   
mat]nal mortality & o!r mat]nal         
morbidity outcomes be=e ! semicolon4    
#ajb4 ,rural ob/etric network grants ,! 
,public ,heal? ,s]vice ,act is am5d$ by 
ins]t+ aft] section #ccj;,a-#a ( su*    
,act 7#db ,u4,s4,c4 #bed;c-#a;a7 !      
foll[+3  #ccj;,a-#b4 ,rural ob/etric    
network grants  7a7 ,program e/abli%$ ,!
 ,secret>y1 act+ ?r\gh ! ,adm9i/rator ( 
! ,heal? ,res\rces & ,s]vices           
,adm9i/ration1 %all aw>d grants to      
eligible entities to e/abli%            
collaborative improvem5t & innovation   
networks 7ref]r$ to 9 ?is section z     
rural ob/etric networks7 to improve bir?
 outcomes & r$uce mat]nal morbidity &   
mortality by improv+ mat]nity c>e &     
access to c>e 9 rural areas1 fronti]    
areas1 mat]nity c>e heal? pr(essional   
t>get areas1 & ,indian c\ntry & )       

,indian ,tribes & tribal organizations4 
7b7 ,use ( funds ,rural ob/etric        
networks receiv+ funds pursuant to ?is  
section may use su* funds to-- 7#a7     
assi/ pregnant wom5 & individuals 9     
areas & )9 populations ref]5c$ 9        
subsection 7a7 ) access+ & utiliz+      
mat]nal & ob/etric c>e1 includ+         
preconception1 pregnancy1 labor &       
deliv]y1 po/p>tum1 & int]conception     
s]vices to improve outcomes 9 bir? &    
mat]nal mortality & morbidity2  7#b7    
id5tify successful deliv]y models =     
mat]nal & ob/etric c>e 7includ+         
preconception1 pregnancy1 labor &       
deliv]y1 po/p>tum1 & int]conception     
s]vices7 = individuals 9 areas & )9     
populations ref]5c$ by subsection 7a71  
includ+ evid5ce-bas$ home visit+        
programs & successful1 culturally       
compet5t models ) positive mat]nal heal?
 outcomes t advance heal? equity2  7#c7 
develop a model = collaboration betwe5  
heal? facilities t h an ob/etric c>e    
unit & heal? facilities t d n h an      

ob/etric c>e unit to improve access to &
 ! deliv]y ( ob/etric s]vices 9         
communities lack+ ^! s]vices2  7#d7     
provide tra9+ & guidance on ob/etric c>e
 = heal? facilities t d n h ob/etric c>e
 units2  7#e7 collaborate ) academic    
in/itutions t c provide regional        
exp]tise & rese>* on access1 outcomes1  
ne$s assessm5ts1 & o!r id5tifi$ data &  
measurem5t activities ne$$ to in=m rural
 ob/etric network ef=ts to improve      
ob/etric c>e2 &  7#f7 measure & address 
inequities 9 bir? outcomes among rural  
resid5ts1 ) an emphasis on racial &     
e?nic m9orities & und]s]v$ populations4 
7c7 ,def9itions ,9 ?is section3 7#a7    
,eligible entities ,! t]m eligible      
entities means entities provid+         
ob/etric1 gynecologic1 & o!r mat]nal    
heal? c>e s]vices 9 rural areas1 fronti]
 areas1 or m$ically und]s]v$ areas1 or  
to m$ically und]s]v$ populations or     
,native ,am]icans1 includ+ ,indian      
tribes or tribal organizations4  7#b7   
,fronti] area ,! t]m fronti] area means 

