,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #gigc  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #ah1 #bjbf,ms4   
,und]wood 7= h]self1 ,ms4 ,adams1 ,mr4  
,aguil>1 ,mr4 ,amo1 ,ms4 ,ans>i1 ,ms4   
,bal9t1 ,ms4 ,b>ragn1 ,mrs4 ,beatty1    
,mr4 ,bell1 ,mr4 ,b]a1 ,mr4 ,bi%op1 ,ms4
 ,bonamici1 ,mr4 ,boyle ( ,p5nsylvania1 
,ms4 ,br[n1 ,ms4 ,br[nley1 ,mr4         
,c>bajal1 ,mr4 ,c>son1 ,mr4 ,c>t] (     
,l\isiana1 ,mr4 ,ca/51 ,ms4 ,ca/or (    
,florida1 ,mr4 ,ca/ro ( ,texas1 ,mrs4   
,*]filus-,mc,cormick1 ,ms4 ,*u1 ,ms4    
,cl>k ( ,massa*usetts1 ,ms4 ,cl>ke (    
,new ,york1 ,mr4 ,cleav]1 ,mr4 ,clyburn1
 ,mr4 ,coh51 ,mr4 ,conaway1 ,mr4        
,correa1 ,mr4 ,c\rtney1 ,ms4 ,craig1    
,ms4 ,crockett1 ,mr4 ,cr[1 ,mr4 ,cuell>1
 ,ms4 ,davids ( ,kansas1 ,mr4 ,davis (  
,ill9ois1 ,ms4 ,dean ( ,p5nsylvania1    
,ms4 ,de,gette1 ,mrs4 ,mc,clain         
,delaney1 ,ms4 ,de,lauro1 ,ms4          
,del,bene1 ,mr4 ,deluzio1 ,mr4          
,de,saulnier1 ,ms4 ,dext]1 ,mrs4 ,d+ell1
 ,ms4 ,elfre?1 ,ms4 ,escob>1 ,mr4       

,espaillat1 ,mr4 ,fields1 ,mr4 ,figures1
 ,mrs4 ,flet*]1 ,mr4 ,fo/]1 ,mrs4       
,f\%ee1 ,ms4 ,lois ,frankel ( ,florida1 
,mr4 ,fro/1 ,mr4 ,g>am5di1 ,ms4 ,g>cia (
 ,texas1 ,mr4 ,g>ca ( ,ill9ois1 ,mr4    
,g>cia ( ,cali=nia1 ,mr4 ,gold5 ( ,ma9e1
 ,mr4 ,goldman ( ,new ,york1 ,mr4       
,vic5te ,gonzalez ( ,texas1 ,ms4        
,goodl&]1 ,mr4 ,got!im]1 ,mr4 ,gray1    
,mr4 ,gre5 ( ,texas1 ,mrs4 ,grijalva1   
,mr4 ,h>d] ( ,cali=nia1 ,mrs4 ,hayes1   
,mr4 ,hors=d1 ,ms4 ,h\lahan1 ,mr4 ,hoy]1
 ,ms4 ,hoyle ( ,oregon1 ,mr4 ,huffman1  
,mr4 ,ivey1 ,mr4 ,jackson ( ,ill9ois1   
,ms4 ,jacobs1 ,ms4 ,jayapal1 ,mr4       
,jeffries1 ,mr4 ,johnson ( ,georgia1    
,ms4 ,johnson ( ,texas1 ,ms4            
,kamlag]-,dove1 ,ms4 ,kaptur1 ,ms4      
,kelly ( ,ill9ois1 ,mr4 ,k5n$y ( ,new   
,york1 ,mr4 ,khanna1 ,mr4 ,kri%namoor?i1
 ,mr4 ,l&sman1 ,mr4 ,l>s5 ( ,wa%+ton1   
,mr4 ,l>son ( ,connecticut1 ,mr4        
,latim]1 ,ms4 ,lee ( ,p5nsylvania1 ,ms4 
,lee ( ,nevada1 ,ms4 ,leg] ,f]n&ez1 ,mr4
 ,lev91 ,mr4 ,licc>do1 ,mr4 ,lieu1 ,mr4 

,lyn*1 ,mr4 ,magaz9]1 ,mr4 ,mannion1    
,ms4 ,matsui1 ,mrs4 ,mc,bath1 ,ms4      
,mc,bride1 ,ms4 ,mc,clellan1 ,ms4       
,mc,collum1 ,ms4 ,mc,donald ,rivet1 ,mr4
 ,mc,garvey1 ,mr4 ,mc,govern1 ,mrs4     
,mc,iver1 ,mr4 ,meeks1 ,mr4 ,m5efee1    
,mr4 ,m55dez1 ,mr4 ,mfume1 ,mr4 ,m91    
,ms4 ,moore ( ,wiscons91 ,mr4 ,morelle1 
,mr4 ,mosk[itz1 ,mr4 ,m\lton1 ,mr4      
,mrvan1 ,mr4 ,mull91 ,mr4 ,nadl]1 ,mr4  
,neguse1 ,mr4 ,norcross1 ,ms4 ,norton1  
,ms4 ,ocasio-,cortez1 ,mr4 ,olszewski1  
,ms4 ,om>1 ,mr4 ,panetta1 ,mr4 ,pappas1 
,ms4 ,pelosi1 ,ms4 ,pett]s51 ,ms4       
,p+ree1 ,ms4 ,plaskett1 ,mr4 ,pocan1    
,ms4 ,pressley1 ,mr4 ,quigley1 ,mrs4    
,ramirez1 ,ms4 ,r&all1 ,mr4 ,rask91 ,mr4
 ,riley ( ,new ,york1 ,ms4 ,rivas1 ,ms4 
,ross1 ,mr4 ,ruiz1 ,mr4 ,ryan1 ,ms4     
,sal9as1 ,ms4 ,scanlon1 ,ms4 ,s*ak[sky1 
,mr4 ,s*neid]1 ,ms4 ,s*olt51 ,ms4       
,s*ri]1 ,mr4 ,david ,scott ( ,georgia1  
,mr4 ,scott ( ,virg9ia1 ,ms4 ,sewell1   
,mr4 ,%]man1 ,ms4 ,simon1 ,mr4 ,smi? (  
,wa%+ton1 ,mr4 ,sor5s51 ,mr4 ,soto1 ,ms4

 ,/ansbury1 ,mr4 ,/anton1 ,ms4 ,/ev5s1  
,ms4 ,/rickl&1 ,mr4 ,subramanyam1 ,mr4  
,suozzi1 ,mr4 ,swalwell1 ,mr4 ,takano1  
,mr4 ,?an$>1 ,mr4 ,?ompson ( ,cali=nia1 
,mr4 ,?ompson ( ,mississippi1 ,ms4      
,titus1 ,ms4 ,tlaib1 ,ms4 ,tokuda1 ,mr4 
,tonko1 ,mr4 ,torres ( ,new ,york1 ,mrs4
 ,trahan1 ,mr4 ,tran1 ,mr4 ,v>gas1 ,mr4 
,veasey1 ,mr4 ,v9dman1 ,mr4 ,walk9%aw1  
,ms4 ,wass]man ,s*ultz1 ,ms4 ,wat]s1    
,mrs4 ,watson ,coleman1 ,ms4 ,williams (
 ,georgia1 ,ms4 ,wilson ( ,florida1 ,mr4
 ,evans ( ,p5nsylvania1 ,mr4 ,gomez1    
,mr4 ,cas>1 ,mr4 ,himes1 ,ms4 ,p\1 ,mrs4
 ,torres ( ,cali=nia1 ,ms4 ,budz9ski1   
,ms4 ,bynum1 ,ms4 ,fri$man1 ,mr4 ,keat+1
 ,mrs4 ,sykes1 ,mr4 ,neal1 ,mr4         
,h]nndez1 & ,mr4 ,co/a7 introduc$ !     
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce1 & 9    
addition to ! ,committees on ,education 
& ,work=ce1 ,vet]ans' ,affairs1 ,natural
 ,res\rces1 & ! ,judici>y1 = a p]iod to 
be subsequ5tly det]m9$ by ! ,speak]1 9  
ea* case = consid]ation ( su* provisions

 z fall )9 ! jurisdiction ( ! committee 
conc]n$  ,a ,,bill  ,to end prev5table  
mat]nal mortality1 sev]e mat]nal        
morbidity1 & mat]nal heal? disp>ities 9 
! ,unit$ ,/ates1 & = o!r purposes4  #a4 
,%ort title ,?is ,act may be cit$ z !   
,momnibus ,act4  #b4 ,table ( cont5ts ,!
 table ( cont5ts = ?is ,act is z foll[s3
  ,sec4 #a4 ,%ort title4 ,sec4 #b4      
,table ( cont5ts4 ,sec4 #c4 ,def9itions4
 ,sec4 #d4 ,s5se ( ,congress4 ,title    
,i--,social ,det]m9ants = ,moms ,sec4   
#aja4 ,task =ce to address ! ,unit$     
,/ates mat]nal heal? crisis4 ,sec4 #ajb4
 ,su/a9$ fund+ to address social        
det]m9ants ( mat]nal heal?4 ,title      
,,ii--,ext5d+ ,,wic = ,new ,moms ,sec4  
#bja4 ,ext5d+ ,,wic eligibility = new   
moms4 ,title ,,iii--,honor+ ,kira       
,johnson ,sec4 #cja4 ,su/a9$ fund+ =    
community-bas$ organizations to advance 
mat]nal heal? equity4 ,sec4 #cjb4       
,respectful mat]nity c>e tra9+ = all    
employees 9 mat]nity c>e sett+s4 ,sec4  
#cjc4 ,/udy on r$uc+ & prev5t+ bias1    

racism1 & discrim9ation 9 mat]nity c>e  
sett+s4 ,sec4 #cjd4 ,respectful mat]nity
 c>e compliance program4 ,sec4 #cje4    
,,gao report4 ,title ,,iv--,mat]nal     
heal? = vet]ans ,sec4 #dja4 ,support =  
mat]nity heal? c>e & coord9ation        
programs ( ! ,dep>tm5t ( ,vet]ans       
,affairs4 ,title ,v--,p]9atal work=ce   
,sec4 #eja4 ,,hhs ag5cy directives4     
,sec4 #ejb4 ,grants to gr[ & div]sify ! 
p]9atal work=ce4 ,sec4 #ejc4 ,grants to 
gr[ & div]sify ! nurs+ work=ce 9 mat]nal
 & p]9atal heal?4 ,sec4 #ejd4 ,,gao     
report4 ,title ,,vi--,data to save moms 
,sec4 #fja4 ,fund+ = mat]nal mortality  
review committees to promote            
repres5tative community engagem5t4 ,sec4
 #fjb4 ,data collection & review4 ,sec4 
#fjc4 ,review ( mat]nal heal? data      
collection processes & quality measures4
 ,sec4 #fjd4 ,/udy on mat]nal heal?     
among ,am]ican ,indian & ,alaska ,native
 individuals4 ,sec4 #fje4 ,grants to    
m9ority-s]v+ in/itutions to /udy mat]nal
 mortality1 sev]e mat]nal morbidity1 &  

o!r adv]se mat]nal heal? outcomes4      
,title ,,vii--,moms matt] ,sec4 #gja4   
,mat]nal m5tal heal? equity grant       
program4 ,sec4 #gjb4 ,grants to gr[ &   
div]sify ! mat]nal m5tal & behavioral   
heal? c>e work=ce4 ,title               
,,viii--,ju/ice = inc>c]at$ moms ,sec4  
#hja4 ,end+ ! %ackl+ ( pregnant         
individuals4 ,sec4 #hjb4 ,creat+ model  
programs = ! c>e ( inc>c]at$ individuals
 9 ! pr5atal & po/p>tum p]iods4 ,sec4   
#hjc4 ,grant program to improve mat]nal 
heal? outcomes = individuals 9 ,/ate &  
local prisons & jails4 ,sec4 #hjd4 ,,gao
 report4 ,title ,,ix--,te* to save moms 
,sec4 #ija4 ,integrat$ teleheal? models 
9 mat]nity c>e s]vices4 ,sec4 #ijb4     
,grants to exp& ! use ( te*nology-enabl$
 collaborative le>n+ & capacity models =
 pregnant & po/p>tum individuals4 ,sec4 
#ijc4 ,grants to promote equity 9       
mat]nal heal? outcomes ?r\gh digital    
tools4 ,sec4 #ijd4 ,report on ! use (   
te*nology 9 mat]nity c>e4 ,title        
,x--,impact to save moms ,sec4 #ajja4   

,p]9atal ,c>e ,alt]native ,paym5t ,model
 ,demon/ration ,project4 ,title         
,,xi--,mat]nal heal? p&emic response    
,sec4 #aaja4 ,def9itions4 ,sec4 #aajb4  
,fund+ = data collection1 surveillance1 
& rese>* on mat]nal heal? outcomes dur+ 
public heal? em]g5cies4 ,sec4 #aajc4    
,public heal? em]g5cy mat]nal heal? data
 collection & disclosure4 ,sec4 #aajd4  
,public heal? communication reg>d+      
mat]nal c>e dur+ public heal? em]g5cies4
 ,sec4 #aaje4 ,task =ce on bir?+        
exp]i5ce & safe1 respectful1 responsive1
 & emp[]+ mat]nity c>e dur+ public heal?
 em]g5cies4 ,title ,,xii--,protect+ moms
 & babies aga9/ climate *ange ,sec4     
#abja4 ,def9itions4 ,sec4 #abjb4 ,grant 
program to protect vuln]able mo!rs &    
babies f climate *ange risks4 ,sec4     
#abjc4 ,grant program = education &     
tra9+ at heal? pr(ession s*ools4 ,sec4  
#abjd4 ,,nih ,consortium on ,bir? &     
,climate ,*ange ,rese>*4 ,sec4 #abje4   
,/rategy = id5tify+ climate *ange risk  
zones = vuln]able mo!rs & babies4 ,title

 ,,xiii--,,nih ,,improve ,sec4 #acja4   
,,improve ,initiative4 ,title           
,,xiv--,mat]nal vacc9ations ,sec4 #adja4
 ,mat]nal vacc9ation aw>5ess & equity   
campaign4  #c4 ,def9itions ,9 ?is ,act3 
7#a7 ,culturally & l+ui/ically congru5t 
,! t]m culturally & l+ui/ically         
congru5t1 ) respect to c>e or mat]nity  
c>e1 means c>e t is 9 agreem5t ) !      
pref]r$ cultural values1 beliefs1       
worldview1 language1 & practices ( !    
heal? c>e consum] & o!r /akehold]s4     
7#b7 ,mat]nal mortality ,! t]m mat]nal  
mortality means a dea? occurr+ dur+ or  
)9 a #a-ye> p]iod aft] pregnancy1 caus$ 
by pregnancy-relat$ or *ildbir?         
complications1 includ+ a suicide1       
ov]dose1 or o!r dea? result+ f a m5tal  
heal? or sub/ance use disord] attribut$ 
to or aggravat$ by pregnancy-relat$ or  
*ildbir? complications4  7#c7 ,mat]nity 
c>e provid] ,! t]m mat]nity c>e provid] 
means a heal? c>e provid] :o--  7,a7 is 
a physician1 a physician assi/ant1 a    
midwife :o meets1 at a m9imum1 !        

int]national def9ition ( a midwife &    
global /&>ds = midwif]y education z     
e/abli%$ by ! ,int]national ,conf$]ation
 ( ,midwives1 an advanc$ practice       
regi/]$ nurse1 a d\la accr$it$ by a     
,/ate to receive reimbursem5t = d\la    
s]vices "u a ,/ate plan 7or a waiv] (   
su* plan7 "u title ,,xix ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acif et  
seq471 or a lactation consultant c]tifi$
 by ! ,int]national ,bo>d ( ,lactation  
,consultant ,exam9]s2 &  7,b7 has a     
focus on mat]nal or p]9atal heal?4  7#d7
 ,p]9atal heal? work] ,! t]m p]9atal    
heal? work] means a noncl9ical heal?    
work] focus$ on mat]nal or p]9atal      
heal?1 su* z a d\la1 community heal?    
work]1 pe] support]1 lactation educator 
or c\nselor1 nutritioni/ or dietitian1  
*ildbir? educator1 social work]1 home   
visitor1 pati5t navigator or coord9ator1
 or language int]pret]4  7#e7 ,po/p>tum 
& po/p>tum p]iod ,! t]ms po/p>tum &     
po/p>tum p]iod ref] to ! #a-ye> p]iod   
beg9n+ on ! la/ day ( ! pregnancy ( an  

individual4  7#f7 ,pregnancy-associat$  
dea? ,! t]m pregnancy-associat$ dea?    
means a dea? ( a pregnant or po/p>tum   
individual1 by any cause1 t occurs dur+1
 or )9 #a ye> foll[+1 ! individual's    
pregnancy1 reg>dless ( ! outcome1       
duration1 or site ( ! pregnancy4  7#g7  
,pregnancy-relat$ dea? ,! t]m           
pregnancy-relat$ dea? means a dea? ( a  
pregnant or po/p>tum individual t occurs
 dur+1 or )9 #a ye> foll[+1 !           
individual's pregnancy1 f a pregnancy   
complication1 a *a9 ( ev5ts initiat$ by 
pregnancy1 or ! aggravation ( an        
unrelat$ condition by ! physiologic     
effects ( pregnancy4  7#h7 ,public heal?
 em]g5cy ,! t]m public heal? em]g5cy    
means a public heal? em]g5cy decl>$ "u  
section #cai ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bdg;d74  7#i7      
,racial & e?nic m9ority gr\p ,! t]m     
racial & e?nic m9ority gr\p has ! mean+ 
giv5 su* t]m 9 section #agjg7;g77#a7 ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #cjju-#f7;g77#a774  7#aj7     

,sev]e mat]nal morbidity ,! t]m sev]e   
mat]nal morbidity means a heal?         
condition1 includ+ m5tal heal?          
conditions & sub/ance use disord]s1     
attribut$ to or aggravat$ by pregnancy  
or *ildbir? t results 9 significant     
%ort-t]m or long-t]m consequ5ces to !   
heal? ( ! individual :o 0 pregnant4     
7#aa7 ,social det]m9ants ( mat]nal heal?
 ,! t]m social det]m9ants ( mat]nal     
heal? means noncl9ical factors t impact 
mat]nal heal? outcomes4  #d4 ,s5se (    
,congress ,x is ! s5se ( ,congress t--  
7#a7 ! respect & prop] c>e t bir?+ p    
des]ve is inclusive2 &  7#b7 reg>dless (
 race1 e?nicity1 g5d] id5tity1 sexual   
ori5tation1 religion1 m>ital /atus1     
prim>y language1 familial /atus1        
socioeconomic /atus1 immigration /atus1 
inc>c]ation /atus1 or disability1 all   
des]ve dignity4  ,i ,social ,det]m9ants 
= ,moms  #aja4 ,task =ce to address !   
,unit$ ,/ates mat]nal heal? crisis  7a7 
,9 g5]al ,! ,secret>y ( ,heal? & ,human 
,s]vices %all conv5e a task =ce 79 ?is  

section ref]r$ to z ! ,task ,=ce7 to    
develop /rategies & coord9ate ef=ts     
betwe5 ,f$]al ag5cies & o!r /akehold]s  
to elim9ate prev5table mat]nal          
mortality1 sev]e mat]nal morbidity1 &   
mat]nal heal? disp>ities 9 ! ,unit$     
,/ates1 includ+ actions to address      
cl9ical & noncl9ical causes ( mat]nal   
mortality1 sev]e mat]nal morbidity1 &   
mat]nal heal? disp>ities4  7b7 ,ex      
(ficio memb]s ,! ex (ficio memb]s ( !   
,task ,=ce %all consi/ ( ! foll[+3 7#a7 
,! ,secret>y ( ,heal? & ,human ,s]vices 
7or a designee !re(74  7#b7 ,! ,secret>y
 ( ,h\s+ & ,urban ,developm5t 7or a     
designee !re(74  7#c7 ,! ,secret>y (    
,transportation 7or a designee !re(74   
7#d7 ,! ,secret>y ( ,agriculture 7or a  
designee !re(74  7#e7 ,! ,secret>y (    
,labor 7or a designee !re(74  7#f7 ,!   
,adm9i/rator ( ! ,environm5tal          
,protection ,ag5cy 7or a designee !re(74
  7#g7 ,! ,assi/ant ,secret>y = !       
,adm9i/ration = ,*ildr5 & ,families 7or 
a designee !re(74  7#h7 ,! ,adm9i/rator 

( ! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices 
7or a designee !re(74  7#i7 ,! ,director
 ( ! ,indian ,heal? ,s]vice 7or a       
designee !re(74  7#aj7 ,! ,director ( ! 
,national ,in/itutes ( ,heal? 7or a     
designee !re(74  7#aa7 ,! ,director ( ! 
,eunice ,k5n$y ,%riv] ,national         
,in/itute ( ,*ild ,heal? & ,human       
,developm5t 7or a designee !re(74  7#ab7
 ,! ,director ( ! ,tribal ,heal? ,rese>*
 ,(fice ( ! ,national ,in/itutes (      
,heal? 7or a designee !re(74  7#ac7 ,!  
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration 7or a designee   
!re(74  7#ad7 ,! ,deputy ,assi/ant      
,secret>y = ,m9ority ,heal? ( !         
,dep>tm5t ( ,heal? & ,human ,s]vices 7or
 a designee !re(74  7#ae7 ,! ,deputy    
,assi/ant ,secret>y = ,wom5's ,heal? ( !
 ,dep>tm5t ( ,heal? & ,human ,s]vices   
7or a designee !re(74  7#af7 ,!         
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion 7or a designee !re(74     
7#ag7 ,! ,director ( ! ,(fice on        
,viol5ce ,aga9/ ,wom5 at ! ,dep>tm5t (  

,ju/ice 7or a designee !re(74  7c7      
,appo9t$ memb]s ,9 addition to ! ex     
(ficio memb]s ( ! ,task ,=ce1 !         
,secret>y ( ,heal? & ,human ,s]vices may
 appo9t ! foll[+ memb]s ( ! ,task ,=ce3 
7#a7 ,repres5tatives ( pati5ts1 to      
include--  7,a7 a repres5tative (       
pati5ts :o h suff]$ f sev]e mat]nal     
morbidity2 or  7,b7 a repres5tative (   
pati5ts :o is a family memb] ( an       
individual :o suff]$ a pregnancy-relat$ 
dea?4  7#b7 ,lead]s ( community-bas$    
organizations t address mat]nal         
mortality1 sev]e mat]nal morbidity1 &   
mat]nal heal? ) a specific focus on     
racial & e?nic disp>ities4 ,9 appo9t+   
su* lead]s "u ?is p>agraph1 ! ,secret>y 
( ,heal? & ,human ,s]vices %all give    
priority to individuals :o are lead]s ( 
organizations l$ by individuals f       
demographic gr\ps ) elevat$ rates (     
mat]nal mortality1 sev]e mat]nal        
morbidity1 mat]nal heal? disp>ities1 or 
o!r adv]se p]9atal or *ildbir? outcomes4
  7#c7 ,lead]s f ! ,indian heal? c>e    

sy/em1 includ+ lead]s f ,tribal         
,epidemiology ,c5t]s4  7#d7 ,p]9atal    
heal? work]s4  7#e7 ,a pr(essionally &  
geographically div]se panel ( mat]nity  
c>e provid]s4  7#f7 ,o!r mat]nal heal?  
/akehold]s outside ( ! ,f$]al ,gov]nm5t 
) exp]tise 9 mat]nal heal?1 includ+     
social det]m9ants ( mat]nal heal?4  7d7 
,*air ,! ,secret>y ( ,heal? & ,human    
,s]vices %all select ! *air ( ! ,task   
,=ce f among ! memb]s ( ! ,task ,=ce4   
7e7 ,topics ,9 develop+ /rategies       
coord9at+ ef=ts betwe5 ,f$]al ag5cies & 
o!r /akehold]s to elim9ate prev5table   
mat]nal mortality1 sev]e mat]nal        
morbidity1 & mat]nal heal? disp>ities 9 
! ,unit$ ,/ates "u ?is section1 ! ,task 
,=ce may address topics su* z-- 7#a7    
address+ b>ri]s t prev5t individuals f  
att5d+ pr5atal & po/p>tum appo9tm5ts1   
access+ mat]nal heal? c>e s]vices1 or   
access+ s]vices & res\rces relat$ to    
social det]m9ants ( mat]nal heal?2  7#b7
 increas+ access to safe1 /able1        
af=dable1 & adequate h\s+ = pregnant &  

po/p>tum individuals & _! families2     
7#c7 deliv]+ heal?y food1 infant =mula1 
clean wat]1 diap]s1 or o!r p]9atal      
necessities to pregnant & po/p>tum      
individuals locat$ 9 areas t are food   
des]ts2  7#d7 address+ ! impacts ( wat] 
& air quality1 exposure to extreme      
temp]atures1 environm5tal *emicals1     
environm5tal risks 9 ! workplace & !    
home1 & pollution levels1 on mat]nal &  
infant heal? outcomes2  7#e7 (f]+ free &
 accessible drop-9 *ildc>e s]vices dur+ 
pr5atal & po/p>tum appo9tm5ts2  7#f7    
address+ ! cl9ical & noncl9ical ne$s (  
po/p>tum individuals & _! families = !  
duration ( ! po/p>tum p]iod2  7#g7      
engag+ ) nongov]nm5tal entities to      
address social det]m9ants ( mat]nal     
heal?1 includ+ ?r\gh public-private     
p>tn]%ips2  7#h7 address+ ! impact (    
dome/ic or intimate p>tn] viol5ce on    
mat]nal heal? outcomes2 &  7#i7 o!r     
topics det]m9$ by ! *air ( ! ,task ,=ce4
  7f7 ,report ,n lat] ?an #b ye>s aft] !
 date ( enactm5t ( ?is ,act1 & e ye>    

!reaft]1 ! ,task ,=ce %all submit to    
,congress & make publicly available on !
 website ( ! ,dep>tm5t ( ,heal? & ,human
 ,s]vices a report-- 7#a7 describ+ !    
,task ,=ce's ef=ts to develop /rategies 
& coord9ate ef=ts betwe5 ,f$]al ag5cies 
& o!r /akehold]s to elim9ate prev5table 
mat]nal mortality1 sev]e mat]nal        
morbidity1 & mat]nal heal? disp>ities 9 
! ,unit$ ,/ates2  7#b7 provid+ an       
ov]view ( actions tak5 by ea* memb] ( ! 
,task ,=ce li/$ "u subsection 7b7 to    
elim9ate prev5table mat]nal mortality1  
sev]e mat]nal morbidity1 & mat]nal heal?
 disp>ities 9 ! ,unit$ ,/ates2  7#c7    
provid+ recomm5dations on ,f$]al fund+  
am\nts & au?orities ne$$ to implem5t    
/rategies develop$ by ! ,task ,=ce to   
elim9ate prev5table mat]nal mortality1  
sev]e mat]nal morbidity1 & mat]nal heal?
 disp>ities 9 ! ,unit$ ,/ates2  7#d7    
provid+ recomm5dations on actions t     
/akehold]s outside ( ! ,f$]al ,gov]nm5t 
c take to elim9ate prev5table mat]nal   
mortality1 sev]e mat]nal morbidity1 &   

mat]nal heal? disp>ities 9 ! ,unit$     
,/ates2 &  7#e7 address+ o!r topics z   
det]m9$ by ! *air ( ! ,task ,=ce4  7g7  
,t]m9ation ,section #ajac ( title #e1   
,unit$ ,/ates ,code1 %all n apply to !  
,task ,=ce ) respect to t]m9ation4      
#ajb4 ,su/a9$ fund+ to address social   
det]m9ants ( mat]nal heal?  7a7 ,9 g5]al
 ,! ,secret>y ( ,heal? & ,human ,s]vices
 79 ?is section ref]r$ to z ! ,secret>y7
 %all aw>d grants to eligible entities  
to address social det]m9ants ( mat]nal  
heal? to elim9ate mat]nal mortality1    
sev]e mat]nal morbidity1 & mat]nal heal?
 disp>ities4  7b7 ,eligible entities ,9 
?is section1 ! t]m eligible entity      
means-- 7#a7 a community-bas$           
organization1 ,indian ,tribe or ,tribal 
organization1 or ,urban ,indian         
organization2  7#b7 a public heal?      
dep>tm5t or nonpr(it organization work+ 
) an entity li/$ 9 p>agraph 7#a72 or    
7#c7 a consortium ( entities li/$ 9     
p>agraph 7#a7 or 7#b7 t includes at     
m9imum "o entity li/$ 9 p>agraph 7#a74  

