,i  #aag? ,,congress  #b;d ,session  ,h4
 ,r4 #hhfb  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,septemb] #ae1        
#bjbb,mr4 ,phillips 7= himself1 ,ms4    
,de,lauro1 ,ms4 ,b>ragn1 ,ms4 ,m5g1 ,ms4
 ,kelly ( ,ill9ois1 ,mr4 ,c>son1 ,ms4   
,port]1 ,ms4 ,norton1 ,ms4 ,wilson (    
,florida1 ,mr4 ,nadl]1 ,mr4 ,mi*ael ,f4 
,doyle ( ,p5nsylvania1 ,mr4 ,khanna1    
,mrs4 ,kirkpatrick1 ,mr4 ,neguse1 ,mr4  
,cicill9e1 ,ms4 ,velzquez1 ,mr4 ,evans1 
,ms4 ,adams1 ,ms4 ,l(gr51 ,mr4          
,connolly1 ,ms4 ,mc,collum1 ,ms4        
,s*ak[sky1 ,mrs4 ,torres ( ,cali=nia1   
,ms4 ,escob>1 ,mr4 ,grijalva1 ,mr4      
,coh51 ,ms4 ,moore ( ,wiscons91 ,ms4    
,titus1 & ,mr4 ,lieu7 introduc$ ! foll[+
 bill2 :i* 0 ref]r$ to ! ,committee on  
,en]gy & ,comm]ce1 & 9 addition to !    
,committees on ,f9ancial ,s]vices1      
,transportation & ,infra/ructure1       
,education & ,labor1 ! ,judici>y1       
,natural ,res\rces1 ,agriculture1       
,vet]ans' ,affairs1 & ,ways & ,means1 = 
a p]iod to be subsequ5tly det]m9$ by !  

,speak]1 9 ea* case = consid]ation ( su*
 provisions z fall )9 ! jurisdiction ( !
 committee conc]n$  ,a ,,bill  ,to inve/
 9 real pro-life policies t support !   
,am]ican family1 & = o!r purposes4  #a4 
,%ort title ,?is ,act may be cit$ z !   
,provid+ ,real ,opportunities &         
,lifelong ,inve/m5ts ,= ,ev]yone ,act ( 
#bjbb or ! ,,pro-,,life ,act ( #bjbb4   
#b4 ,table ( cont5ts ,! table ( cont5ts 
= ?is ,act is z foll[s3 ,sec4 #a4 ,%ort 
title4,sec4 #b4 ,table ( cont5ts4,title 
,i--,black ,mat]nal ,heal?              
,momnibus,sec4 #ajjj4 ,def9itions2 s5se 
( ,congress4,subtitle ,a--,social       
det]m9ants = moms,sec4 #ajja4 ,task =ce 
to develop a /rategy to address social  
det]m9ants ( mat]nal heal?4,sec4 #ajjb4 
,h\s+ = ,moms grant program4,sec4 #ajjc4
 ,dep>tm5t ( ,transportation4,sec4      
#ajjd4 ,dep>tm5t ( ,agriculture4,sec4   
#ajje4 ,environm5tal /udy ?r\gh         
,national ,academies4,sec4 #ajjf4 ,*ild 
c>e access4,sec4 #ajjg4 ,grants to local
 entities address+ social det]m9ants (  

mat]nal heal?4,subtitle ,b--,honor+     
,kira ,johnson,sec4 #aaja4 ,inve/m5ts 9 
community-bas$ organizations to improve 
,black mat]nal heal? outcomes4,sec4     
#aajb4 ,inve/m5ts 9 community-bas$      
organizations to improve mat]nal heal?  
outcomes 9 und]s]v$ communities4,sec4   
#aajc4 ,respectful mat]nity c>e tra9+ = 
all employees 9 mat]nity c>e            
sett+s4,sec4 #aajd4 ,/udy on r$uc+ &    
prev5t+ bias1 racism1 & discrim9ation 9 
mat]nity c>e sett+s4,sec4 #aaje4        
,respectful mat]nity c>e compliance     
program4,sec4 #aajf4 ,,gao              
report4,subtitle ,c--,protect+ moms :o  
served,sec4 #abja4 ,support = mat]nity  
c>e coord9ation4,sec4 #abjb4 ,report on 
mat]nal mortality & sev]e mat]nal       
morbidity among pregnant & po/p>tum     
vet]ans4,subtitle ,d--,p]9atal          
workforce,sec4 #acja4 ,,hhs ag5cy       
directives4,sec4 #acjb4 ,grants to gr[ &
 div]sify ! p]9atal work=ce4,sec4 #acjc4
 ,grants to gr[ & div]sify ! nurs+      
work=ce 9 mat]nal & p]9atal heal?4,sec4 

#acjd4 ,,gao report4,subtitle ,e--,data 
to save moms,sec4 #adja4 ,fund+ =       
mat]nal mortality review committees to  
promote repres5tative community         
engagem5t4,sec4 #adjb4 ,data collection 
& review4,sec4 #adjc4 ,review ( mat]nal 
heal? data collection processes &       
quality measures4,sec4 #adjd4 ,indian   
,heal? ,s]vice /udy on mat]nal mortality
 & sev]e mat]nal morbidity4,sec4 #adje4 
,grants to m9ority-s]v+ in/itutions to  
/udy mat]nal mortality1 sev]e mat]nal   
morbidity1 & o!r adv]se mat]nal heal?   
outcomes4,subtitle ,f--,moms matter,sec4
 #aeja4 ,mat]nal m5tal heal? equity     
grant program4,sec4 #aejb4 ,grants to   
gr[ & div]sify ! mat]nal m5tal &        
behavioral heal? c>e work=ce4,subtitle  
,g--,ju/ice = inc>c]at$ moms,sec4 #afja4
 ,end+ ! %ackl+ ( pregnant              
individuals4,sec4 #afjb4 ,creat+ model  
programs = ! c>e ( inc>c]at$ individuals
 9 ! pr5atal & po/p>tum p]iods4,sec4    
#afjc4 ,grant program to improve mat]nal
 heal? outcomes = individuals 9 ,/ate & 

local prisons & jails4,sec4 #afjd4 ,,gao
 report4,sec4 #afje4 ,,macpac           
report4,subtitle ,h--,te* to save       
moms,sec4 #agja4 ,integrat$ teleheal?   
models 9 mat]nity c>e s]vices4,sec4     
#agjb4 ,grants to exp& ! use (          
te*nology-enabl$ collaborative le>n+ &  
capacity models = pregnant & po/p>tum   
individuals4,sec4 #agjc4 ,grants to     
promote equity 9 mat]nal heal? outcomes 
?r\gh digital tools4,sec4 #agjd4 ,report
 on ! use ( te*nology 9 mat]nity        
c>e4,subtitle ,i--,impact to save       
moms,sec4 #ahja4 ,p]9atal ,c>e          
,alt]native ,paym5t ,model ,demon/ration
 ,project4,sec4 #ahjb4 ,,macpac         
report4,subtitle ,j--,mat]nal heal?     
p&emic response,sec4 #aija4             
,def9itions4,sec4 #aijb4 ,fund+ = data  
collection1 surveillance1 & rese>* on   
mat]nal heal? outcomes dur+ !           
,,covid-#ai public heal? em]g5cy4,sec4  
#aijc4 ,,covid-#ai mat]nal heal? data   
collection & disclosure4,sec4 #aijd4    
,inclusion ( pregnant individuals &     

lactat+ individuals 9 vacc9e & !rapeutic
 developm5t = ,,covid-#ai4,sec4 #aije4  
,public heal? communication reg>d+      
mat]nal c>e dur+ ,,covid-#ai4,sec4      
#aijf4 ,task =ce on bir?+ exp]i5ce &    
safe mat]nity c>e dur+ a public heal?   
em]g5cy4,sec4 #aijg4 ,,gao report on    
mat]nal heal? & public heal? em]g5cy    
prep>$ness4,subtitle ,k--,protect+ moms 
& babies aga9/ climate change,sec4      
#aiaa4 ,def9itions4,sec4 #aiab4 ,grant  
program to protect vuln]able mo!rs &    
babies f climate *ange risks4,sec4      
#aiac4 ,grant program = education &     
tra9+ at heal? pr(ession s*ools4,sec4   
#aiad4 ,,nih ,consortium on ,bir? &     
,climate ,*ange ,rese>*4,sec4 #aiae4    
,/rategy = id5tify+ climate *ange risk  
zones = vuln]able mo!rs &               
babies4,subtitle ,l--,mat]nal           
vaccinations,sec4 #aiba4 ,mat]nal       
vacc9ation aw>5ess & equity             
campaign4,title ,,ii--,*ildr5's ,heal?  
,insurance ,program ,permanency,sec4    
#bjja4 ,p]man5t ext5sion ( *ildr5's     

heal? insurance program4,sec4 #bjjb4    
,p]man5t ext5sions ( o!r programs &     
demon/ration projects4,sec4 #bjjc4 ,/ate
 option to increase *ildr5's eligibility
 = ,m$icaid & ,,*ip4,title              
,,iii--,family & ,m$ical ,leave,sec4    
#cjja4 ,def9itions4,sec4 #cjjb4 ,(fice (
 ,paid ,family & ,m$ical ,leave4,sec4   
#cjjc4 ,family & ,m$ical ,leave         
,insurance b5efit paym5ts4,sec4 #cjjd4  
,e/abli%m5t ( ,family & ,m$ical ,leave  
,insurance ,tru/ ,fund4,sec4 #cjje4     
,int]nal ,rev5ue ,code provisions4,sec4 
#cjjf4 ,regulations4,sec4 #cjjg4 ,,gao  
,/udy4,title ,,iv--,fully ,refundable   
,*ild ,tax ,credit,sec4 #djja4          
,e/abli%m5t ( fully refundable *ild tax 
cr$it4,sec4 #djjb4 ,paym5ts to          
possessions4,title ,v--,*ild ,c>e ,is   
,infrastructure,sec4 #ejja4             
,infra/ructure grants to improve *ild   
c>e safety4,sec4 #ejjb4 ,e>ly *ildhood  
educator loan assi/ance program4,sec4   
#ejjc4 ,grants = e>ly *ildhood          
educators4,sec4 #ejjd4 ,,ccampis        

,reau?orization4,sec4 #ejje4 ,evaluation
 ( applications = assi/ance "u ,*oice   
,neighborhoods ,initiative4,title       
,,vi--,honor+ ,family-,fri5dly          
,workplaces,sec4 #fjja4                 
,def9itions4,sec4 #fjjb4 ,c]tification  
program e/abli%$4,title ,,vii--,mo!rs & 
,(fspr+ ,mortality & ,morbidity         
,awareness,sec4 #gjja4 ,improv+ ,f$]al  
ef=ts ) respect to prev5tion ( mat]nal  
mortality4,sec4 #gjjb4 ,increas+ excise 
taxes on cig>ettes & e/abli%+ excise tax
 equity among all tobacco product tax   
rates4  ,i ,black ,mat]nal ,heal?       
,momnibus  #ajjj4 ,def9itions2 s5se (   
,congress  7a7 ,def9itions ,9 ?is title3
 7#a7 ,culturally congru5t ,! t]m       
culturally congru5t1 ) respect to c>e or
 mat]nity c>e1 means c>e t is 9 agreem5t
 ) ! pref]r$ cultural values1 beliefs1  
worldview1 language1 & practices ( !    
heal? c>e consum] & o!r /akehold]s4     
7#b7 ,mat]nity c>e provid] ,! t]m       
mat]nity c>e provid] means a heal? c>e  
provid] :o-- 7,a7 is a physician1       

physician assi/ant1 midwife :o meets at 
a m9imum ! int]national def9ition ( !   
midwife & global /&>ds = midwif]y       
education z e/abli%$ by ! ,int]national 
,conf$]ation ( ,midwives1 nurse         
practition]1 or cl9ical nurse speciali/2
 &  7,b7 has a focus on mat]nal or      
p]9atal heal?4  7#c7 ,mat]nal mortality 
,! t]m mat]nal mortality means a dea?   
occurr+ dur+ or )9 a "o-ye> p]iod aft]  
pregnancy1 caus$ by pregnancy-relat$ or 
*ildbir? complications1 includ+ a       
suicide1 ov]dose1 or o!r dea? result+ f 
a m5tal heal? or sub/ance use disord]   
attribut$ to or aggravat$ by            
pregnancy-relat$ or *ildbir?            
complications4  7#d7 ,p]9atal heal?     
work] ,! t]m p]9atal heal? work] means a
 d\la1 community heal? work]1 pe]       
support]1 brea/fe$+ & lactation educator
 or c\nselor1 nutritioni/ or dietitian1 
*ildbir? educator1 social work]1 home   
visitor1 language int]pret]1 or         
navigator4  7#e7 ,po/p>tum & po/p>tum   
p]iod ,! t]ms po/p>tum & po/p>tum p]iod 

ref] to ! #a-ye> p]iod beg9n+ on ! la/  
day ( ! pregnancy ( an individual4  7#f7
 ,pregnancy-associat$ dea? ,! t]m       
pregnancy-associat$ dea? means a dea? ( 
a pregnant or po/p>tum individual1 by   
any cause1 t occurs dur+1 or )9 #a ye>  
foll[+1 ! individual's pregnancy1       
reg>dless ( ! outcome1 duration1 or site
 ( ! pregnancy4  7#g7 ,pregnancy-relat$ 
dea? ,! t]m pregnancy-relat$ dea? means 
a dea? ( a pregnant or po/p>tum         
individual t occurs dur+1 or )9 #a ye>  
foll[+1 ! individual's pregnancy1 f a   
pregnancy complication1 a *a9 ( ev5ts   
initiat$ by pregnancy1 or ! aggravation 
( an unrelat$ condition by ! physiologic
 effects ( pregnancy4  7#h7 ,racial &   
e?nic m9ority gr\p ,! t]m racial & e?nic
 m9ority gr\p has ! mean+ giv5 su* t]m 9
 section #agjg7;g77#a7 ( ! ,public      
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjju-#f7;g77#a774  7#i7 ,sev]e mat]nal 
morbidity ,! t]m sev]e mat]nal morbidity
 means a heal? condition1 includ+ m5tal 
heal? conditions & sub/ance use         

disord]s1 attribut$ to or aggravat$ by  
pregnancy or *ildbir? t results 9       
significant %ort-t]m or long-t]m        
consequ5ces to ! heal? ( ! individual :o
 0 pregnant4  7#aj7 ,social det]m9ants (
 mat]nal heal? def9$ ,! t]m social      
det]m9ants ( mat]nal heal? means        
non-cl9ical factors t impact mat]nal    
heal? outcomes1 includ+-- 7,a7 economic 
factors1 :i* may include pov]ty1        
employm5t1 food security1 support = &   
access to lactation & o!r infant fe$+   
options1 h\s+ /ability1 & relat$        
factors2  7,b7 neighborhood factors1 :i*
 may include quality ( h\s+1 access to  
transportation1 access to *ild c>e1     
availability ( heal?y foods & nutrition 
c\nsel+1 availability ( clean wat]1 air 
& wat] quality1 ambi5t temp]atures1     
neighborhood crime & viol5ce1 access to 
broadb&1 & relat$ factors2  7,c7 social 
& community factors1 :i* may include    
sy/emic racism1 g5d] discrim9ation or   
discrim9ation bas$ on o!r protect$      
classes1 workplace conditions1          

inc>c]ation1 & relat$ factors2  7,d7    
h\sehold factors1 :i* may include       
ability to conduct lead te/+ & abatem5t1
 c> seat in/allation1 indoor air        
temp]atures1 & relat$ factors2  7,e7    
education access & quality factors1 :i* 
may include educational atta9m5t1       
language & lit]acy1 & relat$ factors2 & 
7,f7 heal? c>e access factors1 includ+  
heal? insurance cov]age1 access to      
culturally congru5t heal? c>e s]vices1  
provid]s1 & non-cl9ical support1 access 
to home visit+ s]vices1 access to       
wellness & /ress managem5t programs1    
heal? lit]acy1 access to teleheal? &    
items requir$ to receive teleheal?      
s]vices1 & relat$ factors4  7b7 ,s5se ( 
,congress ,x is ! s5se ( ,congress t--  
7#a7 ! respect & prop] c>e t bir?+ p    
des]ve is inclusive2 &  7#b7 reg>dless (
 race1 e?nicity1 g5d] id5tity1 sexual   
ori5tation1 religion1 m>ital /atus1     
familial /atus1 socioeconomic /atus1    
immigration /atus1 inc>c]ation /atus1 or
 disability1 all des]ve dignity4  ,a    

,social det]m9ants = moms  #ajja4 ,task 
=ce to develop a /rategy to address     
social det]m9ants ( mat]nal heal?  7a7  
,9 g5]al ,! ,secret>y ( ,heal? & ,human 
,s]vices %all conv5e a task =ce 79 ?is  
section ref]r$ to z ! ,task ,=ce7 to    
develop a /rategy to coord9ate ef=ts    
betwe5 ,f$]al ag5cies to address social 
det]m9ants ( mat]nal heal? ) respect to 
pregnant & po/p>tum individuals4  7b7   
,ex (ficio memb]s ,! ex (ficio memb]s ( 
! ,task ,=ce %all consi/ ( ! foll[+3    
7#a7 ,! ,secret>y ( ,heal? & ,human     
,s]vices 7or a designee !re(74  7#b7 ,! 
,secret>y ( ,h\s+ & ,urban ,developm5t  
7or a designee !re(74  7#c7 ,! ,secret>y
 ( ,transportation 7or a designee !re(74
  7#d7 ,! ,secret>y ( ,agriculture 7or a
 designee !re(74  7#e7 ,! ,secret>y (   
,labor 7or a designee !re(74  7#f7 ,!   
,adm9i/rator ( ! ,environm5tal          
,protection ,ag5cy 7or a designee !re(74
  7#g7 ,! ,assi/ant ,secret>y = !       
,adm9i/ration = ,*ildr5 & ,families 7or 
a designee !re(74  7#h7 ,! ,adm9i/rator 

( ! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices 
7or a designee !re(74  7#i7 ,! ,director
 ( ! ,indian ,heal? ,s]vice 7or a       
designee !re(74  7#aj7 ,! ,director ( ! 
,national ,in/itutes ( ,heal? 7or a     
designee !re(74  7#aa7 ,! ,adm9i/rator (
 ! ,heal? ,res\rces & ,s]vices          
,adm9i/ration 7or a designee !re(74     
7#ab7 ,! ,deputy ,assi/ant ,secret>y =  
,m9ority ,heal? ( ! ,dep>tm5t ( ,heal? &
 ,human ,s]vices 7or a designee !re(74  
7#ac7 ,! ,deputy ,assi/ant ,secret>y =  
,wom5's ,heal? ( ! ,dep>tm5t ( ,heal? & 
,human ,s]vices 7or a designee !re(74   
7#ad7 ,! ,director ( ! ,c5t]s = ,disease
 ,control & ,prev5tion 7or a designee   
!re(74  7#ae7 ,! ,director ( ! ,(fice on
 ,viol5ce ,aga9/ ,wom5 at ! ,dep>tm5t ( 
,ju/ice 7or a designee !re(74  7c7      
,appo9t$ memb]s ,9 addition to ! ex     
(ficio memb]s ( ! ,task ,=ce1 !         
,secret>y ( ,heal? & ,human ,s]vices    
%all appo9t ! foll[+ memb]s ( ! ,task   
,=ce3 7#a7 ,at lea/ two repres5tatives (
 pati5ts1 to include-- 7,a7 a           

repres5tative ( pati5ts :o h suff]$ f   
sev]e mat]nal morbidity2 or  7,b7 a     
repres5tative ( pati5ts :o is a family  
memb] ( an individual :o suff]$ a       
pregnancy-relat$ dea?4  7#b7 ,at lea/   
two lead]s ( community-bas$             
organizations t address mat]nal         
mortality & sev]e mat]nal morbidity ) a 
specific focus on racial & e?nic        
disp>ities4 ,9 appo9t+ su* lead]s "u ?is
 p>agraph1 ! ,secret>y ( ,heal? & ,human
 ,s]vices %all give priority to         
individuals :o are lead]s (             
organizations l$ by individuals f racial
 & e?nic m9ority gr\ps4  7#c7 ,at lea/  
two p]9atal heal? work]s4  7#d7 ,a      
pr(essionally div]se panel ( mat]nity   
c>e provid]s4  7d7 ,*air ,! ,secret>y ( 
,heal? & ,human ,s]vices %all select !  
*air ( ! ,task ,=ce f among ! memb]s ( !
 ,task ,=ce4  7e7 ,report ,n lat] ?an #b
 ye>s aft] ! date ( ! enactm5t ( ?is    
,act1 ! ,task ,=ce %all submit to       
,congress a report on-- 7#a7 ! /rategy  
develop$ "u subsection 7a72  7#b7       

recomm5dations on fund+ am\nts ) respect
 to implem5t+ su* /rategy2 &  7#c7      
recomm5dations = h[ to exp& cov]age (   
social s]vices to address social        
det]m9ants ( mat]nal heal? "u ,m$icaid  
manag$ c>e organizations & ,/ate        
,m$icaid programs4  7f7 ,t]m9ation      
,section #ad ( ! ,f$]al ,advisory       
,committee ,act 7#e ,u4,s4,c4 ,app47    
%all n apply to ! ,task ,=ce ) respect  
to t]m9ation4  #ajjb4 ,h\s+ = ,moms     
grant program  7a7 ,9 g5]al ,! ,secret>y
 ( ,h\s+ & ,urban ,developm5t %all      
e/abli% a ,h\s+ = ,moms grant program "u
 ?is section to make grants to eligible 
entities to increase access to safe1    
/able1 af=dable1 & adequate h\s+ =      
pregnant & po/p>tum individuals & _!    
families4  7b7 ,application ,to be      
eligible to receive a grant "u ?is      
section1 an eligible entity %all submit 
to ! ,secret>y an application at su* "t1
 9 su* mann]1 & conta9+ su* in=mation z 
! ,secret>y may provide4  7c7 ,priority 
,9 aw>d+ grants "u ?is section1 !       

,secret>y %all give priority to an      
eligible entity t-- 7#a7 is a           
community-bas$ organization or w p>tn] )
 a community-bas$ organization to       
implem5t initiatives to increase access 
to safe1 /able1 af=dable1 & adequate    
h\s+ = pregnant & po/p>tum individuals &
 _! families2  7#b7 is op]at+ 9 an area 
) high rates ( adv]se mat]nal heal?     
outcomes or significant racial or e?nic 
disp>ities 9 mat]nal heal? outcomes1 to 
! ext5t su* data are available2 &  7#c7 
is op]at+ 9 an area ) a high pov]ty rate
 or significant numb] ( individuals :o  
lack consi/5t access to safe1 /able1    
af=dable1 & adequate h\s+4  7d7 ,use (  
funds ,an eligible entity t receives a  
grant "u ?is section %all use funds "u !
 grant = ! purposes (-- 7#a7 id5tify+ & 
conduct+ outrea* to pregnant & po/p>tum 
individuals :o are l[-income & lack     
consi/5t access to safe1 /able1         
af=dable1 & adequate h\s+2  7#b7 provid+
 safe1 /able1 af=dable1 & adequate h\s+ 
options to su* individuals2  7#c7       

connect+ su* individuals ) local        
organizations (f]+ safe1 /able1         
af=dable1 & adequate h\s+ options2  7#d7
 provid+ application assi/ance to su*   
individuals seek+ to enroll 9 programs  
(f]+ safe1 /able1 af=dable1 & adequate  
h\s+ options2  7#e7 provid+ direct      
f9ancial assi/ance to su* individuals = 
! purposes ( ma9ta9+ safe1 /able1 &     
adequate h\s+ = ! duration ( !          
individual's pregnancy & po/p>tum       
p]iods2 &  7#f7 work+ ) relevant        
/akehold]s to ensure t local h\s+ &     
homeless %elt] infra/ructure is         
supportive to pregnant & po/p>tum       
individuals1 includ+ ?r\gh-- 7,a7       
heal?-promot+ h\s+ codes2  7,b7 en=cem5t
 ( h\s+ codes2  7,c7 proactive r5tal    
inspection programs2  7,d7 code en=cem5t
 (fic] tra9+2 &  7,e7 p>tn]%ips betwe5  
regional (fices ( ! ,dep>tm5t ( ,h\s+ & 
,urban ,developm5t & community-bas$     
organizations to ensure h\s+ laws are   
und]/ood & violations are discov]$4  7e7
 ,report+  7#a7 ,eligible entities ,!   

,secret>y %all require ea* eligible     
entity receiv+ a grant "u ?is section to
 annually submit to ! ,secret>y & make  
publicly available a report on ! /atus (
 activities conduct$ us+ ! grant4  7#b7 
,secret>y ,n lat] ?an ! end ( ea* fiscal
 ye> 9 :i* grants are made "u ?is       
section1 ! ,secret>y %all submit to !   
,congress & make publicly available a   
report t-- 7,a7 summ>izes ! reports     
receiv$ "u p>agraph 7#a72  7,b7         
evaluates ! effectiv5ess ( grants aw>d$ 
"u ?is section 9 increas+ access to     
safe1 /able1 af=dable1 & adequate h\s+ =
 pregnant & po/p>tum individuals & _!   
families2 &  7,c7 makes recomm5dations )
 respect to ensur+ activities describ$  
subsection 7d7 cont9ue aft] grant am\nts
 made available "u ?is section are      
exp5d$4  7f7 ,def9itions ,9 ?is section3
 7#a7 ,eligible entity ,! t]m eligible  
entity means-- 7,a7 a community-bas$    
organization2  7,b7 a ,/ate or local    
gov]nm5tal entity1 includ+ a ,/ate or   
local public heal? dep>tm5t2  7,c7 an   

,indian tribe or tribal organization 7z 
su* t]ms are def9$ 9 section #d ( !     
,indian ,self-,det]m9ation & ,education 
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd772 
or  7,d7 an ,urban ,indian organization 
7z su* t]m is def9$ 9 section #d ( !    
,indian ,heal? ,c>e ,improvem5t ,act    
7#be ,u4,s4,c4 #afjc774  7#b7 ,secret>y 
,! t]m ,secret>y means ! ,secret>y (    
,h\s+ & ,urban ,developm5t4  7g7        
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section #aj1jjj1jjj = fiscal ye>    
#bjbc1 :i* %all rema9 available until   
exp5d$4  #ajjc4 ,dep>tm5t (             
,transportation  7a7 ,report ,n lat] ?an
 "o ye> aft] ! date ( enactm5t ( ?is    
,act1 ! ,secret>y ( ,transportation %all
 submit to ,congress & make publicly    
available a report conta9+-- 7#a7 an    
assessm5t ( transportation b>ri]s       
prev5t+ individuals f att5d+ pr5atal &  
po/p>tum appo9tm5ts1 access+ mat]nal    
heal? c>e s]vices1 or access+ s]vices & 
res\rces relat$ to social det]m9ants    

mat]nal ( heal?2  7#b7 recomm5dations on
 h[ to ov]come ! b>ri]s assess$ "u      
p>agraph 7#a72 &  7#c7 an assessm5t (   
transportation safety risks = pregnant  
individuals & recomm5dations on h[ to   
mitigate su* risks4  7b7 ,consid]ations 
,9 c>ry+ out subsection 7a71 ! ,secret>y
 %all give special consid]ation to      
solutions =-- 7#a7 pregnant & po/p>tum  
individuals liv+ 9 a heal? pr(essional  
%ortage area designat$ "u section #ccb (
 ! ,public ,heal? ,s]vice ,act 7#db     
,u4,s4,c4 #bed;e72  7#b7 pregnant &     
po/p>tum individuals liv+ 9 areas ) high
 mat]nal mortality or sev]e morbidity   
rates or significant racial or e?nic    
disp>ities 9 mat]nal heal? outcomes2 or 
7#c7 pregnant & po/p>tum individuals ) a
 disability t impacts mobility4  #ajjd4 
,dep>tm5t ( ,agriculture  7a7 ,special  
supplem5tal nutrition program  7#a7     
,ext5sion ( po/p>tum p]iod ,section     
#ag7;b77#aj7 ( ! ,*ild ,nutrition ,act (
 #aiff 7#db ,u4,s4,c4 #aghf7;b77#aj77 is
 am5d$ by /rik+ six mon?s & ins]t+ #bd  

mon?s4  7#b7 ,ext5sion ( brea/fe$+ p]iod
 ,section #ag7;d77#c77;,a77ii7 ( ! ,*ild
 ,nutrition ,act ( #aiff 7#g ,u4,s4,c4  
#adca7;d77#c77;,a77ii77 is am5d$ by     
/rik+ #a ye> & ins]t+ #bd mon?s4  7#c7  
,report ,n lat] ?an #b ye>s aft] ! date 
( ! enactm5t ( ?is section1 ! ,secret>y 
%all submit to ,congress a report t     
includes an evaluation ( ! effect ( ea* 
( ! am5dm5ts made by ?is subsection on--
 7,a7 mat]nal & infant heal? outcomes1  
includ+ racial & e?nic disp>ities )     
respect to su* outcomes2  7,b7 brea/fe$+
 rates among po/p>tum individuals2  7,c7
 qualitative evaluations ( family       
exp]i5ces "u ! special supplem5tal      
nutrition program "u section #ag ( !    
,*ild ,nutrition ,act ( #aiff 7#db      
,u4,s4,c4 #aghf72 &  7,d7 o!r relevant  
in=mation z det]m9$ by ! ,secret>y4  7b7
 ,grant program = heal?y food & clean   
wat] = pregnant & po/p>tum individuals  
7#a7 ,9 g5]al ,! ,secret>y %all e/abli% 
a program to aw>d grants1 on a          
competitive basis1 to eligible entities 

to c>ry out ! activities describ$ 9     
p>agraph 7#d74  7#b7 ,application ,to be
 eligible = a grant "u ?is subsection1  
an eligible entity %all submit to !     
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y det]m9es appropriate4  7#c7   
,priority ,9 aw>d+ grants "u ?is        
subsection1 ! ,secret>y %all give       
priority to an eligible entity t-- 7,a7 
is1 or w p>tn] )1 a community-bas$      
organization2 &  7,b7 is op]at+ 9 an    
area ) high rates (-- 7i7 adv]se mat]nal
 heal? outcomes2 or  7ii7 significant   
racial or e?nic disp>ities 9 mat]nal    
heal? outcomes4  7#d7 ,use ( funds ,an  
eligible entity %all use grant funds    
aw>d$ "u ?is subsection to deliv] heal?y
 food1 infant =mula1 clean wat]1 or     
diap]s to pregnant & po/p>tum           
individuals locat$ 9 areas t are food   
des]ts1 z det]m9$ by ! ,secret>y us+    
data f ! ,food ,access ,rese>* ,atlas ( 
! ,dep>tm5t ( ,agriculture4  7#e7       
,reports  7,a7 ,eligible entity ,n lat] 

?an #a ye> aft] an eligible entity fir/ 
receives a grant "u ?is subsection1 &   
annually !reaft]1 an eligible entity    
%all submit to ! ,secret>y a report on !
 /atus ( activities conduct$ us+ !      
grant1 :i* %all conta9 su* in=mation z !
 ,secret>y may require4  7,b7 ,secret>y 
7i7 ,9 g5]al ,n lat] ?an #b ye>s aft] ! 
date on :i* ! fir/ grant is aw>d$ "u ?is
 subsection1 ! ,secret>y %all submit to 
,congress a report t includes-- 7,i7 a  
summ>y ( ! reports submitt$ "u          
subp>agraph 7,a72  7,,ii7 an assessm5t (
 ! ext5t to :i* food di/ribut$ ?r\gh !  
grant program 0 pur*as$ f local &       
regional food sy/ems2  7,,iii7 an       
evaluation ( ! effect ( ! grant program 
"u ?is subsection on mat]nal & infant   
heal? outcomes1 includ+ racial & e?nic  
disp>ities ) respect to su* outcomes2 & 
7,,iv7 recomm5dations ) respect to      
ensur+ ! activities describ$ 9 p>agraph 
7#d7 cont9ue aft] ! grant p]iod fund+   
su* activities expires4  7ii7           
,publication ,! ,secret>y %all make !   

report submitt$ "u clause 7i7 publicly  
available on ! website ( ! ,dep>tm5t (  
,agriculture4  7#f7 ,au?orization (     
appropriations ,!re are au?oriz$ to be  
appropriat$ #e1jjj1jjj to c>ry out ?is  
subsection = fiscal ye>s #bjbc ?r\gh    
#bjbe4  7c7 ,def9itions ,9 ?is section3 
7#a7 ,eligible entity ,! t]m eligible   
entity means-- 7,a7 a community-bas$    
organization2  7,b7 a ,/ate or local    
gov]nm5tal entity1 includ+ a ,/ate or   
local public heal? dep>tm5t2  7,c7 an   
,indian tribe or tribal organization 7z 
su* t]ms are def9$ 9 section #d ( !     
,indian ,self-,det]m9ation & ,education 
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd772 
or  7,d7 an ,urban ,indian organization 
7z su* t]m is def9$ 9 section #d ( !    
,indian ,heal? ,c>e ,improvem5t ,act    
7#be ,u4,s4,c4 #afjc774  7#b7 ,secret>y 
,! t]m ,secret>y means ! ,secret>y (    
,agriculture4  #ajje4 ,environm5tal /udy
 ?r\gh ,national ,academies  7a7 ,9     
g5]al ,! ,adm9i/rator ( ! ,environm5tal 
,protection ,ag5cy %all seek to ent] an 

agreem5t1 n lat] ?an #fj days aft] !    
date ( enactm5t ( ?is ,act1 ) !         
,national ,academies ( ,sci5ces1        
,eng9e]+1 & ,m$ic9e 7ref]r$ to 9 ?is    
section z ! ,national ,academies7 "u :i*
 ! ,national ,academies agree to conduct
 a /udy on ! impacts ( wat] & air       
quality1 exposure to extreme            
temp]atures1 environm5tal *emicals1     
environm5tal risks 9 ! workplace & !    
home1 & pollution levels1 on mat]nal &  
infant heal? outcomes4  7b7 ,/udy       
requirem5ts ,! agreem5t "u subsection   
7a7 %all direct ! ,national ,academies  
to make recomm5dations =-- 7#a7 improv+ 
environm5tal conditions to improve      
mat]nal & infant heal? outcomes2 &  7#b7
 r$uc+ or elim9at+ racial & e?nic       
disp>ities 9 su* outcomes4  7c7 ,report 
,! agreem5t "u subsection 7a7 %all      
direct ! ,national ,academies to        
complete ! /udy "u ?is section1 &       
transmit to ! ,congress & make publicly 
available a report on ! results ( !     
/udy1 n lat] ?an #ab mon?s aft] ! date (

 enactm5t ( ?is ,act4  #ajjf4 ,*ild c>e 
access  7a7 ,grant program ,! ,secret>y 
( ,heal? & ,human ,s]vices 79 ?is       
section ref]r$ to z ! ,secret>y7 %all   
aw>d grants to eligible organizations to
 provide pregnant & po/p>tum individuals
 ) free & accessible drop-9 *ild c>e    
s]vices dur+ pr5atal & po/p>tum         
appo9tm5ts4  7b7 ,application ,to be    
eligible to receive a grant "u ?is      
section1 an eligible entity %all submit 
to ! ,secret>y an application at su* "t1
 9 su* mann]1 & conta9+ su* in=mation z 
! ,secret>y may require4  7c7 ,eligible 
organizations  7#a7 ,eligibility ,to be 
eligible to receive a grant "u ?is      
section1 an organization %all be an     
organization t provides *ild c>e s]vices
 & c c>ry out programs provid+ pregnant 
& po/p>tum individuals ) free &         
accessible drop-9 *ild c>e s]vices dur+ 
pr5atal & po/p>tum appo9tm5ts4  7#b7    
,prioritization ,9 select+ grant        
recipi5ts "u ?is section1 ! ,secret>y   
%all give priority to eligible          

organizations t op]ate 9 an area ) high 
rates ( adv]se mat]nal heal? outcomes or
 significant racial or e?nic disp>ities 
9 mat]nal heal? outcomes1 to ! ext5t su*
 data are available4  7d7 ,tim+ ,!      
,secret>y %all comm5ce ! grant program  
"u subsection 7a7 n lat] ?an #a ye> aft]
 ! date ( enactm5t ( ?is ,act4  7e7     
,report+  7#a7 ,grantees ,ea* recipi5t (
 a grant "u ?is section %all annually   
submit to ! ,secret>y & make publicly   
available a report on ! /atus (         
activities conduct$ us+ ! grant4 ,ea*   
su* report %all include-- 7,a7 an       
analysis ( ! effect ( ! fund$ program on
 pr5atal & po/p>tum appo9tm5t att5dance 
rates2  7,b7 summ>ies ( qualitative     
assessm5ts ( ! fund$ program f-- 7i7    
pregnant & po/p>tum individuals         
p>ticipat+ 9 ! program2 &  7ii7 !       
families ( su* individuals2 &  7,c7 su* 
additional in=mation z ! ,secret>y may  
require4  7#b7 ,secret>y ,n lat] ?an !  
end ( fiscal ye> #bjbe1 ! ,secret>y %all
 submit to ! ,congress & make publicly  

available a report conta9+ ! foll[+3    
7,a7 ,a summ>y ( ! reports "u p>agraph  
7#a74  7,b7 ,an assessm5t ( ! effects1  
if any1 ( ! fund$ programs on mat]nal   
heal? outcomes1 ) a specific focus on   
racial & e?nic disp>ities 9 su*         
outcomes4  7,c7 ,a description ( actions
 ! ,secret>y c take to ensure t pregnant
 & po/p>tum individuals eligible =      
m$ical assi/ance "u a ,/ate plan "u     
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #aicf et seq47 h access  
to free & accessible drop-9 *ild c>e    
s]vices dur+ pr5atal & po/p>tum         
appo9tm5ts1 includ+ id5tification ( !   
fund+ necess>y to c>ry out su* actions4 
7f7 ,drop-,9 *ild c>e s]vices def9$ ,9  
?is section1 ! t]m drop-9 *ild c>e      
s]vices means *ild c>e & e>ly *ildhood  
education s]vices t are-- 7#a7 deliv]$  
at a facility t meets ! requirem5ts (   
all applicable laws & regulations ( !   
,/ate or local gov]nm5t 9 :i* x is      
locat$1 includ+ ! lic5s+ ( ! facility z 
a *ild c>e facility2 &  7#b7 provid$ 9  

s+le enc\nt]s )\t requir+ full-"t       
enrollm5t ( a p]son 9 a *ild c>e        
program4  7g7 ,au?orization (           
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#e1jjj1jjj = ! p]iod ( fiscal ye>s #bjbc
 ?r\gh #bjbe4  #ajjg4 ,grants to local  
entities address+ social det]m9ants (   
mat]nal heal?  7a7 ,9 g5]al ,! ,secret>y
 ( ,heal? & ,human ,s]vices 79 ?is      
section ref]r$ to z ! ,secret>y7 %all   
aw>d grants to eligible entities to--   
7#a7 address social det]m9ants ( mat]nal
 heal? = pregnant & po/p>tum            
individuals2 &  7#b7 elim9ate racial &  
e?nic disp>ities 9 mat]nal heal?        
outcomes4  7b7 ,application ,to be      
eligible to receive a grant "u ?is      
subsection an eligible entity %all      
submit to ! ,secret>y an application at 
su* "t1 9 su* mann]1 & conta9+ su*      
in=mation z ! ,secret>y may provide4    
7c7 ,prioritization ,9 aw>d+ grants "u  
subsection 7a71 ! ,secret>y %all give   
priority to an eligible entity t-- 7#a7 

is1 or w p>tn] )1 a community-bas$      
organization to c>ry+ out ! activities  
"u subsection 7d72  7#b7 is op]at+ 9 an 
area ) high rates ( adv]se mat]nal heal?
 outcomes or significant racial or e?nic
 disp>ities 9 mat]nal heal? outcomes2 & 
7#c7 is op]at+ 9 an area ) a high pov]ty
 rate4  7d7 ,activities ,an eligible    
entity t receives a grant "u ?is section
 may-- 7#a7 hire & reta9 /aff2  7#b7    
develop & di/ribute a li/ ( available   
res\rces ) respect to social s]vice     
programs 9 a community2  7#c7 e/abli% a 
res\rce c5t] t provides multiple social 
s]vice programs 9 a s+le location2  7#d7
 (f] programs & res\rces 9 ! communities
 9 :i* ! respective eligible entities   
are locat$ to address social det]m9ants 
( heal? = pregnant & po/p>tum           
individuals2 &  7#e7 consult ) su*      
pregnant & po/p>tum individuals to      
conduct an assessm5t ( ! activities "u  
?is subsection4  7e7 ,te*nical assi/ance
 ,! ,secret>y %all provide to grant     
recipi5ts "u ?is section te*nical       

assi/ance to plan = su/a9+ programs to  
address social det]m9ants ( mat]nal     
heal? among pregnant & po/p>tum         
individuals aft] ! p]iod ( ! grant4  7f7
 ,report+  7#a7 ,grantees ,n lat] ?an #a
 ye> aft] an eligible entity fir/       
receives a grant "u ?is section1 &      
annually !reaft]1 an eligible entity    
%all submit to ! ,secret>y1 & make      
publicly available1 a report on ! /atus 
( activities conduct$ us+ ! grant4 ,ea* 
su* report %all include data on !       
effects ( su* activities1 disaggregat$  
by race1 e?nicity1 g5d]1 & o!r relevant 
factors4  7#b7 ,secret>y ,n lat] ?an !  
end ( fiscal ye> #bjbg1 ! ,secret>y %all
 submit to ,congress a report t         
includes-- 7,a7 a summ>y ( ! reports "u 
p>agraph 7#a72 &  7,b7 recomm5dations   
=-- 7i7 improv+ mat]nal heal? outcomes2 
&  7ii7 r$uc+ or elim9at+ racial & e?nic
 disp>ities 9 mat]nal heal? outcomes4   
7g7 ,au?orization ( appropriations ,!re 
is au?oriz$ to be appropriat$ to c>ry   
out ?is section #ae1jjj1jjj = ea* (     

fiscal ye>s #bjbc ?r\gh #bjbg4  ,b      
,honor+ ,kira ,johnson  #aaja4          
,inve/m5ts 9 community-bas$             
organizations to improve ,black mat]nal 
heal? outcomes  7a7 ,aw>ds ,foll[+ !    
#a-ye> p]iod describ$ 9 subsection 7c71 
! ,secret>y ( ,heal? & ,human ,s]vices  
79 ?is section ref]r$ to z ! ,secret>y7 
%all aw>d grants to eligible entities to
 e/abli% or exp& programs to prev5t     
mat]nal mortality & sev]e mat]nal       
morbidity among ,black pregnant &       
po/p>tum individuals4  7b7 ,eligibility 
,to be eligible to seek a grant "u ?is  
section1 an entity %all be a            
community-bas$ organization (f]+        
programs & res\rces align$ )            
evid5ce-bas$ practices = improv+ mat]nal
 heal? outcomes = ,black pregnant &     
po/p>tum individuals4  7c7 ,outrea* &   
te*nical assi/ance p]iod ,dur+ ! #a-ye> 
p]iod beg9n+ on ! date ( enactm5t ( ?is 
,act1 ! ,secret>y %all-- 7#a7 conduct   
outrea* to enc\rage eligible entities to
 apply = grants "u ?is section2 &  7#b7 

provide te*nical assi/ance to eligible  
entities on be/ practices = apply+ =    
grants "u ?is section4  7d7 ,special    
consid]ation  7#a7 ,outrea* ,9 conduct+ 
outrea* "u subsection 7c71 ! ,secret>y  
%all give special consid]ation to       
eligible entities t-- 7,a7 are bas$ 91 &
 provide support =1 communities ) high  
rates ( adv]se mat]nal heal? outcomes or
 significant racial & e?nic disp>ities 9
 mat]nal heal? outcomes1 to ! ext5t su* 
data are available2  7,b7 are l$ by     
,black wom52 &  7,c7 (f] programs &     
res\rces t are align$ ) evid5ce-bas$    
practices = improv+ mat]nal heal?       
outcomes = ,black pregnant & po/p>tum   
individuals4  7#b7 ,aw>ds ,9 aw>d+      
grants "u ?is section1 ! ,secret>y %all 
give special consid]ation to eligible   
entities t-- 7,a7 are describ$ 9        
subp>agraphs 7,a71 7,b71 & 7,c7 (       
p>agraph 7#a72  7,b7 (f] programs &     
res\rces design$ 9 consultation ) &     
int5d$ = ,black pregnant & po/p>tum     
individuals2 &  7,c7 (f] programs &     

res\rces 9 ! communities 9 :i* !        
respective eligible entities are locat$ 
t-- 7i7 promote mat]nal m5tal heal? &   
mat]nal sub/ance use disord] treatm5ts &
 supports t are align$ ) evid5ce-bas$   
practices = improv+ mat]nal m5tal &     
behavioral heal? outcomes = ,black      
pregnant & po/p>tum individuals2  7ii7  
address social det]m9ants ( mat]nal     
heal? = pregnant & po/p>tum individuals2
  7iii7 promote evid5ce-bas$ heal?      
lit]acy & pregnancy1 *ildbir?1 & p>5t+  
education = pregnant & po/p>tum         
individuals2  7iv7 provide support f    
p]9atal heal? work]s to pregnant &      
po/p>tum individuals2  7v7 provide      
culturally congru5t tra9+ to p]9atal    
heal? work]s2  7vi7 conduct or support  
rese>* on mat]nal heal? issues          
disproportionately impact+ ,black       
pregnant & po/p>tum individuals2  7vii7 
provide support to family memb]s (      
individuals :o suff]$ a                 
pregnancy-associat$ dea? or             
pregnancy-relat$ dea?2  7viii7 op]ate   

midwif]y practices t provide culturally 
congru5t mat]nal heal? c>e & support1   
includ+ = ! purposes (-- 7,i7 support+  
additional education1 tra9+1 &          
c]tification programs1 includ+ support =
 di/ance le>n+2  7,,ii7 provid+ f9ancial
 support to curr5t & future midwives to 
address education co/s1 debts1 & o!r    
ne$s2  7,,iii7 cl9ical site inve/m5ts2  
7,,iv7 support+ preceptor developm5t    
tra9+s2  7,v7 exp&+ ! midwif]y practice2
 or  7,,vi7 relat$ ne$s id5tifi$ by !   
midwif]y practice & describ$ 9 !        
practice's application2 or  7ix7 h      
develop$ o!r programs & res\rces t      
address community-specific ne$s =       
pregnant & po/p>tum individuals & are   
align$ ) evid5ce-bas$ practices =       
improv+ mat]nal heal? outcomes = ,black 
pregnant & po/p>tum individuals4  7e7   
,te*nical assi/ance ,! ,secret>y %all   
provide to grant recipi5ts "u ?is       
section te*nical assi/ance on-- 7#a7    
capacity build+ to e/abli% or exp&      
programs to prev5t adv]se mat]nal heal? 

outcomes among ,black pregnant &        
po/p>tum individuals2  7#b7 be/         
practices 9 data collection1 measurem5t1
 evaluation1 & report+2 &  7#c7 plann+ =
 su/a9+ programs to prev5t mat]nal      
mortality & sev]e mat]nal morbidity     
among ,black pregnant & po/p>tum        
individuals aft] ! p]iod ( ! grant4  7f7
 ,evaluation ,n lat] ?an ! end ( fiscal 
ye> #bjbg1 ! ,secret>y %all submit to ! 
,congress an evaluation ( ! grant       
program "u ?is section t-- 7#a7 assesses
 ! effectiv5ess ( outrea* ef=ts dur+ !  
application process 9 div]sify+ ! pool (
 grant recipi5ts2  7#b7 makes           
recomm5dations = future outrea* ef=ts to
 div]sify ! pool ( grant recipi5ts =    
,dep>tm5t ( ,heal? & ,human ,s]vices    
grant programs & fund+ opportunities    
relat$ to mat]nal heal?2  7#c7 assesses 
! effectiv5ess ( programs fund$ by      
grants "u ?is section 9 improv+ mat]nal 
heal? outcomes = ,black pregnant &      
po/p>tum individuals1 to ! ext5t        
practicable2 &  7#d7 makes              

recomm5dations = future ,dep>tm5t (     
,heal? & ,human ,s]vices grant programs 
& fund+ opportunities t deliv] fund+ to 
community-bas$ organizations t provide  
programs & res\rces t are align$ )      
evid5ce-bas$ practices = improv+ mat]nal
 heal? outcomes = ,black pregnant &     
po/p>tum individuals4  7g7 ,au?orization
 ( appropriations ,to c>ry out ?is      
section1 !re is au?oriz$ to be          
appropriat$ #aj1jjj1jjj = ea* ( fiscal  
ye>s #bjbc ?r\gh #bjbg4  #aajb4         
,inve/m5ts 9 community-bas$             
organizations to improve mat]nal heal?  
outcomes 9 und]s]v$ communities  7a7    
,aw>ds ,foll[+ ! #a-ye> p]iod describ$ 9
 subsection 7c71 ! ,secret>y ( ,heal? & 
,human ,s]vices 79 ?is section ref]r$ to
 z ! ,secret>y7 %all aw>d grants to     
eligible entities to e/abli% or exp&    
programs to prev5t mat]nal mortality &  
sev]e mat]nal morbidity among und]s]v$  
gr\ps4  7b7 ,eligibility ,to be eligible
 to seek a grant "u ?is section1 an     
entity %all be a community-bas$         

organization (f]+ programs & res\rces   
align$ ) evid5ce-bas$ practices =       
improv+ mat]nal heal? outcomes =        
pregnant & po/p>tum individuals4  7c7   
,outrea* & te*nical assi/ance p]iod     
,dur+ ! #a-ye> p]iod beg9n+ on ! date ( 
enactm5t ( ?is ,act1 ! ,secret>y %all-- 
7#a7 conduct outrea* to enc\rage        
eligible entities to apply = grants "u  
?is section2 &  7#b7 provide te*nical   
assi/ance to eligible entities on be/   
practices = apply+ = grants "u ?is      
section4  7d7 ,special consid]ation     
7#a7 ,outrea* ,9 conduct+ outrea* "u    
subsection 7c71 ! ,secret>y %all give   
special consid]ation to eligible        
entities t-- 7,a7 are bas$ 91 & provide 
support =1 communities ) high rates (   
adv]se mat]nal heal? outcomes or        
significant racial & e?nic disp>ities 9 
mat]nal heal? outcomes1 to ! ext5t su*  
data are available2  7,b7 are l$ by     
individuals f racially1 e?nically1 &    
geographically div]se backgr\nds2 &     
7,c7 (f] programs & res\rces t are      

align$ ) evid5ce-bas$ practices =       
improv+ mat]nal heal? outcomes =        
pregnant & po/p>tum individuals4  7#b7  
,aw>ds ,9 aw>d+ grants "u ?is section1 !
 ,secret>y %all give special            
consid]ation to eligible entities t--   
7,a7 are describ$ 9 subp>agraphs 7,a71  
7,b71 & 7,c7 ( p>agraph 7#a72  7,b7 (f] 
programs & res\rces design$ 9           
consultation ) & int5d$ = pregnant &    
po/p>tum individuals f und]s]v$ gr\ps2 &
  7,c7 (f] programs & res\rces 9 !      
communities 9 :i* ! respective eligible 
entities are locat$ t-- 7i7 promote     
mat]nal m5tal heal? & mat]nal sub/ance  
use disord] treatm5ts & support t are   
align$ ) evid5ce-bas$ practices =       
improv+ mat]nal m5tal & behavioral heal?
 outcomes = pregnant & po/p>tum         
individuals2  7ii7 address social       
det]m9ants ( mat]nal heal? = pregnant & 
po/p>tum individuals2  7iii7 promote    
evid5ce-bas$ heal? lit]acy & pregnancy1 
*ildbir?1 & p>5t+ education = pregnant &
 po/p>tum individuals2  7iv7 provide    

support f p]9atal heal? work]s to       
pregnant & po/p>tum individuals2  7v7   
provide culturally congru5t tra9+ to    
p]9atal heal? work]s2  7vi7 conduct or  
support rese>* on mat]nal heal? outcomes
 & disp>ities2  7vii7 provide support to
 family memb]s ( individuals :o suff]$ a
 pregnancy-associat$ dea? or            
pregnancy-relat$ dea?2  7viii7 op]ate   
midwif]y practices t provide culturally 
congru5t mat]nal heal? c>e & support1   
includ+ = ! purposes (-- 7,i7 support+  
additional education1 tra9+1 &          
c]tification programs1 includ+ support =
 di/ance le>n+2  7,,ii7 provid+ f9ancial
 support to curr5t & future midwives to 
address education co/s1 debts1 & o!r    
ne$s2  7,,iii7 cl9ical site inve/m5ts2  
7,,iv7 support+ preceptor developm5t    
tra9+s2  7,v7 exp&+ ! midwif]y practice2
 or  7,,vi7 relat$ ne$s id5tifi$ by !   
midwif]y practice & describ$ 9 !        
practice's application2 or  7ix7 h      
develop$ o!r programs & res\rces t      
address community-specific ne$s =       

pregnant & po/p>tum individuals & are   
align$ ) evid5ce-bas$ practices =       
improv+ mat]nal heal? outcomes =        
pregnant & po/p>tum individuals4  7e7   
,te*nical assi/ance ,! ,secret>y %all   
provide to grant recipi5ts "u ?is       
section te*nical assi/ance on-- 7#a7    
capacity build+ to e/abli% or exp&      
programs to prev5t adv]se mat]nal heal? 
outcomes among pregnant & po/p>tum      
individuals f und]s]v$ gr\ps2  7#b7 be/ 
practices 9 data collection1 measurem5t1
 evaluation1 & report+2 &  7#c7 plann+ =
 su/a9+ programs to prev5t mat]nal      
mortality & sev]e mat]nal morbidity     
among pregnant & po/p>tum individuals f 
und]s]v$ gr\ps aft] ! p]iod ( ! grant4  
7f7 ,evaluation ,n lat] ?an ! end (     
fiscal ye> #bjbg1 ! ,secret>y %all      
submit to ! ,congress an evaluation ( ! 
grant program "u ?is section t-- 7#a7   
assesses ! effectiv5ess ( outrea* ef=ts 
dur+ ! application process 9 div]sify+ !
 pool ( grant recipi5ts2  7#b7 makes    
recomm5dations = future outrea* ef=ts to

 div]sify ! pool ( grant recipi5ts =    
,dep>tm5t ( ,heal? & ,human ,s]vices    
grant programs & fund+ opportunities    
relat$ to mat]nal heal?2  7#c7 assesses 
! effectiv5ess ( programs fund$ by      
grants "u ?is section 9 improv+ mat]nal 
heal? outcomes = pregnant & po/p>tum    
individuals f und]s]v$ gr\ps1 to ! ext5t
 practicable2 &  7#d7 makes             
recomm5dations = future ,dep>tm5t (     
,heal? & ,human ,s]vices grant programs 
& fund+ opportunities t deliv] fund+ to 
community-bas$ organizations t provide  
programs & res\rces t are align$ )      
evid5ce-bas$ practices = improv+ mat]nal
 heal? outcomes = pregnant & po/p>tum   
individuals4  7g7 ,def9ition ,9 ?is     
section1 ! t]m und]s]v$ gr\ps ref]s to  
pregnant & po/p>tum individuals-- 7#a7 f
 racial & e?nic m9ority gr\ps 7z su* t]m
 is def9$ 9 section #agjg7;g77#a7 ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjju-#f7;g77#a7772  7#b7 ^:  
h\sehold income is equal to or less ?an 
#aej p]c5t ( ! ,f$]al pov]ty l9e2  7#c7 