a fronti] c\nty1 z def9$ 9 section      
#ahhf7;d77#c77;,e77iii77,,iii7 ( !      
,social ,security ,act4  7#c7 ,indian   
c\ntry ,! t]m ,indian c\ntry has ! mean+
 giv5 su* t]m 9 section #aaea ( title   
#ah1 ,unit$ ,/ates ,code4  7#d7         
,mat]nity c>e heal? pr(essional t>get   
area ,! t]m mat]nity c>e heal?          
pr(essional t>get area has ! mean+ ( su*
 t]m z us$ 9 section #ccb7k77#b74  7#e7 
,rural area ,! t]m rural area has !     
mean+ giv5 t t]m 9 section #ahhf7;d77#b7
 ( ! ,social ,security ,act4  7#f7      
,indian tribes2 tribal organization ,!  
t]ms ,indian ,tribe & tribal            
organization h ! mean+ giv5 su* t]ms 9  
section #d ( ! ,indian                  
,self-,det]m9ation & ,education         
,assi/ance ,act4  7d7 ,au?orization (   
,appropriations ,!re is au?oriz$ to be  
appropriat$ to c>ry out ?is section     
#c1jjj1jjj = ea* ( fiscal ye>s #bjbj    
?r\gh #bjbd4  4  #ajc4 ,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$-- 7#a7 9 subsection
 7f77#a77;,b77iii71 by add+ at ! end !  
foll[+3  7,,xiii7 ,provid]s ( mat]nal1  
includ+ pr5atal1 labor & bir?1 &        
po/p>tum c>e s]vices & entities op]at+  
ob/etric c>e units4  2 &  7#b7 9        
subsection 7i77#a77;,b71 by ins]t+ labor
 & bir?1 po/p>tum1 be=e or pr5atal4     
#ajd4 ,rural mat]nal & ob/etric c>e     
tra9+ demon/ration ,subp>t #a ( "p ,e ( 
title ,,vii ( ! ,public ,heal? ,s]vice  
,act is am5d$ by ins]t+ aft] section    
#gfj 7#db ,u4,s4,c4 #bidn et seq471 z   
am5d$ by section #bjb1 is am5d$ by add+ 
at ! end ! foll[+3  #gfd4 ,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$ical        
resid5ts1 includ+ family m$ic9e &       
ob/etrics & gynecology resid5ts1 &      
fell[s to practice mat]nal & ob/etric   
m$ic9e 9 rural community-bas$ sett+s2   

7#b7 tra9+ = nurse practition]s1        
physician assi/ants1 nurses1 c]tifi$    
nurse midwives1 home visit+ nurses &    
non-cl9ical home visit+ work=ce         
pr(essionals & p>apr(essionals1 or      
non-cl9ical pr(essionals1 :o meet       
applicable ,/ate tra9+ & lic5s+         
requirem5ts1 to provide mat]nal 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 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+ = m$ical 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 &  

gynecology resid5ts & fell[s2 or  7ii7  
to tra9 new family practice or ob/etrics
 & gynecology 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 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 
,tra9+ program requirem5ts ,! recipi5t (

 a grant "u subsection 7a77#a7 or       
7a77#b7 %all ensure t tra9+ programs    
c>ri$ out "u ! grant are evid5ce-bas$ & 
include in/ruction on-- 7,a7 mat]nal    
m5tal heal?1 includ+ p]9atal depression 
& anxiety2  7,b7 mat]nal sub/ance use   
disord]2  7,c7 social det]m9ants ( heal?
 t impact individuals liv+ 9 rural      
communities1 includ+ pov]ty1 social     
isolation1 access to nutrition1         
education1 transportation1 & h\s+2 &    
7,d7 implicit bias4  7c7 ,eligible      
entities  7#a7 ,tra9+ = m$ical resid5ts 
& fell[s ,to be eligible to receive a   
grant "u subsection 7a77#a71 an entity  
%all-- 7,a7 be a consortium consi/+ (-- 
7i7 at lea/ "o tea*+ heal? c5t]2 or     
7ii7 ! sponsor+ in/itution 7or p>5t     
in/itution ( ! sponsor+ in/itution7 (-- 
7,i7 an ob/etrics & gynecology or family
 m$ic9e 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 =     
m$ical resid5ts or fell[s to tra9 9     
rural community-bas$ 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 free/&+
 bir? c5t] 7z def9$ 9 section           
#aije7l77#c7 ( ! ,social ,security      
,act72 or  7,f7 an ,indian ,heal?       
,program or a ,native ,hawaiian heal?   
c>e sy/em 7z su* t]ms are def9$ 9       
section #d ( ! ,indian ,heal? ,c>e      
,improvem5t ,act & section #ab ( !      
,native ,hawaiian ,heal? ,c>e           

