[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1605 Introduced in Senate (IS)]
<DOC>
118th CONGRESS
1st Session
S. 1605
To authorize appropriations for data collection, surveillance, and
research on maternal health outcomes during public health emergencies,
and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 15, 2023
Ms. Warren (for herself, Mr. Booker, and Mrs. Gillibrand) introduced
the following bill; which was read twice and referred to the Committee
on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To authorize appropriations for data collection, surveillance, and
research on maternal health outcomes during public health emergencies,
and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Maternal Health Pandemic Response
Act''.
SEC. 2. FUNDING FOR DATA COLLECTION, SURVEILLANCE, AND RESEARCH ON
MATERNAL HEALTH OUTCOMES DURING PUBLIC HEALTH
EMERGENCIES.
To conduct or support data collection, surveillance, and research
on maternal health as a result of public health emergencies and
infectious diseases that pose a risk to maternal and infant health,
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 risk to pregnant and
postpartum individuals and their newborns 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 public
health emergencies and infectious diseases that pose a
risk to maternal and infant health on pregnant and
postpartum patients and their newborns, particularly
among patients from racial and ethnic minority groups;
and
(C) establish regionally based centers of
excellence to offer medical, public health, and other
knowledge to ensure communities can help pregnant and
postpartum individuals and newborns get the care and
support they need, particularly in areas with large
populations of individuals from demographic groups with
elevated rates of maternal mortality, severe maternal
morbidity, maternal health disparities, or other
adverse perinatal or childbirth outcomes;
(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 supplement to its PRAMS survey related
to public health emergencies and infectious diseases
that pose a risk to maternal and infant health;
(B) add questions around experiences of respectful
maternity care in prenatal, intrapartum, and postpartum
care; and
(C) work to transition such PRAMS survey to an
electronic platform and expand such PRAMS survey to a
larger population, with a special focus on reaching
underrepresented communities, and other program
improvements; 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 public health
emergencies and infectious diseases that pose a risk to
maternal and infant health, with a particular focus on
individuals from demographic groups with elevated rates of
maternal mortality, severe maternal morbidity, maternal health
disparities, or other adverse perinatal or childbirth outcomes.
SEC. 3. PUBLIC HEALTH EMERGENCY MATERNAL HEALTH DATA COLLECTION AND
DISCLOSURE.
(a) Availability of Collected Data.--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 data described in subsection (b).
(b) Data Described.--The data described in this subsection are data
collected through Federal surveillance systems under the Centers for
Disease Control and Prevention with respect to public health
emergencies and individuals who are pregnant or in a postpartum period.
Such data shall include the following:
(1) Diagnostic testing, confirmed cases, hospitalizations,
deaths, and other health outcomes related to an infectious
disease outbreak among pregnant and postpartum individuals.
(2) Maternal and infant health outcomes among individuals
who test positive for an infectious disease during or after
pregnancy.
(c) American Indian and Alaska Native Health Outcomes.--In carrying
out subsection (a), the Secretary shall consult with Indian Tribes and
confer with Urban Indian organizations.
(d) Disaggregated Information.--In carrying out subsection (a), the
Secretary shall disaggregate data by race, ethnicity, gender, primary
language, geography, socioeconomic status, and other relevant factors.
(e) Update.--During public health emergencies, the Secretary shall
update the data made available under this section--
(1) at least on a monthly basis; and
(2) not less than one month after the end of such public
health emergency.
(f) Privacy.--In carrying out subsection (a), the Secretary shall
take steps to protect the privacy of individuals pursuant to
regulations promulgated under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2 note).
(g) Guidance.--
(1) In general.--Not later than 30 days after the
declaration of a public health emergency, the Secretary shall
issue guidance to States and local public health departments to
ensure that--
(A) laboratories that test specimens for an
infectious disease receive all relevant demographic
data on race, ethnicity, pregnancy status, and other
demographic data as determined by the Secretary; and
(B) data described in subsection (b) are
disaggregated by race, ethnicity, gender, primary
language, geography, socioeconomic status, and other
relevant factors.
(2) Consultation.--In carrying out paragraph (1), the
Secretary shall consult with Indian Tribes--
(A) to ensure that such guidance includes tribally
developed best practices; and
(B) to reduce misclassification of American Indians
and Alaska Natives.
SEC. 4. PUBLIC HEALTH COMMUNICATION REGARDING MATERNAL CARE DURING
PUBLIC HEALTH EMERGENCIES.
The Director of the Centers for Disease Control and Prevention
shall conduct public health education campaigns during public health
emergencies to ensure that pregnant and postpartum individuals, their
employers, and their health care providers have accurate, evidence-
based information on maternal and infant health risks during the public
health emergency, with a particular focus on reaching pregnant and
postpartum individuals in underserved communities.
SEC. 5. TASK FORCE ON BIRTHING EXPERIENCE AND SAFE, RESPECTFUL,
RESPONSIVE, AND EMPOWERING MATERNITY CARE DURING PUBLIC
HEALTH EMERGENCIES.
(a) 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 (in this section referred to as the ``Task
Force'') to develop Federal recommendations regarding respectful,
responsive, and empowering maternity care, including safe birth care
and postpartum care, during public health emergencies.
