Maternal Health Pandemic Response Act

II 118TH CONGRESS 1ST SESSION S. 1605 To authorize appropriations for data collection, surveillance, and research on maternal health outcomes during public health emergencies, and for other purposes. IN THE SENATE OF THE UNITED STATES MAY 15, 2023 Ms. WARREN (for herself, Mr. BOOKER, and Mrs. GILLIBRAND) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To authorize appropriations for data collection, surveillance, and research on maternal health outcomes during public health emergencies, 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 ‘‘Maternal Health Pan- 4 demic Response Act’’. 5 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •S 1605 IS SEC. 2. FUNDING FOR DATA COLLECTION, SURVEILLANCE, 1 AND RESEARCH ON MATERNAL HEALTH OUT- 2 COMES DURING PUBLIC HEALTH EMER- 3 GENCIES. 4 To conduct or support data collection, surveillance, 5 and research on maternal health as a result of public 6 health emergencies and infectious diseases that pose a risk 7 to maternal and infant health, including support to assist 8 in the capacity building for State, Tribal, territorial, and 9 local public health departments to collect and transmit ra- 10 cial, ethnic, and other demographic data related to mater- 11 nal health, there are authorized to be appropriated— 12 (1) $100,000,000 for the Surveillance for 13 Emerging Threats to Mothers and Babies program 14 of the Centers for Disease Control and Prevention, 15 to support the Centers for Disease Control and Pre- 16 vention in its efforts to— 17 (A) work with public health, clinical, and 18 community-based organizations to provide time- 19 ly, continually updated guidance to families and 20 health care providers on ways to reduce risk to 21 pregnant and postpartum individuals and their 22 newborns and tailor interventions to improve 23 their long-term health; 24 (B) partner with more State, Tribal, terri- 25 torial, and local public health programs in the 26 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •S 1605 IS collection and analysis of clinical data on the 1 impact of public health emergencies and infec- 2 tious diseases that pose a risk to maternal and 3 infant health on pregnant and postpartum pa- 4 tients and their newborns, particularly among 5 patients from racial and ethnic minority groups; 6 and 7 (C) establish regionally based centers of 8 excellence to offer medical, public health, and 9 other knowledge to ensure communities can 10 help pregnant and postpartum individuals and 11 newborns get the care and support they need, 12 particularly in areas with large populations of 13 individuals from demographic groups with ele- 14 vated rates of maternal mortality, severe mater- 15 nal morbidity, maternal health disparities, or 16 other adverse perinatal or childbirth outcomes; 17 (2) $30,000,000 for the Enhancing Reviews 18 and Surveillance to Eliminate Maternal Mortality 19 program (commonly known as the ‘‘ERASE MM 20 program’’) of the Centers for Disease Control and 21 Prevention, to support the Centers for Disease Con- 22 trol and Prevention in expanding its partnerships 23 with States and Indian Tribes and provide technical 24 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •S 1605 IS assistance to existing Maternal Mortality Review 1 Committees; 2 (3) $45,000,000 for the Pregnancy Risk As- 3 sessment Monitoring System (commonly known as 4 the ‘‘PRAMS’’) of the Centers for Disease Control 5 and Prevention, to support the Centers for Disease 6 Control and Prevention in its efforts to— 7 (A) create a supplement to its PRAMS 8 survey related to public health emergencies and 9 infectious diseases that pose a risk to maternal 10 and infant health; 11 (B) add questions around experiences of 12 respectful maternity care in prenatal, 13 intrapartum, and postpartum care; and 14 (C) work to transition such PRAMS survey 15 to an electronic platform and expand such 16 PRAMS survey to a larger population, with a 17 special focus on reaching underrepresented 18 communities, and other program improvements; 19 and 20 (4) $15,000,000 for the National Institute of 21 Child Health and Human Development, to conduct 22 or support research for interventions to mitigate the 23 effects of public health emergencies and infectious 24 diseases that pose a risk to maternal and infant 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •S 1605 IS health, with a particular focus on individuals from 1 demographic groups with elevated rates of maternal 2 mortality, severe maternal morbidity, maternal 3 health disparities, or other adverse perinatal or 4 childbirth outcomes. 