,,ii #aagth ,,congress #ast ,session ,s4 #cdf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #bb1 #bjba,mr4 ,booker 7for himself1 ,ms4 ,duckworth1 ,mrs4 ,gillibrand1 ,mr4 ,durbin1 ,mr4 ,kaine1 ,mr4 ,casey1 ,mr4 ,peters1 ,ms4 ,baldwin1 ,mr4 ,merkley1 ,mr4 ,van ,hollen1 ,ms4 ,stabenow1 ,mr4 ,bennet1 ,ms4 ,warren1 ,mr4 ,menendez1 ,mr4 ,markey1 ,mr4 ,blumenthal1 ,ms4 ,smith1 ,mr4 ,brown1 ,mr4 ,whitehouse1 ,ms4 ,klobuchar1 and ,mr4 ,warnock7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to end preventable maternal mortality and severe maternal morbidity in the ,united ,states and close disparities in maternal health outcomes1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,black ,maternal ,health ,momnibus ,act of #bjba4 #b4 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title4,sec4 #b4 ,table of contents4,sec4 #c4 ,definitions4,sec4 #d4 ,sense of ,congress4,,title ,i--,social determinants for moms,sec4 #aja4 ,task force to develop a strategy to address social determinants of maternal health4,sec4 #ajb4 ,housing for ,moms grant program4,sec4 #ajc4 ,department of ,transportation4,sec4 #ajd4 ,department of ,agriculture4,sec4 #aje4 ,environmental study through ,national ,academies4,sec4 #ajf4 ,child care access4,sec4 #ajg4 ,grants to local entities addressing social determinants of maternal health4,,title ,,ii--,honoring ,kira ,johnson,sec4 #bja4 ,investments in community-based organizations to improve ,black maternal health outcomes4,sec4 #bjb4 ,investments in community-based organizations to improve maternal health outcomes in underserved communities4,sec4 #bjc4 ,respectful maternity care training for all employees in maternity care settings4,sec4 #bjd4 ,study on reducing and preventing bias1 racism1 and discrimination in maternity care settings4,sec4 #bje4 ,respectful maternity care compliance program4,sec4 #bjf4 ,,gao report4,,title ,,iii--,protecting moms who served,sec4 #cja4 ,codification of maternity coordination program of ,department of ,veterans ,affairs4,sec4 #cjb4 ,report on maternal mortality and severe maternal morbidity among pregnant and postpartum veterans4,,title ,,iv--,perinatal workforce,sec4 #dja4 ,,hhs agency directives4,sec4 #djb4 ,grants to grow and diversify the perinatal workforce4,sec4 #djc4 ,grants to grow and diversify the nursing workforce in maternal and perinatal health4,sec4 #djd4 ,,gao report4,,title ,v--,data to save moms,sec4 #eja4 ,funding for maternal mortality review committees to promote representative community engagement4,sec4 #ejb4 ,data collection and review4,sec4 #ejc4 ,review of maternal health data collection processes and quality measures4,sec4 #ejd4 ,indian ,health ,service study and report on maternal mortality and severe maternal morbidity4,sec4 #eje4 ,grants to minority-serving institutions to study maternal mortality1 severe maternal morbidity1 and other adverse maternal health outcomes4,,title ,,vi--,moms matter,sec4 #fja4 ,maternal mental health equity grant program4,sec4 #fjb4 ,grants to grow and diversify the maternal mental and behavioral health care workforce4,,title ,,vii--,justice for incarcerated moms,sec4 #gja4 ,ending the shackling of pregnant individuals4,sec4 #gjb4 ,creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods4,sec4 #gjc4 ,grant program to improve maternal health outcomes for individuals in ,state and local prisons and jails4,sec4 #gjd4 ,,gao report4,sec4 #gje4 ,,macpac report4,,title ,,viii--,tech to save moms,sec4 #hja4 ,integrated telehealth models in maternity care services4,sec4 #hjb4 ,grants to expand the use of technology-enabled collaborative learning and capacity models for pregnant and postpartum individuals4,sec4 #hjc4 ,grants to promote equity in maternal health outcomes through digital tools4,sec4 #hjd4 ,report on the use of technology in maternity care4,,title ,,ix--,impact to save moms,sec4 #ija4 ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project4,sec4 #ijb4 ,,macpac report4,,title ,x--,maternal health pandemic response,sec4 #ajja4 ,definitions4,sec4 #ajjb4 ,funding for data collection1 surveillance1 and research on maternal health outcomes during the ,,covid-#ai public health emergency4,sec4 #ajjc4 ,,covid-#ai maternal health data collection and disclosure4,sec4 #ajjd4 ,inclusion of pregnant individuals and lactating individuals in vaccine and therapeutic development for ,,covid-#ai4,sec4 #ajje4 ,public health communication regarding maternal care during ,,covid-#ai4,sec4 #ajjf4 ,task force on birthing experience and safe maternity care during a public health emergency4,sec4 #ajjg4 ,,gao report on maternal health and public health emergency preparedness4,,title ,,xi--,protecting moms and babies against climate change,sec4 #aaja4 ,definitions4,sec4 #aajb4 ,grant program to protect vulnerable mothers and babies from climate change risks4,sec4 #aajc4 ,grant program for education and training at health profession schools4,sec4 #aajd4 ,,nih ,consortium on ,birth and ,climate ,change ,research4,sec4 #aaje4 ,strategy for identifying climate change risk zones for vulnerable mothers and babies4,,title ,,xii--,maternal vaccinations,sec4 #abja4 ,maternal vaccination awareness and equity campaign4 #c4 ,definitions ,in this ,act3 7#a7 ,culturally congruent ,the term culturally congruent1 with respect to care or maternity care1 means care that is in agreement with the preferred cultural values1 beliefs1 worldview1 language1 and practices of the health care consumer and other stakeholders4 7#b7 ,maternity care provider ,the term maternity care provider means a health care provider who-- 7,a7 is a physician1 physician assistant1 midwife who meets at a minimum the international definition of the midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives1 nurse practitioner1 or clinical nurse specialist2 and 7,b7 has a focus on maternal or perinatal health4 7#c7 ,maternal mortality ,the term maternal mortality means a death occurring during or within a one-year period after pregnancy1 caused by pregnancy-related or childbirth complications1 including a suicide1 overdose1 or other death resulting from a mental health or substance use disorder attributed to or aggravated by pregnancy-related or childbirth complications4 7#d7 ,perinatal health worker ,the term perinatal health worker means a doula1 community health worker1 peer supporter1 breastfeeding and lactation educator or counselor1 nutritionist or dietitian1 childbirth educator1 social worker1 home visitor1 language interpreter1 or navigator4 7#e7 ,postpartum and postpartum period ,the terms postpartum and postpartum period refer to the #a-year period beginning on the last day of the pregnancy of an individual4 7#f7 ,pregnancy-associated death ,the term pregnancy-associated death means a death of a pregnant or postpartum individual1 by any cause1 that occurs during1 or within #a year following1 the individual's pregnancy1 regardless of the outcome1 duration1 or site of the pregnancy4 7#g7 ,pregnancy-related death ,the term pregnancy-related death means a death of a pregnant or postpartum individual that occurs during1 or within #a year following1 the individual's pregnancy1 from a pregnancy complication1 a chain of events initiated by pregnancy1 or the aggravation of an unrelated condition by the physiologic effects of pregnancy4 7#h7 ,racial and ethnic minority group ,the term racial and ethnic minority group has the meaning given such term in section #agjg7;g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjju-#f7;g77#a774 7#i7 ,severe maternal morbidity ,the term severe maternal morbidity means a health condition1 including mental health conditions and substance use disorders1 attributed to or aggravated by pregnancy or childbirth that results in significant short-term or long-term consequences to the health of the individual who was pregnant4 7#aj7 ,social determinants of maternal health ,the term social determinants of maternal health means non-clinical factors that impact maternal health outcomes1 including-- 7,a7 economic factors1 which may include poverty1 employment1 food security1 support for and access to lactation and other infant feeding options1 housing stability1 and related factors2 7,b7 neighborhood factors1 which may include quality of housing1 access to transportation1 access to child care1 availability of healthy foods and nutrition counseling1 availability of clean water1 air and water quality1 ambient temperatures1 neighborhood crime and violence1 access to broadband1 and related factors2 7,c7 social and community factors1 which may include systemic racism1 gender discrimination or discrimination based on other protected classes1 workplace conditions1 incarceration1 and related factors2 7,d7 household factors1 which may include ability to conduct lead testing and abatement1 car seat installation1 indoor air temperatures1 and related factors2 7,e7 education access and quality factors1 which may include educational attainment1 language and literacy1 and related factors2 and 7,f7 health care access factors1 including health insurance coverage1 access to culturally congruent health care services1 providers1 and non-clinical support1 access to home visiting services1 access to wellness and stress management programs1 health literacy1 access to telehealth and items required to receive telehealth services1 and related factors4 #d4 ,sense of ,congress ,it is the sense of ,congress that-- 7#a7 the respect and proper care that birthing people deserve is inclusive2 and 7#b7 regardless of race1 ethnicity1 gender identity1 sexual orientation1 religion1 marital status1 familial status1 socioeconomic status1 immigration status1 incarceration status1 or disability1 all deserve dignity4 ,i ,social determinants for moms #aja4 ,task force to develop a strategy to address social determinants of maternal health 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall convene a task force 7in this section referred to as the ,task ,force7 to develop a strategy to coordinate efforts between ,federal agencies to address social determinants of maternal health with respect to pregnant and postpartum individuals4 7b7 ,ex officio members ,the ex officio members of the ,task ,force shall consist of the following3 7#a7 ,the ,secretary of ,health and ,human ,services 7or a designee thereof74 7#b7 ,the ,secretary of ,housing and ,urban ,development 7or a designee thereof74 7#c7 ,the ,secretary of ,transportation 7or a designee thereof74 7#d7 ,the ,secretary of ,agriculture 7or a designee thereof74 7#e7 ,the ,secretary of ,labor 7or a designee thereof74 7#f7 ,the ,secretary of ,defense 7or a designee thereof74 7#g7 ,the ,secretary of ,veterans ,affairs 7or a designee thereof74 7#h7 ,the ,administrator of the ,environmental ,protection ,agency 7or a designee thereof74 7#i7 ,the ,assistant ,secretary for the ,administration for ,children and ,families 7or a designee thereof74 7#aj7 ,the ,administrator of the ,centers for ,medicare ,medicaid ,services 7or a designee thereof74 7#aa7 ,the ,director of the ,indian ,health ,service 7or a designee thereof74 7#ab7 ,the ,director of the ,national ,institutes of ,health 7or a designee thereof74 7#ac7 ,the ,administrator of the ,health ,resources and ,services ,administration 7or a designee thereof74 7#ad7 ,the ,deputy ,assistant ,secretary for ,minority ,health of the ,department of ,health and ,human ,services 7or a designee thereof74 7#ae7 ,the ,deputy ,assistant ,secretary for ,women's ,health of the ,department of ,health and ,human ,services 7or a designee thereof74 7#af7 ,the ,director of the ,centers for ,disease ,control and ,prevention 7or a designee thereof74 7#ag7 ,the ,director of the ,office on ,violence ,against ,women at the ,department of ,justice 7or a designee thereof74 7c7 ,appointed members ,in addition to the ex officio members of the ,task ,force1 the ,secretary of ,health and ,human ,services shall appoint the following members of the ,task ,force3 7#a7 ,at least #b representatives of patients1 to include-- 7,a7 a representative of patients who have suffered from severe maternal morbidity2 or 7,b7 a representative of patients who is a family member of an individual who suffered a pregnancy-related death4 7#b7 ,at least #b leaders of community-based organizations that address maternal mortality and severe maternal morbidity with a specific focus on racial and ethnic disparities4 ,in appointing such leaders under this paragraph1 the ,secretary of ,health and ,human ,services shall give priority to individuals who are leaders of organizations led by individuals from racial and ethnic minority groups4 7#c7 ,at least #b perinatal health workers4 7#d7 ,a professionally diverse panel of maternity care providers4 7d7 ,chair ,the ,secretary of ,health and ,human ,services shall select the chair of the ,task ,force from among the members of the ,task ,force4 7e7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,task ,force shall submit to ,congress a report on-- 7#a7 the strategy developed under subsection 7a72 7#b7 recommendations on funding amounts with respect to implementing such strategy2 7#c7 recommendations for how to expand coverage of social services to address social determinants of maternal health under ,medicaid managed care organizations and ,state ,medicaid programs4 7f7 ,termination ,section #ad of the ,federal ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 shall not apply to the ,task ,force with respect to termination4 #ajb4 ,housing for ,moms grant program 7a7 ,in general ,the ,secretary of ,housing and ,urban ,development shall establish a ,housing for ,moms grant program under this section to make grants to eligible entities to increase access to safe1 stable1 affordable1 and adequate housing for pregnant and postpartum individuals and their families4 7b7 ,application ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may provide4 7c7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to an eligible entity that-- 7#a7 is a community-based organization or will partner with a community-based organization to implement initiatives to increase access to safe1 stable1 affordable1 and adequate housing for pregnant and postpartum individuals and their families2 7#b7 is operating in an area with high rates of adverse maternal health outcomes or significant racial or ethnic disparities in maternal health outcomes1 to the extent such data are available2 and 7#c7 is operating in an area with a high poverty rate or significant number of individuals who lack consistent access to safe1 stable1 affordable1 and adequate housing4 7d7 ,use of funds ,an eligible entity that receives a grant under this section shall use funds under the grant for the purposes of-- 7#a7 identifying and conducting outreach to pregnant and postpartum individuals who are low-income and lack consistent access to safe1 stable1 affordable1 and adequate housing2 7#b7 providing safe1 stable1 affordable1 and adequate housing options to such individuals2 7#c7 connecting such individuals with local organizations offering safe1 stable1 affordable1 and adequate housing options2 7#d7 providing application assistance to such individuals seeking to enroll in programs offering safe1 stable1 affordable1 and adequate housing options2 7#e7 providing direct financial assistance to such individuals for the purposes of maintaining safe1 stable1 and adequate housing for the duration of the individual's pregnancy and postpartum periods2 and 7#f7 working with relevant stakeholders to ensure that local housing and homeless shelter infrastructure is supportive to pregnant and postpartum individuals1 including through-- 7,a7 health-promoting housing codes2 7,b7 enforcement of housing codes2 7,c7 proactive rental inspection programs2 7,d7 code enforcement officer training2 and 7,e7 partnerships between regional offices of the ,department of ,housing and ,urban ,development and community-based organizations to ensure housing laws are understood and violations are discovered4 7e7 ,reporting 7#a7 ,eligible entities ,the ,secretary shall require each eligible entity receiving a grant under this section to annually submit to the ,secretary and make publicly available a report on the status of activities conducted using the grant4 7#b7 ,secretary ,not later than the end of each fiscal year in which grants are made under this section1 the ,secretary shall submit to ,congress and make publicly available a report that-- 7,a7 summarizes the reports received under paragraph 7#a72 7,b7 evaluates the effectiveness of grants awarded under this section in increasing access to safe1 stable1 affordable1 and adequate housing for pregnant and postpartum individuals and their families2 and 7,c7 makes recommendations with respect to ensuring activities described subsection 7d7 continue after grant amounts made available under this section are expended4 7f7 ,definitions ,in this section3 7#a7 ,eligible entity ,the term eligible entity means-- 7,a7 a community-based organization2 7,b7 a ,state or local governmental entity1 including a ,state or local public health department2 7,c7 an ,indian tribe or tribal organization 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd772 or 7,d7 an ,urban ,indian organization 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc774 7#b7 ,secretary ,the term ,secretary means the ,secretary of ,housing and ,urban ,development4 7g7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #aj1jjj1jjj for fiscal year #bjbb1 which shall remain available until expended4 #ajc4 ,department of ,transportation 7a7 ,report ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,transportation shall submit to ,congress and make publicly available a report that contains-- 7#a7 an assessment of transportation barriers preventing individuals from attending prenatal and postpartum appointments1 accessing maternal health care services1 or accessing services and resources related to social determinants of maternal health2 7#b7 recommendations on how to overcome the barriers described in paragraph 7#a72 7#c7 an assessment of transportation safety risks for pregnant individuals and recommendations on how to mitigate those risks2 and 7#d7 an assessment of the impact of disabilities1 including service-related disabilities1 on pregnant and postpartum women's mobility and access to appropriate care4 7b7 ,considerations ,in carrying out subsection 7a71 the ,secretary of ,transportation shall give special consideration to solutions for-- 7#a7 pregnant and postpartum individuals living in a health professional shortage area designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e72 7#b7 pregnant and postpartum individuals living in areas with high maternal mortality or severe morbidity rates or significant racial or ethnic disparities in maternal health outcomes2 and 7#c7 pregnant and postpartum individuals with a disability that impacts mobility4 #ajd4 ,department of ,agriculture 7a7 ,special supplemental nutrition program for women1 infants1 and children 7#a7 ,breastfeeding women 7,a7 ,definition of breastfeeding woman ,section #ag7;b7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;b77 is amended by striking paragraph 7#a7 and inserting the following3 7#a7 ,breastfeeding woman ,the term breastfeeding woman means-- 7,a7 a woman who is not more than #a year postpartum and is breastfeeding the infant of the woman2 and 7,b7 for purposes of subsection 7d71 a woman who is not more than #b years postpartum and is breastfeeding the infant of the woman4 4 7,b7 ,extension of breastfeeding period ,section #ag7;d77#c77;,a77ii7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;d77#c77;,a77ii77 is amended by striking #a year and inserting #b years4 7#b7 ,postpartum women 7,a7 ,definition of postpartum women ,section #ag7;b77#aj7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;b77#aj77 is amended by striking six months and inserting #b years4 7,b7 ,certification ,section #ag7;d77#c77;,a7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;d77#c77;,a77 is amended by adding at the end the following3 7iv7 ,postpartum women ,a ,state may elect to certify a postpartum woman for a period of up to #b years after the termination of pregnancy of the postpartum woman4 4 7#c7 ,report ,not later than #b years after the date of enactment of this section1 the ,secretary of ,agriculture shall submit to ,congress a report that includes an evaluation of the effect of each of the amendments made by this subsection on-- 7,a7 maternal and infant health outcomes1 including racial and ethnic disparities with respect to those outcomes2 7,b7 breastfeeding rates among postpartum individuals2 7,c7 qualitative evaluations of family experiences under the special supplemental nutrition program for women1 infants1 and children established under section #ag of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf72 and 7,d7 other relevant information as determined by the ,secretary of ,agriculture4 7b7 ,grant program for healthy food and clean water for pregnant and postpartum individuals 7#a7 ,definitions ,in this subsection3 7,a7 ,eligible entity ,the term eligible entity means-- 7i7 a community-based organization2 7ii7 a ,state or local governmental entity1 including a ,state or local public health department2 7iii7 an ,indian tribe or tribal organization 7as those terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd772 and 7iv7 an urban ,indian organization 7as defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc774 7,b7 ,secretary ,the term ,secretary means the ,secretary of ,agriculture4 7#b7 ,establishment ,the ,secretary shall establish a program to award grants1 on a competitive basis1 to eligible entities to carry out the activities described in paragraph 7#e74 7#c7 ,application ,to be eligible for a grant under this subsection1 an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary determines appropriate4 7#d7 ,priority ,in awarding grants under this subsection1 the ,secretary shall give priority to an eligible entity that-- 7,a7 is1 or will partner with1 a community-based organization2 and 7,b7 is operating in an area with high rates of-- 7i7 adverse maternal health outcomes2 or 7ii7 significant racial or ethnic disparities in maternal health outcomes4 7#e7 ,use of funds ,an eligible entity shall use grant funds awarded under this subsection to deliver healthy food1 infant formula1 clean water1 or diapers to pregnant women 7as defined in section #ag7;b7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;b777 and postpartum individuals located in areas that are food deserts1 as determined by the ,secretary using data from the ,food ,access ,research ,atlas of the ,department of ,agriculture4 7#f7 ,reports 7,a7 ,eligible entity ,each eligible entity that receives a grant under this subsection shall1 not later than #a year after receiving the grant1 and annually thereafter1 submit to the ,secretary a report on the status of activities conducted using the grant1 which shall contain such information as the ,secretary may require4 7,b7 ,secretary 7i7 ,in general ,not later than #b years after the date on which the first grant is awarded under this subsection1 the ,secretary shall submit to ,congress a report that includes-- 7,i7 a summary of the reports submitted by eligible entities under subparagraph 7,a72 7,,ii7 an assessment of the extent to which food distributed through the grant program under this subsection was purchased from local and regional food systems2 7,,iii7 an evaluation of the effect of the grant program under this subsection on maternal and infant health outcomes1 including racial and ethnic disparities and disparities impacting other underserved mothers1 such as mothers living in rural areas1 with respect to those outcomes2 and 7,,iv7 recommendations with respect to ensuring the activities described in paragraph 7#e7 continue after the grant funding for those activities expires4 7ii7 ,publication ,the ,secretary shall make the report submitted under clause 7i7 publicly available on the website of the ,department of ,agriculture4 7#g7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary #e1jjj1jjj to carry out this subsection for the period of fiscal