[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 1675 Reported in Senate (RS)]
<DOC>
Calendar No. 71
117th CONGRESS
1st Session
S. 1675
To improve maternal health.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 18, 2021
Mr. Warnock (for himself, Mr. Rubio, Ms. Smith, Mr. Marshall, Ms.
Hassan, Mr. Cassidy, and Ms. Murkowski) 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 improve maternal health.
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 ``Maternal Health Quality
Improvement Act''.</DELETED>
<DELETED>SEC. 2. INNOVATION FOR MATERNAL HEALTH.</DELETED>
<DELETED> Title III of the Public Health Service Act (42 U.S.C. 241
et seq.) is amended by inserting after section 330N of such Act, the
following:</DELETED>
<DELETED>``SEC. 330O. INNOVATION FOR MATERNAL HEALTH.</DELETED>
<DELETED> ``(a) In General.--The Secretary, in consultation with
experts representing a variety of clinical specialties, State, tribal,
or local public health officials, researchers, epidemiologists,
statisticians, and community organizations, shall establish or continue
a program to award competitive grants to eligible entities for the
purpose of--</DELETED>
<DELETED> ``(1) identifying, developing, or disseminating
best practices to improve maternal health care quality, improve
maternal and infant health outcomes, eliminate preventable
maternal mortality and severe maternal morbidity, and improve
infant health outcomes, which may include--</DELETED>
<DELETED> ``(A) information on evidence-based
practices to improve the quality and safety of maternal
health care in hospitals and other health care settings
of a State or health care system by addressing topics
commonly associated with health complications or risks
related to prenatal care, labor care, birthing, and
postpartum care;</DELETED>
<DELETED> ``(B) best practices for improving
maternal health care based on data findings and reviews
conducted by a State maternal mortality review
committee that address topics of relevance to common
complications or health risks related to prenatal care,
labor care, birthing, and postpartum care;
and</DELETED>
<DELETED> ``(C) information on addressing
determinants of health that impact maternal health
outcomes for women before, during, and after
pregnancy;</DELETED>
<DELETED> ``(2) collaborating with State maternal mortality
review committees to identify issues for the development and
implementation of evidence-based practices to improve maternal
health outcomes and reduce preventable maternal mortality and
severe maternal morbidity, consistent with section
317K;</DELETED>
<DELETED> ``(3) providing technical assistance and
supporting the implementation of best practices identified in
paragraph (1) to entities providing health care services to
pregnant and postpartum women; and</DELETED>
<DELETED> ``(4) identifying, developing, and evaluating new
models of care that improve maternal and infant health
outcomes, which may include the integration of community-based
services and clinical care.</DELETED>
<DELETED> ``(b) Eligible Entities.--To be eligible for a grant under
subsection (a), an entity shall--</DELETED>
<DELETED> ``(1) submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require; and</DELETED>
<DELETED> ``(2) demonstrate in such application that the
entity is capable of carrying out data-driven maternal safety
and quality improvement initiatives in the areas of obstetrics
and gynecology or maternal health.</DELETED>
<DELETED> ``(c) Report.--Not later than September 30, 2024, and
every 2 years thereafter, the Secretary shall submit a report to
Congress on the practices described in paragraphs (1) and (2) of
subsection (a). Such report shall include a description of the extent
to which such practices reduced preventable maternal mortality and
severe maternal morbidity, and whether such practices improved maternal
and infant health. The Secretary shall disseminate information on such
practices, as appropriate.</DELETED>
<DELETED> ``(d) Authorization of Appropriations.--To carry out this
section, there are authorized to be appropriated $9,000,000 for each of
fiscal years 2022 through 2026.''.</DELETED>
<DELETED>SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS.</DELETED>
<DELETED> Title VII of the Public Health Service Act is amended by
striking section 763 (42 U.S.C. 294p) and inserting the
following:</DELETED>
<DELETED>``SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS.</DELETED>
<DELETED> ``(a) Grant Program.--The Secretary shall establish a
program to award grants to accredited schools of allopathic medicine,
osteopathic medicine, and nursing, and other health professional
training programs for the training of health care professionals to
improve 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.</DELETED>
<DELETED> ``(b) Eligibility.--To be eligible for a grant under
subsection (a), an entity described in such subsection shall submit to
the Secretary an application at such time, in such manner, and
containing such information as the Secretary may require.</DELETED>
<DELETED> ``(c) Reporting Requirements.--</DELETED>
<DELETED> ``(1) Periodic grantee reports.--Each entity
awarded a grant under this section shall periodically submit to
the Secretary a report on the status of activities conducted
using the grant, including a description of the impact of such
training on patient outcomes, as applicable.</DELETED>
<DELETED> ``(2) Report to congress.--Not later than
