,i #aafth ,,congress #b;d ,session ,h4 ,r4 #fadd ,,in ,,the ,,house ,,of ,,representatives ,march #i1 #bjbj,ms4 ,adams 7for herself1 ,ms4 ,underwood1 ,ms4 ,sewell of ,alabama1 ,ms4 ,norton1 ,ms4 ,scanlon1 ,ms4 ,moore1 ,mr4 ,clay1 ,mr4 ,khanna1 ,ms4 ,pressley1 and ,mr4 ,lawson of ,florida7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to make investments in community-based organizations and other initiatives to prevent maternal mortality and severe maternal morbidity1 especially for ,black women1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,kira ,johnson ,act4 #b4 ,investments in community-based organizations ,to improve ,black maternal health outcomes 7a7 ,awards ,following the #a-year period described in subsection 7c71 the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary71 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall award grants to eligible entities to establish or expand programs to prevent maternal mortality and severe maternal morbidity among ,black women4 7b7 ,eligibility ,to be eligible to seek a grant under this section1 an entity shall be a community-based organization offering programs and resources aligned with evidence-based practices for improving maternal health outcomes for ,black women4 7c7 ,outreach and technical assistance period ,during the #a-year period beginning on the date of enactment of this ,act1 the ,secretary shall-- 7#a7 conduct outreach to encourage eligible entities to apply for grants under this section2 and 7#b7 provide technical assistance to eligible entities on best practices for applying for grants under this section4 7d7 ,special consideration 7#a7 ,outreach ,in conducting outreach under subsection 7c71 the ,secretary shall give special consideration to eligible entities that-- 7,a7 are based in1 and provide support for1 communities with-- 7i7 high rates of adverse maternal health outcomes2 and 7ii7 significant racial and ethnic disparities in maternal health outcomes2 7,b7 are led by ,black women2 and 7,c7 offer programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for ,black women4 7#b7 ,awards ,in awarding grants under this section1 the ,secretary shall give special consideration to eligible entities that-- 7,a7 are described in subparagraphs 7,a71 7,b71 and 7,c7 of paragraph 7#a72 7,b7 offer programs and resources designed in consultation with and intended for ,black women2 and 7,c7 offer programs and resources in the communities in which the respective eligible entities are located that-- 7i7 promote maternal mental health and maternal substance use disorder treatments that are aligned with evidence-based practices for improving maternal mental health outcomes for ,black women2 7ii7 address social determinants of health for women in the prenatal and postpartum periods1 including-- 7,i7 housing2 7,,ii7 transportation2 7,,iii7 nutrition counseling2 7,,iv7 healthy foods2 7,v7 lactation support2 7,,vi7 lead abatement and other efforts to improve air and water quality2 7,,vii7 child care access2 7,,viii7 car seat installation2 7,,ix7 wellness and stress management programs2 or 7,x7 coordination across safety-net and social support services and programs2 7iii7 promote evidence-based health literacy and pregnancy1 childbirth1 and parenting education for women in the prenatal and postpartum periods2 7iv7 provide support from doulas and other perinatal health workers to women from pregnancy through the postpartum period2 7v7 provide culturally congruent training to perinatal health workers such as doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dietitians1 social workers1 home visitors1 and navigators2 7vi7 conduct or support research on ,black maternal health issues2 or 7vii7 have developed other programs and resources that address community-specific needs for women in the prenatal and postpartum periods and are aligned with evidence-based practices for improving maternal health outcomes for ,black women4 7e7 ,technical assistance ,the ,secretary shall provide to grant recipients under this section technical assistance on-- 7#a7 capacity building to establish or expand programs to prevent adverse maternal health outcomes among ,black women2 7#b7 best practices in data collection1 measurement1 evaluation1 and reporting2 and 7#c7 planning for sustaining programs to prevent maternal mortality and severe maternal morbidity among ,black women after the period of the grant4 7f7 ,evaluation ,not later than the end of fiscal year #bjbf1 the ,secretary shall submit to the ,congress an evaluation of the grant program under this section that-- 7#a7 assesses the effectiveness of outreach efforts during the application process in diversifying the pool of grant recipients2 7#b7 makes recommendations for future outreach efforts to diversify the pool of grant recipients for ,department of ,health and ,human ,services grant programs and funding opportunities2 7#c7 assesses the effectiveness of programs funded by grants under this section in improving maternal health outcomes for ,black women2 and 7#d7 makes recommendations for future ,department of ,health and ,human ,services grant programs and funding opportunities that deliver funding to community-based organizations to improve ,black maternal health outcomes through programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for ,black women4 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #e1jjj1jjj for each of fiscal years #bjba through #bjbe4 #c4 ,training for all employees in maternity