years #bjbb through #bjbd4 #aje4 ,environmental study through ,national ,academies 7a7 ,in general ,not later than #fj days after the date of enactment of this ,act1 the ,administrator of the ,environmental ,protection ,agency shall seek to enter into an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this section as the ,national ,academies7 under which the ,national ,academies agree to conduct a study on the impacts of water and air quality1 exposure to extreme temperatures1 exposure to environmental chemicals1 environmental risks in the workplace and the home1 and pollution levels on maternal and infant health outcomes4 7b7 ,study requirements ,the agreement under subsection 7a7 shall direct the ,national ,academies to make recommendations for-- 7#a7 improving the environmental conditions described in that subsection to improve maternal and infant health outcomes2 and 7#b7 reducing or eliminating racial and ethnic disparities in those outcomes4 7c7 ,report ,the agreement under subsection 7a7 shall require the ,national ,academies-- 7#a7 to complete the study described in that subsection2 and 7#b7 not later than #a year after the date of enactment of this ,act1 to transmit to ,congress and make publicly available a report that-- 7,a7 describes the results of the study2 and 7,b7 includes the recommendations described in subsection 7b74 #ajf4 ,child care access 7a7 ,grant program ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall award grants to eligible organizations to provide pregnant and postpartum individuals with free and accessible drop-in child care services during prenatal and postpartum appointments1 including for mental health care1 prenatal and childbirth classes1 and labor and delivery4 ,the ,secretary shall coordinate with the ,secretary of ,defense to disseminate information regarding such services and to expand on-installation drop-in child care services for military parents4 7b7 ,application ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,eligible organizations 7#a7 ,eligibility ,to be eligible to receive a grant under this section1 an organization shall be an organization that provides child care services and can carry out programs providing pregnant and postpartum individuals with free and accessible drop-in child care services during prenatal and postpartum appointments4 7#b7 ,prioritization ,in selecting grant recipients under this section1 the ,secretary shall give priority to eligible organizations that operate in an area with high rates of adverse maternal health outcomes or significant racial or ethnic disparities in maternal health outcomes1 to the extent such data are available4 7d7 ,timing ,the ,secretary shall commence the grant program under subsection 7a7 not later than #a year after the date of enactment of this ,act4 7e7 ,reporting 7#a7 ,grantees ,each recipient of a grant under this section shall annually submit to the ,secretary and make publicly available a report on the status of activities conducted using the grant4 ,each such report shall include-- 7,a7 an analysis of the effect of the funded program on prenatal and postpartum appointment attendance rates2 7,b7 summaries of qualitative assessments of the funded program from-- 7i7 pregnant and postpartum individuals participating in the program2 and 7ii7 the families of such individuals2 and 7,c7 such additional information as the ,secretary may require4 7#b7 ,secretary ,not later than the end of fiscal year #bjbd1 the ,secretary shall submit to ,congress and make publicly available a report containing the following3 7,a7 ,a summary of the reports under paragraph 7#a74 7,b7 ,an assessment of the effects1 if any1 of the funded programs on maternal health outcomes1 with a specific focus on racial and ethnic disparities in such outcomes4 7,c7 ,a description of actions the ,secretary can take to ensure that pregnant and postpartum individuals eligible for medical assistance under a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #aicf et seq47 have access to free and accessible drop-in child care services during prenatal and postpartum appointments1 including identification of the funding necessary to carry out such actions4 7f7 ,drop-,in child care services defined ,in this section1 the term drop-in child care services means child care and early childhood education services that are-- 7#a7 delivered at a facility that meets the requirements of all applicable laws and regulations of the ,state or local government in which it is located1 including the licensing of the facility as a child care facility2 and 7#b7 provided in single encounters without requiring full-time enrollment of a person in a child care program4 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #e1jjj1jjj for the period of fiscal years #bjbb through #bjbd4 #ajg4 ,grants to local entities addressing social determinants of maternal health 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall award grants to eligible entities to-- 7#a7 address social determinants of maternal health for pregnant and postpartum individuals2 and 7#b7 eliminate racial and ethnic disparities in maternal health outcomes4 7b7 ,application ,to be eligible to receive a grant under this subsection an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may provide4 7c7 ,prioritization ,in awarding grants under subsection 7a71 the ,secretary shall give priority to an eligible entity that-- 7#a7 is1 or will partner with1 a community-based organization to carrying out the activities under subsection 7d72 7#b7 is operating in an area with high rates of adverse maternal health outcomes or significant racial or ethnic disparities in maternal health outcomes2 and 7#c7 is operating in an area with a high poverty rate4 7d7 ,activities ,an eligible entity that receives a grant under this section may-- 7#a7 hire and retain staff2 7#b7 develop and distribute a culturally and linguistically appropriate list of available resources with respect to social service programs in a community1 including housing supports1 child care access1 nutrition counseling1 and resources for pregnant women facing intimate partner violence2 7#c7 establish a culturally appropriate resource center that provides multiple social service programs in a single location2 7#d7 offer programs and resources in the communities in which the respective eligible entities are located to address social determinants of health for pregnant and postpartum individuals2 and 7#e7 consult with such pregnant and postpartum individuals1 including undocumented pregnant individuals1 to conduct an assessment of the activities under this subsection4 7e7 ,technical assistance ,the ,secretary shall provide to grant recipients under this section technical assistance to plan for sustaining programs to address social determinants of maternal health among pregnant and postpartum individuals after the period of the grant4 7f7 ,reporting 7#a7 ,grantees ,not later than #a year after an eligible entity first receives a grant under this section1 and annually thereafter1 an eligible entity shall submit to the ,secretary1 and make publicly available1 a report on the status of activities conducted using the grant4 ,each such report shall include data on the effects of such activities1 disaggregated by race1 ethnicity1 gender1 and other relevant factors4 7#b7 ,secretary ,not later than the end of fiscal year #bjbf1 the ,secretary shall submit to ,congress a report that includes-- 7,a7 a summary of the reports under paragraph 7#a72 and 7,b7 recommendations for-- 7i7 improving maternal health outcomes2 and 7ii7 reducing or eliminating racial and ethnic disparities in maternal health outcomes4 7g7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ae1jjj1jjj for each of fiscal years #bjbb through #bjbf4 ,,ii ,honoring ,kira ,johnson #bja4 ,investments in community-based organizations to improve ,black maternal health outcomes 7a7 ,awards ,following the #a-year period beginning on the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall award grants to eligible entities to establish or expand programs to prevent maternal mortality and severe maternal morbidity among ,black pregnant and postpartum individuals4 7b7 ,eligibility ,to be eligible to seek a grant under this section1 an entity shall be a community-based organization offering programs and resources aligned with evidence-based practices for improving maternal health outcomes for ,black pregnant and postpartum individuals4 7c7 ,outreach and technical assistance period ,during the #a-year period beginning on the date of enactment of this ,act1 the ,secretary shall-- 7#a7 conduct outreach to encourage eligible entities to apply for grants under this section2 and 7#b7 provide technical assistance to eligible entities on best practices for applying for grants under this section4 7d7 ,special consideration 7#a7 ,outreach ,in conducting outreach under subsection 7c71 the ,secretary shall give special consideration to eligible entities that-- 7,a7 are based in1 and provide support for1 communities with high rates of adverse maternal health outcomes or significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available2 7,b7 are led by ,black women2 and 7,c7 offer programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for ,black pregnant and postpartum individuals4 7#b7 ,awards ,in awarding grants under this section1 the ,secretary shall give special consideration to eligible entities that-- 7,a7 are described in subparagraphs 7,a71 7,b71 and 7,c7 of paragraph 7#a72 7,b7 offer programs and resources designed in consultation with and intended for ,black pregnant and postpartum individuals2 and 7,c7 offer programs and resources in the communities in which the respective eligible entities are located that-- 7i7 promote maternal mental health and maternal substance use disorder treatments and supports that are aligned with evidence-based practices for improving maternal mental and behavioral health outcomes for ,black pregnant and postpartum individuals2 7ii7 address social determinants of maternal health for pregnant and postpartum individuals2 7iii7 promote evidence-based health literacy and pregnancy1 childbirth1 and parenting education for pregnant and postpartum individuals2 7iv7 provide support from perinatal health workers to pregnant and postpartum individuals2 7v7 provide culturally congruent training to perinatal health workers2 7vi7 conduct or support research on maternal health issues disproportionately impacting ,black pregnant and postpartum individuals2 7vii7 provide support to family members of individuals who suffered a pregnancy-associated death or pregnancy-related death2 7viii7 operate midwifery practices that provide culturally congruent maternal health care and support1 including for the purposes of-- 7,i7 supporting additional education1 training1 and certification programs1 including support for distance learning2 7,,ii7 providing financial support to current and future midwives to address education costs1 debts1 and other needs2 7,,iii7 clinical site investments2 7,,iv7 supporting preceptor development trainings2 7,v7 expanding the midwifery practice2 or 7,,vi7 related needs identified by the midwifery practice and described in the practice's application2 or 7ix7 have developed other programs and resources that address community-specific needs for pregnant and postpartum individuals and are aligned with evidence-based practices for improving maternal health outcomes for ,black pregnant and postpartum individuals4 7e7 ,technical assistance ,the ,secretary shall provide to grant recipients under this section technical assistance on-- 7#a7 capacity building to establish or expand programs to prevent adverse maternal health outcomes among ,black pregnant and postpartum individuals2 7#b7 best practices in data collection1 measurement1 evaluation1 and reporting2 and 7#c7 planning for sustaining programs to prevent maternal mortality and severe maternal morbidity among ,black pregnant and postpartum individuals after the period of the grant4 7f7 ,evaluation ,not later than the end of fiscal year #bjbf1 the ,secretary shall submit to ,congress an evaluation of the grant program under this section that-- 7#a7 assesses the effectiveness of outreach efforts during the application process in diversifying the pool of grant recipients2 7#b7 makes recommendations for future outreach efforts to diversify the pool of grant recipients for ,department of ,health and ,human ,services grant programs and funding opportunities related to maternal health2 7#c7 assesses the effectiveness of programs funded by grants under this section in improving maternal health outcomes for ,black pregnant and postpartum individuals1 to the extent practicable2 and 7#d7 makes recommendations for future ,department of ,health and ,human ,services grant programs and funding opportunities that deliver funding to community-based organizations that provide programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for ,black pregnant and postpartum individuals4 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjbb through #bjbf4 #bjb4 ,investments in community-based organizations to improve maternal health outcomes in underserved communities 7a7 ,awards ,following the #a-year period beginning on the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall award grants to eligible entities to establish or expand programs to prevent maternal mortality and severe maternal morbidity among underserved groups4 7b7 ,eligibility ,to be eligible to seek a grant under this section1 an entity shall be a community-based organization offering programs and resources aligned with evidence-based practices for improving maternal health outcomes for pregnant and postpartum individuals4 7c7 ,outreach and technical assistance period ,during the #a-year period beginning on the date of enactment of this ,act1 the ,secretary shall-- 7#a7 conduct outreach to encourage eligible entities to apply for grants under this section2 and 7#b7 provide technical assistance to eligible entities on best practices for applying for grants under this section4 7d7 ,special consideration 7#a7 ,outreach ,in conducting outreach under subsection 7c71 the ,secretary shall give special consideration to eligible entities that-- 7,a7 are based in1 and provide support for1 communities with high rates of adverse maternal health outcomes or significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available2 7,b7 are led by individuals from racially1 ethnically1 and geographically diverse backgrounds2 and 7,c7 offer programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for pregnant and postpartum individuals4 7#b7 ,awards ,in awarding grants under this section1 the ,secretary shall give special consideration to eligible entities that-- 7,a7 are described in subparagraphs 7,a71 7,b71 and 7,c7 of paragraph 7#a72 7,b7 offer programs and resources designed in consultation with and intended for pregnant and postpartum individuals from underserved groups2 and 7,c7 offer programs and resources in the communities in which the respective eligible entities are located that-- 7i7 promote maternal mental health and maternal substance use disorder treatments and support that are aligned with evidence-based practices for improving maternal mental and behavioral health outcomes for pregnant and postpartum individuals2 7ii7 address social determinants of maternal health for pregnant and postpartum individuals2 7iii7 promote evidence-based health literacy and pregnancy1 childbirth1 and parenting education for pregnant and postpartum individuals2 7iv7 provide support from perinatal health workers to pregnant and postpartum individuals2 7v7 provide culturally congruent training to perinatal health workers2 7vi7 conduct or support research on maternal health outcomes and disparities2 7vii7 provide support to family members of individuals who suffered a pregnancy-associated death or pregnancy-related death2 7viii7 operate midwifery practices that provide culturally congruent maternal health care and support1 including for the purposes of-- 7,i7 supporting additional education1 training1 and certification programs1 including support for distance learning2 7,,ii7 providing financial support to current and future midwives to address education costs1 debts1 and other needs2 7,,iii7 clinical site investments2 7,,iv7 supporting preceptor development trainings2 7,v7 expanding the midwifery practice2 or 7,,vi7 related needs identified by the midwifery practice and described in the practice's application2 or 7ix7 have developed other programs and resources that address community-specific needs for pregnant and postpartum individuals and are aligned with evidence-based practices for improving maternal health outcomes for pregnant and postpartum individuals4 7e7 ,technical assistance ,the ,secretary shall provide to grant recipients under this section technical assistance on-- 7#a7 capacity building to establish or expand programs to prevent adverse maternal health outcomes among pregnant and postpartum individuals from underserved groups2 7#b7 best practices in data collection1 measurement1 evaluation1 and reporting2 and 7#c7 planning for sustaining programs to prevent maternal mortality and severe maternal morbidity among pregnant and postpartum individuals from underserved groups after the period of the grant4 7f7 ,evaluation ,not later than the end of fiscal year #bjbf1 the ,secretary shall submit to ,congress an evaluation of the grant program under this section that-- 7#a7 assesses the effectiveness of outreach efforts during the application process in diversifying the pool of grant recipients2 7#b7 makes recommendations for future outreach efforts to diversify the pool of grant recipients for ,department of ,health and ,human ,services grant programs and funding opportunities related to maternal health2 7#c7 assesses the effectiveness of programs funded by grants under this section in improving maternal health outcomes for pregnant and postpartum individuals from underserved groups1 to the extent practicable2 and 7#d7 makes recommendations for future ,department of ,health and ,human ,services grant programs and funding opportunities that deliver funding to community-based organizations that provide programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for pregnant and postpartum individuals4 7g7 ,definition ,in this section1 the term underserved groups means to pregnant and postpartum individuals-- 7#a7 from racial and ethnic minority groups 7as such term is defined in section #agjg7;g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjju-#f7;g77#a7772 7#b7 whose household income is equal to or less than #aej percent of the ,federal poverty line2 7#c7 who live in health professional shortage areas 7as such term is defined in section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e7a77#a7772 7#d7 who live in counties with no hospital offering obstetric care1 no birth center1 and no obstetric provider2 or 7#e7 who live in counties with a level of vulnerability of moderate-to-high or higher1 according to the ,social ,vulnerability ,index of the ,centers for ,disease ,control and ,prevention4 7h7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjbb through #bjbf4 #bjc4 ,respectful maternity care training for all employees in maternity care settings ,part ,b of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bic et seq47 is amended by adding at the end the following new section3 #gdb4 ,respectful maternity care training for all employees in maternity care settings 7a7 ,grants ,the ,secretary shall award grants for programs to reduce and prevent bias1 racism1 and discrimination in maternity care settings and to advance respectful1 culturally congruent1 trauma-informed care4 7b7 ,special consideration ,in awarding grants under subsection 7a71 the ,secretary shall give special consideration to applications for programs that would-- 7#a7 apply to all maternity care providers and any employees who interact with pregnant and postpartum individuals in the provider setting1 including front desk employees1 sonographers1 schedulers1 health care professionals1 hospital or health system administrators1 security staff1 and other employees2 7#b7 emphasize periodic1 as opposed to one-time1 trainings for all birthing professionals and employees described in paragraph 7#a72 7#c7 address implicit bias1 racism1 and cultural humility2 7#d7 be delivered in ongoing education settings for providers maintaining their licenses1 with a preference for trainings that provide continuing education units2 7#e7 include trauma-informed care best practices and an emphasis on shared decision making between providers and patients2 7#f7 include antiracism training and programs2 7#g7 be delivered in undergraduate programs that funnel into health professions schools2 7#h7 be delivered in settings that apply to providers of the special supplemental nutrition program for women1 infants1 and children under section #ag of the ,child ,nutrition ,act of #aiff2 7#i7 integrate bias training in obstetric emergency simulation trainings or related trainings2 7#aj7 include training for emergency department employees and emergency medical technicians on recognizing warning signs for severe pregnancy-related complications2 7#aa7 offer training to all maternity care providers on the value of racially1 ethnically1 and professionally diverse maternity care teams to provide culturally congruent care2 or 7#ab7 be based on one or more programs designed by a historically ,black college or university or other minority-serving institution4 7c7 ,application ,an entity desiring a grant under subsection 7a71 shall submit an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,reporting ,each recipient of a grant under this section shall annually submit to the ,secretary a report on the status of activities conducted using the grant1 including1 as applicable1 a description of the impact of training provided through the grant on patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families4 7e7 ,best practices ,based on the annual reports submitted pursuant to subsection 7d71 the ,secretary-- 7#a7 shall produce an annual report on the findings resulting from programs funded through this section2 7#b7 shall disseminate such report to all recipients of grants under this section and to the public2 and 7#c7 may include in such report findings on best practices for improving patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families in maternity care settings4 7f7 ,definitions ,in this section3 7#a7 ,the term postpartum means the one-year period beginning on the last day of an individual's pregnancy4 7#b7 ,the term culturally congruent means in agreement with the preferred cultural values1 beliefs1 world view1 language1 and practices of the health care consumer and other stakeholders4 7#c7 ,the term racial and ethnic minority group has the meaning given such term in section #agjg7;g77#a74 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #e1jjj1jjj for each of fiscal years #bjbb through #bjbf4 4 #bjd4 ,study on reducing and preventing bias1 racism1 and discrimination in maternity care settings 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall seek to enter into an agreement1 not later than #ij days after the date of enactment of this ,act1 with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this section as the ,national ,academies7 under which the ,national ,academies agree to-- 7#a7 conduct a study on the design and implementation of programs to reduce and prevent bias1 racism1 and discrimination in maternity care settings and to advance respectful1 culturally congruent1 trauma-informed care2 and 7#b7 not later than #b years after the date of enactment of this ,act-- 7,a7 complete the study2 and 7,b7 transmit a report on the results of the study to ,congress4 7b7 ,possible topics ,the agreement entered into pursuant to subsection 7a7 may provide for the study of any of the following3 7#a7 ,the development of a scorecard or other evaluation standards for programs designed to reduce and prevent bias1 racism1 and