Maternal Health Pandemic Response Act

I 118TH CONGRESS 1ST SESSION H. R. 3304 To authorize appropriations for data collection, surveillance, and research on maternal health outcomes during public health emergencies, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY 15, 2023 Ms. UNDERWOOD (for herself, Mr. AGUILAR, Mr. ALLRED, Ms. BARRAGA´N, Mrs. BEATTY, Mr. BISHOP of Georgia, Mr. BLUMENAUER, Ms. BLUNT ROCHESTER, Ms. BROWNLEY, Ms. BUDZINSKI, Ms. BUSH, Ms. CARAVEO, Mr. CARBAJAL, Mr. CARSON, Mr. CARTER of Louisiana, Mrs. CHERFILUS-MCCORMICK, Ms. CLARKE of New York, Mr. CLEAVER, Mr. COHEN, Ms. CRAIG, Ms. CROCKETT, Mr. DAVIS of Illinois, Ms. DEAN of Pennsylvania, Ms. ESCOBAR, Mr. ESPAILLAT, Mr. EVANS, Mrs. FOUSHEE, Mr. GARAMENDI, Ms. GARCIA of Texas, Mr. GARCI´A of Illi- nois, Mr. GREEN of Texas, Mrs. HAYES, Mr. HORSFORD, Mr. HUFFMAN, Mr. IVEY, Mr. JACKSON of Illinois, Ms. JACKSON LEE, Ms. JACOBS, Ms. JAYAPAL, Mr. JOHNSON of Georgia, Ms. KAMLAGER-DOVE, Mr. KRISHNAMOORTHI, Ms. KUSTER, Ms. LEE of California, Mr. LIEU, Ms. LOFGREN, Mrs. MCBATH, Mrs. MCCLELLAN, Ms. MCCOLLUM, Mr. MCGOVERN, Mr. MEEKS, Ms. MENG, Mr. MFUME, Mr. MORELLE, Mr. MOULTON, Ms. MOORE of Wisconsin, Mr. MRVAN, Mr. MULLIN, Mrs. NAPOLITANO, Mr. NEGUSE, Ms. OCASIO-CORTEZ, Mr. PAPPAS, Mr. PAYNE, Mr. PHILLIPS, Ms. PORTER, Ms. PRESSLEY, Mr. RUPPERS- BERGER, Ms. SALINAS, Ms. SCANLON, Mr. SCHIFF, Mr. SCHNEIDER, Ms. SCHOLTEN, Mr. DAVID SCOTT of Georgia, Ms. SEWELL, Mr. SMITH of Washington, Mr. SOTO, Ms. SPANBERGER, Ms. STANSBURY, Ms. STRICK- LAND, Mrs. SYKES, Mr. TAKANO, Ms. TLAIB, Ms. TOKUDA, Mr. TONKO, Mrs. TORRES of California, Mrs. TRAHAN, Mr. TRONE, Mr. VARGAS, Mr. VEASEY, Ms. VELA´ZQUEZ, Ms. WASSERMAN SCHULTZ, Mrs. WATSON COLEMAN, Ms. WEXTON, Ms. WILLIAMS of Georgia, Mr. PASCRELL, Ms. DELBENE, and Mr. LYNCH) introduced the following bill; which was re- ferred to the Committee on Energy and Commerce VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 3304 IH A BILL To authorize appropriations for data collection, surveillance, and research on maternal health outcomes during public health emergencies, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Maternal Health Pan- 4 demic Response Act’’. 5 SEC. 2. FUNDING FOR DATA COLLECTION, SURVEILLANCE, 6 AND RESEARCH ON MATERNAL HEALTH OUT- 7 COMES DURING PUBLIC HEALTH EMER- 8 GENCIES. 9 To conduct or support data collection, surveillance, 10 and research on maternal health as a result of public 11 health emergencies and infectious diseases that pose a risk 12 to maternal and infant health, including support to assist 13 in the capacity building for State, Tribal, territorial, and 14 local public health departments to collect and transmit ra- 15 cial, ethnic, and other demographic data related to mater- 16 nal health, there are authorized to be appropriated— 17 (1) $100,000,000 for the Surveillance for 18 Emerging Threats to Mothers and Babies program 19 of the Centers for Disease Control and Prevention, 20 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 3304 IH to support the Centers for Disease Control and Pre- 1 vention in its efforts to— 2 (A) work with public health, clinical, and 3 community-based organizations to provide time- 4 ly, continually updated guidance to families and 5 health care providers on ways to reduce risk to 6 pregnant and postpartum individuals and their 7 newborns and tailor interventions to improve 8 their long-term health; 9 (B) partner with more State, Tribal, terri- 10 torial, and local public health programs in the 11 collection and analysis of clinical data on the 12 impact of public health emergencies and infec- 13 tious diseases that pose a risk to maternal and 14 infant health on pregnant and postpartum pa- 15 tients and their newborns, particularly among 16 patients from racial and ethnic minority groups; 17 and 18 (C) establish regionally based centers of 19 excellence to offer medical, public health, and 20 other knowledge to ensure communities can 21 help pregnant and postpartum individuals and 22 newborns get the care and support they need, 23 particularly in areas with large populations of 24 individuals from demographic groups with ele- 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 3304 IH vated rates of maternal mortality, severe mater- 1 nal morbidity, maternal health disparities, or 2 other adverse perinatal or childbirth outcomes; 3 (2) $30,000,000 for the Enhancing Reviews 4 and Surveillance to Eliminate Maternal Mortality 5 program (commonly known as the ‘‘ERASE MM 6 program’’) of the Centers for Disease Control and 7 Prevention, to support the