[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 948 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 948
To improve maternal health outcomes for incarcerated individuals, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 8, 2021
Ms. Pressley (for herself, Ms. Underwood, Ms. Adams, Mr. Khanna, Ms.
Velazquez, Mrs. McBath, Mr. Smith of Washington, Ms. Scanlon, Mr.
Lawson of Florida, Mrs. Hayes, Mr. Butterfield, Ms. Moore of Wisconsin,
Ms. Strickland, Mr. Ryan, Mr. Schiff, Mr. Johnson of Georgia, Mr.
Horsford, Ms. Wasserman Schultz, Ms. Barragan, Mr. Deutch, Mr. Payne,
Mr. Blumenauer, Mr. Moulton, Mr. Soto, Mr. Nadler, Mr. Trone, Ms.
Clarke of New York, Ms. Schakowsky, Ms. Bass, Mr. Evans, Ms. Blunt
Rochester, Ms. Castor of Florida, Ms. Sewell, and Ms. Williams of
Georgia) introduced the following bill; which was referred to the
Committee on the Judiciary, and in addition to the Committee on Energy
and Commerce, 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 improve maternal health outcomes for incarcerated individuals, 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 ``Justice for Incarcerated Moms Act of
2021''.
SEC. 2. SENSE OF CONGRESS.
It is the sense of Congress that--
(1) the respect and proper care that birthing people
deserve is inclusive; and
(2) regardless of race, ethnicity, gender identity, sexual
orientation, religion, marital status, familial status,
socioeconomic status, immigration status, incarceration status,
or disability, all deserve dignity.
SEC. 3. ENDING THE SHACKLING OF PREGNANT INDIVIDUALS.
(a) In General.--Beginning on the date that is 6 months after the
date of enactment of this Act, and annually thereafter, in each State
that receives a grant under subpart 1 of part E of title I of the
Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C. 10151 et
seq.) (commonly referred to as the ``Edward Byrne Memorial Justice
Grant Program'') 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 rights,
procedures, requirements, effects, and penalties set forth in section
4322 of title 18, United States Code, the amount of such grant that
would otherwise be allocated to such State under such subpart for the
fiscal year shall be decreased by 25 percent.
(b) Reallocation.--Amounts not allocated to a State for failure to
comply with subsection (a) shall be reallocated in accordance with
subpart 1 of part E of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (34 U.S.C. 10151 et seq.) to States that have
complied with such subsection.
SEC. 4. CREATING MODEL PROGRAMS FOR THE CARE OF INCARCERATED
INDIVIDUALS IN THE PRENATAL AND POSTPARTUM PERIODS.
(a) In General.--Not later than 1 year after the date of enactment
of this Act, the Attorney General, acting through the Director of the
Bureau of Prisons, shall establish, in not fewer than 6 Bureau of
Prisons facilities, programs to optimize maternal health outcomes for
pregnant and postpartum individuals incarcerated in such facilities.
The Attorney General shall establish such programs in consultation with
stakeholders such as--
(1) relevant community-based organizations, particularly
organizations that represent incarcerated and formerly
incarcerated individuals and organizations that seek to improve
maternal health outcomes for pregnant and postpartum
individuals from racial and ethnic minority groups;
(2) relevant organizations representing patients, with a
particular focus on patients from racial and ethnic minority
groups;
(3) organizations representing maternity care providers and
maternal health care education programs;
(4) perinatal health workers; and
(5) researchers and policy experts in fields related to
maternal health care for incarcerated individuals.
(b) Start Date.--Each selected facility shall begin facility
programs not later than 18 months after the date of enactment of this
Act.
(c) Facility Priority.--In carrying out subsection (a), the
Director shall give priority to a facility based on--
(1) the number of pregnant and postpartum individuals
incarcerated in such facility and, among such individuals, the
number of pregnant and postpartum individuals from racial and
ethnic minority groups; and
(2) 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
facility.
(d) Program Duration.--The programs established under this section
shall be for a 5-year period.
