,,ii #aaith ,,congress #b;d ,session ,s4 #ebhc ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,august #f1 #bjbf,mr4 ,booker 7for himself1 ,mr4 ,sanders1 ,mrs4 ,murray1 ,ms4 ,blunt ,rochester1 ,ms4 ,alsobrooks1 ,mr4 ,van ,hollen1 ,mr4 ,hickenlooper1 ,mr4 ,merkley1 ,mr4 ,kaine1 ,ms4 ,duckworth1 ,mr4 ,warnock1 ,mr4 ,gallego1 ,mr4 ,heinrich1 ,mr4 ,schatz1 ,mr4 ,blumenthal1 ,mr4 ,padilla1 ,ms4 ,hirono1 ,ms4 ,baldwin1 ,mr4 ,welch1 ,ms4 ,cortez ,masto1 ,ms4 ,klobuchar1 ,mrs4 ,gillibrand1 ,mr4 ,schiff1 ,ms4 ,slotkin1 ,mr4 ,bennet1 ,mr4 ,kim1 ,ms4 ,smith1 ,mr4 ,markey1 and ,mr4 ,peters7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to end preventable maternal mortality1 severe maternal morbidity1 and maternal health disparities in the ,united ,states1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,momnibus ,act4 #b4 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title4,sec4 #b4 ,table of contents4,sec4 #c4 ,definitions4,sec4 #d4 ,sense of ,congress4,title ,i--,social ,determinants for ,moms,sec4 #aja4 ,task force to address the ,united ,states maternal health crisis4,sec4 #ajb4 ,sustained funding to address social determinants of maternal health4,title ,,ii--,extending ,,wic for ,new ,moms,sec4 #bja4 ,extending ,,wic eligibility for new moms4,title ,,iii--,honoring ,kira ,johnson,sec4 #cja4 ,sustained funding for community-based organizations to advance maternal health equity4,sec4 #cjb4 ,respectful maternity care training for all employees in maternity care settings4,sec4 #cjc4 ,study on reducing and preventing bias1 racism1 and discrimination in maternity care settings4,sec4 #cjd4 ,respectful maternity care compliance program4,sec4 #cje4 ,,gao report4,title ,,iv--,maternal health for veterans,sec4 #dja4 ,support for maternity health care and coordination programs of the ,department of ,veterans ,affairs4,title ,v--,perinatal workforce,sec4 #eja4 ,,hhs agency directives4,sec4 #ejb4 ,grants to grow and diversify the perinatal workforce4,sec4 #ejc4 ,grants to grow and diversify the nursing workforce in maternal and perinatal health4,sec4 #ejd4 ,,gao report4,title ,,vi--,data to save moms,sec4 #fja4 ,funding for maternal mortality review committees to promote representative community engagement4,sec4 #fjb4 ,data collection and review4,sec4 #fjc4 ,review of maternal health data collection processes and quality measures4,sec4 #fjd4 ,study on maternal health among ,american ,indian and ,alaska ,native individuals4,sec4 #fje4 ,grants to minority-serving institutions to study maternal mortality1 severe maternal morbidity1 and other adverse maternal health outcomes4,title ,,vii--,moms matter,sec4 #gja4 ,maternal mental health equity grant program4,sec4 #gjb4 ,grants to grow and diversify the maternal mental and behavioral health care workforce4,title ,,viii--,justice for incarcerated moms,sec4 #hja4 ,ending the shackling of pregnant individuals4,sec4 #hjb4 ,creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods4,sec4 #hjc4 ,grant program to improve maternal health outcomes for individuals in ,state and local prisons and jails4,sec4 #hjd4 ,,gao report4,title ,,ix--,tech to save moms,sec4 #ija4 ,integrated telehealth models in maternity care services4,sec4 #ijb4 ,grants to expand the use of technology-enabled collaborative learning and capacity models for pregnant and postpartum individuals4,sec4 #ijc4 ,grants to promote equity in maternal health outcomes through digital tools4,sec4 #ijd4 ,report on the use of technology in maternity care4,title ,x--,impact to save moms,sec4 #ajja4 ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project4,title ,,xi--,maternal health pandemic response,sec4 #aaja4 ,definitions4,sec4 #aajb4 ,funding for data collection1 surveillance1 and research on maternal health outcomes during public health emergencies4,sec4 #aajc4 ,public health emergency maternal health data collection and disclosure4,sec4 #aajd4 ,public health communication regarding maternal care during public health emergencies4,sec4 #aaje4 ,task force on birthing experience and safe1 respectful1 responsive1 and empowering maternity care during public health emergencies4,title ,,xii--,protecting moms and babies against climate change,sec4 #abja4 ,definitions4,sec4 #abjb4 ,grant program to protect vulnerable mothers and babies from climate change risks4,sec4 #abjc4 ,grant program for education and training at health profession schools4,sec4 #abjd4 ,,nih ,consortium on ,birth and ,climate ,change ,research4,sec4 #abje4 ,strategy for identifying climate change risk zones for vulnerable mothers and babies4,title ,,xiii--,,nih ,i,m,p,r,o,v,e,sec4 #acja4 ,,improve ,initiative4,title ,,xiv--,maternal vaccinations,sec4 #adja4 ,maternal vaccination awareness and equity campaign4 #c4 ,definitions ,in this ,act3 7#a7 ,culturally and linguistically congruent ,the term culturally and linguistically congruent1 with respect to care or maternity care1 means care that is in agreement with the preferred cultural values1 beliefs1 worldview1 language1 and practices of the health care consumer and other stakeholders4 7#b7 ,maternal mortality ,the term maternal mortality means a death occurring during or within a #a-year period after pregnancy1 caused by pregnancy-related or childbirth complications1 including a suicide1 overdose1 or other death resulting from a mental health or substance use disorder attributed to or aggravated by pregnancy-related or childbirth complications4 7#c7 ,maternity care provider ,the term maternity care provider means a health care provider who-- 7,a7 is a physician1 a physician assistant1 a midwife who meets1 at a minimum1 the international definition of a midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives1 an advanced practice registered nurse1 a doula accredited by a ,state to receive reimbursement for doula services under a ,state plan 7or a waiver of such plan7 under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq471 or a lactation consultant certified by the ,international ,board of ,lactation ,consultant ,examiners2 and 7,b7 has a focus on maternal or perinatal health4 7#d7 ,perinatal health worker ,the term perinatal health worker means a nonclinical health worker focused on maternal or perinatal health1 such as a doula1 community health worker1 peer supporter1 lactation educator or counselor1 nutritionist or dietitian1 childbirth educator1 social worker1 home visitor1 patient navigator or coordinator1 or language interpreter4 7#e7 ,postpartum and postpartum period ,the terms postpartum and postpartum period refer to the #a-year period beginning on the last day of the pregnancy of an individual4 7#f7 ,pregnancy-associated death ,the term pregnancy-associated death means a death of a pregnant or postpartum individual1 by any cause1 that occurs during1 or within #a year following1 the individual's pregnancy1 regardless of the outcome1 duration1 or site of the pregnancy4 7#g7 ,pregnancy-related death ,the term pregnancy-related death means a death of a pregnant or postpartum individual that occurs during1 or within #a year following1 the individual's pregnancy1 from a pregnancy complication1 a chain of events initiated by pregnancy1 or the aggravation of an unrelated condition by the physiologic effects of pregnancy4 7#h7 ,public health emergency ,the term public health emergency means a public health emergency declared under section #cai of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d74 7#i7 ,racial and ethnic minority group ,the term racial and ethnic minority group has the meaning given such term in section #agjg7;g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjju-#f7;g77#a774 7#aj7 ,severe maternal morbidity ,the term severe maternal morbidity means a health condition1 including mental health conditions and substance use disorders1 attributed to or aggravated by pregnancy or childbirth that results in significant short-term or long-term consequences to the health of the individual who was pregnant4 7#aa7 ,social determinants of maternal health ,the term social determinants of maternal health means nonclinical factors that impact maternal health outcomes4 #d4 ,sense of ,congress ,it is the sense of ,congress that-- 7#a7 the respect and proper care that birthing people deserve is inclusive2 and 7#b7 regardless of race1 ethnicity1 gender identity1 sexual orientation1 religion1 marital status1 primary language1 familial status1 socioeconomic status1 immigration status1 incarceration status1 or disability1 all deserve dignity4 ,i ,social ,determinants for ,moms #aja4 ,task force to address the ,united ,states maternal health crisis 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall convene a task force 7in this section referred to as the ,task ,force7 to develop strategies and coordinate efforts between ,federal agencies and other stakeholders to eliminate preventable maternal mortality1 severe maternal morbidity1 and maternal health disparities in the ,united ,states1 including actions to address clinical and nonclinical causes of maternal mortality1 severe maternal morbidity1 and maternal health disparities4 7b7 ,ex officio members ,the ex officio members of the ,task ,force shall consist of the following3 7#a7 ,the ,secretary of ,health and ,human ,services 7or a designee thereof74 7#b7 ,the ,secretary of ,housing and ,urban ,development 7or a designee thereof74 7#c7 ,the ,secretary of ,transportation 7or a designee thereof74 7#d7 ,the ,secretary of ,agriculture 7or a designee thereof74 7#e7 ,the ,secretary of ,labor 7or a designee thereof74 7#f7 ,the ,administrator of the ,environmental ,protection ,agency 7or a designee thereof74 7#g7 ,the ,assistant ,secretary for the ,administration for ,children and ,families 7or a designee thereof74 7#h7 ,the ,administrator of the ,centers for ,medicare ,medicaid ,services 7or a designee thereof74 7#i7 ,the ,director of the ,indian ,health ,service 7or a designee thereof74 7#aj7 ,the ,director of the ,national ,institutes of ,health 7or a designee thereof74 7#aa7 ,the ,director of the ,eunice ,kennedy ,shriver ,national ,institute of ,child ,health and ,human ,development 7or a designee thereof74 7#ab7 ,the ,director of the ,tribal ,health ,research ,office of the ,national ,institutes of ,health 7or a designee thereof74 7#ac7 ,the ,administrator of the ,health ,resources and ,services ,administration 7or a designee thereof74 7#ad7 ,the ,deputy ,assistant ,secretary for ,minority ,health of the ,department of ,health and ,human ,services 7or a designee thereof74 7#ae7 ,the ,deputy ,assistant ,secretary for ,women's ,health of the ,department of ,health and ,human ,services 7or a designee thereof74 7#af7 ,the ,director of the ,centers for ,disease ,control and ,prevention 7or a designee thereof74 7#ag7 ,the ,director of the ,office on ,violence ,against ,women at the ,department of ,justice 7or a designee thereof74 7c7 ,appointed members ,in addition to the ex officio members of the ,task ,force1 the ,secretary of ,health and ,human ,services may appoint the following members of the ,task ,force3 7#a7 ,representatives of patients1 to include-- 7,a7 a representative of patients who have suffered from severe maternal morbidity2 or 7,b7 a representative of patients who is a family member of an individual who suffered a pregnancy-related death4 7#b7 ,leaders of community-based organizations that address maternal mortality1 severe maternal morbidity1 and maternal health with a specific focus on racial and ethnic disparities4 ,in appointing such leaders under this paragraph1 the ,secretary of ,health and ,human ,services shall give priority to individuals who are leaders of organizations led by individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7#c7 ,leaders from the ,indian health care system1 including leaders from ,tribal ,epidemiology ,centers4 7#d7 ,perinatal health workers4 7#e7 ,a professionally and geographically diverse panel of maternity care providers4 7#f7 ,other maternal health stakeholders outside of the ,federal ,government with expertise in maternal health1 including social determinants of maternal health4 7d7 ,chair ,the ,secretary of ,health and ,human ,services shall select the chair of the ,task ,force from among the members of the ,task ,force4 7e7 ,topics ,in developing strategies coordinating efforts between ,federal agencies and other stakeholders to eliminate preventable maternal mortality1 severe maternal morbidity1 and maternal health disparities in the ,united ,states under this section1 the ,task ,force may address topics such as-- 7#a7 addressing barriers that prevent individuals from attending prenatal and postpartum appointments1 accessing maternal health care services1 or accessing services and resources related to social determinants of maternal health2 7#b7 increasing access to safe1 stable1 affordable1 and adequate housing for pregnant and postpartum individuals and their families2 7#c7 delivering healthy food1 infant formula1 clean water1 diapers1 or other perinatal necessities to pregnant and postpartum individuals located in areas that are food deserts2 7#d7 addressing the impacts of water and air quality1 exposure to extreme temperatures1 environmental chemicals1 environmental risks in the workplace and the home1 and pollution levels1 on maternal and infant health outcomes2 7#e7 offering free and accessible drop-in childcare services during prenatal and postpartum appointments2 7#f7 addressing the clinical and nonclinical needs of postpartum individuals and their families for the duration of the postpartum period2 7#g7 engaging with nongovernmental entities to address social determinants of maternal health1 including through public-private partnerships2 7#h7 addressing the impact of domestic or intimate partner violence on maternal health outcomes2 and 7#i7 other topics determined by the chair of the ,task ,force4 7f7 ,report ,not later than #b years after the date of enactment of this ,act1 and every year thereafter1 the ,task ,force shall submit to ,congress and make publicly available on the website of the ,department of ,health and ,human ,services a report-- 7#a7 describing the ,task ,force's efforts to develop strategies and coordinate efforts between ,federal agencies and other stakeholders to eliminate preventable maternal mortality1 severe maternal morbidity1 and maternal health disparities in the ,united ,states2 7#b7 providing an overview of actions taken by each member of the ,task ,force listed under subsection 7b7 to eliminate preventable maternal mortality1 severe maternal morbidity1 and maternal health disparities in the ,united ,states2 7#c7 providing recommendations on ,federal funding amounts and authorities needed to implement strategies developed by the ,task ,force to eliminate preventable maternal mortality1 severe maternal morbidity1 and maternal health disparities in the ,united ,states2 7#d7 providing recommendations on actions that stakeholders outside of the ,federal ,government can take to eliminate preventable maternal mortality1 severe maternal morbidity1 and maternal health disparities in the ,united ,states2 and 7#e7 addressing other topics as determined by the chair of the ,task ,force4 7g7 ,termination ,section #ajac of title #e1 ,united ,states ,code1 shall not apply to the ,task ,force with respect to termination4 #ajb4 ,sustained funding to address social determinants of maternal health 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall award grants to eligible entities to address social determinants of maternal health to eliminate maternal mortality1 severe maternal morbidity1 and maternal health disparities4 7b7 ,eligible entities ,in this section1 the term eligible entity means-- 7#a7 a community-based organization1 ,indian ,tribe or ,tribal organization1 or ,urban ,indian organization2 7#b7 a public health department or nonprofit organization working with an entity listed in paragraph 7#a72 or 7#c7 a consortium of entities listed in paragraph 7#a7 or 7#b7 that includes at minimum one entity listed in paragraph 7#a74 7c7 ,application ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may provide4 7d7 ,prioritization ,in awarding grants under subsection 7a71 the ,secretary shall give priority to an eligible entity that is operating in an area with-- 7#a7 high rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 and 7#b7 a high poverty rate4 7e7 ,activities ,an eligible entity that receives a grant under this section may use the grant to address social determinants of maternal health such as-- 7#a7 housing2 7#b7 transportation2 7#c7 nutrition2 7#d7 employment1 workplace conditions1 and other economic factors2 7#e7 environmental conditions2 7#f7 intimate partner violence2 and 7#g7 other nonclinical factors that impact maternal health outcomes4 7f7 ,technical assistance ,the ,secretary shall provide to grant recipients under this section technical assistance to plan for sustaining programs to address social determinants of maternal health after the period of the grant4 7g7 ,reporting 7#a7 ,grantees ,not later than #a year after an eligible entity first receives a grant under this section1 and annually thereafter1 an eligible entity shall submit to the ,secretary1 and make publicly available1 a report on the status of activities conducted using the grant4 ,each such report shall include data on the effects of such activities1 disaggregated by race1 ethnicity1 gender1 primary language1 geography1 socioeconomic status1 and other relevant factors4 7#b7 ,secretary ,not later than the end of fiscal year #bjca1 the ,secretary shall submit to ,congress a report that includes-- 7,a7 a summary of the reports under paragraph 7#a72 and 7,b7 recommendations for future ,federal grant allocations to address social determinants of maternal health4 7h7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ajj1jjj1jjj for each of fiscal years #bjbg through #bjca4 ,,ii ,extending ,,wic for ,new ,moms #bja4 ,extending ,,wic eligibility for new moms 7a7 ,extension of postpartum period ,section #ag7;b77#aj7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;b77#aj77 is amended by striking six months and inserting #bd months4 7b7 ,extension of breastfeeding period ,section #ag7;d77#c77;,a77ii7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;d77#c77;,a77ii77 is amended by striking #a year and inserting #bd months4 7c7 ,report ,not later than #b years after the date of the enactment of this section1 the ,secretary shall submit to ,congress a report that includes an evaluation of the effect of each of the amendments made by this section on-- 7#a7 maternal and infant health outcomes1 including racial and ethnic disparities with respect to such outcomes2 7#b7 breastfeeding rates among postpartum individuals2 7#c7 qualitative evaluations of family experiences under the special supplemental nutrition program under section #ag of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf72 and 7#d7 other relevant information as determined by the ,secretary4 ,,iii ,honoring ,kira ,johnson #cja4 ,sustained funding for community-based organizations to advance maternal health equity 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall award grants to eligible entities to establish or expand programs to advance maternal health equity4 7b7 ,timing ,following the #a-year period described in subsection 7d71 the ,secretary shall commence awarding the grants authorized by subsection 7a74 7c7 ,eligible entities ,to be eligible to seek a grant under this section1 an entity shall be a community-based organization offering programs and resources aligned with evidence-based practices for improving maternal health outcomes for demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7d7 ,outreach and technical assistance period ,during the #a-year period beginning on the date of enactment of this ,act1 the ,secretary shall-- 7#a7 conduct outreach to encourage eligible entities to apply for grants under this section2 and 7#b7 provide technical assistance to eligible entities on best practices for applying for grants under this section4 7e7 ,special consideration 7#a7 ,outreach ,in conducting outreach under subsection 7d71 the ,secretary shall give special consideration to eligible entities that-- 7,a7 are based in1 and provide support for1 communities with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes1 to the extent such data are available2 7,b7 are led by individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 and 7,c7 offer programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7#b7 ,awards ,in awarding grants under this section1 the ,secretary shall give special consideration to eligible entities that-- 7,a7 are described in subparagraphs 7,a71 7,b71 and 7,c7 of paragraph 7#a72 7,b7 offer programs and resources designed in consultation with and intended for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7,c7 offer programs and resources in the communities in which the