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.

I 117TH CONGRESS 1ST SESSION H. R. 945 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 HOUSE OF REPRESENTATIVES FEBRUARY 8, 2021 Ms. MOORE of Wisconsin (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. STRICKLAND, Mr. RYAN, Mr. SCHIFF, Mr. JOHNSON of Georgia, Mr. HORSFORD, Ms. WASSERMAN SCHULTZ, Ms. BARRAGA´N, Mr. DEUTCH, Mr. PAYNE, Mr. BLUMENAUER, Ms. WILLIAMS of Georgia, 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. HOULAHAN, and Ms. SEWELL) introduced the following bill; which was referred to the Com- mittee on Energy and Commerce 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. VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 945 IH 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 (1) IN GENERAL.—Not later than 2 years after 5 the date of enactment of this Act, the Secretary of 6 Health and Human Services shall issue and dissemi- 7 nate guidance to States to educate providers, man- 8 aged care entities, and other insurers about the 9 value and process of delivering respectful maternal 10 health care through diverse and multidisciplinary 11 care provider models. 12 (2) CONTENTS.—The guidance required by 13 paragraph (1) shall address how States can encour- 14 age and incentivize hospitals, health systems, mid- 15 wifery practices, freestanding birth centers, other 16 maternity care provider groups, managed care enti- 17 ties, and other insurers— 18 (A) to recruit and retain maternity care 19 providers, mental and behavioral health care 20 providers acting in accordance with State law, 21 registered dietitians or nutrition professionals 22 (as such term is defined in section 1861(vv)(2) 23 of the Social Security Act (42 U.S.C. 24 1395x(vv)(2))), and lactation consultants cer- 25 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 945 IH tified by the International Board of Lactation 1 Consultants Examiners— 2 (i) from racially, ethnically, and lin- 3 guistically diverse backgrounds; 4 (ii) with experience practicing in ra- 5 cially and ethnically diverse communities; 6 and 7 (iii) who have undergone training on 8 implicit bias and racism; 9 (B) to incorporate into maternity care 10 teams— 11 (i) midwives who meet at a minimum 12 the international definition of the midwife 13 and global standards for midwifery edu- 14 cation as established by the International 15 Confederation of Midwives; and 16 (ii) perinatal health workers; 17 (C) to provide collaborative, culturally con- 18 gruent care; and 19 (D) to provide opportunities for individuals 20 enrolled in accredited midwifery education pro- 21 grams to participate in job shadowing with ma- 22 ternity care teams in hospitals, health systems, 23 midwifery practices, and freestanding birth cen- 24 ters. 25 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 945 IH (b) STUDY ON RESPECTFUL AND CULTURALLY CON- 1 GRUENT MATERNITY CARE.— 2 (1) STUDY.—The Secretary of Health and 3 Human Services acting through the Director of the 4 National Institutes of Health (in this subsection re- 5 ferred to as the ‘‘Secretary’’) shall conduct a study 6 on best practices in respectful and culturally con- 7 gruent maternity care. 8 (2) REPORT.—Not later than 2 years after the 9 date of enactment of this Act, the Secretary shall— 10 (A) complete the study required by para- 11 graph (1); 12 (B) submit to the Congress and make pub- 13 licly available a report on the results of such 14 study; and 15 (C) include in such report— 16 (i) a compendium of examples of hos- 17 pitals, health systems, midwifery practices, 18 freestanding birth centers, other maternity 19 care provider groups, managed care enti- 20 ties, and other insurers that are delivering 21 respectful and culturally congruent mater- 22 nal health care; 23 (ii) a compendium of examples of hos- 24 pitals, health systems, midwifery practices, 25 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 945 IH freestanding birth centers, other maternity 1 care provider groups, managed care enti- 2 ties, and other insurers that have made 3 progress in reducing disparities in mater- 4 nal health outcomes and improving birth- 5 ing experiences for pregnant and 6 postpartum individuals from racial and 7 ethnic minority groups; and 8 (iii) recommendations to hospitals, 9 health systems, midwifery practices, free- 10 standing birth centers, other maternity 11 care provider groups, managed care enti- 12 ties, and other insurers, for best practices 13 in respectful and culturally congruent ma- 14 ternity care. 15 SEC. 2. GRANTS TO GROW AND DIVERSIFY THE PERINATAL 16 WORKFORCE. 