Data to Save Moms Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 6165 To amend the Public Health Service Act to improve data collection with respect to maternal mortality and severe maternal morbidity, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 10, 2020 Ms. DAVIDS of Kansas (for herself, Ms. UNDERWOOD, Ms. ADAMS, Mr. CLAY, Ms. SCANLON, Ms. NORTON, Ms. SEWELL of Alabama, Mr. KHANNA, Ms. MOORE, Mr. LAWSON of Florida, Ms. PRESSLEY, and Ms. HAALAND) in- troduced the following bill; which was referred to the Committee on En- ergy and Commerce, and in addition to the Committee on Natural Re- sources, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdic- tion of the committee concerned A BILL To amend the Public Health Service Act to improve data collection with respect to maternal mortality and severe maternal morbidity, 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 ‘‘Data to Save Moms 4 Act of 2020’’. 5 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 6165 IH SEC. 2. FUNDING FOR MATERNAL MORTALITY REVIEW 1 COMMITTEES TO PROMOTE REPRESENTA- 2 TIVE COMMUNITY ENGAGEMENT. 3 (a) IN GENERAL.—Section 317K(d) of the Public 4 Health Service Act (42 U.S.C. 247b–12(d)) is amended 5 by adding at the end the following: 6 ‘‘(9) GRANTS TO PROMOTE REPRESENTATIVE 7 COMMUNITY ENGAGEMENT IN MATERNAL MOR- 8 TALITY REVIEW COMMITTEES.— 9 ‘‘(A) IN GENERAL.—The Secretary may, 10 using funds made available pursuant to sub- 11 paragraph (C), provide assistance to an applica- 12 ble maternal mortality review committee of a 13 State, Indian tribe, tribal organization, or 14 urban Indian organization (as such term is de- 15 fined in section 4 of the Indian Health Care 16 Improvement Act (25 U.S.C. 1603))— 17 ‘‘(i) to select for inclusion in the mem- 18 bership of such a committee community 19 members from the State, Indian tribe, trib- 20 al organization, or urban Indian organiza- 21 tion by— 22 ‘‘(I) prioritizing community mem- 23 bers who can increase the diversity of 24 the committee’s membership with re- 25 spect to race and ethnicity, location, 26 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 6165 IH and professional background, includ- 1 ing members with non-clinical experi- 2 ences; and 3 ‘‘(II) to the extent applicable, 4 using funds reserved under subsection 5 (f) to address barriers to maternal 6 mortality review committee participa- 7 tion for community members, includ- 8 ing required training, transportation 9 barriers, compensation, and other sup- 10 ports as may be necessary; 11 ‘‘(ii) to establish initiatives to conduct 12 outreach and community engagement ef- 13 forts within communities throughout the 14 State or Tribe to seek input from commu- 15 nity members on the work of such mater- 16 nal mortality review committee, with a par- 17 ticular focus on outreach to minority 18 women; and 19 ‘‘(iii) to release public reports assess- 20 ing— 21 ‘‘(I) the pregnancy-related death 22 and pregnancy-associated death review 23 processes of the maternal mortality 24 review committee, with a particular 25 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 6165 IH focus on the maternal mortality re- 1 view committee’s sensitivity to the 2 unique circumstances of minority 3 women who have suffered pregnancy- 4 related deaths; and 5 ‘‘(II) the impact of the use of 6 funds made available pursuant to 7 paragraph (C) on increasing the diver- 8 sity of the maternal mortality review 9 committee membership and promoting 10 community engagement efforts 11 throughout the State or Tribe. 12 ‘‘(B) TECHNICAL ASSISTANCE.—The Sec- 13 retary shall provide (either directly through the 14 Department of Health and Human Services or 15 by contract) technical assistance to any mater- 16 nal mortality review committee receiving a 17 grant under this paragraph on best practices 18 for increasing the diversity of the maternal 19 mortality review committee’s membership and 20 for conducting effective community engagement 21 throughout the State or Tribe. 22 ‘‘(C) AUTHORIZATION OF APPROPRIA- 23 TIONS.—In addition to any funds made avail- 24 able under subsection (f), there are authorized 25 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 6165 IH to be appropriated to carry out this paragraph 1 $10,000,000 for each of fiscal years 2021 2 through 2025.’’. 3 (b) RESERVATION OF FUNDS.