September 30, 2024, the Secretary shall submit a report to
Congress on the activities conducted using grants under
subsection (a) and any best practices identified and
disseminated under subsection (d).</DELETED>
<DELETED> ``(d) Best Practices.--The Secretary may identify and
disseminate best practices for the training described in subsection
(a).</DELETED>
<DELETED> ``(e) Authorization of Appropriations.--To carry out this
section, there are authorized to be appropriated $5,000,000 for each of
fiscal years 2022 through 2026.''.</DELETED>
<DELETED>SEC. 4. STUDY ON IMPROVING TRAINING FOR HEALTH CARE
PROVIDERS.</DELETED>
<DELETED> Not later than 2 years after date of enactment of this
Act, the Secretary of Health and Human Services shall, through a
contract with an independent research organization, conduct a study and
make recommendations for accredited schools of allopathic medicine,
osteopathic medicine, and nursing, and other health professional
training programs on best practices related to training to improve 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.</DELETED>
<DELETED>SEC. 5. PERINATAL QUALITY COLLABORATIVES.</DELETED>
<DELETED> (a) In General.--Section 317K(a)(2) of the Public Health
Service Act (42 U.S.C. 247b-12(a)(2)) is amended by adding at the end
the following:</DELETED>
<DELETED> ``(E)(i) The Secretary, acting through the
Director of the Centers for Disease Control and Prevention and
in coordination with other offices and agencies, as
appropriate, shall establish or continue a competitive grant
program for the establishment or support of perinatal quality
collaboratives to improve perinatal care and perinatal health
outcomes for pregnant and postpartum women and their infants. A
State, Indian Tribe, or Tribal organization may use funds
received through such grant to--</DELETED>
<DELETED> ``(I) support the use of evidence-based or
evidence-informed practices to improve outcomes for
maternal and infant health;</DELETED>
<DELETED> ``(II) work with clinical teams; experts;
State, local, and, as appropriate, tribal public health
officials; and stakeholders, including patients and
families, to identify, develop, or disseminate best
practices to improve perinatal care and outcomes;
and</DELETED>
<DELETED> ``(III) employ strategies that provide
opportunities for health care professionals and
clinical teams to collaborate across health care
settings and disciplines, including primary care and
mental health, as appropriate, to improve maternal and
infant health outcomes, which may include the use of
data to provide timely feedback across hospital and
clinical teams to inform responses, and to provide
support and training to hospital and clinical teams for
quality improvement, as appropriate.</DELETED>
<DELETED> ``(ii) To be eligible for a grant under clause
(i), an entity shall submit to the Secretary an application in
such form and manner and containing such information as the
Secretary may require.''.</DELETED>
<DELETED> (b) Report to Congress.--Not later than September 30,
2025, the Secretary of Health and Human Services shall submit to
Congress a report regarding the activities conducted by recipients of
grants under subsection (a)(2)(E) of section 317K of the Public Health
Service Act (42 U.S.C. 247b-12).</DELETED>
<DELETED>SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM
WOMEN.</DELETED>
<DELETED> (a) Grants.--Title III of the Public Health Service Act
(42 U.S.C. 241 et seq.) is amended by inserting after section 330O of
such Act, as added by section 2, the following:</DELETED>
<DELETED>``SEC. 330P. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM
WOMEN.</DELETED>
<DELETED> ``(a) In General.--The Secretary may award grants for the
purpose of establishing or operating evidence-based or innovative,
evidence-informed programs to deliver integrated health care services
to pregnant and postpartum women to optimize the health of women and
their infants, including to reduce adverse maternal health outcomes,
pregnancy-related deaths, and related health disparities (including
such disparities associated with racial and ethnic minority
populations), and, as appropriate, by addressing issues researched
under subsection (b)(2) of section 317K.</DELETED>
<DELETED> ``(b) Integrated Services for Pregnant and Postpartum
Women.--</DELETED>
<DELETED> ``(1) Eligibility.--To be eligible to receive a
grant under subsection (a), a State, Indian Tribe, or Tribal
organization (as such terms are defined in section 4 of the
Indian Self-Determination and Education Assistance Act) shall
work with relevant stakeholders that coordinate care to develop
and carry out the program, including--</DELETED>
<DELETED> ``(A) State, Tribal, and local agencies
responsible for Medicaid, public health, social
services, mental health, and substance use disorder
treatment and services;</DELETED>
<DELETED> ``(B) health care providers who serve
pregnant and postpartum women; and</DELETED>
<DELETED> ``(C) community-based health organizations
and health workers, including providers of home
visiting services and individuals representing
communities with disproportionately high rates of
maternal mortality and severe maternal morbidity, and
including those representing racial and ethnic minority
populations.</DELETED>
<DELETED> ``(2) Terms.--</DELETED>
<DELETED> ``(A) Period.--A grant awarded under
subsection (a) shall be made for a period of 5 years.
