[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4060 Introduced in Senate (IS)]

<DOC>






118th CONGRESS
  2d Session
                                S. 4060

To improve maternal health policies in correctional facilities, and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 22, 2024

  Mr. Booker (for himself, Mr. Durbin, and Ms. Hirono) introduced the 
 following bill; which was read twice and referred to the Committee on 
                             the Judiciary

_______________________________________________________________________

                                 A BILL


 
To improve maternal health policies in correctional facilities, 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 ``Justice for Incarcerated Moms Act''.

SEC. 2. ENDING THE SHACKLING OF PREGNANT INDIVIDUALS.

    (a) In General.--Beginning on the date that is 180 days after the 
date of enactment of this Act, and annually thereafter, for each State 
that receives a grant under subpart 1 of part E of title I of the 
Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C. 10151 et 
seq.) (commonly referred to as the ``Edward Byrne Memorial Justice 
Assistance Grant Program'') and that does not have in effect throughout 
the State for such fiscal year laws restricting the use of restraints 
on pregnant individuals in correctional facilities that are 
substantially similar to the rights, procedures, requirements, effects, 
and penalties set forth in section 4322 of title 18, United States 
Code, the amount of such grant that would otherwise be allocated to 
such State under such subpart for the fiscal year shall be decreased by 
25 percent.
    (b) Reallocation.--Amounts not allocated to a State for failure to 
comply with subsection (a) shall be reallocated in accordance with 
subpart 1 of part E of title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (34 U.S.C. 10151 et seq.) to States that have 
complied with such subsection.

SEC. 3. CREATING MODEL PROGRAMS FOR THE CARE OF INCARCERATED 
              INDIVIDUALS IN THE PRENATAL AND POSTPARTUM PERIODS.