respective eligible entities are located that-- 7i7 promote maternal mental health and maternal substance use disorder treatments and supports that are aligned with evidence-based practices for improving maternal mental and behavioral health outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7ii7 address social determinants of maternal health2 7iii7 promote evidence-based health literacy and pregnancy1 childbirth1 and parenting education2 7iv7 provide support from perinatal health workers2 7v7 provide culturally and linguistically congruent training to perinatal health workers2 7vi7 conduct or support research on maternal health issues disproportionately impacting individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7vii7 offer group prenatal care or group postpartum care2 7viii7 coordinate mutual aid efforts during infant formula shortages1 including community milk depots1 donor human milk banks and exchanges1 and forums for community outreach and education2 7ix7 provide support to individuals or family members of individuals who suffered a pregnancy loss1 pregnancy-associated death1 or pregnancy-related death2 or 7x7 operate midwifery practices that provide culturally and linguistically congruent maternal health care and support1 including for the purposes of-- 7,i7 supporting additional education1 training1 and certification programs1 including support for distance learning2 7,,ii7 providing financial support to current and future midwives to address education costs1 debts1 and other needs2 7,,iii7 clinical site investments2 7,,iv7 supporting preceptor development trainings2 7,v7 expanding the midwifery practice2 or 7,,vi7 related needs identified by the midwifery practice and described in the practice's application2 and 7,d7 have developed other programs and resources that address community-specific needs for pregnant and postpartum individuals and are aligned with evidence-based practices for improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7f7 ,technical assistance ,the ,secretary shall provide to grant recipients under this section technical assistance on-- 7#a7 capacity building to establish or expand programs to advance maternal health equity2 7#b7 best practices in data collection1 measurement1 evaluation1 and reporting2 and 7#c7 planning for sustaining programs to advance maternal health equity after the period of the grant4 7g7 ,evaluation ,not later than the end of fiscal year #bjca1 the ,secretary shall submit to the ,congress an evaluation of the grant program under this section that-- 7#a7 assesses the effectiveness of outreach efforts during the application process in diversifying the pool of grant recipients2 7#b7 makes recommendations for future outreach efforts to diversify the pool of grant recipients for ,department of ,health and ,human ,services grant programs and funding opportunities related to maternal health2 7#c7 assesses the effectiveness of programs funded by grants under this section in improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes1 to the extent practicable2 and 7#d7 makes recommendations for future ,department of ,health and ,human ,services grant programs and funding opportunities that deliver funding to community-based organizations that provide programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7h7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ajj1jjj1jjj for each of fiscal years #bjbg through #bjca4 #cjb4 ,respectful maternity care training for all employees in maternity care settings ,part ,b of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bic et seq47 is amended by adding at the end the following new section3 #gdb4 ,respectful maternity care training for all employees in maternity care settings 7a7 ,grants ,the ,secretary shall award grants for programs to reduce and prevent bias1 racism1 and discrimination in maternity care settings and to advance respectful1 culturally and linguistically congruent1 trauma-informed care4 7b7 ,special consideration ,in awarding grants under subsection 7a71 the ,secretary shall give special consideration to applications for programs that would-- 7#a7 apply to all maternity care providers and any employees who interact with pregnant and postpartum individuals in the provider setting1 including front desk employees1 sonographers1 schedulers1 health care professionals1 hospital or health system administrators1 security staff1 and other employees2 7#b7 emphasize periodic1 as opposed to one-time1 trainings for all birthing professionals and employees described in paragraph 7#a72 7#c7 address implicit bias1 racism1 and cultural humility2 7#d7 be delivered in ongoing education settings for providers maintaining their licenses1 with a preference for trainings that provide continuing education units2 7#e7 include trauma-informed care best practices and an emphasis on shared decision making between providers and patients2 7#f7 include antiracism training and programs2 7#g7 be delivered in undergraduate programs that funnel into health professions schools2 7#h7 be delivered in settings that apply to providers of the special supplemental nutrition program for women1 infants1 and children under section #ag of the ,child ,nutrition ,act of #aiff2 7#i7 integrate bias training in obstetric emergency simulation trainings or related trainings2 7#aj7 include training for emergency department employees and emergency medical technicians on recognizing warning signs for severe pregnancy-related complications2 7#aa7 offer training to all maternity care providers on the value of racially1 ethnically1 and professionally diverse maternity care teams to provide culturally and linguistically congruent care2 or 7#ab7 be based on one or more programs designed by a historically ,black college or university or other minority-serving institution4 7c7 ,application ,to seek a grant under subsection 7a71 an entity shall submit an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,reporting ,each recipient of a grant under this section shall annually submit to the ,secretary a report on the status of activities conducted using the grant1 including1 as applicable1 a description of the impact of training provided through the grant on patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families4 7e7 ,best practices ,based on the annual reports submitted pursuant to subsection 7d71 the ,secretary-- 7#a7 shall produce an annual report on the findings resulting from programs funded through this section2 7#b7 shall disseminate such report to all recipients of grants under this section and to the public2 and 7#c7 may include in such report findings on best practices for improving patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families in maternity care settings4 7f7 ,definitions ,in this section3 7#a7 ,the term postpartum means the #a-year period beginning on the last day of an individual's pregnancy4 7#b7 ,the term culturally and linguistically congruent means in agreement with the preferred cultural values1 beliefs1 worldview1 language1 and practices of the health care consumer and other stakeholders4 7#c7 ,the term racial and ethnic minority group has the meaning given such term in section #agjg7;g77#a74 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #e1jjj1jjj for each of fiscal years #bjbg through #bjca4 4 #cjc4 ,study on reducing and preventing bias1 racism1 and discrimination in maternity care settings 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall seek to enter into an agreement1 not later than #ij days after the date of enactment of this ,act1 with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this section as the ,national ,academies7 under which the ,national ,academies agree to-- 7#a7 conduct a study on the design and implementation of programs to reduce and prevent bias1 racism1 and discrimination in maternity care settings and to advance respectful1 culturally and linguistically congruent1 trauma-informed care2 and 7#b7 not later than #bd months after the date of enactment of this ,act-- 7,a7 complete the study2 and 7,b7 transmit a report on the results of the study to the ,congress4 7b7 ,possible topics ,the agreement entered into pursuant to subsection 7a7 may provide for the study of any of the following3 7#a7 ,the development of a scorecard or other evaluation standards for programs designed to reduce and prevent bias1 racism1 and discrimination in maternity care settings to assess the effectiveness of such programs in improving patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families4 7#b7 ,determination of the types and frequency of training to reduce and prevent bias1 racism1 and discrimination in maternity care settings that are demonstrated to improve patient outcomes or patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families4 #cjd4 ,respectful maternity care compliance program 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary7 shall award grants to accredited hospitals1 health systems1 and other maternity care settings to establish as an integral part of quality implementation initiatives within one or more hospitals or other birth settings a respectful maternity care compliance program4 7b7 ,program requirements ,a respectful maternity care compliance program funded through a grant under this section shall-- 7#a7 institutionalize mechanisms to allow patients receiving maternity care services1 the families of such patients1 or perinatal health workers supporting such patients to report instances of racism or evidence of bias on the basis of race1 ethnicity1 or another protected class2 7#b7 institutionalize response mechanisms through which representatives of the program can directly follow up with the patient1 if possible1 and the patient's family in a timely manner2 7#c7 prepare and make publicly available a hospital- or health system-wide strategy to reduce bias on the basis of race1 ethnicity1 or another protected class in the delivery of maternity care that includes-- 7,a7 information on the training programs to reduce and prevent bias1 racism1 and discrimination on the basis of race1 ethnicity1 or another protected class for all employees in maternity care settings2 7,b7 information on the number of cases reported to the compliance program2 and 7,c7 the development of methods to routinely assess the extent to which bias1 racism1 or discrimination on the basis of race1 ethnicity1 or another protected class is present in the delivery of maternity care to patients from racial and ethnic minority groups2 7#d7 develop mechanisms to routinely collect and publicly report hospital-level data related to patient-reported experience of care2 and 7#e7 provide annual reports to the ,secretary with information about each case reported to the compliance program over the course of the year containing such information as the ,secretary may require1 such as-- 7,a7 deidentified demographic information on the patient in the case1 such as race1 ethnicity1 gender identity1 and primary language2 7,b7 the content of the report from the patient or the family of the patient to the compliance program2 7,c7 the response from the compliance program2 and 7,d7 to the extent applicable1 institutional changes made as a result of the case4 7c7 ,secretary requirements 7#a7 ,processes ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall establish processes for-- 7,a7 disseminating best practices for establishing and implementing a respectful maternity care compliance program within a hospital or other birth setting2 7,b7 promoting coordination and collaboration between hospitals1 health systems1 and other maternity care delivery settings on the establishment and implementation of respectful maternity care compliance programs2 and 7,c7 evaluating the effectiveness of respectful maternity care compliance programs on maternal health outcomes and patient and family experiences1 especially for patients from racial and ethnic minority groups and their families4 7#b7 ,study 7,a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall1 through a contract with an independent research organization1 conduct a study on strategies to address-- 7i7 racism or bias on the basis of race1 ethnicity1 or another protected class in the delivery of maternity care services2 and 7ii7 successful implementation of respectful care initiatives4 7,b7 ,components of study ,the study shall include the following3 7i7 ,an assessment of the reports submitted to the ,secretary from the respectful maternity care compliance programs pursuant to subsection 7b77#e74 7ii7 ,based on such assessment1 recommendations for potential accountability mechanisms related to cases of racism or bias on the basis of race1 ethnicity1 or another protected class in the delivery of maternity care services at hospitals and other birth settings4 ,such recommendations shall take into consideration medical and nonmedical factors that contribute to adverse patient experiences and maternal health outcomes4 7,c7 ,report ,the ,secretary shall submit to the ,congress and make publicly available a report on the results of the study under this paragraph4 7d7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated such sums as may be necessary for fiscal years #bjbg through #bjcb4 #cje4 ,,gao report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act and annually thereafter1 the ,comptroller ,general of the ,united ,states shall submit to the ,congress and make publicly available a report on the establishment of respectful maternity care compliance programs within hospitals1 health systems1 and other maternity care settings4 7b7 ,matters included ,the report under subsection 7a7 shall include the following3 7#a7 ,information regarding the extent to which hospitals1 health systems1 and other maternity care settings have elected to establish respectful maternity care compliance programs1 including-- 7,a7 which hospitals and other birth settings elect to establish compliance programs and when such programs are established2 7,b7 to the extent practicable1 impacts of the establishment of such programs on maternal health outcomes and patient and family experiences in the hospitals and other birth settings that have established such programs1 especially for patients from racial and ethnic minority groups and their families2 7,c7 information on geographic areas1 and types of hospitals or other birth settings1 where respectful maternity care compliance programs are not being established and information on factors contributing to decisions to not establish such programs2 and 7,d7 recommendations for establishing respectful maternity care compliance programs in geographic areas1 and types of hospitals or other birth settings1 where such programs are not being established4 7#b7 ,whether the funding made available to carry out this section has been sufficient and1 if applicable1 recommendations for additional appropriations to carry out this section4 7#c7 ,such other information as the ,comptroller ,general determines appropriate4 ,,iv ,maternal health for veterans #dja4 ,support for maternity health care and coordination programs of the ,department of ,veterans ,affairs 7a7 ,report to ,congress ,not later than #a year after the date of the enactment of this ,act1 and annually thereafter until ,september #cj1 #bjca1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate1 and make publicly available1 a report that contains the following3 7#a7 ,a summary of the activities carried out under the programs of the ,department of ,veterans ,affairs relating to maternity health care or coordination4 7#b7 ,data on maternal health outcomes of veterans who receive care furnished by the ,secretary of ,veterans ,affairs1 including pursuant to such programs4 7#c7 ,data on patients who are dually eligible to receive assistance from the ,department of ,veterans ,affairs and the ,indian ,health ,service and the maternity health care outcomes associated with receiving such care4 7#d7 ,recommendations by the ,secretary of ,veterans ,affairs to improve the maternal health outcomes of veterans1 with a particular focus on veterans from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7b7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to the ,secretary of ,veterans ,affairs #ae1jjj1jjj for each of fiscal years #bjbg1 #bjbh1 #bjbi1 #bjcj1 and #bjca1 for the programs of the ,department of ,veterans ,affairs relating to maternity care coordination and related programs1 including the maternity care coordination program described in ,veterans ,health ,administration ,directive #accj4jc4 7#b7 ,supplement not supplant ,amounts authorized under paragraph 7#a7 are authorized in addition to any other amounts authorized for maternity health care and coordination for the ,department of ,veterans ,affairs4 ,v ,perinatal workforce #eja4 ,,hhs agency directives 7a7 ,guidance to ,states 7#a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall issue and disseminate guidance to ,states to educate providers1 managed care entities1 and other insurers about the value and process of delivering respectful maternal health care through diverse and multidisciplinary care provider models4 7#b7 ,contents ,the guidance required by paragraph 7#a7 shall address how ,states can encourage and incentivize hospitals1 health systems1 midwifery practices1 freestanding birth centers1 other maternity care provider groups1 managed care entities1 and other insurers-- 7,a7 to recruit and retain maternity care providers1 mental and behavioral health care providers acting in accordance with ,state law1 and registered dietitians or nutrition professionals 7as such term is defined in section #ahfa7vv77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7vv77#b777-- 7i7 from racially1 ethnically1 and linguistically diverse backgrounds2 7ii7 with experience practicing in racially and ethnically diverse communities2 and 7iii7 who have undergone training on implicit bias and racism2 7,b7 to incorporate into maternity care teams-- 7i7 midwives who meet1 at a minimum1 the international definition of a midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives2 7ii7 perinatal health workers2 7iii7 physician assistants2 7iv7 advanced practice registered nurses2 and 7v7 lactation consultants certified by the ,international ,board of ,lactation ,consultant ,examiners2 7,c7 to provide collaborative1 culturally and linguistically congruent care2 and 7,d7 to provide opportunities for individuals enrolled in accredited midwifery education programs to participate in job shadowing with maternity care teams in hospitals1 health systems1 midwifery practices1 and freestanding birth centers4 7b7 ,study on respectful and culturally and linguistically congruent maternity care 7#a7 ,study ,the ,secretary of ,health and ,human ,services acting through the ,director of the ,national ,institutes of ,health 7in this subsection referred to as the ,secretary7 shall conduct a study on best practices in respectful and culturally and linguistically congruent maternity care4 7#b7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall-- 7,a7 complete the study required by paragraph 7#a72 7,b7 submit to the ,congress and make publicly available a report on the results of such study2 and 7,c7 include in such report-- 7i7 a compendium of examples of hospitals1 health systems1 midwifery practices1 freestanding birth centers1 other maternity care provider groups1 managed care entities1 and other insurers that are delivering respectful and culturally and linguistically congruent maternal health care2 7ii7 a compendium of examples of hospitals1 health systems1 midwifery practices1 freestanding birth centers1 other maternity care provider groups1 managed care entities1 and other insurers that have made progress in reducing disparities in maternal health outcomes and improving birthing experiences for pregnant and postpartum individuals from racial and ethnic minority groups2 and 7iii7 recommendations to hospitals1 health systems1 midwifery practices1 freestanding birth centers1 other maternity care provider groups1 managed care entities1 and other insurers1 for best practices in respectful and culturally and linguistically congruent maternity care4 #ejb4 ,grants to grow and diversify the perinatal workforce ,title ,,vii of the ,public ,health ,service ,act is amended by inserting after section #geg 7#db ,u4,s4,c4 #bid;f7 the following new section3 #geh4 ,perinatal workforce grants 7a7 ,in general ,the ,secretary shall award grants to entities to establish or expand programs described in subsection 7b7 to grow and diversify the perinatal workforce4 7b7 ,use of funds ,recipients of grants under this section shall use the grants to grow and diversify the perinatal workforce by-- 7#a7 establishing accredited schools or programs that provide education and training to individuals seeking appropriate licensing and certification as-- 7,a7 physician assistants who will complete