,,ii #aafth ,,congress #b;d ,session ,s4 #cdbd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #aj1 #bjbj ,ms4 ,harris 7for herself1 ,mr4 ,booker1 ,mr4 ,peters1 ,mrs4 ,gillibrand1 ,ms4 ,baldwin1 ,ms4 ,warren1 ,mr4 ,sanders1 ,ms4 ,duckworth1 ,mr4 ,blumenthal1 ,mr4 ,bennet1 ,ms4 ,klobuchar1 ,mr4 ,menendez1 and ,mr4 ,merkley7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to end preventable maternal mortality and severe maternal morbidity in the ,united ,states and close disparities in maternal health outcomes1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,black ,maternal ,health ,momnibus ,act of #bjbj4 #b4 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title4 ,sec4 #b4 ,table of contents4 ,sec4 #c4 ,definitions4 ,title ,i--,social ,determinants for ,moms ,sec4 #aja4 ,task force to coordinate efforts to address social determinants of health for women in the prenatal and postpartum periods4 ,sec4 #ajb4 ,requirements for guidance relating to social determinants of health for pregnant women4 ,sec4 #ajc4 ,department of ,housing and ,urban ,development4 ,sec4 #ajd4 ,department of ,transportation4 ,sec4 #aje4 ,department of ,agriculture4 ,sec4 #ajf4 ,environmental study through ,national ,academies4 ,sec4 #ajg4 ,child care access4 ,sec4 #ajh4 ,grants to ,state1 local1 and ,tribal public health departments addressing social determinants of health for pregnant and postpartum women4 ,title ,,ii--,honoring ,kira ,johnson ,sec4 #bja4 ,investments in community-based organizations to improve ,black maternal health outcomes4 ,sec4 #bjb4 ,training for all employees in maternity care settings4 ,sec4 #bjc4 ,study on reducing and preventing bias1 racism1 and discrimination in maternity care settings4 ,sec4 #bjd4 ,respectful maternity care compliance program4 ,sec4 #bje4 ,,gao report4 ,title ,,iii--,protecting ,moms ,who ,served ,sec4 #cja4 ,support for maternity care coordination4 ,sec4 #cjb4 ,sense of ,congress on veteran status requirements4 ,sec4 #cjc4 ,report on maternal mortality and severe maternal morbidity among women veterans4 ,title ,,iv--,perinatal ,workforce ,sec4 #dja4 ,,hhs agency directives4 ,sec4 #djb4 ,grants to grow and diversify the perinatal workforce4 ,sec4 #djc4 ,grants to grow and diversify the nursing workforce in maternal and perinatal health4 ,sec4 #djd4 ,,gao report on barriers to maternity care4 ,title ,v--,data ,to ,save ,moms ,sec4 #eja4 ,funding for maternal mortality review committees to promote representative community engagement4 ,sec4 #ejb4 ,data collection and review4 ,sec4 #ejc4 ,task force on maternal health data and quality measures4 ,sec4 #ejd4 ,indian ,health ,service study on maternal mortality4 ,sec4 #eje4 ,grants to minority-serving institutions to study maternal mortality1 severe maternal morbidity1 and other adverse maternal health outcomes4 ,title ,,vi--,moms ,,matter ,sec4 #fja4 ,innovative models to reduce maternal mortality4 ,title ,,vii--,justice for ,incarcerated ,moms ,sec4 #gja4 ,sense of ,congress4 ,sec4 #gjb4 ,ending the shackling of pregnant individuals4 ,sec4 #gjc4 ,creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods4 ,sec4 #gjd4 ,grant program to improve maternal health outcomes for individuals in ,state and local prisons and jails4 ,sec4 #gje4 ,,gao report4 ,sec4 #gjf4 ,,macpac report4 ,title ,,viii--,tech ,to ,save ,moms ,sec4 #hja4 ,,cmi modeling of integrated telehealth models in maternity care services4 ,sec4 #hjb4 ,grants to expand the use of technology-enabled collaborative learning and capacity models that provide care to pregnant and postpartum women4 ,sec4 #hjc4 ,grants to promote equity in maternal health outcomes by increasing access to digital tools4 ,sec4 #hjd4 ,report on the use of technology to reduce maternal mortality and severe maternal morbidity and to close racial and ethnic disparities in outcomes4 ,title ,,ix--,,impact ,to ,save ,moms ,sec4 #ija4 ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project4 ,sec4 #ijb4 ,,macpac report4 #c4 ,definitions ,in this ,act3 7#a7 ,culturally congruent ,the term culturally congruent1 with respect to care or maternity care1 means care that is in agreement with the preferred cultural values1 beliefs1 worldview1 and practices of the health care consumer and other stakeholders4 7#b7 ,maternal mortality ,the term maternal mortality means a death occurring during or within a #a-year period after pregnancy that is caused by pregnancy or childbirth complications4 7#c7 ,postpartum ,the term postpartum means the #a-year period beginning on the last day of a woman's pregnancy4 7#d7 ,severe maternal morbidity ,the term severe maternal morbidity means an unexpected outcome caused by labor and delivery of a woman that results in significant short-term or long-term consequences to the health of the woman4 ,i ,social ,determinants for ,moms #aja4 ,task force to coordinate efforts to address social determinants of health for women in the prenatal and postpartum periods 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall convene a task force 7in this section referred to as the ,task ,force7 to develop strategies to coordinate efforts across the ,federal ,government to address social determinants of health for women in the prenatal and postpartum periods4 7b7 ,members ,the members of the ,task ,force shall consist of the following3 7#a7 ,the ,secretary of ,health and ,human ,services 7or the ,secretary's designee74 7#b7 ,the ,secretary of ,housing and ,urban ,development 7or the ,secretary's designee74 7#c7 ,the ,secretary of ,transportation 7or the ,secretary's designee74 7#d7 ,the ,secretary of ,agriculture 7or the ,secretary's designee74 7#e7 ,the ,administrator of the ,environmental ,protection ,agency 7or the ,administrator's designee74 7#f7 ,the ,assistant ,secretary for the ,administration for ,children and ,families 7or the ,assistant ,secretary's designee74 7#g7 ,the ,administrator of the ,centers for ,medicare ,medicaid ,services 7or the ,administrator's designee74 7#h7 ,the ,director of the ,indian ,health ,service 7or the ,director's designee74 7#i7 ,the ,director of the ,national ,institutes of ,health 7or the ,director's designee74 7#aj7 ,the ,administrator of the ,health ,resources and ,services ,administration 7or the ,administrator's designee74 7#aa7 ,the ,deputy ,assistant ,secretary for ,minority ,health of the ,department of ,health and ,human ,services 7or the ,deputy ,assistant ,secretary's designee74 7#ab7 ,the ,deputy ,assistant ,secretary for ,women's ,health of the ,department of ,health and ,human ,services 7or the ,deputy ,assistant ,secretary's designee74 7#ac7 ,the ,director of the ,centers for ,disease ,control and ,prevention 7or the ,director's designee74 7#ad7 ,a woman who has experienced severe maternal morbidity or a family member of a woman who has suffered a pregnancy-related death4 7#ae7 ,a leader of a community-based organization that addresses maternal mortality and severe maternal morbidity with a specific focus on racial and ethnic disparities4 7#af7 ,a maternal health care provider4 7c7 ,chair ,the ,secretary of ,health and ,human ,services shall select the ,chair of the ,task ,force from among the members of the ,task ,force4 7d7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,task ,force shall-- 7#a7 finalize strategies to coordinate efforts across the ,federal ,government to address social determinants of health for women in the prenatal and postpartum periods2 and 7#b7 submit a report on such strategies to the ,congress1 including-- 7,a7 plans for implementing such strategies2 and 7,b7 recommendations on the funding amounts needed by each ,federal department and agency to implement such strategies4 7e7 ,termination ,the termination provisions under section #ad of the ,federal ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 shall not apply to the ,task ,force4 #ajb4 ,requirements for guidance relating to social determinants of health for pregnant women 7a7 ,in general ,not later than #a year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall issue guidance with respect to how medicaid managed care organizations and ,state ,medicaid programs can use payments made pursuant to section #aijc of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7 to address the following issues related to social determinants of health for high-risk mothers during the presumptive eligibility period for pregnant women3 7#a7 ,housing4 7#b7 ,transportation4 7#c7 ,nutrition4 7#d7 ,lactation and other infant feeding options support4 7#e7 ,lead testing and abatement4 7#f7 ,air and water quality4 7#g7 ,car seat installation4 7#h7 ,child care access4 7#i7 ,wellness and stress management programs4 7#aj7 ,other social determinants of health 7as determined by the ,secretary74 7b7 ,definitions ,in this section3 7#a7 ,medicaid managed care organizations ,the term medicaid managed care organization has the meaning given such term in section #aijc7m77#a77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7m77#a77;,a774 7#b7 ,presumptive eligibility period ,the term presumptive eligibility period has the meaning given such term in section #aibj7;b77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#a7;b77#a774 #ajc4 ,department of ,housing and ,urban ,development 7a7 ,definitions ,in this section-- 7#a7 the term ,department means the ,department of ,housing and ,urban ,development2 7#b7 the term ,secretary means the ,secretary of ,housing and ,urban ,development2 and 7#c7 the term task force means the ,housing for ,moms ,task ,force established under subsection 7b74 7b7 ,task ,force 7#a7 ,establishment ,the ,secretary shall establish within the ,department a ,housing for ,moms ,task ,force that shall be responsible for ensuring that women in the prenatal and postpartum periods have safe1 stable1 affordable1 and adequate housing for themselves and their other children4 7#b7 ,responsibilities ,the task force shall-- 7,a7 study how the ,department can support women in the prenatal and postpartum periods and make recommendations to the ,secretary2 7,b7 provide guidance to regional offices of the ,department on measures to ensure that local housing infrastructure is supportive to women in the prenatal and postpartum periods1 including providing information on-- 7i7 health-promoting housing codes2 7ii7 enforcement of housing codes2 7iii7 proactive rental inspection programs2 7iv7 code enforcement officer training2 and 7v7 partnerships between regional offices of the ,department and community organizations to ensure housing laws are understood and violations are discovered2 and 7,c7 not later than #b years after the date of enactment of this ,act1 and annually thereafter1 submit to ,congress a report summarizing the activities of the task force4 #ajd4 ,department of ,transportation 7a7 ,report ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,transportation shall submit to ,congress a report containing-- 7#a7 an assessment of transportation barriers preventing individuals from attending prenatal and postpartum appointments1 accessing maternal health care services1 or accessing services and resources related to social determinants of health that affect maternal health outcomes1 such as healthy foods2 7#b7 recommendations on how to overcome such barriers2 and 7#c7 an assessment of transportation safety risks for pregnant individuals and recommendations on how to mitigate such risks4 7b7 ,considerations ,in carrying out subsection 7a71 the ,secretary shall give special consideration to solutions for-- 7#a7 women living in a health professional shortage area designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e72 and 7#b7 women living in areas with high maternal mortality or severe maternal morbidity rates and significant racial or ethnic disparities in maternal health outcomes4 #aje4 ,department of ,agriculture 7a7 ,definitions ,in this section3 7#a7 ,eligible entity ,the term eligible entity means-- 7,a7 a public entity2 7,b7 a private community entity2 7,c7 a community-based organization2 7,d7 an ,indian tribe or tribal organization 7as those terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd772 and 7,e7 an urban ,indian organization 7as defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc774 7#b7 ,secretary ,the term ,secretary means the ,secretary of ,agriculture4 7b7 ,special supplemental nutrition program for women1 infants1 and children 7#a7 ,extension of postpartum period ,section #ag7;b77#aj7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;b77#aj77 is amended by striking six months and inserting #bd months4 7#b7 ,extension of breastfeeding period ,section #ag7;d77#c77;,a77ii7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;d77#c77;,a77ii77 is amended by striking #a year and inserting #bd months4 7#c7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall submit to ,congress a report that includes an evaluation of the effect of each of the amendments made by this subsection on-- 7,a7 maternal and infant health outcomes1 including racial and ethnic disparities with respect to those outcomes2 7,b7 qualitative evaluations of family experiences under the special supplemental nutrition program for women1 infants1 and children under section #ag of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf72 and 7,c7 the cost effectiveness of that special supplemental nutrition program4 7c7 ,grant program for healthy food and clean water for pregnant and postpartum women 7#a7 ,in general ,the ,secretary shall carry out a grant program to make grants on a competitive basis to eligible entities to carry out the activities described in paragraph 7#d74 7#b7 ,application ,to be eligible to receive a grant under this subsection1 an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#c7 ,priority ,in awarding grants under this subsection1 the ,secretary shall give priority to an eligible entity that proposes in an application under paragraph 7#b7 to use the grant funds to carry out activities in areas with-- 7,a7 high maternal mortality or severe maternal morbidity rates2 and 7,b7 significant racial or ethnic disparities in maternal health outcomes4 7#d7 ,use of funds ,an eligible entity that receives a grant under this subsection shall use funds under the grant to deliver healthy food1 infant formula1 or clean water to pregnant women and postpartum women 7as those terms are defined in section #ag7;b7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;b77 located in areas that are food deserts1 as determined by the ,secretary using data from the ,food ,access ,research ,atlas of the ,department of ,agriculture4 7#e7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall submit to ,congress a report that includes-- 7,a7 an evaluation of the effect of the grant program under this subsection on maternal and infant health outcomes1 including racial and ethnic disparities with respect to those outcomes2 and 7,b7 recommendations with respect to ensuring the activities described in paragraph 7#d7 continue after the period for grant funding for those activities expires4 7#f7 ,authorization of appropriations ,there are authorized to be appropriated such sums as are necessary to carry out this subsection for each of fiscal years #bjba through #bjbc4 #ajf4 ,environmental study through ,national ,academies 7a7 ,in general ,the ,administrator of the ,environmental ,protection ,agency shall seek to enter an agreement1 not later than #fj 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 agree to conduct a study on the impacts of water and air quality1 exposure to extreme temperatures1 and pollution levels on maternal and infant health outcomes4 7b7 ,study requirements ,the agreement under subsection 7a7 shall direct the ,national ,academies to make recommendations for-- 7#a7 improving environmental conditions to improve maternal and infant health outcomes2 and 7#b7 reducing or eliminating racial and ethnic disparities in those outcomes4 7c7 ,report ,the agreement under subsection 7a7 shall direct the ,national ,academies to complete the study under subsection 7a7 and submit