    (a) In General.--
            (1) Establishment.--Not later than 1 year after the date of 
        enactment of this Act, the Attorney General, acting through the 
        Director of the Bureau of Prisons (referred to in this section 
        as the ``Director''), shall establish, in not fewer than 6 
        Bureau of Prisons facilities, programs to optimize maternal 
        health outcomes for pregnant and postpartum individuals 
        incarcerated in such facilities.
            (2) Consultation with stakeholders.--The Attorney General 
        shall establish such programs in consultation with stakeholders 
        such as--
                    (A) relevant community-based organizations, 
                particularly organizations that represent incarcerated 
                and formerly incarcerated individuals and organizations 
                that seek to improve maternal health outcomes for 
                pregnant and postpartum individuals from demographic 
                groups with elevated rates of maternal mortality, 
                severe maternal morbidity, maternal health disparities, 
                or other adverse perinatal or childbirth outcomes;
                    (B) relevant organizations representing patients, 
                with a particular focus on patients from demographic 
                groups with elevated rates of maternal mortality, 
                severe maternal morbidity, maternal health disparities, 
                or other adverse perinatal or childbirth outcomes;
                    (C) organizations representing maternity care 
                providers and maternal health care education programs;
                    (D) perinatal health workers; and
                    (E) researchers and policy experts in fields 
                related to maternal health care for incarcerated 
                individuals.
    (b) Start Date.--A facility selected under subsection (a) shall 
begin the programs described in subsection (e) not later than 18 months 
after the date of enactment of this Act.
    (c) Facility Priority.--In carrying out subsection (a), the 
Director shall give priority to a facility based on--
            (1) the number of pregnant and postpartum individuals 
        incarcerated in such facility and, among such individuals, the 
        number of pregnant and postpartum individuals from demographic 
        groups with elevated rates of maternal mortality, severe 
        maternal morbidity, maternal health disparities, or other 
        adverse perinatal or childbirth outcomes; and
            (2) the extent to which the leaders of such facility have 
        demonstrated a commitment to developing exemplary programs for 
        pregnant and postpartum individuals incarcerated in such 
        facility.
    (d) Program Duration.--The programs established under subsection 
(e) shall be carried out for a 5-year period.
    (e) Programs.--Bureau of Prisons facilities selected by the 
Director shall establish programs for pregnant and postpartum 
incarcerated individuals, and such programs may--
            (1) provide access to perinatal health workers from 
        pregnancy through the postpartum period;
            (2) provide access to healthy foods and counseling on 
        nutrition, recommended activity levels, and safety measures 
        throughout pregnancy;
            (3) train correctional officers to ensure that pregnant 
        incarcerated individuals receive safe and respectful treatment;
            (4) train medical personnel to ensure that pregnant 
        incarcerated individuals receive trauma-informed, culturally 
        and linguistically congruent care that promotes the health and 
        safety of the pregnant individuals;
            (5) provide counseling and treatment for individuals who 
        have suffered from--
                    (A) diagnosed mental or behavioral health 
                conditions, including trauma and substance use 
                disorders;
                    (B) trauma or violence, including domestic 
                violence;
                    (C) human immunodeficiency virus;
                    (D) sexual abuse;
                    (E) pregnancy or infant loss; or
                    (F) chronic conditions;
            (6) provide evidence-based pregnancy and childbirth 
        education, parenting support, and other relevant forms of 
        health literacy;
            (7) provide clinical education opportunities to maternity 
        care providers in training to expand pathways into maternal 
        health care careers serving incarcerated individuals;
            (8) offer opportunities for postpartum individuals to 
        maintain contact with the individual's newborn child to promote 
        bonding, including enhanced visitation policies, access to 
        prison nursery programs, or breastfeeding support;
            (9) provide reentry assistance, particularly to--
                    (A) ensure access to health insurance coverage and 
                transfer of health records to community providers if an 
                incarcerated individual exits the criminal justice 
                system during such individual's pregnancy or in the 
                postpartum period; and
                    (B) connect individuals exiting the criminal 
                justice system during pregnancy or in the postpartum 
                period to community-based resources, such as referrals 
                to health care providers, substance use disorder 
                treatments, and social services that address social 
                determinants of maternal health; or
            (10) establish partnerships with local public entities, 
        private community entities, community-based organizations, 
        Indian Tribes and Tribal organizations (as such terms are 
        defined in section 4 of the Indian Self-Determination and 
        Education Assistance Act (25 U.S.C. 5304)), and Urban Indian 
        organizations (as such term is defined in section 4 of the 
        Indian Health Care Improvement Act (25 U.S.C. 1603)) to 
        establish or expand pretrial diversion programs as an 
        alternative to incarceration for pregnant and postpartum 
        individuals, including--
                    (A) evidence-based childbirth education or 
                parenting classes;
                    (B) prenatal health coordination;
                    (C) family and individual counseling;
                    (D) evidence-based screenings, education, and, as 
                needed, treatment for mental and behavioral health 
                conditions, including drug and alcohol treatments;
                    (E) family case management services;
                    (F) domestic violence education and prevention;
                    (G) physical and sexual abuse counseling; and
                    (H) programs to address social determinants of 
                health such as employment, housing, education, 
                transportation, and nutrition.
    (f) Implementation and Reporting.--A facility selected under 
subsection (a) shall be responsible for--
            (1) implementing programs, which may include the programs 
        described in subsection (e); and
            (2) not later than 3 years after the date of enactment of 
        this Act, reporting results of the programs to the Director, 
        including information describing--
                    (A) relevant quantitative indicators of success in 
                improving the standard of care and health outcomes for 
                pregnant and postpartum incarcerated individuals in the 
                facility, including data stratified by race, ethnicity, 
                sex, gender, primary language, age, geography, 
                disability status, the category of the criminal charge 
                against such individual, rates of pregnancy-related 
                deaths, pregnancy-associated deaths, cases of infant 
                mortality and morbidity, rates of preterm births and 
                low-birthweight births, cases of severe maternal 
                morbidity, cases of violence against pregnant or 
                postpartum individuals, diagnoses of maternal mental or 
                behavioral health conditions, and other such 
                information as appropriate;
                    (B) relevant qualitative and quantitative 
                evaluations from pregnant and postpartum incarcerated 
                individuals who participated in such programs, 
                including measures of patient-reported experience of 
                care; and
                    (C) strategies to sustain such programs after 
                fiscal year 2029 and expand such programs to other 
                facilities.
    (g) Report.--Not later than 6 years after the date of enactment of 
this Act, the Director shall submit to the Attorney General and 
Congress a report describing the results of the programs funded under 
this section.
    (h) Oversight.--Not later than 1 year after the date of enactment 
of this Act, the Attorney General shall award a contract to an 
independent organization or independent organizations to conduct 
oversight of the programs described in subsection (e).
    (i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2025 through 2029.

