A bill to direct the Secretary of Health and Human Services to issue guidance to States to educate providers, managed care entities, and other insurers about the value and process of delivering respectful maternal health care through diverse and multidisciplinary care provider models, and for other purposes.

II 117TH CONGRESS 1ST SESSION S. 287 To direct the Secretary of Health and Human Services to issue guidance to States to educate providers, managed care entities, and other insurers about the value and process of delivering respectful maternal health care through diverse and multidisciplinary care provider models, and for other purposes. IN THE SENATE OF THE UNITED STATES FEBRUARY 8, 2021 Ms. BALDWIN (for herself and Mr. MERKLEY) introduced the following bill; which was read twice and referred to the Committee on Health, Edu- cation, Labor, and Pensions A BILL To direct the Secretary of Health and Human Services to issue guidance to States to educate providers, managed care entities, and other insurers about the value and process of delivering respectful maternal health care through diverse and multidisciplinary care provider mod- els, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. HHS AGENCY DIRECTIVES. 3 (a) GUIDANCE TO STATES.— 4 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 287 IS (1) IN GENERAL.—Not later than 2 years after 1 the date of enactment of this Act, the Secretary of 2 Health and Human Services shall issue and dissemi- 3 nate guidance to States to educate providers, man- 4 aged care entities, and other insurers about the 5 value and process of delivering respectful maternal 6 health care through diverse and multidisciplinary 7 care provider models. 8 (2) CONTENTS.—The guidance required by 9 paragraph (1) shall address how States can encour- 10 age and incentivize hospitals, health systems, mid- 11 wifery practices, freestanding birth centers, other 12 maternity care provider groups, managed care enti- 13 ties, and other insurers— 14 (A) to recruit and retain maternity care 15 providers, mental and behavioral health care 16 providers acting in accordance with State law, 17 registered dietitians or nutrition professionals 18 (as such term is defined in section 1861(vv)(2) 19 of the Social Security Act (42 U.S.C. 20 1395x(vv)(2))), and lactation consultants cer- 21 tified by the International Board of Lactation 22 Consultants Examiners— 23 (i) from racially, ethnically, and lin- 24 guistically diverse backgrounds; 25 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 287 IS (ii) with experience practicing in ra- 1 cially and ethnically diverse communities; 2 and 3 (iii) who have undergone training on 4 implicit bias and racism; 5 (B) to incorporate into maternity care 6 teams— 7 (i) midwives who meet at a minimum 8 the international definition of the midwife 9 and global standards for midwifery edu- 10 cation as established by the International 11 Confederation of Midwives; and 12 (ii) perinatal health workers; 13 (C) to provide collaborative, culturally con- 14 gruent care; and 15 (D) to provide opportunities for individuals 16 enrolled in accredited midwifery education pro- 17 grams to participate in job shadowing with ma- 18 ternity care teams in hospitals, health systems, 19 midwifery practices, and freestanding birth cen- 20 ters. 21 (b) STUDY ON RESPECTFUL AND CULTURALLY CON- 22 GRUENT MATERNITY CARE.— 23 (1) STUDY.—The Secretary of Health and 24 Human Services acting through the Director of the 25 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 287 IS National Institutes of Health (in this subsection re- 1 ferred to as the ‘‘Secretary’’) shall conduct a study 2 on best practices in respectful and culturally con- 3 gruent maternity care. 4 (2) REPORT.—Not later than 2 years after the 5 date of enactment of this Act, the Secretary shall— 6 (A) complete the study required by para- 7 graph (1); 8 (B) submit to the Congress and make pub- 9 licly available a report on the results of such 10 study; and 11 (C) include in such report— 12 (i) a compendium of examples of hos- 13 pitals, health systems, midwifery practices, 14 freestanding birth centers, other maternity 15 care provider groups, managed care enti- 16 ties, and other insurers that are delivering 17 respectful and culturally congruent mater- 18 nal health care; 19 (ii) a compendium of examples of hos- 20 pitals, health systems, midwifery practices, 21 freestanding birth centers, other maternity 22 care provider groups, managed care enti- 23 ties, and other insurers that have made 24 progress in reducing disparities in mater- 25 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 287 IS nal health outcomes and improving birth- 1 ing experiences for pregnant and 2 postpartum individuals from racial and 3 ethnic minority groups; and 4 (iii) recommendations to hospitals, 5 health systems, midwifery practices, free- 6 standing birth centers, other maternity 7 care provider groups, managed care enti- 8 ties, and other insurers, for best practices 9 in respectful and culturally congruent ma- 10 ternity care. 11 SEC. 2. GRANTS TO GROW AND DIVERSIFY THE PERINATAL 12 WORKFORCE. 