Tech to Save Moms Act

I 116TH CONGRESS 2D SESSION H. R. 6138 To improve maternal health outcomes, especially for underserved populations, through investments in technology, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 9, 2020 Ms. JOHNSON of Texas (for herself, Ms. UNDERWOOD, Ms. ADAMS, Ms. SE- WELL of Alabama, Ms. NORTON, Ms. SCANLON, Ms. MOORE, Mr. CLAY, Mr. KHANNA, Ms. PRESSLEY, and Mr. LAWSON of Florida) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To improve maternal health outcomes, especially for under- served populations, through investments in technology, 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 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Tech to Save Moms 4 Act’’. 5 VerDate Sep 11 2014 23:13 Mar 13, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 6138 IH SEC. 2. CMI MODELING OF INTEGRATED TELEHEALTH 1 MODELS IN MATERNITY CARE SERVICES. 2 (a) IN GENERAL.—Section 1115A(b)(2)(B) of the 3 Social Security Act (42 U.S.C. 1315a(b)(2)(B)) is amend- 4 ed by adding at the end the following new clauses: 5 ‘‘(xxviii) Focusing on title XIX, pro- 6 viding for the adoption of and use of tele- 7 health tools that allow for screening and 8 treatment of common pregnancy-related 9 complications (including anxiety and de- 10 pression, substance use disorder, hemor- 11 rhage, infection, amniotic fluid embolism, 12 thrombotic pulmonary or other embolism, 13 hypertensive disorders of pregnancy, cere- 14 brovascular accidents, cardiomyopathy, and 15 other cardiovascular conditions) for a preg- 16 nant woman receiving medical assistance 17 under such title during her pregnancy and 18 for not more than a 1-year period begin- 19 ning on the last day of her pregnancy.’’. 20 (b) EFFECTIVE DATE.—The amendment made by 21 subsection (a) shall take effect 1 year after the date of 22 the enactment of this Act. 23 VerDate Sep 11 2014 23:13 Mar 13, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 6138 IH SEC. 3. GRANTS TO EXPAND THE USE OF TECHNOLOGY-EN- 1 ABLED COLLABORATIVE LEARNING AND CA- 2 PACITY MODELS THAT PROVIDE CARE TO 3 PREGNANT AND POSTPARTUM WOMEN. 4 Title III of the Public Health Service Act is amended 5 by inserting after section 330M (42 U.S.C. 254c–19) the 6 following: 7 ‘‘SEC. 330N. EXPANDING CAPACITY FOR MATERNAL 8 HEALTH OUTCOMES. 9 ‘‘(a) PROGRAM ESTABLISHED.—Beginning not later 10 than 1 year after the date of enactment of this Act, the 11 Secretary of Health and Human Services shall, as appro- 12 priate, award grants to eligible entities to evaluate, de- 13 velop, and, as appropriate, expand the use of technology- 14 enabled collaborative learning and capacity building mod- 15 els, to improve maternal health outcomes in health profes- 16 sional shortage areas; areas with high rates of maternal 17 mortality and severe maternal morbidity, and significant 18 racial and ethnic disparities in maternal health outcomes; 19 and for medically underserved populations or American 20 Indians and Alaska Natives, including Indian tribes, Trib- 21 al organizations, and urban Indian organizations. 22 ‘‘(b) USE OF FUNDS.— 23 ‘‘(1) REQUIRED USES.—Grants awarded under 24 subsection (a) shall be used for— 25 VerDate Sep 11 2014 03:56 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 6138 IH ‘‘(A) the development and acquisition of 1 instructional programming, and the training of 2 maternal health care providers and other pro- 3 fessionals that provide or assist in the provision 4 of services through models such as— 5 ‘‘(i) training on adopting and effec- 6 tively implementing Alliance for Innovation 7 on Maternal Health (referred to in this 8 section as ‘AIM’) safety and quality im- 9 provement bundles; 10 ‘‘(ii) training on implicit and explicit 11 bias, racism, and discrimination for pro- 12 viders of maternity care; 13 ‘‘(iii) training on best practices in 14 screening for and, as needed, evaluating 15 and treating maternal mental health condi- 16 tions and substance use disorders; 17 ‘‘(iv) training on how to screen for so- 18 cial determinants of health risks in the 19 prenatal and postpartum periods such as 20 inadequate housing, lack of access to nutri- 21 tion, environmental risks, and transpor- 22 tation barriers; and 23 ‘‘(v) training on the use of remote pa- 24 tient monitoring tools for pregnancy-re- 25 VerDate Sep 11 2014 23:13 Mar 13, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 6138 IH lated complications described in section 1 1115A(b)(2)(B)(xxviii); 2 ‘‘(B) information collection and evaluation 3 activities to— 4 ‘‘(i) study the impact of such models 5 on— 6 ‘‘(I) access to and quality of care; 7 ‘‘(II) patient outcomes; 8 ‘‘(III) subjective measures of pa- 9 tient experience; and 10 ‘‘(IV) cost-effectiveness; and 11 ‘‘(ii) identify best practices for the ex- 12 pansion and use of such models; 13 ‘‘(C) information collection and evaluation 14 activities to study the impact of such models on 15 patient outcomes and maternal health care pro- 16 viders, and to identify best practices the expan- 17 sion and use of such models; and 18 ‘‘(D) any other activity consistent with 19 achieving the objectives of grants awarded 20 under this section, as determined by the Sec- 21 retary. 