—Section 317K(f) of 4 the Public Health Service Act (42 U.S.C. 247b–12(f)) is 5 amended by adding at the end the following: ‘‘Of the 6 amount made available under the preceding sentence for 7 a fiscal year, not less than $1,500,000 shall be reserved 8 for grants to Indian tribes, tribal organizations, or urban 9 Indian organizations (as such term is defined in section 10 4 of the Indian Health Care Improvement Act (25 U.S.C. 11 1603))’’. 12 SEC. 3. DATA COLLECTION AND REVIEW. 13 (a) IN GENERAL.—Section 317K(d)(3)(A)(i) of the 14 Public Health Service Act (42 U.S.C. 247b– 15 12(d)(3)(A)(i)) is amended— 16 (1) by redesignating subclauses (II) and (III) 17 as subclauses (V) and (VI), respectively; and 18 (2) by inserting after subclause (I) the fol- 19 lowing: 20 ‘‘(II) to the extent practicable, 21 reviewing cases of severe maternal 22 morbidity in which the patient re- 23 ceived a transfusion of four or more 24 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 6165 IH units of blood and was admitted to an 1 intensive care unit; 2 ‘‘(III) to the extent practicable, 3 consulting with local community-based 4 organizations representing women 5 from demographic groups dispropor- 6 tionately impacted by poor maternal 7 health outcomes to ensure that, in ad- 8 dition to clinical factors, non-clinical 9 factors that might have contributed to 10 a pregnancy-related death are appro- 11 priately considered;’’. 12 (b) SEVERE MATERNAL MORBIDITY DEFINED.—Sec- 13 tion 317K(e) of the Public Health Service Act (42 U.S.C. 14 247b–12(e)) is amended— 15 (1) in paragraph (2), by striking ‘‘and’’ at the 16 end; 17 (2) in paragraph (3), by striking the period at 18 the end and inserting ‘‘; and’’; and 19 (3) by adding at the end the following: 20 ‘‘(4) the term ‘severe maternal morbidity’ 21 means one or more unexpected outcomes of labor 22 and delivery that result in significant short-term or 23 long-term consequences to a woman’s health.’’. 24 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 6165 IH SEC. 4. TASK FORCE ON MATERNAL HEALTH DATA AND 1 QUALITY MEASURES. 2 (a) ESTABLISHMENT.—Not later than 180 days after 3 the date of enactment of this Act, the Secretary of Health 4 and Human Services shall establish a task force to be 5 known as the ‘‘Task Force on Maternal Health Data and 6 Quality Measures’’ (in this section referred to as the 7 ‘‘Task Force’’). 8 (b) DUTIES OF TASK FORCE.— 9 (1) IN GENERAL.—The Task Force shall use all 10 available relevant information, including information 11 from State-level sources, to prepare and submit a re- 12 port containing the following: 13 (A) An evaluation of current State and 14 Tribal practices for maternal health, maternal 15 mortality, and severe maternal morbidity data 16 collection and dissemination, including consider- 17 ation of— 18 (i) the timeliness of processes for 19 amending a death certificate when new in- 20 formation pertaining to the death becomes 21 available to reflect whether the death was 22 a pregnancy-related death; 23 (ii) maternal health data collected 24 with electronic health records, including 25 data on race and ethnicity; 26 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 6165 IH (iii) the barriers preventing States 1 from correlating maternal outcome data 2 with race and ethnicity data; 3 (iv) processes for determining the 4 cause of a pregnancy-associated death in 5 States that do not have a maternal mor- 6 tality review committee; 7 (v) whether maternal mortality review 8 committees include multidisciplinary and 9 diverse membership (as described in sec- 10 tion 317K(d)(1)(A) of the Public Health 11 Service Act (42 U.S.C. 247b–12(d)(1)(A)); 12 (vi) whether members of maternal 13 mortality review committees participate in 14 trainings on bias, racism, or discrimina- 15 tion, and the quality of such trainings; 16 (vii) the extent to which States have 17 implemented systematic processes of listen- 18 ing to the stories of pregnant and postpar- 19 tum women and their family members, 20 with a particular focus on minority women 21 and their family members, to fully under- 22 stand the causes of, and inform potential 23 solutions to, the maternal mortality and se- 24 VerDate Sep 11 2014 01:54 Mar 21, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 6165 IH vere maternal morbidity crisis within their 1 respective States; 2 (viii) the consideration of social deter- 3 minants of health by maternal mortality 4 review committees when examining the 5 causes of pregnancy-associated and preg- 6 nancy-related deaths; 7 (ix) the legal barriers preventing the 8 collation of State maternity care data; 9 (x) the effectiveness of data collection 10 and reporting processes in separating preg- 11 nancy-associated deaths from pregnancy- 12 related deaths; and 13 (xi) the current Federal, State, local, 14 and Tribal funding support for the activi- 15 ties referred to in clauses (i) through (x). 