[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6143 Introduced in House (IH)]
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116th CONGRESS
2d Session
H. R. 6143
To amend the Public Health Service Act to improve maternal mental and
behavioral health outcomes with a particular focus on outcomes for
minority women, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 9, 2020
Mr. Kennedy (for himself, Ms. Underwood, Mr. Katko, Ms. Adams, Ms.
Scanlon, Mr. Long, and Mr. Moulton) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to improve maternal mental and
behavioral health outcomes with a particular focus on outcomes for
minority women, 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 ``Moms Maternal and Behavioral Health
Screening Access, Treatment, and Task Force to Expand Innovative Models
to Reduce Maternal Mortality and Severe Maternal Morbidity Act of
2020'' or the ``Moms MATTER Act of 2020''.
SEC. 2. INNOVATIVE MODELS TO REDUCE MATERNAL MORTALITY.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by adding at the end the following new part:
``PART W--INNOVATIVE MODELS TO REDUCE MATERNAL MORTALITY AND SEVERE
MATERNAL MORBIDITY
``SEC. 399OO. DEFINITIONS.
``In this part:
``(1) The terms `postpartum' and `postpartum period' refer
to the 1-year period beginning on the last day of the
pregnancy.
``(2) The term `Secretary' means the Secretary of Health
and Human Services.
``(3) The term `Task Force' means the Maternal Mental and
Behavioral Health Task Force established pursuant to section
399OO-1.
``(4) The term `behavioral health' includes substance use
disorder and other behavioral health conditions.
``SEC. 399OO-1. MATERNAL MENTAL AND BEHAVIORAL HEALTH TASK FORCE.
``(a) Establishment.--The Secretary shall establish a task force,
to be known as the Maternal Mental and Behavioral Health Task Force, to
improve maternal mental and behavioral health outcomes with a
particular focus on outcomes for minority women.
``(b) Membership.--
``(1) Composition.--The Task Force shall be composed of no
fewer than 20 members, to be appointed by the Secretary.
``(2) Co-chairs.--The Secretary shall designate 2 members
of the Task Force to serve as the Co-chairs of the Task Force.
``(3) Members.-- The Task Force shall include the
following:
``(A) Maternal mental and behavioral health care
specialists; maternity care providers; and researchers,
government officials, and policy experts who specialize
in women's health, maternal mental and behavioral
health, maternal substance use disorder, or maternal
mortality and severe maternal morbidity. In selecting
such members of the Task Force, the Secretary shall
give special consideration to individuals from diverse
racial and ethnic backgrounds or individuals with
experience providing culturally congruent maternity
care in diverse communities.
``(B) One or more patients who have suffered from a
diagnosed mental or behavioral health condition during
the prenatal or postpartum period, or a spouse or
family member of such patient.
``(C) One or more representatives of a community-
based organization that addresses adverse maternal
health outcomes with a specific focus on racial and
ethnic disparities in maternal health outcomes. In
selecting such representatives, the Secretary shall
give special consideration to organizations from
communities with significant minority populations.
``(D) One or more perinatal health workers who
provide non-clinical support to pregnant and postpartum
women, such as a doula, community health worker, peer
supporter, certified lactation consultant, nutritionist
or dietitian, social worker, home visitor, or
navigator. In selecting such perinatal health workers,
the Secretary shall give special consideration to
individuals with experience working in communities with
significant minority populations.
``(E) One or more representatives of relevant
patient advocacy organizations, with a particular focus
on organizations that address racial and ethnic
disparities in maternal health outcomes.
``(F) One or more representatives of relevant
health care provider organizations, with a particular
focus on organizations that address racial and ethnic
disparities in maternal health outcomes.
``(G) One or more leaders of a Federally qualified
health center or rural health clinic (as such terms are
defined in section 1861 of the Social Security Act).
``(H) One or more representatives of health
insurers.
``(4) Timing of appointments.--Not later than 180 days
after the date of enactment of this part, the Secretary shall
appoint all members of the Task Force.
