[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 5284 Introduced in Senate (IS)]
<DOC>
117th CONGRESS
2d Session
S. 5284
To improve the public health response to addressing maternal mortality
and morbidity during the COVID-19 public health emergency.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 15, 2022
Ms. Warren (for herself, Mr. Booker, Mrs. Gillibrand, and Ms. Smith)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To improve the public health response to addressing maternal mortality
and morbidity during the COVID-19 public health emergency.
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 ``Maternal Health Pandemic Response
Act of 2022''.
SEC. 2. FINDINGS.
Congress finds as follows:
(1) The World Health Organization declared COVID-19 a
``Public Health Emergency of International Concern'' on January
30, 2020. As of December 12, 2022, there have been over
643,875,000 confirmed cases of, and over 6,630,000 deaths
associated with, COVID-19 worldwide.
(2) In the United States, the number of cases of COVID-19
has quickly surpassed the number of such cases in every other
nation, and as of December 12, 2022, over 99,000,000 cases and
1,080,000 deaths have been reported by the United States alone.
(3) Longstanding systemic health and social inequities have
put communities of color at increased risk of contracting
COVID-19 or experiencing severe illness; age-adjusted
hospitalization rates from COVID-19 are highest for American
Indian and Alaska Native, Black, and Latinx people.
(4) Prior to the start of the COVID-19 pandemic, the United
States was facing a maternal mortality and morbidity crisis, in
which the United States has the highest maternal mortality rate
in the developed world, and the crisis is worsening.
(5) More than 50,000 women in the United States annually
experience severe maternal morbidity, and much larger numbers
experience more common harmful challenges, such as prenatal and
postpartum mood disorders, including depression, anxiety
disorder, and PTSD; limited access to prenatal and postpartum
care, diagnosis, and treatment of complications; intimate
partner violence; and lack of support for meeting breastfeeding
goals. Many perinatal complications are preventable or
treatable, and most injuries, long-term adverse effects, and
deaths are preventable.
(6) Compared to White women, Black and American Indian and
Alaska Native women in the United States are 2 to 4 times more
likely to die from pregnancy-related complications, and Black
and American Indian and Alaska Native women suffer
disproportionately high rates of maternal morbidity. The
maternal mortality rate for Hispanic women, which historically
has been lower than such rate for White women, is increasing
and is now nearly the same as that of White women.
(7) The causes of maternal mortality and morbidity are
complex and include racial, ethnic, socioeconomic, and
geographic inequities; racism, bias, and discrimination;
comorbidities; and inadequate access to the health care system,
including behavioral health care, which are factors that have
similarly contributed to the racial disparities seen in COVID-
19 outcomes.
(8) The burden of morbidity and mortality in the United
States for both COVID-19 and maternal health outcomes has also
fallen disproportionately on Black, Latinx, and American Indian
and Alaska Native communities, who suffer the most from great
public health needs and are the most medically underserved.
Underserved women also include those living in maternity care
deserts, which lack obstetric providers and hospitals or birth
centers offering obstetric care.
(9) According to the Centers for Disease Control and
Prevention, ``pregnant and recently pregnant people with COVID-
19 are at increased risk for severe illness when compared with
non-pregnant people''. Additionally, ``pregnant people with
COVID-19 are also at increased risk for preterm birth and some
data suggest an increased risk for other adverse pregnancy
complications and outcomes, such as preeclampsia, coagulopathy,
and stillbirth, compared with pregnant people without COVID-
19''. Research has also shown that COVID-19 infection during
pregnancy may increase the risk of preeclampsia; having
preeclampsia and other pregnancy complications also increases
the risks of serious COVID-19 infection.
(10) As of December 2022, the latest information from the
Centers for Disease Control and Prevention indicates that
pregnant women are more likely to be hospitalized and are at
higher risk for intensive care unit admissions than nonpregnant
women due to COVID-19, and Latinx and Black pregnant people
have been disproportionately infected by COVID-19, as well as
more likely to experience severe disease.
(11) Our understanding of the specific impact of COVID-19
on pregnant people has grown significantly. Pregnant and newly
delivered women are more susceptible to serious infection from
COVID-19, a direct impact. In addition, the COVID-19 pandemic
has further strained the health care system and decreased
access to preconception, prenatal, and postpartum care. The
lack of access to care, including mental health care, increases
the risks of maternal mortality and morbidity, pregnancy loss,
and infant mortality. It has also added another layer of fear
and vulnerability for pregnant people, with disproportionate
effects on people of color.