7c7 ,application ,to be eligible to     
receive a grant "u ?is section1 an      
eligible entity %all submit to !        
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may provide4  7d7             
,prioritization ,9 aw>d+ grants "u      
subsection 7a71 ! ,secret>y %all give   
priority to an eligible entity t is     
op]at+ 9 an area )--  7#a7 high rates ( 
mat]nal mortality1 sev]e mat]nal        
morbidity1 mat]nal heal? disp>ities1 or 
o!r adv]se p]9atal or *ildbir? outcomes2
 &  7#b7 a high pov]ty rate4  7e7       
,activities ,an eligible entity t       
receives a grant "u ?is section may use 
! grant to address social det]m9ants (  
mat]nal heal? su* z-- 7#a7 h\s+2  7#b7  
transportation2  7#c7 nutrition2  7#d7  
employm5t1 workplace conditions1 & o!r  
economic factors2  7#e7 environm5tal    
conditions2  7#f7 intimate p>tn]        
viol5ce2 &  7#g7 o!r noncl9ical factors 
t impact mat]nal heal? outcomes4  7f7   
,te*nical assi/ance ,! ,secret>y %all   

provide to grant recipi5ts "u ?is       
section te*nical assi/ance to plan =    
su/a9+ programs to address social       
det]m9ants ( mat]nal heal? aft] ! p]iod 
( ! grant4  7g7 ,report+  7#a7 ,grantees
 ,n lat] ?an #a ye> aft] an eligible    
entity fir/ receives a grant "u ?is     
section1 & annually !reaft]1 an eligible
 entity %all submit to ! ,secret>y1 &   
make publicly available1 a report on !  
/atus ( activities conduct$ us+ ! grant4
 ,ea* su* report %all include data on ! 
effects ( su* activities1 disaggregat$  
by race1 e?nicity1 g5d]1 prim>y         
language1 geography1 socioeconomic      
/atus1 & o!r relevant factors4  7#b7    
,secret>y ,n lat] ?an ! end ( fiscal ye>
 #bjca1 ! ,secret>y %all submit to      
,congress a report t includes-- 7,a7 a  
summ>y ( ! reports "u p>agraph 7#a72 &  
7,b7 recomm5dations = future ,f$]al     
grant allocations to address social     
det]m9ants ( mat]nal heal?4  7h7        
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  

?is section #ajj1jjj1jjj = ea* ( fiscal 
ye>s #bjbg ?r\gh #bjca4  ,,ii ,ext5d+   
,,wic = ,new ,moms  #bja4 ,ext5d+ ,,wic 
eligibility = new moms  7a7 ,ext5sion ( 
po/p>tum p]iod ,section #ag7;b77#aj7 ( !
 ,*ild ,nutrition ,act ( #aiff 7#db     
,u4,s4,c4 #aghf7;b77#aj77 is am5d$ by   
/rik+ six mon?s & ins]t+ #bd mon?s4  7b7
 ,ext5sion ( brea/fe$+ p]iod ,section   
#ag7;d77#c77;,a77ii7 ( ! ,*ild          
,nutrition ,act ( #aiff 7#db ,u4,s4,c4  
#aghf7;d77#c77;,a77ii77 is am5d$ by     
/rik+ #a ye> & ins]t+ #bd mon?s4  7c7   
,report ,n lat] ?an #b ye>s aft] ! date 
( ! enactm5t ( ?is section1 ! ,secret>y 
%all submit to ,congress a report t     
includes an evaluation ( ! effect ( ea* 
( ! am5dm5ts made by ?is section on--   
7#a7 mat]nal & infant heal? outcomes1   
includ+ racial & e?nic disp>ities )     
respect to su* outcomes2  7#b7 brea/fe$+
 rates among po/p>tum individuals2  7#c7
 qualitative evaluations ( family       
exp]i5ces "u ! special supplem5tal      
nutrition program "u section #ag ( !    

,*ild ,nutrition ,act ( #aiff 7#db      
,u4,s4,c4 #aghf72 &  7#d7 o!r relevant  
in=mation z det]m9$ by ! ,secret>y4     
,,iii ,honor+ ,kira ,johnson  #cja4     
,su/a9$ fund+ = community-bas$          
organizations to advance mat]nal heal?  
equity  7a7 ,9 g5]al ,! ,secret>y (     
,heal? & ,human ,s]vices 79 ?is section 
ref]r$ to z ! ,secret>y7 %all aw>d      
grants to eligible entities to e/abli%  
or exp& programs to advance mat]nal     
heal? equity4  7b7 ,tim+ ,foll[+ !      
#a-ye> p]iod describ$ 9 subsection 7d71 
! ,secret>y %all comm5ce aw>d+ ! grants 
au?oriz$ by subsection 7a74  7c7        
,eligible entities ,to be eligible to   
seek a grant "u ?is section1 an entity  
%all be a community-bas$ organization   
(f]+ programs & res\rces align$ )       
evid5ce-bas$ practices = improv+ mat]nal
 heal? outcomes = demographic gr\ps )   
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4  7d7 ,outrea* &      

te*nical assi/ance p]iod ,dur+ ! #a-ye> 
p]iod beg9n+ on ! date ( enactm5t ( ?is 
,act1 ! ,secret>y %all-- 7#a7 conduct   
outrea* to enc\rage eligible entities to
 apply = grants "u ?is section2 &  7#b7 
provide te*nical assi/ance to eligible  
entities on be/ practices = apply+ =    
grants "u ?is section4  7e7 ,special    
consid]ation  7#a7 ,outrea* ,9 conduct+ 
outrea* "u subsection 7d71 ! ,secret>y  
%all give special consid]ation to       
eligible entities t--  7,a7 are bas$ 91 
& provide support =1 communities )      
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes1 to ! ext5t su* data  
are available2  7,b7 are l$ by          
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2 &  7,c7 (f] programs 
& res\rces t are align$ ) evid5ce-bas$  
practices = improv+ mat]nal heal?       

outcomes = individuals f demographic    
gr\ps ) elevat$ rates ( mat]nal         
mortality1 sev]e mat]nal morbidity1     
mat]nal heal? disp>ities1 or o!r adv]se 
p]9atal or *ildbir? outcomes4  7#b7     
,aw>ds ,9 aw>d+ grants "u ?is section1 !
 ,secret>y %all give special            
consid]ation to eligible entities t--   
7,a7 are describ$ 9 subp>agraphs 7,a71  
7,b71 & 7,c7 ( p>agraph 7#a72  7,b7 (f] 
programs & res\rces design$ 9           
consultation ) & int5d$ = individuals f 
demographic gr\ps ) elevat$ rates (     
mat]nal mortality1 sev]e mat]nal        
morbidity1 mat]nal heal? disp>ities1 or 
o!r adv]se p]9atal or *ildbir? outcomes2
  7,c7 (f] programs & res\rces 9 !      
communities 9 :i* ! respective eligible 
entities are locat$ t-- 7i7 promote     
mat]nal m5tal heal? & mat]nal sub/ance  
use disord] treatm5ts & supports t are  
align$ ) evid5ce-bas$ practices =       
improv+ mat]nal m5tal & behavioral heal?
 outcomes = individuals f demographic   
gr\ps ) elevat$ rates ( mat]nal         

mortality1 sev]e mat]nal morbidity1     
mat]nal heal? disp>ities1 or o!r adv]se 
p]9atal or *ildbir? outcomes2  7ii7     
address social det]m9ants ( mat]nal     
heal?2  7iii7 promote evid5ce-bas$ heal?
 lit]acy & pregnancy1 *ildbir?1 & p>5t+ 
education2  7iv7 provide support f      
p]9atal heal? work]s2  7v7 provide      
culturally & l+ui/ically congru5t tra9+ 
to p]9atal heal? work]s2  7vi7 conduct  
or support rese>* on mat]nal heal?      
issues disproportionately impact+       
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  7vii7 (f] gr\p      
pr5atal c>e or gr\p po/p>tum c>e2       
7viii7 coord9ate mutual aid ef=ts dur+  
infant =mula %ortages1 includ+ community
 milk depots1 donor human milk banks &  
ex*anges1 & =ums = community outrea* &  
education2  7ix7 provide support to     
individuals or family memb]s (          
individuals :o suff]$ a pregnancy loss1 

pregnancy-associat$ dea?1 or            
pregnancy-relat$ dea?2 or  7x7 op]ate   
midwif]y practices t provide culturally 
& l+ui/ically congru5t mat]nal heal? c>e
 & support1 includ+ = ! purposes (--    
7,i7 support+ additional education1     
tra9+1 & c]tification programs1 includ+ 
support = di/ance le>n+2  7,,ii7 provid+
 f9ancial support to curr5t & future    
midwives to address education co/s1     
debts1 & o!r ne$s2  7,,iii7 cl9ical site
 inve/m5ts2  7,,iv7 support+ preceptor  
developm5t tra9+s2  7,v7 exp&+ !        
midwif]y practice2 or  7,,vi7 relat$    
ne$s id5tifi$ by ! midwif]y practice &  
describ$ 9 ! practice's application2 &  
7,d7 h develop$ o!r programs & res\rces 
t address community-specific ne$s =     
pregnant & po/p>tum individuals & are   
align$ ) evid5ce-bas$ practices =       
improv+ mat]nal heal? outcomes =        
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    

*ildbir? outcomes4  7f7 ,te*nical       
assi/ance ,! ,secret>y %all provide to  
grant recipi5ts "u ?is section te*nical 
assi/ance on-- 7#a7 capacity build+ to  
e/abli% or exp& programs to advance     
mat]nal heal? equity2  7#b7 be/         
practices 9 data collection1 measurem5t1
 evaluation1 & report+2 &  7#c7 plann+ =
 su/a9+ programs to advance mat]nal     
heal? equity aft] ! p]iod ( ! grant4    
7g7 ,evaluation ,n lat] ?an ! end (     
fiscal ye> #bjca1 ! ,secret>y %all      
submit to ! ,congress an evaluation ( ! 
grant program "u ?is section t-- 7#a7   
assesses ! effectiv5ess ( outrea* ef=ts 
dur+ ! application process 9 div]sify+ !
 pool ( grant recipi5ts2  7#b7 makes    
recomm5dations = future outrea* ef=ts to
 div]sify ! pool ( grant recipi5ts =    
,dep>tm5t ( ,heal? & ,human ,s]vices    
grant programs & fund+ opportunities    
relat$ to mat]nal heal?2  7#c7 assesses 
! effectiv5ess ( programs fund$ by      
grants "u ?is section 9 improv+ mat]nal 
heal? outcomes = individuals f          

demographic gr\ps ) elevat$ rates (     
mat]nal mortality1 sev]e mat]nal        
morbidity1 mat]nal heal? disp>ities1 or 
o!r adv]se p]9atal or *ildbir? outcomes1
 to ! ext5t practicable2 &  7#d7 makes  
recomm5dations = future ,dep>tm5t (     
,heal? & ,human ,s]vices grant programs 
& fund+ opportunities t deliv] fund+ to 
community-bas$ organizations t provide  
programs & res\rces t are align$ )      
evid5ce-bas$ practices = improv+ mat]nal
 heal? outcomes = individuals f         
demographic gr\ps ) elevat$ rates (     
mat]nal mortality1 sev]e mat]nal        
morbidity1 mat]nal heal? disp>ities1 or 
o!r adv]se p]9atal or *ildbir? outcomes4
  7h7 ,au?orization ( appropriations ,to
 c>ry out ?is section1 !re is au?oriz$  
to be appropriat$ #ajj1jjj1jjj = ea* (  
fiscal ye>s #bjbg ?r\gh #bjca4  #cjb4   
,respectful mat]nity c>e tra9+ = all    
employees 9 mat]nity c>e sett+s ,"p ,b (
 title ,,vii ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bic et seq47 is    
am5d$ by add+ at ! end ! foll[+ new     

section3  #gdb4 ,respectful mat]nity c>e
 tra9+ = all employees 9 mat]nity c>e   
sett+s  7a7 ,grants ,! ,secret>y %all   
aw>d grants = programs to r$uce & prev5t
 bias1 racism1 & discrim9ation 9        
mat]nity c>e sett+s & to advance        
respectful1 culturally & l+ui/ically    
congru5t1 trauma-in=m$ c>e4  7b7        
,special consid]ation ,9 aw>d+ grants "u
 subsection 7a71 ! ,secret>y %all give  
special consid]ation to applications =  
programs t w\ld-- 7#a7 apply to all     
mat]nity c>e provid]s & any employees :o
 int]act ) pregnant & po/p>tum          
individuals 9 ! provid] sett+1 includ+  
front desk employees1 sonograph]s1      
s*$ul]s1 heal? c>e pr(essionals1        
hospital or heal? sy/em adm9i/rators1   
security /aff1 & o!r employees2  7#b7   
emphasize p]iodic1 z oppos$ to "o-"t1   
tra9+s = all bir?+ pr(essionals &       
employees describ$ 9 p>agraph 7#a72     
7#c7 address implicit bias1 racism1 &   
cultural humility2  7#d7 be deliv]$ 9   
ongo+ education sett+s = provid]s       

ma9ta9+ _! lic5ses1 ) a pref]5ce =      
tra9+s t provide cont9u+ education      
units2  7#e7 include trauma-in=m$ c>e   
be/ practices & an emphasis on %>$      
decision mak+ betwe5 provid]s & pati5ts2
  7#f7 include antiracism tra9+ &       
programs2  7#g7 be deliv]$ 9            
und]graduate programs t funnel into     
heal? pr(essions s*ools2  7#h7 be       
deliv]$ 9 sett+s t apply to provid]s ( !
 special supplem5tal nutrition program =
 wom51 infants1 & *ildr5 "u section #ag 
( ! ,*ild ,nutrition ,act ( #aiff2  7#i7
 integrate bias tra9+ 9 ob/etric em]g5cy
 simulation tra9+s or relat$ tra9+s2    
7#aj7 include tra9+ = em]g5cy dep>tm5t  
employees & em]g5cy m$ical te*nicians on
 recogniz+ w>n+ signs = sev]e           
pregnancy-relat$ complications2  7#aa7  
(f] tra9+ to all mat]nity c>e provid]s  
on ! value ( racially1 e?nically1 &     
pr(essionally div]se mat]nity c>e teams 
to provide culturally & l+ui/ically     
congru5t c>e2 or  7#ab7 be bas$ on "o or
 m programs design$ by a hi/orically    

,black college or univ]sity or o!r      
m9ority-s]v+ in/itution4  7c7           
,application ,to seek a grant "u        
subsection 7a71 an entity %all submit an
 application at su* "t1 9 su* mann]1 &  
conta9+ su* in=mation z ! ,secret>y may 
require4  7d7 ,report+ ,ea* recipi5t ( a
 grant "u ?is section %all annually     
submit to ! ,secret>y a report on !     
/atus ( activities conduct$ us+ ! grant1
 includ+1 z applicable1 a description ( 
! impact ( tra9+ provid$ ?r\gh ! grant  
on pati5t outcomes & pati5t exp]i5ce =  
pregnant & po/p>tum individuals f racial
 & e?nic m9ority gr\ps & _! families4   
7e7 ,be/ practices ,bas$ on ! annual    
reports submitt$ pursuant to subsection 
7d71 ! ,secret>y--  7#a7 %all produce an
 annual report on ! f9d+s result+ f     
programs fund$ ?r\gh ?is section2  7#b7 
%all dissem9ate su* report to all       
recipi5ts ( grants "u ?is section & to !
 public2 &  7#c7 may include 9 su*      
report f9d+s on be/ practices = improv+ 
pati5t outcomes & pati5t exp]i5ce =     

pregnant & po/p>tum individuals f racial
 & e?nic m9ority gr\ps & _! families 9  
mat]nity c>e sett+s4  7f7 ,def9itions ,9
 ?is section3  7#a7 ,! t]m po/p>tum     
means ! #a-ye> p]iod beg9n+ on ! la/ day
 ( an individual's pregnancy4  7#b7 ,!  
t]m culturally & l+ui/ically congru5t   
means 9 agreem5t ) ! pref]r$ cultural   
values1 beliefs1 worldview1 language1 & 
practices ( ! heal? c>e consum] & o!r   
/akehold]s4  7#c7 ,! t]m racial & e?nic 
m9ority gr\p has ! mean+ giv5 su* t]m 9 
section #agjg7;g77#a74  7g7             
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re is au?oriz$ to be  
appropriat$ #e1jjj1jjj = ea* ( fiscal   
ye>s #bjbg ?r\gh #bjca4  4  #cjc4 ,/udy 
on r$uc+ & prev5t+ bias1 racism1 &      
discrim9ation 9 mat]nity c>e sett+s  7a7
 ,9 g5]al ,! ,secret>y ( ,heal? & ,human
 ,s]vices %all seek to ent] into an     
agreem5t1 n lat] ?an #ij days aft] !    
date ( enactm5t ( ?is ,act1 ) !         
,national ,academies ( ,sci5ces1        
,eng9e]+1 & ,m$ic9e 7ref]r$ to 9 ?is    

section z ! ,national ,academies7 "u :i*
 ! ,national ,academies agree to-- 7#a7 
conduct a /udy on ! design &            
implem5tation ( programs to r$uce &     
prev5t bias1 racism1 & discrim9ation 9  
mat]nity c>e sett+s & to advance        
respectful1 culturally & l+ui/ically    
congru5t1 trauma-in=m$ c>e2 &  7#b7 n   
lat] ?an #bd mon?s aft] ! date (        
enactm5t ( ?is ,act-- 7,a7 complete !   
/udy2 &  7,b7 transmit a report on !    
results ( ! /udy to ! ,congress4  7b7   
,possible topics ,! agreem5t ent]$ into 
pursuant to subsection 7a7 may provide =
 ! /udy ( any ( ! foll[+3  7#a7 ,!      
developm5t ( a scorec>d or o!r          
evaluation /&>ds = programs design$ to  
r$uce & prev5t bias1 racism1 &          
discrim9ation 9 mat]nity c>e sett+s to  
assess ! effectiv5ess ( su* programs 9  
improv+ pati5t outcomes & pati5t        
exp]i5ce = pregnant & po/p>tum          
individuals f racial & e?nic m9ority    
gr\ps & _! families4  7#b7 ,det]m9ation 
( ! types & frequ5cy ( tra9+ to r$uce & 

prev5t bias1 racism1 & discrim9ation 9  
mat]nity c>e sett+s t are demon/rat$ to 
improve pati5t outcomes or pati5t       
exp]i5ce = pregnant & po/p>tum          
individuals f racial & e?nic m9ority    
gr\ps & _! families4  #cjd4 ,respectful 
mat]nity c>e compliance program  7a7 ,9 
g5]al ,! ,secret>y ( ,heal? & ,human    
,s]vices 7ref]r$ to 9 ?is section z !   
,secret>y7 %all aw>d grants to accr$it$ 
hospitals1 heal? sy/ems1 & o!r mat]nity 
c>e sett+s to e/abli% z an integral "p (
 quality implem5tation initiatives )9 "o
 or m hospitals or o!r bir? sett+s a    
respectful mat]nity c>e compliance      
program4  7b7 ,program requirem5ts ,a   
respectful mat]nity c>e compliance      
program fund$ ?r\gh a grant "u ?is      
section %all--  7#a7 in/itutionalize    
me*anisms to all[ pati5ts receiv+       
mat]nity c>e s]vices1 ! families ( su*  
pati5ts1 or p]9atal heal? work]s        
support+ su* pati5ts to report in/ances 
( racism or evid5ce ( bias on ! basis ( 
race1 e?nicity1 or ano!r protect$ class2

  7#b7 in/itutionalize response         
me*anisms ?r\gh :i* repres5tatives ( !  
program c directly foll[ up ) ! pati5t1 
if possible1 & ! pati5t's family 9 a    
timely mann]2  7#c7 prep>e & make       
publicly available a hospital- or heal? 
sy/em-wide /rategy to r$uce bias on !   
basis ( race1 e?nicity1 or ano!r        
protect$ class 9 ! deliv]y ( mat]nity   
c>e t includes-- 7,a7 in=mation on !    
tra9+ programs to r$uce & prev5t bias1  
racism1 & discrim9ation on ! basis (    
race1 e?nicity1 or ano!r protect$ class 
= all employees 9 mat]nity c>e sett+s2  
7,b7 in=mation on ! numb] ( cases       
report$ to ! compliance program2 &  7,c7
 ! developm5t ( me?ods to r\t9ely assess
 ! ext5t to :i* bias1 racism1 or        
discrim9ation on ! basis ( race1        
e?nicity1 or ano!r protect$ class is    
pres5t 9 ! deliv]y ( mat]nity c>e to    
pati5ts f racial & e?nic m9ority gr\ps2 
7#d7 develop me*anisms to r\t9ely       
collect & publicly report hospital-level
 data relat$ to pati5t-report$ exp]i5ce 

( c>e2 &  7#e7 provide annual reports to
 ! ,secret>y ) in=mation ab\t ea* case  
report$ to ! compliance program ov] !   
c\rse ( ! ye> conta9+ su* in=mation z ! 
,secret>y may require1 su* z--  7,a7    
deid5tifi$ demographic in=mation on !   
pati5t 9 ! case1 su* z race1 e?nicity1  
g5d] id5tity1 & prim>y language2  7,b7 !
 cont5t ( ! report f ! pati5t or !      
family ( ! pati5t to ! compliance       
program2  7,c7 ! response f ! compliance
 program2 &  7,d7 to ! ext5t applicable1
 in/itutional *anges made z a result ( !
 case4  7c7 ,secret>y requirem5ts  7#a7 
,processes ,n lat] ?an #ahj days aft] ! 
date ( enactm5t ( ?is ,act1 ! ,secret>y 
%all e/abli% processes =-- 7,a7         
dissem9at+ be/ practices = e/abli%+ &   
implem5t+ a respectful mat]nity c>e     
compliance program )9 a hospital or o!r 
bir? sett+2  7,b7 promot+ coord9ation & 
collaboration betwe5 hospitals1 heal?   
sy/ems1 & o!r mat]nity c>e deliv]y      
sett+s on ! e/abli%m5t & implem5tation (
 respectful mat]nity c>e compliance     

programs2 &  7,c7 evaluat+ !            
effectiv5ess ( respectful mat]nity c>e  
compliance programs on mat]nal heal?    
outcomes & pati5t & family exp]i5ces1   
especially = pati5ts f racial & e?nic   
m9ority gr\ps & _! families4  7#b7 ,/udy
  7,a7 ,9 g5]al ,n lat] ?an #b ye>s aft]
 ! date ( enactm5t ( ?is ,act1 !        
,secret>y %all1 ?r\gh a contract ) an   
indep5d5t rese>* organization1 conduct a
 /udy on /rategies to address-- 7i7     
racism or bias on ! basis ( race1       
e?nicity1 or ano!r protect$ class 9 !   
deliv]y ( mat]nity c>e s]vices2 &  7ii7 
successful implem5tation ( respectful   
c>e initiatives4  7,b7 ,compon5ts ( /udy
 ,! /udy %all include ! foll[+3  7i7 ,an
 assessm5t ( ! reports submitt$ to !    
,secret>y f ! respectful mat]nity c>e   
compliance programs pursuant to         
subsection 7b77#e74  7ii7 ,bas$ on su*  
assessm5t1 recomm5dations = pot5tial    
acc\ntability me*anisms relat$ to cases 
( racism or bias on ! basis ( race1     
e?nicity1 or ano!r protect$ class 9 !   

deliv]y ( mat]nity c>e s]vices at       
hospitals & o!r bir? sett+s4 ,su*       
recomm5dations %all take into           
consid]ation m$ical & nonm$ical factors 
t contribute to adv]se pati5t exp]i5ces 
& mat]nal heal? outcomes4  7,c7 ,report 
,! ,secret>y %all submit to ! ,congress 
& make publicly available a report on ! 
results ( ! /udy "u ?is p>agraph4  7d7  
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re are au?oriz$ to be 
appropriat$ su* sums z may be necess>y =
 fiscal ye>s #bjbg ?r\gh #bjcb4  #cje4  
,,gao report  7a7 ,9 g5]al ,n lat] ?an  
#b ye>s aft] ! date ( enactm5t ( ?is    
,act & annually !reaft]1 ! ,comptroll]  
,g5]al ( ! ,unit$ ,/ates %all submit to 
! ,congress & make publicly available a 
report on ! e/abli%m5t ( respectful     
mat]nity c>e compliance programs )9     
hospitals1 heal? sy/ems1 & o!r mat]nity 
c>e sett+s4  7b7 ,matt]s includ$ ,!     
report "u subsection 7a7 %all include ! 
foll[+3  7#a7 ,in=mation reg>d+ ! ext5t 
to :i* hospitals1 heal? sy/ems1 & o!r   

mat]nity c>e sett+s h elect$ to e/abli% 
respectful mat]nity c>e compliance      
programs1 includ+-- 7,a7 :i* hospitals &
 o!r bir? sett+s elect to e/abli%       
compliance programs & :5 su* programs   
are e/abli%$2  7,b7 to ! ext5t          
practicable1 impacts ( ! e/abli%m5t (   
su* programs on mat]nal heal? outcomes &
 pati5t & family exp]i5ces 9 ! hospitals
 & o!r bir? sett+s t h e/abli%$ su*     
programs1 especially = pati5ts f racial 
& e?nic m9ority gr\ps & _! families2    
7,c7 in=mation on geographic areas1 &   
types ( hospitals or o!r bir? sett+s1   
:]e respectful mat]nity c>e compliance  
programs are n be+ e/abli%$ & in=mation 
on factors contribut+ to decisions to n 
e/abli% su* programs2 &  7,d7           
recomm5dations = e/abli%+ respectful    
mat]nity c>e compliance programs 9      
geographic areas1 & types ( hospitals or
 o!r bir? sett+s1 :]e su* programs are n
 be+ e/abli%$4  7#b7 ,:e!r ! fund+ made 
available to c>ry out ?is section has   
be5 suffici5t &1 if applicable1         

recomm5dations = additional             
appropriations to c>ry out ?is section4 
7#c7 ,su* o!r in=mation z ! ,comptroll] 
,g5]al det]m9es appropriate4  ,,iv      
,mat]nal heal? = vet]ans  #dja4 ,support
 = mat]nity heal? c>e & coord9ation     
programs ( ! ,dep>tm5t ( ,vet]ans       
,affairs  7a7 ,report to ,congress ,n   
lat] ?an #a ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 & annually !reaft] until   
,septemb] #cj1 #bjca1 ! ,secret>y (     
,vet]ans ,affairs %all submit to !      
,committees on ,vet]ans' ,affairs ( !   
,h\se ( ,repres5tatives & ! ,s5ate1 &   
make publicly available1 a report t     
conta9s ! foll[+3  7#a7 ,a summ>y ( !   
activities c>ri$ out "u ! programs ( !  
,dep>tm5t ( ,vet]ans ,affairs relat+ to 
mat]nity heal? c>e or coord9ation4  7#b7
 ,data on mat]nal heal? outcomes (      
vet]ans :o receive c>e furni%$ by !     
,secret>y ( ,vet]ans ,affairs1 includ+  
pursuant to su* programs4  7#c7 ,data on
 pati5ts :o are dually eligible to      
receive assi/ance f ! ,dep>tm5t (       