:o live 9 heal? pr(essional %ortage     
areas 7z su* t]m is def9$ 9 section #ccb
 ( ! ,public ,heal? ,s]vice ,act 7#db   
,u4,s4,c4 #bed;e7a77#a7772  7#d7 :o live
 9 c\nties ) no hospital (f]+ ob/etric  
c>e1 no bir? c5t]1 & no ob/etric        
provid]2 or  7#e7 :o live 9 c\nties ) a 
level ( vuln]ability ( mod]ate-to-high  
or high]1 accord+ to ! ,social          
,vuln]ability ,index ( ! ,c5t]s =       
,disease ,control & ,prev5tion4  7h7    
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re is au?oriz$ to be  
appropriat$ #aj1jjj1jjj = ea* ( fiscal  
ye>s #bjbc ?r\gh #bjbg4  #aajc4         
,respectful mat]nity c>e tra9+ = all    
employees 9 mat]nity c>e sett+s ,"p ,b (
 title ,,vii ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bic et seq47 is    
am5d$ by add+ at ! end ! foll[+ new     
section3  #gdb4 ,respectful mat]nity c>e
 tra9+ = all employees 9 mat]nity c>e   
sett+s  7a7 ,grants ,! ,secret>y %all   
aw>d grants = programs to r$uce & prev5t
 bias1 racism1 & discrim9ation 9        

mat]nity c>e sett+s & to advance        
respectful1 culturally congru5t1        
trauma-in=m$ c>e4  7b7 ,special         
consid]ation ,9 aw>d+ grants "u         
subsection 7a71 ! ,secret>y %all give   
special consid]ation to applications =  
programs t w\ld-- 7#a7 apply to all     
mat]nity c>e provid]s & any employees :o
 int]act ) pregnant & po/p>tum          
individuals 9 ! provid] sett+1 includ+  
front desk employees1 sonograph]s1      
s*$ul]s1 heal? c>e pr(essionals1        
hospital or heal? sy/em adm9i/rators1   
security /aff1 & o!r employees2  7#b7   
emphasize p]iodic1 z oppos$ to "o-"t1   
tra9+s = all bir?+ pr(essionals &       
employees describ$ 9 p>agraph 7#a72     
7#c7 address implicit bias1 racism1 &   
cultural humility2  7#d7 be deliv]$ 9   
ongo+ education sett+s = provid]s       
ma9ta9+ _! lic5ses1 ) a pref]5ce =      
tra9+s t provide cont9u+ education      
units2  7#e7 include trauma-in=m$ c>e   
be/ practices & an emphasis on %>$      
decision mak+ betwe5 provid]s & pati5ts2

  7#f7 include antiracism tra9+ &       
programs2  7#g7 be deliv]$ 9            
und]graduate programs t funnel into     
heal? pr(essions s*ools2  7#h7 be       
deliv]$ 9 sett+s t apply to provid]s ( !
 special supplem5tal nutrition program =
 wom51 infants1 & *ildr5 "u section #ag 
( ! ,*ild ,nutrition ,act ( #aiff2  7#i7
 integrate bias tra9+ 9 ob/etric em]g5cy
 simulation tra9+s or relat$ tra9+s2    
7#aj7 include tra9+ = em]g5cy dep>tm5t  
employees & em]g5cy m$ical te*nicians on
 recogniz+ w>n+ signs = sev]e           
pregnancy-relat$ complications2  7#aa7  
(f] tra9+ to all mat]nity c>e provid]s  
on ! value ( racially1 e?nically1 &     
pr(essionally div]se mat]nity c>e teams 
to provide culturally congru5t c>e2 or  
7#ab7 be bas$ on "o or m programs       
design$ by a hi/orically ,black college 
or univ]sity or o!r m9ority-s]v+        
in/itution4  7c7 ,application ,to seek a
 grant "u subsection 7a71 an entity %all
 submit an application at su* "t1 9 su* 
mann]1 & conta9+ su* in=mation z !      

,secret>y may require4  7d7 ,report+    
,ea* recipi5t ( a grant "u ?is section  
%all annually submit to ! ,secret>y a   
report on ! /atus ( activities conduct$ 
us+ ! grant1 includ+1 z applicable1 a   
description ( ! impact ( tra9+ provid$  
?r\gh ! grant on pati5t outcomes &      
pati5t exp]i5ce = pregnant & po/p>tum   
individuals f racial & e?nic m9ority    
gr\ps & _! families4  7e7 ,be/ practices
 ,bas$ on ! annual reports submitt$     
pursuant to subsection 7d71 !           
,secret>y-- 7#a7 %all produce an annual 
report on ! f9d+s result+ f programs    
fund$ ?r\gh ?is section2  7#b7 %all     
dissem9ate su* report to all recipi5ts (
 grants "u ?is section & to ! public2 & 
7#c7 may include 9 su* report f9d+s on  
be/ practices = improv+ pati5t outcomes 
& pati5t exp]i5ce = pregnant & po/p>tum 
individuals f racial & e?nic m9ority    
gr\ps & _! families 9 mat]nity c>e      
sett+s4  7f7 ,def9itions ,9 ?is section3
 7#a7 ,! t]m po/p>tum means ! "o-ye>    
p]iod beg9n+ on ! la/ day ( an          

individual's pregnancy4  7#b7 ,! t]m    
culturally congru5t means 9 agreem5t ) !
 pref]r$ cultural values1 beliefs1 _w   
view1 language1 & practices ( ! heal?   
c>e consum] & o!r /akehold]s4  7#c7 ,!  
t]m racial & e?nic m9ority gr\p has !   
mean+ giv5 su* t]m 9 section            
#agjg7;g77#a74  7g7 ,au?orization (     
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#e1jjj1jjj = ea* ( fiscal ye>s #bjbc    
?r\gh #bjbg4  4  #aajd4 ,/udy on r$uc+ &
 prev5t+ bias1 racism1 & discrim9ation 9
 mat]nity c>e sett+s  7a7 ,9 g5]al ,!   
,secret>y ( ,heal? & ,human ,s]vices    
%all seek to ent] into an agreem5t1 n   
lat] ?an #ij days aft] ! date ( enactm5t
 ( ?is ,act1 ) ! ,national ,academies ( 
,sci5ces1 ,eng9e]+1 & ,m$ic9e 7ref]r$ to
 9 ?is section z ! ,national ,academies7
 "u :i* ! ,national ,academies agree    
to-- 7#a7 conduct a /udy on ! design &  
implem5tation ( programs to r$uce &     
prev5t bias1 racism1 & discrim9ation 9  
mat]nity c>e sett+s & to advance        

respectful1 culturally congru5t1        
trauma-in=m$ c>e2 &  7#b7 n lat] ?an #bd
 mon?s aft] ! date ( enactm5t ( ?is     
,act-- 7,a7 complete ! /udy2 &  7,b7    
transmit a report on ! results ( ! /udy 
to ! ,congress4  7b7 ,possible topics ,!
 agreem5t ent]$ into pursuant to        
subsection 7a7 may provide = ! /udy (   
any ( ! foll[+3 7#a7 ,! developm5t ( a  
scorec>d or o!r evaluation /&>ds =      
programs design$ to r$uce & prev5t bias1
 racism1 & discrim9ation 9 mat]nity c>e 
sett+s to assess ! effectiv5ess ( su*   
programs 9 improv+ pati5t outcomes &    
pati5t exp]i5ce = pregnant & po/p>tum   
individuals f racial & e?nic m9ority    
gr\ps & _! families4  7#b7 ,det]m9ation 
( ! types & frequ5cy ( tra9+ to r$uce & 
prev5t bias1 racism1 & discrim9ation 9  
mat]nity c>e sett+s t are demon/rat$ to 
improve pati5t outcomes or pati5t       
exp]i5ce = pregnant & po/p>tum          
individuals f racial & e?nic m9ority    
gr\ps & _! families4  #aaje4 ,respectful
 mat]nity c>e compliance program  7a7 ,9

 g5]al ,! ,secret>y ( ,heal? & ,human   
,s]vices 7ref]r$ to 9 ?is section z !   
,secret>y7 %all aw>d grants to accr$it$ 
hospitals1 heal? sy/ems1 & o!r mat]nity 
c>e sett+s to e/abli% z an integral "p (
 quality implem5tation initiatives )9 "o
 or m hospitals or o!r bir? sett+s a    
respectful mat]nity c>e compliance      
program4  7b7 ,program requirem5ts ,a   
respectful mat]nity c>e compliance      
program fund$ ?r\gh a grant "u ?is      
section %all-- 7#a7 in/itutionalize     
me*anisms to all[ pati5ts receiv+       
mat]nity c>e s]vices1 ! families ( su*  
pati5ts1 or p]9atal heal? work]s        
support+ su* pati5ts to report in/ances 
( racism or evid5ce ( bias on ! basis ( 
race1 e?nicity1 or ano!r protect$ class2
  7#b7 in/itutionalize response         
me*anisms ?r\gh :i* repres5tatives ( !  
program c directly foll[ up ) ! pati5t1 
if possible1 & ! pati5t's family 9 a    
timely mann]2  7#c7 prep>e & make       
publicly available a hospital- or heal? 
sy/em-wide /rategy to r$uce bias on !   

basis ( race1 e?nicity1 or ano!r        
protect$ class 9 ! deliv]y ( mat]nity   
c>e t includes-- 7,a7 in=mation on !    
tra9+ programs to r$uce & prev5t bias1  
racism1 & discrim9ation on ! basis (    
race1 e?nicity1 or ano!r protect$ class 
= all employees 9 mat]nity c>e sett+s2  
7,b7 in=mation on ! numb] ( cases       
report$ to ! compliance program2 &  7,c7
 ! developm5t ( me?ods to r\t9ely assess
 ! ext5t to :i* bias1 racism1 or        
discrim9ation on ! basis ( race1        
e?nicity1 or ano!r protect$ class are   
pres5t 9 ! deliv]y ( mat]nity c>e to    
pati5ts f racial & e?nic m9ority gr\ps2 
7#d7 develop me*anisms to r\t9ely       
collect & publicly report hospital-level
 data relat$ to pati5t-report$ exp]i5ce 
( c>e2 &  7#e7 provide annual reports to
 ! ,secret>y ) in=mation ab\t ea* case  
report$ to ! compliance program ov] !   
c\rse ( ! ye> conta9+ su* in=mation z ! 
,secret>y may require1 su* z-- 7,a7     
de-id5tifi$ demographic in=mation on !  
pati5t 9 ! case1 su* z race1 e?nicity1  

g5d] id5tity1 & prim>y language2  7,b7 !
 cont5t ( ! report f ! pati5t or !      
family ( ! pati5t to ! compliance       
program2  7,c7 ! response f ! compliance
 program2 &  7,d7 to ! ext5t applicable1
 in/itutional *anges made z a result ( !
 case4  7c7 ,secret>y requirem5ts  7#a7 
,processes ,n lat] ?an #ahj days aft] ! 
date ( enactm5t ( ?is ,act1 ! ,secret>y 
%all e/abli% processes =-- 7,a7         
dissem9at+ be/ practices = e/abli%+ &   
implem5t+ a respectful mat]nity c>e     
compliance program )9 a hospital or o!r 
bir? sett+2  7,b7 promot+ coord9ation & 
collaboration betwe5 hospitals1 heal?   
sy/ems1 & o!r mat]nity c>e deliv]y      
sett+s on ! e/abli%m5t & implem5tation (
 respectful mat]nity c>e compliance     
programs2 &  7,c7 evaluat+ !            
effectiv5ess ( respectful mat]nity c>e  
compliance programs on mat]nal heal?    
outcomes & pati5t & family exp]i5ces1   
especially = pati5ts f racial & e?nic   
m9ority gr\ps & _! families4  7#b7 ,/udy
  7,a7 ,9 g5]al ,n lat] ?an #b ye>s aft]

 ! date ( enactm5t ( ?is ,act1 !        
,secret>y %all1 ?r\gh a contract ) an   
indep5d5t rese>* organization1 conduct a
 /udy on /rategies to address-- 7i7     
racism or bias on ! basis ( race1       
e?nicity1 or ano!r protect$ class 9 !   
deliv]y ( mat]nity c>e s]vices2 &  7ii7 
successful implem5tation ( respectful   
c>e initiatives4  7,b7 ,compon5ts ( /udy
 ,! /udy %all include ! foll[+3 7i7 ,an 
assessm5t ( ! reports submitt$ to !     
,secret>y f ! respectful mat]nity c>e   
compliance programs pursuant to         
subsection 7b77#e74  7ii7 ,bas$ on su*  
assessm5t1 recomm5dations = pot5tial    
acc\ntability me*anisms relat$ to cases 
( racism or bias on ! basis ( race1     
e?nicity1 or ano!r protect$ class 9 !   
deliv]y ( mat]nity c>e s]vices at       
hospitals & o!r bir? sett+s4 ,su*       
recomm5dations %all take into           
consid]ation m$ical & non-m$ical factors
 t contribute to adv]se pati5t exp]i5ces
 & mat]nal heal? outcomes4  7,c7 ,report
 ,! ,secret>y %all submit to ! ,congress

 & make publicly available a report on !
 results ( ! /udy "u ?is p>agraph4  7d7 
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re is au?oriz$ to be  
appropriat$ su* sums z may be necess>y =
 fiscal ye>s #bjbc ?r\gh #bjbh4  #aajf4 
,,gao report  7a7 ,9 g5]al ,n lat] ?an  
#b ye>s aft] ! date ( enactm5t ( ?is    
,act & annually !reaft]1 ! ,comptroll]  
,g5]al ( ! ,unit$ ,/ates %all submit to 
! ,congress & make publicly available a 
report on ! e/abli%m5t ( respectful     
mat]nity c>e compliance programs )9     
hospitals1 heal? sy/ems1 & o!r mat]nity 
c>e sett+s4  7b7 ,matt]s includ$ ,!     
report "u p>agraph 7#a7 %all include !  
foll[+3 7#a7 ,in=mation reg>d+ ! ext5t  
to :i* hospitals1 heal? sy/ems1 & o!r   
mat]nity c>e sett+s h elect$ to e/abli% 
respectful mat]nity c>e compliance      
programs1 includ+-- 7,a7 :i* hospitals &
 o!r bir? sett+s elect to e/abli%       
compliance programs & :5 su* programs   
are e/abli%$2  7,b7 to ! ext5t          
practicable1 impacts ( ! e/abli%m5t (   

su* programs on mat]nal heal? outcomes &
 pati5t & family exp]i5ces 9 ! hospitals
 & o!r bir? sett+s t h e/abli%$ su*     
programs1 especially = pati5ts f racial 
& e?nic m9ority gr\ps & _! families2    
7,c7 in=mation on geographic areas1 &   
types ( hospitals or o!r bir? sett+s1   
:]e respectful mat]nity c>e compliance  
programs are n be+ e/abli%$ & in=mation 
on factors contribut+ to decisions to n 
e/abli% su* programs2 &  7,d7           
recomm5dations = e/abli%+ respectful    
mat]nity c>e compliance programs 9      
geographic areas1 & types ( hospitals or
 o!r bir? sett+s1 :]e su* programs are n
 be+ e/abli%$4  7#b7 ,:e!r ! fund+ made 
available to c>ry out ?is section has   
be5 suffici5t &1 if applicable1         
recomm5dations = additional             
appropriations to c>ry out ?is section4 
7#c7 ,su* o!r in=mation z ! ,comptroll] 
,g5]al det]m9es appropriate4  ,c        
,protect+ moms :o s]v$  #abja4 ,support 
= mat]nity c>e coord9ation  7a7 ,program
 on mat]nity c>e coord9ation  7#a7 ,9   

g5]al ,! ,secret>y ( ,vet]ans ,affairs  
%all c>ry out ! mat]nity c>e coord9ation
 program describ$ 9 ,vet]ans ,heal?     
,adm9i/ration ,h&book #accj4jc1 or any  
successor h&book4  7#b7 ,tra9+ & support
 ,9 c>ry+ out ! program "u p>agraph     
7#a71 ! ,secret>y %all provide to       
community mat]nity c>e provid]s tra9+ & 
support ) respect to ! unique ne$s (    
pregnant & po/p>tum vet]ans1 p>ticul>ly 
reg>d+ m5tal & behavioral heal?         
conditions relat+ to ! s]vice ( !       
vet]ans 9 ! ,arm$ ,=ces4  7b7           
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to !         
,secret>y #ae1jjj1jjj = fiscal ye> #bjbc
 = ! mat]nity c>e coord9ation program4  
,su* am\nts are au?oriz$ 9 addition to  
any o!r am\nts au?oriz$ = su* purpose4  
7c7 ,def9itions ,9 ?is section3 7#a7 ,! 
t]m community mat]nity c>e provid]s     
means mat]nity c>e provid]s locat$ at   
non-,dep>tm5t facilities :o provide     
mat]nity c>e to vet]ans "u section #agjc
 ( title #ch1 ,unit$ ,/ates ,code1 or   

o!r provisions ( law adm9i/]$ by !      
,secret>y ( ,vet]ans ,affairs4  7#b7 ,! 
t]m non-,dep>tm5t facilities has ! mean+
 giv5 t t]m 9 section #agja ( title #ch1
 ,unit$ ,/ates ,code4  #abjb4 ,report on
 mat]nal mortality & sev]e mat]nal      
morbidity among pregnant & po/p>tum     
vet]ans  7a7 ,,gao report ,n lat] ?an   
two ye>s aft] ! date ( ! enactm5t ( ?is 
,act1 ! ,comptroll] ,g5]al ( ! ,unit$   
,/ates %all submit to ! ,committees on  
,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se 
( ,repres5tatives1 & make publicly      
available1 a report on mat]nal mortality
 & sev]e mat]nal morbidity among        
pregnant & po/p>tum vet]ans1 ) a        
p>ticul> focus on racial & e?nic        
disp>ities 9 mat]nal heal? outcomes =   
vet]ans4  7b7 ,matt]s includ$ ,! report 
"u subsection 7a7 %all include ! foll[+3
 7#a7 ,to ! ext5t practicable-- 7,a7 !  
numb] ( pregnant & po/p>tum vet]ans :o h
 exp]i5c$ a pregnancy-relat$ dea? or    
pregnancy-associat$ dea? 9 ! mo/ rec5t  
#aj ye>s ( available data2  7,b7 ! rate 

( pregnancy-relat$ dea?s p] #ajj1jjj    
live bir?s = pregnant & po/p>tum        
vet]ans2  7,c7 ! numb] ( cases ( sev]e  
mat]nal morbidity among pregnant &      
po/p>tum vet]ans 9 ! mo/ rec5t ye> (    
available data2  7,d7 ! racial & e?nic  
disp>ities 9 mat]nal mortality & sev]e  
mat]nal morbidity rates among pregnant &
 po/p>tum vet]ans2  7,e7 id5tification (
 ! causes ( mat]nal mortality & sev]e   
mat]nal morbidity t are unique to       
vet]ans1 includ+ po/-traumatic /ress    
disord]1 milit>y sexual trauma1 &       
inf]tility or misc>riages t may be caus$
 by su* s]vice2  7,f7 id5tification ( ! 
causes ( mat]nal mortality & sev]e      
mat]nal morbidity t are unique to       
vet]ans f racial & e?nic m9ority gr\ps2 
7,g7 id5tification ( any correlations   
betwe5 ! =m] rank ( vet]ans & _! mat]nal
 heal? outcomes2  7,h7 ! numb] ( vet]ans
 :o h be5 diagnos$ ) inf]tility by      
,vet]ans ,heal? ,adm9i/ration provid]s  
ea* ye> 9 ! mo/ rec5t five ye>s1        
disaggregat$ by age1 race1 e?nicity1    

sex1 m>ital /atus1 sexual ori5tation1   
g5d] id5tity1 & geographical location2  
7,i7 ! numb] ( vet]ans :o receive a     
cl9ical diagnosis ( unexpla9$ inf]tility
 by ,vet]ans ,heal? ,adm9i/ration       
provid]s ea* ye> 9 ! mo/ rec5t five     
ye>s2 &  7,j7 ! ext5t to :i* ! rate (   
incid5ce ( cl9ically diagnos$ inf]tility
 among vet]ans comp>e or diff] to ! rate
 ( incid5ce ( cl9ically diagnos$        
inf]tility among ! civilian population4 
7#b7 ,an assessm5t ( ! b>ri]s to det]m9+
 ! in=mation requir$ "u p>agraph 7#a7 & 
recomm5dations = improvem5ts 9 track+   
mat]nal heal? outcomes among pregnant & 
po/p>tum vet]ans-- 7,a7 :o h heal? c>e  
cov]age ?r\gh ! ,dep>tm5t2  7,b7 enroll$
 9 ! ,,tric>e program2  7,c7 )          
employ]-bas$ or private insurance2  7,d7
 enroll$ 9 ! ,m$icaid program2 &  7,e7  
:o are un9sur$4  7#c7 ,recomm5dations = 
legislative & adm9i/rative actions to   
increase access to m5tal & behavioral   
heal? c>e = pregnant & po/p>tum vet]ans 
:o scre5 positively = mat]nal m5tal or  

behavioral heal? conditions4  7#d7      
,recomm5dations to address homelessness1
 food insecurity1 pov]ty1 & relat$      
issues among pregnant & po/p>tum        
vet]ans4  7#e7 ,recomm5dations on h[ to 
effectively educate mat]nity c>e        
provid]s on be/ practices = provid+     
mat]nity c>e s]vices to vet]ans t       
addresses ! unique mat]nal heal? c>e    
ne$s ( vet]an populations4  7#f7        
,recomm5dations to r$uce mat]nal        
mortality & sev]e mat]nal morbidity     
among pregnant & po/p>tum vet]ans & to  
address racial & e?nic disp>ities 9     
mat]nal heal? outcomes = ea* ( ! gr\ps  
describ$ 9 subp>agraphs 7,a7 ?r\gh 7,e7 
( p>agraph 7#b74  7#g7 ,recomm5dations  
to improve coord9ation ( c>e betwe5 !   
,dep>tm5t & non-,dep>tm5t facilities =  
pregnant & po/p>tum vet]ans1 includ+    
recomm5dations to improve-- 7,a7 heal?  
record int]op]ability2 &  7,b7 tra9+ = !
 directors ( ! ,vet]ans ,integrat$      
,s]vice ,networks1 directors ( m$ical   
facilities ( ! ,dep>tm5t1 *iefs ( /aff (

 su* facilities1 mat]nity c>e           
coord9ators1 & /aff ( relevant          
non-,dep>tm5t facilities4  7#h7 ,an     
assessm5t ( ! au?ority ( ! ,secret>y (  
,vet]ans ,affairs to access mat]nal     
heal? data collect$ by ! ,dep>tm5t (    
,heal? & ,human ,s]vices &1 if          
applicable1 recomm5dations to increase  
su* au?ority4  7#i7 ,any o!r in=mation !
 ,comptroll] ,g5]al det]m9es appropriate
 ) respect to ! r$uction ( mat]nal      
mortality & sev]e mat]nal morbidity     
among pregnant & po/p>tum vet]ans & to  
address racial & e?nic disp>ities 9     
mat]nal heal? outcomes = vet]ans4  ,d   
,p]9atal work=ce  #acja4 ,,hhs ag5cy    
directives  7a7 ,guidance to ,/ates     
7#a7 ,9 g5]al ,n lat] ?an #b ye>s aft] !
 date ( enactm5t ( ?is ,act1 ! ,secret>y
 ( ,heal? & ,human ,s]vices %all issue &
 dissem9ate guidance to ,/ates to       
educate provid]s1 manag$ c>e entities1 &
 o!r insur]s ab\t ! value & process (   
deliv]+ respectful mat]nal heal? c>e    
?r\gh div]se & multidiscipl9>y c>e      

provid] models4  7#b7 ,cont5ts ,!       
guidance requir$ by p>agraph 7#a7 %all  
address h[ ,/ates c enc\rage &          
inc5tivize hospitals1 heal? sy/ems1     
midwif]y practices1 free/&+ bir? c5t]s1 
o!r mat]nity c>e provid] gr\ps1 manag$  
c>e entities1 & o!r insur]s-- 7,a7 to   
recruit & reta9 mat]nity c>e provid]s1  
m5tal & behavioral heal? c>e provid]s   
act+ 9 accordance ) ,/ate law1 regi/]$  
dietitians or nutrition pr(essionals 7z 
su* t]m is def9$ 9 section #ahfa7vv77#b7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciex7vv77#b7771 & lactation 
consultants c]tifi$ by ! ,int]national  
,bo>d ( ,lactation ,consultants         
,exam9]s-- 7i7 f racially1 e?nically1 & 
l+ui/ically div]se backgr\nds2  7ii7 )  
exp]i5ce practic+ 9 racially & e?nically
 div]se communities2 &  7iii7 :o h      
und]gone tra9+ on implicit bias &       
racism2  7,b7 to incorporate into       
mat]nity c>e teams-- 7i7 midwives :o    
meet at a m9imum ! int]national         
def9ition ( ! midwife & global /&>ds =  

midwif]y education z e/abli%$ by !      
,int]national ,conf$]ation ( ,midwives2 
&  7ii7 p]9atal heal? work]s2  7,c7 to  
provide collaborative1 culturally       
congru5t c>e2 &  7,d7 to provide        
opportunities = individuals enroll$ 9   
accr$it$ midwif]y education programs to 
p>ticipate 9 job %ad[+ ) mat]nity c>e   
teams 9 hospitals1 heal? sy/ems1        
midwif]y practices1 & free/&+ bir?      
c5t]s4  7b7 ,/udy on respectful &       
culturally congru5t mat]nity c>e  7#a7  
,/udy ,! ,secret>y ( ,heal? & ,human    
,s]vices act+ ?r\gh ! ,director ( !     
,national ,in/itutes ( ,heal? 79 ?is    
subsection ref]r$ to z ! ,secret>y7 %all
 conduct a /udy on be/ practices 9      
respectful & culturally congru5t        
mat]nity c>e4  7#b7 ,report ,n lat] ?an 
#b ye>s aft] ! date ( enactm5t ( ?is    
,act1 ! ,secret>y %all-- 7,a7 complete !
 /udy requir$ by p>agraph 7#a72  7,b7   
submit to ! ,congress & make publicly   
available a report on ! results ( su*   
/udy2 &  7,c7 include 9 su* report-- 7i7

 a comp5dium ( examples ( hospitals1    
heal? sy/ems1 midwif]y practices1       
free/&+ bir? c5t]s1 o!r mat]nity c>e    
provid] gr\ps1 manag$ c>e entities1 &   
o!r insur]s t are deliv]+ respectful &  
culturally congru5t mat]nal heal? c>e2  
7ii7 a comp5dium ( examples ( hospitals1
 heal? sy/ems1 midwif]y practices1      
free/&+ bir? c5t]s1 o!r mat]nity c>e    
provid] gr\ps1 manag$ c>e entities1 &   
o!r insur]s t h made progress 9 r$uc+   
disp>ities 9 mat]nal heal? outcomes &   
improv+ bir?+ exp]i5ces = pregnant &    
po/p>tum individuals f racial & e?nic   
m9ority gr\ps2 &  7iii7 recomm5dations  
to hospitals1 heal? sy/ems1 midwif]y    
practices1 free/&+ bir? c5t]s1 o!r      
mat]nity c>e provid] gr\ps1 manag$ c>e  
entities1 & o!r insur]s1 = be/ practices
 9 respectful & culturally congru5t     
mat]nity c>e4  #acjb4 ,grants to gr[ &  
div]sify ! p]9atal work=ce ,title ,,vii 
( ! ,public ,heal? ,s]vice ,act is am5d$
 by ins]t+ aft] section #geg 7#db       
,u4,s4,c4 #bid;f7 ! foll[+ new section3 

#geh4 ,p]9atal work=ce grants  7a7 ,9   
g5]al ,! ,secret>y %all aw>d grants to  
entities to e/abli% or exp& programs    
describ$ 9 subsection 7b7 to gr[ &      
div]sify ! p]9atal work=ce4  7b7 ,use ( 
funds ,recipi5ts ( grants "u ?is section
 %all use ! grants to gr[ & div]sify !  
p]9atal work=ce by-- 7#a7 e/abli%+      
s*ools or programs t provide education &
 tra9+ to individuals seek+ appropriate 
lic5s+ or c]tification z-- 7,a7         
physician assi/ants :o w complete       
cl9ical tra9+ 9 ! field ( mat]nal &     
p]9atal heal?2 or  7,b7 p]9atal heal?   
work]s2 &  7#b7 exp&+ ! capacity ( exi/+
 s*ools or programs describ$ 9 p>agraph 
7#a71 = ! purposes ( increas+ ! numb] ( 
/ud5ts enroll$ 9 su* s*ools or programs1
 includ+ by aw>d+ s*ol>%ips = /ud5ts4   
7c7 ,prioritization ,9 aw>d+ grants "u  
?is section1 ! ,secret>y %all give      
priority to any entity t-- 7#a7 has     
demon/rat$ a commitm5t to recruit+ &    
reta9+ /ud5ts & faculty f racial & e?nic
 m9ority gr\ps2  7#b7 has develop$ a    

/rategy to recruit & reta9 a div]se pool
 ( /ud5ts into ! p]9atal work=ce program
 or s*ool support$ by funds receiv$     
?r\gh ! grant1 p>ticul>ly f racial &    
e?nic m9ority gr\ps & o!r und]s]v$      
populations2  7#c7 has develop$ a       
/rategy to recruit & reta9 /ud5ts :o    
plan to practice 9 a heal? pr(essional  
%ortage area designat$ "u section #ccb2 
7#d7 has develop$ a /rategy to recruit &
 reta9 /ud5ts :o plan to practice 9 an  
area ) significant racial & e?nic       
disp>ities 9 mat]nal heal? outcomes1 to 
! ext5t practicable2 &  7#e7 includes 9 
! /&>d curriculum = all /ud5ts )9 !     
p]9atal work=ce program or s*ool a bias1
 racism1 or discrim9ation tra9+ program 
t includes tra9+ on implicit bias &     
racism4  7d7 ,report+ ,z a condition on 
receipt ( a grant "u ?is section = a    
p]9atal work=ce program or s*ool1 an    
entity %all agree to submit to !        
,secret>y an annual report on !         
activities conduct$ ?r\gh ! grant1      
includ+-- 7#a7 ! numb] & demographics ( 

/ud5ts p>ticipat+ 9 ! program or s*ool2 
7#b7 ! ext5t to :i* /ud5ts 9 ! program  
or s*ool are ent]+ c>e]s 9-- 7,a7 heal? 
pr(essional %ortage areas designat$ "u  
section #ccb2 &  7,b7 areas )           
significant racial & e?nic disp>ities 9 
mat]nal heal? outcomes1 to ! ext5t su*  
data are available2 &  7#c7 :e!r !      
program or s*ool has includ$ 9 ! /&>d   
curriculum = all /ud5ts a bias1 racism1 
or discrim9ation tra9+ program t        
includes explicit & implicit bias1 & if 
s ! effectiv5ess ( su* tra9+ program4   
7e7 ,p]iod ( grants ,! p]iod ( a grant  
"u ?is section %all be up to #e ye>s4   
7f7 ,application ,to seek a grant "u ?is
 section1 an entity %all submit to !    
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require1 includ+ any      
in=mation necess>y = prioritization "u  
subsection 7c74  7g7 ,te*nical assi/ance
 ,! ,secret>y %all provide1 directly or 
by contract1 te*nical assi/ance to      
entities seek+ or receiv+ a grant "u ?is

 section on ! developm5t1 use1          
evaluation1 & po/-grant p]iod           
su/a9ability ( ! p]9atal work=ce        
programs or s*ools propos$ to be1 or    
be+1 e/abli%$ or exp&$ ?r\gh ! grant4   
7h7 ,report by ! ,secret>y ,n lat] ?an  
#d ye>s aft] ! date ( enactm5t ( ?is    
section1 ! ,secret>y %all prep>e &      
submit to ! ,congress1 & po/ on !       
int]net website ( ! ,dep>tm5t ( ,heal? &
 ,human ,s]vices1 a report on !         
effectiv5ess ( ! grant program "u ?is   
section at-- 7#a7 recruit+ /ud5ts f     
racial & e?nic m9ority gr\ps2  7#b7     
increas+ ! numb] ( physician assi/ants  
:o w complete cl9ical tra9+ 9 ! field ( 
mat]nal & p]9atal heal?1 & p]9atal heal?
 work]s1 f racial & e?nic m9ority gr\ps 
& o!r und]s]v$ populations2  7#c7       
increas+ ! numb] ( physician assi/ants  
:o w complete cl9ical tra9+ 9 ! field ( 
mat]nal & p]9atal heal?1 & p]9atal heal?
 work]s1 work+ 9 heal? pr(essional      
%ortage areas designat$ "u section #ccb2
 &  7#d7 increas+ ! numb] ( physician   

assi/ants :o w complete cl9ical tra9+ 9 
! field ( mat]nal & p]9atal heal?1 &    
p]9atal heal? work]s1 work+ 9 areas )   
significant racial & e?nic disp>ities 9 
mat]nal heal? outcomes1 to ! ext5t su*  
data are available4  7i7 ,def9ition ,9  
?is section1 ! t]m racial & e?nic       
m9ority gr\p has ! mean+ giv5 su* t]m 9 
section #agjg7;g74  7j7 ,au?orization ( 
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#ae1jjj1jjj = ea* ( fiscal ye>s #bjbc   
?r\gh #bjbg4  4  #acjc4 ,grants to gr[ &
 div]sify ! nurs+ work=ce 9 mat]nal &   
p]9atal heal? ,title ,,viii ( ! ,public 
,heal? ,s]vice ,act is am5d$ by ins]t+  
aft] section #haa ( t ,act 7#db         
,u4,s4,c4 #bif;j7 ! foll[+3  #hab4      
,p]9atal nurs+ work=ce grants  7a7 ,9   
g5]al ,! ,secret>y %all aw>d grants to  
s*ools ( nurs+ to gr[ & div]sify !      
p]9atal nurs+ work=ce4  7b7 ,use ( funds
 ,recipi5ts ( grants "u ?is section %all
 use ! grants to gr[ & div]sify !       
p]9atal nurs+ work=ce by provid+        

s*ol>%ips to /ud5ts seek+ to become--   
7#a7 nurse practition]s ^: education    
includes a focus on mat]nal & p]9atal   
heal?2 or  7#b7 cl9ical nurse speciali/s
 ^: education includes a focus on       
mat]nal & p]9atal heal?4  7c7           
,prioritization ,9 aw>d+ grants "u ?is  
section1 ! ,secret>y %all give priority 
to any s*ool ( nurs+ t-- 7#a7 has       
develop$ a /rategy to recruit & reta9 a 
div]se pool ( /ud5ts seek+ to ent] c>e]s
 focus$ on mat]nal & p]9atal heal?1     
p>ticul>ly /ud5ts f racial & e?nic      
m9ority gr\ps & o!r und]s]v$            
populations2  7#b7 has develop$ a       
p>tn]%ip ) a practice sett+ 9 a heal?   
pr(essional %ortage area designat$ "u   
section #ccb = ! cl9ical placem5ts ( !  
s*ool's /ud5ts2  7#c7 has develop$ a    
/rategy to recruit & reta9 /ud5ts :o    
plan to practice 9 an area ) significant
 racial & e?nic disp>ities 9 mat]nal    
heal? outcomes1 to ! ext5t practicable2 
&  7#d7 includes 9 ! /&>d curriculum =  
all /ud5ts seek+ to ent] c>e]s focus$ on

 mat]nal & p]9atal heal? a bias1 racism1
 or discrim9ation tra9+ program t       
includes education on implicit bias &   
racism4  7d7 ,report+ ,z a condition on 
receipt ( a grant "u ?is section1 a     
s*ool ( nurs+ %all agree to submit to ! 
,secret>y an annual report on !         
activities conduct$ ?r\gh ! grant1      
includ+1 to ! ext5t practicable-- 7#a7 !
 numb] & demographics ( /ud5ts 9 ! s*ool
 ( nurs+ seek+ to ent] c>e]s focus$ on  
mat]nal & p]9atal heal?2  7#b7 ! ext5t  
to :i* su* /ud5ts are prep>+ to ent]    
c>e]s 9-- 7,a7 heal? pr(essional %ortage
 areas designat$ "u section #ccb2 &     
7,b7 areas ) significant racial & e?nic 
disp>ities 9 mat]nal heal? outcomes1 to 
! ext5t su* data are available2 &  7#c7 
:e!r ! /&>d curriculum = all /ud5ts     
seek+ to ent] c>e]s focus$ on mat]nal & 
p]9atal heal? includes a bias1 racism1  
or discrim9ation tra9+ program t        
includes education on implicit bias &   
racism4  7e7 ,p]iod ( grants ,! p]iod ( 
a grant "u ?is section %all be up to #e 

ye>s4  7f7 ,application ,to seek a grant
 "u ?is section1 an entity %all submit  
to ! ,secret>y an application1 at su*   
"t1 9 su* mann]1 & conta9+ su* in=mation
 z ! ,secret>y may require1 includ+ any 
in=mation necess>y = prioritization "u  
subsection 7c74  7g7 ,te*nical assi/ance
 ,! ,secret>y %all provide1 directly or 
by contract1 te*nical assi/ance to      
s*ools ( nurs+ seek+ or receiv+ a grant 
"u ?is section on ! processes ( aw>d+ & 
evaluat+ s*ol>%ips ?r\gh ! grant4  7h7  
,report by ! ,secret>y ,n lat] ?an #d   
ye>s aft] ! date ( enactm5t ( ?is       
section1 ! ,secret>y %all prep>e &      
submit to ! ,congress1 & po/ on !       
int]net website ( ! ,dep>tm5t ( ,heal? &
 ,human ,s]vices1 a report on !         
effectiv5ess ( ! grant program "u ?is   
section at-- 7#a7 recruit+ /ud5ts f     
racial & e?nic m9ority gr\ps & o!r      
und]s]v$ populations2  7#b7 increas+ !  
numb] ( nurse practition]s & cl9ical    
nurse speciali/s ent]+ c>e]s focus$ on  
mat]nal & p]9atal heal? f racial & e?nic

 m9ority gr\ps & o!r und]s]v$           
populations2  7#c7 increas+ ! numb] (   
nurse practition]s & cl9ical nurse      
speciali/s ent]+ c>e]s focus$ on mat]nal
 & p]9atal heal? work+ 9 heal?          
pr(essional %ortage areas designat$ "u  
section #ccb2 &  7#d7 increas+ ! numb] (
 nurse practition]s & cl9ical nurse     
speciali/s ent]+ c>e]s focus$ on mat]nal
 & p]9atal heal? work+ 9 areas )        
significant racial & e?nic disp>ities 9 
mat]nal heal? outcomes1 to ! ext5t su*  
data are available4  7i7 ,au?orization (
 appropriations ,to c>ry out ?is        
section1 !re is au?oriz$ to be          
appropriat$ #ae1jjj1jjj = ea* ( fiscal  
ye>s #bjbc ?r\gh #bjbg4  4  #acjd4 ,,gao
 report  7a7 ,9 g5]al ,n lat] ?an two   
ye>s aft] ! date ( enactm5t ( ?is ,act &
 e five ye>s !reaft]1 ! ,comptroll]     
,g5]al ( ! ,unit$ ,/ates %all submit to 
,congress a report on b>ri]s to mat]nal 
heal? education & access to c>e 9 !     
,unit$ ,/ates4 ,su* report %all include 
! in=mation & recomm5dations describ$ 9 

subsection 7b74  7b7 ,cont5t ( report ,!
 report "u subsection 7a7 %all include--
 7#a7 an assessm5t ( curr5t b>ri]s to   
ent]+ accr$it$ midwif]y education       
programs1 & recomm5dations = address+   
su* b>ri]s1 p>ticul>ly = l[-income wom5 
& wom5 f racial & e?nic m9ority gr\ps2  
7#b7 an assessm5t ( curr5t b>ri]s to    
ent]+ & successfully complet+ accr$it$  
education programs = o!r heal?          
pr(essional c>e]s relat$ to mat]nity    
c>e1 includ+ mat]nity c>e provid]s1     
m5tal & behavioral heal? c>e provid]s   
act+ 9 accordance ) ,/ate law1 regi/]$  
dietitians or nutrition pr(essionals 7z 
su* t]m is def9$ 9 section #ahfa7vv77#b7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciex7vv77#b7771 & lactation 
consultants c]tifi$ by ! ,int]national  
,bo>d ( ,lactation ,consultants         
,exam9]s1 p>ticul>ly = l[-income wom5 & 
wom5 f racial & e?nic m9ority gr\ps2    
7#c7 an assessm5t ( curr5t b>ri]s t     
prev5t midwives f meet+ ! int]national  
def9ition ( ! midwife & global /&>ds =  

midwif]y education z e/abli%$ by !      
,int]national ,conf$]ation ( ,midwives1 
& recomm5dations = address+ su* b>ri]s1 
p>ticul>ly = l[-income wom5 & wom5 f    
racial & e?nic m9ority gr\ps2  7#d7 an  
assessm5t ( disp>ities 9 access to      
mat]nity c>e provid]s1 m5tal or         
behavioral heal? c>e provid]s act+ 9    
accordance ) ,/ate law1 regi/]$         
dietitians or nutrition pr(essionals 7z 
su* t]m is def9$ 9 section #ahfa7vv77#b7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciex7vv77#b7771 lactation   
consultants c]tifi$ by ! ,int]national  
,bo>d ( ,lactation ,consultants         
,exam9]s1 & p]9atal heal? work]s1       
/ratifi$ by race1 e?nicity1 g5d]        
id5tity1 geographic location1 &         
insurance type & recomm5dations to      
promote great] access equity2 &  7#e7   
recomm5dations to promote great] equity 
9 comp5sation = p]9atal heal? work]s "u 
public & private insur]s1 p>ticul>ly =  
su* individuals f racially & e?nically  
div]se backgr\nds4  ,e ,data to save    

moms  #adja4 ,fund+ = mat]nal mortality 
review committees to promote            
repres5tative community engagem5t  7a7  
,9 g5]al ,section #cag,k7d7 ( ! ,public 
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bdg;b-#ab7;d77 is am5d$ by add+ at !   
end ! foll[+3  7#i7 ,grants to promote  
repres5tative community engagem5t 9     
mat]nal mortality review committees     
7,a7 ,9 g5]al ,! ,secret>y may1 us+     
funds made available pursuant to        
subp>agraph 7,c71 provide assi/ance to  
an applicable mat]nal mortality review  
committee ( a ,/ate1 ,indian tribe1     
tribal organization1 or urban ,indian   
organization 7z su* t]m is def9$ 9      
section #d ( ! ,indian ,heal? ,c>e      
,improvem5t ,act 7#be ,u4,s4,c4         
#afjc77-- 7i7 to select = inclusion 9 ! 
memb]%ip ( su* a committee community    
memb]s f ! ,/ate1 ,indian tribe1 tribal 
organization1 or urban ,indian          
organization by-- 7,i7 prioritiz+       
community memb]s :o c increase !        
div]sity ( ! committee's memb]%ip )     

respect to race & e?nicity1 location1 & 
pr(essional backgr\nd1 includ+ memb]s ) 
non-cl9ical exp]i5ces2 &  7,,ii7 to !   
ext5t applicable1 us+ funds res]v$ "u   
subsection 7f71 to address b>ri]s to    
mat]nal mortality review committee      
p>ticipation = community memb]s1 includ+
 requir$ tra9+1 transportation b>ri]s1  
comp5sation1 & o!r supports z may be    
necess>y2  7ii7 to e/abli% initiatives  
to conduct outrea* & community engagem5t
 ef=ts )9 communities ?r\gh\t ! ,/ate or
 ,tribe to seek input f community memb]s
 on ! "w ( su* mat]nal mortality review 
committee1 ) a p>ticul> focus on outrea*
 to m9ority wom52 &  7iii7 to release   
public reports assess+-- 7,i7 !         
pregnancy-relat$ dea? &                 
pregnancy-associat$ dea? review         
processes ( ! mat]nal mortality review  
committee1 ) a p>ticul> focus on !      
mat]nal mortality review committee's    
s5sitivity to ! unique circum/ances (   
pregnant & po/p>tum individuals f racial
 & e?nic m9ority gr\ps 7z su* t]m is    

def9$ 9 section #agjg7;g77#a77 :o h     
suff]$ pregnancy-relat$ dea?s2 &  7,,ii7
 ! impact ( ! use ( funds made available
 pursuant to p>agraph 7,c7 on increas+ !
 div]sity ( ! mat]nal mortality review  
committee memb]%ip & promot+ community  
engagem5t ef=ts ?r\gh\t ! ,/ate or      
,tribe4  7,b7 ,te*nical assi/ance ,!    
,secret>y %all provide 7ei!r directly   
?r\gh ! ,dep>tm5t ( ,heal? & ,human     
,s]vices or by contract7 te*nical       
assi/ance to any mat]nal mortality      
review committee receiv+ a grant "u ?is 
p>agraph on be/ practices = increas+ !  
div]sity ( ! mat]nal mortality review   
committee's memb]%ip & = conduct+       
effective community engagem5t ?r\gh\t ! 
,/ate or ,tribe4  7,c7 ,au?orization (  
appropriations ,9 addition to any funds 
made available "u subsection 7f71 !re   
are au?oriz$ to be appropriat$ to c>ry  
out ?is p>agraph #aj1jjj1jjj = ea* (    
fiscal ye>s #bjbc ?r\gh #bjbg4  4  7b7  
,res]vation ( funds ,section #cag,k7f7 (
 ! ,public ,heal? ,s]vice ,act 7#db     