care settings ,part ,b of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bic et seq47 is amended by adding at the end the following new section3 #gdb4 ,training for all employees in maternity care settings 7a7 ,grants ,the ,secretary shall award grants for programs to reduce and prevent bias1 racism1 and discrimination in maternity care settings4 7b7 ,special consideration ,in awarding grants under subsection 7a71 the ,secretary shall give special consideration to applications for programs that would-- 7#a7 apply to all birthing professionals and any employees who interact with pregnant and postpartum women in the provider setting1 including front desk employees1 sonographers1 schedulers1 health care professionals1 hospital or health system administrators1 and security staff2 7#b7 emphasize periodic1 as opposed to one-time1 trainings for all birthing professionals and employees described in paragraph 7#a72 7#c7 address implicit bias and explicit bias2 7#d7 be delivered in ongoing education settings for providers maintaining their licenses1 with a preference for trainings that provide continuing education units and continuing medical education2 7#e7 include trauma-informed care best practices and an emphasis on shared decision making between providers and patients2 7#f7 include a service-learning component that sends providers to work in underserved communities to better understand patients' lived experiences2 7#g7 be delivered in undergraduate programs that funnel into medical schools1 like biology and pre-medicine majors2 7#h7 be delivered in settings that apply to providers of the special supplemental nutrition program for women1 infants1 and children under section #ag of the ,child ,nutrition ,act of #aiff2 7#i7 integrate bias training in obstetric emergency simulation trainings2 7#aj7 offer training to all maternity care providers on the value of racially1 ethnically1 and professionally diverse maternity care teams to provide culturally congruent care1 including doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dietitians1 social workers1 home visitors1 and navigators2 or 7#aa7 be based on one or more programs designed by a historically ,black college or university4 7c7 ,application ,to seek a grant under subsection 7a71 an entity shall submit an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,reporting ,each recipient of a grant under this section shall annually submit to the ,secretary a report on the status of activities conducted using the grant1 including1 as applicable1 a description of the impact of training provided through the grant on patient outcomes and patient experience for women of color and their families4 7e7 ,best practices ,based on the annual reports submitted pursuant to subsection 7d71 the ,secretary-- 7#a7 shall produce an annual report on the findings resulting from programs funded through this section2 7#b7 shall disseminate such report to all recipients of grants under this section and to the public2 and 7#c7 may include in such report findings on best practices for improving patient outcomes and patient experience for women of color and their families in maternity care settings4 7f7 ,definitions ,in this section3 7#a7 ,the term postpartum means the one-year period beginning on the last day of a woman's pregnancy4 7#b7 ,the term culturally congruent means in agreement with the preferred cultural values1 beliefs1 worldview1 and practices of the health care consumer and other stakeholders4 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #e1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 #d4 ,study on reducing and preventing bias1 racism1 and discrimination in maternity care settings 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall seek to enter into an agreement1 not later than #ij days after the date of enactment of this ,act1 with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this section as the ,national ,academies7 under which the ,national ,academies agrees to-- 7#a7 conduct a study on the design and implementation of programs to reduce and prevent bias1 racism1 and discrimination in maternity care settings2 and 7#b7 not later than #bd months after the date of enactment of this ,act1 complete the study and transmit a report on the results of the study to the ,congress4 7b7 ,possible topics ,the agreement entered into pursuant to subsection 7a7 may provide for the study of any of the following3 7#a7 ,the development of a scorecard for programs designed to reduce and prevent bias1 racism1 and discrimination in maternity care settings to assess the effectiveness of such programs in improving patient outcomes and patient experience for women of color and their families4 7#b7 ,determination of the types of training to reduce and prevent bias1 racism1 and discrimination in maternity care settings that are demonstrated to improve patient outcomes or patient experience for women of color and their families4 #e4 ,respectful maternity care compliance program 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary7 shall award grants to accredited hospitals1 health systems1 and other maternity care delivery settings to establish within one or more hospitals or other birth settings a respectful maternity care compliance office4 7b7 ,office requirements ,a respectful maternity care compliance office funded through a grant under this section shall-- 7#a7 institutionalize mechanisms to allow patients receiving maternity care services1 the families