16 (B) An assessment of whether the funding 17 referred to in subparagraph (A)(xi) is adequate 18 for States to carry out optimal data collection 19 and dissemination processes with respect to ma- 20 ternal health, maternal mortality, and severe 21 maternal morbidity. 22 (C) An evaluation of current quality meas- 23 ures for maternity care, including prenatal 24 measures, labor and delivery measures, and 25 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 6165 IH postpartum measures up to one year postpar- 1 tum. Such evaluation shall be conducted in con- 2 sultation with the National Quality Forum and 3 shall include consideration of— 4 (i) effective quality measures for ma- 5 ternity care used by hospitals, health sys- 6 tems, birth centers, health plans, and other 7 relevant entities; 8 (ii) the sufficiency of current outcome 9 measures used to evaluate maternity care 10 for testing and validating new maternal 11 health care payment and service delivery 12 models; 13 (iii) quality measures for the child- 14 birth experiences of women that other 15 countries effectively use; 16 (iv) current maternity care quality 17 measures that may be eliminated because 18 they are not achieving their intended ef- 19 fect; 20 (v) barriers preventing maternity care 21 providers from implementing quality meas- 22 ures that are aligned from best practices; 23 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 6165 IH (vi) the frequency with which mater- 1 nity care quality measures are reviewed 2 and revised; 3 (vii) the strengths and weaknesses of 4 the Prenatal and Postpartum Care meas- 5 ures of the Health Plan Employer Data 6 and Information Set measures established 7 by the National Committee for Quality As- 8 surance; 9 (viii) the strengths and weaknesses of 10 maternity care quality measures under the 11 Medicaid program under title XIX of the 12 Social Security Act (42 U.S.C. 1396 et 13 seq.) and the Children’s Health Insurance 14 Program under title XXI of such Act (42 15 U.S.C. 1397 et seq.), including the extent 16 to which States voluntarily report relevant 17 measures; 18 (ix) the extent to which maternity 19 care quality measures are informed by pa- 20 tient experiences that include subjective 21 measures of patient-reported experience of 22 care; 23 (x) the current processes for collecting 24 stratified data on the race and ethnicity of 25 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 6165 IH pregnant and postpartum women in hos- 1 pitals, health systems, and birth centers, 2 and for incorporating such racially and 3 ethnically stratified data in maternity care 4 quality measures; 5 (xi) the extent to which maternity 6 care quality measures account for the 7 unique experiences of minority women and 8 their families; and 9 (xii) the extent to which hospitals, 10 health systems, and birth centers are im- 11 plementing existing maternity care quality 12 measures. 13 (D) Recommendations on authorizing addi- 14 tional funds to improve maternal mortality re- 15 view committees and relevant maternal health 16 initiatives by the agencies and organizations 17 within the Department of Health and Human 18 Services. 19 (E) Recommendations for new authorities 20 that may be granted to maternal mortality re- 21 view committees to be able to— 22 (i) access records from other Federal 23 and State agencies and departments that 24 may be necessary to identify causes of 25 VerDate Sep 11 2014 02:03 Mar 17, 2020 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H6165.IH H6165 kjohnson on DSK79L0C42PROD with BILLS 13 •HR 6165 IH pregnancy-associated deaths that are 1 unique to women from specific populations, 2 such as women veterans and women who 3 are incarcerated; and 4 (ii) work with relevant experts who 5 are not members of the maternal mortality 6 review committee to assist in the review of 7 pregnancy-associated deaths of women 8 from specific populations, such as women 9 veterans and women who are incarcerated. 10 (F) Recommendations to improve current 11 quality measures for maternity care, including 12 recommendations on updating the Pregnancy & 13 D [Text truncated for display. 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