Data to Save Moms Act

I 117TH CONGRESS 1ST SESSION H. R. 925 To amend the Public Health Service Act (42 U.S.C. 201 et seq.) to authorize funding for maternal mortality review committees to promote representa- tive community engagement, and for other purposes. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 8, 2021 Ms. DAVIDS of Kansas (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, and in addition to the Committee on Natural Resources, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend the Public Health Service Act (42 U.S.C. 201 et seq.) to authorize funding for maternal mortality re- view committees to promote representative community engagement, 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 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 925 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Data to Save Moms 2 Act’’. 3 SEC. 2. FUNDING FOR MATERNAL MORTALITY REVIEW 4 COMMITTEES TO PROMOTE REPRESENTA- 5 TIVE COMMUNITY ENGAGEMENT. 6 (a) IN GENERAL.—Section 317K(d) of the Public 7 Health Service Act (42 U.S.C. 247b–12(d)) is amended 8 by adding at the end the following: 9 ‘‘(9) GRANTS TO PROMOTE REPRESENTATIVE 10 COMMUNITY ENGAGEMENT IN MATERNAL MOR- 11 TALITY REVIEW COMMITTEES.— 12 ‘‘(A) IN GENERAL.—The Secretary may, 13 using funds made available pursuant to sub- 14 paragraph (C), provide assistance to an applica- 15 ble maternal mortality review committee of a 16 State, Indian tribe, tribal organization, or 17 urban Indian organization (as such term is de- 18 fined in section 4 of the Indian Health Care 19 Improvement Act (25 U.S.C. 1603))— 20 ‘‘(i) to select for inclusion in the mem- 21 bership of such a committee community 22 members from the State, Indian tribe, trib- 23 al organization, or urban Indian organiza- 24 tion by— 25 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 925 IH ‘‘(I) prioritizing community mem- 1 bers who can increase the diversity of 2 the committee’s membership with re- 3 spect to race and ethnicity, location, 4 and professional background, includ- 5 ing members with non-clinical experi- 6 ences; and 7 ‘‘(II) to the extent applicable, 8 using funds reserved under subsection 9 (f), to address barriers to maternal 10 mortality review committee participa- 11 tion for community members, includ- 12 ing required training, transportation 13 barriers, compensation, and other sup- 14 ports as may be necessary; 15 ‘‘(ii) to establish initiatives to conduct 16 outreach and community engagement ef- 17 forts within communities throughout the 18 State or Tribe to seek input from commu- 19 nity members on the work of such mater- 20 nal mortality review committee, with a par- 21 ticular focus on outreach to minority 22 women; and 23 ‘‘(iii) to release public reports assess- 24 ing— 25 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 925 IH ‘‘(I) the pregnancy-related death 1 and pregnancy-associated death review 2 processes of the maternal mortality 3 review committee, with a particular 4 focus on the maternal mortality re- 5 view committee’s sensitivity to the 6 unique circumstances of pregnant and 7 postpartum individuals from racial 8 and ethnic minority groups (as such 9 term is defined in section 1707(g)(1)) 10 who have suffered pregnancy-related 11 deaths; and 12 ‘‘(II) the impact of the use of 13 funds made available pursuant to 14 paragraph (C) on increasing the diver- 15 sity of the maternal mortality review 16 committee membership and promoting 17 community engagement efforts 18 throughout the State or Tribe. 19 ‘‘(B) TECHNICAL ASSISTANCE.—The Sec- 20 retary shall provide (either directly through the 21 Department of Health and Human Services or 22 by contract) technical assistance to any mater- 23 nal mortality review committee receiving a 24 grant under this paragraph on best practices 25 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 925 IH for increasing the diversity of the maternal 1 mortality review committee’s membership and 2 for conducting effective community engagement 3 throughout the State or Tribe. 4 ‘‘(C) AUTHORIZATION OF APPROPRIA- 5 TIONS.—In addition to any funds made avail- 6 able under subsection (f), there are authorized 7 to be appropriated to carry out this paragraph 8 $10,000,000 for each of fiscal years 2022 9 through 2026.’’. 10 (b) RESERVATION OF FUNDS.