[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6144 Introduced in House (IH)]
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116th CONGRESS
2d Session
H. R. 6144
To make investments in community-based organizations and other
initiatives to prevent maternal mortality and severe maternal
morbidity, especially for Black women, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 9, 2020
Ms. Adams (for herself, Ms. Underwood, 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
_______________________________________________________________________
A BILL
To make investments in community-based organizations and other
initiatives to prevent maternal mortality and severe maternal
morbidity, especially for Black 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 ``Kira Johnson Act''.
SEC. 2. INVESTMENTS IN COMMUNITY-BASED ORGANIZATIONS TO IMPROVE BLACK
MATERNAL HEALTH OUTCOMES.
(a) Awards.--Following the 1-year period described in subsection
(c), the Secretary of Health and Human Services (in this section
referred to as the ``Secretary''), acting through the Administrator of
the Health Resources and Services Administration, shall award grants to
eligible entities to establish or expand programs to prevent maternal
mortality and severe maternal morbidity among Black women.
(b) Eligibility.--To be eligible to seek a grant under this
section, an entity shall be a community-based organization offering
programs and resources aligned with evidence-based practices for
improving maternal health outcomes for Black women.
(c) Outreach and Technical Assistance Period.--During the 1-year
period beginning on the date of enactment of this Act, the Secretary
shall--
(1) conduct outreach to encourage eligible entities to
apply for grants under this section; and
(2) provide technical assistance to eligible entities on
best practices for applying for grants under this section.
(d) Special Consideration.--
(1) Outreach.--In conducting outreach under subsection (c),
the Secretary shall give special consideration to eligible
entities that--
(A) are based in, and provide support for,
communities with--
(i) high rates of adverse maternal health
outcomes; and
(ii) significant racial and ethnic
disparities in maternal health outcomes;
(B) are led by Black women; and
(C) offer programs and resources that are aligned
with evidence-based practices for improving maternal
health outcomes for Black women.
(2) Awards.--In awarding grants under this section, the
Secretary shall give special consideration to eligible entities
that--
(A) are described in subparagraphs (A), (B), and
(C) of paragraph (1);
(B) offer programs and resources designed in
consultation with and intended for Black women; and
(C) offer programs and resources in the communities
in which the respective eligible entities are located
that--
(i) promote maternal mental health and
maternal substance use disorder treatments that
are aligned with evidence-based practices for
improving maternal mental health outcomes for
Black women;
(ii) address social determinants of health
for women in the prenatal and postpartum
periods, including--
(I) housing;
(II) transportation;
(III) nutrition counseling;
(IV) healthy foods;
(V) lactation support;
(VI) lead abatement and other
efforts to improve air and water
quality;
(VII) child care access;
(VIII) car seat installation;
(IX) wellness and stress management
programs; or
(X) coordination across safety-net
and social support services and
programs;
(iii) promote evidence-based health
literacy and pregnancy, childbirth, and
parenting education for women in the prenatal
and postpartum periods;
(iv) provide support from doulas and other
perinatal health workers to women from
pregnancy through the postpartum period;
(v) provide culturally congruent training
to perinatal health workers such as doulas,
community health workers, peer supporters,
certified lactation consultants, nutritionists
and dietitians, social workers, home visitors,
and navigators;
(vi) conduct or support research on Black
maternal health issues; or
(vii) have developed other programs and
resources that address community-specific needs
for women in the prenatal and postpartum
periods and are aligned with evidence-based
practices for improving maternal health
outcomes for Black women.
(e) Technical Assistance.--The Secretary shall provide to grant
recipients under this section technical assistance on--
(1) capacity building to establish or expand programs to
prevent adverse maternal health outcomes among Black women;
(2) best practices in data collection, measurement,
evaluation, and reporting; and
(3) planning for sustaining programs to prevent maternal
mortality and severe maternal morbidity among Black women after
the period of the grant.
(f) Evaluation.--Not later than the end of fiscal year 2026, the
Secretary shall submit to the Congress an evaluation of the grant
program under this section that--
(1) assesses the effectiveness of outreach efforts during
the application process in diversifying the pool of grant
recipients;
(2) 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;
(3) assesses the effectiveness of programs funded by grants
under this section in improving maternal health outcomes for
Black women; and
(4) makes recommendations for future Department of Health
and Human Services grant programs and funding opportunities
that deliver funding to community-based organizations to
improve Black maternal health outcomes through programs and
resources that are aligned with evidence-based practices for
improving maternal health outcomes for Black women.