(e) Programs.--Bureau of Prisons facilities selected by the
Director shall establish programs for pregnant and postpartum
incarcerated individuals, and such programs may--
(1) provide access to perinatal health workers from
pregnancy through the postpartum period;
(2) provide access to healthy foods and counseling on
nutrition, recommended activity levels, and safety measures
throughout pregnancy;
(3) train correctional officers to ensure that pregnant
incarcerated individuals receive safe and respectful treatment;
(4) train medical personnel to ensure that pregnant
incarcerated individuals receive trauma-informed, culturally
congruent care that promotes the health and safety of the
pregnant individuals;
(5) provide counseling and treatment for individuals who
have suffered from--
(A) diagnosed mental or behavioral health
conditions, including trauma and substance use
disorders;
(B) trauma or violence, including domestic
violence;
(C) human immunodeficiency virus;
(D) sexual abuse;
(E) pregnancy or infant loss; or
(F) chronic conditions;
(6) provide evidence-based pregnancy and childbirth
education, parenting support, and other relevant forms of
health literacy;
(7) provide clinical education opportunities to maternity
care providers in training to expand pathways into maternal
health care careers serving incarcerated individuals;
(8) offer opportunities for postpartum individuals to
maintain contact with the individual's newborn child to promote
bonding, including enhanced visitation policies, access to
prison nursery programs, or breastfeeding support;
(9) provide reentry assistance, particularly to--
(A) 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 period; and
(B) connect individuals exiting the criminal
justice system during pregnancy or in the postpartum
period to community-based resources, such as referrals
to health care providers, substance use disorder
treatments, and social services that address social
determinants maternal of health; or
(10) establish partnerships with local 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)) to
establish or expand pretrial diversion programs as an
alternative to incarceration for pregnant and postpartum
individuals, including--
(A) evidence-based childbirth education or
parenting classes;
(B) prenatal health coordination;
(C) family and individual counseling;
(D) evidence-based screenings, education, and, as
needed, treatment for mental and behavioral health
conditions, including drug and alcohol treatments;
(E) family case management services;
(F) domestic violence education and prevention;
(G) physical and sexual abuse counseling; and
(H) programs to address social determinants of
health such as employment, housing, education,
transportation, and nutrition.
(f) Implementation and Reporting.--A selected facility shall be
responsible for--
(1) implementing programs, which may include the programs
described in subsection (e); and
(2) not later than 3 years after the date of enactment of
this Act, and 6 years after the date of enactment of this Act,
reporting results of the programs to the Director, including
information describing--
(A) relevant quantitative indicators of success in
improving the standard of care and health outcomes for
pregnant and postpartum incarcerated individuals in the
facility, including data stratified by race, ethnicity,
sex, gender, age, geography, disability status, the
category of the criminal charge against such
individual, rates of pregnancy-related deaths,
pregnancy-associated deaths, cases of infant mortality
and morbidity, rates of preterm births and low-
birthweight births, cases of severe maternal morbidity,
cases of violence against pregnant or postpartum
individuals, diagnoses of maternal mental or behavioral
health conditions, and other such information as
appropriate;
(B) relevant qualitative and quantitative
evaluations from pregnant and postpartum incarcerated
individuals who participated in such programs,
including measures of patient-reported experience of
care; and
(C) strategies to sustain such programs after
fiscal year 2026 and expand such programs to other
facilities.
(g) Report.--Not later than 6 years after the date of enactment of
this Act, the Director shall submit to the Attorney General and to the
Congress a report describing the results of the programs funded under
this section.
(h) Oversight.--Not later than 1 year after the date of enactment
of this Act, the Attorney General shall award a contract to an
independent organization or independent organizations to conduct
oversight of the programs described in subsection (e).
(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $10,000,000 for each of fiscal
years 2022 through 2026.
SEC. 5. GRANT PROGRAM TO IMPROVE MATERNAL HEALTH OUTCOMES FOR
INDIVIDUALS IN STATE AND LOCAL PRISONS AND JAILS.
(a) Establishment.--Not later than 1 year after the date of
enactment of this Act, the Attorney General, acting through the
Director of the Bureau of Justice Assistance, 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 individuals. The Attorney General shall award such grants
in consultation with stakeholders such as--
(1) relevant community-based organizations, particularly
organizations that represent incarcerated and formerly
incarcerated individuals and organizations that seek to improve
maternal health outcomes for pregnant and postpartum
individuals from racial and ethnic minority groups;
(2) relevant organizations representing patients, with a
particular focus on patients from racial and ethnic minority
groups;
(3) organizations representing maternity care providers and
maternal health care education programs;
(4) perinatal health workers; and
(5) researchers and policy experts in fields related to
maternal health care for incarcerated individuals.
(b) Applications.--Each applicant for a grant under this section
shall submit to the Director of the Bureau of Justice Assistance an
application at such time, in such manner, and containing such
information as the Director may require.