to ,congress a report on the results of the study not later than #b years after the date of enactment of this ,act4 #ajg4 ,child care access 7a7 ,grant program ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall award grants to eligible organizations to provide pregnant and postpartum women with free drop-in child care services during prenatal and postpartum appointments4 7b7 ,eligible organizations ,to be eligible to receive a grant under this section1 an organization shall-- 7#a7 be an organization that carries out programs providing pregnant and postpartum women with free and accessible drop-in child care services during prenatal and postpartum appointments in areas which the ,secretary determines have a high maternal mortality and severe maternal morbidity rate and significant racial and ethnic disparities in maternal health outcomes2 and 7#b7 not have previously received a grant under this section4 7c7 ,duration ,the ,secretary shall commence the grant program under subsection 7a7 not later than #a year after the date of the enactment of this ,act4 7d7 ,evaluation ,the ,secretary shall evaluate each grant awarded under this section to determine the effects of the grant on-- 7#a7 prenatal and postpartum appointment attendance rates2 7#b7 maternal health outcomes with a specific focus on racial and ethnic disparities in such outcomes2 7#c7 pregnant and postpartum women participating in the funded programs1 and the families of such women2 and 7#d7 cost effectiveness4 7e7 ,report ,not later than ,september #cj1 #bjbc1 the ,secretary shall submit to the ,congress a report containing the following3 7#a7 ,a summary of the evaluations under subsection 7d74 7#b7 ,a description of actions the ,secretary can take to ensure that pregnant and postpartum women eligible for medical assistance under a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 have access to free drop-in child care services during prenatal and postpartum appointments1 including identification of the funding necessary to carry out such actions4 7f7 ,drop-,in child care services defined ,in this section1 the term drop-in child care services means child care and early childhood education services that are-- 7#a7 delivered at a facility that meets the requirements of all applicable laws and regulations of the ,state or local government in which it is located1 including the licensing of the facility as a child care facility2 and 7#b7 provided in single encounters without requiring full-time enrollment of a person in a child care program4 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #a1jjj1jjj for each of fiscal years #bjba through #bjbc4 #ajh4 ,grants to ,state1 local1 and ,tribal public health departments addressing social determinants of health for pregnant and postpartum women 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall award grants to ,state1 local1 and ,tribal public health departments to address social determinants of maternal health in order to reduce or eliminate racial and ethnic disparities in maternal health outcomes4 7b7 ,use of funds ,a public health department receiving a grant under this section may use funds received through the grant to-- 7#a7 build capacity and hire staff to coordinate efforts of the public health department to address social determinants of maternal health2 7#b7 develop1 and provide for distribution of1 resource lists of available social services for women in the prenatal and postpartum periods1 which social services may include-- 7,a7 transportation vouchers2 7,b7 housing supports2 7,c7 child care access2 7,d7 healthy food access2 7,e7 nutrition counseling2 7,f7 lactation supports2 7,g7 lead testing and abatement2 7,h7 clean water2 7,i7 infant formula2 7,j7 maternal mental and behavioral health care services2 7,k7 wellness and stress management programs2 and 7,l7 other social services as determined by the public health department2 7#c7 in consultation with local stakeholders1 establish or designate a one-stop resource center that provides coordinated social services in a single location for women in the prenatal or postpartum period2 or 7#d7 directly address specific social determinant needs for the community that are related to maternal health as identified by the public health department1 such as-- 7,a7 transportation2 7,b7 housing2 7,c7 child care2 7,d7 healthy foods2 7,e7 infant formula2 7,f7 nutrition counseling2 7,g7 lactation supports2 7,h7 lead testing and abatement2 7,i7 air and water quality2 7,j7 wellness and stress management programs2 and 7,k7 other social determinants as determined by the public health department4 7c7 ,special consideration ,in awarding grants under subsection 7a71 the ,secretary shall give special consideration to ,state1 local1 and ,tribal public health departments that-- 7#a7 propose to use the grants to reduce or end racial and ethnic disparities in maternal mortality and severe maternal morbidity rates2 and 7#b7 operate in areas with high rates of-- 7,a7 maternal mortality and severe maternal morbidity2 or 7,b7 significant racial and ethnic disparities in maternal mortality and severe maternal morbidity rates4 7d7 ,guidance on strategies ,in carrying out this section1 the ,secretary shall provide guidance to grantees on strategies for long-term viability of programs funded through this section after such funding ends4 7e7 ,reporting 7#a7 ,by grantees ,as a condition on receipt of a grant under this section1 a grantee shall agree to-- 7,a7 evaluate the activities funded through the grant with respect to-- 7i7 maternal health outcomes with a specific focus on racial and ethnic disparities2 7ii7 the subjective assessment of such activities by the beneficiaries of such activities1 including mothers and their families2 and 7iii7 cost effectiveness and return on investment2 and 7,b7 not later than #ahj days after the end of the period of the grant1 submit a report on the results of such evaluation to the ,secretary4 7#b7 ,by ,secretary ,not later than the end of fiscal year #bjbf1 the ,secretary shall submit a report to the ,congress-- 7,a7 summarizing the evaluations submitted under paragraph 7#a72 and 7,b7 making recommendations for improving maternal health and reducing or eliminating racial and ethnic disparities in maternal health outcomes1 based on the results of grants under this section4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ae1jjj1jjj for each of fiscal years #bjba through #bjbe4 ,,ii ,honoring ,kira ,johnson #bja4 ,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 ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for each of fiscal years #bjba through #bjbe4 #bjb4 ,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 at local agencies 7as defined in subsection 7b7 of section #ag of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf77 that provide benefits or services under the special supplemental nutrition program for women1 infants1 and children established by that section2 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 #a-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 ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 #bjc4 ,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 agree 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 #bjd4 ,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 #bje4 ,,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 supported under section #bjd within hospitals1 health systems1 and other maternity care settings4 7b7 ,matters included ,the report under subsection 7a7 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 offices supported under section #bjd1 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 #bjd has been sufficient and1 if applicable1 recommendations for additional appropriations to carry out such section4 7#c7 ,such other information as the ,comptroller ,general determines appropriate4 ,,iii ,protecting ,moms ,who ,served #cja4 ,support for maternity care coordination 7a7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to the ,secretary of ,veterans ,affairs #ae1jjj1jjj for fiscal year #bjbb to improve maternity care coordination for women veterans throughout pregnancy and the #a-year postpartum period beginning on the last day of the pregnancy4 7#b7 ,supplement not supplant ,amounts authorized under paragraph 7#a7 are in addition to any other amounts authorized for the purpose specified in that paragraph4 7b7 ,plan 7#a7 ,in general ,not later than #a year after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan to improve maternity care coordination to fulfill the responsibilities and requirements described in the ,veterans ,health ,administration ,handbook #accj4jc dated ,october #e1 #bjab1 and entitled ,maternity ,health ,care and ,coordination1 or any successor handbook4 7#b7 ,elements ,the plan under paragraph 7#a7 shall include the following3 7,a7 ,with respect to the amounts authorized to be appropriated under subsection 7a71 a description of how the ,secretary will ensure such amounts are used to-- 7i7 hire full-time maternity care coordinators2 7ii7 train maternity care coordinators2 and 7iii7 improve support programs led by maternity care coordinators4 7,b7 ,recommendations for the amount of funding the ,secretary determines appropriate to improve maternity care coordination as described in paragraph 7#a7 for each of the #e fiscal years following the date of the plan4 7#c7 ,consultation ,the ,secretary shall develop the plan under paragraph 7#a7 in consultation with veterans service organizations1 military service organizations1 women's health care providers1 and community-based organizations representing women from demographic groups disproportionately impacted by poor maternal health outcomes1 that the ,secretary determines appropriate4 #cjb4 ,sense of ,congress on veteran status requirements ,it is the sense of ,congress that each ,state should list the veteran status of a mother-- 7#a7 in fetal death records2 and 7#b7 in maternal mortality review committee reviews of pregnancy-related deaths and pregnancy-associated deaths4 #cjc4 ,report on maternal mortality and severe maternal morbidity among women veterans 7a7 ,,gao report ,not later than #b years after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 and make publicly available1 a report on maternal mortality and severe maternal morbidity among women veterans1 with a particular focus on racial and ethnic disparities in maternal health outcomes for women veterans4 7b7 ,matters included ,the report under subsection 7a7 shall include the following3 7#a7 ,to the extent practicable-- 7,a7 the number of women veterans who have experienced a pregnancy-related death or pregnancy-associated death in the most recent #aj years of available data2 7,b7 the rate of pregnancy-related deaths per #ajj1jjj live births for women veterans2 7,c7 the number of cases of severe maternal morbidity among women veterans in the most recent year of available data2 7,d7 the racial and ethnic disparities in maternal mortality and severe maternal morbidity rates among women veterans2 7,e7 identification of the causes of maternal mortality and severe maternal morbidity that are unique to women who have served in the military1 including post-traumatic stress disorder1 military sexual trauma1 and infertility or miscarriages that may be caused by such service2 7,f7 identification of the causes of maternal mortality and severe maternal morbidity that are unique to women veterans of color2 and 7,g7 identification of any correlations between the former rank of women veterans and their maternal health outcomes4 7#b7 ,an assessment of the barriers to determining the information required under paragraph 7#a7 and recommendations for improvements in tracking maternal health outcomes among-- 7,a7 women veterans who have health care coverage through the ,department2 7,b7 women veterans enrolled in the ,,tricare program 7as defined in section #ajgb of title #aj1 ,united ,states ,code72 7,c7 women veterans with employer-based or private insurance2 and 7,d7 women veterans enrolled in the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#c7 ,recommendations for legislative and administrative actions to increase access to mental and behavioral health care for women veterans who screen positively for postpartum mental or behavioral health conditions4 7#d7 ,recommendations to address homelessness among pregnant and postpartum women veterans4 7#e7 ,recommendations on how to effectively educate maternity care providers on best practices for providing maternity care services to women veterans that addresses the unique maternal health care needs of veteran populations4 7#f7 ,recommendations to reduce maternal mortality and severe maternal morbidity among women veterans and to address racial and ethnic disparities in maternal health outcomes for each of the groups described in subparagraphs 7,a7 through 7,d7 of paragraph 7#b74 7#g7 ,recommendations to improve coordination of care between the ,department and non-,department facilities for pregnant and postpartum women veterans1 including recommendations to improve training for the directors of the ,veterans ,integrated ,service ,networks1 directors of medical facilities of the ,department1 chiefs of staff of such facilities1 maternity care coordinators1 and relevant non-,department facilities4 7#h7 ,an assessment of the authority of the ,secretary of ,veterans ,affairs to access maternal health data collected by the ,department of ,health and ,human ,services and1 if applicable1 recommendations to increase such authority4 7#i7 ,any other information the ,comptroller ,general determines appropriate with respect to the reduction of maternal mortality and severe maternal morbidity among women veterans and to address racial and ethnic disparities in maternal health outcomes for women veterans4 ,,iv ,perinatal ,workforce #dja4 ,,hhs agency directives 7a7 ,guidance to ,states 7#a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall issue and disseminate guidance to ,states to educate providers and managed care entities about the value and process of delivering respectful maternal health care through diverse care provider models4 7#b7 ,contents ,the guidance required by paragraph 7#a7 shall address how ,states can encourage and incentivize hospitals1 health systems1 freestanding birth centers1 other maternity care provider groups1 and managed care entities-- 7,a7 to recruit and retain maternity care providers1 such as obstetrician-gynecologists1 family physicians1 physician assistants1 midwives who meet at a minimum the international definition of the midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives1 nurse practitioners1 and clinical nurse specialists-- 7i7 from racially and ethnically diverse backgrounds2 7ii7 with experience practicing in racially and ethnically diverse communities2 and 7iii7 who have undergone trainings on implicit and explicit bias and racism2 7,b7 to incorporate into maternity care teams midwives who meet 7at a minimum7 the international definition of the midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives1 doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dietitians1 social workers1 home visitors1 and navigators2 7,c7 to provide collaborative1 culturally congruent care2 and 7,d7 to provide opportunities for individuals enrolled in accredited midwifery education programs to participate in job shadowing with maternity care teams in hospitals1 health systems1 and freestanding birth centers4 7b7 ,study on culturally congruent maternity care 7#a7 ,study ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,national ,institutes of ,health 7in this subsection referred to as the ,secretary71 shall conduct a study on best practices in culturally congruent maternity care4 7#b7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall-- 7,a7 complete the study required by paragraph 7#a72 7,b7 submit to the ,congress and make publicly available a report on the results of such study2 and 7,c7 include in such report-- 7i7 a compendium of examples of