[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 893 Introduced in Senate (IS)]
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117th CONGRESS
1st Session
S. 893
To support the use of technology in maternal health care.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 23, 2021
Mr. Menendez (for himself and Mr. Sullivan) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To support the use of technology in maternal health care.
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 ``Tech to Save Moms Act''.
SEC. 2. INTEGRATED TELEHEALTH MODELS IN MATERNITY CARE SERVICES.
(a) In General.--Section 1115A(b)(2)(B) of the Social Security Act
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the end the
following:
``(xxviii) Focusing on title XIX, providing
for the adoption of and use of telehealth tools
that allow for screening, monitoring, and
management of common health complications with
respect to an individual receiving medical
assistance during such individual's pregnancy
and for not more than a 1-year period beginning
on the last day of the pregnancy.''.
(b) Effective Date.--The amendment made by subsection (a) shall
take effect 1 year after the date of enactment of this Act.
SEC. 3. GRANTS TO EXPAND THE USE OF TECHNOLOGY-ENABLED COLLABORATIVE
LEARNING AND CAPACITY MODELS FOR PREGNANT AND POSTPARTUM
INDIVIDUALS.
Title III of the Public Health Service Act is amended by inserting
after section 330N (42 U.S.C. 254c-19) the following:
``SEC. 330O. EXPANDING CAPACITY FOR MATERNAL HEALTH OUTCOMES.
``(a) Establishment.--Beginning not later than 1 year after the
date of enactment of this section, the Secretary shall award grants to
eligible entities to evaluate, develop, and expand the use of
technology-enabled collaborative learning and capacity building models
and improve maternal health outcomes--
``(1) in health professional shortage areas;
``(2) in areas with high rates of maternal mortality and
severe maternal morbidity;
``(3) in areas with significant racial and ethnic
disparities in maternal health outcomes; and
``(4) for medically underserved populations and American
Indians and Alaska Natives, including Indian Tribes, Tribal
organizations, and Urban Indian organizations.
``(b) Use of Funds.--
``(1) Required uses.--Recipients of grants under this
section shall use the grants to--
``(A) train maternal health care providers,
students, and other similar professionals through
models that include--
``(i) methods to increase safety and health
care quality;
``(ii) methods to address implicit bias,
racism, and discrimination;
``(iii) best practices in screening for
maternal mental health conditions and substance
use disorders and, as needed, evaluating and
treating such conditions and disorders;
``(iv) training on best practices in
maternity care for pregnant and postpartum
individuals during the COVID-19 public health
emergency or future public health emergencies;
``(v) methods to screen for social
determinants of maternal health risks in the
prenatal and postpartum; and
``(vi) the use of remote patient monitoring
tools for pregnancy-related complications
described in section 1115A(b)(2)(B)(xxviii);
``(B) evaluate and collect information on the
affect of such models on--
``(i) access to and quality of care;
``(ii) outcomes with respect to the health
of an individual;
``(iii) the experience of individuals who
receive pregnancy-related health care;
``(C) develop qualitative and quantitative measures
to identify best practices for the expansion and use of
such models;
``(D) study the effect of such models on patient
outcomes and maternity care providers; and
``(E) conduct any other activity, as determined by
the Secretary.
``(2) Permissible uses.--Recipients of grants under this
section may use grants to support--
``(A) the use and expansion of technology-enabled
collaborative learning and capacity building models,
including hardware and software that--
``(i) enables distance learning and
technical support; and
``(ii) supports the secure exchange of
electronic health information; and
``(B) maternity care providers, students, and other
similar professionals in the provision of maternity
care through such models.
``(c) Application.--
``(1) In general.--An eligible entity seeking a grant under
subsection (a) shall submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require.
``(2) Assurance.--An application under paragraph (1) shall
include an assurance that such entity shall collect information
on, and assess the affect of, the use of technology-enabled
collaborative learning and capacity building models, including
with respect to--
``(A) maternal health outcomes;
``(B) access to maternal health care services;
``(C) quality of maternal health care; and
``(D) retention of maternity care providers serving
areas and populations described in subsection (a).
``(d) Limitations.--
``(1) Number.--Each entity receiving a grant under this
section may receive not more than 1 such grant.
