Tech To Save Moms Act

I 117TH CONGRESS 1ST SESSION H. R. 937 To amend title XI of the Social Security Act to integrate telehealth models in maternity care services, and for other purposes. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 8, 2021 Ms. JOHNSON of Texas (for herself, Ms. UNDERWOOD, Ms. ADAMS, Mr. KHANNA, Ms. VELA´ZQUEZ, Mrs. MCBATH, Mr. SMITH of Washington, Ms. SCANLON, Mr. LAWSON of Florida, Mrs. HAYES, Mr. BUTTERFIELD, Ms. MOORE of Wisconsin, Ms. STRICKLAND, Mr. RYAN, Mr. SCHIFF, Mr. JOHNSON of Georgia, Mr. HORSFORD, Ms. WASSERMAN SCHULTZ, Ms. BARRAGA´N, Mr. DEUTCH, Mr. PAYNE, Mr. BLUMENAUER, Mr. MOULTON, Mr. SOTO, Mr. NADLER, Mr. TRONE, Ms. CLARKE of New York, Ms. SCHAKOWSKY, Ms. BASS, Ms. PRESSLEY, Mr. EVANS, Ms. BLUNT ROCHESTER, Ms. CASTOR of Florida, Ms. SEWELL, and Ms. WIL- LIAMS of Georgia) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title XI of the Social Security Act to integrate telehealth models in maternity care services, 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. SHORT TITLE. 3 This Act may be cited as the ‘‘Tech To Save Moms 4 Act’’. 5 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 937 IH SEC. 2. DEFINITIONS. 1 In this Act: 2 (1) POSTPARTUM AND POSTPARTUM PERIOD.— 3 The terms ‘‘postpartum’’ and ‘‘postpartum period’’ 4 refer to the 1-year period beginning on the last day 5 of the pregnancy of an individual. 6 (2) RACIAL AND ETHNIC MINORITY GROUP.— 7 The term ‘‘racial and ethnic minority group’’ has the 8 meaning given such term in section 1707(g)(1) of 9 the Public Health Service Act (42 U.S.C. 300u- 10 6(g)(1)). 11 (3) SEVERE MATERNAL MORBIDITY.—The term 12 ‘‘severe maternal morbidity’’ means a health condi- 13 tion, including mental health conditions and sub- 14 stance use disorders, attributed to or aggravated by 15 pregnancy or childbirth that results in significant 16 short-term or long-term consequences to the health 17 of the individual who was pregnant. 18 (4) SOCIAL DETERMINANTS OF MATERNAL 19 HEALTH.—The term ‘‘social determinants of mater- 20 nal health’’ means non-clinical factors that impact 21 maternal health outcomes, including— 22 (A) economic factors, which may include 23 poverty, employment, food security, support for 24 and access to lactation and other infant feeding 25 options, housing stability, and related factors; 26 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 937 IH (B) neighborhood factors, which may in- 1 clude quality of housing, access to transpor- 2 tation, access to child care, availability of 3 healthy foods and nutrition counseling, avail- 4 ability of clean water, air and water quality, 5 ambient temperatures, neighborhood crime and 6 violence, access to broadband, and related fac- 7 tors; 8 (C) social and community factors, which 9 may include systemic racism, gender discrimi- 10 nation or discrimination based on other pro- 11 tected classes, workplace conditions, incarcer- 12 ation, and related factors; 13 (D) household factors, which may include 14 ability to conduct lead testing and abatement, 15 car seat installation, indoor air temperatures, 16 and related factors; 17 (E) education access and quality factors, 18 which may include educational attainment, lan- 19 guage and literacy, and related factors; and 20 (F) health care access factors, including 21 health insurance coverage, access to culturally 22 congruent health care services, providers, and 23 non-clinical support, access to home visiting 24 services, access to wellness and stress manage- 25 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 937 IH ment programs, health literacy, access to tele- 1 health and items required to receive telehealth 2 services, and related factors. 3 SEC. 3. INTEGRATED TELEHEALTH MODELS IN MATERNITY 4 CARE SERVICES. 5 (a) IN GENERAL.—Section 1115A(b)(2)(B) of the 6 Social Security Act (42 U.S.C. 1315a(b)(2)(B)) is amend- 7 ed by adding at the end the following: 8 ‘‘(xxviii) Focusing on title XIX, pro- 9 viding for the adoption of and use of tele- 10 health tools that allow for screening, moni- 11 toring, and management of common health 12 complications with respect to an individual 13 receiving medical assistance during such 14 individual’s pregnancy and for not more 15 than a 1-year period beginning on the last 16 day of the pregnancy.’’. 17 (b) EFFECTIVE DATE.—The amendment made by 18 subsection (a) shall take effect 1 year after the date of 19 the enactment of this Act. 20 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 937 IH SEC. 4. GRANTS TO EXPAND THE USE OF TECHNOLOGY-EN- 1 ABLED COLLABORATIVE LEARNING AND CA- 2 PACITY MODELS FOR PREGNANT AND 3 POSTPARTUM INDIVIDUALS. 