Maternal Health Quality Improvement Act

II Calendar No. 71 117TH CONGRESS 1ST SESSION S. 1675 To improve maternal health. IN THE SENATE OF THE UNITED STATES MAY 18, 2021 Mr. WARNOCK (for himself, Mr. RUBIO, Ms. SMITH, Mr. MARSHALL, Ms. HASSAN, Mr. CASSIDY, and Ms. MURKOWSKI) introduced the following bill; which was read twice and referred to the Committee on Health, Edu- cation, Labor, and Pensions JUNE 8, 2021 Reported by Mrs. MURRAY, with an amendment [Strike out all after the enacting clause and insert the part printed in italic] A BILL To improve 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 ‘‘Maternal Health Qual- 4 ity Improvement Act’’. 5 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 1675 RS SEC. 2. INNOVATION FOR MATERNAL HEALTH. 1 Title III of the Public Health Service Act (42 U.S.C. 2 241 et seq.) is amended by inserting after section 330N 3 of such Act, the following: 4 ‘‘SEC. 330O. INNOVATION FOR MATERNAL HEALTH. 5 ‘‘(a) IN GENERAL.—The Secretary, in consultation 6 with experts representing a variety of clinical specialties, 7 State, tribal, or local public health officials, researchers, 8 epidemiologists, statisticians, and community organiza- 9 tions, shall establish or continue a program to award com- 10 petitive grants to eligible entities for the purpose of— 11 ‘‘(1) identifying, developing, or disseminating 12 best practices to improve maternal health care qual- 13 ity, improve maternal and infant health outcomes, 14 eliminate preventable maternal mortality and severe 15 maternal morbidity, and improve infant health out- 16 comes, which may include— 17 ‘‘(A) information on evidence-based prac- 18 tices to improve the quality and safety of ma- 19 ternal health care in hospitals and other health 20 care settings of a State or health care system 21 by addressing topics commonly associated with 22 health complications or risks related to prenatal 23 care, labor care, birthing, and postpartum care; 24 ‘‘(B) best practices for improving maternal 25 health care based on data findings and reviews 26 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 1675 RS conducted by a State maternal mortality review 1 committee that address topics of relevance to 2 common complications or health risks related to 3 prenatal care, labor care, birthing, and 4 postpartum care; and 5 ‘‘(C) information on addressing deter- 6 minants of health that impact maternal health 7 outcomes for women before, during, and after 8 pregnancy; 9 ‘‘(2) collaborating with State maternal mor- 10 tality review committees to identify issues for the de- 11 velopment and implementation of evidence-based 12 practices to improve maternal health outcomes and 13 reduce preventable maternal mortality and severe 14 maternal morbidity, consistent with section 317K; 15 ‘‘(3) providing technical assistance and sup- 16 porting the implementation of best practices identi- 17 fied in paragraph (1) to entities providing health 18 care services to pregnant and postpartum women; 19 and 20 ‘‘(4) identifying, developing, and evaluating new 21 models of care that improve maternal and infant 22 health outcomes, which may include the integration 23 of community-based services and clinical care. 24 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 1675 RS ‘‘(b) ELIGIBLE ENTITIES.—To be eligible for a grant 1 under subsection (a), an entity shall— 2 ‘‘(1) submit to the Secretary an application at 3 such time, in such manner, and containing such in- 4 formation as the Secretary may require; and 5 ‘‘(2) demonstrate in such application that the 6 entity is capable of carrying out data-driven mater- 7 nal safety and quality improvement initiatives in the 8 areas of obstetrics and gynecology or maternal 9 health. 10 ‘‘(c) REPORT.—Not later than September 30, 2024, 11 and every 2 years thereafter, the Secretary shall submit 12 a report to Congress on the practices described in para- 13 graphs (1) and (2) of subsection (a). Such report shall 14 include a description of the extent to which such practices 15 reduced preventable maternal mortality and severe mater- 16 nal morbidity, and whether such practices improved ma- 17 ternal and infant health. The Secretary shall disseminate 18 information on such practices, as appropriate. 19 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—To 20 carry out this section, there are authorized to be appro- 21 priated $9,000,000 for each of fiscal years 2022 through 22 2026.’’. 