(g) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $5,000,000 for each of fiscal
years 2021 through 2025.
SEC. 3. TRAINING FOR ALL EMPLOYEES IN MATERNITY CARE SETTINGS.
Part B of title VII of the Public Health Service Act (42 U.S.C. 293
et seq.) is amended by adding at the end the following new section:
``SEC. 742. TRAINING FOR ALL EMPLOYEES IN MATERNITY CARE SETTINGS.
``(a) Grants.--The Secretary shall award grants for programs to
reduce and prevent bias, racism, and discrimination in maternity care
settings.
``(b) Special Consideration.--In awarding grants under subsection
(a), the Secretary shall give special consideration to applications for
programs that would--
``(1) apply to all birthing professionals and any employees
who interact with pregnant and postpartum women in the provider
setting, including front desk employees, sonographers,
schedulers, health care professionals, hospital or health
system administrators, and security staff;
``(2) emphasize periodic, as opposed to one-time, trainings
for all birthing professionals and employees described in
paragraph (1);
``(3) address implicit bias and explicit bias;
``(4) be delivered in ongoing education settings for
providers maintaining their licenses, with a preference for
trainings that provide continuing education units and
continuing medical education;
``(5) include trauma-informed care best practices and an
emphasis on shared decision making between providers and
patients;
``(6) include a service-learning component that sends
providers to work in underserved communities to better
understand patients' lived experiences;
``(7) be delivered in undergraduate programs that funnel
into medical schools, like biology and pre-medicine majors;
``(8) be delivered in settings that apply to providers of
the special supplemental nutrition program for women, infants,
and children under section 17 of the Child Nutrition Act of
1966;
``(9) integrate bias training in obstetric emergency
simulation trainings;
``(10) offer training to all maternity care providers on
the value of racially, ethnically, and professionally diverse
maternity care teams to provide culturally congruent care,
including doulas, community health workers, peer supporters,
certified lactation consultants, nutritionists and dietitians,
social workers, home visitors, and navigators; or
``(11) be based on one or more programs designed by a
historically Black college or university.
``(c) Application.--To seek a grant under subsection (a), an entity
shall submit an application at such time, in such manner, and
containing such information as the Secretary may require.
``(d) 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 grant, including, as applicable, a
description of the impact of training provided through the grant on
patient outcomes and patient experience for women of color and their
families.
``(e) Best Practices.--Based on the annual reports submitted
pursuant to subsection (d), the Secretary--
``(1) shall produce an annual report on the findings
resulting from programs funded through this section;
``(2) shall disseminate such report to all recipients of
grants under this section and to the public; and
``(3) may include in such report findings on best practices
for improving patient outcomes and patient experience for women
of color and their families in maternity care settings.
``(f) Definitions.--In this section:
``(1) The term `postpartum' means the one-year period
beginning on the last day of a woman's pregnancy.
``(2) The term `culturally congruent' means in agreement
with the preferred cultural values, beliefs, worldview, and
practices of the health care consumer and other stakeholders.
``(g) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $5,000,000 for each of fiscal
years 2021 through 2025.''.
SEC. 4. STUDY ON REDUCING AND PREVENTING BIAS, RACISM, AND
DISCRIMINATION IN MATERNITY CARE SETTINGS.
(a) In General.--The Secretary of Health and Human Services shall
seek to enter into an agreement, not later than 90 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 agrees to--
(1) conduct a study on the design and implementation of
programs to reduce and prevent bias, racism, and discrimination
in maternity care settings; and
(2) not later than 24 months after the date of enactment of
this Act, complete the study and transmit a report on the
results of the study to the Congress.
(b) Possible Topics.--The agreement entered into pursuant to
subsection (a) may provide for the study of any of the following:
(1) The development of a scorecard for programs designed to
reduce and prevent bias, racism, and discrimination in
maternity care settings to assess the effectiveness of such
programs in improving patient outcomes and patient experience
for women of color and their families.
(2) Determination of the types of training to reduce and
prevent bias, racism, and discrimination in maternity care
settings that are demonstrated to improve patient outcomes or
patient experience for women of color and their families.
SEC. 5. RESPECTFUL MATERNITY CARE COMPLIANCE PROGRAM.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall award grants
to accredited hospitals, health systems, and other maternity care
delivery settings to establish within one or more hospitals or other
birth settings a respectful maternity care compliance office.
