MOM Act

II 116TH CONGRESS 1ST SESSION S. 2586 To improve maternal health care. IN THE SENATE OF THE UNITED STATES SEPTEMBER 26, 2019 Ms. MCSALLY (for herself and Mr. JONES) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To improve maternal health care. 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 Outcomes 4 Matter Act of 2019’’ or the ‘‘MOM Act’’. 5 SEC. 2. INNOVATION FOR MATERNAL HEALTH. 6 Title III of the Public Health Service Act is amended 7 by inserting after section 330M of such Act (42 U.S.C. 8 254c–19) the following: 9 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 2 •S 2586 IS ‘‘SEC. 330N. INNOVATION FOR MATERNAL HEALTH. 1 ‘‘(a) IN GENERAL.—The Secretary, in consultation 2 with experts representing a variety of clinical specialties, 3 State, Tribal, or local public health officials, researchers, 4 epidemiologists, statisticians, and community organiza- 5 tions, shall establish or continue a program to award com- 6 petitive grants to eligible entities for the purpose of— 7 ‘‘(1) identifying, developing, or disseminating 8 best practices to improve maternal health care qual- 9 ity and outcomes, eliminate preventable maternal 10 mortality and severe maternal morbidity, and im- 11 prove infant health outcomes, which may include— 12 ‘‘(A) information on evidence-based prac- 13 tices to improve the quality and safety of ma- 14 ternal health care in hospitals and other health 15 care settings of a State or health care system, 16 including by addressing topics commonly associ- 17 ated with health complications or risks related 18 to prenatal care, labor care, birthing, and 19 postpartum care; 20 ‘‘(B) best practices for improving maternal 21 health care based on data findings and reviews 22 conducted by a State maternal mortality review 23 committee that address topics of relevance to 24 common complications or health risks related to 25 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 3 •S 2586 IS prenatal care, labor care, birthing, and 1 postpartum care; and 2 ‘‘(C) information on addressing deter- 3 minants of health that impact maternal health 4 outcomes for women before, during, and after 5 pregnancy; 6 ‘‘(2) collaborating with State maternal mor- 7 tality review committees to identify issues for the de- 8 velopment and implementation of evidence-based 9 practices to improve maternal health outcomes and 10 reduce preventable maternal mortality and severe 11 maternal morbidity; 12 ‘‘(3) providing technical assistance and sup- 13 porting the implementation of best practices identi- 14 fied in paragraph (1) to entities providing health 15 care services to pregnant and postpartum women; 16 and 17 ‘‘(4) identifying, developing, and evaluating new 18 models of care that improve maternal and infant 19 health outcomes, which may include the integration 20 of community-based services and clinical care. 21 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible for a grant 22 under subsection (a), an entity shall— 23 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 4 •S 2586 IS ‘‘(1) submit to the Secretary an application at 1 such time, in such manner, and containing such in- 2 formation as the Secretary may require; and 3 ‘‘(2) demonstrate in such application that the 4 entity is capable of carrying out data-driven mater- 5 nal safety and quality improvement initiatives in the 6 areas of obstetrics and gynecology or maternal 7 health. 8 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—To 9 carry out this section, there is authorized to be appro- 10 priated such sums as may be necessary for each of fiscal 11 years 2020 through 2024.’’. 12 SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS. 13 Title VII of the Public Health Service Act is amended 14 by striking section 763 (42 U.S.C. 294p) and inserting 15 the following: 16 ‘‘SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS. 17 ‘‘(a) GRANT PROGRAM.—The Secretary shall estab- 18 lish a program to award grants to accredited schools of 19 allopathic medicine, osteopathic medicine, and nursing, 20 and other health professional training programs for the 21 training of health care professionals to reduce and prevent 22 discrimination (including training related to implicit bi- 23 ases) in the provision of health care services related to 24 prenatal care, labor care, birthing, and postpartum care. 25 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 5 •S 2586 IS ‘‘(b) ELIGIBILITY.