22 ‘‘(2) PERMISSIBLE USES.—In addition to any of 23 the uses under paragraph (1), grants awarded under 24 subsection (a) may be used for— 25 VerDate Sep 11 2014 23:13 Mar 13, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 6138 IH ‘‘(A) equipment to support the use and ex- 1 pansion of technology-enabled collaborative 2 learning and capacity building models, including 3 for hardware and software that enables distance 4 learning, maternal health care provider support, 5 and the secure exchange of electronic health in- 6 formation; and 7 ‘‘(B) support for maternal health care pro- 8 viders and other professionals that provide or 9 assist in the provision of maternity care services 10 through such models. 11 ‘‘(c) LIMITATIONS.— 12 ‘‘(1) NUMBER.—The Secretary may not award 13 more than 1 grant under this section to an eligible 14 entity. 15 ‘‘(2) DURATION.—Each grant under this sec- 16 tion shall be made for a period of up to 5 years. 17 ‘‘(3) AMOUNT.—The Secretary shall determine 18 the maximum amount of each grant under this sec- 19 tion. 20 ‘‘(d) GRANT REQUIREMENTS.—The Secretary shall 21 require entities awarded a grant under this section to col- 22 lect information on the effect of the use of technology- 23 enabled collaborative learning and capacity building mod- 24 els, such as on maternal health outcomes, access to mater- 25 VerDate Sep 11 2014 23:13 Mar 13, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 6138 IH nal health care services, quality of maternal health care, 1 and maternal health care provider retention in areas and 2 populations described in subsection (a). The Secretary 3 may award a grant or contract to assist in the coordina- 4 tion of such models, including to assess outcomes associ- 5 ated with the use of such models in grants awarded under 6 subsection (a), including for the purpose described in sub- 7 section (b)(1)(B). 8 ‘‘(e) APPLICATION.— 9 ‘‘(1) IN GENERAL.—An eligible entity that 10 seeks to receive a grant under subsection (a) shall 11 submit to the Secretary an application, at such time, 12 in such manner, and containing such information as 13 the Secretary may require. 14 ‘‘(2) MATTERS TO BE INCLUDED.—Such appli- 15 cation shall include plans to assess the effect of 16 technology-enabled collaborative learning and capac- 17 ity building models on indicators, including access to 18 and quality of care, patient outcomes, subjective 19 measures of patient experience, and cost-effective- 20 ness. Such indicators may focus on— 21 ‘‘(A) health professional shortage areas; 22 ‘‘(B) areas with high rates of maternal 23 mortality and severe maternal morbidity, and 24 VerDate Sep 11 2014 23:13 Mar 13, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 6138 IH significant racial and ethnic disparities in ma- 1 ternal health outcomes; and 2 ‘‘(C) medically underserved populations or 3 American Indians and Alaska Natives, includ- 4 ing Indian tribes, Tribal organizations, and 5 urban Indian organizations. 6 ‘‘(f) ACCESS TO BROADBAND.—In administering 7 grants under this section, the Secretary may coordinate 8 with other agencies to ensure that funding opportunities 9 are available to support access to reliable, high-speed 10 internet for grantees. 11 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 12 provide (either directly through the Department of Health 13 and Human Services or by contract) technical assistance 14 to eligible entities, including recipients of grants under 15 subsection (a), on the development, use, and post-grant 16 sustainability of technology-enabled collaborative learning 17 and capacity building models in order to expand access 18 to maternal health care services provided by such entities, 19 including for health professional shortage areas and areas 20 with high rates of maternal mortality and severe maternal 21 morbidity, and significant racial and ethnic disparities in 22 maternal health outcomes, and to medically underserved 23 populations or American Indians and Alaska Natives, in- 24 VerDate Sep 11 2014 03:56 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 6138 IH cluding Indian tribes, Tribal organizations, and urban In- 1 dian organizations. 