(c) 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 individuals, and such programs
may--
(1) provide access to perinatal health workers from
pregnancy through the postpartum period;
(2) provide access to healthy foods and counseling on
nutrition, recommended activity levels, and safety measures
throughout pregnancy;
(3) train correctional officers to ensure that pregnant
incarcerated individuals receive safe and respectful treatment;
(4) train medical personnel to ensure that pregnant
incarcerated individuals receive trauma-informed, culturally
congruent care that promotes the health and safety of the
pregnant individuals;
(5) provide counseling and treatment for individuals who
have suffered from--
(A) diagnosed mental or behavioral health
conditions, including trauma and substance use
disorders;
(B) trauma or violence, including domestic
violence;
(C) human immunodeficiency virus;
(D) sexual abuse;
(E) pregnancy or infant loss; or
(F) chronic conditions;
(6) provide evidence-based pregnancy and childbirth
education, parenting support, and other relevant forms of
health literacy;
(7) provide clinical education opportunities to maternity
care providers in training to expand pathways into maternal
health care careers serving incarcerated individuals;
(8) offer opportunities for postpartum individuals to
maintain contact with the individual's newborn child to promote
bonding, including enhanced visitation policies, access to
prison nursery programs, or breastfeeding support;
(9) provide reentry assistance, particularly to--
(A) 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 period; and
(B) connect individuals exiting the criminal
justice system during pregnancy or in the postpartum
period to community-based resources, such as referrals
to health care providers, substance use disorder
treatments, and social services that address social
determinants of maternal health; or
(10) establish partnerships with local 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)) to
establish or expand pretrial diversion programs as an
alternative to incarceration for pregnant and postpartum
individuals, including--
(A) evidence-based childbirth education or
parenting classes;
(B) prenatal health coordination;
(C) family and individual counseling;
(D) evidence-based screenings, education, and, as
needed, treatment for mental and behavioral health
conditions, including drug and alcohol treatments;
(E) family case management services;
(F) domestic violence education and prevention;
(G) physical and sexual abuse counseling; and
(H) programs to address social determinants of
health such as employment, housing, education,
transportation, and nutrition.
(d) Priority.--In awarding grants under this section, the Director
of the Bureau of Justice Assistance shall give priority to applicants
based on--
(1) the number of pregnant and postpartum individuals
incarcerated in the State and, among such individuals, the
number of pregnant and postpartum individuals from racial and
ethnic minority groups; and
(2) 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 State.
(e) Grant Duration.--A grant awarded under this section shall be
for a 5-year period.
(f) Implementing and Reporting.--A State that receives a grant
under this section shall be responsible for--
(1) implementing the program funded by the grant; and
(2) not later than 3 years after the date of enactment of
this Act, and 6 years after the date of enactment of this Act,
reporting results of such program to the Attorney General,
including information describing--
(A) 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 facility, including
data stratified by race, ethnicity, sex, gender, age,
geography, disability status, category of the criminal
charge against such individual, incidence rates of
pregnancy-related deaths, pregnancy-associated deaths,
cases of infant mortality and morbidity, rates of
preterm births and low-birthweight births, cases of
severe maternal morbidity, cases of violence against
pregnant or postpartum individuals, diagnoses of
maternal mental or behavioral health conditions, and
other such information as appropriate;
(B) relevant qualitative and quantitative
evaluations from pregnant and postpartum incarcerated
individuals who participated in such programs,
including measures of patient-reported experience of
care; and
(C) strategies to sustain such programs beyond the
duration of the grant and expand such programs to other
facilities.
(g) Report.--Not later than 6 years after the date of enactment of
this Act, the Attorney General shall submit to the Congress a report
describing the results of such grant programs.
(h) Oversight.--Not later than 1 year after the date of enactment
of this Act, the Attorney General shall award a contract to an
independent organization or independent organizations to conduct
oversight of the programs described in subsection (c).
(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $10,000,000 for each of fiscal
years 2022 through 2026.
SEC. 6. GAO REPORT.
(a) In General.--Not later than 2 years after the date of enactment
of this Act, 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 individuals,
with a particular focus on racial and ethnic disparities in maternal
and infant health outcomes for incarcerated individuals.
(b) Contents of Report.--The report described in this section shall
include--
(1) to the extent practicable--
(A) the number of pregnant individuals who are
incarcerated in Bureau of Prisons facilities;
(B) the number of incarcerated individuals,
including those incarcerated in Federal, State, and
local correctional facilities, who have experienced a
pregnancy-related death, pregnancy-associated death, or
the death of an infant in the most recent 10 years of
available data;
(C) the number of cases of severe maternal
morbidity among incarcerated individuals, including
those incarcerated in Federal, State, and local
detention facilities, in the most recent 10 years of
available data;
(D) the number of preterm and low-birthweight
births of infants born to incarcerated individuals,
including those incarcerated in Federal, State, and
local correctional facilities, in the most recent 10
years of available data; and
(E) statistics on the racial and ethnic disparities
in maternal and infant health outcomes and severe
maternal morbidity rates among incarcerated
individuals, including those incarcerated in Federal,
State, and local detention facilities;
(2) in the case that the Comptroller General of the United
States is unable determine the information required in
subparagraphs (A) through (C) of paragraph (1), an assessment
of the barriers to determining such information and
recommendations for improvements in tracking maternal health
outcomes among incarcerated individuals, including those
incarcerated in Federal, State, and local detention facilities;
(3) causes of adverse maternal health outcomes that are
unique to incarcerated individuals, including those
incarcerated in Federal, State, and local detention facilities;
(4) causes of adverse maternal health outcomes and severe
maternal morbidity that are unique to incarcerated individuals
from racial and ethnic minority groups;
(5) 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 jails; and
(6) 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 individuals.