17 Title VII of the Public Health Service Act is amended 18 by inserting after section 757 (42 U.S.C. 294f) the fol- 19 lowing new section: 20 ‘‘SEC. 758. PERINATAL WORKFORCE GRANTS. 21 ‘‘(a) IN GENERAL.—The Secretary shall award 22 grants to entities to establish or expand programs de- 23 scribed in subsection (b) to grow and diversify the 24 perinatal workforce. 25 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 945 IH ‘‘(b) USE OF FUNDS.—Recipients of grants under 1 this section shall use the grants to grow and diversify the 2 perinatal workforce by— 3 ‘‘(1) establishing schools or programs that pro- 4 vide education and training to individuals seeking 5 appropriate licensing or certification as— 6 ‘‘(A) physician assistants who will complete 7 clinical training in the field of maternal and 8 perinatal health; or 9 ‘‘(B) perinatal health workers; and 10 ‘‘(2) expanding the capacity of existing schools 11 or programs described in paragraph (1), for the pur- 12 poses of increasing the number of students enrolled 13 in such schools or programs, including by awarding 14 scholarships for students. 15 ‘‘(c) PRIORITIZATION.—In awarding grants under 16 this section, the Secretary shall give priority to any entity 17 that— 18 ‘‘(1) has demonstrated a commitment to re- 19 cruiting and retaining students and faculty from ra- 20 cial and ethnic minority groups; 21 ‘‘(2) has developed a strategy to recruit and re- 22 tain a diverse pool of students into the perinatal 23 workforce program or school supported by funds re- 24 ceived through the grant, particularly from racial 25 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 945 IH and ethnic minority groups and other underserved 1 populations; 2 ‘‘(3) has developed a strategy to recruit and re- 3 tain students who plan to practice in a health pro- 4 fessional shortage area designated under section 5 332; 6 ‘‘(4) has developed a strategy to recruit and re- 7 tain students who plan to practice in an area with 8 significant racial and ethnic disparities in maternal 9 health outcomes, to the extent practicable; and 10 ‘‘(5) includes in the standard curriculum for all 11 students within the perinatal workforce program or 12 school a bias, racism, or discrimination training pro- 13 gram that includes training on implicit bias and rac- 14 ism. 15 ‘‘(d) REPORTING.—As a condition on receipt of a 16 grant under this section for a perinatal workforce program 17 or school, an entity shall agree to submit to the Secretary 18 an annual report on the activities conducted through the 19 grant, including— 20 ‘‘(1) the number and demographics of students 21 participating in the program or school; 22 ‘‘(2) the extent to which students in the pro- 23 gram or school are entering careers in— 24 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 945 IH ‘‘(A) health professional shortage areas 1 designated under section 332; and 2 ‘‘(B) areas with significant racial and eth- 3 nic disparities in maternal health outcomes, to 4 the extent such data are available; and 5 ‘‘(3) whether the program or school has in- 6 cluded in the standard curriculum for all students a 7 bias, racism, or discrimination training program that 8 includes explicit and implicit bias, and if so the ef- 9 fectiveness of such training program. 10 ‘‘(e) PERIOD OF GRANTS.—The period of a grant 11 under this section shall be up to 5 years. 12 ‘‘(f) APPLICATION.—To seek a grant under this sec- 13 tion, an entity shall submit to the Secretary an application 14 at such time, in such manner, and containing such infor- 15 mation as the Secretary may require, including any infor- 16 mation necessary for prioritization under subsection (c). 17 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 18 provide, directly or by contract, technical assistance to en- 19 tities seeking or receiving a grant under this section on 20 the development, use, evaluation, and post-grant period 21 sustainability of the perinatal workforce programs or 22 schools proposed to be, or being, established or expanded 23 through the grant. 