—To be eligible for a grant under 1 subsection (a), an entity described in such subsection shall 2 submit to the Secretary an application at such time, in 3 such manner, and containing such information as the Sec- 4 retary may require. 5 ‘‘(c) REPORTING REQUIREMENT.—Each entity 6 awarded a grant under this section shall periodically sub- 7 mit to the Secretary a report on the status of activities 8 conducted using the grant, including a description of the 9 impact of such training on patient outcomes, as applicable. 10 ‘‘(d) BEST PRACTICES.—The Secretary may identify 11 and disseminate best practices for the training of health 12 care professionals to reduce and prevent discrimination 13 (including training related to implicit biases) in the provi- 14 sion of health care services related to prenatal care, labor 15 care, birthing, and postpartum care. 16 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 17 carry out this section, there is authorized to be appro- 18 priated such sums as may be necessary for each of fiscal 19 years 2020 through 2024.’’. 20 SEC. 4. STUDY ON TRAINING TO REDUCE AND PREVENT 21 DISCRIMINATION. 22 Not later than 2 years after date of enactment of this 23 Act, the Secretary of Health and Human Services shall, 24 through a contract with an independent research organiza- 25 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 6 •S 2586 IS tion, conduct a study and make recommendations for ac- 1 credited schools of allopathic medicine, osteopathic medi- 2 cine, and nursing, and other health professional training 3 programs on best practices related to training to reduce 4 and prevent discrimination, including training related to 5 implicit biases, in the provision of health care services re- 6 lated to prenatal care, labor care, birthing, and 7 postpartum care. 8 SEC. 5. PERINATAL QUALITY COLLABORATIVES. 9 Section 317K(a)(2) of the Public Health Service Act 10 (42 U.S.C. 247b–12(a)(2)) is amended by adding at the 11 end the following: 12 ‘‘(E)(i) The Secretary, acting through the 13 Director of the Centers for Disease Control and 14 Prevention and in coordination with other of- 15 fices and agencies, as appropriate, shall estab- 16 lish or continue a competitive grant program 17 for the establishment or support of perinatal 18 quality collaboratives to improve perinatal care 19 and perinatal health outcomes for pregnant and 20 postpartum women and their infants. A State, 21 Indian Tribe, or Tribal organization may use 22 funds received through such grant to— 23 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 7 •S 2586 IS ‘‘(I) support the use of evidence-based 1 or evidence-informed practices to improve 2 outcomes for maternal and infant health; 3 ‘‘(II) work with clinical teams; ex- 4 perts; State, local, and, as appropriate, 5 Tribal public health officials; and stake- 6 holders, including patients and families, to 7 identify, develop, or disseminate best prac- 8 tices to improve perinatal care and out- 9 comes; and 10 ‘‘(III) employ strategies that provide 11 opportunities for health care professionals 12 and clinical teams to collaborate across 13 health care settings and disciplines, includ- 14 ing primary care and mental health, as ap- 15 propriate, to improve maternal and infant 16 health outcomes, which may include the 17 use of data to provide timely feedback 18 across hospital and clinical teams to in- 19 form responses, and to provide support 20 and training to hospital and clinical teams 21 for quality improvement, as appropriate. 22 ‘‘(ii) To be eligible for a grant under 23 clause (i), an entity shall submit to the Sec- 24 retary an application in such form and manner 25 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 8 •S 2586 IS and containing such information as the Sec- 1 retary may require.’’. 2 SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND 3 POSTPARTUM WOMEN. 4 (a) GRANTS.—Title III of the Public Health Service 5 Act is amended by inserting after section 330N of such 6 Act, as added by section 2, the following: 7 ‘‘SEC. 330O. INTEGRATED SERVICES FOR PREGNANT AND 8 POSTPARTUM WOMEN. 9 ‘‘(a) IN GENERAL.—The Secretary may award grants 10 for the purpose of establishing or operating evidence-based 11 or innovative, evidence-informed programs to deliver inte- 12 grated health care services to pregnant and postpartum 13 women to optimize the health of women and their infants, 14 including to reduce adverse maternal health outcomes, 15 pregnancy-related deaths, and related health disparities 16 (including such disparities associated with racial and eth- 17 nic minority populations), and, as appropriate, by address- 18 ing issues researched under subsection (b)(2) of section 19 317K. 20 ‘‘(b) INTEGRATED SERVICES FOR PREGNANT AND 21 POSTPARTUM WOMEN.