II 117TH CONGRESS 1ST SESSION S. 484 To establish grant programs for maternal mental health equity and to grow and diversify the maternal mental and behavioral health care workforce. IN THE SENATE OF THE UNITED STATES FEBRUARY 25, 2021 Mrs. GILLIBRAND (for herself, Ms. SMITH, Mrs. SHAHEEN, and Mr. SAND- ERS) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To establish grant programs for maternal mental health eq- uity and to grow and diversify the maternal mental and behavioral health care workforce. 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 ‘‘Moms Matter Act’’. 4 SEC. 2. MATERNAL MENTAL HEALTH EQUITY GRANT PRO- 5 GRAM. 6 (a) IN GENERAL.—The Secretary, acting through the 7 Assistant Secretary for Mental Health and Substance Use, 8 shall establish a program to award grants to eligible enti- 9 VerDate Sep 11 2014 22:58 Mar 21, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 2 •S 484 IS ties to address maternal mental health conditions and sub- 1 stance use disorders with respect to pregnant and 2 postpartum individuals, with a focus on racial and ethnic 3 minority groups. 4 (b) APPLICATION.—To be eligible to receive a grant 5 under this section an eligible entity shall submit to the 6 Secretary an application at such time, in such manner, 7 and containing such information as the Secretary may 8 provide, including how such entity will use funds for activi- 9 ties described in subsection (d) that are culturally con- 10 gruent. 11 (c) PRIORITY.—In awarding grants under this sec- 12 tion, the Secretary shall give priority to an eligible entity 13 that— 14 (1) is, or will partner with, a community-based 15 organization to address maternal mental health con- 16 ditions and substance use disorders described in sub- 17 section (a); 18 (2) is operating in an area with high rates of— 19 (A) adverse maternal health outcomes; or 20 (B) significant racial or ethnic disparities 21 in maternal health outcomes; and 22 (3) is operating in a health professional short- 23 age area designated under section 332 of the Public 24 Health Service Act (42 U.S.C. 254e). 25 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 3 •S 484 IS (d) USE OF FUNDS.—An eligible entity that receives 1 a grant under this section shall use funds for the fol- 2 lowing: 3 (1) Establishing or expanding maternity care 4 programs to improve the integration of maternal 5 health and behavioral health care services into pri- 6 mary care settings where pregnant individuals regu- 7 larly receive health care services. 8 (2) Establishing or expanding group prenatal 9 care programs or postpartum care programs. 10 (3) Expanding existing programs that improve 11 maternal mental and behavioral health during the 12 prenatal and postpartum periods, with a focus on in- 13 dividuals from racial and ethnic minority groups. 14 (4) Providing services and support for pregnant 15 and postpartum individuals with maternal mental 16 health conditions and substance use disorders, in- 17 cluding referrals to addiction treatment centers that 18 offer evidence-based treatment options. 19 (5) Addressing stigma associated with maternal 20 mental health conditions and substance use dis- 21 orders, with a focus on racial and ethnic minority 22 groups. 23 (6) Raising awareness of warning signs of ma- 24 ternal mental health conditions and substance use 25 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 4 •S 484 IS disorders, with a focus on pregnant and postpartum 1 individuals from racial and ethnic minority groups. 2 (7) Establishing or expanding programs to pre- 3 vent suicide or self-harm among pregnant and 4 postpartum individuals. 5 (8) Offering evidence-aligned programs at free- 6 standing birth centers that provide maternal mental 7 and behavioral health care education, treatments, 8 and services, and other services for individuals 9 throughout the prenatal and postpartum period. 10 (9) Establishing or expanding programs to pro- 11 vide education and training to maternity care pro- 12 viders with respect to— 13 (A) identifying potential warning signs for 14 maternal mental health conditions or substance 15 use disorders in pregnant and postpartum indi- 16 viduals, with a focus on individuals from racial 17 and ethnic minority groups; and 18 (B) in the case where such providers iden- 19 tify such warning signs, offering referrals to 20 mental and behavioral health care professionals. 21 (10) Developing a website, or other source, that 22 includes information on health care providers who 23 treat maternal mental health conditions and sub- 24 stance use disorders. 