Social Determinants for Moms Act

II 117TH CONGRESS 1ST SESSION S. 851 To address social determinants of maternal health. IN THE SENATE OF THE UNITED STATES MARCH 18, 2021 Mr. BLUMENTHAL introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To address social determinants of maternal health. 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 ‘‘Social Determinants 4 for Moms Act’’. 5 SEC. 2. DEFINITIONS. 6 In this Act: 7 (1) MATERNITY CARE PROVIDER.—The term 8 ‘‘maternity care provider’’ means a health care pro- 9 vider who— 10 (A) is a physician, physician assistant, 11 midwife who meets at a minimum the inter- 12 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 851 IS national definition of the midwife and global 1 standards for midwifery education as estab- 2 lished by the International Confederation of 3 Midwives, nurse practitioner, or clinical nurse 4 specialist; and 5 (B) has a focus on maternal or perinatal 6 health. 7 (2) MATERNAL MORTALITY.—The term ‘‘mater- 8 nal mortality’’ means a death occurring during or 9 within a one-year period after pregnancy, caused by 10 pregnancy-related or childbirth complications, in- 11 cluding a suicide, overdose, or other death resulting 12 from a mental health or substance use disorder at- 13 tributed to or aggravated by pregnancy-related or 14 childbirth complications. 15 (3) PERINATAL HEALTH WORKER.—The term 16 ‘‘perinatal health worker’’ means a doula, commu- 17 nity health worker, peer supporter, breastfeeding 18 and lactation educator or counselor, nutritionist or 19 dietitian, childbirth educator, social worker, home 20 visitor, language interpreter, or navigator. 21 (4) POSTPARTUM AND POSTPARTUM PERIOD.— 22 The terms ‘‘postpartum’’ and ‘‘postpartum period’’ 23 refer to the 1-year period beginning on the last day 24 of the pregnancy of an individual. 25 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 851 IS (5) PREGNANCY-RELATED DEATH.—The term 1 ‘‘pregnancy-related death’’ means a death of a preg- 2 nant or postpartum individual that occurs during, or 3 within 1 year following, the individual’s pregnancy, 4 from a pregnancy complication, a chain of events 5 initiated by pregnancy, or the aggravation of an un- 6 related condition by the physiologic effects of preg- 7 nancy. 8 (6) RACIAL AND ETHNIC MINORITY GROUP.— 9 The term ‘‘racial and ethnic minority group’’ has the 10 meaning given such term in section 1707(g)(1) of 11 the Public Health Service Act (42 U.S.C. 300u– 12 6(g)(1)). 13 (7) SEVERE MATERNAL MORBIDITY.—The term 14 ‘‘severe maternal morbidity’’ means a health condi- 15 tion, including mental health conditions and sub- 16 stance use disorders, attributed to or aggravated by 17 pregnancy or childbirth that results in significant 18 short-term or long-term consequences to the health 19 of the individual who was pregnant. 20 (8) SOCIAL DETERMINANTS OF MATERNAL 21 HEALTH.—The term ‘‘social determinants of mater- 22 nal health’’ means non-clinical factors that impact 23 maternal health outcomes, including— 24 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 851 IS (A) economic factors, which may include 1 poverty, employment, food security, support for 2 and access to lactation and other infant feeding 3 options, housing stability, and related factors; 4 (B) neighborhood factors, which may in- 5 clude quality of housing, access to transpor- 6 tation, access to child care, availability of 7 healthy foods and nutrition counseling, avail- 8 ability of clean water, air and water quality, 9 ambient temperatures, neighborhood crime and 10 violence, access to broadband, and related fac- 11 tors; 12 (C) social and community factors, which 13 may include systemic racism, gender discrimi- 14 nation or discrimination based on other pro- 15 tected classes, workplace conditions, incarcer- 16 ation, and related factors; 17 (D) household factors, which may include 18 ability to conduct lead testing and abatement, 19 car seat installation, indoor air temperatures, 20 and related factors; 21 (E) education access and quality factors, 22 which may include educational attainment, lan- 23 guage and literacy, and related factors; and 24 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 851 IS (F) health care access factors, including 1 health insurance coverage, access to culturally 2 congruent health care services, providers, and 3 non-clinical support, access to home visiting 4 services, access to wellness and stress manage- 5 ment programs, health literacy, access to tele- 6 health and items required to receive telehealth 7 services, and related factors. 