,vet]ans ,affairs & ! ,indian ,heal?    
,s]vice & ! mat]nity heal? c>e outcomes 
associat$ ) receiv+ su* c>e4  7#d7      
,recomm5dations by ! ,secret>y (        
,vet]ans ,affairs to improve ! mat]nal  
heal? outcomes ( vet]ans1 ) a p>ticul>  
focus on vet]ans f demographic gr\ps )  
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4  7b7 ,au?orization ( 
appropriations  7#a7 ,9 g5]al ,!re is   
au?oriz$ to be appropriat$ to !         
,secret>y ( ,vet]ans ,affairs           
#ae1jjj1jjj = ea* ( fiscal ye>s #bjbg1  
#bjbh1 #bjbi1 #bjcj1 & #bjca1 = !       
programs ( ! ,dep>tm5t ( ,vet]ans       
,affairs relat+ to mat]nity c>e         
coord9ation & relat$ programs1 includ+ !
 mat]nity c>e coord9ation program       
describ$ 9 ,vet]ans ,heal? ,adm9i/ration
 ,directive #accj4jc4  7#b7 ,supplem5t n
 supplant ,am\nts au?oriz$ "u p>agraph  
7#a7 are au?oriz$ 9 addition to any o!r 
am\nts au?oriz$ = mat]nity heal? c>e &  

coord9ation = ! ,dep>tm5t ( ,vet]ans    
,affairs4  ,v ,p]9atal work=ce  #eja4   
,,hhs ag5cy directives  7a7 ,guidance to
 ,/ates  7#a7 ,9 g5]al ,n lat] ?an #b   
ye>s aft] ! date ( enactm5t ( ?is ,act1 
! ,secret>y ( ,heal? & ,human ,s]vices  
%all issue & dissem9ate guidance to     
,/ates to educate provid]s1 manag$ c>e  
entities1 & o!r insur]s ab\t ! value &  
process ( deliv]+ respectful mat]nal    
heal? c>e ?r\gh div]se & multidiscipl9>y
 c>e provid] models4  7#b7 ,cont5ts ,!  
guidance requir$ by p>agraph 7#a7 %all  
address h[ ,/ates c enc\rage &          
inc5tivize hospitals1 heal? sy/ems1     
midwif]y practices1 free/&+ bir? c5t]s1 
o!r mat]nity c>e provid] gr\ps1 manag$  
c>e entities1 & o!r insur]s--  7,a7 to  
recruit & reta9 mat]nity c>e provid]s1  
m5tal & behavioral heal? c>e provid]s   
act+ 9 accordance ) ,/ate law1 & regi/]$
 dietitians or nutrition pr(essionals 7z
 su* t]m is def9$ 9 section             
#ahfa7vv77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciex7vv77#b777-- 7i7 f

 racially1 e?nically1 & l+ui/ically     
div]se backgr\nds2  7ii7 ) exp]i5ce     
practic+ 9 racially & e?nically div]se  
communities2 &  7iii7 :o h und]gone     
tra9+ on implicit bias & racism2  7,b7  
to incorporate into mat]nity c>e teams--
 7i7 midwives :o meet1 at a m9imum1 !   
int]national def9ition ( a midwife &    
global /&>ds = midwif]y education z     
e/abli%$ by ! ,int]national ,conf$]ation
 ( ,midwives2  7ii7 p]9atal heal?       
work]s2  7iii7 physician assi/ants2     
7iv7 advanc$ practice regi/]$ nurses2 & 
7v7 lactation consultants c]tifi$ by !  
,int]national ,bo>d ( ,lactation        
,consultant ,exam9]s2  7,c7 to provide  
collaborative1 culturally & l+ui/ically 
congru5t c>e2 &  7,d7 to provide        
opportunities = individuals enroll$ 9   
accr$it$ midwif]y education programs to 
p>ticipate 9 job %ad[+ ) mat]nity c>e   
teams 9 hospitals1 heal? sy/ems1        
midwif]y practices1 & free/&+ bir?      
c5t]s4  7b7 ,/udy on respectful &       
culturally & l+ui/ically congru5t       

mat]nity c>e  7#a7 ,/udy ,! ,secret>y ( 
,heal? & ,human ,s]vices act+ ?r\gh !   
,director ( ! ,national ,in/itutes (    
,heal? 79 ?is subsection ref]r$ to z !  
,secret>y7 %all conduct a /udy on be/   
practices 9 respectful & culturally &   
l+ui/ically congru5t mat]nity c>e4  7#b7
 ,report ,n lat] ?an #b ye>s aft] ! date
 ( enactm5t ( ?is ,act1 ! ,secret>y     
%all--  7,a7 complete ! /udy requir$ by 
p>agraph 7#a72  7,b7 submit to !        
,congress & make publicly available a   
report on ! results ( su* /udy2 &  7,c7 
include 9 su* report-- 7i7 a comp5dium (
 examples ( hospitals1 heal? sy/ems1    
midwif]y practices1 free/&+ bir? c5t]s1 
o!r mat]nity c>e provid] gr\ps1 manag$  
c>e entities1 & o!r insur]s t are       
deliv]+ respectful & culturally &       
l+ui/ically congru5t mat]nal heal? c>e2 
7ii7 a comp5dium ( examples ( hospitals1
 heal? sy/ems1 midwif]y practices1      
free/&+ bir? c5t]s1 o!r mat]nity c>e    
provid] gr\ps1 manag$ c>e entities1 &   
o!r insur]s t h made progress 9 r$uc+   

disp>ities 9 mat]nal heal? outcomes &   
improv+ bir?+ exp]i5ces = pregnant &    
po/p>tum individuals f racial & e?nic   
m9ority gr\ps2 &  7iii7 recomm5dations  
to hospitals1 heal? sy/ems1 midwif]y    
practices1 free/&+ bir? c5t]s1 o!r      
mat]nity c>e provid] gr\ps1 manag$ c>e  
entities1 & o!r insur]s1 = be/ practices
 9 respectful & culturally & l+ui/ically
 congru5t mat]nity c>e4  #ejb4 ,grants  
to gr[ & div]sify ! p]9atal work=ce     
,title ,,vii ( ! ,public ,heal? ,s]vice 
,act is am5d$ by ins]t+ aft] section    
#geg 7#db ,u4,s4,c4 #bid;f7 ! foll[+ new
 section3  #geh4 ,p]9atal work=ce grants
  7a7 ,9 g5]al ,! ,secret>y %all aw>d   
grants to entities to e/abli% or exp&   
programs describ$ 9 subsection 7b7 to   
gr[ & div]sify ! p]9atal work=ce4  7b7  
,use ( funds ,recipi5ts ( grants "u ?is 
section %all use ! grants to gr[ &      
div]sify ! p]9atal work=ce by-- 7#a7    
e/abli%+ accr$it$ s*ools or programs t  
provide education & tra9+ to individuals
 seek+ appropriate lic5s+ & c]tification

 z--  7,a7 physician assi/ants :o w     
complete cl9ical tra9+ 9 ! field (      
mat]nal & p]9atal heal?2  7,b7 p]9atal  
heal? work]s2 or  7,c7 midwives :o meet1
 at a m9imum1 ! int]national def9ition (
 a midwife & global /&>ds = midwif]y    
education z e/abli%$ by ! ,int]national 
,conf$]ation ( ,midwives2 &  7#b7 exp&+ 
! capacity ( exi/+ accr$it$ s*ools or   
programs describ$ 9 p>agraph 7#a71 = !  
purposes ( increas+ ! numb] ( /ud5ts    
enroll$ 9 su* accr$it$ s*ools or        
programs1 su* z by aw>d+ s*ol>%ips =    
/ud5ts 7includ+ /ud5ts f racially1      
e?nically1 & l+ui/ically div]se         
backgr\nds74  7c7 ,prioritization ,9    
aw>d+ grants "u ?is section1 ! ,secret>y
 %all give priority to a s*ool or       
program describ$ 9 subsection 7b7 t--   
7#a7 has demon/rat$ a commitm5t to      
recruit+ & reta9+ /ud5ts & faculty f    
racial & e?nic m9ority gr\ps2  7#b7 has 
develop$ a /rategy to recruit & reta9 a 
div]se pool ( /ud5ts into ! s*ool or    
program describ$ 9 subsection 7b7 t is  

support$ by funds receiv$ ?r\gh ! grant1
 p>ticul>ly f racial & e?nic m9ority    
gr\ps & o!r und]s]v$ populations2  7#c7 
has develop$ a /rategy to recruit &     
reta9 /ud5ts :o plan to practice 9 a    
heal? pr(essional %ortage area designat$
 "u section #ccb2  7#d7 has develop$ a  
/rategy to recruit & reta9 /ud5ts :o    
plan to practice 9 an area ) significant
 racial & e?nic disp>ities 9 mat]nal    
heal? outcomes1 to ! ext5t practicable2 
&  7#e7 includes 9 ! /&>d curriculum =  
all /ud5ts )9 ! s*ool or program        
describ$ 9 subsection 7b7 a bias1       
racism1 or discrim9ation tra9+ program t
 includes tra9+ on implicit bias &      
racism4  7d7 ,report+ ,z a condition on 
receipt ( a grant "u ?is section = a    
s*ool or program describ$ 9 subsection  
7b71 an entity %all agree to submit to !
 ,secret>y an annual report on !        
activities conduct$ ?r\gh ! grant1      
includ+-- 7#a7 ! numb] & demographics ( 
/ud5ts p>ticipat+ 9 ! s*ool or program2 
7#b7 ! ext5t to :i* /ud5ts 9 ! s*ool or 

program are ent]+ c>e]s 9-- 7,a7 heal?  
pr(essional %ortage areas designat$ "u  
section #ccb2 &  7,b7 areas ) elevat$   
rates ( mat]nal mortality1 sev]e mat]nal
 morbidity1 mat]nal heal? disp>ities1 or
 o!r adv]se p]9atal or *ildbir?         
outcomes1 to ! ext5t su* data are       
available2 &  7#c7 :e!r ! s*ool or      
program has includ$ 9 ! /&>d curriculum 
= all /ud5ts a bias1 racism1 or         
discrim9ation tra9+ program t includes  
explicit & implicit bias1 & if s !      
effectiv5ess ( su* tra9+ program4  7e7  
,p]iod ( grants ,! p]iod ( a grant "u   
?is section %all be up to #e ye>s4  7f7 
,application ,to seek a grant "u ?is    
section1 an entity %all submit to !     
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require1 includ+ any      
in=mation necess>y = prioritization "u  
subsection 7c74  7g7 ,te*nical assi/ance
 ,! ,secret>y %all provide1 directly or 
by contract1 te*nical assi/ance to      
entities seek+ or receiv+ a grant "u ?is

 section on ! developm5t1 use1          
evaluation1 & po/grant p]iod            
su/a9ability ( ! s*ool or program       
describ$ 9 subsection 7b7 t is propos$  
to be1 or is be+1 e/abli%$ or exp&$     
?r\gh ! grant4  7h7 ,report by !        
,secret>y ,n lat] ?an #d ye>s aft] !    
date ( enactm5t ( ?is section1 !        
,secret>y %all prep>e & submit to !     
,congress1 & po/ on ! int]net website ( 
! ,dep>tm5t ( ,heal? & ,human ,s]vices1 
a report on ! effectiv5ess ( ! grant    
program "u ?is section at--  7#a7       
recruit+ /ud5ts f racial & e?nic m9ority
 gr\ps2  7#b7 increas+ ! numb] ( heal?  
pr(essionals describ$ 9 subp>agraphs    
7,a71 7,b71 & 7,c7 ( subsection 7b77#a7 
f racial & e?nic m9ority gr\ps & o!r    
und]s]v$ populations2  7#c7 increas+ !  
numb] ( su* heal? pr(essionals work+ 9  
heal? pr(essional %ortage areas         
designat$ "u section #ccb2 &  7#d7      
increas+ ! numb] ( su* heal?            
pr(essionals work+ 9 areas ) significant
 racial & e?nic disp>ities 9 mat]nal    

heal? outcomes1 to ! ext5t su* data are 
available4  7i7 ,def9ition ,9 ?is       
section1 ! t]m racial & e?nic m9ority   
gr\p has ! mean+ giv5 su* t]m 9 section 
#agjg7;g77#a74  7j7 ,au?orization (     
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#ae1jjj1jjj = ea* ( fiscal ye>s #bjbg   
?r\gh #bjca4  4  #ejc4 ,grants to gr[ & 
div]sify ! nurs+ work=ce 9 mat]nal &    
p]9atal heal? ,title ,,viii ( ! ,public 
,heal? ,s]vice ,act is am5d$ by ins]t+  
aft] section #haa ( t ,act 7#db         
,u4,s4,c4 #bif;j7 ! foll[+3  #hab4      
,p]9atal nurs+ work=ce grants  7a7 ,9   
g5]al ,! ,secret>y %all aw>d grants to  
s*ools ( nurs+ to gr[ & div]sify !      
p]9atal nurs+ work=ce4  7b7 ,use ( funds
 ,recipi5ts ( grants "u ?is section %all
 use ! grants to gr[ & div]sify !       
p]9atal nurs+ work=ce by provid+        
s*ol>%ips to /ud5ts seek+ to become--   
7#a7 nurse practition]s ^: education    
includes a focus on mat]nal & p]9atal   
heal?2  7#b7 c]tifi$ nurse-midwives2 or 

7#c7 cl9ical nurse speciali/s ^:        
education includes a focus on mat]nal & 
p]9atal heal?4  7c7 ,prioritization ,9  
aw>d+ grants "u ?is section1 ! ,secret>y
 %all give priority to any s*ool ( nurs+
 t-- 7#a7 has develop$ a /rategy to     
recruit & reta9 a div]se pool ( /ud5ts  
seek+ to ent] c>e]s focus$ on mat]nal & 
p]9atal heal?1 p>ticul>ly /ud5ts f      
racial & e?nic m9ority gr\ps & o!r      
und]s]v$ populations2  7#b7 has develop$
 a p>tn]%ip ) a practice sett+ 9 a heal?
 pr(essional %ortage area designat$ "u  
section #ccb = ! cl9ical placem5ts ( !  
s*ool's /ud5ts2  7#c7 has develop$ a    
/rategy to recruit & reta9 /ud5ts :o    
plan to practice 9 an area ) significant
 racial & e?nic disp>ities 9 mat]nal    
heal? outcomes1 to ! ext5t practicable2 
&  7#d7 includes 9 ! /&>d curriculum =  
all /ud5ts seek+ to ent] c>e]s focus$ on
 mat]nal & p]9atal heal? a bias1 racism1
 or discrim9ation tra9+ program t       
includes education on implicit bias &   
racism4  7d7 ,report+ ,z a condition on 

receipt ( a grant "u ?is section1 a     
s*ool ( nurs+ %all agree to submit to ! 
,secret>y an annual report on !         
activities conduct$ ?r\gh ! grant1      
includ+1 to ! ext5t practicable--  7#a7 
! numb] & demographics ( /ud5ts 9 !     
s*ool ( nurs+ seek+ to ent] c>e]s focus$
 on mat]nal & p]9atal heal?2  7#b7 !    
ext5t to :i* su* /ud5ts are prep>+ to   
ent] c>e]s 9--  7,a7 heal? pr(essional  
%ortage areas designat$ "u section #ccb2
 &  7,b7 areas ) elevat$ rates ( mat]nal
 mortality1 sev]e mat]nal morbidity1    
mat]nal heal? disp>ities1 or o!r adv]se 
p]9atal or *ildbir? outcomes1 to ! ext5t
 su* data are available2 &  7#c7 :e!r ! 
/&>d curriculum = all /ud5ts seek+ to   
ent] c>e]s focus$ on mat]nal & p]9atal  
heal? includes a bias1 racism1 or       
discrim9ation tra9+ program t includes  
education on implicit bias & racism4    
7e7 ,p]iod ( grants ,! p]iod ( a grant  
"u ?is section %all be up to #e ye>s4   
7f7 ,application ,to seek a grant "u ?is
 section1 an entity %all submit to !    

,secret>y an application1 at su* "t1 9  
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require1 includ+ any      
in=mation necess>y = prioritization "u  
subsection 7c74  7g7 ,te*nical assi/ance
 ,! ,secret>y %all provide1 directly or 
by contract1 te*nical assi/ance to      
s*ools ( nurs+ seek+ or receiv+ a grant 
"u ?is section on ! processes ( aw>d+ & 
evaluat+ s*ol>%ips ?r\gh ! grant4  7h7  
,report by ! ,secret>y ,n lat] ?an #d   
ye>s aft] ! date ( enactm5t ( ?is       
section1 ! ,secret>y %all prep>e &      
submit to ! ,congress1 & po/ on !       
int]net website ( ! ,dep>tm5t ( ,heal? &
 ,human ,s]vices1 a report on !         
effectiv5ess ( ! grant program "u ?is   
section at-- 7#a7 recruit+ /ud5ts f     
racial & e?nic m9ority gr\ps & o!r      
und]s]v$ populations2  7#b7 increas+ !  
numb] ( advanc$ practice regi/]$ nurses 
ent]+ c>e]s focus$ on mat]nal & p]9atal 
heal? f racial & e?nic m9ority gr\ps &  
o!r und]s]v$ populations2  7#c7 increas+
 ! numb] ( advanc$ practice regi/]$     

nurses ent]+ c>e]s focus$ on mat]nal &  
p]9atal heal? work+ 9 heal? pr(essional 
%ortage areas designat$ "u section #ccb2
 &  7#d7 increas+ ! numb] ( advanc$     
practice regi/]$ nurses ent]+ c>e]s     
focus$ on mat]nal & p]9atal heal? work+ 
9 areas ) significant racial & e?nic    
disp>ities 9 mat]nal heal? outcomes1 to 
! ext5t su* data are available4  7i7    
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re is au?oriz$ to be  
appropriat$ #ae1jjj1jjj = ea* ( fiscal  
ye>s #bjbg ?r\gh #bjca4  4  #ejd4 ,,gao 
report  7a7 ,9 g5]al ,n lat] ?an #b ye>s
 aft] ! date ( enactm5t ( ?is ,act & e  
#e ye>s !reaft]1 ! ,comptroll] ,g5]al ( 
! ,unit$ ,/ates %all submit to ,congress
 a report on b>ri]s to mat]nal heal?    
education & access to c>e 9 ! ,unit$    
,/ates4 ,su* report %all include !      
in=mation & recomm5dations describ$ 9   
subsection 7b74  7b7 ,cont5t ( report ,!
 report "u subsection 7a7 %all include--
  7#a7 an assessm5t ( curr5t b>ri]s to  
ent]+ & successfully complet+ accr$it$  

midwif]y education programs1 &          
recomm5dations = address+ su* b>ri]s1   
p>ticul>ly = l[-income wom5 & wom5 f    
racial & e?nic m9ority gr\ps2  7#b7 an  
assessm5t ( curr5t b>ri]s to ent]+ &    
successfully complet+ accr$it$ education
 programs = o!r heal? pr(essional c>e]s 
relat$ to mat]nity c>e1 includ+ mat]nity
 c>e provid]s1 m5tal & behavioral heal? 
c>e provid]s act+ 9 accordance ) ,/ate  
law1 & regi/]$ dietitians or nutrition  
pr(essionals 7z su* t]m is def9$ 9      
section #ahfa7vv77#b7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciex7vv77#b7771 p>ticul>ly = l[-income
 wom5 & wom5 f racial & e?nic m9ority   
gr\ps2  7#c7 an assessm5t ( curr5t      
b>ri]s t prev5t midwives f meet+ !      
int]national def9ition ( a midwife &    
global /&>ds = midwif]y education z     
e/abli%$ by ! ,int]national ,conf$]ation
 ( ,midwives1 & recomm5dations =        
address+ su* b>ri]s1 p>ticul>ly =       
l[-income wom5 & wom5 f racial & e?nic  
m9ority gr\ps2  7#d7 an assessm5t (     

disp>ities 9 access to mat]nity c>e     
provid]s1 m5tal or behavioral heal? c>e 
provid]s act+ 9 accordance ) ,/ate law1 
& regi/]$ dietitians or nutrition       
pr(essionals 7z su* t]m is def9$ 9      
section #ahfa7vv77#b7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciex7vv77#b7771 & p]9atal heal?       
work]s1 /ratifi$ by race1 e?nicity1 g5d]
 id5tity1 prim>y language1 geographic   
location1 & insurance type &            
recomm5dations to promote great] access 
equity2 &  7#e7 recomm5dations to       
promote great] equity 9 comp5sation =   
p]9atal heal? work]s "u public & private
 insur]s1 p>ticul>ly = su* individuals f
 racially & e?nically div]se backgr\nds4
  ,,vi ,data to save moms  #fja4 ,fund+ 
= mat]nal mortality review committees to
 promote repres5tative community        
engagem5t  7a7 ,9 g5]al ,section        
#cag,k7d7 ( ! ,public ,heal? ,s]vice    
,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77 is  
am5d$ by add+ at ! end ! foll[+3  7#i7  
,grants to promote repres5tative        

community engagem5t 9 mat]nal mortality 
review committees  7,a7 ,9 g5]al ,!     
,secret>y may1 us+ funds made available 
pursuant to subp>agraph 7,c71 provide   
assi/ance to an applicable mat]nal      
mortality review committee ( a ,/ate1   
,indian ,tribe1 ,tribal organization1 or
 ,urban ,indian organization 7z su* t]ms
 are def9$ 9 section #d ( ! ,indian     
,heal? ,c>e ,improvem5t ,act7-- 7i7 to  
select = inclusion 9 ! memb]%ip ( su* a 
committee community memb]s f ! ,/ate1   
,indian ,tribe1 ,tribal organization1 or
 ,urban ,indian organization by--  7,i7 
prioritiz+ community memb]s :o c        
increase ! div]sity ( ! committee's     
memb]%ip ) respect to race & e?nicity1  
location1 p]sonal or family exp]i5ces ( 
mat]nal mortality or sev]e mat]nal      
morbidity1 & pr(essional backgr\nd1     
includ+ memb]s ) noncl9ical exp]i5ces2 &
  7,,ii7 to ! ext5t applicable1 us+     
funds res]v$ "u subsection 7f71 to      
address b>ri]s to mat]nal mortality     
review committee p>ticipation =         

community memb]s1 includ+ requir$ tra9+1
 transportation b>ri]s1 comp5sation1 &  
o!r supports z may be necess>y2  7ii7 to
 e/abli% initiatives to conduct outrea* 
& community engagem5t ef=ts )9          
communities ?r\gh\t ! ,/ate or ,tribe to
 seek input f community memb]s on ! "w (
 su* mat]nal mortality review committee1
 ) a p>ticul> focus on outrea* to wom5 f
 racial & e?nic m9ority gr\ps 7z su* t]m
 is def9$ 9 section #agjg7;g77#a772 &   
7iii7 to release public reports         
assess+--  7,i7 ! pregnancy-relat$ dea? 
& pregnancy-associat$ dea? review       
processes ( ! mat]nal mortality review  
committee1 ) a p>ticul> focus on !      
mat]nal mortality review committee's    
s5sitivity to ! unique circum/ances (   
pregnant & po/p>tum individuals f racial
 & e?nic m9ority gr\ps 7z su* t]m is    
def9$ 9 section #agjg7;g77#a77 :o h     
suff]$ pregnancy-relat$ dea?s2 &  7,,ii7
 ! impact ( ! use ( funds made available
 pursuant to subp>agraph 7,c7 on        
increas+ ! div]sity ( ! mat]nal         

mortality review committee memb]%ip &   
promot+ community engagem5t ef=ts       
?r\gh\t ! ,/ate or ,tribe4  7,b7        
,te*nical assi/ance ,! ,secret>y %all   
provide 7ei!r directly ?r\gh ! ,dep>tm5t
 ( ,heal? & ,human ,s]vices or by       
contract7 te*nical assi/ance to any     
mat]nal mortality review committee      
receiv+ a grant "u ?is p>agraph on be/  
practices = increas+ ! div]sity ( !     
mat]nal mortality review committee's    
memb]%ip & = conduct+ effective         
community engagem5t ?r\gh\t ! ,/ate or  
,tribe4  7,c7 ,au?orization (           
appropriations ,9 addition to any funds 
made available "u subsection 7f71 !re is
 au?oriz$ to be appropriat$ to c>ry out 
?is p>agraph #aj1jjj1jjj = ea* ( fiscal 
ye>s #bjbg ?r\gh #bjca4  4  7b7         
,res]vation ( funds ,section #cag,k7f7 (
 ! ,public ,heal? ,s]vice ,act 7#db     
,u4,s4,c4 #bdg;b-#ab7;f77 is am5d$ by   
add+ at ! end ! foll[+3 ,( ! am\nt made 
available "u ! prec$+ s5t5ce = a fiscal 
ye>1 n less ?an #a1ejj1jjj %all be      

res]v$ = grants to ,indian ,tribes1     
,tribal organizations1 or ,urban ,indian
 organizations 7z ^? t]ms are def9$ 9   
section #d ( ! ,indian ,heal? ,c>e      
,improvem5t ,act74  #fjb4 ,data         
collection & review ,section            
#cag,k7d77#c77;,a77i7 ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4            
#bdg;b-#ab7;d77#c77;,a77i77 is am5d$--  
7#a7 by r$esignat+ subclauses 7,,ii7 &  
7,,iii7 z subclauses 7,v7 & 7,,vi71     
respectively2 &  7#b7 by ins]t+ aft]    
subclause 7,i7 ! foll[+3  7,,ii7 to !   
ext5t practicable1 review+ cases ( sev]e
 mat]nal morbidity1 accord+ to ! mo/    
up-to-date indicators2  7,,iii7 to !    
ext5t practicable1 review+ dea?s dur+   
pregnancy or up to #a ye> aft] ! end ( a
 pregnancy f suicide1 ov]dose1 or o!r   
dea? f a m5tal heal? condition or       
sub/ance use disord] attribut$ to or    
aggravat$ by pregnancy or *ildbir?      
complications2  7,,iv7 to ! ext5t       
practicable1 consult+ ) local           
community-bas$ organizations repres5t+  

pregnant & po/p>tum individuals f       
demographic gr\ps ) elevat$ rates (     
mat]nal mortality1 sev]e mat]nal        
morbidity1 mat]nal heal? disp>ities1 or 
o!r adv]se p]9atal or *ildbir? outcomes 
to ensure t1 9 addition to cl9ical      
factors1 noncl9ical factors t might h   
contribut$ to a pregnancy-relat$ dea?   
are appropriately consid]$2  4  #fjc4   
,review ( mat]nal heal? data collection 
processes & quality measures  7a7 ,9    
g5]al ,! ,secret>y ( ,heal? & ,human    
,s]vices1 act+ ?r\gh ! ,adm9i/rator ( ! 
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices & ! 
,director ( ! ,ag5cy = ,heal?c>e ,rese>*
 & ,quality1 %all consult ) relevant    
/akehold]s--  7#a7 to review exi/+      
mat]nal heal? data collection processes 
& quality measures2 &  7#b7 to make     
recomm5dations to improve su* processes 
& measures1 includ+ topics describ$ "u  
subsection 7c74  7b7 ,collaboration ,9  
c>ry+ out ?is section1 ! ,secret>y %all 
consult ) a div]se gr\p ( mat]nal heal? 
/akehold]s1 :i* may include-- 7#a7      

pregnant & po/p>tum individuals & _!    
family memb]s1 & nonpr(it organizations 
repres5t+ su* individuals1 ) a p>ticul> 
focus on pati5ts f racial & e?nic       
m9ority gr\ps2  7#b7 community-bas$     
organizations t provide support =       
pregnant & po/p>tum individuals1 ) a    
p>ticul> focus on pati5ts f demographic 
gr\ps ) elevat$ rates ( mat]nal         
mortality1 sev]e mat]nal morbidity1     
mat]nal heal? disp>ities1 or o!r adv]se 
p]9atal or *ildbir? outcomes2  7#c7     
memb]%ip organizations = mat]nity c>e   
provid]s2  7#d7 organizations repres5t+ 
p]9atal heal? work]s2  7#e7             
organizations t focus on mat]nal m5tal  
or behavioral heal?2  7#f7 organizations
 t focus on intimate p>tn] viol5ce2     
7#g7 in/itutions ( high] education1 ) a 
p>ticul> focus on m9ority-s]v+          
in/itutions2  7#h7 lic5s$ & accr$it$    
hospitals1 bir? c5t]s1 midwif]y         
practices1 or o!r facilities t provide  
mat]nal heal? c>e s]vices2  7#i7        
relevant ,/ate & local public ag5cies1  

includ+ ,/ate mat]nal mortality review  
committees2 &  7#aj7 ! ,national        
,quality ,=um1 or su* o!r /&>d-sett+    
organizations specifi$ by ! ,secret>y4  
7c7 ,topics ,! review ( mat]nal heal?   
data collection processes &             
recomm5dations to improve su* processes 
& measures requir$ "u subsection 7a7    
%all assess all available relevant      
in=mation1 includ+ in=mation f          
,/ate-level s\rces1 & %all consid] at   
lea/ ! foll[+3  7#a7 ,curr5t ,/ate &    
,tribal practices = mat]nal heal?1      
mat]nal mortality1 & sev]e mat]nal      
morbidity data collection &             
dissem9ation1 includ+ consid]ation (--  
7,a7 ! timel9ess ( processes = am5d+ a  
dea? c]tificate :5 new in=mation p]ta9+ 
to ! dea? becomes available to reflect  
:e!r ! dea? 0 a pregnancy-relat$ dea?2  
7,b7 relevant data collect$ ) electronic
 heal? records1 includ+ data on race1   
e?nicity1 prim>y language1 socioeconomic
 /atus1 geography1 insurance type1 & o!r
 relevant demographic in=mation2  7,c7  

mat]nal heal? data collect$ & publicly  
report$ by hospitals1 heal? sy/ems1     
midwif]y practices1 & bir? c5t]s2  7,d7 
! b>ri]s prev5t+ ,/ates f correlat+     
mat]nal outcome data ) data on race1    
e?nicity1 & o!r demographic *>act]i/ics2
  7,e7 processes = det]m9+ ! cause ( a  
pregnancy-associat$ dea? 9 ,/ates t d n 
h a mat]nal mortality review committee2 
7,f7 :e!r mat]nal mortality review      
committees include multidiscipl9>y &    
div]se memb]%ip 7z describ$ 9 section   
#cag,k7d77#a77;,a7 ( ! ,public ,heal?   
,s]vice ,act 7#db ,u4,s4,c4             
#bdg;b-#ab7;d77#a77;,a7772  7,g7 :e!r   
memb]s ( mat]nal mortality review       
committees p>ticipate 9 tra9+s on bias1 
racism1 or discrim9ation1 & ! quality ( 
su* tra9+s2  7,h7 ! ext5t to :i* ,/ates 
h implem5t$ sy/ematic processes ( li/5+ 
to ! /ories ( pregnant & po/p>tum       
individuals & _! family memb]s1 ) a     
p>ticul> focus on pregnant & po/p>tum   
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e