(b) Office Requirements.--A respectful maternity care compliance
office funded through a grant under this section shall--
(1) institutionalize mechanisms to allow patients receiving
maternity care services, the families of such patients, or
doulas or other perinatal workers supporting such patients to
report instances of disrespect or evidence of bias on the basis
of race, ethnicity, or another protected class;
(2) institutionalize response mechanisms through which
representatives of the office can directly follow up with the
patient, if possible, and the patient's family in a timely
manner;
(3) prepare and make publicly available a hospital- or
health system-wide strategy to reduce bias on the basis of
race, ethnicity, or another protected class in the delivery of
maternity care that includes--
(A) information on the training programs to reduce
and prevent bias, racism, and discrimination on the
basis of race, ethnicity, or another protected class
for all employees in maternity care settings; and
(B) the development of methods to routinely assess
the extent to which bias, racism, or discrimination on
the basis of race, ethnicity, or another protected
class are present in the delivery of maternity care to
minority patients; and
(4) provide annual reports to the Secretary with
information about each case reported to the compliance office
over the course of the year containing such information as the
Secretary may require, such as--
(A) de-identified demographic information on the
patient in the case, such as race, ethnicity, gender
identity, and primary language;
(B) the content of the report from the patient or
the family of the patient to the compliance office; and
(C) the response from the compliance office.
(c) Secretary Requirements.--
(1) Processes.--Not later than 180 days after the date of
enactment of this Act, the Secretary shall establish processes
for--
(A) disseminating best practices for establishing
and implementing a respectful maternity care compliance
office within a hospital or other birth setting;
(B) promoting coordination and collaboration
between hospitals, health systems, and other maternity
care delivery settings on the establishment and
implementation of respectful maternity care compliance
offices; and
(C) evaluating the effectiveness of respectful
maternity care compliance offices on maternal health
outcomes and patient and family experiences, especially
for minority patients and their families.
(2) Study.--
(A) In general.--Not later than 2 years after the
date of enactment of this Act, the Secretary shall,
through a contract with an independent research
organization, conduct a study on strategies to address
disrespect or bias on the basis of race, ethnicity, or
another protected class in the delivery of maternity
care services.
(B) Components of study.--The study shall include
the following:
(i) An assessment of the reports submitted
to the Secretary from the respectful maternity
care compliance offices pursuant to subsection
(b)(4).
(ii) Based on such assessment,
recommendations for potential accountability
mechanisms related to cases of disrespect or
bias on the basis of race, ethnicity, or
another protected class in the delivery of
maternity care services at hospitals and other
birth settings. Such recommendations shall take
into consideration medical and non-medical
factors that contribute to adverse patient
experiences and maternal health outcomes.
(C) Report.--The Secretary shall submit to the
Congress and make publicly available a report on the
results of the study under this paragraph.
(d) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated such sums as may be necessary
for fiscal years 2021 through 2026.
SEC. 6. GAO REPORT.
(a) In General.--Not later than 2 years after date of enactment of
this Act and every 2 years thereafter, 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
offices within hospitals, health systems, and other maternity care
settings.
(b) Matters Included.--The report under paragraph (1) shall include
the following:
(1) Information regarding the extent to which hospitals,
health systems, and other maternity care settings have elected
to establish respectful maternity care compliance offices,
including--
(A) which hospitals and other birth settings elect
to establish compliance offices and when such offices
are established;
(B) to the extent practicable, impacts of the
establishment of such offices on maternal health
outcomes and patient and family experiences in the
hospitals and other birth settings that have
established such offices, especially for minority women
and their families;
(C) information on geographic areas, and types of
hospitals or other birth settings, where respectful
maternity care compliance offices are not being
established and information on factors contributing to
decisions to not establish such offices; and
(D) recommendations for establishing respectful
maternity care compliance offices in geographic areas,
and types of hospitals or other birth settings, where
such offices are not being established.
(2) Whether the funding made available to carry out section
6 has been sufficient and, if applicable, recommendations for
additional appropriations to carry out section 6.
(3) Such other information as the Comptroller General
determines appropriate.
SEC. 7. DEFINITIONS.
In this Act:
(1) The term ``postpartum'' means the one-year period
beginning on the last day of a woman's pregnancy.
(2) The term ``culturally congruent'' means in agreement
with the preferred cultural values, beliefs, worldview, and
practices of the health care consumer and other stakeholders.
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