Perinatal Workforce Act

II 118TH CONGRESS 1ST SESSION S. 1710 To amend the Public Health Service Act to grow and diversify the perinatal workforce, and for other purposes. IN THE SENATE OF THE UNITED STATES MAY 18, 2023 Ms. BALDWIN (for herself, Mr. MERKLEY, 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 grow and diversify the perinatal workforce, 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 ‘‘Perinatal Workforce 4 Act’’. 5 SEC. 2. HHS AGENCY DIRECTIVES. 6 (a) GUIDANCE TO STATES.— 7 (1) IN GENERAL.—Not later than 2 years after 8 the date of enactment of this Act, the Secretary of 9 Health and Human Services shall issue and dissemi- 10 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •S 1710 IS nate guidance to States to educate providers, man- 1 aged care entities, and other insurers about the 2 value and process of delivering respectful maternal 3 health care through diverse and multidisciplinary 4 care provider models. 5 (2) CONTENTS.—The guidance required by 6 paragraph (1) shall address how States can encour- 7 age and incentivize hospitals, health systems, mid- 8 wifery practices, freestanding birth centers, other 9 maternity care provider groups, managed care enti- 10 ties, and other insurers— 11 (A) to recruit and retain maternity care 12 providers, mental and behavioral health care 13 providers acting in accordance with State law, 14 and registered dietitians or nutrition profes- 15 sionals (as such term is defined in section 16 1861(vv)(2) of the Social Security Act (42 17 U.S.C. 1395x(vv)(2)))— 18 (i) from racially, ethnically, and lin- 19 guistically diverse backgrounds; 20 (ii) with experience practicing in ra- 21 cially and ethnically diverse communities; 22 and 23 (iii) who have undergone training on 24 implicit bias and racism; 25 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •S 1710 IS (B) to incorporate into maternity care 1 teams— 2 (i) midwives who meet, at a minimum, 3 the international definition of a midwife 4 and global standards for midwifery edu- 5 cation as established by the International 6 Confederation of Midwives; 7 (ii) perinatal health workers; 8 (iii) physician assistants; 9 (iv) advanced practice registered 10 nurses; and 11 (v) lactation consultants certified by 12 the International Board of Lactation Con- 13 sultant Examiners; 14 (C) to provide collaborative, culturally and 15 linguistically congruent care; and 16 (D) to provide opportunities for individuals 17 enrolled in accredited midwifery education pro- 18 grams to participate in job shadowing with ma- 19 ternity care teams in hospitals, health systems, 20 midwifery practices, and freestanding birth cen- 21 ters. 22 (b) STUDY ON RESPECTFUL AND CULTURALLY AND 23 LINGUISTICALLY CONGRUENT MATERNITY CARE.— 24 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •S 1710 IS (1) STUDY.—The Secretary of Health and 1 Human Services acting through the Director of the 2 National Institutes of Health (in this subsection re- 3 ferred to as the ‘‘Secretary’’) shall conduct a study 4 on best practices in respectful and culturally and lin- 5 guistically congruent maternity care. 6 (2) REPORT.—Not later than 2 years after the 7 date of enactment of this Act, the Secretary shall— 8 (A) complete the study required by para- 9 graph (1); 10 (B) submit to the Congress and make pub- 11 licly available a report on the results of such 12 study; and 13 (C) include in such report— 14 (i) a compendium of examples of hos- 15 pitals, health systems, midwifery practices, 16 freestanding birth centers, other maternity 17 care provider groups, managed care enti- 18 ties, and other insurers that are delivering 19 respectful and culturally and linguistically 20 congruent maternal health care; 21 (ii) a compendium of examples of hos- 22 pitals, health systems, midwifery practices, 23 freestanding birth centers, other maternity 24 care provider groups, managed care enti- 25 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •S 1710 IS ties, and other insurers that have made 1 progress in reducing disparities in mater- 2 nal health outcomes and improving birth- 3 ing experiences for pregnant and 4 postpartum individuals from racial and 5 ethnic minority groups; and 6 (iii) recommendations to hospitals, 7 health systems, midwifery practices, free- 8 standing birth centers, other maternity 9 care provider groups, managed care enti- 10 ties, and other insurers, for best practices 11 in respectful and culturally and linguis- 12 tically congruent maternity care. 13 SEC. 3. GRANTS TO GROW AND DIVERSIFY THE PERINATAL 14 WORKFORCE. 