Any supplemental award made to a grantee under
subsection (a) may be made for a period of less than 5
years.</DELETED>
<DELETED> ``(B) Preference.--In awarding grants
under subsection (a), the Secretary shall--</DELETED>
<DELETED> ``(i) give preference to States,
Indian Tribes, and Tribal organizations that
have the highest rates of maternal mortality
and severe maternal morbidity relative to other
such States, Indian Tribes, or Tribal
organizations, respectively; and</DELETED>
<DELETED> ``(ii) shall consider health
disparities related to maternal mortality and
severe maternal morbidity, including such
disparities associated with racial and ethnic
minority populations.</DELETED>
<DELETED> ``(C) Evaluation.--The Secretary shall
require grantees to evaluate the outcomes of the
programs supported under the grant.</DELETED>
<DELETED> ``(c) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section $10,000,000 for
each of fiscal years 2022 through 2026.''.</DELETED>
<DELETED> (b) Report on Grant Outcomes and Dissemination of Best
Practices.--</DELETED>
<DELETED> (1) Report.--Not later than February 1, 2026, the
Secretary of Health and Human Services shall submit to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives a report that describes--</DELETED>
<DELETED> (A) the outcomes of the activities
supported by the grants awarded under the amendments
made by this section on maternal and child
health;</DELETED>
<DELETED> (B) best practices and models of care used
by recipients of grants under such amendments;
and</DELETED>
<DELETED> (C) obstacles identified by recipients of
grants under such amendments, and strategies used by
such recipients to deliver care, improve maternal and
child health, and reduce health disparities.</DELETED>
<DELETED> (2) Dissemination of best practices.--Not later
than August 1, 2026, the Secretary of Health and Human Services
shall disseminate information on best practices and models of
care used by recipients of grants under the amendments made by
this section (including best practices and models of care
relating to the reduction of health disparities, including such
disparities associated with racial and ethnic minority
populations, in rates of maternal mortality and severe maternal
morbidity) to relevant stakeholders, which may include health
providers, medical schools, nursing schools, relevant State,
tribal, and local agencies, and the general public.</DELETED>
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Maternal Health Quality Improvement
Act''.
SEC. 2. INNOVATION FOR MATERNAL HEALTH.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by inserting after section 330N of such Act, the following:
``SEC. 330O. INNOVATION FOR MATERNAL HEALTH.
``(a) In General.--The Secretary, in consultation with experts
representing a variety of clinical specialties, State, Tribal, or local
public health officials, researchers, epidemiologists, statisticians,
and community organizations, shall establish or continue a program to
award competitive grants to eligible entities for the purpose of--
``(1) identifying, developing, or disseminating best
practices to improve maternal health care quality and outcomes,
improve maternal and infant health, and eliminate preventable
maternal mortality and severe maternal morbidity, which may
include--
``(A) information on evidence-based practices to
improve the quality and safety of maternal health care
in hospitals and other health care settings of a State
or health care system by addressing topics commonly
associated with health complications or risks related
to prenatal care, labor care, birthing, and postpartum
care;
``(B) best practices for improving maternal health
care based on data findings and reviews conducted by a
State maternal mortality review committee that address
topics of relevance to common complications or health
risks related to prenatal care, labor care, birthing,
and postpartum care; and
``(C) information on addressing determinants of
health that impact maternal health outcomes for women
before, during, and after pregnancy;
``(2) collaborating with State maternal mortality review
committees to identify issues for the development and
implementation of evidence-based practices to improve maternal
health outcomes and reduce preventable maternal mortality and
severe maternal morbidity, consistent with section 317K;
``(3) providing technical assistance and supporting the
implementation of best practices identified in paragraph (1) to
entities providing health care services to pregnant and
postpartum women; and
``(4) identifying, developing, and evaluating new models of
care that improve maternal and infant health outcomes, which
may include the integration of community-based services and
clinical care.