clinical training in the field of maternal and perinatal health2 7,b7 perinatal health workers2 or 7,c7 midwives who meet1 at a minimum1 the international definition of a midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives2 and 7#b7 expanding the capacity of existing accredited schools or programs described in paragraph 7#a71 for the purposes of increasing the number of students enrolled in such accredited schools or programs1 such as by awarding scholarships for students 7including students from racially1 ethnically1 and linguistically diverse backgrounds74 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to a school or program described in subsection 7b7 that-- 7#a7 has demonstrated a commitment to recruiting and retaining students and faculty from racial and ethnic minority groups2 7#b7 has developed a strategy to recruit and retain a diverse pool of students into the school or program described in subsection 7b7 that is supported by funds received through the grant1 particularly from racial and ethnic minority groups and other underserved populations2 7#c7 has developed a strategy to recruit and retain students who plan to practice in a health professional shortage area designated under section #ccb2 7#d7 has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes1 to the extent practicable2 and 7#e7 includes in the standard curriculum for all students within the school or program described in subsection 7b7 a bias1 racism1 or discrimination training program that includes training on implicit bias and racism4 7d7 ,reporting ,as a condition on receipt of a grant under this section for a school or program described in subsection 7b71 an entity shall agree to submit to the ,secretary an annual report on the activities conducted through the grant1 including-- 7#a7 the number and demographics of students participating in the school or program2 7#b7 the extent to which students in the school or program are entering careers in-- 7,a7 health professional shortage areas designated under section #ccb2 and 7,b7 areas with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes1 to the extent such data are available2 and 7#c7 whether the school or program has included in the standard curriculum for all students a bias1 racism1 or discrimination training program that includes explicit and implicit bias1 and if so the effectiveness of such training program4 7e7 ,period of grants ,the period of a grant under this section shall be up to #e years4 7f7 ,application ,to seek a grant under this section1 an entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including any information necessary for prioritization under subsection 7c74 7g7 ,technical assistance ,the ,secretary shall provide1 directly or by contract1 technical assistance to entities seeking or receiving a grant under this section on the development1 use1 evaluation1 and postgrant period sustainability of the school or program described in subsection 7b7 that is proposed to be1 or is being1 established or expanded through the grant4 7h7 ,report by the ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall prepare and submit to the ,congress1 and post on the internet website of the ,department of ,health and ,human ,services1 a report on the effectiveness of the grant program under this section at-- 7#a7 recruiting students from racial and ethnic minority groups2 7#b7 increasing the number of health professionals described in subparagraphs 7,a71 7,b71 and 7,c7 of subsection 7b77#a7 from racial and ethnic minority groups and other underserved populations2 7#c7 increasing the number of such health professionals working in health professional shortage areas designated under section #ccb2 and 7#d7 increasing the number of such health professionals working in areas with significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available4 7i7 ,definition ,in this section1 the term racial and ethnic minority group has the meaning given such term in section #agjg7;g77#a74 7j7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjbg through #bjca4 4 #ejc4 ,grants to grow and diversify the nursing workforce in maternal and perinatal health ,title ,,viii of the ,public ,health ,service ,act is amended by inserting after section #haa of that ,act 7#db ,u4,s4,c4 #bif;j7 the following3 #hab4 ,perinatal nursing workforce grants 7a7 ,in general ,the ,secretary shall award grants to schools of nursing to grow and diversify the perinatal nursing workforce4 7b7 ,use of funds ,recipients of grants under this section shall use the grants to grow and diversify the perinatal nursing workforce by providing scholarships to students seeking to become-- 7#a7 nurse practitioners whose education includes a focus on maternal and perinatal health2 7#b7 certified nurse-midwives2 or 7#c7 clinical nurse specialists whose education includes a focus on maternal and perinatal health4 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to any school of nursing that-- 7#a7 has developed a strategy to recruit and retain a diverse pool of students seeking to enter careers focused on maternal and perinatal health1 particularly students from racial and ethnic minority groups and other underserved populations2 7#b7 has developed a partnership with a practice setting in a health professional shortage area designated under section #ccb for the clinical placements of the school's students2 7#c7 has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes1 to the extent practicable2 and 7#d7 includes in the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health a bias1 racism1 or discrimination training program that includes education on implicit bias and racism4 7d7 ,reporting ,as a condition on receipt of a grant under this section1 a school of nursing shall agree to submit to the ,secretary an annual report on the activities conducted through the grant1 including1 to the extent practicable-- 7#a7 the number and demographics of students in the school of nursing seeking to enter careers focused on maternal and perinatal health2 7#b7 the extent to which such students are preparing to enter careers in-- 7,a7 health professional shortage areas designated under section #ccb2 and 7,b7 areas with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes1 to the extent such data are available2 and 7#c7 whether the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health includes a bias1 racism1 or discrimination training program that includes education on implicit bias and racism4 7e7 ,period of grants ,the period of a grant under this section shall be up to #e years4 7f7 ,application ,to seek a grant under this section1 an entity shall submit to the ,secretary an application1 at such time1 in such manner1 and containing such information as the ,secretary may require1 including any information necessary for prioritization under subsection 7c74 7g7 ,technical assistance ,the ,secretary shall provide1 directly or by contract1 technical assistance to schools of nursing seeking or receiving a grant under this section on the processes of awarding and evaluating scholarships through the grant4 7h7 ,report by the ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall prepare and submit to the ,congress1 and post on the internet website of the ,department of ,health and ,human ,services1 a report on the effectiveness of the grant program under this section at-- 7#a7 recruiting students from racial and ethnic minority groups and other underserved populations2 7#b7 increasing the number of advanced practice registered nurses entering careers focused on maternal and perinatal health from racial and ethnic minority groups and other underserved populations2 7#c7 increasing the number of advanced practice registered nurses entering careers focused on maternal and perinatal health working in health professional shortage areas designated under section #ccb2 and 7#d7 increasing the number of advanced practice registered nurses entering careers focused on maternal and perinatal health working in areas with significant racial and ethnic disparities in maternal health outcomes1 to the extent such data are available4 7i7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjbg through #bjca4 4 #ejd4 ,,gao report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act and every #e years thereafter1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on barriers to maternal health education and access to care in the ,united ,states4 ,such report shall include the information and recommendations described in subsection 7b74 7b7 ,content of report ,the report under subsection 7a7 shall include-- 7#a7 an assessment of current barriers to entering and successfully completing accredited midwifery education programs1 and recommendations for addressing such barriers1 particularly for low-income women and women from racial and ethnic minority groups2 7#b7 an assessment of current barriers to entering and successfully completing accredited education programs for other health professional careers related to maternity care1 including maternity care providers1 mental and behavioral health care providers acting in accordance with ,state law1 and registered dietitians or nutrition professionals 7as such term is defined in section #ahfa7vv77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7vv77#b7771 particularly for low-income women and women from racial and ethnic minority groups2 7#c7 an assessment of current barriers that prevent midwives from meeting the international definition of a midwife and global standards for midwifery education as established by the ,international ,confederation of ,midwives1 and recommendations for addressing such barriers1 particularly for low-income women and women from racial and ethnic minority groups2 7#d7 an assessment of disparities in access to maternity care providers1 mental or behavioral health care providers acting in accordance with ,state law1 and registered dietitians or nutrition professionals 7as such term is defined in section #ahfa7vv77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7vv77#b7771 and perinatal health workers1 stratified by race1 ethnicity1 gender identity1 primary language1 geographic location1 and insurance type and recommendations to promote greater access equity2 and 7#e7 recommendations to promote greater equity in compensation for perinatal health workers under public and private insurers1 particularly for such individuals from racially and ethnically diverse backgrounds4 ,,vi ,data to save moms #fja4 ,funding for maternal mortality review committees to promote representative community engagement 7a7 ,in general ,section #cag,k7d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77 is amended by adding at the end the following3 7#i7 ,grants to promote representative community engagement in maternal mortality review committees 7,a7 ,in general ,the ,secretary may1 using funds made available pursuant to subparagraph 7,c71 provide assistance to an applicable maternal mortality review committee of a ,state1 ,indian ,tribe1 ,tribal organization1 or ,urban ,indian organization 7as such terms are defined in section #d of the ,indian ,health ,care ,improvement ,act7-- 7i7 to select for inclusion in the membership of such a committee community members from the ,state1 ,indian ,tribe1 ,tribal organization1 or ,urban ,indian organization by-- 7,i7 prioritizing community members who can increase the diversity of the committee's membership with respect to race and ethnicity1 location1 personal or family experiences of maternal mortality or severe maternal morbidity1 and professional background1 including members with nonclinical experiences2 and 7,,ii7 to the extent applicable1 using funds reserved under subsection 7f71 to address barriers to maternal mortality review committee participation for community members1 including required training1 transportation barriers1 compensation1 and other supports as may be necessary2 7ii7 to establish initiatives to conduct outreach and community engagement efforts within communities throughout the ,state or ,tribe to seek input from community members on the work of such maternal mortality review committee1 with a particular focus on outreach to women from racial and ethnic minority groups 7as such term is defined in section #agjg7;g77#a772 and 7iii7 to release public reports assessing-- 7,i7 the pregnancy-related death and pregnancy-associated death review processes of the maternal mortality review committee1 with a particular focus on the maternal mortality review committee's sensitivity to the unique circumstances of pregnant and postpartum individuals from racial and ethnic minority groups 7as such term is defined in section #agjg7;g77#a77 who have suffered pregnancy-related deaths2 and 7,,ii7 the impact of the use of funds made available pursuant to subparagraph 7,c7 on increasing the diversity of the maternal mortality review committee membership and promoting community engagement efforts throughout the ,state or ,tribe4 7,b7 ,technical assistance ,the ,secretary shall provide 7either directly through the ,department of ,health and ,human ,services or by contract7 technical assistance to any maternal mortality review committee receiving a grant under this paragraph on best practices for increasing the diversity of the maternal mortality review committee's membership and for conducting effective community engagement throughout the ,state or ,tribe4 7,c7 ,authorization of appropriations ,in addition to any funds made available under subsection 7f71 there is authorized to be appropriated to carry out this paragraph #aj1jjj1jjj for each of fiscal years #bjbg through #bjca4 4 7b7 ,reservation of funds ,section #cag,k7f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;f77 is amended by adding at the end the following3 ,of the amount made available under the preceding sentence for a fiscal year1 not less than #a1ejj1jjj shall be reserved for grants to ,indian ,tribes1 ,tribal organizations1 or ,urban ,indian organizations 7as those terms are defined in section #d of the ,indian ,health ,care ,improvement ,act74 #fjb4 ,data collection and review ,section #cag,k7d77#c77;,a77i7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77#c77;,a77i77 is amended-- 7#a7 by redesignating subclauses 7,,ii7 and 7,,iii7 as subclauses 7,v7 and 7,,vi71 respectively2 and 7#b7 by inserting after subclause 7,i7 the following3 7,,ii7 to the extent practicable1 reviewing cases of severe maternal morbidity1 according to the most up-to-date indicators2 7,,iii7 to the extent practicable1 reviewing deaths during pregnancy or up to #a year after the end of a pregnancy from suicide1 overdose1 or other death from a mental health condition or substance use disorder attributed to or aggravated by pregnancy or childbirth complications2 7,,iv7 to the extent practicable1 consulting with local community-based organizations representing pregnant and postpartum individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes to ensure that1 in addition to clinical factors1 nonclinical factors that might have contributed to a pregnancy-related death are appropriately considered2 4 #fjc4 ,review of maternal health data collection processes and quality measures 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services and the ,director of the ,agency for ,healthcare ,research and ,quality1 shall consult with relevant stakeholders-- 7#a7 to review existing maternal health data collection processes and quality measures2 and 7#b7 to make recommendations to improve such processes and measures1 including topics described under subsection 7c74 7b7 ,collaboration ,in carrying out this section1 the ,secretary shall consult with a diverse group of maternal health stakeholders1 which may include-- 7#a7 pregnant and postpartum individuals and their family members1 and nonprofit organizations representing such individuals1 with a particular focus on patients from racial and ethnic minority groups2 7#b7 community-based organizations that provide support for pregnant and postpartum individuals1 with a particular focus on patients from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#c7 membership organizations for maternity care providers2 7#d7 organizations representing perinatal health workers2 7#e7 organizations that focus on maternal mental or behavioral health2 7#f7 organizations that focus on intimate partner violence2 7#g7 institutions of higher education1 with a particular focus on minority-serving institutions2 7#h7 licensed and accredited hospitals1 birth centers1 midwifery practices1 or other facilities that provide maternal health care services2 7#i7 relevant ,state and local public agencies1 including ,state maternal mortality review committees2 and 7#aj7 the ,national ,quality ,forum1 or such other standard-setting organizations specified by the ,secretary4 7c7 ,topics ,the review of maternal health data collection processes and recommendations to improve such processes and measures required under subsection 7a7 shall assess all available relevant information1 including information from ,state-level sources1 and shall consider at least the following3 7#a7 ,current ,state and ,tribal practices for maternal health1 maternal mortality1 and severe maternal morbidity data collection and dissemination1 including consideration of-- 7,a7 the timeliness of processes for amending a death certificate when new information pertaining to the death becomes available to reflect whether the death was a pregnancy-related death2 7,b7 relevant data collected with electronic health records1 including data on race1 ethnicity1 primary language1 socioeconomic status1 geography1 insurance type1 and other relevant demographic information2 7,c7 maternal health data collected and publicly reported by hospitals1 health systems1 midwifery practices1 and birth centers2 7,d7 the barriers preventing ,states from correlating maternal outcome data with data on race1 ethnicity1 and other demographic characteristics2 7,e7 processes for determining the cause of a pregnancy-associated death in ,states that do not have a maternal mortality review committee2 7,f7 whether maternal mortality review committees include multidisciplinary and diverse membership 7as described in section #cag,k7d77#a77;,a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;d77#a77;,a7772 7,g7 whether members of maternal mortality review committees participate in trainings on bias1 racism1 or discrimination1 and the quality of such trainings2 7,h7 the extent to which ,states have implemented systematic processes of listening to the stories of pregnant and postpartum individuals and their family members1 with a particular focus on pregnant and postpartum individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes1 and their family members1 to fully understand the causes of1 and inform potential solutions to1 the maternal mortality and severe maternal morbidity crisis within their respective ,states2 7,i7 the extent to which maternal mortality review committees are considering social determinants of maternal health when examining the causes of pregnancy-associated and pregnancy-related deaths2 7,j7 the extent to which maternal mortality review committees are making actionable recommendations based on their reviews of adverse maternal health outcomes and the extent to which such recommendations are being implemented by appropriate stakeholders2 7,k7 the legal and administrative barriers preventing the collection1 collation1 and dissemination of ,state maternity care data2 7,l7 the effectiveness of data collection and reporting processes in separating pregnancy-associated deaths from pregnancy-related deaths2 and 7,m7 the current ,federal1 ,state1 local1 and ,tribal funding support for the activities referred to in subparagraphs 7,a7 through 7,l74 7#b7 ,whether the funding support referred to in paragraph 7#a77,m7 is adequate for ,states to carry out optimal data collection and dissemination processes with respect to maternal health1 maternal mortality1 and severe maternal morbidity4 7#c7 ,current quality measures for maternity care1 including prenatal measures1 labor and delivery measures1 and postpartum measures1 including topics such as-- 7,a7 effective quality measures for maternity care used by hospitals1 health systems1 midwifery practices1 birth centers1 health plans1 and other relevant entities2 7,b7 the sufficiency of current outcome measures used to evaluate maternity care for driving improved care1 experiences1 and outcomes in maternity care payment and delivery system models2 7,c7 maternal health quality measures that other countries effectively use2 7,d7 validated measures that have been used for research purposes that could be tested1 refined1 and submitted for national endorsement2 7,e7 barriers preventing maternity care providers and insurers from implementing quality measures that are aligned with best practices2 7,f7 the frequency with which