,u4,s4,c4 #bdg;b-#ab7;f77 is am5d$ by   
add+ at ! end ! foll[+3 ,( ! am\nt made 
available "u ! prec$+ s5t5ce = a fiscal 
ye>1 n less ?an #a1ejj1jjj %all be      
res]v$ = grants to ,indian tribes1      
tribal organizations1 or urban ,indian  
organizations 7z ^? t]ms are def9$ 9    
section #d ( ! ,indian ,heal? ,c>e      
,improvem5t ,act 7#be ,u4,s4,c4 #afjc774
  #adjb4 ,data collection & review      
,section #cag,k7d77#c77;,a77i7 ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bdg;b-#ab7;d77#c77;,a77i77 is
 am5d$-- 7#a7 by r$esignat+ subclauses  
7,,ii7 & 7,,iii7 z subclauses 7,v7 &    
7,,vi71 respectively2 &  7#b7 by ins]t+ 
aft] subclause 7,i7 ! foll[+3  7,,ii7 to
 ! ext5t practicable1 review+ cases (   
sev]e mat]nal morbidity1 accord+ to !   
mo/ up-to-date indicators2  7,,iii7 to !
 ext5t practicable1 review+ dea?s dur+  
pregnancy or up to #a ye> aft] ! end ( a
 pregnancy f suicide1 ov]dose1 or o!r   
dea? f a m5tal heal? condition or       
sub/ance use disord] attribut$ to or    

aggravat$ by pregnancy or *ildbir?      
complications2  7,,iv7 to ! ext5t       
practicable1 consult+ ) local           
community-bas$ organizations repres5t+  
pregnant & po/p>tum individuals f       
demographic gr\ps disproportionately    
impact$ by poor mat]nal heal? outcomes  
to ensure t1 9 addition to cl9ical      
factors1 non-cl9ical factors t might h  
contribut$ to a pregnancy-relat$ dea?   
are appropriately consid]$2  4  #adjc4  
,review ( mat]nal heal? data collection 
processes & quality measures  7a7 ,9    
g5]al ,! ,secret>y ( ,heal? & ,human    
,s]vices1 act+ ?r\gh ! ,adm9i/rator =   
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices & ! 
,director ( ! ,ag5cy = ,heal?c>e ,rese>*
 & ,quality1 %all consult ) relevant    
/akehold]s-- 7#a7 to review exi/+       
mat]nal heal? data collection processes 
& quality measures2 &  7#b7 make        
recomm5dations to improve su* processes 
& measures1 includ+ topics describ$ "u  
subsection 7c74  7b7 ,collaboration ,9  
c>ry+ out ?is section1 ! ,secret>y %all 

consult ) a div]se gr\p ( mat]nal heal? 
/akehold]s1 :i* may include-- 7#a7      
pregnant & po/p>tum individuals & _!    
family memb]s1 & nonpr(it organizations 
repres5t+ su* individuals1 ) a p>ticul> 
focus on pati5ts f racial & e?nic       
m9ority gr\ps2  7#b7 community-bas$     
organizations t provide support =       
pregnant & po/p>tum individuals1 ) a    
p>ticul> focus on pati5ts f racial &    
e?nic m9ority gr\ps2  7#c7 memb]%ip     
organizations = mat]nity c>e provid]s2  
7#d7 organizations repres5t+ p]9atal    
heal? work]s2  7#e7 organizations t     
focus on mat]nal m5tal or behavioral    
heal?2  7#f7 organizations t focus on   
intimate p>tn] viol5ce2  7#g7           
in/itutions ( high] education1 ) a      
p>ticul> focus on m9ority-s]v+          
in/itutions2  7#h7 lic5s$ & accr$it$    
hospitals1 bir? c5t]s1 midwif]y         
practices1 or o!r m$ical practices t    
provide mat]nal heal? c>e s]vices to    
pregnant & po/p>tum pati5ts2  7#i7      
relevant ,/ate & local public ag5cies1  

includ+ ,/ate mat]nal mortality review  
committees2 &  7#aj7 ! ,national        
,quality ,=um1 or su* o!r /&>d-sett+    
organizations specifi$ by ! ,secret>y4  
7c7 ,topics ,! review ( mat]nal heal?   
data collection processes &             
recomm5dations to improve su* processes 
& measures requir$ "u subsection 7a7    
%all assess all available relevant      
in=mation1 includ+ in=mation f          
,/ate-level s\rces1 & %all consid] at   
lea/ ! foll[+3 7#a7 ,curr5t ,/ate &     
,tribal practices = mat]nal heal?1      
mat]nal mortality1 & sev]e mat]nal      
morbidity data collection &             
dissem9ation1 includ+ consid]ation (--  
7,a7 ! timel9ess ( processes = am5d+ a  
dea? c]tificate :5 new in=mation p]ta9+ 
to ! dea? becomes available to reflect  
:e!r ! dea? 0 a pregnancy-relat$ dea?2  
7,b7 relevant data collect$ ) electronic
 heal? records1 includ+ data on race1   
e?nicity1 socioeconomic /atus1 insurance
 type1 & o!r relevant demographic       
in=mation2  7,c7 mat]nal heal? data     

collect$ & publicly report$ by          
hospitals1 heal? sy/ems1 midwif]y       
practices1 & bir? c5t]s2  7,d7 ! b>ri]s 
prev5t+ ,/ates f correlat+ mat]nal      
outcome data ) race & e?nicity data2    
7,e7 processes = det]m9+ ! cause ( a    
pregnancy-associat$ dea? 9 ,/ates t d n 
h a mat]nal mortality review committee2 
7,f7 :e!r mat]nal mortality review      
committees include multidiscipl9>y &    
div]se memb]%ip 7z describ$ 9 section   
#cag,k7d77#a77;,a7 ( ! ,public ,heal?   
,s]vice ,act 7#db ,u4,s4,c4             
#bdg;b-#ab7;d77#a77;,a7772  7,g7 :e!r   
memb]s ( mat]nal mortality review       
committees p>ticipate 9 tra9+s on bias1 
racism1 or discrim9ation1 & ! quality ( 
su* tra9+s2  7,h7 ! ext5t to :i* ,/ates 
h implem5t$ sy/ematic processes ( li/5+ 
to ! /ories ( pregnant & po/p>tum       
individuals & _! family memb]s1 ) a     
p>ticul> focus on pregnant & po/p>tum   
individuals f racial & e?nic m9ority    
gr\ps 7z su* t]m is def9$ 9 section     
#agjg7;g77#a7 ( ! ,public ,heal? ,s]vice

 ,act 7#db ,u4,s4,c4 #cjju-#f7;g77#a777 
& _! family memb]s1 to fully und]/& !   
causes (1 & in=m pot5tial solutions to1 
! mat]nal mortality & sev]e mat]nal     
morbidity crisis )9 _! respective       
,/ates2  7,i7 ! ext5t to :i* mat]nal    
mortality review committees are consid]+
 social det]m9ants ( mat]nal heal? :5   
exam9+ ! causes ( pregnancy-associat$ & 
pregnancy-relat$ dea?s2  7,j7 ! ext5t to
 :i* mat]nal mortality review committees
 are mak+ actionable recomm5dations bas$
 on _! reviews ( adv]se mat]nal heal?   
outcomes & ! ext5t to :i* su*           
recomm5dations are be+ implem5t$ by     
appropriate /akehold]s2  7,k7 ! legal & 
adm9i/rative b>ri]s prev5t+ !           
collection1 collation1 & dissem9ation ( 
,/ate mat]nity c>e data2  7,l7 !        
effectiv5ess ( data collection & report+
 processes 9 sep>at+ pregnancy-associat$
 dea?s f pregnancy-relat$ dea?s2 &  7,m7
 ! curr5t ,f$]al1 ,/ate1 local1 &       
,tribal fund+ support = ! activities    
ref]r$ to 9 subp>agraphs 7,a7 ?r\gh     

7,l74  7#b7 ,:e!r ! fund+ support ref]r$
 to 9 p>agraph 7#a77,m7 is adequate =   
,/ates to c>ry out optimal data         
collection & dissem9ation processes )   
respect to mat]nal heal?1 mat]nal       
mortality1 & sev]e mat]nal morbidity4   
7#c7 ,curr5t quality measures = mat]nity
 c>e1 includ+ pr5atal measures1 labor & 
deliv]y measures1 & po/p>tum measures1  
includ+ topics su* z-- 7,a7 effective   
quality measures = mat]nity c>e us$ by  
hospitals1 heal? sy/ems1 midwif]y       
practices1 bir? c5t]s1 heal? plans1 &   
o!r relevant entities2  7,b7 !          
suffici5cy ( curr5t outcome measures us$
 to evaluate mat]nity c>e = driv+       
improv$ c>e1 exp]i5ces1 & outcomes 9    
mat]nity c>e paym5t & deliv]y sy/em     
models2  7,c7 mat]nal heal? quality     
measures t o!r c\ntries effectively use2
  7,d7 validat$ measures t h be5 us$ =  
rese>* purposes t c\ld be te/$1 ref9$1 &
 submitt$ = national endorsem5t2  7,e7  
b>ri]s prev5t+ mat]nity c>e provid]s &  
insur]s f implem5t+ quality measures t  

are align$ ) be/ practices2  7,f7 !     
frequ5cy ) :i* mat]nity c>e quality     
measures are review$ & revis$2  7,g7 !  
/r5g?s & weaknesses ( ! ,pr5atal &      
,po/p>tum ,c>e measures ( ! ,heal? ,plan
 ,employ] ,data & ,in=mation ,set       
measures e/abli%$ by ! ,national        
,committee = ,quality ,assurance2  7,h7 
! /r5g?s & weaknesses ( mat]nity c>e    
quality measures "u ! ,m$icaid program  
"u title ,,xix ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif et seq47 & !  
,*ildr5's ,heal? ,insurance ,program "u 
title ,,xxi ( su* ,act 7#db ,u4,s4,c4   
#acig et seq471 includ+ ! ext5t to :i*  
,/ates volunt>ily report relevant       
measures2  7,i7 ! ext5t to :i* mat]nity 
c>e quality measures are in=m$ by pati5t
 exp]i5ces t include measures (         
pati5t-report$ exp]i5ce ( c>e2  7,j7 !  
curr5t processes = collect+ /ratifi$    
data on ! race & e?nicity ( pregnant &  
po/p>tum individuals 9 hospitals1 heal? 
sy/ems1 midwif]y practices1 & bir?      
c5t]s1 & = incorporat+ su* racially &   

e?nically /ratifi$ data 9 mat]nity c>e  
quality measures2  7,k7 ! ext5t to :i*  
mat]nity c>e quality measures acc\nt = !
 unique exp]i5ces ( pregnant & po/p>tum 
individuals f racial & e?nic m9ority    
gr\ps 7z su* t]m is def9$ 9 section     
#agjg7;g77#a7 ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjju-#f7;g77#a7772
 &  7,l7 ! ext5t to :i* hospitals1 heal?
 sy/ems1 midwif]y practices1 & bir?     
c5t]s are implem5t+ exi/+ mat]nity c>e  
quality measures4  7#d7 ,recomm5dations 
on au?oriz+ additional funds & provid+  
additional te*nical assi/ance to improve
 mat]nal mortality review committees &  
,/ate & ,tribal mat]nal heal? data      
collection & report+ processes4  7#e7   
,recomm5dations = new au?orities t may  
be grant$ to mat]nal mortality review   
committees to be able to-- 7,a7 access  
records f o!r ,f$]al & ,/ate ag5cies &  
dep>tm5ts t may be necess>y to id5tify  
causes ( pregnancy-associat$ &          
pregnancy-relat$ dea?s t are unique to  
pregnant & po/p>tum individuals f       

specific populations1 su* z vet]ans &   
individuals :o are inc>c]at$2 &  7,b7 "w
 ) relevant exp]ts :o are n memb]s ( !  
mat]nal mortality review committee to   
assi/ 9 ! review ( pregnancy-associat$  
dea?s ( pregnant & po/p>tum individuals 
f specific populations1 su* z vet]ans & 
individuals :o are inc>c]at$4  7#f7     
,recomm5dations to improve & /&>dize    
curr5t quality measures = mat]nity c>e1 
) a p>ticul> focus on racial & e?nic    
disp>ities 9 mat]nal heal? outcomes4    
7#g7 ,recomm5dations to improve !       
coord9ation by ! ,dep>tm5t ( ,heal? &   
,human ,s]vices ( ! ef=ts und]tak5 by ! 
ag5cies & organizations )9 ! ,dep>tm5t  
relat$ to mat]nal heal? data & quality  
measures4  7d7 ,report ,n lat] ?an #a   
ye> aft] ! enactm5t ( ?is ,act1 !       
,secret>y %all submit to ! ,congress &  
make publicly available a report on !   
results ( ! review ( mat]nal heal? data 
collection processes & quality measures 
& recomm5dations to improve su*         
processes & measures requir$ "u         

subsection 7a74  7e7 ,def9itions ,9 ?is 
section3 7#a7 ,mat]nal mortality review 
committee ,! t]m mat]nal mortality      
review committee means a mat]nal        
mortality review committee duly au?oriz$
 by a ,/ate & receiv+ fund+ "u section  
#cagk7a77#b77;,d7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4             
#bdg;b-#ab7;a77#b77;,d774  7#b7         
,pregnancy-associat$ dea? ,! t]m        
pregnancy-associat$1 ) respect to a     
dea?1 means a dea? ( a pregnant or      
po/p>tum individual1 by any cause1 t    
occurs dur+1 or )9 #a ye> foll[+1 !     
individual's pregnancy1 reg>dless ( !   
outcome1 duration1 or site ( !          
pregnancy4  7#c7 ,pregnancy-relat$ dea? 
,! t]m pregnancy-relat$1 ) respect to a 
dea?1 means a dea? ( a pregnant or      
po/p>tum individual t occurs dur+1 or )9
 #a ye> foll[+1 ! individual's          
pregnancy1 f a pregnancy complication1 a
 *a9 ( ev5ts initiat$ by pregnancy1 or !
 aggravation ( an unrelat$ condition by 
! physiologic effects ( pregnancy4  7f7 

,au?orization ( appropriations ,!re are 
au?oriz$ to be appropriat$ su* sums z   
may be necess>y to c>ry out ?is section 
= fiscal ye>s #bjbc ?r\gh #bjbf4  #adjd4
 ,indian ,heal? ,s]vice /udy on mat]nal 
mortality & sev]e mat]nal morbidity  7a7
 ,9 g5]al ,! ,director ( ! ,indian      
,heal? ,s]vice 7ref]r$ to 9 ?is section 
z ! ,director7 %all1 9 coord9ation )    
entities describ$ 9 subsection 7b7--    
7#a7 n lat] ?an #ij days aft] ! enactm5t
 ( ?is ,act1 ent] into a contract ) an  
indep5d5t rese>* organization or ,tribal
 ,epidemiology ,c5t] to conduct a       
compreh5sive /udy on mat]nal mortality &
 sev]e mat]nal morbidity 9 ! populations
 ( ,am]ican ,indian & ,alaska ,native   
individuals2 &  7#b7 n lat] ?an #c ye>s 
aft] ! date ( ! enactm5t ( ?is ,act1    
submit to ,congress a report on su* /udy
 t conta9s recomm5dations = policies &  
practices t c be adopt$ to improve      
mat]nal heal? outcomes = pregnant &     
po/p>tum ,am]ican ,indian & ,alaska     
,native individuals4  7b7 ,p>ticipat+   

entities ,! entities describ$ 9 ?is     
subsection %all consi/ ( #ab memb]s1    
select$ by ! ,director f among          
individuals nom9at$ by ,indian tribes & 
tribal organizations 7z su* t]ms are    
def9$ 9 section #d ( ! ,indian          
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 
& urban ,indian organizations 7z su* t]m
 is def9$ 9 section #d ( ! ,indian      
,heal? ,c>e ,improvem5t ,act 7#be       
,u4,s4,c4 #afjc774 ,9 select+ su*       
memb]s1 ! ,director %all ensure t ea* ( 
! #ab s]vice areas ( ! ,indian ,heal?   
,s]vice is repres5t$4  7c7 ,cont5ts (   
/udy ,! /udy conduct$ pursuant to       
subsection 7a7 %all-- 7#a7 exam9e !     
causes ( mat]nal mortality & sev]e      
mat]nal morbidity t are unique to       
,am]ican ,indian & ,alaska ,native      
individuals2  7#b7 include a sy/ematic  
process ( li/5+ to ! /ories ( ,am]ican  
,indian & ,alaska ,native pregnant &    
po/p>tum individuals to fully und]/& !  
causes (1 & in=m pot5tial solutions to1 

! mat]nal mortality & sev]e mat]nal     
morbidity crisis )9 _! respective       
communities2  7#c7 di/+ui% betwe5 !     
causes (1 l&scape ( mat]nity c>e at1 &  
recomm5dations to improve mat]nal heal? 
outcomes )91 ! diff]5t sett+s 9 :i*     
,am]ican ,indian & ,alaska ,native      
pregnant & po/p>tum individuals receive 
mat]nity c>e1 su* z-- 7,a7 facilities   
op]at$ by ! ,indian ,heal? ,s]vice2     
7,b7 an ,indian heal? program op]at$ by 
an ,indian tribe or tribal organization 
pursuant to a contract1 grant1          
coop]ative agreem5t1 or compact ) !     
,indian ,heal? ,s]vice pursuant to !    
,indian ,self-,det]m9ation ,act2 &  7,c7
 an urban ,indian heal? program op]at$  
by an urban ,indian organization        
pursuant to a grant or contract ) !     
,indian ,heal? ,s]vice pursuant to title
 ,v ( ! ,indian ,heal? ,c>e ,improvem5t 
,act2  7#d7 review processes = coord9at+
 programs ( ! ,indian ,heal? ,s]vice )  
social s]vices provid$ ?r\gh o!r        
programs adm9i/]$ by ! ,secret>y (      

,heal? & ,human ,s]vices 7o!r ?an !     
,m$ic>e program "u title ,,xviii ( !    
,social ,security ,act1 ! ,m$icaid      
program "u title ,,xix ( su* ,act1 & !  
,*ildr5's ,heal? ,insurance ,program "u 
title ,,xxi ( su* ,act71 includ+        
coord9ation ) ! ef=ts ( ! ,task ,=ce    
e/abli%$ "u section #adjc2  7#e7 review 
curr5t data collection & quality        
measurem5t processes & practices2  7#f7 
assess causes & frequ5cy ( mat]nal m5tal
 heal? conditions & sub/ance use        
disord]s2  7#g7 consid] social          
det]m9ants ( heal?1 includ+ pov]ty1 lack
 ( heal? insurance1 unemploym5t1 sexual 
viol5ce1 & environm5tal conditions 9    
,tribal areas2  7#h7 consid] ! role t   
hi/orical mi/reatm5t ( ,am]ican ,indian 
& ,alaska ,native wom5 has play$ 9 caus+
 curr5tly high rates ( mat]nal mortality
 & sev]e mat]nal morbidity2  7#i7       
consid] h[ curr5t fund+ ( ! ,indian     
,heal? ,s]vice affects ! ability ( !    
,s]vice to deliv] quality mat]nity c>e2 
7#aj7 consid] ! ext5t to :i* ! deliv]y (

 mat]nity c>e s]vices is culturally     
appropriate = ,am]ican ,indian & ,alaska
 ,native pregnant & po/p>tum            
individuals2  7#aa7 make recomm5dations 
to r$uce misclassification ( ,am]ican   
,indian & ,alaska ,native pregnant &    
po/p>tum individuals1 includ+           
consid]ation ( be/ practices 9 tra9+ =  
mat]nal mortality review committee      
memb]s to be able to correctly classify 
,am]ican ,indian & ,alaska ,native      
individuals2 &  7#ab7 make              
recomm5dations in=m$ by ! /ories %>$ by 
,am]ican ,indian & ,alaska ,native      
pregnant & po/p>tum individuals 9       
p>agraph 7#b7 to improve mat]nal heal?  
outcomes = su* individuals4  7d7 ,report
 ,! agreem5t ent]$ into "u subsection   
7a7 ) an indep5d5t rese>* organization  
or ,tribal ,epidemiology ,c5t] %all     
require t ! organization or c5t]        
transmit to ,congress a report on !     
results ( ! /udy conduct$ pursuant to t 
agreem5t n lat] ?an #cf mon?s aft] !    
date ( ! enactm5t ( ?is ,act4  7e7      

,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section #b1jjj1jjj = ea* ( fiscal   
ye>s #bjbc ?r\gh #bjbe4  #adje4 ,grants 
to m9ority-s]v+ in/itutions to /udy     
mat]nal mortality1 sev]e mat]nal        
morbidity1 & o!r adv]se mat]nal heal?   
outcomes  7a7 ,9 g5]al ,! ,secret>y (   
,heal? & ,human ,s]vices %all e/abli% a 
program "u :i* ! ,secret>y %all aw>d    
grants to rese>* c5t]s1 heal? pr(essions
 s*ools & programs1 & o!r entities at   
m9ority-s]v+ in/itutions to /udy        
specific aspects ( ! mat]nal heal?      
crisis among pregnant & po/p>tum        
individuals f racial & e?nic m9ority    
gr\ps4 ,su* rese>* may-- 7#a7 include ! 
developm5t & implem5tation ( sy/ematic  
processes ( li/5+ to ! /ories ( pregnant
 & po/p>tum individuals f racial & e?nic
 m9ority gr\ps1 & p]9atal heal? work]s  
support+ su* individuals1 to fully      
und]/& ! causes (1 & in=m pot5tial      
solutions to1 ! mat]nal mortality &     
sev]e mat]nal morbidity crisis )9 _!    

respective communities2  7#b7 assess !  
pot5tial causes ( relatively l[ rates ( 
mat]nal mortality among ,hispanic       
individuals1 includ+ pot5tial racial    
misclassification & o!r data collection 
& report+ issues t might be misrepres5t+
 mat]nal mortality rates among ,hispanic
 individuals 9 ! ,unit$ ,/ates2 &  7#c7 
assess diff]5ces 9 rates ( adv]se       
mat]nal heal? outcomes among subgr\ps   
id5tify+ z ,hispanic4  7b7 ,application 
,to be eligible to receive a grant "u   
subsection 7a71 an entity describ$ 9 su*
 subsection %all submit to ! ,secret>y  
an application at su* "t1 9 su* mann]1 &
 conta9+ su* in=mation z ! ,secret>y may
 require4  7c7 ,te*nical assi/ance ,!   
,secret>y may use n m ?an #aj p]c5t ( ! 
funds made available "u subsection 7f7--
 7#a7 to conduct outrea* to m9ority-s]v+
 in/itutions to raise aw>5ess ( !       
availability ( grants "u ?is subsection 
7a72  7#b7 to provide te*nical assi/ance
 9 ! application process = su* a grant2 
&  7#c7 to promote capacity build+ z    

ne$$ to enable entities describ$ 9 su*  
subsection to submit su* an application4
  7d7 ,report+ requirem5t ,ea* entity   
aw>d$ a grant "u ?is section %all       
p]iodically submit to ! ,secret>y a     
report on ! /atus ( activities conduct$ 
us+ ! grant4  7e7 ,evaluation ,beg9n+ "o
 ye> aft] ! date on :i* ! fir/ grant is 
aw>d$ "u ?is section1 ! ,secret>y %all  
submit to ,congress an annual report    
summ>iz+ ! f9d+s ( rese>* conduct$ us+  
funds made available "u ?is section4    
7f7 ,m9ority-,s]v+ in/itutions def9$ ,9 
?is section1 ! t]m m9ority-s]v+         
in/itution has ! mean+ giv5 ! t]m 9     
section #cga7;a7 ( ! ,high] ,education  
,act ( #aife 7#bj ,u4,s4,c4 #ajfgq7a774 
7g7 ,au?orization ( appropriations ,!re 
are au?oriz$ to be appropriat$ to c>ry  
out ?is section #aj1jjj1jjj = ea* (     
fiscal ye>s #bjbc ?r\gh #bjbg4  ,f ,moms
 matt]  #aeja4 ,mat]nal m5tal heal?     
equity grant program  7a7 ,9 g5]al ,!   
,secret>y ( ,heal? & ,human ,s]vices1   
act+ ?r\gh ! ,assi/ant ,secret>y =      

,m5tal ,heal? & ,sub/ance ,use1 %all    
e/abli% a program to aw>d grants to     
eligible entities to address mat]nal    
m5tal heal? conditions & sub/ance use   
disord]s ) respect to pregnant &        
po/p>tum individuals1 ) a focus on      
racial & e?nic m9ority gr\ps4  7b7      
,application ,to be eligible to receive 
a grant "u ?is section an eligible      
entity %all submit to ! ,secret>y an    
application at su* "t1 9 su* mann]1 &   
conta9+ su* in=mation z ! ,secret>y may 
provide1 includ+ h[ su* entity w use    
funds = activities describ$ 9 subsection
 7d7 t are culturally congru5t4  7c7    
,priority ,9 aw>d+ grants "u ?is        
section1 ! ,secret>y %all give priority 
to an eligible entity t-- 7#a7 is1 or w 
p>tn] )1 a community-bas$ organization  
to address mat]nal m5tal heal?          
conditions & sub/ance use disord]s      
describ$ 9 subsection 7a72  7#b7 is     
op]at+ 9 an area ) high rates (-- 7,a7  
adv]se mat]nal heal? outcomes2 or  7,b7 
significant racial or e?nic disp>ities 9

 mat]nal heal? outcomes2 &  7#c7 is     
op]at+ 9 a heal? pr(essional %ortage    
area designat$ "u section #ccb ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;e74  7d7 ,use ( funds ,an
 eligible entity t receives a grant "u  
?is section %all use funds = ! foll[+3  
7#a7 ,e/abli%+ or exp&+ mat]nity c>e    
programs to improve ! integration (     
mat]nal heal? & behavioral heal? c>e    
s]vices into prim>y c>e sett+s :]e      
pregnant individuals regul>ly receive   
heal? c>e s]vices4  7#b7 ,e/abli%+ or   
exp&+ gr\p pr5atal c>e programs or      
po/p>tum c>e programs4  7#c7 ,exp&+     
exi/+ programs t improve mat]nal m5tal &
 behavioral heal? dur+ ! pr5atal &      
po/p>tum p]iods1 ) a focus on           
individuals f racial & e?nic m9ority    
gr\ps4  7#d7 ,provid+ s]vices & support 
= pregnant & po/p>tum individuals )     
mat]nal m5tal heal? conditions &        
sub/ance use disord]s1 includ+ ref]rals 
to addiction treatm5t c5t]s t (f]       
evid5ce-bas$ treatm5t options4  7#e7    

,address+ /igma associat$ ) mat]nal     
m5tal heal? conditions & sub/ance use   
disord]s1 ) a focus on racial & e?nic   
m9ority gr\ps4  7#f7 ,rais+ aw>5ess (   
w>n+ signs ( mat]nal m5tal heal?        
conditions & sub/ance use disord]s1 ) a 
focus on pregnant & po/p>tum individuals
 f racial & e?nic m9ority gr\ps4  7#g7  
,e/abli%+ or exp&+ programs to prev5t   
suicide or self-h>m among pregnant &    
po/p>tum individuals4  7#h7 ,(f]+       
evid5ce-align$ programs at free/&+ bir? 
c5t]s t provide mat]nal m5tal &         
behavioral heal? c>e education1         
treatm5ts1 & s]vices1 & o!r s]vices =   
individuals ?r\gh\t ! pr5atal & po/p>tum
 p]iod4  7#i7 ,e/abli%+ or exp&+        
programs to provide education & tra9+ to
 mat]nity c>e provid]s ) respect to--   
7,a7 id5tify+ pot5tial w>n+ signs =     
mat]nal m5tal heal? conditions or       
sub/ance use disord]s 9 pregnant &      
po/p>tum individuals1 ) a focus on      
individuals f racial & e?nic m9ority    
gr\ps2 &  7,b7 9 ! case :]e su* provid]s

 id5tify su* w>n+ signs1 (f]+ ref]rals  
to m5tal & behavioral heal? c>e         
pr(essionals4  7#aj7 ,develop+ a        
website1 or o!r s\rce1 t includes       
in=mation on heal? c>e provid]s :o treat
 mat]nal m5tal heal? conditions &       
sub/ance use disord]s4  7#aa7 ,e/abli%+ 
or exp&+ programs 9 communities to      
improve coord9ation betwe5 mat]nity c>e 
provid]s & m5tal & behavioral heal? c>e 
provid]s :o treat mat]nal m5tal heal?   
conditions & sub/ance use disord]s1     
includ+ ?r\gh ! use ( toll-free hotl9es4
  7#ab7 ,c>ry+ out o!r programs align$ )
 evid5ce-bas$ practices = address+      
mat]nal m5tal heal? conditions &        
sub/ance use disord]s = pregnant &      
po/p>tum individuals f racial & e?nic   
m9ority gr\ps4  7e7 ,report+  7#a7      
,eligible entities ,an eligible entity t
 receives a grant "u subsection 7a7 %all
 submit annually to ! ,secret>y1 & make 
publicly available1 a report on !       
activities conduct$ us+ funds receiv$   
?r\gh a grant "u ?is section4 ,su*      

reports %all include quantitative &     
qualitative evaluations ( su*           
activities1 includ+ ! exp]i5ce (        
individuals :o receiv$ heal? c>e ?r\gh  
su* grant4  7#b7 ,secret>y ,n lat] ?an !
 end ( fiscal ye> #bjbe1 ! ,secret>y    
%all submit to ,congress a report t     
includes-- 7,a7 a summ>y ( ! reports    
receiv$ "u p>agraph 7#a72  7,b7 an      
evaluation ( ! effectiv5ess ( grants    
aw>d$ "u ?is section2  7,c7             
recomm5dations ) respect to exp&+       
cov]age ( evid5ce-bas$ scre5+s &        
treatm5ts = mat]nal m5tal heal?         
conditions & sub/ance use disord]s2 &   
7,d7 recomm5dations ) respect to ensur+ 
activities describ$ "u subsection 7d7   
cont9ue aft] ! end ( a grant p]iod4  7f7
 ,def9itions ,9 ?is section3 7#a7       
,eligible entity ,! t]m eligible entity 
means-- 7,a7 a community-bas$           
organization s]v+ pregnant & po/p>tum   
individuals1 includ+ su* organizations  
s]v+ individuals f racial & e?nic       
m9ority gr\ps & o!r und]s]v$            

populations2  7,b7 a nonpr(it or pati5t 
advocacy organization ) exp]tise 9      
mat]nal m5tal & behavioral heal?2  7,c7 
a mat]nity c>e provid]2  7,d7 a m5tal or
 behavioral heal? c>e provid] :o treats 
mat]nal m5tal heal? conditions or       
sub/ance use disord]s2  7,e7 a ,/ate or 
local gov]nm5tal entity1 includ+ a ,/ate
 or local public heal? dep>tm5t2  7,f7  
an ,indian ,tribe or ,tribal            
organization 7z su* t]ms are def9$ 9    
section #d ( ! ,indian                  
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd772 
&  7,g7 an ,urban ,indian organization  
7z su* t]m is def9$ 9 section #d ( !    
,indian ,heal? ,c>e ,improvem5t ,act    
7#be ,u4,s4,c4 #afjc774  7#b7 ,free/&+  
bir? c5t] ,! t]m free/&+ bir? c5t] has !
 mean+ giv5 t t]m "u section #aije7l7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acif;d7#a774  7#c7 ,secret>y ,! t]m    
,secret>y means ! ,secret>y ( ,heal? &  
,human ,s]vices4  7g7 ,au?orization (   
appropriations ,to c>ry out ?is section1

 !re is au?oriz$ to be appropriat$      
#be1jjj1jjj = ea* ( fiscal ye>s #bjbc   
?r\gh #bjbf4  #aejb4 ,grants to gr[ &   
div]sify ! mat]nal m5tal & behavioral   
heal? c>e work=ce ,title ,,vii ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bib et seq47 is am5d$ by     
ins]t+ aft] section #geh ( su* ,act1 z  
add$ by section #acjb ( ?is title1 !    
foll[+ new section3  #geh;,a4 ,mat]nal  
m5tal & behavioral heal? c>e work=ce    
grants  7a7 ,9 g5]al ,! ,secret>y may   
aw>d grants to entities to e/abli% or   
exp& programs describ$ 9 subsection 7b7 
to gr[ & div]sify ! mat]nal m5tal &     
behavioral heal? c>e work=ce4  7b7 ,use 
( funds ,recipi5ts ( grants "u ?is      
section %all use ! grants to gr[ &      
div]sify ! mat]nal m5tal & behavioral   
heal? c>e work=ce by-- 7#a7 e/abli%+    
s*ools or programs t provide education &
 tra9+ to individuals seek+ appropriate 
lic5s+ or c]tification z m5tal or       
behavioral heal? c>e provid]s :o w      
specialize 9 mat]nal m5tal heal?        

conditions or sub/ance use disord]s2 or 
7#b7 exp&+ ! capacity ( exi/+ s*ools or 
programs describ$ 9 p>agraph 7#a71 = !  
purposes ( increas+ ! numb] ( /ud5ts    
enroll$ 9 su* s*ools or programs1       
includ+ by aw>d+ s*ol>%ips = /ud5ts4    
7c7 ,prioritization ,9 aw>d+ grants "u  
?is section1 ! ,secret>y %all give      
priority to any entity t-- 7#a7 has     
demon/rat$ a commitm5t to recruit+ &    
reta9+ /ud5ts & faculty f racial & e?nic
 m9ority gr\ps2  7#b7 has develop$ a    
/rategy to recruit & reta9 a div]se pool
 ( /ud5ts into ! mat]nal m5tal or       
behavioral heal? c>e work=ce program or 
s*ool support$ by funds receiv$ ?r\gh ! 
grant1 p>ticul>ly f racial & e?nic      
m9ority gr\ps & o!r und]s]v$            
populations2  7#c7 has develop$ a       
/rategy to recruit & reta9 /ud5ts :o    
plan to practice 9 a heal? pr(essional  
%ortage area designat$ "u section #ccb2 
7#d7 has develop$ a /rategy to recruit &
 reta9 /ud5ts :o plan to practice 9 an  
area ) significant racial & e?nic       

disp>ities 9 mat]nal heal? outcomes1 to 
! ext5t practicable2 &  7#e7 includes 9 
! /&>d curriculum = all /ud5ts )9 !     
mat]nal m5tal or behavioral heal? c>e   
work=ce program or s*ool a bias1 racism1
 or discrim9ation tra9+ program t       
includes tra9+ on implicit bias &       
racism4  7d7 ,report+ ,z a condition on 
receipt ( a grant "u ?is section = a    
mat]nal m5tal or behavioral heal? c>e   
work=ce program or s*ool1 an entity %all
 agree to submit to ! ,secret>y an      
annual report on ! activities conduct$  
?r\gh ! grant1 includ+-- 7#a7 ! numb] & 
demographics ( /ud5ts p>ticipat+ 9 !    
program or s*ool2  7#b7 ! ext5t to :i*  
/ud5ts 9 ! program or s*ool are ent]+   
c>e]s 9-- 7,a7 heal? pr(essional %ortage
 areas designat$ "u section #ccb2 &     
7,b7 areas ) significant racial & e?nic 
disp>ities 9 mat]nal heal? outcomes1 to 
! ext5t su* data are available2 &  7#c7 
:e!r ! program or s*ool has includ$ 9 ! 
/&>d curriculum = all /ud5ts a bias1    
racism1 or discrim9ation tra9+ program t

 includes tra9+ on implicit bias &      
racism1 & if s ! effectiv5ess ( su*     
tra9+ program4  7e7 ,p]iod ( grants ,!  
p]iod ( a grant "u ?is section %all be  
up to #e ye>s4  7f7 ,application ,to    
seek a grant "u ?is section1 an entity  
%all submit to ! ,secret>y an           
application at su* "t1 9 su* mann]1 &   
conta9+ su* in=mation z ! ,secret>y may 
require1 includ+ any in=mation necess>y 
= prioritization "u subsection 7c74  7g7
 ,te*nical assi/ance ,! ,secret>y %all  
provide1 directly or by contract1       
te*nical assi/ance to entities seek+ or 
receiv+ a grant "u ?is section on !     
developm5t1 use1 evaluation1 & po/-grant
 p]iod su/a9ability ( ! mat]nal m5tal or
 behavioral heal? c>e work=ce programs  
or s*ools propos$ to be1 or be+1        
e/abli%$ or exp&$ ?r\gh ! grant4  7h7   
,report by ! secret>y ,n lat] ?an #d    
ye>s aft] ! date ( enactm5t ( ?is       
section1 ! ,secret>y %all prep>e &      
submit to ! ,congress1 & po/ on !       
int]net website ( ! ,dep>tm5t ( ,heal? &

 ,human ,s]vices1 a report on !         
effectiv5ess ( ! grant program "u ?is   
section at-- 7#a7 recruit+ /ud5ts f     
racial & e?nic m9ority gr\ps & o!r      
und]s]v$ populations2  7#b7 increas+ !  
numb] ( m5tal or behavioral heal? c>e   
provid]s specializ+ 9 mat]nal m5tal     
heal? conditions or sub/ance use        
disord]s f racial & e?nic m9ority gr\ps 
& o!r und]s]v$ populations2  7#c7       
increas+ ! numb] ( m5tal or behavioral  
heal? c>e provid]s specializ+ 9 mat]nal 
m5tal heal? conditions or sub/ance use  
disord]s work+ 9 heal? pr(essional      
%ortage areas designat$ "u section #ccb2
 &  7#d7 increas+ ! numb] ( m5tal or    
behavioral heal? c>e provid]s specializ+
 9 mat]nal m5tal heal? conditions or    
sub/ance use disord]s work+ 9 areas )   
significant racial & e?nic disp>ities 9 
mat]nal heal? outcomes1 to ! ext5t su*  
data are available4  7i7 ,def9itions ,9 
?is section3 7#a7 ,racial & e?nic       
m9ority gr\p ,! t]m racial & e?nic      
m9ority gr\p has ! mean+ giv5 su* t]m 9 

section #agjg7;g77#a74  7#b7 ,m5tal or  
behavioral heal? c>e provid] ,! t]m     
m5tal or behavioral heal? c>e provid]   
ref]s to a heal? c>e provid] 9 ! field (
 m5tal & behavioral heal?1 includ+      
sub/ance use disord]s1 act+ 9 accordance
 ) ,/ate law4  7j7 ,au?orization (      
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#ae1jjj1jjj = ea* ( fiscal ye>s #bjbc   
?r\gh #bjbg4  4  ,g ,ju/ice = inc>c]at$ 
moms  #afja4 ,end+ ! %ackl+ ( pregnant  
individuals  7a7 ,9 g5]al ,beg9n+ on !  
date t is #f mon?s aft] ! date (        
enactm5t ( ?is ,act1 & annually !reaft]1
 9 ea* ,/ate t receives a grant "u      
subp>t #a ( "p ,e ( title ,i ( !        
,omnibus ,crime ,control & ,safe ,/reets
 ,act ( #aifh 7#cd ,u4,s4,c4 #ajaea et  
seq47 7commonly ref]r$ to z ! ,edw>d    
,byrne ,memorial ,ju/ice ,grant         
,program7 & t does n h 9 effect ?r\gh\t 
! ,/ate = su* fiscal ye> laws re/rict+ !
 use ( re/ra9ts on pregnant individuals 
9 prison t are sub/antially simil> to ! 

rights1 proc$ures1 requirem5ts1 effects1
 & p5alties set =? 9 section #dcbb (    
title #ah1 ,unit$ ,/ates ,code1 ! am\nt 
( su* grant t w\ld o!rwise be allocat$  
to su* ,/ate "u su* subp>t = ! fiscal   
ye> %all be decreas$ by #be p]c5t4  7b7 
,reallocation ,am\nts n allocat$ to a   
,/ate = failure to comply ) subsection  
7a7 %all be reallocat$ 9 accordance )   
subp>t #a ( "p ,e ( title ,i ( !        
,omnibus ,crime ,control & ,safe ,/reets
 ,act ( #aifh 7#cd ,u4,s4,c4 #ajaea et  
seq47 to ,/ates t h compli$ ) su*       
subsection4  #afjb4 ,creat+ model       
programs = ! c>e ( inc>c]at$ individuals
 9 ! pr5atal & po/p>tum p]iods  7a7 ,9  
g5]al ,n lat] ?an #a ye> aft] ! date (  
enactm5t ( ?is ,act1 ! ,attorney ,g5]al1
 act+ ?r\gh ! ,director ( ! ,bureau (   
,prisons1 %all e/abli%1 9 n few] ?an #f 
,bureau ( ,prisons facilities1 programs 
to optimize mat]nal heal? outcomes =    
pregnant & po/p>tum individuals         
inc>c]at$ 9 su* facilities4 ,! ,attorney
 ,g5]al %all e/abli% su* programs 9     

consultation ) /akehold]s su* z-- 7#a7  
relevant community-bas$ organizations1  
p>ticul>ly organizations t repres5t     
inc>c]at$ & =m]ly inc>c]at$ individuals 
& organizations t seek to improve       
mat]nal heal? outcomes = pregnant &     
po/p>tum individuals f racial & e?nic   
m9ority gr\ps2  7#b7 relevant           
organizations repres5t+ pati5ts1 ) a    
p>ticul> focus on pati5ts f racial &    
e?nic m9ority gr\ps2  7#c7 organizations
 repres5t+ mat]nity c>e provid]s &      
mat]nal heal? c>e education programs2   
7#d7 p]9atal heal? work]s2 &  7#e7      
rese>*]s & policy exp]ts 9 fields relat$
 to mat]nal heal? c>e = inc>c]at$       
individuals4  7b7 ,/>t date ,ea* select$
 facility %all beg9 facility programs n 
lat] ?an #ah mon?s aft] ! date (        
enactm5t ( ?is ,act4  7c7 ,facility     
priority ,9 c>ry+ out subsection 7a71 ! 
,director %all give priority to a       
facility bas$ on-- 7#a7 ! numb] (       
pregnant & po/p>tum individuals         
inc>c]at$ 9 su* facility &1 among su*   

individuals1 ! numb] ( pregnant &       
po/p>tum individuals f racial & e?nic   
m9ority gr\ps2 &  7#b7 ! ext5t to :i* ! 
lead]s ( su* facility h demon/rat$ a    
commitm5t to develop+ exempl>y programs 
= pregnant & po/p>tum individuals       
inc>c]at$ 9 su* facility4  7d7 ,program 
duration ,! programs e/abli%$ "u ?is    
section %all be = a #e-ye> p]iod4  7e7  
,programs ,bureau ( ,prisons facilities 
select$ by ! ,director %all e/abli%     
programs = pregnant & po/p>tum inc>c]at$
 individuals1 & su* programs may-- 7#a7 
provide access to p]9atal heal? work]s f
 pregnancy ?r\gh ! po/p>tum p]iod2  7#b7
 provide access to heal?y foods &       
c\nsel+ on nutrition1 recomm5d$ activity
 levels1 & safety measures ?r\gh\t      
pregnancy2  7#c7 tra9 correctional      
(fic]s to ensure t pregnant inc>c]at$   
individuals receive safe & respectful   
treatm5t2  7#d7 tra9 m$ical p]sonnel to 
ensure t pregnant inc>c]at$ individuals 
receive trauma-in=m$1 culturally        
congru5t c>e t promotes ! heal? & safety

 ( ! pregnant individuals2  7#e7 provide
 c\nsel+ & treatm5t = individuals :o h  
suff]$ f-- 7,a7 diagnos$ m5tal or       
behavioral heal? conditions1 includ+    
trauma & sub/ance use disord]s2  7,b7   
trauma or viol5ce1 includ+ dome/ic      
viol5ce2  7,c7 human immunodefici5cy    
virus2  7,d7 sexual abuse2  7,e7        
pregnancy or infant loss2 or  7,f7      
*ronic conditions2  7#f7 provide        
evid5ce-bas$ pregnancy & *ildbir?       
education1 p>5t+ support1 & o!r relevant
 =ms ( heal? lit]acy2  7#g7 provide     
cl9ical education opportunities to      
mat]nity c>e provid]s 9 tra9+ to exp&   
pa?ways into mat]nal heal? c>e c>e]s    
s]v+ inc>c]at$ individuals2  7#h7 (f]   
opportunities = po/p>tum individuals to 
ma9ta9 contact ) ! individual's newborn 
*ild to promote bond+1 includ+ enhanc$  
visitation policies1 access to prison   
nurs]y programs1 or brea/fe$+ support2  
7#i7 provide re5try assi/ance1          
p>ticul>ly to-- 7,a7 ensure access to   
heal? insurance cov]age & transf] (     

heal? records to community provid]s if  
an inc>c]at$ individual exits ! crim9al 
ju/ice sy/em dur+ su* individual's      
pregnancy or 9 ! po/p>tum p]iod2 &  7,b7
 connect individuals exit+ ! crim9al    
ju/ice sy/em dur+ pregnancy or 9 !      
po/p>tum p]iod to community-bas$        
res\rces1 su* z ref]rals to heal? c>e   
provid]s1 sub/ance use disord]          
treatm5ts1 & social s]vices t address   
social det]m9ants mat]nal ( heal?2 or   
7#aj7 e/abli% p>tn]%ips ) local public  
entities1 private community entities1   
community-bas$ organizations1 ,indian   
,tribes & tribal organizations 7z su*   
t]ms are def9$ 9 section #d ( ! ,indian 
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 
& urban ,indian organizations 7z su* t]m
 is def9$ 9 section #d ( ! ,indian      
,heal? ,c>e ,improvem5t ,act 7#be       
,u4,s4,c4 #afjc77 to e/abli% or exp&    
pretrial div]sion programs z an         
alt]native to inc>c]ation = pregnant &  
po/p>tum individuals4 ,su* programs may 

include-- 7,a7 evid5ce-bas$ *ildbir?    
education or p>5t+ classes2  7,b7       
pr5atal heal? coord9ation2  7,c7 family 
& individual c\nsel+2  7,d7 evid5ce-bas$
 scre5+s1 education1 &1 z ne$$1 treatm5t
 = m5tal & behavioral heal? conditions1 
includ+ drug & alcohol treatm5ts2  7,e7 
family case managem5t s]vices2  7,f7    
dome/ic viol5ce education & prev5tion2  
7,g7 physical & sexual abuse c\nsel+2 & 
7,h7 programs to address social         
det]m9ants ( heal? su* z employm5t1     
h\s+1 education1 transportation1 &      
nutrition4  7f7 ,implem5tation & report+
 ,a select$ facility %all be responsible
 =-- 7#a7 implem5t+ programs1 :i* may   
include ! programs describ$ 9 subsection
 7e72 &  7#b7 n lat] ?an #c ye>s aft] ! 
date ( enactm5t ( ?is ,act1 & #f ye>s   
aft] ! date ( enactm5t ( ?is ,act1      
report+ results ( ! programs to !       
,director1 includ+ in=mation describ+-- 
7,a7 relevant quantitative indicators ( 
success 9 improv+ ! /&>d ( c>e & heal?  
outcomes = pregnant & po/p>tum inc>c]at$

 individuals 9 ! facility1 includ+ data 
/ratifi$ by race1 e?nicity1 sex1 g5d]1  
age1 geography1 disability /atus1 !     
category ( ! crim9al *>ge aga9/ su*     
individual1 rates ( pregnancy-relat$    
dea?s1 pregnancy-associat$ dea?s1 cases 
( infant mortality & morbidity1 rates ( 
pret]m bir?s & l[-bir?weight bir?s1     
cases ( sev]e mat]nal morbidity1 cases (
 viol5ce aga9/ pregnant or po/p>tum     
individuals1 diagnoses ( mat]nal m5tal  
or behavioral heal? conditions1 & o!r   
su* in=mation z appropriate2  7,b7      
relevant qualitative & quantitative     
evaluations f pregnant & po/p>tum       
inc>c]at$ individuals :o p>ticipat$ 9   
su* programs1 includ+ measures (        
pati5t-report$ exp]i5ce ( c>e2 &  7,c7  
/rategies to su/a9 su* programs aft]    
fiscal ye> #bjbg & exp& su* programs to 
o!r facilities4  7g7 ,report ,n lat] ?an
 #f ye>s aft] ! date ( enactm5t ( ?is   
,act1 ! ,director %all submit to !      
,attorney ,g5]al & to ! ,congress a     
report describ+ ! results ( ! programs  

fund$ "u ?is section4  7h7 ,ov]sight ,n 
lat] ?an #a ye> aft] ! date ( enactm5t (
 ?is ,act1 ! ,attorney ,g5]al %all aw>d 
a contract to an indep5d5t organization 
or indep5d5t organizations to conduct   
ov]sight ( ! programs describ$ 9        
subsection 7e74  7i7 ,au?orization (    
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#aj1jjj1jjj = ea* ( fiscal ye>s #bjbc   
?r\gh #bjbg4  #afjc4 ,grant program to  
improve mat]nal heal? outcomes =        
individuals 9 ,/ate & local prisons &   
jails  7a7 ,e/abli%m5t ,n lat] ?an #a   
ye> aft] ! date ( enactm5t ( ?is ,act1 !
 ,attorney ,g5]al1 act+ ?r\gh !         
,director ( ! ,bureau ( ,ju/ice         
,assi/ance1 %all aw>d ,ju/ice =         
,inc>c]at$ ,moms grants to ,/ates to    
e/abli% or exp& programs 9 ,/ate & local
 prisons & jails = pregnant & po/p>tum  
inc>c]at$ individuals4 ,! ,attorney     
,g5]al %all aw>d su* grants 9           
consultation ) /akehold]s su* z-- 7#a7  
relevant community-bas$ organizations1  

p>ticul>ly organizations t repres5t     
inc>c]at$ & =m]ly inc>c]at$ individuals 
& organizations t seek to improve       
mat]nal heal? outcomes = pregnant &     
po/p>tum individuals f racial & e?nic   
m9ority gr\ps2  7#b7 relevant           
organizations repres5t+ pati5ts1 ) a    
p>ticul> focus on pati5ts f racial &    
e?nic m9ority gr\ps2  7#c7 organizations
 repres5t+ mat]nity c>e provid]s &      
mat]nal heal? c>e education programs2   
7#d7 p]9atal heal? work]s2 &  7#e7      
rese>*]s & policy exp]ts 9 fields relat$
 to mat]nal heal? c>e = inc>c]at$       
individuals4  7b7 ,applications ,ea*    
applicant = a grant "u ?is section %all 
submit to ! ,director ( ! ,bureau (     
,ju/ice ,assi/ance an application at su*
 "t1 9 su* mann]1 & conta9+ su*         
in=mation z ! ,director may require4    
7c7 ,use ( funds ,a ,/ate t is aw>d$ a  
grant "u ?is section %all use su* grant 
to e/abli% or exp& programs = pregnant &
 po/p>tum inc>c]at$ individuals1 & su*  
programs may-- 7#a7 provide access to   

p]9atal heal? work]s f pregnancy ?r\gh !
 po/p>tum p]iod2  7#b7 provide access to
 heal?y foods & c\nsel+ on nutrition1   
recomm5d$ activity levels1 & safety     
measures ?r\gh\t pregnancy2  7#c7 tra9  
correctional (fic]s to ensure t pregnant
 inc>c]at$ individuals receive safe &   
respectful treatm5t2  7#d7 tra9 m$ical  
p]sonnel to ensure t pregnant inc>c]at$ 
individuals receive trauma-in=m$1       
culturally congru5t c>e t promotes !    
heal? & safety ( ! pregnant individuals2
  7#e7 provide c\nsel+ & treatm5t =     
individuals :o h suff]$ f-- 7,a7        
diagnos$ m5tal or behavioral heal?      
conditions1 includ+ trauma & sub/ance   
use disord]s2  7,b7 trauma or viol5ce1  
includ+ dome/ic viol5ce2  7,c7 human    
immunodefici5cy virus2  7,d7 sexual     
abuse2  7,e7 pregnancy or infant loss2  
or  7,f7 *ronic conditions2  7#f7       
provide evid5ce-bas$ pregnancy &        
*ildbir? education1 p>5t+ support1 & o!r
 relevant =ms ( heal? lit]acy2  7#g7    
provide cl9ical education opportunities 

to mat]nity c>e provid]s 9 tra9+ to exp&
 pa?ways into mat]nal heal? c>e c>e]s   
s]v+ inc>c]at$ individuals2  7#h7 (f]   
opportunities = po/p>tum individuals to 
ma9ta9 contact ) ! individual's newborn 
*ild to promote bond+1 includ+ enhanc$  
visitation policies1 access to prison   
nurs]y programs1 or brea/fe$+ support2  
7#i7 provide re5try assi/ance1          
p>ticul>ly to-- 7,a7 ensure access to   
heal? insurance cov]age & transf] (     
heal? records to community provid]s if  
an inc>c]at$ individual exits ! crim9al 
ju/ice sy/em dur+ su* individual's      
pregnancy or 9 ! po/p>tum p]iod2 &  7,b7
 connect individuals exit+ ! crim9al    
ju/ice sy/em dur+ pregnancy or 9 !      
po/p>tum p]iod to community-bas$        
res\rces1 su* z ref]rals to heal? c>e   
provid]s1 sub/ance use disord]          
treatm5ts1 & social s]vices t address   
social det]m9ants ( mat]nal heal?2 or   
7#aj7 e/abli% p>tn]%ips ) local public  
entities1 private community entities1   
community-bas$ organizations1 ,indian   

,tribes & tribal organizations 7z su*   
t]ms are def9$ 9 section #d ( ! ,indian 
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 
& urban ,indian organizations 7z su* t]m
 is def9$ 9 section #d ( ! ,indian      
,heal? ,c>e ,improvem5t ,act 7#be       
,u4,s4,c4 #afjc77 to e/abli% or exp&    
pretrial div]sion programs z an         
alt]native to inc>c]ation = pregnant &  
po/p>tum individuals4 ,su* programs may 
include-- 7,a7 evid5ce-bas$ *ildbir?    
education or p>5t+ classes2  7,b7       
pr5atal heal? coord9ation2  7,c7 family 
& individual c\nsel+2  7,d7 evid5ce-bas$
 scre5+s1 education1 &1 z ne$$1 treatm5t
 = m5tal & behavioral heal? conditions1 
includ+ drug & alcohol treatm5ts2  7,e7 
family case managem5t s]vices2  7,f7    
dome/ic viol5ce education & prev5tion2  
7,g7 physical & sexual abuse c\nsel+2 & 
7,h7 programs to address social         
det]m9ants ( heal? su* z employm5t1     
h\s+1 education1 transportation1 &      
nutrition4  7d7 ,priority ,9 aw>d+      

grants "u ?is section1 ! ,director ( !  
,bureau ( ,ju/ice ,assi/ance %all give  
priority to applicants bas$ on-- 7#a7 ! 
numb] ( pregnant & po/p>tum individuals 
inc>c]at$ 9 ! ,/ate &1 among su*        
individuals1 ! numb] ( pregnant &       
po/p>tum individuals f racial & e?nic   
m9ority gr\ps2 &  7#b7 ! ext5t to :i* ! 
,/ate has demon/rat$ a commitm5t to     
develop+ exempl>y programs = pregnant & 
po/p>tum individuals inc>c]at$ 9 !      
prisons & jails 9 ! ,/ate4  7e7 ,grant  
duration ,a grant aw>d$ "u ?is section  
%all be = a #e-ye> p]iod4  7f7          
,implem5t+ & report+ ,a ,/ate t receives
 a grant "u ?is section %all be         
responsible =-- 7#a7 implem5t+ ! program
 fund$ by ! grant2 &  7#b7 n lat] ?an #c
 ye>s aft] ! date ( enactm5t ( ?is ,act1
 & #f ye>s aft] ! date ( enactm5t ( ?is 
,act1 report+ results ( su* program to !
 ,attorney ,g5]al1 includ+ in=mation    
describ+-- 7,a7 relevant quantitative   
indicators ( ! program's success 9      
improv+ ! /&>d ( c>e & heal? outcomes = 

pregnant & po/p>tum inc>c]at$           
individuals 9 ! facility1 includ+ data  
/ratifi$ by race1 e?nicity1 sex1 g5d]1  
age1 geography1 disability /atus1       
category ( ! crim9al *>ge aga9/ su*     
individual1 incid5ce rates (            
pregnancy-relat$ dea?s1                 
pregnancy-associat$ dea?s1 cases (      
infant mortality & morbidity1 rates (   
pret]m bir?s & l[-bir?weight bir?s1     
cases ( sev]e mat]nal morbidity1 cases (
 viol5ce aga9/ pregnant or po/p>tum     
individuals1 diagnoses ( mat]nal m5tal  
or behavioral heal? conditions1 & o!r   
su* in=mation z appropriate2  7,b7      
relevant qualitative & quantitative     
evaluations f pregnant & po/p>tum       
inc>c]at$ individuals :o p>ticipat$ 9   
su* programs1 includ+ measures (        
pati5t-report$ exp]i5ce ( c>e2 &  7,c7  
/rategies to su/a9 su* programs beyond !
 duration ( ! grant & exp& su* programs 
to o!r facilities4  7g7 ,report ,n lat] 
?an #f ye>s aft] ! date ( enactm5t ( ?is
 ,act1 ! ,attorney ,g5]al %all submit to

 ! ,congress a report describ+ ! results
 ( su* grant programs4  7h7 ,ov]sight ,n
 lat] ?an #a ye> aft] ! date ( enactm5t 
( ?is ,act1 ! ,attorney ,g5]al %all aw>d
 a contract to an indep5d5t organization
 or indep5d5t organizations to conduct  
ov]sight ( ! programs describ$ 9        
subsection 7c74  7i7 ,au?orization (    
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#aj1jjj1jjj = ea* ( fiscal ye>s #bjbc   
?r\gh #bjbg4  #afjd4 ,,gao report  7a7  
,9 g5]al ,n lat] ?an #b ye>s aft] ! date
 ( enactm5t ( ?is ,act1 ! ,comptroll]   
,g5]al ( ! ,unit$ ,/ates %all submit to 
,congress a report on adv]se mat]nal &  
infant heal? outcomes among inc>c]at$   
individuals & infants born to su*       
individuals1 ) a p>ticul> focus on      
racial & e?nic disp>ities 9 mat]nal &   
infant heal? outcomes = inc>c]at$       
individuals4  7b7 ,cont5ts ( report ,!  
report describ$ 9 ?is section %all      
include-- 7#a7 to ! ext5t practicable-- 
7,a7 ! numb] ( pregnant individuals :o  

are inc>c]at$ 9 ,bureau ( ,prisons      
facilities2  7,b7 ! numb] ( inc>c]at$   
individuals1 includ+ ^? inc>c]at$ 9     
,f$]al1 ,/ate1 & local correctional     
facilities1 :o h exp]i5c$ a             
pregnancy-relat$ dea?1                  
pregnancy-associat$ dea?1 or ! dea? ( an
 infant 9 ! mo/ rec5t #aj ye>s (        
available data2  7,c7 ! numb] ( cases ( 
sev]e mat]nal morbidity among inc>c]at$ 
individuals1 includ+ ^? inc>c]at$ 9     
,f$]al1 ,/ate1 & local det5tion         
facilities1 9 ! mo/ rec5t #aj ye>s (    
available data2  7,d7 ! numb] ( pret]m &
 l[-bir?weight bir?s ( infants born to  
inc>c]at$ individuals1 includ+ ^?       
inc>c]at$ 9 ,f$]al1 ,/ate1 & local      
correctional facilities1 9 ! mo/ rec5t  
#aj ye>s ( available data2 &  7,e7      
/ati/ics on ! racial & e?nic disp>ities 
9 mat]nal & infant heal? outcomes &     
sev]e mat]nal morbidity rates among     
inc>c]at$ individuals1 includ+ ^?       
inc>c]at$ 9 ,f$]al1 ,/ate1 & local      
det5tion facilities2  7#b7 9 ! case t ! 