``(5) Period of appointment; vacancies.--
``(A) In general.--Each member of the Task Force
shall be appointed for the life of the Task Force.
``(B) Vacancies.--Any vacancy in the Task Force--
``(i) shall not affect the powers of the
Task Force; and
``(ii) shall be filled in the same manner
as the original appointment.
``(6) No pay.--Members of the Task Force (other than
officers or employees of the United States) shall serve without
pay. Members of the Task Force who are full-time officers or
employees of the United States may not receive additional pay,
allowances, or benefits by reason of their service on the Task
Force.
``(7) Travel expenses.--Members of the Task Force may be
allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of services for the Task Force.
``(c) Staff.--The Co-chairs of the Task Force may appoint and fix
the pay of staff to the Task Force.
``(d) Detailees.--Any Federal Government employee may be detailed
to the Task Force without reimbursement from the Task Force, and the
detailee shall retain the rights, status, and privileges of his or her
regular employment without interruption.
``(e) Meetings.--
``(1) In general.--Subject to paragraph (2), the Task Force
shall meet at the call of the Co-chairs of the Task Force.
``(2) Initial meeting.--The Task Force shall meet not later
than 30 days after the date on which all members of the Task
Force have been appointed.
``(3) Quorum.--A majority of the members of the Task Force
shall constitute a quorum.
``(f) Information From Federal Agencies.--
``(1) In general.--The Task Force may secure directly from
any Federal department or agency such information as may be
relevant to carrying out this part.
``(2) Furnishing information.--On request of the Co-chairs
of the Task Force pursuant to paragraph (1), the head of a
Federal department or agency shall, not later than 60 days
after the date of receiving such request, furnish to the Task
Force the information so requested.
``(g) Termination.--Termination under section 14 of the Federal
Advisory Committee Act (5 U.S.C. App.) shall not apply to the Task
Force.
``(h) Duties.--
``(1) National strategy.--The Task Force shall make
recommendations for a national strategy to improve maternal
mental and behavioral health outcomes with a particular focus
on outcomes for minority women. Such strategy shall--
``(A) define collaborative maternity care;
``(B) make recommendations to the Secretary and the
Assistant Secretary for Mental Health and Substance Use
on how to implement collaborative maternity care models
to improve maternal mental and behavioral health with a
particular focus on such outcomes for minority women;
``(C) identify barriers to the implementation of
collaborative maternity care models to improve maternal
mental and behavioral health with a particular focus on
such outcomes for minority women, and make
recommendations to address such barriers;
``(D) take into consideration as models existing
State and other programs that have demonstrated
effectiveness in improving maternal mental and
behavioral health during the prenatal and postpartum
periods;
``(E) promote treatment options and reduce stigma
for pregnant and postpartum women with a substance use
disorder;
``(F) assess the extent to which insurers are
providing coverage for evidence-based mental and
behavioral health screenings and services that adhere
to existing prenatal and postpartum guidelines;
``(G) assess the extent to which existing
guidelines and processes are culturally congruent for
minority women, specifically--
``(i) guidelines for identifying maternal
mental and behavioral health conditions,
including substance use disorders;
``(ii) guidelines for screening and, as
needed, follow-up referrals, evaluations, and
treatments after positive screens for--
``(I) depression;
``(II) anxiety;
``(III) trauma;
``(IV) substance use disorders; and
``(V) other mental or behavioral
health conditions at the discretion of
the Task Force;
``(iii) processes for incorporating mental
and behavioral health screenings into the
current timeline of standard screening
practices for pregnant and postpartum women,
with distinctions for postpartum screening
timelines for uncomplicated and complicated
births; and
``(iv) processes for referring women with
positive screens for substance use disorder to
addiction treatment centers offering--
``(I) on-site wraparound treatment
or networks for referrals;
``(II) multidisciplinary staff;
``(III) psychotherapy;
``(IV) contingency management;
