[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6164 Introduced in House (IH)]
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116th CONGRESS
2d Session
H. R. 6164
To grow and diversify the perinatal workforce, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 10, 2020
Ms. Moore (for herself, Ms. Underwood, Ms. Adams, Ms. Sewell of
Alabama, Ms. Norton, Ms. Scanlon, 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 grow and diversify the perinatal workforce, 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Perinatal
Workforce Act of 2020''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. HHS agency directives.
Sec. 3. Grants to grow and diversify the perinatal workforce.
Sec. 4. Grants to grow and diversify the nursing workforce in maternal
and perinatal health.
Sec. 5. GAO report on barriers to maternity care.
SEC. 2. HHS AGENCY DIRECTIVES.
(a) Guidance to States.--
(1) In general.--Not later than 2 years after the date of
enactment of this Act, the Secretary of Health and Human
Services shall issue and disseminate guidance to States to
educate providers and managed care entities about the value and
process of delivering respectful maternal health care through
diverse care provider models.
(2) Contents.--The guidance required by paragraph (1) shall
address how States can encourage and incentivize hospitals,
health systems, freestanding birth centers, other maternity
care provider groups, and managed care entities--
(A) to recruit and retain maternity care providers,
such as obstetrician-gynecologists, family physicians,
physician assistants, midwives who meet at a minimum
the international definition of the midwife and global
standards for midwifery education as established by the
International Confederation of Midwives, nurse
practitioners, and clinical nurse specialists--
(i) from racially and ethnically diverse
backgrounds;
(ii) with experience practicing in racially
and ethnically diverse communities; and
(iii) who have undergone trainings on
implicit and explicit bias and racism;
(B) to incorporate into maternity care teams
midwives who meet at a minimum the international
definition of the midwife and global standards for
midwifery education as established by the International
Confederation of Midwives, doulas, community health
workers, peer supporters, certified lactation
consultants, nutritionists and dietitians, social
workers, home visitors, and navigators;
(C) to provide collaborative, culturally congruent
care; and
(D) to provide opportunities for individuals
enrolled in accredited midwifery education programs to
participate in job shadowing with maternity care teams
in hospitals, health systems, and freestanding birth
centers.
(b) Study on Culturally Congruent Maternity Care.--
(1) Study.--The Secretary of Health and Human Services
acting through the Director of the National Institutes of
Health (in this subsection referred to as the ``Secretary'')
shall conduct a study on best practices in culturally congruent
maternity care.
(2) Report.--Not later than 2 years after the date of
enactment of this Act, the Secretary shall--
(A) complete the study required by paragraph (1);
(B) submit to the Congress and make publicly
available a report on the results of such study; and
(C) include in such report--
(i) a compendium of examples of hospitals,
health systems, freestanding birth centers,
other maternity care provider groups, and
managed care entities that are delivering
culturally congruent maternal health care;
(ii) a compendium of examples of hospitals,
health systems, freestanding birth centers,
other maternity care provider groups, and
managed care entities that have low levels of
racial and ethnic disparities in maternal
health outcomes; and
(iii) recommendations to hospitals, health
systems, freestanding birth centers, other
maternity care provider groups, and managed
care entities for best practices in culturally
congruent maternity care.
(c) Definition.--In this section, the term ``culturally
congruent'', with respect to care or maternity care, means care that is
in agreement with the preferred cultural values, beliefs, worldview,
and practices of the health care consumer and other stakeholders.
SEC. 3. GRANTS TO GROW AND DIVERSIFY THE PERINATAL WORKFORCE.
Title VII of the Public Health Service Act is amended by inserting
after section 757 (42 U.S.C. 294f) the following new section:
``SEC. 758. PERINATAL WORKFORCE GRANTS.
``(a) In General.--The Secretary may award grants to entities to
establish or expand programs described in subsection (b) to grow and
diversify the perinatal workforce.