,comptroll] ,g5]al ( ! ,unit$ ,/ates is 
unable det]m9e ! in=mation requir$ 9    
subp>agraphs 7,a7 ?r\gh 7,c7 ( p>agraph 
7#a71 an assessm5t ( ! b>ri]s to det]m9+
 su* in=mation & recomm5dations =       
improvem5ts 9 track+ mat]nal heal?      
outcomes among inc>c]at$ individuals1   
includ+ ^? inc>c]at$ 9 ,f$]al1 ,/ate1 & 
local det5tion facilities2  7#c7 causes 
( adv]se mat]nal heal? outcomes t are   
unique to inc>c]at$ individuals1 includ+
 ^? inc>c]at$ 9 ,f$]al1 ,/ate1 & local  
det5tion facilities2  7#d7 causes (     
adv]se mat]nal heal? outcomes & sev]e   
mat]nal morbidity t are unique to       
inc>c]at$ individuals f racial & e?nic  
m9ority gr\ps2  7#e7 recomm5dations to  
r$uce mat]nal mortality & sev]e mat]nal 
morbidity among inc>c]at$ individuals & 
to address racial & e?nic disp>ities 9  
mat]nal heal? outcomes = inc>c]at$      
individuals 9 ,bureau ( ,prisons        
facilities & ,/ate & local prisons &    
jails2 &  7#f7 su* o!r in=mation z may  
be appropriate to r$uce ! occurr5ce (   

adv]se mat]nal heal? outcomes among     
inc>c]at$ individuals & to address      
racial & e?nic disp>ities 9 mat]nal     
heal? outcomes = su* individuals4       
#afje4 ,,macpac report  7a7 ,9 g5]al ,n 
lat] ?an #b ye>s aft] ! date ( enactm5t 
( ?is ,act1 ! ,m$icaid & ,,*ip ,paym5t &
 ,access ,commission 7ref]r$ to 9 ?is   
section z ,,macpac7 %all publi% a report
 on ! implications ( pregnant & po/p>tum
 inc>c]at$ individuals be+ ineligible = 
m$ical assi/ance "u a ,/ate plan "u     
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq47 t conta9s 
! in=mation describ$ 9 subsection4  7b7 
,in=mation describ$ ,= purposes (       
subsection 7a71 ! in=mation describ$ 9  
?is subsection includes-- 7#a7 in=mation
 on ! effect ( ineligibility = m$ical   
assi/ance "u a ,/ate plan "u title ,,xix
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acif et seq47 on mat]nal     
heal? outcomes = pregnant & po/p>tum    
inc>c]at$ individuals1 conc5trat+ on !  
effects ( su* ineligibility = pregnant &

 po/p>tum individuals f racial & e?nic  
m9ority gr\ps2 &  7#b7 ! pot5tial       
implications on mat]nal heal? outcomes  
result+ f susp5d+ eligibility = m$ical  
assi/ance "u a ,/ate plan "u su* title (
 su* ,act :5 a pregnant or po/p>tum     
individual is inc>c]at$4  ,h ,te* to    
save moms  #agja4 ,integrat$ teleheal?  
models 9 mat]nity c>e s]vices  7a7 ,9   
g5]al ,section #aaae;,a7b77#b77;,b7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acae;a7b77#b77;,b77 is am5d$ by add+ at
 ! end ! foll[+3  7xxviii7 ,focus+ on   
title ,,xix1 provid+ = ! adoption ( &   
use ( teleheal? tools t all[ = scre5+1  
monitor+1 & managem5t ( common heal?    
complications ) respect to an individual
 receiv+ m$ical assi/ance dur+ su*      
individual's pregnancy & = n m ?an a    
#a-ye> p]iod beg9n+ on ! la/ day ( !    
pregnancy4  4  7b7 ,effective date ,!   
am5dm5t made by subsection 7a7 %all take
 effect #a ye> aft] ! date ( ! enactm5t 
( ?is ,act4  #agjb4 ,grants to exp& !   
use ( te*nology-enabl$ collaborative    

le>n+ & capacity models = pregnant &    
po/p>tum individuals ,title ,,iii ( !   
,public ,heal? ,s]vice ,act is am5d$ by 
ins]t+ aft] section #ccj,p 7#db         
,u4,s4,c4 #bed;c-#bb7 ! foll[+3  #ccj,q4
 ,exp&+ capacity = mat]nal heal?        
outcomes  7a7 ,e/abli%m5t ,beg9n+ n lat]
 ?an #a ye> aft] ! date ( enactm5t ( ?is
 section1 ! ,secret>y %all aw>d grants  
to eligible entities to evaluate1       
develop1 & exp& ! use ( te*nology-enabl$
 collaborative le>n+ & capacity build+  
models & improve mat]nal heal?          
outcomes-- 7#a7 9 heal? pr(essional     
%ortage areas2  7#b7 9 areas ) high     
rates ( mat]nal mortality & sev]e       
mat]nal morbidity2  7#c7 9 areas )      
significant racial & e?nic disp>ities 9 
mat]nal heal? outcomes2 &  7#d7 =       
m$ically und]s]v$ populations & ,am]ican
 ,indians & ,alaska ,natives1 includ+   
,indian ,tribes1 ,tribal organizations1 
& ,urban ,indian organizations4  7b7    
,use ( ,funds  7#a7 ,requir$ uses       
,recipi5ts ( grants "u ?is section %all 

use ! grants to-- 7,a7 tra9 mat]nal     
heal? c>e provid]s1 /ud5ts1 & o!r simil>
 pr(essionals ?r\gh models t include--  
7i7 me?ods to increase safety & heal?   
c>e quality2  7ii7 implicit bias1       
racism1 & discrim9ation2  7iii7 be/     
practices 9 scre5+ = &1 z ne$$1 evaluat+
 & treat+ mat]nal m5tal heal? conditions
 & sub/ance use disord]s2  7iv7 tra9+ on
 be/ practices 9 mat]nity c>e = pregnant
 & po/p>tum individuals dur+ !          
,,covid-#ai public heal? em]g5cy or     
future public heal? em]g5cies2  7v7     
me?ods to scre5 = social det]m9ants (   
mat]nal heal? risks 9 ! pr5atal &       
po/p>tum2 &  7vi7 ! use ( remote pati5t 
monitor+ tools = pregnancy-relat$       
complications describ$ 9 section        
#aaae;,a7b77#b77;,b77xxviii72  7,b7     
evaluate & collect in=mation on ! effect
 ( su* models on-- 7i7 access to &      
quality ( c>e2  7ii7 outcomes ) respect 
to ! heal? ( an individual2 &  7iii7 !  
exp]i5ce ( individuals :o receive       
pregnancy-relat$ heal? c>e2  7,c7       

develop qualitative & quantitative      
measures to id5tify be/ practices = !   
expansion & use ( su* models2  7,d7 /udy
 ! effect ( su* models on pati5t        
outcomes & mat]nity c>e provid]s2 &     
7,e7 conduct any o!r activity det]m9$ by
 ! ,secret>y4  7#b7 ,p]missible uses    
,recipi5ts ( grants "u ?is section may  
use grants to support-- 7,a7 ! use &    
expansion ( te*nology-enabl$            
collaborative le>n+ & capacity build+   
models1 includ+ h>dw>e & s(tw>e t-- 7i7 
enables di/ance le>n+ & te*nical        
support2 &  7ii7 supports ! secure      
ex*ange ( electronic heal? in=mation2 & 
7,b7 mat]nity c>e provid]s1 /ud5ts1 &   
o!r simil> pr(essionals 9 ! provision ( 
mat]nity c>e ?r\gh su* models4  7c7     
,application  7#a7 ,9 g5]al ,an eligible
 entity seek+ a grant "u subsection 7a7 
%all submit to ! ,secret>y an           
application1 at su* "t1 9 su* mann]1 &  
conta9+ su* in=mation z ! ,secret>y may 
require4  7#b7 ,assurance ,an           
application "u p>agraph 7#a7 %all       

include an assurance t su* entity %all  
collect in=mation on & assess ! effect (
 ! use ( te*nology-enabl$ collaborative 
le>n+ & capacity build+ models1 includ+ 
) respect to-- 7,a7 mat]nal heal?       
outcomes2  7,b7 access to mat]nal heal? 
c>e s]vices2  7,c7 quality ( mat]nal    
heal? c>e2 &  7,d7 ret5tion ( mat]nity  
c>e provid]s s]v+ areas & populations   
describ$ 9 subsection 7a74  7d7         
,limitations  7#a7 ,numb] ,! ,secret>y  
may n aw>d m ?an #a grant "u ?is        
section4  7#b7 ,duration ,a grant aw>d$ 
"u ?is section %all be = a #e-ye> p]iod4
  7e7 ,access to broadb& ,9 adm9i/]+    
grants "u ?is section1 ! ,secret>y may  
coord9ate ) o!r ag5cies to ensure t     
fund+ opportunities are available to    
support access to reliable1 high-spe$   
int]net = grantees4  7f7 ,te*nical      
assi/ance ,! ,secret>y %all provide     
7ei!r directly or by contract7 te*nical 
assi/ance to eligible entities1 includ+ 
recipi5ts ( grants "u subsection 7a71 on
 ! developm5t1 use1 & su/a9ability (    

te*nology-enabl$ collaborative le>n+ &  
capacity build+ models to exp& access to
 mat]nal heal? c>e s]vices provid$ by   
su* entities1 includ+-- 7#a7 9 heal?    
pr(essional %ortage areas2  7#b7 9 areas
 ) high rates ( mat]nal mortality &     
sev]e mat]nal morbidity or significant  
racial & e?nic disp>ities 9 mat]nal     
heal? outcomes2 &  7#c7 = m$ically      
und]s]v$ populations or ,am]ican        
,indians & ,alaska ,natives4  7g7       
,rese>* & evaluation ,! ,secret>y1 9    
consultation ) exp]ts1 %all develop a   
/rategic plan to rese>* & evaluate !    
evid5ce = su* models4  7h7 ,report+     
7#a7 ,eligible entities ,an eligible    
entity t receives a grant "u subsection 
7a7 %all submit to ! ,secret>y a report1
 at su* "t1 9 su* mann]1 & conta9+ su*  
in=mation z ! ,secret>y may require4    
7#b7 ,secret>y ,n lat] ?an #d ye>s aft] 
! date ( enactm5t ( ?is section1 !      
,secret>y %all submit to ! ,congress1 & 
make available on ! website ( !         
,dep>tm5t ( ,heal? & ,human ,s]vices1 a 

report t includes-- 7,a7 a description (
 grants aw>d$ "u subsection 7a7 & !     
purpose & am\nts ( su* grants2  7,b7 a  
summ>y (-- 7i7 ! evaluations conduct$ "u
 subsection 7b77,b72  7ii7 any te*nical 
assi/ance provid$ "u subsection 7g72 &  
7iii7 ! activities conduct$ "u          
subsection 7a72 &  7,c7 a description ( 
any significant f9d+s ) respect to-- 7i7
 pati5t outcomes2 &  7ii7 be/ practices 
= exp&+1 us+1 or evaluat+               
te*nology-enabl$ collaborative le>n+ &  
capacity build+ models4  7i7            
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section1 #f1jjj1jjj = ea* ( fiscal  
ye>s #bjbc ?r\gh #bjbg4  7j7 ,def9itions
 ,9 ?is section3 7#a7 ,eligible entity  
7,a7 ,9 g5]al ,! t]m eligible entity    
means an entity t provides1 or supports 
! provision (1 mat]nal heal? c>e s]vices
 or o!r evid5ce-bas$ s]vices = pregnant 
& po/p>tum individuals-- 7i7 9 heal?    
pr(essional %ortage areas2  7ii7 9 areas
 ) high rates ( adv]se mat]nal heal?    

outcomes or significant racial & e?nic  
disp>ities 9 mat]nal heal? outcomes2 &  
7iii7 :o are-- 7,i7 memb]s ( m$ically   
und]s]v$ populations2 or  7,,ii7        
,am]ican ,indians & ,alaska ,natives1   
includ+ ,indian ,tribes1 ,tribal        
organizations1 & urban ,indian          
organizations4  7,b7 ,inclusions ,an    
eligible entity may include entities t  
lead1 or are capable ( lead+ a          
te*nology-enabl$ collaborative le>n+ &  
capacity build+ model4  7#b7 ,heal?     
pr(essional %ortage area ,! t]m heal?   
pr(essional %ortage area means a heal?  
pr(essional %ortage area designat$ "u   
section #ccb4  7#c7 ,indian ,tribe ,!   
t]m ,indian ,tribe has ! mean+ giv5 su* 
t]m 9 section #d ( ! ,indian            
,self-,det]m9ation & ,education         
,assi/ance ,act4  7#d7 ,mat]nal         
mortality ,! t]m mat]nal mortality means
 a dea? occurr+ dur+ or )9 #a-ye> p]iod 
aft] pregnancy caus$ by pregnancy-relat$
 or *ildbir? complications1 includ+ a   
suicide1 ov]dose1 or o!r dea? result+ f 

a m5tal heal? or sub/ance use disord]   
attribut$ to or aggravat$ by pregnancy  
or *ildbir? complications4  7#e7        
,m$ically und]s]v$ population ,! t]m    
m$ically und]s]v$ population has ! mean+
 giv5 su* t]m 9 section #ccj7;b77#c74   
7#f7 ,po/p>tum ,! t]m po/p>tum means !  
#a-ye> p]iod beg9n+ on ! la/ date ( an  
individual's pregnancy4  7#g7 ,sev]e    
mat]nal morbidity ,! t]m sev]e mat]nal  
morbidity means a heal? condition1      
includ+ a m5tal heal? or sub/ance use   
disord]1 attribut$ to or aggravat$ by   
pregnancy or *ildbir? t results 9       
significant %ort-t]m or long-t]m        
consequ5ces to ! heal? ( ! individual :o
 0 pregnant4  7#h7 ,te*nology-enabl$    
collaborative le>n+ & capacity build+   
model ,! t]m te*nology-enabl$           
collaborative le>n+ & capacity build+   
model means a di/ance heal? education   
model t connects heal? c>e pr(essionals1
 & o!r speciali/s1 ?r\gh simultane\s    
int]active videoconf]5c+ = ! purpose (  
facilitat+ case-bas$ le>n+1 dissem9at+  

be/ practices1 & evaluat+ outcomes 9 !  
context ( mat]nal heal? c>e4  7#i7      
,tribal organization ,! t]m ,tribal     
organization has ! mean+ giv5 su* t]m 9 
section #d ( ! ,indian                  
,self-,det]m9ation & ,education         
,assi/ance ,act4  7#aj7 ,urban ,indian  
organization ,! t]m urban ,indian       
organization has ! mean+ giv5 su* t]m 9 
section #d ( ! ,indian ,heal? ,c>e      
,improvem5t ,act4  4  #agjc4 ,grants to 
promote equity 9 mat]nal heal? outcomes 
?r\gh digital tools  7a7 ,9 g5]al       
,beg9n+ n lat] ?an #a ye> aft] ! date ( 
! enactm5t ( ?is ,act1 ! ,secret>y (    
,heal? & ,human ,s]vices %all make      
grants to eligible entities to r$uce    
racial & e?nic disp>ities 9 mat]nal     
heal? outcomes by increas+ access to    
digital tools relat$ to mat]nal heal?   
c>e4  7b7 ,applications ,to be eligible 
to receive a grant "u ?is section1 an   
eligible entity %all submit to !        
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  

,secret>y may require4  7c7             
,prioritization ,9 aw>d+ grants "u ?is  
section1 ! ,secret>y %all prioritize an 
eligible entity-- 7#a7 9 an area ) high 
rates ( adv]se mat]nal heal? outcomes or
 significant racial & e?nic disp>ities 9
 mat]nal heal? outcomes2  7#b7 9 a heal?
 pr(essional %ortage area designat$ "u  
section #ccb ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bed;e72 &  7#c7 t  
promotes te*nology t addresses racial & 
e?nic disp>ities 9 mat]nal heal?        
outcomes4  7d7 ,limitations  7#a7 ,numb]
 ,! ,secret>y may aw>d n m ?an #a grant 
"u ?is section4  7#b7 ,duration ,a grant
 aw>d$ "u ?is section %all be = a #e-ye>
 p]iod4  7e7 ,te*nical assi/ance ,!     
,secret>y %all provide te*nical         
assi/ance to an eligible entity on !    
developm5t1 use1 evaluation1 & po/-grant
 su/a9ability ( digital tools = purposes
 ( promot+ equity 9 mat]nal heal?       
outcomes4  7f7 ,report+  7#a7 ,eligible 
entities ,an eligible entity t receives 
a grant "u subsection 7a7 %all submit to

 ! ,secret>y a report1 at su* "t1 9 su* 
mann]1 & conta9+ su* in=mation z !      
,secret>y may require4  7#b7 ,secret>y  
,n lat] ?an #d ye>s aft] ! date ( !     
enactm5t ( ?is ,act1 ! ,secret>y %all   
submit to ,congress a report t          
includes-- 7,a7 an evaluation on !      
effectiv5ess ( grants aw>d$ "u ?is      
section to improve heal? outcomes =     
pregnant & po/p>tum individuals f racial
 & e?nic m9ority gr\ps2  7,b7           
recomm5dations on new grant programs t  
promote ! use ( te*nology to improve su*
 mat]nal heal? outcomes2 &  7,c7        
recomm5dations ) respect to-- 7i7       
te*nology-bas$ privacy & security       
safegu>ds 9 mat]nal heal? c>e2  7ii7    
reimbursem5t rates = mat]nal teleheal?  
s]vices2  7iii7 ! use ( digital tools to
 analyze l>ge data sets to id5tify      
pot5tial pregnancy-relat$ complications2
  7iv7 b>ri]s t prev5t mat]nity c>e     
provid]s f provid+ teleheal? s]vices    
across ,/ates2  7v7 ! use ( consum]     
digital tools su* z mobile phone        

applications1 pati5t portals1 & we>able 
te*nologies to improve mat]nal heal?    
outcomes2  7vi7 b>ri]s t prev5t access  
to teleheal? s]vices1 includ+ a lack (  
access to reliable1 high-spe$ int]net or
 electronic devices2  7vii7 b>ri]s to   
data %>+ betwe5 ! ,special ,supplem5tal 
,nutrition ,program = ,wom51 ,infants1 &
 ,*ildr5 program & mat]nity c>e         
provid]s1 & recomm5dations = address+   
su* b>ri]s2 &  7viii7 lessons le>n$ f   
exp&$ access to teleheal? relat$ to     
mat]nity c>e dur+ ! ,,covid-#ai public  
heal? em]g5cy4  7g7 ,au?orization (     
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#f1jjj1jjj = ea* ( fiscal ye>s #bjbc    
?r\gh #bjbg4  #agjd4 ,report on ! use ( 
te*nology 9 mat]nity c>e  7a7 ,9 g5]al  
,n lat] ?an #fj days aft] ! date (      
enactm5t ( ?is ,act1 ! ,secret>y (      
,heal? & ,human ,s]vices %all seek to   
ent] an agreem5t ) ! ,national          
,academies ( ,sci5ces1 ,eng9e]+1 &      
,m$ic9e 7ref]r$ to 9 ?is title z !      

,national ,academies7 "u :i* ! ,national
 ,academies %all conduct a /udy on ! use
 ( te*nology & pati5t monitor+ devices 9
 mat]nity c>e4  7b7 ,cont5t ,! agreem5t 
ent]$ into pursuant to subsection 7a7   
%all provide = ! /udy ( ! foll[+3 7#a7  
,! use ( innovative te*nology 7includ+  
artificial intellig5ce7 9 mat]nal heal? 
c>e1 includ+ ! ext5t to :i* su*         
te*nology has affect$ racial or e?nic   
biases 9 mat]nal heal? c>e4  7#b7 ,! use
 ( pati5t monitor+ devices 7includ+     
pulse oximet] devices7 9 mat]nal heal?  
c>e1 includ+ ! ext5t to :i* su* devices 
h affect$ racial or e?nic biases 9      
mat]nal heal? c>e4  7#c7 ,be/ practices 
= r$uc+ & prev5t+ racial or e?nic biases
 9 ! use ( innovative te*nology & pati5t
 monitor+ devices 9 mat]nity c>e4  7#d7 
,be/ practices 9 ! use ( innovative     
te*nology & pati5t monitor+ devices =   
pregnant & po/p>tum individuals f racial
 & e?nic m9ority gr\ps4  7#e7 ,be/      
practices ) respect to privacy &        
security safegu>ds 9 su* use4  7c7      

,report ,! agreem5t "u subsection 7a7   
%all direct ! ,national ,academies to   
complete ! /udy "u ?is section1 &       
transmit to ,congress a report on !     
results ( ! /udy1 n lat] ?an #bd mon?s  
aft] ! date ( enactm5t ( ?is ,act4  ,i  
,impact to save moms  #ahja4 ,p]9atal   
,c>e ,alt]native ,paym5t ,model         
,demon/ration ,project  7a7 ,9 g5]al ,= 
! p]iod ( fiscal ye>s #bjbc ?r\gh #bjbg1
 ! ,secret>y ( ,heal? & ,human ,s]vices 
7ref]r$ to 9 ?is section z ! ,secret>y71
 act+ ?r\gh ! ,adm9i/rator ( ! ,c5t]s = 
,m$ic>e  ,m$icaid ,s]vices1 %all e/abli%
 & implem5t1 9 accordance ) !           
requirem5ts ( ?is section1 a            
demon/ration project1 to be kn[n z !    
,p]9atal ,c>e ,alt]native ,paym5t ,model
 ,demon/ration ,project 7ref]r$ to 9 ?is
 section z ! ,demon/ration ,project71 = 
purposes ( all[+ ,/ates to te/ paym5t   
models "u _! ,/ate plans "u title ,,xix 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acif et seq47 & ,/ate *ild   
heal? plans "u title ,,xxi ( su* ,act   

7#db ,u4,s4,c4 #acig;aa et seq47 )      
respect to mat]nity c>e provid$ to      
pregnant & po/p>tum individuals enroll$ 
9 su* ,/ate plans & ,/ate *ild heal?    
plans4  7b7 ,coord9ation ,9 e/abli%+ !  
,demon/ration ,project1 ! ,secret>y %all
 coord9ate ) /akehold]s su* z-- 7#a7    
,/ate ,m$icaid programs2  7#b7 mat]nity 
c>e provid]s & organizations repres5t+  
mat]nity c>e provid]s2  7#c7 relevant   
organizations repres5t+ pati5ts1 ) a    
p>ticul> focus on pati5ts f racial &    
e?nic m9ority gr\ps2  7#d7 relevant     
community-bas$ organizations1 p>ticul>ly
 organizations t seek to improve mat]nal
 heal? outcomes = pregnant & po/p>tum   
individuals f racial & e?nic m9ority    
gr\ps2  7#e7 p]9atal heal? work]s2  7#f7
 relevant heal? insurance issu]s2  7#g7 
hospitals1 heal? sy/ems1 midwif]y       
practices1 free/&+ bir? c5t]s 7z su* t]m
 is def9$ 9 p>agraph 7#c77;,b7 ( section
 #aije7l7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acif;d7l7771            
,f$]ally-qualifi$ heal? c5t]s 7z su* t]m

 is def9$ 9 p>agraph 7#b77;,b7 ( su*    
section71 & rural heal? cl9ics 7z su*   
t]m is def9$ 9 section #ahfa7;aa7 ( su* 
,act 7#db ,u4,s4,c4 #aciex7aa7772  7#h7 
rese>*]s & policy exp]ts 9 fields relat$
 to mat]nity c>e paym5t models2 &  7#i7 
any o!r /akehold]s z ! ,secret>y        
det]m9es appropriate1 ) a p>ticul> focus
 on /akehold]s f racial & e?nic m9ority 
gr\ps4  7c7 ,consid]ations ,9 e/abli%+ !
 ,demon/ration ,project1 ! ,secret>y    
%all consid] any alt]native paym5t model
 t-- 7#a7 is design$ to improve mat]nal 
heal? outcomes = racial & e?nic gr\ps ) 
disproportionate rates ( adv]se mat]nal 
heal? outcomes2  7#b7 includes me?ods = 
/ratify+ pati5ts by pregnancy risk level
 &1 z appropriate1 adju/+ paym5ts "u su*
 model to take into acc\nt pregnancy    
risk level2  7#c7 e/abli%es evid5ce-bas$
 quality metrics = su* paym5ts2  7#d7   
includes consid]ation ( non-hospital    
bir? sett+s su* z free/&+ bir? c5t]s 7z 
s def9$72  7#e7 includes consid]ation ( 
social det]m9ants ( mat]nal heal?2 or   

7#f7 includes div]se mat]nity c>e teams 
t include-- 7,a7 mat]nity c>e provid]s1 
m5tal & behavioral heal? c>e provid]s   
act+ 9 accordance ) ,/ate law1 regi/]$  
dietitians or nutrition pr(essionals 7z 
su* t]m is def9$ 9 #db ,u4,s4,c4        
#aciex7vv77#b771 & ,int]national ,bo>d  
,c]tifi$ ,lactation ,consultants-- 7i7 f
 racially1 e?nically1 & pr(essionally   
div]se backgr\nds2  7ii7 ) exp]i5ce     
practic+ 9 racially & e?nically div]se  
communities2 or  7iii7 :o h und]gone    
tra9+ on implicit bias & racism2 &  7,b7
 p]9atal heal? work]s4  7d7 ,eligibility
 ,to be eligible to p>ticipate 9 !      
,demon/ration ,project1 a ,/ate %all    
submit an application to ! ,secret>y at 
su* "t1 9 su* mann]1 & conta9+ su*      
in=mation z ! ,secret>y may require4    
7e7 ,evaluation ,! ,secret>y %all       
conduct an evaluation ( ! ,demon/ration 
,project to det]m9e ! impact ( !        
,demon/ration ,project on-- 7#a7 mat]nal
 heal? outcomes1 ) data /ratifi$ by     
race1 e?nicity1 socioeconomic           

indicators1 & any o!r factors z !       
,secret>y det]m9es appropriate2  7#b7   
sp5d+ on mat]nity c>e by ,/ates         
p>ticipat+ 9 ! ,demon/ration ,project2  
7#c7 to ! ext5t practicable1 qualitative
 & quantitative measures ( pati5t       
exp]i5ce2 &  7#d7 any o!r areas (       
assessm5t t ! ,secret>y det]m9es        
relevant4  7f7 ,report ,n lat] ?an "o   
ye> aft] ! completion or t]m9ation date 
( ! ,demon/ration ,project1 ! ,secret>y 
%all submit to ! ,congress1 & make      
publicly available1 a report conta9+--  
7#a7 ! results ( any evaluation conduct$
 "u subsection 7e72 &  7#b7 a           
recomm5dation reg>d+ :e!r !             
,demon/ration ,project %\ld be cont9u$  
aft] fiscal ye> #bjbg & exp&$ on a      
national basis4  7g7 ,au?orization (    
appropriations ,!re are au?oriz$ to be  
appropriat$ su* sums z are necess>y to  
c>ry out ?is section4  7h7 ,def9itions  
,9 ?is section3 7#a7 ,alt]native paym5t 
model ,! t]m alt]native paym5t model has
 ! mean+ giv5 su* t]m 9 section         

#ahcc7z77#c77;,c7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciel7z77#c77;,c774
  7#b7 ,p]9atal ,! t]m p]9atal means !  
p]iod beg9n+ on ! day an individual     
becomes pregnant & end+ on ! la/ day ( !
 #a-ye> p]iod beg9n+ on ! la/ day ( su* 
individual's pregnancy4  7#c7 ,racial & 
e?nic m9ority gr\p ,! t]m racial & e?nic
 m9ority gr\p has ! mean+ giv5 su* t]m 9
 section #agjg7;g77#a7 ( ! ,public      
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjju-#f7;g77#a774  #ahjb4 ,,macpac     
report ,n lat] ?an two ye>s aft] ! date 
( ! enactm5t ( ?is ,act1 ! ,m$icaid &   
,,*ip ,paym5t & ,access ,commission %all
 publi% a report on issues relat+ to !  
cont9uity ( cov]age "u ,/ate plans "u   
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq47 & ,/ate   
*ild heal? plans "u title ,,xxi ( su*   
,act 7#db ,u4,s4,c4 #acig;aa et seq47 = 
pregnant & po/p>tum individuals4 ,su*   
report %all1 at a m9imum1 include !     
foll[+3 7#a7 ,an assessm5t ( any exi/+  
policies "u su* ,/ate plans & su* ,/ate 

*ild heal? plans reg>d+ presumptive     
eligibility = pregnant individuals :ile 
_! application = enrollm5t 9 su* a ,/ate
 plan or su* a ,/ate *ild heal? plan is 
be+ process$4  7#b7 ,an assessm5t ( any 
exi/+ policies "u su* ,/ate plans & su* 
,/ate *ild heal? plans reg>d+ measures  
to ensure cont9uity ( cov]age "u su* a  
,/ate plan or su* a ,/ate *ild heal?    
plan = pregnant & po/p>tum individuals1 
includ+ su* individuals :o ne$ to *ange 
_! heal? insurance cov]age dur+ _!      
pregnancy or ! po/p>tum p]iod foll[+ _! 
pregnancy4  7#c7 ,an assessm5t ( any    
exi/+ policies "u su* ,/ate plans & su* 
,/ate *ild heal? plans reg>d+ measures  
to automatically re5roll individuals :o 
are eligible to enroll "u su* a ,/ate   
plan or su* a ,/ate *ild heal? plan z a 
p>5t4  7#d7 ,if det]m9$ appropriate by !
 ,commission1 any recomm5dations = !    
,dep>tm5t ( ,heal? & ,human ,s]vices1 or
 su* ,/ate plans & su* ,/ate *ild heal? 
plans1 to ensure cont9uity ( cov]age "u 
su* a ,/ate plan or su* a ,/ate *ild    

heal? plan = pregnant & po/p>tum        
individuals4  ,j ,mat]nal heal? p&emic  
response  #aija4 ,def9itions ,9 ?is     
subtitle3 7#a7 ,,covid-#ai public heal? 
em]g5cy ,! t]m ,,covid-#ai public heal? 
em]g5cy means ! p]iod-- 7,a7 beg9n+ on !
 date t ! ,secret>y ( ,heal? & ,human   
,s]vices decl>$ a public heal? em]g5cy  
"u section #cai ( ! ,public ,heal?      
,s]vice ,act 7#db ,u4,s4,c4 #bdg;d71 )  
respect to ,,covid-#ai2 &  7,b7 end+ on 
! lat] ( ! end ( su* public heal?       
em]g5cy1 or ,janu>y #a1 #bjbc4  7#b7    
,respectful mat]nity c>e ,! t]m         
respectful mat]nity c>e ref]s to c>e    
organiz$ =1 & provid$ to1 pregnant &    
po/p>tum individuals 9 a mann] t-- 7,a7 
is culturally congru5t2  7,b7 ma9ta9s _!
 dignity1 privacy1 & confid5tiality2    
7,c7 ensures fre$om f h>m & mi/reatm5t2 
&  7,d7 enables in=m$ *oice & cont9u\s  
support4  7#c7 ,secret>y ,! t]m         
,secret>y means ! ,secret>y ( ,heal? &  
,human ,s]vices4  #aijb4 ,fund+ = data  
collection1 surveillance1 & rese>* on   

mat]nal heal? outcomes dur+ !           
,,covid-#ai public heal? em]g5cy ,to    
conduct or support data collection1     
surveillance1 & rese>* on mat]nal heal? 
z a result ( ! ,,covid-#ai public heal? 
em]g5cy1 includ+ support to assi/ 9 !   
capacity build+ = ,/ate1 ,tribal1       
t]ritorial1 & local public heal?        
dep>tm5ts to collect & transmit racial1 
e?nic1 & o!r demographic data relat$ to 
mat]nal heal?1 !re are au?oriz$ to be   
appropriat$-- 7#a7 #ajj1jjj1jjj = !     
,surveillance = ,em]g+ ,?reats to ,mo!rs
 & ,babies program ( ! ,c5t]s = ,disease
 ,control & ,prev5tion1 to support !    
,c5t]s = ,disease ,control & ,prev5tion 
9 its ef=ts to-- 7,a7 "w ) public heal?1
 cl9ical1 & community-bas$ organizations
 to provide timely1 cont9ually updat$   
guidance to families & heal? c>e        
provid]s on ways to r$uce risk to       
pregnant & po/p>tum individuals & _!    
newborns & tailor int]v5tions to improve
 _! long-t]m heal?2  7,b7 p>tn] ) m     
,/ate1 ,tribal1 t]ritorial1 & local     

public heal? programs 9 ! collection &  
analysis ( cl9ical data on ! impact (   
,,covid-#ai on pregnant & po/p>tum      
pati5ts & _! newborns1 p>ticul>ly among 
pati5ts f racial & e?nic m9ority gr\ps2 
&  7,c7 e/abli% regionally bas$ c5t]s ( 
excell5ce to (f] m$ical1 public heal?1 &
 o!r k to ensure communities1 especially
 communities ) l>ge populations (       
individuals f racial & e?nic m9ority    
gr\ps1 c help pregnant & po/p>tum       
individuals & newborns get ! c>e &      
support !y ne$2  7#b7 #cj1jjj1jjj = !   
,enhanc+ ,reviews & ,surveillance to    
,elim9ate ,mat]nal ,mortality program   
7commonly kn[n z ! ,,erase ,,mm program7
 ( ! ,c5t]s = ,disease ,control &       
,prev5tion1 to support ! ,c5t]s =       
,disease ,control & ,prev5tion 9 exp&+  
its p>tn]%ips ) ,/ates & ,indian ,tribes
 & provide te*nical assi/ance to exi/+  
,mat]nal ,mortality ,review ,committees2
  7#c7 #de1jjj1jjj = ! ,pregnancy ,risk 
,assessm5t ,monitor+ ,sy/em 7commonly   
kn[n z ! ,,prams7 ( ! ,c5t]s = ,disease 

,control & ,prev5tion1 to support !     
,c5t]s = ,disease ,control & ,prev5tion 
9 its ef=ts to-- 7,a7 create a          
,,covid-#ai supplem5t to its ,,prams    
que/ionnaire2  7,b7 add que/ions ar\nd  
exp]i5ces ( respectful mat]nity c>e 9   
pr5atal1 intrap>tum1 & po/p>tum c>e2    
7,c7 conduct a rapid assessm5t (        
,,covid-#ai aw>5ess1 impact on c>e &    
exp]i5ces1 & use ( prev5tive measures   
among pregnant1 labor+ & bir?+1 &       
po/p>tum individuals dur+ ! ,,covid-#ai 
public heal? em]g5cy2 &  7,d7 "w to     
transition ! survey to an electronic    
plat=m & exp& ! survey to a l>g]        
population1 ) a special focus on rea*+  
und]repres5t$ communities2 &  7#d7      
#ae1jjj1jjj = ! ,national ,in/itute (   
,*ild ,heal? & ,human ,developm5t1 to   
conduct or support rese>* = int]v5tions 
to mitigate ! effects ( ! ,,covid-#ai   
public heal? em]g5cy on pregnant &      
po/p>tum individuals1 ) a p>ticul> focus
 on individuals f racial & e?nic m9ority
 gr\ps4  #aijc4 ,,covid-#ai mat]nal     

heal? data collection & disclosure  7a7 
,availability ( collect$ data ,!        
,secret>y1 act+ ?r\gh ! ,director ( !   
,c5t]s = ,disease ,control & ,prev5tion 
& ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e   
,m$icaid ,s]vices1 %all make publicly   
available on ! website ( ! ,c5t]s =     
,disease ,control & ,prev5tion data     
describ$ 9 subsection 7b74  7b7 ,data   
describ$ ,! data "u subsection 7a7 means
 data collect$ ?r\gh ,f$]al surveillance
 sy/ems "u ! ,c5t]s = ,disease ,control 
& ,prev5tion ) respect to ,,covid-#ai & 
individuals :o are pregnant or 9 a      
po/p>tum p]iod4 ,su* data %all include !
 foll[+3 7#a7 ,diagno/ic te/+1 includ+ !
 numb] ( pregnant & po/p>tum individuals
 :o are te/$ = ,,covid-#ai & ! numb] (  
positive cases4  7#b7 ,suspect$ cases ( 
,,covid-#ai 9 pregnant & bir?+          
individuals & individuals 9 a po/p>tum  
p]iod4  7#c7 ,s]ologic te/+1 includ+ !  
numb] ( pregnant & po/p>tum individuals 
te/$ & ! numb] ( su* s]ologic te/s t 7  
positive4  7#d7 ,heal? c>e treatm5t =   

individuals :o 7 infect$ ) ! virus1     
includ+ hospitalizations1 em]g5cy room  
visits1 & int5sive c>e unit admissions4 
7#e7 ,heal? outcomes = pregnant         
individuals & infants confirm$ or       
suspect$ ( be+ infect$ ) ! virus1       
includ+-- 7,a7 ! numb] ( fatalities &   
case fatalities 7express$ z ! proportion
 ( individuals :o 7 infect$ ) ! virus to
 individuals :o di$ f ! virus72 &  7,b7 
! numb] ( /illbir?s1 infant mortality1  
pre-t]m bir?s1 infants born ) a l[-bir? 
weight1 & ces>ean section bir?s4  7c7   
,indian heal? s]vice ,9 c>ry+ out       
subsection 7a71 ! ,secret>y %all consult
 ) ,indian ,tribes & conf] ) urban      
,indian organizations4  7d7             
,disaggregat$ in=mation ,9 c>ry+ out    
subsection 7a71 ! ,secret>y %all        
disaggregate data by race1 e?nicity1 &  
location4  7e7 ,update ,dur+ !          
,,covid-#ai public heal? em]g5cy1 !     
,secret>y %all update ! data made       
available "u ?is section-- 7#a7 at lea/ 
on a mon?ly basis2 &  7#b7 n less ?an "o

 mon? aft] ! end ( su* public heal?     
em]g5cy4  7f7 ,privacy ,9 c>ry+ out     
subsection 7a71 ! ,secret>y %all take   
/eps to protect ! privacy ( individuals 
pursuant to regulations promulgat$ "u   
section #bfd7;c7 ( ! ,heal? ,insurance  
,portability & ,acc\ntability ,act (    
#aiif 7#db ,u4,s4,c4 #acbj;d-#b note74  
7g7 ,guidance  7#a7 ,9 g5]al ,n lat] ?an
 #cj days aft] ! date ( enactm5t ( ?is  
,act1 ! ,secret>y %all issue guidance to
 ,/ates & local public heal? dep>tm5ts  
to ensure t-- 7,a7 laboratories t te/   
specim5s = ,,covid-#ai receive all      
relevant demographic data on race1      
e?nicity1 pregnancy /atus1 & o!r        
demographic data z det]m9$ by !         
,secret>y2 &  7,b7 data describ$ 9      
subsection 7b7 is disaggregat$ by race1 
e?nicity1 & location4  7#b7             
,consultation ,9 c>ry+ out p>agraph     
7#a71 ! ,secret>y %all consult ) ,indian
 ,tribes-- 7,a7 to ensure t su* guidance
 includes ,tribally develop$ be/        
practices2 &  7,b7 to r$uce             

misclassification ( ,am]ican ,indians & 
,alaska ,natives4  #aijd4 ,inclusion (  
pregnant individuals & lactat+          
individuals 9 vacc9e & !rapeutic        
developm5t = ,,covid-#ai ,! ,director ( 
! ,national ,in/itutes ( ,heal? %all :5 
safe & appropriate1 support & advance ! 
inclusion ( pregnant & lactat+          
individuals 9 !rapeutic & vacc9e cl9ical
 trials ) respect to ! treatm5t or      
prev5tion ( ,,covid-#ai1 includ+        
prioritiz+ recomm5dations made by !     
,task ,=ce on ,rese>* ,specific to      
,pregnant ,wom5 & ,lactat+ ,wom5        
e/abli%$ "u section #bjda ( ! #ba/      
,c5tury ,cures ,act 7#db ,u4,s4,c4      
#bhi;a-#b note7 ) respect to includ+ su*
 individuals 9 su* cl9ical trials4      
#aije4 ,public heal? communication      
reg>d+ mat]nal c>e dur+ ,,covid-#ai ,!  
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion %all conduct a public     
heal? education campaign to increase    
access by pregnant individuals1 _!      
employ]s1 & _! heal? c>e provid]s to    

accurate1 evid5ce-bas$ in=mation on     
,,covid-#ai & pregnancy risks1 ) a      
p>ticul> focus pregnant individuals 9   
und]s]v$ communities4  #aijf4 ,task =ce 
on bir?+ exp]i5ce & safe mat]nity c>e   
dur+ a public heal? em]g5cy  7a7        
,e/abli%m5t ,! ,secret>y1 9 consultation
 ) ! ,director ( ! ,c5t]s = ,disease    
,control & ,prev5tion & ! ,adm9i/rator (
 ! ,heal? ,res\rces & ,s]vices          
,adm9i/ration1 %all conv5e a task =ce 79
 ?is subsection ref]r$ to z ! ,task     
,=ce7 to develop recomm5dations1 & make 
su* recomm5dations publicly available 9 
multiple languages1 on respectful       
mat]nity c>e dur+ ! ,,covid-#ai public  
heal? em]g5cy & o!r public heal?        
em]g5cies1 ) a p>ticul> focus on        
outcomes = individuals f racial & e?nic 
m9ority gr\ps & o!r und]s]v$            
communities4  7b7 ,cont5t ,9 develop+   
recomm5dations "u p>agraph 7#a71 ! ,task
 ,=ce %all address ! foll[+3 7#a7       
,measures to facilitate respectful      
mat]nity c>e4  7#b7 ,/rategies to       

increase access to specializ$ c>e =     
individuals ) high-risk pregnancies4    
7#c7 ,,covid-#ai diagno/ic te/+ =       
pregnant individuals & individuals 9    
labor4  7#d7 ,! designation ( a         
companion dur+ bir?+4  7#e7 ,! ability  
to communicate us+ an electronic mobile 
device dur+ bir?+4  7#f7 ,) respect to  
an individual :o has ! virus t causes   
,,covid-#ai-- 7,a7 sep>ation f a newborn
 aft] bir?2 &  7,b7 ensur+ safety :ile  
brea/fe$+4  7#g7 ,lic5s+1 tra9+1 &      
reimbursem5t = midwives f racial & e?nic
 m9ority gr\ps & und]s]v$ communities4  
7#h7 ,f9ancial support = p]9atal heal?  
work]s :o provide noncl9ical support to 
pregnant individuals & po/p>tum         
individuals f und]s]v$ communities4     
7#i7 ,! id5tification & treatm5t (      
pr5atal & po/p>tum m5tal & behavioral   
heal? conditions may h develop$ dur+ or 
wors5$ because ( ! ,,covid-#ai public   
heal? em]g5cy or future public heal?    
em]g5cies1 includ+ anxiety1 sub/ance use
 disord]1 & depression4  7#aj7          

