Maternal Health Quality Improvement Act of 2020

IIB 116TH CONGRESS 2D SESSION H. R. 4995 IN THE SENATE OF THE UNITED STATES SEPTEMBER 22, 2020 Received; read twice and referred to the Committee on Health, Education, Labor, and Pensions AN ACT To amend the Public Health Service Act to improve obstetric care and 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 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 2 HR 4995 RFS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Maternal Health Qual- 2 ity Improvement Act of 2020’’. 3 SEC. 2. INNOVATION FOR MATERNAL HEALTH. 4 Part D of title III of the Public Health Service Act 5 (42 U.S.C. 254b et seq.) is amended— 6 (1) in the section designation of section 330M 7 of such Act (42 U.S.C. 254c–19) by inserting a pe- 8 riod after ‘‘330M’’; and 9 (2) by inserting after section 330M of such Act 10 (42 U.S.C. 254c–19) the following: 11 ‘‘SEC. 330N. INNOVATION FOR MATERNAL HEALTH. 12 ‘‘(a) IN GENERAL.—The Secretary, in consultation 13 with experts representing a variety of clinical specialties, 14 State, Tribal, or local public health officials, researchers, 15 epidemiologists, statisticians, and community organiza- 16 tions, shall establish or continue a program to award com- 17 petitive grants to eligible entities for the purposes of— 18 ‘‘(1) identifying, developing, or disseminating 19 best practices to improve maternal health care qual- 20 ity and outcomes, eliminate preventable maternal 21 mortality and severe maternal morbidity, and im- 22 prove infant health outcomes, which may include— 23 ‘‘(A) information on evidence-based prac- 24 tices to improve the quality and safety of ma- 25 ternal health care in hospitals and other health 26 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 3 HR 4995 RFS care settings of a State or health care system, 1 including by addressing topics commonly associ- 2 ated with health complications or risks related 3 to prenatal care, labor care, birthing, and 4 postpartum care; 5 ‘‘(B) best practices for improving maternal 6 health care based on data findings and reviews 7 conducted by a State maternal mortality review 8 committee that address topics of relevance to 9 common complications or health risks related to 10 prenatal care, labor care, birthing, and 11 postpartum care; and 12 ‘‘(C) information on addressing deter- 13 minants of health that impact maternal health 14 outcomes for women before, during, and after 15 pregnancy; 16 ‘‘(2) collaborating with State maternal mor- 17 tality review committees to identify issues for the de- 18 velopment and implementation of evidence-based 19 practices to improve maternal health outcomes and 20 reduce preventable maternal mortality and severe 21 maternal morbidity; 22 ‘‘(3) providing technical assistance and sup- 23 porting the implementation of best practices identi- 24 fied pursuant to paragraph (1) to entities providing 25 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 4 HR 4995 RFS health care services to pregnant and postpartum 1 women; and 2 ‘‘(4) identifying, developing, and evaluating new 3 models of care that improve maternal and infant 4 health outcomes, which may include the integration 5 of community-based services and clinical care. 6 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible for a grant 7 under subsection (a), an entity shall— 8 ‘‘(1) submit to the Secretary an application at 9 such time, in such manner, and containing such in- 10 formation as the Secretary may require; and 11 ‘‘(2) demonstrate in such application that the 12 entity is capable of carrying out data-driven mater- 13 nal safety and quality improvement initiatives in the 14 areas of obstetrics and gynecology or maternal 15 health. 16 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—To 17 carry out this section, there are authorized to be appro- 18 priated $5,000,000 for each of fiscal years 2021 through 19 2025.’’. 20 SEC. 3. TRAINING FOR HEALTH CARE PROVIDERS. 21 Title VII of the Public Health Service Act is amended 22 by striking section 763 (42 U.S.C. 294p) and inserting 23 the following: 24 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 5 HR 4995 RFS ‘‘SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS. 1 ‘‘(a) GRANT PROGRAM.