discrimination in maternity care settings to assess the effectiveness of such programs in improving patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families4 7#b7 ,determination of the types and frequency of training to reduce and prevent bias1 racism1 and discrimination in maternity care settings that are demonstrated to improve patient outcomes or patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families4 #bje4 ,respectful maternity care compliance program 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary7 shall award grants to accredited hospitals1 health systems1 and other maternity care settings to establish as an integral part of quality implementation initiatives within one or more hospitals or other birth settings a respectful maternity care compliance program4 7b7 ,program requirements ,a respectful maternity care compliance program funded through a grant under this section shall-- 7#a7 institutionalize mechanisms to allow patients receiving maternity care services1 the families of such patients1 or perinatal health workers supporting such patients to report instances of racism or evidence of bias on the basis of race1 ethnicity1 or another protected class2 7#b7 institutionalize response mechanisms through which representatives of the program can directly follow up with the patient1 if possible1 and the patient's family in a timely manner2 7#c7 prepare and make publicly available a hospital- or health system-wide strategy to reduce bias on the basis of race1 ethnicity1 or another protected class in the delivery of maternity care that includes-- 7,a7 information on the training programs to reduce and prevent bias1 racism1 and discrimination on the basis of race1 ethnicity1 or another protected class for all employees in maternity care settings2 7,b7 information on the number of cases reported to the compliance program2 and 7,c7 the development of methods to routinely assess the extent to which bias1 racism1 or discrimination on the basis of race1 ethnicity1 or another protected class are present in the delivery of maternity care to patients from racial and ethnic minority groups2 7#d7 develop mechanisms to routinely collect and publicly report hospital-level data related to patient-reported experience of care2 and 7#e7 provide annual reports to the ,secretary with information about each case reported to the compliance program over the course of the year containing such information as the ,secretary may require1 such as-- 7,a7 de-identified demographic information on the patient in the case1 such as race1 ethnicity1 gender identity1 and primary language2 7,b7 the content of the report from the patient or the family of the patient to the compliance program2 7,c7 the response from the compliance program2 and 7,d7 to the extent applicable1 institutional changes made as a result of the case4 7c7 ,secretary requirements 7#a7 ,processes ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall establish processes for-- 7,a7 disseminating best practices for establishing and implementing a respectful maternity care compliance program within a hospital or other birth setting2 7,b7 promoting coordination and collaboration between hospitals1 health systems1 and other maternity care delivery settings on the establishment and implementation of respectful maternity care compliance programs2 and 7,c7 evaluating the effectiveness of respectful maternity care compliance programs on maternal health outcomes and patient and family experiences1 especially for patients from racial and ethnic minority groups and their families4 7#b7 ,study 7,a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall1 through a contract with an independent research organization1 conduct a study on strategies to address-- 7i7 racism or bias on the basis of race1 ethnicity1 or another protected class in the delivery of maternity care services2 and 7ii7 successful implementation of respectful care initiatives4 7,b7 ,components of study ,the study under this paragraph shall include the following3 7i7 ,an assessment of the reports submitted to the ,secretary from the respectful maternity care compliance programs pursuant to subsection 7b77#e74 7ii7 ,based on the assessment under clause 7i71 recommendations for potential accountability mechanisms related to cases of racism or bias on the basis of race1 ethnicity1 or another protected class in the delivery of maternity care services at hospitals and other birth settings4 ,such recommendations shall take into consideration medical and non-medical factors that contribute to adverse patient experiences and maternal health outcomes4 7,c7 ,report ,the ,secretary shall submit to ,congress and make publicly available a report on the results of the study under this paragraph4 7d7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated such sums as may be necessary for fiscal years #bjbb through #bjbg4 #bjf4 ,,gao report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act and annually thereafter1 the ,comptroller ,general of the ,united ,states shall submit to ,congress and make publicly available a report on the establishment of respectful maternity care compliance programs within hospitals1 health systems1 and other maternity care settings4 7b7 ,matters included ,the report under paragraph 7#a7 shall include the following3 7#a7 ,information regarding the extent to which hospitals1 health systems1 and other maternity care settings have elected to establish respectful maternity care compliance programs1 including-- 7,a7 which hospitals and other birth settings elect to establish compliance programs and when such programs are established2 7,b7 to the extent practicable1 impacts of the establishment of such programs on maternal health outcomes and patient and family experiences in the hospitals and other birth settings that have established such programs1 especially for patients from racial and ethnic minority groups and their families2 7,c7 information on geographic areas1 and types of hospitals or other birth settings1 where respectful maternity care compliance programs are not being established and information on factors contributing to decisions to not establish such programs2 and 7,d7 recommendations for establishing respectful maternity care compliance programs in geographic areas1 and types of hospitals or other birth settings1 where such programs are not being established4 7#b7 ,whether the funding made available to carry out this section has been sufficient and1 if applicable1 recommendations for additional appropriations to carry out this section4 7#c7 ,such other information as the ,comptroller ,general determines appropriate4 ,,iii ,protecting moms who served #cja4 ,codification of maternity coordination program of ,department of ,veterans ,affairs 7a7 ,program on maternity care coordination 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall carry out the maternity care coordination program described in ,veterans ,health ,administration ,handbook #accj4jc1 or successor handbook4 7#b7 ,training and support ,in carrying out the program under paragraph 7#a71 the ,secretary shall provide to community maternity care providers training and support with respect to the unique needs of pregnant and postpartum veterans1 particularly regarding mental and behavioral health conditions relating to the service of the veterans in the ,armed ,forces4 7b7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to the ,secretary #ae1jjj1jjj for fiscal year #bjbb for the program under subsection 7a77#a74 7#b7 ,supplement not supplant ,amounts authorized under paragraph 7#a7 are authorized in addition to any other amounts authorized for maternity health care and coordination for the ,department of ,veterans ,affairs4 7c7 ,definitions ,in this section3 7#a7 ,community maternity care providers ,the term community maternity care providers means maternity care providers located at non-,department facilities who provide maternity care to veterans under section #agjc of title #ch1 ,united ,states ,code1 or any other law administered by the ,secretary of ,veterans ,affairs4 7#b7 ,non-,department facilities ,the term non-,department facilities has the meaning given that term in section #agja of title #ch1 ,united ,states ,code4 #cjb4 ,report on maternal mortality and severe maternal morbidity among pregnant and postpartum veterans 7a7 ,,gao report ,not later than two years after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 and make publicly available1 a report on maternal mortality and severe maternal morbidity among pregnant and postpartum veterans1 with a particular focus on racial and ethnic disparities in maternal health outcomes for veterans4 7b7 ,matters included ,the report under subsection 7a7 shall include the following3 7#a7 ,to the extent practicable-- 7,a7 the number of pregnant and postpartum veterans who have experienced a pregnancy-related death or pregnancy-associated death in the most recent #aj years of available data2 7,b7 the rate of pregnancy-related deaths per #ajj1jjj live births for pregnant and postpartum veterans2 7,c7 the number of cases of severe maternal morbidity among pregnant and postpartum veterans in the most recent year of available data2 7,d7 the racial and ethnic disparities in maternal mortality and severe maternal morbidity rates among pregnant and postpartum veterans2 7,e7 identification of the causes of maternal mortality and severe maternal morbidity that are unique to veterans1 including post-traumatic stress disorder1 military sexual trauma1 and infertility or miscarriages that may be caused by service in the ,armed ,forces2 7,f7 identification of the causes of maternal mortality and severe maternal morbidity that are unique to veterans from racial and ethnic minority groups2 7,g7 identification of any correlations between the former rank of veterans and their maternal health outcomes2 7,h7 the number of veterans who have been diagnosed with infertility by a health care provider of the ,veterans ,health ,administration each year in the most recent five years1 disaggregated by age1 race1 ethnicity1 sex1 marital status1 sexual orientation1 gender identity1 and geographical location2 7,i7 the number of veterans who have received a clinical diagnosis of unexplained infertility by a health care provider of the ,veterans ,health ,administration each year in the most recent five years2 and 7,j7 the extent to which the rate of incidence of clinically diagnosed infertility among veterans compare or differ to the rate of incidence of clinically diagnosed infertility among the civilian population4 7#b7 ,an assessment of the barriers to determining the information required under paragraph 7#a7 and recommendations for improvements in tracking maternal health outcomes among pregnant and postpartum veterans-- 7,a7 who have health care coverage through the ,department2 7,b7 enrolled in the ,,tricare program2 7,c7 with employer-based or private insurance2 7,d7 enrolled in the ,medicaid program2 and 7,e7 who are uninsured4 7#c7 ,recommendations for legislative and administrative actions to increase access to mental and behavioral health care for pregnant and postpartum veterans who screen positively for maternal mental or behavioral health conditions4 7#d7 ,recommendations to address homelessness1 food insecurity1 poverty1 and related issues among pregnant and postpartum veterans4 7#e7 ,recommendations on how to effectively educate maternity care providers on best practices for providing maternity care services to veterans that addresses the unique maternal health care needs of veteran populations4 7#f7 ,recommendations to reduce maternal mortality and severe maternal morbidity among pregnant and postpartum veterans and to address racial and ethnic disparities in maternal health outcomes for each of the groups described in subparagraphs 7,a7 through 7,e7 of paragraph 7#b74 7#g7 ,recommendations to improve coordination of care between the ,department and non-,department facilities for pregnant and postpartum veterans1 including recommendations to improve-- 7,a7 health record interoperability2 and 7,b7 training for the directors of the ,veterans ,integrated ,service ,networks1 directors of medical facilities of the ,department1 chiefs of staff of such facilities1 maternity care coordinators1 and staff of relevant non-,department facilities4 7#h7 ,an assessment of the authority of the ,secretary of ,veterans ,affairs to access maternal health data collected by the ,department of ,health and ,human ,services and1 if applicable1 recommendations to increase such authority4 7#i7 ,any other information the ,comptroller ,general determines appropriate with respect to the reduction of maternal mortality and severe maternal morbidity among pregnant and postpartum veterans and to address racial and ethnic disparities in maternal health outcomes for veterans4 ,,iv ,perinatal workforce #dja4 ,,hhs agency directives 7a7 ,guidance to ,states 7#a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary7 shall issue and disseminate guidance to ,states to educate providers1 managed care entities1 and other insurers about the value and process of delivering respectful maternal health care through diverse and multidisciplinary care provider models4 7#b7 ,contents ,the guidance required by paragraph 7#a7 shall address how ,states can encourage and incentivize hospitals1 health systems1 midwifery practices1 freestanding birth centers1 other maternity care provider groups1 managed care entities1 and other insurers-- 7,a7 to recruit and retain maternity care providers1 mental and behavioral health care providers acting in accordance with ,state law1 registered dietitians or nutrition professionals 7as such term is defined in section #ahfa7vv77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7vv77#b7771 and lactation consultants certified by the ,international ,board of ,lactation ,consultants ,examiners-- 7i7 from racially1 ethnically1 and linguistically diverse backgrounds2 7ii7 with experience practicing in racially and ethnically diverse communities2 and 7iii7 who have undergone training on implicit bias and racism2 7,b7 to incorporate into maternity care teams-- 7i7 midwives who meet at a minimum the international definition of the midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives2 and 7ii7 perinatal health workers2 7,c7 to provide collaborative1 culturally congruent care2 and 7,d7 to provide opportunities for individuals enrolled in accredited midwifery education programs to participate in job shadowing with maternity care teams in hospitals1 health systems1 midwifery practices1 and freestanding birth centers4 7b7 ,study on respectful and culturally congruent maternity care 7#a7 ,study ,the ,secretary1 acting through the ,director of the ,national ,institutes of ,health1 shall conduct a study on best practices in respectful and culturally congruent maternity care4 7#b7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall-- 7,a7 complete the study required by paragraph 7#a72 7,b7 submit to ,congress and make publicly available a report on the results of such study2 and 7,c7 include in such report-- 7i7 a compendium of examples of hospitals1 health systems1 midwifery practices1 freestanding birth centers1 other maternity care provider groups1 managed care entities1 and other insurers that are delivering respectful and culturally congruent maternal health care2 7ii7 a compendium of examples of hospitals1 health systems1 midwifery practices1 freestanding birth centers1 other maternity care provider groups1 managed care entities1 and other insurers that have made progress in reducing disparities in maternal health outcomes and improving birthing experiences for pregnant and postpartum individuals from racial and ethnic minority groups2 and 7iii7 recommendations to hospitals1 health systems1 midwifery practices1 freestanding birth centers1 other maternity care provider groups1 managed care entities1 and other insurers1 for best practices in respectful and culturally congruent maternity care4 #djb4 ,grants to grow and diversify the perinatal workforce ,title ,,vii of the ,public ,health ,service ,act is amended by inserting after section #geg 7#db ,u4,s4,c4 #bid;f7 the following new section3 #geh4 ,perinatal workforce grants 7a7 ,in general ,the ,secretary shall award grants to entities to establish or expand programs described in subsection 7b7 to grow and diversify the perinatal workforce4 7b7 ,use of funds ,recipients of grants under this section shall use the grants to grow and diversify the perinatal workforce by-- 7#a7 establishing schools or programs that provide education and training to individuals seeking appropriate licensing or certification as-- 7,a7 physician assistants who will complete clinical training in the field of maternal and perinatal health2 or 7,b7 perinatal health workers2 and 7#b7 expanding the capacity of existing schools or programs described in paragraph 7#a71 for the purposes of increasing the number of students enrolled in such schools or programs1 including by awarding scholarships for students4 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to any entity that-- 7#a7 has demonstrated a commitment to recruiting and retaining students and faculty from racial and ethnic minority groups2 7#b7 has developed a strategy to recruit and retain a diverse pool of students into the perinatal workforce program or school supported by funds received through the grant1 particularly from racial and ethnic minority groups and other underserved populations2 7#c7 has developed a strategy to recruit and retain students who plan to practice in a health professional shortage area designated under section #ccb2 7#d7 has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes1 to the extent practicable2 and 7#e7 includes in the standard curriculum for all students within the perinatal workforce program or school a bias1 racism1 or discrimination training program that includes training on implicit bias and racism4 7d7 ,reporting ,as a condition on receipt of a grant under this section for a perinatal workforce program or school1 an entity shall agree to submit to the ,secretary an annual report on the activities conducted through the grant1 including-- 7#a7 the number and demographics of students participating in the program or school2 7#b7 the extent to which students in the program or school are entering careers in-- 7,a7 health professional shortage areas designated under section #ccb2 and 7,b7 areas with significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available2 and 7#c7 whether the program or school has included in the standard curriculum for all students a bias1 racism1 or discrimination training program that includes explicit and implicit bias1 and if so the effectiveness of such training program4 7e7 ,period of grants ,the period of a grant under this section shall be up to #e years4 7f7 ,application ,to seek a grant under this section1 an entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including any information necessary for prioritization under subsection 7c74 7g7 ,technical assistance ,the ,secretary shall provide1 directly or by contract1 technical assistance to entities seeking or receiving a grant under this section on the development1 use1 evaluation1 and post-grant period sustainability of the perinatal workforce programs or schools proposed to be1 or being1 established or expanded through the grant4 7h7 ,report by the ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall prepare and submit to ,congress1 and post on the internet website of the ,department of ,health and ,human ,services1 a report on the effectiveness of the grant program under this section at-- 7#a7 recruiting students from racial and ethnic minority groups2 7#b7 increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health1 and perinatal health workers1 from racial and ethnic minority groups and other underserved populations2 7#c7 increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health1 and perinatal health workers1 working in health professional shortage areas designated under section #ccb2 and 7#d7 increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health1 and perinatal health workers1 working in areas with significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available4 7i7 ,definition ,in this section1 the term racial and ethnic minority group has the meaning given such term in section #agjg7;g74 7j7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjbb through #bjbf4 4 #djc4 ,grants to grow and diversify the nursing workforce in maternal and perinatal health ,title ,,viii of the ,public ,health ,service ,act is amended by inserting after section #haa of that ,act 7#db ,u4,s4,c4 #bif;j7 the following3 #hab4 ,perinatal nursing workforce grants 7a7 ,in general ,the ,secretary shall award grants to schools of nursing to grow and diversify the perinatal nursing workforce4 7b7 ,use of funds ,recipients of grants under this section shall use the grants to grow and diversify the perinatal nursing workforce by providing scholarships to students seeking to become-- 7#a7 nurse practitioners whose education includes a focus on maternal and perinatal health2 or 7#b7 clinical nurse specialists whose education includes a focus on maternal and perinatal health4 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to any school of nursing that-- 7#a7 has developed a strategy to recruit and retain a diverse pool of students seeking to enter careers focused on maternal and perinatal health1 particularly students from racial and ethnic minority groups and other underserved populations2 7#b7 has developed a partnership with a practice setting in a health professional shortage area designated under section #ccb for the clinical placements of the school's students2 7#c7 has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes1 to the extent practicable2 and 7#d7 includes in the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health a bias1 racism1 or discrimination training program that includes education on implicit bias and racism4 7d7 ,reporting ,as a condition on receipt of a grant under this section1 a school of nursing shall agree to submit to the ,secretary an annual report on the activities conducted through the grant1 including1 to the extent practicable-- 7#a7 the number and demographics of students in the school of nursing seeking to enter careers focused on maternal and perinatal health2 7#b7 the extent to which such students are preparing to enter careers in-- 7,a7 health professional shortage areas designated under section #ccb2 and 7,b7 areas with significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available2 and 7#c7 whether the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health includes a bias1 racism1 or discrimination training program that includes education on implicit bias and racism4 7e7 ,period of grants ,the period of a grant under this section shall be up to #e years4 7f7 ,application ,to seek a grant under this section1 an entity shall submit to the ,secretary an application1 at such time1 in such manner1 and containing such information as the ,secretary may require1 including any information necessary for prioritization under subsection 7c74 7g7 ,technical assistance ,the ,secretary shall provide1 directly or by contract1 technical assistance to schools of nursing seeking or receiving a grant under this section on the processes of awarding and evaluating scholarships through the grant4 7h7 ,report by the ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall prepare and submit to ,congress1 and post on the internet website of the ,department of ,health and ,human ,services1 a report on the effectiveness of the grant program under this section at-- 7#a7 recruiting students from racial and ethnic minority groups and other underserved populations2 7#b7 increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health from racial and ethnic minority groups and other underserved populations2 7#c7 increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health working in health professional shortage areas designated under