(b) Duties.--The Task Force shall develop, publicly post, and
update Federal recommendations in multiple languages to ensure high-
quality, nondiscriminatory maternity care, promote positive birthing
experiences, and improve maternal health outcomes during public health
emergencies, with a particular focus on outcomes for individuals from
demographic groups with elevated rates of maternal mortality, severe
maternal morbidity, maternal health disparities, or other adverse
perinatal or childbirth outcomes. Such recommendations shall--
(1) address, with particular attention to ensuring
equitable treatment on the basis of race and ethnicity--
(A) measures to facilitate respectful, responsive,
and empowering maternity care;
(B) measures to facilitate telehealth maternity
care for pregnant people who cannot regularly access
in-person care;
(C) strategies to increase access to specialized
care for those with high-risk pregnancies or pregnant
individuals with elevated risk factors;
(D) diagnostic testing for pregnant and laboring
patients;
(E) birthing without one's chosen companions, with
one's chosen companions, and with smartphone or other
telehealth connection to one's chosen companions;
(F) newborn separation after birth in relation to
maternal infection status;
(G) breast milk feeding in relation to maternal
infection status;
(H) licensure, training, scope of practice, and
Medicaid and other insurance reimbursement for
certified midwives, certified nurse-midwives, and
certified professional midwives, in a manner that
facilitates inclusion of midwives of color and midwives
from underserved communities;
(I) financial support and training for perinatal
health workers who provide nonclinical support to
people from pregnancy through the postpartum period in
a manner that facilitates inclusion from underserved
communities;
(J) strategies to ensure and expand doula coverage
under State Medicaid programs;
(K) how to identify, address, and treat prenatal
and postpartum mental and behavioral health conditions,
such as anxiety, substance use disorder, and
depression, during public health emergencies;
(L) how to identify and address instances of
intimate partner violence during pregnancy which may
arise or intensify during public health emergencies;
(M) strategies to address hospital capacity
concerns in communities with a surge in infectious
disease cases and to provide childbearing people with
options that reduce the 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;
(N) provision of child care services during
prenatal and postpartum appointments for mothers whose
children are unable to attend as a result of
restrictions relating to the public health emergencies;
(O) how to identify and address racism, bias, and
discrimination in the delivery of maternity care
services 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;
(P) how to address the needs of undocumented
pregnant individuals and new mothers who may be afraid
or unable to seek needed care during the public health
emergency;
(Q) how to address the needs of uninsured pregnant
individuals who have historically relied on emergency
departments for care;
(R) how to identify pregnant and postpartum
individuals 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;
(S) how to effectively and compassionately screen
for substance use disorder during pregnancy and
postpartum and help pregnant and postpartum individuals
find support and effective treatment;
(T) how to ensure access to infant nutrition during
public health emergencies; and
(U) such other matters as the Task Force determines
appropriate;
(2) identify barriers to the implementation of the
recommendations;
(3) take into consideration existing State and other
programs that have demonstrated effectiveness in addressing
pregnancy, birth, and postpartum care during public health
emergencies; and
(4) 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.
(c) Membership.--The Secretary shall appoint the members of the
Task Force. Such members shall be comprised of--
(1) representatives of the Department of Health and Human
Services, including representatives of--
(A) the Secretary;
(B) the Director of the Centers for Disease Control
and Prevention;
(C) the Administrator of the Health Resources and
Services Administration;
(D) the Administrator of the Centers for Medicare &
Medicaid Services;
(E) the Director of the Agency for Healthcare
Research and Quality;
(F) the Commissioner of Food and Drugs;
(G) the Assistant Secretary for Mental Health and
Substance Use; and
(H) the Director of the Indian Health Service;
(2) 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;
(3) at least 1 Tribal public health official representing
departments of public health;
(4) 1 or more representatives of community-based
organizations that address adverse maternal health outcomes
with a specific focus on racial and ethnic inequities in
maternal health outcomes, with special consideration given to
representatives of such organizations that are led by a person
of color or from communities with significant minority
populations;
(5) a professionally diverse panel of maternity care
providers and perinatal health workers;
(6) 1 or more patients who were pregnant or gave birth
during the COVID-19 public health emergency;
(7) 1 or more patients who contracted COVID-19 and later
gave birth;
(8) 1 or more patients who have received support from a
perinatal health worker; and
(9) 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. 6. DEFINITIONS.
In this Act:
(1) Culturally and linguistically congruent.--The term
``culturally and linguistically congruent'', with respect to
care or maternity care, means care that is in agreement with
the preferred cultural values, beliefs, worldview, language,
and practices of the health care consumer and other
stakeholders.
(2) Maternal mortality.--The term ``maternal mortality''
means a death occurring during or within a 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-related or childbirth
complications.
(3) Perinatal health worker.--The term ``perinatal health
worker'' means a nonclinical health worker focused on maternal
or perinatal health, such as a doula, community health worker,
peer supporter, lactation educator or counselor, nutritionist
or dietitian, childbirth educator, social worker, home visitor,
patient navigator or coordinator, or language interpreter.
(4) 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.
(5) Public health emergency.--The term ``public health
emergency'' means a public health emergency declared under
section 319 of the Public Health Service Act (42 U.S.C. 247d).
(6) 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)).
(7) Respectful maternity care.--The term ``respectful
maternity care'' refers to care organized for, and provided to,
pregnant and postpartum individuals in a manner that--
(A) is culturally and linguistically congruent;
(B) maintains their dignity, privacy, and
confidentiality;
(C) ensures freedom from harm and mistreatment; and
(D) enables informed choice and continuous support.
(8) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(9) Severe maternal morbidity.--The term ``severe maternal
morbidity'' means a health condition, including mental health
conditions and substance use disorders, attributed to or
aggravated by pregnancy or childbirth that results in
significant short-term or long-term consequences to the health
of the individual who was pregnant.
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