[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6132 Introduced in House (IH)]
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116th CONGRESS
2d Session
H. R. 6132
To address social determinants of health for women in the prenatal and
postpartum periods, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 9, 2020
Mrs. McBath (for herself, Ms. Underwood, Ms. Adams, Mr. Lewis, Ms.
Sewell of Alabama, Ms. Norton, Ms. Scanlon, Ms. Moore, Mr. Clay, Mr.
Khanna, Ms. Pressley, and Mr. Lawson of Florida) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committees on Financial Services,
Agriculture, Transportation and Infrastructure, and Education and
Labor, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To address social determinants of health for women in the prenatal and
postpartum periods, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Social Determinants for Moms Act of
2020''.
SEC. 2. TASK FORCE TO COORDINATE EFFORTS TO ADDRESS SOCIAL DETERMINANTS
OF HEALTH FOR WOMEN IN THE PRENATAL AND POSTPARTUM
PERIODS.
(a) In General.--The Secretary of Health and Human Services shall
convene a task force (in this section referred to as the ``Task
Force'') to develop strategies to coordinate efforts across the Federal
Government to address social determinants of health for women in the
prenatal and postpartum periods.
(b) Members.--The members of the Task Force shall consist of the
following:
(1) The Secretary of Health and Human Services (or the
Secretary's designee).
(2) The Secretary of Housing and Urban Development (or the
Secretary's designee).
(3) The Secretary of Transportation (or the Secretary's
designee).
(4) The Secretary of Agriculture (or the Secretary's
designee).
(5) The Administrator of the Environmental Protection
Agency (or the Administrator's designee).
(6) The Assistant Secretary for the Administration for
Children and Families (or the Assistant Secretary's designee).
(7) The Administrator of the Centers for Medicare &
Medicaid Services (or the Administrator's designee).
(8) The Director of the Indian Health Service (or the
Director's designee).
(9) The Director of the National Institutes of Health (or
the Director's designee).
(10) The Administrator of the Health Resources and Services
Administration (or the Administrator's designee).
(11) The Deputy Assistant Secretary for Minority Health of
the Department of Health and Human Services (or the Deputy
Assistant Secretary's designee).
(12) The Deputy Assistant Secretary for Women's Health of
the Department of Health and Human Services (or the Deputy
Assistant Secretary's designee).
(13) The Director of the Centers for Disease Control and
Prevention (or the Director's designee).
(14) A woman who has experienced severe maternal morbidity
or a family member of a woman who has suffered a pregnancy-
related death.
(15) A leader of a community-based organization that
addresses maternal mortality and severe maternal morbidity with
a specific focus on racial and ethnic disparities.
(16) A maternal health care provider.
(c) Chair.--The Secretary of Health and Human Services shall select
the Chair of the Task Force from among the members of the Task Force.
(d) Report.--Not later than 2 years after the date of enactment of
this Act, the Task Force shall--
(1) finalize strategies to coordinate efforts across the
Federal Government to address social determinants of health for
women in the prenatal and postpartum periods; and
(2) submit a report on such strategies to the Congress,
including--
(A) plans for implementing such strategies; and
(B) recommendations on the funding amounts needed
by each department and agency to implement such
strategies.
(e) Termination.--Termination under section 14 of the Federal
Advisory Committee Act (5 U.S.C. App.) shall not apply to the Task
Force.
SEC. 3. REQUIREMENTS FOR GUIDANCE RELATING TO SOCIAL DETERMINANTS OF
HEALTH FOR PREGNANT WOMEN.
(a) In General.--Not later than 1 year after the date of the
enactment of this Act, the Secretary of Health and Human Services shall
issue guidance with respect to how medicaid managed care organizations
and State Medicaid programs can use payments made pursuant to section
1903 of the Social Security Act (42 U.S.C. 1396b) to address the
following issues related to social determinants of health for high-risk
mothers during the presumptive eligibility period for pregnant women:
(1) Housing.
(2) Transportation.
(3) Nutrition.
(4) Lactation and other infant feeding options support.