maternity care quality measures are reviewed and revised2 7,g7 the strengths and weaknesses of the ,prenatal and ,postpartum ,care measures of the ,health ,plan ,employer ,data and ,information ,set measures established by the ,national ,committee for ,quality ,assurance2 7,h7 the strengths and weaknesses of maternity care quality measures under the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and the ,children's ,health ,insurance ,program under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig et seq471 including the extent to which ,states voluntarily report relevant measures2 7,i7 the extent to which maternity care quality measures are informed by patient experiences that include measures of patient-reported experience of care2 7,j7 the current processes for collecting and making publicly available1 to the extent practicable1 stratified data on race1 ethnicity1 and other demographic characteristics of pregnant and postpartum individuals in hospitals1 health systems1 midwifery practices1 and birth centers1 and for incorporating such demographically stratified data in maternity care quality measures2 7,k7 the extent to which maternity care quality measures account for the unique experiences of pregnant and postpartum individuals from racial and ethnic minority groups2 and 7,l7 the extent to which hospitals1 health systems1 midwifery practices1 and birth centers are implementing existing maternity care quality measures4 7#d7 ,recommendations on authorizing additional funds and providing additional technical assistance to improve maternal mortality review committees and ,state and ,tribal maternal health data collection and reporting processes4 7#e7 ,recommendations for new authorities that may be granted to maternal mortality review committees to be able to-- 7,a7 access records from other ,federal and ,state agencies and departments that may be necessary to identify causes of pregnancy-associated and pregnancy-related deaths that are unique to pregnant and postpartum individuals from specific populations1 such as veterans and individuals who are incarcerated2 and 7,b7 work with relevant experts who are not members of the maternal mortality review committee to assist in the review of pregnancy-associated deaths of pregnant and postpartum individuals from specific populations1 such as veterans and individuals who are incarcerated4 7#f7 ,recommendations to improve and standardize current quality measures for maternity care1 with a particular focus on maternal health disparities4 7#g7 ,recommendations to improve the coordination by the ,department of ,health and ,human ,services of the efforts undertaken by the agencies and organizations within the ,department related to maternal health data and quality measures4 7d7 ,report ,not later than #a year after the enactment of this ,act1 the ,secretary shall submit to the ,congress and make publicly available a report on the results of the review of maternal health data collection processes and quality measures and recommendations to improve such processes and measures required under subsection 7a74 7e7 ,definition ,in this section1 the term maternal mortality review committee means a maternal mortality review committee duly authorized by a ,state and receiving funding under section #cag,k7a77#b77;,d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ab7;a77#b77;,d774 7f7 ,authorization of appropriations ,there are authorized to be appropriated such sums as may be necessary to carry out this section for fiscal years #bjbg through #bjcj4 #fjd4 ,study on maternal health among ,american ,indian and ,alaska ,native individuals 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary7 shall1 in coordination with entities described in subsection 7b7-- 7#a7 not later than #ij days after the enactment of this ,act1 enter into a contract with an independent research organization or ,tribal ,epidemiology ,center to conduct a comprehensive study on maternal mortality1 severe maternal morbidity1 and other adverse perinatal or childbirth outcomes in the populations of ,american ,indian and ,alaska ,native individuals2 and 7#b7 not later than #c years after the date of the enactment of this ,act1 submit to ,congress a report on such study that contains recommendations for policies and practices that can be adopted to improve maternal health outcomes for ,american ,indian and ,alaska ,native individuals4 7b7 ,participating entities ,the entities described in this subsection shall consist of #ab members1 selected by the ,secretary from among individuals nominated by ,indian ,tribes and ,tribal organizations 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd771 and ,urban ,indian organizations 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc774 ,in selecting such members1 the ,secretary shall ensure that each of the #ab service areas of the ,indian ,health ,service is represented4 7c7 ,contents of study ,the study conducted pursuant to subsection 7a7 shall-- 7#a7 examine the causes of maternal mortality and severe maternal morbidity that are unique to ,american ,indian and ,alaska ,native individuals2 7#b7 include a systematic process of listening to the stories of ,american ,indian and ,alaska ,native individuals to fully understand the causes of1 and inform potential solutions to1 the maternal health crisis within their respective communities2 7#c7 distinguish between the causes of1 landscape of maternity care at1 and recommendations to improve maternal health outcomes within1 the different settings in which ,american ,indian and ,alaska ,native individuals receive maternity care1 such as-- 7,a7 facilities operated by the ,indian ,health ,service2 7,b7 an ,indian health program operated by an ,indian ,tribe or ,tribal organization pursuant to a contract1 grant1 cooperative agreement1 or compact with the ,indian ,health ,service pursuant to the ,indian ,self-,determination ,act2 7,c7 an urban ,indian health program operated by an ,urban ,indian organization pursuant to a grant or contract with the ,indian ,health ,service pursuant to title ,v of the ,indian ,health ,care ,improvement ,act2 and 7,d7 facilities outside of the ,indian ,health ,service in which ,american ,indian and ,alaska ,native individuals receive maternity care services2 7#d7 review processes for coordinating programs of the ,indian ,health ,service with social services provided through other programs administered by the ,secretary of ,health and ,human ,services 7other than the ,medicare ,program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq4771 the ,medicaid ,program under title ,,xix of such ,act 7#db ,u4,s4,c4 #acif et seq471 and the ,children's ,health ,insurance ,program under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig et seq472 7#e7 review current data collection and quality measurement processes and practices2 7#f7 assess causes and frequency of maternal mental health conditions and substance use disorders2 7#g7 consider social determinants of health1 including poverty1 lack of health insurance1 unemployment1 sexual and domestic violence1 and environmental conditions in ,tribal areas2 7#h7 consider the role that historical mistreatment of ,american ,indian and ,alaska ,native women has played in causing currently elevated rates of maternal mortality1 severe maternal morbidity1 and other adverse perinatal or childbirth outcomes2 7#i7 consider how current funding of the ,indian ,health ,service affects the ability of the ,service to deliver quality maternity care2 7#aj7 consider the extent to which the delivery of maternity care services is culturally appropriate for ,american ,indian and ,alaska ,native individuals2 7#aa7 make recommendations to reduce misclassification of ,american ,indian and ,alaska ,native individuals1 including consideration of best practices in training for maternal mortality review committee members to be able to correctly classify ,american ,indian and ,alaska ,native individuals2 and 7#ab7 make recommendations informed by the stories shared by ,american ,indian and ,alaska ,native individuals referred to in paragraph 7#b7 to improve maternal health outcomes for such individuals4 7d7 ,report ,the agreement entered into under subsection 7a7 with an independent research organization or ,tribal ,epidemiology ,center shall require that the organization or ,center transmit to ,congress a report on the results of the study conducted pursuant to that agreement not later than #cf months after the date of the enactment of this ,act4 7e7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #b1jjj1jjj for each of fiscal years #bjbg through #bjbi4 #fje4 ,grants to minority-serving institutions to study maternal mortality1 severe maternal morbidity1 and other adverse maternal health outcomes 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall establish a program under which the ,secretary shall award grants to research centers1 health professions schools and programs1 and other entities at minority-serving institutions to study specific aspects of the maternal health crisis among pregnant and postpartum individuals from racial and ethnic minority groups4 ,such research may-- 7#a7 include the development and implementation of systematic processes of listening to the stories of pregnant and postpartum individuals from racial and ethnic minority groups1 and perinatal health workers supporting such individuals1 to fully understand the causes of1 and inform potential solutions to1 the maternal mortality and severe maternal morbidity crisis within their respective communities2 7#b7 assess the potential causes of relatively low rates of maternal mortality among ,hispanic individuals1 including potential racial misclassification and other data collection and reporting issues that might be misrepresenting maternal mortality rates among ,hispanic individuals in the ,united ,states2 7#c7 assess differences in rates of adverse maternal health outcomes among subgroups identifying as ,hispanic1 including disparities in access to early prenatal care2 and 7#d7 include lactation education to promote racial and ethnic diversity within the workforce of health care professionals with breastfeeding and lactation expertise4 7b7 ,application ,to be eligible to receive a grant under subsection 7a71 an entity described in such subsection shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,technical assistance ,the ,secretary may use not more than #aj percent of the funds made available under subsection 7g7-- 7#a7 to conduct outreach to minority-serving institutions to raise awareness of the availability of grants under subsection 7a72 7#b7 to provide technical assistance in the application process for such a grant2 and 7#c7 to promote capacity building as needed to enable entities described in such subsection to submit such an application4 7d7 ,reporting requirement ,each entity awarded a grant under this section shall periodically submit to the ,secretary a report on the status of activities conducted using the grant4 7e7 ,evaluation ,beginning #a year after the date on which the first grant is awarded under this section1 the ,secretary shall submit to ,congress an annual report summarizing the findings of research conducted using funds made available under this section4 7f7 ,minority-,serving institutions defined ,in this section1 the term minority-serving institution has the meaning given the term in section #cga7;a7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajfgq7a774 7g7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjbg through #bjca4 ,,vii ,moms matter #gja4 ,maternal mental health equity grant program 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,assistant ,secretary for ,mental ,health and ,substance ,use1 shall establish a program to award grants to eligible entities to address maternal mental health conditions and substance use disorders1 with a focus on demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7b7 ,application ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to an eligible entity that-- 7#a7 is1 or will partner with1 a community-based organization to address maternal mental health conditions and substance use disorders described in subsection 7a72 7#b7 is operating in an area with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 and 7#c7 is operating in a health professional shortage area designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e74 7d7 ,use of funds ,an eligible entity that receives a grant under this section shall use the grant for the following3 7#a7 ,establishing or expanding maternity care programs to improve the integration of maternal mental health and behavioral health care services into primary care settings where pregnant individuals regularly receive health care services4 7#b7 ,establishing or expanding group prenatal care programs or postpartum care programs4 7#c7 ,expanding existing programs that improve maternal mental and behavioral health during the prenatal and postpartum periods1 with a focus on individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7#d7 ,providing services and support for pregnant and postpartum individuals with maternal mental health conditions and substance use disorders1 including referrals to addiction treatment centers that offer evidence-based treatment options4 7#e7 ,addressing stigma associated with maternal mental health conditions and substance use disorders1 with a focus on individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7#f7 ,raising awareness of warning signs of maternal mental health conditions and substance use disorders1 with a focus on pregnant and postpartum individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7#g7 ,establishing or expanding programs to prevent suicide or self-harm among pregnant and postpartum individuals4 7#h7 ,offering evidence-aligned programs at freestanding birth centers that provide maternal mental and behavioral health care education1 treatments1 and services1 and other services for individuals throughout the prenatal and postpartum period4 7#i7 ,establishing or expanding programs to provide education and training to maternity care providers with respect to-- 7,a7 identifying potential warning signs for maternal mental health conditions or substance use disorders in pregnant and postpartum individuals1 with a focus on individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 and 7,b7 in the case where such providers identify such warning signs1 offering referrals to mental and behavioral health care professionals4 7#aj7 ,developing a website1 or other source1 that includes information on health care providers who treat maternal mental health conditions and substance use disorders4 7#aa7 ,establishing or expanding programs in communities to improve coordination between maternity care providers and mental and behavioral health care providers who treat maternal mental health conditions and substance use disorders1 including through the use of toll-free hotlines4 7#ab7 ,carrying out other programs aligned with evidence-based practices for addressing maternal mental health conditions and substance use disorders for pregnant and postpartum individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7e7 ,reporting 7#a7 ,eligible entities ,an eligible entity that receives a grant under subsection 7a7 shall submit annually to the ,secretary1 and make publicly available1 a report on the activities conducted using funds received through a grant under this section4 ,such reports shall include quantitative and qualitative evaluations of such activities1 including the experience of individuals who received health care through such grant4 7#b7 ,secretary ,not later than the end of fiscal year #bjcj1 the ,secretary shall submit to ,congress a report that includes-- 7,a7 a summary of the reports received under paragraph 7#a72 7,b7 an evaluation of the effectiveness of grants awarded under this section2 7,c7 recommendations with respect to expanding coverage of evidence-based screenings and treatments for maternal mental health conditions and substance use disorders2 and 7,d7 recommendations with respect to ensuring activities described under subsection 7d7 continue after the end of a grant period4 7f7 ,definitions ,in this section3 7#a7 ,eligible entity ,the term eligible entity means-- 7,a7 a community-based organization serving pregnant and postpartum individuals1 including such organizations serving individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7,b7 a nonprofit or patient advocacy organization with expertise in maternal mental and behavioral health2 7,c7 a maternity care provider2 7,d7 a mental or behavioral health care provider who treats maternal mental health conditions or substance use disorders2 7,e7 a ,state or local governmental entity1 including a ,state or local public health department2 7,f7 an ,indian ,tribe or ,tribal organization 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd772 and 7,g7 an ,urban ,indian organization 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc774 7#b7 ,freestanding birth center ,the term freestanding birth center has the meaning given that term under section #aije7l7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7#a774 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #be1jjj1jjj for each of fiscal years #bjbg through #bjca4 #gjb4 ,grants to grow and diversify the maternal mental and behavioral health care workforce ,title ,,vii of the ,public ,health ,service ,act is amended by inserting after section #geh of such ,act 7#db ,u4,s4,c4 #bid;f71 as added by section #djb of this ,act1 the following new section3 #geh;,a4 ,maternal mental and behavioral health care workforce grants 7a7 ,in general ,the ,secretary may award grants to entities to establish or expand programs described in subsection 7b7 to grow and diversify the maternal mental and behavioral health care workforce4 7b7 ,use of funds ,recipients of grants under this section shall use the grants to grow and diversify the maternal mental and behavioral health care workforce by-- 7#a7 establishing schools or programs that provide education and training to individuals seeking appropriate licensing or certification as mental or behavioral health care providers who will specialize in maternal mental health conditions or substance use disorders2 or 7#b7 expanding the capacity of existing schools or programs described in paragraph 7#a71 for the purposes of increasing the number of students enrolled in such schools or programs1 including by awarding scholarships for students4 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to any entity that-- 7#a7 has demonstrated a commitment to recruiting and retaining students and faculty from racial and ethnic minority groups2 7#b7 has developed a strategy to recruit and retain a diverse pool of students into the maternal mental or behavioral health care workforce program or school supported by funds received through the grant1 particularly from racial and ethnic minority groups and other underserved populations2 7#c7 has developed a strategy to recruit and retain students who plan to practice in a health professional shortage area designated under section #ccb2 7#d7 has developed a strategy to recruit and retain students who plan to practice in an area with significant maternal health disparities1 to the extent practicable2 and 7#e7 includes in the standard curriculum for all students within the maternal mental or behavioral health care workforce program or school a bias1 racism1 or discrimination training program that includes training on implicit bias and racism4 7d7 ,reporting ,as a condition on receipt of a grant under this section for a maternal mental or behavioral health care workforce program or school1 an entity shall agree to submit to the ,secretary an annual report on the activities conducted through the grant1 including-- 7#a7 the number and demographics of students participating in the program or school2 7#b7 the extent to which students in the program or school are entering careers in-- 7,a7 health professional shortage areas designated under section #ccb2 and 7,b7 areas with significant maternal health disparities1 to the extent such data are available2 and 7#c7 whether the program or school has included in the standard curriculum for all students a bias1 racism1 or discrimination training program that includes training on implicit bias and racism1 and if so the effectiveness of such training program4 7e7 ,period of grants ,the period of a grant under this section shall be up to #e years4 7f7 ,application ,to seek a grant under this section1 an entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including any information necessary for prioritization under subsection 7c74 7g7 ,technical assistance ,the ,secretary shall provide1 directly or by contract1 technical assistance to entities seeking or receiving a grant under this section on the development1 