``(b) Use of Funds.--Recipients of grants under this section shall
use the grants to grow and diversify the perinatal workforce by--
``(1) establishing schools or programs that provide
education and training to individuals seeking appropriate
licensing or certification as--
``(A) physician assistants who will complete
clinical training in the field of maternal and
perinatal health; and
``(B) other perinatal health workers such as
doulas, community health workers, peer supporters,
certified lactation consultants, nutritionists and
dietitians, social workers, home visitors, and
navigators; and
``(2) expanding the capacity of existing schools or
programs described in paragraph (1), for the purposes of
increasing the number of students enrolled in such schools or
programs, including by awarding scholarships for students.
``(c) Prioritization.--In awarding grants under this section, the
Secretary shall give priority to any institution of higher education
that--
``(1) has demonstrated a commitment to recruiting and
retaining minority students, particularly from demographic
groups experiencing high rates of maternal mortality and severe
maternal morbidity;
``(2) has developed a strategy to recruit and retain a
diverse pool of students into the perinatal workforce program
or school supported by funds received through the grant,
particularly from demographic groups experiencing high rates of
maternal mortality and severe maternal morbidity;
``(3) has developed a strategy to recruit and retain
students who plan to practice in a health professional shortage
area designated under section 332;
``(4) 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 outcomes; and
``(5) includes in the standard curriculum for all students
within the perinatal workforce program or school a bias,
racism, or discrimination training program that includes
training on explicit and implicit bias.
``(d) Reporting.--As a condition on receipt of a grant under this
section for a perinatal workforce program or school, an entity shall
agree to submit to the Secretary an annual report on the activities
conducted through the grant, including--
``(1) the number and demographics of students participating
in the program or school;
``(2) the extent to which students in the program or school
are entering careers in--
``(A) health professional shortage areas designated
under section 332; and
``(B) areas with significant racial and ethnic
disparities in maternal health outcomes; and
``(3) whether the program or school has included in the
standard curriculum for all students a bias, racism, or
discrimination training program that includes explicit and
implicit bias, and if so the effectiveness of such training
program.
``(e) Period of Grants.--The period of a grant under this section
shall be up to 5 years.
``(f) Application.--To seek a grant under this section, an entity
shall submit to the Secretary an application at such time, in such
manner, and containing such information as the Secretary may require,
including any information necessary for prioritization under subsection
(c).
``(g) Technical Assistance.--The Secretary shall provide, directly
or by contract, technical assistance to institutions of higher
education seeking or receiving a grant under this section on the
development, use, evaluation, and post-grant period sustainability of
the perinatal workforce programs or schools proposed to be, or being,
established or expanded through the grant.
``(h) Report by Secretary.--Not later than 4 years after the date
of enactment of this section, the Secretary shall prepare and submit to
the Congress, and post on the internet website of the Department of
Health and Human Services, a report on the effectiveness of the grant
program under this section at--
``(1) recruiting minority students, particularly from
demographic groups experiencing high rates of maternal
mortality and severe maternal morbidity;
``(2) increasing the number of physician assistants who
will complete clinical training in the field of maternal and
perinatal health, and other perinatal health workers, from
demographic groups experiencing high rates of maternal
mortality and severe maternal morbidity;
``(3) increasing the number of physician assistants who
will complete clinical training in the field of maternal and
perinatal health, and other perinatal health workers, working
in health professional shortage areas designated under section
332; and
``(4) increasing the number of physician assistants who
will complete clinical training in the field of maternal and
perinatal health, and other perinatal health workers, working
in areas with significant racial and ethnic disparities in
maternal health outcomes.
``(i) 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. 4. 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 811 of that Act (42 U.S.C. 296j) the following:
``SEC. 812. PERINATAL NURSING WORKFORCE GRANTS.
``(a) In General.--The Secretary may award grants to schools of
nursing to grow and diversify the perinatal nursing workforce.
