Black Maternal Health Momnibus Act of 2021

II 117TH CONGRESS 1ST SESSION S. 346 To end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes, and for other purposes. IN THE SENATE OF THE UNITED STATES FEBRUARY 22, 2021 Mr. BOOKER (for himself, Ms. DUCKWORTH, Mrs. GILLIBRAND, Mr. DURBIN, Mr. KAINE, Mr. CASEY, Mr. PETERS, Ms. BALDWIN, Mr. MERKLEY, Mr. VAN HOLLEN, Ms. STABENOW, Mr. BENNET, Ms. WARREN, Mr. MENEN- DEZ, Mr. MARKEY, Mr. BLUMENTHAL, Ms. SMITH, Mr. BROWN, Mr. WHITEHOUSE, Ms. KLOBUCHAR, and Mr. WARNOCK) introduced the fol- lowing bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes, 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 ‘‘Black Maternal Health 4 Momnibus Act of 2021’’. 5 SEC. 2. TABLE OF CONTENTS. 6 The table of contents for this Act is as follows: 7 VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 346 IS Sec. 1. Short title. Sec. 2. Table of contents. Sec. 3. Definitions. Sec. 4. Sense of Congress. TITLE I—SOCIAL DETERMINANTS FOR MOMS Sec. 101. Task force to develop a strategy to address social determinants of maternal health. Sec. 102. Housing for Moms grant program. Sec. 103. Department of Transportation. Sec. 104. Department of Agriculture. Sec. 105. Environmental study through National Academies. Sec. 106. Child care access. Sec. 107. Grants to local entities addressing social determinants of maternal health. TITLE II—HONORING KIRA JOHNSON Sec. 201. Investments in community-based organizations to improve Black ma- ternal health outcomes. Sec. 202. Investments in community-based organizations to improve maternal health outcomes in underserved communities. Sec. 203. Respectful maternity care training for all employees in maternity care settings. Sec. 204. Study on reducing and preventing bias, racism, and discrimination in maternity care settings. Sec. 205. Respectful maternity care compliance program. Sec. 206. GAO report. TITLE III—PROTECTING MOMS WHO SERVED Sec. 301. Codification of maternity coordination program of Department of Veterans Affairs. Sec. 302. Report on maternal mortality and severe maternal morbidity among pregnant and postpartum veterans. TITLE IV—PERINATAL WORKFORCE Sec. 401. HHS agency directives. Sec. 402. Grants to grow and diversify the perinatal workforce. Sec. 403. Grants to grow and diversify the nursing workforce in maternal and perinatal health. Sec. 404. GAO report. TITLE V—DATA TO SAVE MOMS Sec. 501. Funding for maternal mortality review committees to promote rep- resentative community engagement. Sec. 502. Data collection and review. Sec. 503. Review of maternal health data collection processes and quality meas- ures. Sec. 504. Indian Health Service study and report on maternal mortality and se- vere maternal morbidity. Sec. 505. Grants to minority-serving institutions to study maternal mortality, severe maternal morbidity, and other adverse maternal health outcomes. VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6211 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 346 IS TITLE VI—MOMS MATTER Sec. 601. Maternal mental health equity grant program. Sec. 602. Grants to grow and diversify the maternal mental and behavioral health care workforce. TITLE VII—JUSTICE FOR INCARCERATED MOMS Sec. 701. Ending the shackling of pregnant individuals. Sec. 702. Creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods. Sec. 703. Grant program to improve maternal health outcomes for individuals in State and local prisons and jails. Sec. 704. GAO report. Sec. 705. MACPAC report. TITLE VIII—TECH TO SAVE MOMS Sec. 801. Integrated telehealth models in maternity care services. Sec. 802. Grants to expand the use of technology-enabled collaborative learning and capacity models for pregnant and postpartum individuals. Sec. 803. Grants to promote equity in maternal health outcomes through digital tools. Sec. 804. Report on the use of technology in maternity care. TITLE IX—IMPACT TO SAVE MOMS Sec. 901. Perinatal Care Alternative Payment Model Demonstration Project. Sec. 902. MACPAC report. TITLE X—MATERNAL HEALTH PANDEMIC RESPONSE Sec. 1001. Definitions. Sec. 1002. Funding for data collection, surveillance, and research on maternal health outcomes during the COVID–19 public health emer- gency. Sec. 1003. COVID–19 maternal health data collection and disclosure. Sec. 1004. Inclusion of pregnant individuals and lactating individuals in vaccine and therapeutic development for COVID–19. Sec. 1005. Public health communication regarding maternal care during COVID–19. Sec. 1006. Task force on birthing experience