(5) Lead testing and abatement.
(6) Air and water quality.
(7) Car seat installation.
(8) Child care access.
(9) Wellness and stress management programs.
(10) Other social determinants of health (as determined by
the Secretary).
(b) Definitions.--In this section:
(1) Medicaid managed care organizations.--The term
``medicaid managed care organization'' has the meaning given
such term in section 1903(m)(1)(A) of the Social Security Act
(42 U.S.C. 1396b(m)(1)(A)).
(2) Presumptive eligibility period.--The term ``presumptive
eligibility period'' has the meaning given such term in section
1920(b)(1) of the Social Security Act (42 U.S.C. 1396r-
1(b)(1)).
SEC. 4. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT.
The Secretary of Housing and Urban Development shall establish a
new Housing for Moms task force within the Department that shall be
responsible for ensuring that women in the prenatal and postpartum
periods have safe, stable, affordable, and adequate housing for
themselves and their other children. The task force shall--
(1) study how the Department of Housing and Urban
Development can support women in the prenatal and postpartum
periods and make recommendations to the Secretary;
(2) provide guidance to regional offices of the Department
on measures to ensure that local housing infrastructure is
supportive to women in the prenatal and postpartum periods,
including providing information on--
(A) health-promoting housing codes;
(B) enforcement of housing codes;
(C) proactive rental inspection programs;
(D) code enforcement officer training; and
(E) partnerships between regional offices of the
Department and community organizations to ensure
housing laws are understood and violations are
discovered; and
(3) not later than 2 years after the date of enactment of
this Act, and annually thereafter, submit to the Congress a
report summarizing the activities of the task force.
SEC. 5. DEPARTMENT OF TRANSPORTATION.
(a) Report.--Not later than 1 year after the date of enactment of
this Act, the Secretary of Transportation shall submit to Congress a
report containing--
(1) an assessment of transportation barriers preventing
individuals from attending prenatal and postpartum
appointments, accessing maternal health care services, or
accessing services and resources related to social determinants
of health that affect maternal health outcomes, such as healthy
foods;
(2) recommendations on how to overcome such barriers; and
(3) an assessment of transportation safety risks for
pregnant individuals and recommendations on how to mitigate
such risks.
(b) Considerations.--In carrying out subsection (a), the Secretary
shall give special consideration to solutions for--
(1) women living in a health professional shortage area
designated under section 332 of the Public Health Service Act
(42 U.S.C. 254e); and
(2) women living in areas with high maternal mortality or
severe morbidity rates and significant racial or ethnic
disparities in maternal health outcomes.
SEC. 6. DEPARTMENT OF AGRICULTURE.
(a) Special Supplemental Nutrition Program.--
(1) Extension of postpartum period.--Section 17(b)(10) of
the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)(10)) is
amended by striking ``six months'' and inserting ``24 months''.
(2) Extension of breastfeeding period.--Section
17(d)(3)(A)(ii) of the Child Nutrition Act of 1966 (7 U.S.C.
1431(d)(3)(A)(ii)) is amended by striking ``1 year'' and
inserting ``24 months''.
(3) Report.--Not later than 2 years after the date of the
enactment of this section, the Secretary shall submit to
Congress a report that includes an evaluation of the effect of
each of the amendments made by this subsection on--
(A) maternal and infant health outcomes, including
racial and ethnic disparities with respect to such
outcomes;
(B) qualitative evaluations of family experiences
under the special supplemental nutrition program under
section 17 of the Child Nutrition Act of 1966 (42
U.S.C. 1786); and
(C) the cost effectiveness of such special
supplemental nutrition program.
(b) Grant Program for Healthy Food and Clean Water for Pregnant and
Postpartum Women.--
(1) In general.--The Secretary shall carry out a grant
program to make grants on a competitive basis to eligible
entities to carry out the nutritional activities described in
paragraph (4).
(2) Application.--To be eligible to receive a grant under
this subsection an eligible entity shall submit to the
Secretary an application at such time, in such manner, and
containing such information as the Secretary may provide.