(12) As of March 7, 2022, over 180,000 pregnant people in
the United States have tested positive for COVID-19 and 293
pregnant people have died as a result of COVID-19.
(13) The World Health Organization states that everyone
``has the right to safe and positive childbirth experience,
whether or not they have a confirmed COVID-19 infection, this
includes the right to respect and dignity, a companion of
choice, clear communication by maternity staff, pain relief
strategies, and mobility in labor when possible and the
position of choice''.
(14) A COVID-19 public health response without concerted
Federal action and focus on maternal health care access and
quality, research, data collection, mitigation of negative
socioeconomic consequences of the pandemic, and protection of
the right to safe and positive childbirth experience has
exacerbated the maternal mortality and morbidity crisis. Risk
has also increased for pregnant women who have not been
provided with a continuum of respectful, responsive, and
empowering care from preconception through postpartum, during
the pandemic and beyond.
SEC. 3. DEFINITIONS.
In this Act:
(1) COVID-19 public health emergency.--The term ``COVID-19
public health emergency'' means the period beginning on the
date that the public health emergency declared by the Secretary
of Health and Human Services under section 319 of the Public
Health Service Act (42 U.S.C. 247d) on January 31, 2020, with
respect to COVID-19 took effect, and ending on the later of the
end of such public health emergency or January 1, 2023.
(2) Culturally congruent.--The term ``culturally
congruent'', with respect to care or maternity care, means care
that is anti-racist and is in agreement with the preferred
cultural values, beliefs, worldview, and practices of the
health care consumer and other stakeholders.
(3) Indian tribe, tribal organization, and urban indian
organization.--The terms ``Indian Tribe'' and ``Tribal
organization'' have the meanings given the terms ``Indian
tribe'' and ``tribal organization'', respectively, in section 4
of the Indian Self-Determination and Education Assistance Act
(25 U.S.C. 5304), and the term ``urban Indian organization''
has the meaning given such term in section 4 of the Indian
Health Care Improvement Act (25 U.S.C. 1603).
(4) Maternal mortality.--The term ``maternal mortality''
means a death occurring during pregnancy or within one year of
the end of 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.
(5) Postpartum.--The term ``postpartum'' means the 1-year
period beginning on the last day of a person's pregnancy.
(6) Respectful maternity care.--The term ``respectful
maternity care'' means care organized for, and provided to, all
pregnant and postpartum people in a manner that--
(A) is culturally congruent and linguistically
appropriate;
(B) maintains a person's dignity, privacy, and
confidentiality;
(C) ensures freedom from harm and mistreatment; and
(D) enables informed choice and continuous support
during labor, childbirth, and postpartum.
(7) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(8) Severe maternal morbidity.--The term ``severe maternal
morbidity'' means an unexpected outcome caused by labor and
delivery that results in significant short-term or long-term
consequences to the health of the pregnant person.
SEC. 4. EMERGENCY FUNDING FOR FEDERAL DATA COLLECTION, SURVEILLANCE,
AND RESEARCH ON MATERNAL HEALTH OUTCOMES DURING THE
COVID-19 PUBLIC HEALTH EMERGENCY OR A FUTURE PUBLIC
HEALTH EMERGENCY.
