Text: H.R.6318 — 111th Congress (2009-2010)All Information (Except Text)

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Introduced in House (09/29/2010)


111th CONGRESS
2d Session
H. R. 6318


To amend the Public Health Service Act to ensure a national, coordinated approach to improving maternal and infant health.


IN THE HOUSE OF REPRESENTATIVES

September 29, 2010

Mrs. Capps (for herself, Ms. Roybal-Allard, and Mr. Murphy of Connecticut) introduced the following bill; which was referred to the Committee on Energy and Commerce


A BILL

To amend the Public Health Service Act to ensure a national, coordinated approach to improving maternal and infant health.

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 “Maternity Care Improvement Act of 2010”.

SEC. 2. Table of contents.

The table of contents of this Act is as follows:


Sec. 1. Short title.

Sec. 2. Table of contents.

Sec. 101. National registry of maternal and infant health data.

Sec. 201. Maternal and infant health workforce education and training.

Sec. 202. Report on creation of a uniform maternity care core curriculum.

Sec. 203. Demonstration projects to promote use of core curriculum and interdisciplinary team teaching in maternity care health professions education.

Sec. 204. Report on maternity care workforce.

Sec. 205. Allocation of funds for maternity care workforce development.

Sec. 301. CDC Centers for Research and Demonstration of Health Promotion and Disease Prevention.

Sec. 302. Grants to support a diversified maternity care workforce.

Sec. 401. Maternal health coordinator.

SEC. 101. National registry of maternal and infant health data.

Title III of the Public Health Service Act is amended by inserting after section 317L of such Act (42 U.S.C. 247b–13) the following:

“SEC. 317L–1. Improvement of maternal and infant health through enhanced reporting, research, and evaluation.

“(a) National registry.—

“(1) IN GENERAL.—The Secretary shall establish and maintain a national registry of maternal and infant health information (in this section referred to as the ‘Registry’).

“(2) CONTENTS.—The Registry shall include information on maternal and infant health, including any such information submitted to the Secretary through the Pregnancy Risk Assessment Monitoring System. The Secretary shall disaggregate information in the Registry by race and ethnicity.

“(3) STANDARDIZATION.—In carrying out this subsection, the Secretary shall ensure that information is collected and maintained pursuant to standardized measures of maternal health, including a standardized definition of maternal death.

“(b) Reporting and collection of information.—The Secretary shall expand, enhance, and ensure the coordination of programs of the Department of Health and Human Services relating to the reporting and collection of information on maternal and infant health. Activities under this subsection may include—

“(1) expansion of the Pregnancy Risk Assessment Monitoring System to include standardized reporting, including core questions and any additional State-added information reporting by all States;

“(2) expansion of programs to assist and encourage vital registration systems in each State to use enhanced, standardized electronic birth certificates; and

“(3) disaggregation of information by race and ethnicity.

“(c) Electronic birth and death systems.—The Secretary shall award grants to vital records jurisdictions for the development and implementation of electronic birth and death systems—

“(1) to collect 2003 standard certificate data; and

“(2) for the training of individuals responsible for completing birth and death certificates.

“(d) Analysis of programs that mitigate maternal morbidity and mortality.—The Secretary shall enter into an agreement with the Institute of Medicine of the National Academies under which the Institute will—

“(1) conduct an in-depth analysis, including funding histories, of Federal, State, and local programs (both governmental and private) across the Nation that mitigate maternal mortality and morbidity; and

“(2) not later than 12 months after the date of the enactment of this section, submit a report to the Secretary and the Congress on the results of such analysis.

“(e) Comparative effectiveness of clinical practices related to childbirth.—

“(1) IN GENERAL.—The Secretary shall conduct or support research on the comparative effectiveness of clinical practices related to childbirth, including home birth and other out-of-hospital birth, vaginal birth after cesarean, vaginal breech, multiple gestation, elective induction, and caesarian section without indication.

“(2) CONSIDERATION OF LIABILITY CONCERNS.—The research under paragraph (1) shall take into consideration the liability concerns of health care providers.