section #ccb2 and 7#d7 increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health working in areas with significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available4 7i7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjbb through #bjbf4 4 #djd4 ,,gao report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act and every #e years thereafter1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on barriers to maternal health education and access to care in the ,united ,states4 ,such report shall include the information and recommendations described in subsection 7b74 7b7 ,content of report ,the report under subsection 7a7 shall include-- 7#a7 an assessment of current barriers to entering accredited midwifery education programs1 and recommendations for addressing such barriers1 particularly for low-income women and women from racial and ethnic minority groups2 7#b7 an assessment of current barriers to entering and successfully completing accredited education programs for other health professional careers related to maternity care1 including maternity care providers1 mental and behavioral health care providers acting in accordance with ,state law1 registered dietitians or nutrition professionals 7as such term is defined in section #ahfa7vv77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7vv77#b7771 and lactation consultants certified by the ,international ,board of ,lactation ,consultants ,examiners1 particularly for low-income women and women from racial and ethnic minority groups2 7#c7 an assessment of current barriers that prevent midwives from meeting the international definition of the midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives1 and recommendations for addressing such barriers1 particularly for low-income women and women from racial and ethnic minority groups2 7#d7 an assessment of disparities in access to maternity care providers1 mental or behavioral health care providers acting in accordance with ,state law1 registered dietitians or nutrition professionals 7as such term is defined in section #ahfa7vv77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7vv77#b7771 lactation consultants certified by the ,international ,board of ,lactation ,consultants ,examiners1 and perinatal health workers1 stratified by race1 ethnicity1 gender identity1 geographic location1 and insurance type and recommendations to promote greater access equity2 and 7#e7 recommendations to promote greater equity in compensation for perinatal health workers under public and private insurers1 particularly for such individuals from racially and ethnically diverse backgrounds4 ,v ,data to save moms #eja4 ,funding for maternal mortality review committees to promote representative community engagement 7a7 ,in general ,section #cag,k7d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77 is amended by adding at the end the following3 7#i7 ,grants to promote representative community engagement in maternal mortality review committees 7,a7 ,in general ,the ,secretary may1 using funds made available pursuant to subparagraph 7,c71 provide assistance to an applicable maternal mortality review committee of a ,state1 ,indian tribe1 tribal organization1 or urban ,indian organization-- 7i7 to select for inclusion in the membership of such a committee community members from the ,state1 ,indian tribe1 tribal organization1 or urban ,indian organization by-- 7,i7 prioritizing community members who can increase the diversity of the committee's membership with respect to race and ethnicity1 location1 and professional background1 including members with non-clinical experiences2 and 7,,ii7 to the extent applicable1 using funds reserved under subsection 7f71 to address barriers to maternal mortality review committee participation for community members1 including required training1 transportation barriers1 compensation1 and other supports as may be necessary2 7ii7 to establish initiatives to conduct outreach and community engagement efforts within communities throughout the ,state or ,tribe to seek input from community members on the work of such maternal mortality review committee1 with a particular focus on outreach to minority women2 and 7iii7 to release public reports assessing-- 7,i7 the pregnancy-related death and pregnancy-associated death review processes of the maternal mortality review committee1 with a particular focus on the maternal mortality review committee's sensitivity to the unique circumstances of pregnant and postpartum individuals from racial and ethnic minority groups 7as such term is defined in section #agjg7;g77#a77 who have suffered pregnancy-related deaths2 and 7,,ii7 the impact of the use of funds made available pursuant to subparagraph 7,c7 on increasing the diversity of the maternal mortality review committee membership and promoting community engagement efforts throughout the ,state or ,tribe4 7,b7 ,technical assistance ,the ,secretary shall provide 7either directly through the ,department of ,health and ,human ,services or by contract7 technical assistance to any maternal mortality review committee receiving a grant under this paragraph on best practices for increasing the diversity of the maternal mortality review committee's membership and for conducting effective community engagement throughout the ,state or ,tribe4 7,c7 ,authorization of appropriations ,in addition to any funds made available under subsection 7f71 there are authorized to be appropriated to carry out this paragraph #aj1jjj1jjj for each of fiscal years #bjbb through #bjbf4 4 7b7 ,definitions ,section #cag,k7e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;e77 is amended-- 7#a7 in paragraph 7#b71 by striking and at the end2 7#b7 in paragraph 7#c77;,b71 by striking the period and inserting 2 and2 and 7#c7 by adding at the end the following3 7#d7 the term urban ,indian organization has the meaning given such term in section #d of the ,indian ,health ,care ,improvement ,act4 4 7c7 ,reservation of funds ,section #cag,k7f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;f77 is amended by adding at the end the following3 ,of the amount made available under the preceding sentence for a fiscal year1 not less than #a1ejj1jjj shall be reserved for grants to ,indian tribes1 tribal organizations1 or urban ,indian organizations44 #ejb4 ,data collection and review ,section #cag,k7d77#c77;,a77i7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77#c77;,a77i77 is amended-- 7#a7 by redesignating subclauses 7,,ii7 and 7,,iii7 as subclauses 7,v7 and 7,,vi71 respectively2 and 7#b7 by inserting after subclause 7,i7 the following3 7,,ii7 to the extent practicable1 reviewing cases of severe maternal morbidity1 according to the most up-to-date indicators2 7,,iii7 to the extent practicable1 reviewing deaths during pregnancy or up to #a year after the end of a pregnancy from suicide1 overdose1 or other death from a mental health condition or substance use disorder attributed to or aggravated by pregnancy or childbirth complications2 7,,iv7 to the extent practicable1 consulting with local community-based organizations representing pregnant and postpartum individuals from demographic groups disproportionately impacted by poor maternal health outcomes to ensure that1 in addition to clinical factors1 non-clinical factors that might have contributed to a pregnancy-related death are appropriately considered2 4 #ejc4 ,review of maternal health data collection processes and quality measures 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator for ,centers for ,medicare ,medicaid ,services and the ,director of the ,agency for ,healthcare ,research and ,quality1 shall consult with relevant stakeholders-- 7#a7 to review existing maternal health data collection processes and quality measures2 and 7#b7 make recommendations to improve such processes and measures1 including topics described in subsection 7c74 7b7 ,collaboration ,in carrying out this section1 the ,secretary shall consult with a diverse group of maternal health stakeholders1 which may include-- 7#a7 pregnant and postpartum individuals and their family members1 and nonprofit organizations representing such individuals1 with a particular focus on patients from racial and ethnic minority groups2 7#b7 community-based organizations that provide support for pregnant and postpartum individuals1 with a particular focus on patients from racial and ethnic minority groups2 7#c7 membership organizations for maternity care providers2 7#d7 organizations representing perinatal health workers2 7#e7 organizations that focus on maternal mental or behavioral health2 7#f7 organizations that focus on intimate partner violence2 7#g7 institutions of higher education1 with a particular focus on minority-serving institutions2 7#h7 licensed and accredited hospitals1 birth centers1 midwifery practices1 or other medical practices that provide maternal health care services to pregnant and postpartum patients2 7#i7 relevant ,state and local public agencies1 including ,state maternal mortality review committees2 and 7#aj7 the ,national ,quality ,forum1 or such other standard-setting organizations specified by the ,secretary4 7c7 ,topics ,the review of maternal health data collection processes and recommendations to improve such processes and measures required under subsection 7a7 shall assess all available relevant information1 including information from ,state-level sources1 and shall consider at least the following3 7#a7 ,current ,state and ,tribal practices for maternal health1 maternal mortality1 and severe maternal morbidity data collection and dissemination1 including consideration of-- 7,a7 the timeliness of processes for amending a death certificate when new information pertaining to the death becomes available to reflect whether the death was a pregnancy-related death2 7,b7 relevant data collected with electronic health records1 including data on race1 ethnicity1 socioeconomic status1 insurance type1 and other relevant demographic information2 7,c7 maternal health data collected and publicly reported by hospitals1 health systems1 midwifery practices1 and birth centers2 7,d7 the barriers preventing ,states from correlating maternal outcome data with race and ethnicity data2 7,e7 processes for determining the cause of a pregnancy-associated death in ,states that do not have a maternal mortality review committee2 7,f7 whether maternal mortality review committees include multidisciplinary and diverse membership 7as described in section #cag,k7d77#a77;,a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77#a77;,a7772 7,g7 whether members of maternal mortality review committees participate in trainings on bias1 racism1 or discrimination1 and the quality of such trainings2 7,h7 the extent to which ,states have implemented systematic processes of listening to the stories of pregnant and postpartum individuals and their family members1 with a particular focus on pregnant and postpartum individuals from racial and ethnic minority groups 7as such term is defined in section #agjg7;g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjju-#f7;g77#a777 and their family members1 to fully understand the causes of1 and inform potential solutions to1 the maternal mortality and severe maternal morbidity crisis within their respective ,states2 7,i7 the extent to which maternal mortality review committees are considering social determinants of maternal health when examining the causes of pregnancy-associated and pregnancy-related deaths2 7,j7 the extent to which maternal mortality review committees are making actionable recommendations based on their reviews of adverse maternal health outcomes and the extent to which such recommendations are being implemented by appropriate stakeholders2 7,k7 the legal and administrative barriers preventing the collection1 collation1 and dissemination of ,state maternity care data2 7,l7 the effectiveness of data collection and reporting processes in separating pregnancy-associated deaths from pregnancy-related deaths2 and 7,m7 the current ,federal1 ,state1 local1 and ,tribal funding support for the activities referred to in subparagraphs 7,a7 through 7,l74 7#b7 ,whether the funding support referred to in paragraph 7#a77,m7 is adequate for ,states to carry out optimal data collection and dissemination processes with respect to maternal health1 maternal mortality1 and severe maternal morbidity4 7#c7 ,current quality measures for maternity care1 including prenatal measures1 labor and delivery measures1 and postpartum measures1 including topics such as-- 7,a7 effective quality measures for maternity care used by hospitals1 health systems1 midwifery practices1 birth centers1 health plans1 and other relevant entities2 7,b7 the sufficiency of current outcome measures used to evaluate maternity care for driving improved care1 experiences1 and outcomes in maternity care payment and delivery system models2 7,c7 maternal health quality measures that other countries effectively use2 7,d7 validated measures that have been used for research purposes that could be tested1 refined1 and submitted for national endorsement2 7,e7 barriers preventing maternity care providers and insurers from implementing quality measures that are aligned with best practices2 7,f7 the frequency with which maternity care quality measures are reviewed and revised2 7,g7 the strengths and weaknesses of the ,prenatal and ,postpartum ,care measures of the ,health ,plan ,employer ,data and ,information ,set measures established by the ,national ,committee for ,quality ,assurance2 7,h7 the strengths and weaknesses of maternity care quality measures under the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and the ,children's ,health ,insurance ,program under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig et seq471 including the extent to which ,states voluntarily report relevant measures2 7,i7 the extent to which maternity care quality measures are informed by patient experiences that include measures of patient-reported experience of care2 7,j7 the current processes for collecting stratified data on the race and ethnicity of pregnant and postpartum individuals in hospitals1 health systems1 midwifery practices1 and birth centers1 and for incorporating such racially and ethnically stratified data in maternity care quality measures2 7,k7 the extent to which maternity care quality measures account for the unique experiences of pregnant and postpartum individuals from racial and ethnic minority groups 7as such term is defined in section #agjg7;g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjju-#f7;g77#a7772 and 7,l7 the extent to which hospitals1 health systems1 midwifery practices1 and birth centers are implementing existing maternity care quality measures4 7#d7 ,recommendations on authorizing additional funds and providing additional technical assistance to improve maternal mortality review committees and ,state and ,tribal maternal health data collection and reporting processes4 7#e7 ,recommendations for new authorities that may be granted to maternal mortality review committees to be able to-- 7,a7 access records from other ,federal and ,state agencies and departments that may be necessary to identify causes of pregnancy-associated and pregnancy-related deaths that are unique to pregnant and postpartum individuals from specific populations1 such as veterans and individuals who are incarcerated2 and 7,b7 work with relevant experts who are not members of the maternal mortality review committee to assist in the review of pregnancy-associated deaths of pregnant and postpartum individuals from specific populations1 such as veterans and individuals who are incarcerated4 7#f7 ,recommendations to improve and standardize current quality measures for maternity care1 with a particular focus on racial and ethnic disparities in maternal health outcomes4 7#g7 ,recommendations to improve the coordination by the ,department of ,health and ,human ,services of the efforts undertaken by the agencies and organizations within the ,department related to maternal health data and quality measures4 7d7 ,report ,not later than #a year after the date of enactment of this ,act1 the ,secretary shall submit to ,congress and make publicly available a report on the results of the review of maternal health data collection processes and quality measures and recommendations to improve such processes and measures required under subsection 7a74 7e7 ,definitions ,in this section3 7#a7 ,maternal mortality review committee ,the term maternal mortality review committee means a maternal mortality review committee duly authorized by a ,state and receiving funding under section #cag,k7a77#b77;,d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;a77#b77;,d774 7#b7 ,pregnancy-associated death ,the term pregnancy-associated1 with respect to a death1 means a death of a pregnant or postpartum individual1 by any cause1 that occurs during1 or within #a year following1 the individual's pregnancy1 regardless of the outcome1 duration1 or site of the pregnancy4 7#c7 ,pregnancy-related death ,the term pregnancy-related1 with respect to a death1 means a death of a pregnant or postpartum individual that occurs during1 or within #a year following1 the individual's pregnancy1 from a pregnancy complication1 a chain of events initiated by pregnancy1 or the aggravation of an unrelated condition by the physiologic effects of pregnancy4 7f7 ,authorization of appropriations ,there are authorized to be appropriated such sums as may be necessary to carry out this section for fiscal years #bjbb through #bjbe4 #ejd4 ,indian ,health ,service study and report on maternal mortality and severe maternal morbidity 7a7 ,definitions ,in this section3 7#a7 ,director ,the term ,director means the ,director of the ,indian ,health ,service4 7#b7 ,indian tribe ,the term ,indian ,tribe has the meaning given the term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#c7 ,maternal mortality review committee ,the term maternal mortality review committee means a maternal mortality review committee duly authorized by a ,state and receiving funding under section #cagk7a77#b77;,d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;a77#b77;,d774 7#d7 ,tribal epidemiology center ,the term ,tribal epidemiology center means a ,tribal epidemiology center established under section #bad of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afbam74 7#e7 ,tribal organization ,the term tribal organization has the meaning given the term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#f7 ,urban ,indian organization ,the term urban ,indian organization has the meaning given the term in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc74 7b7 ,study and report 7#a7 ,study 7,a7 ,in general ,not later than #ij days after the date of enactment of this ,act1 the ,director1 in coordination with the individuals selected under subsection 7c71 shall enter into an agreement with an independent research organization or a ,tribal epidemiology center to conduct a comprehensive study on maternal mortality and severe maternal morbidity in ,indian and ,alaska ,native populations4 7,b7 ,report ,the agreement entered into under subparagraph 7,a7 shall require that the independent research organization or ,tribal epidemiology center submit to the ,director a report describing the results of the study conducted pursuant to that agreement by not later than #b years after the date of enactment of this ,act4 7#b7 ,contents of study ,the study conducted under paragraph 7#a7 shall-- 7,a7 examine the causes of maternal mortality and severe maternal morbidity that are unique to ,indians and ,alaska ,natives2 7,b7 include a systematic process of listening to the stories of pregnant and postpartum ,indians and ,alaska ,natives to fully understand the causes of1 and inform potential solutions to1 the maternal mortality and severe maternal morbidity crisis within the ,indian and ,alaska ,native communities2 7,c7 identify the different settings in which pregnant and postpartum ,indians and ,alaska ,natives receive maternity care1 such as-- 7i7 facilities operated by the ,indian ,health ,service2 7ii7 an ,indian health program operated by an ,indian ,tribe or tribal organization pursuant to a grant from1 or contract1 cooperative agreement1 or compact with1 the ,indian ,health ,service pursuant to the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecja et seq472 and 7iii7 an urban ,indian health program operated by an urban ,indian organization pursuant to a grant from or contract with the ,indian ,health ,service pursuant to title ,v of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afea et seq472 7,d7 determine the different landscapes of maternity care received by pregnant and postpartum ,indians and ,alaska ,natives at the different settings identified under subparagraph 7,c72 7,e7 review processes for coordinating programs of the ,indian ,health ,service with social services provided through other programs administered by the ,secretary of ,health and ,human ,services 7other than the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 the ,medicaid program under title ,,xix of that ,act 7#db ,u4,s4,c4 #acif et seq471 and the ,state ,children's ,health ,insurance ,program established under title ,,xxi of that ,act 7#db ,u4,s4,c4 #acig;aa et seq4772 7,f7 review current data collection and quality measurement processes and practices with respect to pregnant and postpartum ,indians and ,alaska ,natives2 7,g7 assess causes and frequency of maternal mental health conditions and substance use disorders with respect to ,indians and ,alaska ,natives2 7,h7 consider social determinants of health1 including poverty1 lack of health insurance1 unemployment1 sexual violence1 and environmental conditions in ,tribal areas2 7,i7 consider the role that historical mistreatment of ,indian and ,alaska ,native women has played in causing currently high rates of maternal mortality and severe maternal morbidity2 7,j7 consider how current funding of the ,indian ,health ,service affects the ability of the ,indian ,health ,service to deliver quality maternity care2 and 7,k7 consider the extent to which the delivery of maternity care services is culturally appropriate for pregnant and postpartum ,indians and ,alaska ,natives4 7#c7 ,report ,not later than #c years after the date of enactment of this ,act1 the ,director shall submit to ,congress a report describing the results of the study conducted under paragraph 7#a71 including recommendations for policies and practices that can be adopted to improve maternal health outcomes for pregnant and postpartum ,indians and ,alaska ,natives1 including recommendations-- 7,a7 on how to improve maternal health outcomes for ,indians and ,alaska ,natives receiving care at the different settings identified under paragraph 7#b77;,c72 7,b7 on how to reduce misclassification of pregnant and postpartum ,indians and ,alaska ,natives1 including consideration of best practices in training for members of maternal mortality review committees to be able to correctly classify ,indians and ,alaska ,natives2 and 7,c7 informed by the stories shared by pregnant and postpartum ,indians and ,alaska ,natives under paragraph 7#b77;,b7 to improve maternal health outcomes for those individuals4 7c7 ,participating individuals 7#a7 ,in general ,the ,director shall select from among individuals nominated by ,indian ,tribes1 tribal organizations1 and urban ,indian organizations #ab individuals for participation in the study conducted under subsection 7b77#a74 7#b7 ,requirement ,in selecting members under paragraph 7#a71 the ,director shall ensure that each of the #ab service areas of the ,indian ,health ,service is represented4 7d7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #b1jjj1jjj for each of fiscal years #bjbb through #bjbd4 #eje4 ,grants to minority-serving institutions to study maternal mortality1 severe maternal morbidity1 and other adverse maternal health outcomes 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall establish a program under which the ,secretary shall award grants to research centers1 health professions