use1 evaluation1 and postgrant period sustainability of the maternal mental or behavioral health care workforce programs or schools proposed to be1 or being1 established or expanded through the grant4 7h7 ,report by the ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall prepare and submit to the ,congress1 and post on the internet website of the ,department of ,health and ,human ,services1 a report on the effectiveness of the grant program under this section at-- 7#a7 recruiting students from racial and ethnic minority groups and other underserved populations2 7#b7 increasing the number of mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders from racial and ethnic minority groups and other underserved populations2 7#c7 increasing the number of mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders working in health professional shortage areas designated under section #ccb2 and 7#d7 increasing the number of mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders working in areas with significant maternal health disparities1 to the extent such data are available4 7i7 ,definitions ,in this section3 7#a7 ,racial and ethnic minority group ,the term racial and ethnic minority group has the meaning given such term in section #agjg7;g77#a74 7#b7 ,mental or behavioral health care provider ,the term mental or behavioral health care provider refers to a health care provider in the field of mental and behavioral health1 including substance use disorders1 acting in accordance with ,state law4 7j7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjbg through #bjca4 4 ,,viii ,justice for incarcerated moms #hja4 ,ending the shackling of pregnant individuals 7a7 ,in general ,beginning on the date that is #f months after the date of enactment of this ,act1 and annually thereafter1 in each ,state that receives a grant under subpart #a of part ,e of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajaea et seq47 7commonly referred to as the ,edward ,byrne ,memorial ,justice ,grant ,program7 and that does not have in effect throughout the ,state for such fiscal year laws restricting the use of restraints on pregnant individuals in prison that are substantially similar to the rights1 procedures1 requirements1 effects1 and penalties set forth in section #dcbb of title #ah1 ,united ,states ,code1 the amount of such grant that would otherwise be allocated to such ,state under such subpart for the fiscal year shall be decreased by #be percent4 7b7 ,reallocation ,amounts not allocated to a ,state for failure to comply with subsection 7a7 shall be reallocated in accordance with subpart #a of part ,e of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajaea et seq47 to ,states that have complied with such subsection4 #hjb4 ,creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods 7a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general1 acting through the ,director of the ,bureau of ,prisons1 shall establish1 in not fewer than #f ,bureau of ,prisons facilities1 programs to optimize maternal health outcomes for pregnant and postpartum individuals incarcerated in such facilities4 ,the ,attorney ,general shall establish such programs in consultation with stakeholders such as-- 7#a7 relevant community-based organizations1 particularly organizations that represent incarcerated and formerly incarcerated individuals and organizations that seek to improve maternal health outcomes for pregnant and postpartum individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#b7 relevant organizations representing patients1 with a particular focus on patients from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#c7 organizations representing maternity care providers and maternal health care education programs2 7#d7 perinatal health workers2 and 7#e7 researchers and policy experts in fields related to maternal health care for incarcerated individuals4 7b7 ,start date ,each selected facility shall begin facility programs not later than #ah months after the date of enactment of this ,act4 7c7 ,facility priority ,in carrying out subsection 7a71 the ,director shall give priority to a facility based on-- 7#a7 the number of pregnant and postpartum individuals incarcerated in such facility and1 among such individuals1 the number of pregnant and postpartum individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 and 7#b7 the extent to which the leaders of such facility have demonstrated a commitment to developing exemplary programs for pregnant and postpartum individuals incarcerated in such facility4 7d7 ,program duration ,the programs established under this section shall be for a #e-year period4 7e7 ,programs ,bureau of ,prisons facilities selected by the ,director shall establish programs for pregnant and postpartum incarcerated individuals1 and such programs may-- 7#a7 provide access to perinatal health workers from pregnancy through the postpartum period2 7#b7 provide access to healthy foods and counseling on nutrition1 recommended activity levels1 and safety measures throughout pregnancy2 7#c7 train correctional officers to ensure that pregnant incarcerated individuals receive safe and respectful treatment2 7#d7 train medical personnel to ensure that pregnant incarcerated individuals receive trauma-informed1 culturally and linguistically congruent care that promotes the health and safety of the pregnant individuals2 7#e7 provide counseling and treatment for individuals who have suffered from-- 7,a7 diagnosed mental or behavioral health conditions1 including trauma and substance use disorders2 7,b7 trauma or violence1 including domestic violence2 7,c7 human immunodeficiency virus2 7,d7 sexual abuse2 7,e7 pregnancy or infant loss2 or 7,f7 chronic conditions2 7#f7 provide evidence-based pregnancy and childbirth education1 parenting support1 and other relevant forms of health literacy2 7#g7 provide clinical education opportunities to maternity care providers in training to expand pathways into maternal health care careers serving incarcerated individuals2 7#h7 offer opportunities for postpartum individuals to maintain contact with the individual's newborn child to promote bonding1 including enhanced visitation policies1 access to prison nursery programs1 or breastfeeding support2 7#i7 provide reentry assistance1 particularly to-- 7,a7 ensure access to health insurance coverage and transfer of health records to community providers if an incarcerated individual exits the criminal justice system during such individual's pregnancy or in the postpartum period2 and 7,b7 connect individuals exiting the criminal justice system during pregnancy or in the postpartum period to community-based resources1 such as referrals to health care providers1 substance use disorder treatments1 and social services that address social determinants maternal of health2 or 7#aj7 establish partnerships with local public entities1 private community entities1 community-based organizations1 ,indian ,tribes and ,tribal organizations 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd771 and ,urban ,indian organizations 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 to establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals4 ,such programs may include-- 7,a7 evidence-based childbirth education or parenting classes2 7,b7 prenatal health coordination2 7,c7 family and individual counseling2 7,d7 evidence-based screenings1 education1 and1 as needed1 treatment for mental and behavioral health conditions1 including drug and alcohol treatments2 7,e7 family case management services2 7,f7 domestic violence education and prevention2 7,g7 physical and sexual abuse counseling2 and 7,h7 programs to address social determinants of health such as employment1 housing1 education1 transportation1 and nutrition4 7f7 ,implementation and reporting ,a selected facility shall be responsible for-- 7#a7 implementing programs1 which may include the programs described in subsection 7e72 and 7#b7 not later than #c years after the date of enactment of this ,act1 and #f years after the date of enactment of this ,act1 reporting results of the programs to the ,director1 including information describing-- 7,a7 relevant quantitative indicators of success in improving the standard of care and health outcomes for pregnant and postpartum incarcerated individuals in the facility1 including data stratified by race1 ethnicity1 sex1 gender1 primary language1 age1 geography1 disability status1 the category of the criminal charge against such individual1 rates of pregnancy-related deaths1 pregnancy-associated deaths1 cases of infant mortality and morbidity1 rates of preterm births and low-birthweight births1 cases of severe maternal morbidity1 cases of violence against pregnant or postpartum individuals1 diagnoses of maternal mental or behavioral health conditions1 and other such information as appropriate2 7,b7 relevant qualitative and quantitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs1 including measures of patient-reported experience of care2 and 7,c7 strategies to sustain such programs after fiscal year #bjca and expand such programs to other facilities4 7g7 ,report ,not later than #f years after the date of enactment of this ,act1 the ,director shall submit to the ,attorney ,general and to the ,congress a report describing the results of the programs funded under this section4 7h7 ,oversight ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general shall award a contract to an independent organization or independent organizations to conduct oversight of the programs described in subsection 7e74 7i7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjbg through #bjca4 #hjc4 ,grant program to improve maternal health outcomes for individuals in ,state and local prisons and jails 7a7 ,establishment ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general1 acting through the ,director of the ,bureau of ,justice ,assistance1 shall award ,justice for ,incarcerated ,moms grants to ,states to establish or expand programs in ,state and local prisons and jails for pregnant and postpartum incarcerated individuals4 ,the ,attorney ,general shall award such grants in consultation with stakeholders such as-- 7#a7 relevant community-based organizations1 particularly organizations that represent incarcerated and formerly incarcerated individuals and organizations that seek to improve maternal health outcomes for pregnant and postpartum individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#b7 relevant organizations representing patients1 with a particular focus on patients from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#c7 organizations representing maternity care providers and maternal health care education programs2 7#d7 perinatal health workers2 and 7#e7 researchers and policy experts in fields related to maternal health care for incarcerated individuals4 7b7 ,applications ,each applicant for a grant under this section shall submit to the ,director of the ,bureau of ,justice ,assistance an application at such time1 in such manner1 and containing such information as the ,director may require4 7c7 ,use of funds ,a ,state that is awarded a grant under this section shall use such grant to establish or expand programs for pregnant and postpartum incarcerated individuals1 and such programs may-- 7#a7 provide access to perinatal health workers from pregnancy through the postpartum period2 7#b7 provide access to healthy foods and counseling on nutrition1 recommended activity levels1 and safety measures throughout pregnancy2 7#c7 train correctional officers to ensure that pregnant incarcerated individuals receive safe and respectful treatment2 7#d7 train medical personnel to ensure that pregnant incarcerated individuals receive trauma-informed1 culturally and linguistically congruent care that promotes the health and safety of the pregnant individuals2 7#e7 provide counseling and treatment for individuals who have suffered from-- 7,a7 diagnosed mental or behavioral health conditions1 including trauma and substance use disorders2 7,b7 trauma or violence1 including domestic violence2 7,c7 human immunodeficiency virus2 7,d7 sexual abuse2 7,e7 pregnancy or infant loss2 or 7,f7 chronic conditions2 7#f7 provide evidence-based pregnancy and childbirth education1 parenting support1 and other relevant forms of health literacy2 7#g7 provide clinical education opportunities to maternity care providers in training to expand pathways into maternal health care careers serving incarcerated individuals2 7#h7 offer opportunities for postpartum individuals to maintain contact with the individual's newborn child to promote bonding1 including enhanced visitation policies1 access to prison nursery programs1 or breastfeeding support2 7#i7 provide reentry assistance1 particularly to-- 7,a7 ensure access to health insurance coverage and transfer of health records to community providers if an incarcerated individual exits the criminal justice system during such individual's pregnancy or in the postpartum period2 and 7,b7 connect individuals exiting the criminal justice system during pregnancy or in the postpartum period to community-based resources1 such as referrals to health care providers1 substance use disorder treatments1 and social services that address social determinants of maternal health2 or 7#aj7 establish partnerships with local public entities1 private community entities1 community-based organizations1 ,indian ,tribes and ,tribal organizations 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd771 and ,urban ,indian organizations 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 to establish or expand pretrial diversion programs as an alternative to incarceration for pregnant and postpartum individuals4 ,such programs may include-- 7,a7 evidence-based childbirth education or parenting classes2 7,b7 prenatal health coordination2 7,c7 family and individual counseling2 7,d7 evidence-based screenings1 education1 and1 as needed1 treatment for mental and behavioral health conditions1 including drug and alcohol treatments2 7,e7 family case management services2 7,f7 domestic violence education and prevention2 7,g7 physical and sexual abuse counseling2 and 7,h7 programs to address social determinants of health such as employment1 housing1 education1 transportation1 and nutrition4 7d7 ,priority ,in awarding grants under this section1 the ,director of the ,bureau of ,justice ,assistance shall give priority to applicants based on-- 7#a7 the number of pregnant and postpartum individuals incarcerated in the ,state and1 among such individuals1 the number of pregnant and postpartum individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 and 7#b7 the extent to which the ,state has demonstrated a commitment to developing exemplary programs for pregnant and postpartum individuals incarcerated in the prisons and jails in the ,state4 7e7 ,grant duration ,a grant awarded under this section shall be for a #e-year period4 7f7 ,implementing and reporting ,a ,state that receives a grant under this section shall be responsible for-- 7#a7 implementing the program funded by the grant2 and 7#b7 not later than #c years after the date of enactment of this ,act1 and #f years after the date of enactment of this ,act1 reporting results of such program to the ,attorney ,general1 including information describing-- 7,a7 relevant quantitative indicators of the program's success in improving the standard of care and health outcomes for pregnant and postpartum incarcerated individuals in the facility1 including data stratified by race1 ethnicity1 sex1 gender1 primary language1 age1 geography1 disability status1 category of the criminal charge against such individual1 incidence rates of pregnancy-related deaths1 pregnancy-associated deaths1 cases of infant mortality and morbidity1 rates of preterm births and low-birthweight births1 cases of severe maternal morbidity1 cases of violence against pregnant or postpartum individuals1 diagnoses of maternal mental or behavioral health conditions1 and other such information as appropriate2 7,b7 relevant qualitative and quantitative evaluations from pregnant and postpartum incarcerated individuals who participated in such programs1 including measures of patient-reported experience of care2 and 7,c7 strategies to sustain such programs beyond the duration of the grant and expand such programs to other facilities4 7g7 ,report ,not later than #f years after the date of enactment of this ,act1 the ,attorney ,general shall submit to the ,congress a report describing the results of such grant programs4 7h7 ,oversight ,not later than #a year after the date of enactment of this ,act1 the ,attorney ,general shall award a contract to an independent organization or independent organizations to conduct oversight of the programs described in subsection 7c74 7i7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjbg through #bjca4 #hjd4 ,,gao report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on adverse maternal and infant health outcomes among incarcerated individuals and infants born to such individuals1 with a particular focus on racial and ethnic disparities in maternal and infant health outcomes for incarcerated individuals4 7b7 ,contents of report ,the report described in this section shall include-- 7#a7 to the extent practicable-- 7,a7 the number of pregnant individuals who are incarcerated in ,bureau of ,prisons facilities2 7,b7 the number of incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local correctional facilities1 who have experienced a pregnancy-related death1 pregnancy-associated death1 or the death of an infant in the most recent #aj years of available data2 7,c7 the number of cases of severe maternal morbidity among incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities1 in the most recent #aj years of available data2 7,d7 the number of preterm and low-birthweight births of infants born to incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local correctional facilities1 in the most recent #aj years of available data2 and 7,e7 statistics on the racial and ethnic disparities in maternal and infant health outcomes and severe maternal morbidity rates among incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities2 7#b7 in the case that the ,comptroller ,general of the ,united ,states is unable determine the information required in subparagraphs 7,a7 through 7,c7 of paragraph 7#a71 an assessment of the barriers to determining such information and recommendations for improvements in tracking maternal health outcomes among incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities2 7#c7 the implications of pregnant and postpartum incarcerated individuals being ineligible for medical assistance under a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 including information about-- 7,a7 the effects of such ineligibility on maternal health outcomes for pregnant and postpartum incarcerated individuals1 with emphasis given to such effects for pregnant and postpartum individuals from racial and ethnic minority groups2 and 7,b7 potential implications on maternal health outcomes resulting from temporarily suspending1 rather than permanently terminating1 such eligibility when a pregnant or postpartum individual is incarcerated2 7#d7 the extent to which ,federal1 ,state1 and local correctional facilities are holding pregnant and postpartum individuals who test positive for illicit drug use in detention with special conditions1 such as additional bond requirements1 due to the individual's drug use1 and the effect of such detention policies on maternal and infant health outcomes2 7#e7 causes of adverse maternal health outcomes that are unique to incarcerated individuals1 including those incarcerated in ,federal1 ,state1 and local detention facilities2 7#f7 causes of adverse maternal health outcomes and severe maternal morbidity that are unique to incarcerated individuals from racial and ethnic minority groups2 7#g7 recommendations to reduce maternal mortality and severe maternal morbidity among incarcerated individuals and to address racial and ethnic disparities in maternal health outcomes for incarcerated individuals in ,bureau of ,prisons facilities and ,state and local prisons and jails2 and 7#h7 such other information as may be appropriate to reduce the occurrence of adverse maternal health outcomes among incarcerated individuals and to address racial and ethnic disparities in maternal health outcomes for such individuals4 ,,ix ,tech to save moms #ija4 ,integrated telehealth models in maternity care services 7a7 ,in general ,section #aaae;,a7b77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#b77;,b77 is amended by adding at the end the following3 7xxviii7 ,focusing on title ,,xix1 providing for the adoption of and use of telehealth tools that allow for screening1 monitoring1 and management of common health complications with respect to an individual