Perinatal Workforce Act

I 118TH CONGRESS 1ST SESSION H. R. 3523 To grow and diversify the perinatal workforce, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY 18, 2023 Ms. MOORE of Wisconsin (for herself, Ms. UNDERWOOD, Ms. ADAMS, 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 Illinois, 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 Cali- fornia, Mr. LIEU, Ms. LOFGREN, Mrs. MCBATH, Mrs. MCCLELLAN, Ms. MCCOLLUM, Mr. MCGOVERN, Mr. MEEKS, Ms. MENG, Mr. MFUME, Mr. MORELLE, Mr. MOULTON, Mr. MRVAN, Mr. MULLIN, Mrs. NAPOLITANO, Mr. NEGUSE, Ms. OCASIO-CORTEZ, Mr. PAPPAS, Mr. PAYNE, Mr. PHIL- LIPS, Ms. PORTER, Ms. PRESSLEY, Mr. RUPPERSBERGER, Ms. SALINAS, Ms. SCANLON, Mr. SCHIFF, Mr. SCHNEIDER, Ms. SCHOLTEN, Mr. DAVID SCOTT of Georgia, Ms. SEWELL, Mr. SOTO, Ms. SPANBERGER, Ms. STANSBURY, Ms. STRICKLAND, 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 referred to the Committee on Energy and Com- merce VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 3523 IH A BILL To grow and diversify the perinatal workforce, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Perinatal Workforce 4 Act’’. 5 SEC. 2. HHS AGENCY DIRECTIVES. 6 (a) GUIDANCE TO STATES.— 7 (1) IN GENERAL.—Not later than 2 years after 8 the date of enactment of this Act, the Secretary of 9 Health and Human Services shall issue and dissemi- 10 nate guidance to States to educate providers, man- 11 aged care entities, and other insurers about the 12 value and process of delivering respectful maternal 13 health care through diverse and multidisciplinary 14 care provider models. 15 (2) CONTENTS.—The guidance required by 16 paragraph (1) shall address how States can encour- 17 age and incentivize hospitals, health systems, mid- 18 wifery practices, freestanding birth centers, other 19 maternity care provider groups, managed care enti- 20 ties, and other insurers— 21 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 3523 IH (A) to recruit and retain maternity care 1 providers, mental and behavioral health care 2 providers acting in accordance with State law, 3 and registered dietitians or nutrition profes- 4 sionals (as such term is defined in section 5 1861(vv)(2) of the Social Security Act (42 6 U.S.C. 1395x(vv)(2)))— 7 (i) from racially, ethnically, and lin- 8 guistically diverse backgrounds; 9 (ii) with experience practicing in ra- 10 cially and ethnically diverse communities; 11 and 12 (iii) who have undergone training on 13 implicit bias and racism; 14 (B) to incorporate into maternity care 15 teams— 16 (i) midwives who meet, at a minimum, 17 the international definition of a midwife 18 and global standards for midwifery edu- 19 cation as established by the International 20 Confederation of Midwives; 21 (ii) perinatal health workers; 22 (iii) physician assistants; 23 (iv) advanced practice registered 24 nurses; and 25 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 3523 IH (v) lactation consultants certified by 1 the International Board of Lactation Con- 2 sultant Examiners; 3 (C) to provide collaborative, culturally and 4 linguistically congruent care; and 5 (D) to provide opportunities for individuals 6 enrolled in accredited midwifery education pro- 7 grams to participate in job shadowing with ma- 8 ternity care teams in hospitals, health systems, 9 midwifery practices, and freestanding birth cen- 10 ters. 11 (b) STUDY ON RESPECTFUL AND CULTURALLY AND 12 LINGUISTICALLY CONGRUENT MATERNITY CARE.— 13 (1) STUDY.—The Secretary of Health and 14 Human Services acting through the Director of the 15 National Institutes of Health (in this subsection re- 16 ferred to as the ‘‘Secretary’’) shall conduct a study 17 on best practices in respectful and culturally and lin- 18 guistically congruent maternity care. 19 (2) REPORT.