13 Title VII of the Public Health Service Act is amended 14 by inserting after section 757 (42 U.S.C. 294f) the fol- 15 lowing new section: 16 ‘‘SEC. 758. PERINATAL WORKFORCE GRANTS. 17 ‘‘(a) IN GENERAL.—The Secretary shall award 18 grants to entities to establish or expand programs de- 19 scribed in subsection (b) to grow and diversify the 20 perinatal workforce. 21 ‘‘(b) USE OF FUNDS.—Recipients of grants under 22 this section shall use the grants to grow and diversify the 23 perinatal workforce by— 24 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 287 IS ‘‘(1) establishing schools or programs that pro- 1 vide education and training to individuals seeking 2 appropriate licensing or certification as— 3 ‘‘(A) physician assistants who will complete 4 clinical training in the field of maternal and 5 perinatal health; or 6 ‘‘(B) perinatal health workers; and 7 ‘‘(2) expanding the capacity of existing schools 8 or programs described in paragraph (1), for the pur- 9 poses of increasing the number of students enrolled 10 in such schools or programs, including by awarding 11 scholarships for students. 12 ‘‘(c) PRIORITIZATION.—In awarding grants under 13 this section, the Secretary shall give priority to any entity 14 that— 15 ‘‘(1) has demonstrated a commitment to re- 16 cruiting and retaining students and faculty from ra- 17 cial and ethnic minority groups; 18 ‘‘(2) has developed a strategy to recruit and re- 19 tain a diverse pool of students into the perinatal 20 workforce program or school supported by funds re- 21 ceived through the grant, particularly from racial 22 and ethnic minority groups and other underserved 23 populations; 24 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 287 IS ‘‘(3) has developed a strategy to recruit and re- 1 tain students who plan to practice in a health pro- 2 fessional shortage area designated under section 3 332; 4 ‘‘(4) has developed a strategy to recruit and re- 5 tain students who plan to practice in an area with 6 significant racial and ethnic disparities in maternal 7 health outcomes, to the extent practicable; and 8 ‘‘(5) includes in the standard curriculum for all 9 students within the perinatal workforce program or 10 school a bias, racism, or discrimination training pro- 11 gram that includes training on implicit bias and rac- 12 ism. 13 ‘‘(d) REPORTING.—As a condition on receipt of a 14 grant under this section for a perinatal workforce program 15 or school, an entity shall agree to submit to the Secretary 16 an annual report on the activities conducted through the 17 grant, including— 18 ‘‘(1) the number and demographics of students 19 participating in the program or school; 20 ‘‘(2) the extent to which students in the pro- 21 gram or school are entering careers in— 22 ‘‘(A) health professional shortage areas 23 designated under section 332; and 24 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 287 IS ‘‘(B) areas with significant racial and eth- 1 nic disparities in maternal health outcomes, to 2 the extent such data are available; and 3 ‘‘(3) whether the program or school has in- 4 cluded in the standard curriculum for all students a 5 bias, racism, or discrimination training program that 6 includes explicit and implicit bias, and if so the ef- 7 fectiveness of such training program. 8 ‘‘(e) PERIOD OF GRANTS.—The period of a grant 9 under this section shall be up to 5 years. 10 ‘‘(f) APPLICATION.—To seek a grant under this sec- 11 tion, an entity shall submit to the Secretary an application 12 at such time, in such manner, and containing such infor- 13 mation as the Secretary may require, including any infor- 14 mation necessary for prioritization under subsection (c). 15 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 16 provide, directly or by contract, technical assistance to en- 17 tities seeking or receiving a grant under this section on 18 the development, use, evaluation, and post-grant period 19 sustainability of the perinatal workforce programs or 20 schools proposed to be, or being, established or expanded 21 through the grant. 22 ‘‘(h) REPORT BY THE SECRETARY.