 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes1 & _! family memb]s1  
to fully und]/& ! causes (1 & in=m      
pot5tial solutions to1 ! mat]nal        
mortality & sev]e mat]nal morbidity     
crisis )9 _! respective ,/ates2  7,i7 ! 
ext5t to :i* mat]nal mortality review   
committees are consid]+ social          
det]m9ants ( mat]nal heal? :5 exam9+ !  
causes ( pregnancy-associat$ &          
pregnancy-relat$ dea?s2  7,j7 ! ext5t to
 :i* mat]nal mortality review committees
 are mak+ actionable recomm5dations bas$
 on _! reviews ( adv]se mat]nal heal?   
outcomes & ! ext5t to :i* su*           
recomm5dations are be+ implem5t$ by     
appropriate /akehold]s2  7,k7 ! legal & 
adm9i/rative b>ri]s prev5t+ !           
collection1 collation1 & dissem9ation ( 
,/ate mat]nity c>e data2  7,l7 !        
effectiv5ess ( data collection & report+
 processes 9 sep>at+ pregnancy-associat$
 dea?s f pregnancy-relat$ dea?s2 &  7,m7
 ! curr5t ,f$]al1 ,/ate1 local1 &       

,tribal fund+ support = ! activities    
ref]r$ to 9 subp>agraphs 7,a7 ?r\gh     
7,l74  7#b7 ,:e!r ! fund+ support ref]r$
 to 9 p>agraph 7#a77,m7 is adequate =   
,/ates to c>ry out optimal data         
collection & dissem9ation processes )   
respect to mat]nal heal?1 mat]nal       
mortality1 & sev]e mat]nal morbidity4   
7#c7 ,curr5t quality measures = mat]nity
 c>e1 includ+ pr5atal measures1 labor & 
deliv]y measures1 & po/p>tum measures1  
includ+ topics su* z--  7,a7 effective  
quality measures = mat]nity c>e us$ by  
hospitals1 heal? sy/ems1 midwif]y       
practices1 bir? c5t]s1 heal? plans1 &   
o!r relevant entities2  7,b7 !          
suffici5cy ( curr5t outcome measures us$
 to evaluate mat]nity c>e = driv+       
improv$ c>e1 exp]i5ces1 & outcomes 9    
mat]nity c>e paym5t & deliv]y sy/em     
models2  7,c7 mat]nal heal? quality     
measures t o!r c\ntries effectively use2
  7,d7 validat$ measures t h be5 us$ =  
rese>* purposes t c\ld be te/$1 ref9$1 &
 submitt$ = national endorsem5t2  7,e7  

b>ri]s prev5t+ mat]nity c>e provid]s &  
insur]s f implem5t+ quality measures t  
are align$ ) be/ practices2  7,f7 !     
frequ5cy ) :i* mat]nity c>e quality     
measures are review$ & revis$2  7,g7 !  
/r5g?s & weaknesses ( ! ,pr5atal &      
,po/p>tum ,c>e measures ( ! ,heal? ,plan
 ,employ] ,data & ,in=mation ,set       
measures e/abli%$ by ! ,national        
,committee = ,quality ,assurance2  7,h7 
! /r5g?s & weaknesses ( mat]nity c>e    
quality measures "u ! ,m$icaid program  
"u title ,,xix ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif et seq47 & !  
,*ildr5's ,heal? ,insurance ,program "u 
title ,,xxi ( su* ,act 7#db ,u4,s4,c4   
#acig et seq471 includ+ ! ext5t to :i*  
,/ates volunt>ily report relevant       
measures2  7,i7 ! ext5t to :i* mat]nity 
c>e quality measures are in=m$ by pati5t
 exp]i5ces t include measures (         
pati5t-report$ exp]i5ce ( c>e2  7,j7 !  
curr5t processes = collect+ & mak+      
publicly available1 to ! ext5t          
practicable1 /ratifi$ data on race1     

e?nicity1 & o!r demographic *>act]i/ics 
( pregnant & po/p>tum individuals 9     
hospitals1 heal? sy/ems1 midwif]y       
practices1 & bir? c5t]s1 & = incorporat+
 su* demographically /ratifi$ data 9    
mat]nity c>e quality measures2  7,k7 !  
ext5t to :i* mat]nity c>e quality       
measures acc\nt = ! unique exp]i5ces (  
pregnant & po/p>tum individuals f racial
 & e?nic m9ority gr\ps2 &  7,l7 ! ext5t 
to :i* hospitals1 heal? sy/ems1 midwif]y
 practices1 & bir? c5t]s are implem5t+  
exi/+ mat]nity c>e quality measures4    
7#d7 ,recomm5dations on au?oriz+        
additional funds & provid+ additional   
te*nical assi/ance to improve mat]nal   
mortality review committees & ,/ate &   
,tribal mat]nal heal? data collection & 
report+ processes4  7#e7 ,recomm5dations
 = new au?orities t may be grant$ to    
mat]nal mortality review committees to  
be able to--  7,a7 access records f o!r 
,f$]al & ,/ate ag5cies & dep>tm5ts t may
 be necess>y to id5tify causes (        
pregnancy-associat$ & pregnancy-relat$  

dea?s t are unique to pregnant &        
po/p>tum individuals f specific         
populations1 su* z vet]ans & individuals
 :o are inc>c]at$2 &  7,b7 "w ) relevant
 exp]ts :o are n memb]s ( ! mat]nal     
mortality review committee to assi/ 9 ! 
review ( pregnancy-associat$ dea?s (    
pregnant & po/p>tum individuals f       
specific populations1 su* z vet]ans &   
individuals :o are inc>c]at$4  7#f7     
,recomm5dations to improve & /&>dize    
curr5t quality measures = mat]nity c>e1 
) a p>ticul> focus on mat]nal heal?     
disp>ities4  7#g7 ,recomm5dations to    
improve ! coord9ation by ! ,dep>tm5t (  
,heal? & ,human ,s]vices ( ! ef=ts      
und]tak5 by ! ag5cies & organizations )9
 ! ,dep>tm5t relat$ to mat]nal heal?    
data & quality measures4  7d7 ,report ,n
 lat] ?an #a ye> aft] ! enactm5t ( ?is  
,act1 ! ,secret>y %all submit to !      
,congress & make publicly available a   
report on ! results ( ! review ( mat]nal
 heal? data collection processes &      
quality measures & recomm5dations to    

improve su* processes & measures requir$
 "u subsection 7a74  7e7 ,def9ition ,9  
?is section1 ! t]m mat]nal mortality    
review committee means a mat]nal        
mortality review committee duly au?oriz$
 by a ,/ate & receiv+ fund+ "u section  
#cag,k7a77#b77;,d7 ( ! ,public ,heal?   
,s]vice ,act 7#db ,u4,s4,c4             
#bdg;b-#ab7;a77#b77;,d774  7f7          
,au?orization ( appropriations ,!re are 
au?oriz$ to be appropriat$ su* sums z   
may be necess>y to c>ry out ?is section 
= fiscal ye>s #bjbg ?r\gh #bjcj4  #fjd4 
,/udy on mat]nal heal? among ,am]ican   
,indian & ,alaska ,native individuals   
7a7 ,9 g5]al ,! ,secret>y ( ,heal? &    
,human ,s]vices 7ref]r$ to 9 ?is section
 z ! ,secret>y7 %all1 9 coord9ation )   
entities describ$ 9 subsection 7b7--    
7#a7 n lat] ?an #ij days aft] ! enactm5t
 ( ?is ,act1 ent] into a contract ) an  
indep5d5t rese>* organization or ,tribal
 ,epidemiology ,c5t] to conduct a       
compreh5sive /udy on mat]nal mortality1 
sev]e mat]nal morbidity1 & o!r adv]se   

p]9atal or *ildbir? outcomes 9 !        
populations ( ,am]ican ,indian & ,alaska
 ,native individuals2 &  7#b7 n lat] ?an
 #c ye>s aft] ! date ( ! enactm5t ( ?is 
,act1 submit to ,congress a report on   
su* /udy t conta9s recomm5dations =     
policies & practices t c be adopt$ to   
improve mat]nal heal? outcomes =        
,am]ican ,indian & ,alaska ,native      
individuals4  7b7 ,p>ticipat+ entities  
,! entities describ$ 9 ?is subsection   
%all consi/ ( #ab memb]s1 select$ by !  
,secret>y f among individuals nom9at$ by
 ,indian ,tribes & ,tribal organizations
 7z su* t]ms are def9$ 9 section #d ( ! 
,indian ,self-,det]m9ation & ,education 
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 
& ,urban ,indian organizations 7z su*   
t]m is def9$ 9 section #d ( ! ,indian   
,heal? ,c>e ,improvem5t ,act 7#be       
,u4,s4,c4 #afjc774 ,9 select+ su*       
memb]s1 ! ,secret>y %all ensure t ea* ( 
! #ab s]vice areas ( ! ,indian ,heal?   
,s]vice is repres5t$4  7c7 ,cont5ts (   
/udy ,! /udy conduct$ pursuant to       

subsection 7a7 %all--  7#a7 exam9e !    
causes ( mat]nal mortality & sev]e      
mat]nal morbidity t are unique to       
,am]ican ,indian & ,alaska ,native      
individuals2  7#b7 include a sy/ematic  
process ( li/5+ to ! /ories ( ,am]ican  
,indian & ,alaska ,native individuals to
 fully und]/& ! causes (1 & in=m        
pot5tial solutions to1 ! mat]nal heal?  
crisis )9 _! respective communities2    
7#c7 di/+ui% betwe5 ! causes (1 l&scape 
( mat]nity c>e at1 & recomm5dations to  
improve mat]nal heal? outcomes )91 !    
diff]5t sett+s 9 :i* ,am]ican ,indian & 
,alaska ,native individuals receive     
mat]nity c>e1 su* z-- 7,a7 facilities   
op]at$ by ! ,indian ,heal? ,s]vice2     
7,b7 an ,indian heal? program op]at$ by 
an ,indian ,tribe or ,tribal            
organization pursuant to a contract1    
grant1 coop]ative agreem5t1 or compact )
 ! ,indian ,heal? ,s]vice pursuant to ! 
,indian ,self-,det]m9ation ,act2  7,c7  
an urban ,indian heal? program op]at$ by
 an ,urban ,indian organization pursuant

 to a grant or contract ) ! ,indian     
,heal? ,s]vice pursuant to title ,v ( ! 
,indian ,heal? ,c>e ,improvem5t ,act2 & 
7,d7 facilities outside ( ! ,indian     
,heal? ,s]vice 9 :i* ,am]ican ,indian & 
,alaska ,native individuals receive     
mat]nity c>e s]vices2  7#d7 review      
processes = coord9at+ programs ( !      
,indian ,heal? ,s]vice ) social s]vices 
provid$ ?r\gh o!r programs adm9i/]$ by !
 ,secret>y ( ,heal? & ,human ,s]vices   
7o!r ?an ! ,m$ic>e ,program "u title    
,,xviii ( ! ,social ,security ,act 7#db 
,u4,s4,c4 #acie et seq4771 ! ,m$icaid   
,program "u title ,,xix ( su* ,act 7#db 
,u4,s4,c4 #acif et seq471 & ! ,*ildr5's 
,heal? ,insurance ,program "u title     
,,xxi ( su* ,act 7#db ,u4,s4,c4 #acig et
 seq472  7#e7 review curr5t data        
collection & quality measurem5t         
processes & practices2  7#f7 assess     
causes & frequ5cy ( mat]nal m5tal heal? 
conditions & sub/ance use disord]s2     
7#g7 consid] social det]m9ants ( heal?1 
includ+ pov]ty1 lack ( heal? insurance1 

unemploym5t1 sexual & dome/ic viol5ce1 &
 environm5tal conditions 9 ,tribal      
areas2  7#h7 consid] ! role t hi/orical 
mi/reatm5t ( ,am]ican ,indian & ,alaska 
,native wom5 has play$ 9 caus+ curr5tly 
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 & o!r adv]se p]9atal
 or *ildbir? outcomes2  7#i7 consid] h[ 
curr5t fund+ ( ! ,indian ,heal? ,s]vice 
affects ! ability ( ! ,s]vice to deliv] 
quality mat]nity c>e2  7#aj7 consid] !  
ext5t to :i* ! deliv]y ( mat]nity c>e   
s]vices is culturally appropriate =     
,am]ican ,indian & ,alaska ,native      
individuals2  7#aa7 make recomm5dations 
to r$uce misclassification ( ,am]ican   
,indian & ,alaska ,native individuals1  
includ+ consid]ation ( be/ practices 9  
tra9+ = mat]nal mortality review        
committee memb]s to be able to correctly
 classify ,am]ican ,indian & ,alaska    
,native individuals2 &  7#ab7 make      
recomm5dations in=m$ by ! /ories %>$ by 
,am]ican ,indian & ,alaska ,native      
individuals ref]r$ to 9 p>agraph 7#b7 to

 improve mat]nal heal? outcomes = su*   
individuals4  7d7 ,report ,! agreem5t   
ent]$ into "u subsection 7a7 ) an       
indep5d5t rese>* organization or ,tribal
 ,epidemiology ,c5t] %all require t !   
organization or ,c5t] transmit to       
,congress a report on ! results ( ! /udy
 conduct$ pursuant to t agreem5t n lat] 
?an #cf mon?s aft] ! date ( ! enactm5t (
 ?is ,act4  7e7 ,au?orization (         
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#b1jjj1jjj = ea* ( fiscal ye>s #bjbg    
?r\gh #bjbi4  #fje4 ,grants to          
m9ority-s]v+ in/itutions to /udy mat]nal
 mortality1 sev]e mat]nal morbidity1 &  
o!r adv]se mat]nal heal? outcomes  7a7  
,9 g5]al ,! ,secret>y ( ,heal? & ,human 
,s]vices %all e/abli% a program "u :i* !
 ,secret>y %all aw>d grants to rese>*   
c5t]s1 heal? pr(essions s*ools &        
programs1 & o!r entities at m9ority-s]v+
 in/itutions to /udy specific aspects ( 
! mat]nal heal? crisis among pregnant & 
po/p>tum individuals f racial & e?nic   

m9ority gr\ps4 ,su* rese>* may-- 7#a7   
include ! developm5t & implem5tation (  
sy/ematic processes ( li/5+ to ! /ories 
( pregnant & po/p>tum individuals f     
racial & e?nic m9ority gr\ps1 & p]9atal 
heal? work]s support+ su* individuals1  
to fully und]/& ! causes (1 & in=m      
pot5tial solutions to1 ! mat]nal        
mortality & sev]e mat]nal morbidity     
crisis )9 _! respective communities2    
7#b7 assess ! pot5tial causes (         
relatively l[ rates ( mat]nal mortality 
among ,hispanic individuals1 includ+    
pot5tial racial misclassification & o!r 
data collection & report+ issues t might
 be misrepres5t+ mat]nal mortality rates
 among ,hispanic individuals 9 ! ,unit$ 
,/ates2  7#c7 assess diff]5ces 9 rates (
 adv]se mat]nal heal? outcomes among    
subgr\ps id5tify+ z ,hispanic1 includ+  
disp>ities 9 access to e>ly pr5atal c>e2
 &  7#d7 include lactation education to 
promote racial & e?nic div]sity )9 !    
work=ce ( heal? c>e pr(essionals )      
brea/fe$+ & lactation exp]tise4  7b7    

,application ,to be eligible to receive 
a grant "u subsection 7a71 an entity    
describ$ 9 su* subsection %all submit to
 ! ,secret>y an application at su* "t1 9
 su* mann]1 & conta9+ su* in=mation z ! 
,secret>y may require4  7c7 ,te*nical   
assi/ance ,! ,secret>y may use n m ?an  
#aj p]c5t ( ! funds made available "u   
subsection 7g7-- 7#a7 to conduct outrea*
 to m9ority-s]v+ in/itutions to raise   
aw>5ess ( ! availability ( grants "u    
subsection 7a72  7#b7 to provide        
te*nical assi/ance 9 ! application      
process = su* a grant2 &  7#c7 to       
promote capacity build+ z ne$$ to enable
 entities describ$ 9 su* subsection to  
submit su* an application4  7d7 ,report+
 requirem5t ,ea* entity aw>d$ a grant "u
 ?is section %all p]iodically submit to 
! ,secret>y a report on ! /atus (       
activities conduct$ us+ ! grant4  7e7   
,evaluation ,beg9n+ #a ye> aft] ! date  
on :i* ! fir/ grant is aw>d$ "u ?is     
section1 ! ,secret>y %all submit to     
,congress an annual report summ>iz+ !   

f9d+s ( rese>* conduct$ us+ funds made  
available "u ?is section4  7f7          
,m9ority-,s]v+ in/itutions def9$ ,9 ?is 
section1 ! t]m m9ority-s]v+ in/itution  
has ! mean+ giv5 ! t]m 9 section        
#cga7;a7 ( ! ,high] ,education ,act (   
#aife 7#bj ,u4,s4,c4 #ajfgq7a774  7g7   
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section #aj1jjj1jjj = ea* ( fiscal  
ye>s #bjbg ?r\gh #bjca4  ,,vii ,moms    
matt]  #gja4 ,mat]nal m5tal heal? equity
 grant program  7a7 ,9 g5]al ,!         
,secret>y ( ,heal? & ,human ,s]vices1   
act+ ?r\gh ! ,assi/ant ,secret>y =      
,m5tal ,heal? & ,sub/ance ,use1 %all    
e/abli% a program to aw>d grants to     
eligible entities to address mat]nal    
m5tal heal? conditions & sub/ance use   
disord]s1 ) a focus on demographic gr\ps
 ) elevat$ rates ( mat]nal mortality1   
sev]e mat]nal morbidity1 mat]nal heal?  
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4  7b7 ,application ,to
 be eligible to receive a grant "u ?is  

section1 an eligible entity %all submit 
to ! ,secret>y an application at su* "t1
 9 su* mann]1 & conta9+ su* in=mation z 
! ,secret>y may require4  7c7 ,priority 
,9 aw>d+ grants "u ?is section1 !       
,secret>y %all give priority to an      
eligible entity t-- 7#a7 is1 or w p>tn] 
)1 a community-bas$ organization to     
address mat]nal m5tal heal? conditions &
 sub/ance use disord]s describ$ 9       
subsection 7a72  7#b7 is op]at+ 9 an    
area ) elevat$ rates ( mat]nal          
mortality1 sev]e mat]nal morbidity1     
mat]nal heal? disp>ities1 or o!r adv]se 
p]9atal or *ildbir? outcomes2 &  7#c7 is
 op]at+ 9 a heal? pr(essional %ortage   
area designat$ "u section #ccb ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;e74  7d7 ,use ( funds ,an
 eligible entity t receives a grant "u  
?is section %all use ! grant = ! foll[+3
 7#a7 ,e/abli%+ or exp&+ mat]nity c>e   
programs to improve ! integration (     
mat]nal m5tal heal? & behavioral heal?  
c>e s]vices into prim>y c>e sett+s :]e  

pregnant individuals regul>ly receive   
heal? c>e s]vices4  7#b7 ,e/abli%+ or   
exp&+ gr\p pr5atal c>e programs or      
po/p>tum c>e programs4  7#c7 ,exp&+     
exi/+ programs t improve mat]nal m5tal &
 behavioral heal? dur+ ! pr5atal &      
po/p>tum p]iods1 ) a focus on           
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4  7#d7 ,provid+       
s]vices & support = pregnant & po/p>tum 
individuals ) mat]nal m5tal heal?       
conditions & sub/ance use disord]s1     
includ+ ref]rals to addiction treatm5t  
c5t]s t (f] evid5ce-bas$ treatm5t       
options4  7#e7 ,address+ /igma associat$
 ) mat]nal m5tal heal? conditions &     
sub/ance use disord]s1 ) a focus on     
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4  7#f7 ,rais+ aw>5ess 

( w>n+ signs ( mat]nal m5tal heal?      
conditions & sub/ance use disord]s1 ) a 
focus on pregnant & po/p>tum individuals
 f demographic gr\ps ) elevat$ rates (  
mat]nal mortality1 sev]e mat]nal        
morbidity1 mat]nal heal? disp>ities1 or 
o!r adv]se p]9atal or *ildbir? outcomes4
  7#g7 ,e/abli%+ or exp&+ programs to   
prev5t suicide or self-h>m among        
pregnant & po/p>tum individuals4  7#h7  
,(f]+ evid5ce-align$ programs at free/&+
 bir? c5t]s t provide mat]nal m5tal &   
behavioral heal? c>e education1         
treatm5ts1 & s]vices1 & o!r s]vices =   
individuals ?r\gh\t ! pr5atal & po/p>tum
 p]iod4  7#i7 ,e/abli%+ or exp&+        
programs to provide education & tra9+ to
 mat]nity c>e provid]s ) respect to--   
7,a7 id5tify+ pot5tial w>n+ signs =     
mat]nal m5tal heal? conditions or       
sub/ance use disord]s 9 pregnant &      
po/p>tum individuals1 ) a focus on      
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       

disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2 &  7,b7 9 ! case :]e 
su* provid]s id5tify su* w>n+ signs1    
(f]+ ref]rals to m5tal & behavioral     
heal? c>e pr(essionals4  7#aj7 ,develop+
 a website1 or o!r s\rce1 t includes    
in=mation on heal? c>e provid]s :o treat
 mat]nal m5tal heal? conditions &       
sub/ance use disord]s4  7#aa7 ,e/abli%+ 
or exp&+ programs 9 communities to      
improve coord9ation betwe5 mat]nity c>e 
provid]s & m5tal & behavioral heal? c>e 
provid]s :o treat mat]nal m5tal heal?   
conditions & sub/ance use disord]s1     
includ+ ?r\gh ! use ( toll-free hotl9es4
  7#ab7 ,c>ry+ out o!r programs align$ )
 evid5ce-bas$ practices = address+      
mat]nal m5tal heal? conditions &        
sub/ance use disord]s = pregnant &      
po/p>tum individuals f demographic gr\ps
 ) elevat$ rates ( mat]nal mortality1   
sev]e mat]nal morbidity1 mat]nal heal?  
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4  7e7 ,report+  7#a7  
,eligible entities ,an eligible entity t

 receives a grant "u subsection 7a7 %all
 submit annually to ! ,secret>y1 & make 
publicly available1 a report on !       
activities conduct$ us+ funds receiv$   
?r\gh a grant "u ?is section4 ,su*      
reports %all include quantitative &     
qualitative evaluations ( su*           
activities1 includ+ ! exp]i5ce (        
individuals :o receiv$ heal? c>e ?r\gh  
su* grant4  7#b7 ,secret>y ,n lat] ?an !
 end ( fiscal ye> #bjcj1 ! ,secret>y    
%all submit to ,congress a report t     
includes-- 7,a7 a summ>y ( ! reports    
receiv$ "u p>agraph 7#a72  7,b7 an      
evaluation ( ! effectiv5ess ( grants    
aw>d$ "u ?is section2  7,c7             
recomm5dations ) respect to exp&+       
cov]age ( evid5ce-bas$ scre5+s &        
treatm5ts = mat]nal m5tal heal?         
conditions & sub/ance use disord]s2 &   
7,d7 recomm5dations ) respect to ensur+ 
activities describ$ "u subsection 7d7   
cont9ue aft] ! end ( a grant p]iod4  7f7
 ,def9itions ,9 ?is section3  7#a7      
,eligible entity ,! t]m eligible entity 

means-- 7,a7 a community-bas$           
organization s]v+ pregnant & po/p>tum   
individuals1 includ+ su* organizations  
s]v+ individuals f demographic gr\ps )  
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  7,b7 a nonpr(it or  
pati5t advocacy organization ) exp]tise 
9 mat]nal m5tal & behavioral heal?2     
7,c7 a mat]nity c>e provid]2  7,d7 a    
m5tal or behavioral heal? c>e provid] :o
 treats mat]nal m5tal heal? conditions  
or sub/ance use disord]s2  7,e7 a ,/ate 
or local gov]nm5tal entity1 includ+ a   
,/ate or local public heal? dep>tm5t2   
7,f7 an ,indian ,tribe or ,tribal       
organization 7z su* t]ms are def9$ 9    
section #d ( ! ,indian                  
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd772 
&  7,g7 an ,urban ,indian organization  
7z su* t]m is def9$ 9 section #d ( !    
,indian ,heal? ,c>e ,improvem5t ,act    
7#be ,u4,s4,c4 #afjc774  7#b7 ,free/&+  

bir? c5t] ,! t]m free/&+ bir? c5t] has !
 mean+ giv5 t t]m "u section #aije7l7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acif;d7#a774  7#c7 ,secret>y ,! t]m    
,secret>y means ! ,secret>y ( ,heal? &  
,human ,s]vices4  7g7 ,au?orization (   
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#be1jjj1jjj = ea* ( fiscal ye>s #bjbg   
?r\gh #bjca4  #gjb4 ,grants to gr[ &    
div]sify ! mat]nal m5tal & behavioral   
heal? c>e work=ce ,title ,,vii ( !      
,public ,heal? ,s]vice ,act is am5d$ by 
ins]t+ aft] section #geh ( su* ,act 7#db
 ,u4,s4,c4 #bid;f71 z add$ by section   
#djb ( ?is ,act1 ! foll[+ new section3  
#geh;,a4 ,mat]nal m5tal & behavioral    
heal? c>e work=ce grants  7a7 ,9 g5]al  
,! ,secret>y may aw>d grants to entities
 to e/abli% or exp& programs describ$ 9 
subsection 7b7 to gr[ & div]sify !      
mat]nal m5tal & behavioral heal? c>e    
work=ce4  7b7 ,use ( funds ,recipi5ts ( 
grants "u ?is section %all use ! grants 
to gr[ & div]sify ! mat]nal m5tal &     

behavioral heal? c>e work=ce by--  7#a7 
e/abli%+ s*ools or programs t provide   
education & tra9+ to individuals seek+  
appropriate lic5s+ or c]tification z    
m5tal or behavioral heal? c>e provid]s  
:o w specialize 9 mat]nal m5tal heal?   
conditions or sub/ance use disord]s2 or 
7#b7 exp&+ ! capacity ( exi/+ s*ools or 
programs describ$ 9 p>agraph 7#a71 = !  
purposes ( increas+ ! numb] ( /ud5ts    
enroll$ 9 su* s*ools or programs1       
includ+ by aw>d+ s*ol>%ips = /ud5ts4    
7c7 ,prioritization ,9 aw>d+ grants "u  
?is section1 ! ,secret>y %all give      
priority to any entity t-- 7#a7 has     
demon/rat$ a commitm5t to recruit+ &    
reta9+ /ud5ts & faculty f racial & e?nic
 m9ority gr\ps2  7#b7 has develop$ a    
/rategy to recruit & reta9 a div]se pool
 ( /ud5ts into ! mat]nal m5tal or       
behavioral heal? c>e work=ce program or 
s*ool support$ by funds receiv$ ?r\gh ! 
grant1 p>ticul>ly f racial & e?nic      
m9ority gr\ps & o!r und]s]v$            
populations2  7#c7 has develop$ a       