schools and programs1 and other entities at minority-serving institutions to study specific aspects of the maternal health crisis among pregnant and postpartum individuals from racial and ethnic minority groups4 ,such research may-- 7#a7 include the development and implementation of systematic processes of listening to the stories of pregnant and postpartum individuals from racial and ethnic minority groups1 and perinatal health workers supporting such individuals1 to fully understand the causes of1 and inform potential solutions to1 the maternal mortality and severe maternal morbidity crisis within their respective communities2 7#b7 assess the potential causes of relatively low rates of maternal mortality among ,hispanic individuals1 including potential racial misclassification and other data collection and reporting issues that might be misrepresenting maternal mortality rates among ,hispanic individuals in the ,united ,states2 and 7#c7 assess differences in rates of adverse maternal health outcomes among subgroups identifying as ,hispanic4 7b7 ,application ,to be eligible to receive a grant under subsection 7a71 an entity described in such subsection shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,technical assistance ,the ,secretary may use not more than #aj percent of the funds made available under subsection 7g7-- 7#a7 to conduct outreach to minority-serving institutions to raise awareness of the availability of grants under this subsection 7a72 7#b7 to provide technical assistance in the application process for such a grant2 and 7#c7 to promote capacity building as needed to enable entities described in such subsection to submit such an application4 7d7 ,reporting requirement ,each entity awarded a grant under this section shall periodically submit to the ,secretary a report on the status of activities conducted using the grant4 7e7 ,evaluation ,beginning one year after the date on which the first grant is awarded under this section1 the ,secretary shall submit to ,congress an annual report summarizing the findings of research conducted using funds made available under this section4 7f7 ,minority-,serving institutions defined ,in this section1 the term minority-serving institution has the meaning given the term in section #cga7;a7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajfgq7a774 7g7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjbb through #bjbf4 ,,vi ,moms matter #fja4 ,maternal mental health equity grant program 7a7 ,in general ,the ,secretary1 acting through the ,assistant ,secretary for ,mental ,health and ,substance ,use1 shall establish a program to award grants to eligible entities to address maternal mental health conditions and substance use disorders with respect to pregnant and postpartum individuals1 with a focus on racial and ethnic minority groups4 7b7 ,application ,to be eligible to receive a grant under this section an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may provide1 including how such entity will use funds for activities described in subsection 7d7 that are culturally congruent4 7c7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to an eligible entity that-- 7#a7 is1 or will partner with1 a community-based organization to address maternal mental health conditions and substance use disorders described in subsection 7a72 7#b7 is operating in an area with high rates of-- 7,a7 adverse maternal health outcomes2 or 7,b7 significant racial or ethnic disparities in maternal health outcomes2 and 7#c7 is operating in a health professional shortage area designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e74 7d7 ,use of funds ,an eligible entity that receives a grant under this section shall use funds for the following3 7#a7 ,establishing or expanding maternity care programs to improve the integration of maternal health and behavioral health care services into primary care settings where pregnant individuals regularly receive health care services4 7#b7 ,establishing or expanding group prenatal care programs or postpartum care programs4 7#c7 ,expanding existing programs that improve maternal mental and behavioral health during the prenatal and postpartum periods1 with a focus on individuals from racial and ethnic minority groups4 7#d7 ,providing services and support for pregnant and postpartum individuals with maternal mental health conditions and substance use disorders1 including referrals to addiction treatment centers that offer evidence-based treatment options4 7#e7 ,addressing stigma associated with maternal mental health conditions and substance use disorders1 with a focus on racial and ethnic minority groups4 7#f7 ,raising awareness of warning signs of maternal mental health conditions and substance use disorders1 with a focus on pregnant and postpartum individuals from racial and ethnic minority groups4 7#g7 ,establishing or expanding programs to prevent suicide or self-harm among pregnant and postpartum individuals4 7#h7 ,offering evidence-aligned programs at freestanding birth centers that provide maternal mental and behavioral health care education1 treatments1 and services1 and other services for individuals throughout the prenatal and postpartum period4 7#i7 ,establishing or expanding programs to provide education and training to maternity care providers with respect to-- 7,a7 identifying potential warning signs for maternal mental health conditions or substance use disorders in pregnant and postpartum individuals1 with a focus on individuals from racial and ethnic minority groups2 and 7,b7 in the case where such providers identify such warning signs1 offering referrals to mental and behavioral health care professionals4 7#aj7 ,developing a website1 or other source1 that includes information on health care providers who treat maternal mental health conditions and substance use disorders4 7#aa7 ,establishing or expanding programs in communities to improve coordination between maternity care providers and mental and behavioral health care providers who treat maternal mental health conditions and substance use disorders1 including through the use of toll-free hotlines4 7#ab7 ,carrying out other programs aligned with evidence-based practices for addressing maternal mental health conditions and substance use disorders for pregnant and postpartum individuals from racial and ethnic minority groups4 7e7 ,reporting 7#a7 ,eligible entities ,an eligible entity that receives a grant under subsection 7a7 shall submit annually to the ,secretary1 and make publicly available1 a report on the activities conducted using funds received through a grant under this section4 ,such reports shall include quantitative and qualitative evaluations of such activities1 including the experience of individuals who received health care through such grant4 7#b7 ,secretary ,not later than the end of fiscal year #bjbd1 the ,secretary shall submit to ,congress a report that includes-- 7,a7 a summary of the reports received under paragraph 7#a72 7,b7 an evaluation of the effectiveness of grants awarded under this section2 7,c7 recommendations with respect to expanding coverage of evidence-based screenings and treatments for maternal mental health conditions and substance use disorders2 and 7,d7 recommendations with respect to ensuring activities described under subsection 7d7 continue after the end of a grant period4 7f7 ,definitions ,in this section3 7#a7 ,eligible entity ,the term eligible entity means-- 7,a7 a community-based organization serving pregnant and postpartum individuals1 including such organizations serving individuals from racial and ethnic minority groups and other underserved populations2 7,b7 a nonprofit or patient advocacy organization with expertise in maternal mental and behavioral health2 7,c7 a maternity care provider2 7,d7 a mental or behavioral health care provider who treats maternal mental health conditions or substance use disorders2 7,e7 a ,state or local governmental entity1 including a ,state or local public health department2 7,f7 an ,indian ,tribe or ,tribal organization 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd772 and 7,g7 an ,urban ,indian organization 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc774 7#b7 ,freestanding birth center ,the term freestanding birth center has the meaning given that term under section #aije7l7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7#a774 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #be1jjj1jjj for each of fiscal years #bjbb through #bjbe4 #fjb4 ,grants to grow and diversify the maternal mental and behavioral health care workforce ,title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bib et seq47 is amended by inserting after section #geh of such ,act1 as added by section #djb of this ,act1 the following new section3 #geh;,a4 ,maternal mental and behavioral health care workforce grants 7a7 ,in general ,the ,secretary may award grants to entities to establish or expand programs described in subsection 7b7 to grow and diversify the maternal mental and behavioral health care workforce4 7b7 ,use of funds ,recipients of grants under this section shall use the grants to grow and diversify the maternal mental and behavioral health care workforce by-- 7#a7 establishing schools or programs that provide education and training to individuals seeking appropriate licensing or certification as mental or behavioral health care providers who will specialize in maternal mental health conditions or substance use disorders2 or 7#b7 expanding the capacity of existing schools or programs described in paragraph 7#a71 for the purposes of increasing the number of students enrolled in such schools or programs1 including by awarding scholarships for students4 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to any entity that-- 7#a7 has demonstrated a commitment to recruiting and retaining students and faculty from racial and ethnic minority groups2 7#b7 has developed a strategy to recruit and retain a diverse pool of students into the maternal mental or behavioral health care workforce program or school supported by funds received through the grant1 particularly from racial and ethnic minority groups and other underserved populations2 7#c7 has developed a strategy to recruit and retain students who plan to practice in a health professional shortage area designated under section #ccb2 7#d7 has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes1 to the extent practicable2 and 7#e7 includes in the standard curriculum for all students within the maternal mental or behavioral health care workforce program or school a bias1 racism1 or discrimination training program that includes training on implicit bias and racism4 7d7 ,reporting ,as a condition on receipt of a grant under this section for a maternal mental or behavioral health care workforce program or school1 an entity shall agree to submit to the ,secretary an annual report on the activities conducted through the grant1 including-- 7#a7 the number and demographics of students participating in the program or school2 7#b7 the extent to which students in the program or school are entering careers in-- 7,a7 health professional shortage areas designated under section #ccb2 and 7,b7 areas with significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available2 and 7#c7 whether the program or school has included in the standard curriculum for all students a bias1 racism1 or discrimination training program that includes training on implicit bias and racism1 and if so the effectiveness of such training program4 7e7 ,period of grants ,the period of a grant under this section shall be up to #e years4 7f7 ,application ,to seek a grant under this section1 an entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including any information necessary for prioritization under subsection 7c74 7g7 ,technical assistance ,the ,secretary shall provide1 directly or by contract1 technical assistance to entities seeking or receiving a grant under this section on the development1 use1 evaluation1 and post-grant period sustainability of the maternal mental or behavioral health care workforce programs or schools proposed to be1 or being1 established or expanded through the grant4 7h7 ,report by the secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall prepare and submit to ,congress1 and post on the internet website of the ,department of ,health and ,human ,services1 a report on the effectiveness of the grant program under this section at-- 7#a7 recruiting students from racial and ethnic minority groups and other underserved populations2 7#b7 increasing the number of mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders from racial and ethnic minority groups and other underserved populations2 7#c7 increasing the number of mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders working in health professional shortage areas designated under section #ccb2 and 7#d7 increasing the number of mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders working in areas with significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available4 7i7 ,definitions ,in this section3 7#a7 ,racial and ethnic minority group ,the term racial and ethnic minority group has the meaning given such term in section #agjg7;g77#a74 7#b7 ,mental or behavioral health care provider ,the term mental or behavioral health care provider refers to a health care provider in the field of mental and behavioral health1 including substance use disorders1 acting in accordance with ,state law4 7j7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjbb through #bjbf4 4 ,,vii ,justice for incarcerated moms #gja4 ,ending the shackling of pregnant individuals 7a7 ,in general ,beginning on the date that is #f months after the date of enactment of this ,act1 and annually thereafter1 in each ,state that receives a grant under subpart #a of part ,e of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajaea et seq47 7commonly referred to as the ,edward ,byrne ,memorial ,justice ,grant ,program7 and that does not have in effect throughout the ,state for such fiscal year laws restricting the use of restraints on pregnant individuals in prison that are substantially similar to the rights1 procedures1 requirements1 effects1 and penalties set forth in section #dcbb of title #ah1 ,united ,states ,code1 the amount of such grant that would otherwise be allocated to such ,state under such subpart for the fiscal year shall be decreased by #be percent4 7b7 ,reallocation ,amounts not allocated to a ,state for failure to comply with subsection 7a7 shall be reallocated in accordance with subpart #a of part ,e of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajaea et seq47 to ,states that have complied with such subsection4 #gjb4 ,creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods 7a7 ,establishment 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general1 acting through the ,director of the ,bureau of ,prisons1 shall establish1 in not fewer than #f ,bureau of ,prisons facilities1 programs to optimize maternal health outcomes for pregnant and postpartum individuals incarcerated in such facilities4 7#b7 ,required consultation ,the ,attorney ,general shall establish the programs authorized under paragraph 7#a7 in consultation with stakeholders such as-- 7,a7 relevant community-based organizations1 particularly organizations that represent incarcerated and formerly incarcerated individuals and organizations that seek to improve maternal health outcomes for pregnant and postpartum individuals from racial and ethnic minority groups2 7,b7 relevant organizations representing patients1 with a particular focus on patients from racial and ethnic minority groups2 7,c7 organizations representing maternity care providers and maternal health care education programs2 7,d7 perinatal health workers2 and 7,e7 researchers and policy experts in fields related to maternal health care for incarcerated individuals4 7b7 ,start date ,each facility selected under subsection 7a7 shall begin facility programs not later than #ah months after the date of enactment of this ,act4 7c7 ,facility priority ,in carrying out subsection 7a71 the ,director shall give priority to a facility based on-- 7#a7 the number of pregnant and postpartum individuals incarcerated in such facility and1 among such individuals1 the number of pregnant and postpartum individuals from racial and ethnic minority groups2 and 7#b7 the extent to which the leaders of such facility have demonstrated a commitment to developing exemplary programs for pregnant and postpartum individuals incarcerated in such facility4 7d7 ,program duration ,the programs established under this section shall be for a #e-year period4 7e7 ,programs ,bureau of ,prisons facilities selected by the ,director shall establish programs for pregnant and postpartum incarcerated individuals1 and such programs-- 7#a7 may-- 7,a7 provide access to perinatal health workers from pregnancy through the postpartum period2 7,b7 provide access to healthy foods and counseling on nutrition1 recommended activity levels1 and safety measures throughout pregnancy2 7,c7 train correctional officers to ensure that pregnant incarcerated individuals receive safe and respectful treatment2 7,d7 train medical personnel to ensure that pregnant incarcerated individuals receive trauma-informed1 culturally congruent care that promotes the health and safety of the pregnant individuals2 7,e7 provide counseling and treatment for individuals who have suffered from-- 7i7 diagnosed mental or behavioral health conditions1 including trauma and substance use disorders2 7ii7 trauma or violence1 including domestic violence2 7iii7 human immunodeficiency virus2 7iv7 sexual abuse2 7v7 pregnancy or infant loss2 or 7vi7 chronic conditions2 7,f7 provide evidence-based pregnancy and childbirth education1 parenting support1 and other relevant forms of health literacy2 7,g7 provide clinical education opportunities to maternity care providers in training to expand pathways into maternal health care careers serving incarcerated individuals2 7,h7 offer opportunities for postpartum individuals to maintain contact with the individual's newborn child to promote bonding1 including enhanced visitation policies1 access to prison nursery programs1 or breastfeeding support2 7,i7 provide reentry assistance1 particularly to-- 7i7 ensure access to health insurance coverage and transfer of health records to community providers if an incarcerated individual exits the criminal justice system during such individual's pregnancy or in the postpartum period2 and 7ii7 connect individuals exiting the criminal justice system during pregnancy or in the postpartum period to community-based resources1 such as referrals to health care providers1 substance use disorder treatments1 and social services that address social determinants maternal of health2 or 7,j7 establish partnerships with local public entities1 private community entities1 community-based organizations1 ,indian ,tribes and tribal organizations 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd771 and urban ,indian organizations 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 to establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals2 and 7#b7 may include-- 7,a7 evidence-based childbirth education or parenting classes2 7,b7 prenatal health coordination2 7,c7 family and individual counseling2 7,d7 evidence-based screenings1 education1 and1 as needed1 treatment for mental and behavioral health conditions1 including drug and alcohol treatments2 7,e7 family case management services2 7,f7 domestic violence education and prevention2 7,g7 physical and sexual abuse counseling2 and 7,h7 programs to address social determinants of health such as employment1 housing1 education1 transportation1 and nutrition4 7f7 ,implementation and reporting ,a selected facility shall be responsible for-- 7#a7 implementing programs1 which may include the programs described in subsection 7e72 and 7#b7 not later than #c years after the date of enactment of this ,act1 and #f years after the date of enactment of this ,act1 reporting results of the programs to the ,director1 including information describing-- 7,a7 relevant quantitative indicators of success in improving the standard of care and health outcomes for pregnant and postpartum incarcerated individuals in the facility1 including data stratified by race1 ethnicity1 sex1 gender1 age1 geography1 disability status1 the category of the criminal charge against such individual1 rates of pregnancy-related deaths1 pregnancy-associated deaths1 cases of infant mortality and morbidity1 rates of preterm births and low-birthweight births1 cases of severe maternal morbidity1 cases of violence against pregnant or postpartum individuals1 diagnoses of maternal mental or behavioral health conditions1 and other such information as appropriate2 7,b7 relevant qualitative and quantitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs1 including measures of patient-reported experience of care2 and 7,c7 strategies to sustain such programs after fiscal year #bjbf and expand such programs to other facilities4 7g7 ,report ,not later than #f years after the date of enactment of this ,act1 the ,director shall submit to the ,attorney ,general and to the ,congress a report describing the results of the programs funded under this section4 7h7 ,oversight ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general shall award a contract to an independent organization or independent organizations to conduct oversight of the programs described in subsection 7e74 7i7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjbb through #bjbf4 #gjc4 ,grant program to improve maternal health outcomes for individuals in ,state and local prisons and jails 7a7 ,establishment 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general1 acting through the ,director of the ,bureau of ,justice ,assistance1 shall award ,justice for ,incarcerated ,moms grants to ,states to establish or expand programs in ,state and local prisons and jails for pregnant and postpartum incarcerated individuals4 7#b7 ,required consultation ,the ,attorney ,general shall award the grants authorized under paragraph 7#a7 in consultation with stakeholders such as-- 7,a7 relevant community-based organizations1 particularly organizations that represent incarcerated and formerly incarcerated individuals and organizations that seek to improve maternal health outcomes for pregnant and postpartum individuals from racial and ethnic minority groups2 7,b7 relevant organizations representing patients1 with a particular focus on patients from racial and ethnic minority groups2 7,c7 organizations representing maternity care providers and maternal health care education programs2 7,d7 perinatal health workers2 and 7,e7 researchers and policy experts in fields related to maternal health care for incarcerated individuals4 7b7 ,applications ,each applicant for a grant under this section shall submit to the ,director of the ,bureau of ,justice ,assistance an application at such time1 in such manner1 and containing such information as the ,director may require4 7c7 ,use of funds ,a ,state that is awarded a grant under this section shall use such grant to establish or expand programs for pregnant and postpartum incarcerated individuals1 and such programs-- 7#a7 may-- 7,a7 provide access to perinatal health workers from pregnancy through the postpartum period2 7,b7 provide access to healthy foods and counseling on nutrition1 recommended activity levels1 and safety measures throughout pregnancy2 7,c7 train correctional officers to ensure that pregnant incarcerated individuals receive safe and respectful treatment2 7,d7 train medical personnel to ensure that pregnant incarcerated individuals receive trauma-informed1 culturally congruent care that promotes the health and safety of the pregnant individuals2 7,e7 provide counseling and treatment for individuals who have suffered from-- 7i7 diagnosed mental or behavioral health conditions1 including trauma and substance use disorders2 7ii7 trauma or violence1 including domestic violence2 7iii7 human