[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 1491 Reported in Senate (RS)]
<DOC>
Calendar No. 70
117th CONGRESS
1st Session
S. 1491
To amend the Public Health Service Act to improve obstetric care in
rural areas.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
April 29, 2021
Ms. Smith (for herself, Ms. Murkowski, Mr. King, Ms. Ernst, Mrs.
Gillibrand, Ms. Stabenow, Mr. Lujan, Mrs. Capito, and Ms. Collins)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
June 8, 2021
Reported by Mrs. Murray, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to improve obstetric care in
rural areas.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE.</DELETED>
<DELETED> This Act may be cited as the ``Rural Maternal and
Obstetric Modernization of Services Act'' or the ``Rural MOMS
Act''.</DELETED>
<DELETED>SEC. 2. IMPROVING RURAL MATERNAL AND OBSTETRIC CARE
DATA.</DELETED>
<DELETED> (a) Maternal Mortality and Morbidity Activities.--Section
301 of the Public Health Service Act (42 U.S.C. 241) is amended--
</DELETED>
<DELETED> (1) by redesignating subsections (e) through (h)
as subsections (f) through (i), respectively; and</DELETED>
<DELETED> (2) by inserting after subsection (d), the
following:</DELETED>
<DELETED> ``(e) The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall expand, intensify,
and coordinate the activities of the Centers for Disease Control and
Prevention with respect to maternal mortality and
morbidity.''.</DELETED>
<DELETED> (b) Office of Women's Health.--Section 310A(b)(1) of the
Public Health Service Act (42 U.S.C. 242s(b)(1)) is amended by striking
``sociocultural contexts'' and inserting ``sociocultural (race,
ethnicity, language, class, income) contexts (including among American
Indians and Alaska Natives, as such terms are defined in section 4 of
the Indian Health Care Improvement Act), and geographic
contexts''.</DELETED>
<DELETED> (c) Safe Motherhood.--Section 317K(b)(2) of the Public
Health Service Act (42 U.S.C. 247b-12(b)(2)) is amended--</DELETED>
<DELETED> (1) in subparagraph (L), by striking ``and'' at
the end;</DELETED>
<DELETED> (2) by redesignating subparagraph (M) as
subparagraph (N); and</DELETED>
<DELETED> (3) by inserting after subparagraph (L), the
following:</DELETED>
<DELETED> ``(M) an examination of the relationship
between maternal health services in rural areas and
outcomes in delivery and postpartum care;
and''.</DELETED>
<DELETED> (d) Office of Research on Women's Health.--Section 486 of
the Public Health Service Act (42 U.S.C. 287d) is amended--</DELETED>
<DELETED> (1) in subsection (b)--</DELETED>
<DELETED> (A) by redesignating paragraphs (4)
through (9) as paragraphs (5) through (10),
respectively;</DELETED>
<DELETED> (B) by inserting after paragraph (3) the
following:</DELETED>
<DELETED> ``(4) carry out paragraphs (1) and (2) with
respect to pregnancy, with priority given to deaths related to
pregnancy;''; and</DELETED>
<DELETED> (C) in paragraph (5) (as so redesignated),
by striking ``through (3)'' and inserting ``through
(4)''; and</DELETED>
<DELETED> (2) in subsection (d)(4)(A)(iv), by inserting ``,
including maternal mortality and other maternal morbidity
outcomes'' before the semicolon.</DELETED>
<DELETED>SEC. 3. RURAL OBSTETRIC NETWORK GRANTS.</DELETED>
<DELETED> The Public Health Service Act is amended by inserting
after section 317L-1 (42 U.S.C. 247b-13a) the following:</DELETED>
<DELETED>``SEC. 317L-2. RURAL OBSTETRIC NETWORK GRANTS.</DELETED>
<DELETED> ``(a) In General.--For the purpose of enabling the
Secretary (through grants, contracts, or otherwise), acting through the
Administrator of the Health Resources and Services Administration, to
establish collaborative improvement and innovation networks (referred
to in this section as `rural obstetric networks') to improve outcomes
in birth and maternal morbidity and mortality, there is appropriated to
the Secretary, out of any money in the Treasury not otherwise
appropriated, $3,000,000 for each of fiscal years 2021 through 2025.
