Data to Save Moms Act

II 118TH CONGRESS 1ST SESSION S. 1599 To amend the Public Health Service Act to provide for grants to promote representative community engagement in maternal mortality review com- mittees, and for other purposes. IN THE SENATE OF THE UNITED STATES MAY 15, 2023 Ms. SMITH (for herself and Mr. BOOKER) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Public Health Service Act to provide for grants to promote representative community engagement in maternal mortality review committees, 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’’. 5 SEC. 2. DEFINITIONS. 6 In this Act: 7 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •S 1599 IS (1) MATERNITY CARE PROVIDER.—The term 1 ‘‘maternity care provider’’ means a health care pro- 2 vider who— 3 (A) is a physician, a physician assistant, a 4 midwife who meets, at a minimum, the inter- 5 national definition of a midwife and global 6 standards for midwifery education as estab- 7 lished by the International Confederation of 8 Midwives, an advanced practice registered 9 nurse, or a lactation consultant certified by the 10 International Board of Lactation Consultant 11 Examiners; and 12 (B) has a focus on maternal or perinatal 13 health. 14 (2) MATERNAL MORTALITY.—The term ‘‘mater- 15 nal mortality’’ means a death occurring during or 16 within a 1-year period after pregnancy, caused by 17 pregnancy-related or childbirth complications, in- 18 cluding a suicide, overdose, or other death resulting 19 from a mental health or substance use disorder at- 20 tributed to or aggravated by pregnancy-related or 21 childbirth complications. 22 (3) PERINATAL HEALTH WORKER.—The term 23 ‘‘perinatal health worker’’ means a nonclinical health 24 worker focused on maternal or perinatal health, such 25 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •S 1599 IS as a doula, community health worker, peer sup- 1 porter, lactation educator or counselor, nutritionist 2 or dietitian, childbirth educator, social worker, home 3 visitor, patient navigator or coordinator, or language 4 interpreter. 5 (4) POSTPARTUM.—The term ‘‘postpartum’’ 6 means the 1-year period beginning on the last day 7 of the pregnancy of an individual. 8 (5) PREGNANCY-ASSOCIATED DEATH.—The 9 term ‘‘pregnancy-associated death’’ means a death of 10 a pregnant or postpartum individual, by any cause, 11 that occurs during, or within 1 year following, the 12 individual’s pregnancy, regardless of the outcome, 13 duration, or site of the pregnancy. 14 (6) PREGNANCY-RELATED DEATH.—The term 15 ‘‘pregnancy-related death’’ means a death of a preg- 16 nant or postpartum individual that occurs during, or 17 within 1 year following, the individual’s pregnancy, 18 from a pregnancy complication, a chain of events 19 initiated by pregnancy, or the aggravation of an un- 20 related condition by the physiologic effects of preg- 21 nancy. 22 (7) RACIAL AND ETHNIC MINORITY GROUP.— 23 The term ‘‘racial and ethnic minority group’’ has the 24 meaning given such term in section 1707(g)(1) of 25 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •S 1599 IS the Public Health Service Act (42 U.S.C. 300u– 1 6(g)(1)). 2 (8) SECRETARY.—The term ‘‘Secretary’’ means 3 the Secretary of Health and Human Services. 4 (9) SEVERE MATERNAL MORBIDITY.—The term 5 ‘‘severe maternal morbidity’’ means a health condi- 6 tion, including mental health conditions and sub- 7 stance use disorders, attributed to or aggravated by 8 pregnancy or childbirth that results in significant 9 short-term or long-term consequences to the health 10 of the individual who was pregnant. 11 (10) SOCIAL DETERMINANTS OF MATERNAL 12 HEALTH.—The term ‘‘social determinants of mater- 13 nal health’’ means nonclinical factors that impact 14 maternal health outcomes. 15 SEC. 3. FUNDING FOR MATERNAL MORTALITY REVIEW 16 COMMITTEES TO PROMOTE REPRESENTA- 17 TIVE COMMUNITY ENGAGEMENT. 18 (a) IN GENERAL.—Section 317K(d) of the Public 19 Health Service Act (42 U.S.C. 247b–12(d)) is amended 20 by adding at the end the following: 21 ‘‘(9) GRANTS TO PROMOTE REPRESENTATIVE 22 COMMUNITY ENGAGEMENT IN MATERNAL MOR- 23 TALITY REVIEW COMMITTEES.— 24 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •S 1599 IS ‘‘(A) IN GENERAL.