“(3) COORDINATION.—The Secretary shall ensure the coordination of research under this section with comparative effectiveness research of the Department of Health and Human Services under section 1181 of the Social Security Act or other provisions of law.

“(f) Report to Congress.—Not later than 12 months after the date of the enactment of this section, the Secretary shall submit a report to the Congress on programs and activities under this section, including an analysis of progress in improving the quality and outcomes of maternity care and infant health.

“(g) Authorization of appropriations.—To carry out this section, there are authorized to be appropriated such sums as may be necessary.”.

SEC. 201. Maternal and infant health workforce education and training.

(a) Health professionals.—Part D of title VII of the Public Health Service Act (42 U.S.C. 294 et seq.) is amended by adding at the end the following:

“SEC. 760. Education and training relating to maternal and infant health.

“The Secretary shall, with respect to maternal and infant health education and training, carry out services and programs equivalent (as determined by the Secretary) to the services and programs under section 753 with respect to maternal and infant health education and training.”.

(b) Nursing.—Title VIII of the Public Health Service Act (42 U.S.C. 296 et seq.) is amended by adding at the end the following:

“PART JComprehensive maternal and infant health professions education

“SEC. 861. Comprehensive maternal and infant health professions education.

“(a) Program Authorized.—The Secretary shall award grants to eligible entities to develop and implement, in coordination with programs under section 760, programs and initiatives to train and educate individuals in providing evidence-based maternal and infant health care.

“(b) Use of Funds.—An eligible entity that receives a grant under subsection (a) shall use funds under such grant to—

“(1) provide training to individuals who will provide maternal and infant health care;

“(2) develop and disseminate core curricula for all maternity care providers that emphasizes health promotion and disease prevention;

“(3) train faculty members in maternal and infant health care;

“(4) provide continuing education to individuals who provide maternal and infant health care; or

“(5) establish traineeships for individuals who are preparing for advanced education nursing degrees deemed appropriate by the Secretary.

“(c) Application.—An eligible entity desiring a grant under subsection (a) shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require.

“(d) Eligible Entity.—For purposes of this section, the term ‘eligible entity’ includes a school of nursing, a health care facility, a program leading to certification as a certified nurse assistant, a partnership of such a school and facility, a partnership of such a program and facility, or a nonprofit entity that issues continuing nursing education.”.

SEC. 202. Report on creation of a uniform maternity care core curriculum.

(a) In general.—The Secretary of Health and Human Services shall seek to enter into an arrangement with the Institute of Medicine of the National Academies to prepare a report on the creation of a uniform maternity care core curriculum to foster a shared knowledge base among maternity care professionals. At a minimum, the report shall address ways in which such core curriculum can support—

(1) preventing and treating complications in pregnancy and childbirth;

(2) physiologic pregnancy, birth, and early parenting;

(3) psychosocial aspects of pregnancy and birth;

(4) woman- and family-centered care;

(5) cultural competence;

(6) collaborative practice;

(7) shared decisionmaking between childbearing women and clinicians;

(8) avoiding overuse of maternity interventions in low-risk women and newborns;

(9) improved systemic approaches to maternity care; and

(10) eliminating disparities in maternal care and maternal outcomes.

(b) Consultation.—The arrangement under subsection (a) shall require the Institute of Medicine, in preparing the report, to consult with consumer and advocacy representatives and with each of the following organizations and their associated educational, accrediting, and certification bodies:

(1) The American College of Obstetricians and Gynecologists.

(2) The American Academy of Family Physicians.

(3) The American College of Nurse-Midwives.

(4) The National Association of Certified Professional Midwives.

(5) The Association of Women’s Health, Obstetric, and Neonatal Nurses.

(6) The Accreditation Council for Graduate Medical Education.

(7) The American Academy of Pediatrics.

(8) The Society for Maternal-Fetal Medicine.

(c) Submission of report.—The arrangement under subsection (a) shall provide for completion of the report and the submission of the report to the Congress within 18 months after the date of the enactment of this Act.

