Kira Johnson Act

I 116TH CONGRESS 2D SESSION H. R. 6144 To make investments in community-based organizations and other initiatives to prevent maternal mortality and severe maternal morbidity, especially for Black women, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 9, 2020 Ms. ADAMS (for herself, Ms. UNDERWOOD, Ms. SEWELL 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 make investments in community-based organizations and other initiatives to prevent maternal mortality and severe maternal morbidity, especially for Black women, 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 ‘‘Kira Johnson Act’’. 4 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 2 •HR 6144 IH SEC. 2. INVESTMENTS IN COMMUNITY-BASED ORGANIZA- 1 TIONS TO IMPROVE BLACK MATERNAL 2 HEALTH OUTCOMES. 3 (a) AWARDS.—Following the 1-year period described 4 in subsection (c), the Secretary of Health and Human 5 Services (in this section referred to as the ‘‘Secretary’’), 6 acting through the Administrator of the Health Resources 7 and Services Administration, shall award grants to eligible 8 entities to establish or expand programs to prevent mater- 9 nal mortality and severe maternal morbidity among Black 10 women. 11 (b) ELIGIBILITY.—To be eligible to seek a grant 12 under this section, an entity shall be a community-based 13 organization offering programs and resources aligned with 14 evidence-based practices for improving maternal health 15 outcomes for Black women. 16 (c) OUTREACH AND TECHNICAL ASSISTANCE PE- 17 RIOD.—During the 1-year period beginning on the date 18 of enactment of this Act, the Secretary shall— 19 (1) conduct outreach to encourage eligible enti- 20 ties to apply for grants under this section; and 21 (2) provide technical assistance to eligible enti- 22 ties on best practices for applying for grants under 23 this section. 24 (d) SPECIAL CONSIDERATION.— 25 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 3 •HR 6144 IH (1) OUTREACH.—In conducting outreach under 1 subsection (c), the Secretary shall give special con- 2 sideration to eligible entities that— 3 (A) are based in, and provide support for, 4 communities with— 5 (i) high rates of adverse maternal 6 health outcomes; and 7 (ii) significant racial and ethnic dis- 8 parities in maternal health outcomes; 9 (B) are led by Black women; and 10 (C) offer programs and resources that are 11 aligned with evidence-based practices for im- 12 proving maternal health outcomes for Black 13 women. 14 (2) AWARDS.—In awarding grants under this 15 section, the Secretary shall give special consideration 16 to eligible entities that— 17 (A) are described in subparagraphs (A), 18 (B), and (C) of paragraph (1); 19 (B) offer programs and resources designed 20 in consultation with and intended for Black 21 women; and 22 (C) offer programs and resources in the 23 communities in which the respective eligible en- 24 tities are located that— 25 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 4 •HR 6144 IH (i) promote maternal mental health 1 and maternal substance use disorder treat- 2 ments that are aligned with evidence-based 3 practices for improving maternal mental 4 health outcomes for Black women; 5 (ii) address social determinants of 6 health for women in the prenatal and 7 postpartum periods, including— 8 (I) housing; 9 (II) transportation; 10 (III) nutrition counseling; 11 (IV) healthy foods; 12 (V) lactation support; 13 (VI) lead abatement and other 14 efforts to improve air and water qual- 15 ity; 16 (VII) child care access; 17 (VIII) car seat installation; 18 (IX) wellness and stress manage- 19 ment programs; or 20 (X) coordination across safety- 21 net and social support services and 22 programs; 23 (iii) promote evidence-based health lit- 24 eracy and pregnancy, childbirth, and par- 25 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 5 •HR 6144 IH enting education for women in the prenatal 1 and postpartum periods; 2 (iv) provide support from doulas and 3 other perinatal health workers to women 4 from pregnancy through the postpartum 5 period; 6 (v) provide culturally congruent train- 7 ing to perinatal health workers such as 8 doulas, community health workers, peer 9 supporters, certified lactation consultants, 10 nutritionists and dietitians, social workers, 11 home visitors, and navigators; 12 (vi) conduct or support research on 13 Black maternal health issues; or 14 (vii) have developed other programs 15 and resources that address community-spe- 16 cific needs for women in the prenatal and 17 postpartum periods and are aligned with 18 evidence-based practices for improving ma- 19 ternal health outcomes for Black women. 