``(V) access to all evidence-based
medication-assisted treatment; and
``(VI) evidence-based recovery
supports;
``(H) propose to the Secretary a multilingual
public awareness campaign for maternal mental health
and substance use disorder, with a particular focus on
minority women, that includes information on--
``(i) symptoms, triggers, risk factors, and
treatment options for maternal mental and
behavioral health conditions;
``(ii) using the website developed under
paragraph (3);
``(iii) the physiological process of
recovery after birth;
``(iv) the frequency of occurrences for
common conditions such as postpartum
hemorrhage, preeclampsia and eclampsia,
infection, and thromboembolism;
``(v) best practices in patient reporting
of health concerns to their maternity care
providers in the prenatal and postpartum
periods;
``(vi) addressing stigma around maternal
mental and behavioral health conditions;
``(vii) how to seek treatment for substance
use disorder during pregnancy and in the
postpartum period; and
``(viii) infant feeding options; and
``(I) disseminate to all State Medicaid programs
under title XIX of the Social Security Act and State
child health plans under title XXI of the Social
Security Act an assessment of the extent to which
States are providing coverage of evidence-based
prenatal and postpartum mental and behavioral health
screenings through such programs and plans, and an
assessment of the benefits of such coverage.
``(2) Grant programs.--The Task Force shall evaluate and
advise on the grant programs under section 399OO-2.
``(3) Centralized website.--The Task Force shall facilitate
a coordinated effort between the Substance Abuse and Mental
Health Services Administration and State departments of health
to develop, either directly or through a contract, a
centralized website with information on finding local mental
and behavioral health providers who treat prenatal and
postpartum mental and behavioral health conditions, including
substance use disorder.
``(4) Report.--Not later than 18 months after the date of
enactment of the Moms MATTER Act of 2020, and every year
thereafter, the Task Force shall submit to the Congress, the
Centers for Medicare & Medicaid, and the Center for Medicare
and Medicaid Innovation, and make publicly available, a report
that--
``(A) describes the activities of the Task Force
and the results of such activities, with data in such
results stratified racially, ethnically, and
geographically; and
``(B) includes the strategy developed under
paragraph (1).
``(i) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for fiscal years 2021 through 2025.
``SEC. 399OO-2. INNOVATION IN MATERNITY CARE TO CLOSE RACIAL AND ETHNIC
MATERNAL HEALTH DISPARITIES GRANTS.
``(a) In General.--The Secretary shall award grants to eligible
entities to establish, implement, evaluate, or expand innovative models
in maternity care that are designed to reduce racial and ethnic
disparities in maternal health outcomes.
``(b) Use of Funds.--An eligible entity receiving a grant under
this section may use the grant to establish, implement, evaluate, or
expand innovative models described in subsection (a) including--
``(1) collaborative maternity care models to improve
maternal mental health, treat maternal substance use disorders,
and reduce maternal mortality and severe maternal morbidity,
especially for minority women, consistent with the national
strategy developed by the Task Force under section 399O-1(h)(1)
and other recommendations of the Task Force;
``(2) evidence-based programming at clinics that--
``(A) provide wraparound services for women with
substance use disorders in the prenatal and postpartum
periods that may include multidisciplinary staff,
access to all evidence-based medication-assisted
treatment, psychotherapy, contingency management, and
recovery supports; or
``(B) make referrals for any such services that are
not provided within the clinic;
``(3) evidence-based programs at freestanding birth centers
that provide culturally congruent maternal mental and
behavioral health care education, treatments, and services, and
other wraparound supports for women throughout the prenatal and
postpartum period; and
``(4) the development and implementation of evidence-based
programs, including toll-free telephone hotlines, that connect
maternity care providers with women's mental health clinicians
to provide maternity care providers with guidance on addressing
maternal mental and behavioral health conditions identified in
patients.