8 SEC. 3. TASK FORCE TO DEVELOP A STRATEGY TO AD- 9 DRESS SOCIAL DETERMINANTS OF MATER- 10 NAL HEALTH. 11 (a) IN GENERAL.—The Secretary of Health and 12 Human Services shall convene a task force (in this section 13 referred to as the ‘‘Task Force’’) to develop a strategy 14 to coordinate efforts between Federal agencies to address 15 social determinants of maternal health with respect to 16 pregnant and postpartum individuals. 17 (b) EX OFFICIO MEMBERS.—The ex officio members 18 of the Task Force shall consist of the following: 19 (1) The Secretary of Health and Human Serv- 20 ices (or a designee thereof). 21 (2) The Secretary of Housing and Urban Devel- 22 opment (or a designee thereof). 23 (3) The Secretary of Transportation (or a des- 24 ignee thereof). 25 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 851 IS (4) The Secretary of Agriculture (or a designee 1 thereof). 2 (5) The Secretary of Labor (or a designee 3 thereof). 4 (6) The Secretary of Defense (or a designee 5 thereof). 6 (7) The Secretary of Veterans Affairs (or a des- 7 ignee thereof). 8 (8) The Administrator of the Environmental 9 Protection Agency (or a designee thereof). 10 (9) The Assistant Secretary for the Administra- 11 tion for Children and Families (or a designee there- 12 of). 13 (10) The Administrator of the Centers for 14 Medicare & Medicaid Services (or a designee there- 15 of). 16 (11) The Director of the Indian Health Service 17 (or a designee thereof). 18 (12) The Director of the National Institutes of 19 Health (or a designee thereof). 20 (13) The Administrator of the Health Re- 21 sources and Services Administration (or a designee 22 thereof). 23 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 851 IS (14) The Deputy Assistant Secretary for Minor- 1 ity Health of the Department of Health and Human 2 Services (or a designee thereof). 3 (15) The Deputy Assistant Secretary for Wom- 4 en’s Health of the Department of Health and 5 Human Services (or a designee thereof). 6 (16) The Director of the Centers for Disease 7 Control and Prevention (or a designee thereof). 8 (17) The Director of the Office on Violence 9 Against Women at the Department of Justice (or a 10 designee thereof). 11 (c) APPOINTED MEMBERS.—In addition to the ex 12 officio members of the Task Force, the Secretary of 13 Health and Human Services shall appoint the following 14 members of the Task Force: 15 (1) At least 2 representatives of patients, to in- 16 clude— 17 (A) a representative of patients who have 18 suffered from severe maternal morbidity; or 19 (B) a representative of patients who is a 20 family member of an individual who suffered a 21 pregnancy-related death. 22 (2) At least 2 leaders of community-based orga- 23 nizations that address maternal mortality and severe 24 maternal morbidity with a specific focus on racial 25 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 851 IS and ethnic disparities. In appointing such leaders 1 under this paragraph, the Secretary of Health and 2 Human Services shall give priority to individuals 3 who are leaders of organizations led by individuals 4 from racial and ethnic minority groups. 5 (3) At least 2 perinatal health workers. 6 (4) A professionally diverse panel of maternity 7 care providers. 8 (d) CHAIR.—The Secretary of Health and Human 9 Services shall select the chair of the Task Force from 10 among the members of the Task Force. 11 (e) REPORT.—Not later than 2 years after the date 12 of enactment of this Act, the Task Force shall submit to 13 Congress a report on— 14 (1) the strategy developed under subsection (a); 15 (2) recommendations on funding amounts with 16 respect to implementing such strategy; and 17 (3) recommendations for how to expand cov- 18 erage of social services to address social deter- 19 minants of maternal health under Medicaid managed 20 care organizations and State Medicaid programs. 21 (f) TERMINATION.—Section 14 of the Federal Advi- 22 sory Committee Act (5 U.S.C. App.) shall not apply to 23 the Task Force with respect to termination. 24 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 9 •S 851 IS SEC. 4. HOUSING FOR MOMS GRANT PROGRAM. 1 (a) IN GENERAL.—The Secretary of Housing and 2 Urban Development shall establish a Housing for Moms 3 grant program under this section to make grants to eligi- 4 ble entities to increase access to safe, stable, affordable, 5 and adequate housing for pregnant and postpartum indi- 6 viduals and their families. 7 (b) APPLICATION.