—Not later than 23 4 years after the date of enactment of this section, the 24 Secretary shall prepare and submit to the Congress, and 25 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 287 IS post on the internet website of the Department of Health 1 and Human Services, a report on the effectiveness of the 2 grant program under this section at— 3 ‘‘(1) recruiting students from racial and ethnic 4 minority groups; 5 ‘‘(2) increasing the number of physician assist- 6 ants who will complete clinical training in the field 7 of maternal and perinatal health, and perinatal 8 health workers, from racial and ethnic minority 9 groups and other underserved populations; 10 ‘‘(3) increasing the number of physician assist- 11 ants who will complete clinical training in the field 12 of maternal and perinatal health, and perinatal 13 health workers, working in health professional short- 14 age areas designated under section 332; and 15 ‘‘(4) increasing the number of physician assist- 16 ants who will complete clinical training in the field 17 of maternal and perinatal health, and perinatal 18 health workers, working in areas with significant ra- 19 cial and ethnic disparities in maternal health out- 20 comes, to the extent such data are available. 21 ‘‘(i) DEFINITION.—In this section, the term ‘racial 22 and ethnic minority group’ has the meaning given such 23 term in section 1707(g). 24 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 287 IS ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—To 1 carry out this section, there is authorized to be appro- 2 priated $15,000,000 for each of fiscal years 2022 through 3 2026.’’. 4 SEC. 3. GRANTS TO GROW AND DIVERSIFY THE NURSING 5 WORKFORCE IN MATERNAL AND PERINATAL 6 HEALTH. 7 Title VIII of the Public Health Service Act is amend- 8 ed by inserting after section 811 of that Act (42 U.S.C. 9 296j) the following: 10 ‘‘SEC. 812. PERINATAL NURSING WORKFORCE GRANTS. 11 ‘‘(a) IN GENERAL.—The Secretary shall award 12 grants to schools of nursing to grow and diversify the 13 perinatal nursing workforce. 14 ‘‘(b) USE OF FUNDS.—Recipients of grants under 15 this section shall use the grants to grow and diversify the 16 perinatal nursing workforce by providing scholarships to 17 students seeking to become— 18 ‘‘(1) nurse practitioners whose education in- 19 cludes a focus on maternal and perinatal health; or 20 ‘‘(2) clinical nurse specialists whose education 21 includes a focus on maternal and perinatal health. 22 ‘‘(c) PRIORITIZATION.—In awarding grants under 23 this section, the Secretary shall give priority to any school 24 of nursing that— 25 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 287 IS ‘‘(1) has developed a strategy to recruit and re- 1 tain a diverse pool of students seeking to enter ca- 2 reers focused on maternal and perinatal health, par- 3 ticularly students from racial and ethnic minority 4 groups and other underserved populations; 5 ‘‘(2) has developed a partnership with a prac- 6 tice setting in a health professional shortage area 7 designated under section 332 for the clinical place- 8 ments of the school’s students; 9 ‘‘(3) has developed a strategy to recruit and re- 10 tain students who plan to practice in an area with 11 significant racial and ethnic disparities in maternal 12 health outcomes, to the extent practicable; and 13 ‘‘(4) includes in the standard curriculum for all 14 students seeking to enter careers focused on mater- 15 nal and perinatal health a bias, racism, or discrimi- 16 nation training program that includes education on 17 implicit bias and racism. 18 ‘‘(d) REPORTING.—As a condition on receipt of a 19 grant under this section, a school of nursing shall agree 20 to submit to the Secretary an annual report on the activi- 21 ties conducted through the grant, including, to the extent 22 practicable— 23 VerDate Sep 11 2014 23:29 Feb 26, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S287.IS S287 pamtmann on DSKBC07HB2PROD with BILLS 12 •S 287 IS ‘‘(1) the number and demographics of students 1 in the school of nursing seeking to enter careers fo- 2 cused on maternal and perinatal health; 3 ‘‘(2) the extent to which such students are pre- 4 paring to enter careers in— 5 ‘‘(A) health professional shortage areas 6 designated under section 332; and 7 ‘‘(B) areas with significant racial and eth- 8 nic disparities in maternal health outcomes, to 9 the extent such data are available; and 10 ‘‘(3) whether the standard curriculum for all 11 students seeking to enter careers focused on mater- 12 nal and perinatal health includes a bias, racism, or 13 discrimination training program that includes edu- 14 cation on implicit bias and racism. 15 ‘‘(e [Text truncated for display. Full text available on Congress.gov.]