(3) Priority.--In awarding grants under this subsection,
the Secretary shall give priority to an eligible entity that
proposes in an application under paragraph (2) to use the grant
funds to carry out activities in areas with--
(A) high maternal mortality or severe maternal
morbidity rates; and
(B) significant racial or ethnic disparities in
maternal health outcomes.
(4) Use of funds.--An eligible entity that receives a grant
under this subsection shall use funds under the grant to
deliver healthy food, infant formula, or clean water to
pregnant and postpartum women located in areas that are food
deserts, as determined by the Secretary using data from the
Food Access Research Atlas of the Department of Agriculture.
(5) Report.--Not later than 2 years after the date of the
enactment of this section, the Secretary shall submit to
Congress a report that includes--
(A) an evaluation of the effect of the grant
program under this subsection on maternal and infant
health outcomes, including racial and ethnic
disparities with respect to such outcomes; and
(B) recommendations with respect to ensuring the
activities described in paragraph (4) continue after
the grant period funding such activities expires.
(6) Authorization of appropriations.--There are authorized
to be appropriated such sums as may be necessary to carry out
this subsection for fiscal years 2021 through 2023.
(c) Definitions.--In this section:
(1) Eligible entity.--The term ``eligible entity'' includes
public entities, private community entities, community-based
organizations, Indian tribes and tribal organizations (as such
terms are defined in section 4 of the Indian Self-Determination
and Education Assistance Act (25 U.S.C. 5304)), and urban
Indian organizations (as such term is defined in section 4 of
the Indian Health Care Improvement Act (25 U.S.C. 1603)).
(2) Secretary.--The term ``Secretary'' means the Secretary
of Agriculture.
SEC. 7. ENVIRONMENTAL STUDY THROUGH NATIONAL ACADEMIES.
(a) In General.--The Administrator of the Environmental Protection
Agency shall seek to enter an agreement, not later than 60 days after
the date of enactment of this Act, with the National Academies of
Sciences, Engineering, and Medicine (referred to in this section as the
``National Academies'') under which the National Academies agree to
conduct a study on the impacts of water and air quality, exposure to
extreme temperatures, and pollution levels on maternal and infant
health outcomes.
(b) Study Requirements.--The agreement under subsection (a) shall
direct the National Academies to make recommendations for--
(1) improving environmental conditions to improve maternal
and infant health outcomes; and
(2) reducing or eliminating racial and ethnic disparities
in such outcomes.
(c) Report.--The agreement under subsection (a) shall direct the
National Academies to complete the study under this section and
transmit to the Congress a report on the results of the study not later
than 24 months after the date of enactment of this Act.
SEC. 8. CHILD CARE ACCESS.
(a) Grant Program.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall award grants to
eligible organizations to provide pregnant and postpartum women with
free drop-in child care services during prenatal and postpartum
appointments.
(b) Eligible Organizations.--To be eligible to receive a grant
under this section, an organization shall--
(1) be an organization that carries out programs providing
pregnant and postpartum women with free and accessible drop-in
child care services during prenatal and postpartum appointments
in areas which the Secretary determines have a high maternal
mortality and severe morbidity rate and significant racial and
ethnic disparities in maternal health outcomes; and
(2) not have previously received a grant under this
section.
(c) Duration.--The Secretary shall commence the grant program under
subsection (a) not later than 1 year after the date of the enactment of
this Act.
(d) Evaluation.--The Secretary shall evaluate each grant awarded
under this section to determine the effects of the grant on--
(1) prenatal and postpartum appointment attendance rates;
(2) maternal health outcomes with a specific focus on
racial and ethnic disparities in such outcomes;
(3) pregnant and postpartum women participating in the
funded programs, and the families of such women; and
(4) cost effectiveness.
(e) Report.--Not later than September 30, 2023, the Secretary shall
submit to the Congress a report containing the following:
(1) A summary of the evaluations under subsection (d).