—The Secretary shall estab- 2 lish a program to award grants to accredited schools of 3 allopathic medicine, osteopathic medicine, and nursing, 4 and other health professional training programs for the 5 training of health care professionals to reduce and prevent 6 discrimination (including training related to implicit and 7 explicit biases) in the provision of health care services re- 8 lated to prenatal care, labor care, birthing, and 9 postpartum care. 10 ‘‘(b) ELIGIBILITY.—To be eligible for a grant under 11 subsection (a), an entity described in such subsection shall 12 submit to the Secretary an application at such time, in 13 such manner, and containing such information as the Sec- 14 retary may require. 15 ‘‘(c) REPORTING REQUIREMENT.—Each entity 16 awarded a grant under this section shall periodically sub- 17 mit to the Secretary a report on the status of activities 18 conducted using the grant, including a description of the 19 impact of such training on patient outcomes, as applicable. 20 ‘‘(d) BEST PRACTICES.—The Secretary may identify 21 and disseminate best practices for the training of health 22 care professionals to reduce and prevent discrimination 23 (including training related to implicit and explicit biases) 24 in the provision of health care services related to prenatal 25 care, labor care, birthing, and postpartum care. 26 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 6 HR 4995 RFS ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 1 carry out this section, there are authorized to be appro- 2 priated $5,000,000 for each of fiscal years 2021 through 3 2025.’’. 4 SEC. 4. STUDY ON TRAINING TO REDUCE AND PREVENT 5 DISCRIMINATION. 6 Not later than 2 years after date of enactment of this 7 Act, the Secretary of Health and Human Services shall, 8 through a contract with an independent research organiza- 9 tion, conduct a study and make recommendations for ac- 10 credited schools of allopathic medicine, osteopathic medi- 11 cine, and nursing, and other health professional training 12 programs, on best practices related to training to reduce 13 and prevent discrimination, including training related to 14 implicit and explicit biases, in the provision of health care 15 services related to prenatal care, labor care, birthing, and 16 postpartum care. 17 SEC. 5. PERINATAL QUALITY COLLABORATIVES. 18 Section 317K(a)(2) of the Public Health Service Act 19 (42 U.S.C. 247b–12(a)(2)) is amended by adding at the 20 end the following: 21 ‘‘(E)(i) The Secretary, acting through the 22 Director of the Centers for Disease Control and 23 Prevention and in coordination with other of- 24 fices and agencies, as appropriate, shall estab- 25 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 7 HR 4995 RFS lish or continue a competitive grant program 1 for the establishment or support of perinatal 2 quality collaboratives to improve perinatal care 3 and perinatal health outcomes for pregnant and 4 postpartum women and their infants. A State, 5 Indian Tribe, or Tribal organization may use 6 funds received through such grant to— 7 ‘‘(I) support the use of evidence-based 8 or evidence-informed practices to improve 9 outcomes for maternal and infant health; 10 ‘‘(II) work with clinical teams; ex- 11 perts; State, local, and, as appropriate, 12 Tribal public health officials; and stake- 13 holders, including patients and families, to 14 identify, develop, or disseminate best prac- 15 tices to improve perinatal care and out- 16 comes; and 17 ‘‘(III) employ strategies that provide 18 opportunities for health care professionals 19 and clinical teams to collaborate across 20 health care settings and disciplines, includ- 21 ing primary care and mental health, as ap- 22 propriate, to improve maternal and infant 23 health outcomes, which may include the 24 use of data to provide timely feedback 25 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 8 HR 4995 RFS across hospital and clinical teams to in- 1 form responses, and to provide support 2 and training to hospital and clinical teams 3 for quality improvement, as appropriate. 4 ‘‘(ii) To be eligible for a grant under 5 clause (i), an entity shall submit to the Sec- 6 retary an application in such form and manner 7 and containing such information as the Sec- 8 retary may require.’’. 9 SEC. 6. INTEGRATED SERVICES FOR PREGNANT AND 10 POSTPARTUM WOMEN. 11 (a) GRANTS.—Title III of the Public Health Service 12 Act is amended by inserting after section 330N of such 13 Act, as added by section 2, the following: 14 ‘‘SEC. 330O. INTEGRATED SERVICES FOR PREGNANT AND 15 POSTPARTUM WOMEN. 16 ‘‘(a) IN GENERAL.