—Section 317K(f) of 11 the Public Health Service Act (42 U.S.C. 247b–12(f)) is 12 amended by adding at the end the following: ‘‘Of the 13 amount made available under the preceding sentence for 14 a fiscal year, not less than $1,500,000 shall be reserved 15 for grants to Indian tribes, tribal organizations, or urban 16 Indian organizations (as those terms are defined in section 17 4 of the Indian Health Care Improvement Act (25 U.S.C. 18 1603))’’. 19 SEC. 3. DATA COLLECTION AND REVIEW. 20 Section 317K(d)(3)(A)(i) of the Public Health Serv- 21 ice Act (42 U.S.C. 247b–12(d)(3)(A)(i)) is amended— 22 (1) by redesignating subclauses (II) and (III) 23 as subclauses (V) and (VI), respectively; and 24 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 925 IH (2) by inserting after subclause (I) the fol- 1 lowing: 2 ‘‘(II) to the extent practicable, 3 reviewing cases of severe maternal 4 morbidity, according to the most up- 5 to-date indicators; 6 ‘‘(III) to the extent practicable, 7 reviewing deaths during pregnancy or 8 up to 1 year after the end of a preg- 9 nancy from suicide, overdose, or other 10 death from a mental health condition 11 or substance use disorder attributed 12 to or aggravated by pregnancy or 13 childbirth complications; 14 ‘‘(IV) to the extent practicable, 15 consulting with local community-based 16 organizations representing pregnant 17 and postpartum individuals from de- 18 mographic groups disproportionately 19 impacted by poor maternal health out- 20 comes to ensure that, in addition to 21 clinical factors, non-clinical factors 22 that might have contributed to a preg- 23 nancy-related death are appropriately 24 considered;’’. 25 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 925 IH SEC. 4. REVIEW OF MATERNAL HEALTH DATA COLLECTION 1 PROCESSES AND QUALITY MEASURES. 2 (a) IN GENERAL.—The Secretary of Health and 3 Human Services, acting through the Administrator for 4 Centers for Medicare & Medicaid Serves and the Director 5 of the Agency for Healthcare Research and Quality, shall 6 consult with relevant stakeholders— 7 (1) to review existing maternal health data col- 8 lection processes and quality measures; and 9 (2) make recommendations to improve such 10 processes and measures, including topics described 11 under subsection (c). 12 (b) COLLABORATION.—In carrying out this section, 13 the Secretary shall consult with a diverse group of mater- 14 nal health stakeholders, which may include— 15 (1) pregnant and postpartum individuals and 16 their family members, and non-profit organizations 17 representing such individuals, with a particular focus 18 on patients from racial and ethnic minority groups; 19 (2) community-based organizations that provide 20 support for pregnant and postpartum individuals, 21 with a particular focus on patients from racial and 22 ethnic minority groups; 23 (3) membership organizations for maternity 24 care providers; 25 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 925 IH (4) organizations representing perinatal health 1 workers; 2 (5) organizations that focus on maternal mental 3 or behavioral health; 4 (6) organizations that focus on intimate partner 5 violence; 6 (7) institutions of higher education, with a par- 7 ticular focus on minority-serving institutions; 8 (8) licensed and accredited hospitals, birth cen- 9 ters, midwifery practices, or other medical practices 10 that provide maternal health care services to preg- 11 nant and postpartum patients; 12 (9) relevant State and local public agencies, in- 13 cluding State maternal mortality review committees; 14 and 15 (10) the National Quality Forum, or such other 16 standard-setting organizations specified by the Sec- 17 retary. 18 (c) TOPICS.