Such amounts shall remain available until expended.</DELETED>
<DELETED> ``(b) Use of Funds.--Amount appropriated under subsection
(a) shall be used for the establishment of collaborative improvement
and innovation networks to improve maternal health in rural areas by
improving outcomes in birth and maternal morbidity and mortality. Rural
obstetric networks established in accordance with this section shall--
</DELETED>
<DELETED> ``(1) assist pregnant women and individuals in
rural areas connect with prenatal, labor and birth, and
postpartum care to improve outcomes in birth and maternal
mortality and morbidity;</DELETED>
<DELETED> ``(2) identify successful prenatal, labor and
birth, and postpartum health delivery models for individuals in
rural areas, including evidence-based home visiting programs
and successful, culturally competent models with positive
maternal health outcomes that advance health equity;</DELETED>
<DELETED> ``(3) develop a model for collaboration between
health facilities that have an obstetric health unit and health
facilities that do not have an obstetric health unit;</DELETED>
<DELETED> ``(4) provide training and guidance for health
facilities that do not have obstetric health units;</DELETED>
<DELETED> ``(5) collaborate with academic institutions that
can provide regional expertise and research on access,
outcomes, needs assessments, and other identified data;
and</DELETED>
<DELETED> ``(6) measure and address inequities in birth
outcomes among rural residents, with an emphasis on Black and
American Indians and Alaska Native residents, as such terms are
defined in section 4 of the Indian Health Care Improvement
Act.</DELETED>
<DELETED> ``(c) Requirements.--</DELETED>
<DELETED> ``(1) Establishment.--Not later than October 1,
2021, the Secretary shall establish rural obstetric health
networks in at least 5 regions.</DELETED>
<DELETED> ``(2) Definitions.--In this section:</DELETED>
<DELETED> ``(A) Frontier area.--The term `frontier
area' means a frontier county, as defined in section
1886(d)(3)(E)(iii)(III) of the Social Security
Act.</DELETED>
<DELETED> ``(B) Indian tribe.--The term `Indian
tribe' has the meaning given such term in section 4 of
the Indian Health Care Improvement Act.</DELETED>
<DELETED> ``(C) Native hawaiian health care
system.--The term `Native Hawaiian Health Care System'
has the meaning given such term in section 12 of the
Native Hawaiian Health Care Improvement Act.</DELETED>
<DELETED> ``(D) Region.--The term `region' means a
State, Indian tribe, rural area, or frontier
area.</DELETED>
<DELETED> ``(E) Rural area.--The term `rural area'
has the meaning given that term in section
1886(d)(2)(D) of the Social Security Act.</DELETED>
<DELETED> ``(F) Tribal organization.--The term
`tribal organization' has the meaning given such term
in the Indian Self-Determination Act.</DELETED>
<DELETED> ``(G) State.--The term `State' has the
meaning given that term for purposes of title V of the
Social Security Act.''.</DELETED>
<DELETED>SEC. 4. TELEHEALTH NETWORK AND TELEHEALTH RESOURCE CENTERS
GRANT PROGRAMS.</DELETED>
<DELETED> Section 330I of the Public Health Service Act (42 U.S.C.