,/rategies to address hospital capacity 
issues 9 communities ) an increase 9    
,,covid-#ai cases1 or cases ( o!r       
infecti\s diseases4  7#aa7 ,options =   
mat]nal c>e t r$uce cross-contam9ation &
 ma9ta9 safety & quality ( c>e1 includ+ 
auxili>y mat]nity units & free/&+ bir?  
c5t]s4  7#ab7 ,me?ods to id5tify &      
address racism1 bias1 & discrim9ation 9 
treatm5t & support to pregnant &        
po/p>tum individuals1 includ+-- 7,a7    
evaluat+ ! tra9+ ( hospital /aff on     
implicit bias & racism & respectful     
mat]nity c>e2 &  7,b7 ! collection (    
demographic data4  7#ac7 ,o!r matt]s !  
,task ,=ce det]m9es appropriate4  7c7   
,memb]%ip  7#a7 ,*air ,! ,secret>y %all 
select ! *air ( ! ,task ,=ce f among !  
memb]s ( ! ,task ,=ce4  7#b7            
,composition ,! ,task ,=ce %all be      
compos$ (-- 7,a7 repres5tatives ( ,f$]al
 ag5cies1 includ+ ! ag5cies li/$ 9      
p>agraph 7#c72  7,b7 ?ree or m          
repres5tatives ( ,/ate1 local1 or       
t]ritorial public heal? dep>tm5ts f     

diff]5t areas 9 ! ,unit$ ,/ates t h a   
l>ge hi/orically m>g9aliz$ population2  
7,c7 "o or m repres5tatives ( ,tribal   
public heal? dep>tm5ts2  7,d7 "o or m   
ob/etrician-gynecologi/s or o!r         
physicians :o provide ob/etric c>e1 )   
consid]ation = physicians :o are f1 or  
"w 91 communities exp]i5c+ a high rate (
 mortality & morbidity f ,,covid-#ai2   
7,e7 "o or m nurses :o provide ob/etric 
c>e1 ) consid]ation = physicians :o are 
f1 or "w 91 communities exp]i5c+ a high 
rate ( mortality & morbidity f          
,,covid-#ai2  7,f7 "o or m p]9atal heal?
 work]s2  7,g7 "o or m individuals :o 7 
pregnant or gave bir? dur+ ! ,,covid-#ai
 public heal? em]g5cy2  7,h7 "o or m    
individuals :o _h ! virus t causes      
,,covid-#ai & lat] gave bir?2  7,i7 "o  
or m individuals :o h receiv$ support f 
a p]9atal heal?2 &  7,j7 ?ree or m      
indep5d5t exp]ts :o are racially &      
e?nically div]se ) k on racial & e?nic  
disp>ities 9-- 7i7 public heal?2  7ii7  
mat]nal heal?2 or  7iii7 mat]nal        

mortality & sev]e mat]nal morbidity4    
7#c7 ,f$]al ag5cies ,! ag5cies repres5t$
 "u p>agraph 7#b77;,a7 %all include !   
foll[+3 7,a7 ,! ,dep>tm5t ( ,heal? &    
,human ,s]vices4  7,b7 ,! ,c5t]s =      
,disease ,control & ,prev5tion4  7,c7 ,!
 ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices4   
7,d7 ,! ,heal? ,res\rces & ,s]vices     
,adm9i/ration4  7,e7 ,! ,indian ,heal?  
,s]vice4  7,f7 ,! ,national ,in/itutes (
 ,heal?4  #aijg4 ,,gao report on mat]nal
 heal? & public heal? em]g5cy prep>$ness
  7a7 ,9 g5]al ,n lat] ?an "o ye> aft] !
 date ( ! enactm5t ( ?is ,act1 !        
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all submit to ,congress a report on    
mat]nal heal? & public heal? em]g5cy    
prep>$ness4 ,su* report %all include !  
in=mation & recomm5dations describ$ 9   
subsection 7b74  7b7 ,cont5t ( report ,!
 report "u subsection 7b7 %all include !
 foll[+3 7#a7 ,a review ( pr5atal1 labor
 & deliv]y1 & po/p>tum exp]i5ces (      
individuals dur+ su* public heal?       
em]g5cy1 includ+-- 7,a7 b>ri]s to       

access+ pregnancy1 bir?1 & po/p>tum c>e 
dur+ a p&emic2  7,b7 public & private   
insurance cov]age ) respect to mat]nal  
heal? c>e1 includ+ teleheal? s]vices2   
7,c7 to ! ext5t practicable1 mat]nal &  
infant heal? outcomes by race & e?nicity
 7includ+ quality ( c>e1 mortality1     
morbidity1 ces>ean section rates1 pret]m
 bir?1 preval5ce ( pr5atal & po/p>tum   
m5tal heal? conditions & sub/ance use   
disord]s72  7,d7 ) respect to su* heal? 
outcomes1 ! impact ( ,f$]al & ,/ate     
policy *anges dur+ su* public heal?     
em]g5cy2  7,e7 contribut+ factors to    
population-bas$ disp>ities 9 heal?      
outcomes1 includ+ bias & discrim9ation  
t[>d individuals f racial & e?nic       
m9ority gr\ps2 &  7,f7 ! effect (       
increas$ unemploym5t1 paid family leave1
 *anges 9 heal? c>e cov]age1 & o!r      
social det]m9ants ( heal? = pregnant &  
po/p>tum individuals dur+ ! public heal?
 em]g5cy4  7#b7 ,recomm5dations on      
improv+ ! public heal? em]g5cy response 
& prep>$ness ef=ts ( ! ,f$]al ,gov]nm5t 

) respect to mat]nal heal?1 ) a focus on
 outcomes = pregnant & po/p>tum         
individuals f racial & e?nic m9ority    
gr\ps1 includ+-- 7,a7 improv+ rese>*1   
surveillance1 & data collection )       
respect to mat]nal heal?2  7,b7 factor+ 
mat]nal heal? outcomes & disp>ities into
 decisions reg>d+ di/ribution (         
res\rces2  7,c7 improv+ ! di/ribution ( 
public heal? funds1 data1 & in=mation to
 ,indian ,tribes & ,tribal organizations
 ) reg>d to mat]nal heal? dur+ a public 
heal? em]g5cy2 &  7,d7 improv+          
communications dur+ a public heal?      
em]g5cy )-- 7i7 mat]nity c>e provid]s2  
7ii7 mat]nal m5tal & behavioral heal?   
c>e provid]s2  7iii7 rese>*]s :o        
specialize 9 mat]nal heal?1 mat]nal     
mortality1 or sev]e mat]nal morbidity2  
7iv7 individuals :o exp]i5c$ pregnancy  
or *ildbir? dur+ ! ,,covid-#ai public   
heal? em]g5cy2  7v7 repres5tatives f    
community-bas$ organizations t address  
mat]nal heal?2 &  7vi7 p]9atal heal?    
work]s4  ,k ,protect+ moms & babies     

aga9/ climate *ange  #aiaa4 ,def9itions 
,9 ?is subtitle1 ! foll[+ def9itions    
apply3 7#a7 ,adv]se mat]nal & infant    
heal? outcomes ,! t]m adv]se mat]nal &  
infant heal? outcomes includes !        
outcomes ( pret]m bir?1 l[ bir? weight1 
/illbir?1 infant or mat]nal mortality1 &
 sev]e mat]nal morbidity4  7#b7         
,in/itution ( high] education ,! t]m    
in/itution ( high] education has ! mean+
 giv5 su* t]m 9 section #aja ( ! ,high] 
,education ,act ( #aife 7#bj ,u4,s4,c4  
#ajja74  7#c7 ,m9ority-s]v+ in/itution  
,! t]m m9ority-s]v+ in/itution means an 
entity specifi$ 9 any ( p>agraphs 7#a7  
?r\gh 7#g7 ( section #cga7;a7 ( ! ,high]
 ,education ,act ( #aife 7#bj ,u4,s4,c4 
#ajfgq7a774  7#d7 ,racial & e?nic       
m9ority gr\p ,! t]m racial & e?nic      
m9ority gr\p has ! mean+ giv5 su* t]m 9 
section #agjg7;g7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4             
#cjju-#f7;g774  7#e7 ,risks associat$ ) 
climate *ange ,! t]m risks associat$ )  
climate *ange includes risks associat$ )

 extreme heat1 air pollution1 extreme   
wea!r ev5ts1 & o!r environm5tal issues  
associat$ ) climate *ange t c result 9  
adv]se mat]nal & infant heal? outcomes4 
7#f7 ,/akehold] organization ,! t]m     
/akehold] organization means-- 7,a7 a   
community-bas$ organization ) exp]tise 9
 provid+ assi/ance to vuln]able         
individuals2  7,b7 a nonpr(it           
organization ) exp]tise 9 mat]nal or    
infant heal? or environm5tal ju/ice2 &  
7,c7 a pati5t advocacy organization     
repres5t+ vuln]able individuals4  7#g7  
,vuln]able individual ,! t]m vuln]able  
individual means-- 7,a7 an individual :o
 is pregnant2  7,b7 an individual :o 0  
pregnant dur+ any portion ( ! prec$+    
#a-ye> p]iod2 &  7,c7 an individual "u  
#c ye>s ( age4  #aiab4 ,grant program to
 protect vuln]able mo!rs & babies f     
climate *ange risks  7a7 ,9 g5]al ,n    
lat] ?an #ahj days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,heal? & ,human ,s]vices %all e/abli% a 
grant program 79 ?is section ref]r$ to z

 ! ,program7 to protect vuln]able       
individuals f risks associat$ ) climate 
*ange4  7b7 ,grant au?ority ,9 c>ry+ out
 ! ,program1 ! ,secret>y may aw>d1 on a 
competitive basis1 grants to #aj cov]$  
entities4  7c7 ,applications ,to be     
eligible = a grant "u ! ,program1 a     
cov]$ entity %all submit to ! ,secret>y 
an application at su* "t1 9 su* =m1 &   
conta9+ su* in=mation z ! ,secret>y may 
require1 :i* %all include1 at a m9imum1 
a description ( ! foll[+3 7#a7 ,plans = 
! use ( grant funds aw>d$ "u ! ,program 
& h[ pati5ts & /akehold] organizations 7
 involv$ 9 ! developm5t ( su* plans4    
7#b7 ,h[ su* grant funds w be t>get$ to 
geographic areas t h disproportionately 
high levels ( risks associat$ ) climate 
*ange = vuln]able individuals4  7#c7 ,h[
 su* grant funds w be us$ to address    
racial & e?nic disp>ities 9-- 7,a7      
adv]se mat]nal & infant heal? outcomes2 
&  7,b7 exposure to risks associat$ )   
climate *ange = vuln]able individuals4  
7#d7 ,/rategies to prev5t an initiative 

assi/$ ) su* grant funds f caus+-- 7,a7 
adv]se environm5tal impacts2  7,b7      
displacem5t ( resid5ts & bus9esses2     
7,c7 r5t & h\s+ price increases2 or     
7,d7 disproportionate adv]se impacts on 
racial & e?nic m9ority gr\ps & o!r      
und]s]v$ populations4  7d7 ,selection ( 
grant recipi5ts  7#a7 ,tim+ ,n lat] ?an 
#bgj days aft] ! date ( ! enactm5t ( ?is
 ,act1 ! ,secret>y %all select !        
recipi5ts ( grants "u ! ,program4  7#b7 
,consultation ,9 select+ cov]$ entities 
= grants "u ! ,program1 ! ,secret>y %all
 consult )-- 7,a7 repres5tatives (      
/akehold] organizations2  7,b7 !        
,adm9i/rator ( ! ,environm5tal          
,protection ,ag5cy2  7,c7 ! ,adm9i/rator
 ( ! ,national ,oceanic & ,atmosph]ic   
,adm9i/ration2 &  7,d7 f ! ,dep>tm5t (  
,heal? & ,human ,s]vices-- 7i7 ! ,deputy
 ,assi/ant ,secret>y = ,m9ority ,heal?2 
7ii7 ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e
  ,m$icaid ,s]vices2  7iii7 !           
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration2  7iv7 !         

,director ( ! ,national ,in/itutes (    
,heal?2 &  7v7 ! ,director ( ! ,c5t]s = 
,disease ,control & ,prev5tion4  7#c7   
,priority ,9 select+ a cov]$ entity to  
be aw>d$ a grant "u ! ,program1 !       
,secret>y %all give priority to cov]$   
entities t s]ve a c\nty-- 7,a7          
designat$1 or locat$ 9 an area          
designat$1 z a nonatta9m5t area pursuant
 to section #ajg ( ! ,clean ,air ,act   
7#db ,u4,s4,c4 #gdjg7 = any air         
pollutant = :i* air quality crit]ia h   
be5 issu$ "u section #ajh7;a7 ( su* ,act
 7#db ,u4,s4,c4 #gdjh7;a772  7,b7 ) a   
level ( vuln]ability ( mod]ate-to-high  
or high]1 accord+ to ! ,social          
,vuln]ability ,index ( ! ,c5t]s =       
,disease ,control & ,prev5tion2 or  7,c7
 ) temp]atures t pose a risk to human   
heal?1 z det]m9$ by ! ,secret>y1 9      
consultation ) ! ,adm9i/rator ( !       
,national ,oceanic & ,atmosph]ic        
,adm9i/ration & ! ,*air ( ! ,unit$      
,/ates ,global ,*ange ,rese>* ,program1 
bas$ on ! be/ available sci5ce4  7#d7   

,limitation ,a recipi5t ( grant funds "u
 ! ,program may n use su* grant funds to
 s]ve a c\nty t is s]v$ by any o!r      
recipi5t ( a grant "u ! ,program4  7e7  
,use ( funds ,a cov]$ entity aw>d$ grant
 funds "u ! ,program may only use su*   
grant funds = ! foll[+3 7#a7            
,initiatives to id5tify risks associat$ 
) climate *ange = vuln]able individuals 
& to provide s]vices & support to su*   
individuals t address su* risks1 :i* may
 include-- 7,a7 tra9+ = heal? c>e       
provid]s1 d\las1 & o!r employees 9      
hospitals1 bir? c5t]s1 midwif]y         
practices1 & o!r heal? c>e practices t  
provide pr5atal or labor & deliv]y      
s]vices to vuln]able individuals on !   
id5tification (1 & pati5t c\nsel+ relat+
 to1 risks associat$ ) climate *ange =  
vuln]able individuals2  7,b7 hir+1      
tra9+1 or provid+ res\rces to community 
heal? work]s & p]9atal heal? work]s :o c
 help id5tify risks associat$ ) climate 
*ange = vuln]able individuals1 provide  
pati5t c\nsel+ ab\t su* risks1 & c>ry   

out ! di/ribution ( relevant s]vices &  
support2  7,c7 enhanc+ ! monitor+ (     
risks associat$ ) climate *ange =       
vuln]able individuals1 includ+ by-- 7i7 
collect+ data on su* risks 9 specific   
c5sus tracts1 neighborhoods1 or o!r     
geographic areas2 &  7ii7 %>+ su* data )
 local heal? c>e provid]s1 d\las1 & o!r 
employees 9 hospitals1 bir? c5t]s1      
midwif]y practices1 & o!r heal? c>e     
practices t provide pr5atal or labor &  
deliv]y s]vices to local vuln]able      
individuals2 &  7,d7 provid+ vuln]able  
individuals-- 7i7 air condition+ units1 
resid5tial wea!rization support1        
filtration sy/ems1 h\sehold appliances1 
or relat$ items2  7ii7 direct f9ancial  
assi/ance2 &  7iii7 s]vices & support1  
includ+ h\s+ & transportation assi/ance1
 to prep>e = or recov] f extreme wea!r  
ev5ts1 :i* may include floods1          
hurricanes1 wildfires1 dr\ghts1 & relat$
 ev5ts4  7#b7 ,initiatives to mitigate  
levels ( & exposure to risks associat$ )
 climate *ange = vuln]able individuals1 

:i* %all be bas$ on ! be/ available     
sci5ce & :i* may include initiatives    
to-- 7,a7 develop1 ma9ta91 or exp& urban
 or community =e/ry initiatives & tree  
canopy cov]age initiatives2  7,b7       
improve infra/ructure1 includ+ build+s &
 pav$ surfaces2  7,c7 develop or improve
 community outrea* networks to provide  
culturally & l+ui/ically appropriate    
in=mation & notifications ab\t risks    
associat$ ) climate *ange = vuln]able   
individuals2 &  7,d7 provide enhanc$    
s]vices to racial & e?nic m9ority gr\ps 
& o!r und]s]v$ populations4  7f7 ,l5g? (
 aw>d ,a grant "u ?is section %all be   
disburs$ ov] #d fiscal ye>s4  7g7       
,te*nical assi/ance ,! ,secret>y %all   
provide te*nical assi/ance to a cov]$   
entity aw>d$ a grant "u ! ,program to   
support ! developm5t1 implem5tation1 &  
evaluation ( activities fund$ ) su*     
grant4  7h7 ,reports to ,secret>y  7#a7 
,annual report ,= ea* fiscal ye> dur+   
:i* a cov]$ entity is disburs$ grant    
funds "u ! ,program1 su* cov]$ entity   

%all submit to ! ,secret>y a report t   
summ>izes ! activities c>ri$ out by su* 
cov]$ entity ) su* grant funds dur+ su* 
fiscal ye>1 :i* %all include a          
description ( ! foll[+3 7,a7 ,!         
involvem5t ( /akehold] organizations 9 !
 implem5tation ( initiatives assi/$ )   
su* grant funds4  7,b7 ,relevant heal? &
 environm5tal data1 disaggregat$1 to !  
ext5t practicable1 by race1 e?nicity1   
g5d]1 & pregnancy /atus4  7,c7          
,qualitative fe$back receiv$ f vuln]able
 individuals ) respect to initiatives   
assi/$ ) su* grant funds4  7,d7 ,crit]ia
 us$ 9 select+ ! geographic areas assi/$
 ) su* grant funds4  7,e7 ,ef=ts to     
address racial & e?nic disp>ities 9     
adv]se mat]nal & infant heal? outcomes &
 9 exposure to risks associat$ ) climate
 *ange = vuln]able individuals4  7,f7   
,any negative & un9t5d$ impacts (       
initiatives assi/$ ) su* grant funds1   
includ+-- 7i7 adv]se environm5tal       
impacts2  7ii7 displacem5t ( resid5ts & 
bus9esses2  7iii7 r5t & h\s+ price      

increases2 &  7iv7 disproportionate     
adv]se impacts on racial & e?nic m9ority
 gr\ps & o!r und]s]v$ populations4  7,g7
 ,h[ ! cov]$ entity w address & prev5t  
any impacts describ$ 9 subp>agraph 7,f74
  7#b7 ,publication ,n lat] ?an #cj days
 aft] ! date on :i* a report is submitt$
 "u p>agraph 7#a71 ! ,secret>y %all     
publi% su* report on a public website ( 
! ,dep>tm5t ( ,heal? & ,human ,s]vices4 
7i7 ,report to ,congress ,n lat] ?an !  
date t is #e ye>s aft] ! date on :i* !  
,program is e/abli%$1 ! ,secret>y %all  
submit to ,congress & publi% on a public
 website ( ! ,dep>tm5t ( ,heal? & ,human
 ,s]vices a report on ! results ( !     
,program1 includ+ ! foll[+3 7#a7        
,summ>ies ( ! annual reports submitt$ "u
 subsection 7h74  7#b7 ,evaluations ( ! 
initiatives assi/$ ) grant funds "u !   
,program4  7#c7 ,an assessm5t ( !       
effectiv5ess ( ! ,program 9-- 7,a7      
id5tify+ risks associat$ ) climate *ange
 = vuln]able individuals2  7,b7 provid+ 
s]vices & support to su* individuals2   

7,c7 mitigat+ levels ( & exposure to su*
 risks2 &  7,d7 address+ racial & e?nic 
disp>ities 9 adv]se mat]nal & infant    
heal? outcomes & 9 exposure to su*      
risks4  7#d7 ,a description ( h[ !      
,program c\ld be exp&$1 includ+-- 7,a7  
monitor+ ef=ts or data collection t w\ld
 be requir$ to id5tify areas ) high     
levels ( risks associat$ ) climate *ange
 = vuln]able individuals2  7,b7 h[ su*  
areas c\ld be id5tifi$ us+ ! /rategy    
develop$ "u section #aiae2 &  7,c7      
recomm5dations = additional fund+4  7j7 
,cov]$ entity def9$ ,9 ?is section1 !   
t]m cov]$ entity means a consortium (   
organizations s]v+ a c\nty t-- 7#a7 %all
 include a community-bas$ organization2 
&  7#b7 may include-- 7,a7 ano!r        
/akehold] organization2  7,b7 ! gov]nm5t
 ( su* c\nty2  7,c7 ! gov]nm5ts ( "o or 
m municipalities )9 su* c\nty2  7,d7 a  
,/ate or local public heal? dep>tm5t or 
em]g5cy managem5t ag5cy2  7,e7 a local  
heal? c>e practice1 :i* may include a   
lic5s$ & accr$it$ hospital1 bir? c5t]1  

midwif]y practice1 or o!r heal? c>e     
practice t provides pr5atal or labor &  
deliv]y s]vices to vuln]able            
individuals2  7,f7 an ,indian tribe or  
tribal organization 7z su* t]ms are     
def9$ 9 section #d ( ! ,indian          
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd772 
7,g7 an ,urban ,indian organization 7z  
def9$ 9 section #d ( ! ,indian ,heal?   
,c>e ,improvem5t ,act 7#be ,u4,s4,c4    
#afjc772 &  7,h7 an in/itution ( high]  
education4  7k7 ,au?orization (         
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#ajj1jjj1jjj = ! p]iod ( fiscal ye>s    
#bjbc ?r\gh #bjbf4  #aiac4 ,grant       
program = education & tra9+ at heal?    
pr(ession s*ools  7a7 ,9 g5]al ,n lat]  
?an #a ye> aft] ! date ( ! enactm5t (   
?is ,act1 ! ,secret>y ( ,heal? & ,human 
,s]vices %all e/abli% a grant program 79
 ?is section ref]r$ to z ! ,program7 to 
provide funds to heal? pr(ession s*ools 
to support ! developm5t & integration ( 

education & tra9+ programs = id5tify+ & 
address+ risks associat$ ) climate *ange
 = vuln]able individuals4  7b7 ,grant   
au?ority ,9 c>ry+ out ! ,program1 !     
,secret>y may aw>d1 on a competitive    
basis1 grants to heal? pr(ession s*ools4
  7c7 ,application ,to be eligible = a  
grant "u ! ,program1 a heal? pr(ession  
s*ool %all submit to ! ,secret>y an     
application at su* "t1 9 su* =m1 &      
conta9+ su* in=mation z ! ,secret>y may 
require1 :i* %all include1 at a m9imum1 
a description ( ! foll[+3 7#a7 ,h[ su*  
heal? pr(ession s*ool w engage )        
vuln]able individuals1 & /akehold]      
organizations repres5t+ su* individuals1
 9 develop+ & implem5t+ ! education &   
tra9+ programs support$ by grant funds  
aw>d$ "u ! ,program4  7#b7 ,h[ su* heal?
 pr(ession s*ool w ensure t su*         
education & tra9+ programs w address    
racial & e?nic disp>ities 9 exposure to1
 & ! effects (1 risks associat$ )       
climate *ange = vuln]able individuals4  
7d7 ,use ( funds ,a heal? pr(ession     

s*ool aw>d$ a grant "u ! ,program %all  
use ! grant funds to develop1 &         
integrate into ! curriculum & cont9u+   
education ( su* heal? pr(ession s*ool1  
education & tra9+ on ea* ( ! foll[+3    
7#a7 ,id5tify+ risks associat$ ) climate
 *ange = vuln]able individuals &        
individuals ) ! int5t to become         
pregnant4  7#b7 ,h[ risks associat$ )   
climate *ange affect vuln]able          
individuals & individuals ) ! int5t to  
become pregnant4  7#c7 ,racial & e?nic  
disp>ities 9 exposure to1 & ! effects (1
 risks associat$ ) climate *ange =      
vuln]able individuals & individuals ) ! 
int5t to become pregnant4  7#d7 ,pati5t 
c\nsel+ & mitigation /rategies relat+ to
 risks associat$ ) climate *ange =      
vuln]able individuals4  7#e7 ,relevant  
s]vices & support = vuln]able           
individuals relat+ to risks associat$ ) 
climate *ange & /rategies = ensur+      
vuln]able individuals h access to su*   
s]vices & support4  7#f7 ,implicit &    
explicit bias1 racism1 & discrim9ation4 

7#g7 ,relat$ topics id5tifi$ by su*     
heal? pr(ession s*ool bas$ on !         
engagem5t ( su* heal? pr(ession s*ool ) 
vuln]able individuals & /akehold]       
organizations repres5t+ su* individuals4
  7e7 ,p>tn]%ips ,9 c>ry+ out activities
 ) grant funds1 a heal? pr(ession s*ool 
aw>d$ a grant "u ! ,program may p>tn] ) 
"o or m ( ! foll[+3 7#a7 ,a ,/ate or    
local public heal? dep>tm5t4  7#b7 ,a   
heal? c>e pr(essional memb]%ip          
organization4  7#c7 ,a /akehold]        
organization4  7#d7 ,a heal? pr(ession  
s*ool4  7#e7 ,an in/itution ( high]     
education4  7f7 ,reports to ,secret>y   
7#a7 ,annual report ,= ea* fiscal ye>   
dur+ :i* a heal? pr(ession s*ool is     
disburs$ grant funds "u ! ,program1 su* 
heal? pr(ession s*ool %all submit to !  
,secret>y a report t describes !        
activities c>ri$ out ) su* grant funds  
dur+ su* fiscal ye>4  7#b7 ,f9al report 
,n lat] ?an ! date t is #a ye> aft] !   
end ( ! la/ fiscal ye> dur+ :i* a heal? 
pr(ession s*ool is disburs$ grant funds 

"u ! ,program1 ! heal? pr(ession s*ool  
%all submit to ! ,secret>y a f9al report
 t summ>izes ! activities c>ri$ out )   
su* grant funds4  7g7 ,report to        
,congress ,n lat] ?an ! date t is #f    
ye>s aft] ! date on :i* ! ,program is   
e/abli%$1 ! ,secret>y %all submit to    
,congress & publi% on a public website (
 ! ,dep>tm5t ( ,heal? & ,human ,s]vices 
a report t includes ! foll[+3 7#a7 ,a   
summ>y ( ! reports submitt$ "u          
subsection 7f74  7#b7 ,recomm5dations to
 improve education & tra9+ programs at  
heal? pr(ession s*ools ) respect to     
id5tify+ & address+ risks associat$ )   
climate *ange = vuln]able individuals4  
7h7 ,heal? pr(ession s*ool def9$ ,9 ?is 
section1 ! t]m heal? pr(ession s*ool    
means an accr$it$-- 7#a7 m$ical s*ool2  
7#b7 s*ool ( nurs+2  7#c7 midwif]y      
program2  7#d7 physician assi/ant       
education program2  7#e7 tea*+ hospital2
  7#f7 resid5cy or fell[%ip program2 or 
7#g7 o!r s*ool or program det]m9$       
appropriate by ! ,secret>y4  7i7        

,au?orization ( ,appropriations ,!re is 
au?oriz$ to be appropriat$ to c>ry out  
?is section #e1jjj1jjj = ! p]iod (      
fiscal ye>s #bjbc ?r\gh #bjbf4  #aiad4  
,,nih ,consortium on ,bir? & ,climate   
,*ange ,rese>*  7a7 ,e/abli%m5t ,n lat] 
?an "o ye> aft] ! date ( ! enactm5t (   
?is ,act1 ! ,director ( ! ,national     
,in/itutes ( ,heal? %all e/abli% !      
,consortium on ,bir? & ,climate ,*ange  
,rese>* 79 ?is section ref]r$ to z !    
,consortium74  7b7 ,duties  7#a7 ,9     
g5]al ,! ,consortium %all coord9ate1    
across ! in/itutes1 c5t]s1 & (fices ( ! 
,national ,in/itutes ( ,heal?1 rese>* on
 ! risks associat$ ) climate *ange =    
vuln]able individuals4  7#b7 ,requir$   
activities ,9 c>ry+ out p>agraph 7#a71 !
 ,consortium %all-- 7,a7 e/abli% rese>* 
priorities1 includ+ by prioritiz+ rese>*
 t-- 7i7 id5tifies ! risks associat$ )  
climate *ange = vuln]able individuals ) 
a p>ticul> focus on disp>ities 9 su*    
risks among racial & e?nic m9ority gr\ps
 & o!r und]s]v$ populations2 &  7ii7    

id5tifies /rategies to r$uce levels (1 &
 exposure to1 su* risks1 ) a p>ticul>   
focus on risks among racial & e?nic     
m9ority gr\ps & o!r und]s]v$            
populations2  7,b7 id5tify gaps 9       
available data relat$ to su* risks2     
7,c7 id5tify gaps 91 & opportunities =1 
rese>* collaborations2  7,d7 id5tify    
fund+ opportunities = community-bas$    
organizations & rese>*]s f racially1    
e?nically1 & geographically div]se      
backgr\nds2 &  7,e7 publi% annual       
reports on ! "w & f9d+s ( ! ,consortium 
on a public website ( ! ,national       
,in/itutes ( ,heal?4  7c7 ,memb]%ip ,!  
,director %all appo9t to ! ,consortium  
repres5tatives ( su* in/itutes1 c5t]s1 &
 (fices ( ! ,national ,in/itutes (      
,heal? z ! ,director consid]s           
appropriate1 includ+1 at a m9imum1      
repres5tatives (-- 7#a7 ! ,national     
,in/itute ( ,environm5tal ,heal?        
,sci5ces2  7#b7 ! ,national ,in/itute on
 ,m9ority ,heal? & ,heal? ,disp>ities2  
7#c7 ! ,eunice ,k5n$y ,%riv] ,national  

,in/itute ( ,*ild ,heal? & ,human       
,developm5t2  7#d7 ! ,national ,in/itute
 ( ,nurs+ ,rese>*2 &  7#e7 ! ,(fice (   
,rese>* on ,wom5's ,heal?4  7d7         
,*airp]son ,! ,*airp]son ( ! ,consortium
 %all be designat$ by ! ,director &     
select$ f among ! repres5tatives appo9t$
 "u subsection 7c74  7e7 ,consultation  
,9 c>ry+ out ! duties describ$ 9        
subsection 7b71 ! ,consortium %all      
consult )-- 7#a7 ! heads ( relevant     
,f$]al ag5cies1 includ+-- 7,a7 !        
,environm5tal ,protection ,ag5cy2  7,b7 
! ,national ,oceanic & ,atmosph]ic      
,adm9i/ration2  7,c7 ! ,occupational    
,safety & ,heal? ,adm9i/ration2 &  7,d7 
f ! ,dep>tm5t ( ,heal? & ,human         
,s]vices-- 7i7 ! ,(fice ( ,m9ority      
,heal? 9 ! ,(fice ( ! ,secret>y2  7ii7 !
 ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices2   
7iii7 ! ,heal? ,res\rces & ,s]vices     
,adm9i/ration2  7iv7 ! ,c5t]s = ,disease
 ,control & ,prev5tion2  7v7 ! ,indian  
,heal? ,s]vice2 &  7vi7 ! ,adm9i/ration 
= ,*ildr5 & ,families2 &  7#b7          

repres5tatives (-- 7,a7 /akehold]       
organizations2  7,b7 heal? c>e provid]s 
& pr(essional memb]%ip organizations )  
exp]tise 9 mat]nal heal? or environm5tal
 ju/ice2  7,c7 ,/ate & local public     
heal? dep>tm5ts2  7,d7 lic5s$ & accr$it$
 hospitals1 bir? c5t]s1 midwif]y        
practices1 or o!r heal? c>e practices t 
provide pr5atal or labor & deliv]y      
s]vices to vuln]able individuals2 &     
7,e7 in/itutions ( high] education1     
includ+ su* in/itutions t are           
m9ority-s]v+ in/itutions or h exp]tise 9
 mat]nal heal? or environm5tal ju/ice4  
#aiae4 ,/rategy = id5tify+ climate *ange
 risk zones = vuln]able mo!rs & babies  
7a7 ,9 g5]al ,! ,secret>y ( ,heal? &    
,human ,s]vices1 act+ ?r\gh ! ,director 
( ! ,c5t]s = ,disease ,control &        
,prev5tion1 %all develop a /rategy 79   
?is section ref]r$ to z ! ,/rategy7 =   
designat+ areas t ! ,secret>y det]m9es  
to h a high risk ( adv]se mat]nal &     
infant heal? outcomes among vuln]able   
individuals z a result ( risks associat$

 ) climate *ange4  7b7 ,/rategy         
requirem5ts  7#a7 ,9 g5]al ,9 develop+ !
 ,/rategy1 ! ,secret>y %all e/abli% a   
process to id5tify areas :]e vuln]able  
individuals are expos$ to a high risk ( 
adv]se mat]nal & infant heal? outcomes z
 a result ( risks associat$ ) climate   
*ange 9 conjunction ) o!r factors t c   
impact su* heal? outcomes1 includ+--    
7,a7 ! incid5ce ( diseases associat$ )  
air pollution1 extreme heat1 & o!r      
environm5tal factors2  7,b7 !           
availability & accessibility ( mat]nal &
 infant heal? c>e provid]s2  7,c7       
,engli%-language pr(ici5cy among wom5 ( 
reproductive age2  7,d7 ! heal?         
insurance /atus ( wom5 ( reproductive   
age2  7,e7 ! numb] ( wom5 ( reproductive
 age :o are memb]s ( racial or e?nic    
gr\ps ) disproportionately high rates ( 
adv]se mat]nal & infant heal? outcomes2 
7,f7 ! socioeconomic /atus ( wom5 (     
reproductive age1 includ+ ) respect to--
 7i7 pov]ty2  7ii7 unemploym5t2  7iii7  
h\sehold income2 &  7iv7 educational    

atta9m5t2 &  7,g7 access to quality     
h\s+1 transportation1 & nutrition4  7#b7
 ,res\rces ,9 develop+ ! ,/rategy1 !    
,secret>y %all id5tify1 & incorporate a 
description (1 ! foll[+3 7,a7 ,exi/+    
mapp+ tools or ,f$]al programs t        
id5tify-- 7i7 risks associat$ ) climate 
*ange = vuln]able individuals2 &  7ii7  
o!r factors t c influ5ce mat]nal &      
infant heal? outcomes1 includ+ ! factors
 describ$ 9 p>agraph 7#a74  7,b7        
,environm5tal1 heal?1 socioeconomic1 &  
demographic data relevant to id5tify+   
risks associat$ ) climate *ange =       
vuln]able individuals4  7,c7 ,exi/+     
monitor+ networks t collect data        
describ$ 9 subp>agraph 7,b71 & any gaps 
9 su* networks4  7,d7 ,f$]al1 ,/ate1 &  
local /akehold]s involv$ 9 ma9ta9+      
monitor+ networks id5tifi$ "u           
subp>agraph 7,c71 & h[ su* /akehold]s   
are coord9at+ _! monitor+ ef=ts4  7,e7  
,additional monitor+ networks1 &        
enhancem5ts to exi/+ monitor+ networks1 
t w\ld be requir$ to address gaps       

id5tifi$ "u subp>agraph 7,c71 includ+ at
 ! subc\nty & c5sus tract level4  7,f7  
,fund+ am\nts requir$ to e/abli% !      
monitor+ networks id5tifi$ "u           
subp>agraph 7,e7 & recomm5dations =     
,f$]al1 ,/ate1 & local coord9ation )    
respect to su* networks4  7,g7 ,pot5tial
 uses = data collect$ & g5]at$ z a      
result ( ! ,/rategy1 includ+ h[ su* data
 may be us$ 9 det]m9+ recipi5ts ( grants
 "u ! program e/abli%$ by section #aiab 
or o!r simil> programs4  7,h7 ,o!r      
in=mation ! ,secret>y consid]s relevant 
= ! developm5t ( ! ,/rategy4  7c7       
,coord9ation & consultation ,9 develop+ 
! ,/rategy1 ! ,secret>y %all-- 7#a7     
coord9ate ) ! ,adm9i/rator ( !          
,environm5tal ,protection ,ag5cy & !    
,adm9i/rator ( ! ,national ,oceanic &   
,atmosph]ic ,adm9i/ration2 &  7#b7      
consult )-- 7,a7 /akehold]              
organizations2  7,b7 heal? c>e provid]s 
& pr(essional memb]%ip organizations )  
exp]tise 9 mat]nal heal? or environm5tal
 ju/ice2  7,c7 ,/ate & local public     

heal? dep>tm5ts2  7,d7 lic5s$ & accr$it$
 hospitals1 bir? c5t]s1 midwif]y        
practices1 or o!r heal? c>e provid]s t  
provide pr5atal or labor & deliv]y      
s]vices to vuln]able individuals2 &     
7,e7 in/itutions ( high] education1     
includ+ su* in/itutions t are           
m9ority-s]v+ in/itutions or h exp]tise 9
 mat]nal heal? or environm5tal ju/ice4  
7d7 ,notice & comm5t ,at lea/ #bdj days 
be=e ! date on :i* ! ,/rategy is publi%$
 9 accordance ) subsection 7e71 !       
,secret>y %all provide-- 7#a7 notice ( !
 ,/rategy on a public website ( !       
,dep>tm5t ( ,heal? & ,human ,s]vices2 & 
7#b7 an opportunity = public comm5t ( at
 lea/ #ij days4  7e7 ,publication ,n    
lat] ?an #ah mon?s aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y %all   
publi% on a public website ( ! ,dep>tm5t
 ( ,heal? & ,human ,s]vices-- 7#a7 !    
,/rategy2  7#b7 ! public comm5ts receiv$
 "u subsection 7d72 &  7#c7 ! responses 
( ! ,secret>y to su* public comm5ts4  ,l
 ,mat]nal vacc9ations  #aiba4 ,mat]nal  

vacc9ation aw>5ess & equity campaign    
7a7 ,9 g5]al ,! ,secret>y ( ,heal? &    
,human ,s]vices 79 ?is section ref]r$ to
 z ! ,secret>y71 act+ ?r\gh ! ,director 
( ! ,c5t]s = ,disease ,control &        
,prev5tion1 %all c>ry out a national    
campaign to-- 7#a7 increase aw>5ess ( ! 
importance ( mat]nal vacc9ations = !    
heal? ( pregnant & po/p>tum individuals 
& _! *ildr52 &  7#b7 increase mat]nal   
vacc9ation rates1 ) a focus on          
communities ) hi/orically high rates (  
unvacc9at$ individuals4  7b7            
,consultation ,9 c>ry+ out ! campaign "u
 ?is subtitle1 ! ,secret>y %all consult 
) relevant community-bas$ organizations1
 heal? c>e pr(essional associations &   
public heal? associations1 ,/ate public 
heal? dep>tm5ts & local public heal?    
dep>tm5ts1 ,tribal-s]v+ organizations1  
nonpr(it organizations1 & nationally    
recogniz$ private entities4  7c7        
,activities ,! campaign "u ?is section  
%all-- 7#a7 focus on increas+ mat]nal   
vacc9ation rates 9 communities )        

hi/orically high rates ( unvacc9at$     
individuals1 includ+ = pregnant &       
po/p>tum individuals f racial & e?nic   
m9ority gr\ps2  7#b7 include ef=ts to   
engage ) pregnant & po/p>tum individuals
 9 communities ) hi/orically high rates 
( unvacc9at$ individuals to seek input  
on ! developm5t & effectiv5ess ( !      
campaign2  7#c7 provide evid5ce-bas$1   
culturally congru5t res\rces &          
communications ef=ts2 &  7#d7 be c>ri$  
out 9 p>tn]%ip ) tru/$ individuals &    
entities 9 communities ) hi/orically    
high rates ( unvacc9at$ individuals1    
includ+ community-bas$ organizations1   
community heal? c5t]s1 p]9atal heal?    
work]s1 & mat]nity c>e provid]s4  7d7   
,collaboration ,! ,secret>y %all ensure 
t ! in=mation & res\rces develop$ = !   
campaign "u ?is section are made        
publicly available & %>$ ) relevant     
,f$]al1 ,/ate1 & local entities4  7e7   
,evaluation ,n lat] ?an ! end ( fiscal  
ye> #bjbf1 ! ,secret>y %all-- 7#a7      
e/abli% quantitative & qualitative      

metrics to evaluate ! campaign "u ?is   
section2 &  7#b7 submit a report detail+
 ! campaign's impact to ! ,congress4    
7f7 ,au?orization ( appropriations ,to  
c>ry out ?is section1 !re is au?oriz$ to
 be appropriat$ #b1jjj1jjj = ea* (      
fiscal ye>s #bjbc ?r\gh #bjbg4  ,,ii    
,*ildr5's ,heal? ,insurance ,program    
,p]man5cy  #bjja4 ,p]man5t ext5sion (   
*ildr5's heal? insurance program  7a7 ,9
 g5]al ,section #bajd7;a77#bh7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acig;dd7a77#bh77 is am5d$ to read z    
foll[s3  7#bh7 = fiscal ye> #bjbg & ea* 
subsequ5t ye>1 su* sums z are necess>y  
to fund allotm5ts to ,/ates "u          
subsections 7c7 & 7m74  4  7b7          
,allotm5ts  7#a7 ,9 g5]al ,section      
#bajd7m7 ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #acig;dd7m77 is am5d$-- 7,a7 
9 p>agraph 7#b77;,b77i71 by /rik+ 11    
#bjbc1 & #bjbg & ins]t+ & #bjbc2  7,b7 9
 p>agraph 7#e7-- 7i7 by /rik+ = a fiscal
 ye> & ins]t+ = a fiscal ye> be=e #bjbg2
 &  7ii7 by /rik+ #bjbc1 or #bjbg &     

ins]t+ or #bjbc2  7,c7 9 p>agraph 7#g7--
 7i7 9 subp>agraph 7,a71 by /rik+ & end+
 ) fiscal ye> #bjbg12 &  7ii7 9 ! flu%  
left matt] at ! end1 by /rik+ or fiscal 
ye> #bjbf & ins]t+ fiscal ye> #bjbf1 or 
a subsequ5t ev5-numb]$ fiscal ye>2  7,d7
 9 p>agraph 7#i7-- 7i7 by /rik+ 7#aj71  
or 7#aa7 & ins]t+ or 7#aj72 &  7ii7 by  
/rik+ #bjbc1 or #bjbg1 & ins]t+ or      
#bjbc2 &  7,e7 by /rik+ p>agraph 7#aa74 
7#b7 ,con=m+ am5dm5t ,section           
#ejaja7;b77#b7 ( ! ,bip>tisan ,budget   
,act ( #bjah 7,public ,law #aae-abc7 is 
repeal$4  #bjjb4 ,p]man5t ext5sions (   
o!r programs & demon/ration projects    
7a7 ,p$iatric quality measures program  
,section #aaci;,a7i77#a7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#acbj;b-#i;a7i77#a77 is am5d$-- 7#a7 9  
subp>agraph 7,c71 by /rik+ at ! end &2  
7#b7 9 subp>agraph 7,d71 by /rik+ !     
p]iod at ! end & ins]t a semicolon2 &   
7#c7 by add+ at ! end ! foll[+ new      
subp>agraphs3  7,e7 = fiscal ye> #bjbh1 
#ae1jjj1jjj = ! purpose ( c>ry+ out ?is 

section 7o!r ?an subsections 7e71 7f71 &
 7g772 &  7,f7 = a subsequ5t fiscal ye>1
 ! am\nt appropriat$ "u ?is p>agraph = !
 previ\s fiscal ye>1 increas$ by !      
p]c5tage increase 9 ! consum] price     
index = all urban consum]s 7all items2  
,unit$ ,/ates city av]age7 ov] su*      
previ\s fiscal ye>1 = ! purpose ( c>ry+ 
out ?is section 7o!r ?an subsections    
7e71 7f71 & 7g774  4  7b7 ,express lane 
eligibility option ,section             
#aijb7;e77#ac7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;a7e77#ac77 is 
am5d$ by /rik+ subp>agraph 7,i74  7c7   
,assurance ( af=dability /&>d = *ildr5 &
 families  7#a7 ,9 g5]al ,section       
#baje7;d77#c7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acig;ee7d77#c77 is     
am5d$-- 7,a7 9 ! p>agraph head+1 by     
/rik+ ?r\gh ,septemb] #cj1 #bjbg2 &     
7,b7 9 subp>agraph 7,a71 9 ! matt]      
prec$+ clause 7i7-- 7i7 by /rik+ ,dur+ !
 p]iod t beg9s on ! date ( enactm5t ( ! 
,pati5t ,protection & ,af=dable ,c>e    
,act & ends on ,septemb] #cj1 #bjbg &   

ins]t+ ,beg9n+ on ! date ( ! enactm5t ( 
! ,pati5t ,protection & ,af=dable ,c>e  
,act2  7ii7 by /rik+ ,dur+ ! p]iod t    
beg9s on ,octob] #a1 #bjai1 & ends on   
,septemb] #cj1 #bjbg & ins]t+ ,beg9n+ on
 ,octob] #a1 #bjai2 &  7iii7 by /rik+ ,!
 prec$+ s5t5ces %all n be con/ru$ z     
prev5t+ a ,/ate dur+ any su* p]iods f & 
ins]t+ ,! prec$+ s5t5ces %all n be      
con/ru$ z prev5t+ a ,/ate f4  7#b7      
,con=m+ am5dm5ts ,section #aijb7;gg77#b7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acif;a7gg77#b77 is am5d$--   
7,a7 9 ! p>agraph head+1 by /rik+ ?r\gh 
,septemb] #cj1 #bjbg2 &  7,b7 by /rik+  
?r\gh ,septemb] #cj & all t foll[s ?r\gh
 ends on ,septemb] #cj1 #bjbg & ins]t+  
7b beg9n+ on ,octob] #a1 #bjai14  7d7   
,qualify+ ,/ates option ,section        
#baje7;g77#d7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acig;ee7g77#d77 is     
am5d$-- 7#a7 9 ! p>agraph head+1 by     
/rik+ = fiscal ye>s #bjji ?r\gh #bjbg & 
ins]t+ aft] fiscal ye> #bjjh2 &  7#b7 9 
subp>agraph 7,a71 by /rik+ = any (      

fiscal ye>s #bjji ?r\gh #bjbg & ins]t+ =
 any fiscal ye> aft] fiscal ye> #bjjh4  
7e7 ,outrea* & enrollm5t program        
,section #baac ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acigmm7 is am5d$-- 
7#a7 9 subsection 7a7-- 7,a7 9 p>agraph 
7#a71 by /rik+ dur+ ! p]iod ( fiscal    
ye>s #bjji ?r\gh #bjbg & ins]t+ 1 beg9n+
 ) fiscal ye> #bjji12  7,b7 9 p>agraph  
7#b7-- 7i7 by /rik+ #aj p]c5t ( su*     
am\nts & ins]t+ #aj p]c5t ( su* am\nts =
 ! p]iod or ! fiscal ye> = :i* su*      
am\nts are appropriat$2 &  7ii7 by /rik+
 dur+ su* p]iod & ins]t+ 1 dur+ su*     
p]iod or su* fiscal ye>12 &  7,c7 9     
p>agraph 7#c71 by /rik+ ,= ! p]iod (    
fiscal ye>s #bjbd ?r\gh #bjbg1 an am\nt 
equal to #aj p]c5t ( su* am\nts & ins]t+
 ,beg9n+ ) fiscal ye> #bjbd1 an am\nt   
equal to #aj p]c5t ( su* am\nts = !     
p]iod or ! fiscal ye> = :i* su* am\nts  
are appropriat$2 &  7#b7 9 subsection   
7g7-- 7,a7 by /rik+ #bjag11 & ins]t+    
#bjag12  7,b7 by /rik+ & #dh1jjj1jjj &  
ins]t+ #dh1jjj1jjj2 &  7,c7 by ins]t+   

aft] ?r\gh #bjbg ! foll[+3 1 #ab1jjj1jjj
 = fiscal ye> #bjbh1 &1 = ea* fiscal ye>
 aft] fiscal ye> #bjbh1 ! am\nt         
appropriat$ "u ?is subsection = !       
previ\s fiscal ye>1 increas$ by !       
p]c5tage increase 9 ! consum] price     
index = all urban consum]s 7all items2  
,unit$ ,/ates city av]age7 ov] su*      
previ\s fiscal ye>4  7f7 ,*ild enrollm5t
 cont+5cy fund ,section #bajd7n7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acig;dd7n77 is am5d$-- 7#a7 9 p>agraph 
7#b7-- 7,a7 9 subp>agraph 7,a77ii7-- 7i7
 by /rik+ & #bjbd ?r\gh #bjbf & ins]t+  
beg9n+ ) fiscal ye> #bjbd2 &  7ii7 by   
/rik+ #bjbc1 & #bjbg & ins]t+ 1 & #bjbc2
 &  7,b7 9 subp>agraph 7,b7-- 7i7 by    
/rik+ #bjbd ?r\gh #bjbf & ins]t+ beg9n+ 
) fiscal ye> #bjbd2 &  7ii7 by /rik+    
#bjbc1 & #bjbg & ins]t+ 1 & #bjbc2 &    
7#b7 9 p>agraph 7#c77;,a7-- 7,a7 by     
/rik+ fiscal ye>s #bjbd ?r\gh #bjbf &   
ins]t+ fiscal ye> #bjbd or any subsequ5t
 fiscal ye>2 &  7,b7 by /rik+ #bjbc1 or 
#bjbg & ins]t+ 1 or #bjbc4  #bjjc4 ,/ate

 option to increase *ildr5's eligibility
 = ,m$icaid & ,,*ip ,section            
#baaj7;b77#a77;,b77ii7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acig;jj7b77#a77;,b77ii77 is am5d$--    
7#a7 9 subclause 7,,ii71 by /rik+ or at 
! end2  7#b7 9 subclause 7,,iii71 by    
/rik+ & at ! end & ins]t+ or2 &  7#c7 by
 ins]t+ aft] subclause 7,,iii7 ! foll[+ 
new subclause3  7,,iv7 at ! option ( !  
,/ate1 ^: family income exce$s ! maximum
 income level o!rwise e/abli%$ = *ildr5 
"u ! ,/ate *ild heal? plan z ( ! date ( 
! enactm5t ( ?is subclause2 &  4  ,,iii 
,family & ,m$ical ,leave  #cjja4        
,def9itions ,9 ?is title1 ! foll[+      
def9itions apply3 7#a7 ,c>egiv+ day ,!  
t]m c>egiv+ day means1 ) respect to an  
individual1 a cal5d> day 9 :i* !        
individual engag$ 9 qualifi$ c>egiv+4   
7#b7 ,commission] ,! t]m ,commission]   
means ! ,commission] ( ,social          
,security4  7#c7 ,deputy ,commission] ,!
 t]m ,deputy ,commission] means !       
,deputy ,commission] :o heads ! ,(fice (

 ,paid ,family & ,m$ical ,leave e/abli%$
 "u section #cjjb7;a74  7#d7 ,eligible  
individual ,! t]m eligible individual   
means an individual :o is entitl$ to a  
b5efit "u section #cjjc = a p>ticul>    
mon?1 ^u fil+ an application = su*      
b5efit = su* mon?4  7#e7 ,initial wait+ 
p]iod ,! t]m initial wait+ p]iod means a
 p]iod beg9n+ ) ! fir/ c>egiv+ day ( an 
individual occurr+ dur+ ! individual's  
b5efit p]iod & end+ aft] ! e>li] (--    
7,a7 ! fif? c>egiv+ day ( ! individual  
occurr+ dur+ ! b5efit p]iod2 or  7,b7 ! 
mon? prec$+ ! fir/ mon? 9 ! b5efit p]iod
 dur+ :i* occur n less ?an #ae c>egiv+  
days ( ! individual4  7#f7 ,qualifi$    
c>egiv+ ,! t]m qualifi$ c>egiv+ means   
any activity engag$ 9 by an individual1 
o!r ?an regul> employm5t1 = a reason =  
:i* an eligible employee w\ld be entitl$
 to leave "u subp>agraphs 7,a7 ?r\gh    
7,e7 ( p>agraph 7#a7 ( section #ajb7;a7 
( ! ,family & ,m$ical ,leave ,act (     
#aiic 7#bi ,u4,s4,c4 #bfab7;a774  7#g7  
,self-employm5t income ,! t]m           

self-employm5t income has ! same mean+ z
 su* t]m 9 section #baa7;b7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #daa7;b774
  7#h7 ,/ate ,! t]m ,/ate means any     
,/ate ( ! ,unit$ ,/ates or ! ,di/rict ( 
,columbia or any t]ritory or possession 
( ! ,unit$ ,/ates4  7#i7 ,wages ,! t]m  
wages1 except z su* t]m is us$ 9        
subsection 7h77#b7 ( section #cjjc1 has 
! same mean+ z su* t]m 9 section #bji ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#dji74  7#aj7 #fj-;day limitation p]iod 
,! t]m #fj-;day limitation p]iod means a
 p]iod-- 7,a7 beg9n+ ) ! fir/ c>egiv+   
day ( an individual occurr+ dur+ !      
individual's b5efit p]iod & aft] !      
expiration ( ! individual's #e-;day     
wait+ p]iod1 if applicable2 &  7,b7 end+
 ) ! #fj? c>egiv+ day ( ! individual    
occurr+ dur+ ! b5efit p]iod & aft] !    
expiration ( ! #e-;day wait+ p]iod1     
disreg>d+ any c>egiv+ day ( ! individual
 occurr+ dur+ any mon? 9 ! b5efit p]iod 
aft] ! fir/ #bj c>egiv+ days ( !        
individual occurr+ dur+ su* mon?4       