immunodeficiency virus2 7iv7 sexual abuse2 7v7 pregnancy or infant loss2 or 7vi7 chronic conditions2 7,f7 provide evidence-based pregnancy and childbirth education1 parenting support1 and other relevant forms of health literacy2 7,g7 provide clinical education opportunities to maternity care providers in training to expand pathways into maternal health care careers serving incarcerated individuals2 7,h7 offer opportunities for postpartum individuals to maintain contact with the individual's newborn child to promote bonding1 including enhanced visitation policies1 access to prison nursery programs1 or breastfeeding support2 7,i7 provide reentry assistance1 particularly to-- 7i7 ensure access to health insurance coverage and transfer of health records to community providers if an incarcerated individual exits the criminal justice system during such individual's pregnancy or in the postpartum period2 and 7ii7 connect individuals exiting the criminal justice system during pregnancy or in the postpartum period to community-based resources1 such as referrals to health care providers1 substance use disorder treatments1 and social services that address social determinants of maternal health2 or 7,j7 establish partnerships with local public entities1 private community entities1 community-based organizations1 ,indian ,tribes and tribal organizations 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd771 and urban ,indian organizations 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 to establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals2 and 7#b7 may include-- 7,a7 evidence-based childbirth education or parenting classes2 7,b7 prenatal health coordination2 7,c7 family and individual counseling2 7,d7 evidence-based screenings1 education1 and1 as needed1 treatment for mental and behavioral health conditions1 including drug and alcohol treatments2 7,e7 family case management services2 7,f7 domestic violence education and prevention2 7,g7 physical and sexual abuse counseling2 and 7,h7 programs to address social determinants of health such as employment1 housing1 education1 transportation1 and nutrition4 7d7 ,priority ,in awarding grants under this section1 the ,director of the ,bureau of ,justice ,assistance shall give priority to applicants based on-- 7#a7 the number of pregnant and postpartum individuals incarcerated in the ,state and1 among such individuals1 the number of pregnant and postpartum individuals from racial and ethnic minority groups2 and 7#b7 the extent to which the ,state has demonstrated a commitment to developing exemplary programs for pregnant and postpartum individuals incarcerated in the prisons and jails in the ,state4 7e7 ,grant duration ,a grant awarded under this section shall be for a #e-year period4 7f7 ,implementing and reporting ,a ,state that receives a grant under this section shall be responsible for-- 7#a7 implementing the program funded by the grant2 and 7#b7 not later than #c years after the date of enactment of this ,act1 and #f years after the date of enactment of this ,act1 reporting results of such program to the ,attorney ,general1 including information describing-- 7,a7 relevant quantitative indicators of the program's success in improving the standard of care and health outcomes for pregnant and postpartum incarcerated individuals in the facility1 including data stratified by race1 ethnicity1 sex1 gender1 age1 geography1 disability status1 category of the criminal charge against such individual1 incidence rates of pregnancy-related deaths1 pregnancy-associated deaths1 cases of infant mortality and morbidity1 rates of preterm births and low-birthweight births1 cases of severe maternal morbidity1 cases of violence against pregnant or postpartum individuals1 diagnoses of maternal mental or behavioral health conditions1 and other such information as appropriate2 7,b7 relevant qualitative and quantitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs1 including measures of patient-reported experience of care2 and 7,c7 strategies to sustain such programs beyond the duration of the grant and expand such programs to other facilities4 7g7 ,report ,not later than #f years after the date of enactment of this ,act1 the ,attorney ,general shall submit to the ,congress a report describing the results of such grant programs4 7h7 ,oversight ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general shall award a contract to an independent organization or independent organizations to conduct oversight of the programs described in subsection 7c74 7i7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjbb through #bjbf4 #gjd4 ,,gao report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on adverse maternal and infant health outcomes among incarcerated individuals and infants born to such individuals1 with a particular focus on racial and ethnic disparities in maternal and infant health outcomes for incarcerated individuals4 7b7 ,contents of report ,the report described in this section shall include-- 7#a7 to the extent practicable-- 7,a7 the number of pregnant individuals who are incarcerated in ,bureau of ,prisons facilities2 7,b7 the number of incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local correctional facilities1 who have experienced a pregnancy-related death1 pregnancy-associated death1 or the death of an infant in the most recent #aj years of available data2 7,c7 the number of cases of severe maternal morbidity among incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities1 in the most recent #aj years of available data2 7,d7 the number of preterm and low-birthweight births of infants born to incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local correctional facilities1 in the most recent #aj years of available data2 and 7,e7 statistics on the racial and ethnic disparities in maternal and infant health outcomes and severe maternal morbidity rates among incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities2 7#b7 in the case that the ,comptroller ,general of the ,united ,states is unable determine the information required in subparagraphs 7,a7 through 7,c7 of paragraph 7#a71 an assessment of the barriers to determining such information and recommendations for improvements in tracking maternal health outcomes among incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities2 7#c7 causes of adverse maternal health outcomes that are unique to incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities2 7#d7 causes of adverse maternal health outcomes and severe maternal morbidity that are unique to incarcerated individuals from racial and ethnic minority groups2 7#e7 recommendations to reduce maternal mortality and severe maternal morbidity among incarcerated individuals and to address racial and ethnic disparities in maternal health outcomes for incarcerated individuals in ,bureau of ,prisons facilities and ,state and local prisons and jails2 and 7#f7 such other information as may be appropriate to reduce the occurrence of adverse maternal health outcomes among incarcerated individuals and to address racial and ethnic disparities in maternal health outcomes for such individuals4 #gje4 ,,macpac report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,medicaid and ,,chip ,payment and ,access ,commission 7referred to in this section as ,,macpac7 shall publish a report on the implications of pregnant and postpartum incarcerated individuals being ineligible for medical assistance under a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 that contains the information described in subsection 7b74 7b7 ,information described ,the information described in this subsection includes-- 7#a7 information on the effect of ineligibility for medical assistance under a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 on maternal health outcomes for pregnant and postpartum incarcerated individuals1 concentrating on the effects of such ineligibility for pregnant and postpartum individuals from racial and ethnic minority groups2 and 7#b7 the potential implications on maternal health outcomes resulting from suspending eligibility for medical assistance under a ,state plan under such title when a pregnant or postpartum individual is incarcerated4 ,,viii ,tech to save moms #hja4 ,integrated telehealth models in maternity care services 7a7 ,in general ,section #aaae;,a7b77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#b77;,b77 is amended by adding at the end the following3 7xxviii7 ,focusing on title ,,xix1 providing for the adoption of and use of telehealth tools that allow for screening1 monitoring1 and management of common health complications with respect to an individual receiving medical assistance during such individual's pregnancy and for not more than a #a-year period beginning on the last day of the pregnancy4 4 7b7 ,effective date ,the amendment made by subsection 7a7 shall take effect #a year after the date of enactment of this ,act4 #hjb4 ,grants to expand the use of technology-enabled collaborative learning and capacity models for pregnant and postpartum individuals ,title ,,iii of the ,public ,health ,service ,act is amended by inserting after section #ccj,n 7#db ,u4,s4,c4 #bed;c-#ai7 the following3 #ccj,o4 ,expanding capacity for maternal health outcomes 7a7 ,establishment ,beginning not later than #a year after the date of enactment of this section1 the ,secretary shall award grants to eligible entities to evaluate1 develop1 and expand the use of technology-enabled collaborative learning and capacity building models and improve maternal health outcomes-- 7#a7 in health professional shortage areas2 7#b7 in areas with high rates of maternal mortality and severe maternal morbidity2 7#c7 in areas with significant racial and ethnic disparities in maternal health outcomes2 and 7#d7 for medically underserved populations and ,american ,indians and ,alaska ,natives1 including ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations4 7b7 ,use of ,funds 7#a7 ,required uses ,recipients of grants under this section shall use the grants to-- 7,a7 train maternal health care providers1 students1 and other similar professionals through models that include-- 7i7 methods to increase safety and health care quality2 7ii7 methods to address implicit bias1 racism1 and discrimination2 7iii7 best practices in screening for maternal mental health conditions and substance use disorders and1 as needed1 evaluating and treating such conditions and disorders2 7iv7 training on best practices in maternity care for pregnant and postpartum individuals during the ,,covid-#ai public health emergency or future public health emergencies2 7v7 methods to screen for social determinants of maternal health risks in the prenatal and postpartum2 and 7vi7 the use of remote patient monitoring tools for pregnancy-related complications described in section #aaae;,a7b77#b77;,b77xxviii72 7,b7 evaluate and collect information on the affect of such models on-- 7i7 access to and quality of care2 7ii7 outcomes with respect to the health of an individual2 and 7iii7 the experience of individuals who receive pregnancy-related health care2 7,c7 develop qualitative and quantitative measures to identify best practices for the expansion and use of such models2 7,d7 study the effect of such models on patient outcomes and maternity care providers2 and 7,e7 conduct any other activity1 as determined by the ,secretary4 7#b7 ,permissible uses ,recipients of grants under this section may use grants to support-- 7,a7 the use and expansion of technology-enabled collaborative learning and capacity building models1 including hardware and software that-- 7i7 enables distance learning and technical support2 and 7ii7 supports the secure exchange of electronic health information2 and 7,b7 maternity care providers1 students1 and other similar professionals in the provision of maternity care through such models4 7c7 ,application 7#a7 ,in general ,an eligible entity seeking a grant under subsection 7a7 shall submit to the ,secretary an application1 at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,assurance ,an application under paragraph 7#a7 shall include an assurance that such entity shall collect information on1 and assess the affect of1 the use of technology-enabled collaborative learning and capacity building models1 including with respect to-- 7,a7 maternal health outcomes2 7,b7 access to maternal health care services2 7,c7 quality of maternal health care2 and 7,d7 retention of maternity care providers serving areas and populations described in subsection 7a74 7d7 ,limitations 7#a7 ,number ,each entity receiving a grant under this section may receive not more than #a such grant4 7#b7 ,duration ,a grant awarded under this section shall be for a #e-year period4 7e7 ,access to broadband ,in administering grants under this section1 the ,secretary may coordinate with other agencies to ensure that funding opportunities are available to support access to reliable1 high-speed internet for grantees4 7f7 ,technical assistance ,the ,secretary shall provide 7either directly or by contract7 technical assistance to eligible entities1 including recipients of grants under subsection 7a71 on the development1 use1 and sustainability of technology-enabled collaborative learning and capacity building models to expand access to maternal health care services provided by such entities1 including-- 7#a7 in health professional shortage areas2 7#b7 in areas with high rates of maternal mortality and severe maternal morbidity or significant racial and ethnic disparities in maternal health outcomes2 and 7#c7 for medically underserved populations or ,american ,indians and ,alaska ,natives4 7g7 ,research and evaluation ,the ,secretary1 in consultation with experts1 shall develop a strategic plan to research and evaluate the evidence for such models4 7h7 ,reporting 7#a7 ,eligible entities ,an eligible entity that receives a grant under subsection 7a7 shall submit to the ,secretary a report1 at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall submit to ,congress1 and make available on the website of the ,department of ,health and ,human ,services1 a report that includes-- 7,a7 a description of grants awarded under subsection 7a7 and the purpose and amounts of such grants2 7,b7 a summary of-- 7i7 the evaluations conducted under subsection 7b77#a77;,b72 7ii7 any technical assistance provided under subsection 7f72 and 7iii7 the activities conducted under a grant awarded under subsection 7a72 and 7,c7 a description of any significant findings with respect to-- 7i7 patient outcomes2 and 7ii7 best practices for expanding1 using1 or evaluating technology-enabled collaborative learning and capacity building models4 7i7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #f1jjj1jjj for each of fiscal years #bjbb through #bjbf4 7j7 ,definitions ,in this section3 7#a7 ,eligible entity 7,a7 ,in general ,the term eligible entity means an entity that provides1 or supports the provision of1 maternal health care services or other evidence-based services for pregnant and postpartum individuals-- 7i7 in health professional shortage areas2 7ii7 in areas with high rates of adverse maternal health outcomes or significant racial and ethnic disparities in maternal health outcomes2 and 7iii7 who are-- 7,i7 members of medically underserved populations2 or 7,,ii7 ,american ,indians and ,alaska ,natives1 including ,indian ,tribes1 ,tribal organizations1 and urban ,indian organizations4 7,b7 ,inclusions ,an eligible entity may include entities that lead1 or are capable of leading1 a technology-enabled collaborative learning and capacity building model4 7#b7 ,health professional shortage area ,the term health professional shortage area means a health professional shortage area designated under section #ccb4 7#c7 ,indian ,tribe ,the term ,indian ,tribe has the meaning given such term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#d7 ,maternal mortality ,the term maternal mortality means a death occurring during or within #a-year period after pregnancy caused by pregnancy-related or childbirth complications1 including a suicide1 overdose1 or other death resulting from a mental health or substance use disorder attributed to or aggravated by pregnancy or childbirth complications4 7#e7 ,medically underserved population ,the term medically underserved population has the meaning given such term in section #ccj7;b77#c74 7#f7 ,postpartum ,the term postpartum means the #a-year period beginning on the last date of an individual's pregnancy4 7#g7 ,severe maternal morbidity ,the term severe maternal morbidity means a health condition1 including a mental health or substance use disorder1 attributed to or aggravated by pregnancy or childbirth that results in significant short-term or long-term consequences to the health of the individual who was pregnant4 7#h7 ,technology-enabled collaborative learning and capacity building model ,the term technology-enabled collaborative learning and capacity building model means a distance health education model that connects health care professionals1 and other specialists1 through simultaneous interactive videoconferencing for the purpose of facilitating case-based learning1 disseminating best practices1 and evaluating outcomes in the context of maternal health care4 7#i7 ,tribal organization ,the term ,tribal organization has the meaning given such term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#aj7 ,urban ,indian organization ,the term urban ,indian organization has the meaning given such term in section #d of the ,indian ,health ,care ,improvement ,act4 4 #hjc4 ,grants to promote equity in maternal health outcomes through digital tools 7a7 ,in general ,beginning not later than #a year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall award grants to eligible entities to reduce racial and ethnic disparities in maternal health outcomes by increasing access to digital tools related to maternal health care4 7b7 ,applications ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall prioritize an eligible entity-- 7#a7 in an area with high rates of adverse maternal health outcomes or significant racial and ethnic disparities in maternal health outcomes2 7#b7 in a health professional shortage area designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e72 and 7#c7 that promotes technology that addresses racial and ethnic disparities in maternal health outcomes4 7d7 ,limitations 7#a7 ,number ,each entity receiving a grant under this section may receive not more than #a such grant4 7#b7 ,duration ,a grant awarded under this section shall be for a #e-year period4 7e7 ,technical assistance ,the ,secretary shall provide technical assistance to an eligible entity on the development1 use1 evaluation1 and post-grant sustainability of digital tools for purposes of promoting equity in maternal health outcomes4 7f7 ,reporting 7#a7 ,eligible entities ,an eligible entity that receives a grant under subsection 7a7 shall submit to the ,secretary a report1 at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,secretary ,not later than #d years after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a report that includes-- 7,a7 an evaluation on the effectiveness of grants awarded under this section to improve health outcomes for pregnant and postpartum individuals from racial and ethnic minority groups2 7,b7 recommendations on new grant programs that promote the use of technology to improve such maternal health outcomes2 and 7,c7 recommendations with respect to-- 7i7 technology-based privacy and security safeguards in maternal health care2 7ii7 reimbursement rates for maternal telehealth services2 7iii7 the use of digital tools to analyze large data sets to identify potential pregnancy-related complications2 7iv7 barriers that prevent maternity care providers from providing telehealth services across ,states2 7v7 the use of consumer digital tools such as mobile phone applications1 patient portals1 and wearable technologies to improve maternal health outcomes2 7vi7 barriers that prevent access to telehealth services1 including a lack of access to reliable1 high-speed internet or electronic devices2 7vii7 barriers to data sharing between the ,special ,supplemental ,nutrition ,program for ,women1 ,infants1 and ,children program and maternity care providers1 and recommendations for addressing such barriers2 and 7viii7 lessons learned from expanded access to telehealth related to maternity care during the ,,covid-#ai public health emergency4 7g7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #f1jjj1jjj for each of fiscal years #bjbb through #bjbf4 #hjd4 ,report on the use of technology in maternity care 7a7 ,in general ,not later than #fj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall seek to enter an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this ,act as the ,national ,academies7 under which the ,national ,academies shall conduct a study on the use of technology and patient monitoring devices in maternity care4 7b7 ,content ,the agreement entered into pursuant to subsection 7a7 shall provide for the study of the following3 7#a7 ,the use of innovative technology 7including artificial intelligence7 in maternal health care1 including the extent to which such technology has affected racial or ethnic biases in maternal health care4 7#b7 ,the use of patient monitoring devices 7including pulse oximeter devices7 in maternal health care1 including the extent to which such devices have affected racial or ethnic biases in maternal health care4 7#c7 ,best practices for reducing and preventing racial or ethnic biases in the use of innovative technology and patient monitoring devices in maternity care4 7#d7 ,best practices in the use of innovative technology and patient monitoring devices for pregnant and postpartum individuals from racial and ethnic minority groups4 7#e7 ,best practices with respect to privacy and security safeguards in such use4 7c7 ,report ,the agreement under subsection 7a7 shall direct the ,national ,academies to complete the study under this section1 and transmit to ,congress a report on the results of the study1 not later than #b years after the date of enactment of this ,act4 ,,ix ,impact to save moms #ija4 ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project 7a7 ,in general ,for the period of fiscal years #bjbb through #bjbf1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall establish and implement1 in accordance with the requirements of this section1 a demonstration project1 to be known as the ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project 7referred to in this section as the ,demonstration ,project71 for purposes of allowing ,states to test payment models under their ,state plans under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and ,state child health plans under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig;aa et seq47 with respect to maternity care provided to pregnant and postpartum individuals enrolled in such ,state plans and ,state child health plans4 7b7 ,coordination ,in establishing the ,demonstration ,project1 the ,secretary shall coordinate with stakeholders such as-- 7#a7 ,state ,medicaid programs2 7#b7 maternity care providers and organizations representing maternity care providers2 7#c7 relevant organizations representing patients1 with a particular focus on patients from racial and ethnic minority groups2 7#d7 relevant community-based organizations1 particularly organizations that seek to improve maternal health outcomes for pregnant and postpartum individuals from racial and ethnic minority groups2 7#e7 perinatal health workers2 7#f7 relevant health insurance issuers2 7#g7 hospitals1 health systems1 midwifery practices1 freestanding birth centers 7as such term is defined in paragraph 7#c77;,b7 of section #aije7l7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l7771 ,federally-qualified health centers 7as such term is defined in paragraph 7#b77;,b7 of such section71 and rural health clinics 7as such term is defined in section #ahfa7;aa7 of such ,act 7#db ,u4,s4,c4 #aciex7aa7772 7#h7 researchers and policy experts in fields related