254c-14) is amended--</DELETED>
<DELETED> (1) in subsection (f)(3), by adding at the end the
following:</DELETED>
<DELETED> ``(M) Providers of maternal, including
prenatal, labor and birth, and postpartum care services
and entities operation obstetric care
units.'';</DELETED>
<DELETED> (2) in subsection (h)(1)(B), by inserting ``labor
and birth, postpartum,'' before ``or prenatal''; and</DELETED>
<DELETED> (3) in subsection (j)(1)(B), by inserting ``,
including equipment useful for caring for pregnant women and
individuals, including ultrasound machines and fetal monitoring
equipment'' before the semicolon.</DELETED>
<DELETED>SEC. 5. RURAL MATERNAL AND OBSTETRIC CARE TRAINING
DEMONSTRATION.</DELETED>
<DELETED> Part D of title VII of the Public Health Service Act is
amended by inserting after section 760 (42 U.S.C. 294k) the
following:</DELETED>
<DELETED>``SEC. 760A. RURAL MATERNAL AND OBSTETRIC CARE TRAINING
DEMONSTRATION.</DELETED>
<DELETED> ``(a) In General.--The Secretary shall establish a
training demonstration program to award grants to eligible entities to
support--</DELETED>
<DELETED> ``(1) training for physicians, medical residents,
including family medicine and obstetrics and gynecology
residents, and fellows to practice maternal and obstetric
medicine in rural community-based settings;</DELETED>
<DELETED> ``(2) training for licensed and accredited nurse
practitioners, physician assistants, certified nurse midwives,
certified midwives, certified professional midwives, home
visiting nurses, or non-clinical professionals such as doulas
and community health workers, to provide maternal care services
in rural community-based settings; and</DELETED>
<DELETED> ``(3) establishing, maintaining, or improving
academic units or programs that--</DELETED>
<DELETED> ``(A) provide training for students or
faculty, including through clinical experiences and
research, to improve maternal care in rural areas;
or</DELETED>
<DELETED> ``(B) develop evidence-based practices or
recommendations for the design of the units or programs
described in subparagraph (A), including curriculum
content standards.</DELETED>
<DELETED> ``(b) Activities.--</DELETED>
<DELETED> ``(1) Training for medical residents and
fellows.--A recipient of a grant under subsection (a)(1)--
</DELETED>
<DELETED> ``(A) shall use the grant funds--
</DELETED>
<DELETED> ``(i) to plan, develop, and
operate a training program to provide obstetric
care in rural areas for family practice or
obstetrics and gynecology residents and
fellows; or</DELETED>
<DELETED> ``(ii) to train new family
practice or obstetrics and gynecology residents
and fellows in maternal and obstetric health
care to provide and expand access to maternal
and obstetric health care in rural areas;
and</DELETED>
<DELETED> ``(B) may use the grant funds to provide
additional support for the administration of the
program or to meet the costs of projects to establish,
maintain, or improve faculty development, or
departments, divisions, or other units necessary to
implement such training.</DELETED>
<DELETED> ``(2) Training for other providers.--A recipient
of a grant under subsection (a)(2)--</DELETED>
<DELETED> ``(A) shall use the grant funds to plan,
develop, or operate a training program to provide
maternal health care services in rural, community-based
settings; and</DELETED>
<DELETED> ``(B) may use the grant funds to provide
additional support for the administration of the
program or to meet the costs of projects to establish,
maintain, or improve faculty development, or
departments, divisions, or other units necessary to
implement such program.</DELETED>
<DELETED> ``(3) Academic units or programs.--A recipient of
a grant under subsection (a)(3) shall enter into a partnership
with organizations such as an education accrediting
organization (such as the Liaison Committee on Medical
Education, the Accreditation Council for Graduate Medical
Education, the Commission on Osteopathic College Accreditation,
the Accreditation Commission for Education in Nursing, the
Commission on Collegiate Nursing Education, the Accreditation
Commission for Midwifery Education, or the Accreditation Review
Commission on Education for the Physician Assistant) to carry
out activities under subsection (a)(3).</DELETED>
<DELETED> ``(4) Training program requirements.--The