To conduct or support data collection, surveillance, and research
on maternal health as a result of the COVID-19 public health emergency
or a future public health emergency, including support to assist in the
capacity building for State, Tribal, territorial, and local public
health departments to collect and transmit racial, ethnic, and other
demographic data related to maternal health, there are authorized to be
appropriated--
(1) $100,000,000 for the Surveillance for Emerging Threats
to Mothers and Babies program of the Centers for Disease
Control and Prevention, to support the Centers for Disease
Control and Prevention in its efforts to--
(A) work with public health, clinical, and
community-based organizations to provide timely,
continually updated guidance to families and health
care providers on ways to reduce health risks to
mothers and babies and tailor interventions to improve
their long-term health;
(B) partner with more State, Tribal, territorial,
and local public health programs in the collection and
analysis of clinical data on the impact of COVID-19 and
future public health emergencies on pregnant and
postpartum patients and their newborns, including among
pregnant people of color; and
(C) establish regionally based centers of
excellence to offer medical, public health, and other
knowledge to ensure communities, especially communities
of color, rural communities, and other underserved
communities can help pregnant and postpartum patients
and infants get the care they need;
(2) $30,000,000 for the Enhancing Reviews and Surveillance
to Eliminate Maternal Mortality program (commonly known as the
``ERASE MM program'') of the Centers for Disease Control and
Prevention, to support the Centers for Disease Control and
Prevention in expanding its partnerships with States and Indian
Tribes and provide technical assistance to existing Maternal
Mortality Review Committees;
(3) $45,000,000 for the Pregnancy Risk Assessment
Monitoring System (commonly known as the ``PRAMS'') of the
Centers for Disease Control and Prevention, to support the
Centers for Disease Control and Prevention in its efforts to--
(A) create a COVID-19 supplement to its PRAMS
questionnaire;
(B) add questions around experiences of respectful,
responsive, and empowering maternity care in prenatal,
intrapartum, and postpartum care;
(C) conduct a rapid assessment of COVID-19
awareness, impact on care and experiences, and use of
preventive measures among pregnant, laboring and
birthing, and postpartum people during the COVID-19
public health emergency; and
(D) work to transition the survey to an electronic
platform and expand the survey to a larger population,
with a special focus on reaching underrepresented
communities and underserved communities, and with
sensitivity to individuals who lack access to such a
platform; and
(4) $15,000,000 for the National Institute of Child Health
and Human Development, to conduct or support research for
interventions to mitigate the effects of the COVID-19 public
health emergency on pregnant and postpartum people, including
Black, Latinx, Asian-American and Pacific Islander, and
American Indian and Alaska Native people, as well as people
living in areas with limited maternity care.
SEC. 5. COVID-19 MATERNAL HEALTH DATA COLLECTION AND DISCLOSURE.
(a) Data Collection.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention and the Administrator of
the Centers for Medicare & Medicaid Services, shall make publicly
available, on the website of the Centers for Disease Control and
Prevention, pregnancy and postpartum data collected across all
surveillance systems relating to COVID-19, disaggregated by race,
ethnicity, primary language, disability status, gender identity, sexual
orientation, immigration status, insurance status, and State and Tribal
location, including the following:
(1) Data related to all COVID-19 diagnostic testing,
including the number of pregnant people and postpartum people
tested and the number of positive cases.
(2) Data related to all suspected cases of COVID-19 in
pregnant, birthing, and postpartum people who did not undergo
testing.
(3) Data related to all COVID-19 serologic testing,
including the number of pregnant and postpartum people tested
and the number of such serologic tests that were positive.
(4) Data related to treatment for COVID-19, including
hospitalizations, emergency room, and intensive care unit
admissions of pregnant, birthing, and postpartum people related
to COVID-19.
(5) Data related to COVID-19 outcomes, including total
fatalities and case fatality (expressed as the proportion of
people who were infected with COVID-19 and died from the virus)
of pregnant and postpartum people.
(6) Data related to pregnancy and infant health outcomes
for pregnant people with confirmed or suspected COVID-19, which
may include stillbirths, maternal mortality and morbidity,
infant mortality, preterm births, low-birth weight infants, and
cesarean section births.
(7) Data related to all long-term effects of COVID-19
related to cases contracted during the pregnancy or postpartum
period.
(b) Timeline.--The Secretary shall update the data made available
under this section not less frequently than monthly, during the COVID-
19 public health emergency and for at least one month after the end of
the COVID-19 public health emergency.
(c) Privacy.--In publishing data under this section, the Secretary
shall take all necessary steps to protect the privacy of people whose
information is included in such data, including by complying with--
(1) privacy protections under the regulations promulgated
under section 264(c) of the Health Insurance Portability and
Accountability Act of 1996 (42 U.S.C. 1320d-2 note); and
(2) protections from all inappropriate internal use by an
entity that collects, stores, or receives the data, including
use of such data in determinations of eligibility (or continued
eligibility) in health plans, and from inappropriate uses.