hospitals1 health systems1 freestanding birth centers1 other maternity care provider groups1 and managed care entities that are delivering culturally congruent maternal health care2 7ii7 a compendium of examples of hospitals1 health systems1 freestanding birth centers1 other maternity care provider groups1 and managed care entities that have low levels of racial and ethnic disparities in maternal health outcomes2 and 7iii7 recommendations to hospitals1 health systems1 freestanding birth centers1 other maternity care provider groups1 and managed care entities for best practices in culturally congruent maternity care4 #djb4 ,grants to grow and diversify the perinatal workforce ,title ,,vii of the ,public ,health ,service ,act is amended by inserting after section #geg 7#db ,u4,s4,c4 #bid;f7 the following3 #geh4 ,perinatal workforce grants 7a7 ,in general ,the ,secretary may award grants to entities to establish or expand schools or programs described in subsection 7b7 to grow and diversify the perinatal workforce4 7b7 ,use of funds ,recipients of grants under this section shall use the grants to grow and diversify the perinatal workforce by-- 7#a7 establishing schools or programs that provide education and training to individuals seeking appropriate licensing or certification as-- 7,a7 physician assistants who will complete clinical training in the field of maternal and perinatal health2 and 7,b7 other perinatal health workers such as doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dietitians1 social workers1 home visitors1 and navigators2 and 7#b7 expanding the capacity of existing schools or programs described in paragraph 7#a71 for the purposes of increasing the number of students enrolled in such schools or programs1 including by awarding scholarships for students4 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to any entity that-- 7#a7 has demonstrated a commitment to recruiting and retaining minority students1 particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity2 7#b7 has developed a strategy to recruit into1 and retain1 a diverse pool of students the perinatal workforce program or school supported by funds received through the grant1 particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity2 7#c7 has developed a strategy to recruit and retain students who plan to practice in a health professional shortage area designated under section #ccb2 7#d7 has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes2 and 7#e7 includes in the standard curriculum for all students within the perinatal workforce program or school a bias1 racism1 or discrimination training program that includes training on explicit and implicit bias4 7d7 ,reporting ,as a condition on receipt of a grant under this section for a perinatal workforce program or school1 an entity shall agree to submit to the ,secretary an annual report on the activities conducted through the grant1 including-- 7#a7 the number and demographics of students participating in the program or school2 7#b7 the extent to which students in the program or school are entering careers in-- 7,a7 health professional shortage areas designated under section #ccb2 and 7,b7 areas with significant racial and ethnic disparities in maternal health outcomes2 and 7#c7 whether the program or school has included in the standard curriculum for all students a bias1 racism1 or discrimination training program that includes explicit and implicit bias1 and if so1 the effectiveness of such training program4 7e7 ,period of grants ,the period of a grant under this section shall be up to #e years4 7f7 ,application ,to seek a grant under this section1 an entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including any information necessary for prioritization under subsection 7c74 7g7 ,technical assistance ,the ,secretary shall provide1 directly or by contract1 technical assistance to institutions of higher education seeking or receiving a grant under this section on the development1 use1 evaluation1 and post-grant period sustainability of the perinatal workforce programs or schools proposed to be1 or being1 established or expanded through the grant4 7h7 ,report by ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall prepare and submit to the ,congress1 and post on the internet website of the ,department of ,health and ,human ,services1 a report on the effectiveness of the grant program under this section at-- 7#a7 recruiting minority students1 particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity2 7#b7 increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health1 and other perinatal health workers1 from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity2 7#c7 increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health1 and other perinatal health workers1 working in health professional shortage areas designated under section #ccb2 and 7#d7 increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health1 and other perinatal health workers1 working in areas with significant racial and ethnic disparities in maternal health outcomes4 7i7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ae1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 #djc4 ,grants to grow and diversify the nursing workforce in maternal and perinatal health ,title ,,viii of the ,public ,health ,service ,act is amended by inserting after section #haa of that ,act 7#db ,u4,s4,c4 #bif;j7 the following3 #hab4 ,perinatal nursing workforce grants 7a7 ,in general ,the ,secretary may award grants to schools of nursing to grow and diversify the perinatal nursing workforce4 7b7 ,use of funds ,recipients of grants under this section shall use the grants to grow and diversify the perinatal nursing workforce by providing scholarships to students seeking to become-- 7#a7 nurse practitioners whose education includes a focus on maternal and perinatal health2 or 7#b7 clinical nurse specialists whose education includes a focus on maternal and perinatal health4 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to any school of nursing that-- 7#a7 has developed a strategy to recruit and retain a diverse pool of students seeking to enter careers focused on maternal and perinatal health2 7#b7 has developed a partnership with a practice setting in a health professional shortage area designated under section #ccb for the clinical placements of the school's students2 7#c7 has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes2 and 7#d7 includes in the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health a bias1 racism1 or discrimination training program that includes education on explicit and implicit bias4 7d7 ,reporting ,as a condition on receipt of a grant under this section1 a school of nursing shall agree to submit to the ,secretary an annual report on the activities conducted through the grant1 including1 to the extent practicable-- 7#a7 the number and demographics of students in the school of nursing seeking to enter careers focused on maternal and perinatal health2 7#b7 the extent to which such students are preparing to enter careers in-- 7,a7 health professional shortage areas designated under section #ccb2 and 7,b7 areas with significant racial and ethnic disparities in maternal health outcomes2 and 7#c7 whether the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health includes a bias1 racism1 or discrimination training program that includes education on explicit and implicit bias4 7e7 ,period of grants ,the period of a grant under this section shall be up to #e years4 7f7 ,application ,to seek a grant under this section1 an entity shall submit to the ,secretary an application1 at such time1 in such manner1 and containing such information as the ,secretary may require1 including any information necessary for prioritization under subsection 7c74 7g7 ,technical assistance ,the ,secretary shall provide1 directly or by contract1 technical assistance to schools of nursing seeking or receiving a grant under this section on the processes of awarding and evaluating scholarships through the grant4 7h7 ,report by ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall prepare and submit to the ,congress1 and post on the internet website of the ,department of ,health and ,human ,services1 a report on the effectiveness of the grant program under this section at-- 7#a7 recruiting minority students1 particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity2 7#b7 increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity2 7#c7 increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health working in health professional shortage areas designated under section #ccb2 and 7#d7 increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health working in areas with significant racial and ethnic disparities in maternal health outcomes4 7i7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ae1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 #djd4 ,,gao report on barriers to maternity care 7a7 ,in general ,not later than #b years after the date of the enactment of this ,act and every #e years thereafter1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on barriers to maternity care in the ,united ,states4 ,such report shall include the information and recommendations described in subsection 7b74 7b7 ,content of report ,the report under subsection 7a7 shall include-- 7#a7 an assessment of current barriers to entering accredited midwifery education programs1 and recommendations for addressing such barriers1 particularly for low-income and minority women2 7#b7 an assessment of current barriers to entering accredited education programs for other maternity care professional careers1 including obstetrician-gynecologists1 family physicians1 physician assistants1 nurse practitioners1 and clinical nurse specialists1 particularly for low-income and minority women2 7#c7 an assessment of current barriers that prevent midwives from meeting the international definition of the midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives1 and recommendations for addressing such barriers1 particularly for low-income and minority women2 and 7#d7 recommendations to promote greater equity in compensation for perinatal health workers1 particularly for such individuals from racially and ethnically diverse backgrounds4 ,v ,data ,to ,save ,moms #eja4 ,funding for maternal mortality review committees to promote representative community engagement 7a7 ,in general ,section #cag,k7d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77 is amended by adding at the end the following3 7#i7 ,grants to promote representative community engagement in maternal mortality review committees 7,a7 ,in general ,the ,secretary may1 using funds made available pursuant to subparagraph 7,c71 provide assistance to an applicable maternal mortality review committee of a ,state1 ,indian tribe1 tribal organization1 or urban ,indian organization 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77-- 7i7 to select for inclusion in the membership of such a committee community members from the ,state1 ,indian tribe1 tribal organization1 or urban ,indian organization by-- 7,i7 prioritizing community members who can increase the diversity of the committee's membership with respect to race and ethnicity1 location1 and professional background1 including members with non-clinical experiences2 and 7,,ii7 to the extent applicable1 to address barriers to maternal mortality review committee participation for community members1 including required training1 transportation barriers1 compensation1 and other supports as may be necessary2 7ii7 to establish initiatives to conduct outreach and community engagement efforts within communities throughout the ,state or ,indian tribe to seek input from community members on the work of such maternal mortality review committee1 with a particular focus on outreach to minority women2 and 7iii7 to release public reports assessing-- 7,i7 the pregnancy-related death and pregnancy-associated death review processes of the maternal mortality review committee1 with a particular focus on the maternal mortality review committee's sensitivity to the unique circumstances of minority women who have suffered pregnancy-related deaths2 and 7,,ii7 the impact of the use of funds made available under subparagraph 7,c7 on increasing the diversity of the maternal mortality review committee membership and promoting community engagement efforts throughout the ,state or ,indian tribe4 7,b7 ,technical assistance ,the ,secretary shall provide 7either directly through the ,department of ,health and ,human ,services or by contract7 technical assistance to any maternal mortality review committee receiving a grant under this paragraph on best practices for increasing the diversity of the maternal mortality review committee's membership and for conducting effective community engagement throughout the ,state or ,indian tribe4 7,c7 ,authorization of appropriations ,in addition to any funds made available under subsection 7f71 there are authorized to be appropriated to carry out this paragraph #aj1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 7b7 ,reservation of funds ,section #cag,k7f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;f77 is amended by adding at the end the following3 ,of the amount made available under the preceding sentence for a fiscal year1 not less than #a1ejj1jjj shall be reserved for grants to ,indian tribes1 tribal organizations1 or urban ,indian organizations 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc774 #ejb4 ,data collection and review 7a7 ,in general ,section #cag,k7d77#c77;,a77i7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77#c77;,a77i77 is amended-- 7#a7 by redesignating subclauses 7,,ii7 and 7,,iii7 as subclauses 7,,iv7 and 7,v71 respectively2 and 7#b7 by inserting after subclause 7,i7 the following3 7,,ii7 to the extent practicable1 reviewing cases of severe maternal morbidity in which the patient received a transfusion of four or more units of blood and was admitted to an intensive care unit2 7,,iii7 to the extent practicable1 consulting with local community-based organizations representing women from demographic groups disproportionately impacted by poor maternal health outcomes to ensure that1 in addition to clinical factors1 non-clinical factors that might have contributed to a pregnancy-related death are appropriately considered2 4 7b7 ,severe maternal morbidity defined ,section #cag,k7e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;e77 is amended-- 7#a7 in paragraph 7#b71 by striking and at the end2 7#b7 in paragraph 7#c71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7#d7 the term severe maternal morbidity means one or more unexpected outcomes of labor and delivery that result in significant short-term or long-term consequences to a woman's health4 4 #ejc4 ,task force on maternal health data and quality measures 7a7 ,establishment ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall establish a task force1 to be known as the ,task ,force on ,maternal ,health ,data and ,quality ,measures 7in this section referred to as the ,task ,force74 7b7 ,duties of task force 7#a7 ,in general ,the ,task ,force shall use all available relevant information1 including information from ,state-level sources1 to prepare and submit a report containing the following3 7,a7 ,an evaluation of current ,state and ,tribal practices for maternal health1 maternal mortality1 and severe maternal morbidity data collection and dissemination1 including consideration of-- 7i7 the timeliness of processes for amending a death certificate when new information pertaining to the death becomes available to reflect whether the death was a pregnancy-related death2 7ii7 maternal health data collected with electronic health records1 including data on race and ethnicity2 7iii7 the barriers preventing ,states from correlating maternal outcome data with race and ethnicity data2 7iv7 processes for determining the cause of a pregnancy-associated death in ,states that do not have a maternal mortality review