``(2) Duration.--A grant awarded under this section shall
be for a 5-year period.
``(e) Access to Broadband.--In administering grants under this
section, the Secretary may coordinate with other agencies to ensure
that funding opportunities are available to support access to reliable,
high-speed internet for grantees.
``(f) Technical Assistance.--The Secretary shall provide (either
directly or by contract) technical assistance to eligible entities,
including recipients of grants under subsection (a), on the
development, use, and sustainability of technology-enabled
collaborative learning and capacity building models to expand access to
maternal health care services provided by such entities, including--
``(1) in health professional shortage areas;
``(2) in areas with high rates of maternal mortality and
severe maternal morbidity or significant racial and ethnic
disparities in maternal health outcomes; and
``(3) for medically underserved populations or American
Indians and Alaska Natives.
``(g) Research and Evaluation.--The Secretary, in consultation with
experts, shall develop a strategic plan to research and evaluate the
evidence for such models.
``(h) Reporting.--
``(1) Eligible entities.--An eligible entity that receives
a grant under subsection (a) shall submit to the Secretary a
report, at such time, in such manner, and containing such
information as the Secretary may require.
``(2) Secretary.--Not later than 4 years after the date of
enactment of this section, the Secretary shall submit to
Congress, and make available on the website of the Department
of Health and Human Services, a report that includes--
``(A) a description of grants awarded under
subsection (a) and the purpose and amounts of such
grants;
``(B) a summary of--
``(i) the evaluations conducted under
subsection (b)(1)(B);
``(ii) any technical assistance provided
under subsection (f); and
``(iii) the activities conducted under a
grant awarded under subsection (a); and
``(C) a description of any significant findings
with respect to--
``(i) patient outcomes; and
``(ii) best practices for expanding, using,
or evaluating technology-enabled collaborative
learning and capacity building models.
``(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $6,000,000 for each of fiscal
years 2022 through 2026.
``(j) Definitions.--In this section:
``(1) Eligible entity.--
``(A) In general.--The term `eligible entity' means
an entity that provides, or supports the provision of,
maternal health care services or other evidence-based
services for pregnant and postpartum individuals--
``(i) in health professional shortage
areas;
``(ii) in areas with high rates of adverse
maternal health outcomes or significant racial
and ethnic disparities in maternal health
outcomes; or
``(iii) who are--
``(I) members of medically
underserved populations; or
``(II) American Indians and Alaska
Natives, including Indian Tribes,
Tribal organizations, and urban Indian
organizations.
``(B) Inclusions.--An eligible entity may include
entities that lead, or are capable of leading, a
technology-enabled collaborative learning and capacity
building model.
``(2) Health professional shortage area.--The term `health
professional shortage area' means a health professional
shortage area designated under section 332.
``(3) Indian tribe.--The term `Indian Tribe' has the
meaning given such term in section 4 of the Indian Self-
Determination and Education Assistance Act.
``(4) Maternal mortality.--The term `maternal mortality'
means a death occurring during or within 1-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 or childbirth
complications.
``(5) Medically underserved population.--The term
`medically underserved population' has the meaning given such
term in section 330(b)(3).
``(6) Postpartum.--The term `postpartum' means the 1-year
period beginning on the last date of an individual's pregnancy.
``(7) Severe maternal morbidity.--The term `severe maternal
morbidity' means a health condition, including a mental health
or substance use disorder, 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.
``(8) Technology-enabled collaborative learning and
capacity building model.--The term `technology-enabled
collaborative learning and capacity building model' means a
distance health education model that connects health care
professionals, and other specialists, through simultaneous
interactive videoconferencing for the purpose of facilitating
case-based learning, disseminating best practices, and
evaluating outcomes in the context of maternal health care.
``(9) Tribal organization.--The term `Tribal organization'
has the meaning given such term in section 4 of the Indian
Self-Determination and Education Assistance Act.
``(10) Urban indian organization.--The term `urban Indian
organization' has the meaning given such term in section 4 of
the Indian Health Care Improvement Act.''.
SEC. 4. GRANTS TO PROMOTE EQUITY IN MATERNAL HEALTH OUTCOMES THROUGH
DIGITAL TOOLS.