2 ‘‘(h) RESEARCH AND EVALUATION.—The Secretary, 3 in consultation with stakeholders with appropriate exper- 4 tise in such models, shall develop a strategic plan to re- 5 search and evaluate the evidence for such models. The 6 Secretary shall use such plan to inform the activities car- 7 ried out under this section. 8 ‘‘(i) REPORTING.— 9 ‘‘(1) BY ELIGIBLE ENTITIES.—An eligible enti- 10 ty that receives a grant under subsection (a) shall 11 submit to the Secretary a report, at such time, in 12 such manner, and containing such information as 13 the Secretary may require. 14 ‘‘(2) BY THE SECRETARY.—Not later than 4 15 years after the date of enactment of this section, the 16 Secretary shall prepare and submit to the Congress, 17 and post on the internet website of the Department 18 of Health and Human Services, a report including, 19 at minimum— 20 ‘‘(A) a description of any new and con- 21 tinuing grants awarded under subsection (a) 22 and the specific purpose and amounts of such 23 grants; 24 ‘‘(B) an overview of— 25 VerDate Sep 11 2014 03:56 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 6138 IH ‘‘(i) the evaluations conducted under 1 subsection (b); 2 ‘‘(ii) technical assistance provided 3 under subsection (g); and 4 ‘‘(iii) activities conducted by entities 5 awarded grants under subsection (a); and 6 ‘‘(C) a description of any significant find- 7 ings related to patient outcomes or maternal 8 health care providers and best practices for eli- 9 gible entities expanding, using, or evaluating 10 technology-enabled collaborative learning and 11 capacity building models. 12 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 13 is authorized to be appropriated to carry out this section, 14 $6,000,000 for each of fiscal years 2021 through 2025. 15 ‘‘(k) DEFINITIONS.—In this section: 16 ‘‘(1) ELIGIBLE ENTITY.— 17 ‘‘(A) IN GENERAL.—The term ‘eligible en- 18 tity’ means an entity that provides, or supports 19 the provision of, maternal health care services 20 or other evidence-based services for pregnant 21 and postpartum women— 22 ‘‘(i) in health professional shortage 23 areas; 24 VerDate Sep 11 2014 23:13 Mar 13, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 6138 IH ‘‘(ii) in areas with high rates of ad- 1 verse maternal health outcomes and sig- 2 nificant racial and ethnic disparities in ma- 3 ternal health outcomes; or 4 ‘‘(iii) medically underserved popu- 5 lations or American Indians and Alaska 6 Natives, including Indian tribes, Tribal or- 7 ganizations, and urban Indian organiza- 8 tions. 9 ‘‘(B) INCLUSIONS.—An eligible entity may 10 include entities leading, or capable of leading, a 11 technology-enabled collaborative learning and 12 capacity building model or engaging in tech- 13 nology-enabled collaborative training of partici- 14 pants in such model. 15 ‘‘(2) HEALTH PROFESSIONAL SHORTAGE 16 AREA.—The term ‘health professional shortage area’ 17 means a health professional shortage area des- 18 ignated under section 332. 19 ‘‘(3) INDIAN TRIBE.—The term ‘Indian tribe’ 20 has the meaning given such term in section 4 of the 21 Indian Self-Determination and Education Assistance 22 Act. 23 ‘‘(4) MATERNAL MORTALITY.—The term ‘ma- 24 ternal mortality’ means a death occurring during or 25 VerDate Sep 11 2014 03:56 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H6138.IH H6138 pamtmann on DSKBC07HB2PROD with BILLS 12 •HR 6138 IH within a 1-year period after pregnancy caused by 1 pregnancy or childbirth complications. 2 ‘‘(5) MEDICALLY UNDERSERVED POPU- 3 LATION.—The term ‘medically underserved popu- 4 lation’ has the meaning given such term in section 5 330(b)(3). 6 ‘‘(6) POSTPARTUM.—The term ‘postpartum’ 7 means the 1-year period beginning on the last date 8 of the pregnancy of a woman. 9 ‘‘(7) SEVERE MATERNAL MORTALITY.—The 10 term ‘severe maternal morbidity’ means an unex- 11 pected outcome caused by labor and delivery of a 12 woman that results in a significant short-term or 13 long-term consequences to the health of the woman. 14 ‘‘(8) TECHNOLOGY-ENABLED COLLABORATIVE 15 LEARNING AND CAPACITY BUILDING MODEL.—The 16 term ‘technology-enabled collaborative learning and 17 capacity building model’ means a distance health 18 education model that connects health care profes- 19 sionals, and particularly specialists, with multiple 20 other health care professionals through simultaneous 21 interactive videoconferencing for the purpose of fa- 22 cilitating case-based learning, disseminating best 23 pra [Text truncated for display. 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