—Not later than 2 years after the 20 date of enactment of this Act, the Secretary shall— 21 (A) complete the study required by para- 22 graph (1); 23 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •HR 3523 IH (B) submit to the Congress and make pub- 1 licly available a report on the results of such 2 study; and 3 (C) include in such report— 4 (i) a compendium of examples of hos- 5 pitals, health systems, midwifery practices, 6 freestanding birth centers, other maternity 7 care provider groups, managed care enti- 8 ties, and other insurers that are delivering 9 respectful and culturally and linguistically 10 congruent maternal health care; 11 (ii) a compendium of examples of hos- 12 pitals, health systems, midwifery practices, 13 freestanding birth centers, other maternity 14 care provider groups, managed care enti- 15 ties, and other insurers that have made 16 progress in reducing disparities in mater- 17 nal health outcomes and improving birth- 18 ing experiences for pregnant and 19 postpartum individuals from racial and 20 ethnic minority groups; and 21 (iii) recommendations to hospitals, 22 health systems, midwifery practices, free- 23 standing 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 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •HR 3523 IH ties, and other insurers, for best practices 1 in respectful and culturally and linguis- 2 tically congruent maternity care. 3 SEC. 3. GRANTS TO GROW AND DIVERSIFY THE PERINATAL 4 WORKFORCE. 5 Title VII of the Public Health Service Act is amended 6 by inserting after section 757 (42 U.S.C. 294f) the fol- 7 lowing new section: 8 ‘‘SEC. 758. PERINATAL WORKFORCE GRANTS. 9 ‘‘(a) IN GENERAL.—The Secretary shall award 10 grants to entities to establish or expand programs de- 11 scribed in subsection (b) to grow and diversify the 12 perinatal workforce. 13 ‘‘(b) USE OF FUNDS.—Recipients of grants under 14 this section shall use the grants to grow and diversify the 15 perinatal workforce by— 16 ‘‘(1) establishing accredited schools or pro- 17 grams that provide education and training to indi- 18 viduals seeking appropriate licensing and certifi- 19 cation as— 20 ‘‘(A) physician assistants who will complete 21 clinical training in the field of maternal and 22 perinatal health; 23 ‘‘(B) perinatal health workers; or 24 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •HR 3523 IH ‘‘(C) midwives who meet, at a minimum, 1 the international definition of a midwife and 2 global standards for midwifery education as es- 3 tablished by the International Confederation of 4 Midwives; and 5 ‘‘(2) expanding the capacity of existing accred- 6 ited schools or programs described in paragraph (1), 7 for the purposes of increasing the number of stu- 8 dents enrolled in such accredited schools or pro- 9 grams, such as by awarding scholarships for stu- 10 dents (including students from racially, ethnically, 11 and linguistically diverse backgrounds). 12 ‘‘(c) PRIORITIZATION.—In awarding grants under 13 this section, the Secretary shall give priority to a school 14 or program described in subsection (b) that— 15 ‘‘(1) has demonstrated a commitment to re- 16 cruiting and retaining students and faculty from ra- 17 cial and ethnic minority groups; 18 ‘‘(2) has developed a strategy to recruit and re- 19 tain a diverse pool of students into the school or pro- 20 gram described in subsection (b) that is supported 21 by funds received through the grant, particularly 22 from racial and ethnic minority groups and other 23 underserved populations; 24 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •HR 3523 IH ‘‘(3) has developed a strategy to recruit and re- 1 tain students who plan to practice in a health pro- 2 fessional shortage area designated under section 3 332; 4 ‘‘(4) has developed a strategy to recruit and re- 5 tain students who plan to practice in an area with 6 significant racial and ethnic disparities in maternal 7 health outcomes, to the extent practicable; and 8 ‘‘(5) includes in the standard curriculum for all 9 students within the school or program described in 10 subsection (b) a bias, racism, or discrimination 11 training program that includes training on implicit 12 bias and racism. 13 ‘‘(d) REPORTING.—As a condition on receipt of a 14 grant under this section for a school or program described 15 in subsection (b), an entity shall agree to submit to the 16 Secretary an annual report on the activities conducted 17 through the grant, including— 18 ‘‘(1) the number and demographics of students 19 participating in the school or program; 20 ‘‘(2) the extent to which students in the school 21 or program are entering careers in— 22 ‘‘(A) health professional shortage areas 23 designated under section 332; and 24 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •HR 3523 IH ‘‘(B) areas with elevated rates of maternal 1 mortality, severe maternal morbidity, maternal 2 health disparities, or other adverse perinatal or 3 childbirth outcomes, to the extent such data are 4 available; and 5 ‘‘(3) whether the school or program has in- 6 cluded in the standard curriculum for all students a 7 bias, racism, or discrimination training program that 8 includes explicit and implicit bias, and if so the ef- 9 fectiveness of such training program. 