SEC. 203. Demonstration projects to promote use of core curriculum and interdisciplinary team teaching in maternity care health professions education.

(a) In general.—Beginning not later than the deadline specified in section 202(c) for completion and submission of the report under section 202, the Secretary shall, on a competitive basis and pursuant to a peer review process, make available grants to eligible entities or consortia to carry out demonstration projects in academic educational programs to develop, implement, and evaluate—

(1) a uniform core maternity care curriculum recommended in the report under section 202; and

(2) interdisciplinary team teaching and learning in maternity care education.

(b) Eligibility.—To be eligible to receive a grant under this section, an entity or consortium shall be or include—

(1) a health professions school;

(2) an academic health sciences center; or

(3) another type of institution specified by the Secretary.

(c) Application.—To seek a grant under subsection (a) for a demonstration project, an entity or consortium shall submit to the Secretary an application that includes—

(1) a plan for developing and implementing the demonstration project, including by—

(A) developing collaborative programs in all maternity care program settings to allow students of all relevant disciplines to observe different practice styles, collaborate, and learn together from faculty including a full range of maternity care providers;

(B) offering a mix of teaching modalities including cognitive, hands-on, and simulation training;

(C) using—

(i) acute hospital settings; and

(ii) community health centers, public health department clinics, freestanding birth clinics, or other sites determined appropriate by the Secretary; and

(D) using an interdisciplinary teaching team approach involving multiple disciplines, which approach may include teaching by an obstetrician, family physician, a nurse-midwife, a nurse, a doula, a mental health professional, and other providers specified by the Secretary;

(2) an agreement to provide for the collection of data regarding the effectiveness of the demonstration project; and

(3) an agreement to provide matching funds in accordance with subsection (d).

(d) Matching Funds.—

(1) IN GENERAL.—The Secretary may award a grant to an entity or consortium under this section only if the entity or consortium agrees to make available non-Federal contributions toward the costs of the demonstration program to be funded under the grant in an amount that is not less than $1 for each $5 of Federal funds provided through the grant.

(2) NON-FEDERAL CONTRIBUTIONS.—Non-Federal contributions under paragraph (1) may be in cash or in-kind, fairly evaluated, including equipment or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such contributions.

(e) Evaluation.—The Secretary shall take such action as may be necessary to—

(1) evaluate the projects funded under this section; and

(2) make publicly available, publish, and disseminate the results of such evaluation as widely as practicable.

(f) Reports.—Not later than 2 years after the date of the enactment of this Act, and annually thereafter, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives a report that—

(1) describes the specific projects supported under this section; and

(2) contains recommendations to Congress based on the evaluation conducted under subsection (e).

(g) Definition.—In this section, the term “Secretary” means the Secretary of Health and Human Services.

SEC. 204. Report on maternity care workforce.

(a) Assessment.—The National Health Care Workforce Commission (established by section 5101 of the Patient Protection and Affordable Care Act (Public Law 111–148)) shall conduct an assessment of current and projected workforce needs for achieving the optimal delivery of maternity care services. At a minimum, the assessment shall include an evaluation of—

(1) an appropriate volume of maternity care providers;

(2) an appropriate geographic distribution of maternity care providers;

(3) an appropriate number of maternity care providers in various health care disciplines to meet the maternity care needs of women with both low- and high-risk pregnancies;

(4) an appropriate sociodemographic diversity of the maternity care workforce;

(5) demographic composition and trends of childbearing families; and

(6) demographic composition and trends (including total hours worked per week, number of years of providing maternity care, and willingness to provide care at night and on weekends) of the workforce that serves childbearing families.

(b) Report.—Not later than 18 months after the date of the enactment of this Act, the National Health Care Workforce Commission shall complete the assessment under subsection (a) and submit a report on the results of such assessment to the Congress.

SEC. 205. Allocation of funds for maternity care workforce development.