23 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 1675 RS SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS. 1 Title VII of the Public Health Service Act is amended 2 by striking section 763 (42 U.S.C. 294p) and inserting 3 the following: 4 ‘‘SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS. 5 ‘‘(a) GRANT PROGRAM.—The Secretary shall estab- 6 lish a program to award grants to accredited schools of 7 allopathic medicine, osteopathic medicine, and nursing, 8 and other health professional training programs for the 9 training of health care professionals to improve the provi- 10 sion of prenatal care, labor care, birthing, and postpartum 11 care for racial and ethnic minority populations, including 12 with respect to perceptions and biases that may affect the 13 approach to, and provision of, care. 14 ‘‘(b) ELIGIBILITY.—To be eligible for a grant under 15 subsection (a), an entity described in such subsection shall 16 submit to the Secretary an application at such time, in 17 such manner, and containing such information as the Sec- 18 retary may require. 19 ‘‘(c) REPORTING REQUIREMENTS.— 20 ‘‘(1) PERIODIC GRANTEE REPORTS.—Each enti- 21 ty awarded a grant under this section shall periodi- 22 cally submit to the Secretary a report on the status 23 of activities conducted using the grant, including a 24 description of the impact of such training on patient 25 outcomes, as applicable. 26 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 1675 RS ‘‘(2) REPORT TO CONGRESS.—Not later than 1 September 30, 2024, the Secretary shall submit a 2 report to Congress on the activities conducted using 3 grants under subsection (a) and any best practices 4 identified and disseminated under subsection (d). 5 ‘‘(d) BEST PRACTICES.—The Secretary may identify 6 and disseminate best practices for the training described 7 in subsection (a). 8 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 9 carry out this section, there are authorized to be appro- 10 priated $5,000,000 for each of fiscal years 2022 through 11 2026.’’. 12 SEC. 4. STUDY ON IMPROVING TRAINING FOR HEALTH 13 CARE PROVIDERS. 14 Not later than 2 years after date of enactment of this 15 Act, the Secretary of Health and Human Services shall, 16 through a contract with an independent research organiza- 17 tion, conduct a study and make recommendations for ac- 18 credited schools of allopathic medicine, osteopathic medi- 19 cine, and nursing, and other health professional training 20 programs on best practices related to training to improve 21 the provision of prenatal care, labor care, birthing, and 22 postpartum care for racial and ethnic minority popu- 23 lations, including with respect to perceptions and biases 24 that may affect the approach to, and provision of, care. 25 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 1675 RS SEC. 5. PERINATAL QUALITY COLLABORATIVES. 1 (a) IN GENERAL.—Section 317K(a)(2) of the Public 2 Health Service Act (42 U.S.C. 247b–12(a)(2)) is amended 3 by adding at the end the following: 4 ‘‘(E)(i) The Secretary, acting through the Di- 5 rector of the Centers for Disease Control and Pre- 6 vention and in coordination with other offices and 7 agencies, as appropriate, shall establish or continue 8 a competitive grant program for the establishment 9 or support of perinatal quality collaboratives to im- 10 prove perinatal care and perinatal health outcomes 11 for pregnant and postpartum women and their in- 12 fants. A State, Indian Tribe, or Tribal organization 13 may use funds received through such grant to— 14 ‘‘(I) support the use of evidence-based or 15 evidence-informed practices to improve out- 16 comes for maternal and infant health; 17 ‘‘(II) work with clinical teams; experts; 18 State, local, and, as appropriate, tribal public 19 health officials; and stakeholders, including pa- 20 tients and families, to identify, develop, or dis- 21 seminate best practices to improve perinatal 22 care and outcomes; and 23 ‘‘(III) employ strategies that provide op- 24 portunities for health care professionals and 25 clinical teams to collaborate across health care 26 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 1675 RS settings and disciplines, including primary care 1 and mental health, as appropriate, to improve 2 maternal and infant health outcomes, which 3 may include the use of data to provide timely 4 feedback across hospital and clinical teams to 5 inform responses, and to provide support and 6 training to hospital and clinical teams for qual- 7 ity improvement, as appropriate. 8 ‘‘(ii) To be eligible for a grant under clause (i), 9 an entity shall submit to the Secretary an applica- 10 tion in such form and manner and containing such 11 information as the Secretary may require.’’. 