,i #aaf? ,,congress #b;d ,session ,h4 ,r4 #fafe ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,m>* #aj1 #bjbj,ms4 ,davids ( ,kansas 7= h]self1 ,ms4 ,und]wood1 ,ms4 ,adams1 ,mr4 ,clay1 ,ms4 ,scanlon1 ,ms4 ,norton1 ,ms4 ,sewell ( ,alabama1 ,mr4 ,khanna1 ,ms4 ,moore1 ,mr4 ,lawson ( ,florida1 ,ms4 ,pressley1 & ,ms4 ,haal&7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ,natural ,res\rces1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to am5d ! ,public ,heal? ,s]vice ,act to improve data collection ) respect to mat]nal mortality & sev]e mat]nal morbidity1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,data to ,save ,moms ,act ( #bjbj4 #b4 ,fund+ = mat]nal mortality review committees to promote repres5tative community engagem5t 7a7 ,9 g5]al ,section #cag,k7d7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77 is am5d$ by add+ at ! end ! foll[+3 7#i7 ,grants to promote repres5tative community engagem5t 9 mat]nal mortality review committees 7,a7 ,9 g5]al ,! ,secret>y may1 us+ funds made available pursuant to subp>agraph 7,c71 provide assi/ance to an applicable mat]nal mortality review committee ( a ,/ate1 ,indian tribe1 tribal organization1 or urban ,indian organization 7z su* t]m is def9$ 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act 7#be ,u4,s4,c4 #afjc77-- 7i7 to select = inclusion 9 ! memb]%ip ( su* a committee community memb]s f ! ,/ate1 ,indian tribe1 tribal organization1 or urban ,indian organization by-- 7,i7 prioritiz+ community memb]s :o c increase ! div]sity ( ! committee's memb]%ip ) respect to race & e?nicity1 location1 & pr(essional backgr\nd1 includ+ memb]s ) non-cl9ical exp]i5ces2 & 7,,ii7 to ! ext5t applicable1 us+ funds res]v$ "u subsection 7f7 to address b>ri]s to mat]nal mortality review committee p>ticipation = community memb]s1 includ+ requir$ tra9+1 transportation b>ri]s1 comp5sation1 & o!r supports z may be necess>y2 7ii7 to e/abli% initiatives to conduct outrea* & community engagem5t ef=ts )9 communities ?r\gh\t ! ,/ate or ,tribe to seek input f community memb]s on ! "w ( su* mat]nal mortality review committee1 ) a p>ticul> focus on outrea* to m9ority wom52 & 7iii7 to release public reports assess+-- 7,i7 ! pregnancy-relat$ dea? & pregnancy-associat$ dea? review processes ( ! mat]nal mortality review committee1 ) a p>ticul> focus on ! mat]nal mortality review committee's s5sitivity to ! unique circum/ances ( m9ority wom5 :o h suff]$ pregnancy-relat$ dea?s2 & 7,,ii7 ! impact ( ! use ( funds made available pursuant to p>agraph 7,c7 on increas+ ! div]sity ( ! mat]nal mortality review committee memb]%ip & promot+ community engagem5t ef=ts ?r\ghout ! ,/ate or ,tribe4 7,b7 ,te*nical assi/ance ,! ,secret>y %all provide 7ei!r directly ?r\gh ! ,dep>tm5t ( ,heal? & ,human ,s]vices or by contract7 te*nical assi/ance to any mat]nal mortality review committee receiv+ a grant "u ?is p>agraph on be/ practices = increas+ ! div]sity ( ! mat]nal mortality review committee's memb]%ip & = conduct+ effective community engagem5t ?r\gh\t ! ,/ate or ,tribe4 7,c7 ,au?orization ( appropriations ,9 addition to any funds made available "u subsection 7f71 !re are au?oriz$ to be appropriat$ to c>ry out ?is p>agraph #aj1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 4 7b7 ,res]vation ( funds ,section #cag,k7f7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;f77 is am5d$ by add+ at ! end ! foll[+3 ,( ! am\nt made available "u ! prec$+ s5t5ce = a fiscal ye>1 n less ?an #a1ejj1jjj %all be res]v$ = grants to ,indian tribes1 tribal organizations1 or urban ,indian organizations 7z su* t]m is def9$ 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act 7#be ,u4,s4,c4 #afjc774 #c4 ,data collection & review 7a7 ,9 g5]al ,section #cag,k7d77#c77;,a77i7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77#c77;,a77i77 is am5d$-- 7#a7 by r$esignat+ subclauses 7,,ii7 & 7,,iii7 z subclauses 7,v7 & 7,,vi71 respectively2 & 7#b7 by ins]t+ aft] subclause 7,i7 ! foll[+3 7,,ii7 to ! ext5t practicable1 review+ cases ( sev]e mat]nal morbidity 9 :i* ! pati5t receiv$ a transfusion ( f\r or m units ( blood & 0 admitt$ to an int5sive c>e unit2 7,,iii7 to ! ext5t practicable1 consult+ ) local community-bas$ organizations repres5t+ wom5 f demographic gr\ps disproportionately impact$ by poor mat]nal heal? outcomes to ensure t1 9 addition to cl9ical factors1 non-cl9ical factors t might h contribut$ to a pregnancy-relat$ dea? are appropriately consid]$2 4 7b7 ,sev]e mat]nal morbidity def9$ ,section #cag,k7e7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;e77 is am5d$-- 7#a7 9 p>agraph 7#b71 by /rik+ & at ! end2 7#b7 9 p>agraph 7#c71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7#c7 by add+ at ! end ! foll[+3 7#d7 ! t]m sev]e mat]nal morbidity means "o or m unexpect$ outcomes ( labor & deliv]y t result 9 significant %ort-t]m or long-t]m consequ5ces to a woman's heal?4 4 #d4 ,task =ce on mat]nal heal? data & quality measures 7a7 ,e/abli%m5t ,n lat] ?an #ahj days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all e/abli% a task =ce to be kn[n z ! ,task ,=ce on ,mat]nal ,heal? ,data & ,quality ,measures 79 ?is section ref]r$ to z ! ,task ,=ce74 7b7 ,duties ( task =ce 7#a7 ,9 g5]al ,! ,task ,=ce %all use all available relevant in=mation1 includ+ in=mation f ,/ate-level s\rces1 to prep>e & submit a report conta9+ ! foll[+3 7,a7 ,an evaluation ( curr5t ,/ate & ,tribal practices = mat]nal heal?1 mat]nal mortality1 & sev]e mat]nal morbidity data collection & dissem9ation1 includ+ consid]ation (-- 7i7 ! timel9ess ( processes = am5d+ a dea? c]tificate :5 new in=mation p]ta9+ to ! dea? becomes available to reflect :e!r ! dea? 0 a pregnancy-relat$ dea?2 7ii7 mat]nal heal? data collect$ ) electronic heal? records1 includ+ data on race & e?nicity2 7iii7 ! b>ri]s prev5t+ ,/ates f correlat+ mat]nal outcome data ) race & e?nicity data2 7iv7 processes = det]m9+ ! cause ( a pregnancy-associat$ dea? 9 ,/ates t d n h a mat]nal mortality review committee2 7v7 :e!r mat]nal mortality review committees include multidiscipl9>y & div]se memb]%ip 7z describ$ 9 section #cag,k7d77#a77;,a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77#a77;,a772 7vi7 :e!r memb]s ( mat]nal mortality review committees p>ticipate 9 tra9+s on bias1 racism1 or discrim9ation1 & ! quality ( su* tra9+s2 7vii7 ! ext5t to :i* ,/ates h implem5t$ sy/ematic processes ( li/5+ to ! /ories ( pregnant & po/p>tum wom5 & _! family memb]s1 ) a p>ticul> focus on m9ority wom5 & _! family memb]s1 to fully und]/& ! causes (1 & in=m pot5tial solutions to1 ! mat]nal mortality & sev]e mat]nal morbidity crisis )9 _! respective ,/ates2 7viii7 ! consid]ation ( social det]m9ants ( heal? by mat]nal mortality review committees :5 exam9+ ! causes ( pregnancy-associat$ & pregnancy-relat$ dea?s2 7ix7 ! legal b>ri]s prev5t+ ! collation ( ,/ate mat]nity c>e data2 7x7 ! effectiv5ess ( data collection & report+ processes 9 sep>at+ pregnancy-associat$ dea?s f pregnancy-relat$ dea?s2 & 7xi7 ! curr5t ,f$]al1 ,/ate1 local1 & ,tribal fund+ support = ! activities ref]r$ to 9 clauses 7i7 ?r\gh 7x74 7,b7 ,an assessm5t ( :e!r ! fund+ ref]r$ to 9 subp>agraph 7,a77xi7 is adequate = ,/ates to c>ry out optimal data collection & dissem9ation processes ) respect to mat]nal heal?1 mat]nal mortality1 & sev]e mat]nal morbidity4 7,c7 ,an evaluation ( curr5t quality measures = mat]nity c>e1 includ+ pr5atal measures1 labor & deliv]y measures1 & po/p>tum measures up to "o ye> po/p>tum4 ,su* evaluation %all be conduct$ 9 consultation ) ! ,national ,quality ,=um & %all include consid]ation (-- 7i7 effective quality measures = mat]nity c>e us$ by hospitals1 heal? sy/ems1 bir? c5t]s1 heal? plans1 & o!r relevant entities2 7ii7 ! suffici5cy ( curr5t outcome measures us$ to evaluate mat]nity c>e = te/+ & validat+ new mat]nal heal? c>e paym5t & s]vice deliv]y models2 7iii7 quality measures = ! *ildbir? exp]i5ces ( wom5 t o!r c\ntries effectively use2 7iv7 curr5t mat]nity c>e quality measures t may be elim9at$ because !y are n a*iev+ _! int5d$ effect2 7v7 b>ri]s prev5t+ mat]nity c>e provid]s f implem5t+ quality measures t are align$ f be/ practices2 7vi7 ! frequ5cy ) :i* mat]nity c>e quality measures are review$ & revis$2 7vii7 ! /r5g?s & weaknesses ( ! ,pr5atal & ,po/p>tum ,c>e measures ( ! ,heal? ,plan ,employ] ,data & ,in=mation ,set measures e/abli%$ by ! ,national ,committee = ,quality ,assurance2 7viii7 ! /r5g?s & weaknesses ( mat]nity c>e quality measures "u ! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 & ! ,*ildr5's ,heal? ,insurance ,program "u title ,,xxi ( su* ,act 7#db ,u4,s4,c4 #acig et seq471 includ+ ! ext5t to :i* ,/ates volunt>ily report relevant measures2 7ix7 ! ext5t to :i* mat]nity c>e quality measures are in=m$ by pati5t exp]i5ces t include subjective measures ( pati5t-report$ exp]i5ce ( c>e2 7x7 ! curr5t processes = collect+ /ratifi$ data on ! race & e?nicity ( pregnant & po/p>tum wom5 9 hospitals1 heal? sy/ems1 & bir? c5t]s1 & = incorporat+ su* racially & e?nically /ratifi$ data 9 mat]nity c>e quality measures2 7xi7 ! ext5t to :i* mat]nity c>e quality measures acc\nt = ! unique exp]i5ces ( m9ority wom5 & _! families2 & 7xii7 ! ext5t to :i* hospitals1 heal? sy/ems1 & bir? c5t]s are implem5t+ exi/+ mat]nity c>e quality measures4 7,d7 ,recomm5dations on au?oriz+ additional funds to improve mat]nal mortality review committees & relevant mat]nal heal? initiatives by ! ag5cies & organizations )9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7,e7 ,recomm5dations = new au?orities t may be grant$ to mat]nal mortality review committees to be able to-- 7i7 access records f o!r ,f$]al & ,/ate ag5cies & dep>tm5ts t may be necess>y to id5tify causes ( pregnancy-associat$ dea?s t are unique to wom5 f specific populations1 su* z wom5 vet]ans & wom5 :o are inc>c]at$2 & 7ii7 "w ) relevant exp]ts :o are n memb]s ( ! mat]nal mortality review committee to assi/ 9 ! review ( pregnancy-associat$ dea?s ( wom5 f specific