/rategy to recruit & reta9 /ud5ts :o    
plan to practice 9 a heal? pr(essional  
%ortage area designat$ "u section #ccb2 
7#d7 has develop$ a /rategy to recruit &
 reta9 /ud5ts :o plan to practice 9 an  
area ) significant mat]nal heal?        
disp>ities1 to ! ext5t practicable2 &   
7#e7 includes 9 ! /&>d curriculum = all 
/ud5ts )9 ! mat]nal m5tal or behavioral 
heal? c>e work=ce program or s*ool a    
bias1 racism1 or discrim9ation tra9+    
program t includes tra9+ on implicit    
bias & racism4  7d7 ,report+ ,z a       
condition on receipt ( a grant "u ?is   
section = a mat]nal m5tal or behavioral 
heal? c>e work=ce program or s*ool1 an  
entity %all agree to submit to !        
,secret>y an annual report on !         
activities conduct$ ?r\gh ! grant1      
includ+-- 7#a7 ! numb] & demographics ( 
/ud5ts p>ticipat+ 9 ! program or s*ool2 
7#b7 ! ext5t to :i* /ud5ts 9 ! program  
or s*ool are ent]+ c>e]s 9-- 7,a7 heal? 
pr(essional %ortage areas designat$ "u  
section #ccb2 &  7,b7 areas )           

significant mat]nal heal? disp>ities1 to
 ! ext5t su* data are available2 &  7#c7
 :e!r ! program or s*ool has includ$ 9 !
 /&>d curriculum = all /ud5ts a bias1   
racism1 or discrim9ation tra9+ program t
 includes tra9+ on implicit bias &      
racism1 & if s ! effectiv5ess ( su*     
tra9+ program4  7e7 ,p]iod ( grants ,!  
p]iod ( a grant "u ?is section %all be  
up to #e ye>s4  7f7 ,application ,to    
seek a grant "u ?is section1 an entity  
%all submit to ! ,secret>y an           
application at su* "t1 9 su* mann]1 &   
conta9+ su* in=mation z ! ,secret>y may 
require1 includ+ any in=mation necess>y 
= prioritization "u subsection 7c74  7g7
 ,te*nical assi/ance ,! ,secret>y %all  
provide1 directly or by contract1       
te*nical assi/ance to entities seek+ or 
receiv+ a grant "u ?is section on !     
developm5t1 use1 evaluation1 & po/grant 
p]iod su/a9ability ( ! mat]nal m5tal or 
behavioral heal? c>e work=ce programs or
 s*ools propos$ to be1 or be+1 e/abli%$ 
or exp&$ ?r\gh ! grant4  7h7 ,report by 

! ,secret>y ,n lat] ?an #d ye>s aft] !  
date ( enactm5t ( ?is section1 !        
,secret>y %all prep>e & submit to !     
,congress1 & po/ on ! int]net website ( 
! ,dep>tm5t ( ,heal? & ,human ,s]vices1 
a report on ! effectiv5ess ( ! grant    
program "u ?is section at--  7#a7       
recruit+ /ud5ts f racial & e?nic m9ority
 gr\ps & o!r und]s]v$ populations2  7#b7
 increas+ ! numb] ( m5tal or behavioral 
heal? c>e provid]s specializ+ 9 mat]nal 
m5tal heal? conditions or sub/ance use  
disord]s f racial & e?nic m9ority gr\ps 
& o!r und]s]v$ populations2  7#c7       
increas+ ! numb] ( m5tal or behavioral  
heal? c>e provid]s specializ+ 9 mat]nal 
m5tal heal? conditions or sub/ance use  
disord]s work+ 9 heal? pr(essional      
%ortage areas designat$ "u section #ccb2
 &  7#d7 increas+ ! numb] ( m5tal or    
behavioral heal? c>e provid]s specializ+
 9 mat]nal m5tal heal? conditions or    
sub/ance use disord]s work+ 9 areas )   
significant mat]nal heal? disp>ities1 to
 ! ext5t su* data are available4  7i7   

,def9itions ,9 ?is section3 7#a7 ,racial
 & e?nic m9ority gr\p ,! t]m racial &   
e?nic m9ority gr\p has ! mean+ giv5 su* 
t]m 9 section #agjg7;g77#a74  7#b7      
,m5tal or behavioral heal? c>e provid]  
,! t]m m5tal or behavioral heal? c>e    
provid] ref]s to a heal? c>e provid] 9 !
 field ( m5tal & behavioral heal?1      
includ+ sub/ance use disord]s1 act+ 9   
accordance ) ,/ate law4  7j7            
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re is au?oriz$ to be  
appropriat$ #ae1jjj1jjj = ea* ( fiscal  
ye>s #bjbg ?r\gh #bjca4  4  ,,viii      
,ju/ice = inc>c]at$ moms  #hja4 ,end+ ! 
%ackl+ ( pregnant individuals  7a7 ,9   
g5]al ,beg9n+ on ! date t is #f mon?s   
aft] ! date ( enactm5t ( ?is ,act1 &    
annually !reaft]1 9 ea* ,/ate t receives
 a grant "u subp>t #a ( "p ,e ( title ,i
 ( ! ,omnibus ,crime ,control & ,safe   
,/reets ,act ( #aifh 7#cd ,u4,s4,c4     
#ajaea et seq47 7commonly ref]r$ to z ! 
,edw>d ,byrne ,memorial ,ju/ice ,grant  
,program7 & t does n h 9 effect ?r\gh\t 

! ,/ate = su* fiscal ye> laws re/rict+ !
 use ( re/ra9ts on pregnant individuals 
9 prison t are sub/antially simil> to ! 
rights1 proc$ures1 requirem5ts1 effects1
 & p5alties set =? 9 section #dcbb (    
title #ah1 ,unit$ ,/ates ,code1 ! am\nt 
( su* grant t w\ld o!rwise be allocat$  
to su* ,/ate "u su* subp>t = ! fiscal   
ye> %all be decreas$ by #be p]c5t4  7b7 
,reallocation ,am\nts n allocat$ to a   
,/ate = failure to comply ) subsection  
7a7 %all be reallocat$ 9 accordance )   
subp>t #a ( "p ,e ( title ,i ( !        
,omnibus ,crime ,control & ,safe ,/reets
 ,act ( #aifh 7#cd ,u4,s4,c4 #ajaea et  
seq47 to ,/ates t h compli$ ) su*       
subsection4  #hjb4 ,creat+ model        
programs = ! c>e ( inc>c]at$ individuals
 9 ! pr5atal & po/p>tum p]iods  7a7 ,9  
g5]al ,n lat] ?an #a ye> aft] ! date (  
enactm5t ( ?is ,act1 ! ,attorney ,g5]al1
 act+ ?r\gh ! ,director ( ! ,bureau (   
,prisons1 %all e/abli%1 9 n few] ?an #f 
,bureau ( ,prisons facilities1 programs 
to optimize mat]nal heal? outcomes =    

pregnant & po/p>tum individuals         
inc>c]at$ 9 su* facilities4 ,! ,attorney
 ,g5]al %all e/abli% su* programs 9     
consultation ) /akehold]s su* z-- 7#a7  
relevant community-bas$ organizations1  
p>ticul>ly organizations t repres5t     
inc>c]at$ & =m]ly inc>c]at$ individuals 
& organizations t seek to improve       
mat]nal heal? outcomes = pregnant &     
po/p>tum individuals f demographic gr\ps
 ) elevat$ rates ( mat]nal mortality1   
sev]e mat]nal morbidity1 mat]nal heal?  
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  7#b7 relevant       
organizations repres5t+ pati5ts1 ) a    
p>ticul> focus on pati5ts f demographic 
gr\ps ) elevat$ rates ( mat]nal         
mortality1 sev]e mat]nal morbidity1     
mat]nal heal? disp>ities1 or o!r adv]se 
p]9atal or *ildbir? outcomes2  7#c7     
organizations repres5t+ mat]nity c>e    
provid]s & mat]nal heal? c>e education  
programs2  7#d7 p]9atal heal? work]s2 & 
7#e7 rese>*]s & policy exp]ts 9 fields  
relat$ to mat]nal heal? c>e = inc>c]at$ 

individuals4  7b7 ,/>t date ,ea* select$
 facility %all beg9 facility programs n 
lat] ?an #ah mon?s aft] ! date (        
enactm5t ( ?is ,act4  7c7 ,facility     
priority ,9 c>ry+ out subsection 7a71 ! 
,director %all give priority to a       
facility bas$ on--  7#a7 ! numb] (      
pregnant & po/p>tum individuals         
inc>c]at$ 9 su* facility &1 among su*   
individuals1 ! numb] ( pregnant &       
po/p>tum individuals f demographic gr\ps
 ) elevat$ rates ( mat]nal mortality1   
sev]e mat]nal morbidity1 mat]nal heal?  
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2 &  7#b7 ! ext5t to   
:i* ! lead]s ( su* facility h demon/rat$
 a commitm5t to develop+ exempl>y       
programs = pregnant & po/p>tum          
individuals inc>c]at$ 9 su* facility4   
7d7 ,program duration ,! programs       
e/abli%$ "u ?is section %all be = a     
#e-ye> p]iod4  7e7 ,programs ,bureau (  
,prisons facilities select$ by !        
,director %all e/abli% programs =       
pregnant & po/p>tum inc>c]at$           

individuals1 & su* programs may--  7#a7 
provide access to p]9atal heal? work]s f
 pregnancy ?r\gh ! po/p>tum p]iod2  7#b7
 provide access to heal?y foods &       
c\nsel+ on nutrition1 recomm5d$ activity
 levels1 & safety measures ?r\gh\t      
pregnancy2  7#c7 tra9 correctional      
(fic]s to ensure t pregnant inc>c]at$   
individuals receive safe & respectful   
treatm5t2  7#d7 tra9 m$ical p]sonnel to 
ensure t pregnant inc>c]at$ individuals 
receive trauma-in=m$1 culturally &      
l+ui/ically congru5t c>e t promotes !   
heal? & safety ( ! pregnant individuals2
  7#e7 provide c\nsel+ & treatm5t =     
individuals :o h suff]$ f-- 7,a7        
diagnos$ m5tal or behavioral heal?      
conditions1 includ+ trauma & sub/ance   
use disord]s2  7,b7 trauma or viol5ce1  
includ+ dome/ic viol5ce2  7,c7 human    
immunodefici5cy virus2  7,d7 sexual     
abuse2  7,e7 pregnancy or infant loss2  
or  7,f7 *ronic conditions2  7#f7       
provide evid5ce-bas$ pregnancy &        
*ildbir? education1 p>5t+ support1 & o!r

 relevant =ms ( heal? lit]acy2  7#g7    
provide cl9ical education opportunities 
to mat]nity c>e provid]s 9 tra9+ to exp&
 pa?ways into mat]nal heal? c>e c>e]s   
s]v+ inc>c]at$ individuals2  7#h7 (f]   
opportunities = po/p>tum individuals to 
ma9ta9 contact ) ! individual's newborn 
*ild to promote bond+1 includ+ enhanc$  
visitation policies1 access to prison   
nurs]y programs1 or brea/fe$+ support2  
7#i7 provide re5try assi/ance1          
p>ticul>ly to-- 7,a7 ensure access to   
heal? insurance cov]age & transf] (     
heal? records to community provid]s if  
an inc>c]at$ individual exits ! crim9al 
ju/ice sy/em dur+ su* individual's      
pregnancy or 9 ! po/p>tum p]iod2 &  7,b7
 connect individuals exit+ ! crim9al    
ju/ice sy/em dur+ pregnancy or 9 !      
po/p>tum p]iod to community-bas$        
res\rces1 su* z ref]rals to heal? c>e   
provid]s1 sub/ance use disord]          
treatm5ts1 & social s]vices t address   
social det]m9ants mat]nal ( heal?2 or   
7#aj7 e/abli% p>tn]%ips ) local public  

entities1 private community entities1   
community-bas$ organizations1 ,indian   
,tribes & ,tribal organizations 7z su*  
t]ms are def9$ 9 section #d ( ! ,indian 
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 
& ,urban ,indian organizations 7z su*   
t]m is def9$ 9 section #d ( ! ,indian   
,heal? ,c>e ,improvem5t ,act 7#be       
,u4,s4,c4 #afjc77 to e/abli% or exp&    
pretrial div]sion programs z an         
alt]native to inc>c]ation = pregnant &  
po/p>tum individuals4 ,su* programs may 
include--  7,a7 evid5ce-bas$ *ildbir?   
education or p>5t+ classes2  7,b7       
pr5atal heal? coord9ation2  7,c7 family 
& individual c\nsel+2  7,d7 evid5ce-bas$
 scre5+s1 education1 &1 z ne$$1 treatm5t
 = m5tal & behavioral heal? conditions1 
includ+ drug & alcohol treatm5ts2  7,e7 
family case managem5t s]vices2  7,f7    
dome/ic viol5ce education & prev5tion2  
7,g7 physical & sexual abuse c\nsel+2 & 
7,h7 programs to address social         
det]m9ants ( heal? su* z employm5t1     

h\s+1 education1 transportation1 &      
nutrition4  7f7 ,implem5tation & report+
 ,a select$ facility %all be responsible
 =-- 7#a7 implem5t+ programs1 :i* may   
include ! programs describ$ 9 subsection
 7e72 &  7#b7 n lat] ?an #c ye>s aft] ! 
date ( enactm5t ( ?is ,act1 & #f ye>s   
aft] ! date ( enactm5t ( ?is ,act1      
report+ results ( ! programs to !       
,director1 includ+ in=mation describ+-- 
7,a7 relevant quantitative indicators ( 
success 9 improv+ ! /&>d ( c>e & heal?  
outcomes = pregnant & po/p>tum inc>c]at$
 individuals 9 ! facility1 includ+ data 
/ratifi$ by race1 e?nicity1 sex1 g5d]1  
prim>y language1 age1 geography1        
disability /atus1 ! category ( ! crim9al
 *>ge aga9/ su* individual1 rates (     
pregnancy-relat$ dea?s1                 
pregnancy-associat$ dea?s1 cases (      
infant mortality & morbidity1 rates (   
pret]m bir?s & l[-bir?weight bir?s1     
cases ( sev]e mat]nal morbidity1 cases (
 viol5ce aga9/ pregnant or po/p>tum     
individuals1 diagnoses ( mat]nal m5tal  

or behavioral heal? conditions1 & o!r   
su* in=mation z appropriate2  7,b7      
relevant qualitative & quantitative     
evaluations f pregnant & po/p>tum       
inc>c]at$ individuals :o p>ticipat$ 9   
su* programs1 includ+ measures (        
pati5t-report$ exp]i5ce ( c>e2 &  7,c7  
/rategies to su/a9 su* programs aft]    
fiscal ye> #bjca & exp& su* programs to 
o!r facilities4  7g7 ,report ,n lat] ?an
 #f ye>s aft] ! date ( enactm5t ( ?is   
,act1 ! ,director %all submit to !      
,attorney ,g5]al & to ! ,congress a     
report describ+ ! results ( ! programs  
fund$ "u ?is section4  7h7 ,ov]sight ,n 
lat] ?an #a ye> aft] ! date ( enactm5t (
 ?is ,act1 ! ,attorney ,g5]al %all aw>d 
a contract to an indep5d5t organization 
or indep5d5t organizations to conduct   
ov]sight ( ! programs describ$ 9        
subsection 7e74  7i7 ,au?orization (    
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#aj1jjj1jjj = ea* ( fiscal ye>s #bjbg   
?r\gh #bjca4  #hjc4 ,grant program to   

improve mat]nal heal? outcomes =        
individuals 9 ,/ate & local prisons &   
jails  7a7 ,e/abli%m5t ,n lat] ?an #a   
ye> aft] ! date ( enactm5t ( ?is ,act1 !
 ,attorney ,g5]al1 act+ ?r\gh !         
,director ( ! ,bureau ( ,ju/ice         
,assi/ance1 %all aw>d ,ju/ice =         
,inc>c]at$ ,moms grants to ,/ates to    
e/abli% or exp& programs 9 ,/ate & local
 prisons & jails = pregnant & po/p>tum  
inc>c]at$ individuals4 ,! ,attorney     
,g5]al %all aw>d su* grants 9           
consultation ) /akehold]s su* z--  7#a7 
relevant community-bas$ organizations1  
p>ticul>ly organizations t repres5t     
inc>c]at$ & =m]ly inc>c]at$ individuals 
& organizations t seek to improve       
mat]nal heal? outcomes = pregnant &     
po/p>tum individuals f demographic gr\ps
 ) elevat$ rates ( mat]nal mortality1   
sev]e mat]nal morbidity1 mat]nal heal?  
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  7#b7 relevant       
organizations repres5t+ pati5ts1 ) a    
p>ticul> focus on pati5ts f demographic 

gr\ps ) elevat$ rates ( mat]nal         
mortality1 sev]e mat]nal morbidity1     
mat]nal heal? disp>ities1 or o!r adv]se 
p]9atal or *ildbir? outcomes2  7#c7     
organizations repres5t+ mat]nity c>e    
provid]s & mat]nal heal? c>e education  
programs2  7#d7 p]9atal heal? work]s2 & 
7#e7 rese>*]s & policy exp]ts 9 fields  
relat$ to mat]nal heal? c>e = inc>c]at$ 
individuals4  7b7 ,applications ,ea*    
applicant = a grant "u ?is section %all 
submit to ! ,director ( ! ,bureau (     
,ju/ice ,assi/ance an application at su*
 "t1 9 su* mann]1 & conta9+ su*         
in=mation z ! ,director may require4    
7c7 ,use ( funds ,a ,/ate t is aw>d$ a  
grant "u ?is section %all use su* grant 
to e/abli% or exp& programs = pregnant &
 po/p>tum inc>c]at$ individuals1 & su*  
programs may-- 7#a7 provide access to   
p]9atal heal? work]s f pregnancy ?r\gh !
 po/p>tum p]iod2  7#b7 provide access to
 heal?y foods & c\nsel+ on nutrition1   
recomm5d$ activity levels1 & safety     
measures ?r\gh\t pregnancy2  7#c7 tra9  

correctional (fic]s to ensure t pregnant
 inc>c]at$ individuals receive safe &   
respectful treatm5t2  7#d7 tra9 m$ical  
p]sonnel to ensure t pregnant inc>c]at$ 
individuals receive trauma-in=m$1       
culturally & l+ui/ically congru5t c>e t 
promotes ! heal? & safety ( ! pregnant  
individuals2  7#e7 provide c\nsel+ &    
treatm5t = individuals :o h suff]$ f--  
7,a7 diagnos$ m5tal or behavioral heal? 
conditions1 includ+ trauma & sub/ance   
use disord]s2  7,b7 trauma or viol5ce1  
includ+ dome/ic viol5ce2  7,c7 human    
immunodefici5cy virus2  7,d7 sexual     
abuse2  7,e7 pregnancy or infant loss2  
or  7,f7 *ronic conditions2  7#f7       
provide evid5ce-bas$ pregnancy &        
*ildbir? education1 p>5t+ support1 & o!r
 relevant =ms ( heal? lit]acy2  7#g7    
provide cl9ical education opportunities 
to mat]nity c>e provid]s 9 tra9+ to exp&
 pa?ways into mat]nal heal? c>e c>e]s   
s]v+ inc>c]at$ individuals2  7#h7 (f]   
opportunities = po/p>tum individuals to 
ma9ta9 contact ) ! individual's newborn 

*ild to promote bond+1 includ+ enhanc$  
visitation policies1 access to prison   
nurs]y programs1 or brea/fe$+ support2  
7#i7 provide re5try assi/ance1          
p>ticul>ly to--  7,a7 ensure access to  
heal? insurance cov]age & transf] (     
heal? records to community provid]s if  
an inc>c]at$ individual exits ! crim9al 
ju/ice sy/em dur+ su* individual's      
pregnancy or 9 ! po/p>tum p]iod2 &  7,b7
 connect individuals exit+ ! crim9al    
ju/ice sy/em dur+ pregnancy or 9 !      
po/p>tum p]iod to community-bas$        
res\rces1 su* z ref]rals to heal? c>e   
provid]s1 sub/ance use disord]          
treatm5ts1 & social s]vices t address   
social det]m9ants ( mat]nal heal?2 or   
7#aj7 e/abli% p>tn]%ips ) local public  
entities1 private community entities1   
community-bas$ organizations1 ,indian   
,tribes & ,tribal organizations 7z su*  
t]ms are def9$ 9 section #d ( ! ,indian 
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 
& ,urban ,indian organizations 7z su*   

t]m is def9$ 9 section #d ( ! ,indian   
,heal? ,c>e ,improvem5t ,act 7#be       
,u4,s4,c4 #afjc77 to e/abli% or exp&    
pretrial div]sion programs z an         
alt]native to inc>c]ation = pregnant &  
po/p>tum individuals4 ,su* programs may 
include-- 7,a7 evid5ce-bas$ *ildbir?    
education or p>5t+ classes2  7,b7       
pr5atal heal? coord9ation2  7,c7 family 
& individual c\nsel+2  7,d7 evid5ce-bas$
 scre5+s1 education1 &1 z ne$$1 treatm5t
 = m5tal & behavioral heal? conditions1 
includ+ drug & alcohol treatm5ts2  7,e7 
family case managem5t s]vices2  7,f7    
dome/ic viol5ce education & prev5tion2  
7,g7 physical & sexual abuse c\nsel+2 & 
7,h7 programs to address social         
det]m9ants ( heal? su* z employm5t1     
h\s+1 education1 transportation1 &      
nutrition4  7d7 ,priority ,9 aw>d+      
grants "u ?is section1 ! ,director ( !  
,bureau ( ,ju/ice ,assi/ance %all give  
priority to applicants bas$ on--  7#a7 !
 numb] ( pregnant & po/p>tum individuals
 inc>c]at$ 9 ! ,/ate &1 among su*       

individuals1 ! numb] ( pregnant &       
po/p>tum individuals f demographic gr\ps
 ) elevat$ rates ( mat]nal mortality1   
sev]e mat]nal morbidity1 mat]nal heal?  
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2 &  7#b7 ! ext5t to   
:i* ! ,/ate has demon/rat$ a commitm5t  
to develop+ exempl>y programs = pregnant
 & po/p>tum individuals inc>c]at$ 9 !   
prisons & jails 9 ! ,/ate4  7e7 ,grant  
duration ,a grant aw>d$ "u ?is section  
%all be = a #e-ye> p]iod4  7f7          
,implem5t+ & report+ ,a ,/ate t receives
 a grant "u ?is section %all be         
responsible =--  7#a7 implem5t+ !       
program fund$ by ! grant2 &  7#b7 n lat]
 ?an #c ye>s aft] ! date ( enactm5t (   
?is ,act1 & #f ye>s aft] ! date (       
enactm5t ( ?is ,act1 report+ results (  
su* program to ! ,attorney ,g5]al1      
includ+ in=mation describ+--  7,a7      
relevant quantitative indicators ( !    
program's success 9 improv+ ! /&>d ( c>e
 & heal? outcomes = pregnant & po/p>tum 
inc>c]at$ individuals 9 ! facility1     

includ+ data /ratifi$ by race1 e?nicity1
 sex1 g5d]1 prim>y language1 age1       
geography1 disability /atus1 category ( 
! crim9al *>ge aga9/ su* individual1    
incid5ce rates ( pregnancy-relat$ dea?s1
 pregnancy-associat$ dea?s1 cases (     
infant mortality & morbidity1 rates (   
pret]m bir?s & l[-bir?weight bir?s1     
cases ( sev]e mat]nal morbidity1 cases (
 viol5ce aga9/ pregnant or po/p>tum     
individuals1 diagnoses ( mat]nal m5tal  
or behavioral heal? conditions1 & o!r   
su* in=mation z appropriate2  7,b7      
relevant qualitative & quantitative     
evaluations f pregnant & po/p>tum       
inc>c]at$ individuals :o p>ticipat$ 9   
su* programs1 includ+ measures (        
pati5t-report$ exp]i5ce ( c>e2 &  7,c7  
/rategies to su/a9 su* programs beyond !
 duration ( ! grant & exp& su* programs 
to o!r facilities4  7g7 ,report ,n lat] 
?an #f ye>s aft] ! date ( enactm5t ( ?is
 ,act1 ! ,attorney ,g5]al %all submit to
 ! ,congress a report describ+ ! results
 ( su* grant programs4  7h7 ,ov]sight ,n

 lat] ?an #a ye> aft] ! date ( enactm5t 
( ?is ,act1 ! ,attorney ,g5]al %all aw>d
 a contract to an indep5d5t organization
 or indep5d5t organizations to conduct  
ov]sight ( ! programs describ$ 9        
subsection 7c74  7i7 ,au?orization (    
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#aj1jjj1jjj = ea* ( fiscal ye>s #bjbg   
?r\gh #bjca4  #hjd4 ,,gao report  7a7 ,9
 g5]al ,n lat] ?an #b ye>s aft] ! date (
 enactm5t ( ?is ,act1 ! ,comptroll]     
,g5]al ( ! ,unit$ ,/ates %all submit to 
,congress a report on adv]se mat]nal &  
infant heal? outcomes among inc>c]at$   
individuals & infants born to su*       
individuals1 ) a p>ticul> focus on      
racial & e?nic disp>ities 9 mat]nal &   
infant heal? outcomes = inc>c]at$       
individuals4  7b7 ,cont5ts ( report ,!  
report describ$ 9 ?is section %all      
include--  7#a7 to ! ext5t practicable--
 7,a7 ! numb] ( pregnant individuals :o 
are inc>c]at$ 9 ,bureau ( ,prisons      
facilities2  7,b7 ! numb] ( inc>c]at$   