recipient of a grant under subsection (a)(1) or (a)(2) shall
ensure that training programs carried out under the grant
include instruction on--</DELETED>
<DELETED> ``(A) maternal mental health, including
perinatal depression and anxiety and postpartum
depression;</DELETED>
<DELETED> ``(B) maternal substance use
disorder;</DELETED>
<DELETED> ``(C) social determinants of health that
impact individuals living in rural communities,
including poverty, social isolation, access to
nutrition, education, transportation, and housing;
and</DELETED>
<DELETED> ``(D) implicit bias.</DELETED>
<DELETED> ``(c) Eligible Entities.--</DELETED>
<DELETED> ``(1) Training for medical residents and
fellows.--To be eligible to receive a grant under subsection
(a)(1), an entity shall--</DELETED>
<DELETED> ``(A) be a consortium consisting of--
</DELETED>
<DELETED> ``(i) at least one teaching health
center; or</DELETED>
<DELETED> ``(ii) the sponsoring institution
(or parent institution of the sponsoring
institution) of--</DELETED>
<DELETED> ``(I) an obstetrics and
gynecology or family medicine residency
program that is accredited by the
Accreditation Council of Graduate
Medical Education (or the parent
institution of such a program);
or</DELETED>
<DELETED> ``(II) a fellowship in
maternal or obstetric medicine, as
determined appropriate by the
Secretary; or</DELETED>
<DELETED> ``(B) be an entity described in
subparagraph (A)(ii) that provides opportunities for
medical residents or fellows to train in rural
community-based settings.</DELETED>
<DELETED> ``(2) Training for other providers.--To be
eligible to receive a grant under subsection (a)(2), an entity
shall be--</DELETED>
<DELETED> ``(A) a teaching health center (as defined
in section 749A(f));</DELETED>
<DELETED> ``(B) a Federally-qualified health center
(as defined in section 1905(l)(2)(B) of the Social
Security Act);</DELETED>
<DELETED> ``(C) a community mental health center (as
defined in section 1861(ff)(3)(B) of the Social
Security Act);</DELETED>
<DELETED> ``(D) a rural health clinic (as defined in
section 1861(aa) of the Social Security Act);</DELETED>
<DELETED> ``(E) a freestanding birth center (as
defined in section 1905(l)(3) of the Social Security
Act);</DELETED>
<DELETED> ``(F) a health center operated by the
Indian Health Service, an Indian tribe, a tribal
organization, or a Native Hawaiian Health Care System
(as such terms are defined in section 4 of the Indian
Health Care Improvement Act and section 12 of the
Native Hawaiian Health Care Improvement Act);
or</DELETED>
<DELETED> ``(G) an entity with a demonstrated record
of success in providing academic training for nurse
practitioners, physician assistants, certified nurse-
midwives, certified midwives, certified professional
midwives, home visiting nurses, or non-clinical
professionals, such as doulas and community health
workers.</DELETED>
<DELETED> ``(3) Academic units or programs.--To be eligible
to receive a grant under subsection (a)(3), an entity shall be
a school of medicine or osteopathic medicine, a nursing school,
a physician assistant training program, an accredited public or
nonprofit private hospital, an accredited medical residency
program, a school accredited by the Midwifery Education and
Accreditation Council, or a public or private nonprofit entity
which the Secretary has determined is capable of carrying out
such grant.</DELETED>
<DELETED> ``(4) Application.--To be eligible to receive a
grant under subsection (a), 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 an estimate of the amount to be expended to conduct
training activities under the grant (including ancillary and
administrative costs).</DELETED>
<DELETED> ``(d) Duration.--Grants awarded under this section shall
be for a minimum of 5 years.</DELETED>
<DELETED> ``(e) Study and Report.--</DELETED>
<DELETED> ``(1) Study.--</DELETED>
<DELETED> ``(A) In general.--The Secretary, acting
through the Administrator of the Health Resources and
Services Administration, shall conduct a study on the
results of the demonstration program under this
section.</DELETED>
<DELETED> ``(B) Data submission.--Not later than 90
days after the completion of the first year of the
training program, and each subsequent year for the
duration of the grant, that the program is in effect,