committee2 7v7 whether maternal mortality review committees include multidisciplinary and diverse membership 7as described in section #cag,k7d77#a77;,a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77#a77;,a772 7vi7 whether members of maternal mortality review committees participate in trainings on bias1 racism1 or discrimination1 and the quality of such trainings2 7vii7 the extent to which ,states have implemented systematic processes of listening to the stories of pregnant and postpartum women and their family members1 with a particular focus on minority women and their family members1 to fully understand the causes of1 and inform potential solutions to1 the maternal mortality and severe maternal morbidity crisis within their respective ,states2 7viii7 the consideration of social determinants of health by maternal mortality review committees when examining the causes of pregnancy-associated and pregnancy-related deaths2 7ix7 the legal barriers preventing the collation of ,state maternity care data2 7x7 the effectiveness of data collection and reporting processes in separating pregnancy-associated deaths from pregnancy-related deaths2 and 7xi7 the current ,federal1 ,state1 local1 and ,tribal funding support for the activities referred to in clauses 7i7 through 7x74 7,b7 ,an assessment of whether the funding referred to in subparagraph 7,a77xi7 is adequate for ,states to carry out optimal data collection and dissemination processes with respect to maternal health1 maternal mortality1 and severe maternal morbidity4 7,c7 ,an evaluation of current quality measures for maternity care1 including prenatal measures1 labor and delivery measures1 and postpartum measures up to one year postpartum4 ,such evaluation shall be conducted in consultation with the ,national ,quality ,forum and shall include consideration of-- 7i7 effective quality measures for maternity care used by hospitals1 health systems1 birth centers1 health plans1 and other relevant entities2 7ii7 the sufficiency of current outcome measures used to evaluate maternity care for testing and validating new maternal health care payment and service delivery models2 7iii7 quality measures for the childbirth experiences of women that other countries effectively use2 7iv7 current maternity care quality measures that may be eliminated because they are not achieving their intended effect2 7v7 barriers preventing maternity care providers from implementing quality measures that are aligned from best practices2 7vi7 the frequency with which maternity care quality measures are reviewed and revised2 7vii7 the strengths and weaknesses of the ,prenatal and ,postpartum ,care measures of the ,health ,plan ,employer ,data and ,information ,set measures established by the ,national ,committee for ,quality ,assurance2 7viii7 the strengths and weaknesses of maternity care quality measures under the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and the ,children's ,health ,insurance ,program under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig;aa et seq471 including the extent to which ,states voluntarily report relevant measures2 7ix7 the extent to which maternity care quality measures are informed by patient experiences that include subjective measures of patient-reported experience of care2 7x7 the current processes for collecting stratified data on the race and ethnicity of pregnant and postpartum women in hospitals1 health systems1 and birth centers1 and for incorporating such racially and ethnically stratified data in maternity care quality measures2 7xi7 the extent to which maternity care quality measures account for the unique experiences of minority women and their families2 and 7xii7 the extent to which hospitals1 health systems1 and birth centers are implementing existing maternity care quality measures4 7,d7 ,recommendations on authorizing additional funds to improve maternal mortality review committees and relevant maternal health initiatives by the agencies and organizations within the ,department of ,health and ,human ,services4 7,e7 ,recommendations for new authorities that may be granted to maternal mortality review committees to be able to-- 7i7 access records from other ,federal and ,state agencies and departments that may be necessary to identify causes of pregnancy-associated deaths that are unique to women from specific populations1 such as women veterans and women who are incarcerated2 and 7ii7 work with relevant experts who are not members of the maternal mortality review committee to assist in the review of pregnancy-associated deaths of women from specific populations1 such as women veterans and women who are incarcerated4 7,f7 ,recommendations to improve current quality measures for maternity care1 including recommendations on updating the ,pregnancy ,delivery ,care measures on the ,hospital ,compare website of the ,centers for ,medicare ,medicaid ,services or any successor website1 with a particular focus on racial and ethnic disparities in maternal health outcomes4 7,g7 ,recommendations to improve the coordination by the ,department of ,health and ,human ,services of the efforts undertaken by the agencies and organizations within the ,department related to maternal health data and quality measures4 7#b7 ,public comment ,not later than #fj days after the date on which a majority of the members of the ,task ,force have been appointed1 the ,task ,force shall publish in the ,federal ,register a notice for a #ij-;day public comment period1 beginning on the date of publication1 on the issues described in paragraph 7#a74 7c7 ,membership 7#a7 ,in general ,the ,task ,force shall be composed of #ah members appointed by the ,secretary of ,health and ,human ,services4 ,the ,secretary shall give special consideration to individuals who are representative of populations most affected by maternal mortality and severe maternal morbidity4 7#b7 ,member criteria ,to be eligible to be appointed as a member of the ,task ,force1 an individual shall be-- 7,a7 a woman who has experienced severe maternal morbidity2 7,b7 a family member of a woman who had a pregnancy-related death2 7,c7 an individual who provides non-clinical support to women from pregnancy through the postpartum period1 such as a doula1 community health worker1 peer supporter1 certified lactation consultant1 nutritionist or dietitian1 social worker1 home visitor1 or a patient navigator2 7,d7 a leader of a community-based organization that addresses adverse maternal health outcomes with a specific focus on racial and ethnic disparities2 7,e7 an academic researcher in a field or policy area related to the duties of the ,task ,force2 7,f7 a maternal health care provider2 7,g7 an elected or duly appointed leader from an ,indian ,tribe2 7,h7 an expert in a field or policy area related to the duties of the ,task ,force2 or 7,i7 an individual who has experience with ,federal or ,state government programs related to the duties of the ,task ,force4 7#c7 ,appointment timing ,appointments to the ,task ,force shall be made not later than #ahj days after the date of enactment of this ,act4 7#d7 ,duration ,each member shall be appointed for the life of the ,task ,force4 7#e7 ,co-,chair selection ,not later than #cj days after the date on which a majority of the members of the ,task ,force have been appointed1 the ,secretary shall select two of the members of the ,task ,force to serve as ,co-,chairs of the ,task ,force4 7#f7 ,vacancies 7,a7 ,in general ,a vacancy in the ,task ,force-- 7i7 shall not affect the powers of the ,task ,force2 and 7ii7 shall be filled in the same manner as the original appointment4 7,b7 ,co-,chair vacancy ,in the event of a vacancy of a ,co-,chair of the ,task ,force1 a replacement ,co-,chair shall be selected in the same manner as the original selection4 7#g7 ,compensation ,except as provided in paragraph 7#h71 members of the ,task ,force shall serve without pay4 7#h7 ,travel expenses ,members of the ,task ,force shall be allowed travel expenses1 including per diem in lieu of subsistence1 at rates authorized for employees of agencies under subchapter ,i of chapter #eg of title #e1 ,united ,states ,code1 while away from their homes or regular places of business in the performance of service for the ,task ,force4 7d7 ,meetings 7#a7 ,in general ,the ,task ,force shall meet at the call of the ,co-,chairs of the ,task ,force4 7#b7 ,quorum ,a majority of the members of the ,task ,force shall constitute a quorum4 7#c7 ,initial meeting ,the ,task ,force shall meet not later than #fj days after the date on which a majority of the members of the ,task ,force have been appointed4 7e7 ,staff of task force 7#a7 ,additional staff ,the ,co-,chairs of the ,task ,force may appoint and fix the pay of additional staff to the ,task ,force as the ,co-,chairs consider appropriate4 7#b7 ,applicability of certain civil service laws ,the staff of the ,task ,force may be appointed without regard to the provisions of title #e1 ,united ,states ,code1 governing appointments in the competitive service1 and may be paid without regard to the provisions of chapter #ea and subchapter ,,iii of chapter #ec of that title relating to classification and ,general ,schedule pay rates4 7#c7 ,detailees ,any ,federal ,government employee may be detailed to the ,task ,force without reimbursement from the ,task ,force1 and the detailee shall retain the rights1 status1 and privileges of his or her regular employment without interruption4 7f7 ,powers of task force 7#a7 ,testimony and evidence ,the ,task ,force may take such testimony and receive such evidence as the ,task ,force considers advisable to carry out this section4 7#b7 ,obtaining official data ,the ,task ,force may secure directly from any ,federal department or agency information necessary to carry out its duties under this section4 ,on request of the ,co-,chairs of the ,task ,force1 the head of that department or agency shall furnish such information to the ,task ,force4 7#c7 ,postal services ,the ,task ,force may use the ,united ,states mails in the same manner and under the same conditions as other ,federal departments and agencies4 7g7 ,report ,not later than #b years after the date on which the initial #ah members of the ,task ,force are appointed under subsection 7c77#a71 the ,task ,force shall submit to the ,committee on ,energy and ,commerce1 the ,committee on ,education and ,labor1 and the ,committee on ,ways and ,means of the ,house of ,representatives and the ,committee on ,finance and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and make publicly available1 a report that-- 7#a7 contains the information1 evaluations1 and recommendations described in subsection 7b72 and 7#b7 is signed by more than half of the members of the ,task ,force4 7h7 ,termination ,section #ad of the ,federal ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 shall not apply to the ,task ,force4 7i7 ,definitions ,in this section3 7#a7 ,maternal health care provider ,the term maternal health care provider means an individual who is an obstetrician-gynecologist1 family physician1 midwife who meets at a minimum the international definition of the midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives1 nurse practitioner1 or clinical nurse specialist4 7#b7 ,maternal mortality review committee ,the term maternal mortality review committee means a maternal mortality review committee duly authorized by a ,state and receiving funding under section #cag,k7a77#b77;,d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;a77#b77;,d774 7#c7 ,pregnancy-associated death ,the term pregnancy-associated death means a death of a woman1 by any cause1 that occurs during1 or within #a year following1 her pregnancy1 regardless of the outcome1 duration1 or site of the pregnancy4 7#d7 ,pregnancy-related death ,the term pregnancy-related death means a death of a woman that occurs during1 or within #a year following1 her pregnancy1 regardless of the outcome1 duration1 or site of the pregnancy-- 7,a7 from any cause related to1 or aggravated by1 the pregnancy or its management2 and 7,b7 not from accidental or incidental causes4 7j7 ,authorization of appropriations ,there are authorized to be appropriated such sums as may be necessary to carry out this section for fiscal years #bjba through #bjbd4 #ejd4 ,indian ,health ,service study on maternal mortality 7a7 ,in general ,the ,director of the ,indian ,health ,service 7referred to in this section as the ,director7 shall1 in coordination with the individuals described in subsection 7b77#a7-- 7#a7 not later than #ij days after the date of enactment of this ,act1 offer to enter into a contract with an independent research organization or ,tribal epidemiology center established under section #bad of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afbam7 to conduct a comprehensive study on maternal mortality and severe maternal morbidity in the populations of ,american ,indian and ,alaska ,native women2 and 7#b7 not later than #c years after the date of enactment of this ,act1 submit to ,congress a report describing the results of that study that contains recommendations for policies and practices that can be adopted to improve maternal health outcomes for those women4 7b7 ,participating entities 7#a7 ,in general ,the individuals referred to in subsection 7a7 are #ab individuals1 selected by the ,director from among individuals nominated by ,indian tribes1 tribal organizations1 and urban ,indian organizations 7as those terms are defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc774 7#b7 ,requirement ,in selecting individuals under paragraph 7#a71 the ,director shall ensure that each of the #ab service areas of the ,indian ,health ,service is represented4 7c7 ,contents of study ,the study conducted pursuant to subsection 7a7 shall-- 7#a7 examine the causes of maternal mortality and severe maternal morbidity that are unique to ,american ,indian and ,alaska ,native women2 7#b7 include a systematic process of listening to the stories of ,american ,indian and ,alaska ,native women to fully understand the causes of1 and inform potential solutions to1 the maternal mortality and severe maternal morbidity crisis within their respective communities2 7#c7 distinguish between the causes of1 landscape of maternity care at1 and recommendations to improve maternal health outcomes within1 the different settings in which ,american ,indian and ,alaska ,native women receive maternity care1 such as-- 7,a7 facilities operated by the ,indian ,health ,service2 7,b7 an ,indian health program operated by an ,indian tribe or tribal organization pursuant to a contract1 grant1 cooperative agreement1 or compact with the ,indian ,health ,service pursuant to the ,indian ,self-,determination ,act 7#be ,u4,s4,c4 #ecba et seq472 and 7,c7 an urban ,indian health program operated by an urban ,indian organization pursuant to a grant or contract with the ,indian ,health ,service pursuant to title ,v of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afea et seq472 7#d7 review processes for coordinating programs of the ,indian ,health ,service with social services provided through other programs administered by the ,secretary of ,health and ,human ,services 7other than the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 the ,medicaid program under title ,,xix of that ,act 7#db ,u4,s4,c4 #acif et seq471 and the ,children's ,health ,insurance ,program under title ,,xxi of that ,act 7#db ,u4,s4,c4 #acig;aa et seq4771 including coordination with the efforts of the ,task ,force established under section #ejc2 7#e7 review current data collection and quality measurement processes and practices2 7#f7 consider social determinants of health1 including poverty1 lack of health insurance1 unemployment1 sexual violence1 and environmental conditions in ,tribal areas2 7#g7 consider the role that historical mistreatment of ,american ,indian and ,alaska ,native women has played in causing currently high rates of maternal mortality and severe maternal morbidity2 7#h7 consider how current funding of the ,indian ,health ,service affects the ability of the ,indian ,health ,service to deliver quality maternity care2 7#i7 consider the extent to which the delivery of maternity care services is culturally appropriate for ,american ,indian and ,alaska ,native women2 7#aj7 make recommendations to reduce misclassification of ,american ,indian and ,alaska ,native women1 including consideration of best practices in training for maternal mortality review committee members to be able to correctly classify ,american ,indian and ,alaska ,native women2 and 7#aa7 make recommendations informed by the stories shared by ,american ,indian and ,alaska ,native women under paragraph 7#b7 to improve maternal health outcomes for such women4 7d7 ,report ,the contract entered into under subsection 7a77#a7 with an independent research organization or ,tribal epidemiology center established under section #bad of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afbam7 shall require that the organization or center submit to ,congress a report on the results of the study conducted pursuant to that contract not later than #c years after the date of enactment of this ,act4 7e7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #b1jjj1jjj for each of fiscal years #bjba through #bjbc4 #eje4 ,grants to minority-serving institutions to study maternal mortality1 severe maternal morbidity1 and other adverse maternal health outcomes 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall establish a program under which the ,secretary shall award grants to minority-serving institutions to study specific aspects of the maternal health crisis among minority women4 ,such research may-- 7#a7 include the development and implementation of systematic processes of listening to the stories of minority women to fully understand the causes of1 and inform potential solutions to1 the maternal mortality and severe maternal morbidity crisis within their respective communities2 and 7#b7 assess the potential causes of low rates of maternal mortality among ,hispanic women1 including potential racial misclassification and other data collection and reporting issues that might be misrepresenting maternal mortality rates among ,hispanic women in the ,united ,states4 7b7 ,application ,to be eligible to receive a grant under subsection 7a71 an entity described in such subsection shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,technical assistance ,the ,secretary may use not more than #aj percent of the funds made available under subsection 7f7-- 7#a7 to conduct outreach to minority-serving institutions to raise awareness of the availability of grants under this subsection 7a72 7#b7 to provide technical assistance in the application process for such a grant2 and 7#c7 to promote capacity building as needed to enable entities described in such subsection to submit such an application4 7d7 ,reporting requirement ,each entity awarded a grant under this section shall periodically submit to the ,secretary a report on the status of activities conducted using the grant4 7e7 ,evaluation ,beginning one year after the date on which the first grant is awarded under this section1 the ,secretary shall submit to ,congress an annual report summarizing the findings of research conducted using funds made available under this section4 7f7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjba through #bjbe4 7g7 ,minority-,serving institutions defined ,in this section1 the term minority-serving institution means an eligible institution described in section #cga7;a7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajfgq7a774 ,,vi ,moms ,,matter #fja4 ,innovative models to reduce maternal mortality ,title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq47 is amended by adding at the end the following new part3 ,w ,innovative ,models ,to ,reduce ,maternal ,mortality and ,severe ,maternal ,morbidity #cii,,oo4 ,definitions ,in this part3 7#a7 ,the terms postpartum and postpartum period refer to the #a-year period beginning on the last day of the pregnancy4 7#b7 ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#c7 ,the term ,task ,force means the ,maternal ,mental and ,behavioral ,health ,task ,force established pursuant to section #cii,,oo-#a4 7#d7 ,the term behavioral health includes substance use disorder and other behavioral health conditions4 #cii,,oo-#a4 ,maternal ,mental and ,behavioral ,health ,task ,force 7a7 ,establishment ,the ,secretary shall establish a task force1 to be known as the ,maternal ,mental and ,behavioral ,health ,task ,force1 to improve maternal mental and behavioral health outcomes with a particular focus on outcomes for minority women4 7b7 ,membership 7#a7 ,composition ,the ,task ,force shall be composed of no fewer than #bj members1 to be appointed by the ,secretary4 7#b7 ,co-,chairs ,the ,secretary shall designate #b members of the ,task ,force to serve as the ,co-,chairs of the ,task ,force4 7#c7 ,members ,the ,task ,force shall include the following3 7,a7 ,maternal mental and behavioral health care specialists1 maternity care providers1 and researchers1 government officials1 and policy experts who specialize in women's health1 maternal mental and behavioral health1 maternal substance use disorder1 or maternal mortality and severe maternal morbidity4 ,in selecting such members of the ,task ,force1 the ,secretary shall give special consideration to individuals from diverse racial and ethnic backgrounds or individuals with experience providing culturally congruent maternity care in diverse communities4 7,b7 ,one or more individuals who have suffered from a diagnosed mental or behavioral health condition during the prenatal or postpartum period1 or a spouse or family member of such individual4 7,c7 ,one or more representatives of a community-based organization that addresses adverse maternal health outcomes with a specific focus on racial and ethnic disparities in maternal health outcomes4 ,in selecting such representatives1 the ,secretary shall give special consideration to organizations from communities with significant minority populations4 7,d7 ,one or more perinatal health workers who provide non-clinical support to pregnant and postpartum women1 such as a doula1 community health worker1 peer supporter1 certified lactation consultant1 nutritionist or dietitian1 social worker1 home visitor1 or navigator4 ,in selecting such perinatal health workers1 the ,secretary shall give special consideration to individuals with experience working in communities with significant minority populations4 7,e7 ,one or more representatives of relevant patient advocacy organizations1 with a particular focus on organizations that address racial and ethnic disparities in maternal health outcomes4 7,f7 ,one or more representatives of relevant health care provider organizations1 with a particular focus on organizations that address racial and ethnic disparities in maternal health outcomes4 7,g7 ,one or more leaders of a ,federally-qualified health center or rural health clinic 7as such terms are defined in section #ahfa of the ,social ,security ,act74 7,h7 ,one or more representatives of health insurers4 7#d7 ,timing of appointments ,not later than #ahj days after the date of enactment of this part1 the ,secretary shall appoint all members of the ,task ,force4 7#e7 ,period of appointment2 vacancies 7,a7 ,in general ,each member of the ,task ,force shall be appointed for the life of the ,task ,force4 7,b7 ,vacancies ,any vacancy in the ,task ,force-- 7i7 shall not affect the powers of the ,task ,force2 and 7ii7 shall be filled in the same manner as the original appointment4 7#f7 ,no pay ,members of the ,task ,force 7other than officers or employees of the ,united ,states7 shall serve without pay4 ,members of the ,task ,force who are full-time officers or employees of the ,united ,states may not receive additional pay1 allowances1 or benefits by reason of their service on the ,task ,force4 7#g7 ,travel expenses ,members of the ,task ,force may be allowed travel expenses1 including per diem in lieu of subsistence1 at rates authorized for employees of agencies under subchapter ,i of chapter #eg of title #e1 ,united ,states ,code1 while away from their homes or regular places of business in the performance of services for the ,task ,force4 7c7 ,staff ,the ,co-,chairs of the ,task ,force may appoint and fix the pay of staff to the ,task ,force4 7d7 ,detailees ,any ,federal ,government employee may be detailed to the ,task ,force without reimbursement from the ,task ,force1 and the detailee shall retain the rights1 status1 and privileges of his or her regular employment without interruption4 7e7 ,meetings 7#a7 ,in general ,subject to paragraph 7#b71 the ,task ,force shall meet at the call of the ,co-,chairs of the ,task ,force4 7#b7 ,initial meeting ,the ,task ,force shall meet not later than #cj days after the date on which all members of the ,task ,force have been appointed4 7#c7 ,quorum ,a majority of the members of the ,task ,force shall constitute a quorum4 7f7 ,information from ,federal ,agencies 7#a7 ,in general ,the ,task ,force may secure directly from any ,federal department or agency such information as may be relevant to carrying out this part4 7#b7 ,furnishing information ,on request of the ,co-,chairs of the ,task ,force pursuant to paragraph 7#a71 the head of a ,federal department or agency shall1 not later than #fj days after the date of receiving such request1 furnish to the ,task ,force the information so requested4 7g7 ,termination ,termination under section #ad of the ,federal ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 shall not apply to the ,task ,force4 7h7 ,duties 7#a7 ,national strategy ,the ,task ,force shall make recommendations for a national strategy to improve maternal mental and behavioral health outcomes with a particular focus on outcomes for minority women4 ,such strategy shall-- 7,a7 define collaborative maternity care2 7,b7 make recommendations to the ,secretary and the ,assistant ,secretary for ,mental ,health and ,substance ,use on how to implement collaborative maternity care models to improve maternal mental and behavioral health with a particular focus on such outcomes for minority women2 7,c7 identify barriers to the implementation of collaborative maternity care models to improve maternal mental and behavioral health with a particular focus on such outcomes for minority women1 and make recommendations to address such barriers2 7,d7 take into consideration as models existing ,state and other programs that have demonstrated effectiveness in improving maternal mental and behavioral health during the prenatal and postpartum periods2 7,e7 promote treatment options and reduce stigma for pregnant and postpartum women with a substance use disorder2 7,f7 assess the extent to which insurers are providing coverage for evidence-based mental and behavioral health screenings and services that adhere to existing prenatal and postpartum guidelines2 7,g7 assess the extent to which existing guidelines and processes are culturally congruent for minority women1 specifically-- 7i7 guidelines for identifying maternal mental and behavioral health conditions1 including substance use disorders2 7ii7 guidelines for screening and1 as needed1 follow-up referrals1 evaluations1 and treatments after positive screens for-- 7,i7 depression2 7,,ii7 anxiety2 7,,iii7 trauma2 7,,iv7 substance use disorders2 and 7,v7 other mental or behavioral health conditions at the discretion of the ,task ,force2 7iii7 processes for incorporating mental and behavioral health screenings into the current timeline of standard screening practices for pregnant and postpartum women1 with distinctions for postpartum screening timelines for uncomplicated and complicated births2 and 7iv7 processes for referring women with positive screens for substance use disorder to addiction treatment centers offering-- 7,i7 on-site wraparound treatment or networks for referrals2 7,,ii7 multidisciplinary staff2 7,,iii7 psychotherapy2 7,,iv7 contingency management2 7,v7 access to all evidence-based medication-assisted treatment2 and 7,,vi7 evidence-based recovery supports2 7,h7 propose to the ,secretary a multilingual public awareness campaign for maternal mental health and substance use disorder1 with a particular focus on minority women1 that includes information on-- 7i7 symptoms1 triggers1 risk factors1 and treatment options for maternal mental and behavioral health conditions2 7ii7 using the website developed under paragraph 7#c72 7iii7 the physiological process of recovery after birth2 7iv7 the frequency of occurrences for common conditions such as postpartum hemorrhage1 preeclampsia and eclampsia1 infection1 and thromboembolism2 7v7 best practices in patient reporting of health concerns to their maternity care providers in the prenatal and postpartum periods2 7vi7 addressing stigma around maternal mental and behavioral health conditions2 7vii7 how to seek treatment for substance use disorder during pregnancy and in the postpartum period2 and 7viii7 infant feeding options2 and 7,i7 disseminate to all ,state ,medicaid programs under title ,,xix of the ,social ,security ,act and ,state child health plans under the ,state ,children's ,health ,insurance ,program under title ,,xxi of the ,social ,security ,act an assessment of the extent to which ,states are providing coverage of evidence-based prenatal and postpartum mental and behavioral health screenings through such programs and plans1 and an assessment of the benefits of such coverage4 7#b7 ,grant programs ,the ,task ,force shall evaluate and advise on the grant programs under section #cii,,oo-#b4 7#c7 ,centralized website ,the ,task ,force shall facilitate a coordinated effort between the ,substance ,abuse and ,mental ,health ,services ,administration and ,state departments of health to develop1 either directly or through a contract1 a centralized website with information on finding local mental and behavioral health providers who treat prenatal and postpartum mental and behavioral health conditions1 including substance use disorder4 7#d7 ,report ,not later than #ah months after the date of enactment of the ,black ,maternal ,health ,momnibus ,act of #bjbj1 and every year thereafter1 the ,task ,force shall submit to the ,congress1 the ,centers for ,medicare ,medicaid ,services1 and the ,center for ,medicare and ,medicaid ,innovation1 and make publicly available1 a report that-- 7,a7 describes the activities of the ,task ,force and the results of such activities1 with data in such results stratified racially1 ethnically1 and geographically2 and 7,b7 includes the strategy developed under paragraph 7#a74 7i7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated such sums as may be necessary for fiscal years #bjba through #bjbe4 #cii,,oo-#b4 ,innovation in maternity care to close racial and ethnic maternal health disparities grants 7a7 ,in general ,the ,secretary shall award grants to eligible entities to establish1 implement1 evaluate1 or expand innovative models in maternity care that are designed to reduce racial and ethnic disparities in maternal health outcomes4 7b7 ,use of funds ,an eligible entity receiving a grant under this section may use the grant to establish1 implement1 evaluate1 or expand innovative models described in subsection 7a7 including-- 7#a7 collaborative maternity care models to improve maternal mental health1 treat maternal substance use disorders1 and reduce maternal mortality and severe maternal morbidity1 especially for minority women1 consistent with the national strategy developed by the ,task ,force under section #cii,,oo-#a7;h77#a7 and other recommendations of the ,task ,force2 7#b7 evidence-based programming at clinics that-- 7,a7 provide wraparound services for women with substance use disorders in the prenatal and postpartum periods that may include multidisciplinary staff1 access to all evidence-based medication-assisted treatment1 psychotherapy1 contingency management1 and recovery supports2 or 7,b7 make referrals for any