``(c) Special Consideration.--In awarding grants under this
section, the Secretary shall give special consideration to applications
for models that will--
``(1) operate in--
``(A) areas with high rates of adverse maternal
health outcomes;
``(B) areas with significant racial and ethnic
disparities in maternal health outcomes; or
``(C) health professional shortage areas designated
under section 332;
``(2) be led by minority women from demographic groups with
disproportionate rates of adverse maternal health outcomes; or
``(3) be implemented with a culturally congruent approach
that is focused on improving outcomes for demographic groups
experiencing disproportionate rates of adverse maternal health
outcomes.
``(d) Evaluation.--As a condition on receipt of a grant under this
section, an eligible entity shall agree to provide annual evaluations
of the activities funded through the grant to the Secretary and the
Task Force. Such evaluations may address--
``(1) the effects of such activities on maternal health
outcomes and subjective assessments of patient and family
experiences, especially for minority women from demographic
groups with disproportionate rates of adverse maternal health
outcomes; and
``(2) the cost-effectiveness of such activities.
``(e) Definitions.--In this section:
``(1) The term `eligible entity' means any public or
private entity.
``(2) The term `collaborative maternity care' means an
integrated care model that includes the delivery of maternal
mental and behavioral health care services in primary clinics
or other care settings familiar to pregnant and postpartum
patients.
``(3) The term `culturally congruent' means care that is in
agreement with the preferred cultural values, beliefs,
worldview, language, and practices of the health care consumer
and other stakeholders.
``(4) The term `freestanding birth center' has the meaning
given that term under section 1905(l)(3)(A) of the Social
Security Act.
``(f) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $15,000,000 for each of fiscal
years 2021 through 2025.
``SEC. 399OO-3. GROUP PRENATAL AND POSTPARTUM CARE MODELS.
``(a) In General.--The Secretary shall award grants to eligible
entities to establish, implement, evaluate, or expand culturally
congruent group prenatal care models or group postpartum care models
that are designed to reduce racial and ethnic disparities in maternal
and infant health outcomes.
``(b) Use of Funds.--An eligible entity receiving a grant under
this section may use the grant for--
``(1) programming;
``(2) capital investments required to improve existing
physical infrastructure for group prenatal care and group
postpartum care programming, such as building space needed to
implement such models; and
``(3) evaluations of group prenatal care and group
postpartum care programming, with a particular focus on the
impacts of such programming on minority women.
``(c) Special Consideration.--In awarding grants under this
section, the Secretary shall give special consideration to applicants
that will--
``(1) operate in--
``(A) areas with high rates of adverse maternal
health outcomes;
``(B) areas with significant racial and ethnic
disparities in maternal health outcomes; or
``(C) health professional shortage areas designated
under section 332;
``(2) be led by minority women from demographic groups with
disproportionate rates of adverse maternal health outcomes; or
``(3) be implemented with a culturally congruent approach
that is focused on improving outcomes for demographic groups
experiencing disproportionate rates of adverse maternal health
outcomes.
``(d) Evaluation.--As a condition on receipt of a grant under this
section, an eligible entity shall agree to provide annual evaluations
of the activities funded through the grant to the Secretary and the
Task Force and address in each such evaluation--
``(1) the effects of such activities on maternal health
outcomes with a particular focus on the effects of such
activities on minority women, including measures such as--
``(A) avoidable emergency room visits;
``(B) postpartum care visits after delivery;
``(C) rates of preterm birth;
``(D) rates of breastfeeding initiation;
``(F) psychological outcomes; and
``(G) subjective measures of patient-reported
experience of care; and
``(2) the cost-effectiveness of such activities.
``(e) Definitions.--In this section:
``(1) The term `eligible entity' means any public or
private entity.
``(2) The term `culturally congruent' means care that is in
agreement with the preferred cultural values, beliefs,
worldview, language, and practices of the health care consumer
and other stakeholders.
``(f) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $10,000,000 for each of fiscal
years 2021 through 2025.''.
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