12 (b) REPORT TO CONGRESS.—Not later than Sep- 13 tember 30, 2025, the Secretary of Health and Human 14 Services shall submit to Congress a report regarding the 15 activities conducted by recipients of grants under sub- 16 section (a)(2)(E) of section 317K of the Public Health 17 Service Act (42 U.S.C. 247b–12). 18 SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND 19 POSTPARTUM WOMEN. 20 (a) GRANTS.—Title III of the Public Health Service 21 Act (42 U.S.C. 241 et seq.) is amended by inserting after 22 section 330O of such Act, as added by section 2, the fol- 23 lowing: 24 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 9 •S 1675 RS ‘‘SEC. 330P. INTEGRATED SERVICES FOR PREGNANT AND 1 POSTPARTUM WOMEN. 2 ‘‘(a) IN GENERAL.—The Secretary may award grants 3 for the purpose of establishing or operating evidence-based 4 or innovative, evidence-informed programs to deliver inte- 5 grated health care services to pregnant and postpartum 6 women to optimize the health of women and their infants, 7 including to reduce adverse maternal health outcomes, 8 pregnancy-related deaths, and related health disparities 9 (including such disparities associated with racial and eth- 10 nic minority populations), and, as appropriate, by address- 11 ing issues researched under subsection (b)(2) of section 12 317K. 13 ‘‘(b) INTEGRATED SERVICES FOR PREGNANT AND 14 POSTPARTUM WOMEN.— 15 ‘‘(1) ELIGIBILITY.—To be eligible to receive a 16 grant under subsection (a), a State, Indian Tribe, or 17 Tribal organization (as such terms are defined in 18 section 4 of the Indian Self-Determination and Edu- 19 cation Assistance Act) shall work with relevant 20 stakeholders that coordinate care to develop and 21 carry out the program, including— 22 ‘‘(A) State, Tribal, and local agencies re- 23 sponsible for Medicaid, public health, social 24 services, mental health, and substance use dis- 25 order treatment and services; 26 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 10 •S 1675 RS ‘‘(B) health care providers who serve preg- 1 nant and postpartum women; and 2 ‘‘(C) community-based health organiza- 3 tions and health workers, including providers of 4 home visiting services and individuals rep- 5 resenting communities with disproportionately 6 high rates of maternal mortality and severe ma- 7 ternal morbidity, and including those rep- 8 resenting racial and ethnic minority popu- 9 lations. 10 ‘‘(2) TERMS.— 11 ‘‘(A) PERIOD.—A grant awarded under 12 subsection (a) shall be made for a period of 5 13 years. Any supplemental award made to a 14 grantee under subsection (a) may be made for 15 a period of less than 5 years. 16 ‘‘(B) PREFERENCE.—In awarding grants 17 under subsection (a), the Secretary shall— 18 ‘‘(i) give preference to States, Indian 19 Tribes, and Tribal organizations that have 20 the highest rates of maternal mortality and 21 severe maternal morbidity relative to other 22 such States, Indian Tribes, or Tribal orga- 23 nizations, respectively; and 24 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 11 •S 1675 RS ‘‘(ii) shall consider health disparities 1 related to maternal mortality and severe 2 maternal morbidity, including such dispari- 3 ties associated with racial and ethnic mi- 4 nority populations. 5 ‘‘(C) EVALUATION.—The Secretary shall 6 require grantees to evaluate the outcomes of the 7 programs supported under the grant. 8 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 9 are authorized to be appropriated to carry out this section 10 $10,000,000 for each of fiscal years 2022 through 2026.’’. 11 (b) REPORT ON GRANT OUTCOMES AND DISSEMINA- 12 TION OF BEST PRACTICES.— 13 (1) REPORT.—Not later than February 1, 14 2026, the Secretary of Health and Human Services 15 shall submit to the Committee on Health, Edu- 16 cation, Labor, and Pensions of the Senate and the 17 Committee on Energy and Commerce of the House 18 of Representatives a report that describes— 19 (A) the outcomes of the activities sup- 20 ported by the grants awarded under the amend- 21 ments made by this section on maternal and 22 child health; 23 VerDate Sep 11 2014 00:51 Jun 09, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6401 E:\BILLS\S1675.RS S1675 pbinns on DSKJLVW7X2PROD with BILLS 12 •S 1675 RS (B) best practices and models of care used 1 by recipients of grants under such amendments; 2 and 3 (C) obstacles identified by recipients of 4 grants under such amendments, and strategies 5 used by such recipients to deliver care, improve 6 maternal and child health, and reduce [Text truncated for display. 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