such services that are not provided within the clinic2 7#c7 evidence-based programs at freestanding birth centers that provide culturally congruent maternal mental and behavioral health care education1 treatments1 and services1 and other wraparound supports for women throughout the prenatal and postpartum period2 and 7#d7 the development and implementation of evidence-based programs1 including toll-free telephone hotlines1 that connect maternity care providers with women's mental health clinicians to provide maternity care providers with guidance on addressing maternal mental and behavioral health conditions identified in patients4 7c7 ,special consideration ,in awarding grants under this section1 the ,secretary shall give special consideration to applications for models that will-- 7#a7 operate in-- 7,a7 areas with high rates of adverse maternal health outcomes2 7,b7 areas with significant racial and ethnic disparities in maternal health outcomes2 or 7,c7 health professional shortage areas designated under section #ccb2 7#b7 be led by minority women from demographic groups with disproportionate rates of adverse maternal health outcomes2 or 7#c7 be implemented with a culturally congruent approach that is focused on improving outcomes for demographic groups experiencing disproportionate rates of adverse maternal health outcomes4 7d7 ,evaluation ,as a condition on receipt of a grant under this section1 an eligible entity shall agree to provide annual evaluations of the activities funded through the grant to the ,secretary and the ,task ,force4 ,such evaluations may address-- 7#a7 the effects of such activities on maternal health outcomes and subjective assessments of patient and family experiences1 especially for minority women from demographic groups with disproportionate rates of adverse maternal health outcomes2 and 7#b7 the cost-effectiveness of such activities4 7e7 ,definitions ,in this section3 7#a7 ,the term eligible entity means any public or private entity4 7#b7 ,the term collaborative maternity care means an integrated care model that includes the delivery of maternal mental and behavioral health care services in primary clinics or other care settings familiar to pregnant and postpartum patients4 7#c7 ,the term culturally congruent means care that is in agreement with the preferred cultural values1 beliefs1 worldview1 language1 and practices of the health care consumer and other stakeholders4 7#d7 ,the term freestanding birth center has the meaning given that term under section #aije7l77#c77;,a7 of the ,social ,security ,act4 7f7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjba through #bjbe4 #cii,,oo-#c4 ,group prenatal and postpartum care models 7a7 ,in general ,the ,secretary shall award grants to eligible entities to establish1 implement1 evaluate1 or expand culturally congruent group prenatal care models or group postpartum care models that are designed to reduce racial and ethnic disparities in maternal and infant health outcomes4 7b7 ,use of funds ,an eligible entity receiving a grant under this section may use the grant for-- 7#a7 programming2 7#b7 capital investments required to improve existing physical infrastructure for group prenatal care and group postpartum care programming1 such as building space needed to implement such models2 and 7#c7 evaluations of group prenatal care and group postpartum care programming1 with a particular focus on the impacts of such programming on minority women4 7c7 ,special consideration ,in awarding grants under this section1 the ,secretary shall give special consideration to applicants that will-- 7#a7 operate in-- 7,a7 areas with high rates of adverse maternal health outcomes2 7,b7 areas with significant racial and ethnic disparities in maternal health outcomes2 or 7,c7 health professional shortage areas designated under section #ccb2 7#b7 be led by minority women from demographic groups with disproportionate rates of adverse maternal health outcomes2 or 7#c7 be implemented with a culturally congruent approach that is focused on improving outcomes for demographic groups experiencing disproportionate rates of adverse maternal health outcomes4 7d7 ,evaluation ,as a condition on receipt of a grant under this section1 an eligible entity shall agree to provide annual evaluations of the activities funded through the grant to the ,secretary and the ,task ,force and address in each such evaluation-- 7#a7 the effects of such activities on maternal health outcomes with a particular focus on the effects of such activities on minority women1 including measures such as-- 7,a7 avoidable emergency room visits2 7,b7 postpartum care visits after delivery2 7,c7 rates of preterm birth2 7,d7 rates of breastfeeding initiation2 7,e7 psychological outcomes2 and 7,f7 subjective measures of patient-reported experience of care2 and 7#b7 the cost-effectiveness of such activities4 7e7 ,definitions ,in this section3 7#a7 ,the term eligible entity means any public or private entity4 7#b7 ,the term culturally congruent means care that is in agreement with the preferred cultural values1 beliefs1 worldview1 language1 and practices of the health care consumer and other stakeholders4 7f7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 ,,vii ,justice for ,incarcerated ,moms #gja4 ,sense of ,congress ,it is the sense of ,congress that the respect and proper care that mothers deserve are inclusive1 and whether the mothers are transgender1 cisgender1 or gender nonconforming1 all deserve dignity4 #gjb4 ,ending the shackling of pregnant individuals 7a7 ,in general ,beginning on the date that is #f months after the date of enactment of this ,act1 and in each fiscal year thereafter1 the total amount of a grant to be allocated to a ,state for a fiscal year under subpart #a of part ,e of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajaea et seq47 7commonly referred to as the ,edward ,byrne ,memorial ,justice ,grant ,program7 shall be decreased by #be percent if the ,state does not have in effect for such fiscal year laws restricting1 throughout the ,state1 the use of restraints on pregnant individuals in prison that are substantially similar to the rights1 procedures1 requirements1 effects1 and penalties set forth in section #dcbb of title #ah1 ,united ,states ,code4 7b7 ,reallocation ,amounts not allocated to a ,state because of a decrease under subsection 7a7 shall be reallocated in accordance with subpart #a of part ,e of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajaea et seq47 to ,states that are not subject to the decrease under subsection 7a74 #gjc4 ,creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods 7a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general1 acting through the ,director of the ,bureau of ,prisons1 shall establish1 in not more than #f ,bureau of ,prisons facilities1 programs to optimize maternal health outcomes for pregnant and postpartum individuals incarcerated in such facilities4 7b7 ,consultation ,the ,attorney ,general shall establish the programs required under subsection 7a7 in consultation with interested entities such as-- 7#a7 relevant community-based organizations1 particularly organizations that represent incarcerated and formerly incarcerated individuals and organizations that seek to improve maternal health outcomes for minority women2 7#b7 relevant organizations representing patients1 with a particular focus on minority patients2 7#c7 relevant organizations representing maternal health care providers2 7#d7 nonclinical perinatal health workers such as doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dietitians1 social workers1 home visitors1 and navigators2 and 7#e7 researchers and policy experts in fields related to women's health care for incarcerated individuals4 7c7 ,start date ,each facility selected by the ,director of the ,bureau of ,prisons under subsection 7a7 shall begin facility programs not later than #ah months after the date of enactment of this ,act4 7d7 ,facility priority ,in carrying out subsection 7a71 the ,director of the ,bureau of ,prisons shall give priority to a facility based on-- 7#a7 the number of pregnant and postpartum individuals incarcerated in such facility and1 among such individuals1 the number of pregnant and postpartum minority individuals2 and 7#b7 the extent to which the leaders of such facility have demonstrated a commitment to developing exemplary programs for pregnant and postpartum individuals incarcerated in such facility4 7e7 ,program duration ,each program established under this section shall be for a #e-year period4 7f7 ,programs ,each ,bureau of ,prisons facility selected under subsection 7a7 shall establish programs for pregnant and postpartum incarcerated individuals1 and such programs may-- 7#a7 provide access to doulas and other perinatal health workers from pregnancy through the postpartum period2 7#b7 provide access to healthy foods and counseling on nutrition1 recommended activity levels1 and safety measures throughout pregnancy2 7#c7 train correctional officers and medical personnel to ensure that pregnant incarcerated individuals receive trauma-informed1 culturally congruent care that promotes the health and safety of the pregnant individuals2 7#d7 provide counseling and treatment for individuals who have suffered from-- 7,a7 diagnosed mental or behavioral health conditions1 including trauma and substance use disorders2 7,b7 domestic violence2 7,c7 human immunodeficiency virus2 7,d7 sexual abuse2 7,e7 pregnancy or infant loss2 or 7,f7 chronic conditions1 including heart disease1 diabetes1 osteoporosis and osteopenia1 hypertension1 asthma1 liver disease1 and bleeding disorders2 7#e7 provide pregnancy and childbirth education1 parenting support1 and other relevant forms of health literacy2 7#f7 offer opportunities for postpartum individuals to maintain contact with the individual's newborn child to promote bonding1 including enhanced visitation policies1 access to prison nursery programs1 or breastfeeding support2 7#g7 provide reentry assistance1 particularly to-- 7,a7 ensure continuity of health insurance coverage if an incarcerated individual exits the criminal justice system during such individual's pregnancy or in the postpartum period2 and 7,b7 connect individuals exiting the criminal justice system during pregnancy or in the postpartum period to community-based resources1 such as referrals to health care providers and social services that address social determinants of health like housing1 employment opportunities1 transportation1 and nutrition2 or 7#h7 establish partnerships with local public entities1 private community entities1 community-based organizations1 ,indian ,tribes and tribal organizations 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd771 and urban ,indian organizations 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 to establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals4 ,such programs may include-- 7,a7 parenting classes2 7,b7 prenatal health coordination2 7,c7 family and individual counseling2 7,d7 evidence-based screenings1 education1 and1 as needed1 treatment for mental and behavioral health conditions1 including drug and alcohol treatments2 7,e7 family case management services2 7,f7 domestic violence education and prevention2 7,g7 physical and sexual abuse counseling2 and 7,h7 programs to address social determinants of health such as employment1 housing1 education1 transportation1 and nutrition4 7g7 ,implementation and reporting ,each ,bureau of ,prisons facility selected under subsection 7a7 shall be responsible for-- 7#a7 implementing programs1 which may include the programs described in subsection 7f72 and 7#b7 not later than #c years after the date of enactment of this ,act1 and #f years after the date of enactment of this ,act1 reporting results of the programs to the ,director of the ,bureau of ,prisons1 including information describing-- 7,a7 relevant quantitative indicators of success in improving the standard of care and health outcomes for pregnant and postpartum incarcerated individuals who participated in such programs1 including data stratified by race1 ethnicity1 sex1 age1 geography1 disability status1 the category of the criminal charge against such individual1 rates of pregnancy-related deaths1 pregnancy-associated deaths1 cases of infant mortality1 cases of severe maternal morbidity1 cases of violence against pregnant or postpartum individuals1 diagnoses of maternal mental or behavioral health conditions1 and other such information as appropriate2 7,b7 relevant qualitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs1 including subjective measures of patient-reported experience of care2 7,c7 evaluations of cost effectiveness2 and 7,d7 strategies to sustain such programs beyond #bjbf4 7h7 ,report ,not later than #g years after the date of enactment of this ,act1 the ,director of the ,bureau of ,prisons shall submit to the ,attorney ,general and to the ,committee on the ,judiciary of the ,house of ,representatives and the ,committee on the ,judiciary of the ,senate a report describing the results of the programs funded under this section4 7i7 ,oversight ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general shall award a contract to an independent organization or independent organizations to conduct oversight of the programs described in subsection 7f74 7j7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjba through #bjbe4 #gjd4 ,grant program to improve maternal health outcomes for individuals in ,state and local prisons and jails 7a7 ,establishment ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general1 acting through the ,director of the ,bureau of ,justice ,assistance1 shall award ,justice for ,incarcerated ,moms grants to ,states to establish or expand programs in ,state and local prisons and jails for pregnant and postpartum incarcerated individuals4 7b7 ,consultation ,the ,attorney ,general shall award the grants authorized under subsection 7a7 in consultation with interested entities such as-- 7#a7 relevant community-based organizations1 particularly organizations that represent incarcerated and formerly incarcerated individuals and organizations that seek to improve maternal health outcomes for minority women2 7#b7 relevant organizations representing patients1 with a particular focus on minority patients2 7#c7 relevant organizations representing maternal health care providers2 7#d7 nonclinical perinatal health workers such as doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dietitians1 social workers1 home visitors1 and navigators2 and 7#e7 researchers and policy experts in fields related to women's health care for incarcerated individuals4 7c7 ,applications ,each applicant for a grant under this section shall submit to the ,director of the ,bureau of ,justice ,assistance an application at such time1 in such manner1 and containing such information as the ,director may require4 7d7 ,use of funds ,a ,state that is awarded a grant under this section shall use such grant to establish or expand programs for pregnant and postpartum incarcerated individuals1 and such programs may-- 7#a7 provide access to doulas and other perinatal health workers from pregnancy through the postpartum period2 7#b7 provide access to healthy foods and counseling on nutrition1 recommended activity levels1 and safety measures throughout pregnancy2 7#c7 train correctional officers and medical personnel to ensure that pregnant incarcerated individuals receive trauma-informed1 culturally congruent care that promotes the health and safety of the pregnant individuals2 7#d7 provide counseling and treatment for individuals who have suffered from-- 7,a7 diagnosed mental or behavioral health conditions1 including trauma and substance use disorders2 7,b7 domestic violence2 7,c7 human immunodeficiency virus2 7,d7 sexual abuse2 7,e7 pregnancy or infant loss2 or 7,f7 chronic conditions1 including heart disease1 diabetes1 osteoporosis and osteopenia1 hypertension1 asthma1 liver disease1 and bleeding disorders2 7#e7 provide pregnancy