—The Secretary may award grants 17 to States, Indian Tribes, and Tribal organizations for the 18 purpose of establishing or operating evidence-based or in- 19 novative, evidence-informed programs to deliver integrated 20 health care services to pregnant and postpartum women 21 to optimize the health of women and their infants, includ- 22 ing to reduce adverse maternal health outcomes, preg- 23 nancy-related deaths, and related health disparities (in- 24 cluding such disparities associated with racial and ethnic 25 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 9 HR 4995 RFS minority populations), and, as appropriate, by addressing 1 issues researched under subsection (b)(2) of section 317K. 2 ‘‘(b) INTEGRATED SERVICES FOR PREGNANT AND 3 POSTPARTUM WOMEN.— 4 ‘‘(1) ELIGIBILITY.—To be eligible to receive a 5 grant under subsection (a), a State, Indian Tribe, or 6 Tribal organization shall work with relevant stake- 7 holders that coordinate care (including coordinating 8 resources and referrals for health care and social 9 services) to develop and carry out the program, in- 10 cluding— 11 ‘‘(A) State, Tribal, and local agencies re- 12 sponsible for Medicaid, public health, social 13 services, mental health, and substance use dis- 14 order treatment and services; 15 ‘‘(B) health care providers who serve preg- 16 nant and postpartum women; and 17 ‘‘(C) community-based health organiza- 18 tions and health workers, including providers of 19 home visiting services and individuals rep- 20 resenting communities with disproportionately 21 high rates of maternal mortality and severe ma- 22 ternal morbidity, and including individuals rep- 23 resenting racial and ethnic minority popu- 24 lations. 25 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 10 HR 4995 RFS ‘‘(2) TERMS.— 1 ‘‘(A) PERIOD.—A grant awarded under 2 subsection (a) shall be made for a period of 5 3 years. Any supplemental award made to a 4 grantee under subsection (a) may be made for 5 a period of less than 5 years. 6 ‘‘(B) PREFERENCE.—In awarding grants 7 under subsection (a), the Secretary shall— 8 ‘‘(i) give preference to States, Indian 9 Tribes, and Tribal organizations that have 10 the highest rates of maternal mortality and 11 severe maternal morbidity relative to other 12 such States, Indian Tribes, or Tribal orga- 13 nizations, respectively; and 14 ‘‘(ii) shall consider health disparities 15 related to maternal mortality and severe 16 maternal morbidity, including such dispari- 17 ties associated with racial and ethnic mi- 18 nority populations. 19 ‘‘(C) PRIORITY.—In awarding grants 20 under subsection (a), the Secretary shall give 21 priority to applications from up to 15 entities 22 described in subparagraph (B)(i). 23 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 11 HR 4995 RFS ‘‘(D) EVALUATION.—The Secretary shall 1 require grantees to evaluate the outcomes of the 2 programs supported under the grant. 3 ‘‘(c) DEFINITIONS.—In this section, the terms ‘In- 4 dian Tribe’ and ‘Tribal organization’ have the meanings 5 given the terms ‘Indian tribe’ and ‘tribal organization’, re- 6 spectively, in section 4 of the Indian Self-Determination 7 and Education Assistance Act. 8 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 9 are authorized to be appropriated to carry out this section 10 $10,000,000 for each of fiscal years 2021 through 2025.’’. 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 ment made by this section on maternal and 22 child health; 23 VerDate Sep 11 2014 03:55 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H4995.RFS H4995 pamtmann on DSKBC07HB2PROD with BILLS 12 HR 4995 RFS (B) best practices and models of care used 1 by recipients of grants under such amendment; 2 and 3 (C) obstacles identified by recipients of 4 grants under such amendment, and strategies 5 used by such recipients to deliver care, improve 6 maternal and child health, and reduce health 7 disparities. 8 (2) DISSEMINATION OF BEST PRACTICES.—Not 9 later than August 1, 2026, the Secretary of Health 10 and Human Services shall disseminate information 11 on best practices and models of care used by recipi- 12 ents of grants under the amendment made by this 13 section (including best practices and models of care 14 relating to the reduction of health disparities, includ- 15 ing such disparities associated with racial and ethnic 16 minority populations, in rates of maternal mortality 17 and severe maternal morbidity [Text truncated for display. Full text available on Congress.gov.]