—The Secretary may, 1 using funds made available pursuant to sub- 2 paragraph (C), provide assistance to an applica- 3 ble maternal mortality review committee of a 4 State, Indian tribe, tribal organization, or 5 Urban Indian organization (as such term is de- 6 fined in section 4 of the Indian Health Care 7 Improvement Act)— 8 ‘‘(i) to select for inclusion in the mem- 9 bership of such a committee community 10 members from the State, Indian tribe, trib- 11 al organization, or Urban Indian organiza- 12 tion by— 13 ‘‘(I) prioritizing community mem- 14 bers who can increase the diversity of 15 the committee’s membership with re- 16 spect to race and ethnicity, location, 17 personal or family experiences of ma- 18 ternal mortality or severe maternal 19 morbidity, and professional back- 20 ground, including members with non- 21 clinical experiences; and 22 ‘‘(II) to the extent applicable, 23 using funds reserved under subsection 24 (f), to address barriers to maternal 25 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •S 1599 IS mortality review committee participa- 1 tion for community members, includ- 2 ing required training, transportation 3 barriers, compensation, and other sup- 4 ports as may be necessary; 5 ‘‘(ii) to establish initiatives to conduct 6 outreach and community engagement ef- 7 forts within communities throughout the 8 State or Indian tribe to seek input from 9 community members on the work of such 10 maternal mortality review committee, with 11 a particular focus on outreach to women 12 from racial and ethnic minority groups (as 13 such term is defined in section 14 1707(g)(1)); and 15 ‘‘(iii) to release public reports assess- 16 ing— 17 ‘‘(I) the pregnancy-related death 18 and pregnancy-associated death review 19 processes of the maternal mortality 20 review committee, with a particular 21 focus on the maternal mortality re- 22 view committee’s sensitivity to the 23 unique circumstances of pregnant and 24 postpartum individuals from racial 25 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •S 1599 IS and ethnic minority groups (as such 1 term is defined in section 1707(g)(1)) 2 who have suffered pregnancy-related 3 deaths; and 4 ‘‘(II) the impact of the use of 5 funds made available pursuant to sub- 6 paragraph (C) on increasing the diver- 7 sity of the maternal mortality review 8 committee membership and promoting 9 community engagement efforts 10 throughout the State or Indian tribe. 11 ‘‘(B) TECHNICAL ASSISTANCE.—The Sec- 12 retary shall provide (either directly through the 13 Department of Health and Human Services or 14 by contract) technical assistance to any mater- 15 nal mortality review committee receiving a 16 grant under this paragraph on best practices 17 for increasing the diversity of the maternal 18 mortality review committee’s membership and 19 for conducting effective community engagement 20 throughout the State or Indian tribe. 21 ‘‘(C) AUTHORIZATION OF APPROPRIA- 22 TIONS.—In addition to any funds made avail- 23 able under subsection (f), there is authorized to 24 be appropriated to carry out this paragraph 25 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •S 1599 IS $10,000,000 for each of fiscal years 2024 1 through 2028.’’. 2 (b) RESERVATION OF FUNDS.—Section 317K(f) of 3 the Public Health Service Act (42 U.S.C. 247b–12(f)) is 4 amended by adding at the end the following: ‘‘Of the 5 amount made available under the preceding sentence for 6 a fiscal year, not less than $1,500,000 shall be reserved 7 for grants to Indian tribes, tribal organizations, or Urban 8 Indian organizations (as such term is defined in section 9 4 of the Indian Health Care Improvement Act)’’. 10 SEC. 4. DATA COLLECTION AND REVIEW. 11 Section 317K(d)(3)(A)(i) of the Public Health Serv- 12 ice Act (42 U.S.C. 247b–12(d)(3)(A)(i)) is amended— 13 (1) by redesignating subclauses (II) and (III) 14 as subclauses (V) and (VI), respectively; and 15 (2) by inserting after subclause (I) the fol- 16 lowing: 17 ‘‘(II) to the extent practicable, 18 reviewing cases of severe maternal 19 morbidity, according to the most up- 20 to-date indicators; 21 ‘‘(III) to the extent practicable, 22 reviewing deaths during pregnancy or 23 up to 1 year after the end of a preg- 24 nancy from suicide, overdose, or other 25 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •S 1599 IS death from a mental health condition 1 or substance use disorder attributed 2 to or aggravated by pregnancy or 3 childbirth complications; 4 ‘‘(IV) to the extent practicable, 5 consulting with local community-based 6 organizations representing pregnant 7 and postpartum individuals from de- 8 mographic groups with elevated rates 9 of maternal mortality, severe maternal 10 morbidity, maternal health disparities, 11 or other adverse perinatal or child- 12 birth outcomes to ensure that, in ad- 13 dition to clinical factors, nonclinical 14 factors that might have contributed to 15 a pregnancy-related death are appro- 16 priately considered;’’. 