—To be eligible to receive a grant 8 under this section, an eligible entity shall submit to the 9 Secretary an application at such time, in such manner, 10 and containing such information as the Secretary may 11 provide. 12 (c) PRIORITY.—In awarding grants under this sec- 13 tion, the Secretary shall give priority to an eligible entity 14 that— 15 (1) is a community-based organization or will 16 partner with a community-based organization to im- 17 plement initiatives to increase access to safe, stable, 18 affordable, and adequate housing for pregnant and 19 postpartum individuals and their families; 20 (2) is operating in an area with high rates of 21 adverse maternal health outcomes or significant ra- 22 cial or ethnic disparities in maternal health out- 23 comes, to the extent such data are available; and 24 (3) is operating in an area with a high poverty 25 rate or significant number of individuals who lack 26 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 10 •S 851 IS consistent access to safe, stable, affordable, and ade- 1 quate housing. 2 (d) USE OF FUNDS.—An eligible entity that receives 3 a grant under this section shall use funds under the grant 4 for the purposes of— 5 (1) identifying and conducting outreach to 6 pregnant and postpartum individuals who are low in- 7 come and lack consistent access to safe, stable, af- 8 fordable, and adequate housing; 9 (2) providing safe, stable, affordable, and ade- 10 quate housing options to such individuals; 11 (3) connecting such individuals with local orga- 12 nizations offering safe, stable, affordable, and ade- 13 quate housing options; 14 (4) providing application assistance to such in- 15 dividuals seeking to enroll in programs offering safe, 16 stable, affordable, and adequate housing options; 17 (5) providing direct financial assistance to such 18 individuals for the purposes of maintaining safe, sta- 19 ble, and adequate housing for the duration of the in- 20 dividual’s pregnancy and postpartum periods; and 21 (6) working with relevant stakeholders to en- 22 sure that local housing and homeless shelter infra- 23 structure is supportive to pregnant and postpartum 24 individuals, including through— 25 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 11 •S 851 IS (A) health-promoting housing codes; 1 (B) enforcement of housing codes; 2 (C) proactive rental inspection programs; 3 (D) code enforcement officer training; and 4 (E) partnerships between regional offices 5 of the Department of Housing and Urban De- 6 velopment and community-based organizations 7 to ensure housing laws are understood and vio- 8 lations are discovered. 9 (e) REPORTING.— 10 (1) ELIGIBLE ENTITIES.—The Secretary shall 11 require each eligible entity receiving a grant under 12 this section to annually submit to the Secretary and 13 make publicly available a report on the status of ac- 14 tivities conducted using the grant. 15 (2) SECRETARY.—Not later than the end of 16 each fiscal year in which grants are made under this 17 section, the Secretary shall submit to Congress and 18 make publicly available a report that— 19 (A) summarizes the reports received under 20 paragraph (1); 21 (B) evaluates the effectiveness of grants 22 awarded under this section in increasing access 23 to safe, stable, affordable, and adequate hous- 24 VerDate Sep 11 2014 04:02 Apr 14, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S851.IS S851 pbinns on DSKJLVW7X2PROD with BILLS 12 •S 851 IS ing for pregnant and postpartum individuals 1 and their families; and 2 (C) makes recommendations with respect 3 to ensuring activities described in subsection (d) 4 continue after grant amounts made available 5 under this section are expended. 6 (f) DEFINITIONS.—In this section: 7 (1) ELIGIBLE ENTITY.—The term ‘‘eligible enti- 8 ty’’ means— 9 (A) a community-based organization; 10 (B) a State or local governmental entity, 11 including a State or local public health depart- 12 ment; 13 (C) an Indian tribe or tribal organization 14 (as such terms are defined in section 4 of the 15 Indian Self-Determination and Education As- 16 sistance Act (25 U.S.C. 5304)); or 17 (D) an Urban Indian organization (as such 18 term is defined in section 4 of the Indian 19 Health Care Improvement Act (25 U.S.C. 20 1603)). 21 (2) SECRETARY.—The term ‘‘Secretary’’ means 22 the Secretary of Housing and Urban Development. 23 (g) AUTHORIZATION OF APPROPRIATIONS.—There is 24 authorized to be appropriated to carry out this section 25 VerDate Sep 11 2014 04:02 Apr 14, 2021 [Text truncated for display. 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