to maternity care payment models2 and 7#i7 any other stakeholders as the ,secretary determines appropriate1 with a particular focus on stakeholders from racial and ethnic minority groups4 7c7 ,considerations ,in establishing the ,demonstration ,project1 the ,secretary shall consider any alternative payment model that-- 7#a7 is designed to improve maternal health outcomes for racial and ethnic groups with disproportionate rates of adverse maternal health outcomes2 7#b7 includes methods for stratifying patients by pregnancy risk level and1 as appropriate1 adjusting payments under such model to take into account pregnancy risk level2 7#c7 establishes evidence-based quality metrics for such payments2 7#d7 includes consideration of non-hospital birth settings such as freestanding birth centers 7as so defined72 7#e7 includes consideration of social determinants of maternal health2 or 7#f7 includes diverse maternity care teams that include-- 7,a7 maternity care providers1 mental and behavioral health care providers acting in accordance with ,state law1 registered dietitians or nutrition professionals 7as such term is defined in section #ahfa7vv77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7vv77#b7771 and ,international ,board ,certified ,lactation ,consultants-- 7i7 from racially1 ethnically1 and professionally diverse backgrounds2 7ii7 with experience practicing in racially and ethnically diverse communities2 or 7iii7 who have undergone training on implicit bias and racism2 and 7,b7 perinatal health workers4 7d7 ,eligibility ,to be eligible to participate in the ,demonstration ,project1 a ,state shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7e7 ,evaluation ,the ,secretary shall conduct an evaluation of the ,demonstration ,project to determine the impact of the ,demonstration ,project on-- 7#a7 maternal health outcomes1 with data stratified by race1 ethnicity1 socioeconomic indicators1 and any other factors as the ,secretary determines appropriate2 7#b7 spending on maternity care by ,states participating in the ,demonstration ,project2 7#c7 to the extent practicable1 qualitative and quantitative measures of patient experience2 and 7#d7 any other areas of assessment that the ,secretary determines relevant4 7f7 ,report ,not later than #a year after the completion or termination date of the ,demonstration ,project1 the ,secretary shall submit to the ,congress1 and make publicly available1 a report containing-- 7#a7 the results of any evaluation conducted under subsection 7e72 and 7#b7 a recommendation regarding whether the ,demonstration ,project should be continued after fiscal year #bjbf and expanded on a national basis4 7g7 ,authorization of appropriations ,there are authorized to be appropriated such sums as are necessary to carry out this section4 7h7 ,definitions ,in this section3 7#a7 ,alternative payment model ,the term alternative payment model has the meaning given such term in section #ahcc7z77#c77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7z77#c77;,c774 7#b7 ,perinatal ,the term perinatal means the period beginning on the day an individual becomes pregnant and ending on the last day of the #a-year period beginning on the last day of such individual's pregnancy4 7#c7 ,racial and ethnic minority group ,the term racial and ethnic minority group has the meaning given such term in section #agjg7;g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjju-#f7;g77#a774 #ijb4 ,,macpac report ,not later than #b years after the date of the enactment of this ,act1 the ,medicaid and ,,chip ,payment and ,access ,commission shall publish a report on issues relating to the continuity of coverage under ,state plans under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and ,state child health plans under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig;aa et seq47 for pregnant and postpartum individuals4 ,such report shall1 at a minimum1 include the following3 7#a7 ,an assessment of any existing policies under such ,state plans and such ,state child health plans regarding presumptive eligibility for pregnant individuals while their application for enrollment in such a ,state plan or such a ,state child health plan is being processed4 7#b7 ,an assessment of any existing policies under such ,state plans and such ,state child health plans regarding measures to ensure continuity of coverage under such a ,state plan or such a ,state child health plan for pregnant and postpartum individuals1 including such individuals who need to change their health insurance coverage during their pregnancy or the postpartum period following their pregnancy4 7#c7 ,an assessment of any existing policies under such ,state plans and such ,state child health plans regarding measures to automatically reenroll individuals who are eligible to enroll under such a ,state plan or such a ,state child health plan as a parent4 7#d7 ,if determined appropriate by the ,commission1 any recommendations for the ,department of ,health and ,human ,services1 or such ,state plans and such ,state child health plans1 to ensure continuity of coverage under such a ,state plan or such a ,state child health plan for pregnant and postpartum individuals4 ,x ,maternal health pandemic response #ajja4 ,definitions ,in this title3 7#a7 ,,covid-#ai public health emergency ,the term ,,covid-#ai public health emergency means the period-- 7,a7 beginning on the date that the ,secretary of ,health and ,human ,services declared a public health emergency under section #cai of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d71 with respect to ,,covid-#ai2 and 7,b7 ending on the later of the end of such public health emergency1 or ,january #a1 #bjbc4 7#b7 ,respectful maternity care ,the term respectful maternity care refers to care organized for1 and provided to1 pregnant and postpartum individuals in a manner that-- 7,a7 is culturally congruent2 7,b7 maintains their dignity1 privacy1 and confidentiality2 7,c7 ensures freedom from harm and mistreatment2 and 7,d7 enables informed choice and continuous support4 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 #ajjb4 ,funding for data collection1 surveillance1 and research on maternal health outcomes during the ,,covid-#ai public health emergency ,to conduct or support data collection1 surveillance1 and research on maternal health as a result of the ,,covid-#ai public health emergency1 including support to assist in the capacity building for ,state1 ,tribal1 territorial1 and local public health departments to collect and transmit racial1 ethnic1 and other demographic data related to maternal health1 there are authorized to be appropriated-- 7#a7 #ajj1jjj1jjj for the ,surveillance for ,emerging ,threats to ,mothers and ,babies program of the ,centers for ,disease ,control and ,prevention1 to support the ,centers for ,disease ,control and ,prevention in its efforts to-- 7,a7 work with public health1 clinical1 and community-based organizations to provide timely1 continually updated guidance to families and health care providers on ways to reduce risk to pregnant and postpartum individuals and their newborns and tailor interventions to improve their long-term health2 7,b7 partner with more ,state1 ,tribal1 territorial1 and local public health programs in the collection and analysis of clinical data on the impact of ,,covid-#ai on pregnant and postpartum patients and their newborns1 particularly among patients from racial and ethnic minority groups2 and 7,c7 establish regionally based centers of excellence to offer medical1 public health1 and other knowledge to ensure communities1 especially communities with large populations of individuals from racial and ethnic minority groups1 can help pregnant and postpartum individuals and newborns get the care and support they need2 7#b7 #cj1jjj1jjj for the ,enhancing ,reviews and ,surveillance to ,eliminate ,maternal ,mortality program 7commonly known as the ,,erase ,,mm program7 of the ,centers for ,disease ,control and ,prevention1 to support the ,centers for ,disease ,control and ,prevention in expanding its partnerships with ,states and ,indian ,tribes and provide technical assistance to existing ,maternal ,mortality ,review ,committees2 7#c7 #de1jjj1jjj for the ,pregnancy ,risk ,assessment ,monitoring ,system 7commonly known as the ,,prams7 of the ,centers for ,disease ,control and ,prevention1 to support the ,centers for ,disease ,control and ,prevention in its efforts to-- 7,a7 create a ,,covid-#ai supplement to its ,,prams questionnaire2 7,b7 add questions around experiences of respectful maternity care in prenatal1 intrapartum1 and postpartum care2 7,c7 conduct a rapid assessment of ,,covid-#ai awareness1 impact on care and experiences1 and use of preventive measures among pregnant1 laboring and birthing1 and postpartum individuals during the ,,covid-#ai public health emergency2 and 7,d7 work to transition the survey to an electronic platform and expand the survey to a larger population1 with a special focus on reaching underrepresented communities2 and 7#d7 #ae1jjj1jjj for the ,national ,institute of ,child ,health and ,human ,development1 to conduct or support research for interventions to mitigate the effects of the ,,covid-#ai public health emergency on pregnant and postpartum individuals1 with a particular focus on individuals from racial and ethnic minority groups4 #ajjc4 ,,covid-#ai maternal health data collection and disclosure 7a7 ,availability of collected data ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention and the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall make publicly available on the website of the ,centers for ,disease ,control and ,prevention data described in subsection 7b74 7b7 ,data described ,the data under subsection 7a7 means data collected through ,federal surveillance systems under the ,centers for ,disease ,control and ,prevention with respect to ,,covid-#ai and individuals who are pregnant or in a postpartum period4 ,such data shall include the following3 7#a7 ,diagnostic testing1 including the number of pregnant and postpartum individuals who are tested for ,,covid-#ai and the number of positive cases4 7#b7 ,suspected cases of ,,covid-#ai in pregnant and birthing individuals and individuals in a postpartum period4 7#c7 ,serologic testing1 including the number of pregnant and postpartum individuals tested and the number of such serologic tests that were positive4 7#d7 ,health care treatment for individuals who were infected with the virus1 including hospitalizations1 emergency room visits1 and intensive care unit admissions4 7#e7 ,health outcomes for pregnant individuals and infants confirmed or suspected of being infected with the virus1 including-- 7,a7 the number of fatalities and case fatalities 7expressed as the proportion of individuals who were infected with the virus to individuals who died from the virus72 and 7,b7 the number of stillbirths1 infant mortality1 pre-term births1 infants born with a low-birth weight1 and cesarean section births4 7c7 ,indian health service ,in carrying out subsection 7a71 the ,secretary shall consult with ,indian ,tribes and confer with urban ,indian organizations4 7d7 ,disaggregated information ,in carrying out subsection 7a71 the ,secretary shall disaggregate data by race1 ethnicity1 and location4 7e7 ,update ,during the ,,covid-#ai public health emergency1 the ,secretary shall update the data made available under this section-- 7#a7 at least on a monthly basis2 and 7#b7 not less than one month after the end of such public health emergency4 7f7 ,privacy ,in carrying out subsection 7a71 the ,secretary shall take steps to protect the privacy of individuals pursuant to regulations promulgated under section #bfd7;c7 of the ,health ,insurance ,portability and ,accountability ,act of #aiif 7#db ,u4,s4,c4 #acbj;d-#b note74 7g7 ,guidance 7#a7 ,in general ,not later than #cj days after the date of enactment of this ,act1 the ,secretary shall issue guidance to ,states and local public health departments to ensure that-- 7,a7 laboratories that test specimens for ,,covid-#ai receive all relevant demographic data on race1 ethnicity1 pregnancy status1 and other demographic data as determined by the ,secretary2 and 7,b7 data described in subsection 7b7 is disaggregated by race1 ethnicity1 and location4 7#b7 ,consultation ,in carrying out paragraph 7#a71 the ,secretary shall consult with ,indian ,tribes-- 7,a7 to ensure that such guidance includes ,tribally developed best practices2 and 7,b7 to reduce misclassification of ,american ,indians and ,alaska ,natives4 #ajjd4 ,inclusion of pregnant individuals and lactating individuals in vaccine and therapeutic development for ,,covid-#ai ,the ,director of the ,national ,institutes of ,health shall1 when safe and appropriate1 support and advance the inclusion of pregnant and lactating individuals in therapeutic and vaccine clinical trials with respect to the treatment or prevention of ,,covid-#ai1 including prioritizing recommendations made by the ,task ,force on ,research ,specific to ,pregnant ,women and ,lactating ,women established under section #bjda of the #bast ,century ,cures ,act 7#db ,u4,s4,c4 #bhi;a-#b note7 with respect to including such individuals in such clinical trials4 #ajje4 ,public health communication regarding maternal care during ,,covid-#ai ,the ,director of the ,centers for ,disease ,control and ,prevention shall conduct a public health education campaign to increase access by pregnant individuals1 their employers1 and their health care providers to accurate1 evidence-based information on ,,covid-#ai and pregnancy risks1 with a particular focus pregnant individuals in underserved communities4 #ajjf4 ,task force on birthing experience and safe maternity care during a public health emergency 7a7 ,establishment ,the ,secretary1 in consultation with the ,director of the ,centers for ,disease ,control and ,prevention and the ,administrator of the ,health ,resources and ,services ,administration1 shall convene a task force 7in this subsection referred to as the ,task ,force7 to develop recommendations1 and make such recommendations publicly available in multiple languages1 on respectful maternity care during the ,,covid-#ai public health emergency and other public health emergencies1 with a particular focus on outcomes for individuals from racial and ethnic minority groups and other underserved communities4 7b7 ,content ,in developing recommendations under paragraph 7#a71 the ,task ,force shall address the following3 7#a7 ,measures to facilitate respectful maternity care4 7#b7 ,strategies to increase access to specialized care for individuals with high-risk pregnancies4 7#c7 ,,covid-#ai diagnostic testing for pregnant individuals and individuals in labor4 7#d7 ,the designation of a companion during birthing4 7#e7 ,the ability to communicate using an electronic mobile device during birthing4 7#f7 ,with respect to an individual who has the virus that causes ,,covid-#ai-- 7,a7 separation from a newborn after birth2 and 7,b7 ensuring safety while breastfeeding4 7#g7 ,licensing1 training1 and reimbursement for midwives from racial and ethnic minority groups and underserved communities4 7#h7 ,financial support for perinatal health workers who provide nonclinical support to pregnant individuals and postpartum individuals from underserved communities4 7#i7 ,the identification and treatment of prenatal and postpartum mental and behavioral health conditions that may have developed during1 or worsened because of1 the ,,covid-#ai public health emergency or future public health emergencies1 including anxiety1 substance use disorder1 and depression4 7#aj7 ,strategies to address hospital capacity issues in communities with an increase in ,,covid-#ai cases1 or cases of other infectious diseases4 7#aa7 ,options for maternal care that reduce cross-contamination and maintain safety and quality of care1 including auxiliary maternity units and freestanding birth centers4 7#ab7 ,methods to identify and address racism1 bias1 and discrimination in treatment1 and to provide support to pregnant and postpartum individuals1 including-- 7,a7 evaluating the training of hospital staff on implicit bias and racism and respectful maternity care2 and 7,b7 the collection of demographic data4 7#ac7 ,other matters the ,task ,force determines appropriate4 7c7 ,membership 7#a7 ,chair ,the ,secretary shall select the chair of the ,task ,force from among the members of the ,task ,force4 7#b7 ,composition ,the ,task ,force shall be composed of-- 7,a7 representatives of ,federal agencies1 including the agencies listed in paragraph 7#c72 7,b7 #c or more representatives of ,state1 local1 or territorial public health departments from different areas in the ,united ,states that have a large historically marginalized population2 7,c7 one or more representatives of ,tribal public health departments2 7,d7 one or more obstetrician-gynecologists or other physicians who provide obstetric care1 with consideration for physicians who are from1 or work in1 communities experiencing a high rate of mortality and morbidity from ,,covid-#ai2 7,e7 one or more nurses who provide obstetric care1 with consideration for physicians who are from1 or work in1 communities experiencing a high rate of mortality and morbidity from ,,covid-#ai2 7,f7 one or more perinatal health workers2 7,g7 one or more individuals who were pregnant or gave birth during the ,,covid-#ai public health emergency2 7,h7 one or more individuals who had the virus that causes ,,covid-#ai and later gave birth2 7,i7 one or more individuals who have received support from a perinatal health2 and 7,j7 #c or more independent experts who are racially and ethnically diverse with knowledge on racial and ethnic disparities in-- 7i7 public health2 7ii7 maternal health2 or 7iii7 maternal mortality and severe maternal morbidity4 7#c7 ,federal agencies ,the agencies represented under paragraph 7#b77;,a7 shall include the following3 7,a7 ,the ,department of ,health and ,human ,services4 7,b7 ,the ,centers for ,disease ,control and ,prevention4 7,c7 ,the ,centers for ,medicare ,medicaid ,services4 7,d7 ,the ,health ,resources and ,services ,administration4 7,e7 ,the ,indian ,health ,service4 7,f7 ,the ,national ,institutes of ,health4 #ajjg4 ,,gao report on maternal health and public health emergency preparedness 7a7 ,in general ,not later than one year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on maternal health and public health emergency preparedness4 ,such report shall include the information and recommendations described in subsection 7b74 7b7 ,content of report ,the report under subsection 7b7 shall include the following3 7#a7 ,a review of prenatal1 labor and delivery1 and postpartum experiences of individuals during such public health emergency1 including-- 7,a7 barriers to accessing pregnancy1 birth1 and postpartum care during a pandemic2 7,b7 public and private insurance coverage with respect to maternal health care1 including telehealth services2 7,c7 to the extent practicable1 maternal and infant health outcomes by race and ethnicity 7including quality of care1 mortality1 morbidity1 cesarean section rates1 preterm birth1 prevalence of prenatal and postpartum mental health conditions and substance use disorders72 7,d7 with respect to such health outcomes1 the impact of ,federal and ,state policy changes during such public health emergency2 7,e7 contributing factors to population-based disparities in health outcomes1 including bias and discrimination toward individuals from racial and ethnic minority groups2 and 7,f7 the effect of increased unemployment1 paid family leave1 changes in health care coverage1 and other social determinants of health for pregnant and postpartum individuals during the public health emergency4 7#b7 ,recommendations on improving the public health emergency response and preparedness efforts of the ,federal ,government with respect to maternal health1 with a focus on outcomes for pregnant and postpartum individuals from racial and ethnic minority groups1 including-- 7,a7 improving research1 surveillance1 and data collection with respect to maternal health2 7,b7 factoring maternal health outcomes and disparities into decisions regarding distribution of resources2 7,c7 improving the distribution of public health funds1 data1 and information to ,indian ,tribes and ,tribal organizations with regard to maternal health during a public health emergency2 and 7,d7 improving communications during a public health emergency with-- 7i7 maternity care providers2 7ii7 maternal mental and behavioral health care providers2 7iii7 researchers who specialize in maternal health1 maternal mortality1 or severe maternal morbidity2 7iv7 individuals who experienced pregnancy or childbirth during the ,,covid-#ai public health emergency2 7v7 representatives from community-based organizations that address maternal health2 and 7vi7 perinatal health workers4 ,,xi ,protecting moms and babies against climate change #aaja4 ,definitions ,in this title1 the following definitions apply3 7#a7 ,adverse maternal and infant health outcomes ,the term adverse maternal and infant health outcomes includes the outcomes of preterm birth1 low birth weight1 stillbirth1 infant or maternal mortality1 and severe maternal morbidity4 7#b7 ,institution of higher education ,the term institution of higher education has the meaning given such term in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja74 7#c7 ,minority-serving institution ,the term minority-serving institution means an entity specified in any of paragraphs 7#a7 through 7#g7 of section #cga7;a7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajfgq7a774 7#d7 ,risks associated with climate change ,the term risks associated with climate change includes risks associated with extreme heat1 air pollution1 extreme weather events1 and other environmental issues associated with climate change that can result in adverse maternal and infant health outcomes4 7#e7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#f7 ,stakeholder organization ,the term stakeholder organization means-- 7,a7 a community-based organization with expertise in providing assistance to vulnerable individuals2 7,b7 a nonprofit organization with expertise in maternal or infant health or environmental justice2 and 7,c7 a patient advocacy organization representing vulnerable individuals4 7#g7 ,vulnerable individual ,the term vulnerable individual means-- 7,a7 an individual who is pregnant2 7,b7 an individual who was pregnant during any portion of the preceding #a-year period2 and 7,c7 an individual under #c years of age4 #aajb4 ,grant program to protect vulnerable mothers and babies from climate change risks 7a7 ,in general ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall establish a grant program 7in this section referred to as the ,program7 to protect vulnerable individuals from risks associated with climate change4 7b7 ,grant authority ,in carrying out the ,program1 the ,secretary may award1 on a competitive basis1 grants to #aj covered entities4 7c7 ,applications ,to be eligible for a grant under the ,program1 a covered entity shall submit to the ,secretary an application at such time1 in such form1 and containing such information as the ,secretary may require1 which shall include1 at a minimum1 a description of the following3 7#a7 ,plans for the use of grant funds awarded under the ,program and how patients and stakeholder organizations were involved in the development of such plans4 7#b7 ,how such grant funds will be targeted to geographic areas that have disproportionately high levels of risks associated with climate change for vulnerable individuals4 7#c7 ,how such grant funds will be used to address racial and ethnic disparities in-- 7,a7 adverse maternal and infant health outcomes2 and 7,b7 exposure to risks associated with climate change for vulnerable individuals4 7#d7 ,strategies to prevent an initiative assisted with such grant funds from causing-- 7,a7 adverse environmental impacts2 7,b7 displacement of residents and businesses2 7,c7 rent and housing price increases2 or 7,d7 disproportionate adverse