,,ii #aahth ,,congress #b;d ,session ,s4 #djgi ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,april #i1 #bjbd,ms4 ,hassan 7for herself1 ,ms4 ,collins1 ,mrs4 ,britt1 and ,ms4 ,smith7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to improve obstetric emergency care4 #a4 ,short title ,this ,act may be cited as the ,rural ,obstetrics ,readiness ,act4 #b4 ,obstetric emergency training program ,section #ccj,o of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;c-#ba7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#c71 by striking 2 and and inserting a semicolon2 7,b7 in paragraph 7#d71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following3 7#e7 developing1 and facilitating access to1 an evidence-based program to train practitioners in rural health care facilities without dedicated obstetric units to provide emergency obstetric services during pregnancy1 labor1 delivery1 or the postpartum period1 including training on how to prepare for1 identify1 stabilize1 and safely transfer1 as appropriate and within the scope of practice of an individual practitioner1 a woman experiencing labor1 delivery1 obstetric hemorrhage1 severe hypertension1 cardiac conditions1 perinatal mental health conditions1 substance use1 sepsis1 or other conditions1 as appropriate4 2 7#b7 by redesignating subsections 7c7 and 7d7 as subsections 7d7 and 7e71 respectively2 7#c7 by inserting after subsection 7b7 the following3 7c7 ,training program for eligible practitioners in rural health care facilities ,a training program described in subsection 7a77#e7 shall include an assessment of obstetric training needs for rural health care facilities without dedicated obstetric units4 ,in developing the training program1 a recipient of a grant under such subsection shall-- 7#a7 work in consultation with at least one representative from a national medical society that has experience or expertise in rural health care delivery in each of the fields of gynecology and obstetrics1 emergency medicine1 family medicine1 and anesthesiology2 and 7#b7 facilitate access to obstetric readiness training via regional training partnerships and technical assistance to rural health care facilities4 2 and 7#d7 in subsection 7e71 as so redesignated1 by adding at the end the following3 ,in addition to amounts appropriated under the previous sentence1 for grants for the purpose described in subsection 7a77#e71 there are authorized to be appropriated #e1jjj1jjj for the period of fiscal years #bjbe through #bjbg4 #c4 ,grant funding for equipment and supplies ,part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b et seq47 is amended by inserting after section #ccj;,a-#b the following3 #ccj;,a-#c4 ,program of support for obstetric services 7a7 ,in general ,the ,secretary shall award grants1 contracts1 or cooperative agreements to eligible entities to integrate obstetric readiness training curriculum into rural health care settings1 build workforce capacity1 and purchase equipment necessary to manage obstetric emergencies4 7b7 ,use of funds ,a recipient of funds under this section shall use such funds for the purpose described in subsection 7a71 which may include any of the following3 7#a7 ,purchasing or providing equipment and technical assistance to train practitioners who are not specialized in obstetrics in preparing for1 identifying1 stabilizing1 and transferring1 as appropriate and within the scope of practice of the practitioner1 individuals experiencing obstetric emergencies4 7#b7 ,purchasing or providing equipment necessary to prepare for1 identify1 stabilize1 or transfer1 as appropriate1 individuals experiencing obstetric emergencies4 7#c7 ,developing and carrying out protocols for transfer of patients to other facilities and network engagement with other facilities4 7#d7 ,hiring additional personnel or paying the salaries of personnel4 7#e7 ,establishing training opportunities to enable non-obstetric health professionals to gain exposure to1 and expertise in1 the delivery of obstetric services1 including through clinical rotations1 fellowships1 or cross-training clinicians in other specialties4 7#f7 ,enabling clinical educators to coordinate1 develop1 and implement comprehensive interdisciplinary trainings1 including team-based simulation training for providers who may need to respond to an obstetric emergency4 7c7 ,eligible entities ,to be eligible to receive a grant under this section1 an entity shall-- 7#a7 be-- 7,a7 a rural hospital1 critical access hospital 7as determined under section #ahbj7;c77#b7 of the ,social ,security ,act71 or a rural emergency hospital 7as defined in section #ahfa7kkk77#b7 of the ,social ,security ,act7 that is located in a maternity care health professional target area or a rural area 7as defined by the ,secretary72 or 7,b7 a consortium of #c entities that includes at least #b entities described in subparagraph 7,a72 and 7#b7 agree to carry out the program described in subsection 7a71 in coordination with other federally funded maternal and child health programs1 to the extent practicable1 and in consultation with other maternal and child health programs in the same geographic area4 7d7 ,definitions ,in this section-- 7#a7 the term maternity care health professional target area means a primary care health professional shortage area that is experiencing a shortage of maternity health care professionals1 as identified under section #ccb7k72 and 7#b7 the term rural area has the meaning given such term by the ,federal ,office of ,rural ,health ,policy4 7e7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ae1jjj1jjj for the period of fiscal years #bjbe through #bjbh4 4 #d4 ,pilot program for teleconsultation ,part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b et seq471 as amended by section #c1 is further amended by inserting after section #ccj;,a-#b the following3 #ccj;,a-#d4 ,pilot program for teleconsultation 7a7 ,in general ,the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration and in consultation with the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall award grants or cooperative agreements to ,states1 political subdivisions of ,states1 and ,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 #ecjd77 to support the provision of urgent maternal health care in rural facilities without a dedicated obstetric unit1 including by-- 7#a7 supporting the development of statewide or regional maternal health care telehealth access programs2 and 7#b7 supporting the improvement of existing statewide or regional maternal health care telehealth access programs described in subsection 7b74 7b7 ,statewide or regional maternal health care telehealth access programs ,a maternal health care telehealth access program described in this section1 with respect to which an award under subsection 7a7 may be used1 shall-- 7#a7 be a statewide or regional network of maternal health care teams that provide urgent support to rural non-obstetric settings of care2 7#b7 support and further develop organized ,state or regional networks of maternal health care teams to provide urgent consultative support to rural non-obstetric settings of care2 7#c7 conduct an assessment of urgent maternal health consultation needs among providers in rural non-obstetric settings of care2 7#d7 provide assurances that the physicians responsive to the tele-consultation line are credentialed within their employing facility and can provide consultation where the patient is receiving care consistent with ,state requirements to provide care to individuals experiencing labor1 delivery1 obstetric hemorrhage1 severe hypertension in pregnancy and postpartum1 cardiac conditions related to or exacerbated by pregnancy1 perinatal mental health conditions1 substance use during pregnancy or the postpartum period1 sepsis during pregnancy or after pregnancy end1 or other conditions1 as appropriate2 7#e7 provide rapid statewide or regional clinical telephone or telehealth consultations when requested between the maternal care teams and providers in rural emergency non-obstetric settings2 and 7#f7 provide information to health care providers about available maternal health services for people in the community and assist with referrals to specialty care and community or behavioral health resources4 7c7 ,reporting ,an entity receiving an award under this section shall submit a report to the ,secretary1 in such manner and containing such information as the ,secretary may require1 not later than #ah months after initial receipt of the grant4 7d7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #e1jjj1jjj for the period of fiscal years #bjbe through #bjbh4 4 #e4 ,study on obstetric units in rural areas ,the ,secretary of ,health and ,human ,services shall-- 7#a7 conduct a study that maps maternity ward closures and regional patterns of patient transport and examines models for regional partnerships for rural obstetric care2 and 7#b7 not later than #c years after the date of enactment of this ,act1 submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce and the ,committee on ,education and the ,workforce of the ,house of ,representatives1 a report on the results of the study conducted under paragraph 7#a74