5 SEC. 3. PUBLIC HEALTH EMERGENCY MATERNAL HEALTH 6 DATA COLLECTION AND DISCLOSURE. 7 (a) AVAILABILITY OF COLLECTED DATA.—The Sec- 8 retary, acting through the Director of the Centers for Dis- 9 ease Control and Prevention and the Administrator of the 10 Centers for Medicare & Medicaid Services, shall make pub- 11 licly available on the website of the Centers for Disease 12 Control and Prevention data described in subsection (b). 13 (b) DATA DESCRIBED.—The data described in this 14 subsection are data collected through Federal surveillance 15 systems under the Centers for Disease Control and Pre- 16 vention with respect to public health emergencies and indi- 17 viduals who are pregnant or in a postpartum period. Such 18 data shall include the following: 19 (1) Diagnostic testing, confirmed cases, hos- 20 pitalizations, deaths, and other health outcomes re- 21 lated to an infectious disease outbreak among preg- 22 nant and postpartum individuals. 23 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •S 1605 IS (2) Maternal and infant health outcomes among 1 individuals who test positive for an infectious disease 2 during or after pregnancy. 3 (c) AMERICAN INDIAN AND ALASKA NATIVE HEALTH 4 OUTCOMES.—In carrying out subsection (a), the Secretary 5 shall consult with Indian Tribes and confer with Urban 6 Indian organizations. 7 (d) DISAGGREGATED INFORMATION.—In carrying 8 out subsection (a), the Secretary shall disaggregate data 9 by race, ethnicity, gender, primary language, geography, 10 socioeconomic status, and other relevant factors. 11 (e) UPDATE.—During public health emergencies, the 12 Secretary shall update the data made available under this 13 section— 14 (1) at least on a monthly basis; and 15 (2) not less than one month after the end of 16 such public health emergency. 17 (f) PRIVACY.—In carrying out subsection (a), the 18 Secretary shall take steps to protect the privacy of individ- 19 uals pursuant to regulations promulgated under section 20 264(c) of the Health Insurance Portability and Account- 21 ability Act of 1996 (42 U.S.C. 1320d–2 note). 22 (g) GUIDANCE.— 23 (1) IN GENERAL.—Not later than 30 days after 24 the declaration of a public health emergency, the 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •S 1605 IS Secretary shall issue guidance to States and local 1 public health departments to ensure that— 2 (A) laboratories that test specimens for an 3 infectious disease receive all relevant demo- 4 graphic data on race, ethnicity, pregnancy sta- 5 tus, and other demographic data as determined 6 by the Secretary; and 7 (B) data described in subsection (b) are 8 disaggregated by race, ethnicity, gender, pri- 9 mary language, geography, socioeconomic sta- 10 tus, and other relevant factors. 11 (2) CONSULTATION.—In carrying out para- 12 graph (1), the Secretary shall consult with Indian 13 Tribes— 14 (A) to ensure that such guidance includes 15 tribally developed best practices; and 16 (B) to reduce misclassification of American 17 Indians and Alaska Natives. 18 SEC. 4. PUBLIC HEALTH COMMUNICATION REGARDING MA- 19 TERNAL CARE DURING PUBLIC HEALTH 20 EMERGENCIES. 21 The Director of the Centers for Disease Control and 22 Prevention shall conduct public health education cam- 23 paigns during public health emergencies to ensure that 24 pregnant and postpartum individuals, their employers, 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •S 1605 IS and their health care providers have accurate, evidence- 1 based information on maternal and infant health risks 2 during the public health emergency, with a particular 3 focus on reaching pregnant and postpartum individuals in 4 underserved communities. 5 SEC. 5. TASK FORCE ON BIRTHING EXPERIENCE AND SAFE, 6 RESPECTFUL, RESPONSIVE, AND EMPOW- 7 ERING MATERNITY CARE DURING PUBLIC 8 HEALTH EMERGENCIES. 9 (a) ESTABLISHMENT.—The Secretary, in consulta- 10 tion with the Director of the Centers for Disease Control 11 and Prevention and the Administrator of the Health Re- 12 sources and Services Administration, shall convene a task 13 force (in this section referred to as the ‘‘Task Force’’) to 14 develop Federal recommendations regarding respectful, re- 15 sponsive, and empowering maternity care, including safe 16 birth care and postpartum care, during public health 17 emergencies. 18 (b) DUTIES.