SEC. 4. GRANT PROGRAM TO IMPROVE MATERNAL HEALTH OUTCOMES FOR 
              INDIVIDUALS IN STATE AND LOCAL CORRECTIONAL FACILITIES.

    (a) In General.--
            (1) Establishment.--Not later than 1 year after the date of 
        enactment of this Act, the Attorney General, acting through the 
        Director of the Bureau of Justice Assistance (referred to in 
        this section as the ``Director''), shall award Justice for 
        Incarcerated Moms grants to States to establish or expand 
        programs in State and local correctional facilities for 
        pregnant and postpartum incarcerated individuals.
            (2) Consultation with stakeholders.--The Attorney General 
        shall award such grants in consultation with stakeholders such 
        as--
                    (A) relevant community-based organizations, 
                particularly organizations that represent incarcerated 
                and formerly incarcerated individuals and organizations 
                that seek to improve maternal health outcomes for 
                pregnant and postpartum individuals from demographic 
                groups with elevated rates of maternal mortality, 
                severe maternal morbidity, maternal health disparities, 
                or other adverse perinatal or childbirth outcomes;
                    (B) relevant organizations representing patients, 
                with a particular focus on patients from demographic 
                groups with elevated rates of maternal mortality, 
                severe maternal morbidity, maternal health disparities, 
                or other adverse perinatal or childbirth outcomes;
                    (C) organizations representing maternity care 
                providers and maternal health care education programs;
                    (D) perinatal health workers; and
                    (E) researchers and policy experts in fields 
                related to maternal health care for incarcerated 
                individuals.
    (b) Applications.--Each applicant for a grant under this section 
shall submit to the Director an application at such time, in such 
manner, and containing such information as the Director may require.
    (c) Use of Funds.--A State that is awarded a grant under this 
section shall use such grant to establish or expand programs for 
pregnant and postpartum incarcerated individuals, and such programs 
may--
            (1) provide access to perinatal health workers from 
        pregnancy through the postpartum period;
            (2) provide access to healthy foods and counseling on 
        nutrition, recommended activity levels, and safety measures 
        throughout pregnancy;
            (3) train correctional officers to ensure that pregnant 
        incarcerated individuals receive safe and respectful treatment;
            (4) train medical personnel to ensure that pregnant 
        incarcerated individuals receive trauma-informed, culturally 
        and linguistically congruent care that promotes the health and 
        safety of the pregnant individuals;
            (5) provide counseling and treatment for individuals who 
        have suffered from--
                    (A) diagnosed mental or behavioral health 
                conditions, including trauma and substance use 
                disorders;
                    (B) trauma or violence, including domestic 
                violence;
                    (C) human immunodeficiency virus;
                    (D) sexual abuse;
                    (E) pregnancy or infant loss; or
                    (F) chronic conditions;
            (6) provide evidence-based pregnancy and childbirth 
        education, parenting support, and other relevant forms of 
        health literacy;
            (7) provide clinical education opportunities to maternity 
        care providers in training to expand pathways into maternal 
        health care careers serving incarcerated individuals;
            (8) offer opportunities for postpartum individuals to 
        maintain contact with the individual's newborn child to promote 
        bonding, including enhanced visitation policies, access to 
        prison nursery programs, or breastfeeding support;
            (9) provide reentry assistance, particularly to--
                    (A) ensure access to health insurance coverage and 
                transfer of health records to community providers if an 
                incarcerated individual exits the criminal justice 
                system during such individual's pregnancy or in the 
                postpartum period; and
                    (B) connect individuals exiting the criminal 
                justice system during pregnancy or in the postpartum 
                period to community-based resources, such as referrals 