receiving medical assistance during such individual's pregnancy and for not more than a #a-year period beginning on the last day of the pregnancy4 4 7b7 ,effective date ,the amendment made by subsection 7a7 shall take effect #a year after the date of the enactment of this ,act4 #ijb4 ,grants to expand the use of technology-enabled collaborative learning and capacity models for pregnant and postpartum individuals ,title ,,iii of the ,public ,health ,service ,act is amended by inserting after section #ccj,p 7#db ,u4,s4,c4 #bed;c-#bb7 the following3 #ccj,q4 ,expanding capacity for maternal health outcomes 7a7 ,establishment ,beginning not later than #a year after the date of enactment of this ,act1 the ,secretary shall award grants to eligible entities to evaluate1 develop1 and expand the use of technology-enabled collaborative learning and capacity building models and improve maternal health outcomes-- 7#a7 in health professional shortage areas2 7#b7 in areas with high rates of maternal mortality and severe maternal morbidity2 7#c7 in rural and underserved areas2 7#d7 in areas with significant maternal health disparities2 and 7#e7 for medically underserved populations and ,american ,indians and ,alaska ,natives1 including ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations4 7b7 ,use of ,funds 7#a7 ,required uses ,recipients of grants under this section shall use the grants to-- 7,a7 train maternal health care providers1 students1 and other similar professionals through models that include-- 7i7 methods to increase safety and health care quality2 7ii7 implicit bias1 racism1 and discrimination2 7iii7 best practices in screening for and1 as needed1 evaluating and treating maternal mental health conditions and substance use disorders2 7iv7 training on best practices in maternity care for pregnant and postpartum individuals during public health emergencies2 7v7 methods to screen for social determinants of maternal health risks in the prenatal and postpartum2 and 7vi7 the use of remote patient monitoring tools for pregnancy-related complications described in section #aaae;,a7b77#b77;,b77xxviii72 7,b7 evaluate and collect information on the effect of such models on-- 7i7 access to and quality of care2 7ii7 outcomes with respect to the health of an individual2 and 7iii7 the experience of individuals who receive pregnancy-related health care2 7,c7 develop qualitative and quantitative measures to identify best practices for the expansion and use of such models2 7,d7 study the effect of such models on patient outcomes and maternity care providers2 and 7,e7 conduct any other activity determined by the ,secretary4 7#b7 ,permissible uses ,recipients of grants under this section may use grants to support-- 7,a7 the use and expansion of technology-enabled collaborative learning and capacity building models1 including hardware and software that-- 7i7 enables distance learning and technical support2 and 7ii7 supports the secure exchange of electronic health information2 and 7,b7 maternity care providers1 students1 and other similar professionals in the provision of maternity care through such models4 7c7 ,application 7#a7 ,in general ,an eligible entity seeking a grant under subsection 7a7 shall submit to the ,secretary an application1 at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,assurance ,an application under paragraph 7#a7 shall include an assurance that such entity shall collect information on and assess the effect of the use of technology-enabled collaborative learning and capacity building models1 including with respect to-- 7,a7 maternal health outcomes2 7,b7 access to maternal health care services2 7,c7 quality of maternal health care2 and 7,d7 retention of maternity care providers serving areas and populations described in subsection 7a74 7d7 ,limitations 7#a7 ,number ,the ,secretary may not award more than #a grant under this section4 7#b7 ,duration ,a grant awarded under this section shall be for a #e-year period4 7e7 ,access to broadband ,in administering grants under this section1 the ,secretary may coordinate with other agencies to ensure that funding opportunities are available to support access to reliable1 high-speed internet for grantees4 7f7 ,technical assistance ,the ,secretary shall provide 7either directly or by contract7 technical assistance to eligible entities1 including recipients of grants under subsection 7a71 on the development1 use1 and sustainability of technology-enabled collaborative learning and capacity building models to expand access to maternal health care services provided by such entities1 including-- 7#a7 in health professional shortage areas2 7#b7 in areas with high rates of maternal mortality and severe maternal morbidity or significant maternal health disparities2 7#c7 in rural and underserved areas2 and 7#d7 for medically underserved populations or ,american ,indians and ,alaska ,natives4 7g7 ,research and evaluation ,the ,secretary1 in consultation with experts1 shall develop a strategic plan to research and evaluate the evidence for technology-enabled collaborative learning and capacity building models4 7h7 ,reporting 7#a7 ,eligible entities ,an eligible entity that receives a grant under subsection 7a7 shall submit to the ,secretary a report1 at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,secretary ,not later than #d years after the date of enactment of this section1 the ,secretary shall submit to the ,congress1 and make available on the website of the ,department of ,health and ,human ,services1 a report that includes-- 7,a7 a description of grants awarded under subsection 7a7 and the purpose and amounts of such grants2 7,b7 a summary of-- 7i7 the evaluations conducted under subsection 7b77#a77;,b72 7ii7 any technical assistance provided under subsection 7f72 and 7iii7 the activities conducted under subsection 7a72 and 7,c7 a description of any significant findings with respect to-- 7i7 patient outcomes2 and 7ii7 best practices for expanding1 using1 or evaluating technology-enabled collaborative learning and capacity building models4 7i7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #f1jjj1jjj for each of fiscal years #bjbg through #bjca4 7j7 ,definitions ,in this section3 7#a7 ,eligible entity 7,a7 ,in general ,the term eligible entity means an entity that provides1 or supports the provision of1 maternal health care services or other evidence-based services for pregnant and postpartum individuals-- 7i7 in health professional shortage areas2 7ii7 in rural or underserved areas2 7iii7 in areas with high rates of adverse maternal health outcomes or significant racial and ethnic disparities in maternal health outcomes2 and 7iv7 who are-- 7,i7 members of medically underserved populations2 or 7,,ii7 ,american ,indians and ,alaska ,natives1 including ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations4 7,b7 ,inclusions ,an eligible entity may include entities that lead1 or are capable of leading a technology-enabled collaborative learning and capacity building model4 7#b7 ,health professional shortage area ,the term health professional shortage area means a health professional shortage area designated under section #ccb4 7#c7 ,indian ,tribe ,the term ,indian ,tribe has the meaning given such term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#d7 ,maternal mortality ,the term maternal mortality means a death occurring during or within #a-year period after pregnancy caused by pregnancy-related or childbirth complications1 including a suicide1 overdose1 or other death resulting from a mental health or substance use disorder attributed to or aggravated by pregnancy or childbirth complications4 7#e7 ,medically underserved population ,the term medically underserved population has the meaning given such term in section #ccj7;b77#c74 7#f7 ,postpartum ,the term postpartum means the #a-year period beginning on the last date of an individual's pregnancy4 7#g7 ,severe maternal morbidity ,the term severe maternal morbidity means a health condition1 including a mental health or substance use disorder1 attributed to or aggravated by pregnancy or childbirth that results in significant short-term or long-term consequences to the health of the individual who was pregnant4 7#h7 ,technology-enabled collaborative learning and capacity building model ,the term technology-enabled collaborative learning and capacity building model means a distance health education model that connects health care professionals1 and other specialists1 through simultaneous interactive video conferencing for the purpose of facilitating case-based learning1 disseminating best practices1 and evaluating outcomes in the context of maternal health care4 7#i7 ,tribal organization ,the term ,tribal organization has the meaning given such term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#aj7 ,urban ,indian organization ,the term ,urban ,indian organization has the meaning given such term in section #d of the ,indian ,health ,care ,improvement ,act4 4 #ijc4 ,grants to promote equity in maternal health outcomes through digital tools 7a7 ,in general ,beginning not later than #a year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall make grants to eligible entities to reduce maternal health disparities by increasing access to digital tools related to maternal health care1 including provider-facing technologies1 such as early warning systems and clinical decision support mechanisms4 7b7 ,applications ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,prioritization ,in awarding grants under this section1 the ,secretary shall prioritize an eligible entity-- 7#a7 in an area with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#b7 in a health professional shortage area designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e7 or a rural or underserved area2 and 7#c7 that promotes technology that addresses maternal health disparities4 7d7 ,limitations 7#a7 ,number ,the ,secretary may award not more than #a grant under this section4 7#b7 ,duration ,a grant awarded under this section shall be for a #e-year period4 7e7 ,technical assistance ,the ,secretary shall provide technical assistance to an eligible entity on the development1 use1 evaluation1 and postgrant sustainability of digital tools for purposes of promoting equity in maternal health outcomes4 7f7 ,reporting 7#a7 ,eligible entities ,an eligible entity that receives a grant under subsection 7a7 shall submit to the ,secretary a report1 at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,secretary ,not later than #d years after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a report that includes-- 7,a7 an evaluation on the effectiveness of grants awarded under this section to improve maternal health outcomes1 particularly for pregnant and postpartum individuals from racial and ethnic minority groups2 7,b7 recommendations on new grant programs that promote the use of technology to improve such maternal health outcomes2 and 7,c7 recommendations with respect to-- 7i7 technology-based privacy and security safeguards in maternal health care2 7ii7 reimbursement rates for maternal telehealth services2 7iii7 the use of digital tools to analyze large data sets to identify potential pregnancy-related complications2 7iv7 barriers that prevent maternity care providers from providing telehealth services across ,states2 7v7 the use of consumer digital tools such as mobile phone applications1 patient portals1 and wearable technologies to improve maternal health outcomes2 7vi7 barriers that prevent access to telehealth services1 including a lack of access to reliable1 high-speed internet or electronic devices2 7vii7 barriers to data sharing between the ,special ,supplemental ,nutrition ,program for ,women1 ,infants1 and ,children program and maternity care providers1 and recommendations for addressing such barriers2 and 7viii7 lessons learned from expanded access to telehealth related to maternity care during the ,,covid-#ai public health emergency4 7g7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #f1jjj1jjj for each of fiscal years #bjbg through #bjca4 #ijd4 ,report on the use of technology in maternity care 7a7 ,in general ,not later than #fj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall seek to enter an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this ,act as the ,national ,academies7 under which the ,national ,academies shall conduct a study on the use of technology and patient monitoring devices in maternity care4 7b7 ,content ,the agreement entered into pursuant to subsection 7a7 shall provide for the study of the following3 7#a7 ,the use of innovative technology 7including artificial intelligence7 in maternal health care1 including the extent to which such technology has affected racial or ethnic biases in maternal health care4 7#b7 ,the use of patient monitoring devices 7including pulse oximeter devices7 in maternal health care1 including the extent to which such devices have affected racial or ethnic biases in maternal health care4 7#c7 ,best practices for reducing and preventing racial or ethnic biases in the use of innovative technology and patient monitoring devices in maternity care4 7#d7 ,best practices in the use of innovative technology and patient monitoring devices for pregnant and postpartum individuals from racial and ethnic minority groups4 7#e7 ,best practices with respect to privacy and security safeguards in such use4 7c7 ,report ,the agreement under subsection 7a7 shall direct the ,national ,academies to complete the study under this section1 and transmit to ,congress a report on the results of the study1 not later than #bd months after the date of enactment of this ,act4 ,x ,impact to save moms #ajja4 ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project 7a7 ,in general ,for the period of fiscal years #bjbg through #bjca1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall establish and implement1 in accordance with the requirements of this section1 a demonstration project1 to be known as the ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project 7referred to in this section as the ,demonstration ,project71 for purposes of allowing ,states to test payment models under their ,state plans under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and ,state child health plans under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig;aa et seq47 with respect to maternity care provided to pregnant and postpartum individuals enrolled in such ,state plans and ,state child health plans4 7b7 ,coordination ,in establishing the ,demonstration ,project1 the ,secretary shall coordinate with stakeholders such as-- 7#a7 ,state ,medicaid programs2 7#b7 maternity care providers and organizations representing maternity care providers2 7#c7 relevant organizations representing patients1 with a particular focus on patients from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#d7 relevant community-based organizations1 particularly organizations that seek to improve maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#e7 perinatal health workers2 7#f7 relevant health insurance issuers2 7#g7 hospitals1 health systems1 midwifery practices1 freestanding birth centers 7as such term is defined in paragraph 7#c77;,b7 of section #aije7l7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l7771 ,federally-qualified health centers 7as such term is defined in paragraph 7#b77;,b7 of such section71 and rural health clinics 7as such term is defined in section #ahfa7;aa7 of such ,act 7#db ,u4,s4,c4 #aciex7aa7772 7#h7 researchers and policy experts in fields related to maternity care payment models2 and 7#i7 any other stakeholders as the ,secretary determines appropriate1 with a particular focus on stakeholders from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 7c7 ,considerations ,in establishing the ,demonstration ,project1 the ,secretary shall consider any alternative payment model that-- 7#a7 is designed to improve maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#b7 includes methods for stratifying patients by pregnancy risk level and1 as appropriate1 adjusting payments under such model to take into account pregnancy risk level1 including consideration of the appropriate transfer of patients by pregnancy risk level2 7#c7 establishes evidence-based quality metrics for such payments2 7#d7 includes consideration of nonhospital birth settings such as freestanding birth centers 7as so defined72 7#e7 includes consideration of social determinants of maternal health2 7#f7 includes diverse maternity care teams that include-- 7,a7 maternity care providers1 mental and behavioral health care providers acting in accordance with ,state law1 and registered dietitians or nutrition professionals 7as such term is defined in section #aciex7vv77#b7 of title #db1 ,united ,states ,code7-- 7i7 from racially1 ethnically1 and professionally diverse backgrounds2 7ii7 with experience practicing in racially and ethnically diverse communities2 or 7iii7 who have undergone training on implicit bias and racism2 and 7,b7 perinatal health workers2 or 7#g7 includes consideration of maternal mental health conditions and substance use disorders4 7d7 ,eligibility ,to be eligible to participate in the ,demonstration ,project1 a ,state shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7e7 ,evaluation ,the ,secretary shall conduct an evaluation of the ,demonstration ,project to determine the impact of the ,demonstration ,project on-- 7#a7 maternal health outcomes1 with data stratified by race1 ethnicity1 primary language1 socioeconomic status1 geography1 insurance type1 and other factors as the ,secretary determines appropriate2 7#b7 spending on maternity care by ,states participating in the ,demonstration ,project2 7#c7 to the extent practicable1 qualitative and quantitative measures of patient experience2 and 7#d7 any other areas of assessment that the ,secretary determines relevant4 7f7 ,report ,not later than one year after the completion or termination date of the ,demonstration ,project1 the ,secretary shall submit to the ,congress1 and make publicly available1 a report containing-- 7#a7 the results of any evaluation conducted under subsection 7e72 and 7#b7 a recommendation regarding whether the ,demonstration ,project should be continued after fiscal year #bjca and expanded on a national basis4 7g7 ,authorization of appropriations ,there are authorized to be appropriated such sums as are necessary to carry out this section4 7h7 ,definitions ,in this section3 7#a7 ,alternative payment model ,the term alternative payment model has the meaning given such term in section #ahcc7z77#c77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7z77#c77;,c774 7#b7 ,perinatal ,the term perinatal means the period beginning on the day an individual becomes pregnant and ending on the last day of the #a-year period beginning on the last day of such individual's pregnancy4 ,,xi ,maternal health pandemic response #aaja4 ,definitions ,in this title3 7#a7 ,respectful maternity care ,the term respectful maternity care refers to care organized for1 and provided to1 pregnant and postpartum individuals in a manner that-- 7,a7 is culturally and linguistically congruent2 7,b7 maintains their dignity1 privacy1 and confidentiality2 7,c7 ensures freedom from harm and mistreatment2 and 7,d7 enables informed choice and continuous support4 7#b7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 #aajb4 ,funding for data collection1 surveillance1 and research on maternal health outcomes during public health emergencies ,to conduct or support data collection1 surveillance1 and research on maternal health as a result of public health emergencies and infectious diseases that pose a risk to maternal and infant health1 including support to assist in the capacity building for ,state1 ,tribal1 territorial1 and local public health departments to collect and transmit racial1 ethnic1 and other demographic data related to maternal health1 there are authorized to be appropriated-- 7#a7 #ajj1jjj1jjj for the ,surveillance for ,emerging ,threats to ,mothers and ,babies program of the ,centers for ,disease ,control and ,prevention1 to support the ,centers for ,disease ,control and ,prevention in its efforts to-- 7,a7 work with public health1 clinical1 and community-based organizations to provide timely1 continually updated guidance to families and health care providers on ways to reduce risk to pregnant and postpartum individuals and their newborns and tailor interventions to improve their long-term health2 7,b7 partner with more ,state1 ,tribal1 territorial1 and local public health programs in the collection and analysis of clinical data on the impact of public health emergencies and infectious diseases that pose a risk to maternal and infant health on pregnant and postpartum patients and their newborns1 particularly among patients from racial and ethnic minority groups2 and 7,c7 