each recipient of a grant under subsection (a) shall
submit to the Secretary such data as the Secretary may
require for analysis for the report described in
paragraph (2).</DELETED>
<DELETED> ``(2) Report to congress.--Not later than 1 year
after receipt of the data described in paragraph (1)(B), the
Secretary shall submit to Congress a report that includes--
</DELETED>
<DELETED> ``(A) an analysis of the effect of the
demonstration program under this section on the
quality, quantity, and distribution of maternal,
including prenatal, labor and birth, and postpartum
care services and the demographics of the recipients of
those services;</DELETED>
<DELETED> ``(B) an analysis of maternal and infant
health outcomes (including quality of care, morbidity,
and mortality) before and after implementation of the
program in the communities served by entities
participating in the demonstration; and</DELETED>
<DELETED> ``(C) recommendations on whether the
demonstration program should be expanded.</DELETED>
<DELETED> ``(f) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section, $5,000,000 for
each of fiscal years 2021 through 2025.''.</DELETED>
<DELETED>SEC. 6. GAO REPORT.</DELETED>
<DELETED> Not later than 1 year after the date of enactment of this
Act, the Comptroller General of the United States shall submit to the
appropriate committees of Congress a report on the maternal, including
prenatal, labor and birth, and postpartum care in rural areas. Such
report shall include the following:</DELETED>
<DELETED> (1) The location of gaps in maternal and obstetric
clinicians and health professionals, including non-clinical
professionals such as doulas and community health
workers.</DELETED>
<DELETED> (2) The location of gaps in facilities able to
provide maternal, including prenatal, labor and birth, and
postpartum care in rural areas, including care for high-risk
pregnancies.</DELETED>
<DELETED> (3) The gaps in data on maternal mortality and
recommendations to standardize the format on collecting data
related to maternal mortality and morbidity.</DELETED>
<DELETED> (4) The gaps in maternal health by race and
ethnicity in rural communities, with a focus on racial
inequities for Black residents and among Indian Tribes and
American Indian and Alaska Native rural residents (as such
terms are defined in section 4 of the Indian Health Care
Improvement Act).</DELETED>
<DELETED> (5) A list of specific activities that the
Secretary of Health and Human Services plans to conduct on
maternal, including prenatal, labor and birth, and postpartum
care.</DELETED>
<DELETED> (6) A plan for completing such
activities.</DELETED>
<DELETED> (7) An explanation of Federal agency involvement
and coordination needed to conduct such activities.</DELETED>
<DELETED> (8) A budget for conducting such
activities.</DELETED>
<DELETED> (9) Other information that the Comptroller General
determines appropriate.</DELETED>
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Rural Maternal and Obstetric
Modernization of Services Act'' or the ``Rural MOMS Act''.
SEC. 2. IMPROVING RURAL MATERNAL AND OBSTETRIC CARE DATA.
(a) Maternal Mortality and Morbidity Activities.--Section 301(e) of
the Public Health Service Act (42 U.S.C. 241) is amended by inserting
``, preventable maternal mortality and severe maternal morbidity,''
after ``delivery''.
(b) Office of Women's Health.--Section 310A(b)(1) of the Public
Health Service Act (42 U.S.C. 242s(b)(1)) is amended by striking ``and
sociocultural contexts,'' and inserting ``sociocultural (including
among American Indians, Native Hawaiians, and Alaska Natives), and
geographical contexts,''.
(c) Safe Motherhood.--Section 317K of the Public Health Service Act
(42 U.S.C. 247b-12) is amended--
(1) in subsection (a)(2)(A), by inserting ``, including
improving disaggregation of data (in a manner consistent with
applicable State and Federal privacy laws)'' before the period;
and
(2) in subsection (b)(2)--
(A) in subparagraph (L), by striking ``and'' at the
end;
(B) by redesignating subparagraph (M) as
subparagraph (N); and
(C) by inserting after subparagraph (L) the
following:
``(M) an examination of the relationship between
maternal health and obstetric services in rural areas
and outcomes in delivery and postpartum care; and''.