20 (e) TECHNICAL ASSISTANCE.—The Secretary shall 21 provide to grant recipients under this section technical as- 22 sistance on— 23 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 6 •HR 6144 IH (1) capacity building to establish or expand pro- 1 grams to prevent adverse maternal health outcomes 2 among Black women; 3 (2) best practices in data collection, measure- 4 ment, evaluation, and reporting; and 5 (3) planning for sustaining programs to prevent 6 maternal mortality and severe maternal morbidity 7 among Black women after the period of the grant. 8 (f) EVALUATION.—Not later than the end of fiscal 9 year 2026, the Secretary shall submit to the Congress an 10 evaluation of the grant program under this section that— 11 (1) assesses the effectiveness of outreach efforts 12 during the application process in diversifying the 13 pool of grant recipients; 14 (2) makes recommendations for future outreach 15 efforts to diversify the pool of grant recipients for 16 Department of Health and Human Services grant 17 programs and funding opportunities; 18 (3) assesses the effectiveness of programs fund- 19 ed by grants under this section in improving mater- 20 nal health outcomes for Black women; and 21 (4) makes recommendations for future Depart- 22 ment of Health and Human Services grant programs 23 and funding opportunities that deliver funding to 24 community-based organizations to improve Black 25 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 7 •HR 6144 IH maternal health outcomes through programs and re- 1 sources that are aligned with evidence-based prac- 2 tices for improving maternal health outcomes for 3 Black women. 4 (g) AUTHORIZATION OF APPROPRIATIONS.—To carry 5 out this section, there is authorized to be appropriated 6 $5,000,000 for each of fiscal years 2021 through 2025. 7 SEC. 3. TRAINING FOR ALL EMPLOYEES IN MATERNITY 8 CARE SETTINGS. 9 Part B of title VII of the Public Health Service Act 10 (42 U.S.C. 293 et seq.) is amended by adding at the end 11 the following new section: 12 ‘‘SEC. 742. TRAINING FOR ALL EMPLOYEES IN MATERNITY 13 CARE SETTINGS. 14 ‘‘(a) GRANTS.—The Secretary shall award grants for 15 programs to reduce and prevent bias, racism, and dis- 16 crimination in maternity care settings. 17 ‘‘(b) SPECIAL CONSIDERATION.—In awarding grants 18 under subsection (a), the Secretary shall give special con- 19 sideration to applications for programs that would— 20 ‘‘(1) apply to all birthing professionals and any 21 employees who interact with pregnant and 22 postpartum women in the provider setting, including 23 front desk employees, sonographers, schedulers, 24 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 8 •HR 6144 IH health care professionals, hospital or health system 1 administrators, and security staff; 2 ‘‘(2) emphasize periodic, as opposed to one- 3 time, trainings for all birthing professionals and em- 4 ployees described in paragraph (1); 5 ‘‘(3) address implicit bias and explicit bias; 6 ‘‘(4) be delivered in ongoing education settings 7 for providers maintaining their licenses, with a pref- 8 erence for trainings that provide continuing edu- 9 cation units and continuing medical education; 10 ‘‘(5) include trauma-informed care best prac- 11 tices and an emphasis on shared decision making be- 12 tween providers and patients; 13 ‘‘(6) include a service-learning component that 14 sends providers to work in underserved communities 15 to better understand patients’ lived experiences; 16 ‘‘(7) be delivered in undergraduate programs 17 that funnel into medical schools, like biology and 18 pre-medicine majors; 19 ‘‘(8) be delivered in settings that apply to pro- 20 viders of the special supplemental nutrition program 21 for women, infants, and children under section 17 of 22 the Child Nutrition Act of 1966; 23 ‘‘(9) integrate bias training in obstetric emer- 24 gency simulation trainings; 25 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 9 •HR 6144 IH ‘‘(10) offer training to all maternity care pro- 1 viders on the value of racially, ethnically, and profes- 2 sionally diverse maternity care teams to provide cul- 3 turally congruent care, including doulas, community 4 health workers, peer supporters, certified lactation 5 consultants, nutritionists and dietitians, social work- 6 ers, home visitors, and navigators; or 7 ‘‘(11) be based on one or more programs de- 8 signed by a historically Black college or university. 