,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #ibe  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,febru>y #h1 #bjba,ms4
 ,davids ( ,kansas 7= h]self1 ,ms4      
,und]wood1 ,ms4 ,adams1 ,mr4 ,khanna1   
,ms4 ,velzquez1 ,mrs4 ,mc,bath1 ,mr4    
,smi? ( ,wa%+ton1 ,ms4 ,scanlon1 ,mr4   
,lawson ( ,florida1 ,mrs4 ,hayes1 ,mr4  
,butt]field1 ,ms4 ,moore ( ,wiscons91   
,ms4 ,/rickl&1 ,mr4 ,ryan1 ,mr4 ,s*iff1 
,mr4 ,johnson ( ,georgia1 ,mr4 ,hors=d1 
,ms4 ,wass]man ,s*ultz1 ,ms4 ,b>ragn1   
,mr4 ,deut*1 ,mr4 ,payne1 ,mr4          
,blum5au]1 ,mr4 ,m\lton1 ,mr4 ,soto1    
,mr4 ,nadl]1 ,mr4 ,trone1 ,ms4 ,cl>ke ( 
,new ,york1 ,ms4 ,s*ak[sky1 ,ms4 ,bass1 
,ms4 ,pressley1 ,mr4 ,evans1 ,ms4 ,blunt
 ,ro*e/]1 ,ms4 ,ca/or ( ,florida1 ,ms4  
,sewell1 & ,ms4 ,williams ( ,georgia7   
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,natural    
,res\rces1 = a p]iod to be subsequ5tly  
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 

! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d ! ,public ,heal?      
,s]vice ,act 7#db ,u4,s4,c4 #bja et     
seq47 to au?orize fund+ = mat]nal       
mortality review committees to promote  
repres5tative community engagem5t1 & =  
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,data to ,save ,moms   
,act4  #b4 ,fund+ = mat]nal mortality   
review committees to promote            
repres5tative community engagem5t  7a7  
,9 g5]al ,section #cag,k7d7 ( ! ,public 
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bdg;b-#ab7;d77 is am5d$ by add+ at !   
end ! foll[+3  7#i7 ,grants to promote  
repres5tative community engagem5t 9     
mat]nal mortality review committees     
7,a7 ,9 g5]al ,! ,secret>y may1 us+     
funds made available pursuant to        
subp>agraph 7,c71 provide assi/ance to  
an applicable mat]nal mortality review  
committee ( a ,/ate1 ,indian tribe1     
tribal organization1 or urban ,indian   
organization 7z su* t]m is def9$ 9      
section #d ( ! ,indian ,heal? ,c>e      

,improvem5t ,act 7#be ,u4,s4,c4         
#afjc77-- 7i7 to select = inclusion 9 ! 
memb]%ip ( su* a committee community    
memb]s f ! ,/ate1 ,indian tribe1 tribal 
organization1 or urban ,indian          
organization by-- 7,i7 prioritiz+       
community memb]s :o c increase !        
div]sity ( ! committee's memb]%ip )     
respect to race & e?nicity1 location1 & 
pr(essional backgr\nd1 includ+ memb]s ) 
non-cl9ical exp]i5ces2 &  7,,ii7 to !   
ext5t applicable1 us+ funds res]v$ "u   
subsection 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 #bjbb ?r\gh #bjbf4  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
  #c4 ,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]$2  4  #d4     
,review ( mat]nal heal? data collection 
processes & quality measures  7a7 ,9    
g5]al ,! ,secret>y ( ,heal? & ,human    
,s]vices1 act+ ?r\gh ! ,adm9i/rator =   
,c5t]s = ,m$ic>e  ,m$icaid ,s]ves & !   
,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 & non-pr(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 #bjbb ?r\gh #bjbe4  #e4   
,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* ,act72  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 #bjbb ?r\gh #bjbd4  #f4 ,grants to 
m9ority-s]v+ in/itutions to /udy mat]nal
 mortality1 sev]e mat]nal morbidity1 &  
o!r adv]se mat]nal heal? outcomes  7a7  
,9 g5]al ,! ,secret>y ( ,heal? & ,human 
,s]vices %all e/abli% a program "u :i* !
 ,secret>y %all aw>d grants to rese>*   
c5t]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 #bjbb ?r\gh #bjbf4  #g4 ,def9itions
 ,9 ?is ,act3 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