establish regionally based centers of excellence to offer medical1 public health1 and other knowledge to ensure communities can help pregnant and postpartum individuals and newborns get the care and support they need1 particularly in areas with large populations of individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7#b7 #cj1jjj1jjj for the ,enhancing ,reviews and ,surveillance to ,eliminate ,maternal ,mortality program 7commonly known as the ,,erase ,,mm program7 of the ,centers for ,disease ,control and ,prevention1 to support the ,centers for ,disease ,control and ,prevention in expanding its partnerships with ,states and ,indian ,tribes and provide technical assistance to existing ,maternal ,mortality ,review ,committees2 7#c7 #de1jjj1jjj for the ,pregnancy ,risk ,assessment ,monitoring ,system 7commonly known as the ,,prams7 of the ,centers for ,disease ,control and ,prevention1 to support the ,centers for ,disease ,control and ,prevention in its efforts to-- 7,a7 create a supplement to its ,,prams survey related to public health emergencies and infectious diseases that pose a risk to maternal and infant health2 7,b7 add questions around experiences of respectful maternity care in prenatal1 intrapartum1 and postpartum care2 and 7,c7 work to transition such ,,prams survey to an electronic platform and expand such ,,prams survey to a larger population1 with a special focus on reaching underrepresented communities1 and other program improvements2 and 7#d7 #ae1jjj1jjj for the ,national ,institute of ,child ,health and ,human ,development1 to conduct or support research for interventions to mitigate the effects of public health emergencies and infectious diseases that pose a risk to maternal and infant health1 with a particular focus on individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 #aajc4 ,public health emergency maternal health data collection and disclosure 7a7 ,availability of collected data ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention and the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall make publicly available on the website of the ,centers for ,disease ,control and ,prevention data described in subsection 7b74 7b7 ,data described ,the data described in this subsection are data collected through ,federal surveillance systems under the ,centers for ,disease ,control and ,prevention with respect to public health emergencies and individuals who are pregnant or in a postpartum period4 ,such data shall include the following3 7#a7 ,diagnostic testing1 confirmed cases1 hospitalizations1 deaths1 and other health outcomes related to an infectious disease outbreak among pregnant and postpartum individuals4 7#b7 ,maternal and infant health outcomes among individuals who test positive for an infectious disease during or after pregnancy4 7c7 ,american ,indian and ,alaska ,native ,health outcomes ,in carrying out subsection 7a71 the ,secretary shall consult with ,indian ,tribes and confer with ,urban ,indian organizations4 7d7 ,disaggregated information ,in carrying out subsection 7a71 the ,secretary shall disaggregate data by race1 ethnicity1 gender1 primary language1 geography1 socioeconomic status1 and other relevant factors4 7e7 ,update ,during public health emergencies1 the ,secretary shall update the data made available under this section-- 7#a7 at least on a monthly basis2 and 7#b7 not less than one month after the end of such public health emergency4 7f7 ,privacy ,in carrying out subsection 7a71 the ,secretary shall-- 7#a7 take steps to protect the privacy of individuals pursuant to regulations promulgated under section #bfd7;c7 of the ,health ,insurance ,portability and ,accountability ,act of #aiif 7#db ,u4,s4,c4 #acbj;d-#b note72 and 7#b7 ensure that-- 7,a7 all data collected is deidentified2 7,b7 at a minimum1 there is no disclosure of any individually identifying or potentially identifying information regarding a patient or a patient's health care provider2 and 7,c7 all data is collected in a manner that is consistent with applicable ,federal and ,state privacy law4 7g7 ,guidance 7#a7 ,in general ,not later than #cj days after the declaration of a public health emergency under section #cai of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d71 the ,secretary shall issue guidance to ,states and local public health departments to ensure that-- 7,a7 laboratories that test specimens for an infectious disease receive all relevant demographic data on race1 ethnicity1 pregnancy status1 and other demographic data as determined by the ,secretary2 and 7,b7 data described in subsection 7b7 are disaggregated by race1 ethnicity1 gender1 primary language1 geography1 socioeconomic status1 and other relevant factors4 7#b7 ,consultation ,in carrying out paragraph 7#a71 the ,secretary shall consult with ,indian ,tribes-- 7,a7 to ensure that such guidance includes tribally developed best practices2 and 7,b7 to reduce misclassification of ,american ,indians and ,alaska ,natives4 #aajd4 ,public health communication regarding maternal care during public health emergencies ,the ,director of the ,centers for ,disease ,control and ,prevention shall conduct public health education campaigns during public health emergencies to ensure that pregnant and postpartum individuals1 their employers1 and their health care providers have accurate1 evidence-based information on maternal and infant health risks during the public health emergency1 with a particular focus on reaching pregnant and postpartum individuals in underserved communities4 #aaje4 ,task force on birthing experience and safe1 respectful1 responsive1 and empowering maternity care during public health emergencies 7a7 ,establishment ,the ,secretary1 in consultation with the ,director of the ,centers for ,disease ,control and ,prevention and the ,administrator of the ,health ,resources and ,services ,administration1 shall convene a task force 7in this subsection referred to as the ,task ,force7 to develop ,federal recommendations regarding respectful1 responsive1 and empowering maternity care1 including safe birth care and postpartum care1 during public health emergencies4 7b7 ,duties ,the ,task ,force shall develop1 publicly post1 and update ,federal recommendations in multiple languages to ensure high-quality1 nondiscriminatory maternity care1 promote positive birthing experiences1 and improve maternal health outcomes during public health emergencies1 with a particular focus on outcomes for individuals from demographic groups with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes4 ,such recommendations shall-- 7#a7 address1 with particular attention to ensuring equitable treatment on the basis of race and ethnicity-- 7,a7 measures to facilitate respectful1 responsive1 and empowering maternity care2 7,b7 measures to facilitate telehealth maternity care for pregnant individuals who cannot regularly access in-person care2 7,c7 strategies to increase access to specialized care for those with high-risk pregnancies or pregnant individuals with elevated risk factors2 7,d7 diagnostic testing for pregnant and laboring patients2 7,e7 birthing without one's chosen companions1 with one's chosen companions1 and with smartphone or other telehealth connection to one's chosen companions2 7,f7 newborn separation after birth in relation to maternal infection status2 7,g7 breast milk feeding in relation to maternal infection status2 7,h7 licensure1 training1 scope of practice1 and ,medicaid and other insurance reimbursement for certified midwives1 certified nurse-midwives1 and certified professional midwives1 who meet1 at a minimum1 the international definition of a midwife and global standards for midwifery education1 as established by the ,international ,confederation of ,midwives1 in a manner that facilitates inclusion of midwives of color and midwives from underserved communities2 7,i7 financial support and training for perinatal health workers who provide nonclinical support to individuals from pregnancy through the postpartum period in a manner that facilitates inclusion from underserved communities2 7,j7 strategies to ensure and expand doula coverage under ,state ,medicaid programs2 7,k7 how to identify1 address1 and treat prenatal and postpartum mental and behavioral health conditions1 such as anxiety1 substance use disorder1 and depression1 during public health emergencies2 7,l7 how to identify and address instances of intimate partner violence during pregnancy which may arise or intensify during public health emergencies2 7,m7 strategies to address hospital capacity concerns in communities with a surge in infectious disease cases and to provide childbearing individuals with options that reduce the potential for cross-contamination and increase the ability to implement their care preferences while maintaining safety and quality1 such as the use of freestanding birth centers2 7,n7 provision of child care services during prenatal and postpartum appointments for mothers whose children are unable to attend as a result of restrictions relating to the public health emergencies2 7,o7 how to identify and address racism1 bias1 and discrimination in the delivery of maternity care services to pregnant and postpartum individuals1 including evaluating the value of training for hospital staff on implicit bias and racism1 respectful1 responsive1 and empowering maternity care1 and demographic data collection2 7,p7 how to address the needs of undocumented pregnant individuals and new mothers who may be afraid or unable to seek needed care during the ,,covid-#ai public health emergency2 7,q7 how to address the needs of uninsured and underinsured pregnant individuals who have historically relied on emergency departments for care2 7,r7 how to identify pregnant and postpartum individuals at risk for depression1 anxiety disorder1 psychosis1 obsessive-compulsive disorder1 and other maternal mood disorders before1 during1 and after pregnancy1 and how to treat those diagnosed with a prenatal or postpartum mood disorder2 7,s7 how to effectively and compassionately screen for substance use disorder during pregnancy and postpartum and help pregnant and postpartum individuals find support and effective treatment2 7,t7 how to ensure access to infant nutrition during public health emergencies2 and 7,u7 such other matters as the ,task ,force determines appropriate2 7#b7 identify barriers to the implementation of the recommendations2 7#c7 take into consideration existing ,state and other programs that have demonstrated effectiveness in addressing pregnancy1 birth1 and postpartum care during public health emergencies2 and 7#d7 identify policies specific to public health emergencies that should be discontinued when safely possible and those that should be continued as the public health emergency abates4 7c7 ,membership ,the ,secretary shall appoint the members of the ,task ,force4 ,such members shall be comprised of-- 7#a7 representatives of the ,department of ,health and ,human ,services1 including representatives of-- 7,a7 the ,secretary2 7,b7 the ,director of the ,centers for ,disease ,control and ,prevention2 7,c7 the ,administrator of the ,health ,resources and ,services ,administration2 7,d7 the ,administrator of the ,centers for ,medicare ,medicaid ,services2 7,e7 the ,director of the ,agency for ,healthcare ,research and ,quality2 7,f7 the ,commissioner of ,food and ,drugs2 7,g7 the ,assistant ,secretary for ,mental ,health and ,substance ,use2 and 7,h7 the ,director of the ,indian ,health ,service2 7#b7 at least #c ,state1 local1 or territorial public health officials representing departments of public health1 who shall represent jurisdictions from different regions of the ,united ,states with relatively high concentrations of historically marginalized populations2 7#c7 at least #a ,tribal public health official representing departments of public health2 7#d7 #a or more representatives of community-based organizations that address adverse maternal health outcomes with a specific focus on racial and ethnic inequities in maternal health outcomes1 with special consideration given to representatives of such organizations that are led by a person of color or from communities with significant minority populations2 7#e7 a professionally diverse panel of maternity care providers and perinatal health workers2 7#f7 #a or more patients who were pregnant or gave birth during the ,,covid-#ai public health emergency or a subsequent public health emergency2 7#g7 #a or more patients who have received support from a perinatal health worker2 and 7#h7 racially and ethnically diverse representation from at least #c independent experts with knowledge or field experience with racial and ethnic disparities in public health1 women's health1 or maternal mortality and severe maternal morbidity4 ,,xii ,protecting moms and babies against climate change #abja4 ,definitions ,in this title1 the following definitions apply3 7#a7 ,adverse maternal and infant health outcomes ,the term adverse maternal and infant health outcomes includes the outcomes of preterm birth1 low birth weight1 stillbirth1 infant or maternal mortality1 and severe maternal morbidity4 7#b7 ,institution of higher education ,the term institution of higher education has the meaning given such term in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja74 7#c7 ,minority-serving institution ,the term minority-serving institution means an entity specified in any of paragraphs 7#a7 through 7#g7 of section #cga7;a7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajfgq7a774 7#d7 ,risks associated with climate change ,the term risks associated with climate change includes risks associated with extreme heat1 air pollution1 extreme weather events1 and other environmental issues associated with climate change that can result in adverse maternal and infant health outcomes4 7#e7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#f7 ,stakeholder organization ,the term stakeholder organization means-- 7,a7 a community-based organization with expertise in providing assistance to vulnerable individuals2 7,b7 a nonprofit organization with expertise in-- 7i7 maternal or infant health2 or 7ii7 environmental or climate justice2 and 7,c7 a patient advocacy organization representing vulnerable individuals4 7#g7 ,vulnerable individual ,the term vulnerable individual means-- 7,a7 an individual who is pregnant2 7,b7 an individual who was pregnant during any portion of the preceding #a-year period2 and 7,c7 an individual under #c years of age4 #abjb4 ,grant program to protect vulnerable mothers and babies from climate change risks 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall establish a grant program to protect vulnerable individuals from risks associated with climate change4 7b7 ,grant authority ,in carrying out the ,program1 the ,secretary may award1 on a competitive basis1 grants to #aj covered entities4 7c7 ,applications ,to be eligible for a grant under the ,program1 a covered entity shall submit to the ,secretary an application at such time1 in such form1 and containing such information as the ,secretary may require1 which shall include1 at a minimum1 a description of the following3 7#a7 ,plans for the use of grant funds awarded under the ,program and how patients and stakeholder organizations were involved in the development of such plans4 7#b7 ,how such grant funds will be targeted to geographic areas that have disproportionately high levels of risks associated with climate change for vulnerable individuals4 7#c7 ,how such grant funds will be used to address racial and ethnic disparities in-- 7,a7 adverse maternal and infant health outcomes2 and 7,b7 exposure to risks associated with climate change for vulnerable individuals4 7#d7 ,strategies to prevent an initiative assisted with such grant funds from causing-- 7,a7 adverse environmental impacts2 7,b7 displacement of residents and businesses2 7,c7 rent and housing price increases2 or 7,d7 disproportionate adverse impacts on racial and ethnic minority groups and other underserved populations4 7d7 ,selection of grant recipients 7#a7 ,timing ,not later than #bgj days after the date of enactment of this ,act1 the ,secretary shall select the recipients of grants under the ,program4 7#b7 ,consultation ,in selecting covered entities for grants under the ,program1 the ,secretary shall consult with-- 7,a7 representatives of stakeholder organizations2 7,b7 the ,administrator of the ,environmental ,protection ,agency2 7,c7 the ,administrator of the ,national ,oceanic and ,atmospheric ,administration2 and 7,d7 from the ,department of ,health and ,human ,services-- 7i7 the ,deputy ,assistant ,secretary for ,minority ,health2 7ii7 the ,administrator of the ,centers for ,medicare ,medicaid ,services2 7iii7 the ,administrator of the ,health ,resources and ,services ,administration2 7iv7 the ,director of the ,national ,institutes of ,health2 and 7v7 the ,director of the ,centers for ,disease ,control and ,prevention4 7#c7 ,priority ,in selecting grantees under the ,program1 the ,secretary shall give priority to covered entities that serve a county or locality-- 7,a7 designated1 or located in an area designated1 as a nonattainment area pursuant to section #ajg of the ,clean ,air ,act 7#db ,u4,s4,c4 #gdjg7 for any air pollutant for which air quality criteria have been issued under section #ajh7;a7 of such ,act 7#db ,u4,s4,c4 #gdjh7;a772 7,b7 with a level of vulnerability of moderate-to-high or higher1 according to the ,social ,vulnerability ,index of the ,centers for ,disease ,control and ,prevention1 or a similar rating of social vulnerability according to related ,federal mapping tools2 7,c7 with temperatures that pose a risk to human health1 as determined by the ,secretary1 in consultation with the ,administrator of the ,national ,oceanic and ,atmospheric ,administration and the ,chair of the ,united ,states ,global ,change ,research ,program1 based on the best available science2 7,d7 with elevated rates of maternal mortality1 severe maternal morbidity1 maternal health disparities1 or other adverse perinatal or childbirth outcomes2 7,e7 with a rating of very high or relatively high risk according to the ,national ,risk ,index for ,natural ,hazards of the ,federal ,emergency ,management ,agency2 or 7,f7 with other climate-sensitive hazards with associations to adverse maternal or infant health outcomes1 as determined by the ,secretary4 7#d7 ,limitation ,a recipient of grant funds under the ,program may not use such grant funds to serve a county or locality that is served by any other recipient of a grant under the ,program4 7e7 ,use of funds ,a covered entity awarded grant funds under the ,program may only use such grant funds for the following3 7#a7 ,initiatives to identify risks associated with climate change for vulnerable individuals and to provide services and support to such individuals that address such risks1 which may include-- 7,a7 training for health care providers1 perinatal health workers1 and other employees in hospitals1 birth centers1 midwifery practices1 and other health care practices that provide prenatal or labor and delivery services to vulnerable individuals on the identification of1 and patient counseling relating to1 risks associated with climate change for vulnerable individuals2 7,b7 hiring1 training1 or providing resources to perinatal health workers who can help identify risks associated with climate change for vulnerable individuals1 provide patient counseling about such risks1 and carry out the distribution of relevant services and support2 7,c7 enhancing the monitoring of risks associated with climate change for vulnerable individuals1 including by-- 7i7 collecting data on such risks in specific census tracts1 neighborhoods1 or other geographic areas2 and 7ii7 sharing such data with local health care providers1 perinatal health workers1 and other employees in hospitals1 birth centers1 midwifery practices1 and other health care practices that provide prenatal or labor and delivery services to local vulnerable individuals2 and 7,d7 providing vulnerable individuals-- 7i7 air conditioning units1 residential weatherization support1 filtration systems1 household appliances1 or related items2 7ii7 direct financial assistance2 and 7iii7 services and support1 including housing assistance1 evacuation assistance1 transportation assistance1 access to cooling shelters1 and mental health counseling1 to prepare for or recover from extreme weather events1 which may include floods1 hurricanes1 wildfires1 droughts1 and related events4 7#b7 ,initiatives to mitigate levels of and exposure to risks associated with climate change for vulnerable individuals1 which shall be based on the best available science and which may include initiatives to-- 7,a7 develop1 maintain1 or expand urban or community forestry initiatives and tree canopy coverage initiatives2 7,b7 improve infrastructure1 such as buildings