,,ii #aaith ,,congress #b;d ,session ,s4 #ddhb ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #aa1 #bjbf,ms4 ,blunt ,rochester introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to require hospitals to develop discharge plans for pregnant individuals as a condition of participation under ,medicare1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,women ,expansion of ,learning and ,labor ,safety ,act or the ,,wells ,act4 #b4 ,requiring hospitals participating in ,medicare to develop discharge plans for pregnant individuals ,section #ahff of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7 is amended-- 7#a7 in subsection 7a77#a7-- 7,a7 in subparagraph 7,x71 by striking and at the end2 7,b7 in subparagraph 7,y71 by striking the period at the end and inserting 1 and2 and 7,c7 by adding at the end the following new subparagraph3 7,z7 beginning ,january #a1 #bjbg1 in the case of a hospital1 critical access hospital1 or rural emergency hospital1 to comply with the requirements described in subsection 7l77#a74 2 and 7#b7 by adding at the end the following new subsection3 7l7 ,discharge plan requirements for pregnant individuals 7#a7 ,in general ,for purposes of subsection 7a77#a77,z71 the requirements described in this paragraph are1 with respect to a hospital1 critical access hospital1 or rural emergency hospital1 that the hospital-- 7,a7 provides for the development and implementation of a discharge plan meeting the standards under paragraph 7#b7 with respect to any individual 7whether or not eligible for benefits under this title7 admitted to the hospital who-- 7i7 is pregnant2 7ii7 is experiencing signs or symptoms consistent with labor1 which may include contractions2 and 7iii7 is expected to be discharged from the hospital1 critical access hospital1 or rural emergency hospital prior to delivery1 as determined based on the documented clinical judgment of the treating physician or practitioner at the time that such discharge is contemplated2 7,b7 includes such discharge plan in the individual's medical record2 and 7,c7 provides for such discharge plan to be discussed with the individual 7or the individual's representative7 prior to discharge4 7#b7 ,discharge plan standards ,a discharge plan for an individual described in paragraph 7#a77;,a7 meets the standards under this paragraph if such plan includes at least the following information3 7,a7 ,a clinical justification for the discharge4 7,b7 ,an assessment of travel distance and time between the primary residence of the individual and the hospital1 critical access hospital1 or rural emergency hospital4 7,c7 ,verification of reliable transportation between the primary residence of the individual and the hospital1 critical access hospital1 or rural emergency hospital4 7,d7 ,identification of a secondary hospital or facility at which such individual may obtain labor and delivery services4 7,e7 ,confirmation that the plan was reviewed and approved by a registered professional nurse1 social worker1 or other appropriately qualified personnel4 7,f7 ,confirmation that the individual 7or the individual's representative7 has received the information described in subparagraphs 7,a7 through 7,d71 that such information was provided in the primary language of such individual 7or representative71 and that such individual 7or representative7 confirmed their understanding of such information4 7#c7 ,rule of construction ,nothing in this subsection shall be construed as limiting or otherwise affecting the discharge planning requirements otherwise applicable to a hospital1 critical access hospital1 or rural emergency hospital under this title1 or any obligation of a health care provider to furnish emergency services as required under ,state or ,federal law1 including section #ahfg of this title 7commonly known as the ,emergency ,medical ,treatment and ,labor ,act74 4 #c4 ,rural maternal and obstetric care training demonstration grants ,section #gfd of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bids7 is amended-- 7#a7 by redesignating subsections 7d7 and 7e7 as subsections 7e7 and 7f71 respectively2 7#b7 by inserting after subsection 7c7 the following3 7d7 ,minimum performance milestones 7#a7 ,establishment ,beginning with the grants awarded under this section for fiscal year #bjbg1 the ,secretary shall establish minimum performance milestones that grant recipients must meet during a fiscal year as a condition of remaining eligible for funding through such a grant for any subsequent fiscal year4 7#b7 ,milestones related to percent of staff trained ,the minimum performance milestones referred to in paragraph 7#a7 shall include milestones related to the percent of all staff of the grant recipient that are trained1 or that receive refresher training1 with support from a grant under this section4 2 and 7#c7 in subsection 7e71 as so redesignated-- 7,a7 in the subsection heading1 by striking report and inserting reports2 7,b7 in paragraph 7#a77;,b71 by striking the report described in paragraph 7#b7 and inserting the reports described in paragraphs 7#b7 and 7#c72 and 7,c7 by adding at the end the following3 7#c7 ,subsequent reports ,not later than ,january #a1 #bjbg1 and annually thereafter1 the ,secretary shall submit to ,congress1 and make publicly available1 a report that includes-- 7,a7 updates to the information described in subparagraphs 7,a7 through 7,c7 of paragraph 7#b72 and 7,b7 additional information regarding the grants under this section1 including-- 7i7 a list of the entities receiving such grants2 7ii7 the number and amount of such grants2 7iii7 whether training supported by such grants was delivered in-person1 virtually1 asynchronously1 or through some other format2 and 7iv7 descriptions of the geographical coverage of such grants1 the number of providers trained under such grants1 and patient-level metrics linked to such training 7such as changes in clinical outcomes1 patient experience1 and racial disparities74 4 #d4 ,multi-center implementation science initiative for maternal health 7a7 ,establishment ,the ,secretary of ,health and ,human ,services1 in consultation with the ,director of the ,agency for ,healthcare ,research and ,quality and the ,director of the ,national ,institutes of ,health 7in this section referred to as the ,secretary7 shall establish a multi-center implementation science initiative for maternal health to rigorously evaluate different training models for health care professionals 7including in-person1 virtual1 simulation1 and cohort-based7 and the impact of such models on provider behavior1 patient outcomes1 and maternal health disparities4 7b7 ,interagency maternal health dashboard ,as part of the initiative described in subsection 7a71 the ,secretary shall develop1 maintain1 and make publicly available on the website of the ,department of ,health and ,human ,services an interagency maternal health dashboard1 which shall include maternal health outcome metrics from agencies within the ,department of ,health and ,human ,services4