populations1 su* z wom5 vet]ans & wom5 :o are inc>c]at$4 7,f7 ,recomm5dations to improve curr5t quality measures = mat]nity c>e1 includ+ recomm5dations on updat+ ! ,pregnancy ,deliv]y ,c>e measures on ! ,hospital ,comp>e website ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices or any successor website1 ) a p>ticul> focus on racial & e?nic disp>ities 9 mat]nal heal? outcomes4 7,g7 ,recomm5dations to improve ! coord9ation by ! ,dep>tm5t ( ,heal? & ,human ,s]vices ( ! ef=ts und]tak5 by ! ag5cies & organizations )9 ! ,dep>tm5t relat$ to mat]nal heal? data & quality measures4 7#b7 ,public comm5t ,n lat] ?an #fj days aft] ! date on :i* a majority ( ! memb]s ( ! ,task ,=ce h be5 appo9t$1 ! ,task ,=ce %all publi% 9 ! ,f$]al ,regi/] a notice = public comm5t p]iod ( #ij days1 beg9n+ on ! date ( publication1 on ! duties & activities ( ! ,task ,=ce4 7c7 ,memb]%ip 7#a7 ,9 g5]al ,! ,task ,=ce %all be compos$ ( #ah memb]s appo9t$ by ! ,secret>y ( ,heal? & ,human ,s]vices4 ,! ,secret>y %all give special consid]ation to individuals :o are repres5tative ( populations mo/ affect$ by mat]nal mortality & sev]e mat]nal morbidity4 7#b7 ,memb] crit]ia ,to be eligible to be appo9t$ z a memb] ( ! ,task ,=ce1 an individual %all be-- 7,a7 a woman :o has exp]i5c$ sev]e mat]nal morbidity2 7,b7 a family memb] ( a woman :o _h a pregnancy-relat$ dea?2 7,c7 an individual :o provides non-cl9ical support to wom5 f pregnancy ?r\gh ! po/p>tum p]iod1 su* z a d\la1 community heal? work]1 pe] support]1 c]tifi$ lactation consultant1 nutritioni/ or dietitian1 social work]1 home visitor1 or a pati5t navigator2 7,d7 a lead] ( a community-bas$ organization t addresses adv]se mat]nal heal? outcomes ) a specific focus on racial & e?nic disp>ities2 7,e7 an academic rese>*] 9 a field or policy area relat$ to ! duties ( ! ,task ,=ce2 7,f7 a mat]nal heal? c>e provid]2 7,g7 an elect$ or duly appo9t$ lead] f an ,indian ,tribe2 7,h7 an exp]t 9 a field or policy area relat$ to ! duties ( ! ,task ,=ce2 or 7,i7 an individual :o has exp]i5ce ) ,f$]al or ,/ate gov]nm5t programs relat$ to ! duties ( ! ,task ,=ce4 7#c7 ,appo9tm5t tim+ ,appo9tm5ts to ! ,task ,=ce %all be made n lat] ?an #ahj days aft] ! date ( enactm5t ( ?is ,act4 7#d7 ,duration ,ea* memb] %all be appo9t$ = ! life ( ! ,task ,=ce4 7#e7 ,co-*air selection ,n lat] ?an #cj days aft] ! date on :i* a majority ( ! memb]s ( ! ,task ,=ce h be5 appo9t$1 ! ,secret>y %all select #b ( ! memb]s ( ! ,task ,=ce to s]ve z co-*airs ( ! ,task ,=ce4 7#f7 ,vacancies 7,a7 ,9 g5]al ,a vacancy 9 ! ,task ,=ce-- 7i7 %all n affect ! p[]s ( ! ,task ,=ce2 & 7ii7 %all be fill$ 9 ! same mann] z ! orig9al appo9tm5t4 7,b7 ,co-*air vacancy ,9 ! ev5t ( a vacancy ( a co-*air ( ! ,task ,=ce1 a replacem5t co-*air %all be select$ 9 ! same mann] z ! orig9al selection4 7#g7 ,comp5sation ,except z provid$ 9 p>agraph 7#h71 memb]s ( ! ,task ,=ce %all s]ve )\t pay4 7#h7 ,travel exp5ses ,memb]s ( ! ,task ,=ce %all be all[$ travel exp5ses1 includ+ p] diem 9 lieu ( subsi/5ce1 at rates au?oriz$ = employees ( ag5cies "u sub*apt] ,i ( *apt] #eg ( title #e1 ,unit$ ,/ates ,code1 :ile away f _! homes or regul> places ( bus9ess 9 ! p]=mance ( s]vice = ! ,task ,=ce4 7d7 ,meet+s 7#a7 ,9 g5]al ,! ,task ,=ce %all meet at ! call ( ! co-*airs ( ! ,task ,=ce4 7#b7 ,quorum ,a majority ( ! memb]s ( ! ,task ,=ce %all con/itute a quorum4 7#c7 ,initial meet+ ,! ,task ,=ce %all meet n lat] ?an #fj days aft] ! date on :i* a majority ( ! memb]s ( ! ,task ,=ce h be5 appo9t$4 7e7 ,/aff ( task =ce 7#a7 ,additional /aff ,! co-*airs ( ! ,task ,=ce may appo9t & fix ! pay ( additional /aff to ! ,task ,=ce z ! co-*airs consid] appropriate4 7#b7 ,applicability ( c]ta9 civil s]vice laws ,! /aff ( ! ,task ,=ce may be appo9t$ )\t reg>d to ! provisions ( title #e1 ,unit$ ,/ates ,code1 gov]n+ appo9tm5ts 9 ! competitive s]vice1 & may be paid )\t reg>d to ! provisions ( *apt] #ea & sub*apt] ,,iii ( *apt] #ec ( t title relat+ to classification & ,g5]al ,s*$ule pay rates4 7#c7 ,detailees ,any ,f$]al ,gov]nm5t employee may be detail$ to ! ,task ,=ce )\t reimbursem5t f ! ,task ,=ce1 & ! detailee %all reta9 ! rights1 /atus1 & privileges ( 8 or h] regul> employm5t )\t int]ruption4 7f7 ,p[]s ( task =ce 7#a7 ,te/imony & evid5ce ,! ,task ,=ce may take su* te/imony & receive su* evid5ce z ! ,task ,=ce consid]s advisable to c>ry out ?is section4 7#b7 ,obta9+ (ficial data ,! ,task ,=ce may secure directly f any ,f$]al dep>tm5t or ag5cy in=mation necess>y to c>ry out its duties "u ?is section4 ,on reque/ ( ! co-*airs ( ! ,task ,=ce1 ! head ( t dep>tm5t or ag5cy %all furni% su* in=mation to ! ,task ,=ce4 7#c7 ,po/al s]vices ,! ,task ,=ce may use ! ,unit$ ,/ates mails 9 ! same mann] & "u ! same conditions z o!r ,f$]al dep>tm5ts & ag5cies4 7g7 ,report ,n lat] ?an #b ye>s aft] ! date on :i* ! initial #ah memb]s ( ! ,task ,=ce are appo9t$ "u subsection 7c77#a71 ! ,task ,=ce %all submit to ! ,committee on ,en]gy & ,comm]ce1 ! ,committee on ,education & ,labor1 & ! ,committee on ,ways & ,means ( ! ,h\se ( ,repres5tatives & ! ,committee on ,f9ance & ! ,committee on ,heal?1 ,education1 ,labor & ,p5sions ( ! ,s5ate1 & make publicly available1 a report t-- 7#a7 conta9s ! in=mation1 evaluations1 & recomm5dations describ$ 9 subsection 7b72 & 7#b7 is sign$ by m ?an half ( ! memb]s ( ! ,task ,=ce4 7h7 ,t]m9ation ,section #ad ( ! ,f$]al ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 %all n apply to ! ,task ,=ce4 7i7 ,def9itions ,9 ?is section3 7#a7 ,mat]nal heal? c>e provid] ,! t]m mat]nal heal? c>e provid] means an individual :o is an ob/etrician-gynecologi/1 family physician1 midwife :o meets at a m9imum ! int]national def9ition ( ! midwife & global /&>ds = midwif]y education z e/abli%$ by ! ,int]national ,conf$]ation ( ,midwives1 nurse practition]1 or cl9ical nurse speciali/4 7#b7 ,mat]nal mortality ,! t]m mat]nal mortality means dea?s occurr+ dur+1 or )9 #ab mon?s aft]1 pregnancy f complications ( pregnancy or *ildbir?4 7#c7 ,mat]nal mortality review committee ,! t]m mat]nal mortality review committee means a mat]nal mortality review committee duly au?oriz$ by a ,/ate & receiv+ fund+ "u section #cagk7a77#b77;,d7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;a77#b77;,d774 7#d7 ,pregnancy-associat$ dea? ,! t]m pregnancy-associat$ dea? means a dea? ( a woman1 by any cause1 t occurs dur+1 or )9 #a ye> foll[+1 h] pregnancy1 reg>dless ( ! outcome1 duration1 or site ( ! pregnancy4 7#e7 ,pregnancy-relat$ dea? ,! t]m pregnancy-relat$ dea? means a dea? ( a woman t occurs dur+1 or )9 #a ye> foll[+1 h] pregnancy1 reg>dless ( ! outcome1 duration1 or site ( ! pregnancy-- 7,a7 f any cause