,,ii #aah? ,,congress #b;d ,session ,s4 #djgi ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,april #i1 #bjbd,ms4 ,hassan 7= h]self1 ,ms4 ,coll9s1 ,mrs4 ,britt1 & ,ms4 ,smi?7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to improve ob/etric em]g5cy c>e4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,rural ,ob/etrics ,read9ess ,act4 #b4 ,ob/etric em]g5cy tra9+ program ,section #ccj,o ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;c-#ba7 is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 9 p>agraph 7#c71 by /rik+ 2 & & ins]t+ a semicolon2 7,b7 9 p>agraph 7#d71 by /rik+ ! p]iod & ins]t+ 2 &2 & 7,c7 by add+ at ! end ! foll[+3 7#e7 develop+1 & facilitat+ access to1 an evid5ce-bas$ program to tra9 practition]s 9 rural heal? c>e facilities )\t d$icat$ ob/etric units to provide em]g5cy ob/etric s]vices dur+ pregnancy1 labor1 deliv]y1 or ! po/p>tum p]iod1 includ+ tra9+ on h[ to prep>e =1 id5tify1 /abilize1 & safely transf]1 z appropriate & )9 ! scope ( practice ( an individual practition]1 a woman exp]i5c+ labor1 deliv]y1 ob/etric hemorrhage1 sev]e hyp]t5sion1 c>diac conditions1 p]9atal m5tal heal? conditions1 sub/ance use1 sepsis1 or o!r conditions1 z appropriate4 2 7#b7 by r$esignat+ subsections 7c7 & 7d7 z subsections 7d7 & 7e71 respectively2 7#c7 by ins]t+ aft] subsection 7b7 ! foll[+3 7c7 ,tra9+ program = eligible practition]s 9 rural heal? c>e facilities ,a tra9+ program describ$ 9 subsection 7a77#e7 %all include an assessm5t ( ob/etric tra9+ ne$s = rural heal? c>e facilities )\t d$icat$ ob/etric units4 ,9 develop+ ! tra9+ program1 a recipi5t ( a grant "u su* subsection %all-- 7#a7 "w 9 consultation ) at lea/ "o repres5tative f a national m$ical society t has exp]i5ce or exp]tise 9 rural heal? c>e deliv]y 9 ea* ( ! fields ( gynecology & ob/etrics1 em]g5cy m$ic9e1 family m$ic9e1 & ane/hesiology2 & 7#b7 facilitate access to ob/etric read9ess tra9+ via regional tra9+ p>tn]%ips & te*nical assi/ance to rural heal? c>e facilities4 2 & 7#d7 9 subsection 7e71 z s r$esignat$1 by add+ at ! end ! foll[+3 ,9 addition to am\nts appropriat$ "u ! previ\s s5t5ce1 = grants = ! purpose describ$ 9 subsection 7a77#e71 !re are au?oriz$ to be appropriat$ #e1jjj1jjj = ! p]iod ( fiscal ye>s #bjbe ?r\gh #bjbg4 #c4 ,grant fund+ = equipm5t & supplies ,"p ,d ( title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b et seq47 is am5d$ by ins]t+ aft] section #ccj;,a-#b ! foll[+3 #ccj;,a-#c4 ,program ( support = ob/etric s]vices 7a7 ,9 g5]al ,! ,secret>y %all aw>d grants1 contracts1 or coop]ative agreem5ts to eligible entities to integrate ob/etric read9ess tra9+ curriculum into rural heal? c>e sett+s1 build work=ce capacity1 & pur*ase equipm5t necess>y to manage ob/etric em]g5cies4 7b7 ,use ( funds ,a recipi5t ( funds "u ?is section %all use su* funds = ! purpose describ$ 9 subsection 7a71 :i* may include any ( ! foll[+3 7#a7 ,pur*as+ or provid+ equipm5t & te*nical assi/ance to tra9 practition]s :o are n specializ$ 9 ob/etrics 9 prep>+ =1 id5tify+1 /abiliz+1 & transf]r+1 z appropriate & )9 ! scope ( practice ( ! practition]1 individuals exp]i5c+ ob/etric em]g5cies4 7#b7 ,pur*as+ or provid+ equipm5t necess>y to prep>e =1 id5tify1 /abilize1 or transf]1 z appropriate1 individuals exp]i5c+ ob/etric em]g5cies4 7#c7 ,develop+ & c>ry+ out protocols = transf] ( pati5ts to o!r facilities & network engagem5t ) o!r facilities4 7#d7 ,hir+ additional p]sonnel or pay+ ! sal>ies ( p]sonnel4 7#e7 ,e/abli%+ tra9+ opportunities to enable non-ob/etric heal? pr(essionals to ga9 exposure to1 & exp]tise 91 ! deliv]y ( ob/etric s]vices1 includ+ ?r\gh cl9ical rotations1 fell[%ips1 or cross-tra9+ cl9icians 9 o!r specialties4 7#f7 ,enabl+ cl9ical educators to coord9ate1 develop1 & implem5t compreh5sive int]discipl9>y tra9+s1 includ+ team-bas$ simulation tra9+ = provid]s :o may ne$ to respond to an ob/etric em]g5cy4 7c7 ,eligible entities ,to be eligible to receive a grant "u ?is section1 an entity %all-- 7#a7 be-- 7,a7 a rural hospital1 critical access hospital 7z det]m9$ "u section #ahbj7;c77#b7 ( ! ,social ,security ,act71 or a rural em]g5cy hospital 7z def9$ 9 section #ahfa7kkk77#b7 ( ! ,social ,security ,act7 t is locat$ 9 a mat]nity c>e heal? pr(essional t>get area or a rural area 7z def9$ by ! ,secret>y72 or 7,b7 a consortium ( #c entities t includes at lea/ #b entities describ$ 9 subp>agraph 7,a72 & 7#b7 agree to c>ry out ! program describ$ 9 subsection 7a71 9 coord9ation ) o!r f$]ally fund$ mat]nal & *ild heal? programs1 to ! ext5t practicable1 & 9 consultation ) o!r mat]nal & *ild heal? programs 9 ! same geographic area4 7d7 ,def9itions ,9 ?is section-- 7#a7 ! t]m mat]nity c>e heal? pr(essional t>get area means a prim>y c>e heal? pr(essional %ortage area t is exp]i5c+ a %ortage ( mat]nity heal? c>e pr(essionals1 z id5tifi$ "u section #ccb7k72 & 7#b7 ! t]m rural area has ! mean+ giv5 su* t]m by ! ,f$]al ,(fice ( ,rural ,heal? ,policy4 7e7 ,au?orization ( appropriations ,to c>ry out ?is section1 !re is au?oriz$ to be appropriat$ #ae1jjj1jjj = ! p]iod ( fiscal ye>s #bjbe ?r\gh #bjbh4 4 #d4 ,pilot program = teleconsultation ,"p ,d ( title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b et seq471 z am5d$ by section #c1 is fur!r am5d$ by ins]t+ aft] section #ccj;,a-#b ! foll[+3 #ccj;,a-#d4 ,pilot program = teleconsultation 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration & 9 consultation ) ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 %all aw>d grants or coop]ative agreem5ts to ,/ates1 political subdivisions ( ,/ates1 & ,indian ,tribes & ,tribal organizations 7z su* t]ms are def9$ 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #ecjd77 to support ! provision ( urg5t mat]nal heal? c>e 9 rural facilities )\t a d$icat$ ob/etric unit1 includ+ by-- 7#a7 support+ ! developm5t ( /atewide or regional mat]nal heal? c>e teleheal? access programs2 & 7#b7 support+ ! improvem5t ( exi/+ /atewide or regional mat]nal heal? c>e teleheal? access programs describ$ 9 subsection 7b74 7b7 ,/atewide or regional mat]nal heal? c>e teleheal? access programs ,a mat]nal heal? c>e teleheal? access program describ$ 9 ?is section1 ) respect to :i* an aw>d "u subsection 7a7 may be us$1 %all-- 7#a7 be a /atewide or regional network ( mat]nal heal? c>e teams t provide urg5t support to rural non-ob/etric sett+s ( c>e2 7#b7 support & fur!r develop organiz$ ,/ate or regional networks ( mat]nal heal? c>e teams to provide urg5t consultative support to rural non-ob/etric sett+s ( c>e2 7#c7 conduct an assessm5t ( urg5t mat]nal heal? consultation ne$s among provid]s 9 rural non-ob/etric sett+s ( c>e2 7#d7 provide assurances t ! physicians responsive to ! tele-consultation l9e are cr$5tial$ )9 _! employ+ facility & c provide consultation :]e ! pati5t is receiv+ c>e consi/5t ) ,/ate requirem5ts to provide c>e to individuals exp]i5c+ labor1 deliv]y1 ob/etric hemorrhage1 sev]e hyp]t5sion 9 pregnancy & po/p>tum1 c>diac conditions relat$ to or exac]bat$ by pregnancy1 p]9atal m5tal heal? conditions1 sub/ance use dur+ pregnancy or ! po/p>tum p]iod1 sepsis dur+ pregnancy or aft] pregnancy end1 or o!r conditions1 z appropriate2 7#e7 provide rapid /atewide or regional cl9ical telephone or teleheal? consultations :5 reque/$ betwe5 ! mat]nal c>e teams & provid]s 9 rural em]g5cy non-ob/etric sett+s2 & 7#f7 provide in=mation to heal? c>e provid]s ab\t available mat]nal heal? s]vices = p 9 ! community & assi/ ) ref]rals to specialty c>e & community or behavioral heal? res\rces4 7c7 ,report+ ,an entity receiv+ an aw>d "u ?is section %all submit a report to ! ,secret>y1 9 su* mann] & conta9+ su* in=mation z ! ,secret>y may require1 n lat] ?an #ah mon?s aft] initial receipt ( ! grant4 7d7 ,au?orization ( appropriations ,to c>ry out ?is section1 !re is au?oriz$ to be appropriat$ #e1jjj1jjj = ! p]iod ( fiscal ye>s #bjbe ?r\gh #bjbh4 4 #e4 ,/udy on ob/etric units 9 rural areas ,! ,secret>y ( ,heal? & ,human ,s]vices %all-- 7#a7 conduct a /udy t maps mat]nity w>d closures & regional patt]ns ( pati5t transport & exam9es models = regional p>tn]%ips = rural ob/etric c>e2 & 7#b7 n lat] ?an #c ye>s aft] ! date ( enactm5t ( ?is ,act1 submit to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce & ! ,committee on ,education & ! ,work=ce ( ! ,h\se ( ,repres5tatives1 a report on ! results ( ! /udy conduct$ "u p>agraph 7#a74