individuals1 includ+ ^? inc>c]at$ 9     
,f$]al1 ,/ate1 & local correctional     
facilities1 :o h exp]i5c$ a             
pregnancy-relat$ dea?1                  
pregnancy-associat$ dea?1 or ! dea? ( an
 infant 9 ! mo/ rec5t #aj ye>s (        
available data2  7,c7 ! numb] ( cases ( 
sev]e mat]nal morbidity among inc>c]at$ 
individuals1 includ+ ^? inc>c]at$ 9     
,f$]al1 ,/ate1 & local det5tion         
facilities1 9 ! mo/ rec5t #aj ye>s (    
available data2  7,d7 ! numb] ( pret]m &
 l[-bir?weight bir?s ( infants born to  
inc>c]at$ individuals1 includ+ ^?       
inc>c]at$ 9 ,f$]al1 ,/ate1 & local      
correctional facilities1 9 ! mo/ rec5t  
#aj ye>s ( available data2 &  7,e7      
/ati/ics on ! racial & e?nic disp>ities 
9 mat]nal & infant heal? outcomes &     
sev]e mat]nal morbidity rates among     
inc>c]at$ individuals1 includ+ ^?       
inc>c]at$ 9 ,f$]al1 ,/ate1 & local      
det5tion facilities2  7#b7 9 ! case t ! 
,comptroll] ,g5]al ( ! ,unit$ ,/ates is 
unable det]m9e ! in=mation requir$ 9    

subp>agraphs 7,a7 ?r\gh 7,c7 ( p>agraph 
7#a71 an assessm5t ( ! b>ri]s to det]m9+
 su* in=mation & recomm5dations =       
improvem5ts 9 track+ mat]nal heal?      
outcomes among inc>c]at$ individuals1   
includ+ ^? inc>c]at$ 9 ,f$]al1 ,/ate1 & 
local det5tion facilities2  7#c7 !      
implications ( pregnant & po/p>tum      
inc>c]at$ individuals be+ ineligible =  
m$ical assi/ance "u a ,/ate plan "u     
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq47 includ+   
in=mation ab\t--  7,a7 ! effects ( su*  
ineligibility on mat]nal heal? outcomes 
= pregnant & po/p>tum inc>c]at$         
individuals1 ) emphasis giv5 to su*     
effects = pregnant & po/p>tum           
individuals f racial & e?nic m9ority    
gr\ps2 &  7,b7 pot5tial implications on 
mat]nal heal? outcomes result+ f        
tempor>ily susp5d+1 r ?an p]man5tly     
t]m9at+1 su* eligibility :5 a pregnant  
or po/p>tum individual is inc>c]at$2    
7#d7 ! ext5t to :i* ,f$]al1 ,/ate1 &    
local correctional facilities are hold+ 

pregnant & po/p>tum individuals :o te/  
positive = illicit drug use 9 det5tion )
 special conditions1 su* z additional   
bond requirem5ts1 due to ! individual's 
drug use1 & ! effect ( su* det5tion     
policies on mat]nal & infant heal?      
outcomes2  7#e7 causes ( adv]se mat]nal 
heal? outcomes t are unique to inc>c]at$
 individuals1 includ+ ^? inc>c]at$ 9    
,f$]al1 ,/ate1 & local det5tion         
facilities2  7#f7 causes ( adv]se       
mat]nal heal? outcomes & sev]e mat]nal  
morbidity t are unique to inc>c]at$     
individuals f racial & e?nic m9ority    
gr\ps2  7#g7 recomm5dations to r$uce    
mat]nal mortality & sev]e mat]nal       
morbidity among inc>c]at$ individuals & 
to address racial & e?nic disp>ities 9  
mat]nal heal? outcomes = inc>c]at$      
individuals 9 ,bureau ( ,prisons        
facilities & ,/ate & local prisons &    
jails2 &  7#h7 su* o!r in=mation z may  
be appropriate to r$uce ! occurr5ce (   
adv]se mat]nal heal? outcomes among     
inc>c]at$ individuals & to address      

racial & e?nic disp>ities 9 mat]nal     
heal? outcomes = su* individuals4  ,,ix 
,te* to save moms  #ija4 ,integrat$     
teleheal? models 9 mat]nity c>e s]vices 
7a7 ,9 g5]al ,section                   
#aaae;,a7b77#b77;,b7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#acae;a7b77#b77;,b77 is am5d$ by add+ at
 ! end ! foll[+3  7xxviii7 ,focus+ on   
title ,,xix1 provid+ = ! adoption ( &   
use ( teleheal? tools t all[ = scre5+1  
monitor+1 & managem5t ( common heal?    
complications ) respect to an individual
 receiv+ m$ical assi/ance dur+ su*      
individual's pregnancy & = n m ?an a    
#a-ye> p]iod beg9n+ on ! la/ day ( !    
pregnancy4  4  7b7 ,effective date ,!   
am5dm5t made by subsection 7a7 %all take
 effect #a ye> aft] ! date ( ! enactm5t 
( ?is ,act4  #ijb4 ,grants to exp& ! use
 ( te*nology-enabl$ collaborative le>n+ 
& capacity models = pregnant & po/p>tum 
individuals ,title ,,iii ( ! ,public    
,heal? ,s]vice ,act is am5d$ by ins]t+  
aft] section #ccj,p 7#db ,u4,s4,c4      

#bed;c-#bb7 ! foll[+3  #ccj,q4 ,exp&+   
capacity = mat]nal heal? outcomes  7a7  
,e/abli%m5t ,beg9n+ n lat] ?an #a ye>   
aft] ! date ( enactm5t ( ?is ,act1 !    
,secret>y %all aw>d grants to eligible  
entities to evaluate1 develop1 & exp& ! 
use ( te*nology-enabl$ collaborative    
le>n+ & capacity build+ models & improve
 mat]nal heal? outcomes--  7#a7 9 heal? 
pr(essional %ortage areas2  7#b7 9 areas
 ) high rates ( mat]nal mortality &     
sev]e mat]nal morbidity2  7#c7 9 rural &
 und]s]v$ areas2  7#d7 9 areas )        
significant mat]nal heal? disp>ities2 & 
7#e7 = m$ically und]s]v$ populations &  
,am]ican ,indians & ,alaska ,natives1   
includ+ ,indian ,tribes1 ,tribal        
organizations1 & ,urban ,indian         
organizations4  7b7 ,use ( ,funds  7#a7 
,requir$ uses ,recipi5ts ( grants "u ?is
 section %all use ! grants to--  7,a7   
tra9 mat]nal heal? c>e provid]s1 /ud5ts1
 & o!r simil> pr(essionals ?r\gh models 
t include-- 7i7 me?ods to increase      
safety & heal? c>e quality2  7ii7       

implicit bias1 racism1 & discrim9ation2 
7iii7 be/ practices 9 scre5+ = &1 z     
ne$$1 evaluat+ & treat+ mat]nal m5tal   
heal? conditions & sub/ance use         
disord]s2  7iv7 tra9+ on be/ practices 9
 mat]nity c>e = pregnant & po/p>tum     
individuals dur+ public heal? em]g5cies2
  7v7 me?ods to scre5 = social          
det]m9ants ( mat]nal heal? risks 9 !    
pr5atal & po/p>tum2 &  7vi7 ! use (     
remote pati5t monitor+ tools =          
pregnancy-relat$ complications describ$ 
9 section #aaae;,a7b77#b77;,b77xxviii72 
7,b7 evaluate & collect in=mation on !  
effect ( su* models on--  7i7 access to 
& quality ( c>e2  7ii7 outcomes )       
respect to ! heal? ( an individual2 &   
7iii7 ! exp]i5ce ( individuals :o       
receive pregnancy-relat$ heal? c>e2     
7,c7 develop qualitative & quantitative 
measures to id5tify be/ practices = !   
expansion & use ( su* models2  7,d7 /udy
 ! effect ( su* models on pati5t        
outcomes & mat]nity c>e provid]s2 &     
7,e7 conduct any o!r activity det]m9$ by

 ! ,secret>y4  7#b7 ,p]missible uses    
,recipi5ts ( grants "u ?is section may  
use grants to support-- 7,a7 ! use &    
expansion ( te*nology-enabl$            
collaborative le>n+ & capacity build+   
models1 includ+ h>dw>e & s(tw>e t--  7i7
 enables di/ance le>n+ & te*nical       
support2 &  7ii7 supports ! secure      
ex*ange ( electronic heal? in=mation2 & 
7,b7 mat]nity c>e provid]s1 /ud5ts1 &   
o!r simil> pr(essionals 9 ! provision ( 
mat]nity c>e ?r\gh su* models4  7c7     
,application  7#a7 ,9 g5]al ,an eligible
 entity seek+ a grant "u subsection 7a7 
%all submit to ! ,secret>y an           
application1 at su* "t1 9 su* mann]1 &  
conta9+ su* in=mation z ! ,secret>y may 
require4  7#b7 ,assurance ,an           
application "u p>agraph 7#a7 %all       
include an assurance t su* entity %all  
collect in=mation on & assess ! effect (
 ! use ( te*nology-enabl$ collaborative 
le>n+ & capacity build+ models1 includ+ 
) respect to-- 7,a7 mat]nal heal?       
outcomes2  7,b7 access to mat]nal heal? 

c>e s]vices2  7,c7 quality ( mat]nal    
heal? c>e2 &  7,d7 ret5tion ( mat]nity  
c>e provid]s s]v+ areas & populations   
describ$ 9 subsection 7a74  7d7         
,limitations  7#a7 ,numb] ,! ,secret>y  
may n aw>d m ?an #a grant "u ?is        
section4  7#b7 ,duration ,a grant aw>d$ 
"u ?is section %all be = a #e-ye> p]iod4
  7e7 ,access to broadb& ,9 adm9i/]+    
grants "u ?is section1 ! ,secret>y may  
coord9ate ) o!r ag5cies to ensure t     
fund+ opportunities are available to    
support access to reliable1 high-spe$   
int]net = grantees4  7f7 ,te*nical      
assi/ance ,! ,secret>y %all provide     
7ei!r directly or by contract7 te*nical 
assi/ance to eligible entities1 includ+ 
recipi5ts ( grants "u subsection 7a71 on
 ! developm5t1 use1 & su/a9ability (    
te*nology-enabl$ collaborative le>n+ &  
capacity build+ models to exp& access to
 mat]nal heal? c>e s]vices provid$ by   
su* entities1 includ+-- 7#a7 9 heal?    
pr(essional %ortage areas2  7#b7 9 areas
 ) high rates ( mat]nal mortality &     

sev]e mat]nal morbidity or significant  
mat]nal heal? disp>ities2  7#c7 9 rural 
& und]s]v$ areas2 &  7#d7 = m$ically    
und]s]v$ populations or ,am]ican        
,indians & ,alaska ,natives4  7g7       
,rese>* & evaluation ,! ,secret>y1 9    
consultation ) exp]ts1 %all develop a   
/rategic plan to rese>* & evaluate !    
evid5ce = te*nology-enabl$ collaborative
 le>n+ & capacity build+ models4  7h7   
,report+  7#a7 ,eligible entities ,an   
eligible entity t receives a grant "u   
subsection 7a7 %all submit to !         
,secret>y a report1 at su* "t1 9 su*    
mann]1 & conta9+ su* in=mation z !      
,secret>y may require4  7#b7 ,secret>y  
,n lat] ?an #d ye>s aft] ! date (       
enactm5t ( ?is section1 ! ,secret>y %all
 submit to ! ,congress1 & make available
 on ! website ( ! ,dep>tm5t ( ,heal? &  
,human ,s]vices1 a report t includes--  
7,a7 a description ( grants aw>d$ "u    
subsection 7a7 & ! purpose & am\nts (   
su* grants2  7,b7 a summ>y (--  7i7 !   
evaluations conduct$ "u subsection      

7b77#a77;,b72  7ii7 any te*nical        
assi/ance provid$ "u subsection 7f72 &  
7iii7 ! activities conduct$ "u          
subsection 7a72 &  7,c7 a description ( 
any significant f9d+s ) respect to--    
7i7 pati5t outcomes2 &  7ii7 be/        
practices = exp&+1 us+1 or evaluat+     
te*nology-enabl$ collaborative le>n+ &  
capacity build+ models4  7i7            
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section1 #f1jjj1jjj = ea* ( fiscal  
ye>s #bjbg ?r\gh #bjca4  7j7 ,def9itions
 ,9 ?is section3  7#a7 ,eligible entity 
7,a7 ,9 g5]al ,! t]m eligible entity    
means an entity t provides1 or supports 
! provision (1 mat]nal heal? c>e s]vices
 or o!r evid5ce-bas$ s]vices = pregnant 
& po/p>tum individuals-- 7i7 9 heal?    
pr(essional %ortage areas2  7ii7 9 rural
 or und]s]v$ areas2  7iii7 9 areas )    
high rates ( adv]se mat]nal heal?       
outcomes or significant racial & e?nic  
disp>ities 9 mat]nal heal? outcomes2 &  
7iv7 :o are-- 7,i7 memb]s ( m$ically    

und]s]v$ populations2 or  7,,ii7        
,am]ican ,indians & ,alaska ,natives1   
includ+ ,indian ,tribes1 ,tribal        
organizations1 & ,urban ,indian         
organizations4  7,b7 ,inclusions ,an    
eligible entity may include entities t  
lead1 or are capable ( lead+ a          
te*nology-enabl$ collaborative le>n+ &  
capacity build+ model4  7#b7 ,heal?     
pr(essional %ortage area ,! t]m heal?   
pr(essional %ortage area means a heal?  
pr(essional %ortage area designat$ "u   
section #ccb4  7#c7 ,indian ,tribe ,!   
t]m ,indian ,tribe has ! mean+ giv5 su* 
t]m 9 section #d ( ! ,indian            
,self-,det]m9ation & ,education         
,assi/ance ,act4  7#d7 ,mat]nal         
mortality ,! t]m mat]nal mortality means
 a dea? occurr+ dur+ or )9 #a-ye> p]iod 
aft] pregnancy caus$ by pregnancy-relat$
 or *ildbir? complications1 includ+ a   
suicide1 ov]dose1 or o!r dea? result+ f 
a m5tal heal? or sub/ance use disord]   
attribut$ to or aggravat$ by pregnancy  
or *ildbir? complications4  7#e7        

,m$ically und]s]v$ population ,! t]m    
m$ically und]s]v$ population has ! mean+
 giv5 su* t]m 9 section #ccj7;b77#c74   
7#f7 ,po/p>tum ,! t]m po/p>tum means !  
#a-ye> p]iod beg9n+ on ! la/ date ( an  
individual's pregnancy4  7#g7 ,sev]e    
mat]nal morbidity ,! t]m sev]e mat]nal  
morbidity means a heal? condition1      
includ+ a m5tal heal? or sub/ance use   
disord]1 attribut$ to or aggravat$ by   
pregnancy or *ildbir? t results 9       
significant %ort-t]m or long-t]m        
consequ5ces to ! heal? ( ! individual :o
 0 pregnant4  7#h7 ,te*nology-enabl$    
collaborative le>n+ & capacity build+   
model ,! t]m te*nology-enabl$           
collaborative le>n+ & capacity build+   
model means a di/ance heal? education   
model t connects heal? c>e pr(essionals1
 & o!r speciali/s1 ?r\gh simultane\s    
int]active video conf]5c+ = ! purpose ( 
facilitat+ case-bas$ le>n+1 dissem9at+  
be/ practices1 & evaluat+ outcomes 9 !  
context ( mat]nal heal? c>e4  7#i7      
,tribal organization ,! t]m ,tribal     

organization has ! mean+ giv5 su* t]m 9 
section #d ( ! ,indian                  
,self-,det]m9ation & ,education         
,assi/ance ,act4  7#aj7 ,urban ,indian  
organization ,! t]m ,urban ,indian      
organization has ! mean+ giv5 su* t]m 9 
section #d ( ! ,indian ,heal? ,c>e      
,improvem5t ,act4  4  #ijc4 ,grants to  
promote equity 9 mat]nal heal? outcomes 
?r\gh digital tools  7a7 ,9 g5]al       
,beg9n+ n lat] ?an #a ye> aft] ! date ( 
! enactm5t ( ?is ,act1 ! ,secret>y (    
,heal? & ,human ,s]vices 79 ?is section 
ref]r$ to z ! ,secret>y7 %all make      
grants to eligible entities to r$uce    
mat]nal heal? disp>ities by increas+    
access to digital tools relat$ to       
mat]nal heal? c>e1 includ+ provid]-fac+ 
te*nologies1 su* z e>ly w>n+ sy/ems &   
cl9ical decision support me*anisms4  7b7
 ,applications ,to be eligible to       
receive a grant "u ?is section1 an      
eligible entity %all submit to !        
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  

,secret>y may require4  7c7             
,prioritization ,9 aw>d+ grants "u ?is  
section1 ! ,secret>y %all prioritize an 
eligible entity--  7#a7 9 an area )     
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  7#b7 9 a heal?      
pr(essional %ortage area designat$ "u   
section #ccb ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bed;e7 or a rural  
or und]s]v$ area2 &  7#c7 t promotes    
te*nology t addresses mat]nal heal?     
disp>ities4  7d7 ,limitations  7#a7     
,numb] ,! ,secret>y may aw>d n m ?an #a 
grant "u ?is section4  7#b7 ,duration ,a
 grant aw>d$ "u ?is section %all be = a 
#e-ye> p]iod4  7e7 ,te*nical assi/ance  
,! ,secret>y %all provide te*nical      
assi/ance to an eligible entity on !    
developm5t1 use1 evaluation1 & po/grant 
su/a9ability ( digital tools = purposes 
( promot+ equity 9 mat]nal heal?        
outcomes4  7f7 ,report+  7#a7 ,eligible 
entities ,an eligible entity t receives 

a grant "u subsection 7a7 %all submit to
 ! ,secret>y a report1 at su* "t1 9 su* 
mann]1 & conta9+ su* in=mation z !      
,secret>y may require4  7#b7 ,secret>y  
,n lat] ?an #d ye>s aft] ! date ( !     
enactm5t ( ?is ,act1 ! ,secret>y %all   
submit to ,congress a report t          
includes--  7,a7 an evaluation on !     
effectiv5ess ( grants aw>d$ "u ?is      
section to improve mat]nal heal?        
outcomes1 p>ticul>ly = pregnant &       
po/p>tum individuals f racial & e?nic   
m9ority gr\ps2  7,b7 recomm5dations on  
new grant programs t promote ! use (    
te*nology to improve su* mat]nal heal?  
outcomes2 &  7,c7 recomm5dations )      
respect to-- 7i7 te*nology-bas$ privacy 
& security safegu>ds 9 mat]nal heal?    
c>e2  7ii7 reimbursem5t rates = mat]nal 
teleheal? s]vices2  7iii7 ! use (       
digital tools to analyze l>ge data sets 
to id5tify pot5tial pregnancy-relat$    
complications2  7iv7 b>ri]s t prev5t    
mat]nity c>e provid]s f provid+         
teleheal? s]vices across ,/ates2  7v7 ! 

use ( consum] digital tools su* z mobile
 phone applications1 pati5t portals1 &  
we>able te*nologies to improve mat]nal  
heal? outcomes2  7vi7 b>ri]s t prev5t   
access to teleheal? s]vices1 includ+ a  
lack ( access to reliable1 high-spe$    
int]net or electronic devices2  7vii7   
b>ri]s to data %>+ betwe5 ! ,special    
,supplem5tal ,nutrition ,program =      
,wom51 ,infants1 & ,*ildr5 program &    
mat]nity c>e provid]s1 & recomm5dations 
= address+ su* b>ri]s2 &  7viii7 lessons
 le>n$ f exp&$ access to teleheal?      
relat$ to mat]nity c>e dur+ !           
,,covid-#ai public heal? em]g5cy4  7g7  
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section #f1jjj1jjj = ea* ( fiscal   
ye>s #bjbg ?r\gh #bjca4  #ijd4 ,report  
on ! use ( te*nology 9 mat]nity c>e  7a7
 ,9 g5]al ,n lat] ?an #fj days aft] !   
date ( enactm5t ( ?is ,act1 ! ,secret>y 
( ,heal? & ,human ,s]vices %all seek to 
ent] an agreem5t ) ! ,national          
,academies ( ,sci5ces1 ,eng9e]+1 &      

,m$ic9e 7ref]r$ to 9 ?is ,act z !       
,national ,academies7 "u :i* ! ,national
 ,academies %all conduct a /udy on ! use
 ( te*nology & pati5t monitor+ devices 9
 mat]nity c>e4  7b7 ,cont5t ,! agreem5t 
ent]$ into pursuant to subsection 7a7   
%all provide = ! /udy ( ! foll[+3  7#a7 
,! use ( innovative te*nology 7includ+  
artificial intellig5ce7 9 mat]nal heal? 
c>e1 includ+ ! ext5t to :i* su*         
te*nology has affect$ racial or e?nic   
biases 9 mat]nal heal? c>e4  7#b7 ,! use
 ( pati5t monitor+ devices 7includ+     
pulse oximet] devices7 9 mat]nal heal?  
c>e1 includ+ ! ext5t to :i* su* devices 
h affect$ racial or e?nic biases 9      
mat]nal heal? c>e4  7#c7 ,be/ practices 
= r$uc+ & prev5t+ racial or e?nic biases
 9 ! use ( innovative te*nology & pati5t
 monitor+ devices 9 mat]nity c>e4  7#d7 
,be/ practices 9 ! use ( innovative     
te*nology & pati5t monitor+ devices =   
pregnant & po/p>tum individuals f racial
 & e?nic m9ority gr\ps4  7#e7 ,be/      
practices ) respect to privacy &        

security safegu>ds 9 su* use4  7c7      
,report ,! agreem5t "u subsection 7a7   
%all direct ! ,national ,academies to   
complete ! /udy "u ?is section1 &       
transmit to ,congress a report on !     
results ( ! /udy1 n lat] ?an #bd mon?s  
aft] ! date ( enactm5t ( ?is ,act4  ,x  
,impact to save moms  #ajja4 ,p]9atal   
,c>e ,alt]native ,paym5t ,model         
,demon/ration ,project  7a7 ,9 g5]al ,= 
! p]iod ( fiscal ye>s #bjbg ?r\gh #bjca1
 ! ,secret>y ( ,heal? & ,human ,s]vices 
7ref]r$ to 9 ?is section z ! ,secret>y71
 act+ ?r\gh ! ,adm9i/rator ( ! ,c5t]s = 
,m$ic>e  ,m$icaid ,s]vices1 %all e/abli%
 & implem5t1 9 accordance ) !           
requirem5ts ( ?is section1 a            
demon/ration project1 to be kn[n z !    
,p]9atal ,c>e ,alt]native ,paym5t ,model
 ,demon/ration ,project 7ref]r$ to 9 ?is
 section z ! ,demon/ration ,project71 = 
purposes ( all[+ ,/ates to te/ paym5t   
models "u _! ,/ate plans "u title ,,xix 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acif et seq47 & ,/ate *ild   

heal? plans "u title ,,xxi ( su* ,act   
7#db ,u4,s4,c4 #acig;aa et seq47 )      
respect to mat]nity c>e provid$ to      
pregnant & po/p>tum individuals enroll$ 
9 su* ,/ate plans & ,/ate *ild heal?    
plans4  7b7 ,coord9ation ,9 e/abli%+ !  
,demon/ration ,project1 ! ,secret>y %all
 coord9ate ) /akehold]s su* z--  7#a7   
,/ate ,m$icaid programs2  7#b7 mat]nity 
c>e provid]s & organizations repres5t+  
mat]nity c>e provid]s2  7#c7 relevant   
organizations repres5t+ pati5ts1 ) a    
p>ticul> focus on pati5ts f demographic 
gr\ps ) elevat$ rates ( mat]nal         
mortality1 sev]e mat]nal morbidity1     
mat]nal heal? disp>ities1 or o!r adv]se 
p]9atal or *ildbir? outcomes2  7#d7     
relevant community-bas$ organizations1  
p>ticul>ly organizations t seek to      
improve mat]nal heal? outcomes =        
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  7#e7 p]9atal heal?  

work]s2  7#f7 relevant heal? insurance  
issu]s2  7#g7 hospitals1 heal? sy/ems1  
midwif]y practices1 free/&+ bir? c5t]s  
7z su* t]m is def9$ 9 p>agraph 7#c77;,b7
 ( section #aije7l7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acif;d7l7771 ,f$]ally-qualifi$ heal?   
c5t]s 7z su* t]m is def9$ 9 p>agraph    
7#b77;,b7 ( su* section71 & rural heal? 
cl9ics 7z su* t]m is def9$ 9 section    
#ahfa7;aa7 ( su* ,act 7#db ,u4,s4,c4    
#aciex7aa7772  7#h7 rese>*]s & policy   
exp]ts 9 fields relat$ to mat]nity c>e  
paym5t models2 &  7#i7 any o!r          
/akehold]s z ! ,secret>y det]m9es       
appropriate1 ) a p>ticul> focus on      
/akehold]s f demographic gr\ps ) elevat$
 rates ( mat]nal mortality1 sev]e       
mat]nal morbidity1 mat]nal heal?        
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4  7c7 ,consid]ations  
,9 e/abli%+ ! ,demon/ration ,project1 ! 
,secret>y %all consid] any alt]native   
paym5t model t-- 7#a7 is design$ to     
improve mat]nal heal? outcomes =        

individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  7#b7 includes me?ods
 = /ratify+ pati5ts by pregnancy risk   
level &1 z appropriate1 adju/+ paym5ts  
"u su* model to take into acc\nt        
pregnancy risk level1 includ+           
consid]ation ( ! appropriate transf] (  
pati5ts by pregnancy risk level2  7#c7  
e/abli%es evid5ce-bas$ quality metrics =
 su* paym5ts2  7#d7 includes            
consid]ation ( nonhospital bir? sett+s  
su* z free/&+ bir? c5t]s 7z s def9$72   
7#e7 includes consid]ation ( social     
det]m9ants ( mat]nal heal?2  7#f7       
includes div]se mat]nity c>e teams t    
include-- 7,a7 mat]nity c>e provid]s1   
m5tal & behavioral heal? c>e provid]s   
act+ 9 accordance ) ,/ate law1 & regi/]$
 dietitians or nutrition pr(essionals 7z
 su* t]m is def9$ 9 section             
#aciex7vv77#b7 ( title #db1 ,unit$      
,/ates ,code7--  7i7 f racially1        

e?nically1 & pr(essionally div]se       
backgr\nds2  7ii7 ) exp]i5ce practic+ 9 
racially & e?nically div]se communities2
 or  7iii7 :o h und]gone tra9+ on       
implicit bias & racism2 &  7,b7 p]9atal 
heal? work]s2 or  7#g7 includes         
consid]ation ( mat]nal m5tal heal?      
conditions & sub/ance use disord]s4  7d7
 ,eligibility ,to be eligible to        
p>ticipate 9 ! ,demon/ration ,project1 a
 ,/ate %all submit an application to !  
,secret>y at su* "t1 9 su* mann]1 &     
conta9+ su* in=mation z ! ,secret>y may 
require4  7e7 ,evaluation ,! ,secret>y  
%all conduct an evaluation ( !          
,demon/ration ,project to det]m9e !     
impact ( ! ,demon/ration ,project on--  
7#a7 mat]nal heal? outcomes1 ) data     
/ratifi$ by race1 e?nicity1 prim>y      
language1 socioeconomic /atus1          
geography1 insurance type1 & o!r factors
 z ! ,secret>y det]m9es appropriate2    
7#b7 sp5d+ on mat]nity c>e by ,/ates    
p>ticipat+ 9 ! ,demon/ration ,project2  
7#c7 to ! ext5t practicable1 qualitative

 & quantitative measures ( pati5t       
exp]i5ce2 &  7#d7 any o!r areas (       
assessm5t t ! ,secret>y det]m9es        
relevant4  7f7 ,report ,n lat] ?an "o   
ye> aft] ! completion or t]m9ation date 
( ! ,demon/ration ,project1 ! ,secret>y 
%all submit to ! ,congress1 & make      
publicly available1 a report conta9+--  
7#a7 ! results ( any evaluation conduct$
 "u subsection 7e72 &  7#b7 a           
recomm5dation reg>d+ :e!r !             
,demon/ration ,project %\ld be cont9u$  
aft] fiscal ye> #bjca & exp&$ on a      
national basis4  7g7 ,au?orization (    
appropriations ,!re are au?oriz$ to be  
appropriat$ su* sums z are necess>y to  
c>ry out ?is section4  7h7 ,def9itions  
,9 ?is section3  7#a7 ,alt]native paym5t
 model ,! t]m alt]native paym5t model   
has ! mean+ giv5 su* t]m 9 section      
#ahcc7z77#c77;,c7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciel7z77#c77;,c774
  7#b7 ,p]9atal ,! t]m p]9atal means !  
p]iod beg9n+ on ! day an individual     
becomes pregnant & end+ on ! la/ day ( !