and childbirth education1 parenting support1 and other relevant forms of health literacy2 7#f7 offer opportunities for postpartum individuals to maintain contact with the individual's newborn child to promote bonding1 including enhanced visitation policies1 access to prison nursery programs1 or breastfeeding support2 7#g7 provide reentry assistance1 particularly to-- 7,a7 ensure continuity of health insurance coverage if an incarcerated individual exits the criminal justice system during such individual's pregnancy or in the postpartum period2 and 7,b7 connect individuals exiting the criminal justice system during pregnancy or in the postpartum period to community-based resources1 such as referrals to health care providers and social services that address social determinants of health like housing1 employment opportunities1 transportation1 and nutrition2 or 7#h7 establish partnerships with local public entities1 private community entities1 community-based organizations1 ,indian ,tribes and tribal organizations 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd771 and urban ,indian organizations 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 to establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals4 ,such programs may include-- 7,a7 parenting classes2 7,b7 prenatal health coordination2 7,c7 family and individual counseling2 7,d7 evidence-based screenings1 education1 and1 as needed1 treatment for mental and behavioral health conditions1 including drug and alcohol treatments2 7,e7 family case management services2 7,f7 domestic violence education and prevention2 7,g7 physical and sexual abuse counseling2 and 7,h7 programs to address social determinants of health such as employment1 housing1 education1 transportation1 and nutrition4 7e7 ,priority ,in awarding grants under this section1 the ,director of the ,bureau of ,justice ,assistance shall give priority to applicants based on-- 7#a7 the number of pregnant and postpartum individuals incarcerated in the ,state and1 among such individuals1 the number of pregnant and postpartum minority individuals2 and 7#b7 the extent to which the ,state has demonstrated a commitment to developing exemplary programs for pregnant and postpartum individuals incarcerated in the prisons and jails in the ,state4 7f7 ,grant duration ,a grant awarded under this section shall be for a #e-year period4 7g7 ,implementing and reporting ,a ,state that receives a grant under this section shall be responsible for-- 7#a7 implementing the program funded by the grant2 and 7#b7 not later than #c years after the date of enactment of this ,act1 and #f years after the date of enactment of this ,act1 reporting results of such program to the ,attorney ,general1 including information describing-- 7,a7 relevant quantitative indicators of the program's success in improving the standard of care and health outcomes for pregnant and postpartum incarcerated individuals who participated in such program1 including data stratified by race1 ethnicity1 sex1 age1 geography1 disability status1 category of the criminal charge against such individual1 incidence rates of pregnancy-related deaths1 pregnancy-associated deaths1 cases of infant mortality1 cases of severe maternal morbidity1 cases of violence against pregnant or postpartum individuals1 diagnoses of maternal mental or behavioral health conditions1 and other such information as appropriate2 7,b7 relevant qualitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs1 including subjective measures of patient-reported experience of care2 7,c7 evaluations of cost effectiveness2 and 7,d7 strategies to sustain such programs beyond the duration of the grant4 7h7 ,report ,not later than #g years after the date of enactment of this ,act1 the ,attorney ,general shall submit to the ,committee on the ,judiciary of the ,house of ,representatives and the ,committee on the ,judiciary of the ,senate a report describing the results of the grant program authorized under this section4 7i7 ,oversight ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general shall award a contract to an independent organization or independent organizations to conduct oversight of the programs described in subsection 7d74 7j7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjba through #bjbe4 #gje4 ,,gao report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on adverse maternal health outcomes among incarcerated individuals1 with a particular focus on racial and ethnic disparities in maternal health outcomes for incarcerated individuals4 7b7 ,contents of report ,the report required under subsection 7a7 shall include-- 7#a7 to the extent practicable-- 7,a7 the number of incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local correctional facilities1 who have experienced a pregnancy-related death or pregnancy-associated death in the most recent #aj years of available data2 7,b7 the number of cases of severe maternal morbidity among incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities1 in the most recent year of available data2 and 7,c7 statistics on the racial and ethnic disparities in maternal and infant health outcomes and severe maternal morbidity rates among incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities2 7#b7 in the case that the ,comptroller ,general of the ,united ,states is unable to determine the information required in subparagraphs 7,a7 through 7,c7 of paragraph 7#a71 an assessment of the barriers to determining such information and recommendations for improvements in tracking maternal health outcomes among incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities2 7#c7 causes of adverse maternal health outcomes that are unique to incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities2 7#d7 causes of adverse maternal health outcomes and severe maternal morbidity that are unique to incarcerated individuals of color2 7#e7 recommendations to reduce maternal mortality and severe maternal morbidity among incarcerated individuals and to address racial and ethnic disparities in maternal health outcomes for incarcerated individuals in ,bureau of ,prisons facilities and ,state and local prisons and jails2 and 7#f7 such other information as may be appropriate to reduce the occurrence of adverse maternal health outcomes among incarcerated individuals and to address racial and ethnic disparities in maternal health outcomes for such individuals4 #gjf4 ,,macpac report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,medicaid and ,,chip ,payment and ,access ,commission 7referred to in this section as ,,macpac7 shall publish a report on the implications of pregnant and postpartum incarcerated individuals being ineligible for medical assistance under a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7b7 ,contents of report ,the report described in this section shall include-- 7#a7 information on the effect of ineligibility for medical assistance under a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 on maternal health outcomes for pregnant and postpartum incarcerated individuals1 concentrating on the effects of such ineligibility for pregnant and postpartum individuals of color2 and 7#b7 the potential implications on maternal health outcomes resulting from suspending eligibility for medical assistance under a ,state plan under such title of such ,act when a pregnant or postpartum individual is incarcerated4 ,,viii ,tech ,to ,save ,moms #hja4 ,,cmi modeling of integrated telehealth models in maternity care services 7a7 ,in general ,section #aaae;,a7b77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#b77;,b77 is amended by adding at the end the following new clauses3 7xxviii7 ,focusing on title ,,xix1 providing for the adoption of and use of telehealth tools that allow for screening and treatment of common pregnancy-related complications 7including anxiety and depression1 substance use disorder1 hemorrhage1 infection1 amniotic fluid embolism1 thrombotic pulmonary or other embolism1 hypertensive disorders of pregnancy1 cerebrovascular accidents1 cardiomyopathy1 and other cardiovascular conditions7 for a pregnant woman receiving medical assistance under such title during her pregnancy and for not more than a #a-year period beginning on the last day of her pregnancy4 4 7b7 ,effective date ,the amendment made by subsection 7a7 shall take effect #a year after the date of the enactment of this ,act4 #hjb4 ,grants to expand the use of technology-enabled collaborative learning and capacity models that provide care to pregnant and postpartum women ,title ,,iii of the ,public ,health ,service ,act is amended by inserting after section #ccj,m 7#db ,u4,s4,c4 #bed;c-#ai7 the following3 #ccj,n4 ,expanding capacity for maternal health outcomes 7a7 ,program established ,beginning not later than #a year after the date of enactment of this ,act1 the ,secretary shall1 as appropriate1 award grants to eligible entities to evaluate1 develop1 and expand the use of technology-enabled collaborative learning and capacity building models1 to improve maternal health outcomes-- 7#a7 in health professional shortage areas2 7#b7 in areas with high rates of maternal mortality and severe maternal morbidity1 and significant racial and ethnic disparities in maternal health outcomes2 and 7#c7 for medically underserved populations or ,american ,indians and ,alaska ,natives1 including ,indian tribes1 tribal organizations1 and urban ,indian organizations4 7b7 ,use of ,funds 7#a7 ,required uses ,grants awarded under subsection 7a7 shall be used for-- 7,a7 the development and acquisition of instructional programming1 and the training of maternal health care providers and other professionals that provide or assist in the provision of services1 through models such as-- 7i7 training on adopting and effectively implementing ,alliance for ,innovation on ,maternal ,health 7referred to in this section as ,,aim7 safety and quality improvement bundles2 7ii7 training on implicit and explicit bias1 racism1 and discrimination for providers of maternity care2 7iii7 training on best practices in screening for and1 as needed1 evaluating and treating maternal mental health conditions and substance use disorders2 7iv7 training on how to screen for social determinants of health risks in the prenatal and postpartum periods such as inadequate housing1 lack of access to nutrition1 environmental risks1 and transportation barriers2 and 7v7 training on the use of remote patient monitoring tools for pregnancy-related complications2 7,b7 information collection and evaluation activities to-- 7i7 study the impact of such models on-- 7,i7 access to and quality of care2 7,,ii7 patient outcomes2 7,,iii7 subjective measures of patient experience2 and 7,,iv7 cost-effectiveness2 and 7ii7 identify best practices for the expansion and use of such models2 7,c7 information collection and evaluation activities to study the impact of such models on patient outcomes and maternal health care providers1 and to identify best practices for the expansion and use of such models2 and 7,d7 any other activity consistent with achieving the objectives of grants awarded under this section1 as determined by the ,secretary4 7#b7 ,permissible uses ,in addition to any of the uses under paragraph 7#a71 grants awarded under subsection 7a7 may be used for-- 7,a7 equipment to support the use and expansion of technology-enabled collaborative learning and capacity building models1 including for hardware and software that enables distance learning1 maternal health care provider support1 and the secure exchange of electronic health information2 and 7,b7 support for maternal health care providers and other professionals that provide or assist in the provision of maternity care services through such models4 7c7 ,limitations 7#a7 ,number ,the ,secretary may not award more than #a grant under this section to an eligible entity4 7#b7 ,duration ,each grant under this section shall be made for a period of up to #e years4 7#c7 ,amount ,the ,secretary shall determine the maximum amount of each grant under this section4 7d7 ,grant requirements 7#a7 ,in general ,the ,secretary shall require entities awarded a grant under this section to collect information on the effect of the use of technology-enabled collaborative learning and capacity building models1 such as on maternal health outcomes1 access to maternal health care services1 quality of maternal health care1 and maternal health care provider retention in areas and for populations described in subsection 7a74 7#b7 ,coordination support ,the ,secretary may award a grant or contract to assist in the coordination of models described in paragraph 7#a71 including to assess outcomes associated with the use of such models in grants awarded under subsection 7a71 including grants awarded for the purpose described in subsection 7b77#a77;,b74 7e7 ,application 7#a7 ,in general ,an eligible entity that seeks to receive a grant under subsection 7a7 shall submit to the ,secretary an application1 at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,matters to be included ,such application shall include plans to assess the effect of technology-enabled collaborative learning and capacity building models on indicators1 including access to and quality of care1 patient outcomes1 subjective measures of patient experience1 and cost-effectiveness4 ,such indicators may focus on-- 7,a7 health professional shortage areas2 7,b7 areas with high rates of maternal mortality and severe maternal morbidity1 and significant racial and ethnic disparities in maternal health outcomes2 and 7,c7 medically underserved populations or ,american ,indians and ,alaska ,natives1 including ,indian tribes1 tribal organizations1 and urban ,indian organizations4 7f7 ,access to broadband ,in administering grants under this section1 the ,secretary may coordinate with other agencies to ensure that funding opportunities are available to support access to reliable1 high-speed internet for grantees4 7g7 ,technical assistance ,the ,secretary shall provide 7either directly through the ,department of ,health and ,human ,services or by contract7 technical assistance to eligible entities1 including recipients of grants under subsection 7a71 on the development1 use1 and post-grant sustainability of technology-enabled collaborative learning and capacity building models in order to expand access to maternal health care services provided by such entities1 including-- 7#a7 for health professional shortage areas2 7#b7 for areas with high rates of maternal mortality and severe maternal morbidity1 and significant racial and ethnic disparities in maternal health outcomes2 and 7#c7 to medically underserved populations or ,american ,indians and ,alaska ,natives1 including ,indian tribes1 tribal organizations1 and urban ,indian organizations4 7h7 ,research and evaluation ,the ,secretary1 in consultation with stakeholders with appropriate expertise in such models1 shall develop a strategic plan to research and evaluate the evidence for such models4 ,the ,secretary shall use such plan to inform the activities carried out under this section4 7i7 ,reporting 7#a7 ,by eligible entities ,an eligible entity that receives a grant under subsection 7a7 shall submit to the ,secretary a report1 at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,by the ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall prepare and submit to the ,congress1 and post on the internet website of the ,department of ,health and ,human ,services1 a report including1 at minimum-- 7,a7 a description of any new and continuing grants awarded under subsection 7a7 and the specific purpose and amounts of such grants2 7,b7 an overview of-- 7i7 the evaluation activities conducted under subsection 7b77#a77;,b77i72 7ii7 technical assistance provided under subsection 7g72 and 7iii7 activities conducted by entities awarded grants under subsection 7a72 and 7,c7 a description of any significant findings related to patient outcomes or maternal health care providers and best practices for eligible entities