17 SEC. 5. REVIEW OF MATERNAL HEALTH DATA COLLECTION 18 PROCESSES AND QUALITY MEASURES. 19 (a) IN GENERAL.—The Secretary, acting through the 20 Administrator of the Centers for Medicare & Medicaid 21 Services and the Director of the Agency for Healthcare 22 Research and Quality (referred to in this section as the 23 ‘‘Secretary’’), shall consult with relevant stakeholders— 24 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •S 1599 IS (1) to review existing maternal health data col- 1 lection processes and quality measures; and 2 (2) to make recommendations to improve such 3 processes and measures, including topics described 4 under subsection (c). 5 (b) COLLABORATION.—In carrying out this section, 6 the Secretary shall consult with a diverse group of mater- 7 nal health stakeholders, which may include— 8 (1) pregnant and postpartum individuals and 9 their family members, and nonprofit organizations 10 representing such individuals, with a particular focus 11 on patients from racial and ethnic minority groups; 12 (2) community-based organizations that provide 13 support for pregnant and postpartum individuals, 14 with a particular focus on patients from demo- 15 graphic groups with elevated rates of maternal mor- 16 tality, severe maternal morbidity, maternal health 17 disparities, or other adverse perinatal or childbirth 18 outcomes; 19 (3) membership organizations for maternity 20 care providers; 21 (4) organizations representing perinatal health 22 workers; 23 (5) organizations that focus on maternal mental 24 or behavioral health; 25 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •S 1599 IS (6) organizations that focus on intimate partner 1 violence; 2 (7) institutions of higher education, with a par- 3 ticular focus on minority-serving institutions; 4 (8) licensed and accredited hospitals, birth cen- 5 ters, midwifery practices, or other facilities that pro- 6 vide maternal health care services; 7 (9) relevant State and local public agencies, in- 8 cluding State maternal mortality review committees; 9 and 10 (10) the National Quality Forum, or such other 11 standard-setting organizations specified by the Sec- 12 retary. 13 (c) TOPICS.—The review of maternal health data col- 14 lection processes and recommendations to improve such 15 processes and measures required under subsection (a) 16 shall assess all available relevant information, including 17 information from State-level sources, and shall consider at 18 least the following: 19 (1) Current State and Tribal practices for ma- 20 ternal health, maternal mortality, and severe mater- 21 nal morbidity data collection and dissemination, in- 22 cluding consideration of— 23 (A) the timeliness of processes for amend- 24 ing a death certificate when new information 25 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 12 •S 1599 IS pertaining to the death becomes available to re- 1 flect whether the death was a pregnancy-related 2 death; 3 (B) relevant data collected with electronic 4 health records, including data on race, eth- 5 nicity, primary language, socioeconomic status, 6 geography, insurance type, and other relevant 7 demographic information; 8 (C) maternal health data collected and 9 publicly reported by hospitals, health systems, 10 midwifery practices, and birth centers; 11 (D) the barriers preventing States from 12 correlating maternal outcome data with data on 13 race, ethnicity, and other demographic charac- 14 teristics; 15 (E) processes for determining the cause of 16 a pregnancy-associated death in States that do 17 not have a maternal mortality review com- 18 mittee; 19 (F) whether maternal mortality review 20 committees include multidisciplinary and di- 21 verse membership (as described in section 22 317K(d)(1)(A) of the Public Health Service Act 23 (42 U.S.C. 247b–12(d)(1)(A))); 24 VerDate Sep 11 2014 22:20 May 25, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1599.IS S1599 pbinns on DSKJLVW7X2PROD with $$_JOB 13 •S 1599 IS (G) whether members of maternal mor- 1 tality review committees participate in trainings 2 on bias, racism, or discrimination, and the qual- 3 ity of such trainings; 4 (H) the [Text truncated for display. 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