,improvem5t ,act1 respectively74  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$ic9e1 a s*ool ( o/eopa?ic     
m$ic9e1 a s*ool ( nurs+ 7z def9$ 9      
section #hja71 a physician assi/ant     
education program1 an accr$it$ public or
 nonpr(it private hospital1 an accr$it$ 
m$ical resid5cy tra9+ program1 a s*ool  
accr$it$ by ! ,midwif]y ,education &    
,accr$itation ,c\ncil1 by !             
,accr$itation ,commission = ,midwif]y   
,education1 or by ! ,am]ican ,midwif]y  
,c]tification ,bo>d1 or a public or     
private nonpr(it educational entity :i* 
! ,secret>y has det]m9$ is capable (    
c>ry+ out su* grant4  7#d7 ,application 
,to be eligible to receive a grant "u   
subsection 7a71 an entity %all submit to
 ! ,secret>y an application at su* "t1 9
 su* mann]1 & conta9+ su* in=mation z ! 
,secret>y may require1 includ+ an       
e/imate ( ! am\nt to be exp5d$ to       
conduct tra9+ activities "u ! grant     

7includ+ ancill>y & adm9i/rative co/s74 
7d7 ,/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> = !        
duration ( ! grant1 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 ! 
,committee on ,en]gy & ,comm]ce ( !     
,h\se ( ,repres5tatives & ! ,committee  
on ,heal?1 ,education1 ,labor1 &        
,p5sions ( ! ,s5ate a report t          
includes-- 7,a7 an analysis ( ! effect (
 ! demon/ration program "u ?is section  

on ! quality1 quantity1 & di/ribution ( 
mat]nal 7includ+ pr5atal1 labor & bir?1 
& po/p>tum7 c>e s]vices & ! demographics
 ( ! recipi5ts ( ^? s]vices2  7,b7 an   
analysis ( mat]nal & infant heal?       
outcomes 7includ+ quality ( c>e1        
morbidity1 & mortality7 be=e & aft]     
implem5tation ( ! program 9 !           
communities s]v$ by entities p>ticipat+ 
9 ! demon/ration2 &  7,c7 recomm5dations
 on :e!r ! demon/ration program %\ld be 
exp&$4  7e7 ,au?orization (             
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section1    
#e1jjj1jjj = ea* ( fiscal ye>s #bjbj    
?r\gh #bjbd4  4  #aje4 ,,gao report ,n  
lat] ?an #ah mon?s aft] ! date (        
enactm5t ( ?is ,act1 ! ,comptroll]      
,g5]al ( ! ,unit$ ,/ates %all submit to 
! ,committee on ,en]gy & ,comm]ce ( !   
,h\se ( ,repres5tatives & ! ,committee  
on ,heal?1 ,education1 ,labor1 &        
,p5sions ( ! ,s5ate a report on mat]nal 
c>e 9 rural areas1 includ+ pr5atal1     
labor & bir?1 & po/p>tum c>e 9 rural    

areas4 ,su* report %all include !       
foll[+3 7#a7 ,tr5ds 9 data t may id5tify
 pot5tial gaps 9 mat]nal & ob/etric     
cl9icians & heal? pr(essionals1 includ+ 
non-cl9ical pr(essionals4  7#b7 ,tr5ds 9
 ! numb] ( facilities able to provide   
mat]nal c>e1 includ+ pr5atal1 labor &   
bir?1 & po/p>tum c>e1 9 rural areas1    
includ+ c>e = high-risk pregnancies4    
7#c7 ,! gaps 9 data on mat]nal mortality
 & morbidity & recomm5dations to /&>dize
 ! =mat on collect+ data relat$ to      
mat]nal mortality & morbidity4  7#d7 ,! 
gaps 9 mat]nal heal? outcomes by race & 
e?nicity 9 rural communities1 ) a focus 
on racial inequities = resid5ts :o are  
racial & e?nic m9orities or memb]s (    
und]s]v$ populations4  7#e7 ,an         
exam9ation (-- 7,a7 activities :i* !    
,secret>y ( ,heal? & ,human ,s]vices    
plans to conduct to improve mat]nal c>e 
9 rural areas1 includ+ pr5atal1 labor & 
bir?1 & po/p>tum c>e2 &  7,b7 ! ext5t to
 :i* ! ,secret>y has a plan = complet+  
^! activities1 has id5tifi$ ! lead ag5cy

