,,ii #aahth ,,congress #ast ,session ,s4 #bbci ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,july #aa1 #bjbc,mr4 ,warnock 7for himself1 ,mr4 ,padilla1 ,mr4 ,booker1 ,ms4 ,smith1 and ,mr4 ,menendez7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to prevent maternal mortality and severe maternal morbidity among ,black pregnant and postpartum individuals and other underserved populations1 to provide training in respectful maternity care1 to reduce and prevent bias1 racism1 and discrimination in maternity care settings1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,kira ,johnson ,act4 #b4 ,sustained funding for community-based organizations to advance maternal health equity 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7referred to in this ,act as the ,secretary7 shall award grants to eligible entities to establish or expand programs to advance maternal health equity4 7b7 ,timing ,following the #a-year period described in subsection 7d71 the ,secretary shall commence awarding the grants authorized by subsection 7a74 7c7 ,eligible entities ,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 demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7d7 ,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 7e7 ,special consideration 7#a7 ,outreach ,in conducting outreach under subsection 7d71 the ,secretary shall give special consideration to eligible entities that-- 7,a7 are based in1 and provide support for1 communities with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes1 to the extent such data are available2 7,b7 are led by individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 and 7,c7 offer programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 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 individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 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 individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7ii7 address social determinants of maternal health2 7iii7 promote evidence-based health literacy and pregnancy1 childbirth1 and parenting education2 7iv7 provide support from perinatal health workers2 7v7 provide culturally and linguistically congruent training to perinatal health workers2 7vi7 conduct or support research on maternal health issues disproportionately impacting individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7vii7 offer group prenatal care or group postpartum care2 7viii7 coordinate mutual aid efforts during infant formula shortages1 including community milk depots1 donor human milk banks and exchanges1 and forums for community outreach and education2 7ix7 provide support to individuals or family members of individuals who suffered a pregnancy loss1 pregnancy-associated death1 or pregnancy-related death2 or 7x7 operate midwifery practices that provide culturally and linguistically 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 and 7,d7 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 individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7f7 ,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 advance maternal health equity2 7#b7 best practices in data collection1 measurement1 evaluation1 and reporting2 and 7#c7 planning for sustaining programs to advance maternal health equity after the period of the grant4 7g7 ,evaluation ,not later than the end of fiscal year #bjbh1 the ,secretary shall submit to the ,congress an evaluation of the grant program under this section that-- 7#a7 assesses the effectiveness of outreach efforts during the application process in diversifying the pool of grant recipients2 7#b7 makes recommendations for future outreach efforts to diversify the pool of grant recipients for ,department of ,health and ,human ,services grant programs and funding opportunities related to maternal health2 7#c7 assesses the effectiveness of programs funded by grants under this section in improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes1 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 individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7h7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ajj1jjj1jjj for each of fiscal years #bjbd through #bjbh4 #c4 ,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 and linguistically 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 and linguistically 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 ,to seek a grant under subsection 7a71 an entity shall submit an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,reporting ,each recipient of a grant under this section shall annually submit to the ,secretary a report on the status of activities conducted using the grant1 including1 as applicable1 a description of the impact of training provided through the grant on patient outcomes and patient experience for 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 #a-year period beginning on the last day of an individual's pregnancy4 7#b7 ,the term culturally and linguistically congruent means in agreement with the preferred cultural values1 beliefs1 worldview1 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 #bjbd through #bjbh4 4 #d4 ,study on reducing and preventing bias1 racism1 and discrimination in maternity care settings 7a7 ,in general ,the ,secretary 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 and linguistically congruent1 trauma-informed care2 and 7#b7 not later than #bd months 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 the ,congress4 7b7 ,possible topics ,the agreement entered into pursuant to subsection 7a7 may provide for the study of any of the following3 7#a7 ,the development of a scorecard 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 #e4 ,respectful maternity care compliance program 7a7 ,in general ,the ,secretary 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 is 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 deidentified 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 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 such assessment1 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 nonmedical factors that contribute to adverse patient experiences and maternal health outcomes4 7,c7 ,report ,the ,secretary shall submit to the ,congress and make publicly available a report on the results of the study under this paragraph4 7d7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated such sums as may be necessary for fiscal years #bjbd through #bjbi4 #f4 ,,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 the ,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 subsection 7a7 shall include the following3 7#a7 ,information regarding the extent to which hospitals1 health systems1 and other maternity care settings have elected to establish respectful maternity care compliance 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