#cjjb4 ,(fice ( ,paid ,family & ,m$ical 
,leave  7a7 ,e/abli%m5t ( ,(fice ,!re is
 e/abli%$ )9 ! ,social ,security        
,adm9i/ration an (fice to be kn[n z !   
,(fice ( ,paid ,family & ,m$ical ,leave4
 ,! ,(fice %all be head$ by a ,deputy   
,commission] :o %all be appo9t$ by !    
,commission]4  7b7 ,responsibilities (  
,deputy ,commission] ,! ,commission]1   
act+ ?r\gh ! ,deputy ,commission]1 %all 
be responsible =-- 7#a7 hir+ p]sonnel & 
mak+ employm5t decisions ) reg>d to su* 
p]sonnel2  7#b7 issu+ su* regulations z 
may be necess>y to c>ry out ! purposes (
 ?is title2  7#c7 ent]+ into coop]ative 
agreem5ts ) o!r ag5cies & dep>tm5ts to  
ensure ! effici5cy ( ! adm9i/ration ( ! 
program2  7#d7 det]m9+ eligibility =    
family & m$ical leave insurance b5efits 
"u section #cjjc2  7#e7 det]m9+ b5efit  
am\nts = ea* mon? ( su* eligibility &   
mak+ timely paym5ts ( su* b5efits to    
entitl$ individuals 9 accordance ) su*  
section2  7#f7 e/abli%+ & ma9ta9+ a     
sy/em ( records relat+ to ! adm9i/ration

 ( su* section2  7#g7 prev5t+ fraud &   
abuse relat+ to su* b5efits2  7#h7      
provid+ in=mation on reque/ reg>d+      
eligibility requirem5ts1 ! claims       
process1 b5efit am\nts1 maximum b5efits 
payable1 notice requirem5ts1            
nondiscrim9ation rights1 confid5tiality1
 coord9ation ( leave "u ?is title & o!r 
laws1 collective b>ga9+ agreem5ts1 &    
employ] policies2  7#i7 annually provid+
 employ]s a notice in=m+ employees ( !  
availability ( su* b5efits2  7#aj7      
annually mak+ available to ! public a   
report t includes ! numb] ( individuals 
:o receiv$ su* b5efits1 ! purposes = :i*
 su* b5efits 7 receiv$1 & an analysis ( 
utilization rates ( su* b5efits by g5d]1
 race1 e?nicity1 & income levels2 &     
7#aa7 tailor+ culturally & l+ui/ically  
compet5t education & outrea* t[>d       
increas+ utilization rates ( b5efits "u 
su* section4  7c7 ,availability ( data  
,! ,commission] %all make available to !
 ,deputy ,commission] su* data z !      
,commission] det]m9es necess>y to enable

 ! ,deputy ,commission] to effectively  
c>ry out ! responsibilities describ$ 9  
subsection 7b74  #cjjc4 ,family &       
,m$ical ,leave ,insurance b5efit paym5ts
  7a7 ,9 g5]al ,e individual :o-- 7#a7  
is insur$ = disability insurance b5efits
 7z det]m9$ "u section #bbc7;c7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#dbc7;c777 at ! "t su* individual's     
application is fil$2  7#b7 has e>n$     
income f employm5t dur+ ! #ab mon?s     
prior to ! mon? 9 :i* ! application is  
fil$2  7#c7 has fil$ an application = a 
family & m$ical leave insurance b5efit 9
 accordance ) subsection 7d72 &  7#d7 0 
engag$ 9 qualifi$ c>egiv+1 or           
anticipates be+ s engag$1 dur+ ! p]iod t
 beg9s #ij days be=e ! date on :i* su*  
application is fil$ or )9 #cj days aft] 
su* date1  %all be entitl$ to su* a     
b5efit = ea* mon? 9 ! b5efit p]iod      
specifi$ 9 subsection 7c71 n to exce$   
#fj c>egiv+ days p] b5efit p]iod4  7b7  
,b5efit am\nt  7#a7 ,9 g5]al ,except z  
o!rwise provid$ 9 ?is subsection1 !     

b5efit am\nt to :i* an individual is    
entitl$ "u ?is section = a mon? %all be 
an am\nt equal to ! great] (-- 7,a7 !   
less] ( #a_/ah ( ! wages &              
self-employm5t income ( ! individual = !
 cal5d> ye> 9 :i* su* wages &           
self-employm5t income are ! highe/ among
 ! mo/ rec5t ?ree cal5d> ye>s1 or !     
maximum b5efit am\nt det]m9$ "u p>agraph
 7#b72 or  7,b7 ! m9imum b5efit am\nt   
det]m9$ "u p>agraph 7#b71  multipli$ by 
! quoti5t 7n great] ?an #a7 obta9$ by   
divid+ ! numb] ( c>egiv+ days ( !       
individual 9 su* mon? by #bj4  7#b7     
,annual increase ( maximum & m9imum     
b5efit am\nts  7,a7 ,= individuals :o   
initially become eligible = family &    
m$ical leave insurance b5efits 9 ! fir/ 
full cal5d> ye> aft] ! date ( enactm5t (
 ?is ,act1 ! maximum mon?ly b5efit am\nt
 & ! m9imum mon?ly b5efit am\nt %all be 
#d1jjj & #ehj1 respectively4  7,b7 ,=   
individuals :o initially become eligible
 = family & m$ical leave insurance      
b5efits 9 any cal5d> ye> aft] su* fir/  

full cal5d> ye> ! maximum b5efit am\nt &
 ! m9imum b5efit am\nt %all be1         
respectively1 ! product ( ! correspond+ 
am\nt det]m9$ ) respect to ! fir/ cal5d>
 ye> "u subp>agraph 7,a7 & ! quoti5t    
obta9$ by divid+-- 7i7 ! national av]age
 wage index 7z def9$ 9 section          
#bji7k77#a7 ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #dji7k77#a777 = ! second 
cal5d> ye> prec$+ ! cal5d> ye> = :i* !  
det]m9ation is made1 by  7ii7 ! national
 av]age wage index 7z s def9$7 = !      
cal5d> ye> imm$iately prec$+ ! cal5d>   
ye> 9 :i* occurs ! date ( enactm5t ( ?is
 ,act4  7#c7 ,limitations on b5efits    
paid  7,a7 ,nonpayable wait+ p]iod ,any 
cal5d> day dur+ an individual's b5efit  
p]iod :i* occurs be=e ! expiration ( an 
initial wait+ p]iod %all n be tak5 into 
acc\nt "u ?is subsection z a c>egiv+ day
 ( ! individual4  7,b7 ,limitation on   
total b5efits paid ,any cal5d> day dur+ 
an individual's b5efit p]iod :i* occurs 
aft] ! expiration ( a #fj-;day          
limitation p]iod %all n be tak5 into    

acc\nt "u ?is subsection z a c>egiv+ day
 ( ! individual4  7#d7 ,r$uction 9      
b5efit am\nt on acc\nt ( receipt ( c]ta9
 b5efits ,a b5efit "u ?is section = a   
mon? %all be r$uc$ by ! am\nt1 if any1 9
 c]ta9 b5efits 7z det]m9$ "u regulations
 issu$ by ! ,commission]7 z may be      
o!rwise receiv$ by an individual4 ,=    
purposes ( ! prec$+ s5t5ce1 c]ta9       
b5efits include-- 7,a7 p]iodic b5efits  
on acc\nt ( su* individual's total or   
p>tial disability "u a workm5's         
comp5sation law or plan ( ! ,unit$      
,/ates or a ,/ate2 &  7,b7 p]iodic      
b5efits on acc\nt ( an individual's     
employm5t /atus "u an unemploym5t law or
 plan ( ! ,unit$ ,/ates or a ,/ate4     
7#e7 ,coord9ation ( b5efit am\nt ) c]ta9
 /ate b5efits ,a b5efit receiv$ "u ?is  
section %all be coord9at$1 9 a mann]    
det]m9$ by regulations issu$ by !       
,commission]1 ) ! p]iodic b5efits       
receiv$ f tempor>y disability insurance 
or family leave insurance programs "u   
any law or plan ( a ,/ate1 a political  

subdivision 7z t t]m is us$ 9 section   
#bah7;b77#b7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #dah7;b77#b7771 or an    
in/rum5tality ( two or m ,/ates 7z t t]m
 is us$ 9 section #bah7;g7 ( su* ,act ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#dah7;g7774  7c7 ,b5efit p]iod  7#a7 ,9 
g5]al ,except z provid$ 9 p>agraph 7#b71
 ! b5efit p]iod specifi$ 9 ?is          
subsection %all beg9 on ! #a/ day ( !   
#a/ mon? 9 :i* ! individual meets !     
crit]ia specifi$ 9 p>agraphs 7#a71 7#b71
 & 7#c7 ( subsection 7a71 & %all end on 
! date t is #cfe days aft] ! #a/ day ( !
 b5efit p]iod4  7#b7 ,retroactive       
b5efits ,9 ! case ( an application =    
b5efits "u ?is section = qualifi$       
c>egiv+ 9 :i* ! individual 0 engag$ at  
any "t dur+ ! #ij-;day p]iod prec$+ !   
date on :i* su* application is submitt$1
 ! b5efit p]iod specifi$ 9 ?is          
subsection %all beg9 on ! lat] (-- 7,a7 
! #a/ day ( ! #a/ mon? 9 :i* !          
individual engag$ 9 su* qualifi$        
c>egiv+2 or  7,b7 ! #a/ day ( ! #a/ mon?

 t beg9s dur+ su* #ij-;day p]iod1  &    
%all end on ! date t is #cfe days aft] !
 #a/ day ( ! b5efit p]iod4  7d7         
,application ,an application = a family 
& m$ical leave insurance b5efit %all    
include-- 7#a7 a /atem5t t ! individual 
0 engag$ 9 qualifi$ c>egiv+1 or         
anticipates be+ s engag$1 dur+ ! p]iod t
 beg9s #ij days be=e ! date on :i* !    
application is submitt$ or )9 #cj days  
aft] su* date2  7#b7 if ! qualifi$      
c>egiv+ describ$ 9 ! /atem5t 9 p>agraph 
7#a7 is engag$ 9 by ! individual because
 ( a s]i\s heal? condition ( !          
individual or a relative ( ! individual1
 a c]tification1 issu$ by ! heal? c>e   
provid] treat+ su* s]i\s heal?          
condition1 t affirms ! in=mation        
specifi$ 9 p>agraph 7#a7 & conta9s su*  
in=mation z ! ,commission] %all specify 
9 regulations1 :i* %all be no m ?an !   
in=mation t is requir$ to be /at$ "u    
section #ajc7;b7 ( ! ,family & ,m$ical  
,leave ,act ( #aiic 7#bi ,u4,s4,c4      
#bfac7;b772  7#c7 if su* qualifi$       

c>egiv+ is engag$ 9 by ! individual =   
any o!r au?oriz$ reason1 a c]tification1
 issu$ by a relevant au?ority det]m9$ "u
 regulations issu$ by ! ,commission]1 t 
affirms ! circum/ances giv+ rise to su* 
reason2 &  7#d7 an atte/ation f !       
applicant t 8 or h] employ] has be5     
provid$ ) writt5 notice ( ! individual's
 int5tion to take family or m$ical      
leave1 if ! individual has an employ]1  
or to ! ,commission] 9 all o!r cases4   
7e7 ,ineligibility2 disqualification    
7#a7 ,ineligibility = b5efit ,an        
individual %all be ineligible = a b5efit
 "u ?is section = any mon? = :i* !      
individual is entitl$ to-- 7,a7         
disability insurance b5efits "u section 
#bbc ( ! ,social ,security ,act 7#db    
,u4,s4,c4 #dbc7 or a simil> p]man5t     
disability program "u any law or plan ( 
a ,/ate or political subdivision or     
in/rum5tality ( a ,/ate 7z su* t]ms are 
us$ 9 section #bah ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #dah772  7,b7      
mon?ly insurance b5efits "u section #bjb

 ( su* ,act 7#db ,u4,s4,c4 #djb7 bas$ on
 su* individual's disability 7z def9$ 9 
section #bbc7;d7 ( su* ,act 7#db        
,u4,s4,c4 #dbc7;d7772 or  7,c7 b5efits  
"u title ,,xvi ( su* ,act 7#db ,u4,s4,c4
 #acha et seq47 bas$ on su* individual's
 /atus z a disabl$ individual 7z det]m9$
 "u section #afad ( su* ,act 7#db       
,u4,s4,c4 #achb;c774  7#b7              
,disqualification ,an individual :o has 
be5 convict$ ( a violation "u section   
#bjh ( ! ,social ,security ,act 7#db    
,u4,s4,c4 #djh7 or :o has be5 f\nd to h 
us$ false /atem5ts to secure b5efits "u 
?is section1 %all be ineligible =       
b5efits "u ?is section = a #a-ye> p]iod 
foll[+ ! date ( su* conviction4  7f7    
,review ( eligibility & b5efit paym5t   
det]m9ations  7#a7 ,eligibility         
det]m9ations  7,a7 ,9 g5]al ,!          
,commission] %all provide notice to an  
individual apply+ = b5efits "u ?is      
section ( ! initial det]m9ation (       
eligibility = su* b5efits1 & ! e/imat$  
b5efit am\nt = a mon? 9 :i* "o c>egiv+  

day ( ! individual occurs1 z soon z     
practicable aft] ! application is       
receiv$4  7,b7 ,review ,an individual   
may reque/ review ( an initial adv]se   
det]m9ation ) respect to su* application
 at any "t be=e ! end ( ! #bj-;day p]iod
 t beg9s on ! date notice ( su*         
det]m9ation is receiv$1 except t su*    
#bj-;day p]iod may be ext5d$ = good     
cause4 ,z soon z practicable aft] !     
individual reque/s review ( !           
det]m9ation1 ! ,commission] %all provide
 notice to ! individual ( a f9al        
det]m9ation ( eligibility = b5efits "u  
?is section4  7#b7 ,b5efit paym5t       
det]m9ations  7,a7 ,9 g5]al ,!          
,commission] %all make any mon?ly b5efit
 paym5t to an individual claim+ b5efits 
= a mon? "u ?is section1 or provide     
notice ( ! reason su* paym5t w n be made
 if ! ,commission] det]m9es t !         
individual is n entitl$ to paym5t = su* 
mon?1 n lat] ?an #bj days aft] !        
individual's mon?ly b5efit claim report 
= su* mon? is receiv$4 ,su* mon?ly      

report %all be fil$ ) ! ,commission] n  
lat] ?an #ae days aft] ! end ( ea* mon?4
  7,b7 ,review ,if ! ,commission]       
det]m9es t paym5t w n be made to an     
individual = a mon?1 or if !            
,commission] det]m9es t paym5t %all be  
made bas$ on a numb] ( c>egiv+ days 9 ! 
mon? inconsi/5t ) ! numb] ( c>egiv+ days
 9 ! mon?ly b5efit claim report ( !     
individual = su* mon?1 ! individual may 
reque/ review ( su* det]m9ation at any  
"t be=e ! end ( ! #bj-;day p]iod t beg9s
 on ! date notice ( su* det]m9ation is  
receiv$1 except t su* #bj-;day p]iod may
 be ext5d$ = good cause4 ,n lat] ?an #bj
 days aft] ! individual reque/s review (
 ! det]m9ation1 ! ,commission] %all     
provide notice to ! individual ( a f9al 
det]m9ation ( paym5t = su* mon?1 & %all 
make paym5t to ! individual ( any       
additional am\nt n includ$ 9 ! initial  
paym5t to ! individual = su* mon? to :i*
 ! ,commission] det]m9es ! individual is
 entitl$4  7#c7 ,burd5 ( pro( ,an       
application = b5efits "u ?is section & a

 mon?ly b5efit claim report ( an        
individual %all ea* be presum$ to be    
true & accurate1 unless ! ,commission]  
demon/rates by a prepond]ance ( !       
evid5ce t in=mation conta9$ 9 !         
application is false4  7#d7 ,def9ition (
 mon?ly b5efit claim report ,= purposes 
( ?is subsection1 ! t]m mon?ly b5efit   
claim report means1 ) respect to an     
individual = a mon?1 ! individual's     
report to ! ,commission] ( ! numb] (    
c>egiv+ days ( ! individual 9 su* mon?1 
:i* %all be fil$ no lat] ?an #ae days   
aft] ! end ( ea* mon?4  7#e7 ,review    
,all f9al det]m9ations ( ! ,commission] 
"u ?is subsection %all be reviewable    
accord+ to ! proc$ures set out 9 section
 #bje ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #dje74  7g7 ,relation%ip )    
,/ate law2 employ] b5efits  7#a7 ,9     
g5]al ,?is section does n preempt or    
sup]c$e any provision ( ,/ate or local  
law t au?orizes a ,/ate or local        
municipality to provide paid family &   
m$ical leave b5efits simil> to ! b5efits

 provid$ "u ?is section4  7#b7 ,great]  
b5efits all[$ ,no?+ 9 ?is title %all be 
con/ru$ to dim9i% ! obligation ( an     
employ] to comply ) any contract1       
collective b>ga9+ agreem5t1 or any      
employm5t b5efit program or plan t      
provides great] paid leave or o!r leave 
rights to employees ?an ! rights        
e/abli%$ "u ?is title4  7h7 ,prohibit$  
,acts2 en=cem5t  7#a7 ,9 g5]al ,x %all  
be unlawful = any p]son to dis*>ge or 9 
any o!r mann] discrim9ate aga9/ an      
individual because ! individual has     
appli$ =1 indicat$ an int5t to apply =1 
or receiv$ family & m$ical leave        
insurance b5efits4  7#b7 ,civil ,action 
by an individual  7,a7 ,liability ,any  
p]son :o violates p>agraph 7#a7 %all be 
liable to any individual employ$ by su* 
p]son :o is affect$ by ! violation-- 7i7
 = damages equal to ! sum (-- 7,i7 !    
am\nt (-- 7aa7 any wages1 sal>y1        
employm5t b5efits1 or o!r comp5sation   
d5i$ or lo/ to su* individual by reason 
( ! violation2 or  7bb7 9 a case 9 :i*  

wages1 sal>y1 employm5t b5efits1 or o!r 
comp5sation h n be5 d5i$ or lo/ to !    
individual1 any actual monet>y losses   
su/a9$ by ! individual z a direct result
 ( ! violation1 su* z ! co/ ( provid+   
c>e1 up to a sum equal to #fj cal5d>    
days ( wages or sal>y = ! individual2   
7,,ii7 ! int]e/ on ! am\nt describ$ 9   
subclause 7,i7 calculat$ at ! prevail+  
rate2 &  7,,iii7 an additional am\nt z  
liquidat$ damages equal to ! sum ( !    
am\nt describ$ 9 subclause 7,i7 & !     
int]e/ describ$ 9 subclause 7,,ii71     
except t if a p]son :o has violat$      
p>agraph 7#a7 proves to ! satisfaction (
 ! c\rt t ! act or omission :i* violat$ 
p>agraph 7#a7 0 9 good fai? & t ! p]son 
_h reasonable gr\nds = believ+ t ! act  
or omission 0 n a violation ( p>agraph  
7#a71 su* c\rt may1 9 ! discretion ( !  
c\rt1 r$uce ! am\nt ( ! liability to !  
am\nt & int]e/ det]m9$ "u subclauses    
7,i7 & 7,,ii71 respectively2 &  7ii7 =  
su* equitable relief z may be           
appropriate1 includ+ employm5t1         

re9/atem5t1 & promotion4  7,b7 ,"r (    
action ,an action to recov] ! damages or
 equitable relief prescrib$ 9           
subp>agraph 7,a7 may be ma9ta9$ aga9/   
any p]son 9 any ,f$]al or ,/ate c\rt (  
compet5t jurisdiction by any individual 
= & on behalf (-- 7i7 ! individual2 or  
7ii7 ! individual & o!r individuals     
simil>ly situat$4  7,c7 ,fees & co/s ,! 
c\rt 9 su* an action %all1 9 addition to
 any judgm5t aw>d$ to ! pla9tiff1 all[ a
 reasonable attorney's fee1 reasonable  
exp]t witness fees1 & o!r co/s ( !      
action to be paid by ! def5dant4  7,d7  
,limitations ,! "r provid$ by           
subp>agraph 7,b7 to br+ an action by or 
on behalf ( any individual %all         
t]m9ate-- 7i7 on ! fil+ ( a compla9t by 
! ,commission] 9 an action "u p>agraph  
7#e7 9 :i* re/ra9t is s\ght ( any fur!r 
delay 9 ! paym5t ( ! am\nt describ$ 9   
subp>agraph 7,a77,i7 to su* individual  
by ! p]son responsible "u subp>agraph   
7,a7 = ! paym5t2 or  7ii7 on ! fil+ ( a 
compla9t by ! ,commission] 9 an action  

"u p>agraph 7#c7 9 :i* a recov]y is     
s\ght ( ! damages describ$ 9 subp>agraph
 7,a77,i7 ow+ to an individual by a     
p]son liable "u subp>agraph 7,a71       
unless ! action describ$ 9 clause 7i7 or
 7ii7 is dismiss$ )\t prejudice on      
motion ( ! ,commission]4  7#c7 ,action  
by ! ,commission]  7,a7 ,civil action ,!
 ,commission] may br+ an action 9 any   
c\rt ( compet5t jurisdiction to recov] !
 damages describ$ 9 p>agraph            
7#b77;,a77,i74  7,b7 ,sums recov]$ ,any 
sums recov]$ by ! ,commission] pursuant 
to subp>agraph 7,a7 %all be held 9 a    
special deposit acc\nt & %all be paid1  
on ord] ( ! ,commission]1 directly to   
ea* individual affect$4 ,any su* sums n 
paid to an individual because (         
inability to d s )9 a p]iod ( #c ye>s   
%all be deposit$ into ! ,f$]al ,family &
 ,m$ical ,leave ,insurance ,tru/ ,fund4 
7#d7 ,limitation  7,a7 ,9 g5]al ,an     
action may be br\ght "u ?is subsection n
 lat] ?an #c ye>s aft] ! date ( ! la/   
ev5t con/itut+ ! alleg$ violation = :i* 

! action is br\ght4  7,b7 ,comm5cem5t   
,an action br\ght by ! ,commission] "u  
?is subsection %all be consid]$ to be   
comm5c$ on ! date :5 ! compla9t is fil$4
  7#e7 ,action = ,injunction by         
,commission] ,! di/rict c\rts ( ! ,unit$
 ,/ates %all h jurisdiction1 = cause    
%[n1 9 an action br\ght by !            
,commission]-- 7,a7 to re/ra9 violations
 ( p>agraph 7#a71 includ+ ! re/ra9t (   
any )hold+ ( paym5t ( wages1 sal>y1     
employm5t b5efits1 or o!r comp5sation1  
plus int]e/1 f\nd by ! c\rt to be due to
 an individual2 or  7,b7 to aw>d su* o!r
 equitable relief z may be appropriate1 
includ+ employm5t1 re9/atem5t1 &        
promotion4  7i7 ,special rule = railroad
 employees ,= purposes ( subsection     
7a77#a71 an individual %all be deem$ to 
be insur$ = disability insurance b5efits
 if ! individual w\ld be s insur$ if !  
individual's s]vice z an employee 7z    
def9$ 9 ! section #a7;b7 ( ! ,railroad  
,retirem5t ,act ( #aigd7 aft] ,decemb]  
#ca1 #aicf1 7 includ$ )9 ! mean+ ( ! t]m

 employm5t = purposes ( title ,,ii ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#dja et seq474  7j7 ,det]m9ation ( :e!r 
an activity con/itutes qualifi$ c>egiv+ 
7#a7 ,9 g5]al ,= purposes ( det]m9+ :e!r
 an activity engag$ 9 by an individual  
con/itutes qualifi$ c>egiv+ "u ?is      
section-- 7,a7 ! t]m sp\se 7z us$ 9     
section #ajb7;a7 ( ! ,family & ,m$ical  
,leave ,act 7#bi ,u4,s4,c4 #bfab7;a777  
includes ! individual's dome/ic p>tn]2 &
  7,b7 ! t]m son or daught] 7z us$ 9 su*
 section7 includes a son or daught] 7z  
def9$ 9 section #aja ( su* ,act7 ( !    
individual's dome/ic p>tn]4  7#b7       
,dome/ic p>tn]  7,a7 ,9 g5]al ,=        
purposes ( p>agraph 7#a71 ! t]m dome/ic 
p>tn]1 ) respect to an individual1 means
 ano!r individual ) :om ! individual is 
9 a committ$ relation%ip4  7,b7         
,committ$ relation%ip def9$ ,! t]m      
committ$ relation%ip means a relation%ip
 betwe5 two individuals 7ea* at lea/ #ah
 ye>s ( age7 9 :i* ea* individual is !  
o!r individual's sole dome/ic p>tn] &   

bo? individuals %>e responsibility = a  
significant measure ( ea* o!r's common  
welf>e4 ,! t]m includes any su*         
relation%ip betwe5 two individuals1     
includ+ individuals ( ! same sex1 t is  
grant$ legal recognition by a ,/ate or  
political subdivision ( a ,/ate z a     
m>riage or analog\s relation%ip1 includ+
 a civil union or dome/ic p>tn]%ip4  7k7
 ,applicability ( c]ta9 ,social         
,security ,act provisions ,! provisions 
( sections #bjd1 #bje1 #bjf1 & #bjh ( ! 
,social ,security ,act %all apply to    
b5efit paym5ts au?oriz$ by & paid out   
pursuant to ?is section 9 ! same way t  
su* provisions apply to b5efit paym5ts  
au?oriz$ by & paid out pursuant to title
 ,,ii ( su* ,act4  7l7 ,effective date =
 applications ,applications describ$ 9  
?is section may be fil$ beg9n+ #ah mon?s
 aft] ! date ( enactm5t ( ?is ,act4     
#cjjd4 ,e/abli%m5t ( ,family & ,m$ical  
,leave ,insurance ,tru/ ,fund  7a7 ,9   
g5]al ,!re is h]eby creat$ on ! books ( 
! ,treasury ( ! ,unit$ ,/ates a tru/    

fund to be kn[n z ! ,f$]al ,family &    
,m$ical ,leave ,insurance ,tru/ ,fund4  
,! ,f$]al ,family & ,m$ical ,leave      
,insurance ,tru/ ,fund %all consi/ ( su*
 gifts & beque/s z may be made z provid$
 9 section #bja7;i77#a7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#dja7;i77#a77 & su* am\nts z may be     
appropriat$ to1 or deposit$ 91 ! ,f$]al 
,family & ,m$ical ,leave ,insurance     
,tru/ ,fund z provid$ 9 ?is section4    
7b7 ,au?orization ( appropriations  7#a7
 ,9 g5]al ,!re is au?oriz$ to be        
appropriat$ to ! ,f$]al ,family &       
,m$ical ,leave ,insurance ,tru/ ,fund   
out ( moneys 9 ! ,treasury n o!rwise    
appropriat$-- 7,a7 = ! fir/ ?ree fiscal 
ye>s beg9n+ aft] ! date ( enactm5t ( ?is
 ,act1 su* sums z may be necess>y = !   
,commission] to adm9i/] ! (fice e/abli%$
 "u section #cjjb & pay ! b5efits "u    
section #cjjc2  7,b7 #ajj p]c5t ( !     
taxes impos$ by sections #caja7;c7 &    
#caaa7;c7 ( ! ,int]nal ,rev5ue ,code (  
#aihf ) respect to wages 7z def9$ 9     

section #caba ( su* ,code7 report$ to ! 
,secret>y ( ! ,treasury pursuant to     
subtitle ,f ( su* ,code1 z det]m9$ by ! 
,secret>y ( ! ,treasury by apply+ !     
applicable rate ( tax "u su* sections to
 su* wages2  7,c7 #ajj p]c5t ( ! taxes  
impos$ by section #adja7;c7 ( su* ,code 
) respect to self-employm5t income 7z   
def9$ 9 section #adjb ( su* ,code7      
report$ to ! ,secret>y ( ! ,treasury on 
tax returns "u subtitle ,f ( su* ,code1 
z det]m9$ by ! ,secret>y ( ! ,treasury  
by apply+ ! applicable rate ( tax "u su*
 section to su* self-employm5t income2 &
  7,d7 #ajj p]c5t ( ! taxes impos$ by   
sections #cbja7;c71 #cbaa7;c71 &        
#cbba7;c7 ( su* ,code ) respect to      
comp5sation 7z def9$ 9 section #cbca (  
su* ,code7 report$ to ! ,secret>y ( !   
,treasury on tax returns "u subtitle ,f 
( su* ,code1 z det]m9$ by ! ,secret>y ( 
! ,treasury by apply+ ! applicable rate 
( tax "u su* sections to su*            
comp5sation4  7#b7 ,repaym5t ( initial  
appropriation ,am\nts appropriat$       

pursuant to subp>agraph 7,a7 ( p>agraph 
7#a7 %all be repaid to ! ,treasury ( !  
,unit$ ,/ates n lat] ?an #aj ye>s aft] !
 fir/ appropriation is made pursuant to 
su* subp>agraph4  7#c7 ,transf] to ,tru/
 ,fund ,! am\nts describ$ 9 p>agraph    
7#b7 %all be transf]r$ f "t to "t f !   
g5]al fund 9 ! ,treasury to ! ,f$]al    
,family & ,m$ical ,leave ,insurance     
,tru/ ,fund1 su* am\nts to be det]m9$ on
 ! basis ( e/imates by ! ,secret>y ( !  
,treasury ( ! taxes1 specifi$ 9 su*     
p>agraph1 paid to or deposit$ into !    
,treasury4 ,prop] adju/m5ts %all be made
 9 am\nts subsequ5tly transf]r$ to !    
ext5t prior e/imates 7 inconsi/5t ) !   
taxes specifi$ 9 su* p>agraph4  7c7     
,managem5t ( ,tru/ ,fund ,! provisions (
 subsections 7c71 7d71 7e71 7f71 7i71 & 
7m7 ( section #bja ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #dja7 %all apply ) 
respect to ! ,f$]al ,family & ,m$ical   
,leave ,insurance ,tru/ ,fund 9 ! same  
mann] z su* provisions apply to ! ,f$]al
 ,old-,age & ,survivors ,insurance ,tru/

 ,fund & ! ,disability ,insurance ,tru/ 
,fund4  7d7 ,b5efits paid f ,tru/ ,fund 
,b5efit paym5ts requir$ to be made "u   
section #cjjc %all be made only f !     
,f$]al ,family & ,m$ical ,leave         
,insurance ,tru/ ,fund4  7e7            
,adm9i/ration ,!re are au?oriz$ to be   
made available = exp5diture1 out ( !    
,f$]al ,family & ,m$ical ,leave         
,insurance ,tru/ ,fund1 su* sums z may  
be necess>y to pay ! co/s ( !           
adm9i/ration ( section #cjjc1 includ+   
/>t-up co/s1 te*nical assi/ance1        
outrea*1 education1 evaluation1 &       
report+4  7f7 ,prohibition ,no funds f !
 ,social ,security ,tru/ ,fund or       
appropriat$ to ! ,social ,security      
,adm9i/ration to adm9i/] ,social        
,security programs may be us$ = ,f$]al  
,family & ,m$ical ,leave ,insurance     
b5efits or adm9i/ration set =? "u ?is   
title4  #cjje4 ,int]nal ,rev5ue ,code   
provisions  7a7 ,9 g5]al  7#a7 ,employee
 contribution ,section #caja ( !        
,int]nal ,rev5ue ,code ( #aihf is       

am5d$-- 7,a7 by r$esignat+ subsection   
7c7 z subsection 7d72 &  7,b7 by ins]t+ 
aft] subsection 7b7 ! foll[+3  7c7      
,family & m$ical leave insurance  7#a7  
,9 g5]al ,9 addition to o!r taxes1 !re  
is h]eby impos$ on ! income ( e         
individual a tax equal to ! applicable  
p]c5tage ( ! wages 7z def9$ 9 section   
#caba7;a77 receiv$ by ! individual )    
respect to employm5t 7z def9$ 9 section 
#caba7;b774  7#b7 ,applicable p]c5tage  
,= purposes ( p>agraph 7#a71 ! t]m      
applicable p]c5tage means #j4b p]c5t 9 !
 case ( wages receiv$ 9 any cal5d> ye>4 
4  7#b7 ,employ] contribution ,section  
#caaa ( su* ,code is am5d$-- 7,a7 by    
r$esignat+ subsection 7c7 z subsection  
7d72 &  7,b7 by ins]t+ aft] subsection  
7b7 ! foll[+3  7c7 ,family & m$ical     
leave insurance  7#a7 ,9 g5]al ,9       
addition to o!r taxes1 !re is h]eby     
impos$ on e employ] an excise tax1 )    
respect to hav+ individuals 9 8 employ1 
equal to ! applicable p]c5tage ( ! wages
 7z def9$ 9 section #caba7;a77 paid by !

 employ] ) respect to employm5t 7z def9$
 9 section #caba7;b774  7#b7 ,applicable
 p]c5tage ,= purposes ( p>agraph 7#a71 !
 t]m applicable p]c5tage means #j4b     
p]c5t 9 ! case ( wages paid 9 any cal5d>
 ye>4  4  7#c7 ,self-employm5t income   
contribution  7,a7 ,9 g5]al ,section    
#adja ( su* ,code is am5d$-- 7i7 by     
r$esignat+ subsection 7c7 z subsection  
7d72 &  7ii7 by ins]t+ aft] subsection  
7b7 ! foll[+3  7c7 ,family & m$ical     
leave insurance  7#a7 ,9 g5]al ,9       
addition to o!r taxes1 !re is h]eby     
impos$ = ea* taxable ye>1 on !          
self-employm5t income ( e individual1 a 
tax equal to ! applicable p]c5tage ( !  
am\nt ( ! self-employm5t income = su*   
taxable ye>4  7#b7 ,applicable p]c5tage 
,= purposes ( p>agraph 7#a71 ! t]m      
applicable p]c5tage means #j4d p]c5t 9 !
 case ( self-employm5t income 9 any     
taxable ye>4  4  7,b7 ,exclusion ( c]ta9
 net e>n+s f self-employm5t ,section    
#adjb7;b77#a7 ( su* ,code is am5d$ by   
/rik+ tax impos$ by section #adja7;a7 & 

ins]t+ taxes impos$ by subsections 7a7 &
 7c7 ( section #adja4  7b7 ,railroad    
,retirem5t ,tax ,act  7#a7 ,employee    
contribution ,section #cbja ( su* ,code 
is am5d$-- 7,a7 by r$esignat+ subsection
 7c7 z subsection 7d72 &  7,b7 by ins]t+
 aft] subsection 7b7 ! foll[+3  7c7     
,family & ,m$ical ,leave insurance  7#a7
 ,9 g5]al ,9 addition to o!r taxes1 !re 
is h]eby impos$ on ! income ( ea*       
employee a tax equal to ! applicable    
p]c5tage ( ! comp5sation receiv$ dur+   
any cal5d> ye> by su* employee = s]vices
 r5d]$ by su* employee4  7#b7           
,applicable p]c5tage ,= purposes (      
p>agraph 7#a71 ! t]m applicable p]c5tage
 means #j4b p]c5t 9 ! case ( comp5sation
 receiv$ 9 any cal5d> ye>4  4  7#b7     
,employee repres5tative contribution    
,section #cbaa ( su* ,code is am5d$--   
7,a7 by r$esignat+ subsection 7c7 z     
subsection 7d72 &  7,b7 by ins]t+ aft]  
subsection 7b7 ! foll[+3  7c7 ,family & 
,m$ical ,leave insurance  7#a7 ,9 g5]al 
,9 addition to o!r taxes1 !re is h]eby  

impos$ on ! income ( ea* employee       
repres5tative a tax equal to !          
applicable p]c5tage ( ! comp5sation     
receiv$ dur+ any cal5d> ye> by su*      
employee repres5tative = s]vices r5d]$  
by su* employee repres5tative4  7#b7    
,applicable p]c5tage ,= purposes (      
p>agraph 7#a71 ! t]m applicable p]c5tage
 means #j4b p]c5t 9 ! case ( comp5sation
 receiv$ 9 any cal5d> ye>4  4  7#c7     
,employ] contribution ,section #cbba (  
su* ,code is am5d$-- 7,a7 by r$esignat+ 
subsection 7c7 z subsection 7d72 &  7,b7
 by ins]t+ aft] subsection 7b7 ! foll[+3
  7c7 ,family & ,m$ical ,leave insurance
  7#a7 ,9 g5]al ,9 addition to o!r      
taxes1 !re is h]eby impos$ on e employ] 
an excise tax1 ) respect to hav+        
individuals 9 8 employ1 equal to !      
applicable p]c5tage ( ! comp5sation paid
 dur+ any cal5d> ye> by su* employ] =   
s]vices r5d]$ to su* employ]4  7#b7     
,applicable p]c5tage ,= purposes (      
p>agraph 7#a71 ! t]m applicable p]c5tage
 means #j4b p]c5t 9 ! case ( comp5sation

 paid 9 any cal5d> ye>4  4  7c7 ,con=m+ 
am5dm5ts  7#a7 ,section #fdac7;c7 ( !   
,int]nal ,rev5ue ,code ( #aihf is       
am5d$-- 7,a7 9 p>agraph 7#a7-- 7i7 by   
ins]t+ 1 section #caja7;c71 aft] by     
section #caja7;a72 &  7ii7 by /rik+ bo? 
& ins]t+ ea*2 &  7,b7 9 p>agraph 7#b71  
by ins]t+ or #caja7;c7 aft] #caja7;a7   
ea* place x appe>s4  7#b7 ,section      
#ae7;a7 ( ! ,railroad ,retirem5t ,act ( 
#aigd 7#de ,u4,s4,c4 #bcan7a77 is am5d$ 
by ins]t+ 7o!r ?an sections #cbja7;c71  
#cbaa7;c71 & #cbba7;c77 be=e ! p]iod at 
! end4  7d7 ,effective date ,! am5dm5ts 
made by ?is section %all take effect    
#abj days aft] ! date ( ! enactm5t ( ?is
 ,act4  #cjjf4 ,regulations ,!          
,commission]1 9 consultation ) !        
,secret>y ( ,labor1 %all prescribe      
regulations necess>y to c>ry out ?is    
title4 ,9 develop+ su* regulations1 !   
,commission] %all consid] ! input f a   
volunte] advisory body compris$ ( n m   
?an #ae individuals1 includ+ exp]ts 9 ! 
relevant subject matt] & (ficials *>g$ )

 implem5t+ ,/ate paid family & m$ical   
leave insurance programs4 ,!            
,commission] %all take su* programs into
 acc\nt :5 propos+ regulations4 ,su*    
individuals %all be appo9t$ z foll[s3   
7#a7 ,five individuals to be appo9t$ by 
! ,presid5t4  7#b7 ,?ree individuals to 
be appo9t$ by ! majority lead] ( !      
,s5ate4  7#c7 ,two individuals to be    
appo9t$ by ! m9ority lead] ( ! ,s5ate4  
7#d7 ,?ree individuals to be appo9t$ by 
! ,speak] ( ! ,h\se ( ,repres5tatives4  
7#e7 ,two individuals to be appo9t$ by !
 m9ority lead] ( ! ,h\se (              
,repres5tatives4  #cjjg4 ,,gao ,/udy ,z 
soon z practicable aft] cal5d> ye>      
#bjbe1 ! ,comptroll] ,g5]al %all submit 
to ,congress a report on family & m$ical
 leave insurance b5efits paid "u section
 #cjjc = any mon? dur+ ! #a-ye> p]iod   
beg9n+ on ,janu>y #a1 #bjbe4 ,! report  
%all include ! foll[+3 7#a7 ,an         
id5tification ( ! total numb] (         
applications = su* b5efits fil$ = any   
mon? dur+ su* #a-ye> p]iod1 & ! av]age  

numb] ( days occurr+ 9 ! p]iod beg9n+ on
 ! date on :i* su* an application is    
receiv$ & end+ on ! date on :i* !       
initial det]m9ation ( eligibility )     
respect to ! application is made4  7#b7 
,an id5tification ( ! total numb] (     
reque/s = review ( an initial adv]se    
det]m9ation ( eligibility = su* b5efits 
made dur+ su* #a-ye> p]iod1 & ! av]age  
numb] ( days occurr+ 9 ! p]iod beg9n+ on
 ! date on :i* su* review is reque/$ &  
end+ on ! date on :i* ! f9al det]m9ation
 ( eligibility ) respect to su* review  
is made4  7#c7 ,an id5tification ( !    
total numb] ( mon?ly b5efit claim       
reports = su* b5efits fil$ dur+ su*     
#a-ye> p]iod1 & ! av]age numb] ( days   
occurr+ 9 ! p]iod beg9n+ on ! date on   
:i* su* a claim report is receiv$ & end+
 on ! date on :i* ! initial det]m9ation 
( eligibility ) respect to ! claim      
report is made4  7#d7 ,an id5tification 
( ! total numb] ( reque/s = review ( an 
initial adv]se det]m9ation relat+ to a  
mon?ly b5efit claim report = su* b5efits

 made dur+ su* #a-ye> p]iod1 & ! av]age 
numb] ( days occurr+ 9 ! p]iod beg9n+ on
 ! date on :i* su* review is reque/$ &  
end+ on ! date on :i* ! f9al det]m9ation
 ( eligibility ) respect to su* review  
is made4  7#e7 ,an id5tification ( any  
excessive delay 9 any ( ! p]iods        
describ$ 9 p>agraphs 7#a7 ?r\gh 7#d71 & 
a description ( ! causes = su* delay4   
,,iv ,fully ,refundable ,*ild ,tax      
,cr$it  #djja4 ,e/abli%m5t ( fully      
refundable *ild tax cr$it  7a7          
,elim9ation ( exi/+ *ild tax cr$it      
,subp>t ,a ( "p ,,iv ( sub*apt] ,a (    
*apt] #a ( subtitle ,a ( ! ,int]nal     
,rev5ue ,code ( #aihf is am5d$ by /rik+ 
section #bd4  7b7 ,e/abli%m5t ( fully   
refundable *ild tax cr$it ,subp>t ,c (  
"p ,,iv ( sub*apt] ,a ( *apt] #a (      
subtitle ,a ( su* ,code is am5d$ by     
ins]t+ aft] section #cf;,b ! foll[+ new 
section3  #cf;,c4 ,*ild tax cr$it  7a7  
,all[ance ( cr$it ,9 ! case ( an        
eligible individual1 !re %all be all[$ z
 a cr$it aga9/ ! tax impos$ by ?is *apt]

 = ! taxable ye> an am\nt equal to ! sum
 (-- 7#a7 ) respect to ea* qualify+ *ild
 ( ! taxpay] :o has atta9$ #f ye>s ( age
 be=e ! close ( su* taxable ye> & = :i* 
! taxpay] is all[$ a d$uction "u section
 #aea1 an am\nt equal to #c1jjj1 &  7#b7
 ) respect to ea* qualify+ *ild ( !     
taxpay] :o has n atta9$ #f ye>s ( age   
be=e ! close ( su* taxable ye> & = :i* !
 taxpay] is all[$ a d$uction "u section 
#aea1 an am\nt equal to #abj p]c5t ( !  
doll> am\nt 9 p>agraph 7#a74  7b7       
,limitation  7#a7 ,9 g5]al ,! am\nt ( ! 
cr$it all[able "u subsection 7a7 %all be
 r$uc$ 7b n bel[ z]o7 by ! applicable   
am\nt = ea* #a1jjj 7or fraction !re(7 by
 :i* ! taxpay]'s modifi$ adju/$ gross   
income exce$s ! ?re%old am\nt4 ,=       
purposes ( ! prec$+ s5t5ce1 ! t]m       
modifi$ adju/$ gross income means adju/$
 gross income increas$ by any am\nt     
exclud$ f gross income "u section #iaa1 
#ica1 or #icc4  7#b7 ,?re%old am\nt     
7,a7 ,9 g5]al ,= purposes ( p>agraph    
7#a71 ! t]m ?re%old am\nt means-- 7i7   

#ahj1jjj 9 ! case ( a jo9t return1  7ii7
 #acj1jjj 9 ! case ( an individual :o is
 n m>ri$1 &  7iii7 #ij1jjj 9 ! case ( a 
m>ri$ individual fil+ a sep>ate return4 
7,b7 ,m>ital /atus ,= purposes ( ?is    
p>agraph1 m>ital /atus %all be det]m9$  
"u section #ggjc4  7#c7 ,applicable     
am\nt ,= purposes ( p>agraph 7#a71 ! t]m
 applicable am\nt means an am\nt equal  
to ! quoti5t (-- 7,a7 ! am\nt ( ! cr$it 
all[able "u subsection 7a71 z det]m9$   
)\t reg>d to ?is subsection1 divid$ by  
7,b7 an am\nt equal to ! product (-- 7i7
 #bj1 multipli$ by  7ii7 ! total numb] (
 qualify+ *ildr5 ( ! taxpay]4  7c7      
,qualify+ *ild ,= purposes ( ?is        
section-- 7#a7 ,9 g5]al ,! t]m qualify+ 
*ild means a qualify+ *ild ( ! taxpay]  
7z def9$ 9 section #aeb7;c77 :o has n   
atta9$ #ah ye>s ( age4  7#b7 ,exception 
= c]ta9 non-citiz5s ,! t]m qualify+ *ild
 %all n include any individual :o w\ld n
 be a dep5d5t if subp>agraph 7,a7 (     
section #aeb7;b77#c7 7 appli$ )\t reg>d 
to all t foll[s resid5t ( ! ,unit$      

,/ates4  7d7 ,eligible individual ,=    
purposes ( ?is section1 ! t]m eligible  
individual means1 ) respect to any      
taxable ye>1 any individual if su*      
individual's pr9cipal place ( abode is 9
 ! ,unit$ ,/ates 7z det]m9$ "u section  
#cb7;c77#d77 = m ?an "o-half ( su*      
taxable ye>4  7e7 ,inflation adju/m5t   
7#a7 ,9 g5]al ,9 ! case ( any taxable   
ye> beg9n+ aft] #bjbb1 ! #c1jjj am\nt 9 
subsection 7a77#a7 %all be increas$ by  
an am\nt equal to-- 7,a7 su* doll>      
am\nt1 multipli$ by  7,b7 ! co/-(-liv+  
adju/m5t det]m9$ "u p>agraph 7#b7 = !   
cal5d> ye> 9 :i* ! taxable ye> beg9s4   
7#b7 ,co/-(-liv+ adju/m5t ,= purposes ( 
p>agraph 7#a71 ! co/-(-liv+ adju/m5t =  
any cal5d> ye> is ! p]c5tage 7if any7 by
 :i*-- 7,a7 ! ,,cpi = ! prec$+ cal5d>   
ye> 7z det]m9$ pursuant to section      
#a7;f77#d771 exce$s  7,b7 ! ,,cpi =     
cal5d> ye> #bjba4  7#c7 ,r\nd+ ,if any  
increase det]m9$ "u p>agraph 7#a7 is n a
 multiple ( #ej1 su* increase %all be   
r\nd$ to ! ne>e/ multiple ( #ej4  7f7   

,p>tial non-,refundable cr$it all[$ =   
c]ta9 o!r dep5d5ts  7#a7 ,9 g5]al ,9 !  
case ( a taxable ye> beg9n+ aft]        
,decemb] #ca1 #bjba1 & be=e ,janu>y #a1 
#bjbf1 ! aggregate cr$its all[$ to a    
taxpay] "u subp>t ,a %all be increas$ by
 #ejj = ea* dep5d5t ( ! taxpay] 7z def9$
 9 section #aeb7 o!r ?an a qualify+ *ild
 describ$ 9 subsection 7c74 ,! am\nt ( !
 cr$it all[$ "u ?is subsection %all n be
 treat$ z a cr$it all[$ "u ?is subp>t4  
7#b7 ,exception = c]ta9 noncitiz5s      
,p>agraph 7#a7 %all n apply ) respect to
 any individual :o w\ld n be a dep5d5t  
if subp>agraph 7,a7 ( section           
#aeb7;b77#c7 7 appli$ )\t reg>d to all t
 foll[s resid5t ( ! ,unit$ ,/ates4  7#c7
 ,limitation  7,a7 ,9 g5]al ,! am\nt ( !
 cr$it all[able "u p>agraph 7#a7 %all be
 r$uc$ 7b n bel[ z]o7 by #ej = ea*      
#a1jjj 7or fraction !re(7 by :i* !      
taxpay]'s modifi$ adju/$ gross income   
exce$s ! ?re%old am\nt4  7,b7 ,modifi$  
adju/$ gross income ,= purposes (       
subp>agraph 7,a71 ! t]m modifi$ adju/$  

gross income means adju/$ gross income  
increas$ by any am\nt exclud$ f gross   
income "u section #iaa1 #ica1 or #icc4  
7,c7 ,?re%old am\nt  7i7 ,9 g5]al ,=    
purposes ( subp>agraph 7,a71 ! t]m      
?re%old am\nt means-- 7,i7 #bjj1jjj 9 ! 
case ( a jo9t return1  7,,ii7 #aej1jjj 9
 ! case ( an individual :o is n m>ri$1 &
  7,,iii7 #ajj1jjj 9 ! case ( a m>ri$   
individual fil+ a sep>ate return4  7ii7 
,m>ital /atus ,= purposes ( ?is         
subp>agraph1 m>ital /atus %all be       
det]m9$ "u section #ggjc4  7g7          
,id5tification requirem5ts  7#a7        
,qualify+ *ild & dep5d5t id5tification  
requirem5t ,no cr$it %all be all[$ "u   
?is section to a taxpay] ) respect to   
any qualify+ *ild or dep5d5t unless !   
taxpay] includes ! "n & taxpay]         
id5tification numb] ( su* qualify+ *ild 
or dep5d5t on ! return ( tax = ! taxable
 ye> & su* taxpay] id5tification numb] 0
 issu$ on or be=e ! due date = fil+ su* 
return4  7#b7 ,taxpay] id5tification    
requirem5t ,no cr$it %all be all[$ "u   

?is section if ! taxpay] id5tification  
numb] ( ! taxpay] 0 issu$ aft] ! due    
date = fil+ ! return = ! taxable ye>4   
7h7 ,taxable ye> mu/ be full taxable ye>
 ,except 9 ! case ( a taxable ye> clos$ 
by reason ( ! dea? ( ! taxpay]1 no cr$it
 %all be all[able "u ?is section 9 !    
case ( a taxable ye> cov]+ a p]iod (    
less ?an #ab mon?s4  7i7 ,re/rictions on
 taxpay]s :o improp]ly claim$ cr$it 9   
prior ye>  7#a7 ,taxpay]s mak+ prior    
fraudul5t or reckless claims  7,a7 ,9   
g5]al ,no cr$it %all be all[$ "u ?is    
section = any taxable ye> 9 !           
disall[ance p]iod4  7,b7 ,disall[ance   
p]iod ,= purposes ( subp>agraph 7,a71 ! 
disall[ance p]iod is-- 7i7 ! p]iod ( #aj
 taxable ye>s aft] ! mo/ rec5t taxable  
ye> = :i* !re 0 a f9al det]m9ation t !  
taxpay]'s claim ( cr$it "u ?is section 0
 due to fraud1 &  7ii7 ! p]iod ( #b     
taxable ye>s aft] ! mo/ rec5t taxable   
ye> = :i* !re 0 a f9al det]m9ation t !  
taxpay]'s claim ( cr$it "u ?is section 0
 due to reckless or int5tional disreg>d 

( rules & regulations 7b n due to       
fraud74  7#b7 ,taxpay]s mak+ improp]    
prior claims ,9 ! case ( a taxpay] :o is
 d5i$ cr$it "u ?is section = any taxable
 ye> z a result ( ! defici5cy proc$ures 
"u sub*apt] ,b ( *apt] #fc1 no cr$it    
%all be all[$ "u ?is section = any      
subsequ5t taxable ye> unless ! taxpay]  
provides su* in=mation z ! ,secret>y may
 require to demon/rate eligibility = su*
 cr$it4  7j7 ,reconciliation ( cr$it &  
advance cr$it  7#a7 ,9 g5]al ,! am\nt ( 
! cr$it all[$ "u ?is section to any     
taxpay] = any taxable ye> %all be r$uc$ 
7b n bel[ z]o7 by ! aggregate am\nt (   
paym5ts made "u section #gebg;,a to su* 
taxpay] dur+ su* taxable ye>4  7#b7     
,excess advance paym5ts ,if ! aggregate 
am\nt ( paym5ts "u section #gebg;,a to !
 taxpay] dur+ ! taxable ye> exce$s !    
am\nt ( ! cr$it all[$ "u ?is section to 
su* taxpay] = su* taxable ye> 7det]m9$  
)\t reg>d to p>agraph 7#a771 ! tax      
impos$ by ?is *apt] = su* taxable ye>   
%all be increas$ by ! am\nt ( su*       

excess4  4  7c7 ,advance paym5t ( cr$it 
,section #gebg;,a ( su* ,code is am5d$  
to read z foll[s3  #gebg;,a4 ,advance   
paym5t ( *ild tax cr$it  7a7 ,9 g5]al ,z
 soon z practicable aft] ! date ( !     
enactm5t ( ?is section1 ! ,secret>y %all
 e/abli% a program = mak+ mon?ly paym5ts
 to taxpay]s :i*1 9 ! aggregate dur+ any
 cal5d> ye>1 equal ! annual advance     
am\nt det]m9$ ) respect to su* taxpay] =
 su* cal5d> ye>4  7b7 ,annual advance   
am\nt ,= purposes ( ?is section-- 7#a7  
,9 g5]al ,except z o!rwise provid$ 9 ?is
 subsection1 ! t]m annual advance am\nt 
means1 ) respect to any taxpay] = any   
cal5d> ye>1 ! am\nt ( ! cr$it :i* w\ld  
be all[$ to su* taxpay] "u section      
#cf;,c7a7 7det]m9$ )\t reg>d to         
subsection 7j7 !re(7 = ! taxpay]'s      
taxable ye> beg9n+ 9 su* cal5d> ye> if--
 7,a7 ! taxpay]'s modifi$ adju/$ gross  
income = su* taxable ye> 7 equal to !   
taxpay]'s modifi$ adju/$ gross income = 
! ref]5ce taxable ye>1  7,b7 ! only     
qualify+ *ildr5 ( su* taxpay] are       

qualify+ *ildr5 prop]ly claim$ on !     
taxpay]'s return ( tax = ! ref]5ce      
taxable ye>1 &  7,c7 ! age ( su*        
qualify+ *ildr5 is det]m9$ = su* taxable
 ye> by tak+ into acc\nt ! passage ( "t 
s9ce ! ref]5ce taxable ye>4  7#b7       
,ref]5ce taxable ye> ,except z provid$ 9
 p>agraph 7#c77;,a71 ! t]m ref]5ce      
taxable ye> means1 ) respect to any     
taxpay] = any cal5d> ye>1 ! taxpay]'s   
taxable ye> beg9n+ 9 ! prec$+ cal5d> ye>
 or1 9 ! case ( taxpay] :o did n file a 
return ( tax = su* taxable ye>1 !       
taxpay]'s taxable ye> beg9n+ 9 ! second 
prec$+ cal5d> ye>4  7#c7 ,modifications 
dur+ cal5d> ye> ,! ,secret>y may modify1
 dur+ any cal5d> ye>1 ! annual advance  
am\nt ) respect to any taxpay] = su*    
cal5d> ye> to take into acc\nt-- 7,a7 a 
return ( tax fil$ by su* taxpay] dur+   
su* cal5d> ye> 7& ! taxable ye> to :i*  
su* return relates may be tak5 into     
acc\nt z ! ref]5ce taxable ye>71 &  7,b7
 any o!r in=mation provid$ by ! taxpay] 
to ! ,secret>y :i* all[s ! ,secret>y to 

det]m9e paym5ts "u subsection 7a7 :i*1 9
 ! aggregate dur+ any taxable ye> ( !   
taxpay]1 m closely total ! ,secret>y's  
be/ e/imate ( ! cr$it all[$ to ! taxpay]
 "u section #cf;,c7a7 7det]m9$ )\t reg>d
 to subsection 7i7 !re(7 = su* taxable  
ye>4  7c7 ,on-,l9e in=mation portal ,!  
,secret>y %all e/abli% an on-l9e portal 
:i* all[s taxpay]s to-- 7#a7 elect n to 
receive paym5ts "u ?is section1 &  7#b7 
provide in=mation to ! ,secret>y :i*    
w\ld be relevant to a modification "u   
subsection 7b77#c77;,b7 ( ! annual      
advance am\nt1 includ+ in=mation        
reg>d+-- 7,a7 a *ange 9 ! numb] ( !     
taxpay]'s qualify+ *ildr51 includ+ by   
reason ( ! bir? ( a *ild1  7,b7 a *ange 
9 ! taxpay]'s m>ital /atus1  7,c7 a     
significant *ange 9 ! taxpay]'s modifi$ 
adju/$ gross income1 &  7,d7 any o!r    
factor :i* ! ,secret>y may provide4  7d7
 ,notice ( paym5ts ,n lat] ?an ,janu>y  
#ca ( ! cal5d> ye> foll[+ any cal5d> ye>
 dur+ :i* ! ,secret>y makes "o or m     
paym5ts to any taxpay] "u ?is section1 !