(d) Indian Health Service.--The Director of the Indian Health
Service and Director of the Centers for Disease Control and Prevention
shall consult with Indian Tribes and confer with urban Indian
organizations on data collection and reporting for purposes of this
section.
(e) Data Collection Guidance.--The Secretary shall issue guidance
to States and local public health departments to ensure that all
relevant demographic data, including pregnancy and postpartum status,
are collected and included when sending COVID-19 testing specimen to
laboratories, and State and local health departments and Indian Tribes
are disaggregating data on COVID-19 status in data on maternal and
infant morbidity and mortality. The Secretary shall ensure that the
guidance is developed in consultation with Indian Tribes to ensure that
it includes Tribally developed best practices on reducing
misclassification of American Indian and Alaska Native people in
Federal, State, and local public health surveillance systems.
SEC. 6. PUBLIC HEALTH COMMUNICATION REGARDING MATERNAL CARE DURING
COVID-19.
(a) Public Health Campaign.--The Director of the Centers for
Disease Control and Prevention shall undertake a robust public health
education effort to enhance access by pregnant people, their employers,
and their providers to accurate, evidence-based health information
about COVID-19 and pregnancy, safety, and risk, with a particular focus
on reaching pregnant and postpartum people in underserved communities.
(b) Emergency Temporary Standard.--
(1) In general.--In consideration of the grave risk
presented by COVID-19 and the need to strengthen protections
for employees, pursuant to section 6(c)(1) of the Occupational
Safety and Health Act of 1970 (29 U.S.C. 655(c)(1)) and
notwithstanding the provisions of law and the executive order
described in paragraph (3), not later than 7 days after the
date of enactment of this Act, the Secretary of Labor shall
promulgate an emergency temporary standard to protect all
employees at occupational risk from occupational exposure to
SARS-CoV-2.
(2) Pregnant and postpartum employees.--The emergency
temporary standard promulgated under this subsection shall
include consideration of the risks and needs specific to
pregnant and postpartum employees.
(3) Inapplicable provisions of law and executive order.--
The requirements of chapter 6 of title 5, United States Code
(commonly referred to as the ``Regulatory Flexibility Act''),
subchapter I of chapter 35 of title 44, United States Code
(commonly referred to as the ``Paperwork Reduction Act''), the
Unfunded Mandates Reform Act of 1995 (2 U.S.C. 1501 et seq.),
and Executive Order 12866 (58 Fed. Reg. 190; relating to
regulatory planning and review) shall not apply to the standard
promulgated under this subsection.
(c) Task Force on Birthing Experience and Safe, Respectful,
Responsive, and Empowering Maternity Care During Pandemics and Other
Public Health Emergencies.--
(1) Establishment.--The Secretary, in consultation with the
Director of the Centers for Disease Control and Prevention and
the Administrator of the Health Resources and Services
Administration, shall convene a task force to develop Federal
recommendations regarding respectful, responsive, and
empowering maternity care, including safe birth care and
postpartum care, during public health emergencies.
(2) Duties.--The task force established under paragraph (1)
shall develop, publicly post, and update Federal
recommendations in multiple languages to ensure quality,
provide nondiscriminatory maternity care, promote positive
birthing experiences, and improve maternal health outcomes
during the COVID-19 public health emergency and future public
health emergencies, with a particular focus on outcomes for
communities of color and rural populations. Such guidelines and
recommendations shall--
(A) address, with particular attention to ensuring
equitable treatment on the basis of race and
ethnicity--
(i) measures to facilitate respectful,
responsive, and empowering maternity care;
(ii) measures to facilitate telehealth
maternity care for pregnant people who cannot
regularly access in-person care;
(iii) strategies to increase access to
specialized care for those with high-risk
pregnancies or pregnant individuals with
elevated risk factors;
(iv) diagnostic testing for pregnant and
laboring patients;
(v) birthing without one's chosen
companions, with one's chosen companions, and
with smartphone or other telehealth connection
to one's chosen companions;
(vi) newborn separation after birth in
relation to maternal infection status;
(vii) breast milk feeding in relation to
maternal infection status;
(viii) licensure, training, scope of
practice, and Medicaid and other insurance
reimbursement for certified midwives, certified
nurse-midwives, certified professional
midwives, in a manner that facilitates
inclusion of midwives of color and midwives
from underserved communities;
(ix) financial support and training for
perinatal health workers who provide non-
clinical support to people from pregnancy
through the postpartum period, such as a doula,
community health worker, peer supporter,
lactation consultant, nutritionist or
dietitian, social worker, home visitor, or a
patient navigator in a manner that facilitates
inclusion from underserved communities;
(x) strategies to ensure and expand doula
coverage under State Medicaid programs;
(xi) how to identify, address, and treat
prenatal and postpartum mental and behavioral