and paved surfaces2 7,c7 develop or improve community outreach networks to provide culturally and linguistically appropriate information and notifications about risks associated with climate change for vulnerable individuals2 and 7,d7 provide enhanced services to racial and ethnic minority groups and other underserved populations4 7f7 ,length of award ,a grant under this section shall be disbursed over #d fiscal years4 7g7 ,technical assistance ,the ,secretary shall provide technical assistance to a covered entity awarded a grant under the ,program to support the development1 implementation1 and evaluation of activities funded with such grant4 7h7 ,reports to ,secretary 7#a7 ,annual report ,for each fiscal year during which a covered entity is disbursed grant funds under the ,program1 such covered entity shall submit to the ,secretary a report that summarizes the activities carried out by such covered entity with such grant funds during such fiscal year1 which shall include a description of the following3 7,a7 ,the involvement of stakeholder organizations in the implementation of initiatives assisted with such grant funds4 7,b7 ,relevant health and environmental data1 disaggregated1 to the extent practicable1 by race1 ethnicity1 primary language1 socioeconomic status1 geography1 insurance type1 pregnancy status1 and other relevant demographic information4 7,c7 ,qualitative feedback received from vulnerable individuals with respect to initiatives assisted with such grant funds4 7,d7 ,criteria used in selecting the geographic areas assisted with such grant funds4 7,e7 ,efforts to address racial and ethnic disparities in adverse maternal and infant health outcomes and in exposure to risks associated with climate change for vulnerable individuals4 7,f7 ,any negative and unintended impacts of initiatives assisted with such grant funds1 including-- 7i7 adverse environmental impacts2 7ii7 displacement of residents and businesses2 7iii7 rent and housing price increases2 and 7iv7 disproportionate adverse impacts on racial and ethnic minority groups and other underserved populations4 7,g7 ,how the covered entity will address and prevent any impacts described in subparagraph 7,f74 7#b7 ,publication ,not later than #cj days after the date on which a report is submitted under paragraph 7#a71 the ,secretary shall publish such report on a public website of the ,department of ,health and ,human ,services4 7i7 ,report to ,congress ,not later than the date that is #e years after the date on which the ,program is established1 the ,secretary shall submit to ,congress and publish on a public website of the ,department of ,health and ,human ,services a report on the results of the ,program1 including the following3 7#a7 ,summaries of the annual reports submitted under subsection 7h74 7#b7 ,evaluations of the initiatives assisted with grant funds under the ,program4 7#c7 ,an assessment of the effectiveness of the ,program in-- 7,a7 identifying risks associated with climate change for vulnerable individuals2 7,b7 providing services and support to such individuals2 7,c7 mitigating levels of and exposure to such risks2 and 7,d7 addressing racial and ethnic disparities in adverse maternal and infant health outcomes and in exposure to such risks4 7#d7 ,a description of how the ,program could be expanded1 including-- 7,a7 monitoring efforts or data collection that would be required to identify areas with high levels of risks associated with climate change for vulnerable individuals2 7,b7 how such areas could be identified using the strategy developed under section #abje2 and 7,c7 recommendations for additional funding4 7j7 ,definitions ,in this section3 7#a7 ,the term covered entity means a consortium of organizations serving a county that-- 7,a7 shall include a community-based organization2 and 7,b7 may include-- 7i7 another stakeholder organization2 7ii7 the government of such county2 7iii7 the governments of one or more municipalities within such county2 7iv7 a ,state or local public health department or emergency management agency2 7v7 a local health care practice1 which may include a licensed and accredited hospital1 birth center1 midwifery practice1 or other health care practice that provides prenatal or labor and delivery services to vulnerable individuals2 7vi7 an ,indian tribe or ,tribal organization 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd772 7vii7 an ,urban ,indian organization 7as defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc772 and 7viii7 an institution of higher education4 7#b7 ,the term ,program means the grant program under this section4 7k7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ajj1jjj1jjj for the period of fiscal years #bjbg through #bjcj4 #abjc4 ,grant program for education and training at health profession schools 7a7 ,in general ,not later than #a year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall establish a grant program to provide funds to health profession schools to support the development and integration of education and training programs for identifying and addressing risks associated with climate change for vulnerable individuals4 7b7 ,grant authority ,in carrying out the ,program1 the ,secretary may award1 on a competitive basis1 grants to health profession schools4 7c7 ,application ,to be eligible for a grant under the ,program1 a health profession school shall submit to the ,secretary an application at such time1 in such form1 and containing such information as the ,secretary may require1 which shall include1 at a minimum1 a description of the following3 7#a7 ,how such health profession school will engage with vulnerable individuals1 and stakeholder organizations representing such individuals1 in developing and implementing the education and training programs supported by grant funds awarded under the ,program4 7#b7 ,how such health profession school will ensure that such education and training programs will address racial and ethnic disparities in exposure to1 and the effects of1 risks associated with climate change for vulnerable individuals4 7d7 ,use of funds ,a health profession school awarded a grant under the ,program shall use the grant funds to develop1 and integrate into the curriculum and continuing education of such health profession school1 education and training on each of the following3 7#a7 ,identifying risks associated with climate change for vulnerable individuals and individuals with the intent to become pregnant4 7#b7 ,how risks associated with climate change affect vulnerable individuals and individuals with the intent to become pregnant4 7#c7 ,racial and ethnic disparities in exposure to1 and the effects of1 risks associated with climate change for vulnerable individuals and individuals with the intent to become pregnant4 7#d7 ,patient counseling and mitigation strategies relating to risks associated with climate change for vulnerable individuals4 7#e7 ,relevant services and support for vulnerable individuals relating to risks associated with climate change and strategies for ensuring vulnerable individuals have access to such services and support4 7#f7 ,implicit and explicit bias1 racism1 and discrimination4 7#g7 ,related topics identified by such health profession school based on the engagement of such health profession school with vulnerable individuals and stakeholder organizations representing such individuals4 7e7 ,partnerships ,in carrying out activities with grant funds1 a health profession school awarded a grant under the ,program may partner with one or more of the following3 7#a7 ,a ,state or local public health department4 7#b7 ,a health care professional membership organization4 7#c7 ,a stakeholder organization4 7#d7 ,a health profession school4 7#e7 ,an institution of higher education4 7f7 ,reports to ,secretary 7#a7 ,annual report ,for each fiscal year during which a health profession school is disbursed grant funds under the ,program1 such health profession school shall submit to the ,secretary a report that describes the activities carried out with such grant funds during such fiscal year4 7#b7 ,final report ,not later than the date that is #a year after the end of the last fiscal year during which a health profession school is disbursed grant funds under the ,program1 the health profession school shall submit to the ,secretary a final report that summarizes the activities carried out with such grant funds4 7g7 ,report to ,congress ,not later than the date that is #f years after the date on which the ,program is established1 the ,secretary shall submit to ,congress and publish on a public website of the ,department of ,health and ,human ,services a report that includes the following3 7#a7 ,a summary of the reports submitted under subsection 7f74 7#b7 ,recommendations to improve education and training programs at health profession schools with respect to identifying and addressing risks associated with climate change for vulnerable individuals4 7h7 ,definitions ,in this section3 7#a7 ,the term health profession school means an accredited-- 7,a7 medical school2 7,b7 school of nursing2 7,c7 midwifery program2 7,d7 physician assistant education program2 7,e7 teaching hospital2 7,f7 residency or fellowship program2 or 7,g7 other school or program determined appropriate by the ,secretary4 7#b7 ,the term ,program means the grant program under this section4 7i7 ,authorization of ,appropriations ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for the period of fiscal years #bjbg through #bjcj4 #abjd4 ,,nih ,consortium on ,birth and ,climate ,change ,research 7a7 ,establishment ,not later than one year after the date of the enactment of this ,act1 the ,director of the ,national ,institutes of ,health shall establish the ,consortium on ,birth and ,climate ,change ,research 7in this section referred to as the ,consortium74 7b7 ,duties 7#a7 ,in general ,the ,consortium shall coordinate1 across the institutes1 centers1 and offices of the ,national ,institutes of ,health1 research on the risks associated with climate change for vulnerable individuals4 7#b7 ,required activities ,in carrying out paragraph 7#a71 the ,consortium shall-- 7,a7 establish research priorities1 including by prioritizing research that-- 7i7 identifies the risks associated with climate change for vulnerable individuals with a particular focus on disparities in such risks among racial and ethnic minority groups and other underserved populations2 and 7ii7 identifies strategies to reduce levels of1 and exposure to1 such risks1 with a particular focus on risks among racial and ethnic minority groups and other underserved populations2 7,b7 identify gaps in available data related to such risks2 7,c7 identify gaps in1 and opportunities for1 research collaborations2 7,d7 identify funding opportunities for community-based organizations and researchers from racially1 ethnically1 and geographically diverse backgrounds2 7,e7 identify opportunities to increase public awareness related to risks associated with climate change for vulnerable individuals2 and 7,f7 publish annual reports on the work and findings of the ,consortium on a public website of the ,national ,institutes of ,health4 7c7 ,membership ,the ,director shall appoint to the ,consortium representatives of such institutes1 centers1 and offices of the ,national ,institutes of ,health as the ,director considers appropriate1 including1 at a minimum1 representatives of-- 7#a7 the ,national ,institute of ,environmental ,health ,sciences2 7#b7 the ,national ,institute on ,minority ,health and ,health ,disparities2 7#c7 the ,eunice ,kennedy ,shriver ,national ,institute of ,child ,health and ,human ,development2 7#d7 the ,national ,institute of ,mental ,health2 7#e7 the ,national ,institute of ,nursing ,research2 and 7#f7 the ,office of ,research on ,women's ,health4 7d7 ,chairperson ,the ,chairperson of the ,consortium shall be designated by the ,director and selected from among the representatives appointed under subsection 7c74 7e7 ,consultation ,in carrying out the duties described in subsection 7b71 the ,consortium shall consult with-- 7#a7 the heads of relevant ,federal agencies1 including-- 7,a7 the ,environmental ,protection ,agency2 7,b7 the ,national ,oceanic and ,atmospheric ,administration2 7,c7 the ,occupational ,safety and ,health ,administration2 and 7,d7 from the ,department of ,health and ,human ,services-- 7i7 the ,office of ,minority ,health in the ,office of the ,secretary2 7ii7 the ,centers for ,medicare ,medicaid ,services2 7iii7 the ,health ,resources and ,services ,administration2 7iv7 the ,centers for ,disease ,control and ,prevention2 7v7 the ,indian ,health ,service2 and 7vi7 the ,administration for ,children and ,families2 and 7#b7 representatives of-- 7,a7 stakeholder organizations2 7,b7 health care providers and professional membership organizations with expertise in maternal health or environmental justice2 7,c7 ,state and local public health departments2 7,d7 licensed and accredited hospitals1 birth centers1 midwifery practices1 or other health care practices that provide prenatal or labor and delivery services to vulnerable individuals2 and 7,e7 institutions of higher education1 including such institutions that are minority-serving institutions or have expertise in maternal health or environmental justice4 #abje4 ,strategy for identifying climate change risk zones for vulnerable mothers and babies 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall develop a strategy 7in this section referred to as the ,strategy7 for designating areas that the ,secretary determines to have a high risk of adverse maternal and infant health outcomes among vulnerable individuals as a result of risks associated with climate change4 7b7 ,strategy requirements 7#a7 ,in general ,in developing the ,strategy1 the ,secretary shall establish a process to identify areas where vulnerable individuals are exposed to a high risk of adverse maternal and infant health outcomes as a result of risks associated with climate change in conjunction with other factors that can impact such health outcomes1 including-- 7,a7 the incidence of diseases associated with air pollution1 extreme heat1 and other environmental factors2 7,b7 the availability and accessibility of maternal and infant health care providers2 7,c7 ,english-language proficiency among women of reproductive age2 7,d7 the health insurance status of women of reproductive age2 7,e7 the number of women of reproductive age who are members of racial or ethnic groups with disproportionately high rates of adverse maternal and infant health outcomes2 7,f7 the socioeconomic status of women of reproductive age1 including with respect to-- 7i7 poverty2 7ii7 unemployment2 7iii7 household income2 and 7iv7 educational attainment2 and 7,g7 access to quality housing1 transportation1 and nutrition4 7#b7 ,resources ,in developing the ,strategy1 the ,secretary shall identify1 and incorporate a description of1 the following3 7,a7 ,existing mapping tools or ,federal programs that identify-- 7i7 risks associated with climate change for vulnerable individuals2 and 7ii7 other factors that can influence maternal and infant health outcomes1 including the factors described in paragraph 7#a74 7,b7 ,environmental1 health1 socioeconomic1 and demographic data relevant to identifying risks associated with climate change for vulnerable individuals4 7,c7 ,existing monitoring networks that collect data described in subparagraph 7,b71 and any gaps in such networks4 7,d7 ,federal1 ,state1 and local stakeholders involved in maintaining monitoring networks identified under subparagraph 7,c71 and how such stakeholders are coordinating their monitoring efforts4 7,e7 ,additional monitoring networks1 and enhancements to existing monitoring networks1 that would be required to address gaps identified under subparagraph 7,c71 including at the subcounty and census tract level4 7,f7 ,funding amounts required to establish the monitoring networks identified under subparagraph 7,e7 and recommendations for ,federal1 ,state1 and local coordination with respect to such networks4 7,g7 ,potential uses for data collected and generated as a result of the ,strategy1 including how such data may be used in determining recipients of grants under the program established by section #abjb or other similar programs4 7,h7 ,other information the ,secretary considers relevant for the development of the ,strategy4 7c7 ,coordination and consultation ,in developing the ,strategy1 the ,secretary shall-- 7#a7 coordinate with the ,administrator of the ,environmental ,protection ,agency and the ,administrator of the ,national ,oceanic and ,atmospheric ,administration2 and 7#b7 consult with-- 7,a7 stakeholder organizations2 7,b7 health care providers and professional membership organizations with expertise in maternal health or environmental justice2 7,c7 ,state and local public health departments2 7,d7 licensed and accredited hospitals1 birth centers1 midwifery practices1 or other health care providers that provide prenatal or labor and delivery services to vulnerable individuals2 and 7,e7 institutions of higher education1 including such institutions that are minority-serving institutions or have expertise in maternal health or environmental justice4 7d7 ,notice and comment ,at least #bdj days before the date on which the ,strategy is published in accordance with subsection 7e71 the ,secretary shall provide-- 7#a7 notice of the ,strategy on a public website of the ,department of ,health and ,human ,services2 and 7#b7 an opportunity for public comment of at least #ij days4 7e7 ,publication ,not later than #ah months after the date of the enactment of this ,act1 the ,secretary shall publish on a public website of the ,department of ,health and ,human ,services-- 7#a7 the ,strategy2 7#b7 the public comments received under subsection 7d72 and 7#c7 the responses of the ,secretary to such public comments4 ,,xiii ,,nih ,,improve #acja4 ,,improve ,initiative ,part ,b of title ,,iv of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhd et seq47 is amended by adding at the end the following3 #dji,k4 ,,improve initiative 7a7 ,in general ,the ,director of ,,nih shall continue to carry out a program to improve maternal health outcomes1 to be known as the ,implementing a ,maternal health and ,p,regnancy ,outcomes ,vision for ,everyone ,initiative or the ,,improve ,initiative 7referred to in this section as the ,initiative74 7b7 ,objectives ,the ,initiative shall-- 7#a7 advance research to-- 7,a7 reduce preventable causes of maternal mortality and severe maternal morbidity2 7,b7 reduce health disparities related to maternal health outcomes1 including such disparities associated with populations with disproportionately high rates of maternal mortality and severe maternal morbidity relative to the national rate2 and 7,c7 improve health for pregnant and postpartum women before1 during1 and after pregnancy2 7#b7 use an integrated approach to understand the factors1 including biological1 behavioral1 and other factors1 that affect maternal mortality and severe maternal morbidity by building an evidence base for improved outcomes in specific regions of the ,united ,states2 and 7#c7 target health disparities associated with maternal mortality and severe maternal morbidity by-- 7,a7 implementing and evaluating community-based interventions for disproportionately affected women2 and 7,b7 identifying risk factors and the underlying biological mechanisms associated with leading causes of maternal mortality and severe maternal morbidity in the ,united ,states4 7c7 ,implementation ,the ,director of ,,nih may award grants or enter into contracts1 cooperative agreements1 or other transactions to carry out this section4 7d7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #gc1djj1jjj for each of fiscal years #bjbg through #bjcb4 4 ,,xiv ,maternal vaccinations #adja4 ,maternal vaccination awareness and equity campaign 7a7 ,campaign ,section #cac of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bde7 is amended-- 7#a7 in subsection 7a71 by inserting and among pregnant and postpartum individuals1 after low rates of vaccination12 7#b7 in subsection 7c77#c71 by striking prenatal and pediatric and inserting prenatal1 obstetric1 and pediatric2 7#c7 in subsection 7d77#d77;,b71 by inserting pregnant and postpartum individuals and after including2 and 7#d7 in subsection 7g71 by striking #ae1jjj1jjj for each of fiscal years #bjba through #bjbe and inserting #ag1jjj1jjj for each of fiscal years #bjbg through #bjca4 7b7 ,additional activities ,section #cag7k77#a77;,e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b7k77#a77;,e77 is amended-- 7#a7 in clause 7v71 by striking and at the end2 and 7#b7 by adding at the end the following3 7vii7 increase vaccination rates of pregnant and postpartum individuals1 including individuals from racial and ethnic minority groups1 and their children2 and 4