 responsible = ea* activity1 has        
id5tifi$ any ne$$ coord9ation among     
ag5cies1 & has develop$ a budget =      
conduct+ su* activities4  7#f7 ,o!r     
in=mation t ! ,comptroll] ,g5]al        
det]m9es appropriate4  ,,ii ,o!r        
,improvem5ts to ,mat]nal ,c>e  #bja4    
,innovation = mat]nal heal? ,! ,public  
,heal? ,s]vice ,act is am5d$-- 7#a7 9 ! 
section designation ( section #ccj,m    
7#db ,u4,s4,c4 #bed;c-#ai7 by ins]t+ a  
p]iod aft] #ccj,m2 &  7#b7 by ins]t+    
aft] su* section #ccj,m ! foll[+3       
#ccj,n4 ,innovation = mat]nal heal?  7a7
 ,9 g5]al ,! ,secret>y1 9 consultation )
 exp]ts repres5t+ a v>iety ( cl9ical    
specialties1 ,/ate1 tribal1 or local    
public heal? (ficials1 rese>*]s1        
epidemiologi/s1 /ati/icians1 & community
 organizations1 %all e/abli% or cont9ue 
a program to aw>d competitive grants to 
eligible entities = ! purpose (-- 7#a7  
id5tify+1 develop+1 or dissem9at+ be/   
practices to improve mat]nal heal? c>e  
quality & outcomes1 elim9ate prev5table 

mat]nal mortality & sev]e mat]nal       
morbidity1 & improve infant heal?       
outcomes1 :i* may include-- 7,a7        
in=mation on evid5ce-bas$ practices to  
improve ! quality & safety ( mat]nal    
heal? c>e 9 hospitals & o!r heal? c>e   
sett+s ( a ,/ate or heal? c>e sy/em1    
includ+ by address+ topics commonly     
associat$ ) heal? complications or risks
 relat$ to pr5atal c>e1 labor c>e1      
bir?+1 & po/p>tum c>e2  7,b7 be/        
practices = improv+ mat]nal heal? c>e   
bas$ on data f9d+s & reviews conduct$ by
 a ,/ate mat]nal mortality review       
committee t address topics ( relevance  
to common complications or heal? risks  
relat$ to pr5atal c>e1 labor c>e1 bir?+1
 & po/p>tum c>e2 &  7,c7 in=mation on   
address+ det]m9ants ( heal? t impact    
mat]nal heal? outcomes = wom5 be=e1     
dur+1 & aft] pregnancy2  7#b7           
collaborat+ ) ,/ate mat]nal mortality   
review committees to id5tify issues = ! 
developm5t & implem5tation (            
evid5ce-bas$ practices to improve       

mat]nal heal? outcomes & r$uce          
prev5table mat]nal mortality & sev]e    
mat]nal morbidity2  7#c7 provid+        
te*nical assi/ance & support+ !         
implem5tation ( be/ practices id5tifi$ 9
 p>agraph 7#a7 to entities provid+ heal?
 c>e s]vices to pregnant & po/p>tum     
wom52 &  7#d7 id5tify+1 develop+1 &     
evaluat+ new models ( c>e t improve     
mat]nal & infant heal? outcomes1 :i* may
 include ! integration ( community-bas$ 
s]vices & cl9ical c>e4  7b7 ,eligible   
entities ,to be eligible = a grant "u   
subsection 7a71 an entity %all-- 7#a7   
submit to ! ,secret>y an application at 
su* "t1 9 su* mann]1 & conta9+ su*      
in=mation z ! ,secret>y may require2 &  
7#b7 demon/rate 9 su* application t !   
entity is capable ( c>ry+ out data-driv5
 mat]nal safety & quality improvem5t    
initiatives 9 ! areas ( ob/etrics &     
gynecology or mat]nal heal?4  7c7       
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re is au?oriz$ to be  
appropriat$ #aj1jjj1jjj = ea* ( fiscal  