—The review of maternal health data col- 19 lection processes and recommendations to improve such 20 processes and measures required under subsection (a) 21 shall assess all available relevant information, including 22 information from State-level sources, and shall consider at 23 least the following: 24 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 925 IH (1) Current State and Tribal practices for ma- 1 ternal health, maternal mortality, and severe mater- 2 nal morbidity data collection and dissemination, in- 3 cluding consideration of— 4 (A) the timeliness of processes for amend- 5 ing a death certificate when new information 6 pertaining to the death becomes available to re- 7 flect whether the death was a pregnancy-related 8 death; 9 (B) relevant data collected with electronic 10 health records, including data on race, eth- 11 nicity, socioeconomic status, insurance type, 12 and other relevant demographic information; 13 (C) maternal health data collected and 14 publicly reported by hospitals, health systems, 15 midwifery practices, and birth centers; 16 (D) the barriers preventing States from 17 correlating maternal outcome data with race 18 and ethnicity data; 19 (E) processes for determining the cause of 20 a pregnancy-associated death in States that do 21 not have a maternal mortality review com- 22 mittee; 23 (F) whether maternal mortality review 24 committees include multidisciplinary and di- 25 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 925 IH verse membership (as described in section 1 317K(d)(1)(A) of the Public Health Service Act 2 (42 U.S.C. 247b–12(d)(1)(A))); 3 (G) whether members of maternal mor- 4 tality review committees participate in trainings 5 on bias, racism, or discrimination, and the qual- 6 ity of such trainings; 7 (H) the extent to which States have imple- 8 mented systematic processes of listening to the 9 stories of pregnant and postpartum individuals 10 and their family members, with a particular 11 focus on pregnant and postpartum individuals 12 from racial and ethnic minority groups (as such 13 term is defined in section 1707(g)(1) of the 14 Public Health Service Act (42 U.S.C. 300u– 15 6(g)(1))) and their family members, to fully un- 16 derstand the causes of, and inform potential so- 17 lutions to, the maternal mortality and severe 18 maternal morbidity crisis within their respective 19 States; 20 (I) the extent to which maternal mortality 21 review committees are considering social deter- 22 minants of maternal health when examining the 23 causes of pregnancy-associated and pregnancy- 24 related deaths; 25 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 925 IH (J) the extent to which maternal mortality 1 review committees are making actionable rec- 2 ommendations based on their reviews of adverse 3 maternal health outcomes and the extent to 4 which such recommendations are being imple- 5 mented by appropriate stakeholders; 6 (K) the legal and administrative barriers 7 preventing the collection, collation, and dissemi- 8 nation of State maternity care data; 9 (L) the effectiveness of data collection and 10 reporting processes in separating pregnancy-as- 11 sociated deaths from pregnancy-related deaths; 12 (M) the current Federal, State, local, and 13 Tribal funding support for the activities re- 14 ferred to in subparagraphs (A) through (L). 15 (2) Whether the funding support referred to in 16 paragraph (1)(M) is adequate for States to carry out 17 optimal data collection and dissemination processes 18 with respect to maternal health, maternal mortality, 19 and severe maternal morbidity. 20 (3) Current quality measures for maternity 21 care, including prenatal measures, labor and delivery 22 measures, and postpartum measures, including top- 23 ics such as— 24 VerDate Sep 11 2014 22:40 Mar 04, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H925.IH H925 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 925 IH (A) effective quality measures for mater- 1 nity care used by hospitals, health systems, 2 midwifery practices, birth centers, health plans, 3 and other relevant entities; 4 (B) the sufficiency of current outcome 5 measures used to evaluate maternity care for 6 driving improved care, experiences, and out- 7 comes in maternity care payment and delivery 8 system models; 9 (C) maternal health quality measures that 10 other countries effectively use; 11 (D) validated measures that have been 12 used for research purposes that could be tested, 13 refined, and submitted for national endorse- 14 ment; 15 (E) barriers preventing maternity care pro- 16 viders and insurers from implementing quality 17 measures that are aligned with best practices; 18 (F) the frequency with which maternity 19 care quality measures are reviewed and revised; 20 (G) the strengths and weaknesses of the 21 Prenatal and Postpartum Care measures of the 22 Health Plan Employe [Text truncated for display. 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