relat$ to1 or aggravat$ by1 ! pregnancy or its managem5t2 & 7,b7 n f accid5tal or incid5tal causes4 7#f7 ,sev]e mat]nal morbidity ,! t]m sev]e mat]nal morbidity means unexpect$ outcomes ( labor & deliv]y result+ 9 significant %ort-t]m or long-t]m consequ5ces to ! heal? ( a woman4 7j7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ su* sums z may be necess>y to c>ry out ?is section = fiscal ye>s #bjba ?r\gh #bjbd4 #e4 ,indian ,heal? ,s]vice /udy on mat]nal mortality 7a7 ,9 g5]al ,! ,director ( ! ,indian ,heal? ,s]vice 7ref]r$ to 9 ?is section z ! ,director7 %all1 9 coord9ation ) entities describ$ 9 subsection 7b7-- 7#a7 n lat] ?an #ij days aft] ! enactm5t ( ?is ,act1 ent] into a contract ) an indep5d5t rese>* organization or ,tribal ,epidemiology ,c5t] to conduct a compreh5sive /udy on mat]nal mortality & sev]e mat]nal morbidity 9 ! populations ( ,am]ican ,indian & ,alaska ,native wom52 & 7#b7 n lat] ?an #c ye>s aft] ! date ( ! enactm5t ( ?is ,act1 submit to ,congress a report on su* /udy t conta9s recomm5dations = policies & practices t c be adopt$ to improve mat]nal heal? outcomes = su* wom54 7b7 ,p>ticipat+ entities ,! entities describ$ 9 ?is subsection %all consi/ ( #ab memb]s1 select$ by ! ,director f among individuals nom9at$ by ,indian tribes & tribal organizations 7z su* t]ms are def9$ 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 & urban ,indian organizations 7z su* t]m is def9$ 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act 7#be ,u4,s4,c4 #afjc774 ,9 select+ su* memb]s1 ! ,director %all ensure t ea* ( ! #ab s]vice areas ( ! ,indian ,heal? ,s]vice is repres5t$4 7c7 ,cont5ts ( /udy ,! /udy conduct$ pursuant to subsection 7a7 %all-- 7#a7 exam9e ! causes ( mat]nal mortality & sev]e mat]nal morbidity t are unique to ,am]ican ,indian & ,alaska ,native wom52 7#b7 include a sy/ematic process ( li/5+ to ! /ories ( ,am]ican ,indian & ,alaska ,native wom5 to fully und]/& ! causes (1 & in=m pot5tial solutions to1 ! mat]nal mortality & sev]e mat]nal morbidity crisis )9 _! respective communities2 7#c7 di/+ui% betwe5 ! causes (1 l&scape ( mat]nity c>e at1 & recomm5dations to improve mat]nal heal? outcomes )91 ! diff]5t sett+s 9 :i* ,am]ican ,indian & ,alaska ,native wom5 receive mat]nity c>e1 su* z-- 7,a7 facilities op]at$ by ! ,indian ,heal? ,s]vice2 7,b7 an ,indian heal? program op]at$ by an ,indian tribe or tribal organization pursuant to a contract1 grant1 coop]ative agreem5t1 or compact ) ! ,indian ,heal? ,s]vice pursuant to ! ,indian ,self-,det]m9ation ,act2 & 7,c7 an urban ,indian heal? program op]at$ by an urban ,indian organization pursuant to a grant or contract ) ! ,indian ,heal? ,s]vice pursuant to title ,v ( ! ,indian ,heal? ,c>e ,improvem5t ,act2 7#d7 review processes = coord9at+ programs ( ! ,indian ,heal? ,s]vice ) social s]vices provid$ ?r\gh o!r programs adm9i/]$ by ! ,secret>y ( ,heal? & ,human ,s]vices 7o!r ?an ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act1 ! ,m$icaid program "u title ,,xix ( su* ,act1 & ! ,*ildr5's ,heal? ,insurance ,program "u title ,,xxi ( su* ,act71 includ+ coord9ation ) ! ef=ts ( ! ,task ,=ce e/abli%$ "u section #c2 7#e7 review curr5t data collection & quality measurem5t processes & practices2 7#f7 consid] social det]m9ants ( heal?1 includ+ pov]ty1 lack ( heal? insurance1 unemploym5t1 