ye>s #bjbj ?r\gh #bjbd4  4  #bjb4 ,tra9+
 = heal? c>e provid]s ,title ,,vii ( !  
,public ,heal? ,s]vice ,act is am5d$ by 
/rik+ section #gfc 7#db ,u4,s4,c4 #bidp7
 & ins]t+ ! foll[+3  #gfc4 ,tra9+ =     
heal? c>e provid]s  7a7 ,grant program  
,! ,secret>y %all e/abli% a program to  
aw>d grants to accr$it$ s*ools (        
allopa?ic m$ic9e1 o/eopa?ic m$ic9e1 &   
nurs+1 & o!r heal? pr(essional tra9+    
programs = ! tra9+ ( heal? c>e          
pr(essionals to r$uce & prev5t          
discrim9ation 7includ+ tra9+ relat$ to  
implicit & explicit biases7 9 !         
provision ( heal? c>e s]vices relat$ to 
pr5atal c>e1 labor c>e1 bir?+1 &        
po/p>tum c>e4  7b7 ,eligibility ,to be  
eligible = a grant "u subsection 7a71 an
 entity describ$ 9 su* subsection %all  
submit to ! ,secret>y an application at 
su* "t1 9 su* mann]1 & conta9+ su*      
in=mation z ! ,secret>y may require4    
7c7 ,report+ requirem5t ,ea* entity     
aw>d$ a grant "u ?is section %all       
p]iodically submit to ! ,secret>y a     

report on ! /atus ( activities conduct$ 
us+ ! grant1 includ+ a description ( !  
impact ( su* tra9+ on pati5t outcomes1 z
 applicable4  7d7 ,be/ practices ,!     
,secret>y may id5tify & dissem9ate be/  
practices = ! tra9+ ( heal? c>e         
pr(essionals to r$uce & prev5t          
discrim9ation 7includ+ tra9+ relat$ to  
implicit & explicit biases7 9 !         
provision ( heal? c>e s]vices relat$ to 
pr5atal c>e1 labor c>e1 bir?+1 &        
po/p>tum c>e4  7e7 ,au?orization (      
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#e1jjj1jjj = ea* ( fiscal ye>s #bjbj    
?r\gh #bjbd4  4  #bjc4 ,/udy on tra9+ to
 r$uce & prev5t discrim9ation ,n lat]   
?an #b ye>s aft] date ( enactm5t ( ?is  
,act1 ! ,secret>y ( ,heal? & ,human     
,s]vices 7ref]r$ to 9 ?is section z !   
,secret>y7 %all1 ?r\gh a contract ) an  
indep5d5t rese>* organization1 conduct a
 /udy & make recomm5dations = accr$it$  
s*ools ( allopa?ic m$ic9e1 o/eopa?ic    
m$ic9e1 & nurs+1 & o!r heal? pr(essional

 tra9+ programs1 on be/ practices relat$
 to tra9+ to r$uce & prev5t             
discrim9ation1 includ+ tra9+ relat$ to  
implicit & explicit biases1 9 !         
provision ( heal? c>e s]vices relat$ to 
pr5atal c>e1 labor c>e1 bir?+1 &        
po/p>tum c>e4  #bjd4 ,p]9atal quality   
collaboratives  7a7 ,grants ,section    
#cag,k7a77#b7 ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;a77#b77
 is am5d$ by add+ at ! end ! foll[+3    
7,e7 7i7 ,! ,secret>y1 act+ ?r\gh !     
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion & 9 coord9ation ) o!r     
(fices & ag5cies1 z appropriate1 %all   
e/abli% or cont9ue a competitive grant  
program = ! e/abli%m5t or support (     
p]9atal quality collaboratives to       
improve p]9atal c>e & p]9atal heal?     
outcomes = pregnant & po/p>tum wom5 & _!
 infants4 ,a ,/ate1 ,indian ,tribe1 or  
tribal organization may use funds       
receiv$ ?r\gh su* grant to-- 7,i7       
support ! use ( evid5ce-bas$ or         
evid5ce-in=m$ practices to improve      