— 22 ‘‘(1) ELIGIBILITY.—To be eligible to receive a 23 grant under subsection (a), a State, Indian Tribe, or 24 Tribal organization (as such terms are defined in 25 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 9 •S 2586 IS section 4 of the Indian Self-Determination and Edu- 1 cation Assistance Act) shall work with relevant 2 stakeholders that coordinate care (including coordi- 3 nating resources and referrals for health care and 4 social services) to develop and carry out the pro- 5 gram, including— 6 ‘‘(A) State, Tribal, and local agencies re- 7 sponsible for Medicaid, public health, social 8 services, mental health, and substance use dis- 9 order treatment and services; 10 ‘‘(B) health care providers who serve preg- 11 nant and postpartum women; and 12 ‘‘(C) community-based health organiza- 13 tions and health workers, including providers of 14 home visiting services and individuals rep- 15 resenting communities with disproportionately 16 high rates of maternal mortality and severe ma- 17 ternal morbidity, and including those rep- 18 resenting racial and ethnicity minority popu- 19 lations. 20 ‘‘(2) TERMS.— 21 ‘‘(A) PERIOD.—A grant awarded under 22 subsection (a) shall be made for a period of 5 23 years. Any supplemental award made to a 24 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 10 •S 2586 IS grantee under subsection (a) may be made for 1 a period of less than 5 years. 2 ‘‘(B) PREFERENCE.—In awarding grants 3 under subsection (a), the Secretary shall— 4 ‘‘(i) give preference to States, Indian 5 Tribes, and Tribal organizations that have 6 the highest rates of maternal mortality and 7 severe maternal morbidity relative to other 8 such States, Indian Tribes, or Tribal orga- 9 nizations, respectively; and 10 ‘‘(ii) shall consider health disparities 11 related to maternal mortality and severe 12 maternal morbidity, including such dispari- 13 ties associated with racial and ethnic mi- 14 nority populations. 15 ‘‘(C) PRIORITY.—In awarding grants 16 under subsection (a), the Secretary shall give 17 priority to applications from up to 15 entities 18 described in subparagraph (B)(i). 19 ‘‘(D) EVALUATION.—The Secretary shall 20 require grantees to evaluate the outcomes of the 21 programs supported under the grant. 22 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 23 are authorized to be appropriated to carry out this section 24 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 11 •S 2586 IS such sums as may be necessary for each of fiscal years 1 2020 through 2024.’’. 2 (b) REPORT ON GRANT OUTCOMES AND DISSEMINA- 3 TION OF BEST PRACTICES.— 4 (1) REPORT.—Not later than February 1, 5 2026, the Secretary of Health and Human Services 6 shall submit to the Committee on Health, Edu- 7 cation, Labor, and Pensions of the Senate and the 8 Committee on Energy and Commerce of the House 9 of Representatives a report that describes— 10 (A) the outcomes of the activities sup- 11 ported by the grants awarded under the amend- 12 ments made by this section on maternal and 13 child health; 14 (B) best practices and models of care used 15 by recipients of grants under such amendments; 16 and 17 (C) obstacles identified by recipients of 18 grants under such amendments, and strategies 19 used by such recipients to deliver care, improve 20 maternal and child health, and reduce health 21 disparities. 22 (2) DISSEMINATION OF BEST PRACTICES.—Not 23 later than August 1, 2026, the Secretary of Health 24 and Human Services shall disseminate information 25 VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS 12 •S 2586 IS on best practices and models of care used by recipi- 1 ents of grants under the amendments made by this 2 section (including best practices and models of care 3 relating to the reduction of health disparities, includ- 4 ing such disparities associated with racial and ethnic 5 minority populations, in rates of maternal mortality 6 and severe maternal morbidity) to relevant stake- 7 holders, which may include health providers, medical 8 schools, nursing schools, relevant State, Tribal, and 9 local agencies, and the general public. 10 Æ VerDate Sep 11 2014 02:21 Oct 05, 2019 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6301 E:\BILLS\S2586.IS S2586 kjohnson on DSK79L0C42 with BILLS