sexual viol5ce1 & environm5tal conditions 9 ,tribal areas2 7#g7 consid] ! role t hi/orical mi/reatm5t ( ,am]ican ,indian & ,alaska ,native wom5 has play$ 9 caus+ curr5tly high rates ( mat]nal mortality & sev]e mat]nal morbidity2 7#h7 consid] h[ curr5t fund+ ( ! ,indian ,heal? ,s]vice affects ! ability ( ! ,s]vice to deliv] quality mat]nity c>e2 7#i7 consid] ! ext5t to :i* ! deliv]y ( mat]nity c>e s]vices is culturally appropriate = ,am]ican ,indian & ,alaska ,native wom52 7#aj7 make recomm5dations to r$uce misclassification ( ,am]ican ,indian & ,alaska ,native wom51 includ+ consid]ation ( be/ practices 9 tra9+ = mat]nal mortality review committee memb]s to be able to correctly classify ,am]ican ,indian & ,alaska ,native wom52 & 7#aa7 make recomm5dations in=m$ by ! /ories %>$ by ,am]ican ,indian & ,alaska ,native wom5 9 p>agraph 7#b7 to improve mat]nal heal? outcomes = su* wom54 7d7 ,report ,! agreem5t ent]$ into "u subsection 7a7 ) an indep5d5t rese>* organization or ,tribal ,epidemiology ,c5t] %all require t ! organization or c5t] transmit to ,congress a report on ! results ( ! /udy conduct$ pursuant to t agreem5t n lat] ?an #cf mon?s aft] ! date ( ! enactm5t ( ?is ,act4 7e7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section #b1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbc4 #f4 ,grants to m9ority-s]v+ in/itutions to /udy mat]nal mortality1 sev]e mat]nal morbidity1 & o!r adv]se mat]nal heal? outcomes 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices %all e/abli% a program "u :i* ! ,secret>y %all aw>d grants to rese>* c5t]s & o!r entities at m9ority-s]v+ in/itutions to /udy specific aspects ( ! mat]nal heal? crisis among m9ority wom54 ,su* rese>* may-- 7#a7 include ! developm5t & implem5tation ( sy/ematic processes ( li/5+ to ! /ories ( m9ority wom5 to fully und]/& ! causes (1 & in=m pot5tial solutions to1 ! mat]nal mortality & sev]e mat]nal morbidity crisis )9 _! respective communities2 & 7#b7 assess ! pot5tial causes ( l[ rates ( mat]nal mortality among ,hispanic wom51 includ+ pot5tial racial misclassification & o!r data collection & report+ issues t might be misrepres5t+ mat]nal mortality rates among ,hispanic wom5 9 ! ,unit$ ,/ates4 7b7 ,application ,to be eligible to receive 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 ,te*nical assi/ance ,! ,secret>y may use n m ?an #aj p]c5t ( ! funds made available "u subsection 7f7-- 7#a7 to conduct outrea* to ,m9ority-,s]v+ ,in/itutions to raise aw>5ess ( ! availability ( grants "u ?is subsection 7a72 7#b7 to provide te*nical assi/ance 9 ! application process = su* a grant2 & 7#c7 to promote capacity build+ z ne$$ to enable entities describ$ 9 su* subsection to submit su* an application4 7d7 ,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+ ! grant4 7e7 ,evaluation ,beg9n+ "o ye> aft] ! date on :i* ! fir/ grant is aw>d$ "u ?is section1 ! ,secret>y %all submit to ,congress an annual report summ>iz+ ! f9d+s ( rese>* conduct$ us+ funds made available "u ?is section4 7f7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section #aj1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 7g7 ,m9ority-,s]v+ in/itutions def9$ ,9 ?is section1 ! t]m m9ority-s]v+ in/itution has ! mean+ giv5 ! t]m 9 section #cga7;a7 ( ! ,high] ,education ,act ( #aife 7#bj ,u4,s4,c4 #ajfgq7a774