``(b) Eligible Entities.--To be eligible for a grant under
subsection (a), an entity shall--
``(1) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require; and
``(2) demonstrate in such application that the entity is
capable of carrying out data-driven maternal safety and quality
improvement initiatives in the areas of obstetrics and
gynecology or maternal health.
``(c) Report.--Not later than September 30, 2024, and every 2 years
thereafter, the Secretary shall submit a report to Congress on the
practices described in paragraphs (1) and (2) of subsection (a). Such
report shall include a description of the extent to which such
practices reduced preventable maternal mortality and severe maternal
morbidity, and whether such practices improved maternal and infant
health. The Secretary shall disseminate information on such practices,
as appropriate.
``(d) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $9,000,000 for each of fiscal
years 2022 through 2026.''.
SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS.
Title VII of the Public Health Service Act is amended by striking
section 763 (42 U.S.C. 294p) and inserting the following:
``SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS.
``(a) Grant Program.--The Secretary shall establish a program to
award grants to accredited schools of allopathic medicine, osteopathic
medicine, and nursing, and other health professional training programs
for the training of health care professionals to improve 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.
``(b) Eligibility.--To be eligible for a grant under subsection
(a), an entity described in such subsection shall submit to the
Secretary an application at such time, in such manner, and containing
such information as the Secretary may require.
``(c) Reporting Requirements.--
``(1) Periodic grantee reports.--Each entity awarded a
grant under this section shall periodically submit to the
Secretary a report on the status of activities conducted using
the grant, including a description of the impact of such
training on patient outcomes, as applicable.
``(2) Report to congress.--Not later than September 30,
2025, the Secretary shall submit a report to Congress on the
activities conducted using grants under subsection (a) and any
best practices identified and disseminated under subsection
(d).
``(d) Best Practices.--The Secretary may identify and disseminate
best practices for the training described in subsection (a).
``(e) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $5,000,000 for each of fiscal
years 2022 through 2026.''.
SEC. 4. STUDY ON IMPROVING TRAINING FOR HEALTH CARE PROVIDERS.
Not later than 2 years after date of enactment of this Act, the
Secretary of Health and Human Services shall, through a contract with
an independent research organization, conduct a study and make
recommendations for accredited schools of allopathic medicine,
osteopathic medicine, and nursing, and other health professional
training programs on best practices related to training to improve 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.
SEC. 5. PERINATAL QUALITY COLLABORATIVES.
(a) In General.--Section 317K(a)(2) of the Public Health Service
Act (42 U.S.C. 247b-12(a)(2)) is amended by adding at the end the
following:
``(E)(i) The Secretary, acting through the Director of the
Centers for Disease Control and Prevention and in coordination
with other offices and agencies, as appropriate, shall
establish or continue a competitive grant program for the
establishment or support of perinatal quality collaboratives to
improve perinatal care and perinatal health outcomes for
pregnant and postpartum women and their infants. A State,
Indian Tribe, or Tribal organization may use funds received
through such grant to--
``(I) support the use of evidence-based or
evidence-informed practices to improve outcomes for
maternal and infant health;
``(II) work with clinical teams; experts; State,
local, and, as appropriate, Tribal public health
officials; and stakeholders, including patients and
families, to identify, develop, or disseminate best
practices to improve perinatal care and outcomes; and
``(III) employ strategies that provide
opportunities for health care professionals and
clinical teams to collaborate across health care
settings and disciplines, including primary care and
mental health, as appropriate, to improve maternal and
infant health outcomes, which may include the use of
data to provide timely feedback across hospital and
clinical teams to inform responses, and to provide
support and training to hospital and clinical teams for
quality improvement, as appropriate.
``(ii) To be eligible for a grant under clause (i), an
entity shall submit to the Secretary an application in such
form and manner and containing such information as the
Secretary may require.''.