                to health care providers, substance use disorder 
                treatments, and social services that address social 
                determinants of maternal health; or
            (10) establish partnerships with local public entities, 
        private community entities, community-based organizations, 
        Indian Tribes and Tribal organizations (as such terms are 
        defined in section 4 of the Indian Self-Determination and 
        Education Assistance Act (25 U.S.C. 5304)), and Urban Indian 
        organizations (as such term is defined in section 4 of the 
        Indian Health Care Improvement Act (25 U.S.C. 1603)) to 
        establish or expand pretrial diversion programs as an 
        alternative to incarceration for pregnant and postpartum 
        individuals, including--
                    (A) evidence-based childbirth education or 
                parenting classes;
                    (B) prenatal health coordination;
                    (C) family and individual counseling;
                    (D) evidence-based screenings, education, and, as 
                needed, treatment for mental and behavioral health 
                conditions, including drug and alcohol treatments;
                    (E) family case management services;
                    (F) domestic violence education and prevention;
                    (G) physical and sexual abuse counseling; and
                    (H) programs to address social determinants of 
                health such as employment, housing, education, 
                transportation, and nutrition.
    (d) Priority.--In awarding grants under this section, the Director 
shall give priority to applicants based on--
            (1) the number of pregnant and postpartum individuals 
        incarcerated in the State and, among such individuals, the 
        number of pregnant and postpartum individuals from demographic 
        groups with elevated rates of maternal mortality, severe 
        maternal morbidity, maternal health disparities, or other 
        adverse perinatal or childbirth outcomes; and
            (2) the extent to which the State has demonstrated a 
        commitment to developing exemplary programs for pregnant and 
        postpartum individuals incarcerated in the correctional 
        facilities in the State.
    (e) Grant Duration.--A grant awarded under this section shall be 
for a period of 5 years.
    (f) Implementing and Reporting.--A State that receives a grant 
under this section shall be responsible for--
            (1) implementing the program funded by the grant; and
            (2) not later than 3 years after the date of enactment of 
        this Act reporting results of such program to the Attorney 
        General, including information describing--
                    (A) relevant quantitative indicators of the success 
                of the program in improving the standard of care and 
                health outcomes for pregnant and postpartum 
                incarcerated individuals in the facility, including 
                data stratified by race, ethnicity, sex, gender, 
                primary language, age, geography, disability status, 
                category of the criminal charge against such 
                individual, incidence rates of pregnancy-related 
                deaths, pregnancy-associated deaths, cases of infant 
                mortality and morbidity, rates of preterm births and 
                low-birthweight births, cases of severe maternal 
                morbidity, cases of violence against pregnant or 
                postpartum individuals, diagnoses of maternal mental or 
                behavioral health conditions, and other such 
                information as appropriate;
                    (B) relevant qualitative and quantitative 
                evaluations from pregnant and postpartum incarcerated 
                individuals who participated in such programs, 
                including measures of patient-reported experience of 
                care; and
                    (C) strategies to sustain such programs beyond the 
                duration of the grant and expand such programs to other 
                facilities.
    (g) Report.--Not later than 6 years after the date of enactment of 
this Act, the Attorney General shall submit to Congress a report 
describing the results of programs carried out using grants under this 
subsection.
    (h) Oversight.--Not later than 1 year after the date of enactment 
of this Act, the Attorney General shall award a contract to an 
independent organization or independent organizations to conduct 
oversight of the programs described in subsection (c).
    (i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2025 through 2029.