 ,secret>y %all provide su* taxpay] ) a 
writt5 notice :i* includes ! taxpay]'s  
taxpay] id5tity 7z def9$ 9 section      
#fajc7;b77#f771 ! aggregate am\nt ( su* 
paym5ts made to su* taxpay] dur+ su*    
cal5d> ye>1 & su* o!r in=mation z !     
,secret>y det]m9es appropriate4  7e7    
,au?ority ,to adju/ int]val ( paym5ts   
,if ! ,secret>y det]m9es t x is n       
adm9i/ratively feasible to make mon?ly  
paym5ts "u ?is section1 su* paym5ts %all
 be made on ! basis ( ! %orte/ int]val  
:i* ! ,secret>y det]m9es is             
adm9i/ratively feasible4  4  7d7 ,con=m+
 am5dm5ts  7#a7 ,! table ( sections =   
subp>t ,a ( "p ,,iv ( sub*apt] ,a (     
*apt] #a ( subtitle ,a ( ! ,int]nal     
,rev5ue ,code ( #aihf is am5d$ by /rik+ 
! item relat+ to section #bd4  7#b7 ,!  
table ( sections = subp>t ,c ( "p ,,iv (
 sub*apt] ,a ( *apt] #a ( subtitle ,a ( 
su* ,code is am5d$ by ins]t+ aft] ! item
 relat+ to section #cf;,b ! foll[+3     
,sec4 #cf;,c4 ,*ild tax cr$it44  7#c7   
,subp>agraph 7,b7 ( section #de,r7f77#c7

 ( su* ,code is am5d$ to read z foll[s3 
7,b7 ,special rule ,any am\nts paid     
pursuant to an agreem5t "u section      
#caba7l7 7relat+ to agreem5ts ent]$ into
 by ,am]ican employ]s ) respect to =eign
 affiliates7 :i* are equival5t to !     
taxes ref]r$ to 9 subp>agraph 7,a7 %all 
be treat$ z taxes ref]r$ to 9 su*       
subp>agraph4  4  7#d7 ,section          
#aeb7;f77#f77;,b77ii7 ( su* ,code is    
am5d$ by /rik+ section #bd & ins]t+     
section #cf;,c4  7#e7 ,p>agraph 7#bf7 ( 
section #eja7;c7 ( su* ,code is am5d$ 9 
! flu% matt] at ! end by /rik+ section  
#bd7;c77 & ins]t+ section #cf;,c7c774   
7#f7 ,section #fbaa7;b77#d77;,a7 ( su*  
,code is am5d$-- 7,a7 by /rik+ #bd7;d712
 &  7,b7 by ins]t+ #cf;,c7a71 aft]      
#cf;,b14  7#g7 ,section #fbac7;g77#b7 ( 
su* ,code is am5d$-- 7,a7 9 subp>agraph 
7,i71 by /rik+ section #bd7;e7 & ins]t+ 
section #cf;,c7g72 &  7,b7 9 subp>agraph
 7,l71 by /rik+ #bd1 or #cb & ins]t+    
#cb1 or #cf;,c4  7#h7 ,p>agraph 7#b7 (  
section #acbd7;b7 ( title #ca1 ,unit$   

,/ates ,code1 is am5d$ by ins]t+ #cf;,c1
 aft] #cf;,b14  7e7 ,effective date ,!  
am5dm5ts made by ?is section %all apply 
to taxable ye>s beg9n+ aft] ,decemb]    
#ca1 #bjba4  #djjb4 ,paym5ts to         
possessions  7a7 ,mirror code possession
 ,! ,secret>y ( ! ,treasury %all pay to 
ea* possession ( ! ,unit$ ,/ates ) a    
mirror code tax sy/em am\nts equal to ! 
loss to t possession by reason ( !      
application ( section #cf;,c ( !        
,int]nal ,rev5ue ,code ( #aihf 7z add$  
by section #djja7 ) respect to taxable  
ye>s beg9n+ aft] #bjbj4 ,su* am\nts %all
 be det]m9$ by ! ,secret>y ( ! ,treasury
 bas$ on in=mation provid$ by ! gov]nm5t
 ( ! respective possession4  7b7 ,o!r   
possessions ,! ,secret>y ( ! ,treasury  
%all pay to ea* possession ( ! ,unit$   
,/ates :i* does n h a mirror code tax   
sy/em am\nts e/imat$ by ! ,secret>y ( ! 
,treasury z be+ equal to ! aggregate    
b5efits t w\ld h be5 provid$ to resid5ts
 ( su* possession by reason ( !         
application ( section #cf;,c ( su* ,code

 7z s add$7 = taxable ye>s beg9n+ aft]  
#bjba if a mirror code tax sy/em _h be5 
9 effect 9 su* possession4 ,! prec$+    
s5t5ce %all n apply ) respect to any    
possession ( ! ,unit$ ,/ates unless su* 
possession has a plan1 :i* has be5      
approv$ by ! ,secret>y ( ! ,treasury1 "u
 :i* su* possession w promptly di/ribute
 su* paym5ts to ! resid5ts ( su*        
possession4  7c7 ,coord9ation ) cr$it   
all[$ aga9/ ,unit$ ,/ates income taxes  
,no cr$it %all be all[$ aga9/ ,unit$    
,/ates income taxes = any taxable ye> "u
 section #cf;,c ( ! ,int]nal ,rev5ue    
,code ( #aihf 7z s add$7 to any p]son-- 
7#a7 to :om a cr$it is all[$ aga9/ taxes
 impos$ by ! possession by reason ( !   
am5dm5ts made by ?is section = su*      
taxable ye>2 or  7#b7 :o is eligible = a
 paym5t "u a plan describ$ 9 subsection 
7b7 ) respect to su* taxable ye>4  7d7  
,def9itions & special rules  7#a7       
,possession ( ! ,unit$ ,/ates ,=        
purposes ( ?is section1 ! t]m possession
 ( ! ,unit$ ,/ates includes !           

,commonweal? ( ,pu]to ,rico & !         
,commonweal? ( ! ,nor!rn ,m>iana ,isl&s4
  7#b7 ,mirror code tax sy/em ,=        
purposes ( ?is section1 ! t]m mirror    
code tax sy/em means1 ) respect to any  
possession ( ! ,unit$ ,/ates1 ! income  
tax sy/em ( su* possession if ! income  
tax liability ( ! resid5ts ( su*        
possession "u su* sy/em is det]m9$ by   
ref]5ce to ! income tax laws ( ! ,unit$ 
,/ates z if su* possession 7 ! ,unit$   
,/ates4  7#c7 ,treatm5t ( paym5ts ,=    
purposes ( section #acbd7;b77#b7 ( title
 #ca1 ,unit$ ,/ates ,code1 ! paym5ts "u 
?is section %all be treat$ 9 ! same     
mann] z a refund due f ! cr$it all[$ "u 
section #cf;,c ( ! ,int]nal ,rev5ue     
,code ( #aihf4  ,v ,*ild ,c>e ,is       
,infra/ructure  #ejja4 ,infra/ructure   
grants to improve *ild c>e safety  7a7  
,9 g5]al ,"p ,a ( title ,,iv ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #fja et  
seq47 is am5d$ by ins]t+ aft] section   
#dah ! foll[+3  #dah;,a4 ,infra/ructure 
grants to improve *ild c>e safety  7a7  

,%ort title ,?is section may be cit$ z !
 ,infra/ructure ,grants ,to ,improve    
,*ild ,c>e ,safety ,act4  7b7 ,ne$s     
,assessm5ts  7#a7 ,imm$iate ne$s        
assessm5t  7,a7 ,9 g5]al ,! ,secret>y   
%all conduct an imm$iate ne$s assessm5t 
( ! condition ( *ild c>e facilities     
?r\gh\t ! ,unit$ ,/ates 7) priority giv5
 to *ild c>e facilities t receive ,f$]al
 funds71 t-- 7i7 det]m9es ! ext5t to :i*
 ! ,,covid-#ai p&emic has creat$        
imm$iate infra/ructure ne$s1 includ+    
infra/ructure-relat$ heal? & safety     
ne$s1 :i* mu/ be address$ = *ild c>e    
facilities to op]ate 9 compliance )     
public heal? guidel9es2  7ii7 consid]s !
 effects ( ! p&emic on a v>iety ( *ild  
c>e c5t]s1 includ+ home-bas$ c5t]s2 &   
7iii7 consid]s h[ ! p&emic has impact$  
specific metrics1 su* z-- 7,i7 capacity2
  7,,ii7 inve/m5ts 9 infra/ructure      
*anges2  7,,iii7 ! types ( infra/ructure
 *anges c5t]s ne$ to implem5t & _!      
associat$ co/s2  7,,iv7 ! price (       
tuition2 &  7,v7 any *anges or          

anticipat$ *anges 9 ! numb] &           
demographic ( *ildr5 att5d+4  7,b7 ,tim+
 ,! imm$iate ne$s assessm5t %\ld occur  
simultane\sly ) ! fir/ grant-mak+ cycle 
"u subsection 7c74  7,c7 ,report ,n lat]
 ?an #a ye> aft] ! date ( ! enactm5t (  
?is section1 ! ,secret>y %all submit to 
! ,congress a report conta9+ ! result ( 
! ne$s assessm5t conduct$ "u subp>agraph
 7,a71 & make ! assessm5t publicly      
available4  7#b7 ,long-t]m ne$s         
assessm5t  7,a7 ,9 g5]al ,! ,secret>y   
%all conduct a long-t]m assessm5t ( !   
condition ( *ild c>e facilities ?r\gh\t 
! ,unit$ ,/ates 7) priority giv5 to *ild
 c>e facilities t receive ,f$]al funds74
 ,! assessm5t may be conduct$ ?r\gh     
repres5tative r&om sampl+4  7,b7 ,report
 ,n lat] ?an #d ye>s aft] ! date ( !    
enactm5t ( ?is section1 ! ,secret>y %all
 submit to ! ,congress a report conta9+ 
! results ( ! ne$s assessm5t conduct$ "u
 subp>agraph 7,a71 & make ! assessm5t   
publicly available4  7c7 ,*ild c>e      
facilities grants  7#a7 ,grants to      

,/ates  7,a7 ,9 g5]al ,! ,secret>y may  
aw>d grants to ,/ates = ! purpose (     
acquir+1 con/ruct+1 r5ovat+1 or improv+ 
*ild c>e facilities1 includ+ adapt+1    
reconfigur+1 or exp&+ facilities to     
respond to ! ,,covid-#ai p&emic4  7,b7  
,prioritiz$ facilities ,! ,secret>y may 
n aw>d a grant to a ,/ate "u subp>agraph
 7,a7 unless ! ,/ate involv$ agrees1 )  
respect to ! use ( grant funds1 to      
prioritize-- 7i7 *ild c>e facilities    
prim>ily s]v+ l[-income populations2    
7ii7 *ild c>e facilities prim>ily s]v+  
*ildr5 :o h n atta9$ ! age ( #e ye>s2   
7iii7 *ild c>e facilities t made maximum
 heal? & safety modifications to acc\nt 
= ! impact ( ! ,,covid-#ai p&emic2  7iv7
 *ild c>e facilities t op]ate "u        
nontraditional h\rs2 &  7v7 *ild c>e    
facilities locat$ 9 rural or und]s]v$   
communities4  7,c7 ,duration ( grants ,a
 grant "u ?is subsection %all be aw>d$ =
 a p]iod ( n m ?an #e ye>s4  7,d7       
,application ,to seek a grant "u ?is    
subsection1 a ,/ate %all submit to !    

,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require1 :i* in=mation    
%all-- 7i7 be disaggregat$ z ! ,secret>y
 may require2 &  7ii7 include a plan to 
use a portion ( ! grant funds to report 
back to ! ,secret>y on ! impact ( us+ ! 
grant funds to improve *ild c>e         
facilities4  7,e7 ,priority ,9 select+  
,/ates = grants "u ?is subsection1 !    
,secret>y %all prioritize ,/ates t-- 7i7
 plan to improve c5t]-bas$ & home-bas$  
*ild c>e programs1 :i* may include a    
comb9ation ( *ild c>e & e>ly ,head ,/>t 
or ,head ,/>t programs2  7ii7 aim to    
meet specific ne$s across urban1        
suburban1 or rural areas z det]m9$ by ! 
,/ate2 &  7iii7 %[ evid5ce (            
collaboration )-- 7,i7 local gov]nm5t   
(ficials2  7,,ii7 o!r ,/ate ag5cies2    
7,,iii7 nongov]nm5tal organizations1 su*
 z-- 7aa7 organizations )9 !            
philan?ropic community2  7bb7 c]tifi$   
community developm5t f9ancial           
in/itutions1 z def9$ 9 section #ajc ( ! 

,community ,developm5t ,bank+ &         
,f9ancial ,in/itutions ,act ( #aiid 7#ab
 ,u4,s4,c4 #dgjb72 &  7cc7 organizations
 t h demon/rat$ exp]i5ce 9-- 7,,aa7     
provid+ te*nical or f9ancial assi/ance =
 ! acquisition1 con/ruction1 r5ovation1 
or improvem5t ( *ild c>e facilities2    
7,,bb7 provid+ te*nical1 f9ancial1 or   
manag]ial assi/ance to *ild c>e         
provid]s2 & 7,,cc7 secur+ private s\rces
 ( capital f9anc+ = *ild c>e facilities 
or o!r l[-income community developm5t   
projects2 &  7,,iv7 local community     
organizations1 su* z-- 7aa7 *ild c>e    
provid]s2  7bb7 community c>e ag5cies2  
7cc7 res\rce & ref]ral ag5cies2 &  7dd7 
unions4  7,f7 ,consid]ation ,9 select+  
,/ates = grants "u ?is subsection1 !    
,secret>y %all consid]-- 7i7 :e!r !     
applicant-- 7,i7 has or is develop+ a   
plan to address *ild c>e facility ne$s2 
&  7,,ii7 demon/rates ! capacity to     
execute su* a plan2 &  7ii7 aft] ! date 
! report requir$ by subsection          
7b77#a77;,c7 is submitt$ to ! ,congress1

 ! ne$s ( ! applicants bas$ on ! results
 ( ! assessm5t4  7,g7 ,div]sity ( aw>ds 
,9 aw>d+ grants "u ?is section1 !       
,secret>y %all give equal consid]ation  
to ,/ates ) v>y+ capacities "u          
subp>agraph 7,f74  7,h7 ,mat*+          
requirem5t  7i7 ,9 g5]al ,z a condition 
= ! receipt ( a grant "u subp>agraph    
7,a71 a ,/ate t is n an ,indian tribe   
%all agree to make available 7directly  
or ?r\gh donations f public or private  
entities7 contributions ) respect to !  
co/ ( ! activities to be c>ri$ out      
pursuant to subp>agraph 7,a71 :i* may be
 provid$ 9 ca% or 9 k9d1 9 an am\nt     
equal to #aj p]c5t ( ! funds provid$    
?r\gh ! grant4  7ii7 ,det]m9ation (     
am\nt contribut$ ,contributions requir$ 
by clause 7i7 may include-- 7,i7 am\nts 
provid$ by ! ,f$]al ,gov]nm5t1 or       
s]vices assi/$ or subsidiz$ to any      
significant ext5t by ! ,f$]al ,gov]nm5t2
 or  7,,ii7 philan?ropic or             
private-sector funds4  7,i7 ,report ,n  
lat] ?an #f mon?s aft] ! la/ day ( !    

grant p]iod1 a ,/ate receiv+ a grant "u 
?is p>agraph %all submit a report to !  
,secret>y z describ$ 9 subp>agraph      
7,d7-- 7i7 to det]m9e ! effects ( !     
grant 9 con/ruct+1 r5ovat+1 or improv+  
*ild c>e facilities1 includ+ any *anges 
9 response to ! ,,covid-#ai p&emic & any
 effects on access to & quality ( *ild  
c>e2 &  7ii7 to provide su* o!r         
in=mation z ! ,secret>y may require4    
7,j7 ,am\nt limit ,! annual am\nt ( a   
grant "u ?is p>agraph may n exce$       
#ce1jjj1jjj4  7#b7 ,grants to int]m$i>y 
organizations  7,a7 ,9 g5]al ,!         
,secret>y may aw>d grants to int]m$i>y  
organizations1 su* z c]tifi$ community  
developm5t f9ancial in/itutions1 tribal 
organizations1 or o!r organizations )   
demon/rat$ exp]i5ce 9 *ild c>e          
facilities f9anc+1 = ! purpose ( provid+
 te*nical assi/ance1 capacity build+1 & 
f9ancial products to develop or f9ance  
*ild c>e facilities4  7,b7 ,application 
,a grant "u ?is p>agraph may be made    
only to int]m$i>y organizations t submit

 to ! ,secret>y an application at su*   
"t1 9 su* mann]1 & conta9+ su* in=mation
 z ! ,secret>y may require4  7,c7       
,priority ,9 select+ int]m$i>y          
organizations = grants "u ?is           
subsection1 ! ,secret>y %all prioritize 
int]m$i>y organizations t-- 7i7         
demon/rate exp]i5ce 9 *ild c>e facility 
f9anc+ or relat$ community facility     
f9anc+2  7ii7 demon/rate ! capacity to  
assi/ ,/ates & local gov]nm5ts 9        
develop+ *ild c>e facilities & programs2
  7iii7 demon/rate ! ability to lev]age 
grant fund+ to support f9anc+ tools to  
build ! capacity ( *ild c>e provid]s1   
su* z ?r\gh cr$it enhancem5ts2  7iv7    
propose to focus on *ild c>e facilities 
t op]ate "u nontraditional h\rs2  7v7   
propose to meet a div]sity ( ne$s across
 ,/ates & across urban1 suburban1 &     
rural areas at v>y+ types ( c5t]-bas$1  
home-bas$1 & o!r *ild c>e sett+s1       
includ+ e>ly c>e programs locat$ 9      
free/&+ build+s or 9 mix$-use prop]ties2
 &  7vi7 propose to focus on *ild c>e   

facilities prim>ily s]v+ l[-income      
populations & *ildr5 :o h n atta9$ ! age
 ( #e ye>s4  7,d7 ,am\nt limit ,! am\nt 
( a grant "u ?is p>agraph may n exce$   
#aj1jjj1jjj4  7#c7 ,report ,n lat] ?an !
 end ( fiscal ye> #bjbg1 ! ,secret>y    
%all submit to ! ,congress a report on !
 effects ( ! grants provid$ "u ?is      
subsection1 & make ! report publically  
accessible4  7d7 ,labor /&>ds = all     
grants ,! ,secret>y %all require t ea*  
entity1 includ+ grantees & subgrantees1 
t applies = an infra/ructure grant =    
con/ruct+1 r5ovat+1 or improv+ *ild c>e 
facilities1 includ+ adapt+1 reconfigur+1
 or exp&+ su* facilities1 :i* is fund$ 9
 :ole or 9 "p "u ?is section1 %all      
include 9 its application writt5        
assurance t all labor]s & me*anics      
employ$ by contractors or subcontractors
 9 ! p]=mance ( con/ruction1 alt]nation 
or repair1 z "p ( su* project1 %all be  
paid wages at rates n less ?an ^?       
prevail+ on simil> "w 9 ! locality z    
det]m9$ by ! ,secret>y ( ,labor 9       

accordance ) sub*apt] ,,iv ( *apt] #ca (
 title #dj1 ,unit$ ,/ates ,code         
7commonly ref]r$ to z ! ,davis-,bacon   
,act71 & ) respect to ! labor /&>ds     
specifi$ 9 ?is subsection1 ! ,secret>y (
 ,labor %all h ! au?ority & functions   
set =? 9 ,reorganization ,plan ,numb]$  
#ad ( #aiej 7#ae ,f$4 ,reg4 #cagf2 #e   
,u4,s4,c4 ,app474  7e7 ,limitations on  
au?orization ( appropriations  7#a7 ,9  
g5]al ,to c>ry out ?is section1 !re is  
au?oriz$ to be appropriat$              
#aj1jjj1jjj1jjj = fiscal ye> #bjbc1 :i* 
%all rema9 available ?r\gh fiscal ye>   
#bjbg4  7#b7 ,res]vations ( funds  7,a7 
,indian tribes ,! ,secret>y %all res]ve 
#c p]c5t ( ! total am\nt made available 
to c>ry out ?is section1 = paym5ts to   
,indian tribes4  7,b7 ,t]ritories ,!    
,secret>y %all res]ve #c p]c5t ( ! total
 am\nt made available to c>ry out ?is   
section1 = paym5ts to t]ritories4  7#c7 
,grants = int]m$i>y organizations ,n    
less ?an #aj p]c5t & n m ?an #ae p]c5t (
 ! total am\nt made available to c>ry   

out ?is section may be us$ to c>ry out  
subsection 7c77#b74  7#d7 ,limitation on
 use ( funds = ne$s assessm5ts ,n m ?an 
#e1jjj1jjj ( ! am\nts made available to 
c>ry out ?is section may be us$ to c>ry 
out subsection 7b74  7f7 ,def9ition (   
,/ate ,9 ?is section1 ! t]m ,/ate has ! 
mean+ provid$ 9 section #dai1 except t x
 includes ! ,commonweal? ( ! ,nor!rn    
,m>iana ,isl&s & any ,indian tribe4  4  
7b7 ,exemption ( t]ritory grants f      
limitation on total paym5ts to !        
t]ritories ,section #aajh7;a77#b7 ( su* 
,act 7#db ,u4,s4,c4 #acjh7;a77#b77 is   
am5d$ by ins]t+ #dah;,a7c71 aft]        
#dac7;f714  #ejjb4 ,e>ly *ildhood       
educator loan assi/ance program ,"p ,q (
 title ,,iii ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bhj;h7 is am5d$ by 
add+ at ! end ! foll[+3  #cii,z-#c4     
,e>ly *ildhood educator loan assi/ance  
program  7a7 ,au?ority ,! ,secret>y may 
c>ry out a program ( ent]+ into         
contracts ) eligible e>ly *ildhood      
educators "u :i* su* educators agree to 

s]ve = a p]iod ( #e ye>s z e>ly *ildhood
 educators ) a qualifi$ employ]1 9      
consid]ation ( ! ,f$]al ,gov]nm5t agree+
 to repay1 = ea* ye> ( su* s]vice1 n m  
?an #f1jjj ( ! pr9cipal & int]e/ ( !    
educational loans ( su* educators4  7b7 
,rec]tification ,an eligible e>ly       
*ildhood educator seek+ to cont9ue to   
receive paym5ts "u ?is section %all     
submit on an annual basis to ! ,secret>y
 su* in=mation z ! ,secret>y may require
 to c]tify t ! educator is cont9u+ to   
meet ! crit]ia to be consid]$ an        
eligible educator4  7c7 ,maximum am\nt (
 loan ,! total am\nt ( paym5ts receiv$  
by an eligible e>ly *ildhood educator "u
 ?is section may n exce$ ! total am\nt (
 ! pr9cipal & int]e/ ( ! educational    
loans ( su* educator4  7d7              
,applicability ( c]ta9 provisions ,!    
foll[+ provisions ( ! ,national ,heal?  
,s]vice ,corps ,loan ,assi/ance ,program
 e/abli%$ 9 subp>t ,,iii ( "p ,d %all   
apply to ! program e/abli%$ "u ?is      
section 9 ! same mann] & to ! same ext5t

 z su* provisions apply to ! ,national  
,heal? ,s]vice ,corps ,loan ,assi/ance  
,program3 7#a7 ,p>agraphs 7#a7 ?r\gh    
7#c7 ( section #cch;,b7c7 7relat+ to    
application in=mation1 und]/&ability1 & 
availability74  7#b7 ,section           
#cch;,b7c77#d7 7relat+ to recruitm5t &  
ret5tion74  7#c7 ,section #cch;,b7d7    
7relat+ to factors consid]$ 9 provid+   
contracts74  7#d7 ,section #cch7;e7     
7relat+ to ! approval requir$ =         
p>ticipation74  7#e7 ,section #cch;,b7f7
 7relat+ to cont5ts ( contracts74  7#f7 
,section #cch;,b7g7 7relat+ to paym5ts1 
includ+ repaym5t s*$ule & tax           
liability74  7e7 ,report to ,congress ,n
 lat] ?an #e ye>s aft] ! date ( !       
enactm5t ( ?is section1 ! ,secret>y %all
 submit to ,congress a report on !      
implem5tation ( ?is section4  7f7       
,def9itions ,9 ?is section3 7#a7 ,! t]m 
eligible e>ly *ildhood educator means an
 individual t-- 7,a7 z ( ! date on :i* !
 agreem5t ref]r$ to 9 subsection 7a77#a7
 is ent]$ into-- 7i7 has out/&+ ,f$]al  

direct loans obta9$ = purposes ( pursu+ 
an associate's degree1 a #d-ye>         
ba*elor's degree1 a graduate degree1 or 
a comb9$ ba*elor & ma/]'s degree1 9 e>ly
 *ildhood education or a relat$ field f 
an accr$it$ in/itution 7includ+ any su* 
loan = :i* ! individual is enroll$ 9 an 
income-bas$ repaym5t plan72 &  7ii7 is 9
 good /&+ ) respect to ! loans ref]r$ to
 9 clause 7i72 &  7,b7 agrees to-- 7i7  
s]ve z an e>ly *ildhood educator ) a    
qualifi$ employ] = a p]iod ( n less ?an 
#e ye>s2 &  7ii7 make timely paym5ts )  
respect to ! loans describ$ 9           
subp>agraph 7,a77i74  7#b7 ,! t]m       
qualifi$ employ] means a *ildc>e provid]
 t receives or is eligible to receive   
v\*]s or assi/ance "u ! ,*ild ,c>e &    
,developm5t ,block ,grant ,act ( #aiij4 
7g7 ,au?orization ( appropriations ,!re 
are au?oriz$ to be appropriat$ to c>ry  
out ?is section #be1jjj1jjj = ea* (     
fiscal ye>s #bjbc ?r\gh #bjbh4  4       
#ejjc4 ,grants = e>ly *ildhood educators
  7a7 ,9 g5]al ,beg9n+ n lat] ?an #ahj  

days aft] ! date ( ! enactm5t ( ?is     
,act1 ! ,secret>y ( ,education 7ref]r$  
to 9 ?is section z ! ,secret>y7 %all    
c>ry out a program "u :i* ! ,secret>y   
makes paym5ts to in/itutions ( high]    
education ) a qualifi$ e>ly *ildhood    
educator program to enable su*          
in/itutions to make grants1 on a        
competitive basis1 to eligible          
individuals :o file an application &    
agreem5t 9 accordance ) subsections 7b7 
& 7c74  7b7 ,applications  7#a7 ,9 g5]al
 ,! ,secret>y %all p]iodically set dates
 by :i* eligible individuals %all file  
applications = a grant "u ?is section4  
,ea* eligible individual desir+ a grant 
"u ?is section %all file an application 
conta9+ su* in=mation & assurances z !  
,secret>y may det]m9e necess>y to enable
 ! ,secret>y to c>ry out ! functions &  
responsibilities ( ?is section4  7#b7   
,r5ewal ,a grant aw>d$ "u ?is section   
may be r5ew$ = additional "o-ye> p]iods 
if-- 7,a7 ! recipi5t submits a r5ewal   
application conta9+ su* in=mation &     

assurances z ! ,secret>y may det]m9e    
necess>y2 &  7,b7 ! grant is r5ew$ n m  
?an ?ree times1 = a total ( n m ?an f\r 
academic ye>s = ea* eligible recipi5t4  
7c7 ,s]vice obligation  7#a7 ,agreem5ts 
to s]ve ,ea* application "u subsection  
7b7 %all include1 or be accompani$ by-- 
7,a7 an agreem5t by ! applicant t-- 7i7 
9 ! ev5t t ! applicant receives a grant 
"u ?is section1 ! applicant %all-- 7,i7 
s]ve z a full-"t or "p-"t educator 9 a  
lic5s$ e>ly le>n+ program = a total ( n 
less ?an "o academic ye>1 & f\r         
additional mon?s = ea* subsequ5t grant  
r5ewal1 )9 two ye>s aft] ! date on :i* !
 p]iod ( "t cov]$ by ! grant is         
complet$2 &  7,,ii7 submit a            
c]tification ( employm5t by ! employ+   
e>ly le>n+ program 9 su* =m z !         
,secret>y may det]m9e necess>y2 &  7ii7 
9 ! ev5t t ! applicant is det]m9$ to h  
fail$ or refus$ to c>ry out su* s]vice  
obligation1 ! sum ( ! am\nts ( any      
grants receiv$ by su* applicant "u ?is  
section w be treat$ z a loan & collect$ 

f ! applicant 9 accordance ) p>agraph   
7#c7 & ! regulations !reund]2 &  7,b7 a 
pla9-language disclosure =m develop$ by 
! ,secret>y t cle>ly describes ! nature 
( ! grant aw>d1 ! s]vice obligation1 & !
 loan repaym5t requirem5ts t are !      
consequ5ce ( ! failure to complete !    
s]vice obligation4  7#b7 ,treatm5t (    
concurr5t s]vice ,an individual :o s]ves
 z a full or "p-"t educator 9 a lic5s$  
e>ly *ildhood education program         
concurr5tly :ile enroll$ 9 a qualifi$   
e>ly *ildhood educator program may c\nt 
su* s]vice t[>d ! fulfillm5t ( ! s]vice 
obligation 9 ! agreem5t "u p>agraph     
7#a74  7#c7 ,repaym5t = failure to      
complete s]vice ,except z provid$ 9     
p>agraph 7#d71 9 ! ev5t t any recipi5t (
 a grant "u ?is section fails or refuses
 to comply ) ! s]vice obligation 9 !    
agreem5t "u p>agraph 7#a71 ! sum ( !    
am\nts ( any grants receiv$ by su*      
recipi5t %all1 ^u a det]m9ation ( su* a 
failure or refusal 9 su* s]vice         
obligation1 be treat$ z a ,f$]al ,direct

 ,unsubsidiz$ ,/af=d ,loan "u "p ,d (   
title ,,iv ( ! ,high] ,education ,act ( 
#aife 7#bj ,u4,s4,c4 #ajhg;a et seq47   
except t-- 7,a7 no int]e/ %all accrue on
 su* am\nts2 &  7,b7 su* am\nts %all be 
subject to repaym5t 9 accordance )-- 7i7
 an income-cont+5t or income-bas$       
repaym5t plan1 if ! individual meets !  
eligibility requirem5ts = su* a repaym5t
 plan2 &  7ii7 su* o!r t]ms & conditions
 z are specifi$ by ! ,secret>y 9        
regulations promulgat$ "u ?is section4  
7#d7 ,h>d%ip ext5sion ,9 ! case ( a     
recipi5t :o has made a good fai? ef=t to
 f9d employm5t 9 a lic5s$ e>ly le>n+    
program & has be5 unable to acquire su* 
employm5t1 ! ,secret>y is au?oriz$ to   
provide a h>d%ip ext5sion = a p]iod ( n 
m ?an "o ye> to grant recipi5ts :o fail 
to complete _! s]vice requirem5t )9 a   
#b-ye> p]iod4  7d7 ,grant am\nt ,an     
eligible individual select$ to receive a
 grant or a grant r5ewal "u ?is section 
%all receive a grant 9 an am\nt n to    
exce$ #c1jjj = ea* academic ye> dur+ :i*

 ! individual is enroll$ on a full-"t or
 "p-"t basis 9 ! qualifi$ e>ly *ildhood 
educator program = :i* ! grant 0 aw>d$4 
7e7 ,grant disbursem5t ,paym5ts "u ?is  
section %all be made 9 accordance )     
regulations promulgat$ by ! ,secret>y = 
su* purpose & 9 su* mann] z w be/       
accompli% ! purposes ( ?is section1     
provid$-- 7#a7 any disbursem5t made by  
cr$it+ a grant recipi5t's acc\nt %all be
 limit$ to tuition & fees & o!r mat]ials
 necess>y = ! completion ( c\rsework z  
det]m9$ by ! ,secret>y2 &  7#b7 n less  
?an #he p]c5t ( any funds provid$ to an 
eligible in/itution "u subsection 7a7   
%all be advanc$ to ! eligible in/itution
 prior to ! />t ( ea* paym5t p]iod &    
%all be bas$ ^u an am\nt reque/$ by !   
in/itution z ne$$ to cov] ! total co/ ( 
grants aw>d$ to eligible recipi5ts until
 su* "t z ! ,secret>y det]m9es &        
publi%es 9 ! ,f$]al ,regi/] ) an        
opportunity = comm5t1 an alt]native     
paym5t sy/em t provides paym5ts to      
in/itutions 9 an accurate & timely      

mann]1 except t ?is s5t5ce %all n be    
con/ru$ to limit ! au?ority ( !         
,secret>y to place an in/itution on a   
reimbursem5t sy/em ( paym5t4  7f7       
,direct paym5t ,no?+ 9 ?is section %all 
be con/ru$ to prohibit ! ,secret>y f    
mak+ a grant directly to an eligible    
individual 9 a case 9 :i* an in/itution 
( high] education ) a qualifi$ e>ly     
*ildhood educator program does n        
p>ticipate 9 ! program "u subsection    
7a74  7g7 ,def9itions ,9 ?is section3   
7#a7 ,eligible individual ,! t]m        
eligible individual means an individual 
:o is enroll$ on a full-"t or "p-"t     
basis 9 a qualifi$ e>ly *ildhood        
educator program4  7#b7 ,in/itution (   
high] education ,! t]m in/itution (     
high] education has ! mean+ giv5 t t]m 9
 section #ajb ( ! ,high] ,education ,act
 ( #aife 7#bj ,u4,s4,c4 #ajjb74  7#c7   
,qualifi$ e>ly *ildhood educator program
 ,! t]m qualifi$ e>ly *ildhood educator 
program means a c\rse ( /udy lead+ to an
 associate's degree or a c]tificate 9   

e>ly *ildhood education or a relat$     
field f an in/itution ( high] education4
  7#d7 ,lic5s$ e>ly le>n+ program ,! t]m
 lic5s$ e>ly le>n+ program means any    
,/ate-lic5s$ or ,/ate-regulat$ program  
or provid]1 reg>dless ( sett+ or fund+  
s\rce1 t provides e>ly c>e & education =
 *ildr5 f bir? to k9d]g>t5 entry1       
includ+1 b n limit$ to1 programs op]at$ 
by *ild c>e c5t]s & 9 family *ild c>e   
homes4  7h7 ,au?orization (             
appropriations  7#a7 ,9 g5]al ,!re are  
au?oriz$ to be appropriat$ to c>ry out  
?is section #aj1jjj1jjj = ea* ( fiscal  
ye>s #bjbc ?r\gh #bjbg4  7#b7           
,limitation ,( ! am\nt made available "u
 p>agraph 7#a7 9 any fiscal ye>1 n m ?an
 #c p]c5t may be us$ = evaluation1      
monitor+1 sal>ies1 & adm9i/rative       
exp5ses4  #ejjd4 ,,ccampis              
,reau?orization ,section #dai,n ( !     
,high] ,education ,act ( #aife 7#bj     
,u4,s4,c4 #ajgj;e7 is am5d$-- 7#a7 9    
subsection 7b7-- 7,a7 9 p>agraph 7#b7-- 
7i7 9 subp>agraph 7,a7-- 7,i7 by /rik+  

,! am\nt & ins]t+ ,except z provid$ 9   
subp>agraph 7,c71 ! am\nt2 &  7,,ii7 by 
/rik+ #a p]c5t & ins]t+ #b p]c5t2  7ii7 
9 subp>agraph 7,b77ii71 by /rik+        
subsection 7g7 & ins]t+ subsection 7h72 
&  7iii7 by add+ at ! end ! foll[+3     
7,c7 ,p]=mance bonus  7i7 ,9 g5]al      
,not)/&+ subp>agraph 7,a71 = any fiscal 
ye> = :i* ! am\nt appropriat$ "u        
subsection 7h7 is n less ?an            
#adj1jjj1jjj1 ! ,secret>y may pay a     
p]=mance bonus to an eligible in/itution
 ( high] education4  7ii7 ,maximum am\nt
 ,a bonus paid to an eligible in/itution
 ( high] education "u clause 7i7 = a    
fiscal ye> %all n exce$ an am\nt equal  
to #bj p]c5t ( ! am\nt ( ! annual grant 
paym5t receiv$ by ! in/itution "u       
p>agraph 7#c77;,b7 = ! fiscal ye> prec$+
 ! fiscal ye> = :i* ! bonus is paid4    
7iii7 ,use ( bonus ,a bonus receiv$ by  
an in/itution "u clause 7i7 %all be us$ 
by ! in/itution 9 ! same mann] z a grant
 "u ?is section & %all be treat$ z grant
 funds = purposes ( ! application (     

p>agraph 7#e71 except t ! ,secret>y may 
ext5d ! grant p]iod z necess>y = !      
in/itution to use su* bonus4  7iv7      
,eligible in/itution ( high] education  
,9 ?is subp>agraph1 ! t]m eligible      
in/itution ( high] education means an   
in/itution ( high] education t-- 7,i7   
has receiv$ a grant "u ?is section = n  
less ?an ! p]iod ( ?ree consecutive     
fiscal ye>s prec$+ ! fiscal ye> 9 :i* ! 
bonus is paid "u clause 7i72  7,,ii7 =  
ea* su* prec$+ fiscal ye>1 has met or   
exce$$ ! p]=mance levels e/abli%$ by !  
in/itution = su* ye> "u subsection      
7e77#a77;,b77v72 &  7,,iii7 has         
demon/rat$ ! ne$ = su* bonus4  2 &  7,b7
 9 p>agraph 7#c7-- 7i7 9 subp>agraph    
7,a71 by /rik+ #d ye>s & ins]t+ #e ye>s2
 &  7ii7 9 subp>agraph 7,b71 by /rik+   
subsection 7e77#b7 & ins]t+ subsection  
7e77#c72  7#b7 by am5d+ subsection 7c7  
to read z foll[s3  7c7 ,applications    
7#a7 ,9 g5]al ,an in/itution ( high]    
education desir+ a grant "u ?is section 
%all submit an application to !         

,secret>y at su* "t1 9 su* mann]1 &     
accompani$ by su* in=mation z !         
,secret>y may require4 ,su* application 
%all-- 7,a7 demon/rate t ! in/itution is
 an eligible in/itution describ$ 9      
subsection 7b77#d72  7,b7 specify !     
am\nt ( funds reque/$2  7,c7 demon/rate 
! ne$ ( l[-income /ud5ts at ! in/itution
 = campus-bas$ *ild c>e s]vices by      
includ+ 9 ! application-- 7i7 in=mation 
reg>d+ /ud5t demographics1 includ+ :e!r 
! /ud5t is a full-"t or "p-"t /ud5t2    
7ii7 an assessm5t ( *ild c>e capacity on
 or ne> campus2  7iii7 in=mation reg>d+ 
! wait+ li/s = *ild c>e s]vices on or   
ne> campus2  7iv7 in=mation reg>d+      
additional ne$s creat$ by conc5trations 
( pov]ty or by geographic isolation2    
7v7 in=mation ab\t ! numb] ( l[-income  
/ud5t p>5ts be+ s]v$ ?r\gh campus-bas$  
*ild c>e s]vices2 &  7vi7 o!r relevant  
data2  7,d7 specify ! e/imat$ p]c5tage (
 ! in/itution's grant t w be us$        
directly to subsidize ! fee *>g$ =      
on-campus & (f-campus *ildc>e1          

respectively1 = l[-income /ud5ts2  7,e7 
conta9 a description ( ! activities to  
be assi/$1 includ+ :e!r ! grant funds w 
support an exi/+ *ild c>e program or a  
new *ild c>e program2  7,f7 id5tify !   
res\rces1 includ+ te*nical exp]tise &   
f9ancial support1 t ! in/itution w draw 
^u to support ! *ild c>e program & !    
p>ticipation ( l[-income /ud5ts 9 !     
program 7su* z access+ social s]vices   
fund+1 us+ /ud5t activity fees to help  
pay ! co/s ( *ild c>e1 us+ res\rces     
obta9$ by meet+ ! ne$s ( p>5ts :o are n 
l[-income /ud5ts1 & access+ f\ndation1  
corporate1 or o!r in/itutional support7 
& demon/rate t ! use ( ! res\rces w n   
result 9 increases 9 /ud5t tuition2     
7,g7 conta9 an assurance t ! in/itution 
w meet ! *ild c>e ne$s ( l[-income      
/ud5ts ?r\gh ! provision ( s]vices1 or  
?r\gh a contract = ! provision (        
s]vices2  7,h7 describe ! ext5t to :i* !
 *ild c>e program w coord9ate ) !       
in/itution's e>ly *ildhood education    
curriculum1 to ! ext5t ! curriculum is  

available1 to meet ! ne$s ( ! /ud5ts 9 !
 e>ly *ildhood education program at !   
in/itution1 & ! ne$s ( ! p>5ts & *ildr5 
p>ticipat+ 9 ! *ild c>e program assi/$  
"u ?is section2  7,i7 9 ! case ( an     
in/itution seek+ assi/ance = a new *ild 
c>e program-- 7i7 provide a timel9e1    
cov]+ ! p]iod f receipt ( ! grant ?r\gh 
! provision ( ! *ild c>e s]vices1       
del9eat+ ! specific /eps ! in/itution w 
take to a*ieve ! goal ( provid+         
l[-income /ud5ts ) *ild c>e s]vices2    
7ii7 specify any measures ! in/itution w
 take to assi/ l[-income /ud5ts ) *ild  
c>e dur+ ! p]iod be=e ! in/itution      
provides *ild c>e s]vices2 &  7iii7     
include a plan = id5tify+ res\rces ne$$ 
= ! *ild c>e s]vices1 includ+ space 9   
:i* to provide *ild c>e s]vices1 &      
te*nical assi/ance if necess>y2  7,j7   
conta9 an assurance t any *ild c>e      
facility assi/$ "u ?is section w meet ! 
applicable ,/ate & local gov]nm5t       
lic5s+1 c]tification1 approval1 or      
regi/ration requirem5ts2  7,k7 9 ! case 

( an in/itution t is aw>d$ a grant "u   
?is section aft] ! date ( ! enactm5t ( !
 ,,pro-,,life ,act ( #bjbb1 provide an  
assurance t1 n lat] ?an ?ree ye>s aft] !
 date on :i* su* grant is aw>d$1 any    
*ild c>e facility assi/$ ) su* grant w--
 7i7 meet ,head ,/>t p]=mance /&>ds "u  
sub*apt] ,b ( *apt] #ac ( title #de1    
,code ( ,f$]al ,regulations 7z 9 effect 
on ! date ( enactm5t ( ! ,,pro-,,life   
,act ( #bjbb7 & any successor           
regulations2  7ii7 be 9 ! top ti] ( !   
quality rat+ improvem5t sy/em = su*     
facilities us$ by ! ,/ate 9 :i* !       
facility is locat$2  7iii7 meet ! lic5s+
 requirem5ts ( ! ,/ate 9 :i* ! facility 
is locat$ & ! quality requirem5ts "u !  
,*ild ,c>e & ,developm5t ,block ,grant  
,act ( #aiij 7#db ,u4,s4,c4 #iheh et    
seq472 or  7iv7 be accr$it$ by a        
national e>ly *ildhood accr$it+ body )  
demon/rat$ valid & reliable program     
quality /&>ds2  7,l7 conta9 an assurance
 t ! in/itution1 :5 applicable1 w make  
in=mation available to /ud5ts receiv+   

*ild c>e s]vices provid$ "u ?is section 
ab\t ! eligibility ( su* /ud5ts & _!    
dep5d5ts = assi/ance "u ! supplem5tal   
nutrition assi/ance program "u ! ,food &
 ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4  
#bjaa et seq471 ! special supplem5tal   
nutrition program = wom51 infants1 &    
*ildr5 "u ! ,*ild ,nutrition ,act (     
#aiff 7#db ,u4,s4,c4 #aghf71 & ! program
 ( block grants = ,/ates = tempor>y     
assi/ance = ne$y families e/abli%$ "u "p
 ,a ( title ,,iv ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #fja et seq472 &    
7,m7 conta9 an ab/ract summ>iz+ !       
cont5ts ( su* application & h[ !        
in/itution int5ds to a*ieve ! purpose "u
 subsection 7a74  7#b7 ,te*nical        
assi/ance ,! ,secret>y may provide      
te*nical assi/ance to eligible          
in/itutions to help su* in/itutions     
qualify1 apply =1 & ma9ta9 a grant "u   
?is section4  2  7#c7 9 subsection 7d7--
 7,a7 9 ! matt] prec$+ p>agraph 7#a71 by
 /rik+ to in/itutions ( high] education 
t submit applications describ+ programs 

t2  7,b7 by am5d+ p>agraph 7#a7 to read 
z foll[s3  7#a7 bas$ on ! ext5t to :i*  
in/itutions ( high] education t submit  
applications = su* a grant lev]age local
 or in/itutional res\rces1 includ+ 9-k9d
 contributions1 to support ! activities 
assi/$ "u ?is section2  2  7,c7 by      
r$esignat+ p>agraph 7#b7 z p>agraph     
7#c72  7,d7 by ins]t+ aft] p>agraph     
7#a71 ! foll[+3  7#b7 to in/itutions (  
high] education t1 comp>$ to o!r        
in/itutions ( high] education t submit  
applications = su* a grant1 demon/rate a
 high likelihood ( ne$ = campus-bas$    
*ild c>e bas$ on /ud5t demographics 7su*
 z a high proportion ( l[-income /ud5ts 
or indep5d5t /ud5ts72 &  2 &  7,e7 9    
p>agraph 7#c7 7z r$esignat$ by          
subp>agraph 7,c771 by ins]t+ to         
in/itutions ( high] education t submit  
applications describ+ programs t be=e   
utilize2 &  7#d7 9 subsection 7e7-- 7,a7
 9 p>agraph 7#a77;,b7-- 7i7 by          
r$esignat+ clauses 7ii71 7iii71 & 7iv7 z
 clauses 7vi71 7vii71 & 7viii71         

respectively2 &  7ii7 by /rik+ !        
semicolon at ! end ( clause 7i7 & ins]t+
 ! foll[+3 1 :i* %all include-- 7,i7 !  
numb] ( full- & "p-"t /ud5ts1           
respectively1 receiv+ *ild c>e s]vices  
"u ?is section at lea/ once p] week dur+
 ! academic ye>2  7,,ii7 ! numb] (      
cr$its accumulat$ by /ud5ts receiv+ su* 
*ild c>e s]vices2 &  7,,iii7 ! numb] (  
/ud5ts receiv+ *ild c>e s]vices "u ?is  
section at lea/ once p] week dur+ !     
academic ye> :o-- 7aa7 rema9 enroll$ at 
! in/itution dur+ ! academic ye> = :i*  
!y receiv$ su* s]vices2  7bb7 enroll at 
! in/itution = ! foll[+ academic ye>2 & 
7cc7 graduate or transf] )9-- 7,,aa7    
#aej p]c5t ( ! normal "t = completion ( 
a /ud5t's f\r-ye> degree grant+ program2
 or 7,,bb7 #bjj p]c5t ( ! normal "t =   
completion ( a /ud5t's two-ye>          
degree-grant+ program2  7ii7 ) respect  
to ! total /ud5t enrollm5t at !         
in/itution & ! total enrollm5t (        
l[-income /ud5ts at ! in/itution1       
respectively-- 7,i7 ! rate at :i* /ud5ts