10 ‘‘(e) PERIOD OF GRANTS.—The period of a grant 11 under this section shall be up to 5 years. 12 ‘‘(f) APPLICATION.—To seek a grant under this sec- 13 tion, an entity shall submit to the Secretary an application 14 at such time, in such manner, and containing such infor- 15 mation as the Secretary may require, including any infor- 16 mation necessary for prioritization under subsection (c). 17 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 18 provide, directly or by contract, technical assistance to en- 19 tities seeking or receiving a grant under this section on 20 the development, use, evaluation, and postgrant period 21 sustainability of the school or program described in sub- 22 section (b) that is proposed to be, or is being, established 23 or expanded through the grant. 24 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •HR 3523 IH ‘‘(h) REPORT BY THE SECRETARY.—Not later than 1 4 years after the date of enactment of this section, the 2 Secretary shall prepare and submit to the Congress, and 3 post on the internet website of the Department of Health 4 and Human Services, a report on the effectiveness of the 5 grant program under this section at— 6 ‘‘(1) recruiting students from racial and ethnic 7 minority groups; 8 ‘‘(2) increasing the number of health profes- 9 sionals described in subparagraphs (A), (B), and (C) 10 of subsection (b)(1) from racial and ethnic minority 11 groups and other underserved populations; 12 ‘‘(3) increasing the number of such health pro- 13 fessionals working in health professional shortage 14 areas designated under section 332; and 15 ‘‘(4) increasing the number of such health pro- 16 fessionals working in areas with significant racial 17 and ethnic disparities in maternal health outcomes, 18 to the extent such data are available. 19 ‘‘(i) DEFINITION.—In this section, the term ‘racial 20 and ethnic minority group’ has the meaning given such 21 term in section 1707(g)(1). 22 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—To 23 carry out this section, there is authorized to be appro- 24 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •HR 3523 IH priated $15,000,000 for each of fiscal years 2024 through 1 2028.’’. 2 SEC. 4. GRANTS TO GROW AND DIVERSIFY THE NURSING 3 WORKFORCE IN MATERNAL AND PERINATAL 4 HEALTH. 5 Title VIII of the Public Health Service Act is amend- 6 ed by inserting after section 811 of that Act (42 U.S.C. 7 296j) the following: 8 ‘‘SEC. 812. PERINATAL NURSING WORKFORCE GRANTS. 9 ‘‘(a) IN GENERAL.—The Secretary shall award 10 grants to schools of nursing to grow and diversify the 11 perinatal nursing workforce. 12 ‘‘(b) USE OF FUNDS.—Recipients of grants under 13 this section shall use the grants to grow and diversify the 14 perinatal nursing workforce by providing scholarships to 15 students seeking to become— 16 ‘‘(1) nurse practitioners whose education in- 17 cludes a focus on maternal and perinatal health; 18 ‘‘(2) certified nurse-midwives; or 19 ‘‘(3) clinical nurse specialists whose education 20 includes a focus on maternal and perinatal health. 21 ‘‘(c) PRIORITIZATION.—In awarding grants under 22 this section, the Secretary shall give priority to any school 23 of nursing that— 24 VerDate Sep 11 2014 23:53 Jun 09, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H3523.IH H3523 pbinns on DSKJLVW7X2PROD with $$_JOB 12 •HR 3523 IH ‘‘(1) has developed a strategy to recruit and re- 1 tain a diverse pool of students seeking to enter ca- 2 reers focused on maternal and perinatal health, par- 3 ticularly students from racial and ethnic minority 4 groups and other underserved populations; 5 ‘‘(2) has developed a partnership with a prac- 6 tice setting in a health professional shortage area 7 de [Text truncated for display. 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