and safe maternity care during a public health emergency. Sec. 1007. GAO report on maternal health and public health emergency pre- paredness. TITLE XI—PROTECTING MOMS AND BABIES AGAINST CLIMATE CHANGE Sec. 1101. Definitions. Sec. 1102. Grant program to protect vulnerable mothers and babies from cli- mate change risks. Sec. 1103. Grant program for education and training at health profession schools. Sec. 1104. NIH Consortium on Birth and Climate Change Research. Sec. 1105. Strategy for identifying climate change risk zones for vulnerable mothers and babies. VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6211 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 346 IS TITLE XII—MATERNAL VACCINATIONS Sec. 1201. Maternal vaccination awareness and equity campaign. SEC. 3. DEFINITIONS. 1 In this Act: 2 (1) CULTURALLY CONGRUENT.—The term ‘‘cul- 3 turally congruent’’, with respect to care or maternity 4 care, means care that is in agreement with the pre- 5 ferred cultural values, beliefs, worldview, language, 6 and practices of the health care consumer and other 7 stakeholders. 8 (2) MATERNITY CARE PROVIDER.—The term 9 ‘‘maternity care provider’’ means a health care pro- 10 vider who— 11 (A) is a physician, physician assistant, 12 midwife who meets at a minimum the inter- 13 national definition of the midwife and global 14 standards for midwifery education as estab- 15 lished by the International Confederation of 16 Midwives, nurse practitioner, or clinical nurse 17 specialist; and 18 (B) has a focus on maternal or perinatal 19 health. 20 (3) MATERNAL MORTALITY.—The term ‘‘mater- 21 nal mortality’’ means a death occurring during or 22 within a one-year period after pregnancy, caused by 23 pregnancy-related or childbirth complications, in- 24 VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 346 IS cluding a suicide, overdose, or other death resulting 1 from a mental health or substance use disorder at- 2 tributed to or aggravated by pregnancy-related or 3 childbirth complications. 4 (4) PERINATAL HEALTH WORKER.—The term 5 ‘‘perinatal health worker’’ means a doula, commu- 6 nity health worker, peer supporter, breastfeeding 7 and lactation educator or counselor, nutritionist or 8 dietitian, childbirth educator, social worker, home 9 visitor, language interpreter, or navigator. 10 (5) POSTPARTUM AND POSTPARTUM PERIOD.— 11 The terms ‘‘postpartum’’ and ‘‘postpartum period’’ 12 refer to the 1-year period beginning on the last day 13 of the pregnancy of an individual. 14 (6) PREGNANCY-ASSOCIATED DEATH.—The 15 term ‘‘pregnancy-associated death’’ means a death of 16 a pregnant or postpartum individual, by any cause, 17 that occurs during, or within 1 year following, the 18 individual’s pregnancy, regardless of the outcome, 19 duration, or site of the pregnancy. 20 (7) PREGNANCY-RELATED DEATH.—The term 21 ‘‘pregnancy-related death’’ means a death of a preg- 22 nant or postpartum individual that occurs during, or 23 within 1 year following, the individual’s pregnancy, 24 from a pregnancy complication, a chain of events 25 VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 346 IS initiated by pregnancy, or the aggravation of an un- 1 related condition by the physiologic effects of preg- 2 nancy. 3 (8) RACIAL AND ETHNIC MINORITY GROUP.— 4 The term ‘‘racial and ethnic minority group’’ has the 5 meaning given such term in section 1707(g)(1) of 6 the Public Health Service Act (42 U.S.C. 300u– 7 6(g)(1)). 8 (9) SEVERE MATERNAL MORBIDITY.—The term 9 ‘‘severe maternal morbidity’’ means a health condi- 10 tion, including mental health conditions and sub- 11 stance use disorders, attributed to or aggravated by 12 pregnancy or childbirth that results in significant 13 short-term or long-term consequences to the health 14 of the individual who was pregnant. 15 (10) SOCIAL DETERMINANTS OF MATERNAL 16 HEALTH.—The term ‘‘social determinants of mater- 17 nal health’’ means non-clinical factors that impact 18 maternal health outcomes, including— 19 (A) economic factors, which may include 20 poverty, employment, food security, support for 21 and access to lactation and other infant feeding 22 options, housing stability, and related factors; 23 (B) neighborhood factors, which may in- 24 clude quality of housing, access to transpor- 25 VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 346 IS tation, access to child care, availability of 1 healthy foods and nutrition counseling, avail- 2 ability of clean water, air and water quality, 3 ambient temperatures, neighborhood crime and 