SEC. 7. MACPAC REPORT.
(a) In General.--Not later than 2 years after the date of enactment
of this Act, the Medicaid and CHIP Payment and Access Commission
(referred to in this section as ``MACPAC'') shall publish a report on
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 (42 U.S.C. 1396 et seq.) that contains
the information described in subsection.
(b) Information Described.--For purposes of subsection (a), the
information described in this subsection includes--
(1) information on the effect of ineligibility for medical
assistance under a State plan under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) on maternal health
outcomes for pregnant and postpartum incarcerated individuals,
concentrating on the effects of such ineligibility for pregnant
and postpartum individuals from racial and ethnic minority
groups; and
(2) the potential implications on maternal health outcomes
resulting from suspending eligibility for medical assistance
under a State plan under such title of such Act when a pregnant
or postpartum individual is incarcerated.
SEC. 8. DEFINITIONS.
In this Act:
(1) Culturally congruent.--The term ``culturally
congruent'', with respect to care or maternity care, means care
that is in agreement with the preferred cultural values,
beliefs, worldview, language, and practices of the health care
consumer and other stakeholders.
(2) Maternity care provider.--The term ``maternity care
provider'' means a health care provider who--
(A) is a physician, physician assistant, midwife
who meets at a minimum the international definition of
the midwife and global standards for midwifery
education as established by the International
Confederation of Midwives, nurse practitioner, or
clinical nurse specialist; and
(B) has a focus on maternal or perinatal health.
(3) Maternal mortality.--The term ``maternal mortality''
means a death occurring during or within a one-year period
after pregnancy, caused by pregnancy-related or childbirth
complications, including a suicide, overdose, or other death
resulting from a mental health or substance use disorder
attributed to or aggravated by pregnancy-related or childbirth
complications.
(4) Perinatal health worker.--The term ``perinatal health
worker'' means a doula, community health worker, peer
supporter, breastfeeding and lactation educator or counselor,
nutritionist or dietitian, childbirth educator, social worker,
home visitor, language interpreter, or navigator.
(5) Postpartum and postpartum period.--The terms
``postpartum'' and ``postpartum period'' refer to the 1-year
period beginning on the last day of the pregnancy of an
individual.
(6) Pregnancy-associated death.--The term ``pregnancy-
associated death'' means a death of a pregnant or postpartum
individual, by any cause, that occurs during, or within 1 year
following, the individual's pregnancy, regardless of the
outcome, duration, or site of the pregnancy.
(7) Pregnancy-related death.--The term ``pregnancy-related
death'' means a death of a pregnant or postpartum individual
that occurs during, or within 1 year following, the
individual's pregnancy, from a pregnancy complication, a chain
of events initiated by pregnancy, or the aggravation of an
unrelated condition by the physiologic effects of pregnancy.
(8) Racial and ethnic minority group.--The term ``racial
and ethnic minority group'' has the meaning given such term in
section 1707(g)(1) of the Public Health Service Act (42 U.S.C.
300u-6(g)(1)).
(9) Severe maternal morbidity.--The term ``severe maternal
morbidity'' means a health condition, including mental health
conditions and substance use disorders, 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 pregnant.
(10) Social determinants of maternal health defined.--The
term ``social determinants of maternal health'' means non-
clinical factors that impact maternal health outcomes,
including--
(A) economic factors, which may include poverty,
employment, food security, support for and access to
lactation and other infant feeding options, housing
stability, and related factors;
(B) neighborhood factors, which may include quality
of housing, access to transportation, access to child
care, availability of healthy foods and nutrition
counseling, availability of clean water, air and water
quality, ambient temperatures, neighborhood crime and
violence, access to broadband, and related factors;
(C) social and community factors, which may include
systemic racism, gender discrimination or
discrimination based on other protected classes,
workplace conditions, incarceration, and related
factors;
(D) household factors, which may include ability to
conduct lead testing and abatement, car seat
installation, indoor air temperatures, and related
factors;
(E) education access and quality factors, which may
include educational attainment, language and literacy,
and related factors; and
(F) health care access factors, including health
insurance coverage, access to culturally congruent
health care services, providers, and non-clinical
support, access to home visiting services, access to
wellness and stress management programs, health
literacy, access to telehealth and items required to
receive telehealth services, and related factors.
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