(a) In General.--Beginning not later than 1 year after the date of
the enactment of this Act, the Secretary of Health and Human Services
shall award grants to eligible entities to reduce racial and ethnic
disparities in maternal health outcomes by increasing access to digital
tools related to maternal health care, including provider-facing
technologies, such as early warning systems and clinical decision
support mechanisms.
(b) Applications.--To be eligible to receive a grant under this
section, an eligible entity shall submit to the Secretary an
application at such time, in such manner, and containing such
information as the Secretary may require.
(c) Prioritization.--In awarding grants under this section, the
Secretary shall prioritize an eligible entity--
(1) in an area with high rates of adverse maternal health
outcomes or significant racial and ethnic disparities in
maternal health outcomes;
(2) in a health professional shortage area designated under
section 332 of the Public Health Service Act (42 U.S.C. 254e);
and
(3) that promotes technology that addresses racial and
ethnic disparities in maternal health outcomes.
(d) Limitations.--
(1) Number.--Each entity receiving a grant under this
section may receive not more than 1 such grant.
(2) Duration.--A grant awarded under this section shall be
for a 5-year period.
(e) Technical Assistance.--The Secretary shall provide technical
assistance to an eligible entity on the development, use, evaluation,
and post-grant sustainability of digital tools for purposes of
promoting equity in maternal health outcomes.
(f) Reporting.--
(1) Eligible entities.--An eligible entity that receives a
grant under subsection (a) shall submit to the Secretary a
report, at such time, in such manner, and containing such
information as the Secretary may require.
(2) Secretary.--Not later than 4 years after the date of
the enactment of this Act, the Secretary shall submit to
Congress a report that includes--
(A) an evaluation on the effectiveness of grants
awarded under this section to improve health outcomes
for pregnant and postpartum individuals from racial and
ethnic minority groups;
(B) recommendations on new grant programs that
promote the use of technology to improve such maternal
health outcomes; and
(C) recommendations with respect to--
(i) technology-based privacy and security
safeguards in maternal health care;
(ii) reimbursement rates for maternal
telehealth services;
(iii) the use of digital tools to analyze
large data sets to identify potential
pregnancy-related complications;
(iv) barriers that prevent maternity care
providers from providing telehealth services
across States;
(v) the use of consumer digital tools such
as mobile phone applications, patient portals,
and wearable technologies to improve maternal
health outcomes;
(vi) barriers that prevent access to
telehealth services, including a lack of access
to reliable, high-speed internet or electronic
devices;
(vii) barriers to data sharing between the
Special Supplemental Nutrition Program for
Women, Infants, and Children program and
maternity care providers, and recommendations
for addressing such barriers; and
(viii) lessons learned from expanded access
to telehealth related to maternity care during
the COVID-19 public health emergency.
(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $6,000,000 for each of fiscal
years 2022 through 2026.
SEC. 5. REPORT ON THE USE OF TECHNOLOGY IN MATERNITY CARE.
(a) In General.--Not later than 60 days after the date of enactment
of this Act, the Secretary of Health and Human Services shall seek to
enter an agreement with the National Academies of Sciences,
Engineering, and Medicine (referred to in this Act as the ``National
Academies'') under which the National Academies shall conduct a study
on the use of technology and patient monitoring devices in maternity
care.
(b) Content.--The agreement entered into pursuant to subsection (a)
shall provide for the study of the following:
(1) The use of innovative technology (including artificial
intelligence) in maternal health care, including the extent to
which such technology has affected racial or ethnic biases in
maternal health care.
(2) The use of patient monitoring devices (including pulse
oximeter devices) in maternal health care, including the extent
to which such devices have affected racial or ethnic biases in
maternal health care.
(3) Best practices for reducing and preventing racial or
ethnic biases in the use of innovative technology and patient
monitoring devices in maternity care.
(4) Best practices in the use of innovative technology and
patient monitoring devices for pregnant and postpartum
individuals from racial and ethnic minority groups.
(5) Best practices with respect to privacy and security
safeguards in such use.
(c) Report.--The agreement under subsection (a) shall direct the
National Academies to complete the study under this section, and
transmit to Congress a report on the results of the study, not later
than 2 years after the date of enactment of this Act.
SEC. 6. DEFINITIONS.
In this Act:
(1) 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.
(2) 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.
(3) 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)).
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