health conditions, such as anxiety, substance
use disorder, and depression, which may have
arisen or increased during the COVID-19 public
health emergency, and how to mitigate the
impact of future public health emergencies on
maternal mental health;
(xii) how to identify and address instances
of intimate partner violence during pregnancy
which may arise or intensify during public
health emergencies, and how to mitigate the
impact of future public health emergencies on
maternal mental health;
(xiii) strategies to address hospital
capacity concerns in communities with a surge
in infectious disease cases and to provide
childbearing people with options that reduce
potential for cross-contamination and increase
the ability to implement their care preferences
while maintaining safety and quality, such as
the use of auxiliary maternity units and
freestanding birth centers;
(xiv) provision of child care services
during prenatal appointments for mothers whose
children are unable to attend as a result of
restrictions relating to the public health
emergencies;
(xv) how to identify and address racism,
bias, and discrimination in the delivery
treatment and support to pregnant and
postpartum people, including evaluating the
value of training for hospital staff on
implicit bias and racism, respectful,
responsive, and empowering maternity care, and
demographic data collection;
(xvi) how to address the needs of
undocumented pregnant women and new mothers who
may be afraid or unable to seek needed care
during the COVID-19 public health emergency;
(xvii) how to address the needs of
uninsured pregnant women who have historically
relied on emergency departments for care;
(xviii) how to identify women at risk for
depression, anxiety disorder, psychosis,
obsessive-compulsive disorder, and other
maternal mood disorders before, during, and
after pregnancy, and how to treat those
diagnosed with a postpartum mood disorder;
(xix) how to effectively and
compassionately screen for substance abuse
during pregnancy and postpartum and help moms
find support and effective treatment; and
(xx) such other matters as the task force
determines appropriate;
(B) identify barriers to the implementation of the
guidelines and recommendations;
(C) take into consideration existing State and
other programs that have demonstrated effectiveness in
addressing pregnancy, birth, and postpartum care during
the COVID-19 public health emergency; and
(D) identify policies specific to COVID-19 that
should be discontinued when safely possible and those
that should be continued as the public health emergency
abates.
(3) Membership.--The task force established under paragraph
(1) shall be comprised of--
(A) representatives of the Department of Health and
Human Services, including representatives of--
(i) the Secretary;
(ii) the Director of the Centers for
Disease Control and Prevention;
(iii) the Administrator of the Health
Resources and Services Administration;
(iv) the Administrator of the Centers for
Medicare & Medicaid Services;
(v) the Director of the Agency for
Healthcare Research and Quality; and
(vi) the Director of the Indian Health
Service;
(B) at least 3 State, local, or territorial public
health officials representing departments of public
health, who shall represent jurisdictions from
different regions of the United States with relatively
high concentrations of historically marginalized
populations, to be appointed by the Secretary;
(C) at least 1 Tribal public health official
representing departments of public health;
(D) 1 or more representatives of a community-based
organization that addresses adverse maternal health
outcomes with a specific focus on racial and ethnic
inequities in maternal health outcomes, appointed by
the Secretary, with special consideration given to
organizations led by a person of color or from
communities with significant minority populations;
(E) 1 or more obstetrician-gynecologist or other
physician who provides obstetric care, with special
consideration for physicians who are from, or work in,
communities experiencing, or that have experienced, the
highest rates of COVID-19 mortality and morbidity;
(F) 1 or more nurse, such as a certified nurse-
midwife, women's health nurse practitioner, or other
nurse who provides obstetric care, with special
consideration for nurses who are from, or work in,
communities experiencing, or that have experienced, the
highest rates of COVID-19 mortality and morbidity;
(G) 1 or more perinatal health workers who provide
non-clinical support to people from pregnancy through
postpartum period, such as a doula, community health
worker, peer supporter, lactation consultant,
nutritionist or dietitian, social worker, home visitor,
or patient navigator;
(H) 1 or more patients who were pregnant or gave
birth during the COVID-19 public health emergency;
(I) 1 or more patients who contracted COVID-19 and
later gave birth;
(J) 1 or more patients who have received support
from a perinatal health worker who provides prenatal
and postpartum support, such as a doula, community
health worker, peer supporter, lactation consultant,
nutritionist or dietitian, social worker, home visitor,
or a patient navigator, or a spouse or family member of
such patient; and
(K) racially and ethnically diverse representation
from at least 3 independent experts with knowledge or
field experience with racial and ethnic disparities in
public health, women's health, or maternal mortality
and severe maternal morbidity.