15 Title VII of the Public Health Service Act is amended 16 by inserting after section 757 (42 U.S.C. 294f) the fol- 17 lowing new section: 18 ‘‘SEC. 758. PERINATAL WORKFORCE GRANTS. 19 ‘‘(a) IN GENERAL.—The Secretary shall award 20 grants to entities to establish or expand programs de- 21 scribed in subsection (b) to grow and diversify the 22 perinatal workforce. 23 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •S 1710 IS ‘‘(b) USE OF FUNDS.—Recipients of grants under 1 this section shall use the grants to grow and diversify the 2 perinatal workforce by— 3 ‘‘(1) establishing accredited schools or pro- 4 grams that provide education and training to indi- 5 viduals seeking appropriate licensing and certifi- 6 cation as— 7 ‘‘(A) physician assistants who will complete 8 clinical training in the field of maternal and 9 perinatal health; 10 ‘‘(B) perinatal health workers; or 11 ‘‘(C) midwives who meet, at a minimum, 12 the international definition of a midwife and 13 global standards for midwifery education as es- 14 tablished by the International Confederation of 15 Midwives; and 16 ‘‘(2) expanding the capacity of existing accred- 17 ited schools or programs described in paragraph (1), 18 for the purposes of increasing the number of stu- 19 dents enrolled in such accredited schools or pro- 20 grams, such as by awarding scholarships for stu- 21 dents (including students from racially, ethnically, 22 and linguistically diverse backgrounds). 23 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •S 1710 IS ‘‘(c) PRIORITIZATION.—In awarding grants under 1 this section, the Secretary shall give priority to a school 2 or program described in subsection (b) that— 3 ‘‘(1) has demonstrated a commitment to re- 4 cruiting and retaining students and faculty from ra- 5 cial and ethnic minority groups; 6 ‘‘(2) has developed a strategy to recruit and re- 7 tain a diverse pool of students into the school or pro- 8 gram described in subsection (b) that is supported 9 by funds received through the grant, particularly 10 from racial and ethnic minority groups and other 11 underserved populations; 12 ‘‘(3) has developed a strategy to recruit and re- 13 tain students who plan to practice in a health pro- 14 fessional shortage area designated under section 15 332; 16 ‘‘(4) has developed a strategy to recruit and re- 17 tain students who plan to practice in an area with 18 significant racial and ethnic disparities in maternal 19 health outcomes, to the extent practicable; and 20 ‘‘(5) includes in the standard curriculum for all 21 students within the school or program described in 22 subsection (b) a bias, racism, or discrimination 23 training program that includes training on implicit 24 bias and racism. 25 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •S 1710 IS ‘‘(d) REPORTING.—As a condition on receipt of a 1 grant under this section for a school or program described 2 in subsection (b), an entity shall agree to submit to the 3 Secretary an annual report on the activities conducted 4 through the grant, including— 5 ‘‘(1) the number and demographics of students 6 participating in the school or program; 7 ‘‘(2) the extent to which students in the school 8 or program are entering careers in— 9 ‘‘(A) health professional shortage areas 10 designated under section 332; and 11 ‘‘(B) areas with elevated rates of maternal 12 mortality, severe maternal morbidity, maternal 13 health disparities, or other adverse perinatal or 14 childbirth outcomes, to the extent such data are 15 available; and 16 ‘‘(3) whether the school or program has in- 17 cluded in the standard curriculum for all students a 18 bias, racism, or discrimination training program that 19 includes explicit and implicit bias, and if so the ef- 20 fectiveness of such training program. 21 ‘‘(e) PERIOD OF GRANTS.—The period of a grant 22 under this section shall be up to 5 years. 23 ‘‘(f) APPLICATION.—To seek a grant under this sec- 24 tion, an entity shall submit to the Secretary an application 25 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •S 1710 IS at such time, in such manner, and containing such infor- 1 mation as the Secretary may require, including any infor- 2 mation necessary for prioritization under subsection (c). 3 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 4 provide, directly or by contract, technical assistance to en- 5 tities seeking or receiving a grant under this section on 6 the development, use, evaluation, and postgrant period 7 sustainability of the school or program described in sub- 8 section (b) that is proposed to be, or is being, established 9 or expanded through the grant. 