expanding1 using1 or evaluating technology-enabled collaborative learning and capacity building models4 7j7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #f1jjj1jjj for each of fiscal years #bjba through #bjbe4 7k7 ,definitions ,in this section3 7#a7 ,eligible entity 7,a7 ,in general ,the term eligible entity means an entity that provides1 or supports the provision of1 maternal health care services or other evidence-based services for pregnant and postpartum women-- 7i7 in health professional shortage areas2 7ii7 in areas with high rates of adverse maternal health outcomes and significant racial and ethnic disparities in maternal health outcomes2 or 7iii7 from medically underserved populations or ,american ,indians and ,alaska ,natives1 including ,indian tribes1 tribal organizations1 and urban ,indian organizations4 7,b7 ,inclusions ,an eligible entity may include entities leading1 or capable of leading1 a technology-enabled collaborative learning and capacity building model or engaging in technology-enabled collaborative training of participants in such model4 7#b7 ,health professional shortage area ,the term health professional shortage area means a health professional shortage area designated under section #ccb4 7#c7 ,indian tribe ,the term ,indian tribe has the meaning given such term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#d7 ,maternal mortality ,the term maternal mortality means a death occurring during or within #a-year period after pregnancy caused by pregnancy or childbirth complications4 7#e7 ,medically underserved population ,the term medically underserved population has the meaning given such term in section #ccj7;b77#c74 7#f7 ,postpartum ,the term postpartum means the #a-year period beginning on the last date of the pregnancy of a woman4 7#g7 ,severe maternal morbidity ,the term severe maternal morbidity means an unexpected outcome caused by labor and delivery of a woman that results in significant short-term or long-term consequences to the health of the woman4 7#h7 ,technology-enabled collaborative learning and capacity building model ,the term technology-enabled collaborative learning and capacity building model means a distance health education model that connects health care professionals1 and particularly specialists1 with multiple other health care professionals through simultaneous interactive videoconferencing for the purpose of facilitating case-based learning1 disseminating best practices1 and evaluating outcomes in the context of maternal health care4 7#i7 ,tribal organization ,the term tribal organization has the meaning given such term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#aj7 ,urban ,indian organization ,the term urban ,indian organization has the meaning given such term in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc74 4 #hjc4 ,grants to promote equity in maternal health outcomes by increasing access to digital tools 7a7 ,in general ,beginning not later than #a year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall carry out a program1 to be known as the ,investments in ,digital ,tools to ,promote ,equity in ,maternal ,health ,outcomes ,program1 under which the ,secretary makes grants to eligible entities to reduce racial and ethnic disparities in maternal health outcomes by increasing access to digital tools related to maternal health care4 7b7 ,applications ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,limitations 7#a7 ,number ,the ,secretary may not award more than #a grant under this section to an eligible entity4 7#b7 ,duration ,each grant under this section shall be made for a period of not more than #e years4 7#c7 ,amount ,the ,secretary shall determine the maximum amount of each grant under this section4 7#d7 ,prioritization ,in awarding grants under this section1 the ,secretary shall prioritize the selection of an eligible entity that-- 7,a7 operates in an area with high rates of adverse maternal health outcomes and significant racial and ethnic disparities in maternal health outcomes2 and 7,b7 promotes technology that addresses racial and ethnic disparities in maternal health outcomes4 7d7 ,technical assistance ,the ,secretary shall provide technical assistance to an eligible entity on the development1 use1 evaluation1 and post-grant sustainability of digital tools for purposes of promoting equity in maternal health outcomes4 7e7 ,reporting 7#a7 ,by eligible entities ,an eligible entity that receives a grant under subsection 7a7 shall submit to the ,secretary a report1 at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,by the ,secretary ,not later than #d years after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a report that-- 7,a7 evaluates the effectiveness of grants awarded under this section in improving maternal health outcomes for minority women2 7,b7 makes recommendations for future grant programs that promote the use of technology to improve maternal health outcomes for minority women2 and 7,c7 makes recommendations that address-- 7i7 privacy and security safeguards that should be implemented in the use of technology in maternal health care2 7ii7 reimbursement rates for maternal telehealth services2 7iii7 the use of digital tools to analyze large data sets for the purposes of identifying potential pregnancy-related complications as early as possible2 7iv7 barriers that prevent maternal health care providers from providing telehealth services across ,states and recommendations from the ,centers for ,medicare ,medicaid ,services for addressing such barriers in ,state ,medicaid programs2 7v7 the use of consumer digital tools such as mobile phone applications1 patient portals1 and wearable technologies to improve maternal health outcomes2 7vi7 barriers that prevent consumers from accessing telehealth services or other digital technologies to improve maternal health outcomes1 including a lack of access to reliable1 high-speed internet or lack of access to electronic devices needed to use such services and technologies2 and 7vii7 any other related issues as determined by the ,secretary4 7f7 ,eligible entity defined ,in this section1 the term eligible entity is an entity that is described in section #ea;a4#c7;a7 of title #db1 ,code of ,federal ,regulations or any successor regulation1 including domestic faith-based and community-based organizations4 7g7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #f1jjj1jjj for each of fiscal years #bjba through #bjbe4 #hjd4 ,report on the use of technology to reduce maternal mortality and severe maternal morbidity and to close racial and ethnic disparities in outcomes 7a7 ,in general ,not later than #fj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall seek to enter an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this section as the ,national ,academies7 under which the ,national ,academies shall conduct a study on the use of technology to reduce preventable maternal mortality and severe maternal morbidity1 and close racial and ethnic disparities in maternal health outcomes in the ,united ,states4 ,the study shall assess current and future uses of artificial intelligence in maternity care1 including issues such as-- 7#a7 the extent to which artificial intelligence technologies are currently being used in maternal health care2 7#b7 the extent to which artificial intelligence technologies have exacerbated racial or ethnic biases in maternal health care2 7#c7 recommendations for reducing racial or ethnic biases in artificial intelligence technologies used in maternal health care2 7#d7 recommendations for potential applications of artificial intelligence technologies that could improve maternal health outcomes1 particularly for minority women2 and 7#e7 recommendations for privacy and security safeguards that should be implemented in the development of artificial intelligence technologies in maternal health care4 7b7 ,report ,as a condition of any agreement under subsection 7a71 the ,administrator shall require that the ,national ,academies transmit to ,congress a report on the results of the study under subsection 7a7 not later than #bd months after the date of enactment of this ,act4 ,,ix ,,impact ,to ,save ,moms #ija4 ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project 7a7 ,in general ,for the period of fiscal years #bjbb through #bjbf1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall establish and implement1 in accordance with the requirements of this section1 a demonstration project1 to be known as the ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project 7referred to in this section as the ,demonstration ,project71 for purposes of allowing ,states to test payment models under their ,state plans under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and ,state child health plans under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig;aa et seq47 with respect to maternity care provided to pregnant and postpartum women enrolled in such ,state plans and ,state child health plans4 7b7 ,coordination ,in establishing the ,demonstration ,project1 the ,secretary shall coordinate with stakeholders such as-- 7#a7 ,state ,medicaid programs2 7#b7 relevant organizations representing maternal health care providers2 7#c7 relevant organizations representing patients1 with a particular focus on women from demographic groups with disproportionate rates of adverse maternal health outcomes2 7#d7 relevant community-based organizations1 particularly organizations that seek to improve maternal health outcomes for women from demographic groups with disproportionate rates of adverse maternal health outcomes2 7#e7 non-clinical perinatal health workers such as doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dieticians1 social workers1 home visitors1 and navigators2 7#f7 relevant health insurance issuers2 7#g7 hospitals1 health systems1 freestanding birth centers 7as such term is defined in paragraph 7#c77;,b7 of section #aije7l7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l771 ,federally-qualified health centers 7as such term is defined in paragraph 7#b77;,b7 of such section71 and rural health clinics 7as such term is defined in section #ahfa7;aa7 of such ,act 7#db ,u4,s4,c4 #aciex7aa7772 7#h7 researchers and policy experts in fields related to maternity care payment models2 and 7#i7 any other stakeholders as the ,secretary determines appropriate1 with a particular focus on stakeholders from demographic groups with disproportionate rates of adverse maternal health outcomes4 7c7 ,considerations ,in establishing the ,demonstration ,project1 the ,secretary shall consider each of the following3 7#a7 ,findings from any evaluations of the ,strong ,start for ,mothers and ,newborns initiative carried out by the ,centers for ,medicare ,medicaid ,services1 the ,health ,resources and ,services ,administration1 and the ,administration on ,children and ,families4 7#b7 ,any alternative payment model that-- 7,a7 is designed to improve maternal health outcomes for racial and ethnic groups with disproportionate rates of adverse maternal health outcomes2 7,b7 includes methods for stratifying patients by pregnancy risk level and1 as appropriate1 adjusting payments under such model to take into account pregnancy risk level2 7,c7 establishes evidence-based quality metrics for such payments2 7,d7 includes consideration of non-hospital birth settings such as freestanding birth centers 7as so defined72 7,e7 includes consideration of social determinants of health that are relevant to maternal health outcomes such as housing1 transportation1 nutrition1 and other non-clinical factors that influence maternal health outcomes2 or 7,f7 includes diverse maternity care teams that include-- 7i7 maternity care providers1 including obstetrician-gynecologists1 family physicians1 physician assistants1 midwives who meet1 at a minimum1 the international definition of the term midwife and global standards for midwifery education 7as established by the ,international ,confederation of ,midwives71 and nurse practitioners-- 7,i7 from racially1 ethnically1 and professionally diverse backgrounds2 7,,ii7 with experience practicing in racially and ethnically diverse communities2 or 7,,iii7 who have undergone trainings on racism1 implicit bias1 and explicit bias2 and 7ii7 non-clinical perinatal health workers such as doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dieticians1 social workers1 home visitors1 and navigators4 7d7 ,eligibility ,to be eligible to participate in the ,demonstration ,project1 a ,state shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7e7 ,evaluation ,the ,secretary shall conduct an evaluation of the ,demonstration ,project to determine the impact of the ,demonstration ,project on-- 7#a7 maternal health outcomes1 with data stratified by race1 ethnicity1 socioeconomic indicators1 and any other factors as the ,secretary determines appropriate2 7#b7 spending on maternity care by ,states participating in the ,demonstration ,project2 7#c7 to the extent practicable1 subjective measures of patient experience2 and 7#d7 any other areas of assessment that the ,secretary determines relevant4 7f7 ,report ,not later than #a year after the completion or termination date of the ,demonstration ,project1 the ,secretary shall submit to the ,committee on ,energy and ,commerce1 the ,committee on ,ways and ,means1 and the ,committee on ,education and ,labor of the ,house of ,representatives and the ,committee on ,finance and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and make publicly available1 a report containing-- 7#a7 the results of any evaluation conducted under subsection 7e72 and 7#b7 a recommendation regarding whether the ,demonstration ,project should be continued after fiscal year #bjbf and expanded on a national basis4 7g7 ,authorization of appropriations ,there are authorized to be appropriated such sums as are necessary to carry out this section4 7h7 ,definitions ,in this section3 7#a7 ,alternative payment model ,the term alternative payment model has the meaning given such term in section #ahcc7z77#c77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7z77#c77;,c774 7#b7 ,perinatal ,the term perinatal means the period beginning on the day a woman becomes pregnant and ending on the last day of the #a-year period beginning on the last day of such woman's pregnancy4 #ijb4 ,,macpac report ,not later than #b years after the date of the enactment of this ,act1 the ,medicaid and ,,chip ,payment and ,access ,commission shall publish a report on issues relating to the continuity of coverage under ,state plans under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and ,state child health plans under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig;aa et seq47 for pregnant and postpartum women4 ,such report shall1 at a minimum1 include the following3 7#a7 ,an assessment of any existing policies under such ,state plans and such ,state child health plans regarding presumptive eligibility for pregnant women while their application for enrollment in such a ,state plan or such a ,state child health plan is being processed4 7#b7 ,an assessment of any existing policies under such ,state plans and such ,state child health plans regarding measures to ensure continuity of coverage under such a ,state plan or such a ,state child health plan for pregnant and postpartum women1 including such women who need to change their health insurance coverage during their pregnancy or the postpartum period following their pregnancy4 7#c7 ,an assessment of any existing policies under such ,state plans and such ,state child health plans regarding measures to automatically reenroll women who are eligible to enroll under such a ,state plan or such a ,state child health plan as a parent4 7#d7 ,if determined appropriate by the ,commission1 any recommendations for the ,department of ,health and ,human ,services1 or such ,state plans and such ,state child health plans1 to ensure continuity of coverage under such a ,state plan or such a ,state child health plan for pregnant and postpartum women4