SEC. 5. GAO REPORT.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, the Comptroller General of the United States shall submit 
to Congress a report on adverse maternal and infant health outcomes 
among incarcerated individuals and infants born to such individuals, 
with a particular focus on racial and ethnic disparities in maternal 
and infant health outcomes for incarcerated individuals.
    (b) Contents of Report.--The report described in subsection (a) 
shall include--
            (1) to the extent practicable, for the available data for 
        the 10 years preceding the date of the report--
                    (A) the number of pregnant individuals who are 
                incarcerated in Bureau of Prisons facilities;
                    (B) the number of incarcerated individuals, 
                including those incarcerated in Federal, State, and 
                local correctional facilities, who have experienced a 
                pregnancy-related death, pregnancy-associated death, or 
                the death of an infant;
                    (C) the number of cases of severe maternal 
                morbidity among incarcerated individuals, including 
                those incarcerated in Federal, State, and local 
                correctional facilities;
                    (D) the number of stillbirths, miscarriages, and 
                other adverse pregnancy outcomes experienced by 
                incarcerated individuals, including those incarcerated 
                in Federal, State, and local correctional facilities;
                    (E) the number of pregnant incarcerated 
                individuals, including those incarcerated in Federal, 
                State, and local correctional facilities, receiving 
                prenatal care;
                    (F) the number of preterm and low-birthweight 
                births of infants born to incarcerated individuals, 
                including those incarcerated in Federal, State, and 
                local correctional facilities; and
                    (G) statistics on the racial and ethnic disparities 
                in maternal and infant health outcomes and severe 
                maternal morbidity rates among incarcerated 
                individuals, including those incarcerated in Federal, 
                State, and local correctional facilities;
            (2) in the case that the Comptroller General of the United 
        States is unable determine the information required under 
        paragraph (1), an assessment of the barriers to determining 
        such information and recommendations for improvements in 
        tracking maternal health outcomes among incarcerated 
        individuals, including those incarcerated in Federal, State, 
        and local correctional facilities;
            (3) the implications of pregnant and postpartum 
        incarcerated individuals being ineligible for medical 
        assistance under a State plan under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.), including information 
        about--
                    (A) the effects of such ineligibility on maternal 
                health outcomes for pregnant and postpartum 
                incarcerated individuals, with emphasis given to such 
                effects for pregnant and postpartum individuals from 
                racial and ethnic minority groups; and
                    (B) potential implications on maternal health 
                outcomes resulting from temporarily suspending, rather 
                than permanently terminating, such eligibility when a 
                pregnant or postpartum individual is incarcerated;
            (4) the extent to which Federal, State, and local 
        correctional facilities are holding pregnant and postpartum 
        individuals who test positive for illicit drug use in detention 
        with special conditions, such as additional bond requirements, 
        due to drug use by the individual, and the effect of such 
        detention policies on maternal and infant health outcomes;
            (5) causes of adverse maternal health outcomes that are 
        unique to incarcerated individuals, including those 
        incarcerated in Federal, State, and local correctional 
        facilities;
            (6) causes of adverse maternal health outcomes and severe 
        maternal morbidity that are unique to incarcerated individuals 
        from racial and ethnic minority groups;
            (7) recommendations to reduce maternal mortality and severe 
        maternal morbidity among incarcerated individuals and to 
        address racial and ethnic disparities in maternal health 
        outcomes for incarcerated individuals in Bureau of Prisons 
        facilities and State and local correctional facilities; and
            (8) such other information as may be appropriate to reduce 
        the occurrence of adverse maternal health outcomes among 
        incarcerated individuals and to address racial and ethnic 
        disparities in maternal health outcomes for such individuals.
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