of such patients1 or doulas or other perinatal workers supporting such patients to report instances of disrespect or evidence of bias on the basis of race1 ethnicity1 or another protected class2 7#b7 institutionalize response mechanisms through which representatives of the office can directly follow up with the patient1 if possible1 and the patient's family in a timely manner2 7#c7 prepare and make publicly available a hospital- or health system-wide strategy to reduce bias on the basis of race1 ethnicity1 or another protected class in the delivery of maternity care that includes-- 7,a7 information on the training programs to reduce and prevent bias1 racism1 and discrimination on the basis of race1 ethnicity1 or another protected class for all employees in maternity care settings2 and 7,b7 the development of methods to routinely assess the extent to which bias1 racism1 or discrimination on the basis of race1 ethnicity1 or another protected class are present in the delivery of maternity care to minority patients2 and 7#d7 provide annual reports to the ,secretary with information about each case reported to the compliance office over the course of the year containing such information as the ,secretary may require1 such as-- 7,a7 de-identified demographic information on the patient in the case1 such as race1 ethnicity1 gender identity1 and primary language2 7,b7 the content of the report from the patient or the family of the patient to the compliance office2 and 7,c7 the response from the compliance office4 7c7 ,secretary requirements 7#a7 ,processes ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall establish processes for-- 7,a7 disseminating best practices for establishing and implementing a respectful maternity care compliance office within a hospital or other birth setting2 7,b7 promoting coordination and collaboration between hospitals1 health systems1 and other maternity care delivery settings on the establishment and implementation of respectful maternity care compliance offices2 and 7,c7 evaluating the effectiveness of respectful maternity care compliance offices on maternal health outcomes and patient and family experiences1 especially for minority patients and their families4 7#b7 ,study 7,a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall1 through a contract with an independent research organization1 conduct a study on strategies to address disrespect or bias on the basis of race1 ethnicity1 or another protected class in the delivery of maternity care services4 7,b7 ,components of study ,the study shall include the following3 7i7 ,an assessment of the reports submitted to the ,secretary from the respectful maternity care compliance offices pursuant to subsection 7b77#d74 7ii7 ,based on such assessment1 recommendations for potential accountability mechanisms related to cases of disrespect or bias on the basis of race1 ethnicity1 or another protected class in the delivery of maternity care services at hospitals and other birth settings4 ,such recommendations shall take into consideration medical and non-medical factors that contribute to adverse patient experiences and maternal health outcomes4 7,c7 ,report ,the ,secretary shall submit to the ,congress and make publicly available a report on the results of the study under this paragraph4 7d7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated such sums as may be necessary for fiscal years #bjba through #bjbf4 #f4 ,,gao report 7a7 ,in general ,not later than #b years after date of enactment of this ,act and every #b years thereafter1 the ,comptroller ,general of the ,united ,states shall submit to the ,congress and make publicly available a report on the establishment of respectful maternity care compliance offices within hospitals1 health systems1 and other maternity care settings4 7b7 ,matters included ,the report under paragraph 7#a7 shall include the following3 7#a7 ,information regarding the extent to which hospitals1 health systems1 and other maternity care settings have elected to establish respectful maternity care compliance offices1 including-- 7,a7 which hospitals and other birth settings elect to establish compliance offices and when such offices are established2 7,b7 to the extent practicable1 impacts of the establishment of such offices on maternal health outcomes and patient and family experiences in the hospitals and other birth settings that have established such offices1 especially for minority women and their families2 7,c7 information on geographic areas1 and types of hospitals or other birth settings1 where respectful maternity care compliance offices are not being established and information on factors contributing to decisions to not establish such offices2 and 7,d7 recommendations for establishing respectful maternity care compliance offices in geographic areas1 and types of hospitals or other birth settings1 where such offices are not being established4 7#b7 ,whether the funding made available to carry out section #f has been sufficient and1 if applicable1 recommendations for additional appropriations to carry out section #f4 7#c7 ,such other information as the ,comptroller ,general determines appropriate4 #g4 ,definitions ,in this ,act3 7#a7 ,the term postpartum means the one-year period beginning on the last day of a woman's pregnancy4 7#b7 ,the term culturally congruent means in agreement with the preferred cultural values1 beliefs1 worldview1 and practices of the health care consumer and other stakeholders4