(d) Office of Research on Women's Health.--Section 486(d)(4)(A)(iv)
of the Public Health Service Act (42 U.S.C. 287d(d)(4)(A)(iv)) is
amended by inserting ``, including preventable maternal mortality and
severe maternal morbidity'' before the semicolon.
SEC. 3. RURAL OBSTETRIC NETWORK GRANTS.
The Public Health Service Act is amended by inserting after section
330A-1 of such Act (42 U.S.C. 254c-1a) the following:
``SEC. 330A-2. RURAL OBSTETRIC NETWORK GRANTS.
``(a) Program Established.--The Secretary shall award grants or
cooperative agreements to eligible entities to establish collaborative
improvement and innovation networks (referred to in this section as
`rural obstetric networks') to improve maternal and infant health
outcomes and reduce preventable maternal mortality and severe maternal
morbidity by improving maternity care and access to care in rural
areas, frontier areas, maternity care health professional target areas,
or jurisdictions of Indian Tribes and Tribal organizations.
``(b) Use of Funds.--Grants or cooperative agreements awarded
pursuant to this section shall be used for the establishment or
continuation of collaborative improvement and innovation networks to
improve maternal and infant health outcomes and reduce preventable
maternal mortality and severe maternal morbidity by improving prenatal
care, labor care, birthing, and postpartum care services in rural
areas. Rural obstetric networks established in accordance with this
section may--
``(1) develop a network to improve coordination and
increase access to maternal health care and assist pregnant
women in the areas described in subsection (a) with accessing
and utilizing prenatal care, labor care, birthing, and
postpartum care services to improve outcomes in birth and
maternal mortality and morbidity;
``(2) identify and implement evidence-based and sustainable
delivery models for providing prenatal care, labor care,
birthing, and postpartum care services, including home visiting
programs and culturally appropriate care models that reduce
health disparities;
``(3) develop a model for maternal health care
collaboration between health care settings to improve access to
care in areas described in subsection (a), which may include
the use of telehealth;
``(4) provide training for professionals in health care
settings that do not have specialty maternity care;
``(5) collaborate with academic institutions that can
provide regional expertise and help identify barriers to
providing maternal health care, including strategies for
addressing such barriers; and
``(6) assess and address disparities in infant and maternal
health outcomes, including among racial and ethnic minority
populations and underserved populations in such areas described
in subsection (a).
``(c) Definitions.--In this section:
``(1) Eligible entities.--The term `eligible entities'
means entities providing prenatal care, labor care, birthing,
and postpartum care services in rural areas, frontier areas, or
medically underserved areas, or to medically underserved
populations or Indian Tribes or Tribal organizations.
``(2) Frontier area.--The term `frontier area' means a
frontier county, as defined in section 1886(d)(3)(E)(iii)(III)
of the Social Security Act.
``(3) Indian tribes; tribal organization.--The terms
`Indian Tribe' and `Tribal organization' have the meanings
given the terms `Indian tribe' and `tribal organization' in
section 4 of the Indian Self-Determination and Education
Assistance Act.
``(4) Maternity care health professional target area.--The
term `maternity care health professional target area' has the
meaning described in section 332(k)(2).
``(d) Report to Congress.--Not later than September 30, 2025, the
Secretary shall submit to Congress a report on activities supported by
grants awarded under this section, including--
``(1) a description of activities conducted pursuant to
paragraphs (1) through (6) of subsection (b); and
``(2) an analysis of the effects of rural obstetric
networks on improving maternal and infant health outcomes.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $3,000,000 for each of fiscal
years 2022 through 2026.''.
SEC. 4. TELEHEALTH NETWORK AND TELEHEALTH RESOURCE CENTERS GRANT
PROGRAMS.