9 ‘‘(c) APPLICATION.—To seek a grant under sub- 10 section (a), an entity shall submit an application at such 11 time, in such manner, and containing such information as 12 the Secretary may require. 13 ‘‘(d) REPORTING.—Each recipient of a grant under 14 this section shall annually submit to the Secretary a report 15 on the status of activities conducted using the grant, in- 16 cluding, as applicable, a description of the impact of train- 17 ing provided through the grant on patient outcomes and 18 patient experience for women of color and their families. 19 ‘‘(e) BEST PRACTICES.—Based on the annual reports 20 submitted pursuant to subsection (d), the Secretary— 21 ‘‘(1) shall produce an annual report on the find- 22 ings resulting from programs funded through this 23 section; 24 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 10 •HR 6144 IH ‘‘(2) shall disseminate such report to all recipi- 1 ents of grants under this section and to the public; 2 and 3 ‘‘(3) may include in such report findings on 4 best practices for improving patient outcomes and 5 patient experience for women of color and their fam- 6 ilies in maternity care settings. 7 ‘‘(f) DEFINITIONS.—In this section: 8 ‘‘(1) The term ‘postpartum’ means the one-year 9 period beginning on the last day of a woman’s preg- 10 nancy. 11 ‘‘(2) The term ‘culturally congruent’ means in 12 agreement with the preferred cultural values, beliefs, 13 worldview, and practices of the health care consumer 14 and other stakeholders. 15 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To 16 carry out this section, there is authorized to be appro- 17 priated $5,000,000 for each of fiscal years 2021 through 18 2025.’’. 19 SEC. 4. STUDY ON REDUCING AND PREVENTING BIAS, RAC- 20 ISM, AND DISCRIMINATION IN MATERNITY 21 CARE SETTINGS. 22 (a) IN GENERAL.—The Secretary of Health and 23 Human Services shall seek to enter into an agreement, 24 not later than 90 days after the date of enactment of this 25 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 11 •HR 6144 IH Act, with the National Academies of Sciences, Engineer- 1 ing, and Medicine (referred to in this section as the ‘‘Na- 2 tional Academies’’) under which the National Academies 3 agrees to— 4 (1) conduct a study on the design and imple- 5 mentation of programs to reduce and prevent bias, 6 racism, and discrimination in maternity care set- 7 tings; and 8 (2) not later than 24 months after the date of 9 enactment of this Act, complete the study and trans- 10 mit a report on the results of the study to the Con- 11 gress. 12 (b) POSSIBLE TOPICS.—The agreement entered into 13 pursuant to subsection (a) may provide for the study of 14 any of the following: 15 (1) The development of a scorecard for pro- 16 grams designed to reduce and prevent bias, racism, 17 and discrimination in maternity care settings to as- 18 sess the effectiveness of such programs in improving 19 patient outcomes and patient experience for women 20 of color and their families. 21 (2) Determination of the types of training to re- 22 duce and prevent bias, racism, and discrimination in 23 maternity care settings that are demonstrated to im- 24 VerDate Sep 11 2014 22:36 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H6144.IH H6144 jbell on DSKJLSW7X2PROD with BILLS 12 •HR 6144 IH prove patient outcomes or patient experience for 1 women of color and their families. 2 SEC. 5. RESPECTFUL MATERNITY CARE COMPLIANCE PRO- 3 GRAM. 4 (a) IN GENERAL.—The Secretary of Health and 5 Human Services (referred to in this section as the ‘‘Sec- 6 retary’’) shall award grants to accredited hospitals, health 7 systems, and other maternity care delivery settings to es- 8 tablish within one or more hospitals or other birth settings 9 a respectful maternity care compliance office. 10 (b) OFFICE REQUIREMENTS.—A respectful maternity 11 care compliance office funded through a grant under this 12 section shall— 13 (1) institutionalize mechanisms to allow pa- 14 tients receiving maternity care services, the families 15 of such patients, or doulas or other perinatal work- 16 ers supporting such patients to report instances of 17 disrespect or evidence of bias on the basis of race, 18 ethnicity, or another protected class; 19 (2) institutionalize response mechanisms 20 through which representatives of the office can di- 21 rectly follow up with the patient, if possible, and the 2 [Text truncated for display. Full text available on Congress.gov.]