 :o complete an academic ye> at !       
in/itution re-enroll 9 ! in/itution = ! 
foll[+ academic ye>2 &  7,,ii7 !        
p]c5tage ( /ud5ts graduat+ or transf]r+ 
)9-- 7aa7 #aej p]c5t ( ! normal "t =    
completion ( a /ud5t's f\r-ye> degree   
grant+ program2 or  7bb7 #bjj p]c5t ( ! 
normal "t = completion ( a /ud5t's      
two-ye> degree grant+ program2  7iii7 ! 
p]c5tage ( ! in/itution's grant t 0 us$ 
directly to subsidize ! fee *>g$ =      
on-campus & (f-campus *ildc>e1          
respectively1 = l[-income /ud5ts2  7iv7 
:e!r ! in/itution re/ricts eligibility =
 *ild c>e s]vices to only full-"t       
/ud5ts2  7v7 ! suffici5tly ambiti\s     
levels ( p]=mance e/abli%$ = su* ye> by 
! in/itution t demon/rate mean+ful      
progress & all[ = mean+ful evaluation ( 
program quality bas$ on ! in=mation 9   
clauses 7i77,,iii7 & 7iii72  2  7,b7 by 
r$esignat+ p>agraph 7#b7 z p>agraph     
7#c72  7,c7 by ins]t+ aft] p>agraph 7#a7
 ! foll[+3  7#b7 ,report  7,a7 ,report  
requir$ ,on an annual basis1 ! ,secret>y

 %all submit to ! au?oriz+ committees a 
report t includes-- 7i7 a summ>y ( !    
in=mation describ$ 9 p>agraph 7#a72 &   
7ii7 ea* ab/ract submitt$ "u subsection 
7c77#a77,m7 by an in/itution ( high]    
education t receives a grant "u ?is     
section4  7,b7 ,public availability ,!  
,secret>y %all make ea* report submitt$ 
"u subp>agraph 7,a7 publicly available4 
2  7,d7 9 p>agraph 7#c71 z s r$esignat$1
 by ins]t+ 7o!r ?an ! in=mation provid$ 
"u subp>agraph 7,b77v7 ( su* p>agraph7  
aft] p>agraph 7#a72 &  7,e7 by add+ at !
 end ! foll[+3  7#d7 ,te*nical assi/ance
 ,! ,secret>y %all provide te*nical     
assi/ance to in/itutions ( high]        
education receiv+ grants "u ?is section 
to help su* in/itutions meet ! report+  
requirem5ts "u ?is subsection4  2  7#e7 
by r$esignat+ subsection 7g7 z          
subsection 7h72  7#f7 by ins]t+ aft]    
subsection 7f7 ! foll[+3  7g7           
,nondiscrim9ation ,no p]son 9 ! ,unit$  
,/ates %all1 on ! basis ( actual or     
p]ceiv$ race1 color1 religion1 national 

orig91 sex 7includ+ sexual ori5tation1  
g5d] id5tity1 pregnancy1 *ildbir?1 a    
m$ical condition relat$ to pregnancy or 
*ildbir?1 & sex /]eotype71 or           
disability1 be exclud$ f p>ticipation 91
 be d5i$ ! b5efits (1 or be subject$ to 
discrim9ation by any program fund$1 9   
:ole or 9 "p1 ) funds made available "u 
?is section or ) am\nts appropriat$ =   
grants1 contracts1 or c]tificates       
adm9i/]$ ) su* funds4  2 &  7#g7 9      
subsection 7h71 z s r$esignat$1 by /rik+
 su* sums z may be necess>y = fiscal ye>
 #bjji & ins]t+ #bjj1jjj1jjj = fiscal   
ye> #bjbc4  #ejje4 ,evaluation (        
applications = assi/ance "u ,*oice      
,neighborhoods ,initiative ,9 provid+   
assi/ance = fiscal ye> #bjbc & any      
fiscal ye> !reaft] "u ! ,*oice          
,neighborhoods ,initiative ( ! ,secret>y
 ( ,h\s+ & ,urban ,developm5t 7pursuant 
to section #bd ( ! ,unit$ ,/ates ,h\s+  
,act ( #aicg 7#db ,u4,s4,c4 #adcgv771 ! 
,secret>y %all consid] e>ly c>e & le>n+ 
facilities = *ildr5 z a neighborhood    

asset = purposes ( evaluat+ applications
 = plann+ & implem5tation grants1 %all  
ensure t any metric = evaluat+ su*      
applications gives cr$it = ! provision (
 e>ly c>e & le>n+ facilities "u a       
neighborhood plan1 & %all include e>ly  
c>e & le>n+ facilities z su* an asset 9 
any ,notice ( ,fund+ ,availability = any
 su* fiscal ye>4  ,,vi ,honor+          
,family-,fri5dly ,workplaces  #fjja4    
,def9itions ,9 ?is title3 7#a7          
,employee2 employ] ,! t]ms employee &   
employ] h ! mean+s giv5 su* t]ms 9      
section #c ( ! ,fair ,labor ,/&>ds ,act 
( #aich 7#bi ,u4,s4,c4 #bjc74  7#b7     
,secret>y ,! t]m ,secret>y means !      
,secret>y ( ,labor4  7#c7 ,s]i\s heal?  
condition ,! t]m s]i\s heal? condition  
has ! mean+ giv5 su* t]m 9 section #aja 
( ! ,family & ,m$ical ,leave ,act (     
#aiic 7#bi ,u4,s4,c4 #bfaa74  #fjjb4    
,c]tification program e/abli%$  7a7 ,9  
g5]al ,! ,secret>y %all e/abli% a       
national c]tification program to aw>d   
c]tifications to recognize employ]s t h 

a commitm5t to help+ employees balance  
employm5t responsibilities & family     
obligations 7ref]r$ to 9 ?is section z  
family-fri5dly c]tifications74  7b7     
,crit]ia = c]tification ,9 ord] to be   
eligible to receive a family-fri5dly    
c]tification1 an employ] %all c>ry out  
ea* ( ! foll[+ family-fri5dly employm5t 
policies & b5efits3 7#a7 ,assi/ance pay+
 =1 or ref]r+ employees to1 f]tility or 
adoption s]vices4  7#b7 ,paid family    
leave ( n less ?an #ab weeks p] ye>1    
includ+ ! option to use leave = any ( ! 
foll[+ reasons3 7,a7 ,! bir? ( a *ild ( 
! employee & 9 ord] to c>e = su* *ild4  
7,b7 ,! placem5t ( a *ild ) ! employee =
 adoption or fo/] c>e4  7,c7 ,to address
 ! s]i\s heal? condition1 includ+       
pregnancy1 *ildbir?1 or pregnancy loss1 
( ! employee4  7,d7 ,to address ! s]i\s 
heal? condition ( a family memb]4  7,e7 
,= specific milit>y c>egiv+ & leave4    
7#c7 ,paid sick days = employees t are  
sep>ate f "t accru$ z "p ( a paid "t (f 
policy4  7#d7 ,a subsidy = *ild c>e or  

policies t all[ p>5ts to "w alongside _!
 infants 9 safe sett+s4  7#e7 ,policies 
t all[ = flexible h\rs once a p>5t      
returns to "w aft] a bir?1 adoption1 or 
fo/] c>e placem5t4  7#f7 ,if feasible1  
policies t all[ employees to "w remotely
 z ne$$ = reasons relat$ to ! c>e ( a   
*ild4  7#g7 ,lactation support1 su* z   
reimbursem5t ( express$ brea/milk       
deliv]y :ile on travel1 access to pumps1
 kits1 & o!r lactation supplies &       
am5ities1 & access to lactation         
consultants & support4  7c7 ,application
 ,an employ] :o desires to receive a    
family-fri5dly c]tification f !         
,secret>y "u ?is section %all submit an 
application to ! ,secret>y at su* "t1   
conta9+ su* in=mation1 & 9 su* mann] z !
 ,secret>y may require4  7d7 ,aw>d (    
c]tification ,! ,secret>y %all review   
applications submitt$ "u subsection 7c7 
& aw>d a family-fri5dly c]tification to 
an employ] ^: application demon/rates t 
! employ] has met ! requirem5ts e/abli%$
 "u subsection 7b7 reg>d+ family-fri5dly

 policies & b5efits4  ,,vii ,mo!rs &    
,(fspr+ ,mortality & ,morbidity ,aw>5ess
  #gjja4 ,improv+ ,f$]al ef=ts ) respect
 to prev5tion ( mat]nal mortality  7a7  
,te*nical assi/ance = ,/ates ) respect  
to report+ mat]nal mortality ,n lat] ?an
 "o ye> aft] ! date ( enactm5t ( ?is    
,act1 ! ,director ( ! ,c5t]s = ,disease 
,control & ,prev5tion 7ref]r$ to 9 ?is  
section z ! ,director71 9 consultation )
 ! ,adm9i/rator ( ! ,heal? ,res\rces &  
,s]vices ,adm9i/ration1 %all provide    
te*nical assi/ance to ,/ates t elect to 
report compreh5sive data on mat]nal     
mortality & factors relat+ to su*       
mortality 7includ+ oral & m5tal heal?71 
intimate p>tn] viol5ce1 & brea/fe$+     
heal? in=mation1 = ! purpose ( enc\rag+ 
uni=mity 9 ! report+ ( su* data & to    
enc\rage ! %>+ ( su* data among !       
respective ,/ates4  7b7 ,be/ practices  
relat+ to prev5tion ( mat]nal mortality 
7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! 
date ( enactm5t ( ?is ,act-- 7,a7 !     
,director1 9 consultation ) relevant    

pati5t & provid] gr\ps1 %all issue be/  
practices to ,/ate mat]nal mortality    
review committees on h[ be/ to id5tify &
 review mat]nal mortality cases1 tak+   
into acc\nt any data made available by  
,/ates relat+ to mat]nal mortality1     
includ+ data on oral1 m5tal1 & brea/fe$+
 heal?1 & utilization ( any em]g5cy     
s]vices2 &  7,b7 ! ,director1 work+ 9   
collaboration ) ! ,heal? ,res\rces &    
,s]vices ,adm9i/ration1 %all issue be/  
practices to hospitals1 ,/ate           
pr(essional society gr\ps1 & p]9atal    
quality collaboratives on h[ be/ to     
prev5t mat]nal mortality4  7#b7         
,au?orization ( appropriations ,=       
purposes ( c>ry+ out ?is subsection1 !re
 is au?oriz$ to be appropriat$          
#e1jjj1jjj = ea* ( fiscal ye>s #bjbc    
?r\gh #bjbg4  7c7 ,alliance =           
,innovation on ,mat]nal ,heal? ,grant   
,program  7#a7 ,9 g5]al ,n lat] ?an "o  
ye> aft] ! date ( enactm5t ( ?is ,act1 !
 ,secret>y ( ,heal? & ,human ,s]vices   
7ref]r$ to 9 ?is subsection z !         

,secret>y71 act+ ?r\gh ! ,associate     
,adm9i/rator ( ! ,mat]nal & ,*ild ,heal?
 ,bureau ( ! ,heal? ,res\rces & ,s]vices
 ,adm9i/ration1 %all e/abli% a grant    
program to be kn[n z ! ,alliance =      
,innovation on ,mat]nal ,heal? ,grant   
,program 7ref]r$ to 9 ?is subsection z  
,,aim7 "u :i* ! ,secret>y %all aw>d     
grants to eligible entities = ! purpose 
(-- 7,a7 direct+ widespread adoption &  
implem5tation ( mat]nal safety bundles  
?r\gh collaborative ,/ate-bas$ teams2 & 
7,b7 collect+ & analyz+ process1        
/ructure1 & outcome data to drive       
cont9u\s improvem5t 9 ! implem5tation ( 
su* safety bundles by su* ,/ate-bas$    
teams ) ! ultimate goal ( elim9at+      
prev5table mat]nal mortality & sev]e    
mat]nal morbidity 9 ! ,unit$ ,/ates4    
7#b7 ,eligible entities ,9 ord] to be   
eligible = a grant "u p>agraph 7#a71 an 
entity %all-- 7,a7 submit to ! ,secret>y
 an application at su* "t1 9 su* mann]1 
& conta9+ su* in=mation z ! ,secret>y   
may require2 &  7,b7 demon/rate 9 su*   

application t ! entity is an            
int]discipl9>y1 multi-/akehold]1        
national organization ) a national      
data-driv5 mat]nal safety & quality     
improvem5t initiative bas$ on           
implem5tation approa*es t h be5 prov5 to
 improve mat]nal safety & outcomes 9 !  
,unit$ ,/ates4  7#c7 ,use ( funds ,an   
eligible entity t receives a grant "u   
p>agraph 7#a7 %all use su* grant funds--
 7,a7 to develop & implem5t1 ?r\gh a    
robu/1 multi-/akehold] process1 mat]nal 
safety bundles to assi/ ,/ates1 p]9atal 
quality collaboratives1 & heal? c>e     
sy/ems 9 align+ national1 ,/ate1 &      
hospital-level quality improvem5t ef=ts 
to improve mat]nal heal? outcomes1      
specifically ! r$uction ( mat]nal       
mortality & sev]e mat]nal morbidity2    
7,b7 to ensure1 9 develop+ & implem5t+  
mat]nal safety bundles "u subp>agraph   
7,a71 t su* mat]nal safety bundles-- 7i7
 satisfy ! quality improvem5t ne$s ( a  
,/ate1 p]9atal quality collaborative1 or
 heal? c>e sy/em by factor+ 9 ! results 

& f9d+s ( relevant data reviews1 su* z  
reviews conduct$ by a ,/ate mat]nal     
mortality review committee2 &  7ii7     
address topics :i* may include-- 7,i7   
in=mation on evid5ce-bas$ practices to  
improve ! quality & safety ( mat]nal    
heal? c>e 9 hospitals & o!r heal? c>e   
sett+s ( a ,/ate or heal? c>e sy/em1    
includ+ by address+ topics commonly     
associat$ ) heal? complications or risks
 relat$ to pr5atal c>e1 labor c>e1      
bir?+1 & po/p>tum c>e2  7,,ii7 be/      
practices = improv+ mat]nal heal? c>e   
bas$ on data f9d+s & reviews conduct$ by
 a ,/ate mat]nal mortality review       
committee t address topics ( relevance  
to common complications or heal? risks  
relat$ to pr5atal c>e1 labor c>e1 bir?+1
 & po/p>tum c>e2  7,,iii7 in=mation on  
address+ det]m9ants ( heal? t impact    
mat]nal heal? outcomes = wom5 be=e1     
dur+1 & aft] pregnancy2  7,,iv7 ob/etric
 hemorrhage2  7,v7 ob/etric & po/p>tum  
c>e = wom5 ) sub/ance use disord]s1     
includ+ opioid use disord]2  7,,vi7     

mat]nal c>diovascul> sy/em2  7,,vii7    
mat]nal m5tal heal?2  7,,viii7 po/p>tum 
c>e basics = mat]nal safety2  7,,ix7    
r$uction ( p]ip>tum racial & e?nic      
disp>ities2  7,x7 r$uction ( prim>y     
caes>ean bir?2  7,,xi7 sev]e hyp]t5sion 
9 pregnancy2  7,,xii7 sev]e mat]nal     
morbidity reviews2  7,,xiii7 support    
aft] a sev]e mat]nal morbidity ev5t2    
7,,xiv7 ?romboembolism2  7,,xv7         
optimization ( support = brea/fe$+2     
7,,xvi7 mat]nal oral heal?2 &  7,,xvii7 
intimate p>tn] viol5ce2 &  7,c7 to      
provide ongo+ te*nical assi/ance at !   
national & ,/ate levels to support      
implem5tation ( mat]nal safety bundles  
"u subp>agraph 7,a74  7#d7 ,mat]nal     
safety bundle def9$ ,= purposes ( ?is   
subsection1 ! t]m mat]nal safety bundle 
means /&>diz$1 evid5ce-in=m$ processes =
 mat]nal heal? c>e4  7#e7 ,au?orization 
( appropriations ,= purposes ( c>ry+ out
 ?is subsection1 !re is au?oriz$ to be  
appropriat$ #aj1jjj1jjj = ea* ( fiscal  
ye>s #bjbc ?r\gh #bjbg4  7d7 ,fund+ =   

,/ate-,bas$ p]9atal quality             
collaboratives developm5t & su/a9ability
  7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] 
! date ( enactm5t ( ?is ,act1 !         
,secret>y ( ,heal? & ,human ,s]vices    
7ref]r$ to 9 ?is subsection z !         
,secret>y71 act+ ?r\gh ! ,division (    
,reproductive ,heal? ( ! ,c5t]s =       
,disease ,control & ,prev5tion1 %all    
e/abli% a grant program to be kn[n z !  
,/ate-,bas$ ,p]9atal ,quality           
,collaborative grant program "u :i* !   
,secret>y aw>ds grants to eligible      
entities = ! purpose ( developm5t &     
su/a9ability ( p]9atal quality          
collaboratives 9 e ,/ate1 ! ,di/rict (  
,columbia1 & eligible t]ritories1 9 ord]
 to measurably improve p]9atal c>e &    
p]9atal heal? outcomes = pregnant &     
po/p>tum wom5 & _! infants4  7#b7 ,grant
 am\nts ,grants aw>d$ "u ?is subsection 
%all be 9 am\nts n to exce$ #bej1jjj p] 
ye>1 = ! duration ( ! grant p]iod4  7#c7
 ,/ate-bas$ p]9atal quality             
collaborative def9$ ,= purposes ( ?is   

subsection1 ! t]m ,/ate-bas$ p]9atal    
quality collaborative means a network ( 
teams t-- 7,a7 is multidiscipl9>y 9     
nature & includes ! full range ( p]9atal
 & mat]nity c>e provid]s2  7,b7 works to
 improve measurable outcomes = mat]nal &
 infant heal? by advanc+ evid5ce-in=m$  
cl9ical practices us+ quality improvem5t
 pr9ciples2  7,c7 works ) hospital-bas$ 
or outpati5t facility-bas$ cl9ical      
teams1 exp]ts1 & /akehold]s1 includ+    
pati5ts & families1 to spread be/       
practices & optimize res\rces to improve
 p]9atal c>e & outcomes2  7,d7 employs  
/rategies t include ! use ( !           
collaborative le>n+ model to provide    
opportunities = hospitals & cl9ical     
teams to collaborate on improvem5t      
/rategies1 rapid-response data to       
provide timely fe$back to hospital & o!r
 cl9ical teams to track progress1 &     
quality improvem5t sci5ce to provide    
support & coa*+ to hospital & cl9ical   
teams2  7,e7 has ! goal ( improv+       
population-level outcomes 9 mat]nal &   

infant heal?2 &  7,f7 has ! goal (      
improv+ outcomes ( all bir?+ p1 ?r\gh ! 
coord9ation1 integration1 &             
collaboration across bir? sett+s4  7#d7 
,au?orization ( appropriations ,=       
purposes ( c>ry+ out ?is subsection1 !re
 is au?oriz$ to be appropriat$          
#ad1jjj1jjj p] ye> = ea* ( fiscal ye>s  
#bjbc ?r\gh #bjbg4  7e7 ,expansion (    
,m$icaid & ,,*ip cov]age = pregnant &   
po/p>tum wom5  7#a7 ,requir+ cov]age (  
oral heal? s]vices = pregnant & po/p>tum
 wom5  7,a7 ,m$icaid ,section #aije ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7 is am5d$-- 7i7 9 subsection    
7a77#d7-- 7,i7 by /rik+ 2 & 7,f7 &      
ins]t+ 2 7,f72 &  7,,ii7 by ins]t+ 2 &  
7,g7 oral heal? s]vices = pregnant &    
po/p>tum wom5 7z def9$ 9 subsection     
7jj77 aft] if o!rwise cov]$ "u ! ,/ate  
plan 7or waiv] ( su* plan72 &  7ii7 by  
add+ at ! end ! foll[+ new subsection3  
7jj7 ,oral heal? s]vices = pregnant &   
po/p>tum wom5  7#a7 ,9 g5]al ,= purposes
 ( ?is title1 ! t]m oral heal? s]vices =

 pregnant & po/p>tum wom5 means d5tal   
s]vices necess>y to prev5t disease &    
promote oral heal?1 re/ore oral         
/ructures to heal? & function1 & treat  
em]g5cy conditions t are furni%$ to a   
woman dur+ pregnancy 7or dur+ ! #a-ye>  
p]iod beg9n+ on ! la/ day ( !           
pregnancy74  7#b7 ,cov]age requirem5ts  
,to satisfy ! requirem5t to provide oral
 heal? s]vices = pregnant & po/p>tum    
wom51 a ,/ate %all1 at a m9imum1 provide
 cov]age = prev5tive1 diagno/ic1        
p]iodontal1 & re/orative c>e consi/5t ) 
recomm5dations = p]9atal oral heal? c>e 
& d5tal c>e dur+ pregnancy f ! ,am]ican 
,academy ( ,p$iatric ,d5ti/ry & !       
,am]ican ,college ( ,ob/etricians &     
,gynecologi/s4  4  7,b7 ,,*ip ,section  
#bajc7;c77#f77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acig;cc7c77#f77;,a77 is am5d$ by ins]t+
 or a t>get$ l[-income pregnant woman   
aft] t>get$ l[-income *ild4  7#b7       
,ext5d+ ,m$icaid cov]age = pregnant &   
po/p>tum wom5 ,section #aijb ( ! ,social

 ,security ,act 7#db ,u4,s4,c4 #acif;a7 
is am5d$-- 7,a7 9 subsection 7e7-- 7i7 9
 p>agraph 7#e7-- 7,i7 by ins]t+ 7includ+
 oral heal? s]vices = pregnant &        
po/p>tum wom5 7z def9$ 9 section        
#aije7;hh777 aft] po/p>tum m$ical       
assi/ance "u ! plan2 &  7,,ii7 by /rik+ 
#fj-;day & ins]t+ #a-ye>2 &  7ii7 9     
p>agraph 7#f71 by /rik+ #fj-;day &      
ins]t+ #a-ye>2 &  7,b7 9 subsection     
7l77#a77;,a71 by /rik+ #fj-;day & ins]t+
 #a-ye>4  7#c7 ,ext5d+ ,m$icaid cov]age 
= lawful resid5ts ,section              
#aijc7v77#d77;,a77i7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#acif;b7v77#d77;,a77i77 is am5d$ by     
/rik+ #fj-;day & ins]t+ #a-ye>4  7#d7   
,ext5d+ ,,*ip cov]age = pregnant &      
po/p>tum wom5 ,section                  
#baab7;d77#b77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acigll7d77#b77;,a77 is am5d$ to read z 
foll[s3  7,a7 dur+ pregnancy & ?r\gh !  
end ( ! mon? 9 :i* ! #a-ye> p]iod       
7includ+ 9 ! case t subp>agraph 7,a7 (  

section #aijb7;e77#af7 applies to !     
,/ate *ild heal? plan 7or waiv] ( su*   
plan71 pursuant to section              
#bajg7;e77#a771 beg9n+ on ! la/ day ( h]
 pregnancy ends2  4  7#e7 ,ma9t5ance (  
ef=t  7,a7 ,m$icaid ,section #aijb7l7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acif;a7l77 is am5d$ by add+ at ! end ! 
foll[+ new p>agraph3  7#e7 ,dur+ ! p]iod
 t beg9s on ! date ( enactm5t ( ?is     
p>agraph & ends on ! date t is five ye>s
 aft] su* date ( enactm5t1 z a condition
 = receiv+ any ,f$]al paym5ts "u section
 #aijc7;a7 = cal5d> qu>t]s occurr+ dur+ 
su* p]iod1 a ,/ate %all n h 9 effect1 ) 
respect to wom5 :o are eligible = m$ical
 assi/ance "u ! ,/ate plan or "u a waiv]
 ( su* plan on ! basis ( be+ pregnant or
 hav+ be5 pregnant1 eligibility /&>ds1  
me?odologies1 or proc$ures "u ! ,/ate   
plan or waiv] t are m re/rictive ?an !  
eligibility /&>ds1 me?odologies1 or     
proc$ures1 respectively1 "u su* plan or 
waiv] t are 9 effect on ! date (        
enactm5t ( ?is p>agraph4  4  7,b7 ,,*ip 

,section #baje7;d7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acig;ee7d77 is    
am5d$ by add+ at ! end ! foll[+ new     
p>agraph3  7#d7 ,9 eligibility /&>ds =  
t>get$ l[-income pregnant wom5 ,dur+ !  
p]iod t beg9s on ! date ( enactm5t ( ?is
 p>agraph & ends on ! date t is five    
ye>s aft] su* date ( enactm5t1 z a      
condition ( receiv+ paym5ts "u          
subsection 7a7 & section #aijc7;a71 a   
,/ate t elects to provide assi/ance to  
wom5 on ! basis ( be+ pregnant 7includ+ 
pregnancy-relat$ assi/ance provid$ to   
t>get$ l[-income pregnant wom5 7z def9$ 
9 section #baab7;d771 pregnancy-relat$  
assi/ance provid$ to wom5 :o are        
eligible = su* assi/ance ?r\gh          
application ( section                   
#aijb7v77#d77;,a77i7 "u section         
#bajg7;e77#a71 or any o!r assi/ance "u !
 ,/ate *ild heal? plan 7or a waiv] ( su*
 plan7 :i* is provid$ to wom5 on ! basis
 ( be+ pregnant7 %all n h 9 effect1 )   
respect to su* wom51 eligibility /&>ds1 
me?odologies1 or proc$ures "u su* plan  

7or waiv]7 t are m re/rictive ?an !     
eligibility /&>ds1 me?odologies1 or     
proc$ures1 respectively1 "u su* plan 7or
 waiv]7 t are 9 effect on ! date (      
enactm5t ( ?is p>agraph4  4  7#f7       
,in=mation on b5efits ,! ,secret>y (    
,heal? & ,human ,s]vices %all make      
publicly available on ! int]net website 
( ! ,dep>tm5t ( ,heal? & ,human         
,s]vices1 in=mation reg>d+ b5efits      
available to pregnant & po/p>tum wom5 & 
"u ! ,m$icaid program & ! ,*ildr5's     
,heal? ,insurance ,program1 includ+     
in=mation on-- 7,a7 b5efits t ,/ates are
 requir$ to provide to pregnant &       
po/p>tum wom5 "u su* programs2  7,b7    
optional b5efits t ,/ates may provide to
 pregnant & po/p>tum wom5 "u su*        
programs2 &  7,c7 ! availability (      
diff]5t k9ds ( b5efits = pregnant &     
po/p>tum wom51 includ+ oral heal? &     
m5tal heal? b5efits1 "u su* programs4   
7#g7 ,f$]al fund+ = co/ ( ext5d$        
,m$icaid & ,,*ip cov]age = po/p>tum wom5
  7,a7 ,m$icaid ,section #aije ( !      

,social ,security ,act 7#db ,u4,s4,c4   
#acif;d71 z am5d$ by p>agraph 7#a71 is  
fur!r am5d$-- 7i7 9 subsection 7b71 by  
/rik+ & 7ii7 & ins]t+ 7ii71 & 7kk72 &   
7ii7 by add+ at ! end ! foll[+3  7kk7   
,increas$ ,,fmap = ext5d$ m$ical        
assi/ance = po/p>tum wom5 ,not)/&+      
subsection 7b71 ! ,f$]al m$ical         
assi/ance p]c5tage = a ,/ate1 ) respect 
to am\nts exp5d$ by su* ,/ate = m$ical  
assi/ance = a woman :o is eligible = su*
 assi/ance on ! basis ( be+ pregnant or 
hav+ be5 pregnant t is provid$ dur+ !   
#cje-;day p]iod t beg9s on ! #fj? day   
aft] ! la/ day ( h] pregnancy 7includ+  
any su* assi/ance provid$ dur+ ! mon? 9 
:i* su* p]iod ends71 %all be equal to-- 
7#a7 #ajj p]c5t = ! fir/ #bj cal5d>     
qu>t]s dur+ :i* ?is subsection is 9     
effect2 &  7#b7 #ij p]c5t = cal5d>      
qu>t]s !reaft]4  4  7,b7 ,,*ip ,section 
#baje7;c7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acig;ee7c77 is am5d$ by 
add+ at ! end ! foll[+ new p>agraph3    
7#ac7 ,enhanc$ paym5t = ext5d$ assi/ance

 provid$ to pregnant wom5 ,not)/&+      
subsection 7b71 ! enhanc$ ,,fmap1 )     
respect to paym5ts "u subsection 7a7 =  
exp5ditures "u ! ,/ate *ild heal? plan  
7or a waiv] ( su* plan7 = assi/ance     
provid$ "u ! plan 7or waiv]7 to a woman 
:o is eligible = su* assi/ance on !     
basis ( be+ pregnant 7includ+           
pregnancy-relat$ assi/ance provid$ to a 
t>get$ l[-income pregnant woman 7z def9$
 9 section #baab7;d771 pregnancy-relat$ 
assi/ance provid$ to a woman :o is      
eligible = su* assi/ance ?r\gh          
application ( section                   
#aijb7v77#d77;,a77i7 "u section         
#bajg7;e77#a71 or any o!r assi/ance "u !
 plan 7or waiv]7 provid$ to a woman :o  
is eligible = su* assi/ance on ! basis (
 be+ pregnant7 dur+ ! #cje-;day p]iod t 
beg9s on ! #fj? day aft] ! la/ day ( h] 
pregnancy 7includ+ any su* assi/ance    
provid$ dur+ ! mon? 9 :i* su* p]iod     
ends71 %all be equal to-- 7,a7 #ajj     
p]c5t = ! fir/ #bj cal5d> qu>t]s dur+   
:i* ?is p>agraph is 9 effect2 &  7,b7   

#ij p]c5t = cal5d> qu>t]s !reaft]4  4   
7#h7 ,guidance on ,/ate options =       
,m$icaid cov]age ( d\la s]vices ,n lat] 
?an #a ye> aft] ! date ( ! enactm5t (   
?is ,act1 ! ,secret>y ( ,heal? & ,human 
,s]vices1 act+ ?r\gh ! ,adm9i/rator ( ! 
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1    
%all issue guidance = ! ,/ates conc]n+  
options = ,m$icaid cov]age & paym5t =   
support s]vices provid$ by d\las4  7#i7 
,effective date  7,a7 ,9 g5]al ,subject 
to subp>agraph 7,b71 ! am5dm5ts made by 
?is subsection %all take effect on !    
fir/ day ( ! fir/ cal5d> qu>t] t beg9s  
on or aft] ! date t is "o ye> aft] !    
date ( enactm5t ( ?is ,act4  7,b7       
,exception = ,/ate legislation ,9 ! case
 ( a ,/ate plan "u title ,,xix ( !      
,social ,security ,act or a ,/ate *ild  
heal? plan "u title ,,xxi ( su* ,act t !
 ,secret>y ( ,heal? & ,human ,s]vices   
det]m9es requires ,/ate legislation 9   
ord] = ! respective plan to meet any    
requirem5t impos$ by am5dm5ts made by   
?is subsection1 ! respective plan %all n

 be reg>d$ z fail+ to comply ) !        
requirem5ts ( su* title solely on !     
basis ( its failure to meet su* an      
additional requirem5t be=e ! fir/ day ( 
! fir/ cal5d> qu>t] beg9n+ aft] ! close 
( ! fir/ regul> session ( ! ,/ate       
legislature t beg9s aft] ! date (       
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 ! session %all be consid]$ to be a     
sep>ate regul> session ( ! ,/ate        
legislature4  7f7 ,regional c5t]s (     
excell5ce ,"p ,p ( title ,,iii ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bhj;g et seq47 is am5d$ by   
add+ at ! end ! foll[+ new section3     
#cii,v-#g4 ,regional c5t]s ( excell5ce  
address+ implicit bias & cultural       
compet5cy 9 pati5t-provid] int]actions  
education  7a7 ,9 g5]al ,n lat] ?an "o  
ye> aft] ! date ( enactm5t ( ?is        
section1 ! ,secret>y1 9 consultation )  
su* o!r ag5cy heads z ! ,secret>y       
det]m9es appropriate1 %all aw>d         

coop]ative agreem5ts = ! e/abli%m5t or  
support ( regional c5t]s ( excell5ce    
address+ implicit bias1 cultural        
compet5cy1 & respectful c>e practices 9 
pati5t-provid] int]actions education = !
 purpose ( enhanc+ & improv+ h[ heal?   
c>e pr(essionals are educat$ 9 implicit 
bias & deliv]+ culturally compet5t heal?
 c>e4  7b7 ,eligibility ,to be eligible 
to receive a coop]ative agreem5t "u     
subsection 7a71 an entity %all-- 7#a7 be
 a public or o!r nonpr(it entity        
specifi$ by ! ,secret>y t provides      
educational & tra9+ opportunities =     
/ud5ts & heal? c>e pr(essionals1 :i* may
 be a heal? sy/em1 tea*+ hospital1      
community heal? c5t]1 m$ical s*ool1     
s*ool ( public heal?1 s*ool ( nurs+1    
d5tal s*ool1 social "w s*ool1 s*ool (   
pr(essional psy*ology1 or any o!r heal? 
pr(essional s*ool or program at an      
in/itution ( high] education 7z def9$ 9 
section #aja ( ! ,high] ,education ,act 
( #aife7 focus$ on ! prev5tion1         
treatm5t1 or recov]y ( heal? conditions 

t contribute to mat]nal mortality & !   
prev5tion ( mat]nal mortality & sev]e   
mat]nal morbidity2  7#b7 demon/rate     
community engagem5t & p>ticipation1 su* 
z ?r\gh p>tn]%ips ) home visit+ & case  
managem5t programs2  7#c7 demon/rate    
engagem5t ) gr\ps engag$ 9 !            
implem5tation ( heal? c>e pr(essional   
tra9+ 9 implicit bias & deliv]+         
culturally compet5t c>e1 su* z dep>tm5ts
 ( public heal?1 p]9atal quality        
collaboratives1 hospital sy/ems1 & heal?
 c>e pr(essional gr\ps1 9 ord] to obta9 
input on res\rces ne$$ = effective      
implem5tation /rategies2 &  7#d7 provide
 to ! ,secret>y su* in=mation1 at su* "t
 & 9 su* mann]1 z ! ,secret>y may       
require4  7c7 ,div]sity ,9 aw>d+ a      
coop]ative agreem5t "u subsection 7a71 !
 ,secret>y %all take into acc\nt any    
regional diff]5ces among eligible       
entities & make an ef=t to ensure       
geographic div]sity among aw>d          
recipi5ts4  7d7 ,dissem9ation (         
in=mation  7#a7 ,public availability ,! 

,secret>y %all make publicly available  
on ! int]net website ( ! ,dep>tm5t (    
,heal? & ,human ,s]vices in=mation      
submitt$ to ! ,secret>y "u subsection   
7b77#c74  7#b7 ,evaluation ,! ,secret>y 
%all evaluate ea* regional c5t] (       
excell5ce e/abli%$ or support$ pursuant 
to subsection 7a7 & dissem9ate ! f9d+s  
result+ f ea* su* evaluation to !       
appropriate public & private entities4  
7#c7 ,di/ribution ,! ,secret>y %all %>e 
evaluations & ov]all f9d+s ) ,/ate      
dep>tm5ts ( heal? & o!r relevant ,/ate  
level (fices to in=m ,/ate & local be/  
practices4  7e7 ,mat]nal mortality def9$
 ,9 ?is section1 ! t]m mat]nal mortality
 means dea? ( a woman t occurs dur+     
pregnancy or )9 ! "o-ye> p]iod foll[+ ! 
end ( su* pregnancy4  7f7 ,au?orization 
( appropriations ,= purposes ( c>ry+ out
 ?is section1 !re is au?oriz$ to be     
appropriat$ #e1jjj1jjj = ea* ( fiscal   
ye>s #bjbc ?r\gh #bjbg4  4  7g7 ,special
 supplem5tal nutrition program = wom51  
infants1 & *ildr5 ,section              

#ag7;d77#c77;,a77ii7 ( ! ,*ild          
,nutrition ,act ( #aiff 7#db ,u4,s4,c4  
#aghf7;d77#c77;,a77ii77 is am5d$-- 7#a7 
by /rik+ ! clause designation & head+ & 
all t foll[s ?r\gh ,a ,/ate & ins]t+ !  
foll[+3  7ii7 ,wom5  7,i7 ,brea/fe$+    
wom5 ,a ,/ate  2  7#b7 9 subclause 7,i7 
7z s designat$71 by /rik+ #a ye> & all t
 foll[s ?r\gh e>li] & ins]t+ #b ye>s    
po/p>tum2 &  7#c7 by add+ at ! end !    
foll[+3  7,,ii7 ,po/p>tum wom5 ,a ,/ate 
may elect to c]tify a po/p>tum woman = a
 p]iod ( #b ye>s4  4  7h7 ,def9itions ,9
 ?is section3 7#a7 ,mat]nal mortality ,!
 t]m mat]nal mortality means dea? ( a   
woman t occurs dur+ pregnancy or )9 !   
"o-ye> p]iod foll[+ ! end ( su*         
pregnancy4  7#b7 ,pregnancy relat$ dea? 
,! t]m pregnancy relat$ dea? includes ! 
dea? ( a woman dur+ pregnancy or )9 "o  
ye> ( ! end ( pregnancy f a pregnancy   
complication1 a *a9 ( ev5ts initiat$ by 
pregnancy1 or ! aggravation ( an        
unrelat$ condition by ! physiologic     
effects ( pregnancy4  7#c7 ,sev]e       

mat]nal morbidity ,! t]m sev]e mat]nal  
morbidity includes unexpect$ outcomes ( 
labor & deliv]y t result 9 significant  
%ort-t]m or long-t]m consequ5ces to a   
woman's heal?4  #gjjb4 ,increas+ excise 
taxes on cig>ettes & e/abli%+ excise tax
 equity among all tobacco product tax   
rates  7a7 ,tax p>ity = ,roll-,y\r-,own 
tobacco ,section #egja7;g7 ( ! ,int]nal 
,rev5ue ,code ( #aihf is am5d$ by /rik+ 
#bd4gh & ins]t+ #di4ef4  7b7 ,tax p>ity 
= pipe tobacco ,section #egja7;f7 ( !   
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by /rik+ #b4hcaa c5ts & ins]t+ #di4ef4  
7c7 ,tax p>ity = smokeless tobacco  7#a7
 ,section #egja7;e7 ( ! ,int]nal ,rev5ue
 ,code ( #aihf is am5d$-- 7,a7 9        
p>agraph 7#a71 by /rik+ #a4ea & ins]t+  
#bf4hd2  7,b7 9 p>agraph 7#b71 by /rik+ 
#ej4cc c5ts & ins]t+ #aj4gd2 &  7,c7 by 
add+ at ! end ! foll[+3  7#c7 ,smokeless
 tobacco sold 9 discrete s+le-use units 
,on discrete s+le-use units1 #ajj4ff p] 
?\s&4  4  7#b7 ,section #egjb7m7 ( su*  
,code is am5d$-- 7,a7 9 p>agraph 7#a71  

by /rik+ or *ew+ tobacco & ins]t+ 1 *ew+
 tobacco1 or discrete s+le-use unit2    
7,b7 9 p>agraphs 7#b7 & 7#c71 by ins]t+ 
t is n a discrete s+le-use unit be=e !  
p]iod 9 ea* su* p>agraph2 &  7,c7 by    
add+ at ! end ! foll[+3  7#d7 ,discrete 
s+le-use unit ,! t]m discrete s+le-use  
unit means any product conta9+1 made f1 
or d]iv$ f tobacco or nicot9e t-- 7,a7  
is n int5d$ to be smok$2 &  7,b7 is 9 ! 
=m ( a loz5ge1 tablet1 pill1 p\*1       
dissolvable /rip1 or o!r discrete       
s+le-use or s+le-dose unit4  4  7d7 ,tax
 p>ity = small cig>s ,p>agraph 7#a7 (   
section #egja7;a7 ( ! ,int]nal ,rev5ue  
,code ( #aihf is am5d$ by /rik+ #ej4cc &
 ins]t+ #ajj4ff4  7e7 ,tax p>ity = l>ge 
cig>s  7#a7 ,9 g5]al ,p>agraph 7#b7 (   
section #egja7;a7 ( ! ,int]nal ,rev5ue  
,code ( #aihf is am5d$ by /rik+ #eb4ge  
p]c5t & all t foll[s ?r\gh ! p]iod &    
ins]t+ ! foll[+3 #di4ef p] p\nd & a     
proportionate tax at ! l rate on all    
fractional p>ts ( a p\nd b n less ?an   
#aj4jff c5ts p] cig>44  7#b7 ,guidance  

,! ,secret>y ( ! ,treasury1 or !        
,secret>y's delegate1 may issue guidance
 reg>d+ ! appropriate me?od = det]m9+ ! 
weight ( l>ge cig>s = purposes (        
calculat+ ! applicable tax "u section   
#egja7;a77#b7 ( ! ,int]nal ,rev5ue ,code
 ( #aihf4  7f7 ,tax p>ity =             
,roll-,y\r-,own tobacco & c]ta9 process$
 tobacco ,subsection 7o7 ( section #egjb
 ( ! ,int]nal ,rev5ue ,code ( #aihf is  
am5d$ by ins]t+ 1 & includes process$   
tobacco t is remov$ = deliv]y or deliv]$
 to a p]son o!r ?an a p]son ) a p]mit   
provid$ "u section #egac1 b does n      
include removals ( process$ tobacco =   
exportation aft] wrapp]s !re(4  7g7     
,cl>ify+ tax rate = o!r tobacco products
  7#a7 ,9 g5]al ,section #egja ( !      
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by add+ at ! end ! foll[+ new           
subsection3  7i7 ,o!r tobacco products  
,any product n o!rwise describ$ "u ?is  
section t has be5 det]m9$ to be a       
tobacco product by ! ,food & ,drug      
,adm9i/ration ?r\gh its au?orities "u ! 

,family ,smok+ ,prev5tion & ,tobacco    
,control ,act %all be tax$ at a level ( 
tax equival5t to ! tax rate = cig>ettes 
on an e/imat$ p] use basis z det]m9$ by 
! ,secret>y4  4  7#b7 ,e/abli%+ p] use  
basis ,= purposes ( section #egja7;i7 ( 
! ,int]nal ,rev5ue ,code ( #aihf1 n lat]
 ?an #ab mon?s aft] ! lat] ( ! date ( ! 
enactm5t ( ?is ,act or ! date t a       
product has be5 det]m9$ to be a tobacco 
product by ! ,food & ,drug              
,adm9i/ration1 ! ,secret>y ( ! ,treasury
 7or ! ,secret>y ( ! ,treasury's        
delegate7 %all issue f9al regulations   
e/abli%+ ! level ( tax = su* product t  
is equival5t to ! tax rate = cig>ettes  
on an e/imat$ p] use basis4  7h7        
,cl>ify+ def9ition ( tobacco products   
7#a7 ,9 g5]al ,subsection 7c7 ( section 
#egjb ( ! ,int]nal ,rev5ue ,code ( #aihf
 is am5d$ to read z foll[s3  7c7        
,tobacco products ,! t]m tobacco        
products means-- 7#a7 cig>s1 cig>ettes1 
smokeless tobacco1 pipe tobacco1 &      
roll-y\r-own tobacco1 &  7#b7 any o!r   

product subject to tax pursuant to      
section #egja7;i74  4  7#b7 ,con=m+     
am5dm5ts ,subsection 7d7 ( section #egjb
 ( su* ,code is am5d$ by /rik+ cig>s1   
cig>ettes1 smokeless tobacco1 pipe      
tobacco1 or roll-y\r-own tobacco ea*    
place x appe>s & ins]t+ tobacco         
products4  7i7 ,increas+ tax on         
cig>ettes  7#a7 ,small cig>ettes        
,section #egja7;b77#a7 ( su* ,code is   
am5d$ by /rik+ #ej4cc & ins]t+ #ajj4ff4 
7#b7 ,l>ge cig>ettes ,section           
#egja7;b77#b7 ( su* ,code is am5d$ by   
/rik+ #aje4fi & ins]t+ #baa4ch4  7j7    
,tax rates adju/$ = inflation ,section  
#egja ( su* ,code1 z am5d$ by subsection
 7g71 is am5d$ by add+ at ! end ! foll[+
 new subsection3  7j7 ,inflation        
adju/m5t  7#a7 ,9 g5]al ,9 ! case ( any 
cal5d> ye> beg9n+ aft] #bjbb1 ! doll>   
am\nts provid$ "u ?is *apt] %all ea* be 
increas$ by an am\nt equal to-- 7,a7 su*
 doll> am\nt1 multipli$ by  7,b7 !      
co/-(-liv+ adju/m5t det]m9$ "u section  
#a7;f77#c7 = ! cal5d> ye>1 det]m9$ by   

sub/itut+ cal5d> ye> #bjba = cal5d> ye> 
#bjaf 9 subp>agraph 7,a77ii7 !re(4  7#b7
 ,r\nd+ ,if any am\nt z adju/$ "u       
p>agraph 7#a7 is n a multiple ( #j4ja1  
su* am\nt %all be r\nd$ to ! next highe/
 multiple ( #j4ja4  4  7k7 ,floor ,/ocks
 ,taxes  7#a7 ,imposition ( tax ,on     
tobacco products manufactur$ 9 or       
import$ into ! ,unit$ ,/ates :i* are    
remov$ be=e any tax increase date & held
 on su* date = sale by any p]son1 !re is
 h]eby impos$ a tax 9 an am\nt equal to 
! excess (-- 7,a7 ! tax :i* w\ld be     
impos$ "u section #egja ( ! ,int]nal    
,rev5ue ,code ( #aihf on ! article if ! 
article _h be5 remov$ on su* date1 ov]  
7,b7 ! prior tax 7if any7 impos$ "u     
section #egja ( su* ,code on su*        
article4  7#b7 ,cr$it aga9/ tax ,ea*    
p]son %all be all[$ z a cr$it aga9/ !   
taxes impos$ by p>agraph 7#a7 an am\nt  
equal to #ejj4 ,su* cr$it %all n exce$ !
 am\nt ( taxes impos$ by p>agraph 7#a7  
on su* date = :i* su* p]son is liable4  
7#c7 ,liability = tax & me?od ( paym5t  

7,a7 ,liability = tax ,a p]son hold+    
tobacco products on any tax increase    
date to :i* any tax impos$ by p>agraph  
7#a7 applies %all be liable = su* tax4  
7,b7 ,me?od ( paym5t ,! tax impos$ by   
p>agraph 7#a7 %all be paid 9 su* mann] z
 ! ,secret>y %all prescribe by          
regulations4  7,c7 ,"t = paym5t ,! tax  
impos$ by p>agraph 7#a7 %all be paid on 
or be=e ! date t is #abj days aft] !    
effective date ( ! tax rate increase4   
7#d7 ,articles 9 =eign trade zones      
,not)/&+ ! ,act ( ,june #ah1 #aicd      
7commonly kn[n z ! ,=eign ,trade ,zone  
,act1 #dh ,/at4 #iih1 #ai ,u4,s4,c4     
#ha;a et seq471 or any o!r provision (  
law1 any article :i* is locat$ 9 a =eign
 trade zone on any tax increase date    
%all be subject to ! tax impos$ by      
p>agraph 7#a7 if-- 7,a7 int]nal rev5ue  
taxes h be5 det]m9$1 or cu/oms duties   
liquidat$1 ) respect to su* article be=e
 su* date pursuant to a reque/ made "u !
 fir/ proviso ( section #c7;a7 ( su*    
,act1 or  7,b7 su* article is held on   

su* date "u ! sup]vision ( an (fic] ( ! 
,unit$ ,/ates ,cu/oms & ,bord]          
,protection ( ! ,dep>tm5t ( ,homel&     
,security pursuant to ! second proviso (
 su* section #c7;a74  7#e7 ,def9itions  
,= purposes ( ?is subsection-- 7,a7 ,9  
g5]al ,any t]m us$ 9 ?is subsection :i* 
is also us$ 9 section #egjb ( su* ,code 
%all h ! same mean+ z su* t]m has 9 su* 
section4  7,b7 ,tax increase date ,! t]m
 tax increase date means ! effective    
date ( any increase 9 any tobacco       
product excise tax rate pursuant to !   
am5dm5ts made by ?is section 7o!r ?an   
subsection 7j7 !re(74  7,c7 ,secret>y ,!
 t]m ,secret>y means ! ,secret>y ( !    
,treasury or ! ,secret>y's delegate4    
7#f7 ,controll$ gr\ps ,rules simil> to !
 rules ( section #ejfa7;e77#c7 ( su*    
,code %all apply = purposes ( ?is       
subsection4  7#g7 ,o!r laws applicable  
,all provisions ( law1 includ+ p5alties1
 applicable ) respect to ! taxes impos$ 
by section #egja ( su* ,code %all1 ins(>
 z applicable & n inconsi/5t ) !        

provisions ( ?is subsection1 apply to ! 
floor /ocks taxes impos$ by p>agraph    
7#a71 to ! same ext5t z if su* taxes 7  
impos$ by su* section #egja4 ,!         
,secret>y may treat any p]son :o bore ! 
ultimate burd5 ( ! tax impos$ by        
p>agraph 7#a7 z ! p]son to :om a cr$it  
or refund "u su* provisions may be all[$
 or made4  7l7 ,effective dates  7#a7 ,9
 g5]al ,except z provid$ 9 p>agraphs    
7#b7 ?r\gh 7#d71 ! am5dm5ts made by ?is 
section %all apply to articles remov$ 7z
 def9$ 9 section #egjb7;j7 ( ! ,int]nal 
,rev5ue ,code ( #aihf7 aft] ! la/ day ( 
! mon? :i* includes ! date ( ! enactm5t 
( ?is ,act4  7#b7 ,discrete s+le-use    
units & process$ tobacco ,! am5dm5ts    
made by subsections 7c77#a77;,c71       
7c77#b71 & 7f7 %all apply to articles   
remov$ 7z def9$ 9 section #egjb7;j7 ( ! 
,int]nal ,rev5ue ,code ( #aihf7 aft] !  
date t is #f mon?s aft] ! date ( !      
enactm5t ( ?is ,act4  7#c7 ,l>ge cig>s  
,! am5dm5ts made by subsection 7e7 %all 
apply to articles remov$ aft] ,decemb]  

#ca1 #bjbb4  7#d7 ,o!r tobacco products 
,! am5dm5ts made by subsection 7g77#a7  
%all apply to products remov$ aft] ! la/
 day ( ! mon? :i* includes ! date t !   
,secret>y ( ! ,treasury 7or ! ,secret>y 
( ! ,treasury's delegate7 issues f9al   
regulations e/abli%+ ! level ( tax = su*
 product4