Section 330I of the Public Health Service Act (42 U.S.C. 254c-14)
is amended--
(1) in subsection (f)(3), by adding at the end the
following:
``(M) Providers of prenatal, labor care, birthing,
and postpartum care services, including hospitals that
operate obstetric care units.''; and
(2) in subsection (h)(1)(B), by striking ``or prenatal care
for high-risk pregnancies'' and inserting ``prenatal care,
labor care, birthing care, or postpartum care''.
SEC. 5. RURAL MATERNAL AND OBSTETRIC CARE TRAINING DEMONSTRATION.
Subpart 1 of part E of title VII of the Public Health Service Act
(42 U.S.C. 294n et seq.) is amended by adding at the end the following:
``SEC. 764. RURAL MATERNAL AND OBSTETRIC CARE TRAINING DEMONSTRATION.
``(a) In General.--The Secretary shall award grants to accredited
schools of allopathic medicine, osteopathic medicine, and nursing, and
other appropriate health professional training programs, to establish a
training demonstration program to support--
``(1) training for physicians, medical residents, fellows,
nurse practitioners, physician assistants, nurses, certified
nurse midwives, relevant home visiting workforce professionals
and paraprofessionals, or other professionals who meet relevant
State training and licensing requirements, as applicable, to
reduce preventable maternal mortality and severe maternal
morbidity by improving prenatal care, labor care, birthing, and
postpartum care in rural community-based settings; and
``(2) developing recommendations for such training
programs.
``(b) Application.--To be eligible to receive a grant under
subsection (a), an entity shall submit to the Secretary an application
at such time, in such manner, and containing such information as the
Secretary may require.
``(c) Activities.--
``(1) Training for health care professionals.-- A recipient
of a grant under subsection (a)--
``(A) shall use the grant funds to plan, develop,
and operate a training program to provide prenatal
care, labor care, birthing, and postpartum care in
rural areas; and
``(B) may use the grant funds to provide additional
support for the administration of the program or to
meet the costs of projects to establish, maintain, or
improve faculty development, or departments, divisions,
or other units necessary to implement such training.
``(2) Training program requirements.--The recipient of a
grant under subsection (a) shall ensure that training programs
carried out under the grant are evidence-based and address
improving prenatal care, labor care, birthing, and postpartum
care in rural areas, and such programs may include training on
topics such as--
``(A) maternal mental health, including perinatal
depression and anxiety;
``(B) substance use disorders;
``(C) social determinants of health that affect
individuals living in rural areas; and
``(D) improving the provision of prenatal care,
labor care, birthing, and postpartum care for racial
and ethnic minority populations, including with respect
to perceptions and biases that may affect the approach
to, and provision of, care.
``(d) Evaluation and Report.--
``(1) Evaluation.--
``(A) In general.--The Secretary shall evaluate the
outcomes of the demonstration program under this
section.
``(B) Data submission.--Recipients of a grant under
subsection (a) shall submit to the Secretary
performance metrics and other related data in order to
evaluate the program for the report described in
paragraph (2).
``(2) Report to congress.--Not later than January 1, 2025,
the Secretary shall submit to Congress a report that includes--
``(A) an analysis of the effects of the
demonstration program under this section on the
quality, quantity, and distribution of maternal health
care services, including prenatal care, labor care,
birthing, and postpartum care services, and the
demographics of the recipients of those services;
``(B) an analysis of maternal and infant health
outcomes (including quality of care, morbidity, and
mortality) before and after implementation of the
program in the communities served by entities
participating in the demonstration; and
``(C) recommendations on whether the demonstration
program should be continued.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $5,000,000 for each of fiscal
years 2022 through 2026.''.
Calendar No. 70
117th CONGRESS
1st Session
S. 1491
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A BILL
To amend the Public Health Service Act to improve obstetric care in
rural areas.
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June 8, 2021
Reported with an amendment