outcomes = mat]nal & infant heal?2      
7,,ii7 "w ) cl9ical teams2 exp]ts2      
,/ate1 local1 &1 z appropriate1 tribal  
public heal? (ficials2 & /akehold]s1    
includ+ pati5ts & families1 to id5tify1 
develop1 or dissem9ate be/ practices to 
improve p]9atal c>e & outcomes2 &       
7,,iii7 employ /rategies t provide      
opportunities = heal? c>e pr(essionals &
 cl9ical teams to collaborate across    
heal? c>e sett+s & discipl9es1 includ+  
prim>y c>e & m5tal heal?1 z appropriate1
 to improve mat]nal & infant heal?      
outcomes1 :i* may include ! use ( data  
to provide timely fe$back across        
hospital & cl9ical teams to in=m        
responses1 & to provide support & tra9+ 
to hospital & cl9ical teams = quality   
improvem5t1 z appropriate4  7ii7 ,to be 
eligible = a grant "u clause 7i71 an    
entity %all submit to ! ,secret>y an    
application 9 su* =m & mann] & conta9+  
su* in=mation z ! ,secret>y may require4
  4  7b7 ,au?orization ( appropriations 
,section #cag,k7f7 ( ! ,public ,heal?   

,s]vice ,act 7#db ,u4,s4,c4             
#bdg;b-#ab7;f77 is am5d$ by /rik+       
#eh1jjj1jjj = ea* ( fiscal ye>s #bjai   
?r\gh #bjbc & ins]t+ #fe1jjj1jjj = ea* (
 fiscal ye>s #bjbj ?r\gh #bjbd4  #bje4  
,integrat$ s]vices = pregnant & po/p>tum
 wom5  7a7 ,grants ,! ,public ,heal?    
,s]vice ,act is am5d$ by ins]t+ aft]    
section #ccj,n ( su* ,act1 z add$ by    
section #bja1 ! foll[+3  #ccj,o4        
,integrat$ s]vices = pregnant & po/p>tum
 wom5  7a7 ,9 g5]al ,! ,secret>y may    
aw>d grants = ! purpose ( e/abli%+ or   
op]at+ evid5ce-bas$ or innovative1      
evid5ce-in=m$ programs to deliv]        
integrat$ heal? c>e s]vices to pregnant 
& po/p>tum wom5 to optimize ! heal? (   
wom5 & _! infants1 includ+-- 7#a7 to    
r$uce adv]se mat]nal heal? outcomes1    
pregnancy-relat$ dea?s1 & relat$ heal?  
disp>ities 7includ+ su* disp>ities      
associat$ ) racial & e?nic m9ority      
populations72 &  7#b7 z appropriate1 by 
address+ issues rese>*$ "u section      
#cag,k7b77#b74  7b7 ,integrat$ s]vices =

 pregnant & po/p>tum wom5  7#a7         
,eligibility ,to be eligible to receive 
a grant "u subsection 7a71 a ,/ate1     
,indian ,tribe1 or tribal organization  
7z su* t]ms are def9$ 9 section #d ( !  
,indian ,self-,det]m9ation & ,education 
,assi/ance ,act7 %all "w ) relevant     
/akehold]s t coord9ate c>e 7includ+     
coord9at+ res\rces & ref]rals = heal?   
c>e & social s]vices7 to develop & c>ry 
out ! program1 includ+-- 7,a7 ,/ate1    
,tribal1 & local ag5cies responsible =  
,m$icaid1 public heal?1 social s]vices1 
m5tal heal?1 & sub/ance use disord]     
treatm5t & s]vices2  7,b7 heal? c>e     
provid]s :o s]ve pregnant & po/p>tum    
wom52 &  7,c7 community-bas$ heal?      
organizations & heal? work]s1 includ+   
provid]s ( home visit+ s]vices &        
individuals repres5t+ communities )     
disproportionately high rates ( mat]nal 
mortality & sev]e mat]nal morbidity1 &  
includ+ ^? repres5t+ racial & e?nicity  
m9ority populations4  7#b7 ,t]ms  7,a7  
,p]iod ,a grant aw>d$ "u subsection 7a7 