impacts on racial and ethnic minority groups and other underserved populations4 7d7 ,selection of grant recipients 7#a7 ,timing ,not later than #bgj days after the date of enactment of this ,act1 the ,secretary shall select the recipients of grants under the ,program4 7#b7 ,consultation ,in selecting covered entities for grants under the ,program1 the ,secretary shall consult with-- 7,a7 representatives of stakeholder organizations2 7,b7 the ,administrator of the ,environmental ,protection ,agency2 7,c7 the ,administrator of the ,national ,oceanic and ,atmospheric ,administration2 and 7,d7 from the ,department of ,health and ,human ,services-- 7i7 the ,deputy ,assistant ,secretary for ,minority ,health2 7ii7 the ,administrator of the ,centers for ,medicare ,medicaid ,services2 7iii7 the ,administrator of the ,health ,resources and ,services ,administration2 7iv7 the ,director of the ,national ,institutes of ,health2 and 7v7 the ,director of the ,centers for ,disease ,control and ,prevention4 7#c7 ,priority ,in selecting a covered entity to be awarded a grant under the ,program1 the ,secretary shall give priority to covered entities that serve a county-- 7,a7 designated1 or located in an area designated1 as a nonattainment area pursuant to section #ajg of the ,clean ,air ,act 7#db ,u4,s4,c4 #gdjg7 for any air pollutant for which air quality criteria have been issued under section #ajh7;a7 of such ,act 7#db ,u4,s4,c4 #gdjh7;a772 7,b7 with a level of vulnerability of moderate-to-high or higher1 according to the ,social ,vulnerability ,index of the ,centers for ,disease ,control and ,prevention2 or 7,c7 with temperatures that pose a risk to human health1 as determined by the ,secretary1 in consultation with the ,administrator of the ,national ,oceanic and ,atmospheric ,administration and the ,chair of the ,united ,states ,global ,change ,research ,program1 based on the best available science4 7#d7 ,limitation ,a covered entity awarded grant funds under the ,program may not use such grant funds to serve a county that is served by any other recipient of a grant under the ,program4 7e7 ,use of funds ,a covered entity awarded grant funds under the ,program may only use such grant funds for the following3 7#a7 ,initiatives to identify risks associated with climate change for vulnerable individuals and to provide services and support to such individuals that address such risks1 including-- 7,a7 training for health care providers1 doulas1 and other employees in hospitals1 birth centers1 midwifery practices1 and other health care practices that provide prenatal or labor and delivery services to vulnerable individuals on the identification of1 and patient counseling relating to1 risks associated with climate change for vulnerable individuals2 7,b7 hiring1 training1 or providing resources to community health workers and perinatal health workers who can help identify risks associated with climate change for vulnerable individuals1 provide patient counseling about such risks1 and carry out the distribution of relevant services and support2 7,c7 enhancing the monitoring of risks associated with climate change for vulnerable individuals1 including by-- 7i7 collecting data on such risks in specific census tracts1 neighborhoods1 or other geographic areas2 and 7ii7 sharing such data with local health care providers1 doulas1 and other employees in hospitals1 birth centers1 midwifery practices1 and other health care practices that provide prenatal or labor and delivery services to local vulnerable individuals2 and 7,d7 providing vulnerable individuals-- 7i7 air conditioning units1 residential weatherization support1 filtration systems1 household appliances1 or related items2 7ii7 direct financial assistance2 and 7iii7 services and support1 including housing and transportation assistance1 to prepare for or recover from extreme weather events1 which may include floods1 hurricanes1 wildfires1 droughts1 and related events4 7#b7 ,initiatives to mitigate levels of and exposure to risks associated with climate change for vulnerable individuals1 which shall be based on the best available science and which may include initiatives to-- 7,a7 develop1 maintain1 or expand urban or community forestry initiatives and tree canopy coverage initiatives2 7,b7 improve infrastructure1 including buildings and paved surfaces2 7,c7 develop or improve community outreach networks to provide culturally and linguistically appropriate information and notifications about risks associated with climate change for vulnerable individuals2 and 7,d7 provide enhanced services to racial and ethnic minority groups and other underserved populations4 7f7 ,length of award ,a grant under this section shall be disbursed over #d fiscal years4 7g7 ,technical assistance ,the ,secretary shall provide technical assistance to a covered entity awarded a grant under the ,program to support the development1 implementation1 and evaluation of activities funded with such grant4 7h7 ,reports to ,secretary 7#a7 ,annual report ,for each fiscal year during which a covered entity is disbursed grant funds under the ,program1 such covered entity shall submit to the ,secretary a report that summarizes the activities carried out by such covered entity with such grant funds during such fiscal year1 including a description of the following3 7,a7 ,the involvement of stakeholder organizations in the implementation of initiatives assisted with such grant funds4 7,b7 ,relevant health and environmental data1 disaggregated1 to the extent practicable1 by race1 ethnicity1 gender1 and pregnancy status4 7,c7 ,qualitative feedback received from vulnerable individuals with respect to initiatives assisted with such grant funds4 7,d7 ,criteria used in selecting the geographic areas assisted with such grant funds4 7,e7 ,efforts to address racial and ethnic disparities in adverse maternal and infant health outcomes and in exposure to risks associated with climate change for vulnerable individuals4 7,f7 ,any negative and unintended impacts of initiatives assisted with such grant funds1 including-- 7i7 adverse environmental impacts2 7ii7 displacement of residents and businesses2 7iii7 rent and housing price increases2 and 7iv7 disproportionate adverse impacts on racial and ethnic minority groups and other underserved populations4 7,g7 ,how the covered entity will address and prevent any impacts described in subparagraph 7,f74 7#b7 ,publication ,not later than #cj days after the date on which a report is submitted under paragraph 7#a71 the ,secretary shall publish such report on a public website of the ,department of ,health and ,human ,services4 7i7 ,report to ,congress ,not later than the date that is #e years after the date on which the ,program is established1 the ,secretary shall submit to ,congress and publish on a public website of the ,department of ,health and ,human ,services a report on the results of the ,program1 including the following3 7#a7 ,summaries of the annual reports submitted under subsection 7h74 7#b7 ,evaluations of the initiatives assisted with grant funds under the ,program4 7#c7 ,an assessment of the effectiveness of the ,program in-- 7,a7 identifying risks associated with climate change for vulnerable individuals2 7,b7 providing services and support to such individuals2 7,c7 mitigating levels of and exposure to such risks2 and 7,d7 addressing racial and ethnic disparities in adverse maternal and infant health outcomes and in exposure to such risks4 7#d7 ,a description of how the ,program could be expanded1 including-- 7,a7 monitoring efforts or data collection that would be required to identify areas with high levels of risks associated with climate change for vulnerable individuals2 7,b7 how such areas could be identified using the strategy developed under section #e2 and 7,c7 recommendations for additional funding4 7j7 ,definition of ,covered entity ,in this section1 the term covered entity means a consortium of organizations serving a county that-- 7#a7 shall include a community-based organization2 and 7#b7 may include-- 7,a7 another stakeholder organization2 7,b7 the government of such county2 7,c7 the governments of one or more municipalities within such county2 7,d7 a ,state or local public health department or emergency management agency2 7,e7 a local health care practice1 which may include a licensed and accredited hospital1 birth center1 midwifery practice1 or other health care practice that provides prenatal or labor and delivery services to vulnerable individuals2 7,f7 an ,indian ,tribe or ,tribal organization 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd772 7,g7 an ,urban ,indian organization 7as defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc772 and 7,h7 an institution of higher education4 7k7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ajj1jjj1jjj for the period of fiscal years #bjbb through #bjbe4 #aajc4 ,grant program for education and training at health profession schools 7a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary shall establish a grant program 7in this section referred to as the ,program7 to provide funds to health profession schools to support the development and integration of education and training programs for identifying and addressing risks associated with climate change for vulnerable individuals4 7b7 ,grant authority ,in carrying out the ,program1 the ,secretary may award1 on a competitive basis1 grants to health profession schools4 7c7 ,application ,to be eligible for a grant under the ,program1 a health profession school shall submit to the ,secretary an application at such time1 in such form1 and containing such information as the ,secretary may require1 including a description of the following3 7#a7 ,how such health profession school will engage with vulnerable individuals1 and stakeholder organizations representing such individuals1 in developing and implementing the education and training programs supported by grant funds awarded under the ,program4 7#b7 ,how such health profession school will ensure that such education and training programs will address racial and ethnic disparities in exposure to1 and the effects of1 risks associated with climate change for vulnerable individuals4 7d7 ,use of funds ,a health profession school awarded a grant under the ,program shall use the grant funds to develop1 and integrate into the curriculum and continuing education of such health profession school1 education and training on each of the following3 7#a7 ,identifying risks associated with climate change for vulnerable individuals and individuals with the intent to become pregnant4 7#b7 ,how risks associated with climate change affect vulnerable individuals and individuals with the intent to become pregnant4 7#c7 ,racial and ethnic disparities in exposure to1 and the effects of1 risks associated with climate change for vulnerable individuals and individuals with the intent to become pregnant4 7#d7 ,patient counseling and mitigation strategies relating to risks associated with climate change for vulnerable individuals4 7#e7 ,relevant services and support for vulnerable individuals relating to risks associated with climate change and strategies for ensuring vulnerable individuals have access to such services and support4 7#f7 ,implicit and explicit bias1 racism1 and discrimination4 7#g7 ,related topics identified by such health profession school based on the engagement of such health profession school with vulnerable individuals and stakeholder organizations representing such individuals4 7e7 ,partnerships ,in carrying out activities with grant funds1 a health profession school awarded a grant under the ,program may partner with-- 7#a7 a ,state or local public health department2 7#b7 a health care professional membership organization2 7#c7 a stakeholder organization2 7#d7 a health profession school2 or 7#e7 an institution of higher education4 7f7 ,reports to ,secretary 7#a7 ,annual report ,for each fiscal year during which a health profession school is disbursed grant funds under the ,program1 such health profession school shall submit to the ,secretary a report that describes the activities carried out with such grant funds during such fiscal year4 7#b7 ,final report ,not later than the date that is #a year after the end of the last fiscal year during which a health profession school is disbursed grant funds under the ,program1 the health profession school shall submit to the ,secretary a final report that summarizes the activities carried out with such grant funds4 7g7 ,report to ,congress ,not later than the date that is #f years after the date on which the ,program is established1 the ,secretary shall submit to ,congress and publish on a public website of the ,department of ,health and ,human ,services a report that includes-- 7#a7 a summary of the reports submitted under subsection 7f72 and 7#b7 recommendations to improve education and training programs at health profession schools with respect to identifying and addressing risks associated with climate change for vulnerable individuals4 7h7 ,definition of health profession school ,in this section1 the term health profession school means an accredited-- 7#a7 medical school2 7#b7 school of nursing2 7#c7 midwifery program2 7#d7 physician assistant education program2 7#e7 teaching hospital2 7#f7 residency or fellowship program2 or 7#g7 other school or program determined appropriate by the ,secretary4 7i7 ,authorization of ,appropriations ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for the period of fiscal years #bjbb through #bjbe4 #aajd4 ,,nih ,consortium on ,birth and ,climate ,change ,research 7a7 ,establishment ,not later than one year after the date of enactment of this ,act1 the ,director of the ,national ,institutes of ,health shall establish the ,consortium on ,birth and ,climate ,change ,research 7in this section referred to as the ,consortium74 7b7 ,duties 7#a7 ,in general ,the ,consortium shall coordinate1 across the institutes1 centers1 and offices of the ,national ,institutes of ,health1 research on the risks associated with climate change for vulnerable individuals4 7#b7 ,required activities ,in carrying out paragraph 7#a71 the ,consortium shall-- 7,a7 establish research priorities1 including by prioritizing research that-- 7i7 identifies the risks associated with climate change for vulnerable individuals with a particular focus on disparities in such risks among racial and ethnic minority groups and other underserved populations2 and 7ii7 identifies strategies to reduce levels of1 and exposure to1 such risks1 with a particular focus on risks among racial and ethnic minority groups and other underserved populations2 7,b7 identify gaps in available data related to such risks2 7,c7 identify gaps in1 and opportunities for1 research collaborations2 7,d7 identify funding opportunities for community-based organizations and researchers from racially1 ethnically1 and geographically diverse backgrounds2 and 7,e7 publish annual reports on the work and findings of the ,consortium on a public website of the ,national ,institutes of ,health4 7c7 ,membership ,the ,director of the ,national ,institutes of ,health shall appoint to the ,consortium representatives of such institutes1 centers1 and offices of the ,national ,institutes of ,health as the ,director considers appropriate1 including representatives of-- 7#a7 the ,national ,institute of ,environmental ,health ,sciences2 7#b7 the ,national ,institute on ,minority ,health and ,health ,disparities2 7#c7 the ,eunice ,kennedy ,shriver ,national ,institute of ,child ,health and ,human ,development2 7#d7 the ,national ,institute of ,nursing ,research2 and 7#e7 the ,office of ,research on ,women's ,health4 7d7 ,chairperson ,the ,chairperson of the ,consortium shall be designated by the ,director and selected from among the representatives appointed under subsection 7c74 7e7 ,consultation ,in carrying out the duties described in subsection 7b71 the ,consortium shall consult with-- 7#a7 the heads of relevant ,federal agencies1 including-- 7,a7 the ,environmental ,protection ,agency2 7,b7 the ,national ,oceanic and ,atmospheric ,administration2 7,c7 the ,occupational ,safety and ,health ,administration2 and 7,d7 from the ,department of ,health and ,human ,services-- 7i7 the ,office of ,minority ,health in the ,office of the ,secretary2 7ii7 the ,centers for ,medicare ,medicaid ,services2 7iii7 the ,health ,resources and ,services ,administration2 7iv7 the ,centers for ,disease ,control and ,prevention2 7v7 the ,indian ,health ,service2 and 7vi7 the ,administration for ,children and ,families2 and 7#b7 representatives of-- 7,a7 stakeholder organizations2 7,b7 health care providers and professional membership organizations with expertise in maternal health or environmental justice2 7,c7 ,state and local public health departments2 7,d7 licensed and accredited hospitals1 birth centers1 midwifery practices1 or other health care practices that provide prenatal or labor and delivery services to vulnerable individuals2 and 7,e7 institutions of higher education1 including such institutions that are minority-serving institutions or have expertise in maternal health or environmental justice4 #aaje4 ,strategy for identifying climate change risk zones for vulnerable mothers and babies 7a7 ,in general ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall develop a strategy 7in this section referred to as the ,strategy7 for designating areas that the ,secretary determines to have a high risk of adverse maternal and infant health outcomes among vulnerable individuals as a result of risks associated with climate change4 7b7 ,strategy requirements 7#a7 ,in general ,in developing the ,strategy1 the ,secretary shall establish a process to identify areas where vulnerable individuals are exposed to a high risk of adverse maternal and infant health outcomes as a result of risks associated with climate change in conjunction with other factors that can impact such health outcomes1 including-- 7,a7 the incidence of diseases associated with air pollution1 extreme heat1 and other environmental factors2 7,b7 the availability and accessibility of maternal and infant health care providers2 7,c7 ,english-language proficiency among women of reproductive age2 7,d7 the health insurance status of women of reproductive age2 7,e7 the number of women of reproductive age who are members of racial or ethnic groups with disproportionately high rates of adverse maternal and infant health outcomes2 7,f7 the socioeconomic status of women of reproductive age1 including with respect to-- 7i7 poverty2 7ii7 unemployment2 7iii7 household income2 and 7iv7 educational attainment2 and 7,g7 access to quality housing1 transportation1 and nutrition4 7#b7 ,resources ,in developing the ,strategy1 the ,secretary shall identify1 and incorporate a description of1 the following3 7,a7 ,existing mapping tools or ,federal programs that identify-- 7i7 risks associated with climate change for vulnerable individuals2 and 7ii7 other factors that can influence maternal and infant health outcomes1 including the factors described in paragraph 7#a74 7,b7 ,environmental1 health1 socioeconomic1 and demographic data relevant to identifying risks associated with climate change for vulnerable individuals4 7,c7 ,existing monitoring networks that collect data described in subparagraph 7,b71 and any gaps in such networks4 7,d7 ,federal1 ,state1 and local stakeholders involved in maintaining monitoring networks identified under subparagraph 7,c71 and how such stakeholders are coordinating their monitoring efforts4 7,e7 ,additional monitoring networks1 and enhancements to existing monitoring networks1 that would be required to address gaps identified under subparagraph 7,c71 including at the subcounty and census tract level4 7,f7 ,funding amounts required to establish the monitoring networks identified under subparagraph 7,e7 and recommendations for ,federal1 ,state1 and local coordination with respect to such networks4 7,g7 ,potential uses for data collected and generated as a result of the ,strategy1 including how such data may be used in determining recipients of grants under the program established by section #b or other similar programs4 7,h7 ,other information the ,secretary considers relevant for the development of the ,strategy4 7c7 ,coordination and consultation ,in developing the ,strategy1 the ,secretary shall-- 7#a7 coordinate with the ,administrator of the ,environmental ,protection ,agency and the ,administrator of the ,national ,oceanic and ,atmospheric ,administration2 and 7#b7 consult with-- 7,a7 stakeholder organizations2 7,b7 health care providers and professional membership organizations with expertise in maternal health or environmental justice2 7,c7 ,state and local public health departments2 7,d7 licensed and accredited hospitals1 birth centers1 midwifery practices1 or other health care providers that provide prenatal or labor and delivery services to vulnerable individuals2 and 7,e7 institutions of higher education1 including such institutions that are minority-serving institutions or have expertise in maternal health or environmental justice4 7d7 ,notice and comment ,at least #bdj days before the date on which the ,strategy is published in accordance with subsection 7e71 the ,secretary shall provide-- 7#a7 notice of the ,strategy on a public website of the ,department of ,health and ,human ,services2 and 7#b7 an opportunity for public comment of at least #ij days4 7e7 ,publication ,not later than #ah months after the date of enactment of this ,act1 the ,secretary shall publish on a public website of the ,department of ,health and ,human ,services-- 7#a7 the ,strategy2 7#b7 the public comments received under subsection 7d72 and 7#c7 the responses of the ,secretary to such public comments4 ,,xii ,maternal vaccinations #abja4 ,maternal vaccination awareness and equity campaign 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary71 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall carry out a national campaign to-- 7#a7 increase awareness of the importance of maternal vaccinations for the health of pregnant and postpartum individuals and their children2 and 7#b7 increase maternal vaccination rates1 with a focus on communities with historically high rates of unvaccinated individuals4 7b7 ,consultation ,in carrying out the campaign under this section1 the ,secretary shall consult with relevant community-based organizations1 health care professional associations and public health associations1 ,state public health departments and local public health departments1 ,tribal-serving organizations1 nonprofit organizations1 and nationally recognized private entities4 7c7 ,activities ,the campaign under this section shall-- 7#a7 focus on increasing maternal vaccination rates in communities with historically high rates of unvaccinated individuals1 including for pregnant and postpartum individuals from racial and ethnic minority groups2 7#b7 include efforts to engage with pregnant and postpartum individuals in communities with historically high rates of unvaccinated individuals to seek input on the development and effectiveness of the campaign2 7#c7 provide evidence-based1 culturally congruent resources and communications efforts2 and 7#d7 be carried out in partnership with trusted individuals and entities in communities with historically high rates of unvaccinated individuals1 including community-based organizations1 community health centers1 perinatal health workers1 and maternity care providers4 7d7 ,collaboration ,the ,secretary shall ensure that the information and resources developed for the campaign under this section are made publicly available and shared with relevant ,federal1 ,state1 and local entities4 7e7 ,evaluation ,not later than the end of fiscal year #bjbe1 the ,secretary shall-- 7#a7 establish quantitative and qualitative metrics to evaluate the campaign under this section2 and 7#b7 submit a report detailing the impact of the campaign under this section to ,congress4 7f7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #b1jjj1jjj for each of fiscal years #bjbb through #bjbf4