(2) A description of actions the Secretary can take to
ensure that pregnant and postpartum women eligible for medical
assistance under a State plan under title XIX of the Social
Security Act (42 U.S.C. 1936 et seq.) have access to free drop-
in child care services during prenatal and postpartum
appointments, including identification of the funding necessary
to carry out such actions.
(f) Drop-In Child Care Services Defined.--In this section, the term
``drop-in child care services'' means child care and early childhood
education services that are--
(1) delivered at a facility that meets the requirements of
all applicable laws and regulations of the State or local
government in which it is located, including the licensing of
the facility as a child care facility; and
(2) provided in single encounters without requiring full-
time enrollment of a person in a child care program.
(g) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $1,000,000 for each of fiscal
years 2021 through 2023.
SEC. 9. GRANTS TO STATE, LOCAL, AND TRIBAL PUBLIC HEALTH DEPARTMENTS
ADDRESSING SOCIAL DETERMINANTS OF HEALTH FOR PREGNANT AND
POSTPARTUM WOMEN.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall award grants to
State, local, and Tribal public health departments to address social
determinants of maternal health in order to reduce or eliminate racial
and ethnic disparities in maternal health outcomes.
(b) Use of Funds.--A public health department receiving a grant
under this section may use funds received through the grant to--
(1) build capacity and hire staff to coordinate efforts of
the public health department to address social determinants of
maternal health;
(2) develop, and provide for distribution of, resource
lists of available social services for women in the prenatal
and postpartum periods, which social services may include--
(A) transportation vouchers;
(B) housing supports;
(C) child care access;
(D) healthy food access;
(E) nutrition counseling;
(F) lactation supports;
(G) lead testing and abatement;
(H) clean water;
(I) infant formula;
(J) maternal mental and behavioral health care
services;
(K) wellness and stress management programs; and
(L) other social services as determined by the
public health department;
(3) in consultation with local stakeholders, establish or
designate a ``one-stop'' resource center that provides
coordinated social services in a single location for women in
the prenatal or postpartum period; or
(4) directly address specific social determinant needs for
the community that are related to maternal health as identified
by the public health department, such as--
(A) transportation;
(B) housing;
(C) child care;
(D) healthy foods;
(E) infant formula;
(F) nutrition counseling;
(G) lactation supports;
(H) lead testing and abatement;
(I) air and water quality;
(J) wellness and stress management programs; and
(K) other social determinants as determined by the
public health department.
(c) Special Consideration.--In awarding grants under subsection
(a), the Secretary shall give special consideration to State, local,
and Tribal public health departments that--
(1) propose to use the grants to reduce or end racial and
ethnic disparities in maternal mortality and severe morbidity
rates; and
(2) operate in areas with high rates of--
(A) maternal mortality and severe morbidity; or
(B) significant racial and ethnic disparities in
maternal mortality and severe morbidity rates.
(d) Guidance on Strategies.--In carrying out this section, the
Secretary shall provide guidance to grantees on strategies for long-
term viability of programs funded through this section after such
funding ends.
(e) Reporting.--
(1) By grantees.--As a condition on receipt of a grant
under this section, a grantee shall agree to--
(A) evaluate the activities funded through the
grant with respect to--
(i) maternal health outcomes with a
specific focus on racial and ethnic
disparities;
(ii) the subjective assessment of such
activities by the beneficiaries of such
activities, including mothers and their
families; and
(iii) cost effectiveness and return on
investment; and
(B) not later than 180 days after the end of the
period of the grant, submit a report on the results of
such evaluation to the Secretary.
(2) By secretary.--Not later than the end of fiscal year
2026, the Secretary shall submit a report to the Congress--
(A) summarizing the evaluations submitted under
paragraph (1); and
(B) making recommendations for improving maternal
health and reducing or eliminating racial and ethnic
disparities in maternal health outcomes, based on the
results of grants under this section.
(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $15,000,000 for each of fiscal
years 2021 through 2025.
SEC. 10. DEFINITION.
In this Act, the term ``postpartum'' means the one-year period
beginning on the last day of a woman's pregnancy.
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