25 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 5 •S 484 IS (11) Establishing or expanding programs in 1 communities to improve coordination between mater- 2 nity care providers and mental and behavioral health 3 care providers who treat maternal mental health 4 conditions and substance use disorders, including 5 through the use of toll-free hotlines. 6 (12) Carrying out other programs aligned with 7 evidence-based practices for addressing maternal 8 mental health conditions and substance use dis- 9 orders for pregnant and postpartum individuals from 10 racial and ethnic minority groups. 11 (e) REPORTING.— 12 (1) ELIGIBLE ENTITIES.—An eligible entity 13 that receives a grant under subsection (a) shall sub- 14 mit annually to the Secretary, and make publicly 15 available, a report on the activities conducted using 16 funds received through a grant under this section. 17 Such reports shall include quantitative and quali- 18 tative evaluations of such activities, including the ex- 19 perience of individuals who received health care 20 through such grant. 21 (2) SECRETARY.—Not later than the end of fis- 22 cal year 2024, the Secretary shall submit to Con- 23 gress a report that includes— 24 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 6 •S 484 IS (A) a summary of the reports received 1 under paragraph (1); 2 (B) an evaluation of the effectiveness of 3 grants awarded under this section; 4 (C) recommendations with respect to ex- 5 panding coverage of evidence-based screenings 6 and treatments for maternal mental health con- 7 ditions and substance use disorders; and 8 (D) recommendations with respect to en- 9 suring activities described under subsection (d) 10 continue after the end of a grant period. 11 (f) DEFINITIONS.—In this section: 12 (1) CULTURALLY CONGRUENT.—The term ‘‘cul- 13 turally congruent’’, with respect to care or maternity 14 care, means care that is in agreement with the pre- 15 ferred cultural values, beliefs, worldview, language, 16 and practices of the health care consumer and other 17 stakeholders. 18 (2) ELIGIBLE ENTITY.—The term ‘‘eligible enti- 19 ty’’ means— 20 (A) a community-based organization serv- 21 ing pregnant and postpartum individuals, in- 22 cluding such organizations serving individuals 23 from racial and ethnic minority groups and 24 other underserved populations; 25 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 7 •S 484 IS (B) a nonprofit or patient advocacy organi- 1 zation with expertise in maternal mental and 2 behavioral health; 3 (C) a maternity care provider; 4 (D) a mental or behavioral health care pro- 5 vider who treats maternal mental health condi- 6 tions or substance use disorders; 7 (E) a State or local governmental entity, 8 including a State or local public health depart- 9 ment; 10 (F) an Indian Tribe or Tribal organization 11 (as such terms are defined in section 4 of the 12 Indian Self-Determination and Education As- 13 sistance Act (25 U.S.C. 5304)); and 14 (G) an Urban Indian organization (as such 15 term is defined in section 4 of the Indian 16 Health Care Improvement Act (25 U.S.C. 17 1603)). 18 (3) FREESTANDING BIRTH CENTER.—The term 19 ‘‘freestanding birth center’’ has the meaning given 20 that term under section 1905(l) of the Social Secu- 21 rity Act (42 U.S.C. 1396d(1)). 22 (4) MATERNITY CARE PROVIDER.—The term 23 ‘‘maternity care provider’’ means a health care pro- 24 vider who— 25 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 8 •S 484 IS (A) is a physician, physician assistant, 1 midwife who meets at a minimum the inter- 2 national definition of the midwife and global 3 standards for midwifery education as estab- 4 lished by the International Confederation of 5 Midwives, nurse practitioner, or clinical nurse 6 specialist; and 7 (B) has a focus on maternal or perinatal 8 health. 9 (5) POSTPARTUM AND POSTPARTUM PERIOD.— 10 The terms ‘‘postpartum’’ and ‘‘postpartum period’’ 11 refer to the 1-year period beginning on the last day 12 of the pregnancy of an individual. 13 (6) RACIAL AND ETHNIC MINORITY GROUP.— 14 The term ‘‘racial and ethnic minority group’’ has the 15 meaning given such term in section 1707(g)(1) of 16 the Public Health Service Act (42 U.S.C. 300u– 17 6(g)(1)). 18 (7) SECRETARY.—The term ‘‘Secretary’’ means 19 the Secretary of Health and Human Services. 20 (g) AUTHORIZATION OF APPROPRIATIONS.—To carry 21 out this section, there is authorized to be appropriated 22 $25,000,000 for each of fiscal years 2022 through 2025. 