Centers for Disease Con- 8 trol and Prevention in expanding its partnerships 9 with States and Indian Tribes and provide technical 10 assistance to existing Maternal Mortality Review 11 Committees; 12 (3) $45,000,000 for the Pregnancy Risk As- 13 sessment Monitoring System (commonly known as 14 the ‘‘PRAMS’’) of the Centers for Disease Control 15 and Prevention, to support the Centers for Disease 16 Control and Prevention in its efforts to— 17 (A) create a supplement to its PRAMS 18 survey related to public health emergencies and 19 infectious diseases that pose a risk to maternal 20 and infant health; 21 (B) add questions around experiences of 22 respectful maternity care in prenatal, 23 intrapartum, and postpartum care; and 24 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •HR 3304 IH (C) work to transition such PRAMS survey 1 to an electronic platform and expand such 2 PRAMS survey to a larger population, with a 3 special focus on reaching underrepresented 4 communities, and other program improvements; 5 and 6 (4) $15,000,000 for the National Institute of 7 Child Health and Human Development, to conduct 8 or support research for interventions to mitigate the 9 effects of public health emergencies and infectious 10 diseases that pose a risk to maternal and infant 11 health, with a particular focus on individuals from 12 demographic groups with elevated rates of maternal 13 mortality, severe maternal morbidity, maternal 14 health disparities, or other adverse perinatal or 15 childbirth outcomes. 16 SEC. 3. PUBLIC HEALTH EMERGENCY MATERNAL HEALTH 17 DATA COLLECTION AND DISCLOSURE. 18 (a) AVAILABILITY OF COLLECTED DATA.—The Sec- 19 retary, acting through the Director of the Centers for Dis- 20 ease Control and Prevention and the Administrator of the 21 Centers for Medicare & Medicaid Services, shall make pub- 22 licly available on the website of the Centers for Disease 23 Control and Prevention data described in subsection (b). 24 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •HR 3304 IH (b) DATA DESCRIBED.—The data described in this 1 subsection are data collected through Federal surveillance 2 systems under the Centers for Disease Control and Pre- 3 vention with respect to public health emergencies and indi- 4 viduals who are pregnant or in a postpartum period. Such 5 data shall include the following: 6 (1) Diagnostic testing, confirmed cases, hos- 7 pitalizations, deaths, and other health outcomes re- 8 lated to an infectious disease outbreak among preg- 9 nant and postpartum individuals. 10 (2) Maternal and infant health outcomes among 11 individuals who test positive for an infectious disease 12 during or after pregnancy. 13 (c) AMERICAN INDIAN AND ALASKA NATIVE HEALTH 14 OUTCOMES.—In carrying out subsection (a), the Secretary 15 shall consult with Indian Tribes and confer with Urban 16 Indian organizations. 17 (d) DISAGGREGATED INFORMATION.—In carrying 18 out subsection (a), the Secretary shall disaggregate data 19 by race, ethnicity, gender, primary language, geography, 20 socioeconomic status, and other relevant factors. 21 (e) UPDATE.—During public health emergencies, the 22 Secretary shall update the data made available under this 23 section— 24 (1) at least on a monthly basis; and 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •HR 3304 IH (2) not less than one month after the end of 1 such public health emergency. 2 (f) PRIVACY.—In carrying out subsection (a), the 3 Secretary shall take steps to protect the privacy of individ- 4 uals pursuant to regulations promulgated under section 5 264(c) of the Health Insurance Portability and Account- 6 ability Act of 1996 (42 U.S.C. 1320d–2 note). 7 (g) GUIDANCE.— 8 (1) IN GENERAL.—Not later than 30 days after 9 the declaration of a public health emergency under 10 section 319 of the Public Health Service Act (42 11 U.S.C. 247d), the Secretary shall issue guidance to 12 States and local public health departments to ensure 13 that— 14 (A) laboratories that test specimens for an 15 infectious disease receive all relevant demo- 16 graphic data on race, ethnicity, pregnancy sta- 17 tus, and other demographic data as determined 18 by the Secretary; and 19 (B) data described in subsection (b) are 20 disaggregated by race, ethnicity, gender, pri- 21 mary language, geography, socioeconomic sta- 22 tus, and other relevant factors. 23 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •HR 3304 IH (2) CONSULTATION.—In carrying out para- 1 graph (1), the Secretary shall consult with Indian 2 Tribes— 3 (A) to ensure that such guidance includes 4 tribally developed best practices; and 5 (B) to reduce misclassification of American 6 Indians and Alaska Natives. 