``(b) 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--
``(1) nurse practitioners whose education includes a focus
on maternal and perinatal health; or
``(2) clinical nurse specialists whose education includes a
focus on maternal and perinatal health.
``(c) Prioritization.--In awarding grants under this section, the
Secretary shall give priority to any school of nursing that--
``(1) has developed a strategy to recruit and retain a
diverse pool of students seeking to enter careers focused on
maternal and perinatal health;
``(2) has developed a partnership with a practice setting
in a health professional shortage area designated under section
332 for the clinical placements of the school's students;
``(3) 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 outcomes; and
``(4) includes in the standard curriculum for all students
seeking to enter careers focused on maternal and perinatal
health a bias, racism, or discrimination training program that
includes education on explicit and implicit bias.
``(d) Reporting.--As a condition on receipt of a grant under this
section, a school of nursing shall agree to submit to the Secretary an
annual report on the activities conducted through the grant, including,
to the extent practicable--
``(1) the number and demographics of students in the school
of nursing seeking to enter careers focused on maternal and
perinatal health;
``(2) the extent to which such students are preparing to
enter careers in--
``(A) health professional shortage areas designated
under section 332; and
``(B) areas with significant racial and ethnic
disparities in maternal health outcomes; and
``(3) whether the standard curriculum for all students
seeking to enter careers focused on maternal and perinatal
health includes a bias, racism, or discrimination training
program that includes education on explicit and implicit bias.
``(e) Period of Grants.--The period of a grant under this section
shall be up to 5 years.
``(f) Application.--To seek a grant under this section, an entity
shall submit to the Secretary an application, at such time, in such
manner, and containing such information as the Secretary may require,
including any information necessary for prioritization under subsection
(c).
``(g) Technical Assistance.--The Secretary shall provide, directly
or by contract, technical assistance to schools of nursing seeking or
receiving a grant under this section on the processes of awarding and
evaluating scholarships through the grant.
``(h) Report by Secretary.--Not later than 4 years after the date
of enactment of this section, the Secretary shall prepare and submit to
the Congress, and post on the internet website of the Department of
Health and Human Services, a report on the effectiveness of the grant
program under this section at--
``(1) recruiting minority students, particularly from
demographic groups experiencing high rates of maternal
mortality and severe maternal morbidity;
``(2) increasing the number of nurse practitioners and
clinical nurse specialists entering careers focused on maternal
and perinatal health from demographic groups experiencing high
rates of maternal mortality and severe maternal morbidity;
``(3) increasing the number of nurse practitioners and
clinical nurse specialists entering careers focused on maternal
and perinatal health working in health professional shortage
areas designated under section 332; and
``(4) increasing the number of nurse practitioners and
clinical nurse specialists entering careers focused on maternal
and perinatal health working in areas with significant racial
and ethnic disparities in maternal health outcomes.
``(i) 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. 5. GAO REPORT ON BARRIERS TO MATERNITY CARE.
(a) In General.--Not later than two years after the date of the
enactment of this Act and every five years thereafter, the Comptroller
General of the United States shall submit to Congress a report on
barriers to maternity care in the United States. Such report shall
include the information and recommendations described in subsection
(b).
(b) Content of Report.--The report under subsection (a) shall
include--
(1) an assessment of current barriers to entering
accredited midwifery education programs, and recommendations
for addressing such barriers, particularly for low-income and
minority women;
(2) an assessment of current barriers to entering
accredited education programs for other maternity care
professional careers, including obstetrician-gynecologists,
family physicians, physician assistants, nurse practitioners,
and clinical nurse specialists, particularly for low-income and
minority women;
(3) an assessment of current barriers that prevent midwives
from meeting the international definition of the midwife and
global standards for midwifery education as established by the
International Confederation of Midwives, and recommendations
for addressing such barriers, particularly for low-income and
minority women; and
(4) recommendations to promote greater equity in
compensation for perinatal health workers, particularly for
such individuals from racially and ethnically diverse
backgrounds.
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