23 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 9 •S 484 IS SEC. 3. GRANTS TO GROW AND DIVERSIFY THE MATERNAL 1 MENTAL AND BEHAVIORAL HEALTH CARE 2 WORKFORCE. 3 Title VII of the Public Health Service Act is amended 4 by inserting after section 757 of such Act (42 U.S.C. 5 294f) the following new section: 6 ‘‘SEC. 758. MATERNAL MENTAL AND BEHAVIORAL HEALTH 7 CARE WORKFORCE GRANTS. 8 ‘‘(a) IN GENERAL.—The Secretary may award grants 9 to entities to establish or expand programs described in 10 subsection (b) to grow and diversify the maternal mental 11 and behavioral health care workforce. 12 ‘‘(b) USE OF FUNDS.—Recipients of grants under 13 this section shall use the grants to grow and diversify the 14 maternal mental and behavioral health care workforce 15 by— 16 ‘‘(1) establishing schools or programs that pro- 17 vide education and training to individuals seeking 18 appropriate licensing or certification as mental or 19 behavioral health care providers who will specialize 20 in maternal mental health conditions or substance 21 use disorders; or 22 ‘‘(2) expanding the capacity of existing schools 23 or programs described in paragraph (1), for the pur- 24 poses of increasing the number of students enrolled 25 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 10 •S 484 IS in such schools or programs, including by awarding 1 scholarships for students. 2 ‘‘(c) PRIORITIZATION.—In awarding grants under 3 this section, the Secretary shall give priority to any entity 4 that— 5 ‘‘(1) has demonstrated a commitment to re- 6 cruiting and retaining students and faculty from ra- 7 cial and ethnic minority groups; 8 ‘‘(2) has developed a strategy to recruit and re- 9 tain a diverse pool of students into the maternal 10 mental or behavioral health care workforce program 11 or school supported by funds received through the 12 grant, particularly from racial and ethnic minority 13 groups and other underserved populations; 14 ‘‘(3) has developed a strategy to recruit and re- 15 tain students who plan to practice in a health pro- 16 fessional shortage area designated under section 17 332; 18 ‘‘(4) has developed a strategy to recruit and re- 19 tain students who plan to practice in an area with 20 significant racial and ethnic disparities in maternal 21 health outcomes, to the extent practicable; and 22 ‘‘(5) includes in the standard curriculum for all 23 students within the maternal mental or behavioral 24 health care workforce program or school a bias, rac- 25 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 11 •S 484 IS ism, or discrimination training program that in- 1 cludes training on implicit bias and racism. 2 ‘‘(d) REPORTING.—As a condition on receipt of a 3 grant under this section for a maternal mental or behav- 4 ioral health care workforce program or school, an entity 5 shall agree to submit to the Secretary an annual report 6 on the activities conducted through the grant, including— 7 ‘‘(1) the number and demographics of students 8 participating in the program or school; 9 ‘‘(2) the extent to which students in the pro- 10 gram or school are entering careers in— 11 ‘‘(A) health professional shortage areas 12 designated under section 332; and 13 ‘‘(B) areas with significant racial and eth- 14 nic disparities in maternal health outcomes, to 15 the extent such data are available; and 16 ‘‘(3) whether the program or school has in- 17 cluded in the standard curriculum for all students a 18 bias, racism, or discrimination training program that 19 includes training on implicit bias and racism, and if 20 so the effectiveness of such training program. 21 ‘‘(e) PERIOD OF GRANTS.—The period of a grant 22 under this section shall be up to 5 years. 23 ‘‘(f) APPLICATION.—To seek a grant under this sec- 24 tion, an entity shall submit to the Secretary an application 25 VerDate Sep 11 2014 23:56 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S484.IS S484 tkelley on DSK125TN23PROD with BILLS 12 •S 484 IS at such time, in such manner, and containing such infor- 1 mation as the Secretary may require, including any infor- 2 mation necessary for prioritization under subsection (c). 3 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 4 provide, directly or by contract, technical assistance to en- 5 tities seeking or receiving a grant under this section on 6 the development, use, evaluation, and post-grant period 7 sustainability of the maternal mental or behavioral health 8 care workforce programs or schools proposed to be, or 9 being, established or expanded through [Text truncated for display. 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