%all be made = a p]iod ( #e ye>s4 ,any  
supplem5tal aw>d made to a grantee "u   
subsection 7a7 may be made = a p]iod (  
less ?an #e ye>s4  7,b7 ,pref]5ce ,9    
aw>d+ grants "u subsection 7a71 !       
,secret>y %all-- 7i7 give pref]5ce to   
,/ates1 ,indian ,tribes1 & tribal       
organizations t h ! highe/ rates (      
mat]nal mortality & sev]e mat]nal       
morbidity relative to o!r su* ,/ates1   
,indian ,tribes1 or tribal              
organizations1 respectively2 &  7ii7    
%all consid] heal? disp>ities relat$ to 
mat]nal mortality & sev]e mat]nal       
morbidity1 includ+ su* disp>ities       
associat$ ) racial & e?nic m9ority      
populations4  7,c7 ,priority ,9 aw>d+   
grants "u subsection 7a71 ! ,secret>y   
%all give priority to applications f up 
to #ae entities describ$ 9 subp>agraph  
7,b77i74  7,d7 ,evaluation ,! ,secret>y 
%all require grantees to evaluate !     
outcomes ( ! programs support$ "u !     
grant4  7c7 ,au?orization (             
appropriations ,to c>ry out ?is section1

 !re is au?oriz$ to be appropriat$      
#ae1jjj1jjj = ea* ( fiscal ye>s #bjbj   
?r\gh #bjbd4  4  7b7 ,report on grant   
outcomes & dissem9ation ( be/ practices 
7#a7 ,report ,n lat] ?an ,febru>y #a1   
#bjbf1 ! ,secret>y ( ,heal? & ,human    
,s]vices %all submit to ! ,committee on 
,en]gy & ,comm]ce ( ! ,h\se (           
,repres5tatives & ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions (
 ! ,s5ate a report t describes-- 7,a7 ! 
outcomes ( ! activities support$ by !   
grants aw>d$ "u ! am5dm5ts made by ?is  
section on mat]nal & *ild heal?2  7,b7  
be/ practices & models ( c>e us$ by     
recipi5ts ( grants "u su* am5dm5ts2 &   
7,c7 ob/acles id5tifi$ by recipi5ts (   
grants "u su* am5dm5ts1 & /rategies us$ 
by su* recipi5ts to deliv] c>e1 improve 
mat]nal & *ild heal?1 & r$uce heal?     
disp>ities4  7#b7 ,dissem9ation ( be/   
practices ,n lat] ?an ,augu/ #a1 #bjbf1 
! ,secret>y ( ,heal? & ,human ,s]vices  
%all dissem9ate in=mation on be/        
practices & models ( c>e us$ by         

recipi5ts ( grants "u section #ccj,o ( !
 ,public ,heal? ,s]vice ,act 7z add$ by 
?is section7 7includ+ be/ practices &   
models ( c>e relat+ to ! r$uction (     
heal? disp>ities1 includ+ su* disp>ities
 associat$ ) racial & e?nic m9ority     
populations1 9 rates ( mat]nal mortality
 & sev]e mat]nal morbidity7 to relevant 
/akehold]s1 :i* may include heal?       
provid]s1 m$ical s*ools1 nurs+ s*ools1  
relevant ,/ate1 tribal1 & local ag5cies1
 & ! g5]al public4  ,septemb] #ag1      
#bjbj,report$ ) an am5dm5t2 committ$ to 
! ,committee ( ! ,:ole ,h\se on ! ,/ate 
( ! ,union & ord]$ to be pr9t$