4 violence, access to broadband, and related fac- 5 tors; 6 (C) social and community factors, which 7 may include systemic racism, gender discrimi- 8 nation or discrimination based on other pro- 9 tected classes, workplace conditions, incarcer- 10 ation, and related factors; 11 (D) household factors, which may include 12 ability to conduct lead testing and abatement, 13 car seat installation, indoor air temperatures, 14 and related factors; 15 (E) education access and quality factors, 16 which may include educational attainment, lan- 17 guage and literacy, and related factors; and 18 (F) health care access factors, including 19 health insurance coverage, access to culturally 20 congruent health care services, providers, and 21 non-clinical support, access to home visiting 22 services, access to wellness and stress manage- 23 ment programs, health literacy, access to tele- 24 VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 346 IS health and items required to receive telehealth 1 services, and related factors. 2 SEC. 4. SENSE OF CONGRESS. 3 It is the sense of Congress that— 4 (1) the respect and proper care that birthing 5 people deserve is inclusive; and 6 (2) regardless of race, ethnicity, gender iden- 7 tity, sexual orientation, religion, marital status, fa- 8 milial status, socioeconomic status, immigration sta- 9 tus, incarceration status, or disability, all deserve 10 dignity. 11 TITLE I—SOCIAL 12 DETERMINANTS FOR MOMS 13 SEC. 101. TASK FORCE TO DEVELOP A STRATEGY TO AD- 14 DRESS SOCIAL DETERMINANTS OF MATER- 15 NAL HEALTH. 16 (a) IN GENERAL.—The Secretary of Health and 17 Human Services shall convene a task force (in this section 18 referred to as the ‘‘Task Force’’) to develop a strategy 19 to coordinate efforts between Federal agencies to address 20 social determinants of maternal health with respect to 21 pregnant and postpartum individuals. 22 (b) EX OFFICIO MEMBERS.—The ex officio members 23 of the Task Force shall consist of the following: 24 VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 346 IS (1) The Secretary of Health and Human Serv- 1 ices (or a designee thereof). 2 (2) The Secretary of Housing and Urban Devel- 3 opment (or a designee thereof). 4 (3) The Secretary of Transportation (or a des- 5 ignee thereof). 6 (4) The Secretary of Agriculture (or a designee 7 thereof). 8 (5) The Secretary of Labor (or a designee 9 thereof). 10 (6) The Secretary of Defense (or a designee 11 thereof). 12 (7) The Secretary of Veterans Affairs (or a des- 13 ignee thereof). 14 (8) The Administrator of the Environmental 15 Protection Agency (or a designee thereof). 16 (9) The Assistant Secretary for the Administra- 17 tion for Children and Families (or a designee there- 18 of). 19 (10) The Administrator of the Centers for 20 Medicare & Medicaid Services (or a designee there- 21 of). 22 (11) The Director of the Indian Health Service 23 (or a designee thereof). 24 VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 346 IS (12) The Director of the National Institutes of 1 Health (or a designee thereof). 2 (13) The Administrator of the Health Re- 3 sources and Services Administration (or a designee 4 thereof). 5 (14) The Deputy Assistant Secretary for Minor- 6 ity Health of the Department of Health and Human 7 Services (or a designee thereof). 8 (15) The Deputy Assistant Secretary for Wom- 9 en’s Health of the Department of Health and 10 Human Services (or a designee thereof). 11 (16) The Director of the Centers for Disease 12 Control and Prevention (or a designee thereof). 13 (17) The Director of the Office on Violence 14 Against Women at the Department of Justice (or a 15 designee thereof). 16 (c) APPOINTED MEMBERS.—In addition to the ex 17 officio members of the Task Force, the Secretary of 18 Health and Human Services shall appoint the following 19 members of the Task Force: 20 (1) At least 2 representatives of patients, to in- 21 clude— 22 (A) a representative of patients who have 23 suffered from severe maternal morbidity; or 24 VerDate Sep 11 2014 21:40 Mar 08, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S346.IS S346 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 346 IS (B) a representative of patients who is a 1 family member of an individual who suffered a 2 pregnancy-related death. 3 (2) At least 2 leaders of community-based orga- 4 nizations that address maternal mortality and severe 5 maternal morbidity with a specific focus on racial 6 and eth [Text truncated for display. 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