4 Title III of the Public Health Service Act is amended 5 by inserting after section 330M (42 U.S.C. 254c–19) the 6 following: 7 ‘‘SEC. 330N. EXPANDING CAPACITY FOR MATERNAL 8 HEALTH OUTCOMES. 9 ‘‘(a) ESTABLISHMENT.—Beginning not later than 1 10 year after the date of enactment of this Act, the Secretary 11 shall award grants to eligible entities to evaluate, develop, 12 and expand the use of technology-enabled collaborative 13 learning and capacity building models and improve mater- 14 nal health outcomes— 15 ‘‘(1) in health professional shortage areas; 16 ‘‘(2) in areas with high rates of maternal mor- 17 tality and severe maternal morbidity; 18 ‘‘(3) in areas with significant racial and ethnic 19 disparities in maternal health outcomes; and 20 ‘‘(4) for medically underserved populations and 21 American Indians and Alaska Natives, including In- 22 dian Tribes, Tribal organizations, and Urban Indian 23 organizations. 24 ‘‘(b) USE OF FUNDS.— 25 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 937 IH ‘‘(1) REQUIRED USES.—Recipients of grants 1 under this section shall use the grants to— 2 ‘‘(A) train maternal health care providers, 3 students, and other similar professionals 4 through models that include— 5 ‘‘(i) methods to increase safety and 6 health care quality; 7 ‘‘(ii) implicit bias, racism, and dis- 8 crimination; 9 ‘‘(iii) best practices in screening for 10 and, as needed, evaluating and treating 11 maternal mental health conditions and 12 substance use disorders; 13 ‘‘(iv) training on best practices in ma- 14 ternity care for pregnant and postpartum 15 individuals during the COVID–19 public 16 health emergency or future public health 17 emergencies; 18 ‘‘(v) methods to screen for social de- 19 terminants of maternal health risks in the 20 prenatal and postpartum; and 21 ‘‘(vi) the use of remote patient moni- 22 toring tools for pregnancy-related com- 23 plications described in section 24 1115A(b)(2)(B)(xxviii); 25 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 937 IH ‘‘(B) evaluate and collect information on 1 the effect of such models on— 2 ‘‘(i) access to and quality of care; 3 ‘‘(ii) outcomes with respect to the 4 health of an individual; 5 ‘‘(iii) the experience of individuals who 6 receive pregnancy-related health care; 7 ‘‘(C) develop qualitative and quantitative 8 measures to identify best practices for the ex- 9 pansion and use of such models; 10 ‘‘(D) study the effect of such models on 11 patient outcomes and maternity care providers; 12 and 13 ‘‘(E) conduct any other activity determined 14 by the Secretary. 15 ‘‘(2) PERMISSIBLE USES.—Recipients of grants 16 under this section may use grants to support— 17 ‘‘(A) the use and expansion of technology- 18 enabled collaborative learning and capacity 19 building models, including hardware and soft- 20 ware that— 21 ‘‘(i) enables distance learning and 22 technical support; and 23 ‘‘(ii) supports the secure exchange of 24 electronic health information; and 25 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 937 IH ‘‘(B) maternity care providers, students, 1 and other similar professionals in the provision 2 of maternity care through such models. 3 ‘‘(c) APPLICATION.— 4 ‘‘(1) IN GENERAL.—An eligible entity seeking a 5 grant under subsection (a) shall submit to the Sec- 6 retary an application, at such time, in such manner, 7 and containing such information as the Secretary 8 may require. 9 ‘‘(2) ASSURANCE.—An application under para- 10 graph (1) shall include an assurance that such entity 11 shall collect information on and assess the effect of 12 the use of technology-enabled collaborative learning 13 and capacity building models, including with respect 14 to— 15 ‘‘(A) maternal health outcomes; 16 ‘‘(B) access to maternal health care serv- 17 ices; 18 ‘‘(C) quality of maternal health care; and 19 ‘‘(D) retention of maternity care providers 20 serving areas and populations described in sub- 21 section (a). 22 ‘‘(d) LIMITATIONS.— 23 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 937 IH ‘‘(1) NUMBER.—The Secretary may not award 1 more than 1 grant under this section to an eligible 2 entity. 3 ‘‘(2) DURATION.—A grant awarded under this 4 section shall be for a 5-year period. 5 ‘‘(e) ACCESS TO BROADBAND.—In administering 6 grants under this section, the Secretary may coordinate 7 with other agencies to ensure that funding opportunities 8 are available to support access to reliable, high-speed 9 internet for grantees. 