 #a-ye> p]iod beg9n+ on ! la/ day ( su* 
individual's pregnancy4  ,,xi ,mat]nal  
heal? p&emic response  #aaja4           
,def9itions ,9 ?is title3 7#a7          
,respectful mat]nity c>e ,! t]m         
respectful mat]nity c>e ref]s to c>e    
organiz$ =1 & provid$ to1 pregnant &    
po/p>tum individuals 9 a mann] t--  7,a7
 is culturally & l+ui/ically congru5t2  
7,b7 ma9ta9s _! dignity1 privacy1 &     
confid5tiality2  7,c7 ensures fre$om f  
h>m & mi/reatm5t2 &  7,d7 enables in=m$ 
*oice & cont9u\s support4  7#b7         
,secret>y ,! t]m ,secret>y means !      
,secret>y ( ,heal? & ,human ,s]vices4   
#aajb4 ,fund+ = data collection1        
surveillance1 & rese>* on mat]nal heal? 
outcomes dur+ public heal? em]g5cies ,to
 conduct or support data collection1    
surveillance1 & rese>* on mat]nal heal? 
z a result ( public heal? em]g5cies &   
infecti\s diseases t pose a risk to     
mat]nal & infant heal?1 includ+ support 
to assi/ 9 ! capacity build+ = ,/ate1   
,tribal1 t]ritorial1 & local public     

heal? dep>tm5ts to collect & transmit   
racial1 e?nic1 & o!r demographic data   
relat$ to mat]nal heal?1 !re are        
au?oriz$ to be appropriat$--  7#a7      
#ajj1jjj1jjj = ! ,surveillance = ,em]g+ 
,?reats to ,mo!rs & ,babies program ( ! 
,c5t]s = ,disease ,control & ,prev5tion1
 to support ! ,c5t]s = ,disease ,control
 & ,prev5tion 9 its ef=ts to-- 7,a7 "w )
 public heal?1 cl9ical1 & community-bas$
 organizations to provide timely1       
cont9ually updat$ guidance to families &
 heal? c>e provid]s on ways to r$uce    
risk to pregnant & po/p>tum individuals 
& _! newborns & tailor int]v5tions to   
improve _! long-t]m heal?2  7,b7 p>tn] )
 m ,/ate1 ,tribal1 t]ritorial1 & local  
public heal? programs 9 ! collection &  
analysis ( cl9ical data on ! impact (   
public heal? em]g5cies & infecti\s      
diseases t pose a risk to mat]nal &     
infant heal? on pregnant & po/p>tum     
pati5ts & _! newborns1 p>ticul>ly among 
pati5ts f racial & e?nic m9ority gr\ps2 
&  7,c7 e/abli% regionally bas$ c5t]s ( 

excell5ce to (f] m$ical1 public heal?1 &
 o!r k to ensure communities c help     
pregnant & po/p>tum individuals &       
newborns get ! c>e & support !y ne$1    
p>ticul>ly 9 areas ) l>ge populations ( 
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  7#b7 #cj1jjj1jjj = !
 ,enhanc+ ,reviews & ,surveillance to   
,elim9ate ,mat]nal ,mortality program   
7commonly kn[n z ! ,,erase ,,mm program7
 ( ! ,c5t]s = ,disease ,control &       
,prev5tion1 to support ! ,c5t]s =       
,disease ,control & ,prev5tion 9 exp&+  
its p>tn]%ips ) ,/ates & ,indian ,tribes
 & provide te*nical assi/ance to exi/+  
,mat]nal ,mortality ,review ,committees2
  7#c7 #de1jjj1jjj = ! ,pregnancy ,risk 
,assessm5t ,monitor+ ,sy/em 7commonly   
kn[n z ! ,,prams7 ( ! ,c5t]s = ,disease 
,control & ,prev5tion1 to support !     
,c5t]s = ,disease ,control & ,prev5tion 
9 its ef=ts to--  7,a7 create a         

supplem5t to its ,,prams survey relat$  
to public heal? em]g5cies & infecti\s   
diseases t pose a risk to mat]nal &     
infant heal?2  7,b7 add que/ions ar\nd  
exp]i5ces ( respectful mat]nity c>e 9   
pr5atal1 intrap>tum1 & po/p>tum c>e2 &  
7,c7 "w to transition su* ,,prams survey
 to an electronic plat=m & exp& su*     
,,prams survey to a l>g] population1 ) a
 special focus on rea*+ und]repres5t$   
communities1 & o!r program improvem5ts2 
&  7#d7 #ae1jjj1jjj = ! ,national       
,in/itute ( ,*ild ,heal? & ,human       
,developm5t1 to conduct or support      
rese>* = int]v5tions to mitigate !      
effects ( public heal? em]g5cies &      
infecti\s diseases t pose a risk to     
mat]nal & infant heal?1 ) a p>ticul>    
focus on individuals f demographic gr\ps
 ) elevat$ rates ( mat]nal mortality1   
sev]e mat]nal morbidity1 mat]nal heal?  
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4  #aajc4 ,public heal?
 em]g5cy mat]nal heal? data collection &
 disclosure  7a7 ,availability (        

collect$ data ,! ,secret>y1 act+ ?r\gh !
 ,director ( ! ,c5t]s = ,disease        
,control & ,prev5tion & ! ,adm9i/rator (
 ! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1 
%all make publicly available on !       
website ( ! ,c5t]s = ,disease ,control &
 ,prev5tion data describ$ 9 subsection  
7b74  7b7 ,data describ$ ,! data        
describ$ 9 ?is subsection are data      
collect$ ?r\gh ,f$]al surveillance      
sy/ems "u ! ,c5t]s = ,disease ,control &
 ,prev5tion ) respect to public heal?   
em]g5cies & individuals :o are pregnant 
or 9 a po/p>tum p]iod4 ,su* data %all   
include ! foll[+3  7#a7 ,diagno/ic te/+1
 confirm$ cases1 hospitalizations1      
dea?s1 & o!r heal? outcomes relat$ to an
 infecti\s disease outbreak among       
pregnant & po/p>tum individuals4  7#b7  
,mat]nal & infant heal? outcomes among  
individuals :o te/ positive = an        
infecti\s disease dur+ or aft]          
pregnancy4  7c7 ,am]ican ,indian &      
,alaska ,native ,heal? outcomes ,9 c>ry+
 out subsection 7a71 ! ,secret>y %all   

consult ) ,indian ,tribes & conf] )     
,urban ,indian organizations4  7d7      
,disaggregat$ in=mation ,9 c>ry+ out    
subsection 7a71 ! ,secret>y %all        
disaggregate data by race1 e?nicity1    
g5d]1 prim>y language1 geography1       
socioeconomic /atus1 & o!r relevant     
factors4  7e7 ,update ,dur+ public heal?
 em]g5cies1 ! ,secret>y %all update !   
data made available "u ?is section--    
7#a7 at lea/ on a mon?ly basis2 &  7#b7 
n less ?an "o mon? aft] ! end ( su*     
public heal? em]g5cy4  7f7 ,privacy ,9  
c>ry+ out subsection 7a71 ! ,secret>y   
%all--  7#a7 take /eps to protect !     
privacy ( individuals pursuant to       
regulations promulgat$ "u section       
#bfd7;c7 ( ! ,heal? ,insurance          
,portability & ,acc\ntability ,act (    
#aiif 7#db ,u4,s4,c4 #acbj;d-#b note72 &
  7#b7 ensure t--  7,a7 all data        
collect$ is deid5tifi$2  7,b7 at a      
m9imum1 !re is no disclosure ( any      
individually id5tify+ or pot5tially     
id5tify+ in=mation reg>d+ a pati5t or a 

pati5t's heal? c>e provid]2 &  7,c7 all 
data is collect$ 9 a mann] t is consi/5t
 ) applicable ,f$]al & ,/ate privacy    
law4  7g7 ,guidance  7#a7 ,9 g5]al ,n   
lat] ?an #cj days aft] ! decl>ation ( a 
public heal? em]g5cy "u section #cai ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #bdg;d71 ! ,secret>y %all     
issue guidance to ,/ates & local public 
heal? dep>tm5ts to ensure t--  7,a7     
laboratories t te/ specim5s = an        
infecti\s disease receive all relevant  
demographic data on race1 e?nicity1     
pregnancy /atus1 & o!r demographic data 
z det]m9$ by ! ,secret>y2 &  7,b7 data  
describ$ 9 subsection 7b7 are           
disaggregat$ by race1 e?nicity1 g5d]1   
prim>y language1 geography1             
socioeconomic /atus1 & o!r relevant     
factors4  7#b7 ,consultation ,9 c>ry+   
out p>agraph 7#a71 ! ,secret>y %all     
consult ) ,indian ,tribes-- 7,a7 to     
ensure t su* guidance includes tribally 
develop$ be/ practices2 &  7,b7 to r$uce
 misclassification ( ,am]ican ,indians &

 ,alaska ,natives4  #aajd4 ,public heal?
 communication reg>d+ mat]nal c>e dur+  
public heal? em]g5cies ,! ,director ( ! 
,c5t]s = ,disease ,control & ,prev5tion 
%all conduct public heal? education     
campaigns dur+ public heal? em]g5cies to
 ensure t pregnant & po/p>tum           
individuals1 _! employ]s1 & _! heal? c>e
 provid]s h accurate1 evid5ce-bas$      
in=mation on mat]nal & infant heal?     
risks dur+ ! public heal? em]g5cy1 ) a  
p>ticul> focus on rea*+ pregnant &      
po/p>tum individuals 9 und]s]v$         
communities4  #aaje4 ,task =ce on bir?+ 
exp]i5ce & safe1 respectful1 responsive1
 & emp[]+ mat]nity c>e dur+ public heal?
 em]g5cies  7a7 ,e/abli%m5t ,!          
,secret>y1 9 consultation ) ! ,director 
( ! ,c5t]s = ,disease ,control &        
,prev5tion & ! ,adm9i/rator ( ! ,heal?  
,res\rces & ,s]vices ,adm9i/ration1 %all
 conv5e a task =ce 79 ?is subsection    
ref]r$ to z ! ,task ,=ce7 to develop    
,f$]al recomm5dations reg>d+ respectful1
 responsive1 & emp[]+ mat]nity c>e1     

includ+ safe bir? c>e & po/p>tum c>e1   
dur+ public heal? em]g5cies4  7b7       
,duties ,! ,task ,=ce %all develop1     
publicly po/1 & update ,f$]al           
recomm5dations 9 multiple languages to  
ensure high-quality1 nondiscrim9atory   
mat]nity c>e1 promote positive bir?+    
exp]i5ces1 & improve mat]nal heal?      
outcomes dur+ public heal? em]g5cies1 ) 
a p>ticul> focus on outcomes =          
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4 ,su* recomm5dations  
%all--  7#a7 address1 ) p>ticul>        
att5tion to ensur+ equitable treatm5t on
 ! basis ( race & e?nicity-- 7,a7       
measures to facilitate respectful1      
responsive1 & emp[]+ mat]nity c>e2  7,b7
 measures to facilitate teleheal?       
mat]nity c>e = pregnant individuals :o  
_c regul>ly access 9-p]son c>e2  7,c7   
/rategies to increase access to         
specializ$ c>e = ^? ) high-risk         

pregnancies or pregnant individuals )   
elevat$ risk factors2  7,d7 diagno/ic   
te/+ = pregnant & labor+ pati5ts2  7,e7 
bir?+ )\t "o's *os5 companions1 ) "o's  
*os5 companions1 & ) sm>tphone or o!r   
teleheal? connection to "o's *os5       
companions2  7,f7 newborn sep>ation aft]
 bir? 9 relation to mat]nal infection   
/atus2  7,g7 brea/ milk fe$+ 9 relation 
to mat]nal infection /atus2  7,h7       
lic5sure1 tra9+1 scope ( practice1 &    
,m$icaid & o!r insurance reimbursem5t = 
c]tifi$ midwives1 c]tifi$               
nurse-midwives1 & c]tifi$ pr(essional   
midwives1 :o meet1 at a m9imum1 !       
int]national def9ition ( a midwife &    
global /&>ds = midwif]y education1 z    
e/abli%$ by ! ,int]national ,conf$]ation
 ( ,midwives1 9 a mann] t facilitates   
inclusion ( midwives ( color & midwives 
f und]s]v$ communities2  7,i7 f9ancial  
support & tra9+ = p]9atal heal? work]s  
:o provide noncl9ical support to        
individuals f pregnancy ?r\gh ! po/p>tum
 p]iod 9 a mann] t facilitates inclusion

 f und]s]v$ communities2  7,j7 /rategies
 to ensure & exp& d\la cov]age "u ,/ate 
,m$icaid programs2  7,k7 h[ to id5tify1 
address1 & treat pr5atal & po/p>tum     
m5tal & behavioral heal? conditions1 su*
 z anxiety1 sub/ance use disord]1 &     
depression1 dur+ public heal? em]g5cies2
  7,l7 h[ to id5tify & address in/ances 
( intimate p>tn] viol5ce dur+ pregnancy 
:i* may arise or int5sify dur+ public   
heal? em]g5cies2  7,m7 /rategies to     
address hospital capacity conc]ns 9     
communities ) a surge 9 infecti\s       
disease cases & to provide *ildbe>+     
individuals ) options t r$uce ! pot5tial
 = cross-contam9ation & increase !      
ability to implem5t _! c>e pref]5ces    
:ile ma9ta9+ safety & quality1 su* z !  
use ( free/&+ bir? c5t]s2  7,n7         
provision ( *ild c>e s]vices dur+       
pr5atal & po/p>tum appo9tm5ts = mo!rs ^:
 *ildr5 are unable to att5d z a result (
 re/rictions relat+ to ! public heal?   
em]g5cies2  7,o7 h[ to id5tify & address
 racism1 bias1 & discrim9ation 9 !      

deliv]y ( mat]nity c>e s]vices to       
pregnant & po/p>tum individuals1 includ+
 evaluat+ ! value ( tra9+ = hospital    
/aff on implicit bias & racism1         
respectful1 responsive1 & emp[]+        
mat]nity c>e1 & demographic data        
collection2  7,p7 h[ to address ! ne$s (
 undocum5t$ pregnant individuals & new  
mo!rs :o may be afraid or unable to seek
 ne$$ c>e dur+ ! ,,covid-#ai public     
heal? em]g5cy2  7,q7 h[ to address !    
ne$s ( un9sur$ & und]9sur$ pregnant     
individuals :o h hi/orically reli$ on   
em]g5cy dep>tm5ts = c>e2  7,r7 h[ to    
id5tify pregnant & po/p>tum individuals 
at risk = depression1 anxiety disord]1  
psy*osis1 obsessive-compulsive disord]1 
& o!r mat]nal mood disord]s be=e1 dur+1 
& aft] pregnancy1 & h[ to treat ^?      
diagnos$ ) a pr5atal or po/p>tum mood   
disord]2  7,s7 h[ to effectively &      
compassionately scre5 = sub/ance use    
disord] dur+ pregnancy & po/p>tum & help
 pregnant & po/p>tum individuals f9d    
support & effective treatm5t2  7,t7 h[  

to ensure access to infant nutrition    
dur+ public heal? em]g5cies2 &  7,u7 su*
 o!r matt]s z ! ,task ,=ce det]m9es     
appropriate2  7#b7 id5tify b>ri]s to !  
implem5tation ( ! recomm5dations2  7#c7 
take into consid]ation exi/+ ,/ate & o!r
 programs t h demon/rat$ effectiv5ess 9 
address+ pregnancy1 bir?1 & po/p>tum c>e
 dur+ public heal? em]g5cies2 &  7#d7   
id5tify policies specific to public     
heal? em]g5cies t %\ld be discont9u$ :5 
safely possible & ^? t %\ld be cont9u$ z
 ! public heal? em]g5cy abates4  7c7    
,memb]%ip ,! ,secret>y %all appo9t !    
memb]s ( ! ,task ,=ce4 ,su* memb]s %all 
be compris$ (--  7#a7 repres5tatives ( !
 ,dep>tm5t ( ,heal? & ,human ,s]vices1  
includ+ repres5tatives (-- 7,a7 !       
,secret>y2  7,b7 ! ,director ( ! ,c5t]s 
= ,disease ,control & ,prev5tion2  7,c7 
! ,adm9i/rator ( ! ,heal? ,res\rces &   
,s]vices ,adm9i/ration2  7,d7 !         
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices2  7,e7 ! ,director ( !
 ,ag5cy = ,heal?c>e ,rese>* & ,quality2 

7,f7 ! ,commission] ( ,food & ,drugs2   
7,g7 ! ,assi/ant ,secret>y = ,m5tal     
,heal? & ,sub/ance ,use2 &  7,h7 !      
,director ( ! ,indian ,heal? ,s]vice2   
7#b7 at lea/ #c ,/ate1 local1 or        
t]ritorial public heal? (ficials        
repres5t+ dep>tm5ts ( public heal?1 :o  
%all repres5t jurisdictions f diff]5t   
regions ( ! ,unit$ ,/ates ) relatively  
high conc5trations ( hi/orically        
m>g9aliz$ populations2  7#c7 at lea/ #a 
,tribal public heal? (ficial repres5t+  
dep>tm5ts ( public heal?2  7#d7 #a or m 
repres5tatives ( community-bas$         
organizations t address adv]se mat]nal  
heal? outcomes ) a specific focus on    
racial & e?nic inequities 9 mat]nal     
heal? outcomes1 ) special consid]ation  
giv5 to repres5tatives ( su*            
organizations t are l$ by a p]son (     
color or f communities ) significant    
m9ority populations2  7#e7 a            
pr(essionally div]se panel ( mat]nity   
c>e provid]s & p]9atal heal? work]s2    
7#f7 #a or m pati5ts :o 7 pregnant or   

gave bir? dur+ ! ,,covid-#ai public     
heal? em]g5cy or a subsequ5t public     
heal? em]g5cy2  7#g7 #a or m pati5ts :o 
h receiv$ support f a p]9atal heal?     
work]2 &  7#h7 racially & e?nically     
div]se repres5tation f at lea/ #c       
indep5d5t exp]ts ) k or field exp]i5ce )
 racial & e?nic disp>ities 9 public     
heal?1 wom5's heal?1 or mat]nal         
mortality & sev]e mat]nal morbidity4    
,,xii ,protect+ moms & babies aga9/     
climate *ange  #abja4 ,def9itions ,9 ?is
 title1 ! foll[+ def9itions apply3 7#a7 
,adv]se mat]nal & infant heal? outcomes 
,! t]m adv]se mat]nal & infant heal?    
outcomes includes ! outcomes ( pret]m   
bir?1 l[ bir? weight1 /illbir?1 infant  
or mat]nal mortality1 & sev]e mat]nal   
morbidity4  7#b7 ,in/itution ( high]    
education ,! t]m in/itution ( high]     
education has ! mean+ giv5 su* t]m 9    
section #aja ( ! ,high] ,education ,act 
( #aife 7#bj ,u4,s4,c4 #ajja74  7#c7    
,m9ority-s]v+ in/itution ,! t]m         
m9ority-s]v+ in/itution means an entity 

specifi$ 9 any ( p>agraphs 7#a7 ?r\gh   
7#g7 ( section #cga7;a7 ( ! ,high]      
,education ,act ( #aife 7#bj ,u4,s4,c4  
#ajfgq7a774  7#d7 ,risks associat$ )    
climate *ange ,! t]m risks associat$ )  
climate *ange includes risks associat$ )
 extreme heat1 air pollution1 extreme   
wea!r ev5ts1 & o!r environm5tal issues  
associat$ ) climate *ange t c result 9  
adv]se mat]nal & infant heal? outcomes4 
7#e7 ,secret>y ,! t]m ,secret>y means ! 
,secret>y ( ,heal? & ,human ,s]vices4   
7#f7 ,/akehold] organization ,! t]m     
/akehold] organization means-- 7,a7 a   
community-bas$ organization ) exp]tise 9
 provid+ assi/ance to vuln]able         
individuals2  7,b7 a nonpr(it           
organization ) exp]tise 9-- 7i7 mat]nal 
or infant heal?2 or  7ii7 environm5tal  
or climate ju/ice2 &  7,c7 a pati5t     
advocacy organization repres5t+         
vuln]able individuals4  7#g7 ,vuln]able 
individual ,! t]m vuln]able individual  
means-- 7,a7 an individual :o is        
pregnant2  7,b7 an individual :o 0      

pregnant dur+ any portion ( ! prec$+    
#a-ye> p]iod2 &  7,c7 an individual "u  
#c ye>s ( age4  #abjb4 ,grant program to
 protect vuln]able mo!rs & babies f     
climate *ange risks  7a7 ,9 g5]al ,n    
lat] ?an #ahj days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y %all   
e/abli% a grant program to protect      
vuln]able individuals f risks associat$ 
) climate *ange4  7b7 ,grant au?ority ,9
 c>ry+ out ! ,program1 ! ,secret>y may  
aw>d1 on a competitive basis1 grants to 
#aj cov]$ entities4  7c7 ,applications  
,to be eligible = a grant "u ! ,program1
 a cov]$ entity %all submit to !        
,secret>y an application at su* "t1 9   
su* =m1 & conta9+ su* in=mation z !     
,secret>y may require1 :i* %all include1
 at a m9imum1 a description ( ! foll[+3 
7#a7 ,plans = ! use ( grant funds aw>d$ 
"u ! ,program & h[ pati5ts & /akehold]  
organizations 7 involv$ 9 ! developm5t (
 su* plans4  7#b7 ,h[ su* grant funds w 
be t>get$ to geographic areas t h       
disproportionately high levels ( risks  

associat$ ) climate *ange = vuln]able   
individuals4  7#c7 ,h[ su* grant funds w
 be us$ to address racial & e?nic       
disp>ities 9--  7,a7 adv]se mat]nal &   
infant heal? outcomes2 &  7,b7 exposure 
to risks associat$ ) climate *ange =    
vuln]able individuals4  7#d7 ,/rategies 
to prev5t an initiative assi/$ ) su*    
grant funds f caus+-- 7,a7 adv]se       
environm5tal impacts2  7,b7 displacem5t 
( resid5ts & bus9esses2  7,c7 r5t & h\s+
 price increases2 or  7,d7              
disproportionate adv]se impacts on      
racial & e?nic m9ority gr\ps & o!r      
und]s]v$ populations4  7d7 ,selection ( 
grant recipi5ts  7#a7 ,tim+ ,n lat] ?an 
#bgj days aft] ! date ( enactm5t ( ?is  
,act1 ! ,secret>y %all select !         
recipi5ts ( grants "u ! ,program4  7#b7 
,consultation ,9 select+ cov]$ entities 
= grants "u ! ,program1 ! ,secret>y %all
 consult )-- 7,a7 repres5tatives (      
/akehold] organizations2  7,b7 !        
,adm9i/rator ( ! ,environm5tal          
,protection ,ag5cy2  7,c7 ! ,adm9i/rator