24 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 945 IH ‘‘(h) REPORT BY THE SECRETARY.—Not later than 1 4 years after the date of enactment of this section, the 2 Secretary shall prepare and submit to the Congress, and 3 post on the internet website of the Department of Health 4 and Human Services, a report on the effectiveness of the 5 grant program under this section at— 6 ‘‘(1) recruiting students from racial and ethnic 7 minority groups; 8 ‘‘(2) increasing the number of physician assist- 9 ants who will complete clinical training in the field 10 of maternal and perinatal health, and perinatal 11 health workers, from racial and ethnic minority 12 groups and other underserved populations; 13 ‘‘(3) increasing the number of physician assist- 14 ants who will complete clinical training in the field 15 of maternal and perinatal health, and perinatal 16 health workers, working in health professional short- 17 age areas designated under section 332; and 18 ‘‘(4) increasing the number of physician assist- 19 ants who will complete clinical training in the field 20 of maternal and perinatal health, and perinatal 21 health workers, working in areas with significant ra- 22 cial and ethnic disparities in maternal health out- 23 comes, to the extent such data are available. 24 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 945 IH ‘‘(i) DEFINITION.—In this section, the term ‘racial 1 and ethnic minority group’ has the meaning given such 2 term in section 1707(g). 3 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—To 4 carry out this section, there is authorized to be appro- 5 priated $15,000,000 for each of fiscal years 2022 through 6 2026.’’. 7 SEC. 3. GRANTS TO GROW AND DIVERSIFY THE NURSING 8 WORKFORCE IN MATERNAL AND PERINATAL 9 HEALTH. 10 Title VIII of the Public Health Service Act is amend- 11 ed by inserting after section 811 of that Act (42 U.S.C. 12 296j) the following: 13 ‘‘SEC. 812. PERINATAL NURSING WORKFORCE GRANTS. 14 ‘‘(a) IN GENERAL.—The Secretary shall award 15 grants to schools of nursing to grow and diversify the 16 perinatal nursing workforce. 17 ‘‘(b) USE OF FUNDS.—Recipients of grants under 18 this section shall use the grants to grow and diversify the 19 perinatal nursing workforce by providing scholarships to 20 students seeking to become— 21 ‘‘(1) nurse practitioners whose education in- 22 cludes a focus on maternal and perinatal health; or 23 ‘‘(2) clinical nurse specialists whose education 24 includes a focus on maternal and perinatal health. 25 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 945 IH ‘‘(c) PRIORITIZATION.—In awarding grants under 1 this section, the Secretary shall give priority to any school 2 of nursing that— 3 ‘‘(1) has developed a strategy to recruit and re- 4 tain a diverse pool of students seeking to enter ca- 5 reers focused on maternal and perinatal health, par- 6 ticularly students from racial and ethnic minority 7 groups and other underserved populations; 8 ‘‘(2) has developed a partnership with a prac- 9 tice setting in a health professional shortage area 10 designated under section 332 for the clinical place- 11 ments of the school’s students; 12 ‘‘(3) has developed a strategy to recruit and re- 13 tain students who plan to practice in an area with 14 significant racial and ethnic disparities in maternal 15 health outcomes, to the extent practicable; and 16 ‘‘(4) includes in the standard curriculum for all 17 students seeking to enter careers focused on mater- 18 nal and perinatal health a bias, racism, or discrimi- 19 nation training program that includes education on 20 implicit bias and racism. 21 ‘‘(d) REPORTING.—As a condition on receipt of a 22 grant under this section, a school of nursing shall agree 23 to submit to the Secretary an annual report on the activi- 24 VerDate Sep 11 2014 22:21 Mar 05, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H945.IH H945 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 945 IH ties conducted through the grant, including, to the extent 1 practicable— 2 ‘‘(1) the number and demographics of students 3 in the school of nursing seeking to enter careers fo- 4 cused on maternal and perinatal health; 5 ‘‘(2) the extent to which such students are pre- 6 par [Text truncated for display. Full text available on Congress.gov.]