—The Task Force shall develop, publicly 19 post, and update Federal recommendations in multiple 20 languages to ensure high-quality, nondiscriminatory ma- 21 ternity care, promote positive birthing experiences, and 22 improve maternal health outcomes during public health 23 emergencies, with a particular focus on outcomes for indi- 24 viduals from demographic groups with elevated rates of 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •S 1605 IS maternal mortality, severe maternal morbidity, maternal 1 health disparities, or other adverse perinatal or childbirth 2 outcomes. Such recommendations shall— 3 (1) address, with particular attention to ensur- 4 ing equitable treatment on the basis of race and eth- 5 nicity— 6 (A) measures to facilitate respectful, re- 7 sponsive, and empowering maternity care; 8 (B) measures to facilitate telehealth mater- 9 nity care for pregnant people who cannot regu- 10 larly access in-person care; 11 (C) strategies to increase access to special- 12 ized care for those with high-risk pregnancies 13 or pregnant individuals with elevated risk fac- 14 tors; 15 (D) diagnostic testing for pregnant and la- 16 boring patients; 17 (E) birthing without one’s chosen compan- 18 ions, with one’s chosen companions, and with 19 smartphone or other telehealth connection to 20 one’s chosen companions; 21 (F) newborn separation after birth in rela- 22 tion to maternal infection status; 23 (G) breast milk feeding in relation to ma- 24 ternal infection status; 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •S 1605 IS (H) licensure, training, scope of practice, 1 and Medicaid and other insurance reimburse- 2 ment for certified midwives, certified nurse-mid- 3 wives, and certified professional midwives, in a 4 manner that facilitates inclusion of midwives of 5 color and midwives from underserved commu- 6 nities; 7 (I) financial support and training for 8 perinatal health workers who provide nonclinical 9 support to people from pregnancy through the 10 postpartum period in a manner that facilitates 11 inclusion from underserved communities; 12 (J) strategies to ensure and expand doula 13 coverage under State Medicaid programs; 14 (K) how to identify, address, and treat 15 prenatal and postpartum mental and behavioral 16 health conditions, such as anxiety, substance 17 use disorder, and depression, during public 18 health emergencies; 19 (L) how to identify and address instances 20 of intimate partner violence during pregnancy 21 which may arise or intensify during public 22 health emergencies; 23 (M) strategies to address hospital capacity 24 concerns in communities with a surge in infec- 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •S 1605 IS tious disease cases and to provide childbearing 1 people with options that reduce the potential for 2 cross-contamination and increase the ability to 3 implement their care preferences while main- 4 taining safety and quality, such as the use of 5 auxiliary maternity units and freestanding birth 6 centers; 7 (N) provision of child care services during 8 prenatal and postpartum appointments for 9 mothers whose children are unable to attend as 10 a result of restrictions relating to the public 11 health emergencies; 12 (O) how to identify and address racism, 13 bias, and discrimination in the delivery of ma- 14 ternity care services to pregnant and 15 postpartum people, including evaluating the 16 value of training for hospital staff on implicit 17 bias and racism, respectful, responsive, and em- 18 powering maternity care, and demographic data 19 collection; 20 (P) how to address the needs of undocu- 21 mented pregnant individuals and new mothers 22 who may be afraid or unable to seek needed 23 care during the public health emergency; 24 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1605.IS S1605 pbinns on DSKJLVW7X2PROD with $$_JOB 12 •S 1605 IS (Q) how to address the needs of uninsured 1 pregnant individuals who have historically relied 2 on emergency departments for care; 3 (R) how to identify pregnant and 4 postpartum individuals at risk for depression, 5 anxiety disorder, psychosis, obsessive-compul- 6 sive disorder, and other maternal mood dis- 7 orders before, during, and after pregnancy, and 8 how to treat those diagnosed with a postpartum 9 mood disorder; 10 (S) how to effectively and compassionately 11 screen for substance use disorder during preg- 12 nancy and postpartum and help pregnant and 13 postpartum individuals find support and effec- 14 tive treatment; 15 (T) [Text truncated for display. Full text available on Congress.gov.]