(b) Report to Congress.--Not later than September 30, 2025, the
Secretary of Health and Human Services shall submit to Congress a
report regarding the activities conducted by recipients of grants under
subsection (a)(2)(E) of section 317K of the Public Health Service Act
(42 U.S.C. 247b-12).
SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM WOMEN.
(a) Grants.--Title III of the Public Health Service Act (42 U.S.C.
241 et seq.) is amended by inserting after section 330O of such Act, as
added by section 2, the following:
``SEC. 330P. INTEGRATED SERVICES FOR PREGNANT AND POSTPARTUM WOMEN.
``(a) In General.--The Secretary may award grants for the purpose
of establishing or operating evidence-based or innovative, evidence-
informed programs to deliver integrated health care services to
pregnant and postpartum women to optimize the health of women and their
infants, including to reduce adverse maternal health outcomes,
pregnancy-related deaths, and related health disparities (including
such disparities associated with racial and ethnic minority
populations), and, as appropriate, by addressing issues researched
under subsection (b)(2) of section 317K.
``(b) Integrated Services for Pregnant and Postpartum Women.--
``(1) Eligibility.--To be eligible to receive a grant under
subsection (a), a State, Indian Tribe, or Tribal organization
(as such terms are defined in section 4 of the Indian Self-
Determination and Education Assistance Act) shall work with
relevant stakeholders that coordinate care to develop and carry
out the program, including--
``(A) State, Tribal, and local agencies responsible
for Medicaid, public health, social services, mental
health, and substance use disorder treatment and
services;
``(B) health care providers who serve pregnant and
postpartum women; and
``(C) community-based health organizations and
health workers, including providers of home visiting
services and individuals representing communities with
disproportionately high rates of maternal mortality and
severe maternal morbidity, and including those
representing racial and ethnic minority populations.
``(2) Terms.--
``(A) Period.--A grant awarded under subsection (a)
shall be made for a period of 5 years. Any supplemental
award made to a grantee under subsection (a) may be
made for a period of less than 5 years.
``(B) Priorities.--In awarding grants under
subsection (a), the Secretary shall--
``(i) give priority to States, Indian
Tribes, and Tribal organizations that have the
highest rates of maternal mortality and severe
maternal morbidity relative to other such
States, Indian Tribes, or Tribal organizations,
respectively; and
``(ii) shall consider health disparities
related to maternal mortality and severe
maternal morbidity, including such disparities
associated with racial and ethnic minority
populations.
``(C) Evaluation.--The Secretary shall require
grantees to evaluate the outcomes of the programs
supported under the grant.
``(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $10,000,000 for each of fiscal
years 2022 through 2026.''.
(b) Report on Grant Outcomes and Dissemination of Best Practices.--
(1) Report.--Not later than February 1, 2026, the Secretary
of Health and Human Services shall submit to the Committee on
Health, Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of
Representatives a report that describes--
(A) the outcomes of the activities supported by the
grants awarded under the amendments made by this
section on maternal and child health;
(B) best practices and models of care used by
recipients of grants under such amendments; and
(C) obstacles identified by recipients of grants
under such amendments, and strategies used by such
recipients to deliver care, improve maternal and child
health, and reduce health disparities.
(2) Dissemination of best practices.--Not later than August
1, 2026, the Secretary of Health and Human Services shall
disseminate information on best practices and models of care
used by recipients of grants under the amendments made by this
section (including best practices and models of care relating
to the reduction of health disparities, including such
disparities associated with racial and ethnic minority
populations, in rates of maternal mortality and severe maternal
morbidity) to relevant stakeholders, which may include health
providers, medical schools, nursing schools, relevant State,
Tribal, and local agencies, and the general public.
SEC. 7. MATERNAL VACCINATION AWARENESS.
In carrying out the public awareness initiative related to
vaccinations pursuant to section 313 of the Public Health Service Act
(42 U.S.C. 245), the Secretary of Health and Human Services shall take
into consideration the importance of increasing awareness and knowledge
of the safety and effectiveness of vaccines to prevent disease in
pregnant and postpartum women and in infants and the need to improve
vaccination rates in communities and populations with low rates of
vaccination.
Calendar No. 71
117th CONGRESS
1st Session
S. 1675
_______________________________________________________________________
A BILL
To improve maternal health.
_______________________________________________________________________
June 8, 2021
Reported with an amendment