7 SEC. 4. PUBLIC HEALTH COMMUNICATION REGARDING MA- 8 TERNAL CARE DURING PUBLIC HEALTH 9 EMERGENCIES. 10 The Director of the Centers for Disease Control and 11 Prevention shall conduct public health education cam- 12 paigns during public health emergencies to ensure that 13 pregnant and postpartum individuals, their employers, 14 and their health care providers have accurate, evidence- 15 based information on maternal and infant health risks 16 during the public health emergency, with a particular 17 focus on reaching pregnant and postpartum individuals in 18 underserved communities. 19 SEC. 5. TASK FORCE ON BIRTHING EXPERIENCE AND SAFE, 20 RESPECTFUL, RESPONSIVE, AND EMPOW- 21 ERING MATERNITY CARE DURING PUBLIC 22 HEALTH EMERGENCIES. 23 (a) ESTABLISHMENT.—The Secretary, in consulta- 24 tion with the Director of the Centers for Disease Control 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •HR 3304 IH and Prevention and the Administrator of the Health Re- 1 sources and Services Administration, shall convene a task 2 force (in this subsection referred to as the ‘‘Task Force’’) 3 to develop Federal recommendations regarding respectful, 4 responsive, and empowering maternity care, including safe 5 birth care and postpartum care, during public health 6 emergencies. 7 (b) DUTIES.—The Task Force shall develop, publicly 8 post, and update Federal recommendations in multiple 9 languages to ensure high-quality, nondiscriminatory ma- 10 ternity care, promote positive birthing experiences, and 11 improve maternal health outcomes during public health 12 emergencies, with a particular focus on outcomes for indi- 13 viduals from demographic groups with elevated rates of 14 maternal mortality, severe maternal morbidity, maternal 15 health disparities, or other adverse perinatal or childbirth 16 outcomes. Such recommendations shall— 17 (1) address, with particular attention to ensur- 18 ing equitable treatment on the basis of race and eth- 19 nicity— 20 (A) measures to facilitate respectful, re- 21 sponsive, and empowering maternity care; 22 (B) measures to facilitate telehealth mater- 23 nity care for pregnant people who cannot regu- 24 larly access in-person care; 25 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •HR 3304 IH (C) strategies to increase access to special- 1 ized care for those with high-risk pregnancies 2 or pregnant individuals with elevated risk fac- 3 tors; 4 (D) diagnostic testing for pregnant and la- 5 boring patients; 6 (E) birthing without one’s chosen compan- 7 ions, with one’s chosen companions, and with 8 smartphone or other telehealth connection to 9 one’s chosen companions; 10 (F) newborn separation after birth in rela- 11 tion to maternal infection status; 12 (G) breast milk feeding in relation to ma- 13 ternal infection status; 14 (H) licensure, training, scope of practice, 15 and Medicaid and other insurance reimburse- 16 ment for certified midwives, certified nurse-mid- 17 wives, and certified professional midwives, in a 18 manner that facilitates inclusion of midwives of 19 color and midwives from underserved commu- 20 nities; 21 (I) financial support and training for 22 perinatal health workers who provide nonclinical 23 support to people from pregnancy through the 24 VerDate Sep 11 2014 20:30 May 25, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3304.IH H3304 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •HR 3304 IH postpartum period in a manner that facilitates 1 inclusion from underserved communities; 2 (J) strategies to ensure and expand doula 3 coverage under State Medicaid programs; 4 (K) how to identify, address, and treat 5 prenatal and postpartum mental and behavioral 6 health conditions, such as anxiety, substance 7 use disorder, and depression, during public 8 health emergencies; 9 (L) how to identify and address instances 10 of intimate partner violence during pregnancy 11 which may arise or intensify during public 12 health emergencies; 13 (M) strategies to address hospital capacity 14 concerns in communities with a surge in infec- 15 tious disease cases and to provide childbearing 16 people with options that reduce the potential for 17 cross-contamination and increase the ability to 18 implement their care preferences while main- 19 taining safety and quality, such as the use of 20 auxiliary maternity units and freestanding birth 21 centers; 22 (N) provision of child care services during 2 [Text truncated for display. 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