10 ‘‘(h) REPORT BY THE SECRETARY.—Not later than 11 4 years after the date of enactment of this section, the 12 Secretary shall prepare and submit to the Congress, and 13 post on the internet website of the Department of Health 14 and Human Services, a report on the effectiveness of the 15 grant program under this section at— 16 ‘‘(1) recruiting students from racial and ethnic 17 minority groups; 18 ‘‘(2) increasing the number of health profes- 19 sionals described in subparagraphs (A), (B), and (C) 20 of subsection (b)(1) from racial and ethnic minority 21 groups and other underserved populations; 22 ‘‘(3) increasing the number of such health pro- 23 fessionals working in health professional shortage 24 areas designated under section 332; and 25 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •S 1710 IS ‘‘(4) increasing the number of such health pro- 1 fessionals working in areas with significant racial 2 and ethnic disparities in maternal health outcomes, 3 to the extent such data are available. 4 ‘‘(i) DEFINITION.—In this section, the term ‘racial 5 and ethnic minority group’ has the meaning given such 6 term in section 1707(g)(1). 7 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—To 8 carry out this section, there is authorized to be appro- 9 priated $15,000,000 for each of fiscal years 2024 through 10 2028.’’. 11 SEC. 4. GRANTS TO GROW AND DIVERSIFY THE NURSING 12 WORKFORCE IN MATERNAL AND PERINATAL 13 HEALTH. 14 Title VIII of the Public Health Service Act is amend- 15 ed by inserting after section 811 of that Act (42 U.S.C. 16 296j) the following: 17 ‘‘SEC. 812. PERINATAL NURSING WORKFORCE GRANTS. 18 ‘‘(a) IN GENERAL.—The Secretary shall award 19 grants to schools of nursing to grow and diversify the 20 perinatal nursing workforce. 21 ‘‘(b) USE OF FUNDS.—Recipients of grants under 22 this section shall use the grants to grow and diversify the 23 perinatal nursing workforce by providing scholarships to 24 students seeking to become— 25 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •S 1710 IS ‘‘(1) nurse practitioners whose education in- 1 cludes a focus on maternal and perinatal health; 2 ‘‘(2) certified nurse-midwives; or 3 ‘‘(3) clinical nurse specialists whose education 4 includes a focus on maternal and perinatal health. 5 ‘‘(c) PRIORITIZATION.—In awarding grants under 6 this section, the Secretary shall give priority to any school 7 of nursing that— 8 ‘‘(1) has developed a strategy to recruit and re- 9 tain a diverse pool of students seeking to enter ca- 10 reers focused on maternal and perinatal health, par- 11 ticularly students from racial and ethnic minority 12 groups and other underserved populations; 13 ‘‘(2) has developed a partnership with a prac- 14 tice setting in a health professional shortage area 15 designated under section 332 for the clinical place- 16 ments of the school’s students; 17 ‘‘(3) has developed a strategy to recruit and re- 18 tain students who plan to practice in an area with 19 significant racial and ethnic disparities in maternal 20 health outcomes, to the extent practicable; and 21 ‘‘(4) includes in the standard curriculum for all 22 students seeking to enter careers focused on mater- 23 nal and perinatal health a bias, racism, or discrimi- 24 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1710.IS S1710 pbinns on DSKJLVW7X2PROD with $$_JOB 12 •S 1710 IS nation training program that includes education on 1 implicit bias and racism. 2 ‘‘(d) REPORTING.—As a condition on receipt of a 3 grant under this section, a school of nursing shall agree 4 to submit to the Secretary an annual report on the activi- 5 ties conducted through the grant, including, to the extent 6 practicable— 7 ‘‘(1) the number and demographics of students 8 in the school of nursing seeking to enter careers fo- 9 cused on maternal and perinatal health; 10 ‘‘(2) the extent to which such students are pre- 11 paring to enter careers in— 12 ‘‘(A) health professional shortage areas 13 designated under section 332; and 14 ‘‘(B) areas with elevated rates of maternal 15 mortality, severe maternal morbidity, maternal 16 health disparities, or other adverse perinatal or 17 childbirth outcomes, to the extent such data are 18 available; and 19 ‘‘(3) whether [Text truncated for display. 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