Section 740 of the Public Health Service Act (42 U.S.C. 293d) is amended—

(1) by redesignating subsection (d) as subsection (e); and

(2) by inserting after subsection (c) the following:

“(d) Activities relating to maternity care workforce.—Of the amounts made available to carry out sections 737, 738, and 739 for fiscal year 2013 and each succeeding fiscal year, the Secretary shall allocate a percentage (to be determined by the Secretary) of such amounts for activities relating to maternity care workforce development under such sections.”.

SEC. 301. CDC Centers for Research and Demonstration of Health Promotion and Disease Prevention.

Paragraph (2) of section 1706(b) of the Public Health Service Act (42 U.S.C. 300u–5(b)) is amended—

(1) in subparagraph (B), by striking “and” at the end;

(2) in subparagraph (C) by striking the period at the end and inserting “; and”; and

(3) by adding at the end the following:

    “(D) community-based participatory research on maternal and infant health, focusing on disparities in maternal and infant health.”.

SEC. 302. Grants to support a diversified maternity care workforce.

(a) In General.—The Secretary may award grants to eligible entities or consortia to carry out demonstration projects to increase recruitment of underrepresented minorities into the maternity care professions. Such awards shall be made on a competitive basis and pursuant to peer review.

(b) Eligibility.—To be eligible to receive a grant under this section, an entity or consortium shall be or include—

(1) a health professions school;

(2) an institution with a graduate medical education program;

(3) a hospital;

(4) a community health center;

(5) a freestanding birth center;

(6) a public health department clinic;

(7) a nonprofit professional organization; or

(8) another type of institution specified by the Secretary.

(c) Application.—To seek a grant under subsection (a) for a demonstration project, an entity or consortium shall submit to the Secretary an application that includes each of the following:

(1) A plan for carrying out the demonstration project, including by performing one or more of the following:

(A) Strengthening recruitment, education, retention, and mentoring of underrepresented minorities.

(B) Increasing the racial, ethnic, geographic, linguistic, and socioeconomic diversity of the maternity care workforce.

(C) Engaging in early outreach to students in elementary and secondary schools in disparity communities about maternity care careers.

(D) Creating assistance programs in community colleges and other institutions of higher learning to support low-income students and students from underrepresented backgrounds who wish to become maternity caregivers. Such assistance programs may include the provision of grants, scholarships, housing stipends, health insurance for students and their families, and childcare services for student-parents.

(E) Establishing community-based doula, childbirth educator, and peer breastfeeding counselor training programs for women in underserved communities.

(2) An agreement to provide for the collection of data regarding the effectiveness of the demonstration project.

(3) An agreement to provide matching funds in accordance with subsection (d).

(d) Matching Funds.—

(1) IN GENERAL.—The Secretary may award a grant to an entity or consortium under this section only if the entity or consortium agrees to make available non-Federal contributions toward the costs of the project to be funded under the grant in an amount that is not less than $1 for each $5 of Federal funds provided through the grant.

(2) NON-FEDERAL CONTRIBUTIONS.—Non-Federal contributions under paragraph (1) may be in cash or in-kind, fairly evaluated, including equipment or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such contributions.

(e) Evaluation.—The Secretary shall take such action as may be necessary to—

(1) evaluate the projects funded under this section; and

(2) make publicly available, publish, and disseminate the results of such evaluation as widely as practicable.

(f) Reports.—Not later than 2 years after the date of enactment of this section, and annually thereafter, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives a report that—

(1) describes the specific projects supported under this section; and

(2) contains recommendations for Congress based on the evaluation conducted under subsection (e).

(g) Definition.—In this section, the term “Secretary” means the Secretary of Health and Human Services.

SEC. 401. Maternal health coordinator.

Title III of the Public Health Service Act is amended—

(1) by redesignating section 317K (42 U.S.C. 247b–12) as section 317K–1; and

(2) by inserting after section 317J the following:

“SEC. 317K. Coordination of maternal health programs and activities.

“The Secretary shall designate an official within the Office of the Secretary whose primary responsibility shall be to coordinate the programs and activities of the Department of Health and Human Services relating to maternal health.”.