 ( ! ,national ,oceanic & ,atmosph]ic   
,adm9i/ration2 &  7,d7 f ! ,dep>tm5t (  
,heal? & ,human ,s]vices-- 7i7 ! ,deputy
 ,assi/ant ,secret>y = ,m9ority ,heal?2 
7ii7 ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e
  ,m$icaid ,s]vices2  7iii7 !           
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration2  7iv7 !         
,director ( ! ,national ,in/itutes (    
,heal?2 &  7v7 ! ,director ( ! ,c5t]s = 
,disease ,control & ,prev5tion4  7#c7   
,priority ,9 select+ grantees "u !      
,program1 ! ,secret>y %all give priority
 to cov]$ entities t s]ve a c\nty or    
locality-- 7,a7 designat$1 or locat$ 9  
an area designat$1 z a nonatta9m5t area 
pursuant to section #ajg ( ! ,clean ,air
 ,act 7#db ,u4,s4,c4 #gdjg7 = any air   
pollutant = :i* air quality crit]ia h   
be5 issu$ "u section #ajh7;a7 ( su* ,act
 7#db ,u4,s4,c4 #gdjh7;a772  7,b7 ) a   
level ( vuln]ability ( mod]ate-to-high  
or high]1 accord+ to ! ,social          
,vuln]ability ,index ( ! ,c5t]s =       
,disease ,control & ,prev5tion1 or a    

simil> rat+ ( social vuln]ability       
accord+ to relat$ ,f$]al mapp+ tools2   
7,c7 ) temp]atures t pose a risk to     
human heal?1 z det]m9$ by ! ,secret>y1 9
 consultation ) ! ,adm9i/rator ( !      
,national ,oceanic & ,atmosph]ic        
,adm9i/ration & ! ,*air ( ! ,unit$      
,/ates ,global ,*ange ,rese>* ,program1 
bas$ on ! be/ available sci5ce2  7,d7 ) 
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  7,e7 ) a rat+ ( v   
high or relatively high risk accord+ to 
! ,national ,risk ,index = ,natural     
,haz>ds ( ! ,f$]al ,em]g5cy ,managem5t  
,ag5cy2 or  7,f7 ) o!r climate-s5sitive 
haz>ds ) associations to adv]se mat]nal 
or infant heal? outcomes1 z det]m9$ by !
 ,secret>y4  7#d7 ,limitation ,a        
recipi5t ( grant funds "u ! ,program may
 n use su* grant funds to s]ve a c\nty  
or locality t is s]v$ by any o!r        
recipi5t ( a grant "u ! ,program4  7e7  
,use ( funds ,a cov]$ entity aw>d$ grant

 funds "u ! ,program may only use su*   
grant funds = ! foll[+3 7#a7            
,initiatives to id5tify risks associat$ 
) climate *ange = vuln]able individuals 
& to provide s]vices & support to su*   
individuals t address su* risks1 :i* may
 include--  7,a7 tra9+ = heal? c>e      
provid]s1 p]9atal heal? work]s1 & o!r   
employees 9 hospitals1 bir? c5t]s1      
midwif]y practices1 & o!r heal? c>e     
practices t provide pr5atal or labor &  
deliv]y s]vices to vuln]able individuals
 on ! id5tification (1 & pati5t c\nsel+ 
relat+ to1 risks associat$ ) climate    
*ange = vuln]able individuals2  7,b7    
hir+1 tra9+1 or provid+ res\rces to     
p]9atal heal? work]s :o c help id5tify  
risks associat$ ) climate *ange =       
vuln]able individuals1 provide pati5t   
c\nsel+ ab\t su* risks1 & c>ry out !    
di/ribution ( relevant s]vices &        
support2  7,c7 enhanc+ ! monitor+ (     
risks associat$ ) climate *ange =       
vuln]able individuals1 includ+ by-- 7i7 
collect+ data on su* risks 9 specific   

c5sus tracts1 neighborhoods1 or o!r     
geographic areas2 &  7ii7 %>+ su* data )
 local heal? c>e provid]s1 p]9atal heal?
 work]s1 & o!r employees 9 hospitals1   
bir? c5t]s1 midwif]y practices1 & o!r   
heal? c>e practices t provide pr5atal or
 labor & deliv]y s]vices to local       
vuln]able individuals2 &  7,d7 provid+  
vuln]able individuals--  7i7 air        
condition+ units1 resid5tial            
wea!rization support1 filtration sy/ems1
 h\sehold appliances1 or relat$ items2  
7ii7 direct f9ancial assi/ance2 &  7iii7
 s]vices & support1 includ+ h\s+        
assi/ance1 evacuation assi/ance1        
transportation assi/ance1 access to     
cool+ %elt]s1 & m5tal heal? c\nsel+1 to 
prep>e = or recov] f extreme wea!r      
ev5ts1 :i* may include floods1          
hurricanes1 wildfires1 dr\ghts1 & relat$
 ev5ts4  7#b7 ,initiatives to mitigate  
levels ( & exposure to risks associat$ )
 climate *ange = vuln]able individuals1 
:i* %all be bas$ on ! be/ available     
sci5ce & :i* may include initiatives    

to--  7,a7 develop1 ma9ta91 or exp&     
urban or community =e/ry initiatives &  
tree canopy cov]age initiatives2  7,b7  
improve infra/ructure1 su* z build+s &  
pav$ surfaces2  7,c7 develop or improve 
community outrea* networks to provide   
culturally & l+ui/ically appropriate    
in=mation & notifications ab\t risks    
associat$ ) climate *ange = vuln]able   
individuals2 &  7,d7 provide enhanc$    
s]vices to racial & e?nic m9ority gr\ps 
& o!r und]s]v$ populations4  7f7 ,l5g? (
 aw>d ,a grant "u ?is section %all be   
disburs$ ov] #d fiscal ye>s4  7g7       
,te*nical assi/ance ,! ,secret>y %all   
provide te*nical assi/ance to a cov]$   
entity aw>d$ a grant "u ! ,program to   
support ! developm5t1 implem5tation1 &  
evaluation ( activities fund$ ) su*     
grant4  7h7 ,reports to ,secret>y  7#a7 
,annual report ,= ea* fiscal ye> dur+   
:i* a cov]$ entity is disburs$ grant    
funds "u ! ,program1 su* cov]$ entity   
%all submit to ! ,secret>y a report t   
summ>izes ! activities c>ri$ out by su* 

cov]$ entity ) su* grant funds dur+ su* 
fiscal ye>1 :i* %all include a          
description ( ! foll[+3 7,a7 ,!         
involvem5t ( /akehold] organizations 9 !
 implem5tation ( initiatives assi/$ )   
su* grant funds4  7,b7 ,relevant heal? &
 environm5tal data1 disaggregat$1 to !  
ext5t practicable1 by race1 e?nicity1   
prim>y language1 socioeconomic /atus1   
geography1 insurance type1 pregnancy    
/atus1 & o!r relevant demographic       
in=mation4  7,c7 ,qualitative fe$back   
receiv$ f vuln]able individuals )       
respect to initiatives assi/$ ) su*     
grant funds4  7,d7 ,crit]ia us$ 9       
select+ ! geographic areas assi/$ ) su* 
grant funds4  7,e7 ,ef=ts to address    
racial & e?nic disp>ities 9 adv]se      
mat]nal & infant heal? outcomes & 9     
exposure to risks associat$ ) climate   
*ange = vuln]able individuals4  7,f7    
,any negative & un9t5d$ impacts (       
initiatives assi/$ ) su* grant funds1   
includ+-- 7i7 adv]se environm5tal       
impacts2  7ii7 displacem5t ( resid5ts & 

bus9esses2  7iii7 r5t & h\s+ price      
increases2 &  7iv7 disproportionate     
adv]se impacts on racial & e?nic m9ority
 gr\ps & o!r und]s]v$ populations4  7,g7
 ,h[ ! cov]$ entity w address & prev5t  
any impacts describ$ 9 subp>agraph 7,f74
  7#b7 ,publication ,n lat] ?an #cj days
 aft] ! date on :i* a report is submitt$
 "u p>agraph 7#a71 ! ,secret>y %all     
publi% su* report on a public website ( 
! ,dep>tm5t ( ,heal? & ,human ,s]vices4 
7i7 ,report to ,congress ,n lat] ?an !  
date t is #e ye>s aft] ! date on :i* !  
,program is e/abli%$1 ! ,secret>y %all  
submit to ,congress & publi% on a public
 website ( ! ,dep>tm5t ( ,heal? & ,human
 ,s]vices a report on ! results ( !     
,program1 includ+ ! foll[+3  7#a7       
,summ>ies ( ! annual reports submitt$ "u
 subsection 7h74  7#b7 ,evaluations ( ! 
initiatives assi/$ ) grant funds "u !   
,program4  7#c7 ,an assessm5t ( !       
effectiv5ess ( ! ,program 9-- 7,a7      
id5tify+ risks associat$ ) climate *ange
 = vuln]able individuals2  7,b7 provid+ 

s]vices & support to su* individuals2   
7,c7 mitigat+ levels ( & exposure to su*
 risks2 &  7,d7 address+ racial & e?nic 
disp>ities 9 adv]se mat]nal & infant    
heal? outcomes & 9 exposure to su*      
risks4  7#d7 ,a description ( h[ !      
,program c\ld be exp&$1 includ+--  7,a7 
monitor+ ef=ts or data collection t w\ld
 be requir$ to id5tify areas ) high     
levels ( risks associat$ ) climate *ange
 = vuln]able individuals2  7,b7 h[ su*  
areas c\ld be id5tifi$ us+ ! /rategy    
develop$ "u section #abje2 &  7,c7      
recomm5dations = additional fund+4  7j7 
,def9itions ,9 ?is section3  7#a7 ,! t]m
 cov]$ entity means a consortium (      
organizations s]v+ a c\nty t-- 7,a7 %all
 include a community-bas$ organization2 
&  7,b7 may include-- 7i7 ano!r         
/akehold] organization2  7ii7 ! gov]nm5t
 ( su* c\nty2  7iii7 ! gov]nm5ts ( "o or
 m municipalities )9 su* c\nty2  7iv7 a 
,/ate or local public heal? dep>tm5t or 
em]g5cy managem5t ag5cy2  7v7 a local   
heal? c>e practice1 :i* may include a   

lic5s$ & accr$it$ hospital1 bir? c5t]1  
midwif]y practice1 or o!r heal? c>e     
practice t provides pr5atal or labor &  
deliv]y s]vices to vuln]able            
individuals2  7vi7 an ,indian tribe or  
,tribal organization 7z su* t]ms are    
def9$ 9 section #d ( ! ,indian          
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd772 
7vii7 an ,urban ,indian organization 7z 
def9$ 9 section #d ( ! ,indian ,heal?   
,c>e ,improvem5t ,act 7#be ,u4,s4,c4    
#afjc772 &  7viii7 an in/itution ( high]
 education4  7#b7 ,! t]m ,program means 
! grant program "u ?is section4  7k7    
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section #ajj1jjj1jjj = ! p]iod (    
fiscal ye>s #bjbg ?r\gh #bjcj4  #abjc4  
,grant program = education & tra9+ at   
heal? pr(ession s*ools  7a7 ,9 g5]al ,n 
lat] ?an #a ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 ! ,secret>y ( ,heal? &     
,human ,s]vices %all e/abli% a grant    
program to provide funds to heal?       

pr(ession s*ools to support ! developm5t
 & integration ( education & tra9+      
programs = id5tify+ & address+ risks    
associat$ ) climate *ange = vuln]able   
individuals4  7b7 ,grant au?ority ,9    
c>ry+ out ! ,program1 ! ,secret>y may   
aw>d1 on a competitive basis1 grants to 
heal? pr(ession s*ools4  7c7            
,application ,to be eligible = a grant  
"u ! ,program1 a heal? pr(ession s*ool  
%all submit to ! ,secret>y an           
application at su* "t1 9 su* =m1 &      
conta9+ su* in=mation z ! ,secret>y may 
require1 :i* %all include1 at a m9imum1 
a description ( ! foll[+3  7#a7 ,h[ su* 
heal? pr(ession s*ool w engage )        
vuln]able individuals1 & /akehold]      
organizations repres5t+ su* individuals1
 9 develop+ & implem5t+ ! education &   
tra9+ programs support$ by grant funds  
aw>d$ "u ! ,program4  7#b7 ,h[ su* heal?
 pr(ession s*ool w ensure t su*         
education & tra9+ programs w address    
racial & e?nic disp>ities 9 exposure to1
 & ! effects (1 risks associat$ )       

climate *ange = vuln]able individuals4  
7d7 ,use ( funds ,a heal? pr(ession     
s*ool aw>d$ a grant "u ! ,program %all  
use ! grant funds to develop1 &         
integrate into ! curriculum & cont9u+   
education ( su* heal? pr(ession s*ool1  
education & tra9+ on ea* ( ! foll[+3    
7#a7 ,id5tify+ risks associat$ ) climate
 *ange = vuln]able individuals &        
individuals ) ! int5t to become         
pregnant4  7#b7 ,h[ risks associat$ )   
climate *ange affect vuln]able          
individuals & individuals ) ! int5t to  
become pregnant4  7#c7 ,racial & e?nic  
disp>ities 9 exposure to1 & ! effects (1
 risks associat$ ) climate *ange =      
vuln]able individuals & individuals ) ! 
int5t to become pregnant4  7#d7 ,pati5t 
c\nsel+ & mitigation /rategies relat+ to
 risks associat$ ) climate *ange =      
vuln]able individuals4  7#e7 ,relevant  
s]vices & support = vuln]able           
individuals relat+ to risks associat$ ) 
climate *ange & /rategies = ensur+      
vuln]able individuals h access to su*   

s]vices & support4  7#f7 ,implicit &    
explicit bias1 racism1 & discrim9ation4 
7#g7 ,relat$ topics id5tifi$ by su*     
heal? pr(ession s*ool bas$ on !         
engagem5t ( su* heal? pr(ession s*ool ) 
vuln]able individuals & /akehold]       
organizations repres5t+ su* individuals4
  7e7 ,p>tn]%ips ,9 c>ry+ out activities
 ) grant funds1 a heal? pr(ession s*ool 
aw>d$ a grant "u ! ,program may p>tn] ) 
"o or m ( ! foll[+3 7#a7 ,a ,/ate or    
local public heal? dep>tm5t4  7#b7 ,a   
heal? c>e pr(essional memb]%ip          
organization4  7#c7 ,a /akehold]        
organization4  7#d7 ,a heal? pr(ession  
s*ool4  7#e7 ,an in/itution ( high]     
education4  7f7 ,reports to ,secret>y   
7#a7 ,annual report ,= ea* fiscal ye>   
dur+ :i* a heal? pr(ession s*ool is     
disburs$ grant funds "u ! ,program1 su* 
heal? pr(ession s*ool %all submit to !  
,secret>y a report t describes !        
activities c>ri$ out ) su* grant funds  
dur+ su* fiscal ye>4  7#b7 ,f9al report 
,n lat] ?an ! date t is #a ye> aft] !   

end ( ! la/ fiscal ye> dur+ :i* a heal? 
pr(ession s*ool is disburs$ grant funds 
"u ! ,program1 ! heal? pr(ession s*ool  
%all submit to ! ,secret>y a f9al report
 t summ>izes ! activities c>ri$ out )   
su* grant funds4  7g7 ,report to        
,congress ,n lat] ?an ! date t is #f    
ye>s aft] ! date on :i* ! ,program is   
e/abli%$1 ! ,secret>y %all submit to    
,congress & publi% on a public website (
 ! ,dep>tm5t ( ,heal? & ,human ,s]vices 
a report t includes ! foll[+3 7#a7 ,a   
summ>y ( ! reports submitt$ "u          
subsection 7f74  7#b7 ,recomm5dations to
 improve education & tra9+ programs at  
heal? pr(ession s*ools ) respect to     
id5tify+ & address+ risks associat$ )   
climate *ange = vuln]able individuals4  
7h7 ,def9itions ,9 ?is section3  7#a7 ,!
 t]m heal? pr(ession s*ool means an     
accr$it$-- 7,a7 m$ical s*ool2  7,b7     
s*ool ( nurs+2  7,c7 midwif]y program2  
7,d7 physician assi/ant education       
program2  7,e7 tea*+ hospital2  7,f7    
resid5cy or fell[%ip program2 or  7,g7  

o!r s*ool or program det]m9$ appropriate
 by ! ,secret>y4  7#b7 ,! t]m ,program  
means ! grant program "u ?is section4   
7i7 ,au?orization ( ,appropriations ,!re
 is au?oriz$ to be appropriat$ to c>ry  
out ?is section #e1jjj1jjj = ! p]iod (  
fiscal ye>s #bjbg ?r\gh #bjcj4  #abjd4  
,,nih ,consortium on ,bir? & ,climate   
,*ange ,rese>*  7a7 ,e/abli%m5t ,n lat] 
?an "o ye> aft] ! date ( ! enactm5t (   
?is ,act1 ! ,director ( ! ,national     
,in/itutes ( ,heal? %all e/abli% !      
,consortium on ,bir? & ,climate ,*ange  
,rese>* 79 ?is section ref]r$ to z !    
,consortium74  7b7 ,duties  7#a7 ,9     
g5]al ,! ,consortium %all coord9ate1    
across ! in/itutes1 c5t]s1 & (fices ( ! 
,national ,in/itutes ( ,heal?1 rese>* on
 ! risks associat$ ) climate *ange =    
vuln]able individuals4  7#b7 ,requir$   
activities ,9 c>ry+ out p>agraph 7#a71 !
 ,consortium %all-- 7,a7 e/abli% rese>* 
priorities1 includ+ by prioritiz+ rese>*
 t--  7i7 id5tifies ! risks associat$ ) 
climate *ange = vuln]able individuals ) 

a p>ticul> focus on disp>ities 9 su*    
risks among racial & e?nic m9ority gr\ps
 & o!r und]s]v$ populations2 &  7ii7    
id5tifies /rategies to r$uce levels (1 &
 exposure to1 su* risks1 ) a p>ticul>   
focus on risks among racial & e?nic     
m9ority gr\ps & o!r und]s]v$            
populations2  7,b7 id5tify gaps 9       
available data relat$ to su* risks2     
7,c7 id5tify gaps 91 & opportunities =1 
rese>* collaborations2  7,d7 id5tify    
fund+ opportunities = community-bas$    
organizations & rese>*]s f racially1    
e?nically1 & geographically div]se      
backgr\nds2  7,e7 id5tify opportunities 
to increase public aw>5ess relat$ to    
risks associat$ ) climate *ange =       
vuln]able individuals2 &  7,f7 publi%   
annual reports on ! "w & f9d+s ( !      
,consortium on a public website ( !     
,national ,in/itutes ( ,heal?4  7c7     
,memb]%ip ,! ,director %all appo9t to ! 
,consortium repres5tatives ( su*        
in/itutes1 c5t]s1 & (fices ( ! ,national
 ,in/itutes ( ,heal? z ! ,director      

consid]s appropriate1 includ+1 at a     
m9imum1 repres5tatives (--  7#a7 !      
,national ,in/itute ( ,environm5tal     
,heal? ,sci5ces2  7#b7 ! ,national      
,in/itute on ,m9ority ,heal? & ,heal?   
,disp>ities2  7#c7 ! ,eunice ,k5n$y     
,%riv] ,national ,in/itute ( ,*ild      
,heal? & ,human ,developm5t2  7#d7 !    
,national ,in/itute ( ,m5tal ,heal?2    
7#e7 ! ,national ,in/itute ( ,nurs+     
,rese>*2 &  7#f7 ! ,(fice ( ,rese>* on  
,wom5's ,heal?4  7d7 ,*airp]son ,!      
,*airp]son ( ! ,consortium %all be      
designat$ by ! ,director & select$ f    
among ! repres5tatives appo9t$ "u       
subsection 7c74  7e7 ,consultation ,9   
c>ry+ out ! duties describ$ 9 subsection
 7b71 ! ,consortium %all consult )--    
7#a7 ! heads ( relevant ,f$]al ag5cies1 
includ+-- 7,a7 ! ,environm5tal          
,protection ,ag5cy2  7,b7 ! ,national   
,oceanic & ,atmosph]ic ,adm9i/ration2   
7,c7 ! ,occupational ,safety & ,heal?   
,adm9i/ration2 &  7,d7 f ! ,dep>tm5t (  
,heal? & ,human ,s]vices-- 7i7 ! ,(fice 

( ,m9ority ,heal? 9 ! ,(fice ( !        
,secret>y2  7ii7 ! ,c5t]s = ,m$ic>e     
,m$icaid ,s]vices2  7iii7 ! ,heal?      
,res\rces & ,s]vices ,adm9i/ration2     
7iv7 ! ,c5t]s = ,disease ,control &     
,prev5tion2  7v7 ! ,indian ,heal?       
,s]vice2 &  7vi7 ! ,adm9i/ration =      
,*ildr5 & ,families2 &  7#b7            
repres5tatives (--  7,a7 /akehold]      
organizations2  7,b7 heal? c>e provid]s 
& pr(essional memb]%ip organizations )  
exp]tise 9 mat]nal heal? or environm5tal
 ju/ice2  7,c7 ,/ate & local public     
heal? dep>tm5ts2  7,d7 lic5s$ & accr$it$
 hospitals1 bir? c5t]s1 midwif]y        
practices1 or o!r heal? c>e practices t 
provide pr5atal or labor & deliv]y      
s]vices to vuln]able individuals2 &     
7,e7 in/itutions ( high] education1     
includ+ su* in/itutions t are           
m9ority-s]v+ in/itutions or h exp]tise 9
 mat]nal heal? or environm5tal ju/ice4  
#abje4 ,/rategy = id5tify+ climate *ange
 risk zones = vuln]able mo!rs & babies  
7a7 ,9 g5]al ,! ,secret>y ( ,heal? &    

,human ,s]vices1 act+ ?r\gh ! ,director 
( ! ,c5t]s = ,disease ,control &        
,prev5tion1 %all develop a /rategy 79   
?is section ref]r$ to z ! ,/rategy7 =   
designat+ areas t ! ,secret>y det]m9es  
to h a high risk ( adv]se mat]nal &     
infant heal? outcomes among vuln]able   
individuals z a result ( risks associat$
 ) climate *ange4  7b7 ,/rategy         
requirem5ts  7#a7 ,9 g5]al ,9 develop+ !
 ,/rategy1 ! ,secret>y %all e/abli% a   
process to id5tify areas :]e vuln]able  
individuals are expos$ to a high risk ( 
adv]se mat]nal & infant heal? outcomes z
 a result ( risks associat$ ) climate   
*ange 9 conjunction ) o!r factors t c   
impact su* heal? outcomes1 includ+--    
7,a7 ! incid5ce ( diseases associat$ )  
air pollution1 extreme heat1 & o!r      
environm5tal factors2  7,b7 !           
availability & accessibility ( mat]nal &
 infant heal? c>e provid]s2  7,c7       
,engli%-language pr(ici5cy among wom5 ( 
reproductive age2  7,d7 ! heal?         
insurance /atus ( wom5 ( reproductive   

age2  7,e7 ! numb] ( wom5 ( reproductive
 age :o are memb]s ( racial or e?nic    
gr\ps ) disproportionately high rates ( 
adv]se mat]nal & infant heal? outcomes2 
7,f7 ! socioeconomic /atus ( wom5 (     
reproductive age1 includ+ ) respect to--
 7i7 pov]ty2  7ii7 unemploym5t2  7iii7  
h\sehold income2 &  7iv7 educational    
atta9m5t2 &  7,g7 access to quality     
h\s+1 transportation1 & nutrition4  7#b7
 ,res\rces ,9 develop+ ! ,/rategy1 !    
,secret>y %all id5tify1 & incorporate a 
description (1 ! foll[+3 7,a7 ,exi/+    
mapp+ tools or ,f$]al programs t        
id5tify--  7i7 risks associat$ ) climate
 *ange = vuln]able individuals2 &  7ii7 
o!r factors t c influ5ce mat]nal &      
infant heal? outcomes1 includ+ ! factors
 describ$ 9 p>agraph 7#a74  7,b7        
,environm5tal1 heal?1 socioeconomic1 &  
demographic data relevant to id5tify+   
risks associat$ ) climate *ange =       
vuln]able individuals4  7,c7 ,exi/+     
monitor+ networks t collect data        
describ$ 9 subp>agraph 7,b71 & any gaps 

9 su* networks4  7,d7 ,f$]al1 ,/ate1 &  
local /akehold]s involv$ 9 ma9ta9+      
monitor+ networks id5tifi$ "u           
subp>agraph 7,c71 & h[ su* /akehold]s   
are coord9at+ _! monitor+ ef=ts4  7,e7  
,additional monitor+ networks1 &        
enhancem5ts to exi/+ monitor+ networks1 
t w\ld be requir$ to address gaps       
id5tifi$ "u subp>agraph 7,c71 includ+ at
 ! subc\nty & c5sus tract level4  7,f7  
,fund+ am\nts requir$ to e/abli% !      
monitor+ networks id5tifi$ "u           
subp>agraph 7,e7 & recomm5dations =     
,f$]al1 ,/ate1 & local coord9ation )    
respect to su* networks4  7,g7 ,pot5tial
 uses = data collect$ & g5]at$ z a      
result ( ! ,/rategy1 includ+ h[ su* data
 may be us$ 9 det]m9+ recipi5ts ( grants
 "u ! program e/abli%$ by section #abjb 
or o!r simil> programs4  7,h7 ,o!r      
in=mation ! ,secret>y consid]s relevant 
= ! developm5t ( ! ,/rategy4  7c7       
,coord9ation & consultation ,9 develop+ 
! ,/rategy1 ! ,secret>y %all--  7#a7    
coord9ate ) ! ,adm9i/rator ( !          

,environm5tal ,protection ,ag5cy & !    
,adm9i/rator ( ! ,national ,oceanic &   
,atmosph]ic ,adm9i/ration2 &  7#b7      
consult )--  7,a7 /akehold]             
organizations2  7,b7 heal? c>e provid]s 
& pr(essional memb]%ip organizations )  
exp]tise 9 mat]nal heal? or environm5tal
 ju/ice2  7,c7 ,/ate & local public     
heal? dep>tm5ts2  7,d7 lic5s$ & accr$it$
 hospitals1 bir? c5t]s1 midwif]y        
practices1 or o!r heal? c>e provid]s t  
provide pr5atal or labor & deliv]y      
s]vices to vuln]able individuals2 &     
7,e7 in/itutions ( high] education1     
includ+ su* in/itutions t are           
m9ority-s]v+ in/itutions or h exp]tise 9
 mat]nal heal? or environm5tal ju/ice4  
7d7 ,notice & comm5t ,at lea/ #bdj days 
be=e ! date on :i* ! ,/rategy is publi%$
 9 accordance ) subsection 7e71 !       
,secret>y %all provide--  7#a7 notice ( 
! ,/rategy on a public website ( !      
,dep>tm5t ( ,heal? & ,human ,s]vices2 & 
7#b7 an opportunity = public comm5t ( at
 lea/ #ij days4  7e7 ,publication ,n    

lat] ?an #ah mon?s aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y %all   
publi% on a public website ( ! ,dep>tm5t
 ( ,heal? & ,human ,s]vices-- 7#a7 !    
,/rategy2  7#b7 ! public comm5ts receiv$
 "u subsection 7d72 &  7#c7 ! responses 
( ! ,secret>y to su* public comm5ts4    
,,xiii ,,nih ,,improve  #acja4 ,,improve
 ,initiative ,"p ,b ( title ,,iv ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bhd et seq47 is am5d$ by add+
 at ! end ! foll[+3  #dji,k4 ,,improve  
initiative  7a7 ,9 g5]al ,! ,director ( 
,,nih %all cont9ue to c>ry out a program
 to improve mat]nal heal? outcomes1 to  
be kn[n z ! ,implem5t+ a ,mat]nal heal? 
& ,p,regnancy ,outcomes ,vision =       
,ev]yone ,initiative or ! ,,improve     
,initiative 7ref]r$ to 9 ?is section z !
 ,initiative74  7b7 ,objectives ,!      
,initiative %all-- 7#a7 advance rese>*  
to--  7,a7 r$uce prev5table causes (    
mat]nal mortality & sev]e mat]nal       
morbidity2  7,b7 r$uce heal? disp>ities 
relat$ to mat]nal heal? outcomes1       

includ+ su* disp>ities associat$ )      
populations ) disproportionately high   
rates ( mat]nal mortality & sev]e       
mat]nal morbidity relative to ! national
 rate2 &  7,c7 improve heal? = pregnant 
& po/p>tum wom5 be=e1 dur+1 & aft]      
pregnancy2  7#b7 use an integrat$       
approa* to und]/& ! factors1 includ+    
biological1 behavioral1 & o!r factors1 t
 affect mat]nal mortality & sev]e       
mat]nal morbidity by build+ an evid5ce  
base = improv$ outcomes 9 specific      
regions ( ! ,unit$ ,/ates2 &  7#c7 t>get
 heal? disp>ities associat$ ) mat]nal   
mortality & sev]e mat]nal morbidity by--
 7,a7 implem5t+ & evaluat+              
community-bas$ int]v5tions =            
disproportionately affect$ wom52 &  7,b7
 id5tify+ risk factors & ! und]ly+      
biological me*anisms associat$ ) lead+  
causes ( mat]nal mortality & sev]e      
mat]nal morbidity 9 ! ,unit$ ,/ates4    
7c7 ,implem5tation ,! ,director ( ,,nih 
may aw>d grants or ent] into contracts1 
coop]ative agreem5ts1 or o!r            

transactions to c>ry out ?is section4   
7d7 ,au?orization ( appropriations ,!re 
is au?oriz$ to be appropriat$ to c>ry   
out ?is section #gc1djj1jjj = ea* (     
fiscal ye>s #bjbg ?r\gh #bjcb4  4  ,,xiv
 ,mat]nal vacc9ations  #adja4 ,mat]nal  
vacc9ation aw>5ess & equity campaign    
7a7 ,campaign ,section #cac ( ! ,public 
,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bde7
 is am5d$--  7#a7 9 subsection 7a71 by  
ins]t+ & among pregnant & po/p>tum      
individuals1 aft] l[ rates (            
vacc9ation12  7#b7 9 subsection 7c77#c71
 by /rik+ pr5atal & p$iatric & ins]t+   
pr5atal1 ob/etric1 & p$iatric2  7#c7 9  
subsection 7d77#d77;,b71 by ins]t+      
pregnant & po/p>tum individuals & aft]  
includ+2 &  7#d7 9 subsection 7g71 by   
/rik+ #ae1jjj1jjj = ea* ( fiscal ye>s   
#bjba ?r\gh #bjbe & ins]t+ #ag1jjj1jjj =
 ea* ( fiscal ye>s #bjbg ?r\gh #bjca4   
7b7 ,additional activities ,section     
#cag7k77#a77;,e7 ( ! ,public ,heal?     
,s]vice ,act 7#db ,u4,s4,c4             
#bdg;b7k77#a77;,e77 is am5d$-- 7#a7 9   

clause 7v71 by /rik+ & at ! end2 &  7#b7
 by add+ at ! end ! foll[+3  7vii7      
increase vacc9ation rates ( pregnant &  
po/p>tum individuals1 includ+           
individuals f racial & e?nic m9ority    
gr\ps1 & _! *ildr52 &  4