SEC. 7. GAO REPORT ON MATERNAL HEALTH AND PUBLIC HEALTH EMERGENCY
PREPAREDNESS.
Not later than 1 year after the end of the public health emergency
declared by the Secretary of Health and Human Services under section
319 of the Public Health Service Act (42 U.S.C. 247d) on January 31,
2020, with respect to COVID-19, the Comptroller General of the United
States shall submit to the appropriate committees of Congress a report
on maternal health and public health emergency preparedness, including
prenatal, labor and delivery, and postpartum care during the COVID-19
public health emergency, including the following:
(1) A review of the prenatal, labor and delivery, and
postpartum experiences of people during the COVID-19 public
health emergency, which shall--
(A) identify barriers to accessing preconception,
pregnancy, birth, and postpartum care during a
pandemic, including maternal behavioral health care;
(B) assess the extent to which public and private
insurers were providing coverage for maternal health
care during the public health emergency, including for
telehealth services and out-of-hospital births;
(C) review the impact of the continuous enrollment
condition included in the Families First Coronavirus
Response Act (Public Law 116-127) had on enrollment of
postpartum people in State Medicaid programs and
analyze health care services utilized by this
population in the postpartum period;
(D) to the extent practicable, analyze maternal and
infant health outcomes by race and ethnicity (including
quality of care, mortality, morbidity, cesarean section
rates, preterm birth, prevalence of prenatal and
postpartum anxiety and depression, and other mood
disorders) during the COVID-19 public health emergency
and the impact of Federal and State policy changes made
in response to the COVID-19 pandemic on such outcomes;
(E) identify contributors to population-based
disparities seen in COVID-19 outcomes, such as racial
profiling of, and bias and discrimination against,
Black, American Indian and Alaska Native, Latinx, and
Asian-American and Pacific Islander people;
(F) review the impact of increased unemployment,
paid family leave, changes in health care coverage, and
other social determinants of health for pregnant and
postpartum people during the public health emergency,
including intimate partner violence; and
(G) assess the impact of the lack of inclusion of
pregnant and lactating people in clinical trials for
COVID-19 therapeutics and vaccines.
(2) Consultation with maternity care providers, maternal
behavioral health care specialists, researchers who specialize
in women's health or maternal mortality and severe maternal
morbidity, people who experienced pregnancy or childbirth
during the COVID-19 public health emergency, representatives
from community-based organizations that address maternal
health, and perinatal health workers who provide nonclinical
support to pregnant and postpartum people (such as a doula,
community health worker, peer support, certified lactation
consultant, nutritionist or dietician, social worker, home
visitor, or navigator).
(3) Recommendations to improve the public health emergency
response and preparedness efforts of the Federal Government
specific to maternal health, with a particular focus on
outcomes for minority women, including--
(A) ways to improve research, surveillance, and
data collection of the Federal Government related to
maternal health;
(B) ways for the Federal Government to factor
maternal health outcomes and disparities into decisions
regarding distribution of resources, including COVID-19
tests, personal protective equipment, and emergency
funding;
(C) the extent to which guidelines and
recommendations of the Federal Government related to
maternal health care during the COVID-19 public health
emergency were culturally congruent and linguistically
competent for minority women;
(D) ways to improve the distribution of public
health funds, data, and information to Indian Tribes
and Tribal organizations with regard to maternal health
during public health emergencies; and
(E) opportunities to incentivize or require
sponsors to include safety data on pregnant and
lactating people for therapeutics and vaccines in
emergency use authorization submissions.
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