10 ‘‘(f) TECHNICAL ASSISTANCE.—The Secretary shall 11 provide (either directly or by contract) technical assistance 12 to eligible entities, including recipients of grants under 13 subsection (a), on the development, use, and sustainability 14 of technology-enabled collaborative learning and capacity 15 building models to expand access to maternal health care 16 services provided by such entities, including— 17 ‘‘(1) in health professional shortage areas; 18 ‘‘(2) in areas with high rates of maternal mor- 19 tality and severe maternal morbidity or significant 20 racial and ethnic disparities in maternal health out- 21 comes; and 22 ‘‘(3) for medically underserved populations or 23 American Indians and Alaska Natives. 24 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 937 IH ‘‘(g) RESEARCH AND EVALUATION.—The Secretary, 1 in consultation with experts, shall develop a strategic plan 2 to research and evaluate the evidence for such models. 3 ‘‘(h) REPORTING.— 4 ‘‘(1) ELIGIBLE ENTITIES.—An eligible entity 5 that receives a grant under subsection (a) shall sub- 6 mit to the Secretary a report, at such time, in such 7 manner, and containing such information as the Sec- 8 retary may require. 9 ‘‘(2) SECRETARY.—Not later than 4 years after 10 the date of enactment of this section, the Secretary 11 shall submit to the Congress, and make available on 12 the website of the Department of Health and 13 Human Services, a report that includes— 14 ‘‘(A) a description of grants awarded 15 under subsection (a) and the purpose and 16 amounts of such grants; 17 ‘‘(B) a summary of— 18 ‘‘(i) the evaluations conducted under 19 subsection (b)(B); 20 ‘‘(ii) any technical assistance provided 21 under subsection (g); and 22 ‘‘(iii) the activities conducted under 23 subsection (a); and 24 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 11 •HR 937 IH ‘‘(C) a description of any significant find- 1 ings with respect to— 2 ‘‘(i) patient outcomes; and 3 ‘‘(ii) best practices for expanding, 4 using, or evaluating technology-enabled col- 5 laborative learning and capacity building 6 models. 7 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 8 authorized to be appropriated to carry out this section, 9 $6,000,000 for each of fiscal years 2022 through 2026. 10 ‘‘(j) DEFINITIONS.—In this section: 11 ‘‘(1) ELIGIBLE ENTITY.— 12 ‘‘(A) IN GENERAL.—The term ‘eligible en- 13 tity’ means an entity that provides, or supports 14 the provision of, maternal health care services 15 or other evidence-based services for pregnant 16 and postpartum individuals— 17 ‘‘(i) in health professional shortage 18 areas; 19 ‘‘(ii) in areas with high rates of ad- 20 verse maternal health outcomes or signifi- 21 cant racial and ethnic disparities in mater- 22 nal health outcomes; or 23 ‘‘(iii) who are— 24 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 12 •HR 937 IH ‘‘(I) members of medically under- 1 served populations; or 2 ‘‘(II) American Indians and Alas- 3 ka Natives, including Indian Tribes, 4 Tribal organizations, and urban In- 5 dian organizations. 6 ‘‘(B) INCLUSIONS.—An eligible entity may 7 include entities that lead, or are capable of 8 leading a technology-enabled collaborative learn- 9 ing and capacity building model. 10 ‘‘(2) HEALTH PROFESSIONAL SHORTAGE 11 AREA.—The term ‘health professional shortage area’ 12 means a health professional shortage area des- 13 ignated under section 332. 14 ‘‘(3) INDIAN TRIBE.—The term ‘Indian Tribe’ 15 has the meaning given such term in section 4 of the 16 Indian Self-Determination and Education Assistance 17 Act. 18 ‘‘(4) MATERNAL MORTALITY.—The term ‘ma- 19 ternal mortality’ means a death occurring during or 20 within 1-year period after pregnancy caused by preg- 21 nancy-related or childbirth complications, including a 22 suicide, overdose, or other death resulting from a 23 mental health or substance use disorder attributed 24 VerDate Sep 11 2014 23:55 Mar 07, 2021 Jkt 019200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H937.IH H937 pbinns on DSKJLVW7X2PROD with BILLS 13 •HR 937 IH to or aggravated by pregnancy or childbirth com- 1 plications. 2 ‘‘(5) MEDICALLY UNDERSERVED POPU- 3 LATION.—The term ‘medically underserved popu- 4 lation’ has the meaning given such term in section 5 330(b)(3). 6 ‘‘(6) POSTPARTUM.—The term ‘postpartum’ 7 means the 1-year period beginning on the last date 8 of an individua [Text truncated for display. 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